variante locale de tous ces «maux de saints» qui mobilisent, dans la coutume chré-
tienne, d'amples réseaux sémantiques<fnref n="2" />.

Ces réserves sur les modes d'analyse des usages rituels liés à une pratique cultuelle invitent, par contraste, à souligner à nouveau l'apport d'une étude historiographique lorsqu'elle s'emploie à contextualiser précisément les auteurs, les textes, les méthodes d'enquête et les modèles conceptuels qui composent au XVIIIe siècle la vaste bibliothèque du tarentisme.

Giordana Charuty, Paris (F)

Donzé, Pierre-Yves: **L'ombre de César.** Les chirurgiens et la construction du système hospitalier vaudois (1840-1960). Avant-propos de John V. Pickstone. Lausanne, Editions BHMS, 2007. (Bibliothèque d'histoire de la médecine et de la santé). XIX, 369 p. Ill. Fr. 48.–; € 32.–. ISBN 978-2-9700536-2-0.

With the history of the hospitals in the canton of Vaud in relation to the development
of modern surgery Pierre-Yves Donzé's book "L'ombre de César" takes up an
important and original topic. Despite its character of a regional case study, the inves-
tigation opens up new perspectives on the history of medicine in general. Even though
the influence of surgery on the emergence of the modern hospital has been pointed
out by other authors before, there is a definite need to investigate this relationship
in more detail in studies such as the present one. Moreover, the author's approach
is of special interest for hospital history because he looks not only at one institution,
but at the hospitals of a whole region and investigates their interrelationship. At the
same time this study is valuable for the history of modern surgery. By combining the
technical with the social history of surgery, it helps to better understand the spread
of modern surgical techniques and approaches. The choice of Vaud as a relatively mar-
ginal region – compared to the great European and American centres of surgery – is
fortunate too, since investigating examples outside those big centres helps to under-
stand the large-scale spread of modern surgery in the Western world. Also, looking at
surgery, hospital technology and hospital administration in combination is a promis-
ing research strategy. In addition, the huge time span (1840–1960) of this study makes
it particularly useful. The study is based on an impressive amount of unprinted and
printed sources which are documented in a flawless manner. The introductory chap-
ter presents the topic in an engaging and concise way. Its extensive and sophisticated
discussion of the research literature is evidence of the author's superior knowledge
of the current research literature. It is also the place where the theoretical structure
of the study is presented. It starts with the assumption that one can identify a hospi-
tal system (système hospitalier) and a technical medical system (système technique
médical), which originally existed independent of each other. Over the course of the
nineteenth and twentieth century, these systems gradually fused and produced the
modern hospital as an institution where technically sophisticated medical treatment
is available. The idea of distinguishing the two systems in order to investigate their
interaction is a fruitful way of coming to terms with the common history of the modern
hospital and modern surgery. Chapter one is dedicated to biographical and prosopo-

<footnote n="2">2 Voir la lecture que j'en ai proposée dans *Folie, mariage et mort. Pratiques chrétiennes de la folie en Europe occidentale* (Paris, Le Seuil, 1987).</footnote>
graphical research on the main protagonists in the history of the fusion of two sys-
tems, which was mainly driven by the concerns of surgeons. In this chapter, the title-
giving César Roux comes up as the most influential among a whole cohort of surgeon-
modernisers, who, trained in the new German style of surgery, played a crucial role in
the transformation of the canton's hospitals. The chapter does not restrict itself to
looking at human actors. It also examines the history of technologies. The passages
on surgical objects, in particular the operating table, work very well. They demonstrate
how enlightening the investigation of the interaction between medicine and technol-
ogy can be. Chapter two, on the Cantonal Hospital in Lausanne, illuminates the eco-
nomic and social background of these changes. Particularly useful is the examination
of the different dimensions of society in which the historical protagonists participated.
Here the advantage of a local approach comes out most clearly. By enabling a recon-
struction of the networks of political allegiances and personal relationships, it opens
up a whole new dimension for explaining events and developments in the history of
medicine. It also helps to put the modernisation of hospitals into the context of the
modernisation of society more generally. Chapter three, which deals with the regional
hospitals, is of particular value, not least because the history of smaller hospitals is
a much neglected topic. The chapter provides not only an analysis of the cultural-
religious background of founding and running these hospitals but also comes up
with details on the architects who actually designed them – another often-neglected
dimension of hospital history. From the point of view of the history of surgery the
details on surgery in a rural setting are also extremely useful. Chapter four, on the
emergence of a hospital policy in the canton of Vaud, adds another dimension to
this intriguing study. The concluding chapter demonstrates once again the benefits
of focusing on one particular region and investigating its hospitals as a system. The
approach helps to better understand both surgery's development from a craft to a
science-based, quasi-industrialised technology and the transformation of the hospital
from a refuge for the indigent sick to the place where this technology was offered.

Thomas Schlich, Montréal (CDN)

Dorlin, Elsa: **La matrice de la race.** Généalogie sexuelle et coloniale de la Nation française. Paris, La Découverte, 2006. 307 p. (Textes à l'appui. Série «genre et sexualité»). € 27.–. ISBN 978-2-7071-4881-0.

Au croisement de l'histoire de la médecine, des études genre et des études postcoloniales, l'ouvrage d'Elsa Dorlin met en évidence le rôle des discours médicaux dans la généalogie d'une nation française envisagée sous l'angle des discriminations qui la constituent. L'autrice propose ainsi un modèle inédit de l'imbrication du genre et de la race dans la fabrique politique des corps des XVIIe et XVIIIe siècles. Ce modèle met en relation différents usages de la notion de tempérament au sein d'une «matrice» épistémologique commune.

Dans la première partie, Elsa Dorlin rompt avec Laqueur en faisant de la physio-
logie humorale plutôt que l'anatomie le site crucial de la différenciation des sexes à
l'âge classique. Le tempérament froid et humide des femmes dote leur corps d'un
fonctionnement pathologique, objet des traités des «Maladies des femmes» des XVIIe