Consultation by correspondence was a mainstay of the eighteenth-century doctor/patient relationship. Doctors around Europe diagnosed on the basis of written description only, relying heavily on the descriptive prowess of patients and their local doctors. This was, understandably, a fraught system. Doctors required certain information – in his Avis au peuple sur sa santé, Tissot lists a number of questions that the patient needed to address – but patients didn’t always provide what they wanted.
The consultation letters in the Fonds Tissot reveal patients grappling with the limitations of language, the inability of text to describe their bodily experiences. Some details conform to Tissot’s list and offer insight into the patient’s age, medical history, current condition, current treatments, etc. Other details, however, confound and we are left wondering why they were included. Thus, we read about the weather, the political situation, the moral behaviour of the patient, and the social responsibilities of the family. Why might these seemingly random details have been included?
It would be easy to ignore them and to focus directly on the issues of direct medical concern. But to do so would, I think, be a mistake. These details are part of the individual’s shaping of her (or him) self as a social being, and as such, they reveal an understanding of the body and of bodily experience that is inherently social.
The body is not just something that gets in the way, it is something that defines one’s place in the world. More than this, the body is not easily accessible. According to Tissot’s patients, the body cannot be easily condensed into a neat list of answers to predetermined questions. Rather, it is something that exists in a much bigger space and is shaped and organised by a far greater range of experiences than those suggested by Tissot’s list. Indeed, Tissot’s questions, which sound very similar to those asked by doctors today, just barely scratch the surface of bodily experience and it seems clear that Tissot’s patients had much more to share.
From horse riding in the rain to swimming in the Rhine on a hot summer’s day, sleeping in a humid room as a child and immoderate engagement with the ‘pleasures of the flesh’, these life writings are much more than ‘medical consultations’; they offer insight into the social, cultural and corporeal thought worlds of suffering individuals during this period.
Reading through them, I am reminded of the words of Virginia Woolf, as found in her 1930 volume, On Being Ill:
“…literature does its best to maintain that its concern is with the mind; that the body is a sheet of plain glass through which the soul looks straight and clear, and, save for one or two passions such as desire and greed, is null, and negligible and non-existent. On the contrary, the very opposite is true. All day, all night the body intervenes; blunts or sharpens, colours or discolours, turns to wax in the warmth of June, hardens to tallow in the murk of February. The creature within can only gaze through the pane – smudged or rosy; it cannot separate off from the body like the sheath of a knife or the pod of a pea for a single instant; it must go through the whole unending procession of changes, heat and cold, comfort and discomfort, hunger and satisfaction, health and illness, until there comes the inevitable catastrophe; the body smashes itself to smithereens, and the soul (it is said) escapes. But of all this daily drama of the body there is no record.” (Virginia Woolf, On Being Ill. 1930. Ashfield: Paris Press, 2002, pp. 4-5)
Woolf goes on to suggest that English has no adequate language for the body. The same, I would suggest, might be true of French. The consultation letters are not so much about medical conditions per se. Rather, the majority reveal the struggles to articulate bodily experience in written language; in other words, the struggle to make meaning out of the workings of thebody and from there, to share these ideas with others.