Content area
Full text
SUMMARY: In the second half of the eighteenth century, medical doctors faced heavy competition. They competed for patients and for institutional positions and sought a variety of means to enhance their reputations. Among rank-and-file physicians, some strove to respond to the high expectations and rationalistic discourse fueled by Enlightenment philosophy. They aimed to build a new medicine on rational and empirical principals. Concentrating on the rich correspondence left by young physicians born in Geneva, this article maps out the social and moral dilemmas encountered by ambitious young physicians in the second half of the eighteenth century, who, like many thousands of others, flocked to Edinburgh, "the first medical school" in Europe. Conscious that they formed but one group among a series of possible practitioners, they pondered over cultural codes, civilities and economic realities as they strove to promote the figure of a knowledgeable, experienced, gentlemanlike physician.
KEYWORDS: enlightened physician, medical practice, philanthropy, medical identity, medicine and money
God is my witness that my views are not selfish, but I would like to be paid so as to live independent and able to practice with generosity, dignity to the rich and mercy to the poor, spirit of benevolence to all, and satisfaction to myself.
-Louis Odier1
In the second half of the eighteenth century, the future looked bleak for academic physicians. The status of traditional medical knowledge as it was taught in conservative universities was declining whereas empirical practitioners were very much the fashion.2 After an apprenticeship as an apothecary or a surgeon, many low-key practitioners turned to physic, sometimes taking degrees to enhance their occupational profiles.3 The value of academic diplomas was unequal, and towns set up examinations to ascertain if doctors possessed minimum levels of knowledge.4 Empirical and practical medicine thrived,5 fueled by belief in the powers of reason and a general mistrust in l'esprit de système, and yet more and more students undertook long and costly academic medical studies that offered only uncertain access to medical practice and no guarantee of success.6 Why did they do so? Arguably they were prompted by Enlightenment culture and philanthropic ideals and attracted by the potential or the idea of medicine rather than medicine itself. Skeptical of medical systems, convinced that rationally processed empirical knowledge...