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An internal version is performed after spontaneous rupture of the membranes and all this, of course, in the patient's home and without anaesthesia. Tetanus was common after both civilian and army injuries because of the presence of the spores of this disease in the faeces of the ubiquitous horse. But by the s antiseptic and aseptic techniques had been adopted and in Les Femmes Eunuques the surgeon performs an ovariectomy clad in a bibbed apron and scrubs his hands in antiseptic; rubber gloves having not yet been invented.

He boasts that every item of his equipment has been flamed and boiled in phenol for two hours. There the unfortunate victims are tidied up by ribald medical students.

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Needless to say the sepsis and death rates are appalling. Daudet later assured readers that this and other atrocities depicted in this book were not exaggerated. The passage of time and advances in medical knowledge are responsible for rendering old theories redundant and many nineteenth-century syndromes have all but disappeared from the corpus of common experience. It is thus that the medical content of the novels studied requires historical and literary research for its elucidation and has indeed revealed a remarkable pageant of descriptions of diseases which differ fundamentally from the diseases which are prevalent today.

The high infant and maternal mortality, the ubiquity of tuberculosis and syphilis and the prevalence of typhoid fever, lousiness and typhus were, at the beginning of the nineteenth century, part of the normal fabric of life, barely requiring comment and usually not recorded in official statistics. Similarly the alleged risks entailed by getting wet in the rain, the physical and moral dangers of bathing and the therapeutic efficacy of venesection were generally accepted as real. Now however, more than a hundred years later, when medical research has revealed the precise cause of many diseases, these beliefs seem ludicrous.

Several literary scholars have published studies of the the medical content of, usually, one author's work. Others have attempted diagnosis of mysterious syndromes exhibited by some of the characters, for instance the blind beggar in Madame Bovary , 47 who was in fact a concocted character synthesised by discussion between the author and a medical friend. One must accept that not all the invalids depicted in these works are drawn from life and may not suffer from specific illnesses but merely represent, as in the case of the beggar, an incarnation of sickness or evil.

The present work presents the medical content of some nineteenth-century French novels from a different angle, that of the interested physician, desirous of learning from this material something of the diseases of the period described, not academically in a medical text, but usually by direct observation. Contemporary English novels do not seem to contain the same wealth of medical material. One remembers the description of typhoid in Charlotte Bronte's Jane Eyre 48 and several heroines fading gracefully away, presumably as a result of the ravages of tuberculosis.

No purple medical prose here, just tear-jerking pathos. One can only speculate on the reason for this difference on the two sides of the Channel.

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Perhaps Victorian prudery precluded anything more direct in Britain or maybe the French public was more interested in medicine and its progress because many of the innovations were made in their own country. Many of the nineteenth-century novels were published as eagerly awaited weekly instalments in newspapers. Thus the authors used the medical material to provide focal points in the action or to introduce an element of drama or even a frisson of macabre or sexual interest into realist or naturalist novels.

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This perhaps goes some way to explain the rather odd absence of some common diseases such as cancer and the childhood fevers which had less dramatic or sexual appeal. In addition, descriptions of familiar diseases helped to imbue the works with verisimilitude. Little insights illuminate aspects of life and medicine which do not reach standard texts of the history of medicine.

The commonness of chilblains testifies to the inadequacy of clothing and heating. Very few of the novels are written in the first person and this work is specifically a study of novels rather than diaries or autobiographies. These works therefore rarely provide first-hand accounts of the effects of sickness on the individual. Nevertheless, it is obvious that most of the descriptions of disease are founded on either the personal observations of the author or on accounts given him by books or third parties.

Since, in many instances these episodes of sickness, births and deaths are important and integral parts of the novels the behaviour of the characters is profoundly affected by them, illustrating an aspect of disease not usually addressed in treatises on medical history. The tardy adoption of new techniques such as use of the stethoscope is perhaps not surprising when we remember the difficulty in learning to recognise the sounds heard through it in medical school. It must be even more daunting when self taught in middle life.

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To some extent one can follow the advances in medical knowledge through the century. The lingering belief in humours and the medical conferences around the rich patient's bed highlight the paucity of clear cut diagnoses available in the earlier part of the century. Later on one is regaled with descriptions of surgery often, in these books, performed for dubious reasons such as ovariectomy for contraception in young women.

Other literature campaigned against various ills of the period such as alcoholism and syphilis. Life was often short, painful and brutish. Finally we are reminded of the enormous advances in medicine which have occurred in the last hundred years and the horrors of treating, for instance, compound fractures or abdominal infections without antibiotics.

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Curiously, many aspects of modern medicine seem simpler than those of the nineteenth century. With scientifically proven aetiologies and diagnosis of disease now usually readily confirmed in the living patient by imaging or bacteriological or blood test, prolonged diagnostic discussion and excessive precautions against such postulated precipitating factors as emotion and the weather have become less relevant. One usually consults a single specialist in the expectation that similar advice would be proffered by any other doctor similarly qualified.

But perhaps the overwhelming emotion aroused by reading these novels is thankfulness that we live in an age of antibiotics and plastic surgery so that the grossly disfiguring conditions described in the nineteenth century now rarely occur. But we must beware of complacency and smugness. What will people of the twenty-second century think of our fumbling attempts to prevent and cure cancer and of our poor understanding of such conditions as the chronic fatigue syndrome and the effects of stress? The thesis from which the material for this paper is taken was written under the guidance of Professor David Walker of the Department of French, Sheffield University.

I am very grateful to him for his kindness, advice and patience. Email: Margaret. Dates in the text after the titles of novels are those of first publication. Dates in the references are those of publication of the edition cited. You will be able to get a quick price and instant permission to reuse the content in many different ways. Skip to main content. We use cookies to improve our service and to tailor our content and advertising to you.

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Log in via Institution. Email alerts. Article Text. Article menu. Some medical syndromes encountered in nineteenth-century French literature. Abstract The medical content of a hundred selected French novels written between and has been examined. Statistics from Altmetric. Disease nineteenth-century French novel Introduction In the nineteenth century, France was the acknowledged leader in medicine and simultaneously there was an extraordinary flowering of French novels written by such realist and naturalist authors as Balzac, the Goncourts, Zola and Flaubert.

Observations The novels of the first half of the century reveal few illnesses recognisable today and the behaviour of the doctors shows that many maladies were ill defined diagnostically. Discussion and conclusions The passage of time and advances in medical knowledge are responsible for rendering old theories redundant and many nineteenth-century syndromes have all but disappeared from the corpus of common experience.

In addition, descriptions of familiar diseases helped to imbue the works with verisimilitude Little insights illuminate aspects of life and medicine which do not reach standard texts of the history of medicine.

Acknowledgments The thesis from which the material for this paper is taken was written under the guidance of Professor David Walker of the Department of French, Sheffield University.