Flesh in the Age of Reason
Authors: R. Carter
Journal: Journal of the Royal Society of Medicine (2005)

'... my next book', wrote Professor Roy Porter in 2000, '... will examine the triangle of the moral, the material and the medical in the anglophone Enlightenment.' The final draft of Flesh in the Age of Reason was finished before he died in March 2002. It lacks only the end notes which the author did not live to complete.

Porter's 'triangle' is roughly equilateral and, as the opening quotation implies, the discourse covers an exceptionally wide field; this review concentrates on the medical arm of the triangle. The 'Age of Reason' broadly covers a span between John Locke, whose philosophy is central to the whole book, and William Blake. The latter might seem an incongruous defining figure here but it will become apparent that his impact on the Age of Reason was profound.

Porter's dominant theme is the transformation of the sense of self or personal singularity which occurred over this period—a time when '... dogma and sedimented popular belief(s)' were increasingly questioned. Evidence of such questioning comes mainly from the polite and educated segments of society, largely urban, and enjoying increasing (albeit selective) affluence in a strongly entrepreneurial and secular setting.

Implicit in Porter's proposed transformation of the sense of personal identity is a parallel transformation in ideas about the flesh which not only composes self but, in a moral sense, impinges on it and shapes individual conduct, thoughts and beliefs. To what extent were the traditionally inimical effects of the flesh secularized and rationalized during this time?

The structure and function of flesh—as distinct from its moral connotations—were legitimate topics for enquiry after the age of Vesalius and Harvey. Public dissections were performed and 'anatomizing' became a familiar approach among writers, philosophers and theologians. Joseph Addison contributed articles to The Spectator as 'Mr Dissector'. In 1699 the anatomist Giorgio Baglivi wrote that the human body 'is truly nothing else but a complex of chymicomechanical motions'. An anatomical location for the soul proved difficult to establish and the conflicting claims made for the pineal gland, the brain in general and the blood were unresolved. The later investigations of abnormal or 'morbid' anatomy, often linked to previous clinical changes, represented logical and important developments. Morgagni's Seats and Causes of Diseases as Described by Anatomical Dissections had appeared in Venice in 1761 and Matthew Baillie published his Morbid Anatomy of some of the Most Important Parts of the Human Body in London in 1793. Despite these advances, serious ailments of the flesh were still rarely amenable to cure or prevention (with the obvious exception of small pox). Porter does, however, describe the increasing attention paid at this time to keeping the flesh in order by regulating diet, sleep, exercise and personal hygiene—curiously modern preoccupations. Excesses of the flesh were seen in a largely secular context, though the religious might urge the positive duty of maintaining the divinely designed machinery. The over-indulgent and affluent increasingly found themselves packed off to spas, immersed in the sea or condemned to sessions on Dr Cheyne's 'Chamber-Horse' or (still worse) Dr Sanctorius's 'Mathematical Chair'.

Certain writers towards the end of the 18th century returned to earlier mechanistic views of human flesh, reflecting the machine-driven society of the emergent industrial revolution. Though deeply materialistic, these mechanistic views could be optimistic as well. The scope for improvement in people, as in machines, might be limitless. Locke had expressed cautious confidence in the educability of man as a progressive creature, but future predictions became increasingly wild. 'Why may not man one day be immortal?' asked the atheist William Godwin, pointing (as Porter observes) to a future geriatric paradise. It is difficult to know how much credence was given to such views; but Porter describes the parallel emergence of unreason on several fronts.

Reason had painfully self-evident limitations and clearly did not preclude the irrational, even for some of the greatest intellects of the age. The interest in alchemy shown by Boyle and Newton and the religious terrors of Dr Johnson illustrate the point in different ways. Less exalted examples are, however, also instructive. The cult of sensibility seems little more than a trivial feature of fashionable 18th century society but Porter examines it in a much wider context. The products of such self-absorption and introspection might, in most instances, be worthless but there are two important points to note. The process would eventually come to be recognized as a new and valid way of viewing the self and its interactions with flesh—another phase in Porter's proposed transformation. Such changes impinged on several aspects of contemporary life, including medicine, where they led to new and more humane approaches to the appraisal and management of mental disorders. Secondly, the process might, in a few exceptional individuals, result in fundamental changes in almost any area of human activity—intellectual, artistic, social, moral, philosophical. The justification for including Blake in this book is now apparent. He presents himself as totally unorthodox in every respect—antirationalist, subversive and someone for whom the world is a mystery to be celebrated and not elucidated. Blake is supremely unreasonable.

Concluding the book, Porter notes that his narrative contains 'No simple unilinear shift from point A to position Z...no wide reaching teleological development, no final solution'. This judgment seems pessimistic for a truly remarkable account of one of the most stimulating periods of history. As Simon Schama observes in his foreword, '... the exhilaration of reading this... vital and exuberant book is punctuated by the mournfulness of realizing that there will not be another'.