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Medicine, media and the public

Medicine has become increasingly professionalised and institutionalised in the modern era. Within this narrative of medicalisation, popularisation has been interpreted as a process directed by the traditional protagonists of medical history: physicians and institutions. Although historians have argued that medical knowledge was ultimately democratised throughout the nineteenth and twentieth centuries, they have mostly portrayed the increasingly large numbers of users of medicine as passive consumers of knowledge that was nominally created by professionals. Over the past two decades, however, historians have paid more attention to the circulation of knowledge, arguing that knowledge is constructed by mutual interactions between the scientific and the public domain. In a similar vein, historians have shown that the sharp antagonism between ‘official’ and ‘alternative’ medical beliefs was not a historical reality, but a cultural construct.

This chapter shows the implications of these new theoretical approaches for the Belgian context – in which ‘popular’ and ‘alternative’ views of medicine have not yet been subject to much historical scrutiny. By focusing on visual media through which medical knowledge was communicated and circulated, concrete models displayed in health exhibitions and public health films, this chapter takes a first step to decentralise the history of ‘popularisation’. By drawing attention to the ways in which medicine circulated, we give lay audiences agency in the historical narrative: they transform from passive recipients into active actors and consumers, who have the agency to interpret, choose from and respond to different views of the body, sickness and health.

The newspaper advertisement in Figure 9.1 from 1914 promised women a way to ‘develop and firm their chest’.1 The seller provided expert evidence in order to convince customers – namely, two images contrasting the internal anatomy of the breast before and after treatment, accompanied by references from ‘very well-known doctors of medicine’. The advertisement seems to reflect a well-known historiographical narrative, emphasising the growing influence of medicine in the nineteenth and twentieth centuries. First, it suggests that medicine had become the most authoritative field of knowledge regarding the body and health. Second, it illustrates the increasing impact of medicine in society: a preference for large, firm breasts – the beauty ideal – was represented as a medical issue, and the strategic use of medical images suggests that laypeople were familiar with visual depictions of anatomy. Yet the advertisement also complicates grand narratives of professionalisation and medicalisation, for it shows that ‘quacks’ also claimed medicine as a privileged site of knowledge for their own commercial agenda, and indeed often created their professional identities by copying mainstream physicians.

Over the past two decades, philosophers and historians of science have replaced the model of diffusion, according to which knowledge was created by scientists before moving to the public sphere, by a model of circulation, according to which knowledge was constructed by mutual interactions between the scientific and the public domain. Building on Bruno Latour’s notion of actor-network theory or Nicholas Thomas’s account on material exchange, historians of science, most importantly James Secord, argued that knowledge production in itself should be seen as a process of communication and exchange.2 As a result of this theoretical shift, historians have questioned the dichotomy between the scientific and the popular, instead looking for connections between them.3

In a similar vein, historians have shown that the sharp antagonism between ‘official’ and ‘alternative’ medical beliefs was not a historical reality, but a cultural construct that did not match the practices of patients and practitioners. They have argued that ‘professional’ physicians could not monopolise medicine: not only treatments, but also different views of health co-existed and complemented each other on the medical market. Furthermore, as the advertisement above suggests, not only ‘professional’ physicians made use of a medical discourse to bolster their credibility.4 In fact, studies have shown that experts of all kinds, ranging from academics to natural healers, mothers or priests, were dependent on their audiences for recognition of their authority.5 To sum up, static divides – between the scientific and the popular sphere, between the expert and the lay public, and between orthodox and heterodox medicine – were nuanced by a more multifaceted interpretation of knowledge production, ascribing a more active role to historical actors outside of the academic world.

Yet Belgian historiography regarding the permeable boundaries between the scientific and the popular is still in its infancy, although recent mass digitisation projects of primary sources such as newspapers and magazines could certainly facilitate research along these lines.6 The history of public manifestations of medicine is mostly confined to short chapters in edited volumes, monographs or doctoral dissertations. In these works, the history of popularisation is mostly a sidetrack to contextualise the actual topic of study, be it a general history of medicine or a history of homosexuality, adolescence or anatomical models.7 Only a handful of articles have accorded sustained attention to the history of popularisation.8 Apart from the work of Evert Peeters and Anne Hilde van Baal, the picture is equally bleak for the history of ‘alternative’ medicine.9

As there exists no comprehensive Belgian monography on the history of popular medicine or science, historians are dependent on general works discussing British, French, German or other European contexts.10 Although these studies are useful to indicate broad evolutions, such as the importance of the hygienist movement or the rise of mass media, their findings do not always fully apply to the Belgian sociopolitical context. From existing case studies we know that local specificities are crucial to understand the transformation of medical knowledge. For example, Peeters has suggested that humoral representations of the body adhered to the worldview of many Catholic physicians in Belgium, and that this might explain both the popularity of holistic therapies such as hydrotherapy, and why academic physicians continued to pay lip service to the humoral theories until well into the nineteenth century.11 Another example considers the state interference towards mass media. Public television retained a factual monopoly until 1989. In Flanders, scientific programmes took centre stage in programming despite a lack of popularity. As these programmes served political goals, namely the emancipation of the Flemish people and the cultural integration of the Dutch linguistic region, viewing figures were not television makers’ primary concern.12

Yet international movements and media were also quintessential for the popularisation of medicine in Belgium, as the market was too small to sustain original large-scale productions. The ‘carriers’ of medical knowledge, whether magazines, exhibitions, movies or other forms of media, often came from abroad. In the nineteenth century, for example, Belgium was so well known for its contrefaçon (counterfeit) publishing, that scholars have argued that it held the ‘monopoly of the French book’, as French literary and scientific works travelled the world through Belgian copies.13 In her work on popular anatomical atlases, Veronique Deblon has shown that anatomists and editors made compilations combining the ‘best of’ French and German medical images, and adapted and enriched them with extra information. Rather than simply reprinting international works, they turned them into ‘Belgian’ editions and tailored them to the needs of the intended audience.14 In a similar vein, recent literature has highlighted Belgium as a ‘European leader in organizing international action against depravity in film’, despite its lack of a commercially strong domestic film industry – a reality that also impacted the creation and distribution of medical and public health films.15 As will become evident throughout this chapter, other manifestations of medical knowledge should likewise be interpreted within a system of exchange: ‘foreign’ knowledge changed according to local norms and customs, and in ways that were dependent on the intended audience.

In order to thematise this tension between the local and the global, this chapter focuses on the media through which medicine circulated, in particular models displayed in health exhibitions and medical films. A perspective based on Secord’s concept of circulation allows us to elucidate context-specific trajectories of knowledge, recognising that views regarding the body and health travel and shift in meaning. This approach allows us to decentralise grand narratives on medicalisation and professionalisation, and to place the medical patient and consumer at the centre of our attention. We do not interpret popular medicine as a body of knowledge, but rather as the relationship between science and the public. We interpret this relationship as a mutual one: medical knowledge was not simply transferred from the scientific to the public domain, but was transformed and adapted between the scientific and the popular spheres. By drawing attention to these modifications and interpretations of medicine, we give lay audiences agency in the historical narrative: they transform from passive recipients into active actors and consumers, who have the agency to interpret, choose from and respond to different views of the body and health.

Even though this chapter mainly focuses on health exhibitions and medical films, it is certainly possible to study other audiovisual media in a similar vein. Within media studies, virtually all forms of knowledge communication (radio programmes, lectures, magazines, posters, charts, slides, advertisements and so on) have been analysed as a dynamic process, using the same key questions. In a nutshell, the question of ‘what’ is being communicated is always dependent on a simultaneous understanding of ‘how’, ‘where’, ‘when’, ‘by whom’ and ‘for whom’.16 In our view, historians can learn a lot from such a media approach. Until now, Belgian historiography has mainly focused on ‘products’ of popular medicine, most notably posters, leaflets and manuals, newspapers and magazines.17 Studies mostly have neglected the process of communication that is inherent to these media. Audiences have rarely received any attention. The same holds true for actors such as publishing houses, manufacturers and sponsors. In our view, it is time to change this. If we want to write histories of popular science that transcend boundaries between different cultural spheres, geographic localities or time spans, we should not interpret primary sources as finished products but as ongoing processes.

This chapter consists of two main parts: one on health exhibitions, the other on medical films. Within both parts, three questions structure our narrative. First, we clarify the model of circulation by focusing on the movement of knowledge between different places, cultural domains and disciplines. Then, we turn to the question of expertise. We complicate the narrative of professionalisation by drawing attention to the diverse ways in which popular medicine was given credibility, and by looking at collaborations between professional physicians and other actors. Lastly, we draw attention to the agency of the audience. We argue that historians should treat the lay public as an active actor by contrasting curatorial or directorial aims with actual visitors’ responses.

Health exhibitions

In La leçon d’hygiène (ca. 1878–81), the Belgian painter Félicien Rops depicts two military men visiting a hygiene museum (Figure 9.2). They are looking at wax models illustrating the symptoms of syphilis. One soldier appears to be explaining the displayed disease; the other is blushing uneasily. Health exhibitions such as the one depicted by Rops were a common phenomenon. Itinerant, often international, collections on the body and health toured around Belgium from the 1840s onwards.18 In the early twentieth century, a provincial hygienist museum was established within this tradition in Mons.19 Temporary and travelling exhibitions also continued to exist. In the 1930s, for example, the Belgian Red Cross organised the exhibition De Mensch (The Human Being) in the Egmont Palace in Brussels.20 Health and hygiene were important topics in the world fairs.21 Today, Gunther von Hagens carries on the tradition by touring the world with spectacular displays of plastinated bodies, bearing both explanatory labels with medical information and quotes about mortality from religious and philosophical sources.22

These exhibitions reached ever wider audiences. Around 1860, anatomical museums moved from coffee houses or shopping arcades (venues of bourgeois entertainment) to the fairground. Aligning themselves with both the prophylactic aims of the emergent hygienist movement and the cultural ideal of educating the people, proprietors of popular museums lowered their entrance fees in order to ‘allow the working man to visit their collections’.23 Aside from workers, they targeted other high-risk groups in the battle against epidemics. Soldiers, who not coincidentally took centre stage in Rops’s painting, could often visit health museums at half price, as it was, perhaps justifiably, believed that their lifestyle put them at risk of ‘the venereal peril’.24

Yet the visual display of pathological models, many of them depicting the results of venereal disease, was not considered to be appropriate for everyone. Until well into the twentieth century women could only visit anatomical museums separately. This was both because their presence would make male visitors feel uneasy and in order to protect their modesty. Women received a censored and gendered view of the body and health (see Chapter 1, p. 40). For instance, models depicting genital organs or venereal diseases were removed from display, and maternal tasks were emphasised and grounded in anatomical ‘facts’.25 Yet these separate visits also generated possibilities for women, as they created job opportunities for female guides and thus possibly paved the way for female proprietors. At least in Belgium, it was not unusual for wives of museum owners to take over the anatomical museum after their husband’s death.26 In fact, international studies have stressed the importance of women for the circulation and popularisation of science in general, thus disrupting the idea that women were excluded from science during the nineteenth century.27

Children, too, only gradually gained access to health exhibitions. From the 1890s onwards, a few popular anatomical museums represented themselves as suitable and didactic for family outings, offering reduced rates for children.28 Schools became attractive customers after 1895, when health education became a compulsory part of the curriculum.29 The provincial hygiene museum of Mons and the De Mensch exhibition, for instance, tried to attract schools by emphasising their didactic potential in the first half of the twentieth century.30

Things in motion

Having discussed a few general characteristics of health exhibitions – what, when and for whom – we now turn to the question of circulation. In historiography, there has been a tendency to discuss different types of health exhibitions separately.31 As an unintended consequence of this approach, the differences between these institutions have been overly emphasised. In this section, however, we focus on the circulation and (re)interpretation of objects in between different types of exhibitions, such as itinerant anatomical museums, academic collections and provincial hygiene museums. When studying the trajectories of museum objects, three forms of movement come to the fore: between different countries, between university museums and popular collections and between private and public exhibitions. A focus on ‘things in motion’, rather than on ‘snapshots’ of things in specific case studies, allows historians to elucidate both the circulation and, perhaps more importantly, the transformation of medicine across borders and cultural domains.32

First, health exhibitions provide an insight into the dynamics between the international and the local (see Chapter 4, p. 135). Nineteenth-century popular anatomical museums were international phenomena. Most of them, for instance the museums of Kahn, Prauscher and Spitzner, came from abroad and toured across Europe. The objects on display were international as well, ranging from French or German anatomical models to specimens from colonial contexts.33 In later exhibitions, too, objects were exchanged across borders. On the world fairs, for example, didactic objects from several countries were displayed in the same pavilion.34 In 1938, the Red Cross arranged the move of the ‘see-through man’ from the hygiene museum of Dresden to Brussels. This anatomical model entirely made from glass, enabling viewers to see organs, nerves and blood vessels, was one of the most popular models of the time and toured the international exhibition circuit as a symbol of Aryan superiority and modernity.35

Yet despite their international character, health exhibitions did change per country, and even per city. Research has shown that curators of itinerant collections accommodated their displays to the interests and sensitivities of the public. Local doctors were, for example, asked to review the collection on its scientific merits, and supposedly obscene objects were occasionally removed from display at the request of the local police, suggesting that the authority and decency of international collections had to be confirmed locally.36 These mechanisms persisted well into the twentieth century. In newspapers from 1938, for instance, reviews by Belgian physicians and professors, as well as by King Leopold III, had to confirm the quality of the exhibition De Mensch.37 Moreover, international studies have shown that visitors’ responses to exhibitions could differ profoundly depending on the particular context.38 The study of the content of, and response to, health exhibitions across borders thus appears to be a fruitful area of research, enabling historians to see the continued importance of local contexts in an era in which the organisation of science became international. Contemporary research on the different responses to Body Worlds – provoking the ‘anger of Christians’ in Germany while being welcomed as ‘a wonderful educational vehicle’ in the United States – might provide inspiration for this type of research.39

Objects also moved between the university and the fairground. Hieke Huistra has shown that universities in the Netherlands closed their anatomical collections for general audiences around 1850.40 A similar evolution took place in Belgium, although universities continued to open their doors for lay audiences on public holidays.41 Significantly, popular itinerant museums started to tour across Belgium (and the Netherlands) around the same time. These collections were inspired by their, now inaccessible, academic counterparts. The Spitzner museum, for example, was modelled after the Museum Dupuytren, the anatomical museum of the Faculty of Medicine of Paris.42 Most popular museums displayed medical models that were also part of university collections, such as anatomical wax models by Louis Auzoux or Jules Baretta. Even objects that contemporary critics occasionally described as ‘sensational’, such as the display of criminals’ or celebrities’ skulls, were also part of university collections. The anatomical museum of Liège, for instance, contained a collection of skulls of decapitated convicts, while the University of Leuven possessed an anatomical preparation and plaster cast of the brains of the famous writer and poet Guido Gezelle.43

Lastly, the contents of private or temporary exhibitions, and official museums, were strikingly similar. To name but a few examples, although politicians claimed that the provincial hygiene museum of Mons, which opened in 1911 and still constitutes a blind spot in research, offered a sober and serious, less ‘sensational’, display of knowledge, the collection does not appear to have differed from those of fairground museums. For instance, 148 models depicting the results of venereal disease were placed in a separate room inaccessible for children – a practice reminiscent of the display of controversial models in cabinets reservés in fairground museums.44 In 1938, several newspaper reports compared the De Mensch exhibition to the Spitzner museum, again suggesting that a focus on similarities and exchanges would be a fruitful approach for historians.45

Doctors, showmen and expertise

Strict divisions between the ‘academic’ and the ‘popular’ are equally hard to maintain when we consider interactions between physicians and proprietors of popular health exhibitions. Curators from popular collections positioned themselves within the medical community. Many of them called themselves physicians (even if they had no medical training), and guided visitors around in white doctor’s coats. In doing so, they constructed medicine as an authoritative field of knowledge regarding the body: when it came to health and disease, physicians received expert status.46

Even the enfants terribles of the popular scene used a medical discourse to bolster their credibility. A well-researched example is the case of Constant Crommelinck, who occasionally gave lectures on health and the body in mid-nineteenth-century Belgium, sometimes in popular anatomical museums.47 Even though important medical journals such as Le Scalpel refuted his holistic views of the body as ‘quack’ medicine, Crommelinck continued to call himself a doctor. Crommelinck remained, arguably, the most popular medical lecturer for over twenty years, showing that alienation from academic medicine did not necessarily lead to the downfall of popular scientists (or museums). In the end, one’s recognition as a medical expert did not depend on professional opinions, but on the judgement of the audience.48 A similar argument was made in studies on hydropaths and other contested healers. Although many ‘alternative’ practitioners questioned the effectiveness of mainstream therapies, they used scientific knowledge, networks and institutions to strengthen their authority.49

In general, however, the relations between the medical community and proprietors of popular museums were friendly in Belgium; unlike in Britain and other European countries, where physicians increasingly denounced popular museums as sensationalist and obscene establishments.50 The Musée Spitzner, for instance, was appreciated for decades by both the medical community and local authorities.51 Physicians regularly organised lectures on public hygiene within the museum. Medical practitioners, students and nurses could visit at a reduced price. In 1926, the city council of Antwerp gave Spitzner a fairground stand at the Sinksenfoor for the following three years because ‘the museum is managed in a decent way, and its collections have a good reputation in the local medical community’.52 In fact, the extraordinarily lengthy existence of popular anatomical museums in Belgium suggests that they were seen as effective institutions for a long time. The Spitzner collection, for example, toured the big Belgian cities from the 1880s until as late as the 1960s. When it was increasingly considered to be outdated for medical education, it gradually became a museum on the history of medicine.53

One reason for the continued existence of popular medical exhibitions was their embeddedness in local politics. From the twentieth century onwards, as local and federal authorities began to see health education as their responsibility, politicians increasingly collaborated with private institutions. In the words of Onghena, popularisation became part of ‘conscious, urban politics’.54 In 1933, for instance, Madame Spitzner proposed the Brussels aldermen for public health to work systematically together in order to establish a city museum for social hygiene.55 This example also points to the importance of the proprietor, as Madame Spitzner’s continuous efforts to promote her collection as important to public health – seeking collaborations with health organisations, city councils and schools – was perhaps the most important reason that her museum continued to exist.

The stance of the twentieth-century medical establishment was ambiguous. On the one hand, physicians criticised the ‘sensational’ nature of ‘pseudoscience’ that was so seemingly hard to control and administer. The medical community occasionally rejected popular exhibitions – not only fairground museums, but also world fairs and the aforementioned exhibition De Mensch – as they turned ‘serious’ science into a consumer good.56 On the other hand, physicians participated in what they called ‘the education of the people’. By organising public lectures on practical themes, most importantly on hygiene topics, they attempted to stimulate the public’s moral and intellectual development.57

Discipline and agency

Several historians have underlined the disciplinary or moralising aspects of health exhibitions. Inspired by the Foucauldian notion of ‘biopolitics’, they have argued that these exhibitions were meant to discipline the visitor’s gaze, body or behaviour. When discussing the ‘strategies’ of nineteenth-century hygienism in Belgium, Karel Velle, argued that medical advice had ‘other motives than the advancement of health’, as it was imbued with cultural norms and values.58 In more recent international research, too, the disciplinary aspects of health exhibitions were an object of scrutiny. Michael Sappol argued that popular museums represented disease as a natural enforcement of moral law, and Elizabeth Stephens called anatomical displays a ‘disciplinary technology, requiring one to regulate one’s body and its practices in accordance with cultural norms’.59 Underpinning these interpretations was the grand narrative of medicalisation, according to which the authority of physicians grew while more and more previously religious or social norms and values were becoming grounded in medicine and the body.

It is true that the programmatic aim of prevention went hand in hand with moralisation in health exhibitions. The late nineteenth-century battle against venereal disease, for instance, led to an idealisation of traditional conjugal ethics. Sexual acts outside of faithful heterosexual relationships (i.e. marriage) were condemned as irresponsible and unhealthy. In the introduction of the exhibition catalogue of the Musée Consael, the proprietor proudly stated that many young men had changed their promiscuous lifestyle after viewing the objects on display. In the same museum, several models allegedly showed the ‘pathological results’ of sexually deviant behaviour, ranging from masturbation to homosexuality or prostitution.60 More generally, popular representations of disease were, and still are, imbued with notions of right and wrong, of responsibility and guilt. In the nineteenth-century popular anatomical museum, kidney disease was represented as the stubborn alcoholic’s fate; today, the display of smokers’ lungs in the Body Worlds exhibits or printed images on cigarette packs might convince smokers to change their ways.

Curators of health exhibitions thought three-dimensional models were particularly suitable for conveying these preventive and moralising messages to a broad audience. Not only did visual representations of disease enable illiterate visitors to learn about the symptoms of diseases, realistic depictions of impaired bodies also allowed for identification. The pathological model had to function as a conditional, future self: a scary outcome of behaviour that should be changed. Through identification, pathological models were meant to create a shock that would lead to a permanent change of mentality. In the words of the catalogue of the Spitzner Museum, the horror evoked by pathological models would ‘perpetuate’ the lessons of the museum ‘in our memory’.61

Yet fear was not the only emotion that exhibitions evoked. Inspired by the history of emotions, historians have shown that curators’ intentions did not always match visitors’ responses.62 Regarding anatomical displays specifically, historians have pointed at erotic responses from visitors, especially in an era during which visual representations of naked bodies were rare. Anna Maerker, for instance, has found that the glass cabinets containing anatomical models of female genitalia in the Specola Museum in Florence had to be replaced more regularly than other display cases, presumably because visitors touched them.63 One could wonder why the soldier in Rops’s painting is blushing: is he afraid he might have contracted a venereal disease, or is he distracted by the graphic and three-dimensional display of naked women?

Health exhibitions could not only be titillating. They could also be pleasant rather than instructive or boring. Indeed, some contemporary critics worried that health exhibitions were ‘sensationalist’, meaning that science was made subordinate to entertainment. In the words of one reviewer of the De Mensch exhibition, visitors ‘would leave the exhibition with the same attitudes they entered’ because they did not go to the exhibition to learn, but to have fun.64 In Stijn Bussels and Bram van Oostveldt’s research on the 1894 world fair in Antwerp, the emotion of ‘boredom’ took centre stage. In their view, the world fair did not evoke admiration or pleasure, but disinterest and fatigue. As visitors had gotten used to large-scale spectacles in the preceding decades, the world fair had lost much of its appeal. Yet Bussels and Van Oostveldt also drew attention to curators’ responses, arguing that they increasingly changed visual displays for experiments and performances, allowing for a more active kind of spectatorship.65 Similar stories of interaction and dialogue hold true for health exhibitions. In response to criticism regarding the pornographic nature of their displays, for instance, proprietors of popular anatomical museums developed ways to discipline their visitors. They organised guided tours in order to gain control of visitors’ interpretation of the museum or placed explicit models in cabinets reservés – separate rooms that were inaccessible for working-class audiences and women.66

To sum up, the history of health exhibitions shows the value of an approach based on circulation. A focus on interaction not only enables historians to nuance their understanding of the boundaries between ‘science proper’ and ‘popular science’, but also allows for a more active interpretation of audiences. Visitors of health exhibitions did not passively soak up the knowledge on display, but had the agency to respond in unintended ways. In the next section, we will show that similar mechanisms were at play in the medical film industry. By looking at the production and reception of movies regarding health, specifically the film Un ennemi public (1937), we will further emphasise the importance of non-medical actors and contexts for the circulation of medical knowledge.

Medical films

The camera initially pans over the lavish Palais de Justice, the emblem of national power built under the now notorious King Leopold II, before it leads the film spectator to the narrow streets of the working-class district the ‘Marolles’. The film Un ennemi public, produced in 1937,67 depicts a view on urban everyday life in Brussels (Figure 9.3). The film was cinematographically interpreted by documentary filmmaker Henri Storck, and sponsored by representatives of the national public health circle, such as the physician, professor and social reformer René Sand, and the Ligue Nationale belge contre la tuberculose.68 The film, which was directed at a working-class audience, depicts the life of a factory worker: his family life, the insanitary housing situation in the metropole and the challenging physical work in the printing factory, are all part of the main narration. Un ennemi public was in the first instance produced to communicate knowledge regarding tuberculosis, which was at the time seen as both a social and an epidemic disease. Storck and his sponsors wished to raise awareness, and to mobilise support for public health measures aimed at prevention.69

Today we may be used to seeing surgical operations in reality TV formats introduced with the trigger warning ‘viewer discretion advised’. Fictional TV shows, such as Emergency Room and Grey’s Anatomy, lead their viewers through dramatic episodes about common and rare diseases, modern diagnostic technologies and operations, exploring the lives of both doctors and patients in the microcosmos of the clinic. Whereas these documentaries and fictional dramas are an integral part of today’s programming for television, radio and digital broadcasting, their origins have until recently been a blind spot in medical historical and media study research.70 After the First World War, the growing film industry with an increased attention for health programmes against epidemics and social disease engendered a new genre: the public health film. Films on topics such as general hygiene, sexual education, venereal disease, tuberculosis and malaria prevention gained popularity in the 1920s, notably in Europe and the United States.71

As a result, there were contentious debates regarding the useful application, composition and configuration in the medical, artistic and commercial film worlds as to what extent, and how, delicate medical subjects should be shown to cinemagoers.72 Depending on the topic, screenings were divided into projections for men, women and children. Films on infant hygiene, birth and childcare, were commonly intended for women only and sex education films were appropriated for specific audiences too. Similarly to offering soldiers exclusive visits to health exhibitions on venereal disease, film scenes depicting male genitals affected with syphilis were exclusively shown to male military audiences.73

Explicit clinical depictions were rather rare in health or popular-scientific films, and if used they were contested by moral, aesthetical and scientific commentators.74 Much like tuberculosis films, venereal disease films tried to address a broad public by introducing different social milieus and life circumstances, framing the topic of risk in a storyline that made viewers empathetic. Films conveyed the message that everyone could be put at endemic, epidemic and hygiene risk, regardless of one’s gender, social status or race. Whereas addressed audiences were the targeted consumers in this context, the various early cinematographically depicted forms of health and disease were still exclusively outlined by medical scientists, public health officers, teachers and film professionals. Yet, the health educators’ intentions to change public ideas on the body, hygiene, sexuality, health and sickness, could not be fulfilled without turning to the targeted public itself. In addition, medical experts had to turn to other professionals, as they were often neither knowledgeable of filmmaking techniques, nor experienced public health promoters.75

Between the clinic and the public cinema

The invention and vast improvement of imaging techniques, such as photography and cinematography, as well as of medical imaging techniques, such as X-ray and microscopic photography, led on to new considerations regarding how to use them as tools for medical and public education and research at the end of the nineteenth century (see Chapter 5, p. 184). European film producers were eager to promote the importance of a scientific affiliation with the newly introduced cinematograph. Professional filmmakers wanted to collaborate with physicians in the production of public health films in order to diversify and advance their professional repertoire. Clinicians were further using film as a life-like medical record, evidencing their research practices. The oldest preserved Belgian medical films, held in the Cinémathèque Royale de Belgique, are part of a collection of clinical short films that date back to 1905. They were produced by Arthur van Gehuchten, a neurologist and professor at the Université catholique de Louvain, who established the university’s neurology chair and clinic.76

Presumably inspired by the work of the Romanian neurologist Gheorghe Marinescu, Van Gehuchten started to film patients with so-called maladies nerveuses resulting in movement disorders, like Parkinson’s and Huntington’s. He recorded them in different settings: outdoors, in the garden of the clinic and in his so-called cage de verre,77 a gallery-like laboratory that functioned as an indoor film studio.78 As uncontrollable movements were hard to describe in words, neurologists were (next to surgeons) the leading specialists using film for research and education. Much like medical models, rare clinical cases served as a ‘celluloid archive’ that could be reused and reproduced with the cinematograph. Whereas in most cases Van Gehuchten operated the camera himself, his early film series encouraged other medical specialists – namely neurologists, psychologists and psychiatrists, such as his son Paul van Gehuchten at the Université catholique de Louvain, Ovide Decroly in Brussels, Ludo van Bogaert in Antwerp and Léon Laruelle in Brussels – to collaborate with professional camera operators including Antoine Castille.79

Although clinical films were not intended for public viewing, questions regarding how to show patients in a ‘scientifically’ and ‘aesthetically’ appealing way were at times as controversial as for public health films. The filming of nude patients, for instance, was constantly challenging medical and lay audiences. In the early 1920s, health films often included clinical reels from patients in order to make them visually impactful and effectively disturbing.80 Unlike elsewhere in Europe, clinical research and teaching films appear to have been mainly produced by individual neuroscientists or others occupied with mental health (see Chapter 8, p. 334). From the early twentieth century onwards, university professors in Belgium bought and used foreign educational films, notably surgical films, for their courses. While centralised national film departments in other European countries were systematically collaborating with university clinics and public health educators for the production of films in disciplines such as surgery and gynaecology, the market for, and interest in, these initiatives, was absent in Belgium until the interwar period.81

The earliest clinical films were quite isolated as they were issued by individual medical researchers and teachers. Although they were intended only for scientific venues, they were also projected beyond their original purpose. For example, the French surgeon Eugène-Louis Doyen had filmed surgeries and showed them at medical meetings. Interestingly, Doyen’s films were also accessible for public and private screenings, and were widely advertised and distributed in Brussels.82 After critics had denounced him for using film as a tool for self-promotion, Doyen had learnt that copies of his surgical films were leaked to non-scientific distribution channels, such as public fairgrounds, and were sold to well-known film producers without his consent.83 This case had demonstrated the risks of the new medium, and further challenged the standing of medical educational films.84 This example of problematic circulation between clinical and public spaces appears to have led to a decline in the production of surgical films. Extracted from their original purpose of educating medicine in the clinical projection room, clinical films allegedly became sensationalist or voyeuristic, as lay audiences paid to see the body turned inside out, the blood gushing, the patient exposed. More generally, the controversy concerning the leaking of the Doyen films appears to have impacted the position of the medical community, which neglected the possibilities of film for public health until the end of the First World War. Another reason for this reluctant attitude towards film was its connotation with occult magic, an association that blurred the boundaries between science and spectacle.85

When public health themed films finally found their way to the public in the late 1910s through screenings in public venues such as schools, factories, fairs and army camps, filmmakers preferred purely fictional re-enactments over ‘real’ footage, or at least enriched information with fictional elements that made scientific knowledge easier to comprehend for lay spectators.86 Public lectures, microscopic images and other visual displays of bodily processes and medical examinations were contrasted with the counterexample of bad housing and labour circumstances.87 In the first half of the twentieth century, Belgian public health films, much like elsewhere in Europe, focused on topics such as hygiene, childcare, epidemics and occupational accident protection. Educational hygiene films mostly considered social diseases and epidemics, such as alcoholism and tuberculosis, and were aimed at high-risk groups, such as industrial workers, but also military men and veterans, mothers, children and, in colonial contexts, indigenous people.88 Realised by different public health departments these films were prepared and executed by professional and clinical film directors. This specific genre is therefore an optimal source for discussing interdisciplinary, intercultural, scientific and public, institutional and visual questions regarding how concepts of the healthy and the diseased body could be conveyed in motion as well as in still pictures.89

The extensive Belgian collection of public health films circulating in the early twentieth century is almost entirely composed of French and American national hygiene films that were distributed by Belgian health prevention and public film organisations.90 In the tradition of films such as Le dispensaire antituberculeux (France, 1917),91 La visiteuse d’hygiène (France, ca. 1925),92 and Les Maladies Sexuelles et leurs Conséquences (France, 1923), the public health films that are conserved in Belgian archives took over corresponding film elements regarding the state of the art narratives, displaying content, form and aesthetic styles common for public films about tuberculosis and venereal disease. The films discuss hygiene behaviour regarding nutrition, housing and the workplace, and show statistics of epidemics and possible relief and treatment.93 Despite the existence of a vivid documentary film culture in Belgian cinema from the 1920s onwards, with directors such as Charles Dekeukeleire and Henri Storck as important figures, it was not unusual for small countries without a strong film industrial infrastructure to use international movies before turning to the production of local films, notably regarding specific genres such as hygiene film.94

In fact, Un ennemi public was the first official, nationally produced public health film.95 The lack of a local film production scene makes one wonder about the extent to which Belgian films were considered to be important as identificatory media tools, as authorities argued in other European countries, such as France, Germany, the United Kingdom, Italy and Austria.96 A representative number of foreign hygiene films were distributed and circulated in Belgian cinemas or other projection venues, and the press regularly received and reported of these films. In contrast, prior to the production of Un ennemi public, the value of domestically produced health films was underreported. Health propaganda supporters, such as René Sand, frequently promoted the motion picture as a promising medium for communicating health prophylaxis and educating a public mass audience on treatment and self-monitoring (see Chapter 4, p. 151). Nonetheless, as they referred to the existing French film productions, there does not appear to have been an explicit institutional desire for national production.97 This can be explained by a lack of budget and infrastructure in the 1920s, a decade characterised by both an economic crisis and a relative lack of political authority over health matters. In this context, it was hard to compete with the French and the American educational film market as it was easier and cheaper to buy existing international films, and appropriate them for distribution and screenings in Belgian cinemas, also with the insertion of translated intertitles.98

Professional filmmakers, medical film directors and expertise

Cinematography developed in scientific spaces: the first motion pictures, whether as (pre-cinema) serial photographs, chronophotographs or cinematic films were created by natural scientists or technophiliacs, being therefore self-evidently part of the scientific sphere.99 Yet these mechanically produced images immediately caught the public’s attention: X-rays and microscopic photography, as well as motion pictures, were projected in, and circulated between, scientific and public spheres.100 In the interwar years, the medical community debated about using film as scientific evidence, while a few scientists and physicians began to use the medium for public health education.

Questions regarding ‘the good educational film’101 emerged in Europe after the First World War, when the film industry as well as the educational film movement were supported in a more systematic way. A growing community was interested in the conception, production and distribution of health films despite the fact that they were less profitable than entertainment movies. Public health films, issued by national health departments, were interdisciplinary collaborations between professional filmmakers, politicians and physicians. The alliance of well-known filmmakers and directors brought together by Storck and Sand can be seen as a classic example in view of European health film policy.102

Commercial filmmakers increasingly collaborated with representatives from the medical community.103 Documentary filmmakers, such as Storck and Castille, worked with physicians, such as the psychologist and progressive educator Ovide Decroly and neurologist Léon Laruelle from the 1920s onwards.104 In this way, the link between film and science, already imagined by the Lumière brothers, was finally established.105

The case of Storck, who individually took action to produce public health films, shows that national debates on medical filmmaking as a tool for public education could be promoted and stimulated by various actors, who interacted with each other. Professional filmmakers not only interacted with physicians, but also with producers and the intended audience, whether this was a population of ‘health consumers’ or students training to be physicians. Storck’s efforts to promote these films were not exclusively grounded in the wish to better citizens’ health, but were also a strategical attempt to better his standing with national authorities and to secure his future career as a filmmaker. The transformation of the film medium into a channel of health-related information engendered various questions regarding the interaction between viewers and health film producers.106

Discipline and agency: viewers as consumers?

In national and international debates regarding how best to convey public health knowledge to lay audiences, physicians and health authorities were outlining what composers should know about the topic of their films and about the targeted audience and their struggles in life. In order to make films effective, so it was believed, abstract medical knowledge, for example regarding bacteria, had to be made as legible as possible for a viewing audience that lacked prior knowledge.107

Until well into the 1930s and 1940s, audiences did not play an active role in the filmmaker’s decision-making process. Public viewers’ reactions and feedback at screenings were taken into consideration but were only debated within an expert-driven network. Systematic surveys or interviews were only erratically conducted. However, as consumer advocacy became more important – both in general and in relation to medical care – market research for public health productions gained ground.

Production notes of hygiene films suggest that debates between filmmakers and sponsors not only considered the question of how to convey a scientific moral message, but also of how sociopolitical narratives could be implemented through film.108 Cinema appealed to those trying to popularise public health information following institutional agendas and health marketing narratives. But the actual transdisciplinary collaboration of those involved in film production was more complex than expected. For instance, a representative of the Ligue Nationale belge contre la tuberculose, who corresponded with Storck about the tuberculosis film production, wished to prominently film the building of the Ligue in Schaerbeek and insert the Cross of Lorraine, the symbol for the ‘crusade’ against tuberculosis. Storck diplomatically declined the request, because viewers would easily recognise camouflaged advertising and often did not react well to this kind of ‘in-your-face’ propaganda.109

Film narratives attempted to speak to the public’s emotions in order to inform them about the prevention or treatment of disease. This could mean reaching the viewer with emotions of disgust, shock, reassurance or solidarity.110 Filmmakers tried to make the viewer feel like a potential patient. Citizens were not only addressed as film consumers, but also as modern health consumers. Visual practices of health promotion and disease prevention had to produce a new way to think about the body and health. Epidemics were often discussed in terms of individual behaviour and risk. Disease was represented as self-inflicted; its treatment as one’s own responsibility.111 As the emphasis was on the individual, this meant that social and structural problems – such as limited workers’ rights or bad housing – were neglected. The underlying message was that for those who were instructed, and did not take the expert’s advice seriously, disease could be framed as being one’s own fault.112

Whereas this emphasis on individual responsibility was commonly left uncriticised by reviewers, they did suggest that filmmakers had to know the lives and struggles of targeted spectators. In an essay entitled ‘Does Cinema Appear as Educationally or Morally Corruptive?’113 written in 1934, Victor de Ruette, inspector for ‘des Etablissements pour malades mentaux et enfants anormaux du Royaume’ (‘institutions for the mentally ill and abnormal children of the kingdom’) stated that the different contexts of the potential viewers, distinguished by their profession, urban or rural origin, confession, gender, race and age, should be taken into account when evaluating hygiene and public health films. In de Ruette’s view, however, physicians remained the most suitable evaluators of such films since they would be able to judge the educational and psychological value of different narratives and visual displays.

Conforming with the international contemporary debate on the so-called good and immoral as opposed to the ‘morally corruptive’ cinema, de Ruette elaborated that the most crucial task for health educational films should be to exclusively claim film as an educational rather than an entertaining medium. The point of this was to prevent the supposed moral and physical decay of ‘the’ public. Illiterate rural and colonised populations, who did not have the same access to public education as citizens in the metropole, were considered to be important target groups. In addition, a crusade against illiteracy was globally pronounced with the help of educational films, which would reach and inform viewers who were not able to read books or access formal education. The cinematic image was considered to be a suitable vivid didactic media that could visualise complex phenomena hard to describe in words.114

Un ennemi public is a classic example of combining scientific images with fictional narrative: micro-cinematographic displays of tuberculosis pathogens or authentic shootings from Belgian clinics and sanatoria were intertwined with fictional scenes. The scene in which the protagonist visits a doctor and attends an X-ray examination in the clinic was staged at the actual hospital rooms of the St-Pierre university clinic in Brussels.115 On set the film staff was instructed by the hospital’s technicians on how to operate the X-ray device.116 The shooting location was thus ‘real’, but the character of the doctor was interpreted. In other European health films, it was common to feature real patients, doctors and members of clinical staff to underline the immediate reality of medical risk and care.

Storck had suggested a private physician as consultant, who should arrange terms with the Ligue Nationale belge contre la tuberculose. The logistics of all participating and funding parties proved to be difficult. The production was more time-consuming since not all parties agreed on who should be the primary decision-making authority. Storck was increasingly dissatisfied with the way in which the production had unfolded. At some point, in a letter to one of his fellow film peers, Storck minimalised his impact on the final film, as he criticised the lack of artistic freedom during the production.

The storyline and impact of Un ennemi public appeared to lose importance throughout its production. Whereas the film was originally intended for a large audience, the producers were ultimately content to be able to screen the film in representative settings. Political officials, journalists and other distinguished members of Belgian society were invited to the premiere. Invited officials and press reported gushily about the successful, both morally and educationally valuable, film.

Afterwards, Un ennemi public was screened in local cinemas in the city, periphery and countryside, and was made accessible to all ages and sexes. Yet the public audience was less enthusiastic, as often was the case for educational films.117 The lacking commercial outlet was anticipated, but the failure in popularity by the targeted viewing population was still frustrating for the producers and health officials. The impact was, rather, to be found in the interaction between participating producers and public addressees.118 Viewers were often fed up with the moral tone or the disgusting motion pictures of diseased body parts. Young cinemagoers preferred exotic travelogues, crime stories and adventurous western films to ‘boring’ educational films. Even after introducing more representative forms of evaluation through conducting surveys and collecting statistical data, the actual educational impact on public health film viewers was criticised and doubted.

Experienced hygiene film producers suggested that educational films should be ‘easily understood, visually impressive, sensual, appealing or when needed deterrent’, but principally they should be relatable, convincing and at least capable of raising interest. In turning to humorous film elements and introducing microcinematographic images they thought they could minimise the risk of boring their audiences. Tuberculosis films tried to combine a moral tone with humour. In Un ennemi public, for instance, the white-coated doctor talked to his blue-collar patient in a conventional scientific paternalist manner, but nevertheless comic ways are used to attract viewers (indeed, the actors and extended film cast often came from comedy backgrounds).119 Despite the growing concern with the public’s response, it was always an expert authority that transformed medical knowledge for a public audience. Even though interactions between the public and the professional sphere were increasingly sought after, they remained hierarchical.

Conclusion

The second half of the twentieth century is often represented as a period in which the gap between the scientific and the public sphere grew – an evolution that was confirmed by the rise of mediating actors, such as the science journalist.120 However, this chapter shows that specialised ‘mediators’, such as curators, guides or film directors, have played an important role in the spread and transformation of medical knowledge since the nineteenth century. Similarly, the years in between 1945 and the emergence of anti-authoritative movements in the late 1960s are often characterised as the golden age for alliances between politics, media and science.121 Yet this phenomenon, too, can be compared to earlier initiatives from city councils or public institutions, such as the Ligue nationale belge contre la tuberculose.

Audiences were never mere passive consumers of knowledge. In the nineteenth century, just as today, they had the agency to choose from and adapt different views of the body and health, and could respond to them in unintended ways. Sometimes their reactions incited popularisers to change their ways. The role of the audience has grown further in times of broadcasting media. The systematic acquisition of data on visitors’ and viewers’ reactions became pivotal for health-related market research and media programming. When one takes into account that television programmes, for instance, can be dismissed if they do not reach good viewing figures, the power of the audience becomes hard to deny.122 Since the digital era, democratic accessibility of websites and databases, such as YouTube, Wikipedia, medical trial sites or health and fitness apps monitoring physiological data, are easier to consume than ever before, and have given rise to reflection and criticism regarding the status of experts in science communication.123 US surveys in the late 1990s showed, for instance, that most of the respondents were getting healthcare information from television before they would consult doctors. Magazines, journals, newspapers, radio and, most importantly, the Internet have become crucial media for seeking medical advice.124

From all this, it is clear that the popularisation of medicine was, and is, not a top-down process, but rather the result of exchanges between different actors, ranging from physicians to carnies, from film directors to working-class audiences, from politicians to television producers. Knowledge was not simply diffused by scientists, but transformed as different actors interacted with each other. Even if the relationship between the scientific and the public sphere was hierarchic, interactions were mutual. Not only did popularisers enter (or pretended to enter) in alliances with scientists to bolster their authority, scientists also actively pursued rapprochements with larger audiences in order to enhance their own. Until today, the reach and public relevance of one’s scientific work is an important argument for the legitimation of research and its funding.

Belgium appears to be a particularly interesting case to study these instances of circulation. As the market was often too small for original productions, there was room for international institutions. Yet in order to attract Belgian audiences, these foreign players (whether curators of health exhibitions, moviemakers or others) did have to adapt themselves to local tastes and sensitivities. The boundaries between the scientific and the popular sphere, too, appear to have been more permeable than in other countries. The example of the Spitzner Museum suggests that Belgian politicians were particularly enthused by collaborations with commercial institutions.

To conclude, it is time to revise our big pictures and the place of popularisation within them. The idea of ‘professionalisation’ does not account for the continued importance of lay experts, and ‘medicalisation’ was not a mere top-down process but was at least in part initiated by lay audiences and patients, who sought medical knowledge and treatments themselves.125 As Huistra’s research on the Netherlands has shown, recent mass digitisation projects might provide us with the right tools to grasp the history of popularisation in all its complexity.126 It is now possible to complement more traditional sources, such as medical journals or parliamentary discussions, with a systematic study of newspapers, ego-documents and popular magazines. Historians are better equipped than ever to elucidate both the roles of different actors in the popularisation process and the circulation of ideas. Popularisation was not a monologue but a conversation: let us study it as such.

Notes

1 ‘Développez et raffermissez votre poitrine’, Le Peuple (19 May 1914).
2 B. Latour, Pandora’s Hope: Essays on the Reality of Science Studies (Cambridge, MA: Harvard University Press, 1999); N. Thomas, Entangled Objects: Exchange, Material Culture, and Colonialism in the Pacific (Cambridge, MA: Harvard University Press, 1991); J. A. Secord, ‘Knowledge in transit’, Isis, 95:4 (2004), 654–72.
3 J. R. Topham, ‘Rethinking the history of science popularization/popular science’, in Popularizing Science and Technology in the European Periphery 1800–2000, ed. F. Papanelopoulou et al. (London: Routledge, 2009), 1–20.
4 F. Huisman, ‘Shaping the medical market: on the construction of quackery and folk medicine in Dutch historiography’, Medical History, 43:3 (1999), 359–75.
5 J. Vandendriessche, E. Peeters and K. Wils, ‘Introduction: performing expertise’, in Scientists’ Expertise as Performance: Between State and Society, 1860–1960, ed. J. Vandendriessche, E. Peeters and K. Wils (London: Pickering & Chatto, 2014), 1–13. On lay actors claiming medical expertise, see W. Ruberg, ‘Mother knows best: the transmission of knowledge of the female body and venereal diseases in nineteenth-century Dutch rape cases’, in The Transmission of Health Practices, c.1500 to 2000, ed. M. Dinges and R. Jütte (Frankfurt: Franz Steiner Verlag, 2011), 35–48.
6 The Royal Library of Belgium started the digitisation of newspapers in 2004. A selection of newspapers can be accessed through their website at www.belgicapress.be (accessed 20 February 2018). Several medical journals are also being digitised, cf. www.kbr.be/fr/impress (accessed 20 February 2018).
7 K. Velle, De nieuwe biechtvaders: de sociale geschiedenis van de arts in België (Leuven: Kritak, 1991); W. Dupont, ‘Free-floating evils: a genealogy of homosexuality in Belgium’ (PhD diss., University of Antwerp, 2015); L. Di Spurio, Du côté des jeunes filles: Discours (contre-)modèles et histoire de l’adolescence féminine (Brussels: éditions de l’université libre de Bruxelles, 2020); C. Pirson, Corps à Corps. Les Modèles anatomiques entre art et médecins, 1699–2008 (Paris: Mare & Martin, 2009).
8 S. Onghena, ‘Professor, wat kunt U ons vertellen? Wetenschapsprogramma’s tijdens de pioniersjaren van de Vlaamse televisie, 1953 – ca. 1970’, Tijdschrift voor Geschiedenis, 125:2 (2012), 217–32; S. Onghena, ‘Tot lering en vermaak: wetenschappelijke kinderboeken van Belgische uitgevers in de tweede helft van de negentiende eeuw, De Gulden Passer, 89:2 (2011), 211–37; T. Claes and V. Deblon, ‘Van panoramisch naar preventief. Populariserende anatomische musea in de Lage Landen (1850–1880)’, Negentiende Eeuw, 39:3/4 (2015), 287–306; K. Wils, ‘Tussen wetenschap en spektakel. Hypnose op de Belgische theaterscène, 1875–1900’, Tijdschrift voor mediastudies, 20:2 (2017), 54–73. An ongoing interuniversity project looks at the history of the use of the ‘magic lantern’, including for science popularisation, see www.uantwerpen.be/en/projects/b-magic (accessed 19 March 2020).
9 E. Peeters, De beloften van het lichaam. Een geschiedenis van de natuurlijke levenswijze in België, 1890–1940 (Amsterdam: Bert Bakker, 2008); A. H. van Baal, In Search of a Cure: The Patients of the Ghent Homeopathic Physician Gustave A. van den Berghe 1837–1902 (Rotterdam: Erasmus, 2008).
10 For example, K. Knight, Public Understanding of Science: A History of Communicating Scientific Ideas (London: Routledge, 2006); P. Bowler, Science for All: The Popularization of Science in Early-Twentieth-Century Britain (Chicago: University of Chicago Press, 2009); D. Raichvarg and J. Jacques, Savants et ignorants: une histoire de la vulgarisation des sciences (Paris: Seuil, 1991); S. Nikolow (ed.), Erkenne Dich selbst! Strategien der Sichtbarmachung des Körpers im 20. Jahrhundert (Cologne: Böhlau, 2015).
11 E. Peeters, ‘Questioning the medical fringe: the “cultural doxy” of Catholic hydrotherapy in Belgium, 1890–1914’, Bulletin of the History of Medicine, 84:1 (2010), 92–119.
12 Onghena, ‘Professor’, 225–30.
13 J. Hellemans, ‘Les contrefaçons belges au Québec … Au temps où le livre français était belge’, Documentation et bibliothèques, 57:3 (2011), 169–77.
14 V. Deblon, ‘Imitating anatomy: recycling anatomical illustrations in nineteenth-century atlases’, in Bodies Beyond Borders: Moving Anatomies, 1750–1950, ed. K. Wils, R. De Bont and S. Au (Leuven: Leuven University Press, 2017), 139–61.
15 R. Molhant, Les Catholiques et le Cinéma: Une étrange histoire de craintes et de passions. Les débuts: 1895–1935 (Brussels: OCID), 19; J. Trumpbour, Selling Hollywood to the World: U.S. and European Struggles for Mastery of the Global Film Industry, 1920–1950 (Cambridge: Cambridge University Press 2001), 211–13; D. Biltereyst and D. Treveri Gennari (eds), Moralizing Cinema: Film, Catholicism, and Power (New York: Routledge, 2014).
16 On the value of such a media-approach, see J. Leach, ‘Science communication’, in The Handbook of Communication History, ed. P. Simonson et al. (London: Routledge, 2013), 289–301.
17 K. Velle, Lichaam en hygiëne (Ghent: MIAT–KRITAK, 1984); K. Velle, ‘Bronnen voor de medische geschiedenis: de Belgische medische pers (begin XIXde eeuw–1940)’, Annalen van de Belgische vereniging voor de geschiedenis van de hospitalen en de volksgezondheid, 23–4 (1988), 66–119; W. H Helfland, ‘Some one sole unique advertisement’: public health posters in the twentieth century, in Imaging Illness. Public Health and Visual Culture, ed. D. Serlin (Minneapolis: University of Minnesota Press, 2010), 126–42.
18 Pirson, Corps à Corps, 163–205; Claes and Deblon, ‘Van panoramisch’, 287–306.
19 Province de Hainaut, Musée d’Hygiène: nouveau catalogue illustré (Mons: Charleroi Imprimerie provinciale, 1925).
20 Roode Kruis, De mensch: tentoonstelling Egmont-paleis, Brussel, 1–31 oktober 1938: catalogus (Brussels: Roode Kruis van België, 1938).
21 G. Convents, ‘Van de verburgelijking van het populair vermaak tot amusement voor iedereen’, in De panoramische droom: Antwerpen en de wereldtentoonstellingen 1885, 1894, 1930, ed. M. Nauwelaerts C. Terryn and P. Verbraeken (Antwerpen: Uitgeverij Antwerpen 93 vzw, 1993), 236–47.
22 E. Stephens, ‘Inventing the bodily interior: écorché figures in early modern anatomy and Von Hagens’ Body Worlds’, Social Semiotics, 17 (2007), 313–26.
23 Claes and Deblon, ‘Van panoramisch’, 301.
24 L. Nys, ‘De grote school van de natie. Legerartsen over drankmisbruik en geslachtsziekten in het leger, 1850–1950’, in Degeneratie in België 1860–1940: Een geschiedenis van ideeën en praktijken, ed. J. Tollebeek, G. Vanpaemel and K. Wils (Leuven: Leuven University Press, 2003), 79–118.
25 ‘M. Spitzner’, La Chronique (20 July 1878); ‘Een bezoek aan het anatomisch museum’, Vooruit (4 September 1921).
26 For instance, Madame Consael and Madame Spitzner inherited their late husbands’ museum.
27 Knight, Public Understanding, 182–96; M. Rossiter, ‘Women and the history of scientific communication’, Journal of Library History, 21:1 (1986), 39–59.
28 ‘Le Musée Castan’, La Chronique (3 March 1892).
29 Velle, Lichaam en hygiëne, 63–4.
30 ‘Door beter weten naar gezonder leven’, De Gentenaar (22 June 1938).
31 G. Achten et al., Grand Musée anatomique du docteur Spitzner: 1856–1896 (Brussels: Musée d’Ixelles, 1979); N. Poot, G. Vanpaemel and S. Waelkens, Een walvis in de stad. De collecties van de Leuvense Faculteit Wetenschappen (Leuven: Lipsius, 2014).
32 We borrow the term ‘things in motion’ from A. Appadurai, ‘Introduction: commodities and the politics of value’, in The Social Life of Things: Commodities in Cultural Perspective, ed. A. Appadurai (Cambridge: Cambridge University Press, 1986), 3–63.
33 Claes and Deblon, ‘Van panoramisch’, 292; Pirson, Corps à Corps, 163–205.
34 La société médicale allemande de Paris’, La médecine à l’exposition l’universelle de 1867 (Paris: Germer-Baillière, 1867).
35 Roode Kruis, De Mensch, 8. On the Glass Man, see K. Fiss, Grand Illusion: The Third Reich, the Paris Exhibition and the Cultural Seduction of France (Chicago: University of Chicago Press, 2009), 73–5.
36 Claes and Deblon, ‘Van panoramisch’, 287–306.
37 ‘De tentoonstelling De Mensch of het geheim van het leven’, De Gentenaar (1 October 1938).
38 A. Maerker, Model Experts: Wax Anatomies and Enlightenment in Florence and Vienna, 1775–1815 (Manchester: Manchester University Press, 2011).
39 F. Hutton, The Study of Anatomy in Britain, 1700–1900 (London: Pickering & Chatto, 2013), 133; L. Schulte-Sasse, ‘Advise and consent: on the Americanization of Body Worlds’, BioSocieties, 1:4 (2006), 369–84.
40 H. Huistra, ‘Weg met pottenkijkers! Hoe het publiek verdween uit het Leids anatomisch kabinet’, Negentiende Eeuw, 34:3 (2010), 193–208.
41 City Archives Ghent, 335, Musées de l’université de zoologie et d’anatomie comparée: ouverture au public 1919–20.
42 Pirson, Corps à Corps, 163–205.
43 T. Claes, ‘De onwetendheid baart de ziekte. Het populaire anatomische museum als een plaats van preventie en moralisering’, in Vesalius: het lichaam in beeld, ed. G. Vanpaemel (Leuven: Davidsfonds, 2014), 139–45.
44 Province de Hainaut, Musée d’Hygiène, 100.
45 J. D., ‘A propos de l’exposition de l’Homme, organisée par la Croix Rouge de Belgique’, La Libre Belgique (5 October 1938).
46 Pirson, Corps à Corps, 197.
47 Deblon, ‘Imitating anatomy’, 115–37; T. Claes, ‘Alternative anatomy: the popular lectures of Constant Crommelinck in Brussels (1850–1880)’, in Wils et al., Bodies Beyond Borders, 139–61.
48 Vandendriessche et al., ‘Introduction’, in Scientists’ Expertise as Performance, 1–13.
49 Peeters, ‘Questioning the medical fringe’, 92–119.
50 A. W. Bates, ‘Dr Kahn’s museum: obscene anatomy in Victorian London’, Journal of the Royal Society of Medicine, 99:12 (2006), 618–24.
51 Pirson, Corps à Corps, 197–8.
52 City Archives Brussels, ASB IP II 2581, Letter from City Council of Antwerp to City Council of Brussels, 27 September 1926.
53 Achten, Grand musée anatomique.
54 S. Onghena, ‘Spektakelstukken. De mise-en-scène van de wetenschap in de Belgische stad, 1890–1914’, in Tussen beleving en verbeelding: de stad in de negentiende-eeuwse literatuur, ed. I. Bertels et al. (Leuven: University Press Leuven, 2013), 4369, at 44.
55 City Archives Brussels, ASB IP II 3333, Letter from Madame Spitzner to City Council of Brussels, 27 December 1933.
56 J. D., ‘A propos de l’exposition de l’Homme’, 2.
57 Onghena, ‘Spektakelstukken’, 61–5.
58 Velle, Lichaam en hygiëne, 101.
59 E. Stephens, ‘Inventing the healthy body: the use of popular medical discourses in public anatomical exhibitions’, in The Body Divided: Human Beings and Human ‘Material’ in Modern Medical History, ed. S. Ferber and S. Wilde (Ashgate: Farnham, 2011), 22338, at 236.
60 T. Consael, Museum voor ontleed-, volken- en ziektenkunde: gids van den bezoeker, bevattende de noodige en juiste aanduidingen en uitleggingen van ons verzameling (Brussels: Lefèvre, 1885).
61 P. Spitzner, Katalogus van het groot anatomisch museum van dr. P. Spitzner (n.pub., n.d.).
62 S. Alberti, ‘Objects and the museum’, Isis, 96:4 (2005), 559–71. On Belgium, see L. Nys, De intrede van het publiek: Museumbezoek in België, 1830–1914 (Leuven: Leuven University Press, 2012), 219–50.
63 Maerker, Model Experts, 128–33.
64 J. D., ‘A propos de l’exposition de l’Homme’, 2.
65 S. Bussels and B. van Oostveldt, ‘De Antwerpse wereldtentoonstelling van 1894 als ambigu spektakel van de moderniteit’, Tijdschrift voor Geschiedenis, 125:1 (2012), 5–20.
66 Claes and Deblon, ‘Van panoramisch’, 302.
67 H. Storck, Un ennemi public. Ligue Nationale belge contre la tuberculose. sound film. b/w 15 min (Belgium, 1937).
68 Archives générales du Royaume (AGR), Brussels, Section Prophylaxie de l’Oeuvre Nationale Belge de Défense contre la Tuberculose, founded in the 1920s, Dossier: Min. Santé Publique, Adm. Hygiène Publique, 1482, Buhl Committee 117.
69 R. Sand, ‘Le programme de la médecine sociale’, Vers la santé, 3 (1922), 497–506; K. Ostherr, Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World Health (Durham, NC: Duke University Press, 2005).
70 Cf. Chapter ‘Television’, in Cultural Sutures: Medicine and Media, ed. L. D. Friedmann (Durham, NC: Duke University Press, 2004), 197–262.
71 Cf. D. Cantor, ‘Uncertain enthusiasm: the American Cancer Society – public education and the problems of the movie, 1921–1960’, Bulletin of the History of Medicine, 1:81 (2007), 39–69; C. Bonah, D. Cantor and A. Laukötter (eds), Health Education Films in the Twentieth Century (Rochester, NY: University of Rochester Press, 2018).
72 Cf. Ostherr, ‘Cinematic prophylaxis’.
73 C. Bonah, ‘A word from man to man: interwar venereal disease education films for military audiences in France’, Gesnerus: Swiss Journal of the History of Medicine and Sciences, 72:1 (2015), 15–38.
74 Cf. K. Pilz, ‘Aufklärung? Abschreckung? In der mit Sexualität gespannten Atmosphäre des Kinos? Sexualität in Wiener klinischen und populärwissenschaftlichen Filmen der Moderne’, in Sexualität und Widerstand. Internationale Filmkulturen, ed. A. Basaran, J. B. Köhne, K. Sabo and C. Wieder (Vienna: Mandelbaum, 2018), 54–76.
75 M. S. Pernick, ‘Thomas Edison’s tuberculosis films: mass media and health propaganda’, Hastings Center Report, 8:3 (1978), 21–7, 25.
76 G. Aubert, ‘Arthur van Gehuchten takes neurology to the movies’, Neurology, 59:10 (2002), 1612–18; T. Lefebvre, ‘À la découverte d’Arthur van Gehuchten’, Bulletin de la Sémia, 1 (2002), 7. His filmed cases were partly published posthumously in A. van Gehuchten, ‘Les Maladies Nerveuses’ (Leuven: Librairie Universitaire, 1920), 532–44.
77 P. van Gehuchten, L’œuvre scientifique de Arthur van Gehuchten (Brussels: Impr. des Sciences, 1973).
78 G. Marinesco, ‘Application du cinématographe à l’étude des troubles de la marche dans les maladies nerveuses’, Journal de Neurologie, 18 (1900), 316; A. van Gehuchten, ‘Coup de couteau dans la moelle lombaire’, Le Névraxe, 9:2 (1907), 208–32.
79 Medical film collections: Achives de la Cinématèque Royale de Belgique, Brussels, Arthur van Gehuchten (Archives UCL, Louvain 1905–1914); Private Archive Institute Born-Bunge, Antwerp, Ludo van Bogaert (Instituut Born-Bunge, Antwerp, 1934–50).
80 Cf. A. Laukötter, ‘Vom Ekel zur Empathie. Strategien der Wissensvermittlung im Sexualaufklärungsfilm des 20. Jahrhunderts’, in Erkenne Dich selbst! Strategien der Sichtbarmachung des Körpers im 20. Jahrhundert, ed. S. Nikolow (Cologne: Böhlau, 2015), 305–19.
81 As was the case in Germany, France and Austria. Cf. K. Pilz, ‘Medicine in motion: early medical filmmaking shaping clinical specialisation, public health and visual modernity in Vienna and Brussels’ (PhD diss., Université libre de Bruxelles and Universität Wien, 2020).
82 Annonce films Doyen’, Cinéma-Revue-Belge. Journal hebdomadaire de la Cinématographie et de toutes les industries qui s’y rattachent, 12 (1912), 8–9.
83 Quoted by Desjardin in Contrefaçon artistique des cinématographies du Dr Doyen (21–2), in T. Lefebvre, La chair et le celluloïd. Le cinéma chirurgical du docteur Doyen (Paris: Brionne, Jean Doyen éditeur, 2004), 54.
84 L. Haesaerts, ‘Le Cinéma scientifique’, in Numéro spécial de Les Beaux-Arts publié pour l’Institut national de cinématographie scientifique de Belgique à l’occasion du IIIe Congrès de l’Association internationale du cinéma scientifique (Brussels: n.pub., 1949), 37892, at 368.
85 P. Väliaho, Mapping the Moving Image: Gesture, Thought and Cinema circa 1900 (Amsterdam: Amsterdam University Press, 2010), 109.
86 Cf. P. Thevenard and C. Tassel, Le cinéma scientifique français (Paris: La Jeune Parque, 1948).
87 M. Cadé, L’écran bleu: La représentation des ouvriers dans le cinéma français (Perpignan: Presses Universitaires de Perpignan, 2004).
88 R. Sand, ‘L’histoire de la médecine du travail’, Archives Belges de Médecine Sociale, Hygiène, Médecine du Travail et Médecine Légale, 9:7 (1949), 395–420 and 484–507.
89 Cf. ‘Darstellung von Krankheiten in neueren Lehr- und Kulturspielfilmen’, Zeitschrift für Ärztliche Fortbildung, 25:13 (1928), 472–3.
90 Cinémathèque Royale de Belgique (CRB), Brussels, List/Dossier: films hygièniques.
91 L. Bourgeois, Le dispensaire antituberculeux. L’assistance publique de Paris, b/w 5 min. (France 1917), CRB.
92 Comité National: La visiteuse d’hygiène, b/w 5 min. (France ca. 1925), CRB.
93 Cf. T. Lefebvre, ‘Les victimes de l’alcoolisme (Pathé – 1902). Quand le cinéma des premiers temps puise son inspiration dans le discours hygiéniste dominant’, Archives. Institut Jean Vigo – Cinémathèque de Toulouse (May 1992); Archives de la Ville de Bruxelles (AVB), Brussels, film poster, AVB, Affiches cinéma XIII-12 ‘Affiche de cinéma. Les Maladies Sexuelles et leurs Conséquences. Cinéma Le Régent. Rue Neuve, Bruxelles (‘Un document scientifique sensationnel … Pour combattre un fléau il faut le connaître!’)
94 F. Henrion, ‘A propos de Cinéma Scientifique’, Union des anciens étudiants de l’ULB, 334 (1966), 37–40.
95 Until then, colonial and in Belgium produced health films were nominally produced by American health officers, such as a film on venereal diseases produced in 1926, AGR, Brussels, Dossier: Min. Santé Publique, Adm. Hygiène Publique, 1482, Dossier: Cinéma/films éducatives.
96 Cf. M. Braun et al. (eds), Beyond the Screen: Institutions, Networks and Publics of Early Cinema (New Barnet: John Libbey, 2012); C. Taillibert, L’Institut international du Cinématographe éducatif. Regards sur le rôle du cinéma éducatif dans la politique internationale du fascisme italien (Paris: L’Harmattan, 1999); Z. Druick, ‘The International Educational Cinematograph Institute, reactionary modernism, and the formation of film studies’, Canadian Journal of Film Studies, 16:1 (2007), 80–97.
97 Among others such as micro-cinematographic (microscopic motion pictures) life science and surgical films, cf. B. de Pastre and T. Lefebvre (eds), Filmer la science, comprendre la vie: le cinéma de Jean Comandon [exhibition catalogue] (Paris: Centre national de la cinématographie, 2012).
98 Which was common also for other films in smaller countries with less commercial film industry, cf. P. Mosley, Split Screen: Belgian Cinema and Cultural Identity (New York: State University of New York Press, 2001).
99 Cf. K. Pilz, ‘Hearts and brains in motion: medical animated film as a popular and controversial medium for education and research’, Wiener Klinische Wochenschrift – The Central European Journal of Medicine, 132 (2020), 52–6.
100 Cf. W. Benjamin, Das Kunstwerk im Zeitalter seiner technischen Reproduzierbarkeit (Berlin: Suhrkamp, [1936] 2010), 500.
101 Cf. E. Blaschitz, Der ‘Kampf gegen Schmutz und Schund’. Film, Gesellschaft und die Konstruktion nationaler Identität in Österreich (1946–1970) (Vienna: Lit Verlag, 2014).
102 These collaborations were common also in the case for contemporary Germany, France and Austria.
103 Cf. O. Decroly, ‘Le cinéma comme procédé d’étude et moyen d’enseignement de la psychologie de l’enfant’, Document pédotechnique (1929), in CED, Brussels, manuscript.
104 S. Wagnon, Ovide Decroly, un pedagogue de l’Éducation nouvelle 1871–1932 (Brussels: PIE, 2013), 141–6.
105 A. Lumière, Notice sur le titres et travaux de Auguste Lumière Correspondant de l’Institut et de l’Académie de Médecine de 1887 à 1940 (Lyon: Imp. Léon Sézanne, 1940).
106 Cf. K. Ostherr, ‘Empathy and objectivity. health education through corporate publicity films’, in Serlin, Imaging Illness, 62–82.
107 Cf. J. Rancière, Le destin des images (Paris: La Fabrique éditions, 2003).
108 S. Curtis, The Shape of Spectatorship: Art, Science, and Early Cinema in Germany, Film and Culture Series (New York: Columbia University Press, 2005).
109 Archives de l’ULB (AULB), Fond Henri Storck, Dossier: correspondence Un ennemi public, letter Ligue Nationale belge contre la tuberculose and Henri Storck, spring 1937.
110 Cf. Laukötter, ‘Vom Ekel zur Empathie’, 305–19.
111 K. Ostherr, Medical Visions: Producing the Patient Through Film, Television, and Imaging Technologies (New York: Oxford University Press, 2013).
112 Pernick, ‘Thomas Edison’s tuberculosis films’, 25.
113 V. de Ruette, ‘Cinéma éducatif ou cinéma démoralisateur?’, Journal de l’Institut international du cinématographe éducatif, 4 (1933), 290–308.
114 M. Loiperdinger, ‘The social impact of screen culture 1880–1914’, in Screen Culture and the Social Question 1880–1914, ed. L. Vogl-Bienek and R. Crangle (New Barnet: KINtop, 2014), 9–19.
115 Cf. on the history of Brussels university clinics: R. Bardez, ‘La Faculté de médecine de l’Université Libre de Bruxelles: entre création, circulation et enseignement des savoirs (1795–1914)’ (PhD diss., Université libre de Bruxelles, 2015); and V. Leclercq, ‘Guérir, travailler, désobéir: Une histoire des interactions hospitalières avant l’ère du “patient autonome” (Bruxelles, 1870–1930)’ (PhD diss., Université Libre de Bruxelles, 2017).
116 AULB, Brussels, fond Henri Storck, production notes 1937.
117 A. Mebold, ‘Just like a public library maintained for public welfare: 28mm as a comprehensive service strategy for non-theatrical clientele, 1912–1923’, in Networks of Entertainment: Early Film Distribution 1895–1915, ed. F. Kessler and N. Verhoeff (New Barnet: John Libbey, 2007), 260–74.
118 J. Tanner, ‘Populäre Wissenschaft. Metamorphosen des Wissens im Medium des Films’, Gesnerus: Swiss Journal of the History of Medicine and Sciences, 66:1 (2009), 15–39, at 17.
119 De Ruette, ‘Cinéma éducatif ou cinéma démoralisateur?’, 303–4.
120 Onghena, ‘Professor’, 227.
121 R. Halleux and G. Xhayet, ‘De ontwikkeling der ideeën’, in Geschiedenis van de wetenschappen in België 1815–2000, ed. R. Halleux et al. (Brussels: Dexia, 2001), 15–34.
122 T. Boon, Films of Fact: A History of Science in Documentary Films and Television (London: Wallflower Press, 2008), 2 and 184.
123 F. Mclellan, ‘Medicine.com: the internet and the patient–physician relationship’, in Cultural Sutures: Medicine and Media, ed. L. D. Friedmann (Durham, NC: Duke University Press, 2004), 373–85.
124 Ibid., 1–5.
125 P. Conrad, ‘The shifting engines of medicalization’, Journal of Health and Social Behavior, 46:1 (2005), 3–14; S. Snelders and F. Meijman, De mondige patiënt: historische kijk op een mythe (Amsterdam: Bert Bakker, 2009).
126 H. Huistra, ‘Experts by experience: lay users as authorities in slimming remedy advertisements, 1918–1939’, Bijdragen en Mededelingen Betreffende de Geschiedenis der Nederlanden, 132:1 (2017), 126–48.

Selected bibliography

Anderson, N. and Dietrich, M. R., The Educated Eye: Visual Culture and Pedagogy in the Life Sciences (Hanover, NH: Dartmouth College Press, 2012).
Bonah, C., Cantor, D. and Laukötter, A. (eds), Health Education Films in the Twentieth Century (Rochester, NY: University of Rochester Press, 2018).
Bonah, C. and Laukötter, A. (eds), Body, Capital, and Screens: Visual Media and the Healthy Self in the 20th Century (Amsterdam: Amsterdam University Press, 2020).
Claes, T. and Deblon, V., Van panoramisch naar preventief. Populariserende anatomische musea in de Lage Landen (1850–1880)’, Negentiende Eeuw, 39:3/4 (2015), 287–306.
Friedmann, L. D. (ed.), Cultural Sutures: Medicine and Media (Durham, NC: Duke University Press, 2004).
Onghena, S., ‘Professor, wat kunt U ons vertellen? Wetenschapsprogramma’s tijdens de pioniersjaren van de Vlaamse televisie, 1953–ca. 1970’, Tijdschrift voor Geschiedenis, 125:2 (2012), 217–32.
Onghena, S., ‘Spektakelstukken. De mise-en-scène van de wetenschap in de Belgische stad, 1890–1914’, in I. Bertels, J. H. Furnée, T. Sintobin, H. Vandevoorde and R. van de Schoor (eds), Tussen beleving en verbeelding: de stad in de negentiende-eeuwse literatuur (Leuven: Leuven University Press, 2013), 43–69.
Pauwels, L. (ed.), Visual Cultures of Science: Rethinking Representational Practices in Knowledge Building and Science Communication (Hanover: University Press of New England, 2006).
Peeters, E., De beloften van het lichaam. Een geschiedenis van de natuurlijke levenswijze in België, 1890–1940 (Amsterdam: Bert Bakker, 2008).
Peeters, E., ‘Questioning the medical fringe: the “cultural doxy” of Catholic hydrotherapy in Belgium, 1890–1914, Bulletin of the History of Medicine, 84:1 (2010), 92–119.
Secord, J. A., ‘Knowledge in transit’, Isis, 95:4 (2004), 654–72.
Serlin, D. (ed.), Imaging Illness: Public Health and Visual Culture(Minneapolis: University of Minnesota Press, 2010).
Van Baal, A. H., In Search of a Cure: The Patients of the Ghent Homeopathic Physician Gustave A. van den Berghe 1837–1902(Rotterdam: Erasmus, 2008).
Vandendriessche, J., Peeters, E. and Wils, K. (eds), Scientists’ Expertise as Performance: Between State and Society, 1860–1960 (London: Pickering & Chatto, 2014).
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Medical histories of Belgium

New narratives on health, care and citizenship in the nineteenth and twentieth centuries

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