ABSTRACT
In modern medical practice, the physical examination of the patient’s body plays an important part. Though the range of available diagnostic technologies has widened substantially over the last years, inspection, palpation and auscultation have remained at the centre of the typical medical consultation. Medical historians have commonly considered the rise of physical examination as a fairly recent phenomenon, closely linked to the ‘birth of the clinic’ in the early nineteenth century. In early modern medicine, by contrast, authors like Roy and Dorothy Porter, Eve Keller and Edward Shorter have found, physicians were ‘reluctant to get closely to grips with the body.’1 There was a ‘nearly complete absence of physical contact’ and ‘medical diagnosis made almost no use of physical examination of the patient’.2 Indeed, in ‘the routine clinical encounters of the seventeenth or eighteenth century, anything more than the most perfunctory and formal physical contact – as for example that involved in pulse-taking – was extremely unusual between doctor and patient.’3 ‘A physician who routinely laid hands upon his patients would have appeared “eccentric, and possibly offensive”.’4 ‘When a physical examination actually occurred,’ there was ‘no palpation of the abdomen, no careful inspection of the veins in the neck … no rectal or vaginal exams.’5 In eighteenth-century France, Brockliss and Jones have found, physicians ‘still touched their patients as little as possible’.6 Malcolm Nicolson has shown that palpation figures with remarkable frequency in the case histories of Giovanni Battista Morgagni’s ‘De sedibus et causis morborum’ (1761) but even he has come to the conclusion that only ‘relatively rarely would the physician examine the patient’s body manually’.7 In the early nineteenth century, according to Stanley J. Reiser, ‘failure of doctors to examine the body in the presence of internal disease, and the reluctance of patients to allow it’, were still common.8
