Quinlan Sean M
Department of History, University of Idaho, Moscow 83844-3175, USA.
Bull Hist Med. 2006 Winter;80(4):649-76. doi: 10.1353/bhm.2006.0141.
This essay examines the medical debates over hereditary disease and moral hygiene in France between 1748 and 1790. During this time, which was marked by two formal academic exchanges about pathological inheritance, doctors critically studied the existence of hereditary diseases--including syphilis, arthritis, phthisis, scrofula, rickets, gout, stones, epilepsy, and insanity--and the problems that heredity might pose for curing and preventing these diseases. Amid public debate, doctors first treated heredity with formal skepticism and then embraced the idea. Their changing attitudes stemmed less from epistemological or cognitive reasons than from new cultural beliefs about gender, domesticity, and demographic policy. Fearing moral degeneracy and demographic decline, they argued that a number of social pathologies were truly hereditary and that these diseases spread within the family itself. These beliefs were seemingly confirmed by new clinical studies on tuberculosis. Though doctors conceded that hereditary diseases might limit Enlightenment hopes to perfect society, they also suggested that sexual hygiene and physical education could cure hereditary degeneracy and transcend genealogy and descent. Consequently, they stressed that physical regeneration was a dynamic process, one that stretched from the conjugal bed to weaning and beyond. Rather than accepting the accidents of birth, physicians believed that their patients could self-consciously overcome inherited defects and thus regenerate themselves and even all of society itself. Heredity thus gave doctors an idiom with which to diagnose a felt social crisis and to prescribe appropriate hygienic responses.
本文考察了1748年至1790年间法国关于遗传病和道德卫生的医学辩论。在此期间,有两次关于病理遗传的正式学术交流,医生们批判性地研究了遗传病的存在——包括梅毒、关节炎、肺结核、瘰疬、佝偻病、痛风、结石、癫痫和精神错乱——以及遗传可能给治疗和预防这些疾病带来的问题。在公众辩论中,医生们起初对遗传持正式的怀疑态度,后来接受了这一观点。他们态度的转变与其说是出于认识论或认知方面的原因,不如说是源于关于性别、家庭生活和人口政策的新的文化观念。由于担心道德堕落和人口减少,他们认为一些社会病理确实是遗传性的,而且这些疾病在家庭内部传播。这些观点似乎得到了关于肺结核的新临床研究的证实。尽管医生们承认遗传病可能会限制启蒙运动对完美社会的期望,但他们也认为性卫生和体育教育可以治愈遗传退化,超越谱系和出身。因此,他们强调身体再生是一个动态过程,从婚姻床榻延伸到断奶及以后。医生们认为,与其接受出生带来的偶然因素,他们的病人可以自觉地克服遗传缺陷,从而实现自我再生,甚至使整个社会本身得到再生。因此,遗传为医生们提供了一种措辞,用以诊断一种切实感受到的社会危机,并开出适当的卫生应对措施。