Views & Reviews Past caring

Heads you lose

BMJ 2007; 335 doi: http://dx.doi.org/10.1136/bmj.39281.611609.59 (Published 26 July 2007) Cite this as: BMJ 2007;335:212
  1. Wendy Moore, freelance writer and author, London
  1. wendymoore{at}ntlworld.com

    Ever since Hippocrates supposedly uttered the injunction “First do no harm,” doctors have been inextricably associated with squandering lives in the name of political and religious ideology. From the Alexandrian anatomists who dissected living convicts in the 4th century BC to the Nazi Physicians' League, doctors have bent their talents to state-sponsored murder.

    None, however, has contributed more to the cause of terror—albeit unintentionally—than the well meaning French physician Dr Joseph Ignace Guillotin. A respected doctor with a lucrative practice in pre-revolutionary Paris, Guillotin was a professor of the Paris Faculty of Medicine. A disciple of reason, he helped investigate and condemn the hypnotism craze brought to Paris by the charlatan Franz Mesmer. In the same spirit of enlightenment, he called for sweeping reforms of the capital's atrocious hospitals and asylums.

    Espousing revolutionary idealism, the progressive doctor was elected a deputy to the National Assembly in 1789. After persuading the assembly to establish a Health Committee, which he chaired, Guillotin set about modernising French medical education and practice. And it was with the same reforming zeal, in the rosy dawn of the new republic, that the good doctor turned his attentions to the iniquity of capital punishment.

    Keen to extend the principle of equality to the republic's criminals, Guillotin proposed that anyone executed should be beheaded; previously the nobility alone had enjoyed this privilege while commoners suffered a long, agonising death by hanging. In order to render this end as humanitarian as possible, he advocated a fast, foolproof, and painless decapitation machine. Eloquently arguing his case before the assembly, he enthused: “The device strikes like lightning, the head flies, blood spouts, the man has ceased to live.”

    Contrary to popular belief, Guillotin did not invent, design, build, use, or die by his eponymous contraption, nor was it even the first machine devoted to beheading; there had been earlier devices in Scotland and elsewhere. The French model was designed by a Parisian surgeon, Antoine Louis, built by a German musical instrument maker and tested on corpses and live sheep.

    Initially, its nicknames included the “Louisette” after its surgeon designer and the “Mirabelle” after its ardent supporter the comte de Mirabeau. But soon after its first use, to execute the murderer Nicholas Pellétier on 25 April 1792, “la guillotine” acquired its enduring soubriquet.

    After his device had removed an estimated 40 000 heads during the Reign of Terror, Guillotin undoubtedly came to regret his humanitarian mission, especially when he narrowly escaped death from a brush with his own creation. Later returning to his good work, he made some amends by championing Jenner's smallpox vaccine before dying, peacefully, in 1814.

    He may be less easily forgiven, of course, for bequeathing England its Department of Health, inspired by its French revolutionary predecessor.

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