The genesis of the medical field : the case of France, 1795-1870
What characterized the medical field in 1795 in France as it emerged from a process in which medical and scientific institutions had been reconstructed is the fact that it was immediately differentiated into three spaces constructed around distinct institutions and producing three types of activity : clinical medicine, social medicine, and sciences termed auxiliary to medicine. The medical field in France resulted from a set of interdependent scientific and social determinants that in turn were related to the role assigned to hospitals in the matter of producing knowledge, the way doctors were trained, and the selection of a medical elite through competitive examination. That field has been dominated by clinical medicine hospital doctors. Their domination was a means of preserving the field’s autonomy, because the spaces of social medicine and auxiliary science were constituted through overlap with other spaces and developed by constructing hybrid knowledge and practices that were not specifically medical and could therefore be mastered by other professional groups. However, it was actually through the development of these two dominated spaces that medicine extended the range and variety of its practices and managed to assume an active role in preventing disease, rolling back mortality and pushing forward knowledge of life, thereby increasing its authority within the society.