Book Review: ‘History Within: The Science, Culture, and Politics of Bones, Organisms, and Molecules’

Marianne Sommer, History Within: The Science, Culture, and Politics of Bones, Organisms, and Molecules, London and Chicago, University of Chicago Press, 2016, 544 pages, cloth $50.00 ISBN 9780226347325.

by Chris Renwick

UNESCO – the United Nations Educational, Scientific, and Cultural Organisation – is probably best known to the public for the “world heritage site” status it has awarded to buildings, structures, and places including the Acropolis, the Galapagos Islands, and the Taj Mahal since it was founded in 1945. Given this role as a guardian of the globe’s heritage, it might surprise some people that UNESCO’s first director – and the man who insisted it include science as well as education and culture in its remit – was Julian Huxley (1887-1975). Grandson of “Darwin’s Bulldog”, Thomas Henry Huxley, Julian was a distinguished biologist in his own right and a public intellectual who had written numerous best-sellers, including Evolution: The Modern Synthesis (1942), been Secretary of the Zoological Society of London, and even won an Oscar for his documentary film, The Private Life of Gannets (1934). Julian Huxley’s connection with UNESCO made perfect sense. A campaigner for what he called “evolutionary” or “scientific” humanism, he believed there was no good reason to exclude the stuff of which we are made from our concept of heritage.

Huxley’s vision is one of the three overlapping evolutionary programmes – the others belonging to the American paleontologist Henry Fairfield Osborn (1857-1935) and the Italian geneticist Luigi Luca Cavalli-Sforza (b. 1922) – that Marianne Sommer has weaved into the compelling History Within. Charting almost 100 years across 15 deeply researched and packed chapters, Sommer tells a story about the efforts to come to terms with the biological, social, and cultural meaning of evolution during the twentieth century. Focusing on an evolving understanding of heritage, through which thinkers fused biology, society, and culture whilst avoiding reductionism, History Within documents a complex intergenerational project to provide us with a scientifically-informed account of what it is to be human. In so doing, Sommer takes us from the early twentieth-century world of what historians have called “mainline” eugenics, in which categories like race had essentialist properties, to the triumph of diversity, in both politics and biology, 70 years later.

Central to Sommer’s argument about those developments is the idea that they were both made possible by and a direct consequence of networks that included not only scientific and political ideas but also technology and modes of communication. Whilst Huxley went so far as resigning his university chair to devote more time to communicating his ideas to a wider public, Osborn worked as both a professor of biology at Columbia University and a curator at the American Museum of Natural History. Cavalli-Sforza, a former student of the British population geneticist R. A. Fisher, integrated his work at Stanford with the latest advances in computing, helping to lay foundations for both the Human Genome Diversity Project and the National Geographic-funded Genographic Project. Immersing ourselves in each of these thinkers’ worlds takes us from an effort to illustrate and encourage people to engage with human evolution through dioramas at the American Museum of Natural History to electronic maps showing the migration of genes across the globe. At each stage, new research techniques made it possible to look deeper into ourselves and increased the amount of information that accounts of human history could include. But they also furnished people like Osborn, Huxley and Cavalli-Sforza with new ways of thinking about humans and opened up new possibilities for people to engage with them.

As Sommer shows, these developments, which have created businesses that will decode genomes for a fee and the idea that heritage can be identified with our genetic makeup, have always existed within a complex and precarious set of political and cultural relationships. Indeed, History Within is most thought-provoking and insightful when it comes to the twentieth-century struggle to fashion a biology that worked productively with left and liberal politics. When allied with his science, Osborn’s somewhat unforgiving eugenics generated a story about humanity that was hierarchical and excluded races and groups. Huxley, however, saw eugenics as having more to do with equality of opportunity – an idea that provided the foundation for his later and more famous work on the UN Statements on Race, which declared race a social, not biological, category. Yet in a post-war world where Huxley’s once-progressive beliefs about eugenics suddenly sounded old-fashioned, Cavalli-Sforza transformed apparently empty biological categories into positive political statements. Genetic geography, with arrows and maps showing the global movement of people, told us about that a common humanity that stretched deep into the past and could be discovered within us.

As Sommer argues, though, problems have persisted, even with this apparent resolution to the challenge set by mid-twentieth-century biosocial progressives. One is the tendency to treat some communities as living fossils – reminders of some geographic and cultural staging post on the way to our own current state. Given that the science involves choices about which groups to sample, stories about genetic and cultural development map historical change in complex and politically fraught ways; for example, by making some people and places part of others’ pasts. At the same time, however, the constant pursuit of diversity in the biosocial sphere threatens to overload us with information, making it difficult to support a story about human heritage that is as coherent as it was when Cavalli-Sforza first started work – a scenario that will be familiar to anyone engaged with the politics of “big data”. Indeed, there is another order of questions that History Within alludes to, namely what all these developments in understanding our past might mean for our future. In the decades after the Second World War, when he was forced to drop eugenics as a frontline concern, Huxley wrote about something he called “transhumanism” – how our knowledge of biological and psychological science might be used to overcome our physical limitations. Diversity was an important part of this project because Huxley had come to believe that, given it was essential for evolutionary progress, society’s role was to compensate for its costs, such as disability. This was a very different answer, of course, to the one offered by earlier mainline eugenicists, who believed in the purity of races. In this respect, progressive social and political ideals have been integral to biology and our understanding of the human during the past 70 years. But with private companies becoming significant actors in the development and communication of these ideas, there are profoundly important questions about the ownership of human heritage, not to mention inequalities in participating in it and accessing any of its future benefits. Sommer offers us a profoundly important historical frame for thinking about this problem, not to mention the others that will emerge in future.

Chris Renwick is senior lecturer in modern history at the University of York and an editor of History of the Human Sciences. He works on the relationship between biology, social science, and politics, and is the author of British Sociology’s Lost Biological Roots: A History of Futures Past (Palgrave Macmillan, 2012).

 

The Holofernes Complex: a new edition of Michel Leiris’ ‘Manhood’

L’Âge d’homme preceded by L’Afrique fantôme, by Michel Leiris. Paris: Gallimard, 2014. Edited by Denis Hollier, in collaboration with Francis Marmande and Catherine Maubon, Series: Bibliothèque de la Pléiade, n°600. 1456 pages, 38 ill., ISBN: 9782070114559.

by Emmanuel Delille

A new edition of L’Âge d’homme (available in English as Manhood)[ref]Leiris, M. (1992) Manhood: A Journey from Childhood into the Fierce Order of Virility, translated by Richard Howard. Chicago: University of Chicago Press.[/ref] by Michel Leiris (1901-1990), overseen by Denis Hollier, was published by the Bibliothèque de la Pléiade at the end of 2014. It constitutes the second volume of Leiris’ selected works, the first volume being La Règle du jeu[ref] Leiris, M. (2003) La Règle du jeu, ed. Denis Hollier, in collaboration with Nathalie Barberger, Jean Jamin, Catherine Maubon, Pierre Vilar, and Louis Yvert. Paris: Gallimard.[/ref]. The edition presents selected autobiographical texts in addition to L’Âge d’homme, including L’Afrique fantôme. (The latter is often translated into English as Ghostly Africa, but will be soon published for the first time as Phantom Africa in a new translation by Brent Hayes Edwards).[ref]Available in English in February 2017: Leiris, M. (2016) Phantom Africa, trans. Brent Hayes Edwards. Chicago: University of Chicago Press.[/ref] L’Afrique fantôme is an essay that is simultaneously controversial and foundational for French ethnology. Hollier’s editorial decision highlights Leiris’ contribution to the genre that we call autofiction, wherein autobiographical materials are rewritten using the techniques of fiction writing – in contrast to the raw journals kept by Leiris between 1922 and 1989. Hollier has proposed the general title L’âge d’homme fantôme[ref]Hollier, D. (2014a) ‘Préface’, in Michel Leiris, L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, XI.[/ref] to identify this corpus; following Edwards’ new translation of Phantom Africa, an English version of this title could be Phantom Manhood [ref]I am very grateful to Professor Brent Hayes Edwards (Columbia University), who answered my questions about his new translation and suggested Phantom Manhood as a general title in English.[/ref]

The volume is imposing; for this reason, my analysis focuses solely on L’Âge d’homme, the best-known of Leiris’ books among the general public (L’Afrique fantôme is the object of another review article, in the Japanese academic journal Zinbun).[ref]Delille, E. (2017) ‘Michel Leiris, L’Âge d’homme, précédé de L’Afrique fantôme. Édition de Denis Hollier, avec la collaboration de Francis Marmande et Catherine Maubon, (Paris, Gallimard, Collection: Bibliothèque de la Pléiade, n°600, 2014, 1456 pages, ill.)’, Zinbun: Memoirs of the Research Institute for Humanistic Studies, Kyoto University, 47: in press. [/ref] From my perspective, it is not, for all that, his masterpiece; however, this narrative has benefited from its long availability as a mass-market paperback, unlike L’Afrique fantôme. Of Leiris’ books, it is also the one closest to the genre of confessional literature: it reveals the author’s sexual obsessions, the pathological shame he felt, and how he turned to the psychoanalytic interpretation of myths to narrate his experience.

Hollier soberly recounts the book’s context: after a period of anguish and impotence, Leiris began psychoanalysis in 1929 with Adrien Borel (1886-1966), one of the first French psychoanalysts, on the advice of his friend Georges Bataille (1897-1962). He then joined the Dakar-Djibouti Ethnographic Mission (1931-1933) and published a long travel narrative, L’Afrique fantôme (1934). L’Âge d’homme soon followed (1935), although it only really began to take shape after a second series of psychoanalytic treatments (1933-34).

While Leiris was at the very beginning of his scientific career in the 1930s, it is obvious that he drew on two disciplinary genres in order to breathe new life into confessional writing: psychoanalytic and ethnographic narratives. Indeed, as in L’Afrique fantôme, Leiris began with the principle that writing in the subjective mode increases the value of the testimony contained in the book and brings it closer to the truth. Eight chapters tell the story of his childhood and adolescence until the age of reason: marriage, the publication of his first works, and the beginning of a scientific career. Parental figures, his brothers and sister, and his first romantic relationships haunt the narrative, even though the figure of the beloved brother is not as well developed as in The Rules of the Game (La Règle du jeu). Nevertheless, the text is not structured as a family drama in the strict sense; instead, the plot is organized around a painting by Cranach that represents two biblical figures: Judith and Lucretia (Cranach, 16th century). Leiris saw in this diptych a kind of crystallization of his obsessions: two women who personify the two faces, desired and terrifying, of his fantasy. At one and the same time, woman is the object of man’s imperious desire (rape of Lucretia) and triumphant against her rapist (Judith decapitating Holofernes). The influence of psychoanalysis allowed him to identify his fascination with Cranach’s diptych with the concept of the castration complex, which Leiris believed explained his anxieties: “By psychoanalysis, I hoped to free myself from this chimerical fear of punishment, a chimera reinforced by the absurd power of Christian morality – which one must never flatter oneself that one has altogether escaped.”[ref]Leiris, M. (1992) Manhood: A Journey from Childhood into the Fierce Order of Virility, translated by Richard Howard. Chicago: University of Chicago Press, 138. See also: Leiris, M. (2014) L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, 889-890.[/ref] In Freudian psychoanalysis, the castration complex designates the anxiety that results from the Oedipus complex, which is to say the love children have for their mother, as it is checked by paternal power. This infantile fear represents a certain renunciation of the maternal object, but also an irreversible loss: it thus constitutes an existential anguish, which makes it susceptible to displacement onto substitute objects.

Yet one of the most interesting aspects of this new edition is precisely that it draws attention to the biblical personage with whom Leiris identifies: Holofernes. Indeed, in his foreword, Hollier justly stresses the disappearance of Judith and Lucretia in the conclusion of L’Âge d’homme; they are replaced by masculine figures, suggestive of homosexuality, that are designed to be more harmonious with the psychoanalytic theme of castration.[ref]Hollier, D. (2014b) ‘Notice: David et Goliath ou la castration’, in Michel Leiris, L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, 1227.[/ref] He also reproduces some of Leiris’ corrected proofs, one of which is soberly entitled Psychanalyse (Psychoanalysis, December 1930).[ref]Leiris, M. (2014) L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, 31.[/ref] which Leiris had originally intended to insert before a dream narrative.

From a historical point of view, we know that the interpretation of symbols played an important role in the beginnings of psychoanalysis, particularly in the first half of the 20th century. This practice first appeared as a technique for interpreting dreams, with the goal of filling out the material obtained in the patient’s free associations while recounting a dream. For the therapist, it helped both to overcome mental blocks and to explain Oedipal fantasies to the patient. But psychoanalysts soon extended this practice to interpreting symbols in myths, religions, and literary texts; Freud himself based his analysis of infantile sexuality on Greek mythology and published an essay on the biblical figure of Moses.

Hollier also presents a previously unpublished letter written by Leiris to his wife, dated May 30th, 1932. It explains that Borel’s virtue lay in his having understood that Leiris wanted to play the role of a mythological character: he would stage himself in the form of a new Holofernes[ref]Hollier, D. (2014b) ‘Notice : David et Goliath ou la castration’, in Michel Leiris, L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, 1229.[/ref], in an autobiographical narrative where confession would have a cathartic function. Finally, Hollier observes that castration is also an explicit theme of two texts, contemporary with Leiris’ writings, that were published in 1930 in the journal Documents; this journal was edited by Bataille and lists Borel as one of its contributors.

These materials make a convincing argument that Leiris identified himself with a mythological character. It is unfortunate, however, that the editors chose not to present more context about the appropriation of psychoanalysis by writers of this generation, and that they even forgot to list Borel in their index. This oversight is all the more curious because the very interesting appendices of this new edition contain a Note remise au docteur Borel (Note delivered to Doctor Borel, 1929)[ref]Leiris, M. (2014) L’Âge d’homme précédé de L’Afrique fantôme, ed. Denis Hollier in collaboration with Francis Marmande and Catherine Maubon. Paris: Gallimard, 912.[/ref], followed by Projets de mémoires (Ideas for Memoirs, 1930)[ref]Ibid., 913-915.[/ref], extracted from Leiris’ journal and contemporaneous with his psychoanalysis – a corpus of texts which should have been compared with those written by other former surrealists who undertook psychoanalysis with Borel.

And yet evidence indicating that these texts represent collective practices is not lacking, and editors might have remembered that in the Bible, Judith’s victims include not only Holofernes, but his army as well! Because in addition to Leiris and Bataille, we must also take into account Jacques Baron, Raymond Queneau, Colette Peignot (pseudonym: Laure), and Boris Souvarine, all of whom were in therapy with Borel. Moreover, Borel was not only a confidant of but also an intermediary between the members of this group, as their correspondence demonstrates. For example, in 1934, Baron revealed to Leiris that he too had taken the initiative of asking for help: “I’m not joking, but I’m heading to Privas to visit Doctor Borel! Tell no one about this idiocy, but I’m dreaming: I have all of hell in my head.”[ref]The original French text: “Je ne rigole pas, mais je pars pour Privas rendre visite au Docteur Adrien Borel. Ne souffle mot à personne d’une telle idiotie mais je rêve: j’ai tout l’enfer dans la tête.” Leiris, M. & Baron, J. (2013) Correspondance 1925-1973. Nantes: Joseph K., 149. The English translation here, by Marie Satya McDonough, is literal, because Baron’s expressions are not clear in French. We know that he suffered from depression after the War, but we must be wary of retrospective diagnoses. See also: Delille, E. (2016) ‘Michel Leiris & Jacques Baron, Correspondance. Édition établie, annotée et préfacée par Patrice Allain & Gabriel Parnet (Nantes, éditions Joseph K., 2013, 192 pages)’, Zinbun: Memoirs of the Research Institute for Humanistic Studies, Kyoto University, 46: 213-215.[/ref] That same year, Leiris wrote to Bataille: “If you see Borel after receiving this letter, give him my regards and tell him that I am trying hard to be good.”[ref]Bataille, G. & Leiris, M. (2008) Correspondence, trans. Liz Heron. Chicago: University of Chicago Press/Seagull Books, 105.[/ref] Similarly, in 1943 he wrote him about the posthumous publication of a text by Peignot: “Did you receive the Histoire d’une petite fille? All the copies planned have now been distributed, except Borel’s (but I expect to go and see him within a very few days).”[ref]Ibid., 160.[/ref] We thereby see how in the 1930s, psychoanalysis was a collective practice, much like automatic writing, introduced in The Magnetic Fields (Les Champs magnétiques) in 1920.[ref]Available in English as The Magnetic Fields: Breton A. & Soupault P. (1985) The Magnetic Fields, translated and introduced by David Gascoyne. London: Atlas Press.[/ref]

This intellectual social scene, enthusiastic about psychoanalysis, also had an impact on academic psychology. For example, after the suicide of the eccentric writer Raymond Roussel (1877-1933), Leiris was tasked with editing How I Wrote Certain of My Books[ref]Roussel, R. (2005) How I Wrote Certain of My Books, edited by Trevor Winkfield and introduced by John Ashbery. Boston: Exact Change.[/ref] (Comment j’ai écrit certains de mes livres, 1935), a posthumous autobiographical essay. The project led him to contact the psychologist Pierre Janet, a professor at the Collège de France and Roussel’s psychotherapist, in order to reconstruct his illustrious patient’s last days. Bataille would repeat the gesture in consulting Borel with regard to the posthumous edition of Peignot – and that is not all: in 1937, Leiris would join Bataille in founding a Société de Psychologie Collective, with Borel and Janet! This Society’s goal was to study the psychological factors in social facts. While it may be argued that this information is well-known, unfortunately the existing historiography on the crossed histories of psychoanalysis, psychology, and early 20th century avant-gardes reveals that the collaborations between the literary world and academic psychology are relatively unknown. I am thinking in particular of Alexandra Bacopoulos-Viau’s research,[ref]Bacopoulos-Viau, A. (2012) ‘Automatism, Surrealism and the Making of French Psychopathology: The Case of Pierre Janet’, History of Psychiatry 23(3): 259-276.[/ref] which is well documented but too focused on Breton, and where Leiris is literally forgotten. Beyond Borel and Janet, Leiris would consult other psychotherapists after the war, including Julián de Ajuriaguerra (1911-1993), who would later become, like Janet, professor at the Collège de France. To sum up, it would have been interesting to establish the similarities and the differences between L’Âge d’homme and the accounts, diaries, and fictions that Leiris’ contemporaries left on the practice of psychoanalysis.

Emmanuel Delille is a historian of medicine and health, currently Visiting Scholar at the Max Planck Institute for the History of Science. He is an Associate Researcher at the Centre d’Archives en Philosophie, Histoire et Édition des Sciences (CAPHÉS, École Normale Supérieure, Paris) and at the Centre Marc Bloch (CMB, Humboldt University, Berlin). One of his major interests is the history of psychiatry: intellectual networks and comparative history between France, Germany, and North America – particularly Canada. Other research projects include the history of the French psychiatric hospital Bonneval (Eure-et-Loir) and the history of the French scholarly society “L’Évolution Psychiatrique” (created in 1924). His work in intellectual history focuses on epistolary material, above all, letters between scientists involved in scholarly networks.

What is philosophy of medicine good for?

An Interview with Cornelius Borck on his recently published book, Introduction to Philosophy of Medicine (in German: Medizinphilosophie. Zur Einführung, 2016. Junius: Hamburg)

by

Lara Keuck

Philosophy of medicine is booming. In the past decade or so, several special issues, textbooks and anthologies have been published that promise to chart the field. One of the most recent additions to this body of literature is The Routledge Companion to Philosophy of Medicine, edited by Miriam Solomon, Jeremy Simon and Harold Kincaid. While the editors strive to include a broad array of perspectives, their ‘predominant thread is the philosophy of medicine treated as part of the Anglophone philosophy of science tradition’ (p.2).

Earlier last year, Cornelius Borck, Professor of History of Medicine and Science Studies at the University of Lübeck in Germany, published a quite different book. Introduction to Philosophy of Medicine (in German: Medizinphilosophie. Zur Einführung) advocates a closer affiliation of philosophy of medicine with history, anthropology, and social studies of medicine, as well as with the phenomenological tradition in philosophy, moving it away from the predominant thread of analytic (and Anglophone) philosophy of science.

As more and more fields of life become medicalized, and indeed often seem to be inevitably medical, Borck urges his readers to stand back, and to look at the ‘functioning logics’’ (Funktionslogik) of evidence-based medicine, biomedicine, or palliative medicine from a critical distance. He puts the distinction between experiencing an illness and having a disease up front, and makes a strong argument that philosophy of medicine ought not be reduced to serving medicine in clarifying biomedical concepts of disease. Rather, philosophers of medicine should think about health and illness as phenomena of human life, for which medicine provides but one ‘pattern of interpretation’ (Deutungsmuster).

Borck exemplifies past and present approaches of medical reasoning. He opposes pre-modern doctors’ attempts of accompanying people through their illness to current trends of overly focusing on intervening medically into human conditions. Borck is not hesitant to make normative judgements, but they are carefully weighed, and they neither lend themselves to a general cultural pessimism nor to a naïve belief in technological progress. Drawing on a broad array of historical studies, the book rather wants to sensitize its readers to, first, an understanding of how medicine became the authority in providing, or at least searching for, scientific explanations for disorders of biological functioning; and, second, a critical engagement with this authority: birth, illness, pain, and dying became medical problems and to-be-solved ‘puzzles’ (Rätsel) of biomedicine. But are these really ‘problems’ that can, and should, be solved? Philosophy of medicine, in Borck’s reading, ought to be informed about medical developments, while propagating a philosophy of health and illness of its own that does not uncritically follow current medical trends. How does this interplay between closeness and distance work? And could this programmatic vision for philosophy of medicine work as an agenda for medical humanities?  I put these questions directly to Cornelius Borck, during a conversation that took place in Berlin and Lübeck, over December 2016

Lara Keuck (LK): I read your book as an invitation to think about what medicine is good for. You distance yourself from other approaches to philosophy of medicine that seem to be united by the basic assumption that medicine (if practiced well and based on solid scientific grounds) is good per se. You identify these approaches with Anglophone philosophy of science and the German tradition of theory of medicine. Do you think that these traditions are in principle ill-suited to address the questions that you raise?

Cornelius Borck (CB): I very much like your description of my book as ‘an invitation to think about what medicine is good for. There can be no question that medicine deals very effectively with many different medical problems and that access to affordable medical treatment is a high common good. As a specialized branch of philosophy of science, philosophy of medicine can thus zoom in on the ways in which biomedicine structures and organizes its practice, how it generates knowledge and orders it to explanatory theories, how its concepts articulate with decision strategies, how access to treatment is regulated and costs and benefits are distributed, etc. Unlike most other sciences, however, medicine does not start with an open search for knowledge; it cannot start from scratch, so to speak, as it deals with human suffering and illness. Illness and suffering precede any science; they call for medical intervention, which in turn shapes and formats states of illness into medical problems. Philosophy of medicine as the reasoning about the fundamental problems medicine is concerned with, should not start with an analysis of the problems as defined in medical practice but open its analysis to the formatting of these problems by medicine. Illness and suffering obviously go far beyond the boundaries of medicine, and medical practice addresses them explicitly and in scientific ways. Philosophy of medicine should hence also comprise a reflection about how it addresses health and illness.

LK: A couple of years ago, you co-edited a book called Maß und Eigensinn (‘Rule and Obstinacy’) that presented historical studies on medical sciences inspired by the work of the French epistemologist Georges Canguilhem. Your new book ends with the statement that philosophy of medicine can help society to articulate its obstinacy (Eigensinn) vis-à-vis medicine. Obstinacy captures only part of the meaning of ‘Eigensinn.’ In German, the term can also be applied to a person who shows integrity and self-coherence in her stubbornness. What does the concept mean to you?

CB: Well spotted! You are probably right in pointing this out as an idiosyncrasy of mine. Here, however, I had in mind what I regard the biopolitical relevance of philosophy of medicine: because biomedicine is so deeply entrenched in the current understanding of life and health, it defines almost every health related issue as a biomedical problem and assigns its interventions as the only salient solutions. Biomedicine’s descriptions of life-and-health-related problems tend to be taken as imperative and peremptory, without asking whether they serve a meaningful understanding of life and health – which obviously transgresses the limits of medical definitions in most instances. In his famous treatise on The Normal and the Pathological, Canguilhem determined the living as that form of being which not only follows rules and norms but establishes them in the first place – because of its obstinacy. Without such an obstinacy and autonomy life would simply not exist. This was the core idea of the book he finished in 1943, the same time he was an active member of the Resistance – and I think this is still an important message.

LK: While your book urges for more critical distance within philosophy of medicine, it is also filled with much details about recent developments, for instance in evidence-based medicine and palliative medicine. Could you elaborate a bit on how this interplay between closeness and distance to your subject of inquiry works? Do you regard this as a general methodology for philosophy of medicine?

CB: Many thanks for this zooming-in as it provides me the opportunity to state clearly that I do not conceive of philosophy of medicine as the search for a completely different form of medicine or as a credo for alternative and holistic medicine. On the contrary, I want to open philosophy of medicine and bring in the ‘critical distance’ you mention for discussing how well it serves in addressing the needs of particular patients. Evidence-based medicine (EBM) is the currently dominating framework of biomedicine and there is probably hardly a better way of doing medicine than ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients,’ as David Sackett and his colleagues defined EBM. However, patients suffer from many different diseases with particular conditions and under very specific circumstances. The available evidence from clinical trials and other studies certainly offers important information, but for systematic, epistemological and pragmatic reasons this cannot cover every condition. A proper analysis of the details of EBM thus brings in critical distance as it reveals, for example, how EBM turns complex clinical conditions into discernible, treatable disease states and measurable treatment effects. Intended as the most accurate picture of the problems biomedicine has to deal with, EBM exerts a tendency to mistake the composite of EBM units for the world of medicine. And on another, more political and health-systems level, EBM introduced new forms of governance and regulation that increased transparency by linking medical services to cost effectiveness. Transparency is an important issue for democratic governance, but instead of opening new arenas for political debates on the health system, the decision-making often gets delegated to the anonymous power of statistical data.

Palliative care is an important topic for my analysis for two very different reasons: as a form of medical practice in the absence of curative treatment, it offers to explore how biomedicine deals with its own failure – and here I see a highly problematic medicalization of terminal care and dying, following on from the medicalization of birth. At the same time, palliative care operates in situations when medicine is cut off from its routines of effectiveness and hence allows us to study forms of practice adapted to individual needs. Where medicine gets disconnected from the imperatives of the perfect cure, a plurality of practices surface, which generate forms of significance and meaning which got lost with biomedicine’s effectiveness. In the absence of effective curative treatment, palliative care provides a window onto some of the other dimensions involved in medical practice that EBM and biomedicine have pushed to the side. At stake here is an ontology of disease conditions and states of illness according to a tinkering logic of care rather then the epistemology of biomedicine. Here, I see a special potential for phenomenology and the phenomenological analysis of states of illness.

LK: You extensively draw on anthropological, sociological and historical work in your book. Why did you decide to flag it as an introduction to philosophy of medicine?  You make clear that you are critical about the term ‘medical humanities.’ Yet, your book seems to me a prime example of both the fruitfulness of cross-talk between the meta-disciplines studying medicine and the importance of educating medical students (and society at large) to not only think about what is technically possible, but also about the limits of medical interventionism.

CB: I have already explained why philosophy of medicine should be more than the branch of philosophy of science specializing in medicine. As such a fundamental questioning, philosophy of medicine must build on the insights from science studies, anthropology and historical epistemology. If my book also serves as an introduction to medical humanities properly understood, I have no problems with that. In their present form however, ‘medical humanities’ often functions as a term describing an array of attempts to adapt biomedicine to the needs of patients without questioning the way biomedicine defines their problems. A good medical education must include some form of medical humanities and it should also offer some philosophical reflection on how biomedicine operates as a scientific practice – and in addition, philosophy of medicine should be the ‘cross-talk between the meta-disciplines studying medicine,’ as you just described it. Biomedicine has generated a wealth of possible and effective interventions. The problem with the technically possible is less the risks and costs involved, but the inherent tendency to foreclose a proper discussion about benefit. The limitations of medical interventionism transpire not along the limits of the technically possible but along their unlimited extension.

LK: Recently, Mark Zuckerberg, the founder of Facebook, and his wife, Priscilla Chan, advertised that they wanted to spend 100 billion dollars in biomedical (and bioinformatic) research, announcing the aim to eradicate all diseases by the end of this century. Your book reveals puzzle-solving to be the ‘working mode’ (Arbeitsmodus) of biomedicine and you argue that this is an ‘unattainable phantasm’ (uneinholbares Phantasma). You oppose philosophy of medicine to this reductionist understanding. Do you see a role for philosophers of medicine in publicly raising their voices in light of such news?

CB: The aim to treat more diseases and to treat them more effectively is very laudable. But it must be added that, on a global scale, the most pressing health problems are already now treatable and effectively manageable. Clean water, healthy food and good hygiene are still the most important factors determining health and disease epidemiologically.  Any initiative to eradicate disease by fostering biomedical research and bioinformatics is hence a very Western and elitist program. But that is another problem and not your question. Living without disease is an old dream, the hope for a new paradise. My suspicion about the Zuckerberg and Chan vision is that to eradicate all diseases does not lead to utopia but to an inhuman dystopia of perfected life, mistaking the ‘absence of disease’ with proper health – to echo the famous definition by the WHO. Alas, my scepticism regarding the Zuckerberg and Chan initiative does not rely on the assumption that diseases are necessary requirements for a meaningful life; it revolves around the understanding that frailty and failure are part and parcel of life itself – and not only of its defective forms. Strictly speaking, life can only be perfected by bringing it to its end. Philosophy of medicine can and should explain why the aim to eradicate disease is good but the underlying vision mistaken; and by the way, the Companion to Philosophy of Medicine you mentioned in the beginning is a nice example of how also the Anglophone branches of philosophy of medicine open up to this.

LK: Imagine Zuckerberg and Chan, inspired by the Human Genome Project, decided to reserve 1 % of this 100 billion dollar programme for the medical humanities. What should be done?

CB: They should, indeed, decide so, but for the form of cross-talk you mentioned! Since the Humane Genome Project we have ELSI, the study of the ethical, legal and social issues of biomedical research. This is more than a mere ‘nice to have,’ because it is important to explore these issues together with the scientific projects. But as it is implemented today, ELSI research follows rather the scientific agenda than interacting with it, and hence, discussion has started about how ELSI research can be better integrated in and connected with on-going biomedical research. In a similar way, medical humanities should be conceived not only as a training program but as a research area, interconnected with biomedical research. A substantial proportion of the 1 billion dollars should be hence allotted to patient groups and for citizen science projects, for articulating, fostering and incorporating their views, needs and values into the biomedical research agenda. And I would apply to Zuckerberg and Chan for funding an interdisciplinary PhD program in philosophy of medicine, offering philosophical reflection in combination with social studies and an immersion in clinical and lab-based research. Instead of specializing philosophers in a subfield, the program would train a new generation of cross-talkers with a thorough understanding of the articulation of research, needs and problems of the many actors in the health system. Their expertise and mediation will be required.

Lara Keuck specializes in history and philosophy of biomedical knowledge. She leads a junior research group on “Learning from Alzheimer’s disease. A history of biomedical models of mental illness”. The group is based at the Department of History at Humboldt University in Berlin, Germany, and is funded through ETH Zurich’s “Society in Science – The Branco Weiss Fellowship”. Together with Geert Keil and Rico Hauswald she has just published an edited volume on Vagueness in Psychiatry (Oxford University Press, 2017).

Cornelius Borck studied medicine and philosophy and is director of the Institute of History of Medicine and Science Studies of the University of Lübeck, Germany. Before coming to Lübeck, he held a Canada Research Chair in Philosophy and Language of Medicine at McGill University in Montreal. Beyond philosophy of medicine, he works on the history of brain research between media technology and neurophilosophy and on  the epistemology of experimentation in art and science.

Medizinphilosophie. Zur Einführung is out now from Junius Verlag.

Book Review: ‘Wilhelm Reich, Biologist.’

James E. Strick, Wilhelm Reich, Biologist. (London: Harvard University Press, 2015). 467pp. ISBN 9780674736092. (hardcover), £31.95

by Matei Iagher 

In his biography of Wilhelm Reich (1983), Myron Sharaf began the section on Reich’s scientific work with a warning that he did not have the requisite competence to judge this scientific work, and that the existing literature on this aspect of Reich’s work was too unreliable to be used  in making a critical assessment. This caveat could be read as a challenge for historians of science, but as the Reich archives only became available in 2007, the task of providing a competent, historical account of Reich’s biological work also had to wait. The wait has not been in vain, as with James Strick’s Wilhelm Reich, Biologist we now have a balanced and thoroughly researched account of Reich’s experimental work in the 1930s, which is likely to become the standard for any future historical investigation of Reich’s work.

Outside of a small circle of researchers and aficionados, Wilhelm Reich’s name does not immediately evoke associations with laboratory biological research. Rather, he is much more well-known as a psychotherapist, a psychoanalyst and Freudian dissenter, and above all, as a forefather of  the 1960s sexual revolution and as an intellectual source for later American and European counterculture. Much of the popular image of Reich is, even today, glazed over with an unsavory patina—an echo of the sensationalist reporting that tarnished his reputation in the 1950s, when the US Food and Drug Administration (FDA) also made him the target of a witch hunt (Reich’s books were burnt, and he was eventually imprisoned for contempt of court). Part of the aim of Strick’s book is to destroy this popular, pseudo-scientific aura that hangs around Reich, by showing that some of his most controversial theories were rooted in serious, cutting edge research.

Methodologically, the book draws on an extensive engagement with the Reich archive (his laboratory notebooks, correspondence, research and personal images), which is used to reconstruct Reich’s working methods, theoretical commitments and the process whereby he obtained his results. In addition, this is very much a book about debates in early twentieth century biology (and Reich’s place within them) as well as a book about changing paradigms in the life-sciences. The word ‘paradigm’ is not accidental, as Strick mentions Kuhn, and particularly his notion of ‘revolutionary science,’ more than once, as a way of describing Reich’s biological work. As he writes in the introduction: ‘Scientists, then, whose names we associate with revolutions—Copernicus, Newton, Lavoisier, Darwin, Pasteur, Semmelweiss—all, by definition, faced staunch, often irrational resistance to their ideas, not least from the established scientific authorities of their day. I argue that Reich’s work on biogenesis in the bion experiments, and certainly the visceral reactions it provoked, need to be understood in this light’ (p.8). This is pretty illustrious company, to say the least, but it reflects Strick’s sense that Reich drew the short straw of history and that he deserves a posthumous rehabilitation.

Wilhelm Reich, Biologist thus sets out to perform this rehabilitation, by examining Reich’s theoretical and experimental work in biology, undertaken in Oslo between 1934-1939. The book’s seven chapters chart Reich’s discovery of the ‘bions’ (microscopic particles that Reich saw as intermediary between inanimate matter and life) and outline the process by which Reich tried (and ultimately failed) to get his research validated by the wider academic community. As Strick’s focus is on Reich’s work as a biological researcher, the book contains only scattered remarks about Reich’s work as a psychotherapist and a psychologist in the 1930s. It is regrettable that Strick did not explore the connection with psychology in more depth, both in the case of Reich himself, as well as by comparing Reich’s forays into biology with those of other contemporary psychologists (such as Freud and Jung, for example, who both based their psychological systems on biological theories). Sulloway’s Freud, Biologist of the Mind (1979) or Shamdasani’s Jung and the Making of Modern Psychology (2003) might have helped to further contextualise the question of why an early twentieth century psychologist would look toward biology as a way of vindicating and expanding upon his psychological theories. At the same time, I can find no argument (other than the book’s already substantial length) for why the narrative does not continue beyond 1939, and into Reich’s American years.

The book’s first chapter (pp.16-63) examines the intellectual context of Reich’s experimental work, surveying the relevant debates in the turn of the century research in the life sciences (mechanism/vitalism, the concept of a specific life-energy, holism, dialectical materialism) and also surveys Reich’s personal journey from Viennese psychoanalyst to origin of life researcher. Chapter 2 (pp. 64-98) then proceeds to outline the process whereby Reich discovered the bions. As Strick explains, Reich was early on struck by an analogy between the amoeba’s extending of a pseudopod and the erection of the penis (p.61, 75). In a rather androcentric way, Reich argued that human sexuality in general was ‘functionally equivalent’ to the protist’s reaching out ‘toward the world’ with its pseudopod. Sexual arousal was rooted in the autonomic nervous system, which Reich claimed was a protozoan structure still present in the metazoan organism. Strick then traces the way in which Reich’s work on human sexuality precipitated his turn towards laboratory science.

After moving to Oslo in 1934, Reich began to study the bioelectric potential of the human skin. The conclusion of this study was that ‘the sexual process, then, is the biological-productive energy process per se’ (73). As Strick shows, it was this idea that, around 1936, led Reich to study the electrical charges of microorganisms like the amoeba. The discovery of the ‘bions’ followed from there: Reich was instructed to soak moss in water for ten to fourteen days in order to obtain a fresh culture of amoebas. Unsure of, or unconvinced by the explanation that amoebas came from spores present everywhere in nature, Reich proceeded to observe the process under the microscope. He concluded that before protozoa were formed, a series of vesicular shapes (i.e. bions) could be clearly seen detaching from the moss and then assuming some of the signs of life, such as motility and inner pulsation. The bions could be further cultivated through successive generations, using various preparations. Over time, through variations in the ingredients, Reich was able to produce bions with different properties.

In chapter 3 (pp. 99-145), Strick charts Reich’s dialogue and collaboration with Roger du Teil, a French philosopher who took an early interest in the bion work, and who offered to perform control experiments and to lobby on behalf of Reich’s theories among his French colleagues. This chapter allows Strick to go into more depth about the criticisms that were leveled against the bions, such as the fact that Reich was merely looking at bacteria picked up through air contamination, or that the lifelike movement he was observing was merely Brownian movement. As Strick convincingly argues, both of these critiques fell wide of the mark. Reich took particular care to sterilize his preparations, over and above what normal sterilization procedures at the time would have required. In one such instance, he burned soot to incandescence, before sticking it into his culture media (p.133). Such temperature would have been enough to kill off any common bacteria. Curiously however, Reich’s bions formed faster when the preparations where boiled than when they were not. Regarding the issue of the lifelike movements of the bions, Strick notes that Reich was using a state of the art microscope not usually available to most laboratories at the time and that the failure of other researchers to identify these movement was also due to a lack of requisite high-end apparatus (p.102, 127).

In chapter 4 (pp. 146-185), Strick halts the narrative in order to discuss Reich’s theoretical commitments and methodology. As Strick argues, Reich considered his dialectical-materialist method (later rebranded as ‘energetic functionalism’) as essential to understanding his work on bions. The chapter is an interesting case study of what constituted the scientific-method for Reich (as opposed to other contemporary dialectical materialists such as Alexander Oparin or J.D. Bernal) and serves as a prelude to chapter 5, which discusses Reich’s work on cancer. As Strick shows, Reich had theorised (on the basis of his own materialist ontology) that cancer was an endogenous disease, brought about by bions formed from disintegrating organic material, well before he ever looked at cancer tissue under the microscope. In chapter 5 (pp.186-217), Strick traces the development of Reich’s ideas about cancer and the experiments (some of them frustrated by his falling out with one of the main cancer specialists in Oslo) he devised to test them.

While Reich’s ontology was no doubt productive in setting him on the track of an original cancer theory, the public articulation of that ontology may have well have set him up for the response that followed from his Norwegian colleagues. As shown in chapter 6 (pp. 218-269), Reich was the target of a bitter press campaign meant to discredit his work, and, as some hoped, to get him to leave the country. As Strick shows, in ‘the small town of Oslo,’ the academic establishment did not take kindly to a dialectical materialist who was also a Jew, with no formal training in biology, and who evinced a radical stance toward sexuality and unorthodox ideas about the origin of life and cancer. As Strick also demonstrates, Reich’s Norwegian detractors had a vested interest in attacking Reich and his work: they were competing for the same funding from the Rockefeller foundation, the only major funding body around in the Depression era (p.227). The book’s seventh chapter (pp.270-310) seeks to bring the story full circle, by returning to the issue of the specific life-energy first broached in the first chapter. This final chapter thus charts Reich’s discovery of the radiating ‘SAPA bions’ and his eventual conclusion that the energy emitted by these bions was the specific life-energy or, as he began to call it in 1939, ‘orgone.’

In the Epilogue, Strick asks himself: ‘Is this story of purely historical interest?’ (311). The answer, one is led to believe, is clearly ‘no.’ Much like Hasok Chang, who has put forward the idea of a history and philosophy of science that functions as ‘complementary science,’ Strick is interested in the way in which historical knowledge might be useful in uncovering and helping to reinstate forms of scientific knowledge that have been obscured or deliberately left out in the development of scientific disciplines (Chang, 2004).  At the same time, to ask what relevance Reich’s work might have today is a question that follows from the attempt to take Reich’s work seriously—something which, as Strick reminds us, few historians and scientists have done before. And to take it seriously means to consider the proposition that Reich was indeed looking at something real, that his bions were not merely the imaginary constructs of a deluded dilettante. Strick’s work makes the reasoned case that Reich was indeed on to something. What that something might be is not for the historian to decide. Nevertheless, Strick seems to write for more than just a historical audience, and biologically minded readers might want to pick up on some of the suggestions that are scattered throughout the book. Even so, as Strick shows, Reich’s work diverged so radically from everything that happened in biology in the decades since the discovery of the bions that it may prove as difficult to give it a fair hearing today as it was in the 1930s.

 

Matei Iagher obtained his PhD in the History of Medicine from UCL in 2016, with a thesis about the history of the psychology of religion. He is now working on turning his dissertation into a monograph.

 

References

Chang, H. (2004) Inventing Temperature: Measurement and Scientific Progress. Oxford: Oxford University Press.

Shamdasani, S. (2003) Jung and the Making of Modern Psychology: The Dream of a Science. Cambridge: Cambridge University Press.

Sharaf, M. (1983) Fury on Earth: A Biography of Wilhelm Reich. New York: St. Martin’s Press.

Sulloway, F.J. (1979) Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend. London: Burnett Books.

 

Book review: ‘Work, psychiatry and society, c. 1750-2015

Waltraud Ernst (ed.), Work, psychiatry and society, c. 1750-2015 (Manchester: Manchester University Press, 2016). ISBN: 978-0-7190-9769-0 (hardback), £75.00.

by Louise Hide

Given the amount of work that has been produced on labour and economic history on the one hand and asylum history on the other, it is surprising that the two have not been brought together more often. As this excellent volume shows, these sub-disciplines have much to learn from each other because the meanings given to patients’ work and occupation inside institutions have always reflected wider socio-political concerns on the outside.

In this volume, Waltraud Ernst has brought together 17 essays with great skill. Together, they demonstrate how ‘work’ with its myriad meanings has different significance – treatment, punishment, reform, exploitation, empowerment – within shifting conditions brought about by colonialism, revolution, war, economic change, and new medical ideologies. The collection makes a great temporal and geographical sweep across the entire modern period to the present day, addressing attitudes and praxis in North America, Japan, India, and Western and Eastern Europe.

The introduction is impressive. Ernst takes her discussion of patient activity back to the Graeco-Roman era before deftly contextualising it within later periods of feudalism and industrialisation, giving due consideration to the influence of socialism, urbanisation, colonialism and migration along the way. Whilst she identifies a number of themes that the volume addresses as a whole, she has organised the essays loosely by geographical region and time period. Generally, this works well. However, the contributions are a little uneven, not only in terms of their word length, but of their content and approach too: some span a century or more offering an overview of changing attitudes, while others make greater use of case studies to draw out more nuanced interpretations.

Inevitably, issues around gender, social class and race are drawn out of wider socio-political contexts, as are responses to overarching questions such as how the notion of ‘industriousness’ has been defined and redefined within medical, legal and moral discourse. Oonagh Walsh shows how in late nineteenth century Ireland work was used as a ‘test of sanity’ that was viewed by patients as a privilege and as a way of demonstrating their worth inside the institution. According to Monika Ankele, the meaning of work changed in one German asylum as its boundaries became more porous over a period of unemployment and economic instability during the Weimar Republic. This situation was not dissimilar to that of the First Republic of Austria where the ‘workshy’ were forced into labour facilities to receive moral improvement and where, as Sonja Hinsch has illustrated, the focus was not on whether or not patients worked, but on how they worked.

Mental hospitals have always faced accusations of exploiting patient labour. Kathryn McKay has analysed institutional reports in Canada to detail how alienists negotiated a course that demonstrated both the therapeutic and the economic benefits of patients’ work. Vicky Long addresses a later period to illustrate how industrial therapy of the 1950s was phased out with deinstitutionalisation, shifting the responsibility for employing people with mental health problems from the medico-social sphere to one that needed to be met by the labour market. John Hall traces the professionalisation of occupational therapy during the first half of the twentieth century, demonstrating how the shift from biological psychiatry to post-war psychosocial approaches, which included rehabilitation, also contributed to the process of deinstitutionalisation. Interestingly, the reverse was happening in Japan where, as Akira Hashimoto shows, ‘life therapy’ – a combination of work and occupational therapy – was introduced in the 1950s and psychiatric hospital populations continued to rise until the 1990s.

Gauging an individual’s moral and mental state by his or her approach to work is another important theme. Sarah Chaney comments on how ‘malingering’ as a concept was increasingly associated with some asylum patients who were believed to self-harm in order to shirk work. James Moran’s essay describes how New Jersey legislators used the meaning invested in productive work to signify whether or not an individual was deemed to be compos mentis and entitled to own property. Valentin-Veron Toma explores the ways in which work was promulgated as a social obligation, especially for the poor, in Romania’s psychiatric hospitals. Thomas Müller illustrates how attitudes to mental patient labour changed over a century in Germany, leading to the horrific consequences brought about by National Socialism from the 1930s.

Reflecting Ernst’s cross-cultural interests, many contributors examine the ways in which certain paradigms from the West were fused with local cultures and practices, particularly in colonial settings. Leonard Smith writes about the medical men who took their ‘civilising mission’ to the British West Indies where asylums also appropriated practices and attitudes from the plantations. A useful comparative approach within a single geographical region is taken by Jane Freebody who weighs up differences between France, Tuscany and Britain in the early nineteenth century when notions of moral treatment were gaining traction across the early discipline of psychiatry. Ben Harris demonstrates how American enthusiasm for this approach waned towards the end of the century as institutions became overcrowded with the chronically ill. And in Japan, Osamu Nakamura reveals how the practice of ‘boarding out’ patients to local families was brought to an abrupt end in 1950 as greater emphasis was given to a Western model of institutional care.

Jennifer Laws’ essay ends the volume with a beautifully written, thoughtful and intellectually sophisticated reflection on the relationship between reason and work, suggesting that scholars look beyond the standard framing of work to how meanings have been constructed out of the more intangible relationships between patients and staff. This is a superb ending to a rich volume of essays, which Ernst eloquently describes as offering insights into ‘moments when humans realise their humanity through their working relationships’. It will be of interest to historians of medicine and psychiatry, labour and economics, as well as to sociologists, anthropologists, and healthcare professionals.

Louise Hide is a Birkbeck/Wellcome Trust ISSF Fellow based in the Department of History, Classics and Archaeology at Birkbeck, University of London. Her monograph Gender and Class in English Asylums, 1890-1914 was published by Palgrave Macmillan in 2014. Her current research is on cultures of harm and abuse in psychiatric spaces in the twentieth century.

 

Future of the History of the Human Sciences: Talks

“The Future of the History of the Human Sciences” – hosted jointly by History of the Human Sciences and Dr Chris Renwick – saw established scholars and early-career researchers gather in York for a two-day meeting in April 2016. The aim was to consider changes wrought in the broad interdisciplinary field of the history of the human sciences by new developments in the medical humanities, biological sciences, and literary/cultural theory. In so doing, these scholars not only marked the beginning of a new era for History of Human Sciences with a new editorial team, led by Felicity Callard, but also give thanks to the outgoing editor, James Good.

You can find out more about the conference on its website and in the reports on this blog from those who attended. Thanks to the kind permission of many of those who took part, we can now also make available recordings of a number of the talks. Abstracts for each talk can be found here.

• Roger Smith, “Resisting Neurosciences and Sustaining History”

• Steve Fuller, “Kuhn’s Curse and the Crisis of the Human”

• Des Fitzgerald, “The commotion of the social”

• Maurizio Meloni, “The Social as the Non-Biological: Genealogy and Perspectives”

• Jessica Hendy, “Molecular Archives of Human History: Moving Beyond Text-Based Sources”

• Michael A. Finn, “Possibilities and Problems with the Growing Archive”

• Peter Mandler, “The Language of Social Science in Everyday Life: What it Does, How it Circulates, How to Track it”

• Amanda Rees “Biocultural Evolution Then and Now: The Brain in Environmental Context OR Counterfactualising the History of Biology and Sociology”

 

 

 

 

Book review: ‘Italian Psychology and Jewish Emigration under Fascism. From Florence to Jerusalem and New York.’

Patrizia Guarnieri, Italian Psychology and Jewish Emigration under Fascism. From Florence to Jerusalem and New York

New York, Palgrave Macmillan US, 2016, 275 pages, Hardcover $100.00; E-Book: $79.99,  ISBN: 978-1-137-30655-5/978-1-137-30656-2

by John Foot

This is a difficult and at the same time a fascinating book. It has many sites of focus and can also be read as a set of collective biographies or individual pathlines through the worlds of psychology, fascism and Jewish identity in Italy and elsewhere. The overall analysis of the book is linked to the study of psychology and psychologists in Italy – and the way this nascent and marginalised discipline developed in that country before, during and after fascism – and in particular in the city of Florence. Thus, Guarnieri tells us a number of important stories of individuals who carried forward this discipline and taught and research within various areas of psychology. Within this world, in Italy, we quickly come across the all powerful role played by Agostino Gemelli in the private Catholic University in Milan. As Guarnieri points out, Gemelli had institutional resources behind him. Gemelli, a friar, turns up time and time again in this book as a king-maker, able to create or destroy careers – and someone who, within Italian psychology, it was very difficult to avoid.

For me, the most fascinating parts of this volume are those linked to the pernicious effects of Italy’s anti-semitic laws of 1938.  These laws led in most cases to the expulsion of all Jews from academic posts in Italian universities.  These people were forced to find another job – not easy in a country which officially discriminated against Jews and where psychology itself was hardly a major discipline. Guarnieri then takes up individual pathways of certain key psychologists. There is the detailed and extraordinary story of Enzo Bonaventura, who emigrated to Palestine in March 1939 and became Professor of Psychology in the Hebrew University.

But perhaps the most shocking part of this book are the stories of what happened to these Jewish psychologists after fascism had fallen during and after World War Two. Unfortunately, as with many other Jews who had been discriminated against or sacked in a variety of sectors, their reintegration and rehabilitation was neither easy nor straightforward. Would these people simply be offered their former jobs back? Some were happy to stay where they were, but others tried to return to Italy. Others appeared lost – nobody seemed to know where they were or what they were doing. Should those who ‘replaced’ these people be themselves sacked or moved on?

In 1947 a national competition was opened up for a Professor of Psychology (in reality this was for three prestigious Chairs).  Bonaventura was an obvious candidate for one of these posts. But Gemelli was to play a key role in deciding who got these jobs, despite his (to put it mildly) co-habitation with fascism. In the end Bonaventura did not even put himself forward. Guarnieri argues that this was thanks to political and personal manoeuvres designed to keep him out and assign these jobs to others. This is also – for Italy – a sad and depressing tale of half-truths and conspiracies, of the re-writing of the past and of continuity with fascism (something which was particularly true within academic institutions).  Bonaventura died in April 1948 during clashes with what Guarnieri calls ‘Arab forces’ in Jerusalem. A street there is still named after him.

More controversially, Guarnieri also points the finger at the role played by Cesare Musatti in this story. Musatti was a legendary public figure in Italy – the first intellectual to bring psychoanalysis to the masses and a frequent presence in the press and on television during his lifetime. He was also, very clearly, a man of the left and someone with – it seems – impeccable anti-fascist credentials. Guarnieri does not pull her punches concerning Musatti – and it is surprising that this ‘case’ has not been taken up in the Italian press in any way. In short, Guarnieri accuses Musatti of having re-invented his own past – both before and after obtaining the coveted chair of psychology in Milan’s Statale University. Worse, Guarnieri argues that Musatti had ‘not made any bones about collaborating with the promoters of racist theories’ under fascism. This is explosive stuff to say the least. It is to be hoped that a debate and further historical research will follow these revelations about Musatti’s role before and after fascism.

This is a book packed to the brim with interesting material for further study and pathways to be followed. It is intensely multi-disciplinary and inter-disciplinary – touching not just on psychology, but also on social history, trans-national history, cultural studies, Jewish studies, politics and memory. However, the text itself is a major hindrance to an understanding of the arguments made within the book. Much more copy-editing was needed and I can find no reference as to whether this is a translation or was directly written in English. Either way, it needed an extensive re-write to clarify much of what is included here. And this is a great pity, because this book sheds light not just on the history of academic psychology in Italy, but also on a complicated and painful past which has remained hidden for some time. In that sense, it is a brave and important book.

John Foot is professor of modern Italian history at Bristol University. His most recent book, The man who closed the asylums: Franco Basaglia and the revolution in mental health care, is available now from Verso.

Book Review: ‘Understanding Emotion in Chinese Culture: Thinking Through Psychology.’

Louise Sundararajan, Understanding Emotion in Chinese Culture: Thinking Through Psychology. 

Springer International Publishing, 2015, 201 pages, Hardcover £90.00/-Book £72.99, ISBN: 978-3-319-18220-9/978-3-319-18221-6

by Gerald C. Cupchik

Louise Sundararajan’s book offers a comparison between Western and Chinese culture based in part on differing modes of cognition that underlie lived experiences. Her approach is more nuanced than the usual East and West comparison. First, she is careful to focus on Chinese culture instead of making sweeping generalizations about the East. Second, while using the term “West,” she focuses on contemporary Western psychology. Since scientific psychology does not necessarily represent the full scope of knowledge about Western emotions, this book pertains primarily to western psychological conceptualizations of emotions, not Western emotional experiences per se. Sundararajan presents as a scholar with a foot in each of two worlds. On the one hand, she introduces many valuable concepts from Chinese culture and, in particular, the contrast by Confucian and Daoist approaches to life and meaning. On the other hand, she is well versed and established in the mainstream literature from Western psychology with a bit of philosophy thrown in.

Sundararajan summarizes the challenge of understanding Chinese emotions as follows: ‘This suggests that a central problem for understanding Chinese emotions is the gap between mainstream western scientific terminology and indigenous Chinese psychology.’  At the heart of her book is the bridging of dynamics of emotional processes in Chinese culture with concepts and findings in the Western empirical tradition. Implicitly juxtaposed against mechanistic thinking in Western psychology is the Chinese approach that focuses on dynamic processes.  Sundararajan explains this difference in terms of that between non-relational and relational cognition. Relational cognition, which applies to Chinese culture, focuses on holistic mind-to-mind transactions based on shared meanings. Western culture embodies more linear non-relational cognition emphasizing mind-to-world transactions and mastery over the environment. Whereas the former is marked by Communal Sharing, the latter is reflected in Market Pricing. Understood in terms of a “dual processing model,” the Chinese mode of thought is automatic, intuitive, and holistic (System 1), whereas the Western approach is effortful and reflective (System 2). Summing up these differences in mindsets, she claims that the Western and Chinese cultures are ‘upside-down universes of each other.’

Obviously, establishing broad categories and binary oppositions such as the ‘West’ and the ‘East’, involves many levels of abstraction. To some, this distinction is suspect and ultimately misleading. One of the most stringent critics of this approach is Edward Said[ref]Said, E.W. (1978). Orientalism. London: Routledge & Kegan Paul.[/ref]  who considers it a legacy of Orientalism, the persistent East and West comparison.

“Throughout the exchange between Europeans and their ‘others’ that began systematically half a millennium ago, the one idea that has scarcely varied is that there is an ‘us’ and a ‘them,’ each quite settled, clear, unassailably self-evident.”  (Said, 1993, p. xxv)[ref]Said, E. W.  (1993). Culture and Imperialism.  New York:  Alfred A. Knopf.[/ref]

Continuing this line of criticism, Sundararajan uses the East and West comparison in a subversive manner. First, instead of using the West-East comparison in an ‘us versus them’ fashion, she suggests that the two conceptualizations of emotion are complementary– somewhat like yin and yang with each taking turns being the under-current of the other. Second, she turns cultural reductionism on its head.  Instead of reducing all cultural phenomena to collectivism versus individualism, she uses the cross cultural findings on cognitive styles as an explanatory framework to foreground the rich cultural phenomena of Chinese emotions, with special focus on the nuanced differences in conceptualization of emotion between China and modern Western psychology.

To elaborate on this central theme, Sundararajan devotes one chapter each to the three foundational ways of thinking in Chinese history — harmony, Confucianism and Daoism.  Chinese discourse on emotion is founded on the notion of harmony which is ‘understood as moderation’ based on self-regulation. There is a dynamic quality associated with the search for complementary relations between seeming opposites (the yin and yang dialectic). This effort after optimal harmony leads to emotional refinement as exemplified in this description of Confucius as ‘mild, and yet dignified; majestic, and yet not fierce; respectful, and yet easy.’ Framed in terms of Western psychology, this effort after harmony is characterized in terms of ‘concurrent goal pursuit’ so as to be inclusive and make the best possible choices.

The Confucian approach to social development emphasized strong social ties and inner/private consciousness in a ‘rites-based’ society. This contrasts with a Western emphasis on ‘big gods,’ laws, and public spaces. The Chinese communal approach emphasizes the quality of relationships and concern for the other. The goal was to humanize power so that respect was ‘earned through sharing and helping.’ Accordingly, ‘the ideal model of the social order is the family’ and the cultivation of an inner sense of self that is sincere and cultivated through the arts, in particular music and poetry. Thus, emotional engagement is fundamental to ritual performances as in mourning where deep sorrow is considered more important than attention to minute details of observances. The outcome of this approach is filial piety combining intimate benevolence with respect for authority.

The ideals of Daoism are exemplified in the attributes of hermits who abandon the existing social order in favour of the solitude preferred by wanderers. Giving up the comforts of society and social status enabled inward hermits to achieve a state of transcendence and a deeper appreciation of harmony with nature. This was embodied in a spiritualized approach to social relations which emphasized equality in contrast to the hierarchy embodied in a Confucian emphasis on elder and younger, father and son, and so forth. The Daoist approach to independence and transcendence focussed on uniqueness rather than on egocentrism and competition with the attendant deleterious effects on health. The acceptance of an eremetic life style flourished when Chinese civilization was at its zenith during the Tang and Song dynasties rather than during its decline under the Mongol rulers.

The second part of the book is dedicated to exploring complementary ‘contours of the emotional landscape’ in Chinese culture. An example of dynamic harmony is embodied in deep feelings (qing) surrounding ‘heart-aching love’ (xin-teng) which can be both bitter and sweet at the same time. In Western language, this emotion combines the perception of vulnerability with empathy and anxiety over the well-being of another. These feelings are situated in a ‘gut-feeling approach to morality’ that is central to Chinese culture. This analysis of intimacy is predicated on ‘we–ness,’ bonding that is based on shared mind-to-mind intention and modelled after the parent-child relationship rather than the mating pair. Metaphysically, the Chinese notion of affect implies a sympathetic universe which is sustained by an affective bond among all things from humans to stones and rocks in nature. Emotion in this context works by means of a ‘resonating feedback loop’ not unlike that of a tuning fork. The importance of emotional resonance/attunement is brought home through examples of paradoxical communications of affect such as an expressed emotion of seeming anger that masks the underling feeling of relief and gratitude.

Of particular importance in a Chinese context is the presence of spontaneity, authenticity, and creativity in an emotion. Wisdom of the ancients helps to explicate these different facets of emotion. As in the case of traditional poetry, the ideal state of emotion freely embodies a simple message that is deeply felt. Thus, an authentic expression of emotion is sensitive to the meaning of a situation and is free from the interference of intentions to control it by a deliberate mind. This account of spontaneity in the Chinese expression of emotion is at odds with a Western academic emphasis on appraisal and purposive action. But it does fit with a mystical approach such ‘that the unleavened bread of mystical experience has no use for the yeast of discursive thought.’

The author reminds us of the duality in Chinese culture, between the hierarchical nature of social relations from a Confucian perspective (e.g., between parent and child) and the horizontal emphasis on egalitarian relations in Daoist thought (e.g., between person and nature). In a hierarchical context, we find the complex intimacy between parent and child who may be “spoiled rotten,” given vulnerability and immaturity. This transforms into caring gestures toward parents as youth gives way to indebted gratitude in adulthood. Thus, the good feelings attendant to gratification of impulses leave a glow of self-worth that changes to filial piety and caring gestures. As my young guide on a tour of Nanjing expressed it to me: ‘I am nothing without my family.’

Refinement in Chinese culture is embodied in the concept of savoring which applies both in everyday life and in an aesthetic context. This concept is unique in that it encompasses both positive and negative episodes. Temporality plays an important role encompassing both immediate and retrospective experiences in subtle nuances. Thus, from a Chinese perspective, savoring includes mindful awareness of sensory experiences that are integrated in an ideal mental world best expressed in poetry. The greatest challenge to a Western mind is appreciating the insight into emotions that comes from experiencing emptiness which may also apply to negative experiences in one’s life. Savoring without blinding expectations (thus emptiness) enables the person to appreciate the gist of things and also fosters novel connections. This new understanding is enhanced by reflective self-consciousness that formalizes relationships and sets the stage for “enlightenment.”

When placed in a broad multicultural and historical context, the Chinese approach to emotion differs substantially and substantively from that favoured in the West. While the West has long been concerned with the ways that emotion can distort ‘reality,’ the Chinese notion of qing holds that emotion ‘discloses something that is true about the person and the world’ by grounding the person in reality. This sensitizes the person to the undisclosed or implicit impact that the world has upon us. While Western theory focuses on differences (‘symmetry breakdown’) that foster action and control, the Chinese privilege symmetry as evidenced by a heightened appreciation of harmony and resonance with others and nature as a whole.

My reading experience heightened an understanding of the ways that the principle of complementarity is actively embodied in Chinese philosophy and social relations. The Confucian emphasis on hierarchy, and its effects on maintaining social harmony through parent-child relations, is complemented by a Daoist appreciation of how silence and intimacy helps us savour subtle qualities of nature and our social world.

Sundararajan makes a valiant attempt to build a bridge between traditional Chinese concepts and thinking through ideas in contemporary psychology. In part, this effort is successful because it shows how Western ideas and findings can resonate with Chinese culture. But it also indirectly reveals the burdens of Western mechanistic ideas that are worlds apart from the holistic attitude underlying Chinese thought. This awakens a savouring mind to the need for Western culture to be more reflective about its own purposive and ‘Enlightened’ biases or,  as the subtitle of the book suggests, ‘thinking through psychology.’

I hope that Europeans/North Americans appreciate Sundararajan’s in-depth representation of their work. But I personally feel that her account of Chinese emotion does not need Western psychology at all since, from my perspective, Western research seems to have lost ecological validity. Thus, the value of this book is not just that it introduces us to principles underlying the empathic, moral, and aesthetic values of Chinese culture. It shows us the limitations of our own Western concepts and empirical methods that may lead us away from a resonant understanding of the social world. In Chinese landscape paintings, we project ourselves into the empty spaces and resonate (from Hsieh Ho’s Six Principles) with the implied meanings; in other words, projection and empathy. Thus, by adopting a Daoist worldview, we enter into phenomena and overcome the alienating effects of experimental conditions and method as a whole. We essentially adopt the Verstehen orientation at the heart of a German Romantic perspective that is both empathic and intuitive rather than the British Enlightenment emphasis on distant and logical sympathy. Incorporating a sense for “emptiness” and “resonance” can help us think through the biases of Western psychology and enhance the insightful outcomes of our empirical projects.

 

Gerald C. Cupchik  is Professor of Psychology at the University of Toronto, Scarborough. His book The aesthetics of emotion: up the down staircase of the mind-body is out now from Cambridge University Press. 

Space, in its place: a report on the annual meeting of the Society for the Social History of Medicine

The biennial Society for the Social History of Medicine (SSHM) conference took place at the University of Kent, 7-10 July 2016. The conference was opened by the chairman of the society Carsten Timmermann, and Julie Anderson, who organised the event with half a dozen of other postgraduate students in Kent’s history department. They made it clear that as a biennial meeting of members of the field from all over the world, the programme was kept flexible, to enable historians of medicine of diverse approaches and methodologies to present their work, even beyond social history itself. Nonetheless, the conference was officially titled Medicine in its place: situating medicine in historical contexts. The notion of place was open to different interpretations: physical and geographical places, ‘places’ of knowledge production, and the idea of a ‘social space’ as originally conceived by Henri Lefebvre. However, historians were perhaps in agreement that medicine must be understood, as stated in the title, within the social and cultural contexts in which they were practiced at the time. ‘Medicine’, often misinterpreted as a branch of western science within the popular imagination, has always been contingently constructed within its own time and space.

The clearest reflection of the theme of medicine in its place was how many of the papers discussed medicine as practiced within a specific geographical or physical space. Fabrice Cahen explored the geographically located pathology of congenital hip dislocation in provincial France, while at the transnational level Bill Leeming compared the process of institutional diffusion of prenatal diagnosis between Canada and Mexico. Kate Grauvogel’s fascinating paper discussed the renovation of an infamous mental hospital in suburban Stockholm to a modern residential area, articulating how the stigma associated with mental health was ‘contagious’ to the land even after the function of the space changed.

As an appropriate commentary on the role of ‘place’ in the construction of medical knowledge, Steve Sturdy delivered the first plenary of the event on the commercialisation of genetic testing in the second half of the twentieth century. Sturdy argued that the topic was a good case study to understand the process of the ‘medical-industrial complex’ in both Britain and the United States through the increasing penetration of private enterprise in the realm of health care. He employed the notion of ‘place’ in the often-cited shift in medical knowledge production in the late twentieth century, from one based on clinical genetics and molecular biology to that of the population-based epidemiological approach. Understandings of genetic diseases and predispositions came to be constructed primarily through the exploration of disease associations through graphs and spreadsheets, transcending the confinement of the laboratory and the hospital.

The application of the notion of ‘social space’ has been a recent development within the discipline of history. This methodology was in fact the central focus of the second plenary delivered by Graham Mooney on the relationship of ‘medical spaces’ and mobility across history. The paper explored multiple cases in which these two themes intersected, one familiar case being his exploration of the history of the hospital waiting room in twentieth century Britain. Mooney explained how the waiting area, as a sedentary space, itself potentiated the exercise of power through the ‘imposition’ of health education leaflets. Chris Millard’s paper on shifting clinical thought-styles on emotional health and child abuse in postwar Britain went beyond merely taking the hospital space for granted, exploring the debates over the impact of the spatial environment on the psychological development of newborns.

Social historians of medicine have been especially adamant that medicine should be framed, as the title of the conference suggests, in its place. Medical knowledges could well be understood in a similar or an identical manner across geographical boundaries, but ultimately they have been influenced by the social and cultural contexts within which they were practiced. On the peculiar case of the consumption of Jamaican ginger (a ‘cure-all’ patent medicine of high alcohol content) in the American South, Stephen Mawdsley framed its popularity under the prevailing culture of self-medication in the Southern and Western United States during prohibition. Jane Seymour’s paper sought to reinterpret the history of public health in interwar Britain by placing it within the political context of the interwar period itself. Seymour critiqued the traditional historiography of the period as being largely influenced by the hindsight of postwar achievements in the establishment of the NHS, arguing that public health measures during the interwar period, within their particular context, had a strong progressive initiative behind them.

Without these engaging and stimulating papers delivered by speakers on their latest research, an academic conference would be empty and meaningless. However, the SSHM conference at Kent was unusual in going beyond the traditional academic conference by having a variety of unique sessions and opportunities outside of the hundreds of research papers that were being delivered by the participants in their respective panels. There were three roundtable panel discussions by some of the leading practitioners of the field exploring the most recent developments in the profession. One of the panels, which included Lauren Kassell, Elizabeth Toon, Helen Valier, Heather Perry, and Carsten Timmermann, talked about the place of the medical historian in the university curriculum and the challenges that come from teaching the history of medicine to undergraduate students who major in STEM subjects. There were also two workshops delivered by Thomas Bray from the Wellcome Trust on grants and funding, and Emma Brennan and Tom Dark from Manchester University Press advising on how to publish a paper or a book within the current academic climate. As a postgraduate historian and an early-career researcher, I found both sessions to be highly informative and helpful. Perhaps the most unique aspect of the event is that we had an official poet and an artist representing the conference, who hosted sessions that happened parallel with the panel presentations. Dorothy Lehane ran a writing session on medicine and poetry, while Frances Stanfield explored the theme of the representations of the body by encouraging her participants to instinctively draw one another without looking directly at the paper. These sessions and workshops provided a crucial space for visitors to escape the brain fatigue that often results from a hectic schedule of academic events, allowing historians to explore health, illness, and the body beyond the confines of research papers that come one after another in most conferences.

This was the first major conference that I have attended on the history of medicine. As first conferences go, where I barely knew anyone, the organisers from the Department of History at Kent did an excellent job at creating a friendly environment. The fact that it had a large number of established scholars did not create a hierarchical atmosphere, quite unlike a lot of other important international conferences where it can be quite intimidating for an early-career researcher to feel included. Perhaps as a reflection of the relatively relaxed academic culture of the field of history of medicine, there were a plenty of informal occasions to socialise over food and drink. Large academic conferences such as these have an important function in providing a scholar with the space to interact with likeminded people, to escape from the isolation that one might feel from specialising in the history of medicine. The event was satisfying both as an arena for the exchange of knowledge and for the dozens of wonderful people that I was able to get in contact with. I am very much looking forward to the next SSHM conference.

Ryosuke Yokoe is a PhD student at the Department of History, University of Sheffield and officially affiliated with Medical Humanities Sheffield (MHS). His research concerns the twentieth century history of popular and scientific understandings of alcohol and liver disease. Follow him on twitter! @RyoYokoe1.

Thanks to Jaipreet Virdi-Dhesi for the photo.

 

Book Review: ‘The neurologists A history of a medical specialty in modern Britain, c.1789–2000.’

Stephen T. Casper, The Neurologists: A History of a Medical Specialty in Modern Britain c. 1789-2000

Manchester, Manchester University Press, 2014, 288 pages, hardcover £70.00, ISBN: 978-0-7190-9192-6

Stephen T. Casper’s first book is an interesting reflection on the early origins of neurological sciences and the reasons why they came to dominate descriptions of mental processes and human reasoning.  Casper uses traditional techniques in the history of medicine to reveal the long history of the birth and development of the specialism of neurology in Britain.

One of the most important contributions of this book is its consideration of how late-nineteenth and early-twentieth century descriptions and understandings of the brain and the nervous system fell within a wider humanistic project. Casper’s exploration of the archives of the Neurological Society of London offers a unique window onto the nature of debates on topical issues at the time, in particular the conflict between specialisation and general medicine or generalist approaches to the body and mind.  As Casper argues, ‘specialisation’ was an idea that was ‘peculiar to modernity’ which otherwise employed the language of evolution to develop organic models of society ultimately within functionalist sociology. His reflection on neurology as a discipline thus offers insights into how and why neurological hypotheses and ideas prospered in the British context as well how neurologists themselves negotiated their ability to offer wider insights on human nature whilst simultaneously protecting their own science.

Although the term ‘neurology’ can be traced to 1664 in the work of Thomas Willis, and was used by phrenologists in the late 18th-century, it appeared rarely in both medical and lay literature until the latter part of the 19th century.  The specialty of neurology also emerged at this time. Its origins are associated with the foundation of the journal Brain: A Journal of Neurology in 1876. However, Casper argues, neurology did not achieve a coherent form until the interwar period.  And even when it did, there were always attempts to protect it from the constraints of disciplinary limitations and to promote its insights more widely.

The Neurological Society of London had some pretty important members.  In 1886, John Hughlings Jackson became first president of the Society, its members also consisting of David Ferrier, who had famously experimented on cerebral localization of function in animals; Francis Galton, statistician and general polymath; and Herbert Spencer who had been critical in establishing the discipline of psychology using the logic of evolutionary sciences. The society brought thus together a highly significant group of intellectuals, providing a venue for the integration of multiple fields of knowledge.  Most physicians who were members of the Society regarded themselves as generalists with broad interests in physiology, medicine and the general issue of nervous conditions. As Robert Young has argued, these thinkers were critical to harnessing epistemological questions in psychology and relating them to theories of brain and nerve function. [ref]Robert M. Young, Mind, Brain and Adaptation in the Nineteenth Century : Cerebral Localization and Its Biological Context from Gall to Ferrier, History of Neuroscience ; No. 3 (New York ; Oxford: Oxford University Press, 1990).[/ref] Casper’s first chapter reflects on how these ideas influenced the formation of a distinct medical discipline of neurology in the twentieth century.

As many historians have noted, the First World War was critical in the rationalisation of medical practice and the drive for efficiency and economy that compelled the specialisation of both hospital care and scientific disciplines.[ref]Roger Cooter, Mark Harrison, and Steve Sturdy, War, Medicine and Modernity (Stroud: Sutton, 1998).[/ref] Casper’s second chapter explores the significance of this to the science of neurology where, he argues, it was particularly transformational.  This chapter looks in depth at the work of Henry Head and Russell Brain, neurologists at the London Hospital, and their discussions of war injuries.  It also examines how they considered the significance of their own practice, which is very revealing in its grandiosity, for example Head’s claim that he worked ‘in the passage-way between the physical universe and the dwelling place of the mind.’  There is something exceptional about these general claims to cultural and scientific knowledge and Casper elucidates this well.

Chapter three explores a controversial episode in the history of scientific research concerning Kathleen Chevassut’s research under James Morgan Purves Stewart into the spinal fluid of patients with multiple sclerosis. Chevassut claimed to have found an organism responsible for causing the disease and argued that a vaccine could be produced, publishing in the Lancet, but wider medical opinion turned against her, guided by the research of emerging expert Edward Carmichael.  Casper argues that this episode drew attention to the need for further regulation in neurological research and the formation of a new professional association, The Association of British Neurologists, from which Purves Stewart was forever excluded. The scandal brought to light the significance of professional guidelines and the threat of the Victorian ideal of united social and medical investigations.  Casper claims that it demonstrated why the science of neurology was restricted in its scope.

Chapter four explores the relationship between neurology and state medicine from the 1940s to the 1960s, pointing out that the success of the Association of British Neurologists and the growing monopoly of neurologists in carving out a well-supported and stable field of clinical practice.  The Association of British Neurologists lobbied the Ministry of Health to appoint an advisor in neurology, which they finally did in 1958.  As Casper notes, it was the success in the formation of neurology as a clinical science that ironically led to its demise as a comprehensive field of scientific enquiry.  At that point, laboratory research was increasingly conducted by basic scientists who did not have a wider interest in clinical problems. Neither did they necessarily have interests in the wider human sciences on the relation between psychology, physiology and evolution. What came to be known as the ‘neurosciences’ were demarcated as a separate field.

As Casper argues in the final chapter, the rise of specialized clinical neurology never fully replaced the earlier model of neurological sciences as part of a wider reflection on human nature and motivation. The formation of the ‘neurosciences’ that drew together biological sciences and social sciences have provided a new kind of outlet for these questions, although within a very different framework of professional expertise.

There are some limitations to Casper’s approach and his focus purely on neurology as a disciplinary practice.  Although this enables precision and focus, sometimes it detracts from the wider debates and discussions about nerves within other fields such as psychoanalysis, psychology and endocrinology.  Furthermore, greater contextualization of debates within the social sciences and the wider political landscape of Britain, particularly in the post-war period, would have enriched the discussion. The history of neurology and the neurosciences is becoming increasingly topical as today’s scholars wrestle again with the hierarchy of the disciplines and the potential of current neuroscience and epigenetics to renew or revitalize the disciplines of sociology and history.[ref]e.g. D. Fitzgerald, N. Rose, and I. Singh, “Revitalizing Sociology: Urban Life and Mental Illness between History and the Present,” Br J Sociol 67, no. 1 (2016).[/ref][ref]e.g. Renwick, C 2016, ‘Biology, Social Science, and History: Interdisciplinarity in Three Directions’ Palgrave Communications, vol 2, 16001 (2016).[/ref] Although Casper makes links between the historical discipline of neurology and today’s neurosciences, it would have been useful for him to have used more innovative questions to engage more strongly with work by Nikolas Rose and Fernando Vidal on the dominance of the neurosciences and the significance of this in relation to other social sciences, particularly in the post-war period.[ref]e.g. Nikolas S. Rose and Joelle M. Abi-Rached, Neuro : The New Brain Sciences and the Management of the Mind (Princeton, N.J.: Princeton University Press, 2013)[/ref][ref] F. Vidal, “Brainhood, Anthropological Figure of Modernity,” Hist Human Sci 22, no. 1 (2009).[/ref] There is much more to be said on how disciplinary lines in the ‘neuro’ disciplines have been drawn and how they may be drawn in the future.

Nevertheless, Casper’s book is a very good reflection on the history of disciplinarity and how knowledge has been created and passed down in the field of neurology. It is an excellent complement to histories of psychological and psychiatric knowledge. It is also a very good reference book as it presents a close reading of archival sources and is meticulously referenced. Casper’s first work also demonstrates his ability to think widely on the connections between disciplines in the creation of medical knowledge. It is thus a welcome addition to the literature on the history of neurology and other disciplines and their relation to the wider history of the human sciences.

Bonnie Evans is a Wellcome Trust Postdoctoral Fellow at Queen Mary, University of London.  She is conducting a project on Neuroscience, Psychology and Education: Autism in the UK 1959-2014. Her peer-reviewed publications include a recent article in History of the Human Sciences: ‘How Autism Became Autism: The Radical Transformation of a Central Concept of Child Development’. Her forthcoming book The Metamorphosis of Autism: A History of Child Development in England (Manchester University Press) is due out in December.