{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T20:53:44Z","timestamp":1760043224287},"reference-count":73,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Med. Hist."],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>In early twentieth-century France, syphilis and its controversial status as a hereditary disease reigned as a chief concern for physicians and public health officials. As syphilis primarily presented visually on the surface of the skin, its study fell within the realms of both dermatologists and venereologists, who relied heavily on visual evidence in their detection, diagnosis, and treatment of the disease. Thus, in educational textbooks, atlases, and medical models, accurately reproducing the visible signposts of syphilis \u2013 the colour, texture, and patterns of primary chancres or secondary rashes \u2013 was of preeminent importance. Photography, with its potential claims to mechanical objectivity, would seem to provide the logical tool for such representations.<\/jats:p><jats:p>Yet photography\u2019s relationship to <jats:italic>syphilographie<\/jats:italic> warrants further unpacking. Despite the rise of a desire for mechanical objectivity charted in the late nineteenth century, artist-produced, three-dimensional, wax-cast <jats:italic>moulages<\/jats:italic> coexisted with photographs as significant educational tools for dermatologists; at times, these models were further mediated through photographic reproduction in texts. Additionally, the rise of phototherapy complicated this relationship by fostering the clinical equation of the light-sensitive photographic plate with the patient\u2019s skin, which became the photographic record of disease and successful treatment. This paper explores these complexities to delineate a more nuanced understanding of objectivity vis-\u00e0-vis photography and syphilis. Rather than a desire to produce an unbiased image, fin-de-si\u00e8cle dermatologists marshalled the photographic to exploit the verbal and visual rhetoric of objectivity, authority, and persuasion inextricably linked to culturally constructed understandings of the photograph. This rhetoric was often couched in the Peircean concept of indexicality, which physicians formulated through the language of witness, testimony, and direct connection.<\/jats:p>","DOI":"10.1017\/mdh.2019.79","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T11:10:56Z","timestamp":1576753856000},"page":"116-141","update-policy":"http:\/\/dx.doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Photograph as Skin, Skin as Wax: Indexicality and the Visualisation of Syphilis in Fin-de-Si\u00e8cle France <i>The William Bynum Prize Essay<\/i>"],"prefix":"10.1017","volume":"64","author":[{"given":"Kathleen","family":"Pierce","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"key":"S0025727319000796_r70","first-page":"100","volume-title":"Photography in Print: Writings from 1816 to the Present","author":"Holmes","year":"1988"},{"key":"S0025727319000796_r69","unstructured":"Ibid., 28."},{"key":"S0025727319000796_r14","unstructured":"Leja, \u2018Peirce, Visuality, and Art\u2019, 101; Albert Atkin, \u2018Peirce on the Index and Indexical Reference\u2019, Transactions of the Charles S. Peirce Society41, 1 (2005), 178."},{"key":"S0025727319000796_r64","unstructured":"Finsen qtd. in Woloshyn, \u2018Kissed by the Sun\u2019, 183."},{"key":"S0025727319000796_r58","volume-title":"Pr\u00e9cis-Atlas de pratique dermatologique","author":"Brocq","year":"1921"},{"key":"S0025727319000796_r33","unstructured":"Hunter, \u2018Effroyable R\u00e9alisme\u2019, 51."},{"key":"S0025727319000796_r22","unstructured":"Claude Qu\u00e9tel , History of Syphilis, trans. Brian Pike and Judith Braddock (Baltimore, MD: Johns Hopkins University Press, 1992), 166\u20138."},{"key":"S0025727319000796_r39","unstructured":"Besnier, Fournier, et\u00a0al., Le Mus\u00e9e de l\u2019H\u00f4pital Saint Louis, 1."},{"key":"S0025727319000796_r63","first-page":"133","volume-title":"La Dermatologie en France","author":"Amblard","year":"2002"},{"key":"S0025727319000796_r68","first-page":"27","volume-title":"Syphilis et cancer, cancer sur syphilis ou cancer juxtasyphilitique","author":"Horand","year":"1908"},{"key":"S0025727319000796_r60","unstructured":"Ernest Besnier, Louis Brocq, and Lucien Jacquet, La pratique dermatologique: trait\u00e9 de dermatologie appliqu\u00e9e, Vol.\u00a04 (Paris: Masson et Cie, 1904), 436."},{"key":"S0025727319000796_r71","unstructured":"For writing about wax and the compelling materiality of moulages, see Hunter, \u2018Effroyable R\u00e9alisme\u2019, 45 and Georges Didi-Huberman, \u2018Wax flesh, vicious circles\u2019, in Monika von D\u00fcring and Marta Poggesi (eds), Encyclopaedia Anatomica: A Complete Collection of Anatomical Waxes (K\u00f6ln and New York: Taschen, 1999), 66."},{"key":"S0025727319000796_r50","unstructured":"Delpeux, \u2018Photographie en dermatologie \u00e0 l\u2019H\u00f4pital Saint-Louis (1860\u20131900)\u2019, 26; \u2018F\u00e9lix M\u00e9heux\u2019, cote: 826W507, Archives de l\u2019Assistance Publique \u2013 H\u00f4pitaux de Paris, Paris."},{"key":"S0025727319000796_r3","first-page":"92","volume-title":"Imagining Illness: Public Health and Visual Culture","author":"Ott","year":"2010"},{"key":"S0025727319000796_r41","unstructured":"Besnier, Fournier, et\u00a0al., Le Mus\u00e9e de l\u2019H\u00f4pital Saint Louis, 192. It should be noted that this specific case study does not discuss an iteration of syphilitic infection, but rather describes a case of epithelioma following lupus. I reproduce it here, however, given the ways Jacquet\u2019s description of moulagesand photographs meaningfully complicates the hierarchies among media established in other scholarship."},{"key":"S0025727319000796_r73","unstructured":"Daston and Galison, Objectivity, 135."},{"key":"S0025727319000796_r66","unstructured":"Woloshyn, \u2018Kissed by the Sun\u2019, 184."},{"key":"S0025727319000796_r34","unstructured":"Ibid., 43."},{"key":"S0025727319000796_r37","unstructured":"Ibid., 85."},{"key":"S0025727319000796_r15","unstructured":"In fact, Peirce identifies the photograph as a quintessential example of the index, stating, \u2018Photographs\u00a0\u2026\u00a0are very instructive, because we know that they are in certain respects exactly like the objects they represent. But this resemblance is due to the photographs having been produced under such circumstances that they were physically forced to correspond point by point to nature\u2019. See Peirce, op. cit. (note 13), 11."},{"key":"S0025727319000796_r52","unstructured":"Hallopeau and Leredde, Trait\u00e9 pratique de dermatologie, vi."},{"key":"S0025727319000796_r23","first-page":"191","volume-title":"French Medical Culture in the Nineteenth Century","author":"Hildreth","year":"1994"},{"key":"S0025727319000796_r29","unstructured":"Edgar Allen Poe and Dominique Fran\u00e7ois Arago qtd. in Sabine\u00a0T. Kriebel and Andr\u00e9s Mario Zervig\u00f3n, \u2018Introduction\u2019, in Sabine T. Kriebel and Andr\u00e9s Mario Zervig\u00f3n (eds), Photography and Doubt (New York: Routledge, 2016), 1."},{"key":"S0025727319000796_r25","unstructured":"Ibid., 141."},{"key":"S0025727319000796_r42","unstructured":"Fournier, Syphilis h\u00e9r\u00e9ditaire de l\u2019\u00e2ge adulte, 127; Gaucher qtd. in Fournier, Syphilis h\u00e9r\u00e9ditaire de l\u2019\u00e2ge adulte, 127."},{"key":"S0025727319000796_r8","unstructured":"For important writing on moulages, especially collections at the Saint-Louis hospital in Paris, see Mechthild Fend, \u201c\u2018Order and affect\u201d: the Museum of Dermatological Wax Moulages at the H\u00f4pital Saint-Louis in Paris\u2019, in Johannes Grave, Christiane Holm, Val\u00e9rie Kobi, and Caroline van Eck (eds), The Agency of Display: Objects, Framings, and Parerga (Dresden: Sandstein Verlag, 2018); Mary Hunter, \u201c\u2018Effroyable R\u00e9alisme\u201d: Wax, Femininity, and the Madness of Realist Fantasies\u2019, RACAR: Revue d\u2019art Canadienne\/Canadian Art Review 33, 1\/2 (2008); Mary Hunter, The Face of Medicine: Visualising Medical Masculinities in Late Nineteenth-Century Paris (Manchester: University of Manchester Press, 2016), especially chapter\u00a02, \u2018The sleep of reason: Dr\u00a0Jules \u00c9mile P\u00e9an\u2019s collection of bodies in wax and in paint\u2019; Thomas Schnalke, \u2018Casting skin: meanings for doctors, artists, and patients\u2019, in Soraya de Chadarevian and Nick Hopwood (eds), Models: The Third Dimension of Science (Stanford: Stanford University Press, 2004); Schnalke, Diseases in Wax; and G\u00e9rard Tilles and Daniel Wallach, Le mus\u00e9e des moulages de l\u2019h\u00f4pital Saint-Louis (Paris: Doin \u00c9diteurs, 1996). For scholarship on the photographic production centred at the Saint-Louis hospital, see Sophie Delpeux, \u2018Photographie en dermatologie \u00e0 l\u2019H\u00f4pital Saint-Louis (1860\u20131900)\u2019 (Unpublished Masters Thesis, Universit\u00e9 Paris\u00a01 Panth\u00e9on-Sorbonne, 1998) and G\u00e9rard Tilles, \u2018Histoire des biblioth\u00e8ques m\u00e9dicales et des mus\u00e9es des h\u00f4pitaux de l\u2019assistance publique \u00e0 Paris. L\u2019exemple de l\u2019h\u00f4pital Saint-Louis\u2019, (Doctoral Dissertation, Universit\u00e9 Paris\u00a0XII, 1995)."},{"key":"S0025727319000796_r28","unstructured":"Ibid., 120."},{"key":"S0025727319000796_r62","first-page":"181","volume-title":"A Medical History of Skin: Scratching the Surface","author":"Woloshyn","year":"2013"},{"key":"S0025727319000796_r30","unstructured":"Kriebel and Zervig\u00f3n, \u2018Introduction\u2019, 2."},{"key":"S0025727319000796_r46","volume-title":"Fistules ur\u00e9thro-p\u00e9niennes cons\u00e9cutives au chancre simple et \u00e0 la syphilis","author":"Saint-Hilaire","year":"1898"},{"key":"S0025727319000796_r40","unstructured":"Ibid., 163, 53."},{"key":"S0025727319000796_r11","first-page":"7","volume-title":"Nature Exposed: Photography as Eyewitness in Victorian Science","author":"Tucker","year":"2005"},{"key":"S0025727319000796_r45","unstructured":"Fournier, Le\u00e7ons sur la syphilis, 547. Emphasis my own."},{"key":"S0025727319000796_r47","unstructured":"Ibid., 25."},{"key":"S0025727319000796_r57","unstructured":"Besnier, Brocq and Jacquet, La pratique dermatologique, 1900, Vol.\u00a01, 877."},{"key":"S0025727319000796_r19","first-page":"19","volume-title":"Le\u00e7ons sur la syphilis: \u00e9tudi\u00e9e plus particuli\u00e8rement chez la femme","author":"Fournier","year":"1873"},{"key":"S0025727319000796_r2","first-page":"166","volume-title":"French Medical Culture in the Nineteenth Century","author":"Weisz","year":"1994"},{"key":"S0025727319000796_r26","unstructured":"Ibid.."},{"key":"S0025727319000796_r55","unstructured":"Besnier, Brocq, and Jacquet, La pratique dermatologique, 1900, Vol.\u00a01, 877."},{"key":"S0025727319000796_r53","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2008.03683.x"},{"key":"S0025727319000796_r72","unstructured":"See, for example, Daston and Galison, Objectivity, 135, where \u2018objective\u2019 is used as a synonym for \u2018indexical\u2019."},{"key":"S0025727319000796_r38","unstructured":"Henri Feulard, \u2018Le Mus\u00e9e de l\u2019h\u00f4pital Saint-Louis\u2019, in Ernest Besnier and Alfred Fournier et al., Le Mus\u00e9e de l\u2019H\u00f4pital Saint Louis: Iconographie des maladies cutan\u00e9es et syphilitiques (Paris: Reuff et cie., 1895)."},{"key":"S0025727319000796_r67","unstructured":"Louis Landouzy qtd. in Woloshyn, \u2018Kissed by the Sun\u2019, 185."},{"key":"S0025727319000796_r48","unstructured":"In French writing, the term \u2018exact\u2019 has been tied to photography and qualities of the photographic from the medium\u2019s origins. In the earliest known description of the process written by Louis Daguerre himself, a unique broadside almost certainly printed before 1839 and given to the George Eastman House collections, Daguerre writes that his early experiments following the death of Joseph Nic\u00e9phore Ni\u00e9pce were not entirely successful, as they \u2018did not record with enough exactness [exactitude]\u2019. Describing the more satisfactory process revealed to the public in 1839, he wrote, \u2018[F]or art can imitate neither the exactness [exactitude] of the [daguerreotype] pictures nor their perfect detail\u2026.\u2019 In a report included in Daguerre\u2019s Historique et description des proc\u00e9d\u00e9s du daguerreotype et du diorama[History and description of the processes of the daguerreotype and the diorama] of 1839, one M.\u00a0Gay-Lussac similarly wrote, \u2018The principal advantage of the process of M.\u00a0Daguerre consists of promptly obtaining \u2013 in a very exact [exacte] manner \u2013 objects\u2019 images\u2026.\u2019 An entry in an early twentieth-century edition of Le Larousse pour tous demonstrates the continuity of this connection; under the entry for \u2018photographier\u2019, or, to photograph, the reader finds among the definitions: \u2018To describe, to depict with a rigorous exactitude [exactitude]\u2019. See Louis Daguerre, \u2018Daguerr\u00e9otype\u2019, reproduced in \u2018An Announcement by Daguerre\u2019, Image: The Journal of the George Eastman House of Photography 8, 1 (March 1959), 33\u20136, translation from the French included in secondary source; Louis Daguerre, Historique et description des proc\u00e9d\u00e9s du daguerreotype et du diorama (Paris: Alphonse Giroux et Cie, 1839), 34; and Pierre Larousse, Larousse pour tous: nouveau dictionnaire encyclop\u00e9dique, Vol.\u00a02 (Paris: Librairie Larousse, 1907\u201310), 435."},{"key":"S0025727319000796_r61","first-page":"61","volume-title":"Each Wild Idea: Writing, Photography, History","author":"Batchen","year":"2002"},{"key":"S0025727319000796_r20","volume-title":"La Syphilis h\u00e9r\u00e9ditaire tardive","author":"Fournier","year":"1886"},{"key":"S0025727319000796_r18","unstructured":"Rebecca J. Culyba , \u2018Classification and the Social Construction of Disease in Medical Systems: A Historical Comparison of Syphilis and HIV\/AIDS in the United States\u2019 (Dissertation, Northwestern University, 2008), 10."},{"key":"S0025727319000796_r5","first-page":"19","volume-title":"Objectivity","author":"Daston","year":"2007"},{"key":"S0025727319000796_r27","unstructured":"Daston and Galison, Objectivity, 20."},{"key":"S0025727319000796_r65","first-page":"31","volume-title":"Before-and-After Photography: Histories and Contexts","author":"Sidlauskas","year":"2017"},{"key":"S0025727319000796_r43","unstructured":"Fournier, Syphilis h\u00e9r\u00e9ditaire de l\u2019\u00e2ge adulte, 127."},{"key":"S0025727319000796_r1","first-page":"19","volume-title":"Syphilis h\u00e9r\u00e9ditaire de l\u2019\u00e2ge adulte","author":"Fournier","year":"1912"},{"key":"S0025727319000796_r4","first-page":"185","volume-title":"Constructing Paris Medicine","author":"Jacyna","year":"1998"},{"key":"S0025727319000796_r6","unstructured":"Thomas Schnalke , Diseases in Wax: The History of the Medical Moulage, trans. Kathy Spatschek (Chicago: Quintessence, 1995), 13. Archival records indicate that the mouleur St\u00e9phan Joseph Littre remained employed at the Saint-Louis hospital until 1965. See Directeur of the Administration G\u00e9n\u00e9rale de l\u2019Assistance Publique \u00e0 Paris, \u2018R\u00e9siliation: Contrat de Littre\u2019, June\u00a011, 1965, Cote: 826W27, Archives de l\u2019Assistance Publique \u2013 H\u00f4pitaux de Paris, Paris."},{"key":"S0025727319000796_r7","first-page":"360","volume-title":"Trait\u00e9 g\u00e9n\u00e9ral de photographie en noir et en couleurs","author":"Coustet","year":"1921"},{"key":"S0025727319000796_r9","unstructured":"Daston and Galison, Objectivity, 19\u201321. It should be made clear that Lorraine Daston and Peter Galison\u2019s goal in Objectivitywas never to give a detailed account of all models of scientific image making. Rather, they sought to identify larger trends in representation from the eighteenth through twentieth centuries, largely in Europe and North America, which they do with great success. I grapple with their text because it is the most recent and most comprehensive scholarly contribution to the field of scientific image making, but also because its broad scope encourages a wake of microhistories that nuance its claims, for, as the authors write, \u2018some significant historical phenomena are invisible at the local level, even if their manifestations must by definition be located somewhere, sometime\u2019. See Daston and Galison, Objectivity, 47."},{"key":"S0025727319000796_r10","first-page":"44","volume-title":"Image-Music-Text","author":"Barthes","year":"1978"},{"key":"S0025727319000796_r12","unstructured":"While I invoke Peirce\u2019s late nineteenth-century writings as historically situated texts, it should be noted that the role of the index in the broader history of photography and in art history has been consistently and hotly debated over the past fifty years. These dialogues largely center on the ontology of photography, that is, analyses of its status as a mechanical reproduction of the world. See Rosalind Krauss, \u2018Notes on the Index: Seventies Art in America, Part\u00a01\u2019, October, 1977; Rosalind Krauss, \u2018Notes on the Index: Seventies Art in America, Part\u00a02\u2019, October, 1977; Susan Sontag, On Photography (New York: Farrar, Straus and Giroux, 1977); and Michael Leja, \u2018Peirce, Visuality, and Art\u2019, Representations, 2000."},{"key":"S0025727319000796_r13","first-page":"12","volume-title":"Semiotics: An Introductory Anthology","author":"Peirce","year":"1985"},{"key":"S0025727319000796_r16","first-page":"2","volume-title":"Prophylaxie de la syphilis","author":"Fournier","year":"1903"},{"key":"S0025727319000796_r17","first-page":"5","article-title":"But et esp\u00e9rances de notre soci\u00e9t\u00e9","volume":"1","author":"Fournier","year":"1901","journal-title":"Bulletin mensuel de la Soci\u00e9t\u00e9 fran\u00e7aise de prophylaxie sanitaire et morale"},{"key":"S0025727319000796_r21","unstructured":"Kathleen Pierce , \u2018Surface Tension: Skin, Disease, and Visuality in Third Republic France\u2019 (Dissertation, Rutgers University, 2019), 17, 20\u20135."},{"key":"S0025727319000796_r24","unstructured":"Qu\u00e9tel, History of Syphilis, 140."},{"key":"S0025727319000796_r31","unstructured":"Schnalke, Diseases in Wax, 9\u201311."},{"key":"S0025727319000796_r32","unstructured":"Schnalke, Diseases in Wax, 13; Schnalke, \u2018Casting Skin\u2019, 216\u20137."},{"key":"S0025727319000796_r35","first-page":"v","volume-title":"Trait\u00e9 de la syphilis","author":"Hallopeau","year":"1911"},{"key":"S0025727319000796_r36","unstructured":"Fend, \u2018Order and Affect\u2019, 84\u20135."},{"key":"S0025727319000796_r44","unstructured":"Ibid., 283. Emphasis my own."},{"key":"S0025727319000796_r49","first-page":"734","volume-title":"Trait\u00e9 pratique de dermatologie","author":"Hallopeau","year":"1900"},{"key":"S0025727319000796_r51","first-page":"647","article-title":"Photographies dermatologiques au XIXe si\u00e8cle","volume":"125","author":"Tilles","year":"September\u00a01998","journal-title":"Annales de Dermatologie et de Venereologie"},{"key":"S0025727319000796_r54","unstructured":"Ernest Besnier, Louis Brocq, and Lucien Jacquet, La pratique dermatologique: trait\u00e9 de dermatologie appliqu\u00e9e, Vol.\u00a01 (Paris: Masson et Cie, 1900), iv."},{"key":"S0025727319000796_r56","volume-title":"La syphilis h\u00e9r\u00e9ditaire et le rachitis: maladies des enfants","author":"Parrot","year":"1886"},{"key":"S0025727319000796_r59","first-page":"51","volume-title":"Brought to Light: Photography and the Invisible, 1840\u20131900","author":"Gunning","year":"2008"}],"container-title":["Medical History"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0025727319000796","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T11:13:14Z","timestamp":1576753994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0025727319000796\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,19]]},"references-count":73,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["S0025727319000796"],"URL":"https:\/\/doi.org\/10.1017\/mdh.2019.79","relation":{},"ISSN":["0025-7273","2048-8343"],"issn-type":[{"value":"0025-7273","type":"print"},{"value":"2048-8343","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,19]]},"assertion":[{"value":"\u00a9 The Author 2019. Published by Cambridge University Press.\u00a0","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}