Medical societies and scientific culture in nineteenth-century Belgium 9781526133212

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Medical societies and scientific culture in nineteenth-century Belgium

SOCIAL HISTORIES OF MEDICINE Series editors: David Cantor and Keir Waddington Social Histories of Medicine is concerned with all aspects of health, illness and medicine, from prehistory to the present, in every part of the world. The series covers the circumstances that promote health or illness, the ways in which people experience and explain such conditions, and what, practically, they do about them. Practitioners of all approaches to health and healing come within its scope, as do their ideas, beliefs, and practices, and the social, economic and cultural contexts in which they operate. Methodologically, the series welcomes relevant studies in social, economic, cultural and intellectual history, as well as approaches derived from other disciplines in the arts, sciences, social sciences and humanities. The series is a collaboration between Manchester University Press and the Society for the Social History of Medicine. Previously published The metamorphosis of autism: A history of child development in Britain Bonnie Evans Payment and philanthropy in British healthcare, 1918–48 George Campbell Gosling The politics of vaccination: A global history Edited by Christine Holmberg, Stuart Blume and Paul Greenough Leprosy and colonialism: Suriname under Dutch rule, 1750–1950 Stephen Snelders Medical misadventure in an age of professionalization, 1780–1890 Alannah Tomkins Conserving health in early modern culture: Bodies and environments in Italy and England Edited by Sandra Cavallo and Tessa Storey Migrant architects of the NHS: South Asian doctors and the reinvention of British general practice (1940s–1980s) Julian M. Simpson Mediterranean quarantines, 1750–1914: Space, identity and power Edited by John Chircop and Francisco Javier Martinez Sickness, medical welfare and the English poor, 1750–1834 Steven King

Medical societies and scientific culture in nineteenth-century Belgium Joris Vandendriessche

Manchester University Press

Copyright © Joris Vandendriessche 2018 The right of Joris Vandendriessche to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. Published by Manchester University Press Altrincham Street, Manchester M1 7JA www.manchesteruniversitypress.co.uk British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library ISBN  978 1 5261 3320 5  hardback First published 2018 The publisher has no responsibility for the persistence or accuracy of URLs for any external or third-party internet websites referred to in this book, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

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Contents

List of figures Preface

viii x

Introduction 1 Sociability and medical reform 2 Debate and controversy 3 Publishing and editing 4 Networks and collections 5 Expertise and advice 6 Celebrating and commemorating 7 A new scientific landscape Conclusions

1 15 55 93 142 168 206 250 279

Select bibliography Index

285 306

Figures

1 The Antichambre du Bourgmestre, a room in the Brussels town hall where the Society of Medical and Natural Sciences of Brussels met in the late nineteenth century. (Source: ULG, Postcard ‘Bruxelles: Hôtel de Ville: L’Antichambre du Bourgmestre’ CC BY-SA 4.0) 2 Drawing of the medal Jean Fierens received from his patients in 1837. (Source: ULG, Guioth, Histoire numismatique de la révolution belge (Hasselt: Milis, 1844), pl. xxxiv CC BY-SA 4.0) 3 Drawings presenting the patient before and after a surgical operation of the nose by Charles Phillips. (Source: ULG, C.V.J. Phillips, ‘Observations chirurgicales,’ ASMG 5 (1839): 15–26 CC BY-SA 4.0) 4 The facsimile that embellished Jean Carolus’ edition of a medieval medical manuscript. (Source: ULG, J. Carolus, La chirurgie de maître Jean Ypermans, le père de la chirurgie flamande (1295–1351) (Ghent: Gyselinck, 1854) CC BY-SA 4.0) 5 Drawings of a malformed baby discussed in the Medical Society of Ghent. They were made by Charles Van Bambeke, who ‘drew from nature’ (‘ad nat[uram] delin[eatus]’), meaning that they were original drawings of the actual specimens. (Source: ULG, C. Poelman, ‘Déscription d’un cyclope iniencéphale,’ BSMG, 29 (1862), 320–3 CC BY-SA 4.0)

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6 Portrait of Charles Poelman lithographed by Florimond Van Loo. (Source: University Archive Ghent © Universiteitsarchief Gent) 7 Nineteenth-century drawing of a malformed baby. The specimen was sent to Charles Poelman by Dr Debeule, a private practitioner from Lokeren, to be included in the anatomical collection of the University of Ghent. (Source: ULG, C. Poelman, Description d’une monstre para-cyclocéphale (Ghent: Gyselynck, 1850) CC BY-SA 4.0) 8 Portrait of Adolphe Burggraeve lithographed by Florimond Van Loo after a design by Jozef Pauwels. (Source: University Archive Ghent © Universiteitsarchief Gent) 9 Medal of the Royal Belgian Academy of Medicine. Clockwise starting from the top are represented: Andreas Vesalius, Jan Palfyn, Henricus Rega, Rembert Dodoens, Adriaan Van den Spieghel, Jan-Baptist Van Helmont and Philip Verheyen. (Source: ULG, BRKZ. NUM.013090 ‘Erkentelijkheidsmedaille van de Académie Royale de Médecine de Belgique, [1846]’ CC BY-SA 4.0) 10 Portrait of Jean-François Joseph Dieudonné that was included in Louis Martin’s biographical sketch. The volumes on the table behind Dieudonné appear as a reference to his talents as a writer and editor. (Source: ULL, L. Martin, Notice sur Jean-François-Joseph Dieudonné (Brussels: Manceaux, 1865) © Digitaal Labo KU Leuven) 11 Photo of the Laboratory of Bacteriology and Pathological Anatomy in the Antwerp Stuivenberg Hospital. (Source: ULL, E. Trétrôp, ‘Le laboratoire de bactériologie et d’anatomie pathologique des hôpitaux civils d’Anvers,’ BSMA, 57 (1895), 60–8 © Digitaal Labo KU Leuven)

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Preface

My interest in the history of medical sociability goes back a long way. I first came across the subject in the medical history seminars and master’s courses I followed at the universities of Leuven and Minnesota between 2008 and 2010 – the latter training only made possible by a generous fellowship of the Belgian American Educational Foundation. In those years, the idea took shape to study nineteenth-century medical societies as spaces of scientific practice rather than as professional organizations. Thanks to a doctoral fellowship of the Flanders Research Foundation (2010–2014), I was able to put this idea into practice and start a research project titled ‘Scientific Medicine in the City: The Scientific Practices and Urban Embeddedness of Medical Societies in Belgium, 1830–1914.’ A postdoctoral fellowship of the Special Research Funds of the University of Leuven (2015) allowed me to conduct additional research (e.g. on the networks and publishing practices of these societies). I was given the opportunity to present this research at many venues in Belgium, the Netherlands and elsewhere. My work has benefited enormously from the comments I received at these meetings and my gratitude goes out to all those who took an interest in my work. Two people merit a special word of thanks. Kaat Wils has encouraged me to pursue my research from the very start. She proved a dedicated supervisor of my doctoral research. My conversations with her have shaped my understanding of nineteenth-century science and medicine, and she has been a meticulous reader of all the chapters in this book. Frank Huisman’s sharp analytical comments, conceptual advice and apt literature suggestions kept me on track. I also thank him for enabling me to spend several months at the Descartes Centre for the History and

Preface xi

Philosophy of the Sciences in Utrecht, a visit during which I benefited from the advice of Wijnand Mijnhardt and Bert Theunissen. Several collegueas have taken a special interest in my work by commenting on chapters at different stages. I am grateful in particular to Michael Brown, Raf De Bont, Josephine Hoegaerts, Matthias Meirlaen, Evert Peeters, Jo Tollebeek, Jacob Steere-Williams, Truus Van Bosstraeten, Geert Vanpaemel and Karel Velle. It is difficult to overestimate the impact of their help. Without a doubt, many of the concepts I have used in this book to analyze how science was practiced in medical societies are the product of my conversations with them. Upon reading this book, I hope they will find their advice reflected in the way I have paid attention to performance, to (unwritten) codes of conduct, to the construction of ‘expertise’ or to the mechanisms of commemoration in nineteenthcentury scientific sociability. The Cultural History since 1750 Research Group at the University of Leuven proved a stimulating context for my research. Studying medical history amidst cultural historians who are working on topics such as the history of universities, museums, shopping or historical culture – an exchange stimulated by monthly seminars to discuss work in progress – proved a constant reminder of the social and cultural milieu in which physicians were embedded. If I originally studied the urban nature of medical societies in terms of geography and the presence of scientific infrastructure in the city, such as libraries and universities, I came to understand – inspired by this shared tradition of cultural history – this urban embeddedness of medical societies much more in terms of physicians’ participation in an urban-based civil society. These insights allowed me to open up my research and make links with contemporary political and historical culture. They are the product not only of formal seminars, but also of many informal chats in the office or over lunch and during several leisure trips to museums, for which I want to thank Bram Van Nieuwenhuyze, Liesbet Nys and Elwin Hofman, among many other colleagues from the Leuven History Department. A parallel project on the history of anatomy in Belgium enabled me to discuss my findings with experts in medical history on an almost daily basis. While these exchanges have left their traces throughout the book, this is particularly the case for the chapter on networks and collections, in which I explore how anatomists used societies to gather specimens. I therefore want to thank Veronique Deblon,

xii Preface

Tinne Claes, Jolien Gijbels, Pieter Huistra and Sokhieng Au in particular. As my research advanced, a certain esprit de corps grew among us as medical historians in Belgium, a sentiment that was reinforced as we teamed up with colleagues from the Free University of Brussels to establish the Network of Belgian Medical History. Its meetings offered valuable opportunities to discuss work in progress, for which I want to thank in particular Renaud Bardez, Valérie Leclercq, Julie De Ganck, Kenneth Bertrams and Benoît Majerus. When doing the research for this book, I spent many solitary days browsing through medical periodicals, many of which are preserved in the rich collections of the university libraries of Leuven and Ghent. The staff members of these libraries helped me locate the right titles, find missing volumes and proved flexible in bringing out materials again, sometimes on short notice. I want to thank them also for their assistance in preparing the illustrations for this book. The published meeting reports of societies, the key sources of this study, proved difficult to master. Written in French and in a somewhat high-flown style, they are typical of Belgian intellectual and polical life in the nineteenth century. In this book, I chose to translate all citations into English to improve readability. I am grateful to Michelle Ostyn, with whom I followed evening courses in French for several years, for her help in translating some of the most difficult French citations in this book into English. The editors and reviewers of Manchester University Press made valuable suggestions to improve and clarify my argument and to better present my research to an international audience, of which many are unfamiliar with Belgian history. It took an outsider’s view to make me realize the importance of Belgium’s status as a young, developing nation-state in the nineteenth century for my research. Readers will hopefully find themselves quickly up to speed after reading the introduction and the first chapter, in which I have tried to sketch Belgium’s early political history in relation to developments in the medical field. Friends and family, finally, were equally essential to this book. My parents Katelijne and Hans, grandfather René, brother Jasper and his wife Tine as well as my family-in-law Ronny, Hilde, Steven and Stephanie never ceased to support me and have listened to my stories about this research with remarkable patience. My final word of thanks goes to my partner Miranda. She has witnessed the genesis of this study from close by. I dedicate this book to her.

Introduction

In the middle of the 1850s, the Belgian physician Édouard Lesseliers faced an unpleasant monthly task. As the assistant-secretary of the Medical Society of Ghent, a club of physicians founded in 1834 with the aim of advancing the Belgian medical sciences, he was responsible for editing the society’s meeting reports. In a letter to secretary Charles Poelman, he complained about the difficulties of the job: Everyone was informed that those who had not sent in their notes by Sunday, would see their speech reproduced at their own risk and peril. […] When I do it well, no one complains; but the moment a member acted improperly or awkwardly during discussion, they blame me for reproducing the blunders they committed.1

The ‘risk and peril’ and ‘blunders’ mentioned in Lesseliers’ letter in no way refer to actual failed medical treatments or medical misconduct. They refer, surprisingly, to the behavior of society members during meetings and the style of their speeches. To understand the potential risk of ‘improper’ conduct in medical societies, one needs to know that these reports were not stored away securely in the archives, where they would be rarely consulted. To the contrary, they were published in the society’s monthly Bulletin and could potentially be read by colleagues from across the country. Hence came the need for careful editing. Speeches were often embellished for publication, to showcase one’s knowledge and eloquence. Particularly in cases of more heated exchanges or controversies, the printed form of the discussion had to display mutual respect and gentlemanly behavior. Central to such editorial work was thus the matter of representing ‘science’ and of upholding one’s reputation in the medical community – a matter

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which, as Lesseliers’ complaints reveal, was considered of utmost importance. Lesseliers’ editorial practices direct our attention to aspects of medical sociability that have hitherto been rarely studied. When physicians gathered in medical societies to present, share, discuss, evaluate, publish and even celebrate their medical studies, they engaged in a scientific community with specific practices, rules and manners. These customs and codes of conduct, and the ways in which they were set and imposed, lie at the heart of this book. By scrutinizing the scientific activities of medical societies, it treats, more broadly speaking, the function of sociability in the nineteenth-century medical sciences. And this function, it will be argued, was above all of a normative nature. As medical study evolved from an intellectual pursuit by learned men to an enterprise of professional (academic) scientists over the course of the nineteenth century – a project described as ‘making medicine scientific’ by both contemporaries and later historians2 – the boundaries of what constituted ‘science’ or ‘scientific’ conduct were continuously redefined. Medical societies, I argue, were spaces where such arbitration took place. This book explores the different ways in which such norms were set and uncovers the rich scientific culture that emerged in and around these societies. The current lack of attention to the scientific activities of nineteenthcentury medical societies may be regarded, to an extent, as surprising. For scientific study formed an essential topic in the historiography of eighteenth-century learned societies, those institutions after which nineteenth-century medical societies were modelled.3 This lacuna seems mostly the product of our dominant framework for studying the nineteenth-century medical world: the ‘professionalization’ of medicine. Different from the professionalization of science – meaning science becoming a full-time paid activity rather than a voluntary one – this concept refers to the coordinated efforts of physicians to improve their social status.4 Medical societies have been represented as agents of such professionalization, as spaces of professional union, which lobbied the government for more autonomy. Within such a framework, science was mostly studied as a form of professional discourse, a means to strengthen professional claims through a narrative of scientific progress. The literature on medical societies therefore illustrates a tendency that holds true for the historiography of nineteenth-century medicine

Introduction 3

more generally, that is that attention to professionalization has generated an all too limited, rhetorical understanding of ‘science’ in medicine. As John Warner has advanced, inquiries into the ‘rhetoric’ of science might have critically assessed older stories of scientific progress, they have also reinforced ‘unhelpful dichotomies between medical science as ideology and medical science as a body of knowledge and technique; between science as discourse and science as social practice; […] between science and society.’5 Much of the recent literature on science in medicine has aimed to transcend these dichotomies and widen our understanding of the practices and social contexts that have shaped medical knowledge.6 This book contributes to this effort and builds on the work of Warner and others on the changing meanings of ‘scientific medicine’ in the past.7 Of particular inspiration was Michael Brown’s work on the performance of medicine in York at the turn of the nineteenth century. The York physicians, as Brown shows, constructed their professional identity before different audiences. When engaging in philanthropic or scientific activities (e.g. publishing), they tailored their efforts to the expectations of audiences in different settings, including the setting of the medical society with its audience of fellow-physicians.8 This study too pays attention to the performative dimension of medical sociability. Participating in medical societies always meant engaging with one’s peers. Whether presenting a study, reviewing a manuscript, or responding to an opponent in a debate, the presence of an audience of colleagues always impacted the form and content of one’s interventions. While Brown studied performances to achieve new insights in physicians’ shifting professional identity, I use them to uncover the codes of conduct that underpinned nineteenth-century scientific culture. The history of medical societies becomes in this way a history of written and unwritten procedures, and of succeeding generations bending these to their advantage. Some of these procedures were very formal. When (young) physicians founded the first societies in the early nineteenth century they aspired to the prestige of learned institutions with their strict rules for membership and publishing. Whether one became a member or not, or whether one’s manuscript was published or not, was determined by a system of voting. Yet, at the same time, this founding generation also relaxed the rules to allow more medical colleagues to participate in

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scientific work, in line with their reformatory agenda. Other mechanisms, which were no less important for setting standards, operated in more subtle ways. The praise for an eloquent speech, or the applause given to those doctors who committed themselves socially – compliments typically made during jubilees and celebrations, or during memorial and funeral eulogies – reinforced shared scientific codes. Each of these formal speeches – as George Weisz has shown for the French Academy of Medicine – created an ideal image for colleagues to follow.9 By participating in medical societies, physicians thus underwent a process of socialization during which they familiarized themselves with the rules and manners of the scientific community. Throughout the century, a shift took place on the level of these more subtle, unwritten rules as well. From the 1860s onwards, professional scientists who worked in academic laboratories or in the new research institutes of the state started replacing the founders of medical societies. To them, the original customs no longer seemed suited to manage professionalized science. The changing style of society debates forms a telling example. In the second half of the nineteenth century, a preference for stating facts replaced a tradition of oratory. In the field of epidemiology, the accumulation of experimental results in the laboratory was considered a far more valid and trustworthy approach than the eloquent debating of medical theories and observations – a scholarly tradition that had flourished in the mid-nineteenth century, when society members discussed the major cholera outbreaks. The downfall of this tradition, however, did not signal the end of societies’ scientific activities. Professional scientists rather reshaped their form and function to meet new needs, such as assisting promising students with their first steps in research or bridging the gap between different medical specialisms. Uncovering these shifts requires a specific methodology. Throughout this book, I have paid particular attention to those moments when established norms were debated and transgressed. Outsiders such as the rural physician Jean Fierens, whose dispute with the members of the Medical Society of Ghent on a treatment for ophthalmia I discuss in the second chapter, contested the procedures on which society members based their authority. Attention to disputes alone, however, does not suffice to trace shifts in societies’ functioning. Scientific sociability was often marked by a longing for tradition and a sense of

Introduction 5

continuity. Reforms occurred at a slow pace. To draw general lines I have adopted a wide chronological perspective that covers the entire nineteenth century. The fourth chapter on anatomical networks and collections, for example, reveals that a tradition of rural private practitioners donating a ‘rare’ anatomical specimens to medical societies continued throughout the century. Yet, from a long-term perspective, it is clear that the heyday of this practice is to be situated in the early and mid-nineteenth century. The context in which I study the scientific activities of medical societies is a developing civil society in nineteenth-century Belgium. The profound confidence in the potential of societies to turn medicine into a ‘science,’ it will be shown, cannot be understood without acknowledging the shared civil values that underpinned physicians’ scientific beliefs. Societies’ ambitions of advancing the sciences consisted of organizing debates, publishing journals, providing medical advice to the state and celebrating historical events – efforts that corresponded well to the values of social engagement, polite debate, a free press and a national historical awareness of the urban bourgeoisie. The history of medical societies therefore offers a new perspective on the relation between science, sociability and citizenship.10 One of the claims of this book is that the urban medical society formed the most-suited institutional model for early and mid-nineteenth-century physicians – more than the university or national academy – to establish a scientific community that reflected their shared civil values. The scientific culture that emerged through the efforts of medical societies was, to a large extent, a ‘civil’ culture. This intertwinement of science and civil society will be traced on the level of scientific practices and ideals. For the better part of the century, the scientific customs and values reinforced in medical societies corresponded to contemporary ideals of citizenship. The praise for an eloquent and polite speech in mid-nineteenth-century society debates, for example, can be considered part of a cultural tradition of public speaking among the urban bourgeoisie. Put in more general terms, the socially and culturally-engaged ‘gentleman physician’ embodied the medical sciences in this period. Paying attention to (changing) scientific codes of conduct, as explained above, becomes in this way a means to uncover the relation between science and civil society.

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This relation offers a better suited framework than the professionalization of medicine to understand the scientific practices that took place during society meetings. It not only allows these practices to be contextualized, but explains the changes that occurred in the course of the century. The correspondence between the medical sciences and a wider civil culture was indeed far from stable. As medical study evolved into a form of professionalized science – performed in laboratories and structured around a rising number of (academic) specialties – new scientific values and codes of conduct began to mirror the customs of civil society less. The scientific field now acquired a far greater autonomy vis-à-vis the civil world. As a result, the faith in the established practices of scientific sociability, as the example of polite debates versus experiments has shown, was greatly reduced. Through the lens of medical societies, the rise of ‘scientific medicine’ therefore becomes both a process of construction, of using the tools and customs of civil culture to build a new science, and one of erosion, as the successes of the sciences also stimulated an evolution towards a professional community, which increasingly questioned these early civil codes of conduct. These two interconnected narratives of the construction and erosion of a ‘civil’ scientific culture form the connecting threads throughout this book. The movement to make medicine ‘scientific’ was, of course, not limited to Belgium. The search for the right methods, standards and codes of conduct was part of a much wider shift in the European sciences. On a methodological level, it involved an evolution from more descriptive, cataloguing methods to more experimental research in the course of the nineteenth century. More than a clear movement originating in French clinical medicine, this process had many different intellectual origins.11 In early nineteenth-century Germany, natural history offered models for physicians to describe, compare and classify medical observations.12 In late nineteenth-century Britain, new experimentally oriented views on scientific medicine were not based exclusively on physiology, but encompassed a variety of practices from the physical and chemical sciences.13 The adoption of experimental methods was thus as diverse as the ‘rise’ of the clinic and differed according to national contexts and to existing scientific traditions. With regard to nineteenth-century scientific sociability as well, both general trends and differences between the European nations may be

Introduction 7

identified. As an urban bourgeoisie rose to power in the wake of the political upheaval of the first decades of the century, new forms of sociability developed in many European cities. Society members from Belgian cities such as Ghent and Antwerp exchanged their journals and publications with colleagues in Paris, Amsterdam, London and Berlin, effectively maintaining an international network. To an extent, this was a continuation of an older, eighteenth-century network of learned societies. Yet the foundation of national academies in this period illustrates the increased importance of national identity and prestige. And more importantly, the liberal ideology that was the product of the revolutionary era allowed physicians to reinvent the model of the learned society to better fit in with their ambitons. To many young physicians, the newly acquired political freedoms (e.g. to meet without surveillance, to publish without censorship) held great potential to improve their profession, which also meant turning this profession into a ‘science’. This applies to medicine, but also holds true for other developing disciplines such as biology or chemistry.14 The faith in the power of all sorts of scientific societies to contribute to the progress of their respective fields was thus rooted in these liberal ideals of the early nineteenth century, which were widely shared across Europe.15 The organization and scientific production of these societies differed considerably. The degree of state intervention in the sciences in each European nation proved an important factor in this. Contemporary Belgian physicians often juxtaposed the ‘centralized’ model of France with the more ‘decentralized’ German model. In France, the Parisian medical faculty, which dominated the French Academy of Medicine, attracted most government support; its prestige made it difficult for provincial medical centers to develop.16 In Germany, the more fragmented academic landscape was said to promote a much more ‘spontaneous’ scientific practice.17 The limited historiography of medical sociability in this period, however, does not allow clear conclusions to be drawn on national traditions and emerging science policies.18 But it does suggest that state intervention was not the only factor. Local – mostly urban – circumstances, such as the presence of universities, hospitals, publishers and libraries, were essential to the success of scientific societies. Moreover, cultural traditions of debate had a profound influence on the meetings and publications of societies. In the literature, a British tradition of ‘gentlemanly debate,’ conducted behind

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closed doors and rarely published in minutes, has been contrasted to a French tradition, in which a more confrontational style was adopted both during debates and in the (scientific) press.19 Belgium forms a well-suited case study to scrutinize the impact of liberal freedoms on the development of the medical sciences in nineteenth-century Europe. Its origins as a nation-state lay in the 1830 revolt of the southern parts of the United Kingdom of the Netherlands against the policies of King William I. The new state was built upon a political compromise between an upcoming industrial bourgeoisie and the Catholic Church. Both shared a profound distrust of state intervention. To prevent the state (or the monarch) from interfering in their respective economic and religious programs, profound liberal freedoms were included in the new and highly progressive constitution of 1831. This spirit of liberalism also helped secure the political viability of the new state, together with the country’s strategic value as a buffer against French aggression, as it was shared by international decision-makers.20 Belgium became a state where capitalism could blossom. While physicians did not belong to the upper ranks of the industrial bourgeoisie, who profited most economically and politically, they did belong to an upcoming middle class and petty bourgeoisie that had supported the revolution of 1830 and gradually profited from the nation’s economic success. They were part of a social stratum with upward social mobility, which as political liberalism triumphed in the mid-nineteenth century, actively sought social engagement, contributing to the ambitions of the Belgian state to take its place among the European nations.21 These political and social circumstances also determined the organization of the scientific landscape in Belgium. Here as well, state intervention remained limited and much was left to the private initiative, resulting in strong regional centers. In higher education, the creation of four universities in 1835 – two state universities in Ghent and Liège, one Catholic university in Leuven and one explicitly liberal one in Brussels – testified to the balances between public and private, between Catholics and liberals, and between the capital city of Brussels and the expanding provincial cities.22 Societies followed a similar geographical pattern, but ideological tensions seemed to have played a less prominent role. Only in the state-funded Belgian Academy of Medicine, founded in 1841, a good balance between professors from the Catholic University of Leuven and the Free University of Brussels was closely

Introduction 9

monitored. At the same time, several (private) medical societies were founded in Ghent, Brussels, Antwerp and many smaller cities – products of an upcoming middle class making use of the acquired freedom of association. It were these organizations, as I will show in Chapter 1, that sought to augment Belgium’s status and affirm its raison d’être as a ‘scientific’ nation among its European neighbours.23 As the century progressed, however, these balances became disturbed. As elsewhere in Europe, ideological struggles between Catholics and liberals intensified over matters such as education and public health.24 And also within liberal circles, the gradual development of national health policies generated tensions on the scope of state intervention – tensions which were echoed in societies’ debates on the public role of the physician.25 Financial investments in the modernization of the Belgian universities further indicated the end of the state’s hesitance to invest in science. Nevertheless, these investments were made slowly in Belgium and came into full effect only in the final decades of the century.26 Taken together, these circumstances – a strong urban, liberally oriented bourgeoisie, a hesitant development of state infrastructure, and a slow modernization of the universities – meant that much space was left for ‘civil’ engagement in the medical sciences, turning Belgium into an interesting case to study the relation between science, sociability and citizenship. To uncover this function, particular cases and source materials were selected. If histories of professionalization have studied nation-wide medical organizations, such as the Belgian Medical Federation (1863),27 research into societies’ scientific function requires attention to those societies with an explicitly scientific aim, which had fewer members but a far greater scientific production. This study therefore focuses on the medical societies in Belgium’s major cities, of which the most important ones were the Society of Medical and Natural Sciences of Brussels (1822), the Medical Society of Ghent (1834) and the Medical Society of Antwerp (1834). The Belgian Academy of Medicine (1841) is considered to a lesser extent; its financial dependence on the state and its advisory role to the government made it less suited to study science in relation to civil society. All the societies have produced a wealth of published records in the form of monthly journals, which form a stable corpus from the 1830s until the end of the century.

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Of particular interest are the meeting reports included in these journals. Rather than verbatim accounts of society members’ speeches and debates, these reports – as Lesseliers’ editorial work has illustrated – were carefully crafted with an audience of colleagues in mind. I have analyzed them almost as the scripts of plays, in which science was ‘staged’. In addition to the systematic analysis of the meeting reports of the mentioned societies, I also looked, when developing a particular case in one of the chapters, at other medical journals and at some of the monographs published by society members. In this way, I was able to follow debates as they left societies’ meeting rooms, include views from the outside and occasionally expand the framework of the study. A number of archival collections equally allowed me to put the printed discussions into perspective. Some correspondence between medical societies and the Belgian authorities has been preserved in the state archives (e.g. subsidy requests). The archive of the Medical Society of Ghent, however, was a far more useful and richer collection. These archival materials provide a welcome look behind the scenes, revealing for example, as Lesseliers’ letter has done, the ‘staged’ nature of societies’ publications. This study consists of seven chapters. The first chapter sets the scene by situating the growing faith in societies as a means to reform the medical field against the background of changing political regimes in Southern Netherlands since the late eighteenth century. It shows how the model of the eighteenth-century learned society was refashioned by the middle of the nineteenth century into a ‘civil’ institution that corresponded to contemporary liberal ideals. This was not a one-way process. Physicians struggled to ‘democratize’ these institutions and determine their relation to the state. The next two chapters lay bare the inner scientific functioning of medical societies, focusing respectively on traditions of medical debate and publishing over the course of the nineteenth century. They present the urban medical society as a specific setting where physicians’ success in constructing authority depended on their skills in navigating societies’ customs and procedures. The second chapter, on medical debates, reveals the importance of oratorical skills and scientific demonstrations during meetings as means to establish the validity of one’s scientific claims. Controversies over who had come up first with a new innovation – so-called ‘priority disputes’ – reveal mechanisms of professional recognition and accreditation.

Introduction 11

Societies’ publishing efforts, discussed in the third chapter, highlight authors’ motivations for submitting articles, reviewers’ ways of criticizing, editors’ decisions to reach new audiences and publishers’ role in the spreading of scientific journals. The chapter situates society journals within the wider, changing and highly competitive landscape of the nineteenth-century medical press. The fourth and fifth chapters each discuss the function of societies in one particular medical subfield, respectively anatomy and public health. By scrutinizing societies’ role in the networks through which anatomical specimens circulated, we get a look into societies’ networks of correspondents and their relation to universities. Rural practitioners, for example, could acquire a form of scientific recognition by sending a rare specimen to a medical society. Such specimens often travelled further, from medical societies to the universities, which were the primary actors – much more than medical societies – in building anatomical collections. Chapter 5, on public health, focuses on the changing profile of ‘experts’ in this field – from elite practitioners to paid professionals working in state service – and the way they used the forums provided by medical societies to claim an expert status. Their presence and initiatives during society meetings reveal the difficult relation between medical societies and the Belgian state, and more generally the tensions between science and politics. Public health was indeed a field in which the upholding of scientific standards and the showing of medicine’s social usefulness proved difficult to reconcile. The sixth chapter focuses on practices that are rarely considered as an integral part of scientific culture, but were nevertheless essential to building a scientific community. It discusses a set of ‘commemorative practices’ in medical societies – practices that established a shared, collective memory. By celebrating historical predecessors (e.g. Vesalius) or mourning the deaths of one’s colleagues, society members confirmed shared scientific beliefs. The changes in these ideals reveal how societies sought closer affiliation to the expanding universities in the late nineteenth century. The seventh chapter scrutinizes the shifting position of urban societies in the scientific landscape of the late nineteenth century, which was increasingly dominated by universities. It measures the effects of the specialization and professionalization of (academic) medical research by showing how medical societies repositioned

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Medical societies and scientific culture

themselves as ‘local’ and ‘general’ institutions, taking up new functions of vulgarization and postgraduate education, but also losing much of their central role as ‘arbiters’. It meant the downfall of an institutional model for scientific practice that had determined the course of the medical sciences for the better part of the century. Notes 1 ULG, Cor. R., Letter of October 21, 1854 of Edouard J. Lesseliers to Charles Poelman. 2 For a general introduction to this evolution: W.F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1994). 3 J.E. III McClellan, ‘Scientific Institutions and the Organization of Science,’ in R. Porter (ed.), The Cambridge History of Science. Volume 4: EighteenthCentury Science (Cambridge: Cambridge University Press, 2003), pp. 87–106. 4 J.C. Burnham, ‘How the Concept of Profession Changed the Writing of Medical History,’ Medical History Supplement 18 (1998), 1–195, 5–8. 5 J.H. Warner, ‘The History of Science and the Sciences of Medicine,’ in A. Thackray (ed.), Constructing Knowledge in the History of Science, special issue of Osiris, 10 (1995), pp. 164–93, on p. 174. 6 For an overview of this literature: S. Müller-Wille, ‘History of Science and Medicine,’ in M. Jackson (ed.), The Oxford Handbook of the History of Medicine (Oxford: Oxford University Press, 2011), pp. 469–83. 7 See also: T.M. Romano, Making Medicine Scientific: John Burdon Sanderson and the Culture of Victorian Science (Baltimore: Johns Hopkins University Press, 2002). 8 M. Brown, Performing Medicine: Medical Culture and Identity in Provincial England, c. 1760–1850 (Manchester: Manchester University Press, 2011). 9 G. Weisz, ‘The Self-Made Mandarin: The “Éloges” of the French Academy of Medicine, 1824–47,’ History of Science, 26:1 (1988), 13–40. 10 T.H. Broman, ‘Introduction: Some Preliminary Considerations on Science and Civil Society,’ Osiris, 17 (2002), 1–21. 11 For a revision of the development of clinical medicine and the pioneering role of Parisian clinics: O. Keel, L’avènement de la médecine clinique moderne en Europe, 1750–1815: Politiques, institutions et savoirs (Montréal: Les Presses de l’Université de Montréal, 2001). 12 J. Bleker, Die naturhistorische Schule 1825–1845: Ein Beitrag zur Geschichte des klinischen Medizin in Deutschland (Stuttgart: Fischer, 1981); V. Hess,

Introduction 13

13 14

15 16

17

18

Von der semiotischen zur diagnostischen Medizin: Die Entstehung des klinischen Methode zwischen 1750 und 1850 (Husum: Matthiesen, 1993). See for example: Romano, Making Medicine Scientific. On natural history societies: D.A. Finnegan, Natural History Societies and Civic Culture in Victorian Scotland (London: Pickering & Chatto, 2009). For a study of a society of chemists (the Association belge des chimistes): G. Vanpaemel and B. Van Tiggelen, ‘The profession of chemistry in nineteenthcentury Belgium,’ in D. Knight and H. Kragh (eds), The Making of the Chemist: The Social History of Chemistry in Europe 1789–1914 (Cambridge: Cambridge University Press, 1998), pp. 191–206. On the expansion of learned societies in France, see: J.-P. Chaline, Sociabilité et erudition: Les sociétés savantes en France, XIXe–XXe siècles (Paris: CTHS, 1998). G. Weisz, The Medical Mandarins: The French Academy of Medicine in the Nineteenth and Early Twentieth Centuries (Oxford: Oxford University Press, 1995). On the particularities of provincial science in France: J.M. Nye, Science in the Provinces: Scientific Communities and Provincial Leadership in France, 1860–1930 (Berkeley: University of California Press, 1986). For a discussion of the French scientific landscape, in comparison to Britain, see also: M.P. Crosland, Scientific Institutions and Practice in France and Britain, c. 1700–c. 1870 (Aldershot: Ashgate, 2007). For a useful discussion on the German medical landscape: A. Tuchman, Science, Medicine, and the State in Germany: The Case of Baden, 1815–1871 (New York: Oxford University Press, 1993). For an introduction to the relation between medical science and the state in (south) eastern Europe: T. Buklijas and E. Lafferton, ‘Science, Medicine and Nationalism in the Habsburg Empire from the 1840s to 1918,’ Studies in History and Philosophy of Biol. & Biomed. Sci., 38:4 (2007), 679–86. Some examples of the fragmented research into nineteenth-century medical societies: on the Swedish Society of Medicine: E. Âhrén, Death, Modernity and the Body: Sweden, 1870–1940 (Rochester: University of Rochester Press, 2009), pp. 52–3; on the Medical Society of Geneva: P. Rieder and M. Louis-Courvoisier, ‘Enlightened Physicians: Setting Out on an Elite Academic Career in the Second Half of the Eighteenth Century,’ Bulletin of the History of Medicine, 84:4 (2010), 578–606; on late eighteenth- and early nineteenth-century French medical societies: P. Rieder, ‘La médecine pratique: une activité heuristique à la fin du 18e siècle?,’ Dix-huitième siècle, 47 (2015), 135–48; on British medical societies: S.C. Lawrence, ‘“Desirous of Improvements in Medicine”. Pupils and Practitioners in the Medical Societies at Guy’s and St. Bartholomew’s Hospitals, 1795–1815,’ Bulletin of the History of Medicine, 59 (1985), 89–104. On

14

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20 21 22 23 24

25

26

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Medical societies and scientific culture

the literature on medical societies in the Low Countries: J. Vandendries­ sche, ‘Wetenschapsbeoefening en belangenbehartiging: naar een nieuwe geschiedschrijving van negentiende-eeuwse medische genootschappen in de Lage Landen,’ Studium, 7:1 (2014), 36–49. See: R. De Bont, ‘“Writing in Letters of Blood”: Manners in Scientific Dispute in Nineteenth-Century Britain and the German Lands,’ History of Science, 51 (2013), 309–35. On a tradition of British gentleman science: M.J.S. Rudwick, The Great Devonian Controversy: The Shaping of Scientific Knowledge among Gentlemanly Specialists (Chicago: Chicago University Press, 1985), pp. 25–6, 29; J. Endersby, Imperial Nature: Joseph Hooker and the Practices of Victorian Science (Chicago: The University of Chicago Press, 2008). E. Witte, J. Craeybeckx and A. Meynen, Political History of Belgium: From 1830 onwards (Brussels: ASP, 2009), pp. 19–28. Ibid., pp. 61–4. P. Dhondt, Un double compromis: Enjeux et débats relatifs à l’enseignement universitaire en Belgique au XIXe siècle (Ghent: Academia Press, 2006). The foundation of the Belgian Academy of Medicine, and its relation to urban medical societies is discussed in more detail in Chapter 1, pp. 38–43. E. Witte, ‘The Battle for Monasteries, Cemeteries and Schools: Belgium,’ in C. Clark and W. Kaiser (eds), Culture Wars: Secular-Catholic Conflict in Nineteenth-Century Europe (Cambridge: Cambridge University Press, 2003), pp. 102–28. Even though politics were banned from society meetings, ideologically delicate questions, such as the public health benefits of cremation, a practice that was opposed by Catholics, were treated in medical societies. Such matters generated discussion over the extent to which societies should become engaged in the public debate. This public role of societies is discussed in Chapter 5. K. Bertrams, Universités et entreprises: milieux académiques et industriels en Belgique, 1880–1970 (Bruxelles: Le Cri Éd, 2006). For a brief overview, see: R. Halleux, Tant qu’il y aura des chercheurs. Science et politique en Belgique de 1772 à 2015 (Bruxelles: Luc Pire, 2015), pp. 29–47. This medical association has been well researched: K. Velle, De nieuwe biechtvaders. De sociale geschiedenis van de arts in België (Leuven: Kritak, 1991); R. Schepers, De opkomst van het medisch beroep in België. De evolutie van de wetgeving en de beroepsorganisaties in de 19de eeuw (Amsterdam: Rodopi, 1989); C. Havelange, Les figures de la guérison (XVIIIe–XIXe siècles): une histoire sociale et culturelle des professions médicales au pays de Liège (Paris: Belles Lettres, 1990).

1

Sociability and medical reform

In 1841, the Antwerp physician Jean-Corneille Broeckx measured the state of Belgian medicine. Discussing each medical institution in turn, from the late eighteenth century to his own time, Broeckx composed one of the best-documented contemporary accounts of early nineteenthcentury Belgian medicine.1 Among the institutions discussed by Broeckx were the state-directed academies of the late eighteenth century, the first short-lived medical societies of the revolutionary period, but also the medical societies, in which more numerous physicians participated, that had emerged in the 1830s in Belgium’s major cities. The connecting thread throughout Broeckx’ history was an ever expanding ‘spirit of association’ among the Belgian physicians. If during the period of French occupation, this spirit was said ‘not [to have] sprouted strong roots,’ Broeckx claimed that after the Belgian Revolution of 1830 a new era had begun for the nation in which ‘the spirit of association had reached the masses.’2 In tracing this spirit through time, Broeckx’ account supported the program of a generation of medical reformers. For them, the involvement of more numerous practitioners in the medical sciences – through the medium of medical societies – fit in well with the ambition to make these sciences more observationbased, grounding them in everyday medical practice rather than in abstract theories.3 Broeckx’ narrative of the changing structures of learned sociability points to a little studied transition in the medical reforms of the first half of the nineteenth century. Studies of this period have focused on the successive medical laws, which adapted the structures of the Ancien Régime to the changing needs of the medical profession and the state. The eighteenth-century collegia medica, corporate bodies that

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controlled the practice of medicine and surgery and the sales of drugs, were replaced by local and provincial medical commissions, which not only supervised medical practice, but also advised the government on matters of public health.4 In the 1840s, centralized advisory bodies such as the Belgian Academy of Medicine (1841) and the Superior Health Council (1849) followed.5 At the same time, a common national medical curriculum was established, replacing the separate education in surgery and medicine. In 1849, Belgium was one of the first European states to introduce a unified academic degree of Doctor of Medicine, Surgery and Obstetrics.6 Medical societies have been mostly regarded as a means by which physicians pressed for these legislative and educational reforms – as they allowed physicians to gather and reach consensus – rather than as institutions that were themselves subject to reform. Yet, as Broeckx’ narrative indicates, the eighteenth-century learned academies can equally be considered part of the structures that were transformed during the first half of the nineteenth century.7 This chapter discusses the foundation and transformation of medical societies in the Southern Netherlands from the late eighteenth century to the 1840s. It situates these societies within a changing scientific landscape, which gained a particular ‘Belgian’ outlook in a period of successive political shifts and reforms. In this process, medical societies were refashioned into a new type of institution. The older organizational model of the learned society was adapted to meet the needs of a new audience of medical practitioners. Broeckx acts as our guide in retracing this shift. Making a literary career for himself after the Belgian Revolution, he proved a strong defender of the newly acquired political freedoms of press and association that underpinned the young nationstate. These convictions shaped his views of an open and strictly medically oriented scientific sociability. In writing his account of medical societies, he criticized those features of past and contemporary institutions, such as exclusive membership and encyclopedic scope, that did not fit in with reformers’ ideal of a broad participation to scientific societies, while praising others, such as societies’ publishing efforts, which stimulated physicians’ scientific engagement. At the same time, however, his narrative needs to be critically assessed. The process in which learned traditions were adapted to new needs occurred much more gradually than Broeckx’ history suggested. Older traditions of philanthropy, exclusive membership and close cooperation with the

Sociability and medical reform

17

state were continued as well. To uncover them, the chapter starts with the oldest medical societies, which were founded at the end of the eighteenth century. It then successively discusses reformers’ views on the function of medical societies, shifts in membership and their position in urban society. The chapter ends with a debate on the Belgian Academy of Medicine, which challenged the model of the urban society as a scientific meeting place. Opportunities of the French Revolution

At the end of the eighteenth century, the scientific landscape of the Southern Netherlands, which was part of the Habsburg Monarchy, and the Prince-Bishopric of Liège – the territories that would become Belgium in 1830 – had a decidedly aristocratic outlook. Only a handful of members from the medical elite, mostly university professors and those physicians and surgeons employed at the court, participated in state-run learned societies such as the Royal and Imperial Academy of Sciences and Belles-Lettres (1772) in Brussels and the Society of Emulation (1779) in Liège.8 Characteristic of these learned societies was the encyclopedic scope of their investigations, which ran from poetry to agriculture and were strictly controlled by the state. Medicine was rarely treated, with the exception of matters in which the state had a clear interest, such as the study of epidemics.9 Besides these academies, the medical faculty of the University of Leuven and the collegia medica were similarly run by a small medical elite. These latter institutions, apart from their educational and regulatory function, can also be considered scientific spaces.10 Anatomical dissections were, for example, organized by the collegium medicum of Ghent in the city’s town hall, in which an anatomical theater had been constructed in the late seventeenth century.11 The foundation of the first medical societies may be regarded an attempt to adapt this scientific landscape to the needs of clinical medicine. Bedside observations had become increasingly important to medical study and diagnosis in the second half of the eighteenth century.12 The ‘practical’ work performed by surgeons, in turn, gained a new significance, obscuring the traditional division between academic physicians and surgical craftsmen, and creating the need to share observations – a need medical societies could meet. Early attempts to found

18

Medical societies and scientific culture

such societies in the Southern Netherlands, however, were blocked by the Habsburg authorities. In 1776, a group of Ghent physicians, surgeons and apothecaries had founded the Literary Society of Medicine Nobis et Aliis and requested governmental recognition and the right to publish transactions. Despite positive advice, the government declined the request to preserve the scientific monopoly of the Brussels Academy.13 This Habsburg policy was continued in governmental responses to similar initiatives such as the Free Association for Humanity in Brussels in 1780, of which the members conducted medical experiments with electricity, and the project to found an Academy of Surgery in that same city in 1786. A year earlier, a plan by the Leuven professors of medicine to set up a network of regional scientific societies under the supervision of the university had equally been rejected.14 In neighbouring regions, new medical associations did emerge. In France and in the Dutch Republic medical societies emerged that followed the eighteenth-century academy model.15 Through a network of correspondents, the Royal Society of Public Health (1776) and the Academy of Surgery (1731) in Paris, and the Dutch Natural and Medical Correspondence Society (1779) in The Hague gathered medical, surgical and meteorological observations from across the country. These societies maintained close ties with the ruling elite, who provided financial support, and were fully embedded in the social fabric of the Ancien Régime.16 Besides such ‘learned’ medical societies, student societies and reading groups were developed in the Dutch Republic and in Britain (in France, they seem to have developed only later).17 In these societies, a less state-directed and utilitarian, and more humanistic scientific tradition took root, which focused on the self-improvement of their members. One of the earliest of these new societies was the Medical Society of Edinburgh (1734), which organized debates for medical students to train their ‘critical spirit’ and supplemented university education by discussing clinical cases.18 Such student societies functioned as meeting places for aspiring physicians and surgeons who sought further anatomical and clinical training.19 The absence of such societies in the Southern Netherlands meant that the revolutionary period, more than in neighboring regions, formed a clear break in the development of the medical field. In 1792, and again in 1794, French troops invaded the Southern Netherlands and the Prince-Bishopric of Liège, annexing the region to the French empire

Sociability and medical reform

19

– a situation that lasted until 1815. Under French rule, established institutions such as the Brussels Academy, the University of Leuven and the collegia medica were abolished and replaced by the French system of medical education and medical practice. This system included a distinction between two medical orders: the doctors of medicine and surgery, who obtained their separate academic degrees at the university, and the health officers (officiers de santé), a type of general practitioner, who were trained in private medical schools.20 The latter combined ‘internal’ and ‘external’ medicine, effectively bridging the gap between medicine and surgery. While private medical schools emerged in the Southern Netherlands under French rule, no academic medical training was offered after the abolition of the University of Leuven.21 At the same time, the Austrian reserve vis-à-vis private medical sociability was replaced by a more encouraging policy of the French departmental prefects. Societies of medical students now emerged. In Brussels, the students of Professor Pierre-Etienne Kok founded the Society of Emulation Sano et Aegro, which they described as a means ‘to assemble and to give their studies the necessary attitude.’22 They also applied for a meeting room in the city’s central school at the old court of Charles of Lorraine, which possessed an extensive library.23 In Antwerp, a similar medical society was set up in 1806 by the medical students in the St. Elisabeth Hospital, who aimed ‘to accelerate their progress in the healing arts.’24 Before granting them permission to meet, the Antwerp mayor asked to receive the society’s rulebook, a list of its members and information on the frequency and location of its meetings.25 If medical societies were now approached more willingly, they nevertheless remained under government control. Besides these student clubs, societies aiming for more experienced physicians emerged in the major cities. As Karel Velle has documented, between 1795 and 1815 such medical societies were founded in Brussels (1795; 1804), Antwerp (1796; 1804), Mons (1797), Ghent (1797; 1800; 1812), Liège (1807) and Tournai (1812).26 These societies were able to realize what had not been possible under Habsburg rule: they applied the organizational model of the learned society to the medical field. Similar to eighteenth-century societies, the Society of Medicine, Surgery and Pharmacy of Brussels (1795) distinguished between resident members and (foreign) correspondents.27 Its board – a president, two secretaries (one French-speaking and one Dutch-speaking), a

20

Medical societies and scientific culture

treasurer and an inspector – were elected from the group of resident members. The society met weekly, held an annual public meeting and published transactions.28 Its successor, the Medical Society of Brussels (1804) expanded the board by installing a committee, which would judge new studies, and established an additional class of honorary members, ‘recommendable for their talents, knowledge and morality.’29 In 1807, this committee was split up into special commissions for each new study and an editorial committee. The function of librarian was also added, relieving the secretary of one of his former tasks.30 Most later nineteenth-century medical societies divised tasks similarly. Presidents took on formal roles (e.g. leading debates); secretaries made practical arrangements and conducted the society’s correspondence; the most active members participated in editorial committees. Another feature taken over from learned societies was the rigid admission procedures. To become a member, one had to anonymously submit a treatise (a mémoire); in Antwerp, this could also be a less elaborate study (an observation). Only if the society approved of the study, was the candidate admitted. While the demand for anonymity later became reserved for prize competitions, the tradition of submitting a manuscript continued to serve as an ‘entrance exam’ for aspiring members. Admission by majority vote, on the basis of one’s scientific reputation, formed a second, more direct route to membership. Such a procedure was adopted by the Medical Society of Brussels in 1804, but again abandoned in 1807. Most medical societies in the 1830s would include this system in their rulebook as either a direct route to membership (Antwerp) or as a complement to the judging of a submitted study (Ghent and Brussels).31 Once a member, further obligations were imposed. Apart from the once-only entrance fee, an annual contribution was demanded, which could be recovered through a system of attendance tokens distributed during each meeting.32 More importantly, each member had to present at least one new study every year – a rule that was, however, rarely put into practice. Few members were able to maintain such a frequency. The members of these earliest societies belonged to the medical elite. Compared to the medical men who had participated in the Imperial Academy of Science and Belles-Lettres or the Society of Emulation, surgeons were now better represented. They too belonged to the top of the profession, governing civil and military hospitals.33 A second group

Sociability and medical reform

21

were the professors who taught at private medical schools. They took up functions as board members: Dominicus Leroy was the first president of the Society for the Improvement of Medicine and Surgery (1796) in Antwerp; Pierre-Etienne Kok was the Flemish-speaking secretary of a similar society in Brussels; and Joseph-François Kluyskens, who taught surgery in Ghent, was secretary of the Medical Society of Ghent (1800), later becoming the perpetual secretary of its successor, the Medico-Surgical Society of Ghent (1812).34 The elitist membership of these societies also helps to explain their philanthropic activities. Besides publishing transactions every few years, which mostly compiled the submissions to prize competitions, society members offered free consultations to the urban poor. The members of the medical societies in Brussels (1795) and Ghent (1812), for example, ran a biweekly consultation service.35 Such charitable activities testify to the affluent status of most society members, who had the time and means to devote themselves to philanthropy – an essential element of their public image. As Michael Brown has shown for York at the turn of the nineteenth century, philanthropy was part of a wider culture of ‘medico-gentility,’ a concept with which he indicated elite physicians’ participation in a social landscape ‘shaped by the values of gentility, polite sociability and civic belonging.’36 Medical societies facilitated such civil participation, allowing their members not only to engage in philanthropy, but also to display these charitable efforts to urban society. Civil display also drove the propagation of one of the most talkedabout medical innovations of the turn of the century: smallpox vaccination. As the news of the vaccine reached the Southern Netherlands in the early 1800s, it was the founding members of medical societies who promoted the method and organized vaccination services.37 In Ghent and Brussels, Joseph-François Kluyskens and François Fournier published a popularizing treatise on the topic.38 In Liège, four of the six board members of the Free Society of Physics and Medicine (1807) were also part of the city’s vaccination committee.39 Besides such interpersonal ties, medical societies also took the initiative to promote the method. The Medical Society of Ghent published a pamphlet in favor of vaccination against smallpox in 1802.40 In their call to the public, the society members targeted ‘the denigrations and nonsense of a few, little enlightened people’ on the nature of vaccination.41 Driven by motives of ‘humanity and public wellbeing,’ they hoped to convince the fathers

22

Medical societies and scientific culture

of a household (playing into their parental responsibility) of the benefits of vaccination and put it at the disposal of all classes of citizens. They therefore invited ‘the indigent people’ to receive free vaccination every Tuesday between 5 and 6 o’clock in their meeting room in the town hall of Ghent.42 Political patronage added to the success of such initiatives. The mayor of Ghent acted as a patron to the Medico-Surgical Society of Ghent (1812) and the French prefects supported the foundation of the medical societies in Brussels and Antwerp. Collaboration between societies and government officials became most clear in the nascent domain of public health, a traditional area of state interest in the medical field. The Medical Society of Brussels planned to compose a medical topography of the city, a work which comprised charting the geological and meteorological circumstances and their relation to diseases in the area.43 More importantly, the society also acted as an advisory institution to the French authorities. In 1802, the prefect Doulcet de Pontécoulant asked the society to investigate the hygienic conditions in the prison of Vilvoorde. Soon after, the mayor of Brussels, Charles Guillaume de Mérode, asked for its expert opinion on the quality of the water distributed by a new company and on a new bathhouse in the city.44 These close ties between medical societies and the authorities also had drawbacks. They made these societies subject to the (cultural) politics of the French departmental prefects, who were eager to exercice control in politically turbulent times. The promotion of the French language was part of such politics. In Antwerp, this most clearly became a matter of dispute. In the final years of the eighteenth century, the Society for the Improvement of Medicine and Surgery had published several volumes of transactions in Dutch, claiming there was ‘no need to be ashamed of one’s language’ and referring to the publications of learned societies in the Dutch Republic.45 In 1801, this publishing tradition came to an end, as the Antwerp society was forced to merge with the Society of Emulation of Antwerp, a broader society founded by the prefect d’Herbouville. In 1806, the Medico-Latin Literary Society of Antwerp was founded, which organized debates in Latin (possibly to get round the French language politics). The new society met every Wednesday in the tavern Grand Miroir in Antwerp.46 In Liège as well, the Free Society of Physics and Medicine, whose members were closely involved in public health and medical education, was integrated in an

Sociability and medical reform

23

over-arching structure. Here, the French prefect opted for one encyclopedic learned society under his governance by re-founding the Society of Emulation in 1809, into which the Free Society was integrated.47 These forced mergers illustrate the continued political control that was exerciced on scientific sociability. Even though the earliest medical societies created a new disciplinary space for medicine, perhaps this was why Broeckx showed little sympathy for them in his overview of 1841. In revolutionary years, he concluded, the spirit of association ‘had not sprouted strong roots.’48 The elitist members of medical societies seemed indeed difficult to reconcile with Broeckx’ vision of an ever expanding participation of physicians to medical associations. The political turmoil of the period around 1800 was another important factor. The rapidly changing political circumstances, and the shifting public health policies that accompanied them, did not form a stable basis for the activities of medical societies. Scientific engagement

After Napoleon’s defeat near Waterloo in 1815, the Southern Netherlands and the Prince-Bishopric of Liège were joined together with the former Dutch Republic, creating a new buffer state – the United Kingdom of the Netherlands, ruled by William I – against French aggression. The union lasted until the Belgian Revolution of 1830. It was a period of intense reform, during which a new balance had to be found between restoration and innovation in many social areas, including the medical field. These reforms reached well into into the first two decades of the new state of Belgium. Older institutions such as the universities and academies were now restored – the Brussels Academy was re-established by King William I in 1816 – but, at the same time, the innovations of the revolutionary period were not completely undone. In an atmosphere of liberalism, certainly after the Belgian Revolution, a civil society emerged that was grounded in civil liberties, including the right to organize education, to found associations and to publish without censorship.49 Reforms occurred in the first place on the level of medical practice and education. In 1817, three state universities (in Ghent, Leuven and Liège) were created, which offered academic degrees in medicine, surgery and obstetrics. The Law on the Medical Profession of 1818

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Medical societies and scientific culture

maintained the French system of two medical classes, but the second class – the former officiers de santé – became more focused on surgical practice. Private medical schools continued to train this second class of rural surgeons who could only practice ‘internal’ medicine, a privilege for academically educated doctors, in case of emergency.50 Provincial and local medical commissions were to investigate medical malpractice, to license non-academic medical practitioners, and to take measures in case of epidemics.51 In 1835, the second class of medical men was abolished and a central jury was installed that issued degrees to all medical students. The jury was part of a political compromise that sought to regulate a changing academic landscape. The two state universities in Ghent and Liège (the state university of Leuven disappeared) had been supplemented with two newly founded private and ideologically opposed universities: the Catholic University of Leuven and the Free University of Brussels.52 A central jury allowed the state some supervision of the medical profession without interfering with the right to organize education freely. The system reflected the difficulties of organizing state control in the young Belgian nation-state, which depended on an alliance between liberals and Catholics. Both parties had supported the revolution of 1830 against William I, whose policies were regarded as too authoritarian and excluded an upcoming bourgeoisie from power. The right to freely organize education became a cornerstone of the new Belgian state.53 In 1849, well before The Netherlands (1865) and the United Kingdom (1886), the unified academic degree of Doctor of Medicine, Surgery and Obstetrics was introduced, joining together ‘external’ and ‘internal’ medicine after half a century of intense debate.54 Medical sociability as well was subject to further reform. In the debate on the successive medical laws, which created a certain esprit de corps among physicians, the model of the learned society was discussed as a tool to develop Belgian medicine.55 As the center of a network, it was regarded a means to spread medical knowledge and incite physicians to share their findings. Science, in other words, stimulated cooperation between physicians and thus strengthened professional cohesion and fraternity, while at the same advancing the progress of the healing arts. It is tempting to read a strong longing for interest-based union into these early nineteenth-century reform proposals. Yet the potential of sociability to assemble large groups and lobby government officials, as

Sociability and medical reform

25

would be realized in the mid-nineteenth century by nationwide organizations such as the Belgian Medical Federation (1863), was in fact not strongly emphasized. Societies were rather seen as tools of ‘improvement,’ building on the eighteenth-century tradition of émulation. The practice of science and devotion to the profession were thus not regarded at all as different activities. Inspiration for these views came from France. Medical societies in Paris were said, together with the clinical education in the city, to contribute to the established reputation of the Parisian medical world.56 Among these were societies of medical students, but also the Medical Society of Paris, in which the members of the Parisian medical faculty participated, and the state-sponsored French Academy of Medicine.57 For Belgian advocates of medical reform, such as Dominique Delahaye, Parisian medicine offered an organizational model worthy of following. In 1821, he pleaded for the foundation of a central university in Brussels, after the example of Paris, to improve medical education.58 This university, he argued, would enable the foundation of a medical society since the examples of London, Paris and Edinburgh had shown that the most renowned societies flourished in cities where medical education was offered.59 Even more important is that Delahaye designated a new audience for medical societies, in addition to the medical elite. Societies, in his view, should be oriented to private practitioners and inform them of scientific developments, relieving these practitioners of having to browse through the medical literature themselves. In his reform proposal, he stressed that ‘by gathering the discoveries made by us, and by making use of those made elsewhere, such a society could keep up with science, and liberate us from the mass of books and miscellanea.’60 Such views were later echoed in a presidential address by J. Jacques in the Medical Society of Antwerp (1834). Jacques claimed that the society ‘could replace the reading matter of the busy practitioner, who, in attending its biweekly meetings, could acquire or maintain his erudition.’61 Even more clearly than Delahaye, Jacques thus aimed for an audience of occupied private practitioners seeking assistance. The Brussels physician Pierre-Josse Van Esschen, another reformer and a founding member of the Society of Medical and Natural Sciences of Brussels (1822), saw a more active role for societies in stimulating medical study. Van Esschen had obtained his medical degree at the

26

Medical societies and scientific culture

University of Ghent in 1828 and became professor at the University of Brussels in 1834. Two years later, he made the change-over to the Catholic University of Leuven.62 In 1831, he published a proposal for medical reform, in which he, similar to Delahaye ten years earlier, held up Parisian medicine as an example: If one, moreover, considers the extent to which being part of this mass of scientific societies [in Paris], which the government happily supports, is at the same time honorable and flattering, and the extent to which young people have to show themselves zealous to merit it, we stay convinced that this is more than sufficient to carry the love for work to its top, as well as the love for glory, which in this way becomes a guaranteed reward!63

For Van Esschen, the strength of medical societies lay in the prestige that went hand in hand with membership and scientific study, a prestige that had to be earned. In stressing these aspects, he reformulated an older ideal of stimulating competition – another element in the eighteenth-century tradition of émulation – as the driving force of science, but now with a new audience of young physicians in mind. The prospects voiced by reformers were soon put into practice. During the time of the United Kingdom of the Netherlands, new societies were established in Bruges (1815), Leuven (1821), Brussels (1822) and Antwerp (1824). This latter one, the Medical Reading Circle for the Extension of Knowledge, was somewhat atypical as it seems uniquely directed to the setting up and running of a library.64 After Belgian independence, again several new societies were founded in Ghent (1834), Antwerp (1834), Willebroeck (1836), Bruges (1838) and Malines (1840). The Society of Practical Medicine of the Province of Antwerp, founded in Willebroeck, deserves special attention as it was the first society of rural physicians in Belgium. In the 1840s, similar societies were founded in other provinces. While such initiatives were generally encouraged, the members of urban societies nevertheless regarded the ‘scientific isolation’ of rural physicians as one of the reasons of the ‘incontestable superiority of urban centers where all ideas are brought together and united, and where individual successes are advantageous to all.’65 In their view, a critical mass of medical practitioners was a prerequisite for well functioning societies, and such a mass could only be found in the cities.

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The medical societies founded after the Belgian Revolution differed from their predecessors in several ways. They formulated their mission differently, revealing a changed view on the nature of the medical sciences. At the turbulent turn of the century, when the Brussels academy and the University of Leuven had been abolished, societies had described their ambitions in terms of preserving a body of theoretical knowledge. The Medical Society of Brussels regarded itself as a place ‘where the scientific doctrines are preserved in their integrity,’ as a ‘sanctuary where knowledge was purified.’66 Such views were replaced with the idea that these sciences had become too theoretical. In the first issue of their Proceedings and Observations in 1834, the members of the Medical Society of Antwerp did not paint a very encouraging picture of Belgian medicine. A gap had emerged, they argued, between medicine’s ‘science’ and ‘art,’ between medical theory and medical practice – a gap that impeded the progress of the field and necessitated reform. What was needed, they advanced, was ‘a new science, [a science] of the art itself.’67 Philip Rieder has pointed to the rise of this practical, observation-based medicine (médecine pratique) in France in the second half of the eighteenth century. For Rieder, the success of ‘practical medicine’ went hand in hand with a shift in the codes of medical practice, from a literary and historical tradition of knowledge production in the Enlightenment to one grounded in one’s own observations and those of one’s colleagues, suggesting a central role for societies in the spreading of this ideal.68 In the Medical Society of Ghent, such collaboration was certainly stressed. In his opening speech in 1834, Charles-Auguste Van Coetsem emphasized the need for a ‘practical’ science, which would allow physicians, by engaging in medical societies, ‘to pay their share, to take an active part’ in medical progress.69 Together with societies’ ambition to recruit members among private practitioners, a view of scientific progress emerged that seemed more open to participation. As Jacques explained at the Antwerp society, ‘every member brings his tribute to science, and contributes to the formation of a collection of enlightenments, that belongs to all of us, but is no one’s property.’70 This new science was to be established collectively. A second difference between ‘Belgian’ medical societies and their predecessors lies in their networks and mode of communication. After the Belgian Revolution, French became the official language of government administration. The medical world soon followed: Flemish

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disappeared in the medical literature.71 At the same time, the intellectual ties with the Netherlands were cut. Only from the 1840s onwards, after the Treaty of London of 1839, in which Belgium’s independence was officially recognized, were these ties gradually restored. In his report of a journey to the Netherlands in 1842, the Ghent physician Joseph Guislain deplored the lost scientific contacts between the physicians on both sides of the political border, but also recounted that Dutch works were now seeping through to Belgium.72 Shortly after, the members of the Medical Society of Ghent started corresponding with the Rotterdam physician Georges Groshans, assuring him that the society ‘continued to regard [the Dutch physicians] as brothers, even though political events have separated us.’73 In another revealing letter, the society explained the reasons for publishing in French to Groshans: That we write in French must in no way be attributed to a disdain for Flemish or Low German [Dutch] that we hold dear as our mother tongue. It is a compelling necessity, which has forced us to use the French language in our scientific writings. If we would write in Flemish, our writings would in our own country, where half of the population speaks and writes French, only rarely or not at all be read. They would not reach beyond the borders of Flanders.74

The choice for French, according to the Ghent physicians, was thus inspired by the ambition to reach a wider medical audience in Belgium (and undoubtedly also in France). The choice of words, such as ‘hold dear’ and ‘forced,’ moreover, indicates that a certain will to promote the Flemish language remained present among the Ghent physicians. Such emancipatory motives, however, would not occur in the medical, but in the literary societies that emerged in the major cities in the 1830s, and in which physicians such as Auguste Snellaert also participated.75 The revaluation of Dutch as a scientific language would only occur in the twentieth century.76 A new membership

The reformers of the 1820s and 1830s thus aimed for democratization. They envisioned a new audience of private practitioners for medical societies. From the middle of the 1830s, the number of members of the medical societies of Antwerp, Ghent and Brussels gradually increased.

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By 1840, the Medical Society of Ghent and Society of Medical and Natural Sciences of Brussels comprised a little over thirty resident members. The Medical Society of Antwerp, which counted twenty-two members at the time, was slightly smaller.77 Yet these numbers reveal little about the profile of these members. To what extent did societies succeed in recruiting private practitioners? Were they able to keep them up to date on the medical literature and provide them with publication space? Answering these questions requires a more detailed look at the founding generation and early activities of urban medical societies. The twelve founding members of the Medical Society of Antwerp tellingly presented themselves as ‘the young physicians of the city.’78 By 1841, in addition to its twenty-two resident members, the society counted seventy-two correspondents. A third of the resident members were private practitioners. Little under another third were military physicians, who were employed at the city’s military hospital or supervised the health conditions of the battalions and regiments that were quartered in the city. The assistant-physicians and surgeons who worked in the city’s hospitals, such as the St. Elisabeth Hospital, formed a third group. They comprised a fifth of all society members. Apothecaries formed a final group, equal in size to the hospital physicians. Their presence among the members of medical societies, however, gradually diminished from the 1840s onward – an evolution that paralleled the foundation of pharmaceutical societies in Antwerp (1836), Liège (1842) and Brussels (1846).79 A comparison with the Society of Sciences, Letters and Arts of Antwerp, also founded in 1834, helps bring out the particularities of the membership and activities of the Medical Society of Antwerp. The members of the Society of Sciences, Letters and Arts were of higher social standing and had more diverse professional backgrounds. Among its nineteen founding members were politicians, lawyers, teachers and also six physicians. Nearly all members occupied high positions as parliamentarians and mayors, or as directors of tribunals or museums. This was also the case for the physicians among the society members: Joseph-Romain-Louis De Kerckhove, who had taken the initiative to start the society, was a former physician in chief of the military hospitals; Henri-Prosper Gouzée was the head of the military hospital of Antwerp; J.-B. Van Vaerenbergh was the president of the medical commission of the city, of which another society member, F.J. Hanegraeff,

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was also a member; P.-J. Lambrechts, mayor of Hoboken, was the president of the provincial medical commission, of which society members Van Vaerenbergh and J.-B. Celarier were also part.80 These established physicians, unlike their colleagues in the Medical Society of Antwerp, stood at the top of their career and were much more embedded in the state’s public health infrastructure. In terms of membership profile, the Society of Sciences thus resembled the ‘elitist’ medical societies of the French period. These differences in the membership were paralleled by a different set of ambitions. The Medical Society of Antwerp focused on the needs of the young Belgian physicians. As president Jacques declared, ‘the young practitioner will find in our Society a friend that he may consult without fear on the difficult cases he encounters in his practice, a protector against slander and consolation against the ingratitude of fortune.’81 Jacques, in addition, described the mission of medical societies also as being ‘the mentor of those who feel up to the difficult and perilous career of the writer.’82 The Society of Sciences, Letters and Arts, in turn, aimed for public profiling. Its inaugural meeting was opened by a speech of the Antwerp mayor Gérard Legrelle, which was reported in both the medical and literary press.83 As Legrelle explained, the goal of the society was ‘to cultivate and encourage the sciences, letters and arts’ and to offer the liberal professions in the city a ‘common center of knowledge and efforts.’84 De Kerckhove further explained that such a society was destined ‘to propagate the love for instruction to our fellow citizens.’85 To this end, the society planned to organize free lessons in science, musical meetings, artistic and industrial exhibitions, and a physical and mineralogical cabinet, which would be open to the public.86 Yet the results obtained by both societies differed greatly. In the first decade of its existence, the Medical Society of Antwerp succeeded in setting up a library, which by 1845 included volumes of 74 periodicals, mostly published in France and Germany, and 392 monographs, which covered subjects ranging from anatomy to venereal diseases.87 At the same time, the society offered publication space to its members. In 1836, the first volume of its Mémoires et observations appeared and from 1837 to 1840 several studies were published in two Brussels-based journals, the Bulletin médical belge and the Archives de la médecine belge. In 1840, the society started its own monthly periodical, the Annales de la Société de Médecine d’Anvers.88

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Whereas the Medical Society of Antwerp established a rich library and started up its own medical journal, it seems that far less became of the grand ambitions of the Society of Sciences, Letters and Arts. It mostly directed its attention to one prestigious project, erecting a statue to the painter Peter Paul Rubens in the city. Finalized in 1844, this project entailed considerable financial difficulties, which led to the dissolution of the society in the same year.89 Contrasting grand ambitions with limited results, contemporary observers were critical of the society. Broeckx spoke of a somewhat failed institution: ‘the meetings […] were sporadic and during those rare meetings medicine was seldom discussed. Despite an existence of six years, […] the society has not published anything yet.’90 Other contemporary observers drew similar conclusions. In 1853, the same society was discussed by the urban historians François-Henri Mertens, himself a founding member of the society, and Louis Torfs, in their history of Antwerp: ‘it comprised too many things at once and exhausted itself, in fulfilling the noble task […] of honoring the prince of the old Flemish School [Rubens] with a statue.’91 The same authors wrote about the Medical Society of Antwerp: ‘In a few years, the Society expanded greatly […], saw the number of residing, corresponding and honorary members increase significantly and was thus enabled to start […] its own periodical and annually award medals to the writers of the best medical studies, which were subsequently published.’92 The judgments of Broeckx, Mertens and Torfs reveal that the model of the encyclopedic learned society was deemed insufficient, by the middle of the nineteenth century, to advance the medical sciences. Disciplinary-based societies were regarded more suited to this end. The development of the Medical Society of Ghent (1834) followed a somewhat different trajectory. The presence of a university in the city (the state university of Ghent had been founded in 1817) stimulated the cooperation between established and younger physicians. A look at the society’s membership in 1840 reveals that university professors formed the second largest (22%) and oldest group of resident members. Several of them took up functions as board members. Joseph Guislain, aged 37, and Charles-Auguste Van Coetsem, aged 46, became the society’s directors (the third director was the 53-year-old military physician Ferdinand Colson). Besides these professors, the surgeon Joseph-François Kluyskens, a former member of the older Medical Society of Ghent

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(1800) and the Medico-Surgical Society of Ghent (1812) also joined. The majority of the members were much younger than these academics. Most of them had obtained their medical degree in the late 1820s and 1830s at the University of Ghent. These younger physicians can be divided into several professional groups, comparable to those of the Antwerp society: private practitioners comprised 38% of all society members, while the hospital physicians (19%), apothecaries (12%) and military physicians (9%) formed smaller groups. From their ranks too, board members were recruited, but for the positions of secretary, the two adjunct-secretaries and librarian of the society. The success of the Medical Society of Ghent thus relied mostly on the continued interaction between university professors and their former students. Professors’ international contacts, moreover, proved helpful in setting up the society’s library. Through a system of exchanging journals between societies, and common practices of donating new books as a means of publicity, the library soon became one of the most extensive medical collections in the 1830s.93 A certain elitism nevertheless did remain part of medical sociability in this period. In Brussels, the presence of the Free University of Brussels in the city did not lead to a mixed membership of professors and their former students in the Society of Medical and Natural Sciences. The society pursued a more exclusive membership policy. Broeckx, in this light, made a revealing remark. While his judgment of the Brussels society was generally positive, praising, for example, the article in the society’s rulebook that obliged each member to present at least one work every year, he also regretted that ‘in a city like Brussels the society only allows fifteen members.’94 In Broeckx’ view, ‘the more numerous similar associations would be, the more their divergence of opinion would shed light on the subjects of their deliberations.’95 The Brussels physicians, on the other hand, explained their membership restrictions, in a letter to the urban government, as a means ‘to consolidate our undertaking and prevent the disorder that would necessarily result from the all too easy admission of numerous members to this type of meetings.’96 Their policy shows that not all the medical institutions of the 1820s and 1830s fit in with Broeckx’ narrative of an expanding ‘spirit of association’. In Brussels, exclusivity remained an important part of the urban medical world.

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Who then became part of this exclusive group? With an average age of 26 in 1822, the twelve founding members had formed a relatively young group. Older, more established medical men were nevertheless brought in as honorary members, including the botanist Jean Kickx and the physician Antoine-François Curtet.97 The Viscount Dubus de Gisignies, governor of the province of Brabant, became the honorary president of the society, continuing a tradition of political patronage. In the course of the 1830s, the restrictive membership policy set at the society’s foundation in 1822 was loosened and additional members were admitted. In the new rulebook of 1841, the maximum number of society members was brought to thirty.98 As a result, the same professional groups as in Ghent were present in the Brussels society in the early 1840s: a little under half were private practitioners (45%), a third were university professors (29%), and the military physicians (13%) and their colleagues of the urban hospitals (10%) each composed a tenth of the members. Apothecaries were largely absent, except for Kickx and Gaspard-Francois Leroy, who was both a physician and an apothecary. All of these members occupied leading positions, either in the military health service, such as Louis Seutin and Jean-François Vleminckx, at the university or as editors in the Brussels medical press. In sum, the Society of Medical and Natural Sciences of Brussels, more than its counterparts in Ghent and Antwerp, was above all a meeting place for the urban medical elite.99 Science and the city

Elitism was not the only element of continuity between the first generation of medical societies and their successors in the 1830s. A tradition of public usefulness was equally continued. Such public service contributed to the favorable reception of medical societies in the local press. In 1834, the Gazette van Gend announced the creation of the Medical Society of Ghent with great enthusiasm: Our city has been enriched with an institution, which the most important cities already possessed and of which Ghent was in need for a long time, that is with a Medical Society, which will have to publish Transactions every year and which will grant a great prize every two years to the writer of the best response to the prize contest it will hold, and in which

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also foreign physicians will be allowed to compete. In addition, this Society will offer gratuitous consultations to the indigent three times every week.100

The author of the article, and possibly its readers as well, regarded medical societies as useful institutions. A certain prestige seems involved with scientific societies, their presence being a testimony to the importance of the city of Ghent. The announcement also highlighted the organization of free consultations, which testify to a form of philanthropy and social engagement that had been part of medical sociability since the late eighteenth century. Such philanthropy took place in a new context. Among an expanding range of civil societies in the 1830s, and in relation to an urban government far less keen on controlling or directing such initiatives than in the past, medical societies had to rethink their public role in the city.101 Yet the importance of public initiatives among the range of activities in which medical societies engaged, diminished. Their new audience of private practitioners was less affluent – the ability to invest one’s time in unpaid medical services was limited to the medical elite. They were also much less interested in the public display of citizenship, which has been the driving force behind the social initiatives (e.g. vaccination) taken by the earliest societies. By the 1830s, the combination of scientific and philanthropic activities had, in fact, become rather unusual. In setting up a service of free medical consultations, the Medical Society of Ghent was an exception in the Belgian scientific landscape. Broeckx only briefly mentioned the society’s philanthropic activities, remarking that its goal was ‘not uniquely scientific.’102 Van Coetsem, one of its presidents, also defined the particularity of the institution in this way. Addressing his colleagues at the inaugural meeting, he argued ‘few Medical Societies, founded in Europe, combine and try to achieve the double goal, of both science and philanthropy, that you have taken as the raison d’être of the one you have just founded.’103 Apart from the Ghent society, only the Medical Society of Leuven (1821) ran a vaccination office and had provided free medical consultations to the indigent during the 1820s. By 1830, however, the Leuven society seems to have ceased to exist.104 A system of urban health care may have replaced, to a certain extent, such initiatives. Medical commissions, offices of poor relief and official

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vaccination committees formed an infrastructure with which new philanthropic initiatives had to fit in. The Medical Society of Ghent, for example, requested permission from the Commission of Hospitals – a body that governed the public medical institutions in the city – to use the same room at the St. Jean Hospital for their free consultations as was used by the vaccination committee. In their request they stressed the type of patients their service would attract: ‘those persons belonging to the indigent classes, who are not recognized as such, and who do not receive any help from the office for poor relief.’105 By treating these people in good time, the Ghent physicians argued, they could get back to work – an argument that was later used to claim that their free consultations entailed important economies for the city.106 In 1843, the service moved to two rooms in the main guardhouse of the fire brigade on the Grand Place in the city center.107 The new location led to a considerable increase in the annual number of consultations, which exceeded 1600 in 1847.108 At the same time, many other urban clubs were engaged in philanthropy. In 1845, the society cooperated with L’Union, a Ghent club that was setting up a charitable project to which all urban associations could contribute.109 Many members of the Medical Society of Ghent were also part of La Concorde, a gentleman’s club on the Kouter in the city center. Although its main activities were providing members with a place to meet and read their newspapers, and organizing balls and banquets every now and then, La Concorde also conducted philanthropic activities by distributing bread and potatoes to Ghent’s population of workers.110 The participation of the members of the Medical Society of Ghent in this urban philanthropic network is also revealing of their social status – philanthropy, in fact, required a considerable investment of time and financial means. At least some members apparently were able to afford such philanthropic engagement. Others did not have such luxury; a request for subsidies to the urban government was substantiated with the claim that ‘not all [society members were] favored by fortune.’111 The urban authorities often responded positively to such requests. From the early 1820s, policies of surveillance were gradually replaced by a much more encouraging program of subsidies for the advancement of the sciences, which were allocated by the urban, provincial and central government. Between 1822 and 1844, the Society of Medical

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and Natural Sciences of Brussels was able to secure a steady stream of subsidies. In many cases, the urban government acted as the society’s promoter by advising the provincial governor to allocate a subsidy. In 1829, its importance was said to lie in the presence of ‘the most renowned professors of our universities’ – science thus brought a certain prestige to the city – but reference was also made to the edition of the Brussels pharmacopeia, which was said to have formed ‘a great source of economies’ for the city’s office for poor relief.112 In 1832, at a time when the cholera epidemic had struck Paris, the Brussels authorities argued that ‘the terrible epidemic that overwhelms the capital of France would perhaps be less murderous, if for a longer time already learned societies, all called to do research into new, useful techniques in medicine, would have communicated their doubts and discoveries to each other.’113 In 1840, the public health investigations of the society were mentioned as ‘grand services regarding the sanitary state of the country.’114 The society’s usefulness was thus associated with its inquiries in public health, in addition to a certain prestige connected to its presence in the city. In Ghent as well, the urban government supported the city’s medical society financially. In 1836, the society members explained their financial needs to the urban government: ‘the costs of first-time furnishing, the renting of a large room to hold meetings, the allowances of the directors, the sums allocated to the annual prizes, the publishing of the Annales and the Bulletin […] all these things entail exorbitant expenses.’115 The society’s service of free consultations, in this light, formed an important aspect in their claim for government support. Already in their first subsidy request, the society members had emphasized their ‘dedication to the public well-being.’116 Particularly in the 1840s, as the number of consultations expanded because of the relocation of its consultation room to the city center, the society eagerly reported these rising numbers to the urban authorities: 1200 consultations were conducted in 1844, and by 1848, the ‘enormous number’ of 1800 had been reached.117 Such figures supported the claim that ‘through its medical work, it [the Medical Society of Ghent] has given the City of Ghent a particularly humanitarian character.’118 Government support also helped to find a suitable meeting room. In Ghent, the Medico-Surgical Society (1812) had met in the city’s medical school on the Korenmarkt.119 Its successor, the Medical Society of Ghent, succeeded in obtaining a room in the Ghent town hall at least

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in 1843, when the Pavillion room was assigned to the society.120 In 1847, the society members moved to a room on the second floor of the Conciergerie, the north-west part of the town hall on the corner of the Hoogpoort and the Stadhuissteeg, where the music school was also housed.121 In Brussels, the older Medical Society (1804), which was briefly restarted in 1827, had similarly been granted a room in the town hall, which it had to share with the general learned society Tot ‘t nut van ‘t algemeen.122 The initial meeting place of the Society of Medical and Natural Sciences of Brussels remains unclear. But certainly from the middle of the century, it met in the Antichambre du Bourgmestre, a room in the Brussels town hall, until 1879 when the society moved to rooms provided by the University of Brussels.123

1  The Antichambre du Bourgmestre, a room in the Brussels town hall where the Society of Medical and Natural Sciences of Brussels met in the late nineteenth century.

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Towards a national academy

Besides support at the local level, in the form of subsidies and meeting rooms, the state’s interest in the sciences was visible most clearly at the national level. Belgium’s science policy in the 1830s and 1840s consisted of evoking a certain national pride and awareness. This meant finding a balance between French and German influences in managing the state universities, for example in academic appointments. It also required investing in national institutions such as the Brussels Academy of Sciences, Letters and Fine Acts (1845), the successor of the Academy of Sciences and Belles-Lettres.124 In the medical field, state authorities combined an interest in public health with the need for national prestige. Such state involvement, however, was not uncontested. As in other policy areas of the young liberal state (e.g. education), a balance had to be found between private initiative and state intervention, and between the capital city of Brussels and the different provinces. The question of how physicians from different cities and provinces were to cooperate to advance a truly ‘Belgian’ medicine was addressed in urban societies as well. This eventually led to the creation of the Royal Academy of Medicine of Belgium in 1841. The first attempt at organizing the medical sciences on the national level was made by the Brussels physician Jean-Romualde Marinus. In 1835, he organized the first edition of the Medical Congress of Belgium, an annual meeting during which the Belgian physicians could discuss scientific questions. The model of periodical conferences was inspired by examples in France and Germany. In 1833, Marinus had praised, for example, the French Medical Society of Caen for having organized a ‘grand reunion of learned men of all classes.’125 In his opening speech at the Belgian congress, Marinus set out his vision of ‘a broad and liberal scientific association to which each could bring the fruits of his research and experience.’126 ‘Free from any narrow view of locality, corporation or clan,’ he continued, the Medical Congress of Belgium had to form ‘a center of emulation [émulation] and intellectual activity amidst the physicians of the kingdom.’127 The initiative, however, was no success. The first meeting was dominated by the Brussels physicians; their colleagues from the provincial cities were particularly underrepresented.128 Only one more event was organized in 1836. A multi-day national meeting, unlike the monthly meetings of urban societies, proved little

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suited to attracting medical practitioners from across the country. This was also Broeckx’ conclusion as he evaluated Marinus’ initiative. Broeckx doubted whether physicians could abandon their practices for an entire week to attend the meetings: ‘that would be demanding too great a sacrifice from these useful men.’129 The very model of the periodical conference seemed unfit for the type of close scientific interactions ‘between learned men and physicians’ that Broeckx and Marinus had in mind.130 During the meetings of the Medical Congress of Belgium, Jean-François Vleminckx, the director of the Belgian military health service, put forward the plan for a more successful national institution: a Belgian Academy of Medicine, which would be modelled on its French counterpart in Paris.131 The new institution was to serve a double purpose. On the one hand, it would advance the Belgian medical sciences by publishing transactions and organizing prize competitions. On the other hand, it would function as an advisory body for the Belgian government. In the run-up to its foundation in 1841, the future membership of the Academy generated considerable debate. The Antwerp physicians submitted a proposal in which they tried to curtail the influence of their Brussels colleagues.132 Their demarche was not without effect: university professors and top ranking physicians from the provincial cities were well-represented in the new institution.133 This turned the Belgian Academy of Medicine into a meeting place of the country’s medical elite. Advocates of the new Academy feared that the institution would be regarded as ‘old-fashioned’ (as an institution of the Ancien Régime), so they stressed its modern features. Unlike older academies, Salomon Laurrillard-Fallot emphasized at its inaugural meeting, the academy was a specialized institution, which had ‘the right to take initiative’.134 Academicians could choose freely which topics to debate, the subject of their examinations not being imposed by the state. Its representativeness of the Belgian medical community, the result of including scholars from outside of Brussels, was equally stressed, and such remarks were not only made by insiders. In an article in the French Gazette médicale de Paris, reported in the Belgian press, which praised the Belgian Academy, the presence of physicians from all over the country was applauded. This presence, it was stressed, was made possible by the country’s superb public transport system – as a rapidly industrializing

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nation, Belgium was indeed early to start building railways. ‘The network of railways, which connect the major Belgian cities to Brussels,’ the French author added, ‘has made these scientific centers into a single metropolis of science.’135 To French readers, it was an implicit critique on the French Academy of Medicine, which was heavily dominated by Parisian academics. In urban medical societies, the new Belgian Academy of Medicine failed to gain approval. Society members feared a negative impact on the tradition of voluntary scientific engagement in Belgium. Because of its elitist and centralized character, the new institution was said to restrict access to the medical sciences for a wider medical public. Such critique had already been part of medical debates in the 1830s. The Bulletin médical belge had, for example, taken a critical attitude towards state-directed institutions in a commentary on the foundation of the Institut historique (1834) in Paris. The new institute was described as ‘a free academy, which does not have the inconvenience of receiving its inspiration from the government in the nomination of its members.’ Other academies in Paris, however, ‘were under the influence of government power; […] their rulebooks, by limiting them to a certain number of members, leave out a multitude of men of merit, knowledge and diligence.’136 A similar critique was uttered during the first Medical Congress of Belgium. The Brussels physician Bourson, in a response to Vleminckx’ proposal to found an academy, had argued that ‘a free association has much more activity than is shown by state bodies, which fall asleep in their seats.’137 Bourson later quit the commission that studied the organization of the future Academy. After the foundation of the Academy, the ideals of a broadly conceived and open science continued to collide with the vision of a statedirected academy. In this context, we may understand an opinion piece published by the members of the Medical Society of Ghent, in which they informed their correspondents of the – in their eyes – regretful decision to found an Academy of Medicine in Brussels: the moral and intellectual future of the country lies in a dissemination of centers of civilization, and not in a concentration of scattered elements, detached from those [centers]; […] an academy, with its relation to the medical profession, was hardly desirable in Belgium; the [Ghent] Society has made an effort to prove that the Belgian physicians in particular have the duty of studying the medical constitution, which is

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different in almost all of our provinces, and that the entirely scientific, entirely spontaneous inspiration, which has been manifested in different localities since the formation of our medical societies, was such that it could lead directly to the intended goal, without it being necessary to make expensive attempts to form a scientific medical corps, endowed with considerable privileges, which only the grand nations have hitherto been able to sustain in the long run.138

In their critique, the Ghent physicians put forward a double argument in support of a decentralized organization of the medical sciences. The first part was rooted in the older medical notion of the constitutio epidemica, the idea that local climatic and geographical conditions determined the presence of specific diseases in a given region. The different conditions in each of the Belgian provinces supported a claim for more regional autonomy in the sciences. The second part of the argument pointed to the ‘spontaneity’ of local scientific organizations, which made expensive efforts to set up official structures unnecessary. This spontaneity was later contrasted with the ‘sterility’ of state institutions, as the Ghent physicians warned the new academicians that if they did not display diligence, they would soon become ‘a sterile representation of men who wait for others to work for them.’139 Voluntary engagement in the sciences, in the eyes of the Ghent physicians, seemed a much more suitable road to advance the sciences than working in state service. The Academy, moreover, was perceived by these provincial physicians as an all too ‘French’ institution, a powerful argument in the context of a young country seeking to affirm its right to exist by stressing its unique characteristics. In his travel reports, Joseph Guislain put this dominant orientation of Belgian medicine towards France into perspective. The geographical position of Belgium, he argued, facilitated a broader international orientation, which would certainly include England and Germany.140 Dutch physicians, he had noticed, were far better informed of the scientific developments in these countries than their Belgian colleagues. Furthermore, referring to similarities in the constitutio epidemica between the north of Belgium and the Netherlands, Guislain claimed that the Belgian physicians, ‘[who] run to Paris, and turn to Italy to study hospitals and diseases,’ should rather visit Holland, where diseases are treated in the same special circumstances.141 In 1841, Guislain also presented a draft letter to the society to protest

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against the suspension of German in the Latin classes at the Athenée, a secondary school in Ghent. Such a decision would prevent future physicians from following the scientific developments in Germany – a prospect Guislain denounced. ‘Belgian physicians,’ he added, ‘have an interest to establish close ties with Germany. […] Our medical traditions in Flanders are those of the physicians of the North, our sympathies lie with them.’142 In their opinion piece, the Ghent physicians similarly indicated the necessity of following the example of Germany: There, every city, every university, every school, possesses men of the greatest merit: it is that the dissemination of centers of intelligence is eminently useful to scientific progress, to the development of the individual genius. Well, compare Germany to France, which we have copied for the millionth time: France, or it is better to say, Paris, which has an academic center always derogatory to the departments and their men of science who it constantly attempts to crush; can France, we ask in good faith, serve as example for us?143

The necessity of organizing the Belgian medical sciences through a system of regionally based medical societies was thus not only grounded in its ‘spontaneity,’ or in the medical geography of Belgium; it was also legitimized by a wider northern European tradition of decentralized medical study. Such decentralization, in the eyes of the Ghent physicians, formed the best guarantee of exploiting all the present talents, and preventing the dominance of a small elite. Despite societies’ fears, the creation of the Academy did not lead to the downfall of urban societies. But it did affect their financing. In 1842, the governmental budget for the encouragement of the sciences dropped from 50,000 Fr to 44,000 Fr annually – a measure that seems related to the foundation of the Academy one year earlier. The Medical Society of Ghent was one of the victims of these economies. Its subsidy was halved to 1000 Fr. In Brussels as well, subsidies were allocated less easily. In a negative response to a subsidy request of the Society of Medical and Natural Sciences, the provincial council of Brabant explicitly mentioned that ‘the creation of the Royal Academy of Medicine had rendered its conservation [the Society] less important in light of the interests of the province.’144 This financial crisis, however, was of short duration. In the following years, the urban and provincial government continued to support the Brussels and Ghent Society. By the middle of the 1840s, Guislain, who had himself been appointed as a member of

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the Academy, spoke of reconciliation: ‘But time has already made clear that medical societies can exist and prosper outside of the circle of the new institution [the Academy]; perhaps it shall be proven one day that all of our medical associations are destined to render mutual services.’145 By the 1840s, a new scientific landscape had emerged in Belgium – a landscape of which urban medical societies, together with the newly founded universities, were regarded a permanent feature. These societies represented the longing for autonomy of the medical field vis-à-vis other scientific branches, which had previously been treated simultaneously in learned societies. Sociability, much more than in the late eighteenth century, was regarded as a tool to shape medicine, both as an independent scientific branch and as a profession. As spaces where medical practitioners could share knowledge and observations, medical societies – reformers argued – established a unique ‘Belgian’ medical community. The role of the state in such scientific exchange was subject to debate. The Belgian medical field was organized by balancing the centralist model of France with the decentralized traditions of the ‘physicians of the North’. A state-financed Royal Academy of Medicine of Belgium in the capital and private societies in the provincial cities co-existed. Broeckx’ historical narrative of an expanding ‘spirit of association’ of 1841 captured this enthusiasm for medical sociability. It echoed a shared belief in the potential of associations as tools for advancement. Written little over ten years after the Belgian Revolution of 1830, his narrative in many ways resembled the founding myth of the new nation. Long oppressed by foreign invaders, the profoundly liberal Belgian nation, according to this myth, had always been marked by a love of freedom and could hence only prosper when independence was finally achieved. Medical societies had similarly, in Broeckx’ view, started to flourish only after 1830, when foreign state control on science had ended and physicians could freely gather. The history of medical societies, in Broeckx’ mind, was therefore one of a slow run-up leading to a fast expansion. At the same time, an ideal of democratization underpinned this expansion. The success of urban medical societies, their number and membership increasing, also signaled the end of elitism in the medical sciences. Exclusivity was to disappear together with state control – both were regarded as impediments to scientific progress. It

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was a historical interpretation that aptly articulated the liberal ideals of societies’ founding generation. In practice, much less revolutionary shifts occurred. A tradition of elitism and state-directed scientific study continued, the Royal Academy of Medicine embodying this model in particular. But urban societies themselves also remained relatively exclusive: the positions of board members were still taken up by the medical elite, and with each having around thirty active members, these societies did not succeed at all in engaging the majority of Belgian medical practitioners. With hindsight, the reformers of the 1830s overestimated the potential of science as a tool for self-improvement and community building in the medical field. The full potential of medical associations to engage the rank and file of the profession would be achieved not through active scientific participation, but through a mixture of defending professional interests and postgraduate education, supplied by a major organization such as the Belgian Medical Federation (1863) in the second half of the century. If the membership of urban medical societies cannot be compared to that of future professional organizations, it nevertheless differed considerably from that of turn-of-the-century societies, which had been fully run by the medical elite. From the 1830s, societies recruited among the more ambitious private practitioners, expanding the scientific community considerably in this way. They reflected the growing influence of an urban bourgeoisie in the medical field, which had previously been regulated by state control on societies’ membership and policies of censorship. The cultural and political views of this urban bourgeoisie would transform – through the activities of medical societies – the practice of science in nineteenth-century medicine. The following chapters will explore different aspects of the ‘civil’ scientific culture that emerged in and around these urban medical societies, starting with the procedures of scientific debate. In the solemn rooms of the Belgian town halls, where medical societies held their meetings, a style of debate flourished that corresponded to the contemporary ideals of oratory and polite verbal exchanges. Notes 1 J.-C. Broeckx, Coup d’oeil sur les institutions médicales belges, depuis les dernières années du dix-huitième siècle, jusqu’à nos jours, suivi de la

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2 3 4 5 6

7

8

9

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bibliographie de cette époque (Brussels: Société Encyclographique des Sciences Médicales, 1841). Ibid., pp. 19–20, 32. This program has been well studied for the United States: J.H. Warner, Against the Spirit of System. The French Impulse in Nineteenth-Century American Medicine (Baltimore: Johns Hopkins University Press, 1998). R. Schepers, ‘Towards Unity and Autonomy: The Belgian Medical Profession in the Nineteenth Century,’ Medical History, 38 (1994), 237–54. On this latter institution, see: E. Bruyneel, De Hoge Gezondheidsraad (1849–2009): Schakel tussen wetenschap en volksgezondheid (Leuven: Peeters, 2009). Schepers, ‘Towards Unity,’ 247–51; C. Dickstein-Bernard, ‘Panorama de l’enseignement médical en Belgique au XIXe siècle (1795–1876),’ in C. Bruneel and P. Servais (eds), La formation du médecin: Des lumières au laboratoire (Louvain-la-Neuve: UCL, Faculté de philosophie et lettres, 1989), pp. 59–76; P. Dhondt, Un double compromis: Enjeux et débats relatifs à l’enseignement universitaire en Belgique au XIXe siècle (Ghent: Academia Press, 2011), 21–48, 225–37. On the role of societies in Belgian medical reform, see also: J. Vandendriessche, ‘Een stedelijke wetenschap. Medische genootschappen en de organisatie van de Belgische geneeskunde, 1800–1850,’ Handelingen der Koninklijke Zuid-Nederlandse Maatschappij voor Taal- en Letterkunde en Geschiedenis, 67 (2014), 95–111. Six of the thirty members of the Brussels Academy were physicians: C. Tilmans-Cabiaux, ‘De geneeskunde,’ in R. Halleux, C. Opsomer and J. Vandersmissen (eds), Geschiedenis van de wetenschappen in België van de Oudheid tot 1815 (Brussels: Dexia, 1998), pp. 365–79, 371–2. Twelve of the 155 members of the Society of Emulation of Liège were physicians, surgeons or apothecaries. See the membership lists in: D. Droixhe, La sociabilité des Lumières au banc d’épreuve: La Société d’Émulation de Liège de 1779 à 1815 (Liège: Groupe d’étude du dix-huitième siècle de l’Université de Liège, 2007–2011). C. Opsomer and R. Halleux, ‘Wetenschappelijke instellingen en netwerken,’ in R. Halleux, J. Vandersmissen, A. Despy-Meyer and G. Vanpaemel (eds), Geschiedenis van de wetenschappen in België, 1815–2000 (Brussels: Dexia, 2001), pp. 303–30, 318–20; J. Marx, ‘L’activité scientifique de l’Académie Impériale et Royale des Sciences et Belles-Lettres de Bruxelles, 1772–1794,’ Etudes sur le XVIIe siècle, 4 (1977), 49–61. For an overview of the general features of eighteenth-century learned societies: J.E. III McClellan, Science Reorganized. Scientific Societies in the Eighteenth Century (New York: Columbia University Press, 1985), pp. 13–15, 17–22.

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10 On the diverse functions of collegia medica: H. Zuidervaart, ‘Het in 1658 opgerichte theatrum anatomicum te Middelburg: Een medischwetenschappelijk en cultureel convergentiepunt in een vroege stedelijke context,’ Archief. Mededelingen van het Zeeuwsch Genootschap der Wetenschappen (2009), 73–140, 93–6. 11 F. Van Tyghem, Het stadhuis van Gent. Voorgeschiedenis, bouwgeschiedenis, veranderingswerken, restauraties, beschrijving, stijlanalyse (Brussels: Paleis der Academiën, 1978), I, pp. 185–6. 12 O. Keel, L’avènement de la médecine clinique moderne en Europe, 1750–1815: Politiques, institutions et savoirs (Montréal: Les Presses de l’Université de Montréal, 2001). 13 P. Lenders, Overheid en geneeskunde in de Habsburgse Nederlanden en het Prinsbisdom Luik (Heule: UGA, 2001), pp. 66–8; P. Lenders, ‘Vrije geleerde genootschappen voor geneeskunde in de Oostenrijkse Nederlanden,’ Handelingen der Maatschappij van Geschiedenis en Oudheidkunde te Gent: Nieuwe reeks, 51 (1997), 118–217. One of these advice letters recommended publishing in French or Latin rather than in Flemish: ULG, BIB. VLBL. HFI. M. 032.03 ‘Société de Médecine,’ Draft letter of December 2, 1776 to the Austrian authorities. 14 Lenders, Overheid en geneeskunde, pp. 67–8, 122–3. 15 J.E. III McClellan, ‘Scientific Institutions and the Organization of Science,’ in R. Porter (ed.), The Cambridge History of Science. Volume 4: EighteenthCentury Science (Cambridge: Cambridge University Press, 2003), pp. 87–106. 16 C. Hannaway, ‘The Société Royale de Médecine and Epidemics in the Ancien Régime,’ Bulletin of the History of Medicine, 46 (1972), 257–73; H.J. Zuidervaart, ‘An Eighteenth-Century Medical-Meteorological Society in the Netherlands: An Investigation of Organization, Instrumentation and Quantification,’ British Society for the History of Science, 38 (2005), 379–410, and 39 (2006), 49–66. On this latter society, see also: F. Huisman, ‘De correspondenten: Medici, staat en samenleving tijdens de Nederlandse Verlichting,’ in F. Huisman and C. Santing (eds) Medische geschiedenis in regionaal perspectief: Groningen 1500–1900 (Rotterdam: Erasmus Publishing, 1997), pp. 75–93. 17 W. Mijnhardt, Tot heil van ‘t menschdom: Culturele genootschappen in Ne­ derland, 1750–1815 (Amsterdam: Rodopi, 1984), pp. 44–58. For a brief overview of the student societies in Paris at the turn of the eighteenth century: F. Palluault, Étudiants et praticiens au service de la médecine: La Société Anatomique de Paris de 1803 à 1873. Étude institutionelle et prosopographique d’une société médicale parisienne au XIXe siècle (Unpublished thesis, 1999), pp. 35–8.

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18 C. Lawrence, Medicine as Culture: Edinburgh and the Scottish Enlightenment (PhD Diss., University College London, 1984), pp. 200–19. 19 W.F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1994), pp. 2–11. 20 Schepers, ‘Towards Unity,’ 241–2. 21 P. Dhondt and R. Bardez, ‘Ways of Knowing Medicine,’ in J. Vandendriessche and B. Majerus (eds), Medical Histories of Belgium: New Narratives of Health, Care and Citizenship in the Nineteenth and Twentieth Centuries (forthcoming). 22 CAB, ASB IP I 110, folder ‘Sociétés médicales diverses,’ Letter of 16 Vendémiaire IX (October 8, 1800) from the mayor of Brussels to the prefect of the Département de la Dyle. 23 CAG, folder ‘Sociétés médicales diverses,’ Letter of Brumaire IX from the Medical Emulation Society to the mayor of the city of Brussels. 24 CAA, MA 382/5 (A), Letter of February 19, 1806 from the mayor of Antwerp to Mr Cuypers. 25 Ibid. 26 K. Velle, ‘Het verenigingsleven van de Belgische geneesheer,’ Annalen van de Belgische vereniging voor de geschiedenis van hospitalen en volksgezondheid, 26–7 (1988–1989), 47–118. 27 The activities and regulations of the society are discussed in: V. Vanderhasselt, Geleerde genootschappen te Brussel onder het Franse Regime, 1794–1815 (Master’s thesis, University of Leuven, 1986), pp. 38–80. 28 Réglement de la Société de Médecine, de Chirurgie et de Pharmacie, établie à Bruxelles, sous la devise: Aegrotantibus (s.l.: s.n., s.d. [1795]). 29 Réglement adopté par la Société de Médecine de Bruxelles, dans sa Séance du 25 Messidor an XII (s.l.: s.n., s.d. [1804]), pp. 4–5. 30 Règlement adopté par la Société de Médecine de Bruxelles, dans sa séance du 17 Février 1807 (Brussels: Wassenbruck, s.d.). 31 Statuts de la Société de Médecine de Gand, modifiés d’après la décision prise dans la séance du 18 juillet 1837 (Ghent: Gyselynck, 1837). 32 On the coins of the Brussels medical society: E. Vanden Broeck, Jetons de présence de la Société de Médecine de Bruxelles, messidor an XII (Brussels: Goemaere, 1900). 33 See for example: the membership list of the Medical Society of Brussels in the Actes de la Société de Médecine de Bruxelles (1806). 34 H. Kluyskens, ‘Notice historique sur la Société Medico-Chirurgicale de Gand,’ BSMG, 18 (1851), 57–82, 61. 35 Vanderhasselt, Geleerde genootschappen; Velle, ‘Het verenigingsleven’. In the yearbook of the Province of East-Flanders, it was also mentioned that the Medico-Surgical Society of Ghent (1812) provided free medical

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36 37 38

39 40

41 42 43 44 45 46

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advice to anyone who presented himself at one of its meetings: Almanach du département de l’Escaut, pour l’an 1815 (Ghent: Stéven, 1815), pp. 179–80. Brown, Performing Medicine, pp. 13–47. On the vaccination campaign in Belgium: Tilmans-Cabiaux, ‘De geneeskunde,’ pp. 377–8; Vanderhasselt, Geleerde genootschappen, pp. 64–8. S.J.F. Kluyskens, Verhandeling over koepokjes, het ware voorbehoedsmiddel der kinderpokken (Ghent: Stéven, 1801); F. Fournier. Essai historique et pratique sur l’inoculation de la vaccine (Brussels: s.n., 1801). In Antwerp, the vaccination campaign was set up by Vrancken, who was less involved in medical societies: L.H.J.V. Vrancken, Aenmerking over de inenting met de vaccine (Antwerp: Bruers, 1801); L.H.J.V. Vrancken, La cinquantaine. Notice historique et statistique sur la vaccine depuis son introduction à Anvers en 1801 jusqu’à ce jour (Antwerp: Schoesetters, 1851). M. Florkin, Un prince, deux préfets: Le mouvement scientifique et médicosocial au Pays de Liège sous la règne du despotisme éclairé (1771–1830) (Liège: Vaillant-Carmanne, 1957), pp. 209–10, 224–5. J.B Vervier et al., Adresse de la Société Médicale de Gand à ses concitoyens, sur les bienfaits inappréciables de la Vaccine / Vertoog van het Geneeskundig Genootschap der stad Gent aanzyne mede-burgers wegens de onschatbare weldaden der Vaccine (Ghent: A.B. Stéven, 1802). Ibid., p. 2. Ibid., pp. 14–16. Réglement adopté par la Société de Médecine de Bruxelles [1804], p. 7. Vanderhasselt, Geleerde genootschappen, pp. 55–64, 69. Verhandeling van het genootschap ter bevordering van genees- en heelkunde opgeregt tot Antwerpen (Antwerp: s.n., 1797), p. xiii–xiv. Lenders, ‘Vrije geleerde genootschappen,’ pp. 209–12; Velle, ‘Het vereni­ gingsleven,’ pp. 55–6. In another article Broeckx claimed that the society met weekly in the tavern Ostende in Antwerp: J.C. Broeckx, Notice sur le docteur Jean-Corneille Stappaerts, président du collège des médecins et du Société Médico-Latine d’Anvers (Antwerp: Buschmann, 1851), p. 13. On this society see also: J.C. Broeckx, ‘Histoire du Collegium Medicum Antverpiense,’ ASMA, 19 (1858), 297–335, 330–5. The Antwerp mayor also demanded to be updated on any new members of the society: CAA, MA 382/5 (A), Letter of November 20, 1805 from the Antwerp mayor to the members of ‘une société médico-latine.’ Unlike in its eighteenth-century predecessor, however, medical men played a more important role in the new society, together with military

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48 49 50 51 52 53 54 55 56 57 58 59 60 61 62

63 64 65 66 67 68

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men and state officials. Their number had grown to twenty (18%) of the 109 society members: Florkin, Un prince, pp. 209–10, 224–5. Broeckx, Coup d’oeil, pp. 19–20. E. Witte, J. Craeybeckx and A. Meynen, Political History of Belgium: From 1830 onwards (Brussels: ASP, 2009), pp. 17–64. Dickstein-Bernard, ‘Panorama de l’enseignement,’ pp. 62–73. R. Schepers, De opkomst van het medisch beroep in België: De evolutie van de wetgeving en de beroepsorganisaties in de 19de eeuw (Amsterdam: Rodopi, 1989), pp. 52–61. Dickstein-Bernard, ‘Panorama de l’enseignement,’ p. 67–8; Schepers, De opkomst, pp. 106–15. Witte, Craeybeckx and Meynen, Political History of Belgium, pp. 21–4. Dhondt and Bardez, ‘Ways of Knowing Medicine’. Velle, ‘Het verenigingsleven,’ pp. 49–51. For an overview of some of the literature on French medicine: C. Hannaway and A.F. La Berge (eds), Constructing Paris Medicine (Amsterdam and Atlanta: Rodopi, 1998). G. Weisz, The Medical Mandarins. The French Academy of Medicine in the Nineteenth and Early Twentieth Centuries (New York and Oxford: Oxford University Press, 1995), pp. 4–10; Palluault, Étudiants et praticiens. D. Delahaye, De la nécessité de reformer l’enseignement médical dans la Belgique (Bruges: De Moor, 1821). On Delahaye, see also: Dhondt, Un double compromis, 54–5; Velle, ‘Het verenigingsleven,’ 58–9. Delahaye, De la nécessité, pp. 24–5. Ibid., pp. 25–6. Mémoires et observations de la Société de Médecine d’Anvers, 1 (1836), viii. On Van Esschen’s career: P.F.X. De Ram, Discours prononcé par M. l’abbé De Ram, recteur de l’université catholique de Louvain, sur la tombe de M. le professeur Van Esschen, au cimétière d’Heverlé le 21 janvier 1838 (Leuven: Van Linthout and Vandenzande, 1838). P.J. Van Esschen, Lettre à monsieur Lesbroussart, administrateur-général de l’instruction publique, sur l’état actuel de l’enseignement médical en Belgique et sur les moyens de l’améliorer (Brussels: Ode and Wodon, 1831), p. 30. CAA, MA 382/5 (A), Reglement voor het Geneeskundig leesgezelschap tot uitbreiding van kennis (Antwerp: s.n., 1824). ASMA, 1 (1836), p. 8. Actes de la Société de Médecine de Bruxelles, 1 (1806), iii–iv. Mémoires et observations de la Société de Médecine d’Anvers, 1 (1836), p. 3. P. Rieder, ‘La médecine pratique: une activité heuristique à la fin du 18e siècle?,’ Dix-huitième siècle, 47 (2015), 135–48, 146–7.

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69 C.A. Van Coetsem, ‘Discours prononcé dans la séance ordinaire du 19 août 1834,’ Mémoires de la Société de Médecine de Gand, 1 (1836), 1–15, 9. 70 Mémoires et observations de la Société de Médecine d’Anvers, 1 (1836), viii. 71 Flemish would reappear in the medical literature at the turn of the twentieth century, together with the revaluation of the Flemish language in Belgian society as a whole. For a brief discussion, see Chapter 7. 72 J. Guislain, Lettre médicale sur la Hollande, adressée à MM. les membres de la Société de Médecine de Gand (Ghent: Gyselynck, 1842), pp. 61–2. 73 ULG, Hs. 3012.4.2, Letter of November 10, 1848 from the Medical Society of Ghent to G.Ph.F. Groshans. On Groshans, see: M.J. Van Lieburg, ‘G.Ph.F. Groshans (1814–1874) en de Clinische school te Rotterdam,’ Nederlandsch Tijdschrift voor Geneeskunde, 118:49 (1974), 1886. 74 ULG, Hs. 3012.4.2, Letter of April 16, 1848 from the Medical Society of Ghent to G.Ph.F. Groshans. 75 On Snellaert’s active participation in literary societies: G. Draye, Laboratoria van de natie: Literaire genootschappen in Vlaanderen 1830–1914 (Nijmegen: Uitgeverij Vantilt, 2009), pp. 54–6. 76 See Chapter 7. 77 See following membership lists: ‘Liste des membres de la Société de Médecine d’Anvers,’ ASMA, 1 (1840) [addendum]; Volume jubilaire publié à l’occasion du centenaire de la Société Royale des Sciences Médicales et Naturelles de Bruxelles (Brussels: s.n., 1922), pp. 57–62; ‘Liste des membres de la Société de Médecine de Gand,’ BSMG, 6 (1840), 5–17. 78 Mémoires et observations de la Société de Médecine d’Anvers, 1 (1836), 9. 79 See the entries ‘Cercle médico-chimique et pharmaceutique de Liège,’ ‘Société Royale de Pharmacie de Bruxelles’ and ‘Koninklijke Apothekersvereniging van Antwerpen’ in Bestor (www.bestor.be). 80 See the composition of the medical commissions for the year 1841: Almanach de Belgique pour l’an 1841 (Brussels: Librarie polytechnique, 1841), p. 455. 81 J. Jacques, ‘Discours prononcé à la Société de Médecine d’Anvers, dans la séance solennelle, le 17 xbre [décembre] 1838,’ Mémoires de la Société de Médecine d’Anvers (1838–1839), v–ix. 82 Ibid., viii. 83 ‘Société des Sciences, Lettres et Arts d’Anvers, fondée le 10 novembre 1834, et installée le même jour à l’hôtel de la régence,’ Messager des sciences et des arts de Belgique (1835), 176–80. An article with the same title was published in the Bulletin médicale belge, 1 (1834), 211–12. 84 ‘Société des Sciences, Lettres et Arts,’ BMB, 211. 85 Ibid.

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86 For an overview of the intended project of the Society: Réglement de la Société des Sciences, Lettres et Arts d’Anvers (Antwerp: Van Assche, 1834), pp. 3–4, 20–4. 87 Berchem (ed.), Catalogue des ouvrages contenus dans la bibliothèque de la Société de Médecine d’Anvers (Antwerp: Buschmann, 1845). Only seven of these were non-medical, including three recently published books by the Belgian writer Hendrik Conscience: Ibid., p. 44. 88 On these publishing efforts, see Chapter 3. 89 F.H. Mertens and K.L. Torfs, Geschiedenis van Antwerpen sedert de stich­ ting der stad tot onze tyden (Antwerp: De Olyftak, 1853), VII, pp. 409–21. 90 Broeckx, Coup d’oeil, p. 29. 91 Mertens and Torfs, Geschiedenis van Antwerpen, p. 513. 92 Ibid., pp. 515–16. 93 ULG, Hs. 3012. 6, ‘Registre contenant l’indication des ouvrages reçus pour la société par M.M. les Bibliothécaires, 1845,’ ‘Catalogue alphabétique de la bibliothèque de la Société de Médecine de Gand’. 94 CAB, ASB IP I 110, folder ‘Sociétés scientifiques, littéraires et artistiques en général; relevé de ces sociétés, dressé en 1851,’ Rulebook of the Society of Medical and Natural Sciences of Brussels [1822]. 95 Broeckx, Coup d’oeil, pp. 25–6. 96 CAB, ASB IP I 110, folder ‘Société des Sciences Médicales et Naturelles,’ Letter of July 6, 1822 from the society to the urban government. 97 On Curtet: L. Wellens-De Donder, ‘François-Antoine Curtet et l’enseignement de la médecine à Bruxelles au début du XIXe siècle,’ Cahiers Bruxellois, 8 (1963), 94–119. 98 CAB, ASB IP I 110, folder ‘Sociétés scientifiques, littéraires et artistiques en général; relevé de ces sociétés, dressé en 1851,’ Rulebook of the Society of Medical and Natural Sciences of Brussels [1841]. 99 The Society of Medical and Natural Sciences of Brussels did not seem to have set up an extensive library. Another society in the capital – the Vesalius Society (1843), see Chapter 4 – took up the challenge and established a library in the St. Jean Hospital: A. Uytterhoeven, Notice sur l’hôpital Saint-Jean de Bruxelles, ou étude sur la meilleure manière de construire et d’organiser un hôpital de maladies (Brussels: Grégoir, 1852), pp. 208–10. 100 Gazette van Gend, July 27, 1834 (fragment in ULG, VLBL. HFI. M. 032.03 Société de Médecine). 101 The advisory activities of medical societies in the domain of public health are discussed in Chapter 5. 102 Broeckx, Coup d’oeil, p. 27. 103 Van Coetsem, ‘Discours,’ p. 10.

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104 Schepers, De opkomst, pp. 61–2; Velle, ‘Het verenigingsleven,’ 58–9. 105 CAG, T 539, Letter of July 24, 1834 from the Medical Society of Ghent to the urban government of Ghent. 106 ULG, Hs. 3012 4.1., Letter of September 30, 1843 from the Medical Society of Ghent to the Commission of Hospitals. 107 ‘Séance du 6 septembre 1843,’ BSMG, 9 (1843), pp. 143–63, 143. 108 ULG, Hs. 3012 4.1, Letters of May 26, 1845 and April 27, 1848 from the Medical Society of Ghent to the governor of the province of East Flanders. The register in which the Ghent society members recorded each of the patients who made use of their consultation service has been preserved as part of the archive of the society: ULG, Hs. 3012.05, ‘Registre des malades, 1846–1849’. 109 ULG, HS.3012 4.1., Letter of October 8, 1845 from the Secretary of the Medical Society of Ghent to Mr De Smedt. 110 J. De Ketelbutter, Burgerlijke sociabiliteit in de lange 19e eeuw: De Société d’agrément la Concorde en haar contacten met andere genootschappen te Gent tussen 1808 en 1914 (Master’s thesis, University of Ghent, 2001), pp. 53–9. On La Concorde, see also: R. Mantels, Gent. Een geschiedenis van universiteit en stad, 1817–1940 (Ghent: Mercatorfonds/UGentMemorie, 2013), pp. 65–6. 111 ULG, Hs. 3012 4.1, Letter of September 19, 1845 from the Medical Society of Ghent to the Minister of Internal Affairs. 112 CAB, ASB IP I 110, folder ‘Société des Sciences Médicales et Naturelles,’ Letter of November 11, 1829 from the urban government to the provincial governor. 113 CAB, folder ‘Société des Sciences Médicales et Naturelles,’ Letter of August 13, 1832 from the urban government to the provincial governor. 114 CAB, ASB IP I 110, folder ‘Société des Sciences Médicales et Naturelles,’ Letter of January 28, 1840 from the urban government to the provincial governor. 115 CAG, T, 539, ‘Briefwisseling betreffende het subsidiëren van de Société de Médecine, 1835–1837,’ Letter of August 14, 1836 from the Medical Society of Ghent to the urban government of Ghent. 116 Ibid. 117 ULG, HS. 3012 4.1, Letter of September 25, 1845 from the Medical Society of Ghent to the urban government of Ghent; ULG, HS. 3012 4.1, Letter of April 26, 1849 to the urban government of Ghent. 118 ULG, HS. 3012 4.1, Letter of August 15, 1847. 119 Almanach du département de l’Escaut, pour l’an 1815 (Ghent: Stéven, 1815), pp. 179–80. 120 ‘Séance du 6 septembre 1843,’ BSMG, 9 (1843), pp. 143–63, 143.

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121 On the conciergerie: Van Tyghem, Het stadhuis, p. 186. Charles Van Bambeke mentions that the society later moved to the Hôtel Oldi together with the Société des Mélomanes: C. Van Bambeke, ‘A propos d’un tableau ornant le local de réunion de la Société de Médecine de Gand,’ ASMG (1901): 303–14, 311. 122 On the renewed activities of the Medical Society of Brussels: CAB, ASB IP I 110, folder ‘Société de Médecine de Bruxelles,’ undated letter [1828] from P.S. Kok and V.J. Uytterhoeven to the urban government of Brussels. On its meeting room in the Brussels town hall: CAB, ASB IP I 110, folder ‘Société de Médecine de Bruxelles,’ Letter of March 15, 1828 from the mayor of Brussels to the Medical Society of Brussels. 123 P. Heger and E. Zunz, ‘Notice historique,’ in Société Royale des Sciences Médicales et Naturelles de Bruxelles: Volume jubilaire publié à l’occasion du centenaire de la société (Brussels: Lamertin, 1922), pp. 40–8. 124 R. Halleux, Tant qu’il y aura des chercheurs: Science et politique en Belgique de 1772 à 2015 (Bruxelles: Luc Pire, 2015), pp. 34–41. 125 ‘Congrès scientifique de France, tenue à Caen en juillet 1833,’ BMB, 1:2 (1834), 24–5; ‘Séance du 3 février 1834,’ BMB, 1:2 (1834), 26. 126 ‘Congrès médical de Belgique: Première session, tenue à Bruxelles, en septembre 1835,’ BMB, 2:10 (1835), 233–4. 127 Ibid., 235–6. 128 Schepers, De opkomst, pp. 95–6. Of the 82 participants 38 (46%) were Brussels-based. The 44 other conference members came from across the country. Only two physicians were present from Ghent, of which Burggraeve represented the Medical Society of Ghent. The physicians HenriProsper Gouzée and Romain-Louis De Kerckhove and the pharmacists Verbert and Rigouts came from Antwerp. 129 Broeckx, Coup d’oeil, pp. 29–30. 130 Ibid., p. 29. 131 ‘Congrès médicale de Belgique,’ 259; ‘Congrès médical de Belgique. Compte rendu de la deuxième session,’ BMB, 3:9 (1836), 243, 252. 132 Schepers, De opkomst, pp. 83–4. 133 ‘Nominations,’ BARMB, 1 (1842), 7–11; ‘Séance d’installation du 26 septembre 1841,’ BARMB, 1 (1842), 53–78, 73–8. 134 ‘Séance d’installation,’ 70. On scientific expertise in service of the nineteenth-century state: R. Fox, The Savant and the State. Science and Cultural Politics in Nineteenth-Century France (Baltimore: Johns Hopkins University Press, 2012). 135 ‘Académie royale de médecine de Belgique,’ L’indépendance belge, September 22, 1845. 136 ‘Nouvelles de Science,’ BMB, 1:5 (1834), 36–7.

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137 ‘Congrès médical de Belgique. Première session,’ 259. 138 ‘À nos membres correspondants,’ BSMG, 7 (1841), 270–80, 270. 139 Ibid., 272. 140 J. Guislain, Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse. Résumé d’un voyage fait en 1838, adressée à la Société de Médecine de Gand (Ghent: F.E. Gyselynck, 1840), pp. 314–15. 141 J. Guislain, Lettre médicale sur la Hollande, adressée à MM. les membres de la Société de Médecine de Gand (Ghent: Gyselynck, 1842), pp. 49–50. 142 ‘Séance du 2 février 1841,’ BSMG, 7 (1841), 35–60, 58–60. 143 ‘À nos membres correspondants,’ 270–1. 144 CAB, ASB IP I 110, folder ‘Société des Sciences Médicales et Naturelles,’ Letter of July 20, 1844 from the provincial governor to the urban government. 145 Séance du 1 août 1843,’ BSMG, 9 (1843), 113.

2

Debate and controversy

Formalities mattered in medical societies. As their rulebooks reveal, the scientific debates conducted during society meetings followed a strict scenario. Once the meeting started, the president handed the floor to a series of speakers, who successively presented their manuscripts or review reports – usually by reading these out loud.1 Each of these speeches was followed by a discussion, which ended with a vote on the approval of the manuscript. The discussion itself was subject to several restrictions. Society members could speak only after being given the floor and were forbidden to discuss any subject other than science.2 In the rulebook of the Brussels Society of Medical and Natural Sciences, it was added that these discussions needed to be conducted ‘with moderation and mutual respect.’3 Yet not all procedures were described in societies’ rulebooks. The need to use particular jargon, including popular tropes (e.g. praising ‘practical’ medicine or denouncing ‘secrecy’ when it came to new drugs), was not written down. Neither did society members articulate what it meant to adopt the right attitude in a scientific debate, somewhere in-between respect for established authority and an assertiveness driven by curiosity. No written rules existed for presenting instruments, scientific drawings or patients to strengthen one’s arguments, combining verbal skills with visual aids. Yet such performances were regulated as well, albeit by unwritten codes of conduct rather than formal articles. To deliver a good speech, society members had to meet the expectations of their audience – an effort which required, besides moderation and mutual respect, a strong performative capacity with the spoken word. Many of these written and unwritten codes were not unique to medical societies. They were part of a wider nineteenth-century culture

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of public speaking. A tradition of oratory flourished in many different spaces: from literary circles and learned societies to political arenas (e.g. the Belgian parliament) and the courtroom.4 In all these spaces, debating skills in the form of one’s capability to deliver eloquent speeches formed a prerequisite for participation. Given these similarities, Diarmid Finnegan has argued that nineteenth-century scientific speech should be studied alongside these other verbal performances. Such an integrated approach, he continues, should take into account the omnipresence of oratory in civil society, but should equally focus on the particularities of scientific debate by paying attention to local customs, norms and background knowledge.5 Indeed, if the scientific debates in medical societies resembled the political debates in the Belgian parliament, which also consisted of a succession of speeches, discussions and votes (on laws, not manuscripts), medical debates lacked the sharpness and satire typical of political debates, which often went together with laughter from the audience.6 This chapter focuses on the function and formalities of scientific debates in medical societies. It considers these regulated debates as a means to put into practice the shared ideal of ‘scientific engagement,’ one of the founding principles of medical societies in the 1820s and 1830s. To understand the function of debates, and the rules that determined their course, we need to take into account the new practicebased conception of the medical sciences as a body of knowledge to which all medical men could contribute. By organizing scientific debates, medical societies used the potential of such a conception of science to forge a community. It enabled them to differentiate between those who did and those who did not contribute to the collective enterprise, and thus to determine the outside disciplinary boundaries of the medical field at a moment when the cultural authority of medicine was far less established. But the machinery of debate also made it possible to establish internal hierarchies, to structure social relations within the medical community itself. New forms of professional recognition and scientific accreditation allowed physicians to measure someone’s contributions to the collective enterprise. For the communicating of one’s observations – the product of many years’s experience – also entailed a ‘loss’ of ownership that somehow needed to be compensated. Providing such compensations through the recognition of one’s efforts by peers was another important function of societies’ debates. Such recognition

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(or the failure to achieve it) could easily give rise to conflict, in particular over who came up with a new instrument or treatment first. Hence the need for codes of conduct that structured the interactions between society members. This chapter will show that only by conforming to the conventions of the debate could one’s scientific efforts become recognized: the form and content of one’s contribution, in other words, were closely linked. The chapter will focus on three types of scientific debates, giving an indication of the diversity of subjects, actors and practices in societies’ meeting rooms. Debates on medical therapies allowed private practitioners to participate in the scientific community and show how ‘scientific conduct’ was used as a marker to differentiate between proper medicine and quackery. Discussions on surgical innovations were typically conducted by the medical elite, whose privileged position – they often had access to the hospital, an important site for experimentation – enabled them to engage in the verbal and visual performances that were needed to establish ‘priority’ of a new instrument or treatment. Debates on epidemics, finally, reveal a tradition of oratory and civil debate in the sciences, which flourished in the middle of the century but later disappeared. The chapter alternates the discussion of these three types of debate with a closer look at two controversial figures: the rural physician Jean Fierens, whose ‘secret remedy’ of ophthalmia made him clash with the members of medical societies, and the Brussels surgeon Louis Seutin, who walked a narrow line between assertiveness and controversy when engaging in scientific debates. Both provide an insight into the way physicians experienced (and used) the regulated environment of society meetings. For some, the strict codes of conduct that were enforced during societies’ debates were a means of empowerment, particularly for those with strong oratorical skills. For others, who were either denied the right to speak (such as patients, and to a lesser extent, instrument makers) or were less well-versed in the tradition of civil debate (such as rural medical practitioners), these same codes formed a clear drawback and reinforced existing social hierarchies. Openness and moderation

Of all the subjects that were passed in review during society meetings, medical therapies were among the most popular and most frequently

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discussed. More than the discussions on epidemiology or surgical instruments, questions of therapy were closely related to everyday medical practice. Choosing the right treatment to administer to a patient was indeed an essential part of every physician’s private practice. Nineteenth-century medical practitioners, when making therapeutic decisions, paid much attention to the right timing, the right drug and the right dose – all elements that needed to be carefully adjusted to each individual patient’s weight, age and sex.7 Therefore they were keen on augmenting their own experience with the findings of their colleagues. This also meant that debates on therapeutic medicine lay at the center of societies’ mission of professional improvement through science. They hence presented themselves as the central forums for such exchange of medical experience. The move from the bedside to the meeting room, however, was not self-evident. As Steven Stowe has shown for the southern United States, nineteenth-century physicians regarded their knowledge on the administration of drugs to a large extent as a personal matter, the result of many years’ experience and perhaps their most valuable ‘commodity’ on the medical marketplace.8 Many physicians had their favorite medicines, of which they had frequently witnessed the success in their practices. Communicating these treatments could not only feel like giving away their trump cards, it could also expose them to the criticism of their colleagues. When Dr Swéron, from the town of Haacht, communicated his treatment of an abscess on the thigh of one his patients to the Society of Medical and Natural Sciences of Brussels, he was criticized for not having followed up his patient for twenty-five days.9 Others were reprimanded for their use of ‘dangerous’ drugs, a judgment that was not uncommon, as many of the available drugs, including calomel, were highly toxic.10 At the same time, the adoption of methods of observation and experimentation from the natural sciences in early nineteenth-century medicine also offered opportunities for private practitioners to engage in the sciences. In fact, such experimenting easily fit in with a certain creativeness typical of medical practice. At the bedside, the administration of drugs was often mixed with folk remedies, making it necessary for physicians to negotiate with patients on the treatment to be followed. Everyday medicine thus involved a degree of improvisation when it came to prescribing drugs.11 The scientific gains that resulted from such

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‘experimentation’ were welcomed in medical societies. This experimentation should not be understood in terms of standardized experiments, as were conducted in the research laboratories of the late nineteenth century. The term rather referred to a scientific method of trial and error, through which physicians could acquire experience. During a discussion on quinine in 1843, Joseph Guislain, one of the directors of the Medical Society of Ghent, described such a method as a form of ‘medical positivism’.12 For Guislain, scientific medicine was about accumulating ‘facts’ by trying new treatments, carefully observing the obtained results, and finally sharing these with one’s colleagues. If private practitioners’ daily practices formed ideal sites for experimenting with new treatments, medical societies provided the necessary forums for this final step. For mid-nineteenth-century physicians, the practice of science thus did not require an entirely different approach to medical practice. It was rather a matter of being willing to share and discuss one’s medical findings, of adopting, in other words, a certain attitude of open communication. Medical societies formed the primary spaces where such an attitude was promoted. During society meetings, the sharing of one’s experience with different types of drugs was generally presented as an unselfish act that allowed one’s colleagues to benefit from the knowledge one had gained in practice. Those physicians who took the step of communicating their therapeutic experiences were praised for their exemplary conduct, which was contrasted with the ‘apathy and egoism of those physicians who knew the specific power [of drugs] in certain cases, but neglected to communicate this to the medical profession.’13 These scientific codes of conduct thus reinforced a certain collective awareness, in which one’s personal achievements were subordinated to the project of establishing a shared body of knowledge. Such codes of conduct, moreover, fit in well with contemporary norms of politeness and gentlemanly conduct. The open communication of scientific results, success and failure alike, meant that criticism should neither be directed nor taken personally. Instead, critique was intended to further science by demanding new experiments or by doubting the completeness of an observation. As Raf de Bont has shown, the rules of early nineteenth-century scientific etiquette were based on avoiding personal confrontations by emphasizing politeness.14 In medical societies, ridicule or offense were similarly rejected, reflecting

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the customs of gentlemanly science, and urban civil culture more generally. When someone took a critical stance, it became commonplace to state that he respected his opponent. Dr Perkins, for example, defended a critical report by adding that it included ‘nothing that was directed against the person of the author, who I greatly respect.’15 Another way of avoiding conflict was to limit oneself to the ‘scientific discussion’ – a strategy that was often used in the Bulletin médical belge to respond to unfair criticism, suggesting that one’s opponent had lapsed into personal accusations.16 Dignity and moderation were the civil norms that paralleled a collective ambition in which individual success was deemed far less important than the collective progress of the sciences. The ‘scientific’ physician, in other words, was also a well-behaved citizen. A belief in the free circulation of ideas, in the power of collective reasoning and in the adoption of a gentlemanly etiquette as the prerequisites for progress were present in all sorts of civil and scientific milieus – from the town council to the societies’ meeting rooms. The opposite of the scientific physician was the charlatan. Scientific codes of conduct, grounded in contemporary rules of gentlemanly behavior, need also to be understood against the background of the professional struggles between orthodox and alternative medicine.17 Science could play an important role in demarcating these fields. In fact, the image of the ‘charlatan’ or ‘quack’ was constructed by using opposite characteristics: he was someone who kept his experience for himself, engaged in polemics and deceived the public with his dangerous ‘secret remedies,’ which he claimed could cure all sorts of diseases. The twin concepts of openness and secrecy, and of moderation and polemic, pervaded the scientific debates that were held in medical societies in the mid-nineteenth century. The pharmacist Louel, for example, was praised for revealing the composition of his ‘epispatic paper,’ a new type of plaster with which the Ghent society members were about to experiment. Such openness, the society members added, ensured ‘its harmlessness, a guarantee that no secret remedy can offer.’18 Opposite to such praise was an aversion to the announcement of ‘miracle cures’ in the newspapers, which was regarded as a form of mercantile malpractice. In 1847, Dr Hélin, a correspondent of the Society of Medical and Natural Sciences of Brussels, was said to have compromised ‘medical honor’ by making announcements in the political journals.19 Such misconduct could lead to the enforcement of one of the most far-reaching

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articles in societies’ rulebooks – the exclusion of a member from the society, a measure that was effectively taken against Hélin. If such exclusions were rare, they are also telling about the importance that was attached to open communication in the construction of the disciplinary boundaries of the medical field.20 Yet it was not always so easy to separate ‘charlatans’ from ‘true’ physicians. And more generally, the extent to which societies’ desired codes of conduct were effectively observed in practice remains to be questioned. An outsider’s view may help to put societies’ ambitions as the new spaces of debate into perspective. In fact, some physicians successfully developed their careers without ever partaking in these debates. Their views show both the persistence of an older professional culture, rooted in philanthropy and patronage rather than in a collective notion of the medical sciences, and the fragility of medical societies’ efforts to establish themselves as authoritative scientific forums. Fierens’ secret remedy

One of these successful outsiders was the rural physician Jean Fierens. Born in Antwerp in 1792, Fierens studied surgery in Ghent, where he obtained the title of chirurgien du plat pays in 1821. After his studies, he moved to the countryside and started a private practice in Beervelde, a village located twelve kilometres east of Ghent.21 As a private practitioner, Fierens became famous for his treatment of ophthalmia, an infection of the eye that could lead to blindness. In the first decade of the nineteenth century, European armies had brought home the disease after the Napoleonic wars in Egypt (the disease was therefore also called ‘military’ or ‘Egyptian’ ophthalmia).22 In Belgium, the disease spread rapidly in the 1830s, when many soldiers became infected, and particularly after 1842, when five thousand soldiers were sent home to recover and infected the general population. By then, ophthalmia had evolved into a full scale epidemic among the Belgian population and attracted much attention from both the general press and the state.23 It was in this context that Fierens soon acquired national fame for his successful treatment of the disease. What makes Fierens’ career so interesting is that he did not use the scientific forums provided by urban medical societies to promote his treatment. His successes in the middle of the nineteenth century, in fact,

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2  Drawing of the medal Jean Fierens received from his patients in 1837.

challenged societies’ claims of an open debate between colleagues as the primary road to professional success. Instead of openly communicating his treatment, he built upon an older tradition of philanthropy and patronage, in which success did not depend on the scientific approval of one’s colleagues, but on the appreciation from the general public and the Belgian government. The basis for this appreciation lay in the 1830s, when Fierens had treated numerous cases of ophthalmia in his private practice, often free of charge. In the summer of 1837, a campaign was started by his patients, who could subscribe by paying 20 centimes each, to publicly award ‘this skillful, philanthropic and altruistic oculist’ a medal to commemorate his cures and talents.24 At first, such philanthropy seemed compatible with societies’ scientific interests. The campaign received much attention in the general press, and was supported by the Medical Society of Ghent, who had elected him as a correspondent, and by the provincial governor, Pierre de Schiervel, who was present at the medal ceremony.25 In 1841, a poem was also dedicated to him, in which his humanitarian motives were praised, and soon after he received the prestigious title of Knight in the Order of Leopold.26 Fierens, in turn, did not hesitate to take advantage of the public support he received and offered his services to several state services, such as the military health service in the late 1830s, and the health services of the cities of Antwerp (1845), Kortrijk (1849) – for which he received another medal – and Roubaix (1856) in northern France.27

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Yet, even though Fierens succeeded in establishing himself as a successful physician, his career in the treatment of ophthalmia went against the current. As elsewhere in Europe, the ophthalmia epidemic in Belgium set in motion a process of specialization.28 Societies organized prize competitions on the subject and in 1839, the Annales d’oculistique was founded, a new Belgian scientific journal edited by the military physician Florent Cunier, whose career paralleled the growing state investment in ophthalmological research.29 In 1840, a military ophthalmological institute was founded in Leuven, which was led by Frédéric Hairion. And in 1851, an international conference on ophthalmology was organized in Brussels.30 In the same years during which Fierens constructed his reputation in the public domain, the field of ophthalmology became an ever more specialized scientific branch, in which military physicians took the lead. It was these circumstances that made Fierens clash with medical societies, which counted many army doctors among their members. The immediate cause of this conflict lay in an offer made by Fierens to Jean-Jacques Willmar, the Belgian Minister of War, to treat a number of soldiers who suffered from ophthalmia. Several high-ranking military physicians, such as Jean-François Vleminckx, the head of the military health service, and Ferdinand Colson, the head of the military hospital of Ghent and one of the directors of that city’s medical society, advised against cooperation with Fierens, viewing such interference by an outsider as a disgrace to the skills of the specialized physicians in the army. Political pressure, however, led Willmar to allow Fierens to test his method on a group of soldiers. In 1837 the Catholic parliamentarian Eugène Desmet, who was familiar with Fierens’ reputation, had declared in the Belgian parliament: You are aware, gentlemen, that it was not long ago that the heads of the [military] health service completely disagreed on the way to cure those who suffer from ophthalmia. All the disputes of these physicians led nowhere; because by disputing and writing pamphlets for and against, they do not move the recovery of the soldier forward: I urge you, Mr Minister, to consider inquiring after the method used by Mr Fierens of Bryveld [Beervelde] to cure ophthalmia.31

Dissatisfaction with the military physicians indeed lay at the basis of Fierens’ political support. In fact, the origin of the disease divided the

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medical community throughout the 1830s: some – the ‘compressionists’ – thought that soldiers’ tight uniform worsened minor eye infections into ophthalmia; others – the ‘contagionists’ – believed in the contagious nature of the disease. It was to this disagreement Desmet referred. Besides Desmet, the governor of the province of East Flanders, Pierre de Schiervel, equally supported Fierens. In a letter to Willmar, he wrote that ‘a bit of professional jealousy’ had perhaps meant that Fierens’ remedy, which should not be doubted, had not yet been used in the army.32 Such letters influenced Willmar’s decision to send twenty soldiers from the military hospital of Ghent to Beervelde for treatment by Fierens. Vleminckx and Colson, in turn, negotiated that ten soldiers would be treated simultaneously in the military hospital of Ghent by Colson. The result was a comparative experiment, which took over a year, to determine which treatment for ophthalmia was superior.33 In the course of the experiment, the disagreement between both parties escalated because of the secrecy Fierens observed regarding the nature of his treatment. In the Medical Society of Ghent, such secrecy was soon denounced. The society had become involved in the conflict through the participation of its members in a commission that was to examine both groups of soldiers at the start and the end of the experiment. One of these members, the military surgeon Auguste Sotteau, declared that it was Fierens’ duty as a physician and member of a medical society ‘to make known, in the name of the [healing] art, humanity and his own honor, the methods that he has seen successful and that, according to him, are the most suitable.’34 Colson, at the same meeting, contrasted his own professional behavior with Fierens’ silence and strategy of writing to the newspapers, stating that ‘it is only in a medical society that is appropriate to expose the method that guides me in the treatment of ophthalmia.’35 Colson’s remark shows how openness in the medical sciences was situated in specific spaces. Medical societies’ meetings, where an audience of colleagues was present, were considered the right spaces for such openness, while the general forum of newspapers was rather associated with an unscientific polemical and commercial form of communication. Colson certainly opted for the ‘right’ forum. In a lengthy speech, he further elucidated the treatment used by the military physicians, gaining him the appreciation of his fellow members who thanked him for ‘the openness he displayed in the exposition of his method; this is the way

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all physicians should act,’ and decided to invite Fierens to the next meeting, ‘because M. Fierens, being a true physician, can now no longer refuse to make his method known’.36 Instead of attending the next meeting, however, Fierens wrote a letter to the Ghent society members in which he refused to engage in any scientific discussion.37 What followed was a sharp condemnation of Fierens’ conduct. Another military physician, François Lutens, declared to ‘throw down my gauntlet to him’ to defend the honor of the military physicians: They [the military physicians] are accused of ignorance, and such an accusation comes from men who are not known from any special work, from any literary production on the matter. These men are only known by the ovations of which they were the object: they announce miracles, they appear to possess secrets, specific methods, and their voices are heard! The medical society approaches, it addresses these men personally, they who do not cease to cover us in the most incomprehensible blame; it has invited one to come to our meeting to pay tribute to science and humanity; but it requests his presence in vain. It can certainly not go along with all these generous souls who applaud the successes of M. Fierens […]. I repeat, the medical society, scientific in its nature as an institution, cannot judge before having examined the question.38

As is clear from Lutens’ speech, Fierens’ refusal to engage in a scientific debate conflicted with the ideal of open communication, as a means of serving science and society, to which the members of medical societies subscribed. The conflict, in essence, was a disagreement on the very role of science in medicine. All society members therefore collectively declared that Fierens ‘had not acted as a true physician and that his conduct was blameworthy’.39 From Fierens’ perspective, however, his secrecy should be understood differently. Since his authority depended on public and political support, he adapted his conduct to the expectations of these audiences rather than conforming to scientific guidelines put forward by professional peers. In keeping his remedy secret, Fierens was able to hold the attention of the Minister of War, who remained interested in his ‘goods’. When Colson, for example, refused to send him the second group of ten soldiers for the experiment, he urged Willmar to intervene by promising ‘the most brilliant result’ and the immediate revealing of his method afterwards.40 Willmar, in turn, reprimanded Colson, and after a second refusal to cooperate, even gave him eight days of arrest.41

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Fierens, furthermore, countered the critique of the members of the Medical Society of Ghent by playing into the perceptions of medical discord that were present in the views of politicians and the general public. He depicted his conflict with Colson and the military physicians foremost as a professional quarrel – a view that also reigned in the Belgian parliament. From the start, Fierens declared that he feared to be exposed to the ‘grandiloquence and the sarcasm of those who are envious’.42 And when he was criticized in the Medical Society of Ghent, he declared that he had no other option than to restart a polemic in the newspapers, where the experiment was closely followed.43 At the end of the experiment, Fierens kept his promise and sent Willmar a three-page document on his treatment, in which he described his position, instruments and the actions of an assistant.44 By then, however, it had already become clear that Fierens’ treatment consisted of the cauterization of the (upper) eyelid – a method that was also practiced by military physicians at the same time, and therefore, in Vleminckx’s words, was ‘no secret to any physician.’45 Fierens’ brief document stood out in stark contrast to the circumstantial mémoires that had been sent by the heads of the different military hospitals, in which they engaged with the medical literature and gave statistics and timetables of their treatments.46 Given this discrepancy, Fierens received no scientific credit for his method.47 After reading the final report, Willmar concluded in a letter to one of his colleagues that the system of cauterization was well-known and more efficiently used by the military physicians than by Fierens, although he continued to praise Fierens’ philanthropic intentions.48 Even if he was proven wrong, Fierens’ reputation as a successful physician in the eyes of the general public and state officials was little damaged. In the 1840s, he continued to operate in state service and remained at odds with medical societies. His appointment in Antwerp in 1845 led the Medical Society of Antwerp to write a letter to the town council, in which they accused him of ‘dispersing fallacies amidst the people’ and criticized the legitimacy given to him by such an official appointment.49 Fierens’ continued success in the 1830s and 1840s shows the fragility of societies’ efforts to enforce scientific codes of conduct among physicians. Even if Fierens’ treatment for ophthalmia only represented one case, his views as an outsider put the development of medical societies into the central authorities of medical treatments into perspective. An

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older tradition of grounding one’s authority in the approval of the general public and the state continued to exist – much to the frustration of some society members. Fierens’ collision with the Ghent society members nicely illustrates the gradual process by which scientific standards and codes of conduct, reinforced in medical societies, eroded this older tradition of medical authority and established the boundaries of the medical field. The conflict reveals in this way the intertwinement of new forms of scientific practice with the professional boundary-work of the mid-nineteenth century. Both were based on the idea that one’s colleagues should be the primary judges of the validity of one’s medical claims and conduct. The performance of innovation

If the discussions on medical therapies are well-suited to situate the virtue of openness within a wider program of medical reform, they are much less revealing about the potential advantages to physicians for displaying such openness. For if physicians were to give up secrecy, and share their experiences with their colleagues, the loss of exclusive rights was to be compensated by new forms of professional recognition. The often very technical debates on new surgical instruments and techniques in medical societies allow studying the mechanisms of accreditation and recognition that replaced older traditions of individual ownership. What was at stake here was one’s position within the medical community. To augment one’s status, it was important to affirm that one had been the first to come up with a particular innovation. This could be the use of ether or chloroform as an anesthetic in a particular operation, the introduction of new devices in abdominal surgery and obstetrics, the application of new bandages to fix broken limbs etc. – all matters that were intensely debated in societies and academies. Historians of science and technology have paid considerable attention to these so-called ‘priority disputes’ – the struggles over who should be given credit for an innovation – as a means to disentangle the concept of intellectual property associated with them.50 Historians of medicine have explored such matters of ownership far less. Moreover, as Sally Frampton has recently argued, physicians’ experience with these issues might be different from those in other fields because of the wide-spread anti-patent feelings in medicine – it was indeed not done

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to keep a remedy to oneself.51 Yet, as Frampton rightfully adds, the study of priority disputes in medicine shows great promise in providing new insight into the ‘careful negotiation that was needed to establish ownership around an invention or innovation.’52 Medical societies were sites of such negotiations. Whether one’s name became attached to a new instrument, such as the Van Huevel forceps (named after the obstetrician Jean-Baptiste Van Huevel) or the bandage Seutin (a plaster cast for fractures named after the surgeon Louis Seutin, which is discussed further on),53 depended to a large extent on the skills of its inventor in establishing himself as the ‘owner,’ and thus in deciding priority disputes to his advantage. Matters of priority therefore reveal a much less altruistic motivation for engagement in societies’ debates – one of securing one’s personal reputation. Such self-fashioning also turned societies’ debates into means of establishing hierarchies within the scientific community. In the field of surgery, such hierarchies did not just exist between surgeons, elevating some above others as ‘inventors’ of a new surgical technique or instrument. The question of ownership also structured the relations between surgeons and instrument makers, who were seldom credited for their work, but whose technical skills were no less essential in the process of innovation. This small group of instrument makers, who kept their shops in Belgium’s major cities, played a central role in enabling the use of new materials such as rubber, starch and guttapercha (a form of natural latex made out of the sap of gutta-percha trees) for the design of new instruments. The Ghent instrument maker Henri Bayly, for example, worked closely with several members of the Medical Society of Ghent. He produced the scarifiers – a type of surgical knife – designed by the military surgeon Auguste Sotteau for urethral and eye surgery and for operations of inguinal hernia. He also manufactured a device for Edouard De Nobele to stretch a patient’s foot and leg and Adolphe Burggraeve’s ‘quilted apparatus’ (appareil ouaté) to treat fractures. Both instruments were offered for sale in his shop. Bayly’s counterpart in Brussels was the manufacturer Félix Bonneels, who had his shop in the rue de l’hôpital near the old St. Jean Hospital and was similarly affiliated to the city’s university. From the 1820s onwards, Bonneels cooperated closely with the members of the Society of Medical and Natural Sciences of Brussels. The contributions of these instrument makers were only rarely acknowledged during societies’ meetings. In 1851, when new catheters

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in gutta-percha were discussed in the Brussels Society, it was mentioned that these were ‘prepared by M. Quentin, manufacturer in Brussels.’54 Around the same time, a pessary in rubber was attributed to ‘M. Barnasconi, producer of surgical instruments.’55 More than in societies’ meeting rooms, their craftsmanship was assessed on the industrial exhibitions of the first half of the nineteenth century.56 On these exhibitions, surgical and orthopedic instruments were part of the many technical items that were presented, judged and awarded by a professional jury. Bayly, for example, obtained a silver medal at the industrial exhibition of 1841 for the scarifiers he had manufactured for Sotteau.57 Bonneels, in turn, won several golden medals at the industrial exhibitions of the 1820s, 1830s and 1840s. Yet the boundaries between the craftsmanship needed to manufacture surgical instruments (by instrument makers) and the experience-based design of these same instruments (by physicians) should also not be overstated. Manufacturers also ‘invented’ instruments themselves – a fact recognized by the professional jury who commented on Bonneels’ work: ‘but the sciences also owe to him new instruments, of which experience has proven their usefulness.’58 This may also help explain the exceptional occasions on which instrument makers participated in the meetings of medical societies. In 1841, Henri Bayly presented an artificial leg to the Ghent society members, emphasizing the modest price of his invention, which made it accessible for all classes in society, as well as the simplicity of the apparatus – an often cited ideal for any medical instrument.59 The society members, in turn, approved his invention, and printed a lithography with an explanatory note, praising Bayly’s skills and encouraging him to further pursue his career.60 More than scientific credit perhaps, Bayly aimed for publicity in presenting his artificial leg at the Ghent society. On his visiting card, Bayly put both an image of his invented artificial leg and the medal he won at the 1841 exhibition.61 Bonneels similarly succeeded in acquiring formal approval from the medical community. In 1855, after years of collaboration with the Brussels professors, he became a correspondent of the Society of Medical and Natural Sciences after a positive judgment on two new surgical instruments.62 The exceptional accreditation of instrument makers’ contributions should not distract attention from the clear difference between the

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‘technical’ and the ‘scientific’ aspects of surgical instruments. In the eyes of society members, innovation in surgery was not primarily an element of manufacturing, but rather a matter of how new instruments were applied by surgeons. Such accreditation required different forms and criteria of judgment. Witnessing, in particular, proved essential in the evaluation of surgical techniques.63 When medical societies judged the quality of a new surgical instrument, great importance was given to those who had actually seen the instrument being used. In Brussels, a commission of society members was assigned to follow the experiments of André Uytterhoeven and Charles Van Hoeter with guttapercha in the post-operative treatment of fractures.64 After two months, the commission reported its ‘most promising’ findings to the society, discussing eleven successful treatments of fractures with splints made out of gutta-percha.65 The role of these commissioners was that of eyewitnesses, who bore testimony to the operations and patients they had seen. In Ghent, the military surgeon Auguste Sotteau, in a discussion on an operation of the arteries, equally proposed assembling a commission to witness that ‘my needle never misses its goal.’66 Such statements hint at the importance of witness accounts in the construction of one’s authority as surgeon. When Dr Mouillard presented his ‘mechanical leeches’ to the Brussels society, he also stated that he successfully used these instruments at the Brussels St. Pierre Hospital ‘in the presence of Mr Seutin.’67 Other techniques that were used to construct one’s authority include ‘visualizing’ the obtained results. This was often done by presenting patients who had been successfully treated during society meetings. In the summer and autumn of 1840, Auguste Sotteau presented at least a dozen soldiers at the Medical Society of Ghent to promote his operative method for inguinal hernia (the protrusion of intestines into the groin area). Sotteau’s method consisted of an adjustment to the procedure used by Dr Wutzer, Professor of Surgery at the University of Bonn.68 On June 7, Sotteau presented five soldiers who had undergone his treatment to his fellow society members, who ‘examined the different individuals with the greatest attention and found them perfectly cured.’69 Such statements signified a form of general support by the medical community, grounding Sotteau’s authority, not in a single witness account but in the approval of an entire assembly of physicians. One of

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the soldiers, Théodore Vlies, would again appear before the society members three years later to show that there had been no relapse. For Vlies, such clinical examinations were undoubtedly unpleasant. During his second staging at the society, the meeting report stated that ‘the attempts to cough of the patient did not provoke any particular movement to the fingers [of the society members] applied at the outside of the canal.’70 Vlies’s discomfort seemed outweighed by Sotteau’s efforts to establish his reputation. The same materials that inspired innovation in the treatment of fractures (such as starch) were also used for models to demonstrate surgical progress. On some occasions, the presented patients were compared to plaster models that indicated their situation before the operation. As Charles Van Hoeter explained when he presented a patient whose knee he had operated on, ‘the plaster, showing the form of the limb before the operation, allows the degree of infirmity and the achieved improvement to be determined.’71 Such comparisons worked particularly well for the treatment of major fractures. For more subtle operations, for example in the burgeoning field of plastic surgery or eye diseases, detailed drawings were used to present the patient’s pre-operative condition. Adolphe Burggraeve, for example, passed along such a drawing, ‘which faithfully represented the face of the subject before the operation,’ to his colleagues when he presented a patient whose eyelids he had corrected after she had been severely burnt.72 The intended goal was the same: the drawings should help the society members assess the improvements created by Burggraeve’s surgery. The presentation of patients, drawings and plaster models was common practice in medical societies throughout the nineteenth century. These visualizations, of course, did not stand alone. They were part of more elaborate performances, which included lecturing and debate. One particularly successful performance occurred in 1839, when the Liège surgeon Charles Phillips presented his technique of nose surgery during a meeting of the Medical Society of Ghent. Phillips, who gave courses in anatomy at the free medical school and at the school for veterinary medicine in Liège, was a talented artist and lecturer.73 Since Liège, at that time, did not possess a medical society, Phillips’ trip to Ghent in 1839 was a rare occasion to convey his surgical innovations to a medical audience.74 To show his technique, Phillips performed nose

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surgery on several cadavers, which had been brought to the meeting. As the meeting report stipulated: These different operations are effectively practiced by M. Phillips. His dexterity, the remarkable talent of lecturing of which he testified and the new ideas he articulated on the different subjects under discussion, have gained him the applause of the assembly, and the congratulations passed on by the Society’s president on behalf of all members.75

From the meeting report it is clear that Phillips’ talents as a lecturer helped him during his scientific performances, showing the close ties between the worlds of science and education. Convincing one’s colleagues seemed to be as much about argumentation as it was about ‘showing’ the improvements that came along with new instruments or operative techniques. But Phillips’ lecture also illustrates a more a general aspect of the scientific debates conducted in medical societies. More than polite verbal exchanges between gentlemen, such debates were also highly staged events, which reflected contemporary social hierarchies. Phillips, in fact, carefully chose the forum provided by the Ghent society to present his new technique, as well as the form (a demonstration) in which he wanted to prove his claim. His visit to the Ghent society reveals that the performance of innovation, reinforced or not with visual aids, always remained a form of self-fashioning that was, to an important extent, ‘strategic’. Such strategic use also had a disruptive potential. It could undermine the functioning of society debates as it privileged individuals’ ambitions over collective progress. This potential becomes clear by looking more closely at the priority disputes of one the central figures of Belgian surgery in this period, the Brussels professor Louis Seutin. If Seutin can be considered as the exponent of a tradition of showmanship that flourished in early and mid-nineteenth-century surgery, his use of societies’ scientific forums also pushed the boundaries of what was perceived as legitimate self-fashioning within a professional community built upon an ideal of collective rather than personal success. Seutin’s priority disputes

Seutin’s medical career started in the early 1810s, when he gained experience as a military surgeon during the revolutionary wars. Afterwards,

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3  Drawings presenting the patient before and after a surgical operation of the nose by Charles Phillips.

he obtained his medical degrees at the universities of Leiden (1816) and Liège (1820). In 1823, he was appointed as the main surgeon of the Brussels St. Pierre Hospital – a position he held until 1861. After the Belgian Revolution, Seutin reached the very top of the medical profession. As a government advisor, he played a central role in the development of the Academy of Medicine and the health service of the Belgian army.76 At the same time, he established himself as a medical practitioner, recruiting patients among the wealthiest citizens in and around Brussels, including King Leopold I.77 And also academically Seutin obtained successes, as he was appointed Professor of Surgery at the Free University of Brussels in 1834. It was in these years that he experimented with starch bandages in the restoration of fractures and developed his méthode amovo-inamovible, which consisted of an apparatus that used starch to fix fractured limps, but also allowed the (re-) opening of the bandage to inspect the recovery.78

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The ownership of this method became one of the central debates in mid-nineteenth-century Belgian surgery. Innovations in the fixation of fractures, in fact, seem to have developed largely in parallel in several countries. Besides Seutin in Belgium, the French surgeon and anatomist Alfred Velpeau developed similar techniques in Paris, while in the Netherlands, Antonius Matthysen likewise experimented with starch bandages. As a result, the question of who had ‘invented’ these new bandages became, for many physicians, a matter of national honor. In his road to international recognition, Seutin mostly found Velpeau in his way. The conflict between both men started in 1837, when Velpeau – in the eyes of many Belgian physicians – had failed to acknowledge Seutin’s ownership of the méthode amovo-inamovible in a new study. In the Society of Medical and Natural Sciences in Brussels, a strong reaction was given in a report of one of Seutin’s studies: ‘We repeat, M. Seutin is the first in Europe who has proclaimed the principles that we previously discussed. The new method of treating fractures is a discovery that belongs to Belgium and the numerous observations reported in the study of M. Seutin prove its efficiency.’79 The commission also encouraged Seutin to send copies of his study to the ‘principal physicians of the country [Belgium] and those in Paris who might have been mislead by the claims of M. Velpeau.’80 At the same time, the members of the Medical Society of Ghent published a letter from Florent Cunier, in which he criticized Velpeau for reducing Seutin’s innovation to the mere application of paste, when it also comprised different sorts of attachments and fixations that allowed patients to walk around – a sight first seen in Brussels and only later in Paris.81 A few years later, Joseph Guislain defended Seutin’s rights during his travels in Italy. In his travel report, Guislain wrote that, when being told about the many successes with the appareil inamovible known in Italy as the appareil Velpeau, he corrected this matter of ownership: ‘I took the occasion in this place to claim the rights of a compatriot, M. Professor Seutin of Brussels.’82 Seutin’s success consisted in his skill to capture and reinforce such patriotic support. Playing into sentiments of national pride worked well with a younger generation of medical men, who were making a career for themselves in a new nation-state and were eager to defend national honor. More than anybody else, Seutin succeeded in embodying the new ‘Belgian medicine’ and in making his own interests correspond to

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those of a generation of medical reformers, using the new forums they had created to his advantage. In 1835, he published a description of his method in the Bulletin médical belge, the first ‘Belgian’ medical journal, and one year later, explained his techniques in a monograph, which he also sent to the Parisian Academy of Medicine.83 In the 1840s, he continued publishing with the help of his former students, by then colleagues at the university, resulting in several widely reviewed major monographs and creating what can be considered a Belgian school of surgery around him.84 These same men later accompanied him on his trips through Europe – to the German lands and Russia in 1851, to France, Spain and Portugal in 1854 – during which he promoted his method, and, after his death, also secured his fame in biographical writings. For Seutin, the promotion of his méthode amovo-inamovible was almost a lifetime’s work. While major publications and travels were essential for establishing priority, debates in medical societies and academies were also crucial. Throughout his career, Seutin participated in scientific institutions in Brussels, such as the Society of Medical and Natural Sciences (which he had co-founded) and the Belgian Academy of Medicine. These promotional efforts required coordination. When he invited both institutions to investigate his successes at the St. Pierre Hospital, a discussion was started within the Brussels society on whether it could study the matter simultaneously with the Academy.85 While some society members argued that such investigations were necessary ‘because too many practitioners, certainly in the countryside, still don’t know what the méthode amovo-inamovible really is,’ others wanted to avoid competition with the Academy, which would be ‘regrettable for science’.86 In the end, it was in these forums Seutin obtained his recognition. When he presented a new study at the Brussels society, he added that he had received a letter by Velpeau, in which he recognized Seutin as the inventor of the bandage amidonné and would declare this at the next meeting of the French academy.87 Seutin later also travelled himself to the Parisian Academy of Medicine to defend his rights. Such an action testified to the increased importance of national academies in the mid-nineteenth century in settling controversies. But it was also an indication of Seutin’s approach to society debates in general. More than anybody else, Seutin knew how to use the authority that radiated from the collective judgments of scientific bodies.

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Seutin’s continuous drive for publicity also had its drawbacks. The promotion of one’s individual merits, even if these were emblematic for an entire nation, was to a certain extent at odds with the ideal polite verbal exchanges between gentlemen – an ideal that was grounded in a more collective view of science, as something to which mere contributing should suffice as one’s motivation (rather than the ambition to augment one’s reputation). The quest for priority, if pursued too strongly, could thus run against the borders of a professional identity rooted in shared gentlemanly values. These limits became clear in 1840 when Seutin accused the military surgeon Auguste Sotteau of not giving him the credit he deserved as ‘the first importer of the [Wutzer] procedure in the country’ in a study of inguinal hernia. In a letter to the Medical Society of Ghent, he argued that anyone in the medical world may claim ‘what belongs to him by right as scientific property’ and should receive ‘the support of Medical Societies in the defense of his rights.’88 Sotteau, in turn, tellingly claimed that Seutin had been misguided by ‘his vanity as an author in a case where his name effectively did not merit to be cited.’89 He added that no one disputed that Seutin was the first to use the Wutzer procedure, ‘not even the manufacturer who had copied the instrument in Belgium,’ suggesting that the introduction of foreign instruments did not deserve scientific credit, but rather belonged to the world of instrument makers.90 If Sotteau’s response shows the hierarchy between physicians and technicians in matters of ownership, it also reveals the polemical nature of Seutin’s engagement in debates. Sotteau was not alone in criticizing Seutin’s debating style. As Renaud Bardez has recently shown, Seutin’s carefully (self-)constructed reputation became bruised after his death in 1862.91 In a retrospective in the late 1860s, Louis Deroubaix, one of Seutin’s successors in Brussels, praised him for his clinical work but deplored his oratorical skills: ‘Blessed with a vehement and strong spirit, he transgressed nevertheless by the absence of consequence in his ideas, by the lack of logic in the succession of arguments, by a fierceness that spoilt the best things, and which created confusion and disorder where there should have been clarity and conviction. It is to him the Academy owes the heterogeneity and lack of coherence in certain sessions.’92 Deroubaix’s characterization contrasts sharply with contemporary praise on Seutin’s scientific career. One way to understand such critique might be to consider that

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Seutin’s high status allowed him to use the meetings of societies and academies in a more instrumental and polemical way. If Seutin’s showmanship thus forms a telling example of the mid-nineteenth-century culture of priority disputes, his actions also show its reverse side. As spaces of scientific accreditation, societies could in fact also be turned into ‘arenas’ for personal conflicts rather than meeting spaces to collectively advance the medical sciences, revealing the narrow boundaries between ‘contributing to science’ and mere self-fashioning, between gentlemanly debate and personal controversy. As had been the case with Jean Fierens, Seutin’s controversies were experienced as a breach with the customs of polite scientific debate. Observations and oratory

While surgical debates illustrated the tension between the individual interests of society members and their collective ambitions, such tension was far less present in debates on epidemics. The study of epidemics lent itself pre-eminently to collaborative work, as it required the gathering and interpreting of a great number of medical observations. The complexity that accompanied such compilation typically resulted in broad, circumstantial debates. In the words of the Antwerp physician Van Haesendonck, the study of epidemics required the inclusion of ‘everything, the march, the symptoms, the duration and the treatment’ into the analysis to allow ‘the preponderant physician, if we may put it this way, from an elevated position, to gaze upon the epidemic philosophically.’93 This interpretative dimension also meant that in epidemiology, more than in surgery, debate itself was seen as an essential component of scientific study. In other words: the debate was regarded as a scientific method in its own right rather than as a mere means of accrediting physicians’ individual work.94 This strong belief in the function of debate also turns the debates on epidemics into a suitable case to study the effectiveness of gentlemanly debate, as it was perceived by society members in the course of the nineteenth century, revealing a changing attitude towards oratory in the medical sciences. Debates on epidemiology generally followed major epidemic outbreaks. During the epidemic itself, scientific study formed no priority. When Dr F.J. Matthyssens took stock of the, albeit limited, scientific activities of the Medical Society of Antwerp in 1849, he pointed to

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the ‘grave [cholera] epidemic that was raging during several months of the current year, obliging nearly all physicians to consecrate all their time to their patients, and not permitting them to devote themselves to study.’95 Yet, once the peak of the epidemic was over, medical societies placed epidemiological analyses high on their agendas. Thanks to their network of correspondents, and the key positions of their resident members in the urban hospitals, they played a central role in gathering observations on the symptoms, spread and treatment of the disease. At the end of 1848, the Medical Society of Antwerp, for example, founded a ‘cholera commission,’ with the double goal of tracing the march of cholera in the city and composing a general work on cholera based upon the observations submitted by its correspondents.96 Such efforts to assemble the knowledge of all society members also help explain the popular debating genre of ‘discussions on prevailing diseases’ in medical societies, during which society members reported on the cases they had witnessed in their private practices to draw a general picture of the health conditions in the city. It was a typical way to end society meetings. One aspect of epidemiological research, the etiology of epidemic diseases, gave rise to the most lengthy debates. While some diseases, such as scarlet fever and smallpox, were generally accepted to be contagious (although the génie épidémique or disease agent remained unknown), others, including cholera, caused disagreement between the supporters and opponents of contagion. What made these discussions so elaborate was that the same ‘facts’ were often used as evidence on both sides of the debate. The Antwerp physician Paul-Joseph Bessems, a fierce opponent of the contagious nature of cholera, claimed that ‘all the facts cited in favor of contagion, could be just as well be explained by the combination of epidemic influences and supporting causes.’97 For Bessems, cholera was essentially due to changes in the constitutio epidemica of certain localities – meaning the susceptibility of a certain region for particular epidemic diseases, which resulted from environmental circumstances (e.g. the atmosphere) – which came under ‘epidemic influences’. Such etiology, in his eyes, explained the irregular march of the epidemic, which seemed to have erupted at the same time in different places, and in particular struck the unsanitary areas within the major cities.98 Most of his colleagues at the Medical Society of Antwerp opposed Bessems’ views, arguing that the irregularity in the

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march of cholera was only based on a lack of observations, which could trace the disease from one locality to another.99 From March to August 1850, the debate between the two sides was pursued with vigor, each interpreting and reinterpreting the same facts from different perspectives – facts that, as one participant noted, proved ‘remarkably militant in favor of both opinions.’100 Persuasiveness and solid argumentation were therefore essential during debate. As the Ghent physician Frédericq argued, even if the facts could not be questioned themselves, the argumentation that linked facts to etiology, ‘fell within the domain of critique.’101 Debating cholera was about identifying the contradictions in the argument of one’s opponent, and exposing these in an eloquent manner, for example by using literary expressions to re-enforce one’s point. Dr Rul-Ogez, one of the supporters of contagion in the Medical Society of Antwerp, parried Bessems’ critique on his concept of ‘personal aptitude’ (which Rul-Ogez used to explain why some and not others were struck by the disease) by pointing to the flexible way in which Bessems himself used the concept of ‘epidemic influences,’ which seemed to account for all deviant cases. Rul-Ogez concluded by addressing his colleagues with the following: ‘it’s always the story of the mote and the beam, as in the Gospel.’102 When Bessems later responded to another opponent, Dr Matthyssens, he played into the established distinction between objective ‘facts’ and subjective ‘judgments,’ reproaching Matthyssens’ lack of logic in questioning ‘accomplished facts,’ yet adopting without any problem the ‘judgments’ on facts that took place abroad.103 The cholera debate can therefore be regarded as an exercise in oratory; a form of debate that, to a certain extent, resembled contemporary political debate as it was conducted between two parties, who each used the available facts to strengthen their arguments. Such resemblance need not be surprising. Bessems, Matthyssens and Van Haesendonck also participated in the debates in the Antwerp town council, while RulOgez had experience in a more adversarial form of debate as a medical expert in the court room.104 Yet the question remained, among contemporaries also, whether such a political or judicial debating style was the best way to practice science.105 Already in the mid-nineteenth century, the idea held sway that some of the debates in medical societies generated far too few results. In a discussion on typhoid fever in 1846, Dr Van Swygenhoven

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criticized the Belgian Academy for its ‘endless and useless discussion on typhoid fever.’106 Three years later, Dr Jean Crocq’s work on typhoid fever was disapproved of for its ‘long-windedness,’ and the commissioners critically added that ‘this superfluous long-windedness used to be a feature of the past rather than of our times,’ suggesting that attempts to reduce the verbosity of medical studies were regarded as a long-term effort.107 In discussions on other topics, as well as epidemiology, requests for new debates were sometimes rejected for similar reasons. Dr Biver’s proposition to pursue a general debate on the different kinds of cancer was turned down because it would start ‘endless discussions, from which science would not profit at all.’108 Good discussions were, in the eyes of many physicians, always well-defined. A critique on the elaborateness of contemporary oratory, as a potential danger for scientific progress, may be considered as one of the tropes in societies’ debates. In the second half of the century, such critiques seem to have gradually augmented, as new research methods, in particular the increased use of statistics, brought about a new attitude towards scientific ‘facts’ and their interpretation.109 In Belgium, the state played a pioneering role in the development of statistics, in particular by establishing statistical commissions whose overviews were also sent to medical societies.110 In addition, medical societies themselves also (re)produced statistical information in their journals. The Medical Society of Ghent published a meteorological table for the city of Ghent in every monthly issue, followed by a brief discussion of the ‘medical constitution’ of the city. From the 1870s onwards, these were complemented by the monthly mortality statistics of the Ghent population, which also included the causes of death. In Brussels, the mortality statistics assembled by Eugène Janssens, a member of the Society of Medical and Natural Sciences, were also published monthly, and were often discussed during society meetings. Men such as Janssens belonged to a growing group of public health specialists, who embraced statistics as their central research method.111 Statistical knowledge seems to have fundamentally changed the style of the debates on epidemics. They reflected an increasingly positivist atmosphere, in which interpretations and hypotheses were pushed into the background. In line with the emphasis on the statistical accumulation of facts, the interpretive dimension of the debates on the etiology of epidemic diseases, with its continuous stream of arguments back and

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forth, became increasingly criticized. While in 1850, the debate on the nature of cholera in Antwerp was seen as ‘a new step in the question towards a final solution,’ in 1866, the members of the Brussels Society of Medical and Natural Sciences found it sufficient to say that the matter ‘had been debated extensively in all learned societies,’ but had only brought forth contradictions.112 What was at the heart of these statements was an unwillingness to reopen a debate that seemed to lead nowhere. Instead, a more reserved approach emerged. When Dr De Wachter, in a study in 1863, argued that the theory of contagion best explained the spreading of fevers in the town of Ruisbroeck, societies’ reports remained hesitant over either supporting or criticizing his claims. In a review report at the Medical Society of Liège, the strong implications of his claim were emphasized: ‘if the matter is understood correctly, this would evidently overthrow all our knowledge of miasmas and viruses, and it would be necessary to turn over a new leaf on everything that has been taught until today on the distinctive characteristics of infection and contagion.’113 The Liège society members therefore reacted with patience and chose not to take sides: ‘We therefore wait for more numerous and convincing facts before endorsing the views of our savant colleague.’114 The members of the Medical Society of Antwerp, who had published De Wachter’s study, had responded similarly: ‘more than an allegation, facts are needed and numerous facts, well-observed and concluding.’115 In the debates on cholera after 1866, a similar attitude was often adopted. Given the certainty on the causes of cholera, physicians simply did not want to make a stand against or in favor of contagion – a stand which could easily cause controversy. ‘It is important,’ Dr Henriette concluded after a debate in Brussels, ‘not to declare oneself in an uncompromising way.’116 In the face of uncertainty, reserve became the best scientific attitude. The introduction of laboratory analyses in the medical sciences in the late nineteenth century would further develop this hesitance to engage in speculative debates. Microscopic specimens with bacilli now enabled the visualization of formerly obscure causes of epidemic diseases.117 During society meetings, ‘demonstrations’ were organized for the members, in which these specimen were shown. In 1884, most members of the Medical Society of Antwerp must have seen the cholera bacillus – identified by the German researcher Robert Koch one year earlier – for the first time during such a demonstration. As the meeting

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report briefly documents: ‘Mr Schleicher shows the assembly the comma-shaped Cholera bacilli of Koch. These curved bacilli are clearly visible at a magnification of 600 diameters. They are colored violet on a white background.’118 Such demonstrations fit in with a claim made by Michael Worboys on the adoption of germ theories. For Worboys, the central shift in late nineteenth-century medical knowledge lay in the idea that ‘mechanisms of disease ought to be knowable and demonstrable’ – an idea, he argued, that emerged out of the medical debates of the 1860s and 1870s.119 The demonstrations of the 1880s, such as the one in Antwerp in 1884, fulfilled that promise. The interpretative debates on epidemics were now replaced with new forms of visualizing research results, which left little room for doubt. In the long run, the introduction of new research methods seems to have eroded the function of gentlemanly debates in the medical sciences. A new conception of medical knowledge – as universal knowledge that could be demonstrated by laboratory analyses – thus also entailed new modes of scientific communication. In this light, George Weisz’ reflections on the debates in the French Academy of Medicine in the late nineteenth century are of interest. In describing the changes in debating style in this period, Weisz refers to an intervention of Louis Pasteur in the Academy in 1875, in which Pasteur claimed that the words ‘speech’ and ‘orator’ no longer fit in with the simplicity and rigor of the medical sciences. For Weisz, Pasteur’s conclusion was somewhat premature in the 1870s, but in the final decade of the century, experimental facts, based on laboratory analyses, finally replaced reasoning as the central research method in medicine, turning the notion of oratorical debate into an uncomfortable idea for the Parisian academicians.120 The gradual disappearance of the verbatim meeting report as a scientific genre in the journals of medical societies – a genre that reflected the belief in the importance of these polite debates for the advancement of the medical sciences – equally testifies to this trend.121 The basis of this uneasiness with oratory can be traced back to the positivist ideas that developed, along with the introduction of statistics and laboratory analyses in the second half of the nineteenth century. In these debates, a new attitude towards uncertainty and a mistrust of speculations was developed. This chapter has examined the form and function of scientific debates in nineteenth-century medical societies. It has provided a look into the

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mechanisms that allowed physicians to establish both outside borders and internal hierarchies. In the first half of the century, society debates offered a way of differentiating between those who participated in the open exchange of knowledge (the true physicians) and those who did not (the charlatans). Societies’ debates, in other words, originated in an effort to provide the medical profession with a solid basis for its authority, a basis that prioritized the collective above the individual. At the same time, they gave a certain respectability to the profession by fitting in with the prevailing codes of gentlemanly conduct in civil society. Yet the belief in the need to share medical knowledge, which underpinned societies’ debates, was not only a matter of professional boundary-work. It also had profound consequences for the practice of science. An understanding of knowledge as a collective good brought about a new concept of scientific ownership, which depended on the approval of one’s colleagues. This added considerably to the importance of societies’ debates in the scientific field, for such approval was to be achieved through formal interactions between society members. At the heart of societies’ debates was thus a tension between the individual and the collective, between acknowledging physicians’ individual contributions and stressing the importance of collaboration. Written and unwritten codes of conduct regulated these different interests. Only by conforming to the customs of gentlemanly debate, could one become part of the community or establish oneself as the inventor of a new treatment, instrument or technique. Yet not all actors were given a right to the floor. Patients, in particular, were turned into objects of clinical study (rather than into privileged witnesses). Instrument makers rarely succeeded in becoming interlocutors of equal merit. But the formal rules along which debates were conducted also reinforced hierarchies among physicians. They privileged those physicians with strong capacities for the spoken word. Across the debates on medical therapies, surgical innovations and epidemiological theories, the importance of oratory and eloquence, of speaking persuasively before an audience, has become clear. Such skills were typically present among the medical elite – whose members had access to patients in the hospitals and acquired experience in public speaking through their political engagement and academic teaching – rather than among (rural) private practitioners. In that sense, the conventions of scientific debate reflected the social hierarchies within the medical profession.

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The ideal of the contributing physician was grafted onto the image of the eloquent and engaged citizen. At the same time, scientific codes of conduct proved flexible. They reveal a continuous search to find the right form for societies’ debates – a form that would best match their perceived function. Society members did not simply conform to the reigning codes of conduct, they also interpreted these same codes creatively. During controversies, in particular, the function of societies’ debates and the mode of interaction between society members became itself subject to debate. Auguste Sotteau, in his attack on Jean Fierens, articulated the very agenda of medical societies as spaces of scientific judgment. Louis Seutin called upon societies’ role in the defense of authors’ rights. In emphasizing these functions, they helped shape and create new norms of scientific ownership. Scientific codes of conduct, one might conclude, thus not only structured medical debates, but were themselves also the product of these same debates. Put another way, the prerequisites of a successful scientific performance were constantly renegotiated. The critique on the ‘long windedness’ of some scientific exchanges illustrates this well. While at first such critique did not challenge the need for polite debate, later on it took a more severe form, as it was articulated by a new generation of medical scientists, whose views on science took shape within a professionalized academic world and for whom the ‘civil’ procedures of scientific communication needed reform. These same dynamics were in operation in societies’ publishing efforts. Here too, as the next chapter will show, the initial goals of the founding members had to be adapted to meet the changing needs of both the authors and audiences of societies’ journals in the course of the century. Notes 1 Statuts de la Société de Médecine de Gand, modifiés d’après la décision prise dans la séance du 18 juillet 1837 (Ghent: F.E. Gyselynck, 1837), p. 7. 2 Ibid. 3 Règlement de la Société des Sciences Médicales et Naturelles de Bruxelles: Adopté dans la séance du 17 Avril 1841 (Bruxelles: J. Delfosse, 1841), p. 21. 4 See for example: J.S. Meisel, Public Speech and the Culture of Public Life in the Age of Gladstone (New York: Columbia University Press, 2001). 5 D.A. Finnegan, ‘Placing Science in an Age of Oratory: Spaces of Scientific Speech in Mid-Victorian Edinburgh,’ in D. Livingstone and C. Withers (eds),

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7

8 9 10

11 12

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Geographies of Nineteenth-Century Science (Chicago and London: The University of Chicago Press, 2011), pp. 153–77, 154–6. On the codes of conduct in parliamentary debate in Belgium: J. Hoegaerts, ‘La Voix du Pays: Masculinity, Vocal Authority and the Disembodied Citizen in the Nineteenth Century,’ in K. Starck and B. Sauer (eds), Political Masculinities (Cambridge: Cambridge Scholars Publishing, 2014), pp. 39–50; M. Beyen, ‘De Parlementaire Handelingen en andere bronnen voor de studie van de taal van de negentiende–eeuwse politicus,’ Verslagen en mededelingen van de Koninklijke Academie voor Nederlandse taal en letterkunde, 114 (2004), 11–18. There is little research on everyday medical therapies in nineteenthcentury Belgium. The practice of Jan Renier Snieders is one of the scarce well-studied cases: K. Martens, ‘Mijnheer doktoor’: De verhouding tussen dokter Jan Renier Snieders en zijn patiënten ca. 1840–1888 (Master’s thesis, University of Leuven, 2017); G. Tack, Ziekte en zorg in de Kempen: Renier Snieders, geneesheer in de 19de eeuw (Turnhout: Brepols, 2015). S.M. Stowe, Doctoring the South: Southern Physicians and Everyday Medicine in the Mid-Nineteenth Century (Chapel Hill: University of North Carolina Press, 2004), pp. 149–55. ‘Bulletin de la séance du 7 juillet 1851,’ JMCP, 13 (1851), 363–5. In 1847, Dr Vervier’s treatment with high doses of camphor was, for example, judged by the Medical Society of Ghent as ‘far from being without danger’: ULG, Hs. 3012 4.2, Undated letter [March 1847] from the Medical Society of Ghent to Dr Vervier. Stowe, Doctoring the South, pp. 156–62. ‘Séance du 1 août 1843,’ BSMG, 9 (1843), 111–39, 136. Guislain seemed to have used the term ‘positivism’ in a strictly scientific way, without reference to the political connotations that characterized its early introduction in Belgium: K. Wils, De omweg van de wetenschap: Het positivisme en de Belgische en Nederlandse intellectuele cultuur 1845–1914 (Amsterdam: Amsterdam University Press, 2005), pp. 133–5. ‘Bulletin de la séance du 3 novembre,’ JMCP, 13 (1851), 570–2. R. De Bont, ‘“Writing in Letters of Blood”: Manners in Scientific Dispute in Nineteenth-Century Britain and the German Lands,’ History of Science, 51 (2013), 309–35. ‘Bulletin de la séance du 6 décembre,’ JMCP, 16 (1853), 87–107, 88. See for example the letter of the Brussels pharmacist Gaspard-François Leroy to Jean-Romualde Marinus: G.F. Leroy, ‘Monsieur le rédacteur,’ BMB, 5:2 (1838), 59. R. Schepers, ‘Towards Unity and Autonomy: The Belgian Medical Profession in the Nineteenth Century,’ Medical History, 38 (1994), 237–54.

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18 ‘Séance du 5 mai 1840,’ BSMG, 7 (1840), 61–7. 19 ‘Séance du 7 juin,’ JMCP, 15 (1852), 94–6. 20 The meeting reports of medical societies often provide few explanations on these exclusions, merely stating that a member had not kept up medical honor; see for example: ‘Séance du 30 avril 1852,’ ASMA, 13 (1852), 313. In Brussels, another member, Dr Merchie, was excluded because of commercial advertising in 1872: JMCP, 55 (1872), 388, 587–8. 21 H. Kluyskens, Des hommes célèbres dans les sciences et les arts, et des médailles qui consacrent leur souvenir (Ghent: Hebbelynck, 1859), pp. 304–5. 22 C. Kelly, ‘Medicine and the Egyptian Campaign: The Development of the Military Medical Officer during the Napoleonic Wars c. 1798–1801,’ Canadian Bulletin of Medical History / Bulletin canadien de l’histoire de la médecine, 27:2 (2010), 321–42; C. Kelly, War and the Militarization of British Army Medicine, 1793–1830 (London: Pickering & Chatto, 2011). 23 On the efforts of Belgian army doctors to contain ophthalmia: J. Vandendriessche, ‘Ophthalmia Crossing Borders: Belgian Army Doctors between the Military and Civilian Society, 1830–1860,’ Journal of Belgian History, 46:2 (2016), 10–33. 24 Gazette van Gend, May 24, 1837; Guioth, Histoire numismatique de la révolution belge, ou description raisonnée des médailles, des jetons et des monnaies qui ont été frappés depuis le commencement de cette révolution jusqu’à ce jour (Hasselt: Milis, 1844), pp. 237–8. On Fierens’ medal, see also: Kluyskens, Des hommes célèbres, pp. 304–5. 25 ‘Séance du 5 décembre 1837,’ BSMG, 3 (1837), 185–95; ‘Séance du 9 janvier 1838,’ BSMG, 4 (1838): 5–20, 10; ‘Séance du 8 février 1837,’ BSMG, 3 (1837), 21–32, 21; RMAF, ‘Service de Santé,’ N. 2194, Letter of November 21, 1837 from Pierre de Schiervel to the Minister of War. 26 Courtmans, Het blinde meisje, aen den weldadigen oogmeester van Beirvelde: M.J. Fierens (Ghent: Dhont, 1841). 27 Th. Leuridan, Histoire des établissements religieux et charitables de Roubaix (Roubaix: Reboux, 1860), II, pp. 328–9. 28 For an overview of the literature: Kelly, War and the Militarization, p. 171 (note 4). See in particular: L. Davidson, ‘“Identities Ascertained”: British Ophthalmology in the First Half of the Nineteenth Century,’ Social History of Medicine, 9 (1996), 313–33. 29 In 1837, the Society of Medical and Natural Sciences in Brussels organized a prize competition on the matter of ophthalmia, of which the considerable amount of 1500 Fr was the first prize: ‘Société des Sciences Médicales et Naturelles de Bruxelles,’ BMB, 4:2 (1837), 33. This sum had been donated by ‘a philanthropist from St. Petersburg’ in the previous

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31 32 33

34 35 36 37 38 39 40 41

42 43 44 45 46

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year and had been applauded by the members of the Brussels Society: ‘Ophthalmie,’ BMB, 3:6 (1836), 148. See also: K. Velle, ‘Bronnen voor de medische geschiedenis: De Belgische medische pers (begin XIXde eeuw–1940),’ Annalen van de Belgische vereniging voor de geschiedenis van hospitalen en volksgezondheid, 23–4 (1985–1986), 78–9. J. Matthieu, ‘De Belgische militaire gezondheidsdienst in de 19de eeuw,’ in E. Evrard, J. Mathieu, R.J. François and R. Moorthamers (eds), Asklepios onder de wapens: 500 jaar militaire geneeskunde in België (Brussels: Wetenschappelijke vereniging van de militaire medische dienst, 1997), pp. 205–32, 211. ‘Séance du samedi 13 mai 1837,’ Chambre des représentants (www. unionisme.be/ch18370513.htm consulted on March 27, 2014). RMAF, ‘Service de Santé,’ N. 2194, Letter of November 21, 1837 from Pierre de Schiervel to the Minister of War. For the military health service, the experiment was also expensive. The total cost of 2,387 Fr was more than the annual subsidy of the Medical Society of Ghent: Pasinomie ou collection complète des lois, décrets, arrêtés et règlement généraux qui peuvent être invoqués en Belgique (Brussels: Wahlen, 1847), p. 513. ‘Séance du 5 décembre 1837,’ 186. ‘Séance du 5 décembre 1837,’ 186. ‘Séance du 5 décembre 1837,’ 193–5. ‘Séance du 9 janvier 1838,’ 10. ‘Séance du 9 janvier 1838,’ 11. ‘Séance du 9 janvier 1838,’ 15. RMAF, ‘Service de Santé, N. 2216, Letter of January 15, 1838 from Fierens to the Minister of War. RMAF, ‘Service de Santé, N. 2219, Letter of January 22, 1838 from the Minister of War to Vleminckx; N. 2262, Letter of May 12, 1838 from Colson to Vleminckx; N. 2263, Letter of May 16, 1838 from Vleminckx to the Minister of War. RMAF, ‘Service de Santé,’ N. 2193, Letter of November 18, 1837 from Fierens to the Minister of War. RMAF, ‘Service de Santé,’ N. 2212, Letter of January 13, 1839 from Fierens to the Minister of War. RMAF, ‘Service de Santé,’ N. 2229, Note titled ‘Méthode pour cautériser les paupières par le Docteur Fierens de Beirvelde’. RMAF, ‘Service de Santé,’ N. 2199, Letter of November 30, 1837 from Vleminckx to the Minister of War. See the reports from the hospitals of Leuven, Antwerp, Ghent, Brussels, Tournai and Namur: RMAF, ‘Service de Santé,’ N. 2230–2235.

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47 Fierens still claimed priority of the treatment in a letter to the Annales d’oculistique in 1840: Annales d’oculistique (1840): 188. 48 RMAF, ‘Service de Santé,’ N. 2296, Letter of August 1840 from the Minister of War to the Minister of Internal Affairs. 49 ‘Séance du 4 septembre,’ ASMA, 6 (1845), 549–52. 50 See for example: S. Arapostathis and G. Gooday, Patently Contestable: Electrical Technologies and Inventor Identities on Trial in Britain (Cambridge, MA: MIT Press, 2013). 51 S. Frampton, ‘Patents, Priority Disputes and the Values of Credit: Towards a History and (Pre-History) of Intellectual Property in Medicine,’ Medical History 55 (2011): 319–24. 52 Ibid., 320. On innovation in the history of medicine, see: J.V. Pickstone, ‘Introduction,’ in J.V. Pickstone (ed.), Medical Innovations in Historical Perspective (New York: St. Martin’s Press, 1992). 53 On Van Huevel’s forceps see: B. Hibbard, The Obstetrician’s Armamentarium: Historical Obstetric Instruments and Their Inventors (San Anselmo: Norman Publishing, 2000), p. 259; M. Thiery, ‘Jean-Baptiste Van Huevel (1802–1883) en de Van Huevel-forceps,’ Tijdschrift voor geneeskunde, 63:21 (2007), 1067–9. On Seutin’s surgical work: M. Thiery, ‘Louis Seutin (1763–1862) en de behandeling van de beenbreuken,’ Scientiarum Historia, 27:1 (2001), 83–91. 54 ‘Séance du 1 septembre,’ JMCP, 13 (1851), 366–7. 55 ‘Bulletin de la séance du 5 mai,’ JMCP, 13 (1851), 91. The Society of Medical and Natural Sciences of Brussels also experimented with Barnascroni’s apparatus and made several recommendations for its improvement: ‘Séance du 5 avril,’ JMCP, 15 (1852), 83. 56 On instrument makers in the Low Countries: M. Rooseboom, Bijdrage tot de geschiedenis der instrumentenmakerskunst in de Noordelijke Nederlanden tot omstreeks 1840 (Leiden: Rijksmuseum voor de Geschiedenis der Natuurwetenschappen, 1950). 57 Rapport du jury et documents de l’exposition de l’industrie belge en 1841 (Brussels: s.n., 1842), p. 171. 58 Ibid., pp. 168–71. 59 ‘Séance du 6 avril 1841,’ 116–17. 60 ‘Séance du 5 et 12 janvier 1841,’ BSMG, 7 (1841), 3–18. 61 Huis van Alijn, N. 200-038-043-002, ‘Visiting card of Henri Bayly.’ 62 ‘Bulletin de la séance du février,’ JMCP, 20 (1855), 294–303. 63 On witnessing in nineteenth-century medicine: C. Hamlin, ‘Scientific Method and Expert Witnessing: Victorian Perspectives to a Modern Problem,’ Social Studies of Science, 16 (1986), 485–513. 64 ‘Bulletin de la séance du 6 décembre,’ JMCP, 6 (1848), 71–2. 65 ‘Bulletin de la séance du 7 février,’ JMCP, 6 (1848), 267–9.

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66 ‘Séance du 5 mars 1844,’ BSMG, 10 (1844), 99–142, 114. 67 ‘Bulletin de la séance du 5 juillet 1852,’ JMCP, 15 (1852), 182–4. 68 Wutzer had designed an instrument that had to be applied for five to six days and created a fold of the skin in the inguinal canal that stopped the descending of the intestines. Sotteau was said to have improved Wutzer’s instrument by adding an additional metal plate, to allow a double fold of the skin and to operate in more severe cases: ‘Séance du 5 mai,’ BSMG, 6 (1840), 61–8. 69 ‘Séance supplémentaire du 7 juin,’ BSMG, 6 (1840), 71–88. 70 ‘Séance du 7 mars,’ BSMG, 9 (1843), 27–31. 71 ‘Bulletin de la séance du 3 février 1845,’ JMCP, 3 (1845), 210–14. 72 ‘Séance du 4 juin 1844,’ BSMG, 10 (1844), 199–216, 200. 73 Phillips later moved to Paris, where he became a successful urologist. For an overview of his career: J. Leval, ‘Charles Phillips, a Famous Urologist, Born in Liège, and Yet Unknown in that City,’ Revue médicale de Liège, 63:7–8 (2008), 504–7; G. Dewalque, ‘Phillips Charles, chirurgien (1811–1870),’ Biographie Nationale, 17 (1903), 363–8. 74 Phillips indeed needed to travel to present his scientific work. In 1837, for example, he presented a study on harelips in the Society of Medical and Natural Sciences in Brussels: ‘Société des Sciences Médicales et Naturelles de Bruxelles. Séance du 4 septembre 1837,’ BMB, 4:9 (1837), 156. 75 ‘Séance du 8 janvier 1839,’ BSMG, 4 (1838), 5–20, 6; Charles V.J. Phillips, ‘Observations chirurgicales,’ ASMG, 5 (1839), 15–26. 76 To these advisory activities, he linked political interests. Seutin weighed in on the debate on prostitution and venereal diseases. In 1854, he became a senator for the liberal party. 77 The elaborate notebooks of Seutin’s private practice have been preserved in the Brussels city archive. At a brief glance, they reveal a flourishing practice with many patients from the Brussels upper classes: CAB, N. 3214–3216 and N. 3462–3463. 78 Thiery, ‘Louis Seutin,’ 86. 79 ‘Séance du 6 novembre 1837,’ BMB, 4:11 (1837), 222–4. 80 Ibid. 81 F. Cunier, ‘Lettre de M. Cunier, à MM. Dezeimeris et Littré, rédacteurs de l’Expérience (journal médical qui se publie à Paris),’ BSMG, 3 (1837), 195–200. Moreover, during his trip to the south of France, Cunier had introduced the bandage Seutin to Professor Serre in Montpellier: ‘Séance du 4 avril 1837,’ BSMG, 3 (1837), 49–80, 72. 82 J. Guislain, Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse; résumé d’un voyage fait en 1838, adressé à la Société de Médecine de Gand (Ghent: Gyselynck, 1840), p. 212.

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83 For an overview of Seutin’s publications: V. Jacques, ‘Seutin (Baron Louis-Joseph),’ Biographie Nationale, 22 (1936–1938), 324–39. 84 L. Seutin, Du bandage amidonné, ou recueil de toutes les pièces composées sur ce bandage depuis son invention jusqu’à ce jour, précédé d’une esquisse historique; suivi de la thèse de M. Hyp. Larrey sur le bandage inamovible et de la description générale et du mode d’application de l’appareil amidonné (Brussels: J.B. Tircher, 1840). In 1851, Seutin again published a major work: L. Seutin, Traité de la méthode amovo-inamovible: comprenant des recherches historiques sur l’origine et la constitution de cette méthode … et ses applications cliniques aux divers ordres de lésions et maladies chirurgicales (Brussels: De Mortier, 1851). 85 ‘Bulletin de la séance du 4 août 1845,’ JMCP, 3 (1845), 579–80. 86 Ibid., 579. 87 L. Seutin, ‘Sur le traitement des fractures en général, par le bandage amidonné,’ BMB, 4:12 (1837), 236–42. 88 Ibid., 144. 89 ‘Séance du 6 octobre’. 90 Ibid., 151. 91 R. Bardez, Histoire de la faculté de médecine de l’ULB en dix-neuvième siècle (PhD Diss., Free University of Brussels, 2016). 92 L. Deroubaix, Compte-rendu des travaux relatifs à la chirurgie pendant la période 1841–1866 (Brussels: Royal Academy of Medicine of Belgium, 1867). 93 ‘Séance du 8 mars 1850,’ ASMA, 11 (1850), 144–157, 148. 94 On debate as scientific practice, see also: A.F. La Berge, ‘Debate as Scientific Practice in Nineteenth-Century Paris: The Controversy Over the Microscope,’ Perspectives on Science, 12:4 (2004), 424–53. 95 ‘Séance annuelle publique du 20 décembre,’ ASMA 11 (1850), 59–62. In 1866, when cholera again struck the European cities, the meeting report for August of the Medical Society of Ghent explained that only a few physicians made it to the meeting, because ‘the medical practitioners don’t have a moment’s quiet neither at night nor by day’: ‘Séance ordinaire du 7 août 1866,’ BSMG, 33 (1866), 197–8. 96 ‘Séance du 27 décembre 1848,’ ASMA, 10 (1849), 50–2. 97 ‘Séance du 5 juillet 1850,’ ASMA, 11 (1850), 354–85, 364. 98 P.J. Bessems, ‘Communication de l’épidémie de choléra à Anvers,’ ASMA, 10 (1849), 606–23; P.J. Bessems, ‘Quelques mots sur la question de la contagion du choléra,’ ASMA, 11 (1850), 193–237; P.J. Bessems, ‘Quelques données statistiques sur l’épidémie de choléra, qui a régné à Anvers pendant les années 1848 et 1849,’ ASMA, 11 (1850), 529–616. 99 ‘Séance du 7 juin 1850,’ ASMA, 11 (1850), 239–66, 242–3.

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100 Ibid., 247. 101 ‘Séance du 7 juin 1850,’ 249. 102 Ibid., 261. 103 ‘Séance du 5 juillet 1850,’ ASMA, 11 (1850), 354–85, 370. 104 On Bessems’ political engagement: S. Heylen and B. D’hondt, ‘Paul Bessems (1818–1886),’ in ODIS – Database Intermediary Structures Flanders (www.odis.be), consulted on April 14, 2014. 105 On the performance of physicians as experts in the courtroom in Belgium: L. Tuybens, Verloren intimiteit: Medische expertise bij aanrandings- en verkrachtingszaken in België (1850–1900) (Master’s thesis, University of Leuven, 2017). 106 ‘Bulletin de la séance du 5 janvier 1866,’ JMCP, 4 (1846), 184–93. 107 ‘Bulletin de la séance du 6 août 1849,’ JMCP, 9 (1849), 498–501. 108 ‘Bulletin de la séance du 4 janvier,’ JMCP, 5 (1847), 226–7. 109 On the use of statistics in nineteenth-century medicine: J.H. Cassedy, American Medicine and Statistical Thinking, 1800–1860 (Cambridge and London: Harvard University Press, 1984); E. Houwaart, ‘Medische statistiek,’ in H.W. Lintsen et al. (eds), Geschiedenis van de techniek in Nederland: De wording van een moderne samenleving 1800–1890 (Zutphen: Walburg Pers, 1993), pp. 19–45. For Belgium: K. Velle, ‘Statistiek en sociale politiek: De medische statistiek en het gezondheidsbeleid in België in de negentiende eeuw,’ Belgisch Tijdschrift voor Nieuwste Geschiedenis, 16 (1985), 213–42. 110 On the development of governmental statistics in Belgium: N. Bracke, Een monument voor het land: Overheidsstatistieken in België, 1795–1870 (Gent: Academia Press, 2003). In 1844, the Society of Medical and Natural Sciences of Brussels decided to exchange its Journal with the Bulletin de la commission centrale de statistique. In the same year, the society received the Statistique de la Belgique: Mouvement de l’état civil pendant l’année 1841, published by the Ministry of Internal Affairs: ‘Séance du 8 janvier 1844,’ JMCP, 2 (1844), 91–3; ‘Bulletin de la séance du 5 février 1844,’ JMCP, 2 (1844), 144. 111 The close ties maintained by hygienist physicians between science, profession and government also pressurized the position of medical societies as scientific institutions. This impact will be discussed in Chapter 5. 112 ‘Séance annuelle publique du 23 décembre 1862,’ ASMA, 24 (1863), 79. 113 ‘Bibliographie,’ ASMCL, 2 (1863), 434–9. 114 Ibid. 115 ‘Séance du 23 janvier 1863,’ ASMA 24 (1863): 192–200. 116 Ibid., 79.

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117 On these new forms of visualization, see the section ‘Dialogue between specialties’ in Chapter 7, pp. 258–65. 118 ‘Séance du 14 novembre 1884,’ ASMA, 46 (1884), 699–705. 119 M. Worboys, Spreading Germs: Disease Theories and Medical Practice in Britain, 1865–1900 (Cambridge: Cambridge University Press, 2000), pp. 272–92. 120 G. Weisz, The Medical Mandarins: The French Academy of Medicine in the Nineteenth and Early Twentieth Centuries (Oxford: Oxford University Press, 1995), pp. 81–3. 121 A discussion of the modifications made to the journals of medical societies in the late nineteenth century is included in Chapter 3.

3

Publishing and editing

Scientific journals were ‘new’ in the nineteenth century. To be sure, a form of periodical publishing in science existed long before. Publications such as the Philosophical Transactions of the Royal Society in London date back to the seventeenth century. But several of the features we consider today as typical of scientific journals only appeared from the late eighteenth and early nineteenth century. These include an increase in the speed and regularity of scientific periodicals, as these latter publications took over practices and techniques from the general press.1 In nineteenth-century science, as a result, the journal article gradually became the most authoritative form of scientific knowledge.2 Compared to books or treatises appearing in annually published transactions, articles allowed for far more speedy communication – a considerable advantage when one aims to decide priority disputes in one’s favor. Specialization forms a second feature. Scientific journals increasingly aimed at an audience of specialists. This evolution went hand in hand with the disappearance of ‘amateurs’ in favor of ‘scientific professionals’ among the ranks of potential authors.3 A final feature comprises the formalization of scientific papers (e.g. through the introduction of abstracts, footnotes and standardized citations, plus the creation of bibliographies and catalogues). This machinery proved essential for journals to present themselves as spaces of authoritative knowledge.4 Medical societies played a key role in the way this transformation played out in the medical field. Scientific publishing was perhaps their most important activity, and one which had a lasting impact on the way medical findings were communicated. Their journals developed in parallel with the introduction of the freedom of the press in Belgium. As such, they acted as sites of experimentation to explore the possibilities

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of this newly acquired freedom for the medical sciences. In the first decade of the century, societies published their studies in book form at an often irregular pace, leaving several years in-between their volumes. Before publishing, they waited until sufficient materials had been gathered by means of prize competitions or until new manuscripts were submitted by their members. By 1850, however, articles appeared regularly in monthly issues and consisted, besides original studies, of meeting reports, book reviews, summaries of articles from foreign medical journals, professional news and obituaries. All submitted articles were reviewed and their journals circulated widely in the country and abroad. There were, however, limits to the flexibility with which societies adapted their journals to the changes in the way science was practiced. In the late nineteenth century, the rise of specialization again forced societies to alter their publishing strategies. This proved a major challenge, perhaps one too many, since society journals aimed for an audience of private practitioners. By expanding their editorial boards and by including more translations and summaries of foreign studies, societies hoped to keep private practitioners updated on the increasing body of specialized literature, while continuing to provide publication space for original contributions at the same time. It was a publishing model that by the end of the century had reached its limits. Specialized journals, managed by universities or research institutes, became the new norm. This chapter discusses the publishing activities of medical societies, and their particular trajectory in the nineteenth-century medical press.5 The publication of a journal – similar to the organization of scientific debates – was central to societies’ ambitions. It was a means to stimulate the scientific engagement of medical practitioners and update them on the progress of the medical sciences – private practitioners were thus regarded both as potential authors and readers. Their preferences and interests hence greatly influenced the form and content of society journals. This dynamic may help explain the ways in which society members experimented with their journals: a need for regularity, originality and practice-oriented contributions turned society journals into the most innovative and leading periodicals of the mid-nineteenth century.6 But this same dynamic also determined the somewhat forced reaction to specialization in the late nineteenth century. As academics and specialists became the principle group of authors of new studies, a growing

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division occurred between the authors and audiences of society journals, which still aimed for a readership of private practitioners. This division marginalized society journals in a scientific landscape in which specialists increasingly sought like-minded audiences to communicate their results. This chapter offers a broad view on scientific publishing. Following Jonathan Topham, it focuses on the diversity of actors involved in the production of scientific articles, all those who were part of a ‘communication circuit of print.’7 It pays attention to the motivations and needs of authors and readers (and the alternatives available to them); to the role of reviewers in societies’ publishing procedures; to the strategies of editors, who tried to position their journals in a diversifying medical press; and finally to the role of publishers in the financing of societies’ journals. The chapter starts with a look into the landscape of medical publishing in the 1830s, at a time when commercial medical journals presented new publishing opportunities for medical societies. Science and the reprinting industry

The commercial organization of the Belgian printing industry was fundamental to the development of the periodicals of nineteenth-century medical societies. The period between 1830 and 1850 saw the heyday of the contrefaçon or the reprinting of books and journals without permission by the authors.8 Most of these reprints were originally published abroad, often in the Netherlands or France. The Belgian counterfeit editions of these works were sold at a much lower price than the original editions. It was only in the 1850s that bilateral agreements between countries – an agreement was made with France in 1854, and one with the Netherlands in 1855 – put an end to this lucrative industry. While the reprinting of journals and books occurred in many European countries, Belgium, and Brussels in particular, was certainly one of its most important centers. This dominant position was in no small measure due to the presence of several major publishing houses. As has been argued for the reprinting of Dutch literary books in this period, the phenomenon had both a cultural and a commercial side. Many of the involved publishers had the advancement of Flemish literature in mind, an emancipatory project that could also be turned into a profitable undertaking.9

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In the medical press as well, commercial motives could be successfully coupled with the ambition to advance the field. In the first two decades of Belgian independence, the number of medical journals rose steeply. As Karel Velle has shown, 13 new journals were founded during the 1830s and another 20 new journals were created in the 1840s.10 By way of comparison, only four medical journals had been published in the late 1820s.11 The reprinting of foreign, in majority French, articles in many of these new journals was presented as a means to provide Belgian physicians with access to the medical literature. As such, these reproductions could easily fit in with a reformist and nationalist discourse on the advancement of the medical sciences. When two of these new journals, L’Abeille and L’Observateur médical belge, merged in 1834, their editors pointed to a shared goal of ‘liberating Belgium from the necessity of resorting to publications printed in other countries to keep abreast of scientific progress.’12 The champion in the reprinting of foreign articles was the Encyclographie des sciences médicales, which systematically reprinted nearly all Parisian medical journals from 1832, and later on also several British and German journals, making up a total of 260 book-length volumes until its demise in 1854.13 Its editor in the 1830s was Jean-Romualde Marinus, who marketed the Encyclographie by emphasizing its exactitude and completeness. In 1833, Marinus reassured his readers that ‘nothing that has appeared in the [Parisian] issues of this month, has been removed.’14 In the middle of the 1840s, when 125 volumes had already appeared, the Encyclographie was advertised as a journal ‘that one does not read every day,’ but consults as a handbook.15 This focus on the full reproduction of foreign articles by no means excluded the publication of original Belgian studies. Within the patriotic framework of advancing Belgian medicine, the goals of informing Belgian practitioners of scientific developments abroad, and of providing them with publication space, seemed part of the same project. In the Encyclographie, Belgian publications were more than welcome. Such openness was, for example, articulated in 1833, when a work on gangrene by the Belgian physician Victor François, was published: We are delighted to include such a remarkable work of one of our compatriots in our archives, and we take the occasion to remind Belgian physicians that the columns of the Encyclographie are open to them. The

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editor will willingly take up all occasions to publish and spread their work, and his deepest desire will always be to see the Belgian medical literature occupy the place it deserves in the learned world.16

Marinus’ ambition to offer Belgian physicians publication space led to the foundation of a new journal in 1834, the Bulletin médical belge, which was sold as an appendix to the Encyclographie. The Bulletin presented itself as ‘the spokesman of the majority of the practitioners’ and wanted to provide these practitioners with an accessible forum to voice their professional desires and scientific insights.17 It raised topical subjects such as the reform of medical legislation and the question of ‘military ophthalmia,’ subjects on which all Belgian practitioners were invited to send articles to convey their opinion.18 Marinus’ journal, moreover, was not an isolated phenomenon: many of the new medical journals of the 1830s opened up their pages for new articles, which could discuss matters of professional and scientific interest, in addition to the reprinting of existing work. For medical societies, the development of these new journals offered interesting publishing opportunities. First of all, their monthly issues formed a much more speedy way of publishing than the traditional annual volumes of Annales. Such publishing was probably also cheaper, as the running costs of the journal fell to its editors. Perhaps it generated less pressure to produce scientific work at a regular pace, as studies could be passed on to these new journals when they were ready. These benefits meant that medical societies in the 1830s seriously debated cooperating with ‘reprint journals’ instead of publishing annual volumes, or starting their own monthly journal. In 1834, the Medical Society of Ghent had approached the Annales de médecine belge et étrangère (the result of the merger between L’Observateur and L’Abeille) to publish the studies they had judged worthy of publication during society meetings. The editors, in turn, used the promising prospects of the society’s publications as a marketing tool, announcing the inclusion of their studies as a matter of great interest to its subscribers.19 In the end, however, the society decided to publish its own journals: the Ghent Annales, Bulletin and Mémoires. The combination of a monthly Bulletin (with meeting reports and smaller studies) and annual Annales and Mémoires (with more elaborate studies) combined old and new publishing trends. Other societies, such as the Medical Society of Antwerp and the Society

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of Medical and Natural Sciences in Brussels, did publish their studies through the agency of commercial medical journals. Both published Annales as a separate section of the Bulletin médical belge in the 1830s. The Antwerp society also published meeting reports in the Archives de la médecine belge.20 In the early 1840s, however, this cooperation ended and both societies started their own monthly journals. The Bulletin médical belge nevertheless continued to attract the interest of medical societies, even beyond national borders. In 1841, Marinus’ successor Florent Cunier negotiated with the Medical Society of Rotterdam on the publication of its proceedings. In the end, the Dutch society rejected Cunier’s offer, arguing that ‘it would assume the appearance of dependence, if we wanted to incorporate our small society in a large one, but of a different coat of arms.’21 Just over ten years after the Belgian Revolution, national sensitivities still seemed to have prevented such an agreement. If the advantages seemed considerable, why then did medical societies stop their collaboration with ‘reprint journals’ and start their own periodicals? One precondition was at least a sufficiency of scientific materials to fill the pages of monthly issues. In the early years of medical societies, such an amount of copy was perhaps lacking. But, more generally, the development of societies’ journals reflects a need for more autonomy in scientific publishing – a need that was difficult to reconcile with the close ties between the scientific, professional and commercial motives that marked the reprinting industry. Most of the ‘reprint journals’ were run by the Brussels publishing company Société Encyclographique. Besides medical journals, the company also published a ‘yearbook of the Belgian medical profession’ and ‘an agenda of the Belgian physician,’ which contained a calendar ‘to note visits and consultations,’ lists of the members of medical commissions and societies, excerpts of medical legislation etc.22 Much more than scientific journals, agendas and yearbooks were commercial products. They show how the forging of a ‘Belgian’ medical community was coupled to commercial initiatives that benefited the editors of the Société Encyclographique. In the eyes of the Brussels editors, professional advancement through science was by no means contradictory with commerce. Moreover, the commercial side had been a crucial part of the reformist ambitions of the Société Encyclographique, which, in publishing the Encyclographie, aimed ‘to render this important publication accessible to all

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fortunes.’23 Cheap periodicals were a means of democratizing the medical sciences. This intertwinement between science and commerce had a clear impact on the content of medical journals. In the section for book reviews in the Bulletin médical belge scientific assessments were combined with advertisements. The Belgian reproduction of Boivin’s and Dugès’s Traité pratique des maladies de l’utérus, an overview of diseases of the uterus, was discussed as a way ‘to render their [Boivin’s and Dugès’s] research more profitable to the sciences.’24 Moreover, the forty-one drawings that embellished the study, the reviewer added, ‘leave nothing to be desired in the Belgian edition; they have been reproduced with the most perfect accuracy and measure up to those of the original edition.’25 In a footnote, readers were informed that the study was for sale at the Établissement encyclographique for 12 Fr with figures in black-and-white and 28 Fr for colored figures.26 The reprint of Jean Cruveilhier’s extensive anatomical treatise, Anatomie pathologique du corps humain, was similarly reviewed and advertised. The Belgian copy was printed in twenty-four to thirty issues, which each contained ten drawings at 3 Fr for black-and-white and 6.5 Fr for colored images. The reviewer also explicitly compared the Belgian edition with the original French publication by adding that ‘the Parisian edition only adds six drawings to each issue and costs 11 Fr.’27 Both examples show how reviewing and advertising went hand in hand in the publications of the Société Encyclographique. They also highlight the importance of illustrations in the sales of medical studies and journals. Scientific judgments thus became intertwined with the commercial reproductions of major French studies. In Paris, such a combination of science and commerce was regarded far less as a project of scientific advancement. French editors followed the development of new Belgian journals with a certain degree of disdain and did not go along with the claims of their neighboring colleagues of establishing a truly ‘Belgian’ medicine. In 1834, the Gazette médicale de Paris incuded a new review section on the Belgian medical press, arguing that ‘Belgium, although politically separated from France, by its language and theories, is nothing more, to be honest, than a scientific province of France.’28 Such denial of Belgium’s autonomy on the scientific level was a touchy subject for Belgian editors. It revealed an ambiguity in the combination of reprinting French journals and

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encouraging Belgian scientific production. Was the first not an admission of the weakness of Belgian medicine in terms of original contributions? Parisian editors, at least, seem to have thought so, deeming the reprinting of French journals as characteristic of Belgian medicine. In 1844, a Parisian serial writer commented: ‘Belgium, we all are well aware, and the gentlemen librarians are even more aware, has an irresistible tendency to imitate […] everything her dear sister France does.’29 References to mimicry gave the reprinting industry an entirely different, negative connotation, as a feature of Belgian medical publishing that damaged its national honor. Belgian editors responded to such statements by defending Belgium’s honor. Florent Cunier parried the French critique with a reference to the vanity of French authors: ‘It has to be said, France often shows injustice against us, and the reprinting, which does not fall to me to defend, [is] mostly opposed by those whose works are not judged worthy of reprinting.’30 The response to the critique on the contrefaçon, however, also divided the Belgian medical community. As a reaction to the statement of Belgian mimicry, the Medical Society of Ghent published an article titled ‘A Rectification’ in their Bulletin. Unlike other journals, the Ghent physicians surprisingly did not defend the Belgian medical press. To the contrary, they agreed with the Parisian commentator, denouncing ‘a tendency that is fatal for our literature, distorts our ideas, dishonors Belgium.’31 Their rectification rather applied to the geography of the Belgian press. In the eyes of the Ghent physicians, not all Belgian journals were guilty of malpractices. Rather, ‘the swindlers of typography’ were located in one city: Brussels, ‘a little Paris, as they say there.’32 Negative comments, such as those of the Ghent Medical Society, may have contributed to the gradual diminution of the reprinting of foreign medical journals in the late 1840s. In 1847, Charles Van Swygenhoven and Philip-Jacob Van Meerbeeck commented in their yearbook for the Belgian medical profession that the Encyclographie ‘is dying, it has had its time.’33 With the demise of ‘reprint journals’ came an end to a type of medical periodical that combined reprinted with original articles, professional with scientific subjects. It was precisely this intertwinement of different aims and subjects that prompted medical societies to venture into medical publishing themselves and create a new type of ‘scientific’ medical journal, in which commercial and

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professional interests were pushed into the background. As such, they took an active part in the diversification of the medical press, a process in which different forms of content were increasingly directed towards different medical audiences. Engaging audiences

The development of societies’ own ‘scientific’ journals cannot be understood without a closer look at their relation to another journal type that developed simultaneously: the ‘professional’ medical journal. Since the 1840s, biweekly and professionally oriented medical periodicals became highly popular and attracted a wide readership. As Carl Havelange has described, these journals formed a ‘medico-professional press that had the insight to orient its action in a double direction, scientific, on the one hand, corporative, on the other.’34 In fact, journals such as the Gazette médicale belge (Brussels, 1843) and Le scalpel (Liège, 1849), to name the two most influential, continued the efforts of the Bulletin médical belge in providing a forum for physicians to voice their criticism and suggestions on matters of professional interest, and supplying them with professional news.35 At the same time, they acted as agents of scientific vulgarization by keeping their readers up to date on the progress of the medical sciences. ‘This important mission,’ in Havelange’s words, was one of ‘postgraduate education.’36 The emergence of this new journal type forced societies to reposition their journals within the medical press. More than merely informing medical practitioners, societies encouraged them to participate actively in the medical sciences by submitting original studies and observations for publication. Although both models of journals were intended for the Belgian medical practitioner, their success rate differed greatly. A closer look at the developments in the Liège medical press helps to explain these differences. The success of Le scalpel – the Belgian counterpart of The Lancet in Britain37 – contrasted sharply with the demise of the Annales of the Medical Society of Liège, of which only five volumes appeared between 1846 and 1851.38 Several reasons can be mentioned to explain this failure. The society, first of all, was unsuccessful in recruiting authors from a traditionally prolific medical subgroup – the academics of Liège’s university. In 1847, the society’s president, Charles Wasseige, had already admitted that the publication of scientific articles had been

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somewhat disappointing, and expressed the hope ‘to see all the leaders of Science come to us and contribute, by their presence and support, to the success of the work we have begun.’39 Rather than ‘leaders of Science,’ the bulk of the society members were provincial physicians in the region of Liège, who were more interested in establishing fraternal unity and professional consensus than in practicing science.40 Several society members understood these aspirations and themselves became players in the medical press. Their new professional journals fit in better with the interests of the Liège physicians than the society’s own Annales. The society’s secretary, Charles Détienne, founded the Revue médicale, pharmaceutique et hippiatrique in 1847, which combined scientific and professional news, but this only lasted a year.41 It was another society member, Auguste Festraets who started Le scalpel, of which the number of subscribers rose steeply to twelve hundred in 1859 and fifteen hundred in 1862.42 Compared to such numbers, society journals were relatively ‘small’. Although exact numbers are difficult to retrieve, the print run indicated in the contracts between the medical societies of Ghent and Antwerp with their publishers in the same period only amounts to respectively four hundred and two hundred and fifty issues.43 Professional journals thus reached far wider audiences than societies’ publications, which aimed for a ‘niche’ audience of the most scientifically interested physicians. In Brussels, the competition between professional journals and societies’ publications reveals another important difference between both journal types. In the middle of the 1840s, the tension between the Journal de médecine, published by the Society of Medical and Natural Sciences, and the Gazette médicale belge, edited by Charles Van Swygenhoven and Philip-Jacob Van Meerbeeck, seemed to have augmented. In 1844, Van Swygenhoven, who was also a member of the Brussels society, presented two manuscripts to the society as a peace offering, hoping to end ‘some of the wrong interpretations of its tendency and goal.’ ‘In fact,’ Van Swygenhoven added, ‘it [the Gazette] does not want to expand at the cost of the publication of theoretical and practical works, to which it considers medical societies rightfully entitled.’44 The Gazette, which focused on professional news and vulgarized scientific knowledge, and the society’s Journal de médecine, which published original scientific studies, focused on different audiences, Van Swygenhoven seemed to suggest. In practice, however, the competition was real, as

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scientifically interested physicians, perhaps not the bulk of practitioners, weighed the benefits of both types of publications. Van Swygenhoven’s maneuver hints at the fact that the publication of new, original studies seemed a privilege of medical societies and functioned as a marker between both journals. Unlike the Liège Annales, the Journal de médecine was nevertheless able to secure its place in the medical press. In 1847, the society members looked back upon ‘a successful march of this publication,’ but also added that this was ‘despite the competition formed by several low-priced journals.’45 Its success shows that there was a specific, although small, market for original studies in nineteenthcentury medicine. If medical societies may not have attracted a wide readership, their relatively small number of subscribers was not seen as a problem. The mission that medical societies set out to accomplish, prevailed over such sales figures. And this mission was advancing the medical sciences by publishing original work and engaging practitioners to take up their pen. Society members, of course, formed the prime audience to address in gathering new manuscripts and realizing such ambitions. Most societies’ rulebooks included obligations to annually submit new work – obligations that were, however, rarely enforced in practice. Even without such formal requirements, the studies of societies’ own members formed an important share of the scientific content of their medical journals. Physicians such as Auguste Sotteau in Ghent or Corneille Broeckx in Antwerp regularly supplied their societies with materials. In the nineteenth-century publishing world, such an institutional basis meant a considerable advantage. As Jean and Irvine Loudon have shown for the British medical press, ‘house journals’ – journals published by an institution, such as a medical society, college or hospital – were generally the most stable journals because they could always fall back upon a fixed group of authors and readers.46 Society members alone, however, were not sufficient to fill the pages of such ‘house journals.’ To encourage unaffiliated physicians to submit manuscripts, medical societies offered certain advantages. These benefits comprised, in the first place, the covering of the publication costs. According to the Ghent rulebook of 1837, each manuscript that passed judgment would be published by the society.47 In addition, the author would receive twenty-five copies, with the possibility of ordering more at a reasonable price, together with the prestigious title

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of ‘correspondent’ of the society. Of equal importance was the stipulation that such a title could not be allocated for donating published work, excluding therefore the common practice of assembling titles by sending books to the libraries of different societies.48 Such a rigid approach to the allocation of titles should not necessarily be considered a means of establishing an ‘elitist’ scientific community. In Ghent and in Antwerp, the measure acted as a means of encouragement, as even short medical observations by rural physicians, of sometimes only a few pages, could lead to the title of correspondent, but donations of major publications by foreign physicians could not.49 In Brussels, this latter rule was applied less strictly, since well-established authors were not obliged to submit a manuscript to the society to become members. Rank and file practitioners, on the other hand, faced severe procedures, as the submission of a study only ensured entering a ‘list of candidates,’ out of which correspondents were elected on the basis of their scientific qualities.50 The extent of the benefits to authors was thus linked to the different degree of democratization in each medical society, the Brussels society being the most conservative in this regard. Private practitioners benefited most from these publishing procedures. They embodied the ideal of collectively establishing a practicebased science by sending observations from their daily medical work to societies. These doctors, holding private practice in the regions around the major cities or in smaller cities, rarely attended the meetings of the medical societies, but they might be considered part of societies’ journals readerschip. For them, the publication of a scientific study formed an occasional in-depth exploration of an exceptional case from their daily practice. One of them was Louis Verhaeghe, from the seaside town of Ostend.51 In a letter to the Medical Society of Ghent in 1854, Verhaeghe reveals his motivations for publishing, as he apologized to the society for not having submitted any new work: ‘It is because I had no interesting case to present to you. Since then, I have come across a dislocation of the humerus of which I hereby send you the observation. If it could be used for the Annales, that would give me great satisfaction.’52 While Verhaeghe’s apology hints at the expectations of frequent scientific contributions of a correspondent of the society – Verhaeghe seemed to have felt obliged to contribute – his reference to satisfaction suggests that the writing of a scientific contribution was most likely an

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exceptional, but appreciated occasion during which private practitioners could engage with the medical literature. The participation of these authors in the editorial process reflects this view of science as an exceptional activity. When Désiré De Jumné was asked whether some parts of his observation of a malformation – an exceptional case – might be omitted for publication, he authorized the society’s secretary to leave out ‘what you think is necessary; I even take the Liberty, Sir, to request you to do what is best.’53 Like Verhaeghe, De Jumné emphasized that he only wanted ‘some copies for my personal satisfaction.’54 Others, like Dr Dambre, even informed the secretary of their intentions with the copies: ‘I will distribute them among my neighboring colleagues; it will be a means to establish clientele relationships between us.’55 Such a combination of motivations for scientific study, as a means to improve one’s knowledge and skills, but also to increase one’s professional status, was not uncommon in nineteenthcentury medicine. John Warner characterized similar intentions of American physicians as the ‘pursuit of professional development’ – a category which could include a wide array of motivations, from commercial interests to augmenting one’s self-esteem.56 In light of such motivations, it is telling that both De Jumné and Verhaeghe referred to ‘satisfaction’ to describe their reasons for publishing a scientific study. Medical societies anticipated these motivations for publishing. The division between the Ghent Bulletin and Annales can be understood in this light. While major studies, such as Guislain’s travel reports or Sotteau’s surgical treatises, appeared in the society’s Annales, the Bulletin formed the perfect forum for the short studies or notes by medical practitioners. De Jumné’s and Verhaeghe’s studies were indeed published in the Bulletin (even though Verhaeghe had requested the Annales). The evolution from the ponderous volumes of the early 1800s to the more accessible journal type of the middle of the century was in that sense also a means of accommodating a new group of authors. Societies’ prize competitions were another area of reform. Contests continued to attract elite practitioners, but seemed less appealing to general practitioners, who lacked the means to devote themselves to the detailed questions posed by medical societies. To give in to these objections, ‘open questions,’ which left the choice of the subject to the authors, became popular in medical societies around the middle of the nineteenth century. In Antwerp, where the absence of academics in

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the city created a greater dependence upon private practitioners, these traditional questions were even abolished. In 1845, the society decided to establish a special committee, to henceforth award medals to the best studies in the Annales of that year, which were published by correspondents or physicians who were not part of the society.57 In practice, this functioned as an additional means of encouraging authors in choosing the Antwerp journal for their publications. In Brussels and Ghent, the traditional system of prize competitions continued to be successful throughout the nineteenth century. This success hints at another group of authors for whom ‘professional development’ was more a matter of acquiring prestige than of obtaining satisfaction. Both foreign and domestic elite practitioners – academics, the heads of clinical and surgical services in the urban hospitals – typically participated in prize competitions. Their motivations for choosing societies’ journals were based on the established reputation of these journals and their review procedures, which ensured (and defended, as the analysis of priority disputes has shown) the originality of their research. This importance of the ‘reputation’ of societies’ journals is nicely illustrated in a letter from the Brussels pharmacist Henri Bonnewijn to the Medical Society of Ghent. Bonnewijn had sent the same manuscript to both the Medical Society of Ghent and the Gazette médicale de Liège, a short-lived scientific journal edited from 1854 to 1855 by Hubert Boëns and L.M. Lombard.58 Having wrongly interpreted the lack of answer from the society as a negative judgment, Bonnewijn apologized profusely: [I then decided] to publish my study, not through the agency of a learned society, after report and preceding discussion, but through a simple scientific journal which contented itself with the simple reproduction of a study, and leaves all responsibility to the author. […] It was thus not at all my intention to render the Society ridiculous in the eyes of the medical world when I charged another journal with the publication of my note.59

Although Bonnewijn clearly played up to the Ghent society members, his comparison shows that he estimated a publication in the Ghent Annales as much more prestigious than in the Liège Gazette médicale. Moreover, his apology also shows that the maneuvering between different journals was a tricky undertaking. Medical societies generally did

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not appreciate the simultaneous publication of the same work in different journals – a strategy that was nevertheless common as a means to secure sufficient exposure. Societies’ emphasis on the originality of their works, however, prevented such double editions. Some works were rejected, even before reviewing, for this reason.60 The prestige that came along with medical publications also becomes clear in the embellishments that were made to medical studies. The more wealthy and established physicians, in particular, added expensive drawings to their studies. One such was the Brussels physician and botanist Jean Carolus, who published his La chirurgie de maître Jean Ypermans – an annotated edition of a manuscript of the fourteenthcentury surgeon Jean Ypermans (1296–1351) – in the Ghent Annales. To embellish his study, Carolus ordered a facsimile of two excerpts from the Brussels lithographers Simoneau and Foovay, ‘to draw attention to its age and give a good impression of the [fourteenth-century] manuscript.’61 Another formal aspect of a study, besides drawings, was the title page of additional copies. Unlike the title page of the studies in the Annales, which contained merely the professional employment of the author and his title of correspondence, the copies for the author featured, upon a common request, the entire list of his memberships. The Swiss physician Édouard Cornaz, for example, requested that the names of Ghent and Vaud (France) be added to the alphabetic list of titles he had already sent to the society.62 Carolus similarly asked to print his ‘personal titles’ as indicated on a specimen.63 Their requests show how studies featured as a means to construct an image of a wellestablished, well-connected scientist. Given this attention paid to the design of their studies, it seems hardly surprising that these same authors ordered considerable numbers of additional copies: Cornaz ordered two hundred, Carolus an additional forty, and Bonnewijn asked for an additional hundred copies that were ‘luxuriously sewn,’ which for Bonnewijn meant: ‘[with a] beautifully titled cover page, beautiful paper, thick and of a large format.’64 Such luxury editions hint at the uses of these separate copies as promotional gifts. The French physician Mordret indicated that he needed additional copies ‘to distribute among friends and among several Societies that I promised.’65 Since societies’ libraries rarely bought books, but were kept up to date by donations and exchanges, such separate copies were an indispensable means of making known one’s work. The

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4  The facsimile that embellished Jean Carolus’ edition of a medieval medical manuscript.

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importance of donations shows, as Michael Brown has argued, that medical publications also need to be examined as ‘physical objects’ that served as means of social self-fashioning.66 While Brown studied such mechanisms for the gentlemanly medical culture around 1800, the request of the authors who published with medical societies shows that this tradition was carried on by the nineteenth-century medical community, especially by its more prosperous and established members. Review in print

By the middle of the century, medical societies had thus developed a machinery to encourage physicians to publish. But even though the benefits of publishing with societies were considerable, publishing remained a tricky undertaking, as each submitted manuscript still had to be judged worthy – or not worthy – of publication by a commission of society members. For medical societies, it was essential to evaluate new content matter to assure its originality and scientific nature. Such assessment required a constant balancing act. When reviewers’ criticism was too severe, it could damage the reputation of the author and discourage other authors from submitting their studies for review (a situation that was particularly harmful as the societies’ editorial boards were always looking out for copy). But conversely, when too light, it could harm the society’s reputation as a judge and damage its reputation in the scientific world. For the reviewers themselves, the task at hand – of balancing appreciation and critique, between strictness and leniency – was made even more difficult through the publication of their judgments in societies’ meeting reports. To understand the practice of reviewing manuscripts in medical societies, the link between reviewers and the readership of societies’ journals needs to be taken into account. Since meeting reports were published, readers were well aware of the selection procedure of articles. For reviewers, the virtual presence of these readers during society meetings provided opportunities to justify their critical role. Instead of speaking in one’s own name, the reviewer presented himself as a representative of the audience of medical practitioners.67 His judgment of the scientific merit of a study was equated with its ‘worthiness’ to be brought to the attention of such an audience. The match between the intended audience of a submitted study and the readership of the societies’ journals was therefore one of the first elements to be considered.

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A study on ‘the nature of gout,’ submitted to the Brussels Society of Medical and Natural Sciences in 1853, was, for example, deemed too theoretical, aiming for an audience of students and not one of practitioners.68 As Dr Mouremans argued: ‘our publications have to be practical, because we write for practitioners and not young people. A single well drawn-up observation is better than a grand study; when one reads all of these voluminous chimeras, one still knows nothing.’69 Other society members, however, emphasized that medical practice could never be advanced without theory and that the theoretical question of the ‘nature’ of gout should be judged in its own right.70 In this example, the ambition of playing into the interests of readers (practitioners not students) was to be balanced with fairness vis-à-vis the author. Besides students, the general public or the upper classes formed another audience that was equally difficult to align with societies’ readership. In 1847, a study by Dr Pisani, ‘On the improper uses of drugs,’ was first praised as a ‘true service to the physicians and the ill,’ but then criticized for being intended for the urban elite and not for physicians.71 Truly scientific works, it was suggested, were exclusively oriented towards medical practitioners. If observations were of more interest than a ‘grand study’ to practitioners, which criteria then were used to assess whether a medical observation was, in Mouremans’ words, ‘well drawn-up’? An article titled ‘On the Art of Compiling and Composing Peculiar Histories of Diseases,’ published in the Bulletin médical belge in 1838, discussed several of these criteria.72 It summarized the advice in several medical textbooks on how to write a sound clinical observation with the aim of providing a useful tool to physicians who considered publishing on a case from their private practices. Two main criteria were presented: completeness and soberness. Completeness meant that articles needed to comprise ‘the truthful and integral account of everything in the condition of the patient that strikes the senses of the observer.’73 Soberness meant that, at the same time, ‘these histories have to be simple, short, stripped of all unnecessary circumstances, of all explanation, of all figures of speech and rhetoric.’74 Accurate and detailed, but without superfluous ornaments, the advice to aspiring authors seemed to have been. If such criteria were described in theory, they were also applied by the reviewers in their judgments on new manuscripts. Accuracy, in the

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sense of completeness, was certainly one of their main concerns. When Dr Martin submitted a description of an abscess, the reviewers suggested a more accurate description of its ‘physical features […] for the understanding of the readers.’75 If the lack in accuracy was more severe, works could be rejected on this basis. Dr Leva’s observation of a case of poisoning could not be published by the Medical Society of Antwerp because of ‘the absence of certain important details.’76 One way to compensate for such lack of detail was by including drawings. As the article in the Bulletin médical belge recommended: if descriptions were difficult, ‘make up this shortage with the pencil or the paint brush of the artist; it will be nature itself that you show to the reader.’77 Reviewers, in turn, emphasized that drawings also needed to be included to ensure the authenticity of the study. Such suggestions were often made when authors included a pathological specimen with their manuscript or had presented a patient during one of the society meetings. By publishing a drawing of these specimens or patients, the readers of the societies’ journals would get the same information as the society members to whom such ‘evidence’ had been shown.78 It was another way for reviewers to act as the representatives of the audience of practitioners, and to turn these practitioners, in the words of Steven Shapin and Simon Schaffer, into ‘virtual witnesses’ of societies’ meetings.79 Not every physician was as skillful in making such drawings. While surgeons and anatomists were often talented artists, private practitioners and military physicians, such as Dr Décondé, were often not.80 When the Medical Society of Ghent requested subsidies for the publication of Décondé’s study of military ophthalmia, the drawings that accompanied the work were deemed unsuited for publication by Dr Vleminckx, who reviewed the manuscript on behalf of the military health service. In a letter to Vleminckx, Décondé acknowledged this deficit: ‘these drawings are far from perfect; having never received training in drawing or painting, I could not give them the perfection the subject requires.’81 The added value of drawings was thus regarded to lie in the details they could convey to the readers. As such, their quality formed an integral part of the reviewing process. Readers indeed influenced the judgments of reviewers in no small way. But the interaction between both also worked the other way around. The publication of meeting reports turned reviewing into a normative process. The reviewer could not simply apply criteria; he also needed

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to explain why these criteria were in the interest of the audience he claimed to represent. Such justifying made these reports into a means of setting standards. When Dr Stacquez had blamed an author for only communicating his successes with a treatment, but not his failures, he defended his judgment in such general terms: ‘as if the physician who decided to publish what he has observed, only intends to boast about his successes, as if by indicating that he’s not always successful, he would compromise his reputation.’82 In articulating such publishing codes, Stacquez presented himself not only as a representative, but also as an authority who could explain the ideal motivations for scientific publishing. Through such reports, the readers of the Bulletin were made aware of the norms and values of scientific conduct: it was openness, the accumulation of observations and facts, and practicality that guided the ‘scientific’ physician. The key to a successful performance of criticism lay therefore in finding the right relation to one’s audience by mixing ideals of scientific conduct and detailed expert knowledge. The reviewers themselves could also become subject to critique. In fact, a set of unwritten rules guided the drawing-up of review reports. An author’s views, society members agreed, were to be faithfully represented and critique had to be fair. When discussion arose on a review report, the severity of the reviewer’s judgment often stood at the center of the debate. On such instances, the reviewer had to account for his critique, and often started his reply by emphasizing he respected the author and – following scientific etiquette – in no way aimed to attack him personally. Faced with the remark by a fellow member that his report was too severe, Joseph Guislain asked for an understanding of ‘my specific position, my position of rapporteur [reviewer]’ and to not consider him as an ‘obstinate critic.’83 Another possible reproach to reviewers was an insufficient treatment of the work under discussion. The discussion of a report by Arsène Pigeolet in the Society of Medical and Natural Sciences in Brussels was postponed because it had represented the author’s ideas too concisely.84 On other occasions, the authors themselves criticized the reviewers. A severe review report could indeed become the start of a scientific dispute, in which even a single misplaced word could become the subject of debate. In 1839, Laurillard Fallot wrote a letter to claim that he had not written ‘profoundly’ but ‘strongly’ – a misquotation that led him to conclude that the criticism of his work lacked ‘accuracy and justice.’85

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Accuracy was thus a crucial element in the reviewing process. But what about writing style? The ‘soberness’ suggested to aspiring authors seemed a less evident publishing ideal. Even though authors were discouraged to spend time in constructing beautifully composed phrases or philosophical reflections, several literary genres remained part of the nineteenth-century medical literature. In the first half of the century, ‘recollections,’ ‘medical journeys’ or ‘medical letters’ formed popular genres. They were remnants of eighteenth-century learned traditions, in which the ‘elegance’ of one’s writing could be as noteworthy as its content.86 Such texts put together a series of observations from one’s medical practice (e.g. an article titled ‘A day from my medical practice’), but were also used to report on one’s scientific travels. In the latter case, they could contain non-medical remarks on the landscape of foreign countries and their inhabitants.87 In the second half of the nineteenth century, these genres disappeared, but an aspect of ‘form’ continued to be used as a criterion in reviews. The works of little experienced authors, in particular, were criticized for their writing style. At the same time, encouragements were made, suggesting that such a shortage could be compensated by more writing experience. One of the first studies by Dr Puttaert, a member of the Brussels Society of Medical and Natural Sciences, was said to reflect ‘the penchant for work, the spirit of observation,’ despite ‘its unpolished style.’88 Such an assessment reveals a somewhat pedagogical role for the reviewer, whose remarks should help improve authors in the early stages of their publishing career. For more experienced authors, the form of their work proved an important aspect in the reviewing process. This is illustrated by a controversial study submitted by Jules Brenier to the Medical Society of Ghent in 1845. Brenier’s study treated one of the themes that caused heated debate at that time: the relationship between diseases and organic lesions. In early nineteenth-century Belgium, the theories of the French physician François Broussais on the inflammation of organic tissues as the exclusive cause of all diseases sharply divided the medical community.89 As the Ghent meeting report stipulated, the society members initially ‘felt attacked in their scientific principles.’90 Yet they concluded that Brenier’s study was ‘a work written with ease and even with elegance’ and that the society should ‘pay tribute to its conviction and the talent with which he expresses his views.’91 After the meeting,

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the secretary explained to Brenier in a letter the ‘quasi-contradiction’ that his scientific views were opposed, but his style applauded. One passage, however, in which the doctrine of materialism was expressed, needed to be cut: ‘It is the sacrifice of a dozen lines of which the suppression may thwart you, but which will one day be pleasant, and perhaps advantageous.’92 Brenier understood the message, commenting in a published response to the report, that ‘such a discussion would lead us to the controversial question of spiritualism and materialism, and it is perhaps not the moment to approach such a grave matter.’93 It was indeed by conforming to the procedures and style of scientific publishing that men like Brenier could become part of the scientific world, although their opinions might have been regarded as ‘non-scientific’ by most society members. It was only in the second half of the century that this preoccupation with the form and style of works disappeared from medical publishing. A literary way of writing was now more and more banned from scientific journals. In 1867, a work by the Italian physician, Dr Fenicia di Ruvo, was not discussed extensively because it was written in ‘a philosophical and speculative manner, typical of the author, more than from a scientific and practical point of view.’94 The increased emphasis on ‘scientific’ content also had profound implications for the reception of controversial studies. When Brenier, in 1866, again submitted a contentious work to the Ghent society – this time on homeopathy – he submitted his study anonymously, a highly exceptional procedure as anonymity was normally only used for prize competitions. The Ghent society members nevertheless agreed to evaluate the anonymous work, because it ‘may present an actual scientific value.’95 After the work had been found suited for publication, Brenier revealed his identity and started a fierce polemic with several of the members of the Ghent society, who doubted the scientific grounds of homeopathy. Even though his work was published, Brenier’s anonymous submission reflects the boundaries that were increasingly being drawn between ‘scientific’ and alternative forms of medicine in the second half of the century. Writing style alone seemed no longer a shared value that could overcome such conflicts. The reviewing process, in turn, increasingly functioned as an important marker of the medical profession. Of course the risk of being rejected had always existed. And it was not limited to physicians operating at the medical fringe. In the second

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half of the century, the possibility for such rejection also increased for private practitioners. In the study of public health – a rapidly professionalizing medical subfield96 – a more critical attitude was adopted vis-à-vis the observations of local physicians, whose medical topographies were reproached with a lack of rigor in accumulating facts, or a shortage in statistical knowledge or knowledge of the medical literature. In 1852, a study submitted by the French physician Liégey was criticized for its all too brief medical topography of the town of Rahincourt. Dr Joly, in particular, commented unfavorably on the work’s ‘mass of errors and medical heresies.’97 Joly mostly had problems with the brief sketch of the health conditions in Rahincourt. He first cited the passage from Liégey’s work – ‘Inconveniently situated, unsanitary, as are most villages in these parts; it has 200 inhabitants, generally very hardworking, and generally very malnourished’ – and then ironically commented: ‘Behold, the entire medical topography of the place!’98 Instead of a brief glance, Joly continued, correspondents should ‘observe well, precisely and for a longer period, and then make a table of the disease, well matured and well arranged.’99 Liégey was no exception: from the 1850s onward, epidemiological studies were increasingly criticized for lacking sufficient observations. Dr Cauterman anticipated such criticism from the members of the Medical Society of Ghent on his ‘Note on an epidemic of smallpox in Saint-Gillis-Waes’ by stating that his observations were ‘too few in numbers to give them the entire value of scientific truth.’100 These more severe publishing criterions hint at the growing specialization of medicine in the second half of the nineteenth century – a specialization that also brought changes in the group of authors who published in societies’ journals. Changing authorship

The tightening of the publishing criteria in societies’ journals from the 1860s onwards was not an isolated evolution. It was part of a wider reorientation in the medical audience out of which medical societies wanted to recruit new authors. The general medical practitioner seemed no longer the most desirable participant in the scientific enterprise. Instead, young physicians who sought a career in the medical sciences were increasingly encouraged to publish. This shift can be considered as part of the professionalization of the medical sciences. The more that

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science became a profession, the more private practitioners were turned into ‘amateurs’ and the less they could participate in the scientific community. The start of this evolution may be situated around 1860, at a time when contemporaries raised questions on the future of medical societies. In Brussels, Professor Henriette spoke of ‘a deceleration in the society’s activities.’101 In Antwerp, secretary Antoine Kums more clearly named the problem: society members submitted too few studies.102 These sentiments marked a new phase in medical societies’ search for physicians to engage in scientific publishing. Several reasons were identified for the malaise in the supply of scientific manuscripts around 1860. Both Kums and Henriette, first of all, acknowledged that attending to one’s clientele was such a timeconsuming occupation that little time remained to devote oneself to medical study. Besides a lack of time, a shortage in opportunities was also regarded as a problem. As Kums added, ‘the cases that are sufficiently important to become the subject of a work are rare and are sometimes completely lacking.’103 A third difficulty comprised the scientific quality and the reviewing of their work. While Kums described ‘a fear, a bit legitimate, it is true, to reproduce forgotten or neglected older ideas,’104 Henriette argued that some physicians ‘feared some sort of censorship or control that would harm their dignity,’ a fear that his colleague Dr Koepl phrased as one of ‘being severely criticized.’105 Rumors had been spread, Koepl also added, that the society was for insiders only. If time was lacking, interesting cases were scarce, and severe criticism was to be expected, it seemed indeed no surprise that private practitioners dropped out of the scientific world. Rather than being the main causes, however, these problems were part of deeper-lying changes in the general practitioner’s attitude towards science. The tightening of review criteria on the side of medical societies was only one part of the story. On the other side, active scientific study became a less attractive means of professional development for private practitioners. Assembling with colleagues to discuss professional interests provided a much more popular alternative. This shift again was a gradual process. In the 1840s, the success of professional journals had already shown that professional news could attract far more readers than original scientific studies. At around the same time, the first professional societies that valued professional discussions and fraternal unity over scientific study had appeared.106 This movement

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seemed to have reached a new peak around 1860. In the run-up to the foundation of the Belgian Medical Federation (1863), which would act as an umbrella organization for these professional societies and led to the foundation of many new ones, it became clear that the scientifically active private practitioner was becoming a rare breed. Mart Van Lieburg has identified the same trend in Dutch medical societies around the middle of the nineteenth century. Many of these local societies lost much of their scientific vigor when they became divisions of the Dutch Society for Medicine (1849).107 The reaction of medical societies to this trend varied. In the Medical Society of Antwerp, the decrease in scientific activities had been most prominent. Its relatively strong dependence on private practitioners, given the lack of academics in the city, made the society highly vulnerable to changes in the scientific interest of this group. The strategy of its remaining core members was to focus their efforts on the society’s journal. While the attendance rates of the society’s meetings dropped considerably – from an already low average of eleven present members in 1852 to sometimes only four or five in 1859108 – the society’s journal survived. It was the editorial work of a small group of members, including Dr Giebens and Corneille Broeckx, that kept up the Antwerp periodical through summaries of foreign works and the serial publication of major studies, including several historical studies by Broeckx. ‘It was he who took up the task in times of scarcity,’ it was later remembered, ‘of providing us with works to nourish our Annales.’109 A more structural attempt to improve the society’s functioning was made in 1861. During its annual public meeting, both secretary Antoine Kums and president Joseph Koyen called for a renewed scientific engagement of the private practitioner. In a lecture titled ‘On the Usefulness of Medical Societies,’ Koyen argued that it did not suffice for practitioners to have studied at the university, or to have followed clinical lessons, or even to have acquired experience over long years. ‘To have a clear conscience,’ Koyen continued, one had ‘to divide one’s time between the study and the practice of medicine.’110 His call, in a certain sense, was reactionary as it reiterated the same discourse that had captured the enthusiasm for societies of the 1830s. Now, such emphasis on continued scientific study by participating in medical societies seemed contrary to practitioners’ desire for fraternal unity by means of sociability. Kums’ and Koyen’s plea meant the start of a difficult decade for the

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society in which a broadening of its membership had to be balanced with its scientific ambitions. In the next meeting, a formal call was addressed to all members of the Antwerp medical profession to become engaged in the society (without first having to submit an original scientific work).111 Nine new members were soon welcomed.112 At the same time an arrangement was made with Antwerp’s municipal library to manage the medical journals that were sent to the society. Providing better access to medical knowledge drove this decision, which was defended by the remark that ‘our city now possesses one more treasure to which the medical profession can always appeal.’113 Such a new audience, however, also brought its own agenda. As the society’s membership expanded, its scientific production diminished. Professional news, petitions and reports of medical reform increasingly filled the pages of the Antwerp Annales in the 1860s. The tension between the practice of science and the defense of professional interests finally led to the foundation of the Medical Circle of Antwerp (1873), which would only discuss professional matters. The Society of Medical and Natural Sciences in Brussels made a more moderate attempt to broaden its membership. In 1861, a proposal was made to relax the society’s admission criteria and allow physicians to request membership without having to submit a manuscript. A committee would then decide upon the scientific qualities of the candidate, who was expected to have at least published some work elsewhere.114 This more liberal approach to membership was seen as a means to attract ‘young men, friends of hard-work,’ a group whose absence was said to threaten the society’s future.115 Although all members agreed on the necessity of taking action, several members objected that this measure might lead to the admission of ambitious, but still mediocre medical men. The Brussels society, unlike its Antwerp counterpart, did not aim for the rank and file of the medical profession. It rather attempted to recruit among the ‘intellectual elite of the students at our universities.’116 Its society members, it was suggested, found themselves in a suitable position to estimate who was part of such an elite. They occupied chairs as university professors or as heads of hospital services and could therefore judge ‘the degree of competence and intelligence of the candidates, and, what is no less important, their character and sociability.’117 The Brussels society thus remained an elitist institution,

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perhaps indeed one for insiders only, but around 1860 it made an opening to the most promising medical students. In the Medical Society of Ghent, medical students were likewise recruited. The decrease in scientific activity, which had formed the subject of discussion in Antwerp and Brussels, seems to have been less felt in Ghent. Young, newly graduated physicians at Ghent university easily found their way to the society. In 1856, Nicholas-Chrétien Du Moulin, who would later himself become Professor of Pharmacology, described his submission as ‘the work of a young man taking his first steps in the domain of publicity.’118 Starting in the 1860s, students such as Du Moulin were given publication space even before they had graduated. In 1865, Adolphe Burggraeve presented a study on the waters of Dikkelvenne on behalf of two medical students, Mr Morel and Mr Ledeganck, who both later became society members.119 Another student, Jules MacLeod, published a note on the dissection of a python from Java at the university in 1877.120 In 1867, a new annual prize competition for medical students further reinforced the ties between the society and the University of Ghent.121 Its winner received a set of medical books or surgical instruments during the inauguration of the new academic year at the university.122 Winning this student competition was a mark of scientific potential. Many of the laureates made a career for themselves in the medical sciences, combining academic appointments with scientific engagement in the Ghent society. One of these was Charles De Visscher.123 Soon after his award, he was appointed head of the surgical clinic of the university. From 1877 onward, he also became an active society member, reviewing studies on antisepsis in surgery, one of his specialties.124 Paul Goddyn won the student competition in 1879. What De Visscher achieved in surgery, Goddyn achieved in obstetrics, as he was appointed head of the obstetrical service of the university. He also became one of the two assistant-secretaries of the society.125 These complementary activities in academia and in Ghent’s Medical Society did not pass by unnoticed. In 1868, Alexis-César Lados had already claimed that membership to the society formed a good preparation for academia, for it allowed aspiring professors ‘to acquire the ability to express oneself with ease and clarity, to consider a question in all of its aspects and to answer objections that are often more deceptive than real.’126 The society, in other words, provided opportunities for

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further training in the skills that were required at the university and access to an academic network. Editorial practices

While the authorship of the articles in society journals changed in the second half of the nineteenth century, the readership of these journals remained largely the same throughout the century. Editors continued to focus on an audience of scientifically interested medical practitioners (even though these practitioners experienced more and more difficulty partaking in scientific research). Such an audience was not only interested in original works, but also wanted to be updated on scientific developments, both in Belgium and abroad. To cater for these needs, recently published medical books were discussed, and interesting articles that had been published elsewhere were selected and summarized. Such editorial practices were already developing in the 1840s and 1850s, when society members experimented with different journal sections, and societies’ journals reached a more or less stable form. In the second half of the century, the importance of such practices seems to have only increased. As the medical press became more specialized and international, the link between new scientific research and everyday medical practice became less evident. New forms of selection and ‘translation’ – from science to practice – were therefore developed. Both the summarizing of articles and the reviewing of medical books were part of the activities undertaken by the first editors of medical journals. In the Bulletin médical belge, Dr Canstatt edited the section Littérature médicale étrangère [Foreign Medical Literature], in which French summaries of articles that appeared in German and English medical journals were presented, and Marinus regularly published book reviews in the section Revue bibliographique [Bibliographic Review]. The journals of medical societies took over and expanded these sections during the middle of the century. Shortly after the establishment of the Brussels Journal de médecine, a proposition was made to add ‘a more or less extensive analysis of works published abroad’ to the journal.127 Its section Revue analytique et critique, in which short analyses of foreign and national journal articles appeared, became a model for other journals, while its section Bibliographie provided space for more lengthy and critical analyses of book-length studies. The development of these

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sections mid-century reflects a shift from reprinting to selection and discussion as a means of providing access to the medical literature.128 These different review sections enabled new editorial strategies. Society members not only judged whether an original work was to be published; they also made decisions on where to publish review reports and whether donated publications were to be reviewed. In the Medical Society of Antwerp, Broeckx’ analysis of Matthyssens’ anatomical study was voted ‘for publication in the Annales in the section Bibliographie.’129 In Brussels, the society members similarly decided on Dr Cazin’s work on medical plants ‘to call the attention of practitioners to the work of Mr Cazin, by way of a short bibliographical notice.’130 On other occasions, the section could provide a way out of conflict. When Dr Perkins’ report of a study by Ottenbourg was found too severe, the society members decided to transform the report into a bibliographic article in Perkins’ own name.131 The development of review sections thus provided new spaces for scientific assessment. Editing and reviewing, as a result, became closely related practices. The composing of summaries and bibliographic articles required considerable organization. Of the Belgian medical societies, the Society of Medical and Natural Sciences in Brussels seemed to be organized most professionally. Its Journal de médecine was the most elaborate scientific medical journal. Presented as ‘one of the most extensive scientific repertories,’ its monthly issues together comprised two annual volumes, each of at least 600 pages from 1847 onwards.132 Its secretary Jean-Romualde Marinus was the architect of the journal. After having passed on the direction of the Bulletin médical belge to Florent Cunier, he became the ‘editor in chief ’ (rédacteur principal) of the Journal and steered the society’s editorial board. In the 1850s, the editorial board further professionalized and became a more autonomous part of the society. While Marinus had combined the functions of secretary and editor in chief, his successor Jean-François Dieudonné resigned as secretary in 1850 but continued to hold his function as editor in chief until his death in 1865.133 In 1853, it was further decided that the editorial board was to be composed of ‘the editor in chief, the secretary of the society, elected for three years, and three members elected every year.’134 Of these members, it was also stipulated, ‘one member at least had to be part of the section of natural and pharmaceutical sciences [of the society].’135 Such a composition gave the editorial board more stability

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and balance than the society board, whose members (besides the secretary) and president were elected annually. The function of editor in chief, because of its long-term stability, was one of the most important and honorable functions in the society. After Dieudonné’s death in 1865, Edouard Van Den Corput, who held a doctorate in the natural sciences, took over the function.136 His appointment was exemplary of the rapprochement between the medical and the natural sciences in the late nineteenth century.137 The Brussels Journal de médecine was unique in setting up an elaborate editorial board in the 1840s. In Ghent and Antwerp, it was mostly the society’s secretary and assistant-secretaries who ran the journals. The organizational model of the Brussels journal would nevertheless spread to those societies in the late nineteenth century. The increasing diversification and specialization of the medical press necessitated such professionalization.138 At the Medical Society of Ghent, Jules Morel raised the matter of the society’s editorial practices in 1869 and proposed the foundation of an editorial board parallel to the existing society board. The commission that examined Morel’s proposal recognized a sore point in the society’s activities: the edition of the Variétés, the journal’s review section for journal articles, was too much work for the assistant-secretary.139 Going through all of the journal issues, selecting the interesting articles and summarizing them for publication was not only time-consuming; the choice to be made was also ‘one of the most delicate, one of the most difficult’ and could become the subject of criticism.140 Neither was it possible ‘to judge all of the specialized articles.’141 A more elaborate editorial board could remedy these difficulties. Its members would be able to divide the periodicals among them, ‘according to the specialty in which they were active,’ and could contribute to ‘a scientific content as extensive as possible in the Bulletin.’142 The society members also agreed that more articles needed to be translated from German, Dutch and English. The lack of such articles in the society’s journal was linked to the selection of the journals that were exchanged with the society’s publications. Of the roughly thirty periodicals that were part of this selection, only one was in English and none in German.143 The expansion of this selection can equally be regarded as part of the modernization of the society’s editorial office. In the next decade, these editorial innovations were gradually realized. In addition to the thirty, mostly French, medical periodicals, the

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Bulletin and Annales were exchanged with twenty-four new journals, of which seven were in English (for example the Medical Record from London), four in Italian (such as the Movimento médico-chirurgico), three in German (among which the Centralblatt für Chirurgie) and one in Dutch (the Geneeskundige Courant voor het Koningrijk der Nederlanden).144 Such internationalism became the new standard in the late nineteenth-century medical press, which also began paying attention to American medical journals. The cosmopolitan character of the American journals, such as The Boston Medical and Surgical Journal was praised in particular.145 The expansion of the society’s international gaze was also reflected in the organization of its Bulletin. In 1870, the review section for journal articles was separated from the Variétés, which was now used for announcements (such as academic appointments, prize competitions and obituaries). The new review section was printed in two columns and divided into thematic units, such as ‘psychiatry’ or ‘obstetrics’.146 Jules Morel was the driving force behind the reorganization. His efforts gained him the praise of his fellow society members: in 1871, he was promoted from correspondent to resident member ‘in recognition of his active participation in the workings of the editorial board.’147 The modifications to the society’s journal were presented as a modernization process to its subscribers. As had been the case since its foundation, the journal wanted to inform the Belgian medical practitioner of the progress of the medical sciences. But this mission, the society’s editors argued, became ever more important in light of the rising number of specialized journals that flooded the market: Given the radical transformation medicine is going through in our times, in the midst of this feverish activity that excites the medical press, we have made some modifications to our mode of publication and we have arrived, by way of a methodical table, at uniting within every issue the indispensable notions for the medical practitioner, notions he could not gain otherwise but at the expense of long and monotonous research.148

The answer to the increased degree of specialization in the medical press, according to the Ghent editors, was precisely the reinforcing of a general perspective, which would focus on the practical uses that resulted from scientific innovation in different fields. Put another way, general medical practitioners themselves became more and more a

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specific audience, with specific needs, as specialized knowledge became less and less accessible to them. Translations formed another, increasingly appreciated, component of editorial work. In the Medical Society of Ghent, Morel’s translation of a study from German into French in 1875 can be considered part of his effort to give the Ghent Bulletin and Annales a more international character. Dr Boucqué, another member, analyzed and translated several works from Italian. Such translations required a considerable knowledge of medical terminology, as a submitted manuscript by the Italian physician Joachim Tani on a case of craniotomy shows. In a letter to the Ghent society, Tani argued that he would have written the study in French, ‘if he had not such a fear of failing because of the technical terms involved.’149 Boucqué’s efforts to translate such technical Italian studies did not pass by unnoticed. In 1876, he received the ‘Cross of Knight in the Order of the Italian Crown’ because of his contributions ‘in the vulgarization of the works of Italian surgeons in Belgium.’150 Similar practices occurred in other medical societies. In Antwerp, Dutch medical works were regularly translated into French. Several studies of the Dutch surgeon Van Haesendonck featured in French translation in the Antwerp Annales.151 For Dutch as well as Italian medical men, such translations formed the means to spread their work to the French-speaking medical world. At least for those physicians, Belgian medical societies formed a ‘hub’ to make their research known to a wider audience. The extent to which society journals actually succeeded in reaching an audience of private practitioners is difficult to assess. Readers’ appreciation of societies’ journals only rarely seeped through in meeting reports. A letter written by Dr Anciaux at his retirement from medical practice in 1861 forms one of the scarce examples. In the letter, Anciaux thanked the Brussels society for the ‘wise advice and the useful works of which he had seen, he said, so much evidence during the twenty years that he had subscribed to its publications.’152 While such a favorable letter was eagerly included in the meeting report, more critical letters from readers, who might have argued that the society’s publications were becoming too specialized, were of course not shared with all readers. Yet such a critique seems in itself not inconceivable. As medical practitioners were no longer part of the group of potential authors, a

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gap between authors and audiences emerged that seemed difficult to sustain in the long run. These tensions came to the surface in several editorial decisions of the Society of Medical and Natural Sciences of Brussels in the early 1890s. In the second half of the 1880s, the Journal de médecine had already followed a somewhat irregular trajectory, as the sections ‘news’ and ‘academies and societies,’ in which meeting reports were published, had often been omitted. In 1892, a thorough reorganization followed. The Journal de médecine now became published in weekly rather than monthly issues and focused more on general medical studies and summaries of a variety of (international) medical articles. It was an attempt to create a more accessible publication for private practitioners. At the same time, a new journal was started in the form of the Annales of the Society of Medical and Natural Sciences, which provided publication space for the (specialized) research of its society members. Both audiences – general practitioners and (academic) medical specialists – thus received their own forum. These double publishing efforts only lasted for three years. In 1895, the publication of the Journal de médecine was stopped. This decision was motivated by ‘the fact that the ever growing number of Belgian medical journals render the role unnecessary that has been taken up by the Journal for so many years, of keeping its readers updated on the most interesting scientific facts published across the medical press.’153 The society would now concentrate on its Annales and would also publish a monthly Bulletin with its meeting reports. In fact, this decision meant the end of the society’s ambition to reach a wide audience of Belgian medical practitioners with its publications. These now became more exclusively focused on the needs of its core group of academic medical specialists. Financing scientific publishing

For the editors of societies’ journals and the authors who published with them, the second half of the century brought along significant changes. Other aspects of scientific publishing, such as its financing, remained relatively stable over the course of the century. Governmental subsidies were allocated from the early to the late nineteenth century. Such subsidies alone were not sufficient to cover all publishing costs.

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To understand the financial mechanisms behind societies’ journals, we need to consider these journals not only as means of scientific communication, but also as commodities, which entailed considerable production costs, but could equally potentially generate profit. This balancing of costs and profits required the collaboration between medical societies and a group of artisans that has hitherto received little attention: the urban publishers. The agreements they made with medical societies formed an essential component in the reconciling of science and commerce – an effort which, as the controversies surrounding the contrefaçon have shown, was by no means easy.154 The number of subscribers formed an important element in these agreements. In the eyes of publishers, scientific journals were commercial products and as such they could only be profitable if a sufficient share of the consumers of medical journals could be reached. This share, as we have already shown, was relatively small. In its contract with the publishers Ferdinand and Édouard Gyselynck in 1848, the Medical Society of Ghent vouched for four hundred subscriptions, giving an indication of the print run of the journal in this period.155 In a similar contract, concluded in 1845, the Medical Society of Antwerp ordered two hundred and fifty copies of its journal from the publisher Ernest Buschmann.156 The print run of the Brussels Journal de médecine, published by J.B. Tircher, is more difficult to estimate. In the eyes of the Brussels society members at least, the Journal de médecine was a prosperous undertaking; in 1848, the society’s excellent financial condition was attributed to the success of its journal, and in 1855, it was reported that the society counted a hundred more subscribers than the previous year.157 Such remarks suggest that the Journal de médecine must have had a print run that was at least similar to that of the publications of the Medical Society of Ghent. Subscription fees differed between journals. In the mentioned overview of the Belgian medical press in 1846, Van Swygenhoven and Van Meerbeeck compared these critically. In their eyes, the Brussels Journal de médecine, with its Belgian and foreign articles, its review section, meeting reports and Variétés-section, at a price of 10 Fr in Brussels, and 12 Fr for the Belgian provinces (including postage), was ‘the best journal within its category.’158 For the Ghent publications, every Belgian subscriber paid 11 Fr annually, a price well worth spending as the Annales contained ‘works of the highest interest’ and the Bulletin was

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‘marked by its scientific discussions.’159 The journal of the Medical Society of Antwerp, with an annual subscription fee of 6 Fr for Antwerp and 7 Fr for elsewhere in Belgium, was considerably cheaper than those of its counterparts in Ghent and Brussels. According to Van Swygenhoven and Van Meerbeeck, the journal was quite successful: ‘Several meritorious works, a well-composed repository and a carefully executed typography have won many subscribers to this journal.’160 Such attention to the form of the journal is also clear from agreements between societies and publishers on the inclusion of lithographs. The Gyselynck brothers, for example, agreed to include ten lithographs every year in the Ghent journal, for which ‘perfectly made drawings’ were to be delivered.161 Attracting a wide readership was a shared goal for publishers and medical societies. While the first saw their profit increase, the latter increased their impact. The Medical Society of Ghent therefore decided to outsource the sale of their journals to the Gyselynck firm. The contract between both parties only stipulated the amount of pages, not the number of copies. In 1848 this amount was set on 70 sheets, which each composed 16 pages, making up a total of 1120 pages for the Annales and the Bulletin.162 With regards to the number of copies, the agreement stipulated that Gyselynck would print as many as needed to accommodate the subscribers, and would present a hundred free copies to the society – copies which were used for exchanges with other journals. The society, in turn, gave the revenue of the subscriptions to the publisher – around 8 Fr. for each subscriber – together with an annual payment of 1,100 Fr. In addition, the society vouched for 400 subscriptions.163 When this number was not reached, the society could reduce the amount of sheets to cover the deficit by 31 Fr per sheet. Such an agreement worked to the advantage of both parties: more numerous subscriptions allowed more elaborate journals for the society and more profit for the publisher, while less subscriptions resulted in thinner journals, diminishing the costs of the publisher, but also preventing the society from taking great financial risks. This financial agreement certainly contributed to the growing literary production of the society in the 1830s and 1840s. In a circular letter to the subscribers, the Gyselynck firm declared that the number of pages of the Annales and Bulletin had been set to 560 for 1839, but that in reality 730 pages had been printed. The augmentation of the

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publishing costs, however, had not been passed on to the subscribers since ‘we [the publishers] have received encouragements from our subscribers, whose number has rapidly grown, that compensate for this increase in costs.’164 Moreover, the Gyselynck brothers declared they would not raise the annual subscription for the next year, even though the literary production of the society would be even more extensive, ‘in the hopes that the medical public will continue its confidence.’165 A similar agreement was made with the subscribers to the Brussels Journal de médecine. Since the Brussels society, unlike its Ghent counterpart, managed the subscriptions to its journal by itself, it was the editors who addressed the subscribers in 1844, declaring that the adoption of a new format (part of the journal was now published in two columns), another font and another way of aligning had allowed them to include ‘three times more content matter than in the first year [1843].’166 With the support of a growing number of subscribers, the editors promised that ‘although our scope is already extensive, we will expand further, without however raising the price of the subscription.’167 The editors of the journal thus sketched a deal between them and their subscribers: the more subscribers the Journal won, the more extensive it could become. Such extensive volumes seemed impossible to realize for smaller societies, such as the Medical Society of Antwerp. In its agreement with Buschmann, they simply arranged that the society would buy a fixed number of journal issues, and then further organize the commercial exploitation of the society’s journal by itself. The contract of 1845 between both parties stipulated a price per sheet of 24 Fr for 250 copies.168 As each monthly issue could only comprise 5 sheets (80 pages), the annual cost could rise up to 1,440 Fr.169 Compared to the arrangement of the Ghent physicians, the members of the Medical Society of Antwerp took more risk by paying higher fees to the publisher (for less pages and without illustrations) and exposing themselves to the ups and downs of subscriptions. The smaller number of subscriptions perhaps gave the society less margin for negotiation. Many other nineteenth-century societies, for that matter, continued to publish annual volumes, instead of the labor-intensive and competitive monthly issues. Such a form of publication required less continuous editorial efforts.

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The financial agreement between the Medical Society of Antwerp and its publisher also influenced the society’s publication procedures. Contrary to the medical societies of Ghent and Brussels, the society had great difficulties in expanding its journal ad hoc. Publication space always remained costly and limited. When Jules Brenier sent his overview of the diseases of the skin to the society in 1854, the work was deemed too extensive to be published entirely. Instead, the editors declared they had extracted, with Brenier’s consent, ‘those chapters that seem to us of the most interest to our readers.’170 Who these readers were, was made more explicit in a report on an addition to Brenier’s original work in 1861. The addition comprising the Flemish nomenclature of skin diseases was found particularly suited for the society’s journal: ‘Since the Annales are mostly read by Belgian practitioners, and the majority of them exercise their profession in the Flemish towns, it often occurs that the patients who come to them want to know the name of the disease of which they suffer.’171 Since the Flemish names of specific diseases were not generally known, Brenier’s work could help practitioners in their communication with patients. This example shows how the limited publication space in the society’s journal had to be carefully tailored to the needs of its subscribers. These circumstances also help to explain the positive reception of a proposition by Dr Giebens to forbid additions to works after they had been voted on for inclusion in the journal: M. Giebens’ proposition particularly takes notice of the difficulties that the irregularities, on which has been spoken, may pose to the editorial board; because it should not be ignored that it is often difficult to reconcile the right of authors and the respect they deserve, with the preferences of our subscribers, the opinions of different members and the financial state of the Society.172

Giebens’ proposition was indeed approved. As a former secretary of the society, who had been in charge of the Annales, Giebens was a hands-on expert in editing, well aware that lengthy publications were an expensive matter. Advertisements were another way to finance medical journals. As Karel Velle has suggested, the inclusion of medical and pharmaceutical advertisements must have formed a part of the financing of the majority

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of medical journals.173 Yet this does not hold true for the publications of medical societies, of which most – as we have seen in the first chapter – were able to obtain governmental subsidies. At the end of the century, Hector Leboucq opposed the introduction of pharmaceutical advertisements in the Ghent Bulletin by referring to the non-commercial character of the society’s publications: For that matter, the Society has always refused to insert pharmaceutical or other advertisements, as it wanted to exclude any idea of seeking profit or commercial enterprise. The scientific market on which it has been able to maintain itself is not, we are aware, sufficiently profitable to cover the great publication costs. It is the subsidies that the enlightened support of the State, the province and the city have always allocated to the Medical Society of Ghent that allow it to occupy a distinguished place among the foreign institutions.174

The interests of publishers and societies did not always coincide. On some occasions, after a bungled package or a wrongly sent invoice, the Ghent secretary, Charles Poelman, indeed complained of ‘a man who is entirely occupied with the profits of his business.’175 Besides such minor problems, reprints, in particular, could evoke disagreement. When Guislain’s study Sur l’instinct was reproduced without permission and offered for sale, the society was offended, emphasizing that the Ghyselynck brothers were only the publishers and not the proprietors of the study.176 It is therefore hardly surprising that Guislain in 1854 asked for guarantees that no additional copies would be printed without the permission of the society.177 Besides matters of ownership, disagreements could also be related to publishing delays. In March 1853, Poelman similarly wrote, on behalf of all the society members, to the society’s publishers to complain about the ‘irregularity of our publications which is not of the sort to attract numerous subscriptions.’178 These anxieties were equally present in other medical societies. In its contract with Buschmann, the Medical Society of Antwerp even included fines in case of publication delays.179 Medical societies, this chapter has shown, brought a new feature to nineteenth-century medical publishing: the need for originality. If the potential readership of original scientific articles was too small to make society journals commercially profitable, this does not alter the

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prestige these ‘scientific’ journals enjoyed in the medical community. Such prestige was a welcome reward for those authors who had made it through the review process, a hazardous undertaking. A close look at the practices of publishing and editing has revealed the same tensions between the interests of individuals and those of the medical community as I have uncovered in the analyses of societies’ debates – both were key activities for societies. Such tensions were managed through strict publishing procedures. Through the comments of reviewers, who represented the audience of private practitioners for which societies’ journals were intended, medical societies acted as places where scientific standards were set. Scientific articles hence became more formalized in the course of the century as reviewers paid increasing attention to accuracy and clarity. In practice, however, a tradition of scientific publishing as a means of social self-fashioning for physicians was also continued. The individual copies that were awarded to authors were often used as promotional gifts, which displayed the scientific qualities of the author and, through the accumulation of titles, the networks in which he was involved. Such ‘gentlemanly’ scientific practices and a gradual ‘professionalization’ of science went hand in hand. If medical societies thus contributed to the professionalization of scientific publishing, this process, at the same time, also eroded the participatory ambitions that had led to their foundation. The more science became a profession, and the more the writing of scientific articles became a matter of specialists, the less an ideal of a disinterested contribution to science remained a realistic, or even desirable undertaking for private practitioners, who traditionally formed the group from which medical societies hoped to recruit both readers and authors. The result was a growing division between societies’ audiences and authors. This division could be overcome initially by new editorial strategies, such as ‘translating’ specialized medical research to an audience of practitioners. In the long run, however, the very essence of medical societies’ functioning came under pressure. They became less and less organizations run by and oriented to practitioners, who considered each other equals, but more and more editorial boards, run by academics who aimed to make the best scientific work, across specialties, available to the ‘general’ medical profession. This latter ambition, finally, also turned societies’ journals into a somewhat atypical

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publication in the late nineteenth century. Among a rising number of specialized periodicals, they formed a rare breed of general publications in which the unity of the medical sciences continued to be represented. Notes 1 For an introduction to the recent research on the topic, see the special issue of the Notes and Records of the Royal Society, 69:3 (2015). On the early nineteenth-century function of scientific journals: I. Watts, ‘“We Want No Authors”: William Nicholson and the Contested Role of the Scientific Journal in Britain, 1797–1813,’ The British Journal for the History of Science, 47 (2014): 397–419. For a useful overview, see the chapter ‘The Rise of the Scientific Journal’ in: A.J. Meadows, Communication in Science (London: Butterworths, 1974), pp. 66–90. 2 A. Csiszar, ‘Seriality and the Search for Order: Scientific Print and Its Problems during the Late Nineteenth Century,’ History of Science, 48: 3–4 (2010), 399–434. 3 Melinda Baldwin has analyzed this shift by examining the evolution of Nature from a non-specialist periodical to a specialized scientific journal in this period: M. Baldwin, ‘The Shifting Ground of Nature: Establishing an Organ of Scientific Communication in Britain, 1869–1900,’ History of Science, 50 (2012), 125–54. 4 Csiszar, ‘Seriality and the Search for Order.’ 5 The research for this chapter has also resulted in an article that focuses on the publishing procedures of the Medical Society of Ghent: J. Vandendriessche, ‘Setting Scientific Standards: Publishing in Medical Societies in Nineteenth-Century Belgium,’ Bulletin of the History of Medicine, 88 (2014), 434–61. 6 On the variety of Belgian medical periodicals: K. Velle, ‘Bronnen voor de medische geschiedenis: De Belgische medische pers (begin XIXde eeuw–1940),’ Annalen van de Belgische vereniging voor de geschiedenis van hospitalen en volksgezondheid, 23–4 (1985–1986), 67–119. 7 J.R. Topham, ‘Scientific Publishing and the Reading of Science in Nineteenth-Century Britain: A Historiographical Survey and Guide to Sources,’ Studies in History and Philosophy of Science, 31:4 (2000), 559–612, 560–2. 8 On this subject see: F. Godfroid, Aspects inconnus et méconnus de la contrefaçon en Belgique (Brussels: Académie Royale de langue et de littératures françaises, 1998); M. Lambert, Stratégies manipulatrices de la

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10 11 12 13 14 15 16 17 18

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contrefaçon belge: 1815–1854 (Master’s thesis, University of Leuven, 2003). L. Simons, Het boek in Vlaanderen sinds 1800: Een cultuurgeschiedenis (Tielt: Lannoo, 2013), pp. 61–74; J. Weijermars, ‘“Een moeijelijk problema”: Integratie, natievorming en het boekbedrijf in het Verenigd Koninkrijk der Nederlanden 1815–1830,’ Jaarboek voor Nederlandse boekgeschiedenis, 18 (2011), 50–68. Velle, ‘De Belgische medische pers,’ 76–85. Ibid., 73–6. ‘Avis aux abonnés de L’Observateur médical belge,’ L’Observateur médical belge (1834), 467–9. Velle, ‘De Belgische medische pers,’ 76–7. Encyclographie des sciences médicales, 5 (1833) [editorial note at the end of the volume]. ‘Journaux de médecine et des sciences accessoires publiés par la Société Encyclographique des Sciences Médicales,’ Encyclographie des sciences médicales (1840) [advertisement in the back of the volume]. V. François, ‘Essai sur les gangrènes spontanées,’ Encyclographie des sciences médicales, 7 (1833) [editorial note at the end of the volume]. ‘Art de guérir. Pharmacopée belge. Enseignement médical,’ BMB, 2:6 (1835), 147–8. See for example: ‘Réorganisation médicale,’ BMB, 1:1 (1834), 10; ‘Note du rédacteur,’ BMB, 3:5 (1836), 125. On the epidemic of ophthalmia in Belgium, see: J. Vandendriessche, ‘Ophthalmia Crossing Borders: Belgian Army Doctors between the Military and Civilian Society, 1830–1860,’ Journal of Belgian History, 46:2 (2016), 10–33. ‘Variétés,’ Annales de médecine belge et étrangère, 1 (1834), 282. Velle, ‘De Belgische medische pers,’ 79. City Archive of Rotterdam, Nr 100: Archive of the ‘Geneeskundig Genootschap “Disce docendus adhuc quae cens et amiculus”,’ Part 6, Summary of a letter of August 28, 1841 of Dr Roelants to Dr Pincoffs on Cunier’s offer. See also: M.J. Van Lieburg, ‘Geneeskunde en medische professie in het genootschapswezen van Nederland in de eerste helft van de negentiende eeuw,’ De negentiende eeuw, 7 (1983), 123–45, 132. F. Cunier (ed.), Agenda du médecin belge (Brussels: Société Encyclographique, 1841); ‘Agenda du médecin belge pour 1841,’ Encyclographie des sciences médicales (1840) [advertisement on the back of the front cover]; P.J. Van Meerbeeck and Ch. Van Swygenhoven (eds), Annuaire du corps médical belge (Brussels: s.n., 1846). The yearbook was published in three editions until 1849. ‘Congrès Médical de Belgique,’ BMB, 2:7 (1835), 177–8.

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‘Revue bibliographique,’ BMB, 1:2 (1834), 24. Ibid. ‘Revue bibliographique,’ 24. ‘Revue bibliographique,’ BMB, 1:3 (1834), 36. ‘Journaux Belges,’ Encyclographies des sciences médicales, 24 (1834), reprint of the Gazette médicale de Paris, 116. ‘Une rectification,’ BSMG, 10 (1844), 95–7. ‘Lettre de M. Cunier, à MM. Dezeimeris et Littré, rédacteurs de l’Expérience (journal médical qui se publie à Paris),’ BSMG, 3 (1837), 195–200. ‘Une rectification,’ 95. Ibid., 96. Van Meerbeeck and Van Swygenhoven, Annuaire, p. 198. C. Havelange, Les figures de guérison (XVIIIe–XIXe siècle): Une histoire sociale et culturelle des professions médicales au pays de Liège (Liège: Bibliothèque de la Faculté de Philosophie et Lettres de l’Université de Liège, 1990), p. 306. For an overview of this type of medical journal: Velle, ‘De Belgische medische pers,’ 80–5. Havelange, Les figures, p. 307. On the editorial techniques used in The Lancet: B. Pladek, ‘“A variety of Tastes”: The Lancet in the Early Nineteenth-Century Periodical Press,’ Bulletin of the History of Medicine, 85 (2011), 560–86. On the installation of the editorial board: ‘Séance du 4 décembre,’ ASML, 1 (1847), 16–19. Ibid., 22–3. The society’s project of setting up a disciplinary committee was much more of a success than the publishing of a scientific journal: Havelange, Les figures, p. 304; ‘Réglement disciplinaire,’ ASMG, 1 (1847), 31–7. Velle, ‘De Belgische medische pers,’ 81; Havelange, Les figures, p. 303. Havelange, Les figures, p. 306. ULG, Hs. 3012. 11, Contract of 1848 between the Medical Society of Ghent and the Gyselynck firm; House of Literature, Antwerp, S. 7346 ‘Société de Médecine,’ Contract of March 8, 1845 between the Medical Society of Antwerp and the publisher Ernest Buschmann. ‘Bulletin de la séance du 2 septembre 1844,’ JMCP, 2 (1844), 483–4. ‘Bulletin de la séance du 4 janvier,’ JMCP, 5 (1847), 226–7. J. Loudon and I. Loudon, ‘Medicine, Politics and the Medical Periodical 1800–50,’ in W.F. Bynum, S. Lock and R. Porter (eds), Medical Journals and Medical Knowledge: Historical Essays (London: Routledge, 1992), pp. 49–69, 56.

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47 Statuts de la Société de Médecine de Gand, modifiés d’après la décision prise dans la séance du 18 juillet 1837 (Ghent: F.E. Gyselynck, 1837), p. 8. 48 This measure can be traced back to the learned societies in the late eighteenth century: J.E. III McClellan, Science Reorganized: Scientific Societies in the Eighteenth Century (New York: Columbia University Press, 1985), pp. 178–81, 240–9. 49 In the Medical Society of Ghent, the rule was mostly applied to exclude foreign physicians who hoped to receive a membership by donating publications. In 1848, the request of the editors of the Abeja medica in Barcelona to become associated to the society was declined, while the exchange between both journals was nevertheless agreed: ULG, Hs. 3012.4.2, Letter of January 18, 1848 from Charles Poelman to F. Arroz. 50 See the ninth article in the Brussels rulebook: Règlement de la Société des Sciences Médicales et Naturelles de Bruxelles (Brussels: Delfosse, 1841), p. 5. 51 On Verhaeghe’s career: L. Frédericq, ‘Verhaeghe, Louis,’ Biographie Nationale, 26, (1936–1938), 621–3. 52 ULG, Hs. 3012 4.1, Letter of January 25, 1854 from Louis Verhaeghe to the Medical Society of Ghent. Verhaeghe’s study was published soon after in the Bulletin: L. Verhaeghe, ‘Luxation de l’humérus en arrière,’ BSMG, 21 (1854), 286–92. 53 ULG, Hs. 3012 4.1, Letter of March 8, 1854 from Dr Jumné to the Medical Society of Ghent. 54 Ibid. Jumné’s note, like Verhaeghe’s study, was published in the Bulletin: D. Jumné, ‘Note sur un monstre double sycéphalien,’ BSMG, 21 (1854), 179–81. 55 ULG, Hs. 3012 4.1, Letter of March 15, 1856 from Dr Dambre to the Medical Society of Ghent. 56 J.H. Warner, Against the Spirit of System: The French Impulse in NineteenthCentury American Medicine (Baltimore: Johns Hopkins University Press, 1998), pp. 20–4. 57 ‘Séance du 23 janvier,’ ASMA, 4 (1845), pp. 167–9. 58 Velle, ‘De Belgische medische pers,’ 88. 59 ULG, Hs. 3012 4.1, Letter of September 12, 1854 from Henri Bonnewijn to Charles Poelman. 60 In 1845, Dr Swéron and Dr De Baelen had submitted the same manuscript to both the medical societies of Antwerp and Ghent. After consultation between these societies, both decided to reject the studies for publication: ‘Séance du 7 janvier,’ BSMG, 11 (1845), 5–49, 7; ‘Séance du 11 février 1845,’ BSMG, 11 (1845), 53–74, 54.

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61 ULG, Hs. 3012 4.1, Letter of July 8, 1853 from Jean Carolus to Charles Poelman (facsimile); Letter of January 11, 1854, of Jean Carolus to Charles Poelman (missing chapters), Letter of April 14, 1856 from Jean Carolus to Charles Poelman (return of manuscript). The majority of the work appeared in the Annales of 1854: J. Carolus, ‘La chirurgie de maître Jean Ypermans, le père de la chirurgie flamande (1295–1351),’ ASMG, 32 (1854), 19–148. 62 ULG, Hs. 3012 4.1, Undated letter [ June 1854] from Dr Cornaz to the Medical Society of Ghent. 63 ULG, Hs. 3012 4.1, Letter of August 4, 1853 from Jean Carolus to the Medical Society of Ghent. 64 ULG, Hs. 3012 4.1, Letter of February 5, 1856 from Henri Bonnewijn to the Medical Society of Ghent. 65 ULG, Hs. 3012 4.1, Letter of January 22, 1856 from Dr Mordret to Charles Poelman. 66 See for example: Brown’s discussion of John Hunter’s publications: M. Brown, Performing Medicine: Medical Culture and Identity in Provincial England, c. 1760–1850 (Manchester: Manchester University Press, 2011), pp. 57–63. 67 The rapporteur was the member of a review commission, which was generally composed of three society members, who was given the floor during society meetings to discuss the work under review and present the conclusions of the review commission. 68 ‘Séance extraordinaire du 20 décembre,’ JMCP, 16 (1853), 192–4. 69 Ibid., 193. 70 Ibid. 71 ‘Bulletin de la séance du 9 novembre,’ JMCP, 5 (1847): 66–73. 72 ‘Sur l’art de recueillir et de rédiger des histoires particulières de maladies,’ BMB, 5:7 (1838), 189–91. 73 Ibid., 190. For this definition, a reference was made to Jean-BaptisteHippolyte Dance’s Guide pour l’étude de la Clinique médicale (Paris: Béchet, 1834). 74 Ibid. 75 ‘Bulletin de la séance du 5 mars,’ JMCP (1849), 381–3. 76 ‘Séances du moi d’août 1862,’ ASMA, 23 (1862): 615–24. 77 ‘Sur l’art de recueillir,’ 191. 78 ‘Séance du 4 juin 1844,’ BSMG, 10 (1844), 199–216, 200. 79 S. Shapin and S. Schaffer, Leviathan and the Air-Pump: Hobbes, Boyle and the Experimental Life (Princeton: Princeton University Press, 1985), reprinted with a new introduction by the authors (Princeton: Princeton University Press, 2011), pp. 22–79, 336.

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80 The studies of the surgeon and anatomist Charles Phillips were, for example, often accompanied by detailed drawings: Ch. Phillips, ‘Sur la restauration des lèvres,’ BMB, 5:1 (1838), 21–4. 81 RMAF, ‘Service de Santé,’ N. 2159, Letter of November 19, 1840 from Dr Decondé to Dr Vleminckx. 82 ‘Séance du 4 juillet 1843,’ BSMG, 9 (1843), 87–107, 88. 83 ‘Séance du 10 septembre 1844,’ BSMG, 10 (1844), 295–330, 305. 84 ‘Séance du 4 octobre,’ JMCP, 15 (1852), 470–2. 85 ‘Séance du 9 juillet 1839,’ BSMG, 5 (1839), 89–99, 90. 86 On literary practices in late eighteenth-century medicine: Brown, Performing Medicine, pp. 48–75. 87 J. Jacques, ‘Lettre médicale adressée à la Société de Médecine d’Anvers, sur l’inoculation des sels de morphine dans les névralgies et surtout dans l’ischias,’ ASMA, 3 (1842), 379–91; J. Guislain, Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse: Résumé d’un voyage fait en 1838, adressée à la Société de Médecine de Gand (Ghent: F.E. Gyselynck, 1840). 88 ‘Bulletin de la séance du 2 décembre 1844,’ JMCP, 3 (1845), 135–41. 89 P.F. Daled, Spiritualisme et matérialisme au XIXe siècle: L’universite libre de Bruxelles et la religion (Brussels: Éditions de l’Université de Bruxelles, 1998), pp. 88–96; W. Randall Albury, ‘Corvisart and Broussais: Human Individuality and Medical Dominance,’ in C. Hannaway and A. La Berge (eds), Constructing Paris Medicine (Amsterdam and Atlanta: Rodopi, 1998), pp. 221–50. 90 ‘Séance du 2 décembre 1845,’ BSMG, 11 (1845), 321–60, 321. 91 Ibid., 327. 92 ULG, Hs. 3012.4.2, Letter of December 16, 1845, of the Medical Society of Ghent to Jules Brenier. 93 ‘Seánce du 3 mars 1846,’ BSMG, 12 (1846), 13–18. 94 ‘Séance ordinaire du 4 juin,’ BSMG, 34 (1867), 161–3. 95 ‘Séance ordinaire du 2 octobre 1866,’ BSMG, 33 (1866), 261–3. 96 See Chapter 5. 97 ‘Bulletin de la séance du 2 février 1852,’ JMCP, 14 (1852), 379–89. 98 Ibid., 383. 99 Ibid., 386. 100 Cauterman, ‘Note sur une épidémie de variole à Saint-Gillis-Waes,’ BSMG, 29 (1862), 344–8. Another example forms Dr Stapleton’ study of 1866 on the epidemic of croup in the town of Kruishoutem. His medical topography was said to contain scientific errors, and never got published: ‘Séance ordinaire du 6 novembre 1866,’ BSMG, 33 (1866), 301–3.

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101 ‘Bulletin de la séance du 6 mai 1861,’ JMCP, 32 (1861), 621–37. 102 ‘Séance solennelle annuelle tenue le 17 décembre 1861,’ ASMA, 23 (1862), 19–28. 103 Ibid., 26. 104 Ibid., 27. 105 ‘Bulletin de la séance du 6 mai 1861,’ 627. 106 Velle, ‘Het verenigingsleven,’ 78–105. 107 On the Nederlandsche Maatschappij tot bevordering der Geneeskunst: Van Lieburg, ‘Geneeskunde en medische professie,’ 136–8. 108 This decrease in the attendance of members to the society’s meetings occurred gradually. The average attendance dropped from eleven (1852 and 1853) to nine (1854 and 1855), then seven (1856). In 1857, no meeting reports were published; in 1858 only one and in 1859 only five, of which some show that only four of five physicians had assembled. 109 ‘Nécrologie,’ ASMA, 30 (1869), 660–7. 110 ‘Discours prononcé par M. Koyen, président, à la séance solennelle de la Société, tenue le 17 décembre 1861,’ ASMA, 23 (1862), 51–4. 111 ‘Séance extraordinaire du 20 décembre 1861,’ ASMA, 23 (1862), 28. 112 ‘Séance du 17 janvier 1862,’ ASMA 23 (1862), 96–7. 113 ‘Séance annuelle publique du 23 décembre 1862,’ ASMA, 24 (1863), 50–64. 114 ‘Bulletin de la séance du 6 mai 1861,’ 623–9. 115 Ibid., 624. 116 Ibid., 625. 117 Ibid. 118 ULG, Hs. 3012.4.1, Letter of January 7, 1856, of Nicholas-Chrétien Du Moulin to the Medical Society of Ghent. 119 ‘Séance du 3 octobre,’ BSMG, 32 (1865), 233–5, 233–4. 120 ‘Note sur des cristaux de phosphate ammoniaco-magnésien, trouvés sur les replis péritonaux d’un python,’ BSMG, 46 (1879), 357. Macleod was later appointed Professor of Physiology and Botany at the University of Ghent. 121 ‘Concours pour les élèves en médecine de l’université de Gand,’ BSMG, 34 (1867), 260. 122 One of the first medical students to have won the award was Pierre Dutrieux with a study on anemia and chlorosis: BSMG, 36 (1869), 591. On the announcement of Dutrieux’s award: ‘Séance solennelle de rentrée des cours à l’université de Gand,’ BSMG, 36 (1869), 647. 123 C. De Visscher, ‘Observations recueillies à la clinique de M. le professeur Poirier,’ BSMG, 41 (1874).

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124 See for example: De Visscher, Review of Borlée, ‘Observations chirurgicales: Guérison à l’aide des pansements à l’alcool,’ BSMG, 47 (1880), 258. 125 Similar to De Visscher, Goddyn regularly reviewed studies in his own field of interest. See for example: P. Goddyn, Review of Wasseige, Essai pratique du forceps de Tarnier: Trois nouvelles observations de laminage de la tête foetale, BSMG, 47 (1880), 28–9. 126 ‘Séance ordinaire du 6 octobre 1868,’ BSMG 35 (1868), 437–9. 127 ‘Séance du 12 juin 1843,’ JMCP 1 (1843): 385–444. 128 This was also the way Marinus advertised the Journal de médecine when it first appeared in 1843. Instead of the time-consuming browsing through (reprinted) foreign journals, practitioners could now rely on the summaries of the most important articles in the Brussels Journal: J.R. Marinus, ‘Aux médecins belges,’ JMCP 1 (1843): 5–8. 129 ‘Séance du 21 octobre 1853,’ ASMA, 14 (1853), 500–1. 130 ‘Bulletin de la séance du 7 octobre,’ JMCP, 11 (1850), 487–8. 131 ‘Bulletin de la séance du 6 décembre,’ JMCP, 16 (1853), 87–107, 87–8. 132 In 1847, the editors declared they would further expand the Journal de médecine, publishing two volumes instead of one every year. In this way, ‘the Belgian physicians will truly possess and at a low cost, one of the most extensive scientific repertories’: ‘Un mot à nos confrères,’ JMCP, 5 (1847): 977–8. 133 ‘Bulletin de la séance du 3 décembre,’ JMCP, 11 (1850), 184. 134 ‘Bulletin de la séance du 6 décembre,’ JMCP, 16 (1853), 87–107, 88. 135 Ibid. 136 ‘Bulletin de la séance de 4 septembre 1865,’ JMCP, 41 (1865), 374–81. 137 Such rapprochement also occurred in the Amsterdam-based Society for the Advancement of Medicine, Surgery and Obstetrics [Genootschap ter bevordering van de genees-, heel- en verloskunde]: K. Van Berkel, M.J. Van Lieburg and H.A.M Snelders, Spiegelbeeld der wetenschap: Het Genootschap ter bevordering van Natuur-, Genees- en Heelkunde, 1790–1990 (Rotterdam: Erasmus Publishing, 1991), pp. 23–7, 119–56. 138 Velle, ‘De Belgische medische pers,’ 85–7. 139 ULG, VLBL. HFI. M. 032.02, C. Van Bambeke, Rapport concernant le service de la Bibliothèque et la formation d’un comité de publication [1869], 7. 140 Ibid., 7. 141 Ibid., 7. 142 Ibid., 8. 143 Ibid. By way of comparison: the Medical Society of Antwerp possessed 33 journals in 1862, of which 18 were Belgian and 15 foreign: ‘Liste des journaux que la société reçoit en échange de ses annales,’ ASMA, 23

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(1862), 56. Similar to the Medical Society of Ghent, it expanded the amount of exchanges with other journals in this period. By the end of the year, the number of journals had increased to 42: ‘Séance annuelle publique du 23 décembre 1862,’ ASMA, 24 (1863): 50–64. 144 At the same time, demands to exchange issues with journals of which the scientific nature was unclear, such as the Annales de l’électricité médicale and La revue homoeopathique belge, were rejected. 145 This cosmopolitism was seen mostly in the fact that American physicians read French, English and German studies, a combination that was regarded as highly beneficial for the future of American medicine. The society therefore planned to further expand its relations with American journals and societies: ‘Séance ordinaire du 7 novembre 1871,’ BSMG, 38 (1871), 505–16. 146 See for example: ‘Revue des journaux,’ BSMG, 37 (1870). 147 ‘Séance extraordinaire du 24 janvier 1871,’ BSMG, 38 (1871): 10–11. 148 ULG, VLBL. HFI. M. 032.03, ‘Annales et Bulletin de la Société de Médecine de Gand. 42e année, 1876’. Emphasis in original. 149 ULG, Hs. 3012. 12, Letter of September 5, 1874 from Joachim Tani to the Medical Society of Ghent. The same archival record also holds manuscripts of Tani’s original work in Italian and its French translation. 150 BSMG, 43 (1876), 119. 151 See for example: Van Haesendonck, ‘Observations obstétricales,’ ASMA, 22 (1861), 153–65. The work was translated from Dutch by Henri De Ceuleneer-Van Bouwel, one of the Antwerp society members. 152 ‘Bulletin de la séance du 4 mars 1861,’ JMCP, 32 (1861), 408–18. 153 ‘Variétés,’ JMCP 97 (1895): 825. 154 On the considerable costs of scientific publishing in this period, see Aileen Fyfe’s insightful reconstruction of the financing of the Philosophical Transactions in this period: A. Fyfe, ‘Journals, Learned Societies and Money: Philosophical Transactions, ca. 1750–1900,’ Notes and Records of the Royal Society, 69:3 (2015), 277–99. 155 ULG, Hs. 3012. 11, Contract of 1848 between the Medical Society of Ghent and the Gyselynck firm, fifth article. 156 House of Literature, Antwerp, S. 7346 ‘Société de Médecine,’ Contract of March 8, 1845 between the Medical Society of Antwerp and the publisher Ernest Buschmann. 157 ‘Bulletin de la séance du 3 juillet,’ JMCP, 7 (1848), 173–5; ‘Bulletin de la séance du 4 juin,’ JMCP, 21 (1885), 86–7. 158 Van Swygenhoven and Van Meerbeeck, Annuaire, p. 194. 159 Ibid. 160 Ibid.

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161 ULG, Hs. 3012. 11, Contract of 1848 between the Medical Society of Ghent and the Gyselynck firm, third article. 162 Ibid., first article. 163 Ibid., fifth article. 164 ULG, VLBL. HFI. M. 032.0, Circular letter of January 1, 1840 from F. and E. Gyselinck to the subscribers to the Annales and Bulletin of the Medical Society of Ghent. 165 Ibid. 166 ‘Un mot à nos confrères,’ 978. 167 Ibid. 168 House of Literature, Antwerp, S. 7346 Société de Médecine, Contract of March 8, 1845 between the Medical Society of Antwerp and the publisher Ernest Buschmann. 169 Ibid. 170 J. Brenier, ‘Résumé de pathologie cutanée,’ ASMA, 15 (1854), 198–212, 198 (footnote). 171 J. Brenier, ‘Résumé de pathologie cutanée. Synonymie flamande,’ ASMA, 22 (1861), 553–73. 172 ‘Séance du 24 mai 1861,’ ASMA 22 (1861): 425–6, on p. 426. 173 Velle, ‘De Belgische medische pers,’ 87. 174 ULG, VLBL. HFI. M. 032.02, Undated letter [1896] of C. Verstraeten and H. Leboucq to the President and Members of the Provincial Council of East Flanders. 175 ULG, Hs. 3012 4.2, Letter of November 6, 1854 from the Medical Society of Ghent to Dr Van Berchem. 176 ULG Hs. 3012 4.2, Letter of March 19, 1846 from the Medical Society of Ghent to the publishers Ghyselynck. 177 ULG Hs. 3012 4.2, Letter of September 9, 1853 from the Medical Society of Ghent to the publishers Ghyselynck; ULG, Hs. 3012 4.1, Letter of September 7, 1853 from Joseph Guislain to Charles Poelman; ULG Hs. 3012 4.1, Letter of September 10, 1853 from the publishers Ghyselynck to the Medical Society of Ghent. 178 ULG, Hs. 3012 4.2, Letter of March 2, 1853 from the Medical Society of Ghent to the publishers Ghyselynck. 179 House of Literature, Antwerp, S. 7346.

4

Networks and collections

On May 6, 1862, Charles Poelman, Professor of Anatomy at the University of Ghent, presented the specimen of a malformed baby to his colleagues in the Medical Society in that same city. By then, the specimen had already travelled from the town of Aalst, about 30 kilometers from Ghent, where a local practitioner, Dr De Moor, had acquired it and sent it to Poelman. At the society meeting, the specimen was collectively examined by the society members present and identified as a case of ‘cyclopie,’ a condition that referred to the child’s eyes being grown together. Given the rarity of such a case, it was decided that a detailed description was to be published in the society’s journal, which would be accompanied by several drawings.1 Charged with this task, Poelman contacted De Moor, who in a letter to the society provided some details of the pregnancy of the child’s mother.2 One month later, the society again received a letter, but now from Ms Hutsebaut, a midwife from Aalst, who – as the meeting report stipulated – communicated ‘some comments on the topic of the “monster” she had sent to the Society,’ revealing yet another actor in the journey of the specimen.3 Shortly after, Poelman’s description appeared in the journal (in which, for that matter, Dr De Moor but not Ms Hutsebaut was mentioned). It meant the start for the further dissemination of the specimen – not as a physical object, but in print – to a new audience composed of the readers of the society’s journal.4 De Moor and Poelman were both members of the Medical Society of Ghent. But they also belonged to different social classes. Their cooperation followed a familiar pattern within the Ghent society: professors working together with private practitioners (of which many were formers students). De Moor was indeed a private practitioner, occupied

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with the day-to-day duties of medical practice; Poelman was an established professor, who taught courses at the university, wrote scientific articles and participated in urban society life. The specimen had brought them together. Its trajectory had cut across the social divisions within the medical profession – and even across those outside of it. The specimen had also brought Ms Hutsebaut into view, and, through her remarks, the mother of the child (of whom we know very little). This revelatory potential of the trajectory of anatomical preparations helps us to understand the attractiveness of ‘object biographies’ as a methodological tool for medical historians.5 By following the objects, historians get a rare look into the relation between the spheres of medical practice and scientific inquiry, into the attributions of new meanings and the loss of older ones during these shifts – body parts being turned into scientific objects – and not least into the variety of actors and audiences that were involved in these processes.6 What was the driving force behind the trajectory of the malformed baby? Its journey may be partly explained by its particular features. The oddness of the baby or, in medical terms, the rarity of such a case seemed to have triggered the idea with Ms Hutsebaut and Dr De Moor that the baby had ‘scientific’ value.7 They seemed acquainted with the discipline of teratology, which focused on classifying abnormal babies and studying these abnormalities in anatomical cabinets, and felt obliged to contribute to this field. Such awareness proved essential for the trajectory of the specimen. Yet Hutsebaut’s and De Moor’s intellectual universe does not suffice to explain the baby’s journey. For without the institutional infrastructure, provided by the Medical Society of Ghent, the trajectory – and certainly our reconstruction of it – would have been different. The specimen would not have passed through the society’s meeting room for examination; it would not have been accurately described in medical terms; and it would not have been reproduced in print. By focusing on the circulation of anatomical objects, this chapter highlights the role of societies as scientific networks.8 Contrary to the two previous chapters, which each discussed a set of scientific practices (debating and publishing) and laid bare the ‘inner’ scientific functioning of medical societies, this chapter focuses on one specific subfield: anatomy. It shows how anatomists used societies to realize one of the most prestigious contemporary medical projects: to give the young

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5  Drawings of a malformed baby discussed in the Medical Society of Ghent. They were made by Charles Van Bambeke, who ‘drew from nature’ (‘ad nat[uram] delin[eatus]’), meaning that they were original drawings of the actual specimens.

Belgian nation its own anatomical collections and traditions. Since medical collections were mostly housed at the Belgian universities, this focus allows an analysis of the relationship between societies and universities, which in the late nineteenth century, as the latter became the central research institutions of the country, became much closer. As I will show, societies contributed to the expansion of academic collections by encouraging their members and correspondents to collect new specimens. They were thus key institutions in the networks through which anatomical specimens circulated. These networks, the chapter will show, depended on different forms of professional recognition for partaking in scientific study, which help us to understand the motivations of Dr De Moor and Ms Hutsebaut in sending a specimen to the Medical Society of Ghent. Such mechanisms of recognition make it clear that collection building was not necessarily

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the primary goal of those physicians involved in the circulation of specimens. Obtaining and presenting anatomical preparations – and receiving credit for it – seemed just as important. Unlike in (academic) medical museums, where anatomical specimens could be admired by visitors in relation to other specimens as part of a collection, anatomical preparations in medical societies were generally viewed in isolation and were attributed a scientific meaning through collective discussion and judgment by colleagues. Physicians’ intentions in presenting a specimen at society meetings were thus not, in the first place, the expansion of an anatomical collection, but rather practicing science together through debate. In such a setting, the anatomical object could have different functions. It could satisfy (or evoke) a shared sense of curiosity, but it could also act as scientific evidence for a certain claim. These uses, which drove the circulation of anatomical specimens, were thus closely tied to the nineteenth-century culture of scientific sociability. In the following paragraphs, I will sketch a shift in the networks through which anatomical specimens circulated, which were operated by medical societies, in the course of the nineteenth century. This shift occurred on three levels. On the level of the participants, it involved the replacing of private practitioners by students and young researchers as the main providers of new specimens – an evolution that we have also traced on the level of authorship of scientific studies. This evolution was paralleled by an equally important, second shift in the nature of this participation. Increasingly, an accurate scientific description was required from these providers in addition to the mere acquiring and presenting of specimens. Simply donating a specimen, as De Moor had done, was no longer regarded as a true and sufficient contribution to the sciences. A third shift concerned scientific ideals and standards. Rarity, curiosity and esthetics became superseded by accuracy and seriality as the shared ideals that motivated the circulation of anatomical objects by society members – a shift that reflected the growing importance of quantification in medicine, as well as the rise of pathological anatomy as a scientific specialism in the second half of the century. Societies and collection building

If studying the history of anatomy and medical sociability simultaneously has methodological advantages, as explained above, it also makes sense for historical reasons. Within the context of mid-nineteenth-century

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6  Portrait of Charles Poelman lithographed by Florimond Van Loo.

medical reform, the concurrent emergence of medical societies and the expansion of anatomical collections seems hardly coincidental. Both were, in fact, part of the same reformist movement. As shown in the first chapter, medical societies sought to reinforce the disciplinary boundaries of medicine as a scientific field. If medicine had long been a profession in its own right, its position as a separate branch of the sciences was established only in the early nineteenth century. Before this period, medical study was regarded as part of an encyclopedic pursuit of knowledge by learned men, who did not apply strict boundaries between

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the later disciplines of biology, medicine, chemistry etc. In the field of anatomy as well, these implicit boundaries were now made explicit, for example through the institutionalization of formerly private anatomical collections, which until then were often part of larger cabinets of curiosity. Their content was delineated more sharply: they became more strictly medical by excluding antiquities, botanical specimens or objects belonging to natural history or geology. Institutional collections and medical societies can thus be considered new manifestations of collection building and sociability that replaced the private cabinets and learned circles of the eighteenth-century gentleman scientist.9 In Belgium, the movement towards medical societies had particularly strong roots. As has been previously discussed, the country’s profoundly liberal constitution left much to civil initiative, which helps explain the early successes of medical societies. But these circumstances also made the establishment of anatomical collections more laborious. The hesistance towards state investments and the country’s decentralized academic landscape made investments in such collections difficult. In the state universities, small budgets were provided for the creation of anatomical cabinets. Here, as elsewhere, the argument that such collections contributed to a national fame, a means for Belgium to take its place among the European nations, proved essential. In Brussels, however, the even more limited finances of the Free University of Brussels left little room for anatomical acquisitions. The purchase of the important private collection of Onderdenwijngaart Canzius for the University’s anatomical cabinet could only be made with the financial aid of the city’s Commission of Hospitals.10 In 1836, this latter body decided to establish anatomical cabinets in the St. Jean and St. Pierre Hospitals and in the city’s maternity – cabinets which would be developed and maintained by the interns working there, but were not the property of the university.11 By 1840, some progress had nevertheless been made. At that time, Joseph Guislain reviewed the country’s anatomical collections. Praising the work of several academics, which had resulted in remarkable specimens in Liège and Ghent, Guislain also emphasized the country’s backwardness in pathological anatomy. ‘Nowhere in our hospitals,’ he concluded, ‘do we find Pathological Museums.’12 Society members were well aware of this (perceived) lack of collections of pathological anatomy in Belgium. On several occasions, they

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tried to remedy the situation by engaging in collection building, albeit with limited success. The Medical Society of Ghent, for example, possessed its own ‘cabinet of pathological anatomy,’ in which specimens sent to the society and presented during its meetings could be preserved.13 Its size, however, is difficult to assess, since the cabinet was rarely mentioned in the society’s meeting reports. But it is important to note its disciplinary specificity – grouping together particular specimens and, in all likelihood, only accessible to its members. In this way it clearly differed from contemporary and more traditional scientific societies. The previously mentioned Society of Sciences, Letters and Arts of Antwerp, for example, aimed, in those same years, to establish a physical and mineralogical cabinet open to the general public.14 In Brussels, the Vesalius Society (1843) most explicitly answered Guislain’s call. In a request for subsidies to the urban government, the society sketched its ambitions to establish anatomical cabinets and medical libraries as a means of paying tribute to ‘the memory of the great anatomist’ for whom the society had been named.15 Affiliated to the Brussels St. Jean Hospital, its sole purpose – the society did not organize debates or publish transactions – seemed to be to stimulate the acquisition of anatomical specimens and the donation of medical books to the hospital’s library.16 The Belgian Academy of Medicine perhaps had the greatest ambitions in terms of collection building. In 1844, President Jean-François Vleminckx expressed the wish that the Academy would establish a Museum of Pathological and Comparative Anatomy under its auspices. Patriotism again proved an important motivation. References were made to the grand collections in Vienna, London, Berlin and Paris. A similar Belgian museum would give more weight to the country’s medical achievements and would provide scholars – who seemed the only intended audience – with ‘the desirable facilities to verify and extend the discoveries that are made daily in physiology.’17 ‘The necessary pathological pieces for such a collection,’ Vleminckx added, ‘could be partly provided by the military hospitals, the numerous hospices in Brussels and the veterinary clinics.’18 In the years following Vleminckx’ address, specimens were regularly deposited in the academy’s collection, but it never reached the size of a true national museum. The Brussels professor Joseph-Emile Lequime was among the most active contributors. Interested in the study of diseases related to ageing, on

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which he taught a course at the Free University of Brussels, he presented and donated several specimens of hardened arteries, which he acquired from the deceased elderly in the Brussels Grand Hospice.19 In this way, he realized, on a modest scale, Vleminckx’ ambition to obtain specimens from the Brussels hospices. Why were societies’ efforts to establish their own collections unsuccessful? On a general level, we might advance that collection building did not fit in well with the type of scientific sociability of the 1830s and 1840s, which was much more oriented to organizing debates and publishing journals. In other words, establishing anatomical collections was not their core business. More specific factors may have contributed to this situation. One element might be the lack of space to house collections. The Medical Society of Ghent had been granted a room to hold its meetings in the Conciergerie, an annex building of the Ghent town hall, only through the courtesy of the urban board.20 To obtain a large room to potentially display hundreds of specimen was another matter. The Academy of Medicine, even though it was generously funded by the government, equally did not possess the ‘appropriate rooms,’ as Vleminckx emphasized, to establish an Anatomical Museum.21 The Brussels Musée, in which the academy held its meetings, was a complex of buildings known as the ‘Ancient Court’– referring to their previous function as the palace of Charles of Lorrains. Besides the academy, it housed the Academy of Sciences, an art school and several other institutions, suggesting competition for space.22 The diversity of objects that were sent to them was another impediment to societies’ collecting efforts. In practice, it proved difficult to develop a policy for their collections because their members donated all sorts of objects: plants and minerals, animal specimens (mostly of malformed pigs or cattle), anatomical models in leather, besides of course all sorts of human anatomical specimens, ranging from tumors and fetuses to bones and skin tissue. In Ghent, the German correspondent Moeller sent a collection of beetles to the society, which was deposited in the society’s ‘cabinet of natural history,’ another division of its scientific collections.23 During another meeting, a skull was collectively examined and discussed in light of recent archaeological findings near Liège, testifying to the diverse intellectual interests of its members – interests which reminded one of the encyclopedic nature of the former cabinets of curiosity. A related problem was the delineation between

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animal and human anatomy. An attempt made by Vleminckx in the Academy of Medicine to refer specimens of animals to the Academy of Sciences failed. After receiving a ‘fetus of an abnormal pig,’ he had raised the question whether these specimens ‘belonged to the domain of the Academy of Medicine’. He was answered by Théodore Thiernesse, the director of Brussels veterinary school, and Joseph Guislain, who both stressed the importance of comparative anatomy and physiology for the medical field.24 Thiernesse’s active participation in the academy – he was later elected its permanent secretary – guaranteed the continued presentation of animal specimens at the academy, often from the collection of the veterinary school. A continued tradition of private ownership of anatomical preparations, finally, also limited societies’ collections. Some physicians, in fact, chose not to donate specimens and maintained their own private anatomical cabinets. During meeting debates, preparations from these collections, and their origins, were occasionally mentioned. The French Dr Payan described in a study how he had once possessed a remarkable preparation, but had given it to his former professor in Montpellier as a mark of gratitude. Others mentioned visitors to their own private cabinets to emphasize the rarity and peculiarity of a certain specimen, which was ‘observed with great pleasure by numerous physicians.’25 Here a gentlemanly tradition of collegiality was continued, in which anatomical preparations – in a way similar to separate copies of scientific articles – were used as means to reinforce professional ties. These examples again reveal a tension between the individual physician and the collective medical community. Donating a specimen, in fact, also inevitably meant a loss of private ownership, somewhat similar to giving up a secret remedy. In the case of Payan, the compensation for such loss was the strengthening of his professional network through his gift. It is to these mechanisms we must turn to better understand societies’ function in the circulation of anatomical objects, which indeed did not primarily consist in successfully establishing their own collections. Keeping an eye out for rarities

Veronique Deblon and Pieter Huistra have shown how the Ghent Professor of Anatomy Adolphe Burggraeve acquired great fame for expanding the anatomical collections of the University of Ghent in the middle

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of the nineteenth century. As Deblon explains, a form of individual prestige continued to be connected to these academic collections, even though they properly belonged to the state, which financed the maintenance and acquisition of anatomical specimens at the state universities of Ghent and Liège. This prestige can be regarded, she advanced, as a form of ‘scientific ownership,’ which was related to the skillful preparing of specimens – Burggraeve claimed to have rediscovered the method used by the famous Dutch anatomist Frederik Ruysch – but also to their rarity, and to the size and quality of the collection as a whole. Anatomists such as Burggraeve, in sum, became equated with their institutional collections.26 Such a personal relationship was far more easily established between Professors of Anatomy and their academic collections, which were tied to their chairs, than between individual members and the shared collections of medical societies. If the loss of private ownership was more easily compensated by donations to academic collections, this did not mean that the country’s major anatomists did not participate in scientific societies. On the contrary, they used these forums to build and extend their reputations and often mentioned particular specimens from academic collections during scientific debates. On several occasions, specimens travelled from academic collections to societies’ meeting rooms, where they could assess their scientific value and thus increase their importance (and by extension the reputation of their makers). The Brussels professor Jean Crocq, for example, expressed his intention to present a specimen of a heart with cancer tissue, of which a medical observation of the above-mentioned Thiernesse reminded him: ‘I have preserved this piece, it is at the university, and I hope to show it to the Academy in the next meeting.’27 In 1835, Adolphe Burggraeve showed ‘the bladder of a man […] of which the stone could not be extracted,’ and later that year, he presented ‘two kidneys filled with stones’ from the anatomical collection of the University of Ghent.28 Anatomical objects, in other words, circulated between universities and societies. Such journeys reveal that societies were rarely the final destination of traveling specimens. They were rather transitional spaces, in which their scientific value was established and in which their creators received a form of recognition from their colleagues. Afterwards, the specimens could be included in (or return to) another collection. In the abovementioned examples, this process of accreditation was relatively

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straightforward: the academics who showcased the specimens received applause for their work. But for longer trajectories, in which new specimens or multiple actors were involved, this scientific ownership was, in fact, often shared. Different actors needed to receive at least some credit. By unraveling these dynamics, societies’ agency as regulatory bodies in the supply networks of anatomists becomes clear. They weighed the contributions of the different actors in the acquisition of new anatomical specimens. The specimens that travelled longer distances were typically gathered by societies’ correspondents: generally rural physicians, or physicians from smaller towns, who came across what was, in their eyes, a rare medical case. By contacting medical societies, they often collaborated with their former professors. This was certainly the case for the Medical Society of Ghent, the leadership of which was comprised mostly of academics, while the correspondents were generally physicians who had graduated at the University of Ghent. What is so interesting about these interactions is that sometimes physicians’ motivations for engaging with the society were made explicit. A specimen of an embryo of triplets, for example, was submitted by Dr Van Ooteghem, together with the description of another rare case with the remark: ‘Here are two considerably rare cases, of which the explication belongs, I think, to the High Physiology; I leave the care to explain them to your insights.’29 Another physician, Dr Debeule from Lokeren, who sent the specimen of a baby whose face was malformed, explicitly added the wish that the specimen ‘would become part of the teratological cabinet of the University of Ghent.’30 Poelman later published a description and a drawing of the specimen and added it to the university’s anatomical collection, where it is still preserved.31 The remarks of Van Ooteghem and Debeule suggest a sort of hierarchy between these private practitioners and the urban academics, but they also hint at an ambition by the former to contribute to the progress of the medical sciences, not so much by writing studies themselves but by reporting and submitting these ‘rare’ cases. Such cooperation was not without its problems. In the Belgian Academy of Medicine, president Vleminckx looked rather critically upon the large number of studies sent by private practitioners: ‘These works are not all of equal interest.’ But he added that ‘none of them was lost for science.’32 It was indeed within these parameters that private

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7  Nineteenth-century drawing of a malformed baby. The specimen was sent to Charles Poelman by Dr Debeule, a private practitioner from Lokeren, to be included in the anatomical collection of the University of Ghent.

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practitioners could make a contribution, if only modest, to the advancement of the medical sciences. A specimen of the kidney of a pig by a certain M. Bayenet, veterinary, was deemed ‘interesting nevertheless, even though it brings nothing new to the sciences.’33 A pathological specimen of a heart, submitted to the academicians’ judgment by Dr Heuse from Liège, received an equally double conclusion. Heuse’s description was regarded as ‘unfortunately very incomplete,’ but the specimen itself was said to represent ‘such a rare case of pathological anatomy.’34 Bayenet, Heuse and many others were therefore granted at least some credit within the chain of actions and persons that turned an anatomical specimen into a scientific object. The mere ‘delivery’ of the specimen did require some scientific insight, in particular into what was a rare case, and therefore was equally considered a scientific act. Some specimens, for example, were unmasked after close examination. What was thought to be a rare polyp from the intestines turned out to be an undigested piece of meat – a finding which, according to the commentary of one society member, occurred regularly with specimens sent to the Academy.35 Societies, in fact, determined which objects could be considered scientifically interesting and thus ‘true’ anatomical specimens. The trajectories of these specimens, moreover, are also revealing of the strategies of Professors of Anatomy in expanding their collections. Charles Poelman mentioned in his reports to the government that he had received specimens from hospital physicians as well as from rural physicians, in particular for his collections of embryos and of teratology.36 The trajectories of the above-mentioned specimens suggest that medical societies played an important role in the networks through which Professors of Anatomy such as Poelman acquired these specimens. Societies, in fact, seem to have allowed academics to make use of their considerable networks of correspondents (of which many were former students). In some case descriptions, as was the case with De Moor’s, it was also mentioned that Poelman had met with one of the society’s correspondents to discuss the case, but it was always Poelman himself who wrote the final article. Preparations’ trajectories also exposed the inner hierarchies of the academic world. At the university, specimens were generally made by the prosector of an academic course, a position regarded as a potential first step in an academic career. The Brussels professor Louis Seutin, for

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example, presented three pathological specimens ‘prepared by M. Simonart, prosector of anatomy at the Free University of Brussels.’37 The Liège prosector Louis Dujardin, affiliated to the course of surgery at that city’s university, prepared the specimen of a man’s tumor, presented by Dr Lavacherie to the academy. In the latter case, Dujardin also wrote the anatomical description of the preparation that was read and later published.38 The presentation of anatomical specimens at societies’ meetings thus offered younger academics an opportunity to receive credit for their work. The balance of power between them and the professors was simultaneously affirmed. It was always the professor who presented the specimen, explained its importance and engaged in the scientific debate, and in this way became associated with the specimen as its scientific owner. In that sense, both the actual preparing and describing of anatomical preparations were regarded as less important than their oral, scientific evaluation, the process of accreditation by one’s colleagues. Far less importance was given to the patients whose participation was, in fact, no less essential to the circulation of anatomical objects than the work of medical actors. In societies’ meeting reports, their (or their families’) willingness – if such agreement was even sought – to hand over body parts was seldom acknowledged. Nevertheless, as Shannon Withycombe has shown, a close reading of medical case reports does allow us to restore some agency to the patient. For the case of embryology, she showed the ‘embeddedness’ of mothers in the scientific enterprise. The act of allowing miscarriage materials to be studied by doctors, Withycombe suggests, might have been emotionally helpful within the cultural context of the nineteenth century.39 In societies’ reports, patients’ voices seem to have been included mostly when they opposed the practice of science. Louis Seutin, for example, mentioned, when discussing a case study of a 28-year-old girl who had died of a tumor in her neck, that her parents had refused the autopsy. In their presence, a form of autopsy was nevertheless performed, as Seutin added: ‘Still, M. Bosch was able to remove the larynx and the trachea on which the tumor was situated before them [the parents].’40 In general, the inability to perform an autopsy due to the family’s opposition was deplored by physicians as a missed chance for scientific study. Yet physicians themselves also seemed aware of the ethical tension between patients’ wishes and scientific study. In a rare moment of critical

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reflection on collecting practices, the Ghent professor Burggraeve disapproved of physicians who allowed tumors to grow, ‘and when the illness had matured, to cut them as a rare piece, and make of them the ornament of some museum of pathological anatomy.’ Such ‘love for what are called the beautiful cases’ had caused much wrongdoing, Burggraeve added.41 The end of curiosity

Burggraeve’s reference to the beauty of anatomical specimens, even though he criticized the hunt for such beauty, is telling about the reception of specimens within the nineteenth-century medical community. Aesthetic aspects continued to matter. The act of observing an anatomical specimen together might have evoked a feeling of solidarity, a shared sentiment of curiosity, a sentiment that perhaps reminded them of the older tradition of visiting cabinets of curiosity. In the meeting reports at least, references to the collective examination of ‘curious’ objects hint at the continued importance of such visual ‘spectacle’ in medical societies. Yet such continuities should equally not be overstated. The mainstream trend, in particular in pathological anatomy, was in an opposite direction. In the course of the nineteenth century, specimens were studied more and more closely and serially, and were integrated with other, clinical findings. In 1843, a member of the Academy of Medicine praised ‘the radical reforms that the microscope, with the aid of chemistry, had introduced during the last ten years in general anatomy, [which promised] a salutary influence on pathological anatomy and the treatment of different tumors.’ These evolutions increasingly transformed ‘curious objects’ into forms of scientific evidence.42 The passage of pathological specimens through societies’ meeting rooms testifies to this transformation. Their function as scientific evidence became clear, in the first place, in the debates conducted by medical academics in the Academy of Medicine. In 1855, the Leuven professor Maximilien Michaux argued that ‘the specimen I hold in my hands’ proved the existence of a particular type of fracture of the thighbone.43 Seutin similarly presented ‘two pieces of bone’ to support his claim of being the first to have partly removed the fibula of a patient during surgery.44 Michaux’s and Seutin’s performances at the Academy reveal a scientific culture in which visual evidence served to underpin

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priority claims and disease theories.45 Surgeons, in particular, presented the (amputated) body parts of their patients at society meetings; on rare occasions even together with the healthy patient – the patient then acted as the evidence of the surgery being successful. In 1848, Burggraeve, for example, presented part of the upper jaw bone he had amputated from a man three months earlier and announced that he would bring the patient, who had fully recovered, to the next meeting of the Medical Society of Ghent.46 During such performances, members’ curiosity and longing for visual display seemed not to contradict their scientific ambitions, at least among the medical elite. The rank and file of the profession was much less interested in priority disputes or in the classification of fractures and conditions. Among private practitioners, in fact, the criticism was uttered that anatomical research, despite its many successes, had become much too theoretical. In the Academy of Medicine, this position was represented by Louis Varlez, who boldly advanced that pathological anatomy was a poor guide for medical therapeutics, resulting only in ‘vagueness, error, uncertainty and confusion.’47 At a time when the innovations in anatomy were generally praised, Varlez’ remarks spawned a heated discussion on the position of pathological anatomy in the medical field. Yet, even if Varlez was in the minority at the Academy, his views spoke to an audience of private practitioners, the readership of societies’ journals. Other members also kept this audience in mind when they described the specimens under scrutiny, stressing its potential implications for medical practice. Seutin, for example, explained how the pathological specimen of a hip he presented at the Academy allowed for a more accurate diagnosis.48 Simon, in the same body, based his plea for Caesarean sections for certain pregnancies on the study of ‘three pelvises I possess in my collection of obstetrical pathological pieces.’49 Pathological anatomy here supported a form of science-based medical practice. Anatomy’s turn to medical practice nevertheless had a paradoxical effect. Intended as a means to involve private practitioners in the study of pathological anatomy, the complexity that accompanied its integration into clinical medicine made it increasingly difficult for them to participate in anatomical research. The combination of clinical case studies with accurate descriptions of specimens proved challenging. Only a few private practitioners succeeded in getting their work published. One of them was Dr Luytgaerens, a correspondent of the

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Medical Society of Ghent, who submitted a study on uterine cancer to the society. Together with his manuscript, he included a specimen of part of the uterus he had surgically removed from a patient. The meeting report mentioned in this light that ‘to support his work, the author included an anatomical specimen, which all societies’ members examined with great interest.’50 Luytgaerens’ work was published in the Ghent Annales,51 and, in the following year was presented as an example of sound scientific conduct. Aspiring authors were advised that their studies should include ‘details that give them features of authenticity, with the production, for example, of pathological specimens, as Dr Luytgaerens has done, whose technique of removing the uterus is confirmed by the pathological specimen deposited in the society’s cabinet.’52 As early as 1839, the evaluation of Luytgaerens’ work anticipated the further march of research in pathological anatomy, in which detailed descriptions were increasingly emphasized over the rarity of the presented objects. The rise of pathological anatomy therefore revealed the boundaries of a scientific enterprise, regulated by urban medical societies, that had been based on collaboration between academics and private practitioners. The networks through which rare and curious objects were acquired had successfully cut across the social hierarchies between these different medical men. Their gradual erosion in the second half of the century, under the impulse of rising standards and specialization, was part of a wider shift in the nineteenth-century medical sciences. In other subfields as well, private practitioners were unable to acquaint themselves with the changing research methods, and with their withdrawal from the active scientific community, the model of the medical society as a scientific institution also came under pressure. As a result, these societies sought closer alliance with universities, which now took on a more central position in the scientific landscape. Collections of ordinary facts

The Society for Pathological Anatomy of Brussels (1857) forms a suitable case study for scrutinizing the shifts in medical sociability in the second half of the century, and, more importantly, their impact upon the networks of collecting anatomical specimens. The society, which remained active until 1914, was, first of all, much more successful in

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collection building than the societies that have hitherto been discussed. It proved an essential factor in the expansion of the anatomical collections of the Free University of Brussels. Central to this success was the permission, granted by the Commission for Hospitals, to collect specimens in all the institutions under its supervision, such as the St. Jean Hospital, the St. Pierre Hospital and the city’s maternity.53 The Society of Pathological Anatomy was thus able to build upon the existing tradition of collecting specimens within these different institutions – a tradition of which the Vesalius Society was also part – and could bring these scattered efforts together. By 1866, it had assembled around 300 specimens.54 And in the early 1870s, the creation of a catalogue of the collection prompted the donation to the University of numerous specimens which had been the property until then of the different hospitals.55 Professor Jean-Hubert Thiry, the then president of the society, expressed his gratitude to the members of the Commission for Hospitals: ‘Thanks to you, Gentlemen, the Free University finally possesses a museum of pathological anatomy worthy of her.’56 In terms of its membership and activities, the Brussels society clearly differed from the Medical Society of Ghent or the Academy of Medicine. Instead of resident members and regional correspondents, a core group of interns at the Brussels hospitals and a few academics made up its members. And instead of a general scientific focus, the society concentrated on the presentation of specimens and the discussion of the clinical cases from which they were collected. As Renaud Bardez has shown in his study of the Brussels Faculty of Medicine, these particular ambitions of the society cannot be understood in isolation from the views of its founder, the Brussels Professor of Anatomy Gottlieb Gluge. His ambition to integrate pathological anatomy into clinical medicine, as a means of making the clinic more ‘scientific,’ materialized most clearly in the Society for Pathological Anatomy.57 Since being appointed in 1838, Gluge had experienced difficulties in introducing pathological anatomy into the medical curriculum. It remained, in fact, only an optional course. By discussing cases and specimens with students during society meetings, Gluge was able to circumvent these limitations and simultaneously teach and advance his views of an integrated, clinical approach to pathological anatomy. In this way, Bardez has argued, he anticipated the further intertwinement of the Faculty of Medicine and the urban hospitals – ‘these inexhaustible mines of pathological

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resources’ – both scientifically and on the infrastructural level in the late nineteenth century.58 The society’s meeting reports reveal its regular modus operandi. During its bi-weekly meetings, on average four to five clinical case studies were discussed.59 These typically started with a description of the development of the illness, including some comments on the ‘constitution’ of the patient that were sometimes provided by family members or midwives. A detailed account of the autopsy and of the microscopic analyses of the collected specimen(s) then followed. These accounts testify to the mid-nineteenth-century developments in histology, which generated closer attention to the cellular level. An analysis of tumor tissue, acquired by Dr Deroubaix from the breast of a 55-yearold woman, reads as follows: ‘The cells of the pathological production of the breast are very small. They are barely larger than one sixty-fifth of a millimeter.’60 Much effort went into recognizing such tumors, and into the techniques of successfully removing them. Compared to the function of pathological specimens in general societies, as evidence for scientific claims, the specimens in the Brussels society were much more part of an exercise in clinical diagnosis. Their trajectories, in turn, also occurred on a smaller geographical scale. They moved back and forth in the inner city of Brussels, from the anatomical theaters in the hospitals to the society’s meeting room, which was provided by the university. This new society model, and the more local, hospital-based supply networks that developed parallel to it, nevertheless suffered from growing pains. These seem related to the difficulties of breaking loose from the traditional society model and its established mechanisms of recognition. In 1859, a debate had been conducted in the Brussels society on the desirability of publishing meeting reports. At its heart was the question, as secretary Léon Marcq recalled, whether the society was a ‘Society of Medical Education’ or rather a ‘Learned Society.’61 Put another way, the question was whether the established publishing tradition within medical sociability, which encompassed an ambition to reach a wide medical audience and thus publicly credit the contributions of its members in print, fit in with the ambitions of the Brussels society. One group of members answered this question negatively. For them, the society should primarily focus on the self-improvement of its members and hence had no reason to seek publicity. They wanted to

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confine the society’s activities ‘to studying in the family circle.’62 Another group of members, to which the society’s academic leadership belonged, emphasized the function of publications as a means to attract ‘learned men, from whose company we have much to gain.’ Had not its publications, they added, resulted in ‘the submission of rare pathological pieces, which without them [the published meeting reports] would have been lost for us?’63 The latter group won the debate. Around 1860, the Brussels society indeed sought a more regional audience. The Ghent Professor Charles Poelman, for example, sent several specimens to the society, while Marcq added in his annual report that the society ‘was no longer confined to the capital’ because it could count on correspondents who sent ‘specimens of the greatest interest.’64 Yet this revival of traditional collecting networks, through the mechanisms of learned sociability, proved short-lived. In the academic year 1862–1863, the society went through a crisis that centered around the figure of president Gluge, who resigned in 1863, but which, more fundamentally, concerned the very nature of the society and the desires of its core members: the interns at the urban hospitals.65 A comparison made between Gluge and his successor as the society’s president, Thiry, illustrates these tensions. The latter was described as a man ‘who did not come here to teach us pathological anatomy, but to study it together with us.’66 Other reforms similarly intended to ensure a more active role for the élèves médecins within the society, which was now said to consist of ‘a number of young practitioners with their professor as president,’ who participated ‘out of love for science itself.’67 The most remarkable measure was the inauguration of a prize for the best participant among the interns in the hospitals – a measure that was also taken in other societies, and exemplified the shift from private practitioners to students and young researchers as the target audience for scientific societies in the late nineteenth century.68 The raison d’être of the society, in other words, now became fully tied to the education of medical students. In 1868, for example, 29 of the 39 observations presented during society meetings came from this group, a far greater number than in the society’s early years.69 Together with these reforms, finally, came a further shift in scientific standards that marked the success of pathological anatomy in the clinic, and of which the first signs had already been visible in general societies. Instead of the rarity of specimens, it was their number and the quality

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of their description that became the norm. Students were warned not to be led by ‘the hunt for curiosities’ but rather to invest in daily study, in series of preparations and comparisons. True science lay in ‘a collection of ordinary facts’ and in their integration into clinical cases.70 In one year, the aforementioned prize for the best student was not awarded because the quality of the descriptions was regarded as insufficient.71 The former mechanisms of recognition, which rewarded private practitioners for having recognized the rarity of a given specimen and the professors for their accurate description, thus seemed replaced by a more extensive and educational engagement of soon-to-be clinicians. This chapter has revealed the role of medical societies in the networks through which anatomical objects, such as the specimen of a malformed baby by Dr De Moor and Ms Hutsebaut, circulated. These objects followed a variety of trajectories. Sometimes specimens travelled from physicians’ private practices to medical societies and ended up in an academic collection. On other occasions, they moved from existing collections to societies back and forth – here societies opened up the rather static collections of medical museums: objects were put ‘to work’ in scientific debates. And in still other cases a selection was made: not all objects discussed in medical societies were regarded as sufficiently interesting to be included in collections. But in each of these trajectories, societies proved essential in offering a form of professional recognition to the various actors who participated. In that sense, there is a parallel between these objects and the articles submitted by private practitioners for publication: both were the product of a desire to participate, to engage with science. That being said, objects were more attractive than written texts. There was an element of curiosity, or even beauty, in play in the circulation of anatomical specimens that was less present in the circulation of texts. They caused a shared sense of admiration – to the extent even that they were said to distract members during society debates. The chapter has also shown the difficulties in categorizing these different trajectories chronologically. Old and new ways of acquiring and describing anatomical specimens in medical societies often co-existed. In hindsight, however, the trajectory of De Moor’s specimen in 1862 can be considered an example of circulations that were fading away in the 1860s. The networks that were driven by a shared interest in rarity

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and particularity depended on the support of private practitioners, and are reminders of an even older tradition of aesthetic anatomy and gentlemanly science which were most prominent in the early and midnineteenth century. In the late nineteenth century, the integration of pathological anatomy into clinical medicine turned the modern hospital into the primary scientific site within the anatomical field, replaced ideals of rarity with accuracy and seriation, and placed medical students in a more advantageous position than private practitioners to participate in the circulation of anatomical specimens. Specimens now fully became objective representations of the body and tools for medical education, more than curious objects. At the same time, the networks through which these specimens moved became more closely linked to universities and hospitals, and thus more urban, excluding the former routes through which specimens travelled from the countryside to societies. This shift in networks, finally, was connected to wider changes in the late nineteenth-century scientific landscape, in which universities became the dominant players. The demise of collaborations between academics and private practitioners, such as Poelman and De Moor, is in that sense emblematic for the downfall of the society model as a means to practice science more generally by the end of the century. Notes ‘Séance ordinaire du 6 mai 1862,’ BSMG, 29 (1862), 133–4. ‘Séance ordinaire du 3 juin 1862,’ BSMG, 29 (1862), 166–7. ‘Séance ordinaire du 1 juillet 1862,’ BSMG 29 (1862), 189–91. C. Poelman, ‘Déscription d’un cyclope iniencéphale,’ BSMG, 29 (1862), 320–3. 5 S. Alberti, ‘Objects and the Museum,’ Isis, 96:4 (2005), 559–71 and S. Alberti, Morbid Curiosities: Medical Museums in Nineteenth-Century Britain (Oxford: Oxford University Press, 2011). 6 See for example: L. O’Sullivan and R.L. Jones, ‘Two Australian Fetuses: Frederic Wood Jones and the Work of an Anatomical Specimen,’ Bulletin of the History of Medicine, 89 (2015), 243–66; S.K. Withycombe, ‘From Women’s Expectations to Scientific Specimens: The Fate of Miscarriage Materials in Nineteenth-Century America,’ Social History of Medicine, 28 (2015), 245–62. 7 De Moor and Hutsebaut must have been aware of the contemporary fascination for abnormalities, to which the success of popular anatomical 1 2 3 4

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museums testified: T. Claes and V. Deblon, ‘Van panoramisch naar preventief: Populariserende anatomische musea in de Lage Landen (1850–1880),’ De negentiende eeuw 39 (2015), 287–306. This chapter was origally published as: J. Vandendriessche, ‘Anatomy and Sociability in Nineteenth-Century Belgium,’ in K. Wils, R. De Bont and S. Au (eds), Bodies Beyond Borders: Moving Anatomies, 1750–1950 (Leuven: Leuven University Press, 2017), pp. 51–72. Michael Brown has examined these shifts in collection building in detail in late eighteenth and early nineteenth-century York: M. Brown, Performing Medicine: Medical Culture and Identity in Provincial England, c. 1760–1850 (Manchester: Manchester University Press, 2011), pp. 122–37. R. Bardez, La Faculté de médecine de l’Université Libre de Bruxelles: Entre création, circulation et enseignement des savoirs (1795–1914) (PhD diss., Free University of Brussels, 2015), pp. 186–7. In 1852, the anatomical cabinet of the St. Pierre Hospital, for example, possessed 581 anatomical objects: Ibid., pp. 184–7. J. Guislain, Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse: Résumé d’un voyage fait en 1838, adressée à la Société de Médecine de Gand (Ghent: F.E. Gyselynck, 1840), p. 313. Luytgaerens, ‘Extirpation de la presque totalité de la matrice,’ ASMG (1839): 580. Réglement de la Société des Sciences, Lettres et Arts d’Anvers (Antwerp: Van Assche, 1834), pp. 3–4, 20–4. On this society, see the section ‘A new membership’ in Chapter 1, pp. 28–33. CAB, ASB IP I 110, Sociétés scientifiques, littéraires et artistiques en général, entry for the Vesalius Society [Société Vésalienne]. A. Uytterhoeven, Notice sur l’hôpital Saint-Jean de Bruxelles, ou étude sur la meilleure manière de construire et d’organiser un hôpital de malades (Brussels: Grégoir, 1852), pp. 202–14. ‘Séance publique annuelle de 27 octobre 1844,’ BARMB, 3 (1843–1844), 955–6. Ibid. See for example: J.E. Lequime, ‘Ossification de l’artère coronaire stomatique,’ BARMB 3 (1843–1844), 162–5. On the meeting rooms of medical societies, see the section ‘Science and the city’ in Chapter 1, pp. 33–7. ‘Séance publique annuelle de 27 octobre 1844,’ 955–6. M. Van Kalck (ed.), De Koninklijke musea voor schone kunsten van België: Twee eeuwen geschiedenis (Tielt: Lannoo, 2003), p. 152. ‘Séance du 7 juillet ,’ BSMG, 7 (1840), 89–90.

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24 T. Thiernesse, ‘Rapport sur un monstre double monomphalien de l’espèce porcine, compliqué de rhinocéphalie chez l’un des sujets composants: Formation d’un nouveau genre appelé gastropage,’ BARMB, 10 (1850–1851), 249–50. 25 ‘Continuation de la discussion sur la note de M. Didot, relative aux gangrènes spontanées,’ BARMB, 12 (1852–1853), 963. 26 V. Deblon, ‘Constructing Belgian Anatomy: The Secret of a Collection’ (paper presented at the Science and Technology in the European Periphery Meeting, Lisbon, September 2–5, 2015). On Burggraeve’s collection, see also: V. Deblon and P. Huistra, ‘Het geheim van de anatoom: De ontwikkeling van de Belgische anatomie in de negentiende eeuw,’ Studium: Tijdschrift voor Wetenschaps- en Universiteitsgeschiedenis / Revue de l’Histoire des Sciences et des Universités, 9 (2016), 202–16. 27 T. Thiernesse, ‘Concrétion polypiforme dans le ventricule gauche du cœur d’un jeune porc,’ BARMB, 15 (1855–1856), 528. 28 ‘Séance du 9 juin 1835,’ BSMG 1 (1835), 82; ‘Séance du 1 septembre 1835,’ BSMG 1 (1835): 143. 29 Van Ooteghem, ‘Grossesse trijumellaire, arrêt de développement de deux des trois fœtus,’ BSMG, 28 (1861), 100–1. 30 ‘Séance du 5 juin,’ BSMG, 17 (1850), 138. 31 C. Poelman, Description d’une monstre para-cyclocéphale (Ghent: Gyselynck, 1850). 32 ‘Séance publique annuelle de 27 octobre 1844,’ 953. 33 T. Thiernesse, ‘Rapport de la sixième section sur une communication de M. Bayenet relative à une affection pathologique d’un rein de porc,’ BARMB, 6 (1846–1847), 20. 34 Heuse, ‘Notes et réflexions sur un cas de kystes apoplectiques développés dans les parois du coeur et d’anévrysmes des artères coronaires cardiaques,’ BARMB, 15 (1855–1856), 492–503. 35 Raikem, ‘Rapport de la Commission chargée d’examiner une note de M. Sovet, relative à un corps membraneux expilsé par la voie rectale,’ BARMB, 11 (1851–1852), 718–19. 36 See for example: University Archive Ghent, 4A2/4 017 1857–1859, Report on the Cabinet of Pathological Anatomy. 37 ‘Communications verbales,’ BARMB, 2 (1841–1842), 31–4. 38 Lavacherie, ‘Tumeur sanguine fibroïde du cordon testiculaire droit du volume d’une tête d’adulte produite par cause traumatique,’ BARMB, 4 (1844–1845), 301–4. 39 Withycombe, ‘From Women’s Expectations’. 40 L. Seutin, ‘Mémoire et observations sur les kystes de cou,’ BARMB, 12 (1852–1853): 262–7.

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41 ‘Suite de la discussion sur les amputations,’ BARMB 2e série, 3 (1860), 547. Emphasis in original. 42 On this process of objectification, see: Alberti, Morbid Curiosities, pp. 99–102. 43 ‘Discussion du rapport de la troisième section sur une communication de M. Sédillot, relative à un cas de fracture du col du fémur,’ BARMB, 15 (1855–1856), 413. 44 P.-J. Graux, ‘Observation de résection du péroné,’ BARMB, 4 (1844–1845), 57. 45 See the sections ‘The performance of innovation’ and ‘Seutin’s priority disputes’ in Chapter 2, pp. 67–72 and 72–7. 46 ‘Séance du 6 juin 1848,’ BSMG, 15 (1848), 174. 47 ‘Rapports,’ BARMB, 2 (1842–1843), 357. 48 ‘Communications verbales,’ BARMB, 2 (1842–1843), 31–4. 49 Simon, ‘Observations d’application du forceps-scie, suivies de quelques considérations sur cet instrument et sur les différent moyens employés jusqu’à ce jour pour délivrer la femme dans le cas d’angustie du bassin,’ BARMB, 11 (1851–1852), 67. 50 ‘Séance du 5 novembre 1839,’ BSMG, 5 (1839), 105. 51 Luytgaerens, ‘Extirpation’. 52 ‘Séance du 1 et du 8 décembre,’ BSMG, 6 (1840), 193–210. 53 Bardez, La Faculté de médecine, pp. 180–2. 54 ‘Séance du 19 novembre 1865,’ ASAPB, 10 (1866), 5–6. 55 Archive of the Brussels Centre Public d’Action Social, N. 69: ‘File on the catalogue of the collection of pathological anatomy composed by Dr. Carpentier.’ 56 Archive of the Brussels Centre Public d’Action Social, N. 69, Letter of January 15, 1873, of J.H. Thiry to the Commission of Hospitals. 57 Bardez, La Faculté de médecine, pp. 177–81. 58 L. Marcq, ‘Compte-rendu des travaux de l’année 1859–1860,’ ASAPB, 4 (1860), 3–5. 59 In the academic year 1861–1862, for example, 133 specimens were discussed during 30 meetings. The society at that time had 53 members: L. Marcq, ‘Coup d’oeil sur l’histoire de l’anatomie pathologique: Discours prononcé lors de la reprise des travaux,’ ASAPB, 7 (1862), 3–11. 60 ‘Séance du 24 novembre 1862,’ Bulletin des séances de la Société AnatomoPathologique de Bruxelles, 2:1 (1863), 12–14. 61 L. Marcq, ‘Compte-rendu des travaux de l’année 1858–1859,’ ASAPB, 3 (1860), 3. 62 Ibid., 4. 63 Ibid., 4–5.

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64 Marcq, ‘Compte-rendu des travaux de l’année 1859–1860,’ 3–4. 65 This resignation is also discussed in a brief biography of Gluge: S. Zylberszac, ‘Gluge (Gottlieb-Gotschalk),’ Biographie Nationale, 40 (1977), 362. 66 ‘Séance du 19 novembre 1865,’ ASAPB, 10 (1868), 6–7. 67 Ibid., 4. 68 See the section ‘Changing authorship’ in Chapter 3, pp. 115–20. 69 ‘Séance du 17 novembre 1867,’ ASAPB, 14 (1868), 14. 70 ‘Séance du 19 novembre 1865,’ ASAPB, 10 (1866), 13–14. 71 ‘Séance du 18 novembre 1866,’ ASAPB, 12 (1866), 7.

5

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In 1864, an extraordinary meeting was organized by the Medical Society of Ghent. Its only agenda item was the latest study on the living conditions of Ghent’s workers population by Adolphe Burggraeve. In a plenary speech, Burggraeve seized the opportunity to reflect upon the social role of medicine. ‘It does not suffice for the physician,’ so he addressed his colleagues, ‘to engage in the medical sciences to keep abreast of their progress and of the discoveries that are of interest to him; it is necessary, in addition, to put these sciences into service for the improvement of the hygienic conditions of suffering humanity.’1 Burggraeve himself seems to have lived up to his own ideals. After being appointed Professor of Anatomy and Surgery at Ghent University in 1830, he published various scientific studies on surgical instruments and techniques.2 Of even greater fame was his work within the field of public health. As a socially and politically engaged physician – Burggraeve was a member of the town council of Ghent in the late 1850s and throughout the 1860s – he spread his views on sanitation, the prevention of epidemics, and personal hygiene in numerous treatises, plans, studies and booklets intended for an equally diverse public of physicians, politicians and lay men.3 By the middle of the century, Burggraeve was indeed an established expert in the public health debate. The presentation of his new study at the Medical Society of Ghent was a means to consolidate this expert position within the medical community. Burggraeve’s social engagement reflected both new and old traditions of expertise in public health in the nineteenth century. On the one hand, his diverse publications followed the trends of his age, as they were directed to specific audiences: text books on health for his fellow

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citizens, scientific studies for his medical colleagues, legal and organizational treatises for an audience of policymakers. They reflect Burggraeve’s keen understanding of the growing diversification in the field of public health in the second half of the century. His background in other medical subfields (anatomy and surgery), on the other hand, seemed somewhat outdated by the middle of the century. By 1860, the combination of teaching anatomical and surgical courses, and engaging at the same time in different forms of social and advisory work, increasingly made him something of an atypical expert, a rare breed among the growing ranks of public health professionals in state service. For this latter group of paid professionals, the way Burggraeve framed his (unsalaried) efforts as a ‘duty’ – a discourse that was reminiscent of the philanthropic activities of the earliest medical societies – might have sounded rather odd or pretentious. Some might have even considered such statements a form of disloyalty to one’s colleagues: at a time when new positions for public health professionals were being negotiated with the state, the offering of free services was not necessarily considered professional behavior. As such, the 1864 meeting of the Medical Society of Ghent needs to be considered within a much wider evolution of expertise in public health through the course of the nineteenth century – from a philanthropic, activist form of engagement, performed by the medical elite, to a paid activity by public health professionals, who managed to organize themselves as a medical subgroup and a scientific specialism grounded at the universities. Such professionalization, it has been stressed in the historiography of public health, required strong professional medical unions, which could lobby government officials for new state investments. The growing cooperation between the medical profession and the state indeed proved the main drive behind the expansion of public health as an independent field of medical study.4 But scientific recognition of the work of these new professionals was also required – an element stressed far less in histories of public health, and for which the support of one’s medical colleagues from other branches was necessary. Medical societies formed one of the spaces where such scientific recognition could be obtained. This chapter discusses the engagement of public health experts – old and new – with medical societies in the course of the nineteenth century.5 By focusing on one, emerging medical subfield – similar to the

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previous chapter on anatomy – it illustrates how societies’ forums were used by specialists to advance their respective fields of study and, at the same time, set the boundaries of these same fields. Yet, different from the case of anatomy, which elucidated the changing relationships between societies, universities and private practitioners, the activities of public health experts reveal rather different aspects of societies’ position in the nineteenth-century medical field. The close ties of these experts with the state, and their engagement in all sorts of professional medical organizations, in fact posed considerable challenges to medical societies. It forced them to (re)consider their own social role, to define their relation to the state (and to politics) and to determine their position vis-à-vis the rising number of professional medical associations. In response to such challenges, medical societies defined themselves increasingly as strictly ‘scientific’ societies. The chapter is structured chronologically. It follows old and new public health experts in their efforts to find the right forums and audiences for their work, making use of medical societies in the process. It opens with a discussion of the type of ‘philanthropic’ expertise, of which Burggraeve’s 1860 study can be considered a late example. Such a philanthropic framing of public health studies, it will be shown, allowed members of the medical elite – the traditional experts – to simultaneously reach an audience of physicians and policymakers. The second section discusses the reasons why such studies disappeared in the second half of the century, pointing to three elements: the emphasis on ‘paid’ expertise in professional organizations, the emphasis on ‘pure’ science in scientific circles and, to a lesser extent, the development of a market for popular works on hygiene. Within such a diversified landscape, the third section shows, medical societies took up new functions of arbitration by determining which studies of public health professionals could be considered ‘scientific’. The final section shows how the rhetoric of ‘applied science’ proved essential in establishing the scientific nature of public health as an independent field of study – again allowing experts to reach both policymakers and physicians. Philanthropic expertise

The public initiatives of medical societies can be traced back to their founding years. In the first decade of the nineteenth century, the

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8  Portrait of Adolphe Burggraeve lithographed by Florimond Van Loo after a design by Jozef Pauwels.

development of medical societies paralleled the first vaccination campaign for smallpox in Belgium. By advocating the benefits of vaccination, elite medical practitioners, many of them being engaged society members, presented themselves as philanthropists, whose efforts contributed to the wellbeing of their fellow citizens.6 Such performances allowed these practitioners to reach different audiences. Their medical colleagues regarded them as testimonies of professional engagement,

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since they testified to the social usefulness of medicine, increasing the status of the profession. To the urban public and state officials, vaccination campaigns were mostly acts of citizenship, which augmented the social status of their initiators in the urban community. This rationale of philanthropy and civic engagement was continued well into the midnineteenth century. Reformers such as Joseph Guislain, who devoted himself to the improvement of the living conditions in Belgium’s insane asylums, and Édouard Ducpétiaux, who reorganized the national prison system, were praised in the medical community for their philanthropic work. The editors of the Bulletin médical belge lauded Guislain’s efforts to indicate the deficiencies in Belgian asylums: ‘Honor to the physicianphilanthropist who spends his time alleviating those unfortunate men, who have lost reason, and who takes up his pen to report abuses.’7 Ducpétiaux’s statistical study of mortality in Brussels was similarly applauded in the Medical Society of Ghent as ‘the work of a true philanthropist.’8 The social context in which such philanthropic engagement was to be performed changed profoundly in the second quarter of the century. The emerging industries in Belgium’s major cities radically altered the social fabric, creating a working class whose living conditions severely worsened. The so-called ‘social question’ was placed high on the agenda of the political elite, who feared revolts in an era marked by revolutionary upheaval.9 Only in the late nineteenth century, did this political debate result in the development of social policy, which through new laws (e.g. on child labor) was to tackle the excrescences of industrial economic growth. Around 1850, government officials nevertheless turned to experts, whose observations on the health conditions in the slums and factories were to inform political discussions and at the same time testify to politicians’ attention to the social question.10 In the 1840s, several governmental requests were made for investigations into the daily occupational and living conditions of the working class – requests which, because of their political origins, may be considered a form of ‘science on demand’.11 The medical elite was eager to comply with these requests. In fact, the legitimization of politicians’ attention to the social question through experts’ studies was a two-way process, which also brought about benefits for the experts involved.12 At a time when scientific study was regarded a tool of medical reform, state officials’ appreciation of

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observation-based studies entailed a legitimization of the scientific skills of their authors. For elite practitioners, research into the social circumstances of the working class thus formed a way of augmenting their status within the medical community. One of these well-respected studies was Jean Dieudonné’s inquiry into the living conditions of the workers population and child labor in the province of Brabant, which he published in 1846 on behalf of the Central Council for Public Health.13 In the introduction to his study, Dieudonné, a Brussels professor, praised the Minister of Internal Affairs, Jean-Baptiste Nothomb, for having taken the initiative for the study – ‘an eminent service to humanity’ – while at the same time emphasizing the laborious research he had conducted to formulate his opinion ‘on the basis of facts, the result of direct and attentive observations.’14 In 1843, the provincial governor of Antwerp had posed a similar set of questions on child labor and workers’ health to the Medical Society of Antwerp. In response to the request, the society had published the questions in its journal to gather observations from its correspondents, and had nominated a commission of five members, who presented a bulky report in the next year.15 The most well-known example of such expert studies ‘on demand’ was the inquiry into the working conditions in Ghent’s cotton mills in 1845. The study resulted from a request made by the Ministry of Internal Affairs to the Medical Society of Ghent and was conducted by two society members, the physician and Professor of Chemistry, Daniel Mareska, and his colleague Jean-Julien Heyman.16 Its presentation at the Ghent society, as the meeting report indicated, was ‘met with unanimous applause’ by the members present, who decided to publish the study in their journal.17 Because of its clear description and analysis, it became an often-cited work, both in contemporary medical and political reports and in later historical analyses.18 For the Medical Society of Ghent, the publication of the Mareska and Heyman report provided a means to make its social usefulness concrete. Seven months after the government had made its request, at a time when a reduction in the annual subsidies had caused financial difficulties for the society, its secretary urged both authors ‘to accelerate your work; your diligence will engage the government to speed up the [additional] subsidy, on which the society has strongly insisted.’19 Once the study was published, the society did not fail to emphasize its importance as the result of ‘long and laborious inquiries,’ which had been conducted ‘in the factories

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themselves and in the presence of the workers.’20 In 1846, the study was sent, along with a subsidy request, as a testimony of the society’s social usefulness. In the request, Mareska’s and Heyman’s work was praised as a ‘monument for the country.’21 The participation of medical societies as centers of expertise in the slowly developing government machinery of public health is telling about the porous boundaries between ‘public’ and ‘private’ initiatives in Belgium’s social policy. If societies had shown little enthusiasm for state direction in the medical sciences, as the debate on the Belgian Academy of Medicine in the first chapter showed, the cooperation between the state and civil societies on social matters was not all regarded as problematic.22 Such cooperation fit in well with the vision of limited state intervention that had underpinned the new state in 1830 and can be considered a typical feature of philanthropy in midnineteenth-century Belgium.23 It is also against this background that we may understand the voluntary advisory work of Dieudonné, Heyman and Mareska. An appointment as a public health expert in either state institutions or through the intermediary of medical societies was regarded above all as an honorary, prestigious position, which reflected one’s scientific merits and civic engagement.24 To become a successful expert, it was therefore essential to get one’s message across to both a medical and a political audience. When this was done successfully, the appreciation of both audiences could be mutually reinforcing: an augmented medical status strengthened the confidence of state officials in one’s capabilities as an expert, and state approval of one’s expertise conversely assured being held in respect by one’s colleagues. A typical example of such a successful expert was the Ghent Professor of Obstetrics, Alexis-César Lados. In the 1830s, Lados had rapidly built an academic and scientific career in obstetrics and legal medicine as a member of various medical and scientific societies, including the Medical Society of Ghent. ‘His remarkable works,’ as his biographer later noted, ‘attracted the attention of the government.’25 In 1841, Lados was indeed appointed a member of the provincial medical commission of East Flanders, of which he would become president in 1865. In 1862, he was elected an honorary member of the Academy of Medicine.26 The basis of Lados’ expert fame lay in his skills to effectively reach a double audience of state officials and medical colleagues with his studies of public health. In 1844, he published a report on an epidemic of

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smallpox in the town of Machelen, which he had written for the provincial governor, in the Ghent Bulletin. Lados saw no difficulties in such a publication, since ‘anything that concerns science should be part of the public domain and the publication of writings that make known the sanitary state of different localities in the province should necessarily be of interest to the Society.’27 He only decided to leave out some details on the administration of the town that were ‘of too local an importance to possibly be of interest to our readers.’28 With minimal editing, the same studies could please different audiences. Besides publication space for government reports, medical societies also offered other ways to get one’s opinion across to medical practitioners and politicians. Mid-century, prize competitions were regularly organized on matters of public health, such as medical topography (the study of the diseases unique to a specific town or region), urban sanitation, and the potatoes’ disease of the 1840s.29 In 1848, the Society of Medical and Natural Sciences in Brussels decided to maintain its competition on the medical topography of the province of Brabant for as many years as was needed to complete such a work. The accumulation of smaller topographical studies – the first submissions dealt with the towns of Haacht and Perwez – would ultimately lead to the accomplishment of this goal, it was believed.30 Such competitions encouraged physicians to devote themselves to socially relevant questions and pleased an audience of policymakers, who also decided upon the subsidies of societies. Leading politicians were often invited to the prize-giving ceremony, which took place during the annual public meeting of medical societies. At these festive meetings, public lectures on topics such as cholera or smallpox vaccination were to highlight societies’ social usefulness. At such a public meeting in Antwerp in 1852, mayor Jan Frans Loos presented a medal to Henri-Vincent Decondé for his contributions to the society’s Annales, most notably for his Hygiene of the Polders and Marches.31 Sometimes, financial support was given to cover the prize money of specific questions. In 1861, the Ministry of Internal Affairs allocated a subsidy of 300 Fr to the Medical Society of Ghent to organize a competition on the hygienic measures to be taken in schools.32 The next year, the Ghent urban government sponsored a similar competition on ‘the diseases that may have their origin in the linen and cotton industries.’33 Such collaboration reinforced the ties between societies and state officials, who were often made honorary

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members,34 and allowed (aspiring) public health experts to augment their status in both worlds. On some occasions, an even broader audience could be reached, as awarded studies were picked up by the general press. In 1863, the editors of the journal Le Progrès received the approval of the Ghent society to reproduce parts of the awarded study on school hygiene.35 Such cooperation and public performances reveal how in the middle of the century the scientific ambitions of medical societies, the aims of urban, provincial and national policymakers, and the individual careers of leading experts were in line. This intertwinement is nicely illustrated by the audience granted by the Belgian King Leopold I to the Medical Society of Ghent during his visit to Ghent in 1860. In an answer to a speech by Lados, who represented the society at this occasion, the Belgian king referred to the publications of the society on the poor hygienic conditions of the working class, encouraging them in their work: ‘Continue, Gentlemen, together with my government to work for the improvement of the sanitary condition of this region.’36 Such a speech, rhetorical in its meaning as it was and published in the society’s journal, could nonetheless convince both medical practitioners and state officials of the social relevance of the Medical Society of Ghent and the expert studies of its leading members. Paid professionals

The downfall of this tradition of ‘philanthropic expertise’ in public health was tied to changing views on the role of philanthropy in the medical field more generally. The ideological basis of the medical profession, it has been argued, changed during the course of the nineteenth century – from the idea of the physician as a ‘benefactor’ to the idea of physicians as paid professionals, whose authority was grounded in scientific knowledge.37 Public health was certainly one of the medical subfields in which this shift occurred most clearly. While vaccinations to children had been provided freely by the medical elite as acts of philanthropy in the early nineteenth century, paid school doctors had taken over this task by 1900. It was also a field in which the tensions that came along with such professionalization became evident because of the close ties of public health professionals with the state. A contested issue was whether one could reconcile working full-time in service of the

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state with the status of medicine as a liberal profession.38 And more particular to physicians’ advisory roles was the question whether ‘disinterested’ scientific advice could be given by paid experts. These were matters that also shaped the position and participation of a new group of public health specialists in medical societies. Who were these new specialists? Among them can be counted the physicians in prisons, school doctors and health and food inspectors. They occupied a growing number of full-time positions in state service, performing tasks that had previously been part of the wide range of duties of the so-called ‘doctors of the poor,’ who provided medical service in the working-class districts. In the late nineteenth century, statisticians and bacteriologists were added to their ranks. These new public health professionals – they themselves used the term médecins hygiénistes (‘hygienist physicians’) – opposed the philanthropic basis on which the interaction between physicians and the state had been founded. Instead, they advocated a further professionalization of the state machinery in public health, in which physicians, not as (unsalaried) philanthropists, but as (paid) professionals could be put into service. Unlike the ‘philanthropic’ medical elite, who were often wealthy by birth, public health professionals typically worked their way up from the rank and file of the profession. In their search for professional improvement, they aimed at a much more direct link between the progress of the medical sciences and the promotion of professional interests: the scientifically grounded knowledge of physicians, in their view, was to be translated into better professional positions in state service.39 As state investments were necessary to realize these ambitions, it should not come as a surprise that public health professionals were well represented among the advocates of professional organizations, such as the Belgian Medical Federation, which defended the interests of all Belgian physicians vis-à-vis the state.40 The expert role of the physician, in their eyes, was to be turned into a professional activity. Philanthropy was difficult to align with this new conception of the physician as a paid expert. The question stirred debates in the medical community in the 1860s. The Antwerp physician Léopold Durant, one of the founders of the aforementioned Federation in 1863 and an ardent advocate of a more important social role for the physician, published two works on the topic.41 Another leading member of the Federation, the Brussels professor and member of the Society of Medical and

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Natural Sciences, Jean Crocq, was equally critical of traditional philanthropy in the public health sector. In a review of a study on the organization of medical services in the countryside, Crocq denounced what he called an ‘unjust philanthropy’ and defended the rights of the physician against the wealthy who ‘make him provide almost free medical services to the poor, and are happy to see them satisfied without their purse suffering.’42 As Crocq emphasized, the rural physician ‘was not a person of private means, who could spend his time doing good works.’43 Crocq therefore made a plea for workers’ associations, of which the members would make a small contribution to finance their medical costs. Such a system would also give workers a certain ‘dignity,’ which would allow them to escape from poverty in the long run. Within such a framework, the philanthropic activities of physicians became almost a form of disloyal behavior towards one’s colleagues. These new views of expertise had profound implications for the scientific activities of medical societies. If scientific knowledge was to be financially valorized, could the ‘disinterested’ practice of science in medical societies, as a means of professional and social engagement, then be continued? And what about the mutual legitimization between medical societies and the state? In answer to these questions, medical societies sought for a new relation vis-à-vis the Belgian Medical Federation and the growing medical infrastructure of the Belgian state – a relation that became based on the separation of matters of professional interest from efforts to advance the medical sciences. Such delineation is well illustrated by medical societies’ response to a brochure of the Liège professor Jean-Hubert Dresse in 1850. In the brochure, which Dresse had sent to all Belgian medical societies, he urged physicians to take on social and political engagement.44 Of the societies in the major cities, only the Medical Society of Antwerp debated Dresse’s call and warned for the danger of descending into the arena of party politics.45 In Brussels and Ghent, Dresse’s brochure was dismissed by arguing that their societies did not deal with social or political issues but with issues of science.46 Such response meant the start of a repositioning of these societies as strictly ‘scientific’ institutions. If medical societies had taken the lead in the professional movement in the 1830s (e.g. by organizing petitions on medical legislation), in the second half of the century they saw the pursuit of such activities as potentially harmful for their scientific work. While they supported national organizations such as the

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Federation, the initiative to found it had been taken by new professional medical societies, often in smaller cities.47 The professional movement during the middle of the century indeed developed ‘from below’ and was led by the editors of broad medical journals, such as Auguste Festraets of Le scalpel, taking over a professional leadership that had previously been in the hands of the medical elite. Faced with this new dynamic, leading academics and society members shielded the scientific world against these professional efforts. The growing distinction between the venues for scientific and professional activities, however, did not mean that society members refrained from professional efforts altogether. To the contrary, the leading members of the medical societies of Ghent and Antwerp labored for the foundation of pension funds and organizations that supported physicians and their families who found themselves in needy circumstances. In Brussels and Liège, academics such as Jean Crocq, Augustin-Joseph Daumerie, Adolphe Wasseige and Fréderic-Antoine Spring equally participated in such professional initiatives.48 But these new types of professional support developed outside of traditional medical societies, whose scientific profile was increasingly emphasized.49 Moreover, the involvement of leading society members in these new initiatives should not obscure the considerable differences between them and a new generation of (public health) professionals.50 The matter of ‘just’ or ‘unjust’ philanthropy in relation to paid services, and the matter of independence in the provision of scientific advice proved vexing questions. In the eyes of most academics, the disinterested and independent public health expert was the logical counterpart of the limited, liberal state. The Brussels academics, in particular, opposed any systematic organization of salaried employment by the state, which would turn the physician into ‘one of the radars of the great machine.’51 In debates on the organization of public health, they pleaded instead for more financial support to be given to private associations and defended the autonomy of the Academy of Medicine as an independent advisory body. While the Brussels professors, and more generally the medical elite, stood in relative isolation with such views, their reserve nevertheless hints at some of the fragilities of combining scientific research, expert advice and political statements. In their eyes, such combinations jeopardized the autonomy and credibility of the public health expert.52

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The emphasis on such scientific autonomy and credibility as a precondition for public health expertise was reinforced by two parallel evolutions, the first of which took place in academia. In the second half of the century, both the research activities of the Belgian universities and the scientific nature of medical education were emphasized. Their mission was not only to train medical practitioners but also scientists.53 This evolution was also felt in the medical societies of Belgium’s university cities, in which greater emphasis was put on scientific righteousness and impartiality as the key values of medical study. Academics such as Jean-Hubert Thiry called for ‘pure research’ at the university.54 Such calls were echoed in the annual speeches of the Brussels Society of Medical and Natural Sciences. In his speech of 1860, the society’s secretary Édouard Van den Corput discussed the original aims of the society, and in doing so replaced the traditional, philanthropic phrase that the activities of the society members were to be profitable to their fellow citizens with ‘the search for scientific truth.’55 Besides the diligence of its members, Van den Corput continued, it was the calm impartiality and scientific integrity of the society that lay at the basis of its respected position in the medical landscape: But what above all assures our continuous success, is that free from personal prejudices, devoid of cliquishness, and preserving intact this virtue more rare than worldly virtues, scientific integrity, it [the Brussels Society] does not bow to the idols of absolute theories nor to the charms of professional status.56

Such ‘scientific integrity’ was to be concretized in the impartial judgment of studies, and formed the society’s most severe law, the basis of its authority, which assured that the society would continue in the ‘pure and salubrious sphere of science.’57 In the second half of the century, the scientific focus of medical societies, parallel to academic shifts, became more and more exclusive. A second evolution that complicated public health expertise and reinforced society members’ demands for scientific autonomy occurred in medical publishing. It comprised the growth of a market for popularized studies on hygiene in the second half of the century.58 The emergence of such popularization can be considered as the reverse side of the increasing exclusivity of the ‘scientific’ medical domain. A wide range of authors now took up the challenge of translating scientific knowledge

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for an audience of educated workers and urban citizens, an effort that could form a new way to display social awareness. Besides private practitioners and public health professionals, academics were certainly also part of this group of authors, as the publishing career of Adolphe Burggraeve illustrates. From the middle of the 1850s, and increasingly in the 1860s and 1870s, he published various hygiene treatises and manuals. Many of these had multiple editions, his most successful being The Art of Extending Life.59 Yet, similar to the professional activities of these same academics, such popularizing efforts were best separated from the world of science, and thus from the agenda of medical societies. The social engagement of academics thus did not simply disappear; its manifestation rather moved from performances in medical societies to publishing efforts to popularize hygiene education.60 These evolutions in state infrastructure, academia and book trade all help to understand why society members were rather skeptical about the work of a new group of public health professionals in the second half of the century. At the same time, they also help explain why the ‘philanthropic’ expert performances – of which Burggraeve’s speech of 1864 was a late example – were becoming somewhat outdated. A skepticism towards paid expertise and a distancing from older forms of social engagement were both products of a medical landscape in which the borders of scientific, professional and popular efforts were more strictly delineated. Within the ever more exclusive ‘scientific’ setting of urban medical societies, addressing a public of both medical colleagues and state officials became increasingly difficult. Public health experts nevertheless took up the challenge and tried to get access to medical societies’ scientific forums, hoping to advance their careers by obtaining a certain scientific legitimacy for their work. For these new professionals, the rise to expert fame required navigating these new boundaries to secure not only the support of the state or the public, but also of their medical colleagues. Old and new experts

The degree to which public health professionals gained access to societies’ scientific fora differed considerably. It depended on the willingness of society members to discuss what Brussels Professor Louis Martin in 1875 called disappointingly ‘hybrid questions.’61 As societies applied

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scientific standards more rigidly, as discussed in previous chapters, studies in which all sorts of practical and organizational aspects of public health were discussed – for an audience of policymakers – were assessed rather critically. Such studies, Martin explained, did not come under ‘pure science,’ but nevertheless ‘learned societies, for some time, had made it their aim to produce [such hybrid studies], which can only pointlessly compromise this science, for which they have no use.’62 But his remark also hints at an openness to this type of study among other society members, for whom their social relevance acted as a counterweight to their hybrid character. The scientific nature and quality of public health studies, as a result, became a matter of negotiation between old and new experts, turning medical societies into spaces of arbitration of what could be considered ‘scientific’ expertise in public health. In the Medical Society of Ghent, experts’ studies were carefully tested by the scientific standards of the society. If the close ties with Ghent’s university had turned the society into a welcome venue for young academics, public health professionals, to the contrary, rarely succeeded in becoming successful members. The intense reviewing of their studies held back their inclusion. The trajectory of one of these experts, César-Alexandre Frédericq, illustrates these difficulties. In 1861, Frédericq became a member of the Ghent society after a positive review of his study on the treatment of military ophthalmia.63 Yet in the following year, while he was developing his interests in public health, his study on hygienic measures in the hospitals was heavily criticized. Even though the reviewers initially stated that because of the importance of the question, ‘Any work on hygiene in the hospitals will be welcomed by us favorably,’ they added: ‘we make only one reservation, which is that we also recall that the desire to be charitable might lead to exaggeration.’64 Further in the discussion, it was not so much with exaggeration as with vagueness and lack of originality that the reviewers reproached Frédericq’s study. Had the necessity of separate pavilions in hospitals, as suggested by Frédericq, not long been shown by the professors who debated in the Parisian Academy of Medicine? Moreover, his study was regarded not as a concrete plan, but rather as a collection of ‘very general ideas.’65 In Frédericq’s case, the review procedures of the Medical Society of Ghent functioned as a mechanism of selection, which allowed the exclusion of popular studies from scientific discussion.

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After this negative review, Frédericq never again submitted his work to the Medical Society of Ghent. Yet his somewhat failed scientific trajectory in the Ghent society did not mean that his career in the field of public health was over. In the following years, he was successful in publishing several textbooks that were intended for a broad audience.66 In the afterword to his Textbook on Hygiene, which was awarded a prize by the provincial council of East Flanders, Frédericq reflected on these different audiences, warning his lay readers that while textbooks could be read by anyone, scientific studies of treatments should only be consulted by physicians.67 Frédericq himself had understood well this division in genres and now focused on the popularization of scientific knowledge rather than on conducting scientific research himself. His participation in the Medical Society of Ghent, in fact, had been no more than a small intermezzo in an otherwise successful career as a publicly recognized public health expert.68 If the support of popular audiences could entail expert fame, the same held true for scientific audiences if these were addressed on their own terms. The trajectory of another Ghent public health expert, Emile Vandermeersch, shows that if experts’ studies came up to the expectations of reviewers, scientific engagement could be advantageous to one’s career. After becoming a member of the Medical Society of Ghent in 1868, Vandermeersch published and reviewed several works on rabies, taking advantage of the occasions to show off his scientific qualities by applying strict scientific criteria.69 In his review of a study by Dr Raucq, a physician from the small town of Loochristy, Vandermeersch showed himself highly critical of Raucq’s work, which he regarded as ‘nothing more than the incomplete and, in certain passages, servile reproduction of a small brochure […] by Jac. Dycer.’70 By unmasking Raucq’s study, Vandermeersch showed his mastery of the rapidly growing body of literature and his critical attitude towards the repetition of old ideas. Through such reviews, ‘expertise’ was performed in much more subtle ways than the grand performances of social engagement that Vandermeersch’s predecessors had used. By displaying scientific values, aspiring experts tried to distinguish themselves from authors such as Raucq and Frédericq as ‘scientists’. Such scientific engagement seemed advantageous to a career in state service. In the 1870s and 1880s, Vandermeersch first became a member of the Ghent town council and was later appointed as the secretary of the

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provincial medical commission. At his death in 1889, his extensive commission reports on epidemics were praised for their detail and accuracy – ‘truly scientific studies’ as the Ghent professor Nicholas-Chrétien Du Moulin added in his funeral eulogy.71 Du Moulin also pointed to Vandermeersch’s early insight into the importance of bacteriological knowledge for the field of public health, which had inspired him to support the foundation of a bacteriological laboratory at Ghent university.72 In Vandermeersch’s career, science and expertise went hand in hand. In the Brussels Society of Medical and Natural Sciences, the admission of public health professionals followed a somewhat different trajectory. The members of the Brussels society seemed more receptive to studies conducted by this new professional group. Even though the society had undergone the same ‘academic turn’ as its Ghent counterpart, it had also maintained close ties with the health services and advisory commissions of the urban and central government (e.g. the Superior Health Council), in which many society members took part. The worlds of private science and state service thus remained more closely intertwined in Brussels, turning public health into an important theme for the society. Such interest did not mean, however, that society members did not distinguish between scientific and what they called ‘administrative’ studies, which discussed the organization of health services by the state. It rather meant that this division did not always determine the acceptance or refusal of studies. When Théodore Belval submitted his study on the organization of public health in Belgium in 1872, Professor Martin argued that this study ‘belongs more to the administrative domain than to the field of proper science. Yet public health, the object of the study, has such a distinct importance that our society cannot but be interested in all measures that help spread its application and certainly its organization.’73 Martin’s judgment was typical of the way studies of public health were treated in the Brussels society. Reviewers always had to compromise between the scientific value of the study and its social importance. So, even if studies were openly characterized as non-scientific, they could still be discussed. This was also the case for Belval’s study, which brought him membership of the society. Public health professionals, in turn, anticipated these negotiations by stressing that their studies could contribute to the social relevance

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of medical societies. Eugène Janssens, physician, statistician and head of the Brussels health services, was particularly skillful in this regard and succeeded in placing matters of public health high on the society’s agenda.74 As his fame rose on the international scene, especially after the international Hygiene Conference of 1876 in Brussels, he played into a certain urban chauvinism about the city’s modern public health infrastructure. In 1882, Janssens compared the health services of Brussels and Paris, and argued that Brussels was enjoying ‘an epidemic of good health’ because of the innovative work of the city’s health services. International comparisons were indeed particularly fit for such different audiences. In 1878, Belval had made a similar remark concerning a report by the French physician Du Mesnil at the conference of 1876. In his review, Belval highlighted that Du Mesnil viewed the organization of public health in Brussels as a model for Paris.75 What seemed a shared urban chauvinism could in this case overcome the differences between an audience of academics and one of state officials. The admission of hygienist physicians, however, did not always go well. The affiliation of Hubert Boëns to the Brussels society forms an example of such a difficult integration. In 1860, Boëns had sent his study on the organization of public health in the region of Charleroi to the Brussels society, which followed the same reasoning as Belval’s study. The reviewer argued that the work ‘had no scientific value and consisted exclusively of recommendations and views on the organization of medical services.’76 Boëns nevertheless became affiliated to the society as a correspondent. The members of the Brussels society would later regret their decision. Boëns, unlike Belval, was a rather controversial figure, who made sharp interventions in contemporary debates, including the debate on vaccination in the 1860s, of which he became one of the most well-known opponents.77 The study, reviewed in the Brussels society in 1860, formed no exception to his trajectory of controversy. A group of Charleroi physicians reacted against the critical review in an open letter, claiming that ‘the elevated and scientific atmosphere’ of the society had failed to pick up the flaws and personal interests behind Boëns’ so-called objective description.78 Even though Brussels Professor Crocq tried to put the matter into perspective by pointing to Boëns’ reputation of ‘writing too much and thinking too little,’ the letter of protest made painfully clear how the reputation of the society could be damaged by unintentionally engaging in local

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disputes on the organization of public health through the allocation of memberships and the reviewing of ‘non-scientific’ studies. In the Medical Society of Antwerp, public health professionals perhaps had the best chance to lay a scientific basis for their authority. The society’s openness to research on public health can be explained by various factors. The absence of academics, first of all, meant that calls for ‘pure science’ penetrated the society far less than its counterparts in university towns. Moreover, as discussed earlier, the gradual withdrawal of private practitioners from the ranks of authors in the middle of the century put the society in no position to impose strict selection criteria on the scarce manuscripts it received.79 Instead, membership regulations were loosened and a broad range of scientific, professional and popularizing studies were discussed in the 1850s and 1860s. Established members such as François-Jean Matthyssens, Jean-Corneille Broeckx and Henri De Ceuleneer-Van Bouwel regularly reviewed experts’ studies intended for a broad audience and published studies directed to an audience of policymakers. Matthyssens published ‘Some General Thoughts on Public Health’ in 1852;80 Broeckx reviewed a study by Descuret intended for ‘clergymen, students in philosophy and elite men’ in 1856;81 De Ceuleneer-Van Bouwel published his ‘On the Necessity of Isolating Maternities’ in 1860 and his ‘Hygiene and its Rapprochements to Modern Industry’ in 1861–1862.82 Around 1860, a receptive climate to hygienist studies was clearly present in the Antwerp society. Such circumstances were favorable for the scientific engagement of a new generation of public health experts in the 1860s. Unlike their predecessors, their expert performances were not the result of scientific fame in other medical subfields, but rather of their specialized knowledge and experience in the field of public health. Physicians such as Antoine Kums, Victor Desguin and Abraham Mayer all became members of the Medical Society of Antwerp in the 1860s, at an early moment in their career: Desguin started out as a military physician, Kums and Mayer as doctors of the city’s Social Service. They were socalled ‘doctors of the poor,’ the Belgian equivalent of British Poor Law officers. Later on, each of them made a career for themselves in the expanding health institutions of the city. Kums became a member of the provincial medical commission; Desguin became part of the Antwerp urban government, gaining authority over the city’s schools

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and health services; Mayer became one of the first ‘school doctors’ in Antwerp (and Belgium), a new full-time function that was created in 1882.83 The dynamic that lay behind their success depended on the mutually reinforcing interaction between scientific research and state investments. Public health professionals not only advocated investments in public health on the basis of their scientific claims. The reverse side was equally important: state investments in public health also brought forth new professional positions and opportunities for public health research. For these physicians, it was important to present themselves as ‘scientific’ professionals, an effort that required both scientific engagement and professional support. Yet in Antwerp as well, although at a slower pace than in Brussels and Ghent, tensions arose between professional and scientific activities. If the Medical Society of Antwerp had declared in 1853 ‘to principally treat scientific questions and secondarily professional matters,’84 little remained of this policy in the 1860s, as rulebooks, petitions and opinion pieces on subjects of professional interest were regularly published.85 This growing number of professional initiatives under the auspices of the society could sometimes evoke objections. In 1865, several members protested against the publication of such a petition without formal permission by the society.86 In 1874, the foundation of the Medical Circle of Antwerp, which would focus exclusively on matters of professional interest, was said to structurally resolve these tensions by allowing the Medical Society of Antwerp to focus more strictly on scientific questions.87 In practice, however, the demarcation of the responsibilities between both societies required ad hoc decisions. On some occasions both cooperated, for example in 1876, when the annual meeting of the Belgian Medical Federation was held in Antwerp.88 Yet when it came to presenting petitions, the Medical Circle of Antwerp clearly took the lead.89 Until the end of the century, debates took place on what was to be judged the right forum to discuss ‘hybrid’ questions. Physicians, in fact, could differ in their assessment of the ‘scientific’ side of such studies on the organization of public health. In 1897–1898, the Medico-Surgical Society of Antwerp (1895), which had split off from the Antwerp Medical Society, considered physicians’ duty to report cases of epidemic diseases a purely deontological question, to be treated in the Medical Circle, while the Medical Society of Antwerp judged this matter to be of scientific interest, as such reporting led to better

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statistics and should thus be treated by a scientific society.90 For public health professionals, it became essential to find the right forum for their ‘hybrid’ studies – a forum that could vary according to the judgment of the scientific relevance of these studies. Yet if such a forum was found, and negotiations over the nature of their work were successfully conducted, the reward could be considerable; for the approval of one’s colleagues proved an important step in the development of public health studies into a proper medical subfield. The politics of applied science

This ambition was gradually realized in the late nineteenth century. While the third quarter of the century was indeed a period of searching for the right forums to present ‘hybrid’ studies, the final decades of the century were marked by the scientific anchoring of public health as a medical specialism. Several factors, outside of societies’ meeting rooms, contributed to this success. Changes in the research methods of public health professionals, first of all, facilitated their integration into the scientific community. The introduction of statistics in public health research since the middle of the century, and more importantly, the use of bacteriological analyses since the 1870s, objectified experts’ claims and added to their credibility. At the same time, state investments increased considerably. Progressive forces in mostly liberal political circles used scientific claims to press for the foundation of better health services in Belgium’s major cities. The investments in modern medical infrastructure (hospitals, laboratories etc.) were to show the benefits of a progressive, science-based policy. The health politics of the Brussels mayor Charles Buls were perhaps the exponent of this movement.91 Such investments, in turn, enabled further research into the health conditions of the city and its inhabitants. Public health experts, much more than in the early or middle of the century, now succeeded in steering urban policy.92 These changes were noticeable in medical societies. They strengthened the position of public health specialists and enabled new forms of cooperation between them and their medical colleagues. Together with such an approved status, a new framing of public health studies was developed. Such works were no longer regarded as ‘hybrid studies,’ but rather as products of ‘applied science.’ This new presentation was mostly

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developed in the national professional organization of public health specialists, the Royal Society of Public Health of Belgium (1876).93 The new society had the ambition of providing a space for scientific discussions and informing governmental health policies, effectively combining the two central audiences of its members. Its initial goals were defined as the statistical mapping of the health conditions in the country and making suggestions for concrete measures to improve public health.94 In the 1890s, the society’s objectives were recast by a new generation of bacteriologists in terms of ‘pure’ and ‘applied’ research – twin concepts that enabled a flexible presentation of public health research to different audiences.95 As Sophie Onghena has shown, the directors of academic laboratories described their field of study as ‘pure science,’ reflecting the scientific ideals in contemporary academic contexts, while their colleagues in the provincial bacteriological institutes of the state emphasized the practical or applied nature of their work to show its social relevance.96 Such flexibility helped assure the adoption of the study of public health as a scientific specialism within the medical community. Graeme Gooday has argued that the distinction between pure and applied science was created as a means of establishing a hierarchical relation between academic science and traditions of technical knowledge, in which the latter could be presented as the result of the former, a mere application of previously conducted ‘pure’ research.97 Public health experts had good reasons for stepping into such a hierarchy. Even if the label of an applied science confirmed the primacy of academics, it still provided experts with a scientific legitimization of their studies. The bacteriologist Edmond Trétrôp, director of the Laboratory of Bacteriology and Pathological Anatomy of the Stuivenberg Hospital in Antwerp, presented the concrete measures proposed by public health experts as ‘these hygienic rules that stem naturally from modern scientific knowledge.’98 Moreover, the label of an applied science allowed the practical nature of experts’ studies to be emphasized to an audience of state officials, who were more interested in concrete measures than in the pursuit of scientific knowledge. At the same time, a new appreciation arose in medical societies of the practical work of public health experts. Such appreciation reveals that the ever more exclusive demarcation of ‘science’ was not the only possible outcome of societies’ functioning. If sufficient consensus was

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reached, the boundaries of what constituted ‘science’ could also be expanded. This was the case with the studies of public health in the late nineteenth century. Practical measures to improve hygiene, in particular, were increasingly well received during society meetings. When Frans Jacobs learned about a comparative study on the organization of tuberculosis prevention by Gustaaf Schamelhout in the Medical Society of Antwerp, he immediately put Schamelhout’s recommendations into practice in the city’s St. Elisabeth Hospital.99 Conversely, the support of hospital physicians provided experts’ pleas for sanatoria with a broader scientific basis. Schamelhout’s study was sent to the Antwerp town council with unanimous approval of all society members.100 The Medical Society of Ghent took a similar initiative in 1900 by addressing a petition to the provincial government to provide funding for the foundation of sanatoria for tubercular patients.101 In the struggle against tuberculosis, the collaboration between public health experts and their colleagues enabled a new public role for medical societies. This dynamic was also visible in societies’ responses to rumors and popular beliefs in the city. By negating such rumors, societies made their ‘scientific’ voice heard and could reassure the public. In 1867, the Medical Society of Ghent declared in its meeting report that ‘the sanitary condition of the city was satisfactory and that nothing justified the alarming rumors caused by superficiality or fear.’102 In Brussels in 1882, president Sacré asked his colleagues whether they had any knowledge of incidences of cholera. During the last meeting of the town council, such incidences had been denied by the mayor in response to rumors of cholera in the city. Some members had viewed cases of cholérine, of diarrhea, but cholera proper, they declared, was not present in the city.103 Such authoritative judgments were grounded in the collective medical knowledge of all society members, which in the late nineteenth century was often seen as the result of the society uniting members from different specialties. In a debate on vaccination in 1880, JeanHubert Thiry recast the distinction between matters of practical and scientific importance in a new positive way, arguing that ‘our Society, where one finds authoritative men, both from a scientific and a practical perspective, is in a perfect position to clarify the question and reassure in this way the trust of the public that imprudent theoreticians wanted to undermine.’104 It was precisely the diversity of the society members, including the public health professionals – those ‘practical’

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men – that made it possible to exert scientific authority in public debate. There were, however, also limits to the public actions of medical societies, for these actions carried with them the danger of bringing contemporary politics into their meetings. As the ‘culture wars’ between Catholics and liberals in Belgium intensified from the 1860s onwards, public health became a contested issue.105 It was one of those policy areas where liberals tried to prove the advantages of a science-based approach over one grounded in a religious worldview. Public health arguments were, for example, used in the debate on cremation, a method of disposing of bodies that was presented by liberals as being more ‘hygienic’ than traditional burials, but which was opposed fiercely by Catholics. When the matter reached the Brussels Society of Medical and Natural Sciences, Thiry tried to prevent the society from undertaking any public actions, arguing that ‘the matter would be no longer to limit our intervention to a purely scientific role, we would have to exert political influence, vulgarize and defend this new system [of cremation] through the press, contact various governmental powers and provoke a general petitioning.’106 Such tasks, Thiry suggested, were not essential to the functioning of the society. Nevertheless, the delineation of a more modest, scientific role for the society was agreed upon. Under the influence of some of the public health experts, it was decided that the society could report on new techniques and scientific studies regarding cremation during its meetings. This information would be published in a new separate section of the Journal de médecine.107 The discussion on cremation was not an isolated case. On various occasions, the political nature of the questions under discussion made consensus difficult. Such discussion was not so much between Catholic and liberal physicians. Only in the Academy of Medicine did the Catholic professors of the University of Leuven clearly engage with their liberal colleagues from the Free University of Brussels. In the medical societies in Belgium’s major cities – governed by explicitly liberal urban boards – one rather has to distinguish between different liberal factions: the conservative and the progressive liberals, the latter being more favorable towards expanding state intervention. In Brussels, the leading academics of that city’s medical society, such as Jean Crocq and Arsène Pigeolet, were conservative liberals who were involved in local, provincial and national politics.108 Their political views on individual

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liberty and limited state intervention were echoed during society meetings. In his opening speech of 1870, Thiry declared that liberalism was at the core of the Belgian nation and therefore should also form the basis of Belgian medicine.109 From 1834 onward, the Free University of Brussels formed a breeding ground for liberal ideology. But while progressive views became popular among medical students, and among the rising group of public health professionals, they only gradually seeped through at the medical faculty, where conservative views continued to hold sway.110 Within such a context, the pleas for more government intervention by (progressive) public health experts could attract only limited support. As Evert Peeters and Kaat Wils have shown, the question of state intervention in public health divided liberal politicians and physicians alike, and required the balancing of the ideals of individual freedom and rational progress, of which the state was seen as the main vehicle.111 These tensions were reflected in the discussions in the Brussels medical society on mortuaries, obligatory vaccination and the promotion of breast feeding. For the (conservative) Brussels academics, mortuaries were without doubt hygienically better than placing bodies on the bier at home, but not strictly necessary as the local doctor could also determine the cause of death. Breast feeding was unmistakably beneficial for each child, but rendering it mandatory a bridge too far. ‘Liberty, nothing but liberty, these are our principles,’ the meeting report documents, ‘touching upon the liberty of the family is an issue that will not gather many partisans in this circle.’112 Within such a context, the proposals of hygienist physicians to collectively advocate for health reforms received little support.113 The growing intertwinement of science and politics in the field of public health thus also restrained the public engagement of medical societies. The embellishing of research results for political reasons formed another stumbling block for public health specialists. In the Medical Society of Antwerp, a comparative study by G. Ballieux on the health services of Antwerp and Brussels caused severe disagreements in 1888. Ballieux’s analysis of the mortality rates in both cities had led him to claim the superiority of the Brussels services, which were coordinated by a central office, and a plea for the foundation of such an office in Antwerp.114 After the Antwerp society had published the study in its Annales and had sent a copy to the urban government, a strong reaction

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followed by Paul Roselt, a member of the local medical commission. In a letter to the urban board, Roselt accused Ballieux of scientific dishonesty, arguing that he had deliberately presented Brussels’ health conditions as highly favorable and had selected his statistics in such a way that these would support his claim.115 With his letter, Roselt sent a critical article from the Journal de Bruxelles on the sanitary state of Brussels and added a statistical table with more recent mortality rates, showing that mortality in Antwerp was lower than in Brussels. A similar criticism was voiced a few years later in the Medical Society of Antwerp following the publication of the local medical commission’s annual report,116 the commission having stressed that mortality rates were lower in Antwerp than in Brussels in 1892. The society commented it ought to have added that for infectious and endemic diseases those rates were far higher than in the capital.117 An all too rosy presentation of Antwerp’s sanitary state, based on a flexible use of mortality figures, was thus greeted with skepticism in the scientific community. The scientific grounding of public health studies thus remained a fragile process. If policymakers were addressed too directly, these studies became vulnerable to scientific critique. But when experts succeeded in convincing such an audience of the necessity of new investments in medical infrastructure, the benefits could be great. The support of the state effectively created new research opportunities, and – despite the tensions between science and politics that such support generated – contributed considerably to experts’ reputations. Participation in local medical societies reflected this increased scientific status. For the most talented among them, urban societies became a stepping stone to prestigious national organizations such as the Belgian Academy of Medicine. The studies of the Antwerp health services by Victor Desguin, in particular on medical inspection over public schools, as well the statistical works of his Brussels colleague Eugène Janssens, gained both men access to the academy.118 Desguin’s presidency over the academy in 1898 was celebrated as a victory of the entire medical community of Antwerp.119 By the end of the century, public health research had indeed developed into an established and autonomous scientific subfield. While this trend was present in all medical societies, it was most prominent in the Medical Society of Antwerp. More than in the university cities, where academics continued to occupy the leading functions, public health professionals increasingly dominated the society. Since

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the late 1870s, urban investments had enabled new research topics. The foundation of an abattoir in 1878 stimulated research into food safety by its directors.120 The expansion of health services for the city’s public schools in the 1880s and 1890s was reflected in the publications of school doctors on hygiene in the classroom, gymnastics and prevention of epidemics.121 Investments in swimming pools and bathhouses inspired research on water therapy.122 And bacteriological research could only flourish in the city after Trétrôp’s laboratory had been installed in the Stuivenberg Hospital in 1892.123 The participation of this rising number of scientifically active public health professionals in the Antwerp society strengthened the ties between the society and the city’s public health policy. The Antwerp Annales not only offered publication space to these new experts; its reviews and reports of hygienist studies, expositions and (international) meetings formed a scientific resource that kept them updated on the developments in their subfield. The urban government supported this evolution. From 1881 onwards, the society, for the first time, received a subsidy from the city, which also sponsored the scientific travels of its health professionals.124 Conversely, the society also increasingly contacted the urban government to indicate useful studies, or suggest improvements to the city’s public health policy.125 At a time when the medical societies in the university cities were becoming more affiliated to academic science, the Medical Society of Antwerp thus sought alliance with the public health services of the city. In the course of the nineteenth century, members of the medical elite were replaced by new professionals as the experts in the field of public health. This chapter has analyzed this transition by looking at the performances of these experts in medical societies and has examined the strategies they used to convince different audiences of their authority and acquire an expert status. Such an approach offers a new understanding of the professionalization of public health, not so much as a process of collaboration between two actors – physicians and the state – but rather as a multifaceted process, in which old and new experts interacted with each other, and in which medical interests and scientific research had to be balanced. The connecting thread within these complex changes was experts’ search for the right audiences and the right means to reach them. As the relatively small-scale, civic medical

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world of the early nineteenth century – in which a philanthropic framing of expert studies satisfied state officials and brought social prestige among colleagues – was replaced by an expanding and diversifying medical field, new forms of legitimization of expert authority became required. The label of public health expertise as a form of ‘applied science’ proved successful in convincing both state officials and fellow physicians, but also laid bare the porous boundary between science and politics in the state-funded domain of public health. If medical societies have functioned in this chapter as the lens through which shifts in public health expertise have been examined, these shifts, in turn, are also revealing of the changing function of these institutions. The fluid boundaries between private and public scientific institutions in the first half of the nineteenth century –when the belief in limited state intervention was professed most strongly – allowed medical societies to take an active part in public health policy as advisory organs. By producing expert studies on demand, they confirmed their social relevance in the process. As state infrastructure expanded in the second half of the century, this form of social engagement disappeared. Although the diversification of popular, professional and scientific studies brought about new arbitrational functions for medical societies, these new functions were mostly relevant within the medical community. For an audience of medical men, science functioned as a marker to distinguish valid from non-valid expert knowledge. The lack of social relevance could be filled with public scientific statements, but these were given a more limited character: as authorities of science, societies restrained from strong political engagement and only acted when consensus was reached among their members. The efforts of public health specialists therefore offer another perspective on the downfall of the medical society as an institutional model for scientific practice in the late nineteenth century (in addition to the previously discussed evolutions in the culture of scientific debate and publishing, and in the networks of anatomists). When limited to a self-defined scientific orthodoxy, their public role indeed no longer satisfied the needs of those physicians seeking a wider forum to display the social relevance of their work. As the seventh and final chapter will show, this was part of a wider effort to rethink the function of sociability in the late nineteenth-century medical landscape. New organizational forms of sociability were developed to meet the changing needs of

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medical specialists and professional scientists. But first, the way this shift from a ‘civil’ to a ‘professionalized’ scientific world was reflected in the commemorative activities of medical societies will be explored. Notes 1 ‘Séance extraordinaire du 26 janvier 1864,’ BSMG, 31 (1864), 32. The study presented by Burggraeve: A. Burggraeve, Question sociale: Amélioration de la vie domestique de la classe ouvrière (Ghent: De Busscher, 1864). 2 Burggraeve’s research included histology, human anatomy (see Chapter 4) and the design of new splints and quilted bandages. See for example: A. Burggraeve, Histologie ou anatomie de texture (Ghent: AnnootBraekman, 1843); A. Burggraeve, Mémoire sur les appareils ouatés (Ghent: Gyselinck, 1850). 3 On Burggraeve’s career: G. Leboucq, ‘Burggraeve (Adolphe-Pierre),’ Biographie Nationale, 29 (1956), 377–80; P. Gunst, ‘Burggraeve, Adolphe (1806–1902),’ UGent Memorie, www.ugentmemorie.be/personen/ burggraeve-adolphe-1806-1902 (consulted on October 24, 2017). 4 For a recent discussion of the historiography of public health: H. Oos­ terhuis and F. Huisman, ‘The Politics of Health and Citizenship: Historical and Contemporary Perspectives,’ in F. Huisman and H. Oosterhuis (eds), Health and Citizenship: Political Cultures of Health in Modern Europe (London: Pickering & Chatto, 2014), pp. 1–40, 5–6. On the interaction between public health experts and the state: P. Baldwin, Contagion and the State in Europe, 1830–1930 (Cambridge: Cambridge University Press, 1999); D. Porter (ed.), The History of Public Health and the Modern State (Amsterdam: Rodopi, 1994). 5 Part of the research for this chapter has been published as: J. Vandendriessche, ‘Arbiters of Science: Expertise in Public Health in NineteenthCentury Belgian Medical Societies,’ in J. Vandendriessche, E. Peeters and K. Wils (eds), Scientists’ Expertise as Performance: Between State and Society, 1860–1960 (London: Pickering & Chatto, 2015), pp. 31–45. 6 See the section ‘Opportunities of the French Revolution’ in Chapter 1, pp. 17–23. 7 J.R. Marinus, Review of J. Guislain, Exposé sur l’état actuel des aliénés en Belgique, et notamment dans la province de la Flandre orientale, avec l’indication des moyens propres à améliorer leur sort (Ghent: Gyselynck, 1838), BMB, 5:10 (1838), 280–2. 8 Review of E. Ducpétiaux, De la mortalité à Bruxelles, comparée à celle des autres grandes villes, mémoire adressée à l’administration communale et au

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conseil central de salubrité de Bruxelles (Brussels: Société Encyclographique des Sciences Médicales, 1844), BSMG, 10 (1844), 292–4. On such revolts in Ghent’s cotton industry: G. Deneckere, Katoenoproer van Gent in 1839: Collectieve actie en sociale geschiedenis (Nijmegen: SUN, 1998). On mid-nineteenth-century Belgian social policy: Witte, Craeybeckx, and Meynen, Political History of Belgium, pp. 66–82. On the problems of such ‘science on demand,’ see: J.R. Ravitz, Scientific Knowledge and its Social Problems (Oxford: Clarendon, 1971). Eric Ash’s discussion of expertise in the early modern period offers useful insights into this mechanism of reciprocal legitimization: E. Ash, ‘Introduction: Expertise and the Early Modern State,’ Osiris, 25 (2010), 1–24. J.F.J. Dieudonné, Mémoire sur la condition des classes ouvrières et sur le travail des enfants (Brussels: Lesigne, 1846). Ibid., p. 2. Berchem, C. Broeckx, J. Jaques, J. Koyen and F.J., Matthyssens, ‘Rapport sur le travail des enfants et la condition des ouvriers dans la province d’Anvers,’ ASMA, 5 (1844), 165–235. D. Mareska and J.J. Heyman, Enquête sur le travail et la condition physique et morale des ouvriers employés dans les manufactures de coton, à Gand (Ghent: Gyselinck, 1845). ‘Séance du 8 juillet 1845,’ BSMG, 11 (1845), 161–2. C. Verbruggen, De stank bederft onze eetwaren: De reacties op industriële milieuhinder in het 19de-eeuwse Gent (Gent: Academia Press, 2002), pp. 12–13. ULG, Hs. 3012.4.2, Letter of April 27, 1844 of the secretary of the Medical Society of Ghent to Daniel Mareska and Jean-Julien Heyman. ULG, Hs. 3012.4.2, Letter of July 9, 1845 of the Medical Society of Ghent to the Minister of Internal Affairs. ULG, Hs. 3012.4.2, Letter of December 1846 of Adolphe Burggraeve and Édouard De Nobele to the Minister of Internal Affairs. On this debate, see the section ‘Towards a national academy’ in Chapter 1, pp. 38–43. J.H. Dekker, ‘Transforming the Nation and the Child: Philanthropy in the Netherlands, Belgium, France and Engeland, c. 1780–c.1850,’ in H. Cunningham and J. Innes (eds), Charity, Philanthropy and Reform from the 1690s to 1850 (London: Palgrave Macmillan, 1998), pp. 130–47. On the development of public health institutions in Belgium: E. Bruyneel, De Hoge Gezondheidsraad (1849–2009). Schakel tussen wetenschap en volksgezondheid (Leuven: Peeters, 2009), pp. 17–33.

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25 ‘Le professeur Alexis-César Lados, Président honoraire de la Société de Médecine de Gand,’ BSMG, 47 (1880), 56–64, 58. 26 Ibid., 58–60. 27 ‘Séance du 5 mars 1844,’ BSMG, 10 (1844), 99–142, 133. 28 Ibid. 29 The Society of Medical and Natural Sciences organized a prize competition on the cheapest way to clean up Brussels’ populous quarters in 1848. The Medical Society of Ghent organized a prize competition on ‘the history of the potato and its different connections to the medical sciences’ in 1846: ‘Séance extraordinaire du 16 septembre,’ BSMG, 11 (1845), 252–3. 30 ‘Bulletin de la séance du 7 août 1848,’ JMCP, 7 (1848), 479; ‘Programme des questions proposées pour le concours de 1849,’ JMCP, 7 (1848), 494–5. 31 ‘Séance annuelle publique du 15 décembre 1851,’ ASMA, 13 (1852), 88–101, 101; H.V. Decondé, ‘Hygiène des polders et des marécages,’ ASMA, 13 (1852), 377–404 and 425–63. 32 ‘Séance ordinaire du mois de décembre,’ BSMG, 28 (1861), 414–16. 33 ‘Séance ordinaire du 11 février 1862,’ BSMG, 29 (1862), 39–40. 34 In Ghent, mayor Charles de Kerckhove and Minister of Internal Affairs Alphonse Van den Peerenboom received such titles in 1867: ‘Séance ordinaire du mois de mars 1867,’ BSMG, 34 (1867), 33–5. In Brussels, mayor Jules Anspach became an honorary member in 1872: ‘Bulletin de la séance du 5 août 1872,’ JMCP, 55 (1872), 177–80. 35 ‘Séance ordinaire du 2 juin 1863,’ BSMG, 30 (1863), 205–7. 36 ‘Visite à la Famille Royale,’ BSMG, 27 (1860), 273–4. 37 M. Brown, ‘Medicine, Reform and the “End” of Charity in Early Nineteenth-Century England,’ English Historical Review, 124:511 (2009), 1353–88, 1357–8. 38 K. Velle, De nieuwe biechtvaders: De sociale geschiedenis van de arts in België (Leuven: Kritak, 1991), pp. 266–71. 39 See also Eddy Houwaart’s definition of ‘hygienist physicians’ in this light: E. Houwaart, De hygiënisten: Artsen, staat & volksgezondheid in Nederland 1840–1890 (Groningen: Historische Uitgeverij, 1991), pp. 297–9. 40 R. Schepers, De opkomst van het medisch beroep in België: De evolutie van de wetgeving en de beroepsorganisaties in de 19de eeuw (Amsterdam: Rodopi, 1989), pp. 95–105, 160–73. 41 L. Durant, De la profession médicale et de la charité publique (Antwerp: Buschmann, 1860); L. Durant, De l’indifférence en matière de philanthropie (Brussels: s.n., 1868). 42 ‘Séance du 1 décembre 1851,’ JMCP, 14 (1852), 90–6.

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43 Ibid. 44 J.H. Dresse, Intérêts sociaux: Devoir du corps médical de prendre part à la politique, aux questions sociales et à l’élaboration des lois, ou mission générale du corps médical (Liège: Denoel, 1848). 45 ‘Compte-rendu des travaux de la Société de Médecine de Liège, lu à la séance anniversaire du 29 mai 1851,’ ASML, 5 (1854), 69–78; J.G. Stevens, ‘De la mission sociale des médecins,’ ASMA, 12 (1851), 129–39. 46 ‘Séance du 6 novembre 1850,’ BSMG, 17 (1850), 249–50; ‘Bulletin de la séance du 4 novembre 1850,’ JMCP, 11 (1850), 598. 47 In 1863, the Medical Society of Ghent decided not to become affiliated to the Federation and referred to its scientific nature to account for this decision: ‘Séance ordinaire du 6 novembre,’ BSMG, 30 (1863), 317–19. The Medical Society of Antwerp saw no problem in such an affiliation and delegated Joseph Koyen as its representative in the Federation: ‘Séance de juin 1864,’ ASMA, 25 (1864), 475–6. The Society of Medical and Natural Sciences of Brussels initially supported the Federation, but broke all ties with the organizaton in 1880 after a dispute concerning a law proposal: ‘Bulletin de la séance du 5 janvier 1880,’ JMCP, 70 (1880), 88–105, 89–92. 48 Daumerie played an important role in the efforts to establish a national professional medical organization, the Belgian Medical Union [Union médicale belge] in the early 1850s. Crocq became president of its successor, the Belgian Medical Federation in 1864. The Liège professors Wasseige and Spring founded the professionally oriented General Association of the Physicians of the Province of Liege (1853) [Association générale des médecins de la province de Liège]: K. Velle, ‘Het verenigingsleven van de Belgische geneesheer,’ Annalen van de Belgische vereniging voor de geschiedenis van hospitalen en volksgezondheid, 26–7 (1988–1989), 47–118, 83–8; C. Havelange, Les figures de guérison (XVIIIe–XIXe siècle): Une histoire sociale et culturelle des professions médicales au pays de Liège (Liège: Bibliothèque de la Faculté de Philosophie et Lettres de l’Université de Liège, 1990), pp. 311–12. 49 In Ghent, Adolphe Burggraeve contributed to the foundation of the Medical Society of the District of Ghent (1853) [Société Médicale de l’Arrondissement de Gand]: Velle, ‘Het verenigingsleven,’ 81. Ten years later, an association was founded to support the physicians who graduated from the University of Ghent. Its annual meeting reports were published in the Ghent Bulletin: ‘Statuts de l’association de prévoyance et de secours mutuel, dite Association des anciens élèves en médecine de l’université de Gand,’ BSMG, 30 (1863), 214–20. In Antwerp, JeanGuillaume Stevens and his colleagues set up the Medical Committee of

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the District of Antwerp (1848) [Comité médical de l’arrondissement d’Anvers]: Velle, ‘Het verenigingsleven,’ 82. On the different opinions on the role of the state in the medical community, see also Oosterhuis’ and Huisman’s discussion of ‘liberaldemocratic citizenship’ and the nineteenth-century sanitary movement: Oosterhuis and Huisman, ‘The Politics of Health and Citizenship,’ pp. 22–31, 25–6. ‘Bulletin de la séance du 5 novembre 1860,’ JMCP, 31 (1860), 616–37, 618. On the problems of ‘disinterested expertise’: N. Stehr and R. Grundmann, Experts: The Knowledge and Power of Expertise (London and New York: Routledge, 2011); T.M. Porter, Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton: Princeton University Press, 1995). P. Dhondt, Un double compromis: Enjeux et débats relatifs à l’enseignement universitaire en Belgique au XIXe siècle (Ghent: Academia Press, 2006), pp. 361–79. See the chapter on the modernization of medical education in Belgium: ‘La modernisation de l’enseignement en médecine,’ in Dhondt, Un double compromis, pp. 361–84. ‘Bulletin de la séance du 2 juillet,’ JMCP, 31 (1860): 203–13. Ibid. Ibid., 205. For a general overview on the popularization of science: D.M. Knight, ‘Scientists and Their Public: Popularization of Science in the Nineteenth Century,’ in M.J. Nye (ed.), The Modern Physical and Mathematical Sciences (Cambridge: Cambridge University Press, 2002), pp. 72–90. A. Burggraeve, Art de prolonger la vie (Brussels: Office de Publicité, 1868); A. Burggraeve, Médecine populaire: De l’homme physique (Ghent: Hoste, 1853–1854); A. Burggraeve, Le livre de tout le monde sur la santé: Notions de physiologie et d’hygiène (Paris: Didier, 1863); A. Burggraeve, Hygiène populaire: Longévité humaine, ou art de prolonger la vie (Brussels: Lesigne, 1876). On health education in Belgium: K. Velle and P. Viaene, Lichaam en hygiene: Naar de wortels van de huidige gezondheidskultuur (Ghent and Leuven: Museum voor industriële archeologie en textiel and Kritak, 1984), pp. 61–97. ‘Bulletin de la séance du 6 septembre 1875,’ JMCP, 61 (1875), 258–67. Ibid. ‘Séance du 24 décembre,’ BSMG, 29 (1862), 5–6; L. Frédericq, ‘Ophthalmies chroniques guéries par le chlorate de potasse à l’intérieur,’ ASMG, 39 (1861), 228–48.

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64 ‘Rapport sur le mémoire intitulé: Quelques considérations sur la question de l’hygiène des hôpitaux, par M. le docteur Frédericq,’ BSMG, 30 (1863), 161–9. 65 Ibid., 164. 66 L. Frédericq, Handboek van gezondheidsleer voor alle standen (Ghent: Rogghé, 1867); L. Frédericq, Hygiène populaire (Ghent: Hoste, 1875); L. Frédericq, Lichaamsongelukken: Hulpmiddelen vóór de aankomst van den geneesheer (Ghent: Vuylsteke, 1882). 67 Frédericq, Handboek van gezondheidsleer, p. 261. See also: Velle, De nieuwe biechtvaders, p. 295. 68 Frédericq, in those same years, pursued a political career and resided in the town council of Ghent between 1860 and 1883. On his career: ‘Nécrologie,’ BSMG, 54 (1887), 28–32. 69 ‘Séance ordinaire du 5 mai 1868,’ BSMG, 35 (1868), 189–91; E. Vandermeersch, ‘Observation d’un cas de rage,’ BSMG, 35 (1868), 310–12. 70 ‘Séance ordinaire du 2 juin 1868,’ BSMG, 35 (1868), 237–40. 71 ‘Nécrologie,’ Flandre libérale, April 24, 1889 (clipping preserved in ULG, VLBL. HFI. M. 032. 17, ‘Emile Vandermeersch’). 72 Ibid. 73 ‘Bulletin de la séance du 8 janvier 1872,’ JMCP, 54 (1872), 78–82. 74 On Janssens, see: K. Velle, ‘Janssens, Eugène Dorothé,’ Nationaal Biografisch Woordenboek (Brussels: Paleis der Academiën, 1996), X, pp. 302–7. 75 ‘Bulletin de la séance du 7 janvier 1878,’ JMCP, 66 (1878), 84–91. 76 ‘Bulletin de la séance du 9 janvier 1860,’ JMCP, 30 (1860), 182–92. 77 J.-L. Delaet, ‘Rationalisme et progressisme au Pays de Charleroi: Biographie du Docteur Hubert Boëns (1825–1898),’ Documents et rapports de la Société Royale d’Archéologie et de Paléontologie de Charleroi 60 (1986–88): 156–67; K. Wils, De omweg van de wetenschap: Het positivisme en de Belgische en Nederlandse intellectuele cultuur 1845–1914 (Amsterdam: Amsterdam University Press, 2005), p. 173; G. Leboucq, ‘Hubert Boëns,’ Biographie Nationale, 29 (1936–1938), 309. 78 ‘Bulletin de la séance du 5 mars 1860,’ JMCP, 30 (1860), 412–18. 79 See the section ‘Changing authorship’ in Chapter 3, pp. 115–20. 80 F.J. Matthyssens, ‘Quelques considérations générales sur l’hygiène publique,’ ASMA, 13 (1852), 65–73. 81 J.C. Broeckx, Review of Descuret, Les merveilles du corps humain, précis méthodique d’anatomie, de physiologie et d’hygiène dans leurs rapports avec la morale et la religion: Ouvrage destiné aux ecclésiastiques, aux élèves de philosophie, aux gens du monde, et servant d’introduction à la médecine des passions et à la théorie morale du goût (Paris: Labé, 1856), ASMA, 17 (1856), 371–84.

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82 H. De Ceuleneer-Van Bouwel, ‘Sur la nécessité d’isoler les maternités,’ ASMA, 21 (1860), 497–536, 545–96; H. De Ceuleneer-Van Bouwel, ‘L’hygiène dans ses rapports avec les industries modernes,’ ASMA, 22 (1861), 289–300, 345–83, 401–23, 457–80, 521–52, 585–611 and ASMA, 23 (1862), 73–95, 152–84, 217–56, 291–331, 367–84, 450–92. 83 For a brief outline of Kums’ professional career: J. Van Lennep, Uit het verleden van de Geneeskundige Kring van Antwerpen / Cercle Médical d’Anvers (Antwerpen: Resseler, s.d.), pp. 30–2. On Desguin’s activities as a politician and public health expert: J. Vandendriessche, ‘Medische expertise en politieke strijd: De dienst medisch schooltoezicht in Antwerpen, 1860–1900,’ Stadsgeschiedenis, 6:2 (2011), 113–28. On the interplay between his urban activities and his appearance at international conferences: N. Randeraad, ‘Triggers of Mobility: International Congresses (1840–1914) and their Visitors,’ in S. Panter (ed.), Mobility and Biography, Jahrbuch für Europäische Geschichte, 16 (2015), pp. 63–82, 68–70. For an overview of Mayer’s career: ‘Notice biographique sur le docteur Abraham Mayer,’ ASMCA, 4 (1899), 89–97. 84 ‘Séance du 18 novembre 1853,’ ASMA, 14 (1853), 565–69. Emphasis in original. 85 Articles dealt with the trust between physicians and their patients, and the reserve physicians maintained in the courtroom regarding the identity of their patients: ‘Secret médical,’ ASMA, 16 (1855), 160, 348–52, 575. The society also published regulatory texts on health issues: ‘Règlement pour la répression de l’ivrognerie,’ ASMA, 23 (1862), 427–8. Petitions also featured in the society’s journal: ‘Pétition adressée à la Chambre des Représentants par les médecins des cantons Eeckeren, Brecht et environs, province d’Anvers,’ ASMA, 23 (1862), 683–8. The society, finally, also reported on the meetings of the Belgian Medical Federation. 86 The editorial board had published a demand for the appointment of a physician in the Board of Hospitals in the Annales without first obtaining formal permission during one of the society’s meetings: ‘Séance de janvier 1865,’ ASMA, 26 (1865), 70. For the petition: ‘À Messieurs les Membres du Conseil communal d’Anvers,’ ASMA, 25 (1864), 591–6. 87 For an overview of the ambitions and activities of the new society: Cercle Médical d’Anvers: Statuts (Antwerp: s.n., 1875). 88 The boards of both societies met on several occasions to discuss the organization of the meeting and the banquet directly after: ‘Séance du 18 février 1876,’ ASMA, 37 (1876), 65; Séance du 10 mars 1876,’ ASMA, 37 (1876), 152–3; ‘Séance du 9 juin 1876,’ ASMA, 37 (1876), 461. 89 When the Belgian Medical Federation proposed to organize a petition, the members of the Medical Society of Antwerp declared ‘to give precedence

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to the Medical Circle of Antwerp, [which was] founded in particular to defend the professional interests of the Antwerp medical profession’: ‘Séance du 24 mars 1880,’ ASMA, 41 (1880), 56. On the Medical Circle of Antwerp, see also: K. Van Acker, J. Deferme and L. Vandeweyer, Hoeders van de volksgezondheid. Artsen en mutualiteiten tijdens het interbellum: Het Antwerpse voorbeeld (Ghent: Amsab/ISG, 2005). Séance du 19 novembre 1897,’ BSMA, 55 (1897), 247–9; ‘Séance du 4 janvier 1898,’ ASMCA, 3 (1898), 20–2. Y.J.D. Peeters, Karel Buls (1837–1914), burgemeester op de raaklijn van twee kulturen (Antwerp: De Nederlanden, 1982). On the struggle of Antwerp public health specialists to gain scientific credibility: J. Vandendriessche and K. Wils, ‘Een traject van onderhandeling. Hygiënisme als wetenschap, Antwerpen, 1880–1900,’ BMGN – The Low Countries Historical Review, 128:3 (2013), 3–28. Velle, ‘Het verenigingsleven,’ 75–6; ‘Introduction,’ BSRMP, 1 (1878), i– iv; H. Kuborn, ‘Dix ans d’histoire: Rapport général sur l’origine, la marche et les travaux de la Société Royale de Médecine Publique, depuis son origine en 1877,’ BSRMP, 5 (1886), 504–22. ‘Introduction,’ iii. On state laboratories in Belgium: L. Diser, Wetenschap op de proef: Laboratoria in het Belgisch overheidsbeleid 1870–1940 (Leuven: Leuven University Press, 2016). S. Onghena, ‘Altruïstisch ambtenaar of heroïsch genie? Het gepropageerde beeld van provinciale en academische directeurs van bacteriologische laboratoria in België (ca. 1900–1940),’ Studium. Tijdschrift voor Wetenschaps- en Universiteitsgeschiedenis: Revue d’Histoire des Sciences et des Universités, 2:4 (2009), 191–210, 205–9. G. Gooday, ‘“Vague and Artificial”: The Historically Elusive Distinction between Pure and Applied Science,’ Isis, 102 (2012), 546–54. On the origins of this distinction, see also: B. Theunissen, ‘Inleiding: Zuivere wetenschap en praktisch nut. Visies op de maatschappelijke betekenis van wetenschappelijk onderzoek rond 1900,’ Gewina, 17 (1994), 141–4; B. Theunissen, Nut en nog eens nut: Wetenschapsbeelden van Nederlandse natuuronderzoekers, 1800–1900 (Hilversum 2000), pp. 7–11. Trétrôp borrowed this saying from the French bacteriologist Émile Roux: ‘La diphtérie,’ ASMA, 56 (1894): 269–305. On Trétrôp’s laboratory in the Stuivenberg Hospital: E. Trétrôp, ‘Le laboratoire de Bactériologie et d’Anatomie pathologique des Hôpitaux civils d’Anvers,’ BSMA, 57 (1895), 60–8. ‘Séance du 9 juin 1899,’ BSMA, 61 (1899), 159–61. On Gustaaf Schamelhout: R. de Bont, Van literaire avant-garde tot raswetenschap: Gustaaf

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Schamelhout (1869–1944) (Brussels: Koninklijke Vlaamse academie van België voor wetenschappen en kunsten, 2002). 100 ‘Séance du 10 mars 1899,’ BSMA, 61 (1899), 150–61. 101 ‘Séance ordinaire du 5 juin 1900,’ BSMG, 67 (1900), 241–4. 102 ‘Séance ordinaire du 7 mai 1867,’ BSMG, 34 (1867): 129–31. 103 ‘Bulletin de la séance du 2 octobre 1882,’ JMCP, 75 (1882), 397–400. 104 ‘Bulletin de la séance du 5 avril 1880,’ JMCP 70 (1880), 412–29. 105 E. Witte, ‘The Battle for Monasteries, Cemeteries and Schools: Belgium,’ in C. Clark and W. Kaiser (eds), Culture Wars : Secular-Catholic Conflict in Nineteenth-Century Europe (Cambridge: Cambridge University Press, 2003), pp. 102–28. 106 ‘Bulletin de la séance du 1 juin 1874,’ JMCP, 58 (1874), 565–71. 107 ‘Bulletin de la séance du 3 janvier 1876,’ JMCP, 62 (1876), 83–91. Such new journal sections were the result of the participation of public health specialists in medical societies. Since the late 1860s, they pushed to include ‘sanitary bulletins’ with information on reigning epidemics and hygienic and climatic tables in societies’ journals. 108 Jean Crocq was elected a member of the Belgian senate in 1870 and a member of the provincial council in 1872: H. Leboucq, ‘Crocq (Jean),’ Biographie Nationale, 30 (1959), 301–3; ‘Crocq, Jean, Joseph,’ in J.-L. De Paepe and C. Raindorf-Gérard (eds), Le Parlement belge 1831–1894: Données biographiques (Brussels: Académie royale de Belgique, 1996), p. 81. Arsène Pigeolet was a member of the Belgian senate and the town council of Brussels: ‘Pigeolet, Arsène, Victor, Auguste,’ in De Paepe and Raindorf-Gérard, Le Parlement belge, pp. 462–3. 109 ‘Bulletin de la séance du 1 août 1870,’ JMCP, 51 (1870), 165–71. 110 Wils, De omweg van de wetenschap, pp. 170–4. More generally on the political engagement of Belgian physicians: Velle, De nieuw biechtvaders, pp. 177–85; A. Morelli, ‘Les médecins parlementaires belges (19e–20e siècles),’ in L’engagement social et politique des médecins: Belgique et Canada, XIXe et Xxe siècles. Actes du colloque tenu à l’U.L.B. les 5 et 6 février 1993 (Brussels: Institut Emile Vandervelde, 1993), pp. 9–18. 111 E. Peeters and K. Wils, ‘Ambivalences of Liberal Health Policy: Lebensreform and Self-Help Medicine in Belgium, 1890–1914,’ in Huisman and Oosterhuis (eds), Health and Citizenship, pp. 101–17, 102–7. 112 ‘Bulletin de la séance du 7 décembre 1868,’ JMCP, 47 (1868), 568–77. 113 Janssens’ plea for the construction of mortuaries, for example, evoked little interest: ‘Bulletin de la séance du 5 octobre 1868,’ JMCP, 47 (1868), 378–88. 114 Séance du 10 août 1888,’ BSMA, 50 (1888), 161; G. Ballieux, ‘Parallèle entre l’organisation du service de l’hygiène publique à Bruxelles et à

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Anvers,’ BSMA, 50 (1888), 163–76 (an offprint has been preserved in CAA, MA, 641#525). 115 CAA, MA 641#525, Letter of June 3, 1889 from Paul Roselt to the Antwerp urban board. The article sent by Roselt was ‘L’état sanitaire de Bruxelles,’ Journal de Bruxelles, October 21, 1887 (Clipping preserved in CAA, MA 641#525). 116 See for example: the annual report of 1890: CAA, MA 641#631. 117 ‘Hygiène publique,’ BSMA, 55 (1893), 70–82, 81. 118 E. Janssens, Le service communal de la désinfection à Bruxelles, discours prononcé à l’Académie de Médecine de Belgique par le dr. Janssens (Brussels: s.n., 1884). Desguin presented his Note sur l’inspection médicale des écoles de la ville d’Anvers et la revaccination des élèves during one of the meetings of the Academy: ‘Séance du 28 Avril 1883,’ ASMA, 45 (1883), 287. 119 ‘Séance du 19 novembre 1897,’ ASMCA, 2 (1897), 327–8; ‘Manifestation en l’honneur du Dr. Victor Desguin: Président de l’Académie Royale de Médecine,’ ASMCA, 2 (1897), 329–32. 120 E. Dèle, ‘Expertise obligatoire des viandes destinées à la consommation dans toutes les communes dépourvues d’un abbatoir,’ ASMA, 51 (1889), 99–114. On food safety and the quality of drinking-water, see also: W. Van Craenenbroeck, Antwerpen op zoek naar drinkwater: Het ontstaan en de ontwikkeling van de openbare drinkwater-voorziening in Antwerpen, 1860–1930 (Tielt: Lannoo, 1998). 121 See for example: A. Ley, ‘Des troubles de la parole et de leur thérapeutique éducative,’ ASMCA, 4 (1899), 57–74. 122 E. Descamps, ‘Projet de grand établissement de bains (à ériger à Anvers),’ ASMA, 57 (1895), 53–74; W. Kesteloot, Reinheid, gezondheid en therapie: Baden en zwemmen in Antwerpen (1875–1915) (Master’s thesis, University of Leuven, 2012); E. Peeters, ‘Questioning the Medical Fringe: The “Cultural Doxy” of Catholic Hydropathy in Belgium, 1890–1914,’ Bulletin of the History of Medicine, 84 (2010): 92–119. 123 Trétrop, ‘Le laboratoire de Bactériologie’; Trétrop, ‘La désinfection des locaux,’ ASMA, 58 (1896), 187–96. Trétrôp published thirteen articles in the Antwerp Annales in the 1890s. 124 For a discussion of this system of financial support: Vandendriessche and Wils, ‘Een traject,’ 24–5. 125 See for example: A. Ley, and Brandès, ‘Quelques considérations sur l’hygiène de la vue chez les écoliers,’ ASMA, 60 (1898), 113–33, 135–7.

6

Celebrating and commemorating

The October meeting of 1893 was one of celebration in the Brussels Society of Medical and Natural Sciences. Professor Arsène Pigeolet, whose fiftieth anniversary as a member of the society was being celebrated, was the center of attention. It was the first event of this kind in the society’s history.1 Briefly retracing Pigeolet’s career, president Stiénon recalled how the Brussels University, the Academy of Medicine and many other institutions ‘had, each in their turn, opened their doors to you,’ but he also stressed that ‘nowhere, we are sure, have you received more affection than in the midst of the Royal Society of Medical and Natural Sciences of Brussels.’2 In a response to Stiénon’s address, Pigeolet seized the opportunity to reflect on the history of the Brussels society, bringing its founding members to the fore – men such as Louis Seutin, with whom Pigeolet had collaborated for many years – and who were now (posthumously) celebrated as the founding fathers of Belgian medicine.3 The memory of this first generation, with whom Pigeolet identified himself, was used to support the current ambitions of the Brussels society. At a time when the society sought ever closer affiliation with the Brussels University, Pigeolet praised Seutin’s views on the society ‘as an institution that provided a connection [trait d’union] between itself and the University.’4 The society’s journal and prize competitions, which facilitated academic publishing, were presented as means of ‘maintaining the firm bases of the society’; its current editors as ‘the worthy representatives of ancient traditions that have brought the society its universal renown.’5 The celebration of Pigeolet’s membership was typical of the way commemorations functioned as a means of community building. By reflecting on the past, in an often intimate and cordial atmosphere, a

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shared, collective memory was constructed and shared values were confirmed. These commemorations typify medical societies, not as spaces of scientific accreditation, publishing houses, networks of collecting or advisory bodies – functions that have been discussed in the previous chapters – but as communities, in which a feeling of solidarity prevailed over scientific disagreements. The events that could inspire such commemorative activity were multiple: the jubilees of academic appointments, the acquisition of an honorary title (most notably in the national Order of Leopold), but also the death of an (important) society member. Moreover, against the background of a flourishing historical culture in Belgium, the pioneering works of medieval and early modern physicians were celebrated. The form of these commemorations was diverse as well. Speeches, biographical notes and funeral eulogies appeared in societies’ journals. Medals, portraits, busts and statues formed the material expressions of these events, giving the memory a more tangible and artistic form that extended beyond the mere moment of commemoration. These ‘commemorative practices,’ an umbrella term used to describe a set of practices that establish a shared memory, have increasingly received attention in the historiography of science and medicine since the late 1990s. Pnina Abir-Am has pointed, in the first place, to the complex relationship between the commemorating present and the commemorated past. The choice of the person, institution or discovery to be commemorated, as well as the way these are represented, she has stressed, invariably reflect contemporary agendas.6 When Pigeolet reconstructed the history of the Brussels Society of Medical and Natural Sciences, he was also selective, highlighting its long tradition of scientific publishing, but not its tradition of scientific debate and social engagement – aspects of the society’s functioning that had lost much of their value in the late nineteenth century. Ludmilla Jordanova has pointed to the opportunities offered by Benedict Anderson’s concept of ‘imagined communities’ for the history of science and medicine. By means of biographies and portraits, Jordanova suggested, scientists and physicians established themselves as an (imagined) ‘sub-nation’ within the nation.7 More recently, research into the representations of commemorated scientists has revealed the (gendered) ideal types or scholarly personae, that underpinned these commemorations.8 A tradition of anthropologically inspired research has finally expanded the set of

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commemorative ‘rites’ performed in scientific communities by including smaller practices (e.g. the exchanging of drawings of portraits between scientists) in different academic settings, from the professorial home to the modern laboratory.9 This chapter adds an analysis of an early example of such commemorative rites to the existing literature by studying nineteenth-century medical societies as commemorative spaces. While the study of commemorations in science has typically focused on the foundational period of the modern sciences – the rise of the research university at the turn of the twentieth century – a study through the lens of medical societies offers a look into the genesis of a scientific community within the civil world of the mid- and late nineteenth century and against the backdrop of a modernizing profession. A second point revealed by the commemorations in medical societies is their explicit normative character. Similar to how processes of reviewing functioned as a means of setting scientific standards, the eulogies and biographical sketches of society members re-enforced ideals of scientific study.10 At the same time, however, these commemorative rites left room for deviant interpretations and critical remarks on contemporary science. As such, they could, on some occasions, also become places of criticism in which the reigning scientific codes were questioned. The central evolution discussed in this chapter is one of the community with which society members identified themselves. The commemorative practices in medical societies show how the gentleman scientists of the early and mid-nineteenth century considered themselves, in the first place, as members of the Belgian nation. The commemoration of famous, historical ‘Belgian’ physicians functioned as a means to emphasize physicians’ contributions to this nation as a subgroup. As the processes of professionalization and institutionalization of science weakened the traditional ties between the scientific elite, the medical profession and the urban civil world, the link between medicine and the nation was gradually eroded – an evolution that paralleled the demise of Belgian medical history as the central means of selfidentification and community building. Historical references to a gentlemanly medical culture could still function as a means to criticize present-day medicine. But society members increasingly presented their scientific work as a defining feature of their position in the medical profession and in society as a whole. The ‘scientific’ medical community

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that emerged in this way constructed its own set of beliefs and norms and sought closer affiliation to academe. The manifestations that were held in honor of university professors and the mourning rituals that accompanied their deaths now acted as the primary occasions of community building. Through these rites, the scientific elite presented itself as a family, celebrating its ‘fathers’ for their guidance and praising the ascetic life they led in the name of science. National heroes

The climate of patriotic pride during the first two decades of the Belgian state formed the cultural backdrop against which a Belgian medical historiography developed. A new generation of historians presented Belgium as a historical nation that had contributed to the march of civilization, but which, because of its geographical location in the center of Europe, had been politically suppressed by foreign powers.11 Physicians subscribed to this narrative by arguing that such civilization comprised not only political or artistic developments but also scientific progress, a process to which many Belgian physicians had contributed, but for which they had seldom been credited. Such historiographical efforts established the medical community as – in Jordanova’s words – a ‘sub-nation’ of Belgium, which was united in its search for scientific progress, but was also part of a larger Belgian community. The study of this medical past took the form of a (re)discovery of a historical lineage of Belgian physicians. Their rehabilitation was a means of strengthening internal medical ties, but also contributed to medicine’s cultural authority in the public domain. Medical societies took the lead in laying down the outline of this new Belgian medical historiography. In 1835, the physician and reformer Charles Houdet took the initiative of organizing a prize competition in the Medical Society of Ghent on the history of Belgian medicine from Andreas Vesalius in the sixteenth century to the suppression of the University of Leuven by the French revolutionaries in 1796.12 ‘The love for the country,’ Houdet explained, ‘demands respect for the celebrities who have been born on its soil.’13 In 1839, and again in 1841, the same patriotic sentiments inspired the Medical Society of Antwerp, under the leadership of Jean-Corneille Broeckx, to organize a follow-up competition for the period from the early nineteenth century until present

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times, ‘to show the services our compatriots have rendered to the advancement of the medical sciences.’14 Broeckx, in a sense, answered both prize questions. His Essay on the History of Belgian Medicine Before the 19th Century of 1837 won the Ghent competition and was praised in the medical press.15 His Overview of the Belgian Medical Institutions since the late 18th Century of 1841 was intended as a first step towards a broader history of this period.16 Despite the renewal of the Antwerp competition in 1842, such a history never materialized. The next medical historical overview was published no earlier than 1866. Léon Marcq’s Essay on the History of Contemporary Belgian Medicine was judged a satisfactory answer to the prize question drawn up by the Belgian Academy of Medicine ‘to expose and evaluate the scientific medical movement that has arisen since 1835 in the institutions of higher education and the learned societies of Belgium.’17 Ten years later, in 1875, a chapter on medical history by Victor Desguin appeared in the Belgian encyclopedia Patria Belgica. Desguin’s text reads as a summary of previous overviews, but with a greater emphasis on the most recent period.18 The narrative in these overviews was colored by contemporary views on medicine as an observation-based science. In general terms, the history of medicine was structured by the succession of numerous medical theories or ‘systems’ (e.g. the doctrine on inflammation by the French physician François Broussais in the early nineteenth century), of which many later proved incorrect. Yet, throughout this sequence of theories, a tradition of ‘practical’ medical observations could be identified, which ran from Hippocrates to present-day medicine. This tradition was said to be shaped by the pioneers of their age, physicians and surgeons who stood out among their contemporaries. Andreas Vesalius’ anatomical research or Jean-Baptiste Van Helmont’s theories on ‘vitalism’ formed the bright spots in medical history. Institutional developments, such as the foundation of the University of Leuven in 1425 and its suppression in 1797, were used as caesurae. The revolutionary period initially functioned as the anchoring point of modern, contemporary medicine. On the ruins of revolutionary upheaval, Broeckx argued, a new scientific landscape, which consisted of universities, societies and medical periodicals, had been founded. In the late nineteenth century, this anchoring point was pushed forward. In Marcq’s and Desguin’s overviews, the academic reforms of 1835, when the system of four

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Belgian universities was finally established, counted as the starting point of modern Belgian medicine – a shift that reflected the heightened position of universities as the new centers of the medical sciences. As John Warner has shown, these historical narratives functioned as markers of professional identity, as means of self-identification for nineteenth-century physicians, who could ground their authority in a long, established tradition.19 The most successful Belgian physicians were also visually commemorated. Similar to famous statesmen or artists, medical heroes were collectively portrayed, together embodying the tradition of observationbased medicine. As Jo Tollebeek and Tom Verschaffel have shown, the genre of the ‘pantheon,’ which collected national heroes in books, monuments and illustrations, flourished in nineteenth-century Belgium.20 The Belgian ‘medical pantheon’ received its most iconic form in the Academy of Medicine. The medals awarded by the Academy since its foundation in 1841 display a circle of seven portraits, with the effigy of Vesalius at the top, surrounded by: the eighteenth-century ‘inventor of the forceps’ Jan Palfyn, his contemporary and professor at the University of Leuven; Henricus Rega, the sixteenth-century botanist and physician; Rembert Dodoens, the seventeenth-century Brussels-born professor in Padua; Adriaan van den Spiegel, the seventeenth-century chemist and physician; Jan-Baptist Van Helmont; and the seventeenthcentury surgeon and anatomist Philip Verheyen.21 This same group was represented by the busts that embellished the Academy’s meeting room. These busts forged an alliance between the present academicians and their colleagues from a distant past – an alliance to which Charles Nothomb, the Minister of Internal Affairs, alluded when he addressed the members of the Academy at its opening: ‘You will have your seat in the midst of your illustrious ancestors.’22 In the course of the century, new names were added to this elitist group of Belgian medical heroes. The sixteenth-century pharmacist Pierre Coudenberg was one of them.23 By taking the lead in the creation of a small canon of Belgian medical heroes, the Academy affirmed its national status. Urban medical societies were less exclusive when it came to the composition of medical pantheons. Broeckx, in particular, criticized a vision of medical history that only paid attention to celebrities.24 His Panthéon médical belge – a lithography of which unfortunately no copies have been preserved – presented Belgian medicine as a monument in

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9  Medal of the Royal Belgian Academy of Medicine. Clockwise starting from the top are represented: Andreas Vesalius, Jan Palfyn, Henricus Rega, Rembert Dodoens, Adriaan Van den Spieghel, Jan-Baptist Van Helmont and Philip Verheyen.

which a broad selection of names of physicians were inscribed.25 As Broeckx’ biographer Pierre Génard later described, his Panthéon, which was dedicated to his colleagues of the Medical Society of Antwerp, represented the ‘Temple of Medicine’ and provided, at a single glance, an overview of Belgian medicine.26 Moreover, Broeckx’ numerous biographical sketches testify to his preference for local physicians, as he focused mostly (but not exclusively) on physicians in sixteenth- and

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seventeenth-century Antwerp, a period of florescence in trade, of which, as Broeckx often stressed, also the arts and sciences benefited.27 In 1866, he published his ‘Antwerp Medical Gallery’ in which he aimed to ‘exhume several little known names from the Antwerp medical catacombs.’28 A similar project was undertaken by the Tournay physician and botanist François Dubois, who published a series of biographical notes of Belgian physicians in the Bulletin médical belge in 1836.29 Dubois covered what he called ‘secondary celebrities,’ a resolute choice he explained by comparing his work to that of a geologist who could not only include the gold and silver mines in his descriptions, but also needed to mention the lead and copper mines.30 Dubois saw his project as a collaborative undertaking and called upon his colleagues to send him information on those physicians that were missing from his overview. Their names would become associated with ‘this entirely patriotic undertaking.’31 In Ghent, medical pantheons were adapted to local medical traditions, connecting contemporary physicians to their historical predecessors. In the meeting room of the Medical Society of Ghent, busts of local physicians were placed to emphasize intellectual kinship. In 1837, Dr Van Oost proposed ordering a bust of the Ghent physician JeanCharles Van Rotterdam, who had died three years earlier and was praised by Broeckx for his resistance against the theories of Broussais in the early nineteenth century.32 Van Oost also added a comment on the position of Van Rotterdam’s bust in the room, which should be ‘facing the one of Hippocrates, for which he showed most veneration.’33 In 1844, the bust of Joseph-François Kluyskens was added to the gallery. It was a gift from the Ghent sculptor Parmentier, for which the society members were particularly grateful, adding that they would place the bust opposite the one of Pierre-Engelbert Wauters, which had also been sculpted by him.34 In the second half of the century, the busts of the university professors Joseph Guislain and Adolphe Burggraeve were further added to this ‘Ghent medical pantheon.’35 The figure of Jan Palfyn, who died in Ghent in 1730, played a central role in this locally grounded commemorative culture. In 1847, the Ghent society had asked the urban government to restore a painting that was ‘precious to the physicians and the friends of beaux-arts. It is a painting made in commemoration of Palfyn, [the] famous physician to whom humanity is indebted the invention of the forceps.’36 The

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painting concerned was Norbert Sauvage’s ‘Dissection of Siamese twins,’ which had been commissioned by Ghent’s city board in 1704 to commemorate Palfyn.37 After Sauvage’s work had been restored, it was placed in the society’s meeting room in the Ghent town hall, to the delight of the society members: ‘In this act, which is a homage paid to the memory of one of our illustrious medical men,’ they wrote to the urban board, ‘the society finds an unequivocal testimony of the interest you take in its scientific work.’38 Three years later, Auguste Snellaert recited a poem on Palfyn in this same setting. The poem had been donated by the poet Maria Van Ackere-Doolaeghe.39 She too seems to have regarded the Ghent physicians as Palfyn’s successors. If paintings, busts, eulogies and historical overviews could indeed stir up historical awareness, they were mostly directed to a medical audience. Historical commemorations, however, also allowed the social position of the medical profession to be strengthened if the broader public could be reached. In the eyes of many physicians, such a rehabilitation of national medical heroes formed a means to augment the status of the profession, by showing the social usefulness and cultural importance of the medical sciences. For such a purpose, more public commemorations of physicians were necessary, a program which among others Joseph Guislain heavily supported. As he explained in the travel report of his trip to Italy and Switzerland, the historical merits of physicians were hardly recognized in Belgium: After having traversed Italy, where the memory of distinguished men is surrounded by extraordinary respect, it is painful to see that the grand Vesalius, the father of the anatomists, has no monument in his city of birth. In vain one seeks a statue, a bust erected in honor of Van Helmont, the founder of vitalism, while the city of Ghent has acquitted itself from the noble debt by consecrating a beautiful memorial stone to Palfyn, the inventor of the forceps.40 The time has come for Belgium to express its gratitude to Jean de Saint-Amand, Van Lom and Wier, who were part of the most remarkable physicians of their time, to Dodoens, famous naturalist and grand physician; to Verheyen, distinguished anatomist, and to Van den Spieghel who, similar to Vesalius, belongs at the same time to Belgium and Italy.41

Guislain’s remarks of 1840 sketched a commemorative program that was realized in the next decades. A statue for Andreas Vesalius was placed at the Brussels Barricade square in 1848; the pharmacist and

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botanist Pierre Coudenberg received a statue in Antwerp in 1861; a statue for Rembert Dodoens was erected in the botanical garden of Malines in 1862, and in the same year, a monument for the surgeon Philip Verheyen was realized in Verrebroek.42 Later in the century, this series of statues was expanded with one for Jan-Baptist Van Helmont in Brussels in 1889, but also with those of more contemporary physicians such as Joseph Guislain and Louis Seutin.43 The result was a clear presence of medical men in the nation’s monumentalized memory. The most successful rehabilitation fell to Andreas Vesalius. The studies and dissections of this sixteenth-century Brussels-born physician were said to form the basis of ‘modern’ anatomy. Vesalius, more than other medical heroes, was commemorated in different societies, in Ghent as well as in Brussels; he became the icon with which Belgian physicians identified and which could represent the medical profession in society. Vesalius’ portrait was used for the engravings of societies’ medals or as a frontispiece in medical studies, such as Broeckx’ history of early modern Belgian medicine.44 His life and work was discussed in numerous biographies and eulogies that appeared from the middle of the century onwards. The most influential of these works was the Studies on Andreas Vesalius by Adolphe Burggraeve.45 In Brussels, several institutions were named after Vesalius. The Vesalius Society (1843) aimed to advance Belgian anatomy and physiology by establishing anatomical cabinets and medical libraries, a means of paying tribute to ‘the memory of the great anatomist.’46 In 1857, the Dispensaire Vésale was founded, a charitable institution that offered free medical consultations to the Brussels poor.47 In Leuven, the Institut Vésale – a research institute for anatomy – was founded in 1877.48 The figure of Vesalius could represent both modern science and philanthropy, and be celebrated both in liberal and Catholic milieus. Moreover, Vesalius’ memory was picked up in the literary and artistic world. Among the reasons for this popularity can be cited the visual attraction that radiated from anatomical scenes – Vesalius’ anatomical dissections were indeed favorite topics for painters49 – but also his remarkable course of life, which inspired poets and playwrights. The tale that Vesalius had executed a dissection at the Spanish court on a man who turned out to be still alive and was accused of murder – a tale that was disregarded by Burggraeve as an ‘absurd fable’50 – was performed in the Brussels theaters in the middle of the century.51 The

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Brussels poet Louis Schoonen, a pseudonym of baron Louis de Geelhand, dedicated several poems to this tale in his ‘Homage to Andreas Vesalius.’52 Vesalius’ biography was also discussed in public lectures. The Brussels urban archivist Felix-Victor Goethals discussed Vesalius’ career in his lecture series on Belgian sciences, arts and politics.53 The erection of a statue of Vesalius on the Brussels’ Barricades square in 1848 formed the high point of this public commemoration. The initiative for the monument was taken by the local medical commission of Brussels, which set up a fund-raising campaign, secured the support of the Belgian government, and entrusted the order to the sculptor Joseph Geefs.54 The inauguration of the statue was accompanied with great ostentation and was discussed in the national and international medical press.55 A miniature statue and a commemorative medal were also distributed among the supporters.56 Many politicians attended the ceremony: the entire Brussels town council, the Brussels mayor François-Jean Wyns de Raucourt and the Minister of Internal Affairs Charles Rogier. Their presence turned the inauguration into an ideal opportunity to present Vesalius – and by extension Belgian medicine – as an integral part of the Belgian nation. After the statue was unveiled and the applause had faded, Jean-François Vleminckx took the floor. Vleminckx first pointed out the scientific merits of Vesalius, as the father of anatomy, but soon delivered a political message. The newly gained fame of Vesalius, Vleminckx claimed, was a mark of Belgium’s independence. In the early decades of the young Belgian state, a historical awareness thus pervaded the esprit de corps of the medical profession. This awareness was expressed externally, in the public commemorations of famous physicians, which tied the medical community to the Belgian nation, turning physicians into a civil subgroup with its own historical merits. The construction of the Belgian medical pantheon therefore seems to confirm Ludmilla Jordanova’s argument that ‘the concept of ‘nation’ came to serve […] as a vehicle through which the political aspirations of scientific communities and science’s claims to public usefulness could be articulated and realized.’57 But such historical awareness also served more internal purposes. Historical narratives of Belgian medicine structured the views of medical practitioners and inspired sentiments of alliance. Moreover, these narratives could be adapted to local circumstances, as the composition of urban medical pantheons indicates. While the external (symbolic) function of medical history was

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continued in the second half of the century, most notably by institutions who claimed to represent Belgian medicine such as the Academy of Medicine, its internal purpose, as the primary framework for physicians’ shared identity, gradually lost its value. Gentleman science as antidote

The gradual demise of the strong identification of society members with an imagined national and historical medical community was linked to the same processes that have been described in the previous chapters. The medico-professional movement, on the one hand, challenged the leadership of academic ‘gentleman scientists,’ replacing the connection between scientific study, professional engagement and medical reform with a more activist, interest-based model. On the other hand, the medical sciences sought ever closer affiliation to the universities, creating a distance between university professors – who became professional researchers rather than gentlemen scientists – and the bulk of the medical profession, who were no longer seen as capable of contributing to scientific progress. These mutually reinforcing evolutions bred a different kind of imagined community in medical societies, one which was more exclusively scientific, and embedded in academe rather than in the medical profession. One factor needs to be added to this set of explanations: the changing position of historical texts in medicine. In fact, the study of such texts was transformed in the course of the nineteenth century from an integral part of scientific research into a much more marginal activity. By the late nineteenth century, biographies of historical physicians and in-depth studies of their work largely disappeared from medical journals. Medical history became more anecdotal. Under the editorship of Édouard Van den Corput, the Brussels Journal de médecine started to publish a monthly column of ‘Memorable Medical Events,’ in which the epidemics, medical discoveries and deaths of famous physicians in one specific year in history were recorded.58 This more marginal position of medical history, as part of the miscellanea section, was not without significance. It was indicative of a growing division between the literary and the medical world – a division which eroded the ‘civil’ culture of gentleman science in the middle of the century and with it the function of medical history as the primary form of community building.

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Historical awareness, however, did not disappear completely from the shared value pattern of modern medicine; it lived on as a form of ‘antidote,’ a counterweight to what came to be seen as an all too ‘positivist’ interpretation of the medical sciences in the late nineteenth century. To understand this shift, a closer look is needed at the profile and the philosophy of those physicians who originally engaged in historical study. By pursuing medical history, a relatively small ‘medico-historical community’ succeeded in bridging the institutional gap between the literary and the medical world, which had emerged as traditional learned societies fell apart in the early years of the century. They belonged to a varied group of ‘amateurs’ in historical study, who cooperated between themselves, but also corresponded with librarians and archivists. Jean-Corneille Broeckx, for example, collaborated intensely with the Antwerp archivist and librarian Pierre Génard for his research on leprosy in the sixteenth century.59 Others, such as the Ghent physician Auguste Snellaert, maintained close contacts with a network of literary men, who devoted themselves to the revaluation of the Flemish language within the Belgian nation. As a member of both medical and literary societies, and a champion of the early Flemish movement, Snellaert’s historical research was driven by his ambition to expand the medical pantheon with ‘Flemish’ physicians, whose works written in their native tongue had yet to be discovered.60 This medico-historical community transcended national borders. The annotated editions of classical texts of Galen and Hippocrates of the Frenchmen Charles Daremberg and Joseph-Pierre Pétrequin were well appreciated by their Belgian colleagues.61 It was also Daremberg who drew Broeckx’ attention to an unknown manuscript of the medieval surgeon Jean Ypermans. Engagement with medical history thus allowed physicians to partake in a cultural world that existed in-between the disciplinary divides between specialized (literary and medical) societies. Even though this medico-historical network was reminiscent of the learned culture of the turn of the century, its objectives should not be considered at all reactionary. As Danielle Gourevitch has shown, the same clinical gaze, the same positivist attitude that physicians demonstrated in their present-day medical observations, also steered their historical practices.62 Medico-historical research was, in fact, recast in an observation-based form. In his Speech on the Usefulness of Medical History, Broeckx stressed that physicians needed to focus on ‘the true history of the art [of medicine]’ by distinguishing ‘between true facts,

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dubious facts and unauthentic facts.’63 The tracing of these facts comprised, in Broeckx’ view, the ‘intrinsic’ history of medicine, which allowed lessons to be drawn from the past: the medical discoveries and errors of the past formed an immense reservoir of observations, which was far larger than the experience one could gain in one’s own medical career.64 These views materialized in the locating, annotating, translating and reproducing of old medical texts of ‘Belgian’ physicians. The editions of Jean Ypermans’ manuscripts in Flemish forms the most telling example of these activities. A first partial French translation was published by the Brussels physician Jean Carolus in the Ghent Annales.65 Later on, after the discovery of another transcript in Cambridge by Daremberg, Broeckx published the entire original manuscript; his colleague De Wachter translated the most important passages into French.66 The hunt for manuscripts went hand in hand with a preoccupation with the accuracy of medical facts. The accumulation of facts was not the sole purpose of medical history. Historical study was also said to bring a form of philosophical insight into the process of scientific progress, which was particularly helpful for young practitioners, who were said to get too easily carried away by new, revolutionary medical theories. Broeckx claimed in this light that the (overly) strong enthusiasm surrounding pathological anatomy, as the means to find the cause of all diseases, had led physicians astray from sound observations of symptoms and medical therapeutics.67 To put new medical theories into perspective, Broeckx saw a remedy in the study of the ‘extrinsic’ history of medicine. By scrutinizing the circumstances that had influenced the ups and downs of scientific progress – the philosophical spirit of the time, the state of civilization, the lives of physicians, the different medical institutions68 – physicians could gain insight into the purpose of different theories, even if they proved unsuccessful, and understand the trajectory of medical progress.69 Such philosophical insight would not only allow physicians to better appreciate the work of their predecessors; it would also show them ‘the deficiencies in certain theories they were about to adopt’ and prevent them from ‘confusing universal revolutions, of which one needs to be suspicious, with true progress.’70 Such views hint at the influence of romantic historiography on Broeckx’ view of medical history, which was also present among contemporary German medical historians. Medical history was to bring a certain maturity, wisdom and modesty to the younger generation.71

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In the second half of the century, the relationship between what Broeckx had named ‘intrinsic’ and ‘extrinsic’ history changed. The next generation of medical historiographers paid far less attention to the social and cultural circumstances of medical progress and focused solely on charting the trajectory that had led to modern scientific knowledge. Léon Marcq’s interpretation of the Academy’s prize question on the progress of the medical sciences in 1866 testifies to this approach. Marcq, presented a ‘clear and true course of the major directions in which research has developed,’ leaving out ‘useless details and anything which could interfere with the course by overloading it with mere trifles.’72 The aim was ‘a vivid picture of which the unity was easily comprehensible,’ which left no room for side-roads, secondary celebrities or outmoded theories.73 Evaluating scientific progress, according to Marcq, did not consist of a philosophical exposition, but rather meant judging the importance of medical breakthroughs and their social uses. Marcq’s vision reveals the changed relation between past and present in late nineteenth-century medicine. Present-day medicine was no longer seen as the mere continuation of a long medical tradition, with its ups and downs; the success of scientific medicine was rather placed in the contemporary period. Ancient, medieval and early modern medical history, in fact, became the pre-history of an era of ‘scientific medicine’. Such a historiography betrayed the growing self-confidence of the scientific community. This break with the past, as Frank Huisman and John Warner have shown, was part of the creation of a modern professional identity, based on a growing faith in scientific progress through experiments in the laboratory rather than through studies of the medical literature in the library.74 At the same time, however, calls for a more ‘philosophical’ approach to medical history continued to be voiced. The positive reception of an inaugural address on the usefulness of the history of medicine, delivered by Pedro Francisco Da Costa Alvarenga at Lisbon’s medical school in 1869, shows that the idea of history as a magistra vitae was still popular in the late nineteenth century.75 In many ways, Da Costa Alvarenga’s call echoed Broeckx’ views of 1838, of history as a guide amidst the range of medical theories and conflicting opinions, a means of becoming ‘learned’. On the other hand, his lecture emphasized far less the importance of historical study for present-day medical research, a connection which had been fundamental to the first generation of

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historians. In contemporary calls for the integration of medical history into the medical curriculum – a cause Da Costa Alvarenga supported in his address – historical study was rather presented as a counterweight for modern scientific medicine, a means of putting contemporary science in perspective, avoiding tunnel vision and gaining a broader understanding of life. In fact, the optional course in medical history had disappeared from the medical curriculum in all Belgian universities in the middle of the century for want of interest from students.76 In the 1870s, the course was again the object of discussion in academic milieus: Richard Boddaert saw it as a means to augment student’s insight in human psyche, which would benefit their psychiatric research and understanding; the Leuven rector Alexandre Namèche argued that medical history helped prevent a certain absolutism in the sciences.77 Namèche’s remark was indicative of a wider, critical tendency. Medical history became embedded in a somewhat reactionary, critical discourse on medical and scientific culture. Such critique had, in fact, always been present in historical writings. As a sharp witness of his time, Broeckx had presented historical study as an antidote for the trends in medicine he deplored in 1838, such as the ‘mercantile spirit’ of physicians who focused more on the growth of their clientele than on conscious scientific study, and the fear of being pedantic and not ‘practical’ enough, which led physicians away from books. Those who studied the ‘heritage of their ancestors,’ Broeckx had added, were ridiculed and gained the vile nickname of ‘armchair physician’ [médecin de cabinet].78 In his later work, such criticism transformed into a form of contemplation on the demise of ‘gentleman science,’ which influenced the choice of his historical subjects. He now frequently wrote on the ‘physicianpoets’ of the sixteenth century, who he admired for their multiple talents and occupations: There is a general remark applicable to the physicians of the sixteenth century, which is that all of those who have distinguished themselves in medicine, have made themselves known because of the purity and the elegance of their style and by the variety of their accessory skills. This fact testifies sufficiently in favor of the education in this period. Several physicians also added knowledge of the belles-lettres to their medical skills. Hence, the great number of physician-poets in so progressive a century.79

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In 1858, Broeckx undertook a more elaborate study of these ‘physician-poets’. In his introduction, he sketched a meeting with friends, in which he was challenged to prove that poets had existed among the Belgian physicians.80 Faced with such a challenge, Broeckx took up the defense of the medical profession against ‘the positivism, the dryness with which our art is reproached.’81 The design of the text, which let his literary friends utter this critique on contemporary medicine, allowed Broeckx not only to defend the medical profession but also to remind his colleagues of the existence of such a literary tradition, which was vanishing in his own age. A similar example comprises his study of the sixteenth-century bibliophile and physician Johan Ferreulx, whose love for (old) books equally contrasted with contemporary occupations with either experiments in the laboratory or clinical observations in the hospital.82 Broeckx’ historical writings thus evolved from mainstream national narratives, whose use for the medical profession was generally accepted, to somewhat niche publications in which a culture of gentleman science was regenerated. The literary qualities and bibliophile character of the gentleman physician formed a ‘counterimage’ to the dominant conception of scientific medicine, which became ever more fact- and experiment-based.83 Part of this counter-image was also an ideal of solemnity, a sentiment of profound duty that was attributed to medical gentlemen in their interaction with patients. Already in 1840, Guislain had included such a critical remark in his funeral eulogy of the Ghent doyen PierreEngelbert Wauters, a model of the gentleman-physician. Wauters, when treating his patients, as Guislain stressed, ‘had something solemn, grave and intimate, which one used to find, if I may say so, among medical practitioners,’ but which had currently been replaced by ‘a less impressive appearance and less pervasive phrases.’84 Such remarks lived on in the late nineteenth century. In an obituary of 1882 of the Brussels professor Louis Martin, Edouard Van den Corput added that Martin had ‘a solemnity of form too entirely neglected in our own time and that brought our colleague a certain force and self-confident appearance, a certain gentlemanly-like style and character.’85 By the late nineteenth century, the gentleman came to represent a mark of respect for form and tradition, and became strongly linked to the ideal of the true clinician.

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In the second half of the century, vestiges of an older tradition of gentleman science were thus turned into forms of criticism vis-à-vis the dominant scientific culture that took shape in the new laboratories and scientific institutes of the universities. But these images were far from dominant. While in the patriotic climate of the first decades of the Belgian state, commemorations had centered around historical figures such as Vesalius, the emphasis was shifted to more contemporary heroes in the second half of the century. These heroes embodied a set of uniquely ‘scientific’ values, which were to be emulated by the members of urban medical societies. In this way, the ‘scientific’ medical community distinguished itself from the larger professional medical community. It took shape, in the first place, through the celebrations of its leaders, the university professors. Celebrating fatherhood

The organization of celebrations and banquets in honor of renowned colleagues proved an important means of community building in the second half of the century. The reasons for such celebrations were multiple: a nomination for the prestigious Order of Leopold, the twenty-fifth or fiftieth anniversary of one’s medical practice or of one’s membership to the Academy of Medicine, or, in the case of academics, the end of one’s academic career. Karel Velle has rightfully argued that such celebrations were part of the professional culture of medicine. Festive gatherings strengthened professional ties, created a shared identity and could overcome, for a moment, some of the disagreements on fees and regulations between the different regions and professional subgroups of the nineteenth-century medical profession.86 In the second half of the century, these sociable events were structured, to an important extent, along the borderlines between professional and scientific societies. In professional organizations, physicians were typically praised for their successful medical practice, their upholding of professional dignity and fraternity, and their dedication to movement for medical reform. In scientific societies, a more intimate, family-like sociability developed, which sought closer affiliation to academic culture. Yet these borders between science and profession were not always sharply drawn. In fact, urban medical societies often supported

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celebrations of a more professional nature. In 1861, the Medical Society of Antwerp participated in a ‘fraternal banquet’ for the Antwerp physicians, organized by Jean-Corneille Broeckx – an event in which the recently founded pension fund was celebrated.87 A more exceptional gathering occurred in 1868, when the society took the initiative of organizing a dinner for Dr Lambrechts, president of the provincial medical commission, who had recently been named Officer in the Order of Leopold.88 Such support of professional initiatives was also reflected in the reports and announcements of these events, which appeared in the miscellanea section of societies’ journals and increased in the last quarter of the century. In 1881, Édouard Van den Corput, editor of the Brussels Journal de médecine at that time, was amazed at the quick succession of banquets organized by the Academy of Medicine, the Belgian pharmacists and the University of Brussels. Van den Corput, who himself regularly organized celebrations and held speeches as the president of the provincial medical commission of Brabant, applauded these meetings because ‘these fortified fraternal harmony and reinforced the union that forms the strength of professions as well as of institutions.’89 The flourishing of such a (dining) culture in which a professionbased fraternity was cultivated, raises the question of the place of more amiable manners within scientific sociability. Could sentiments of alliance among scientists be evoked in a similar manner? As shown in the second chapter, the formal and highly directed course of society meetings left little room for friendly chatting. Yet, after these meetings, and certainly after the annual public meeting of societies, dining together offered an occasion to discuss matters in a more informal (and unrecorded) atmosphere. At least in the 1850s and 1860s, the Medical Society of Ghent organized an elaborate annual banquet for its members.90 In those same years, the society typically met from half past four until half past six, making it plausible that at least some of the members dined together afterwards.91 Of course, many of these social events also occurred in different settings. Most members of the Ghent society were also members of the gentleman’s club La Concorde on the Kouter, a square in the center of Ghent within walking distance from the city’s town hall, where the society held its meetings.92 Those social interactions outside the meeting room, however, are difficult to trace. In societies’ journals only scientific activities were reported. Sociable

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events did not seem to fit in with the representation of science in print. The tributes to fellow members that crossed the normal course of societies’ meetings form an exception to this rule. On those occasions, the meeting reports recorded more amiable – but equally staged – interactions between society members. When Joseph Guislain first entered the Ghent society’s meeting room in 1855 after his nomination as Knight in the Order of Leopold, president Daniel Mareska stood up and delivered a ‘kind speech’ in which he congratulated Guislain on his new title – a seemingly spontaneous gesture that was supported by the society members present with prolonged applause.93 On a similar occasion in the Medical Society of Antwerp, it was decided that a delegation of society members would visit Jean-Corneille Broeckx after the meeting to congratulate him on his nomination.94 Honorary nominations and the awarding of memberships to prestigious institutions, such as the Belgian Academy of Medicine, were indeed mentioned during societies’ meetings. Such events led to more modest celebrations than the banquets organized by professional societies or medical commissions, but they were nevertheless moments of appreciation for one’s years of hard work. Such nominations were also regarded as honorable for the entire society, as it increased its standing. In the Antwerp society, in which the goals of practicing science and defending professional interests were often combined, nominations of society members to the board of the Belgian Medical Federation were also celebrated. Abraham Mayer’s appointment as vice-president of the Federation was seen as ‘a homage paid to our Society for the role it has never ceased to take up in the grand medical movement.’95 Both in scientific and professional venues, a culture of personal tributes thus emerged. Yet while in professional celebrations, the lives of individuals formed a starting point for reflections on fraternity and professional unity, the celebrations of the scientific community affirmed the leadership of the celebrated physician. The development of academic laboratories and research institutes in Belgium brought about a pyramidal organization of scientific research, in which the university professor stood at the top of an emerging class of assistants.96 The celebration of this academic elite, both within medical societies and at the universities, not only strengthened the dominance of university professors in the medical sciences; it also anchored their new functions as

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professional researchers and supervisors. In 1872, the Medical Society of Ghent organized a homage to professor Floribert Soupart to celebrate his role as a ‘tutor’ of many of the society members in their early surgical careers.97 The fact that Soupart had never himself taken up an active role in the Ghent society apparently posed no difficulties to such honoring. Academic relationships could be easily drawn into the society. If scientific celebrations confirmed hierarchies, this did not devalue their function in the forging of (hierarchy-based) alliances. Central to such celebrations was the establishment of a connection between the university professor and his (former) students and colleagues. Typically, a gift was presented to the celebrated physician that symbolized these connections. This gift could be a portrait, an album with the portraits of one’s colleagues or a marble bust. The effigies were often reproduced – a lithography was made of the portraits, a small-scale plaster copy of the busts – and distributed among those colleagues who had (financially) subscribed to the gift. In this way, the image of the celebrated colleague was perpetuated and became part of the collective memory of the profession. This tradition started at least in the middle of the century (Guislain’s bust was presented to him by his students in 1855)98 and was continued in the late nineteenth century (the Brussels professor Sacré received a bust from his students in 1894).99 These were events in which medical societies actively participated. The societies’ president was nearly always one of the speakers, in addition to a representative of the medical faculty and one of the students. It showed the intertwinement of societies with the university in the late nineteenth century. The metaphor of the family occupied an important place in these commemorative events. When Adolphe Burggraeve addressed Joseph Guislain on behalf of the Ghent society at the presentation of his marble bust, he evoked the image of an intimate gathering: ‘all of your colleagues, who are your friends, all your students, who are your children, surround you. Yes, my dear Colleague, today we hold a family celebration.’100 The small-scale plaster reproductions of Guislain’s bust, which were given to all subscribers, added to this atmosphere of friendship and intimacy. As Guislain stressed in his words of gratitude, ‘this bust will be with you: I will find myself in the midst of you, I will have a place at the center of the sanctuary of friendship.’101 In reduced form, Guislain

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seemed to suggest, his bust could indeed enter the homes of his colleagues and students, in a way similar to medical portraits of colleagues, which were also collected and assembled in private collections. In 1856, the German physician Konrad, for example, requested the portrait of Pierre-Engelbert Wauters, which had appeared in the Ghent Bulletin in 1840, but which he had lost, for his collection.102 In this way, medical societies were part of a culture of remembrance in which the collecting (and exchanging) of the effigies of celebrated physicians formed a means of community building.103 The family-like intimacy which society members attributed to such events was regarded as typical of ‘local’ celebrations. The most celebrated physicians were part of numerous (national) institutions and commissions, which each organized their own festivities. Faced with this abundance of activities, medical societies had to justify their share and stressed the more intimate and personal character of their tributes. As Burggraeve explained in his ‘Eulogy on Guislain’ of 1867, another such eulogy would soon be delivered in the Academy of Medicine, which would focus on the services that Guislain had rendered to the entire country. ‘We,’ Burggraeve continued, ‘who have lived in his intimacy, it belongs to us to say how good, loyal, delicate, grand and generous we have found him.’104 By this, he meant Guislain’s personal qualities: his refinement in medical practice and the zeal with which he counseled younger colleagues. A similar division in commemorative activity was present in the festivities for Arsène Pigeolet, with whom this chapter opened. The Brussels society emphasized that it had organized ‘a simple and intimate reunion, to better indicate its cordiality’ and argued that while Pigeolet had acquired considerable scientific authority at the university and in the Academy, ‘nowhere, we are sure, have you received more affection than in the midst of the Royal Society of Medical and Natural Sciences of Brussels.’105 As spaces of local academic sociability, urban societies sought to position themselves vis-à-vis the national Academy of Medicine and the universities in the late nineteenth century. It was indeed the Academy who continued a now more symbolic commemorative tradition of ‘Belgian’ medicine, by incorporating new heroes such as Guislain, but also by continuing its efforts in the erection of statues for historic ones, such as Van Helmont in 1889.106 The scientific leadership of academics also colored societies’ views on their own institutional histories. In the final decades of the century,

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societies started to reach a respectable age, celebrating their fiftieth jubilees. For the Brussels society, this occurred in 1872; for its counterparts in Antwerp and Ghent, in 1884. The commemorative events and publications that accompanied these festivities are remarkable in the sense that they pay relatively little attention to the idea of collectively ‘contributing to the sciences’ – an idea that had formed the guiding principle of medical societies in their early years. Instead, societies’ histories were linked to the pioneering views of a small group of heroic founding members. The Medical Society of Antwerp formed an exception to this phenomenon. The society’s broader recruiting base and close ties with professional organizations may help explain why the idea of collective labor and professional unity was stressed as one of the lessons of the society’s past.107 In Brussels and Ghent, however, the societies’ foundation and successes were linked, in particular, to the visionary efforts of, respectively, Louis Seutin and Joseph Guislain. In Brussels, the fiftieth anniversary of the society was celebrated with a banquet and a solemn meeting in the Brussels town hall, in which many representatives of Belgian and foreign societies took part. During the meeting a eulogy was delivered by professor Thiry on Louis Seutin and one by Van Den Corput on Jean-Joseph Dieudonné, who had been the editor in chief of the Journal de médecine in the middle of the century, representing the society’s connection to the university and the success of its journal.108 In Ghent, Guislain’s legacy was invoked to proclaim that the Medical Society of Ghent would never disappear. Its vanishing would not only weaken the urban medical community, ‘the medical faculty of our University would also suffer the consequences, because a Faculty cannot live and prosper but in a scientific milieu. This is what Guislain never stopped repeating.’109 In both cities, the commemoration of societies’ founders induced an attempt to strengthen the ties between society and university. By dedicating prize competitions to these same founders, the idea of medical societies as the pillars of the urban ‘scientific milieu’ was further strengthened. The Brussels society called into being a Prix Seutin and a Prix Dieudonné – in memory of the two men who most clearly embodied its scientific program. In 1892, the Prix Victor De Smeth was added to this list. De Smeth was a young professor who had died prematurely, in the eyes of his colleagues, as he was about ‘to bring students together around him, form a school and continue the traditions of his masters

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[maîtres].’110 On his deathbed, De Smeth had expressed a message to his students: ‘Tell them that I never cease to think of them […] and tell those who may instruct them that they can never do enough for the younger generation.’111 In those same moments, he also testified to his love for the university ‘to which I am indebted for what I know; I love it also because of the principle of liberty on which it is founded.’112 In this way, De Smeth embodied the scientific values of the (liberal) university professor. The Prix Victor De Smeth was initiated precisely to honor this professorial tradition. Each of these prizes carried the memory, and with it the scientific ideals, of those to whom they were dedicated. This was also the rationale behind the foundation of the Prix Guislain by the Medical Society of Ghent in the 1860s. Its implementation, however, proved a difficult undertaking. At his death, Guislain had left a considerable part of his heritage – no less than 50,000 Fr – to the Ghent Commission of Hospitals, which was to use this sum to the benefit of the poorest among the insane.113 Guislain had also left 2,500 Fr to the Ghent society to organize a prize competition every five years on ‘a matter of medical practice,’ for which the winner would receive 500 Fr.114 Yet the fact that the society did not possess a legal corporate identity and could thus not accept the donation caused severe problems. While initially an agreement was signed between the society and Guislain’s heirs, which stipulated that the prize money would be allocated through the intermediary of the Commission of Hospitals, this agreement was never ratified by the government, which allowed the heirs to later reconsider their decision.115 It was a bitter pill to swallow for the society, which was ‘indignant about the little respect that these ungrateful and miserly heirs show to the last will of their respectable parent.’116 Nevertheless, the society decided to establish the prize competition with its own means in memory of Guislain. Prize competitions were the final piece in the construction of a new ‘scientific’ medical pantheon in the late nineteenth century – a pantheon that was composed not of national historical physicians, but of the founding members of medical societies and contemporary academics. The commemorations and celebrations of these men supported a new set of scientific ideals that differed from the ideals of professional unity and fraternity that had developed simultaneously in professional medical organizations. Rather, the conception of the university

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professor as a maître, a scientific leader and supervisor now stood center stage. Such a conception was strengthened by the family-like events in which these professors were praised as ‘father figures’. To the virtues of leadership and mentorship, which were glorified during such family celebrations, another set of more private virtues was added. To bring these virtues, which were linked to one’s lifestyle, to the fore, celebrations seemed less suitable occasions. The commemorative rites that started after the death of prominent society members proved more appropriate moments to reflect upon the scientific life of the deceased, and the sacrifices that accompanied such a life. Mourning and the morality of science

The scale of these posthumous commemorative rites varied according to the scientific reputation of the deceased. The death of the most prominent society members could result in the convening of an extraordinary society meeting, during which the necessary arrangements were made to perpetuate the memory of their colleague (e.g. the publication of a biography). While such elaborate arrangements were scarce, it was customary for society members to collectively attend to the funeral of their fellow members, including the less active ones. In addition, societies’ presidents or secretaries typically delivered a eulogy, in which the personal and scientific qualities of their revered colleague were praised. Afterwards, these funeral speeches, and sometimes full biographical articles, were published in societies’ journals, often accompanied by a portrait of the deceased physician. These mourning rituals, more than jubilees and tributes, allowed for reflections on the morals of science. It seemed easier, in moments of grief, than during celebratory speeches, to voice sentiments of regret and reflect on the drawbacks of a life devoted to the medical sciences. These drawbacks, as Steven Shapin has shown, became increasingly linked to an ideal of self-sacrifice in the second half of the nineteenth century.117 In medical societies, as well, the commemorations of revered colleagues affirmed a new scientific morality by reflecting on their ascetic lifestyle. This ideal of self-sacrifice was not present from the start. In the earliest funeral eulogies, which remembered the generation before those of the founders of medical societies, the philanthropy and general refinement of the deceased were stressed more than the sacrifices

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made during his lifetime. Joseph Guislain’s funeral eulogies of PierreEngelbert Wauters (1840) and Joseph-François Kluyskens (1843), the two doyens of Ghent’s medical community at the time, highlight, besides their talent for medical observations, their generosity and social engagement in using their own time and private means to treat less fortunate patients. In addition, Wauters’ command of Latin and his love for music, and Kluyskens’ superb understanding of English were cited as evidence of their cultivation and erudition.118 A late example of these gentlemanly ideals was Guislain’s eulogy on Wauters’ son Jean (1855). According to Guislain, Jean Wauters was ‘the charitable man of the Gospel,’ who had devoted himself entirely to the free medical consultations offered by the Medical Society of Ghent, and to the improvement of the sanitary state of the city and its insane asylums. At the same time Wauters was also praised for his love of the art of painting, for music and for horseback riding – activities which he supported through his membership of different Ghent societies, a testimony of his sociable character.119 Such references to one’s leisure activities disappeared from the obituaries of physicians in the second half of the century. Parallel to the demise of the ideal of the cultivated gentleman, an ideal of asceticism took ever stronger root. This transition did not occur suddenly. The idea that scientific study demanded the sacrifice of one’s spare time had already existed in the early and mid-nineteenth century. It fit in with a conception of science as a tool for personal development and professional reform, accessible to all medical practitioners. Science, in other words, was seen as a useful and noble undertaking on top of one’s private practice, in the scarce leisure time that remained for occupied physicians. Yet, while such determination for scientific study was presented as a shared ideal to which all physicians should aspire, it was increasingly used as a marker of a specific group of scientifically engaged physicians in the second half of the century. This desire for differentiation, David Hollinger has shown, was typical of the growing autonomy of communities of scientists in the nineteenth century – a process which required an identifying ethical code.120 In the medical sciences, such detachment seems double. As ‘scientists,’ physicians lost their embeddedness in the civil culture of gentlemen (hence the demise of the virtues of literacy and cultivation), but they also differentiated themselves from the broader medical community. The ideal of

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self-sacrifice in the name of science marked this more exclusive scientific community. The commemoration of Jean-François Joseph Dieudonné, after his sudden death in 1865, forms one of the earliest examples of the representation of society members as ascetic scientists. Dieudonné, in fact, did not have the typical profile of the Belgian ‘medical hero’ (unlike, for example, Louis Seutin or Joseph Guislain, who were celebrated for their patriotism in this same period). Born in Breda in 1810 and having grown up in Brussels, Dieudonné moved to the Netherlands for a few years as the Belgian revolution broke loose. Upon his return to Belgium in 1833, he experienced difficulties in obtaining his academic degree in medicine because of his Dutch background.121 Although he made a successful career for himself in the medical sciences afterwards, these circumstances meant that in Dieudonné’s commemoration, citizenship was not placed center stage. Instead, Dieudonné was represented as ‘an active and tireless worker, who is marked by his ready and brilliant pen as much as by his varied knowledge, ceaselessly alimented by his assiduous reading.’122 This image of the tireless worker was also evoked in the commemoration of his editorship of the Brussels Journal de médecine, a position he held from 1846 to his death in 1865. As Louis Martin wrote in his biographical notice, Dieudonné ‘devoted during his long days, and part of his nights, all of his time, all of his leisure and we can even add all of his most necessary domestic pleasures’ to the editing of this journal.123 At his funeral, his successor as the editor in chief, Édouard Van den Corput, highlighted that Dieudonné ‘fell like a soldier, on his own field of honor, devoting his last strength, his last thoughts to the Journal de médecine.’124 In Dieudonné’s commemoration, science had replaced the nation as the greater good to which one devoted one’s life. This image was further carried out by an impressive commemorative machinery: a medal with the effigy of Dieudonné was made and Martin’s biographical note with a drawing of Dieudonné’s portrait was widely distributed by the society’s publisher Manceaux, who had printed several thousands of issues at his own cost to express his sympathy.125 Dieudonné, finally, also received his own commemorative place within the rooms of the society. A few months after his death, his widow sent a portrait of him to the society, which was hung in the society’s library.126

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10  Portrait of Jean-François Joseph Dieudonné that was included in Louis Martin’s biographical sketch. The volumes on the table behind Dieudonné appear as a reference to his talents as a writer and editor.

While an ascetic, scientific lifestyle became a truism in the biographies of nearly all late nineteenth-century scientists, the obituaries of physicians were particular in the sense that they sometimes connected this lifestyle to the cause of death. In the enthusiastic climate for pathological anatomy of the 1830s and 1840s, reports of dissection on the

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bodies of deceased colleagues could even be included in their obituaries. The Bulletin médical belge, for example, reported on Guillaume Dupuytren’s wish to leave his body for dissection to the Parisian anatomists François Broussais and Jean Cruveilhier. Their examination showed that Dupuytren had died from an effusion of pus in his right lung and also had an unusually enlarged heart and brain.127 Most of all, the autopsy testified to Dupuytren’s devotion to the medical sciences; even after his death, his body could still serve as a means of scientific study. A similar autopsy was undertaken by the Ghent physicians Édouard Blariau and Adolphe Burggraeve on the body of PierreEngelbert Wauters, who died aged ninety-five and who had predicted that his colleagues would find a stone in his bladder.128 The dissection revealed a swollen prostate, a scaly bladder stone and a liver full of bile, but his other organs, Blariau and Burggraeve emphasized, had been perfectly preserved.129 ‘The findings of this necropsy,’ they added, ‘augment the regret that causes the loss of the physician Wauters. Only a few years [referring to Wauters’ old age] and a century of existence could have shown what austerity and an orderly life could do to prevent the physician from this mass of causes that threaten him in the course of his laborious career.’130 Anatomical findings here supported a morality of living austerely. As the ideal of self-sacrifice began to hold sway, the link between physicians’ bodies and their lifestyle was made in a different way. The unhealthy body was now a testament to the sacrifices made in the name of science. Alongside a general image of the physician as a martyr, who risked his own life to save others, a more specific discourse on the health risks of medical scientists was developed. By emphasizing the physical discomforts of the continuous, solitary work of scholars in their studies, the ideal of self-sacrifice could be recast in medical terms. Also, the persistent and profound dream-like state of thinkers (and the more distracted reverie of literary men) were related by some to hysteria and hypochondria.131 These so-called ‘diseases of scholars’ formed a small domain of medical study. The unhealthy lifestyle that resulted from solitary scientific work also meant that the ideal of asceticism could be contested within the medical community. In a volume on ‘intellectual hygiene,’ which was part of his series of popular books on hygiene, Adolphe Burggraeve put his finger on the seemingly contradictory relation between scientists’ ascetic, and in his eyes unhealthy,

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lifestyle and the hygienic notions these same men preached to the masses. Therefore, he made a call to scholars to engage more in physical exercises instead of shutting themselves in their poorly aired studies and depriving themselves of sleep.132 In a sense, Burggraeve thus refashioned an older discourse of living austerely, of paying attention to one’s health, in modern hygienist terms as a means of criticizing a contemporary work ethic. Whether his call had any effect remains doubtful. On the level of representation, at least, endless labor continued to be regarded as more praiseworthy than personal health. Besides contemporary medical thought, the representation of the active, ascetic scientist was tied up with notions of masculinity. The institutionalization of science in societies and universities in the course of the nineteenth century moved science away from the home, which now became a more characteristically feminine space.133 The commemorative practices in these masculine settings continuously affirmed the image of the scientist as a disciplined man, who chose scientific labor over domestic pleasure – Dieudonné, for example, was said to have denied himself the joys of family life. Yet, at the same time, moments of grief also formed scarce occasions on which the divide between these masculine settings, such as medical societies, and the feminine private sphere of the home could be transcended. When news of a serious illness of a member reached societies, it was common that a delegation of society members would visit their ill colleague at his home.134 This contact between both spheres intensified at the death of a society member. It was the widow of a society member, in the first place, who informed societies of the death of her husband and thanked them for their funeral eulogies.135 A lack of contact between a widow and medical societies could disrupt commemorative rites. In 1868, the news of Charles Van Leynseele’s death and funeral at the Ghent St. Amand grave yard had reached the Medical Society of Ghent too late. No funeral discourse had therefore been pronounced on behalf of the society, to the regret of president Lados.136 On some occasions, widows (or other family members) presided over the reputation and intellectual heritage of their late husbands. The widow of the Montpellier physician Louis-Jules Saurel, editor of the Revue thérapeutique du Midi, donated a posthumously published work on naval surgery to the Medical Society of Antwerp in 1861.137 The case of the widow of the German physician Henneman reveals an even

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stronger engagement in the scientific reputation of her husband as she wrote to the Medical Society of Ghent to posthumously submit a manuscript: It is the wish of a dying man I carry out; he has strongly urged me to fulfill it. Sadly, he has been unable to see himself to the publication of his work! His endless occupations have prevented him to do so. He assiduously worked on it towards the end of his life; one has said that a secret presentiment of his approaching death hastened him to finish it.138

Only as the executor of what seems the scientific testament of her husband, could Mrs Henneman engage with the Ghent society. Her letter can also be regarded as a contribution to the reputation of her late husband, as she stressed his continuous work and scientific enthusiasm as a characteristic that marked him until the last days of his life. Conversely, societies could send posthumous publications to the family of their deceased colleague as a mark of respect, as was the case for Broeckx’ study on Van Helmont.139 In times of grief, the traditional boundaries between the domestic sphere and the more public sphere of societies could thus be transcended, allowing family members to participate, for a brief moment, in the scientific community. At the same time, the national boundaries of the scientific community could similarly be transcended during commemorative rites. In the late nineteenth century, the imagined community of scientists increasingly became an international community. In the Brussels Journal de médecine, lists with deceased university professors from France, Germany and Italy appeared, often accompanied with a brief description of their scientific work (e.g. a particular surgical invention). These lists evoke a broadly conceived scientific community. They included the Italian professor Giovanni Polli, who was remembered as ‘the promoter of cremation in Italy,’ the French philosopher Émile Littré, ‘[author] of an excellent translation of Hippocrates, and the founder of the Philosophy of positivism, who the medical world may claim with honor as one of its own’ and even famous scientists without a clear link to the medical sciences such as Charles Darwin.140 Not all of these men received equal attention. The growing international dimension of scientific commemorations is perhaps best illustrated by the elaborate biographies of the foreign ‘stars’ of laboratory science. The German director of the Physiological Institute in Leipzig, Carl Ludwig, and the French chemist Louis

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Pasteur were celebrated in ways that measured up to the commemorative rites of the most important society members.141 These commemorations show that the new pantheon of scientific heroes in the late nineteenth century was expanded beyond the nation-state. This chapter has traced a transition in the communities with which society members identified themselves: from a broadly conceived national medical community to a more exclusive, academic scientific community. This shift was indicative of the way the scientific elite presented itself to the (bulk of the) medical profession, and more generally to society as a whole. It was, in other words, a shift in the ‘imagined community’ of society members, the community to which they felt they belonged. In the middle of the century, this community corresponded fully with the medical profession, which in turn was regarded as a part – a ‘sub-nation’ – of the Belgian nation. Society members considered themselves the carriers of this nation: by supporting the Belgian nation-state, they augmented the social status of their profession. In the late nineteenth century, these affiliations changed. Society members now identified with a uniquely scientific community, which had its basis in Belgian academe and, in its most extended form, comprised an international network of scientists. This change in self-identification is telling about the embeddedness of the medical sciences in nineteenth-century civil culture. It hints at a more general transition from ‘civil’ to ‘professionalized’ science that was completed in the course of the century. The connection between scientific study and citizenship and the representation of the gentleman physician as a learned, cultivated man reveal how science was part of the cultural milieu of the urban middle class. National and local sentiments and historical interests transcended the disciplinary boundaries between the different urban institutions and societies, as the networks and practices of historical research into Belgium’s medical past have shown. The gradual replacement of the Belgian nation with ‘science’ as an equally abstract entity to which one could devote one’s life, testifies to the growing autonomy of the scientific domain in the second half of the century. In this new culture of professionalized science, the ideals of gentleman science moved to the background and were replaced by more exclusive values, which affirmed the specificity of the scientific community. The celebration of university professors as ‘fathers’ and

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tutors reflected the increasingly exclusive and hierarchical organization of the scientific world; their ascetic lifestyle was a mark of the selfdetermination of the modern scientist. Medical societies played a fundamental role in this process. As vital links in the commemorative machinery, they formed places where shared ideals were continuously affirmed. As such, they functioned indeed as ‘technologies of imagination’ as Michael Brown has suggested.142 This finding may also lead to a broader interpretation of medical societies as normative agents in the scientific landscape. Their role in setting standards was not limited to practices of peer review or to determining who rightfully enjoyed a reputation as a scientific expert. They also operated at a more imaginary level by establishing the (historical) framework in which physicians could position their own efforts. This function did not disappear in the late nineteenth century: medical societies continued to form suitable forums on which the autonomy of science as an abstract entity could be affirmed through the commemoration of its leaders. Notes 1 ‘Bulletin de la Société Royale des Sciences Médicales et Naturelles de Bruxelles,’ JMCP, 95 (1893), 721–6. 2 Ibid., 723. 3 Louis Seutin and Joseph Guislain featured among the ‘founding fathers’ who were commemorated in the second half of the century: J.R. Marinus, Le baron L. Seutin: Sa vie et ses travaux. Ouvrage posthume (Brussels: De Mortier, 1862); J. Thiry, Seutin, sa vie, ses travaux et son influence sur le progrès de la chirurgie en Belgique (Brussels, 1878); A. Burggraeve, Études médico-philosophiques sur Joseph Guislain (Brussels: Lesigne, 1867); R. Boddaert, Joseph Guislain (Ghent, 1887). 4 ‘Bulletin,’ 724. 5 Ibid., 724–5. 6 P.G. Abir-Am, ‘Introduction,’ in P.G. Abir-Am and C.A. Elliott (eds), Commemorative Practices in Science: Historical Perspectives on the Politics of Collective Memory, Osiris 14 (1999), 1–33, 27–8; P.G. Abir-Am (ed.), La mise en mémoire de la science: Pour une ethnographie historique des rites commémoratifs (Amsterdam: OPA, 1998). 7 L. Jordanova, ‘Science and Nationhood: Cultures of Imagined Communities,’ in G. Cubitt (ed.), Imagining Nations (Manchester and New York:

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Manchester University Press, 1998), pp. 192–211, 206. David Cahan has made a similar call for the study of ‘imagined scientific communities’: D. Cahan, ‘Institutions and Communities,’ in D. Cahan (ed.), From Natural Philosophy to the Sciences: Writing the History of Nineteenth-Century Science (Chicago and London: The University of Chicago Press, 2003), pp. 291–328. S. Onghena, ‘Altruïstisch ambtenaar of heroïsch genie? Het gepropageerde beeld van provinciale en academische directeurs van bacteriologische laboratoria in België (ca. 1900–1940),’ Studium. Tijdschrift voor Wetenschaps- en Universiteitsgeschiedenis: Revue d’Histoire des Sciences et des Universités, 2:4 (2009), 191–210; K. Wils, ‘The Revelation of a Modern Saint: Marie Curie’s Scientific Asceticism and the Culture of Professionalised Science,’ in E. Peeters, L. Van Molle and K. Wils (eds), Beyond Pleasure: Cultures of Modern Asceticism (New York and Oxford: Berghahn Books, 2011), pp. 172–89, 173–5. On scholarly personae: H. Paul, ‘Sources of the Self: Scholarly Personae as Repertoires of Scholarly Selfhood,’ BMGN – The Low Countries Historical Review, 131:4 (2016), 135–54. T. Van Bosstraeten, ‘Dogs and Coca-Cola: Commemorative Practices as part of Laboratory Culture at the Heymans Institute Ghent, 1902–1970,’ Centaurus, 53:1 (2011), 1–30. On such rites in the humanities: J. Tollebeek, Gedachtenissen: Commemoratieve praktijken in de geesteswetenschappen omstreeks 1900 (Academiae analecta. Nieuwe reeks: 21) (Brussels: KVAB, 2013). On the moralizing role of retracing the lives of famous physicians: G. Weisz, ‘The Self-Made Mandarin: The “Éloges” of the French Academy of Medicine, 1824–47,’ History of Science, 26:1 (1988), 13–40. More recently, attention has been directed to the epistemic virtues and scholarly personae present in such biographical texts: H. Paul, ‘What is a Scholarly Persona? Ten Theses on Virtues, Skills and Desires,’ History and Theory, 53:3 (2014), 348–71. E. Peeters, Het labyrint van het verleden: Natie, vrijheid en geweld in de Belgische geschiedschrijving, 1787–1850 (Leuven: Leuven University Press, 2003), pp. 93–100; J. Tollebeek, ‘Enthousiasme en evidentie: De negentiende-eeuwse Belgisch-nationale geschiedschrijving,’ in J. Tollbeek, De ijkmeesters: Opstellen over de geschiedschrijving in Nederland en België (Amsterdam: Bert Bakker, 1994), pp. 57–74. This new ‘Belgian’ history was expressed in numerous popular history books, but also seeped through in history education: M. Meirlaen, Revoluties in de klas: Secundair geschiedenisonderwijs in de Zuidelijke Nederlanden, 1750–1850 (Leuven: Leuven University Press, 2014), pp. 329–31. ‘Séance du 9 juin 1835,’ BSMG, 1 (1835), 76–90, 84–90.

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13 Ibid., 89. 14 ‘Concours de 1841,’ Mémoires de la Société de Médecine d’Anvers (1838–1839), xxxi; ‘Programme des questions proposées par la société, pour le concours de 1842,’ ASMA, 2 (1841), 272–3. 15 J.C. Broeckx, Essai sur l’histoire de la médecine belge avant le XIXe siècle (Ghent: Hebbelynck, 1837); J.R. Marinus, Review of Broeckx, Essai sur l’histoire, BMB, 5:1 (1838), 29–30; J. Lequime, Review of Broeckx, Essai sur l’histoire, BMB, 5:8 (1838), 220–5. 16 J.-C. Broeckx, Coup d’oeil sur les institutions médicales belges, depuis les dernières années du dix-huitième siècle, jusqu’à nos jours, suivi de la bibliographie de cette époque (Brussels: Société Encyclographique des Sciences Médicales, 1841). 17 L. Marcq, Essai sur l’histoire de la médecine belge contemporaine (Brussels: Manceaux, 1866), on the title page. 18 V. Desguin, ‘Histoire de la médecine,’ in E. Van Bemmel (ed.), Patria Belgica: Encyclopédie nationale ou exposé méthodique de toutes les connaissances relatives à la Belgique ancienne et moderne, physique, sociale et intellectuelle (Brussels: Bruylant-Christophe, 1875), III, pp. 239–66. 19 J.H. Warner, Against the Spirit of System: The French Impulse in NineteenthCentury American Medicine (Baltimore: Johns Hopkins University Press, 1998), pp. 166–7. 20 J. Tollebeek and T. Verschaffel, ‘Group Portraits with National Heroes: The Pantheon as an Historical Genre in Nineteenth-Century Belgium,’ National Identities, 6:2 (2004), 91–102. 21 ULG, BRKZ.NUM.013090, ‘Erkentelijkheidsmedaille van de Académie royale de Médecine de Belgique,’ [1846]. 22 Séance d’installation du 26 septembre 1841,’ BARMB, 1 (1841), 53–78, 55. 23 Broeckx made a report on the scientific qualities of Pierre Coudenberg for the Academy of Medicine: J.C. Broeckx, Rapport sur les titres scientifiques de Pierre Coudenberg (Antwerp: Buschmann, 1861). 24 J.C. Broeckx, Discours sur l’utilité de l’histoire de la médecine (Antwerp: J.B. Heirstraeten, 1839), p. 13. 25 J.C. Broeckx, Panthéon Médical Belge dessinée par De Lahoese, dédiée à Messieurs les membres de la Société de Médecine d’Anvers (s.l.: s.d. [ca. 1840]). 26 P. Génard, Notice nécrologique sur M. le docteur C. Broeckx (Antwerp: Buschmann, 1871), p. 10. 27 For his views on the relation between economic prosperity and the sciences: C. Broeckx, ‘Notice sur Gabriel d’Ayala, docteur en médecine, médecin pensionnaire de la ville de Bruxelles,’ ASMA, 14 (1853), 5–23, 5–6. Among the Antwerp physicians studied by Broeckx can be

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31 32 33 34 35 36 37

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mentioned Lazare Marcquis and Johan Ferreulx: C. Broeckx, ‘Notice sur le docteur Lazare Marcquis, médecin et ami de P.P. Rubens,’ ASMA, 12 (1853), 5–35; C. Broeckx, Johan Ferreulx, boekminnend geneesheer in de XVIe eeuw (Antwerp: Buschmann, 1861). C. Broeckx, ‘Gallérie médicale anversoise,’ ASMA, 27 (1866), 158–261, 158. F. Dubois, ‘La Belgique médicale, ou notice sur la vie et les écrits des Belges qui se sont distingués dans les sciences médicales,’ BMB, 3:1 (1836), 17; 3:2 (1836), 37–43; 3:5 (1836), 117–23. Dubois, ‘La Belgique médicale,’ p. 37. The category of less famous physicians typically comprised (academic) physicians of which a manuscript or tombstone had been preserved, such as Jacques Bogaert and Jean Spierinck who taught at the University of Leuven at the turn of the sixteenth century: Dubois, ‘Bogaert ( Jacques) de Louvain,’ BMB, 3:2 (1836), 37; ‘Spierinck ( Jean),’ BMB, 3:5 (1836), 117. Dubois, ‘La Belgique médicale,’ p. 17. J.C. Broeckx, Notice sur Jean-Charles Van Rotterdam (Antwerp: Buschmann, 1864). ‘Séance du 4 avril 1837,’ BSMG, 3 (1837), 49–80, 79–80. ULG, Hs. 3012.4.2, Letter of June 20, 1844 from the Medical Society of Ghent to Parmentier. ‘Séance ordinaire du 2 août 1864,’ BSMG, 31 (1864), 173–5. ULG, Hs. 3012.4.2, Letter of February 4, 1847 from the Medical Society of Ghent to the urban government of Ghent. Museum for Fine Arts Ghent, Nr. 1980-N, ‘Dissectie van een Siamese tweeling’ (Norbert Sauvage, 1703); C. Van Bambeke, A propos d’un tableau ornant le local de réunion de la Société de Médecine de Gand (Ghent: E. vander Haeghen, 1901). On this painting, see also: P. Allegaert and V. Van Roy (eds), Ijzeren longen, warme harten: Musea & collecties van geneeskunde en zorg in België, Nederland en Luxemburg (Antwerp and Appeldoorn: Garant, 2014), p. 61. ULG, Hs. 3012.4.2, Letter of December 7, 1848 from the Medical Society of Ghent to the urban government of Ghent. ‘Séance du 1 mai,’ BSMG, 17 (1850), 109–36, 109. The recited poem was: M. Van Ackere-Doolaeghe, Palfyn, vaderlantsch gedicht (Ghent: SnoeckDucajou, 1849). Guislain referred to the memorial stones for Palfyn in Ghent’s St.Jacob church that were erected in 1783 and 1784: ‘Het eerste monument Palfyn,’ Ghendtsche Tydignhen, 18:1 (1989), 25–7; ‘Het tweede monument Palfyn,’ Ghendtsche Tydignhen, 18:2 (1989), 80–2. Emphasis in original.

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41 J. Guislain, Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse: Résumé d’un voyage fait en 1838, adressée à la Société de Médecine de Gand (Ghent: F.E. Gyselynck, 1840), pp. 310–11. 42 These various statues are also mentioned throughout Victor Desguin’s chapter on the medical history of Belgium: Desguin, ‘Histoire de la médecine’. 43 Guislain’s statue in Ghent was inaugurated in 1887: Inauguration de la statue de Joseph Guislain à Gand. 10 juillet 1887 (Ghent: Vanderhaeghen, 1887). A statue for Louis Seutin was erected in 1875 at the entrance of the Brussels St. Pierre Hospital. 44 Broeckx, Essai sur l’histoire, frontispice ‘Vésale’. 45 A. Burggraeve, Études sur André Vésale, précédées d’une notice historique sur sa vie et ses écrits (Ghent: Annoot-Braeckman, 1841). 46 CAB, ‘Sociétés scientifiques, littéraires et artistiques en général,’ entry for the Vesalius Society [Société Vésalienne]. 47 ‘Dispensaire-Vésale,’ Het werkverbond: Volksblad voor Handel en Nyverheid, stielen en ambachten, October 28, 1860. 48 K. Wils, ‘Institut Vésale (Amphithéâtre),’ ‘Institut Vésale – Salle de dissection,’ ‘Institut Vésale – Auditoire,’ in G. Vanpaemel, M. Derez and J. Tollebeek (eds), Album van een wetenschappelijke wereld / Album of a Scientific World (Leuven: Leuven University Press, 2012), pp. 162–5, 168–9. 49 M. Biesbrouck, L. Missotten and O. Steeno, ‘De Vesalius-schilderijen van E.J.C. Hamman (1819–1888),’ in B. Van Hee and C. Van Tilburg (eds), Heel-meesters: Befaamde artsen en figuren uit de geschiedenis van de geneeskunde (Antwerp and Appeldoorn: Garant, 2014), pp. 19–39. 50 Burggraeve, Études, xii. 51 André Vésale, ou le créateur de l’anatomie: Drame allégorique en cinq tableaux, en vers et en prose (Brussels: Société des Beaux-Arts, 1848); J. Guillaume, André Vésale: Drame en cinq actes (Brussels: s.n., 1852); T. Rimbaut, André Vésale ou le triomphe de l’anatomie, comédie historique en deux actes (Tournay: Casterman, 1863). 52 L. Schoonen, Hommage à André Vésale (Brussels: Raes, 1847). On Louis de Geelhand: C. Verbruggen, Schrijverschap in de Belgische belle époque: Een sociaal-culturele geschiedenis (Ghent and Nijmegen: Academia Press and Uitgeverij Vantilt, 2009), p. 34. 53 F.V. Goethals, ‘Vésale,’ in F.V. Goethals, Lectures relatives à l’histoire des sciences et des arts, des moeurs de la politique en Belgique, et dans les pays limitrophes, commencés en 1818 et publiées en 1837 (Brussels: Vandooren, 1837), II, pp. 112–33.

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54 On this campaign: O. Steeno, ‘De historiek van het Vesaliusstandbeeld op het Barricadenplein in Brussel,’ in L. Missotten (ed.), Omtrent Vesalius (Garant: Antwerp and Appeldoorn, 2007), pp. 59–68. See also Victor Uytterhoeven’s letter as president of the organizational committee: Monument Vésale comité central: Lettre du Président Victor Uytterhoeven (Brussels, s.n., 1841). 55 ‘Inauguration de la statue de Vésale,’ Archives de la médecine belge (1847), 121–31; ‘Inauguration de la statue de Vésale,’ Archives de médecine militaire, 1 (1848), 92–101; ‘Variétés,’ Bulletin général de thérapeutique médicale et chirurgicale, 34 (1848), 82–96, 95. 56 ‘The Brussels Society of Medical and Natural Sciences received such a miniature statue: ‘Bulletin de la séance du 2 octobre 1848,’ JMCP, 7 (1848), 579–84. For the commemorative medal: ULG, RKZ. NUM.007664, ‘Inhuldiging van het standbeeld van Andreas Vésalius door J. Geefs.’ 57 Jordanova, ‘Science and Nationhood,’ p. 195. 58 See the section ‘Éphémérides médicales’ at the end of each issue of the Journal de médecine in the 1870s and 1880s. 59 An example of cooperation between amateurs forms Joseph Guislain’s contacts with the Ghent judge Albert Gheldolf, who provided Guislain with biographical information on the medieval surgeon Jean Yperman on the basis of his archival research in the municipal archives of Ypres: ‘Discussion sur le lieu de naissance et les travaux militaires de maître Jehan Yperman, chirurgien flamand au xve siècle,’ BSMG, 22 (1855), 51–4. 60 Ibid. On Snellaert’s somewhat controversial ‘Flemish’ profile within the Ghent medical community: A. Deprez, ‘De jonge Snellaert (1809–1838),’ Verslagen en mededelingen van de Koninklijke Academie voor Nederlandse taal- en letterkunde (nieuwe reeks) (1970), 1–155, 98–107. The emancipatory program of the literary societies in which Snellaert participated, has been studied extensively: Draye, Laboratoria van de natie: literaire genootschappen in Vlaanderen 1830–1914 (Nijmegen: Uitgeverij Vantilt, 2009). 61 On this international network of nineteenth-century medical historians: D. Gourevitch (ed.), Médecins érudits de Coray à Sigerist (Paris: De Boccard, 1995). On Dalemberg’s contacts with Broeckx: D. Gourevitch and S. Byl, ‘Amitié et ambition: Broeckx, Daremberg et l’Académie royale de médecine de Belgique,’ Acta Belgica historiae medicinae, 4 (1991): 12–19. 62 D. Gourevitch, ‘Charles Daremberg, His Friend Émile Littré, and Positivist Medical History,’ in F. Huisman and J.H. Warner (eds), Locating

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67 68

69 70

71 72 73 74 75

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Medical History: The Stories and Their Meanings (Baltimore and London: Johns Hopkins University Press, 2004), pp. 53–69, 66–8. Broeckx, Discours sur l’utilité, pp. 13, 17. The publication was the result of a lecture held by Broeckx in the Medical Society of Antwerp in November 1839. Ibid., 12–13. On this publication, see the section ‘Engaging audiences’ in Chapter 3, pp. 101–9. C. Broeckx, ‘La chirurgie de maître Jehan Yperman, chirurgien belge du XIIIe siècle, publiée pour la première fois d’après la copie flamande de Cambridge’ (Antwerp, 1863); C. Broeckx, ‘Traité de médecine pratique de maître Jehan Yperman, médecin belge (xiiie–xive siècle), publié pour la première fois d’après la copie flamande de la bibliothèque royale de Bruxelles,’ ASMA, 28 (1867), 5–150. Broeckx, Discours sur l’utilité, 7–8. It is also in this light Broeckx’ emphasis on Antwerp’s golden age as a fertile climate for scientific study needs to be understood. Later in his career, Broeckx also engaged in the study of medical institutions. His studies of the collegia medica, the corporate structures of the medical profession in the early modern period, of Antwerp (1858) and Brussels (1862) were the most well-known: J.C. Broeckx, Histoire du Collegium medicum Antverpiense (Antwerp: Buschmann, 1858); J.C. Broeckx, Histoire du Collegium medicum Bruxellense (Antwerp: Buschmann, 1862). Broeckx, Discours sur l’utilité, 10–12. Ibid., p. 16, 17. Broeckx emphasized the idea of history as a remedy for contemporary revolutionary medical theories, such as Broussais’ medicine and homeopathy, in an essay that was awarded by the Medical Society of Ghent in 1835: Broeckx, Essai sur l’histoire, pp. ii–iii. F. Huisman and J.H. Warner, ‘Medical Histories,’ in F. Huisman and J.H. Warner (eds), Locating Medical History, pp. 1–30, 6–7. Marcq, Essai sur l’histoire, p. 6. Ibid. Huisman and Warner, ‘Medical Histories,’ p. 8. Da Costa Alvarenga’s text was translated from Portuguese into French by Édouard Van Den Corput, the editor of the Brussels Journal de médecine and also published in the Antwerp Annales: P.F. Da Costa Alvarenga, ‘De l’utilité de l’histoire de la médecine,’ ASMA, 30 (1869), 599–615. The Ghent professor Etienne Poirier supported Da Costa Alvarenga’s call for the introduction of medical history into the medical curriculum: E. Poirier, Review of Da Costa Alvarenga, De l’utilité, BSMG, 37 (1870), 151–4.

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76 P. Dhondt, Un double compromis: Enjeux et débats relatifs à l’enseignement universitaire en Belgique au XIXe siècle (Ghent: Academia Press, 2011), p. 232. 77 Ibid., pp. 369–70. Broeckx also appealed for the introduction of a course in medical history at the Belgian universities. The introduction of a mandatory course, he claimed, formed the sole means to rectify ‘[physicians’] ignorance of the history of their profession and their disdain for national medicine’: Broeckx, ‘Gallérie médicale,’ 157–8. 78 Broeckx, Discours sur l’utilité, pp. 6–7. 79 Broeckx, ‘Notice sur Gabriel d’Ayala,’ 6. 80 Broeckx, ‘Dissertation sur les médecins poètes belges,’ ASMA, 19 (1858), 489–512, 541–65. 81 Broeckx, ‘Dissertation,’ 492. 82 According to Broeckx, Ferreulx’ love for books made him into a learned man. He also praised Ferreulx’ decision to donate his library to the newly founded Collegium medicum of Antwerp in 1620 and criticized the physicians who split up and sold this collection in 1805, a decision he contrasted with the donation of the library of the Medical Society of Antwerp to the urban library in 1859: Broeckx, Johan Ferreulx, pp. 6–8, 16. 83 On these counter-images of scientific medicine in the late nineteenth century, see: J.H. Warner, ‘Ideals of Science and Their Discontents in Late Nineteenth-Century American Medicine,’ Isis, 82 (1991), 454–78. 84 J. Guislain, ‘Discours sur le Médecin P.E. Wauters, prononcé le jour de son enterrement,’ BSMG, 6 (1840), 166–76, 169–71. 85 ‘Nécrologie,’ JMCP, 74 (1882): 211–12. 86 K. Velle, De nieuwe biechtvaders: De sociale geschiedenis van de arts in België (Leuven: Kritak, 1991), pp. 105–7. 87 ‘Banquet fraternel à Anvers,’ ASMA, 22 (1861), 454–6. Another early example forms the banquet organized in Brussels in honor of Louis Seutin in 1852, an effort supported by the Brussels Society of Medical and Natural Sciences. In the same year, Seutin returned the favor to show his appreciation for the marks of respect that had been expressed to him: ‘Banquet offert à M. le docteur Seutin par les médecins belges,’ JMCP, 14 (1852), 193–200; ‘Banquet offert par M. Seutin aux médecins belges,’ JMCP, 14 (1852), 389–90. 88 ‘Séance ordinaire du 25 septembre 1868,’ ASMA, 28 (1868), 528. 89 ‘Faits divers,’ JMCP, 72 (1881): 406–7. 90 The invitations to the banquets of the Ghent Society in 1856, 1864, 1865 and 1868 have been preserved in: ULG, VLBL. HFI. M. 032.03 ‘Société de Médecine’.

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91 The time schedule of societies’ meetings are often difficult to trace as these were not always included in the meeting reports. In the Medical Society of Antwerp, no such remarks were made. The Brussels Society generally closed its meeting around eight o’clock in the evening, at least from the 1860s onwards. 92 ULG, Hs. 3012.4.2, Letter of October 8, 1845 from the Medical Society of Ghent to Mr De Smedt [in which the Society declared that all its members were also part of La Concorde]. 93 ‘Séance du 6 mars 1855,’ BSMG, 22 (1855), 88–9. When NicholasChrétien Du Moulin received the same nomination, the society’s board had visited Du Moulin at his home to congratulate him. During the next society meeting, these congratulations were repeated before the entire society: ‘Séance ordinaire du 5 décembre,’ BSMG, 38 (1870), 558–9. 94 ‘Séance du 12 octobre 1855,’ ASMA, 16 (1855), 522. A similar visit was paid to Dr Schaeffer on behalf of the Society in 1860: ‘Séance du 16 novembre 1860,’ ASMA, 21 (1860), 602. 95 ‘Séance du 30 avril 1880,’ ASMA, 41 (1880), 204–6. 96 Dhondt, Un double compromis, pp. 307–23. 97 ‘Séance ordinaire du 3 Décembre 1899,’ BSMG 39 (1872), 501–3. 98 ‘Ovation à M. le professeur Guislain,’ BSMG, 22 (1855), 455–60. 99 ‘Manifestation en l’honneur de M. le professeur Sacré,’ JMCP, 96 (1894), 225–7. 100 ‘Ovation,’ 458. The reunion of Sacré’s colleagues, assistants and students were similarly described as a gathering of ‘the great medical family’: ‘Manifestation,’ 225. 101 ‘Ovation,’ 457. The sculptor of the bust, Mr Van Eenaeme, cast several full-scale copies of the bust that could be purchased for 25 F: Ibid., 460. Seven years after Guislain’s death, in 1867, this bust was placed in the meeting room of the Ghent Society in the city’s town hall, an event to which much luster was added by inviting local politicians plus physicians from all over the country. It marked Guislain’s formal entrance into the Ghent medical pantheon: Burggraeve, Éloge de Joseph Guislain. 102 ULG, Hs. 3012.4.1, Letter of March 22, 1856 from Dr Konrard to the Medical Society of Ghent. 103 On portraits as means of community building: L. Jordanova, Defining Features: Scientific and Medical Portraits 1660–2000 (London: Reaktion Books, 2000). On the role of such images in the late nineteenth-century community of historians: J. Tollebeek, Fredericq & Zonen: Een antropologie van de moderne geschiedwetenschap (Amsterdam: Bert Bakker, 2008), pp. 174–86.

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104 Ibid., 40–1. 105 ‘Bulletin,’ 723. 106 ‘Discours prononcé à l’inauguration de la statue de Van Helmont, le 15 juillet 1880, par le docteur Rommelaere,’ JMCP, 89 (1889), 373–82. 107 A. De Mets, Cinquantenaire de la Société de Médecine d’Anvers, 1834–1887: Rapport sur les travaux de la société présenté dans la séance solennelle du 23 avril 1887 (Antwerp: Buschmann, 1887), pp. 49–51. 108 ‘Célébration du 50e anniversaire de la fondation de la Société Royale des Sciences Médicales et Naturelles de Bruxelles,’ JMCP, 55–6 (1872), 86–9. The meeting received much attention in the medical press, see for example: ‘Variétés et Nouvelles,’ Presse médicale belge, 24 (1872), 255, 262–3. 109 Burggraeve, Éloge de Guislain, p. 25. 110 ‘Bulletin de la séance du 30 octobre 1892,’ JMCP, 94 (1892), 789–98. 111 Ibid., 792. 112 Ibid. 113 Archive OCMW Ghent, B19 Guislaingesticht, N.1, ‘Note sur le patronage des aliénés sortis des asiles de Gand et le legs de Joseph Guislain pour le patronage’ (August 7, 1902). 114 Ibid., ‘Donations héritiers Guislain’ (October 19, 1860), ‘une question de médecine pratique’. 115 The correspondence between the Medical Society of Ghent, the Commission of Hospitals of Ghent and the Ministry of Internal Affairs on the subject of Guislain’s donation in the early 1860s has been preserved in: Archive OCMW Ghent, B19, N. 1. 116 ‘Séance ordinaire du 3 mars 1863,’ BSMG, 30 (1863), 69–71. 117 S. Shapin, The Scientific Life: A Moral History of a Late Modern Vocation (Chicago and London: The University of Chicago Press, 2008). 118 Guislain, ‘Discours sur le Médecin P.E. Wauters,’ 169–71; J. Guislain, ‘Mort du professeur Kluyskens: Notice nécrologique,’ BSMG, 9 (1843), 219–42, 223–6, 235. 119 J. Guislain, ‘Notice nécrologique du Docteur Wauters, médecin praticien à Gand, décédé à Naples,’ BSMG, 21 (1855), 81–7. On the eulogies of the professors of the nineteenth-century Faculty of Medicine at the University of Leuven: J. Buyens, Over de dokter niets dan goed: De Leuvense hoogleraren geneeskunde in de 19de eeuw (Master’s thesis, University of Leuven, 2016). 120 D.A. Hollinger, ‘Inquiry and Uplift: Late Nineteenth-Century American Academics and the Moral Efficacy of Scientific Practice,’ in T.L. Haskell (ed.), The Authority of Experts: Studies in History and Theory (Bloomington: Indiana University Press, 1984), pp. 142–56.

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121 L.L.H. Martin, Notice sur Jean-François-Joseph Dieudonné, président de la Société des Sciences Médicales et Naturelles de Bruxelles, né à Bréda le 18 juin 1810, décédé à Bruxelles, le 10 août 1865 (Brussels: Manceaux, 1865), pp. 2–3. 122 Ibid., p. 2. 123 Ibid., p. 5. 124 ‘Nécrologie,’ JMCP, 41 (1865), 190–2. A highly similar narrative was used at the death of Benjamin Ingels, one of the directors of the Ghent Society and also the editor of the Bulletin of the Society of Mental Medicine (1869). Like Dieudonné, Ingels had died suddenly at the relatively young age of 56, when he was still highly active in both societies. He was similarly represented as a ‘martyr of science,’ who had died while dedicating his life to the sciences: ‘Nécrologie,’ BSMG, 53 (1886), 149–60. 125 One of these medals is preserved at the Museum Oudenaarde en de Vlaamse Ardennen, N. M&P_1072, medal Joseph Dieudonné. For Manceaux’s announcement: ‘Séance extraordinaire du 11 août,’ JMCP 41 (1865): 287–8; Martin, Notice sur Dieudonné. 126 ‘Bulletin de la séance du 6 novembre 1865,’ JMCP, 41 (1865): 581–7, 581. 127 ‘Biographie médicale,’ BMB, 2:6 (1835), 149–51. 128 ‘Variétés,’ BSMG, 6 (1840), 175–6. 129 Ibid., 175. 130 Ibid., 176. 131 See for example: the discussion on hysteria in the Ghent medical society: ‘Séance du 7 novembre 1843,’ BSMG, 9 (1843), 199–218, 203–18, 217. 132 Burggraeve, Art de prolonger. 133 Wils, ‘The Revelation,’ 175. 134 In 1865, the board members of the Society of Medical and Natural Sciences of Brussels visited their former president Jean-François-Joseph Dieudonné to express their regret on his current absence from the society’s meetings and their hope for speedy recovery: ‘Bulletin de la séance du 1 mai 1865,’ JMCP, 40 (1865), 580–5. They were deeply concerned about the ‘desperate condition’ of Dieudonné, who, in fact, died shortly after the visit: ‘Bulletin de la séance du 7 août 1865,’ JMCP, 41 (1865), 270–87. A more exceptional case forms the death of President Martin’s wife, which also led to the decision to send a delegation of society members to Martin to express their condolences on behalf of the Society of Medical and Natural Sciences of Brussels: ‘Bulletin de la séance du 5 juillet 1875,’ JMCP, 61 (1875), 75–81, 75. 135 This was the case, for example, with the death of Jean-Joseph Borlée (1845) and Pierre Jean Wauters (1855), who were members of the Medical Society of Ghent: ‘Séance du 4 mars,’ BSMG, 11 (1845): 77–84;

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ULG, Hs. 3012.4.1, Letter of March 9, 1855 from the family members of P.J. Wauters to the Medical Society of Ghent. Mrs Frédericq also wrote to the Medical Society of Antwerp to report the death of her husband Louis-Auguste Frédericq, editor of L’Observateur médical belge: ‘Séance du 23 septembre,’ ASMA, 14 (1853), 498–500. 136 Lados did propose sending a letter of condolence to the family and a committee was established to acquire the necessary information for a biographical sketch and a portrait, which were to be included in the next issue of the Bulletin: ‘Séance ordinaire du 4 août 1868,’ BSMG, 35 (1868), 353–5. 137 ‘Séance du 28 juin 1861,’ ASMA, 22 (1861), 426–9. The donated work was L.J. Saurel, Traité de chirurgie navale suivi d’un résumé de leçons sur le service chirurgical de la flotte par le docteur J. Bochard (Paris: Baillière, 1861). 138 ‘Séance du 9 janvier 1844,’ BSMG, 6 (1840), 3–41. 139 ‘Séance ordinaire du 26 novembre 1869,’ ASMA, 30 (1869), 641; J.C. Broeckx, ‘Le baron François-Mercure Van Helmont, seigneur de mérode, oirschot, pellines, royenborch, etc.,’ ASMA, 31 (1870), 73–88, 129–39. 140 ‘Nécrologie,’ JMCP, 71 (1880), 210; ‘Nécrologie,’ JMCP, 72 (1881), 524; ‘Nécrologie,’ JMCP, 74 (1882), 424 [death of Charles Darwin]. 141 Carl Ludwig’s death was announced by Paul Heger during a meeting of the Brussels Society of Medical and Natural Sciences: ‘Bulletin de la séance du 6 mai 1895,’ JMCP, 97 (1895), 369–74. Heger’s communication was first published as a short obituary; later a full biography appeared in the society’s journal: P. Heger, ‘Nécrologie Carl Ludwig,’ JMCP, 97 (1895), 296–7; P. Heger, ‘Carl Ludwig,’ JMCP, 97 (1895), 375–380. In the same year, Louis Pasteur was similarly remembered: ‘Nécrologie. Louis Pasteur,’ JMCP, 97 (1895), 625; Pechère, ‘Louis Pasteur,’ JMCP, 97 (1895), 657–68. 142 M. Brown, Performing Medicine: Medical Culture and Identity in Provincial England, c. 1760–1850 (Manchester: Manchester University Press, 2011), p. 160.

7

A new scientific landscape

In 1894, professor Paul Heger made a well-received announcement to the Brussels Society of Medical and Natural Sciences. The banker Léon Lambert and several of his acquaintances in the Brussels financial and industrial elite had made a donation of 10,600 Fr to the new Institute of Hygiene, Bacteriology and Therapeutics.1 After Heger had explained that the gift would be used to set up a vaccination service against diphtheria, a discussion was started on the recent progress made in bacteriology. If laboratory science was sometimes criticized for having little effect on actual medical practice, the discovery of the diphtheria bacillus and the successive development of a vaccine, based on serum therapy, proved such critics wrong.2 Moreover, the erection of new scientific institutes and the support these received from philanthropists such as Lambert augmented the prestige and the public visibility of laboratory-based sciences such as bacteriology. This new prestige also reflected on Paul Heger himself. As the architect of the Cité scientifique of the University of Brussels, a campus in the Brussels Leopold Park, Heger embodied the successes of laboratory science and its institutional expansion in the final decades of the nineteenth century.3 Previous chapters have discussed the introduction of laboratory or experimental science in nineteenth-century medicine, albeit indirectly, in the analyses of the changes in scientific manners in medical societies. The more abstract interpretation of ‘science,’ as a form of universal knowledge, that developed in parallel with laboratory methods, underpinned late nineteenth-century shifts in scientific debate, publishing culture, anatomical networks, expert authority and commemorative ideals. This new conception lay precisely at the basis of the erosion of the civil embeddedness of science. In the early and

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mid-nineteenth century, ‘science’ had been represented by the (socially engaged) gentleman. It was tied up with the skills of polite debate and sound literary writing – skills that testified to the cultivation and erudition that seemed inherent to scientific practice. The rise of laboratory experiments altered this conception. The arbitration of scientific ‘truth’ could now only be achieved through experiments, rather than through polite conversation or literary exchanges between gentlemen. In the representation of the (self-sacrificing) professional scientist, the markers of civil identity now lost their value. Moreover, this shift in the conception of medical science, as John Warner has shown, led to a reconfiguration of therapeutic practice and professional medical identity.4 The late nineteenth-century physician rooted his authority in universal biomedical knowledge rather than in his experience as a judge of patients’ individual health conditions. It was a move, in Warner’s words, from the ‘exercise of judgment’ to the ‘application of knowledge.’5 This chapter examines the professionalization of science, of which the introduction of the laboratory was part, on a more ‘macro’ level. It focus on wider transitions in the scientific landscape of the late nineteenth century, which altered the position of urban societies. The breakthrough of experimental science, in fact, reinforced an ongoing process of fragmentation of the medical sciences into a wide array of specialized disciplines, of which some (e.g. bacteriology) grounded their right of existence in the scientific methods of the laboratory.6 Other disciplines, which were based on (traditional) clinical observations (e.g. dermatology), were equally strengthened, as the ideal of modern, universal knowledge took the edge off the traditional argument of patients’ individuality and physicians’ experience. Knowledge from the clinic was now more easily transposed to medical practice, empowering the hospital as a site of scientific knowledge.7 These processes of specialization turned the last decades of the century into a period of intense organizational reform – a period comparable to the 1830s and 1840s, discussed in the first chapter, when the general learned society had disintegrated into separate medical, literary and artistic societies and a new balance was established between state interference and private initiatives. By 1900, the scientific landscape was no longer the same. Universities and hospitals had become the central institutions of scientific research. The space for ‘civil science’ in the world of the urban

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bourgeoisie, in which medical societies had flourished, was considerably reduced. The chapter first discusses the emergence of new scientific meeting places (e.g. national specialized societies and international conferences), which took over many of the arbitrational functions of urban societies. As science became structured according to a sub-disciplinary logic, the determination of what could be considered ‘scientific’ knowledge shifted to these new specialized over-arching spaces. At the same time, the function of traditional urban societies was reconsidered. They now took up new roles as mediators between the local, the national and the international level, as well as between the different medical subdisciplines. In a landscape marked by specialization, urban societies occupied a unique position because of their ‘general’ character and provided a space for discussion across disciplinary divides. Alongside these new functions, scientific vulgarization also increased. The traditional role of urban medical societies, of engaging the medical public in the sciences, was now recast in terms of postgraduate education. These different changes are indicative of the demise of medical societies as ‘normative’ scientific institutions – as the central spaces where scientific standards were set. But they also provide insight into late nineteenthcentury processes of discipline formation and specialization by showing how spaces of general debate and vulgarization co-developed with new specialized institutions. National and international forums

Specialization in medicine existed well before the late nineteenth century. As George Weisz has convincingly argued, the Paris medical community of the 1830s and 1840s was marked by a considerable degree of specialization, which manifested itself in the gradual rise of specialized journals, private teaching in specialties and in the different divisions of hospital services.8 In Belgium too such specialization took shape in the middle of the century. The review sections of societies’ journals were, for example, typically divided into medical specialties (e.g. children’s diseases, obstetrics, pathological anatomy, legal medicine etc.). The Belgian Academy of Medicine was similarly structured in different sections. Yet it was only from the 1880s onwards that these specialties became institutionally grounded in academic chairs and

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specialized societies. According to Weisz, the resistance against specialization disappeared as specialization became associated with ‘modern science’ and the model of the German research university. Specialization now became almost a requirement for any form of medical education or research that aspired to a scientific status.9 Unlike in France, the institutionalization of medical specialties in Belgium entailed, most of all, the diminution of the decentralized structure of the scientific community, which comprised of different local communities in the major cities. Specialized knowledge rather than location became the organizational principle. As a corollary, new over-arching meeting places emerged that united like-minded specialists. These new spaces developed initially at the national level. What, in the middle of the century, had only been realized by the state-sponsored Academy of Medicine, a truly ‘national’ scientific society, took place on the level of medical specialties in the late nineteenth century. One of these new national societies was the Belgian Society of Gynecology and Obstetrics (1889). The collaboration between the Brussels professor Deroubaix and his Leuven colleague Hubert in the leadership of the society testified to the way in which the local (and in this case also ideological) divides that had traditionally marked the organization of scientific societies were now bridged.10 A second feature of this new type of society was the pursuit of both scientific study and the defense of professional interests. While the exclusion of professional matters had been essential to the profiling of urban medical societies as ‘scientific’ societies, the combination of both seemed self-evident within a disciplinebased framework. The institutional anchoring of specialties was in fact considered a prerequisite for their further scientific development. The Society of Forensic Medicine of Belgium (1889), for example, both aspired to improve forensic medicine as a field of scientific study and lobbied for specialist training at the universities and greater professional recognition by the state.11 The same ambitions steered the foundation of numerous other discipline-focused societies, which united psychiatrists, public health specialists, dermatologists, ophthalmologists, urologists etc.12 A closer look at one of these specialized fields, psychiatry, allows this process to be interpreted as a search for more responsive audiences. The foundation of the Society of Mental Medicine (1869) forms one of the earliest examples of a specialized society. The society initially remained

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rooted in the local ground of the Ghent medical community. Frequent debates on the treatment of psychiatric patients, the origins of their condition and the architecture of insane asylums had turned the regular Medical Society of Ghent into the center of Belgian psychiatry by the middle of the century. Joseph Guislain’s pioneering research, his (philanthropically framed) calls for better living conditions in the asylums and the construction of the Institut Guislain (1857) in Ghent were the reasons behind this dynamic.13 The participation of several Belgian psychiatrists, such as the national inspector of insane asylums Victor Oudart and the director of the public psychiatric center in the town of Geel, Jean-François Bulckens, as correspondents to the society further testifies to its leading role.14 In 1861, Bulckens had, for example, travelled to Ghent to partake in the debate on the Geel model of lodging the insane with private families.15 Given this tradition of ‘national’ debates within the Ghent medical society, the foundation of an overarching psychiatric society in Ghent did not appear out of thin air. Its initiators were Auguste Vermeulen, who led the psychiatric asylum De Strop for the more affluent patients in Ghent, and Benjamin Ingels, who had succeeded Guislain as the head of the Institut Guislain. Both were active members of the Medical Society of Ghent. The new Society of Mental Medicine, which met four times a year, also used the meeting room of the Medical Society of Ghent in the Ghent town hall.16 Among its founding members were the directors of insane asylums in other cities, including Joseph De Smeth from Brussels, François Van den Abeele from Bruges, François Lentz from Tournay and Bulckens from Geel.17 In its early years, the society only gradually emphasized the autonomy of psychiatry as an independent scientific discipline. The presidency of Benjamin Ingels of both societies and the legacy of Guislain ensured a close connection between the Ghent medical scene and the new Society of Mental Medicine, at least until Ingels’ death in 1886.18 The subject matter of the Prix Guislain, which in Guislain’s view should have considered a question of medical practice, offers the first indications of such a disciplinary emphasis.19 The prize competition typically included matters related to psychiatry, such as the medical doctrines that together formed ‘psychiatry’ (1869), the scientific progress made in psychiatry since the beginning of the century, and the influence of Guislain’s works in this process (1875). The 1875 competition was won

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by François Lentz, the director of the Tournay insane asylum and a founding member of the Society of Mental Medicine.20 Lentz’ historical narrative, in which Guislain’s legacy occupied center stage, grounded psychiatry as an independent discipline. This connection between Guislain’s work and the ‘psychiatric science’ was made even more firmly at the inauguration of Guislain’s statue in 1887 – the result of a campaign that was started five years earlier by the society.21 Lentz, now in his capacity of secretary of that same society, delivered a clear message at the event: It [the statue] will be the torch that enlightens the people by inspiring in them respect for the insane, regard for the psychiatrist and trust in the sciences of the mind [la science mentale]: by glorifying the man, it will demonstrate in everyone’s eyes, the science for which he stands and of which he was one of the most illustrious representatives; it will be the public recognition of the right of the psychiatric specialism to exist.22

The recasting of Guislain’s legacy in specialist terms was indicative of the spirit of the age. If the ideal of observation-based science, in the service of medical practice, had formed the shared framework for ‘specialists’ and medical practitioners alike (categories that were not mutually exclusive in the middle of the century), specialists now strived for more autonomy and recognition. The same mechanisms of community building which had tied the medical community to the Belgian nation in the mid-nineteenth century seemed to operate on the level of medical specialties. A new terminology of the ‘sciences of the mind’ and a clear connection between these sciences and the social status of its practitioners formed the central axis on which psychiatrists sought to build their own field. This more autonomous course of the Society of Mental Medicine went along with a change in its leadership. Since the mid-1880s, Jules Morel increasingly set out the policy of the society. As Ingels’ assistant in the 1870s, Professor of Chemistry at the Ghent industrial school and Professor of Anatomy at the Academy of Beaux-Arts, Morel had initially been fully part of the urban medical world in Ghent. During this period, he had modernized the Bulletin of the Medical Society of Ghent (by adding more summaries of articles from international medical journals) and had also edited the Bulletin of the Society of Mental Medicine.23 Yet, after succeeding Ingels as the head of the Institut Guislain in 1886,

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Morel’s career developed increasingly on a national level. As the secretary and later president of the Society of Mental Medicine, he epitomized the struggle for the academic grounding of psychiatry as a specialism, working hard for the professionalization of the staff of psychiatric institutions as well as for the reform of coursework in psychiatry at the universities. By then, the membership of the society had reached around forty members from all over the country and its meeting room had also been moved from the Ghent town hall to the more centrally located Brussels Palais de l’Université, the main university building.24 This relocation, in a sense, marked the growing autonomy of the psychiatric field from the Ghent medical community at the turn of the twentieth century. The case of psychiatry and the Society of Mental Medicine forms but one of the possible trajectories that could be followed in the establishment of scientific disciplines. The growth of the society out of one particular urban center (Ghent) to a full-scale national organization was not necessarily a ‘model’ for the development of other medical specialties. The Royal Society of Public Health (1876), which united the Belgian public health specialists, for example, developed out of different local groups in Belgium’s major cities. With a central board and regional divisions, the society was organized in a different way than the Society of Mental Medicine, resembling more the structure of the Belgian Medical Federation. While specialization in psychiatry and public health was driven by increasing state investments in these areas, other medical sub-disciplines (such as dermatology or ophthalmology) developed out of the division of labor in hospitals. The extent to which the trajectories of these disciplines differed remains unclear. While ophthalmology is, for example, typically presented as an ‘early specialism’ – in Belgium as well, the epidemic of ophthalmia in the first half of the century had inspired a considerable degree of specialization25 – the foundation of the Belgian Society of Ophthalmology (1896) occurred relatively late in comparison to other medical specialties.26 To account for such differences, more research is needed into these specialized societies as well as into the clinical settings out of which they developed. The increase in scale, of which these new specialized societies testified, was not limited to the national level. International scientific conferences formed a similar ‘new’ and often discipline-based meeting place

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in the late nineteenth century. As Wolf Feuerhahn and Pascale RabaultFeuerhahn have argued, these conferences were ‘the echo of the transformations of modern life: the professionalization of science, the drastic improvement and acceleration of transport, the augmentation of the carriers of information.’27 As new places of scientific debate, international conferences took over the function of urban societies. Scientific disagreements, which in the middle of the century had been settled in societies and academies (e.g. Seutin’s priority dispute with Velpeau), were now increasingly arbitrated on the international level. National interests nevertheless continued to influence scientific debates, revealing the boundaries of such an atmosphere of ‘internationalism’.28 Moreover, international conferences also supported the formation of new disciplines: they determined who could or could not be considered part of the disciplinary community and which topics were regarded as ‘scientific’ questions.29 At the same time, the function of local societies was reconsidered. Urban medical societies had, in fact, always cultivated a certain international character. Through their reviews of international journals and their network of foreign correspondents they had stimulated a debate (in print) that easily crossed national borders. They had operated, in fact, as intermediaries in the international circulation of knowledge. As the scientific debate moved to the over-arching space of the conference, this intermediary function shifted to informing local communities about international developments and mobilizing them for upcoming meetings. The Brussels Journal de médecine published the announcements and programs of new conferences as well as the reports of past events.30 For conference organizers, the fixing of a suitable date, these announcements show, proved a difficult undertaking, since overlaps with other conferences were to be avoided. In 1895, the third International Conference of Dermatology was, for example, postponed because it coincided with the annual meeting of the British Medical Association.31 Conferences were often organized during international exhibitions and world fairs. At the 1885 world fair in Antwerp both the Royal Society of Public Health and the Society of Mental Medicine organized a conference in the city.32 Four years later, when a world fair was held in Paris, the Brussels editors collected the dates of fifty-four of the sixtynine Paris conferences for their readers, who might be interested in

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attending those that concerned the medical sciences.33 When a world fair was again organized in Antwerp in 1894, the organizational committee invited the Brussels Society of Medical and Natural Sciences to participate in the organization of conferences, which were regarded to augment the prestige of these exhibits and attract an international audience.34 These examples show the participation of medical societies in the machinery that promoted and diffused an ‘international spirit’ in the sciences. As such, they form places where not only the spreading, but also the reception of this spirit in national and local scientific communities can be studied.35 Awareness of the performative nature of the reports of these conferences, which appeared in societies’ journals, offers opportunities in this light. In fact, these reports were not only informative texts; they were also a means for its authors (the conference-goers) to present themselves as respected and authoritative specialists. In 1862, the Antwerp physician François-Aimé Rul-Ogez repeated the speech he had delivered at the first meeting in Brussels of the International Association for the Progress of the Social Sciences in the Antwerp Medical Society.36 Such a performance allowed Rul-Ogez to reinforce his call for courses in hygiene in schools to reduce tuberculosis among the workers population by associating his efforts with those of an international group of respected social reformers.37 A similar use of one’s international activities to augment one’s local authority was Édouard Van den Corput’s report of an international conference for physicians who worked in the colonized territories, which was held in Amsterdam in 1883. In his report, Van den Corput included a full account of his call for the foundation of an International Sanitary League.38 The report not only strengthened Van den Corput’s international profile, it also shows how conference reports in societies’ journals were carefully edited, highlighting some and leaving out other parts of the debates. Dialogue between specialties

Rul-Ogez’s and Van den Corput’s speeches hint at a new function for urban societies. What seemed old-fashioned, their lack of focus on one specialism, also proved a strength. The reason for this is that specialists, in carving out a new space for their disciplines, needed to consult with

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their medical collegues and secure the latter’s support. To be clear, this function was not the same as the arbitration of the mid-nineteenth century, when societies were at the center of the medical sciences and assessed the quality of new research. In a scientific landscape that was being reshaped by the forces of internationalization and specialization, urban societies were effectively marginalized. New, original research was rarely discussed in their meeting rooms. Society debates rather took the form of a dialogue between the main professional subgroups that were represented among their members: clinicians, public health professionals and laboratory scientists. At best, this dialogue led to new insights and collaborations. But in many cases, presentations remained superficial and evoked little actual debate, a type of promotional event. Each medical subgroup thus had its own agenda and tried to use urban societies to advance their particular program. Laboratory scientists most clearly used urban forums as promotional venues. If their most innovative research results were now presented (and accredited) on the national and international level, urban societies – as the appreciation for Paul Heger’s efforts has shown – could be helpful to secure additional support for new investments in infrastructure at a time when experimental science was still in its infancy. To convince a broad medical public, several strategies were used. First of all, the value of laboratory research for medical practice and public health was stressed. The vaccination services of the Brussels Institute of Serotherapy, for which Heger had collected donations, and the Central Office of Vaccination, which was modernized by the Belgian state in 1882, received much positive publicity in societies’ journals.39 Jules Van den Berghe, who had set up an agricultural laboratory in Roeselare communicated his analyses of the local water supply and the chemical composition of bread to the Medical Society of Ghent.40 These services concretized the gains of laboratory-based science. Plans for new laboratories were also presented during society meetings. Camille Verstraeten, Jules MacLeod and Charles Van Bambeke communicated reports of their visits to foreign laboratories and plans to establish similar institutions at Ghent’s university.41 Such promotional efforts were not unique to academic laboratories. The Antwerp clinician Edmond Trétrôp similarly presented a plan (and photos) of the Laboratory for Bacteriology and Pathological Anatomy he had set up in the

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11  Photo of the Laboratory of Bacteriology and Pathological Anatomy in the Antwerp Stuivenberg Hospital.

Antwerp Stuivenberg Hospital to the Medical Society of Antwerp.42 Advocates of experimental science, in state institutions and universities alike, were well represented at societies’ meetings. Plans, reports and announcements were not the only ways in which laboratory science was made tangible in medical societies. New ways of visualizing research results were also introduced. Microscopic and histological specimens were increasingly presented during societies’ meetings to support scientific claims. Similar to the way surgeons presented pre-operative drawings and plaster casts side by side with their recovered patients, public health specialists and clinicians used these specimens to illustrate their scientific assertions. But there were also clear differences between both types of performance. If mid-nineteenthcentury surgeons, such as Auguste Sotteau, had presented (series of) patients in support of their priority claims concerning new surgical

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techniques, the ‘demonstrations’ of microscopic specimens were of a rather promotional, vulgarizing nature. In 1884, most members of the Medical Society of Antwerp must have seen the cholera bacillus, identified by the German researcher Robert Koch one year earlier, for the first time during such a demonstration at the society. As the meeting report documents: ‘Mr Schleicher shows the assembly the comma-shaped cholera bacilli of Koch. These curved bacilli are clearly visible at a magnification of 600 diameters. They are colored violet on a white background.’43 Such presentations were not intended to accredit one’s individual scientific findings, they rather advanced bacteriological research in a more general way by updating local medical communities on international discoveries. Presentations of laboratory findings were not limited to bacteriology. By the middle of the 1880s, specimens were used by specialists from a range of medical sub-disciplines to advance the introduction of experimental methods. In the Medical Society of Ghent, Dr Nepper showed a ‘microscopic specimen of blood’ when he presented his work on the transformation of red blood cells;44 the ophthalmologist Daniel Van Duyse on one occasion ‘gave a demonstration of the microbe of tuberculosis’ and later showed ‘microscopic preparations of membranes’ in a discussion of a work on menstrual pain.45 His colleague and later Professor of Hygiene and Bacteriology, Emile Van Ermengem, ‘gave a lecture with demonstration, on photogenic bacteria’.46 And the veterinarian Remy, director of the Ghent abattoir, ‘showed microscopic preparations of bacillus anthracis and presented inoculated animals’ during one meeting.47 Dr Claeys accompanied his work on the structure of the retina by ‘numerous histological specimens and showed beautiful photos that illuminated the facts advanced in his work.’48 The presentation of these different specimens testifies to the growing authority of laboratory findings as ‘evidence’ of scientific claims. In ophthalmology, bacteriology and physiology alike, microscopic specimens became an integral part of scientific debate. The reception of these new experimental methods nevertheless varied from subfield to subfield. Epidemiology forms an example of the enthusiastic acceptance of laboratory science, of which the introduction was perceived almost as a revolution. In 1899, a study on cholera, published in 1885 by Abraham Mayer, one of the first generation of public health professionals in Antwerp, and based on traditional

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topographical methods, was attributed ‘a purely historical interest, as the current methods have rendered the old ones obsolete.’49 Yet, in most other medical subfields, new and old knowledge claims were rather weighed against each other. Because of their general nature, medical societies formed suitable spaces for such efforts of synthesis and integration. Their original goal of bringing science closer to medical practice facilitated discussions across different disciplines on how the new laboratory sciences could improve diagnosis and therapy. Societies, in other words, formed spaces where the central question John Warner has identified in his study of the American reception of laboratory science – Cui bono? To what benefit? – was continuously addressed. The debate on tuberculosis forms a telling example in this light. Its causes and treatment feature among the most widely discussed topics in medical societies during the late nineteenth century. The reception of Robert Koch’s research into the tuberculosis bacillus, in particular, reveals how the practical uses of laboratory science were being negotiated.50 When Koch’s tuberculin therapy (based on extracts of bacteria) was announced, responses in the Belgian medical community generally stressed the need for clinical confirmation of the proposed cure. In the Antwerp Annales, a rather critical article appeared, in which Koch’s experiments were described as ‘only laboratory experiments, which lack the supreme sanction of experiments on men.’51 Clinical observations remained the ultimate test. Experiments with Koch’s treatment by Dr Casse in the seaside town of Middelkerke similarly revealed a useful effect, but also stressed the treatment was not at all ‘an absolute remedy.’52 In the Medical Society of Ghent, another new treatment, which was based on the inhalation of heated air as a means of destroying the tuberculosis bacilli, was equally received with reserve. Dr Debersaques compared the new treatment to the surgical operations of patients’ lungs, dermal injections, and anti-parasitic substances, which each had inspired great hope, but had not delivered the desired clinical results.53 The reception of laboratory-based treatments of tuberculosis was thus rooted in a tradition of practice-based science, which inspired prudence and mistrusted claims of new panacea. Opposite to such hesitance vis-à-vis miracle treatments stood the enthusiastic participation of society members in the machinery of prevention and recovery that emerged in the same period around the disease. Instructional booklets and campaigns for the construction of

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sanatoria reveal the mixing of new scientific knowledge with existing notions of hygiene. The tuberculosis campaigns of the late nineteenth century therefore form an example of what David Barnes has called the ‘sanitary-bacteriological synthesis,’ the process in which hygienic measures, which were originally based in the miasmatic theory, were integrated with new bacteriological disease claims.54 In the Medical Society of Antwerp, discussions on the prevention of tuberculosis through ventilation, the improvement of nutrition and physical exercises grounded older hygienic notions in modern science.55 These discussions are also revealing of the role of medical societies in this developing machinery. While they clearly performed a mediatory role by fitting in old principles with new disease claims, they also proved unfit to set up large preventive campaigns. These were now organized on an unprecedented scale by new institutions such as the National League against Tuberculosis (1898).56 While the Antwerp society had initially provided publication space to the League, it later asked the urban government and the local medical commission to publish ‘these [preventive] books, [which are] too expensive for private societies.’57 Public initiatives, such as spreading brochures on a large scale, were now left to larger organizations. If public health specialists successfully integrated laboratory science with their traditional program, how did clinicians respond to these new knowledge claims? As the example of tuberculosis has shown, clinical observations continued to form a central component in the assessment of new treatments. In urban medical societies, their importance was not reduced at all. To the contrary, the presentation of patients rather increased in frequency in the final decades of the century.58 Such a finding may, first of all, put the growing specialization of the late nineteenth century into perspective. Laboratory directors such as Heger and Trétrôp regularly attended and participated in collective clinical examinations during society meetings. Secondly, the pathologies of these patients were presented more accurately. Compared to the middle of the century, when patients’ names, family situation, work and ‘constitution’ were mentioned, their personal backgrounds now received far less attention. Instead, new technologies, such as photography and tissue specimens, were used to present a seemingly more objective and detailed report of the now anonymous patient.59 These developments show that clinical and laboratory medicine shared an ideal of objective,

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depersonalized knowledge and strived for a similar ‘objectification’ of medical knowledge. As the primary sites of these increasingly ‘objective’ observations, hospitals became more active players in the scientific field. The reviews of their publications in societies’ journals supported this evolution. In a review of the annual report of a hospital in Boston in 1884, the Ghent professor Nicholas-Chrétien Du Moulin called upon the major Belgian hospitals to publish similar works.60 His call was answered by the Liège professor Masius and his assistants who published their Records of the Clinic of Internal Medicine at the University of Liège in 1887, a work that compiled and discussed the most interesting observations in the hospital between 1877 and 1882. According to Dr Naudts, who reviewed the work for the Ghent society, the Liège Records were of great ‘practical’ value because of their diagnostic remarks for each of the discussed pathologies. But Naudts also added a revealing comment on the relation between bacteriological analyses and clinical medicine: The period in which the observations have been gathered explains, to a certain extent, the nearly complete absence of bacteriological diagnosis. This science, these days, is definitely part of clinical medicine and its revelations have a character of certainty perhaps greater than those delivered by certain methods such as, for example, the analysis of gastric juice.61

Naudts’ remark demostrated the growing faith in the scientific certainty offered by bacteriological research. His message was one of integration: clinical research could only become stronger by embracing the methods of the modern laboratory. Such views of synthesis, however, were not shared by all medical practitioners. The question of the scientific validity of clinical versus laboratory research could also become a matter of dispute. In a scientific disagreement between the surgeons F. Van Imschoot and Jules Félix on the treatment of cancer, the latter reproached the former with not having conducted microscopic examinations of his patients’ tissues: ‘Only the microscope, in fact, is on its own capable of confirming a diagnosis in a certain, incontestable way. For us, all diagnoses that are not based on histological examinations present no scientific value.’62 Van Imschoot, in turn, defended his diagnosis by referring to the experience-based tradition of clinical observations and claimed to have

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fulfilled ‘the true mission of the medical practitioner, by never forgetting that medicine is a science and its practice a calling.’63 He further strengthened his position with a reference to ‘the immortal principles of Hippocrates: “first preventing, then healing and finally comforting.”’64 By stressing both his empathic relation to his patients and his trust in observation-based science, Van Imschoot presented a different model of the more intimately connected relation between science and medical practice. The certainty of laboratory methods was indeed not always embraced. The exchange between Van Imschoot and Félix is an example of a substantive debate, one that was more than ‘promo-talk’. It shows that societies’ new, more modest role as spaces of dialogue between all sorts of physicians could materialize in a mediation between old and new knowledge claims. It is also revealing of the mechanisms of such mediation. The balancing of clinical and bacteriological findings was a two-way process. On the one hand, new laboratory-based treatments were critically assessed on the basis of (traditional) clinical observations, curtailing some of the more revolutionary ambitions of laboratory science. On the other hand, laboratory analyses were said to bring a new degree of certainty to existing clinical methods, exposing what seemed the ‘subjective’ side of clinical observations. Such mediations reveal urban societies’ role as spaces of deliberation, places where specialists’ views on science could either collide or turn out to be complementary. Democratization and postgraduate education

As already shown in previous chapters, the membership of medical societies changed in the late nineteenth century. Societies became less exclusive, for example by opening their doors to promising medical students. At the fifty-year jubilees of the 1880s, academics reformulated the role of urban societies as local spaces of advanced study, where the (academic) scientific community could be filled up with new young researchers.65 By the end of the century, a further broadening of societies’s membership occurred. This evolution went hand in hand with the changes in the nature of society debates, from the arbitration of original research to the promotion and discussion of specialist research across disciplinary borders. The former function required a certain exclusivity to maintain high standards, with medical societies acting as the

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gatekeepers of the scientific community. The latter function, if it was to be conducted effectively, rather necessitated societies to reach a larger medical audience. As they approached the new century, societies thus lost much of their traditional features and developed into much broader institutions. Democratization, moreover, was a wider trend in late nineteenthcentury medical sociability. Physicians became members of a diverse range of societies, most of which, but not all, were of a specialized nature. Regional and provincial medical societies testify most clearly to this trend. Such societies had existed since the middle of the century (e.g. the Society of Practical Medicine of the Province of Antwerp (1836)), but they became much more successful in the late nineteenth century. The Medico-Surgical Society of Brabant (1890), for example, united the provincial physicians in the vicinity of Brussels. Founded on the initiative of the Brussels professor Jean Crocq, the society saw itself as a counterpart to the Brussels Society of Medical and Natural Sciences, whose membership limitations were said to exclude many scientifically interested physicians. By 1895, the society counted more than a hundred members; by 1908 this number had grown to three hundred.66 Besides scientific questions, the society also considered matters of professional interests. In Liège, this resulted in an early merger between the two society types: the Medico-Surgical Society of Liège incorporated the Medical Circle of Liège in 1887.67 As membership democratized and societies functioned more and more on a regional level, their activities increasingly fit in with the diverse (scientific and professional) needs of general medical practitioners. In the traditional urban societies in Belgium’s major cities, these changes in medical sociability were not without effect. Here as well, democratization occurred. In the Society of Medical and Natural Sciences in Brussels, which had traditionally been the most elitist of all urban societies, the number of members was successively brought from thirty to thirty-five in 1888, to forty in 1891, to forty-five in 1896 and finally to fifty in 1898.68 In Ghent, the exclusively ‘medical’ character of the city’s medical society was broadened in 1885. ‘Anyone who occupies himself with the medical, natural or physical-mathematical sciences and who expresses the desire to attend the meetings of the society or to establish scientific relations with it’ could now become a member.69 The requirement to submit an unpublished study was abolished but

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later, at Ingels’ request, restored.70 In the final years of the century, discussions on the loosening of membership regulations again took place. In 1900, plans were made to set up a ‘a Medico-Surgical Society of a more democratic character’ – plans which, however, never seem to have materialized.71 In the Medical Society of Antwerp, membership rose steeply in these years. If the society had counted around fifty members in the middle of the 1880s, this number had grown to a hundred and twenty in 1905. Moreover, in 1895 a split had occurred in the society. According to Jacob Van Lennep’s account of this episode in 1955, based on inquiries of the oldest members in the 1940s, the rejection of the Jewish physician Landeau lay at the basis of the conflict (of which the society’s meeting reports speak only in guarded terms).72 As a result, the Medico-Surgical Society of Antwerp (1896) was founded by the dissident members. The fact that the new society remained more exclusive and was dominated by hospital physicians hints at underlying, more structural reasons for the secession. This broadened membership brought about adaptations to societies’ functioning at the turn of the twentieth century. Instead of debating pioneering scientific research, more general forms of knowledge transfer were now developed. Vulgarizing lectures (conférences) were intended to inform medical practitioners of recent scientific developments in a specific specialism. Such lectures regularly appeared in the Brussels Journal de médecine and dealt with general topics such as ‘Theories of Contagion in Illness’ or ‘The Functioning of the Brain. Practical Applications.’73 In that same journal medical practitioners could also find announcements of the ‘practical sessions of micrography’ that were organized by the Society of Microscopy in the Brussels botanical garden or of the postgraduate summer courses of the University of Brussels.74 The members of the Medical Society of Ghent introduced monthly debates on ‘one or more topical questions of practical interest, [which] will be taken from the diverse branches of the medical sciences’ in the middle of the 1890s.75 Among the initial topics for debate were serotherapy and ‘the current treatment of osteo-arthritic tuberculosis’.76 In Antwerp, the organization of general lectures formed the first step in the rapprochement between the Medical and Medico-Surgical Society in the city. In the early twentieth century, Dr Conrad of the latter society would take the lead in the organization of ‘postgraduate conferences’ in the city.77

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An increase in the accessibility of societies’ collections formed a second way in which the broadening of societies’ membership impacted on their functioning. Societies’ libraries were now moved to different institutions, where they would be more easily accessible to their members. In Brussels, the society’s library (which resided with its secretary and had suffered a severe loss due to a fire in 1886) and its meeting room in the Brussels town hall, were moved to new rooms provided by the University in 1890.78 The move, in a sense, symbolized how science withdrew from the civil spaces it had occupied in the early and mid-nineteenth century. The library of the Medical Society of Antwerp was transferred from the city’s library, where it had been insufficiently updated according to the society members, to two rooms in the Antwerp Athenaeum, which were made available through the intermediary of Victor Desguin, at that time member of the town council. In 1919, the library was again moved to the newly purchased House of Physicians [Geneesherenhuis] in the Louizastraat.79 The Medical Society of Ghent seems to have stored its books in the University Library in the early twentieth century, but continued to manage the collection itself. Such arrangements were not uncommon in this period and were encouraged by librarian-in-chief Ferdinand Vanderhaeghen, who often provided literary and scientific societies with meeting rooms and library space.80 Vanderhaeghen’s close ties with the society – he had been named an honorary member as a mark of appreciation for his biographical work on Palfyn – undoubtedly facilitated such collaboration. In 1931, the society finally donated its full collection to the University Library.81 At the same time, the use of Flemish during societies’ meetings was debated for the first time. Since Belgium’s independence, Flemish had disappeared, with very few exceptions, from the scientific medical press.82 In 1905, a discussion occurred in the Medical Society of Antwerp on the equality of Flemish and French, which resulted in the society becoming bilingual in 1906, and the first articles appearing in Flemish in the Antwerp Annales.83 In 1907, bilingualism was also introduced in the Medical Circle of Antwerp.84 Although further research is needed, the movement for the revaluation of Flemish as a scientific language in the medical field seems to have gained much strength in the interwar years, especially in the wake of the foundation of the Flemish Academy of Medicine in 1938.85 The introduction of Flemish, together

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with the democratization of societies, shows how a tradition of exclusive, civil and unilingual French scientific sociability among the medical elite was fading. The centenaries of urban medical societies in the 1920s and 1930s consolidated these changes in medical sociability. Their histories were rewritten from the viewpoint of the now disciplinary structured and (inter)nationally organized scientific field. In 1922, Paul Heger and Edgard Zunz retraced how ‘critical overviews of topical questions had replaced preliminary communications of original facts’ in the Brussels Society of Medical and Natural Sciences.86 New national scientific societies, such as the Belgian Society of Biology, they argued, now ‘allowed the rapid diffusion of the favorable findings of the research in our laboratories.’87 The Brussels society, in turn, had been transformed into ‘a society of mutual education’.88 At the centenary of the Medical Society of Ghent in 1934, president Van Cauwenberghe retraced this educational function into the society’s past. Shortly after Dutch had become the official language of the university, he addressed his colleagues in Dutch (in an otherwise still unilingual French celebration), praising the Ghent’s medical professors, ‘who had powerfully supported our Society since its foundation, and who inform us now, as in the old days, of their investigations and experiments in the beautiful laboratories and clinics of the University.’89 Van Cauwenberghe’s further historical reflections tellingly focused on the discoveries in bacteriology since the late nineteenth century, leaving out a period of pre-laboratory science in which urban societies had taken up a much more decisive role in the scientific landscape. A contemporary agenda produced a new view on societies’ history. As a corollary, the scientific function of local medical societies was interpreted against the backdrop of medical specialization. Such interpretations could sometimes carry a (critical) overtone of a bygone ‘general’ medicine, as secretary Debersaques’ speech at the Ghent centenary illustrates: Every specialism currently has its own society. The result being that regional societies have lost their prestige. Yet these societies serve a useful purpose. Specialization is necessary. But it is to be feared that specialization, pushed to its extremes, might become dangerous. […] Societies such as ours are necessary to permit the practitioner to become acquainted, by a talk of a particularly qualified colleague, of the progress

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made in recent years in such or such domain of medicine, to allow physicians to expose and discuss clinical observations – ars medica tota in observationibus -, to examine the causes and eventually be clear about the means to control regional epidemics.90

Debersaques’ words show how the tradition of émulation, which had marked the earliest medical societies, was recast in terms of postgraduate education in the early twentieth century. The same practices of discussing clinical cases and staying updated on the medical literature were no longer presented as a means of emancipation for physicians, a means to contribute to the medical sciences, but rather as a means to counterbalance the losses (or dangers) that came along with medical specialization. As the medical sciences dispersed into different specialties and the gap between science and medical practice increased, urban societies were turned into somewhat atypical spaces of scientific unity in the medical landscape. They preserved, in a sense, the ideals of practice-based science that had formed the basis of their foundation. These ideals were now rather voiced as a necessary counterweight to an all too specialist interpretation of modern medicine. As such, urban medical societies no longer accommodated the scientific needs of the medical elite. Processes of democratization and initiatives of postgraduate education had now tailored them to the needs of a much broader medical audience. This chapter has traced how the breakthrough of laboratory science reshaped the Belgian scientific landscape, fundamentally altering the position of medical societies. As experimental science reinforced specialization and augmented the role of universities and hospitals as scientific institutions, urban medical societies lost their central function as the ‘arbiters’ of the scientific community. The validity of scientific knowledge now became increasingly discussed on the national and international level; research results were published in international journals; and access to the scientific community became regulated in research institutes. This shift, however, did not result in societies’ disappearance. They took up a new role as mediators, as spaces of dialogue across specialties. Nevertheless, societies moved from center to periphery. If they had once represented the ‘forefront’ of the medical sciences, they now operated from the margins and went somewhat against the

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current. They became one of those scarce places where the gaps between subdisciplines, and between medical science and medical practice – gaps created by the restructuring of the medical field in disciplinary specialties – could be bridged. This also resulted in a new relation between universities and societies. For the better part of the century, they had been complementary institutions. Societies acted as the gatekeepers and publishing houses of the academic community, while universities provided the infrastructure for research. In the late nineteenth century, this symbiotic relationship was recast in a much more hierarchical form. Societies now became tools for academics in the diffusion of scientific knowledge across sub-disciplinary divides, a means to compensate for the lack of ‘general’ medical science, which seemed, in the eyes of academics, a mere side-effect of scientific progress. Notes 1 ‘Bulletin de la séance du 1 octobre 1894,’ JMCP, 96 (1894), 713–22, 715. On the relation between the industrial elite and the Brussels scientists: K. Bertrams, Universités et entreprises: Milieux académiques et industriels en Belgique, 1880–1970 (Bruxelles: Le Cri Éd, 2006). 2 In the discussion, the practical use of bacteriological innovations, in particular, was stressed: Ibid., 716–19. See also: J.H. Warner, ‘Ideals of Science and Their Discontents in Late Nineteenth-Century American Medicine,’ Isis, 82 (1991), 454–78. 3 When the Cité scientifique was inaugurated in 1895, Heger was praised for his devotion to the sciences as one of the originators of the new campus: ‘L’inauguration des Instituts à l’Université de Bruxelles,’ JMCP, 97 (1895), 689–97. On the Cité scientifique see: A. Despy-Meyer and D. Devriese, Ernest Solvay et son temps (Brussels: Archives of the ULB, 1997); A. DespyMeyer and D. Devriese, ‘Paul Heger, maître d’œuvre des Instituts d’enseignement et de recherche en science médicale voulus par Ernest Solvay à Bruxelles (1891–1895),’ in De Toga om de Wetenschap, Special issue of Gewina, 16 (1995), 90–103. The new Brussels campus was not an isolated case. In Ghent, the Institute of the Sciences [Institut des Sciences] was inaugurated in 1890, and in Liège and Leuven, a series of institutes were realised by Walthère Spring and Henry de Dorlodot. For a brief overview: R. Halleux, Tant qu’il y aura des chercheurs; Science et politique en Belgique de 1772 à 2015 (Bruxelles: Luc Pire, 2015), pp. 44–7. 4 J.H. Warner, The Therapeutic Perspective: Medical Practice, Knowledge and Identity in America, 1820–1885 (Cambridge: Harvard University Press,

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1986), pp. 258–83; A. Cunningham and P. Williams, ‘Introduction,’ in A. Cunningham and P. Williams (eds), The Laboratory Revolution in Medicine (Cambridge: Cambridge University Press, 1992), pp. 1–13. Warner, The Therapeutic Perspective, p. 260. G. Weisz, Divide and Conquer: A Comparative History of Medical Specialization (Oxford: Oxford University Press, 2005). On the decline of the principle of specificity of diseases: Warner, The Therapeutic Perspective, pp. 264–5. G. Weisz, ‘The Emergence of Medical Specialization in the Nineteenth Century,’ Bulletin of the History of Medicine, 77 (2003), 536–75. Ibid., 560–1. K. Velle, ‘Het verenigingsleven van de Belgische geneesheer,’ Annalen van de Belgische vereniging voor de geschiedenis van hospitalen en volksgezondheid, 26–7 (1988–1989), 73. Ibid., 74. On the professionalization of this medical subfield, see also: K. Velle, ‘Medisch onderwijs en de professie: De gerechtelijke geneeskunde in België in de negentiende eeuw,’ Gewina, 16 (1993), 171–86, 57–72. Velle, ‘Het verenigingsleven,’ 71–7. For a brief overview of Joseph Guislain’s efforts in psychiatry: P. Gunst, ‘Guislain, Jozef (1797–1860),’ UGent Memorie, www.ugentmemorie. be/personen/guislain-jozef-1797-1860 (http://www.ugentmemorie.be/ personen/guislain-jozef-1797-1860 consulted on October 24, 2017). Bulckens and Oudart also regularly published studies and reports in the Ghent Bulletin. Oudart was named an honorary member of the society in 1874: BSMG, 41 (1874), 9. ‘Séance ordinaire du mois de juin,’ BSMG, 28 (1861), 161–3. L. Merken, L’union fait la force: Schaalvergroting en structuurverandering in de Belgische psychiatrie (Master’s thesis, University of Leuven, 2014), pp. 16–23. Ibid., p. 16. Since 1867, Ingels had set the course of the Medical Society of Ghent as one of its three directors. In those same years, he had also been the driving force behind the Society of Mental Medicine, most notably as the editor of its Bulletin: ‘Nécrologie,’ BSMG, 53 (1886), 149–60. See the discussion on the Prix Guislain in Chapter 6, p. 229. Séance ordinaire du 1 août 1876,’ BSMG, 43 (1876), 289–90; ‘Rapport sur le mémoire “Histoire des progrès de la médecine mentale depuis le commencement du XIXe siècle jusqu’à ce jour”,’ BSMG, 43 (1876), 240–9; F. Lentz, Histoire des progrès de la médecine mentale depuis le commencement du XIXe siècle jusqu’à nos jours (Ghent: Vanderhaeghen, 1876). ULG, BIB.G.016555/-40, ‘Lettres de la Société de Médecine de Gand de la souscription pour l’érection d’une statue au docteur Joseph Guislain.’

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22 Inauguration de la statue de Joseph Guislain à Gand. 10 juillet 1887 (Ghent: Vanderhaeghen, 1887), p. 27. 23 See the discussion of the editorial changes in the Ghent Bulletin in the late nineteenth century in Chapter 4, pp. 122–4. 24 Merken, L’union, pp. 17, 26–45. On the society’s meeting place, see the meeting reports in the Bulletin de la Société de Médecine Mentale de Belgique in the 1880s. 25 On the development of ophthalmology in Belgium: J. Vandendriessche, ‘Ophthalmia Crossing Borders: Belgian Army Doctors between the Military and Civilian Society, 1830–1860,’ Journal of Belgian History, 46:2 (2016), 10–33. 26 Velle, ‘Het verenigingsleven,’ 73. The different medical sub-disciplines that emerged in the late nineteenth century offer a wealth of opportunities for scholars interested in ‘discipline formation’. Such research might benefit from studying not only the ‘new’ specialized societies, but also the ‘old’ general societies out of which these societies emerged. 27 W. Feuerhahn and P. Rabault-Feuerhahn, ‘Présentation: La science à l’échelle internationale,’ in W. Feuerhahn and P. Rabault-Feuerhahn (eds), La fabrique internationale de la science, Special issue of Revue germanique internationale, 12 (2010), 5–15. 28 Ibid., 10–11. 29 Raf de Bont discussed the role of international conferences in the emerging field of nature protection at the turn of the twentieth century: R. De Bont, ‘Borderless Nature: Experts and the Internationalization of Nature Protection, 1890–1940,’ in J. Vandendriessche, K. Wils and E. Peeters (eds), Scientists’ Expertise as Performance: Between State and Society, 1860–1960 (London: Pickering & Chatto, 2015), 49–65. International conferences also gave a certain visibility and prestige to new disciplines. On the decorum that surrounded nineteenth-century statistical conferences: N. Randeraad, State and Statistics in the Nineteenth Century: Europe by Numbers (Manchester: Manchester University Press, 2010). 30 In 1880, the editors of the Journal de médecine collected several conference reports in the Belgian medical press to provide their readers with an overview of the International Conference for the Study of Alcoholism [Congrès international pour l’étude des questions relatives à l’alcoolisme] and the Conference of Hygiene and Public Health [Congrès d’hygiène et de médecine publique], which had recently been held in Brussels: ‘Les congrès,’ JMCP, 71 (1880): 199–209. 31 ‘Troisième congrès international de dermatologie,’ JMCP, 97 (1895), 80. 32 ‘Congrès d’hygiène publique, du 26 au 30 août 1885,’ ASMA, 47 (1885), 520–37; ‘Congrès de Phréniatrie et de Neuropathologie, tenu à Anvers le 7, 8 et 9 septembre 1885,’ ASMA, 47 (1885), 537–51. Victor Desguin, who

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presided over the latter conference, had earlier called upon his Antwerp colleagues to participate in the conference: ‘Séance du 10 juillet 1885,’ ASMA, 47 (1885), 411–12. ‘Les congrès de l’Exposition internationale de 1889,’ JMCP, 89 (1889), 285. ‘Bulletin de la séance du 7 mai 1894,’ JMCP, 96 (1894), 353–9. Chris Leonards and Nico Randeraad have similarly made a call to reconnect the transnational space with national, regional and local settings in their study of nineteenth-century experts in social reform: C. Leonards and N. Randeraad, ‘Transnational Experts in Social Reform, 1840–1880,’ International Review of Social History, 55:2 (2010), 215–39, 229–34, 237; N. Randeraad, ‘Triggers of Mobility: International Congresses (1840–1914) and their Visitors,’ in S. Panter (ed.), Mobility and Biography, Jahrbuch für Europäische Geschichte, 16 (2015), pp. 63–82. ‘Séances du mois d’octobre 1862,’ ASMA, 30 (1863), 642–6. The Medical Society of Ghent was equally invited to attend the conferences of the Association. At the Brussels meeting of 1862, the society was represented by Adolphe Burggraeve and Alexis-César Lados: ‘Séance ordinaire du 2 septembre 1862,’ BSMG, 29 (1862): 285–7. Between 1862 and 1865, the Association organized four international conferences in Brussels, Ghent, Amsterdam and Bern. On this association and the role of internationalism in social reform: C. Müller and J. Van Daele, ‘Peaks of Internationalism in Social Engineering: A Transnational History of International Social Reform Associations and Belgian Agency, 1860–1925,’ Belgisch Tijdschrift voor Filologie en Geschiedenis, 90:4 (2012), 1297–320. ‘Congrès international des médecins des colonies à Amsterdam,’ JMCP (1883), 317–31, 325–9. ‘Office vaccinogène central de l’état établi à l’école de médecine vétérinaire, Bruxelles (Midi),’ JMCP, 74 (1882), 525–7 (the same article was published in: BSMG, 49 (1882), 310–12). On the development of the statedirected laboratories and the Central Office of Vaccination in Belgium: L. Diser, Wetenschap op de proef: Laboratoria in het Belgisch overheidsbeleid 1870–1940 (Leuven: Leuven University Press, 2016). On the Brussels Institute of Serotherapy: ‘Avis. Service sérothérapeutique du Parc Léopold,’ JMCP, 97 (1895), 79. See the review of the Ghent professor Eduard Dubois of Van den Berghe’s work: E. Dubois, Review of J. Van den Berghe, Rapports du laboratoire provincial de chimie agricole à Roulers, BSMG, 54 (1887), 234–5. In the 1880s, Van den Berghe published several of his reports in the Ghent Bulletin: J. Van den Berghe, ‘Note sur la présence et le dosage du cuivre dans

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le pain,’ BSMG, 48 (1881), 499–502; J. Van den Berghe, ‘Flandre occidentale. Laboratoire agricole provincial. Rapport annuel. 1882. 2e annexe. Étude sur les eaux publiques de la ville de Roulers,’ BSMG, 49 (1882), 465–78. Charles Van Bambeke explained his plans for an Institute for Hygiene and Therapy in Ghent during a meeting of the Medical Society of Ghent: ‘Séance ordinaire du 1 Avril 1884,’ BSMG, 51 (1884), 97–8. Jules MacLeod reported on his visit to the physiological laboratory of Vlissingen (The Netherlands): ‘Séance ordinaire du 2 septembre 1884,’ BSMG, 51 (1884), 221–3. Camille Verstraeten discussed the laboratories and clinics he had visited in Berlin: ‘Séance ordinaire du 5 octobre 1886,’ BSMG, 53 (1886), 273–4. The works of laboratory scientists from other cities, such as the Liège physiologist Léon Frédericq, were generally also positively reviewed: Lahousse, Review of L. Frédericq, Travaux du laboratoire de physiologie de l’Université de Liège, BSMG, 57 (1890), 32–5. E. Trétrôp, ‘le laboratoire de bacteriologie et d’anatomie pathologique des hopitaux civils d’anvers,’ BSMA, 57 (1895), 60–8. ‘Séance du 14 novembre 1884,’ ASMA, 46 (1884), 699–705. ‘Séance ordinaire du 3 février 1885,’ BSMG, 52 (1885), 17–19. ‘Séance ordinaire du 5 septembre 1882,’ BSMG, 49 (1882), 345; ‘Séance ordinaire du 5 juillet 1887,’ BSMG, 54 (1887), 225–6. ‘Séance ordinaire du 6 décembre 1887,’ BSMG, 54 (1887), 388–9. ‘Séance extraordinaire du 19 janvier 1886,’ BSMG, 53 (1886), 6–7. ‘Séance ordinaire du 7 septembre 1886,’ BSMG, 53 (1886), 249–50. ‘Notice biographique sur le docteur Abraham Mayer,’ ASMCA, 4 (1899), 89–97. For a detailed account of Koch’s tuberculosis research: C. Gradmann, Laboratory Disease: Robert Koch’s Medical Bacteriology (Baltimore: Johns Hopkins University Press, 2009), pp. 69–114. ‘La question de la tuberculose: Les expériences de Koch sur l’homme,’ BSMA, 52 (1890): 226–7. The Brussels professor Jean Crocq was also highly critical of Koch’s experiments in these years, regarding them as ‘simple, gratuitous affirmations’ that lacked sufficient evidence: ‘Résultats des inoculations de la lymphe de Koch faites à Middelkerke,’ BSMA, 52 (1890), 257–9. ‘Résultats des inoculations,’ 258. Ch. Debersaques, Review of Weigert, De la phtisie pulmonaire et de sa guérison par les inhalations d’air surchauffé, BSMG, 75 (1890), 144–5. For another example of the integration of bacteriological notions with hygienic traditions: Ch. Naudts, Review of V. Desguin, ‘Le traitement de la phtisie pulmonaire,’ BSMG, 54 (1887), 337–9.

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54 While I use the term here to describe the process of integrating new and old knowledge within the scientific medical community, David Barnes has also shown how this synthesis reflected contemporary cultural and political agendas that promoted ‘cleanliness’: D.S. Barnes, The Great Stink of Paris and the Nineteenth-Century Struggle against Filth and Germs (Baltimore: Johns Hopkins University Press, 2006), pp. 1–11. 55 In the middle of the 1880s, the contagious nature of tuberculosis was widely debated in the Antwerp Society. Around 1890, the debates shifted to preventive measures, see: ‘Instructions au public pour se défendre contre la tuberculose,’ ASMA (1889), 265; ‘Prophylaxie de la tuberculose,’ ASMA (1889), 299; ‘Traitement de la phtisie par les fenêtres ouvertes,’ ASMA (1890), 80. 56 On the development of the National League against Tuberculosis: C. Bruyère, L’initiative privée et la lutte contre la tuberculose en Belgique, 1886–1914 (Master’s thesis, Free University of Brussels, 1994), pp. 70–106. 57 ‘Séance de 10 mars 1899,’ ASMA (1899), 79–80. 58 In the 1880s and 1890s, patients were nearly always presented during the meetings of the Society of Medical and Natural Sciences in Brussels – a frequency that was much higher than in the 1860s and 1870s. 59 The development of specialties such as ophthalmology seems bound up with these more accurate representational techniques. The Brussels ophthalmologist Henri Coppez and his Ghent colleague Charles Van Duyse regularly presented and published photographs of their patients. 60 ‘Séance ordinaire du 7 octobre,’ BSMG, 51 (1884), 253–4. 61 Ch. Naudts, Review of Masius, Closson and Schiffers, Annales de la clinique interne de l’Université de Liège, BSMG, 54 (1887), 201–4. 62 ‘Réponse à la lettre de M. le dr. Felix,’ BSMG, 56 (1889), 69–70. The basis of the dispute was a negative review by Van Imschoot of Félix’ study on cancer: F. Van Imschoot, Review of J. Félix, Emploi des caustiques dans les cas de cancer, BSMG, 55 (1888), 355–6. 63 ‘Correspondance,’ BSMG, 56 (1889), 67–9. 64 Ibid. 65 At the fiftieth anniversary of the Medical Society of Ghent, president Richard Boddaert held a speech on the usefulness of ‘local scientific societies,’ a classification that co-developed with the creation of over-arching national and international forums: ‘Cinquantième anniversaire de la fondation de la société,’ BSMG, 51 (1884), 191–2. 66 Velle, ‘Het verenigingsleven,’ 69–70. 67 Ibid. A similar merger occurred after the First World War when the Medical Society of Antwerp incorporated the Medico-Surgical Society and turned itself into the scientific division of the Medical Circle of Antwerp. For a

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brief overview of the rapprochement between these different societies: J. Van Lennep, Histoire de la Société Royale de Médecine d’Anvers depuis ses origines jusqu’à nos jours (Brussels: Ascia, 1955), pp. 71–92; J. Van Lennep, Uit het verleden van de Geneeskundige Kring van Antwerpen / Cercle Médical d’Anvers (Antwerpen: Resseler, s.d.), pp. 57–130. P. Heger and E. Zunz, ‘Notice historique,’ in Société Royale des Sciences Médicales et Naturelles de Bruxelles: Volume jubilaire publié à l’occasion du centenaire de la société (Brussels: Lamertin, 1922), pp. 43, 47, 50. ‘Séance extraordinaire du 13 janvier 1885,’ BSMG, 52 (1885), 6–7. ‘Séance ordinaire du 3 février 1885,’ BSMG, 52 (1885), 17–19. ‘Séance extraordinaire du 8 janvier 1900,’ BSMG, 67 (1900), 5–48. The membership of the Medical Society of Ghent would continue to grow in the early twentieth century. At its centenary in 1934, the now ‘Royal’ Society of Ghent comprised of seventy-seven members: ‘Membres titulaires de la Société Royale de Médecine de Gand,’ in Centenaire de la Société Royale de Médecine de Gand: Livre jubilaire édité avec le concours de la Revue Belges des Sciences Médicales (Louvain: Ceuterick, 1934), pp. ix–x. Van Lennep, Histoire, pp. 71–3. Destrée, ‘Conférences universitaires. Les théories de la contagion dans la maladie,’ JMCP, 90 (1890), 1–16; L. Warnots, ‘Conférences universitaires: Le cerveau, sa fonction. Applications pratiques,’ JMCP, 90 (1890), 65–82. These sessions were held during the winter and were announced annually. See for example: ‘Société Belge de Microscopie,’ JMCP, 78 (1884), 110–11. On the summer courses of the Free University of Brussels, see: ‘Variétés: Cours de vacances de l’Université de Bruxelles,’ JMCP, 97 (1895), 320. ‘Séance ordinaire du 6 août 1895,’ BSMG, 62 (1895), 113–15. Ibid.; ‘Séance ordinaire du 3 décembre 1895,’ BSMG, 62 (1895), 241–2. Velle, ‘Het verenigingsleven,’ 77. On this move and the fire: Heger and Zunz, ‘Notice historique,’ pp. 40, 44–5, 48. A. Geerts, De bibliotheek van het geneesherenhuis te Antwerpen (s.l.: s.d. [1999]). R. Aspers, Schets eener geschiedenis der Universiteitsbibliotheek te Gent (Ghent: Vyncke, 1933), pp. 81–2. R. Aspers ‚ ‘De universiteitsbibliotheek,’ in Gedenkboek van de Rijksuniversiteit te Gent na een kwarteeuw Vervlaamsing (1930/31–1955/56) (Rijksuniversiteit Gent 1957), pp. 70–85. A tradition of translating Dutch works into French had nevertheless developed in the Medical Society of Antwerp, see Chapter 3, p. 124. Van Lennep, Histoire, pp. 82–6. Van Lennep, Uit het verleden, p. 76.

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85 J. Verhaeghe, ‘De oprichting van de Vlaamse Academieën voor Wetenschappen en voor Geneeskunde in 1938,’ in G. Verbeke (ed.). Colloquium ‘De weg naar eigen Academiën (1772–1938)’ (Brussels: Koninklijke Belgische academie, 1983), pp. 287–317. 86 Heger and Zunz, ‘Notice historique,’ p. 54. 87 Ibid., p. 55. 88 Ibid. 89 Centenaire, p. xiv. 90 Ibid., pp. xxxi–xxxii.

Conclusions

This book started with the ‘risk and peril’ that society members faced in having their speeches reproduced in the Bulletin of the Medical Society of Ghent. Besides these editorial efforts, it has discussed a variety of scientific practices that animated societies’ meetings and has drawn attention to a wide range of actors: from urban academics to rural practitioners, from patients and midwives to instrument makers and publishers. By scrutinizing their efforts, I have analyzed the different ways in which the medical sciences were ‘performed’ in Belgian medical societies: by addressing a speech to one’s fellow members; by donating an anatomical specimens; by offering a manuscript for publication (or by reviewing one); by taking up a role as an ‘expert’ in public health; and by commemorating the work of one’s colleagues. Together, these performances have shed new light on – what appears in hindsight – a process of growing autonomy of the medical sciences, from its emancipation from a broader learned culture at the turn of the nineteenth century to its institutionalization in specialized academic subdisciplines around 1900. Each of the previous chapters has reflected on this process by bringing a specific set of practices and views to the fore. Let us now take stock of these different perspectives. Which general lines can be drawn? And to what extent can these be considered representative of wider European trends? The founders of medical societies certainly had not anticipated the particular trajectory of their institutions in the course of the century. They had not foreseen the success of societies in the mid-nineteenth century, exemplified most clearly in the voluminous editions of their periodicals. But neither had they expected the transformation of universities into the centers of the scientific field in the second half of the

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century, the strong affiliation societies would seek to these institutions or the gradual demise of their arbitrational role that resulted from these processes. To understand this trajectory, I have placed the history of medical societies within the wider framework of the relation between science and civil society. Urban medical societies, this book has shown, were the exponents of a ‘civil’ form of science. Their embeddedness in civil society was most clear in the early and mid-nineteenth century, when efforts to make medicine scientific were seen, above all, as a voluntary, ‘engaged’ campaign that corresponded to physicians’ display of citizenship. In that sense, they seem comparable to contemporary natural history societies, whose civil grounding has equally attracted attention.1 From roughly the 1860s onwards, voluntary scientific practice was gradually replaced by professionalized research. The formation of a new, professional academic community went hand in hand with the erosion of scientific study as a means of public display or personal improvement. Science became a purpose in itself and gained an autonomy that was expressed in new customs and ideals that were less based on contemporary civil norms – to this process as well, medical societies have strongly contributed.2 This book has traced these processes in detail, on the level of the concrete practices and performances in urban medical societies. In the early and mid-nineteenth-century, the display of gentlemanly conduct by being polite and respectful, but also by defending one’s personal honor, formed an integral part of scientific debate; physicians’ philanthropic efforts acted as a means to show their social awareness; speeches testified to their oratorical talents, and historical works of their literary skills and patriotism. The practice of science thus reflected the diverse values of nineteenth-century citizenship. Put another way, science was embodied by the socially and culturally engaged gentleman physician. Processes of specialization and internationalization in the late nineteenth century led to a new set of norms and moral values, as the obituaries and eulogies in medical societies have revealed. The civil grounding of the medical sciences and their embodiment by gentlemen physicians was here finally broken down. Polite ‘parliamentary’ conversations seemed unfit for discussing laboratory knowledge; literary skills unnecessary (and even unhelpful) to convey the results of experiments. The rise of laboratory science and the growing exclusivity of scientific research required new institutions (e.g. research institutes), ideals and modes of communications.

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To what extent were these scientific practices and performances in medical societies unique to Belgium? The considerable space given to civil engagement in the medical sciences was certainly related to particular socio-political circumstances. A strong tradition of liberalism and a hesitance towards state intervention, reflected also in the slow modernization of the country’s universities, may help to explain why much room was left to civil initiative in the sciences, which was essential for the success of private medical societies. On a cultural level level as well, the context of a young nation-state, anxious to take its place among the European nations, is essential to understand societies’ scientific activities. The downfall of reprinting in Belgium in favor of publishing more original research was tied up with sentiments of national pride. The turning of famous physicians from a distant past into ‘Belgian’ heroes equally fits in with the country’s search for identity and prestige. But besides these political and cultural particularities, there are also good reasons to assume that the same chronology of the construction and erosion of a civil scientific culture occurred elsewhere in Europe. The rise of an urban bourgeoisie and the increasing role of the state in financing academic research – two processes that were at the heart of the success and the downfall of societies as scientific institutions – were far from limited to Belgium. Even if the pace at which state support for science was realized and the patterns of institutionalization differed in different countries, the co-development of science and civil society took place across Europe and forms a suitable framework to study scientific sociability. Further research into the scientific function of medical societies in other European countries may reveal ‘strong’ or ‘weak’ forms of civil science compared to Belgium. It may also, on the level of scientific practice, show the impact of national cultural traditions. The extent to which a more private, gentlemanly style of debate was limited to Britain and a French ‘public’ and confrontational style rather typical of the European mainland, for example, remains to be explored. If Belgium, as a case where medical societies took particularly strong roots, is regarded as indicative of wider European trends – to be confirmed indeed by findings elsewhere – more general conclusions may also be drawn on their role in the nineteenth-century scientific landscape. As this study has shown, urban medical societies met a need for deliberation and debate. They allowed physicians to make agreements on what constituted ‘science’ and to develop rules that regulated the

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position of individuals vis-à-vis the scientific community. They functioned, in sum, as spaces where scientific standards could be set and reinforced. Whether conducted on an urban level or by national academies – a matter which indeed depended on national traditions – this normative function seems a defining feature of nineteenth-century scientific sociability. The setting of norms pervaded societies’ activities. It operated through highly formal mechanisms such as the votes on whether or not a study was worthy of publication or a physician could become a member of the society. But the standards of science were also set and spread in much more subtle ways: through the (unwritten) manners of scientific debate, through the values and ideal types that were spread by obituaries and eulogies. It were these mechanisms that turned medical societies into spaces of socialization, where physicians became familiarized with the modus operandi of the medical sciences. This function transcended national borders. On an international level as well, as the case of Louis Seutin has shown, such rules had to be respected and judgments were made through deliberation and debate. If we take this function fully into account, this also means we should not underestimate the role of medical societies in the movement to make medicine ‘scientific’. Without doubt, the expansion of state intervention in public health and the growth of the universities were the main driving forces behind the transformation of the medical sciences in the course of the century. Yet societies did pursue their own policies, responded to these evolutions and through their debates and journals shaped the scientific field. Critics may advance that society members only talked, while actual science was practiced elsewhere in clinics and laboratories. But this would be to underestimate the importance of such discourse in the scientific field. It was here the seeds were sown for a new conception of the medical sciences as a collective effort. As the debates and reviews in medical societies have shown, individual fame and commercial profit were pushed into the background as improper motivations for the practice of science. At the same time, new procedures were developed to safeguard the scientific rights of individual physicians. The rise of originality and openness as essential scientific values was paralleled by new ways of establishing authors’ right of priority and organizing trust and agreement among medical practitioners (e.g. through open reviewing). Nineteenth-century medical societies, this book has shown, were thus not at all old-fashioned institutions,

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mere remnants of the far more powerful learned societies of the Ancien Régime. They too acted as scientific centers, offering support and recognition to those who exerted themselves for the collective enterprise. What are the historiographical implications of these findings? By bringing these different arbitrational practices to the fore, and by placing their development in wider contexts, from the evolutions in the medical press to the proces of nation building, this study has offered a window on a rich scientific culture within nineteenth-century medicine. In doing so, it has established a different image of the nineteenth-century physician than that of the medical professional as a lobbyist or social expert. Medical practitioners in this study have been presented – in the words of Steven Shapin – as ‘truth-seekers,’ as agents in the production of knowledge.3 The different thematic chapters, moreover, demonstrate the potential of including analyses of sociability in established research domains, such as the history of anatomy or public health. In those histories, academies and societies have mostly been considered in passing, their potential to broaden our understanding of the networks of knowledge production and circulation remaining unrealized. In other, more recent scholarly subfields, such as the history of scientific publishing, more attention to sociability might shed new light on the relation between the scientific field and the literary, historical and artistic fields. Practices such as ‘reprinting’ were indeed far from limited to the medical world. Further research into the civil foundations of nineteenth-century science is not without interest for topical debates on our current system of professionalized science. If contemporary science is often criticized for pressuring scholars to publish, medical societies’ efforts allow historians to study the historical origins of these tensions. They reveal how the values and codes of modern science, such as a form of ‘peer review’ (which experienced difficulties from the start) and a particular notion of ‘scientific authorship,’ originated from an early nineteenth-century liberal, civil culture which valued debate highly, and in which new forms of scientific publishing were experimented with. The idea of science as a collective enterprise, an objective worthy of pursuit in its own right, can be traced back to the political and cultural climate of the early nineteenth century – a climate marked by a desire for civil participation and social engagement by the urban bourgeoisie. This desire lay at the basis of the procedures of modern science, which were initially intended

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to achieve consensus and reach out to a broader audience, rather than to function as mechanisms of selection and exclusivity. At least part of the problem seems to lie in the fact that such codes were developed in relatively ‘small’ communities of scholars, in which trust and agreement were based on shared civil identities and worldviews, but were used on a much wider scale from the late nineteenth-century onwards – a scale on which such shared identities and ideologies seem far less present. If the practice of science in medical societies thus reveals the civil roots of modern science, their history has also demonstrated that the desire for a broader basis, for public support did not disappear with the professionalization of science. This desire was rather articulated in new ways. The ‘formative’ function of science was, for example, continued by twentieth-century medical societies through the organization of all sorts of postgraduate activities. Similarly, societies – now one of the scarce spaces where the unity of the medical field could be affirmed – became spaces where a critique on modern, specialized science could be formulated. Current calls for citizen science and for more transparent scientific procedures themselves thus seem to have a longer history, which seems intertwined with the shifting position of science in society. The further exploration of this history may form a means for historians to participate in the debate on the future of professionalized science. Notes 1 See for example the work by Lynn Nyhart and Diarmid Finnegan: L. K. Nyhart, Modern Nature: The Rise of the Biological Perspective in Germany (Chicago and London: The University of Chicago Press, 2009); D. A. Finnegan, Natural History Societies and Civic Culture in Victorian Scotland (London: Pickering & Chatto, 2009). 2 For a discussion of this process, see also: S. Shapin, The Scientific Life: A Moral History of a Late Modern Vocation (Chicago and London: The University of Chicago Press, 2008), pp. 21–46. 3 S. Shapin and C. Lawrence, ‘Introduction: The Body of Knowledge,’ in: S. Shapin and C. Lawrence, Science Incarnate: Historical Embodiments of Natural Knowledge (Chicago and London: The University of Chicago Press, 1998), pp. 1–19.

Select bibliography

Abbreviations ASAPB ASMA ASMCA ASMG ASML BARMB BMB BSMA BSMG BSRMP CAA CAB CAG JMCP RLB RMAF ULG ULL

Annales de la Société Anatomo-Pathologique de Bruxelles Annales de la Société de Médecine d’Anvers Annales de la Société Médico-Chirurgicale d’ Anvers Annales de la Société de Médecine de Gand Annales de la Société de Médecine de Liège Bulletin de l’Académie royale de médecine de Belgique Bulletin médical belge Bulletin de la Société de Médecine d’Anvers Bulletin de la Société de Médecine de Gand Bulletin de la Société Royale de Médecine Publique City Archive of Antwerp City Archive of Brussels City Archive of Ghent Journal de médecine, de chirurgie et de pharmacologie Royal Library of Belgium Royal Museum of the Armed Forces and of Military History University Library Ghent University Library Leuven Archival sources

Antwerp, House of Literature

S. 2346 Société de Médecine. S. 7346 Société de Médecine.

286

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Antwerp, City Archive of Antwerp

MA 641#525, Dienst ter bevestiging van geboortes en sterfte / gezondheidsbureel. MA 641#631, Jaarverslagen van de lokale geneeskundige commissie van Antwerpen. MA 382/5 (A), Wetenschappelijke verenigingen te Antwerpen.

Brussels, City Archive of Brussels

ASB IP I 110, ‘Correspondance administrative, relevé des sociétés dressé en 1851, organisation, règlement, demandes d’autorisation.’ N. 3108, ‘Esquisse historique sur l’origine et le but de la Société des Sciences Médicales et Naturelles établie à Bruxelles. Signé: Laisné, docteur en médecine, 6 octobre 1822.’ N. 3214–3216, ‘Journal du baron Seutin (1833–1841; 1843–1855); Agenda des visites du docteur Seutin (1845 et années suivantes).’ N. 3462–3463, ‘Livres des visites et consultations du docteur Seutin (1824–1825; 1834–1845).’

Brussels, Royal Museum of the Armed Forces and of Military History

14, ‘Service de Santé et Croix Rouge, 1831–1914.’ 2180–2296: ‘Traitement du docteur J.A.Y. Fierens.’ 2157–2170: ‘La Société des Sciences Médicales et Naturelles de Bruxelles sollicite un subside du Gouvernement pour la publication des deux meilleurs mémoires sur l’ophthalmie militaire; enquête du Ministre de la Guerre (1840–1842).’

Ghent, City Archive of Ghent

MA, Reeks T, 539, ‘Briefwisseling betreffende het subsidiëren van de Société de Médecine, 1835–1837.’ MA, Reeks T, 544, ‘Stukken betreffende voorstellen van de Société de Médecine aan het stadsbestuur in verband met de wedstrijd van 1842 en 1841.’ MA, Reeks T, 568, ‘Briefwisseling betreffende het subsidiëren van de Société de Médecine, 1862.’ MA, Reeks S, 2, ‘Geneeskunde algemeen; Medisch Genootschap van Gent, 1801–1839.’

Ghent, University Library Ghent

Vliegende bladen. VLBL. HFI. M. 032.02, ‘Société de Médecine’. VLBL.HFI.M. 032.03, ‘Société de Médecine’. VLBL.HFI.M.032.17, ‘Meersch, Van der’.

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287

G.016555/-40, ‘Lettres de la Société de Médecine de Gand de la souscription pour l’érection d’une statue au docteur Joseph Guislain.’ BRKZ. NUM.007664, ‘Inhuldiging van het standbeeld van Andreas Vésalius door J. Geefs.’ BRKZ. NUM.013090, ‘Erkentelijkheidsmedaille van de Académie royale de Médecine de Belgique, 1846.’ [Postcard] ‘Bruxelles: Hôtel de Ville: L’Antichambre du Bourgmestre’. Société de Médecine de Gand. Régistre des consultations gratuites et autres documents. Hs. 3012 4.1, ‘Correspondance reçu, 1840–1890.’ Hs. 3012 4.2, ‘Correspondance, 1840–1890.’ Hs. 3012 5, ‘Régistre des malades, 1846–1849.’ Hs. 3012 6, ‘Registre contenant l’indication des ouvrages reçus pour la société par M.M. les Bibliothécaires, 1845,’ ‘Catalogue alphabétique de la bibliothèque de la Société de Médecine de Gand’. Hs. 3012 11, ‘Contracten tussen de société en de drukkers Gyselinck (1841, 1844) en Hebbelynck (1854, 1869, 1870, 1872, 1873).’ Hs. 3012 12, ‘Artikelen, foto’s, tekeningen.’

Ghent, University Archive Ghent

4A2/4 017 1857–1859, Report on the Cabinet of Pathological Anatomy. Periodicals and other serial sources Actes de la Société de Médecine de Bruxelles. Almanach de Belgique pour l’an 1841 (Brussels: Librarie polytechnique, 1841). Almanach du département de l’Escaut, pour l’an 1815 (Ghent: Stéven, 1815). Annales de médecine belge et étrangère. Annales de la Société de Médecine d’ Anvers. Annales de la Société de Médecine de Gand. Annales de la Société de Médecine de Liège. Annales de la Société Médecine physique d’Anvers. Annales de la Société Médico-Chirurgicale d’ Anvers. Annales de la Société Médico-Chirurgicale de Liège. Annales d’oculistique. Annuaire du corps médical belge. Archives de la médecine belge. Archives de médecine militaire. Biographie Nationale. Bulletin de l’Académie Royale de Médecine de Belgique. Bulletin de la Société Royale de Médecine Publique.

288

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Bulletin de la Société de Médecine d’Anvers. Bulletin de la Société de Médecine de Gand. Bulletin général de thérapeutique médicale et chirurgicale. Bulletin médicale belge. Encyclographie des sciences médicales. Flandre Libérale. Het Werkverbond: Volksblad voor Handel en Nyverheid, Stielen en Ambachten. Journal de Bruxelles. Journal de medecine, de chirurgie et de pharmacologie. L’Observateur médical belge. Mémoires de la Société de Médecine d’Anvers. Mémoires de la Société de Médecine de Gand. Mémoires et observations de la Société de Médecine d’Anvers. Presse médicale belge. Verhandelingen van het genootschap ter bevordering van genees – en heelkunde opgeregt tot Antwerpen. Other published sources André Vésale, ou le créateur de l’anatomie: Drame allégorique en cinq tableaux, en vers et en prose (Brussels: Société des Beaux-Arts, 1848). Aspers, R., Schets eener geschiedenis der Universiteits-bibliotheek te Gent (Ghent: Vyncke, 1933). Berchem (ed.), Catalogue des ouvrages contenus dans la bibliothèque de la Société de Médecine d’Anvers (Antwerp: Buschmann, 1845). Boddaert, R., Joseph Guislain (Ghent: s.n., 1887). Broeckx, J.C., Essai sur l’histoire de la médecine belge avant le XIXe siècle (Ghent: Hebbelynck, 1837). Broeckx, J.C., Discours sur l’utilité de l’histoire de la médecine (Antwerp: J.B. Heirstraeten, 1839). Broeckx, J.C., Coup d’oeil sur les institutions médicales belges, depuis les dernières années du dix-huitième siècle, jusqu’à nos jours, suivi de la bibliographie de cette époque (Brussels: Société Encyclographique des sciences médicales, 1841). Broeckx, J.C., Notice sur le docteur Jean-Corneille Stappaerts, président du collège des médecins et du Société Médico-Latine d’Anvers (Antwerp: Buschmann, 1851). Broeckx, J.C., Johan Ferreulx, boekminnend geneesheer in de XVIe eeuw (Antwerp: Buschmann, 1861). Broeckx, J.C., Rapport sur les titres scientifiques de Pierre Coudenberg (Antwerp: Buschmann, 1861).

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289

Broeckx, J.C., Histoire du Collegium medicum Bruxellense (Antwerp: Buschmann, 1862). Broeckx, J.C., La Chirurgie de maître Jehan Yperman, chirurgien belge du XIIIe siècle, publiée pour la première fois d’après la copie flamande de Cambridge (Antwerp: s.n., 1863). Broeckx, J.C., Notice sur Jean-Charles Van Rotterdam (Antwerp: Buschmann, 1864). Broeckx, J.C., Panthéon Médical Belge dessinée par De Lahoese, dédiée à Messieurs les membres de la Société de Médecine d’Anvers (s.l., s.n. [ca. 1840]). Burggraeve, A., Études sur André Vésale, précédées d’une notice historique sur sa vie et ses écrits (Ghent: Annoot-Braeckman, 1841). Burggraeve, A., Histologie ou anatomie de texture (Ghent: Annoot-Braekman, 1843). Burggraeve, A., Éloge de Vésale (Brussels: De Mortier, 1845). Burggraeve, A., Mémoire sur les appareils ouatés (Ghent: Gyselinck, 1850). Burggraeve, A., Mélanges de médecine et de chirurgie pratique (Ghent: F.E. Gyselinck, 1851). Burggraeve, A., Médecine populaire: De l’homme physique (Ghent: Hoste, 1853–1854). Burggraeve, A., Le livre de tout le monde sur la santé: Notions de physiologie et d’hygiène (Paris: Didier, 1863). Burggraeve, A., Question sociale: Amélioration de la vie domestique de la classe ouvrière (Ghent: De Busscher, 1864). Burggraeve, A., Éloge de Joseph Guislain, prononcé en séance publique de la Société de Médecine de Gand, le 24 décembre 1866, à l’occasion de l’inauguration solennelle de son buste (Ghent: Hebbelynck, 1867). Burggraeve, A., Études médico-philosophiques sur Joseph Guislain (Brussels: Lesigne, 1867). Burggraeve, A., Art de prolonger la vie, V. hygiène intellectuelle (Brussels: Office de Publicité, 1868). Burggraeve, A., Hygiène populaire: Longévité humaine, ou art de prolonger la vie (Brussels: Lesigne, 1876). Carolus, J., La chirurgie de maître Jean Ypermans, le père de la chirurgie flamande (1295–1351) (Ghent: Gyselinck, 1854). Cassedy, J.H., American Medicine and Statistical Thinking, 1800–1860 (Cambridge and London, 1984). Centenaire de la Société Royale de Médecine de Gand: Livre jubilaire édité avec le concours de la Revue Belges des Sciences Médicales (Leuven: Ceuterick, 1934). Cercle Médical d’Anvers: Statuts (Antwerp: s.n., 1875). Courtmans, Het blinde meisje, aen den weldadigen oogmeester van Beirvelde: M.J. Fierens (Ghent: Dhont, 1841).

290

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Dance, J.P.H., Guide pour l’étude de la Clinique médicale (Paris: Béchet, 1834). Delahaye, D., De la nécessité de reformer l’enseignement médical dans la Belgique (Bruges: De Moor, 1821). De Mets, A., Cinquantenaire de la Société de Médecine d’Anvers, 1834–1887: Rapport sur les travaux de la société présenté dans la séance solennelle du 23 avril 1887 (Antwerp: Buschmann, 1887). De Ram, P.F.X., Discours prononcé par M. l’abbé De Ram, recteur de l’université catholique de Louvain, sur la tombe de M. le professeur Van Esschen, au cimétière d’Heverlé le 21 janvier 1838 Louvain (s.l.: Van Linthout and Vandenzande, 1838). Desguin, V., ‘Histoire de la médecine,’ in E. Van Bemmel (ed.), Patria Belgica: Encyclopédie nationale ou exposé méthodique de toutes les connaissances relatives à la Belgique ancienne et moderne, physique, sociale et intellectuelle (Brussels: Bruylant-Christophe, 1875), III, pp. 239–66. Dieudonné, J.F.J., Mémoire sur la condition des classes ouvrières et sur le travail des enfants (Brussels: Lesigne, 1846). Dresse, J.H., Intérêts sociaux: Devoir du corps médical de prendre part à la politique, aux questions sociales et à l’élaboration des lois, ou mission générale du corps médical (Liège: Denoel, 1848). Durant, L., De la profession médicale et de la charité publique (Antwerp: Buschmann, 1860). Durant, L., De l’indifférence en matière de philanthropie (Brussels: s.n., 1868). Fournier, F., Essai historique et pratique sur l’inoculation de la vaccine (Brussels: s.n., 1801). Frédericq, L., Handboek van gezondheidsleer voor alle standen (Ghent: Rogghé, 1867). Frédericq, L., Hygiène populaire (Ghent: Hoste, 1875). Frédericq, L., Lichaamsongelukken: Hulpmiddelen vóór de aankomst van den geneesheer (Ghent: Vuylsteke, 1882). Génard, P., Notice nécrologique sur M. le docteur C. Broeckx (Antwerp: Buschmann, 1871). Goethals, F.V., ‘Vésale,’ in F.V. Goethals, Lectures relatives à l’histoire des sciences et des arts, des moeurs de la politique en Belgique, et dans les pays limitrophes, commencés en 1818 et publiées en 1837 (Brussels: Vandooren, 1837), II, pp. 112–33. Gouzée, H.P., De l’ophthalmie qui règne dans l’armée belge (Bruxelles: J.B. Tircher, 1842). Guillaume, J., André Vésale: Drame en cinq actes (Brussels: s.n., 1852). Guioth, Histoire numismatique de la révolution belge, ou description raisonnée des médailles, des jetons et des monnaies qui ont été frappés depuis le commencement de cette révolution jusqu’à ce jour (Hasselt: Milis, 1844).

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291

Guislain, J., Lettres médicales sur l’Italie, avec quelques renseignements sur la Suisse (Résumé d’un voyage fait en 1838, adressée à la Société de Médecine de Gand) (Ghent: F.E. Gyselynck, 1840). Guislain, J., Lettre médicale sur la Hollande, adressée à MM. les membres de la Société de Médecine de Gand (Ghent: Gyselynck, 1842). Inauguration de la statue de Joseph Guislain à Gand. 10 Juillet 1887 (Ghent: Vanderhaeghen, 1887). Janssens, E., Le service communal de la désinfection à Bruxelles, discours prononcé à l’Académie de Médecine de Belgique par le dr. Janssens (Brussels, 1884). Kluyskens, H., Des hommes célèbres dans les sciences et les arts, et des médailles qui consacrent leur souvenir (Ghent: Hebbelynck, 1859). Kluyskens, J.F., Verhandeling over koepokjes, het ware voorbehoedsmiddel der kinderpokken (Ghent: Stéven, 1801). Kluyskens, J.F., Discours du professeur Kluyskens sur la civilisation Ancienne et Moderne (Ghent: Ghyselynck, 1844). Leuridan, Th., Histoire des établissements religieux et charitables de Roubaix (Roubaix: Reboux, 1860). Livre jubilaire publié par la Société de Médecine de Gand à l’occasion du cinquantième anniversaire de sa fondation (Ghent: Vanderhaeghen, 1885). Marcq, L., Essai sur l’histoire de la médecine belge contemporaine (Brussels: Manceaux, 1866). Mareska, D. and Heyman, J.J., Enquête sur le travail et la condition physique et morale des ouvriers employés dans les manufactures de coton, à Gand (Ghent: Gyselinck, 1845). Marinus, J.R., Le baron L. Seutin: Sa vie et ses travaux. Ouvrage posthume (Brussels: De Mortier, 1862). Martin, L.L.H., Notice sur Jean-François-Joseph Dieudonné, président de la Société des Sciences Médicales et Naturelles de Bruxelles, né à Bréda le 18 juin 1810, décédé à Bruxelles, le 10 août 1865 (Brussels: Manceaux, 1865). Monument Vésale comité central: Lettre du Président Victor Uytterhoeven (Brussels: s.n., 1841). Pasinomie ou collection complète des lois, décrets, arrêtés et règlement généraux qui peuvent être invoqués en Belgique (Brussels: Wahlen, 1847), 513. Phillipart, A.J., Leçons d’anatomie des formes appliquées à la peinture et à la sculpture (Tournai: Blanquart, 1834). Phillips, C., Amputations dans la contiguité des membres (avec seize planches représentant les articulations des membres) (Liège: Riga, 1838). Rapport du jury et documents de l’exposition de l’industrie belge en 1841 (Brussels: s.n., 1842). Réglement adopté par la Société de Médecine de Bruxelles (s.l.: s.n., s.d. [1804]).

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Réglement adopté par la Société de Médecine de Bruxelles, dans sa Séance du 25 Messidor an XII (s.l.: s.n., s.d. [1804]). Règlement adopté par la Société de Médecine de Bruxelles, dans sa séance du 17 Février 1807 (Brussels: Imprimerie Wassenbruck (imprimeur de la société), s.d.). Réglement de la Société de Médecine, de Chirurgie et de Pharmacie, établie à Bruxelles, sous la devise: Aegrotantibus (s.l.: s.n., s.d. [1795]). Reglement voor het Geneeskundig leesgezelschap tot uitbreiding van kennis (Antwerp: s.n., 1824). Réglement de la Société des Sciences, Lettres et Arts d’Anvers (Antwerp: Van Assche, 1834). Règlement de la Société des Sciences Médicales et Naturelles de Bruxelles (Brussels: Delfosse, 1841). Rimbaut, T., André Vésale ou le triomphe de l’anatomie, comédie historique en deux actes (Tournay: Casterman, 1863). Saurel, L.J., Traité de chirurgie navale suivi d’un résumé de leçons sur le service chirurgical de la flotte par le docteur J. Bochard (Paris: Baillière, 1861). Schoonen, L., Hommage à André Vésale (Brussels: Raes, 1847). Seutin, L., Du Bandage amidonné, ou recueil de toutes les pièces composées sur ce bandage depuis son invention jusqu’à ce jour, précédé d’une esquisse historique; suivi de la thèse de M. Hyp. Larrey sur le bandage inamovible et de la description générale et du mode d’application de l’appareil amidonné (Brussels: J.B. Tircher, 1840). Seutin, L., Traité de la méthode amovo-inamovible: Comprenant des recherches historiques sur l’origine et la constitution de cette méthode … et ses applications cliniques aux divers ordres de lésions et maladies chirurgicales (Brussels: De Mortier, 1851). Statuts de la Société de Médecine de Gand, modifiés d’après la décision prise dans la séance du 18 Juillet 1837 (Ghent: F.E. Gyselynck, 1837). Thiry, J., Seutin, sa vie, ses travaux et son influence sur le progrès de la chirurgie en Belgique (Brussels: Manceaux, 1878). Uytterhoeven, A., Notice sur l’hôpital Saint-Jean de Bruxelles, ou étude sur la meilleure manière de construire et d’organiser un hôpital de malades (Brussels: Grégoir, 1852). Van Ackere-Doolaeghe, M., Palfyn, vaderlantsch gedicht (Ghent: SnoeckDucajou, 1849). Van Bambeke, C., A propos d’un tableau ornant le local de réunion de la Société de Médecine de Gand (Ghent: E. vander Haeghen, 1901). Vanden Broeck, E., Jetons de présence de la Société de Médecine de Bruxelles, messidor an XII (Brussels: Goemaere, 1900).

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Vanderlinden, P.J., Compte rendu des travaux de la Société des Sciences Médicales et Naturelles de Bruxelles (Brussels: Voglet, 1826). Vandermaelen, Ph. and Meisser, F.J., Fragment de la correspondance de l’établissement géographique de Bruxelles (Brussels: Établissement géographique, 1831). Van Duyse, D., Coup d’oeil sur l’histoire de l’opthalmologie au XIXe siècle (Ghent: Hoste, 1912). Van Esschen, P.J., Lettre à monsieur Lesbroussart, administrateur-général de l’instruction publique, sur l’état actuel de l’enseignement médical en Belgique et sur les moyens de l’améliorer (Brussels: Ode and Wodon, 1831). Van Esschen, P.J., Du cholera morbus asiatique (Bruxelles: J.B. Tircher, 1833). Vervier a.o., J.B., Adresse de la Société Médicale de Gand à ses concitoyens, sur les bienfaits inappréciables de la Vaccine / Vertoog van het Geneeskundig Genootschap der stad Gent aanzyne mede-burgers wegens de onschatbare weldaden der Vaccine (Ghent: A.B. Stéven, 1802). Volume jubilaire publié à l’occasion du centenaire de la Société Royale des Sciences Médicales et Naturelles de Bruxelles (Brussels: Lamertin, 1922), 57–62. Vrancken, L.H.J., Aenmerking over de inenting met de vaccine (Antwerp: Bruers, 1801). Vrancken, L.H.J., La cinquantaine. Notice historique et statistique sur la vaccine depuis son introduction à Anvers en 1801 jusqu’à ce jour (Antwerp: Schoesetters, 1851).

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Abir-Am, P.G. (ed.), La mise en mémoire de la science: Pour une ethnographie historique des rites commémoratifs (Amsterdam: OPA, 1998). Abir-Am, P.G., ‘Introduction,’ in P.G. Abir-Am and C.A. Elliott (eds), ‘Commemorative Practices in Science: Historical Perspectives on the Politics of Collective Memory,’ Osiris, 14 (1999), 1–33. Âhrén, E., Death, Modernity and the Body: Sweden, 1870–1940 (Rochester: University of Rochester Press, 2009). Ash, E., ‘Introduction: Expertise and the Early Modern State,’ Osiris, 25 (2010), 1–24. Baldwin, P., Contagion and the State in Europe, 1830–1930 (Cambridge: Cambridge University Press, 1999). Barnes, D.S., The Great Stink of Paris and the Nineteenth-Century Struggle against Filth and Germs (Baltimore: Johns Hopkins University Press, 2006). Berkowitz, C., ‘The Beauty of Anatomy: Visual Displays and Surgical Education in Early Nineteenth-Century London,’ Bulletin of the History of Medicine, 85:2 (2011), 248–71.

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Index

All given names belong to physicians unless otherwise indicated. Academy of Medicine of Belgium (1841) anatomical collections 148–59 commemorative practices 210–27 passim culture of debate 76, 80 foundation 38–43 organization and membership 8–9, 44, 73, 191, 193, 206, 252 relation to other medical societies 75, 40–3, 253 relation to the state 9, 179 Academy of Medicine of Paris (1820) 4, 7, 25, 39–40, 75, 82, 182 Academy of Sciences, Letters and Fine Arts (1845) 38, 149–50 see also Royal and Imperial Academy of Sciences and Belles-Lettres (1772) Academy of Surgery (1731) 18 alternative medicine see homeopathy; quackery anaesthesiology 67 anatomy autopsies 155, 160, 234 collections 143, 145–50, 163–4n.7, 164n.11, 215

dissections 17, 119, 214–15, 233–4 pathological anatomy 111, 145, 147–8, 154–63, 189, 219, 233, 252, 259–60 specimens 5, 11, 84, 111, 142–63 passim, 260–1, 263 treatises 99, 121 see also Vesalius, Andreas Anciaux 124 Annales de médecine belge et étrangère 97 Annales d’oculistique 63 anonymity 20, 114, 263 Archives de la médecine belge 30, 98 bacteriology 177, 184, 188–9, 194, 250–1, 259–61, 263–5, 269 Ballieux, G. 192–3 Bayenet (veterinary) 154 Bayly, Henri (instrument maker) 68–9 Belgian Medical Federation (1863) 9, 25, 44, 117, 177–8, 187, 225, 256 Belgian Society of Biology 269 Belgian Society of Gynecology and Obstetrics (1889) 253

Index 307

Belgian Society of Ophthalmology (1896) 256 Belgium Belgian Revolution (1830) 15–16, 23, 27, 43, 73, 98, 154, 232 citizenship 5, 9, 34, 172, 232, 237, 280 constitution and liberal freedoms 7–9, 16, 93, 147 patriotism 74, 96, 148, 209–11, 213, 216, 223, 232, 280–1 Belval, Théodore 184–5 Bessems, Paul-Joseph 78–9 Blariau, Édouard 234 Boddaert, Richard 221, 276n.65 Boëns, Hubert 106, 185 Bogaert, Jacques 241n.30 Bonneels, Felix (instrument maker) 68–9 Bonnewijn, Henri (pharmacist) 106–7 botany 33, 107, 138n.120, 147, 213, 215, 267 Boucqué 124 Bourson 40 Brenier, Jules 113–14, 129 Broeckx, Jean-Corneille 15–16, 23, 31–2, 34, 39, 43, 103, 117, 121, 186, 209–15 passim, 218–22, 224–5, 236 Broussais, François 113, 210, 213, 234, 244n.70 Bulckens, Jean-François 254 Bulletin médical belge 30, 40, 60, 75, 97–9, 101, 110–11, 120–1, 172, 213, 234 Buls, Charles (mayor of Brussels) 188 Burggraeve, Adolphe 68, 71, 119, 150–1, 156–7, 168–71, 181, 213, 215, 226–7, 234–5 Buschmann, Ernest (publisher) 126, 128, 130

cancer 80, 151, 158, 264, 276n.62 Canstatt 120 Carolus, Jean 107–8, 219 Casse 262 Catholic University of Leuven 8, 17–19, 23–4, 26–7, 63, 156, 191, 209–11, 215, 221, 253, 271n.3 Cauterman 115 Cazin 121 Celarier, J.-B. 30 Claeys 261 collegia medica 15–17, 19, 244n.68 conferences 38–9, 63, 185, 252, 256–8 Conrad 267 Colson, Ferdinand 31, 63–6 contrefaçon see reprinting Coppez, Henri 276n.59 Cornaz, Édouard 107 Coudenberg, Pierre (pharmacist) 211, 215 Crocq, Jean 80, 151, 178–9, 185, 191, 199n.48, 204n.108, 266, 275 Cruveilhier, Jean 99, 234 Cunier, Florent 63, 74, 98, 100, 121 Curtet, Antoine-François 33 Da Costa Alvarenga, Pedro Francisco 220–1 Dambre 105 Daremberg, Charles 218–19 Darwin, Charles (biologist) 236 Daumerie, Augustin-Joseph 179 Debersaques 262, 269–70 Debeule 152–3 De Ceuleneer-Van Bouwel, Henri 186 Decondé, Henri-Vincent 111, 175 de Dorlodot, Henry (theologist) 271

308 Index

de Geelhand, Louis (baron) 216 De Jumné, Désiré 105 De Kerckhove, Charles (mayor of Ghent) 198n.34 De Kerckhove, Joseph-RomainLouis 29–30 Delahaye, Dominique 25–6 De Moor 142–5, 154, 162–3 De Nobele, Edouard 68 Deroubaix, Louis 76, 160, 253 De Schiervel, Pierre (governor of East Flanders) 62, 64 Descuret 186 Desguin, Victor 186, 193, 210, 268, 273–4n.32 Desmet, Eugène 63–4 De Smeth, Joseph 254 De Smeth, Victor 228–9 Détienne, Charles 102 De Visscher, Charles 119 De Wachter 81, 219 Dieudonné, Jean-François 121–2, 173–4, 228, 232–3, 235, 248n.134 Dodoens, Rembert 211–15 passim drawings 62, 71, 73, 99, 107, 111, 127, 137n.80, 142–4, 152–3, 208, 232, 260 Dresse, Jean-Hubert 178 Dubois, Eduard 274n.40 Dubois, François 213 Ducpétiaux, Édouard 172 Dujardin, Louis 155 Du Mesnil 185 Du Moulin, Nicholas-Chrétien 119, 184, 246n.93, 264 Dupuytren, Guillaume 234 Durant, Léopold 177 Dutch Republic 18, 22–3 Dutch Society for Medicine (1849) 117

Encyclographie des sciences médicales 96–8, 100 see also reprinting epidemics anthrax 261 cholera 4, 36, 77–9, 81–2, 90n.95, 175, 190, 261 diphtheria 250 ophthalmia 4, 57, 61–7, 71, 97, 111, 182, 256 smallpox 21, 78, 115, 171, 174–5 tuberculosis 190, 258, 261–3, 267 typhoid fever 79–80 see also public health; vaccination epidemiology 4, 58, 77–83, 115, 261 exhibitions industrial exhibitions 30, 69 world fairs 257–8 Félix, Jules 264–5 Fenicia Di Ruvo 114 Ferreulx, Johan 222, 240–1n.27 Festraets, Auguste 102, 179 Fierens, Jean 4, 57, 61–7, 77, 84 Foovay (lithographer) 107 France centralization in science 7, 41–3, 253 clinical medicine in Paris 6, 25–6, 113 see also Broussais, François competition with/influence on Belgium 38, 41–2, 74–5, 99–100, 185 contacts between French and Belgian physicians 74–5, 107, 113, 115, 150, 185, 218 culture of debate 8, 281 medical press 30, 39–40, 122, 140n.145 medical societies 18, 25, 27, 38

Index 309

political relation to Belgium 8, 18–19, 22–3, 209 reprints of French works 95–6, 99–100 travels to France 62, 75, 89n.81 see also Academy of Medicine of Paris (1820); languages: French François, Victor 96 Frédericq 79 Frédericq, César-Alexandre 182–3 Frédericq, Léon 275n.41 Free Association of Humanity (1780) 18 Free Society of Physics and Medicine (1807) 21–2 Free University of Brussels 8, 24, 32, 73, 147, 149, 151, 155, 159–60, 191–2, 206–9, 224, 227–9, 250–2, 256, 267–8 Galen 218 Gazette médicale belge 101–2 Gazette médicale de Liège 106 Gazette médicale de Paris 39, 99 Gazette van Gend 33 Geefs, Joseph (sculptor) 216 Génard, Pierre (archivist) 212, 218 gender relations 207, 235–6 gentlemanly conduct see scientific etiquette gentleman science 5, 7, 59–60, 76, 83, 109, 131, 147, 150, 163, 208, 217–23 passim, 231, 237, 251, 280–1 Germany decentralization in science 7, 42 influence on Belgian academe 38, 41, 253 medical press 30, 96, 120, 122–3 natural history 6

scientific contacts between Belgian and German physicians 41–2, 81, 149, 219, 227, 235–6, 261 travels to Germany 75 see also languages: German Giebens 117, 129 Gluge, Gottlieb 159, 161 Goddyn, Paul 119 Goethals, Felix-Victor (archivist) 216 Gouzée, Henri-Prosper 29 Groshans, Georges 28 Guislain, Joseph commemorative activities 213, 215, 222, 225–9, 231, 255 participation in the Medical Society of Ghent 31, 59, 112, 130 philanthropy and care for the mentally ill 172, 254–5 scientific travels 28, 74, 105, 214 views on the Academy of Medicine 41–3 views on Belgian anatomy 147–8, 150 Gyselynck (publishing house) 126–8 Hairion, Frédéric 63 Hanegraeff, F.J. 29 Heger, Paul 250, 259, 263, 269 Hélin 60–1 Henneman (Mr and Mrs) 235–6 Henriette 81, 116 Heuse 154 Heyman, Jean-Julien 173–4 Hippocrates 210, 213, 218, 236, 265 homeopathy 114, 244n.70 hospitals Commission of Hospitals 35, 147, 159, 229

310 Index

military hospitals 20, 29, 63–4, 66, 148 organization and hygiene 182, 256 as publishing houses 264 St. Elisabeth Hospital (Antwerp) 19, 29, 190 St. Jean Hospital (Brussels) 35, 51n.99, 68, 147–8, 159 St. Pierre Hospital (Brussels) 70, 73, 75, 147, 159, 242n.43 as scientific institutions 57, 83, 222, 251, 264, 270 as sites of clinical education 159–63 Stuivenberg Hospital (Antwerp) 189, 194, 203n.98, 260 see also laboratories: hospital laboratories; libraries: hospital Houdet, Charles 209 Hubert, Eugène 253 Hutsebaut (midwife) 142–4, 162 hygiene food safety and water quality 22, 177, 194, 259 hygiene in hospitals 182, 186, 190 personal hygiene 168 popular works and education 170, 180–1, 183, 234 school hygiene 175–7, 187, 193–4, 258 see also professionalization: of public health; public health Ingels, Benjamin 248n.124, 254–5, 267 instrument makers 57, 68–70, 76, 83, 280 International Association for the Progress of the Social Sciences 258

internationalism 32, 41, 63, 74, 123–5, 185, 194, 216, 236–7, 252, 255–61 passim, 280, 282 Italy 41 medical press 123 scientific contacts between Belgian and Italian physicians 114, 124, 236 travels 41, 74, 214 see also languages: Italian Jacobs, Frans 190 Jacques, J. 25, 27, 30 Janssens, Eugène 80, 185, 193, 204n.113 Joly 115 Journal de Bruxelles 193 Journal de médecine, de chirurgie et de pharmacologie see Society of Medical and Natural Sciences of Brussels: publishing practices Kickx, Jean (botanist) 33 Kluyskens, Joseph-François 21, 31, 213, 231 Koch, Robert 81–2, 261–2 Koepl 116 Kok, Pierre-Etienne 19, 21 Konrad 227 Koyen, Joseph 117, 199n.47 Kums, Antoine 116–17, 186 L’abeille 96–7 laboratories 208 academic laboratories 4, 184, 189, 223, 225, 236, 250–2, 259, 269 analyses and experiments 59, 81–2, 220, 222, 250–1, 259–65

Index 311

hospital laboratories 189, 194, 259–60 state laboratories 188–9, 259 La Concorde 35, 224 Lados, Alexis-César 119, 174–6, 235 Lambert, Léon (banker) 250 Lambrechts, P.-J. (mayor of Hoboken) 30, 224 Landeau 267 languages Dutch/Flemish 19, 21–2, 27–8, 46n.13, 95, 123, 129, 218–19, 268–9, 277n.82 English 120, 122–3, 140n.145, 231 French xii, 19, 22, 27–8, 46n.13, 96, 120, 122, 124, 140n.145, 219, 244n.75, 268–9 German 41–2, 96, 120, 122–4, 140n.145 Italian 123–4 Latin 22, 42, 46n.13, 231 Portuguese 244n.75 Laurillard-Fallot, Salomon 39, 112 Lavacherie 155 learned societies (eighteenth century) activities 17, 31, 147, 218, 279 emulation 25–6, 38, 270 historiography 2 membership 3, 20 writing genres 113 Leboucq, Hector 130 Ledeganck 119 Legrelle, Gérard (mayor of Antwerp) 30 Lentz, François 254–5 Leopold I (Belgian King) 73, 176 Le Progrès 176 Lequime, Joseph-Emile 148 Leroy, Domenicus 21 Leroy, Gaspard-François 33

Le scalpel 101–2, 179 Lesseliers, Édouard J. 1–2, 10 libraries hospital 148 librarians 20, 32, 100, 218 medical societies’ 20, 26, 30–2, 104, 107, 148, 232, 268 municipal 118, 245n.82, 268 private 245n.82 royal 19 university 268 Liégey 115 Literary Society of Medicine Nobis et Aliis 18 Littré, Émile (philosopher) 236 L’observateur médical belge 96–7, 249n.135 Lombard, L.M. 106 Loos, Jan Frans (mayor of Antwerp) 175 Louel (pharmacist) 60 Ludwig, Carl 236 Lutens, François 65 Luytgaerens 157–8 MacLeod, Jules (botanist and biologist) 119, 259 Manceaux (publisher) 232 Marcq, Léon 160–1, 210, 220 Mareska, Daniel 173–4, 225 Marinus, Jean-Romualde 38–9, 96–8, 120–1 Martin, Louis 111, 181–2, 184, 222, 232–3, 248n.134 Masius 264 Matthysen, Antonius 74 Matthyssens, F.J. 77, 79, 121, 186 Mayer, Abraham 186–7, 225, 261 Medical Circle of Antwerp (1873) 118, 187, 268, 276–7n.67 Medical Circle of Liège (1872) 266

312 Index

Medical Congress of Belgium (1835–1836) 38–40 medical education medical curriculum 16, 19, 23–4, 159, 180, 220–1, 253, 256 medical students 4, 32, 75, 110, 118–20, 145, 159, 161–3, 192, 221, 226–9, 265 postgraduate education 44, 101, 252, 265–70 passim, 284 student societies 18–19, 25, 160–2 see also France: clinical medicine in Paris; Society for Pathological Anatomy of Brussels (1857) medical laws 15, 23–4 Medical Reading Circle for the Extension of Knowledge (1824) 26 Medical Society of Antwerp (1834) foundation and ambitions 25, 27 library 30–1, 118, 245n.82, 268 membership 28–30, 104, 117–18, 193–4, 267 prize competitions 105–6, 209–10 public role 78, 173, 190, 194, 263 publishing practices 30, 97–8, 102, 104, 117–18, 129 Medical Society of Brussels (1804) 20, 22, 27, 37 Medical Society of Edinburgh (1734) 18 Medical Society of Ghent (1834) demonstrations and experiments 59–60, 64–6, 71–2, 142–3, 157, 261 foundation and ambitions 27, 33–4 international contacts 28, 107, 114, 124, 149, 227, 235–6

library and collections 10, 32, 148–9, 268 meeting room 36–7, 149, 213, 254 membership 28–9, 30–1, 104, 119–20, 266 prize competitions 106, 114, 175, 209–10, 229, 254–5 public role 34–35, 80, 173–4, 190 publishing practices 1, 97, 100, 102–5, 122–4 Medical Society of Leuven (1821) 34 Medical Society of Liège (1845) 81, 101 Medical Society of Paris (1796) 25 Medical Society of Rotterdam (1838) 98 medical topography 22, 115, 175 Medico-Surgical Society of Antwerp (1895) 187–8, 267, 276–7n.67 Medico-Surgical Society of Brabant (1890) 266 Medico-Surgical Society of Ghent (1812) 21–2, 32, 36 Medico-Surgical Society of Liège (1861) 266 Mertens, François-Henri (historian) 31 Michaux, Maximilien 156 midwives 142, 160, 279 see also Hutsebaut (midwife) military medicine 29 membership of military physicians to medical societies 29, 31–3 military health service 33, 39, 62–3, 73, 111 soldiers 61, 63–5, 70–1 see also epidemics: ophthalmia; hospitals: military hospitals

Index 313

Moeller 149 Mordret 107 Morel, Jules 119, 122–4, 255–6 Mouremans 110 Namèche, Alexandre (rector of the Catholic University of Leuven) 221 National League against Tuberculosis (1898) 263 see also epidemics: tuberculosis natural history 6, 147, 149, 280 Natural and Medical Correspondence Society (1779) 18 Naudts 264 Nepper 261 Nothomb, Jean-Baptiste (Minister of Internal Affairs) 173, 211 obstetrics 16, 23–4, 67, 119, 123, 157, 174, 252–3 see also midwives ophthalmology 63, 253, 256, 261 see also Colson, Ferdinand; epidemics: ophthalmia; Fierens, Jean oratory 4–5, 44, 55–7, 76–82, 280 see also politics: political/ parliamentary speech Ottenbourg 121 Oudart, Victor 254 ownership 56, 67–8, 74, 76, 83–4, 150, 151–2 Palfyn, Jan 211–14, 268 Parmentier (sculptor) 213 Pasteur, Louis 82, 236–7 patients as agents in the circulation of knowledge 155–6, 160

deontology 155–6, 202n.85, 263, 265 everyday medical practice 58, 73, 78, 85n.7, 89n.77, 129, 222, 251 free consultations 34–5, 62, 215, 231 as objects of clinical study 64–7, 110 payments and recognition 62 presentation during meetings 70–1, 73, 83, 111, 157, 260–1, 263, 276n.58–9 Pauwels, Jozef (artist) 171 Payan 150 peer review 3, 56, 65, 109–15, 238, 283 Perkins 60, 121 Pétrequin, Joseph-Pierre 218 pharmacy drugs 16, 36, 55, 58–9, 110, 129–30 pharmaceutical sciences 119, 121 pharmaceutical societies 19, 29 philanthropy 21, 34–5, 62, 66, 170–9 passim, 230, 250 Phillips, Charles 71–3, 137n.80 physiology 6, 138n.120, 148, 150, 152, 215, 236, 261, 275n.41 Pigeolet, Arsène 112, 191, 204n.108, 206–7, 227 Pisani 110 Poelman, Charles 1, 130, 142–3, 146, 152–4, 161, 163 politeness see scientific etiquette politics liberalism 7–10, 23–4, 43–4, 179, 188, 191–2, 281, 283 political/parliamentary speech 56, 79, 83, 280 social policy 172–4

314 Index

societies and (party) politics 63, 65–6, 178–9, 191–3, 195 struggles between Catholics and liberals 8–9, 23–4, 191 Polli, Giovanni 236 practical medicine 17, 27, 56, 94, 102, 110, 112, 114, 123, 189–90, 210, 221, 262–7 passim priority claims 10, 57, 67–8, 72–7, 93, 106, 156–7, 257, 260, 282 prize competitions 20–1, 33, 36, 39, 63, 86–7n.29, 94, 105–6, 114, 119, 123, 161–2, 175, 183, 206, 209–10, 220, 228–9, 254–5 professional identity 3, 76, 211, 217, 220, 223, 251 professionalization of medical publishing 121–2, 131 of medicine 2–3, 6, 9 of psychiatry 256 of public health 115, 169, 176–9, 194 of science 2, 4, 6, 11, 84, 115, 131, 196, 208, 231, 237, 251, 257, 280, 283 professional medical societies 169–70, 179, 199n.48, 229 see also Belgian Medical Federation (1863); Medical Congress of Belgium (1835–1836) psychiatry 123, 172, 231, 253–6 public health laboratory analyses 184, 188 see also bacteriology medical advice to the state 22, 170–6, 189–90, 194 see also Medical Society of Antwerp (1834): public

role; Medical Society of Ghent (1834): public role; Society of Medical and Natural Sciences of Brussels: public role mortality statistics 80, 192–3 see also Janssens, Eugène; statistics poor relief 34–6, 177 sanitary investigations 36, 40–1, 78–9, 168, 173–4, 189, 231 state investments 169, 177, 187–8, 193–4 see also epidemics; hygiene; medical topography; professionalization: of public health; Royal Society of Public Health of Belgium (1876) Puttaert 113 quackery 57, 60–1 Raucq 183 Rega, Henricus 211–12 Remy (veterinary) 261 reprinting 95–101, 121, 130, 281, 283 Revue médicale, pharmaceutique et hippiatrique 102 Revue thérapeutique du Midi 235 Rogier, Charles (Minister of Internal Affairs) 216 Roselt, Paul 193 Royal and Imperial Academy of Sciences and Belles-Lettres (1772) 17–18, 20, 23 see also Academy of Sciences, Letters and Fine Arts (1845) Royal Society of London (1660) 93

Index 315

Royal Society of Public Health of Belgium (1876) 189, 256–7 Royal Society of Public Health of Paris (1776) 18 Rul-Ogez, François-Aimé 79, 258 rural medicine rural medical societies 26 see also Society of Practical Medicine of the Province of Antwerp (1836) rural practitioners 4–5, 11, 26, 57, 83, 104, 152, 154, 178, 279 see also Fierens, Jean Ruysch, Frederik 151 Sacré 190, 226 Saurel, Louis-Jules 235 Sauvage, Norbert (artist) 214 Schamelhout, Gustaaf 190 Schoonen, Louis see de Geelhand, Louis (baron) scientific etiquette 1, 5–6, 21, 44, 59–60, 76–7, 82–4, 112, 251, 280 Seutin, Louis 33, 57, 68, 70, 72–7, 84, 154–7, 206, 215, 228, 232, 257, 282 Simon 157 Simonart 155 Simoneau (lithographer) 107 Snellaert, Auguste 28, 214, 218 Société Encyclographique 98–9 Society of Emulation of Liège (1779) 17, 20, 23 Society of Emulation Sano et Aegro (1800) 19 Society for Forensic Medicine of Belgium (1889) 253 Society for the Improvement of Medicine and Surgery (1796) 21–2

Society of Medical and Natural Sciences of Brussels experiments 58, 70 foundation and ambitions 33 library and meeting room 37, 51n.99, 232, 268 membership 28–9, 32–3, 60–1, 104, 118–19, 266 prize competitions 106, 175, 228–9 public role 35–6, 175 publishing practices 97–8, 102–4, 120–2, 125 Society of Medicine, Surgery and Pharmacy of Brussels (1795) 19 Society of Mental Medicine (1869) 248n.124, 253–7 Society of Microscopy 267 Society for Pathological Anatomy of Brussels (1857) 158–62 see also anatomy: pathological anatomy Society of Practical Medicine of the Province of Antwerp (1836) 26, 266 Society of Sciences, Letters and Arts of Antwerp (1834) 29–31, 148 Sotteau, Auguste 64, 68–71, 76, 84, 103, 105, 260 Soupart, Floribert 226 specialization 63, 93–5, 115, 120, 122–32, 145, 158, 169–70, 186–90, 218, 251–71 passim, 279–80, 284 see also ophthalmology; anatomy: pathological anatomy; professionalization: of public health; psychiatry Spierinck, Jean 241n.30

316 Index

Spring, Fréderic-Antoine 179 Spring, Walthère (chemist) 271n.3 Stacquez 112 state Ministry of Internal Affairs 173, 175, 211, 216 Ministry of War 63–6 relation to societies 10–11, 15–18, 30, 39–44, 169–96 passim see also Academy of Medicine of Belgium (1841) science politics 4, 7–9, 38, 151, 281–2 see also anatomy: collections subsidies to societies 34–6, 42, 130, 173–4, 194 see also Belgium; public health: state investments; universities: investments State University of Ghent 8, 23–6, 31–2, 119–20, 142–3, 147, 150–3, 161, 168, 173–4, 182, 184, 226–8, 259, 264, 268–9 State University of Liège 8, 23–4, 101–2, 147, 151, 155, 178–9, 264, 271n.3, 275n.41 statistics 66, 80–2, 115, 177, 188–9, 193 Stiénon 206 Superior Health Council (1849) 16, 184 surgery eighteenth-century surgery 17–19 membership of surgeons to medical societies 20–1, 29, 31 plastic surgery 71–2 surgical instruments and innovations 57–8, 67–77, 119

see also anaesthesiology; drawings; instrument makers; medical education; medical laws; patients: presentation during meetings; priority claims Swéron 58 Tani, Joachim 124 The Lancet 101 The Netherlands reprints, summaries and translations of Dutch works 95, 122–4 scientific contacts with Belgium 28, 41, 98 see also Dutch Republic; Dutch Society for Medicine (1849); languages: Dutch/ Flemish; Medical Society of Rotterdam (1838); United Kingdom of the Netherlands Thiernesse, Théodore 150–1 Thiry, Jean-Hubert 159, 161, 180, 190–2, 228 Tircher, J.B. (publisher) 126 Torfs, Louis (historian) 31 translations 94, 122, 124, 219, 227n.82, 236, 244n.75 travels (study trips) 41, 74–5, 105, 113, 194, 214 Trétrôp, Edmond 189, 194, 259, 263 United Kingdom experimental culture 6 gentlemanly debate 7–8, 281 medical press 96, 101, 103, 120, 122–3 medical societies 13n.18, 18, 257 United Kingdom of the Netherlands 8, 23, 26

Index 317

United States of America medical press 123, 140n.145 universities creation 8, 23–4 investments 9, 147, 250, 259, 281 relation to medical societies 144, 151, 158, 163, 207–9, 225–8 as spaces of research 180, 225 see also Catholic University of Leuven; Free University of Brussels; State University of Ghent; State University of Liège Uytterhoeven, André 70 vaccination 21–2, 34–5, 171–2, 175–6, 185, 190, 192, 250, 259 Van Ackere-Doolaeghe, Maria (poet) 214 Van Bambeke, Charles 144, 259 Van Coetsem, Charles-Auguste 27, 31, 34 Van den Abeele, François 254 Van den Berghe, Jules 259 Van Den Corput, Édouard 122, 180, 217, 222, 224, 228, 232, 258 Van den Peerenboom, Alphonse (Minister of Internal Affairs) 198n.34 Van den Spieghel, Adriaan 212, 214 Vanderhaeghen, Ferdinand (librarian) 268 Vandermeersch, Emile 183–4 Van Duyse, Daniel 261 Van Ermengem, Emile 261 Van Esschen, Pierre-Josse 25–6 Van Haesendonck 77, 79, 124 Van Helmont, Jean-Baptiste 210–12, 214–15, 227, 236 Van Hoeter, Charles 70–1 Van Huevel, Jean-Baptiste 68

Van Imschoot, F. 264–5 Van Leynseele, Charles 235 Van Loo, Florimond (lithographer) 146, 171 Van Meerbeeck, Philip-Jacob 100, 102, 126–7 Van Oost 213 Van Ooteghem 152 Van Rotterdam, Jean-Charles 213 Van Swygenhoven, Charles 79, 100, 102–3, 126–7 Van Vaerenbergh, J.B. 29–30 Varlez, Louis 157 Velpeau, Alfred 74–5, 257 Verhaeghe, Louis 104–5 Verheyen, Philip 211–12, 214–15 Vermeulen, Auguste 254 Verstraeten, Camille 259 Vesalius, Andreas 11, 148, 209–16 passim, 223 Vesalius Society (1843) 148, 159, 215 Vleminckx, Jean-François 33, 39–40, 63–6, 111, 148–50, 152, 216 Wasseige, Adolphe 179 Wasseige, Charles 101 Wauters, Jean 231 Wauters, Pierre-Engelbert 213, 222, 227, 231, 234 William I (King) 8, 23–4 Willmar, Jean-Jacques (Minister of War) 63–6 witnessing 70, 83, 111 Wyns de Raucourt, François-Jean (mayor of Brussels) 216 Ypermans, Jean 107, 218–19 Zunz, Edgard 269