The growth of wealth, the rise of the middle classes in number and purse, and the progress of medical science and education gave a higher status and income to physicians than they had usually known before. La Mettrie, himself a physician, rejoiced: “Everything gives way to the great art of the healer. The doctor is the one philosopher who deserves well of his country.… The mere sight of him restores our calm, … and breeds fresh hope.”42 Voltaire was critical of medicines—“regimen is superior to medicine”; and of most doctors—“out of every hundred physicians ninety-eight are charlatans”; but he added: “Men who are occupied in the restoration of health to other men, by the joint exercise of skill and humanity, are above all the great of the earth. They even partake of divinity, since to preserve and renew is almost as noble as to create.”43 Diderot praised the Faculty of Medicine in the University of Paris44 whose Faculty of Theology was the bane of his life. “There are no books I read more gladly,” he said, “than books about medicine, no men whose conversation is more interesting to me than that of doctors—but only when I am well.”45 He made Dr. de Bordeu the central character in Le Rêve d’Alembert. The profession was satirized as usual, as in the plays of Goldoni, the pictures of Chodowiecki, the Ferdinand Count Fathom of Smollett, and the delectable caricatures of Thomas Rowlandson.
Better fees and incomes raised physicians to better status. Most of them, in England, charged a guinea for a visit. Some of them earned six thousand pounds a year. Sir Hans Sloane, the first physician to be made a baronet, became president of the Royal Society, and Josef von Quarin was made a baron by Joseph II of Austria. Physicians were welcomed in the best clubs of London, in the best salons of Paris. They no longer wore the lugubrious soutane, or black robe; they dressed in the best fashion of the upper middle class. In England they displayed a coat of red satin or brocade, knee breeches, buckled shoes, goldheaded cane, and sometimes a sword; in France they dressed with the pomp of a high ecclesiastic.
Some physicians call for special remembrance. Simon André Tissot was famous in Lausanne as a leading advocate of inoculation and an authority on epilepsy; he labored not only to heal the sick but also to keep the well well; his Avis au peuple sur la santé,orAdvice to the People on Health (1760), ran through ten editions in six years, and was translated into every major language of Europe. Leopold Auenbrugger was chief in a circle of great doctors who gave honor to Vienna under Maria Theresa; he was loved for his modesty, honesty, and charity, “a noble example of the substantial worth and charm of old-fashioned German character at its very best.”46 Not quite so popular was Dr. Joseph Ignace Guillotin, who served as a deputy in the States-General of 1789, upheld capital punishment, and proposed the use of a beheading machine that would avoid the misstrokes of executioners. And Théodore Tronchin was the most famous physician in Switzerland.
He was a favorite pupil of Boerhaave at Leiden, practiced twenty years in Amsterdam, married the granddaughter of Jan de Witt, moved back to his native Geneva, and there introduced inoculation (1749) by beginning on himself and his children. In 1756 the Due d’Orléans invited him to Paris to inoculate his son the Due de Chartres and his daughter the current Mlle. de Montpensier. Paris marveled at such courage; but when the patients came through with no perceivable harm, the elite world flocked to Tronchin’s lodgings in the Palais-Royal, eager to be made immune to a disease that had long maintained a high rate of mortality in France.
His success gave weight to his views on other matters. He preceded Rousseau in urging mothers to nurse their children. He told his patients to take less medicine and more exercise in the open air, to eat simple foods, to bathe more frequently, to wash in cold water, discard their wigs, nightcaps, and bed curtains, and retire and rise at an early hour. He startled the court at Versailles by ordering the windows of the palace—which had always remained closed—to be opened at least part of every day, even in winter. His ideas became fashionable. Highborn ladies took walks in the early morning hours, clad, for ventilation’s sake, in short skirts that were soon named tronchines.47
When Voltaire settled in Geneva he put himself under Tronchin’s care. “He is a man six feet tall,” said Voltaire, “wise as Aesculapius, and as handsome as Apollo.”48 Tronchin did not reciprocate these compliments, but, as Voltaire said of himself and Haller, perhaps they were both mistaken. Mme. d’Épinay, who had come all the way from Paris to Geneva to take treatment from Tronchin, gave a very flattering picture of him:
I am going to spend two or three days at Voltaire’s house with M. Tronchin. Really, I discover every day new features in Tronchin which inspire me with boundless respect and regard for him. His charity, his distinterestedness, his affection and care for his wife, are unexampled. Now that I know her, I declare to you that she is the sulkiest and most unendurable woman in existence.49
But who can trust one woman on another?
It was not an especially great century in the history of medicine; the medical scene was still darkened with mysticism, quackery, and theories that should already have been shamed by experience. But the progress of anatomy and physiology had now placed medicine upon a sounder basis than before; medical education was more thorough and more widely available; unlicensed practice was fading away; specialties were increasing knowledge and improving care; surgery was liberated; miraculous cures were losing repute; and the triumphs of medicine were playing their quiet part in that basic conflict between faith and reason which was taking the forefront in the life of the mind.