Douglas Peter Mackaman, Leisure Settings: Bourgeois Culture, Medicine, and the Spa in Modern France. Chicago: University of Chicago Press, 1998. xi + 219 pp. Notes and index. ISBN 0-226-50075-6.

Review by Christopher E. Forth, Australian National University, for H-France, October 1999.

Social historians of modern France will no doubt embrace Douglas Mackaman's Leisure Settings for finally providing a study of an institution which was so central to the lives of the bourgeoisie during the nineteenth century. It is surprising that such a work was not written years ago, and Mackaman is to be credited with helping to fill this lacuna in modern historiography. With meticulous attention to the many details of spa culture, from financial investments and architectural strategies to guide books, spa novels, and the particulars of curing itself, Mackaman has written a lively and engaging work which will hold an important place in contemporary social studies of the creation and reproduction of bourgeois culture.

Mackaman's subtle but sustained use of the ideas of Michel Foucault allows him to make many useful observations about the strategies at work in the inner workings of a number of spas, and helps him to frame the significant differences between traditional curing and the more exacting therapeutic and fiscal practices which emerged in the late eighteenth century. As Mackaman demonstrates in the first chapter, spa culture under the Old Regime was far less lucrative and provided few of the opportunities for simple leisure that would make thermal establishments magnets for the bourgeoisie during the nineteenth century. The author also notes that these early modern spas were not "medicalized" in any strict sense, by which he means that the authority of spa doctors was "not girded by the epistemological shifts to a medicalized articulation of social relations that the eighteenth century would announce" (p. 22). This is an important observation, not only insofar as it provides a useful counterpoint to the more modern developments which occupy the remaining chapters, but in that it also helps explain why older spas often featured centralized common pools freely open to all bathers regardless of gender or class.

Yet the changes in sensibility that would demand greater attention to modesty and compel spa administrators to insist upon a separation of classes and genders were certainly afoot during the late eighteenth century. Since the popular phase of the Revolution had resulted in even more free pools and discouraged aristocrats from flaunting their status in such venues, the local economies of spa towns were further compromised, thus necessitating the sort of entrepreneurial stance taken up by many doctors early in the nineteenth century. Above all, by beginning to publicize their registry lists, these establishments trumpeted the fact that the dawning century seemed to bring within their walls a new class of bourgeois clientele which had not normally taken the cure in the past. Basing their collective identities on their difference from both the aristocracy and the popular classes, members of the bourgeoisie recognized themselves in the privileging of work over leisure and of simple elegance over luxurious excess and, through the expert guidance of etiquette manuals, became attentive to activities which might allow them to practice and project the distinctiveness of their class. Here Mackaman situates the spa holiday alongside such "edifying pleasures" as theater and opera while emphasizing the pitfalls of this new form of leisure. Unlike a night at the opera, spa vacations typically lasted three weeks and usually entailed some degree of travel, thus threatening to undermine the specifically "edifying" sense of this pleasure. In Mackaman's view, the spa was rendered socially legitimate by serving as a "living etiquette book" where the bourgeoisie and those aspiring to such a status both projected and practiced the distinctive life style that accompanied their social station. Thanks to the subtle implementation of class-specific cultural coding in architecture, interior design, and sociable diversions, spa administrators were able to appeal to a solidly bourgeois clientele while offering to the rising French middle class "a pleasurable place to become more bourgeois" (p. 52).

Nineteenth-century spa organizers took advantage of these changes in sensibility by restructuring their establishments in accordance with the demands of their paying clients and medicalized notions of the social order. Responding to a long-standing wish of social elites that poor curists be isolated from more "respectable" visitors, administrators erected a set of administrative hurdles that might filter out unsavory social types and admit only those indigents who could demonstrate their financial need and moral standing. While such needy patients were often prescribed cures that did not entail access to the main establishment and others were sequestered in separate hospitals, in time all clients were given "bath numbers" that allowed authorities to keep track of their coming and going. These and other practices, including gender-segregated bathing, time management, and an expanding network of bathing regulations, contributed to the rise of surveillance as a means of ensuring that spa establishments functioned efficiently and in accordance with the needs of their bourgeois clients. "From simple partitions to individual bath rooms, private sedan chairs, and personal changing rooms," Mackaman explains, "the organization of space within the spas articulated the same conceptions of respectability, modesty, and hygiene that the French bourgeoisie increasingly saw in itself" (p. 84).

With the transformation of thermal culture into a thriving industry, bourgeois notions of propriety were carefully couched in a rhetoric of hygienic order and used to shape the promotional literature generated by most spas during the early and mid nineteenth century. Aimed primarily at women, who were assumed to be more prone to illness and more medically literate than men, these guides were often cast in a novelesque narrative style which amused as well as informed. Each spa had to convince the reader of the distinctive healing properties of its mineral water, which in this age of hydrotherapy could be prescribed for a host of maladies from gout, constipation, and nervousness to impotence, spermatorrhea, and infertility. And these waters, Mackaman explains in some detail, could be administered in a number of ways, from simple oral ingestion and swimming in thermal pools to more formidable methods like hot mud baths, wet sheet treatments, shower massages and vapour baths. In some cases, the patient was prescribed more aggressive treatments like the icy cold blast of the Scotch Shower, the pressurized heat of the "showers of hell", or the downright invasive flow of the "ascendant shower" which brought mineral water directly into the body through the anus or vagina.

Despite the rather challenging aspects of the thermal ordeal, Mackaman emphasizes that this was still in fact a bourgeois holiday which in time would be pursued for its strictly pleasurable potential. While sociable pleasures had to a certain extent always been present in spas, Mackaman argues that the trend toward pleasure alone became more pronounced after 1850 when the majority of travellers to villes d'eaux did not register as curists at all. Although the medical aspects of spa culture were emphasized by doctors, it was "altogether common for spa doctors to denounce pleasure in their medical writings while investing in it under the cloak of a blind corporate entity" (p. 121). After all, as Mackaman demonstrates, spas that refused to include a range of pleasurable activities in their facility typically did not last very long. Any spa which wanted to compete for respectable clientele featured not only cafés, restaurants, nature parks, and even gaming after mid-century, but also offered piano lessons, dancing classes, and organized formal dances. After mid-century, spa novels became a genre in their own right and helped pitch the non-medical pleasures of a thermal holiday to their bourgeois audience. Most importantly, such literature provided a script for how one should behave at a spa, especially for those actively seeking embourgeoisement in a setting where they were likely to mingle freely with their social betters. As Mackaman demonstrates, the casino became a site for the demonstration of conspicuous leisure, and those desiring social acceptance would be expected to master the codes of correct table manners, proper attire, and polished conversational skills. In short, by offering its clients a host of non-medical diversions, thermal establishments played an important role in the development of the bourgeois vacation.

The strengths of Mackaman's book lie not only in its detailed presentation of the inner workings of nineteenth-century spa culture, but also in its interesting and illuminating analysis of the thermal milieu as a leisurely setting for the rehearsal of bourgeois identity. Less satisfying is the treatment of the relationship between medicine, the body, and bourgeois identity, mostly due to the fact that when it comes to such matters Mackaman generally opts for description rather than the rigorous analysis which accompanies the material on social life. While we are provided with ample evidence of how bodies were distributed, monitored, and administered by spa personnel, we have little sense of how the body might have been experienced by those bourgeois men and women who frequented such establishments. This is an odd oversight, especially considering the work that has been done by scholars like Georges Vigarello and Alain Corbin(1) exploring how concepts of cleanliness and moral hygiene helped construct bourgeois identity through an emphasis on the clean body itself (rather than simply through an insistence on sanitized and orderly spaces). Mackaman's bourgeoisie seems to construct its identity primarily through the emplacement of modesty, propriety, and sociable diversions that are secondary rather than central to the physical rigours of the therapeutic regime. In short, while Mackaman teaches us a great deal about how the French bourgeoisie crafted itself socially, we learn little about how male and female bodies were produced, perceived, and lived through thermal culture.

Notions of pleasure and pain, for instance, figure prominently in Mackaman's study, mostly as expressions of what he takes to be the distinction between the pains of hydrotherapy and the pleasures afforded by an emerging emphasis on leisure for its own sake. At the outset Mackaman appears to avoid making easy distinctions by claiming that "medicine never disappeared from spa culture in the nineteenth century, just as I contend that pleasure was always there" (p. 5). While conceding that pleasure and pain may have coexisted in spa facilities, the author suggests a sharp separation between the two, not only in his general description of the inner workings of spa life, but in his distinction between tourists and curists. If pleasure was to be found at the spas, Mackaman wants us to assume, it would only be through the sociable diversions proffered by the spa's casinos rather than by taking the cure itself. After all, who could possibly find pleasure in the physical assault of hydrotherapy? Yet this assumption seems somewhat simplistic in light of Alain Corbin's account of early nineteenth century male bathers who used confrontations with the crushing surf as tests of masculinity, thus willingly engaging in painful ordeals which no doubt brought them as much satisfaction as discomfort. Indeed, Corbin asserts that such manly approaches to bathing, which helped "steel" the body, "procured a particular delight that [Gaston] Bachelard calls 'the conaesthetic joy of violence'."(2) Might not some curists have also experienced the hydrotherapeutic barrage as being at once terrible and edifying, painful yet strangely pleasurable at the same time? Did hydrotherapy's prophylactic potential refer simply to the prevention of future illness, or did it have some relation to the maintenance of embodied gender identities?

More specifically historical questions spring from Mackaman's discovery that the number of registered curists travelling to spa towns declined during the last few decades of the century. Mackaman considers but ultimately discounts two alternative explanations of the decline in registered curists. One suggests that spa doctors simply did not keep records as conscientiously as they had in earlier decades, making it difficult to draw any conclusions about the shifting ratio of tourists to curists; another submits that the number of curists did not decline at all, but that a new group of people began frequenting spas after 1850. What Mackaman considers the most fulfilling explanation is that the bourgeoisie had largely disengaged leisure practices from any therapeutic rationale: "Instead of seeking a medicalized mode of leisure that implanted productivity where uncertainty might otherwise have taken root, many bourgeois vacationers went to the spas in the latter half of the nineteenth century confident of who they were" (p. 120).

While Mackaman's interpretation certainly has merit, how do we reconcile this view with what we already know about the fin de siècle, a period which has been described by Jackson Lears as being dominated by a "therapeutic ethos" and by Anson Rabinbach as consumed by the problem of fatigue?(3) Both these historians suggest an increase in bourgeois concern for the body rather than the declining urgency charted in this book. The bourgeoisie may have achieved a certain confidence in their social and political power after mid-century, but contemporary scholarship suggests that this confidence was frustrated by a growing anxiety about their own health and the well being of the body politic. Perhaps some consideration of the social status of the invalid, especially the fatigued or neurasthenic male, may have helped make sense of the apparent shift to simple tourism during this period. At a time when masculine identity was called into question on a number of fronts, was a stigma attached to publicly defining oneself as ill, something that registering as a curist would have certainly accomplished? Were people increasingly taking their health into their own hands through the numerous nostrums and patent medicines offered in magazines and newspapers? Was therapy really becoming eclipsed by the pursuit of pleasure, or was pleasure becoming subtly therapeutic?

While greater attention to bourgeois identity as a mode of embodiment would have added an interesting dimension to Mackaman's work, its fairly minimal treatment here does not diminish the importance of the book as a whole. Addressing such complex issues would have no doubt resulted in a much larger study in an age when academic publishers demand shorter manuscripts. To his credit Mackaman provides a great deal of significant information and persuasive interpretations to make his work a real contribution to French social history. The extent of his research into the inner workings of a variety of spas is impressive indeed, and he presents his findings in quite eloquent and lively prose. Not only will social historians find this text extremely useful, but it would be surprising if they did not make it required reading in their advanced undergraduate and graduate courses.

1. Georges Vigarello, Concepts of Cleanliness: Changing Attitudes in France since the Middle Ages, trans. Jean Birrell (Cambridge, 1988); Alain Corbin, The Foul and the Fragrant: Odor and the French Social Imagination (Cambridge, Mass., 1986).
2. Alain Corbin, The Lure of the Sea: The Discovery of the Seaside in the Western World, 1750-1840, translated by Jocelyn Phelps (Cambridge, 1994), p. 76.
3. Jackson Lears, Fables of Abundance: A Cultural History of Advertising in America (New York, 1994); Anson Rabinbach, The Human Motor: Energy, Fatigue, and the Origins of Modernity (Berkeley, 1990).

Christopher E. Forth
Australian National University