1. Emerson, Ralph Waldo, “Fate,” essay of 1851 in The Conduct of Life, Centenary Ed., 6 (Cambridge, Mass.: At the Riverside Press, 1904), 13.Google Scholar

2. From the Preface to Shryock, Richard Harrison, Medicine in America: Historical Essays (Baltimore: Johns Hopkins Univ. Press, 1966), p. xiiiGoogle Scholar. See also two other books by Shryock, , The Development of Modern Medicine: An Interpretation of the Social and Scientific Factors Involved (Philadelphia: Univ. of Penn. Press, 1936)CrossRefGoogle Scholar, and Medicine and Society in America, 1660–1860 (New York: New York Univ. Press, 1960)Google Scholar. Others who comment on the ties between medical history and cultural history are Duffy, John, The Healers: The Rise of the Medical Establishment (New York: McGraw-Hill, 1976)Google Scholar; Kett, Joseph F., The Formation of the American Medical Profession: The Role of Institutions, 1780–1860 (New Haven: Yale Univ. Press, 1968)Google Scholar; Rothstein, William G., American Physicians in the Nineteenth Century; From Sects to Science (Baltimore: Johns Hopkins Univ. Press, 1972)Google Scholar; Shafer, Henry Burnell, The American Medical Profession, 1783–1850Google Scholar, Faculty of Political Science of Columbia Univ. eds., Studies in History, Economics and Public Law, No. 417 (New York: Columbia Univ. Press, 1936); and Stern, Bernhard J., American Medical Practice in the Perspectives of a Century (New York: Commonwealth Fund, 1945).Google Scholar

3. Shryock, Richard Harrison, “The Need for Studies in the History of American Science” (1944), p. 301Google Scholar, and “The Interplay of Social and Internal Factors in Modern Medicine: An Historical Analysis” (1953), p. 307Google Scholar—both in Medicine in America.

4. Parsons, Talcott, “Social Structure and Dynamic Process: The Case of Modern Medical Practice,” in The Social System (Glencoe, Ill.: Free Press, 1951), pp. 431, 479.Google Scholar

5. Illich, Ivan, Medical Nemesis: The Expropriation of Health, Ideas in Progress: Open Forum (London: Calder & Boyers, 1975), p. 70Google Scholar, and Sontag, Susan, Illness as Metaphor (New York: Farrar, Straus & Giroux, 1978).Google Scholar

6. Illich, , pp. 37, 60.Google Scholar

7. Cassell, Eric, The Healer's Art: A New Approach to the Doctor-Patient Relationship (Philadelphia: J. B. Lippincott, 1976), p. 193.Google Scholar

8. Cited by Oliver Wendell Holmes as a statement made by one of Rush's biographers.—“Currents and Counter-Currents,” in Medical Essays, 1842–1882 (Boston: Houghton Mifflin, 1891), p. 180.Google Scholar

9. When Rush sued the British pamphleteer William Cobbett for libel because of his attacks against Rush's methods of bleeding and purging, contemporary politics was drawn in. Cobbett, backed by Hamilton, supported the Federalists, who believed in government directed by strong leaders free to impose “heroic” regulations on the citizenry. Rush stood with the Jeffersonians, who preferred a light hand in government, in the manner of what was later called “self-limiting,” or laissez-faire, medical therapy. In the trial (conducted during December 1799 in Philadelphia), therefore, Rush's medical practices took a position counter to his political beliefs. See Winthrop, and Neilson, Frances, Verdict for the Doctor: The Case of Benjamin Rush (New York: Hastings House, 1958).Google Scholar

10. Holmes warns against dabbling “in the muddy sewer of politics” in Medical Essays, p. 384Google Scholar. Even more circumspect, Dr. D. W. Cathell cautions against making any public show of personal political concerns, in his influential volume, The Physician Himself and What He Should Add to His Scientific Acquirements, 2nd ed., “carefully revised” (Baltimore: Cushing & Bailey, 1882), p. 11Google Scholar. On the other hand, the early years of the Republic found many physicians serving directly in politics. See Knapp, Samuel Lorenzo, Lectures on American Literature (New York: Bliss, 1829), Lecture 9, p. 122Google Scholar. See also “Doctors in Government,” Organization Section, The Journal of the American Medical Association, 163, No. 5 (02 2, 1957), 361–64Google Scholar, and Glaser, William A., “Doctors and Politics,” American Journal of Sociology, 66, no. 3 (11 1960), pp. 230–45.CrossRefGoogle Scholar

11. Illich, , p. 109.Google Scholar

12. Brown, Charles Brockden, Arthur Mervyn; or, Memoirs of the Year 1793, 1 (Charles Brockden Brown's Novels, 2) (Port Washington, N.Y.: Kennikat Press, 1963), 173–74.Google Scholar

13. Letter of November 24, 1808, in Ford, Paul L., ed., The Writings of Thomas Jefferson, 9 (New York: Putnam's, 1892–1899), 235.Google Scholar

14. See letter of Jefferson, to Adams, , 10 28, 1813Google Scholar, in ibid., pp. 425–26.

15. Letter of October 24, 1823, in ibid., 10:277. That Jefferson was normally for free trade is amply attested to. See The Anas of 06 3, 1792Google Scholar (ibid., 1:198); letter of August 13, 1800 (ibid., 7:452); Notes on the State of Virginia (ibid., 3: 279). But he went on record in “Report of Commerce and Navigation” (1793)Google Scholar that if foreign nations tried to impose commercial regulations, the United States would enforce “counter prohibitions, duties, and regulations, also” (ibid., 6:480). Hamilton, who wanted to “leave industry to itself,” also believed that if other nations placed monopolies on its goods, the United States would act likewise, “by the principles of distributive justice.” See “The Report on the Subject of Manufactures” of 1792, in Syrett, Harold C., ed., The Papers of Alexander Hamilton, 10 (New York: Columbia Univ. Press, 1979), 232–97Google Scholar. As for the “free trade” of people and ideas, Jefferson insisted (letter of June 20, 1816) that the United States had the right to keep out undesirables whose presence might upset the “fundamental principles of its association.” Wanting nothing to do with ‘ephemeral and pseudocitizens,” he said, “we may exclude them from our territory, as we do persons infected with disease” (Ford, 10:34). Of course, if “dangerous” ideas came from within American shores, they were approved, as when Jefferson noted in a letter of December 26, 1820, to Lafayette, “The disease of liberty is catching” (ibid., p. 179).

16. Price, Richard, Observations on the Importance of the American Revolution, and the Means of Making It a Benefit to the World (Boston: Powars & Willis, 1784), pp. 63–64Google Scholar. See also note 130, below.

17. See p. 76 below, and note 47, below, for the Hobbesian definitions.

18. Rush, Benjamin, Medical Inquiries and Observations upon the Diseases of the MindGoogle Scholar, The History of Medicine Series, Auspices of the Library of the New York Academy of Medicine, No. 15 (1812; rpt. New York: Hafner, 1962), pp. 114–15. By the 1840s, however, hypochondria, courtesy of the Whigs, was back in force; see Emerson's vivid account of the sickness in Gilman, William H. and Parson, J. E., The Journals and Miscellaneous Notebooks …, 8 (1841–1843; rpt. Cambridge, Mass.: Belknap Press, 1970), 87–89.Google Scholar

19. See D'Elia, Donald J., “Benjamin Rush: Philosopher of the American Revolution,” Transactions of the American Philosophical SocietyGoogle Scholar, new series, No. 64, part 5 (1974), 88. Rush would have nothing to do with the kind of heroic treatments that supported an imperialistic, nationalistic fever. See his “Medicine Among the Indians of North America; A Discussion” (1774)Google Scholar, and “A Plan for a Peace Office for the United States” (1799)Google Scholar, in Runes, Dagobert D., ed., The Selected Writings … (New York: Philosophical Library, 1947), pp. 286, 22–23Google Scholar. In the former essay Rush states that the ancient Jews and the Indians were a healthy people because theirs was a “democratic form of government.” By like means—naturally, without aggression—Americans could sustain their new Republic, pursue happiness, and keep in good health. Rush did not consider that the Jews and the Indians had difficulty in keeping from extinction at the hands of those who used “heroic” methods in order to curtail the “diseases” their alien ways of life seemed to spread.

20. Bigelow, Jacob, “On Self-limited Diseases: A Discourse Delivered Before the Massachusetts Medical Society, at Their Annual Meeting, May 27th, 1835,” in Nature in Disease: Illustrated in Various Discourses and Essays, to Which Are Added Miscellaneous Writings, Chiefly on Medical Subjects, 2nd ed., enlarged (New York: Wood, 1859), p. 49.Google Scholar

21. Bigelow, Jacob, “On the Treatment of Disease,”Google Scholar in ibid., pp. 66, 68.

22. Etzler, John Adolphus, The Paradise Within the Reach of All Men …, in The Collected Works, Facsimile Reproductions (Delman, N.Y.: Scholars' Facsimiles and Reprints, 1977), p. 55.Google Scholar

23. Thoreau, Henry David, “Paradise (To Be) Regained,” Democratic Review, No. 13 (11 1843), 451–63Google Scholar; included in Glick, Wendell, ed., Henry David Thoreau, Reform Papers (Princeton, N.J.: Princeton Univ. Press, 1973), pp. 19–47.Google Scholar

24. As an example of negative interpretation, see the full-scale attack (by means of a Freudian reading of the sanitation reforms led by Edwin Chadwick for the London slums) delivered by Schoenwald, Richard L., “Training Urban Man,” in Dyos, H. J. and Wolff, Michael, eds., The Victorian City: Images and Realities (London: Routledge & Kegan Paul, 1973), II, 669–92.Google Scholar

25. Jefferson, Thomas, Writings, Memorial Edition (Washington, D.C.: Jefferson Memorial Association, 1903), II, 230Google Scholar. When writing to Rush about the yellow fever (letter of September 23, 1800; Ford, Writings, 7:459), he shifted from reference to a literal disease to metaphor: “I view great cities as pestilential to the morals, the health and the liberties of men.”

26. Robert A. Ferguson makes this clear in his essay “‘Mysterious Obligation’: Jefferson's Notes on the State of Virginia,” American Literature, 52, No. 3 (11 1980), 381–406.Google Scholar

27. Hofstadter, Richard, Miller, William, Aaron, Daniel, eds., The United States: The History of a Republic, 2nd ed. (Englewood Cliffs, N.J.: Prentice-Hall, 1967), p. 708.Google Scholar

28. Rush, , “Medicine Among the Indians …,” p. 283Google Scholar; Thoreau, Henry David, “Paradise (To Be) Regained,” in Reform Papers, p. 20Google Scholar; Emerson, Ralph Waldo, “Power,” in Conduct of Life, p. 55. Italics added.Google Scholar

29. Emerson clearly states the danger of, and desire for, the attainment of a “single-theory” interpretation of complex matters in Nature, 1 (Centenary Edition, 3): “All Science has one aim, namely to find a theory of nature.… Whenever a true theory appears, it will be its own evidence. Its test is, that it will explain all phenomena.” That “all” is the sticking point.

30. Although Sennett and Sontag are highly critical of the injurious misuse, for political and social purposes, of metaphor, their own books indicate that if metaphors can be badly used, they also lead toward understanding. See Sennett, Richard, Authority (New York: Alfred A. Knopf, 1980)Google Scholar, and Sontag. As Lian Hudson points out, “Metaphors permeate thought, and thought guides action.” See Hudson's review of George Lakoff and Mark Johnson, Metaphors We Live By, in Times [London] Literary Supplement, No. 4, 067 (03 13, 1981), 271–72Google Scholar. And social action is what is being examined—the consequences of metaphoric thought.

31. Booth, Wayne, “Metaphors as Rhetoric,” Critical Inquiry, 5, No. 1 (Autumn 1978), 66CrossRefGoogle Scholar. The next quotation is from p. 68. Booth's essay is in an issue devoted entirely to examination of the legitimacy of the metaphor as a means of getting at truth.

32. This quotation and the following extract are from the abstract of Chapter 4 provided by Wallas, Graham in Human Nature in Politics (New York: Alfred A. Knopf, 1921), p. 19.Google Scholar

33. Bateson, Gregory, Mind and Nature: A Necessary Unity (New York: E. P. Dutton, 1979), pp. 11, 170.Google Scholar

34. Thomas, Lewis, The Lives of a Cell: Notes of a Biology Watcher (New York: Viking Press, 1974), pp. 12, 14Google Scholar. The following quotations are from pp. 14, 104, 5. See also Thomas, Lewis, The Medusa and the Snail: More Notes of a Biology Watcher (New York: Viking Press, 1979), pp. 3–4Google Scholar, where Thomas states that biological information justifies the speculation that all creatures are “determined” to “locate others, not for predation but to set up symbiotic households.”

35. Brody, Howard, “The Systems View of Man: Implications for Medicine, Science, and Ethics,” Perspectives in Biology and Medicine, No. 17 (Autumn 1973), 71–92Google Scholar. The diagram is from p. 74. Brody is most interested in what his “systems” view promises “for the expectations of the concepts ‘health’ and ‘disease’” He believes this method can solve many current medical problems.

36. Wilson, Edward O., On Human Nature (Cambridge, Mass.: Harvard Univ. Press, 1978).Google ScholarPubMed

37. Thomas, , The Medusa and the Snail, pp. 3, 10Google Scholar. Hobbes rejects the notion that communities of bees and of men have anything in common: The former are naturally good to one another; the latter are not. See Hobbes, Thomas, Elements of Law, Natural and Politic, 2nd ed., with new Introduction by M. M. Goldsmith, ed. Tonnies, Ferdinand (London: Cass, 1969), pp. 102–3.Google Scholar

38. Wills, Garry, Inventing America: Jefferson's Declaration of Independence (Garden City, N.Y.: Doubleday, 1978)Google Scholar. Chapter 7 shows Jefferson approaching the Declaration as a “scientific paper.” Daniel Boorstin's The Lost World of Thomas Jefferson (New York: Holt, 1948)Google Scholar turns specifically to the ideas held by Rush and other members of the American Philosophical Society that link together physiological, mechanical, and political data. See letter of February 23, 1798, from Jefferson that likens the constitutional government to planets in balanced orbit; in Jefferson, Memorial Edition, 10:3.

39. Macpherson, C. B., The Political Theory of Possessive Individualism: Hobbes to Locke (Oxford: Clarendon Press, 1962)Google Scholar; Coleman, Frank M., Hobbes and America: Exploring the Constitutional Foundations (Toronto: Univ. of Toronto Press, 1977)CrossRefGoogle Scholar; Mace, George, Locke, Hobbes, and the Federalist Papers: An Essay on the Genesis of the American Political Heritage (Carbondale and Edwardsville: Southern Illinois Univ. Press, 1979)Google Scholar; Hinnant, Charles, Thomas Hobbes (Boston: Twayne, 1977)Google Scholar; Lemos, Ramon, Hobbes and Locke: Power and Consent (Athens: Univ. of Georgia Press, 1978)Google Scholar. Essays by Chapman, Chaudhuri, Rossun, and Scaff appear in Chaudhuri, Joyotpaul, ed., The Non-Lockean Roots of American Democratic Thought (Tucson: Univ. of Arizona Press, 1977).Google Scholar

40. Hobbes, Thomas, Leviathan; or, The Matter, Form, and Power of a Commonwealth, Ecclesiastical and CivilGoogle Scholar, in SirMolesworth, William, ed., The English Works … (London: Bohn, 1839), 3:113.Google Scholar

41. In Molesworth, 2 (London: Bohn, 1841), 5.

42. Ibid., p. 6.

43. Ibid., pp. 115–17. On page 132, Hobbes indicates that “natural” fathers are good only for “generation,” while “preservation” is the mother's work. Only the “artificial” father—the “sovereign”—is capable of taking over the mother's role.

44. Ibid., p. 44.

45. Hobbes, Thomas, Elements of PhilosophyGoogle Scholar, in Molesworth, I:11. In his “Epistle Dedicatory” (p. viii) Hobbes praises the study of natural science for contributing to knowledge of the nature of motion (as furthered by Galileo), especially as exemplified by “man's body” (as advanced by the “new doctrine” of Doctor Harvey). “The end of knowledge is power” (p. 7); the knowledge of physics and physicians is about power and how it is attained. Macpherson (pp. 10, 18, 40) qualifies previous arguments that Hobbes's political theory rests only on psychological principles; he believes that Hobbes drew heavily on the “laws of the motion of material” implied to be “physiological,” which is what Jefferson and Rush took the study of nature's mechanics to be. In his quest for effective “motion,” Hobbes's man is as much a body in action as a mass of emotions. Thus the medical slant is appropriate for following Hobbes's theory to its expression in American political policy. In his Introduction to Elements of Law Goldsmith states that the “organic analogy” in Leviathan is merely incidental to Hobbes's line of argument. I grant that the connections between the body natural and the body politic fade in and out like static, but where they appear they are expressed with a clarity and forcefulness that command our attention.

46. Hobbes, , Elements of Law, pp. 1, 71.Google Scholar

47. Ibid., p. 193.

48. Hobbes, , Leviathan, p. 306.Google Scholar

49. Ibid., p. x.

50. Ibid., p. 196.

51. Ibid., pp. 306–9. The following quotations are from pp. 309 and 319–21.

52. Hinnant, Charles, p. 124.Google Scholar

53. Locke, John, Two Treatises of Government, ed. Laslett, Peter (Cambridge, U.K.: At the Univ. Press, 1960), p. 289. Italics added.Google Scholar

54. C. Delisle Burns, essay on “Politics,” in Hastings, James, ed., Encyclopaedia of Religion and Ethics, 10 (New York: Scribner's, 1908), 101Google Scholar. Actually Locke's references are more “physical” than Hobbes's because the latter made mathematics, not anatomy, the basis of his physiology of human mechanics.

55. Locke, , pp. 250–51.Google Scholar

56. See Dewhurst, Kenneth, John Locke (1632–1704), Physician and Philosopher: A Medical Biography, with an Edition of the Medical Notes in His Journals (London: Wellcome Historical Medical Library, 1963).Google Scholar

57. Locke, , p. 164.Google Scholar

58. Ibid., p. 349.

59. Ibid., p. 351.

60. Ibid., pp. 368–69. Hobbes and Locke agree that if men were differently constituted, there would be no governments. For “were it not for the corruption, and vitiousness of degenerate Men, there would be no need of any other, no necessity that Men should separate from this great … Community [of nature], and by positive agreements combine into smaller and divided associations” (ibid., p. 370). See Leviathan, p. 155Google Scholar, for Hobbes's statement of what could be but is not since men are what they are.

61. Henry D. Aiken—editor of Hume's Moral and Political Philosophy (New York: Hafner, 1948)Google Scholar —offers an important comment on the kind of laissez-faire approach Hume's notion of “little governing” implies (pp. xlv–xlvi). Today's theorists who pick up on the Humean theme of limited government action out of their own dislike of totalitarianism are overlooking the fact that Hume thought people need few laws only because they are habituated by custom to unconscious obedience to the state's authority. Because the state does not consider it ought to act vigorously to serve the people, there is no occasion for it to assume (for better or worse) “protectionist” powers. As for Locke, note the difference between his position and that of Rush. Rush the physician was for the “artifice” of extreme interventionist therapies; Rush the political theorist generally preferred a free play of social action on the part of citizen and society. Locke the doctor and Locke the theorist assumed the reverse of Rush's positions.

62. Syrett, 4, n. 1, 216; speech to the Constitutional Convention of June 22, 1787, as reported by Robert Yates. The conversation is reported in Adams, James Truslow, Hamiltonian Principles (Boston: Little, Brown, 1928), p. xvii.Google Scholar

63. Thomas Jefferson, letter of February 4, 1792, to President Washington, in Ford, 5: 438; Paine, Thomas, The Rights of Man, Part 2 (1792)Google Scholar, in Conway, Moncure D., ed., Writings … (New York: Putnam's, 1894–1896), pp. 412–13.Google Scholar

64. Three examples: Scanlan, James P., “The Federalist and Human Nature,” Review of Politics, 21, No. 4 (10 1959), 657–77CrossRefGoogle Scholar; Wills, Garry, Explaining America: The Federalist (Garden City, N.Y.: Doubleday, 1981)Google Scholar; Wright, Benjamin F., ed., The Federalist, by Alexander Hamilton, James Madison, and John Jay (Cambridge, Mass.: Belknap Press, 1961)Google Scholar. Wright comments (p. 26) on the importance of the mixed elements of human nature as the premise lying behind the preparation of these papers and their author's defense of the Constitution.

65. Henry David Thoreau, journal entry of June 1850, in Torrey, Bradford and Sanborn, Franklin B., The Writings …, 9 (Journals, 2) (Boston: Houghton Mifflin, 1906), 45.Google Scholar

66. Jackson in his 1834 “protest” to the Senate, quoted in Remini, Robert V., ed., The Age of Jackson (Columbia: Univ. of South Carolina Press, 1972), pp. 116–17.Google Scholar

67. Ferguson, Robert (“Mysterious Obligation,” p. 405)Google Scholar speaks of it as a time when citizens of the new Republic were “obsessed with its frailty,” a fact made clear by Jefferson's Notes on the State of Virginia, a “combination of assertions and anxiety.” That “bodies” are mortal may be why Paine rejected this traditional metaphor, preferring to liken the nation to a body contained within a circle; geometry is not disease-prone. See Paine, , p. 425.Google Scholar

68. John Dickinson, letter 12 of Letters from a Farmer in Pennsylvania in The Writings, I, Political Writings, 1764–1774 (Philadelphia: Historical Society of Pa., 1895), p. 401.Google Scholar

69. Syrett, 5:74.

70. Rutland, Robert A., ed., The Papers of James Madison, 10 (Chicago: Univ. of Chicago Press, 1977), 265–66.Google Scholar

71. Ford, 5:121.

72. Wills, , Explaining America, p. 166.Google Scholar

73. Ibid., pp. xvi–xvii, 163.

74. Hobbes, , Leviathan, p. 319.Google Scholar

75. Flexner, Abraham, Medical Education in the United States and Canada (New York: Carnegie Foundation for the Advancement of Teaching, 1910), p. 53.Google Scholar

76. Hobbes, , “Epistle Dedicatory,” in Human Nature: or, The Fundamental Elements of PolicyGoogle Scholar, from Tripos: in Three Discourses, in The English Works, 4:120–21.Google Scholar

77. See Part 1 of De Corpore Politics, in Tripos, 4:120–21.Google Scholar

78. Thomas, , The Medusa and the Snail, p. 15.Google Scholar

79. Remini, , The Age of Jackson, p. 75.Google Scholar

80. In Part 2 of De Corpore Politico from Tripos, 4:163–64Google Scholar, Hobbes insists this is only an apparent inconvenience, because it is based on a man's belief that his own “liberty” comes about solely when he rules over others. The Hobbesian position insists that “natural equality” is the same as the “social inequity” that results when one man's might is another's subservience. See Part 1, pp. 85–87.

81. Hobbes, , Of Liberty and Necessity, from Tripos, 4:273–74.Google Scholar

82. Hobbes, , Human Nature, from Tripos 4:53.Google Scholar

83. See Hobbes on political equilibrium, English Works, 4:104Google Scholar, and Dr. William Osier on the merits of medical equanimity, Aequanimitas, with Other Addresses to Medical Students, Nurses and Practitioners of Medicine (Philadelphia: Blakiston's, 1904).Google Scholar

84. Chris Holmes provides a detailed, convincing account of the development of Rush's approach, which under the cultural and scientific conditions of the time, makes the “logic” Rush followed in connecting treatment to theory more understandable, in “Benjamin Rush and the Yellow Fever,” Bulletin of the History of Medicine, 40, No. 3 (05–06 1966), 246–63.Google Scholar

85. Rush's remark is quoted on page 95 of John Duffy's The Healers. Other studies offering indispensable information about the battle between the therapies and about other medical developments are the works listed above in note 2. Also useful are Corner, George W., Two Centuries of Medicine: A History of the School of Medicine, University of Pennsylvania (Philadelphia: J. B. Lippincott, 1965)Google Scholar; Galdston, Iago, “Doctor and Patient in Medical History,” The Journal of Medical Education, 37, No. 3 (03 1962), 222–32Google ScholarPubMed; Holmes, Bayard, The Friends of the Insane, the Soul of Medical Education, and Other Essays (Cincinnati: Lancet-Clinic, 1911)Google Scholar; King, Lester S., The Road to Medical Enlightenment, 1650–1695, History of Science Library (London: American Elsevier, 1970)Google Scholar; Long, Esmond R., A History of Pathology (New York: Dover Publications, 1965)Google Scholar; and SirOsier, William, The Evolution of Modern Medicine: A Series of Lectures Delivered at Yale University on the Silliman Foundation in April, 1913 (New Haven: Yale Univ. Press, 1921).Google Scholar

86. Shafer, , p. 97.Google Scholar

87. Women were particularly alert to the effects of well-meant but inept heroic therapies. The best of a group of current studies of this subject is Morantz, Regina, “The Lady and Her Physician,” in Hartman, Mary S. and Banner, Lois, eds., Clio's Consciousness Raised (New York: Harper & Row, 1974), pp. 38–53.Google Scholar

88. On one occasion Rush indulged the hope that men could reform the body into the attainment of angelic moral faculties. See his 1786 essay “The Influence of Physical Causes upon the Moral Faculty,” in Selected Writings, pp. 181–211.Google Scholar

89. Rush saw fever as an enemy that (in his words) “requires medicine that possesses the strength of Hercules to subdue it.” See Holmes, p. 250. In 1862 the fevers in New York City's slums were also causing the concerned to call for a “Hercules.” See Brieger, Gert H., “Sanitary Reform in New York City: Stephen Smith and the Passage of the Metropolitan Health Bill,” Bulletin of the History of Medicine, 40, No. 5 (09–10 1966), 417.Google Scholar

90. Especially helpful here are Shryock, , Medicine in America, pp. 314–25Google Scholar, and Medicine and Society in America, pp. 44–81Google Scholar; Long; Duffy, , p. 27Google Scholar; and Appendix I (“Rush's Medical Theories”) provided by George Corner for his edition of The Autobiography of Benjamin Rush: His “Travels Through Life,” Together with His Commonplace Book for 1789–1813 (Princeton, N.J.: Princeton Univ. Press, 1948)Google Scholar. The humoral tradition continued during the time of the emergence of the iatrophysical (or iatromathematical) school and the iatrochemical theory, the growth of anatomical pathology, and Haller's experiments on nerves and tissues. What was at stake was whether diseases were to be seen as the malfunctioning of a machine or of chemical action, as an imbalance of humoral fluids or of the nervous system. In general, emphasis was placed on stimulus and response and on nervous activity as the main, if not the only, cause of disease.

91. Corner, , The Autobiography of Benjamin Rush, p. 364.Google Scholar

92. Holmes, , “Scholastic and Bedside Teaching,” in Medical Essays, p. 292.Google Scholar

93. Rush, Benjamin, “Medicine Among the Indians,”Google Scholar in Runes, , p. 273.Google Scholar

94. The intention of Colonel P. M. Ashburn (Medical Corps, U.S. Army) in The Ranks of Death: A Medical History of the Conquest of A merica (New York: Coward-McCann, 1947)Google Scholar is to show that the diseases brought by European settlers caused the defeat of the American Indians; it was perhaps not deliberate destruction, but the consequences were the same. See also Duffy, , pp. 5, 12Google Scholar, and Shryock, , p. 83.Google Scholar

95. Concerning the cultural causes of such time lags, see Bateson, , pp. 220–21Google Scholar, and Ogburn, William Fielding, Social Change with Respect to Culture and Original Nature (New York: Huebsch, 1923).Google Scholar

96. See Malcolm, Janet, “Profiles: The Impossible Profession,” The New Yorker, Part 1: 56, No. 40 (11 24, 1980), 61–62, 92Google Scholar; Part 2: 56, No. 41 (December 1, 1980), 146, 150—concerning Freud's shift from heroic, “cathartic” treatment to laissez-faire practices of psychoanalysis.

97. Sims, J. Marion, The Story of My Life (New York: Appleton, 1884), p. 150.Google Scholar

98. There was a great discrepancy between the theories advanced at the centers of medical training (themselves of differing quality) and the everyday practices of the country's doctors, who were largely unaware of changes in medical knowledge. There was also a gap between the “best” doctors and the others in training, as well as in their economic and social standing, since education translated into money and prestige. See Duffy, , The Healers, pp. 98, 180.Google Scholar

99. Jackson, James, Another Letter to a Young Physician: To Which Are Appended Some Other Medical Papers (Boston: Ticknor & Fields, 1861)Google Scholar. Jackson carried out suggestions made by Bigelow in 1835 and anticipated the clinical nihilism of Holmes and his generation; all three men were influential in making Harvard Medical School a major institution by the 1830s. While a student in 1808 in Philadelphia, Bigelow attended the lectures of Rush and Caspar Wistar; he later opposed Rush's methods, which Wistar also disliked. Jefferson, a close friend of both Wistar's and Rush's, wrote Wistar on June 21, 1807, to declare his objections to heroic therapy and his preference for natural cures. See Ford, , 9: 78–85Google Scholar. Keep the date of Jackson's essay in mind; the Civil War provided sobering lessons about the inadequacies of the medical profession. Far more men died of disease and infections than in battle, as had been the case during the Revolutionary War (a fact that caused Rush's famous run-in with General Washington over the administration of the field hospitals by William Shippen). See Butterfield, L. H., ed., Letters of Benjamin Rush, 1 (1761–92) (Princeton, N.J.: Princeton Univ. Press, 1951), 175–76, 182–83Google Scholar, and Benger, Carl, Revolutionary Doctor: Benjamin Rush, 1746–1813 (New York: W. W. Norton, 1966), 121Google Scholar. For accounts of the appalling losses because of infections during the Civil War, see Shryock, , pp. 90–108Google Scholar; Adams, George Washington, Doctors in Blue: The Medical History of the Union Army in the Civil War (New York: Collier, 1961)Google Scholar; and Steiner, Paul E., Physician-Generals in the Civil War: A Study in Nineteenth Mid-Century American Medicine (Springfield, Ill.: Charles C Thomas, 1966).Google Scholar

100. Jackson, , p. viiGoogle Scholar. The following quotations are from pp. viii, ix.

101. Williams, William Carlos, The Autobiography of William Carlos Williams (New York: Random House, 1951), pp. 94–95.Google Scholar

102. Locke, 's De Arte MedicaGoogle Scholar in English translation is included in Gibson, Alexander George, The Physician's Art: An Attempt to Expand John Locke's Fragment De Arte Medica (Oxford: Clarendon Press, 1933).Google Scholar

103. James, Henry, The American Scene (Bloomington: Indiana Univ. Press, 1968), pp. 325–26.Google Scholar

104. Emerson, , Nature, 1:4.Google Scholar

105. See Jefferson, 's letters of 08 19, 1785Google Scholar, and July 6,1787, in The Papers of Thomas Jefferson (Princeton, N.J.: Princeton Univ. Press), 8 (1953), 407; 11 (1955), 558.Google Scholar

106. Bigelow, Jacob, “On Self-Limited Diseases”Google Scholar and Preface to 1st ed., in Nature in Disease, pp. 14, viii.Google Scholar

107. Life and Medical Discoveries of Samuel Thomson, and, History of the Thomsonian Materia Medica, as Shown in “The New Guide to Health” (1835)Google Scholar, with the Literature of the Day, Bulletin of the Lloyd Library of Botany, Pharmacy, and Materia Medica, Bulletin No. 11 (1909)Google Scholar, Reproduction Series, No. 7. (Cincinnati: Lloyd, 1909), p. 9.Google Scholar

108. Cathell, , p. 157.Google Scholar He continued the same argument intact into the eleventh edition, Book on the Physician Himself…, Twentieth Century Ed. (Philadelphia: Davis, 1902).Google Scholar

109. What Rush deemed the “dietary revolution” began in the late eighteenth century and continued to pick up converts under the leadership of such men as Sylvester Graham. See Shryock, , Medicine in America, pp. 27, 111–25Google Scholar, and Duffy, , pp. 112, 119.Google Scholar See also comments in Holmes, , Medical Essays, p. 275Google Scholar, and Osier, , p. 130.Google Scholar Cleanliness grew apace, but dismaying lapses still occurred. Cathell's bible of respectable medical practices advised that dressings used to treat gonorrhea and syphilis be collected in a pail, then burned when enough had accumulated, and that examining instruments be wiped clean with a wet rag (Book on the Physician Himself, p. 27).Google Scholar Septic conditions in the army hospitals (see note 99, above), where a kind of “biological warfare” was carried out, however unintentionally, were scandalous. See Steiner, , p. 3.Google Scholar

110. See Shryock, , Medicine and Society, pp. 154–58.Google Scholar

111. See Duffy, , pp. 173–76, 185–88Google Scholar, and Flexner, , pp. vii–xvii, 3–19, 28–51.Google Scholar

112. It took more than a century after Rush's experiences to learn how to end yellow-fever epidemics. See Osier, 's account (Evolution of Modern Medicine, pp. 223–31)Google Scholar of the successful efforts of the U.S. Army Medical School Commission that led to Reed, Walter's “mosquito theory” of 1900.Google Scholar See also Duffy, , The Healers, pp. 239–40.Google Scholar

113. Shryock's theory is that the practical nature of American society, led by nineteenth-century commercial interests that placed utilitarian know-how before theoretical research, retarded medical science in ways not common in Britain or Europe. See his Medicine in America, pp. 71–89Google Scholar; see also Duffy, , pp. 228–31.Google Scholar Taking exception to this view, Donald Fleming emphasizes the ways in which businessmen helped to back health reforms, and he details the formation of the Rockefeller Foundation under the directorship of Dr. William Welch. See Fleming, 's William H. Welch and the Rise of Modern Medicine (Boston: Little, Brown, 1954), p. 153.Google Scholar

114. Duffy, , p. 231.Google Scholar

115. Ibid., p. 51.

116. This phrase was used ironically by Dr. J. Marion Sims in his 1876 AMA presidential address (see Rothstein, p. 200), but the association preferred to take it seriously.

117. Extensive documentation and interpretation of licensing procedures are available. They give the details of the processes by which various self-appointed groups jockeyed for authority to regulate exclusion or to open the gates to all comers. Either action might have been prompted by laudable motives or for selfaggrandizing reasons. Useful sources are Duffy, , pp. 54–71, 241, 291–97Google Scholar, and Shryock, , Medical Licensing in America, 1650–1965 (Baltimore: Johns Hopkins Univ. Press, 1967).Google Scholar Also see Rothstein, , pp. 107–8Google Scholar; and Pilcher, Lewis S., “Codes of Medical Ethics,”Google Scholar “American Medical Association, First Code of Medical Ethics,” and “American Medical Association, Principles of Medical Ethics”—all contained in Reiser, Stanley Joe, Dyck, Arthur J., and Curran, William J., eds., Ethics in Medicine: Historical Perspectives and Contemporary Concerns (Cambridge, Mass.: MIT Press, 1977), pp. 26–39.Google ScholarShryock, , Development of Modern Medicine, p. 255Google Scholar, and Kett, , Formation …, p. 165Google Scholar, quote declarations made in 1844 and 1847 that take opposed political views of licensing.

118. See D'Elia, , “Benjamin Rush,” p. 63Google Scholar, for his discussion of Rush's Enlight enment view of progress as an inevitable cause of betterment of social conditions, both political and medical, through reason, Christianity, and God's will. Rush did not, however, define the doctor's role as that of a passive witness to divine action. Medicine was a human activity, and diseases were natural phenomena.

119. Holmes, , “Currents and Counter-Currents,” in Medical Essays, pp. 195–96.Google Scholar

120. Holmes, , Medical Essays, p. 212.Google Scholar This essay's title and date are significant: “Border Lines in Medical Science” of 1861.Google Scholar

121. Ibid., pp. 259–60. The next quotation is from page 267.

122. Schlesinger, Arthur M. Jr., “Ideas and Economic Development,” pp. 113–15Google Scholar, and Lerner, Max, “The Triumph of Laissez Faire,” pp. 147–48Google Scholar, both in Schlesinger, Arthur M. Jr, and White, Morton, eds., Paths of American Thought (Boston: Houghton Mifflin, 1963).Google Scholar

123. The Annals of the American Academy of Political and Social Science, vol. 346 (03 1963)Google Scholar is devoted to this subject. It contains excellent essays by Edmund D. Pellegrino, Robert Straus and John A. Clausen, Eliot Freidson, Talcott Parsons, Milton I. Roemer, and Robert N. Wilson.

124. Quoted in Schlesinger, Arthur M. Jr., The Age of Jackson (Boston: Little, Brown, 1949), p. 335.Google Scholar On page 338 he observes that businessmen of the period were largely unaware of what was falling into their laps; they continued to fight programs promoting their own interests.

125. Remini, , pp. 94, 97–98.Google Scholar

126. Schlesinger, , Age of Jackson, pp. 341–42.Google Scholar

127. Remini, , p. 183.Google Scholar

128. Hooker, Worthington, Physician and Patient; or, A Practical View of the Mutual Duties, Relations and Interests of the Medical Profession and the Community (New York: Baker & Scribner, 1849), pp. 252, 257.Google Scholar

129. Hofstadter, , Miller, , and Aaron, , The United States, pp. 531.Google Scholar In contrast, Fleming, Donald, in William H. Welch and the Rise of Modern Medicine, p. 139Google Scholar, argues that social Darwinism was a weak and short-lived force. Whatever the big-business groups were up to, there is ample evidence of the growth of social and medical reform alliances. See Duffy, , The Healers, pp. 198–211, 303–15Google Scholar; see also Duffy, , “An Account of the Epidemic Fevers That Prevailed in the City of New York from 1791 to 1822,” The New-York Historical Society Quarterly, 50, No. 4 (10 1966), 332–64Google ScholarPubMed, for a study of one of the earliest of these movements. See also Duffy, , A History of Public Health in New York City, 1625–1866, and 1866–1966 (2 vols.) (New York: Russell Sage Foundation, 1968)Google Scholar; Brieger, Gert H., “Sanitary Reform in New York City”; and Carter, Richard, The Gentle Legions (Garden City, N.Y.: Doubleday, 1961).Google ScholarGarceau, Oliver, The Political Life of the American Medical Association (Cambridge, Mass.: Harvard Univ. Press, 1941), pp. 394–95Google Scholar, speaks of the AMA's recent reluctance to be “political,” although their active involvement in reform movements continued until the 1920s. Duffy indicates that the “enlightened self-interest” of businessmen in the 1880s and 1890s led them to support many reforms (The Healers, p. 314).Google Scholar See also Lubove, Roy, The Progressives and the Slums: Tenement House Reform in New York City, 1890–1907 (Westport, Conn.: Greenwood Press, 1974).Google Scholar

130. See Duffy, , The Healers, pp. 191–92Google Scholar, and Lubove, , pp. 52–55Google Scholar, on the fears expressed about the immigrants who were said to be importing European filth and infecting the “natives” with their diseases. Such sentiments hardly revealed awareness of the devastating diseases the Europeans (ancestors of those now on the attack) had imposed on the native American Indians in the seventeenth century.

131. Article 25,1 of the Universal Declaration of Human Rights was adopted by the United Nations in 1948 and expanded in 1966. It stresses everyone's right “to a standard of living adequate for the health and well-being of himself and his family.”

132. Thomas, , Lives of a Cell, p. 81.Google Scholar

133. Deaths of the young from infectious diseases have dropped markedly, while deaths of the aged from diseases of the circulatory organs have increased. See Cohn, Alfred E. and Lingg, Claire, The Burden of Disease in the United States (New York: Oxford Univ. Press, 1950).Google Scholar

134. Cassell, , The Healer's Art, p. 62.Google Scholar

135. Batt, John, “They Shoot Horses, Don't They,” UCLA Law Review, 15, No. 2 (02 1968), 510–50.Google Scholar

136. Reiser, Stanley, Medicine and the Reign of Technology (Cambridge, U.K.: Cambridge Univ. Press, 1978), pp. 198–99, 201Google Scholar, deplores the loss of human touch to machines that contribute more errors than accuracy while cutting back on the intimate information that can be conveyed only by patient to physician.

137. Cassell, , The Healer's Art, pp. 66, 99, 102, 105.Google Scholar

138. Rawls, John, A Theory of Justice (Cambridge, Mass.: Belknap Press, 1971).Google Scholar

139. Brieger, 's essay “Sanitary Reform in New York City,”Google Scholar on municipal actions that retarded necessary health reforms during the Civil War, presents an example of the latter instance.

140. Rush, Benjamin, “On the Application of Metaphysicks to Medicine,”Google Scholar from a manuscript cited in D'Elia, , “Benjamin Rush,” p. 67.Google Scholar

141. Brown was present during the early days of the epidemic before fleeing for New York in September. President Washington, Secretary of State Jefferson, and Secretary of the Treasury Hamilton also left quickly. (Hamilton had contracted the fever and been treated by Rush's rival Dr. Edward Stevens.) John Adams directly equated the disease-ridden city with what he called the constitutional crisis facing the nation that summer.

142. Carey, Mathew, A Short Account of the Malignant Fever Lately Prevalent in Philadelphia, 4th ed., improved (Philadelphia, 1794; rpt. New York: Arno Press, 1970), p. 23.Google ScholarPowell, J. H.'s book is Bring Out Your Dead: The Great Plague of Yellow Fever in Philadelphia in 1793 (Philadelphia: Univ. of Pennsylvania Press, 1949).CrossRefGoogle Scholar Rush's account is entitled An Account of the Bilious Remitting Yellow Fever as It Appeared in the City of Philadelphia in the Year 1793 (Philadelphia: Dobson, 1794).Google Scholar The quotations that follow with pagination given within parentheses are all from Carey.

143. Powell, , p. 253.Google Scholar During another time of plague John Adams wrote Rush of the latter's fight against “the empire of death”; referred to the fever as being like foreign-born toryism; equated cities, fevers, and “democracy”; and noted the quackery in politics and medicine. See Schutz, John A. and Adair, Douglass, eds., From The Spur of Fame: Dialogues of John Adams and Benjamin Rush, 1805–1813 (San Marino, Calif.: Huntingdon Library, 1966), pp. 21, 23, 37, 50, 243.Google Scholar

144. Devèze is obviously Powell's hero, but Chris Holmes's essay “Benjamin Rush and the Yellow Fever” still stands as the most balanced review of the medical situation.

145. “When Muncie Was Under Martial Law” and “When Muncie Was Under Quarantine Law,” in Haimbaugh, Frank D., ed., History of Delaware County, Indiana, 1 (Indianapolis: Historical Publications, 1924), 570–72.Google Scholar

146. Rush, Benjamin, “Of the Mode of Education Proper in a Republic” (1798)Google Scholar, in Runes, , The Selected Writings …, p. 90.Google Scholar

147. Walzer, Michael, Radical Principles, Reflections of an Unreconstructed Democrat (New York: Basic Books, 1980), p. 95.Google Scholar

148. Parsons, Talcott, “Social Change and Medical Organizations in the United States: A Sociological Perspective,” The Annals of the American Academy of Political and Social Science, No. 346 (03 1963), p. 22.Google Scholar

149. Brody, Howard, “The Systems View of Man,” p. 76.Google Scholar

150. May, William, “Code, Covenant, Contract, or Philanthropy,” in Hastings Center Report, No. 5 (12 1975), 29–38.Google Scholar A revised and expanded version is given in Reiser, , Dyck, , and Curran, , Ethics in Medicine, pp. 65–76.Google Scholar Subsequent parenthetical page references are to the latter version.

151. Berlant, Jeffrey, Profession and Monopoly: A Study of Medicine in the United States and Great Britain (Berkeley: Univ. of California Press, 1975).Google Scholar In all the statements made by Percival and the AMA codes of 1847, 1913, 1921, 1949, and 1957, Berlant finds anticompetitive sentiments (pp. 64–127).

152. Parsons, Talcott, “The Sick Role and the Role of the Physician Reconsidered,” Milbank Memorial Fund Quarterly, health-and-society issue, No. 53 (Summer 1975), 257–77.Google Scholar

153. The old-fashioned aspect of codes that call for a paternalistic stance is borne out not only by Sennett, 's AuthorityGoogle Scholar but also by Parsons's observation that the members of the AMA act collectively as an anachronism of small-town businessmen and the nineteenth-century middle class (Parsons, , “Social Change and Medical Organizations,” p. 32).Google Scholar

154. Thomas, , Lives of a Cell, pp. 40–41.Google Scholar The next two quotations are from pp. 76 and 131–32.

155. Virchow, Rudolf, Cellular Pathology, as Based upon Physiological and Pathological Histology: Twenty Lectures Delivered in the Pathological Institute of Berlin During the Months of February, March and April 1858, trans, from 2nd ed. by Chance, Frank (New York: De Witt, 1860), pp. 50–51.Google Scholar Page references for further quotations will be given within parentheses.

156. Long, , History of Pathology, pp. 114, 122Google Scholar, accuses Virchow of being a dreamer who sought the “one true theory.” Virchow himself recognized what the mind wants most (to impose unity), in contrast to what the body does (force multiplicity of meanings). See Virchow, p. 323. To adapt D. H. Lawrence's suggestion to Virchow's theory, one must (as Virchow implies) trust the text (the organism), not the author (the interpreting theorist).

157. Hobbes, , Leviathan, pp. 40–41.Google Scholar

158. Wills, , Inventing America, pp. 185–89Google Scholar, and Boorstin, , The Lost World, pp. 53, 245.Google Scholar

159. Etzler, John Adolphus, The New World of Mechanical System (1840), p. 5Google Scholar, in the same volume as Etzler, , The Paradise Within the Reach of All Men.Google Scholar

160. Thomas, , The Medusa and the Snail, p. 14.Google Scholar He goes on to say, “This is what I meant in proposing the committee as the basis of terrestrial life. The most centrally placed committee… is the vast community of prokaryotic, nonnucleated, microbes.”

161. Bosanquet, Bernard, The Philosophical Theory of the State (London: Macmillan, 1958), p. 158.Google Scholar The following quotations are from pp. 19 and 34.

162. Wallace, Anthony, “The Psychic Unity of Human Group,” in Kaplan, Bert, ed., Studying Personality Cross-culturally (Evanston, Ill.: Row, Peterson, 1961) p. 137.Google Scholar

163. Cassell, , The Healer's Art, pp. 92, 138.Google Scholar

164. Thomas, , in The Lives of a Cell, pp. 79–80Google Scholar, describes how biological mechanisms cause self-disintegration when unnecessarily “panic-driven” by instinctual “memories” of fear as a result of which the organism “launches all his defenses at once and destroys himself.” The sorry fact is that it kills itself not because of any real danger but by a “response to propaganda” that releases endotoxins. “We tear ourselves to pieces because of symbols, and we are more vulnerable to this than to any host of predators. We are, in effect, at the mercy of our own Pentagons, most of the time.”

165. Parsons, , The Social System, pp. 450, 469.Google Scholar

166. Thomas, , The Lives of a Cell, p. 76.Google Scholar

167. Ramsay, Paul, The Patient as Person: Explorations in Medical Ethics (Lyman Beecher Ethics at Yale; New Haven: Yale Univ. Press, 1970), p. 259 and all of chap. 7.Google Scholar

168. Rawls, , A Theory of Justice, p. 137Google Scholar: Brody, , “The Systems View of Man,” pp. 89–91.Google Scholar

169. Schlesinger, , “Ideas and Economic Development,”Google Scholar in Schlesinger, and White, , Paths of American Thought, p. 119.Google Scholar

170. Wilson, Robert N., “The Social Structure of a General Hospital,” The Annals of the American Academy of Political and Social Science, 346 (03 1963), 74–76.CrossRefGoogle Scholar

171. Here Brody picks up on Monod's words from Chance and Necessity (New York: Alfred A. Knopf, 1971), p. 91.Google Scholar

172. Walter Bagehot praised the effects of “discussion” that breaks the monotony of repeated history; he also believed that the evolution of social systems had led from an early need for fixed legal systems to a loosening of such systems for the sake of progress and freedom. See his Physics and Politics; or, Thoughts on the Application of the Principles of “Natural Selection” and “Inheritance” to Political Society (1867; rpt. Boston: Beacon Press, 1956), pp. 16, 22, 47–48, 159.Google ScholarWilson, Robert N., in “The Social Structure of a General Hospital,” p. 73Google Scholar, stresses the “informal ties [that] may be conceptually untidy [but] are the flesh and blood of an institution as the formal blueprint is the skeleton.” Roemer, Milton I.'s essay “Changing Patterns of Health Service: Their Dependence on a Changing World,” in The Annals of the American Academy of Political and Social Science, 346 (03 1963), p. 55CrossRefGoogle Scholar, points to the “polyglot picture” of levels of growth within complex institutions (such as hospitals). These levels reflect the “historical origin of each program more than a rational approach.” This leads to problems of fragmentation that require special efforts at cooperation and coordination, but at least the naturalness of the institution and its people (both staff and patients in the case of a hospital) is fully acknowledged by those involved.

173. Quoted by Adolf Meyer in an essay that praises Rush, 's “holistic”Google Scholar vision of human existence and bodily functions: “Revaluation of Benjamin Rush,” The American Journal of Psychiatry, 101, No. 4 (01 1945), 441.Google Scholar

174. Higginson, Francis, “New-Englands Plantation; or, a Short and True Description of the Commodities and Discommodities of That Countrey” (1630), reprinted in Proceedings of the Massachusetts Historical Society, No. 62 (10 1928—June 1929), 305–21.Google Scholar

175. Emerson, , Nature, p. 4.Google Scholar

176. Rush, Benjamin, “The Vices and Virtues of Physicians” (1801)Google Scholar, in Runes, , The Selected Writings …, pp. 303–4.Google Scholar