The (Off)Springs of Literature and Experimental Medicine

Benjamin Gagnon Chainey

“And from this they drew the conclusion that physiology is
– as a well-worn phrase expresses it –
the romance of medicine[1].”
Bouvard and Pécuchet
Gustave Flaubert

            When the second half of the 19th century witnessed a multiplication of medical and scientific triumphs – think of vaccines, radiology, echocardiography, and the advance of psychiatry – medical practice moved away from books and treatises, as well as from unreliable subjective intuition. In an effort to embrace the rigor of scientific objectivity, physicians and their apprentices tested their knowledge and their skills against the direct trial of reality. By observing the signs and symptoms of suffering bodies, by actively evaluating and treating them, and through the analysis of the results of these actions, the medical body reduced the human body to the status of object of “pure science:” objects upon which it was possible to experiment in order to produce facts, and to tell apart what is true from what is not. In his now canonical Introduction to the Study of Experimental Medicine, the famous French physiologist Claude Bernard states:

It is therefore clear to all unprejudiced minds that medicine is turning toward its permanent scientific path. By the very nature of its evolutionary advance, it is little by little abandoning the region of systems, to assume a more and more analytic form, and thus gradually to join in the method of investigation common to the experimental sciences[2].

It is in this medical, scientific and historical context that Bouvard and Pécuchet–two copyist-companions who are the protagonists of Gustave Flaubert’s 1881 “encyclopedia of human stupidity”[3]–leave Paris together to move to the countryside, where they hope to experiment and know everything. From agriculture to theology, through chemistry, medicine, history, literature and philosophy, Bouvard and Pécuchet improvise for themselves roles as the caricatures of Denis Diderot and Claude Bernard. They survey the knowledge contained in all of the treatises, manuals and encyclopedias of the time, and try to capture the ways it manifests itself in various experiments and experiences. However, in the majority of them, and in particular when it comes to medical experiments, Bouvard and Pécuchet prove to be poor medical autodidacts. They are incapable of comprehending that anatomic terms refer to body parts in various and complex ways, and study them only as semantic curiosities, as is illustrated by the scene where they dissect a pasteboard manikin:

When they were tired of one organ they went on to another, in this way taking up and then throwing aside the heart, the stomach, the ear, the intestines; for the pasteboard manikin bored them to death, despite their efforts to become interested in him. At last the doctor came on them suddenly, just as they were nailing him up again in his box.[4]

Bouvard and Pécuchet, copyists by trade, cannot muster the intellectual and analytic capability to look beyond the autonomy of the words, or that of each separate organ, to capture their modulations and relations, in all their equivocality and mutual influence. In that sense, the rigidity of their reasoning contrasts with the 19th century’s movement towards an epistemological conversion that would at once solidify clinical practice and make it suppler: a conversation that would make reason sensitive to unreason. That is what Jean-Charles Sournia, the French surgeon and historian of medicine, explains:

Medicine became truly scientific in the 19th century, thanks to the efforts that began in the previous centuries. The publication of many books whose titles include, in one way or another, the word “rational,” is indicative of the time’s spirit. Not that earlier periods had not counted on “reason,” but we know of the nuances between “reasoned” and “rational,” and of the traps that “reason” can pose depending on place and culture[5].

Those (un)reasonable nuances and traps are legions in Bouvard and Pécuchet’s encyclopedic quest. Consequently, while they are physician’s and scientist’s apprentices, it appears that the two companions are also sufferer’s apprentices: access to knowledge, through a to-and-fro between reason and unreason, is not without pain – “and the more ideas they had, the more they suffered[6].” Beyond their physical body, object of pure science at the service of experimental medicine, Bouvard and Pécuchet’s suffering becomes an epistemological suffering. One must suffer to know, it seems, and the more the apprentices know, the more the unknown reveals itself to them, to their eyes, at the bottom of their hearts, and deep inside their brains. In a paradoxical way, the trial of experimental medicine turns out to destabilize the certainty of their bookish knowledge, at the same time as it solidifies it. Bouvard and Pécuchet’s quest to learn requires them to “unlearn” a total experiment, where intellectual flexibility is primordial to capture the paradoxes at work not only in literature, but also at the very heart of medical practice:

They read the prescriptions of their physicians, and were surprised at the fact that anodynes are sometimes excitants, and emetics purgatives, that the same remedy suits different ailments, and that a malady may disappear under opposite systems of treatment. Nevertheless, they gave advice, got on the moral hobby again, and had the assurance to auscultate. Their imagination began to ferment.[7]

However, this imagination shared by the two men does not leave their bodies. It draws its inspiration from their organs, even as science attempts to study them. Hence “the brain inspired [Bouvard and Pécuchet] with philosophic reflections,”[8] and it appears that as they move from books to experiments, the companions’ medical epistemology undergoes a form of backwash. “The springs of life are hidden from us, the ailments too numerous, the remedies problematical. No reasonable definitions are to be found in the authors of health, disease, diathesis, or even pus.” After moving from books to clinical experimentation, Bouvard and Pécuchet find themselves having to operate a second conversion, this time towards the philosophical and back to the literary. For “if the springs of life are hidden from us,” it does not prevent them, “those (off)springs,” to act on reality as much as on the languages that attempt to capture them, to analyze them, and to make sense of them. These actions translate into clinical examination, into remedies and poisons. Not unlike Plato’s pharmakon, and the pharmacy Derrida[9] built around it, literature and experimental medicine are evidently becoming inextricably related in Bouvard and Pécuchet’s incredible adventures. In the heart of a 19th century that witnesses, among others, the translation of Hippocrates by Littré,[10] Bouvard and Pécuchet’s experimentation with the imbrication of the medical and literary is all the more eloquent. It is essential to any apprentice aspiring to understand the signs and symptoms of disease, and to undertake diagnostic exams to evaluate them and treatments to remedy them. If they cannot cure disease, at least will they have the intellectual flexibility – and the imagination – to apprehend this impossibility.

In this sense, following Jean-Charles Sournia, the French surgeon and historian of medicine, Dr. Claude Bernard, even though he was convinced of the benefits of the experimental medicine he founded,[11] still remained sensitive to its limits, both epistemological and practice. For Bernard, objectivity does not consist in negating abstraction in itself, and scientific rigor is not the assertion that nothing subjective, fluid, and silent exists, invisible to instruments: “the kind of materialism that affirms there is nothing beyond matter is outside of science.”[12]

Perhaps Bernard owes this sensitivity to his first love, theatre, more than to his scientific and medical vocation, which came later in his life.[13]  Like Bouvard and Pécuchet, Bernard walked all his life in a precarious balance on the thin rope that separates literature and medicine, philosophy and science. He continuously adjusted his balance through a series of epistemological conversions, until the two seemingly distinct realms proved to be just one. Like Bouvard and Pécuchet, Dr. Bernard found a balm to soothe his epistemological suffering in the wise maxim he developed in his own adventures,  which serves as a slogan for both medical-experimental and literary endeavors, a call to solidarity across kinds of knowledge in the 19th century. It continues to resonate in the dawn of the 21st century, through scientific voices reverberated by the humanities: “Unique truth, in whose search science is engaged, will only be reached when all of the sciences reciprocally penetrate each other.”[14] All the sciences–and, as Bouvard and Pécuchet, the copyists, would undoubtedly add–all the literatures too.

 

[1] Gustave Flaubert. (1881). Bouvard and Pécuchet. http://www.gutenberg.org/etext/25014. p. 63.

[2] Claude Bernard. (1865). An Introduction to the Study of Experimental Medicine. p. 1. Translated by H.C. Green. London: University College. https://archive.org/details/b21270557

[3] Pierre-Marc de Biasi. (1999). La Galaxie Bouvard et Pécuchet. In Gustave Flaubert, Bouvard et Pécuchet. Paris : Le Livre de Poche, p. 7. My translation of “encyclopédie de la bêtise humaine”.

[4] Gustave Flaubert. (1881). Bouvard and Pécuchet. http://www.gutenberg.org/etext/25014. p. 58.

[5] Jean-Charles Sournia. (1997). Histoire de la médecine. Paris : Découverte. p. 199. My translation.

[6] Gustave Flaubert. (1881). Bouvard and Pécuchet. http://www.gutenberg.org/etext/25014. p. 11.

[7] Ibid. p. 65.

[8] Ibid. p. 58.

[9] See Jacques Derrida. (1972). “La pharmacie de Platon” in La dissémination. Paris : Éditions du Seuil, Points Essais. 445 pages.

[10] Jean-Charles Sournia. (1997). Histoire de la médecine. Paris : Découverte. p. 213.

[11] In this sense, posterity will have proven Claude Bernard right, as his works are still highly praised within today’s medical and scientific circles.

[12] Claude Bernard cited by Jean-Charles Sournia. (1997). Histoire de la médecine. Paris : Découverte. p. 211. My translation.

[13] Ibid. p. 211.

[14] Ibid. p. 212.

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