ABSTRACT
Shortly after the middle of the seventeenth century, the status of the Paris surgeon appeared to have reached such a low level that one hundred years later Antoine Louis, the secretary of the Paris Académie de chirurgie, would reflect woefully that ‘the beautiful century of Louis XIV was an iron age for our art’.1 Yet at the time of Louis’s writing, surgeons were enjoying what Toby Gelfand has described as ‘undeni able success in terms of their own objectives and public recognition’.2 How could such a spectacular change have taken place in the accepted medical hierarchy of the ancien régime, and why? Gelfand’s work on the turbulent shifts of power within and between the various members of this structure has already been of great value in providing a picture of those on the lower rungs of the surgical ladder. It will also serve now as a platform from which to view the rise of French surgery in the late seventeenth and early eighteenth centuries, helping, in the process, to show how that rise was achieved and how it would affect the standing of the academic surgeon. With his help, and by looking at the teachings and writings of some contemporary surgeons and the actions of others, we shall be able to travel one step further towards an understanding of the part played by technique and theoretical knowledge in this rise - and, as a result, we shall see that surgeons no longer saw their activity purely as an ‘opération manuelle’ as had been the case in Paré’s time.3 Knowing how to cure would no longer be enough - the surgeon would now need to know why to cure in that particular way. By the first decade of the eighteenth century, the practice of surgery would demand the possession of a full and detailed body of theoretical knowledge founded on principles and precepts, essential for the successful inven tion and performance of operations: a science for the surgeon.4 It should be noted that the word science will be italicized to indicate the use of the French term, and not as an indication of emphasis. But what cir cumstances would encourage such a demand for theoretical knowledge, and how would it be created?
