1: Marat the Physician
Marat’s first calling was to the art of medicine. Why he chose medicine and exactly how he began his education in that field is not clear, but he started medical studies in his late teens, at the University of Bordeaux, during the two years he spent in that city from 1760 to 1762. After that he was in Paris, from 1762 to 1765, attending classes on a variety of subjects, including medicine. According to his own later account, his first cure—perhaps as early as 1764 or 1765—was the successful treatment of a friend for a case of gleets, a painful and embarrassing manifestation of gonorrheal disease.
In 1765 Marat moved to England, where he says he practiced medicine for ten or eleven years. Two case studies in his published pamphlets that provide detailed accounts of at least some aspects of his medical activities in England are dated October 1769 and January 1773. In 1776 he returned to Paris and quickly attracted an aristocratic clientele. His career as a physician continued until the early 1780s when he transformed himself into a full-time experimental physicist.
Although Marat has frequently been portrayed as an itinerant quack without credentials, a patent-medicine huckster, or a horse-doctor, he did in fact possess a valid medical degree and practiced in Paris as a high-society physician with a good reputation among the rich and famous, including high-ranking members of the royal court.
Marat’s M.D. degree was awarded to him by St. Andrews University, Scotland, on June 30, 1775. Hostile commentators have often alleged that since Marat apparently attended no classes at St. Andrews he must simply have bought the degree. The diploma was signed, however, by two legitimate medical examiners—Dr. William Buchan and Dr. Hugh James—who affirmed Marat’s competence as a doctor. Their judgment is corroborated by the two medical pamphlets Marat published a few months later, which will be discussed below. One of Marat’s examiners, Dr. Buchan, was an important medical author whose works went through multiple editions in French as well as in English.
St. Andrews’ method of awarding degrees may seem insufficiently rigorous by modern standards of medical education, but such comparisons are unwarranted. Marat’s degree was legitimate according to the standards of the day. By the time Marat received his degree in 1775 he had been making his living as a doctor for some ten years. In the eighteenth century it was common practice for universities to award degrees as a means of certifying the professional competence and educational preparation of working practitioners who had not actually attended classes at those institutions—a practice that continued in France well into the nineteenth century. Furthermore, in spite of a frequently quoted wisecrack by Dr. Johnson to the effect that St. Andrews “grows richer by degrees,” the Scottish university did not have a reputation as a mere diploma mill; Benjamin Franklin was proud of the doctorate it had conferred upon him.
Not a great deal is known about Marat’s medical practice in England—the first five years are an almost complete blank—but enough is known to reject the tales that make him out to be a shady, down-and-out character with no legitimacy as a physician. First of all, the address of his practice was Church Street in Soho, which at the time was London’s most fashionable section. Furthermore, his social milieu consisted in part of a group of talented and important artists. Among them was Angelica Kauffmann, later a renowned painter, with whom Marat is reputed to have had a love affair. Finally, his publications of that period testify to his general medical knowledge as well as to his familiarity with certain specialties, such as eye disease and electrotherapy.
After moving his practice to Paris in 1776, Marat rapidly built a list of patients that included well-placed and important people. Exactly how he originally gained entrée to these aristocratic circles is not known, but one particular incident that propelled his career forward stands out. Marat’s reputation as a healer was greatly enhanced in 1777 by his success in treating one especially influential patient, the marquise de l’Aubespine. She credited Marat with curing her of a chronic respiratory ailment that other doctors had said was incurable. The case was publicized in the Gazette de Santé, increasing Marat’s prestige.
Since Marat was a newcomer, the publicity annoyed some members of the Parisian medical establishment, leading to a counterarticle in the Gazette de Santé questioning the value of Marat’s therapeutics. Then the marquis de l’Aubespine himself entered the debate and publicly attributed his wife’s restored health to Marat’s medical skills. Marat’s reputation was secure, at least in the milieus that mattered to him. Not all of his aristocratic patients were satisfied customers, however. In December 1777 the comte de Zabielo, upset over the amount of Dr. Marat’s bill, physically assaulted him. Marat and his personal servant, it seems, were lucky to escape serious injury. Zabielo threatened to ruin Marat’s reputation, but the challenge seems not to have affected Marat’s ability to continue charging high fees.
Aside from his lucrative private practice, Marat also held an official position that entailed a great deal of prestige and an annual stipend of 2,000 livres a year (roughly twice the annual wages of an unskilled laborer): From 1777 to 1783 he was a physician in the household of the comte d’Artois, a “prince of the blood” (that is, a brother of King Louis XVI). It is likely that Marat was introduced into these lofty circles by the marquise de l’Aubespine, who was the niece of the duc de Choiseul, one of the King’s most powerful ministers.
The nature of Marat’s employment by the comte d’Artois has frequently been distorted—for example, by such influential historians as Thomas Carlyle and Jules Michelet, both of whom accepted for good coin the allegation that Marat had been merely a horse-doctor. The motive was to expose Marat as a faker for claiming more importance than he deserved. On the title pages of his major publications, Marat had identified himself as “Physician to the Comte d’Artois’s Company of Bodyguards.” According to his detractors, Marat had been nothing more than a lowly veterinarian in Artois’s stables.
Historians still repeat this canard in spite of the fact that as long ago as 1927 Gottschalk observed that “a glance at the Almanac Royal” serves to disprove it: “There he is listed as Doctor of the Body-Guard of the Count of Artois until the appointment of his successor in 1786, although he resigned in 1783.”
Marat may in fact have served for a while as physician to Artois’s squires as well as to his bodyguards; this seems to be the only real link between Marat and the stables. That would still not make him a veterinarian, of course, since squires are not horses. (It should be noted in passing that veterinary medicine was not held in the low esteem that Marat’s detractors seem to think. Its utility to agricultural science was perceived as having highly beneficial economic implications. L.J. Daubenton’s prestige as a scientist was based in no small part upon his contributions to veterinary medicine.)
Evidence of hostility to Marat on the part of academic doctors of the University of Paris’s Faculty of Medicine, and of Vicq d’Azyr and other members of the Royal Society of Medicine, has often been cited to signify that Marat, far from being part of the official medical profession, had been shunned by it. An excerpt from a Parisian police dossier, for example, reveals that his medical enemies even sought to use the power of the police against him:
Marat: Bold charlatan. M. Vicq d’Azyr asks, in the name of the Royal Society of Medicine, that he be run out of Paris. He is from Neuchâtel in Switzerland. Many sick persons have died in his hands, but he has a doctor’s degree, which was bought for him.
Marat’s rivals also struck at him by submitting the medicine he used to cure the marquise de l’Aubespine—and which he was selling to the general public—to chemical analysis. The abbé Tessier, doctor-regent of the Faculty of Medicine, issued a report stating that Marat’s “eau-factice-pulmonique” was simply chalk dissolved in water. Charges of quackery and charlatanism against Marat intensified. Again, however, the context must be considered. Techniques of chemical analysis were in their infancy. The therapeutic efficacy of spa waters was routinely evaluated on purely empirical grounds. Marat’s pharmacology fell within that tradition; there is no evidence of fraud on his part.
As for Marat’s alleged alienation from the medical profession, it is worth recalling what his opponents represented. One medical historian has described Tessier’s institution, the Parisian Faculty of Medicine, as “the most formidable opponent of change and medical advance” in prerevolutionary France.
The medical establishment was itself divided: The Royal Society of Medicine (founded in 1776, the year of Marat’s return to France) and the Faculty of Medicine were battling each other for the right to determine, by means of control over licensing procedures, who was an official physician and who was not. Before the Revolution, of course, that was ultimately a matter of royal prerogative; both the Faculty and the Royal Society looked to the court to sanction their authority.
Meanwhile, Marat’s position on the comte d’Artois’s payroll clearly signified that he already enjoyed the court’s official approval and needed neither the Faculty nor the Royal Society to ratify it. In the context of old-regime society, Marat was incontestably a legitimate member of the medical profession, and a relatively high-ranking one at that.
Marat the Clinician
Historians of medicine have recently begun to assess Marat’s actual performance as a doctor. Jean François Lemaire, for example, has concluded that Marat was on the leading edge of—and perhaps even in advance of—the medical revolution described by Michel Foucault in his Birth of the Clinic. Lemaire observes that:
Consultations in the 18th century were very different from what they became in the 19th. They were practiced at a distance. The doctor did not see the patient; he received a written account of the sick person’s complaints and responded with a lengthy report, usually several pages long, ending with prescriptions.
Marat’s approach was significantly different. From the evidence contained in the account of his treatment of the marquise de l’Aubespine and other published case studies, it is clear that he examined patients face to face.
Marat, already working in a clinical setting, posed precise questions [directly to the patient] that oriented his process of diagnosis.
Foucault contended that a revolution in medicine occurred when the eighteenth-century question “What’s wrong with you?” was replaced by “Where does it hurt?” in the early nineteenth century. Marat, says Lemaire, “broke through that frontier” in the 1770s at the latest. He believes Marat to have been a “conscientious and knowledgeable practitioner, a pioneer clinician, and an imaginative and prudent therapist.”
Marat’s published writings on medical subjects also testify to his professional competence. His first major published work, A Philosophical Essay on Man (1773), was primarily a metaphysical treatise, but he based his argument on anatomical and physiological data. In this book Marat joined the company of those who, like Descartes, attempted to demonstrate a specific physical link between the human body and the human soul. Marat’s proposed solution to the old mind-body conundrum was to locate the physical link in the meninges (membranes enclosing the brain). Although that hypothesis proved to be of little consequence, the work as a whole serves to show that Marat had a good command of contemporary anatomical knowledge.
The Philosophical Essay on Man, which he had written in English, also appeared two years later as De l’homme, an expanded three-volume French edition published by Marc Michel Rey in Amsterdam. Rey, a major publisher of Rousseau’s works, was “among the most powerful publishers of the Enlightenment.” That Marat was already playing in the major leagues, so to speak, of French intellectual life, or was at least on their fringes, was further indicated by a caustic rejoinder that De l’homme elicited from Voltaire. Diderot, too, was critical of Marat’s work, but considerably less so than Voltaire.
Marat had wandered into the factional literary politics of the Enlightenment; polemics he had directed against Helvetius had provoked Voltaire’s ire. Some years later, during the Revolution, Marat remarked that Voltaire’s irony might have wounded him if it had been deserved. In any event, he observed, it put him in good company since Voltaire “had taken the same liberty with Montesquieu and Rousseau.”
Marat also wrote two smaller, more specific medical treatises; one having to do with the erupting sores associated with gonorrhea (“gleets”), and another on a particular disease of the eyes that he called “accidental presbytopia.” Both papers, written in English, present clear descriptions of his prescribed treatments and recount several case histories to illustrate their successful implementation.
In the first paper, Marat explains that he discovered “the most effectual method of curing Gleets” by “reflecting on the deplorable condition of a bosom friend.” Calling on his friend in Paris one day, he found him suffering from the painful venereal condition and “in the deepest melancholy.” His friend was “on the point of marriage to a young lady of fortune whom he loved,” but “with whom he could not bear the thought of engaging, while under so cruel a circumstance.” Marat agreed to try to cure him.
The same day he took an apartment next to mine. I immediately began his treatment, attended him closely, and by suppuration properly conducted, [he] was radically cured in seven weeks.
Marat explains that the purulence of gleets had often previously been “attributed to a relaxation of the afflicted parts, an opinion still in credit among the ignorant.” Not so, says Marat; “it is wholly caused by ulcers.” The discharge “comes from the ulcerated glands of the internal tunic of the urethra.” Marat attributes this discovery to a prominent Parisian doctor, Jacques Daran, who had “attempted to cure gleets by suppurative bougies.” (These were probes to be inserted into the urethra in order to draw out pus.) While acknowledging that Daran’s technique was rational and represented an advance over previous therapies, Marat felt that it failed in far too many cases. Furthermore, it often left the urethra permanently damaged, making erection painful and urination difficult.
Marat’s own experience in treating gleets led him to conclude that the principle defect of Daran’s method was that it was too harsh and invasive. Marat continued to employ “suppurative bougies,” but he experimented with gentler materials and chemicals that were less astringent, and found some that he believed were far more effective in curing the underlying ulcers. He further insisted that the strength of the chemicals should be varied “according to the stages of the disease” rather than applying them at full strength at all times. The paper describes his techniques and materials in detail in order that they could be adopted by other practitioners, and concludes with the optimistic rallying cry: “There is no gleet incurable.”
Marat’s second paper had to do with “a singular disease of the eyes, hitherto unknown, and yet common.” The primary symptom of the disease was a sudden onset of far-sightedness—“near situated Objects can no longer be seen.” This symptom is not unusual in people over forty whose lenses naturally undergo a loss of accommodation, but Marat was finding it in acute form in much younger people, accompanied by eye pain and a diminished ease of lateral eye movements.
It was not, Marat believed, a natural condition, but was caused by some of the medicines doctors were prescribing for various ailments: This “accidental presbytopia,” as he calls it, “is ever the fatal Consequence of taking prepared Mercury without proper Care.” He presents a theoretical explanation of how mercury does its damage and suggests that most oculists were unaware of the problem because of their lack of knowledge of the science of optics with regard to the structure of the eye.
He then outlines a prescribed course of treatment and illustrates it with three case histories. These three cases, he says, are the only ones of their kind that he ever treated; “they indeed are not numerous, but are sufficient to prove the [recommended therapy] as safe as it is rational.”
Marat’s treatment included a mixture of traditional elements (“a moderate Bleeding at the foot . . . once every Week”) and avant-garde techniques (“some electrical Sparks are to be drawn from the Canthi of the Eyes, Morning and Evening, during a few Weeks”). As retrograde as bloodletting seems to modern readers, it was part of the standard medical repertoire well into the nineteenth century and “continued to be used in France until the 1920s.”
His first patient, an eleven-year-old girl named Charlotte Blondel, was afflicted to the point that “she could hardly distinguish any Object.” Marat devised a vision test for her: “I framed a Scale, whereon I marked the nearest Distance she could tell the Hour by a Watch.” After two weeks of treatment, “the Distance was Eight-and-Twenty Inches.” A month later the distance was 22 inches and eventually, when she could read the watch at nine inches, Marat pronounced her cured. The two other case histories reported equally satisfactory results.
Marat’s work on diseases of the eye, which grew out of and stimulated an interest in optics, was one of the paths that led him from medical practice to experimental physics. A recent study concludes that “for Marat ophthalmology had already become the combination of physiological optics, medicine, and ocular surgery that today still represents the three aspects of the specialty.” Marat’s “principal merit,” according to this study, was his opposition to the widespread use of mercury in treating eye problems. Marat’s “refusal to use this toxic substance” represented “good sense” on his part; the prestigious doctors of the Faculty of Medicine, by comparison, “did not play a very good role” in the controversy over this issue.
Another connecting point between Marat’s interests in medicine and experimental physics was electrotherapy. Marat’s electrical experiments with small animals led him to challenge the efficacy of certain therapeutic fads, such as generalized “baths” of positive and negative electricity, and convulsive shock treatments. Instead, Marat recommended the use of milder, localized electrical stimulation for specific ailments. He carefully recorded the results of his electrical treatments and catalogued their possible curative effects.
After he had left medical practice to concentrate his efforts on experimental physics, Marat drew on both areas of his expertise to produce an essay on the medical uses of electricity. His Mémoire sur l’électricité médicale (1783) won first prize in a provincial academy’s competition. In the essay, he described his own clinical applications of electricity, surveyed the various ways other doctors had utilized electricity as a healing agent, and attempted to distinguish between valid and invalid therapies. He was sharply critical of the electrical cures claimed by a rival, the abbé Bertholon, and skeptical of Dr. Mesmer’s animal magnetism, which was at that time taking Paris by storm.
To sum up the evidence concerning Marat’s practice of medicine: His credentials were genuine, his clientele was socially substantial, his writings demonstrated medical knowledge, his techniques were state-of-the-art, and the testimony of his patients suggests that his healing powers were commensurate with contemporary standards. Without advancing claims as to the efficacy of his cures or as to any enduring contributions he may have made to medical science, it is reasonable to conclude that Marat was at least justified in presenting himself as a professional physician in prerevolutionary France. The charges of quackery, charlatanism, or fakery arose from rivalries within the nascent profession, and were amplified after Thermidor as a weapon in the ideological war against the memory of Marat the revolutionary.
 Marat, An Essay on Gleets.
 The two pamphlets were An Essay on Gleets and An Enquiry into the Nature, Cause and Cure of a Singular Disease of the Eyes.
 The full text of Marat’s diploma (translated from Latin to French) is in F. Chèvremont, Jean-Paul Marat, 363–5.
 William Buchan (1729–1805), Domestic Medicine; or, The family physician (1769). See Jean François Lemaire, “Le Dr. Jean-Paul Marat, médecin parisien,” in Lemaire and Poirier, eds., Marat homme de science?, 17.
 See Lemaire’s discussion of Marat’s degree, “Le Dr. Jean-Paul Marat,” in Lemaire and Poirier, eds., Marat homme de science?, 16.
 The only source of information on Marat’s first years in London is a few anecdotes collected in 1793 by Joseph Farington, an English painter and an important member of the Royal Academy. Farington himself had not directly encountered Marat, but his diary reports conversations with people whom he says had been “well acquainted” with him (The Farington Diary, vol. I, 23; see the entry for Sunday, 26 October 1793). By the time Farington recorded his remarks, Marat’s reputation in England had become that of a revolutionary fiend; nonetheless, the diary yields a few bits of apparently reliable data.
 Farington (see note 6, above) received most of his information about Marat from an Englishman named Hamilton, who like himself was a painter and member of the Royal Academy. Most of Marat’s other London friends seem to have been foreigners with whom he apparently spoke Italian rather than French. In addition to Angelica Kauffmann (who was not Italian but had lived in Italy for many years) were a Venetian artist, Antonio Zucchi, and an architect, Joseph Bonomi. According to Farington, “Hamilton studied under Zucchi, to whose house Marat came in the most familiar manner.” Young Doctor Marat “cured Bonomi the architect of severe complaints twice or three times” (The Farington Diary, vol. I, 23).
 The allegations of Marat’s intimacy with Kauffmann are possibly true but the evidence supporting them—mainly the hostile Mémoires of Jacques Pierre Brissot—is not compelling. Brissot claims that Marat had boasted to him of his liaison with Kauffmann (Brissot, Mémoires, vol. I, 196). Kauffmann and Antonio Zucchi (see note 7, above) married in 1781 and by 1782 were living in Italy.
 Gazette de Santé, 13 November 1777, 189–90. See Vellay, “Supplément à la correspondance de Marat,” 81–4, 89–94.
 Gazette de Santé, 27 November 1777.
 Ibid., 4 December 1777.
 See Cabanès, Marat Inconnu, 90–1, 500–10.
 Ironically, Marat’s royal patron, Artois, would later turn out to be the most intransigent of counterrevolutionaries, heading the émigré army attempting to crush the Revolution. After the Bourbon Restoration ended Napoleon’s reign, Marat’s former employer headed the ultraroyalist faction and finally in 1824 ascended to the throne himself as Charles X. He was deposed by the revolution of 1830.
 Gottschalk, Jean Paul Marat, 9. As recently as 1979, historian of science J. L. Heilbron wrote that Marat had been “doctor to the grooms, or perhaps the horses, of the Duc d’Artois.” Heilbron, Electricity in the 17th and 18th Centuries, 429.
 See James Guillaume, “Le Berger Daubenton: Encore une légende contre-révolutionnaire.”
 Quoted by Robert Darnton, Literary Underground of the Old Regime, 26–7. Darnton gives the source as Lenoir papers, Bibliothèque Municipal d’Orleans, ms. 1423.
 This report also appeared in the Gazette de Santé (1 January 1778). Its author was Henri Alexandre Tessier (1741–1837); he was admitted to the Academy of Sciences in 1783.
 David M. Vess, Medical Revolution in France, 1789–1796, 17.
 Lemaire, “Le Dr. Jean-Paul Marat,” in Lemaire and Poirier, eds., Marat homme de science?, 22.
 Ibid., 34.
 Robert Darnton, The Business of Enlightenment: A Publishing History of the Encyclopédie, 1775–1800, 19. For Rey’s relationship with Rousseau, see Maurice Cranston, The Noble Savage: Jean-Jacques Rousseau, 1754–1762.
 Gazette de politique et de littérature, 5 May 1777.
 Diderot, Eléments de physiologie, in Œuvres complètes, vol. XI, 378.
 Ami du Peuple no. 455, 11 May 1791.
 Marat, An Essay on Gleets and An Enquiry into the Nature, Cause and Cure of a Singular Disease of the Eyes.
 Marat, Essay on Gleets.
 Marat, Singular Disease of the Eyes.
 Roderick E. McGrew, Encyclopedia of Medical History, 33–4. “The practice was common enough to make leeches a sought-after commodity. Early in the nineteenth century, normal annual demand for the bloodsuckers in France for example, ran to 2 to 3 million; during the bleeding craze which crested in the 1830s that demand increased eightfold.”
 Marat, Singular Disease of the Eyes.
 Pierre Almaric, “Marat et l’optique,” in Lemaire and Poirier, eds., Marat homme de science?, 116.
 Ibid., 117.
 See Marcel Boiteux, “Marat électricien,” in Lemaire and Poirier, eds., Marat homme de science?, 109–13.
 More will be said about this essay in Chapter 2 on this website.
 See Bertholon, De l’électricité du corps humain dans l’état de santé et de maladie. On Mesmer and animal magnetism, see Robert Darnton, Mesmerism.