The Genesis of the Medical Field : France, 1795-1870
What characterized the medical field in France in 1795 as it emerged from the reconstruction
of medical and scientific institutions consequent to the abolition of the Ancien Régime was that it had already been differentiated into three distinct spaces constructed around distinct institutions. These spaces respectively produced clinical medicine, social medicine, and what were termed the sciences accessoires (i.e., sciences auxiliary to medicine). The medical field—the product of a set of closely interrelated scientific and social determinants, all concerning the functions assigned to hospitals of producing medical knowledge, training physicians and selecting an elite through a system of competitive examinations—was dominated by hospital physicians in the clinical space. That domination worked to preserve the field’s autonomy, since the spaces of social medicine and auxiliary sciences overlapped those of other fields and developed through the construction of hybrid rather than specifically medical knowledge and practices ; i.e., knowledge and practices in those two spaces could be mastered by other professional groups. However, it was through the development of those dominated spaces that medicine was able to extend the variety and types of its own practices and assume an active role in preventing disease, reducing mortality and pushing forward knowledge of life, thereby increasing its authority in French society.