Presentism, Poxes, and Pap Smears

Today’s post tries to bring together a bunch of issues that have come up in my various listserv and blog reading. First, the issue of presentism came up on Christopher Green’s blog, Advances in the History of Psychology. I don’t usually read this blog, but Chris advertised this exchange on Cheiron’s listserv. Chris is concerned about edits to his history of psychology entry in Wikipedia, about 6,000 words of which Chris wrote himself. Chris objects to a contributor named “Jagged 85” who has been inserting material on medieval Islamic psychology. Because part of what Jagged 85 writes argues that the Islamic world pioneered in the treatment of mentally ill individuals, including building the first mental asylums, I asked the question, “It seems to me that a related question is what “counts” as the history of psychology. Much of the Islamic section seems concerned with treatment of mentally ill patients, i.e. clinical psychiatry. Isn’t this part of the history of psychology? If not, why not?” So far, no one has addressed this point. I should note that a certain kind of presentism is at work in Chris’ blog in that he starts from the point of view of what “counts” as psychology today, and then works backward to the field’s roots in 18th century laboratory science.

Another kind of presentism appears on in a post on Historiann. regarding the new vaccine for HPV. She ties the current controversy regarding Guardasil to earlier debates about smallpox inoculation. Since I’m currently teaching about Cotton Mather and the inoculation debate in early 18th-century Boston in my history methods class, I wrote that in Mather’s time inoculation was a risky procedure — there was no certainty that the patient would not develop a full-blown case of smallpox, the patient could still transmit smallpox to others, and because inoculation consisted of introducing pus or scabs under the skin, the risk of infection at the inoculation site was not insignificant. So, we should be careful about attributing opposition to Mather solely to ignorance — there were legitimate concerns about the safety of the procedure which were raised by physicians and laypersons alike. For more on this issue, see Maxine VandeWetering, “A Reconsideration of the Inoculation Controversy.” New England Quarterly 58/1 (1985): 46-67.

Now on to pap smears. I recently submitted a proposal for a conference on “Cancer Vaccines for Girls? The Science, Ethics, and Cultural Politics of HPV Prevention,” which is going to be held at Rutgers University in May. My plan is to relate this debate back to my earlier work on the history of gynecological exams for girls. I’d also like to comment on Karen Houppert’s article in the Nation. Although I think Houppert raises some good points, I that the term “strange bedfellows” that lumps together religious conservatives, anti-vaccine libertarians, Big Pharma critics, and “and a smattering of women’s health advocates” too easily dismisses attempts by feminist health activists to craft a nuanced reaction to this new technology. I think she is particular unfair to Amy Allina at the National Women’s Health Network. My thoughts on the issue, thus far, are that by focusing on individual attitudes and choice, and emphasizing what Allan Brandt calls the “moral valence of individual risk,” the push for universal vaccination overlooks larger public health issues such as socioeconomic status and access to health care services. Until there is a greater social commitment to meeting the health needs of uninsured and underinsured women, a disproportionate number of whom are from racial minorities, these women will lack the routine preventive care more privileged women take for granted.

7 thoughts on “Presentism, Poxes, and Pap Smears

  1. Hi Heather,

    I don’t think that’s a fair reading of my post. I clearly say in the second paragraph that there was a great deal more to fear from variolation than modern vaccination. To wit: “In all fairness, inoculation (also known as variolation) was in fact a risky procedure, unlike modern vaccination, which involved infecting a healthy body with live virus to induce a mild course of the disease that would render the patient immune to future infection. People who were inoculated were infectious to others, and some died from the resulting illness.”

  2. Heather, Thanks for mentioning the discussion over at AHP. I did not respond directly to your comment there, but I think that what I said in response to Jagged 85’s comment applies equally to your question. I will quote it here.

    “Jagged 85 says ‘the definition [of ‘psychology’] I had in mind while making those edits was simply the study of mental processes and behaviours.’ [This seems to be precisely what lies behind your question about asylums, Heather.] Herein lies precisely the difference between scientists writing about the history of science and historians writing about it. For the psychologist, there is a sense in which anyone anywhere writing about the mind or specific mental processes is doing ‘psychology.’ The historian, by contrast, takes the view that scholarly disciplines are a certain kind of historically-situated social structure, in which a group of individuals self-consciously assemble and articulate a set of problems as being closely-enough related to each other that they constitute what might be termed an ‘intellectual kind’ (an analog to a ‘natural kind’). In short, they are of a piece with one another. “Psychology” didn’t really come together in this way until the mid-18th century, in Central and Western Europe.” [I explain this further in the original comment, for anyone interested.]

    This does not, to my mind, partake of presentism, which imposes modern categories and values on the past. Rather, I attempt to identify boundaries for what is properly, historically called “psychology.” The proof, contra your claim, that I am not simply imposing today’s “psychology” on the past is that I would follow the same approach if I were studying a discipline that does not exist today, e.g., alchemy. I would identify a group of people who self-consciously assembled a set of problems that were seen to be “of a kind” and places them under the term “alchemy.” Thus, e.g., ancient Egyptian “magicians” could not really be said to be alchemists, even if they were trying to, e.g., turn base metals into gold because they were part of an entirely different intellectual tradition from the medieval European alchemists, even if their ultimate goal was superficially the same as that of the medieval European alchemists.

  3. First, to reply to Historiann — Perhaps I can explain this better than I did the first time. Yes, you do indicate the risks associated with inoculation. My point was that Mather was touting the procedure, and others were opposing it, for much different reasons than those who support/criticize HPV vaccines. In other words, you seem to be projecting a modern scientific framework onto the past.

    As to the modern-day controversy surrounding HPV vaccine, I think it needs to be seen within a longer history of human experimentation and health care for women. From my perspective, the science is sound, the vaccine appears safe, but I also have concerns about whether this is the best way to use public health resources.

    Chris — I understand your perspective much better now. Does clinical care of mentally ill patients count as part of history of psychology?

  4. You ask: “Does clinical care of mentally ill patients count as part of history of psychology?” You prejudice the answer by using modern terms like “clinical care” and “mentally ill.” I don’t know much about what was going on in Medieval Muslim medicine (except, ironically, that Nestorian Christians were particularly renowned for their medical skills). I don’t know much about where those who *we* might call “mentally ill” (a very recent conception, even in the West) fit in the medieval Muslim intellectual landscape. Was “madness” (as it was probably called) even considered a medical matter at that time and place? It would be surprising if it were. It wasn’t, generally speaking, in the Ancient world. And if it were, to what degree did their “mad” overlap with our “mentally ill”? I know virtually nothing at all about whether Medieval Muslims had anything approximating our modern “clinics” or “hospitals” (though I would doubt it, considering that they didn’t appear until very recently in the Western world — i.e., it wasn’t a tradition of care that we both derived from the Ancient world). Once I had answers to those question, then I might have an answer to your question.

  5. Hi Chris and Heather,

    You’ve both raised some interesting questions regarding mental illness in medieval Islamic medicine. I’ll try to answer some of these questions, although my knowledge on the subject is derived from secondary/tertiary sources rather than the primary sources themselves, and I don’t really have much knowledge on the non-scientific (i.e. philosophical/theological/religious or superstitious/magical/occultist) aspects of medieval Islamic medicine (which may be why some of my edits at Wikipedia might appear presentist).

    Regarding the medieval Muslim view of madness or mental illness, there were two different views I know of: one was based on unhealthiness of either the mind, body, soul or spirit, and the other was based on possession by jinns (i.e. genies), but the latter view appears to have been uncommon with the medieval Muslim physicians I know of. The study of madness or mental health was indeed considered a distinct branch of medieval Islamic medicine and was variously known as “diseases of the mind”, “al-Tibb al-Ruhani” (“spiritual/psychological health” in Arabic) or “Tibb al-Qalb” (“mental medicine” in Arabic).

    There was something similar to a hospital in the medieval Islamic world called a “Bimaristan” (“place for the sick” in Persian), which was very different to the healing temples or sleep temples found in the ancient world, and had many of the facilities we usually associate with a hospital. There was also apparently something similar to a clinic, but I haven’t read too deep into it yet. As for a medieval Muslim tradition of care, I’m not sure whether there was something similar in the ancient world, but I’ve read that there was an Islamic law suggesting that the insane must be be taken care of, so it could very well be a tradition derived from their own culture.

    I’m not too sure how much exactly these medieval Muslim concepts overlap with our modern concepts, although from my (non-historian) point of view, they appear to have more in common with the early modern period than they do with antiquity as far as mental illness is concerned.

    Jagged 85

  6. Although Mr. Green argues against presentism, he wrote a book chapter entitled Ancient Greek psychology. It seems as though he forgot to mention that chapter in his blog. Isn’t that somewhat Presentism? He seems somewhat comfy categorizing to a degree, but other forms of categorization are presentist. I also t hink that he is viewing things very dichotomously. He stated that psychology did exist or not so I think he should be more open to viewpoints such as postmodern. He also said that Islamic writings need only to be mentioned, but wrote an entire chapter about Ancient Greek psychology! From his writings, I have found that he has categorized some Ancient Greek thought as Psychology, modern Central Europe thoughts as psychology, and modern European thoughts as psychology. What’s missing you say?

    The missing piece is Medieval Islamic thought. The science of the soul. “ELM-OL NAFS” in Arabic and RAVAN’SHENASI in Farsi, NAFS/ Ravan means Soul and ELM/Shenasi means Logy. This is the current term used in Arabic/Farsi for what is the equivelant of Psychology. These terms have been used since the Middle Ages. Many poeple compare modern day Ravan Shenasi and Psychology even though they are influenced by their own culture because this is the term for psychology in these cultures. So when he says something like the historical definition of psychology has been…, I don’t think he is being entirely accurate. He says that there was no discipline called psychology, but he is in error. There was and medieval physicians practiced medicine based on this knowledge, he just does not think there was this category because of his own interpretations.

    In addition, this concept of presentism is also presentist in trying to be multicultural. Other cultures have more fluid interpretations of concepts of time. Everyone’s interpretations are flavored by their enviornmental surroundings. He believes that there has been one historical definition of psychology, but it is really that he interprets that others have had similar definitions of psychology. He is analyzing their definitions from his own cultural viewpoint as well. What is the operational definition of the present and past. Who made these definitions? What purpose do they serve? What was their cultural influences? Why should we apply these culturally influenced terms onto other cultures? Aren’t my writings in the past as you read them?

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