La Mettrie: Medicine, Philosophy, and Enlightenment
by Kathleen Wellman
Duke University Press, 342 pp., $34.95
More than a few notable philosophers have been doctors. Four that come to mind are Locke, Hartley, Lotze, and William James. Locke’s medical services to Lord Shaftesbury got him started on his public career as ideologist-in-chief to the Whigs, who wanted to exclude James II from succeeding his brother Charles II on the throne of England. Hartley was the associationist thinker who was such an object of veneration to Coleridge that the poet named his first son after him. Hermann Lotze was much respected by the British Hegelians of the late nineteenth century, who had all his writings translated. William James’s achievement is well known. Aristotle was, like Helvétius and Humphrey Bogart, the son of a fashionable doctor, but not a medical man himself. He was, however, biologically minded, believing that to understand the real nature of anything one must grasp what it is striving to become and asserting the continuity of all varieties of life: vegetable, animal, and human. All of these philosophers, with the exception of Lotze, but including Aristotle, were naturalistic, rather than spiritualistic, Hartley to the point of materialism and Locke approaching it.
Julien Offray de La Mettrie (1709–1751) was perhaps the most intensely medical and the most materialistic of all doctor-philosophers. He was trained in Paris and Rheims, studied under the great Boerhaave in Leiden, served as surgeon to the royal guard, and contributed to the study of smallpox, dysentery, and vertigo. He was not all that progressive in some of the details of his practice. He was in favor of bleeding and opposed inoculation for smallpox. In the history of medicine he has left only the faintest trace. His name does not appear, for example, in the gigantically comprehensive history of the subject by Arturo Castiglioni or in the well-known shorter history of Charles Singer.
Kathleen Wellman, in her solid, lucidly written, somewhat pedestrian book, argues that the materialistic and unedifyingly hedonistic philosophy for which La Mettrie is best known—a scandal to his contemporaries and an embarrassment to the philosophes among them—was a direct continuation and fulfillment of his medical interests. These were expressed in the first instance at an institutional level, in the form of a series of vigorous satires directed at the leaders of the medical profession in France. At the time his career began, physicians, who were only a fifth as numerous as the surgeons, were tightly organized to make the most of the benefits of their monopoly position in the medical world. Surgeons—the “physicians of the poor”—combined their medical undertakings with the practice of barbering. With wigs becoming fashionable, the two trades drifted apart from each other, leaving surgeons proper free for upward social movement.
La Mettrie’s case against the physicians was not just that they exploited the sick by restricting entry into the profession. His main point was that the theoretical training they received in the ancient classics of medicine and which they saw as the basis of their preeminence was …