Abstract
Helena Jaskov’s Negotiating States of Mind is a richly researched and methodologically refined study of melancholia as a diagnostic category vanishing from psychiatric thought and practice in the decades spanning the end of the 19th and the beginning of the 20th century. The present study is distinguished from numerous other contributions to the history of science by its focus on the disappearance of a notion, as opposed to the invention, emergence, or construction of a new paradigm or concept. Reworked from a doctoral thesis submitted at Heidelberg University and published by Heidelberg University Publishing in 2025, the book offers a transnational history of psychiatric knowledge by placing the medical worlds of Imperial Germany (1871–1918) and Meiji Japan (1868–1912) in dialogue. Drawing on source materials in German, English, French, Russian, and Japanese, including patient case files, psychiatric journals, and textbooks, Jaskov reconstructs how an ancient and capacious disease concept gradually became unintelligible within the new institutional and epistemological landscape of modern psychiatry. The result is a work that makes a considerable and original contribution to the intellectual and institutional global history of medicine.
The book is organized into two broad parts. The first four chapters examine academic debates, institutional structures, laboratory methods, and textbook production within the global psychiatric community of the period, tracing in particular how the successive editions of Emil Kraepelin’s influential Psychiatrie textbook reshaped the conceptual landscape through which melancholia, manic-depressive insanity, and dementia praecox were understood. The second part pivots to the Russo-Japanese War (1904–1905), analysing the mental-health provision for Japanese soldiers in Manchuria and the competing diagnostic practices of three key psychiatrists, Araki Sōtarō, Kure Shūzō, and Hanabusa Kenya, as they confronted the same population of war patients with fundamentally different observational and classificatory frameworks. Jaskov’s central argument is that the displacement of melancholia was driven neither by a mere synthesis of mood disorders nor by a single act of nosological intervention, but rather by the intersection of institutional pressures, experimental reductionism, and the gradual naturalisation of volitional behaviour, whose diagnostic weight did not adhere to any self-evident pathological reality.
One of the most important historiographical moves in the book is Jaskov’s re-examination of Kraepelin’s role in psychiatric history. Resisting both hagiography and denunciation, she situates Kraepelin firmly within his institutional context, demonstrating that his prognosis-based classification system, with its infamous dichotomy between dementia praecox and manic-depressive insanity, emerged not primarily from a neutral empirical assessment of patient populations, but from the administrative imperatives of the Heidelberg University clinic, where chronic overcrowding compelled an early and reliable means of separating curable from incurable cases. Her analysis of Kraepelin’s famous diagnostic cards (Zählkarten) is particularly illuminating: drawing on the work of Eric Engstrom and Matthias Weber, Jaskov shows that more than half of the preserved cards contained no information on illness trajectory, casting serious doubt on the claim that the firm dichotomy was established from long-term observational data. This is not a minor observation, for it fundamentally alters how we understand the epistemic status of the categories that have governed psychiatric nosology for more than a century, including their legacy in the DSM and ICD systems. Readers trained in the historiography of 19th century scientific laboratory medicine will appreciate how Jaskov weaves together the institutional sociology of the profession with a close reading of its medical literature.
The chapters devoted to experimental psychology and the “rise of numbers” (Chapters 3 and 4) are very stimulating and enrich our understanding of the scientific turn of 19th-century psychiatry. Jaskov traces how the laboratory instruments of experimental psychology, that is, writing-pressure curves, association tests, and reaction-time measurements, entered psychiatric practice in the late 19th century, adding a touch of scientific rigor to a discipline anxious to establish its credibility alongside the natural sciences. She argues, however, that this quantitative turn introduced a new reductionism into psychiatric evaluation, one that displaced the holistic, experience-based assessment of the patient’s subjective world in favour of measurable behavioural agents whose relationship to mental suffering was somewhat obscure. The analysis of Japanese psychiatrist Matsubara Saburō’s stay in the United States, where he studied under Adolf Meyer, provides a fascinating counterpoint. Matsubara’s distinction between pure depression and alternating types anticipates the later differentiation between unipolar and bipolar disorders, a path not taken in the consolidation of Krapelinian nosology.
The second part of the book, devoted to the Russo-Japanese War, is in many respects the most original, not only because this decisive conflict is often overlooked in the historiography of psychiatry, but also because it foreshadows comparable developments documented in World War I. Jaskov examines the case files of soldiers diagnosed with mental illness along the evacuation chain from Manchuria to Hiroshima to Tokyo, comparing the notes of Araki Sōtarō, who worked closest to the front, with those of Kure Shūzō, who examined the same patients on their return to the capital. The contrast is quite revealing. Where Araki recorded melancholia as a diagnosis anchored in the patient’s affective world, his expressed suffering, and his inhibited associations, Kure systematically recasts the same symptoms as dementia praecox or manic-depressive insanity by highlighting behavioural characteristics, like the manner in which a patient closed their eyes when questioned, their refusal to eat when observed or the content and consistency of their delusions. The detailed case history of the soldier Satō, traced across three diagnostic moments and through Jaskov’s careful bilingual analysis of the original Japanese records, stands as a remarkable example of applied microhistory. It demonstrates that the transformation of melancholia into dementia praecox was achieved not through the discovery of new symptoms but through a reorganisation of the narrative and hierarchy of the case records. It marks a distinctive shift in what was considered “significant” within the psychiatric clinical gaze.
Jaskov’s handling of the question of pension eligibility and military compensation adds a further, politically charged dimension to this analysis. Her examination of Hanabusa Kenya’s statistical research reveals how attributing soldiers’ mental breakdowns to hereditary predispositions rather than to the traumatic experiences of combat minimized the state’s financial liability to veterans, whether intentionally or not. The parallel with German, and one should add Austrian, military psychiatry and neurology at the outset of World War I, where similar processes gave rise to similar diagnostic regimes, is drawn without falling into the trap of anachronism. The book situates the Russo-Japanese War as a crucial but underappreciated moment in the global history of military psychiatry, noting that Araki’s findings were published in German and actively consulted by European psychiatrists preparing for the conflicts that would follow. This transnational circulation of knowledge across languages, from East to West as well as West to East is one of the book’s most valuable contributions to the existing literature.
The theoretical framework is set out well balanced. Jaskov is indebted to Lorraine Daston’s work on the biographies of scientific objects, to Foucault’s historical epistemology while keeping a distance from more reductive applications of his framework, and to scholars such as Canguilhem, Ginzburg, and Shapin. Her stated aim of writing a global intellectual history attentive to social context is consistently enacted rather than just declared. She is also explicit about what she does not want the book to be: neither a history of the word “melancholia” across the millennia, nor a study in the social construction of diagnosis, nor an account of knowledge transfer from West to East. She even transcends the traditional historiographic hierarchy by providing a deeper understanding of a Western-derived medical concept through “Eastern” discourse. These demarcations are themselves a form of argumentation, and they help clarify her intended contribution to the existing body of literature. Her critique of scholarship that portrays early Meiji university psychiatrists as shallow instruments of a repressive state, while celebrating traditional healers as the true bearers of a more humane approach to mental disorders, is grounded in close readings of the primary sources.
The discussion of Japanese textbook production and the practice of intellectual borrowing (Chapter 2) provide a nuanced picture. Jaskov demonstrates that the texts produced by Kure Shūzō and his contemporaries were not simple translations of German sources but active reworkings that restructured content, selected different illustrative cases, and situated Western medical concepts within a long history of Chinese and Japanese medical learning. The story of Kure’s attempts to introduce European-style bed-therapy at the Sugamo Mental Hospital in Tokyo, frustrated by a municipal government unwilling to purchase heavy wooden beds for patients accustomed to futons, illuminates the reality of psychiatric modernisation beyond the abstractions of diagnostic debates. The appendix, which provides a concordance of patient case histories across Araki’s Japanese and German publications and Kure’s records, is a valuable resource for future researchers working in this field.
A few questions remain to be addressed. The book’s focus on male patients, which is largely a function of the military setting of Part II, means that the gendered dimensions of melancholia’s disappearance receive less attention than some readers may hope for. Jaskov herself does not fail to notice the intriguing reversal of the gender distribution of melancholia between Heidelberg and Tokyo. Where Kraepelin’s textbook illustrated the condition with photographs of female patients, Ishida’s Japanese version used a male subject. Jaskov acknowledges this discrepancy without being able to pursue it at length. This is not a criticism of the book itself, but a methodological consequence of the sources, suggesting a productive avenue for future inquiry. Similarly, while Jaskov’s observations on the role of the indigenous Japanese concept of utsu 鬱 in mediating the transition from melancholia to manic-depressive insanity within Japanese language and thought are suggestive, one hopes for a fuller engagement with the semantic and cultural history of that concept in subsequent studies.
These are minor objections in the face of a work of considerable scholarly accomplishment. Negotiating States of Mind will be of immediate interest to historians of psychiatry and of medicine more broadly, but its reach extends well beyond those fields. Historians of science concerned with the social consequences of laboratory methods, scholars of Japan’s modernisation, those working on the history of wars and military medicine, and anyone interested in the mechanisms by which scientific concepts are created, travel across linguistic and cultural borders, and ultimately disappear will all find much to engage with. The book’s multilingual approach, with its simultaneous command of German, Japanese, Russian, French, and English sources, sets a high standard for what a transnational history of medicine should look like.
