1 In this chapter I quote freely from documents gathered in Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. A. M. Sheridan Smith (New York: Pantheon, 1973).

   2 Walter Artelt, Einfühnmg in die Medizinhistorik: Ihr Wesen, ihre Arbeitsweise and ihre Hilfsmittel (Stuttgart: Enke, 1949). An excellent introduction to the methodology of medical history and its tools.

   3 Heinrich Schipperges, "Die arabische Medizin als Praxis und als Theorie," Sudkoffs Archiv 43 (1959): 317-28, provides a historiographic perspective.

   4 On the evolution of the hospital as an architectonical element in urbanization, consult a dated monument: Henry Burdett, Hospitals and Asylums of the World: Their Origin, History, Construction, Administration . . . and Legislation, 4 vols. (London: Churchill, 1893). Also Dieter Jetter, Geschichte des Hospitals, vol. 1, Westdeutschland von den Anfängen bis 1850 (Wiesbaden: Steiner, 1966); several volumes planned.

   5 Fernando da Silva Coreia, Origmes e formaqaõ das misericórdias portuguesas (Lisbon: Torres, 1944). The first two hundred pages deal with the hospital in antiquity and during the Middle Ages in the Orient and in Europe. Jean Imbert, Histoire des hôpitaux français; contribution à l'étude des rapports de I'église et de I'état dans le domaine de l'assistance publique: les hôpitaux en droit canonique, Collection L'Église et I'état au moyen âge, no. 8 (Paris: Vrin, 1947). Well-documented guide to the sources of the medieval hospital and the transition of public assistance from ecclesiastic to civilian control. F. N. L. Poynter, ed., The Evolution of Hospitals in Britain (London: Pitman, 1964); see the classified bibliography of British hospital history, pp. 255-79. For the hospital in the New World consult Josefina Muriel de la Torre, Hospitales de la Nueva España (vol. 1), Fundaciones de las siglos XVII y XVIII (vol. 2), publications of the Institute de Historia, Universidad Nacional, ser. 1, nos. 35, 62 (Mexico, 1956-60).

   6 On the history of the hospital bed, consult F. Boinet, Le Lit d'hõpital en France: Étude historique (Paris: Foulton, 1945); James N. Blyth, Notes on Beds and Bedding: Historical and Annotated (London: Simpkin Marstall, 1873). More general, but also more pleasant reading: Laurence Wright, Warm and Snug: The History of the Bed (London: Routledge, 1962). On good behavior when in bed, see work by Norbert Elias cited in note 28, p. 166 below.

   7 Marcel Fosseyeux, L'Hõtel Dieu aux XVIIe et XVIIIe siècles (Paris: Levrault, 1912).

   8 For the origins and the evolution of the idea: David Rothman, The Discovery of the Asylum (Boston: Little, Brown, 1971). Milton Kotler, Neighborhood Government: The Local Foundations of Political Life (Indianapolis: Bobbs-Merrill, 1969), makes a clear case for Boston. See also Foucault, Birth of the Clinic.

   9 It was enjoined on Christian princes not to use life imprisonment as a punishment because it was much too cruel. Prisons might be used to keep criminals until their hearing, their execution, or their judicial mutilation. Andreas Perneder, Van Straff und Pern alter undjeder Malefitz handlungm ain kurtzer Bericht, ed. W. Hunger (Ingolstadt, 1544).

   10 For documentation on the carefully qualified and rich thought of Rousseau on medicine, see Gerhard Rudolf, "Jean-Jacques Rousseau (1712-1778) und die Medizin," Sudhoffs Archiv 53 (1969): 30-67. Rousseau was probably misunderstood even more on medicine than on education.

   11 On the dream of "wild" health consult Edward Dudley and Maximillian E. Novak, eds., The Wild Man Within: An Image in Western Thought from the Renaissance to Romanticism (Pittsburgh: Pittsburgh Univ. Press, 1972).

   12 Jacques-René Tenon, Mémoires sur les hôpitaux (Paris, 1788), p. 451; cited in Foucault, Birth of the Clinic, p. 17.

   13 Brian Abel-Smith, The Hospitals, 1800-1948: A Study in Social Administration in England and Wales (London: Heinemann, 1964). Carefully documented on economic and professional changes. Leonard K. Eaton, New England Hospitals, 1790-1833 (Ann Arbor: Univ. of Michigan Press, 1957). See especially the bibliographical essay, pp. 239-46.

   14 François Millepierres, La Vie quotidienne des médecins an temps de Molière (Paris: Hachette, 1964). Popular but reliable; a composite picture of the day-by-day life of the physician at the time of Moliere.

   15 Jean-Pierre Peter, "Malades et maladies a la fin du XVIIIe siecle," in Jean-Paul Dessaive et al., Médecins, climat et épidémies à la fin du XVIIIe siècle (Paris: Mouton, 1972), pp. 135-70: "During the French Revolution the hospital, like the laboratory, both discovered around 1770, would play the midwife's role in the birth of these pre-existing ideas."

   16 Helmut Vogt, Das Bild des Krankm: Die Darstellung äusserer Veränderungen durch innere Leiden and ihre Heitmassnahmen van der Renaissance bis zu unserer Zeit (Munich: Lehmann, 1960). More than 500 reproductions of artistic representations of sick people since the Renaissance; allows a study of perception. For a medical study of ergotism in the past based on its representation in paintings, see Veil Harold Bauer, Das Antonius Feuer in Kunst und Medizin (Heidelberg: Springer, 1973); bibliog., pp. 118-25; afterword by Wolfgang Jacob, pp. 127-9. Painting and plastic arts provide an invaluable complement to the history of patient-doctor relations: Eugen Hollander, Die Medizin in der klassischen Malerei, 4th ed. (Stuttgart: Enke, 1950). Eugen Holländer, Plastik und Medizin (Stuttgart: Enke, 1912).

   17 W. Muri, "Der Massgedanke bei griechischen Ärzten," Gymnasium 57 (1950): 183-201. H. Laue, Mass und Mitte: Eine problemgeschichtliche Untersuchung zur fruehen griechischen Philosophic und Ethik (Münster: Osnabrueck, 1960). Measure in antiquity was related to virtue and proportion, not to operational verification. On the prehistoric Indo-Germanic semantic field which includes both measure and medicine see Emile, Benveniste, "Médecine et la notion de mesure," in Le Vocabulaire des institutions indo-européennes, vol. 2, Pouvoir, droit, religion, 1969, pp. 123-32. The English version is Indo-European Language and Society (Miami: University of Miami Press, 1973).

   18 For the history of measurements consult two symposia: Harry Woolf, ed., Quantification: A History of the Meaning of Measurement in the Natural and Social Sciences (Indianapolis: Bobbs-Merrill, 1961), and Daniel Lerner, Quantity and Quality: The Hoyden Colloquium on Scientific Method and Concept (New York: Free Press, 1961). Particularly consult, in Woolf, the paper by Richard Shryock, "The History of Quantification in Medical Science," pp. 85-107. For the application of measurement to nonmedical aspects of man, see S. S. Stevens, "Measurement and Man," Science 127 (1958): 383-9, and S. S. Stevens, Handbook of Experimental Psychology (New York: Wiley, 1951).

   19 Richard H. Shryock and Otho T. Beall, Cotton Mother: The First Significant Figure in American Medicine (Baltimore: Johns Hopkins Univ. Press, 1954).

   20 When disease became an entity that could be separated from man and dealt with by the doctor, other aspects of man suddenly became detachable, usable, salable. The sale of the shadow is a typically 19th-century literary motif (A. V. Chamisso, Peter Schlemihls wtmdersame Geschichte, 1814). A demoniacal doctor can deprive man of his mirror-image (E. T. A. Hoffman, "Die Geschichte vom verlorenen Spiegelbild," in Die Abenteuer einer Sylvesnacht, 1815). In W. Hauff, "Des steinerne Hertz," in Das Wirtshaus im Spessat (1828), the hero exchanges his heart for one of stone to save himself from bankruptcy. Within the next two generations, literary treatment was given to the sale of appetite, name, youth, and memories.

   21 For this evolution in France, see Maurice Rochaix, Essai sur l'évolution del questions hospitalières de la fin de I'Ancien Régime à nos jours (Saintes: Federation hospitaliere de France, 1959), the only well-documented history of public assistance to the sick in France. See Jean Imbert, Les Hôpitaux en France, "Que sais-je?" (Paris: Presses Universitaires de France, 1958), on the adaptation of the French hospital to changing medical techniques during the 19th century. Of course, consult also Foucault, Birth of the Clinic.

   22 On the history of the concept of disease, see P. Diepgen, G. B. Gruber, and H. Schadewaldt, "Der Krankheitsbegriff, seine Geschichte und Problematik," in Prolegomena einer allgemeinen Pathologic (Berlin: Springer, 1969), 1:1-50. Emanuel Berghoff, Entwicklungsgeschichte des Krankheitsbegriffes: In seinen Haupzügen dargestellt, 2nd ed., Wiener Beiträge zur Geschichte der Medizin, vol. 1 (Vienna: Maudrich, 1947). Pedro Lain Entralgo, El médico y el enfermo (Madrid: Ediciones Guadarrama, 1970).

   23 Mirko D. Grmek, "La Conception de la maladie et de la santé chez Claude Bernard," in Alexandre Koyré, Mélanges Alexandre Koyré: L'Aventure de la science (Paris: Hermann, 1964), 1:208-27.

   24 Georges Canguilhem, Le Normal et le pathologique (Paris: Presses Universi-taires de France, 1972), is a thesis on the history of the idea of normalcy in 19th-century pathology, finished in 1943 with a postscript in 1966. On the history of "normality" in psychiatry see Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason (New York: Pantheon, 1965).

   25 For the history of medical ideas during the 19th century, see Pedro Lain Entralgo, La medicina hipocrática (Madrid: Revista de Occidente, 1970). Werner Leibrand, Heilkunde: Eine Problemsgeschichte der Medizin (Freiburg: Alber, 1953). Fritz Hartmann, Der ärztliche Auftrag: Die Entwicklung der Idee des abendländischen Arzttums aus ihren weltanschaulich-anthropologischen Voraussetzungen bis zum Beginn der Neuzeit (Göttingen: Musterschmidt, 1956). M. Merleau-Ponty, "L'Oeil de 1'esprit," Les Temps Modemes, nos. 184-5 (1961), pp. 193 ff. M. Merleau-Ponty, Phénoménologie de la perception (Paris: Gallimard, 1945). Werner Leibrand, Spekulative Medizin der Romantik (Hamburg: Claassen, 1956). Hans Freyer, "Der Arzt und die Gesellschaft," in Der Arzt und der Stoat (Leipzig: Thieme 1929). René Fiilop-Miller, Kulturgeschichte der Heilkunde (Munich: Bruckmann, 1937). K. E. Hrag Rothschuh, Was ist Krankheit? Erscheinung, Erklärung, Sinngebung, Wege der Forschung, vol. 362 (Darmstadt: Wissenschaftliche Buchgesellschaft, 1976): 18 historically important critical contributions of the 19th and 20th centuries to the epistemology of sickness, among them C. W. Hufeland, R. Virchow, R. Koch, and F. Alexander. Richard Toellner will publish a parallel volume, Erfahrung und Denken in der Medizin.

   26 On this development, especially as it centered around the influence of Virchow, see Wolfgang Jacob, "Medizinische Anthropologie im 19. Jh.: Mensch, Natur, Gesellschaft: Beitrag zu einer theoretischen Pathologic," in Beiträge aus der allgemeinen Medizin, no. 20 (Stuttgart: Enke, 1967).

   27Janine Ferry-Pierret and Serge Karsenty, Pratiques médicales et système hospitaller (Paris: CEREBE, 1974), an economic analysis of the rising marginal disutilities to health care which have resulted from a take-over by the hospital in medical care (the takeover was possible because of a hospital-centered perception of disease). For a dozen sociological perspectives on the contemporary hospital, consult Eliot Freidson, ed., The Hospital in Modern Society (New York: Free Press, 1963). See also Johann J. Rhode, Soziologie des Krankmhauses: Zur Einführung in die Soziologie der Medizin . . . (Stuttgart: Enke, 1962), perhaps the most comprehensive sociology of the hospital.

   28 On the history of body perception in European cultures, see Norbert Elias, Über den Prozess der Zivilisation: Soziogenetische und psychogenetische Untersuchungm, vol. 1, Wandlungen des Verhaltens in den Weltlickten des Abendlandes; vol. 2, Wandlungen der Gesellschaft Entwurfzu einer Theme der Zivilisation (Bern/Munich: Francke, 1969). (French translation, Paris: Calmann-Levy, 1973).

   29 An example: D. L. Rosenhan, "On Being Sane in Insane Places," Science 179 (1973): 250-58. "Once eight pseudopatients had gained admission to mental institutions (by saying they heard voices), they found themselves indelibly labeled with a diagnosis of schizophrenia—in spite of their subsequent normal behavior. Ironically, it was only the other inmates who suspected that the pseudopatients were normal. The hospital personnel were not able to acknowledge normal behavior within the hospital milieu."

   30 Thomas S. Szasz, The Myth of Mental Illness (New York: Harper & Row, 1961). Thomas S. Szasz, Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement (New York: Harper & Row, 1970). Ronald Leifer, In the Name of Mental Health: Social Functions of Psychiatry (New York: Aronson, 1969). Erving Goffman, Asylums: Essays on the Social Situation of Mental Patients and Other Inmates (1961; paperback ed., New York: Doubleday, 1973). R. D. Laing and A. Esterson, Sanity, Madness, and the Family (Baltimore: Penguin, 1970).

   31 Gregoria Hermann, La Santé mentale en Chine, trans. A. Barbaste (Paris: Maspero, 1974). Original title: La salud mental en China (Buenos Aires: Ed. Jorge Alvarez, 1970).

   32 Peter Sedgwick, "Illness, Mental and Otherwise: All Illnesses Express a Social Judgement," Hastings Center Studies 1, no. 3 (1973): 19-40, points out that events constitute sickness and disease only after man labels them both as deviances and as conditions that are under social control. He promises to raise the epistomological question about sickness in general in a book soon to be published by Harper & Row.

   33 Albert Görres, "Sinn und Unsinn der Krankheit: Hiob und Freud," in Albert Görres, ed., Der Kranke, Ärgemis der Leistungsgesellschaft (Düsseldorf: Patmos, 1971), pp. 74-88.

   34 B. L. Whorf, Language, Thought and Reality (New York: Wiley, 1956), describes the language barrier that technical terminology creates between the professional ingroup and the clients defined as the outgroup. K. Engelhardt et al., Kranke im Krankenhaus (Stuttgart: Enke, 1973). While at the hospital, patients are intensively and progressively mystified. At the time of dismissal less than one-third have understood what disease they have been treated for, and less than one-fourth, what therapy they have been subjected to. M. B. Korsch and V. F. Negrete, "Doctor-Patient Communication," Scientific American 227 (August 1972): 66-9. In Los Angeles Childrens' Hospital, 20% of mothers do not understand what ails their children, 50% do not grasp the origins of their disease, and 42% do not follow the advice they receive, frequently because they cannot grasp it. Raoul Carson, in Les Vieilles Douleurs, rev. ed. (Paris: Julliard, 1960), confirms in a more intuitive fashion that the same is true for his French patients.

   35 For the language of disease in Mediterranean antiquity see Nadia van Brock, Recherches sur le vocabulaire médical du Grec ancien: Soins et guérison (Paris: Klincksieck, 1961). Hermann Grapow, Kranker, Krankheiten und Arzk Vomgesunden und kranken Ägypter, van den Krankheiten, vom Arzt and van der ärztlichen Tâtigkeit (Berlin: Akademie-Verlag, 1956), 7:168. Georges Contenau, La Médicine en Assyrie et en Babylonie (Paris: Librairie Maloine, 1938). For the language of the Bible on disease, see references of note 44, p. 147 above.

   36 Max Höfler, Deutsches Krankheitsnamen-Buch (Munich: Piloty & Lohle, 1899). A monumental collection of German popular expressions relating to organs, their functions, and disease in man and domestic animals, as well as those which designate remedies, natural or magical; 922 packed pages.

   37 Otto E. Moll, Sprichwörter—Bibliographie (Frankfurt am Main: Klostermann, 1958), lists 58 collections of proverbs in all languages dealing with "health, sickness, medicine, hygiene, stupidity, and laziness" (pp. 534-7). In contrast, for a history of medical language see Johannes Steudel, Die Sprache des Arztes: Ethjmologie und Geschichte medizinischer Termini (seen only in extracts).

   38 Dietlinde Goltz, "Krankheit und Sprache," Sudhoffs Archie 53, no. 3 (1969): 225-69.

   39 During the 19th century the new middle classes developed a sense of guilt or shame about disease, while the upper bourgeoisie and nobility turned their need for constant health care into an excuse for fashionable "cures," particularly at spas. The "season" at the great spas played a political function analogous to summit meetings today. See Walter Ruegg, "Der Kranke in der Sicht der bürgerlichen Gesellschaft an der Schwelle des 19. Jahrhunderts," and Johannes Steudel, "Therapeutische und soziologische Funktion der Mineralbäder im 19. Jahrhundert," both in Walter Artelt and Walter Ruegg, eds., Der Arzt und der Kranke in der Gesellschaft, des 19. Jahrhunderts: Vorträge eines Symposions vom 1.-3. April, 1963 in Frankfurt a.M., Studien zur Medizingeschichte des 19. Jahrhunderts, vol. 1 (Stuttgart: Enke, 1967). R. H. Shryock, "Medicine and Society in the 19th Century," Cahiers d'histoire mmdiale 5 (1959): 116-46. Luc Boltanski, "La Découverte de la maladie: La Diffusion du savoir médical," mimeographed, Centre de Sociologie Européenne (Paris, 1968). Based on much empirical data, this paper gathers evidence for the class-specific diffusion of medical civilization, and shows the economic origin of the poor man's "hardiness" in the face of suffering and contrasts it with the middle-class "struggle against pain."

   One way to explore reactions against the medicalization of disease perception is to study the history of humor whose butt is the doctor. Materials on caricatures can be found in U.S. National Library of Medicine, Caricatures from the Art Collection, comp. Sheila Durling (Washington, D.C., 1959); Helmut Vogt, Medizinische Karikaturen van 1800 bis zur Cegenaiart (Munich: Lehmann, 1960); Curt Proskauer and Fritz Witt, Pictorial History of Dentistry (Cologne: Dumont, 1970); A. Weber, Tableau de la caricature médicale depuis les origines jusqu' à nos jours (Paris: Éditions Hippocrate, 1936).