Isabelle Coquillard’s 800-page »Corps au temps des Lumières« is a work of admirable depth, thoroughness and erudition, that brings before a wider public the findings of her prize-winning doctoral thesis, successfully defended at the University of Paris Nanterre in 2018. In essence it is a prosopographic study of the 458 docteurs régents who matriculated from the medical faculty of the University of Paris from 1707, when the Edict of Marly reorganised university studies across France and 1792, when the Revolution ended the faculty’s life. Around 90 per cent of graduates through the period remained in the capital and were permitted to teach.

Collectively the docteurs régents composed a legally-constituted corporative body – the corps of the book’s title – with its own rites, practices and privileges, including the theoretical monopoly of medical practice in Paris. In reality, this was undercut by numerous physicians qualified elsewhere who secured themselves a post in the royal medical household. Many of these latter were trained in Montpellier. Hélène Berlan’s similarly magisterial work on the Paris medical faculty’s great rival – »Faire sa médecine au XVIII^e siècle. Recrutement et devenir professionnel des étudiants montpelliérains (1707–1789)« (2013) – will allow historians to explore the many points of comparison and contrast between the two institutions. Montpellier produced nearly ten times as many practitioners across the century, yet Paris could regard itself as the apex of the country’s corporative medical hierarchy tree, and its location in the nation’s capital and its closeness to the ruler gave it access to levels of power, authority and wealth that Montpellier lacked.

Membership of the Paris faculty allowed the docteurs régents to live materially comfortable and privileged lives. Notarial archives show many of them building up solid fortunes and winning respect from within the city’s professional classes. They were also well placed to take advantage of the municipal and national government’s growing concern for public health: notably in city hospitals and parish charities, as medical consultants within the domain of »medical police« and (especially) in the burgeoning number of posts in military hospitals, army regiments and naval facilities (and to a lesser extent in the colonies). They also competed with Montpelliérains and other outsiders for positions within the very capacious royal medical household.

Dr Coquillard sees a widening of opportunities for Parisian practitioners over the period as also being linked to the general public’s growing interest in their own health and well-being. Philip Rieder has illuminated this phenomenon in private correspondence across the period and though Dr Coquillard’s analysis does not dip deeply into this source, her use of notarial documents, legal records and private papers confirms the trend and allows a perspective »from below« to inform her prosopographical emphasis on practitioners. Dr Coquillard sees these Parisian developments bearing witness to a growing process of »medicalisation« – a term that needs careful handling in view of the accepted obsolescence of modernisation theory with which the term has tended to be linked.

Dr Coquillard is on less contentious ground in exploring the city as the site of an extraordinarily buoyant medical market-place. The docteurs régents found themselves competing for custom with other physicians resident in Paris but also with increasingly popular surgeons and marginal practitioners who complemented medical consultation with retailing proprietary medicines, mineral waters and the like. The docteurs régents reacted, she shows, in two opposed ways. First, they tightened up on access, by policing corporative boundaries and keeping the costs of training inordinately high, so as to reduce internal competition. The strategy was relatively successful – the number of physicians per head of the population was less than a half of what it would be a century later. Yet the second response to competition was on the lines of »if you can’t beat them, join them«. Though decrying as undignified and unacceptable the often sophisticated marketing techniques and publicity deployed by their rivals, they themselves increasingly used commercialised practices and freely adapted to the medical whims of their patients.

Historians have followed the many Enlightenment critics of the Paris medical faculty in viewing it as resistant to medical innovation. Dr Coquillard emphasises that hers is a social-historical analysis rather than one which engages with the history of medical science. But she is aware that the faculty seemed less inclined to innovation than its Montpellier rival and its professional competitors (notably surgeons). The faculty claimed to represent »la bonne médicine«, but what this anodyne, backward-looking and uninspirational description represented lay largely in the eye of the beholder. Whilst the faculty as a corps tended to play safe doctrinally and in terms of therapeutic innovation, moreover, there were invariably good numbers of individual docteurs régents who refused to toe the faculty line on all the main medical fads and fancies of the last half century of the Ancien Régime, from smallpox inoculation and treatments for venereal disease through to medical electricity and mesmerism. They split down the middle too in their reception to the Société royale de médecine established in the 1770s as a nationwide network for research and health improvement. Some docteurs régents subscribed to the hostile views of the faculty towards it; others were quick to sign up for membership.

Dr Coquillard concludes favourably on the professional solidity of the faculty over the century and sees many of the features of the scientific medicine of the nineteenth century sketched out by these Ancien Régime forebears. It may be that by centring her study on one element in the Parisian medical world she is perhaps less fair to other groupings and interests. (And it is highly regrettable in an 800-page book that the index has no thematic element and only lists the names of docteurs régents.) Yet it is very much to the credit of Dr Coquillard’s research that so many of the contradictions and paradoxes in Parisian medicine in the age of the Enlightenment emerge so powerfully from her fine study.