Nineteenth-century demographers tried to take the measure of death. Years before Emile Durkheim, they counted suicide rates as barometers of social dissolution, and their rage for mathematical precision extended into all corners of 'mortal knowledge'. Reflecting contemporary anxieties over urban growth, urban squalor, industrial accidents, the persistence of cholera, and, later in the century, the declining birthrate and the spread of tuberculosis, the new ranks of social scientists calculated the consequences of a rapidly changing French society. Thomas Kselman, in this superb new book, notes the paradox: hard facts about deadly disorders both heightened fears and raised hopes that solutions would follow. Government officials tackled problems of public hygiene, doctors formed professional organisations and vied with midwives and priests as bedside ministers; and hospitals, long rejected as sink-holes of contagion where the poor went to die, improved their practices, polished their image, and increased their clientele. The change was gradual, but the trend was clear: the 19th century marked 'the medicalisation of sickness and death'. We live - or we are kept alive - by its legacy.

LRB 18 November 1993 | PDF Download