Modern medicine and the civilising process

Abstract

Medical sociology, mainly an Anglo-Saxon invention, was developed almost without any theoretical reference to Norbert Elias' work. One of the consequences of this ignorance was that a very challenging idea had been lost. This idea addressed the sociological problems associated with the historical changes that in turn affected the role played by hygiene in the normalisation of human behaviour. According to Elias' Civilizing Process, the progressive changes in human behaviour were part of global dynamics involving the transformation of both social structures and individuals' habitus. In the construction of the 'civilised behaviour' characteristic of the dominant group, hygienic preoccupation played no role. The medical discoveries of the 19th century about the infectious diseases gave a posteriori an addition of legitimacy to this civilised behaviour. Adopting Elias' perspective, I try to answer a question left unexplored in his work, i.e. the place of contemporary medical knowledge and practices within the ongoing civilising process. This question leads me to analyse: 1 the role played by 'Pasteurian hygiene in the policy of civilization' of the lower classes in France 2 the tendency towards the medicalisation of self-control behaviour and the emergence of the patient as medical auxiliary involved in the division of medical works.