The charitable imperative: hospitals and nursing in ancien régime and Revolutionary France

sometimes meagre, this is because the descriptions were probably sent to the consultant and were not written by him. Consultants compensated for this by attempting to explain every phenomenon connected with the illness and, when unable to give complete descriptions of diseases, by relying on doctrine and experience. It is the tempering of established doctrine with contemporary developments and personal observation that is perhaps the most interesting aspect of the consultations. For example, iatrophysical and iatrochemical ideas were used to revise Greek concepts of humoral harmony. Likewise, with regard to Albertini, weakness in contemporary physical and supplementary chemical diagnosis was partially made up for by experience gained at autopsy. Also striking is the occasional expression of doubt regarding the efficacy of prescribed remedies and, in one case, the recommended use of a placebo, or "some apparent remedy that is at least harmless it not useful, since God, the weather, and the very nature of things changes matters, as sometimes happens, to our consternation" (p. 26). This ably translated collection is thus a useful and intriguing work of reference, and Jarcho's introduction, notes, and index are detailed and informative. In recent years, studies of medicine in ancien regime France have presented us with the image of a radical transformation of the role of the hospital. From the late eighteenth century, under the pressure of new ideas about the practice and teaching of medicine and the ambitions of the rising medical profession, the hospital allegedly shifted from a shelter aimed at the relief of various categories of the needy to a medical institution primarily devoted to the treatment of the sick and to the education and training of medical students. A challenge to this unproblematic picture of "medicalization" is the core of Colin Jones's book. Arguing that historians have restricted their analysis to changes at the level of medical ideas and aspirations of medical men, and have assumed that practices in the hospital changed accordingly, Jones focuses on what was actually going on in the hospital. He also points out the exceptionality of the well-worn case of the Parisian H6tel-Dieu, turning instead to the under-explored provincial hospitals. He revises the medicalization argument through a critical reconsideration of the usual variables employed to assess the level of medical identity of the hospital. Jones shows that, despite the establishment of separate institutions for the relief of the poor (the H6pitaux Generaux) in the seventeenth …