Mission and method: the early-nineteenth-century French public health movement
There are then, some knotty problems of overall interpretation in this work. They do not, however, detract from the immenseness of Dora Weiner's achievement, nor the debt in which she leaves us all. Following a trail blazed by Erwin Ackerknecht and later illuminated by William Coleman, Ann La Berge provides a full-scale analysis of the public health movement in post-Revolutionary France, and especially in the 1 830s and 1 840s. Her coverage of public health interest is exceptionally broad and researched with commendable intensity. The public and private hygiene of early nineteenth-century Paris, that laboratory of public health experimentation, as well as the city's water-supply, sewerage and waste disposal, hospitals and poor relief, food quality, patent medicines, epidemic controls, vaccination schemes, housing regulations, prostitution and wet-nursing all and more come under her microscope. The main focus of her interest is the ideology of what she calls "hygienism", and her way into this is largely prosopographical: the main actors in her story are the motley crew of physicians, administrators, enlightened philanthropists, scientists and engineers who dominated the Paris health council and who, from 1829, wrote in the pages of the Annales d 'hygiene publique et de medecine legale. This was a high-profile and self-conscious group-self-regarding too, with a strong sense of social mission. Largely shunning efforts at mobilizing public opinion, they operated in a way which evoked the enlightened "medical police" and social medicine traditions which had evolved before 1789. Compared with similar groups in western Europe at the time, Professor La Berge shows, the Paris hygienists were highly statist in their approach and tended to concentrate their efforts on influencing the administrative and legislative efforts of government. Their sense of mission was crucial, for throughout the period, they had an uphill fight against the dominant non-interventionist policies associated with laisser-faire liberalism. Professor La Berge is exceptionally thorough and helpful in showing how this group went about its task, and how they developed and elaborated the "scientific" discipline of hygienism. She is perhaps less successful in providing a broader explanatory framework to highlight their successes and their failures. For such a high-profile group with a strongly statist orientation, it is chastening to learn that by mid-century, their only real legislative success was a (largely unenforced) child labour law. Though it is true that Napoleon III implemented many of the policies with which their names had been associated, La Berge is not …