Changes in Medical Authority The Physician Priest and the New Body

It is now well known that since the beginning of the 19th century, the moral authority of the physician in the United States grew to encompass that of the priest. As noted by the social historian Englehardt, "the cycle of sin, confession, penance, and redemption was transferred from the confessional to the consulting room" (29) (also see Ref. 30). In this new role of physician/priest, doctors not only attempted to cure diseases but also enforced the standards of a puritanical sexual morality well into the middle of the 20th century (31). By being able to tie the scientifically established consequences of masturbation to morally freighted proscriptions against it, doctors were able to give a new legitimacy to the idea of postmasturbatory diseases. From then on, such diseases would constitute the locus for the definition of normal sexuality and the massive political efforts to control people. Although the moral injunction against masturbation was venerable, the addition of the scientific standing of medicine in the early 19th century provided decisive weight to the political management of sexuality. For example, the nerve theory of Haller and Cullen; the discovery of tissues as the site of disease by Bichat and Broussais; the confirmation of the mechanical nature of respiration and circulation first suggested by Harvey; and the entitative nature of disease agents established by Mortgagni constituted some of the diverse strands that led the emergence of scientific medicine (32).

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