The July 2016 issue of the Journal of the History of Medicine and Allied Sciences includes an article of interest to AHP readers. The piece describes the use of breathing exercises as a treatment for neurasthenia in Japan in the first half of the twentieth century. Full details follow below.
“A Disorder of Qi: Breathing Exercise as a Cure for Neurasthenia in Japan, 1900–1945,” by Yu-Chuan Wu. The abstract reads,
Neurasthenia became a common disease and caused widespread concern in Japan at the turn of the twentieth century, whereas only a couple of decades earlier the term “nerve” had been unfamiliar, if not unknown, to many Japanese. By exploring the theories and practices of breathing exercise—one of the most popular treatments for neurasthenia at the time—this paper attempts to understand how people who practiced breathing exercises for their nervous ills perceived, conceived, and accordingly cared for their nerves. It argues that they understood “nerve” based on their existing conceptions of qi. Neurasthenia was for them a disorder of qi, although the qi had assumed modern appearances as blood and nervous current. The paper hopes to contribute to the understanding of how the concept of nerves has been accepted and assimilated in East Asia. It also points out the need to understand the varied cultures of nerves not only at the level of concept and metaphor, but also at the level of perception and experience.
““The Glamour of Arabic Numbers”: Pliny Earle’s Challenge to Nineteenth-Century Psychiatry,” by Lawrence Goodheart. The abstract reads,
A well-established interpretation associates the nineteenth-century psychiatrist Pliny Earle’s deflation of high cure rates for insanity with the onset of a persistent malaise in patient treatment and public health policy during the Gilded Age. This essay comes not to praise Earle but to correct and clarify interpretations, however well intentioned, that are incomplete and inaccurate. Several points are made: the overwhelming influence of antebellum enthusiasm on astonishing therapeutic claims; the interrogation of high “recovery” rates begun decades before Earle’s ultimate provocation; and, however disruptive, the heuristically essential contribution of Earle’s challenge to furthering a meaningful model of mental disorder. In spite of the impression created by existing historiography, Earle, a principled Quaker, remained committed to “moral treatment.”
“Constitutional Therapy and Clinical Racial Hygiene in Weimar and Nazi Germany,” by Michael Hau. The abstract reads,
The paper examines the history of constitutional therapy in Weimar and Nazi Germany. Focusing on Walther Jaensch’s “Institute for Constitutional Research” at the Charité in Berlin, it shows how an entrepreneurial scientist successfully negotiated the changing social and political landscape of two very different political regimes and mobilized considerable public and private resources for his projects. During the Weimar period, his work received funding from various state agencies as well as the Rockefeller foundation, because it fit well with contemporary approaches in public hygiene and social medicine that emphasized the need to restore the physical and mental health of children and youths. Jaensch successfully positioned himself as a researcher on the verge of developing new therapies for feeble-minded people, who threatened to become an intolerable burden on the Weimar welfare state. During the Nazi period, he successfully reinvented himself as a racial hygienist by convincing influential medical leaders that his ideas were a valuable complement to the negative eugenics of Nazi bio-politics. “Constitutional therapy,” he claimed, could turn genetically healthy people with “inhibited mental development” (geistigen Entwicklungshemmungen) into fully productive citizens and therefore made a valuable contribution to Nazi performance medicine (Leistungsmedizin) with its emphasis on productivity.
A number of new articles of interest to AHP readers are now in print. Relevant articles from the most recent issues of Subjectivity, the Journal of the History of Medicine and Allied Sciences, and History of Science are listed below.
I here explore the manifestation of problematic memories on a psychosomatic level, with a focus on the work of psychiatrist Franco Basaglia (1924–1980) in the Italian city of Gorizia. As Basaglia transformed the local asylum into a Therapeutic Community during the 1960s, the city became a nationally acclaimed pilot for alternative psychiatry. After he left in 1968, Gorizia’s characterisation in the media shifted from being a radical experiment to a failed revolution, and the city has since held an ambiguous relationship with this heritage. Using the data gathered through an ethnography conducted between 2011 and 2012, I suggest that the controversial vicissitudes of ‘the Basaglia experience’ and the attempts to erase their emotional weight in Gorizia have left traces that I frame as embodied remembering practices. In discussing psychosomatic expressions of social discomfort, I formulate a body that is both somatic and psychological, contributing to a field at the intersection between psychoanalysis, trauma and affect studies.
Journal of the History of Medicine and Allied Sciences
Starting perhaps in the second century BCE, and with Hippocratic precedent, ancient medical writers described a condition they called hysterike pnix or “uterine suffocation.” This paper argues that uterine suffocation was, in modern terms, a functional somatic syndrome characterized by chronic anxiety and panic attacks. Transcultural psychiatrists have identified and described a number of similar panic-type syndromes in modern populations, and a plausible theory of how they work has been advanced. These insights, applied to the ancient disease of hysterike pnix, demystify the condition and illuminate the experience of the women who suffered from it.
This article interrogates the way/s in which rival schools studying hypnotism in late 19th-century France framed what counts as valid evidence for the purposes of science. Concern over the scientific reality of results is particularly situated in the notion of simulation (the faking of results); the respective approaches to simulation of the Salpêtrière and Nancy schools are analysed through close reading of key texts: Binet and Féré for the Salpêtrière, and Bernheim for Nancy. The article reveals a striking divergence between their scientific frames, which helps account for the bitterness of the schools’ disputes. It then explores Bernheim’s construction of scientific authority in more detail, for insights into the messiness entailed by theorizing hypnotism in psychical terms, while also attempting to retain scientific legitimacy. Indicative of this messiness, it is argued, is the way in which Bernheim’s (apparently inconsistent) approach draws on multiple epistemic frames.
“Efficacy and Enlightenment: LSD Psychotherapy and the Drug Amendments of 1962,” by Matthew Oram. The abstract reads,
The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy’s demise, as they frustrated researchers’ efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial’s design. LSD psychotherapy’s complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers’ attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.
“Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession,” by Edgar Jones. The abstract reads,
In 1943, Basil Wright produced a documentary film about the treatment of servicemen and civilians with psychological disorders at Mill Hill Emergency Medical Service Hospital. Funded by the Ministry of Information, Neuro Psychiatry was shot to convince influential clinicians and policy makers in North America that the British had developed expertise in the management of psychiatric casualties. By emphasizing novel and apparently effective interventions and excluding severe or intractable cases from the film, Wright encouraged an optimistic sense of achievement. Filmed at a time when victory was considered an eventual outcome, the picture presented a health service to which all had access without charge. Children and unemployed women, two groups excluded under the 1911 National Insurance Act, had been required to pay for healthcare in the prewar period and were shown receiving free treatment from the Emergency Medical Service. However, the therapeutic optimism presented in the film proved premature. Most U.K. battle casualties arose in the latter half of the conflict and follow-up studies failed to confirm the positive outcome statistics reported in the film. Aubrey Lewis, clinical director of the hospital, criticized research projects conducted at Mill Hill for a lack of rigor. The cinematographic skills of Wright and director Michael Hankinson, together with their reformist agenda, created a clinical presentation that emphasized achievements without acknowledging the limitations not only of the therapies offered by doctors but also the resources available to a nation at war.
“The Cost of War—Then and Now: Commentary on ‘Neuro Psychiatry 1943’,” by Heiner Fangerau. The abstract reads,
In his essay “Neuro Psychiatry 1943: The Role of Documentary Film in the Dissemination of Medical Knowledge and Promotion of the U.K. Psychiatric Profession” Edgar Jones provides a detailed case study of a single movie that was made under unusual wartime conditions. From this case, he builds a general analysis of the interpretation and portrayal of scientific expertise that shaped the production, distribution, and reception of this genre of documentary. The paper provides a fresh perspective for the historical analysis of film documentaries, while remaining highly topical and germane to present-day issues in medicine and health care.
The film that Jones studied was produced in a British hospital where war victims (mostly soldiers) were treated for war neuroses. The filmmakers documented the therapies employed and the apparently successful posttreatment reintroduction of patients into military service and civilian work. They hoped to convince informed audiences, especially those outside Britain in the United States and Canada, about the effectiveness of the British Health Care Service in …
The July 2012 issue of the Journal of the History of Medicine and Allied Sciences is now online. Included in this issue are two articles that tackle the history of mental health. The first article describes the work of Arthur Hurst who filmed soldiers suffering from shell shock post World War I. Further films by Hurst were used to convey the message that these soldiers could be “cured” with relative ease. The second mental health related article in this issue explores the relationship between mentally ill smokers and the tobacco industry, including efforts to cast smoking as an activity with positive effects for the mentally ill. Full titles, authors, and abstracts follow below.
“War Neuroses and Arthur Hurst: A Pioneering Medical Film about the Treatment of Psychiatric Battle Casualties,” by Edgar Jones. The abstract reads,
From 1917 to 1918, Major Arthur Hurst filmed shell-shocked patients home from the war in France. Funded by the Medical Research Committee, and using Pathé cameramen, he recorded soldiers who suffered from intractable movement disorders as they underwent treatment at the Royal Victoria Hospital in Netley and undertook programs of occupational therapy at Seale Hayne in Devon. As one of the earliest UK medical films, Hurst’s efforts may have drawn inspiration from the official documentary of the Battle of the Somme and films made in 1916 by French Army neurologists. Although initially motivated to make use of a novel medium to illustrate lectures, Hurst was alert to the wider appeal of the motion picture and saw an opportunity to position himself in the postwar medical hierarchy. Some “before treatment” shots were reenacted for the camera. Hurst, like some other shell shock doctors, openly used deception as a therapeutic measure. On the basis that the ends justified the means, they defended this procedure as ethical. Clinicians also took advantage of changes in military regulations to address functional symptoms. Claims made of “cures” in the film and associated publications by Hurst were challenged by other doctors treating shell shock. The absence of follow-up data and evidence from war pension files suggested that Hurst may have overstated the effectiveness of his methods. Nevertheless, the message conveyed in the film that chronic cases could be treated in a single session had a powerful resonance for ambitious or charismatic doctors and was revived in World War II.
The January 2012 issue of the Journal of the History of Medicine and Allied Sciences has just been released online. Included in this issue are a number of articles that may be of interest to historians of psychology and related fields. A special issue devoted to recent developments in the intellectual history of medicine, the issue includes articles on sexual inversion, shell shock (right), koro as a culture-bound syndrome, and the rise of hypnosis in Germany, among other topics. Titles, authors, and abstracts follow below.
“Recent Developments in the Intellectual History of Medicine: A Special Issue of the Journal of the History of Medicine,” by Chiara Beccalossi and Peter Cryle. An extract from this introduction to the special issue reads,
The history of medicine is probably best thought of as a wide range of different types of inquiry, rather than a single, well-defined field. It can involve, among other things, the history of institutions, technologies, and outstanding individuals. The articles gathered in this special issue are offered specifically as contributions to the intellectual history of medicine. Each shows, in its own way, how a particular disorder became conceptualized or how a particular set of difficulties was made into a topic of debate. Inquiry of this kind is not quite the same thing as a history of ideas—if by the latter one understands only the study of ideas as they traverse medical writing—since our concern is not with major ideas in the field of medicine, as such. One of our working assumptions is that intellectual history ought to be no grander an enterprise than social history at its most focused, or cultural history at its most closely bounded. We will simply examine ways of thinking that prevailed at given points in history, indicating the material consequences to which they gave rise. By seeking to articulate thought, writing, and professional practice, we are responding to the challenge Michel Foucault laid down for historians. But the histories offered here are not “Foucauldian” in the manner of histories that focus primarily on articulating epistemic “rupture” and unprecedented conceptual “invention.” The point of our contributions is to examine the contexts in which new kinds of thinking emerged gradually, and often unevenly. We seek, as Foucault did at his best, to highlight the circumstantial nature of thought and the intellectually productive nature of circumstance.
This special issue had its beginnings in a seminar series conducted in 2009 by the Center for the History of European Discourses at the University of Queensland…
The April 2011 issue of the Journal of the History of Medicine and Allied Sciences has just been released online. Included in this issue is an article that may be of interest to AHP’s readers. In “The Chief Seat of Mischief: Soldier’s Heart in the First World War” Sean Dyde explores the fate of “soldier’s heart” a medical-psychological diagnosis assigned from the American Civil War through to the period just following the First World War. Appearing as a variety of heart-related symptoms, soldier’s heart was held by physicians in the twentieth century to be psychosomatic until experimental results showed otherwise. Title, author, and abstract follow below.
“The Chief Seat of Mischief: Soldier’s Heart in the First World War,” by Sean Dyde. The abstract reads,
Soldier’s heart was a medico-psychiatric condition that was first documented during the American Civil War. This condition affected British and American soldiers during the late-nineteenth and early-twentieth centuries; doctors recorded patients experiencing palpitations, breathlessness, headaches, and praecordial pain among other symptoms. While the number of cases of this disorder reached its peak in the First World War, it disappeared shortly afterwards. Based on an analysis of experimental results published in generalist and specialized medical journals as well as the correspondence between physicians and researchers that these journals maintained, this study challenges the view that soldier’s heart disappeared because doctors realized that the disorder was, in fact, psychosomatic. Instead, this article shows that this notion was an unintentional by-product of the research conducted into the condition, the results of which opposed the somaticist philosophy that many of the researchers had tried to uphold.
The Journal of the History of Medicine and Allied Sciences has just released its January 2010 issue online. Included in this issue is an article by Fulbright scholar Lawrence B. Goodheart. In “From Cure to Custodianship of the Insane Poor in Nineteenth-Century Connecticut” Goodheart provides an account of life at the Hospital for the insane at Middletown, Connecticut (pictured above). Connecticut, Goodheart argues, was the exception among Northeastern states in that it did not open a public institution for the insane until the latter half of the nineteenth century. In documenting the institution’s history Goodheart, examines how initiatives meant to cure individuals and return them to society in a timely manner failed. Rather, custodianship became the norm. The abstract to this article reads:
Connecticut was the exception among the Northeastern and Middle Atlantic states in not founding a public institution for the insane until after the Civil War when it opened the Hospital for the Insane at Middletown in 1868, a facility previously neglected by scholars. The state had relied on the expedient of subsidizing the impoverished at the private Hartford Retreat for the Insane that overtaxed that institution and left hundreds untreated. Despite abundant evidence to the contrary, well meaning officials oversold the idea that the Middletown site would promote cures and be cost effective. Continue reading “From Cure to Custodianship”→