Moliere's Medics

The Hypochondriac by Molière, adapted by Edward Kemp

West Yorkshire Playhouse, 1996

Four of Molière’s comedies are satires upon the medical profession: Le médecin volant, (The Flying Doctor), L’amour médecin (Love is the Best Doctor), Le médecin malgré lui (The Doctor In Spite of Himself), and Le malade imaginaire (The Hypochondriac). In writing these, Molière was following a time-honoured comedic tradition, but they also provide the modern reader with a valuable commentary on the medical profession of his day.

The Humours – No Laughing Matter

What gives the plays their bite, then as now, is Molière’s own grudge against the would-be healers, a result of his personal experience. The physicians he consulted had failed to save the lives of his son and his closest friend, or to cure the playwright himself of consumption. He suffered from poor health for most of his life and actually died while performing the title role on, ironically, Le malade imaginaire. The enemas and purgatives that Argan undergoes in the play, along with the endless pills, potions and injections he is given, were normal procedure for the time and had doubtless been suffered on many occasions by Molière himself.

To all intents and purposes, medical practice at the beginning of the 17th century was still very much that of the middle ages, and nowhere more so than in France where the Christian dogma of medieval times had held scientific investigation back for hundreds of years. The only physician whose teachings were sanctioned by the Church was Galen, who had lived in the 2nd century AD. Galen himself had never once dissected a human body, but based his anatomy on his investigations of pigs, dogs, goats and apes. It is hardly surprising that surgery was of such a crude standard when doctors didn’t even know – and were not allowed to discover – the shape of the bones in the body, or the functions od the various organs.

Even among the best there was a dearth of basic knowledge. The majority of medics in Molière’s time still clung to medieval idea such as the interaction of the four humours (phlegm, blood, choler and bile), the four elements (earth, air, fire and water), and the four qualities (heat, cold, moisture and dryness). Most ailments were treated by blood-letting, but there were countless other procedures, from the raising of blisters to the laying on of hands. The French kings, up to Louis XVI, touched sick people to cure them of ‘the King’s Evil’ (tuberculosis of the lymph glands, then also known as scrofula).

The Body – Vessel of Shame and Sin

Any successes were more likely due to luck than judgement. Some of the herbs and remedies the apothecaries prescribed were obviously beneficial, but there was a vast array of other medicines which ranged from useless to harmful, if not downright lethal. A list of pill ingredients gives an indication of the sort of thing the poor patient had to swallow: viper flesh, ground-up jewels, dried fox lung, bear grease, crabs’ eyes, animal hoofs, spiders’ webs and – very popular, apparently – moss scraped from the skull of a convict hanged in chains. What to prescribe and when to administer it was frequently decided by study of the stars, the patient’s palm, or even by witchcraft.

Beyond science, there was superstition. Various 17th-century English remedies included pushing a child through a cleft in a tree as a cure for rickets; a black snake tied around the neck for goitre; a spider in a bag to cure fits; and many others too gruesome to contemplate. When the doctors knew no better it was hardly surprising that people sought their own cures, not that members of the medical profession should be regarded as charlatans. Strange to think that this was the same century which produced Galileo and a while host of other distinguished scientists.

Since the start of the Renaissance, around the end of the 14th century, a new era of freethinking had begum and the results were far-reaching. One outcome beyond the stuffy atmosphere of French academia, was a desire to know more about the human body which, until then, had been regarded with a mixture of shame and religious awe, However, it took time to impose on the scientific establishment views which challenged the accepted wisdom of over a thousand years.

Syphilis – a Poem

In the early years of the 16th century, four men had emerged in Europe who changed the course of medicine for good. The first was Paracelsus, who prefaced his lectures by burning the works of Galen, and who reinstated the wise and humane approach to treatment of the sick advocated by the ancient Greek physician Hippocrates. Then there followed Vesalius, who indulged in illegal grave-robbing in order to obtain corpses for dissection, and thereby managed to correct much of the erroneous thinking about anatomy. France contributed Ambroise Paré, who – an army surgeon rather than a scholar – reformed surgery from a despised and clumsy handicraft into a delicate skill requiring a sound practical knowledge of anatomy. And lastly there was Fracastoro, who explained the transmission of infectious diseases, and among whose published writings is a poem describing syphilis. All these men rated first-hand observation above obsolete theory and in so doing put medicine on a scientific basis from which it could develop.

During the 17th century, even greater advances were to be made. Radical concepts advanced by men such as Galileo, Descartes and Francis Bacon opened up new avenues of scientific approach. The microscope was invented, the circulation of the blood was discovered by the English physician William Harvey, while another Englishman, Thomas Sydenham, begam the classification of different diseases. All these things, in time, were to have an enormous effect on medical progress, but in their own day they had little impact on the practices of ordinary physicians.

Even the scientists themselves often reverted to the old ways when dealing with medical emergencies. Half a century after Harvey had been physician to Charles I, another court physician was called to attend Charles II after he had collapsed in his bedroom. The King was bled extensively; given an emetic, two phsycis and an enema (whose ingredients included rock salt, violets, aloes, and a variety of seeds); was administered a sneezing powder; had his feet encased in pigeon dung, and given a mixture (presumably to drink) which contained, among other strange things, forty drops “of the extract of a human skull”. It is hard to know now what finally carried the old King off – his original complaint or his physicians’ treatment of it.

The King’s Fistula – Every Courtier Should Have One

If this was the state of ignorance at the English court, the French court of ‘Sun King’ Louis XIV, which Molière himself frequently attended, was even worse. Due to the system of absolute monarchy, the chief aim of any ambitious physician was a court appointment, and so medical development was subordinated to the cause of personal advancement. Courtiers with little to think about other than their health and ever in need of new subjects of gossip, seized on every new recipe and cure they came across, creating a veritable culture dish for quacks. Bleeding and purging were fashionable at Court, although the very height of style was to suffer the same complaint as the King. When in 1686 Louis was operated on for a rectal fistula, more than thirty perfectly healthy courtiers clamoured to have the same procedure.

Molière found much to ridicule, and with the hindsight of 20th-century learning we can afford to look back with incredulity and a smug grin. Few today would advocate the use of dung, dirt or natural dregs in treating ailments, much less submit themselves to such treatment. On the other hand, there may be more things in heaven and earth than are dreamed of in our medical dictionaries; leeches, for one, are making a comeback based on their ability to reduce swelling in damaged tissue, and less traditional techniques like acupuncture and homeopathy are gaining ground in the West, paradoxically at a time when medical technology has, in theory, never been more advanced.

But while the paraphernalia of hospital, surgery and operating theatre becomes ever more sophisticated and frightening, it is perhaps understandable that many today look to whatever method they believe will effect a cure. However weird or wonderful they may seem, the ways of the professional healer have always been a mystery to the layman. Our lives are in their hands; we must, for good or ill, trust one another or die.