Memoirs on Paris hospitals

way to a further divergence between medical researchers, such as comparative anatomists, and clinical practitioners during the era of university reform after the breakup of the Holy Roman Empire and the ReichsdeputationshauptschluJ3 of 1803. The competing cultural politics of the German states provided another public sphere for this theory-practice division. In his conclusions Broman notes that it is remarkable that the German medical profession "retained a veneer of professional unity at all", yet he insists that with the "discourse of theory and practice" it had acquired "a crucial characteristic of modem professionalism". These statements point to some rather neglected aspects in his otherwise very instructive historical account. The formation of professional identity, as any identity, requires similarity as well as difference and demarcation. It would therefore have been helpful if the identity of eighteenth-century academically educated physicians had been contrasted with that of surgeons and of apothecaries, and if doctors' complaints about Kurpfuscherei, i.e. transgressions of competence and unlicensed practice, had been examined more closely. The academic rise of surgeons towards the end of the eighteenth century might have provided another interesting case for the study of a changing professional identity. In this way physicians' sense of unity despite internal theory-practice divides might have become clearer. Moreover, Broman's account tends to overrate the historical importance of Brunonianism as an attempt to ground medical practice on scientific principles. latrochemistry, iatromechanics, and Stahlianism can be seen as having made similar claims earlier-claims for which medical inaugural dissertations (usually reflecting the professors' opinions) provided an academic sphere. Also "empirical" practices in the eighteenth-century, such as the trying out of new treatments and record-keeping in case histories, aimed via inductive reasoning at improved therapeutic concepts. I agree, however, with Broman's argument that the public sphere created by the general review periodicals was something qualitatively new, and that doctors' public claims of scientific practice must have been central to their professional development. Broman sees a problem in the fact that in the course of the nineteenth and twentieth centuries, i.e. the main period for medical professionalization, scientific knowledge has become less accessible to the general reader, and he tries to save his argument by stating that it has still remained "accessible in principle", though "recondite in practice". Yet, his point can also be supported in another way. In the second half of the nineteenth century German academic medicine began to be confronted with a number …