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The Glut of Doctors in Mid-Nineteenth-Century France

Published online by Cambridge University Press:  03 June 2009

George D. Sussman
George D. Sussman
Affiliation:
Vanderbilt University
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Extract

The history of the professions in the West since the French Revolution is a success story, a triumph, but not always an easy one. From the beginning of the nineteenth century in continental Europe the professions had a great attraction as careers presumably open to talent, but the demand for professional services developed more slowly than interest in professional careers and more slowly than the schools that supplied the market. Lenore O'Boyle has drawn attention to this discrepancy and the revolutionary potential of the frustrated careerists produced by it.

Type
Theory and Practice of Medicine
Information
Comparative Studies in Society and History , Volume 19 , Issue 3 , July 1977 , pp. 287 - 304
Copyright
Copyright © Society for the Comparative Study of Society and History 1977

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References

This article was presented as a paper delivered to the Second Annual Conference of the Western Society for French History, San Francisco, November 23, 1974. I would like to express my gratitude to the National Endowment for the Humanities, to Vanderbilt University and to Vanderbilt University Research Council for financial support in the research and preparation of this paper.

1 O'Boyle, Lenore, “The Middle Class in Western Europe, 1815–1848,” American Historical Review, LXXI (04. 1966), 826–45,CrossRefGoogle Scholar and “The Problem of an Excess of Educated Men in Western Europe, 1800–1850,” Journal of Modern History, XLII (12. 1970), 471–95.Google Scholar

2 For the text of the Law of 19 Ventose, , see Gazette nationale ou le Moniteur universel, 8 Ventôse an XI, pp. 645éGoogle Scholaronard estimates that in 1833 it cost a family 12,000 francs to educate ason as a medical doctor and 2,000 francs as a health officer: Léonard, Jacques, “Les etudes medicales en France entre 1815 et 1848,” Revue d'histoire moderne et contemporaine, XIII (01.-Mar. 1966), 87.CrossRefGoogle Scholar

4 Unsigned article, “De la condition actuelle du médecin en France,” Gazette medicate de Paris, I (01. 9, 1830), 9–13.Google Scholar

5 See, for example, the character of Dr. Poulain, a young Parisian physician without patients, in Balzac's Cousin Pons (1848), or the career of Dr. Véron, who held several respected positions in the hospitals of Paris after receiving his M. D. from the Faculty in 1823, but abandoned medicine in favor of journalism because he was unable to convert his initial success into a private practice in the capital: Veron, L., Mémoires d'un bourgeois de Paris, I (Paris: 1853), pp. 2–11.Google Scholar

6 Léonard, , “Les études médicales en France,” pp. 92–95Google Scholar, and also Jacques Léonard, “L'exemple d'une categorie socio-professionnelle au XIXe siécle: les médecins francais, “in Ordres et classes, Colloque d'histoire sociale, Saint-Cloud, 24–25 mai 1967 (Paris-The Hague: Mouton, 1973), p. 229.Google Scholar

7 Remarks of Place, Charles, Actes du Congrès médical de France, Session de 1845, Section de médecine (Paris: 1846), p. 291.Google Scholar

8 Thus, any specific discussion of fees and salaries was carefully avoided at the Con gress because, “This matter interests only us; the others are questions of humanity as much as questions of science and of the profession:” Actes du Congrès médical, p.251 and elsewhere.Google Scholar

9 For the bill presented to the Chamber of Peers by Salvandy, see Moniteur universel, Feb. 18, 1847, pp. 323–25, and for the discussion of the bill in the Chamber of Peers, see subsequent issues of the Moniteur and the two articles by Jacques Léonard cited above.

10 “The Revolution of 1848 saw maximum political participation by physicians,” Ackerknecht, Erwin H., Medicine at the Paris Hospital, 1794–1848 (Baltimore: The Johns Hopkins University Press, 1967), pp. 185–86.Google Scholar See also Zeldin, Theodore, France, 1848–1945, I, Ambition, Love and Politics (Oxford: The Clarendon Press, 1973), p. 23;CrossRefGoogle ScholarDrAstruc, Pierre, “1848 et la médecine,” Le Progrès médical, no. 12 (06 24,1946), 269–82Google Scholar, and no. 13 (July 10,1946), 297–302; Léonard, , “Les etudes medicates en France,” p. 94.Google Scholar

11 For one example, see Archives Nationales (hereafter AN), F17 4469, Procès-verbal des séances tenues à Nîlmes, dans une des salles de la mairie, par les médecins du d´epartement du Gard, à I'effet d'adhérer au Congrès médical ouvert à Paris le 1er novembre 1845 (Montpellier: Imprimerie de Ricard frères, n.d.), p. 7.Google Scholar

12 AN, F17 4468, dossier 3, Commission pour I'organisation de l'enseignement et de I'exercice de la médecine et de la pharmacie, remarks by the Minister at meeting of May 24, 1838.

13 AN, F17 1468, Salvandy, Minister of Public Instruction, circular to the prefects, Nov. 26, 1845; F17 4537, responses from the prefects.

14 AN, F17 4537, responses by various prefects to the Minister's circular of Nov. 26, 1845.

15 AN, F17 4469, DrLeviez, (Directeur de l'École secondaire de MéDecine d'Arras), Réflexions sur le projet de loi concernant l'instruction et l'exercice de la médecine en France, adressées a M. le Ministre de l'Instruction publique … approuvées par le Conseil des professeurs le 14 decembre 1839 (Arras: Imprimerie d'Aug. Tierny, 1840), p. 10.Google Scholar

16 Actesdu Congrés médical, pp. 107–19, 123–31.Google Scholar

17 Léonard, , “L'exemple d'unecategorie socio-professionnelle,” pp. 230–32;Google ScholarHuard, P., “L'officiat de santé (1794–1892),” Concours medical, LXXXIII, no. 22 (1961), 3231–39.Google Scholar

18 Actes du Congres medical, p. 129.Google Scholar

19 Ibid., pp. 170–87, 192–96.

20 AN, F17 4468, dossier 3, remarks by the Minister at the meeting of July 20, 1838.

21 Title VI of the bill in the Moniteur, Feb. 18, 1847, p. 325, and Léonard, , “L'exemple d'une categorie socio-professionnelle,” pp. 229–30.Google Scholar

22 Dr. Küntzli, an avowed admirer of Fourier, wrote, “There is only one thing to do for medicine, that is to socialize it [c'est de la socialiser], to make it a public, sacerdotal function, for all the words in the world will not make the poor … able to pay the physician, nor the rich … willing to pay him.” Küntzli, État de la médecine, position des médecins, garanties sanitaires du peuple en France, et plan d'organisation médicale (Paris: 1846), pp. xiiGoogle Scholar, 28. See also the remarks of Sanson, Actes du Congrès médical, p. 32, and AN, F17 4469, a pamphlet by a military doctor, Peyre, B. L., Considérations et réglement concernant la santé publique et l'exercice de la médecine (Paris: Librairie des Sciences medicates de Just-Rouvier, and Lille: Vanackere fits, 1833).Google Scholar

23 Actesdu Congrès médical, pp. 119–23Google Scholar,131–34,312, and Léonard, , “L'exemple d'une catégorie socio-professionnelle,“ p. 226x.Google Scholar

24 Articles 26–27, Moniteur, Feb. 18, 1847, p. 324.

25 AN, F17 1468, prefects” responses to the circular of Nov. 26,1845, and F17 4537–4539, responses to the circular of July 8, 1847. Responses to the first circular, concerning medical practitioners in communes with fewer than 2,000 inhabitants, were complete for 50 departments and partial for 10 more. Responses to the second circular, concerning the number of practitioners by arrondissement and chef-lieu, were complete for all of France but the tiny Arrondissement of Castellane (Basses- Alpes), which I simply neglected, and the Department of the Seine, for which I supplied figures from Domange-Hubert, , Al manack général de médecine pour la villedeParis, 1847(Paris: Victor Masson, 1847), pp. 352, 365, 400–7.Google Scholar

26 Population figures are mostly those of the 1846 census, as reported in Pouthas, Charles H., La population française pendant la première moitié du XlXe siècle, Institut national d'études démographiques, Travaux et Documents, Cahier no. 25 (Paris: Presses Universitaires de France, 1956), pp. 40–45Google Scholar, 98. For the population of communes with fewer than 2,000 inhabitants and of the chefs-lieux, I used the figures of the 1851 census, as reported in Statistique de la France, 2e série, II, Territoire et population (Paris: Imprimerie imperiale, 1855), tables 22, 23, 42 bis.Google Scholar

27 United Nations, Statistical Yearbook, 1973 (New York: 1974), pp. 719–22.Google Scholar

28 Kandell, Jonathan, “Bar to Medical Students is Debated in Argentina,” New York Times, 02. 3, 1973.Google Scholar

29 Pouthas, , La population francaise pendant la première moitié du XIXe siècle, pp. 38–66.Google Scholar

30 This possibility was suggested in a work by a doctor and medical editor, Lucas-Championnière, , Statistique du personnel médical en France et dans quelques autres contrées de l' Europe, avec une carte figurative du nombre de médecins comparé à la population (Paris: au Bureau du Journal de MÉDecine et de Chirurgie pratiques, 1845), p. 36. Using figures from a different source, Lucas-Championnière arrived at statistical results similar to mine.Google Scholar

31 Of course, not all licensed practitioners were necessarily practicing medicine. Some had undoubtedly retired because of old age or to enter another career, while others may never have intended to practice medicine but acquired a degree for purely cultural or intellectual reasons—a costly indulgence. If a high proportion of doctors was not practicing by choice, then the appearance of medical overcrowding in some areas may be a false one. I wonder, in particular, whether this was the case in the Midi, with its long tradition of medical culture. The medicine taught at the Faculty of Montpellier was reputed to be theoretical and bookish by comparison with the practical medicine taught in the hospitals of Paris.

32 Coury, Charles, “The Teaching of Medicine in France from the Beginning of the Seventeenth Century,” in The History of Medical Education, edited by O'Malley, C. D. (Berkeley: University of California Press, 1970), pp. 121–72.Google Scholar

33 AN, F17 1468, prefects'responses to the circular of Nov. 26, 1845. One problem with these figures, especially those from 1835, is to decide how to count medical titles from the Ancien Régime. My practice was to count practitioners listed simply as “chirurgiens” with the health officers and those listed as “maîtres en chirurgie,” as well as the post- Revolutionary “docteurs en chirurgie,” with the medical doctors.

34 Léonard, , “Les études médicales en France,” p. 87.Google Scholar

35 AN, F17 4537–4539, prefects' responses to circular of July 8, 1847.

36 Huard, , “L'officiat de sante,” pp. 3232, 3234.Google Scholar

37 Ibid.

38 AN, F17 2364–2367, registers of M.D.s granted by the three medical faculties of the University.

39 AN, F17 4469, letter from Orflla to the Minister of Public Instruction, Paris, Oct. 27, 1839.