David Robertson // Aided by the rapid growth of publicly available big data and internet search engines, genealogy tracing has become a hugely popular activity. But its origins are not so technologically glamorous: as historian Theodore Porter puts it, ‘The science of human heredity arose first amid the moans, stench, and unruly despair of mostly hidden places where data were recorded, combined, and grouped into tables and graphs” (2). Porter, renowned among historians for his esteemed contributions to the history of quantitative knowledge,[1] has written a timely and exciting history of the asylum and the effort to mobilize the knowledge it contained in the pursuit of hereditary research. Genetics in the Madhouse: The Unknown History of Human Heredity (Princeton University Press, 2018) contributes to the history of the mind sciences, offering important insights into the historical relationship of psychological knowledge to the recording, storage, and use of patient data. But in making heredity, as an object of scientific study, the central concern of the book, rather than asylums or psychiatry per se, Porter bridges the history of psychiatry and related fields in the history of science. In doing so, he shows how the asylum became a space of convergence for researchers interested in studying the data of human heredity.
In the book’s first section, “Recording Heredity,” Porter locates the origins of hereditary research in the practices established by early alienists. Managing asylums meant that keeping patient records and data on heredity “first materialized on the pages of case books and admission forms as answers to innocent medical-administrative questions about causes of illness” (Porter 8). In the British physician William Black’s 1789 work Medical Analysis of the Diseases and Mortality of the Human Species, patient information was displayed in tables attempting to demonstrate relationships between causes of illness and “the urgent question of curability” (Porter 27). Already by the early nineteenth-century, “asylum reports were becoming formulaic, subsuming medical data into bureaucratic tables. Almost anything put down in the admission book was likely to be summed up as statistics” (Porter 34). Alongside an expanding system of asylum care across the early part of the century arose a concern for the provision of good-quality statistics, and by 1840 it seemed possible that “good recordkeeping might turn the asylums into data banks for the investigation of causes” (Porter 35).
The second section, “Tabular Reason,” builds on the first by exploring efforts to standardize the collection of data. Surprisingly, it centers such efforts not in Britain, America, or Continental Europe, but rather, in Norway. Already in 1859 in Norway, “three decades before pedigree tables emerged as the principal template for eugenic data,” researchers published family pedigrees “made possible by detailed census records” (Porter 10). Porter closely examines the contributions of Norwegian alienist Ludvig Dahl who, in 1857, published the surprisingly widely-read text Contribution to the Knowledge of Insanity in Norway. In this work, Dahl constructed pedigree charts in which he traced hereditary insanity through lineages. While the contribution of census-takers to psychiatric statistics is well-known to historians of psychiatry,[2] Porter demonstrates that the influence flowed in both directions. The visions of statisticians designing a new German census in the late 1860s “extended to counts of insanity,” and in 1867, the Medical-Psychological Society of Berlin contributed to these discussions. Such planning replaced the tables of alienists with a new system of card technologies on which data for individuals could be stored and readily “sent to data workers in households all over Berlin to be sorted into piles and counted off with hand movements like those of a dealer, then boxed up and returned for control.” It was a revolutionary technology, enabling “new combinations of categories,” and “far better suited to the preparation of complex tables than the old census lists” (Porter 176). By the last decades of the 19th century, the tables and ledger books of early alienists had been replaced by more flexible and detailed instruments for counting and dividing patient characteristics, including heredity.
The third and final section of Genetics in the Madhouse, “A Data Science of Human Heredity,” deals with a batch of more widely known characters in the history of science. Covering roughly the period from the late 19th century until the Second World War, Porter re-examines Francis Galton, Karl Pearson, Charles Davenport, and Lionel Penrose, among others. Well-known to historians of science, their research agendas nevertheless take on new significance when viewed from the context of the asylum. Porter links the origins of Galton’s research on heredity to the data made available by the asylum, while Davenport is seen to vacillate between the rigorously defined traits of psychiatric researchers undertaking Mendelian agendas and less demanding biostatisticians like Pearson, who was content with utilizing hereditary data from asylums and other institutions to study fuzzy categories like “insanity” or “feeblemindedness.” In 1911, New York-based neurologist Smith Ely Jelliffe criticized Davenport fervently on this point, arguing that the “great bane of psychiatry” has been “the hopeless confusion of statistical studies for lack of fundamental nosological conceptions” (Porter 269). While Porter clarifies well here the role of psychiatrists and asylums in making these debates possible, those interested specifically in the history of psychiatry may be disappointed that he does not go into finer detail regarding the relationship between emerging calls for, and debates over, psychiatric classification and disagreements such as that between Jelliffe and Davenport over the categories of psychiatric analysis.
Genetics in the Madhouse comprises succinct, accessible chapters and is largely devoid of recondite historiographical in-text discussions. Those hoping to read about the “patient’s perspective” will likely be disappointed, though we get an excellent idea about some of the technologies that have been developed to enumerate that figure. While the book’s scope is international, covering important contributions from British, European, Scandinavian, and American scientists, Porter is attentive to local distinctions. Disagreements over Bénédict Morel’s theory of degeneration (dégénérescence), for example, led French scientists to announce heredity too profound a concept to be visualized through data, while Germans got to building a database in order to do just that. Similarly, attention to the importance of the notion of Anlagen in German and Scandinavian psychiatry demonstrates that “heredity” was not everywhere an identical concept. Finally, as well as being an excellent contribution to histories of genetics and eugenics, Genetics in the Madhouse offers an important contribution to the history of psychiatry by way of attending to the discipline’s shifting use of paper technologies. Long before there were textbooks or detailed classification systems in psychiatry, there were ledgers, tables, and registers for recording patient data and for drawing divisions between those patients.
References
Theodore M. Porter, Genetics in the Madhouse: The Unknown History of Human Heredity (Princeton: Princeton University Press, 2018).
[1] Theodore M. Porter, Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton: Princeton University Press, 1995); The Rise of Statistical Thinking, 1820-1900 (Princeton, N.J. : Princeton University Press, 1986).
[2] See especially: Eric J. Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca: Cornell University Press, 2003).
