Cabanis, Pierre-Jean-Georges

Cabanis, Pierre-Jean-Georges

(b. Cosnac, Corrèze, France, 5 June 1757; d. Rueil, near Paris, France, 5 May 1808),

philosophy, medicine, history and sociology of medicine.

Cabanis’s father was a landed proprietor who was interested in agricultural innovations and experiments. He was also a friend of Turgot and it was through the latter that the young Pierre Cabanis was introduced, in 1771, into Parisian society, after studying in the local church-run schools. From 1773 to 1775 Cabanis lived in Poland as secretary to Prince Massalsky, bishop of Vilna. From 1777 to 1783 he studied medicine at Saint-Germain-en-Laye, under the guidance of a noted doctor, Léon Dubreuil. On 22 September 1784 Cabanis became a doctor of medicine at Rheims. From 1785 to 1789 he lived in the immediate neighborhood of Mme. Helvétius at Auteuil and often attended her salon, where he became friendly with Volney and Dominique Garat. It was they who, after the taking of the Bastille by the people of Paris, introduced him to Mirabeau, whose doctor he became.

On the strength of his Observations sur les hôpitaux (1790) Cabanis was named a member of the Commission de Réforme des Hopitaux (1791–1793). In 1792 Condorcet moved to Auteuil, and he and Cabanis became very close friends. Cabanis helped Condorcet escape the pursuit of the Convention, although ultimately Condorcet was unsuccessful. (Arrested on 27 March 1794, he poisoned himself two days later.) In 1796 Cabanis married Charlotte de Grouchy, the sister of Mme. Condorcet and Emmanuel de Grouchy.

In 1794 the Convention had organized the Écoles Centrales, created by a decree of 1793, and Cabanis was named professor of hygiene. In 1795 he was elected a member of the Institut de France, in the class of moral sciences. Following the creation of the Écoles de Santé, which replaced the Facultés de Médecine in Paris, Montpellier, and Strasbourg, Cabanis held successively, in Paris, the positions of assistant professor at the École de Perfectionnement, of assistant to Corvisart in the chair of internal medicine, and of titular professor in the chair of the history of medicine and of legal medicine.

In 1797 Cabanis was elected to the Conseil des Cinq-Cents. He approved of Bonaparte’s coup d’etat of 18 Brumaire and was named senator. But his relations with Bonaparte, as first consul and then as emperor of the French, deteriorated as a result of distrust and mutual hostility. Cabanis refrained from attending the sessions of the Senate. On 22 April 1807 Cabanis suffered his first attack of apoplexy. He died on 5 May 1808, at the age of fifty years and eleven months.

Cabanis applied medicine to philosophy and philosophy to medicine from a purely theoretical point of view, even when he acted as a reformer.

As a philosopher, Cabanis sought in medicine an instrument for the analysis of ideas, that is to say, for the reconstruction of their genesis. His fundamental philosophical work, Rapports du physique et du moral de l’homme, is presented as “simple physiological researches.”¹ It is composed of twelve Mémoires (the first six of which were first read in the sessions of the Institute) collected in one volume in 1802. In this work Cabanis sets forth a psychology and an ethical system based on the necessary effects of an animal’s organization upon its relationships with its environment. Even the unlimited perfectibility of the human species, which renders it “capable of all things,” derives from the fact that “man is undoubtedly the most subject to the influence of exterior causes.”²

Even more than his friends the Idéologues—Antoine Destutt de Tracy, Joseph Garat, Marie-Joseph Degérando, Pierre Laromiguière—Cabanis deemed as too abstract and limited Condillac’s method of analysis, which regarded all psychic functions as transformations of sensations.³ Sensation, he contended, cannot be studied in isolation from organic needs and from sensibility (in the physiological sense of the term) in its relations to motor irritability.

As a physician, Cabanis considered, in the seventh memoir of the Rapports, the influence of illnesses on the formation of ideas and values. The text is a summary of his physiological and medical conceptions. It is without originality, especially in regard to the theory of fevers. Still, it helps us to understand the importance he attributed, from a moral and social point of view, to perfecting the art of medicine, “the basis of all the moral sciences.” Borrowing the word from the German philosophers, Cabanis termed the science of man anthropologie, the methodical joining of the physical history and the moral history of man.⁴

In the epoch of the “Lumières,” all philosophy in France merged with politics. Cabanis’s medical philosophy was no exception. In seeking the most rational means of making men more reasonable by improvement of public health, Cabanis simultaneously sought to render physicians more knowledgeable and more effective by the reform of medical instruction. The reorganization of the hospitals seemed to meet this twofold requirement. This explains Cabanis’s interest in the question, which concerns both public health and medical pedagogy.

In 1790 Cabanis published his Observations sur les hôpitaux, in which he advocated the establishment of small hospital units outside the large cities because, according to him, large hospitals preclude individual care, are conducive to the spread of contagious diseases, and ultimately make impossible “the fulfillment of the purpose for which they were founded.” From this time on, Cabanis desired that there be annexed to the hospitals practical medical schools, modeled on the teaching clinic founded by Gerard Van Swieten in Vienna, where the lessons were given in the hospital and “it is the different illnesses that serve as the textbook.”

Cabanis’s Du degré de certitude de la medécine (1798) contains a defense of medical empiricism enriched by a history of medical practice through the centuries; in this account the Hippocratic concept of nature is once more paramount, and the clearest conclusion consists in the rejection of theoretical systems. This rejection is based on the philosophical conviction that the human mind, incapable of discovering causes, should content itself with organizing, without preconceived ideas, relations of facts.

Despite its title, Coup d’oeil sur les révolutions et sur la réforme de la médecine (written in 1795, published in 1804), the principal work of Cabanis the physician, remains a purely speculative treatise. A history of medicine, retraced by Cabanis in the beginning of the book (ch. 2), allows him to affirm that the succession of nosological systems and the erroneous application of other sciences (physics, chemistry, mathematics) to medicine have discredited the art of healing. The revolutions in medicine, he says, have been only revolutions in ideas and have done nothing but engender the skepticism of the public and the arrogance of the charlatans. An effective reform is now indispensable. The new medical doctrine will be constituted by the relations of order and of logical sequence established between methodically gathered tables of observations and experiments. These relations will be extracted by philosophical analysis, combining the two procedures of decomposition and recomposition. Likewise, medical instruction ought to be given according to the method of analysis. Cabanis states that he attaches the greatest importance to making “complete collections of observations on all the human infirmities,”⁵ and to their comparison, in the clinical schools attached to the hospitals.

Although Cabanis perceived, after or along with a great many others—Vicq d’Azyr and Jacques Tenon, for example—that the hospital was the place where the reform of medicine must occur, he did not understand that this reform was not only one of observation. In making possible the permanent consultation of numerous cases of illnesses identified by the cross-checking of clinical examination and anatomicopathological autopsies, the hospital dethroned the centuries-old practice of observing individual sick people.

Although he was a friend of Condorcet, Cabanis did not understand the meaning and the interest of the latter’s researches in the application of the mathematics of probability to the analysis of social facts. The statistical method applied, over a great number of cases, to the relationship of symptom and lesion, or even to the effects of a certain treatment, would show itself, in the near future, to be more pertinent and more effective as an instrument of analysis than the genetic analysis of ideas inherited from Condillac. At the very moment when the France of the Revolution, of the Consulate, and of the Empire, under the guidance of Pinel and Corvisart, was successfully experimenting with new practices in its hospitals, Cabanis, appearing to be a reformer of public health and of medical pedagogy, remained a theoretician of a barely reformed classical medicine.

NOTES

1. Preface to the 1st ed. (1802).

2. Memoir 8, § 3.

3. Memoir 10, sec, II. § II.

4. Coup d’oeil sur les révolutions et sur la réforme (It la mé decine, ch. 1.§2.

5. Ibid., ch. 4. § 4.

BIBLIOGRAPHY

I. Original Works. Cabanis’s writings include Observations sur les hôpitaux (Paris, 1790); Journal de la maladie et de la mort d’H.-G.-V. Riquetti Mirabeau (Paris, 1791); Du degre de certitude de la medecine (Paris, an VI [1798]);Rapports du physique et du moral de I’homme, 2 vols, (Paris, an X [1802]; 2nd ed., an XIII [1805]); Coup d’oeil sur les revolutions et sur la réforms de la médecine (Paris, an XII [1804]); and Lettre (posthume et inédite) de Cabanis à Mr. F. sur les causes premières (Paris, 1824).

These works have been collected, along with many articles, discourses, reports, éloges, and notices, in Oeuvres complètes de Cabanis. François Thurot, ed., 5 vols. (Paris, 1823–1825); and Oeuvres philosophiques de Cabanis, C. Lehec and J. Cazeneuve, eds., 2 vols. (Paris, 1956), which is Corpus Général des Philosophes François, XLIV, 1.

II. Secondary Literature. Cabanis or his work is discussed in E. H. Ackerknecht, Medicine at the Paris Hospital 1794–1848 (Baltimore, 1967); F. Colonna d’Istria, “Cabaniset les origines de la vie psychologique,” in Revue de métaphysique et de morale (1911), 177 ff.; “Les formes de la vie psychologique et leurs conditions organiques selon Cabanis,” ibid. (1912), 25 ff.; “L’influence du moral sur le physique d’aprés Cabanis et Maine de Biran,” ibid (1913), 451 ff.; “La logique de la médecine d’aprés Cabanis,” ibid. (1917), 59 ff.; J. M. Guardia, Histoire de la médecine d’Hippocrate à Broussais et à ses successeurs (Paris, 1884), pp. 218–227, 442–453; A. Guillois, Le salon de Mme. Helvétius. Cabanis et les Idéologues (Paris, 1894); Pierre-Louis Ginguené, “Cabanis,” in Michaud, ed., Biographie universelle, VI (Paris, 1812) 426–433; P. Janet, “Schopenhauer et la physiologie franqaise, Cabanis et Bichat,” in Revue desdeux-mondes (I May 1880), 35 ff.; M. Laignel—Lavastine,“La médecine Françoise sous la Revolution,” in Progrè smedical (1935), no. 3, 115 ff.; and C. Lehec and J. Cazeneuve, introduction to their ed. of Oeuvres philosophiques de Cabanis, vol. I (Paris, 1956).

Georges Canguilhem