New Year, Renewed Focus

This year I’ll commence a short-term “project-to-publication” fellowship with the Australian Research Council Centre of Excellence for the History of Emotions. It will transpire only for a short 6 months, so I’ll have to make the most of it. One of the things that the Centre encourages its researchers to do is regularly blog about their research topic (though I’m sure it is more pressing for long-term fellows to do it). I was perhaps sorely in need of any kind of spur to blog, as I’ve never found any success in doing so in the past. Rather obsessed with web and text design as I have been, I have generally tended to waste time on learning to develop WordPress sites, and have neglected my writing production in the process. But no more (he says, hubristically). I have developed this basic site—and have accepted its flaws—precisely in order to focus entirely on my aims concerning writing production.

I was awarded the fellowship on the basis of a submission I prepared on what is really a peripheral research interest, a study of the history of neurology and its relationship to the development of knowledge about psychiatric disorder and the emotions. One of the aims of my proposal was to throw light on the development of neurology in the late twentieth century, and particularly on the litigation that arose in the context of the violent railway accidents that occurred both in Europe and Australia.

Perhaps the most famous case of “nervous shock,” the dubious name given to the psychiatric disorder resulting from a severe trauma or shock after an accident, remains an Australian one. Victorian Railways Commissioner v Coultas [1888] UKPC 3 was a case in which a pregnant woman, Mary Coultas, had been advised by a railway gate operator that it was safe to cross at a railway crossing when, in fact, a train was approaching her at high speed. While not struck by the train itself, the plaintiff fainted at the scene, and later suffered a miscarriage, losing her unborn child. On appeal, the Privy Council rejected Coultas’s claim for damages, finding that her claim, that she had suffered the injury of “nervous shock,” was just too remote from the alleged negligent act.1 One wonders, however, whether today such a plaintiff might be diagnosed with post-traumatic stress disorder (PTSD) rather than nervous shock, and, if the case were heard again, whether a claim of PTSD, with its freshness and ubiquity as a nosological category, might lend a new gravitas to the strict application of the remoteness test. But I digress.

The point of analysing cases such as Coultas is to show how the experts who appeared before the courts in these matters were not simply the sober-minded functionaries of the scientific method, the objective and impartial conveyors of the empirical gravamen of physiological truth. Rather, almost all of these experts intended to bolster their own professional reputations at a time when certain theories of biology, and indeed neurology, were only beginning to achieve institutional recognition. While leading neurologists of the time in Germany, such as Hermann Oppenheim, contended that nervous shock emanated from actual physical damage to the spine or brain, British neurologists tended to refute the proposition that physical or organic harm had precipitated the symptoms.

In an 1883 monograph on injuries without lesion, the British neurologist Herbert Page argued that “fright and . . . fright alone” produced these injuries, as well as many similar injuries grouped under the nosological category of “railway spine,” some of which had led to the “gravest disturbances of function, and even death or annihilation of function.”2 Indeed, for Page, as for William Tuke (the Quaker who developed more humane methods of caring for those with mental disorders), it was the mind, subject to so many emotional and affective turns, and not the body, that caused the symptoms of nervous shock to arise, however serious and damaging, however injurious, they were for the victim. Quoting Tuke with approval, Page’s book noted that any “anxious reflection upon any of the bodily sensations . . . may originate a host of imaginary disorders.”3 Among these, Page asserted, was the disease of “hysteria,” which, while it affected both men and women, was more commonly seen in the latter.

On the publication of his 1883 book (cited above), Page was appointed the President of the Neurological Society. This was a promotion that ensured that his view of nervous shock—his idea that the disorder was no more than an emotional illness, comorbid with hysteria—would attract the imprimatur of the neurological fraternity, not to mention the deference and respect of the courts.4 More than this, however, it was Page who had served as the surgeon-doctor to the London and North Western Railway Company; and it was perhaps Page, he who had so many times dismissed the legitimacy of nervous shock when acting for that company, who was responsible for the wholesale reconstitution of nervous shock as hysteria, a medical reclassification no less than embraced by Freud and Breuer in their Studies on Hysteria (1895).5 No doubt the unfortunate result in Coultas was but one of the many ramifications of Page’s formidable influence among British neurologists and their various debuts as expert witnesses in the English courts. With unmatched authority, Page shaped not only the taxonomy and nosology of neurological injury in the late nineteenth century, but the development of tort liability for psychiatric damage into the twentieth century.

It is with this kind of argumentation that I’ll be taking steps towards developing and submitting a few publications between now (January, 2017) and July of this year. I’ll be aiming for three.

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