Such a trade in legacies, transferring a precursor from one science to another, is merely a symptomatic of a much larger problem. When considered as purveyors of medical jargon, then any medical thinker in history may be purchased for whatever role we see fit. The potential remains because it has happened before. Footnote 6 Whether this becomes the foundation of purely biological account of neurosis, according to which Cullen is a precursor once again, remains to be seen. The social historian Heather Beatty’s examination of Cullen’s medical correspondence has shown that most of his nervous patients complained of embarrassingly somatic ailments rather than ‘the vague symptoms of nervous sensibility typically discussed in novels and sources intended for public consumption’. At least in recent years the analysis has become more nuanced. Footnote 5 But Cullen was not a mad-doctor, just as he was not a neuroscientist. Because the diagnostic term he coined – neurosis – was also the term used by psychoanalysts to describe a mild psychological problem, mid twentieth-century historians of psychiatry have attached this later meaning to this eighteenth-century Edinburgh Professor of the Theory and Practice of Medicine. Indeed, Cullen and his bequest to medicine have been remade several times before. William Cullen remains an important and influential figure within the history of medicine, if only because he can be easily drafted into whatever historiographical trend is currently fashionable. An older, more trusted, method is the hunt for precursors. Footnote 4 Moreover, judging the past with, or according to, the scientific theories of the present is only one means of establishing their credibility. To spoil the ending of Antonio Damaio’s Descartes’ Error: Emotion, Reason and the Human Brain, the problem is that Descartes was not a twentieth-century neuroscientist. Footnote 2 Such a reduction of human passions, motives and understanding is not without its problems: on the one hand, reducing the humanities to the neurosciences has not been left uncontested Footnote 3 and, on the other, rewriting the past in this manner is no different from the way in which neuroscientists themselves have been remaking it. However, a more recent development is the enthusiasm with which historians and sociologists have taken up this project as well. Footnote 1 While scientific research on the brain may well antedate the president’s approbation, the notion that we understand ourselves by first understanding our brains has had a much greater lifespan than perhaps Bush intended. Bush, when he designated the 1990s as the ‘decade of the brain’. The prophet in this case is President George H.W.
But even rarer than a prediction that comes true is a prediction that outlasts its creator’s intentions.
Neurosis was not simply a nervous ailment, but it is a warning against reductionism in history making.ĭivination is the most difficult of all sciences. It also values precisely what Cullen warned against: simplistic explanations of the body and disease, and unthinking confidence in the next big idea or silver bullet. This image has survived to the present, a blank canvas onto which any theory can be projected. When these hopes faded, Cullen became a figure obsessed with the nerves.
Moreover, this article examines how Cullen’s standing fell in the 1820s as British physicians and surgeons turned to an idea which promised to reform medicine: pathological anatomy. The result is a more complicated version of neurosis which, importantly, carries significant insights into the nature and practice of medicine. This article attempts to subvert this process, by rebuilding the original meaning of neurosis through Cullen’s physiological and medical works, in comparison with his predecessor, Robert Whytt (1714–66), and illustrating this meaning using one particular neurosis: hypochondriasis. William Cullen (1710–90), whose work on neurosis was once part of the history of psychoanalysis, is now well placed to become part of such a neuro-history. History is being rewritten with the brain as its centrepiece the search for great men and big ideas of the past begins again. Existential questions – about who we are, about our origins and future, about what is valuable – no longer require difficult soul searching, especially when straightforward answers are expected from the neurosciences. Some ideas return after the briefest of exiles: reductionism is back in vogue.