Bull. Sci. Tech. Soc., Vol. 6, pp. 23-28, 1986. Printed in the USA.

0270-4676/86 Copyright © 1986 STS Press.

HISTORICAL CONCEPTS OF THE BODY

Barbara Duden

Abstract
In the perspective of cultural history, "health" is a late 18th century construct. It
appears as a term that legitimates the organized concern for the well-being of others.
Under the banner of health, institutionalized intervention related to the redefinition and
management of women’s bodies multiply during the 19th century.
Recent women’s studies have amply documented the sexist use to which the new
health-related concepts have been put. But the semantic reconstruction of the female body
as an implicit result of the new scientific concepts has unfortunately attracted less attention.
Because it is precisely in the mirror of gynecology that the insidious new dependence of
the citizen’s well-being from professional management can be best studied. The historical
study of body images and related scientific themes is fundamental to the critique of the now
prevalent ideology of "health."
Historical Concepts of the Body
For several years I have tried to understand how German women in the 18th century
have experienced their bodies, and how a physician in Eisenach has interpreted their
complaints. As I studied these women, my own feelings about my body have begun to
change. At first I felt condescending towards these women; it seemed to me that they did
not know their bodies and were unable to recognize their real needs. However, the more I
came to understand and believe those women, the less I took my own body for granted.
My own body ceased to be for me a non-historical, natural fact.
I had always taken for granted that I have a body. None of the women I studied
referred to herself by using a possessive pronoun. I am certain to have organs and know
where they are. None of those women has visualized her innards. Whatever lies below
their skin for them is enveloped in darkness and cannot be placed within a cartesian space.
When I go to a physician I want to get rid of a disease or a pain, or prevent a future
breakdown. None of those women went to the doctor to get something fixed; they went to
find comfort in their suffering. Nothing like my categories of health or life, sexuality or
reproduction appear in their discourse.
I studied my source to reconstruct the image of the body and the sense of the body in
the 18th century. This purpose is a different one from that which usually motivates the
medical historian. I do not ask what diseases people really had, nor how well they
understood the biology of the body. My subject is not the progress of scientific
knowledge but the phenomenology of past body experience. And what these women have
to say about the experience of their flesh and blood simply does not jibe with what I
perceive as my body, and what I tend to believe about women in general. My body and
theirs belong to two kinds of space, generated from different axioms. My body cannot be
used as a map for theirs. If I want to understand what those women have to say, I have to
detach myself from the certainty that the body that I perceive as mine is a natural fact. I
was brought to study the sociogenesis of our bodies because I perceived it as a prerequisite
for the study of the past.
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Your invitation to speak to this panel has led me to discover the relevance of body
history in a different perspective. I believe that body history can support the social critic of
science in the search for new insights in medicine. Body history cannot generate such
insights but it can remove some off the accepted truths that are obstacles to them. This
panel has not been assembled to study the past but to encourage research on late 20th
century needs. One of the needs that we have come to take for granted is the pursuit of
health. This need has been only recently coined, and body history can shown when, how
and why. I find no expression of such a need in any historical source before the late 1 goth
century. Neither the women I study nor the physician can conceive of health as a goal.
They cannot think of &dquo;health&dquo; as something which is attainable and therefore will not
pursue it as something desirable. Medicine then was not hooked to the pursuit of health;
the intrinsic linkage between health and medicine began to emerge only two generations
later. Health then became one of several fundamental themes that co-evolved. The new
body which we received can be understood as a tissue that is woven out of these 19th
century thematic strands.
I willnow first share with you some observations on more than seventeen hundred
women from the small town of Eisenach, who have served me as a counterfoil with which
Ican contrast the modem body. These women are close enough to us to challenge our
understanding much more than women from distant contemporary cultures or women from
much earlier epochs in our own tradition. Then I will pick out three recent themes that we
tend to take for obvious epistemological axioms, and point out what kind of perceptions
the acceptance of these axioms exclude.

The Women of Eisenach

My women appear in the diary kept by Doctor Johannes Storch from 1719 to 1742.
He published his records in seven voluminous volumes. Many of the women he saw
appear as only one entry; most of these are peasants or town poor. On the other side there
are some five hundred women whose records appear three or more times over the years.
These are mostly the wives of artisans or ladies from the small court. Occasionally some
of the rich women have seen the doctor more than once in a day. Thirdly there are patients
whom the doctor prescribes to but never sees: he knows them only through messages they
send.

Dr. Storch’s entries into his diary vary in length from a few lines to several pages.
He first mentions his impression of the woman’s appearance, the humoral character that he
attributes to her at first sight, and her husband’s social status. The next entry into each
record relates the woman’s own story which is followed by the physician’s reflection on
what she has said. He concludes with his prescription of drugs or bleeding, his dietary
advice and his opinion about the result. There is little evidence of any physical
examination; on the rare occasion when a woman allows Storch to peep under her lifted
shirt or to palpate her swollen breast, he mentions this with a mixture of embarrassment,
consternation and pride.

The meaty part for me are the stories the women have to tell. No doubt, the male
doctor must have sometimes misunderstood, misquoted or edited a story. However, the
accent and stress, the word-order and metaphors make them sound distinctly different from
the language the doctor uses immediately thereafter to reflect on these complaints. The
women speak about hot flashes in their face and fire that rages through their marrow.
They accuse cramps, contortions and stabs in their bellies; needles cross their skill; they
have the white or the red flux and feel their flesh opening or closing or tightening up.
They have a rich, precise and vivid language that gives them the power to describe the
misery they are in. They feel that their blood curdles or clots or is thinning out. Their skin
becomes moist, fluffy, dry, puffy or red. They speak about their acceptance of
irremediable discomforts that I have great difficulty imagining: they have wounds that
continue to fester, sores that stay raw for years, rashes and itches that seem to be
constitutive parts of their existence. Without any prodding from the physician they
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volunteer these details, but they do not present them as symptoms of a disease. What they
present to the physician is the verbal embodiment of their constant, habitual reality. Their
metaphors express their experience of daily suffering of discomfort, toil and often of pain.
They do not come to the physician to be diagnosed or to get rid of a disease.
Especially when they are poor, they come to the physician as a last resort. They come
when, without him, they do not want to continue their suffering. From their outpouring
they expect that their burden be made bearable again. The visit to the doctor gives them the
occasion to make a formal, almost public confession of what they feel like. They want the
doctor to accept this self-revelation, and from this they expect consolation and renewed
strength to carry on.
In fact, the physician does not respond to their symptoms but to their stories, to their
character and to their station in life. If occasionally he takes the initiative and proceeds to
an examination, this is nothing but an inquisition into more details out of this patient’s
past, usually her menses. When occasionally a woman comes to the doctor with a
question, it is probably of the same kind. Could her present amenorrhea be the result of
her anger in an argument with her godmother at the baptism of her child? Could a fright
that she experienced in puberty, and that then constricted her breast be the cause for her
menses’ recent irregularity? Dr. Storch’s consultation room can no more be reduced to a
clinic than it can be reduced to a witchdoctor’s church. Medical historians have studied
what medical men have said to each other. They have followed through the ages how
medical discourse on the body has evolved. But what patients said has been less
documented, and how their complaints have shaped the mental guidelines of their
physician’s practice has been left almost unexplored. Storch’s performance cannot be
deciphered unless we explore the opposition in him between the learned doctor and the
practical man.
Dr. Storch is a social upstart. He studied in Jena, read widely and over the years
acquired a broad medical education. He translated parts of the work of Georg-Emst Stahl
from Latin into German and in his theory kept close to the teachings of Stahl. As a learned
doctor he seeks respectability and the approval of his peers. Storch began to publish a
century after William Harvey had published on the Movements of the Heart, and he
acknowledges Harvey’s discovery of the circulation of blood in England. But he cannot
disengage himself from his patients’ imagination. His patients’ verbal embodiment of their
bloody sufferings eclipses Harvey for Storch. Much of Storch’s prescribing and
bloodletting has the stated purpose of treating the blood of those suffering women to flow
and ebb at the rhythm that befits each patient. The body of his theories does not fully
match that of his practice, and on the latter, physician and patients largely agree. And yet,
he views this body of female experience as a man. There are certain matters on which he
prescribes against the desire of his patients, and then complains because they consistently
disobey his advice. The women, like the doctor, fear that their blood would become too
thick and lumpy. But, unlike the doctor, the women want to heat up their body, bring
themselves to a paroxysm, expel their juices, push out the curdled blood. In contrast to
them the practitioner wants to control the internal movements of their blood, lead the blood
into its appropriate path, entice it to move in the right direction, and finally put it out. The
man and the women have dissymetric views about the same flesh and blood. Several
kinds of body are contemporary in Storch’s diary.

In Storch’s practice the cobbler’s wife embodies a different kind of experience than
the lady at court. Storch responds to this difference, which is not mere cow-towing in
order to keep his rich patient. He responds to a kind of body that is unlike our
standardized 3-dimensional body map. The body of tradition is the embodied response to
the challenge that is given by one’ story and status at a precise time and place.

Medical history tells me that in the early 18th century medical science has made
major advances, but the effectiveness of medical care had not improved. Neither of these
are relevant to what I read in Storch’s practice. For instance, he has
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studied the embryology of his time. As a young man he has dissected some bodies. And
yet, the women he treats--and not only in the perspective of the women, but also in
his--have no localized uterus but rampaging wombs. Their &dquo;mother&dquo; is anxious, and when
it hurts it is perceived as roaming through the blood. Dr. Storch accepts such statements
and builds his prescriptions on them: he advises strong bloodletting at the left ankle to
bring the mother to rest. His view on pregnancy fits into the same picture. A bloated belly
might result in a hemorrhage, in the expulsion of a mole, a monster, a miscarriage or a
happy birth. As long as I held to my modem concept of an abortion I could not but ask
what was &dquo;really&dquo; happening in such cases. Were these women hedging and performing
secret abortions? Were they victims of an illusion? Was the doctor just looking the other
way? I had to unlearn to colonize the past with my verities or to use my own body as a
bridge into the past.
comparison with Dr. Storch’s patients I am out of touch with historical time and
In
space. My body can fit anywhere because it belongs nowhere. I have lost the old art of
embodying a keen sense of reality, and I feel anesthetized because the categories I was
educated to describe myself cannot be felt. The modern body is the result of a
self-description in which we use professionally defined concepts and notions. We
constantly visualize our anatomy, which literally means our dismemberment. From grade
school on we mirror our innards in charts that illustrate our skeleton and bloodflow, our
muscles, glands, and nerves as separate systems.
I did not grow into the art of suffering the macrocosmos of Eisenach or of any other
place. As a result of this, I am not embodied in a microcosmos shaped by me in
accoi hnce with the esthetic rules of my culture. The body I visualize is an an-esthetic
cluster of non-historical facts. For example, I had to identify with woman as a fact. When
I tried to find out more about this one, I entrusted myself to the guidance of other women,
and once more I was given further pictures and maps, albeit from a different perspective. I
gained so-called self-knowledge by constructing a body image that could now be compared
to a layer-cake of texts. From this body of description and measurements and norms I can
pull out any number of sheets that all fit together, although each sheet is inscribed by a
different profession and each sheet defines for me a different set of needs. My needy body
has become the rationale for a prolific service profession: the transmogrification of the
body befits that of society, and the radical newness of modem society will be understood
only when it is mirrored in the transformation of the body.
The needy body and the productive society fit each other; they are spun out of the
same yam. To illustrate their consistency I will reflect on three themes that are common to
them: reproduction, sexuality and health.

The term&dquo;reproduction&dquo; does not occur in Storch--nor any term that covers a similar
field. There is no18th century concept that comprises all and only those things in which
today gynecology deals. Storch kept a separate diary on the women who came to his
general practice, as he kept one on children or soldiers. But this does in no way make him
into a gynecologist: he dealt with the woman’s whole vita (bios), not with the woman as
an agent who reproduces life (zoe). As a result of this lack he also has no concept like our
sexuality, which we can oppose to reproduction. Sexuality has now become something
which people are prone to attribute to themselves, but not so reproduction. We might refer
to our reproductive organs, but I still have met no woman who would say &dquo;I have already
reproduced three times.&dquo; Reproduction was meaningless to Storch’s patients; they still
thought in terms of generation. Children were then bom from women, the womb had not
yet been integrated into a reproductive apparatus. Women were still delivered by other
women; not babies by professionals as 100 years laters. Women were said to give life to
their children; medicine was still far from assuming the mandate to protect human life
within their womb. The very concept of a &dquo;life&dquo; that can be publicly entrusted to medical
care does not appear before 1770 and then in the writings of the &dquo;medical police.&dquo; There
simply was no grab bag like our &dquo;reproduction&dquo; in which insemination, pregnancy,
childbirth and even lactation would fit. Reproduction has been derived from &dquo;production,&dquo;
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when this concept around 1850 became important for the understanding of political
economy. By that time, very rapidly everyday wants were being translated into needs for
commodities, and as a result all goods came to be perceived as the result of a culturally
disembedded process which was called production. Capital and labour were called the
productive factors, while the womb and housework came to be understood as the factors
through which the labor force itself is reproduced. Homo oeconomicus was outfitted with
a biological body that reflects this economic division of tasks. &dquo;Reproduction&dquo; was
ascribed to the woman as her specific destiny, and thereby the body attributed to her
became a living proof for the natural origin of economic concepts. The endowment of
women with a reproductive apparatus resulted in a cultural disembodiment of the process
of generation in analogy with the disembedding of a productive economy that signalled the
end of cultural self-sufficiency and subsistence.

The emergence of &dquo;sexuality&dquo; reflects in terms of the body a new view about the
physical universe, and does so parallel to the way in which reproduction reflects a new
view of society that is economic. Unlike sexuality, that is absent in Storch’s practice, lust
is present, but it occupies a minor place. For Storch, as for most of Galen’s pupils, lust
itself was not a medical issue. Lust attracts the doctor’s attention only when it becomes too
hot. Only intemperate lust is then classified into the medical category of the &dquo;excess,&dquo;
together with the abuse of wine and beer, overeating and all kinds of self-indulgence.
Our &dquo;sexuality&dquo; begins to take shape only after de Sade. With and after de Sade
&dquo;sexuality&dquo; becomes visible like a photographic plate that slowly develops. Juliette
willingly, Justine unwillingly are mere screens onto which club-members project their
view about sexuality. Only at this point does the history of attributes towards lust
approach that Michel Foucault has called an epistemological fault-line beyond which
sexuality is one of those multiple texts that together constitute the anatomized body.
When much later Freud describes libido as psychic energy he does so by lifting
entire sentences from an article by Helmholtz. He ties human nature to the new mythology
that sweeps the academy in the wake of discoveries in physics. As &dquo;reproduction&dquo; has tied
the body of women into the context of the labor force, so sexuality roots us in physics.
Through many centuries and until the mid-1840s, the cosmos was perceived as the result
of a dissymetric complementarity between body and movement, force and mater.
&dquo;Energy&dquo; as the one ultimate reality, as the last stuff of existence, becomes the dominant
theme only around 1870. The age-old mater, &dquo;materia&dquo; shrivels into the &dquo;principle of
energy conservation,&dquo; a kind of cosmic housewife. Energy and sexuality are but two
expressions of one theme: the genderless monism of the ultimate stuff. Sexuality
re-interprets lust as thoroughly as reproduction has re-interpreted generation. The older
words, namely lust and generation, are still in use, but their old embodiment has vanished.
History is no quarry. The better the historian remembers the past, the deeper he knows
that nothing from it can be recovered.

Finally our pursuit of health has extinguished the art of regeneration. Suffering
regeneration has been replaced by the ideal of an-esthetic maintenance and repair. The
mentality of the body-engineer and the body-accountant can be more prominent in the
promoters of self-help than among doctors.
Not the pursuit of health as a goal or as a norm but regeneration was the central
concern of old medical traditions. Overcoming my incredulity about women’s statements
opened my eyes to what is central to other texts of past times that I formerly misread. The
women relieve themselves by telling their life-story (their biology) and they ask for purges.
The doctor stimulates their outpourings of words and of blood. Both pursue the
regeneration of the patient: they try to enhance the woman’s ability to suffer, to carry on
the embodiment of the world as it happens to be, as it is. From our perspective this scene
is gory and absurd.

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I cannot help imagining that in the perspective of those women our pursuit of health
looks equally revolting and non-sensical. This is so because in 1740 their world is still
constituted under the Ancien Regime. It does not yet incorporate the pursuit of happiness
as an inalienable right. It does not place science and technology at the service of a social
pursuit of an-esthetic health.

Barbara Duden is a Visiting Lecturer in History at the California Institute of

Technology and at Pitzer College, Colleges of Claremont, Claremont, CA 91711. This
paper was presented before the Session on Medical Science: Alternative Insights and
Approaches at the American Association for the Advancement of Science Meeting, Los
Angeles, CA, May 28, 1985.

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