The Royal College of Physicians and Surgeons of Canada, 1960–80: the pursuit of unity

such statements as "Disease does not exist. What does exist is not disease but practices". (Practices are contrasted with "the subjective intentions of the actors".) As the work progresses, however, it is clear that models derived from Foucault are, perhaps mercifully, a veneer on what is a traditional, complex but interesting and worthwhile analysis of medical thought in the France of the Juste-Milieu. The book is divided into seven main chapters, with only one, on 'Fear', being concerned with viewing the disease from the perspective of the victims of cholera. This is the weakest chapter in the book, failing to go beyond the parameter's laid down by Chevalier. The remaining chapters are concerned with the ways in which doctors, hygienists, urbanists, and "reactionaries"-none of these categories is clearly defined or distinguished from the others-used cholera to explain and justify their social and class-based ideas about contemporary French civilization. He demonstrates effectively how the epidemic tipped the balance from a concentration on traditional Hippocratic categories of disease causation-the "contagionist" view, which looked to climatic and topographical features of the environmenttowards a more modern, "bourgeois" emphasis on localized sources of disease-the "infectionist" position. In Delaporte's account these extreme positions have a monopoly and appear immovable; there is no mention of an intermediate position being developed in France in 1832, as happened in Britain, where a "contingent contagionist" philosophy, a via media between the extremes, was a major consequence of the medical profession's experiences. Delaporte is at his most interesting when considering opinions on both western and French civilizations which the epidemic brought forth. Even though the epidemic was so severe in Paris, both "reactionaries" and hygienists rationalized the disaster, either by claiming that savagism, in the shape of the poor, existed at the very centre of civilization, or that the disease would have been even more destructive if urban improvements had not already occurred. It is unfortunate that Delaporte, presumably as an act of piety to the memory of Foucault, is so dismissive of other historians' achievements, for his book, in conjunction with others, now makes it possible to accomplish a genuine comparative history of governmental, medical, and philosophical responses to the new disease in 1832. Delaporte's is a useful contribution to a body of literature which now needs to be extended to incorporate subsequent cholera epidemics in Europe. Michael Durey Murdoch University, Australia