Historisk Tidsskrift
Copyright © by Den danske historiske Forening.

SUMMARY: 

GERDA BONDERUP 

The Medical Profession in Historiography, and how Doctors "Really" 
were in Nineteenth Century Denmark 

(92:1, 64-65)

Topics related to the public health sector have seldom attracted the professional interest of historians, and until the 1960s the history of medicine had, by and large, been left to its practitioners, who generally traced a bright story of linear progress, periodically propelled by the accomplishments of the profession's outstanding figures. In the 1960s, however, during that decade of rebellious and innovative thinking, this sort of story telling provoked certain practitioners of other disciplines in a number of countries into investigating the subject for themselves: American, English and German sociologists, some anti-modernists or neocritics. But in particular, it was the French historian of knowledge, M. Foucault, who launched a devastating critique, especially of nineteenth century doctors and their significance. All this generated a new source of inspiration in the research of anthropologists, cultural sociologists and social historians. The main thrust of their results can be briefly summarised as follows. 

The powerful, mercantilist, bureaucratic state of the eighteenth century needed a large and healthy population as a recruiting ground for its standing army and new manufactures. To that end it also needed more physicians to man a new and more effective health system. On the basis of its own premises the state therefore promoted both a quantitative and qualitative improvement of the medical profession, which so far had formed a small, educated elite with high ethical standards. Industrialisation with its concomitant enlargement of the market quickly secularised its practitioners, incorporating them into the larger group of academically trained middle class, with whom they shared a sense for business, a demand for monopoly, and other rational and technical interests. Debate revolved on medical qualifications through standardised training and on the individual physician's autonomy vis-á-vis the patient as well as the profession's autonomy vis-á-vis the larger society. By the end of the nineteenth century the new doctor-power had produced a disciplined and "medicalised" population. 

This briefly sketched aggregate of pejorative assessments of the medical profession's history, at times equally outrageous and stimulating, is rooted in its authors' views on contemporary conditions, the elements of which are genealogically traced back to their origins. This is a dubious methodology, in part because erroneous present-day conceptions would be projected back into the past, and in part because it attributes to the actors of the past an exaggerated clarity of goals and resolute strategy. 

It was therefore tempting to test the conclusions of this international research on the historical development of Denmark, where it has attracted little attention. The results disclose a number of deviations from the alleged pattern. Firstly, when the Danish government established a public health system, thereby lending powerful support to the medical profession, it did so on the initiative of physicians at the royal court. Moreover, on the whole, the state intervened very little in the affairs of the profession, which for its part pursued its activities with no indications of strategic consciousness. Doctors did create an association of their own, but for medical and social purposes, not the pursuit of their own group interests. They did again access to the entire health market through the system of sick benefits associations and free health examinations, but only within a limited number of activities. And they were never granted a monopoly. During crisis situations such as the nineteenth century cholera epidemic, there was a relaxation of the elitist and autonomous character of medical practice, in as much as medical students and others with less than the prescribed medical education were called upon to help. Nor did people in the nineteenth century feel that they had been "medicalised" or disciplined, a conception resulting, perhaps, more from present-day retrospective projection than contemporary evidence. On the whole, there is much to indicate that the animosity towards the medical profession animating international research is in fact characteristics of only certain academic circles and media coverage, for to the extent opinion polls can be relied upon, the population, by and large, is satisfied with its doctors. 

Translated by Michael Wolfe