Paper medicine man. John Gregory Bourke and his American West

Bucke, at the London Asylum in Canada, embraces such an entity is more questionable. S.E.D. Shortt's monograph has certainly taken a bold leap, incorporating a general review of the development of Victorian medical psychology with a detailed analysis of data from an Ontario asylum and its keeper, but the result is top-heavy and awkward. The enterprise parallels one of Bucke's, his all-explanatory Cosmic consciousness (1901, many reprints, eight publishers, a German translation in 1975), which derived from a hero-worship ofWalt Whitman, an ecstatic experience in an English hansom cab, and more than twenty years cloistered in an asylum superintendency. Consisting of five chapters and over forty pages of annotation, the work reads more like five articles rather roughly stitched together. Chapter 1 is a brief biography rather too full of subjunctives, such as "Bucke might later have felt an affinity.. ." and unnecessary details of famous medical contemporaries. Chapter 3 is too broad in its sweep. Titled 'Toward a secular physiology of a mind', it attempts a complete picture of the nineteenth-century philosophy of mind, and is doomed to be obscure and colourless. The final chapter explores Bucke's use of gynaecological surgery and finds it ineffective but fails to consider the wider surgical assault on mental patients.. By contrast, the rich details of'The human ecology of the London Asylum' (Ch. 2) and the useful discussions in 'The social genesis of etiological speculation' (ch. 4) are of surprising value. About one-fifth of attendants resign annually; the case notes are scant, sometimes reporting as alive those who have been dead for two years; chronicity abounds. Yet "degeneration theory ... lifted alienists from the stigma of therapeutic defeat to the pedestal of social prophecy", and Shortt clarifies usefully this relationship between theory and practice. Compared to the integrated detail of Michael MacDonald, Anne Digby, or Nancy Tomes, this is a slighter work because by reaching at grander themes it has made worryingly trivial mistakes. Who, for example, was Robert Gardiner Hall? Who was James Pritchard? What is a "medical mindset"? We are told of Bucke's "peculiar ways", "his loud laughter", "his fluctuations in mood", his search for a "less strenuous form ofmedical employment", the political placemanship that got him his job as superintendent. Such loopy incompetence may well have been typical of Victorian alienists, yet is never described as such and it is this failure to distinguish the second-rate from the mad, the relevant from the coincidental, that undermines this work. The detailed analysis ofVictorian psychiatry, both in the asylums and in its social context, goes on apace and provides an exciting research enterprise. Many of these themes are touched on by Shortt, and we urgently need a detailed analysis of the operative practices, for example, of these times. Likewise, the resort to cosmic and utopian notions, and their espousal by cranky physicians, would be in itself an interesting exploration. Victorian lunacy is much "more than interpretation", despite the author's assertion to the contrary.