Medical Consulting by Letter in France 1665-1789

Résumé du livre

[Truncated abstract] In 1994, historian of eighteenth-century French medicine Laurence Brockliss posed the question as to whether consulting by letter was a widespread practice in pre-revolutionary France. This thesis sets out to analyse some 2500 letters between patients, members of their families and their local medical advisers written to expert physicians and surgeons and the responses of these experts. Primary source material has been collected from many libraries and archival deposits, large and small, across France in manuscript and printed formats. Whilst scholars have drawn on epistolary consultations for various purposes, this thesis through its large source base seeks to examine the genre in depth to give a broader picture of medical practice on a day-by-day basis than has been previously explored. The thesis investigates the relationships between the various parties as expressed in their correspondence and how these are linked to perceived and actual authorities. It examines the manner in which patients saw their bodies in health and in sickness. It compares the physicians' views of these matters to the changing medical theories of the period and whether or not they migrated into the therapeutic advice proffered. Historical studies of epistolary consulting in countries from England, Spain, Switzerland and Italy have been concerned with the output of physicians. A unique feature of this thesis is that it draws also on consultations written by surgeons a hitherto overlooked aspect of this form of providing medical advice. The thesis opens with an introduction to the topic of medical consulting by letter and its historiography. Its analysis is then divided into two parts. In the first half, chapters 1 to 4 examine a series of contexts: textual, professional and social. Firstly the nature and authorship of the sources is detailed; an examination is then made of the hierarchy of medical practice in earlymodern France, and how the relationships between practitioners and patients are represented in the correspondence including the question of the costs of providing medical advice by letter which is compared with other formats. The thesis then turns to the question of the basis on which claims of authority were made by the various participants in the correspondence. In the second half, chapters 5-7, the thesis considers how the body, health and illness were perceived by practitioners and patients. The theories used to justify the medicine practised are examined, to contextualise the therapies which were proposed to deal with the various ailments that were addressed by letter. A regime of therapy was the consultant's final step. Whether or not his proposals were adopted or efficacious are matters that are examined. The specific disorders venereal disease, hypochondria and epilepsy have been analysed in some detail to illustrate the issues raised in chapters 3, 6 and 7 respectively. ... That surgeons challenged the monopoly claims of physicians in the period is well known, this thesis has been innovative in bringing to the fore the practice of surgeons consulting by letter, an aspect of French medical history hitherto overlooked. Analysis of the letter format provides insight into how claimed authorities were in fact fragile and the issue of authority, and its corollary power, imbues every aspect of this thesis. The pendulum of power swung between patients and practitioners according to the patients' desperation for relief on one side and their social and economic weight on the other.