Companion to Medicine in the Twentieth Century

Roger Cooter, John Pickstone

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781136794711
• Edition: 1
• Topic: History
• Subtopic: World History
• Index: History

During the twentieth century, medicine has been radically transformed and powerfully transformative. In 1900, western medicine was important to philanthropy and public health, but it was marginal to the state, the industrial economy and the welfare of most individuals. It is now central to these aspects of life. Our prospects seem increasingly depe

CHAPTER 13

The Historiographical Body

MARK S.R. JENNER AND BERTRAND O. TAITHE

In the last fifteen years ‘the history of the body’ has become fashionable to the point of ubiquity. Recent studies include titles as various as Body Politics, Body Criticism, Body Work, The Body Emblazoned, The Body Social, and The Body and Samuel Johnson. This chapter will not and cannot summarize all this diverse literature; rather, it provides a critical review of some of the cultural and intellectual developments which have made the body an important subject for historical inquiry and a central analytical category within research.

Despite its importance as a topic for research, the physical body remains largely absent from the mainstream of historical representation. Professional historians are deeply suspicious of modes of representation based upon bodily practices such as those followed by reenactment societies and sponsored by institutions such English Heritage or the Museum of Colonial Life at Williamsburg in the United States. Even though such pedagogic techniques are commonplace and greatly valued in primary and secondary education, wielding a sixteenth-century scalpel, or dressing up as Louis Pasteur, is unlikely to enhance your academic reputation within most university departments, no matter how well it might go down with students. Unlike historians of music interested in performance, historians of medicine rarely seek theatrically to recapture and master the manipulative techniques, the precision of hand, and other non-verbal embodied skills which were and are at the core of much medical practice, and which, as the French anthropologist Pierre Bourdieu has emphasized, constitute a fundamentally different semiotic register from language. Although, as the seventeenth-century English doctor, Thomas Sydenham, argued, many patients prefer practitioners who cure them by doing something, rather than discoursing eruditely and eloquently about their condition, academic history (including the history of medicine) remains, as the historian and literary critic, Hayden White, has emphasized, a literary genre largely modelled on nineteenth-century novels.

From where has this sudden surge of interest in the body originated? It is worth stressing at the outset that history did not suddenly turn somatic in a road-to-Paris vision of the French philosopher Michel Foucault. In the standard accounts of this historiographical turn, sociologist, Bryan Turner, and historian, Roy Porter, have presented this new interest in the body on the part of the Western European and American historical professions (it is not noticeably shared by non-Western scholars) as one facet of a generalized narrative of emancipation. In such accounts the history of the body represents a belated recognition of the implications of feminism, the sixties and the death of Victorian sexual hypocrisy, recently tempered by the advent of AIDS. However, these claims to novelty are greatly exaggerated and to a significant extent misplaced.

Firstly, the history of medicine has almost always been concerned with the interpretation of sick bodies. As Georges Canguilhem pointed out, it has been predicated upon the shifting definitions of normativity and normality, the history of the normal and the pathological. Most nineteenth-century historians of medicine, like modern historical epidemiologists, not to mention medical archaeologists studying excavated human remains, emphasize the essential existence of their medical nosology throughout history; they have sought to perform the ‘correct’ retrospective diagnosis. In the 1890s, for instance, the French doctor and historian of medicine, François Buret, reinterpreted medieval leprosy as syphilis, while in the early 1980s Graham Twigg’s The Black Death controversially argued that the epidemic was ‘really’ anthrax. There has thus long been a history of the pathological body. As we explore below, the history of the normal and normative body has by contrast only self-consciously been attempted since Michel Foucault.

The history of manners or moeurs (a fashionable topic for research after the translation of Norbert Elias’ The Civilizing Process) was often the central theme of eighteenth- and nineteenth-century mainstream history writing. Manners, in the work of the Enlightenment philosopher Montesquieu, or the Victorian historian Henry Thomas Buckle, were an all-encompassing category of civilization. Their history concerned itself with bodily comportment as well social and political structures. In Britain, bodily themes such as costume or marital practices were only banished from academic history to become the preserve of the antiquarian or amateur enthusiast in the late-nineteenth and early-twentieth centuries when the discipline became entrenched in the universities and sought to achieve intellectual respectability to rival the allegedly more cerebral faculties of law or theology.

The first generation of the Annales school of French historians writing between the two world wars were strikingly preoccupied by bodies. You will find few finer examples of ‘body history’ than Marc Bloch’s discussion of medieval and early modern monarchs’ claims to heal scrophula by touching the afflicted, or Lucien Febvre’s evocations of the sensory world of the sixteenth century. In Britain popular history writing such as The Antiquary series of the early-twentieth century continued this interest in bodily themes; while since the late-nineteenth century collectors and museums of folklife, such as the Castle Museum in York or the Musée des Arts et Métiers in Paris have preserved and displayed artefacts relating to the bodily practices of the past and the ‘lower orders’.

Museums of ethnography established during the colonial period also stressed the different bodily practices of native populations; more generally colonial exhibitions, medical theories such as physiognomy and the wide distribution of colonialist images sought to ground white European superiority with reference to alleged bodily differences. This condescension of well-fed people to other cultures still permeates many modern views of the past.

The discipline of anthropology emerged hand-in-hand with the colonial enterprise; indeed, physical anthropology provided much of the data which sustained claims to racial superiority. However, from the early twentieth century cultural and social anthropologists, not least Bronislaw Malinowski, Marcel Mauss and, slightly later, Margaret Mead, broke away from some aspects of such unsavory ideologies. Nevertheless their work retained a pronounced focus upon bodies. Righthandedness, culinary habits, forms of bodily adornment and the social practices surrounding birth and sex were seen as expressing wider truths about social organization. This anthropological interest in what Mauss termed “the techniques of the body” has continued throughout the twentieth century,¹ and has had perhaps its greatest impact upon historians, and historians of medicine in particular, through the work of Mary Douglas and Victor Turner, notably Purity and Danger (1966) and The Ritual Process (1969) respectively.

Moreover, such concerns were not the exclusive domain of anthropologists. Throughout the nineteenth century strands of what are now described as psychology and sociology addressed similar themes. From Henry Mayhew (1856) to Havelock Ellis in The Criminal (1891) early sociologists and psychologists drew links between signs on the body and patterns of behaviour, between what they termed ‘moral and physical deformities’. Early economic writing was similarly somatic. Political economy, notably the work of Malthus and Ricardo, not to mention Marx, was centrally concerned with the productive and reproductive capacity of human beings, developing the Enlightenment’s intense interest in the statistical enumeration and surveying of bodies within particular places. Max Weber’s interest in work discipline and in the redirection of asceticism towards production and profit emphasized its physical manifestations.

Unsurprisingly, therefore, the work of many economic historians and historical demographers over the last twenty-five years has paid a great deal of attention to the physical condition of past populations. Some scholars have used height and weight records of military recruits and schoolchildren to examine nutritional standards over time, while the monumental work of the Cambridge Group for the History of Population and Social Structure and other demographers has been centrally concerned with the interaction of the biological and physiological characteristics of human beings with changing cultural, ecological and economic circumstances. They have, for instance, argued over the influence of nutritional levels, breast-feeding on women’s fertility, and on the susceptibility of populations to infectious diseases.

Moreover, one finds a striking preoccupation with the corporeal in the exciting syntheses of history, anthropology and social theory which characterized the emergence of social history and ‘history from below’ between the late 1960s and early 1980s. Peter Burke’s Popular Culture in Early Modern Europe (1978), for instance, was structured around the Carnivalesque figures of Carnival and Lent to be found in Rabelais and his World (Eng. trans., 1968), the highly influential study of the Humanist and peasant culture written in the 1930s by the formalist literary critic, Mikhail Bahktin, and the paintings of Breughel. Natalie Zemon Davis influentially explored sixteenth- and seventeenth-century gender norms through a study of transvesticism and the inversion of bodily norms.

While many historians of the medieval and early-modern periods borrowed freely from social anthropology, the new social history of the nineteenth century and early-twentieth century was more influenced by the materialist claims of Marxism. Yet, as Eric Hobsbawn’s article on the male and female figure within socialist iconography suggested nearly twenty years ago, the writing of many middle-class Marxist historians was suffused with an intellectualized desire for the beautiful and hard-(working) body of the proletarian. This is perhaps most fully articulated in the autobiography of the French Marxist philosopher, Louis Althusser, when he noted his sense that “I had no body” and yet simultaneously recorded the deep attraction he felt for Marxist theory because “I subscribed to it with my body” and because in it “I discovered a system of thought which acknowledged the primacy … of … bodily activity ….”²

Although somatic concerns are apparent within the pioneering work of Karl Sudhoff (1853–1938), Henry Sigerist (1891–1957) and Oswei Temkin (b.1902) in the history of (especially ancient and medieval) medicine, the first wave of professional social historians of medicine emerged alongside and in dialogue with the new social history. Charles Rosenberg thus emphasized the body of the patient in a series of studies leading up to The Care of Strangers, while the early issues of Social History contained a significant number of articles on medical themes such as chlorosis. There are clear parallels between the efforts of social historians to rescue women and the poor from what E.P. Thompson termed the “condescension of posterity”³ and the critical stance taken towards professional medicine in the historical work of the anti-psychiatric movement of the 1960s and 1970s—notably that of Thomas Szasz and Andrew Scull—and in feminist critiques of medical knowledge by authors as diverse as Barbara Ehrenreich and Dierdre English, Mary Daly and Germaine Greer. Furthermore, many postcolonial historians such as the Subaltern Studies school in India and South East Asia (often directly inspired by Thompson) have denounced the ideological uses of science and medicine in the Imperial context.

Yet none of this work cared to style itself ‘the history of the body’. The first question we should ask, therefore, is not why has ‘the body’ become fashionable, but why has a diverse range of historical and literary inquiry rallied behind this label rather than, say, the history of ‘ordinary people’, ‘women’ or the ‘working class’?

The best explanation might be that in a post-Marxist and post-structuralist world such appeals to the body provide a more effective rhetorical rallying point than invocations of common class or gender experience. Historians working today often emphasize the role of body as the primary locus upon which power has been and is inscribed. Many contemporary black American poets and novelists as well as historians of slavery have thus foregrounded the whipped and branded body of the slave, while one of the most eloquent and ambitious general statements of this approach is Dorinda Outram’s introduction to The Body and the French Revolution, where she seeks to make a phenomenology of pain the basis of political action and analysis. “[B]odies”, she writes, “are important because the only experiences which cannot be co-opted by political systems are the inevitably personal bodily experiences of individuals.”⁴

No matter how great one’s sympathy is with this emphasis on the need historically to consider suffering and the ethical implications of the study of the body, many historians in the field would strongly disagree with Outram’s contention that the body is a transhistorical category. Such scholars stress that the body is apprehended in radically different ways in different historical contexts and is consequently experienced and treated in wildly varying ways. Outram’s own work on how French revolutionaries identified with Stoicism to the point of suicide, not to mention the Christian discourses of martyrdom, indicate that many ideologies are built upon the suffering bodies of their progenitors, and that many people will embrace and act out such agonies. Indeed, what were Freud’s reinterpretation of Dora’s ‘seduction’, or hagiographers’ rewriting of St. Francis and his stigmata, but effective cooptions of terrible personal and bodily experiences?

This culturalist approach often points to a diversity of anthropological and historical work which has destabilized our understandings of biological ‘knowledge’. Anthropologists have demonstrated that beliefs about physiology, let alone the maintenance of health, are widely variable. Contemporary understandings of sexual difference and of the link between sex and reproduction are not cultural universals. Barbara Duden has shown how early-modern women interpreted the internal workings of their bodies as an unpredictable system of flows. While in Making Sex (1990), perhaps the most influential work of medical history published in the last two decades, Thomas Laqueur argued that until the late-eighteenth century people interpreted human beings as having one sex but two genders. Mutual orgasm was thus necessary for conception. Contrary to the title of the feminist classic, then, our bodies are not unproblematically our own; for many historians they are only apprehended through culture and above all through discourse.

The body, we might conclude from the juxtaposition of these diametrically opposed approaches, is both supremely real and not real at all, a confusion often compounded in its historiography. ‘Body history’ has gained its considerable currency in part precisely because of this polyvalency and ambiguity. It appeals because it offers the seductive possibility that we might be able to have our deconstructive cake and eat it too. Histories of the body, or aspects thereof—childbirth, civility, corseting—derive much of their rhetorical purchase by implicating the body of the reader or auditor. The historian can see students wriggle as they somatically register the description of an early modern lithotomy or public execution, and yet his or her argument can also maintain the intellectual terrorism in which everything solid melts into the mist of discourse.

For one important factor in the growth of ‘body history’ has been the influence of aspects of literary studies and a wider concern with the notion of representation. Indeed overt historical interest in the body has grown in conjunction with a preoccupation with the determining role of discourse in society and/or a stress on the extreme difficulty of establishing a clear or stable link between language and ‘social reality’. The body has thus offered a seductively productive site for interdisciplinary work in th...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• List of Contributors
• Introduction
• Power
• Bodies
• Experiences
• Index