Abstract

It is a truism of medical historiography that, with the rise of pathological anatomy in early nineteenth-century Paris, physicians focused their attention on the signs of the physical body, neglecting patients’ accounts of experience which had dominated in a client centred medicine. At best, an interest in the biography of disease survived on the margins of clinical practice, far away from the centres of hospital medicine. This paper examines the activities of a group of prominent London consultant physicians – William Gull, Sam Wilks and James Paget – who after years of doing and teaching morbid anatomy, turned to natural history to understand the variable manifestations of disease in their patients. They turned as well to organizing British general practitioners in a programme of research into the biography of disease. While an interest in natural history is not unknown in the second half of the nineteenth century, I will argue that this turn to the natural history of disease was rooted in the distinctive career paths of London consultants who spent multiple decades doing morbid anatomy before developing their clinical practices. It was the limitations of morbid anatomy, as they saw it, which led them to their interest in biographical medicine. Beyond the relevance of this story to medical history, I would like to explore two issues: 1) remnants of the zeitgeist – how do we best account for intellectual/epistemological developments in a discipline which resemble contemporaneous developments in other disciplines, without resorting to difficult claims about influence and/or zeitgeist? 2) Survivals: how do we best understand the survival, beyond the immediate milieu in which they originate, of heterodox intellectual traditions like the one analysed in this paper?