Introduction

Ours is not the first generation to be preoccupied with modernity, nor the first to search for clues as to when ‘our’ kind of medicine began. Conventional wisdom generally locates that origin in the Revolutionary Paris of the 1790s. Thus, R. H. Shryock's chapter on early-nineteenth-century French medicine is entitled ‘The emergence of modern medicine, 1800-1850’, and the ‘clinic’ described by Michel Foucault does not simply concern the activities of Bichat and Laennec, but also the ‘conditions of possibility of medical experience in modern times’. This French hospital medicine coincided with political and social upheaval and with ‘the end of the Enlightenment’, a fact which deepens the apparent chasm separating our medicine from that of the Enlightenment and before.

If our own medicine derives in some important sense from the hospitals of Revolutionary France, the medical forms, patterns, and practices of the Enlightenment can be viewed in two antithetical ways: as having created the possibility of modernity; or, by way of reaction, the ultimate victim of it. The latter has been the more common historical attitude. Thus Shryock, while applauding eighteenth-century advances in mathematics, physics, chemistry, and the social sciences, discovered a variety of social and intellectual reasons why medicine lagged behind.