VIII. Application des mêmes moyens de liberté aux arts qui agissent sur les hommes, et d'abord aux a

CHAP. 18: VIII. Application of the same means of liberty to the arts that act on men, and first to the arts that act on the body of man. On the liberty of the arts whose object is the conservation and perfection of physical man.

§ 1. After having treated successively, in the preceding chapters, of the arts that are exercised on things, on raw bodies, on plants, on animals, we are now going, following the progressive course of ideas, to occupy ourselves with those that bear their attention and their activity directly on men.

The former, surely, are foreign neither by their object, nor by their effects, to the education of the human species. They procure for it the means to live, to grow, to multiply, to become healthier, more beautiful, more intelligent, more moral. One has been able to see well enough what developments they permit it to take, what concourse of faculties they impose on it the obligation and furnish it the means to acquire.

But while carriage, manufacturing, and agriculture exercise indirectly on it such an immense influence, there is a multitude of other arts that make its education and its culture their proper and immediate object, that expressly propose to perfect its physical, intellectual, and affective nature, and it is of these that I must now entertain the reader.

These latter, to this day, had not found a place in the works of economists. They had not entered into the classifications they made of the diverse industries, and were not among those whose nature and functions they have expounded. That was, I dare say, a very great lacuna. One can affirm that we have no true idea of the economy of society, so long as one has not shown us how these arts figure in it; what order of products they create there and how the diverse elements of power of which the liberty of labor is formed are applied to their labors. They ought to be included in a good exposition of social economy, even if one assigned to this science, as has been done until now, no other object than to research according to what laws society becomes rich. Where, in effect, are the arts that pour into society products of a better nature and a greater sum of products than those that are directly occupied with the culture of the human species, and that are occupied with it suitably? These products, it is true, are not attached to any sort of thing; they are realized in persons: but what does it matter? Are they any less products for that? Do the products so improperly called material consist in the matter of which they are formed? Is there ever, in fact of products, anything other than produced utilities? and can there exist utilities more real, more susceptible to conservation, increase, exchange, and transmission, than those that the arts concerned with their education succeed in placing in men?

Once again, one would therefore have to treat of these arts even if one wished to speak only of those that contribute immediately to the production of wealth, to the production of exchangeable values; and with all the more reason must one occupy oneself with them when, taking the words social economy in a more just and more complete sense, one wishes to determine, not only in what manner the social body becomes rich, but according to what laws it succeeds in executing all its functions freely, by what means men succeed in using their forces with the most facility, extent, and plenitude.

Thus, what had been done only for the industries that act on things, for the agricultural art, manufactures, and commerce, I have to do for the medical art, gymnastics, teaching, the priesthood, government, and in general for all the professions that are exercised immediately on men. I have to seek what these professions consist of, what role they play in the social economy, in what manner each of them contributes to the movement of society, to what causes its power is linked, and how the general principles of liberty apply to it.

Considered in themselves and in their nature, the arts in question here have a certain analogy with the one that was discussed in the last chapter, and which is occupied with the culture of plants and animals. They make use, in effect, of the same occult power, and, like the agricultural art, they can operate their transformations only with the help of life. They have, it is true, a thousand means of acting chemically and mechanically on man, of affecting his external and internal organs; but there are no chemical or mechanical agents whose action can suffice for the results they propose to obtain. The sole effect of these agents is to stimulate the forces that man carries within himself, and it is only with the aid of these forces that they succeed in fashioning him. They need, to perfect his limbs and organs, the help of organic life; it is only by the intervention of his affective faculties that they succeed in modifying his inclinations, and they find only in his intellectual forces the means to form his intelligence. They thus use, to elevate men, agents analogous to those that the cultivator makes use of to train animals. Only, as in man, these agents, and especially those that constitute the intellectual and affective life, are of an infinitely stronger and more refined nature: one obtains from them infinitely more considerable results. Of all the arts that the human race exercises, those that it exercises on itself are perhaps the most fecund in great and good effects.§ 2. Even if one wished to consider the arts that act on men only in their relation to the industries that work on matter, one could not refuse to recognize in them a very high degree of importance. We know, in effect, that the first condition of liberty for these industries is that the men who wish to exercise them be fit for this exercise, that they have health, vigor, skill, intelligence, instruction, enlightenment, morals, good civil habits, and this is precisely what the elevated and numerous professions we must now consider work to procure for them.

As much as the industries that are exercised on inanimate nature are favorable to the culture of men, so too do those that are directly occupied with their culture contribute to the advancement of those whose object is the exploitation of the material world. Even if one wished to subordinate everything to the progress of the latter, one would still have to attach the greatest value to the perfection of the former.

But it is not only because they make us capable of acting on nature with more power that the industries occupied with the physical, intellectual, and moral education of man deserve to interest us: they deserve it for themselves and for the direct goods they allow us to enjoy.

It would be a pleasure to feel strong, fit, skillful, agile, even if the good state of our bodily faculties were not, in every profession, an essential element of success.

There would be honor and glory in possessing a cultivated mind, even if one did not wish to use one's knowledge for the enlightened exercise of any kind of industry.

There would be elevation, dignity, happiness in the practice of virtue, even if it were not indispensable for succeeding in any art whatsoever, for exercising it with honor and with fruit, to be in a state to repress one's bad inclinations and to abstain from any unjust enterprise.

In a word, the perfection of our faculties is in itself a true good; it is the first and last of goods; it is the final object of all our efforts; the industries that act on things are important only because they contribute to the conservation and perfection of the human species; and, consequently, those that have man for their immediate and direct object, even if they were not as indispensable as they are to the success of all the others, should still be the object of the most keen and most elevated interest.

Let us speak first of those that act on the body of man.

§ 3. If I wished to grant in this work to the industries occupied with the perfection of physical man only a place proportionate to the interest that society in general attaches to them, I would have, it seems to me, rather little to say of them. It is worthy of remark, in effect, that the part of ourselves that we ordinarily love the most is precisely the one we cultivate the least. However imperfect the education we give to our affective faculties may still be, and even that which our intelligence receives, these two kinds of education are nevertheless far superior to that of which our body is generally the object.

There are in society professions that expressly propose to teach us to regulate our sentiments; there are still more that undertake to perfect our mind: one can scarcely say that there are any that truly have for their object the culture and perfection of our physical nature. Medicine proposes rather to repair our ills than it thinks of preventing them by subjecting us to a wise regimen and by working early on to give us a good constitution. Dancing, fencing, horsemanship, are arts that are little cultivated in general; and which one learns rather to distinguish oneself, or to obey custom, or to be in a position to procure certain pleasures, than with a view to perfecting one's bodily faculties.

It thus happens that our body, which is nevertheless on our part the object of so partial an affection, for which it so often happens that we sacrifice our noblest faculties, to whose appetites we make so many sacrifices, for which we set in motion so many industries, which is for our soul so constant a subject of trouble, of care, of anxiety, of agitation, of perplexity, finds itself, on the other hand, and in the most essential respects, the object of the most complete and truly the strangest carelessness.

One cannot deny, doubtless, that it is better treated, in many respects, than it was in earlier epochs of civilization, that it is better provided with the things necessary for its existence, that we have removed from it a host of causes of defilement and deterioration, that it has infinitely more chances of life and duration than it had in the savage state; but one must admit at the same time that, for lack of exercising and developing as would be suitable the faculties proper to it, we cause it to lose in large part the advantages of so happy a position. One would say that civilization tends to deliver it from the excess of labor only to make it fall into the excess of softness.

It is worthy of remark, in effect, that at the time when we make our mind capable of the strongest and most difficult exercises, we learn to make almost no use of our body: we cannot support ourselves at a height of a few feet without experiencing vertigo; we drown in the slightest current of water; we would be reduced, in a multitude of cases, to seeing the beings dearest to us perish without being in a state to bring them any useful assistance. To climb to the end of a rather high ladder, to climb to the top of a tree or a mast, to slide down a pole or a rope, to cross a precipice on a poorly secured beam, to swim across a river, to save a person who is drowning: these are actions that, among cultivated peoples, exceed the strength of the great majority of men; there is even a sort of shame attached to the pursuit of the talents that would permit us to execute these actions; and I do not know if civil life, which perfects and fortifies us in so many respects, has not caused us to lose in this one, at least until this moment, a part of the powers we had at epochs of a much less perfect culture [^507].

It is true that at first this could hardly have failed to happen thus. So long as man was surrounded by obstacles, and, to vanquish them, found himself reduced to the use of his muscular forces alone, he necessarily had to exercise these forces a great deal and make very extensive use of them. But as the obstacles were smoothed away, or as the artificial means of surmounting them became less rare, one feels that he must have made less use of his limbs, and gradually replaced their use with that of the instruments he had procured for himself.

It is not by choice that a savage crosses long distances on foot, or that he swims across the river that bars his route; it is because he has no better means of transport. If he had a canoe, he would not swim across the river; if he had a mount, he would not take the trouble to go on foot; if he had a ladder, he would not tire himself climbing the tree whose fruit he wishes to pick. It is not in man's nature to give himself useless trouble: we know that it is already difficult enough to obtain the necessary efforts from him.

One should therefore be little surprised that he exercises his physical forces less as he is less obliged to; and one understands how civilization, removing the dangers and difficulties from his path, multiplying before him the means of action, surrounding him with ease and facilities of every kind, could have made him neglect the culture of his bodily faculties, and caused him to fall in this regard into a sort of inferiority, or at least prevented him from making in this respect the same progress as in many others.

However, that is a considerable evil and indubitably contrary to the results that civilization proposes to obtain. It cannot be part of its views to sacrifice one part of our being to the development of the other, and to perfect our moral faculties only to the detriment of our physical forces. If we let our body become enervated, if we fall into languor and softness, it is by an evident abuse of the goods it gives us, and contrary to its most certain wishes and needs. It is among its wishes that the cultivated man be distinguished from the uncultivated man by the beauty, vigor, grace, harmony of his features and his forms, no less than by the superiority of his intellectual faculties.

I add that it is among its needs that man remain robust, at the same time that he becomes intelligent and moral. The conquests of civilization can be preserved only by the means that served to make them. When all its enemies had been vanquished, courage would be necessary to prevent others from arising. When all imaginable processes had been found, the intelligence that had presided over their invention would still be indispensable to regulate their use. When we no longer had need of muscular force to do what our machines do, we would need it to make our machines.

And then, however much we may have perfected our means of acting, we are still far from having removed peril and fatigue from all labors. There is a multitude of professions in which cool-headedness, poise, agility, skill, courage, are always indispensable qualities. There are many others that demand great bodily vigor. There is none that one does not exercise better, with firm and healthy organs than with a weak and languishing constitution. The less certain sedentary classes of workers make use of their bodily forces, the more they would need to maintain them, in order to prevent the nature of their labors from degrading them.

Besides, even if one did not need these forces for the exercise of one's profession, would they not still be sought after as a resource good to hold in reserve against unforeseen dangers and accidents? Whatever precautions our foresight has imagined and the means of conservation with which we have surrounded ourselves, it is only too possible still to see our life or that of our fellow men exposed to more or less grave perils; and no one is assured of not finding himself, from one moment to the next, in a situation where he would be happy to have a good fund of vigor or bodily skill to put at his service or at the service of others.

After that, even if one had no labors to do, no perils to fear, no services to render; if there remained only to enjoy the goods that civilization brings forth, it would still be, and for that reason alone, very advantageous to possess a robust and healthy body. The better life becomes, the more it would matter to have it tough. Besides, strength and health are needed to enjoy the goods that civilization procures. Still more is needed to use these goods with measure: our body, which languishes in privations, is scarcely less subject to becoming enervated in the midst of too great a well-being; and it has long been remarked that if vigor was needed to resist the fatigues of war, no less was needed to bear the leisures of peace.

Finally, these faculties deserve to be cultivated for themselves; for the pleasure one finds in feeling them, in exercising them; because they form a part of the perfections of which our being is susceptible; because they serve as an instrument for activity, devotion, courage, and are like the support and the base of our most elevated faculties.

It will perhaps be observed that it is not possible to develop our physical forces and our intellectual faculties to a high degree at the same time. It will be said that, being endowed with only a certain degree of total energy, we cannot direct this energy toward our limbs without stealing it from our intelligence; that it is very rare to see an athlete who is a man of genius; that Hercules does not have the mind of Apollo, nor Apollo the strength of Hercules, etc.

We must come to an understanding: surely, if one wanted to direct education in such a way as to perfect muscular forces above all else, it would be greatly to be feared that one would harm the development of the affective and mental faculties. But that is not what is at issue. No doubt that the mind and sentiment must retain their preeminence; no doubt that our intelligence and our inclinations are the faculties that it is most important to develop and to learn to conduct well; but far from a good physical education opposing the culture of our other faculties, it is certain that it favors it. It is less a question of stealing time from the exercises of the mind than of better employing the intervals of rest that are granted to it, of knowing how to make these hours of respite serve the education of the body. It is only by alternately exercising the organs of locomotion and those of thought that we can give these two orders of faculties the degree of development and perfection of which they are naturally susceptible.

In effect, each of them does not profit only from the particular education it receives: they fortify one another. If moral energy adds to bodily forces, bodily forces in turn sustain moral energy. If one must exercise one's mind to know how to make use of one's body, there is no doubt that by maintaining the forces of one's body, one greatly facilitates the action of one's intellectual faculties.

What is more proper, for example, I will not say perhaps to give courage, but to stimulate the courage one has, than the feeling of great physical vigor, united with much skill and agility? And as for the intelligence, how many examples have we not of individuals whose mental faculties, troubled by an overly keen or overly sustained excitation, or else having become inactive as a result of the general wasting away of the body, have been brought back to the normal state by diverting toward the organs of locomotion the life that was directed there with too much force, or else revived by exercises that would restore vigor and health to the body?

Thus, admitting, as is reasonable, that it is necessary above all to make man an intelligent and loving being, there is no doubt that one must also occupy oneself with making him as much as possible a being who is healthy, beautiful, well-made, agile, skillful, vigorous, and that the care to be given to this part of his education can very well be reconciled with that which the others demand.

Let us therefore speak here of the industries that take charge of the culture of physical man, and let us not fear to grant in this work some place to arts that occupy or at least that should occupy a very considerable one in society.

§ 3. All industries, whatever they may be, contribute to the perfection of all of man's faculties. Consequently, all contribute to the perfection of his physical faculties, even those that do not act directly on him, those that are exercised on matter, and whose immediate object is to appropriate things to his needs. We know from what causes of degradation and infirmity he can escape, what sources of vigor and health he can open up for himself simply by modifying the places he inhabits, the foods with which he nourishes himself, the clothes with which he covers himself. It is with the human species as with other animal species, which become more beautiful for the sole reason that they are better cared for. It always happens that a population gains in strength and beauty as it acquires more well-being. We know how much more rare it is, in general, to find among the poor classes, than in well-to-do families, persons distinguished by the delicacy of their features or the regularity of their forms. M. Simond says he remarked in England that the class of gentlemen is more beautiful and stronger than that of the lower class, and not only the lower class of the cities, but that of the countryside [^508]. It has been observed that in France, for fifty years, the human species has become singularly more beautiful, that one almost no longer sees children born deformed or contracting deformities in early childhood; and the reason for this change has been found above all in the growing prosperity of the population, which has permitted it to have more salubrious dwellings, cleaner clothes, healthier foods, to lead, in all respects, a more hygienic life [^509]. But I have spoken sufficiently of the arts to which man owes all these external means of ease; which contribute in so powerful a manner to his conservation and his perfection. I have only to occupy myself here with those that act immediately on his person, and among these, even, the only ones of which I wish to speak at this moment are those that have his physical person for their object.

These latter are very numerous and very diverse, and it would be equally difficult to make an exact enumeration of them and to find a name that would embrace them all. In designating the arts of the doctor, the surgeon, the oculist, the pedicure, the dentist, the gymnasiarch, the master of fencing, of swimming, of dancing, of horsemanship, I would make a very long enumeration, and would not be sure of having made a complete one.There are, in effect, powerful means of acting on the body of man that do not appear to be included among the arts I have just named! 1. Medicine, for example, which is very generally practiced as an art of healing, is very little so in its relation to the particular object of this chapter, that is to say, as a means of raising and maintaining the body of man in its best state of conformation and health. Of all the parts of the medical art, hygiene, which could be the most effective, is without question the least practiced.

It is especially not so in that of its means which would appear susceptible of yielding the most favorable results. If one sometimes has recourse to it to act on generations already born, one does not yet ask it how it would be possible to act on generations to be born. Some parents will perhaps consult it on the means of correcting certain defects of conformation in their progeny, of moderating the overly keen action of some organs, of accelerating the overly slow play of some others, of establishing between all functions that equilibrium and that harmony from which perfect health results; but a man will not ask it, before marrying, how he ought to direct his choice to improve his race, to what temperament it is important for him to unite his own, by what alliance he could avoid transmitting to his posterity certain unfortunate predispositions. After having, one cannot be more curiously occupied, observes an illustrious physiologist [^510], with the means of rendering more beautiful and better the races of useful and agreeable animals or plants; after having reworked a hundred times that of horses or dogs; after having transplanted, grafted, worked in every manner the fruits and flowers, we have done absolutely nothing to improve the race of man.

 

And yet, it is impossible not to consider the cross-breeding of races as one of the most energetic means the species has of acting upon itself.

Such is the influence of this practice, that a small number of families who would wish to ally themselves only among themselves, thereby concentrating in their bosom all the hereditary infirmities they might have, or that time would expose them to contracting, and making among themselves a continual exchange of their deformities and their vices, would be infallibly degenerated at the end of very few generations.

This is even, to observe it in passing, one of the causes that most profoundly undermines the monarchical system of our old Europe, a system in which a small number of sovereign houses, to better separate themselves from the rest of humanity, have adopted the custom of allying themselves only with one another, and by that very fact have exposed themselves to making common to all their members the natural imperfections with which some of them might be accidentally born affected.

Such are, for these august families, the inconveniences of such a custom, that they must have been endowed in the beginning with a physical and moral constitution so particularly distinguished, that, without ever going to draw new life from the common source, and without any fraudulent infusion of plebeian blood, they could have preserved themselves as beautiful, noble, intelligent, worthy in a word of the high situation in which they are placed. It would not have been possible otherwise for the law that presides over their alliances not to have made them undergo profound alterations [^511].

It has been easy to see, in less elevated ranks, to what inevitable degeneration one is exposed under the influence of such a law. One cannot doubt that the prejudice which, at all times in Europe, has forbidden aristocratic races from seeking in marriage persons who were not of station, is one of the causes that have most harmed the duration of these races. By dint of wishing to ally oneself only to families of one's rank, one so circumscribed the number of those from which one could make a choice, that it became nearly impossible to make a good one, at least for all that did not pertain to birth or riches.

Thus one knows how many great families have become extinct with all the means of fortune proper to sustain them; how many others have sustained themselves only by illegitimate unions or by the favor of commoner marriages. Certain great lords were interested in more than one respect in contracting these useful alliances. Lost to dissipation and debauchery, equally ruined in their fortune and in their health, they had at the very least as much need to renew their blood as to manure their lands.

Among Oriental peoples, the masters, who are not guided in their marriages by the prejudices of the European aristocracy, and who do not disdain to make wives of their slaves, when they are beautiful, appear to have thereby acted very usefully on their posterity. It is asserted that among the Turks and the Persians, this custom, observed for several centuries, has in some sort changed the species; and perhaps the same cause had contributed to a certain point to give the ancient Greeks that almost ideal beauty of form that we are disposed to believe they had, judging them by their statues.

Although physiology has not yet directed its research toward the effects that it is possible for us to produce on ourselves by the mixture of colors, forms, and temperaments, it is believed to be known however that the fusion of a certain quantity of Indian and even African blood with our own can produce good effects. Travelers assert that the Hispano-Americans, whose fathers first married Indian women, and for some time mixed their blood with that of the coppery race, today form, with respect to the whiteness of their complexion and the elegance of their forms, a race superior to that of the Spanish. Others have observed that there were few races more beautiful than the races produced by a mixture of white blood with black blood already cut several times over.

It appears that the diverse shades of our race could also ally themselves with one another with much profit for their common improvement. It would be difficult, it is said, to see more beautiful creatures than the women of certain cities in the south of Spain, come from a mixture of Spanish blood with that of blond men from the north of Europe whom commerce has attracted to these cities at various times, and who have ended by establishing themselves there [^512].

Finally, there would perhaps be as many advantages in marrying diverse temperaments as diverse colors; and enlightened physiologists think that the alliance of contrary humors, and, for example, of lymphatic temperaments with bilious temperaments, would be the best means of effacing what is excessive in the predominances that distinguish them. There is therefore no way to doubt that the cross-breeding of races, which the medical art has not yet included among its practical means of acting on the human body, is one of the most powerful there could be to modify and perfect its nature.

 

I could say as much of exercise, which has been much better appreciated, and of which nevertheless one is still far from taking as much advantage as one could.

If we are founded in supposing that the military peoples of antiquity owed something of the beauty of their forms to the faculty that victory gave them of marrying the most beautiful women who could be found among the vanquished peoples, there is reason to believe that they were still more indebted for this advantage to the exercises of the gymnasium and to the skill with which these exercises were directed.

The effect of exercise, according to physiologists, is to call blood and life into the parts of the body that are the seat of the muscular contractions it provokes, to cause those that it thus puts into action to gain volume, to cause those that it leaves at rest to lose it, and thereby to influence very sensibly the proportions of the ones to the others. One can, in a way, by the manner of directing it, develop whatever part of the body one wishes, the muscles of the legs or of the arms, those of the shoulders or of the chest. It has been observed that, among professional dancers, the legs, thighs, and especially the buttocks take on a marked increase at the expense of the torso, neck, arm, and forearm; that, among sailors, blacksmiths, and market porters, on the contrary, the arms, shoulders, and chest are very developed at the expense of the buttocks and abdominal limbs; that, finally, among men who, without specially exercising any of their limbs, occupy themselves with care with the education of all, each part of the body develops in such a way as to contribute to the regular proportions of the whole.

Next, if exercise can act to this point on the form of the parts it affects, it influences their vigor no less. It is not rare to see, in gymnasiums, men who, at first, could remain suspended by their hands from a rope or a pole for only a few seconds, acquire by exercise the power to thus support the weight of their body, with only the phalanges of their fingers, for twenty-five, thirty, and thirty-five minutes; one sees them gradually become capable of jumping over ropes stretched seven and eight feet high; of launching themselves without a ladder onto walls ten feet high; of clearing, in one leap, ditches eighteen and twenty feet wide.

Finally, a last effect of the same cause is to develop suppleness and agility in the muscles where it can thus give birth to strength. There is no one who does not know by experience that by repeating a certain movement several times, and with intervals of rest, one develops in the muscle where this movement operates a facility of action that was not there before. The effects that it is possible to obtain thereby sometimes seem to hold of the prodigious. One need only see an agile dancer execute his steps, a subtle conjuror perform his feats of skill, an practiced pianist play a tune on his instrument, to judge the degree of precision, certainty, and rapidity of action that exercise can make our muscles acquire.

And it is not only on the external parts of the body that exercise acts with great power; it is also on our internal organs. There are in organic life many disorders, especially in the class of those that are tied to external defects of conformation, that can be made to cease only by an enlightened use of exercise. It has been seen to produce almost miraculous effects on young persons threatened with phthisis, as a result of a poor conformation of the chest, and for whose cure all the recipes of therapeutics and all the resources of the pharmacy had been exhausted without fruit. It is considered one of the surest means of curing scrofulous, lymphatic, rachitic, atonic, etc., affections.

It is true that, to operate all the good that it is in its power to produce, it needs to be employed with much art and precaution; that it requires several sorts of knowledge; that it demands that one take account of the age, sex, temperament, and habits of the subject to whom it is a question of applying it, of the current state of his strength, of the place, the season, the hours of the day when one wishes to make it act.

But in the end, employed as it is susceptible of being, exercise is, after the mixing of races, without question the most powerful means man can use to improve his physical nature, to give his limbs grace, vigor, flexibility, skill, agility, and also to perfect his internal organs; for, besides the fact that his viscera develop by a sort of gymnastics, as do his limbs, the structure and play of these organs depend greatly, as we have just observed, on the external forms of the body over which he can influence very powerfully by exercise [^513].

It is easier to perfect our faculties or to prevent them from deteriorating, than to return them to a healthy state once they are altered: medicine properly so-called does not proceed with as much certainty as hygiene. Nor does it obtain results as satisfactory: for, if it is fortunate to be cured, it would be more fortunate still not to become sick, and the art that wards off illness from us is indubitably more precious than that which only tries to deliver us from it.

Thus, even if the latter fulfilled its object better than it is in its power to do; even if it had varied less in the explanation of the disorders that can arise in our machine, and in the choice of the most proper means to repair them; even if its knowledge were more certain and, in many cases, its procedures less hazardous, it would seem difficult, at first glance, to include it among the arts that are occupied with the culture and perfection of our physical nature.

However, on the other hand, the medical art can repair so many natural or accidental defects; it has against certain very grave, and nearly inevitable, ills such sure preservatives; it contributes to relieving and even to curing so many sufferings, that it would be impossible not to rank it among those that act most usefully on the body of man, and that most help to put and to maintain it in good condition. One need only, to make its importance felt, indicate some of the principal effects it produces.

The medical art succeeds, by mechanical operations, in curing blindness that comes from cataracts, deafness that results from the thickening of the tympanic membrane, mutism that is tied to the congenital division of the upper lip, the palate of the mouth, and the uvula; it succeeds in making the vicious curvatures of our strongest bones disappear, even those of the vertebral column; it restores fractured or dislocated limbs to their natural state; it goes to break urinary calculi inside the bladder where they develop; it remedies, by the process of invagination, transverse wounds of the intestines, etc. [^514].

Medically, it has found a way to shield us from the contagion of the variolic virus; it has modified our temperaments in such a way that syphilis seems no longer to have such a murderous influence on us and can no longer rage with the same fury; it has almost infallible specifics against intermittent fevers, and more or less effective remedies against many other diseases, etc. Now, when it can produce on our body such diversely salutary effects, how would it be possible not to admit it among those whose object is to conserve and perfect it?

In sum, one need only recall what were, a few centuries ago, the frequency of plagues, the periodic ravages of smallpox, the more or less deep traces of its passage that this cruel disease successively left on the face of all generations, the no less great devastations and the even more hideous mutilations that the venereal disease wrought, the immense number of the unfortunate who were afflicted with rickets, of those whom leprosy devoured, of those whom cold humors caused to fall to pieces, and of a multitude of others whose deformities and sufferings a multitude of other diseases varied; one need only place in parallel the state in which the population then found itself and that in which it finds itself today, to feel what the arts that take charge of the culture and perfection of physical man are capable of. Everything authorizes us to believe that the present generations are more beautiful and healthier than the past generations [^515]; the average duration of existences is longer; fewer births are needed to maintain a certain population.

Doubtless, these results are not due solely to the arts that act on the body of man. I know that many others have powerfully concurred to produce them; but these too have contributed, and they have contributed, although the physical perfection of the species has never been a goal that they have formally proposed for themselves. One has obtained to a certain point, without seeking them, and by the sole fact that marriages have been formed in general between persons who are healthier and better conformed, the good effects that result from the cross-breeding of races. Exercise has contributed in various ways to the maintenance and development of strength, although it has not been asked to produce this effect. Life has been more hygienic, without one having thought to conform to the precepts of hygiene. The medical art has beautified the species, by working only to relieve its ills: let one consider the influence it has exercised on its beauty, merely by the discovery of the vaccine and by the success with which it has combated the venereal disease [^516].

[^510]: Cabanis, Rapports du physique et du moral, 1st memoir. [^511]: See, on this subject, the Quarterly Review, No. 71, p. 119. [^512]: Travels in Spain, by M. de Laborde. [^513]: See, on this subject, the works of M. Amoros, and particularly the Manuel d'éducation physique, gymnastique et morale. [^514]: See, on this subject, the Dictionnaire des sciences médicales, article Chirurgie. [^515]: See, on this subject, the Statistical Research on the City of Paris, by M. le comte de Chabrol, Prefect of the Seine. [^516]: See, on this subject, the Dictionnaire des sciences médicales, article Vaccine.Now, if these arts have been able to produce such effects, so to speak, unwittingly, or at least without one thinking of making them serve the perfection of our physical nature, one feels how much better they would succeed in attaining this end if they were directed to it with intention, with skill, with concert. Today, each man, in what is particular to him, is in a way only what the fortuitous circumstances in the midst of which he develops make him: the diversity of temperaments, the differences in height, the proportions of the body, the features of the face, are in general only pure accidents. Yet, in this as in all things, we could surely seek to direct the forces of nature to our greatest good; and it is not doubtful that the arts with which this chapter is concerned could attempt it with success..... But I have said enough to give an idea of their importance and to inspire the desire to seek the general causes to which their power is linked.

These causes are already known to us. They are the same as those on which the liberty of the other industries depends. One exercises with facility and with success the arts that act on the human body only by the same general means that facilitate, extend, and affirm the practice of all possible arts. It requires a certain capacity for business, an aptitude for undertaking, founding, conducting, and administering; it requires practical instruction, theoretical knowledge, a talent for applications and for execution; one cannot doubt that success in them depends greatly on the state of moral habits; it is essential that the workshops be well-situated and well-equipped. The only difference is in the particular kind of notions, habits, and instruments that the labors of this order demand, and in general in the manner in which the nature of these labors allows the diverse elements of power I have just enumerated to be applied to them.

§ 3. Thus, for example, there is no doubt that, for the founder of a gymnasium or a health establishment, just as for the head of a factory, the talent for speculating is an indispensable means of success.

Let a doctor wish to establish a hospice in a place where everyone will have his own home and the means to be treated there; let an Opera dancer go to hold a dance school in a village and teach peasants to do entrechats; let a fencing master undertake to open a fencing hall in a society of Quakers; let a professor of gymnastics take it into his head to offer lessons in pugilism to noble and polite families: it is clear that all of them will be undertaking absurd enterprises that cannot fail to miscarry.

In this, as in everything, the essential thing at first is to know what one can reasonably undertake, and what kind of products or services it is possible to have society accept. It is not always enough to propose useful things to it: one must propose things that it approves of; and for that it is essential that they enter to a certain point into its tastes, that they be more or less connected to its ideas and its customs.

Gymnastics, such as a judicious philosophy has striven, for some time, to accredit, is surely a good thing; it responds to a fundamental need of society; it tends to develop a whole order of faculties that the established systems of public and private instruction left absolutely uncultivated or developed only very imperfectly; and yet how much trouble have the persons who tried to restore this essential branch of education among us had in making it take hold? Gymnastics, it was said, was a thing renewed from the Greeks, with no relation to our modern ideas and habits; and although the exercises of M. Amoros were founded on the same bases as children's games, and differed from them only by the more enlightened direction and the greater development he had given them, he had still, after ten or twelve years of efforts and care, succeeded only very imperfectly in winning public favor for them.

What greater service could be proposed to men than to offer to preserve them from the ravages of smallpox? And yet how many obstacles did the principal inventor of the vaccine not at first find to the application of his discovery, and how much trouble has one not had, since Jenner, in propagating it? I could make the same remark about the practice of inoculation, and about a host of other useful processes, taken from among those that relate to the arts with which I am here concerned.

The industrious person whose profession consists in acting on the human body is therefore obliged to research, before all else, what treatments men are willing to receive, what bodily qualities they desire to acquire, and for that, what exercises, processes, and treatments they will consent to submit to. In a word, there is here an order of demands whose state he must necessarily know.

There is likewise a necessity that he be informed of the state of the offers that are made; that he know the number and the means of the competitors he has; that he judge if this number is insufficient, or if the means they employ are inferior to those he could put to work; that he be in a state to determine, finally, if there are chances of success for the pharmacist's shop, for the health establishment, for the school of fencing, of horsemanship, of gymnastics that he might intend to establish.

I scarcely need to add that these sorts of establishments demand, like others, to be skillfully conducted, and that there is many a hospice that requires no less administrative capacity and talent for accounting than the most considerable factory.

The diverse faculties that make the true man of business thus find, to a certain measure, the means to be applied here, and can be considered in this a very real and very necessary element of power.

§ 4. The same can be said of the faculties that relate to the art.

Nowhere, for example, is what I have said of the importance of practical knowledge better verified. This knowledge is all the more necessary here as the help of theory is more limited and more doubtful. Just like the agricultural industry, the arts that act on the human body can operate their transformations, as I have already remarked, only with the help of life, a mysterious agent whose nature they are absolutely ignorant of, whose functions they know only very imperfectly, and whose use, for that very reason, it is impossible for them to subject to fixed principles of theory.

In this state of ignorance, the best thing they can do is doubtless to observe attentively the external facts by which this secret agent manifests itself, to watch how it acts in health and in sickness, to see how its action can be modified by that of stimuli of every kind to which it is possible to subject it—by heat, by cold, by air, by foods, by remedies, by exercise—and to act consequently to these indications. This reasoned empiricism, so long as the true explanation of vital phenomena has not been found, will incontestably be the best guide one can follow.

This is so true that all the medical science of the ancients, among whom medicine was nevertheless practiced with great distinction, was reduced to knowledge of this order. Hippocrates, whose writings, by the admission of the most enlightened doctors, still offer such profoundly instructive reading, Hippocrates was ignorant of the sciences that are today regarded as the basis of medicine, and had on the organization and functions of the human body only notions that were not very exact and not very extensive. He knew, in a way, of man only what is manifested by external phenomena; but he had profoundly studied these phenomena; he had attentively examined the action of the causes by which it is possible to influence them; and although his anatomical knowledge was below mediocre, his practice, observes Cabanis, still today excites the admiration of the greatest doctors [^517].

It appears that the same could be said of that of many doctors of antiquity, who, at an epoch when anatomy and physiology were not yet born, must not have been more anatomists and physiologists than Hippocrates:

“True pathology,” Cabanis writes further, “is found above all in the books of the ancients, to which a small number of modern observers have made some happy additions. Hippocrates, Aretaeus, Alexander of Tralles, Aetius of Amida, Paul of Aegina, Galen, and two or three Arab doctors, have left us the most exact pictures that the art still possesses: no man of good faith can deny it; and their general rules of treatment, drawn, at least in general, from the very bosom of nature, have no less right to astonish us by the great views they suppose than by their wisdom and by their eternal truth [^518].”

“The explanations of the ancients,” adds the same author, “although formed on the simple observation of the healthy or sick man, without the help of anatomy, of the physiological knowledge that is due to it, of experiments, of which the art was almost entirely ignorant in their time, and of the collateral sciences, which lend us ceaselessly either direct lights, or new instruments: these explanations have not always been replaced in a very happy manner. There are several that reappear from time to time with brilliance, and that seem destined to survive all those that have overthrown them; there are some in which the seal of nature appears so strongly imprinted that each new progress of science confirms them; there are, finally, some that the good sense of the fathers of medicine had left in vagueness, and which, after so many useless efforts to give them more precision, one must perhaps consider as destined to remain there always [^519].”

One can judge by these remarks of the importance that practical knowledge offers in the arts that act on the human body. The less advanced the theory of these arts is, the more one needs to take counsel from experience in them. Good minds, observes on this subject the philosopher-physician I have just cited, cannot hasten too much to come to grips with the very objects of their labors. The doctors of Cos were far from thinking that medicine could be taught from the top of a chair, and far from the objects on which it must act. The true way to teach it is to teach it at the bedside of the sick. Under the eyes of the professor, and almost without his participation, are formed young doctors whose instruction is all the more solid as nature bears almost all the costs. In this continual exercise of their sagacity and their judgment, at the sight of pictures composed entirely of facts, they contract the habit of seeing them better, and a distaste for all reasoning that is not confined to them [^520].

If Hippocrates acquired such a high reputation in medicine, he owed it above all to a medical education that was entirely practical. It was in the midst of childhood games, says Cabanis, that Hippocrates, whose ancestors had constantly practiced medicine for seventeen generations, received, from the very mouth of his parents, the elementary notions of this art. It was at the sight of diseases that he learned to recognize them; it was by seeing remedies prepared and put to use that he made himself equally familiar with their preparation and their employment. He was surrounded from the cradle by all the objects of his studies and sucked in the principles of his art, so to speak, with his mother's milk [^521].

Instead of proceeding as Hippocrates did, we follow a method that is in a way opposite. The observation of facts is the last thing we arrive at, and it is above all by the study of medical theories that one prepares oneself among us for the practice of the art of healing. Attending hospitals is surely not forbidden, but neither is it required, and it can very well happen that a young man receives the diploma of doctor without having seen a sick person, without having assisted at an operation, without having prepared or administered a remedy, without having learned to recognize a disease anywhere but in courses or in books.

Is this way of preparing for the practice of medicine made to inspire great security? Would it not be better to deal with a hospital nun, very ignorant in the matter of theory, but who had seen and cared for many sick people, than with a young graduate who had neither seen nor treated diseases, however rich he might otherwise be in theoretical knowledge? Students are imposed the obligation of attending schools, and they are left the faculty of frequenting hospitals: it seems that the inverse would be wiser, and that if society ought to require something of the men who destine themselves to give care to the sick, it would be above all that they had in advance observed and seen many diseases treated. Between the study of practice and that of theory, it is evidently the first labor that should be made obligatory, and the second that could be left optional.

For the rest, however important the practical knowledge of the trade may be here, it is not doubtful that notions of theory are a very real element of power in it. It is impossible that there not be some advantage for the industrious who act on the body of man to possess exact notions on the organization of the human machine, and on the functions that this machine accomplishes, even if one were otherwise ignorant of the nature of the principle that makes it act and the manner in which this agent proceeds.

It is true that the Greek gymnasts formed very good runners, although they were not physiologists: yet it appears that physiology furnishes, relative to the movements of which running is composed, some notions proper to well direct this exercise and to increase its speed and duration.

Observational medicine, philosophical empiricism can cure many ills without the help of physiology: and yet the doctors least disposed to exaggerate the importance of this science admit that medicine owes to the progress of anatomical and physiological knowledge the bolder and firmer march it has followed since these progresses began.

The same can be said of surgery.

“It was only,” observes Cabanis, “at the birth of anatomy, at the epoch when Vesalius shook off the yoke of Galenism and the schools, that, aided by physics, which was itself then clearing new paths, surgery took that bold flight which has since led it from discovery to discovery and from success to success. Anatomy,” adds the same writer, “serving as a base for the art of healing, especially for its surgical part, now appears inseparable from the practice of this art, whose successes it often ensures [^522].”

In truth, it would be rather difficult to say in what measure it has contributed to affirming and facilitating its exercise. It appears that there exists no work in which one has attempted to determine in a detailed and precise manner the influence that anatomy, physiology, and several collateral sciences have exercised on the practice of the arts that have the body of man for their object. But this influence, although it has not been exposed ex professo, is nonetheless very real, and there is no doctor or surgeon of some instruction who could not easily cite cases where it makes itself usefully felt.There are, for example, circumstances where it becomes very essential to be able to perform the ligation of an artery; and yet surgery formerly did not dare to attempt this operation, for fear that the blood would no longer vivify the limb to which this artery led: the anatomical discovery of the capillary system and of the property that the capillary vessels have of dilating has permitted the execution of this operation, which until then had been regarded as impracticable.—Fungous tumors sometimes develop in certain parts of the body, caused by the engorgement of the canals through which the glands execute their secretions: before these canals and their use were known, one did not know to what to attribute these tumors, nor by what means to cure them: anatomy and physiology, by discovering the cause of the malady, have put us on the path to the remedy. —It was formerly falsely supposed that the phenomena of nutrition could not be accomplished in the midst of inaction and immobility, and, consequently, rest was condemned in the treatment of deformities of the osseous system, and especially in that of the vicious curvatures of the vertebral column; one based this on the specious pretext that, the disease originating from weakness, this weakness must not be increased by prolonged inaction, and, as a result of this error, an iron cross was placed behind the trunk, whose vertical rod descended from the occiput to the sacrum, while the horizontal rod extended from one shoulder to the other; this was a new weight added to that from which one wished to relieve the vertebral column, and the state of standing became even more painful for the patient, burdened with this additional weight, and hindered in his movements by the ties necessary to solidly attach the trunk and the head to it: healthier ideas on the effects of immobility relative to nutrition and the increase of strength have caused this procedure to be abandoned; instead of adding to the load of the vertebral column, it is now unburdened of the weight of the body, and the deviation is remedied by a slow and graduated traction, whose action is infinitely more effective [^523]. – Physiology does not know how sorrow can provoke the formation of tubercles in the lungs: but once these tubercles are formed, it explains very well the difficulty they cause in respiration and in circulation.—The same science cannot say in what the numerous varieties of heart affections consist: but once these affections are declared, it knows why in certain cases the extremities are habitually cold, why the face is sometimes bluish, sometimes livid and pale, etc. – Physiology is equally ignorant of what a scirrhus of the pylorus is: but this scirrhus existing, it knows how to account for the disorders that arise in digestion, and finally in nutrition. – Physics does not know how the optic nerve can receive the impression of external objects: but if the crystalline lens happens to lose its transparency, it has no trouble explaining how the phenomenon can no longer take place. – Mechanics would have great difficulty saying how our will has the power to move our limbs: but if our bones happen to dislocate or break, it accounts without difficulty for the powerlessness in which we find ourselves to execute the same movements. – Chemistry does not know how bile is made, nor how it acts in the phenomenon of digestion: but if one of the elements of which bile is composed happens to be lacking, it can enlighten the doctor on the consequences of this alteration, etc., etc.

These are a few examples of the services that anatomy, physiology, physics, and chemistry can render to the practice of the medical art; and it is not doubtful that men versed in this art could cite many others, and probably more striking ones.

Let us avoid, however, falling into a rather common exaggeration, and while recognizing that the art can here receive great help from science, let us not believe that to exercise it with distinction it is necessary to push theoretical instruction very far. Here, as everywhere, what particularly matters for the success of the art is the study of the art itself. I have seen surgeons, very skilled anatomists, avow that a great part of their anatomical knowledge was, in application, of only mediocre utility to them.

“Therapeutic anatomy, that which the art applies daily, is confined within the most restricted limits. The structure, situation, and connections of the viscera, the distribution of the principal trunks of the vessels and nerves, the form and disposition of the bones, the attachments of the muscles, the expansions of the aponeuroses, and perhaps a few other minor objects no less easy to grasp: that is what the doctor needs to know well. Perhaps it would even be permissible to add that delicate anatomy is very rarely useful for surgical operations: I would dare to appeal on this point to the good faith of the most enlightened surgeon-anatomists.”

This is what a judicious author writes, whom I have already cited several times in the course of this chapter [^524]. It appears certain that in the arts that act on the body of man, as in those that work on inanimate matter, it is less a matter, in order to succeed, of acquiring very extensive scientific knowledge than of learning to make good use of a small number of elementary notions. It is in the good employment of these simple notions that the progress of the art consists, and its power is all the greater, as it has made happier and more multiplied applications of them.

Thus the practical knowledge of the trade, theoretical notions, the talent for applications, are here means of liberty just as real as in the arts that work on matter.

The same is true of the talents of execution. There is in the industries that act on the body of man, as in the other arts, an indispensable manual labor, by means of which the product one proposes to obtain is realized. The riding master, the gymnast, the fencing master exercise a material action on the man they undertake to modify: they make him take certain postures, they make him execute certain movements. The surgeon acts in an even more sensible manner on the body of the patient he operates on, the orthopedist on that of the patient whose bones he wishes to straighten, the pharmacist on that of the man whom he makes swallow his drugs: all execute some chemical or mechanical operation on the human body, and it is not doubtful that the power of their art depends greatly on the greater or lesser skill they can apply to this workmanship.

It is only to be remarked that in these industries, it is ordinarily the same person who conceives and who executes, and that the functions of the worker are found united in the same person as those of the engineer, the scholar, and the entrepreneur. It is the fencing master who teaches his students to fence; it is the dance professor who instructs them to dance; the surgeon does not have his operation done, he executes it himself: it is above all his workmanship that is sought after, and the principal merit here is in the execution. Of all the artists who act on the human body, there is scarcely anyone but the physician who confines himself to giving prescriptions and who acts through an intermediary. One conceives nevertheless that the riding master, the dancer, the gymnast, can have workers, professors who act under their orders and who execute for them. This is even what happens to those of these artists who possess large establishments and who have succeeded in gathering many students there.

§ 5. I fear that the details into which I have just entered in the two preceding paragraphs may be found quite imperfect. One could surely show much better than I have done how the arts with which I am concerned lend themselves to the application of the diverse orders of faculties I have just enumerated. I hope, however, to have said enough to convince the reader that all these faculties are here, not only very applicable, but very necessary, and that, to become truly powerful in the arts that act on physical man, as in any other order of professions, it is indispensable to unite the diverse means that make the skilled speculator and the experienced artist.

I do not believe it is more difficult to show the need one has in them for good moral habits. It almost goes without saying that medicine, hygiene, and gymnastics can do nothing without the help of a wisely regulated life. Hippocrates demands that the doctor be patient and sober, that he have grave manners and a moderate conduct. One sees in the history of the Greeks that the ancient athletes ordinarily lived in a very frugal manner, and that several forbade themselves the use of women and wine. It appears that in England professional boxers, the masters in the matter of pugilism, observe nearly the same regimen. M. Simond [^525] remarks that these athletes are obliged to live regularly and soberly, and that, especially before a great fight, they spend several weeks in preparations, abstaining from all strong liquors, even beer, and exercising continually, though without excess fatigue.

Habits of sobriety, moderation, and temperance are equally necessary to the artist who acts on the body of another and to the subject on whom his industry is exercised. There is between the arts that are exercised on things and those that work on men this essential difference, that in the latter the raw material of the artist, the man on whom he acts, cannot be and is almost never entirely passive: he must lend himself to the action of which he is the object, and in most cases concur in it himself. Doubtless he who undertakes to modify him must have begun by acting on his own person; he must have made himself capable of giving the example of the actions that his student must perform to perfect himself. But it is no less essential that the latter imitate him; he is in a way his own second, and can be considered an athlete who works on himself, and who aspires to perfect his own body.

Now, to succeed in this work, the thing he perhaps needs most is to lead a regular life. Health, vigor, beauty, can be obtained or preserved only at this price. The best remedies would be powerless against habitual errors of regimen. There is no exercise that could make a robust man out of a man inclined to voluptuousness and incapable of resisting its lures. A people given over to gross debauchery is almost always an ugly, unhealthy, ailing people; just as a sober and temperate population is ordinarily a healthy and beautiful population. Of all the exercises to which the man who is occupied with the improvement of his bodily faculties devotes himself, one of the best he can perform is therefore to learn to regulate his appetites, to subordinate his pleasures to the laws of hygiene and morality.

If in France, for half a century, the human species has physically improved, this result is due at least as much to the progress of morals as to that of ease and well-being. M. Simond, after having observed, in his Voyage en Angleterre, that the class of gentlemen appeared to him more beautiful and stronger than that of the lower class of the cities and the countryside, adds, I do not know if with foundation, that in France it is the complete opposite, that the messieurs are inferior to the peasants in bodily faculties, and he gives this reason, that in France the life of well-to-do young men is far from being as active as in England, that athletic amusements enter for much less into their education and that they are thrown much earlier into the society of women: if it is of honest women, he says, the result is sedentary habits little favorable to the development of the constitution and of beautiful forms; and in the contrary case, it is much worse [^526].

If I wished to examine at all the influence that those of a man's virtues that relate particularly to himself—cleanliness, activity, courage, sobriety, continence, etc.—exercise upon him, it would be easy for me to show that there is not an order of means from which the arts that act on the human body draw more real and more effective help.

What happy effects, for example, have not been obtained from cleanliness, that is to say, from that respect for oneself, from that sort of dignity that leads men to remove any filth from their body, their clothes, their dwellings, and which the ancients cultivated under the name of purity? This good habit, to which the name of virtue has recently been refused, although, seeing how rare and imperfect it still is, one is permitted to think that it is not acquired without much effort; this good habit, I say, is perhaps of all the individual virtues the one that has most contributed to the physical improvement of the human race; that has most weakened the contagious influence of several more or less deadly diseases; that has most helped to make disappear, or at least to render very rare, a good number of other more or less hideous diseases; that preserves the present generations from ringworm, from scabies, from leprosy, impure daughters of filth, which so long devoured past generations; that has really done the most for the progress of the health and beauty of our species.

Who does not know, on the other hand, to what point a certain activity is favorable to the maintenance of strength and how much certain exercises are proper to develop our limbs in just proportions? Who would not find in his own experience some good reason to recognize that intemperance is fatal to health? Who has not seen or been able to see men enervated, brutalized by debauchery, and women whom the same vice had withered before their time?

The arts that are occupied with the perfection of physical man can draw means of power even from the private virtues that one might believe most foreign to their object. The love of simplicity, for example, which appeared to us so favorable to other industries, seems to exercise the same happy influence here. It is in the nature of this sentiment to make us renounce a multitude of bizarre ornaments and practices that tend only to deform, to disfigure the body while pretending to embellish it; the use of strangling the waist, of making the hips protrude, of shortening the foot, of elongating the lips, the ears, of perforating the nostrils, of shaving the head, of burying it in enormous wigs, of raising the hair of women in such a way as to place their face nearly in the middle of their body. To it we owe the passing of the fashion for tattooing, for beauty spots, for plastered faces, for powdered hair. It leads us, finally, to reject exaggeration and bad taste from the forms we give to the body of man, as from those we impress upon the products he uses, and to make us seek, in general, the easiest, most natural, and truest manners, postures, and attitudes.

§ 6. If personal virtues are necessary to the success of the arts that are exercised on the human body, let us recognize that these arts can no better do without good civil habits. It is clear, for example, that it is no more possible here than elsewhere to raise exclusive pretensions, without mutually hindering one another. Now, there are few of these arts in which some pretensions of this kind have not been formed.

In gymnastics, for example, certain exercises were seen to be forbidden for a long time to certain classes of individuals. The dominant classes, under the feudal regime, had reserved for themselves the monopoly of the art of fencing and horsemanship; they alone could learn to fence; they alone could indulge in the exercise of hunting and figure in tournaments; they alone, in judicial combats, could fight on horseback armed with the sword or the lance. The serfs, the villeins fought only on foot and fenced only with the staff: all the exercises proper to give the body vigor, grace, a certain air of nobility, were forbidden to them [^527].

Exclusive pretensions have not been lacking either in other arts of the class of those that are the subject of this chapter. There were formerly, for example, brotherhoods of surgeons to which it was necessary to belong in order to be able to practice surgery. Not only did these surgeons forbid the exercise of the art to all who were outside the corporation; but they did violence even among themselves: it was not permitted for one to show himself more skilled than another; the theory, the manner of operating, were established by invariable regulations from which none could deviate.

There existed besides brotherhoods of barber-surgeons, or short-robe surgeons, with whom the long-robe surgeons were perpetually in dispute. The latter notably contested the right of the others to send their students to the Faculty of Medicine; and the Faculty having granted the students of the barber-surgeons permission to follow its courses, this concession by the Faculty became, between the brotherhood of the long-robe surgeons and that of the short-robe surgeons, the source of sixty years of lawsuits [^528].

[^523]: See, on this subject, the Dictionnaire des sciences médicales, article Orthopédie. [^524]: Cabanis, Rapports du physique et du moral, 1st memoir. [^525]: Voyage en Angleterre, vol. II, p. 257. [^526]: Voyage en Angleterre, vol. I, p. 235. [^527]: See, on this subject, the Histoire de la législation, by M. Pastoret, vol. XI, p. 293. [^528]: See, on this subject, the Dictionnaire des sciences médicales, article Chirurgie.It is rare, today, to see pretensions of the nature of those I have just described being raised. However, the fashion for them has not yet entirely passed. In England, for example, the Royal College of London was recently seen to invoke against Dr. Harrisson a charter of Henry VIII which forbade any doctor, whatever the university where he might have taken his degrees, from coming to practice medicine in London and within a radius of seven miles around the capital, without having received a license from the Royal College, which is always granted, it is said, after a light oral examination, and without requiring from the candidate, as proof of his capacity, any other document than a sum of fifty-seven guineas. Dr. Harrisson, strong in the titles that had been granted to him by the Edinburgh school, had neglected to submit to this regulation, and nevertheless he came to practice his art within the privileged radius and even in the city of London. At this news, there was a great rumor at the Royal College. The doctor was summoned to appear before the censors of the College. He resisted and refused to recognize their authority. The matter was in litigation in 1827 [^529]. I do not know how it was decided.

There are no longer, among us, any individuals or private establishments that would dare to form similar pretensions. But society still raises some that it would perhaps not be any easier to justify. It does not happen, it is true, for it to interfere, as in the past, through the intermediary of its magisterial bodies, in the teaching or practice of the medical art. Its royal courts do not pretend, like the old parliaments, to determine, in certain cases, the treatment that will or will not be administered to the sick: one does not see them render judgments against the use of the emetic or the practice of inoculation. But its administration and its legislature still do things that seem scarcely less strange and less outside of common sense and common law.

There are countries where the public entity is prudent enough not to want to vouch for the capacity of anyone who claims to practice an art, and just enough at the same time not to subject the study and practice of that art to arbitrary regulations. In Geneva, if I am well informed, he is a doctor who wants to be. The republic does not impose on anyone the obligation to take degrees and pay for diplomas. It leaves to private individuals the care of seeking to place their confidence well, and wants those who need to obtain it to take the trouble to merit it. Yet it does not refuse to deliver certificates of capacity; but it grants these certificates only on good grounds; and when a doctor comes to ask it to attest that he is worthy of the confidence of the citizens, he is subjected to examinations all the more rigorous as they were not imposed on him, as it is a distinction he is asking for, and as care has been taken to remove from his judges any motive to treat him with favor.

Things, among us, happen in another way. The examinations, instead of being optional, are obligatory: society does not suffer a man to become a doctor, surgeon, health officer, pharmacist, or herbalist without having assured itself, so it claims, that he has the required knowledge. What is more, not believing it sufficient to assure itself of his capacity, it pretends to indoctrinate him itself, and it decides in advance everything he will have to do to become skilled in his art. Thus a young man cannot devote himself to the study of medicine if he does not have a sponsor, if he does not produce his birth certificate, the consent of his parents, a certificate of good life and morals, the diploma of bachelor of letters, and that of bachelor of sciences. Society itself chooses his professors for him; it determines what they must teach him, and regulates even the costume they must wear while instructing him. He is obliged to follow these professors and not others; to be graduated by them and not by others: those alone have the virtue of making doctors, whom it has vested with the square cap and the simarre. Whether he has few or many means, he always needs, before he can be recognized as capable of practicing, so many years of study, so many registrations, so many examinations, so many examinations in Latin, so many examinations in French, so many theses, no more, no less. The rules for making a health officer or a pharmacist are a little different, a little less rigorous. For example, society having judged that it was necessary to be less skilled to practice medicine in a single department than to exercise it throughout all of France, the health officer, who has the right to practice his profession only in the department where he was received, is subjected on that account to trials that are a little less long, less multiplied, and less costly, etc. [^530].

That such regulations hinder the teaching and study of the medical art is a thing that is not contestable. But another thing no less certain, although it is not as recognized, is that they hinder it without profit, that they present only illusory guarantees, and that instead of answering for the skill of doctors, they have for their direct effect to prevent one from preparing oneself suitably for the practice of medicine and the diverse professions it embraces.

It is superfluous to observe first that medical knowledge is not of the kind that society needs to propagate at its expense. This knowledge is surely in sufficient demand that one could be certain that private establishments would arise to disseminate it. The whole question is therefore to know whether free schools, whose successes would be entirely subordinated to the merit of the instruction they would disseminate, would not disseminate an instruction as strong and as sound as can be done by privileged faculties, which have no competition to fear, which are sure to have students for the very reason that they alone have the right to create doctors, where intrigue makes professors as much as merit, where the most skilled masters are no better treated than the most ignorant. Now I do not think that this question can be one. I have had occasion in the past to examine our faculties of law and medicine, and I believe I have solidly established that these schools, by their nature, were the most vicious part of a system of instruction that is vitiated in its entirety by the illegitimate intervention of society [^531].

Not only must the existence of establishments having the exclusive privilege of making doctors prevent the medical art from being well taught, but it must also prevent it from being well learned. When it is the diploma that creates the doctor, one naturally limits oneself to doing what is necessary to obtain the diploma. Now, I ask if this title, even justly granted, offers a true guarantee of the capacity of the one who bears it? I have already observed that it was possible to obtain it without having seen a sick person, without having made any observation oneself on the living man, without having the slightest practical knowledge of either diseases or the art of curing them.

Suppose, on the contrary, that it were impossible to become a doctor by patent. It is clear that then one would have to try to become one by one's knowledge. The aspirant, no longer having the means to prove by titles that he possesses his art, would be well obliged to establish his capacity in another manner, and the only one he would have would be to work first to make himself truly capable, and then to show by his acts that he has become so. Like all other classes of artists, he would try to offer as a guarantee of his capacity his practice, his successes, his good repute, and that one would be well worth that of the diploma.

The true effect of diplomas and patents is to permit those who are furnished with them to commit with impunity the most murderous blunders. In this system, one can be culpable by practicing without a title, by neglecting to conform to some regulation; but once in good standing with the University and the police, once all the formalities are punctually fulfilled, one has nothing more to fear from one's carelessness or one's ignorance, and the most gross errors, the most fatal mistakes cannot expose the one who commits them to any kind of punishment. It would not be so in a system where one would be a doctor, surgeon, or pharmacist at his own peril and risk; and he who, having held himself out as capable of practicing these delicate professions, had, by carelessness or by ignorance, caused some great harm, could be punished with all justice. Now, I do not doubt that such punishments, exactly applied, would protect the citizens better than all the preventive measures; and that an order of things where society, finally renouncing these measures, would leave to each the full responsibility for his acts, would offer to the men who would wish to devote themselves to the practice of the medical art more means and motives to prepare themselves well for it than any other kind of regime.

If, therefore, it is important for the good practice of the medical art that each abstain from monopolizing it, from hindering it, it would be no less essential that society impose the same constraint on itself, and that it know how to impose on the powers charged with acting for it the obligation to give, in this regard as in every other, the example of the reserve and justice that are prescribed to each individual.

§ 8. There is, as one sees, no order of personal faculties that cannot be, in the arts that are exercised on the human body as in those that work on dead matter, a source of power and liberty of action. Let us pursue our analysis, and we will likewise discover, without much effort, that everything that enters into the stock of real objects can equally become here a means of liberty and strength.

Scarcely, for example, do I need to indicate that the location of the workshop is not an indifferent thing in them, and that the men whose profession consists in caring for, in perfecting our bodily faculties, need to choose with intelligence the place of their establishment. It almost goes without saying that a doctor, a pharmacist, a gymnast, a master of dance, of fencing, of horsemanship, cannot establish themselves indiscriminately everywhere, and that in this regard their principal object must be to draw as close as possible to the raw material, that is to say, to place themselves in the places where are gathered in the greatest number the men who have need of their services, who seek the diverse orders of faculties that each of them is particularly apt to develop.

It seems that here the good organization of the workshop is not as much to be considered as the choice of a good place. A doctor, a surgeon, often have all their patients in town; a master of dance or fencing can likewise have all their students scattered. In such cases, these artists have in a way as many workshops as there are houses where they go to practice their art, or rather one can say that they have none. But it is not always the same: they do not always act on isolated individuals; it may happen that a doctor has the greatest part of his patients agglomerated in a health establishment, in a hospice; it is possible that a dance master gathers most of his students at his home; a riding master, a gymnast, instead of going to give their lessons in town, ordinarily have an establishment where they assemble their students. All then have a workshop. A school of gymnastics, a hospital can, in a way, be considered as factories. A hospice is a factory where one undertakes to restore sick bodies to a healthy state. A gymnasium is a factory of bold, vigorous, agile men, etc. Now, it is not doubtful that the success of these enterprises depends to a high degree on the good disposition, the intelligent organization of the places where they are put into execution.

Machines do not play here a role nearly as important as in the industries that were the object of the preceding chapters. One can even less than in agriculture make use of inanimate motors. The arts that work on the human body do not execute movements simple enough for it to be possible to entrust their direction to blind forces; they do not do a continuous enough work, they do not have to overcome strong enough resistances to need very powerful agents: I do not believe that it ever happens that they act through the intermediary of a machine moved by steam or by some other physical power. A surgeon, a pharmacist, a dentist, an oculist employ only tools that are in general very simple and guided by hand. One can say as much of the gymnast, although his instruments are of a larger dimension and occupy much more space. A ladder, a mast, a knotted or unknotted rope, a swing, a trapeze are uncomplicated tools, which the student in gymnastics applies to his limbs to form them to certain movements and to develop their vigor or their skill; etc.

However, while recognizing that, by their nature, the arts with which I am concerned at this moment receive perhaps less power than others from the influence of machines, it is certainly not doubtful that their power depends in large part on the perfection of the instruments they employ. What a happy revolution has not been produced, in the treatment of certain diseases, by the discovery of certain instruments? How much, for example, has not the extraction of urinary calculi been perfected by the invention of lithotriptic instruments, which previously could be effected only by processes so cruel and so perilous? With what advantage have the mechanical beds on which one lays young persons with deformities not replaced the iron cross with which they were formerly burdened, and to which their spinal column was tied? With the help of good instruments, cancers formerly reputed inaccessible have been pursued even into the depths of the pleura and the excavation of the pelvis. It is recognized among people of the art that the falciform bistoury of Professor Dubois singularly facilitates the release of hernias. By means of the double-current catheter, invented by Hales and reinvented by M. J. Cloquet, one can practice a sort of irrigation in the bladder and pass several tons of water through it without tiring the patient [^532]. Gymnastic and orthopedic instruments can be conceived in such a way as to exercise precisely the muscle one wants, in the measure that is suitable, and Colonel Amoros has made real progress, in this respect, in gymnastics and orthopedics. It would be easy to cite other examples; but these are enough to be authorized to conclude that machines contribute essentially to the liberty of the arts that act on the human body.

One can say as much of the division of labor. I know well that there are still reasons why this element of force cannot be employed here with the same success as in other industries. It is not with the arts that work on man as with those that act on raw bodies, and which employ chemical and mechanical forces. Wherever one can operate only with the help of life, the processes of labor must necessarily be imperfect. The vital force acts in a slow and often irregular manner; one is master neither of hastening nor of controlling its march; one must wait for it to have operated; one must follow it in its deviations: these are so many reasons why the arts that make use of it do not lend themselves to a good division of labor.

There is, probably, a certain order to follow in the treatment of each kind of disease; but the state of the sick is subject to so many variations that one could not, without extravagance, think of subjecting them to a certain series of ways always the same, always uniform, and to pass them from hand to hand, like dead matter, until the complete execution of the treatment that should operate the cure. It is good, on the contrary, that, from the beginning to the end of the illness, the body of the patient remain subject to the inspection of the same individual, and this individual, instead of adopting a uniform march, is obliged to subordinate his processes to the incidents that arise and to all the variations that the body of the patient may undergo under the influence of the principle that animates it and of all the causes that do not cease to act on this principle.

The best doctor, it is said, is he who knows best how to individualize, who is most capable of discerning what is particular in each case that presents itself, who can best say, at each instant, what is the true situation of the patient and the special manner in which it is appropriate to act. There is therefore no march that one can rigorously determine in advance in the treatment of diseases, nor, consequently, any regular and symmetrical division that it is possible to introduce into the work one executes on the sick.

However, let us recognize that there is still a way to adopt a certain order in this regard and to classify the sick in such a way as to render at once easier and more fruitful the functions of the men called to give them care. All the sick are not confused in a hospice; great care is taken, on the contrary, to distribute them according to the nature of the malady with which they are affected, and it is not doubtful that this order is very favorable to the intellectual and material operations of the art [^533].

[^529]: The Lancet, 1827. [^530]: See, on this subject, the Almanach royal, article Université. [^531]: See my work entitled De l'Enseignement dans ses rapports avec l'industrie. [^532]: Dictionnaire des sciences médicales, article Sonde. [^533]: See, on this subject, the Dictionnaire des sciences médicales, article Hospice.Medicine, moreover, is not the only profession that acts on the body of man; it is not always a matter of treating the sick; it is much more often a matter of developing certain physical faculties in healthy bodies; and as life proceeds here in a more regular fashion, it appears that this work can be subjected to a more uniform course, and that it is easier to divide it among a certain number of individuals. There is a rigorous order in the sequence of movements that a young man must execute to learn dancing, horsemanship, gymnastics. Simple movements must precede compound movements, easy exercises must come before difficult exercises. Therefore, these exercises can be permanently divided into a certain number of classes, and entrusted to a similar number of workers, through whose hands the students are made to pass successively. This is even how one proceeds in a well-run gymnasium; the students there are subjected to the action of a series of pedotribes, and they pass from the hands of one into those of another until their physical education is complete. One can add that the work is not divided only among these professors: there is ordinarily in a gymnasium a director who is at the head of the enterprise, physiologists who scientifically direct the exercises, and workers, pedotribes, who have them executed; just as there are in a hospice administrators who have the material management, doctors who are its scholars, and pharmacists, aides of every kind who execute the prescriptions of science. Finally, these divisions are not the only ones that can be usefully introduced into the professions in question here, and these professions, where the work is fruitfully divided among so many persons, are themselves divided, and not without profit, into a multitude of particular arts which I enumerated above.

I will not push these remarks further. This is enough to make it understood that the division of labor, machines, the methodical organization of the workshop, the enlightened choice of locations, are also of some effect in the arts that act on the body of man, and that in sum, there is not one of the elements of which the power of labor is generally formed that does not find its application, more or less, in this one.

Perhaps, for want of having sufficiently known the particular nature of these arts that make the culture and improvement of our physical faculties their special object, I have not sufficiently marked the differences in the manner in which the principles of liberty apply to them. But what I wished above all to make felt is that they fulfill functions of high importance in society, that they create a very precious order of products, and that they become free and powerful by the same general means as all the others. I hope that this object has been more or less fulfilled. Let us now speak of those that are occupied with the education of intelligences.

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Notes

[^507]: "A great error has existed until now," observes M. de Laborde, "which is to spread instruction only among the classes that already have all the enlightenment, and to relegate the labors of the body among those who are overburdened with them. Enlightenment would be useful, on the contrary, to individuals whose occupations tend to make them coarse, while the labors of the body, introduced into the education of well-to-do families, would give them the physical strength their fathers had, with the enlightenment they have more than them." [^508]: Voyage en Angleterre, second ed., vol. I, pp. 33 and 34. [^509]: See, concerning the influence that all this exerts on the physical man, a very curious paper by M. Villermé on the height of man in France, inserted in the second issue of the Annales d'hyg. pub. et de méd. lég., p. 351 et seq. [^510]: Cabanis, Rapport du physique et du moral, etc., vol. III, p. 433 of his complete works. [^511]: The families in question here follow, as much as they can, in their marriages, the method known as inbreeding, a method that some agronomists regard, in certain cases, as the most favorable for the conservation of good breeds. Backevell thought that when a species of animal approached perfection in terms of form, its individuals should be bred among themselves. His maxim was that one must unite the most perfect animals, without examining whether or not they were of the same family: like father, like son, he would say. To which Sir John Sebright observes that there is no doubt that one should unite the most perfect subjects; but that the question is precisely to know how long, by following the method of inbreeding, a family could preserve qualities that it had only acquired through a series of judicious cross-breedings. See the Ann. agric. de Roville, vol. IV, p. 362 et seq. - The members of certain reigning houses are perhaps right to marry only among themselves; but it seems they would have been wise, before adopting this method, to examine whether they were, physically and morally, the most perfect of men, and whether they did not have to fear, by following it, losing a part of that perfection. [^512]: The women of Malaga are especially cited. [^513]: I do not wish to end these reflections on exercise without rendering a just homage to a distinguished Spaniard, naturalized among us, to whom we owe having called the attention of the French public to the importance of physical education, and having introduced gymnastics to France. In creating this precious branch of teaching in our country, M. Amoros has rendered a true service to the country that adopted him, and one all the more worthy of gratitude, as it was at first less understood, and as it required, for him to have it accepted, more zeal and more constancy. [^514]: See the history of the recent progress of surgery, by M. Richerand. [^515]: "I have always been astonished," observes a historian, "at the false ideas that have been left in our minds about the century of Louis XIV. It seems that the men and women there were privileged beings. One supposes nothing but what is agreeable and perfect in their stature or their face. The poets, especially when speaking of the princes and princesses of the blood, cannot find colors flattering enough to paint the beauty of these children of the gods. Let us see, then, the rare assemblage that this Olympus offered."Maria Theresa of Austria, wife of Louis XIV, was thin, withered, and very short; Henrietta of England, so seductive in her wit, was a bit hunchbacked; and La Vallière, as is known, a bit lame. The Grand Dauphin had his nose broken in his youth while playing with the Prince de Conti. The Duke of Burgundy, who would have been the idol of the French, nonetheless had one shoulder higher than the other. His wife, whose mischievousness delighted the court, did not have a single healthy tooth in her mouth. The Duke du Maine was lame. Mademoiselle de Bourbon, granddaughter of the great Condé, was one-armed; and Henri de Bourbon, who was minister after the regency, was one-eyed. As for the king himself, he exuded an odor that no courtier ever noticed, naturally, but which an irritated mistress one day dared to reproach him for, etc." (The Court and the City under Louis XIV, Louis XV, and Louis XVI, or Historical Revelations drawn from unpublished manuscripts, by F. Barrière). [^516]: This disease was so common toward the end of the fifteenth century that the most severe police measures had to be taken to oppose its progress; and its marks were so apparent that the unfortunate people infected with it were recognized on sight. In Paris, they were arrested within the city and at the barriers. Entry into the city was forbidden, under penalty of the gallows, to those from outside. As for those from within, they were confined to their homes, and if they were caught, they were taken to hospitals where they were given a whipping with stirrup-leathers before and after treatment. V. Dulaure, Hist de Paris, t. II, p. 515; III, p. 79 et seq.; VI, p. 24. [^517]: Revolutions and Reform of Medicine, vol. I of the author's complete works, p. 60 et seq., and p. 258 and 318. [^518]: Ibid., p. 288. [^519]: Ibid., p. 270. [^520]: Ibid., p. 288, 289 and 295. [^521]: Ibid., p. 60 et seq. [^522]: Revolutions and Reform of Medicine, p. 305 and 306. [^523]: V. Richerand, History of the recent progress of Surgery. [^524]: Cabanis, Revolutions and Reform of Medicine, p. 363 et seq. [^525]: Voyage en Angleterre, vol. I, p. 175, second ed. [^526]: Voyage en Angleterre, vol. I, p. 33 and 34, second ed. [^527]: V. The Spirit of the Laws, book XXVIII, ch. 20, 14 and 25. [^528]: Dulaure, Hist. de Paris, vol. II, p. 104, 227, 228, 661, 662, first ed. [^529]: V. the Brit. Rev. vol. XIV, p. 164 and 165. [^530]: Law of 19 Ventôse, Year XI [10 March 1803], art. 15, 26 and 29. VOL. II. [^531]: V. the Censeur européen, vol. VI, p. 50 to 121, and notably p. 110 et seq. [^532]: V., on these instruments and on a multitude of others, what M. Richerand says in his History of the recent progress of surgery. [^533]: The Arab physicians, observes Cabanis, regarded a vast infirmary as a necessary laboratory for the observations and experiments of practitioners; as a kind of gallery where young students found instructive pictures that books always retrace imperfectly. They no more believed they could do without a gathering of patients in their schools than a collection of remedies, or a chemistry or pharmacy laboratory, or a garden of plants used for treatments." (Rev. and ref. of med., vol. I of the author's complete works, p. 291.)