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Book Forum: Diagnosis and Treatment   |    
Health and Disease in Human History: A Journal of Interdisciplinary History Reader
Am J Psychiatry 2002;159:1069-1070. doi:10.1176/appi.ajp.159.6.1069
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New Haven, Conn.

Edited by Robert I. Rotberg. Cambridge, Mass., MIT Press, 2000, 345 pp., $60.00; $25.00 (paper).

Medicine has long had a love affair with history. Psychiatrists, relying almost exclusively as we do on the personal histories of our patients, may be the physicians most vulnerable to this romantic affliction. It is hard for even the strongest willed of us to resist the temptation of revisiting the past, of diagnosing away and fancying on the possible outcomes that the tools of our day would have allowed. As a telling example, I learned as an impressionable young medical student that Beethoven had been afflicted with otosclerosis. Fair enough. His disease, alas, progressed to osteopetroses by the time of my internship and aggressively morphed into chronic lead toxicity and then into late-onset paranoid psychosis by the time I became a card-carrying psychiatrist. As armchair historians, psychiatrists have tended to be long in theory but short in (or oblivious to) actual data.

Health and Disease in Human History is an edited volume that brings together the best papers published in the Journal of Interdisciplinary History over the last 20 years. The book is a demanding read that covers a wide range of medical topics. Even if none of its 13 chapters deals directly with a psychiatric disorder, its overall tone and full-immersion approach to history make this book relevant. Whether the topic be fertility and pellagra in turn-of-the-century rural Italy or the tracking of an isolated community afflicted with intermittent porphyria in 19th-century Oregon, the bottom line is clear: a return to the original sources is inevitable, indeed mandatory, in order to do justice to the past.

In their detective work, the chapter authors go to sources as detailed as they are geographically spread out. Daily prices of bread between 1550 and 1750 are meticulously recorded in order to reexamine whether adulterated bread could have contributed to excess infant mortality in London—plausibly so, we learn. Mountains of newly available sources in both Spanish and Nahuatl are translated in painstaking detail by one author to revisit the decimation of Meso-America through the introduction of smallpox from Europe—corroborating the long-suspected importance of this disease.

Medical history is sobering and serious at times, as in a chapter on the mortality associated with the slave trade, but, as the volume reflects, it can be amusing as well. In "Urban Sanitation in Preindustrial Japan" we learn that the rights to human fecal matter and waste (top-line fertilizers of the day) were so important as to lead to outright battles and aggressive legislation. More importantly, the value placed on fecal matter contributed to cities in Japan becoming more hygienic than their American and European counterparts, such as 1850s Paris and the "shockingly direct connection" between its sewage disposal and water supply).

Psychiatrists have not always been at fault when venturing into history; nor have they always failed to follow the rigors exemplified in this volume. In a recent essay on Emily Dickinson’s work, for example, John McDermott (1) rolled up his sleeves by returning to the source—to the exact text and dating of each of her poems—in order to draw conclusions regarding the cycling of Dickinson’s creativity and her possible underlying psychopathology. Health and Disease in Human History provides a useful guide to those who venture to revisit the past and epitomizes what can be accomplished by applying responsible and accurate historical methods. "Spare my past," pleads Stephen Dedalus in Ulysses. The nature of our calling makes us unlikely to spare any past. On that same account, we should show utmost diligence and respect when proceeding along.

McDermott JF: Emily Dickinson revisited: a study of periodicity in her work. Am J Psychiatry  2001; 158:686-690; correction, 158:1179


McDermott JF: Emily Dickinson revisited: a study of periodicity in her work. Am J Psychiatry  2001; 158:686-690; correction, 158:1179

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