Public institutions, private networks, and medical careers in Bordeaux, c.1690-1790
Based on institutional histories of the three corporations governing medical practice in Bordeaux in the century before 1790, and a collective biography of the apothecaries, physicians, and surgeons who were members of those corps, this study develops several interlinked arguments. First, that existing analyses offered by historians do not fully describe the transformations in the eighteenth century medical world, as corporations balanced the need to uphold the principles of corporatism against the need for higher standards of training and practice. The surgeons, for example, sacrificed both local autonomy to professionalise and their internal cohesion to a hierarchy, while the physicians masked traditional tendencies with an outwardly meritocratic stance. Secondly, that profound alterations within France, such as an increasing dysfunction within the state apparatus, a breakdown of some social barriers, and the onset of the market, provided new opportunities for medical practice that were reflected in more varied career patterns. The emergence of a wider market for health, especially in the successful commercial centre of Bordeaux, produced among the apothecaries, for example, an increase in numbers of scientists and entrepreneurs within the group. Thirdly, using three distinct cohorts of apothecaries, physicians and surgeons, the study demonstrates the emerging pluralism of practitioners, and contrasts the more rapid acceptance of new practices by individuals with the slower adjustments of their corporations. It argues that these different attitudes to new practices led to tensions within the corps, and a divergence between the needs of practitioners and corporations. Finally, in tracing the networks of influence used by individuals to further their careers including those within the cultural, economic, and professional worlds, and noting the continuing tendency towards endogamy, it concludes that the family remained the most important factor in creating and maintaining a medical career.
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