The Emergence of Tropical Medicine in France 9780226114668

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The Emergence of Tropical Medicine in France

The Emergence of Tropical Medicine in France

MICHAEL A. OSBORNE

The University of Chicago Press Chicago and London

Michael A. Osborne is professor of history of science at Oregon State University and president-elect of the International Union of History and Philosophy of Science and Technology’s Division of the History of Science and Technology. He is the author of Nature, the Exotic, and the Science of French Colonialism. The University of Chicago Press, Chicago 60637 The University of Chicago Press, Ltd., London © 2014 by The University of Chicago All rights reserved. Published 2014. Printed in the United States of America 23 22 21 20 19 18 17 16 15 14

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ISBN-13: 978-0-226-11452-1 (cloth) ISBN-13: 978-0-226-11466-8 (e-book) DOI: 10.7208/chicago/9780226114668.001.0001 Library of Congress Cataloging-in-Publication Data Osborne, Michael A., author. The emergence of tropical medicine in France / Michael A. Osborne. pages cm Includes bibliographical references and index. ISBN 978-0-226-11452-1 (cloth : alkaline paper) — ISBN 978-0-226-11466-8 (e-book) 1. Tropical medicine—France— History—19th century. 2. Medicine—France—Colonies—History— 19th century. I. Title. RC962.F8083 2014 616.9’88300944—dc23 2013028983 This paper meets the requirements of ANSI/NISO Z39.48-1992 (Permanence of Paper).

à une femme exceptionnelle

CONTENTS

List of Abbreviations / ix Introduction: Place, Medicine, and the Colonial Situation / 1

/ Emplacements: Medicine, the Navy, and the Enlightenment Heritage / 11

ONE

T WO

THREE

FOUR

/ Medical Constructions of Race: Biological Determinism and Anthropological Pluralism / 77

/ Belligerence, Bombs, and Bordeaux: A New Place for Naval and Colonial Medicine / 111

FIVE

SIX

/ A Medicine and Hygiene of Place / 47

/ The Emergence of Colonial Medicine in Marseille / 155

/ Colonial Medicine at the Paris Faculty of Medicine / 189 Conclusion / 217 Acknowledgments / 226 Notes / 227 Bibliography / 273 Index / 301

A B B R E V I AT I O N S

Bordeaux

Brest Marseille

Paris

Rochefort-sur-Mer Toulon Vincennes

Archives municipales de Bordeaux (BoAM) Université de Bordeaux, Faculté de Médecine et Pharmacie (BoFMP) Archives de la Marine (BAM) Archives municipales de Marseille (MAM) Chambre de Commerce (MCC) Institut de médecine tropicale du Service de santé des armées (IMTSSA) Archives de Police Préfecture (PPP) Archives nationales (AN) Bibliothèque interuniversitaire de Santé (BIUM) Institut Pasteur, Service des Archives (IP) Archives de l’ancienne École de médecine navale de Rochefort (REM) Archives de la Marine (TAM) Service historique de la Défense, archives de la Marine (SHDAM)

INTRODUCTION

Place, Medicine, and the Colonial Situation

This history of the ideas, people, and institutions of French colonial medicine focuses on the period from the end of the Napoleonic Empire (1815) through World War I. France reconstituted an empire in these years and what counted then as colonial medicine, with the exception of the army colony of Algeria in the midcentury years, was largely naval medicine, a constellation of healing practices elaborated and refined in provincial medical schools in the cities of Brest, Rochefort-sur-Mer, and Toulon. In the late nineteenth century additional nodes of activity coalesced in Bordeaux, Marseille, and Paris. As the twentieth century opened, the vast majority of young healers bound for the colonies learned and refined their craft in coastal cities or while voyaging with the navy. For all but a few months of the period studied, the navy administered the colonies through a subdirectorate, though its grasp on colonial activities weakened in the 1890s. The book considers the social, technological, and disease environments of these Atlantic and Mediterranean port cities, and the ships that voyaged from them. It also, I hope, recovers an important dimension of French medicine and locates its place in the ideas, institutions, and practices of naval and colonial medicine over the long nineteenth century. Why, it might be asked, is such a book needed? A primary reason, recognizable to all historians of medicine and of modern European imperialism, is the asymmetry of the field’s historiography and the attendant ways we conceptualize the problems we study. The vast majority of historical scholarship engaging the dynamics of health in Europe and its colonies focuses primarily on the British Empire and particularly British activities in India, Britain’s most important colony of the nineteenth century, and secondarily on Africa. There are sound reasons for these scholarly em-

2 / Introduction

phases beyond those of English-language sources and concentrated and well-ordered archives. The British Empire was larger and more populous than that of France. India, or at least its importance in matters of health, was also well-known to European physicians who identified India as the source of cholera, the major disease behind nineteenth-century European sanitary reform. Moreover, John Snow’s identification of “Asiatic” cholera’s water-borne nature in 1854, and the Indian Rebellion of 1857 followed by Britain’s Government of India Act of the next year, linked the destinies of the two countries for nearly a century. Studies by David Arnold and Mark Harrison on India, and those of Philip Curtin on Africa, have underlined the centrality of disease and sanitation measures for military activities, imperialism, colonial governance, and commerce.1 Harrison, in particular, has examined British colonial medicine and noted that by the 1840s the experience of India’s physical environment, one aspect of place, occasioned a hardening of racial categories and a shift away from the notion that Europeans would eventually adapt to the Indian climate.2 While I find this scholarship incisive, it is not an explanatory model for investigating French racial theory or French colonial medicine, or the dynamics of colonial medicine in the Portuguese, Spanish, or Dutch empires. Nineteenth-century colonial medicine resists incorporation into a pan-European model, although instances of international cooperation between empires exist. Colonial medicine was heterodox in the training of its practitioners, diverse in its missions and patients, and subject to divergent imperial and national policy regimes. The emplaced nature of the activity was itself enmeshed in the evolving contexts of colony and European nation-state relations, and those nations were frequently at war. Thus public-health procedures common in British India for the prevention of smallpox were more fluid in the neighboring Portuguese colony of Goa.3 A second reason for this book is rather more narrow and reflective of the historiography of French medicine itself. Most of what we know about nineteenth-century French medicine concerns civil medicine, particularly Parisian medicine and especially individuals associated with the Paris Faculty of Medicine. This is not very surprising, as the Paris Faculty trained more French physicians than all other medical faculties combined. Paris also hosted two additional fonts of medical imperialism: the army postgraduate medical school and hospital at Val-de-Grâce, and, after 1887, the Pasteur Institute. Both were important centers of colonial and tropical medicine, and the Pasteur Institutes and Pasteur’s science still generate much historical scholarship. Additionally, the archives of these Pari-

Place, Medicine, and the Colonial Situation / 3

sian institutions are concentrated, well-kept, and easily accessible. In short, a historian’s dream! Understandably, then, the historiography of French medicine and medical imperialism is often told in relation to Parisian institutions and actors. Yet this current historiography of Parisian and civilian emphasis merits reevaluation. For colonial medicine and the study of “exotic pathology” and its pedagogy, the action until the very end of the nineteenth century was not in Paris but in those provincial port cities constructed by the navy, on the “great school of the sea,” at colonial stations, and later in Bordeaux and Marseille. The naval medical schools of the coastal cities and the Paris Faculty of Medicine had very different resources and patient populations. Moreover, unlike the civilian faculties of medicine which operated under the Ministry of Public Instruction, naval medical schools could not confer medical degrees. Additionally, naval medical training and career patterns were vastly different from those of civilian medicine and even from those of army medicine. It was, as its practitioners noted time and time again, a special and distinctive sort of medicine in virtue of its content, practitioners, patients, diseases, and places of practice. My hope is that this book will enable a more comprehensive and nuanced view of French medicine and will signal the navy’s crucial role in the fight against “exotic” diseases such as yellow fever and the construction and medical policing of the modern French Empire. In this book I argue that maritime France was the cradle of the new French Empire, and I give voice to those physicians who had experience in the colonies, encountered colonized peoples, and battled colonial diseases. Colonial physicians, of course, pondered ideas of race and combined analyses of physical characteristics with observations on morbidity, mortality, habits, and physiology. Their perspectives complicate and in some ways recast the narrative of French racial ideas. Racial ideas and ideas of empire were fluid, and visions of the colonial project differed widely among those in Paris and agents in the colonies.4 When I began research on this book, the Service Historique de la Marine at the Château de Vincennes near Paris was a more independent agency than it has become since a 2005 décret forced greater integration with the army and the Ministry of Defense. The integration of naval institutions into those of the army has a long history in France, and in many ways the process has worked against the sorts of localism, discrete social worlds, and attachments to place that readers will encounter in this book. A chance encounter at Vincennes with the retired naval physician and historian Méde-

4 / Introduction

cin Général Bernard Brisou provided a seed crystal to my ideas. Dr. Brisou is one of very few people to have written about the reformer of French naval medicine, Dr. Laurent Jean-Baptiste Bérenger-Féraud, who will appear in chapters 3 and 4. In 1982 and 1983 Brisou directed the successor institution to the navy’s central medical school in Bordeaux, the École du service de santé des armées. This was immediately after Prime Minister Raymond Barre’s government had attempted to close the school and incorporate it into the army medical school at Lyon. I asked Dr. Brisou if he thought that Bérenger-Féraud had really posted book bombs to government officials of the Third Republic. Brisou found the historical records ambiguous on this point, but his reply surprised me when he said, “You would have to be from Toulon to know.”5 What, I thought, could Toulon have to do with it? And further, since General Brisou was a member of the Académie du Var located in Toulon and had lived and worked in the city for many years, what sort of an answer was this? The issue of Bérenger-Féraud’s culpability, and a fascination with the places of nineteenth-century colonial medicine, has taken me to archives in Toulon, Rochefort, Bordeaux, Brest, Marseille, and of course Paris. This book is my attempt to understand the logics of localism and the contexts of colonial medicine in France. It is about the power of place and how place functioned in one sector of French medicine. Place, as defined in this book, is not only a point on a map. It is also a site of meaning and attachment, one to which value is assigned, often through the textured facts of experience and memory. There are, of course, studies of colonial places and health, and Dane Kennedy’s study of hill stations in British India and Julyan G. Peard’s examination of academic physicians in Brazil are good places to start.6 In contrast, I have focused on how attachments to places in France structured ideas and actions about diseases and peoples. Good history reconstructs this “world of meaning,” and as much as possible I have tried to elucidate emotional and intellectual attachments to place.7 The notion of places enabling and structuring actions has been around for some time. The microbiologist and environmentalist René Dubos endowed places with a special genius of physical, biological, social, and historical forces, and more recently Pierre Nora and others have tried to sort out how places and memory intertwine.8 Places are intensely human, and they change as human memory changes.9 For the philosopher Edward S. Casey, places are embodied in human action, for “we are not only in places but of them.”10 For cultural and historical geographers, whose ranks have dwindled in the last few decades, the concept of place offers an alternative to newer cartographic perspectives such as spatial science

Place, Medicine, and the Colonial Situation / 5

which have tended to erase humans from geography. In medicine, the diagnosis of disease, therapeutic actions, and sanitation projects occur within socially emplaced worlds and are conducted within a nexus of intellectual and material constraints and opportunities. As employed in this book, then, the concept of place incorporates regulatory, experiential, and locational elements of French maritime culture with chorology-like levels of local and regional analysis. The manuscript owes a minor debt of conceptualization to Jürgen Habermas’s distinction between the “lifeworld” of daily life and mutual interactions, and the “system” of more distant bureaucratic regulations.11 But while Habermas interpreted these two spheres as being in more or less permanent conflict, I have treated them as resources to be marshaled and as productive of dynamic energies that at times might be channeled into states of quiescence, agreement, or conflict. In the case of the navy the “system” was not distant from the life of the port cities and their medical schools, for while regulations might be codified in Paris, they often addressed or incorporated recommendations from the ports. This book, of long chronology and wide geographical breadth, examines how diverse places and peoples in France were situated in a highly problematic and enmeshed relationship with infranational realities and colonial regimes. Many scholars, including Eugen Weber and Mary Jo Nye, have examined the effects of telegraphy, the railroad, and the modern university system on regional identities and the French nation. They have shown how both local and national interests negotiated the passage to modernity.12 As regards colonial medicine, I have tried to make a case for the centrality of cosmopolitan naval personages in this modernizing process, healers who circulated between the colonies and mainland French institutions in the provinces or Paris. I have great respect for what Georges Balandier termed the “colonial situation” and his plea to reflect on the reality of colonialism as we write colonial and metropolitan histories.13 Balandier was not interested in medicine although he should have been. Modern colonization created an infrastructure for the transmission of diseases, not only from the colonies to Europe, but also in Africa where sleeping sickness became epidemic as a result of European incursion and plantation culture. Around 1900, the European empires nurtured international networks of specialists in a newer tropical medicine founded on medical parasitology.14 One recent scholar has even argued that the age of colonization was also the first age of universal contagion.15 Locating place at the center of the narrative recognizes the specificity of the colonial situation and brings to view how the vibrant

6 / Introduction

and highly localized histories of French maritime culture conditioned the careers, ideas, and sensibilities of naval healers. Naval and colonial medicine was conducted in discrete regulatory and physical environments. Their spheres of activity were similar but not identical, although until the early twentieth century training in naval medicine constituted the main gateway for colonial medical careers. The French navy trained their medical men in their own schools and prepared them for service to naval personnel, other state employees, prisoners, and workers shipped from one corner of the empire to another. Healers worked largely within a world structured by the navy’s ports, ships, and in the case of Southeast Asia prior to 1887, the navy’s own colonies and other colonial postings. French agents, and those who worked for them, constituted the majority of the patient base, and little attention was paid to the health of indigenous peoples before 1900. Hence, understanding French naval and colonial medicine mandates recognition of its discrete regulatory regime and educational institutions. Following Balandier’s lead, we might call this the special situation of naval and colonial medicine. Perceptions constitute one way of associating people with places. The hygienic sciences, both before and after the bacteriological revolution, delighted in investigating and categorizing unclean and unhealthy places and peoples. Commentators, from the novelist Gustave Flaubert to the contemporary historian of medicine David S. Barnes, have noted how the places and peoples associated with the navy allowed Parisians and some Frenchmen and women to define themselves as clean or modern. The large naval port of Brest in Brittany and its naval medical school and hospital were iconic features of naval healing, and for Barnes, “Brittany represented the absolute self-defining Other for secular, urbane, and scientific-minded Frenchmen. The prevailing way of life there became, in essence, the very antithesis of Frenchness.”16 Defining “Frenchness,” of course, is problematic, as is determining the sort of medicine appropriate for most Frenchmen and women. Nineteenth-century France was a collage of people typified by differences in physiological constitution, language, ethnicity, diet, religious sensibility, and personal hygiene. These factors, while important for civilian healers, were often predisposing for naval physicians who cared for men under the stress of long campaigns and on foreign soil. As the historian of medicine John Harley Warner has noted, there was wide appeal even in antebellum America to the notion that the medical art was not universal but “had to be adjusted to such individuation characteristics of place as climate, topography, and settlement patterns, just as it had to be tailored to the gender, ethnicity, temperament, and race of individual

Place, Medicine, and the Colonial Situation / 7

patients.”17 Accepted methods die hard in medicine and the navy could be counted on to support tradition. In the early twentieth century, several years after a viable germ theory of disease and the emergence of medical parasitology, French naval physicians continued to record and map the location and distribution of diseases. This tradition of spacial medicine, examined in chapter 2, continued even as naval healers embraced clinical and laboratory methods. Thus in 1929, when Alexandre Le Dantec—a naval physician and France’s first professor of exotic pathology in a civilian medical faculty—published the fifth edition of his textbook, the Précis de pathologie exotique, he reviewed basic geography and climatology as well as the geographical distribution of malaria and yellow fever. He also recorded how local circumstances and ethnicity altered the presentation and etiological course of these afflictions.18 As George Weisz and others have shown, even civil medicine in this era experienced a revival of climatological and hydrological healing under the banner of medical holism and neoHippocratic ideals.19 But naval healers, who often worked under extreme climates and in the cramped quarters of prisons, arsenals, and ships, were especially attentive to what Charles Rosenberg has termed the “implacable situatedness of morbidity and mortality.”20 The Emergence of Tropical Medicine in France investigates two senses of place and attempts to balance analysis of the universal and particular, after the fashion of chorologists, or regional geographers.21 The first axis of investigation is translocational and administrative and follows the evolution of a naval regulatory regime which coalesced in the late seventeenth and early eighteenth centuries. A second sense of place derives from the physical and social conditions of maritime culture and the ecology of disease in ports, prisons, and on ship. Many of the physicians and surgeons in this book wrote of their attachments to the coastal cities of Rochefort, Brest, Toulon, and Marseille, and the regions of their birth. In this I hope the book goes some way toward recovering the personal attachments to real and imagined landscapes, people, and ships. These two elements of place, the translocational and attachment to region of origin and venue of training, counted for much in the advancement system of the French navy. Regulations, of course, could be circumvented or applied inconsistently. They might also be unenforceable, or nearly so, and fuel tensions and resentment.22 Disparities in salary and opportunities for advancement stimulated impassioned calls to overturn regulations and pitted navigans who voyaged against better-paid professors who taught in the port medical schools. Regulatory reform also provided pretexts for violence such as the book bomb incident recounted in chapter 4.

8 / Introduction

The regulatory apparatus of the French navy, codified in 1689, governed naval surgical and medical training for about two centuries. It structured and disciplined the place of naval and colonial medicine within the navy. This is why chapter 1 devotes many pages to the rarified, discrete, and cumbersome naval regulatory system and the ports, ships, and people governed by it. Cardinal Richelieu, who led the maritime offices after 1626 and served Louis XIII in several capacities, fashioned the core of the Royal Navy.23 Inheriting a navy improvised from merchant ships and typified as “extraordinarily fragmented and regional,” he left as legacy a cohesive fleet of royal warships and a zealous mentality of accounting.24 Richelieu focused less on colonial matters than on the subjugation of Protestant minorities (the Huguenots) and strengthening France for battle with the Hapsburg Empire.25 Naval healing practices and institutions developed in tight relationship with the growth of the navy and the sovereign’s valuation or at least recognition of colonial activities. When Richelieu arrived on the scene, French maritime activities remained rooted in feudal privileges, obligations, and concessions. The maritime professions and trades of this era, more often the purview of adventurers rather than savants, were overseen by four separate jurisdictions or admiralties. These included the king’s fleet and three others: the admiralty of Guyenne, based northwest of Bordeaux in and around the Atlantic port of Brouage between the mouths of the Gironde and Charente rivers; the admiralty of Provence, which profited from trade with the Levant; and that of Brittany, whose destiny remained linked to French projects in the Americas.26 Richelieu’s successors—Jean-Baptiste Colbert, who took over the department of the navy in 1669, and particularly Colbert’s eldest son, JeanBaptiste Antoine Colbert de Seignelay—instituted reforms which crystallized as the navy’s Ordonnance (hereafter “ordinance”) of 1689, sometimes referred to as the fundamental ordinance.27 Ordinances established basic legal codes promulgated by the king and thus constituted a higher order of comprehensive regulations. They were distinguished from less comprehensive legal actions such as édicts, which generally addressed a single specific issue, or déclarations, legislative acts modifying prior édicts or déclarations. The ordinance, signed by the king on April 15, 1689, constituted the French navy’s birth certificate. The contexts of its emergence, and the creation of naval hospitals, medical schools, prisons, and arsenals receive sustained attention in the following chapter. Chapters 2 and 3, respectively, demonstrate how the administrative system and the daily activities of medical men intersected at significant sites

Place, Medicine, and the Colonial Situation / 9

of naval and colonial medicine. Chapter 2 focuses on the practice and status of hygiene within the naval medical schools and on the “laboratory” of the ship. Hygiene and medical geography constituted the quintessential sciences of place. The chapter also investigates the etiological riddle of “dry colic,” a disease perceived to be of tropical origin and one which emerged simultaneous to modernization of the French fleet and French colonial expansion into Africa and Latin America in the nineteenth century. Chapter 3 examines the medicalized body and concepts of ethnicity, or what I have termed internal and external concepts of race. The former refers to the perceived races of the French themselves, while the second or external concept focuses on studies of the peoples of Africa and the Caribbean. The evolution of these racial concepts is examined in relation to the staffing needs of the navy and colonies, and the ethnic selectivity of yellow fever, or, as John R. McNeill might say, the differential immunity to yellow fever.28 The study of yellow fever, the memory of its place in French colonial history, and nineteenth-century encounters with the disease, filtered into the very fabric of French colonial medicine. Several of the physicians in this book considered yellow fever, a disease active in the Americas since at least the mid-seventeenth century. It seemed to follow the slave trade and was present as France developed the Caribbean cane colony of Saint Domingue (now Haiti). This engine of wealth for the French Crown was the iconic French colony of the eighteenth century and might have become a French colony to rival British India. But the French exited the island in 1803 after history’s deadliest outbreak of yellow fever. French colonial physicians encountered the disease at home and abroad and tried to control outbreaks of it on ships and in ports from French Guiana in South America to Mexico, Martinique, and Guadeloupe. The disease also frustrated French efforts in West Africa, and epidemics of 1878 and 1881 on the island of Gorée and the mainland city of Saint Louis decimated the European population.29 The majority of the physicians who died in these West African epidemics were neither army nor civilian physicians. They were naval physicians in colonial service, and their presence exemplifies the special situation of French colonial medicine. I argue that French naval and colonial physicians combined ethnological views of African and Caribbean peoples with perspectives from physical anthropology and physiology. Moreover, naval physicians were most interested in physiology and physical capabilities as these two attributes related to labor and staffing, and many naval physicians were more pluralist and less essentialist in their racial thinking than has been portrayed. Here, I think, inclusion of the medical dimensions of racial thinking complicates

10 / Introduction

histories of the advance of physical anthropology over ethnography. I am of course fully aware that perceptions of difference are neither made nor supported solely on the basis of anthropology, ethnography, or medicine. A number of scholars including Tyler S. Stovall, Georges Van Den Abbeele, Laura L. Frader, and Herrick Chapman have shown how literary, linguistic, religious, and nationalistic terms inflect racial concepts.30 Chapter 4 addresses naval and colonial medicine during the republican reforms of the Third Republic and charts the partial separation of these two activities. The expansion of the empire, its partial civilianization, and structural tensions within the system itself mandated changes. This time of crisis, reform, and centralization prefaced the eventual demise of the system of port medical schools founded under the Old Regime and forever altered the status and career patterns of navy medical school professors. It also signaled changes in the navy’s role in colonization and the teaching of colonial medicine. Two concluding chapters examine aspects of the new civilian and army colonial medicine. Chapter 5 describes the key institutions of colonial science and medicine in Marseille. It compares and contrasts the scientific norms for physiological research found there with those of the very different world of Paris and shows how place and disease ecology influenced administrative choices and scientific research programs. Chapter 6 assesses the emergence of a civilianized colonial medicine in Paris and the founding of the Paris Faculty of Medicine’s Institute of Colonial Medicine. The institute’s founder, the parasitologist Raphaël Blanchard, was a medical humanist who elaborated a cultural program for colonial medicine and parasitology. An advocate of scientific internationalism, his career and creations mark the transition from the port-based local and regional medical traditions appropriate for naval and colonial medicine to a newer yet still emergent regime of universal tropical medicine. Blanchard, who was not a navy man, was a skilled manipulator of the system of regulations. His career at the largest civilian medical faculty in France exemplifies the convergence of the new “lifeworld” of practitioners with an altered system of colonial medicine.

ONE

Emplacements: Medicine, the Navy, and the Enlightenment Heritage

Naval and colonial medicine arose in the early modern era as part of France’s maritime activities and the emergence of a Royal Navy. This chapter examines the industrial, colonial, and military contexts of this emergence with special reference to the three naval ports of Brest, Rochefort-sur-Mer, and Toulon. The story includes lifeworlds of squalor and labor conducted within or on the margins of the navy’s discrete regulatory regime—a source of the navy’s alterity. After 1689 the naval ports housed a substantial population of patients with minimal but important rights to health care. Some six decades later the addition of bagnes, prisons structured around forced labor, transformed port environments. Prisoners fashioned the armaments of war, repaired ships, built hospitals and worked in them, and undertook a variety of public works projects. The bagnes also provided a steady supply of cadavers for anatomical and surgical instruction, and the institution itself was a kind of laboratory for the study of morbidity, forensic medicine, race, and epidemiology. Historians of colonialism find it convenient to write of the French Empire as composed of “old” and “new” colonies. This distinction, though, is not especially useful for understanding the history of French colonial medicine. The so-called old colonies, for the main part acquired and lost prior to 1830, included holdings in South Asia (Chandernagor, Pondichéry), North America (New France, Louisiana), the Caribbean (Gaudeloupe, Martinique, Saint Domingue), South America (Guiana), the western nose of Africa (Ft. Saint-Louis, Île de Gorée), and the Indian Ocean (Île de France, Mauritius, Île de Bourbon). In the eighteenth and early nineteenth centuries wars, particularly the Seven Years’ War (1756–1763) and the French Revolution, reduced this colonial network to a shadow of its former self. The newer colonies, essentially those formed from 1830 onward when the

12 / Chapter One

1. Map of France showing location of five major naval ports and other cities mentioned in this book. Target symbol indicates a major naval port.

French took the North African city of Algiers, became far more extensive than those of the Old Regime. By midcentury the French navy, diplomats, and commercial interests had established a presence in Southeast Asia. The French consolidated their holdings in the region and declared Vietnam a colony in 1887. With Algeria seemingly in control, the French expanded into Morocco, Tunisia, Sub-Saharan Africa, and Madagascar. Such a skeletal account of old and new colonies, however, presents an overly discontinuous view of empire. For example, France regained and strengthened its presence in West Africa in 1817 when it reacquired Senegal. It also developed Senegal in new directions once a primary reason for its existence ceased with the abolition of the slave trade. Other continuities existed as well, and the governance and institutions of colonial and naval medicine effectively straddles the pre- and postrevolutionary eras. Significant features of the old regulatory regime of the seventeenth century, and the domestic port bagnes of the eighteenth century, persisted into the early years of the Third Republic and continued to structure naval and colonial medical activities.

Lived Environments: Lifeworlds and Early Modern Industry at Brest, Rochefort, and Toulon Pedagogy for naval healing arose, as Balandier might have termed it, in a special or discrete situation, structured around the sea, colonies, and the

Emplacements / 13

highly specific social and technological environments of the Atlantic cities of Brest and Rochefort, and the Mediterranean port of Toulon. There ports arose from marsh, mud, and stone, and did so in accord with contingent and evolving naval mandates. Frustration and disaster marked this situation as the French navy was defeated and destroyed three times at the hands of foreign powers (1763, 1789, and 1870), and dry-docked and severely underfunded in 1690 while the Sun King conducted campaigns throughout Europe.1 The navy designated the ports of Brest, Cherbourg, Lorient, Rochefort, and Toulon as strategically and administratively significant grands ports to distinguish them from secondary ports like La Rochelle and Nantes. Naval activities in these grands ports of the French state enabled an institutionalization of surgical and medical schools at Rochefort (1722), Toulon (1725), and Brest (1731). While Cherbourg and Lorient had hospitals and naval physicians in charge of port health, the system of naval healing and particularly its pedagogical dimensions were concentrated in Rochefort, Toulon, and Brest. These schools and their associated hospitals drew patients from those who worked for the navy. In the middle of the eighteenth century, the addition of bagnes and thousands of prisoners expanded the fund of patients overseen by the navy. The three schools were insular as the majority of students and professors hailed from regions near these ports. This circumstance ensured that ethnicity and regional ties remained features of naval medicine. French was the language of the French nation, yet in Brittany parish priests embraced Breton as a means of preserving the Catholic faith. Even as late as 1863, a public school inspector in the department of Finistère found that teachers used Breton to communicate with their students.2 Substantial numbers of surgeons grew up speaking local languages such as Breton and counted French as a second language, a circumstance that reinforced their identity as Brestois, Rochefortais, or Toulonnais. Brest, Rochefort, and Toulon shared similarities in that they were naval towns with arsenals and prisons. All of them experienced significant immigration from the surrounding countryside and wildly erratic cycles of economic expansion and decline. Yet they varied substantially in regional culture, language, and identity. In the 1660s the government of Louis XIV, after spending lavish sums to construct an arsenal at the Atlantic port of Le Havre, separated the ports of the Royal Navy from those of the commercial fleet. The rapid and intensive construction of harbors and arsenals and the later addition of large prisons structured these centers of early modern industry. Insularity mingled with the cosmopolitanism of empire in these naval worlds which lodged some seventy-two thousand naval officers and

14 / Chapter One

seamen on the eve of the revolution.3 The navy remained an abiding presence in the intellectual, commercial, and cultural lives of Brest and Toulon through much of the nineteenth century; however, the navy’s commitment to Rochefort receded within a few decades of its organization. Nonetheless, naval and colonial medicine gained and maintained a foothold in all three locations. The formal institutional separation from the civil sphere marked inhabitants, naval careers, and naval medicine. Arsenal work anchored economic life in Toulon, Brest, and Rochefort, and lesser maritime workshops clustered around the northern Atlantic ports of Le Havre and Dunkerque.4 Toulon, Brest, and Rochefort sprang to life and persisted as places designed to marshal and engineer resources for the acquisition, maintenance, and governance of empire. With the possible exception of Bordeaux, site of commercial ventures with West Africa and the classic Old Regime sugar colony of Saint Domingue, the three new ports experienced infrastructural growth and demographic features not seen in France’s interior. In contrast to Bordeaux, which also had viticultural industries, the funding of “sea power” by the Crown and postrevolutionary governments was the lifeblood of Brest, Rochefort, and Toulon.5 Substantial Crown funding enhanced the separation of these cities from the life of their regions. For example, the economy of early eighteenth-century Brest bears more resemblance to the Mediterranean port of Sète, or the Atlantic port of Lorient which was home to the Compagnie des Indes, than to the agricultural economy of its region, and in all three cities laborers and artisans counted for about two-thirds of the population. Location mattered as the three cities had different relationships to the seas they bordered. In the age of sail, only Toulon and Brest could be accessed consistently by large ships. But westerly winds at Brest, a town of about 3,500 in the 1630s, made passage difficult seven months of the year.6 In contrast, Toulon, poised on the Mediterranean between Marseille and Nice, possessed an ideal anchorage. The French state recognized Toulon’s strategic utility in the sixteenth century and in 1513 constructed an imposing tower to guard the harbor.7 The city and its fortifications grew as the French state reduced its reliance on Spanish and Genoan ships and built its own. Early modern Toulonnais engaged in fishing, commerce in slaves, and a bit of agriculture. But if the port was deep it was practically indefensible against invaders of all sorts. Romans, pirates, Normans, the English, and waves of cholera and plague invaded and took up residence in the city. Sited within the shadow of the more populous commercial port of Marseille, Toulon launched the fleets of empire including Bonaparte’s expedi-

Emplacements / 15

tion to Egypt of 1798 and Charles X’s expedition to Algiers in 1830. The building of a massive arsenal and the construction of ships for the king’s navy, for which Toulon would be celebrated, began in earnest in 1665 with Louis Le Roux d’Infreville’s appointment as intendant.8 Shipbuilding and maintenance are complex and expensive processes. In times of rapid technological change, as when steam replaced sail power, the time required to build a ship could surpass its time in service. The three ports performed these tasks according to local contingencies and resource endowments of labor and materials. Provided a ship was not retired as the result of war or accident, the quality of materials and craftsmanship as well as its venues of service and anchorage determined its life span. One eighteenthcentury commentator estimated that ships built in Rochefort might last up to fifteen years, while those of Brest and Toulon could be expected to last twice that time.9 Another estimate of the era calculated that Toulon’s ships lasted somewhat less than twenty years, while those of the Atlantic ports were likely to be retired after a decade.10 Toulon’s intendant noted in 1769, as had Colbert’s eldest son in the 1680s, that it was frequently cheaper and always faster to build new ships than to retrofit older ones.11 Thus the differing material endowments of the three ports and most likely the quality of the timber which was at first gathered from the regions around the arsenals, and the manner in which that timber was cured, had a significant effect on perceptions of ship longevity and possibly the longevity itself. In 1666 Toulon’s arsenal outfitted nineteen vessels, including France’s first 120-cannon ship. The entire flotilla then joined the Dutch in battle against England. Yet according to the intendant’s report of 1673 the arsenal was still too small. Weaponry and timber had to be stored outside the arsenal and at most the shipyard could work on only four ships at a time. The intendant hoped for a covered building for rope making as the present corderie, such as it was, was inside the arsenal in the open air where it disrupted other teams of workers.12 The engineer and military architect Sébastien Le Prestre de Vauban addressed the corderie problem and others after his arrival in 1678 as Toulon’s new Commissaire général des fortifications. Vauban renovated the port and drew up plans for an expanded arsenal as well as a hospital and chapel. Colbert subsequently reduced the scale of Vauban’s plan but expanded the arsenal to include a covered corderie and buildings for constructing, arming, and disarming ships. From 1679 to 1691, the peak years of port construction at Toulon, the government spent at least 3.2 million livres. Between 1691 and 1705 funding collapsed and work slowed in Toulon and other ports. The budget for the navy, colonies included, fell from a peak of 33.43 million livres in 1691, gyrated widely,

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and settled at around 8 million livres in 1716 shortly after the Sun King’s passing in 1715.13 Nonetheless, by 1738 the Toulon arsenal had been accoutered with a massive door framed by Doric columns and topped by statues of the gods Mars and Minerva.14 The Toulon arsenal expanded substantially in the nineteenth century with the addition of three major annexes. Forced laborers had begun the first of these, the Arsenal du Mourillon designed to house naval timber, a century before the city launched the French fleet which took the city of Algiers. In 1853 Napoléon III commissioned a second expansion, the Arsenal de Castigneau, for the repair of steam engines. A third annex, the Arsenal de Missiessy, also begun under the reign of Napoléon III and expanded in 1875 and 1892, fabricated torpedoes and housed a school for mechanics. Around 1900 more than a thousand officers and administrators and some 9,600 employees and laborers worked at this industrial complex sprawling over 250 acres.15 Toulon’s population swelled precipitously during the reign of Louis XIV, growing from about 12,000 at his coronation in 1642 to around 27,000 at his death in 1715.16 The city expanded erratically and Vauban described it as being as full as an “egg.” By 1689 Toulon was the third largest city in Provence trailing only the 85,000 souls of Marseille and about half that number in Aix. Most striking for Toulon—and characteristic of naval cities where the availability of work depended on the activities of an arsenal— was the transitory nature of its population. While Toulon grew by some 15,000 inhabitants between 1668 and 1690, it lost 10,000 inhabitants in the years 1690 to 1698, and an additional 5,000 had departed by 1703.17 Estimates of the 1765 population placed the city at 26,264 inhabitants, and on the eve of the revolution the arsenal employed 2,330 permanent workers and masses of day laborers and prisoners.18 Beginning the nineteenth century with 20,500, the population more than tripled by the time of Napoléon III’s coup d’état in 1851.19 Naval influence intensified and from 1815 through century’s end the majority of Toulon’s workers labored at the arsenal.20 The navy also held sway in Brest and Rochefort. Brest, by virtue of its proximity to England and French government largesse, became the major naval port on the Atlantic. Located in the present-day department of Finistère at the tip of Brittany, Brest lies just twenty kilometers east of the western tip of France. Its fashioning as a naval port stemmed from events of the 1620s and English blockades of the Atlantic port of La Rochelle. As a result Cardinal Richelieu ordered a survey of the Atlantic and Mediter-

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ranean coasts which warned of a maritime population in decline with few merchant ships suitable for armament. A flurry of construction activity and investment ensued, and at Richelieu’s death in 1642, the king had a fleet of sixty-three ships and twenty-eight galleys.21 Somewhat later the army engineer Nicolas de Clerville, active in Marseille in the 1660s, became a trusted confidant of Colbert and traveled several times to Rochefort and Sète even as he sold the king’s grain for his own profit.22 Clerville and others focused central government attention on fortifying the coast of Brittany and constructing a naval base at Brest. From 1666 to 1670, Louis XIV’s major efforts on the Atlantic coast included renovation of the port of Le Havre and creation of a new arsenal at Rochefort. Brest, though slated for improvements to the port, was not then intended to have a new arsenal, though fragments of an arsenal built during the reign on Henry I remained. However, the distance between Versailles and Brest was indeed vast, and work on a new arsenal began after Brest’s first intendant, Pierre Chertemps de Seuil, diverted funds from other activities. The arsenal at Brest, in contrast to Vauban’s well-planned Toulon arsenal, grew in haphazard fashion. A plan for Brest envisioned quarters for 1,200 soldiers, ten forges, a powder depot, and a school of hydrography. Hoped for too was a hospital for injured and ill workers and soldiers, and a dispensary “with a place for surgeons to prepare surgical kits for ship surgeons and treat injured workers.”23 Following review of the plans by Vauban and extended negotiations, hospital construction began in the winter of 1684. The institution took shape over the next decade, and a study of 1700 estimated the hospital could hold 1,200 beds although another calculation in 1721 noted nine rooms with a total capacity of 750 beds. 24 Seventeenth-century Brest, like Toulon, was full as an egg. Squalor, social dislocations, and disease colored the lifeworld of residents. In 1670 Chertemps de Seuil wrote of Brest as a town of four hundred hearths but able to lodge only two of every three inhabitants in service to the king. Even those who found lodging were crammed ten or twelve to a room.25 Arsenal workers mutinied and abandoned their posts at least twice, and in 1704 a group of workers’ wives rallied in front of the intendant’s office to demand pay owed to their husbands.26 In 1690 the king imposed rent controls and forbade rooming houses from serving meat on Fridays. Another effort at hospital construction began in 1696 in nearby Recouvrance, but worker health was not a priority and the project crept toward completion only at midcentury. The fashioning of the place of Brest accelerated under Jean-Baptise

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2. Entry to naval port of Brest in 1856. Image courtesy of Bibliothèque nationale de France.

Colbert, who sent de Clerville to the site. Construction of Brest’s arsenal continued under Vauban, who visited Brittany in 1683, 1685, and 1689.27 Vauban’s vision of siege warfare and fortifications can be seen in massive city walls and a variety of structures from Dunkerque to Strasbourg including the ports and arsenals of Brest and Toulon.28 The austere built environments of Brest and other port cities, more often feats of engineering than of architectural genius, marked the sensibility of port inhabitants and visitors. For example, a commentary of the 1880s on Brest’s school for naval officers rendered an oft-repeated portrait of Brest as a place of perpetual humidity and having no public monuments of note save for a massive bridge and a rather ugly church. According to one visitor, after crossing the “old walls of Vauban one feels stricken by this severe gloominess of places of war which here duplicate the natural gloominess of the climate. The streets are narrow and deserted, the houses built of granite that blackens under rain.”29 Even the famed nineteenth-century geographer, Élisée Reclus, compared Brest unfavorably with Toulon, describing the former city as somber and almost sinister.30 Yet Brest prospered and became the major naval port

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on the Atlantic. A different fate awaited Rochefort, Brest’s sister port to the south organized in the same era. Rochefort, sited some twenty-five kilometers to the southeast of the port of La Rochelle in the present-day department of Charente-Maritime, was something of a second choice for the Royal Navy. Colbert first thought of creating a second Atlantic naval port in the salt marshes of nearby Brouage. But Brouage was beset by political intrigues including adherents to the Fronde and would be consumed by revolts of Protestants angered by the revocation of the Edict of Nantes in 1685. Eventually, Colbert’s cousin, Charles Colbert du Terron, and his wife’s first cousin, Michel Bégon, founded and developed Rochefort’s naval destiny. Sited on the right bank of the Charente River and sheltered from northern winds, Rochefort suffered murderous seasonal outbreaks of malaria. The town had only a few hundred fishermen and laborers and their families when Colbert du Terron claimed the land for the king on May 5, 1666. Swelling to a town of 10,000 by 1669, Rochefort became home to the first dry dock in the Western world.31 But all was not well and soon the tenacious silt of the Charente River prevented large ships from gaining Rochefort’s harbor, and in 1680 the Atlantic naval headquarters moved to Brest.32 In contrast to the history of Toulon’s arsenal, which so dominated that city’s history in the nineteenth century, the trajectory of arsenal and naval activities in Rochefort bespoke of hurried construction followed by decline and senescence. Unlike Toulon, a town with a long history prior to the attentions of the king’s architects, Rochefort was a community created more or less de novo along a geometrically precise grid. In 1666 during the second Anglo-Dutch War, and after much indecision as to whether to expand naval activities at Brest, or build an arsenal in nearby Brouage, stones went down for the foundation of Rochefort’s massive 378-meter-long corderie. Local residents usually built without stone foundations because the soil was too damp, and the mud of the Charente River floodplain bedeviled construction of the building which occupied about two thousand men over a period of four years. The expense of the venture and other problems brought a visit in 1671 by Colbert senior who had hoped Louis XIV would visit and inspect the port and see the masting of a ship. But the king preferred Versailles to the mud of Brittany.33 Living conditions remained marginal, and as late as 1688, a great supporter of Rochefort, the Capuchin Father Théodore de Bloys, commented that poorly constructed houses were only then beginning to spring up and that the “unpaved streets were filled with an empoisoned mire giving off deadly odor.”34

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The linkage of port life to ship armament, construction, colonial adventures, and Crown politics colored the lifeworld of port residents. As the navy evolved from its origins in regional admiralties toward a more unified and Royalist enterprise, the Crown codified procedures for the maritime sphere. The training of naval health workers and their employment, formerly handled on an ad hoc basis, became the subject of study and a system of comprehensive regulations. Provisions for naval health were part of the enabling legislation of the French navy—the fundamental Ordinance of 1689. This document experienced only light revision in the prerevolutionary era as the navy organized schools of surgery and medicine, assumed administration of naval prisons, and created an infrastructure of hospital-based instruction in surgery and medicine at Rochefort, Brest, and Toulon. Naval healers worked primarily in the naval ports, on ship, and ministered to naval personnel in the colonies. Not everyone was pleased with the emergent system, and medical practitioners in important colonies like Saint Domingue enacted rules to prevent naval medical men from treating civilian patients while on the island.35 The navy’s Ordinance of 1689 codified a unique regulatory world and simultaneously structured a system of health care and created a population of patients with rights to health care.

The Birth Certificate of the Modern Navy: The Fundamental Ordinance of 1689 Both Jean-Baptiste Colbert and his son who succeeded him as head of the naval department in 1683, Colbert de Seignelay, labored on the ordinance and the associated reform of French commerce. Naval reform was one part of a larger program that reorganized the Parisian police department in 1666 and elaborated a commercial court system in 1673.36 Colbertian reforms of 1681 targeted the merchant marine and those of 1689 impacted the navy. Although the 1681 reform treated the merchant marine as if it existed in isolation, French merchant and naval fleets shared human and physical resources as it was common practice to arm merchant ships in times of war and merchant marine sailors could be forced to serve on naval vessels. Actions of the 1670s by the elder Colbert, followed by those of the Ordinance of 1689, also formalized naval health-care policies. The 1689 document created a separate sphere circumscribing naval medical alterity for both practitioners and patients. Sailors and arsenal workers became the first state employees to benefit from a kind of social-security system. Participants cofunded this right to health assistance for occupational dis-

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abilities and payments to widows of sailors killed in the line of duty.37 The health needs of arsenal workers, and later those of naval prisoners who also worked in the arsenals and ports, abided as features of naval medicine’s place. The Ordinance of 1689 installed an intendant at the top of the port administrative hierarchy and charged him with directing five lines of responsibility including a commissary overseeing both hospitals and prisons. Although the navy’s administrative structure changed over the next century, medical services occupied a rather stable niche within the organization’s ecology. Thus port hospitals, nodes for surgical and medical training, remained linked to the bagnes created at midcentury even as an Ordinance of 1776 restricted the intendant’s powers. As the revolution loomed military commandants took over administration of arsenals, construction, and other major port activities. Civil service indendants, remained, however, to govern reduced spheres of activity and retained oversight of medical services, bagnes, and supplies.38 Publication of the ordinance came early in the Nine Years’ War of 1688 to 1697 at a fleeting moment when the French navy was as powerful as the English and Dutch fleets it defeated in 1690 in the Battle of Beachy Head. Colbert de Siegnelay died the same year, and by 1692 French fortunes had reversed and naval strategy soon shifted from one of confronting enemies with a grand naval fleet, or a guerre d’escadre, to a less resource-intensive policy of piracy and commerce-destruction, or guerre de course. Eighteenthcentury naval tactics vacillated between these two poles of activity while tensions rose among arsenal workers.39 Tradition counted for much in the navy, and while the Ordinance of 1689 underwent refinement and alteration for the next two centuries it persisted and structured the naval lifeworld. Tradition also celebrates the elder Colbert as the father of the navy, and as late as 1908 the admiralty in Paris used his desk as a worktable.40 The ordinance also defined the place of naval medicine and exerted a preponderant influence on its evolution. The medical needs of seamen and arsenal workers had been addressed in piecemeal fashion prior to 1689, and the ordinance summed up and extended prior regulations and conventions. The document required the main practitioners of naval healing, the surgeons, to keep a journal on ship and record the illnesses encountered, deaths and injuries, and the administration of drugs or other remedies. Though there were some differences between naval ports, a regulation of 1684 placed cooking, supervision of the dispensary, the compounding of simple remedies, and much patient care in the hands of members of religious orders who acted as nurses and orderlies. While a commissary officer

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was in charge of running the port hospital or hospitals, nuns supervised lower-level surgeons and had much autonomy.41 More generally, the ordinance fomented deep resentment and confirmed a great separation between the conditions of shipboard service, which it privileged in terms of pay, status and advancement, and service in port. It also balanced the Colbertian heritage of administrative centralization with confusing divisions of power and responsibility at the port level. The early modern navy was a bifurcated world divided along combatant and noncombatant lines. Military chiefs administered functions attributed to the immediate acts of war and indendants shouldered responsibility for the arsenals, justice, police, finances, food stores and health services including hospitals. A subsequent Ordinance of March 25, 1765, a report by the Conseil d’état and an arrêt of the revolutionary era, codified a new tripartite arrangement of administration directed at those who sailed, those who built and repaired, and those who administered. All three organizational lines now reported to a Préfet maritime who in turn reported to the minister of the navy. As if this confusing array of regulations were not enough, a series of early nineteenth-century reforms complicated matters further. In particular an Ordinance of November 29, 1815, rid the system of Préfets who were subsequently brought back in 1826. The fundamental ordinance required each Royal squadron of at least ten vessels to include a hospital ship which would keep its portholes open and be well ventilated to prevent the circulation of corrupt and bad-smelling air. On ship medical personnel served under the ship’s captain. But they also answered to an intendant, or to his representative at the commissary. Regulations also required hospital ships to have provisions for one hundred furnished beds, a staff chaplain, a writer/accountant, a surgeon who supervised two assistant surgeons, a pharmacist and two assistant pharmacists, two nurses, two men charged with laundry, and a cook and a baker. The number of potential patients in the navy fluctuated over the eighteenth century, more so than the total number of ships to be served; about 48,000 men served on the navy’s 187 armed ships in 1692, and in 1779 some 72,000 souls manned 212 ships.42 Responsibility for the port hospitals and nearly everything else in terms of onshore healing resided with the indentant. Naval healers complained frequently of low status and pay and resented having their art lumped in with justice, policing, and finances. They struggled to be free of the commissary officer’s direction and to have physicians control hospital life. In terms of the hierarchy among healers themselves, the chief physician of the port hospital supervised the surgeon major, and the 1689 regulations

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enjoined them to visit the ill twice daily and to assist with the dressing of wounds. An apothecary was to accompany them on clinical rounds. In addition, the chief physician and surgeon major were to visit each military ship prior to its departure from port, count the ill and wounded, check the ship’s pharmacy, tally the supplies used, and note those in need of refurbishment.43 Procedures proscribed by the document and practices which evolved at the port hospitals contained, albeit in a protean state, a procedural impetus for the three port surgical and medical schools which sprang up later in the cities of Rochefort, Brest, and Toulon. The ordinance assigned pedagogical, staffing, and examination functions to the chief physician and surgeon major. It enjoined the port physician, assisted by master surgeons, to perform anatomical dissections at the hospital and instruct master surgeons in pathological anatomy. The ordinance also required surgeon majors at port hospitals to examine surgeon and assistant surgeon candidates in the presence of the port physician and the hospital commissary officer, and it required them to instruct those under their command in surgical and anatomical knowledge.44 These activities in the anatomical theater and at the bedside were to be joined with required voyaging and possibly colonial service. Together these activities formed the essence of early naval medical pedagogy. Finally, the ordinance provided for patients’ spiritual needs. The organization of hospitals at Rochefort and Brest had begun before the signing of the ordinance, in 1683 and 1684, respectively. Seminaries, formed initially by members of the Jesuit order in Lyon, operated in the ports of Brest and Toulon, much as the brothers of Saint Vincent de Paul had ministered to those on Marseille’s galleys. The arrangement bothered some naval administrators as the navy had its own chaplains, and concerns over loyalty of the Jesuits to the king led to their suppression in 1764.45 Yet religious orders remained active in the ports. In the nineteenth century, for example, a special Jesuit mission combed the Toulon bagne in search of souls during one of its several cholera epidemics.46 A visiting American physician of the nineteenth century described the Toulon seminary building as “massive and plain” except for an entrance where Ionic columns supported the twin statues of Pity and Fortitude holding the shield of France between them.47 This building later housed the naval hospital although Toulon, because of its proximity to the Levant and the danger of plague and cholera, had a number of civil and naval hospitals, infirmaries, and lazarettos. The most famous of these, the Hôpital Saint-Mandrier, was located on an island and functioned intermittently beginning in the 1670s. In 1819 prisoners from

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Toulon’s bagne rebuilt it.48 Another religious order, the Congregation of the Mission, addressed spiritual needs at the hospital at Rochefort. Seminaries existed in all three ports where they trained men to tend the spiritual needs of hospital patients, staff, and those on voyage. Seminarians usually lived in the hospital and received free medical treatment and meals.49 Members of religious orders, both male and female, retained an abiding presence in naval medicine throughout the nineteenth century. With the ordinance arsenal workers in career positions gained health benefits and could be admitted to a hospital and receive half their salary for the duration of their stay. This basic right was extended and expanded in piecemeal fashion over subsequent decades. Naval physicians or surgeons determined which workers were deserving of care and compensation and identified malingerers. Procedures stipulated issuance of a health certificate specifying the injuries, their extent, and recommendations for treatment and duration of stay. After 1846, if a worker fell ill and lived with his family, a naval health officer might treat him in his home and he might draw half of his salary for up to six weeks. An officier de santé de garde, frequently a medical student, gave medical examinations to conscripts and others who worked in the arsenal. Benefits expanded once again in 1855 as the state provided ill or injured workers with salary and travel subventions for rehabilitation at baths and spas. Rochefort, with hot springs located adjacent to the naval hospital and medical school, became a major site of thermalism and remains so today. Toward the end of the century a décret of August 9, 1883, further expanded compensation. Workers injured on the job might now receive three-quarters of their salary while hospitalized, and another regulation of 1898 stipulated that the highest-paid arsenal workers who were totally and permanently disabled in the performance of their duties would get two-thirds of their salary. Finally, in 1907, the navy extended the right of home treatment to workers who did not live with their families. Henceforth, workers in this class were only required to notify their supervisors of illness rather than have an examination and present a medical certificate attesting to their condition.50 While procedures, materials, and the predominant diseases and traumas varied somewhat between the three arsenals, similar problems of organization and funding beset all three ports. Patients were overwhelmingly male in gender, but women and children also worked in the arsenals and in workshops contracting with the navy. From 1661 to Colbert’s passing in 1683, the three arsenals constructed a total of ninety-nine ships; Brest and Toulon each built thirty-six vessels, and Rochefort launched the rest. Crews of specialists in woodworking and framing, boring, and caulking, as well as

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day laborers, also refurbished ships. The task required coordination and at times, as with the repair of the 112-gunship the Soleil Royal at the Brest arsenal in 1688, nearly three hundred workers, organized into teams, swarmed over a single vessel.51 Debilitating accidents, hernias, and the many health traumas of concentrated industrial labor were common. The quality of arsenal workers’ lives, and their ability to provide for self and family, were subject to the king’s budgets as well as to wars and the expansion and contraction of the colonial empire. Additionally, the arrival of war casualties, venereal disease, plague, yellow fever, typhus, or scurvy altered port life and influenced regional ecologies of disease as well as the workers and their naval healers. The Ordinance of 1689 simultaneously proscribed the regulatory place of naval healing and created a class of patients and healers compensated by the French state. It also envisioned an ordered and rational system of naval medicine, and the navy more generally. The naval ports became epicenters of early modern industry, and their social organization and governance largely reflected this mission. In the French administrative mind as well as in their functions, the ports constituted vital cogs in what James E. McClellan III and François Regord have termed the Old Regime’s “colonial machine.”52 By the revolutionary era, members of the French Council of State praised the ports as modes of industrial organization and signaled the need for additional control, rational planning, and discipline. The ports, noted the council, constituted “a major workshop of vessels [in] which work must be regulated and distributed so that everyone only does what they best know how to do.”53 The French state fashioned the ports into a system by imposing naval governance and separated them from the civilian sphere. The regulatory regime, then, formed the place of naval healing and enhanced its separateness from civil and even army medicine. The discrete sphere of naval medicine enclosed many elements of alterity beyond physical locality, a dedicated class of healers, and patients compensated by the state. It also included pedagogical elements.

Hospitals and Schools Nonacademic medicine, and particularly surgery, was a low-status craft in the early modern era. A similar situation existed for healers of all stripes in the navy. Medicine was something of an afterthought for the navy, and healers were not members of the most important part of the navy, the fighting force. In contrast to the rapid construction and organization of the port arsenals, the medical infrastructures of Rochefort, Brest, and Toulon crept

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to realization. Hospitals and schools of surgery, however, were important sites where the “lifeworlds” of the ports and the “system” of regulations intersected. The Ordinance of 1689 did little to alter the status of naval surgeons who continued to learn their art by apprenticeship and serve as the mainstays of shipboard healing from 1642 to 1772. Although freed of knowing Latin and esoteric medical theory, surgeons were expected to “write legibly, know how to shave [and] bleed, [and] have good eyesight and hands that were clean and free of deformities.”54 Recruitment and training of naval surgeons became more formal after 1689.55 Prior to that time merchant marine captains might employ private surgeons and an early mention of the routine embarkation of a surgeon on a French vessel dates to 1637. Around midcentury, the Royal Navy kept six surgeons ready for embarkation in each of the three ports of Toulon, Rochefort, and Brest. Formal instruction in naval healing began when the navy commissioned two healers, a physician and surgeon, to act as port health officers and oversee health matters in each of the three locations. Nonetheless, captains retained discretion over the hiring of surgeons. Thus in 1657, when the 76-cannon vessel La Couronne sailed from Dieppe with a crew of 646 men, it carried six surgeons in the personal employ of the captain who lodged them in a room in the poop deck.56 This arrangement mirrored similar conventions throughout the decentralized world of seventeenth-century French maritime activities. In 1673 the elder Colbert instructed his son and protégé, Colbert de Seignelay, to allow hospital ships to follow the fleet to battle, an idea attributed to d’Infreville of Toulon and later present in the fundamental ordinance.57 He also sent Parisian physicians, surgeons, and apothecaries on French naval expeditions.58 Also in 1673, in an ordinance dated September 23, 1673, Colbert authorized two general hospitals, one each at Rochefort and Toulon, and ordered the building of other hospitals in the arsenals of these ports.59 With this in mind, let us examine the evolution of naval healing at Rochefort. In 1666 Rochefort’s indentant Colbert du Terron ordered installation of a rudimentary hospital in nearby Tonnay-Charente and charged the Capuchin religious order to care for the ill at their priory of Saint-Éloi. Injured arsenal workers and casualties from the war with Holland swelled the facility in 1672 and 1673. Likely this pressured the king to create naval hospitals in Rochefort and Toulon. Construction of Rochefort’s naval hospital began in 1681 and in 1683 patients from Tonnay-Charente transferred to the new facility, a single building of four wards and about four hundred beds. Six years later at the time of the fundamental ordinance the hospi-

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tal still lacked furnishings but later expanded to a building of 250 meters in length, which included a chapel and warehouse. Problems arose when the Capuchins relocated to the new structure from Tonnay-Charente and the navy contracted the services of a rival healing order, the Brothers of the Mission. The brothers were to tend to the spiritual needs of patients and run a seminar for the instruction of naval chaplains. A separate religious group, the sisters of Saint Vincent de Paul, provided nursing services. The dispute with the Capuchins lasted for two years and was only settled with the signing of a contract with a third group, the congregation of the Mission of Saint-Lazare who moved into the hospital. Similar configurations of religious and civil care emerged in Brest and Toulon, although as noted previously the Jesuit order also operated in those two ports.60 The Ordinanance of 1689 did not immediately rationalize hospital governance. Confusion and heterogeneous procedures persisted well into the eighteenth century. For example, while a port intendant governed all hospitals in his jurisdiction, in practice he delegated this duty to a writer and a paymaster who represented him at weekly hospital administration meetings. The two were to meet with the chief physician, the chief surgeon, and head chaplain, and then prepare reports for the intendant. But the conditions of service for naval healers varied by institution. For example, in the 1690s the Daughters of Charity of Saint-Vincent de Paul and naval surgeons shared medical duties at a hospice and home for widows and orphans. To complicate matters, a 1683 navy contract stipulated that the brothers and sisters were under the protection of the king and not subject to the control of the intendant, naval officers, physicians, or surgeons.61 At the Rochefort naval hospital, another contract of July 18, 1684, gave the six members of the Daughters of Charity the right to criticize surgeons and to compound and administer medicines.62 The fundamental Ordinance of 1689 subsequently excluded members of religious confraternities from significant roles in hospital administration but these traditions died hard. Accounts from 1724 list the Rochefort hospital as having 270 beds, but thirty of those were for the sisters and chaplains so the real capacity for the ill was 480 patients lodged two to a bed.63 Reorganization continued and one 1776 document signaled plans for a 1,500-bed hospital. By 1787, after cost overruns reminiscent of Rochefort’s early years, the port finally opened a thousand-bed hospital supplied with water pumped by a new steam engine.64 The naval hospital, shuttered only in 1983, would outlive the arsenal, which closed in 1926, and the naval medical school which ceased in 1963.65 In retrospect, construction of the new Rochefort hospital and the instal-

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lation of the steam engine, the first to function in a French arsenal, were bright spots in a rather grim century for the port. The arsenal suffered partial abandonment and then lost a warehouse to fire in 1756 during the first year of the Seven Years’ War. By 1763 and the demise of the first French colonial empire, Rochefort lost its primary mission. This was followed in 1771 by closure of the Rochefort branch of an officer’s training school, the Compagnie des gardes de la marine, and the eighty students dispersed to Toulon and Brest. The years immediately prior to the revolution were particularly hard for the port. More than four thousand workers labored at the arsenal in the early months of 1783. But by December of that year their numbers had been halved. A survey of 1786 recorded 348 children employed in the port but many of these cheaper workers were terminated and seventeen of their number were conscripted into the mousses, the navy’s apprentice program for shipboard service.66 Ironically, after Rochefort’s port silted in and its fortunes declined its influence on naval medicine and pedagogy grew. Much of the credit for this goes to Jean Cochon-Dupuy (1674–1757), who lobbied the navy to found a surgical school in the port. Cochon-Dupuy, born forty kilometers to the northeast of Rochefort in the town of Niort, took a medical degree in Toulouse and arrived in Rochefort in 1704. Appointed first physician of the

3. Naval hospital and medical school at Rochefort-sur-Mer in the nineteenth century. Anonymous, © Musée National de la Marine/P. Dantec.

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port in 1712, he began teaching an anatomical and surgical course in the rooms of the civil hospital, the Hôpital Charente. Issuing a series of pleas to found a school for instruction in naval medicine and surgery beginning in 1715, in 1717 he gained authorization to teach four students bound for naval service. In February 1722 he presided at the opening of the École d’anatomie et de chirurgie, the first navy school for training surgeons.67 An anatomical amphitheater was inaugurated the same year and became the site of both surgeries and dissections, the latter being performed by a surgical demonstrator while the physician read. It was soon lined with cabinets of preserved anatomical specimens, some of them done up in angelic poses after the fashion of the Dutch anatomist Frederik Ruysch.68 Insular, and exhibiting dynastic tendencies typical of the French civil service of the era, Rochefort and the other port schools soon achieved a certain unity of procedures and curricula. Jean Cochon-Dupuy directed the Rochefort school until his death in 1757 and was succeeded in that year by his son, Gaspard Cochon-Dupuy. The younger Cochon-Dupuy held the directorship until his own death in 1788, the year of the opening of a new port hospital. The school, tightly integrated into the daily activities of the hospital, admitted between six hundred and seven hundred students during the regime of the Cochon-Dupuys.69 Here port life intersected with the contingencies of new regulations, war, and the expansion and contraction of the colonial empire. These factors had an impact on instruction, which was often suspended in time of war, and on student enrollment. In 1736 when the minister of the navy began taking students for colonial service, the school had a dozen student surgeons in the employ of the navy, ten second-class surgeons, and an additional fifteen students on small scholarships. New regulations championed by the elder Cochon-Dupuy regularized instruction and hospital rotations, and in the 1740s the students, who had been living in the hospital, moved into separate lodgings. This was fortuitous as in 1745 the hospital overflowed as combined outbreaks of scurvy and typhus felled about two thousand souls and killed more than five hundred. In the late 1740s the school had forty-eight students, most of them already attuned to the hardships of naval duty.70 Rochefort’s influence on instruction at Toulon and Brest owed much to the pen of the elder Cochon-Dupuy, who wrote an astounding number of instructional texts on anatomy and surgery. A lengthy unpublished manuscript on human anatomy, his L’introduction à l’ostéologie et à la myologie, dates from the 1720s and summarized lectures on the subject. A later eighteenthcentury text also intended for students, Antoine Poissonnier-Desperrières’s Abrégé d’anatomie à l’usage des élèves en chirurgie dans les Écoles royals de la

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marine, was rigorously similar to Cochon-Dupuy’s earlier manual which followed the traditional presentation of anatomy. Both began with the skeleton and considered in order the head, the trunk, and the extremities followed by an enumeration of muscle groups and organs.71 Another text of Cochon-Dupuy, Sr., Manuel des opérations de chirurgie, collected excerpts from the era’s surgical texts and presented them in ten lectures. Beginning with bleeding, leeching, and cauterization, the lectures covered interventions for hernia, breast cancer, kidney stones, fistulas, and procedures for successful trepanations, sutures, and amputations.72 These texts circulated at all three port schools and were soon joined by those of Étienne Chardon de Courcelles, a naval physician at Brest who published manuals on bleeding, general surgery, and compounding of simple remedies to assist the Daughters of Charity in their duties.73 Three men shared instructional duties at Rochefort. Cochon-Dupuy, as first physician, taught internal medicine, medicinal botany, and drugs. The school’s first surgeon major, the aged François Bouchillon (dit Fondalon) who retired in 1730 at the age of eighty, taught surgery and anatomy. The third, a surgical demonstrator, copied notes, demonstrated anatomy, and supervised anatomical and surgical exercises. He also taught a course on dressing wounds. Classes in botany began with the organization of the botanical garden in 1741 and the appointment of Gaspard Cochon-Dupuy as its director. The entire tenor of the instruction was to be practical rather than theoretical, and medical practice was tied to the discrete activities of the navy. The cosmos of naval medical students and their “lifeworld” differed substantially from students at the Paris Faculty of Medicine and was akin to the instruction found at provincial surgical schools. Beyond all else, naval medical and surgical pedagogy was designed to meet the health needs of the male maritime population with only some attention given to women and children, and this accounts for much of its specificity and alterity. Following the formalization of surgical instruction at Rochefort in 1722, the navy authorized two surgical schools: in Toulon in 1725, and Brest in 1731. Toulon’s context, the major naval port serving the Levant and greater Mediterranean world, differed in several particulars from that of Rochefort although regulations placed surgeons in subordinate positions to physicians at all three ports. This issue, as well as others in a medical world dedicated largely to surgery, anatomical knowledge, and practical healing techniques for laboring men, fanned resentments among the surgeons. The foundational text for the new Toulon school was Cochon-Dupuy’s Manuel des opérations de chirurgie, which the indendant Mithon de Senneville had

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printed in 1726.74 Yet organization of a functional naval surgical school eluded port leaders for decades and was finally accomplished by the navy’s incorporation of a civil surgical school after midcentury. There were several hurdles to overcome, from organizing hospitals for instruction to securing cadavers for dissection and study. The latter problem was solved after 1748 with the installation of the Toulon bagne and the arrival of some two thousand forced laborers from Marseille. The other ports also received bagnes, institutions producing a reliable and plentiful source of cadavers and instructional materials for surgery. In Toulon, as in Rochefort, it took some time to achieve the directives of the Ordinance of 1689. Multiple decrees had not led to a functioning hospital in the Toulon arsenal or even a dedicated hospital for naval patients. There was, in fact, no dedicated teaching hospital for naval healers, and in 1716 injured or ill sailors in Toulon found treatment at the civil hospital. Thus the navy, of necessity, contracted with civilian healers and at times lodged its ill and injured in rented houses or tents. Moreover, the port physician Boyer resisted the intendant’s plans for the new school. In 1735, ten years after the school’s official founding and in the wake of the massive mortality of plague of Marseille, Toulon’s civil hospital still ministered to naval casualties. In times of epidemic disease an infirmary on the island at Saint Mandrier, some fifteen kilometers from center city, might open. Yet neither the civil hospital nor Saint Mandrier were appropriate for sustained and guided clinical instruction. There were also local competitors to naval plans for medical and surgical training. The surgeon major Boucauld founded a College of Surgery in 1740 which gave public lectures but functioned without the participation of the port’s naval physician. Its curriculum, directed at naval surgical students and civil practitioners bound for the countryside, excluded both medicine and materia medica. The Seven Years’ War ended in 1763 and left the port schools and the navy in disarray. That year the government created the post of inspector and director for medicine in the ports and colonies and named the physician Pierre Poissionner as its first incumbent. Poissionnier and his brother Antoine-Marie Poissonnier-Desperrières, who assisted Pierre in several capacities after 1768, studied the situation in the schools and produced a sweeping nine-part addendum to the Ordinance of 1689. These new regulations of March 1, 1768, standardized instruction at all three port schools, at least on paper. They also listed the minimum materials needed for dissection and instruction and instituted a series of practical and written examinations for advancement. Examinations for surgeons, for example, were to be held annually at a time when most surgeons would be in port and

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able to sit for six tests conducted over fifteen days. The port’s first physician was to direct the school and teach an astounding number of classes on anatomy, general pathology, and botany, and lead grand rounds at the hospital. Regulations also specified duties for a surgeon major, lower-ranking demonstrators, second surgeons and surgical aides.75 In the 1750s the three port schools remained heterogeneous institutions in several particulars. Proposals for reform issued frequently from Paris and the ports themselves. In Brest, for example, surgeons came forth with a failed project of the 1770s to found a school to address what they saw as the poor level of instruction at the naval school, and at Rochefort the naval surgeon Lahaie opened a civil school to instruct both civil and naval students.76 In Paris common training for civilian physicians and surgeons had occurred before the revolution so in the civil arena these two classes of healers were actually closer to each other by the 1790s.77 This was not the case in the navy, where tensions between surgeons and physicians expanded after the revolution. Animosity between surgeons who sailed frequently, the lesser-trained navigans, and those who held medical degrees and were in port to sit for examination to gain the post of professor, energized the fray. Service in the professoriate was required to attain the highest levels of rank and pay, and port directors were most often members of the professoriate. Professors might begin their semesters late and finish them early with the effect of shortening the hours of instruction by half, and had lower-ranking colleagues second them in their duties.78 Although regulations forbade it, some professors supplemented their income by taking on private clients. To fever-wracked surgeons on campaign, the professoriate seemed to be a world of privileges and relative safety and ease. While the new regulations of 1768 exacerbated tensions between the naval surgical and medical communities, they also went some way toward unifying the three port schools into one system as they specified minimum standards and stipulated a uniformity of instructional duties. For an ephemeral moment the schools were subject to routine inspection by Poissionner, but in 1791 the revolutionary government suppressed Poissionner’s office. The First Republic then reinstituted inspections but these too ceased in 1801. Finally, in 1813 the government resurrected the post of inspector general with the appointment of the Brestois surgeon and physician, Pierre-François Kéraudren. The capable Kéraudren had been a physician-consultant to the minister of the navy and was an accomplished medical administrator. Port councils of health, bodies composed of the ranking officers in the schools in 1799 and created to oversee all hygienic

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and medical matters in the port, now reported to Kéraudren who codified their responsibilities in 1828.79 Several features of place and patient population separate naval healing from its civilian homologue. The hospitals and healers of the early modern navy persisted within an exceptional context in a largely rural and agricultural society. Shipboard healing was a discrete activity, of course, but the ports themselves were smaller urban islands with concentrated industries. Because of their situation and links to the greater sphere of French influence and commerce, they were also somewhat cosmopolitan. A majority of the navy’s patients came from the cohort of sixty to seventy thousand sailors and officers in service to the king. Subject to frequent turnover, sailors might sign on with the merchant marine when not in service to the king. Others entered service after having the misfortune of being caught by press gangs. After Colbert altered his recruitment techniques in the 1660s, the names of young men appeared on a maritime register sorted into classes stipulating the obligation of a month of service every three, four, or five years. This system, which did not outlive Colbert, was not a great improvement over press-gangs as the frequency of naval wars led to the extension of terms of service and evasion was common.80 Although Colbert sought a national recruitment for naval service, the sailors who formed the patient base of naval medicine and the physicians and surgeons who tended them most often originated in the coastal regions of France. Naval patients were noteworthy for their remarkable homogeneity in terms of age and sex—nearly all of them were young to middle-aged men from the maritime provinces. The naval prisons or bagnes added significantly to patient numbers as did laborers in the arsenals. This latter cohort included a few women and sometimes children. The large public-works projects undertaken by the navy, and the ongoing activities of the arsenals which cut and formed timber, fabricated anchors, tarred marine fixtures, fashioned hemp into cord, and manufactured sails and rigging for ships, created a distinctive disease ecology specific to the port cities. Prisoners were significant for the labor ecology and epidemiology of the ports as well as for training in naval medicine. Not surprisingly, the medical conditions of laboring and incarcerated men figured prominently in the naval medical cosmos. In terms of career paths, until the very end of the nineteenth century, many naval physicians did duty in colonial hospitals, colonial prisons, or as health officers for the colonial service. In the port towns of France they encountered patients with a variety of medical conditions from scurvy to cholera, venereal diseases, and innumerable injuries and physi-

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ological insults sustained while laboring either in or for the navy. The arsenals, and the prisons which the navy came to administer, provided the largest number of patients who were not sailors. In the nineteenth century the ports adhered to a specialized functionalism inspired by an industrial model of organization. This model divided the administrative physiology of the port along five lines reporting to the Préfet maritime. Below him were a major général whose functions were purely military; a chef de l’administration under whose responsibility fell the prisons, recruitment, and the hospital support services inclusive of nursing; and three other administrators overseeing the arsenal, artillery, and the movements of ships within the port. Damned by generations of naval officers, the cumbersome features of naval administration had much institutional momentum and persisted for much of the century. I will conclude by investigating another feature of naval medicine distinguishing it from its civil counterpart. This was the navy’s long association with prisons, forced laborers, and the diseases and medical treatment of prisoners. Other healers treated prisoners in France’s many carceral institutions, but in comparison to these, naval healers had a more intimate and sustained relationship with prisoners and specifically with the large population of forçat labor which constituted important elements of the social and medical world in the ports of Toulon, Brest, and Rochefort. The naval ministry ran prisons in these three ports and at Lorient, port for the East India Company located in Brittany. The linkage of the navy with prisons was not foreseen in the Ordinance of 1689. In 1749, however, some two thousand galériens from Marseille were relocated to Toulon where they were housed in the hulks of ships and later on pontoons and in prisons erected by their labors. Rochefort and Brest also received thousands of these unfortunates, and they would be incorporated into the arsenal and hospital workforce of all three ports. The prisoners altered the character and institutional ecology of all three cities.

Prisons, Prisoners, and Patients Naval medicine’s tight relationship with bagnes and prisoners sets it apart from the norms of civilian medicine where about 4 percent of physicians practiced prison medicine.81 In the navy, physicians and their students had substantial and sometimes daily contact with prisoners both inside the bagne and outside its walls. Training in forensic medicine was routine and part of naval medicine’s special situation. Additionally, prisoners sometimes worked alongside naval medical students. For example, when need

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arose, as it did at Brest in 1757 during a typhus epidemic and at Rochefort in 1780 during a wave of particularly deadly malaria, able-bodied prisoners assumed duties as orderlies or nurses in the port hospitals. But even in normal times prisoners performed a variety of tasks in port medical schools, libraries, and botanical gardens.82 Anatomical study provided the foundation of surgical study and trauma medicine, and in death prisoners provided the port medical schools with thousands of cadavers for study and dissection. From its opening in 1749 until its closure in 1858, more than 70,000 souls passed through the Brest bagne, and to the south at Rochefort, an institution open from 1766 until 1852, 25,950 condemned men entered the bagne, and 13,272 of them, more than half their number, died there.83 Naval medical instruction suffered once the bagnes closed and the supply of cadavers slowed. Toulon hosted the largest population of forçats with Brest and Rochefort next in size. Seven other cities, including Lorient and Nice, hosted smaller and shorter-lived institutions formed during the revolution or in its aftermath. Of these, only the Lorient bagne which closed in 1830 survived for more than two decades.84 At the three ports with medical schools the navy provided medical care for these prisoners and it was common for naval medical students to write medical theses on aspects of criminological health, anthropology, and disease. Spectacular epidemics of scurvy, cholera, cerebrospinal meningitis, typhus, and other diseases swept these institutions, with typhus striking Toulon’s bagne at least five times between 1830 and midcentury. The navy became a prison master with an Ordinance of September 27, 1748, which decommissioned the galley fleet of Marseille and unified it with the navy. A century earlier, in 1630, some 6,000 men had staffed Marseille’s flotilla of about twenty ships. During Louis XIV’s reign perhaps one in five galériens were slaves and the others were foes of the regime including vagabonds, dealers in contraband salt or tobacco, deserters, and Protestants. About one thousand men per year were condemned to galley service at the time of the fundamental Ordinance of 1689. While not technically a death sentence, about half of those so incarcerated died in service. Mortality rates in eighteenth-century bagnes hovered between thirty-five and fiftyfive per thousand per year, but could double in years of epidemics.85 The 1748 Ordinance opened a relationship between metropolitan bagnes and the navy which endured until 1873. After that time the navy retained responsibility for these institutions after their transfer to the colonies of French Guiana and New Caledonia.86 In 1748 Marseille had a fleet of sixteen galleys, only half of them seaworthy. Transfer of some 3,700

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men to Toulon, Brest, Rochefort, Lorient, and other ports began shortly thereafter. Most went to Toulon where the first group resided on four ships. Brest received prisoners in 1749 and others in 1766 when Rochefort also received men. Toulon received its last shipment from Marseille in 1781.87 Subsequent condemnations replenished the respective populations and the initial intention was that the men would first build and then occupy land-based prisons. In Toulon, however, prisoners still lived in rotting galleys as late as 1814 and around 1840 when the Toulon bagne contained 2,300 condemned men, many slept on vessels or simply pontoons.88 Prisoners became prominent features of port life and frequently worked side by side with better-paid civilian day laborers and employees in the arsenals and workshops. Bagne infirmaries and hospitals allowed naval surgical and medical students to hone forensic skills, ponder phrenological characters and criminal psychology, and gain experience with a variety of traumas and diseases. In 1784 the commissary at Toulon converted a warehouse into a prison hospital. The first floor housed a pharmacy, kitchens, offices for administration, a naval physician, a chaplain, and guards. A second floor featured separate wards for those with fevers, injuries, and venereal and dermatological afflictions. Nuns, who acted as nurses, resided in a separate building. Physician-patient relationships in the bange differed substantially from those found in civilian practice. Prisoner patients remained in chains unless a physician ordered otherwise, and the naval physician needed to be on the lookout for malingerers. Food rations for patient-prisoners were the same as for navy employees admitted to a separate naval hospital.89 In contrast to civilian medical students, those in the navy encountered prisoners as patients and coworkers at the hospital, at medical inspections upon a chain gang’s arrival at the bagne, as workers in medical school gardens and demonstrators in the Rochefort school’s course on pharmaceutical chemistry, and of course as laborers at the arsenal and on diverse public-works projects.90 Michel Foucault rarely mentioned naval prisons or naval medicine, although he correctly asserted that the economic consideration of goods preceded the supervision of diseases and bodies in naval hospitals. This is hardly surprising, however. The reform of maritime commerce preceded that of naval activities by a few years, and accounting for and supervising goods were the primary missions of the commissary, the administrative section governing naval medical services and prisons.91 Naval prisons constituted the least-reformed sector of the French carceral world and had few of the redemptive features Foucault ascribed to postrevolutionary civil

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prison life. All three bagnes persisted into the Second Empire as unreformed vestiges of another century. After 1810 civil prisons generally had provisions for work, redemption, and strict scrutiny throughout the day. This was followed by isolation at night. In contrast to Foucault’s account of imprisonment in this era as emphasizing detention as the “essential form of punishment,” inmates of the bagnes, although they had religious services, lived under a harsh regime of labor conducted throughout the port community.92 The regime of naval inmates differed from their civilian counterparts in others ways as well, for at night naval inmates returned to barrack benches and slept in groups or conducted other activities while chained.

Louis René Villermé: The Bagne as Laboratory Bagnards may have had a better diet than civilian prisoners, possibly due to the modest income laboring provided, which could purchase food to supplement the regulation diet. Yet civil prisons of the postrevolutionary era also had wage-labor schemes and canteens where prisoners spent the majority of their salaries.93 At times the sharing or exchange of items purchased at the commissary provoked jealousies and may have been a factor in violent acts like the murder recounted in the following section. Numerical studies of the 1820s revealed deplorably high mortality rates in civil institutions and especially at the dépôts de mendicité.94 For example, the statistician, social investigator, and physician Louis René Villermé, although he did not visit bagnes in Brest or Rochefort, examined Restoration-era records supplied by the naval surgeon major Charles Vincet Payen and concluded that inmates at Brest’s bagne were less likely to die while incarcerated than inmates at the civilian prison for vagabonds and beggars at Saint-Denis near Paris.95 Even if Payen’s records and Villermé’s calculations provided reliable indicators of bagne mortality, this was little consolation. Death and misery abided in the port prisons. A medial thesis by the naval physician Montgrand calculated that during the years 1846 to 1852 about a third of the more than a thousand inmates hospitalized at Brest for tuberculosis or pneumonia had died there.96 Villermé also examined bagne records from Rochefort, the home port of the fever expert and naval physician Charles-Adolphe Maher whose career is assessed in chapter 3. Again, working from records compiled by others, Villermé compared mortality figures for Rochefort’s civilian workers and military employees with those of the bagnards and asked why, once ill, prisoners died with greater frequency. He found that prisoners, though generally younger in average age than the two comparison groups, frequently

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died from fevers during the warmer months. He also determined that when epidemic fevers erupted the navy relocated convalescent arsenal workers and sailors to the nearby town of Saintes while the bagnards remained behind to suffer repeated exposure to the causes of their illnesses. This deplorable situation kept prisoners in the elements of their own demise. Yet Villermé justified the situation as necessary because of Rochefort’s strategic importance and because “the death of a prisoner is far less regrettable than that of any other person.”97 During the first half of the nineteenth century at the two largest bagnes of Toulon and Brest, prison populations oscillated around 3,000 and 3,500 at each institution and were roughly equivalent to the numbers of free laborers employed at the two respective arsenals. At Toulon some arsenal work was conducted on the island of Saint-Mandrier, and forçats spent nights there rather than returning to the bagne.98 The overall impression then of the bagne world is of a discrete and separate place, one where lives were less disciplined and less isolated than in Foucault’s account of civil prisons. The admiralty sought ways to rid itself of the bagnes but seemed reluctant or unable to reform them or to circumvent tradition and modernize or civilianize its medical services and medical training, topics examined in chapter 4. To reiterate, metropolitan bagnes and their associated hospitals and infirmaries persisted to midcentury as the cocooned and insular heritage of Marseille’s galleys. They were part of naval medicine’s special situation and an important element of its lifeworld. Villermé’s studies, and those of more strident critics of the French penal system, finally emboldened reform. By the 1840s the naval prison administrator Maurice Alhoy came forward with astounding claims asserting that food rations in the bagnes were healthier and more preferable to the cuisine of free men and that bagnards lived in “relative tranquility” enjoying a life of “happy criminality [in] an establishment of charity in favor of thieves and assassins.”99 The colonies needed laborers and settlers, and within this context the oft-mentioned idea of creating colonial labor colonies gained renewed vigor. All three ports were tied to the colonies, and the port of Toulon, particularly, prospered as the French Empire expanded into Algeria in the 1830s. Later commercial and colonial activities in Latin America and Southeast Asia buoyed the fortunes of other ports. After the revolutions of 1848 France found itself with a government favorable to modernizing the navy and to ridding the naval ports of the Old Regime’s legacy of bagnes. At midcentury the navy sailed on under the perception that it was less important to the French nation than the more meritocratic and professionalized army. Naval administrators and those at its subdirectorate for the

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colonies admired British successes in prisoner relocation and settlement schemes at Botany Bay. In this context an 1851 report of a commission chaired by Admiral Armand de Makinau recommended closure of the port bagnes, and the newly crowned emperor Napoléon III ordered their transfer to the colonies.100 The Rochefort and Brest bagnes closed in 1852 and 1858, respectively, and inmates relocated to French Guiana. The navy retained control of the new colonial institutions, and naval physicians worked in them and transported new generations of convicts and laborers to these distant shores. But naval medicine also lost things which had been essential to its port medical schools: the easy availability of cadavers for dissection and the ability to study diseases and forensic medicine in large populations of confined men. In 1860 naval prisons incarcerated some 5,600 prisoners, about one of every ten prisoners in France. About 16,000 souls

4. Fortifications of Toulon port and arsenal in eighteenth century. Image courtesy of Bibliothèque nationale de France.

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passed through the Toulon bagne in the 1850s and 1860s, and shortly before its closure in 1873 an influx of defeated Communards arrived to await transportation to the new colonial bagnes.101 The section below examines the perspectives of four naval medical men whose lives intersected with the last metropolitan bagne after midcentury.

Forensic Medicine, Murder, and Epidemiological Study at the Toulon Bagne The bagnes were ideal sites for the study of race, forensic medicine, and criminal psychology. Naval medical students learned forensic medicine and related subjects such as legal medicine and toxicology as required parts of their training. Forensic medicine was important for assessing how a place like the bagne might influence behavior. Physicians became investigators if the crime included injuries or death and many naval healers wrote poignant portraits of bagnard life. For example, in 1850, Gustave Adolphe Villers, surgeon major at the Toulon bagne who had written his Paris Faculty of Medcinie thesis on typhus at the same institution, recorded his investigation of a homicide committed by an “Arab” prisoner.102 His report moralized on race and the effects the place of the bagne may have had on the event. The document, entitled “An Intimate Friendship at the Bagne of Toulon,” first recounted the January 30, 1850, execution of two bagnards.103 At the bagne, the same day, a condemned man named Ferradji-ben-salem, a twenty-six-year-old former farmer from the Algerian town of Blida, stabbed and murdered an inmate by the name of Rousseau. The bagne physician began his investigation with the supposition that the murder was the result of a homosexual relationship gone bad. He was in good company as Villermé too had written openly of homosexuality and masturbation in prisons and many penologists shared these concerns.104 Ferradji had migrated from Blida to Algiers at a young age and then served as an auxiliary soldier with three different battalions of French troops. An 1846 conviction for burglary condemned him to five years’ hard labor. In Toulon he converted to Christianity from Islam and had three years of generally excellent behavior. However, Villers noted how the stresses of the bagne world affected the fragile psychology of the African race as regards friendships with Europeans. In these situations, wrote Villers, “the man of the black race clings strongly; in this situation his devotion, his abnegation, frequently rise to adoration, because, as is known, attachment is one of his instinctive qualities.”105 The murder and the immediate actions surrounding it were evident; the

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assailant had stabbed the victim in the heart, who gave out a single but long and painful cry before falling dead. Ferradji, who by Villers’s account then knew the victim was dead, entered a state of vertigo and continued to slash and stab the corpse relenting only upon achieving “a double vengeance; the death of Rousseau, and following [this] the satisfaction of having lacerated his body.”106 Villers interviewed prisoners and others, conducted medical examinations of the corpse and perpetrator, and assessed what was known of the relationship between the two men. No witnesses came forward to confirm a homosexual relationship, and the perpetrator himself denied such acts. The physician examined Ferradji’s penis and found it in a flaccid state. This and Ferradji’s overall demeanor convinced Villers that the man was telling the truth. A few things seemed certain. Rousseau and Ferradji had worked in the same prison workshop, and they had been seen together at meals and elsewhere in the bagne where they sometimes shared food purchased at the canteen. The physician determined that Ferradji was a hard worker and paid for the majority of these shared pleasures. Rousseau, described as young and of athletic constitution, earned less than Ferradji and some said he was lazy. The relationship, it seemed, had endured for about a year but cooled a month before the murder. Villers adopted what he called a “psychological point of view” in the investigation and conducted two interviews with Ferradji, who did not deny the crime. Criminal psychology and the study of racial and ethnic sensibilities, preferences, and limits have a long association with naval medicine, and the tone of the report prefigures modes of reportage and moralization adopted by the naval physician, criminologist, and racial theorist Armand Corre, whose writings on race and Creoles are examined in chapter 3. What psychological forces or natural limitations of race and intelligence, asked the physician in Toulon, had guided Ferradji’s murderous hand? Villers pieced together a narrative of homicidal monomania and implicated Rousseau as an agent of his own demise. Ferradji, speculated Villers, had developed a friendship with Rousseau that had transformed into a psychological need. Ferradji’s physiology and the mental limitations thought to be common to his race had driven this change annealed in the powerful uniqueness of the place he lived. A new relationship cultivated by Rousseau with the prisoner Matelot had transformed Ferradji’s friendship into jealously and an ensuing rage had guided the knife. Rousseau, commented Villers, had made the mistake of treating Ferradji as he would have treated a member of the French race. But Ferradji had been “born in the deserts of Africa without moral principle[s] to instruct him to moderate his proclivities, to curb his passions.”107 Additionally, the bagne environment exacer-

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bated matters. It was all too easy to imagine this deplorable chain of events when “the theater in which the drama which we come to recount is an exceptional locale [lieu] without counterpart, a locale that has its own habits, morals, practices, even its own exigencies; when this locale, in a word, is the Bagne [bold in original].”108 In this fashion, then, Villers joined other naval physicians in proclaiming the powerful specificity and alterity of his professional environment and in investigating how the elements of place altered racial psychology, physiology, and behavior. If the bagne created opportunities for the medical investigation of homicides, such as the one committed by Ferradji, and some suicides, it was more often a venue for the study of hygiene and epidemics. These studies, frequently framed as a numerical exercise, could also have racial dimensions. Bagne infirmaries and hospitals enabled surgical and medical students to hone skills in forensic medicine and criminal psychology, as recounted above, and to investigate phrenological characters and the danger-filled lives of bagnards. Naval medical students who continued on to the medical degree learned on the great school of the sea and in the naval institutions where they worked. The majority of those who achieved the MD degree drew their thesis topics from their immediate places of duty. Observations on the residents and diseases of the bagnes, like the medical histories of the ships they served on or their colonial stations of duty, were common. A number of naval medical students and physicians who worked at the bagnes wrote of epidemics and of the perceived resistance of select ethnic groups to cholera, typhus, pneumonia, and the like. For example, one of Toulon’s medical school professors, Dr. Hubert Lauvergne, investigated phrenology and cholera in the 1830s and 1840s. His study of cholera proposed a local genesis for the disease and implicated the very place of Toulon in what he termed the mal de Toulon. The disease resulted from an ephemeral and unholy etiological trinity formed by the scourge’s unknowable and immaterial cause that somehow altered the all too receptive material place of Toulon. Individual physiological and psychological competencies, themselves entwined with meteorological and material environments, constituted a third factor.109 Prisons and ships, of course, provided they enclosed sufficiently heterogeneous populations, were ideal venues for assessing the ethnic dimensions of these epidemiological experiments made by nature. As recounted in the following chapter, Jean René Constant Quoy, a former Pacific Ocean explorer who at midcentury became inspector general of naval medicine, attended to racial and dietetic information in his investigations of the epidemic “dry colic.”

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Naval physicians were better poised than the majority of their civil counterparts to investigate the health capacities of racially diverse patients, a circumstance they owed to the colonial situation and to the navy’s role in that situation. In the 1860s, with Toulon in sole possession of a metropolitan bagne, a series of observations there warranted the ethnographic conclusion that “Arab” men died more frequently of fevers than their French counterparts but had better survival rates during typhus and cholera outbreaks. For example, the naval physician of the first class and Toulon native Louis-Baptiste Merlin recounted battling the cholera epidemic of 1865 in his Montpellier medical thesis of 1866. Merlin cited studies by Professor Ollivier, the former Toulon naval medical school professor and director of port medical services who had died during the outbreak. Ollivier had calculated that about 500 of the 1,750 bagnards institutionalized at Toulon were “Arabs” with some resistance to cholera.110 Merlin’s thesis was typical of the genre: highly descriptive of a series of cases over the course of the epidemic. Autopsies had not revealed specific anatomical lesions among the victims, but Merlin reviewed causal mechanisms for cholera suggested by others. The author largely avoided etiological speculations in his recounting of observed and recorded “facts,” by which he meant reproducing patient records. He then categorized cases according to four degrees of severity as determined by symptoms and reviewed proposed therapies from baths to the administration of ice. His recommendations of note were that the bagne needed to be well ventilated, and that ill prisoners should be removed from proximity to the causes of infection, whatever they were, and that in the early days of an outbreak the prisoners should abbreviate their normal work schedules. Finally, ill prisoners should be removed to isolation wards and any fluids they expelled should be disinfected with sulfate of iron.111 While Merlin and a host of others wrote of one epidemic or disease, other students followed Villermé and selected general mortality figures as their object of study. Although it was hardly the norm, medical theses could muster substantial research and evaluation and a few ranged beyond the narrow confines of one institution or ship. For example, Joseph-Marcel Aiguier, who was born about ten miles to the north of Toulon in the town of Solliès-Pont, completed his doctorate at Montpellier in 1868 with a thesis on mortality at the Toulon bagne. Aiguier worked in the bagne hospital’s fever ward during the winter of 1866 and had been struck by the number of Arabs who died there. His study concluded that Arab prisoners most often suffered from higher mortality rates than their European counterparts, the few exceptions being a typhus epidemic in 1855 and two visitations of

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cholera in 1854 and 1865. The bagne, he thought, offered an ideal laboratory for the study of race and health because the prisoners existed under the same identical conditions of “lodging, clothing, diet, labor, climatic conditions, [and] there are no other well-defined differences except for those introduced by race.” 112 Aiguier calculated that in nonepidemic times mortality figures for Arabs were twice that of other inmates. He noted too that the imprecise term “Arab” referred to Sub-Saharan Africans, Kabyle peoples, Jews, and people of partial African heritage lumped under the rubric of Algerians, which often included mixtures of French, Maltase, and Spanish. Likewise, the term “European” most often referred to French but could include prisoners of Spanish, German, and Italian ancestry. Aiguier’s thesis indicted the bagne on several counts and applauded its impending closure. The institution was incapable of meting out appropriate punishment or providing for rehabilitation. It was principally a “school of vices” producing an unending stream of new and heinous criminals. The solution, it seemed, was closure. Newer colonial institutions, he hoped, would adopt a system of individual cells rather than retain the common sleeping quarters of the older model. Aiguier closed by arguing that relocation of the bagnes to the colonies would improve the health of the Arabs. One of every seven Arabs in the Toulon bagne died there, and they would fare better in the South Seas. There, “under a more hospitable climate, employed at tasks more to their tastes, . . . condemned men from our Algerian possessions will contribute . . . to the development of this new neighbor and perhaps the future happy rival of Australia.”113 The bagne did close, of course, but not before it welcomed a last band of unfortunates, a group of former Communards. In the spring of 1871, after France’s defeat in the Franco-Prussian War, Paris endured widespread civil war and fighting between national troops, militias, and others. By May the Paris Commune had been suppressed, and thousands executed or condemned to exile and hard labor. The Toulon bagne was a major staging area for the relocation. In June of 1872 the typographer and former Communard, Jean Allemane, arrived at the bagne. His first glimpse of the inhabitants left him “suffocating in horror,” and he quickly realized that he was among the defeated of the Paris and Algerian insurrections and in an environment of chained men and lashings.114 Allemane became inmate number 24,328 and would labor for a time in a foundry outside the bagne walls. He then endured a ninety-six day voyage from Toulon to New Caledonia in 1873. When Allemane arrived in Toulon at the same bagne hospital ward where Aiguier had once worked,

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another naval medical student was collecting materials for his Montpellier thesis. Charles-Louis-François Aubin was born in Alexandria, Egypt, and collected material for his medical thesis on pneumonia at the Toulon bagne. He had previously served in Cochin China. Pneumonia, tuberculosis, and respiratory illnesses received intensive study from naval medical men such as the Montpellier professor of hygiene Jean-Baptiste Fonssagrives, whose contributions to naval hygiene are examined in the following chapter.115 Aubin examined seventy-two cases of pneumonia which passed through his ward from January through June in 1872 and determined that the general health of the new arrivals was better than what was usually seen at the bagne. Comparison of the two groups of patients confronting pneumonia led to general guidelines. No medication worked in all cases, but he thought those with weak constitutions might benefit from tonics and quinine and alcohol mixtures, while the more robust sometimes benefited from digitalis or ipecac. Aubin was not a therapeutic nihilist, but he thought it impossible that medicine could become what he called a “unitary medicine” with specific therapies designed for specific diseases. To do so would result in the “negation of medicine,” and he counseled his colleagues to “treat ill people and not illnesses.”116 Closure of the Toulon bagne marked the end of an era for naval healing which had grown up with the organization of separate naval ports and become a medicine and surgery for sailors and convicts. The schools of naval surgery and medicine at Brest, Rochefort, and Toulon had become centers of anatomical investigation and hygienic instruction on the basis of their relationship with prisons housing a diversity of ethic groups and producing cadavers for study. While the places of naval medical instruction had evolved since the fundamental ordinance, attachments to regional origins remained strong and the naval medical services, in part because of their recruitment practices, continued to identify with infranational territories like Provence and Brittany. The special situation of naval medicine altered with the closure of the port bagnes, and by the time Toulon’s bagne closed the colonial and domestic situations were coevolving in erratic and dynamic fashion. At the end of the nineteenth century, when the government of the Third Republic enacted a series of long-pleaded-for reforms in naval and colonial medicine, Toulon added a second medical school, a postgraduate school of application, and the navy centralized instructional activities at Bordeaux, a city with a newly constituted civilian medical faculty. This era of profound intellectual and institutional change revolutionized naval

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medical instruction and practices. New sailing technologies also altered the course of naval medical education and the lifeworlds of its students.

This chapter has recounted, framed, and enumerated the regulatory and material elements of the place of naval medicine and the conditions of its emergence. The following chapter focuses on medical geography and the techniques naval investigators employed in their enumeration of the spaces of disease and illness in the postrevolutionary era. It discusses the alleged centrality of hygiene to naval medical pedagogy and transformations in hygienic techniques. Of special interest are the investigative strategies and literary technologies deployed in the study and suppression of a disease deemed to be the navy’s own creation, the mysterious “dry colic” of the midcentury.

T WO

A Medicine and Hygiene of Place

Hygienists to the soul, the health officers of the Navy had a meteorological and sociological vision of illnesses.1 —Jacques Léonard

The previous chapter examined the distinctive technological and social environments of the ports and how the fundamental ordinance structured naval health activities. It also signaled the context of the naval healer’s lifeworld of naval hospitals, arsenals, and prisons. This chapter focuses on medical geography and hygiene, the navy’s preferred tools for investigating the relationships between place and health. Hygiene, at first regarded as a synthetic science, gained definition and attracted advocates and practitioners throughout Europe well before midcentury.2 It combined geography and statistics in eclectic fashion and drew on medicine, public works, architecture, and urbanism. Naval hygiene considered the port cities and their prostitutes, prisoners, sailors, and arsenal workers, as well as epidemics on ship and shore. Markers of hygiene’s maturity as a science apart from others accumulated after a decree of December 18, 1848, required a Council of Public Hygiene and Health in each département. In 1851 Paris hosted the first International Sanitary Conference, and the next year the first International Congress of Hygiene convened in Brussels. Further specialization within the hygienic arts was evident by the early twentieth century, with congresses on hygiene in schools (Nuremberg, 1904) and diet and hygiene (Paris, 1906).3 Place, as used here, interpenetrates with naval medicine’s specificity and alterity. Knowledge of place mandated activity, observation, enumeration, inscription, and reflection. This intimate accounting of place and the

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knowledge that obtained might facilitate disease avoidance strategies and hopefully preserve the health of the crew. It also framed how and when the navy moved men and quarantined ships during outbreaks of yellow fever, malaria, and other afflictions. Medical geography and preventive hygiene comingled as exemplars of how the naval healing arts confronted and attempted to manage place. There are subtle aspects of place and distinctiveness as regards the relationship between naval medicine and French medicine in general, for the majority of naval practitioners lacked medical degrees. The elite of naval medicine participated in the educational structures of civilian medicine, and the two domains shared enthusiasms such as medical geography. Yet naval medicine occupied a kind of hybrid niche within the larger ecology of medicine in the Second Empire and early Third Republic. Until the late nineteenth century naval healers were far-distanced in skill and training from the norms of civilian medicine, and especially removed from the elite clinical and civilian medicine of Parisian hospitals and the Paris Faculty of Medicine. Naval medicine’s place was in the provinces, on ship, and in the colonies. It was at best a minor concern of the grandes villes, Bordeaux and Marseille excepted. Biogeographical views of disease, their historical range, perceived origins, and etiology influenced naval hygiene on several levels. The navy’s localities of practice in colony, port, and especially on ship, were also used to argue for the necessity of a distinctive naval hygiene, something different in kind from what was encountered in civilian or army medicine. As seen in the previous chapter, technology and the conditions of labor and career structure enabled by them formed essential aspects of place. In the navy, however, the ship itself constituted the primary space of naval hygiene, no matter where the ship traveled. It was in this special laboratory of the ship, then, where participant-observer hygienists confronted “the two greatest dangers of nautical life, the corrupt atmosphere of the hold, and cluttering in close quarters, and all their consequences.”4 Naval healers envisioned ship occupants as suspended above a disease producing swamp. Prophylaxis generally implied increased ventilation as the quality of breathable air was seen as “the most indispensable condition for the maintenance of health.”5 Yet hygienic theories of disease etiology were dynamic and most certainly evolved over the century, even prior to the germ theory of disease. Confrontations with a mysterious “dry colic” during the middle third of the century mandated change although forms of miasmatic thinking persisted. As summarized in the navy’s official manual of hygiene of the late 1860s, the atmosphere of the ship likely bore two sorts of pathological dangers,

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miasmas arising mainly and directly from the hold, and another human miasma, a kind of infective agent exhaled mainly by ill sailors, a “something in substance which we do not know well.”6 Naval as well as army institutions facilitated advances in epidemiology and hygiene. One thinks immediately of the riddle of malaria. Yet naval medicine’s record of the nineteenth century is not very heroic. The navy’s heritage of tradition and regulations, its resolute focus on training practitioners and generalists rather than on medical research, moderated the navy’s participation in medical leadership. As regards hygiene, what was often impossible in civil situations, such as detailed scrutiny of an epidemic, and fairly strict control of diet, for example, might be possible on ship or in barrack or bagne. Investigators of these highly disciplined environments might actually exclude as unimportant some of the myriad explanatory threads forming the Gordian knot of epidemic disease. In this way there was the prospect of naval healers isolating phenomena relevant to epidemic disease and rising above the flood of information pressing on most shore-bound healers. In this regard the environments of army and naval medicine were similar. Additionally, in Brest, as at other locations, maritime hospitals served both army and naval patients. Men in all branches of the military suffered from venereal afflictions, and the Brest hospital was a good place to study them. In the early 1850s venereal patients accounted for a fifth of all hospital admissions and a third of the institution’s 140,000 yearly patient days.7 The opportunities then, were there, if only one had the time and resources for study. The navy and army medical worlds differed in many ways, and theories of disease evolved as responses to distinctive challenges on ship, in colony and port.8 The naval disease ecology differed from that of the army, for in addition to having a high incidence of venereal disease, it had its own special mixture of signature diseases and traumas. This chapter examines the relationship between two high-profile naval signature diseases, scurvy and dry colic, and the following one investigates yellow fever, the supreme signature disease of the midcentury French maritime world. Naval healers developed a distinctive style of hygienic medicine in response to these major naval threats. Dry colic and yellow fever, most often associated with the tropics and colonies of the Caribbean and Africa, presented novel racial and ethnic profiles. Naval hygienists realized the need for comprehensive study of the specific tasks sailors engaged in, the places they inhabited and sailed to, and the ethnic heritages of their charges. In summary, then, naval healers viewed their art as special in content. It was neither army medicine nor civilian medicine. This separateness of

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practice and view, aspects of which are enumerated below, interpenetrate the cultural place of naval medicine, colonial medicine’s precursor. I agree with Alan Bewell that “seeing disease as essentially geographical, a problem of places more than people, provided a powerful ideological underpinning for European expansion.”9 But the concept of place as operationalized by naval healers was even more powerful than Bewell implies. Concepts of place and race interpenetrated with each other, and the study of place did not efface the study of people and their bodies; it enhanced it.

Army, Civilian, and Naval Medicine: A Shared Heritage of Medical Geography The three great divisions of French healers, army, civilian, and naval, held in common some ideas and approaches to healing. The elite of French naval medicine obtained MD degrees in civilian faculties and sometimes they worked in army institutions and by late century a few naval physicians followed courses at the Pasteur Institute. Prior to the Third Republic, army physicians, who most often attended a civilian faculty prior to undertaking postgraduate work in army medicine at Val-de-Grâce hospital and the army’s school of applied army medicine in Paris, and civilian practitioners, were in many ways more similar to each other than to naval healers, most of whom failed to win an MD degree. The mass of naval healers were akin to civilian health officers, moderately schooled healers who learned by apprenticeship and were allowed to practice medicine in a geographically restricted area under the supervision of a physician. Thus it is not surprising to find the elites of naval medicine, the professors and chiefs of clinic, like their civilian and army counterparts, engaged in medical geography and other fashions of the era. French medical geography evolved from many sources and garnered an enthusiastic following when two foreigners active in France, Alexander von Humboldt and Conrad Malte-Brun, enlivened and refined Enlightenment ideas of climate and place.10 Humboldt’s Cosmos popularized the mapping of diverse attributes of the terrestrial and celestial environments and his style of medical geography inspired many imitators.11 In 1827, one of Humboldt’s followers, Friedrich Schnurrer, published his “Charte über die geographische Ausbreitung der Krankheiten,” the first map charting the distribution of human diseases.12 August Hirsch, writing three decades later, followed the same line of reasoning and produced a much-admired two volume history and geography of human disease.13 The Dane Conrad Malte-Brun also inspired followers and imitators. Malte-Brun, who began

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publishing his Géographie universelle in 1810 and helped found the Société de géographie de Paris in 1821, defined geographical knowledge as the combination of detailed local studies, a theory of geography, and a universal vision. At first approach Malte-Brun’s conception of geography seems similar to the vision of medical geography adopted by the naval physician JeanBaptiste Mahé, author of a monograph on medical geography published in 1882. Yet Mahé kept medical concerns in focus and avoided broad generalizations. “Medical geography,” he wrote, embraces all the applications of geography to medicine: it is not only the science and distribution of diseases or geographical nosology, because [geographical nosology] only constitutes a part of it, truthfully a very important part. In other terms, all geographical notions which concern human existence, his health, his illnesses, belong to iatro-géographie.14

Mahé traced medical geography’s origins to Schnurrer rather than to MalteBrun’s expansive physical geography.15 Physicians had many professional societies, perhaps too many, and only a hand full of them were active in the Société de géographie de Paris. Moreover, by 1840 the sphere of geography had contracted. According to Anne Godlewska, the once broad and inclusive programs of Humboldt and Malte-Brun had “surrendered questions of environment and disease to medicine and field observation of antiquities to archaeologists.”16 Mahé also found fault with the works of his two main predecessors in medical geography who wrote in French, the army physician Jean-Christian-M.-F.-J. Boudin, and the Genevan physician, Henri-Clermond Lombard. The army physician Jean-Christian-M.-F.-J. Boudin is a good example of what Ann La Berge terms a “statistician-hygienist.”17 Boudin completed tours of duty in the Mediterranean basin and rose to become chief physician for the army of the Alps and Italy. During the 1840s and 1850s he published studies on the demography of France and its empire, and on medical and economic aspects of Algerian colonization. It is uncertain when the term géographie médicale made its first appearance in French, but Bodin used it in an 1843 study.18 His magnum opus on medical geography, a two-volume Traité de géographie et de statistique médicales et des maladies endémiques, appeared in 1857. The book, an effort of compilation and synthesis rather than fieldwork, took its definition of “climate” from Humboldt’s Cosmos and was especially concerned with ethnicity, health, and military recruitment.19 Boudin employed nine maps and numerous tables

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to display the afflictions, health, and ethnicity of the French nation. The study, though regarded as pioneering, wove together odd bits of information. One map charted the frequency of goiter as a function of exemptions from military service, another indicated the frequency of lightening strikes on humans in different départements of France, and yet another displayed the demography of Jews. Naval man Mahé’s evaluation of Boudin’s legacy charged the army doctor with missing his mark and hinted at interservice rivalry.20 If the book had been an “event in French medical literature,” it was also an “overly comprehensive and untidy assemblage of geographical notions, medical statistics and endemic diseases, teaming with errors and making unjustified hypotheses of a nosological flora comparable to the diversity of plants and animals according to different terrestrial locations.”21 The second predecessor of Mahé’s account, Henri-Clermond Lombard, produced the monumental Traité de climatologie médicale, a four-volume work with an additional atlas published from 1877 to 1880. 22 The Genevan Lombard, who likely suffered from tuberculosis, completed a medical thesis on that disease in Paris where he had studied under two seminal figures of French hygiene, Pierre-Charles-Alexander Louis and Gabriel Andral. Louis, a clinician with an activist spirit who campaigned against the ravages of tuberculosis, was an inspiring mentor for the cosmopolitan Lombard. In addition to his Traité he published widely on influenza, demography, and especially alpine medicine and matching wealthy patients with the proper spas and meteorological conditions.23 The notion of climates as harmful or curative was widespread, especially among physicians who dealt with tuberculosis. For example, an 1866 study of tuberculosis therapy by the former naval hygienist Jean-Baptiste Fonssagrives, devoted more than a hundred pages to curative climates and the nuances of atmosphere.24 Unlike Mahé, Lombard praised Boudin as France’s first medical geographer and considered his Traité de géographie et de statistique médicales a foundational text of the discipline.25 Lombard’s Traité de climatologie médicale was actually a collaborative effort between himself and two younger and barely credited physicians, Jean Henri Adolphe d’Espine, the son of Lombard’s friend Dr. Jacob-Marc d’Espine, and Lombard’s nephew.26 Its atlas contained twenty-five maps displaying seasonal mortality patterns. Some maps were European in scope, while others were global exercises sketching the distribution of yellow fever, tuberculosis, cholera, and malaria. Medical geography was something of a pastiche for Lombard, a synthetic endeavor which borrowed notions from geography, ethnography, anthropology, demography, physiology, and comparative pathology.27 In this it was similar to the science of hygiene it-

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self. The consistently critical Mahé found faults with Lombard’s work as he had with Boudin’s earlier study. He complained about its length, of long chapters on political and descriptive geography, and especially criticized Lombard for giving too wide a place to climatic influences in his explanations of acute diseases.28 Mahé’s criticism of these works of army and civilian medicine drew attention to naval matters and promoted his own succinct studies of naval hygiene and medical geography. He might also have mentioned the navy’s experienced geographers and how they had led the systematic mapping of the French coast, an effort crowned in 1844 by publication of CharlesFrançois Beautemps-Beaupré’s Pilote français.29 By 1864 French naval physicians had launched their first professional journal and begun what they hoped would be a more systematic collection and synthetic presentation of geographical, climatic, and health information. A major goal of the new Archives de médecine navale, remarked its first editor, Alfred Le Roy de Méricourt, was to construct “a kind of medical guidebook for the coasts of the entire world.” Little by little, the rigorous collection and publication of regional medical topographies would allow the “united naval health corps to achieve a durable work: [a] climatology and exotic pathology.”30 In many ways, however, the work of medical geography, though it was not then called that, was a proud naval tradition which had existed from the moment of the Royal Navy’s birth in the seventeenth century. The fundamental ordinance had required a sort of medical accounting on naval voyages. The tradition continued in the work of naval medical men such as CharlesAdolphe Maher, director of the medical school at Rochefort in the 1860s, who chronicled the malarial fevers of his native city, and myriads of others who served at nearly all floating and terrestrial stations of duty.31

Enumerating the Elements of Place: The Journal fin de campagne The fundamental Ordinance of 1689 required naval healers to record information on the medicine, hygiene, and predominant diseases of their places of duty. This mandated formal accounting of the most privileged of all naval places, the ship, and forced surgeons to inventory the ship’s medicine chest. Little autonomy was presumed as a writer and chaplain also had access to the medicine chest key. A regulation of 1683 for maritime surgeons, later reiterated for naval healers in the Ordinance of 1689, enjoined them to “keep a journal of the nature of the illness which may come forward for their examination during the campaign, and the medicines they might consume [during the voyage]. This journal must be seen by the chaplain

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and the writer.”32 The product varied in quality. If composed by a partly lettered surgeon, observations might be recorded in clipped French prose bearing the marks of the writer’s linguistic origins. If composed by a physician or near-physician, as was more common in the nineteenth century, the document might display considerable eloquence, engage neo-Hippocratic theory, and comment freely on the nature of the environments and diseases encountered. Composition of the required Journal fin de campagne mandated assessing disease, meteorological conditions, diet, and locale. The conditions of observation, but especially the construction of reports, the method of reporting, the order of presentation of subjects, the things to be attended to, and the required summations, evolved into a confusing exercise. In a memo of 1848, the inspector general of the naval health service, Jean René Constant Quoy, who had explored Hawaii, New Zealand, and the Western Pacific as a naturalist on the Uranie under Louis de Freycinet, and also accompanied Jules Dumont d’Urville on the Astrolabe, complained about heterodox methods of reporting and summarizing health information. At issue were reports of thirty-four voyages to West Africa undertaken in 1847 implying that West Africa was actually a healthier place to live than any location in France. Among the myriad of issues to be addressed was ethnicity, and Quoy wanted all future journals to distinguish “between whites and natives to investigate in which proportions morbid susceptibility manifests itself in the two races.”33 Quoy changed how the navy reported hygienic information and codified procedures for what it did with this information. The process took most of a decade, and in an official instruction of 1857, itself designed to clarify an earlier decree of 1851, he again championed standardization of reporting procedures and enumeration of the races of those who fell ill or died. Like most things in the navy, these new instructions were not entirely new though Quoy clearly specified the content requested in different sorts of reports. Jean-Baptiste Fonssagrives’s popular manual of naval hygiene of 1856 had listed seven elements of the Journal fin de campagne and provided model forms for talking medical observations on campaign. The forms requested information on ethnicity to be recorded in two columns as “diseases observed on ships” and “diseases of natives.”34 The two categories, however, were not necessarily mutually exclusive as the navy employed colonized peoples to work on ship, and as noted below Quoy gave healers a measure of autonomy in disease identification, naming, and classification. Quoy’s instructions reiterated the primacy of the ship as the favored place of naval medicine. The mobility of the ship and its conditions of

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service determined report frequency and content. On permanently armed ships, and those affected to stationary service or surveillance of fisheries, the surgeon major was to submit in January a single annual report, or, if requested by superiors, submit the report on demand. Healers posted on long voyages composed a Journal fin de campagne upon returning to port. Quoy felt this second class of reports were least amenable to summation and thus ripe for the introduction of errors. The new procedures required surgeon majors to assess the health history of the ship and crew prior to lifting anchor and to close the report only after the disembarkation of crew and cargo. Ideally, the information was collected each day of the voyage and inscribed to facilitate the collation and summation of health information in daily, weekly, and monthly registers. Once completed the journal passed to the port’s Council of Health, headed by the chief of the health service, which in Toulon, Rochefort, and Brest usually meant the director of the medical school and the professors.35 Councils then evaluated journals and usually added their own written comments. After evaluation at the port level, the chief of the health service incorporated this additional information and produced a summary report sent to Paris on an annual basis. Port libraries retained the journals for consultation by physicians in the hope the next ship sent to the same region might avert health disasters, or at least the physician and captain might know what to expect. By midcentury the journal had evolved into a document framed around a proscribed logbook format listing information in three separate categories: meteorological observations, medical statistics, and a less precise category on general medical observations and regulations. The final report submitted to the port health councils was to be rearranged and summed up into two parts; the first of these contained the itinerary, meteorological observations, and medical statistics. The second part was a medical history of the voyage. Quoy charged authors to “scrupulously conform to the larger divisions adopted for their classification; but the health officer will employ the designations which accord with the teaching of our schools and current state of science; he will group them according to the nosological methods which appear clearest to him.”36 This invited heterodox information nearly incapable of summation. It also pushed nosological precision back on the pedagogy of the schools, and finally on the individual diagnostic skills of naval healers. However, a uniform, coherent, and tightly scripted pedagogy for naval hygiene, as I discuss below, was a rarely realized dream. Naval hygiene was a heterogeneous set of practices directed at an evolving disease ecology. In terms of its theoretical foundations, however, naval hygiene awaited heroic figures, someone who could analyze widely dispersed

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mounds of heterogeneous information and produce a bold synthesis, a Charles Darwin or Antoine Lavoisier of naval medicine. The second and last part of the journal, the medical history of the campaign, was arranged in four sections. It began by enumerating the hygienic state of the ship and crew prior to embarkation. Reporting physicians and surgeon majors were counseled to review the information recorded in the first half of the report and to present in order a hygienic consideration of the crew and ship, review meteorological conditions encountered in relation to hygiene, enumerate clinical observations collected at the bedside of patients and distilled from the medical observations recorded in part one, and compose a narrative section summarizing all statistical information. Quoy readdressed the problem of recording health statistics by ethnicity but again invited a creativity in reporting that worked against standardization. It was noted, he wrote, that in far flung stations, a certain number of men of color are employed today of which [their] organization, different from that of Europeans, enables them to escape many endemic illness, and, on the other hand, also exposes them to mishaps of little consequence for our sailors. If the surgeon-major, in his love of science, has gathered observations on this subject, he will usefully record them and shall note in what fashion they moderate the general results. He can even establish, in the course of the report, a [complete and separate] résumé no 4 for each of the two races forming the crew.37

Once the reports were complete and reviewed and commented upon by port councils of health, the quintessence of these highly localized journals had to be skimmed off and reconfigured in required annual summaries composed by the five chief health officers of Lorient, Cherbourg, Brest, Rochefort, and Toulon. Finally, port authorities transmitted the summaries to Paris. The multiple constraints of place informed how the information was collected, summarized, and passed on. It also enforced the localization of primary documents in the ports. Thus a physician working in Lorient would not, for example, have easy access to reports filed in the distant port of Toulon. Still, the strategy of seeing disease and mapping its geographical and meteorological presence or absence, and then filing reports of voyages in the port of the ship’s origination, made sense, at least to the navy. In practice ships bound for Mediterranean ports most often sailed from Toulon, whereas those bound for America generally began the journey from an Atlantic port. For example, the most complete information on instances

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of plague in Constantinople would be found in the archives at Toulon. On the other hand, if a ship sailed from Rochefort to Asia and subsequently encountered plague and returned, that report would be placed in Rochefort. Weak links in the information chain persisted. For example, immediate study of primary documents relating the medical histories of ships encountering yellow fever in Gibraltar, Mexico, or West Africa, required travel to the individual ports that housed the information, or necessitated repeated pleas to navy copyists who might skip marginalia added to the document during review by port health councils. The naval accounting system encouraged nosographies founded on locality and sometimes ethnicity. Physicians wrote of the ulcer of Cochin China, colics from the four corners of the world, and of epigastric pains associated with the negro stomach. This localistic view, simultaneously expressed on many levels, rendered difficult any reduction of geographically typed diseases into simpler nosological categories, even when diseases presented similar clinical signs. If clinical concerns resided near or at the top of the cognitive hierarchy at the Paris Faculty of Medicine and in its hospitals, in the ports and on ship physicians judiciously weighed clinical signs against a more leveled and sociologically informed knowledge of the places where diseases occurred. Staffing procedures, and specifically the rotation of healers through several ports, telegraphy, and an efficient mail system, mitigated but failed to efface the health service’s structured localism and its port-centered and ship-centered viewpoint. Although naval patients were largely male, and from the younger and middle-aged demographic, seamen differed by competencies, sobriety, susceptibility to disease, and ethnicity. Some naval professions, and some locales on ship, were grievously unhealthful in comparison to others. For example the medical thesis Paul Bourel-Roncière defended at Montpellier on May 28, 1864, showed precisely how technological advance, in this case the shift from wind power to steam, had compromised the health of certain crew members. In some cases, where temperatures on outside decks measured between eighty-two and ninety-five degrees Fahrenheit, the stokers and mechanics who worked near the engine endured temperatures between 158 and 176 degrees.38 These men drank copious amounts of liquids just to survive, and this put mechanics and stokers at risk for lead poisoning, a condition frequently identified variously as a nervous or dry colic, the epidemiology of which is discussed below. As regards shipboard temperatures, especially on hospital ships laden with malaria victims who had rights to a hammock below deck, or were so sick as to be semimobile at best, the sweltering below-deck environment exacerbated disease symp-

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toms and might cause dehydration or death. Additionally, nurses often treated dehydration with acidified water or lemonade designed to prevent scurvy and other ills. But as the navy came to realize, the routine ingestion of these substances led to widespread epidemics of the mysterious dry colic. The historical reconstruction of etiology is a hazardous exercise, but technological changes in the primary physical place of naval medicine, the ship, and specifically improvements in architecture and materials, caused the epidemic. A number of well-meaning hygienic procedures, and forceful medical personalities, sustained the dry colic epidemic and gave it an iatrogenic dimension.

Prestige, Tradition, and Naval Hygiene The physician Jules Rochard, born in Brittany in the town of Saint-Brieuc in 1819, began his career as initial reports of dry colic came before the port councils of health. Symptoms of the condition included nausea, sluggishness, loss of appetite, gastrointestinal complaints, and dehydration. If the disease progressed, as it often did, victims suffered paralysis, which frequently included a limp wrist and sometimes fell into a coma. Rochard sailed to the far reaches of the disease’s range in Senegal, India, and the Caribbean. Both a surgeon and hygienist, Rochard supported his fellow naval physician, hygienist, and friend, Jean-Baptiste Fonssagvires, in a dispute over the etiology of the disease in the 1850s. Rochard was among the most influential naval physicians of the century and he finished his life as a member of the Académie de médecine and foe of tobacco smoking. None of this was foreseen when he claimed his MD degree in 1847, or when he began his professorial career at the bottom rung of the naval career path in the anatomical laboratory at Brest. Passing the concours for professor two years later, he would teach successively anatomy, physiology and minor surgery, serve as chief of clinical surgery, and instruct students in administrative and legal medicine. Called from the directorship of the Brest school in 1875 to be named inspector general of the naval health service, he served in that capacity until 1886 when the government abolished the position in preparation for integrating colonial health services into the army and civilian realm. Rochard remained active in medical politics and lobbied hard and successfully to form a subsection of hygiene and public medicine within the august confines of the Association française pour l’avancement des sciences.39 He eventually served as president of that association and the Société de médecine publique, and his many publications included a history of French surgery, contributions

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to the Revue d’hygiène, and a coauthored Traité d’hygiène, de médecine et de chirurgie navales published in the year of his death, 1896.40 Naval healers, at least in the aggregate, shared a commitment to hygiene, the medicine of place, and geographically framed views of disease. But the path to this hygienic commitment merits evaluation. Naval healers, according to the late Jacques Léonard, “were forced above all to be hygienists and were charged to reduce the number of ill.”41 In this they shared an allegiance to the sciences of disease avoidance found among army epidemiologists. 42 As Mahé put it, “the medical geographer must conduct himself like the naturalist, whose principal goal is to begin with the study, differentiation, and registering of all present day species.”43 This obtained naturally from the requirements of the craft: the proscribed keeping of shipboard journals, the taking of meteorological observations, and the enumeration of who was ill. Léonard, who portrays naval healers as mainly empirics, nearly incapable of synthetic thought, continues that a characteristic of the instruction given in the ports emerges from a medicine of climates and places; there again, it is a tradition of the Navy; since the eighteenth century, the “constitutions” dear to Sydenham were taken in extreme consideration, the social environment and geographical conditioning: the soil, water, climate, seasons, winds, traditions of diet and dress, work, deficiencies, fears, etc. Hygienists to the soul, the health officers of the Navy had a meteorological and sociological vision of illnesses.44

While hygiene may have resided in the souls of naval health officers, the record of the navy’s instruction in hygiene at its schools was inconsistent and even noncommittal when it required money for new professorships. If fact instruction in naval hygiene was a pedagogical orphan and offerings were not standardized across the curriculum of the three schools. Generations of students passed through the system without encountering any course in hygiene and exited the schools for up to two years of shipboard duty without a comprehensive view of the subject. This does not mean students were naive to hygienic principles and procedures. But they received hygienic instruction in piecemeal fashion and likely through the experience of voyaging on the great school of the sea. A history of the teaching of hygiene at Rochefort reveals its marginal pedagogical status. The three port medical schools evolved from hospital instruction and the teaching of anatomy, surgery, and trauma medicine. Hence it is not surprising a history of the Rochefort school to 1789 found no courses with identifiable hygienic content, but noted progress in shipboard hygiene,

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especially for typhoid and typhus, and improvements in the sanitary situation of the city and port.45 Documents from the Napoleonic era record the presence of a M. Faye, who is listed as teaching hygiene.46 In 1830, as revolutions rocked Europe, the Rochefort school offered nine different courses: medical natural history, anatomy, bone setting and minor surgery, medical chemistry, clinical surgery, clinical medicine, chemistry, and pharmacy. But the class on hygiene, noted the school’s director, had not been taught “for many years because this course is not assigned to any of the chiefs [of service] or professors.”47 Students recognized this insufficiency in their training, as did critics of the schools like Dr. Eugène Leconte, since 1846 the holder of an MD degree from Paris who had written a thesis on topographical influences on illnesses.48 In 1848 Leconte produced a “Plan for a New Constitution for the Corps of Naval Health Officers.” Charging that the number of professors in each of the three schools was insufficient to cover the material naval healers needed to master, why was it, he asked, that naval medical men were sent all over the globe but none of the three schools had a professor of hygiene? 49 But Leconte’s plan, like the various revolutions which occurred that year in many European cities, failed. In 1862, the school’s director, the Rochefort native Charles-Adolphe Maher, whose career and views on yellow fever are discussed in the following chapter, drew up another reform plan listing eight teaching chairs. None of them were dedicated to teaching hygiene, although he suggested the directors of the schools assume as additional duties instruction in naval hygiene, regulations, and procedures.50 This solution, adopted frequently by the port schools, resulted in a piecemeal pedagogy with the teaching of hygiene dispersed over a number of courses. Hygienic principles were linked frequently to specific practices naval healers would be expected to master as part of their craft: quarantine procedures, forensic medicine, and general naval and maritime regulations. A course syllabus from the 1880s of Dr. Ferdinand Burot, another of Rochefort’s directors, provides some clarification on this dispersed status of hygiene. Burot, who was quick to apply Pasteur’s germ theory to the bilious fevers of Guiana, authored numerous studies of malaria, mental suggestion, and hygiene.51 Burot’s 1888–1889 course on “Legal Medicine and Toxicology” met thirty-four times and covered aspects of social medicine. Lectures reveal a “sociological” view of healing identified by Léonard as a main stay of naval medicine and examined the navy’s relationship with the judicial system, the legal regime of naval medicine, mental illness, and responsibility. The circumstances of naval medical careers almost assured that healers would be called upon repeatedly to determine the cause or causes of death of their

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charges. Hence much of Burot’s course dealt with forensics and included two lectures on infanticide, two on abortion, three on asphyxia, and six on toxicology and poisonings.52 Toxicology of course can be construed as a subset of dietetics, or perhaps professional hygiene, and asphyxia might have any number of environmental modes of transmission and causes, including that of ship architecture or where men slept and worked while voyaging and in port. Hygiene, however, was not the main emphasis of the class. Despite the uneven pedagogical attention paid to hygiene in their schools, naval medical men issued frequent pleas for hygiene’s centrality to the health of the fleet, nation, and civilization. Oft sounded were assertions of hygiene’s incomplete nature, and distinctly sanguine but cloudy views of a future utopian-like world founded on a truly hygienic civilization. Some healers reframed this localized science of place as an art meant to incorporate global views of health and cultures. For example, in 1845, the former naval physician, Évariste Bertulus, whose activities are evaluated in greater detail in chapter 5, addressed the Société royale de médecine de Marseille pleading for completion of the half-finished science of hygiene. Citing Hippocrates, he argued that medical topography was the fundamental healing art.53 Two decades later, the hygienist Jean-Baptiste Fonssagrives, like Bertulus one who forsook the navy for civilian practice, addressed a final lecture to former colleagues at the Brest school. Speaking more to the incompleteness of the curriculum in the naval medical schools, than to the science of hygiene per se, he signaled his faith in “the moral, material, and scientific future of naval medicine when its institutions have been completed, modernized, and strengthened.”54 In 1886, Dr. Charles Auffret, a naval surgeon and anatomist at the Brest school, took license to exaggerate in his obituary of Fonssagrives. Auffret drew parallels between chemistry and hygiene where he likened Fonssagrives to the great Enlightenment chemist, Antoine Lavoisier, whose identification of oxygen had reformed chemistry. Hygiene, asserted Auffret, like chemistry, had rested on infirm foundations prior to the appearance of Fonssagrives’s 1856 text on naval hygiene, and he was willing to claim that until then “the science of hygiene had yet to be created.”55 The tenuous curricular status of hygiene at the Rochefort school mirrored the situation at Toulon, and likely too at Brest. Continuity of instruction suffered at all three port schools as the navy struggled to accommodate technological and scientific innovations and rode out changes in government. New regulations altered the mixture of professorial chairs twice during the Second Empire, in 1857 and 1866, and again in 1875 amid the

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instabilities of the Third Republic.56 Instruction of sailors and lower-level officers in personal hygiene began in response to a circular of April 27, 1872. Conducted for an hour on Saturday mornings, the syllabus made no mention of epidemiology but spent much time on the dangers of alcoholism and traced a predictable review of health issues surrounding atmosphere, water, soil, and climate.57 Long after civilian medical faculties added specialty chairs of hygiene and legal medicine, the navy still geared its institutions to producing generalist practitioners. In 1910, Jules Regnault, a surgeon and professor of anatomy at the Toulon school and a leader in the town’s antituberculosis campaigns, traced the history of his institution’s teaching chairs and reflected on the navy’s practice of having professors change teaching specialties every few years. The incessant progress of medical science, he concluded, had made “this dispersion of efforts more and more impossible.”58 Toulon’s chair of Hygiene had been stable early in the century and in the capable hands of the Toulon native, Jean-François Hernandez, who wrote on typhus, venereal diseases, and fevers. Quite soon, however, the Préfet of the port tried to remove Hernandez for promoting John Brown’s controversial theories of physiological irritability, excitability, and disease. Hernandez remained but it is not clear how much effort he devoted to instruction in hygiene as he was also chief of clinic until 1815. From 1836 to 1866 the subject of hygiene was attached to other chairs, but remerged again as a professorial chair in 1866 with the title chair of General Hygiene, Naval Hygiene, and Exotic Pathology. From 1866 to 1890 four different incumbents held the chair. In 1896 after the centralization of naval medical studies at Bordeaux, the chair migrated to Toulon’s new postgraduate school for naval medicine, the École d’application, as the chair of Naval Hygiene and Exotic Pathology. In 1906, ten years after the addition of a chair of Bacteriology at the same institution, the subject continued under a chair of Hygiene.59 Naval physicians were proud of naval healing’s heritage and often traced its lineage back to the age of the Roman emperor Augustus whose reign coincided with the birth of Jesus.60 A real but often romanticized heritage of Hippocrates, frequently comingled with those of Galen and Thomas Sydenham, watched over their shoulders as they compiled accounts of place and investigated epidemics. The Hippocratic heritage was of course not one heritage but many. Diverse groups of physicians in Paris, Lyon, and Montpellier instrumentalized clinical, meteorological, or holistic aspects of Hippocratic doctrines for very different reasons.61 The Panthéon, the Paris mausoleum of remembrance for France’s great men and woman (only Ma-

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rie Curie is so honored), contains few places for physicians. Only the great physician and physiologist of the revolutionary era, Pierre-Jean-Georges Cabanis, rests there. But had their been room for naval physicians, JeanBaptiste Fonssagrives, hygienist extraordinaire, would have been among the pretenders.

Hygiene, Civilization, and the Places of Dry Colic: Jean-Baptiste Fonssagrives and Amédée Lefèvre Jean-Baptiste Fonssagrives shared the modest beginnings of many in his naval cohort. Born in Limoges, prefectoral city of Haute-Vienne in 1823, his father died when he was nine. Moving to Rochefort he entered the local naval medical school and became a lowly third-class surgeon in December of 1841.62 Like Jules Rochard he too began service just as the navy converted ships from sail power to steam. Said to be of a serious and studious demeanor, he was remembered as one “who never laughed or laughed only a little.” 63 Voyaging, including two years of duty in 1850 and 1851 off the west coast of Africa on the steam-powered frigate, Eldorado, occupied his early years. Brilliant at the art of the concours and quick and precise with his pen, he collated his experiences on the Eldorado for a medical thesis defended at Paris in 1852. Drawing again on the epidemiological lessons of the Eldorado and reports of other ships, he also published in the same year a lengthy study on what he took to be a disease endemic to the hot countries, a kind of nervous affliction of the bowels variously identified as dry colic, nervous colic, or colic of Madrid, among other names.64 Fonssagrives’s ideas on race, ethnicity, and staffing of the maritime professions are reserved for the following chapter, although notions of place inflect them as well. He was also a medical humanist, the very exemplar of a learned man of wide culture, and the kind of man detractors of naval medicine claimed was lacking in the navy. Fonssagrives was a synthesizer of note, one who read widely, published poetry under the pseudonym of Victor Müller, and authored studies on hygiene and therapeutics. Those of his activities analyzed here attend mainly to his career and voluminous studies of place, especially his work on naval hygiene, civil hygiene, and tuberculosis, a disease frequently associated with the maritime professions. The fabled white plague of René and Jean Dubos, tuberculosis likely killed more Europeans over the course of the long nineteenth century than any other single disease.65 It also remained incurable until after Selman Waksman’s 1943 discovery of streptomycin and its widespread distribution. Tuberculosis and other respiratory diseases posed continuing public-health

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problems for the navy, which sequestered men in cramped, poorly illuminated and ill-ventilated quarters. Le Havre, at the mouth of the Seine River in Normandy, came to be regarded as an epicenter of tuberculosis in France during the nineteenth century, though there were many other candidates for this title.66 The relationships between hygiene, therapeutics, and tuberculosis fascinated Fonssagrives and elicited thoughts on the curative nature of civilization and the place of tuberculosis in society. One day, predicted Fonssagrives, though he could not say exactly when, tuberculosis would be stopped. In an 1866 book dedicated to naval physicians and his new civilian colleagues at Montpellier’s Faculty of Medicine, he wrote of the disease shrinking back under the embrace of hygiene and the progressive reduction of ignorance and misery. A force arises in our time which must without fail lead to this result. Resting simultaneously on morality and well-being, hygiene borrows from [the former] the moderation which renders it effective, from the other, the material resources which render its possibility, and in identifying with civilization itself, [hygiene] cannot remain indifferent to any of the social problems posed to it daily, to any of the tribulations which retard it or drive it forward, to any of the dangers which threaten it. And from this relationship derives the state of advancement of private and public hygiene in a given country[;] thanks to this solidarity, [hygiene] is a sufficiently exact measure of the civilization from which it issues.67

Much French writing on empire including that of Fonssagrives promoted Western civilization as a cure-all for the ills of colonized peoples. Thus scientism, Christianity, or sedentary rational agriculture, nearly whatever constituted the writer’s definition of civilization, figured into an ideological discourse of resuscitation and restoration deployed toward what the French perceived as the degraded cultures of Algeria, Sub-Saharan Africa, and other colonial dominions.68 Upon returning from Africa, Fonssagrives served in Lorient and treated the afflictions of the city’s impoverished. He also ministered to typhus victims on Russian ships in port. By 1853, he had assumed the chair of Therapeutics at Brest and would go on to develop courses on internal pathology, exotic pathology, and the hygiene of the intertropical countries.69 Careful in teaching as well as in his personal life, he put off marriage until gaining a professorship, at which time he married a woman he had met while ministering to the dispossessed of the Atlantic seaboard. The navy embraced his prize-winning comprehensive text on naval hygiene of 1856 and placed

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it in its shipboard and port libraries. The book proved so popular that he bought out another edition in 1877, but as he was then a civilian, the navy asked one of its own, the noted hygienist and medical geographer JeanBaptiste Mahé, to produce a similar text. During Fonssagrives’s time in the Atlantic ports controversy erupted over his views on the mysterious dry colic he had encountered on the Eldorado. Amédée Lefèvre, his adversary, was close at hand and director of his school. Colic, although the class was not unified, appeared occasionally on land and had attracted medical scrutiny. Fonssagrives set the epidemiology of the navy’s dry colic within miasmatic tradition and was convinced its epidemic status on naval ships in West Africa and Latin America obtained from climatic conditions found in those two regions. He argued the navy’s dry colic, which rarely appeared on land in West Africa, was something different from terrestrial incidents of lead poisoning. Moreover, examination of the tongues and gums of patients had not revealed a blue line or discolorations forming typical clinical signs for lead poisoning.70 Fonssagrives was certainly in good company. Guépratte, a surgeon major in the navy, issued a memoir to the Académie de médecine in 1850 and 1851 which related his experiences in the Indian Ocean on the steam ship L’Archimède where dry colic had felled thirteen of seventeen men tending the engine. Guépratte stated his desire to unify the class of colics but found no clinical evidence justifying such a move.71 The director of the naval health service, Jules Rochard, quoted Fonssagrives at length in the gossipy pages of the Union médicale, the voice of the Parisian medical profession.72 Rochard deployed numerous arguments grounded in place and medical geography. All ships were subject to the same rules of hygiene, so why for example did “dry colic reign only in the hot countries?”73 Within the ecology of the ship, why were the majority of the disease’s victims those who labored in the highest ambient air temperatures, the engine room, next to the water stills, and in front of ovens? Rochard was disposed to Fonssagrives’s etiological suspicions, that the unknown principle generating dry colic had heretofore escaped detection and possibly existed even in the holds of sail-powered ships. The shift to steam power had merely activated this preexisting principle. He concluded with words he would live to regret: No, dry colic is not lead poisoning. If it were due to this cause, we would not have let it poison us and those around us for such a long time. We would have discovered the toxic agent a long time ago, and the maritime authority would have undertaken the measures necessary to cause its disappearance.74

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As the remarks of Fonssagrives, Guépratte, and Rochard reveal, place-based reasoning and localistic thinking persisted in the higher echelons of naval medicine. Fonssagrives, and his adversary in the dispute over dry colic, Amédée Lefèvre, spent much of their careers at the Brest school. Lefèvre, who was born in Paris in 1798 passed his youth in Rochefort. Shipping out at age twelve as a “mousse,” a kind of provisional status for young sailors in training, he passed a concours for advancement in a field without vacancies. However, vacancies in the medical track existed, as they almost always did, and Lefèvre converted to medicine in 1816 and spent his entire career in the navy. Lefèvre voyaged on the Isère and other ships to West Africa, Guiana, Greece, and the Levant.75 His Journal fin de campagne for a West African voyage of 1819 contained many elements later proscribed in Quoy’s Instruction of 1857. But it also contained commentary on the prevalence of lions, natural history, the signing of a treaty with Amet d’Hou, king of the Brakenas tribe, and the boarding of fifty African sailors in the West African port of Saint-Louis. The voyage was a healthy one; only twenty-two men fell moderately ill, and those mainly from intestinal complaints. Lefèvre thought these were due to changes in temperature during the first two weeks, the copious quantities of water the men consumed in the tropics, and the intensity of the sun itself.76 A subsequent posting on the Marsouin to the Levant in 1825 provided materials for his 1827 MD thesis at Montpellier on the diseases of the Levant’s commercial ports.77 Lefèvre, like Quoy and his companion René Lesson who had also sailed with Dumont d’Urville, and so many others, practiced natural history in the employ of the navy. In 1820 he participated in the exploration of the Mana River in Guiana where he registered surprise at encountering a tapir, botanized, and collected materials destined for the Muséum d’histoire naturelle in Paris. Reports of intestinal complaints, respiratory illnesses, and urinary problems, the first condition treated by adding rum to the victim’s drinking water, fill his journal. Although he was not an “environmentalist” in the modern since of the term, he counseled against clear-cutting trees and recorded how “in the countries of the torrid zone, the trees are a benefit of providence that moderate the extreme heat to which they are exposed.”78 These and other field experiences as a naturalist, and as a physician on the great school of the sea, provided Lefèvre with tools for etiological investigation of a new disease, the dry colic. Lead and a host of toxic substances crept on board beginning in 1820 with the arrival of the Voyageur and the Africaine, the first steam-powered ships constructed and armed in French ports. Deployed from Lorient as

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river boats in West Africa, they were followed by the Caroline which steamed to destiny along the coast of Guiana. Steam power was there, too, in 1830, at the outset of the “new” French Empire when French troops took Algiers. The expedition which sailed from Toulon to North Africa included the first French steam ship to participate in a war operation, the Sphinix. In 1840 sail still powered the majority of French war ships but paddle-wheel steamers had proved their worth for service in the tropics. A series of other innovations brought additional metals on ships and altered living conditions: the exploding shell, and the weaponry necessary to throw it; and metalpropeller technology which allowed the navy to change the transverse position of the motor which during the era of paddle wheelers had reduced the habitable space on ship and effectively bisected it. By the 1850s steel cladding was employed on the Napoléon, a ship deployed to the Black Sea, and other similar ships soon entered naval service.79 Dry colic emerged in this new technological environment. Technological change exasperated naval hygienists and created new disease ecologies. As Alfred Le Roy de Méricourt commented in an 1867 report on naval hygiene, “each day the changes outdistance the hygienist; in this breathtakingly rapid race toward an as yet unrealized ideal, the hygienist can only follow behind the engineer at great distance.”80 Lefèvre, who wrote on asthma, from which he suffered, as well as typhoid fever, tuberculosis, and cerebro-spinal meningitis, considered carefully the utility of materialism and contagion theory to understand dry colic.81 He would become convinced that dry colic was entwined with technological modernity and that ingestion of lead on ship, not miasms, caused dry colic. Lefèvre pioneered industrial health with dogged and impeccable methods. But his work on lead was a naval affirmation of the work of others, a recovery of etiological knowledge lost, or not attended to, possibly because prior outbreaks of similar diseases had occurred on land rather than in the place of the navy. Several seventeenth- and eighteenth-century physicians, and even America’s Benjamin Franklin, had identified lead with a “metallic colic” and usually linked it to cider or wine adulterated with lead salts.82 By the mid-nineteenth century a smattering of medical school theses considered the clinical signs of dry colic and argued for the essential unity of Madrid colic, dry colic, vegetable colic, and many others. Yet naval toxicological reports revealed only traces of lead in the bodies of victims and in water cisterns on ship. If the danger was clear and present, and quantifiable in terms of its effects, synthesis of the various clues and revelation of the condition’s etiology was not. Lefèvre attacked the riddle of dry colic with historical, observational, and

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clinical methods. A review of the health histories of 250 ships affected by colics enabled comparisons, drew attention to ship architecture and places of service, and to the diverse ecologies and differing elements of place on individual ships. Clues resided in episodic reports of epidemics and in the histories of the ships themselves. Not all frigates were equal or standardized in fittings and architecture, or completely refurbished for steam power or metal cladding at the same time. Metal-coated water cisterns supplanted those of wooden construction after 1825, and the navy retrofitted ships on an as-needed basis. In 1851, as Lefèvre pondered masses of information and categorized evidence, an epidemic of colic erupted in Paris. At first likened to vegetable colic, and particularly to the colic of Poitou, an applegrowing region northeast of Rochefort, investigators determined all victims had consumed cider. Chemical analysis of the questionable cider revealed the presence not of lead itself, but of its oxides.83 Prestige, and the trust which obtained from it, as well as the privilege of place, framed knowledge of dry colic, particularly its early history.84 Lefèvre’s painstaking analysis of ships’ journals revealed frightening portraits of neurological afflictions and pain. In Guiana, where the aforementioned steamer Africaine, equipped with its leaded water cisterns undertook service, physicians recorded an epidemic of dry colic which affected 203 men, fully one of every four crew members. Several men died and observers recorded the disease arrived with the first steam ships, as it had in West Africa. Yet Alexandre Segond, the chief physician of Guiana and a respected investigator of ethnicity and disease, located its cause in corruptions of the atmosphere. His etiological reasoning elaborated upon and reinforced miasmatic tradition and accused the tyrannical and pathogenic atmospheres emanating from the ship’s hold. If the colic had touched all members of the crew who tended the engine, the mechanics and stokers, this too was atmospheric in nature and because these professions endured the high temperatures of the engine room.85 Clinical evidence of dry colic’s ravages mounted but was amenable to interpretation. Dr. Raoul, who would also teach at Brest, albeit briefly, initially supported Segond’s ideas.86 Raoul was said to be the navy’s first recognized specialist in the diseases of the hot countries, and Fonssagrives had been his replacement as chief of the health service for the African coast. At Brest, Raoul converted to Lefèvre’s view and as professor of clinical medicine taught students that lead intoxication was the cause of dry colic.87 Raoul died shortly after going to Brest and was once again replaced by Fonssagrives. In 1852, upon return from his West Africa tour on the Eldorado, Fonssagrives rendered a careful but quite different interpretation

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of dry colic’s clinical signs. As he saw it, dry colic was a kind of neurological affliction, a névrose with an individuality specific to the hot countries. A miasmatic poison, a contagion of unknown origin but present in hot countries, produced dry colic by altering the blood.88 Incidents of the disease continued to rise, and hygienic doctrine counseled looking not only to the atmosphere as the source of disease, but also to ingesta, or diet. What the men drank, and how much they drank, provided a key to the riddle. Water distillation machines had become practical and widely diffused once the navy adopted steam power. Another ship, the Érigone, counted more than four hundred victims of dry colic on a single voyage. Records from the disaster provided Lefèvre with an essential clue. The disease had spared only those crew members who had not drunk from the Érigone’s leaded water cisterns. Reports from a third ship, the Domingua from Sardinia, also linked an epidemic to a water distillation machine lined with tin. Lefèvre was also a man of the field and he supplemented reading with visits to naval arsenals and shipbuilding facilities to see how lead and metal were used in ship construction and how they were installed.89 Subsequent calculation revealed that a ship of ninety cannons might have as much as 13,226 kilograms of lead aboard, distributed among ovens for cooking, water basins and pipes, and even on the thirty-two porthole covers in the officers’ quarters, all of which were made of lead. As if this were not enough pewter cups and utensils were found to contain as much as 50 percent lead. Demonstration of lead’s presence on ship and its correlation with epidemic appearances of disease did not, inexorably, link the two in etiological relationship. Left unanswered were two additional considerations: why did the various colics suffered by seamen on campaign occur almost exclusively in the tropics or near tropics; and why were some naval professions at special risk? The disease struck nurses, stokers, and mechanics with uncanny universality, and yet often spared others, like the officer corps. Colic stalked painters and others who worked in the arsenals of France but achieved epidemic form primarily in tropical and near tropical regions. More perplexing still, the incubation period of the disease seemed to vary with the region visited and might reach epidemic stage after a month on a ship bound for Senegal, yet take four months or more on ships bound for India.90 The everdiligent Lefèvre addressed these circumstances from an environmental viewpoint with specific attention to the many alterations which ensued when lead and leaded materials encountered salt water and were assaulted by storms and the inescapably high temperatures and atmospheric conditions of the tropics. Under such conditions particles of lead might be dispersed

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widely throughout the ship and in the atmosphere below deck, particularly in areas near the engine and other rooms with elevated temperatures. The most elegant and convincing of all arguments, however, was the product of historical research, the application of tradition, and perhaps voyaging. It concerned the differential morbidity of the epidemics and derived from careful study of diet and drink on the one hand, and of the activities performed, on the other hand. Lefèvre, of course, was working within a tradition, and not merely a neo-Hippocratic one. Diet and drink, and exercise, constituted two of Galen’s six nonnaturals, and the Roman physician had preached a hygienic doctrine founded on their regulation. Study of these nonnaturals, like ingesta, and especially the liquids consumed by the men, provided foundation for Lefèvre’s hygienic thoughts and actions. He soon determined that water stills, water filters, and pipes released lead into the water consumed on board. Technological progress had also produced a new kind of still which produced fresh water by boiling sea water. Developed by Peyre and Rocher, the navy installed it in ship galleys after 1845.91 Scurvy, another signature disease of the naval world and one still common in naval bagnes and on immigrant transport ships, interacted with dry colic and likely assisted in the latter’s expansion. The British navy had adopted the ideas of James Lind on the prophylactic use of citrus juice for scurvy by the 1790s. In 1855 Fonssagrives suggested France follow England’s leadership in the fight against scurvy and grow lemons in its own colonies. A dispatch of April 8, 1856, mandated the use of lime juice on French naval vessels but left open the question of its production and provisioning. A bit later, a naval regulation of July 21, 1860, concerning ships bound for the American colonies and tropics stipulated the addition of sugar, rum, eau-de-vie, or vinegar to rations. If these provisions were lacking, lemons or oranges were suggested as substitutes. Mandated too, in the event the engine functioned for more than twelve hours, was a second ration for the engine-room crew which included an additional forty-six centiliters of wine.92 If the wine were served in a pewter pitcher, this occasioned an additional risk of lead intoxication. The practice of acidifying water once a ship reached tropical environs soon became widespread. Lead, of course, might be added to rum and sugar as an adulterant to add sweetness by unscrupulous merchants. In the infirmary, and when citrus fruit could be had, the sailors and the nurses who tended the ill enjoyed lemonade but received it mainly while on tropical duty. Stokers in the engine room might drink up to eight liters of these liquids per day. These acidic substances efficiently stripped lead from cistern and pipe linings and enhanced its physi-

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ological toxicity by converting it to lead acetate. Among the most revelatory of findings, however, were the ethnic dimensions of dry colic’s complex epidemiology. Quoy, of course, had been calling for naval health statistics to include consistent mention of the racial dimensions of morbidity and mortality since at least 1848. In his review of records, Lefèvre determined that many of those spared on ship were of African descent. In general Africans in naval employ were also Islamic in religion and declined the rations of wine served in pewter cups and when possible avoided drinking water from the cisterns because of its alcoholic content.93 To the factor of ethnicity, Lefèvre added a clinical sign for lead poisoning, a bluish discoloration of the gums identified in 1840 by Burton.94 He also summarized his investigations in a book of 1859, developed a granulated charcoal filter for water systems, and in 1862 published a guide for mitigating lead pollution in water distillation systems.95 One by one, Lefèvre’s adversaries either died or admitted to lead’s role in dry colic. Quoy, as inspector general of the health service, was favorable to Lefèvre’s ideas and to improvements in ship design, charcoal filters for water distilleries, and to minimizing lead and human contact on ship. Fonssagrives not only accepted lead’s role in the production of dry colic, but was gracious in defeat and praised Lefèvre as a man of “sagacious perseverance.”96 Many years after the dispute, he would remark how he had underestimated the importance of lead in his earlier work on naval hygiene and signal how Lefèvre had convinced him “by his erudite and conscientious research that I was mistaken in supporting the non-identity of lead colic and the dry colic of ships and the hot countries.”97 But Lefèvre did not live to read these words. Passed over for promotion to inspector general of naval medicine he retired in 1863 and moved to his preferred place, Rochefort, where he won election to the city council. By the time the epidemic of dry colic slowed, Fonssagrives’s research program, and Fonssagrives himself, had moved on as well. Naval hygiene and general hygiene managed a mixture of morals and material. Fonssagrives was a pious man in practice, and a vitalist in physiology. “Humble one self before God,” he wrote, “and never before men.”98 While at Montpellier Fonssagrives wrote several books on tuberculosis, therapeutics, vaccination, family hygiene, the role of mothers in child hood diseases, and a dictionary of health intended for families and school children.99 He also ran a clinic for children and the aged in the 1870s. Preferring the label of neovitalist, to distinguish himself from the vitalism of Paul Joseph Barthez and other important figures of Montpellier’s past, he also

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eschewed the federated vitalism of the tissues promoted by Xavier Bichat. In his inaugural lecture at Montpellier he argued for the impossibility of defining health and elaborated a style of hygiene which “habitually commands the renunciation of things which undermine health [and] caress the passions.”100 For him, life itself was a special force evoked at creation and a fundamental principle displaying “spontaneity, autonomy, and unity.”101 Fonssagrives retired from Montpellier in 1880 and returned to Brittany where cholera claimed him 1884. His ideas on Christian vitalism and suspicions of materialism and Claude Bernard’s physiological determinism were not the path pursued by the next generation of physicians. Yet at Montpellier vitalism was a continuing if fading symbol of distinctiveness which set their medical faculty apart from that of Paris. Moreover, Montpellier had a special relationship with naval healers, especially surgeons. Between 1802 and 1893, more than a thousand naval healers submitted theses at Montpellier and some years naval men captured about a third of all completed medical degrees. In 1870, the naval contingent claimed more than half of all degrees.102 Fonssagrives was one of the most cited authors produced by the naval medical schools, and he shared much in common in terms of his career, ideas, and Christian vitalism with the Marseille hygienist, physician, and essayist, Évariste Bertulus, whose story is reserved for chapter 5. Most certainly both men knew of the utility of religion for maintaining health and discipline. As Fonssagrives had written in his manual of naval hygiene of 1856, the Christian hygienist knew how religion soothed the passions and how belief preserved men against sexual excesses. Religion was also “the most certain safeguard of discipline and subordination.”103

The Many Hygienes of the Liberal Empire By the twilight of the Second Empire and the Third Republic’s troubled dawn naval hygiene had matured yet many still regarded it as a science in the making. Much of this obtained from the incessant design revolutions in ships chronicled above. The ship remained the primary place of naval medicine, and claims for the discrete and properly separate nature of naval hygiene usually mentioned the ship as an object of study and specified the methods to investigate its impacts on health. The ship, Fonssagrives reminded his readers in 1875, was “the most special of all abodes, and one cannot apply the methods employed in the study of ordinary habitations to it without falling at each instant into banalities or errors.”104 A series of reports commissioned by the minister of public instruction in 1867 are

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revealing of naval hygiene’s progress and status. Each of four authors summarized the state of hygienic science in their respective sectors of activity— civilian, army, naval, and veterinary. The minister deemed all four vital to the French nation but only the first three of these reports will be analyzed here.105 All of the reports gave vital statistics, though the veterinary one gave figures not for humans but for the mortality of army horses. The report on general or civilian hygiene, composed by Apollinaire Bouchardat, a professor of hygiene at the Paris Faculty of Medicine, was nearly twice the size of the modest sixty pages or so produced by the army and navy. The Ministry of Public Instruction, of course, had substantial influence over civil faculties such as Paris, and very little to none over army and navy activities. Bouchardat had defended a medical thesis on cholera at Paris in 1832 where he argued that the disease was probably the result of a ferment which acted in accord with nature’s laws.106 The next year he completed a doctorate in pharmacy. In 1852 he became professor of hygiene at the Paris Faculty of Medicine, a post he would hold until 1885. A zealot for laboratory methods and microscopy, his report returned time and again to the theme of a hygiene based on the true causes of disease. He also pointed to the recognition of lead’s toxic etiology as an example of how hygiene, and medicine, were at last founding actions on knowledge of cause. He did not, however, mention the role of naval hygienists in the decipherment of dry colic, instead preferring to note it had been part of the general progress of hygiene.107 Hygiene, felt Bouchardat, had lagged behind general medicine for about twenty-five years. But now, emboldened by attention to the true causes of illness, hygiene would become an engine reforming all of medicine.108 Microscopy constituted the path to etiological knowledge and Pasteur’s studies of spontaneous generation had led the way. At every turn, Bouchardat implicated species of infusorians or other microscopic animals in all manner of diseases, though he searched for precise paths of pathological action. His reasoning was resolutely materialistic. Viruses existed in liquids and were transmitted by inoculation; specific miasms were an analogue of viruses but materialized as powdered airborne particles capable of similar nefarious action. The bodies of the ill produced these dustlike particles which then spread disease to the healthy. Inclining toward the doctrine that specific organisms caused specific fevers, rather than to the idea of one or a few infectious agents causing a multiplicity of diseases depending on the physiological constitution of the victim, he classified yellow fever among plague, cholera, and typhus. True knowledge was obtained mainly through comparative methods, whether it be comparing colonial and do-

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mestic diseases or investigating diverse species of infusorians. “The comparative study of ferments, venoms, effluvia, viruses, and specific miasms,” he wrote, “would put prophylaxis on a surer path.”109 When examining the three reports side by side, Bouchardat’s report appears the product of another world, or place. Neither of the far briefer army or navy reports displays the same attention to etiological precision and fascination with material explanations of disease. The army report’s author, Michel Lévy, had become a professor at the army’s Val-de-Grâce hospital in 1837 and was director of the same institution when he authored the report thirty years later. For Lévy military (army) hygiene followed the same principles as general hygiene. But it dealt with issues not found in civilian medicine, the campaign, and the mobility of its arena of action which stretched the army from Algeria to South East Asia. Like Bouchardat he too felt hygiene was of recent origin and gained definition with Napoléon’s First Physician, Jean Noël Hallé.110 For Lévy, the army, not infection or contagion, was the proper object of study.111 His report spoke at length of the regulatory apparatus of the army and the higher level administration of health. In terms of health sociology, the men’s habits, and their control, mattered most. Deploring the use of tobacco he admitted its provisioning was a necessity and one health authorities needed to study. He also wrote of the suppression of clandestine prostitution, venereal diseases, and careless examiners who certified women as disease-free without ever examining them with a speculum.112 The naval report, composed by Alfred Le Roy de Méricourt, cited Fonssagrives more than any other single author. Le Roy de Méricourt, sometime coauthor with Dr. Armand Corre, whose racial ideas are investigated in the following chapter, obtained his MD from Paris in 1853 with a thesis chronicling the medical history’of L’Archimède, Guépratte’s old ship, on a voyage to the Indian Ocean.113 Devoted to the Archives de médecine navale, of which he served as the founding editor from 1864 until Georges Treille replaced him in 1886, he also wrote on cholera, leprosy, and tuberculosis. The naval report recounted in fine detail the sanitation of ships, changes in technology, and the history of scurvy and dry colic. The cultural conditions of hygienic practice, the rush for technological modernity, and the iatrogenic dimensions of dry colic were addressed with the simple phrases: “It is rare that civilization does not buy progress at the price of peril. Too often public health pays for the marvelous conquests of commerce and industry.”114 The story of scurvy and dry colic, their entwined etiology, the acidification of drinking water, and the prophylaxis of lead occupied a third of the report.115 Le Roi de Méricourt found praise for Fonssagrives, especially

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his manual of hygiene of 1856 which he credited with restoring the teaching of hygiene in the three port schools, and for creating a special course in hygiene for students on the navy’s instructional vessel, the Jean Bart.116 As the Second Empire suffered through the Franco-Prussian War and Paris endured the additional trauma of the Commune, naval hygiene still awaited its Charles Darwin or Antoine Lavoisier. The activity simply defied summing up in many particulars and naval healing still constituted a place apart from civilian and army medicine. Fonssagrives was a seminal figure of naval hygiene, yet his vitalistic views of disease, frequently mingled with neo-Hippocratic concepts, enabled a very different sort of medicine from the seemingly causal and material future charted for medicine by Bouchardat, Claude Bernard, and late nineteenth-century Parisian materialists and clinicians such as Germain Sée. Lefèvre’s efforts brought clarity to one sector of etiology. But a tool of forensic medicine, chemical analysis, had provided the linchpin enabling sound prophylactic science. Forensic chemistry, and of course anatomy, would remain fundamental to naval healers, but Fonssagrives, and through his influence much of naval hygiene, retained focus on the “variable and ultimately indefinable nature of illness.”117

The following chapter takes up medicalized notions of anatomy, ethnicity, and racial immunity as seen from the field. Ideas of race, at least for the majority of naval authors who voyaged far from Paris, were not defined only or even mainly by morphology, anthropometry, or skin color. Even in the mature Third Republic the navy medical canon reflected an understanding of race as expressive of place, though perhaps not totally defined by it. Notions of place and naval medical alterity remained influential among these point guards of French colonialism. In this, then, the various ways in which navy medical men distinguished the African and European races, or grouped the Norman, Breton, and Provençal races, reflected the power of place.

THREE

Medical Constructions of Race: Biological Determinism and Anthropological Pluralism

These are, in reality, two different races of men; only their shared heroism and courage in the moment of battle reveals their common nationality.1 —Jean-Baptiste Fonssagrives on Breton and Provençal races

The physical anthropology pioneered by Paul Broca in the 1850s provided sustenance for the view that human races were inalterable or fixed by their biological or physical nature, however one defined that nature. There is little doubt that physical anthropology grew more prominent during the Third Republic, particularly among Parisian physicians and academics. However, quite a few naval physicians, especially those with experiential knowledge of non-French peoples, were reserved on Broca’s program. Their views on race remained highly medicalized, pluralistic, heterodox, and infused with ethnographical analysis. Physiological vitalism, but also ideas of civilization and rumination on the seeming ethnic selectivity of diseases such as yellow fever and dry colic, informed how navy medical men constructed race. Many naval medical students completed doctoral degrees at Montpellier, a font of vitalist thought that complicated the drawing of racial boundaries based on morphology or skin color. Conceptions of race mirrored the definitional challenges posed by vitalistic theory: what was illness, what was health, and how could one distinguish between these two? When it came to defining race, aspects of geography, habit, temperament, and susceptibility to disease commingled with perspectives drawn from physical anthropology. Additionally, extrascientific factors such as the reemergence after 1871 of republican government, with its ideas of inclusiveness and assimilation to French norms, altered the trajectory of racial thinking.

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Racial discourse was also about civilization, and vitalism influenced ideas about the social organism, how it was studied, and how hygienists might intervene or withhold action for fear of disturbing the natural state of society. For example, Martin S. Staum’s investigation of French “social organicism” points to Xavier Bichat, the quintessential revolutionary-era vitalist who had conceived of the body as a federation of twenty-one different kinds of tissues, each animated by its own discrete sort of life. “With Bichat,” comments Staum, variability in organic disposition became a signal that no one person would excel in all capacities. The only answer for a productive society, therefore, was specialization in which the naturally talented would rise to the top. On a world scale, Europeans would be the global brains, at the head of economic development, while other peoples might attain guidance to climb the ladder of being or advance through the several stages of development. In a harsher view, however, some would always remain uncivilizable.2

Seen in this way, terms like “inferiority” or “superiority” are best understood when measured against specific tasks rather than against a universal taxonomy situating Africans and Europeans in firm biological or anatomical categories. Hence a group of individuals who excelled at fighting might be seen as “inferior” in poetry, procreation, or agricultural labor. In other words, within a navy or an army, which required men of special aptitudes for specific tasks, Africans might surpass Europeans in some trials, such as surviving an attack of yellow fever or cholera, but be judged “inferior” to Europeans in susceptibility to pneumonia, in personal hygiene, and in activities such as trade and commerce. According to the late William B. Cohen, biological views of race and the notion of Black Africans as innately inferior to Europeans had triumphed by 1850.3 This claim hinges largely on the midcentury appearance of Arthur de Gobineau’s Essai sur l’inégalité des races humaines, a study which Cohen notes was rarely read in France.4 More recently, Joe Lunn’s study of West African troops who fought for France in World War I extends the biological argument. For Lunn, “the tenets of biological determinism (including its racist implications) were widely accepted, and that, far from providing an exception to the rule, French attitudes were consistent with the mainstream of western European thought.”5 Nonetheless, environmentalist ideas associated with the comprehensive program of Jean-Baptiste Lamarck remained robust in France, and Gobineau’s ideas are a midcentury snapshot in the nonlinear progression of French racial ideas. Moreover, according

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to Andrew D. Evans, Gobineau’s ideas on biological inequality were not influential in Germany where Rudolf Virchow and Adolf Bastian adhered to concepts of human commonality and promoted cultural and pluralistic approaches to the study of man.6 Place and environment counted for much in French concepts of the human organism, and French racial ideas were not always in step with those of other European nations. Although this chapter focuses on biomedical issues, staffing in the French navy, and race mixing in the nineteenth century, a number of twentieth-century figures such as the zoologist Edmond Perrier and the politician Albert Sarraut, a governor of French Indochina, also adhered to the idea that the environment drove fundamental changes in the organism.7 In many particulars the idea of “hard” or “fixed” anatomical or behavioral characters runs counter to the history of French naval medicine and biology. Unlike Germany and Great Britain, the majority of French naturalists rejected Darwinism and some clung to variants of Lamarckian transformist ideas which privileged the biology of individuals, environmental agency, notions of plasticity, and the ultimate unity of biological types, including the races of human kind.8 Additionally, the very concept of what constitutes a biological, or “hard” or “separate” race, and what was needed to keep that race firm or “fixed,” requires contextualization. What, then, constitutes the “biology” in biological determinism? Darwin had only rudimentary ideas of particulate inheritance, and certainly nothing as sophisticated as Mendelism. In the five editions of On the Origin of Species subsequent to the original of 1859, Darwin grew ever more favorable to the agency of acquired characteristics and so-called Lamarckian factors as influences on the life of the organism. The grudgingly slow acceptance of Mendelian genetics in France is telling, for Mendelism, prior to its recognition as a source of variation, might have provided a scientific logic for firming racial boundaries. But until the 1930s most French scientists were as insistent in their rejection of Mendelian genetics as earlier scientists had been of Darwinian ideas.9 Given these circumstances, plasticity, as opposed to firmness, typified racial categories which in some measure remained permeable to the influences of both culture and environment. Based on the scientific knowledge of the era, even biological races had some—but probably not limitless—ability to acquire and pass on through inheritance elements of European culture such as the skills of singing, poetry, making fine wine, and operating a rifle. Science and medicine are pursued in several ways, and French culture and colonialism infused French biology and conditioned aspects of its trajectory. Broca and others founded the Société anthropologique de Paris in 1859,

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and Broca himself was a master of literary performance. We must not read too much into his posturing and programmatic distinctions between old and new concepts of man. Nor should we imagine that his representations of French anthropology were unbiased. Above all, Broca was institution building, and sought to define what he was doing as the new wave of the investigation of man. At the discursive and methodological levels there is a good deal of continuity in racial thought and anthropological techniques throughout the nineteenth century. For example, in the late eighteenth century the Dutch anatomist Peter Camper, soon followed by the French comparative anatomist Georges Cuvier and a host of phrenologists, promoted the study of facial angle, an emblematic technique of anthropometry. Thus there was much overlap and continuity in the concerns of the Société ethnologique de Paris founded by the physician William Edwards in 1839 and Broca’s group.10 Edwards promoted an idea of racial types influenced by intermixture which does not map well onto later ideas of race. But his vision of a research program for the Société ethnologique de Paris was eminently pluralistic and included investigation of languages, moral character, and historical traditions.11 Numerous naval medical men shared these ethnographical interests. Beyond Broca, French anthropology remained ecumenical in approach. For example, the zoologist and physician Armand de Quatrefages de Bréau, perhaps second only to Broca in anthropological celebrity and second to none in volume of publications on anthropology and natural history, assumed the chair of anthropology at the Paris Museum of Natural History in 1856. He too, like Edwards, envisioned an inclusive anthropological science which would subsume traditions as diverse as ethnography, ethnology, anthropography, and the sociology and psychology of peoples.12 Quatrefages de Bréau, while recognizing minor ethnological variations in disease susceptibility, felt that most diseases were common to all races, and that men shared a “fundamental nature.”13 The medical viewpoint should not be discounted. French expeditionary, naval, and army physicians recorded attributes of race on campaign and frequently assessed them in relationship to place and the heritages of neo-Hippocratic and Galenic medicine.14 In the colonial context, as Pascal Grosse has noted, the study of race and citizenship commingled with issues of inclusion and the biopolitics of nationhood.15 Moreover, French medicine was a jumble of sometimes inchoate traditions and this opened the door to assessing race in multiple ways. Thus French army physicians who studied the Arab and Berber peoples of North Africa between 1830

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and 1870 elaborated their ideas “prior to a time when the superiority of French medicine could be delineated in technological terms and was thus measured according to philosophical, sociological or moral indexes.”16 Until 1890 the vast majority of colonial physicians trained in naval port schools and on ship. There they continued the enumerative and localized medicine of place described in the previous chapter, a medicine different in kind and emphasis from the clinical approach to medicine promoted by the Paris Faculty of Medicine.17 The medico-geographical underpinnings of naval medicine bound it to place and race. Thus for Armand Corre, a naval physician whose writings on race, ethnicity, and criminality are examined below, geographical circumstance rather than bodily essence expressed race. Pondering colonial criminality at century’s end, his prose recalled the rather unsophisticated climatic determinism of Charles de Montesquieu’s Spirit of the Laws. “Climates,” wrote Corre, “understood in the broadest meaning of the term—produce races and maintain them in their physical and psychic modalities.”18 Quoy’s instruction of 1857, as seen in the previous chapter, mandated collection of racial information in conjunction with morbidity and mortality statistics. In naval medicine, however, race was often less the unique subject of exacting study than an object subsumed in a forest of details.19 For example, the naval healer André Richaud, engaged in early French activities in Southeast Asia in the 1860s, wrote a medical topography of the region. Earlier French medical literature had represented Cochin China as a country of widespread cholera and ulcers. Richaud qualified the belief that only Asians contracted the ulcer and argued that while the disease was most severe among Asian peoples it also affected Europeans and Africans. Thus his approach was to break down the idea that Europeans and Asians had radically different immunities or predispositions to disease. He related that while Annamite peoples appeared pale and rather sickly they had many attributes of value including an aptitude for heavy and sustained labor. Given a better diet they would gain even more strength. They might even surpass Europeans as soldiers, as “wounds, in general, are endured by Annamites with a remarkable courage and perfect resignation. Is this lack of sensibility or is it Stoicism? At any rate . . . the Annamite dies with a resoluteness and calm rarely found among Europeans.”20 Richaud and others who adopted this genre of medical commentary were not driven primarily by scientific racism or by physical anthropology; instead, they sought enumeration of competencies of use to the colonizer. Richaud’s study of ulcer etiology was one of many to argue against absolute notions of firm racial immunity and, by extension, to argue for the

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permeability of racial boundaries in relation to illness. Others too noted that colonizer and colonized suffered from the same diseases though perhaps in somewhat different proportions. Doctor J. Chapuis, first physician in chief of the colony of Cayenne in 1864, argued that the ulcers described by Richaud were identical with those which struck all races in Guiana and afflicted the ethnically diverse peoples of New Caledonia, Mozambique, and Senegal. Hinting that malaria was a universal phenomenon which also struck without much regard for race, he wrote of the ulcers that “no race is exempt but the rapidity of progression, its extent, and its depth of some disorders are, for different races, in direct relation to . . . the distressing hygienic conditions that their social state induces.”21 Several naval medical school professors began to question the firmness of other racialized categories of disease such as Mal d’estomac des nègres and tried to consolidate these diseases into unified categories after the fashion of Lefèvre’s work on dry colic.22 In India, too, members of the Indian Medical Service began to see immunity not in terms of race but as the product of cultural factors including sanitation.23 In addition to constructing race in terms of competencies and through the lens of etiological concerns, a French proclivity for placing the study of man within the purview of general natural history mitigated against the notion of race as a biological category apart from climatic and cultural influences. The navy required its physicians to take classes in medical natural history and human anatomy, and these traditions were themselves set within a larger program of botanical, zoological, and climatological study. A pamphlet solicited by the minister of the navy for use by its officers and crafted by professors at the Paris Museum of Natural History enunciates aspects of this program. This Instructions pour voyageurs of 1818, republished with slight modifications in 1824, 1827, 1829, 1845, and 1860, called for reconnaissance and close enumeration of the three kingdoms of nature with an eye toward the exploitation of useful plants.24 This pluralistic and utilitarian approach to exotic nature and its peoples continued within the French navy, as did the naval physician’s interest in how climate and culture intersected with physical anthropological ideas of race. French presence in West Africa expanded and in 1859 the naval physician Barthélemy Benoit, shortly before his departure for Senegal in 1859, requested that the new Société de anthropologie de Paris draft instructions for anthropological research on the region’s peoples. Authored by three early members of the group, including Broca and the zoologist and critic of Georges Cuvier, Isidore Geoffroy Saint-Hilaire, the instructions appeared in the inaugural volume of the Archives de médecine navale

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in 1864. Its authors asserted the primacy of West Africa for anthropological investigation and noted how “no region of the globe offers the anthropologist a field of observations more fertile than our colony of Senegal.”25 The methodology suggested to guide investigations in Senegal was pluralistic and combined physical anthropology with cultural and ethnological approaches. Anthropologists recognized three great races in West Africa: Yoloffs, Mandingues, and an invading race, the Foulahs. The latter were described as having a reddish-brown complexion and smooth hair and being largely of the Islamic faith. In terms of physical anthropology, it was hoped that crania and skeletons, or failing these, casts of crania or at least craniometric and dentitional information might be gathered.26 Yet even here the brief was pluralistic and ethnological in content, for in addition to these physical characteristics, the anthropologists also asked whether it was true that African newborns were born white and then changed color. The instructions also solicited information on language, religion, and the uses of domesticated animals. In terms of placing the peoples of West Africa into a racial hierarchy, contemporaries once more framed this exercise in terms of practical applications or specific aptitudes, rather than reducing all to a narrow focus on the physical features of race. The anthropologists saw the major task of the naval physician as one of constructing a comparative pathology of the races, and they asked for information to determine if people living in or nearly at the “savage state” were mostly free of cancers, aneurisms, and mental diseases common to Europeans. Some also thought that colonized peoples endured childbirth better than Europeans.27 Regarding the racialized dimensions of disease, Broca asked the navy men if these more or less complete immunities depend upon race, or a savage mode of life, or on diet, or climate. Racial influences appear to be demonstrated at least for some cases, and naval physicians will be able to furnish important information on this point. The question of acclimatization, so important from all points of view, is equally among the questions still awaiting solution.28

The medical study of human acclimatization, and more broadly, the ability of Europeans to adapt to life in the tropics, whether through regimes of public and personal hygiene, or through individual physiological adaptation to new disease ecologies, was linked with anthropological concerns and also to neo-Lamarckian biology.29 As one historian of anthropology

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put it, “the utilitarian objectives of colonialism made acclimatization the fundamental scientific question it raised.”30 Given the multitudinous tasks of colonial physicians, race was only one element in the riddle of disease. Even when views of race were mainly biological in nature, that biology remained open to cultural and climatic influences and was only partially abstracted by the tools of physical anthropology. On balance then, French anthropologists spent their energies studying non-French peoples. This may have predisposed some physical anthropologists to draw firmer contrasts between an imagined essential Frenchness, or what was French or European on the one hand, and what was foreign or exotic on the other. The regulatory regime of the Third Republic promoted assimilation to Frenchness but this did not assure the unity of the nation. France, when viewed from the place of naval medicine, harbored not one race but at least three and possibly five diverse groups of peoples. Here again what counted for race was a mixture of biological, linguistic, and cultural elements. If the essence of Frenchness was as difficult to define as the concepts of heath and illness were for vitalists, then the lines of difference between French and non-French were equally difficult to discern.

The Internal Dimensions of Ethnicity: Naval Medicine, Regionality, and Recruitment Precise but admittedly impressionistic descriptions of the races of the French nation melded with the demands of naval recruitment and staffing. Impressionistic categorizations, of course, persist to this day. For example, the historian Michel Mollat du Jourdin, who quite rightly challenges the notion of France having a single maritime culture, locates the power of place in the heterogeneity of the Atlantic and Mediterranean waters and especially in the diverse reactions of coastal populations to the sea: “The human reactions are diverse: Nordic violence, Breton anger, explosive Mediterranean [temperament]. The language [of these regions] is itself different, and the old navy had to take this into account.”31 Mollat du Jourdin could have added that the new navy took these factors into account and embraced them. Regional distinctiveness is woven into the fabric of French history, and naval institutions were cut from the same cloth. David Bell has argued that in prerevolutionary France the ancient provinces of Brittany, Flanders, Occitania, and the Basque Country, were more “exotic quasi-nations” than properly French.32 Regionalism persisted even after the revolution, and in general, nineteenth-century texts on naval hygiene conjoined race with

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place as they enumerated the heterogeneity and competencies of the French navy’s human resources after the fashion of the country’s prerevolutionary groupings. This can be seen in the naval hygiene manuals authored by the aforementioned Jean-Baptiste Fonssagrives and Jean-Baptiste Mahé. The two texts are usefully treated together as Mahé’s Manuel pratique d’hygiène navale of 1874 quoted at length Fonssagrives’s earlier study of 1856.33 These texts, in terms of length, precision, and scope, stand head and shoulders above many earlier efforts which gave wide play to scurvy.34 Mahé’s Manuel pratique d’hygiène navale conceptualized sailors as dirty children indifferent to the rules of hygiene.35 It also grouped people by spoken language, perceived regional habits, stature, and modes of life; and evaluated the races of French sailors to discern their optimal place to function in the labor ecology of the ship and the conditions of voyaging.36 His portrait of the diversity and insularity of French maritime culture prefigured by a century Eugen Weber’s seminal study of the protracted integration of rural communities into the French nation. The belief that growing up by the sea ineffably set one’s trajectory toward a maritime career persisted in naval circles, and a eulogy of the Brest native and naval physician, Eugène Rochard, nicely encapsulated these sentiments: “A Breton, in addition to being a Brestois, is by definition a sailor. The sea forms part of his horizon.”37 Recruitment procedures and the management and care of human resources posed both a general challenge for the navy and a specific one for its medical services. Before examining the races of French men and recruitment and staffing as seen from the lifeworld of naval medicine, it is useful to compare the navy’s special situation with that of the army. Maritime recruitment of physicians was localized in the port cities, and in some provincial towns the army and navy competed for personnel.38 In the eighteenth century the army conducted anatomical and surgical instruction at a series of hospitals and amphitheaters in traditional army strongholds such as Metz and Strasbourg and in naval towns such as Brest and Toulon. Naval pay scales were lower than those of the army, and continuing tensions revolved around salary and rank. In 1863, army physicians assimilated to the ranks of colonel, lieutenant-colonel, and battalion chief, received 6,250, 5,300, and 4,500 francs per year, respectively. Naval counterparts with equivalent duties received only 5,000, 4,000, and 3,500 francs, respectively.39 Salaries were not the only issue as the conditions of service in the army and navy were quite different. For example, in 1862, with the navy adding ships, Charles-Adolphe Maher, director at the Rochefort medical school, chronicled the problems of recruitment. Nearly all the students claimed

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Maher had been sent on campaign, and in 1861 there had been only two medical students at Brest and none at Rochefort. Either the navy ought to train more people for medical careers or reduce the number of ships by half. First-class surgeons, he noted, did not even bother to sit for the concours for promotion to professor, and only one candidate had sat for each of the last three concours for the professorship of surgery. Smart young men with a bachelors degree in hand, he felt, now choose the liberal professions or the postal and telegraph service over the navy. It was not only a matter of a dangerous career as graduates of the École polytechnique sometimes ended up in those, but at least the army and École polytechinque offered “the compensations of glory and fortune which we cannot claim.”40 In some ways the army’s recruitment scheme for healers mimicked the naval system by attempting to “grow” its own physicians. But the army was somewhat better in seeing that the men had a medical degree in hand prior to deployment. In contrast, until centralization of naval medical education at Bordeaux in the late nineteenth century, naval students began course work but left school prior to obtaining a degree for a required voyage on the great school of the sea. The time away from school could be two years or longer. Those who returned in a healthy state and were not reposted immediately then tried to complete medical examinations at a civil faculty and produce a doctoral thesis. The army medical services struggled too, and during the Second Empire the army revised its system of recruiting candidates among civilian doctors. In 1853 and 1854, for example, when demand for physicians rose due to the Crimean War, the army’s Val-de-Grâce postgraduate medical program in Paris could accommodate up to eighty students but had only twenty. The following year, only five doctors and fifteen pharmacists hazarded study there. The Crimean War, with its epidemics of typhus and cholera, where about one in every five of the 558 French army physicians and pharmacists met their end, spurred creation of an army medical school at Strasbourg. The school, opening on November 3, 1856, as the École impériale du service de santé militaire, had 132 students by 1860 but later fell to the Germans during the Franco-Prussian War and the army only reconstituted the school at Lyon in 1888.41 Fonssagrives, who would leave naval service for the civilian professoriate, and Mahé certainly recognized the intractable recruitment problems of the naval healing profession. They wrote from the necessity to select and train the right men for specific naval professions and inhospitable postings. Their perspective was one of strength in heterogeneity rather than the essentialism of biological difference.

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The Internal Dimensions of Ethnicity: The Races of France Did Bell’s “quasi-nations” persist long after the revolution, and just how different from one another were the races of France? In this respect Brittany, and the naval town of Brest, where Mahé’s career led him, merits special mention. Few regions of France were more distant from Paris, regarded as more “backward,” and less integrated into the French nation. When the novelist Gustave Flaubert and his friend Maxime Du Camp hiked though Brittany in the summer of 1847, Flaubert characterized Brest’s naval arsenal as “the true city . . . the other one only [exists] because of it.”42 Additional implantations of French culture, the bagne and the naval hospital, seemed to be incongruous and ineffective extensions of the French nation into the bog of a separate world. The floors of the naval hospital, thought Flaubert, posed a danger to patients who might slip on their highly waxed surface, and he recounted seeing a sailor who had crushed his skull in a fall lying on clean sheets but still waiting for a visit from the physician eighteen hours after admission.43 Flaubert’s portrayal of Brest merits the license to exaggerate accorded to great novelists. But Brittany was insular and between 1814 and 1835 one of every four students at the naval medical school hailed from the surrounding department of Finistère. Rochefort and Toulon were insular as well but to lesser degrees.44 Brittany, a mainstay of Catholicism in a time of republican secular ideals, was also marked by its distinct Celtic language, Breton.45 Along with Normandy, and other coastal regions of the Atlantic and Mediterranean seaboard, Brittany provided the men and technological infrastructure to launch the voyages of empire, train naval surgeons, and construct and maintain naval and merchant ships voyaging to America, India, Africa, and Southeast Asia. The racial classifications of Mahé’s Manuel pratique d’hygiène navale of 1874 mirror those given by Fonssagrives in 1856, and he analyzed race in terms of the navy’s five regional recruitment zones administered from the coastal cities of Cherbourg, Brest, Lorient, Rochefort and Toulon. Fonssagrives, by then a civilian professor at the Montpellier Faculty of Medicine, had revised his ideas and issued a second edition of his 1856 text in 1877. In this latter edition, Normans, Bretons, and the people of Provence formed the three principal branches of the French maritime family. They were joined by “four secondary races: the Flammands, the Saintongaois, the Gascons, and the Basques.”46 Mahé’s text enumerated five separate races each with different abilities. These were the Normans of Northern France near the Channel; the Bret-

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ons of Brittany in the Northwestern regions of the country; the Saintongais to the south of Brittany around Rochefort and La Rochelle; the Bordelais and Basque peoples around Bordeaux and extending south to the Spanish border from the southern shores of the Gironde River; and finally the population of Provence inhabiting the region bordering the Mediterranean and Corsica.47 The basic assumption was that the navy would be most efficient if it took advantage of the aptitudes of men who already knew the hardships and challenges of maritime life. Naval instruction would perfect these preexisting traits and inure the men to naval discipline. The terminology for this process, rendered in French as the verb amariner, was defined as “to habituate [men] to the sea: it is to adapt them to the maritime profession.”48 For Mahé this process found a precise parallel in, and “expressed exactly the same fact,” as “acclimatization,” a paradigmatic process of adaptation usually linked with settler colonialism and applied to men, animals, or plants forced to accept new rules of hygiene and residence.49 Mahé classified the men of these regions like a naturalist giving a practical assessment of their talents for naval professions, noting their origins, and enumerating their physical and moral qualities. Normans benefited from a vigorous constitution, were tall in stature, hardworking and intelligent. Long familiarity with coastal navigation in the North Sea, as well as deep sea fishing in the waters off of Iceland and Canada, enabled the Normans to endure hardship and danger. However, depending on the nature of the campaign, its duration, and the functions to be performed on ship, the race presented problems. Normans were difficult to manage on lengthy voyages and suffered from “a certain impatience with the disciplinary yoke and a lack of solidity.”50 Normans were especially fit for duty in northern seas but Mahé accused them of maintaining only “partial sobriety.”51 Breton seamen also had special proclivities and aptitudes but shared the Norman love of alcohol. Both Fonssagrives and Mahé examined the Bretons by contrasting their special virtues and vices with those of men from Provence. Of all maritime peoples, wrote Fonssagrives, those from Provence were most strongly tinged by their race: Their character, their habits, their naval aptitudes, contrast in a most striking manner with those of the Bretons. . . . To the taciturn nature of Breton sailors, their indifference to all that is not of their country or useful to them, their disciplined habits, their sturdiness at sea, their uncleanliness, their intemperance, we must contrast the noisy exuberance of the Provençaux; their overly excitable and lively imagination, their impatience with discipline, their brilliant qualities during easy navigations where they return to the sky

Medical Constructions of Race / 89 of their region, their tendency to be discouraged, their extreme cleanliness, their sobriety. These are, in reality, two different races of men; only their shared heroism and courage in the moment of battle reveals their common nationality.52

Mahé judged Fonssagrives too severe in his assessment of the Saintongais race, men from the region south of Brittany near Rochefort. Yet he dutifully followed Fonssagrives in typifying Saintongais seamen as far inferior to Bretons and Gascons between which their geographical position places them: they are intelligent but [without much energy]. The navy is a trade for them, not a calling; their sobriety and regular habits do not compensate well for their stunted height and the feebleness of their constitution, which most always bears the mark of the swampy region they inhabit.53

Fonssagrives likened Bordelais seamen to the race from Provence. He regarded them as sober, active, and industrious and as having “the eloquence [and] cheerfulness of Provençaux seamen and the seafaring skills of the [Norman]. He can only be reproached for his spirit of independence which some times extends to insubordination.”54 The two men reached agreement again on the topic of the Basque race. Fonssagrives found the Basques of southwestern France a vigorous race of mountain-dwellers admirably suited for the profession of the sea; their small stature is redeemed by a remarkable vigor which they owe to national habits of gymnastics; their health is good, their energy invincible. . . . [rarely does] a Basque crew member resign himself to shore work . . . and not win his place in the crow’s nest.55

These considerations of race by Mahé and Fonssagrives, however elegant, became impractical in time of war and rather at odds with the evolution of the modern navy. In 1875, it seemed to Fonssagrives, the world was changing and he hinted at the backwardness of naval recruiting practices in a technological age. He fully recognized the technological advance of civilization and the strengthening of the nation state as erasing “more and more the regional and ethnic characteristics of geographical pathology.”56 The new navy needed engineers and mechanics, and urban centers had schools to train them. It was also unclear how an eclectic selection from among the five races of sailors facilitated the smooth functioning of ships. Fonssagrives thought it better to have a relatively homogeneous crew recruited from a

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single region of France similar to the climates to be encountered in the voyage, thus men “of the same regional provenance and well-adapted to the nature of the campaign: Normans and Bretons for the cold countries; Basques, Bordelais and Provençaux for the hot countries.”57 Race, however defined, was only one of three important factors naval physicians considered in assessing the dynamics of health. The other two were temperament and constitution. Biological heritage conferred temperament, a highly individualized form of health. According to Mahé, temperament was “a particular trait” or “a sort of style of health of each of us.”58 Dominance of one of the four organ groups in relationship to the remaining three provided the engine of their expression. Thus the nervous temperament expressed predominance of the brain and nervous system; the lymphatic temperament, in many ways the opposite of the sanguine, was linked to the lymphatic system; and the bilious temperament indicated an active liver. Like race, the predominant temperament might render a sailor fit for tropical service but inappropriate for other locales. A third element of health, the constitution, was “the physiognomy or even portrait of our health.”59 The result, a kind of health qua collage, resonated with neo-Hippocratic ideas of balance and imbalance but with one crucial difference. For Hippocrates, health had been a state of balance among the four humors. Fonssagrives and Mahé demoted the notion of health as a general balance and embraced temperaments in all their individuality. Their view of medicine focused on the individual and had little in common with bold programs like Claude Bernard’s general physiology, but then Fonssagrives had said health was impossible to define. Fonssagrives and Mahé theorized race in relation to place, temperament, constitution, and morphology. They also provided naval healers with a rich technical lexicon capable of explaining the symptomatology of most conditions. However, on a more prosaic level, and once the ship left port, the logic of a medicine of temperaments and races made less sense as optimizing the men’s individual capacities would have required different dietary regimes, and naval rations were standardized by profession and rank. Additionally, the hardships of voyaging might tilt the health of individuals of all four temperaments in divergent but perfidious directions. Mahé thought that the Midi region produced bilious men in abundance. They were enthusiastic but given to passion, anger, and vengeance. Those of sanguine temperament had extremely developed muscles but tropical duty exposed them to “unfortunate [respiratory] congestions due to an overabundance of blood.” 60 Likely, the best a physician could hope for was to avert disaster by telling the captain to keep half-drunken Normans and

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Bretons away from the tiller and be prepared for an epidemic of chest colds among those of sanguine temperament. Neither Mahé nor Fonssagrives took the study of race as their main task and they mixed together ethnographic, physical anthropological, and medical information. Their work on the races of France is similar to Jean Boudin’s anthropological studies of army recruitment examined in the previous chapter. Mahé once argued his Manuel considered man “only in relation to the structure of the body [that] marvelous [and] living machine.”61 Fonssagrives was even more explicit in an 1875 article where he cited Boudin and marshaled many anthropometric studies. There he described naval recruits and the races of France in terms of their height, chest size, spirometric capacities, weight, and strength.62 Both physicians elaborated a highly medicalized view of race appropriate to the navy. Another site of racialized medicine, the epidemiology of fevers, especially malaria and yellow fever, fascinated naval healers. A decade after Fonssagrives exchanged the Atlantic winds of Brest and a naval career for the Mediterranean breezes of Montpellier and a professorship at its medical faculty, he reflected on the utility of the concept of racial immunity for naval hygiene. In doing so he evaluated earlier writings on racial immunity, particularly the supposed resistance to tropical fevers enjoyed by the Saintongais race because of their exposure to the malarial swamps of their birth. Fonssagrives took a stance against this alleged acclimatization to fevers and argued that prior episodes of malaria weakened the body and would not help the Saintongais in subsequent encounters with the disease. Citing studies by former colleagues Paul Bourel-Roncière on sailors voyaging to Brazil who had previously contracted malaria in France, and additional work by Alfred Le Roy de Méricourt, he now believed “prior and recent infection of a ship and its crew is poor preparation for the resistance of malaria in the colonies.”63 Fonssagrives, like many other naval medical school professors, prospered and advanced in his career by avoiding all but required voyages. As he wrote the above words on malaria in the 1870s, his polar opposite, another naval physician and old sea wolf who wanted to be a professor, was thinking along similar lines and just back from two years duty in Senegal.

The External Dimensions of Ethnicity: Jean-Baptiste Laurent Bérenger-Féraud, Racial Immunity, and Yellow Fever Among naval physicians who wrote on West African anthropology and racial immunity, none wrote more than Jean-Baptiste Laurent Bérenger-

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Féraud. Bérenger-Féraud, whose role in reforming naval medical education is addressed in the following chapter, was born in Saint-Paul du Var in 1832 and first traveled to West Africa in 1855.64 In a career lasting some four decades, he spent about half his time on ship or posted in the colonies at stations including Senegal, the Antilles, Tunisia, and Pondicherry. As Cohen notes, Bérenger-Féraud was a polygenist who wrote against racial intermixture.65 Bérenger-Féraud grounded his views in his experiences in Senegal where, he wrote, there was no Creole race after four hundred years; “we can add,” he continued, that European blood “can absolutely not acclimatize to Senegal, even when it mixes in considerable proportion with black blood.”66 In other instances, Bérenger-Féraud’s racial views combined biological, ethnological, and folkloric perspectives in subtle ways. His views on racial immunity, however, diverged from those of the anthropologist Paul Topinard and others who thought that racial intermixture might actually strengthen resistance to disease.67 Bérenger-Féraud, after serving with distinction at the army’s Val-de-Grâce hospital during the siege of Paris, gained promotion and posting to the West African outpost of Gorée. Shortly thereafter he became director of Senegal’s nascent health service where served during 1872 and 1873.68 A book on the illnesses of Europeans in Senegal published after his tour of duty criticized the idea that Europeans could ever adapt to the West African environment.69 Bérenger-Féraud, though widely read, privileged colonial experience of disease over theoretical knowledge. His racial ideas evolved over his many colonial postings. For example, in 1870 he commented that naval surgeons who had “served in tropical countries know the marvelous facility with which savage and half-savage groups of the Caucasian, Mongolian, and Ethiopian races withstand injuries and operations without complications.”70 Author of some fifteen books and more than one hundred articles, his writings included ethnographical studies of African and French Provincial stories, songs, migrations, and habits.71 Even hard-line racialists like Bérenger-Féraud could adopt a pluralistic approach in their medical writings. Although he was not a monogenist, his stance on the absoluteness of racial immunity to yellow fever softened over the years. Yellow fever fascinated Bérenger-Féraud who published an informed historical study of yellow fever in Senegal in 1874, a colony visited by epidemics of the disease in 1778, 1830, 1837, 1859, 1866, and 1867.72 In an 1881 book on the diseases of Europeans in Martinique, he wrote confidently of yellow fever as a disease distinct from malaria; no one, he felt, now believed in their nosological unity.73 The aforementioned 1830 epidemic in West Africa had apparently killed with impunity Africans, Eu-

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ropeans, and Creoles. However, by 1837 “the immunity of the natives was nearly complete; in 1866 and 1867 too, as much as it can be confirmed, not one paid with his life.”74 Struggling to explain these discrepancies, he noted how an 1868 epidemic on the island of Guadeloupe had killed both blacks and Creoles. This led him to distinguish six degrees of receptivity to the disease. Europeans were most at risk, followed by Asians, “in direct relation to their coloration,” who were in turn followed by mulatto Africans or white Africans, white Creoles, mulatto Creoles, and African Creoles.75 Bérenger-Féraud engaged the topic again in a massive survey of 1891. Impressed by the emergent science of medical parasitology and Louis Pasteur’s germ theory, he was open to the idea that an as yet unknown microorganism might cause yellow fever.76 In the end, Bérenger-Féraud arrived at a middle ground of the question of racial immunity to yellow fever. “The question of race,” he wrote, “is one of the most remarkable of [yellow fever’s] nosological history.”77 By studying the white and black races and their intermixtures alongside records of several epidemics, he again distinguished six degrees of relative immunity or susceptibility to the disease much as he had done in 1881. Place of birth, but also term of residence and degree of acclimatization to colonial conditions, framed the exercise and led him to conclude that “in Senegal as well as the Antilles, negroes have only a relative immunity.”78 For Bérenger-Féraud, as for Fonssagrives and Mahé, race was only part of the etiological riddle, though clearly the white race was most susceptible to yellow fever and Africans least susceptible. Prior contraction of the illness seemed to confer some immunity, but no race enjoyed absolute immunity. The “question of the immunity of races and individuals as regards yellow fever,” he wrote, “is variable and too often contingent.”79 In this he was similar to Fonssagrives’s reserve over defining health. Hence, though inclining toward what Cohen and Lunn might term biological or perhaps fixist notions of race, even Bérenger-Féraud, in his investigations of ethnicity and disease, left considerable place for contingent extraracial factors such as place of birth and term of residence. Other naval physicians, including Alexandre Le Dantec, a future professor of tropical medicine at the new naval medical school at Bordeaux, removed race from the etiological equation but retained notions of place. His medical school thesis of 1886 had argued as much, asserting that “the immunity of negroes is not an immunity of race; it is acquired by a visit to countries conquered by yellow fever and the white race is subject to the same laws.”80 Thus, many years prior to the 1928 International Congress of Tropical Medicine and Hygiene, when W. H. Hoffmann of Cuba’s Instituto Finlay declared that racial immunity

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to yellow fever did not exist, the research of naval physicians like BérengerFéraud and Le Dantec had destabilized biological notions of race in matters of health.81 This, of course, is precisely the opposite of generally received versions of the evolution of biological racism in France. By the 1890s, on medical grounds at least, commonalities rather than essential differences typified the races of humanity.

Yellow Fever: Signature Disease of Colonialism Yellow fever constitutes a signature disease of colonial medicine. It was a disease of major concern, much as scurvy had been in the eighteenth century and as dry colic and malaria also were for the nineteenth century. The disease posed significant problems for Europe’s colonial intentions. Its interactions with French naval healers commend historical study precisely because it was so lethal to Europeans, and yet, like dry colic, appeared to spare or strike more lightly African and Caribbean peoples. Malaria was endemic at points on the European continent and well-known to the peoples of southern Italy and the delta of the Charente River around Rochefort-surMer. The French navy’s engagement with epidemic yellow fever extended back to the ancien régime and was annealed by experiences in the old colony of Saint Domingue in the Caribbean. But a series of nineteenthcentury encounters, from the abortive invasion of Mexico to sustained interventions in West Africa, put the disease on naval medicine’s agenda. Gibraltar, Spain, France, and England all tasted the disease’s temper, and European investigators pondered how place had enabled its appearance, attenuated its power, or enhanced its virulence. Epidemic yellow fever occupies a prominent place in the historical memory of French naval and colonial physicians. It is well-known that in 1900 Walter Reed, with the assistance of Carlos Finlay and others, demonstrated the mosquito-borne nature of the disease at one of its epicenters in Cuba. But it is easy to forget that the causal organism for yellow fever, an unfilterable virus, escaped laboratory detection until 1930 or so, though researchers identified many yellow fever “germs.”82 The persistence of yellow fever in an age of Pasteurian medicine and its seemingly protean nature made it a topic of international investigation, and the disease has been almost ceaselessly productive of medical and historical scholarship.83 In the 1970s, more than two hundred French colonial physicians identified yellow fever, malaria, and sleeping sickness as the major epidemiological challenges of their careers.84 Yellow fever and malaria, now recognized as two separate diseases, present confusing symptoms and were sometimes

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seen as two differing manifestations of a single underlying condition. Some naval healers thought one disease might transform into the other, while still others lumped both together as periodic or intermittent fevers. In the absence of confirmation by laboratory methods, or the telltale black vomit of yellow fever, physicians struggled over diagnosis and appropriate therapeutic interventions. By the last third of the nineteenth century naval healers recognized yellow fever as a disease distinct from malaria, an uninvited and lethal “exotic” visitor. Long ago Erwin Ackerknecht reviewed French and English attitudes toward yellow fever between 1821 and 1867 and argued how debates between advocates of the imported nature of yellow fever, or contagionists, and those of noncontagionists, were never only about the disease itself. They were also about commerce and quarantine policies for diseased or potentially diseased ships, people, and goods.85 Subsequent scholars, from Roger Cooter to Margaret Pelling and Christopher Hamlin, have faulted Ackerknecht for overemphasizing the strength of English anticontagionism, signaled his neglect of an established tradition of a medicine of constitutions, or challenged Ackerknecht’s alignment of quarantine policy and contagionism.86 Two significant lacunae are addressed below. First, none of these scholars examine the frightful specter of yellow fever in terms of its impact on the point guards of French encounters with the disease, the physicians and surgeons of the French navy. These were not famous professors from Paris called in to study the disease in episodic fashion at Gibraltar, but navy men who lived with the disease and had substantial experiential knowledge of it. Second, the sensibilities displayed by healers toward yellow fever became more nuanced, exasperated, and detail-laden after about 1870, the outer limits of the time frame covered by Ackerknecht, William Coleman, Hamlin, and Pelling.87 Yellow fever seemed to flare up like a fire and then smolder and cool. In 1878, as if putting a grotesque and only provisional coda on its siren song, the disease claimed twenty-two of thirty navy physicians in Senegal.88 In the same year, Jean-Baptiste Fonssagrives struggled for etiological clarity as he placed yellow fever in a small and confusing nosological category. The nefarious disease exhibited a dynamism and variability reminiscent of his vitalistic physiological theories. The culprit, he concluded, was a miasmatic virus, an infective-contagious agent originating in atmospheric miasmas which likely entered the body through mucosal respiratory tissues and then transformed to become a virus. Fonssagrives excluded most species of malaria from this category, but found similarity of cause implied in yellow fever, cholera, plague, typhus, and typhoid fever.89 In previous work, he

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had noted how some naval medical men had embraced Nicolas Chervin’s assertions of the disease’s local origins. Yet he was now so unsure of yellow fever’s nature that he indicated its classification with a question mark. This tentative gesture ranked yellow fever among one of four subspecies of infections caused by plant material which contaminated the blood. Systemic malaria and “vegetable colics” resided there as well.90 The benchmark for yellow fever epidemics remained the health disaster of the late eighteenth century in France’s Caribbean colony of Saint Domingue which later claimed independence as the nation of Haiti. Some 23,000 British and 35,000 French troops failed to hold the Old Regime’s most profitable colony. Ackerknecht even opined that this epidemic may have spared the American nation a visit from Napoléon and facilitated the Louisiana Purchase of 1803.91 At the time the Black Jacobins of the island declared Haiti’s independence in 1804, about two-thirds of the British force and some 29,000 French had perished, most of them from yellow fever. The nineteenth century was long and dangerous for naval healers, but nothing equaled the scale of the epidemic in Saint Domingue. Yet French naval physicians continued to study yellow fever, contract it, and upon occasion the disease followed them home. Outbreaks of yellow fever tortured Brest in 1802, and again in 1856, the same year Fonssagrives wrote of the ship’s hold forming an unhealthy “nautical swamp.”92 In 1861, the disease struck near Nantes in the civilian port of Saint-Nazaire, soon to be connected to an even greater world by the ships of the Compagnie Générale Transatlantique ferrying passengers and cargo to and from Central America. Shortly thereafter, the disease gained the British port of Swansea and in 1908 it made a lethal visitation in Saint-Nazaire.93 Yellow fever altered the bureaucratic system of regulations and endangered maritime economies in the American South, Cuba, Africa, and Western Europe.94 The French ports of Marseille and Toulon tried a host of regulatory interventions against it. The disease also impacted the families of those who died in the Americas as the minister of the navy forbade repatriation of human remains if yellow fever was determined to be the cause of death, or if exhumation of other remains occurred during an epidemic.95 Yellow fever attacked Cadiz and other Spanish towns in the early nineteenth century and French medical authorities expressed concern when the disease struck Barcelona in 1821. Louis XVIII’s ministers responded with a new uniform quarantine policy, the Sanitary Law of March 3, 1822, and set up a government-funded cordon sanitaire along the Pyrenees. The epidemic spared France but border-guarding troops soon invaded Spain and restored to power the ousted Bourbon King Ferdinand VII.96 However, the

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door could not be closed to yellow fever. In the 1830s the government sent P. de Ségur-Dupeyron, a contagionist on the matter of plague and secretary of the Conseil supérieur de santé, to investigate quarantine regulations in Marseille and the great ports of the central and eastern Mediterranean: Toulon, Venice, Trieste, Livorno, and Genoa. Marseille was the most liberal of these in terms of required quarantine days for cargoes from the Caribbean and Mexico, the recognized font of yellow fever. Provided these regions of the New World were deemed free of epidemics, ship captains arriving from them could expect Genoa to hold their merchandise for fifty days, Trieste and Venice for twenty-one, but Marseille for only seven.97 The navy did not own yellow fever. Famous civilian doctors undertook ephemeral, or in a few instances, sustained investigations. For example, Étienne Pariset, a physician for the insane at Bicêtre hospital in Paris and the Médecin des épidémies of the Arrondissement of Sceaux, arrived in Cadiz on January 3, 1820, at the end of the epidemic. There he collected information from French consular authorities and avoided performing any autopsies. Apparently, the techniques of the fabled clinical school of Paris did not extend to Cadiz. It was Pariset’s first encounter with yellow fever and he apparently made few, if any, clinical observations of patients.98 The famous Parisian clinician Armand Trousseau followed Pariset in 1828 and did similar duty in Gibraltar. Others in Paris such as Trousseau’s contemporary Pierre-Charles-Alexandre Louis, the Parisian hygienist and mentor of the Swiss medical geographer Henri Lombard, also studied the disease. Yet all of these activities counted for little and paled in comparison to those of Nicolas Chervin, the dogged investigator and tenacious foe of quarantines and contagion theory. Born in 1783 near Lyon and claiming a medical degree from Paris in 1812, Chervin had studied typhus for a year at the Mainz military hospital. The disease, he argued, was neither imported nor the result of a contagion passed from person to person. In 1814 he sailed off on a remarkable study tour of yellow fever in the Caribbean and the great port cities of the Americas. His methods included a public health questionnaire, and he adopted the epidemiological technology of spot mapping, a place-based visualization technique which noted times and occurrences of the disease and was also used by the New York physician Valentine Seaman and the Philadelphia practitioner Félix Pascalis-Ouvrière.99 Chervin returned to Paris in 1822 with copious information supporting a theory of the local origin of yellow fever.100 He concluded that the disease was not something transported in cargo so quarantine measures against it were futile. He regarded the disease as an infection arising from local atmospheric conditions and as

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something incapable of spreading directly from person to person. Chervin, who died in 1843, was a darling of the liberal and commercial classes and sang variations on the same anticontagionist song for the rest of his days. He investigated the 1828 Gibraltar epidemic and lobbied parliamentary bodies to overturn what he considered were overly strict quarantine regulations injurious to commerce.101 He was also partisan to the idea that survivors of yellow fever gained considerable immunity against a second attack, but this immunity might be lost if the survivor moved to a cold climate. Residence in place as well as race also mattered, for if one lived in Gibraltar, he wrote, this itself conferred an immunity against future attacks on par with those who had survived a first attack.102 All naval hygienists who dealt with yellow fever in the midcentury knew of Chervin’s ideas. They may also have resented this investigator who was not a navy man and risked much less than they did. William Coleman’s study of yellow fever investigators found the French medical community embracing contagionist attitudes by the 1860s. Chervin’s work, according to Coleman, “led only to renewed disputes on virtually every front.”103 Definitional problems abounded and were similar to issues found with Fonssagrives’s vitalistic concepts of illness and health. Coleman continues, “Clinical and pathological identity, definite connections between cases, appropriate therapies, and epidemiological and etiological implications were all left unresolved.”104 However, study of the places of yellow fever by naval physicians, in this case infected ships, changed the tenor of etiological discussion just as Lefèvre’s studies of the places of dry colic had enabled clarifications on the nature of that disease. While some naval healers likely accepted Chervin’s ideas, many of them felt the navy should determine sanitary rules for all French ports, and it is doubtful that those encountering yellow fever with regularity welcomed Chervin’s interventions on quarantine. A number of retired naval physicians took posts with passenger, cargo, or mail ships, or as sanitary police in port cities. For the Christian vitalist physician Évariste Bertulus, a former hygienist at Marseille’s École préparatoire de médecine, effective regulation of yellow fever required expertise in naval medicine, a qualification Chervin lacked. No friend of commercial interests, Bertulus decried the weakening of quarantine regulations which had occurred in 1850 when the office of Préfect sanitaire had replaced the older naval Intendance sanitaire. In a lengthy study of 1864 examining the Saint-Nazaire epidemic, quarantine regulation, and the dangers posed by yellow fever, plague, and cholera, Bertulus had harsh words for Chervin. Commercial considerations, he continued, ought to be secondary to the first priority, public health.105

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In his view, the disease needed to be controlled through stringent sanitary policing. In striking both the colonial periphery and metropolitan cities and transgressing national boundaries and colonial empires, yellow fever facilitated a circulation of knowledge among the colonial powers much as sleeping sickness would do in the following century.106 In matters of disease, however, the prior experiences of place and memories of them framed the diagnostic moment. Some naval healers, as the case below demonstrates, went some way with Chervin and thought yellow fever was a manifestation of an indigenous health danger residing in their own backyard.

The Laboratory of the Ship: Charles-Adolphe Maher, Yellow Fever, and Malaria The reported incidence of dry colic fell as the century aged but yellow fever continued to stalk French sailors in dry colic’s preferred homes of Latin America and West Africa. Charles-Adolphe Maher, born in the port of Rochefort a year after Haitian independence, would be among those conflating yellow fever and malaria. Experiential knowledge of the disease ecology of his hometown and his medical training there colored his impressions of the yellow fever he encountered in the New World. Maher exited the Rochefort medical school after two years of study in 1823 to complete the voyage required for advancement. He was then eighteen years old and the only medical officer on the frigate Herminie which carried seventy men. An early convert to the use of quinine therapy for intermittent fevers and critic of François-Joseph-Victor Broussais, who counseled therapeutic bleeding of fever patients, his ship encountered yellow fever in both Havana and Veracruz.107 In Havana, Maher attended the clinic of Dr. Bélot who bled patients with heroic fidelity to Broussais’s doctrines. Maher also dealt with yellow fever within the confines of his ship. The crew suffered heavy losses during two seemingly separate epidemics, one in the Havana harbor in 1837, which displayed ordinary characteristics, and another in 1838 in the harbor at Veracruz which looked suspiciously like the seasonal fevers of his native Rochefort. Both outbreaks occurred on ship, a more disciplined and laboratory-like environment than the urban centers and smaller towns preferred by the disease. Maher compared the symptoms presented by victims of the two epidemics and noted their varied course. He also recorded how the second outbreak, which had attacked the supposedly acclimatized or seasoned survivors of the Havana epidemic, responded to expectant therapies usu-

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ally employed for malaria. As such, he described an intermittent yellow fever, a variety of the disease, he claimed, with strong malarial elements and one that responded well to quinine and the wait-and-see approach of expectant medicine, but not to heroic bloodletting.108 As if dietary privations and enduring two epidemics were not enough, the Herminie ran aground in Bermuda. Survivors continued on to Martinique where an earthquake killed an additional three.109 Maher survived and soon ascended in rank to become professor of anatomy and physiology at Brest. A varied career took him to Toulon where he served as surgeon to the bagne, assisted at executions, and became one of the first naval men to amputate a leg while the patient was under anesthesia. Maher and Chervin arrived at similar conclusions and identified marsh fevers and yellow fever as varied forms of a single disease.110 Maher’s experience at Veracruz, however, cast doubt on Chervin’s notion that prior contraction of the disease conferred protection against subsequent exposure. The disease was not easily unraveled, of course, and both men were in good company. Even the great Fonssagrives thought systemic malaria and yellow fever had much in common.111 Much later, in 1929, just before the identification of the yellow fever virus, Alexandre Le Dantec, by then a retired professor of naval medicine and exotic diseases at Bordeaux, considered the racial dimensions of yellow fever and malaria in the fifth and final edition of his Précis de pathologie exotique. Le Dantec knew well the ravages of yellow fever as he had contracted and survived it while in the navy. Evidence suggested that Africans had a solid immunity to both yellow fever and malaria, and might even have enhanced their resistance to yellow fever through prior contraction of malaria.112 Significantly, his arguments were not grounded in essentialist interpretations of racial characteristics. Rather, after the fashion of Bérenger-Féraud and Chervin, he thought prior contraction of the disease or diseases conferred resistance. Maher finished his career as director of the naval medical school at Rochefort among the intermittent fevers he had conflated with yellow fever. In the 1860s he pondered the causes of two malaria epidemics which struck his hometown in the summers of 1858 and 1859. Health statistics indicated an imported contagion might be working hand in hand with endemic fevers. It was in “the appearance of certain diseases foreign to the normal constitution of the region,” he wrote, that “we must search for the explanation of exceptional mortality.”113 Ever passionate for bettering the health of his fellow townspeople, he exemplified a naval physician who embraced the medicine of place. Voyaging was over, but he answered the call to ambulance service in Lorient during the Franco-Prussian War. Early

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in the Third Republic he published a summary of his city’s demography and climatology.114 It was a place he loved.

Ethnicity and Hybridity: The Hell of Colonialism, Creole Questions, and Creoles Although a generation apart in age, the careers of the naval physicians Armand Corre and Albert Clarac intersected in many ways. Corre, the older of the two, was born in 1841 in Laval in the department of Mayenne at the eastern edge of Brittany. By marriage and schooling he was Breton. In 1861, after two years at the naval medical school at Brest, he sailed to Martinique in a convoy carrying African troops and then volunteered for service with French expeditionary forces bound for Mexico. Had he looked carefully at children playing around the port of Fort-de-France in Martinique, he might have seen the young Creole Albert Clarac enthralled by the magnificent French ships. Perhaps Clarac was one of the young boys who dove for coins passengers tossed into the harbor and recovered a coin from Corre? Both Clarac and Corre would battle yellow fever, but Corre encountered it first, initially in the Veracruz military hospital. He soon returned to Mexico in 1865 and 1866 where he served with the French army of occupation in France’s abortive colonization effort. These experiences were written up for his Paris Faculty of Medicine thesis of 1869 and provided a foundation for his racism, xenophobia, anti-Semitism, and thinly veiled disgust of Creole peoples.115 Naval physicians frequently contracted the diseases they battled, and Corre was no exception. One medical examination from Brest diagnosed him as having anemia from intermittent fevers contracted in Mexico; another from July 1867 indicated chronic bronchitis contracted while ferrying immigrants from India to Martinique, while yet another from 1877 noted severe anemia as a result of exposure to malaria in Senegal.116 In 1867 Corre obtained three months of leave at full salary and married Palymyre Catherine Hérard, a young Brestoise whose parents owned a building in Brest. Shortly thereafter he obtained another three month leave and fee waivers for the sixteen remaining inscriptions required to obtain his medical degree. Almost immediately, stormy relationships ensued both with the navy and the French colonial project. Resigning from the navy in 1870 he was soon on campaign with the army of the Loire. When peace returned he worked as a civil practitioner in Brest and near Paris. Reenlisting in the navy in 1874 at a rank below his previous one, he went to Senegal where he worked under Bérenger-Féraud. Journals from his two years in Western

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Africa document his growing preoccupations with racial theory, anthropological investigations, and questioning of European colonialism. Corre’s African journals are fairly standard contributions to medical geography, statistical demography, and ethnography. Traveling with a French cleric, Father Lamoise, he investigated sleeping sickness, made microscopic analyses of water and milk, composed maps, and sketched African dwellings, baskets, hair styles, and ovens.117 Corre was skeptical of Lamoise’s opinions including his idea that sleeping sickness might be the result of enchantment by the devil.118 The journals reflected on biblical accounts of the diasporas of the tribes of humanity and were composed among desolation wrought by plagues of locusts and fire. Corre also chronicled French abuses of Africans in what must have seemed like a colonial hell, at first mentioning perpetrators by name, then striking them out, then adding them back as frustrations with the navy mounted. Members of the Wolof tribe, French allies in the pacification of Senegal, he wrote, were the same everywhere: “insolent, presumptuous, abusing the authority they owe to our protection and secretly, our worst enemies, either keeping traditional dress or adopting our long double-breasted top coats [after the fashion of] our brothers of the Christian doctrine.”119 He also wrote of demographic collapse and brought forth arguments in support of climatic alteration of temperaments. Corre continued in the navy with postings to Madagascar, Saigon, and Guadeloupe interspersed with periods at Brest teaching obstetrics. The end, however, was near. Sent to the island of Nosy Be off Madagascar in 1878, he soon disagreed in public with a superior officer over medical treatment of the civil population and was transferred. A new period of productivity ensued and books on obstetrics and articles on yellow fever, anthropology and ethnology flowed from his pen. He continued to write of the racial elements typifying yellow fever’s history, and held close to the idea that Creole and African races, while not entirely spared by it, were mainly immune. This of course meant they could be employed as nurses during epidemics or as workers disinfecting ships. The disease could not have been transmitted by Africans to America, he thought, because of their remarkable immunity to the disease.120 Although Corre arrived at positions similar to those of Bérenger-Féraud, his writings brimmed with criticism of him and at one point he accused Bérenger-Féraud of stealing his ideas.121 Corre sought firm connections between proposed etiological agents and diseases. But he was skeptical of both parasitology and Pasteur’s ideas as well, and delighted in ridiculing physicians who proposed a series of yellow fever germs.122 His last posting, to Guadeloupe from 1885 to 1887, enabled re-

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search for his most famous publication, Nos Créoles, which first appeared in 1890. Between 1889 and 1891 Corre published four books on French colonial administration and criminality in Creole countries, France and Brittany.123 Nos Créoles argued that Creole races were not viable and would disappear by reversion to their original stocks. Creoles were, he thought, perversions of nature similar to inconsistently fertile plant hybrids and incapable of forced acclimatization to tropical life. This was similar to Bérenger-Féraud’s arguments about the nonviability of the Creole race in Senegal but Corre globalized the position. Black Africans and their Creole progeny had failed to become an “independent race in intertropical countries situated outside of Africa.”124 The French nation itself was culpable for the deplorable state of affairs in its colonies, and he told his compatriots so in an ethnographic study of colonial criminality published in 1894.125 The book was a frontal attack on the regulatory regime of colonial policy and the hell it had created. The methods of this book, L’ethnographie criminelle d’après les observations et les statistiques judiciaries recueillies dans les colonies françaises, recalled those of Boudin’s medical geographical studies. Corre too fashioned his book from judicial records and personal experiences. The text had no glimmer of Fonssagrives’s faith in hygiene or the power of civilization to improve things. He portrayed France and other colonizing nations as “predatory parasite[s] in relationship to the races of colonized countries.”126 Civilization, he argued, was “powerless to transform the primitives and raise them to its level; it kills them. . . .”127 Countries now colonized would have been better off without French intervention, he concluded, as there was actually less crime in the uncivilized world. Colonization merely replaced indigenous vices with other degenerative tendencies and at base it was “a hypocritical and deceptive process of adaptation.”128 Viewed in this way, the ship of civilization was in irons, and its colonized passengers were eternally incapable, or nearly so, of moving forward.129 Corre’s contemporary, the celebrated French magistrate and criminologist Gabriel Tarde, lightly criticized his views. Tarde, an admirer of positivism and like Corre a critic of Cesare Lombroso’s criminal anthropology, undertook an extended review of Corre’s 1889 book, Les Criminels, where he praised the author’s erudition and style. According to Tarde, Corre was a “convinced phrenologist” who had merely shifted the site of analysis to the brain from the more accessible cranial morphology. Tarde lauded Corre for employing positivist experimental psychology in criminological studies but he did not deign to include Corre in his monumental Penal Philosophy

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5. Crania of Rochefort bagnards and their crimes. From left to right: Huet, murderer and pirate; Passio, forger of commercial notes; Joubert, forger and bigamist. © Musée National de la Marine/P. Dantec.

of 1890, though both authors approached their subject from similar perspectives and engaged themes of colonial penology.130 But was Corre following in the path of physical anthropology in matters of racial difference, or was he more pluralist in approach? While it is tempting to believe Tarde and interpret Corre’s views as supportive of biological essentialism, for at times he inclined in that direction, his ideas on race were complex, highly medicalized, and evolved over time. He employed historical methods and archaeological sensibility as well as anthropometry and the techniques of physical anthropology. Corre’s ideas were also highly synthetic and not entirely novel. Research conducted by the anthropologist, medical geographer, and physician Arthur Bordier on crania exhibited on the occasion of the 1878 Paris Exposition Universelle, provided ostensible links between cranial morphology, savagery, and criminality. Bordier’s study of the skulls of thirty-six guillotined assassins, similar to subsequent investigations by Lombroso, led him to view the criminal as the product of anthropological and even biological determinism, a kind of anomalous savage in a civilized country.131 Corre was also familiar with

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the work of Dr. Hubert Lauvergne, chief of medical services at the Toulon bagne in the 1840s, and quoted him at length in a study of the crania of criminals housed at the anatomical museum at the Brest medical school. Yet Corre refused to draw conclusions from his charts and enumeration of more than two hundred skulls and plaster casts of crania. “The science of criminal craineometry,” he advanced, “remains too little advanced to authorize any deduction which is sufficiently scientific.”132 Still, he admired Lauvergne who had noted how the obligatory shaving of prisoners’ heads in the bagnes rendered them perfect specimens for phrenological study. Corre also linked ritualistic crime and cannibalism to animality but pointed not to biological essentialism but to the perturbing influence of colonialism in the genesis of criminality. Modern scholarship now interprets Corre as inclining toward the medical and historical sociology of criminology rather than toward the dated and more deterministic doctrines of phrenology’s founder, Franz Joseph Gall. Lauvergne may be an uncommon exemplar and few naval physicians were as enthusiastic about Gall as he was. Moreover, Marc Renneville has found that naval healers contested Gall’s ideas prior to 1840 and as Jan Goldstein has noted, attentive readers of Gall and Johann-Caspar Spurzheim recognized that the brain was malleable through education though perhaps only to a limited extent.133 By 1841, the Société ethnologique de Paris had adopted an ecumenical approach to the study of man that weighed “physical organization, intellectual and moral character, languages and historical traditions.”134 In terms of criminology and its anthropological dimensions, Corre interpreted colonial crime as the product of “civilizations profoundly troubled by colonialism,” rather than as something rooted in biological or cultural inferiority.135 Finally, the historian of criminology Laurent Mucchielli signals Corre’s criticism of overly deterministic and hereditarian explanations of crime and likens his rejection of biologism to that of the Durkheimian sociologist, Gaston Richard. Corre is a complex figure, and one who first disputed the utility of capital punishment and later favored it.136 Most certainly, though, Corre did not like Creoles. But neither he nor others needed biological essentialism to sustain their prejudices. Yet might Corre have followed tradition and tossed sous to young Creole divers upon his arrival in the harbor at Port-de-France? One of Albert Clarac’s earliest childhood memories of growing up in Fort-de-France in Martinique was of French transport ships carrying men and cargo to the war in Mexico. Many years later he recalled how as a boy of eight or nine years of age, the arrival of the ships had been “a true party for mischievous young boys of our age. . . . I can see, as though it were

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yesterday, all the elements of the French army then marching past us: infantry, cavalry, artillery.”137 Few Creole physicians ascended the ranks of the naval medical hierarchy during the Third Republic, and Clarac was the most prominent of them. Born into a notable island family in 1854, after schooling in Martinique he traveled to Brest and passed examinations for the bachelier ès letters in 1873. A brother-in-law of his cousin, the naval physician Dr. Désiré Lucas, encouraged the young man and prepared him for examinations. In 1874 Clarac won a second bachelors degree and won admittance to the naval medical school at Brest as a second-year student. Voyaging, however, was anathema to Clarac, who suffered from sea sickness. After sailing to New Caledonia, Tahiti, and the South Pacific with a cargo of exiled Communards, he sought posts in the colonies and in port hospitals. Clarac ascended rapidly through the ranks and completed his medical dissertation at Paris in 1881 on the subject of elephantiasis among Arab peoples. He was posted three times to his native Martinique, twice to Guiana, and saw duty in Madagascar and Senegal in port hospitals and in bagne clinics.138 Clarac’s investigations of ethnicity and disease, evident in his medical school thesis, evolved through his diverse postings. Africans were thought to be spared from many cancers affecting Europeans, and Clarac investigated dermatological conditions, scar formation, and wrote on keloidal growths among Africans.139 As a Creole of Caribbean origin, Clarac’s superiors presumed he had some immunity to yellow fever, and he served in two epidemics in his native Martinique, one in 1880 and another in 1888–1889. There he noted that four of every five Europeans who had not previously contracted a mild case of the disease died or fell gravely ill from it.140 He also saw firsthand how yellow fever, ethnicity, and the disease ecology of colonial stations affected staffing decisions. Clarac’s medical chief in Martinique argued for his retention after two years of duty by asserting that it was to the colony’s advantage to retain someone of his skills with at least partial immunity to yellow fever.141 Clarac moved within the upper echelons of Creole society in Martinique. In an account of the 1888–89 epidemic he politely criticized the work of Bérenger-Féraud by noting how the disease had not spared the island’s Creoles. He also pressed the discussion beyond race to emphasize the civilized nature of Creolized peoples who had always been shocked by deaths from yellow fever among their countrymen. For Clarac partial immunity and susceptibility to the disease were less questions of ethnicity or race than of acclimatization and prior exposure. It was certain, he wrote, that the diverse races of Creoles of his home island enjoyed immunity in

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virtue of their acclimatization to the locality “and probably more or less severe prior attacks of the disease.”142 Much depended on the man, of course, but neither Corre nor Clarac had much faith in the administrators they encountered in the Carribean and both accused colonial authorities of under reporting incidents of the disease. Corre had clashed with civil authorities while battling yellow fever in Guadeloupe in 1886 and 1887 and went even further in asserting they had ignored or actively covered up evidence of the epidemic. He also kept a thick folder on Creole “abuses” entitled “How epidemics are made and develop: How Creole interests prevail over metropolitan interests and how one does not hesitate to sacrifice . . . our functionaries and soldiers.”143 Clarac took a less global and absolute approach in an article on yellow fever which appeared the same year as Nos Créoles. There he lauded BérengerFéraud for having organizing Martinique’s health service but noted it still functioned under the director of the Interior rather than a proper military authority. “Those who know the colonies, and particularly Martinique” he wrote, “will understand how such a system is defective.”144 In this he was similar to many naval colleagues who felt the navy was the proper agency to secure health in the colonies and in ports with colonial and commercial connections. Corre and Clarac shared another experience, a loss of what little heritage they shared. The medical school at Brest where both had once sat in lectures and assisted at clinics was a mere shade of its former self by the 1890s. The end was seldom in doubt but the process evolved in uneven and resolute fashion. Naval medicine would soon be centralized at Bordeaux and the army would pluck administrative control of the colonies from the navy. Corre retired before the process was well-advanced but Clarac rode the waves of change in perfect fashion, left the navy, and became the founding director of the army’s new École d’application du service de santé des troupes coloniales founded in Marseille. The new École d’application, also known as the “Pharo,” began taking students in 1907 and became France’s leading institution for colonial medicine in the new civilianized empire. Its founding and Clarac’s challenges are recounted in chapter 5 on Marseille’s institutions of colonial medicine and science. Shortly before his second retirement from the navy, Corre had mentored a young Albert Calmette. Unlike Corre, Calmette embraced Pasteurian medicine. The founder of the Institut bactériologique de Saïgon in 1891, Calmette later became assistant director of the Insitut Pasteur in Paris. Calmette had great affection for Corre, whom he frequently addressed as “monsieur” and “dear master,” and did his bibliographic work while Corre

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was posted on ship. On November 10, 1885, Calmette wrote from Cherbourg with good news. He had passed his first examination for the doctorate in Paris on the previous Friday. The questions had been easy enough and a Professor Raphaël Blanchard, the examiner for natural history, had asked him about filarial infections of the blood. He also informed Corre that Cherbourg’s new medical chief, Bérenger-Féraud, was almost always absent from his post.145 A few months later, on June 30, 1886, Calmette wrote to Corre about a young naval physician, Alexandre Le Dantec, who had also defended a thesis in Paris, one where he politely challenged Corre’s views on yellow fever. Calmette then promised to get Corre a copy of the thesis.146 Neither man knew it then, but Le Dantec, whose career and contributions are discussed in the following chapter, would become the first professor of tropical medicine in a French medical faculty and finish his career in Bordeaux. Corre spent his final years in Brest. It was his place and he wrote on local and regional history and served for a time as city archivist. There he ruminated on the fate of Brittany and France. Corre must have felt the problems of the colonial world had followed him back to France and now threatened the French nation. Brest had changed too, and he wrote of a city overrun by Creoles and in danger of becoming an “exotic colony in the middle of Brittany.”147 Corre’s assessment of Brittany as a kind of colony within metropolitan France was similar to the sentiments expressed a few years later by his fellow Breton, the naval physician, novelist, and poet, Victor Segalen. Segalen, an early graduate of Bordeaux’s new École principale and the eventual namesake of the University of Bordeaux II, had defended his medical thesis on January 29, 1902. Arriving at the port of Toulon in February, he followed the required postgraduate practical course for naval physicians in preparation for eventual placement on ship.148 Before completing studies at the hospital and setting sail for Tahiti on the Touraine, Segalen sent Corre his thesis, aptly retitled “Les clinicians ès-lettres,” with the inscription “To Monsieur the Doctor Corre. Respectful homage—In full gratitude for his kindness and the interest given to this first attempt— In lively admiration of his inexhaustible and effective erudition. Toulon 5 March 02 Dr Victor Ségalen.”149 The two writers, both of them interested in ethnology and anthropology, took radically different positions on the Creole question. Corre decried and feared all manner of racial and cultural intermixture. Segalen embraced hybridity and operationalized it in a series of novels and poems challenging older ideas of exoticism. One of his favored motifs, the quintessentially cosmopolitan exote, emerged from his own colonial experience

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and denoted a person who had no home but lived life in an ascetic manner with aesthetic vision. The opium-smoking and bisexual Segalen also put his philosophy into action after contracting typhoid fever in Chicago. Recuperating in San Francisco he was struck by the splendor of its Chinatown which influenced his own philosophy of exoticism. It was also in San Francisco that he had an affair with a young female nurse at the French hospital, “a petite jew of eighteen, a mixture of Mexican and a bit of German. The result of these unlikely crossings is purely exquisite.”150 French naval physicians, in virtue of their familiarity with African, Asian, and Caribbean populations, had privileged views of race and colonialism. Physical anthropology and a racism founded on the premise of biologically inalterable natures, however valuable to Parisian academics, had precious little value for the study of fevers and the maintenance of European health in the tropics. Significant numbers of naval physicians pursued the study of man within a pluralistic and nonreductive framework which attempted to match competencies with professions and conditions of service. Broca and Gobineau’s views were not particularly useful for naval hygiene or for staffing decisions which instead counseled attention to temperament, constitution, and place-based factors such as prior exposure to diseases. Even naval physicians like Bérenger-Féraud and Corre, identified by historians for their admittedly extreme views on race, included ethnological and place-based evidence drawn from their respective lifeworlds to support their ideas.

When Corre died in May of 1908 the local paper, La Dépêche de Brest, made no mention of his passing. The world had changed. The places of naval medicine now included Bordeaux, which unlike Brest, Rochefort, Toulon, Cherbourg, and Lorient, was not a traditional naval port—what the French would call a port of first instance. Corre’s private library was dispersed among assorted friends and a handful of naval physicians including Albert Calmette and Victor Segalen.

FOUR

Belligerence, Bombs, and Bordeaux: A New Place for Naval and Colonial Medicine

The slanderers, my enemies, are but another epidemic for me, far less dangerous to fight than the others.1 —Laurent Bérenger-Féraud

The Place of Bordeaux The city of Bordeaux prospered on the strength of commercial ties to England and the old French colonial empire. A bastion of Protestant faith and center of wine production, water levels at its port on the Garonne estuary rose and fell with Atlantic tides. The slave trade buoyed Bordeaux’s fortunes as it did those of Nantes and Rouen. In 1705 the king authorized a Chamber of Commerce and commerce grew sixfold over the century as ships returning from the Caribbean islands carried sugar, coffee, and indigo, and sugar refining became a significant activity.2 Colonial ties sustained the city, even after the 1763 Treaty of Paris which ended the Seven Years’ War and stripped away the colony of New France.3 By the late eighteenth century colonial trade accounted for about 60 percent of port traffic. This soon collapsed with the loss of Saint Domingue and then suffered again in 1843 from customs legislation which imposed fees on domestic beet and colonial cane sugar.4 Shortly thereafter, in 1848, France abolished slavery and the city garnered a reputation as a stronghold of old wealth and Royalist sentiment. In the Third Republic, when the navy centralized its medical educational activities there, only about 2 percent of the city’s port traffic went to the Caribbean colonies. Bordeaux’s disease ecology differed from that of Marseille. For example, plague struck both cities in the eighteenth century but Bordeaux suffered less mortality per capita than Marseille, possibly because Bordeaux’s

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population was smaller, more homogenous, and better nourished than that of Marseille. In 1841 Bordeaux counted about 120,000 residents and by 1891 that had grown to a respectable 230,000. Epidemics of flu struck in 1801, 1837, 1842, 1847, and 1858, and returned again in the winter of 1889–1890 to claim more than three hundred souls. Mortality estimates for the great pandemic of 1918–1919 calculated between 700 and 1,700 deaths. Smallpox too was an abiding threat and sailors were implicated in its genesis.5 Smallpox caused about 2,650 deaths between 1869 and 1871, and typhoid fever was active too killing about 700 in the five-year period of 1886 to 1890. Of all diseases, though, epidemic cholera which struck in 1832, 1849, and 1854, provided a focus for sanitary action. Even Claude Bernard’s teacher, the great physiologist François Magendie whom the city liked to claim as its own, could only recommend victims drink a punch of rum, tea, and lemon.6 The city had a long tradition of pedagogy in medicine and surgery and had once possessed an ancient faculty of medicine, although the breadth of instruction cannot have been large as the faculty consisted of two professors from 1624 to its abolition in 1793.7 Members of a College of Physicians, and a surgical corporation, the latter of which formed the École publique de chirurgie de Saint-Côme in 1755, also taught the healing arts. By 1758 the Saint-Côme surgical school had six chairs spanning surgery, osteology, anatomy, therapeutics, and birthing.8 Physicians and surgeons clashed frequently when vacancies arose at the faculty or the surgical school, and while candidates for chairs underwent a concours and were ranked by a jury, the king might disregard winners and appoint favorites. In addition to instruction in surgery, arguably the healing art nearest to the needs of naval medicine, Bordeaux had a long tradition of training apothecaries, and its Corporation of Apothecaries was among the most successful of pharmaceutical confraternities in all of France. Here too the colonial situation mattered. Bordeaux had a merchant fleet of seventy-nine ships in 1730 which grew more than threefold by 1778. By the 1780s more than two hundred ships, many of them slavers, departed each year for Africa, the West Indies, and other locations. One local chemist even proposed organization of a common laboratory to produce drugs for marine medical chests.9 In 1776 corporation member Jean Dubedat became apothecary to the admiralty, a post whose duties included inspecting the drug chests required on all vessels with a crew of twenty or more.10 The corporation dissolved in 1791 just two years prior to the disappearance of the city’s medical faculty, but the corporative spirit lived on and in 1798 physicians

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and surgeons joined with apothecaries to found a Société de médecine de Bordeaux.11 Yet aside from the apothecary arts, maritime medicine was a fairly minor feature of Bordeaux’s heritage. After the revolution two rival schools vied for students, the École de médecine de Saint-Côme headed by JeanBaptiste Moulinié, and another school located at the Saint-André hospital. The École de médecine de Saint-Côme had eight professorial chairs but no clinical instruction, while at Saint-André students had access to a clinic but not to laboratories or dissection rooms. In 1829 the city established an École de médecine et de pharmacie. The surgeon Brulatour, formerly associated with the Saint-André school, assumed an active role in governance and teaching at the new school as did the physicians Élie Gintrac and his son Henri.12 The city reestablished its Faculty of Letters in 1838 and launched a new Faculty of Sciences. The Gintracs had allies throughout the city and in the Société de médecine de Bordeaux. Their coalition achieved elevation of the city’s École de médecine to full medical faculty status in 1874. In this context then Bordeaux notables amplified the city’s moderate heritage of naval and maritime medicine and promoted it to win a medical faculty for the city. Bordeaux was attractive to the navy but not for its port. In comparison to Marseille which lurched from one financial crisis to another, Bordeaux was financially solvent. Pleas for a new medical faculty, sounded repeatedly after 1793, finally succeeded amid collective soul searching after the nation’s defeat in the Franco-Prussian War. The National Assembly and the Conseil supérieur de l’instruction publique weighed applications for new medical faculties while the medical faculty at Strasbourg was in German hands. By the time the city hosted the Association française pour l’avancement des sciences in 1872 the city council had firmed up financing for new medical school buildings required by the central government. Bordeaux won approval for a new Faculté Mixte de Médecine et de Pharmacie in 1874 and opened for business in 1878.13 Numerous Bordeaux learned groups and associations focused on aspects of place and race. Though they were not all specifically interested in medicine, they were interested in recovering the prosperity colonial connections had once brought the city. Hosting of the Association française pour l’avancement des sciences provided the enthusiasm needed to found a Société de géographie commerciale de Bordeaux in 1876, a group with interests in maritime health and healing. It brought together men of commerce, naval, and maritime activities with those in higher education. Be-

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hind the society stood the businessman Marc Maurel who had worked in Senegal for the firm of his uncle, Hilaire Maurel. The younger Maurel won election to both the city council and Chamber of Commerce during the Third Republic. His politics were those of free trade and similar to those of his better-known analogue in Marseille, Jules Charles-Roux, whose activities are detailed in the following chapter. Joining Maurel was Pierre Foncin, a graduate of the École normal supérieure who would later hold the chair of Geography at Bordeaux’s Faculty of Letters. He would also serve as the group’s general secretary and a link to the university.14 Medical men assumed leadership roles in several Bordeaux learned societies as they did in the greater political life of the Third Republic.15 For example, Dr. Eugène Azam, the new medical faculty professor of external pathology and surgery, had launched the Société médico-chirurgicale des hôpitaux in the 1860s and become president of the Société de médecine de Bordeaux in 1876. He would also preside over the Groupe géographique du Sud-Ouest, the regional outreach arm of the Société de géographie commerciale with ties to Rochefort and other maritime cities. This last group promoted French colonialism and distributed and collated a number of questionnaires, notably one of 1890 requested by lieutenant-colonel Joseph Galliéni and sent to West Africa addressing commercial, geographical, and medical concerns. In its first twenty-five years the society organized about ten public lectures per year in Southwestern France on geography, ethnography, and commerce. Place and race were conjoined in Bordeaux much as they were in other locations examined in this book, although the specific emphases differed by city and that city’s ties with specific colonies. In 1894 the Société de géographie commerciale merged with the Société d’anthropologie et d’ethnographie de Bordeaux et du Sud-Ouest.16 By the turn of the century, the group had formed a colonial section and was still promoting the foundation of a commercial and colonial museum. Simultaneously, the fortunes of the colonial section rose while those of the mother society declined.17 Just as the Bordeaux meeting of the Association française pour l’avancement des sciences had stimulated the Bordelais to found their own geographical society, so too a visit and lecture by Dr. Édouard Heckel of Marseille, the French apostle of colonial institutes, sparked action. The local school of commerce had maintained a museum of colonial products since 1877 but a lack of students had frozen plans for expansion.18 The Société des amis de l’université invited Heckel in the spring of 1899 to speak on colonial museums, and a contemporary related how this visit led to the founding of the Institut colonial de Bordeaux.19 Heckel, whose activities

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are examined in the following chapter, promoted a particular type of colonial institute. The best organizations joined together specialty museums for colonial products, gardens for research on colonial botany, laboratories for testing colonial products, and a program of public classes and documentation on geography, commerce, and health. In comparison to Heckel’s organization in Marseille, which was backed by the wealthy Chamber of Commerce, the Bordeaux programs were more the expression of municipal government action. Bordeaux’s Institut colonial obtained authorization in 1901 after the mayor traveled to Paris and secured promises of financial support from Albert Decrais, a native son of the city then serving as the minister of colonies. Alexandre Nicolai, a city council member and professor of political economy at the Faculty of Letters served on the institute board and secured inclusion of colonial geography in the Faculty’s offerings.20 The Institut’s activities included teaching through a colonial section at the École supérieure de commerce, and sponsoring a museum, information service, and a display at the city’s botanical garden. On balance these four divisions of activity were oriented more toward commerce and less toward science, health, and the testing of colonial products than what developed in Marseille. Like Heckel, who seemed to be a part of everything colonial in Marseille, Bordelais figures like the botanist Lucien Beille fulfilled multiple roles. Beille, who published widely on pharmacology, botany, and the new science of parasitology, served as general secretary of the Congrès colonial de Bordeaux held in August of 1907.21 Simultaneously he was also director of the botanical garden, director of the Institut colonial’s museum now located in a greenhouse at the garden, adjunct professor at the Faculty of Medicine, and the assistant general secretary of the Institut colonial.22 The 1907 colonial congress at Bordeaux was a high point of the Institut’s prewar history. The event signaled Bordeaux’s commitment to colonial affairs but did so at a time when the city’s commercial ties to the colonies were weakening. Still, congress members delivered papers on the economic botany of cotton, rubber, tobacco, pineapple and the like. Many of Bordeaux’s own, including a founder of the Insititut colonial, the professor of geography, Pierre Camena d’Almeida, spoke on their special areas of competence.23 Like Beille, Camena d’Almeida served the community in many capacities, notably as general secretary of the Société de géographie commerciale from 1919 to 1939.24 The Bordeaux colonial congress of 1907, like Marseille’s of the previous year, featured contributions on colonial biology, medicine, and health. For example Pierre Achalme, director of the colonial laboratory at the Paris

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Museum of Natural History, spoke on “The Role of the Biological Sciences in Colonization.” Achalme declared the era of settler colonialism had ended and enumerated how mosquitoes, tsetse flies, helminths, and microbes threatened the advance of colonization. The rational scientific tools of quinine, vaccination, and surgery, rather than guns, he argued, would develop the new empire and rally colonized peoples to French civilization. In locations where the Western physician had been allowed to treat colonized peoples, he continued, “the superiority of the white was immediately admitted there . . . the physician in the native home is the collaboration of races, the peace and prosperity of the colonies.”25 In this, Achalme echoed earlier pleas for a scientific colonialism issued by the medical geographer Arthur Bordier and prefigured those of the colonial theorist and cartographer Édouard de Martonne.26 The Annales of the institute published a number of similar narratives on the need for scientific medicine, including one ethnographic study from the Ivory Coast on how African healers were confronting sleeping sickness.27 The Institut’s courses were directed at students of the school of commerce, though the larger public could attend, and by 1910 many classes convened at the university. The program included Beille’s course on colonial botany, and others on colonial geography, colonial products, construction practices in the tropics, colonial economics and legislation, Arabic language, and colonial hygiene. The hygiene course was taught by the naval physician and medical faculty professor Alexandre Le Dantec who in six lectures examined plague, yellow fever, sleeping sickness, malaria, and poisonous snakes. About fifty students took courses though most were not enrolled at the École supérieure de commerce and only twenty-five or so, about the number of consultations each month in the institute library, remained with the program to year’s end.28 Instruction targeted the needs of colonial functionaries, potential colonists, and commerce. For example, the professor of Arabic, the Abbot Feghali, instrumentalized the language after the fashion of Achalme’s account of biology and colonization. Feghali noted how Arabic was a commercial tool in Algeria and a “powerful means to practice a true civilizing influence on the masses. Indeed, the native is profoundly scornful of those who are ignorant of his language: and for a Muslim nothing is more venerable than the language of his prophet.”29 As this review of colonial Bordeaux has shown, a number of colonial activities sprang to life around 1890 just as the new naval medical school arrived. Until this time, the navy, but more particularly colonial commerce, was part of the city’s history but not a large part. Moreover, the history of colonial trade in the nineteenth century was actually one of decline.

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Bordeaux was mainly a commercial port with a naval presence. The city’s terrestrial trade grew markedly after 1844 when a rail line connected the city with Paris and the city renovated the port during the Second Empire.30 However, ties to Africa persisted. Hilaire Maurel opened Bordeaux’s first peanut oil factory in 1857 to process unshelled nuts from Senegal, though it was perhaps less efficient than factories in Marseille handling shelled nuts. Unlike Marseille, however, Bordeaux failed to invest in large cargo cranes and expansive docks and its port suffered from its place on the estuary. The new transatlantic steamers drew up to seven meters of water, and at low tide water levels in Bordeaux’s port fell to half that depth.31 Moderate economic expansion occurred during the Second Empire, mainly due to increases in rail traffic, with some contribution from trade with Senegal and the Far East, particularly with Saigon and Latin America. As discussed in the following chapter, the Marseille context differed in several particulars, not the least of which was a dynamic commercial lobby dedicated to furthering colonial interests. In contrast, members of Bordeaux’s Chamber of Commerce argued against the establishment of Dakar and the group effectively abandoned trade with southern Senegal to rival interests in Marseille and Le Havre. In 1869 about one French ship per day left the port. About one in every three ships from Bordeaux sailed for Latin America, a major market for French wine, while only one in eight sailed for Senegal and only one in ten for Saigon.32 Around 1890 a series of events, several of long gestation and in many instances the result of arcane naval regulations and attempts to reform those regulations, coalesced to bring the city a new central naval medical school. The city’s personalities and their influential connections were of course important to this process. But so was the place Bordeaux had become. By the 1880s it was home to a new medical faculty, a major requirement for a naval administration wearied by years of complaints and intent on revising the way it trained its physicians. Secondly, Bordeaux would be selected because of what it was not, a naval a port of the first instance as were Brest, Toulon, and Rochefort.

Reform and Resentment: Tinkering with Naval Medicine, 1835, 1866, 1875, and Bit After A series of perturbations brought naval medicine to Bordeaux.33 The regulatory regime of naval medical education had remained fairly stable from the fundamental Ordinance of 1689 to 1835. However, naval administrators tinkered incessantly with regulations and naval physicians consistently

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complained about them. After the revolution naval healers focused on a long list of what they saw as wrong with the system; issues of recruitment and retention, remuneration, educational level of practitioners, hospital administration, naval nursing practices, and assimilation in grades and equivalence to the navy’s larger advancement system. Essential reforms of naval medicine, but by no means the only changes to the system, clustered around the dates of 1835, 1866, and 1875. Personal alliances, allegiance to place, and resentment drove the process. In 1813 Napoléon appointed Pierre-François Kéraudren inspector general of naval medicine. Kéraudren held the post through several governments until 1845 and was known for nepotism and self-serving demands for salary increases, honors, and gifts. In 1830 Kéraudren was sixty-one years of age, ensconced in Paris, and out of touch with the lifeworld of the ports. He was also the recipient of a bag of diamonds from Czar Nicolas I and was reluctant to change the way he ran the medical service.34 Epidemic cholera stuck France in 1832 and Kéraudren appointed auxiliary physicians to permanent naval posts without concours. A number of voices, among them a retired naval physician from Brest, Pierre Delaporte, lobbied for change. Finally, a series of meetings between Kéraudren, Jean René Quoy who was then at Brest, and assorted representatives of the administration and professoriate enabled the reforms of 1835–1836. Quoy was a second physician in chief in 1835 and remembered Kéraudren’s committee as two months of arguments where he sketched pictures of shells and fish. One committee member disagreed with nearly everything and other members consistently voted down his views. The committee focused on the conditions of advancement and assimilation to naval military ranks and set aside curricular reform.35 These meetings and subsequent polling of faculty at the three port schools led to the first substantial changes in naval medicine since 1689. Jacques Léonard has portrayed the reforms of 1835 as seminal precisely because they recognized naval healers as having a certain intellectual competence, an art of expertise meriting a degree of autonomy in matters of health. It also marked a kind of claiming of naval medicine by the naval hierarchy by assimilating naval physicians to the naval ranking system which meant that healers were now identified by grade with those engaged in combat functions.36 The reforms of 1835–1838 and others of the same era secured rights for pensions, gave moderate pay increases, and allowed physicians to redress salary issues. Yet not all parties were satisfied. In terms of assimilation to rank, the inspector general for the naval health service became equivalent to the rank of rear admiral, physicians in chief gained

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parity with captains of the navy’s largest ships, second physicians in chief were equated with captains of frigates, and medical school professors were equated with captains of smaller and lightly armed ships, corvettes which might carry from twenty-four to thirty-two cannons. Significantly, the regulations confirmed that port health councils, basically the professors or in ports without schools the ranking medical officers, were at long last free of supervision by the commissary general, the noncombatant office in the naval hierarchy charged with provisioning supplies for hospitals, ships, and the like. Henceforth port health councils reported directly to the maritime prefect of their port. These reforms addressed but did not resolve an essential tension, the perceived disparity between the professoriate of the three port schools, and the navigans, naval healers who sailed on ship or served in the colonies. The 1835 regulations gave navigans increased hope of advancement and partially addressed the problem of their frequent absences during concours. The concours, required to advance to the professoriate since 1820, now applied to all grades and was offered twice per year. Provided they passed the concours for advancement, both surgeons without the doctoral degree and physicians with the doctorate, could rise to the rank of first-class physician or surgeon. But there parity ended and those without doctoral degrees, no matter how many years of experience they had, went no further. The regulations also slighted pharmacists by decreeing that only a physician or surgeon (with a doctoral degree) could rise to the highest rank, that of inspector general. Another source of tension, a discrepancy of long standing, was codified the next year. Naval healers who served in the colonies did so under terms prejudicial to their advancement. Concours for colonial posts were distinct from those held in the ports for naval advancement and in 1836 the minister decreed the location of open colonial posts should be kept secret until after the exam. But few candidates sat for exams under these conditions. As an incentive to undertake colonial service the minister reserved places in the naval health service for returning colonial physicians which they might win without concours and be advanced to by seniority. This was hardly inventive as the navy routinely combined credit for time in service with examination scores at the time of advancement. 37 In 1836 another commission met in Paris to address the concours system and curriculum of the three port schools. Its effort, a reform plan of July 23, 1836, guided the activities of the schools until a subsequent modification of 1854 and a whole-scale revision in 1865. Like the reforms discussed above, those of 1854 were less revolutionary than evolutionary, and bore close relationship to previously expressed views sounded

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by the professoriate at Brest. According to the naval medical geographer Jean-Baptiste Mahé the 1854 reforms left in tact the teaching program, the concours system, and what was seen as the privilege of the professoriate to remain in their posts for life, if they choose, and thereby limit the possibility of advancement for those behind them.38 Navy medical men continued to proclaim the specificity and discreteness of their art, but save for a few particulars admission requirements for the port schools now mirrored those of civil medical faculties. For example, an Ordinance of August 9, 1836, required a bachelors degree in letters for admission to the civil faculties of medicine at Paris, Montpellier and Strasbourg, and students were expected to complete a bachelors degree in science prior to their second year of study.39 Additionally, the naval school student body, also composed solely of those holding a baccalaureate of letters degree who had passed an admission examination, was divided into groups of interns and externs. Interns, if they did well, received a modest stipend of 150 francs per semester. The projected needs of service determined the number of internships awarded which in 1835 meant an entering class of only thirty-two students with paid internships for all three schools combined. Externs, while not paid, could still follow courses and the navy had frequent recourse to this reserve and to its auxiliary medical corps. All students had to be at least sixteen years of age but less than twenty-two. Reform unleashed additional tensions. In 1835 port medical services counted 317 health officers of various rank. By 1849 there were 570 and most of those were at the low and middle level of the career track. Additionally, the French Empire was in full expansion so even more potential candidates for advancement were absent from port and unable to sit for concours. This substantial increase in naval medical personnel, most of them navigans without medical degrees and unlikely to obtain them, put the navy at odds with civilian physicians. For example, members of the 1845 Congrès médical de France had worried about standards and medical overcrowding. The group also lobbied to get rid of civilian health officers, the logical career path for former naval medical men without the doctorate.40 Simultaneously voices from within the naval health corps sought expansion of higher-level posts. The 1835 and 1836 reforms exposed the professoriate to criticism on several fronts. The number of professorial posts, which one needed to hold for a time to be eligible for higher rank and remuneration, had not expanded, and the reforms made no provision for professorial chairs in either general or naval hygiene. Further, no matter how one did the calculations, it seemed like the navy was not getting its money’s worth. The number of professors and chiefs stood at twenty-nine

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while that of the entire student body composed of about twenty interns and perhaps eighty externs yielded a student-professor ratio of less than four to one.41 Jean-René Constantin Quoy, whom we first met in chapter 2, is remembered as a naturalist on the voyages of Freycinet (1817–20) and Dumont d’Urville (1826–29). He was also named inspector general of naval medicine in 1848 and his career spanned several attempted reforms, including moderate tinkering in 1854 under the minister of the navy Théodore Ducos. He may also have inspired the substantial reforms of 1865 which occurred under his successor, Auguste Reynaud, inspector general from 1858 to 1872.42 Quoy grew up in rural Vendée, a coastal region south of Brittany and north of Bordeaux where his surgeon father taught him botany and the art of therapeutic bleeding. Quoy’s diary provides an engaging if biased portrait of naval medicine. On an early and rather monotonous posting on a corvette along the coast of southwestern France he took along Antoine Lavoisier’s Elements of Chemistry, which was chewed upon by the ship’s rats, and Abraham Tremblay’s studies of hydra. 43 Quoy began studies at Rochefort in 1806 at age sixteen and in 1808 shipped out to the Antilles. By 1814 he had completed his doctoral degree and was twenty-seven years old.44 A man of the north, he disliked Creole peoples, members of the Provençal race, and in one instance took revenge on a surgeon from Guadeloupe he considered “pathological [and] indolent like a creole.”45 Quoy’s dislike of the Provençal race was unfortunate as he was posted to Toulon to battle cholera and would return there again in 1837. A majority of professors there hailed from Provence if not from Toulon itself. Quoy had facility in Latin and Greek and had the audacity to quote Hippocrates in Greek during examinations. The navy was changing yet most surgeons knew neither Latin nor Greek and some spoke French with difficulty. Among others, Quoy’s diary targeted his former superior officer, Jean-Joseph Reynaud, a surgeon and president of Toulon’s health council. Quoy wrote of Reynaud as a vain pedant and remembered him as one of the old guard of naval surgeons, “without much education or distinction, having descended from the rocky mountains of PROVENCE, with an accent of gibberish. . . . To this detestable accent he joined a smashed nose and rude manners.”46 Another son of Provence, the bagne physician and phrenologist, Hubert Lauvergne, whose writings inspired Armand Corre’s investigations on ethnicity and crime, merited similar judgment. To Quoy, Lauvergne was a “confirmed provençal in character and language . . . and after talking with him for a time one could see a most false and fantastic imagination emerging . . . it was impossible to follow him.”47

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Of course Quoy did not need to go to Toulon to encounter naval medical men of Provençal birth. There were many in Rochefort and Brest as well. By Quoy’s account the Rochefort professor Gal, who would later rise to first physician in chief at the school appeared tall, dry, and thin, walking in half-stooped posture dragging his shoe, always ready to explode in anger, strongly marked [by] the accent of his region and speaking poorly a French intermingled with curses (for him ipecachanha was hipecacouane; opium was opion, laudanum was laudane . . . , etc. For [P]rovincials, a pneumonia is a neumonia; they have infinite difficulty pronouncing well the first word). What a tribulation it was for the poor man to compose prescriptions . . . in the decimal system. He muddled everything in his memory, confusing measures of weight with those of volume and range, prescribing five centimeters of Emetic for five centigrams, etc.48

Quoy’s self-serving descriptions of his colleagues and naval procedures, composed in the 1860s, signal a system in disarray. Duels among students were not uncommon, and Quoy himself was a second for a duel which ended short of a final confrontation. Gal and other professors adhered to eclectic therapeutic doctrines mixing Galenic and Hippocratic elements filtered through the writings of Thomas Sydenham and William Cullen.49 Quoy was not alone in his prejudices and resentment, though few went as far as the Toulon veteran Laurent Bérenger-Féraud, whose story is told below. Quoy supported the concours for advancement even though taking it was a problem for the navigans. Even those who sat for examinations knew they were not necessarily objective exercises as the school’s professors composed the jury. Quoy related one instance where four candidates took the concours and since there were four places all were promoted. In another instance, according to Quoy, when a respected professor of anatomy died, all eligible candidates except his son, the surgeon Jean-Baptiste-Joachim Clémot, refused to sit for the concours to replace him. The younger Clémot had studied with Bichat in Paris and would gain election to the Académie de médecine. But according to Quoy the son did not realize the advantage his colleagues had given him, offered no courses students followed, and was the “father of a large family occupying himself with his private patients and hunting.”50 Examinations for the professoriate in Toulon in the late 1820s and 1830s provide additional evidence of dysfunction. One jury was divided between a faction of Toulonnais professors and those favoring a candidate

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with ties to Normandy. After bribes and several intrigues, two candidates, including Hubert Lauvergne, advanced.51 Things were not necessarily much better in the civil medical faculties. At Montpellier, near the end of the Napoleonic Empire, where Quoy submitted his doctoral thesis, he related how the questions on pathology were asked in Latin but students selected which questions they wanted to answer. There, wrote Quoy, the faculty secretary was kind to us and wanted to speed up the process and reduce our expenses, so “we agreed to acknowledge him by secretly slipping him an extra louis in his fees.”52 The revolution of 1848 and Second Republic afforded naval healers opportunities for airing grievances before parliamentary bodies and elaborating reform projects. One reformer, Dr. Eugène Leconte of Rochefort, proposed a new constitution for naval medicine including curricular reform in the schools. The plan wanted a true fusion of the surgical and medical lines, and a significant increase in the number of higher level posts in the colonies, including two chiefs of service each for the yellow fever infested islands of Martinique and Guadeloupe.53 The minister of the navy solicited comments for reform in September 1848 and echoes of Leconte’s new constitution and alternative plans reverberated through the early years of the Second Empire. A committee at Brest also met and developed their own ideas. They recognized the distinctive nature of naval medicine, calling it an anomaly, but because of the potential cost of reform they suggested no ameliorations for the surgeons of the second class, the group with the least prospect of advancement. As the committee saw it, the special and distinctive nature of naval medicine required a special organization all its own. They sought to preserve naval medicine from incorporation into army medicine and to recognize that the special conditions under which the health Officers of the navy generally work, the exceptional arrangements of the localities in which they are habitually called to exercise their functions, [and] finally the exigencies of the fleet, must necessarily entail a special organization and render difficult a complete and absolute reconciliation between the two medical corps of the navy and army.54

However much naval medical men coveted the pay and working conditions of their brothers in the army, they resisted incorporation into the army and proclaimed their art was neither purely civil nor army in essence. This strategy of continued independence worked, for the most part, until 1968. Yet problems beset naval medicine at midcentury, and in Quoy’s last

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year of service his letters to the Director of the Rochefort school adopted an exasperated tone. At one point pharmacy students at Rochefort were so ill-prepared for the concours it had to be delayed. Quoy railed against the overly practical tenor of instruction and counseled the navy to allow some license to theoretical interpretations by students as was done in civil faculties.55 The time was ripe for change but would require sustained attention by skilled administrators. Fitting the bill was Prosper de Chasseloup-Laubat, Napoléon III’s capable minister of the navy who held the post briefly in 1851, and again from 1860 to 1867. Chasseloup-Laubat was a longtime member of the National Assembly and had followed Prince Jérôme Napoléon in leading the ephemeral Ministry for Algeria and the Colonies, the only time the colonies had been separated from the navy since their inception as a navy subdirectorate. Upon reintegration of the colonies into the naval ministry he modernized the fleet, established a protectorate over Cambodia, and pacified the naval colony of Cochin China. Auguste Reynaud, who followed Quoy as inspector general in 1858 and served in that capacity until 1872 was another capable administrator and like Chasselouop-Laubat a stabilizing influence. Reports of discontent were on Chasseloup-Laubat’s desk by November of 1861. The ongoing medical needs of the new French Empire, the situation in Mexico, and continuing problems in naval medical education commanded Chasseloup-Laubat’s attention. One prolific critic of the system, the naval pharmacist Joseph Malespine, issued a stream of articles in the newspaper L’opinion nationale and pamphlets diagnosing the ills of the system, comparing naval and army health services, examining the requirement of the doctorate to practice naval medicine, and hammering at the perceived privileges of the professoriate.56 Malespine suggested closing the schools at Brest and Rochefort and retaining just one at Toulon and creating an annex for naval healers at Montpellier. He wrote repeatedly of naval medicine’s “radical defects,” and charged that instruction at the schools was not only “incomplete; it is more than useless as, in general, the professors speak to an empty room.”57 Charles-Adolphe Maher, director of the Rochefort school in the 1860s whose work on malaria, yellow fever, and demography was treated in the previous chapter, responded with his own pamphlet of 1863, Les Médecins de la Marine.58 But Maher too was critical of the naval system and the controversy pressured Chasseloup-Laubat to come up with solutions addressing the colonial situation and confirming the discrete nature of naval healing. In 1862 Maher issued a plea for action and provided inspector general

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Reynaud with a stark assessment of naval medicine in an age of colonial expansion. All Rochefort’s surgeons were on ship, he wrote, and the port’s medical services were stretched thin. Either the navy needed to hire more healers or reduce the number of ships by half. He also expressed alarm over the quality of the corps, “our surgeons,” he lamented, “no longer have the worth they formerly had; each concours, unfortunately, furnishes the judges with official proof of this.”59 The specificity of naval medical education had itself created this erosion of quality as students were forced to sea prematurely always distanced from the school, and subsequently from amphitheaters, museums, clinics, professors’ lessons, they forget anatomy, they do not perform operations, they loose the habit of attending the sick and even the taste for work; perhaps it could be otherwise? In the short time they have to spend on land at the return of a long and painful campaign study becomes a new fatigue for the mind which only rest can restore to normal.60

Most of the points made by Maher in 1862 reappeared the next year in his Les Médecins de la Marine. It countered more radical calls by Malespine to make the professoriate a temporary grade of limited term, close two port naval medical schools, and recast the system after the fashion of either army or civilian medicine. Chasseloup-Laubat summarized the situation for the emperor in October of 1862, and by January of 1863 Maher was lobbying deputies at the National Assembly and the maritime prefect of Brest had engaged in the fray.61 Les Médecins de la Marine held fast to the idea of naval medicine as a specific and discrete art but went some way with Malespine in agreeing that naval medical men should have the doctorate in hand before setting off to sea or colonial duty. For this he felt it necessary to maintain all three port schools and to keep the professoriate in permanent posts as in the civil faculties. But rather than dispersing entering students to all three schools, each year an entering class would go as a single cohort to a single school and spend three years there where each professor would teach his entire repertoire in three-year rotation. Maher also called for an assimilation of rank to that of the army but cautioned after the fashion of an 1848 committee of professors at Brest that any reform had to be adapted to the navy’s special needs.62 Maher was vocal and in many ways fighting for the life of his school in the place of his birth. If a school were to be cut it would likely have been Rochefort as its port had silted in and its student body was usu-

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ally the smallest of the three schools. The admiralty had considered closing the school at midcentury but the Rochefort City Council, Quoy, and others supported its continuation.63 The Rochefort school was notable in one way, for unlike the other schools it had access to a civil hospital where its students learned birthing procedures. Rochefort’s naval surgeons had won this right for their service during a 1745 epidemic, and while the city’s civil medical corps tried several times to retract this privilege, they did not succeed until after World War I.64 A second reorganization of naval medicine’s regulatory world occurred in 1866.65 Chasseloup-Laubat’s report to the Emperor had signaled the dangers of having moderately trained surgeons, who had passed only a handful of examinations, in charge of the health of a ship. He had also explained how the 1835 Ordinance had required a doctoral degree to become a professor or higher rank and how advancement by concours disadvantaged the navigans. The sixty-two articles of the 1866 Ordinance sanctioned much of what Leconte and others had been asking for since 1848 and replaced the old title of the corps, Service de santé, with the term Corps de santé de la marine. The reform also gave naval medical men their own publication, the Archives de médecine navale. The new organization combined surgeons and physicians into a single career track and placed pharmacists in another. It also established a Conseil de santé supérieur chaired by the inspector general and composed of two adjunct inspectors, one a physician and the other a pharmacist. Titles like doctors or surgeons of the third class disappeared and were replaced with physician aid, or pharmacist aid, and either a medical degree or a university pharmacy diploma became required for advancement to the title and grade of doctor. One site of tension, the concours system, remained in place, though examination scores and time in service now counted for equal weight in advancement and new students would be mostly free of voyaging until they had a doctorate in hand. The 1866 Ordinance expanded the number of professors at each school to ten and added five adjunct posts limited to three-year terms. Technically, after the decree of July 14, 1865, entered into force, holding the rank of professor for a term was not necessary to gain higher office. Yet advancement, even advancement by “choice” as it was termed if the candidate had failed to complete the necessary time in service or other requirements, was rare and required powerful sponsorship and an intellectual profile often measured through publications. Actual practices changed more slowly than regulations, however, and many navigans and observers of naval medicine still regarded the professoriate as a bastion of privilege. In this they were right as professors usually held their posts

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for fourteen or fifteen years and this de facto immovability of professorial chairs remained until 1886.66 The reforms of 1866 and subsequent amendments still left the navy with significant problems. In 1875 a third round of reforms centralized procedures by convening a single jury for examinations at all three port schools. Major problems linked to colonial expansion and navy careers still loomed. Enrollment at the three schools port schools grew from 102 in 1865 to 244 in 1873. But all too often once students obtained the doctorate or passed most of their exams they fled the navy for civilian practice. The places of duty were considered carefully by those who left service, and after 1875 the navy required colonial service.67 But whatever organizational formula the navy tried, naval healing was not an attractive career, and from 1864 to 1874, 462 vacancies occurred among a total of 521 posts and deaths while in colonial service accounted for 100 of those vacancies.68 The navy also experienced problems recruiting adjunct professors. The post offered a three-year leave from voyaging but unlike the situation in civilian faculties it was not a prelude to a professorship, and of course professors often stayed in place for years. Second, and more significantly, service in the colonies at the rank of physician in chief actually slowed advancement upon return to port duty in France. The reforms of 1835, 1866, and 1875 had altered aspects of naval medicine without addressing a profound problem, the fate of lower-ranking healers. The following section examines the career and tribulations of the voice of the navigans, naval medicine’s great reformer, and sets this narrative against the background of the ferment, confusion, and resentments unleashed by the century’s most substantial reform of naval medical education, the decree of June 24, 1886. This decree effectively dismantled a system of medical instruction which had existed for nearly two centuries and, in a sense, effaced the ports of Rochefort, Brest, and Toulon as the proper places of naval medical education. It also created an option, which, when embodied, brought naval medicine to Bordeaux. As in any duel, there would be winners and losers, and certainly professorial privileges were among the latter. Few of the Third Republic’s leaders, and certainly not the lofty incumbent of the Ministry of the Interior and his favorites, were prepared for what transpired. None of them could fathom the depth of resentment harbored by an enraged sea-wolf. With the passions and resolve of the Provençal race flowing in his veins, the yellow fever expert Laurent Bérenger-Féraud, a man of the colonies and waves, would bring naval medicine to Bordeaux and secure justice for his fellow navigans. The process dislodged naval medicine from its historical place.

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The Frustrated Voice of the Navigans: Laurent Jean-Baptiste Bérenger-Féraud Laurent Jean-Baptiste Bérenger-Féraud was the most accomplished navigan of the nineteenth century. As noted in chapter 3, he had been born in Provence and taken his first tour of service in West Africa in 1855. When forced into retirement in 1892 he had survived almost two decades of voyaging and colonial service.69 A man who never married, he was in many ways quintessentially cosmopolitan, not unlike Victor Segalen’s exote. The navy, colonies and the sun of Provence constituted his life and place. Born in a small village in the Var as the illegitimate son on an auxiliary surgeon, his family spent several years on the Algerian coast where the young boy learned Arabic and finished school prior to moving to Toulon. At the time of the 1866 reforms Bérenger-Féraud was living a life he could not have imagined. He had spent three years sailing the Mediterranean on a yacht owned by Napoléon III’s cousin, Prince Jérôme Napoléon, and had become the personal physician of the prince and his wife Clotilde, who introduced him to Europe’s royalty. It had not always been easy though. Beginning medical study in 1850 first as an extern at Toulon’s Hôtel-Dieu hospital, he was an intern the next year and an auxiliary naval surgeon of the third class by October of 1852. Losing his father in 1854 to fevers contracted in Africa, he gained promotion to the full naval track in 1855 and later served in the Crimean War. Writing under pressure and brilliant at all concours save for one, he gained his medical doctorate at Montpellier in 1860 and added another in surgery from Paris in 1864. At career’s end he would have more than a dozen books and some one hundred articles. In 1866 Bérenger-Féraud traveled to Rochefort for the concours for professor. There a committee of physicians found him in such a state of exhaustion and nervousness that they deemed it impossible for him to continue without injuring his health. In September of the same year he requested a second chance but it is unlikely he made a second attempt and certain he never became a professor.70 This traumatic setback to an otherwise stellar career fueled smoldering resentments toward the professoriate. Two subsequent decades of voyaging and colonial postings only annealed his resolve to pursue his task “against those who want to be physicians on the safety of land.”71 Fate, in the form of new regulations buried in the reform of 1866, smiled on the young man from the Var, as the new regime made a term in the professoriate unnecessary to win higher rank. Fortunately Bérenger-Féraud had a number of highly placed sponsors, including Prince Jérôme Napoléon, who wrote the minister of the navy to lobby for

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his advancement to principal physician and he advanced over thirty privileged professors then at lower rank.72 Although it did not then seem Bérenger-Féraud even needed a term as a professor, he ruminated over his failure and considered leaving the navy as had Fonssagrives and so many others. Like the latter, Bérenger-Féraud too had supporters at the Montpellier Faculty of Medicine. In 1872 ÉtienneFrédéric Bouisson, the school’s dean and a deputy from the Hérault, lobbied the minister of the navy to promote Bérenger-Féraud to a post in Senegal. In 1875 physician inspector general Jules Roux, who was about to retire, approved Bérenger-Féraud’s plan to stand for the chair of surgery at Montpellier. Bérenger-Féraud, felt Roux, merited this in virtue of his “aptitude and scientific works . . . and appears to have all the qualifications of the situation he seeks at the Faculty of Montpellier.”73 Roux’s successor Jules Rochard, who had supported Fonssagrives in the dry colic dispute, was markedly less sympathetic to the old sea wolf and found his writings on the hygienic situation in Senegal alarmist and out of date. Rochard thwarted Bérenger-Féraud’s career until the weight of regulations forced him to retreat. Ten years after his failure at Rochefort Bérenger-Féraud still pined wistfully for a life that was not to be. “I have some chance of being named,” he wrote, at least if I believe the assessments of some professors of this faculty and some highly placed functionaries in the [Ministry] of public Instruction. A chair is the most desired object of a physician who loves work and science, and since I can no longer hope to obtain one in the schools of naval medicine, I have as my aim professorial positions at the faculty of Montpellier.74

It is unlikely Bérenger-Féraud took examinations for the civil professoriate. The sedentary life was not to his liking and soon he was steaming toward India. Bérenger-Féraud’s nerve, talent, and merit continued to win powerful patrons. Posted to Metz in July of 1870 to direct a reserve ambulance service for Marshal Mac-Mahon, he saw action at the battles of Mouzon and Baseilles. An exploding shell at Sedan caused contusions and evacuation to Paris where he then worked as a resident surgeon at the army’s Val-deGrâce hospital during the siege of Paris. Ever the workhorse, he slipped out of Paris before the end of hostilities to become chief of the health service of Gorée, the island enclave off West Africa serving as France’s beach head in the region. Important postings followed as head of the health service of Senegal from 1872 to 1873 and a brief term in India in 1875 followed

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by two years as physician in chief of Martinique from 1875 to 1877. He returned to his beloved Toulon as physician in chief at the naval hospital of Saint-Mandrier and finally gained the directorship of the health service at Lorient in January of 1884, just in time to combat a typhoid fever epidemic. He would be posted at Cherbourg in 1885 at the same rank before arriving back at Toulon in July of 1886.75 No one could discount Bérenger-Féraud’s intellectual productivity and, perhaps to compensate for his failure at Rochefort, he published more than most port school professors. In addition to the yellow fever studies and investigations of racial medicine examined in chapter 3, he wrote on hygiene, legal medicine, therapeutics, and history. Elected corresponding member of the Société de chirurgie and Société médicale d’observation in 1872, the Académie de médecine accorded a similar title in 1875. The army physician Baron Hippolyte Larrey who presented Bérenger-Féraud’s works to the Académie de médecine and the inspector of the army health service, Michel Lévy, were among his sponsors.76 He also collected several medals and prizes for his diverse publications, including two from the Académie de médecine, one for a study of bone fractures and another for an 1874 book on epidemic yellow fever in Senegal.77 The posting to Toulon, though, placed him on a collision course with the professors of the school and his superiors. Years of service in the tropics were taking their toll on Bérenger-Féraud’s health. A medical examination of 1873 in Port de Saint-Louis diagnosed him as having “chronic hepatitis” and recommended repatriation to France, while others detected “intertropical anemia with congestion of the liver, conditions endemic to Martinique,” or signaled “endemic liver congestion contracted in tropical climates.”78 Bérenger-Féraud knew Toulon well and returned there in March of 1878 and moved into the physician in chief’s apartment at the Saint-Mandrier hospital.79 The aging island hospital had been rebuilt by laborers from Toulon’s bagne in 1819 and after 1849 a steam-powered shuttle linked it to town.80 Bérenger-Féraud knew well its halls as he had frequented them as a lowly student and would write affectionately of its history.81 The sea wolf had come home to Toulon, or so it seemed, finishing off ethnographical and folkloric studies of West African peoples and writing similar studies of the Provençal race.82 His work on the Provençal race examined its physical and intellectual characteristics in relation to place and expressed concern with a general decline in the French population. The region of Provence, he concluded, was a net “consumer of population . . . [which] imprints on men who live on its soil special physical and intellectual attributes.”83 The women of Provence, from Celto-

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Lycurgian times onward, had always looked favorably on men from outside the region. But those “Celts, Gauls, Iberians, Sarrasins, and Germanic peoples” who fell to their charms were so altered by the place that their children “resembled more their compatriots than their own ascendants.”84 In 1879 Bérenger-Féraud wrote a series of letters to inspector general Jules Rochard requesting membership in Toulon’s Conseil de santé. He also wanted living arrangements in Toulon as the council met twice per week and was far from Saint-Mandrier. But Toulon was a different place than his previous postings at the same rank in Cherbourg and Lorient; Toulon had a medical school and its Conseil de santé was the professor’s enclave and usually governed by the school’s director. Rochard did not answer the first letter but warned the naval hierarchy of several problems—there would be inevitable conflicts and numerous difficulties, and these would be compounded should Bérenger-Féraud become the highest-ranking medical officer in the port and the interim director of the school. He would then be a member of the jury examining students and preside over concours for advancement and the professoriate. Rochard found this intolerable and added, We cannot allow these special functions to be allotted to a physician in chief foreign to the Schools. This interference would be particularly offensive in Toulon where M. Bérenger-Féraud would have under his orders a Physician in Chief who was part of the Jury when [he] took the concours for [Physician of] the first class, and a Professor who was victorious over him when he took the concours for the Professoriate.85

Rochard recognized this possibility was legislated by the reform of 1866, but he had no advice on how to avoid the inevitable. Bérenger-Féraud seethed at Rochard’s treatment and went over his head to the minister of the navy complaining that his first letter to Rochard had not been answered and that it was neither natural nor equitable that the physician in chief of the port with the most seniority, he who has the most important duties under the lofty influence of the Director of the Health Service, and in consequence he among them who is most authorized to formulate an opinion on questions . . . is excluded from the Conseil de Santé.86

Additional confrontation was avoided for a few years by Bérenger-Féraud’s subsequent postings with the Tunisian campaign of 1880 and 1881 and

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tours of duty in Cherbourg and Lorient. But by July of 1886 he was back in Toulon as director of the port’s health service and director of the school of medicine. Bérenger-Féraud’s resentment toward the professoriate constituted only one ember of change; many others smoldered. Civil practitioners working through a variety of parliamentary means pressed for reform and especially for the necessity of the doctorate to practice medicine. A general aim was to recast naval medicine along the lines of army medicine after the fashion of its former school at Strasbourg.87 The problem, some charged, was that naval “‘physicians’ practice medicine illegally by special authorization of the Minister of the Navy.”88 Port school professors countered with their own weaker reform plans and suggested increasing the number of positions for navigans.89 But tensions had escalated to a point where only substantial change would do. Naval medical education was again under fire by a host of pamphleteers and critics, and the navy itself was locked in a struggle with the army over the control of colonial troops. In 1882 the newspaper Virgie de Cherbourg published letters critical of naval medical education which were collected and reissued as a booklet.90 One of the letters was signed with the initials “A.C.” who claimed to be a former professor at the port schools.91 The letters attacked outright the privileges of the professoriate, questioned their silence on the many problems of the health service, and drew long quotations from parliamentary debates over the suppression or reorganization of the schools. A correspondent in the Toulon paper, the Petit Var, repeated similar complaints and noted how the director of a naval medical school ought to be one of the professors, and charged a “lazy, incapable [and] ignorant” professoriate with canceling classes due to a lack of students.92 After airing the serial and seemingly just grievances of the navigans against the professoriate, the booklet concluded with four recommendations, and the major ones struck at the idea of naval medicine’s specificity and discreteness. The author or authors called for a separation of navigans and professoriate and the creation of two separate corps. They championed limiting the term of the professoriate and requiring voyaging or colonial duty for their advancement. Called for too was reorganization of the system after the fashion of England where civil faculties trained naval physicians. A fourth recommendation counseled making naval medicine a branch of army medicine by sending postdoctoral students to the army’s school of application at Val-de-Grâce where they would only take two additional courses, one in naval hygiene and another in exotic pathology.93 Like Charles-Adolphe Maher and others before him, Rochard too re-

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sponded with his own reform plan.94 In 1884, after years of criticism, much of it now in the public sphere, naval medicine was on the verge of another major reform. Rochard, like Bérenger-Féraud who was now his logical replacement as inspector general at the summit of naval medicine once he retired, ruminated on the state of things in a lengthy report to the minister of the navy in October 1884. With the navy responsible for colonial health services as well as its own needs, he had major staffing problems, and yet with nearly a decade of experience in leading naval medicine Rochard knew the budget would not sustain additional personnel. After thanking the minister for his indulgence in the last two concours when all candidates had been advanced regardless of their scores or merit, he cautioned that if the colonies were separated from the navy, the navy would have far too many physicians. He dreamed of a balanced equivalence between naval and colonial service and regulations facilitating the recruitment of civil physicians seeking naval and colonial careers.95 Rochard championed retention of the port schools and conservation of alterity by a weak alignment rather than integration with civilian medicine. By his estimation civil medicine was another world; naval medicine had only nine professors of medicine, pharmacy, and surgery in each school, whereas civilian faculties had three or four times that number. Manifold problems existed, however, and the navy’s dysfunctional system had “literally crushed” the lower ranks, meaning the navigans dear to BérengerFéraud’s heart. 96 The navy was not even granting students a six-month leave to study for final doctoral examinations and complete the thesis, a procedure stipulated in the reforms of June 9, 1875. Rochard closed the 1884 report by suggesting that the navy alter the curriculum so students received the doctoral degree prior to advancement to physicians of the second class. He also counseled making it easier for civilian physicians to enter naval service by requiring only a year of satisfactory service as an auxiliary before automatic advancement to the rank of second-class physician without a supplemental concours. There would still be a concours for advancement to the rank of first class, but the exam would be rendered “exclusively practical and special, in grounding it on the clinic, operations, naval hygiene and exotic pathology.”97 Nowhere did Rochard address the permanence of the professoriate or tackle the substantial problems of obtaining a doctorate at Brest, Rochefort, or Toulon. In 1885 a commission of Rochefort’s professors contemplated change but pleaded for retaining the concours. In their opinion the suppression of the port schools would be a “veritable disaster for the corps of naval physicians and for the well-being of the service.”98 Navy ministers

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had heard similar arguments for many years, as in 1877 and 1878 when Rochard had fought to save the Rochefort school and written of the inability of civilian faculties to train naval physicians. They were incapable, he wrote, despite the brilliant merit of their Professors, of giving their Students the entirely special instruction required of naval medicine. Four years of the free and independent life of the Student renders him mostly unfit for the harsh life of a sailor and poorly disposed for military discipline. The Faculties are liberal institutions which dispense a kindly sort of instruction they do not impose. They exercise over their Students neither pressure nor oversight and have no power over them.99

These and similar arguments, sounded time and time again, maintained the privilege of the professoriate, kept at bay substantial reform, and failed to improve conditions for the navigans. Arguments for the discrete and distinctive nature of naval medicine applied as well to the men who sought naval careers. The Rochefort commission feared the direct recruitment of civilian doctors would only attract physicians who would leave service after the first campaign. The naval healing art, they claimed, required special men and was different from what was taught in army and civil settings. The moral conditions which may suffice for service in the army are not equal to those which must be shown by those who are destined to a career which of necessity casts them into an environment of incessantly renewed dangers. It is to be feared that physicians of 27 and 28 years of age entering a highly specialized service for which they are in no way prepared would almost immediately abandon such a difficult profession. Moreover and without a doubt, it would most certainly not be the elite [graduates] of the faculties who would respond to a call from the navy . . . the commission is completely convinced that following this sort of recruitment the scientific level of the naval medical corps would fall in short order.100

Naval medicine was a conservative institution with a proud heritage, and if substantial reform came it would need to be imposed from above. The need to resolve the many problems of naval medical education pressed on the admiralty and resulted in sweeping reforms, many of them not to Rochard’s liking. This new wave of change struck with the decree of June 24, 1886, during the ministry of Admiral Hyacinthe Aube. The

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professoriate now became a temporary grade rather than a rank, and the formerly separate tracks of advancement for navigans and the professoriate now fused into a single career path. The decree also removed the concours as an instrument of advancement and replaced it with a formula weighing seniority and the judgment of superior officers while requiring students to purse a four-year course of study in a civilian faculty. The 1886 reform also reduced to six months the term of the voyage required after two years of study.101 With luck and good health a naval medical student might now complete his degree in about five years. While in some corners of France few cared about such regulations, in Toulon this was front-page news in the local newspaper.102 If Bérenger-Féraud was cheered by many of these actions, he was also supremely frustrated by a cruel turn of fate—abolition of naval medicine’s highest-ranking position, that of inspector general. Rochard retired from naval service and his son Eugène, also a naval physician, resigned in protest.103 Under the old regime Bérenger-Féraud could not have replaced Rochard because the inspector general was only recruited from among the professoriate. But with the reform of 1886 and the fusion of the professoriate and navigans lines of advancement, he would have been eligible for advancement to the pinnacle of naval medicine. But the post was snatched from his grasp. Adding to his frustrations were local disputes with Jules Fontan, a socialist surgeon in Toulon who quickly adopted aseptic surgery. Fontan was a brilliant surgeon whom Bérenger-Féraud thought took too many risks.104 Bérenger-Féraud never achieved the rank of inspector general, and to add insult to injury the navy reestablished it after his retirement in 1892. He did, however, continue to advocate for reform on behalf of the navigans and would be named president of the Conseil supérieur de santé de la marine. In 1887 on the occasion of his candidature for corresponding membership in the Institut he produced a long poem dealing with the navy’s seemingly unjust treatment of him and his fellow navigans, wrote of the professoriate as an aristocracy, and identified himself proudly as “chief of the party of physicians called navigans against that of the professors.”105 Perhaps lyricism was the only way to confront his frustration? By the late 1880s serial budgetary and administrative crises beset the navy. With the empire now requiring more and more men, parliamentary bodies soon elaborated no less than thirty different laws and projects concerning colonial troops.106 In 1888 the army reestablished its own school of medicine next to the medical faculty at Lyon and for a time it looked as though the navy might move their programs there, possibly under army control. Incorporation into army medicine remained a persistent and re-

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peated threat, but it would be accomplished only late in the next century. Significantly, a decree of January 7, 1890, formed a new colonial health service and this itself was but a prelude to greater changes wrought by a newly independent Ministry of Colonies in 1894 and a final indignity of transferring control of colonial troops from the navy to the army in July of 1900.107 In terms of naval medicine, on April 10, 1890, the minister of the navy Édouard Barbey, a senator from Tarn and the mayor of Bordeaux, appointed Bérenger-Féraud to survey locations for a new centralized naval medical school. Politicians and citizens in Bordeaux, Marseille, Montpellier, Lyon, and elsewhere knew of the pending move, and representatives from Marseille fought unsuccessfully to change legislation so the new school might be located in their city which lacked a medical faculty.108 The very day Barbey charged Bérenger-Féraud with the mission, a Bordelais living in Marseille wrote the mayor of Bordeaux with arguments to use against Marseille’s candidacy.109 In May Bérenger-Féraud visited Lyon, Marseille, Montpellier, and Bordeaux, and on June 13, 1890, the admiralty voted unanimously in favor of Bordeaux. A decree of July 22, 1890, gave definitive form to the Bordeaux school and simultaneously restricted the three port schools to teaching only firstyear medical studies.110 These three annex schools as they were now termed offered instruction in anatomy, physiology, and basic semiotics, and until 1922 would be the only schools preparing students for the concours to enter higher studies at Bordeaux.111 In November of 1890 Bordeaux hosted a banquet at city hall to inaugurate the new École du service de santé de la marine. One hundred invitations had gone out to the new school’s staff, city council members, firemen, the medical faculty, and a half dozen newspaper publishers. Speeches followed bottles of the region’s finest wines and dinner catered by M. Berrieux of the Café de la Comédie. Vice admiral Ribell of Rochefort, the headquarters of the fourth naval district which included Bordeaux, presided.112 The establishment of the navy’s central medical school at Bordeaux and the achievement of near parity between navigans and professoriate highlighted Bérenger-Féraud’s career. In Bordeaux Albert Pitres, the dean of the faculty of medicine, had lionized Bérenger-Féraud for bringing his city the central school of naval medicine, and the mayor, M. Baysselance, had told a small fib about how Bordeaux had always been a city concerned mainly with overseas activities and had always inclined more toward maritime activities than to those of the army.113 Yet less than a year later things had gone bad, incredibly bad. Bérenger-Féraud’s world and prospects for advancement changed forever on July 23, 1891.

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Georges Treille, Exploding Books, and the Freeing of the Slaves France, like many Western countries of the late nineteenth century, was beset by anarchist activity, syndicalism, and violence. Only a few years after General Georges Boulanger ended his own life in exile in 1891, an assassin in Lyon took the life of the president of the republic, Sadi Carnot. Bombs, many sent in hollowed out books, constituted a preferred method of violence. On October 1, 1889, Bérenger-Féraud became president of the Conseil supérieur de santé de la marine and soon proposed his younger colleague, the physician in chief Georges Treille, as an officer in the Legion of Honor.114 Treille, born in Poitiers in 1847, was an audacious and impatient man. After completing his bachelors degree in 1866 he set out on an excursion from Algeria to Senegal in a failed attempt to win a prize from the Société de géographie. A studio photograph from 1867 shows him posing in nomadic garb and he would later try to claim the adventure as part of his military qualifications and affect expertise in Arabic.115 Treille entered the naval medical system in 1869 and completed his doctorate at Paris in 1872 with a thesis on fractures of the sacrum.116 Although he voyaged to Australia, Martinique, India, China, and Cochin China, he tried several times to secure colonial and port duty and passed the concours for the professoriate in 1881 and became a professor at Brest the following year. By 1886 he had moved to Paris to replace the retired Alfred Le Roy de Méricourt as editor of the Archives de médecine navale and for this reason obtained a seat on the Conseil supérieur de santé de la marine. Treille also represented the navy in Vienna at the sixth international congress of hygiene and demography and spoke on European acclimatization in the colonies. His racial ideas of colonized peoples were pessimistic and inclined toward those of Armand Corre examined in chapter 3. Yet Treille championed the colonial project and regarded cholera and yellow fever as localized afflictions and therefore not impossible obstacles to colonization. Above all he sought rational hygienic guidelines for Europeans in the tropics. Europeans, he argued, should never do agricultural work there, but should “only provide capital and oversee labor.—The kindly initiator of the Natives, pioneer of civilization, he can only be an organizer and director of colonial labor.”117 Like many of his colleagues who had experienced the power of place on colonial duty, he too considered that diseases, with the possible exception of yellow fever, presented themselves in differing forms and were often linked to unclean places. I believe in “climatic illnesses,” he wrote in 1888, “I believe in their transformations, in their aggravation. I adopt, in

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this regard, the etiological ideas which numerous French naval physicians have already put forward for some time.”118 Somewhat later in 1902, after leaving the navy, he still promoted a natural historical approach to tropical diseases and stressed the necessity of training colonial physicians in medical geography. Not only did the colonies have their own specific afflictions, the diseases Europeans normally encountered at home adopted extreme forms and varying clinical signs under the tropical sun.119 Less original than synthetic in his thinking, Treille leveraged any and all opportunities to accelerate his career. Navy headquarters in Paris on the rue Royale favored encounters with powerful patrons, and Treille cultivated ties with Eugène Étienne, the future leader in what would be termed the Parti colonial français. Étienne had entered the National Assembly as a deputy from Algeria’s Oran department in 1881 and would serve in a variety of government positions until 1919. A supporter of Jules Ferry’s expansionist politics he accomplished terms as the undersecretary of colonies in 1887, and again from 1889 to 1892. In 1894 he and others succeeded in separating the colonies from the navy and established them as an independent ministry. In January of 1890, less then two weeks after the founding of the colonial health service, Treille asked to leave the navy and join the new service. By February 1891 at forty-four years of age he was now physician inspector of the first class at the same equivalent rank as his former navy superior, Bérenger-Féraud. Many other navy veterans, including the Creole physician Albert Clarac, also opted for the new service and were rewarded with increased salaries and accelerations in rank. Within this context three octavo-sized medical texts posted from Toulon arrived in Paris on July 23, 1891. The resentments of Toulonnais naval physicians toward the new colonial medical corps formed by the decree of January 7, 1890, were well-known. A pamphlet printed in Toulon that year and circulated to members of the National Assembly, Senate, and Council of State complained of extreme prejudice toward naval medicine and accused the decree and those behind it of wrecking the careers of naval physicians.120 The books arrived at the residences of Treille, the minister of the Interior Ernest Constans, and the under-secretary of the colonies Eugène Étienne.121 Treille, who had once suffered from dysentery contracted in Cochin China, received a volume on ailments of the stomach, and Étienne, born in Algeria, received a volume containing a study on syphilis in Algiers.122 All three books were hollowed out and equipped with bombs, two made of sardine cans and one constructed from a tin of English biscuits.

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The bombs themselves each contained about two hundred grams of fulminate of mercury, some two dozen six millimeter cartridges, percussion caps, and filter paper to slow and enhance the explosive reaction. When the post arrived Constans and Étienne were at a meeting of the Council of Ministers. Madame Constans attempted to open the package and discerned it was a book but stopped upon realizing the pages were glued shut. Treille, who had received threatening letters in August and November from a person claiming to be a retired naval physician became suspicious of the package and after cursory examination wrote up a complaint and took it to the local police station. Treille informed Étienne of the incident later that day and Étienne returned home to find a book posted from Toulon among his mail at which time he had his servant take it to the police station. The book addressed to Étienne contained a note implying that this time the bomb was not set to go off and that the sender had “simply wanted to show you I am master of your life the next time I will strike you without pity and I know all the world will applaud.”123 Yet analysis of the packages by an explosives engineer at the police laboratory found all three bombs operational, charged with “practically enormous quantities of fulminate of mercury,” and judged them sophisticated products of a “man habituated to varied laboratory manipulations.”124 One could imagine a naval surgeon, or possibly a naval pharmacist, producing such devices. Police investigator Goron arrived in Toulon on July 25th and began questioning bookstore owners, postal employees, interviewing naval physicians, and generally searching for clues. The police followed up leads in other ports as well but none led to anything substantial. What is clear is that the Parisians had a low opinion of Provincial authorities. One report counseled avoiding the local police entirely as they were “venal or maladroit, and always gossipy” and sending a discrete agent to the Café de la Renaissance in Nice to gather clues.125 There, it was said, was a special room able to hold some 200 people, where all the vile of the Mediterranean coast congregate who carry out all sorts of jobs for a few louis. Found there are ‘Bedouins,’ pickpockets, pimps, adventurers, suspicious foreigners, solicitors, burglars, ex-convicts, refugees of all nations, etc. . . . This room, strange to visit, has as a bartender a good and intelligent girl named Darlay, whose age has soured her comely nature. She knows all the tricks of concealment, the perpetrators of most of the ‘done-deeds’: if she does not know, she has the resources to find out.126

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Yet the culprits escaped even Mademoiselle Darlay, and Bérenger-Féraud was placed under surveillance on August 10th as police speculated the perpetrator may have been a former naval officer from a reactionary family.127 The attack on the three men was taken seriously by the police and by M. Atthalin, Judge d’Instruction du Tribunal de première instance du département de la Seine who took a deposition from Bérenger-Féraud. The socialist press, however, used the incident as another opportunity to attack the opportunist Republican minister Constans, bring up questions of corruption regarding his term as governor general of Indochina in the late 1880s, and at least two journalists accused Constans of organizing the affair.128 Bérenger-Féraud used the deposition as an opportunity to recount to Atthalin the wrongs visited on naval physicians by the formation of the new colonial medical corps and apparently gave a lengthy interview to the newspaper Le XIXe siècle. Le Temps published an article on the affair sympathetic to the cause of the navigans and pointed out how the new colonial medical corps circumvented the rights of seniority accorded to naval physicians by the regulations of 1886.129 Other papers picked up remarks credited to Bérenger-Féraud, and L’éclair reported how after speaking of the heroic but difficult lives of the navigans, whom he likened to slaves, he remarked how many years ago he had “resolved to free the slaves.”130 Maintaining his innocence but striking a combative pose he added, “The slanderers, my enemies, are but another epidemic for me, far less dangerous to fight than the others.”131 The Le Temps article incensed Étienne who felt Bérenger-Féraud had avoided answering Judge Atthalin’s questions. He fired off a letter to Barbey, the minister of the navy, and demanded a public apology and retraction. Other accusations would follow, with disputes breaking out in the Council of Ministers and Bérenger-Féraud complaining that Treille had accused him of personal responsibility for the bombs. Barbey protected Bérenger-Féraud until he was forced from his position by a new government in February 1892. Étienne remained with the new government in charge of colonies, however, and a presidential decision of August 10, 1892, forced Bérenger-Féraud to retire early. The old sea wolf returned to Toulon and an esteemed place in the Académie du Var where he wrote lovingly of Provence. Shortly thereafter, a law of March 20, 1894, severed the colonies from the navy and gave them autonomy as their own ministry. Some three years later, Georges Treille, not yet fifty years of age, retired as Inspecteur-général du Service de santé des colonies and moved to Vichy.132 He would later move to Marseille, author studies of colonial hygiene, and,

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as noted in the following chapter, become a professor at that city’s school of medicine.133 Moving to Nice after retiring from civil practice, it is not known if he visited Mademoiselle Darlay or dined at the Café de la Renaissance. By 1892 Bérenger-Féraud’s travels and fighting days were over. But in Bordeaux at the new École du service de santé de la marine, in many ways Bérenger-Féraud’s legacy, the old sea wolf’s former colleagues struggled to organize and conserve that legacy.

Global Medicine: Alexandre Le Dantec and the Birth of Colonial Medicine in Bordeaux Naval medicine’s place in Bordeaux was negotiated within the context of a recently organized medical faculty functioning since 1878. Additionally, the regulatory regime of French medicine was itself in ferment, with the civilian designation of health officer, which some former naval healers qualified for, being suppressed in 1892. A subsequent decree of July 31, 1893, instituted the “P.C.N.” or Certificat d’études physiques, chimiques et naturelles. The P.C.N., a year-long course of instruction in the nonmedical sciences, would be the focus of much dispute but was ultimately modified and adopted as the gatekeeper to medical studies in 1907. In Bordeaux, Henri Gintrac, director of the municipal medical school from 1871 to 1878, was designated as dean of the new faculty but was too ill to attend the opening and would die within a week of its founding. In 1888 the president of the republic, Sadi Carnot, inaugurated Bordeaux’s new faculty. At that time about three of every four French medical students in a Faculty still studied in Paris, and Bordeaux awarded about one hundred medical degrees per year and an equal number of diplomas in the related activities of pharmacy and midwifery.134 Albert Pitres, charged with teaching histology at the new Faculty, was dean during two crucial periods for naval medicine, from 1885 to 1897 when the naval school was organized, and again from 1904 to 1913 when the navy and city council fought against suppression of the school or its transfer to Lyon. Leading the new Faculty between Pitres’s two terms was the naturalist and professor of materia medica, Barthélemy Marie Napoléon de Nabias, who had received his doctorate from Bordeaux with a thesis on a seventeenth-century physician-botanist.135 Pitres and de Nabias supported the teaching and study of colonial medicine. When city fathers had asked for a new medical faculty in 1872 they had pointed to Bordeaux’s colonial connections and promoted the scientific value of the study of exotic pathology. Yet when the faculty opened in

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1878 its courses accorded no place to colonial or maritime subjects.136 As discussed previously in this chapter Bordeaux’s commercial and academic interests had desired a colonial museum for some time. The naval physician Alexandre Le Dantec, who arrived in Bordeaux in 1891 as the new naval school was being organized, provided impetus for founding a similar sort of museum. In 1894, the year before he passed the concours for the agrégation at the Bordeaux Faculty in internal pathology and legal medicine, Le Dantec lobbied the Faculty to create a Musée de pathologie exotique et d’études coloniales. A similar institution had been planned as early as 1888, and had been intended to focus on medical geography and exotic pathology and be annexed to the chair of Hygiene’s Institute of Hygiene.137 But Le Dantec succeeded and his new institution grew quickly. The first class of naval medical students graduated in 1895. They remembered fondly their time in Bordeaux and swelled the museum’s collections with gifts. The museum soon expanded beyond its initial focus on pathology and physical anthropology. In 1900 the Ministry of Public Instruction entrusted eighty cases of materials to the museum, and it followed up with three additional significant loans of Asian, African, Oceanic, and Latin American materials.138 The museum altered its name to reflect these resources, first to the Musée ethnographique et colonial and then to the Musée d’ethnographie et d’études coloniales. Le Dantec would serve as the foundational director and Paul-Louis Lemaire, secretary of the medical faculty, served as a curator until his retirement in 1914.139 With the coming of the war the museum’s finest hours had passed and its history in the interwar period was one of neglect and loss of exhibition space to government agencies. When Alexandre Le Dantec arrived in Bordeaux he was one of four lowly répétiteurs at the navy medical school. The better-funded army school in Lyon had six such posts and at both schools incumbents served five-year terms.140 Le Dantec assisted naval medical students with the courses they took at the Faculty and enforced naval discipline with a regime of interrogations, study drills, and quizzes. These quizzes were important for ranking naval students at graduation where the scores might confer the right of choice to opt for either a naval or colonial career. But unless a student consistently failed these internal naval school examinations he was allowed to remain in the program and his scores did not impact his studies at the Faculty.141 Le Dantec, on the strength of his merit and experience, achieved a unique position within the history of French medicine. Having begun teaching a course in exotic pathology for the Faculty in 1902, he was the first to be named professor of exotic pathology in any French medical faculty. Supporting his activities was an inventive funding scheme unique in

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all of France. The navy, the Ministry of Public Instruction, and the city’s Colonial Institute all paid portions of his salary.142 Born in 1857 in Brittany in Ploujean, a small town northeast of Brest, Le Dantec passed his baccalaureate in Rennes in 1876 and entered the naval medical school at Brest in 1877. Navigan of the first order, in 1880 he began a three-year tour of Cochin China. Returning to Brest in 1883 he finished at the head of his class in the concours for physician of the second class. Immediately posted to Guiana for two years, he contracted yellow fever and saw three of his medical brethren die of if before joining the Tonkin expedition of 1886. He also ferried Indian workers from Guiana back to India on a sail-powered ship where he diagnosed cases of scurvy. Lingering in India for a time he worked at a hospital in Bangalore and as physician to the Rajah of Mysore.143 His Paris medical thesis of 1886 was on yellow fever and was completed under the professor of pathological anatomy, Victor Cornil, at a time when Alexandre Yersin was also working in Cornil’s service at the Hôtel-Dieu. Unlike many medical theses of the day, Le Dantec’s was an important piece of research. Based on the microscopic examination of tissue specimens from fifty autopsies performed during the yellow fever epidemic in Guiana, it confirmed his status as a medical microbiologist of the first order.144 It also piqued the interest of a young Dr. Albert Calmette who in turn mentioned it to his mentor at the Brest school, Armand Corre. Among other findings, Le Dantec showed that the signature black vomit of yellow fever consisted of blood and gastric juices and was not, as some American authors had claimed, a secretion of a yellow fever microbe. Le Dantec also challenged Corre’s ideas on racial immunity insisting that both the black and white races were subject to the same laws of receptivity. Corre had also speculated that outbreaks of yellow fever might be caused by a “living agent” that mired into coastal soils and altered them to form infectious products sparking disease. Le Dantec took issue with this view and thought yellow fever was an invasive and contagious disease, a “microparasitological” illness which ended only after a weakening of the invasive organism’s virulence “because of the manner in which epidemics end by attenuation of the virus (Pasteur).”145 Le Dantec was among the first naval physicians to employ the microscope to study tropical diseases and took a microscope on an 1886 voyage to South Africa. Improving his skills in bacteriology courses taught by the Pasteurians Émile Roux and André Chantemesse, he returned to Paris in 1889 to study ophthalmology and neurology under the great neurologist Jean-Marie Charcot. Over the course of a long career he would travel to London and interact with Patrick Manson, and

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publish on leprosy, elephantiasis, dysentery, malaria, Mediterranean fever, smallpox, and poisoned arrows. He also directed or inspired many theses in medical microbiology. Le Dantec’s successor in Bordeaux, the malariaologist Henri Bonnin, remembered him as stocky, bespectacled, and excessively timid, a man who was “tenaciously obstinate in pursuit of a goal” who feared the world and loved the solitude of laboratory, and, “above all [,] owed these qualities to his [Breton] race.”146 Bonnin also explained Le Dantec’s extreme skepticism toward Hideyo Noguchi’s identification of the Leptospiria icteroides “germ” of yellow fever as a result of his “Pasteurian training and his Breton origin.”147 At Bordeaux Le Dantec frequented Faculty laboratories and investigated taking the agrégation. The navy, however, told him to abandon the project but offered him a break in service if he wished to sit for the examination. Eventually an accord was reached where Le Dantec was allowed to keep his rank in the navy until his next promotion and thus enhance his navy retirement pay. Resigning from the navy in 1903 after a full professorship at the Faculty was in hand, he reminded the ministers of public instruction and navy that he was “the only physician of the Navy to win the Concours d’agrégation in medicine and all the more obtain the professorship while in service.”148 Various ministers squabbled over the years about his salary and how it might be funded. But the navy recognized a good deal when they saw it and continued to pay part of his salary until his retirement in 1928. In 1903, a year after appointment as a full professor, Le Dantec qualified for a hospital post. The university changed his title to chair of Colonial Medicine and Clinic of Exotic Illnesses and he soon ran a clinic first at the Hôpital Tondu, and later at the Hôpital Saint-Anne. Le Dantec advocated a “global medicine” and used that terminology in an article published the same year.149 He opened his course at the Faculty with the prediction that one day French faculties of medicine would teach tropical and exotic pathology alongside the general pathology of temperate-zone medicine. It was improper, he felt, that comparative pathology counted for so little and the diseases of South Asians and Africans were only studied in relation to the diseases of Europeans. “It may be said,” he continued, “that human pathology is reduced to the pathology of the white man in Europe.”150 Le Dantec saw the Bordeaux school as addressing this dangerous circumstance and imagined producing sixty graduates each year competent in global medicine, with fifteen each going into naval medicine, maritime medicine, colonial medicine, and colonial army medicine. Cognizant of the politi-

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cal dimensions of colonial medical practice, he counseled against awarding medical degrees to colonized peoples unless they took their training at a French metropolitan faculty. To do so “would be the ruination of the moral authority the white must always keep over the native.”151 Le Dantec, like Georges Treille, hoped that general pathology could be enriched and improved by incorporation of exotic pathology’s methods and observations.152 But in many ways colonial and naval medicine remained discrete from civilian medicine. Le Dantec’s Bordeaux courses were complementary ones—that is, they were not required for the general medical degree. The incorporation of exotic pathology into the general medical curriculum had not happened by the time of his retirement in 1928, but colonial medicine had become a postgraduate specialty and the university had organized a special diploma track for colonial physicians, later renaming it a university diploma in tropical medicine. Eventually all naval students were required to complete this diploma.153 By Le Dantec’s retirement 373 naval students had qualified for the colonial diploma at the Bordeaux faculty which had also created courses to prepare students for the examination for a certificate in maritime hygiene.154 While this was not quite global medicine, it was certainly a step in that direction. Naval authorities welcomed these developments but clung to the idea of the discrete nature of the naval medical art. They wanted their students identified as doing naval medicine rather than colonial, army, or tropical medicine. In the wake of Bérenger-Féraud’s retirement the navy reinstituted the post of inspector general of medicine in 1896 and appointed Professor Bernard Cuéno of Toulon to the position. In 1901 Cuéno inspected the Bordeaux school and wrote the minister of the navy with exciting news. The city of Bordeaux had resolved to found a Colonial Institute and the dean of the Medical Faculty would organize medical studies. Plans included a postgraduate diploma in colonial medicine requiring three months of study. The agrégé professor Alexandre Le Dantec was to lead the initiative but would be supported by other faculty members, and Cuéno enumerated the resources in bacteriology and parasitology already at Bordeaux and mentioned preparations for a Musée d’ethnographie et d’étude coloniale. Cuéno thought this ideal and stressed the desirability of having naval students take the diploma prior to going to the postgraduate naval school of application in Toulon. Inspiration for Bordeaux’s diploma had come from schools founded in London, Liverpool, and Hamburg. He had also heard that the Paris Faculty had plans for a similar postgraduate program but found this troubling as whatever Paris came up with he was sure

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it would focus on research rather than on the practice of naval and colonial medicine. For Cuéno, the proper place for instruction in colonial medicine was in the provinces. Was it not, he asked more logical to allow Colonial Institutes to be created in cities like Bordeaux or Marseille, where at least one can find numerous patients suffering from exotic afflictions. Here is a decentralization which is logical and must be encouraged. As for the special concerns of the Navy, we have the greatest interest in having our students follow courses at the Colonial Institute of Bordeaux in preference to Paris, because in the former city we will not have pecuniary sacrifices to make, while sending the students of Bordeaux to Paris would put a considerable strain on the budget with out improving their technical instruction.155

The place of colonial medicine, it seemed, was in the provinces and Le Dantec anchored that activity in Bordeaux. This formula worked and Bordeaux conferred twenty-one diplomas in colonial medicine in 1908 and eleven in 1913.156 This was by far the largest number outside of Paris, where, as recounted below in chapter 6, Professor Raphaël Blanchard of the Faculty of Medicine had created an Institute of Colonial Medicine in 1902. The naval physician Pierre-Jean-Marcellin Brassac had accompanied Bérenger-Féraud to Bordeaux in November 1890 as the new school’s designated director. Like Bérenger-Féraud Brassac too had sailed to India, served at Toulon’s Saint-Mandrier hospital, and never achieved the professorship. An 1863 medical graduate of Montpellier he had published a moderate number of studies on elephantiasis, the poison arrows of Pacific islanders, and the diseases of the Antilles.157 Bordeaux was not a port of the first instance as were Rochefort, Toulon, and Brest, and Brassac, then nearly sixty years of age, held a rank below his colleagues directing the port schools. The Bordeaux school faculty were six in number; a director at the level of physician in chief, an assistant director at the same grade or the lower grade of principal physician, three répétiteurs in medicine at the level of first-class physician and a pharmacist of the same grade. Each of the three port schools, now termed “annexes,” retained eight faculty inclusive of the director. Pharmacy students were to remain at a port school for three years and take classes from pharmacy professors in physics, chemistry and medical chemistry, and natural history. Professorial chairs on the medical track included minor surgery, anatomy, military and naval surgery, and exotic pathology and naval hygiene. The subjects Fonssagrives and others had devoted their lives to, exotic pathology and naval hygiene, were now

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postdoctoral-level practical courses and reserved for those who had completed studies at Bordeaux. Initially, graduates of Bordeaux took an additional year of practical training at one of the three port schools. But after 1896 the flow of postdoctoral students back to the ports shifted to Toulon where the navy formed its own school of application after the model of the army’s school at Val-de-Grâce and the term of applied studies was reduced from a year to seven months.158 With precise scheduling naval medical students claimed the diploma at Bordeaux before arrival in Toulon. Brassac addressed the audience at the school’s inauguration by recounting the struggles of the navigans and continued with vignettes of his service in the Crimea as a young and admittedly ill-prepared surgeon in his midtwenties. He recounted how different the practice of naval medicine was from that of the civilian world, especially civil practice in large cities. “You will not be able to be and you must not be,” he continued, “specialists confined in one branch of the profession and science.”159 Above all the navy needed brave, disciplined, level-headed men committed to generalist medicine. In contrast to the agitation, strikes, and discontent of Parisian medical students, Brassac closed by calling on the students to “abstain from the sterile agitations of politics, which will only create among you deathly divisions and unfortunate antagonisms prejudicial to camaraderie, the esprit de corps and the solidarity which must exist between you.”160 Bordeaux lodged the naval medical school in a former asylum, a substantial building in which the city invested nearly one million francs. It was located in easy distance from the train station and near the new medical faculty buildings at the Place de la Victoire. Unfortunately, it was also near a slaughter house and bordered by a street of cobblestones used by noisy horse carts and an electric tram. Brassac complained to the city council of foul smells and of hearing noises from animals as they met their end. Eventually the city moved the slaughter house and funded additional improvements as the school’s needs grew in tandem with the expanding empire. In 1914, when the school had about 250 students, the Ministry of War, now in charge of colonial troops, demanded places for an additional sixty students for each of the next few years. This meant as many as four hundred students would be in residence from October to January in a school designed for far fewer. Incorporation of the school to Lyon was again threatened, but with the advent of war the Bordeaux school closed until 1919. At war’s end, of the 250 students present at the school in 1914, twenty-seven had fallen on the field of honor and an additional eighty were wounded.161 Another order of business for Brassac and members of the navy’s Conséil supérieur de santé, a body charged with overseeing activities at all four

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navy medical schools (five after 1896 with the addition of Toulon’s postgraduate naval medical school), was creating a library for tutorials. A committee of October 1890 selected books and judiciously included texts by Bordeaux Faculty professors including Abel Bouchard’s text on external pathology. Bouchard, who had been trained at the army school of medicine in Strasbourg and passed the agrégation at Val-de-Grâce, did fundamental work on the nerves and had joined Bordeaux at its opening and founded an Institut anatomique. But these were naval medical students and the committee also selected materials from the leading personages of naval medicine including Fonssagrives’s text on naval hygiene and two authored by Armand Corre, one on obstetrics and another on the diseases of the hot countries.162 Brassac got the school functioning but stepped aside in 1894 and was replaced as director by Joseph Henri Bourru who had grown up on the Atlantic seaboard and studied at Rochefort. Bourru, who directed the school for eight years until 1902, had been born on the Île de Ré, an island with a proud maritime tradition north of Bordeaux near La Rochelle. Bourru began studies in Rochefort and although he was posted for three years in Senegal the majority of his service had been on the Atlantic seaboard, especially in Rochefort, where from 1885 to 1894 he was a professor.163 His major challenge was negotiating clinical experience for his students, an exercise which began with examinations for the internat and externat. The historian George Weisz has pointed out the how crucial clinical posts were to the training of French physicians and especially how the clinic, in contrast to instruction at the Faculties, constituted a site of innovation and experiment.164 Bourru’s first years in Bordeaux provide a microcosm for the study of civil and military relations on this issue. Bourru first tried to alter the school’s recruitment cycle so its first-year students might complete a required hospital rotation prior to exams and he received permission to have naval students sit for the exam after accomplishing a shorter rotation. But in 1896 civilian students complained of the practice and held meetings which were soon reported in the local press. Professors at the Faculty then voted to support the civilian students. After four years of effort with faculty and hospital administrators Bourru prevailed on the specific issue of eligibility for the two exams but was still engaged in a larger battle to secure clinical experience for all naval students.165 The conflict dragged on for years. In 1898 Bourru reviewed the school’s relationship with the Faculty and the competencies of its graduates. Still lacking, he felt, was practical instruction. This was especially so in terms of clinical experience as the navy school did not have its own clinic and could not add to the few instances

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of student-patient interaction afforded at the Faculty. Yet the navy, he argued, was in the main doing an excellent job “completing” the incomplete instruction given at the Faculty through quizzes and in one instance, where Dr. Barbe, a naval physician who had won a post as an anatomical assistant, gave voluntary tutorials for naval students at the Faculty amphitheater.166 Also, naval students and their répéteurs frequently used the rooms and laboratories of the Faculty for tutorials. Yet the new marriage of civil and naval medical instruction was still strained. In the teaching of subjects such as physiology, wrote Bourru, Faculty professors were too detailed and too theoretical. Critical too felt Bourru was improvement in the teaching of medical microscopy as the naval school did not have a hospital service and lacked tissue samples for pathological study. Surgery, a mainstay of naval medicine, was also underserved and students only practiced operations three times over a two-week period in the summer. The situation for instruction in hygiene was hardly better as at the Faculty its instruction was “subject to no rules,” and the naval school had no means to teach the subject except through the occasional drill.167 Bourru’s responded to what he regarded as the overly theoretical approach taken by Faculty professors by reducing the number of theoretical lectures given at the navy school and replacing them with a series of practical exercises and manipulations. Students had felt pressured by having two sets of examinations, one at the Faculty and another at the naval school, and Bourru had reduced the number of quizzes and exams on a trial basis. But it had not worked, he insisted, and “inspired by these ideas which appeared liberal to us” the results were “deplorable and all we got was a considerable reduction in the work effort of the group.”168 Bourru closed the report by complaining as he had in previous years about the school’s ridiculously small library and renewed requests for instruction in German and English. Three years later in 1901, when Le Dantec still had one foot in the navy and the other in the civil world, Bourru returned to the challenges still faced by the school which he had now directed for seven years. He clearly wanted to give a good account of his leadership and noted the school was succeeding in producing devoted officers and well-educated physicians. It had taken him four years but the Faculty had finally relented and now allowed naval students to compete for the externat upon arrival, though not for the more prestigious internat. However, the school was not yet producing functional physician practitioners, and Bourru admitted failure on this point. The problem, as he saw it, obtained from the very conception of the school itself. Naval students had no assured access to clinics, hospital ser-

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vice, or cadavers. In short the students were “devoid of all tools of practical instruction and this omission is gravely ascribable to the founders of the school and will have the same consequences as long as it exists.”169 Bourru was frankly embarrassed by a recent situation where naval students had talked with Faculty professors about the quizzes and examinations given by the navy school. Bourru had had to justify his methods to his superiors and explain them to the Faculty.170 There were likely disciplinary problems as well, for at least one young medical graduate from 1902, Victor Segalen, wrote of smoking opium and the joys of having an apartment in town. Bourru went even further on two issues, those of establishing greater equality between the army and navy medical tracks, and the propriety of integrating naval medicine with civil medicine. On the issue of equivalence with the army, he pointedly asked that a teaching hospital be annexed to Bordeaux as was the case at the army medical school in Lyon. This request took the form of an ultimatum and if it was not realized he predicted again “the inferiority of our young physicians as practitioners will persist inevitably and I decline all responsibility.”171 There was a larger issue too, that of the specificity of naval medicine. Bourru pointed to the navy’s relationship with the Faculty, adding: Better still! There exists between the traditions of [the Ministory of] Public Instruction and the necessities of a military School something which is incompatible;—I am ready to demonstrate it. So let the navy disengage itself from Public Instruction. May it recognize, after eleven years of experience, the error committed by the creation of its School at Bordeaux and let it found in one of our large hospitals an École de plein exercice and thereby concentrate the resources of personnel and scientific material today now scattered among four Schools! There the navy will produce physicians habituated to treating patients and clinical observation, less infatuated with their own merit, but full of initiative. There lies the remedy and there exclusively.172

The old system of port schools, which had nurtured Bourru’s career, may have had some advantages. But there was no turning back. Naval medicine was in Bordeaux for the long haul, but the school was not structured in such a way that even a man of vision might develop appropriate changes and sustain them.173 Though termed the “central school” it was still administratively dependent on Rochefort and its directorship was something of a rotating door. By the time the school closed during World War I five different directors had followed Bourru.

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The navy frowned on officers who avoided responsibility for their command. But the issue of access to patients and other clinical materials was a critical and sensitive subject. Under the Old Regime access to patients had been facilitated in the major ports as the navy generally had its own hospitals, staffed clinics at arsenals, bagnes, and factories, and in the case of Rochefort it had access to civilian patients as well. Until relocation of the bagnes to the colonies, the port schools also had an assured supply of cadavers for anatomical instruction. But Bordeaux was not a naval city in the way that Toulon and even Lorient were. Brassac had tried to gain access to the civil hospitals and clinics of Bordeaux only to have his students formally dismissed by civilian physicians. Bourru was doing no better but he had tried, and in 1899 he persuaded the minister of the navy to write the city a formal request on this issue only to have it rejected. Here was a man demanding to be transferred and in 1902 he relinquished the directorship to Dr. Paul-F.-J.-B. Talairach of Lorient on the eve of Le Dantec’s appointment at the Faculty. Three years later Bourru retired in Lorient at the same rank he had held upon leaving Bordeaux. He had not left town emptyhanded, however, and shipped out to Lorient with a consolation prize, his nomination as a commander in the Légion d’honneur.174 A 1905 inspection still noted flaws in the level of technical instruction given to naval students at Bordeaux but wrote of progress since Bourru’s departure. The army maintained a hospital in Bordeaux with 150 beds, and that year twenty-seven naval students assisted in its clinic. This made sense on a number of levels. The army now controlled the colonial troops and the majority of Bordeaux graduates, about thirty in a class of fifty, entered colonial service and the rest followed the naval track. Colonials would soon have their own school of application which was just being organized in the vibrant city of Marseille, the topic of the following chapter. Naval men would continue to go to Toulon. The navy was in the business of identity formation, and inspector general Charles-J.-E. Auffret wanted graduates to arrive in Toulon as soon as possible and not remain in Bordeaux, even to complete the postgraduate diploma in colonial medicine. Auffret added that the Bordeaux school should not be subject to the same administration as the ports. In terms of regulatory regime, of course, this would have effaced the historical place of naval medicine. But a more proximate danger, and one Auffret combated strenuously, was incorporation of naval medicine into army medicine.175 His concern merely prefaced more intense disputes between the deputy from Lyon, Victor Augagneur, a former surgeon and governor of Madagascar, and the minister of the navy Camille

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Pelletan. Augagneur, a future minister of the navy in 1914 and 1915, had attacked the Bordeaux school in the early 1900s. In 1909 he secured the support of Georges Clémenceau, himself a physician and longtime critic of French imperialism and the navy. Pelletan prevailed, but Augagneur and other like-minded deputies trimmed the navy’s budget. World War I soon put aside such squabbles, and the autonomy of the Bordeaux school and its separation from army medicine remained in place until a decree of February 9, 1970. It would close definitively in 2011 amid a wave of French government consolidation. Le Dantec volunteered for service in 1914 and would serve until war’s end in a Rochefort hospital. Expertise in colonial medicine and tropical diseases was soon at a premium but particularly so after thousands of Senegalese, Indochinese, and other colonial troops arrived in France to assist in the war effort. Fears broke out about the importation of exotic diseases, particularly yellow fever, which had appeared in France as recently as 1908. Bordeaux was the largest city near two important camps billeting foreign troops, Arcachon and Courneau. The wretched health conditions in the camps, described by many Bordeaux graduates in hurriedly written thèses de guerre, portrayed them as hot beds of racially typed diseases and fertile breeding grounds for cholera and pneumonia.176 Concern escalated over the possibility that exotic diseases might spread to civilian populations and that civilian physicians were ill-trained to diagnose these conditions. The Parisian parasitologist Professor Raphaël Blanchard, a subject of chapter 6, was a prominent and soothing voice on this issue. The war forced members of the Bordeaux Faculty of Medicine to look more favorably on colonial medicine, and administrators drafted plans for a special clinic of forty beds to segregate colonial soldiers and workers with exotic diseases from other patients. They also clearly wanted Le Dantec to take charge of the clinic, but he had returned to the cradle of French colonial medicine and remained in Rochefort until the end of the war.177 From the time of Bérenger-Féraud’s demise in 1892 to World War I, the main two career tracks pursued by Bordeaux’s graduates, naval medicine and colonial medicine, adopted different trajectories. Naval medicine, in terms of the number of career possibilities, either hovered in steady state or slight expansion. Additionally, naval advancement tended to proceed at a slower pace and the navy itself was a favored target of criticism by the republic’s politicians and journalists such as Clémenceau and others. Conversely, the newer colonial health service created in 1900 was in full expansion, and its godfather, Georges Treille, was refreshed from the waters of

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Vichy and moving to Marseille to teach exotic pathology at the city’s medical school.

In Marseille city fathers and the medical community, and Édouard Heckel who had inspired the Bordelais to found a Colonial Institute, resented the fact that the navy had selected Bordeaux rather than Marseille to host its medical school, and they had resolved it would not happen again when the now autonomous colonial health service created its school of application, the younger sister to the navy school in Toulon and the army’s Val-deGrâce in Paris.

FIVE

The Emergence of Colonial Medicine in Marseille

It is unquestionable that Marseille possess resources found no where else to the same degree for clinical education in colonial medicine.1 —Clavel, Directeur du Service de santé des troupes coloniales

The Place of Marseille Neither Bordeaux nor Marseille were naval towns after the fashion of Toulon, Rochefort, or Brest, but the navy had operated an arsenal at Marseille prior to the revolution. Galériens, men who worked at the arsenal and manned oar-powered galley ships docked nearby, constituted a sixth of the city’s population in 1700. When plague struck in 1720 nearly four hundred galériens were promised freedom if they cleared the city of bodies. Only four survived to enjoy that freedom. Marseille lost some 38,000 of its 75,000 inhabitants, about double the average mortality rate for the epidemic.2 In 1748 Louis XV closed the arsenal and dispersed the galériens to Toulon and other ports. The navy reestablished an arsenal in 1762 but closed it definitively in 1781.3 Marseille merits inclusion in a study of French colonial medicine in virtue of its medical institutions, unique commercial and colonial vocation, and the city’s disease ecology and demography. By the early twentieth century it was home to the most dynamic constellation of colonial medical and scientific institutions in all of France. Marseille’s Chambre de commerce was the oldest in France. Founded in 1599 to combat pirates, the chamber invested in trade companies and was a diplomatic presence throughout the Mediterranean. An Ordinance of January 1, 1753, divided the organization into six departments, one of which dealt expressly with trade to the Levant and North Africa.4 Nostalgia for lucrative trade contracts with these regions persisted after the revolu-

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tion. In 1828 chamber member Pierre-Honoré de Roux, a National Assembly deputy from Marseille, championed French intervention in Algeria. In 1830, upon learning of the capitulation of the city of Algiers to French forces, the chamber set aside 25,000 francs for the widows and children of soldiers injured or killed in the campaign.5 In 1856 regular rail connections to the Paris–Lyon line cemented the city’s reputation a key transshipment hub to North Africa.6 At the time of the revolution Marseille was a busy commercial port and second only to Bordeaux in French colonial traffic. By 1832 it was Europe’s third port in total maritime traffic behind only London and Liverpool. As the nineteenth century progressed its situation, as measured in terms of tonnage, fell behind that of other Continental ports such as Hamburg and Anvers.7 Yet the city grew ever more dependent on its colonial connections and the General Council of the Bouches-du-Rhône, the city council, and the Chamber of Commerce spent lavishly to expand port facilities.8 The embrace of colonial commerce continued and by 1875 half of all French tonnage to and from the empire passed through Marseille.9 At the time of naval medicine’s transformation the colonies (inclusive of Algeria and Tunisia) claimed about a quarter of all port tonnage.10 This differed from the case of Bordeaux where colonial commerce became less important as the century wore on. In addition to shipping, the artisanal production of comestible olive oil and particularly soap manufacture from oils anchored local industry. On the eve of the revolution soap fabrication and commerce accounted for half of local industrial production, and by the start of the nineteenth century perhaps one in five workers traced their livelihood to its manufacture and trade. Sugar refining was also important to the city’s economic life. At century’s end, at the time of the institutionalization of the city’s suite of colonial medical and scientific institutions described below, Marseille factories still produced half of all French soap.11 As in Liverpool, a foci for British tropical medicine, Marseille’s manufacturing and shipping interests, many of them also engaged in trade with Africa, were well represented in their respective Chambers of Commerce.12 In Marseille olive oil provided a high quality but expensive chemical base for soap. As the empire expanded manufacturers shifted processes to include cheaper colonial oils from palm, peanut, copra, and areca. Soap and oil interests, sugar refiners, and others joined with maritime and railway entrepreneurs such as the powerful Talabot and Charles-Roux families in support of colonial and maritime medicine and science. Local notables were especially supportive of activities near to their business interests such

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as tropical botany, plant chemistry, colonial medicine, and training in colonial commerce. In several particulars commercial interests funded but also interpenetrated with the medicine and colonial sciences prosecuted in the city. In Marseille, as in the case of science faculties in other provincial cities examined by Mary Jo Nye, the place “affected the choice and content of scientific research by favoring or ignoring certain orientations in scientific fields.”13 The Chamber of Commerce had practical scientific interests. They built a laboratory for testing raw sugar and silk and sponsored evening classes for mechanics and stokers. Often, as with the École pratique d’industrie, a technical school which opened in 1899, the municipality shared costs or provided buildings.14 The coterie of commercial and industrial wealth which dominated city politics also funded an impressive variety of scholarships, handed out subventions for study and teaching in commercial and colonial subjects, and in a rare attempt to deal with burgeoning social problems founded a short-lived hôtel des marins for injured sailors. The chamber also joined with the General Council of the Bouches-du-Rhône to fund a chair at the Faculty of Sciences in historical and economic geography and in 1899 opened the doors of its lavish Bourse building to classes on colonial topics. There, at the pivot of the Marseille commercial world, the public heard lectures on colonial products, colonial geography, colonial legislation, and colonial medicine and hygiene. Marseille’s disease ecology was unenviable in the extreme and partially the result of its commercial prowess. A tax (the octrois) on goods entering the city provided most of the municipality’s income. The legacy of rapid industrial growth, the city’s openness to trade from the Levant, West Africa, and Latin America, and the very heterogeneity of its residents created a nightmare of urban sanitation. In this its infrastructural challenges resembled those of Manchester and other European cities. But unlike Manchester nineteenth-century Marseille was a thriving port city and one with warm or even hot weather much of the year. Diseases long associated with tropical climates—yellow fever, cholera, and plague—disrupted city life. The social edifice of Marseille also favored the extension of typhoid fever and tuberculosis, the later of these accounting for perhaps one in ten deaths. The cholera which tormented the great cities of Europe broke out in Marseille in 1865 upon arrival of a ship from Egypt laden with pilgrims to Mecca. It reappeared in 1884 and 1885 killing more than 3,000 residents and also struck neighboring Toulon. Evidence linked these outbreaks to the city’s life blood, maritime traffic.15 As if this were not enough, smallpox flared up in 1876, 1886, and 1895. The 1886 epidemic which claimed more than

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2,000 souls came in the wake of the cholera and issued a clarion call for sanitary action. Marseille’s style of governance and its demography underlines once again the discreteness of place and how very different provincial institutions might be from those of Paris but also from one another. Marseille was not like other large French cities such as Paris or Lyon which were run by prefects, representatives of the central government. In the late 1860s the central government appointed Marseille’s mayor but had to select him from among elected council members.16 Marseille was also unlike its rival city of Bordeaux in that its economy was quite diverse and it experienced a vast influx of immigrants. Foreigners, mainly Italians, accounted for one in ten city residents in 1851 and by 1906 one in every four residents was of foreign origin.17 The serial health crises experienced by Marseille spurred reform sentiment and provided a conjuncture supportive of sanitary initiatives, tropical medicine and the colonial sciences. Of the large cities of France, Marseille was the acknowledged leader in fatalities per capita from diphtheria. Typhoid too persisted there as well claiming 1,040 souls for every 100,000 residents in 1886 while Paris recorded less than half that total and Lyon registered but 295.18 In the 1880s the municipality gained some control over waste by shipping it away from the city by rail, and in the 1890s it welcomed an outpost of the Institut Pasteur. In 1893, shortly after the inauguration of a laboratory for antidiphtheria vaccines, the socialist mayor of the city, Dr. Siméon Flaissières, went to Paris and proposed to Pasteur that Marseille host a rabies vaccination institute. Flaissières, an 1877 graduate of the Montpellier medical faculty who practiced among the working men and women of Marseille, served the city as mayor from 1892 to 1902, and again from 1919 to 1931. He also married Marie Alquier, a descendant of one of the Midi’s most established families and entered the Senate in 1906.19 Pasteur agreed to Flaissières’s project and Dr. Charles Livon of the city’s École de médecine led the new institute which opened in 1893. In the first two years the clinic saw 650 cases including twenty-three from Algeria, and in 1913, the Insitut Pasteur de Marseille added antityphus vaccines to its therapeutic arsenal.20 Significant advances in water and sewer systems were completed by 1896, the same year the municipal medical school began teaching a course on microbiology.21 Finally, in 1912 after four years of heated debate, the city began filtering drinking water.22 Disease ecology aside, Marseille possessed an enviable multidisciplinary infrastructure for colonial medicine, commerce, and science. The place inflected the science as what was taught and done was often framed in local

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rather than national or universal terms. In the 1840s the city council and the General Council of the Bouches-du-Rhône requested a faculty of sciences, but it took a change of government and a decree of 1854 signed by the new emperor, Napoléon III, to endow the institution with a faculty of four professors—one each in physics, pure and applied mathematics, chemistry, and natural history. In celebrating the new faculty at the Hôtel de Ville, the rector of the Académie de Aix, Ambroise Mottet, praised the four new professors and pointed to the rich local traditions of the soap, sugar, chemical, and metallurgical industries. “Science,” asserted Mottet, “is the base of all our industries, the source of all our riches, the first and permanent cause of our civilization.”23 The new professor of physics and dean of the Faculty, François-Auguste Morren, who had recently organized the Faculty of Sciences at Rennes, emphasized that teaching at the new faculty would be appropriate to the local context. Marseille, noted Morren, was “an industrial and commercial city; our lessons, in putting forward the substantial and precise reproduction of the theories of pure science, must also attend to the applications which, in our days, have given the modern sciences their glorious popularity.”24 Classes at the Faculty of Sciences opened in 1857 and in 1860 Napoléon III inaugurated the city’s Palais de la Bourse, the new seat of the Chambre de commerce. Even the Faculty of Law in neighboring Aix celebrated the cosmopolitanism and commercial vocation of Marseille. In 1863 foreign students had swelled enrollment to 350 making Aix France’s third largest law faculty. Located as it was, gushed the dean at the return of students in 1863, “near Marseille, between the West and the East, within reach of Algeria, it has a character, in some ways international and cosmopolitan, which no other department [Faculty] possesses in the same degree.”25 Most certainly, the demographic numbers were with Marseille. Long known as the third most populous city of France after Paris and Lyon, the city’s population doubled between 1850 and 1890.26 In that year the population achieved the 400,000 mark.27 As the place of Marseille evolved, knowledge of tropical science and exotic diseases came to be seen as useful to students of the École supérieure de commerce, to Marseille’s quest for a full faculty of medicine, and to combating Marseille’s considerable problems of urban hygiene. Lastly, place is also about identity, and no French city was more wedded to the colonies than this cross roads of Mediterranean peoples. A plaque at the city’s Old Port commemorates its founding by the Phoceans and historians of the modern era signal frequently its lavish colonial expositions of 1906 and 1922. Georges Valois, a visitor to the second exposition,

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commented that Marseille itself was “a colonial city, . . . [like] a capital of the French colonial empire.”28 Scientists and physicians were involved in both expositions and the congresses held in conjunction with them. A principal figure in this chapter, the former naval physician Dr. Édouard Heckel, planned much of the 1906 exposition with his longtime friend at the Chamber of Commerce, the politician and wealthy industrialist Jules Charles-Roux. Enthusiasm for the colonies and things colonial was widely shared in the city. Photographers, artists, agriculturalists, and others participated in annual events devoted to specific colonial regions or, more often, to colonial products and crops such as coffee, tea, and oleaginous plants.29 Marseille’s institutions of colonial medicine benefited from these activities. But as a history of the municipal medical school and its struggles to attain full fledged faculty status shows, budgets were tight and change slow. Moreover, theories of hygiene promoted by some professors at the École de médecine differed substantially from those found in Paris. In this they inclined toward the ideas of Jean-Baptiste Fonssagrives and a style of medical thinking common among naval hygienists and others in the hexagon’s southern tier.

Naval Legacies: Évariste Bertulus, Christian Vitalism, and the Art of Hygiene As seen in the previous chapter, possession of a full medical faculty was instrumental in Bordeaux gaining the navy’s central school of medicine. Of course, the minister of the navy then was also from that city. In the south of France Aix, Avignon, Valence, and Orange had had medical faculties prior to the revolution. From the revolution until 1840 only three French medical faculties awarded medical degrees; Paris, Montpellier, and Strasbourg. Although Marseille lacked a medical faculty, it, more than Bordeaux, had a creditable tradition of naval and colonial medicine and prerevolutionary Marseille had boasted a dozen hospitals. When peace returned only three remained: the 878-bed Hôtel-Dieu for general medicine and two smaller institutions for foundlings, the aged, and the insane.30 Medical and surgical instruction too was reestablished at the Hôtel-Dieu’s clinics and amphitheater. In 1820 physicians and surgeons organized an École secondaire de médecine et de pharmacie with six teaching chairs. A chair of Naval Hygiene and Illnesses of Seamen followed the next year, substantially before naval medicine’s institutionalization in Bordeaux. By 1835 thirty-seven students followed courses on the health officer track, while twenty-four pursued the more ambitious medical degree.31 A regulation of October, 13,

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1840, conferred a minor upgrade and changed the institution’s status to an École préparatoire de médecine et de pharmacie. The Marseille City Council grudgingly funded a new dissection room with eight tables and approved a recommendation by the rector of the Académie de Aix to add two additional teaching chairs, one in therapeutics and another in obstetrics. The council contributed about 12,000 francs a year to the school although this figure fluctuated and formed a subject of debate.32 The reconstituted medical school did not have a full professorship devoted to naval hygiene and medicine but Dr. Évariste Bertulus taught a course on the subject.33 Évariste Bertulus, a former navy man, is less well known than his younger colleague Édouard Heckel who came to the school a few years before Bertulus’s death in 1881. Bertulus’s career, like that of Fonssagrives and Heckel, provides further illustration of how the concerns and agendas of naval and colonial medicine influenced medical pedagogy in civil institutions. Bertulus likely assumed the course on naval hygiene around 1846.34 When the Congrès scientifique de France met in Marseille that year attendees praised his course and issued a voeu (wish) that the school create another one on public hygiene. City fathers balked at funding a professorial chair in naval and public hygiene but the ministers of the navy and public instruction considered cofunding it and also funding a similar chair in Bordeaux, but neither plan succeeded.35 Évariste Bertulus was born in Toulon in 1809. His father Jean Évariste Bertulus was also a native of the city, as was his mother, Thérèse Dommenge. His father was a professor of design at the École navale and a favorite son of the city. Young Évariste admired naval discipline and was fearless when confronting epidemics. His sentiments on quarantine ran counter to those of Marseille’s commercial interests, and he consistently championed strict quarantine measures. He was also a Christian vitalist in physiology cut from the same cloth as Fonssagrives. Colleagues remembered him as a liberal Catholic physician, medical administrator, and essayist.36 Bertulus began sailing at age fifteen.37 Soon he was a young surgeon of the second class on campaign to Algiers, Mogador, and Mexico. Disaster struck while voyaging on the transport ship Caravane. On the ship’s return voyage from Mexico to Brest Bertulus and several crew members contracted yellow fever, a disease he regarded as altering the composition of the blood. The epidemic raged from April 17 to June 21, 1839, and Bertulus stayed with his shipmates anchored in the port of Brest and employed the heroic blood-letting therapy promoted by Broussais. A letter from his superiors proposed him for the Legion of Honor and noted how he had given little thought to the dangers “despite the formidable symptoms which forced

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him to take nearly one-hundred ounces of blood from their veins, [he displayed] self-abnegation for his health, and before his own convalescence was precisely declared he reappeared at the hospital to devote himself to the ill.”38 Leaving the navy in 1845 with nearly twenty years of service he was successively physician at Marseille’s Lycée, at the navy’s branch office, and later a professor at the École de médecine. His concerns as a civil practitioner and professor remained close to what he had learned while voyaging, and he often distilled lessons learned on the great school of the sea and applied them to the metropolitan context. In 1868 Bertulus became professor of internal pathology and in 1876 his chair incorporated additional duties for general pathology.39 He wrote frequently on hygiene and epidemiology, particularly naval and public hygiene and the dangers posed by yellow fever and cholera.40 He was also fully engaged with the social, religious, and philosophical questions of the day including atheism and medical humanism.41 Bertulus allied himself with those Catholic clerics who stood against positivism, physiological determinism, materialism, and atheism, precisely the doctrines associated with Professor Germain Sée of the Paris Faculty of Medicine who would be the adversary of his colleague Édouard Heckel. Most certainly the Christian vitalist Bertulus would not have liked Sée’s brand of physiological science as he targeted Sée’s inspiration, Claude Bernard’s program of physiological determinism. According to Bertulus, Bernard’s science had nothing to offer to therapeutic medicine. He also found folly in mechanistic views of the human body held by the great German pathologist and student of blood chemistry, Rudolf Virchow. He also felt that animals and humans differed too much to be compared in the way contemporary physiologists maintained; the former often had a greater vital force than humans, and, according to Bertulus, knew nothing of nostalgia, were unsusceptible to malaria, and could consume poisons which killed humans. “That which is true for the sheep, rabbit, dog, . . .” wrote Bertulus, “can be perfectly false for man.”42 Bertulus was not among the original thinkers of his generation. But he combined historical, philosophical, and medical argumentation in ingenious ways and wrote of atheism as the most grievous of all plagues, one which struck the moral and physical fiber of humanity.43 From his naval voyages and from Victor Bally, his mentor at the Paris Faculty of Medicine who had studied yellow fever in both Saint-Domingue and Spain, Bertulus gained a deep appreciation of the social dislocations wrought by tropical diseases. Like his friend the physician Antoine Barthélémy Clot-Bey, who had trained as a health officer at Marseille’s Hôtel-Dieu and established the

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Egyptian health service, Bertulus too thought diseases like plague and yellow fever attacked vital properties in the blood.44 Clot-Bey spent a number of years in Marseille in the 1850s prior to settling there in 1861 and likely he and Bertulus discussed their experiences as French physicians abroad. Bertulus thought the purity of blood assured the normal functioning of the vital force and possibly his therapeutic allegiance to Boussais obtained from trying to free the body of polluted blood. Medicine, he insisted, also needed to account for reciprocal relationships between the blood and soul. Both were intertwined and subject to traumas.45 In the matter of atheism and the argument that humans had descended from apes, Bertulus, like Bally, elaborated a psycho-materialistic view of the organism which made room for the special nature of the human soul and sought accommodation between spiritual and materialistic aspects of life.46 His views on hygiene, the organism, and society resonated with the physiological vitalism and social physiology of Fonnsagrives.47 For Bertulus, then, medicine was an art. It was neither an exact science, as Bernard hoped it might become, nor was it amenable to higher-order quantification. Healing rested on social practices, including faith in something beyond the material realm. As an art, its success depended on the eclectic intellectual skills of the physician. “The idea of God,” he wrote, “. . . and that of immortality which springs naturally from it, are the corner stone of the social edifice.”48 By the early Third Republic, physiological and medical vitalism, as promoted by Fonssagrives and Bertulus, were disparaged as unscientific and contributing to the enfeeblement of teaching at its font, the Montpellier Faculty of Medicine.49 Near the end of Bertulus’s career in 1875 medical school faculty and city council members again studied the possibility of founding a faculty of medicine in the city, and yet again the City Council of Montpellier and members of its Faculty of Medicine fought the proposal.50 Moreover, after an 1874 report in the National Assembly by the physiologist and Deputy Paul Bert on founding new medical faculties, it was clear Marseille’s cause was lost. The Bert report ranked Lyon and Bordeaux in the first and second spots, and in an address to the assembly he indicated only two new faculties should be created.51 Marseille finished in distant sixth place behind Toulouse, Lille, and Nantes in terms of facilities, and in fifth place when ranked by the value and authority of its physicians.52 City council members pointed out their budget could not fund a new faculty anyway, so the logical move was to upgrade the present school and a commission chaired by M. Prou-Gaillard recommended expansion and transformation of the old École préparatoire de médecine into an École de plein exercice.

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The commission found the current situation at the École preparatoire untenable as students completed twelve of the sixteen examinations required for the doctorate but then lost two of those upon transfer to a full faculty where they still had to pass six additional examinations. With an École de plein exercice local students would be better served and be able to complete their course work in Marseille although they would still need to finish their degrees at a full faculty. Prou-Gaillard’s report made a number of placed-based arguments praising the city’s hospitals and “the diversity of illnesses one encounters there, the importance of our population and our geographical position.”53 He also framed the report in terms of civic competition with Bordeaux, Lyon, and Montpellier and warned against concentrating medical studies in Paris where “at certain moments 5,000 men can take on a character which is disquieting for public order.”54 Plans for the new École de plein exercice de médecine et de pharmacie called for seventeen full professorial chairs and eight adjoints.55 In 1875 clinical rounds were taken in the Hôtel-Dieu which also provided 124 cadavers during winter semester, and teaching took place at the old Palais de Justice now converted into two amphitheaters with separate laboratories for practical anatomy, physiology, chemistry, pharmacy, and microscopy.56 The new school was larger than the preparatory school and students could now complete all course work, a total of sixteen inscriptions, in Marseille. However, much to the consternation of the professors at Marseille, a jury of Montpellier professors assembled annually at the Marseille school to test its doctoral candidates.57 Fonssagrives, at Montpellier from 1866 to 1880, may have been one of those examiners and may have discussed Christian vitalism with Bertulus and others. The Marseille school was still not a full faculty and would not have helped the city in competition for the central naval medical school. In 1879, two years before Bertulus died, the school hired the pharmacist Édouard Heckel as its professor of materia medica. Heckel was relatively new to Marseille and had held the chair of botany at the Faculty of Sciences since 1877. Like Bertulus he was both a Toulonnais and a former navy man, and his influence would mark Marseille institutions of colonial science and medicine.

Naval Legacies: Édouard Heckel, Jules Charles-Roux, and the Institutions of Colonial Science Bertulus died at a time of accelerating colonial ambitions as the moderate Republican Jules Ferry began his first premiership. In Marseille social-

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ist candidates took control of the city council. Dr. Édouard Marie Heckel prospered as no one else in this environment and created or led several institutions devoted to colonial crops, botany, and medicine. Like Raphaël Blanchard, a professor at the Faculty of Medicine in Paris whose contributions to parasitology are examined in the following chapter, Heckel too secured funding for colonial medicine and scientific activities. He was especially adept at winning funds from the city of Marseille and the Chamber of Commerce. Heckel was born in Toulon in 1843. His father was a captain in the naval infantry and his mother died shortly after his birth. Beginning study at the local naval medical school he voyaged to Martinique in 1859 where he surveyed local flora for therapeutic agents. The assignment was formative for his scientific career. During his three years in the Antilles he likely contracted yellow fever and certainly combated epidemic smallpox.58 By age twenty-two he was the chief of naval pharmacy for the colony of New Caledonia. Subsequent voyages took him to India and Senegal. Naval superiors characterized him as an impoverished bachelor of considerable intelligence but evaluated his service as slow and unenthusiastic.59 Heckel, however, was extremely diligent in preparing for examinations. He advanced to pharmacist of the first class with a thesis on the toxicology of mussels in 1867 and completed a medical degree in 1869 and doctorate in natural sciences (1875), all from Montpellier. He also botanized widely in Australia and undertook additional investigations in Java, Sumatra, Cochin China, Ceylon, and elsewhere, and was a delegate to the Sydney Exposition of 1867–70. Heckel’s voyaging ended after service as a physician during the FrancoPrussian War. After taking medical leave in 1871 he soon married Marie Rosalie Raboisson of Nantes. Their son Francis Heckel was born the next year and later obtained a medical degree and collaborated with Émile Roux of the Institut Pasteur. The senior Heckel suffered from anemia, intermittent fevers, and chronic bronchitis, complaints common to naval physicians. Troubled by sciatica and a progressive weakening of his left leg as well he resigned from the navy in 1874. Heckel arrived in Marseille after transitory posts at the science faculties of Montpellier and Grenoble, and possibly the pharmacy school at Nancy. He assumed the chair of Botany at the Marseille Faculty of Sciences in 1877 and for two years directed the city’s natural history museum before joining Bertulus at the École de plein exercice de médecine et de pharmacie as the chair of Materia Medica. A member of the city’s Council of Hygiene and for a time administrator of the city’s hospices, the city council appointed him director of the botani-

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cal garden in 1885 where he conducted studies on the acclimatization of exotic plants. He also won election to the City Council and to the Departmental Council of the Var. Although born in Toulon Heckel was Alsatian in heritage and maintained ties with colleagues in Nancy and Strasbourg after France’s defeat in 1871. His most famous research on the pharmacology of kola nuts was undertaken with Charles-Frédéric Schlagdenhauffen of Nancy’s École supérieure de pharmacie and is examined in detail below in the following section. Heckel was also skilled in languages and while at Grenoble in 1876 he wrote Charles Darwin of his admiration for the naturalist’s recent book, The Effects of Cross and Self Fertilisation in the Vegetable Kingdom, and secured permission to translate it into French.60 In his preface to the translation Heckel wrote of his own experiments at plant cross-fertilization and of humanity’s hunger for scientific progress. Heckel agreed with Darwin that nature abhorred continual self-fertilizations but does not seem to have adopted evolutionary views and was most excited about the practical implications of Darwin’s studies for crop breeding.61 He subsequently translated other works by Darwin and remained in contact with him while in Marseille.62 Heckel’s ties to the industrial and commercial elites of Marseille are evident in his institutional activities, and he likely taught the sons of some local notables at the Faculty of Sciences. A man on the moderate pole of the political spectrum, he won a city council seat in May of 1884 but resigned in December of 1886, shortly before the election of his wealthy acquaintance Jules Charles-Roux and just after disclosure of financial misdeeds by council members and city employees.63 A participant in the colonial section of the Exposition Universelle de Paris in 1900 organized by CharlesRoux, Heckel promoted the colonial sciences. He was the motive force behind the city’s Musée colonial and the Jardin botanique colonial as well as coorganizer and heart and soul of the Exposition coloniale de Marseille of 1906. The origins of the Musée colonial and Marseille’s first Institut colonial extended back to at least January of 1893 and collaboration between the Faculty of Sciences and Chambre de commerce. Heckel was the linchpin in this network of institutions although his colleague at the Faculty, professor of geology Gaston Vasseur, had proposed similar schemes linking science with colonial exploration, commerce, and governance.64 Heckel was also the right man at the right time, one who rode to perfection an expansion of commerce in peanut and palm oils from West Africa which fired Marseille’s economy.65 In August of 1893 the Marseille businessman Théodore

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6. Édouard-Marie Heckel. Late nineteenth or early twentieth century. Collection of the author.

Mantes and Joseph Chailley-Bert founded the Union coloniale to lobby for colonial causes and in 1894 the Ministry of the Colonies gained independence from the navy.66 The minister of the colonies soon allocated space to Heckel in its Marseille office and provided an annual subvention of 5,000 francs. A campaign headed by Heckel raised an additional 32,000 francs to support the museum and institute which at times melded together.67 Marseille’s was the first and most robust of all French colonial institutes. Soon, a string of lesser imitators sprang up in Bordeaux (1901), Nancy (1902), Nice (1927), Le Havre (1929), and Montpellier (1931). Paris followed provincial leadership in 1920 with its own Insitut colonial français but the action, in terms of colonies, was in Marseille.68 The minister of commerce Mesureur visited Marseille in 1896 to inaugurate the institute and museum at its six-story building at 5, rue Noailles. The colonial museum occupied the second floor along with a large gallery, the director’s office, a library, and a laboratory. The fourth floor housed a separate commercial museum of colonial products. The Société de géographie also rented space in the building. The Musée colonial remained on rue Noailles until 1922 when it moved to the new Faculty of Science buildings at Saint-Charles. Funding for colonial medical and health pedagogy arrived at century’s end.

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In 1898 the Chambre de commerce gave 2,000 francs in support of a course on colonial products. It would be taught by Heckel’s eventual successor at the Faculty of Sciences, the botanist Henri Jumelle, beginning in 1899. The next year the chamber funded additional courses on colonial mineral products, colonial animal products, colonial law, colonial history and geography, and another course on colonial hygiene, climatology, and epidemiology. Heckel orchestrated these initiatives and proposed a syllabus for Jumelle’s course in 1897 which was to cover plants, animals, minerals, and specific products from sugar cane and bread fruit to quinine, kola, and kava kava. There was also a scheme to integrate colonial education into the Faculty of Sciences, but the Faculty resisted this much like they had rejected the chamber’s offer of a chair of bacteriology in 1886.69 Jumelle’s course soon split into three separate offerings on plants, animals, and minerals. The course on animals products was titled “History of Animal Products, Acclimitazation,” and that on minerals “History of Mineral Products and Colonial Physical Geography.”70 Classes were held at the Palais de la Bourse and directed toward students at the École supérieure de commerce and the general public. Dr. Gustave Reynaud, a retired colonial physician who also taught at the École de plein exercice de médecine et de pharmacie, shouldered duties for the course on colonial hygiene. Reynaud authored texts on army and colonial hygiene and had undertaken a study of malaria and other health problems encountered during the French expedition to Madagascar.71 In 1901 Reynaud wrote of classes at the Palais de la Bourse covering eight different topics including courses on “Hygiene and Colonial Medical Geography” and “Maritime Sanitary Inspection.”72 The École de plein exercice was not to be outdone and school faculty and city council members joined forces to lobby for Marseille to be the site of the army’s new École d’application du service de santé colonial. Hope still circulated that Marseille might obtain the favor of the Ministry of Public Instruction and secure a full Faculty of Medicine and to this end the city concentrated medical instruction on the grounds of the “Pharo,” a chateau and park on the eastern edge of the city’s Old Port given to the city by the former empress Eugénie. The city was now more forthcoming with money and funded five new chairs at the école including Reynaud’s chair of hygiene. The other four chairs gave instruction in the pathology and bacteriology of exotic diseases, clinical medicine of exotic diseases, colonial natural history, and colonial materia medica and therapeutics. Clinical materials were abundant and Reynard estimated that at least 1,800 patients per year with exotic diseases sought treatment in the

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city.73 These activities sustained the core interests of Bertulus, Heckel, and other naval and maritime hygienists and healers. Heckel’s Institut colonial and Musée colonial quickly became a center for the scientific evaluation and promotion of products derived from colonial flora and fauna. The museum also displayed, interpreted, and promoted colonial products to the larger public, primary school students, and researchers. In contrast to other metropolitan colonial museums its history was fairly stable and after Heckel died in 1916 only Henri Jumelle (1916–35) and Pierre Choux (1935–62) would lead the institution. The colonial museum moved to the Faculty of Sciences from downtown under Heckel’s leadership and closed in 1962, the year of Algerian independence. Jumelle was a man of talent trained at the Sorbonne and had begun his career in Gaston Bonnier’s laboratory at Fontainebleau investigating the physiological dimensions of chlorophyll function. In 1894 when the university mandated all medical students first complete the P. C. N. Jumelle moved southward as a new maître de conferences at the Marseille Faculty of Sciences. The place of Marseille and Heckel altered his research in fundamental ways. Unlike his situation in Paris, Jumelle had no laboratory facilities but culled things together at the École de médecine. Finally, though, Jumelle turned from academic physiology to study the forests and botany of Madagascar. In Marseille, as Alfred Lacroix, perpetual secretary of the Académie des sciences remarked, Jumelle was transported “to a new world, to the colonial, industrial, and commercial world, next to Heckel, who communicated his sacred fire to him for all that touched the prosperity of France’s outre-mer and applied botany.”74 The Exposition coloniale de Marseille of 1906 marked the apogee of Heckel’s career and possibly too signaled a waning of his style of science which focused on the colonies as sources of new medicines and industrial products. The general commissioner of the 1906 Exposition, Jules CharlesRoux, had gained a license from the local Faculty of Sciences during the Second Empire and may have followed Michel Chevreul’s course on organic chemistry at the Muséum d’histoire naturelle in Paris.75 Like Heckel, he too served as president of the city’s Société de géographie et d’études colonials and on the city council. Unlike Heckel, Charles-Roux was from an established Marseille family and entered the National Assembly in 1889 where he fought for a colonial ministry independent from the navy. The two men had worked together on colonial section activities for the Paris Exposition of 1900 and this led to their substantial collaboration on the 1906 Exposition coloniale de Marseille.

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Charles-Roux was also a prominent figure in the Chamber of Commerce who would become a vice president of the Compagnie du Canal de Suez, and president of both the Compagnie transatlantique and the powerful colonial lobby, the Union coloniale. At the chamber’s behest he undertook study missions to Suez and Panama. Although he apparently avoided contracting yellow fever or malaria he was aware of their power and wrote of their ravages in Panama. “The sanitary question prevails over all others,” he wrote, as he praised the young engineers he encountered in Panama who confronted fatigue and death with a “thoroughly French cheerfulness” and as “soldiers of science and civilization.”76 Author of studies on economics, the merchant marine, and agricultural commodities, he and Heckel shared a vision of colonial commerce and the place of science therein.77 The two men also shared an affection for Marseille. Heckel, reared in a Toulon orphanage, was two years older than Charles-Roux and had made his way in the world on the great school of the sea and in the university system. Charles-Roux, the son of a soap-factory magnate had done well at the university and championed free trade. His politics where those of the Christian opposition and he mixed calls for decentralization with a guarded acceptance of conservative Republican ideals. He also admired the social engineering philosophy of Frédéric Le Play and while he mistrusted the socialist agenda he sometimes counseled state leadership in matters of public health and welfare. At the National Assembly Charles-Roux spoke against protectionism unless free-trade policies endangered his economic interests and what he saw as those of Marseille. For example, a 1909 essay in the Revue des Deux Mondes stated the case for separate labor regulations for workers in the maritime and terrestrial trades and argued that maritime laborers should not be accorded the right to strike.78 He also counseled that practical experience in business was more valuable than scholarly training in business or economics.79 Charles-Roux cultivated artists and poets as friends, wrote charming histories of the legends of Provence, and joined the poet Frédéric Mistral’s Félibridge movement to preserve the Occitain language. Unlike Heckel, Charles-Roux spent much of the year in Paris. The 1906 Marseille Exposition hosted 1,800,000 visitors and was a resounding success. The fifty-nine-acre site at the present-day Parc Chanot featured more than fifty pavilions extolling France’s civilizing mission. Visitors strolled on the rue de Saïgon or the rue d’Annam and entered pavilions dedicated to the forests of Indochina and the antiquities of Tunisia. The event showcased Marseille’s place in the larger colonial empire and was mainly a local affair rooted in the place and circumstances of Marseille. National government representatives were absent at the inauguration

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7. Grand Palais of the 1922 Marseille Colonial Exposition. Collection of the author.

and national ministries covered only a tiny fraction of the exposition’s 3,250,000-franc budget.80 The exposition of 1906 and that of 1922 at the same site, and the lavish Paris exposition of 1931 at the Bois de Vincennes, were the largest French colonial expositions.81 Waves of procolonial publicity and rounds of congresses marked these events. For example, Heckel and a school teacher published a lengthy review of colonial education in France, Europe, and America in conjunction with the 1906 Exposition.82 Intended as a text for primary and middle school teachers, it proposed a series of museums of colonial education and suggested colonial topics be included in the dictation exercises students took to learn French.83 A congress also convened in conjunction with the exposition. CharlesRoux served as president of the congress and as editor of its proceedings. Participants, a veritable “Who’s Who” of French colonialism, investigated topics from demography to public works, economics, agriculture, organization of the indigenous labor force, and colonial hygiene and sanitary police.84 Charles-Roux was no stranger to scientific audiences and had once addressed the Association française pour l’avancement des sciences on the dangers of economic protectionism.85 His opening address at the 1906 congress pointed to the seminal role of private-industry and civilian maritime interests in colonization and pondered the best forms of government for France’s colonized peoples. Madagascar’s Queen Ranavalo visited the expo-

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sition and the newly conquered island and its emergent relationship with France was on everyone’s mind. Charles-Roux found Madagascar’s peoples so different from one another in nature and civilization that he felt the island could not be governed by a single universal government policy. “How could Hovas and Betsiléos, whose civilization is relatively advanced,” he asked, “and the Baras or Tanalos, who are nearly savages, or the Sakalaves who not long ago were true brigands, be placed on an equal footing?”86 He closed by asking participants to formulate voeux to guide future actions. Colonial and naval medical men participated in several sections of the congress. Bérenger-Féraud’s old nemesis, Georges Treille, spoke on colonial medical services. Now teaching at the Institut colonial de Marseille, Treille praised the colonial administration for founding a health service for indigenous peoples. To have understood the “benefits of hygiene for our colonial subjects,” he asserted, was “an act of higher humanity and the measure of wise administration.”87 While some historians have interpreted the medicine of Pasteur and Laveran as displacing older public-health strategies, congress participants targeted diseases such as malaria and expressed the wish that France pursue both styles of medicine side by side.88 Other contributions on colonial medicine peppered the proceedings. For Charles-Roux and Heckel the 1906 exposition would be their last as both would be gone when Marseille hosted a second exposition in 1922, originally planned for 1916. Charles-Roux would be remembered as a one who fought for the special places of Marseille and Provence and did so by lobbying against the centralizing tendencies of the Third Republic. The alliance between science and commerce which evolved in Marseille was dynamic, contingent, and dependent on strong personalities such as Heckel and Charles-Roux. Yet not all chamber members supported the Institut colonial’s costly marriage of medicine, science, and commerce. Consolidation seemed prudent and in the wake of the 1906 Exposition the chamber established a kind of federated center for the production of colonial knowledge now named the Institut colonial marseillais. The reconfigured institution combined Heckel’s colonial museum, the chamber’s commercial museum, an information office, a laboratory for the study of grains and starchy plants, and continued the cours coloniaux to which was added a course in Arabic. Incorporation of the “Heckel network” into the chamber’s activities paralleled changes in colonial policy and a shift of focus from the study of colonies and their products to the notion of colonies as markets for metropolitan products.89 Although the chamber was now giving forty thousand francs per year to support these activities, enrollments in the cours coloniaux fell in 1909 and 1910. In 1913, over Heckel’s objec-

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tion, the chamber rented out additional space in the museum building. This required him to move display cases and a lecture room. Resignations ensued at the chamber and a financial crisis deepened.90 In 1914 chamber president Adrien Artaud spoke to a banquet and recalled how “our Institut Colonial was created to render permanent the advantages for the Exposition of 1906. It has not failed in its task; the useful ideas it has propagated, the information it has provided for eight years.”91 The planned exposition of 1916, he continued, would have an even greater impact in virtue of the institute’s ability to conserve the collections of the first exposition, display them to an attentive public, and centralize colonial information.92 But almost immediately France was once again at war and the Institut’s general secretary was mobilized and sent to the front. After Heckel’s passing in 1916 the Musée colonial closed for the duration of hostilities.93 Its postwar history was brighter than that of Bordeaux’s Musée d’ethnographie et d’études coloniales, but it would never again be as vital as it was under Heckel. Heckel’s force of personality had allowed him to negotiate space for his science but in a sense after 1913 his influence was pared down to his academic positions and directorship of the cours coloniaux. As chamber officers fretted about expenses and debated Marseille’s role in colonial commerce, the “action” in terms of colonial medicine in Marseille had moved to a new site, one overlooking the Old Port and in view of the island chateau of Alexandre Dumas’s fabled Count of Monte Cristo. Heckel accumulated yet another simultaneous appointment at this new place of colonial medicine, the École d’application du service de santé colonial, and for a short while participated in the school’s health service for charter ships. Those graduates of the central naval medical school in Bordeaux destined for the new colonial service began classes there in 1907. Before examining the early history of this school organized and initially led by the Creole physician Albert Clarac, and how the place of Marseille featured in the city’s selection as the school’s home, let us first examine in detail Heckel’s style of colonial science and his most famous research effort.

Marseille and Paris: Kola Nuts and Incommensurability The development and testing of the biscuits accélérateurs, cracker-sized pastry cakes containing kola nut extract, sugar, and wheat flour, provides a sterling example of Heckel’s careful pharmacological and botanical research. It also brings into focus two very different styles of physiological medicine, one accepted in Paris, another embraced in Marseille, and each of them spe-

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cific to their respective places and resource endowments. Little was known in France about kola nuts when Heckel and Charles-Frédéric Schlagdenhauffen began their research. Prior to their work the caffeine-laden kola had been called Coffee of Sudan and other local names. In 1876, Schlagdenhauffen, a pharmacologist formerly at the Strasbourg Faculty of Medicine, and Heckel, began a series of monographs on the industrial and medicinal botanical resources of the French colonies. Schlagdenhauffen opted for French citizenship after Alsace fell to Germany and moved with the Faculty to Nancy. Named professor of toxicology there in 1873 he likely encountered Heckel there who soon moved on to the University of Grenoble and from there to Marseille. Their lengthy collaboration produced more than six dozen articles.94 Kola research fit within a series of investigations on oleaginous plants, insecticidal plant extracts, botanical poisons from Gabon, and the bark of the Doundaké plant, an antimalarial and a substitute for quinine which merited clinical trials in a Marseille hospital.95 By the 1893 foundation of the Marseille Colonial Institute, Schlagdenhauffen and Heckel had investigated plants from all the major colonies. Of their numerous research projects, though, the kola investigations where the most protracted and also the most frustrating for Heckel. Heckel first published on kola in an 1883 article which garnered the Bussy Prize from the Association générale des pharmaciens de France. He and Schlagdenhauffen focused on kola’s botanical, chemical, and therapeutic potential and identified a physiologically active substance, kola-red, later renamed kolanin, as something additional to caffeine, tannin, and cacao’s chief alkaloid, theobromine. Like Fonssagrives, Mahé, and a few other naval medical men, Heckel too collaborated on Amedée Dechambre’s massive Dictionnaire Encyclopédique des Sciences médicales and authored the entry on kola published in 1889. There he compared the composition and physiological effects of kola extract with those of quinine and made his case for the specificity of kola’s physiological action. Kola-red, he wrote, “was a more complex product than its name seems to indicate, because it has a special action which incites the nervous system. It will be advisable to examine it again. Do we not find the majority of alkaloids in the red of Quinine?”96 For the next decade Heckel, in a series of ingenious studies linking laboratory and field, championed the efficacy and medicinal specificity of kola-red, later determined to be a kola tannate of caffeine. This monumental effort required numerous steps: fabrication of thousands of kola biscuits with measured doses of extract, usually fifteen milligrams of the substance; distribution of the biscuits to hundreds of experimental

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subjects, mostly human but also equine; and collation and evaluation of the results. Kola was not entirely new to Europe and was used throughout West Africa and Brazil. It was cultivated in the British West Indies and even at Cambridge in the UK, though Heckel credited himself for introducing the plant to the Indian Ocean island colony of Réunion. Heckel employed the naturalist’s methodology he had retained from his navy days to establish an ethnographic portrait of kola’s use, collection, and processing. In African marriage rituals, for example, exchange of white kola powder signaled approval of the union, while exchange of red powder at any time halted prenuptial negotiations. Heckel felt Europeans could benefit from kola’s tonic properties and experimented with different doses and compositions before settling on the biscuits accélérateurs. Marketing these kola biscuits and investigating their special physiological properties became his pet project in the 1880s and early 1890s. Soldiers, mountain climbers, and bicyclists might use it to ward off fatigue. It seemed to moderate altitude sickness and generally improve appetite and performance. Heckel promoted kola mainly as a dietary supplement although he also approved of it as a sole ration for shorter periods. Heckel’s kola research attained national prominence in April of 1890 when an aged Germain Sée, successor of the great clinician Armand Tousseau in the Paris Faculty of Medicine’s chair of Materia Medica and Therapeutics, challenged Heckel and Schlagdenhauffen’s findings before the Académie de médecine. Heckel and Sée shared Alsatian heritage and both wrote on materia medica. Yet their careers had taken widely divergent trajectories. Heckel was a man of the colonies, provinces, and field, someone who had contracted “exotic” diseases while laboring on the navy’s great school of the sea and had worked at three universities prior to settling in Marseille. He was a botanist and pharmacologist, not a clinician. Sée, on the other hand, was a man of the clinic, physiological laboratory, and fixture at the Académie de médecine. His private clients included Napoléon III, Émile Zola, and a host of wealthy foreigners. Yet he was not cosmopolitan in the sense of Heckel. Originally from Metz in eastern France, Sée took his MD from the Paris Faculty in 1846 and made his career there.97 Medical students regarded Sée as a spokesman for materialism and positivism and as applying Claude Bernard’s experimental physiology to medicine. In 1866, the year following publication of Bernard’s Introduction à l’étude de la médecine expérimentale, Sée instituted a course on experimental pathology at the hospital Beaujon. Two years later, in May 1868, the conservative Catholic Cardinal de Bonnechose and his allies in the French

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Senate criticized Sée, who was Jewish, and other medical faculty professors. Bonnechose drew a sharp contrast between the good Christian physician and the social danger posed by atheistic practitioners. Sée protested to the minister of public instruction noting that medicine needed to become scientific and leave behind the artful medicine of observation rooted in vague vitalistic doctrines.98 Ensuing debate in the Senate and Parisian press unleashed a swell of support for Sée from colleagues and students. Sée’s brand of positivist science and materialistic philosophy, of course, continued in the lineage of ideas so derided by Heckel’s former colleagues, Évariste Bertulus, Fonssagrives, and other keepers of vitalism’s flame. The kola dispute surpassed narrow pharmacological and physiological considerations of the extract’s efficacy and spilled over into methodological issues, particularly the status of field studies in physiological research and the reliability of personal attestations. For Heckel it was his best-known piece of research and the culmination of a decade of labors. By the time of Heckel’s book-length response to Sée in 1893, Sée was caught up in another controversy over whether Jews had their own racially determined illnesses.99 Sée caustically rejected such thinking as regards the Jewish race and did so in a vastly firmer manner than contemporary naval physicians such as Armand Corre, Laurent Bérenger-Féraud, and Alexandre Le Dantec, who similarly pondered the couplet of race and illness but did so from the field while assessing yellow fever’s ethic selectivity. Above all Sée’s allegiance was to therapeutic rationalism founded on rigorous physiological research, animal experimentation, and clinical evaluation. In this the dispute between Heckel and Sée is reminiscent of Steven Shapin’s social history of scientific truth telling and gentlemanly science, where social status mediated what was accepted as truth.100 But Heckel was no gentleman. He was an outsider from Provence, a navy veteran, and not among the anointed elite of French medicine. Also, as noted below, he felt betrayed by Sée and his assistant. Kola nut studies were one of many attempts to bring colonial knowledge and its benefits to France. While it is true Europeans may have had selective memories over the abortifacient properties of plants, upon occasion, as with the case of quinine therapy for malaria, they embraced colonial knowledge in fuller fashion.101 Quinine therapy had long been used for a variety of fevers but results obtained at a military hospital in Bône, Algeria, from trials of quinine by Antonini and Maillot in 1832 and 1833, showed its utility for treating malaria, especially when bloodletting was reduced. Determination of a clinically effective dosage of quinine took time to work out but Fonssagrives’s manual of 1856 had recommended its prophylactic use for malaria.102 Kola of course

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differed from quinine in several particulars. The quinine experiments had been founded on clinical trials in a military hospital in response to disease crises in the early stages of a campaign. Kola was a dietary supplement of possible strategic use introduced when France was not formally at war and when many spoke of civilianizing the colonial empire. Still, Germany now owned the land of Heckel’s origins and Sée’s Alsatian forefathers, and the French nation hungered for revenge and restoration of its lost provinces. Sée, innovator of many highly profitable therapeutic remedies, focused on the chemical properties of kola and, specifically, on Heckel’s assertion of kola-red’s ability to provoke physiological actions different from those of caffeine. Heckel claimed to have kept secret the formula for the biscuits accélérateurs because he hoped the French army would use them to enhance performance, fearing, as he said, “an indiscretion vis-à-vis foreign military officers viewing [French] troop movements.”103 In this he was right because German forces utilized kola in World War I. However, in 1888, in conjunction with many different trials of the cakes, he sent materials for testing to a Monsieur Lapique, a bicyclist for the army and Sée’s laboratory chief at the Hôtel-Dieu hospital. At Lapique’s request Heckel also revealed the secret formula. Lapique dutifully tested the concoction on two separate bicycle trips; one of thirty-five kilometers in length where he took fifty grams of kola powder and another of about twenty-two kilometers where he ate two cakes. On the first trip all feelings of hunger vanished within fifteen minutes of the first dose. He reported improved performance and “felt absolutely cheerful and fresh, perhaps even more so than before my departure.”104 This was hardly rigorous physiological science as on the first trip Lapique reported eating lunch and then leaving on his journey at six p.m. Recounting a second trip two days later he gave no indication of departure time or meals. He also revealed to Heckel that he was no longer trying the cakes under experimental conditions but merely eating them now and then to ward off fatigue. Heckel responded to Sée’s criticisms in an article of 1890 and an 1893 book on kola’s pharmacology, physiological dynamics, therapeutic promise, and natural history.105 Both pieces disputed Sée’s key contention that the alkaloid of caffeine was identical to that of kola and that this was kola’s only physiologically active ingredient. The book, Les kolas africains, brimmed with letters of support and personal attestations to the efficacy of the biscuits accélérateurs. The range of field trials was truly astounding. A host of experimenters, from army soldiers, mountain climbers, bicycle club members and Heckel’s fellow pharmacists wrote of careful comparative studies where they recorded taking measured equivalent doses of ei-

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ther coffee or kola and performing heroic feats in the interest of science. All this should have been enough to convince Sée and other “pseudo-scientists more inclined to easy criticism than concerned with demonstrated scientific facts, that [kola] is a product endowed with its own characteristic, as much from the viewpoint of its natural history and chemical composition as from the viewpoint of [its actions as] a physiological agent.”106 An apparently unexpected intervention by a mountain climber clarified a number of methodological issues, raised a masculine point d’honneur and gave the dispute the flavor of a duel.107 Henry Duhamel, one of kola’s most ardent supporters, compared the effects of kola extract and coffee. Duhamel hailed from Gières, near Grenoble in the French Alps, and had first seen snowshoes and skis at the 1878 Universal Exposition. An alpine enthusiast, in 1874 he became the first president of the Club Alpin Français de l’Isère and is reputed to have made twenty-three first ascents on neighboring peaks and also introduced alpine skiing to France.108 Duhamel had little respect for Sée’s brand of abstract physiological science and the findings of his Parisian laboratory. For Duhamel knowledge was intensely personal and the kola question would be decided on the slopes of Mont Blanc. A man of conviction and action he issued a bold challenge; he would demonstrate kola’s efficacy by out hiking any climber of superior ability provided his adversary took only caffeine while he himself took only kola.109 Once the mountain had “floored” the adversary, Duhamel would revivify him with a dose of kola.110 Heckel approved of this method and remarked, “I like to think Monsieur G. Sée, himself, would not challenge the value of this empirical experiment although he never leaves his laboratory.”111 Like so many duels Duhamel’s challenge went unanswered but after the fashion of seconding an offended friend he brokered experiments and provided Heckel with reports of them. In one Duhamel’s friend, a commandant in the fourth regiment of engineers, climbed the Som, a prominent peak of the Chartreuse, and this was after a day of military maneuvers and eating only kola cakes. In still another, a Monsieur Thorant of Duhamel’s Club Alpin Français de l’Isère, nourished only on kola cakes and hiking from 1:00 a.m. to 10:00 p.m., had ascended to the 3,983 meter high summit of the Meije. Duhamel assured Heckel that this was one of the most difficult climbs in all the Alps. He would have known, of course, as he had tried but failed to be the first to reach the Meije’s summit. The kola cakes must have been marvelous as Thorant reported that he had felt as fresh on the summit as he had at the start.112 With the stage set and the challenge issued, climbers from the Alps to Algeria set out to determine the relative merits of kola, caffeine, and in

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some cases cocaine.113 The Club Alpin Français de l’Isère had admitted women since 1885 but all of Heckel’s experimenters were male. This very style of this extralaboratory science, its self-observational nature and manner of experimentation must have been anathema to Sée, who once characterized himself as a clinician with “one foot in the hospital ward and the other in the laboratory.”114 But in which place or places would the question of kola-red’s efficacy and the fate of kola biscuits be decided—in the Alps, Marseille, or Paris? And by which scientific norms, those of the physiological laboratory or those of field? Heckel collated many experiments which he felt resolved, definitively, Sée’s concern over kola-red and did so at a sufficiently scientific level. Heckel needed “seconds” for this duel, collaborators who could do what he himself could not. Heckel had left the navy suffering from degeneration of one leg and sciatica. As he got older these conditions worsened and he could not have resolved the question by self-dosing and exercise. Heckel claimed Sée’s remarks at the Académie de médecine had provoked an avalanche of letters affirming the value of kola. It had been then, he wrote, in 1890, that letters arrived from all sides, communications from people “completely unknown to me,” and for the most part these were “intelligent men, good observers, [who] became interested in the comparative effects of kola and caffeine and spontaneously began to experiment on the fatigue and breathlessness caused by long marches on both plain and mountain.”115 In one set of experiments a fellow pharmacist, Monsieur Tardieu from Sisteron in the Basses-Alpes, came to his aid in the summer of 1890 with a carefully scripted series of four experiments.116 Each of Tardieu’s biscuits weighted ten grams and contained one gram of kola extract. In a first experiment Tardieu rose on June 5 at 6:00 a.m. and left home at 9:00 without having had breakfast. Arriving after a nine-kilometer hike at the foot of the Gache, a wooded peak of the Midi, he consumed two biscuits and drank a quarter liter of water. Over the course of a thirty-five kilometer circumnavigation around the mountain’s base he took only four additional biscuits and water. Arriving home at 7:00 p.m. “without the least fatigue and without much appetite” he had a light dinner and worked until 11:00 p.m.117 He calculated that he had hiked for nine hours, rested for one, and had consumed nine biscuits though his letter, as reproduced by Heckel, indicated consummation of only six. Tardieu’s second experiment began at 4:00 a.m. on June 8 in conjunction with the director of a local school. The two men hiked for nearly eight hours taking only water and eating but five biscuits each on a trip of

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twenty-six kilometers. Tardieu reported “NO BREATHLESSNESS, NO FATIGUE and this was obtained with only five cakes of rations accélératrices.”118 Upon return Tardieu had lunch, read the paper, served customers at his pharmacy, examined students at a local primary school, answered mail, and took a short walk before retiring. On June 19 Tardieu began a third test, or as he called it, a double comparative experiment. That Thursday he repeated the circuit around the base of the Gache. Initially, his trip differed in only two particulars: he left at 4:00 a.m. rather than at 9:00, and he substituted fifteen milligram doses of caffeine for each kola cake taken on the first trip. By 11:30 things were not going well. He had pulled a leg muscle and returned home with hunger gnawing at his stomach. “I will not try caffeine again,” he recorded, “but with Kola everything is different.”119 He did, however, accomplish the comparative leg of the third experiment with kola although it was on another mountain. Heckel, in commenting on Tardieu’s third experiment, revealed where he thought the question of kola-red had been decided. “These experiments of incontestable value . . . clearly establish that there is no parity between the action of free caffeine and that of the alkaloid contained in Kola absorbed in nature.”120 For Heckel then the field, much like the vast school of the sea, and not the physiological laboratory, was the proper place of trial, study, and decision. This of course was reflective of the largely practical and experiential trajectory of naval perspectives on healing and health. The indefatigable Tardieu reneged on his decision to be done with caffeine in a final experiment in July undertaken with a fellow hiker in the Southern Alps. Relating how he had eaten a single kola biscuit prior to sleeping at the trailhead, the two men rose at 3:30 a.m. On the trial by 4:00 a.m. Tardieu consumed fifteen milligrams of caffeine while his companion took one kola biscuit. At 9:00 a.m. in a pass separating the Sasse and Blanche valleys in the Alpes-de-Haute-Provence, his legs gave out and he was over come by hunger. Giving up again on caffeine and quickly eating two kola biscuits he recorded their transformative powers writing “About twenty minutes after taking the two biscuits, I felt more energy in my legs and especially the sensation of hunger disappear. I was able to arrive in Seyne at 10:30 in very proper style for men who have already been hiking since 4 in the morning with only a half-hour of rest.”121 Heckel’s response to these experiments was predictable: “The method involves no error. . . . The conclusion to draw is definite: it is not solely free caffeine which acts in Kola.”122 Sée and Heckel failed to resolve their issues but a decision on the commercial fate of the biscuits accélérateurs had been issued in 1890 three years

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prior to Heckel’s scientific testament in Les kolas africains. The place of commercial decision was neither Sée’s physiological laboratory, nor a pass separating two valleys in the Alps, nor Heckel’s Marseille laboratory—it was in an office at the Ministry of War. The army had been Heckel’s sought-after client for kola cakes and had tested them on men and horses. Heckel might have made a pretty penny had he become a supplier of cakes to the army although in an act of patriotism he apparently offered the formula for free. Sée had won the battle by arguing for the equivalence of caffeine and kola extract before the Académie de médecine. Neither Heckel nor Sée was present when Dr. Léon Colin, the army inspector general for health, recommended the army stick with coffee. The minister of war, then, according to Heckel, destroyed records of its kola experiments. It was most important, wrote Heckel, “that the responsibility of M. G. Sée is established on this point.”123 Sée labored on amid calls to retire and the press running parodies of him as an aged professor. He died in 1896 during a resurgence of antiSemitism and before the second trial of a young Jewish graduate of the École polytechnique, Alfred Dreyfus, and just two years before his patient Émile Zola exposed the affair by penning “J’accuse!” The year Les kolas africains appeared Heckel took leadership of France’s most remarkable constellation of institutions studying colonial medicine, science, and commerce, and these were in Marseille, not Paris. All things considered, aside from this frustration of his kola research, things were looking up for Heckel and what did the judgments of Parisian physiologists matter in Marseille? A decade after Sée’s passing during the exposition and congress he and CharlesRoux were the toast of Marseille. Colonial physicians, particularly those associated with the city’s newest medical institution, the École d’application du service de santé colonial, were represented in many sections of the congress. One of them, now Dr. Albert Clarac, had been a young Creole boy in Martinique when Dr. Armand Corre, the future author of Nos Créoles, had sailed into the harbor of Fort-de-France.

The End of the Old Regime: The École d’application du service de santé colonial Albert Clarac addressed the 1906 colonial congress on sanitary measures in Madagascar where he had worked from 1900 to 1904 under General Joseph Gallieni and interacted with the French hero of Morocco, Colonel Hubert Lyautey.124 Also present at the congress were Professor Paul-Louis Simond of the new École d’application du service de santé colonial, and their im-

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mediate superior, Charles Grall, physician inspector general of colonial troops. All had started their careers in the navy and then opted for the colonial medical service. Professor Alexandre Le Dantec of Bordeaux, whom we met in the previous chapter, was also there and gave an intervention on an outbreak of beriberi on a sail-powered ship ferrying rice from Saigon to Bordeaux.125 Simond, the school’s assistant director, had studied plague in India and shown the role of fleas in its transmission. He had also directed the Pasteur Institute in Saigon from 1898 to 1900, and undertaken yellowfever research in Brazil and Martinique, all of this prior to his posting in Marseille. His congress contribution on yellow fever promoted Walter Reed and Carlos Finlay’s ideas and counseled eradication of Stegoymia fasciata as the surest defense against the disease.126 Not all members of the audience accepted his ideas. For example, Dr. P. Just Navarre, professor of hygiene and colonial climatology at Lyon’s Chamber of Commerce, pointed out that since the etiological agent of yellow fever remained unknown older strategies of rational hygiene ought to remain in place.127 Inspector general Grall agreed and reviewed how France was indeed bringing civilization to colonized peoples via colonial public-health measures.128 Founded in 1905, the École d’application for colonial physicians began taking students in 1907. No longer the young boy enthralled with ships but now a seasoned veteran of the naval medical system, Clarac had collected his medical degree from Paris nearly a decade prior to the founding of Bordeaux’s École centrale and was one of several former naval men to follow Treille to the new colonial medical corps.129 In Clarac’s case, he traded naval service in Cherbourg for a three-year posting in his native Martinique. Students, the vast majority of them graduates of Bordeaux, arrived at the École d’application du service de santé colonial, affectionately called the Pharo, with medical degree in hand. There they underwent a practical orientation similar to the program at the Army’s Val-de-Grâce Hospital in Paris and the navy’s school of application at Toulon, the latter functioning since 1896. Each of these three schools of application, however, retained courses orienting students to the specific administrative regulations of their branch of service and to the discrete nature of their projected conditions of practice. Clarac’s memoirs mention trips from Paris to Marseille to negotiate with municipal authorities and to check on construction. However, they provide only a sparse account of the school’s founding and the first promotion or graduating class of 1907. Clarac felt he had the school in hand by the time the third class graduated and made only briefest mention of subsequent classes or the life of the school prior to his 1912 departure for Indochina. Quite possibly he disliked the drudgery of paperwork and

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administration or found colonial postings more to his liking.130 Possibly too this new generation of cosmopolitan professors, unlike their naval predecessors who often finished their careers in one of the port schools, felt less attached to a place they knew was a temporary step in their career. All the same, the place of Marseille affected Clarac and his family. His daughter married Georges Treille’s cousin, and he wrote of coming to know the city but not its insular citizens who seemed thoroughly provincial in language and life after the fashion of Mahé and Fonssagrives’s characterization of Bretons.131 His great-granddaughter, herself a physician, would one day practice pediatrics there at a clinic near Marseille’s new medical faculty.132 Pharo professors formed a tight-knit and disciplined group of prolific authors who put their stamp on the new colonial medicine. Grall and Clarac, for example, edited an encyclopedia on exotic pathology. Publication of its six volumes straddled World War I and signaled the maturation of tropical medicine. Simond and Clarac coauthored its article on yellow fever, with Clarac reviewing the disease’s medical geography, clinical course, pathological anatomy, and the problems of diagnosis and prognosis, while the slightly younger Simond focused on its epidemiology and prophylaxis.133 Yellow fever remained a threat and in 1908 killed seven people on a ship returning from Martinique in the French port of Saint-Nazaire.134 Studies of Creole populations in Martinique, Guadeloupe, and elsewhere convinced Simond of yellow fever’s racial selectivity. They were not spared by the disease but Creoles like his coauthor and superior seldom died from its effects and developed less severe atypical forms of it although outbreaks were always correlated with the presence of Stegomia and he provided a map of the mosquito’s global distribution.135 Classes at the Pharo began on February 1, 1907. The first “promotion” numbered forty-six: forty-two physicians and four pharmacists. Thirty-nine of them had graduated from Bordeaux where they had entered in 1903, and an additional five had been admitted by examination. As might be expected since the majority of students had gained entry to Bordeaux from the écoles annexes at Brest, Rochefort, and Toulon, about three-quarters were from these traditional maritime regions of France. Most were twenty-five years of age and fourteen had lost either one or both parents. The cohort was not well off and one historian has characterized Pharo graduates as a kind of plebian elite. About half the first class began colonial service in West Africa, while seven sailed for Madagascar and five boarded ship for Indochina. Upon return, the physicians followed courses at diverse venues; some studied dentistry in Paris while others took advanced training at the Pasteur Institutes of Paris or Lille, and one pursued studies in London.

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Classes at the Pharo would be suspended during World War I, and African troops billeted on the premises. By the end of hostilities, a fourth of physicians in the promotion of 1907 had perished.136 Between 1907 and 1914 some 267 postgraduate students in medicine and pharmacy passed through the Pharo. Bordeaux continued to provide more than eight of every ten students, and the rest entered by concours. Professors were appointed by the minister of war who drew faculty from the local medical school, the Institut colonial, and from physicians in the new medical service. These latter, unlike professors in the civilian faculties or those at the former port schools, rotated through their posts to higher grades and other duties. Students began school in January, stayed in town, and took clinical rounds at Marseille’s army hospital. Final examinations and classification occurred in September. Teaching was divided among six chairs, each seconded by an adjunct. The course of study at the Pharo, as at the other two schools of application in Toulon and Paris, was that of a medical finishing school intended to provide practical skills needed for a particular branch of service. In addition to surgery and some chemistry and toxicology, subjects included internal medicine and illnesses of the warm countries. Students also received training in bacteriology, parasitology, military and colonial hygiene, prophylaxis of tropical diseases, sanitary police, and domestic and colonial health services.137 Why, it might be asked, had Marseille rather than Lyon, Bordeaux or another site with a full medical faculty been selected for the school, and how did Marseille’s place affect the process? A decree of June 11, 1901, mandated that the new school should function by 1903 so there was some rush in the matter, but a number of elements led to Marseille’s selection. City fathers felt they had lost out to Bordeaux not only as a site of a medical faculty but also for the navy’s École central in 1890. From the army’s point of view, it might have been better to group instructional activities in Lyon. But Lyon soon dropped out and when the minister of war sent the director of the colonial health service to Marseille in March of 1902 the contest was between Bordeaux and Marseille.138 An internal report compared point by point the advantages of the two cities noting their respective colonial institutes, universities, and port traffic. It also commented favorably on Heckel’s creations and found it fortunate that “a colonial botanical garden and colonial museum . . . complete the totality of resources Marseille presents for the study of colonial topics.”139 The report continued: But the superiority of this port relative to the advantages which it offers . . . stems especially from its geographical situation which places it in daily re-

The Emergence of Colonial Medicine in Marseille / 185 lations with all colonies French as well as foreign. 17,000 ships per year, more than 300,000 travelers, at least 1,800 of whom are ill from afflictions contracted in the colonies. Consequently, it is unquestionable that Marseille possesses resources found no where else in the same degree for clinical education in colonial medicine.140

Marseille, then, was selected as the site because of its clinical materials, which derived from its geographical, commercial, and disease-laden place. It was the metropole of insalubrity and the specificity of its disease ecology clinched the deal. In the early 1890s the Marseille City Council tried again to transform its medical school into a Faculty but again the effort came to naught. A positive effect was that the École de plein exercice eventually moved to the Pharo grounds where President Félix Faure inaugurated it on March 7, 1896.141 In 1903, with the quarters for the new colonial medical school still incomplete, the Ministry of War delegated a Monsieur Martine to investigate the situation in Marseille. Martine arrived in August and quickly discerned that the city had not met its obligations and hinted to authorities that Bordeaux was still in the running.142 Among his tasks was assuaging the fears of Professor Auguste Queirel, who taught military surgery and obstetrics at the municipal école. Queirel pointedly told Martine he resented the closed and military character of the new school and considered it an antagonistic rival to what the civilian École was trying to accomplish.143 But Martine won over Queirel. The army could be diplomatic when needed and civilian documents from the interwar period refer to the Pharo as an army school of mixed civilian and military nature, although Clarac, perhaps because the Ministry of War ran the school, still wrote of it as a Valde-Grâce in Marseille.144 At the somewhat delayed inauguration of the École d’application du service de santé colonial on September 29, 1907, Clarac singled out Heckel from the audience as a “sure friend, a scientist initiated beyond all others in the questions that interest us; knowing that one must not be content to stir up ideas but [also] know how to give them embodiment and make them a reality.”145 Joining Clarac at the podium were General Louis Archinard, the army hero credited with pacifying the French Sudan, a representative of the Ministry of the Colonies, and M. Olivier from the mayor’s office, who welcomed the new school and once again underscored the city council’s resolve to fight for a full Faculty of Medicine which was the “legitimate and forceful compliment of the school which we inaugurate.”146 As war broke out in Europe, the aged Heckel called for a colonial medi-

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cine capable of responding to the contingencies of war. The colonies, formerly valued for agricultural products and industrial feedstuffs, or as bargaining chips in European politics, were now promoted as reservoirs of men for battle. French medical practitioners in the colonies, he insisted, required broad training not only in science and hygiene, but also in tropical demography, a science crafted to produce soldiers and laborers.147 Perhaps he remembered then how a younger man, the French apostle of medical parasitology, Professor Raphaël Blanchard of Paris, had come to the 1906 colonial exposition and how proud he had been for this recognition by his Parisian acquaintance who brought colored posters detailing the curious lives of mosquitoes and tsetse flies and spoke of how those lives intersected with humans in perfidious ways.148 All too soon, research by Pierre Jandeau, a young physician who quickly threw together a thèse de guerre, would implicate kola nut use in hypertension and as a factor in the high rates of pneumonia suffered by African troops billeted near Bordeaux.149 But by that time Heckel was gone. The long-awaited transformation of the Marseille École de plein exercice into a full faculty of medicine finally occurred at an appropriate date, 1930, the centenary of the fall of the city of Algiers to French forces.150 Many Marseille physicians and politicians labored long and hard for that moment. For example in March 1896 when President Félix Faure had come to town to inaugurate the école’s new Institute of Anatomy he was greeted by Victor Audibert, a young medical student who shouted, “Vive Félix Faure, la Faculté, la Faculté,” and shook his hand. Audibert passed his medical thesis at Montpellier in 1903 and was a professor at his old school in 1907. In November of 1919 Dr. Siméon Flaissières was again elected mayor. Audibert was also on the slate and Flaissières entrusted him with higher education issues. In 1920 Flaissières warmed to the idea of a medical faculty in Marseille after the city council in neighboring Aix expressed support. Audibert doggedly pursued the transformation and even cornered the mayor of Lyon, Édouard Herriot, over dinner and persuaded him to write to Paris in support of Marseille.151 In September of 1920, Professor Roger, dean of the Paris Faculty of Medicine, inspected facilities in Marseille and recommended elevation to Faculty status. The report became a matter of public record on December 13, 1922, and suggested a faculty of general and colonial medicine and pharmacy but was contradictory on what needed to be done first in terms of a library, new buildings at Saint Charles and the Faculty of Sciences, and the role of the Institut colonial.152 Léon Imbert, the last director of the École de plein exercice, spent much of his time negotiating with Parisian

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authorities and raising money. By his account the world of tropical and colonial medicine was in a muddle when he arrived in Marseille. The aged Georges Treille, the founder of the colonial medical corps and Clarac’s relative by marriage, had had very few patients at the Hôtel-Dieu, and he soon switched to treat patients with nonexotic conditions. Treille’s successor had done no better and soon the tropical disease clinic had failed.153 Some things did not change, however, and Marseille’s old nemesis, the Montpellier Faculty of Medicine, campaigned against the new school but finally lost a crucial vote in the Senate and National Assembly in December 1929. The new Marseille Faculty of Medicine opened in May of 1930 without proper clinical facilities. The Chamber of Commerce spearheaded a subscription for twenty million francs and again the city followed suit. Tensions persisted between Pharo professors and those at the new Faculty. Imbert felt Pharo professors failed to reciprocate his goodwill and at one point in the struggling Faculty’s existence the army considered purchasing land adjacent to the Pharo for another military hospital.154 The monetary issues of the young faculty found some solution in 1934 in a style typical of the place that was Marseille. Imbert and Victor Audibert, and a new addition to the staff from Paris, a young parasitologist by the name of Charles Joyeux who had trained at Val-de-Grâce and in Raphaël Blanchard’s parasitological laboratory, learned by chance that Monsieur Messimy from the Ministry of Colonies was returning from a mission to Morocco and would be landing by pontoon plane at the Marseille airport. The trio piled into Imbert’s car, more or less hijacked Messimy from the airport, and put a large dossier in his lap extolling the virtues of having a wellfunded civilian institute of colonial medicine in Marseille. Messimy’s unexpected ride ended at the Pharo. According to Imbert, Messimy kept telling them of his “amused astonishment at his kidnapping.”155 But the tactic had the desired effect, and on October 7, 1934, the Ministry of Colonies authorized funds to support the new Faculty’s Institute of Colonial Medicine. Heckel would have been proud of Audibert and Imbert’s ability to embody ideas and also that the Marseille medical world now attracted candidates like Joyeux from Paris. Changes in the regulatory world of colonial medicine had effaced the primacy of the original naval port schools. With the possible exception of Toulon, none of them now compared favorably with the instructional opportunities in colonial medicine at Marseille and Bordeaux.

The following chapter examines the institutionalization of colonial and tropical medicine in Paris, and particularly Raphaël Blanchard’s promo-

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tion of medical parasitology. Paris was also home to the Pasteur Institute, a font of the new science of bacteriology, and also to the army’s postgraduate medical school at Val-de-Grâce. On balance, parasitology, rather than bacteriology, became the pivot of the new tropical medicine. Blanchard, and the group of talented young researchers he supported in Paris, from Joyeux, to the sleeping sickness expert Émile Brumpt, turned their attentions to the colonies, though for different reasons and in different ways.

SIX

Colonial Medicine at the Paris Faculty of Medicine

The rapid movement which leads medicine into the current of parasitology cannot be stopped. In reality these two branches of general biology seem more or less distinct, but, as two rivers whose waters meet and flow side by side for a certain distance soon come together, so parasitology may include almost the entire domain of medicine.1 —Raphaël Blanchard

The Place of Paris The career of this chapter’s central personage, parasitologist and Paris Faculty of Medicine professor Raphaël Blanchard, spanned tumultuous reforms in naval and colonial medicine. Blanchard exploited the new regulatory regime of colonial medicine and developed a market for his talents in the study of vector-borne diseases. His career exemplifies how Parisian scientists and institutions extended their reach to the colonies and appropriated portions of colonial medicine to civil institutions. The vast scale of Paris, its distance from the maritime sphere, and its status as the intellectual, educational, and governmental hub of France distinguishes it from coastal cities examined in this book. Blanchard would argue that the city’s concentration of commercial and cultural resources constituted a major reason for creating an institute of colonial medicine in the city.2 His lifeworld intersected with and profited from the new regulatory regime of colonial medicine. Paris had been Europe’s most populous city at the time of fundamental ordinance in 1689.3 The seat of government returned to the city from Versailles after the revolution and its reconstituted Faculty of Medicine began the nineteenth century as the largest and most powerful of the na-

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tion’s three medical faculties. As previously noted, chambers of commerce attended mainly to local interests and few of them had stood in solidarity with La Rochelle’s chamber when the city lost the Quebec trade in the 1760s.4 Parisian merchants had formed a professional interest corporation called the Six Corps before the revolution. After the revolution they founded the Chambre de commerce de Paris which subsumed functions of the Six Corps and a Council of Commerce. Unlike the chamber in Marseille, its members had only moderate interest in colonial trade and mainly corresponded with the Préfecture de la Seine and the Ministries of the Interior and Commerce on transportation and customs issues. Attributes of place channeled the chamber’s role in civic life. The Paris Chamber was less prominent in the workings of the city than similar organizations were in Marseille and possibly Bordeaux. Chambers of Commerce in port cities like Marseille, where economic life depended in large measure on shipping and the processing of oils and sugar, focused squarely on colonial connections and issues. The commercial situation of Paris was more diffuse and varied, and the chamber evolved into a significant provider of business information to legislators and government officials. Its statistical inquiry of 1847–48 enumerated 325 enterprises employing six or more workers, and the group assembled other statistical inquiries during the Second Empire and Third Republic.5 By 1895 chamber representatives sat on some two dozen consultative committees spread over six different ministries giving advice on topics from child labor to grain and colonial commerce.6 Commerce advanced in tandem with population growth. Paris began the nineteenth century with some 546,856 inhabitants and nearly doubled in size by 1846. Average population density rose from 159 per hectare in 1801 to 307 in 1846.7 The demographer and historian Louis Chevalier discerned three phases in the growth of the city. The first was a period of fairly ordered expansion beginning in 1801 and ending in 1836, when nearly nine hundred thousand lived within the city’s walls, and the city’s peripheral suburbs grew more rapidly than the city itself. In the next two decades, from 1836 to 1856, the rate of demographic expansion surpassed that of the previous years but was highly uneven. During the early Second Empire the city and near suburbs experienced frenzied growth and by 1896 the city was home to 2.5 million. In that year, more than one of every two Parisians classified among the “active” population worked in the industrial sector, and about one in five labored in commerce.8 Population density in the city and the surrounding Île-de-France exceeded the French average by fourfold, and waves of epidemic cholera as

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well as outbreaks of revolutionary violence altered the cityscape and lives of Parisians. Migration was an important driver of population growth and under Napoléon III Alsatian and German bourgeoisie swelled the city. Within a few years, after the shelling of the city and the nation’s defeat in the Franco-Prussian War, the government suspended immigration and forced thirty thousand Germans from the city. Upon transition to a fragile Third Republic many factories closed. This then was the Paris of Raphaël Blanchard, an ambitious student migrant to the city in October 1874.9 Few Parisians outside of military, governmental, and commercial circles concerned themselves with naval issues or colonial diseases. The city had neither the arsenals, bagnes nor ports to rival those of Toulon or Brest. Still, traffic on the Seine River was substantial and while it is difficult to imagine Paris as a seaport, Henri IV and others had imagined just such a project. In the nineteenth century, Le Havre at the mouth of the Seine River received oceanic cargoes bound for Paris, the usual route being shipment upstream to Rouen and then an additional transfer to flat-bottomed ships which continued on to Paris. Schemes of the 1820s to connect Paris to the sea considered cleaning silt from the Seine and cutting a canal to Dieppe or possibly Rouen. The projects failed to materialize but elicited complaints from members of the Marseille Chamber of Commerce. Even during Blanchard’s career in the mature Third Republic, long after Paris had become the hub of an enviable railway system, the hydrographic engineer Bouquet de la Gyre insisted on the value of connecting Paris to the sea via a canal terminating at Rouen.10 Without the colonial connections of Marseille, London, or Liverpool, it was somewhat illogical that the Paris Faculty of Medicine would become a center for training in colonial medicine. Yet this is what happened. Unlike physicians at the army and civilian medical schools at Marseille, Blanchard had infrequent access to patients suffering from tropical or colonial diseases. Also, his work at the Paris Faculty of Medicine was accomplished in the shadow of two Parisian institutions celebrated for their work on colonial diseases. The first of these was the army postgraduate medical school and hospital, the École du Val-de-Grâce, where army physicians with significant field experience held temporary posts. For example, the malariologist Charles Louis Alphonse Laveran, with whom Blanchard coauthored an 1895 study on diseases of the blood, worked there on a number of occasions, notably as the chair of military hygiene from 1884 to 1894.11 Laveran left the army in 1896 to become an honorary researcher at the second Parisian institution concerned with colonial diseases, the Institut Pasteur.

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Blanchard admired Louis Pasteur and the Institut Pasteur. The Pasteur Institute, which opened in 1888 after Pasteur’s celebrated work on rabies, was an inspiration for Blanchard’s own more modest institution. The two institutions were vastly different, however, and they were part of a new wave of French scientific and social scientific institutions which studied the colonies and its peoples.12 While the Pasteur Institute hosted an important course on microbiology, it was funded by a private foundation and focused mainly on bacteriological research and vaccine production. Pasteur and his associates, beginning with the study of cholera in Alexandria, Egypt, in 1883, traveled overseas to study diseases on site. They also created institutions in the colonies and elsewhere which studied public health and agriculture from diverse angles. For example, Pasteur’s nephew, Adrien Loir, considered a Pasteur Institute in Australia to combat rabbit populations in 1888, and later, in 1891, Albert Calmette, started a laboratory in Saigon. Located in a French military hospital, the Saigon laboratory investigated rabies, cholera, dysentery, leprosy, and studied serotherapy for cobra bites. It later transformed into a Pasteur Institute and many others followed in France, Africa, and around the world.13 In contrast, Blanchard’s Institute of Colonial Medicine, described in detail later in this chapter, was a ward of the French university system. It would never have vast resources or branches overseas and focused on training civil physicians in French approaches to tropical diseases. Above all, it was a Parisian academic institution much as Blanchard himself was a Parisian academic personage. It reflected Blanchard’s personal interests and his personal history which included training in natural history and parasitology, and a passion for scientific internationalism.

Apprenticeships in Zoology, Physiology, and Medicine Raphaël Anatole Émile Blanchard was born on February 28, 1857, in Saint-Christophe-sur-le-Nais, a commune of Indre-et-Loire located some 150 miles southwest of Paris where his father was a poet and playwright.14 Young Raphaël was one of a small number of people from his department who migrated to Paris. Their tiny proportion of the Parisian population was essentially constant for much of the nineteenth century and numbered 15,012 in 1891.15 Upon arrival in Paris in 1874 at the age of seventeen, he sampled courses at the Faculty of Medicine, and after hearing lectures from the chair of Histology, Charles Robin, he devoted himself to microscopy, the foundation of parasitological investigations.16 Blanchard’s microscopical studies continued in the path of another medical migrant to Paris,

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the Hungarian physician David Gruby, who had also used the instrument to study human and animal diseases.17 Somewhat before Blanchard’s arrival academicians at the Académie de médecine and the Parisian medical press had debated the proper use of the microscope in medical oncology and noted how the more utilitarian French school of medical microscopy differed from the pure microscopic studies undertaken in Germany.18 Blanchard soon gained familiarity with both traditions. In the spring of 1876 Blanchard began working in Robin’s laboratory of zoological histology at the Sorbonne’s École pratique des hautes études. By this time Claude Bernard’s An Introduction to the Study of Experimental Medicine, published a decade earlier, and other writings, had emboldened some French physicians to tackle the thorny problems of disease etiology. A few months later, in the summer of 1876, less than two years after his arrival in the city, Blanchard became a founding member of the Société zoologique de France. The initial core of this group included a coterie of amateur naturalists and a sprinkling of aide-naturalistes from the museum. Problems soon ensued and in June of 1880 the group’s main founder, Aimé Bouvier, a merchant in natural historical materials, resigned and the group’s treasury was short the considerable sum of five thousand francs, an amount equal to about half the yearly salary for a museum professor.19 Blanchard stepped in and stabilized things as the group’s general secretary, a post he held until 1900. Additionally, he would serve as its president in 1914. The general secretary’s post was the first of many offices he would hold in Parisian scientific circles. These enabled him to cultivate relationships with the scientific mandarins of the era including the museum’s professor of mammals and birds, Alphonse Milne-Edwards, and other museum scientists such as the zoologists Édmond Perier and Léon Vaillant. Society work also kept him in touch with the problems of zoological nomenclature, a pressing issue in medical parasitology. Robin won election to the French Senate in January of 1876 and was seldom in the laboratory but Georges Pouchet, the laboratory’s assistant director, took Blanchard on as a student. Georges Pouchet’s father Félix Pouchet had been Pasteur’s adversary in studies of spontaneous generation. Blanchard became Pouchet’s protégé and learned microscopic technique from him and the laboratory’s préparateur, Frédéric Tourneux. A few months later Pouchet moved to the École normale supérieure as maître de conferences for zoology and Blanchard followed. There he assisted Pouchet with teratological investigations of chickens and as a personal secretary charged with various tasks including revisions of Pouchet’s textbook on histology.20

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Pouchet demanded much of Blanchard and even made him pay for breaking laboratory equipment. He noted Blanchard’s ability to read English and insisted that he also learn German. Blanchard had his doubts about going to Germany to learn German and claimed his mother was not enthusiastic about the idea. But Pouchet persisted and convinced Mme. Blanchard this was the best move for young Raphaël’s career.21 Pouchet also secured a fellowship for Blanchard from the Paris City Council which enabled the young man to spend a year following lecturers and frequenting laboratories in Germany and Austria. It was one of the first such fellowships after the Franco-Prussian War, and Blanchard left Paris for Strasbourg on August 6, 1877. Blanchard studied in Vienna at Samuel Leopold Schenk’s Institute of Embryology. He also traveled to centers of the new physiology, notably to Leipzig where he visited the new anatomical institute of Wilhelm His, and to Berlin where he commented on laboratory facilities at the institutes of Hermann von Helmholtz and Rudolf Virchow. At the end of the year he had gathered certificates from his hosts allowing him to waive the last four of the sixteen inscriptions required for his medical degree at Paris.22 In 1880 he returned to Germany on another fellowship and this time also traveled to Russia and Scandinavia, publishing excerpts on his travels in Progrès médical and as a monograph.23 Blanchard returned to Paris advocating reform in French laboratories and admiring some German scientists and disliking others. Other French scientists had arrived at similar conclusions, but Blanchard went further than most in support of internationalism and understanding Germanic science by authoring a glossary of German and French anatomical and zoological terms.24 Yet his relationship with Germany and German science was fraught with tension, and he clashed with German taxonomists over the use of Latin in classification after becoming president of the Permanent International Commission on Zoological Nomenclature in 1895. Later, in wartime, he lashed out at the German nation and its “barbarian hordes” while retaining respect for Germany laboratory methods.25 Although the German naval medical school at Hamburg trained physicians for service around the world, the country did not have extensive colonial holdings and Blanchard’s “colonial turn” began while working as a préparateur in Paul Bert’s laboratory in the late 1870s and early 1880s. Bert, a member of the Chamber of Deputies and minister of public instruction, championed the French colonial mission and finished his career as a governor of Annam and Tonkin.26 Bert had succeeded his mentor Claude Bernard in the Sorbonne’s chair of Physiology in 1869 and investigated the

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comparative physiology of respiration, blood chemistry, and other topics. His magisterial La pression barométrique, recherches de physiologie expérimentale appeared in 1878. Blanchard arrived while Bert was still interested in barometric pressure and physiology, experimenting with anesthesia, and publishing on anthrax and rabies. Blanchard claimed his medical degree in 1880 with a thesis examining Bert’s work on the anesthetic properties of nitrous oxide.27 Soon he was teaching natural history at Lycée Louis Le Grand and Lycée Saint-Louis. Teaching reviews from 1881 described him as a serious, devoted, and conscientious professor, while those of 1884 remarked on how his classes lacked discipline and students seemed lost among the details of anatomy and technical terminology. In 1882 Blanchard was teaching ten hours per week and avoiding additional instructional duties. By then he was heavily invested in research and on the path to the agrégation, the examination required to enter the professoriate.28 Bert’s laboratory afforded Blanchard opportunities for original research and publication across a wide spectrum of natural history, biology, and anthropology. Investigations of cartilaginous fish, mollusks, and coccidian parasites found their way into print, as did studies on muscle motion and the pathology of divers’ disease.29 With his fellow laboratory assistant, Jules Regnard, Blanchard gained notoriety in Parisian scientific circles by undertaking vivisectional investigations of the blood chemistry and respiratory capacity of crocodiles at the Sorbonne’s physiological laboratory. The crocodiles, some nearly three meters in length and weighing seventy to one hundred kilograms, were shipped from Saigon on a naval vessel to Toulon where the animals boarded an express train to Paris.30 Blanchard developed an interest in race and maintained it throughout his career. A coauthored textbook on zoology with Bert drew on passages from Darwin’s Descent of Man to support discussion of human racial differences and offered a fairly standard account of racial groupings by dividing humanity into white, yellow, black, and red races.31 While it is difficult to disentangle the thoughts of Bert from those of Blanchard, the authors avoided supporting either monogenism or polygenism and portrayed races as subject to different rates of development though they considered the yellow race incapable of sustained progress. Like other Europeans, they too constructed racial hierarchies founded on perceived cultural level and anatomical information. They also viewed contemporary “primitive” peoples as caught in lower stages of civilization and asserted that Europeans could assist these unfortunates to accomplish steps toward a fuller humanity. In the 1880s Blanchard taught briefly at the École d’anthropologie. His

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course revealed a talent for broad scientific and philosophical endeavors and for the synthesis of current scientific findings. The course considered the organization of matter and evaluated explanations of life’s origin including spontaneous generation, divine creation, and extraterrestrial origin. Like other Third Republic scientists he inclined toward material explanations and did not imply the presence of God at creation. The logical candidate for life’s origin was spontaneous generation, possibly a topic of discussion when he had worked with the younger Pouchet. Blanchard interpreted Pasteur’s work on the subject as applicable only to the experiments he had conducted in the laboratory and urged his listeners to recognize this was not a universal disproof of spontaneous generation for all geological time. In this, Blanchard diverged from the actualism held dear by Darwin and others.32 Blanchard’s early anthropological work revisited Cuvier’s autopsy of Saartjie Baartman, the young African woman exhibited though out Europe as the Hottentot Venus.33 His method of investigation was mainly archival and led to discovery of an unpublished memoir of 1805 by François Péron and Charles Lesueur, two naturalists who had sailed to Australia with Nicolas Baudin. Cuvier had argued that Baartman’s hypertrophied buttocks signaled an affinity with apes. Blanchard thought that Cuvier had confused Hottentot and Bushman peoples and that Baartman was likely Bushman and that Hottentots had arisen from intermixture between Bushman and invading Caffres. Moreover, evidence suggested that the hypertrophied buttocks of the two tribes lacked blood vessels and were not comparable to those of some apes. This condition, he thought, was an atavistic trait of minor value for taxonomy. His general conclusions, though, were similar to Cuvier’s as regards the primitive nature of Bushman people whom he thought resided at the very bottom of the hierarchy of civilization. Blanchard continued to study race and health, race and taxonomy, and piebaldism even as his career drew him nearer to medical parasitology and medical administration.

Medicine and Natural History at the Paris Faculty of Medicine In 1883 Blanchard became the youngest candidate to pass the agrégation at the Paris Faculty of Medicine and was soon teaching zoology to first-year medical students. He was expected to second the chair of Medical Natural History, the botanist Henri-Ernest Baillon, who had held the post since 1863. Blanchard focused resolutely on medical zoology as had Baillon’s predecessor, Charles Alfred Moquin-Tandon, whose interests and erudition

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resembled Blanchard’s own. Both men provided medical students with a respectable knowledge of a larger scientific culture and tradition. The naturalist Jean-Henri Fabre had described Moquin-Tandon as a “ naturalist with far-reaching ideas, a philosopher who soared above petty details to comprehensive views of life, a writer, a poet who knew how to clothe the naked truth with the magic mantle of the glowing word.”34 In terms of eloquence, at least, Blanchard was cut from the same cloth. Blanchard and Moquin-Tandon also shared a love of the arts. Blanchard was attracted by the painting of his era, photography, history, vernacular architecture, and the study of sundials.35 He also pioneered the study of “casta” paintings that depicted the races of Latin America, and thought that Spanish colonizers had created the genre to distinguish themselves from the mixed-race peoples they governed.36 As with his previous investigations of Hottentot anatomy, Blanchard wrote of the hierarchical arrangements of races and did so from a natural historical and ethnological viewpoint. For his part Moquin-Tandon inclined toward poetry which he composed and published in his native provençale language. Additionally, both men published on leeches and were fascinated by these curious animals.37 Blanchard wrote at a time of high imperialism, authoring studies of both French and North African leeches.38 Finally, Moquin-Tandon, like Blanchard after him, signaled the utility of medical natural history for the colonial enterprise and identified the horse leech as one of the main causes of disease in Algeria.39 Blanchard, however, was the institution builder of the two and created enduring institutions which made parasitology and medical entomology relevant to academic medicine and colonial development. Blanchard’s early lectures on medical zoology focused on the life cycles of parasites. It was, as he never tired of claiming, the first such comprehensive class ever given at a French medical faculty. Like earlier scientists such as the zoologist Isidore Geoffroy Saint-Hilaire and the anthropologist Paul Broca, Blanchard spent little time in the field and appealed to naval physicians, surgeons, and explorers to collect materials for study.40 Blanchard’s efforts expanded the pathological and parasitological collections of the Faculty’s anatomical museum, the Musée Orfila. He also issued instructions to naval medical men and asked them to collect leeches, helminths, nematodes, mosquitoes, and all manner of materials illuminating the mysteries of “ethnic pathology.”41 The regulatory world of French civil medicine, like that of naval medicine, transformed just as Blanchard tried to claim his reward for laboring as Baillon’s agrégé. After nine years, the maximum for such a position, Baillon had not retired and Blanchard became an agrégé libre without teaching

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duties. In 1894 at the age of thirty-seven he won election to the Académie de médecine.42 When Baillon fell dead in the Faculty’s botanical garden in July of 1895, it was logical that Blanchard assume his Chair. His research productions surpassed most of his peers and he had an international reputation. Also, his teaching was well-received. Jules Guiart, a student who later became a distinguished medical parasitologist at the Lyon Faculty of Medicine, remembered how he and others in the 1890s were so appreciative of the eloquence and organization of Blanchard’s lectures that they had once followed him home to salute and applaud him outside his apartment on the rue du Luxembourg.43 Yet the Faculty took Baillon’s passing as an opportunity to evaluate the role of the chair of medical natural history, so long associated with a descriptive botany now seemingly marginal to medicine. In the mid-nineteenth century first-year medical students had taken classes in both zoology and botany as it was thought that natural history constituted a valuable model for nosology. But by Blanchard’s era, reforms in medical and university studies, especially the aforementioned P. C. N. reform of 1893 and its many modifications, required students bound for medical careers to first complete a preparatory year of courses in the physical, chemical, and natural sciences. These reforms demoted botany and much of natural history to premedical subjects, something now properly taught in the science faculties. In this age of Pasteur and Robert Koch, what remained of natural history in medicine was scattered among third- and fourth-year courses. After Baillon’s death his Faculty of Medicine classes went untaught for two years and the Paris Faculty of Sciences took over the botanical garden in 1897. Simultaneously, changes in regulations were opening a small market for civilian and international students of colonial medicine. Promotion of medical parasitology and the changing dynamics of empire framed Blanchard’s trajectory. Almost immediately, however, a messy intrigue endangered his career.

Settling Scores: The “Affaire Blanchard-Heim” Blanchard finally won appointment to the long sought chair of Medical Natural History on July 25, 1897. His teaching debut in March of 1898 was memorable as a hundred or so whistling agitators greeted him and the Faculty’s dean, Paul Brouardel. The demonstration seemed to be linked to the Faculty and Blanchard’s treatment of another Faculty agrégé Dr. FrédéricLouis Heim. The crowd shouted down Blanchard and the dean ended the lecture but resolved to check student registrations at the next class. When

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Blanchard next took the podium that class too was cancelled when some 150 people broke down a door and spilled into the amphitheater and demanded Blanchard’s resignation. The dean discerned three separate groups; one hissed and whistled, another hissed and laughed, and a third seemed to be journalists and the assorted curious. The crowd also disrupted the class following Blanchard’s by trumpeting animal cries and by singing the “Marseillaise” and a popular Russian hymn. The Faculty quickly suspended Blanchard and sent him to the provinces to grade examinations.44 The exile took him to Rouen, Caen, Rennes, Nantes, Angers, and Tours but even then the controversy followed and sometimes preceded him. Posters of what was labeled the “Affaire Blanchard-Heim” had been sent to professors at the colleges and schools he visited. The “Affaire Blanchard-Heim” was the most prominent of a small series of intrigues and legal issues befalling Blanchard.45 The confrontation with the botanist Heim, who had also worked under Baillon, was the most damaging and intense of Blanchard’s career. It also implicated the extremely proper Blanchard as a slanderer and resulted in Heim’s dismissal from the Faculty. Animosity between the two had been palpable since at least since 1891 when Blanchard had cast the lone dissenting vote at Heim’s examination for the agrégation. In 1892, when Heim had begun teaching he was greeted with boos and cries of “Long live Blanchard,” and Heim alleged that Blanchard had called him a “dirty Jew,” taken notes of his lectures, and spread rumors of Heim’s incompetence.46 At Baillon’s death Heim became interim director of the Faculty’s botanical garden. Part of the drama concerned ownership of collections of rare colonial flora from Madagascar on loan from the museum and the explorer Alfred Grandidier, and materials from the Exposition permanente des colonies, collected by Heim and placed on loan at the Faculty of Medicine and Heckel’s Institut colonial in Marseille. In September 1897 Blanchard and Heckel had examined these latter materials and discovered cartons of Baillon’s research notes. Heckel also examined Heim’s personal collection of plants and confirmed that many specimens had labels or traces of labels from the museum.47 Baillon had had borrowing privileges at the museum and made liberal use of their botanical collections. He also had books from at least two units of the medical faculty, private books, and voluminous notes and research materials. His son, André Baillon, a medical student at the Faculty, assured investigators that his father had not given any of these objects to Heim but that Heim had access to them as he had retained a key to the elder Baillon’s apartment.48

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Investigators concluded that Heim had first avoided composing an inventory of his predecessor’s collections, and later altered a previous inventory. More damning still was the conclusion that Heim had fabricated publications in an application to become Blanchard’s laboratory manager and possibly plagiarized the research of his mentor. As if this were not enough, his signature was found on books also bearing Baillon’s signature, and in some of them the dedications had been erased or cut off. Finally, Heim’s personal labels were also discovered on several microscopes belonging to the Faculty.49 The university forced Heim out in November of 1897. After leaving the Faculty Heim became a professor at the École nationale supérieure d’agriculture colonial, and held two professorships at the Conservatoire national des arts et métiers, one in agricultural production, and another in industrial hygiene. He also published widely on colonial botany and agronomy including cotton in North Africa.50 Both men remained active in colonial circles, but Blanchard concentrated on animals, especially parasitical ones, and consolidated his position at the Faculty.

Applied Natural History, Parasitology, and Medicine When the faculty confirmed Blanchard’s appointment as a professor in 1897 he tried to adapt his chair to the new regulatory regime of colonial medicine and pressed to rename his post the chair of Parasitology. The Faculty finally assented to a name change in November 1906 and transformed the chair of Medical Natural History into the chair of Parasitology and Medical Natural History. According to Blanchard this long sought title change definitively ended the teaching of purely descriptive zoology and botany at the Faculty. In terms of recognition of parasitology’s value to medicine, Paris was somewhat behind the Lille Faculty of Medicine where in 1894 Alfred Giard had become France’s first incumbent of a chair of parasitology, and of course Alexander Le Dantec had taken up a chair of colonial medicine at Bordeaux in 1902.51 Blanchard’s views on natural history and its applications to medicine and colonialism likely challenged views held by some of his older colleagues. Most colonial diseases and many others, he argued, were parasitical in origin and could only be addressed through extra clinical measures and study. In ferreting out life cycles and taxonomy and experimenting with disease-causing organisms, the naturalist was the “advisor and authorized guide of the hygienist and physician.” 52 Colonialism itself had revalorized natural history, and the naturalist was the logical person to initiate studies

8. Caricature by B. Moloch of Raphaël Blanchard. From Chanteclair 1906. Image courtesy of Wellcome Library, London.

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of racial physiology, morbidity, and the disease susceptibility of colonizers and colonists. The medical parasitologist, noted Blanchard, was also important for metropolitan medicine and he spoke of the dangerous possibility of malaria victims from Senegal or Indochina transmitting the disease to Anopheles mosquitoes in the Paris region.53 Blanchard tirelessly promoted parasitology’s role in colonial settlement and development. At the turn of the century he organized an Enseignement colonial libre, a public lecture course with lantern slides. The new French colony of Madagascar became the inaugural subject and provided material for the first fifteen lectures held in January and February of 1901. A second series on Tunisia, a French protectorate since 1883, followed. Lecturers showcased the physical and cultural attributes of the colony or region and provided economic and scientific appreciations grounded in current knowledge. The spirit of the project mirrored the new regulatory regime of the French colonies where, it was hoped, the mise en valeur and the organization of commerce would now supplant the era of conquest and suppression of revolts. Blanchard turned these changes in the administrative sphere to his advantage and argued that well-trained civilian physicians willing to relocate overseas would be required to develop and retain the colonies. A constellation of Blanchard’s professional acquaintances participated in the series. His network extended deep into colonialist circles and included fellow zoologist Alphonse Milne-Edwards, director of the museum, and Alfred Grandidier, two stalwarts of the Société de géographie. The ornithologist Milne-Edwards had collaborated on Grandidier’s massive encyclopedia of Madagascar and must have recalled the several duties Blanchard had shouldered for him in 1889 when the two had hosted the first International Congress of Zoology in conjunction with that year’s Exposition universelle. Milne-Edwards was supportive of the colonial project and had joined the Comité du Madagascar, a group founded by Blanchard and others in 1896. The Comité and the Union colonial funded the series, and Blanchard cultivated these groups as he developed plans for his Institut de médecine coloniale.54 More than five hundred listeners attended the sessions on Madagascar held in the museum’s large amphitheater. Blanchard targeted what he saw as a neglected audience of the scientifically informed public, those who wanted precise and current information for the purposes of science-driven colonial development. Science ought to precede and guide colonial development, he argued, and noted that without “the geographer, geologist, mineralogist, botanist, zoologist, and ethnographer, the development of

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the country remained uncertain as it did not rest on the firmest achievements of science.”55 Speakers enumerated the health dangers and commercial possibilities of the island and catalogued the attributes of the human and material place of Madagascar. A published volume from the event exemplified a formulaic approach to natural historical knowledge. In addition to MilneEdwards, contributors included Alfred Lacroix, the museum professor of mineralogy, and Marcellin Boule, the professor of geology. Guillaume Grandidier, Alfred’s son, summarized and reviewed his father’s work and his own in contributing three studies on geography, zoology, and ethnography. His ethnographic studies signaled Madagascar as a site of the intermixture among Javanese, African, Indian, and European races. The Malagasy peoples, he noted, learned to read and write with ease, but they were also lazy, apathetic, and lacking in moral sense.56 He underlined distinctive features of the island including its lemurs, and proclaimed the island’s fauna was unique and seemed to have no affinities with other parts of the world.57 The alleged laziness of the Madagascan peoples extended as well to their methods of animal husbandry. Beef was a minor part of their diet and herdsmen, according to Grandidier, were not improving herds with methodical crosses between varieties.58 The implication, of course, was that French scientific expertise and French colonialism would improve the lives of Madagascan peoples. Blanchard’s contribution on the climate, hygiene, and diseases of the island celebrated medical parasitology.59 Replete with charts and tables of rainfall, predominant winds, and temperature variations, the text recalled earlier medical geographical studies undertaken by naval physicians. Yet striking differences existed between, for example, Bérenger-Féraud’s investigations of yellow fever and Blanchard’s program. Both men wrote of race and disease. But for the younger man parasitology was the key to colonization. Blanchard excelled at rhetorical flourish but was inconsistent in his portrayal of colonial medicine. The terminology of colonial and tropical medicine was emergent and fluid in this era, and in a 1904 address entitled “Colonial Medicine” Blanchard employed this label and many others including the study of the maladies des pays chauds, médecine exotique, and “médecine tropicale.60 Although he wrote of the strange nature of the tropics and its plethora of diseases unknown in Europe, the findings of parasitology seemed to mitigate, to some degree, the idea of colonized environments and colonized peoples as essentially different from their metropolitan counterparts in terms of the general rules of hygiene and illness.

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This new medicine reframed ideas of pathological places much as the germ theory of disease had revolutionized notions of disease causation. Parasitology focused on disease-causing organisms and their life cycles among the diverse resources of nature although race remained an element of the etiological riddle. It was formerly said, wrote Blanchard, “that Madagascar was the tomb of Europeans: until quite recently, it was thought that climatic conditions were unique in supporting this uncleanliness.”61 Now, however, parasitology had revealed the weaknesses of neo-Hippocratic climatic doctrines and associated place-based ideas of illness and health. The true source of malaria, claimed Blanchard, a disease that had accounted for some three thousand deaths in the 1895 French expeditionary force to Magagascar, had now been solved. Its cause was neither freshly tilled soil nor swamps, but “always and uniquely, an insect bite.”62 Medical parasitology enabled new styles and opportunities for French colonial activity, and for Blanchard, it could be easily and strategically added to the mixture of successful colonizing techniques. But how, according to Blanchard, could the colonies be held? Successful colonization depended on knowing the causes of disease and then breaking the perfidious disease cycles of malaria and other afflictions. Additionally, natural historical knowledge and especially anthropology would be required for the rational management of human populations, commerce, and interactions. Science aside, however, Blanchard argued that the French needed to accept the limits of their physiology. The government, he continued, should manage the flow of colonists to the island so that only the most robust of their numbers, mainly men, would immigrate. The ideal situation would be for French male colonists to intermarry with Madagascan women and create a Creole population after the fashion of the Spanish in America and in the Philippines, the latter being an archipelago whose peoples seemed related to the Hovas of Madagascar. In Madagascar, wrote Blanchard, the anthropological type is delicate and tender, the women are charming and good-looking: that is all that is needed so our colonists will not devote themselves to unyielding bachelorhood but will marry the women of the country and, as in fairy tales, have many children. It is on this condition alone that colonization, already on the right track, will be able to flourish and attain the lofty extent required by the natural riches of the country. 63

Blanchard’s promotion of miscegenation ran counter to Corre’s ideas of Creole viability and to Bérenger-Féraud’s perspective on racial mixing and

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health. Assiduous auditors of the lectures heard loud and clear that science, medicine, and rational governance could solve the problems of disease and settlement and fashion Madagascar into an efficiently functioning province of a greater France. The second year of the series hosted fourteen lectures on the North African protectorate of Tunisia.64 Tunisia had been within the orbit of the European powers for many years and was a site of intensifying French activity since 1881. In contrast to the previous series on Madagascar—perhaps because the French had several decades of scientific reconnaissance on the neighboring colony of Algeria—the second series had little on human health or parasitology. Blanchard delivered the lecture on zoology where he related his own observations of scorpions and leeches in Tunisia of 1888, and summarized the findings of Aristide Letourneux and Ferdinand Lataste, two explorers who had compiled zoological research from scientific explorations of the 1880s.65 Much discussed, however, was the structure of Tunisian society, the religion of Islam, and the region’s anthropology. Maurice Caudel, a professor at the École des sciences politiques, set the tone for the series by focusing not just on Tunisia but on North Africa as a unified scientific sphere. The botanical unity of the Maghreb, and determination of its Mediterranean as opposed to African status, had been extant in French scientific circles since at least 1820.66 Caudel, however, pointed out that “if the geologists and naturalists demonstrate with ease the perfect unity of aspect of the fauna and flora of the North African plateau, we easily rediscover the same unity in the region’s ethnography, religion, and social organization.” 67 Caudel’s message was very much one of association rather than of assimilation or the creolization model posited for Madagascar by Blanchard. The religion of Islam, argued Caudel, while it had unified North African peoples, had also rendered Tunisian society closed to modernity. Thus if a new colonial society were to arise under French guidance, it would not be by cultural, biological, or religious intermixture or fusion. So separate and different were the two societies, wrote Caudel, that Islamic society had remained constant and unchangeable, while European society had evolved and progressed.68 While any real social assimilation of modern and North African society was impossible, economic and commercial integration in accordance with European models and norms might proceed if indigenous cultivators adopted newer agricultural methods. The notable anthropologist and museum professor Ernest-Théodore Hamy also participated in the lecture series. Hamy had taken cranial measurements and photographed North Africans on a trip to Tunisia in 1887. Whereas Caudel had spoken of the cultural homogeneity produced by the

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advance of Islam, Hamy surveyed ancient dwellings, funerary monuments and terracotta designs, and commented on the astoundingly cosmopolitan tapestry of humanity in the protectorate’s port cities. He also disputed the thesis of Tunisian anthropological and cultural unity. 69 Here anthropological and ethnographic heterogeneity was the norm: All the varieties of humanity are found intermingled there, from the very woolly Sudanese to the very smooth European, from the sometimes very lean Bedouin to the often very obese Moor. Berbers and Arabs, Israelites, Turks and Levantines, Maltese and other Europeans, Negroes, Mulattos, etc., conduct and present themselves [in] a perpetually entangled kaleidoscope of infinitely variable forms and colors.70

Although Claudel and Hamy disagreed over the particulars of culture and anthropology, both judged the Tunisian protectorate a fertile region for agriculture. Hamy, like others of the century, spoke of the region as having been prosperous when it was part of the Roman Empire. Now, he opined, the new French administration heralded a time of renewed prosperity and wealth.71 The Enseignement colonial libre, initially planned to encompass all French colonies, ended after the second year. Blanchard now channeled his passions into two other projects, the organization of an Institut de médecine coloniale for civil practitioners, and the Archives de parasitologie, a journal he founded in 1898 to promote medical parasitology and applied natural history.

Medicine and Medical Entomology In comparison to Alphonse Laveran, Ronald Ross and Patrick Manson, Blanchard is mentioned infrequently, if at all, in discussions of the new tropical medicine. Yet he institutionalized the emergent field in France, developed teaching materials and texts, and constructed a historical and progressive lineage for medical parasitology. His massive Les moustiques: Histoire naturelle et médicale (1905), and L’insecte et l’infection: Histoire naturelle et médicale des arthropodes pathogènes (1909), reflect his ability to synthesize materials from diverse quarters.72 Both books and an earlier collaborative work with Laveran on the blood parasites of humans are thematic studies of the natural history of disease-causing organisms.73 Les moustiques: Histoire naturelle et médicale reflected Blanchard’s international connections and taxonomic zeal. In the preface he thanked both

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the American entomologist Leland Ossian Howard and Frederick Vincent Theobald, chief of the British Museum’s Entomology Section. In Great Britain, where colonial secretary Joseph Chamberlain’s policy of “constructive imperialism,” backed by funding from the Colonial Office, energized a range of tropical sciences from medicine to entomology, Theobald, a renowned expert on entomology and mosquitoes, was compiling a multivolume study of Culicidae.74 Theobald sent Blanchard several specimens and Les moustiques drew mainly on them and on a collection assembled by Blanchard at his Paris laboratory. Blanchard’s book was less comprehensive than Theobald’s and he mainly addressed physicians in regions of the world afflicted by malaria and yellow fever. The text skillfully interwove chapters on taxonomy and mosquito anatomy with chapters on prophylaxis, epidemiology, and parasitology. In terms of classification, Les moustiques assiduously followed the new International Rules of Zoological Nomenclature of which Blanchard had been a major architect.75 Textbooks are not exciting pieces of scholarship. Yet as Ronald Ross ferreted out the life cycle of malaria in India he did so with the aid of Blanchard’s book on medical zoology, Traité de zoologie médicale.76 Blanchard championed medical natural history and parasitology, rather than medical entomology per se or the related activities of “medical ecology,” a term sometimes applied to Charles Nicolle’s 1909 discovery of the relationship between the louse and epidemic typhus, or “economic entomology,” a term sometimes favored in Great Britain.77 Parasitology was Blanchard’s special passion, and it mattered little to him whether leeches or insects hosted and delivered the pathogenic organisms.78 Blanchard differed too from the naval physicians who preceded him, and of course Paris differed significantly from Toulon, Rochefort, and Brest. The consummate Parisian academic, Blanchard was erudite, multilingual, cosmopolitan, and a man of the classroom, taxonomy lab, and writer’s study. Although he advocated a marriage of laboratory and field studies, he was not cut from the same cloth as the luminaries of British tropical medicine like Ross, who had investigated diseases on-site in India and West Africa, or like Manson, who had labored in Taiwan and China. When Blanchard traveled abroad, he most often examined scientific and medical institutions, or, once established, participated in scientific congresses around the world. When Blanchard’s interests turned toward the European colonies and their diseases, his protégé and student, Émile Brumpt, and not he, traveled to Africa to investigate sleeping sickness.79 The dangers of the field avoided by Blanchard were very real, and Brumpt, who crossed Africa from the Red

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Sea to the Atlantic shore as the physician, naturalist, and photographer of the Bourg de Bozas expedition from 1901 to 1903, remarked on being bitten by venomous ticks, saw many of the expedition’s porters endure malaria, and recorded how many of the group’s camels died after being attacked by tsetse flies.80 In comparison to expeditions sent from England to study African diseases, the Bourg de Bozas expedition was underfunded, and more than half its support came from laboratory budgets at the Faculty of Medicine. However, Brumpt returned to Paris with three Africans suffering from sleeping sickness, and the three—Salomon, Makaya, and Bobanghi—were placed under observation at a hospital where they were studied and photographed amid fears that sleeping sickness might spread throughout France. They were also the reason for a visit to Paris by a delegation from the London School of Tropical Medicine including Manson, James Cantlie, George Carmichael Low, and Louis Sambon, one of a few exchanges between Paris and London orchestrated by Blanchard.81 Although Blanchard did some work in Algeria in 1888, his avoidance of field studies led the historian of medicine Jean Théodoridès to characterize him rather uncharitably as the “grandfather” of modern French parasitology.82 Yet Blanchard was fundamental to French parasitology and medical entomology for at least three reasons. First, insect-borne diseases such as malaria, sleeping sickness, and yellow fever are notoriously disrespectful of boundaries and require international efforts at control. Blanchard had much international scientific experience in Germany, England, Italy, and elsewhere and was a cautious advocate of scientific internationalism and international standards for taxonomy. Second, Blanchard organized the teaching and funding of parasitology and medical entomology in the French capital. He challenged the perceived orthodoxy and traditions of the Paris Faculty of Medicine and was an able innovator in the study of colonial diseases at this largest and most ossified of all French medical faculties. Finally, Blanchard was rooted in the broad traditions of a naturalist who synthesizes information and hazards informed generalizations. The most visible French champion of parasitology, he was steeped in medical humanism and presented parasitology to the French learned community in a nonthreatening manner, positioning it as something that followed naturally from bacteriology and represented the most recent stage in the natural progression of scientific medicine. Thus by the first decade of the twentieth century, Blanchard was the most important and visible personage of colonial medicine at the Paris Faculty of Medicine. Through pamphlets and other venues he implored

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travelers and military men bound for the tropics to capture mosquitoes, biting flies, ticks, and other organisms and instructed them on how to pack them in matchboxes or other containers and send them to his laboratory.83 At decade’s end he traveled to Brussels for the first International Congress of Entomology to deliver an address entitled “Entomology and Medicine.” The talk traced the etiology of several insect- and bug-borne illnesses and spoke against miasmatic theory while speculating on the causes of beriberi and other diseases. It also reveals once again his naturalist origins and a willingness to hazard general and even global conclusions from the close study of a few animal groups. The causes of many European diseases remained unknown, and Blanchard speculated on their etiology and drew analogies with tropical afflictions which seemed to produce similar symptoms. As Blanchard noted, it had been thought “that bacteriology was going to be the last word of medicine; it is now outstripped and considerably so by animal parasitology and medical entomology, the sphere[s] of which are truly without limits.” He concluded with explicit consideration of the colonial enterprise. We can predict, he continued, a new golden age for humanity where henceforth “immense territories open up to the white race where formerly, until now, it was stalked by a hundred unknown enemies now revealed. These discoveries, and those of tomorrow, will change the face of the world.”84

Parasitology at the Faculty of Medicine and the Institute of Colonial Medicine For Blanchard, parasitology mounted “a frontal attack on the most recalcitrant questions of hygiene and pathology[;] it brings to diagnosis the precision which it too often lacks, casts light on morbid etiology and prophylaxis, and explains symptomatology and pathology.”85 The global distribution of pathogenic human parasites was of course skewed toward the colonized tropics, so in terms of place, Africa and Indochina, and not Europe, were the logical venues to study parasites throughout their life cycles. Although the Paris Faculty of Medicine was not a traditional center for the study of exotic and colonial diseases, Blanchard made it one by enrolling naval and colonial physicians in his network of collectors. Professional and patriotic urges lay behind the 1902 creation of the Faculty’s new Institute of Colonial Medicine. Blanchard hoped this institution and his own laboratory would demonstrate the utility of his specialism for medical education. The Faculty of Medicine eventually altered its regulations in 1909 when it required third-year students to take a

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laboratory-based course on medical parasitology and be examined on the subject.86 Most certainly, though, the Institute of Colonial Medicine gained Blanchard an audience of postdoctoral students even before 1909. Blanchard modeled his Institute of Colonial Medicine, which he directed until his death in 1919, on the tropical medical schools of Patrick Manson and Ronald Ross at London and Liverpool, respectively. The Paris Institute was also a postdoctoral school where about thirty physicians followed three months of classes to obtain the diploma of colonial physician. While the London School had three separate three-month-long sessions in 1899–1900, the Paris Institute had one session per year.87 With the possible exception of Val-de-Grâce, Parisian hospitals had very few patients with colonial diseases. Part of this was due to the location and place of Paris as Assistance publique regulations prohibited patients with colonial diseases from receiving treatment in public hospitals. Clinical materials would be required for teaching and research, and Blanchard first approached the Institut Pasteur whose hospital was reserved for patients with infectious diseases. After considering affiliation with a convalescent home for colonial veterans in distant Sèvres, Blanchard arranged for a clinic of twelve beds for colonial diseases at a twenty-four-bed hospital run by the Association des dames de France on the edge of Paris in the wealthy sixteenth arrondissement at Auteuil.88 The hospital and the Association des dames de France had ties to the military, the Red Cross, and colonial activities.89 He also gained promises for 150,000 francs of funding from the governor of Indochina who subsequently reneged. Other groups such as the Union coloniale, the minister of the colonies, and the governor of Madagascar showed initial enthusiasm but not generosity. Eventually, Blanchard’s grandiose dream of two new endowed chairs and a freestanding institute devoted to colonial medicine was adjourned and instruction for institute students took place at the Faculty and the hospital at Auteuil. The institute and instruction for about twenty students, including three women, began on October 16, 1902. The term ran to late December and a diplôme de l’Instutut de médecine coloniale was approved on December 26, 1902, and awarded to graduates of the first class.90 The institute focused on teaching all aspects of “exotic pathology” inclusive of medical entomology, bacteriology, tropical hygiene, epidemiology, ophthalmology, dermatology, and sanitary regulations. Medical faculty contributed to the instructional program leading to either the diploma if the students had an MD degree, or a certificate if they did not. For example, André Chantemesse, an associate of Pasteur and Roux and the Faculty’s professor of experimental pathology, taught the course on bacteriology and

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hematology comprised of fifteen lectures and fifteen laboratory exercises, while the agrégé Robert Théodore Würtz taught seventeen lessons on exotic pathology, ten on tropical hygiene, and ran a twenty-session laboratory course on bacteriology applied to the diagnosis of tropical illnesses.91 Blanchard had good technical skills and taught the course on parasitology. He also refreshed his knowledge by attending conferences and following the microscopy course taught at the Institut Pasteur in 1896. But his classes at the Institute and Faculty of Medicine followed his proclivities. They were not like most medical instruction found in the old port schools and could be general and even philosophical exercises. The institute’s parasitology course included twenty-one lectures and practical demonstrations. The first lesson examined insect vectors as one of four modes of disease transmission. Subsequent lectures treated malaria, Texas cattle fever, trypanosomes and sleeping sickness, and filarial illnesses. Blanchard also devoted a lecture to parasitic insects, especially those encountered in the colonies.92 One hundred and thirty-three students claimed the diploma in the institute’s first five years of operation from 1902 to 1906. About half of those (sixty-six) were of French origin, and perhaps a third hailed from Latin America, with Colombia contributing fifteen students, Venezuela five, and Haïti and Nicaragua three each.93 By 1908 medical entomology was in full evidence at the institute in the laboratory course of Maurice Langeron, a mycologist who undertook medical study in Dijon and Paris. Like Blanchard, Langeron had also traveled to Germany to perfect his German language skills. Upon returning to Paris he became Blanchard’s secretary at a salary of fifty francs per month and would eventually head Blanchard’s laboratory and work tirelessly on Blanchard’s journal, the Archives de parasitologie. Langeron’s laboratory course of 1908 covered microscopy and staining techniques, the diagnosis of blood disorders and bacteriological and mycological diseases. About a dozen laboratory exercises and preparations dealt with insects or diseases carried by insects, especially malaria, but also sleeping sickness, tick fever, and elephantiasis. Students learned how to identify the female Culex mosquito and its larvae, the Anopheles mosquito, and examined microscope slides of Plasmodium malariae, Plasmodium vivax, and Plasmodium falciparum.94 Several institute graduates became professors of parasitology or tropical medicine at provincial and foreign medical faculties. These included Blanchard’s first student, Jules Guiart, who served as managing editor of the Archives de parasitologie and in 1906 became professor of medical natural history (professor of parasitology after 1907) at the Lyon Faculty of Medicine. In 1912 Blanchard brought a young physician from Nancy to

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Paris. Charles Joyeux had field experience in West Africa and Upper Guinea and later served on the front in World War I. After the war he returned to Paris and in 1920 passed the agrégation. In 1930 Joyeux became the first professor of parasitology at the new Faculty of Medicine in Marseille.95 In addition to institutionalizing academic parasitology in Paris and founding the Institute of Colonial Medicine and training many students, Blanchard promoted and presented parasitology to a wider public through his historical activities and through the pages of the Archives de parasitologie. The tenor of his publication was quite different from the utilitarian tone of the navy’s Archives de médecine navale and its successors.

Parasitology, Medical Humanism, and History Blanchard’s historical and cultural activities were rooted in the resources of a European capital and intersected with his vision of parasitology in several particulars. Blanchard routinely included historical articles, photographs of monuments and people, artistic caricatures, and similar items in the Archives de parasitologie. Additionally, historical examples featured prominently in his teaching. For example, his 1910–11 course on parasitology covered the sociology of parasitism and its role in ancient Greece and Rome, while a course on parasitism and infection the next year examined ancient theories of parasitology, and covered what he termed the precursors of modern scientific parasitology from the seventeenth-century Italian physician, Francesco Redi, to more modern figures including Vincent Raspail and Louis Pasteur.96 These historical narratives traced the not always logical progression of medicine and culminated with parasitology which incorporated the previous advances of bacteriology and now resided at the pinnacle of medical science. In the decade before World War I, with sectors of the healing arts becoming more scientific and medicine more specialized, the canon of medicine precluded mastery by a single person. A generation of men such as the Canadian physician William Osler, as well as Blanchard, sought to present themselves as learned men rather than as narrow technicians or engineers. Osler collected medical and scientific books, wrote medical history, and delighted in medico-literary pranks. Blanchard dearly wanted to be a man of haute culture, and from his facility in foreign languages to his photographic activities and commentaries on art history and collecting he was exactly that. In the sixteenth and last volume of the Archives de parasitologie, which appeared in 1919, Blanchard reflected on the historical, cultural, and artistic dimensions of parasitology in a section of the journal entitled “Parasites

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and Parasitological Illnesses in History, Poetry, and Art” which reproduced comments by Thucydides on the plague of Athens and eleven photographs of paintings of Napoléon in Egypt. Since the foundation of the journal in 1898, he wrote, it had been his intention to soften the severe and narrow character of which scientific journals ordinarily suffered, and to intercalate historical and artistic content with scientific articles, rather than grouping nonscientific pieces in a single volume. 97 In reviewing the various historical and artistic contributions appearing in the pages of the Archives de parasitologie, one is struck by the number of documents and photographs of items relating to Louis Pasteur, who had died in 1895. Included throughout the volumes of the early 1900s are photographs and an account of the dedication of a statue erected in Paris in 1904, a photograph of a monument to Pasteur in an eponymous village in Algeria, and other photographs of the well-known statues at Melun and at Arbois. Another photograph from 1910 shows a painted earthenware plate adorned with images of Pasteur in his laboratory and watching over the vaccination of a young boy. These admittedly cultish remembrances of Pasteur served Blanchard’s purposes by connecting parasitology with popular culture and utilitarian traditions and positioned Blanchard’s science as the next logical step in a narrative of scientific progress. They were also in-line with Blanchard’s views on what constituted parasitological information, which might come from text or folklore or from the laboratory. In addition to his historical work published in the Archives de parasitologie, Blanchard is also remembered as the founder of the Société française d’histoire de la médecine in 1902. One historical project collected 1,258 inscriptions on monuments of importance to medical history. There Blanchard, with the encouragement of Karl Sudhoff, a historian of medicine at the University of Leipzig, focused on early modern and modern monuments prior to 1900. He collected much of the information during professional conferences or while traveling, and his taxonomic hand was at work in many translations of the entries, arranged by the name of the person commemorated or the structures bearing the text.98 Blanchard’s historical work, which ranged from Hottentot anthropology to the prehistory of parasitology, spoke to an important issue of scientific methodology, that of inclusiveness after the fashion of ethnography or the naturalist who synthesizes vast amounts of information from diverse sources.99 Evidence of disease, and its past ravages and appearances, could be found in numerous sources, and Blanchard considered artistic, photographic, literary, and cultural depictions of disease as evidence bearing on historical diagnosis. Even his student Émile Brumpt, who effectively joined

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laboratory and field research, used linguistic evidence to estimate the prevalence of sleeping sickness and concluded that if the residents of the region had no special name for the disease, it was likely rare or of recent occurrence.100 Thus ethnographic methods persisted in the study and mapping of colonial diseases. The Archives de parasitologie suspended publication in 1914 after the outbreak of war and the German assault on Liège. When Blanchard died on February 7, 1919, the Archives de parasitologie perished with him. A complete list of war casualties might well have included the inclusive internationalism and medical humanism typified in Blanchard’s science. In comparing the Archives de parasitologie with the first few issues of the Annales de parasitologie humaine et comparée, begun in 1923 by Brumpt and edited by him, it is apparent that the newer publication had no place for historical articles or poetry. Whereas Blanchard had welcomed contributions in French, German, English, Spanish, or Italian, and had dedicated the Archives to the “study of parasites, envisaged in their most diverse aspects,” the newer journal accepted only French language contributions and narrowed its brief to original research and taxonomy. Medical parasitology and entomology had now come of age and had a clear utility to medicine, and while Brumpt did not immediately use the term “medical entomology,” his inaugural editorial in the new journal discussed both insects and malaria.101 Other facets of Blanchard’s program survived the war. His Institute of Colonial Medicine spoke to the new regulatory regime in the French colonies, where a few civilian and many army-trained healers replaced those formerly trained by the navy in their port schools. Although the institute bore the word “Colonial,” it was never as closely connected with the French colonies as the port schools had been. In this the French colonial situation differed substantially from that of the United Kingdom where Patrick Manson had been appointed medical advisor to the Colonial Office before the founding of the London School of Tropical Medicine. Brumpt succeeded his mentor as both professor and head of the Institute of Colonial Medicine. Yet the civilianization of colonial medicine did not work out quite as planned. Blanchard had argued that France had a “moral” obligation to provide instruction in civilian colonial medicine to the world community and that the city of Paris and its Faculty of Medicine was the ideal place to do this as the city attracted students from all over the world.102 The institute did attract a sufficient number of students to conduct courses, particularly foreign students. But the institute’s impact within France and its colonies was more modest, and few directors of the overseas Pasteur Institutes bothered to complete the institute diploma. Even in the

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new colony of Vietnam, those who trained first at Bordeaux, and took postgraduate training either at the naval school in Toulon or at the Pharo army school in Marseille, had inside tracks on colonial careers. Yet in the larger scheme of things, Blanchard’s colonial turn was prescient as was his cluster of medical concerns, which included anthropology, culture, and race as factors in disease and illness. Knowledge of parasitology, medical entomology, colonial or exotic diseases, and the health of colonized peoples in Europe was valued during the war and was useful to medical management of the half million troupes indigènes, the force noir, who came to the assistance of France in its hour of need.103

CONCLUSION

He is a very good agent of French influence.1 —Personnel review of Victor Segalen while teaching at Imperial Medical College, Tianjin, China

Naval and colonial physicians pursued a difficult task negotiating the enmeshed dimensions of place—regulatory regime, ship, colony, and port. The postrevolutionary navy remained attached to the system of port medical schools which had grown up in the eighteenth century. In the subsequent century calls to reform the navy’s training and advancement system echoed from within the navy and without. Incremental changes altered the regulatory world in the mid-1830s, 1854, and 1865, but the naval system retained its independence. Medical school professors signaled the special and discrete nature of their art and fought successfully against incorporation into either army or civilian medicine. Experiences of and attachments to the regions of their birth, naval traditions, and their livelihood framed their actions and ideas of disease. In the case of the Rochefort native Charles-Adolphe Maher, experience at home with seasonal fevers conditioned his interpretation of yellow fever in the Caribbean. Further to the south, Marseille’s colonial connections and commercial might influenced that city’s scientific and medical institutions and their associated research programs on kola and quinine substitues. By the start of the twentieth century with the main contours of the French Empire now worked out, the colonial situation transformed. The reform of 1886 dislodged the port schools as centers of naval medical education and set naval medicine adrift. This, however, was only a prelude to the navy’s loss of the colonial directorate and the indignity of ced-

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ing control of colonial troops to the army. Georges Treille, Albert Clarac, and especially Raphaël Blanchard seized upon new opportunities opened by changes in the regulatory world to build a colonial medicine less enmeshed in the lifeworld of the ports and navy. This new medicine of the tropics was a mixture of traditions, neither entirely civilian nor army nor naval in essence. The cofunding of Alexander Le Dantec’s chair at Bordeaux from municipal, naval, and university sources typified the future path of a colonial medicine open to multiple masters including the army and Pasteur Institute. Military regulations muted criticism of superiors and by extension the conduct of the colonial mission while in service. In this situation, novels, poems, and other artistic works provided a voice for those with reservations. This was the case with Victor Segalen, a figure whose career exemplifies the ambiguities of the French colonial project around World War I. After sending his medical thesis of 1902 to Armand Corre, Segalen voyaged widely. In Tahiti he arrived to scenes of devastation a few days after a cyclone swept the region. He took a Polynesian wife and was soon pondering the ravages wrought by Christianity and colonialism on Polynesian culture. A voyage to the Marquesas allowed him to examine remains of the estate of the painter Paul Gauguin and to visit his house. The young man closely examined the painter’s canvases, figures, and drawings. These experiences with Gauguin’s belongings and the remembrances of those who had known him were formative and he later purchased the painter’s palette and seven of his paintings. Segalen took Gauguin’s portrayal of Tahitian peoples to heart and incorporated some of the artist’s materials into his journals. The encounter unleashed an evaluation of his own “exotic” origins in Brittany and European notions exotic peoples. Polynesia also inspired Segalen’s novel Les Immémoriaux, an ethnographic account of Tahitian legend and religion set in the early years of European contact. Segalen consciously composed it after the fashion of Gauguin’s canvases and recounted the encroachments of Western imperialism and Christianity from the perspective of the islanders.2 Many years later he considered writing a Les Immémoriaux set in his native Brittany, an attempt to connect with an authentic and primordial Brittany as it confronted an expanding French culture. Two of Gauguin’s paintings purchased by Segalen depict Brittany, where the painter had wintered in 1888, 1889, and 1890. One, a darkly shaded piece entitled Breton Village under Snow, depicts a melancholic winter in Brittany far distant from the clamor of urban France. A youthful Segalen had toured Brittany on bicycle and considered how its Celtic past differentiated it from other regions of France. In adulthood he ruminated on dif-

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ference from both infranational and international perspectives. Throughout Segalen’s voyages and residence in China, he retained his attachments to the Breton language, Brest, and the region of his birth.3 An agent of the French imperial apparatus, Segalen, like Armand Corre and Gauguin, found fault with the French imperial project. While Corre had finished his days imagining a Brittany awash in Creoles, the young naval doctor tried to get beyond the patina of Western civilization to examine the authentic and deeply hidden levels of Asian culture in South China. The journey was also one of self-reflection. Segalen feared European civilization was fashioning a homogeneous dystopia bereft of diversity and difference, and he thought of parallels with Brittnay’s incorporation into France. Segalen’s personal history mirrored larger changes in the colonial regime and its medicine. For example, the advance of civilization, like the universal claims of Pasteur’s bacteriological science and Blanchard’s theory of modern parasitology, looked beyond differences in soils, smells, and miasma attached to particular places. Race, however one defined it, was recalcitrant to universalistic views. There were still too many unanswered issues of the human terrain of disease including ethnic selectivity, differential morbidity among the races, and the newer problem of the asymptomatic carrier. But like Georges Balandier’s view of colonialism, the colonial situation colored nearly everything and Segalen’s narratives took that situation into account. Both authors used exoticism as a means to critique and investigate European culture and the colonial project. In the mid-1950s the two authors had a rapprochement of sorts in Plon’s new book series Terre humaine, which had just published Claude Lévi-Strauss’s investigation of culture, Tristes tropiques. The editors soon republished Les Immémoriaux in 1956 and followed with Balandier’s Afrique ambiguë, the English edition subtitle of which added the words “Cultures in Collision.”4 Segalen worked out his ideas on diversity and exoticism in an essay entitled “Essai sur l’exotisme, une esthétique du divers.” This Essay on Exoticism: An Aesthetics of Diversity evolved from notes jotted down near Java in 1904, and he wrote of a desire to catalog how the human senses such as smell and sight responded to exoticism.5 He carried these thoughts with him while returning to Toulon via Suez and Cairo. The Essay and projected book evolved but remained unfinished when he revisited it for the last time in 1918. The Essay grappled with the tensions of empire on several levels and Segalen worked out an unviable philosophy of respectful cosmopolitanism based on the motif of the exote, a person who lived in opposition to the rather touristic style of exoticism popularized by Segalen’s more famous fellow navy man, Pierre Loti.

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A problem with Segalen’s brand of cosmopolitanism, of course, is that the true exote has no essential place other than the world at large. Segalen himself, however, had Brest, and by 1918 he was there as chief of the service of dermatology and venereal diseases. At war’s end he had exhausted himself combating the flu pandemic and was wracked by depression. He first traveled to Paris and tried to reestablish his health with injections of René Quinton’s seawater-like plasma. A trip to Algeria followed but his health spiraled downward and he entered the psychiatric ward at the Val-de-Grâce hospital in Paris. Dreams of leaving the navy and becoming an archaeologist and Sinologist soon evaporated, and he died alone at war’s end in the forests of Brittany.6 He did not live to see the rise of nationalist sentiments in the colonies, a protean movement of the interwar years sparked by the return of Africans who had fought for France. Segalen once confided to a friend that he was “happy in the tropics: it is violently real.”7 The shock of authentic difference and its dangers, so apparent in the extreme climatic and hygienic circumstances of the tropical colonies of Africa and Asia, mandated study of how these places differed from wherever one called home, and for the majority of the physicians in this book home was maritime France. Some of the navy’s health dangers such as dry colic were of its own making. Yet even this epidemic was coded as tropical in nature as it emerged in the encounter with the tropical world, and this encounter marked the navy’s system of regulations and the health, psychology and medicine of its healers. While I have argued that naval hygiene was taught in unsystematic fashion at the port schools, other sources of hygienic knowledge and action existed. Medical geography was popular with army and civilian physicians and although the naval healer’s world was discrete, it was not closed to these influences and it follows that the navy too would use place-based hygienic and geographical techniques to investigate and confront tropical dangers. I have also tried to demonstrate how port institutions and nineteenthcentury views of disease were mutually supportive of localism. The world of naval regulations supported this reflexive relationship for the writing of the MD thesis, which for busy naval men was frequently a collation of notes from their stations of duty in ship, port, or bagne. Fragments of this localism persisted into the twentieth century but waned after the founding of the central school at Bordeaux and with the requirement that naval and colonial healers obtain an MD degree prior to sustained voyaging or colonial postings. Once the navy lost control of the colonies, appeals to the specificity of the naval medical art lost traction and opened the system to further centralization and closure by incorporation.

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The centralization of naval medicine at Bordeaux stimulated growth in its medical faculty, and the university developed impressive programs in the study of the tropical world modeled on the interests of Alexandre Le Dantec, who had glimpsed global health issues. The malariologist and Bordeaux graduate Henri-Auguste-François Bonnin followed in Le Dantec’s path, and the navy continued sending its students there. In 1973, long after decolonization but during the era of cooperation with its former colonies, the university drew together existing resources to form the Institut de médecine et hygiène tropicale de Bordeaux to support the university’s diploma in tropical medicine and certificate in maritime health. A board of advisors included the director of the École du service de santé des armées, and the ministers of health or other representatives from Senegal, Madagascar, the Côte d’Ivoire, and the World Health Organization.8 In the late 1980s the university formed a Unité de formation et de recherche (UFR) médecine tropicale et environnement and today hosts a Centre René Labusquière Médecine Tropicale offering a certificate and two diplomas in tropical medicine and a certificare of capacity.9 In the 1990s, after the Université de Bordeaux III adopted the title Michel de Montaigne, and the Université de Bordeaux IV claimed Montequieu, the medical school and life sciences faculty added Victor Segalen to its name. The malariologist Michel Le Bras and others made the case on the basis of Segalen’s ethnographic, anthropological, and literary achievements, and Le Bras recalled the sensual appeal of Segalen’s work noting how taste and smell related to the important local science of enology.10 The name, it seems, fit the place. Another Bordeaux institution featured in this book, the École du service de santé des armées de Bordeaux which continued the navy’s central medical school and narrowly avoided closure in the 1980s under Bernard Brisou’s leadership, has fared less well and closed definitively on July 1, 2011. This was followed three weeks later by closure of Toulon’s Institut de médecine navale du service de santé des armées, the navy’s postdoctoral equivalent of the Pharo at Toulon, and its transfer to the Paris suburb of Brétigny-sur-Orge. The navy’s long battle of resistance to a full institutional incorporation into army medicine had ended and current students now complete medical degrees at the Lyon Faculty of Medicine and the École du service de santé des armées de Lyon-Bron.11 The long-threatened closure of Bordeaux, now finally realized, became an issue as the army established its own school at Lyon in 1888. Pressure mounted when the army added a colonial section to the Lyon school in 1925 and colonial section graduates began joining Bordeaux graduates for postdoctoral training at Marseille’s

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Pharo. In the period of the colonial department’s operation, from 1925 to 1956, its graduates, dubbed “Santards,” accounted for about one of every four colonial physicians serving in the empire.12 After formation of the Marseille Faculty of Medicine in 1930, the army experimented with having colonial students take their entire course of study in Marseille prior to enrollment at l’École d’application du Pharo. However, they soon consolidated operations at Lyon and in 1941 added a section to train air force physicians. The three early cradles of French colonial medicine on the Atlantic and Mediterranean shores, first demoted to écoles annexes in 1890 and charged with teaching entry-level medical studies and preparing students for Bordeaux, persisted through two world wars. But decolonization meant fewer physicians were needed to protect French interests. Still, nearly intractable issues of public health persisted in the former colonies, but without the colonies, and with the continued consolidation of army and navy medical services the schools at Brest, Toulon, and Rochefort closed in the 1960s with Rochefort teaching its last classes in 1964. Place-based arguments for their existence or that of the school of Bordeaux no longer held sway in a decolonized world. Possibly, proximity to the sea was now less important in the age of air travel, and for Europeans the century’s two great wars had been mainly the affair of armies. Pressure to consolidate and centralize also weighed on Marseille’s Pharo, which celebrated its centennial in 2005 in conjunction with hosting the 16th International Congress for Tropical Medicine and Malaria. Pharo graduates have distinguished themselves throughout the colonies, developing world, and in two world wars. By 2005 about eight thousand physicians, pharmacists and nurses had attended classes there.13 In 1962 in an era of cooperation with the former colonies the Pharo became an institution serving all branches of the French military, and a name change of 1975 to the Institut de médecine tropical du service de santé des armées (hereafter Pharo Institute) signified the change. In the 1990s, the army transferred the Pharo Institute’s practical school for military physicians, the reason for its founding in 1905, to Val-de-Grâce in Paris. The Pharo Institute continued into the current century as a center of documentation for tropical diseases and provider of an impressive suite of classes for military and foreign personnel. The student body was a mixed one, with civilians accounting for about three thousand of the eight thousand students who passed through its halls in its first century, and at the time of its centenary it was Europe’s only institute of military tropical medicine.14

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The ceremony commemorating the Pharo’s centenary opened on a bluff overlooking Marseille’s Old Harbor in the Mediterranean heat of midSeptember. Médecin general des Armées and Directeur du Service de santé des armées, Michel Meyran, officiated. Notes of the “Marseillaise” masked the drone of leaf blowers as members of the armies for land, air, and sea and representatives from Bordeaux and Lyon came forward for inspection. It was a time of inclusiveness and remembrance in tropical-like heat. A medical secretary in dress uniform wobbled and nearly fainted but decorum reigned as the ceremony closed. Insiders likely knew then of plans to recentralize and concentrate military medical services in Paris and Lyon, and in 2008 the army announced plans to close the Pharo Institute and transfer it to Brétigny-sur-Orge by 2014.15 In historical terms, this closure which became effective in 2013 has severed naval and colonial medicine’s long association with the ports of France, and with it cast that relationship into historical memory. Although this book has focused on the fate of naval and colonial medicine, medical education of all sorts was linked to reform of the French university. Hence it resonates with a number of issues of civilian life raised by Mary Jo Nye, Harry Paul, Robert Fox, and George Weisz, among others. I have tried to provide a more localized view of the process of institutional consolidation and show how allegiance to the places of maritime France, themselves part of a discrete regulatory world, influenced the lifeworlds of physicians. The contingencies of education for naval and colonial medicine differ substantially from the larger history of the French university system because they are linked directly to the conduct of war and to the expansion and collapse of empire. Thus there is an ephemeral character to these provincial institutions. There is also the personal element and I have tried to relate the challenges of establishing and especially maintaining colonial research programs in provincial cities. By the early 1900s Marseille was more successful in this regard than any other French city and possibly more successful than any other European city as well. Marseille’s success resulted from its strategic location on the Mediterranean and its place as the pole of colonies in France. This was accomplished with the combined support of the Marseille City Council, the Chamber of Commerce, and influential local notables like Jules Charles-Roux. Education for naval and colonial medicine grew in tandem with the construction of the great naval ports of France and the fashioning of a Royal Navy. From then until at least World War I a love of or at least tolerance for the seaborne life was the first test of recruits for many years. Naval

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medical services adhered to this tradition of recruiting and training physicians in the ports. Today, a constellation of new communication and travel technologies, and a more centralized command structure for the military, have devalued what the ports once had to offer: a place with proximity to the sea and access to patients suffering from tropical diseases, a reserve of men who knew how to sail and could endure naval discipline, and communities either built or altered to support naval and colonial activities.

AC K N OW L E D G M E N T S

Several institutions and individuals have supported this project. I am pleased to thank the Shelby Cullom Davis Center for Historical Studies and former director Natalie Zemon Davis; the Centre de Recherche en Histoire des Sciences et des Techniques at the Cité des Sciences et de l’Industrie, La Villette, and former director Robert Fox; the Centre Alexandre Koyré and former director Dominique Pestre; the Oregon State University Center for the Humanities and former director Peter Copek, as well as current director David Robinson and current associate director Wendy Madar; the Camargo Foundation and former executive director Jean-Pierre Dautricourt; and the Aix-Marseille Institute for Advanced Study. The Academic Senate and the Interdisciplinary Humanities Center at the University of California, Santa Barbara, as well as the Centre National de la Recherche Scientifique and the Institut de Recherche pour le Développement, have also extended generosity. Archivists and librarians in Bordeaux, Brest, Marseille, Paris, Rochefortsur-Mer, Toulon, and Vincennes at the archives and repositories cited in the bibliography, and many others, cheerfully guided my research. In the Paris region I wish to acknowledge Geneviève Salkin and Michel Sardet of the Service Historique de la Marine at Vincennes who guided me though the intricacies of naval records and suggested contacts at provincial archives. I also thank Stéphane Kraxner of the Pasteur Institute archives. For cheerful assistance on several trips to Rochefort-sur-Mer I want to thank Dominique Daubigne, aide-documentaliste at the Bibliothèque de l’ancienne École de médecine navale. Several people at the Université Victor Segalen Bordeaux II facilitated my research and I wish to thank Professor Denis Malvy, Director, Centre René Labusquière, médecine et hygiène tropicales; MarieFrançoise Vitrac, Director of the Service Commun de la Documentation;

226 / Acknowledgments

and Florence Olmicca of the Faculty’s Secrétariat Général who assisted me with university records. Friends, colleagues, and a number of anonymous referees have offered criticism and suggestions on this project, and I hope the majority of you will find evidence of your advice. I am immensely grateful for discussions on the nature of empire, medicine, and French history with colleagues on three continents but single out the late Lawrence Badash, Alice Conklin, the late Joseph N. Cotter, Roy MacLeod, and Tyler S. Stovall. My former student Richard S. Fogarty has been the best of coauthors and I learn something new every time we work together. My fellow Camargo Foundation fellows, especially Marilyn Desmond, Maria Grindhart, Sharon Kinoshita, Jane Macavock, Brian Nelson, and Scott Loring Sanders, made Cassis the best of writing ateliers. Sharon, in particular, taught me a lot about the empires of the Mediterranean world and helped me to reflect on the modern French empire. Good fortune also threw me into proximity with Brian, who was always ready to discuss the nuances of translation or assist in cracking the most recalcitrant phrases invented by Breton surgeons. Karen Darling of the University of Chicago Press has been the best of editors and always seemed to know when and how to give the proper mixture of criticism, encouragement, and advice. Finally, Oregon State University harbors a wonderful cluster of scholars who write on the history of French science, medicine, and natural history. I continue to profit from conversations about France with Mary Jo and Robert Nye, Paul and Vreneli Farber, and Anita Guerrini. Anita in particular has heard all the stories many times, and I thank her and my family for perseverance above and beyond the call of duty. Additional thanks go to Brian W. Robb for photographic assistance and navigating the back roads of Provence, Dr. Bruno Vila of Aix-Marseille University, and to Susan Karani, Abby Collier, and Laura and Robert Peckyno.

NOTES

INTRODUCTION

1.

2. 3. 4.

5. 6.

7. 8.

David Arnold, “Cholera and Colonialism in British India,” Past and Present 113 (1986): 118–51; Arnold, Colonizing the Body: State Medicine and Epidemic Disease in Nineteenth-Century India (Berkeley: University of California Press, 1993); Philip D. Curtin, Disease and Empire: The Health of European Troops in the Conquest of Africa (New York: Cambridge University Press, 1998); Mark Harrison, Contagion: How Commerce Has Spread Disease (New Haven, CT: Yale University Press, 2012); Harrison, Medicine in an Age of Commerce and Empire: Britain and Its Tropical Colonies, 1660–1830 (Oxford: Oxford University Press, 2010); Harrison, Public Health in British India: Anglo-Indian Preventive Medicine, 1859–1914 (Cambridge: Cambridge University Press, 1994). Mark Harrison, Climates and Constitutions: Health, Race, Environment and British Imperialism in India, 1650–1830 (Delhi: Oxford University Press, 1999). Cristiana Bastos, “Borrowing, Adapting, and Learning the Practices of Smallpox: Notes from Colonial Goa,” Bulletin of the History of Medicine 83 (2009): 141–63. Alice L. Conklin, A Mission to Civilize: The Republican Idea of Empire in France and West Africa, 1895–1930 (Stanford, CA: Stanford University Press, 1997); Tzvetan Todorov, “Races,” chap. 2, in On Human Diversity: Nationalism, Racism, and Exoticism in French Thought, trans. Catherine Porter (Cambridge, MA: Harvard University Press, 1993), 90–170, esp. 96–123. Bernard Brisou, “Naissance du Service de santé des colonies: Dix ans de drames,” Médecine et armeés 24, no. 5 (1996): 423–31. Dane Kennedy, The Magic Mountains: Hill Stations and the British Raj (Berkeley: University of California Press, 1996); Julyan G. Peard, Race, Place, and Medicine: The Idea of the Tropics in Nineteenth-Century Brazil (Durham, NC: Duke University Press, 2000). Phil Hubbard et al., eds., “Editor’s Introduction,” in Key Thinkers on Space and Place (London: Sage Publications, 2004), 1–15, esp. 5. See Yi-Fu Tuan, “Space and Place: Humanistic Perspective,” Progress in Geography 6 (1974): 233–46; and selected chapters in Human Geography: An Essential Anthology, ed. John Agnew et. al. (Oxford: Blackwell, 1996); René Dubos, “Ecology and the Genius of Place,” http://forestry.berkeley.edu/lectures/albright/1970dubos.html, accessed July 6, 2007; Pierre Nora, ed., Les Lieux de mémoire, 3 vols. (Paris: Gallimard,

228 / Notes to Pages 4–7

9. 10.

11.

12.

13.

14.

15.

16.

17.

18. 19.

1984–92). Gregory Mann takes up the plea for the specificity of place in his “Locating Colonial Histories: Between France and West Africa,” American Historical Review 110 (2005): 409–34. David Lowenthal, The Past Is a Foreign Country (Cambridge: Cambridge University Press, 1985). Edward S. Casey, “How to Get from Space to Place in a Fairly Short Stretch of Time: Phenomenological Prolegomena,” in Senses of Place, ed. Steven Feld and Keith H. Basso (Santa Fe: School of American Research Press, 1996), 13–52, quote on 19. Helen Clark, “Sites of Resistance: Place, ‘Race’ and Gender as Sources of Empowerment,” in Construction of Race, Place and Nation, ed. Peter Jackson and Jan Penrose (Minneapolis: University of Minnesota Press, 1993), 121–42, who references vol. 2 of Jürgen Habermas, The Theory of Communicative Action, 2 vols. (Boston: Beacon Press, 1984–87). Eugen Weber, Peasants into Frenchmen: The Modernization of Rural France, 1870–1914 (Stanford, CA: Stanford University Press, 1976); Mary Jo Nye, Science in the Provinces: Scientific Communities and Provincial Leadership in France, 1860–1930 (Berkeley: University of California Press, 1986). Georges G. Balandier, “La situation coloniale: Approche théorique,” Cahiers internationaux de sociologie 11 (1951): 44–79, and the articles in “Regards croisés: Translantic Perspectives on the Colonial Situation,” ed. Emmanuelle Saada, special issue, French Politics, Culture & Society 20, no. 2 (2002): 1–158. See also Ann Laura Stoler and Frederick Cooper, eds. Tensions of Empire: Colonial Cultures in a Bourgeois World (Berkeley: University of California Press, 1997); Jean-Frédéric Schaub, “La catégorie études coloniales est-elle indispensable?,” Annales, histoire, sciences sociales 63, no. 3 (May–June 2008): 625–46. Deborah J. Neill, Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (Stanford, CA: Stanford University Press, 2012). See Alison Bashford, “‘The Age of Universal Contagion’: History, Disease and Globalization,” in Medicine at the Broder: Disease, Globalization and Security, 1850 to the Present, ed. Alison Brashford (Houndsmills, UK: Palgrave MacMillan, 2006), 1–17. David S. Barnes, The Great Stink of Paris and the Nineteenth-Century Struggle against Filth and Germs (Baltimore, MD: Johns Hopkins University Press, 2006), quote on 87. On the perception of tuberculosis as a disease of the navy and maritime culture, see David S. Barrnes, The Making of a Social Disease: Tuberculosis in Nineteenth-Century France (Berkeley: University of California Press, 1995). John Harley Warner, “Cultural Nationalism and Tropical Fevers: Models of Colonial Medicine in the American South, 1840–1860,” in Mundialización de la ciencia y cultura nacional, Actas del Congreso Internacional “Ciencia, descubrimiento y mundo colonial,” ed. A. Lafuente, A. Elena, and M. L. Ortega (Madrid: Ediciones Doce Calles, 1993), 511–18 at 512. Alexandre Le Dantec, Précis de pathologie exotique (Maladies des Pays chauds et des Pays froids), 5th ed. (Paris: Octave Doin, 1929), 1–57. George Weisz, “Spas, Mineral Waters, and Hydrological Science in TwentiethCentury France,” Isis 92 (2001): 451–83; George Weisz, “A Moment of Synthesis: Medical Holism in France between the Wars,” in Greater than the Parts: Holism in Biomedicine, 1920–1950, ed. Christopher Lawrence and George Weisz (New York: Oxford University Press, 1998), 68–93. See also Michael A. Osborne and Richard S. Fogarty, “Medical Climatology in France: The Persistence of Neo-Hippocratic Ideas

Notes to Pages 7–14 / 229

20. 21.

22. 23.

24. 25. 26.

27. 28. 29. 30.

in the First Half of the Twentieth Century,” Bulletin of the History of Medicine 86 (2012): 543–63. Charles E. Rosenberg, “Epilogue: Airs, Waters, Places. A Status Report,” Bulletin of the History of Medicine 86 (2012): 661–70. Helpful on chorology and the uses of place in geography is J. Nicholas Entrikin, The Betweenness of Place: Towards a Geography of Modernity (Baltimore, MD: Johns Hopkins University Press, 1991). Paul Walden Bamford, “French Forest Legislation and Administration, 1660–1789,” Agricultural History 29, no. 3 (1955): 97–107. Orest A. Ranum, Richelieu and the Concillors of Louis XIII: A Study of the Secretaries of State and Superintendents of Finance in the Ministry of Richelieu, 1635–1642 (London: Oxford University Press, 1963), 98–99. Alan James, The Navy and Government in Early Modern France, 1572–1661 (Woodbridge, UK: Boydell Press, 2004), 31. Alan James, “The Development of French Naval Policy in the Seventeenth Century: Richelieu’s Early Aims and Ambitions,” French History 12 (1998): 384–402. Michel Vergé-Franchesci, Marine et education sous l’ancien régime (Paris: Éditions de Centre National de la Recherche Scientifique, 1991), summarizes the four admiralty jurisdictions (23–38), and Richelieu’s achievements (41–52). Ordonnance de Louis XIV pour les armées navales et arcenaux de marine (Paris: Estienne Michallet, 1689). John R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620– 1914 (New York: Cambridge University Press, 2010). Curtin, Disease and Empire, 78–82. See, for example, Sue Peabody and Tyler S. Stovall, eds., The Color of Liberty: Histories of Race in France (Duke University Press, 2003); Herrick Chapman and Laura L. Frader, eds. Race in France: Interdisciplinary Perspectives on the Politics of Difference (New York: Berghahn Books, 2004); Tyler Stovall and Georges Van Den Abbeele, eds., French Civilization and Its Discontents: Nationalism, Colonialism, Race (Lanham, MD: Lexington Books, 2003); and Patrick Weil and Stéphane Dufoix, eds., L’esclavage, la colonization, et après . . . France, États-Unis, Grande-Bretagne (Paris: Presses Universitaires de France, 2005). CHAPTER ONE

1. 2.

3. 4. 5.

6.

Ronald Chambers Hood, III, Royal Republicans: The French Naval Dynasties between the World Wars (Baton Rouge: Louisiana State University Press, 1985), 8–9. Archives Départementales du Finistère, 1T68, inspection de l’instruction primaire, December 1863, cited in Caroline Ford, Creating the Nation in Provincial France: Religion and Political Identity in Brittany (Princeton, NJ: Princeton University Press, 1993), 25. Alain Cabantous, Les citoyens du large: Les identités maritimes en France (XVIIe–XIXe siècle) (Paris: Aubier, 1995), 79. Lambert de Sainte-Croix, Essai sur l’histoire de l’administration de la marine de France, 1869–1792 (Paris: Calmann Lévy, 1892). Josef W. Konvitz, “Seaworthy Cities: Planning in the Expanding European World of the Seventeenth Century,” in Cities and the Sea: Port City Planning in Early Modern Europe (Baltimore: Johns Hopkins University Press, 1978), 31–69, esp. 69, and 142, table 5, “Vocational Categories in Sète, Lorient, and Brest.” Jean Meyer and Martine Acerra, Histoire de la marine française des origins à nos jours

230 / Notes to Pages 14–18

7. 8. 9.

10.

11.

12. 13. 14. 15. 16. 17. 18. 19. 20. 21.

22. 23. 24. 25. 26. 27.

28.

29.

(Rennes: Éditions Ouest France, 1994), 11–12. Population estimate from Emmanuel de Roux, “Portrait de Brest du temps des Lumières,” Le Monde, December 20, 2001. Laurent Mongin, Toulon: Sa rade, son port, son arsenal, son ancien bagne (Toulon, France: Imprimerie André Lions, 1904), 30. Jean Peter, Vauban et Toulon: Histoire de la construction d’un port-arsenal sous Louis XIV (Paris: Economica, 1994), 9–10. Martine Acerra, Rochefort et la construction navale française, 1661–1815, 4 vols. (Thèse du doctorat, Université de Paris IV, 1992; Paris: Librairie de l’Inde Éditeur, 1993), 3:565n11, which cites AN Marine D2 36 folder 43 and appended notes of folder 45. Acerra, Rochefort et la construction navale française, 3:565. Acerra argues that ships produced in Toulon lasted about four to eight years longer than those issuing from the two Atlantic ports. Ibid., 3:570n24, which cites AN Marine B5 6, and table 129, on p. 603. Question posed by Jean-Baptiste Colbert marquis de Seignelay quoted in Jean Peter, Le port et l’arsenal de Brest sous Louis XIV (Paris: Economica, 1998), 122, from Brest 1 E 449 fo 359. Peter, Vauban et Toulon, 38–41. Georges Lacour-Gayet, La marine militaire de la France sous le règne de Louis XV (Paris: Honoré Champion, 1902), 34. Cabantous, Les citoyens du large, 175–80. Ibid., 179–209. Adolphe Auguste Marie Lepotier, Toulon port du Levant (Paris: Éditions FranceEmpire, 1972), 121–43, figures on 143, Vauban’s comments on 162. Peter, Vauban et Toulon, 163. Maurice Agulhon, Une ville ouvrière au temps du socialisme utopique: Toulon de 1815 à 1851 (Paris: Mouton & C. and École Pratiques des Hautes Études, 1970), 9, 11. Agulhon, Une ville ouvrière, 39, gives the figures of 62,031 in 1846, and 69,404 in 1851. Ibid., 113. Ernest Harold Jenkins, A History of the French Navy (London: Macdonald and Jane’s, 1973), 18–19; Alan James, The Navy and Government in Early Modern France, 1572– 1661 (Woodbridge, UK: Boydell Press for Royal Historical Society, 2004), 148, calculates a standing fleet of thirty-six ships in 1646 of which twenty-four were warships. Konvitz, Cities and the Sea, 73–89. Peter, Le port et l’arsenal de Brest, 1–23, quote on 10 which cites AN D2 folio 32. Ibid., 56–61. Ibid., 267 which cites AN D2 24 folio 282 to 284. Ibid., 267–74. Nicole Le Pourheit-Salat, introduction to Bernard Hulin and Françoise Hamon, L’oeuvre de Vauban et ses collaborateurs en Bretagne (Quimper, France: Société Finistérienne d’histoire et d’archéologie, 1983), i–iii. Jean Peter, Vauban et Toulon; F. J. Hebbert and G. A. Rothrock, Soldier of France: Sebastien Le Prestre de Vauban, 1633–1707 (New York: Peter Lang, 1989), 87–112; Reginald Blomfield, Sebastien le Prestre de Vauban, 1633–1707 (New York: Barnes & Noble, 1938; reprint 1971). Louis Rousselet, Nos grandes écoles militaries et civiles (Paris: Hachetter et Cie, 1888), 2.

Notes to Pages 18–23 / 231 30. François-Jemmy Bennassi Desplantes, Les cinq ports militaires de la France (Limoges, France: Ardant, 1891), quoted on 45. Source of quotation unconfirmed. 31. Michel Vergé-Franchesci, Marine et education sous l’ancien régime (Paris: Éditions de Centre National de la Recherche Scientifique, 1991), 94–96; Acerra, Rochefort et la construction navale française, 1:27–97. 32. Konvitz, Cities and the Sea, 98. 33. Inès Murat, Colbert, trans. Robert Francis Cook and Jeannie Van Asselt (Charlottesville: University Press of Virginia, 1984), 175. 34. Acerra, Rochefort et la construction navale française, 1:87, who cites Théodore de Bloys, Histoire de Rochefort contenant l’établissement de cette ville, de son port et arsenal de marine et les antiquitez de son château (Paris: Briasson, 1733), 78. 35. For regulatory history see Amédée Lefèvre, Histoire du Service de santé de la marine (Paris: Ballière, 1867); and Bernard Broussolle and Philippe Masson, “La santé dans la Marine de l’ancien régime,” in Histoire des médecins et pharmaciens de marine et des colonies, ed. Pierre Pluchon (Toulouse: Privat, 1985), 69–87. On resistance to naval healers in colonial San Domingue see James E. McClellan III, Colonialism and Science: Saint Domingue in the Old Regime (Baltimore: Johns Hopkins University Press, 1992), 129–35. 36. Amalia D. Kessler, A Revolution in Commerce: The Parisian Merchant Court and the Rise of Commercial Society in Eighteenth-Century France (New Haven, CT: Yale University Press, 2007), 11, 18–19. 37. Étienne Tallemite, L’histoire ingorée de la marine française (Paris: Librairie Académique Perrin, 1988), 78–80. 38. Frédérique Joannic-Seta, Le bagne de Brest, 1749–1800: L’émergence d’une institution carcérale au siècle des Lumières (Rennes, France: Presses Universitaires de Rennes, 2000), charts on 104–5 (1689), 159–60 (1776). 39. Geoffrey Symcox, The Crisis of French Sea Power 1688–1697: From the Guerre d’escadre to the Guerre de course (The Hague: Martinus Nijhoff, 1974); Patrick Villers, Marine royale, corsaires et traffic dans l’atlantique de Louis XIV à Louis XVI, 2 vols. (Lille, France: Société Dunkerquoise d’histoire et d’archéologie/Presses de l’atelier national de reproduction des thèses, Université de Lille III, 1991). 40. Jean-Philipe Zanco, Le Ministère de la marine sous le second empire (Houilles, France: Imprimerie de la Marine pour Service Historique de la Marine, 2004), 15–16, 27, 87. 41. The most exhaustive study of the legal regime of naval medicine is Lefèvre, Histoire du Service de santé de la marine. My account combines information from Lefèvre; Alfred Le Roy de Méricourt and Paul M. V. Bourel-Roncière, “Naval (Service de santé),” in Dictionnaire encyclopédique des sciences médicales, ed. A. Dechambre et al., deuxième série, vol. 11 (Paris: G. Masson and P. Asselin, 1875), 558–712, esp. 564–69; Armand Le Hénaff, Étude sur l’organisation administrative du la marine sous l’ancien régime et la révolution (Paris: Recueil Sirey, 1913); and Michel Sardet, L’école de chirurgie du port de Rochefort (1722–1789) (Vincennes, France: Service historique de la Marine, 2000), esp. 4–9. 42. Ordonnance de Louis XIV pour les armées navales et arcenaux de marine (Paris: Estienne Michallet, premier Imprimeur du Roy, 1689), “Livre vingtième: Des hospitaux des armées,” 338–66; Alexandre Labert de Sainte-Croix, Essai sur l’histoire de l’administration de la marine de France, 1689–1792 (Paris: Calmann Lévy, 1892), 313. 43. Ordonnance de Louis XIV pour les armées navales et arcenaux de marine, 338–66.

232 / Notes to Pages 23–29 44. 45. 46. 47.

48.

49. 50. 51.

52.

53. 54. 55. 56. 57.

58. 59.

60. 61. 62.

63. 64. 65. 66. 67. 68.

Sardet, L’école de chirurgie, 8–9. Frédérique Joannic-Seta, Le bagne de Brest, 1749–1800, 214–20. Léon Aubineau, Les Jésuites au Bagne (Paris: Gaume Frères, 1850), 51. Dumont, “Le Service de santé de la marine des origins à l’empire,” Revue historique des armées 2 (1993): 112–17; Richard C. Dean, Naval Medical Schools of France and England with Observations on the Naval Hospitals of Toulon (Washington, DC: Government Printing Office, 1876), quote on 37. François Jouglas, “Saint-Mandrier, son histoire, sa légende,” Bulletin de la Société des amis du vieux Toulon et de sa région 89 (1967): 65–79; and Bernard Brisou, “SaintMandrier: hospital et lazaret,” Bulletin de l’Académie du Var, nouvelle série, 10 (2009): 241–43. Ordonnance de Louis XIV pour les armées navales et arcenaux de marine, 358–66. Jacques Fonlupt-Espéraber, Étude historique et critique sur le recrutement et le salaire des ouvries des arsenaux (Paris: Librairie Blond, 1913), 14–16, 163–93. Peter, Le port et l’arsenal de Brest, 119, for ship totals; 122–23 for the Soleil Royal. The five different rangs of French vessels is explained in Jenkins, A History of the French Navy, 43. James E. McClellan III and François Regord, “The Colonial Machine: French Science and Colonization in the Ancien Régime,” Osiris 15 (2000): 31–50; McClellan and Regord, The Colonial Machine: French Science and Overseas Expansion in the Old Regime (Turnhout, Belgium: Brepols, 2012). Fonlupt-Espéraber, Étude historique et critique sur le recrutement, 12, which quotes from the arête of 7 floréal an VIII (April 27, 1800). Jean-Pierre Ehrhardt, “L’école de santé navale,” La revue maritime 328 (August– September, n.d.), (undated photo copy in Port Archives, Brest), 911–24. Michael A. Osborne, “Médecine navale,” in Dictionnaire de la pensée médicale, ed. Dominique Lecourt (Paris: Presses Universitaires de France, 2004), 776–82. Le Roy de Méricourt and Bourel-Roncière, “Naval (Service de santé),” 563. Jean Baptiste Colbert, Lettres, instructions et mémoires de Colbert (Paris: Imprimerie Impériale, 1865; Nendeln/Liechtenstein: Kraus Reprint, 1979), vol. 3, no. 2, “Instruction pour le voyage de mon fils à Rochefort,” 91–95, quote on 92. Colbert, Lettres, vol. 3, no. 2, “Armaments, armaments en general,” 729–39. Jules Regnault, “L’école de médecine navale de Toulon (Notice Historique),” Bulletin de l’Académie du Var 77 (1910): 57–106; Regnault notes the dates of the port physicians and surgeons as Toulon 1667, Rochefort 1672, and Brest 1674. René Mémain, La marine de guerre sous Louis XIV: Le materiel, Rochefort, arsenal modèle de Colbert (Paris: Librairie Hachette, 1937), 196–203. Mémain, La marine de Guerre sous Louis XI, 203, quotes the contract of 1683. Benjamin Delorge, “Le Service de santé au bagne de Rochefort (1766–1852)” (Thèse pour le doctorat en médecine, Université de Bordeaux II, 1972), 5; Sardet, L’école de chirurgie, 4. Sardet, L’école de chirurgie, 18. Acerra, Rochefort et la construction navale française, 1:92–97. Jean-Luc Suberchicot, “Trois siècles d’histoire hospitalière à Rochefort,” Médecine et armées 27, no. 8 (1999): 658–74. Acerra, Rochefort et la construction navale française, 1:131–35, esp. 134. Regnault, “L’école de médecine navale de Toulon.” Biographical details from Bibliothèque et Musée de l’École de médecine navale de Rochefort, typescript S4. Sardet, L’école de chirurgie, 19.

Notes to Pages 29–36 / 233 69. Sardet, L’école de chirurgie, 66, draws on figures compiled in Philippe Bahaud, “Les chirurgiens navigans de la Marine à Rochefort dans la deuxième partie du XVIIIe siècle,” (Thèse médicale, Université de Nantes, 1971). 70. Sardet, L’école de chirurgie, 56–59, summarizes the nine sections of Règlement pour les écoles de chirurgie de la marine du 1er mars 1768 from a copy in the Archives du Port de Rochefort. 71. Sardet, L’école de chirurgie, 43–44. 72. Ibid., 45–48. 73. “Courcelles (Étienne-François-Marie Chardon de),” in Dictionnaire encyclopédique des sciences médicales, ed. A. Dechambre, premier série, 22:41. See also P. Keisser, “Étude historique sur Chardon de Courcelle, 1er médecin du port de Brest (1741–1775),” Bulletin de la Société académique de Brest, second series, 26 (1900–1901): 229–76, 27 (1901–1902): 5–82. 74. Manuel des operations de chirurgie, extraits des meilleurs livres par M. Cochon-Dupuy, médecin du Roy à Rochefort, imprimé par ordre de Monsieur Mithon, intendant de la marine et des fortifications au department de Toulon, pour servir à l’instruction des élèves chirurgiens de la marine (Toulon, France: Louis Maillard, 1726). See also Thierry Rousseau, “Le manuel des operations de chirurgie extrait des meilleurs livres par Monsieur Cochon-Dupuy pour servir à l’instruction des élèves chirurgiens de la marine” (Thèse médicale, Université de Nantes, 1976). 75. Sardet, L’école de chirurgie, 22–25. 76. Regnault, “L’école de médecine navale de Toulon,” 64–67. 77. Toby Gelfand, Professionalizing Modern Medicine: Paris Surgeons and Medical Science and Institutions in the 18th Century (Westport, CT: Greenwood Press, 1980). 78. Jacques Léonard, Les officiers de santé de la marine francaise de 1814 à 1835 (Thèse du doctorat du 3e cycle, Université de Rennes, Faculté des lettres et sciences humaines; Paris: C. Klincksieck, 1967), 77. 79. Jacques Léonard, Les officiers de santé de la marine francaise, 20–24. 80. Inès Murat, Colbert, 178. 81. Jacques Léonard, “Les médecins des prisions en France au XIXème siècle,” in La prison, le bagne et l’histoire, ed. Jacques-Guy Petit (Geneva: Librairie des Méridiens, 1984), 141–49. 82. Benjamin Delorge, “Le service de santé au bagne de Rochefort (1766–1852)” (Thèse pour le doctorat en médicine, Université de Bordeaux, II, 1972), 63–66. 83. Delorge, “Le service de santé au bagne de Rochefort, 98n12. For the demographics of the Brest bagne see Philippe Henwood, Bagnards à Brest (La Guerche-de-Bretagne: Ouest-France, 1986), 10. 84. Philippe Henwood, Bagnards à Brest, list on p. 18. 85. André Zysberg, “Le temps des galères (1481–1748),” in Histoire des galères, bagnes et prisons, XIIe-XXe siècles, ed. Jacques-Guy Petit et. al. (Toulouse: Privat, 1991), 79–106, esp. 97, 103–4. See also André Zysberg, Les galériens: Vies et destin de 60,000 forçats sur les galères de France (1680–1748) (Paris: Le Seuil, 1987); and Paul W. Bamford, Fighting Ships and Prisons: The Mediterranean Galleys of France in the Age of Louis XIV (Minneapolis: University of Minnesota Press, 1973). 86. Frédérique Joannic-Seta, Le bagne de Brest, while focused on Brest, is broadly comparative with Toulon. See also Stephen A. Toth, Beyond Papillon: The French Overseas Penal Colonies, 1854–1952 (Lincoln: University of Nebraska Press, 2006). 87. Pierre-Marie-Joseph Bonnefoux, Dictionnaire de marine à voiles et vapeur, 2nd ed. (Paris: Arthus Bertrand, s.d. [1856]).

234 / Notes to Pages 36–40 88. André Zysberg, “Présentation” to Les forcats, by Hubert Lauvergne (Grenoble: Éditions Jérôme Millon, 1991; reprint of Baillière edition of 1841), [5]–24, 12. 89. Mongin, Toulon, 221–26. 90. Delorge, “Le service de santé au bagne de Rochefort,” 90. 91. Michel Foucault, Discipline and Punish: The Birth of the Prison, trans. Alan Sheridan (New York: Pantheon Books, 1977), 144. 92. Foucault, Discipline and Punish, 115. For a careful sorting out of what was old and new in French prisons of the early nineteenth century, see Patricia O’Brien, The Promise of Punishment: Prisons in Nineteenth-Century France (Princeton, NJ: Princeton University Press, 1982), esp. 13–51. For criticism of Foucault’s ideas and his response see Michelle Perrot, ed., L’impossible prison: Recherches sur le système pénitentiaire au XIXe siècle reunites par Michelle Perrot, débat avec Michel Foucault (Paris: Éditions du Seuil, 1980). 93. O’Brien, The Promise of Punishment, 163–70. 94. Raoul Chassinat, Études sur la mortalité dans les bagnes et dans les maisons centrales de force et de correction depuis 1822 jusqu’à 1837 inclusivement, faites par ordre de Duchatel, Ministre de l’intérieur (Paris: Dupont, 1844). See also William Coleman, Death Is a Social Disease: Public Health and Political Economy in Early Industrial Europe (Madison: University of Wisconsin Press, 1982), 114, who references and restates Louis René Villermé, “Mémoire sur la mortalité dans les prisons,” Annales d’hygiène publique et de médecine légale 1 (1829): 1–100, at 10. 95. Louis René Villermé, Des prisons telles qu’elles sont, et telles qu’elles devraient être: Ouvrage dans lequel on les considère par rapport à l’hygiène, à la morale et à l’ économie politique (Paris: Méquignon-Marvis, 1820), esp. 150–65. 96. Frédérique Joannic-Seta, Le bagne de Brest, 290–91. 97. Louis René Villermé, “Note sur la mortalité parmi les forçats du bagne de Rochefort, sur la fréquence de leurs maladies, et sur la grande tendance que celles-ci ont à se terminer par mort,” Annales d’hygiène publique, industrielle et sociale 6 (1831): 113–27, quote on 121. 98. André Zysberg, “Le modèle des travaux forces et son application,” in Histoire des galères, bagnes et prisons, ed. Petit et. al, 199–229, 211. 99. Toth, Beyond Papillon, 9, who quotes Maurice Alhoy, Le bagne de Rochefort (Paris: G. Havard, 1845), 41. 100. The history of ideas on relocating the bagnes is examined by Michel Pierre, “La transportation (1848–1938),” in Histoire des galères, bagnes et prisons, ed. Petit et. al, 231–59. See also Toth, Beyond Papillon, 10. 101. Toth, Beyond Papillon, 12. 102. Gustave Adolphe Villers, “Essai historique sur le typhus qui a regné au bagne de Toulon en 1833, considerations theoriques sur cette affection” (Paris, thèse médicale, 1834). 103. AN, CC2 951, unpaginated manuscript, Médecin du bagne, G[ustave Adolphe] Villers, 10 févier 1850, “Une amitié au bagne de Toulon, suivie d’un homicide commis par le condamné Ferradji-ben-salem, sur le condamné Rousseau.” Villers also reported on the incident in the March 12, 1850, issue of the Gazette des hôpitaux (unavailable to me). See also Auguste Bonnet, De la monomanie du meurtre considérée dans ses rapports avec la médecine légale (Bordeaux: Justin Dupuy et Comp., 1852), 21–24. 104. O’Brien, The Promise of Punishment, 90–108; and Toth, Beyond Papillon, 50–54. 105. Villers, “Une amitié au bagne de Toulon,” sheet three.

Notes to Pages 41–49 / 235 106. 107. 108. 109. 110.

111. 112. 113. 114. 115. 116.

Ibid. sheet nine. Ibid., sheets fourteen and fifteen. Ibid., sheets fourteen and fifteen. Hubert Lauvergne, Choléra-morbus en provence, suivie de la biographie du docteur Fleury (Toulon: Aug. Aurel, 1836), 10, 118–19 (passions), 245. Louis-Baptiste Merlin, “Considérations sur le cholera épidémique qui a sévi au bagne de Toulon en 1866” (Montpellier: Imprimerie administrative de L. Cristin et Ce, 1866), 11. Similar sentiments are expressed by Joseph-Marcel Aiguier, “De la mortalité au bagne de Toulon: Contribution à l’étude de la réforme pénitentiaire” (Montpellier: Imprimerie L. Cristin et Ce, thèse médicale, Université de Montpellier, 1868), v, 17–18, 23–24; and Auguste Marie Barralier, Du typhus épidémique et histoire médicale des épidémies de typhus, observées au bagne de Toulon en 1855 et 1856 (Paris: Baillière, 1861). Merlin, “Considérations sur le cholera épidémique,” 53. Aiguier, De la mortalité au bagne de Toulon, v–vii, quote on v. Ibid., 55–56, quote on 56. Jean Allemane, Mémoires d’un communard. Introduction, notes et postface de Michel Winock (Paris: La Découverte, 2001), quote on 217, 219, for Algeria. See also David S. Barnes, The Making of a Social Disease: Tuberculosis in NineteenthCentury France (Berkeley: University of California Press, 1995). Charles-Louis-François Aubin, “Considérations sur le traitement de la pneumonie observée au bagne de Toulon en 1872” (Montpellier: Imprimerie centrale du Midi, thèse médicale, Université de Montpellier, 1875), quotations from 7. C H A P T E R T WO

1.

2.

3.

4. 5. 6.

7.

8.

Jacques Léonard, Les officiers de santé de la marine française de 1814 à 1835 (Thèse pour le Doctorat de Trosième Cycle [Mention Histoire], Unviersité de Rennes, 1967), 82. Public hygiene in France, writ large, though not naval hygiene, is the topic of William Coleman, Death Is a Social Disease: Public Health and Political Economy in Early Industrial France (Madison: University of Wisconsin Press, 1982); Ann F. La Berge, Mission and Method: The Early Nineteenth-Century French Public Health Movement (Cambridge: Cambridge University Press, 1992); and Lion Murard and Patrick Zylberman, L’hygiène dans la république: La santé publique en France, ou, l’utopie contrariée: 1870–1918 (Paris: Fayard, 1996). Anne Rasmussen, “L’hygiène en congrès (1852–1912): Circulation et configurations internationals,” in Les hygiénists, enjeux, modèles et pratiques (XVIIIe–XXe siècles), ed. Patrice Bordelais (Paris: Belin, 2001), 213–39. A[lfred] Le Roy de Méricourt, Rapport sur les Progrès de l’hygiène navale (Paris: Imprimerie impériale, 1867), 2, italics in original. Le Roy de Méricourt, Rapport sur les Progrès, 1. Jean-Baptiste Mahé, Manuel pratique d’hygiène navale; ou, Des moyens de conserver la santé des gens de mer, à l’usage des officiers mariniers et marins des équipages de la flotte (Paris: Baillière, 1874), 166. Jean-Baptiste Fonssagrives, “Navale (Hygiène),” in Dictionnaire encyclopédique des sciences médicales, ed. A. Dechambre, deuxième série, vol. 11 (Paris: G. Masson, 1875), 713–817, 729. Dane Kennedy, The Magic Mountains: Hill Stations and the British Raj (Berkeley: University of California Press, 1996), 226.

236 / Notes to Pages 50–54 9. 10.

11. 12.

13.

14. 15. 16.

17. 18.

19. 20. 21. 22.

23. 24.

25. 26.

27. 28. 29. 30. 31. 32.

Alan Bewell, Romanticism and Colonial Disease (Baltimore: Johns Hopkins University Press, 1999), 34. This section follows closely Michael A. Osborne, “The Geographical Imperative in Nineteenth-Century French Medicine,” in Medical Geography in Historical Perspective, ed. Nicolaas A. Rupke, Medical History, Supplement 20 (2000): 31–50. Rupke, “Humboldtian Medicine,” Medical History 40 (1996): 293–310. Rainer Brömer, “The First Global Map of the Distribution of Human Diseases: Friedrich Schnurrer’s ‘Charte über die geographische Ausbreitung der Krankheiten,’ 1827” in Medical Geography in Historical Perspective, 176–85. August Hirsch, Handbuch der historisch-geograph. Pathol., 2 vols. (Erlangen, 1860– 1864). See also Frank A. Barrett, “August Hirsch: As Critic of, and Contributor to, Geographical Medicine and Medical Geography,” in Medical Geography in Historical Perspective, 98–120. Mahé, “Géographie médicale,” Dictionnaire encyclopédique des sciences médicales, ed. A. Dechambre, quatrième série, vol. 8 (Paris: G. Masson, 1882), 1–400, 1. J. Mahé, “Géographie médicale,” 384. Anne Godlewska, “Traditions, Crisis, and New Paradigms in the Rise of the Modern French Discipline of Geography, 1760–1850,” Annals of the Association of American Geographers 79, no. 2 (1989): 192–213, 209. Ann F. La Berge, Mission and Method. Trésor de la langue française, ed. Paul Imbs (Paris: Gallimard, 1971–94), notes the terminology is antiquated but fails to give examples of its usage. But see Jean Christian Marc François Joseph Boudin, Essai de géographie médicale (Paris: Germer-Baillière, 1843). Boudin, Traité de géographie et de statistique médicales et des maladies endémiques, 2 vols. (Paris: J.-B. Baillière et fils, 1857), 1:217. Mahé, “Géographie médicale,” 385. Ibid. Henri-Clermond Lombard, Traité de climatologie médicale comprenant la métérologie médicale et l’étude des influences physiologiques, pathologiques, prophylactiques et therapeutiques du climat sur la santé, 4 vols., atlas (Paris: J.-B. Baillière, 1877–80). Lombard, Les climates de montagnes considérés au point de vue medical, 2nd ed. (Geneva: Cherbuliez, 1858). Fonssagrives, Thérapeutique de la phthisie pulmonaire basée sur les indications ou l’art de prolonger la vie des phthisiques par les resources combinée de l’hygiène et de la matière médicale (Paris: J.-B. Baillière et fils, 1866), “Atmosphères,” 254–369. Lombard, Traité de climatologie médicale, 2:3. Eduard-Rudolf Mullener, “Genfer Medizinal statistic und Hygiene in der ersten Halfte des 19. Jahrhunderts: André-Louis Gosse (1791–1873), Jacob-Marc d’Espine (1805–60) und Henri-Clermond Lombard (1803–95),” Gesnerus 21 (1964): 154–92. Lombard, Traité de climatologie médicale, 4:339–61. Mahé, “Géographie médicale,” 385–86. Olivier Chapuis, “L’émergence des nouvelles cartes marines: l’oeuvre de BeautempsBeaupré à la fin du début du XIXème siècle,” Imago mundi 44 (1992): 90–98. Le Roy de Méricourt, “Introduction,” Archives de médecine navale 1 (1864): [5]–11, 9. Charles Adolphe Maher, Statistique médicale de Rochefort, Charente-Inférieure (Paris: Baillière, 1874). Le Roy de Méricourt and [Paul Marie Victor] Bourel-Roncière, “Naval (service de

Notes to Pages 54–60 / 237

33. 34. 35.

36. 37. 38.

39. 40.

41. 42.

43.

44. 45. 46. 47. 48. 49. 50.

51.

santé),” in Dictionnnaire encyclopédique des sciences médicales, ed. A. Dechambre, second series, vol. 11 (Paris: G. Masson and P. Asselin, 1875), 558–712, 565. SHDAM, Box CC2 935–1, Quoy, Paris, December 30, 1848, “Note pour la direction du personnel.” Fonssagrives, Traité d’hygiène navale (Paris: J.-B. Baillière, 1856), table 2, “Topographie hygiènique et médicale des relaches.” Ministère de la marine et des colonies. Quoy, “Instruction pour la rédaction des rapports que les officiers du Service de santé doivent addresser, en exécution du décret du 15 août 1851, sur le service à la mer,” Bulletin official 37 (1857). Ibid., 6. Ibid., 7–8, emphasis in original. Bourel-Roncière, “Considérations sur les conditions hygiéniques des mécaniciens et des chauffeurs à bord des navires à vapeur de l’état” (Thèse pour le doctorat, Montpellier, 1864). Marc Renneville, “Politiques de l’hygiène à l’AFAS (1872–1914),” in Les hygiénists, enjeux, modèles et pratiques, 77–96, esp. 84–88. Lereboullet, “Obsèques de M. J. Rochard,” Bulletin de l’ Académie de médecine 36 (1896): 325–29. See also Jules Rochard, Histoire de la chirurgie française au XIXe siècle: Étude historique et critique sur les progrès faits en chirurgie et dans les sciences qui s’y rapportent depuis la suppression de l’Académie royale de chirurgie jusqu’à l’époque actuelle (Paris: J.-B. Baillière et fils, 1875); and Rochard and D. Bobet, Traité d’hygiène, de médecine et de chirurgie navales (Paris: Battaille, 1896). Jacques Léonard, Les officiers de santé,” 12. Michael A. Osborne, “French Military Epidemiology and the Limits of the Laboratory: The Case of Louis-Félix-Achille Kelsch,” in The Laboratory Revolution in Medicine, ed. Andrew Cunningham and Perry Williams (Cambridge: Cambridge University Press, 1992), 189–208. Mahé, “Géographie médicale,” 387. See also John Harley Warner, “The Natural Historian and the True Physician,” in Against the Spirit of System: The French Impulse in Nineteenth-Century American Medicine (Princeton, NJ: Princeton University Press, 1998), 272–81. Warner describes how American physicians tried to cordon off what they saw as the natural historical method. Midcentury French naval healers, in the aggregate, seem more inclined toward a consilence model which sought to balance natural historical knowledge and observational medicine with clinical information. Léonard, Les officiers de santé, 82. Michel Sardet, L’école de chirurgie du port de Rochefort (1722–1789) (Vincennes, France: Service historique de la Marine, 2000), esp. 115–26, 127–35. REM, Box 3, “Service de santé de la marine au port de Rochefort, 1806,” February 7, 1806. REM, Box 7, (Director Clémot?) à Monsieur le Chef d’administration, “Rapport à monsieur le préfet maritime,” October 28, 1830. Eugène Leconte, “Des influences topographiques sur le développement des maladies” (Thèse pour le doctorat, Faculté de Médecine de Paris, 1846). REM, Box 8, Eugène Leconte, manuscript entitled “Plan d’une constitution nouvelle du corps des officiers de santé de la marine.” Unpaginated but see esp. chap. 3. REM, Box 3, Dr. [Charles-Adolphe] Maher, “Sur les conditions d’instruction et de perfectionnement du personnel du Service de santé,” November 1, 1862, sent to M. le Inspecteur-général Reynaud, November 4, 1862, pp. 8–10. Among other studies see Ferdinand Burot, De la fièvre dite bilieuse inflammatoire à la

238 / Notes to Pages 60–63

52. 53.

54. 55. 56. 57.

58. 59. 60.

61.

62.

63.

Guyane; application des découvertes de M. Pasteur à la pathologie des pays chauds (Paris: Doin, 1880); Burot and Henri Bourru, Variations de la personnalité (Paris: Baillière, 1888); and Burot and M[aximillian] A[lbert] Legrand, The Hygiene of the Soldier in the Tropics, trans. George W. Read (Kansas City, MO: Hudson-Kimberly, ca. 1899). SHDAM, Box CC2 934, “Année scolaire, 1888–1889, semestre d’hiver, Cours de Médecine legale, toxicologique.” Évariste Bertulus, “L’hygiène navale dans ses rapports aves l’économie politique, commerciale, et avec l’hygiène publique, ou nouvelles considerations sur la matière, le but, l’enseignement et l’application de cette science” (read before the Société royale de médecine de Marseille, October 18,1845) (Marseille: Typographie Baralatier-Feissat et Demonchy, 1845), 11. Fonssagrives, “Discourse d’adieu de M. le professeur Fonssagrives à l’École de Brest,” Archives de médecine navale 2 (1864): 165–72, 167. C[harles] Auffret, “Éloge de Fonssagrives lu à la rentrée des cours de l’École de Brest le 5 novembre 1886,” Archives de médecine navale 47 (1887): 161–81, 166. Jules Regnault, “L’école de médecine navale de Toulon,” Bulletin de l’Académie du Var 78 (1910): 57–106, 72. TAM, Box 2 A6 460, folder 4, Service de santé, S. Aubert, médecine principal à Monsieur Le Capitaine de Vaisseau commandant les equipages de la Flotte-Toulon, July 1, 1872, “Rapport de M. le Médecine principal sur les cours d’hygiène professés par lui aux officiers-mariniers et marins de la Division.” Regnault, “L’école de médecine navale de Toulon,” 73. Regnault, “L’école de médecine navale de Toulon,” “Chaires et professeurs,” 100–106. Le Roy de Méricourt and Bourel-Roncière, “Naval (Service de santé),” 558–66. See also Michael A. Osborne, “Médecine navale,” in Dictionnaire de la pensée ,médicale, ed. Dominique Lecourt (Paris: Presses Universitaires de France, 2004), 776–82. Osborne, “The Geographical Imperative”; Osborne, “Resurrecting Hippocrates: Hygienic Sciences and the French Scientific Expedition to Egypt, Morea and Algeria,” in Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900, ed. David Arnold (Amsterdam: Rodolpi, 1996), 81–99. See also David Cantor, ed., Reinventing Hippocrates (Aldershot, UK: Ashgate, 2002), especially Cantor’s essay “Introduction: The Uses and Meanings of Hippocrates,” 1–18; Elizabeth A. Williams, “Hippocrates and the Montpellier Vitalists in the French Medical Enlightenment,” 157–77; Ann F. La Berge, “The Rhetoric of Hippocrates at the Paris School,” 178–99; George Weisz, “Hippocrates, Holism and Humanism in Interwar France,” 257–79. For Lyon see Michael A. Osborne and Richard S. Fogarty, “Medical Climatology in France: The Persistence of Neo-Hippocratic Ideas in the First Half of the Twentieth Century,” Bulletin of the History of Medicine 86 (2012): 543–63. Biographical studies employed here include C. Auffert, “Éloge de Fonssagrives lu à la rentrée des cours de l’École de Brest, le 5 novembre 1886,” Archives de médecine navale 48 (1887): 161–81; Bernard Brisou, “Il y a cent ans, Fonssagrives, de l’hygiène à l’Académie de médecine,” Les cols blues, no. 1794 (March 17, 1984): 4–7; A. Coriveaud, “Fonssagrives, étude sur son oeuvre” (Bordeaux: Feret & Fils, 1884); J. Grasset, “Fonssagrives, sa vie et son oeuvre; Première leçon du cours de thérapeutique faite à la Faculté de médedine de Montpellier le 27 mars 1885” [Extrait du Montpellier médical (April 1885)] (Montpellier: Camille Coulet, 1885). Auffert, “Éloge de Fonssagrives,” 161.

Notes to Pages 63–68 / 239 64. Fonssagrives, “Histoire médicale de la frigate à vapeur l’Eldorado station des côtes occidentals d’Afrique, 1850–51,” (Thèse pour le doctorat, Faculté de Médecine de Paris, 1852); Fonssagrives, “Mémoire pour server à l’histoire de la colique nerveuse endémique des pays chauds (colique sèche, colique végétale, barbiers, colique de Madrid, névralgie du grand sympathique, etc.),” Archives générales de Médecine 4e série 29 (1852): 129–51, 299–325; 30 (1852): 160–85. 65. René Dubos and Jean Dubos, The White Plague: Tuberculosis, Man and Society (Boston: Little Brown, 1952). 66. David S. Barnes, The Making of a Social Disease: Tuberculosis in Nineteenth-Century France (Berkeley: University of California Press, 1995). 67. Fonssagrives, Thérapeutique de la phthisie pulmonaire, [vii]–xv, [vii]. 68. Michael A. Osborne, “La renaissance d’Hippocrate: L’hygiène et les expéditions scientifiques en Égypte, en Morée, et en Algérie,” in L’invention scientifique de la Mediterranée: Égypte, Morée, ed. Marie-Noëlle Bourguet et al. (Paris: Éditions de l’École des Hautes Études en Sciences Sociales, 1998), 185–204; and Patricia M. E. Lorcin, “Imperialism, Colonial Identity, and Race in Algeria, 1830–1870: The Role of the French Medical Corps,” Isis 90 (1999): 652–79. 69. Grasset, “Fonssagrives, sa vie et son oeuvre,” 10. 70. Fonssagrives, “Mémoire pour server à l’histoire de la colique nerveuse endémique,” 143. 71. Summary of memoir by Guépratte, “De la colique végétale,” Bulletin de l’Académie de médecine (1850–51): 995–1002. 72. Rochard, “De la non identité de la colique de plomb et de la colique sèche des pays chauds (suite et fin),” Union médicale 10, no. 5 (issue of January 10, 1856): 1, 18. This is part 2 of the article. Part 1 was unavailable to me. 73. Rochard, “De la non identité de la colique de plomb et de la colique sèche,” 18. 74. Ibid., 18. 75. For biographical details see Michel Valentin and Pierre-Marie Niaussat, “Le role fundamental d’Amédée Lefèvre, médecin de la marine (1798–1869), en medicine du travail et en histoire de la medicine,” Histoire des sciences médicales 13 (1979): 407–17; and Le Méhauté, “Éloge d’Amédée Lefèvre,” Archives de médecine navale 71 (1899): 343–69. 76. REM, Rapports fin de campagne, no. 13, tome 1, “Rapport de Mr. Lefèvre, chirurgien du Brick “L’isère,” [unpaginated typescript, compared with manuscript original]. 77. Valentin and Niaussat, “Le role fundamental d’Amédée Lefèvre, 409. 78. REM, Rapports fin de campagne, no. 22, tome 1, “Rapport de Monsieur Lefèvre chirurgien de l’Isère, remis au Conseil de santé le 20 mars 1822.” Quoted section was composed on January 21, 1821, in the city of Cayenne [unpaginated typescript]. Cf. Richard Grove, “The Origins of Environmentalism,” Nature 345 (1990): 11–14. 79. Le Roy de Méricourt, Rapport sur les progrès de l’ hygiène navale (Paris: Imprimerie impériale, 1867), 2n1, and 2–8. On the exploding shell see Patrice Bret, “Genèse et légitimation patrimoniale d’une invention: Les archives de l’Artillerie à l’origine d’une innovation cruciale dans la Marine au XIXe siècle,” in Les chemins de la nouveauté: Innover, inventer au regard de l’histoire, ed. Liliane Hilaire-Perez and Anne-Françoise Garçon (Paris: Éditions du CTHS, 2003), 385–410. 80. Le Roy de Méricourt, Rapport sur les progrès de l’hygiène navale, 3. 81. Valentin and Niaussat, “Le role fundamental d’Amédée Lefèvre,” 411. 82. Mahé, “Géographie médicale, 382–84. 83. Le Méhauté, “Éloge d’Amédée Lefèvre,” 352.

240 / Notes to Pages 68–73 84. Steven Shapin, A Social History of Truth: Civility and Science in Seventeenth-Century England (Chicago: University of Chicago Press, ca. 1994). 85. Alexandre Segond, Essai sur la névralgie du grand sympathique, maladie connue sous les noms de colique végétale, de Poitou, de Devonshire, de Madrid, de Surinam et sous ceux de barbiers, de béribéri, etc. (Paris: Imprimerie Royale, 1837); Segond, De la gastro-entérite chronique chez les nègres, vulgairement appelée mal d’estomac ou mal-coeur (Paris [?]: Imprimerie Royale, 1834). 86. Dr. Raoul, Guide hygiénique et médical: pour les batiments de commerce: qui fréquentent la côtte occidentale d’Afrique (Paris: Imprimerie administrative de Paul Dupont, 1851). 87. Le Roy de Méricourt, Rapport sur les progrès de l’hygiène navale, 52. 88. Fonssagrives, “Mémoire pour server à l’histoire de la colique nerveuse.” 89. Valentin and Niaussat, “Le role fundamental d’Amédée Lefèvre, esp. 412–13; Le Méhauté, “Éloge d’Amédée Lefèvre,” 355. 90. Ibid., 354. 91. Ibid., 360. 92. Le Roy de Méricourt, Rapport sur les progrès de l’hygiène navale, 45. 93. Le Méhauté, “Éloge d’Amédée Lefèvre,” 360. 94. Valentin and Niaussat, “Le role fundamental d’Amédée Lefèvre,” 413. 95. Amédée Lefèvre, Recherches sur les causes de la colique sèche observée sur les navires de guerre français, particulièrement dans les régions équatoriales, et sur les moyens d’en prévenir le développement (Paris: Baillière, 1859); Lefèvre, De l’emploi des cuisines et appareils distillatoires dans la marine (Paris: J.-B. Baillière, 1862). 96. J. Grasset, “Fonssagrives, sa vie et son oeuvre,” 11, quotes the phrase “sagacious perseverance” but fails to cite its source. 97. Fonssagrives, “Navale (Hygiène),” 733. 98. Auffret, “Éloge de Fonssagrives,” 180, source unattributed. 99. Grasset, “Fonssagrives, sa vie et son oeuvre,” 27–39, provides the relevant bibliography of 234 publications. 100. Fonssagrives, “Santé et hygiène,” 573. On vitalistic traditions at Montpellier see Elizabeth A. Williams, A Cultural History of Medical Vitalism in Enlightenment Montpellier (Burlington, VT: Ashgate, ca. 2003). 101. Coriveaud, “Fonssagrives, étude sur son oeuvre,”4–5; Grasset, “Fonssagrives, sa vie et son oeuvre,” 17–18, quotation from Fonssagrives, p. 17, is reproduced without exact citation but from his Principes de thérapeutique générale (Paris: Baillière, 1875), 2nd ed. (Paris, Baillière, 1884). 102. André Borgomano, “Les médecins de la marine et la Faculté de médecine de Montpellier,” Académie des sciences et lettres de Montpellier 42 (2011): 125–33, accessed August 5, 2012, http://www.ac-sciences-lettres-montpellier.fr/. 103. Fonssagrives, Traité d’hygiène navale, 757. 104. Fonssagrives, “Navale (Hygiène),” 730. 105. All four reports are collected in Récueil de rapports sur les progrès des letters et des sciences en France (Paris: Imprimérie Impériale, 1867). The content of J. H. Magne, Rapport sur les progrès de la médecine vétérinaire depuis vingt-cinq ans, is mainly about horses and will not be discussed here. Other citations are Apollinaire Bourcardat, Rapport sur les progrès de l’hygiène; Michel Lèvy, Rapport sur les progrès de l’hygiène militaire; and Alfred Le Roy de Méricourt, Rapport sur les progrès de l’hygiène navale. 106. Apollinaire Bouchardat, Sur la nature, le traitement et les préservatifs du choléra-morbus (Paris: Didot Le Jeune, 1832).

Notes to Pages 73–79 / 241 107. Bouchardat, Rapport sur les progrès de l’hygiène, 4, 101. 108. Ibid., 5. 109. Ibid., “Énumeration et classification des principales maladies à miasmes spécifiques,” 92–96, quote on 95. 110. Lèvy, Rapport sur les progrès de l’hygiène militaire, 4; A. Bouchardat, Rapport sur les progrès de l’hygiène, 1. 111. Lèvy, Rapport sur les progrès de l’hygiène militaire, 12 (army), 39 (infection and contagion). 112. Ibid., “Tabac,” 33–34, “Prophylaxie syphilitique,” 39–41. 113. Le Roy de Méricourt, “Histoire médicale de la campagne de la corvette à vapeur L’Archimède (station de l’Océan Indien années 1850, 51, 52)” (Paris: Imp. Rignoux, 1853). 114. Le Roy de Méricourt, Rapport sur les progrès de l’hygiène navale, 20. 115. Ibid., 42–63. 116. Ibid., 63. 117. Williams, “Hippocrates and the Montpellier Vitalists in the French Medical Enlightenment,” 170. CHAPTER THREE

1.

2.

3.

4. 5. 6. 7.

Jean-Baptiste Mahé, Manuel pratique d’hygiène navale (Paris: J.B. Baillière et fils, 1874), 88–89, emphasis added. Quotation from Jean-Baptiste Fonssagrives, Traité d’hygiène navale (Paris: J.-B. Baillière, 1856). Martin S. Staum, Labeling People: French Scholars on Society, Race and Empire, 1815– 1848 (Montreal: McGill-Queen’s University Press, 2003), 21. This is an elegant consideration of ethnology, phrenology, and the extreme fluidity of theories of race. William B. Cohen, The French Encounter with Africans: White Response to Blacks, 1530– 1880 (Bloomington: Indiana University Press, 1980), 210. In a later contribution Cohen notes the persistence of cultural and, albeit anemic, ethnographical ideas of race in Cohen,”French Racism and Its African Impact,” in Double Impact: France and Africa in the Age of Imperialism, ed. G. Wesley Johnson (Westport, CT: Greenwood Press, 1985), 305–17. See also Joe Lunn, “‘Les Races Guerrières’: Racial Preconceptions in the French Military during the First World War,” Journal of Contemporary History 34 (1999): 517–36, esp. 517n2. Lunn, who argues that racial theory was applied to French military practices, is in disagreement with Charles J. Balesi, From Adversaries to Comrades-in-Arms: West Africa and the French Military, 1885–1918 (Waltham, MA: Crossroads Press, ca. 1979); and Marc Michel, L’appel à l’Afrique: contributions et reactions à l’effort de guerre en AOF (1914–1919) (Paris: Publications de la Sorbonne, 1982). See also Joe Lunn, Memoirs of the Maelstrom: A Senegalese Oral History of the First World War (Portsmouth, NH: Heinemann, 1999). Cohen, French Encounter with Africans, 210. Lunn, “‘Les Races Guerrières,’” quote from 517n2. On Germany see Andrew D. Evans, Anthropology at War: World War I and the Science of Race in Germany (Chicago: University of Chicago Press, 2010), 59–60. See for example Clifford Rosenberg, “Albert Sarraut and Republican Racial Thought,” and David Beriss, “Culture-as-Race or Culture-as-Culture, Caribbean Ethnicity and the Ambiguity of Cultural Identity in French Society,” in Race in France: Interdisciplinary Perspectives on the Politics of Difference, ed. Herrick Chapman and Laura L. Frader (New York: Berghahn Books, 2004), 36–53 (Rosenberg), and 111–40, esp. 122 (Beriss).

242 / Notes to Pages 79–83 8.

9.

10. 11. 12.

13.

14.

15.

16.

17.

18. 19. 20. 21.

22. 23. 24. 25.

Pietro Corsi and Paul J. Weindling, “Darwinism in Germany, France and Italy,” in The Darwinian Heritage, ed. David Kohn, (Princeton, NJ: Princeton University Press, 1985), 683–729. Richard M. Burian, Jean Gayon, and Doris Zallen, “The Singular Fate of Genetics in the History of French Biology,” Journal for the History of Biology 21 (1988): 357– 402. The considerably different American context and the thought of Paul Freer is investigated in Warwick Anderson, “Immunities of Empire: Race, Disease, and the New Tropical Medicine, 1900–1920,” Bulletin of the History of Medicine 70 (1996): 94–118. Martin S. Staum, “Paris Ethnology and the Perfectibility of ‘Races,’” Canadian Journal of History/Annales canadiennes d’histoire 35 (2000): 222–38. Staum, “Paris Ethnology and the Perfectibility of ‘Races,’” which quotes William Edwards, Mémoirs de la Société ethnologique de Paris 1 (1841): i, iii, iv. Jacques Léonard, La médecine entre les savoirs et les pouvoirs: Histoire intellectuelle et politique de la médecine française au XIXe siècle (Paris: Éditions Aubier Montaigne, 1981), 168–69. Anderson, “Immunities of Empire,” 100n23. Quote from Armand de Quatrefages de Bréau, L’espèce humaine (Paris: Librairie Germer Baillière et Cie, 1877), 310 (emphasis in original). Michael A. Osborne, “Resurrecting Hippocrates: Hygienic Science and the French Expeditions to Egypt, Morea and Algeria,” in Warm Climates and Western Medicine: The Emergence of Tropical Medicine, 1500–1900, ed. David Arnold (Amsterdam: Rodopi, 1996), 80–98. Pascal Grosse, “Conceptualizing Citizenship as a Biopolitical Category from the Eighteenth to the Twentieth Centuries,” in Citizenship and National Identity in Twentieth-Century Germany, ed. Geoff Eley and Jan Palmowski (Stanford, CA: Stanford University Press, 2008), 181–97. Patricia M. E. Lorcin, “Imperialism, Colonial Identity, and Race in Algeria, 1830– 1870: The Role of the French Medical Corps,” Isis 90 (1999): 653–79, summarizes the contributions of several military physicians to racial ideas. Quote on 655. Ann La Berge and Caroline Hannaway, “Paris Medicine: Perspectives Past and Present,” in Constructing Paris Medicine, ed. Ann La Berge and Caroline Hannaway (Amsterdam: Rodopi, 1998), 1–69. Armand Corre, L’ethnographie criminelle d’après les observations et les statistiques judiciaries recueillies dans les colonies françaises (Paris: C. Reinwald, 1894), 44. Osborne, “The Geographical Imperative,” 41. Richaud, “Essai de topographie médicale de la Cochinchine française,” Archives de médecine navale 1 (1864): 198–225, 341–62. See esp. 211–21, 357. Quote on 358. J. Chapuis, “De l’identité de l’ulcère observé à la Guyanne française avec celui décrit sous les noms de Gué-Ham, ulcère de Cochinchine, de Saigon, ulcère Annamite,” Archives de médecine navale 1 (1864): 375–81. Malaria comment on 377; quotation from 381n1. Likely this is Jules Guillaume Denis Chapuis. Fonssagrives and Alfred Le Roy de Méricourt, “Du mal-coeur ou mal d’estomac des nègres,” Archives de médecine navale 1 (1864): 362–75. Anderson, “Immunities of Empire,” 100, 113, provides a case in point in the person of Colonel Kenneth MacLeod. Lorelai Kury, “Les instructions de voyage dans les expéditions scientifiques françaises (1750–1830),” Revue d’histoire des sciences 51, no. 1 (1998): 65–91. Isidore Geoffroy Saint-Hilaire, and Paul Broca, and (François de LaPorte) de Castel-

Notes to Pages 83–87 / 243

26. 27. 28. 29.

30. 31.

32. 33. 34. 35. 36. 37. 38.

39.

40.

41. 42.

nau, “Instructions anthropologiques pour le Sénégal,” Archives de médecine navale 1 (1864): 255–65. Geoffroy Saint-Hilaire et al. “Instructions anthropologiques,” 256–58. “L’école de médecine de Pondichery,” Annales d’hygiène et de médecine coloniales 5 (1902): 507–10. “L’école de médecine de Pondichery,” 264–65. On French colonial spa culture, hydrotherapy, and acclimatization, see Eric T. Jennings, Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas (Durham, NC: Duke University Press, 2006), esp. chap. 1, “Acclimatization, Climatology, and the Possibility of Empire,” 8–39. On acclimatization in the German context see Pascal Grosse, “Turning Native? Anthropology, German Colonialism, and the Paradoxes of the ‘Acclimatization Question,’” in Worldly Provincialism: German Anthropology in the Age of Empire, ed. H. Glenn Penny and Matti Bunzl (Ann Arbor: University of Michigan Press, 2003), 179–97. The state of debate in the United Kingdom is the topic of David N. Livingston, “Tropical Climate and Moral Hygiene: The Anatomy of a Victorian Debate,” British Journal for the History of Science 32 (1999): 93–110. Henrika Kuklick, “Islands in the Pacific: Darwinian Biogeography and British Anthropology,” American Ethnologist 23, no. 3 (1996): 611–38, quotation on 628. Michel Mollat du Jourdin, “Le font de mer,” in Les lieux de mémoire, ed. Pierre Nora (Paris: Gallimard, 1984–1992), 3 vols., 3:617–71, quote on 664, and section “Rochefort, la Corderie et l’Hôpital,” 639–42. David A. Bell, The Cult of the Nation in France: Inventing Nationalism, 1680–1800 (Cambridge, MA: Harvard University Press, 2001), quote on xi. Fonssagrives, Traité d’hygiène navale, esp. “Recrutement, Moeurs, Professions, Travaux maritimes,” 91–136. J. B. C. Délivet, Principes d’hygiène navale (Gênes: n.p., 1808). Mahé, Manuel pratique d’hygiène navale, viii. Eugen Weber, Peasants into Frenchmen: The Modernization of Rural France, 1870–1914 (Stanford, CA: Stanford University Press, 1976). Louis Bazy, “Eugène Rochard, 29 octobre 1853–3 octobre 1924,” Archives de médecine et pharmacie navales 126 (1936): 225–32. Michael A. Osborne, “Science and the French Empire,” Isis 96 (2005): 80–87; Jacques Léonard, Les officiers de santé de la marine francaise de 1814 à 1835 (thèse pour le doctorat de troisième cycle [Mention Histoire], Faculté des lettres et sciences humaines, Université de Rennes) (Paris: C. Klincksieck, 1967). SHDAM, 3 S 2782, Adrien [Louis Joseph] Carré, “Notes sur l’histoire des écoles de médecine et chirurgie navales de Brest, 1731–1963,” (typescript, February–May 1973), 41, who quotes from an 1863 manuscript by Maher in BAM, BM. MS 56. See also SHDAM, 3 S 2659 Adrien Carré, “Historique du Service de santé de la marine, 1870–1970,” photocopy from Revue historique de l’armée (1972), 124–55. REM, Box 3, November 1, 1862, [Charles-Adolphe] Maher to M. le Inspecteur général Reynaud, [14 pages] “Sur les conditions d’instruction et de perfectionnement du personnel du Service de santé,” quote on 7. Marotte, Cinquante ans d’histoire de l’école du service de santé militaire de Lyon, 1889– 1939 (Lyon: R. Bonnefon, 1943), 15–28. Gustave Flaubert, Par les Champs et par les grèves (Paris: Bibliothèque-Charpentier, 1924), 174. I thank Jan Gorak for bringing this to my attention. On Flaubert’s pantheistic moments see Benjamin F. Bart, Flaubert (Syracuse, NY: Syracuse University Press, 1967), 173–75.

244 / Notes to Pages 87–92 43. Flaubert, Par les Champs et par les Grèves, 174–75. 44. Léonard, Les officiers de santé de la marine francaise, 241, gives these figures: Brest (25% from immediate department), Toulon (19.5%), Rochefort (15%). 45. On the persistence of Breton see Caroline Ford, Creating the Nation in Provincial France: Religion and Political Identity in Brittany (Princeton, NJ: Princeton University Press, 1993). Promotion of local identities is the topic of Stéphane Gerson, The Pride of Place: Local Memories & Political Culture in Nineteenth-Century France (Ithaca, NY: Cornell University Press, 2003). 46. Jean-Baptiste Fonssagrives, “Navale (Hygiène),” in Dictionnaire encyclopédique des sciences médicales, ed. Amédée Dechambre, deuxième série, vol. 11 (Paris: G. Masson, 1875), 713–817, 716. The second edition of the 1856 volume appeared as JeanBaptiste Fonsagrives, Traité d’hygiène navale, 2nd ed. (Paris: J.-B. Baillière, 1877). 47. Mahé, Manuel pratique d’hygiène navale, “Des qualities physiques et morales des gens de mer, suivant leur provenance originelle,” 82–92. 48. Mahé, Manuel pratique d’hygiène navale, quote on 93. 49. Ibid., quote on 93. Cf. my “Acclimatizing the World: A History of the Paradigmatic Colonial Science,” Osiris 15 (2001): 135–51. 50. Mahé, Manuel pratique d’hygiène navale, 87. 51. Ibid., 88. I have rendered the term démi-sobriété as partial sobriety. 52. Ibid., 88–89, emphasis added. This is part of a long quotation from Fonssagrives’s 1856 text. 53. Ibid., 90. 54. Ibid., 90–91. 55. Ibid., 91. 56. Fonssagrives, “Naval (Hygiène),” 713. 57. Ibid., 716. 58. Mahé, Manuel pratique d’hygiène navale, 60. 59. Mahé, Manuel pratique d’hygiène navale, “De la constitution,” 67–78, quote on 67. 60. Mahé, Manuel pratique d’hygiène navale, 64. 61. Ibid., 2–3. 62. Fonssagrives, “Naval (Hygiène),” 720–27. 63. Ibid., 717, italics in original. 64. Gouriou, “La vie et l’oeuvre de L. J. B. Bérenger-Féraud,” Archives de médecine et pharmacie navales 128 (1938): 297–312, is Gouriou’s heroic narrative of Bérenger-Féraud lacking in detail. Bernard Brisou, “Naissance du Service de santé des colonies: Dix ans de drames,” Médecine et armies 24, no. 5 (1996): 423–31, has determined Bérenger-Féraud’s birth was illegitimate and that he changed his name a number of times. 65. Cohen, The French Encounter with Africans, 235. 66. L.-J. B. Bérenger-Féraud, Traité clinique des maladies des Europeéns au Sénégal, 2 vols. (Paris: Adrien de la Haye, 1875–78), 2:327. 67. Anderson, “Immunities of Empire,” 102. 68. SHDAM, dossier individuel, série 2e moderne, carton no. B 20, “Bérenger-Féraud, Jean-Baptiste Laurent.” 69. Bérenger-Féraud, Traité clinique des maladies des Europeéns au Sénégal, esp. “Hygiène des Européens au Sénégal,” 2:325–531. 70. L.-J. B. Bérenger-Féraud, Traité de l’immobilisation directe des fragments osseux dans les fractures (Paris: Delahaye, 1870), 720. 71. L.-J. B. Bérenger-Féraud, Notice sur les services et les travaux scientifiques de M. L. J. B.

Notes to Pages 92–95 / 245

72. 73. 74. 75. 76. 77. 78. 79. 80.

81. 82. 83.

84.

85. 86.

87.

Bérenger-Féraud, directeur du Service de santé de la marine (Toulon: Imprimerie du Var, 1887). Anthropological titles include La race provençale au point de vue de ses origines (Paris: Octave Doin, 1883); and Les peuplades de la Sénégambie, histoire, ethnographie, moeurs, coutumes (Paris: Ernest Leroux, 1879). Bérenger-Féraud, Traité clinique des maladies des Europeéns au Sénégal had more than eighty tables but only a few of them list disease frequencies by race. L.-J. B. Bérenger-Féraud, Traité clinique des maladies des européens aux Antilles, 2 vols. (Paris: Octave Doin, 1881), 1:489. Ibid., 1:493. Ibid., 1:494. L.-J. B. Bérenger-Féraud, Traité théorique et clinique de la fièvre jaune (Paris: Octave Doin, 1891), 745. Ibid., 461. Ibid., 477. Ibid., esp. 461–82, quotation on 482. Alexandre Le Dantec, Recherches sur la fièvre jaune, critique des théories microbiennes émise en Amérique au sujet de cette maladie (Paris: Imprimerie des Écoles, Henri Jové, 1886), 49. Sheldon Watts, Disease, Power, and Imperialism (New Haven, CT: Yale University Press, 1997), 216. Ilana Löwy, Virus, moustiques et modernité, la fièvre jaune au Brésil entre science et politique (Paris: Éditions des archives contemporaines, ca. 2001). A sampling includes William Coleman, Yellow Fever in the North: The Methods of Early Epidemiology (Madison: University of Wisconsin Press, 1987); François Delaporte, Histoire de la fièvre jaune: Naissance de la médecine tropicale, presentation de Georges Canguilhem (Paris: Payot, ca. 1989); Margaret Humphries, Yellow Fever in the South (New Brunswick, NJ: Rutgers University Press, 1992); Ilana Löwy, Virus, moustiques et modernité; John Robert McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620–1914 (New York: Cambridge University Press, 2010); Mariola Espinosa, Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878–1930 (Chicago: University of Chicago Press, 2009). Simone Clapier-Valladon, “Les médecins français d’outre-mer: Étude psychosociologique du retoru des migrants” (Thèse, Université de Nice, 13 juin 1977) 2 vols. (Lille, France: Atelier reproduction des thèses, Univeristé de Lille III, 1980), 1:557, gives the number of responses as yellow fever (98), malaria (100), sleeping sickness (102). Erwin Ackerknecht, “Anticontagionism between 1821 and 1867,” Bulletin of the History of Medicine 22 (1948): 562–93. E. A. Heaman assesses the debate in “The Rise and Fall of Anticontagionism in France,” Canadian Bulletin of Medical History 12, no. 1 (1995): 3–25. See also Margaret Pelling, Cholera, Fever and English Medicine, 1825–1865 (Oxford: Oxford University Press, 1978); Christopher Hamlin, “Predisposing Causes and Public Health in Early Nineteenth-Century Medical Thought,” Social History of Medicine 5 (1992): 43–70; and Roger Cooter, “Anticontagionism and History’s Medical Record,” in The Problem of Medical Knowledge, ed. P. Wright and A. Treacher (Edinburgh: Edinburgh University Press, 1982), 87–108. Delaporte, Histoire de la fièvre jaune, examined closely the late nineteenth century, and Löwy, Virus, moustiques et modernité, was most concerned with twentieth-century events.

246 / Notes to Pages 95–98 88. Simone Clapier-Valladon, “Les médecins français d’outre-mer,” 1:145. 89. J.-B. Fonssagrives, Traité de thérapeutique appliquée, basé sur les indications suivi d’un précis de thérapeutique et de posologie infantiles et de notions de pharmacologie usuelle sur les médicaments signalés dans le cours de l’ouvrage, 2 vols. (Paris: Delahaye, 1878), 2:220. 90. Fonssagrives, Traité de thérapeutique appliquée, 2:215–23, summary of classification on 223. 91. Erwin H. Ackerknecht, “Yellow Fever,” History and Geography of the Most Important Diseases (New York: Hafner, 1965), 50–59, at 54; and John Robert McNeill, Mosquito Empires, 306. 92. Fonssagrives, “Navale (Hygiène),” 802. I have been unable to confirm the original source. 93. William Coleman, Yellow Fever in the North. 94. Espinosa, Epidemic Invasions; and Humphries, Yellow Fever in the South. 95. Fonssagrives, Traité d’hygiène navale (Paris: J.-B. Baillière,1856), 48–50. 96. George D. Sussman, “From Yellow Fever to Cholera: A Study of French Government Policy, Professionalism and Popular Movements in the Epidemic crises of the Restoration and July Monarchy” (PhD diss., Yale University, 1971), 7–45. 97. P. de Ségur-Dupeyron, Rapport adressé à son exc: Le minister du commerce, par M. de Ségur Dupeyron, chargé de procéder à une enquête sur les divers régimes sanitaires de la Méditeranée (Paris: Imprimerie Royale, 1834), 59. 98. Sussman, “From Yellow Fever to Cholera,” 18. 99. Gary W. Shannon, “Disease Mapping and Early Theories of Yellow Fever,” Professional Geographer 33 (1981): 221–27; Lloyd G. Stevenson, “Putting Disease on the Map: The Early Use of Spot Maps in Yellow Fever,” Journal of the History of Medicine and Allied Sciences 20 (1965): 227–61; Saul Jarcho, “Yellow Fever, Cholera, and the Beginnings of Medical Cartography,” Journal of the History of Medicine and Allied Sciences 25 (1970): 131–42. 100. Manfred J. Wasserman and Virginia Kay Mansfield, “Nicolas Chervin’s Yellow Fever Survey, 1820–1822,” Journal of the History of Medicine and Allied Sciences 26 (1971): 40–51. 101. Nicolas Chervin, De l’origine locale et de la non-contagion de la fièvre jaune qui a régné à gibraltar en 1828 (Paris: [reprint from Annales maritimes, March 1832]), and Chervin, Pétition présentée à la chambre des pairs et à la chambre des députés pour demander la suppression immédiate des mesures sanitaires relatives à la fièvre jaune (Paris: J.-B. Baillière, 1843). 102. Nicolas Chervin, “Opinion du docteur Chervin touchant la proprieté [sic] que possède la fièvre jaune d’attacker deux fois le meme individu,” Gibraltar, 31 mars 1829, BIUM, cote 2482. Http://www.biusante.parisdescartes.fr/histmed/medica/ cote?ms02485, accessed August 29, 2012. 103. William Coleman, Yellow Fever in the North, 55. 104. Ibid. 105. Évariste Bertulus, “L’hygiène navale dans ses rapports avec l’économie politique, commerciale, et avec l’hygiène publique, ou nouvelles considerations sur la matière, le but, l’enseignement et l’application de cette science” (read before the Société royale de médecine de Marseille, October 18, 1845) (Marseille: Typographie Barlatier-Feissal et Demonchy, 1845), 22, point no. 7. For criticism of Chervin see Bertulus, Marseille et son intendance sanitaire, à propos de la peste, de la fièvre jaune, du choléra et des événements de Saint-Nazaire, Loire-Inférieure, en 1861: Études historiques

Notes to Pages 99–103 / 247

106.

107.

108.

109. 110. 111. 112. 113.

114. 115.

116.

117.

118. 119. 120. 121. 122.

123.

et médicales (Marseille: Camoin, 1864), in the first 150 pages. On recommendations for strengthening quarantine regulations see p. 156 and esp. pp. 365–72. On cooperation see Deborah J. Neill, Networks in Tropical Medicine: Internationalism, Colonialism, and the Rise of a Medical Specialty, 1890–1930 (Stanford, CA: Stanford University Press, 2012). For a different notion of circulation see Kapil Raj, Relocating Modern Science: Circulation and the Constitution of Scientific Knowledge South Asia & Europe, Seventeenth to Nineteenth Centuries (New Delhi: Permanent Black, 2006). Léonard, Les officiers de santé de la marine française, 82, argues that naval medical men had only moderate enthusiasm for Broussais’s theories and therapy. For another perspective see Ferdinand Burot, “Éloge de C.-A. Maher . . . discourse pronouncé le 3 novembre 1888 à la rentrée de l’École de médecine navle de Rochefort” (Rochefort-sur-Mer, France: Société anonyme de l’Imprimerie Ch. Thèze, 1889), esp. 5–6. Charles-Adolphe Maher, Relation médicale de deux épidémies de fièvre jaune à bord de la frigate l’Herminie, en 1837 et 1838, à la Havane et à Véra-Cruz (Paris: Locquin, 1839). Burot, “Éloge de C.-A. Maher,” 10. William Coleman, Yellow Fever in the North, 42–52. Fonssagrives, Traité de thérapeutique appliquée, 2:220. Alexandre Le Dantec, Précis de pathologie exotique (Maladies des pays chauds et des pays froids), 2 vols. (Paris: Octave Doin, 1929), 1:44–46. Charles-Adolphe Maher, “Essai de statistique médicale pour Rochefort en 1860,” Travaux [of the] Société d’agriculture, des belles-lettres, sciences et arts de Rochefort [1860–62] (Rochefort, France: Imprimerie Ch. Thèse, 1863), 49–89, at 63. Charles-Adolphe Maher, Statistique médicale de Rochefort, Charente-Inférieure (Paris: Baillière, 1874). Claude Thiébaut, “Présentation,” to Nos Créoles, by Armand Corre (Paris: L’Harmattan, 2001), vii–xxxv, xiii. Original edition is Corre, Nos Créoles (Paris: Albert Savine, 1890). His thesis is Corre, Notes médicales recueillies à la Vera-Cruz (Mexique), 1862, 1865, 1866 (Paris: A. Parent, 1869). SHDAM, Personnel Dossier for Armand Marie Corre, CC7 544. There is of course no way to determine the correctness of these diagnoses. Health certificates for February 6, 1867; July 3,1868; and February 16, 1877. Armand Corre, “Journal du Docteur Corre en Pays Sérère (décembre 1876–janvier 1877),” ed. G. Debien, Bulletin de l’Institut français d’Afrique noire 26, nos. 3–4 (1964): 532–600. The provenance of the map and drawings cannot be determined although the editor implies the map was drawn by Corre. Corre, “Journal du Docteur Corre,” 543. Ibid., 586–87. Armand Corre, “De l’étiologie et de la prophylaxie du typhus amaril (fièvre jaune),” Archives de médecine navale 37 (1882): 5–25, 81–140, 213–30, 14. Corre, Nos Créoles, ed. Thiédbaut, 275. Armand Corre, “Un mot à propos du microbe de l’ictère grave et de l’oscillaire de la malaria,” Archives de médecine navale 37 (1882): 402–6. On Kelsch see my “French Military Epidemiology and the Limits of the Laboratory: The Case of Louis-Félix Kelsch,” in The Laboratory Revolution in Medicine, ed. Andrew Cunningham and Perry Williams (Cambridge: Cambridge University Press, 1992), 189–208. The others were Armand Corre, Les criminels, caractères physiques et psychologiques (Paris: O. Doin, 1889); Corre, Le crime en pays créoles (essquisse d’ethnographie cri-

248 / Notes to Pages 103–106

124.

125. 126. 127. 128. 129. 130.

131. 132.

133. 134.

135.

136.

137.

138. 139.

minelle) (Paris: G. Masson, 1889); Corre, Crime et suicide, étiologie générale, facteurs individuals, sociologiques et cosmiques (Paris: O. Doin, 1891). Corre, Nos Créoles, ed. Thiébaut, 33. Corre and racial theory are investigated by Dominique Taffin, “Des miasmes et des races: Les officiers de santé de la marine et le monde colonial antillais,” Ultramarines 1 (1990): 11–15. I thank her for kind assistance rendered over the years. Armand Corre, L’ethnographie criminelle d’après les observations et le statistiques judiciaries recueillies dans les colonies françaises (Paris: C. Reinwald, 1894). Ibid., 3n1. Ibid., 3. Ibid., 506–7, quote on 506. Michelle Chilcoat, “In/Civility, in Death: On Becoming French in Colonial Martinique,” boundary 2 (2004), 31:3, 47–73. Gabriel Tarde, “Les criminels, par le Dr. Corre,” Archives d’anthropologie criminelle 4 (1889): 112–22, quote on 113. Gabriel Tarde, Penal Philosophy, with a new introduction by Piers Beirne, trans. R. Howell (New Brunswick, NJ: Transaction Publishers, 2001 [reprint originally published by Little, Brown, and Company, 1912]). For Tarde’s analysis of the Australian experience see, 208–9, 516. Arthur Bordier, “Étude anthropologique d’une série de cranes d’assassins,” Revue d’anthropologie, 2nd ser. (1879): 265–300. Armand Corre, “Sur quelques crânes de criminals conservés au musée d’anatomie de l’École de médecine de Brest,” Bulletin de la Société d’anthropologie de Paris (séance du 4 août 1881), 638–54, (séance du 5 janvier 1882), 28–36, quote on 37. Jan Goldstein, The Post-Revolutionary Self: Politics and Psyche in France, 1750–1850 (Cambridge, MA: Harvard University Press), 288–90. Marc Renneville, Le langage des crânes: Histoire de la phrénologie (Paris: Institut d’Édition Sanofi-synthélabo, 2000), 262, where he quotes from the Mémoires de la Société ethnologique de Paris, 1841, III. See p. 25 for comments on naval physicians and phrenology. Also of use is Renneville, La médecine du crime (1785–1885), 2 vols. (Thèse du doctorat ‘Histoire nouveau régime, Université Paris 7–Dennis Diderot, 1997), “La théorie de Gall en question,” 1:304–57. Gilles Boëtsch and Michèle Fonton, “L’ethnographie criminelle, les applications de la doctrine lobrosienne aux peoples colonisés au XIXème siècle,” in Histoire de la criminologie française, ed. Laurent Mucchielli (Paris: L’Harmattan, 1994), 139–56, esp. 142–43, 153. Laurent Mucchielli, “Naissance et decline de la sociologie criminelle (1880–1940),” in Histoire de la criminologie française, ed. Mucchielli, 287–312, at 298–99. See also Mucchielli, “Criminology, Hygienism, and Eugenics in France, 1870–1914,” in Criminals and Their Scientists: The History of Criminology in International Perspective, ed. Peter Becker and Richard F. Wetzell (Washington, DC: German Historical Institute, 2006), 207–30, esp. 220–1. Albert Clarac, Mémoires d’un médecin de la marine et des colonies (1854–1934), pref. Bernard Brisou, ed. Geneviève Salkin (Vincennes, France: Service historique de la marine, 1994), 3–4. See also Alice Bullard, Exile to Paradise: Savagery and Civilization in Paris and the South Pacific, 1790–1900 (Stanford, CA: Stanford University Press, 2000). Biographical details from Clarac, Mémoires d’un médecin de la marine. Albert Clarac, “Notes sur les chéloides observées chez le noir et principalement sur la chéloide de l’oreille,” Archives de médecine navale 55 (1891): 459–71.

Notes to Pages 106–113 / 249 140. Clarac, Mémoires d’un médecin de la marine, “Premier sejour [sic] à Martinique,” 31–36; and “Deuxième séjour à Martinique,” 49–59, 58n1. 141. Geneviève Salkin, “Portrait de carrière du médecin général Albert Clarac au travers de son dossier,” in Clarac, Mémoires d’un médecin, Annexe III, 235–44, at 238. 142. Clarac, “Contribution à l’étude de la fièvre jaune à la Martinique,” Archives de medicine navale 53 (1890): 5–35, 111–22, 118. 143. Thiébaut, “Présentation,” in Corre, Nos Créoles, vii–xxxv, xxvii. 144. Clarac, “Contribution à l’étude de la fièvre jaune à la Martinique,” 114. 145. IP, Armand Corre collection, Box 5, COR. 5, Cherbourg, November 10, 1885, Calmette to Corre. 146. IP, Corre collection, Box 5, COR. 5, June 30, 1886, Calmette to Corre. 147. Thiébaut, “Présentation,” in Corre, Nos Créoles, ixn4, which references a note written by Corre. 148. Henri Bouliner, “Chronologie,” in Victor Segalen, Oeuvres complètes, ed. Bouliner, 2 vols. (Paris: Robert Lafont, 1995), xxxi–lxxxvii, liv. 149. IP, Corre collection, COR.2. 150. Segalen, Oeuvres complètes, 1:liv. CHAPTER FOUR

1. 2.

PPP, cote Ba 139, L’éclair, November 29, 1891. Laurent Morando, “Les Instituts coloniaux et l’Afrique: 1893–1940; Ambitions nationals, réussites locales,” 2 vols. (Thèse pour le doctorat, Université Aix-Marseille I-Université de Provence, 2001), “L’Institut colonial de Bordeaux de 1901 à 1914,” 1:87–111, 87–88. 3. On the most important Old Regime colony, see James E. McClellan III, Colonialism and Science: Saint Domingue in the Old Regime (Baltimore: Johns Hopkins University Press, 1992). 4. Morando, “Les Instituts coloniaux,” 1:88–89. 5. Pierre Guillaume, Les hospices de Bordeaux au XIXe siècle (1796–1885) (Bordeaux: Les Études Hospitalières Éditions, 2000), 224–26. 6. Pierre Guillaume, “Malades, médecine et médecins à Bordeaux au XIXe siècle,” Annales de Bretagne et des Pays de l’Ouest 86, no. 2 (1979): 291–320, 291 for statistics, 293 for Magendie’s formula. 7. Albert Pitres, “A Monsier le Docteur Péry, bibliothécaire de la Faculté de Médecine,” in G. Péry, Histoire de la Faculté de la Médecine de Bordeaux et de l’enseignement médical dans cette ville (Paris: O. Doin, 1888), vii–x, ix, mentions two official chairs. Charles Coury calculates four in his “The Teaching of Medicine in France from the Beginning to the Seventeenth Century,” The History of Medical Education, ed. Charles D. O’Malley (Berkeley: University of California Press, 1970), 121–72. 8. Georges Portmann, “Journées médicales de Bordeaux,” Journal de Médecine de Bordeaux 10 (October 1950): 565–67. 9. Angie Smith, “Weighed in the Balance? The Corporation of Apothecaries in Bordeaux, 1690–1790,” Social History of Medicine 16 (2003): 17–37, esp. 32–34. 10. Smith, “Weighed in the Balance?,” 18, 26–27. 11. E. Loubat, “Préface” to Histoire de la Société de médecine et de chirurgie de Bordeaux à l’occasion de son Cent-cinquantenaire (1798–1948), by Alexandre-Alfred Chabé (Bordeaux: R. Samie, 1948), vii–xii, ix. 12. Louis Desgraves and Georges Dupeux, eds., Bordeaux au XIXe Siècle, vol. 6 of Histoire

250 / Notes to Pages 113–117

13.

14.

15. 16. 17. 18. 19. 20. 21.

22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33.

de Bordeaux, ed. Charles Higounet (Bordeaux: Fédération historique du Sud-Ouest, 1969), 470–71, 478–80. Marie Noëlle Cloitre, “La médecine Bordelaise au XIXème siècle, ses personnalités médicales et académiques” (Thèse pour le doctorat d’état en médecine, Université de Bordeaux II, 1979), 33. J. Manès, “Les vingt-cinq années de la Société de géographie commerciale de Bordeaux (1874–1899),” Revue de géographie commerciale 23 (1900): 139–50; cf. Morando, “Les instituts coloniaux,” 1:92–94. Jack D. Ellis, The Physician-Legislators of France: Medicine and Politics in the Early Third Republic, 1870–1914 (New York: Cambridge University Press, 1990). Manès, “Les vingt-cinq années,” 140–41, 143–45; Chabé, Histoire de la Société de médecine, 50, 86. Manès, “Les vingt-cinq années,” 148–49; cf. Morando, “Les instituts coloniaux,” 1:92–94. Joan Doerge Casey, “Bordeaux, Colonial Port of Nineteenth Century France” (PhD diss., University of Missouri, Columbia, 1973), 217–18. Morando, “Les instituts coloniaux,” 1:96n24, which quotes Joseph Lubet, L’Institut colonial de Bordeaux (Bordeaux: Feret et Fils, 1904), 59. Casey, “Bordeaux, colonial port,” 218. See, for example, Lucien Beille, Précis de botanique pharmaceutique, 2 vols (Lyon: A. Storck, 1904–9); William A. Dubreuilh and L. Beille, Les parasites animaux de la peau humaine (Paris: Masson, 1896). Ministère des colonies, France, Actes de l’Institut colonial de Bordeaux, Congrès colonial de Bordeaux (4–8 août 1907) (Bordeaux: Institut colonial, 1908), front matter. Pierre Camena d’Almeida, “La cartographie des colonies françaises,” in Actes de l’Institut colonial de Bordeaux, 518–22. Morando, “Les instituts coloniaux,” 1:102–3. Pierre Achalme, “Le role des sciences biologiques dans la colonization,” in Actes de l’Institut colonial de Bordeaux, 562–76, 571. Arthur Bordier, La colonisation scientifique et les colonies françaises (Paris: C. Reinwald, 1884); Édouard de Martonne, Le savant colonial (Paris: Larose, 1930). Louis-Yves Bervas, “La maladie du sommeil et les guérisseurs noirs,” Annales de l’Institut colonial de Bordeaux 10 (1911): 126–28. L. Beille, “Rapport de fin d’année,” Annales de l’Institut colonial de Bordeaux 11 (1912): 3–12, esp. 3–8. M. T. Feghali, “Un course de langue arabe,” Annales de l’Institut colonial de Bordeaux 10 (1911): 128–41, 139–40. Desgraves and Dupeux, eds., Bordeaux au XIXe Siècle, 157–60. William B. Cohen, Urban Government and the Rise of the French City: Five Municipalities in the Nineteenth Century (New York: St. Martin’s Press, 1998), 2–7. Desgraves and Dupeux, eds., Bordeaux au XIXe Siècle, 205–9; figures on 208. The most assessable accounts are Philippe Mason, “L’école de santé navale et coloniale de Bordeaux,” in Historire des médecins et pharmaciens de marine et des colonies, ed. Pierre Pluchon (Paris: Privat, c. 1985), 163–84; and Marc Michel, “Le corps de santé des troupes coloniales,” 185–214 in the same volume. See also Adrien Carré, “Historique de Service de santé de la marine, 1870–1970,” Revue Historique de l’Armée, no. 1 (1972): 136–55. More focused on the breakaway period of the colonial health service are Bernard Brisou and Geneviève Salkin, “L’autonomie du Service de santé colonial,” Revue historique des armées, no. 202 (1996): 53–66; Brisou,

Notes to Pages 118–123 / 251

34.

35.

36. 37. 38.

39. 40. 41. 42. 43. 44.

45. 46. 47. 48. 49. 50.

51. 52. 53.

54.

“Naissance du Service de santé des colonies: Dix ans de drames,” Médecine et armées 24 (1996): 423–31, and Brisou, “Georges Treille et le service de santé colonial ou le triple attentat aux livres explosives,” Bulletin de l’Académie du Var (1994): 119–36. Jacques Léonard, Les officiers de santé de la marine française de 1814 à 1835 (Thèse du doctorat du 3e cycle, mention histoire, Université de Rennes) (Paris: C. Klincksieck, 1967), 14, 20–22. For details on naval regulations from 1680 to 1875 see Jean Baptiste Mahé, “Navale (Service de santé),” in Dictionnaire encyclopédique des sciences médicales, deuxième série, vol. 11, ed. A. Dechambre (Paris: G. Masson, 1875), 558– 721. For reforms immediately prior to those of 1835, see esp. 591–603. Quoy in Catherine Allard-Eveille, “Manuscrits et souvenirs rochellois de chirurgien navigant Jean René Quoy, 1790–1869” (Thèse pour le doctorat en médecine, Université de Nantes, 1981–1982), 297. Quoy likely composed this diary in 1864–65. The original is in the Bibliothèque de la Rochelle. Léonard, Les officiers de santé, 14–15, 253–73. The key reforms are ordinances of January 3, 1835, and July 17, 1835. Léonard, Les officiers de santé, 263–68. Léonard, Les officiers de santé, 268, gives the title as “Règlement concernant le mode d’admission, d’enseignement et de concours dans le service de santé de la marine.” See also Mahé, “Navale (Service de santé),” 591–93, 601. George D. Sussman, “The Glut of Doctors in Mid-Nineteenth Century France,” Comparative Studies in Society and History 19 (1977): 287–304, 303. Sussman, “The Glut of Doctors,” 289. Figures from Léonard, Les officiers de santé, 270–71, professor ratio on 272. Étienne Taillemite, “Jean René Quoy,” in Dictionnaire du Second Empire, ed. Jean Tulard (Paris: Fayard, 1995), 1098. Quoy in Allard-Eveille, “Manuscrits et souvenirs rochellois,” 42–43. J. Léonard, Les officiers de santé, 125–27. Léonard, 36–37, portrays the professors at Brest as not giving examinations and typifies the courses at Rochefort as “very neglected.” Quoy in Allard-Eveille, “Manuscrits et souvenirs rochellois,” 38. Quoy in Allard-Eveille, “Manuscrits et souvenirs rochellois,” 322. Capitalization and emphasis in original. Quoy in Allard-Eveille, “Manuscrits et souvenirs rochellois,” 323. Quoy in Allard-Eveille, “Manuscrits et souvenirs rochellois,” 30–31. I have slightly altered the French for reasons of readability. Quoy in Catherine Allard-Eveille, “Manuscrits et souvenirs rochellois,” 78 (duel), 145 (therapeutics). Quoy in Catherine Allard-Eveille, “Manuscrits et souvenirs rochellois,” 73. For a more flattering view of Clémot and the Rochefort school, see Michel Sardet, L’école de chirurgie du port de Rochefort (1722–1789) (Vincennes: Service historique de la Marine, 2000), 140 (Clémot). Léonard, Les officiers de santé, 223–25. Quoy in Catherine Allard-Eveille, “Manuscrits et souvenirs rochellois,” 107–9, quote on 109. REM, Box 8, Eugène Leconte, manuscript entitled “Plan d’une constitution nouvelle du Corps des Officiers de Santé de la Marine;” and Leconte, Exposé des motifs d’un projet de constitution nouvelle du corps des officiers de santé de la marine (Rochefort: Imp. Loustau, 1848). BAM, cote A 3 120, “Rapport de la commission spéciale chargée de rechercher les

252 / Notes to Pages 124–128

55.

56.

57. 58. 59.

60. 61.

62.

63. 64. 65.

66.

67. 68. 69.

70.

71.

ameliorations à introduire . . . et d’étudier les moyens de leur appliquer le décret du 3 mai relative aux officiers de santé de l’armée de terre.” REM, Box 10, folder “Lettres de Inspection,” Quoy to M. Directeur du Service de santé, April 15, 1858 (pharmacy students); April 20, 1858 (demission of poor student); May 10, 1858 (intellectual liberty in matters of theory). A. [Joseph Hippolyte Édouard] Malespine, La médecine navale: Urgence d’une réorganisation (Paris: É. Dentu, 1862); Malespine, De l’organisation du corps médical de l’armée appliquée à la marine (Paris: É. Dentu, 1863); Malespine, La médecine navale et le doctorat (Paris: É. Dentu, 1863); Malespine, Le corps de santé de la marine: ses besoins, ses revendications; assimilation; pondération des grades (Paris: É. Dentu, 1879). Malespine, La médecine navale et le doctorat, quote on 4, 23. Charles-Adolphe Maher, Les Médecins de la marine (Rochefort: Proust-Branday, 1863). REM, Box 3, “Sur les conditions d’instruction et de perfectionnement du personnel du service de santé,” Maher to Reynaud, November 4, 1862 (14 unpaginated leaves). REM, Box 3, “Sur les conditions d’instruction et de perfectionnement.” REM, Box 3, “Note en réponse à la brochure de M. Malespine faisant suite au mémoire du 1 nov 1862, Maher to Reynaud, January 6, 1863.” For Brest see Maher to mon cher deputé, January 10, 1863, and SHDAM, Box CC2 935, ChasseloupLaubat, “Rapport à l’Empereur.” Ferdinand Burot, “Éloge de C.-A. Maher . . . discourse pronouncé le 3 novembre 1888 à la rentrée de l’École de médecine navle de Rochefort” (Rochefort-sur-Mer, France: Société anonyme de l’Imprimerie Ch. Thèze, 1889), 16–18. Mémoire à consulter sur la question relative à la suppression de l’École de médecine navale de Rochefort (Rochefort, France: Imprimeries de Mercier et Devois, 1850). REM, Box 9. Mahé, “Navale (Service de santé),” 607–23, reprints the report and examines the impact of most of the sixty-two articles and subsequent related regulations of April 10 and November 21, 1866. Mahé, “Navale (Service de santé),” 625–26; cf. REM, A. Carré, “Les Écoles françaises de médecine navale et l’École de Bordeaux” (unpaginated typescript of seminar given at the VIIe Colloque franco-allemand d’histoire de la médecine navale, 1981–82). Mahé, “Navale (Service de santé),” 624–26, 632, 645. Philippe Mason, “L’École de santé navale et coloniale de Bordeaux,” in Histoire des médecins et pharmaciens de marine, ed. Pluchon, 163–84, 164. For biographical details and many bibliographies see SHDAM, série 2 moderne, carton B 20, “Bérenger-Féraud,” esp. Laurent Jean-Baptiste Bérenger-Féraud, Notice sur les services et les travaux scientifiques de M. L.-J. B. Bérenger Féraud, directeur du service de santé de la marine (Toulon, France: Imp. Du Var, 1887). The most carefully researched biography is Brisou, “Naissance du service de santé des colonies,” 423–31, esp. 427–29. See also Gouriou, “La vie et l’oeuvre de L. J. B. Bérenger-Féraud,” Archives de médecine et pharmacie navales 128 (1938): 297–312. SHDAM, dossier “Bérenger-Féraud,” Rochefort, April 18, 1866, “Certificate de visite,” and letters from Bérenger-Féraud dated March 21, 1866, and September 22, 1866. Brisou, “Naissance du service de santé des colonies,” 429n3, who cites without page attribution a series of articles on “L’attentat au fulminate,” in Le XIXe siècle,

Notes to Pages 129–132 / 253

72. 73. 74. 75. 76. 77.

78.

79. 80. 81. 82.

83. 84. 85. 86. 87. 88. 89. 90.

July 27–31, 1891; August 30, 1891; November 29, 1891. I have rendered plancher des vaches as “safety of land” rather than terra firma to capture the pejorative context of the longer quotation. SHDAM, dossier “Bérenger-Féraud,” Jérôme Napoléon to minister of the navy, August 4, 1868. SHDAM, dossier “Bérenger-Féraud,” Jules Roux, May 1, 1875, “Note pour la direction du personnel.” The letter refers to the pharmacist J. Bouisson. SHDAM, dossier “Bérenger-Féraud,” Bérenger-Féraud to minister of navy and colonies, April 24, 1875. Summarized from Brisou, “Naissance du service de santé des colonies;” and Bérenger-Féraud, Notice sur les services et les travaux scientifiques. Brisou, “Naissance du service de santé des colonies,” 428. Bérenger-Féraud, Traité des fractures non consolidées; ou, Pseudarthroses (Paris: Delahaye, 1871); and Bérenger-Féraud, De la fièvre jaune au Sénégal (Paris: Delahaye, 1874). SHDAM, “Bérenger-Féraud,” Port de Saint-Louis, September 11, 1873; Conseil de santé, Sénégal et dépendances, “chronic hepatitis;” Toulon, December 4, 1877; Conseil de santé, “intertropical anemia;” Cherbourg, April 13, 1883, Certificate de contre-visite “endemic liver congestion.” TAM, folio 2E4 365. François Jouglas, “Saint-Mandrier, son histoire, sa legende,” Bulletin de la Société des amis du vieux Toulon et de sa région 89 (1967): 65–79. Bérenger-Féraud, Saint-Mandrier (Paris: E. Leroux, 1881; reprint Marseille: Laffitte, 1977). Bérenger-Féraud, Les peupulades de la Sénégambie (Paris: E. Leroux, 1879); BérengerFéraud, Contes populaires de la Sénégambie (Paris: E. Leours, 1885); BérengerFéraud, La race provençale au point de vue de ses origins (Paris: O. Doin, 1883); Bérenger-Féraud, Reminiscences populaires de la Provence (Paris: E. Leroux, 1886); Bérenger-Féraud, Contes populaires des Provençaux de l’antiquité et du moyen age (Paris: E. Leroux, 1887). The naval physician Jules Regnault made similar links between Norman and Far Eastern healing practices. See Evelyn Bernette Ackerman, “The Intellectual Odyssey of a French Colonial Physician: Jules Regnault and Far Eastern Medicine,” French Historical Studies 19 (1996): 1083–1102. Bérenger-Féraud, Notice sur les services et les travaux scientifiques, 43. Bérenger-Féraud, Notice sur les services et les travaux scientifiques, 44. SHDAM, dossier “Bérenger-Féraud,” contains several letters on this issue. Quote from Rochard, April 3, 1879, “Note pour la direction du personnel (Corps Entretenus).” SHDAM, dossier “Bérenger-Féraud,” St. Mandrier (Toulon), March 14, 1879, Bérenger-Féraud to Monsieur le Ministère de la marine et des colonies. Les médecins de la marine devant le parliament (Bordeaux: Imprimerie nouvelle A. Bellier et Cie., 1883), esp. 64. Les médecins de la marine devant le parliament, 8, emphasis in original. Projet de réformes dans le corps de santé de la marine (Toulon: A. Isnard et Cie, 1882). Anon., Les Écoles de médecine naval et les professeurs (Vichy: Imprimerie Wallon, 1883). Apparently a second series of letters and another booklet were published in January of 1883 which also appeared in pamphlet form, see 91n1. Maher’s interventions of the 1860s had not quieted Malespine. See his Le corps de santé de la marin: Ses besoins, ses revendications; Assimilation; pondération des grades (Paris: É. Dentu, 1879).

254 / Notes to Pages 132–137 91. 92. 93. 94. 95. 96. 97. 98.

99.

100. 101. 102.

103. 104. 105. 106. 107.

108. 109. 110.

111. 112.

113. 114.

Anon., Les écoles de médecine naval et les professeurs, 9. Ibid., 59–62, quote on 61, emphasis in original. Ibid., 87–90. REM, Box 3, November 1, 1862, Maher to Reynaud, “Sur les conditions d’instruction.” SHDAM, CC2 935–3, Rochard to Monsieur le Ministre, October 4, 1884. Ibid., quote on 8. Ibid.. quote on 9. REM, Box 8, “Réorganisation 1883–1888–1889,” undated [1885?] draft memo of thoughts of the committee of medical school professors in response to Rochard to Monsieur Le Directeur du Corps de santé de la Marine à Rochefort, January 6, 1885. SHDAM, CC2 935–3, “Projet de suppression de l’École du médecine navale de Rochefort,” Rochard [?], “Note pour le ministère,” March 10, 1877, and copy in note of February 21, 1878. Emphais in original. REM, Box 8, “Réorganisation 1883–1888–1889,” undated draft memo [1885?] of the Rochefort commission. Emphasis in original. Mason, “L’École de santé navale et coloniale de Bordeaux,” esp. 166–73; and Brisou, “Naissance du service de santé.” “La Réorganisation du Corps de Santé,” Le petit Var, no. 2043, May 13, 1886. On the general history of the École de santé navale, see Alain Richer de Forges, “L’École de santé navale (Contribution à son histoire)” (Thèse médicale, Université de Bordeaux II, 1975). M. Lereboulllet, “Obsèques de M. J. Rochard,” Bulletin de l’Académie de médecine 36 (1896): 325–29. Jean Pervès, “De la première intervention cardiaque à l’hibernation artificielle,” Revue historique de l’armée 28, no. 1 (1972): 186–200, 189. Bérenger-Féraud, Notice sur les services et les travaux, 3, quote 13n2. Jean Barreau, “Évolution des troupes de marine de 1871 à 1950,” Revue historique des armées 2 (1983): 4–19, 6. Brisou, “Naissance du service de santé des colonies”; Brisou and Geneviève Salkin, “L’autonomie du service de santé colonial,” Revue historique des Armées, no. 202 (1996): 53–66, esp. 56, 62–63. BoAM, cote 6852 M 6, Mayor Bayssellance to Raynal (Deputy from the Gironde), February 28, 1890. BoAM, 6852 M 6, unsigned letter of April 10, 1890. Décret portant création d’une école du service de santé de la marine à Bordeaux et de trois annexes (du 22 juillet 1890); Décret déterminant la compostion de l’uniforme des élèves du service de santé de la marine (du 23 juillet 1890); Arrêté ministériel concernant l’institution de l’école du service de santé de la marine (du 23 juillet 1890) (Paris: Imprimerie de Librairie militaires de L. Baudoin et Cie, 1890). Mason, “L’école de santé navale et coloniale de Bordeaux,” 168–69. BoAM, cote 1070 R 11, “Banquet à l’occasion de l’inauguration de l’École du service de santé de la marine.” For speeches see “Inauguration de l’École du service de santé de la marine,” Gazette hebdomadaire des sciences médicales 45 (9 November 1890): 479–85. “Inauguration de l’École du service de santé de la marine,” 480, 483. Brisou, “Georges Treille et le Service de santé colonial,” 128. See also Brisou, “Saigon, Nha-Trang, Hanoi: Le Service de santé colonial et les débuts des Instituts

Notes to Pages 137–141 / 255

115. 116. 117. 118.

119. 120.

121. 122. 123. 124. 125. 126. 127. 128.

129. 130.

131. 132. 133.

134.

Pasteur de l’Indochine,” Revue historique des armées 208 (1997): 17–28, esp. 18–19; and Brisou and Salkin, “L’autonomie du Service de santé colonial,” 58–60. For photo see Brisou, “Saigon, Nha-Trang, Hanoi,” 18; for military record Brisou, “Georges Treille et le Service de santé colonial,” 124. Georges-Félix Treille, “De la fracture longitudinale du sacrum, considérée au point de vue de son mécanisme et de ses symptoms” (Paris: A. Parent, 1872). Georges Treille, De l’acclimatation des Européens dans les pays chauds (Paris: Octave Doin, 1888), 134. Treille, De l’acclimatation des Européens, “Préface,” vi. Cf. Eric T. Jennings, Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas (Durham, NC: Duke University Press, 2006), 17. Treille, “De l’enseignement de la pathologie tropicale dans les universités de l’Europe,” Janus 7 (1902): 238, 244, 281–87, esp. 241–42, 283. Brisou, “Georges Treille et le Service de santé colonial,” 129, who cites anon., “Armée coloniale-Service de santé de l’armée coloniale-Art. XI” (Toulon, France: Le petit Var, 1900). PPP, cote Ba 139, “Affaire des livres explosives envoyés à M. Constans (July 1891).” PPP, cote Ba 139, “Rapport de M. M. Girard, chef du laboratoire municipale,” July 24, 1891/signed November 3, 1891. Brisou, “Georges Treille et le Service de santé colonial,” 123. PPP, cote Ba 139, “Rapport de M. M. Girard.” PPP, cote Ba 139, Nourrit, typescript, July 29, 1891. Ibid. PPP, cote Ba 139, Dubois, typescript, August 10, 1891. PPP, cote Ba 139, newspaper clippings including E. Odin, “Les livres explosibles,” L’Égalité, August 11, 1891, and Edmond Bazire, “L’aveu,” [title illegible], August 1, 1891, and cote Ba 1018, “Ernest Constans, Ministère de l’Intérieur,” Edmond Bazire, “Servez dynamite!,” L’Intransigeant, July 21 [?], 1891. Brisou, “Georges Treille et le Service de santé colonial,” 130–31. PPP, cote Ba 139, quoted is a clipping from L’éclair, November 29, 1891. Brisou, “Georges Treille et le Service de santé colonial,” also lists Le XIXe siècle, July 27–31, 1891; August 30, 1891; November 29, 1891. PPP, cote Ba 139, L’éclair, November 29, 1891. On spa culture in this context see Jennings, Curing the Colonizers. SHDAM, série 2 moderne, carton B 20, “Bérenger-Féraud,” Étienne to Monsieur le Ministre de la Marine, August 10, 1891; B. Brisou, “Georges Treille et le Service de santé colonial,” 133–35; Georges Treille, Principes d’hygiène coloniale (Paris: Georges Carré et C. Nand, 1899). Péry, Histoire de la Faculté de la médecine de Bordeaux, 347–72, 424. On French provincial medical education and the genesis and impact of the Paul Bert report, see Christian Bonah, Instruire, guérier, server: Formation, recherché et pratique médicales en France et en Allemagne pendant la deuxième moitié du XIXe siècle (Strasbourg: Presses Universitaires de Strasbourg, 2000), esp. 355–406. For the wider context see Mary Jo Nye, Science in the Provinces: Scientific Communities and Provincial Leadership in France, 1860–1930 (Berkeley: University of California Press, 1986); and George Weisz, “Reform and Conflict in French Medical Education, 1870–1914,” in The Organization of Science and Technology in France, 1808–1914, ed. Robert Fox and George Weisz (Cambridge: Cambridge University Press, 1980), 61–94; and Weisz, The Emergence

256 / Notes to Pages 141–146

135.

136. 137. 138.

139.

140. 141. 142. 143.

144. 145. 146. 147.

148. 149. 150. 151. 152. 153. 154.

155. 156.

of Modern Universities in France, 1863–1914 (Princeton, NJ: Princeton University Press, 1983). Barthélemy M. N. de Nabias, Jean Prevost, médecin de la ville de Pau: et son catalogue des plantes du Béarn, de la Navarre, du Bigorre, et des cotes de la mer depuis Bayonne jusqu’à Saint-Sebastien (1600–1660) (Paris: O. Doin, 1886). Bonah, Instruire, guérier, server, 362–63. Péry, Histoire de la Faculté de la médecine de Bordeaux, 366–67. Sophie Chave-Dartoen, “Le musée d’ethnographie de l’Université de Bordeaux II Victor Segalen,” accessed September 1, 2012, http://culture.univ-lille1.fr/fileadmin/ documents/patrimoine/txt/35dartoen.pdf. Cinquantenaire de la Faculté de médecine et de pharmacie, 1879–1928 (Bordeaux: Imprimerie de l’Université, 1930), 23–24, and the website for the Musée d’ethnographie de Bordeaux II, accessed September 1, 2012, http://www.meb.u-bordeaux2.fr/ histoire/histoire.htm. Docteur X, “Le service de santé militaire et l’enseignement supérieur,” Revue internationalde de l’enseignement 37 (1899): 481–502, esp. 487–91. Mason, “L’école de santé navale et coloniale de Bordeaux,” 168–70. “Chaire de pathologie exotique,” Journal de médecine de Bordeaux, no. 24 (June 15, 1902): 382. Biographical details from BoFMP, personnel dossier, “Le Dantec, Alexandre,” R. C., “Nécrologie, professeur A. Le Dantec,” Journal de médecine de Bordeaux (February 29, 1932): 154, 170; Henri Bonnin, “Le Professeur Alexandre Le Dantec (1857–1932),” Gazette hebdomadaire des sciences médicales 9 (February 28, 1932): 136–39; Bonnin, “Les premiers pas en médecine tropicale de la Faculté de Médecine et des ses élèves: Alexandre Le Dantec,” Journal de médecine de Bordeaux, no. 127, no. 10 (October 1950): 573–77; Alexandre Le Dantec, Titres et travaux scientifiques (Paris: G. Steinheil, 1895). Le Dantec, Recherches sur la fièvre jaune: Critique des théories microbiennes émises en Amérique au sujet de cette maladie (medical thesis) (Paris: Jouve, 1886). Le Dantec, Recherches sur la fièvre jaune, 46–49, quote on 48. Bonnin, “Le Professeur Alexandre Le Dantec,” 136. Bonnin, “Les premiers pas en médecine tropicale,” 576. On Noguchi and this incident see Marcos Cueto, “Sanitation from Above: Yellow Fever and Foreign Intervention in Peru, 1919–1922,” Hispanic American Historical Review 72 (1992): 1–22, esp. 5–6. BoFMP, personnel dossier, [copy] Le Dantec to minister of public instruction, October 1, 1903. Le Dantec, “La médecine coloniale,” Le Caducée: Journal de chirurgie et de médecine d’armée, guerre-marine-colonies 3 (1903): 29–32, quote on 32. Ibid., 32. Ibid., 31. Treille, “De l’enseignement de la pathologie tropicale,” who comments on the curriculum of colonial medicine at Bordeaux and Marseille, 284–87. Bonnin, “Les premiers pas en médecine tropicale,” 577. Cinquantenaire de la Faculté de médecine et de pharmacie, 23, and unpaginated annex “Année scolaire 1928–1929.” See also Dr. Lande, “A Monsier le Docteur Arnozan,” Journal de médecine de Bordeaux 35 (August 31, 1902): 545–46. SHDAM, cote CC2 934–3, Cuéno to minister of the navy, July 4, 1901. Weisz, The Emergence of Modern Universities in France, 192, table 5.8.

Notes to Pages 146–152 / 257 157. Pierre-Jean-Marcellin Brassac, Considerations pathologiques sur les pays chauds: Observations faites aux Antilles français de 1857 à 1862 (Montpellier: n.p, 1863); Brassac, “Les éléphantiasis,” in Dictionnnaire encyclopédique des sciences médicales, premier série, vol. 33, pp. 411–551. Biographical details from J. Bergounioux, “Galerie médicale du Lot: Le médecin-directeur de la marine J.-P.M. Brassac. Organisateur de l’École de médecine navale de Bordeaux (1831–1903),” La France médicale 49 (1912): 261–66. 158. Décret portant création d’une école du service de santé de la marine à Bordeaux et de trois annexes (du 22 juillet 1890); Décret déterminant la compostion de l’uniforme des élèves du service de santé de la marine (du 23 juillet 1890); Arrêté ministériel concernant l’institution de l’école du service de santé de la marine (du 23 juillet 1890) (Paris: Imprimerie de Librairie militaires de L. Baudoin et Cie, 1890), chap. 3. 159. Brassac, “Inauguration de l’École principale du service de santé de la marine,” Gazette hebdomadaire des sciences médicales 11, no. 46 (November 16, 1890): 495–98, quote on 497. 160. Brassac, “Inauguration de l’École,” 498. 161. BoAM, dossier 6852 M 6, especially the sub dossiers “Installation definitive de l’école du Service de santé de la marine,” undated letter by Brassac, and “Demande de maintien à Bordeaux de la Section coloniale,” 1902, “École de santé navale et Coloniale-Agrandissement-projet de convention avec l’État, 1913–1914,” copy of letter, Ministère de la marine to préfet de la Gironde, July 17, 1914. See also anon., “École de santé navale,” Journal de médecine de Bordeaux, no. 8 (April 25, 1919): 164. 162. SHDAM, cote CC2 934–2, October 29, 1890, “Déliberation du conseil d’instruction au sujet de la composition de la bibliothèque individuelle des élèves en médecine et en pharmacie.” 163. SHDAM, cote CC7 4ème moderne 85/1, dossier personnel “Joseph Henri Bourru.” 164. Weisz, “Reform and Conflict in French Medical Education.” 165. SHDAM, cote CC2 934–2, Bourru to Monseiur le vice-amiral, October 21, 1896, same to same, October 22, 1896; cote CC2 934–3, same to same, August 17, 1901. 166. SHDAM, cote CC2 934–3, Bourru to Monseiur l’Inspecteur general, “Rapport pour l’Inspection technique du 9 mai 1898,” quote on 2. 167. SHDAM, cote CC2 934–3, “Rapport pour l’inspection technique du 9 mai 1898,” 10. 168. Ibid., 16. 169. SHDAM, cote CC2 934–3, Bourru to vice amiral, commandant en chef, préfet maritime du 4e arrondissement, August 17, 1901. 170. Ibid. 171. Ibid. 172. Ibid. 173. Following Bourru, according to the navy’s yearly annuaire maritime, were PaulFrançois-Jacques Talairach, 1902–1903; Demond-Isidore-Louis Bertrand, 1904– 1906; André-Émile-Henri-Marius-Bienvenu Jacquemin, 1906–1910; Henri-Gabriel Chevalier, 1910–1912; Aristide-Pierre-Marie Jan, 1913–1915. The school reopened in 1920 under Gustave Bellot. 174. “École du service de santé de la marine,” Journal de médecine de Bordeaux, no. 24 (June 15, 1902): 382. 175. SHDAM, cote CC2 934–3, Auffret to Ministère de la marine, April 17, 1905. 176. Michael A. Osborne and Richard S. Fogarty, “Views from the Periphery: Discourses

258 / Notes to Pages 152–158 of Race and Place in French Military Medicine,” History and Philosophy of the Life Sciences 25 (2003): 363–89. 177. BoFMP, personnel dossier, “Le Dantec, Alexandre,” undated draft, “Utilité de la creation d’un service de clinique à l’usage des soldats et des travailleurs coloniaux.” CHAPTER FIVE

1.

2.

3. 4. 5. 6. 7.

8.

9.

10. 11. 12. 13. 14. 15.

16. 17. 18. 19.

IMTSSA, cote 465, “Rapport sur un projet de création d’une école d’application, du service de santé des troupes coloniales,” Paris, March 1902, Clavel [?], directeur du Service de santé des troupes coloniales, unpaginated draft. André Bouyala d’Arnaud, Évocation du vieux Marseille (Paris: Éditions de Minuit, 1961), 41 (estimate), 100–111. See also Michel Signoli et al., “Paleodemography and Historical Demography in the Context of an Epidemic: Plague in Provence in the Eighteenth Century,” Population 57, no. 6. (November–December 2002): 829–54, at 837, which charts the swath of the disease as visiting 242 localities and killing 119,811 of 394,369 inhabitants. André Zysberg, Les galériens: Vies et destins de 60 000 forçats sur les galères de France 1680–1748 (Paris: Éditions du Seuil, 1987). Louis Bergasse, Notice historique sur la Chambre de commerce de Marseille (1599–1912) (Marseille: Typographie & Lithographie Barlatier, 1913), 55. Bergasse, Notice historique, 95. Jacques Léotard, Le port de Marseille (Paris: Dunod, 1922), 63–70. J. Marchard, “Marseille,” in La grande encyclopédie : Inventaire raisonné des sciences, des letters et des arts, 31 vols., ed. Marcellin Berthelot (Paris: H. Lamirault et cie [vols. 1–22]; Société anonyme de la grande encyclopédie, 1886–1902), 23:303–38. Paul Masson, “La marine marseillaise, 1870–1914,” in Les Bouches-du-Rhône, encyclopédie départementale, 16 vols., ed. Masson (Marseille: Archives départementales des Bouches-du-Rhône, 1914–37), 9:381–420. Georges J. Aillaud, “La botanique, de la ‘science aimable’ à la botanique appliqué soutien du ‘Marseille colonial,’” in Marseille, 2600 ans de découvertes scientifiques Marseille, 2600 ans de découvertes scientifiques, 3 vols., ed. Aillaud et. al. (Aix-en-Provence: Publications de l’Université de Provence, 2002),” 3:240–90, 241. Léotard, Le port de Marseille, 148–51. Marchard, “Marseille.” Helen J. Power, Tropical Medicine in the Twentieth Century: A History of the Liverpool School of Tropical Medicine 1898–1990 (London: Kegan Paul International, 1999). Mary Jo Nye, Science in the Provinces: Scientific Communities and Provincial Leadership in France, 1860–1930 (Berkeley: University of California Press, 1986), 8. Gaston Rambert and Émile Isnard, “La voirie et les transports,” in Les Bouches-duRhône, encyclopédie départementale, 14:264–319, 311. Marc Aubert, “La médecine à Marseille au XIXe siècle,” Province historique 172 (1993): 185–206, esp. 193–98. See also Rambert and Isnard, “La voirie et les transports,” 298–300. William B. Cohen, Urban Government and the Rise of the French City: Five Municipalities in the Nineteenth Century (New York: St. Martin’s Press, 1998), 24–25. Cohen, Urban Government, 10. Ibid., table 7.2, “Typhoid Mortality Rates per 100,000 in Selected French Cities, 1886–1893,” 172. “Flaissières, Siméon,” in Les Bouches-du-Rhône, encyclopédie départementale, 11: 205–7.

Notes to Pages 158–162 / 259 20. Charles Livon, “La vie scientifique: biologie et sciences médicales,” in Les Bouchesdu-Rhône, encyclopédie départementale, 6:328–48, 336. 21. Livon, “La vie scientifique,” 204–6. 22. Cohen, Urban Government, 157. 23. Quoted in Henri Tachoire, “La création de la première Faculté des Sciences aux allées de Meilhan,” in Marseille, 2600 ans de découvertes scientifiques, 2:163–90, unattributed quote on 165–66. 24. Tachoire, “La création,” unattributed quote on 166. 25. Georges Fleury, “L’enseignement supérieur,” in Les Bouches-du-Rhône, encyclopédie départementale, 6:94–127, quote on 100–101. Ferrérol Rebuffat, “Le Palais de la Bourse et son histoire,” in Chambre de commerce et d’industrie de Marseille, Marseille sous le Second Empire: Exposition, conférences, organisées à l’occasion du centenaire du Palais de la Bourse, 10–26 novembre 1960 (Paris: Librarie Plon, 1961), 21–50. 26. Aubert, “La médecine à Marseille au XIXe siècle,” 190. 27. P. Carrère, “L’évolution de la population de Marseille de 1851 à 1876,” in Marseille sous le Second Empire, 99–113. See also Marchard, “Marseille.” 28. Georges Valois, “Marseilles, porte de l’Orient,” L’Action française, October 23, 1922, quoted in Yaël Simpson Fletcher, “‘Capital of the Colonies’: Real and Imagined Boundaries between Metropole and Empire in 1920s Marseilles,” in Imperial Cities: Landscape, Display and Identity, ed. Felix Driver and David Gilbert (Manchester, UK: Manchester University Press, 1999), 136–54, quote on 150. 29. Émile Baillaud, “Préface,” in Les produits coloniaux et le matériel colonial: Congrès et exposition de 1926 (Marseille: Institut colonial, 1926), 7–13. 30. Aubert, “La médecine à Marseille au XIXe siècle;” and Aubert, “L’évolution des hôpitaux de Marseille pendant le XIXe siècle,” in Vingt-six siècles de médecine à Marseille, ed. Georges Serratrice and Constant Vautravers (Marseille: Éditions Jeanne Laffitte, 1996), 251–55. 31. MAM, série 45 R 3, “Extrait des registres des délibérations du conseil municipal de la ville de Marseille,” meeting of July 14, 1875, report of M. Prou-Gaillard. 32. MAM, série 45 R 1, “Extrait des registres,” meeting of September 16, 1841. See comments of council members Negre and Dumas. 33. Aubert, “La médecine à Marseille au XIXe siècle,” 201 for chairs and student numbers. MAM, série 45 R 1, “Extrait des registres,” meeting of January 19, 1845. 34. SHDAM, “Dossier individuel (marine): Joseph Évariste Laurent Bertulus,” Quoy to M. Le Amiral, Toulon, May 8, 1848, and Ministère de l’instruction publique to Ministère de la marine, December 28, 1846. 35. SHADM, “Dossier individuel (marine): Joseph Évariste Laurent Bertulus,” Ministère de l’instruction publique to Ministère de la marine, December 28, 1846, and Ministère de la marine to Ministère de l’instruction publique, January 12, 1847. 36. L. Villeneuve, “Nécrologie,” Marseille médical, 18th year (1881):114–18, indicates Bertulus requested no eulogy and died on February 9, 1881. 37. SHADM, “Dossier individuel (marine): Joseph Évariste Laurent Bertulus.” 38. Ibid., undated letter from Quoy and members of the Brest Conseil de santé, likely from 1839. 39. Aubert, “La médecine à Marseille au XIXe siècle,” 202n67. 40. Évariste Bertulus, “L’hygiène navale dans ses rapports avec l’économie politique, commerciale, et avec l’hygiène publique, ou nouvelles considerations sur la matière, le but, l’enseignement et l’application de cette science” (read before the Société royale de médecine de Marseille, October 18, 1845) (Marseille: Typographie

260 / Notes to Pages 162–165

41.

42. 43. 44.

45. 46. 47.

48. 49.

50.

51. 52.

53. 54. 55. 56. 57.

58.

Barlatier-Feissal et Demonchy, 1845). See also Évariste Bertulus, Observations et réflexions sur l’intoxication miasmatique, considérée en général dans les différents états pathologiques qui en résultent, et plus spécialement dans la peste, le typhus, la fièvre jaune, et le choléra-morbus épidémique (Montpellier: Martel, 1843); and Bertulus, Marseille et son intendance sanitaire, à propos de la peste, de la fièvre jaune, du choléra et des événements de Saint-Nazaire, Loire-Inférieure, en 1861: Études historiques et médicales (Marseille: Camoin, 1864). Bertulus, L’athéism au XIXe siècle devant l’histoire, la philosophie médicale et l’humanité (Paris: Jules Renouad, 1869). On evangelical atheism, leftist politics, and anthropology in Paris, see Jennifer M. Hecht, The End of the Soul: Scientific Modernity, Atheism, and Anthropology in France (New York: Columbia University Press, 2003). Bertulus, L’athéism au XIXe siècle, 486–90, quote on 490. Bertulus, “Avant-propos,” in L’athéism au XIXe siècle, v–x, esp. ix–x. Bertulus, L’athéism au XIXe siècle, 339–40. For Clot-Bey’s activities in Marseille see Jules G. Euzière, Petit histoire d’un grand homme: Clot Bey, docteur de Montpellier, fondateur de la Faculté de Médecine du Caire (Montpellier: Imprimerie de la Charité, 1952). Bertulus, L’athéism au XIXe siècle, 340. Bertulus, L’athéism au XIXe siècle, 257–75, esp. 257–58, 258n1. See also Victor Bally, Du typhus d’Amérique ou fièvre jaune (Paris: Imprimerie de Smith, 1814). Jean-Baptiste Fonssagrives, Histoire médicale de la campagne de la frégate à vapeur l’eldorado (Doctoral thesis, Faculté de médecine de Paris, 1852); Fonssagrives, Traité d’hygiène navale (Paris: J.-B. Baillière, 1856), second edition also with Baillière published in 1877. Bertulus, L’athéism au XIXe siècle, 349. Christian Bonah, Instruire, guérir, server: Formation, recherche et pratique médicales en France et en Allemagne pendant la deuxième moitié du XIXe siècle (Strasbourg: Presses Universitaires de Strasbourg, 2000), 392, who cites, among others, P. Marduel, “Les facultés de Médecine: Bulletin,” Lyon médical 6 (1871): 241–46. Jean-Paul Laurens, “Montpellier prisonnier de la médecine,” in Programme “Villes et institutions scientifiques,” Rapport final, ed. Michael Grossetti et al. (1996): 115–35, esp. 115–24, accessed September 7, 2012, http://w3.1isst.univ-tlse2.fr/cv/publis/ MG4.pdf. Christian Bonah, Instruire, guéir, server, 389–99, 397, which quotes Bert at the National Assembly, December 8, 1874. Commission chargée d’examiner les propositions de créations de facultés de médecine, France, Paul Bert, “Rapport fait au nom de la commission chargée d’examiner,” (Versailles: Imprimeurs de l’Assemblée nationale, 1874). See also Jules CharlesRoux, Vingt ans de vie publique (Paris: Librairie Guillaumin et Cie, 1892), “La Faculté de Médecine de Marseille,” 755–800, 764. MAM, série 45 R 3, “Extrait des registres,” meeting of July 14, 1875. Ibid. Ibid. Student fees might have reduced the city’s contribution by 60,000 francs. Aubert, “La médecine à Marseille au XIXe siècle,” 201–2. Aubert, “La médicine à Marseille au XIXe siècle,” 200–203; Michel Carcassonne, “La Faculté de Médecine de Marseille: Deux siècles de gestation (1730–1930),” in Vingtsix siècles de médecine à Marseille, ed. Georges Serratrice and Constant Vautravers (Marseille: Jeanne Laffitte, 1996), 159–92, 184–85. Michael A. Osborne, “Édouard-Marie Heckel,” in New Dictionary of Scientific Biog-

Notes to Pages 165–168 / 261

59. 60.

61.

62.

63.

64.

65.

66. 67. 68.

69. 70.

71.

72.

raphy, ed. Noretta Koertge, 8 vols (Farmington Hills, MI: Charles Scribner’s Sons, 2008), 3:272–73; and Michel Sardet, “Heckel, Édouard Marie,” in Dictionnaire des médecins, chirurgiens et pharmaciens de la marine, ed. Bernard Brisou and Michel Sardet (Vincennes: Service historique de la Défense, 2010), 403–5. SHDAM, personnel dossier for Édouard Marie Heckel, CC7 Alpha 1160. Heckel to Charles Darwin, December 27, 1876, in A Calendar of the Correspondence of Charles Darwin, 1821–1882, ed. Frederick Burkhardt and Sydney Smith (New York: Garland, 1985), item 10735. Heckel, trans., “Avant-propos du traducteur,” in Des effets de la fécondation croisée et de la fécondation directe dans le règne vegetal, by Charles Darwin (Paris: C. Reinwald, 1877), ix–xv. Heckel also brought out Darwin, Des différentes formes de fleurs dans les plantes de la mème espèce (Paris: C. Reinwald et cie, 1878); and Darwin, La faculté motrice dans les plantes (Paris: C. Reinwald, 1882). The last known exchange occurred when the aged Darwin sent Heckel a photograph of himself. See Darwin to Heckel, January 7, [1881–82] in A Calendar of the Correspondence of Charles Darwin, item 12990. Georges J. Aillaud, “La botanique, de la ‘science aimable,’” 258. See also Aillaud, “Édouard Heckel, un savant organisateur, de la botanique appliqué à l’Éxposition Coloniale de 1906,” Province historique 43 [172] (1993): 153–65. G. J. Aillaud and Arlette Aillaud, “L’Institut colonial, une collaboration Faculté des sciences–Chambre de commerce,” in Marseille, 2600 ans de découvertes scientifiques 2:259–78; Aillaud, “[Pourquoi à Marseille?], Édouard Heckel et l’Institut colonial de Marseille,” in Archives municipales de Marseille, Désirs d’ailleurs: Les expositions colonials de Marseillle 1906 et 1922 (Marseille: Éditions Alors Hors du Temps, 2006), 45–53. Making the case for a commercial and economic history of Marseille based on an economic cycle of oleaginous products is Xavier Daumalin, Marseille et l’Ouest Africain, L’outre-mer des industriels (1841–1956) (Marseille: A. Robert, 1992). Charles-Robert Ageron, France coloniale ou parti colonial? (Paris: Presses Universitaires de France, 1978). Chambre de commerce de Marseille et l’Exposition colonial de 1906 (Marseille: Barlatie [Imprimerie du Sémaphore], 1908), esp. 225–33. Laurent Morando, “Les Instituts coloniaux et l’Afrique: 1893–1940: Ambitions nationals, réussites locales,” 2 vols. [Thèse pour le doctorat, Université Aix-Marseille I-Université de Provence, 2001), 1: 8–179; Morando, “Marseille cité coloniale, de la pratique à la théorie, l’Institut colonial (1893–1944),” 2 vols. (Mémoire pour Institut d’études politiques, Université Aix-Marseille III-Paul Cézane, 1988). Henri Tachoire, “Léon Perdrix, dans le sillage de Pasteur,” in Marseille, 2600 ans de découvertes scientifiques, 3:197–204, 202. The chair went to the École de médecine. MCC, MJ 9102, “Cours coloniaux; musée et Institut colonial de Marseille (1895– 1937),” Heckel to President of Chamber of Commerce, letters of December 1, 1897, and April 27, 1899. Gustave A. Reynaud, L’armée coloniale au point de vue de l’hygiène pratique (Paris: O. Doin, 1892); Reynaud, Considérations sanitaires sur l’expédition de Madagascar et quelques autres expéditions coloniales, françaises et anglaises (Paris: 1898); Reynaud, Hygiène coloniale, 2 vols. (Paris: Baillière, 1903). Reynaud, “Sur l’enseignement colonial à Marseille et sur un voeu relative à l’installation de l’École d’application du service de santé colonial,” Marseille-médicale 38 (1901): 737–44, quote on 739–40. I have translated “police” as “inspection.”

262 / Notes to Pages 169–173 73. Reynaud, “Sur l’enseignement colonial à Marseille,” 737–38. 74. Alfred Lacroix, “Notice historique sur quatre botanistes ayant travaillé pour la France d’outre-mer à la fin du siècle dernier à nos jours” (Paris: Gauthier-Villairs, 1938), 44–51, quote on 45. 75. Christelle Harrir, “Naissance et ascension d’une famille, d’un home,” in Jules Charles-Roux: Le grand marseillais de Paris, Isabelle Aillaud, Dominique Boudet, et al. (Rennes: Marines Éditions, 2004), 6–15, 14–15. 76. Jules Charles-Roux, Vingt ans de vie publique (Paris: Librairie Guillaumin et Cie, 1892), 446–500, quotes on 469–70. 77. Masson, “Charles-Roux, Jules,” in Les Bouches-du-Rhône, encyclopédie départementale 11:122–24. 78. Charles-Roux, “Les grèves et l’inscription maritime,” Revue des deux mondes, série 5, 54, no. 1 (1909): 124–46. 79. Charles-Roux, “Avant-propos,” in Charles-Roux, Vingt ans de vie publique, xi–xxix, quote on xxvii. 80. Jean-Jacques Jordi, “La politique coloniale de la France au tounant du XXe siècle,” in Archives municipales de la Ville de Marseille, Désirs d’ailleurs, 19–22. 81. Archives municipales de la Ville de Marseille, Désirs d’ailleurs. On the Paris exposition see Charles-Robert Ageron, “L’Exposition coloniale de 1931: Mythe républicain ou mythe imperial?,” in Les lieux de mémoire, ed. Pierre Nora, vol. 1, pt. 1 (Paris: Gallimard, 1984), 561–91. 82. Michael A. Osborne, “European Visions: Science, the Tropics, and the War on Nature,” in Nature et Environnement, ed. Christophe Bonneuil and Yvon Chatelin (Paris: ORSTOM, 1996), 21–32. 83. Édouard Heckel and Cyprien Mandine, L’enseignement colonial en France et à l’étranger (Marseille: Barlatier, 1907), 86, 92–93. 84. Compte rendu des travaux du Congrès colonial de Marseille, ed. Charles-Roux, 4 vols. (Paris: Augustin Challamel, 1908). 85. Charles-Roux, Vingt ans de vie publique, 359–85. 86. Charlse-Roux, “Séance d’inauguration,” Compte rendu des travaux du Congrès colonial de Marseille, ed. Charles-Roux, 1:10–22, 19. 87. Treille, “Du service médicale aux colonies,” Compte rendu des travaux du Congrès colonial de Marseille, ed. Charles-Roux, 1:46–60, 60. 88. Compte rendu des travaux du Congrès colonial de Marseille, ed. Charles-Roux, 1:94–95 (prophylaxis), 115–16 (malaria). See also Anne Marcovich, “French Colonial Medicine and Colonial Rule: Algeria and Indochina,” in Disease, Medicine, and Empire: Perspectives on Western Medicine and the Experience of European Expansion, ed. Roy MacLeod and Milton Lewis (London: Routledge, 1988), 103–17. 89. Aillaud and Aillaud, “L’Institut colonial,” in Marseille, 2600 ans de découvertes scientifiques, ed. Aillaud et. al., 2:264–68. 90. MCC, MJ 9111, “Institut colonial de Marseille; Procès-verbaux du conseil d’administration et des assemblées générales,” July, 19, 1906, meeting covers financial issues. Charles-Roux was not willing to give a private donation to the institute. See also MCC, MJ 9112, “Institut colonial de Marseille; Procès-verbaux du bureau,” June 5, 1913, meeting where the firm of A. M. Bokanowski et Cie rents the entire ground floor, and MCC, MJ 9112, meeting of December 2, 1913 [?]. 91. Adrien Artaud, “Discours au banquet de la Bourse,” L’expansion coloniale 8 (1914): 36–41, 37. 92. Artaud, “Discours au banquet de la Bourse,” 37.

Notes to Pages 173–179 / 263 93. MCC, MJ 9114, “Institut colonial de Marseille; Procès-verbaux du conseil d’administration,” indicates numerous challenges. By the meeting of March 2, 1917, contributions from the colonial governors had stopped. On Émile Baillaud see Aillaud and Aillaud, “L’Institut colonial,” in Marseille, 2600 ans de découvertes scientifiques, ed. Aillaud et. al., 2:269, short biography by Marcel Courdurié. 94. Pierre Labrude, “Les recherches de chimie végétale du professeur Schlagdenhauffen avec le professeur Heckel et le pharmacien Reeb, de 1876 à 1907,” Revue d’histoire de la pharmacie 49, no. 330 (2001): 183–92; Labrude, “Le professeur Heckel à Nancy (1873–1876), sa longue et fructueuse collaboration ave le professeur Schlagdenhaufen,” Bulletin de liaison de l’Association des amis du Musée de la pharmacie (Montpellier) 21 (1996): 57–65. 95. Heckel and C. F. Schlagdenhauffen, “Du Doundaké (Sarcocephalus esculentus Don), et de son écorce dite Quinquina africain au point de vue botanique, chimique et thérapeutique,” Archives de médecine navale 44 (1885): 447–64; 45 (1886): 38–58. 96. Heckel, Les kolas africains: Monographie botanique, chinique, thérapeutique pharmacologique (Paris: Société des éditions scientifiques, 1893), 228n2. See also Heckel, “Kola,” in Dictionnaire encyclopédique des sciences médicales, ed. A. Dechambre (Paris: G. Masson, 1889), quatrième série, 16:755–61, at 760. 97. Toby Gelfand, “Dr. Germain Sée (1818–1896): “Israélite de coeur’” Korot 12 (1996–97): 9–34. 98. Gelfand, “Dr. Germain Sée,” 14–15n13, cites the relevant letter as “Sée to minister May 23, 1868,” and the exchange as Annales du sénat et du corps legislative (séances May 20 and 23, 1868), 39, 41, 44, 83. 99. Gelfand, “Dr. Germain Sée,” 28–32. 100. Steven Shapin, A Social History of Truth: Civility and Science in Seventeenth-Century England (Chicago: University of Chicago Press, ca. 1994). 101. Londa L. Schiebinger, Plants and Empire: Colonial Bioprospecting in the Atlantic World (Cambridge, MA: Harvard University Press, 2004). 102. William B. Cohen, “Malaria and French Imperialism,” Journal of African History 24 (1983): 23–36; Dale C. Smith, “Quinine and Fever: The Development of an Effective Dosage,” Journal of the History of Medicine and Allied Sciences 31 (1976): 343–67. 103. Heckel, Les kolas africains, 316n1. 104. Ibid., 317. 105. Heckel, “Expériences comparés entre l’action du kola et le la caféne sur la fatigue et l’essoufflement provenant des grandes marches,” Marseille Médical 27 (1890): 587–98, 649–65. 106. Heckel, Les kolas africains, 17. 107. Robert A. Nye, “Medicine and Science as Masculine ‘Fields of Honor,’” Osiris 12 (1997): 60–79; Nye, Masculinity and Male Codes of Honor in Modern France (New York: Oxford University Press, 1993). 108. “Historique,” http://www.cafgrenoble.com/06_leclub/historique/index.html, Club Alpin de l’Isère, accessed September 7, 2012. 109. Nye, “Medicine and science,” 70, signals the importance of the written challenge. 110. Heckel, Les kolas africains, 322. 111. Ibid., 338. 112. Ibid., 334–35. I have translated aussi dispos as “as fresh as.” 113. Ibid., 332–33. 114. Gelfand, “Dr. Germain Sée,” 22, which cites “Overture du cours de clinique medical: M. G. Sée,” Le progrès médical 10 (November 19, 1882): 911.

264 / Notes to Pages 179–185 115. Heckel, Les kolas africains, 322. 116. Extracts of Tardieu’s letters are reprinted in Heckel, Les kolas africains, 323–28, and I cite these versions. 117. Heckel, Les kolas africains, 323. 118. Ibid., 323, emphasis in original. 119. Ibid., 324–26, quote on 324. 120. Ibid., 325. 121. Ibid., 326–28, quote on 327. 122. Ibid., 326. 123. Ibid., 322n2. 124. Albert Clarac, “La mobilisation sanitaire à Madagascar (Résumé),” in Compte rendu des travaux du Congrès colonial de Marseille, 4 vols. (Paris: Augustin Challamel, 1908), ed. Charles-Roux, 3:442. 125. A. Le Dantec, “Le Béribéri (Résumé),” in Compte rendu des travaux du congrès, ed. Charles-Roux, 3:456. 126. Paul-Louis Simond, “Progagation et prophylaxie maritimes et terrestres de la fièvre jaune,” in Compte rendu des travaux du congrès, ed. Charles-Roux, 3:281–304. See also J. J. Voelckel, “La vie et l’oeuvre de P.-L. Simond (1858–1947),” Médecine tropicale 29 (1969): 429–41. 127. Compte rendu des travaux du congrès, ed. Charles-Roux, comment by Navarre, 3:304. 128. Charles Grall, “L’assistance médicale indigène aux colonies,” in Compte rendu des travaux du congrès, ed. Charles-Roux, 3:268–81. 129. Biographical details from Albert Clarac, Mémoires d’un médecin de la marine et des colonies (1854–1934), comp. Geneviève Salkin (Vincennes, France: Service historique de la Marine, 1994); and Salkin, “Annexe III, Portrait et carrière du médecin général Albert Clarac au travers de son dossier,” 235–44, 239. 130. Clarac, Mémoires; Salkin, “Annexe III, Portrait et carrière,” 244. 131. Clarac, Mémoires, 119–26, 123. 132. IMTSSA, cote 445, “Conference Clarac.” Dr. Claude Paoli lived in neighboring Aubagne in 1996. 133. Charles Grall and Albert Clarac, eds., “Fièvre jaune,” Traité de pathologie exotique: Clinique et thérapeutique, 6 vols. (Paris: J.-B. Baillière, 1910–19), 3:21–176. “Pages authored by Clarac, 21–28 (history and medical geography), 106–76 (clinical medicine, pathological anatomy, diagnosis, prognosis); pages by Simond, 29–105 (epidemiology, prophylaxis, sanitary police). 134. Grall and Clarac, eds., “Fièvre jaune,” Traité de pathologie exotique, 3:78–79. 135. Grall and Clarac, eds., “Immunité des natifs vis-à-vis de la fièvre jaune,” Traité de pathologie exotique, 3:65–66. 136. L. A. Héraut, “Pharo 1907: origins et devenir des médecins et pharmaciens de la première promotion,” Médecine tropicale 65 (2005): 213–18, quote on 214. See also articles in Médecine tropicale 65 (2005): 211–96; and Eric Deroo et. al., L’École du Pharo: Cent ans de médecine outré-mer (Marseille: Éditions Lavauzelle, 2005). 137. Gustave Martin, “École d’application du service de santé des troupes coloniales de Marseille,” in Les Bouches-du-Rhône, encyclopédie départementale, ed. Masson, 6: 690–91. 138. IMTSSA, cote 465, “Rapport sur un projet de création.” 139. Ibid. 140. Ibid. 141. MAM, série 45 R 3, “Extrait des registres des deliberations,” meeting of April 21,

Notes to Pages 185–189 / 265

142.

143.

144.

145. 146. 147.

148. 149.

150.

151. 152. 153. 154. 155.

1891; Charles Livon, “L’École de plein exercice de médecine et de pharmacie de Marseille en 1901,” Annales de l’École de plein exercice de médecine et de pharmacie de Marseille, supplement à la Xème année (1900) (Marseille: Imprimerie Marseillaise, 1901). IMTSSA, cote 465, “Rapport de M. Martine . . . sur sa mission à Marseille,” unpaginated. For city council response see MAM, série 45 R 4, “Création d’une École de santé colonial, Note,” September 29, 1903. IMTSSA, cote 465, unpaginated manuscript, “Rapport de M. Martine . . . sur sa mission à Marseille.” On Queirel see Auguste Queirel, Leçons de clinique obstétricale (Paris: Steinheil, 1902–8); and Queirel, École de médecine de Marseille: Cours de chirurgie d’armée; Des ambulances (Marseille: Barlatier-Feissat père & fils, 1876). Clarac, Mémoires, 119–26. For the mixed character of the school see MAM série 91M-12, “Extrait des registres,” meeting of July 17, 1931,” and “Rapport 18.759, Institut colonial, Parc du Pharo,” September 29, 1931. Clarac, “Discours,” in Inauguration de l’École d’application du service de santé des troupes coloniales, 29 septmebre 1907 (Marseille: Moullot Fils Ainé, 1907), 7–13, 9–10. Olivier, “Discours,” in Inauguration de l’École d’application du service de santé, 14–16. Heckel, “Les enseignements de la guerre actuelle au point de vue colonial, l’enseignement de la médecine coloniale,” L’expansion coloniale (January 1, 1914): 189–91. Heckel and Cyprien Mandine, L’enseignement colonial en France et à l’étranger (Marseille: Barlatier, 1907), 154–58. Pierre Jandeau, Contribution à l’étude de pneumonie chez le tirailleur sénégalais traitement (Bordeaux: Imprimerie de l’Université, 1917). Other wartime theses are examined in Michael A. Osborne and Richard S. Fogarty, “Views from the Periphery: Discourses of Race and Place in French Military Medicine,” History and Philosophy of the Life Sciences 25 (2003): 363–89. On the formation of the Faculty, see Victor Audibert, La création de la Faculté de médecine et de pharmacie de Marseille (Marseille: Imprimerie du Sémaphore, 1942); Léon Imbert, La création de la Faculté de médecine: L’histoire de l’Institut de médecine et de pharmacie coloniales et celle de l’hopital colonial de Marseille (Marseille: Paul Feran, 1938); Michael Carcassone, “La Faculté de Médecine de Marseille,” in Vingt-six siècles de médecine à Marseille, ed. Serratrice and Vautrevers, 159–93; J. Boudouresques, “De l’École à la création de la Faculté de Médecine de Marseille avant la guerre de 1939,” Mémoires de l’Academie des sciences, letteres et arts de Marseille (1988): 45–54. Boudouresques, “De l’École à la création de la Faculté de Médecine,” 44–47, quote on 44. Imbert, La création de la Faculté de Médecine, 5; L’officiel, December 13, 1922. Imbert, La création de la Faculté de Médecine, 39–40. Ibid., 42–45. Ibid., 48–49. CHAPTER SIX

1.

2.

L[eland] O[ssian] Howard, “Striking Entomological Events of the Last Decade of the Nineteenth Century,” Scientific Monthly 31, no. 1 (July 1930): 5–18, quote on 18. Provenance and translation unverified. For a recent perspective on the cultural place of French science, see Robert Fox, The Savant and the State: Science and Cultural Politics in Nineteenth-Century France (Baltimore: Johns Hopkins University Press, 2012).

266 / Notes to Pages 189–194 3. 4.

5. 6. 7.

8. 9.

10.

11. 12. 13.

14.

15. 16. 17. 18.

19. 20. 21.

Colin Jones, Paris: Biography of a City (New York: Viking, 2004), 133, 171. Jean Tarrade, “Les chambers de commerce à la fin du XVIIIe siècle: La naissance d’un réseau portuaire,” in Ville et port, XVIIIe–XXe siècles, ed. Michèle Collin (Paris: Éditions L’Harmattan, 1994), 273–85. Claire Lemercier, Un si discret pouvoir: Aux origins de la chambre de commerce de Paris, 1803–1853 (Paris: Éditions la Découverte, 2003), 340–62. Lemercier, Un si discret pouvoir, 364. Catherine J. Kudlick, Cholera in Post-Revolutionary Paris: A Cultural History (Berkeley: University of California Press, 1996), 15, table 1, which reproduces figures from Louis Chevalier, Laboring Classes and Dangerous Classes (Princeton, NJ: Princeton University Press, 1973). Louis Chevalier, La formation de la population Parisienne au XIXe siècle (Paris: Presses Universitaires de France, 1950), 39–43, 73–80. For sectors see p. 79. G. Lavier and J. Théodoridès, “Raphaël Blanchard (1857–1919), médecin, naturaliste, et fondateur de la Société française d’histoire de la médecine,” Histoire de la médecine 7 (1957): 75–82, 75. François Maury, Le port de Paris depuis un siècle (Paris: Imprimerie de Suresnes, 1903, Thèse de doctorat, Université de Paris, Faculté de Droit), 100–119, 227–52, esp. 245–52. A[lphonse] Laveran and Raphaël Blanchard, Les hématozoaires de l’homme et des animaux, 2 vols. (Paris: Rueff et Cie, 1895). Robert Aldrich, Greater France: A History of French Overseas Expansion (New York: St. Martins Press, 1996), 246–50. Annick Guénel, “The Creation of the First Overseas Pasteur Institute, or the Beginning of Albert Calmette’s Pastorian Career,” Medical History 43 (1999): 1–25; and Anne Marie Moulin, “Patriarchal Science: The Network of the Overseas Pasteur Institutes,” in Science and Empires: Historical Studies about Scientific Development and European Expansion, ed. Patrick Petitjean et. al. (Dordrecht, Netherlands: Kluwer Academic Publishers, 1992), 307–22. For biographical information see André Cornet, “Raphaël Blanchard,” accessed September 23, 2012, http://www.bium.univ-paris5.fr/sfhm/histoire2.htm; “Raphaël Blanchard (1857–1919),” accessed September 23, 2012, http://www.pasteur.fr/ infosci/archives/blr0.html; Émile Brumpt, “Raphaël Blanchard,” Archives de parasitologie 16 (1913–19): i–iv; Lavier and Théodoridès, “Raphaël Blanchard (1857–1919),” Histoire de la médecine 7 (1957); and F. H. Garrison, “Raphael Blanchard (1858 [sic]—1919),” Science, new series, vol. 49, no. 1269 (April 25, 1919), 391–92. Chevalier, La formation de la population parisienne, 285–86. Blanchard, “Souvenirs d’Allemagne,” Bulletin de la Société zoologique de France 40 (1915): 3–26, 7. I. Humphrey-Smith et al., “Parasitology in France: The Past,” Parasitology Today 6 (1990): 217–24, esp. 220–24. Ann Elizabeth Fowler La Berge, “Debate as Scientific Practice in Nineteenth-Century Paris: The Controversy Over the Microscope,” Perspectives on Science 12 (2004): 424–53. Robert Fox, “La Société zoologique de France. Ses origins et ses premières années,” Bulletin de la Société zoologique de France 101, no. 5 (1976): 799–813. Georges Pouchet and Frédéric Tourneax, Précis d’histologie humaine et d’histogénie, 2nd ed. (Paris: Masson, 1878). Blanchard, “Souvenirs d’Allemagne,” 8.

Notes to Pages 194–199 / 267 22. Ibid., 9. 23. Blanchard, Les universités allemandes (Paris: A. Delahaye & E. Lecrosnier, 1883). 24. Blanchard, Glossaire allemande-français des terms d’anatomie et de zoologie (Paris: Asselin et Houzeau, 1908). See also Harry W. Paul, The Sorcerer’s Apprentice: The French Scientist’s Image of German Science, 1840–1919 (Gainesville: University of Florida Press, 1972). 25. Blanchard, “Souvenirs d’Allemagne,” 19–21, quoted in Fox, “La Société zoologique de France,” 807. 26. Nikolaus Mani, “Paul Bert,” Dictionary of Scientific Biography, 2:59–63. 27. Blanchard, “De l’anesthésie par le protoxyde d’azote, d’après la method de M. le professeur Paul Bert” (Paris: Bureaux du Progrès medical, 1880). 28. AN, AJ 16 969. 29. A fairly complete series of Blanchard’s publications may be found at IP, Service des Archives, Raphaël Blanchard collection, cote FR AID BLR. 30. “Les crocodiles de la Sorbonne,” Revue scientifique de la France et de l’étranger, no. 26, December 24, 1881, 3e série, première année, second semestre, 28:819–24. 31. Paul Bert and Raphaël Blanchard, Éleménts de zoologie (Paris: G. Masson, 1885), 46–70. 32. “L’origine de la vie et l’organisation de la matière,” Revue scientifique (revue rose), 1er semestre 1885, 3e série, no. 6, 22e année (February 7, 1885): 161–70. 33. Blanchard, “Étude sur la stéatopygie et le tablier des femmes boschmanes,” Bulletin de la Société zoologique de France 8 (1883): 34–75; Blanchard, “Sur le tablier et la stéatopygie des femmes boschimanes,” Bulletin de la Société d’anthropologie de Paris 6 (1883): 348–58. 34. Quote from Jean-Henri Fabre, The Life of the Fly (1913) reproduced in Plant Talk, accessed January 10, 2008, http://www.plant-talk.org/Pages/15fabre.html. 35. Blanchard, L’art populaire dans le Briançonnais (Paris: É. Champion, 1914). 36. Blanchard, “Les tableaux de métissage au Mexique,” Journal de la Société des Américanistes de Paris, nouvelle série, 5, no. 1 (1908): 59–66; Blanchard, “Encore sur les tableaux de métissage du Musée de Mexico”; Blanchard, Journal de la Société des Américanistes de Paris, nouvelle série, 7, no. 1 (1910): 37–60. 37. Erwin H. Ackerknecht, Medicine at the Paris Hospital (Baltimore: Johns Hopkins University Press, 1967), 61–80. 38. Henri Gadeau De Kerville, Voyage zoologique en Khroumirie (Tunisie) mai-juin 1906 (Paris: J.- B. Baillière, 1908). Blanchard examined the leech specimens from the voyage. 39. Alfred Moquin-Tandon, Elements of Medical Zoology (London: H. Baillière, 1861), 137–47, 217. 40. Isid[ore] Geoffroy Saint-Hilaire, de Castelnau, P[aul] Broca, “Instructions anthropologiques pour le Sénégal,” Archives de médecine navale 1 (1864): 255–65. 41. Blanchard, “Questionnaire de zoologie médicale, instructions à l’usage du corps de santé de la marine,” Archives de médecine navale 44 (1885): 42–60. 42. Jules Guiart, “Notice biographique du professeur R. Blanchard (1857–1919),” Bulletin de la Société zoologique de France 45 (1920): 185–91, 188. 43. Guiart, “Notice biographique du professeur R. Blanchard,” 186–87. 44. AN, F 17 23211, Dossier personnel, “Blanchard, Raphaël Anatole Émile,” March 8, 1898, M. le Vice-Recteur to Monsieur le Ministre de l’Instruction publique des Beaux-Arts, and “Extrait du procès-verbal de la séance [Conseil de la Faculté de médecine de Paris] du March 10, 1898.” The Russian hymn was possibly Gustave Da-

268 / Notes to Pages 195–205

45. 46.

47. 48. 49.

50.

51.

52. 53. 54. 55. 56. 57. 58. 59. 60.

61. 62. 63. 64. 65. 66.

vid’s “Salut à la Russie” of 1891, a song linked with Franco-Russian friendship and the eventual Franco-Russian Alliance of 1894. See Jann Pasler, Composing the Citizen: Music as Public Utility in Third Republic France (Berkeley: University of California Press, 2009), 666–69. AN, F 17 23211, Dossier personnel, Blanchard to Monsieur le Doyen, December 20, 1900, concerns a failed publishing venture. Dossier de la première instance devant le conseil de l’université (Paris: F. Levé, 1898), Pièce no. 9, séance du 7 novembre 1897, deposition de M. Heim, 26–31. Documentation of the investigation continues in Dossier supplémentaire du la deuxième instance devant le conseil supérieur (Paris: F. Levé, 1898). Dossier de la première instance, deposition écrite de M. Heckel, 84. Dossier de la première instance, deposition de M. André Baillon, 47–48. Dossier de la première instance, Commission des affaires contentieuses et disciplinaires, séance du November 6, 1897, dédpositon de M. Blanchard, 23–26; and Conseil de l’université, Rapport de la commission des affaires disciplinaires et contentieuses sur l’affaire Heim, 77–82 . Vincent Biet, “Heim, Frédéric-Louis (de Balsac) (1869–1962), in Les professeurs du Conservatoire national des arts et métiers, 2 vols., ed. Claudine Fontanon and André Grelon (Paris: Institut national de recherché pédagogique; Conservatoire national des arts et métiers, 1994), 1:655–64. Georges Barrière, “Raphaël Blanchard (1857–1919), sa vie-son oeuvre” (Thèse pour docteur en médecine, Université de Aix-Marseille [II], 1982), 28. See also Lavier and Théodoridès, “Raphaël Blanchard (1857–1919),” 77n2. Blanchard, “Zoologie et médicine,” Archives de parasitologie 9 (1905): 129–44, quote on 132. Blanchard, “La médecine colonial,” Archives de parasitologie 9 (1905): 95–121, 107. Michael A. Osborne, “Raphaël Blanchard, Parasitology, and the positioning of Medical Entomology in Paris, Parassitologia 50 (2008): 213–20, esp. 215–16. Blanchard, ed. Madagascar au début du XXème siècle (Paris: Société d’éditions scientifiques et littéraires, 1902), iii. Guillaume Grandidier, “Ethnographie,” in Madagascar au début du XXème siècle, 217–92, esp. 238–39. Grandidier, “Zoologie,” in Madagascar au début du XXème siècle, 157–215, quote on 157. Ibid., 181. Blanchard, “Climat, hygiène et maladies,” in Madagascar au début du XXème siècle, 397–452. Blanchard, “La médecine colonial” 95, “Maladies des pays chauds” (p. 97), “Médecine exotique” (p. 97), and “Médecine tropicale” (p. 99), Archives de parasitologie 9 (1905). Blanchard, “Climat, hygiène et maladies,” in Madagascar au début du XXème siècle, 398. Ibid., 423. Ibid., 405. Blanchard, ed., La Tunisie au début du XXème siècle (Paris: F. R. de Rudeval, Éditeur, 1904). Blanchard, “Zoologie,” in La Tunisie au début du XXème siècle, ed. Blanchard, 129–50, 130–31, 147–48. Jean-Marc Drouin, “Bory de Saint-Vincent et la géographie botanique,” in L’invention

Notes to Pages 205–207 / 269

67. 68. 69. 70. 71.

72.

73. 74.

75.

76.

77.

78. 79.

scientifique de la méditerranée: Égypte, Morée, Algérie, ed. Marie-Noëlle Bourguet et al. (Paris: Éditions de l’École des Hautes Études en Sciences Sociales, 1998), 139–57, who attributes the notion to Augustin Pyramus de Candolle (152–53). Maurice Caudel, “La société indigène,” in Blanchard, ed., La Tunisie au début du XXème siècle, 255–83, quote 256–57. Caudel, “La société indigène,” in La Tunisie au début du XXème siècle, ed. Blanchard, 277. Ernest-Théodore Hamy, “Esquisse anthropologique de la régence de Tunis,” in La Tunisie au début du XXème siècle, ed. Blanchard, 285–311. Hamy, “Esquisse anthropologique de la régence de Tunis,” in La Tunisie au début du XXème siècle, ed. Blanchard, 285. Hamy, “Esquisse anthropologique de la régence de Tunis,” in La Tunisie au début du XXème siècle, ed. Blanchard, 311. On colonizing rationales see Patricia M. E. Lorcin, “Rome and France in Africa: Recovering Colonial Algeria’s Latin Past,” French Historical Studies 25 (2002): 295–329; and Diana K. Davis, Resurrecting the Granary of Rome: Environmental History and French Colonial Expansion in North Africa (Athens: Ohio University Press, 2007). L. O. Howard, Fighting the Insects: The Story of an Entomologist, Telling of the Life and Experiences of the Writer (New York: MacMillian Company, 1933), 242; Blanchard, Les moustiques: Histoire naturelle et médicale (Paris: F. R. de Rudeval, 1905); Blanchard, L’insecte et l’infection: Histoire naturelle et médicale des arthropodes pathogènes (Paris: Librairie scientifique et littéraire 1909). Howard’s career and mosquito work is aptly recalled in Paul S. Sutter, “Nature’s Agents or Agents of Empire: Entomological Workers and Environmental Change during the Construction of the Panama Canal,” Isis 98 (2007): 724–54, esp. 724–26, 735–37. A[lphonse] Laveran and Blanchard, Les hématozoaires de l’homme et des animaux, 2 vols. (Paris: Rueff et Cie, 1895). John F. M. Clark, “Bugs in the System: Insects, Agricultural Science, and Professional Aspiration in Britain, 1890–1920,” Agricultural History 75 (2001): 83–114, 84; Frederick Vincent Theobald, A Monograph of the Culicidae, or Mosquitoes: Mainly compiled from the collections received at the British museum from various parts of the world in connection with the investigation into the cause of malaria conducted by the Colonial Office and the Royal Society, 5 vols., atlas (London: Printed by order of the Trustees, 1901–10). Blanchard, Les moustiques, “Préface,” v–vi; and Règles internationales de la nomenclature zoologique adoptées par les congrès internationaux de zoologie: International rules of zoological nomenclature; Internationale regeln der zoologischen nomenklatur (Paris: F. R. de Rudeval, 1905). W[illiam] F. Bynum and Caroline Overy, eds., The Beast in the Mosquito: The Correspondence of Ronald Ross and Patrick Manson (Amsterdam: Rodopi, 1998), 30, 52, 58, 79, 128, 312, 358, 436. The book was Blanchard, Traité de zoologie médicale, 2 vols., (Paris: J.-B. Ballière, 1889–90). Hervé Harant, “Cinquante ans de Parasitologie de langue française,” Annales de Parasitologie 43, no. 1 (1968): 105–15, 110, for “medical ecology.” For the British context see Clark, “Bugs in the System,” Agricultural History 75 (2001): 83–114. Lavier and Théodoridès, “Raphaël Blanchard (1857–1919),” Histoire de la médecine 7 (1957), 76. On Brumpt see L. W. Hackett, “Émile Brumpt, 1877–1951,” Journal of Parasitology 38, no. 3 (June 1952): 271–73; and Henri Gaillard, “Émile Brumpt,” in Dictionary of Sci-

270 / Notes to Pages 208–213

80.

81. 82.

83. 84.

85. 86. 87.

88. 89. 90.

91. 92. 93. 94.

95. 96. 97.

98.

entific Biography, 2:533–34; Annick Opinel and Gabriel Gachelin, “Emile Brumpt’s Contribution to the Characterization of Parasitic Diseases in Brazil (1909–1914),” Parassitologia 47 (2005): 299–307. Brumpt, Mission de Bourg de Bozas de la Mer Rouge à l’Atlantique à travers l’Afrique tropical, conference faite à la Société de géographie le 5 juin 1903 (Paris: F. R. de Rudeval, 1903). Blanchard, “La médecine coloniale,” Archives de parasitologie 9 (1905): 95–121, 101, 113–15, 118. Théodoridès, “La contribution française à la parasitologie médicale et à la pathologie exotique de 1900 à 1950,” Histoire des sciences médicales 27, no. 3 (1993): 223– 31, quote on 224. Blanchard, Instructions sommaires pour les pays chauds (Paris: F. R. De Rudeval, 1905). Blanchard [résumé by J. Desneux], “L’entomologie et la médecine,” 1er Congrès international d’entomologie, Bruxelles, 1–6 aôut 1910 (Bruxelles: Hayez, 1912), 1:113–23, quotations on 122–23. Blanchard, “Réorganisation des études médicales; le P.C.N.,” Archives de parasitologie 11 (1906): 485–86, quote on 486. Blanchard, “Projet de réorganization du Service de la parasitologie,” Archives de parasitologie 13 (1908–1909): 311–42, 311. Blanchard, “L’enseignement de la médicine tropicale,” Le progrès médical, 3e série, tome 20, no. 28 (July 15, 1899): 38–42; Blanchard, “La médecine des pays chauds: Son enseignement, ses applications à la Colonisation,” Le progrès médical, 3e série, tome 20, no. 44 (November 4, 1899): 289–93. Blanchard, “Rapport sur l’organisation de l’Institut de médecine coloniale,” Archives de parasitologie 5 (1902): 561–68, 564. Rachel Chrastil, “The French Red Cross, War Readiness, and Civil Society, 1866– 1914,” French Historical Studies 31, no. 3 (2008): 445–76, esp. 454–57. Initial organization of the institute and financial struggles are detailed in Blanchard, “L’Institut de médecine coloniale, histoire de sa foundation,” Archives de parasitologie 6, no. 4 (1902): 585–603, 598, 602. Blanchard, “L’Institut de médecine coloniale, histoire de sa foundation,” Archives de parasitologie 6 (1902): 585–603, 585, 596–97. Blanchard, “L’Institut de médecine coloniale,” Archives de parasitologie 6, no. 4 (1902): 585–603; esp. “Programme du cours de parasitologie,” 597–601. Blanchard, “Institut de médecine coloniale,” Archives de parasitologie 11 (1906–7): 513–25, esp. tables on 515. Maurice Langeron, “Technique des manipulations complémentaires de parasitologie,” Archives de parasitologie 12 (1908): 177–91. On Langeron see Johanna Westerdijk and Jacomina Lodder, “Maurice Langeron, 1874–1950,” Antonie van Leeuwenhoek 17, no. 1 (December 1951): 275–77. Barrière, “Raphaël Blanchard (1857–1919), sa vie-son oeuvre,” 28–30. “M. le Professeur R. Blanchard: Cours de parasitologie,” Archives de parasitologie 15 (1911–12): 328–30. Blanchard, “Les parasites et les maladies parasitaires dans l’histoire, la poésie et l’art,” Archives de parasitologie 16 (1913–19): 579–80, which introduces a lengthy section on plague in the writings of Thucydides and La Fontaine and its appearances in Athens and Marseille (581–637). Blanchard, Épigraphie médicale: Corpus inscriptionum ad medicinam biologiamque spectantium (Paris: Asselin et Houzeau, 1909).

Notes to Pages 213–221 / 271 99. Paul L. Farber, Finding Order in Nature: The Naturalist Tradition from Linnaeus to E. O. Wilson (Baltimore: Johns Hopkins University Press, 2000). 100. Brumpt, “Maladie du sommeil, distribution géographique, étiologie, prophylaxie,” Archives de parasitologie 9 (1905): 205–25. 101. Compare, for example, Blanchard, “Notre programme,” Archives de parasitologie 1 (1898): 5–7, quote on 6, with Brumpt, “Avant-propos,” Annales de parasitologie humaine et comparée 1 (1923): 1–3. 102. Blanchard, “La médecine coloniale,” 100. 103. These issues are examined in greater detail in Michael A. Osborne and Richard S. Fogarty, “Views from the Periphery: Discourses of Race and Place in French Military Medicine,” History and Philosophy of the Life Sciences 25 (2003): 363–89. CONCLUSION

1.

Yannick Pocahn, “Victor Segalen médecin de marine,” in Victor Segalen, voyageur et vissionnaire, ed. Mauricette Berne (Paris: Bibliothèque nationale de France, 1999), 32–37, 38. 2. Gilles Manceron, “Koké and Tépéva: Victor Segalen in Gauguin’s Footsteps,” in Gauguin Tahiti, ed. George T. M. Shackelford and Claire Frèches-Thory (Boston: MFA Publications, 2004), 272–83. 3. Henry Bouillier, “Introduction,” to Victor Segalen, oeuvres complètes, 2 vols., ed. Henry Bouillier (Paris: Éditions Robert Laffont, 1995), 1:3–10; Bouillier, “Les années de formation,” in Victor Segalen, voyageur et vissionnaire, 18–21. 4. Claude Lévi-Strauss, Tristes tropiques (Paris: Plon, 1955); Victor Segalen, Les immémoriaux (Paris: Plon, 1956); Georges Balandier, Afrique ambiguë (Paris: Plon, 1957); Balandier, Ambiguous Africa: Cultures in Collision, trans. Helen Weaver (New York: Pantheon Books, 1966). 5. Victor Segalen, “Essai sur l’exotisme, une esthétique du divers,” in Victor Segalen, oeuvres complètes, 1:745–79, esp. 745. 6. Bouillier, “Chronologie,” in Victor Segalen, oeuvres complètes, vol. 1, xxxi–lxxxvii, indicates an accidental death. 7. Cited by Jean Guillou, “Victor Ségalen et l’exotisme,” French Review 41 (1967): 243–49, 247, who references a letter sent to Henri Manceron, cited in Bouillier, Victor Ségalen (Paris: Mercure de France, 1961), 102. 8. BoFMP, “Statuts de l’unité à dominante de recherche de médecine et hygiène tropicales de Bordeaux” (1973). 9. BoFMP, “Statuts de l’unité de formation et de recherche médecine tropicale et environnement” (adopted February 3, 1989). Related modifications can be traced in Journal officiel de la république française, May 16, 1992, Ministère de l’education nationale et de la culture, “Arrêté du 11 mai 1992,” signed by Jack Lang; August 20, 1996, Ministère de l’éducation nationale, de l’enseignement supérieur et de la recherche, “Arrêté du 9 août 1996,” signed by J. R. Cytermann. For the Centre René Labusquière, médecine et hygiène tropicales, see http://u-bordeaux2-medtrop.org/ standard-436–1.html (accessed September 24, 2012). 10. BoFMP, “EXTRAIT du registre des déliberatins du Conseil d’administation de l’Université Bordeaux” 2, Séance Plénière, March 28, 1996. 11. The essentials of the consolidation are related in two websites: http://fr.wikipedia .org/wiki/%C3%89cole_du_service_de_sant%C3%A9_des_arm%C3%A9es_de _Bordeaux (last modified August 17, 2012, accessed September 24, 2012), and http://fr.wikipedia.org/wiki/%C3%89cole_du_service_de_sant%C3%A9_des

272 / Notes to Pages 222–223

12. 13.

14. 15.

_arm%C3%A9es_de_Lyon-Bron (last modified August 9, 2012, accessed September 24, 2012). From website of the Association amicale santé navale et d’outre mer, http://www .asnom.org/en/220_formation.html#d (accessed September 24, 2012). This brief review of Pharo history follows Éric Deroo et al., L’École du Pharo, Cent ans de médecine outre-mer, 1905–2005 (Panazol, France: Charles-Lavauzelle, 2005), and a special issue of Médecine tropicale: Revue française de pathologie et de santé publique tropicales 65 (2005): 209–96, both published in conjunction with the centenary. R. Laroche, “École du Pharo 1905–2005: Formation en médecine tropicale,” Médecine tropicale 65 (2005): 219–24. La Provence, July 15, 2008.

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INDEX

Abbeele, Georges Van Den, 10 Académie de Aix, 159, 161 Académie de médecine, 58, 65, 122, 130, 175, 179, 181, 193, 198 Académie des sciences, 169 Académie du Var, 4, 140 acclimatization, 83–84, 88, 91–93, 99, 103, 106, 137, 166, 168 Achalme, Pierre, 115–16 Ackerknecht, Erwin H., 95–96 admiralty, 8, 20–21, 112, 126; and reform, 38–39, 134–36 Africa (in general), 1–2, 5, 9, 11–12, 40–41, 44, 49, 63–64, 66–68, 71, 75, 78, 80–81, 83, 87, 92–94, 96, 100–103, 106, 109, 112, 116–17, 128, 142–44, 155–56, 175, 177, 181, 184, 186, 192, 196–97, 200, 203, 205, 207–9, 220. See also French Empire Africaine (ship), 66–68 African peoples. See Africa Aiguier, Joseph-Marcel, 43–44 Allemane, Jean (prisoner), 44 amariner, 88 anatomical. See anatomy anatomy, 23, 35, 43, 45, 58–62, 75, 82, 85, 100, 112, 122, 125, 136, 143, 146, 148–49, 151, 164, 183, 186, 194–95; Bushman, 197; and crania, 105; instruction and early texts, 29–32; mosquito, 207; and race theory, 78–80 Annales de parasitologie humaine et comparée, 214

Antonini, Jean-André, 176 Archives de médecine navale, 53, 74, 82–83, 126, 137, 212 Archives de parasitologie, 206, 211–14 Arnold, David, 2 anthropological pluralism, 9, 77–109; defined, 77. See also racial ideas anthropology, 35, 195–97, 221; physical, 9–10, 52, 77–109, 114, 142, 196–97, 204–6, 213, 215. See also ethnography anthropometry, 75, 80, 104 anticontagionism. See contagionism Archimède (ship), 65, 74 Archinard, Louis, 185 arsenals (general), 7–8, 13–15, 20–22, 24, 26, 33–34, 47, 69, 151, 155, 191. See also under individual ports Artaud, Adrien, 173 Association des dames de France, 210 Association française pour l’avancement des sciences, 58, 113–14, 171 Association générale des pharmaciens de France, 174 Astrolabe (ship), 54 atmosphere, 52, 62; and health on ship, 48–49, 68–70 Atthalin (judge), 140 Aube, Hyacinthe, 134 Aubin, Charles-Louis-François, 45 Audibert, Victor, 186–87 Auffret, Charles-J.-E., 61, 151 Augagneur, Victor, 151–52 Azam, Eugène, 114

302 / Index Baartman, Saartjie, 196 bacteriology, 6, 62, 107, 143, 145, 168, 184, 188, 192, 208–12, 219 bagnes (general), 7–8, 11–13, 21, 33–46, 87, 106, 151, 220. See also under individual ports Baillon, André, 199 Baillon, Henri-Ernest, 196–200 Balandier, Georges. See colonial situation Bally, Victor, 162–63 Barbe (Dr.), 149 Barbey, Édouard, 136, 140 Barnes, David S., 6 Barthez, Paul Joseph, 71–72 Basque (race), 84, 87, 89–90 Bastian, Adolf, 79 Baudin, Nicolas, 196 Beautemps-Beaupré, François, 53 Beille, Lucien, 115–16 Bell, David A., 84, 87 Bélot, (Dr.), 99 Benoit, Barthélemy, 82 Bérenger-Féraud, Laurent Jean-Baptiste, 101, 107–8, 111, 122, 146, 152, 172; and book bombs, 4, 7, 137–41; career, 128–31, 138; racial ideas, 92–94, 100, 103, 109, 176, 204–5; and reforms, 127–33, 135–36, 145; on yellow fever, 91–94, 102, 106, 203 Bernard, Claude, 112, 194–95; and physiological determinism, 72, 75, 90, 162–63, 175–76, 193 Bert, Paul, 163, 194–95 Bertulus, Évariste, 61, 72, 165, 169, 176; and Christian vitalism, 160–64; and quarantine, 98; and yellow fever, 98 Bichat, Xavier, 71–72, 78, 122 biological determinism (essentialism), 77–109. See also racial ideas Blanchard, Raphaël, 10, 108, 146, 165, 186– 88, 189–215, 218–19; biography (early), 191–96; dispute with Frédéric-Louis Heim, 198–200; and parasitology, 10, 165, 186–89, 192–93, 196–98, 200, 202– 15, 219; and racial ideas, 152, 195–97, 199–200, 202–5, 215. See also Paris: and Institute of Colonial Medicine Bobanghi (sleeping sickness patient), 208 Bonnechose, Henri de, 175–76 Bonnier, Gaston, 169 Bonnin, Henri-Auguste-François, 144, 221

book bombs, 4, 111–53, esp. 137–41. See also under Bérenger-Féraud, Laurent Jean-Baptiste Bordeaux, 1, 3–4, 8, 14, 48, 88, 111–53; Chamber of Commerce, 111, 114, 117; College of Physicians, 112; Colonial Institute, 114–16, 143, 145–46, 153, 167, 184; Corporation of Apothecaries, 112–13; École de médecine et de pharmacie, 113, 141; École du service de santé de la marine (and successor institutions), 4, 45, 62, 86, 107–9, 136, 141, 160, 173, 182, 220–21; École publique de chirurgie de Saint-Côme (and successor institutions), 112–13; École supérieure de commerce, 115–16; Faculty of Medicine (ancient), 112; Faculty of Medicine (Faculté Mixte de Médecine et de Pharmacie), 93, 100, 108, 113, 115–17, 136, 141–42, 144–52, 160, 164, 184, 186, 221–22, 225–26; Hôpital Saint-Anne, 144; Hôpital Tondu, 144; Musée d’ethnographie et d’études coloniales (and related institutions), 142, 145, 173; Saint-André hospital, 113; struggles for access to hospitals by naval students, 148–51 Bordelais (race), 88–89 Bordier, Arthur, 104, 116 Bouchard, Abel, 148 Bouchardat, Apollinaire, 73–75 Bouchillon, François (dit Fondalon), 30 Boudin, Jean-Christian-M.-F.-J.; and anthropology, 91; and medical geography, 51–53, 103 Bouisson, Étienne-Frédéric, 129 Boulanger, Georges, 137 Boule, Marcellin, 203 Bouquet de la Gyre, J.-J., 191 Bourel-Roncière, Paul, 57, 91 Bourru, Joseph Henri, 148–51 Bouvier, Aimé, 193 Brassac, Pierre-Jean-Marcellin, 146–48, 151 Brest, 1, 4, 6–7, 23–30, 32, 45, 49, 55–56, 58, 61, 64, 66, 68, 85–87, 91, 96, 100– 102, 105–9, 117–18, 120, 122–25, 127, 133, 137, 143, 146, 155, 161, 183, 207, 219–20, 222; arsenal, 17–18, 25, 87, 191; bagne, 35, 37–39, 105, 191; early organization, 11–20; École d’anatomie et de chirurgie, 30, 58, 105; hospitals

Index / 303 in, 6, 17, 23, 49, 87, 162; prisoners, 34–39 Breton (race), 75, 77, 84–85, 87–91, 144, 183, 226 Brisou, Bernard, 3–4, 221 British Empire, 1–2, 4, 9, 39, 175, 207 Brittany, 6, 8, 13, 16–19, 34, 45, 58, 72, 84, 87–89, 101, 103, 108, 121, 143, 218–20 Broca, Paul, 77, 79–80, 82–83, 109, 197. See also anthropology: physical Brouage, 8 Brouardel, Paul, 198 Broussais, François-Joseph-Victor, 99, 161 Brulator (surgeon), 113 Brumpt, Émile, 188, 207–8, 213–14 Burton line, 71 Cabanis, Pierre-Jean-Georges, 63 cadavers, 11, 35, 39, 45, 164; bagnes as source of, 31; lack of, 150–51 Calmette, Albert, 107–9, 143, 192 Camena d’Almeida, Pierre, 115 Camper, Peter, 80 Cantile, James, 208 Caravane (ship), 161 Caribbean, 9, 11, 49, 58, 94, 96–97, 106, 109, 111, 217. See also French Empire Carnot, Sadi, 137, 141 Caroline (ship), 67 Casey, Edward S., 4 Caudel, Maurice, 205–6 Certificat d’études physiques, chimiques, et naturelles. See P.C.N. Chailley-Bert, Joseph, 166–67 Chamberlain, Joseph, 207 Chantemesse, André, 143, 210 Chapman, Herrick, 10 Chapuis, Jules, 82 Charcot, Jean-Marie, 143 Charles-Roux, Jules, 114, 156, 160, 181, 223; and Colonial Exposition of Marseille (1906), 164–73 Cherbourg, 13, 56, 87, 108–9, 130–32, 182; hospitals in, 13 Chertemps de Seuil, Pierre, 17 Chervin, Nicolas, 96–100 Chevalier, Louis, 190 Chevreul, Michel, 169 cholera, 2, 33, 52, 72, 74, 78, 81, 86, 95, 98, 112, 118, 137, 162, 192; in Bordeaux, 152; in Marseille, 157–58; in

Paris, 73–74, 190–91; in Toulon, 14, 23, 35, 42–44, 121 chorology, 5, 7 Choux, Pierre, 169 Christian vitalism. See vitalism cisterns (on ship), 67–71 Clarac, Albert, 101, 105–7, 138, 173, 181–83, 185, 187, 218 Clavel, Charles, 155 Clémenceau, Georges, 152 Clerville, Nicolas de, 17–18 climate. See climatology climatology, 2, 6–7, 50–51, 81–82, 84, 220; medical, 44, 52–53, 59, 62, 65, 83, 90, 98, 101–2, 114, 130, 137–38, 157, 168, 182, 203–4. See also acclimatization Clot-Bey, Antoine Barthélémy, 162–63 Club Alpin Français de l’Isère, 178–79 Cochon-Dupuy, Gaspard, 29–30 Cochon-Dupuy, Jean, 28–31 Cohen, William B., 78, 92–93 Colbert, Jean-Baptiste, 8, 15, 17–19, 20–22, 24, 26, 33 Colbert de Seignelay, Jean-Baptiste Antoine, 8, 15, 20–21, 26 Colbert du Terron, Charles, 19, 26 Coleman, William, 95, 98 colics, 57, 77, 82, 94, 98–99, 129; colic of Poitou, 68; dispute over etiology, 63–72; dry colic, 9, 42, 46, 48–49, 57–58, 220; Madrid colic, 67; metallic colic, 67; vegetable colic, 67–68, 96. See also scurvy Colin, Léon, 181 colonial situation, 1–10, 12, 219 Comité du Madagascar, 202 commissary, 36, 119; and naval physicians, 21–23; and prisons, 37 Communard. See Paris: Paris Commune Commune. See Paris: Paris Commune Constans, Ernst, 138–40 Constans (Mrs.), 139 constitution, 6, 41, 45, 59, 73, 88–90, 95, 100, 109 contagion. See contagionism contagionism, 67, 69, 95, 97–98, 100, 143 Cooter, Roger, 95 Cornil, Victor, 143 Corre, Armand, 41, 74, 107–9, 121, 138, 148, 218–19; climates as producing race, 81; on Creoles, 101–5, 181; and

304 / Index Corre, Armand (continued) etiology of yellow fever, 143; and racial ideas, 137, 176, 204 Council of Health (in ports, Conseil de Santé), 32, 58, 119, 121, 131; and compilation of reports, 55–57 Courcelles, Étienne Chardon de, 30 Creoles, 41, 80, 92–93, 101–9, 121, 138, 173, 181, 183, 196, 203–6, 219 Crimean War, 86, 128, 147 criminology, 35–36, 38, 81; and psychology, 40–44; and racial ideas, 103–5 Cuéno, Bernard, 145–46 Cuvier, Georges, 80, 82, 196 Darlay (bartender), 139–41 Darwin, Charles, 56, 75, 79, 166, 195–96 Darwinism. See Darwin, Charles Dechambre, Amedée, 174 déclaration. See under system of naval regulations Decrais, Albert, 115 decree. See under system of naval regulations Delaporte, Pierre, 118 determinism. See physiological determinism diet, 6, 42, 47, 59, 61, 100; in bagne, 36–38, 44; ingesta, 69–70; and kola, 175, 177, 180; and race, 71, 81, 83, 90, 203; on ship, 54, 69–71, 90 differential immunity. See ethnic selectivity; individual diseases dissection, 23, 29, 31, 35, 39, 113, 161. See also anatomy distinctiveness (of naval medicine), 3, 47–49, 72, 84, 123, 134; and disease ecology, 33; and languages, 87; and parasitology, 189 Domingua (ship), 69 Doundaké (plant), 174 Dreyfus, Alfred, 181 Dubedat, Jean, 112 Dubos, Jean, 63 Dubos, René, 4, 63 Duhamel, Henry, 178 Dumas, Alexandre, 173 Dumont d’Urville, Jules, 54, 66, 121 Durkheim, Émile, 105 Dutch Empire, 2 édict. See under system of naval regulations Edwards, William, 80

Eldorado (ship), 63, 65, 68–69 entomology. See medical entomology epidemic. See epidemiology; individual diseases epidemiology, 5, 9, 11, 23, 31, 33, 35, 38, 40–47, 49, 57–59, 62–63, 65, 68–71, 86, 91–102, 106–7, 111–12, 118, 126, 130, 140, 143, 155, 157, 161–62, 165, 168, 183, 190, 207, 210, 220 Érigone (ship), 69 Espine, Jacob-Marc d’, 52 Espine, Jean Henri Adolphe d’, 52 ethnic selectivity (of disease), 9, 70, 219; dry colic, 77; yellow fever, 77, 176, 183 ethnicity. See racial ideas ethnographic. See ethnography ethnography, 10, 43, 52, 77, 80, 91–92, 102–3, 108, 114, 116, 130, 142, 145, 172–73, 175, 202–3, 205–6, 221; in art, 197; and disease, 213–14; novelistic, 218 ethnology. See ethnography Étienne, Eugène, 138–40 etiological. See etiology etiology, 7, 9, 58, 93, 102, 193; and naval hygiene, 48, 58, 67, 73–75, 81–82, 95, 138; and parasitology, 204, 209. See also individual diseases Evans, Andrew D., 78–79 Fabre, Jean-Henri, 197 Faculty of Medicine. See under locations Faculty of Sciences. See under locations Farber, Paul L., 213, 226 Faure, Félix, 185–86 Fegali, 116 Ferradji-ben-salem (prisoner), 40–42 Ferry, Jules, 138, 164 Finlay, Carlos, 93–94, 182 Flaissières, Siméon, 158, 186 Flammand (race), 87 Flanders, 84 Flaubert, Gustave, 6, 87 Fogarty, Richard S., 226 Foncin, Pierre, 114 Fonssagrives, Jean-Baptiste, 45, 103, 160–61, 174; and dry colic, 63–72, 129; and naval hygiene, 54, 61, 74–75, 85, 146–48, 176; and racial ideas, 77, 86–91, 93, 183; and tuberculosis, 52; and vitalism, 72, 98, 161, 163–64, 176; and yellow fever, 95–96, 100

Index / 305 Fontan, Jules, 135 forçats. See bagnes forensic medicine, 11, 34, 36, 39, 40–42, 60–61, 75, 184. See also hygiene Foucault, Michel, 36–38 Fox, Robert, 223, 225 Frader, Laura L., 10 Franco-Prussian War, 44, 75, 86, 100, 113, 165, 191, 194 Franklin, Benjamin, 67 French Empire (colonies and spheres of influence), 3, 9; Algeria, 1, 12, 38, 40, 44, 51, 64, 74, 116, 128, 137–38, 156, 158–59, 169, 176, 178, 197, 205, 208, 213, 220; Annam, 81, 194; Antilles, 92–93, 121, 146, 165; Cayenne, 82; Chandernagor, 11; Cochin China, 45, 57, 81, 124, 137–38, 143; Gabon, 174; Gorée, 9, 11, 92, 129; Guadeloupe, 9, 93, 102–3, 107, 121, 123, 183; Guiana, 9, 11, 35, 39, 60, 66–68, 82, 106, 143; Île de Bourbon, 9; Île de France, 9; Indochina, 79, 107, 140, 165, 170, 182–83, 202, 209–10; and lecture series on Madagascar, 202–5; and lecture series on Tunisia, 205–6; Louisiana, 11, 96; Madagascar, 12, 102, 106, 151, 168–69, 171–72, 181, 183, 199, 210, 221; Martinique, 9, 11, 92, 100–101, 105–7, 123, 130, 165, 181–83; Mauritius, 11; Mexico, 9, 57, 94, 97, 99, 101, 105, 124, 161; Morocco, 12, 181, 187; New Caledonia, 35, 44, 82, 106, 165; New France, 11, 111; Pondicherry, 11, 92; Réunion, 175; Saint Domingue, 9, 11, 14, 20, 94, 96, 111, 162; Senegal 12, 58, 69, 82–83, 91–93, 95, 101–3, 106, 114, 117, 129–33, 137, 148, 165, 202, 221; Tahiti, 106, 108, 218; Tonkin, 143, 194; Tunisia, 12, 92, 131, 156, 170, 202; Vietnam, 12, 215 fundamental ordinance. See under system of naval regulations: Ordinance (April 15, 1689) Galen. See Galenic ideas Galenic ideas, 62, 70, 80 galériens, 34–35, 155 Gall, Franz Joseph, 105 galley (ship), 17, 23, 35–36, 38, 155 Gallieni, Joseph, 114, 181 Gascon (race), 87, 89

Gauguin, Paul, 218–19 Geoffroy Saint-Hilaire, Isidore, 82–83, 197 germ theory, 7, 48, 60, 93–94, 102, 143–44, 204 Giard, Alfred Mathieu, 200 Gibraltar, 57, 94–95, 97–98 Gintrac, Élie, 113 Gintrac, Henri, 113, 141 global medicine, 141–53, 209, 221 Gobineau, Arthur de, 78–79, 109 Godlewska, Anne, 51 Goldstein, Jan, 105 Goron (police investigator), 139 Grall, Charles, 182–83 Grandidier, Alfred, 199, 202–3 Grandidier, Guillaume, 203 Grosse, Pascal, 80 Gruby, David, 193 Guépratte (surgeon), 65–66, 74 Guiart, Jules, 198, 211 Habermas, Jürgen, 5 Hamy, Ernest-Théodore, 205–6 Haiti. See under French Empire: Saint Domingue Hallé, Jean Noël, 74 Hamburg, 156; Institute for Marine and Tropical Diseases (Institut für Schiffsund Tropenkrankheiten), 145, 194 Hamlin, Christopher, 95 Harrison, Mark, 2 Heckel, Édouard, 114–15, 153, 160–62, 164, 184–87, 199; and Colonial Exposition (1906), 164–73; and kola dispute, 173–81 Heckel, Francis, 165 Heim, Frédéric-Louis, 198–200 Helmholtz, Hermann von, 194 Henry I, 17 Henry IV, 191 Hérard, Catherine (Mrs. Armand Corre), 101 Herminie (ship), 99–100 Herriot, Édouard, 186 Hippocrates. See neo-Hippocratic Hirsch, August, 50 His, Wilhelm, 194 histology, 141, 192–93 historiography of French medicine, 1–10 Hoffmann, Wilhelm H., 93 homosexuality, 40–41 hospital ships, 22, 26, 57, 59, 119

306 / Index hospitals (general), 2, 8, 11, 13, 42–44, 47– 50, 57, 74, 85, 92, 97, 101, 106, 108–9, 118–19, 129, 143, 175–77, 179, 182, 191–92, 208, 210, 220; and governance, 20–23; and governance and naval schools, 25–34; and governance and prisoners, 35–38. See also under patients; individual cities, hospitals in Howard, Leland Ossian, 207 humanism (medical), 10, 63, 162, 208, 212–15 Humboldt, Alexandre von, 50–51 hygiene, 6, 32–33, 42, 64, 78, 82–84, 98, 103, 109, 116, 120, 129–30, 132–33, 137, 142, 145–49, 157, 159, 165, 168–69, 171–72, 182, 184, 186, 200, 203, 220–21, 225; in army, 191; manuals of naval, 85; naval, 220; naval and external racial dimensions, 91–94; naval and immunity to disease, 91–94; naval and internal racial dimensions, 87–91; naval and pedagogy, 45–46, 55; naval and record keeping on ship, 58–63; naval and recruitment, 87–91; naval as pedagogical orphan, 59–63; naval contrasted with civil and army, 48–49, 72–75; and new technologies, 67; and parasitology, 209–11; practice of naval, 46, 55–56, 70–71; as science of place, 47–75; status of naval, 9, 47; and vitalism, 160–64 Imbert, Léon, 186–87 immunity (full and partial), 9, 75, 81–83; cholera, 42–45, 78, 152; other diseases, 43, 81, 152; yellow fever, 78, 91–94, 98, 100, 102, 106–7, 143. See also ethnic selectivity India (French), 58, 69, 87, 101, 129, 137, 143, 146, 182 ingesta. See diet internationalism (scientific), 2, 5, 10, 47, 93–94, 137, 192, 194, 198, 202, 206–9, 214, 222 Islam, 40, 71, 83, 116, 205–6 Islamic. See Islam Jandeau, Pierre, 186 Journal fin de campagne, 21, 53–59, 66, 68 Joyeux, Charles, 187–88, 212 Jumelle, Henri, 168–69

Kennedy, Dane, 4 Kéraudren, Pierre-François, 32–33, 118 Koch, Robert, 198 kola, 166, 168, 173–81, 186, 217 Kraxner, Stéphane, 225 La Berge, Ann F., 51 La Couronne (ship), 26 La Rochelle, 13, 16, 19, 88, 148, 190 Lacroix, Alfred, 169, 203 Lahaie (naval surgeon), 32 Lamarck, Jean-Baptiste, 78–79, 83 Lamarckian. See Lamarck, Jean-Baptiste Lamoise, (Fr.), 102 Langeron, Maurice, 211 Lapique, 177 Larrey, Hippolyte, 130 Lataste, Ferdinand, 205 Latin America, 9, 38, 65, 99, 117, 142, 157, 197, 211. See also French Empire Lauvergne, Hubert, 42, 105, 121, 123 Laveran, Charles Louis Alphonse, 172, 191, 206 Lavoisier, Antoine, 56, 61, 75, 121 Le Bras, Michel, 221 Le Dantec, Alexandre, 7, 93–94, 100, 108, 116, 141–53, 176, 182, 200, 218, 221 Le Havre, 13–14, 17, 64, 117, 167, 191 Le Play, Frédéric, 170 Le Roux d’Infreville, Louis, 15, 26 Le Roy de Méricourt, Alfred, 53, 67, 74–75, 91, 137 lead poisoning. See colics: dry colic Lefèvre, Amédée, 75, 82, 98; and dry colic dispute, 63–72 legal medicine, 40, 58, 60–62, 130, 142. See also hygiene Lemaire, Paul-Louis, 142 Léonard, Jacques, 47, 59–60, 118–19 Lesson, René, 66 Lesueur, Charles, 196 Letourneux, Aristide, 205 Levant, 8, 23, 30, 66, 155, 157 Lévi-Strauss, Claude, 219 Lévy, Michel, 74, 130 lifeworld, 26, 30, 38, 46–47, 49, 109, 118, 189, 218, 223; compared with army lifeworld, 85–86; defined, 5; in ports, 10–21 lifeworlds. See lifeworld Lille Faculty of Medicine, 200

Index / 307 Lind, James, 70 Liverpool School of Tropical Medicine, 145, 156, 210 Livon, Charles, 158 localism, 3–4, 57, 220 Lombard, Henri-Clermond, 51–53, 97 Lombroso, Cesare, 103–4 London School of Tropical Medicine, 143, 145, 183–84, 208, 210, 214 Lorient, 13–14, 34–36, 56, 87, 100, 109, 130–32, 151; hospitals in, 13 Loti, Pierre, 219 Louis, Pierre-Charles-Alexander, 52, 97 Louis XIII, 8 Louis XIV, 13, 16–17, 19, 35 Louis XV, 155 Louis XVIII, 96 Low, George Carmichael, 208 Lucas, Désiré, 106 Lunn, Joe, 78, 93 Lyautey, Hubert, 181 Lyon, 23, 62, 97, 137, 158–59, 164, 186; Chamber of Commerce, 182; École du service de santé militaire (and successor institutions), 4, 86, 135–36, 141–42, 147, 150–52, 221–23; Faculty of Medicine, 163–64, 184, 198, 211, 221 Mac-Mahon, Patrice de, 129 Magendie, François, 112 Mahé, Jean-Baptiste, 174, 183; and hygiene, 65, 85–87; as medical geographer, 51–53, 59; and naval recruitment, 87–91, 93; and reforms, 120 Maher, Charles-Adolphe, 37, 53, 60, 132, 217; as director of Rochefort school, 53, 85–86; and reform, 124–25; and yellow fever, 99–101 Maillot, François-Clément, 176 Makaya (sleeping sickness patient), 208 Makinau, Armand de, 39 Mal d’estomac des nègres. See negro stomach malaria, 19, 35, 48–49, 57, 60, 82, 91–92, 94–96, 116, 124, 144, 162, 168, 170, 172, 174, 176–77, 202, 204, 207–8, 211, 214, 222; conflation with yellow fever, 92, 94–95, 99–101; geography of, 7, 48, 52–53; and race, 91 Malespine, Joseph, 124–25 Malte-Brun, Conrad, 50–51 Manson, Patrick, 143, 206–8, 210, 214

Mantes, Théodore, 166–67 Marseille, 1, 3–4, 7, 10, 14, 16–17, 23, 31, 38, 48, 61, 72, 96–97, 113–15, 117, 136, 140, 146, 151, 153, 155–88, 190–91, 199, 212, 217; Chamber of Commerce, 115, 155–57, 159–60, 165–66, 168, 170, 173, 187, 190–91, 223; Colonial Exposition (1906), 159–60, 166, 169–73, 181, 186; Colonial Exposition (1922), 159–60, 171–72; Colonial Institute (and related institutions), 114–15, 146, 167, 169, 172–74, 184, 186, 199; disease ecology of, 111–12; École d’application du service de santé des troupes coloniales (Pharo and related institutions), 107, 168, 173, 181–85, 187, 215, 221–23; École de plein exercice de médecine et de pharmacie, 163–65, 168–69, 184–87; École pratique d’industrie, 157; École préparatoire de médecine et de pharmacie (and preceding institutions), 98, 160–65; École supérieure de commerce, 159, 168; Faculty of Medicine (Faculté Mixte de Médecine Générale et Coloniale et de Pharmacie; and successor institutions), 159, 163, 168, 185–87, 212, 222; Faculty of Sciences, 157, 159, 164–69, 186; galley fleet, 35–36; hospitals in, 174, 184; Hôtel-Dieu, 160, 162–64, 187; Institute of Colonial Medicine, 187; Jardin botanique colonial, 165–66, 184; Musée colonial, 166–67, 169, 172–73, 184; place of, 155–60 Marsouin (ship), 66 Martine, 185 Martonne, Édouard de, 116 Matelot (prisoner), 41 Maurel, Hilaire, 114, 117 Maurel, Marc, 114 McClellan, James E., III, 25 McNeill, John R., 9 medical entomology, 197, 206–11, 214–15 medical geography, 7, 9, 46–53, 56–57, 59, 65, 77, 81, 97, 102–4, 113–14, 116, 120, 138, 142, 164, 168, 183–85, 203, 220; and naval recruitment, 87–90 medical parasitology, 5, 7, 10, 93, 102, 115–16, 143, 145, 152, 165, 184, 186–88, 189–215, 219. See also Blanchard, Raphaël

308 / Index Mendelism, 79 Merlin, Louis-Baptiste, 43 Messimy, Adolphe Marie, 187 Metz, 85, 129, 175 Meyran, Michel, 223 miasm, 48–49, 65, 67–69, 73–74, 209, 219; and yellow fever, 95 microbiology, 144, 158, 164, 192–93 Milne-Edwards, Alphonse, 193, 202–3 Ministry of Colonies (and related agencies), 124, 136, 138, 140, 167, 169, 185, 187 Ministry of Commerce, 190 Ministry of Defense, 3, 136, 147, 152, 181, 184–85, 221–23 Ministry of Public Instruction, 3, 72–73, 113, 129, 142–43, 168, 176 Ministry of the Interior (and related agencies), 107, 127, 138–40, 190 Ministry of War. See Ministry of Defense Mithon de Senneveille, Jean-Jacques, 30–31 Mollat du Jourdin, Michel, 84 Montesquieu, Charles de, 81 Montgrand (physician), 37 Montpellier, 163, 165; Colonial Institute, 167; Faculty of Medicine, 64, 87, 129, 158, 160, 163–64, 187 Moquin-Tandon, Charles Alfred, 196–97 Morren, François-Auguste, 159 mosquitoes, 94, 116, 183, 186, 197, 202, 206–7, 209, 211 Mottet, Ambroise, 159 Moulinié, Jean-Baptiste, 113 Mucchielli, Laurent, 105 Müller, Victor (pseud.). See Fonssagrives, Jean-Baptiste Muséum de histoire naturelle (Paris). See under Paris: Museum of Natural History Nabias, Barthélemy, 141–42 Nancy, 212; Faculty of Medicine, 174 Nantes, 13, 96, 111, 163, 165, 199 Napoléon, 213 Napoléon (ship), 67 Napoléon, Jérôme, 124, 128–29 Napoléon III, 16, 39, 124, 128, 159, 175, 191 natural history. See naturalist’s method; taxonomy naturalist’s method, 59, 66, 88, 138, 169, 175, 179, 200–201, 206–9, 213

naval medical schools. See under Bordeaux; Brest; Rochefort-sur-Mer; Toulon Navarre, P. Just, 182 navigans (surgeons who sailed), 7, 32, 119–20, 122, 140, 143, 147; resentment of professoriate, 126–37 negro stomach, 57, 82 neo-Hippocratic, 7, 54, 59, 61–62, 70, 75, 80, 90, 121–22, 204 neo-Lamarckian, See Lamarck, Jean-Baptiste neovitalism. See vitalism Nicolai, Alexandre, 115 Nicolle, Charles, 207 Noguchi, Hideyo, 144 Nora, Pierre, 4 Norman (race), 14, 75, 87–91 North Africa. See Africa; French Empire nurses, 21–22, 35–36, 58, 69–70, 102, 109, 222 Nye, Mary Jo, 5, 157, 223, 226 Nye, Robert, 178, 226 Occitania, 84 Olivier, 185 Ordonnance (Ordinance). See under system of naval regulations Osler, William, 212 P.C.N. (Certificat d’études physiques, chimiques, et naturelles), 141, 169, 198 parasitology. See medical parasitology Paris, 1, 4–5; Association des dames de France, 210; Chamber of Commerce (and related institutions), 190; Colonial Exposition (1931), 171; École d’anthropologie, 195–96; Exposition Universelle (1878), 104, 178; Exposition Universelle (1889), 202; Exposition Universelle (1900), 166, 169; Faculty of Medicine, 2–3, 10, 30, 48, 57, 73, 81, 101, 145–46, 160, 162, 164–65, 175, 186, 189–215; Faculty of Medicine and Institute of Colonial Medicine, 10, 146, 189, 192, 202, 206, 209–12, 214; Faculty of Medicine and Natural History, 196–98; Faculty of Sciences, 198; Hôtel-Dieu, 177; Museum of Natural History, 66, 80, 82, 116–17, 169, 193, 199, 202–3, 205; Paris Commune, 40, 44, 75, 106; Pasteur Institute (Paris), 2, 50, 107, 165, 183, 188, 191–92, 210–11,

Index / 309 218, 225 (see also Pasteur Institutes); place of, 189–92; Val-de-Grâce (Army postgraduate medical school and hospital), 2, 50, 74, 86, 92, 129, 132, 147–48, 153, 182, 187–88, 191, 210, 220, 222 Pariset, Étienne, 97 Pascalis-Ouvrière, Félix, 97 Pasteur Institutes (outside of Paris), 2, 107, 158, 182–83, 192, 214. See also Paris: Pasteur Institute Pasteur, Louis, 2, 60, 73, 93–94, 102, 107, 143–44, 158, 172, 192–93, 196, 198, 210, 212–13, 219 pathological anatomy. See anatomy patients, 2–3, 6–7, 13, 26–27, 31, 52, 56–57, 65, 87, 97, 146, 152, 168, 181, 187, 224; access to, 149–51, 191, 210; demographics of naval, 20–25; naval and bloodletting for fevers, 99–100; naval contrasted with civil, 33–46; naval and right to health care, 11; private naval, 32, 122; venereal naval, 49 Paul, Harry, 223 Payen, Charles Vincent (surgeon), 37 Peard, Julyan G., 4 Pelletan, Camille, 151–52 Pelling, Margaret, 95 Péron, François, 196 Perrier, Edmond, 79 Pharo. See Marseille: École d’application du service de santé des troupes coloniales phrenology, 36, 42, 80, 103–5, 121 physical anthropology. See anthropology physiological determinism, 72, 162. See also Bernard, Claude; Sée, Germain physiology, 3, 6, 9–10, 41–42, 52, 58, 62–63, 71–73, 77, 83, 90, 95, 100, 112, 136, 149, 161–64, 169, 192–96, 200–202, 204; and kola, 173–81. See also vitalism Pitres, Albert, 136, 141 place (concept), 79–81, 84–85, 93–94, 109, 128, 130, 146, 151, 164, 169–70, 173, 183–86, 217, 219–24; allegiance to, 118; as altering etiology, 137–38; of Bordeaux,111–17; of Brest, Rochefort-sur-Mer, and Toulon, 11–20; definition and theories of, 1–10; and disease, 97–99; of Madagascar, 203–4; of Marseille, 155–60; and medical

parasitology, 209–10; of Paris, 189–92; in relation to physiological science, 179–81; in relation to race, 90, 113–14; role of regulations in creation of, 21–25; as source of naval alterity, 33–46; and technologies to study, 47–75 plague, 14, 23, 25, 31, 57, 73, 95, 97–98, 111, 116, 155, 157, 163, 182, 213 pneumonia, 37, 42, 45, 78, 122, 152, 186 Poissonnier, Pierre, 31–32 Poissonnier-Desperières, Antoine-Marie, 29–32 ports. See individual cities and towns Portuguese Empire, 2 Pouchet, Félix, 193 Pouchet, Georges, 193–94, 196 prisons. See bagnes professoriate, 32, 86, 137, 195; reform of, 118–28, 131–36 Prou-Gaillard, 163–64 Provençal (race), 75, 77, 87–90, 121–22, 127, 130, 183 Provence (region), 8, 16, 45, 121, 128, 140, 172, 176, 180; as consumer of foreigners, 130–31; and legends of, 170; and naval recruitment, 87–89 quarantine, 48, 60, 95–98, 161 Quatrefages, Armand de, 80 Queirel, Auguste, 185 quinine, 45, 116, 168, 217; contrasted with kola, 176–77; and Doundaké as substitute for, 174; and yellow fever, 99–100 Quinton, René, 220 Quoy, Jean René Constant, 42, 66, 81, 118; career and reforms, 121–27; collection of vital statistics, 54–56; dry colic, 71 Raboisson, Marie Rosalie (Mrs. Édouard Heckel), 165 race. See racial ideas racial ideas, 2, 10, 50, 54, 74, 75, 77–109, 113–14, 143, 183, 195–96, 215, 219; American, 6–7; in bagnes, 11, 40–46; of external races (non-French races), 2–3, 9, 49, 63, 78, 81–83, 91–94, 101–103, 116, 130, 137, 152, 172, 197, 200, 203–4; of internal races (French races), 2–3, 7, 9, 10, 63, 77, 84–94, 98, 104, 121, 127,130, 144, 176, 209; and naval recruitment, 84–91; on ship, 54, 56, 63,

310 / Index racial ideas (continued) 71, 81, 99–100. See also Creoles; ethnic selectivity; immunity racial intermixture. See Creoles Ranavalo III, 171–72 Raoul, Étienne-Louis-Fiacre, 68 rations. See diet recruitment, 26, 33–34, 45, 51, 84–87, 89–91, 118, 127, 133–35, 148, 223–24 Redi, Francesco, 212 Reed, Walter, 94, 182 reform of naval medical education. See system of naval regulations Regord, François, 25 Renneville, Marc, 105 Revolution (French), 11, 14, 16, 25, 32, 35, 160; and naval reforms, 21–22, 25, 32, 35, 160 Reynaud, Auguste, 121, 124–25 Reynaud, Gustave, 168–69 Reynaud, Jean-Joseph, 121 Ribell, Jules, 136 Richard, Gaston, 105 Richaud, André, 81–82 Richelieu, Armand Jean du Plessis, 8, 16–17 Robin, Charles, 192–93 Rochard, Eugène, 85, 135 Rochard, Jules, 58, 63, 129; and dry colic, 65–66; and reform, 131–35 Rochefort-sur-Mer, 1, 4, 7, 23–32, 34–39, 45, 53, 55–57, 59–61, 63, 66, 68, 71, 85–89, 94, 109, 114, 117, 121–30, 133– 34, 136, 146, 148, 150–52, 155, 183, 207, 217, 222; access to civil hospital patients by navy, 126; arsenal, 17, 19, 27–28, 38–39; bagne, 35, 37, 39; early organization, 11–20; École d’anatomie et de chirurgie, 29–30; Hôpital Charente, 29; hospitals in, 23–24, 28, 152; malaria, 99–100; phrenology, 104; Tonnay-Charente hospital, 26–27 Roger, 186 Rosenberg, Charles, 7 Ross, Ronald, 145, 156, 206–7, 210 Rousseau (prisoner), 40–42 Roux, Émile, 143, 165, 210–11 Roux, Jules, 129 Roux, Pierre-Honoré de, 156 Saint-Nazaire, yellow fever in, 96, 98, 183 Salomon (sleeping sickness patient), 208 Sambon, Louis, 208

Santongois (race), 87–89, 91 Sarraut, Albert, 79 Schenk, Samuel Leopold, 194 Schlagdenhauffen, Charles-Frédéric, 166; and kola dispute, 173–81 Schnurrer, Friedrich, 50–51 scurvy, 25, 29, 33, 35, 49, 70, 85, 94, 143; and dry colic, 58, 74 Seaman, Valentine, 97 Second, Alexandre, 68 Sée, Germain, 75, 162; and kola dispute, 175–81 Segalen, Victor, 108–9, 128, 150, 217–21, 225 Ségur-Dupeyron, P. de, 97 Sète, 14, 17 Seven Years’ War, 11, 28, 31, 111 Shapin, Steven, 176 shipbuilding. See arsenals ships. See individual names signature disease (concept), 49, 70, 94–99. See also scurvy; yellow fever Simond, Paul-Louis, 181–83 sleeping sickness, 5, 94, 99, 102, 116, 188, 207–8, 211; ethnographic methods to estimate prevalence of, 214 smallpox, 2, 112, 144, 157, 165 Snow, John, 2 Société anthropologique de Paris, 79–80, 82 Société d’anthropologie et d’ethnographie de Bordeaux et du Sud-Ouest, 114 Société de chirurgie (Paris), 130 Société de géographie et d’études colonials (Marseille), 167, 169 Société de géographie de Paris, 51, 137, 202 Société de géographie commerciale de Bordeaux, 113–15 Société de médecine de Bordeaux, 113–14 Société de médecine publique et d’hygiène professionnelle (Paris), 58 Société des amis de l’université (Bordeaux), 114 Société ethnologique de Paris, 80, 105 Société française d’histoire de la médecine, 213 Société médicale d’observation (Paris), 130 Société médico-chirurgicale des hôpitaux (Bordeaux), 114 Société royale de médecine de Marseille, 61 Société zoologique de France, 193 Soleil Royal (ship), 25

Index / 311 South Africa. See Africa Southeast Asia, 6, 12, 38, 81, 87. See also French Empire Spanish Empire, 2 Sphinix (ship), 67 Spurzheim, Johann-Caspar, 105 Staum, Martin S., 78 Stovall, Tyler S., 10, 226 Strasbourg, 18, 85, 166, 194; École impériale du service de santé militaire, 86, 132, 148; Faculty of Medicine, 113, 120, 160, 174 Sudhoff, Karl, 213 surgeons, 7, 17, 37, 40, 61–63, 65, 95, 100, 128–29, 135, 139, 151, 161, 197; advancement of, 86, 119, 121–22; duties and status of, 20–30, 53–58; linguistic skills of, 13, 226; origins of, 13, 33; and racial ideas, 92; and reform plan, 32 surgery (instruction in), 8, 11, 13, 23, 29–31, 35–36, 42, 45, 59–60, 85, 87, 116, 123, 133, 146–47, 149, 160; aseptic, 135; in Bordeaux, 112–14; in Marseille, 184–85; in Montpellier, 72; in obstetrics at Rochefort-sur-Mer, 125–26 surgical and medical kits (chests), 17, 53, 112 Sydenham, Thomas, 59, 62, 122. See also constitution system of naval regulations, 10–12, 20, 25–26, 46, 103, 132–33, 150–51, 187, 197, 220, 223; compared with army, 86; déclaration (defined), 8; decree of January 7, 1890, 136; decree of July 22, 1890, 36; decree of June 24, 1886, 127, 217–18; defined (as factor in place), 5–8; édict (defined), 8; ordinance (defined), 8; Ordinance (1673), 26; Ordinance (April 15, 1689, fundamental ordinance), 8, 31, 34, 45, 47, 117, 189; Ordinance (1689) and naval health matters, 26–27; Ordinance (1689) and place of naval medicine, 20–25; Ordinance (1689) and record keeping, 53; Ordinance (1748) and bagnes, 35; Ordinance (1765), 22; Ordinance (1776), 21; Ordinance (1815), 22; Ordinance (January 3, 1835), 126; Ordinance (July 17, 1835), 126; Ordinance (1836), 125; Ordinance (1866), 126; reform of

1768, 32; reforms (inclusive of Ordinances and decrees of 1835, 1836, 1866, 1875), 117–26; and yellow fever, 96 Talabot (family), 156 Talairach, Paul-F.-J.-B., 151 Tarde, Gabriel, 103–4 Tardieu (pharmacist), 179–80 taxonomy, 78, 194, 196, 200, 206–8, 213–14 temperament, 6, 77, 84, 90–91, 102, 109 Theobald, Frederick Vincent, 207 Théodoridès, Jean, 208 Thorant, 178 Thucydides, 213 Toulon, 1, 4, 7, 23–31, 34–36, 55–57, 61–62, 67, 85, 87, 96–97, 108–9, 117, 121–22, 124, 127–28, 130–33, 135, 138–40, 145–48, 151, 153, 155, 157, 161, 164–66, 170, 182–84, 187, 195, 207, 215, 219, 221–22; arsenal, 15–16, 31, 36, 38–39, 191; bagne, 23–24, 31, 35–36, 38, 100, 105, 121, 130, 191; bagne prisoners, 38–40; early organization, 11–20; École d’anatomie et de chirurgie, 30–31; École d’application (postgraduate naval medical school and associated schools), 45, 62, 108, 145–48, 215, 221; hospitals in, 15, 26, 31, 130, 215; Hôtel-Dieu hospital, 128; medical studies of bagne, 40–46; SaintMandrier (naval hospital), 23, 31, 38, 130–31, 146 Touraine (ship), 108 Tourneux, Frédéric, 193 Treille, Georges, 74, 137–41, 145, 152–53, 172, 182–83, 187, 218 Trousseau, Armand, 175 tuberculosis, 37, 45, 52, 67, 71, 74, 157; as index of civilization, 62–64 typhoid fever, 60, 67, 95, 109, 112, 130; in Marseille, 157–58 typhus, 25, 29, 35, 40, 42–43, 60, 62, 64, 73, 86, 95, 97, 207; vaccine for, 158 Union coloniale, 166–67, 170, 210 Uranie (ship), 54 Val-de-Grâce. See under Paris: Val-de-Grâce Valois, Georges, 159–60 Vasseur, Gaston, 166 Vauban, Sébastian Le Prestre de, 15–18

312 / Index venereal disease, 25, 33, 36, 49, 62, 74, 220 Villermé, Louis René, 37–40, 43 Villers, Gustave Adolphe, 40–42 Virchow, Rudolf, 79, 162, 194 vitalism, 75, 84, 95, 98, 176; Christian, 71–72, 160–64; in relation to racial ideas, 77–78 Voyageur (ship), 66–67 Waksman, Selman, 63 Warner, John Harley, 6 Weber, Eugen, 5, 85 Weisz, George, 7, 148, 223 West Africa, 9, 11–12, 14, 54, 57, 65–68, 78, 82–83, 91–92, 94, 99, 114, 128–30,

157, 166, 175, 183, 207, 212. See also French Empire Würtz, Robert Thédore, 211 yellow fever, 3, 7, 12, 48, 52, 57, 60, 73, 101, 107–8, 116, 123, 127, 130, 137, 143–44, 152, 157, 161–63, 165, 170, 182–83, 203, 207–8, 217; conflation with malaria, 99–100, 124; ethnic selectivity of, 9, 77, 78, 91–94, 100, 102, 106, 176, 183; as signature disease of colonialism, 49, 94–99 Yersin, Alexandre, 143 Zola, Émile, 175, 181 zoological nomenclature, 193–94, 207