Referring to the medical model of frenzy sketched out in the first two chapters, Chapter 3 explores the metaphysical problems which it caused. The model’s insistence on the total dependence of the mind on the brain, it argues, placed pressure on a Christian cosmology in which ‘flesh’ and ‘spirit’ were supposed to be fully separable. Frenzy forced contemporaries to ask how it was possible for the human mind – made in the ‘image of God’ – to be impaired by organic disease. For most early modern Christians, the mind was a part of the soul, and this soul was immaterial, incorruptible, and immortal. Frenzy gave the impression that it invaded every part of the person, but this impression was false. The soul had to be immune to brain disease. This chapter examines the ancient roots of this problem, and examines how early modern England’s preachers, physicians, and philosophers attempted to solve it.

The Conclusion draws together the book’s various thematic strands: the perceived primacy of the ‘reason’, the right of its possessors to rule, the exculpatory effect of a frenzy diagnosis, and the high cost paid by those who received one. It returns to the larger question posed at the outset: whether the organ of the brain and the faculties of the mind were seen as constitutive of ‘personhood’ in pre-1700s England. The responses to frenzy which we have encountered in this book suggests that they were. The operations of the mental faculties known as ‘reason’, ‘will’, and ‘memory’ (or simply the ‘wits’) were located in (and often colloquially identified with) the brain. The functionality and continuity of these faculties was integral to the maintenance of legal, social, and spiritual personhood. Yet what troubled frenzy’s witnesses the most, the Conclusion argues, was the way it disrupted its sufferers’ predictable ways of being in the world – the values they had once held dear, the ways they had once looked and spoken. It was a disease which had the power to change friends, neighbours, and loved ones beyond recognition.

Chapter 2 considers how the diagnosis of frenzy – in its standard definition, an inflammation of the brain or meninges – both shaped and was shaped by anatomical knowledge. Reading the work of the anatomist Thomas Willis (1621–1675) alongside his various sixteenth- and seventeenth-century interlocutors, it situates his anatomical work within a longer tradition of brain–mind cartography. The chapter argues that Willis’s determination to map the functions of the brain onto its structures was driven, in part, by his clinical experiences of frenzy. His explicit hope was that his anatomy would be the foundation stone on which a new, clinically useful ‘Pathologie of the Brain and nervous stock, might be built’. But not all of his hopes for the project were medical in nature, or even this-worldly. Willis also sought to shore up two vital truths, both of which frenzy seemed to undermine: first, that there was a categorical difference between the human soul and that of all other living beings, and second, that the human soul alone would survive the death of the body.

The Introduction situates the book’s contribution in relation to the historiographies of madness, medicine, emotion, selfhood, and personhood. While mania and melancholy have enjoyed perennial scholarly interest, the same cannot be said of early modern frenzy. The Introduction offers some thoughts as to why frenzy has been neglected, and reflects on some of the conceptual and methodological difficulties which accompany its study. It explains the book’s scope (and limits), and offers short summaries of its six chapters. Sketching out the book’s central claim – that frenzy had devastating effects on personhood, and that these effects drove its early modern observers to unpick the tangle of mind, soul, and brain – it engages with recent claims about the emergence of a distinctively modern ‘cerebral self’. It sets out to test the claim that the possession of certain ‘psychological features, such as memory, consciousness, and self-awareness’ was not constitutive of ‘personhood’ until the end of the seventeenth century.

Chapter 1 tracks frenzy’s trajectory as a medical diagnosis between 1500 and 1700. It offers an introduction to frenzy as it was understood by eight medical practitioners, four of whom came of age in a time of relative stability in English medicine (1560–1640) and four in a time of rapid change (1640–1700). It shows how, from the mid seventeenth century, the old humoral definition of frenzy was altered to fit new medical philosophies – chemical, mechanistic, and corpuscular – and new models of human physiology. Tracing the contours of the disease over two centuries, it highlights points of continuity as well as change. Throughout this period, it argues, theorists from diverse schools explained frenzy’s effects with reference both to the solid structures of the body and the fluids which flowed through them. This chapter argues that it was the devastating effects of brain disease which galvanized medical theorists to seek to explain disorders of the mind as disruptions of material ‘animal spirits’.

Since the discovery of the first Neandertal fossils, the neurocranium has been of particular interest to specialists and the general public, particularly in relation to the question of what cognitive abilities can be inferred from the braincase. Here we present a detailed description and analysis of the neurocranial morphology of Neandertals and compare it with that of living humans and the fossil hominins that likely represent our last common ancestor. Our analyses show that the Neandertal neurocranium provides relatively few clues about the structural and functional characteristics of the brain it once contained. The unique morphology of the Neandertal braincase is best understood as a compromise between the spatial demands of a large brain and the biomechanical demands of a large and evolutionarily derived face.

Chapter 7 begins with Kornblith’s attempt to resurrect a teleology of the mind or intellect. I countenance his semantic, desire and pragmatic arguments, maintaining that none of them shows truth or true belief to be an objective good. By contrast, Aristotle’s idea that the intellect is constitutively directed at truth does show this (in virtue of the Aristotelian functionalist schema: i.e. all functions are correlated with perfections or goods). And Aristotle’s idea is corroborated not only by ‘folk’ and theoretical psychology, but also by cognitive science. For the latter is wedded to the notion that the brain is a cognitive system, functionally directed at cognition (viz. true belief). I go on to address three critiques of this intellectual teleology – those put forward by William James, evolutionary biology and global scepticism respectively – and argue that none of them is cogent. Next, I unpack two alternative accounts of the relation between truth and goodness – those of Ayer and Davidson – and maintain that they, too, fall short. Last, I tackle intellectual goods beyond true belief – such as knowledge and understanding – asking whether they or their objects form discernible hierarchies.

A fundamental dilemma in both the radiology reading room as well as the courtroom is whether a potential abusive head or spinal injury may be mistaken for other entities – both pathological processes and also normal anatomical or physiological variants.

A number of differential diagnoses, or mimics, for abusive head trauma may be apparent radiologically, but many may not be. Striving to achieve a medical “diagnosis” of an abusive injury requires the interplay between the radiologist and numerous other clinical specialties. The wide differentials which we discuss include accidental trauma, coagulopathies – both congenital and acquired, metabolic disorders, sepsis and vascular malformations, with all needing to be excluded before reaching a conclusion of nonaccidental trauma.

The experienced radiologist and clinician working in the challenging field of child protection also recognises that it is not always possible to reach a clear-cut decision and learning to communicate levels of uncertainty is essential. Part of this process is to always be alert to diagnostic mimics that may mislead the inexperienced and unwary.

Abusive head trauma (AHT) is a leading cause of traumatic death in infants, often resulting in severe brain injuries with lifelong consequences. It can cause cognitive, sensory and behavioral impairments, which may not fully emerge until later in childhood. AHT injuries are typically classified as primary (direct mechanical damage, such as contusions and lacerations) or secondary (indirect effects like hypoxic-ischemic injury and cerebral edema).

Infants are particularly vulnerable due to factors like poor neck control, larger head size and incomplete brain development. Neuroimaging, especially MRI and diffusion-weighted imaging, is essential for diagnosing these injuries and tracking their evolution, as some manifestations develop over days or weeks. Mechanisms of cell death, including necrosis, apoptosis and autophagy, play a key role in the progression of brain damage.

Differentiating AHT from accidental trauma is challenging. Certain patterns, such as subdural hemorrhages with ischemic injury, strongly suggest abuse. Comprehensive imaging, clinical evaluation and follow-up are crucial for documenting injury progression and understanding its impact on the developing brain.

This chapter consists of a transcription of a fictitious forum discussion in which a number of fictitious scholars participated, including some very surprising participants. The wide-ranging discussion covers the topics discussed throughout this book, and the chapter ends with the conclusion that the nature–nurture debate is still a vibrant one in which we are seeking to understand the interplay between the nurturing experience and the role of nature, whether in the form of an innate biological endowment or in the form of natural factors that go beyond the realm of the human mind.

There is growing evidence that language plays an important role in emotion because it helps people acquire emotion concept knowledge. In this chapter, we argue that language plays a mechanistic role in emotion because emotion concept knowledge, once acquired, is used by the brain to predictively and adaptively regulate a person’s subjective emotional experiences and behaviors. Building on predictive processing models of brain function, we argue that the emotion concepts learned via language during early development “seed” the brain’s emotional predictions throughout the lifespan. We review constructionist theories of emotion and their support in behavioral, physiological, neuroimaging, and lesion data. We then situate these constructionist predictions within recent neuroscience research to speculate on the neural mechanisms by which emotion concepts “seed” emotional experiences.

Decades of research demonstrate cultural variation in different aspects of emotion, including the focus of emotion, expressive values and norms, and experiential ideals and values. These studies have focused primarily on Western and East Asian cultural comparisons, although recent work has included Latinx samples. In this chapter, we discuss why studying culture is important for studies of emotion and what neuroscientific methods can contribute to our understanding of culture and emotion. We then describe research that uses neuroscientific methods to explore both cultural differences and similarities in emotion. Finally, we discuss current challenges and outstanding questions for future research.

While the preceding two chapters focused on the physiological domains whose motions take place ‘by nature’, that is, involuntarily, this chapter looks at the activities of the physiological system responsible for the motion ‘by will’. Galen depends on Hellenistic anatomists, especially Herophilus, for much of what he knows about the nervous system, but this chapter looks at both inherited knowledge and polemic interaction. In a rare case of disagreement, Galen criticizes Herophilus regarding the claims about the inherent sensitivity of the nerve tissue. The fact that Galen does not accept Herophilus’ experiments and maintains that nerves only receive capacity from the brain shapes his understanding of this physiological domain. The activities of the nervous system encompass not only voluntary motion but also sense perception and pain, and this chapter argues that each of them has distinctive implications for the unity of the living body as a whole.

Pain is a complex experience that includes physical sensations and emotional responses. Research has shown that the central nervous system plays a significant role in how we experience pain. In this chapter, we review the current understanding of the neuroscience of pain, with a particular emphasis on pain processing in the brain. We cover early theories that emphasized the brain’s role in integrating and modulating pain, as well as modern approaches that view pain as distributed processing in the brain. We also introduce functional and computational frameworks for understanding the sensory and motivational aspects of pain and discuss various factors that contribute to the multidimensional nature of pain. The future direction of the study of pain neuroscience includes a deep sampling of subjective pain experience and the use of generative models.

Neuroanthropology aims to understand the interactions between the brain and culture and how such interactions, in part, drive human variation. Current discussions in neuroanthropology aim to understand better how neurological development generates culture and how human sociocultural contexts shape neural development. The chapter described the roots of these discussions in the historical development of anthropology. Anthropology’s holistic approach and emphasis on human variation laid the groundwork for neuroanthropology. The concept of “local neurologies” offers an approach for understanding neural development in interaction with small-scale, situated sociocultural and ecological dynamics. The chapter then discusses how individuals develop within these local constraints using three approaches (developmental systems, embodied cognition, and dynamic epidemiology) that support studies of how sociocultural processes engage with flexible human nervous systems. Ultimately, this chapter contrasts explanations of human behavior and experience that rely on only the neurological or cultural and instead suggests better ways to bridge the gap between the brain and culture.