Download PDF by Patricia Kitcher, Harry Allison, Karl Ameriks, Lewis White: Kant's Critique of pure reason: critical essays
By Patricia Kitcher, Harry Allison, Karl Ameriks, Lewis White Beck, Lorne Falkenstein, Paul Guyer, Philip Kitcher, Charles Parsons, P F. Strawson, Allen W. Wood
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The ordinances establishing the Paris Faculty of Medicine in 1803 and the Academy of Medicine in 1820 speciﬁed that these institutions should The Rise of Specialties in Early Nineteenth-Century Paris 15 be devoted to the advancement of medical knowledge. 65 In these state institutions, models of disciplinary specialization were ﬁrst elaborated. But administrative logic also operated on another plane, making possible the ﬂourishing of research in a network of specialized hospitals. Unlike the private, semi-entrepreneurial institutions of London, these were part of an extensive municipal system that was set up after the French Revolution.
40 One form that such visibility for specialists took in Paris was a slowly growing trade in private teaching of specialties. Among forty-four private courses listed in Hubert’s Almanach of 1830,41 there are only ten specialty courses, seven of them devoted to obstetrics; of the three others, Pierre-Paul Broc taught a course in andrology; Octave Lesuer, in legal medicine and toxicology; and P. S. Ségalas in diseases of the genito-urinary organs. Twenty years later, however, Meding’s directory listed eighty-nine private courses being oﬀered.
The crux of my argument here is that emerging specialization in Paris was based on the coming together of a system of career competition based on some notion of advancing medical knowledge—which itself promoted specialization—with classiﬁcatory categories that emerged from eﬀorts to impose bureaucratic rationality on huge institutional structures. Both these elements were promoted directly, though in quite diﬀerent ways, by the French state. Fifth, there was no sharp distinction between medical research and practice because, except for a handful of laboratory scientists or specialists in public health, research was based in clinical practice, most often though not exclusively in hospitals.