In this highly original and scholarly study, Harry Paul introduces Baron Henri de Rothschild as a physician whom he intends to resurrect. More than this, he succeeds in rehabilitating the scientific and literary stature of a figure regarded by Rothschild historians and even one of his sons as a ‘dabbler’. The only member of the famous banking dynasty to have taken a medical degree, Henri de Rothschild continued the family tradition of enjoying his immense wealth in a variety of aristocratic pursuits along with devoting vast sums to medical philanthropy. But Henri was unique among Rothschilds in his dedication to a medical vocation. Contrary to a Wikipedia assertion that he never practised medicine, Henri’s career centered around more than three decades of examining and treating patients. In addition, he did significant clinical research, specialising in neonatal nutrition; he undertook investigative tours across Europe, lectured and published extensively in the new paediatric specialty, founded a journal in that field, and, most importantly, established and ran a pioneer outpatient clinic for infants that morphed into a full-scale hospital.
Rothschild began his studies at the Paris medical Faculty at the age of twenty. It mattered little that he failed to win a hospital internship. His widowed mother, who probably determined his career choice, made sure through her connections with the Dean of the Faculty that Henri received expert training and close supervision. She had already exposed her fourteen-year-old son to the treatment of severely ill children at the Rothschild hospital at Berck-sur-Mer.
Among the eminent physicians Henri followed was Pierre Budin, a pioneer in the French campaign against infant mortality and founder of the gouttes de lait or milk clinics, which provided pasteurised and sterilised milk to infants of poor families. Three years before receiving his medical degree in 1898, Henri emulated his mentor’s precedent by establishing Paris’ first privately funded goutte de lait at the Rothschild hospital, founded four decades earlier by his great grandfather. His first MD thesis (he wrote two) was an exhaustive clinical and statistical study – containing a bibliography of nearly 250 pages – on artificial and mixed milk feeding of infants. (The other thesis dealt with gastrointestinal diseases in infants.) With a secure foundation in Pastorian germ theory, tremendous progress in reducing the high levels of infant mortality took place during the final decade of the nineteenth century, an achievement largely attributable to the provision of pure milk by public health physicians. Young Henri de Rothschild ‘played a major role in the baby-feeding revolution’ (pp. 125–6).
Paul aptly characterises the medical services Rothschild brought together around the polyclinic he built in the northwest of Paris shortly after the turn of the century as a ‘medical empire’ (Chapter 4). Besides serving the needs of more than ten thousand outpatients and a hundred hospitalised patients annually, the physician–administrator–entrepreneur presided over research, teaching, and radium and drug manufacture. Research activities included thyroid endocrinology and the introduction to France of Ehrlich’s Salvarsan treatment for syphilis. During World War I, Rothschild marketed a new product for the treatment of burns while he, his mother and his wife devoted their personal services along with their hospitals and funds to the care of the sick and wounded.
All this, which Paul discusses in rich, at times dense, detail, could comfortably constitute a book. But in part II, ‘Hippocratic Theater’, the author shifts gears to a subtle analysis of the literary oeuvre of Rothschild, who wrote some thirty-eight plays under the pseudonym André Pascal. Monsieur Pascal often could not resist returning to the profession Dr Rothschild knew intimately. Medical ethics, or rather malpractice, took centre stage in several plays whose melodramatic plots Paul reviews. Audiences flocked to see and critics praised theatrical condemnations of charlatanism and corruption within the elite ranks of the medical profession: shady business alliances by a brilliant surgeon–scientist, fee-splitting, fake diagnoses and unnecessary surgery resulting in death.
In La Vocation (1926), the scenario turned to women in the profession. Anti-feminist sentiments voiced by an elderly academician character provoked a raucous medical student protest at the opening. Rothschild explained in a lecture to women’s clubs that La vocation did not categorically reject medical careers for women, already common in Northern Europe. Rather the play depicted the disastrous consequences when the heroine does not give up her medical vocation after marriage and motherhood.
Paul demonstrates that Rothschild’s plays were no more amateurish than his medicine. Although unlikely to be revived today, they merit the perceptive and witty analysis he provides. More often than not, his claim to the enduring pertinence of the ethical issues broached is justified and backed up with citations to recent New York Times articles, among other references. Harry Paul writes with great knowledge, insight and palpable enthusiasm for French social and cultural history. He presents less and more than a customary biography – less of the personal life and no psychologising – but more, enormously more, contextualisation situating a neglected figure in French medical and scientific culture.
