Medical science and medical industry. The formation of the American pharmaceutical industry

ANNE HARRINGTON, Medicine, mind and the double brain, Princeton University Press, 1987, 8vo, pp. xiii, 322, £24.70. This is a remarkable book, and one that will doubtless become indispensable to students of the history of the neurosciences. It offers a comprehensive account of the growth of ideas within neurology and psychology concerning asymmetries of function between the two hemispheres of the brain, with particular reference to the latter half of the nineteenth century. Its story is likely to surprise, not only on account of repeated citations from this period of well-articulated versions of ideas often thought original to the last three decades, but by the cast ofcharacters called upon. After the famous pioneers of localism and aphasiology, the tracing ofthe theme embraces largely forgotten contributions from the likes of Binet, Ribot, Maudsley, Charcot, Griesinger, Jackson, Bleuler, Janet and even, albeit tenuously, Freud. The narrative benefits greatly from a combination of sympathetic scholarship and a sensitivity to modern parallels that grace the whole work. The result is a highly satisfying demonstration of the inherently radical qualities of good historical research. Dr Harrington approaches her subject with a scrupulous attention to the content of contemporary scientific arguments which permits credible commentaries when fluctuations do seem apparent in the debt owed by scientific opinion to the weight of available evidence. Additional influences on the propagation of early dual brain models are appraised in terms of professional needs, ideological compatability with contemporary political and theological stances, and a possibly more general human tendency to project dualisms onto the universe at large and our own natures in particular. The contents have clearly been selected with care, to retain consistency of focus while demonstrating sustained originality. Among the riches on offer, I enjoyed especially the descriptive detail of an account of the popular impact of dualistic models eighty years ago that gave rise to the ambidextrality movement; a valuable new summary of the conceptual core of Hughling Jackson's system; and a fascinating re-evaluation of the significance of metalloscopy to the development of Charcot's thought. As a coda to the main history, Dr Harrington offers some comments on the continuing scientific and popular renaissance of interest in left and right 'brains' after a half-century of relative neglect. This account is necessarily less complete, both in its detail and in providing no complementary acknowledgement of the impact of post-1960 versions of holism, yet its grasp of the patterns of modem clinical thinking is particularly impressive. The book is lucidly and considerately written throughout; and its readability is enhanced by minimal recourse to notes, which are always confined to the foot of the relevant page. Illustrations include a guide to relevant anatomy and clinical photographs. There is a serviceable index. The volume is well bound, enjoys excellent paper, and comes reasonably priced. Dr Harrington's researches will be of interest to, and deserve, an audience wider than that of many other works of history. This account of them can be recommended not only as a definitive study of their topical theme, but as exegesis of quite exemplary quality. C. J. Mace Institute of Neurology