Abstract
During the 19th century, there were few periodicals dedicated to the inchoate discipline of alienism (now called ‘psychiatry’). Given the newness of alienism and the idiosyncratic structure of the British publishing industry at the time, for a private individual to start a new specialized journal was a major enterprise. Against all odds, Forbes Winslow managed to publish his journal from 1848 to 1860, and during this period the scholarly nature of his publication could not be matched by the Asylum Journal, the official publication of the Association of Medical Officers of Asylums and Hospitals for the Insane.
Under the title Psychological Medicine, Winslow offered a new view of alienism which he clearly conceived as a discipline broader than medicine. He strove to inform his readers about the conceptual and practical complexities that then (as now) beset and besiege the care of the mentally ill. He taught his readers that to understand and manage insanity, knowledge of philosophy and of the human sciences was as important as knowledge about the brain. In the 1850s this was a new message to impart.
Introduction
The concept and purpose of nineteenth-century psychiatric journals were different from what they have become today (Shepherd, 1986). Asylum associations canvassed widely before starting a periodical, and publishing firms considered textbooks and monographs to be safer investments. Methods of financing were also different; indeed, pre-publication subscriptions were favoured because they allowed a publisher to gauge future level of sales. The relationship between psychiatric societies and publishing firms often depended upon the reputation of representative alienists. This was the case in Great Britain, France and Germany. At that time, for a private individual to start a psychiatric journal was a much harder task as his contacts and access to mailing lists were not as good as those of the official psychiatric associations.
This Classic Text is about the views and reactions of Dr Forbes Winslow, an alienist and entrepreneur who in 1848 started the publication The Journal of Psychological Medicine and Mental Pathology. The first of its ilk in Great Britain, this periodical not only anticipated by seven years the publication of the Asylum Journal of Mental Science (the official Journal of the Association of Medical Officers of Asylums and Hospitals for the Insane – later to become the Royal Medico Psychological Association, and even later the Royal College of Psychiatrists), but also set a model for the publication in 1969 of its namesake (Shepherd, 1986).
This Classic Text is unusual in that it blends three shortish pieces by Winslow: the Preface that he wrote for the first issue, setting out his ideas and ideals; the ‘Address to the Readers’ which he published at the beginning of the second volume; and a similar piece included at the beginning of the third volume. The Journal continued until 1860, then changed its name but had to stop soon after. Winslow’s son re-started it in 1875 but could not sustain it for very long. The three pieces below offer an interesting vista of the state of British journals on alienism during this period and hint at the cultural and philosophical tensions that attended the professionalization of alienism (psychiatry). While on the Continent the frictions were mostly between asylum and academic alienists (Jaspers, 1963), in Great Britain the latter were mostly supplanted by a medley of alienists constituted by private asylum entrepreneurs, eccentric mad doctors, gifted amateurs, and theoretical writers on madness (Tomes, 1988). It would not be unfair to say that Winslow was a good representative of all of them. In Great Britain, asylum medical officers presented themselves as hands-on clinicians, as the men at the coal-face, and they saw the others as ‘metaphysicians’ (used then as a term of abuse), as speculators who talked a lot but knew little about the management of the real lunatic.
Most of the biographical details known about Forbes Benignus Winslow (1810–74), including those listed in the Oxford Dictionary of National Biography (Andrews, 2004), can be found in an In Memoriam (Winslow, 1875) written by his son, Lyttleton Stewart Winslow (1844–1913). Born in London, Forbes Winslow was educated in Scotland and New York, and then trained as a physician at the Middlesex Hospital. Of exiguous finances, he had to pay his way through medical school by working as one of The Times reporters at the House of Commons, and during the early stages of his career he wrote short medical potboilers for clinical students. This training may well explain the ease with which he was later able to fill up issues of his Journal when not many submissions were coming in. Soon he started to show interest in (and write on) the mental state of the suicidal person, forensic alienism, and the welfare of the insane. All this suggests that he harboured philosophical interests, that his heart was in the right place, and that he tended to side with the underdog.
To secure an income, Winslow started two private madhouses at Hammersmith, and his views and medical behaviour during this period make him fit well into the type of mad-doctor that Andy Scull (1979) has called ‘entrepreneurs’. Winslow seems to have read widely and kept au fait with philosophical publications falling well beyond the interest of the average nineteenth-century mad-doctor. His forensic notes, clinical summaries and book reviews come across as fair, thorough and often insightful. From its first volume, Psychological Medicine benefited from this cultured stewardship (as it was to do under Michael Shepherd’s a century later) and the result was a comprehensive and balanced publication, on all fronts superior to the Asylum Journal that started publication in 1855.
The Journal
Winslow once wrote that he had designed his Journal of Psychological Medicine 20 years before it had seen the light of day. Published by John Churchill, who until 1847 had run The Lancet and was about to start with The Medical Times in 1850, Winslow’s Journal was in safe hands. When his son started publishing the new series in 1875, it was with Smith, Elder and Co. (Huxley, 1923); the reasons for this change are unclear.
Winslow made much of the collocation of ‘Psychological Medicine’ in the title of his journal. The term ‘psychology’ was already in medical use by the beginning of the nineteenth century, both in France (Virey, 1820) and Germany, where it had been popularized by Christian Wolff (Boring, 1966). The phrase ‘medical psychology’ had been introduced into English by Lloyd and Babington in their 1847 translation of Feuchtersleben’s (1845) Lehrbuch der ärztlichen Seelenkunde as The Principles of Medical Psychology. Indeed, Winslow (1848) himself wrote a long review of this book in the very first volume of his journal.
The origins of the collocation ‘Psychological Medicine’ are harder to trace. In Great Britain the term was in full use by the end of the nineteenth century: there were academic Departments of Psychological Medicine, Certificates in Psychological Medicine, textbooks, and even a famous dictionary (Tuke, 1892). Indeed, the term can be found in English alienism as early as in Daniel Noble’s (1853) Elements of Psychological Medicine and Bucknill and Tuke’s (1858) A Manual of Psychological Medicine. Where it came from, and why it never quite replaced ‘psychiatry’, remain interesting questions. In the prologue to their Manual, Bucknill and Tuke (1858: iii) stated that: ‘Numerous monographs and works on limited portions of Psychological Medicine have appeared of late years …’. However, they did not make clear whether they were referring to publications actually named ‘psychological medicine’ or to publications simply dealing with germane themes. Interestingly enough, there is no mention of ‘psychological medicine’ at the 1852 Seventh meeting of the Association of Asylum Officers at Oxford when in was decided that an Asylum Journal should be published to improve communication between its members (Bucknill, 1853).
Was the term perhaps a euphemism popular among private alienists? Given that, as Tomes (1988) and Scull (1979) have suggested, English alienism at the time was affected by rivalries between medical officers working in the public and private sectors, it is an interesting hypothesis to explore whether the likes of Tuke and Winslow, who were associated with the running of important private madhouses, felt that the term ‘psychological medicine’ was a less stigmatizing name for the study and treatment of insanity. However, in his (very critical) review of Noble’s Elements, Winslow (1854: 25) wrote: ‘Instead of being an introduction to the study of Medical Psychology – or Psychological Medicine (we are indifferent how the words are played upon) – we find the volume split into eight lectures …’. It is unclear whether he actually meant that the two phrases could be used interchangeably.
The publication of Winslow’s journal created a certain urgency in the Association of Asylum Officers to publish its own, and it set an example to follow (Renvoize, 1991). Thus, while in his Preface Winslow simply stated ‘The Editor feels highly flattered at the many kind letters of encouragement which he has had the honour of receiving, from some of the first and most distinguished members of the Profession’, Bucknill (1853) in the Asylum Journal took the further step of actually listing and quoting from the 29 expressions of support he had received!
Winslow was present at the 1852 Oxford meeting that decided on the publication of the new Asylum Journal. Nonetheless, when reviewing the first 13 issues (Winslow, 1855) he felt free to pass some barbed comments. He rued the fact that the Assembly had not considered adopting Psychological Medicine as their own and complained that no member of the association had ever submitted work to it: We were disposed at one time to entertain the opinion that some of the ‘veterans’ connected with the department of the science of medicine we were engaged in cultivating, might have extended to us some degree of literary assistance, and occasionally have held out to us a helping-hand; but they, with a few brilliant exceptions, neither did one nor the other, from motives best known to themselves. (Winslow, 1855: 70)
The Classic Text
In the second extract below, Winslow complained: … when this publication was announced by a prospectus, which was not intended to herald its approach with any very great flourish of trumpets, numerous were the disparaging predictions which on every side assailed us. Such a journal, said one, never can succeed; it will be a jungle of metaphysical quiddities and weather-beaten sophisms – who will care to explore and entangle themselves in its tortuous and briery paths? The study of metaphysics (exclaimed another) has long since been exploded, and fail of necessity it must, for it will eventually be ‘gravelled for lack of matter.’
The pejorative use by anonymous critics of the term ‘metaphysics’ is interesting in this context. Fleming’s The Vocabulary of Philosophy (1857) – a work that Winslow may have consulted – listed a variety of meanings: In this sense the word is now popularly employed to denote, not the rational psychology of the schools, but psychology, or the philosophy of the human mind prosecuted according to the inductive method. In consequence of the subtle and insoluble questions prosecuted by the schoolmen, under the heading Metaphysics, the word and the inquiries which it includes have been exposed to ridicule … (Fleming, 1857: 312, original italics)
In his first ‘Address to the Readers’, Winslow showed his philosophical interests: The recent publication of Reid’s collected writings, with Notes and Addenda by Sir William Hamilton; the admirable and eloquent “Historical and Critical View of the Speculative Philosophy of Europe in the Nineteenth Century,” by Morell; the “Philosophy of the Inductive Sciences,” by Whewell; the “History of the Philosophy of the Mind,” by Blakey; sufficiently prove that the spirit of intellectual philosophy in England is not yet extinct. Indeed, the simple fact that the works of Plato, Schlegel, Ritter, &c., are in the course of publication, in cheap monthly volumes, would alone seem to indicate that mental science, instead of being repudiated and despised, is becoming daily more popular …
In this context, Winslow seems to be equating ‘philosophy’ and ‘philosophy of mind’ with ‘psychological medicine’ and ‘mental science’.
His choice of books is also interesting. Hamilton’s edition of Reid’s work (1854) took several years to complete, partly on account of the disagreement that had developed between Hamilton and William Tait, the Scottish publisher: Hamilton wanted to include a very long introduction and Tait was not prepared to pay for it. Things got compounded by Hamilton’s first stroke which occurred in 1844 (Ryan, 2004). In the event, Hamilton self-financed an incomplete 1854 edition. It was only after his death that the definitive edition was produced by H.L. Mansel. Writing in 1849, it is clear that Winslow was quoting from the 1846 printing. Historians of the Scottish Philosophy of Common Sense (e.g. Grave, 1960) have considered Sir William Hamilton’s (1788–1856) effort to combine Reid and Kant as manqué.
The second work listed by Winslow is also an interesting choice: J.D. Morell’s (1816–91) An Historical and Critical View of the Speculative Philosophy of Europe in the Nineteenth Century (1846). Morell’s family, of Huguenot stock, had settled in England on the revocation of the Edict of Nantes, and Morell was for a while a non-conformist minister (Buckland, 2004). After studying in Bonn, he became influenced by German idealism, and the book quoted by Winslow shows this clearly.
The third work is William Whewell’s (1794–1866) The Philosophy of the Inductive Sciences which appeared in 1840, and at the time it was considered as expressing views too close to the idealistic interpretation of Kant’s epistemology (Yeo, 2004). A possible explanation for choosing this particular work rather than Whewell’s The History of the Inductive Sciences (1837), which was far more popular at the time, may be the fact that Winslow was interested in its Kantian, quasi-constructivist approach to knowledge.
The fourth work quoted by Winslow is also interesting. Robert Blakey (1795–1878) was a self-made radical thinker who eventually got the chair of philosophy at Queen’s University in Belfast (Hawkins, 2004). History of the Philosophy of the Mind was the best book Blakey (1850) was to write. By ‘Philosophy of Mind’ he basically meant metaphysics – what Aristotle had called ‘first philosophy’ and not what currently goes under that name. Influenced by the Scottish Philosophy of Common Sense, and by French eclecticism, particularly Victor Cousin, Blakey admired Morell’s work and used it as a source for his own text, together with the work of Cousin, Lewes, Degérando, Brucker and Ritter (Micheli, 2002).
Lastly, Winslow mentioned ‘Freiderich’s Magazine’. He is here referring to the Magazin für die philosophische, Medicinische und gerichtliche Seelenkunde, edited by Johannes Baptista Friedreich (1796–1862) and published in Würzburg by Carl Strecher. It appeared only from 1829 to 1834 (Hahn, 1880).
Final comment
During the nineteenth century, periodicals dedicated to the inchoate discipline of alienism (now called ‘psychiatry’) were few and irregular. Given the newness of alienism and the idiosyncratic structure of the British publishing industry at the time, for a private individual to start a new specialized journal was a major enterprise. Against all odds, Forbes Winslow managed to publish his journal between 1848 and 1860, and during this period the scholarly nature of his publication could not be matched by the Asylum Journal, the official publication of the Association of Medical Officers of Asylums and Hospitals for the Insane.
Under the title Psychological Medicine, Winslow offered a new view of alienism which he clearly conceived as a discipline broader than medicine. He strove to inform his readers about the conceptual and practical complexities that then (as now) beset and besiege the care of the mentally ill. He taught his readers that to understand and manage insanity, knowledge of philosophy and of the human sciences was as important as knowledge about the brain. In the 1850s this was a new message to impart.
When resuscitated by Michael Shepherd (Russell, 1996) in 1969, Psychological Medicine presented itself once again as a scholarly Journal, and its broad intellectual and cultural compass superseded by far the Asylum Journal then called British Journal of Psychiatry. It should have continued in that fashion, for in our discipline a cultured journal of psychiatry is essential for the education of the young. Alas, with time Psychological Medicine gravitated towards the conventional and joined the hundreds of featureless psychiatric journals published en masse by the large publishing conglomerates. It is a pity that in this brave new world there is no longer place for the likes of Forbes Winslow and his tenacious, individualistic, scholarship.