In the Brittany of yesteryear, there was a dearth of medical doctors practicing in the rural areas and when one could be found, his professional services were not always affordable to the local populace. Traditional healing treatments and remedies were therefore widely used; one of the local healers most commonly consulted was the Bonesetter or Aozer in Breton, Rebouteux in French.
The Age of Enlightenment saw great leaps in the understanding and acceptance of the role and benefits of medicine and treatment. Good health was considered the natural state of the body which therefore needed to be maintained and protected, particularly through diet and environment. However, diagnosis and the relationships between illness and cure were not fully understood and many clung fiercely to a belief in the Hippocratic theory of humours which held that a healthy body and mind came from a good balance between the humours that existed as bodily fluids, identified as blood, phlegm, yellow bile and black bile.
An imbalance between the four humours could result in disease; treatments were therefore aimed towards restoring balance. These could be relatively benign such as dietary or environmental changes but were frequently far more aggressive; purges, enemas and blood-letting being the most common treatments. Purging the body of negative humours was generally regarded as efficient medicine, at times laxatives and emetics were used or deep enemas of water and vinegar administered but blistering the skin and blood-letting were very commonly used.
Indeed, blood-letting was used to treat a very broad range of ailments affecting patients of all ages. Depending on the illness, blood was taken from different parts of the body, although it was traditionally performed at the elbows and knees. The most common, general blood-letting, involved cutting open a vein or artery with a lancet and drawing about a pint of blood at a time but localised blood-letting could also involve the application of cups or leeches.
Initially, in theory at least, doctors in France were responsible for internal medicine while the treatment of wounds and external injuries were the preserve of the surgeon but such boundaries were quite often ignored by both parties. They sometimes even prepared their own medicines but mostly they bought them from apothecaries – whose role was to prepare, preserve and distribute medication – and sold them on to their patients in the form of ointments and plasters. While doctors normally practised only in institutions and in cities, surgeons would sometimes make brief forays into the countryside.
For most people of the time, securing access to a reliable medical practitioner was difficult if not impossible. Even access to one of the overcrowded charity hospitals found in some large towns usually required ready money. The formal, professional, medical community of doctors, surgeons and apothecaries were concentrated in the cities and large towns and all required hefty payment. Little wonder that much of the rural population of Brittany took their ailments to the local healer or put their faith in the healing waters of a sacred fountain.
In March 1803 (or Ventôse – the month of winds – year XI, as styled in the Republican calendar then in use) the French authorities enacted much needed laws to reform the practice of medicine throughout France. Over the next seven years, the right to practice was linked to the obtainment of two nationally recognised degrees; a Doctorate in medicine or surgery awarded by one of the medical schools and the Batchelor-level qualification required to be licensed as a Health Officer.
These Health Officers existed until the end of the 19th century and were initially modelled on the Ancien Régime’s surgeons “of light knowledge” and were the cause of much debate. Practicing within strict Departmental boundaries, their great advantage was that they necessarily happened to be local, understanding and speaking the languages and dialects of their customers. However, their creation supposed two levels of medical competence and thus two modes of medical practice, calling into question the principles of equality which officially was the foundation of the republic. The usefulness of these demi-doctors was questioned, some thought lowering the academic bar unnecessary even dangerous and that it would be better for the countryside to lack doctors than to receive fatal ones.
In managing the risks Health Officers could potentially generate, their role was tightly prescribed. They were to “limit themselves to the most ordinary care, to the simplest procedures. Deliver first aid to the sick, treat the least serious ailments and take care of common dressings. Their main science was to recognise cases where they should not act.” Minimising the role of Health Officers not only created a two tier healthcare system but significantly undermined their standing in the communities they served. After all, these men were serving as the vanguard of the fight against the very empirics, conjurers, witches and charlatans that the 1803 law set out to eliminate.
The doctor was considered to be a man of learning who focused his science on diagnosis, prognosis and prescription but there was little official expectation that he would ply his science outside the cities and largest towns. Lawmakers of the time argued that the effort and expense spent on becoming a doctor would be rewarded by reputation, glory and fortune and that it was inappropriate to expect a doctor to bury his talents in the countryside and practice his art in a sparsely populated commune. This metropolitan bias was compounded by the suggestion that “the inhabitants (of the countryside) having purer manners than those of the inhabitants of the cities have simpler illnesses which require for this reason less education and less preparations.”
This notion that the countryside only needed Health Officers more practiced than learned in theory, to treat mild ailments and minor accidents, totally overlooks the obvious; that without proper trusted care, people will remain with or soon revert to the traditional healers of the locality. Throughout the 19th century, the vast majority of the professional medical practitioners in Brittany were based in the prosperous coastal cities with the greatest concentration in the two cities of Brest and Lorient due to the presence of the prison and naval yards; solid, regular payers. In the middle of the 19th century, the ratio of medical professionals to the Breton population was 1:5740 against a national ratio of 1:1890; the rural interior of Brittany simply did not have access to these professionals. If a patient could afford the time and cost of travelling to the city then the cost of a formal medical consultation, likely in a language they could not understand, would have been found exorbitant.
Given the dearth of accessible and affordable medical professionals, the rural folk of Brittany sought relief from their ailments in their sacred fountains and traditional folk healers such as witches, homeopaths, herbalists and bonesetters. After all, what could the science of a “paper doctor” do against the sacred power of the saints?
The stoic nature of the Breton character was highlighted by the author Émile Souvestre most markedly when recounting the cholera epidemic of 1832; while the Parisians blamed the government for poisoning the water, Bretons largely accepted that the sickness was a form of divine punishment and cries of “God has touched us with His finger! God has delivered us over to Satan!” were heard across the region. This fatalistic approach was noted by Thomas Adolphus Trollope in his travelogue, A Summer in Brittany (1840):
“It is in the hour of sickness and of death, when all men most feel the necessity of it, that the undoubting stern faith and sombre religion of the Breton are seen in the most striking manner. It is rarely that he thinks of appealing to human aid in illness. A few years ago, according to M. Souvestre, the peasants never had any recourse to medical men at all and, at the present day, confidence in their utility is very far from being general.
The more ordinary and more favourite resources are vows to some popular saint, prayers and masses, together with, perhaps, some traditional remedies, whose efficacy is often supposed to depend more on times and places and the observance of various ceremonies, than on any inherent quality in the medicine itself.”
For millennia, sacred springs were considered powerful sources of healing in Brittany and such convictions were still widely held long after these ancient fountains had been given a Christian gloss and patron saint. While waters from all sacred fountains were regarded as possessing therapeutic or curative properties, many fountains and particular saints were believed to hold qualities that tackled very specific ailments from anxiety to leprosy and even madness. One of the sacred fountains associated with the semi-legendary Saint Diboan was believed to cure ear infections but he is more widely known as the saint without suffering, a saint to be invoked to relieve the pain and suffering of the sick and dying. At the saint’s fountain in Plévin, the water was used to divine the fate of a sick loved one; if the fountain’s basin re-filled noiselessly, the sick person would be sure to recover. In extreme cases, it was necessary to collect water from the fountain and pour over the body of the sick person; this would either bring about relief or death, both would see an end to the patient’s suffering.
The traditional healers (louzaouer in Breton) were found in nearly all communities in Brittany; sometimes several being active in the commune and covering a range of specialities. For instance, local witches and herbalists – it is not easy or sometimes even necessary to draw clear distinctions between the two labels – prepared and administered medicines derived from what we would now call medicinal plants. These were mostly composed of a mixture of bark, flowers, fruits, leaves, roots and seeds although animal products such as butter, eggs, honey, milk and even dung were also used along with minerals such as sea salt, alum, antimony, lead, mercury and sulphur. Animal fats were also held to contain healing properties; for instance, to cure a fever, a patient’s chest would be rubbed with the fat of a gull.
For almost every ailment in everyday life, there were traditional remedies that were long regarded as more effective than the expensive cures prescribed by a medical professional. In Brittany, the boiled root of the yellow dock plant was commonly used as a purgative, poultices made from walnut leaves used to treat toothache; pennywort was used to treat sores while ear infections were cured by the juice of a houseleek or by dropping-in some freshly expressed milk from a nursing mother. Whooping cough was held to be alleviated by carrot juice or, in persistent cases, the milk of a white mare. Urine was often thought to sterilise a small cut which would then be protected by the slime from a slug which would act as a kind of collodion. Incantations, charms, amulets and sachets containing bespoke concoctions were also prepared and administered to those seeking relief and cure.
The Breton countryside also featured healers known as the diskanterezed (a hard word to translate literally but it means one who can undo or peel away/take off). It was believed that only children who were born feet-first possessed the gift necessary to be a diskanterez and that only a skilled practitioner could identify which child was worthy of initiation into the mysteries of the craft. Commonly consulted for their expertise in handling benign ailments each diskanterez specialised in a limited number of afflictions such as removing warts and healing eczema. Healing was achieved by the precise recitation of chants and the execution of very specific gestures. For example, to heal eczema, the diskanterez would recite the following three times in a single breath while making the sign of the cross with a silver coin:
“Go away, go away! This is not your home. Neither here nor anywhere. Between nine seas and nine mountains and nine fountains, turn northwest!”
Diseases of the eye were sometimes seen as a manifestation of the presence of an evil spirit and nine grains of salt were squeezed onto a pilewort leaf and applied to the little finger of the hand apposite the infected eye. If a child appeared anaemic, the diskanterez would hunt for signs in the contours of the infant’s head, probing the fontanel or soft spot for confirmation of the klenved ar penn (literally, a head disease). A sharp tug of the hair and the fontanel was explored again, the treatment repeated until the diskanterez judged that the evil had been expelled. Another treatment involving a seemingly unrelated part of the body concerned that for ailments such as rheumatism or gout; the soft palate was scored and a piece of mucosa lining torn out before the patient gargled with salt water.
The diskanterez was not called upon trivially or for matters involving childbirth – unless there were serious complications. Otherwise, the older women of the community acted as midwives and advisers on children’s health, most women preferring the advice of experienced mothers known to them rather than doctors and surgeons whose theoretical health care advice often led to mortality for infants and mothers.
Pierre-Jakez Hélias tells us in his memoir of life in rural Brittany between the World Wars (The Horse of Pride, 1975) that “With the holy healers, you have to believe, it is understood otherwise it is not worth it. The pretences and formulas of ‘old gossips’ and ‘health peddlers’ are nothing other than superstition or junk witchcraft but nothing prevents you from going to see it, if only for a laugh. And laughter is always good. The bonesetters know their job and do it well if they are reasonable enough. If you are seriously ill and have some money, find a doctor.”
Another healer found in most localities was the bonesetter who would be consulted on a broader range of issues, such as stomach aches, headaches, heart and circulation problems, than simply bones. A certain degree of physical strength was needed to be a successful bonesetter and after the reforms enacted in 1803 most had an official primary or secondary occupation to protect them against charges of practicing medicine illegally. As the name implies, bonesetters were adept at re-setting broken bones and dealt with all manner of fractures, dislocations and sprains; manipulating bones, joints and muscles to heal the neighbourhood sick at prices that were eminently affordable.
“For broken limbs, strains, sprains, we prefer to go to a bone repairer. In the canton, there are several, more or less declared. In general, they are millers. These people, whose job is to put on very heavy bags of grain, know from father to son how to put bones and muscles back in place. When they do not succeed, you have to get on a charabanc to go to Quimper on a fair day. There, around the Place des Chevaux Gras, outside the walls of the old town, two or three famous bonesetters receive the mutilated in the back rooms of cafes. They never miss a shot.” . Pierre-Jakez Hélias (The Horse of Pride, 1975).
The author and photographer Charles Géniaux described some of his meetings with bonesetters in Upper Brittany in the works La Vieille France (1903) and La Bretagne Vivante (1912) and they provide an interesting insight into the bonesetter’s craft:
“The bonesetter of Saint-Gourlay.. inherited his practice from his mother… wins over the others for two specialties: healing the demented and caring for the heart. The parents of a fool lead him to the bonesetter for treatment. With a wooden stick he hits the sinciput, then the side walls of the skull, until the patient howls. At this moment, he declared that he had found the lesion and, fortified by this result, he showered the unfortunate with plenty of water. Finally the parents will have to apply poultices on the sick part.”
“I will introduce to you a bonesetter named Josso, or more properly, Big Josso, as he is usually called. Big Josso is not only a bonesetter but also a gardener and the owner of an inn and would work only for reliable farmers of the region. Usually, the client enters his bar and they start to speak together. The customer complains of his ailment and in this case, he fell from the loft.
Josso proposes to help and both of them go where they are sure that nobody will disturb them. The operation starts, the bonesetter feels the painful area. Most of the time, the bonesetter can operate alone but it can be more complicated: Three or four strong men are called for assistance. Two of them are instructed to pull as mightily as they can while the other prevents the body from moving using a large cloth. At the same time, Big Josso is placing the bone at the right place.”
“A farmer seeks treatment for kidney pain. Without being moved, the great Josso made him sit astride a chair, and putting his knee on the patient’s spine and grabbing him strongly with his hands criss-crossed across his chest, he twisted backwards, reducing the lumbago by an effort in the opposite direction.”
In rural Brittany, bonesetters and other traditional healers filled the void created by the severe lack of medical professionals; they enjoyed the trust and support of the local populace. These were not peripheral figures operating at the margins of society but a key part of that society.
In 1951, after pressure from local doctors, a successful bonesetter and miller from Landrévarzec was prosecuted for practicing medicine illegally. A practitioner of some repute, he gave consultations at his mill but also held weekly surgeries in the nearby towns of Douarnenez and Quimper. During his trial, dozens testified on his behalf and reports state that there were up to a thousand protesters outside the courthouse demanding his acquittal. He was found guilty and fined, subsequently being carried by supporters through the city in triumph.
It was not unusual for the professional medical profession to push for the prosecution of traditional healers such as bonesetters whom they regarded as uneducated and thus dangerous, unfair competition. In earlier times, there existed a profound paradox; doctors claimed they could not settle in the countryside because of unfair competition from healers but since there are no doctors, the locals had no alternative but to consult the healers.
The range and specialisms of these traditional folk healers was, and to some extent, remains, very broad. In addition to the homeopaths, herbalists, diskanterezed and bonesetters there were sourciers who doused for a variety of health-related issues; bandagistes who claimed to heal hernias and rheumatisms with bandages; stomach lifters who acted on the viscera; fire-cutters who healed burns but were also called upon to stem bleeding and reduce pain. There were even healers known as uromantes who studied a person’s urine in order to detect traces of diseases such as diabetes or kidney disorders. The gifts that these healers claimed to possess were, by their very nature, difficult to define and even harder to prove empirically by science. Whatever the source of the healers’ legitimacy, the anxieties and superstitions of the Breton countryside were thus fertile territory for the charlatan.
In many countries, these traditional healing practices are regulated but in France, the framework is rather vague. Officially, healers are not allowed to practice and like their predecessors of yesterday, run the risk of being charged with practicing medicine illegally. However, plenty of grey areas exist and there is a significant amount of official toleration. Acupuncture, homeopathy and naturopathy are officially recognised and probably the most frequently consulted types of alternative healing but there are also many other popular non-biomedical practitioners such as magnétiseurs (magnetisers), radiesthésistes (dowsers), iridologists and aromatherapists. Furthermore, it is not uncommon to find a magnétiseur who is also a radiesthésiste or a bonesetter, sometimes re-badged as an osteopath or chiropractor.
Today, over 400 different alternative medical practices are available across France and it has been estimated that as many as four out of ten French people resort to alternative practices, even if only to gain a second opinion after visiting a doctor. While the medical profession might frown upon the continued popularity of practices that might have been expected to drop away with advances in 21st century healthcare, it is perhaps interesting to note that my local Yellow Pages records 580 General Practitioners and 360 bonesetters active today. Plus ça change, plus c’est la même chose.