Morbid Appearances: The Anatomy of Pathology in the Early Nineteenth Century

286 Pages·2002·8.76 MB·English

by  Russell Charles Maulitz

Cambridge History of Medicine
EDITORS: CHARLES WEBSTER AND
CHARLES ROSENBERG
Morbid Appearances
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Morbid Appearances
THE ANATOMY OF PATHOLOGY
IN THE EARLY NINETEENTH CENTURY
Russell C. Maulitz
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© Cambridge University Press 1987
This book is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without
the written permission of Cambridge University Press.
First published 1987
First paperback edition 2002
A catalogue record for this book is available from the British Library
Library of Congress Cataloguing in Publication data
Maulitz, Russell Charles, 1944-
Morbid appearances.
(Cambridge history of medicine).
Includes index.
1. Anatomy, Pathological - France - History - 19th
century. 2. Anatomy, Pathological - Great Britain -
History - 19th century. I. Title. II. Series.
[DNLM: 1. Pathology - history - France. 2. Pathology -
history - Great Britain. QZ 11 GF7 M44m]
RB25.M36 1987 616.07/09034 86-34347
ISBN 0 52132828 4 hardback
ISBN 0 52152453 9 paperback
A portion of Chapter 6 is based on an article entitled "Channel crossing: the
lure of French pathology for English medical students, 1816-36," pp. 475^96
in Bulletin of the History of Medicine, vol 55 (1981)
Contents
Preface vil
Introduction: Ouverture: Bichat's head i
PART ONE: PARIS
1 Genesis of a tradition 9
2 Pathology and the Paris faculty 36
3 Pathology in the middle 60
4 The center holds 83
PART TWO: CHANNEL CROSSING
5 The context of English pathology, 1800-1830 109
6 Channel crossing 134
PART THREE: LONDON
7 After Waterloo: Medical journalism and the
surgeon-apothecaries 161
8 Pathology and the specialist: The London Academy of
Minute Anatomy 175
9 Propagation 198
Conclusion: A language of morbid appearances 224
Appendix: Transcription and translation of Figure 1.1 230
Notes 233
Selected bibliography 265
Index 274
To Joy Eva Fellheimer and Herbert Russell Maulitz
Preface
To begin, a word of explanation and several words of thanks.
I cannot remember reading a book with an exposition based on
selection principles quite like those I ended up using in this work.
While the central account of the monograph is of persons who
will be well known in at least bare outline to most readers, I have
moved off (especially in the second half of the monograph,) into
territory that is considerably more arcane. Why, after sketching
the evolution of pathological anatomy in its fullest development
in France, should one allow the story to veer off on paths that
seem to fall short of the traditional "important" feat of progress?
The answer, as the reader might expect, lies in my reasons for
writing the book in the first place. I have not intended to provide
a symmetrical comparison of French and British pathology in the
era before the microscope, but sought rather to look at the re-
ception of a suite of medical ideas in one culture after examining
how they unfolded in another. My intention was to study the
development of pathological anatomy and, in particular, tissue
pathology in France and then scrutinize various attempts to implant
it in England.
Readers familiar with my work will know that I have studied
German pathology in the nineteenth century, and that I am aware
of the contributions of important figures from Johannes Meckel
to Julius Cohnheim. Those developments, however, are not part
of the story, for one very simple reason: the Anglo-French medical
relationship was a special one. It was a connection not dissimilar,
in intent if not in scale or precise content, to the links forged in
the final quarter of the century between Germany and the United
States, or between Germany and Japan.
It is connections (not merely analogy, contrast, and comparision,);
and innovation (not isolated individual creation,), therefore, that
viii: Preface
most deserve close historical attention, even at the expense of cer-
tain omissions. I have said next to nothing, for example, about
Meckel in Germany, about Richard Bright in England, or about
Franqois Broussais in France. I have chosen this tack in part for
the intrinsic interest of the approach itself. I have done so as well
because of the inherent interest of the figures and episodes that I
do cover, and for what my account of them says about the forces
that move medical ideas and techniques across national boundaries.
I see it now. Authors accumulate a considerable store of intellectual
debt when they attempt to treat a historical subject systematically
and at some length. I think they accumulate a lot more debts in
developing a sustained work than in tripping about ten essays of
one-tenth the length. In any event, that is what happened to me,
and I therefore owe a debt of gratitude to a sizeable number of
individuals in France, Britain, and the United States. Many of
them I am unable to thank by name. I hope they will understand.
I first make mention of the public and private agencies who,
through the provision of research leave and summer support, made
the investigation possible. Between 1^72 and 1982 I was the re-
cipient of grants from the Josiah Macy, Jr., Foundation; the Na-
tional Institutes of Health; the Wellcome Trust; the Faculty Re-
search Fund of the University of Pennsylvania; and the American
Philosophical Society. The support of each proved invaluable and
I gratefully acknowledge it here.
I also acknowledge the help I received from the staffs of the
libraries and archives of the following institutions: in France, the
Medical Faculties of Paris and Nantes; the Archives Nationales
and Assistance Publique in Paris; the College de France and the
Paris Academy of Medicine. In Britain I was graciously assisted
by the librarians at the Royal Colleges of Physicians and Surgeons
of both London and Edinburgh, as well as the University of Edin-
burgh, the University of London (University College,), and Guys
Hospital Medical School. In London, year in and year out, I re-
ceived unflagging attention and support, most particularly, from
the Wellcome Institute for the History of Medicine. I would be
remiss if I were to fail to single out William Bynum and Chris-
topher Lawrence in the academic unit, and Robin Price and Eric
Freeman in the library, for special thanks.
Preface
IX
In the United States I thank the librarians at the National Library
of Medicine; early on, the^Duke University Medical Center (es-
pecially G. S. T. and Susan Cavanaghj; and most recently the
College of Physicians of Philadelphia; all ^provided tireless aid. The
former Curator of Historical Collections, Christine Ruggere, at
the last named institution, was the source of sustained wisdom
and assistance over several years.
A number of people provided intellectual support. At Duke,
Gert Brieger, with insuperable patience, oversaw the writing of
a dissertation that was the distant ancestor of the present work.
Seymour Mauskopf read that version as well and watched it evolve
in the dozen years since. The late Joseph Schiller discovered me
muttering and thrashing in the belly of the Paris Faculty one day
in 1972, and gradually thereafter assumed the important role of a
continent-side mentor. He is missed. In Boston, Edward and
Amalie Kass aided in my understanding of Thomas Hodgkin. At
a crucial moment, George Weisz of Montreal directed my attention
to an all-important, newly opened archive in Paris. Also in Paris,
Mirko D. Grmek was of great and gracious assistance. And in
Philadelphia, critically, Rosemary Stevens, Charles Rosenberg, and
Steven Peitzman all read and materially helped improve the man-
uscript. So, too, did an anonymous reader for Cambridge Uni-
versity Press.
Finally I acknowledge the assistance and support of those who
furnished that other key ingredient, survivability. In bits and
pieces, Sandra Paschale typed all of the manuscript at least once
over the years. Dr. Bonnie Blustein supplied invaluable research
assistance on Chapter 8. Donna Evleth provided imaginative re-
search assistance in the preparation of virtually all those parts of
Parts I and II requiring what the French call depouillement. And
finally, Kristine Billmyer patiently awaited the end. To all of them,
my heartfelt gratitude.