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BERLIN ELECTROPOLIS
WEIMAR AND NOW: GERMAN CULTURAL CRITICISM Edward Dimendberg, Martin Jay, and Anton Kaes, General Editors
Berlin Electropolis Shock, Nerves, and German Modernity
Andreas Killen
UNIVERSITY OF CALIFORNIA PRESS Berkeley Los Angeles London
University of California Press, one of the most distinguished university presses in the United States, enriches lives around the world by advancing scholarship in the humanities, social sciences, and natural sciences. Its activities are supported by the UC Press Foundation and by philanthropic contributions from individuals and institutions. For more information, visit www.ucpress.edu. University of California Press Berkeley and Los Angeles, California University of California Press, Ltd. London, England © 2006 by The Regents of the University of California Library of Congress Cataloging-in-Publication Data Killen, Andreas. Berlin electropolis : shock, nerves, and German modernity / Andreas Killen. p. cm. Includes bibliographical references and index. ISBN 0–520–24362–5 (alk. paper). 1. Neurasthenia—Social aspects—Germany— Berlin—History. 2. Mental fatigue—Social aspects—Germany—Berlin—History. 3. Electrotherapeutics—Germany—Berlin—History. 4. Electrification—Germany—Berlin—History. 5. Industrialization—Germany—Berlin—Psychological aspects. 6. Social change—Germany—Berlin—Psychological aspects. 7. Railroads—Employees—Mental health— Germany—Berlin. 8. Telephone operators—Mental health—Germany—Berlin. 9. Soldiers—Mental health—Germany—Berlin. 10. Psychiatry—Germany—Berlin—History. I. Title. RC552.N5K54 2005 362.196'8528'00943155—dc22
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Contents
Acknowledgments / vii Introduction / 1 1.
Berlin Electropolis / 15
2.
Electrotherapy and the Nervous Self in Nineteenth-Century Germany / 48
3.
Railway Accidents, Social Insurance, and the Pathogenesis of Mass Nervousness, 1889–1914 / 81
4.
Electrotherapy and the Nervous Self during Wartime / 127
5.
Psychiatrists, Telephone Operators, and Traumatic Neurosis, 1900–1926 / 162 Conclusion / 212 Notes / 219 Selected Bibliography / 275 Index / 291
Acknowledgments
My largest debt is to Anson Rabinbach, who provided me with a model of scholarship and who oversaw this project with unfailing generosity from its inauspicious beginnings to its completion. I also owe thanks to Molly Nolan and Jerrold Seigel, who helped define the subject of my original dissertation and prodded me toward its realization. During the course of researching and writing this book, I received help at crucial junctures from Atina Grossmann, Tom Bender, Richard Sennett, John Savage, Peter Lang, Jonathan Skolnik, Paul Lerner, Eric Engstrom, Michael Hubenstorf, Gerhard Baader, Dietrich Milles, Greg Eghigian, Christine Leuenberger, Mary Terrall, Dora Weiner, Sean Quinlan, Dan Brownstein, Jennifer Mason, Michael Hagner, Cornelius Borck, Annabella Bushra, Susan Jaffe, Jason Crouthamel, and Moritz Foellmer. Most of the research was supported by grants from the German Academic Exchange Service (DAAD) and New York University. The writing itself was, for the most part, completed during three stints: one in an office at Cooper Union generously loaned to me by Atina Grossmann; one during a stay at the UCLA Humanities Consortium; and one at the MaxPlanck Institute for the History of Science in Berlin. I wish in particular to thank Vince Pecora at UCLA and Hans-Jörg Rheinberger at the MPI, as well as the staffs of their respective institutes, for the valuable support vii
viii ACKNOWLEDGMENTS
they provided me with. I would also to thank the three readers at the University of California Press for their comments on an earlier version of this manuscript. My work in Berlin was aided by the staffs of the Karl Bonhoeffer Nervenklinik, the Krankenblätterarchiv of the Charité Psychiatric Clinic, the Humboldt University Archives, the Bundesarchiv-Potsdam and Bundesarchiv-Lichterfelde, and the Institute for the History of Medicine. In Berlin, I was fortunate to count among my friends Carolyn Unger, Ulf Damann, Christian Hasucha, and, in particular, Johanna Schenkel, without whose great generosity my introduction to that city would have been far less pleasurable. Parts of chapter 5 were published earlier as Andreas Killen, “From Shock to Schreck: Psychiatrists, Telephone Operators, and Traumatic Neurosis in Germany 1900–1926,” Journal of Contemporary History 38, no. 2 (April 2003): 201–20, reprinted by permission of Sage Publications Ltd. Last, I would like to thank my parents, Richard and Margrith, who long ago awakened my love of books. Above all, I wish to thank my dear wife, Marie, for her love and support, without which I would never have completed this project. It is to her and to my sons Henry and Nicholas and the life we share that this book is dedicated.
Introduction
F
or a long time, to be modern meant to be “nervous,” whether that modernity was located in the emergent capitalist nations of eighteenth-century England and France or in the fully industrialized nineteenth-century Germany and United States. It meant to live in a sped-up world, one saturated with new stimuli, demands, risks, messages, and pleasures, requiring constant adaptation to a wealth of new experiences. For Friedrich Nietzsche, writing in the 1880s, modernity and nervous complaints were virtually synonymous: “The whole burden of culture,” he wrote, “has become so great that there is a general danger of over-stimulation of the nervous and thinking capacity.”1 Yet until the mid-1700s neurosis as such was almost entirely unknown or was reserved for the privileged classes.2 Only in the late nineteenth century did the experience of nervous illness become a more general one. Even then, it still preserved something of its origins within the world of enervated society ladies, hypersensitive bohemians, and, increasingly, overworked men of the professional classes. But once they confronted the fact that other classes of people too seemed to be in the grip of this quintessentially modern condition, German doctors felt compelled to redraw the malady’s social boundaries. By 1900 nervousness seemed to have become a mass phenomenon, a development that would eventually compel the 1
2 INTRODUCTION
nerve doctors to revise their prevailing beliefs regarding this condition, its causes, and its meanings. This book studies the dialogue between the German state and its citizens about the “hidden costs” of the modernization process, a dialogue conducted in the specialized new idiom of “nerves.” Charting the emergence and decline in German society of a new conception of the nervous self between 1870 and 1930, it sets these developments against the backdrop of the rapidly modernizing German capital, which during this period became arguably the most advanced metropolis in Europe. A host of changes, many associated with breakthroughs in electrical technology (electrical lighting and trams, telephone exchanges, cinemas), combined to radically alter the shape and tempo of everyday life in Berlin. The resulting consciousness of accelerated social change with its accompanying shocks and afflictions found its consummate expression in the discourse about nerves, or neurasthenia, a new disease construct first described in the late 1860s by the American physician George Miller Beard. Just as the history of hysteria was closely linked to late nineteenthcentury Vienna and Paris, that of neurasthenia became closely connected to Wilhelmine Berlin.3 The German capital’s position as command center of the most dynamic economy on the Continent and as home to a progressive, materialist school of medicine made it a preeminent setting of the discourse about nerves. As a reflex of a modernization process that was often experienced as tremendously violent, this discourse was laden with considerable anxiety. Berlin was seen as a breeding ground of nervous and mental illness; and the problem of “growing nervousness,” as a harbinger of national decline. But modernity had many faces in Berlin. The late nineteenth century also ushered in a process of reform and experimentation designed to manage the transition to modernity and to remake German society along more rational lines. One important manifestation of this was the Bismarckian social insurance system created in the 1880s, which sought to manage the shocks, accidents, and afflictions of industrial society within a statist framework. Berlin occupied a central place in the rise of the German social state. Social insurance created a network of courts, medical specialists—many of them Jewish and politically progressive—and urban clinics and rural sanatoriums in and around the capital. These became the medium through which the disease picture surrounding sick nerves acquired cultural validity and engendered a new preoccupation with the importance of healthy, rational lifestyles in combating the specter of nervous degeneration.
INTRODUCTION 3
Social insurance transformed what was originally defined as a bourgeois malady of the nerves into a mass condition. It made the German state responsible for managing the consequences of so-called traumatic, or accident, neuroses of the industrial workplace. Turning employees, employers, doctors, and the state into partners in an organized campaign against the nervous afflictions of modern life, it created a new social contract based on the rights to, but also the responsibilities of, a healthy productive existence. In projecting a more rational form onto industrial society, insurance defined a new social body in place of the individual body of the bourgeois patient. But this redefinition had unforeseen consequences: extending what Walter Benjamin called the “rights of nerves” to Germany’s working classes led to a perceived overburdening of the fiscal and professional resources mobilized against nervousness and to the politicization of the discourse about it.4 This process transformed the disease picture surrounding traumatic neurosis, making it the site of conflicts of medical and legal interpretation and entangling it within wider debates about modernity, class, and gender. These developments culminated during the Great War, which unleashed an epidemic of neurosis among the ranks and a tremendous backlash among psychiatrists. This backlash assumed particularly strident form in Berlin, which was now seen by an increasingly reactionary psychiatric profession as a stronghold of two forces with a particular investment in the disease picture and the social therapies surrounding neurasthenia: “Jewish medicine” and Social Democracy. Confronted with what they took to be a crisis of fraud and malingering, psychiatrists recast neurasthenia as a pseudomalady and changed the referent of the neurasthenia discourse from modern technology to social insurance. My study connects this backlash and the larger narrative behind it with a historical shift in the nature of capitalism, legible in Berlin’s physiognomy, which became transformed from what industrialist Walther Rathenau at the turn of the century called “an industrial city” (Industriestadt) to what sociologist Werner Sombart in the 1920s, following Weber’s studies of bureaucracy, called a “city of civil servants” (Beamtenstadt). This transformation was driven by, among other factors, a tremendous expansion of the nation’s public sector, and it fueled the backlash against social insurance and its alleged degenerative effects on the nation’s health. In 1925, in the midst of this backlash, psychiatrist Oswald Bumke would reflect on the astonishing impact of Beard’s disease construct in Germany. Bumke’s overview of the history of the neurosis concept laid out the two opposing schools of thought that had dominated German
4 INTRODUCTION
psychiatry since the 1870s. One interpreted neurosis as the result of trauma to the “nerves,” caused by overwork, stress, or accident; the other viewed it as only indirectly linked to an external force, seeing it rather as a psychological illness whose causes (whether sexual or hereditary) were ultimately located in the self. In Bumke’s opinion, this second—and correct—view had already been widely accepted by the late 1870s: “Then in 1880 Beard, with his neurasthenia, entered the picture. With one blow, the somatic perspective gained the upper hand once again. There is surely no other case in the history of medicine in which a single term has had such an enormous scientific impact and at the same time been the cause of so many new illnesses.”5 Bumke’s account conveys the sense of dismay felt by many nerve doctors looking back on the recent history of their own field. Rather than accept this sense of dismay at face value, however, we must recognize it for what it is: merely one position within the highly contested discourse about what Freud, five years later, would call civilization and its discontents. Freud’s metapsychological analysis of modernity’s discontents—according to which, civilization produced neurosis by imposing restrictions on our needs for instinctual gratification—remains a monument of twentieth-century thought.6 My study, however, traces a somewhat different lineage in the history of modern nervousness, which in the Freudian narrative remains largely a story about the upper classes. It examines the constellation of social, scientific, and cultural forces that converged at the end of the nineteenth century to usher in the age of mass nervousness and then the factors that led to its decline.
NEURASTHENIA AND BERLIN MODERNITY How did late nineteenth-century Germans come to analyze themselves and the shocks and afflictions of industrial society in terms of this idiom of “nerves”? At the beginning of this story lies the impact of a new materialist medicine on the construction of neurasthenia, which was initially construed as a functional, that is to say, invisible, nonlocalizable, yet genuinely somatic, illness of the nerves. Unlike hysteria, neurasthenia was defined by its modernity, and the literature on the syndrome paralleled Germany’s rapid industrialization during the years 1870–1914. The outpouring of writings on this subject is unintelligible unless placed in the context of contemporaneous debates about the nature and effects of modernity on self and society. The uncanniness Bumke perceived in the rise of modern nervousness attests partly to neurasthenia’s ambigu-
INTRODUCTION 5
ous status as both a discursive and a genuinely clinical entity. It was interesting to physicians as well as philosophers, sociologists, and aesthetes for what it suggested about the fragility of the self under the conditions of industrial society. Medical accounts of the condition were invariably coupled with commentary on modern life. The new Germany fashioned by industrialization—the world of the metropolis, railway, telephone exchange, and cinema—represented one pole of this commentary; the other was defined by the no less modern world of morbidity, suggestibility, and sexuality discovered within the self. In stressing one or the other of these poles, Germany’s medical community became enmeshed in wider debates concerning the risks and pathologies of industrial society. Doctors used their new authority to weave a resonant cultural narrative around the topos of nerves, tying that narrative to popular anxieties concerning the dizzying pace of modern life.7 Deploying an arsenal of new technologies of the nervous self, they helped construct the body as a field of energies, limits, and potentialities that became both doctor’s and patient’s duty to objectify, stabilize, and, where possible, liberate. For patients themselves, the discourse about sick nerves had its own implications. As Thomas Mann described it in The Magic Mountain, being an invalid had its advantages: it meant “relief from the burden of respectable life”; escape into a dreamlike world of permanent convalescence; and experimentation with various types of lifestyle reform. Disease, as Mann put it, made men physical, it left them “nothing but the body.” Indeed, it “revolutionized the body,” tempting the invalid with the ambiguous promise of a descent into the body in search of knowledge, new stimuli, pleasures, and refinements.8 In the institutions where nerve invalids congregated, opportunities abounded to test out new codes of conduct and behavior, to try on new attitudes and lifestyles. To the extent that the experience of nervous illness led patients to lifestyle reform and self-experimentation, it could be liberating for many.9 Yet there were ambivalent aspects to this phenomenon as well, insofar as it exposed patients to new kinds of medical intervention and disciplining. As often as not, it was the doctor rather than the patient who “descended into the body in search of knowledge”; and the criteria of this knowledge were often defined less by the needs of individual patients than by those of the profession itself, employers, or the state.10 In coming to grips with modernity’s effects on the invalids they treated, doctors frequently intervened in ways that inscribed these effects more deeply than ever within the self. Changes in examination and treatment mirrored changes in modern life. The use of electricity is paradig-
6 INTRODUCTION
matic in this regard, insofar as electrical treatment—a crucial part of the Beardian disease construct—was frequently administered to nervous invalids believed to suffer from the onrushing stimuli of a world itself increasingly permeated by electrical technologies. Whether used on bourgeois patients or, during wartime, on Germany’s soldier masses, electrical treatment embodied the ambiguous dialectic between emancipation and disciplining that Michel Foucault has identified in the human sciences’ constitution of the modern subject.11 The rules and boundaries of the discursive space opened up by the doctrine of nerves became, over time, highly contested, particularly as it was extended to ever-wider circles of Germans. A central question posed by this study thus concerns the social composition of Germany’s nervously afflicted. Neurasthenia has traditionally been thought of as part of the cultural property of the bourgeoisie. Certainly this was assumed to be true by the doctors who first described it in the 1860s and 1870s, and this assumption has continued to hold sway in much of the scholarly literature on the subject.12 But by the end of the nineteenth century, few German doctors believed that it was any longer restricted to the well-to-do. On the contrary, as it spread to other social strata under the influence of social insurance legislation, doctors were confronted by a new mass neurasthenia that cut across boundaries of class and gender. It was the intersection between psychiatry and social insurance, which transformed nervousness from bourgeois malady into mass condition, that accounts for much of the uncanniness Bumke perceived in the neurasthenia story. Neurasthenia’s transformation into a mass phenomenon is closely related to another of this study’s themes: the syndrome’s psychologization. Beginning in the 1890s, a major shift took place in medical theories about the malady, which had initially been conceived of as an externally caused somatic condition. Simply put, the scales tipped in favor of an interpretation that grounded nervous illness more strongly within the self, identifying it as an inborn or acquired pathology, one merely triggered by external forces. One outcome of this shift was a new emphasis on psychogenetic explanations, which traditionally have been linked with Freud. But the focus on Freud has partly obscured proper appreciation of deeper social undercurrents. It has also resulted in a periodization that ignores the fact that Freud’s ideas did not have a great impact until after World War I, and then in a manner whose relation to the central tenets of psychoanalysis was ambiguous at best.13 My study situates this epistemic shift within a different framework.
INTRODUCTION 7
I argue that the shift from soma to psyche was not merely part of an internal evolution within psychiatry that occurred in some pure space of doctor-patient interaction but was driven by the tremendous conflicts surrounding insurance claims.14 The shift in the discourse about nerves, fueled by a perception that the social insurance bureaucracy created perverse incentives to become nervously ill and reinforced these incentives through the elaborate mechanisms surrounding the claims process, was closely bound up with the backlash against the welfare state that set in around the turn of the century. This backlash would ultimately call into question the underlying tenet of the social insurance system: that society was responsible both for producing and for mitigating its own discontents. Seen from this perspective, the psychologization of nerves takes on a decidedly ambiguous character. The views espoused by Bumke reflect the consolidation of a new consensus within German medical circles in the first two decades of the twentieth century. The decisive development in this process was the outbreak of shell shock within the ranks during the Great War, which produced severe, ultimately unmanageable strains within the system created to administer insurance claims.15 In response Germany’s medical establishment shifted from an externally caused etiology to an internally anchored one—a shift that individualized the malady and, in effect, placed the burden of responsibility on the patient. Neurasthenia, which had started out as authentic disease of industrial modernity, became reconfigured as a pseudoillness. Simultaneously, an important shift in the referent of the discourse about nerves also occurred: initially this referent was usually technology, and nervous breakdown was treated as a predictable, even natural, effect of the special conditions of modern life; then after the war, technology as referent was replaced by others—sex, heredity, and welfare bureaucracy. By the mid-1920s, nerves were being intensely stigmatized, as the onetime psychiatrist Alfred Döblin conveyed in his novel Berlin Alexanderplatz. “If a person’s got sick nerves, then he’s healthy,” pronounces a character midway through the novel.16 At the end of the novel, Döblin’s protagonist, war veteran Franz Biberkopf, experiences this paradox first hand: admitted for evaluation to a psychiatric clinic, he finds that the doctors interpret his own nervous condition as a form of malingering, the ruse of a man feigning illness to evade his obligations to society. They then debate the relative merits of two techniques—electrotherapy and the talking cure—for extracting the truth of Biberkopf’s condition from him. Döblin’s juxtaposition of electrotherapy and the talking cure situ-
8 INTRODUCTION
ates this moment rather precisely within the larger history of the nervous self. It also anchors this moment within the larger history of the modern era. German modernity had many faces, but in the early twentieth century Berlin was its emblematic face. A relatively modest capital prior to 1871, the founding of the empire transformed it into Europe’s most dynamic metropolis. Berlin experienced more intensely than any other city the changes that swept western European society over the second half of the nineteenth century. By the turn of the century, its social landscape was altered almost beyond recognition, and Berlin had become arguably the most modern city in Europe. In honor of its central place in the nation’s electrical industry and its illuminated streets, flashing signs, movie theaters, and electric streetcars—all of which feature in Döblin’s novel— contemporaries referred to it as an electropolis.17 But well before the Weimar period or even the fin de siècle, Berlin’s history was already deeply entwined with the mystique of electricity. From the mid-nineteenth century onward, scientific and intellectual life in Berlin was dominated by the mechanistic spirit associated with the work of scientists such as Hermann von Helmholtz, Emil Du BoisReymond, and Werner Siemens, who endowed electricity with supremely charismatic value as the vital force of modern life. The spirit of these scientists was central to the image of modernity associated with Berlin and played a crucial role in its development. The city’s academic, scientific, and entrepreneurial elite was also an integral part of Berlin’s liberal tradition, which featured all the strengths and weaknesses of German liberalism.18 They stamped the history of the city with a progressive yet highly statist character, one that, partly in compensation for Germany’s history of fragmentation, worshipped the centralizing tendencies of the Prussian military state. Yet despite its status as seat of the empire and its official image as a parade ground for the kaiser’s troops, Berlin was a highly cosmopolitan capital and home to a very diverse citizenry, including Europe’s largest socialist party—itself steeped in the mechanistic ethos and its fascination with electricity—and a sizable Jewish population that made a decisive contribution to the sensibility of this most modern of cities.19 As a capital, Berlin was a place of regimentation, but as a metropolis, it was also a place of experimentation.20 If industrialization had unleashed a host of new risks and afflictions, it also had ushered in a process of experimentation designed to remake society along more rational lines. Berlin thus became both a site of anxiety and shock and an incubator of discourses
INTRODUCTION 9
and practices that were organized around the topos of nervousness and were themselves constitutive of modernity. Modernity both produced and was in turn produced by “sick nerves.” My study shows how this complex thematic coupling took hold in and around the German capital, making it, in the work of thinkers such as turn-of-the-century sociologist Georg Simmel, the setting for a discourse about the enervating effects of modern civilization. The developments traced here were not limited to Berlin alone, and I draw on events external to the history of Berlin per se. Nevertheless it occupies the central place in the unfolding of my study’s themes, insofar as Berlin figured not simply as a physical staging ground for Germany’s modernization but also, as Döblin’s novel suggests, as a virtual persona in its own right within the larger drama of the modernizing process, alive with energies and currents both exciting and destructive.
THE HISTORY OF NERVOUSNESS For a long time, nerves were regarded as a part of the nineteenth-century world that had ended abruptly with the publication of Freud’s Interpretation of Dreams in 1900. Historians treated the Wilhelmine “age of nervousness” as little more than a prelude to the modern psychoanalytic era. When they departed from this narrative, it was only to yoke it to another, equally overdetermined, story about the rise of degenerationist discourse and the eugenics movement.21 More recent work has sought, by studying the topic on its own terms, to emancipate it from the long shadows cast both by Freud and by Nazi racial science. This new literature has filled in our picture of the late nineteenth-century preoccupation with nerves and has succeeded in adding new layers of “thick description” to the older historiography, as well as inscribing Freud himself more deeply within the social, scientific, and cultural history of the period.22 A major contribution to this new literature is Joachim Radkau’s recently published Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler. Radkau’s study presents a more panoramic picture of the Wilhelmine age of nervousness than any previous one. His story operates on a number of levels. On the level of high politics, he examines the nervous subtexts to Wilhelm II’s political maneuverings and comes to the conclusion that the actions of the kaiser and his inner circle leading up to the outbreak of World War I can be construed as the product of a defensive reaction to a perceived crisis of masculinity that was encoded in the language of nerves. On a more granular level, he scrutinizes
10 INTRODUCTION
the minutiae of interactions between doctors and patients to reveal how this language functioned in a more everyday sense. For Radkau, the main thrust of the discourse on nerves, despite its many ambiguities, was positive; in general, he concludes, it was not stigmatizing but emancipatory.23 In his telling, this discourse becomes one of the master narratives of the Kaiserreich. This it certainly was, to a degree that Radkau himself sometimes seems to fail to appreciate. Implicitly taking Freud as paradigmatic, he winds up rehearsing many of the problems of the older historiography on the subject. Most important, he fails to engage fully with the illnesses’ extension to Germany’s working classes under the influence of the nation’s social insurance laws and thus misses both the political dimension and the larger arc of the discourse about nerves. The most interesting new work in this field seeks precisely to link the psychiatric thematization of nerves to the conflict-ridden history of the German social state. Paul Lerner, Greg Eghigian, and others have embedded the discourse about “diseases of civilization” within the historical problematics of the welfare state, both its institutionalization and its later critique and dismantling. They demonstrate that medical views of traumatic neurosis became inseparable from the highly charged conflicts surrounding the social insurance system. Lerner’s study sheds new light on a crucial chapter in this story, showing that the perceived overburdening of the nation’s pensioning system during the war led to the recasting of war neurosis as male hysteria—a diagnosis that made the patient himself responsible for his condition and released the state from any responsibility. Lerner persuasively argues that the specter of the male hysteric—he who, out of personal weakness, shirked his duty (military or economic) to the state—“haunted the German imagination as the nation progressed along the path to modernity.”24 Eghigian, drawing on recent work in the history of welfare, shows how in the Weimar period the social state itself came to be perceived as pathogenic, in the sense that it bred neurotic dependency.25 The backlash against the neurosis construct was thus deeply implicated in the backlash against the social state. Francois Ewald has written of social insurance that “[i]n guaranteeing security the state is equally guaranteeing itself, its own existence. . . . [S]ocial insurance is also an insurance against revolution.”26 Germany’s social legislation was conceived as the cornerstone of a policy aimed at taming the revolutionary impulses of the working classes, which it sought to redirect into what Mann called a revolution of the body. This project was organized around the leitmotif of health, construed in thermodynamic terms as productivity, and was, as such, deeply entwined
INTRODUCTION 11
with the larger cultural preoccupation with energy and fatigue, which has been analyzed by Anson Rabinbach.27 Rabinbach shows how the midcentury discovery of the law of conservation of energy as well as a new paradigm of labor power produced a far-reaching social and medical discourse about the body, its energies and limits. Neurasthenia was one reflex of this discourse. Its emergence and spread, writes Rabinbach, reflected an anxiety about body and self in the face of modernity’s demands; yet it also invited the scientist-doctor to search within the nervous body’s maze of symptoms for the key that would unlock a new social utopia: the “body without fatigue.” Fatigue was thus a refusal of modernity; at the same time, however, it also produced innovation and thus, through a dialectical process, modernity. In thus broadly contextualizing the discourse about nerves, Rabinbach suggests ways of rethinking the historiography of German modernity. The term modernity has a charged meaning in the German context insofar as the alleged German “special path” of delayed or uneven processes of modernization has often been invoked to explain twentiethcentury Germany’s inability to resist the temptations of National Socialism. For a less normative account, we may turn to the historian Detlev Peukert, who distinguishes between three phases in the modernization process: the industrialization that took off on a large scale in the middle of the nineteenth century; the urbanization that followed in the closing decades of that century; and the social and cultural transformations that occurred as the nineteenth century was succeeded by the twentieth.28 Peukert further suggests that modernity is characterized by the social disciplining, bureaucratization, and normalization of the everyday life of the masses. Following Max Weber’s typology, Peukert argues that these processes occurred under the sign of increasing rationalization.29 Rationalization has become a central term in recent efforts to rethink German modernity. The prophets of the rationalization movement sought to recast traditional social and economic relations by finding technical, scientific, and medical solutions to social problems. Peukert’s own work offers some of the most suggestive treatments of this subject. He describes rationalization as an ambiguous, contested project dedicated to the proposition that enlightened planning and intervention could manage many of the conflicts and tensions unleashed in the modern world and help to smooth the transition to a conflict- and risk-free future. One expression of this project was the social insurance legislation passed in the 1880s. But at its height in the Weimar period, as Peukert shows, this project touched all areas of German society, from the work-
12 INTRODUCTION
place, medicine, and mass culture to many areas of private life, sexuality, and lifestyle reform. In a similar vein, Paul Weindling describes the Weimar-era welfare state as a “soaring modernist edifice,” the product of a powerfully utopian strain of modern thought that ultimately collapsed under the weight of the unreal expectations it generated. It was only in the context of this collapse, in the wake of the economic turmoil of the late 1920s, that the darkest undercurrents in the discourse about nervousness became dominant, and German medical science degenerated into racial fantasy.30 If in theory rationalization held out the hope of smoothing the nation’s path to a conflict- and risk-free future, it proved in practice to generate its own tensions and conflicts, which ultimately became unmanageable within the existing framework of Weimar society. Recent studies have analyzed the tremendous cultural battles unleashed by the rationalization movement, particularly those surrounding the iconic Weimar figures of the New Woman and the shell-shocked soldier.31 As an expression of a general social project, rationalization—whether of sexuality, of the domestic sphere, or of wartime psychiatry—turned out to have significant unintended consequences, not least for traditional ideals of the self and the traditional division of gender roles. Ultimately this study examines how rationalization, understood in the broadest sense, left its imprint on the self—how German consciousness became, as Wolfgang Schivelbusch puts it, “industrialized.”32 Social insurance played a key role in this process. At the core of the “discourse network” that developed around social insurance lay the notion of shock.33 As a general heuristic for the experience of modernity, shock assumed a central place in the discourses of risk and its management in industrial Germany. First introduced into medical discourse in the 1870s in the context of railway accidents and their traumatic nervous sequelae, shock’s entry into medical and then popular parlance rested on the understanding that life in the modern world exposed the self to new kinds of risk and calamity. Its power to give meaning to the experience of modern urban life is attested to by its place in the writings—each formed in engagement with Berlin—that collectively make up one of the most compelling analyses of modernity we possess: those of Georg Simmel, Walter Benjamin, and Siegfried Kracauer. The chronology and exposition are as follows. The first chapter begins by looking at Berlin’s late nineteenth-century transformation into “world city,” site and object of a discourse about the “hidden costs” of over-
INTRODUCTION 13
civilization. It ties the capital’s development to the emergence of a new consciousness of accelerated change that crystallized in the discourse about neurasthenia. In this disease construct, doctors fused central tenets of nineteenth-century German science (including electrophysiology and thermodynamics) into a medical construct anchored in the body and susceptible to scientific treatment. A new generation of practitioners examined, treated, and experimented on the body with technologies that became integral parts of the material culture of this age. They also tied neurasthenia to contemporary consciousness of social rupture. In their writings and interactions with patients, doctors tirelessly affirmed the view that the age of electricity and the age of nervousness were one and the same. The possibility of speaking of the body as electrical dynamo in the first place was inseparable from the paradigm shift linked with the advent of the electrotechnical age—a shift experienced more dramatically in Berlin than anywhere else. Chapter 2 looks in detail at the construction in the 1870s and 1880s of neurasthenia as bourgeois malady, focusing principally on the role of electrotherapeutic apparatus in mediating views of the syndrome and doctor-patient interactions. It examines the rise of a progressive new community of nerve doctors, many of them Jewish and based in Berlin, and the “somaticist” world of late nineteenth-century nerve medicine in which the neurasthenia disease construct flourished and gained validity as a signature condition of the modern age. In chapters 3 and 4 the focus turns to neurasthenia’s transformation into mass condition from the 1890s through the Great War. Here the mediating agency is insurance and its function as social technology that submitted the shocks, accidents, and afflictions of modern life to rational techniques of management. Focusing on interactions between doctors and railway personnel and soldiers, the chapter analyzes the new networks and institutions brought into being by social insurance and the reconfiguration of doctor-patient relations as a result. These chapters also take account of the implications for medical theory and practice of the backlash against the social state. Last, they trace electrotherapy’s evolution from bourgeois treatment into the cornerstone of the psychological, disciplinary regime of mass treatment employed by doctors during the Great War. Chapter 5, covering the years 1900–26, looks at medical discourses about female telephone operators and the role of electricity as pathogen in their nervous disorders. The chapter examines the position occupied by operators both in the rationalization movement that animated
14 INTRODUCTION
Weimar social policy and in the postwar backlash against social insurance. Along with shell-shocked soldiers, operators played a central role in the medical recasting of traumatic neurosis as a condition caused not by an external event (a shock) but by morbid internal conditions (fright or hereditary weakness). Reconceptualized as a pseudomalady, traumatic neurosis was ultimately disqualified as a compensable illness in 1926 by the revision of Germany’s social insurance legislation. By the late 1920s, when Freud was theorizing neurosis as a universal condition of modern civilization, mainstream German psychiatrists were dismantling the social contract built around neurasthenia. Losing its anchorage in the individual body, nervous illness became inscribed in more collectivist notions of heredity and mass psychology, even as medical experts shifted the burden of diagnosis away from the technological discontents of modern life to the pathologies of the bureaucratic social state.
ONE
Berlin Electropolis
D
uring the summer of 1896 the attention of Berlin’s populace was captured by the Trade Exhibition held in the Treptow Park along the banks of the Spree. For five and half months that summer Berliners thronged to the grounds of the exhibition to marvel at the accomplishments of industrial civilization. Held to commemorate Berlin’s twenty-fifth anniversary as the capital of unified Germany, the exhibition also offered its citizens an opportunity to take pride in their city’s entry into the ranks of “world cities.”1 To the visiting crowds, the exhibition’s brilliant array of transportation and communications equipment, dynamos, lighting displays, and other mechanical contrivances demonstrated beyond any shadow of a doubt that Berlin’s destiny was tied to that of technology in general and to that of electrical power in particular. As one guidebook put it, visitors beheld in the Trade Exhibition the incontrovertible proof that Berlin had become “the capital of the electrotechnical industry.”2 Visitors were also invited to pay homage to the human labor that had given birth both to the exhibition and to the city that staged the event. The feats of production involved in preparing the parklike grounds and the exhibition’s lavish structures were symbolized in the poster promoting the 1896 exhibition, which depicted the monumental form of a worker’s hand wielding a hammer looming over the entrance to the Trep15
16 BERLIN ELECTROPOLIS
tow Park. The celebration of labor was also a constant theme of the guidebooks. Not for nothing, ran one, did Berlin, “this radiant symbol of tireless work . . . claim to be the first industrial city of the world.” Following an extensive tour of the grounds the guidebook ended on this note: “Our stroll through the main buildings is now at an end. In every sphere of human knowledge and achievement we are confronted by something new and productive, and everywhere we receive the impression of restless striving and purposeful exertion of all forces.” Addressing the visitor as flâneur, the guidebook nevertheless exhorted him to appreciate the exhibition as a monument to the indomitable spirit of this “city of incessant, tireless work.”3 Throughout the summer of 1896 the Trade Exhibition provoked considerable commentary, not all of it equally rapturous. Maximilien Harden, publisher of the weekly Die Zukunft, reflected on the event’s meaning in tones that echoed wider concerns about the tremendous acceleration of Germany’s recent history. The exhibition, he wrote, acted dangerously on the fevered minds of visitors already afflicted with the condition first identified by the great Berlin psychiatrist Wilhelm Griesinger as “excitable weakness” (reizbare Schwäche).4 Visitors who wearied of the official celebration of technology and the Prussian work ethic could also find respite in lectures that attempted to take the exhibition’s measure in less heroic tones. In a talk delivered to one audience, the prominent Berlin neurologist Albert Eulenburg analyzed the exhibition from the perspective of a medical specialist. For Eulenburg, the hallmark of the exhibition was its assault on the senses. No visitor, he observed, could fail to be overwhelmed by the onslaught of noises and visual impressions that crowded in on him from every side. The visitor’s eye was bombarded by “the rays of electric lamps” and by countless other stimuli. Images and impressions of all kinds competed for his attention, until in the end the unwary visitor found himself helplessly immersed in the “torrent of modern life.” Medically speaking, Eulenburg concluded, the exhibition of 1896 was nothing less than a “temple to the cult of nervousness.”5 In his review of the Trade Exhibition, sociologist Georg Simmel noted its implicit claim to universality, a feature it shared with other world fairs: “It is a particular attraction of the world fairs that they form a momentary center of world civilization, assembling the products of the entire world in a confined space as if in a single picture.” Nothing was missing from this world picture; thus, he continued in a somewhat ironic vein, “it becomes clear what is meant by a ‘world city’ and that Berlin, despite everything, has become one.” For Simmel the Trade Exhibition of 1896
BERLIN ELECTROPOLIS 17
therefore represented a turning point in Berlin’s history, a new threshold in the capital’s modernization. Echoing Eulenburg, he went on to note that visitors to the exhibition experienced a kind of sensory derangement, a state he likened to “a veritable hypnosis”: “The way in which the most heterogeneous industrial products are crowded together in close proximity paralyses the senses.” And yet, he went on, it could not be denied that “the richness and variety of fleeting impressions” answered a genuine craving for excitement by “over-stimulated and tired nerves.”6 Simmel traced this paradox to the effects of the industrialized division of labor and suggested that part of the exhibition’s attraction lay in the sheer plurality of impressions that it offered visitors, which compensated them for the sense of estrangement they experienced in their working lives: While increasing civilization leads to ever-greater specialization and to a more frequent one-sidedness of function within an ever-more limited field, in no way does this differentiation on the side of production extend to consumption. Rather the opposite: it appears as though modern man’s one-sided and monotonous role in the division of labor will be compensated for by consumption and enjoyment through the growing process of heterogeneous impressions, and the ever faster and more colorful change of excitements.7
The productive forces unleashed by the modern division of labor were accompanied, at the level of the body, by the destruction of the former unity of experience and the privileging of the eye over the other senses. But through the sheer richness of its sensory impressions, the exhibition seemed to compensate visitors for this loss. At other moments, however, he questioned this possibility, suggesting that, even in the phantasmagorical dream worlds of modern mass consumption, a sense of compulsion reigned. According to Simmel: “We are now called upon to amuse ourselves according to the principle of energy conservation.”8 In writing of the Trade Exhibition in terms of its effects on the nerves, Eulenburg and Simmel were working standard variations on an eminently modern theme. The basis of this theme was that the modernity unleashed upon Germans twenty-five years previously with the founding of the Reich had exacted a psychic cost and that Berlin’s and Germany’s further development was jeopardized by a crisis of growing nervousness. Around 1900 German public discourse was flooded with writings identifying nervousness as the signature condition of technological modernity. The fundamental premise of these writings was that nervous disorders had increased in modern times, fueled by an imbalance between the
18 BERLIN ELECTROPOLIS
increasing demands the civilizing process placed on the nervous system and the nervous system’s inability to cope with those demands. Taken as a whole, these writings suggested a fundamental rethinking of the modernizing process—a conceptual shift reflected in the organization of the Trade Exhibition of 1896. The decisive feature of the image of modernity projected by the exhibition was that of a civilization consciously reflecting both on its own power and on the shocks and dislocations of the modern world. Coupled in this event were a celebration of progress and a simultaneous reflection on its hidden costs. This duality was legible in the spatial program and symbolic language of the exhibition. On the one hand, the exhibition celebrated technology, and in particular electrical technology, as the preeminent symbol of the nineteenth-century gospel of progress. In the writings of commentators, electrotechnology seemed to throw a kind of veil over the entire grounds, above all, in the lighting displays that were a source of universal amazement. The calculated effect was to show that Germany’s economic destiny and world position was bound up with its prowess in the technological arena. On the other hand, alongside the conventional demonstrations of imperial power (the Hall of Machines, Krupp’s cannon works, the colonial pavilion), the exhibition also set aside considerable space for the field of social policy, in which Germany’s world leadership was unrivaled. German achievements in this field were showcased in the Exhibition for Health, Welfare, and Education, where the Ministries of Public Health and Insurance had organized exhibits demonstrating the latest advances in hospital design, welfare, nutrition, sports, and other fields of social hygiene. Informational displays and exhibits presented visitors with data on social insurance, accident prevention, and safety measures in the workplace and on facilities for treatment and recuperation. Statistical tables documented the increasing reach of social insurance over the lives of the nation’s workers; in 1894, according to one, the accident insurance system had considered 282,982 claims and awarded compensation in 69,619 cases.9 Such statistics demonstrated that industrial accidents could no longer be treated merely as unfortunate disruptions of the continuum of modern life; they were regular, even predictable, events, whose occurrence had to be integrated into a rationally planned system for protecting Germany’s worker-citizens against the risks, shocks, injuries, and anxieties of modern life.10 The didactic content of these exhibits also emerged in an encyclopedic work issued in connection with the exhibition, Berlin und seine Arbeit.
BERLIN ELECTROPOLIS 19
Containing lengthy descriptions of every branch of labor, this massive tome interpellated Berliners as workers bound together in a community defined in productivist terms. Equally lengthy sections on social insurance and hospital reform and expansion spelled out measures for the preservation and reproduction of labor power. These sections also described recent developments in the field of healthcare, from the construction of new municipal hospitals and clinics to the introduction of new therapies including x-rays and a variety of electromedical devices. If in the colonial pavilion the visitor’s gaze was invited to range across the glories of empire, in the medical exhibits his or her gaze was invited to penetrate the deepest mysteries of the human body: “The body and its cavities,” so the guidebook ran, “can be illuminated with electric light,” while current could also be used to stimulate the various parts of the body, including the nerves. The special needs of Berliners’ nerves were also addressed in a description of new clinics designed for nervous sufferers: “With these patients the ‘nerves’ play a great role, and even seemingly trivial matters, such as the rustling of a nurses’ clothes, can plunge nervously disposed patients into great disquiet.” Lest this be mistaken as a waste of public resources on the well-to-do, the text noted that “[n]eurasthenia is nowadays very widespread among the working classes as well.”11 The exhibition, which offered itself up to the visitor’s dazzled senses as a utopian metropolis, projected a highly idealized version of Berlin’s rather more complex reality. What emerged from its exhibits and from the texts accompanying them was a vision of a new social order based on the recognition that modernity both produced its own discontents and was responsible for mitigating them. A central symbolic and functional place in the construction of this idealized order was assigned to electricity. Commentators dwelled repeatedly on this aspect of the Trade Exhibition: on the four power stations that supplied the energy necessary to illuminate the grounds; on the electric streetcars that transported visitors around the park and the illuminated kiosks that dotted the grounds; on other novelties such as the electric kitchen and the cinematograph. All these provided further intimations of the increasingly pervasive presence of electricity in everyday life.12 In his account of the impact of mechanization on modern life, Siegfried Giedion identifies the 1890s as a decisive moment in the crystallization of electrical technologies.13 According to Giedion, the question of whether electricity should be made available to the masses was discussed everywhere in that decade.14 Prior to this time, it was chiefly at the international exhibitions that members of the public came into con-
20 BERLIN ELECTROPOLIS
tact with electrical devices. At the First International Electricity Exhibition, held in Paris in 1881, Thomas Edison’s recently invented electric lightbulb captured the public imagination. Visitors were entertained by performances of Wagner transmitted over the telephone, while adventurous young men tested their fortitude by submitting themselves to electric shocks; some wound up in the hospital as a result.15 By the 1890s electricity was entering the sphere of everyday life. The first overhead transmission line was created in 1891 in conjunction with the International Electricity Exhibition held in Frankfurt that year, and alternating current was introduced for the first time.16 In rapid succession, central power stations, electric streetcars, lighting systems, telephones, and cinematographs made their entrance onto the stage of modern life. Cumulatively these technologies would transform Germany’s social landscape over the next three decades.17 The Trade Exhibition of 1896 represented the culmination of the enthusiasm for all things electric that had marked the preceding decade and a half. In a real sense it illustrated that, to paraphrase Walter Benjamin, such events provided visitors with training for interaction with machines, environments in which they learned to adjust their eyes, senses, and bodies to the rhythms and demands of technical apparatus. A striking demonstration of this could be found in the so-called Telephon-pavillon. Visitors received demonstrations in the physics of communication at a distance in this pavilion, where, according to one guidebook, telephone operators were on hand to initiate them into the “secrets of telephony.”18 The pavilion itself was decorated with fanciful allegories depicting these female operators as nymphlike representations of the vital force. But these ornamental figures were more than merely a decorative strategy or a means of domesticating technology for public consumption. The assimilation of the human (female) body to electrical technology was an expression of the Trade Exhibition’s organizing principle: that electrical energy and human labor power were manifestations of the same force and were bound together by an identical law, the law of the conservation of energy. If their simultaneous harnessing was the great project of the social utopia conjured up by the exhibition, then the possibility of their simultaneous breakdown was the specter haunting this society.
CAPITAL OF THE SECOND INDUSTRIAL REVOLUTION The 1890s marked an important threshold in the modernization of both Germany and its capital. Though still a relatively modest city in the mid-
BERLIN ELECTROPOLIS 21
nineteenth century, Berlin made up for its belated development with remarkable speed after 1871. At midcentury its population had been 400,000; fifty years later this figure had reached 2 million, and its surrounding suburbs added another 1.5 million. The city’s vertiginous growth was fueled by the economic boom that followed unification; by waves of immigrants from the countryside; and by the ever-expanding bureaucracies needed to administer the empire. In short order, the city acquired the structures needed to accommodate this growth: the official buildings housing the new empire’s administrative organs; the shopping districts of the West End; and the “rental barracks” (Mietskaserne) of the northern and eastern districts, where the city’s working classes lived. Berlin’s physical development was driven by processes of headlong speculation and construction that succeeded in rapidly building up the city but also in giving it, in the eyes of many contemporaries, a hectic, formless character. The city’s response to this phase of explosive growth was to attempt to impose a more rational form on its own development. With the emergence of an industrial working class in Berlin had come the first appearance of the cluster of problems such as housing shortages and unhygienic living conditions, which collectively made up what contemporaries called the “social question.” 19 Municipal and state authorities collaborated in fashioning programs to address these problems. A concerted building program, resulting in the construction of municipal hospitals, sanitation systems, housing, and other infrastructure, put Berlin in the vanguard of the field of urban hygiene. The capital’s modern profile was further shaped by street lighting systems and innovations such as the electric streetcar, which was pioneered in Berlin.20 All on display in the summer of 1896, these innovations served as tangible symbols of the city’s modernity, evidence that Berlin held out the promise of a new kind of metropolis. The claim that Berlin was a historically unique urban agglomeration was not mere hyperbole. Its transformation into a world city coincided with the advent of the second industrial revolution and made it a symbol of this new phase in the development of capitalism. During the 1890s the German economy underwent a profound inner realignment. Following the crisis of 1873, the nation’s economy had experienced two decades of uneven, crisis-ridden growth. Economic liberalism, never embraced wholeheartedly in Germany, was completely discredited by the end of this so-called Great Depression, whose legacy was a profound mistrust of the instability associated with the free market. By the time the country’s economy finally emerged from this phase in the mid-1890s, it
22 BERLIN ELECTROPOLIS
had assumed a fundamentally new form. As Hans-Ulrich Wehler has written, the year 1895 marked a watershed between two distinct epochs in the history of capitalism, one that, by ushering in a process of concentration and centralization, laid the foundation for the new era of socalled organized or managed capitalism.21 The Trade Exhibition of 1896 thus stood at a threshold moment of transition from one form of capitalism to another, a transition driven by the new industries built on electricity and chemicals.22 The innovations in lighting, transportation, and communications displayed at the exhibition were the most visible manifestation of the revolution in economic and everyday life wrought by electrical power’s replacement of older forms of energy. In Berlin, this shift was perhaps most clearly symbolized in the giant electrical enterprises Siemens and the AEG (Allgemeine Elektrizitäts-Gesellschaft).23 Headquartered in the capital, these imposing firms became visible expressions of what Schivelbusch calls the “new faith in technical, scientific and economic planning that emerged around 1900.”24 They were the most modern firms in Germany not simply in terms of the markets they supplied but also in terms of their workplace organization, their use of the principles of scientific management, and their financial practices.25 Their dramatic growth, noted Egon Friedell, transformed Berlin from the city of Fichte and Hegel into the city of Siemens and Halske.26 The concentration of labor, resources, and money required to build and run these enterprises gave Berlin its distinctive physiognomy. Their factories emblematized the shift from a crafts-based economy to one dominated by large-scale industrial production as well as Berlin’s transformation from “city of hand manufacture” (Handwerkstadt) into Elektropolis.27 Contemporaries described these factories and their ancillary structures, including housing developments, as marvels of modern enterprise, design, and hygiene. They were cleaner, less noisy, and less dangerous than their precursors, and the production process in them was structured and paced according to the most advanced contemporary thinking about the science of work. They thus served as testing grounds for a future society based on the principles of scientific management. Among the new consumer goods these firms manufactured were products ranging from clocks and lamps to telephones.28 The proliferation of such artifacts around the turn of the century radically altered the structure and experience of everyday life, engendering, in Friedrich Kittler’s phrase, a “second industrial revolution of the mind.”29 Synchronized clocks at the entrance to the Academy of Sciences on Unter den
BERLIN ELECTROPOLIS 23
Linden and other central locations around the city were connected to the city’s observatory through underground cables, standardizing time throughout the urban landscape.30 Railway travel, with its timetables, reinforced this new time consciousness and drastically compressed geographical space. The experience of time also became more compressed, particularly through the acceleration of the news cycle. Berlin’s newspapers increased dramatically in number, using technological innovations to report on the day’s events with ever greater immediacy. Front pages were filled with telegrams, often carrying the latest stock-market quotes, and telephone reports delivered in a clipped, highly economical syntax.31 The city’s topography underwent continuous further alteration during the 1890s. The insatiable needs of the Berlin populace for news were met by a thriving newspaper quarter, where “[n]ight and day, messengers arrived, telegrams hummed, phones rang, charging the district with energy.”32 Many of the city’s newspapers were owned by Jews, and their pivotal role in shaping the cosmopolitan tastes of the Berlin reading public became an important aspect of what Peter Gay has called the “BerlinJewish symbiosis.”33 The same was true of many of the department stores that began appearing in the city in the 1890s. The same year that the Trade Exhibition was held, construction began on the colossal department store Wertheim, a temple of modern consumption that enticed customers by displaying its wares in a setting reportedly illuminated by ten thousand lightbulbs. Nearby stood Potsdamer Platz, which more than any other single site symbolized the speed, movement, and crowds that marked Berlin. Two of the city’s train stations stood directly on or adjacent to Potsdamer Platz, and by 1908 thirty-five streetcar lines converged there, competing for space with vehicular traffic and contributing to constant traffic jams. Potsdamer Platz embodied the technological modernity that had produced Berlin and made it simultaneously an exciting and highly disorienting city.34 Moving through such urban spaces, as Walter Benjamin would later memorably write, “involves the individual in a series of shocks and collisions. At dangerous intersections, nervous impulses flow through him in rapid succession, like the energy from a battery. Baudelaire speaks of a man who plunges into a crowd as into a reservoir of electric energy.”35 A classic modernist response to the shocks of the urban milieu was Alfred Döblin’s in his 1913 “Berlin Program,” which recorded his wish to become wholly “depersonalized”: “I am not myself, but the street, the street lamps . . . otherwise nothing.”36 Not flight from the city but com-
24 BERLIN ELECTROPOLIS
plete identification with it was Döblin’s chosen strategy. More characteristic was a sense of dismay in the face of the speed that marked life in the metropolis, which scarcely left time to assimilate its barrage of stimuli. Peter Behrens, house architect for the AEG, noted: Our age has been seized by a haste that leaves no time for absorption in details. When we race at high speed through the metropolis, we can no longer see the details of buildings. Just as the images of the city seen from an express train passing by at high speed can only have an impact through their silhouettes, individual buildings can no longer speak for themselves. Such a way of seeing has already become a habit for us.37
A giant construction site, a city always in the process of “becoming,” never “being,” as Karl Scheffler lamented in 1910, Berlin’s closest analogue was neither Paris nor Vienna but Chicago—a parallel frequently noted by Berliners.38 Berlin’s “Americanization” was a well-established trope by the turn of the century, when the Baedeker guide described three-quarters of the city’s buildings as quite new and hence devoid of historical interest.39 Conservatives deplored this Americanism, seeing Berlin as the embodiment of a soulless and purely mechanical civilization (Gesellschaft) hostile to memory, tradition, and the more intimate scale of community (Gemeinschaft).40 But while some lamented Berlin’s formlessness, others saw that beneath the appearance of formlessness a complex new order was coming into being. As the Trade Exhibition of 1896 seemed to indicate, the capital and its inhabitants were beginning to assimilate the tremendous changes of the preceding twenty-five years and to search for a new principle of social organization. In 1894 an article in Die Zukunft suggested that electrotechnology furthered the process of centralization like no other field of industry, a process welcomed by the article’s author as a harbinger of future progress. A subsequent article on electric trains welcomed them as the cleanest form of transportation known to man.41 Whether it was regarded as a force of centralization or of hygiene, contemporaries generally saw electrification as a development that would impose a more organized and rational form on the modern world and thus repair some of the injuries inflicted by the first industrial revolution.42 The onset of organized capitalism increased Berlin’s importance as both an economic and an administrative and institutional center. Max Weber would later note that bureaucratization and electrification had both developed particularly rapidly in Germany because of the relative absence of preexisting structures and forms of energy, and these
BERLIN ELECTROPOLIS 25
processes gave a definite cast to the capital’s emergence as world city.43 They also imparted a particular character to its inhabitants. This was apparent in the rapid growth of a sector associated with the increasing concentration of industry and population in the capital: the so-called new white-collar class drawn from the managerial strata, service personnel, and municipal and state bureaucracies. By the early 1900s a small army of these salaried masses inhabited Berlin. “The first industrial city of the world,” as the guidebook for the Trade Exhibition had called Berlin, stood at the threshold of a shift that would dramatically change its physiognomy. Turn-of-the-century processes of rationalization and bureaucratization heralded Berlin’s eventual transformation from an Industriestadt into what Siegfried Kracauer, following sociologist Werner Sombart, called a Beamtenstadt.44 As the capital acquired a new profile, moreover, it began to structure the lives and perceptions of its inhabitants accordingly. By the 1910s observers began to note the new disciplining or regimentation of Berlin’s crowds, who increasingly took their cues not only from the multitude of excitements offered up to them but also from the new work routines, behavioral codes, and lifestyle patterns that inscribed their lives in the capital. In the 1920s, Siegfried Kracauer would call this patterning of the masses, which was most visible among the new salaried employees created by Germany’s industrial restructuring, the “mass ornament”—a reconfiguration of the coupling of human body and machinic forms and rhythms depicted in the ornamental allegories of the Telephon-pavillon at the Trade Exhibition.45 New collectivities were being forged, as Peter Fritzsche has shown, through the medium of the increasingly ubiquitous boulevard press and other instruments of the modern mass media, like the cinematographs that first appeared in Berlin around 1905 and thereafter multiplied rapidly.46 Yet another of these new communities was that forged by social insurance and by the set of policies and discourses it brought to bear on the problems of the modernizing process. Taken together, these developments attested to a process of rationalization in German society. This process, whose intent was to create a more stable and productive social order to take the place of that lost in the industrializing process, would, as we shall see, generate its own tensions and crises. These new collectives were themselves often fragile, subject to disturbances and breakdowns. Nevertheless, this process inspired powerful visions, such as that staged at the Trade Exhibition of 1896 and that of Walther Rathenau, heir to the AEG empire, who wrote that, in Berlin as perhaps nowhere else, technology and the human body were
26 BERLIN ELECTROPOLIS
being fused into a single organism; in the German capital, he wrote, “an electrical nerve-system pulsates with the life of the city.”47 This image of Berlin as an intricate, smoothly functioning organism deserves to be taken seriously as the expression of a historically specific vision of a modern, rationally planned society. Yet it could also be seen as more wishful projection than reality, even a form of compensation for the violent shocks that marked life in the capital. Was Berlin, contemporaries wondered, a soulless mechanism or an intricate synthesis of parts? If the latter, what was its organizing and animating principle? This was the question implicitly posed by Egon Friedell in 1912, when he described Berlin as “a wonderful modern engine room, a giant electrical motor, which executes with marvelous precision, speed and energy a plethora of complicated, modern tasks. True, so far, the machine lacks a soul. The life of Berlin is the life of a cinematograph theater, the life of a brilliantly constructed homunculus machine. But that is enough for a start. Berlin is in the awkward adolescent years of a coming culture.”48
BREAKDOWN CITY By the turn of the century, Berliners had become the bearers of a new sensibility characterized by a preoccupation with speed, novelty, technology, and the excitements of modern life. The disease picture surrounding neurasthenia, an American import, was recognized as particularly well suited to this most hypermodern and American of Europe’s cities. When in 1898 the Manoli tobacco firm pioneered the use of electrical advertising by creating a revolving wheel of light above Berlin’s rooftops, it became a Wilhelmine synonym for insanity.49 Nervous overstimulation and breakdown was part of the everyday texture of life in Berlin, as Albert Eulenburg implicitly suggested in his talk at the exhibition of 1896. Eulenburg had concluded by posing the following questions to his audience: “What is nervousness? Who is nervous?” For answers, he turned to the fields of experimental physiology and psychology. These, he said, taught that between the stimulus (Reiz) and our reaction a “definite interrelation” exists. Pathological reactions occurred when excessively strong stimuli produced heightened excitability or exhaustion (reizbare Schwäche). This explained the state of overstimulation experienced by visitors to the Trade Exhibition. As for his second question, Eulenburg implied that, while certain types were particularly prone to nervousness, no one in this day and age possessed a guarantee against it.50 One of Eulenburg’s colleagues, Berlin nerve specialist Alfred Gold-
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scheider, wove another variation on this theme. Goldscheider was similarly interested in the effects on the nervous system of stimuli such as electrical lighting. Advances in lighting technology, according to Goldscheider, meant that society’s demand for illumination no longer knew any limits beyond those of the human organism itself. Saturating the urban landscape with light and eliminating the distinction between day and night, electrical lighting broke up traditional rhythms of activity and rest and allowed individuals no respite from unending streams of light stimuli. The resulting states of psychological overstimulation (Überreizung) often assumed the pathological forms familiar to him from his medical practice.51 Like Eulenburg’s talk, Goldscheider’s text illustrates how the medical response to these processes was implicitly linked with a commentary on modern life. This kind of commentary could also take on a more sociological cast. The concentration of an unmoored, potentially revolutionary proletariat in Berlin fueled anxieties about the effects of new modes of work and urban life on this class. These concerns were articulated in the new idiom of nerves by social psychologist Willy Hellpach. Hellpach regarded nervousness as a malaise rooted in the decline of traditional forms of work. He speculated that the broken connection between the worker and his Heimat, his tools, and the products he made had profoundly negative consequences for his psychological and moral outlook.52 Cut off from Hand und Land, Germany’s urban workers fell prey to nervous disorders. Moreover, unlike the middle classes, they found it harder to find relief from the conditions of their existence. According to Hellpach, one had only to leave Berlin’s West End, with its wealth of consumer goods, for the streets of Berlin’s proletarian districts to experience firsthand the monotony and “soullessness” of proletarian life.53 Even if Hellpach’s commentary revealed more about middle-class anxiety than it did about the situation of the working classes, the deployment of electricity in the workplace unquestionably produced significant changes in the nature of work and the bodies and mentalities of those who performed it. Some commentators, as we saw in the case of Rathenau, discerned visionary possibilities in the new symbiosis of machines and bodies. But if such images expressed a powerful faith in the new possibilities of the technological age, then other possibilities were seen to flow from the increasingly complex meshing of body and technology as well. In 1908 a compendium of occupational illnesses described a new malady spreading among workers in Berlin’s electrotechnical industry: “The number of neurasthenics among the electricians
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working at the control panels is very high; I know very few electricians who don’t suffer from overstimulated nerves. . . . It would appear from the existing experiences that all workers dealing with electricity have an inordinate disposition to nervous illness.”54 Everyday life in Berlin was no smooth, frictionless affair; it was marked by constant accidents, stoppages, and breakdowns.55 The increasing dependency of the city’s inhabitants on precisely calibrated machinery left them ever more vulnerable to technical malfunction. Georg Simmel speculated that if all the clocks in Berlin were to suddenly stop functioning, “its entire economic and commercial life would be derailed for some time.”56 One common site of breakdown, both technical and human, was the telephone exchange. The 4 August 1904 edition of the Berliner Lokaler-Anzeiger documented one of the accidents that had become a common occurrence at these exchanges. According to the article, a series of recent dramatic thunderstorms had charged the atmosphere with electricity. Excess charge had entered the telephone lines to such an extent that, at Exchange 1 in Französischestrasse, one operator had suffered a bad shock from electrical current and was knocked senseless. Service had been briefly disrupted while the young woman was attended to. The article called upon the administrators of the telephone system to take all necessary steps to ensure the safety of these women, whose work was already “nerve-shattering” under the best of circumstances.57 Such scenarios haunted life in the capital and were constantly discussed in the pages of a new specialist literature devoted to electricity and its applications.58 A later, more catastrophic rendering of this potential for breakdown animates the scene in Fritz Lang’s Metropolis (1927), in which an exhausted worker collapses at the controls of the dynamo, triggering a massive electrical short circuit that threatens to destroy the city. Such scenes attest to the central importance of the breakdown—technological, nervous, or social—within the social imaginary of modern Germany. At such moments, the set of constructs that collectively formed what Wolfgang Schivelbusch has called “the technological web”—the complex network of social forms produced by mechanization, the division of labor, and workplace discipline, along with the corresponding perceptual and behavioral forms—could collapse.59 Occurrences such as these generated concern over both safety measures and workers’ disposition and performance. From the 1890s onward, medical conferences and studies generated masses of data relating to the causes of fatigue, accidents, and nervousness in the workplace. Mechanization, it seemed, engendered a general crisis of the body,
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which it became the expert’s task to analyze and, where possible, repair. So argued German-born, Harvard-based industrial psychologist Hugo Münsterberg, who maintained close ties to Berlin’s scientific community: “The rapidity of movement of electrical machines upsets subjective rhythmic experience . . . [thus] turning the factories themselves into one big laboratory,” in which the problem of fatigue could be “studied by practical experiments.”60 Plugged into new networks and grids of power, workers’ bodies and attitudes became objects of scientific analysis. In the early 1900s the electrotechnical giant Siemens conducted a study of its workforce to determine the relationship between power usage (energy curve) and workforce performance (work curve) during hours of peak demand in Berlin. Researchers calculated performance as a function of electrical currents for every branch of the industry. Results showed that the work curve gradually climbed from 7:00 a.m. onward, reaching the high point by midmorning; in the afternoon, as fatigue and monotony took their toll, the curve reached only about three-quarters of its morning peak. Analyzing these findings, Berlin nerve doctor Emmanuel Roth related them to the psychological effects of specialization and the rise of machinedriven labor. The lack of satisfaction associated with such work, he wrote, explained the nervous complaints familiar to the staffs at the city’s hospitals and clinics.61
THE THERMODYNAMIC BODY As novel as the mode of explanation employed in Roth’s analysis is the discursive space within which it was produced. Specifically, this juxtaposition of body and metropolis—and their mediation through the vital force of electricity—illustrates a variant of what Anson Rabinbach has characterized as the thermodynamic calculus of the late nineteenth century, according to which the body, not the social relations of the workplace, was made the arena of labor power.62 As Rabinbach has shown, one important strand in this new paradigm of labor power can be traced back to the work of Hermann von Helmholtz and the “group of 1847,” to which he belonged. This group—a small Berlin-based band of physiologists that also included Emil Du Bois-Reymond, Carl Ludwig, and Ernst Brücke—played a central role in the mid-nineteenth-century revolution of the life sciences. Rejecting the belief that life was governed by a vital principle and insisting that physiology be analyzed exclusively in terms of chemical and physical laws, these mechanists abandoned the
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prevailing vitalist orthodoxy of the life sciences. One of the decisive moments in this shift occurred in 1848 with Helmholtz’s formulation of the law of conservation of energy, according to which all forms of energy, mechanical and physiological, are manifestations of the same universal force, whose total quantity is fixed and unvarying. The implications were spelled out in Du Bois-Reymond’s introduction to his work on electrophysiology, published in 1852: “I have succeeded, unless I am completely deceived, in awakening to vigorous reality . . . that 100-year dream of physicists and physiologists of the identity of the nerve process and electricity.”63 Methodologically, this breakthrough opened up a vast new field of inquiry. Freed from the metaphysical strictures of idealist psychology, the new science rejected the old doctrine of the soul as an indivisible, immaterial entity off-limits to scientific inquiry. The collapse of traditional conceptions of the self (“soul”) left a space into which new conceptions moved.64 The doctrine of nerves assumed a privileged place within the new sciences of physiology and psychology. The proponents of the new science (henceforth known as “psychology without the soul”) defined the basic properties of nerves as “electric currents” and “reflex movements.”65 The new psychology found a powerful image in the famous analogy that Helmholtz drew between nerves and telegraph wires.66 For Helmholtz and his followers, this image had more than just metaphorical significance; these scientists exploited telegraphic technology both for analogical purposes and for instrumentation in their experiments. The device Helmholtz used to perform his celebrated experiment on the speed of nervous conduction, a measuring instrument called a myograph, was adapted from a piece of telegraphic equipment invented by his friend the industrialist Werner Siemens.67 From this point on, innovations in the technical applications of electricity provided one of the preconditions, both practically and conceptually, for the scientific discourses of man.68 Physiologists, psychologists, and psychiatrists framed these discourses in terms borrowed from the realm of advanced communications technology.69 Experimental psychologist Wilhelm Wundt’s description of the apparatus employed in his laboratory made it sound as though he were engaged in telegraphy rather than psychology.70 For Werner Siemens, the telegraph system and the nervous system were structurally and functionally alike in the way that both integrated their respective bodies, social and physical.71 The philosopher of technology Ernst Kapp took this line of argument to its
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logical conclusion in theorizing that the telegraph was an externalization of the human nervous system. Describing his work as a “cultural history of organ projection,” Kapp used diagrams to show the structural similarity between telegraph wires and nerves.72 The one-to-one correspondence between nervous and electrical systems became a staple of psychiatric discourse as well. Theodor Meynert theorized that the brain’s “association centers” connected to reflex movements via a kind of telephone switchboard, while his colleague Carl Wernicke described sensory-motor units as communicating with one another along so-called association fibers, which they ran up and down like electrical pulses along a telegraph line.73 By 1900 this analogy had become a standard feature of popular medical pamphlets such as the one published by Berlin physician Dr. Kurt Hartmann, Die Nervenpflege. According to Hartmann, the body’s nerves were electrical lines no different from telephone wires; normal and pathological function in the one mirrored that in the other: “As in a telegraph office at a nodal station the messages are often ‘umtelegraphiert,’ so in the nervous tissue, there are also ‘switching stations,’ where nerve impulses are relayed.” Breakdowns occurred when these stations became overloaded. Hartmann further developed this analogy by linking it to the “machinery of state”: the “nerve telegraphs” conducted the messages—that is, the “orders of the government”—sent by the brain (the exchange, or Zentrale) to the muscles.74 Out of this combination of scientific speculation and technological enthusiasm emerged a new conception of the self according to which body and psyche were configured as a delicately balanced thermodynamic system, traversed by flows of energy and subject to breakdowns. As Rabinbach shows, this novel conception would have far-reaching implications, reverberating throughout the worlds of medicine, social policy, philosophy, and literature.75 The possibility of a thermodynamic crisis of the body would come to occupy a central place in the work and thought of specialists across a broad range of new fields, including scientists of work, industrial psychologists, medical experts, and insurance administrators. It may receive its consummate expression in Daniel Paul Schreber’s Memoirs of My Nervous Illness, published in 1902. This celebrated account attributes the author’s nervous breakdown to a generalized state of “high-grade excitation,” a process of entropic running-down resulting from “over-civilization.”76 Schreber experienced this condition as a form of “un-manning,” and his memoir records in detail the processes of feminization and technologization that are inscribed onto his body and nerves.
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Variations on this theme also took a more quotidian form. In the early 1900s, an issue of a German trade journal for telephone operators reviewed an article of Thomas Edison’s on care of the body that appeared in the New Yorker World. Edison’s article described the body as a “dynamo-machine” and suggested that, like any machine, the human dynamo needed adequate nourishment and rest. In admiring tones the review reported Edison’s claim to be able to sleep anywhere, anytime—even (so he claimed) in a boiler room—and concluded by exclaiming, “Heaven protect Edison’s nerves!”77 It was in the work of Gustav Theodor Fechner that the implications of the new psychology were followed through most systematically. Fechner’s invention of the field of psychophysics—which came to him in a dream inspired, he claimed, by Helmholtz’s “great energy principle”—made possible the specification of the relations between stimulus and reaction with hitherto unequaled precision.78 By quantifying these relations, Fechner demystified earlier conceptions of excitability, acknowledged since the eighteenth century as the “vital primordial fact.”79 Stimulation as such became a topic of intense scientific interest, and the problem of overstimulation entered the specialized domain of the medical expert.80 Scientists distanced themselves from earlier schools of psychology by making use of experimental methods and subtle methods of stimulation and measurement. From this point onward, physiology—and by implication everything to do with nerves—became virtually inseparable from the “electrical method.”81
ZEITALTER DER REIZBARKEIT How did late nineteenth-century Germans come to analyze themselves and the shocks and afflictions of industrial society in the new idiom of nerves? To answer this question we must place the developments traced above in their broader historical context. The “new psychology” was both a novel scientific discipline and a response to the fundamentally altered psychological makeup of late nineteenth-century man. As such it derived validity from the conditions and needs of a rapidly modernizing society. The prestige of the new sciences of man was greatly enhanced by their contributions to the social medicine that evolved in the 1850s and 1860s in response to the industrializing process. Led by Rudolf Virchow, a close ally of the “group of 1847,” science became the repository of Germany’s liberal culture, and Virchow’s belief that social problems had medical and scientific solutions became the reigning ideology of German liberalism.82
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This was born out in the career of Wilhelm Griesinger, another charter member of the 1848 generation. Griesinger was brought to Berlin in 1865 by Virchow to assume the chair of psychiatry. He proceeded to reorganize the Psychiatric Clinic of the Charité by creating a neurological ward and ending the use of physical restraints. Within the religious worldview of early nineteenth-century German psychiatry, mental illness was equated with sin; patients were warehoused in rural asylums, and care consisted of “moral treatment”: isolation and pedagogically motivated restraints. Griesinger, by contrast, stressed his patients’ social situation, the living conditions of the urban masses, in the etiology of insanity. The materialism of this explanation was matched by the materialism of Griesinger’s conception of mental illness. His conviction that there was no mental disease without nervous disease helped emancipate psychiatry from the doctrine of the soul and its moral therapeutics. Griesinger regarded the brain as an “enormous reflex apparatus,” thus making it subject to the same laws as the rest of the body, though he refused to make this an absolute principle, cautioning that “[o]scillation and vibration, all that is electrical and chemical, are still not mental conditions, acts of thought.”83 The discovery in 1870 that electricity could be used to stimulate the brain effectively made Reizbarkeit universal, inspiring historian Karl Lamprecht to coin the label Zeitalter der Reizbarkeit for the era beginning with the Reich’s founding.84 For Griesinger it was axiomatic that a connection existed between social transformation and mental illness. “The present state of society in Europe and America,” he wrote, “keeps up a general half-intoxicating state of cerebral excitement which is far removed from a natural and healthy condition, and must predispose to mental disorder: thus many become insane.”85 In England and France, as Klaus Doerner writes, nervous disorders, hysteria, and suicide had long since become topics of public debate, functioning as “the yardstick of civil, political and economic freedom.” In Germany, however, this development had been delayed by political and economic fragmentation: “As long as bourgeois society proved incapable of achieving self-awareness, of directing the advance of social processes or even influencing them, it could not develop the reflexive awareness that society itself creates not only its own growth but its own ills.”86 By the 1860s, however, the quickening pace of economic activity in Germany breathed life into the bourgeois public sphere, according to Doerner, and produced a new awareness of the problems associated with the modernization process. It was Griesinger’s view that urban life, commerce, technology, and new forms of “brain
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work” triggered a latent predisposition to neurosis, leading to the condition he called “excitable weakness” (reizbare Schwäche)—a function of abnormal reactions originating in unusually heightened or lowered excitability.87 In turning psychiatry into a commentary on modern civilization, Griesinger’s writings established an important precedent in Germany. Over the second half of the nineteenth century, a species of social criticism came into being that theorized insanity—now encoded in the language of nerves—as the price of civilization. Besieged by the onrushing stimuli of the modern world, the body’s vital energies wore down, and concentration or work became impossible. The result was pathological nervousness. As we shall see, this coupling of modernity and nervousness evolved through many stages. Its beginnings have often been traced to that preeminent symbol of modernity, the railway. The influence of railroads on the history of nineteenth-century psychiatry—both railroad travel’s apparently harmful effects on passengers’ or employees’ nervous systems and the risks involved in speculating on railway stocks—attested to the “socio-economic pathogenesis of illness.”88 Railway work itself was soon recognized as a uniquely modern kind of work, one demanding not simply physical stamina but also enormous responsibility and concentration. The so-called neurasthenia of the switchman was one of the occupational hazards it gave rise to: “The switchman stands eight, sometimes twelve hours in a row, often with barely a pause, at a post that requires unrelieved attention and responsibility; he must watch for every signal, opening and closing the switches repeatedly. . . . Given that the nervous system of such an employee is constantly strained and agitated, it is easy to understand that a gradual overstimulation and enervation of the nerves can set in.”89 Similar accounts multiplied concerning the work of locomotive drivers, a position combining physical exertion with enormous personal responsibility and mental strain. Drivers had to supervise “large, complicated machines equipped with much apparatus”; they had to contend with the ever-intensifying demand for speed, with expanding station facilities and signal systems, and with diminishing rest periods.90 Under such circumstances nervousness was virtually inevitable; it was the price paid by the body for progress in the sphere of concentration and labor efficiency. The telegraph—another of the iconic structures of modern civilization—was similarly linked with the rise of modern nervousness. In the mid-1880s, a medical condition labeled telegraphist-illness was observed in many operators afflicted with intense nervous excitability following
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the “agitated period of 1870–71.”91 Working on a Morse apparatus seemed to exercise a very marked influence on the nervous systems of these employees, according to one account: “The employee’s attention is very markedly strained by [telegraphy].” This strain, the writer noted parenthetically, was made greater by the telegraphist’s alienation from the ultimate content of the message, “whose object ultimately does not concern him.” The account went on: “Equally incontestable is the statement that all mental activity has its roots in sensation, and that the transmitters of mental acts, the nerves, which have been compared countless times to telegraph lines, are the best conductors of electricity.” In a halfday’s work, each operator had to send approximately one hundred telegrams, averaging roughly fifteen words of nine letters each, for which three signs were used. These operators worked under completely different conditions from those of other employees, given that “approximately 40,000 electrical currents of varying degrees of strength flashed through the operator’s nervous system in the course of the workday.” The place given in the preceding accounts to mental faculties such as concentration and attention connects the discourse about nerves to underlying shifts in the organization of work.92 These shifts in turn were related to the transformation of the technological and financial basis of capitalism discussed earlier. The emergence of organized capitalism and the bureaucracies and managerial practices associated with it created a demand for a vast army of workers equipped to perform new kinds of specialized tasks. If an earlier phase of the industrializing process had been dominated by steam power and manual labor, the new phase was increasingly based on electricity and “mental labor.”93 While the Trade Exhibition of 1896 had, in the words of one account, been the coordinated result of “the tireless labor of the heads and hands of countless individuals,” it nevertheless seemed to announce the advent of a new stage in the social division of labor.94 The exhibition’s rhetorical invocation of the “hand” as allegory of labor notwithstanding, Berlin’s position as command center of the new economy reflected the relative decline of Handwerk and the corresponding ascension of a new paradigm of labor power—for which the operators in the telephone pavilion represented a more suitable image than that of hand with hammer.95 This shift would not be fully theorized until the early 1910s, when industrial psychologists took cognizance of the role played by machines in both minimizing human physical labor and in heightening the demands placed on the minds, senses, and nerves of the workers who served as “minders” or “tenders” of these machines. But the shift was already
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being commented on by figures such as philosopher Henri Bergson, who related the increasing disturbances of the nervous system to the weakening of the tie binding mental life to its motor accompaniment.96 It also figured in the psychophysical research of psychiatrist Emil Kraepelin, who devoted a book to the subject of mental labor, a topic he linked explicitly with the problem of neurasthenia. Tellingly, Kraepelin began his book with the image of an electrical generator, making an implicit comparison before going on to discuss the difference between human labor and electrical energy, whose output, he argued, could be precisely calculated in ways that human performance could not.97 When in 1902 the Imperial Health Office commissioned a study on the problem of mass nervousness, its authors came to the conclusion that neurasthenia was much more prevalent among brain workers than manual laborers.98 It was against this backdrop that the doctrine of nerves acquired general currency in Germany. At least initially, nervousness was regarded as a specifically bourgeois malady, a syndrome unique to the capitalist and professional classes. Understood as the imprint of accelerated change on body and psyche, nervousness was a product of the civilizing process and thus part of the cultural property of Germany’s Bürgertum, its “brain workers” and “mental laborers,” whose nervous systems were most sensitive and ramified. Lamprecht identified nerves as antennae attuned to the spirit of the age and linked nervousness with bourgeois striving, risk taking, and accomplishment.99 Yet, as the examples above indicate, the middle classes could no longer claim to hold a monopoly over mental labor or its pathologies. By the early 1900s, Max Laehr, the director of a nerve clinic for working-class patients located outside Berlin, could write: “Reizsamkeit has now become the property of the entire nation, including the lower classes.”100
ANTIMODERNISM, MODERNISM, AND NERVOUSNESS From the outset, the discourse about nerves was highly ambivalent. It attested to capitalism’s emancipation of new productive forces and sensibilities but also to its remorseless extraction of energy from all sources. In this second form the discourse contained a more or less muted protest against the values of the modern world.101 This motif of protest remained a staple of much of the specialist literature on the subject, becoming increasingly prominent as the discourse reached a point of critical mass around the turn of the century. By then Griesinger’s reformist medicalcultural vision had lost some of its luster and, within some parts of the
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medical profession, hardened into a strident antimodernism. This shift reflected the exceptional intensity of the German experience of the modernizing process. The German path of late, accelerated, and uneven industrialization, marked by intermittent economic crisis, class conflict, and rapid urbanization, gave public discourse an increasingly anxietyladen character. This culminated in the 1890s, when the lifting of the anti-Socialist laws, Bismarck’s departure, and the simultaneous emergence of political anti-Semitism, the women’s movement, and a new modernist culture created—in the minds of many elites—the powerful specter of a society in crisis.102 Liberalism gave way to a new political discourse inflected in increasingly Social Darwinist terms. Evidence of the anxieties evoked by this shifting political configuration can be found throughout the medical literature on nerves. The work of Max Nordau may be taken as barometer of this tendency. Nordau’s best-selling Degeneration, published in 1892, used the specialized language of modern psychiatry to translate this sense of social crisis into the specter of degeneration.103 According to Nordau, nervous illnesses of all kinds were becoming more common than ever before under the influence of war, urban life, and the factory system. Yet the modernity thesis represented a red herring for Nordau. In obsessive, repetitive detail, he cataloged an alarming range of psychological and cultural pathologies— epidemics of sexual disease and hysteria, pornography, moral decay, and social anarchy—ultimately tracing their origin to a single underlying cause: hereditary nervous degeneration. Nordau’s writings, as Daniel Pick has suggested, endeavored to master cultural anxiety by projecting it back into the specter of biological decay.104 Historians have been understandably fascinated by Nordau’s writings, both for what they tell us about his era’s cultural anxieties, prejudices, and preoccupations and for their premonitions of the twentieth century’s own dark obsessions. Yet in foregrounding the element of cultural pessimism in the doctrine of nerves, scholars have too often tended to ignore evidence of other, conflicting tendencies and interpretations. This has led them to overlook the role played by the discourse on nerves in recasting German attitudes toward the modernizing process along more pragmatic lines. For medical experts and social reformers, this doctrine served not simply as a form of protest, a purely negative critique, but also as a stimulus to reform and experimentation extending from the worlds of work and public health into the private domains of lifestyle, sexuality, and Weltanschauung. If, on the one hand, nerves provided testimony of the potential for crisis and breakdown in the modern world,
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then on the other they also attested to the genius of modern society, its capacity to seize upon this potential and to use it as the raw material for “the new.” To the extent that civilization generated its own discontents, it was also within the power of civilization to manage those discontents and to take on a new meaning. The conviction that nervous disorders had increased in modern times was one broadly shared by Germany’s professional and middle classes, including eugenicists, life reformers, nerve doctors, and others.105 Responses to the specter of nervousness and all that it conjured varied widely among these groups. At one end of the spectrum were those, such as eugenicist Wilhelm Schallmayer, who believed that treatment of nervously ill patients accelerated the process of degeneration by protecting the weak, a counterselective process that violated Darwinian principles.106 Perhaps even more extreme were the views of Carl Engelbert Sturm, a Berlin doctor who in 1900 published a pamphlet, entitled Rottet die Nervosität aus! (Exterminate Nervousness!), that described nervousness in nearly hysterical terms as the “greatest enemy of mankind” and the “most deadly opponent of all progress,” a plague that had to be “wiped out” before it destroyed the nation.107 Far more moderate in outlook was fellow Berlin doctor Kurt Hartmann, whose publication Die Nervenpflege promoted a medicine called Antineurasthin, which he promised would restore patients’ energy.108 Other physicians believed that a combination of public health and enlightened medicine could effectively manage the problem of nervous degeneration. This belief was strongly held by the social hygienist Alfred Grotjahn. Grotjahn began his career as a nerve doctor, opening a neurological practice in Berlin in 1896. He supplemented his income by working as expert examiner for various insurance funds. In some respects Grotjahn’s concerns echo those of Nordau, insofar as the theme of degeneration served as a leitmotif of his entire career, and following the war he would become increasingly strident in his view that the “unfit”—whose number he estimated at about a third of the German population—had to be prevented from reproducing in order to prevent national degeneration.109 Yet Grotjahn also supported a wide range of progressive medical policies. These included far-reaching programs of hospital reform, social hygiene, and lifestyle reform. To address the problem of mass nervousness, he favored creating a network of clinics and sanatoriums for working-class patients in and around the nation’s urban centers. Even while many doctors saw Germany’s industrial cities, especially Berlin, as breeding grounds for mental and nervous illness,
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others, such as Grotjahn, saw them as laboratories for a new kind of social modernity. Though early in his life he had moved in socialist circles, Grotjahn’s entry into the field of social hygiene coincided with his withdrawal from active politics. He saw medicine as a virtual surrogate for politics, a way of organizing and administering social resources along lines defined by experts in a wide variety of technical, scientific, and medical fields. In his writings he specified two important moments in the history of this field: the new political medicine associated with Virchow in the years after 1848 and the passage of Germany’s social insurance legislation in the 1880s.110 The former had defined the programmatic outlines, but it had been left to the latter to fully implement the vision first outlined in the 1850s and 1860s. In attaching a high value to the role of welfare and hygiene in recasting the “social question,” Grotjahn reflects the combination of social policy, medicine, and science favored by much of the German medical community at this crucial juncture in the nation’s history. The turn of the century, as we have seen, marked a threshold in many areas of Germany’s development. Intellectually and scientifically speaking, this period saw the emergence of society and the social question as objects of analysis. Emancipated from the feudal order, modern Germany now offered itself up to the scientific gaze as a society stripped of its traditional bonds and moorings.111 The pace and intensity of the German experience of industrialization had unleashed considerable distress. Yet one result of the discovery of “society” and its problems was the birth of an array of new disciplines— among them sociology and the human sciences of psychiatry, social hygiene, and criminology—that would take an increasingly decisive role in interpreting and responding to what Doris Kaufmann calls “the sociostructural crisis phenomena” accompanying German industrialization.112 In the wake of the irruptive events of the nineteenth century, as Paul Rabinow has written in the case of France, society became an object of scientific analysis, an object on which experiments could be performed.113 The German social insurance system was just such an experiment. As understood by its advocates, insurance was a symbol of progress in the social and moral sphere, just as the railway and telegraph were symbols of progress in the technological and economic sphere. Insurance was a social technology that, properly utilized, would replace the old bonds of traditional society with new ones, less organic but more egalitarian and thus stronger. In so doing, it would refashion workingclass patients as citizens of a new welfare-based productivist order.
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The system created by Bismarck in the 1880s attempted to manage the shocks, accidents, and afflictions of technological modernity within a statist framework. As we shall see, this legislation took a relatively broad interpretation of the “injury” entitling victims to compensation. Prompted by the emergence of new forms of mental labor and recognition of the role of nerves in the new economy of brain work, this legislation eventually extended coverage to the nervous consequences of workplace accidents. This was a significant development. From this point on, so-called accident-related nervous trauma, stemming from train derailments or workplace breakdowns, became an object of state and scientific policy. The recognition of such conditions as compensable speaks most clearly to the emergence of a new contractual order based on the socialization of those risks unleashed by the modernizing process. It was precisely this principle that underlay a petition sent by the machine-engineer Georg Wetzer to the Reichstag in 1908.114 Basing his entreaty on his own four-year-long history of institutionalization— which included stays in insane asylums, psychiatric clinics, and private nerve sanatoriums—Wetzer beseeched Germany’s highest representatives to consider creating state-funded “people’s nerve sanatoriums” (Volksnervenheilanstalten) to provide for those unable to afford the cost of a private institution. This was, he claimed, the only humane solution given the alternative: institutionalization along with the mentally insane. Wetzer insisted that this was not a case of special pleading, since no one in this nervous day and age possessed a guarantee against the possibility that he, too, might one day wind up in such an institution. Wetzer’s petition concluded with a proposal that the nation’s existing insurance schemes be extended to include insurance against all forms of nervous illness. Though no such far-reaching initiative was ever undertaken—the nation’s social insurance laws covered only workplace accident-related nervous illnesses, and those within relatively narrow limits—Wetzer’s petition nevertheless enunciates with great clarity the social contract underpinning the discourse about nervousness. It illustrates the impact of insurance on ordinary Germans, who began to articulate their claims on the state in a historically novel fashion that wove private distress together with collective well-being in the idiom of nerves. This petitioner represents a new kind of nervous citizen, who conceptualizes his nervous troubles as having wider ramifications, ties his own nervous destiny to that of the nation, and makes society responsible for finding a solution. The moral underpinnings of this new contractual order, and of the ra-
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tionalizing function of social hygiene and lifestyle reform, were spelled out in a key passage in Grotjahn’s memoirs. Raised by a father who was a morphine addict and who eventually suffered a nervous breakdown, and plagued by life-long anxieties about his own inherited nervous tendencies, Grotjahn described a moment of epiphany in which he asked himself whether stimuli such as alcohol and tobacco were not merely ersatz pleasures. “No laboratory experiment, no animal experiment could decide this question,” he realized. “I decided therefore, to carry out a self-experiment.” Abstaining from all alcohol and tobacco for over a year, he ultimately decided that the pleasure of both was merely a form of “self-deception.” This became the leitmotif of his career: “Precisely the hygienist must be the most cautious with life’s pleasures. He takes on a heavy responsibility when he decides to completely eliminate such pleasures from people’s lives.”115 This also became the leitmotif of his relation to politics: abandoning his earlier socialist ties in all but name, Grotjahn practiced a form of “abstinence from politics.”116 If society and self became objects on which to experiment, then in Grotjahn’s case this would have decidedly ambiguous implications, notably in his proposals for measures to prevent the reproduction of the “unfit.” The point here, however, is not that he remained immune to the degenerationist fantasies that haunted Nordau or to the temptation of radical solutions but that in his work eugenic thought operated within the same discursive space as faith in welfare and lifestyle reform. Grotjahn’s visions of a biologically based social engineering are disturbing indeed, and yet to read the specter of Nazi racial science back into them is to impose an overly teleological framework on what was in fact a broad, international movement that crossed most ideological lines and had no single trajectory or outcome.117
TECHNOLOGIES OF THE NERVOUS SELF At the heart of Nordau’s Degeneration was an implicit claim to have constructed an epistemologically stable position from which to analyze both individuals and societies. His book exemplified psychology’s movement out of the clinic and into the realm of social diagnostics and criticism, its transformation into an ideology or a world picture. Yet his obsessive, repetitive formulations were marked by disavowal, a resistance to acknowledging his own entanglement within those same impulses and tendencies he cataloged so industriously under the heading “degeneration.” This distancing strategy mirrored his definition of scientific psychology
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itself. Unlike the older school of “introspectivist” psychology, which consisted of “listening to one’s self” and “spying on one’s self,” modern psychophysics, he wrote, “ ‘spies and listens to,’ not itself, but its experimentists [i.e., subjects] and instruments.”118 The epistemological primacy accorded here to instruments and experiments attests to the extraordinary privileging of objectivity in the norms and values of late nineteenth-century positivist science.119 It further hints—as was noted by one of Nordau’s bêtes noires, Friedrich Nietzsche—at the transformation of scientific thought into the world picture of bourgeois society. Nietzsche suggested that the conventions of modern psychology had become generalized into a kind of cultural a priori. This he defined as “absolute regularity, punctiliousness, unthinking obedience . . . training for ‘impersonality,’ for selfforgetfulness, neglect of self. . . . We psychologists of the future—we have little patience with introspection: we almost take it for a sign of degeneration when an instrument tries to ‘know itself’: we are instruments of knowledge and would like to possess all the naiveté and precision of an instrument.” Applied to certain social types, such a position resulted in an easily caricatured circular logic: for the artist as well as the hysterical female, as Nietzsche put it, “all experiences were crises.”120 Nordau’s position had a clear social function insofar as it allowed him to draw rigid boundaries around the pathological condition of degeneration. In degeneration and hysteria the new psychology, it might be said, came up against its other. Enormous technical and institutional resources were brought to bear on this encounter, most strikingly in the Salpêtrière clinic of the celebrated French neurologist Jean-Martin Charcot, where Nordau had once trained.121 With neurasthenia the case was rather different. Although not always clearly distinguished from degeneration and hysteria, neurasthenia differed from them in two important respects. First, it was explicitly defined as modern, a product of civilization, located in the nerve centers of the brain rather than in the spine or uterus. Second, the boundaries between doctor and patient were less rigidly drawn in the case of neurasthenia. Unlike the theorists of degeneration and hysteria, those who wrote about and treated neurasthenia often did so explicitly from the standpoint of self-experience. In keeping with its initial description as an illness unique to middle-class male “brain workers,” personal accounts were deeply woven into the literature on neurasthenia. George Miller Beard, the American physician who first described it, suffered from nervous complaints and noted that at least 10 percent of his neurasthenic pa-
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tients were themselves doctors, which he interpreted as confirmation of the condition’s modernity.122 For Beard neurasthenia was the hidden pathological side of modern civilization, albeit one that could still be woven into a progressive narrative through the medium of the cure—a cure he effected through the preeminent therapeutic technology of late nineteenth-century nerve medicine: electrical current. In Germany as well, by 1900 neurasthenia could no longer be considered a source of stigma, something pathological, but was coming to be regarded as an inevitable consequence of modern civilization—as the Reichstag petitioner Wetzer suggested, a normal and potentially universal condition. The history of neurasthenia would thus seem to fit less easily into the social control rubric under which degeneration and hysteria have often been analyzed.123 Joachim Radkau stresses that doctors’ personal experience helped validate psychosomatic illness and free it from the prejudices of traditional medicine. This is not to say, he writes, that nerve discourse did not function as a transmitter of prejudice, “but its own inner dynamic always carried it beyond prejudices.”124 Although this argument may have general validity, it must be qualified. Whether the presence of doctors’ self-experience within this discourse made it inherently more emancipatory than that about hysteria is in fact debatable.125 The literature on nerves contains numerous instances in which an awareness of, or anxiety about, a history of familial or personal illness coexisted with profoundly stigmatizing views of social others. Paul Julius Möbius, a psychiatrist and himself a nerve invalid, as well as the figure credited with making suggestion a legitimate therapeutic subject in Germany, descended into degenerationism and extreme misogyny at the end of his career.126 Another physician with his own history of nervous complaint, Willy Hellpach, insistently distinguished between the hysterical tendencies that he observed among female and working-class patients and the “nervous” characteristics he ascribed to male middle-class patients.127 These examples point toward a more general pattern. For these figures, the neurasthenia diagnosis tended to be reserved for members of their own social class and sex, while degeneration and hysteria were used for diagnosing social others. Yet this pattern was by no means a fixed one. Though less visibly burdened by the gender and class associations of hysteria, neurasthenia remained an unstable construct that could become confused with that stigmatized condition. An invisible, functional disease of the nerves, neurasthenia remained difficult to represent; despite a host of ingenious methods for bringing it into the clear light of medicine’s gaze, it insistently defied medical criteria of legibility, visibility, and objectivity.
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What these caveats suggest is that the German discourse about nervousness obeyed no single logic but contained multiple, often conflicting meanings. The entire arc of this discourse must be followed to understand how it mutated in response to distinct historical and social pressures and how, in becoming grafted onto broader German debates about the modernizing process, it became increasingly politicized. If in the 1870s and 1880s neurasthenia was granted legitimacy as a meaningful indicator of the potential for personal crisis within modern civilization, by the late 1920s, in the wake of the epidemic of “male hysteria” that erupted during the Great War, nerves were being intensely stigmatized. One of the factors in this shift was the psychologization of the condition, which is one reason why the conventional view of “nervousness” as prelude to Freud needs to be reexamined.128 Freud, it is often held, shattered the myths of late nineteenth-century nerve discourse when he revealed its truth to lie in the universal experience of repressed sexual instincts. In doing so he broke down the distance that nineteenth-century nerve medicine—symbolized by his teachers Meynert and Charcot—erected between doctor and patient.129 This development may be rather schematically traced in terms of his passage from the technologies of the nineteenth-century cure—electrotherapy and hypnosis—to the twentiethcentury talking cure, or, to put it another way, from a mode of treating the patient as object to treating him as subject.130 The conventional narrative holds that Freud’s break with the methods and epistemologies of late nineteenth-century nerve medicine also meant a break with the prevailing somatic model of nervous illness. His selfanalysis during the 1890s, during which he alternated between the terms neurasthenia and hysteria in describing his own illness, marked the prologue to this development.131 The transitional phase coincided with his growing fascination and then disenchantment with mechanistic psychology, culminating in the abortive “Project” of 1895, which pushed the electrical system analogy of the human nervous system to its breaking point.132 The denouement came with his discovery of the unconscious and insight into the transferential relation between analyst and patient—a relation itself laden with electrical analogies. Yet, however intuitively satisfying this may be as a way of understanding Freud’s work, it has always had a number of problems. It overstates the degree of his break with the materialist scientific culture, in which he received his neurological training; it too easily reduces this culture itself to a kind of systematic falsification or negation of experience; and it ignores the context in which his own ideas gained wider valid-
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ity—namely, during the war when the rise of a psychogenic theory of neurosis was linked to an all-out assault on the outbreak of “male hysteria” in the ranks. It is precisely one of the greatest strengths of his work that Freud remained very much the product of late nineteenthcentury science.133 The foregoing remarks help to situate the late nineteenth-century doctrine of nerves within the more general problematic that marks the history of the human sciences. It is a hallmark of these sciences, as Foucault has noted, that their object is of a type to which the scientist himself belongs.134 “Man,” according to Foucault, is both subject and object of his own knowledge, a condition that has a direct bearing on the strategies adopted by the scientist in this field to make his object “speak.” How the scientist relates to this object under study, whether he acknowledges or disavows his own entanglement with that object, is a choice laden with ethical and political consequences.135 It is to Georg Simmel that we owe one of the most interesting contemporaneous attempts to come to grips with this problem, as a special case of what he identified as modern society’s clash between “objective” and “subjective” culture. According to Simmel, the modern self was traversed by the rationalities of technology, science, bureaucracy, and ideology, the immense weight of which threatened to crush him. The hypertrophy of “objective” culture was mirrored in the increasingly circumscribed, interiorized nature of “subjective” experience and forms of knowledge. The neurasthenic, in Simmel’s view, was a new social type who experienced this conflict with particular intensity, insofar as he bore on and within himself the traces of this immense social and cultural formation. The result was a split within consciousness—a split particularly characteristic of the big-city inhabitant—a growing divergence between the “life of the nerves” (Nervenleben) and the abstract, rationalizing mind (Geist). The metropolitan type, he wrote, “creates a protective organ for itself” against the threatening shocks and discontinuities of its environment.136 This protective organ—Geistesleben, or objective consciousness—shields the Nervenleben from the external milieu, yet in so doing further extends its dominion over the self.137 Yet Simmel also explored the possibility of competing knowledge systems, which he sometimes referred to, by way of contrast with a predominantly “masculine” objective culture, as “feminine” culture. Tellingly, this “neurasthenic philosopher” conceptualized this possibility in terms of the necessity of self-analysis in the medical arts: “Objec-
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tive and clinical methods of examination often come to premature conclusion unless supplemented by a subjective knowledge of the condition and feelings of the patient. I regard this sort of knowledge as a universally operative a priori of the medical art.”138 The extent to which this condition was satisfied determined the limits of the physician’s understanding: They include a certain constitutional analogy between the physician and the patient: the . . . decisive fact, that the inner re-creation of the state of the patient is undoubtedly based on and determined in its extent by the consideration that the physician is also a being of the same kind. It is in this sense that a neurologist of considerable experience once claimed that a thorough medical diagnosis of certain nervous states is possible only if the physician has experienced similar states.139
By implication, the absence or disavowal of such experience would open up a gap between the physician’s “objective” knowledge and the patient’s “subjective” experience, a gap within which misunderstandings and contests of knowledge could erupt, and the doctor himself could become a representative of that cultural formation whose immense weight bore down on the neurasthenic. In this sense the interaction between doctor and patient closely mirrored the experience Simmel had identified in his account of the Trade Exhibition. For Simmel, this exhibition represented a primal scene of modernity, a key moment in Berlin’s transformation into world city—a process, he often noted, that coincided with his own intellectual development.140 It was a scene whose multiple and paradoxical meanings he endeavored to untangle most fully in his Philosophy of Money (1900). A key passage in this book occurs in the context of his discussion of Fechner’s law concerning the relation between stimulus and sensation. The implications of this law were spelled out in the general principle governing “the qualitatively different consequences of quantitatively altered causes.” The most common example, he wrote, related to the so-called threshold of consciousness: “[E]xternal stimuli that affect our nerves are unnoticeable below a certain strength; but when this threshold is reached the stimuli suddenly evoke sensations.”141 The conclusion Simmel drew from this set of psychological theorems concerned the incommensurability of objective causal stimuli and subjective sensation: “With regard to electric shock treatment, it has been observed that frequent repetition may turn the result into its opposite, and again into the opposite of the opposite. It is an everyday experience of major importance that almost all pleasure-affording stimuli, after an original increase in pleasurable sensation, lead to its arrest and even to positive pain.”142 This held true
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for nonsensory feelings as well, though they could not be “quantitatively compared in the same manner as mechanical or electrical stimuli of sensory nerves.” With these reflections Simmel confirms the centrality of the constellation of electricity, shock, and nerves in turn-of-the-century discourses on the metropolitan self. In the next chapter we shall examine an important episode in the prehistory of these discourses, looking in more detail at how these elements interacted in the construction of neurasthenia as exemplary condition of modern civilization.
TWO
Electrotherapy and the Nervous Self in Nineteenth-Century Germany
A
mong the many astonishing objects on display at the International Electrical Exhibition held in Frankfurt in 1891, a device known as the influence machine, which used static electricity to treat nervous disorders, held a particular fascination for the public. While a marvelous array of new contraptions competed for the visitor’s attention—telephones, arc lights, an electrically powered waterfall—this device stood out for the uncanniness of its construction and for the discharges and weird sparks it emitted. Berlin nerve doctor Albert Eulenburg described its impact on visitors in the following way: “[O]ne can see here in the exhibition . . . what a large public assembles each time one of these influence machines is put into operation, and with what . . . powerful feelings of horror it contemplates the intense exchange of sparks between the conducting cables.”1 Eulenburg addressed these comments to an audience of physicians who had gathered at the Frankfurt exhibition to discuss recent criticisms of the use of electrotherapy in treating nervousness. At stake in these criticisms were two issues: whether administering electricity to the body had demonstrable medical benefits; and, if so, whether those beneficial effects were achieved through regenerating the body’s nervous energies with electrical current (as its leading practitioners believed) or through suggestion (as a small number of skeptics argued). Eulenburg was 48
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among the most stalwart defenders of the electrical creed. Yet, in invoking the powerful feelings of horror awakened among the public by the sight of the influence machine, he nevertheless acknowledged the suggestive influence emanating from the imposing apparatus. Eulenburg’s remarks introduce us to a crucial juncture in the history of the so-called electrical method: a moment when its reinvention as a type of suggestive treatment was linked to the emergence of a psychogenic theory of neurosis. For most of its previous history, the electrical method of treatment had rested on a somatic model of nervous illness. Only with the collapse of this model was electrotherapy’s value as a means of influencing the nervous patient’s will realized. Why this should have been so has remained underexamined in the historiography of the subject. Indeed, the whole history of the relationship between electrical apparatus and modern theories of neurosis has been badly neglected, despite the central place this relationship had in the careers of many of the key figures of late nineteenth-century neurology: Charcot, Beard, Oppenheim, and, for a brief period, Freud.2 This chapter examines the nineteenth-century origins of the link between nervousness and the electrical method. Prior to the 1870s, it argues, there was little belief in the somatic nature of, or in the possibility of treating, nervous illness. The appearance in that decade of a neurologically anchored disease picture was closely bound up with the discovery of electricity’s value in treating nervous ailments. That decade also marked the appearance of a new type of patient, the male, middleclass “brain worker” suffering from an assortment of nervous complaints, for whom the neurasthenic diagnosis was relatively free of stigma and for whom the electrotherapeutic apparatus was invested with a welcome scientific aura. Focusing on the world of Berlin nerve medicine, the chapter traces the construction of a new somatic model of nervous illness in the 1870s and 1880s, before going on to describe a growing crisis in this model, which came to a head in the 1890s. It concludes by gesturing toward the later use, during World War I, of a form of electrotherapy explicitly conceptualized as a type of suggestive, disciplinary treatment, one that allowed the doctor, through coercive means, to gain control over the patient’s will.
NEUROLOGY, ELECTRICITY, AND THE CONSTRUCTION OF NEURASTHENIA In the introduction to his handbook on electrotherapy, published in 1883, the great German neurologist Wilhelm Erb informed his readers
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that his field’s advances in recent years were closely bound up with electrotherapy.3 Erb traced neurology’s emergence as a scientific discipline to a moment of technological breakthrough in the 1840s, when “instruments were contrived giving magneto-electric and volta-electric induction currents.” These marvelous new machines yielded “currents of great physiological energy,” required little expenditure of time and labor to use, and, together with the induction coil, were easily adapted to the requirements of medical practice. The founder of modern electrotherapeutics, according to Erb, was the Frenchman Duchenne de Boulogne. Duchenne held a post at the Salpêtrière clinic in Paris, where he conducted extensive research on electricity’s effects on the body among the patient population. On the basis of this research he was able to pinpoint and describe many previously unidentified neurological disorders. Duchenne had a particular interest in human facial expression. Using his electrical devices to produce contractions of the facial nerves and muscles, he photographed these so as to capture what he deemed true representations of emotional states such as “terror” or “lasciviousness.” In the view of this “metteur en scène electrique,” these instruments compensated for deficiencies of the senses that interfered with the accurate perception of facial expression.4 Using the electrode to turn the body into a surface on which signs could be elicited and captured, Duchenne created a semiotics of the living human body.5 A further milestone in this enterprise was reached in 1870, when Berlin doctor Eduard Hitzig and his colleague Gustav Theodor Fritsch demonstrated that the brain could also be excited by electric current. The effect was nothing short of revolutionary: “Almost without exception,” writes one scholar, “the texts which appeared in the 1870s–’90s convey the ‘electric excitement’ engendered by Fritsch and Hitzig’s discoveries.”6 Virtually simultaneously, the Americans George Miller Beard and A. D. Rockwell published their first study on neurasthenia in 1869, following up with their description of general electrization in 1871. Their technique was simple: it entailed placing one electrode on the patient’s feet while moving the other systematically over his back, neck, head, and limbs. The method could be unpleasant, though rarely painful; it was not intended to produce convulsions in the patient. Beard advised only that current should be increased until it was “pleasantly painful.” He recommended the method for treating neurasthenia, in the belief that the current would restore energy to the patient’s depleted nerves.7 Unlike hysteria, a syndrome with a pedigree extending back to the
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Greeks, neurasthenia was defined by its modernity. As Charles Rosenberg has shown, Beard’s new construct assumed three principles, all of which aligned it with the most up-to-date scientific thinking: the identification of electricity with nervous conduction; the first law of thermodynamics, concerning the conservation of energy; and the concept of reflex action.8 Reflecting the impact on medicine of a new energeticist calculus, Beard’s ideas bestowed the stamp of modern science on the functional neuroses, illnesses of the nervous system lacking an identifiable somatic basis.9 The term neurasthenia gave a contemporary ring to maladies formerly known by the vaguely disreputable labels hypochondria or nerve weakness. Neurasthenia, according to Beard, was a disease of modern civilization, especially found among higher classes of the most modern nations. “Civilization excites,” he wrote; and the higher classes were correspondingly more excited. Modern nervousness—or American nervousness, as he called it—was attributable to the impact on modern life of five factors: steam power, the periodical press, the telegraph, the growth of the sciences, and the increased “mental activity” of women. Above all nervousness was the result of mental overexertion, the occupational hazard of a new class of brain workers, men whose vocation demanded prolonged concentration amid conditions of “considerable excitement,” such as politics or commercial activity. An important condition of this disease picture was that its leading diagnosticians counted themselves among this new class of neurasthenic brain workers. In entries made in his journal in the late 1850s, Beard complained frequently of ephemeral pains, low vitality, and nervousness.10 He was troubled by ringing in his ears, throbbing and buzzing noises.11 After experimenting with diet, exercise, and “regimen in general,” Beard found the remedy for his problems in electricity. His first encounter with electricity dated from 1858, when he purchased a battery and administered electric shocks to himself. “Electricity helps me very much,” he recorded in his journal.12 He later reported that 10 percent of his patients were themselves doctors. During the Civil War, Beard worked in an army hospital tending to soldiers suffering from neurological trauma. He then opened an office in New York City and subsequently became acquainted with Thomas Edison, at one point assisting him in some experiments on atmospheric electricity.13 The experience left him with what can only be described as a deep fixation on Edison. He later wrote that if any single person could be held responsible for the increasing nervousness of modern life, it was
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Edison. Edison’s “1000’s of experiments” and “100’s of patents” were directly responsible for the acceleration and multiplication of modern life’s tasks. His inventions and refinements, particularly those involving the telegraph, “kept 1000’s of capitalists in suspense and distress” by making the stock market more volatile and transmitting price fluctuations instantaneously around the world: “The experiments, inventions and discoveries of Edison alone have made and are now making constant and refreshing draughts on the nerve forces of Europe and America.”14 Beard thus linked neurasthenia to a theory of the civilizing process in which the stresses and afflictions of modern life were integrated into a narrative of progress, of incessantly renewed “experiments, inventions, and discoveries.”
ELECTROTHERAPY COMES TO GERMANY In Germany, the newly emerging field of neurology was presided over by a handful of figures schooled in the new scientific medicine. Among them was the eminent Heidelberg physician Wilhelm Erb, whose publications included works on electrotherapy and diseases of the nervous system as well as the popular text “The Growing Nervousness of Our Time,” a central reference point in the fin-de-siècle literature on nerves. Sigmund Freud, who upon entering private practice in 1886 used an electrical apparatus, later accounted for his original interest in electrotherapy with some embarrassment, by explaining that the physician “had after all to do something” for his patients. He went on to write: My knowledge of electrotherapy was derived from Wilhelm Erb’s textbook, which provided detailed instructions for the treatment of all the symptoms of nervous diseases. Unluckily I was soon driven to see that following these instructions was of no help whatsoever and that what I had taken for an epitome of exact observations was merely the construction of fantasy. The realization that the greatest name in German neuropathology had no more relation to reality than some “Egyptian” dreambook, such as is sold in cheap bookshops, was painful, but it helped to rid me of another shred of the innocent faith in authority from which I was not yet free.15
For Freud, the electrical cure proved ultimately to be little more than an exercise in suggestion, and with this judgment he consigned it to the oblivion of psychoanalysis’s prehistory. Lost in this judgment, however, is the role of electrical apparatus in authenticating the notion of nervous illness as a somatic, treatable condition. As Max Nonne, one of Erb’s students, later put it, Erb presided over
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the “Periclean era of neurology,” the heroic era in which the foundations for the field were laid.16 Heidelberg, where Helmholtz received his first university post, was an important site for the medical reception of the new physiology associated with the “Berlin school.”17 Helmholtz reportedly looked favorably on Erb’s interest in electrotherapy.18 A vital aspect of this era was the therapeutic optimism of physicians such as Erb: “As a therapist,” wrote one of his students, “. . . [Erb] was an optimist, took pleasure in treatment, and, without admitting it to himself, exercised an enormously suggestive influence in this regard.”19 Another student later provided the following description of the field’s humble beginnings: In a narrow room of the Medical Clinic in Heidelberg, actually a lumberroom, Professor Wilhelm Erb taught at the end of the ’60s and in the ’70s. . . . On a blackboard that he held across his knees—since there was no room on the wall—he wrote, in the introduction to his diagnostic and electrotherapeutic course, the formula for Ohm’s law. . . . We learned much about the field of electrodiagnostics and the pathology of peripheral nervous illnesses that one could not learn anywhere else in Germany at that time.20
From these cramped quarters emerged a community of practitioners steeped in the methods of scientific medicine and committed to a program of capturing mental illnesses from psychiatry, regarded as the province of false medical doctrines. Erb made no secret of his bias, repeatedly warning students, “Be on your guard against psychiatry!”21 It was during this period that clinicians first began to emphasize detailed, systematic examination of the nervous system. In the early 1870s, patients were still being observed rather than examined.22 This state of affairs changed decisively with the introduction of the electrode into medical practice and the development of the electrical examination. These produced a more active method and freed physicians from dependence on patients’ subjective accounts of their conditions.23 The method was relatively simple: it involved administering current to the patient’s body and then testing his reactions. Eliciting, capturing, and inscribing objective signs (muscular contractions, blinks of the eye, facial twitches), the physician could then draw appropriate inferences concerning the patient’s underlying nervous condition. Proper diagnosis, according to Erb, required exacting knowledge of the laws of the nervous economy: “The question with which we have to deal is the determination of the law of contraction of each individual nerve. . . . It is especially important that you be well informed with regard to the peculiarities of each nerve of the body.” His advice to the
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novice practitioner was: “Make frequent experiments on your own body, determine the law of contraction of your various nerves, faradize all the nerves of your body.”24 But self-experimentation then had to give way to clinical diagnosis proper. The boundaries between physiology and neurology had to be clearly demarcated; physiology was guided by facts learned from experiments performed in the laboratory, whereas neurology took its cues from diseases themselves.25 Thus Erb cautioned against imposing an overly schematic framework: “[E]very patient should be tested, at the beginning of treatment, with regard to his ‘electrical sensitiveness.’ ” Every person, he showed, had a “normal reaction” to electrical current, a reaction that, under conditions of health, remained more or less constant. Diseases of the nervous system, on the other hand, produced pathological reactions, in particular, the telltale “reaction of degeneration,” defined as a “cycle of quantitativequalitative changes of excitability occurring in the nerves and muscles under certain pathological conditions.”26 In addition to Heidelberg, where the influence of the Berlin school was strong, Berlin itself was the other major center of neurological teaching in Germany. Following the death of Wilhelm Griesinger in 1867, the leadership of the Psychiatric and Neurological Clinic of the Charité passed into the hands of Carl Westphal. Over the next two decades Westphal assembled an illustrious group of students around him, including Hermann Oppenheim, Martin Bernhardt, Alfred Goldscheider, Albert Eulenburg, and Emanuel Mendel. Westphal and his students made up a self-consciously avant-garde school that subscribed unwaveringly to the Griesingerian program. As Heinz-Peter Schmiedebach has written, they saw themselves as waging a battle against the “false” medical doctrines of the past. The cultural ideology of the Berlin school was marked by a commitment to an aggressively materialist medicine and to upholding the rights of the patient.27 One effect of Griesinger’s reforms had been to extend university psychiatry’s catchment area. Eliminating restraints, and thus some of the stigma of mental illness, made it easier for members of the urban middle and lower-middle classes to admit themselves for treatment to such facilities. Westphal continued his predecessor’s work by adding new facilities to the hospital and promoting a curriculum designed to further distance it from the medical doctrines of the past.28 This modernization program, which coincided with the founding of the new Reich and with Berlin’s transformation into a big city, made the Charité into Germany’s leading research and teaching institution.
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Westphal’s creation in 1871 of a polyclinic (an out-patient clinic) specifically for nervous patients further helped to lift the stigma associated with public psychiatric institutions.29 Such polyclinics, by opening psychiatric institutions to short-term care, immeasurably broadened the field’s catchment area. They brought doctors into contact with a new category of patient whose illness was defined as curable, in part because it was caught in its early stages, in part because it was simply milder than the psychoses that were the normal fare for asylum doctors. As part of this modernization of the clinic, Westphal also created an electrotherapy unit, arguing that treatment with electricity was cheaper than that with drugs. Undoubtedly he also counted on electricity’s aura as modern and rational to appeal to a new class of patient.30 This modernization program would culminate at the turn of the century with Westphal’s successor, Friedrich Jolly, who oversaw further expansion of the clinic, adding a second electrotherapeutic unit, photography and x-ray facilities, and new laboratories, along with the most up-to-date power supplies.31 From the ranks of Westphal’s students came a generation of practitioners trained in the new science of the nervous system and its illnesses. The Berlin school’s neurologization of psychiatry was driven by a prodigious output of electrodiagnostic and -therapeutic researches. A steady stream of scientific publications flowed out of the Charité, communicating the findings of the new electrical creed.32 So unwavering was their commitment to this creed and its underlying somatic predicates that, by the end of the century, the members of the Berlin school were charged with being in the grip of an “extreme somatology.”33 Westphal and his cohort turned the polyclinic into a space for making the nervous body yield up its secrets. Through artful application of the electrode and other instruments, they fashioned a physiological semiotics that generated meaningful signs out of apparent disorder. Though much of the Berlin school’s work was concerned with mapping the organic basis of severe and untreatable conditions such as multiple sclerosis and progressive paralysis, their new clientele, drawn from the exploding population of the capital, also brought them into contact with a class of borderline conditions lacking clear organic basis. One such condition was agoraphobia, which Westphal provided the first medical account of. Describing this condition as stemming from fear of open spaces, Westphal forged a clear link between the domain of psychopathology and Berlin’s changing spatial and social topography.34 Hypothesizing that agoraphobia was in part the product of a weak constitution, he invoked the monolithic theory of hereditary degeneration,
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which was the basis of much of the scientific vision of late nineteenthcentury psychiatry. More subtly, he proposed that agoraphobic patients feared less the marketplace than their own panic attacks; in proposing this, he opened up a line of inquiry with links to Freud’s later reflections on the role of anxiety in the etiology of neurosis. His student Hermann Oppenheim later linked agoraphobia with neurasthenia. The new social environment of the unified and industrializing Germany held many opportunities for Westphal and his followers to establish theirs as a profession uniquely equipped to minister to the dislocations and shocks of modern life. The advance of neurological knowledge, as medical historian Erwin Ackerknecht has written, was inextricably linked to war and accidents.35 In this respect, the Franco-Prussian War of 1870–71 had a formative impact on the field’s development in Germany.36 Many of the most illustrious names in German neurology worked as field doctors during the war. Their work frequently brought them into contact with soldiers who suffered no visible injury yet were nevertheless afflicted by a multitude of “nervous” symptoms. Much later, following the triumph of a psychogenic theory of neurosis during World War I, Max Nonne blamed Westphal’s influence for the scarcity of cases of psychogenic illness in the literature on this war.37 Though aware of the psychologically traumatic conditions of war, doctors of Westphal’s generation tended both to emphasize physical overexertion and exhaustion as preconditions for the onset of mental illness and to treat their patients with electricity.38 It was in the war’s aftermath, according to a War Ministry study produced in the 1880s, that methods of electrical examination first gained their enormous prestige.39 Eduard Hitzig’s clinical work with soldiers formed the backdrop to his discovery of the electrical excitability of the brain.40 A further area Westphal investigated was nervous illness related to railway accidents. Again, his work coupled speculation about invisible disturbances of the nerve centers with reflections on the role of anxiety in the genesis of the illness.41 Here too, he recommended a course of observation and treatment in the electrotherapeutic unit for nervous victims of railway accidents. Oppenheim would later construct an important new disease picture—traumatic neurosis—out of these early reflections on the nervous disorders of railway travel and in doing so strove to balance the somatic against the psychological causes of the neurosis. These examples suggest that the materialism of the Berlin school by no means precluded interest in the psychogenesis of nervous maladies. It simply predisposed its members to privilege somatic signs and explanations, in
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keeping with their general theoretical and methodological commitments, and to assign the psychological dimension a lower priority. What emerges from the work of the Berlin school is a vision of the body as a field of energies governed by lawful, quantifiable processes, a vision that, as Anson Rabinbach has suggested, reflected the impact of “a new image of the organization of the body, explicitly cast in the language of force, motion and energy.”42 This vision found its consummate expression in the disease construct neurasthenia, a condition that crystallized the era’s anxieties and preoccupations. It became preeminent among the borderline states whose classification Klaus Doerner has identified as central to late nineteenth-century psychiatry. According to Doerner, Griesinger and Westphal ushered in an almost “imperialist” penetration of the borderline; in doing so, they also ushered into medical and social consciousness those countless individuals whose “irrationality” could not previously become visible because they had never been in institutions, who had concealed their problems with society from that society, keeping them locked up within themselves. But now, as their “weakness” was becoming “conspicuous” to that pitiless diagnostic control agent of economic liberalism— efficiency—the army of the “irritable and weak,” the “abnormal,” the “sexual perverts,” the psychopaths, compulsives, neurotics—the area in which the borderline between the “abnormal” and the “normal” is indistinct—began to unburden themselves at least to the privately practicing neurologist or clinical psychiatrist.43
Yet if the university doctors created the conditions of possibility for the new doctrine of nerves, the real institutional setting for promulgating it, as we shall see, lay elsewhere.
HOMO NEURASTHENICUS By the mid-1870s, the nerve doctors were establishing theirs as one of the most dynamic fields in medicine. They did so by claiming an authority based on their new methods; by capturing a growing new clientele; and by defining new areas for their expertise—the vast field of the borderline or of so-called personal problems.44 Finally, they did so by astutely tying their interests into popular themes and anxieties linked with the dizzying acceleration of history in the years after the founding of the Reich in 1871. As the following case history makes clear, the fateful events of the Gründerjahre imprinted themselves deeply on the medical literature on nerves. The case involved a certain K. S., a businessman who had spent
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time living in Paris and London before returning to Germany in 1870. In the war and political turmoil of that year, K. S. saw a financial opportunity; he had gone into business as supplier to the army and had done extremely well. From that time onward, as he later told his doctor, he had lived in a constant state of agitation and stress associated with the intense responsibilities of his work. The crash of 1873 hit him hard. His business survived, but the aftershocks made themselves felt in his faltering health. Disturbances of digestion, sleep, and mood all began to disrupt his daily existence; later followed headaches, anxiety, and depression. He saw doctors, took numerous medications, and visited health spas around Europe. “In the summer of 1879,” wrote his doctor, “we find him in the Black Forest; in September 1880 again in Ostend; and now, in the fall of 1881 . . . returned from the Engadin.” By this time, his anxiety attacks were accompanied by peculiar symptoms. When he read, the individual letters of the book seemed to vibrate; on the street the facades of buildings became blurry and his visual field was drastically foreshortened. He was listless, sleepless, and excitable all at once, with a tendency to weep and a feeling of exhaustion that left him preoccupied with death. K. S. was ultimately diagnosed as suffering from an “exquisite case of cerebral, spinal and sympathetic nerve weakness with general neurasthenia.” After six treatments of electrical current applied liberally to all parts of his body, he left the doctor’s office completely cured.45 The case history of K. S. contains virtually all of the motifs that would come to characterize the literature on sick nerves. The patient’s position as a businessman identified him as a member of Germany’s commercial or professional elite, a class that had assumed a leading role in the empire’s economic expansion. It also made him an example of a new type of brain worker or cultured man whose position at the center of the tumultuous currents of modern life exposed him to the risk of “overburdening,” of a fearfully overtaxed brain. In such case histories the great historical, political, and economic events of the day were mapped directly onto the body and psyche of the nervously afflicted. This marriage of the medical and the historical would be given its most succinct formulation in the phrase “the growing nervousness of our time”—an endlessly reiterated refrain around which countless variations were spun. It was not only their methods and the cultural ideology they shared that made the nerve doctors uniquely well-positioned to explain to German society the changes it was experiencing. It was also their constituency, the social group to which they themselves belonged and to which their treatments and writings were chiefly addressed, that posi-
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tioned them so. The doctrine of modern nervousness became the cultural property of Germany’s so-called Bildungsbürgertum: its scientists, doctors, businessmen, and professors, members of the male, professional, educated middle class.46 It affirmed this class in its cultural ascendancy, in the belief that it was the historical agent of the great social transformations that had begun with the founding of the Reich in 1871. For this class it was self-evident that alongside the other inventions of the modern age—trains, telegraphs, stock markets—a new social type was being invented, for whom financial speculation, mastery of new domains of knowledge, and a love of Wagnerian opera all went hand in hand. If the higher classes were excited, as Beard put it, this was because their nervous systems were more highly developed. Nervousness was an insignia of progress, inscribed in the body, insofar as progress, according to one medical observer, “multiplied and refined the functions of the nervous system” and promoted the “enrichment of the nervous reaction apparatus.”47 But if neurasthenia was a sign of progress, it was also a sign of the sacrifice made by the members of society’s most disciplined, productive class. It was the tribute paid to the god of civilization; in this sense it was also a mark of the dark side of progress, of overcivilization. This notion that the civilizing process inscribed itself within the nervous constitution was reflected in the care with which physicians differentiated neurasthenia from other nervous conditions such as spinal irritation and hysteria. Up until the 1870s, medical thinking about nervous illness had concentrated on its spinal origins. The term railway spine was a product of this tendency: it designated a nervous affliction caused by the prolonged shocks to the spinal nerve centers brought on by railway travel. By the mid-1870s, railway spine was being displaced by neurasthenia, a development that marked the disorder’s shift from the spine to the brain.48 This reflected the influence of Helmholtz’s law of thermodynamics on conceptions of the nervous system and the replacement of localized symptoms with functional disorders of exhaustion and excitability.49 As one of the unified Germany’s master narratives, the doctrine of nerves shared many points of contact with the history of the new nation and its capital. In the 1860s a debate over the internal organization of the nervous system had played itself out in the scientific community, which split into two camps: those who believed the nervous system was organized in a nonhierarchical fashion and those who believed in a more centralized model. Once the localizers were refuted by Hitzig’s experiment, the brain’s control over the nervous system came to be likened to
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that of a “government minister.”50 Just as the nation itself underwent a tremendous process of centralization after 1871 in all areas of its life, economic, administrative, and intellectual—this last symbolized by Helmholtz’s move to Berlin in 1871 to assume the chair in physics—medical experts increasingly came to see the nervous system as operating under the centralized control of the brain. This shift also reflected the mapping of an implicit social hierarchy onto the nervous system. It is here that the notion of the brain worker came to the fore. As a disease of Germany’s intellectual elite, neurasthenia was anchored within the cerebral nerve centers. Helmholtz’s own frequently cited nervous complaints were a case in point of the risks of modern brain work. Hysteria and other nervous conditions, on the other hand, were diseases associated with the lower organs.51 Doctors went to particularly great lengths to distinguish neurasthenia from hysteria because of the latter’s vague symptomatology and its closeness to hypochondria, but above all because of its association with women. Hysteria connoted weakness and effeminacy, a body under the control not of the brain but of the lower organs.52 The scientific rationale for this view was inscribed within evolutionary doctrine, according to which the advancement of civilization was mirrored in the increasing ramification and complexity of the nervous system. The laws governing the constitutionally sound nervous system were gendered masculine, according to Erb’s so-called normal formula—the healthy body’s reaction to current: “There are so many variations in women and children . . . that I do not consider it practicable to determine the normal formula for them. That mentioned above refers to healthy laboring men of middle age.”53 Very carefully marking its boundaries with other nervous conditions enabled physicians to define neurasthenia as an affliction relatively free of stigma. Female nervousness was conventionally ascribed to weakness, to overactive imagination, to unruly sexual impulses—in other words, to conditions located within the female constitution rather than in the brain overtaxed by work or by its interaction with the milieu. Similarly, the Jewish predilection to nervousness that many doctors took for granted—without ever finding proof of—was interpreted as a sign of congenitally lowered resistance to the onrushing stimuli of modern life.54 Patterns of social stratification and differentiation were mirrored in the organization of the nervous system. Though neurasthenia looked identical to hysteria in many respects, it remained distinct from that condition, sui generis. It was found “chiefly if not wholly in the higher walks of life,” mostly among professional
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men, even though in some cases it produced a “remarkably womanish disposition, a tendency to weep,” and a “want of self-possession.”55 The paradoxical achievement of the nerve doctors lay in their commitment to the authenticity and singularity of this disease picture despite its close proximity to conditions about which they entertained a multitude of prejudices and doubts. This paradox shows up again and again in the literature on neurasthenia. Lacking a clear anatomical basis, doctors conceptualized neurasthenia as a purely functional disturbance, knowable only by its multiple symptoms. These included weakness and fatigue, disturbances of the sensory organs and sexual functions, pain, and sleeplessness. Compared with this profusion of complaints, however, “the objective symptoms . . . are almost wholly negative.” For a generation of physicians, the disease’s defining feature was this “disproportion between the acute subjective complaints of the patient and the almost negative result of objective examination.” As Erb would put it: This is the fashionable neurosis of the time, and appears in 1,000 remarkable forms. . . . You should always remember that, despite the innumerable complaints of the patient, the most careful examination always affords an absolutely negative result. Every objective change, however slight, of sensation, motion, the reflexes, pupils, etc., must cast a doubt on the accuracy of the diagnosis. Electrical examination offers no assistance, since it reveals, as a rule, absolutely normal conditions.56
Despite such caveats, German doctors remained convinced both of neurasthenia’s authenticity and of the value of electrotherapy in treating it. By contrast, they felt that hysteria was impervious to electrical treatment. It was an illness that did not conform to laws; the paralyses and tremors it seemed to share with diseases such as epilepsy were based on a wholly imaginary symptomatology. This skepticism toward hysteria, especially the possibility of a male variant, was shared by much of the German medical community.57 Encoded in the doctrine of nerves was a set of enduring cultural assumptions about class, gender, and race that reflected the worldview of the newly ascendant Bildungsbürgertum. Yet the new doctrine also reflected the singular accomplishment of the nerve doctors in rescuing neurasthenia from the world of malingering and moral stigma, where it had formerly languished. More than anything else, the newly forged connection between nerves and electricity made this possible. This connection also had important consequences for the doctors’ professionalizing project. In making electrotherapy a serious subject, these physicians helped to emancipate neurology as a discipline. With their new methods
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of diagnosis and treatment neurologists gradually turned their field into a specialized area; in German universities, as one physician later wrote, chairs in electrotherapy preceded those in neurology: “When in 1877 I entered my practice there were no ‘neurologists’; there were . . . ‘electrotherapists’ from whose ranks the neurologists later issued. Hitzig, Remak, Rosenthal, Möbius, Erb and others were originally electrotherapists, and we owe them many successful electrical procedures that still have not lost their significance today.”58 In terms of medical history, the impact of electrical methods was nothing short of revolutionary.59 In neurasthenia, neurologists found a construct that promoted development of their newly emerging field; in electrotherapy, a method that filled a therapeutic void. As Erwin Ackerknecht has argued, it was neurologists rather than psychiatrists who invented the modern concept of neurosis as a generalized, treatable condition. Psychiatrists, who worked for the most part in public asylums, mainly saw only incurable psychoses, whereas neurologists, who worked in private offices or clinics, spent much of their time treating a bourgeois clientele suffering from “weak nerves.”60 For this reason the discourse about neurasthenia was elaborated largely outside the precincts of asylum psychiatry, whose custodial function allowed little time for the nervous disorders of the more wellto-do and, in any case, saw relatively few such patients. In private clinics, on the other hand, the doctor had—as Freud put it—“to do something” for his patients. Electrotherapy satisfied this imperative, and it did so precisely because of its intimate connection with the Beardian doctrine of nerve weakness, so well-suited for an era preoccupied with the meaning and effects of new forms of “brain work,” overexertion, exhaustion, and excitement.61
SICK NERVES AS SOMATIC IDIOM The case of K. S., cited above, illustrates how “growing nervousness” became a virtual axiom of late nineteenth-century German middle-class consciousness. Though it drew upon large reserves of anxiety about the possibility of personal and cultural crisis, in its early formation it expressed optimism about cure. As in the case of Beard, the social location and identity of those physicians involved in promulgating the discourse about nerves were crucial. The case of K. S. was described in Sigmund Theodor Stein’s General Electrification of the Human Body, a popular text that detailed electricity’s virtues in treating tired nerves. Stein was the director of a clinic in Frankfurt that offered electrotherapy to afflu-
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ent patients suffering from nervous ailments. Stein was also an inventor and medical impresario who tirelessly followed the lecture and conference circuits, promoting electricity as an all-purpose panacea to the diseases of civilization. As editor of the popular publication Elektrische Rundschau, he kept readers up to date not just with the latest developments in medical electricity but in the whole burgeoning field of electrical technology. The International Electrical Exhibition, held in Frankfurt in 1891, reportedly was his brainchild.62 Stein was part of a large Jewish contingent within the community of nerve doctors. Though legally entitled to compete for any occupation, Jews were usually barred from high civil service and university positions. One of the fields open to them was private medical practice. It was for this reason that Jews made up a disproportionately large number of the practitioners in new specialties such as neurology, electrotherapy, and sexology. Klaus Doerner writes that whereas psychiatry was already professionalized, neurology “occupied the position of outsider discipline.” Jewish doctors, themselves social outsiders, gravitated to the field, drawn by its growing prestige.63 Freud, Eulenburg, Benedikt, Mendel, Oppenheim, and many more of the most illustrious figures in German neurology were Jews.64 This tendency was especially pronounced in Berlin, which had the highest concentration of Jewish doctors in Germany. One-third of all doctors in the capital were of Jewish descent, a high percentage of them specializing in the treatment of nerves with electricity. “Of any place in Europe,” writes Edward Shorter, “Berlin probably had the greatest concentration of nerve-doctors.” It has been estimated that, by the end of the century, in Berlin alone, over sixty private clinics for nervous diseases were staffed largely by Jewish doctors, most of them subscribing to the somatic theory of nervous illness.65 The career of Albert Eulenburg illustrates this general pattern. Eulenburg began working as an assistant to Griesinger at the Charité in 1867. Following a ten-year interlude as professor at the University of Greifswald, Eulenburg returned to Berlin and went into private practice, opening a polyclinic in the Johannisstrasse in 1885 for patients with nervous disorders. In the exploding population of the new capital, as a later eulogist put it, he encountered a “reiches Krankenmaterial.”66 In Berlin, physicians such as Eulenburg came into contact with a large clientele who suffered from an array of “personal problems” and welcomed the scientific aura surrounding the neurasthenia diagnosis. Within the context of a perceived crisis of nervous health, these physicians began to confront issues relating less to the world of the acutely in-
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sane than to those of everyday life: work, sex, education. A prolific writer and public speaker, Eulenburg staked out a prominent place within the new psychosocial terrain defined by sick nerves. He became a leading figure in Berlin medical circles, editing several important journals and lecturing at the University of Berlin on neurology and electrotherapy.67 He also cultivated a public profile, promulgating the Beardian doctrine to a wider audience by writing frequently for middle-class publications such as Die Zukunft and Die Gartenlaube on a range of subjects relating to “growing nervousness.”68 Eulenburg later became increasingly interested in sexology, cofounding the Berlin Society for Sexual Science and Eugenics.69 Eulenburg fits the profile shared by many of the Jewish neurologists in Berlin during this period, among them Martin Bernhardt, Hermann Oppenheim, Emanuel Mendel, and Ernst Remak. Mendel, who had studied with Griesinger and Virchow, began his career by opening a clinic in the Berlin suburb of Pankow. Later he opened an outpatient clinic in the more centrally located Dorotheenstrasse, treating a steady stream of nervously debilitated patients with liberal doses of electricity. He received many referrals from the Charité and sometimes sent his patients there for observation.70 Denied a secure foothold in the university for religious reasons, many of these figures straddled the worlds of public and private medicine, operating their own clinics while also lecturing at the Charité.71 They were steeped in the materialism and the progressive outlook of the Griesinger school, tending to be more socially and culturally progressive than their psychiatric counterparts. They were also committed to the new doctrine of growing nervousness and the belief that the best weapon against it was electricity. These nerve doctors became “accredited guides” not just to the terrain of modern selfhood, with its prescriptions and new forms of hygiene, but also to the social landscape of urbanizing, industrializing Germany, with its opportunities, its demands and risks.72 Oppenheim, for instance, became the leading expert on neuroses of the railway, while Eulenburg and Bernhardt both wrote on the nervous disorders of telephone operators. All three wrote on the “mental overburdening” of schoolchildren.73 It was within this community that nervousness acquired institutional anchorage in German society. In the network of specialized neurological clinics and private sanatoriums that developed in and around Berlin, the middle-class patients of doctors such as Mendel and Eulenburg found relief from their symptoms and were exposed to new ideas concerning the value of nervous hygiene, lifestyle reform, and rational care of the
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body.74 The therapeutic optimism of these institutions became linked with broader emancipatory impulses by doctors who sought to replace older moral discourses about psychiatric illness with the language and methods of modern medical science. Members of the educated middle classes increasingly rejected traditional nonsecular modes of treatment in favor of rational modes. Insofar as it seemed to hold out the promise of the humanitarian relief of suffering, electrotherapy was brought into direct relation with middle-class ideals of emancipation.75 The most complete account of neurasthenia’s transformation into a “disease of civilization” has been offered by Edward Shorter. According to Shorter the symptoms of nervous illness originate in codes of behavior, which are inculcated by physicians and internalized by patients. The language of bodily and psychic distress, the language of the doctorpatient interaction, is culturally constructed. In the late nineteenth century, Shorter writes, “[t]he new diagnosis that brought home to patients the message of the central nervous system paradigm, indicating to them how they were to behave, was ‘neurasthenia,’ or tired nerves.”76 Among other factors affecting the spread of this diagnosis was the necessity for doctors “to do something” for their patients in order to make a living, as the earlier citation of Freud reminds us. The competitive world of late nineteenth-century private medical practice encouraged sensitivity to and greater sympathy for the needs of patients. Charges of hypochondria and malingering naturally carried the risk of alienating patients, with a consequent loss of business. Neurasthenia was thus a useful diagnosis; anchored in the nervous system, it shielded the male, middle-class patient from being called a malingerer or worse. It occupied a middle ground between insanity and shirking, a middle ground that, according to Shorter, was defined by the cultural pressure to “somaticize” psychological illness. The institutional setting in which this pressure was most perfectly realized was the “somaticist” world of the late nineteenth-century private neurological clinic that proliferated in and around Berlin.77 Its central therapeutic instrument was the electrical machine. Electrical machines “regenerated” the energy-depleted body; equally important, they helped endow the ailment with reality by fixing the patient’s symptoms into a coherent, stable picture shielded against the stigma of hysteria.
THE ELECTRICAL MISE-EN-SCÈNE In 1880, Beard’s American Nervousness was translated into German, making his views available to a wider audience for the first time. Its
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impact among neurologists was tremendous. German doctors readily endorsed Beard’s equation of neurosis with the civilizing process, and the following decades saw an outpouring of literature dedicated to variations on the Beardian doctrine. Neurasthenia provided many doctors with their daily bread, as psychologist Willy Hellpach later reported. In the 1890s, he wrote, “It was believed that the future belonged to the nerve doctor, that the 20th century would be one of neurasthenia and its conquest, that as nerve doctor one was a made man.”78 Treatment of nervous patients with electricity became the vocation of an ever-growing number of practitioners, to whose offices patients thronged, lured by the enthusiasm for all things electric. As manufacturers competed to bring new and more effective electrodes, induction coils, batteries, and electromagnetic machines to the market, these practitioners were able to call upon a truly amazing array of electrical apparatus for shocking and stimulating their patients’ bodies.79 The most common forms of treatment employed galvanic or faradic current, which doctors administered by means of electrodes to their patients’ heads, chests, backs, hands, feet, eyes, and genitalia. For treatment with static electricity, the patient was seated on an insulated stool and gently bombarded by current through a force-field effect. Another popular technique involved submerging the patient in an “electric bath.” Through this process of “intensifying areas, electrifying surfaces,” this “intensification of the body,” the nerve doctors drove home the lesson of the new doctrine of nerves.80 It was part of the modernity of this disease construct that the image of the machine and of electrical technologies was everywhere in the literature about it. Electricity provided both a means of treatment and a heuristic for understanding the workings and interaction of body and mind. Physicians were fascinated by the implications of the connection between bodies and machines and by the idea that the body could run down and become depleted, just as a battery could. Paul Berger, the author of a guide to central Europe’s private convalescent institutions, offered a standard variation on this theme that tied the doctrine of nerves to social changes in the organization of work: In the age of the machine, in which physical strength and handwork increasingly diminish in value, in which only intelligence and mental capacity enable mastery of the enormous claims of social life, in which the demands on the activity and performance of the brain increase along with the expansion of knowledge and the flood of information, in which the tranquility
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and contemplation of the good old days have long disappeared, overstimulation and agitation of the nerves and the central organs of the nervous system, the brain and the spinal column, have increased to a hitherto unknown degree. We live in the age of nervous disorders.81
Berger went on to explain the privileged role of electrotherapy in treating nervousness by reminding his readership of Emil Du Bois-Reymond’s researches, which had “showed that all muscle and nerve activity is of a purely electrical nature, and that the muscles and nerves were constantly in the condition of a closed electrical chain.”82 Statements such as this connected the emergence of new forms of mental labor and their maladies to Berlin’s transformation from Handwerkstadt to Elektropolis. The industrial restructuring of the body went hand in hand with the remapping of urban form in the capital, where the decline of artisanal labor and the privileging of brain labor resulted in the historically novel disorders of Überreizung of brain and nerves peculiar to the city’s inhabitants. If part of the modernity of this construct was the promise that it could be mastered with electrical current, then electricity also permeated the imagery of affliction and shock to which the inhabitants of the new Berlin were exposed. When contemporaries spoke of the benefits and risks of the modern era, they invariably came back to electricity. Berlin was an electropolis—a place where Siemens and the AEG vied for control of the electrotechnical industry, but also where electricity was imagined and rhetorically constructed as coursing invisibly through the streets. A new genre of popular journals, exemplified by Stein’s Elektrische Rundschau, linked the proliferating new world of electrotechnology to a host of new risks associated with electrical machinery.83 Such journals combined enthusiastic accounts of the latest developments in transportation and communications technology and medicine with sober analyses of the perils attendant on the advance of the electrotechnical age. Cut off from Hand und Land, the citizens of the metropolis became, as author G. C. Schwarz put it, Nervenmenschen.84 Schwarz, like a growing number of doctors, counseled relief from the stimuli of the Großstadt in rural nerve clinics such as Haus Schönow. Located on the outskirts of Berlin in Zehlendorf, Schönow was run by Max Laehr and situated on the same property as Schweizerhof Asyl, which Laehr’s father, Heinrich, had opened in the late 1850s at a time when it was still part of the countryside. Forty years later, when his son Max opened Haus Schönow, Zehlendorf had been transformed into a suburb of Berlin and was becoming increasingly plugged into the urban grid, the landscape around it permeated with electrical cables. At the sanatorium’s
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opening, the AEG, which sent many of its employees for convalescence there, donated 360 lightbulbs.85 Paradoxically, as patients sought out rural retreats for temporary respite from the speeded-up tempo of life and rapidly changing physical fabric of Berlin, the nerve clinics and sanatoriums that ringed the capital acquired ever-more imposing collections of electrical machines. At the Kurhaus St. Georg, located in Hermsdorf near Berlin, patients could choose between a remarkable array of treatments. Alongside hydrotherapy, massage, sports, and work therapy, the Kurhaus offered the following forms of electrotherapy to its patients: galvanization, direct current, alternating current, galvano-faradization and faradization, localized use of electrodes, hydroelectric baths of various forms including d’Arsonvalization (high-current electricity) and Franklinization (influence electricity). The Kurhaus’s clientele was made up of an extremely diverse and discriminating population, including neurasthenics, hysterics, hypochondriacs, migraine sufferers, traumatic neurotics, insomniacs, and others suffering from anxiety, neuralgia, and illnesses of the nerves.86 Somewhat more remote from the capital, the Sanatorium Johannisbad in Eisenach offered its clients a similarly wide-ranging and up-to-date selection of electrical treatments in an idyllic setting.87 As Berger would put it in his guidebook, the new nerve sanatoriums were not hospitals but schools in which the patient learned to live naturally and healthily, in accordance with a set of principles for regulating and managing the body’s energies.88 Although the rural setting of sanatoriums such as the Kurhaus St. Georg harkened back to preindustrial society, the form in which they offered treatment was nevertheless highly modern. The cure might remove the patient from the enervating influences of the capital, yet the market for such cures was very much the product of an industrializing and urbanizing society. The movement from one setting to the next, the switching of doctors, clinics, and therapies, the monitoring of the body and its needs, which marked the existence of many nerve invalids, all attest to the emergence of a highly competitive market for medical care presupposing the existence of a mobile clientele as well as a railway system servicing a network of spas, sanatoriums, and convalescent institutions.89 One consequence of the wider availability of new treatment methods was the pilgrimages that patients with the means to do so made to the clinics of eminent doctors. In 1896 Herr S., a professional violinist, checked into Berlin’s Charité complaining of nervous symptoms (headaches, shaking, paralysis) stemming from a shock suffered eleven
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years previously, when he claimed he’d been struck by lightning. He had initially traveled to Vienna to consult with Moritz Benedikt, one of Freud’s teachers and the first doctor in central Europe to hold a university chair in electrotherapy. From there S. had gone to seek help from Jean-Martin Charcot in Paris. Charcot diagnosed his frequent attacks as hystero-epileptic in nature and treated him with static electricity. A renewed attack brought him to Berlin’s Charité, where he was again treated with electrical machines and released.90 The case of Herr S. introduces us to one of the stock personages of the literature on nerves: the “professional invalid.” In search of respite from their ailments, such patients spent much of their time crisscrossing Germany and Europe beyond, seeking help from the Continent’s great doctors. In an earlier era they might have been labeled hypochondriacs or shirkers, but the new diagnosis of nervous exhaustion shielded them at least partly from such charges. Nevertheless, they were often blamed for contaminating other patients with their afflictions as they made the rounds. Westphal’s former assistant, the Jena neurologist Otto Binswanger, suggested that such invalids left agitation and confusion in their wake as they drifted from one clinic to another, propagating the malady throughout society. Exposed to the influences of such figures, otherwise quite healthy people learned for the first time to perceive their normal worries and cares as symptoms of a “nervous condition” entitling them to special consideration from their spouses, their employers, their doctors. In this sense the schooling to which Berger referred could have unintended consequences. As neurasthenia began to spread to new social groups, such secondary phenomena of the Beardian doctrine began to attract increasing scrutiny. Already in 1880 Erb was noting the rise of nervousness among the urban proletariat, a rise that, he predicted, would arouse the interest of the state in this new branch of medicine.91 Sixteen years later Binswanger wrote that doctors’ offices were being overrun by a veritable “army of neurasthenic city dwellers.”92 These developments reflected broader changes connected with the expansion of the medical market in the late 1880s and 1890s, which was in part brought about by the social insurance legislation passed in the 1880s, a development that vastly expanded the nerve doctors’ clientele base.93 But this expansion also reflected the success with which nerve doctors had popularized their views. What had begun as a professionally defined syndrome gradually began to take on epidemic contours, and as it did so, these questions posed themselves: Was nervousness really on the rise, or was it simply receiv-
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ing more attention? Had shifting definitions of what constituted neuroticism simply resulted in the relabeling of certain kinds of behavior as neurotic? Was it an artifact of modern medical consciousness? Certainly modern life seemed to tax the brain and nerves; yet nervousness also seemed to have other, less easily explicable sources. Exposure to nervous people could induce nervousness, as could too much time spent in clinics. Merely reading about the subject could have similar effects, as the case of one patient, Emilie E., admitted to Berlin’s Charité in 1893, suggested. The patient, who came from Schlesien, complained of symptoms of neurasthenia and agoraphobia; she related that since coming to Berlin she had noticed that when she was on the street she was plagued by feelings of apprehension, so much so that she could no longer go out without having a packet or umbrella in her hand. When she crossed a large square, she was overcome by anxiety and had to creep along the sides of the buildings. Asked when her symptoms had first appeared, she told the examining doctor that she had first noticed them after reading an article on agoraphobia in the middle-class weekly Die Gartenlaube.94 Having been endowed with the imprimatur of modern medical science, such diagnoses were acquiring talismanic status. In noting such phenomena and prescribing countermeasures—for instance, limiting contact among patients or the kind of reading material available in clinics—doctors began to grapple with a more uncanny dimension of nervous illness, one that could not so easily be squared with the somatic model. Discovery of this new suggestive dimension proved fertile ground for those, like Freud, interested in fashioning an authentically psychological disease picture as well as for those skeptics who had held from the beginning that neurasthenia was simply a label of convenience that shielded the patient from the stigma of mental illness on the one hand and malingering on the other. Writing in the 1880s about the proliferation of private nerve sanatoriums, Ewald Hecker stated, “Among insiders, it is an open secret that this designation has been chosen euphemistically in order to make it easier for the relatives of an insane patient, to whom the term insane asylum appears horrifying, to bring the individual for admission.”95 Skeptics accused nerve doctors of overdiagnosis or simply of being too credulous of their patients’ complaints. Skeptics also focused attention on the settings in which nervous patients congregated—the private offices of urban physicians, the rural sanatoriums, the waiting rooms of public hospitals—in the belief that these settings had become contaminated with the possibility of suggestion or psychic contagion. Within the vast outpouring of words on the subject of modern nerv-
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ousness, such writings formed at first only a small trickle. Yet they indicate the fragility of the Beardian construct and suggest that the new legitimacy of neurasthenia remained conditional. The oft-cited “capriciousness” of nerve invalids did not always endear them to medical men. As Nonne observed about Erb, he “had to reign himself in, in order to listen to the nervous riffraff—as he once called them—to become engaged, and to cure or to console.”96
FROM ELECTROTHERAPY TO ELECTROSUGGESTION To understand subsequent developments in German neurology and electrotherapy, we must briefly turn our attention to France and to the work of Jean-Martin Charcot and Hippolyte Bernheim. One of the most celebrated and charismatic figures in nineteenth-century medicine, Charcot had staked his career on his studies on hysteria. Following in the footsteps of Duchenne, whom he called his master, Charcot had become holder of the world’s first chair in diseases of the nervous system, at Paris’s Salpêtrière clinic. There he assembled the resources of modern medicine into an institution devoted to the science of hysteria.97 Like many of his German contemporaries, Charcot viewed hysteria as deeply problematic, a “malady that does not submit to laws.”98 In its artful imitation of other illnesses, he saw the essence of the condition. Charcot defined imitation as the hysterical symptom par excellence, postulating the existence in the nervous system of a property he called “neuromimesis”: “this property which functional diseases have of resembling organic ones.”99 Nevertheless, following lengthy study he accorded hysteria the status of a positive illness, in part by distinguishing neuromimesis from simulation, seeing the latter as an intentional form of imitation “in which the patient exaggerates real symptoms, or again creates all at once an imaginary group of symptoms.” Using the resources at his disposal, he was able to demonstrate that hysteria had its laws—the three phases of the hysterical fit—and objective symptoms. By bringing hysteria into the laboratory and the clinical demonstration and by subjecting it to experimental procedures, he was able to impose order on the malady’s unruly symptomatology and to rescue it from the realm of hypochondria and simulation, where it had formerly languished. But Charcot was not content to stop there. Having established that hysteria was a genuine illness, he went on to report that he had found it among working-class men as well. This discovery blurred the distinctions between male and female neurotics, though there is evidence that in his
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private practice at least, Charcot tried to preserve this distinction by diagnosing his middle-class male patients as neurasthenic. At the Salpêtrière, where patients were mostly working-class, he tended to diagnose them as hysterical.100 Charcot also experimented with new and sometimes disreputable methods of treatment. Among these were hypnosis and static electricity, which he reintroduced to medicine. Known in Germany as Influenzelektrizität, this kind of current harkened back to an earlier era of medical electricity. Instead of the directional flow associated with faradic and galvanic current, it generated a force-field effect. Static electricity machines were large and noisy; their operation was accompanied by showers of sparks; the current could not be measured or quantified as could galvanic current. As observers frequently noted, the effects associated with the so-called influence machine were altogether more uncanny than those generated by conventional apparatus. Germans disparaged this treatment as a relic of the prescientific era of electrotherapy, but Charcot recommended it precisely for its suggestive value in treating hysterics.101 At the Salpêtrière he practiced a kind of mass treatment, using six of these machines simultaneously, a phenomenon reported with amazement by one German doctor who witnessed the scene.102 Charcot’s research challenged many of the epistemological foundations that German neurologists had worked so laboriously to construct. Their response was understandably vehement. His theories of male hysteria were rejected by much of the German medical establishment; his experiments with hypnosis and static electricity and his views on the role of suggestion in treating neurotic patients were also greeted with skepticism. Eventually his unorthodox methods led to charges that he had invented the whole disease picture surrounding hysteria.103 Critics claimed that Charcot had created, rather than a temple to science, a highly excitable and theatrical atmosphere in which suggestion, contagion, and libido ran riot. Yet the implications of Charcot’s work with hypnosis were ultimately mild compared with those of his countryman and fellow physician Bernheim. Unlike Charcot, who believed that only hysterics were susceptible to hypnosis, Bernheim advanced the radical notion that anyone could be hypnotized.104 Out of Bernheim’s theories of suggestion emerged a new psychogenic paradigm of neurosis. Freud’s psychodynamic model replaced social trauma with sexual trauma and then with a model of universal psychosexual development, in which the role of trauma receded into the background. Meanwhile, electrotherapy was replaced first by hypnosis, then by the talking cure. Within the mainstream of German medical psychology, however,
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Freud’s ideas received little attention at first, and the debate over suggestion took on a highly ambivalent character. With relatively few exceptions, German physicians treated suggestion not as a therapeutic resource but as itself a kind of malady. They did so despite being aware that suggestion could play a role in the treatment of nervous illness. Beard himself had observed that he had sometimes been able to get remarkable results simply from treating a patient with an electrical apparatus with the current switched off. Erb based his own conclusions concerning hysteria on a similar discovery: “I have often thought it desirable to test the effect of the psychical impression upon [hysterics] . . . by applying the electrodes in the proper manner without closing the circuit. The statements made to us concerning the effects of such a sitting may be remarkable, but they give a clear idea of how much must be attributed to imagination and mental excitement, and how much to action of the current.”105 To Erb, the failure of live current in treating hysteria could mean only one thing: that it was not a genuine illness. Not everyone was convinced of this. Erb’s student, Leipzig physician Paul Möbius, came to the opposite conclusion: the “suggestive” effects of electrotherapy on the hysterical patient cast doubt on the apparatus itself, not on the patient’s illness. Möbius, who introduced to German medicine the Charcotian notion that ideas could produce changes in the body and that hysterical symptoms were simply materializations of psychic conflicts, regarded electrical apparatus as a prop that enhanced the physician’s authority and his purely psychological influence over the patient. He wrote that he used electricity far more in his polyclinic than he did in his private practice, where presumably he had the leisure to try out more directly psychological styles of treatment.106 The shift in the way that doctors conceived of electrotherapy, as a result of new pressures acting on the therapeutic scene, can be seen clearly in the case of Alfred Grotjahn. Grotjahn began his medical career as a neurologist in Berlin in the mid-1890s, working as an assistant to Emanuel Mendel.107 Upon first entering private practice, Grotjahn later wrote, he prescribed electrical treatment schematically at cut-rate prices, “for otherwise the mass demand could hardly have been managed.” Like Eulenburg, with whom he later collaborated in the founding of the Berlin Society for Sexual Science and Eugenics, Grotjahn found a large clientele in the capital, though in his case it was in the working-class district of Kreuzberg. Many of his patients came to him from one of the sickness funds established by the social insurance legislation of the 1880s. Grotjahn later experimented with hypnosis but ultimately, compelled by the
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demands of insurance practice to find a way of treating large numbers of patients rapidly and cheaply, switched back to electrotherapy because it was less time-consuming. He also found that the apparatus lent him an impressive scientific aura in the eyes of his patients.108 With clinics becoming clogged with patients complaining of nervousness, insomnia, fatigue, and headaches, considerations of speed and efficiency came to dominate the methods of treatment used.109 The boundaries of the clinical setting were being redefined, with important consequences for the doctor-patient relationship. This redefinition of the institutional space of nerve medicine was accompanied by a shift in the patient population. A new class of patient had begun to show up in doctors’ offices: the working-class or lower-middle-class nerve invalid. Treatment of these patients took place less in the world of the private clinic than in the world of the public hospital. The impact on doctorpatient relations was considerable. Previously, the question of secondary gain, of malingering or of simulation (conscious imitation), remained in the background, since the patients had paid for their own treatment. With treatment paid for by the state or by sickness funds and the prospect of compensation at stake, simulation moved to center stage. This shift in the patient population and in the setting brought a shift in the doctor’s relation to his patients as well. As Freud later observed, in his testimony in the postwar malpractice suit brought against Julius Wagner-Jauregg for his misuse of electrotherapy on shell-shocked soldiers, doctors in private practice had a stake in not “being disagreeable,” for fear of alienating their patients. Physicians employed by the state, he suggested pointedly, could abandon such discretion.110 While the literature on neurasthenia swarmed with descriptions of socalled objective symptoms, many practitioners felt that genuine understanding of the underlying disease picture was more remote than ever.111 Moreover, a new note of realism began creeping into the medical literature. The therapeutic euphoria of the 1870s and 1880s had been replaced by a more sober mood. Earlier claims made on behalf of the electrical method were scaled back to more modest levels. Electricity no longer seemed as effective in treating nervous disorders; in some cases, prolonged treatment or repeated examination only seemed to implant the symptoms more firmly in the patient’s consciousness.112 Skeptics raised doubts even about Erb’s reaction of degeneration, the very cornerstone of neurological diagnostics, a reaction that, according to Charcot, only a patient trained in physiology could imitate. The sign system surrounding nervous illness was proving to be an unstable one.
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According to neurologist Adolf Strümpell, “many so-called ‘objective laws’ in the phenomena of hysteria are . . . simply the result of the suggestive effects of the methods of examination which are applied with similar ‘lawfulness.’ ”113 Examination by the artful techniques of scientific medicine simply taught the patient to internalize the doctor’s gaze. The logic of objective symptoms was circular: doctors found them because they were looking for them. The most damaging attack came from Möbius. The iconoclastic Möbius was one of the most steadfast early followers of the electrical creed. But under the influence of Charcot and Bernheim, he became interested in suggestive methods of treatment and increasingly skeptical of electrotherapy’s value. From his position at Leipzig, where, as Shorter has suggested, resistance to the somatic ideology of the Berlin school was particularly strong, Möbius had by the late 1880s begun describing the whole procedure surrounding electrical treatment as simply a piece of theater, arguing that electrodes were “the entry portals for suggestion.”114 The fetishization of electrical methods was symptomatic, he wrote, of a hopeless “confusion of physiological and therapeutic knowledge.” Disturbed by what he perceived as a confusion of the doctor’s role, Möbius argued that the incidence of simulation was being exaggerated and that using electrical devices to unmask simulators was punitive, a form of “torture.”115 Though Möbius himself downplayed simulation as a significant factor, his writings provided ammunition for doctors who placed economic incentives at the heart of the spread of neurosis among the working classes.
THE CRISIS OF ELECTROTHERAPY The debate surrounding electrotherapy and suggestion culminated in the early 1890s. At the electrotherapeutic conference convened on 27 September 1891, in conjunction with the International Electrical Exhibition held at Frankfurt that year, Möbius’s charges provided the main topic of debate. The setting for the conference had been chosen with care: it was the biggest exhibition of this kind yet held, an occasion to demonstrate to the public the progress that had been made in realizing the vision of an electrified world. The Frankfurt exhibition signaled that an important threshold in Germany’s modernization had been reached and that the nation stood on the verge of a new phase of the industrialization process. A fully operational power station erected for the occasion generated current for street lamps, electric trains, household appliances, and numer-
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ous other products, including a full array of devices from the field of medical electricity.116 A leading attraction was the ballet Pandora, oder Götterfunken, in which young female dancers allegorically represented the new forces—telegraphy, telephony, phonography, and photography—unleashed by the “age of electricity.”117 Against this backdrop, the tone of the conference should have been optimistic, self-congratulatory. Instead the mood was defensive and embattled among those gathered, who included leading practitioners from across Europe, such as Benedikt from Vienna and Romain Vigoroux from Charcot’s Salpêtrière, as well as Erb, the young Kraepelin, and, representing Berlin, Eulenburg. Throughout the conference, the critique of electrotherapy was framed as subversive, as part of an attack not just on the profession but also on the social order. As chair of the proceedings, Erb set the tone in his opening remarks, speaking forcefully of the need to combat “negation and therapeutic skepticism.” He noted that the timing of the conference coincided with the hookup of the electrotherapist’s office to central power supplies. This assertion of the growing ties between medicine and the nation was echoed by the next speaker, Leopold Laquer, a Frankfurt physician, who wasted no time getting to the point: The claims Möbius has repeatedly made in recent years, that most electrotherapeutic successes are the result of suggestion, are subversive ideas. They would not have found such a receptive audience if suggestion had not developed into a veritable national malady, spreading not simply throughout medicine but in law and even to the highest levels of statecraft. . . . The partisans of suggestion ascribe to, even cultivate in, the individual a weakness of will and absence of character, against which the unprejudiced neurologist, who seeks to work against modern humanity’s increasing weakness of nerves, must energetically fight.118
The talks that followed underscored two related points. One was the need for greater diagnostic clarity. When it came to treating functional neuroses, reported one speaker, it was only natural that doubts would arise as to whether the success achieved could be attributed to electricity or to suggestion, since so many of the symptoms of the functional neuroses could “be traced to autosuggestion.”119 The second point concerned the need to enforce standards. Categorically rejecting Möbius’s charges regarding neurology’s “confusion of physiological and therapeutic knowledge,” Erb proposed that the solution lay in further experiments and more test data. Other speakers focused on the need for higher technical standards: more reliable galvanometers, standardized current dosage, and conventions governing usage.120
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Yet much more was at stake in the crisis facing the participants than simply the purity of their methods. The challenge of processing growing numbers of neurotic patients was generating a need for methods of mass treatment under circumstances in which considerations of skill counted less than speed and ease of use by nonexperts. Precisely the features that recommended the electrical method for wider use in public hospitals were contributing to a decline in standards. Electrotherapy was moving out of the private office and assuming a more public face. This change in clientele and institutional setting was touched on only indirectly, yet in a revealing fashion. As Laquer lamented, electrotherapy’s use on a larger scale, which many doctors had welcomed as a prerequisite for conducting studies large enough to validate experimental results, had unfortunately had not had that effect: “The public hospitals, which meet these preconditions and could collect the corresponding experiences, have not carried out these duties, which would be so important for electrotherapy. . . . Everyone knows how electrification is used in the hospitals, in whose hands the application of current lies: nurses, assistants, underassistants are the usual guardians of this therapeutic treasure.”121 Left unspoken here was a deeper concern: that the professionally defined problem of “nerves” was mutating into something else, an epidemic of suggestion. Over the course of the 1890s the orthodoxies of preceding decades were challenged on several fronts. As middle-class brain workers lost their monopoly over the illness and neurasthenia spread to new social strata, the careful differentiation of hysteria and neurasthenia yielded to mixed diagnoses such as hysteroneurasthenia, while orthodox methods of treatment faced increasing competition from new suggestive methods, including electrosuggestion. This last development was the subject of a testy exchange between Erb and Albert Eulenburg, the Berlin neurologist who presented a paper on static, or so-called influence, electricity. Insisting on the authenticity of the electrical cure, Eulenburg nevertheless tried to account for the suggestive aspects of the influence machine: The large, uncanny machine . . . with its special motor, its incomprehensible accessory apparatus, its noisy workings, the hissing and rattling of the discharges, the sparks, the flashing of lights in the dark, the buildup of ozone and so on, all this and other similar factors inarguably exercise a mysteriously alluring and imposing total effect, one that powerfully excites the senses. . . . It is within the doctor’s ability to heighten quite significantly this impression of the mysterious and the fantastic, by means of casually made remarks.122
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Eulenburg’s remarks seemed to locate the influence machine in the same cultural space as Ottomar Anschütz’s elektrischer Schnellseher, a primitive protocinematic device first unveiled at the exhibition, or to link it to the devices for administering electrical shocks that visitors to the exhibition tested their reflexes and fortitude on.123 Erb’s response to Eulenburg was to insist on the distinction between scientific and “unscientific” uses of electrical current. In his experience, he reported, influence electricity did not work at all, which undermined the validity of the suggestion theory. Though conceding the difficulty of “representing electricity’s effect on the nerves,” he believed this would be resolved through further experimental research. Lacquer reinforced Erb’s point by arguing that, to the extent the electrical method worked, it did so not because of the patient’s belief in the electricity but despite his fear.124 Yet the faith in future medical and technical breakthroughs that had once been a hallmark of the young discipline could no longer be taken for granted. One of the ironies of this story is that, even as the Frankfurt exhibition heralded the advent of a new electrotechnical age, the naive era of electrotherapy was ending and a shift was getting underway in German nerve medicine. This was a protracted development, entangled in many medical and social conflicts. Ultimately the challenge to the somatic model would prepare the way for a new psychological model. But as Doerner writes, this shift was not completed until the war, when the problem of war neurosis and its attendant economic and manpower consequences secured the triumph of a psychogenic theory of neurosis and, not coincidentally, of electrosuggestion as the preferred method of treatment: The term “neurosis”, introduced by Cullen [in the 18th century], retained its meaning as a disorder of the nerve function without any significant structural damage for over 100 years, until psychologically internalized, it lost its reference to the nerves. This trend was accelerated in the late 19th century by the development of neurology as a specialty and came to fruition not with Freud, but ironically, when psychiatry was forced to the conclusion that the trembling and other “neurotic” responses of many soldiers to the technologizing process of World War I were due to psychological factors, not to organic causes. In Germany . . . this was a scientific judgment but was also seen as a contribution to military morale and to the economy, since it offered a handy tool for fighting the pension claims of veterans.125
FROM SOMA TO PSYCHE Wilhelm Erb’s seminal article of 1893, “Über die wachsende Nervosität unserer Zeit” (The Growing Nervousness of Our Time), spelled out the
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terms of the shift that was occurring in medical thinking about this disease of civilization. In this piece, a central point of reference in the turnof-the-century literature on nerves, Erb traced the nerve weakness, exhaustion, and excitability that were neurasthenia’s chief characteristics to “overburdening.” In this “age of electricity,” he wrote, cities, machinery of all kinds, new forms of travel and communication, mental and physical overexertion had become facts of life. The great cultural progress of modern times, the inventions and discoveries, the economic competition, and the conflict of worldviews that characterized modern life, all had taken their toll on the human organism. Nowadays, he went on, everyone was at least a potential neurasthenic, though some, he was careful to add—women, Jews, the constitutionally weak—were more at risk than others. No longer a distinct diagnosis, neurasthenia was rather a style of reaction to which, under certain circumstances, anyone could succumb. This normalization of neurasthenia came at a price, however, namely, a significant retreat from the therapeutic optimism of earlier. Emphasizing prevention over treatment, Erb outlined a program of “hygiene of the nervous system,” a phrase covering a wide range of medical intervention in areas such as physical culture, educational reform, and military service.126 Meanwhile, other figures promoted “suggestive” methods of treatment. These included the electrical method as well, which Möbius defended as a medium of unsurpassed psychological influence. “Should the electrodes be put aside?” he asked, answering with a decided no. “Precisely as a medium of psychological influence, electrical treatment is perhaps irreplaceable.”127 The battle lines in the fight for the nation’s nervous health were shifting to a psychological front. But whereas for Möbius suggestion was a useful resource, the doctor’s ally, for those concerned about the effects of repeated examination and extended treatment on the patient’s morbid consciousness, it remained a potentially dangerous ally if not an adversary. Fritz Kaufmann, the physician who popularized the use of electrosuggestion during World War I to treat war neurotics, first successfully treated a patient with electricity and suggestion at Erb’s Heidelberg clinic in 1903. Perfected during the Great War on Germany’s soldier-patient masses, Kaufmann’s dubious solution to the potential problems involved in incorporating suggestion into the clinical setting was to limit the treatment to a single session, often brutally protracted in length, until the patient surrendered to the cure.128 From the 1890s onward, explanations of the underlying nature of nervous illness took an increasingly psychological turn. As nervousness
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became recast as a psychological condition and increasingly stigmatized as a form of shirking, the electrical method’s aura of scientific authority became the doctor’s accomplice in luring the patient into unwittingly exposing his own deception.129 The power of the electrode to ascertain the truth of nervous illness—even when not transmitting current—is strikingly illustrated in the following statement, made by Dr. Julius WagnerJauregg’s sadistic assistant Dr. Kozlowski in his testimony in the malpractice suit brought against Wagner-Jauregg after the war: “I preferred it when the malingerer, on being touched with the brush, let out a fearful howl of pain, although the current had been cut off without his knowledge, so that he could be feeling anything.” In that way, Kozlowski claimed, the malingerer “was at once unmasked.”130 In the somaticist world of the private clinics that developed in and around Berlin, electrical machines had endowed the nervous disorders of middle-class patients with the imprimatur of medical science. These machines did not invent these disorders; rather, they conferred on them a new condition of visibility. Freed of the stigma of mental illness, “nerves” became “real” in the eyes of doctors and patients alike. In the world of public medicine, where medical imperatives became enmeshed with social imperatives, these machines positioned new kinds of patients as objects of an administrative and forensic system whose operative assumption was that neurosis was not real. Once used to treat the fatigued body, the machines increasingly became a means of gaining control over the patient’s recalcitrant will.
THREE
Railway Accidents, Social Insurance, and the Pathogenesis of Mass Nervousness, 1889–1914
I
n an opinion commissioned in 1897 by the Reich Insurance Office (Reichsversicherungsamt, RVA), the psychiatric faculty of Berlin’s Charité hospital surveyed the case of a worker who had been treated there on three separate occasions in the late 1880s. The patient had been the victim of a railway accident and was thus eligible for a pension under Germany’s insurance laws. Initially diagnosed with neurasthenia, he had subsequently been examined by neurologist Hermann Oppenheim and diagnosed with traumatic neurosis. A third and final examination by another doctor led to the restoration of the original diagnosis. Each opinion had been based on a series of electrodiagnostic, memory, and visual field tests conducted to determine the severity of the patient’s illness and any possible evidence of malingering, or simulation, on his part. The results, according to the Charité report, pointed to a genuine illness. Nevertheless, though the patient’s claim seemed legitimate, some caution was warranted. The discrepancies among the three earlier opinions, noted the report, were typical in such cases, whose symptom picture was marked by “phenomenological combinations that contradict our scientific preconceptions and experiences but of which we know one thing: they are not ‘consciously simulated.’ ”1 As the Charité opinion attests, the transformation of nervousness into 81
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a mass phenomenon during the 1890s, under the influence of the nation’s social insurance laws, aroused increasing interest on the part of state authorities in the connection among industrial work, nervous illness, and pensions. When first passed in the 1880s, Germany’s social insurance legislation was greeted as a pioneering initiative in the field of social policy, laying the foundations of a rational system for managing the shocks and afflictions of industrial society. The legislation contained tangible benefits for both working-class patients and doctors, who profited from the professional opportunities afforded by the expansion of clientele. By the 1910s, however, the system was in crisis, plagued by what critics charged was an epidemic of fraud and by growing tensions between doctors and patients. Arguing that the system worsened the very problems it sought to manage, critics launched a concerted campaign against the “degenerative” effects of worker’s insurance.2 Recognition of traumatic neurosis as a compensable condition in 1889 would consume the attention of medical and insurance experts as well as patients until 1926, when the law was rewritten to disqualify traumatic neurosis from compensation. While social insurance institutionalized the coupling of modernity and nervousness in German society, it thus also exposed this coupling to mounting skepticism. As one doctor would put it in 1926, following revision of the law: “The causes of the emergence of the so-called accident neuroses lie in our laws.”3 It was no accident that the case chosen by the Charité faculty, Germany’s highest authority for medical judgments on pension claims, involved a railway employee. Within the discourse about nerves, the traumatic sequelae of railway accidents commanded a place of special importance. This reflected the railway’s status as iconic structure of modernity, charismatic symbol both of progress and of the shocks and injuries of industrial society. In the railway accident, scenarios of technological and nervous breakdown were fused in an image that held a powerful fascination for the German imagination. But the precise nature of the relationship between nervous and technological breakdown remained a subject of considerable debate. If social insurance institutionalized a collective responsibility for the risks of modern life, by the eve of the Great War a concerted effort was underway to shift this responsibility away from society and onto the individual. A crucial aspect of this shift was the recasting of the old somatic model of sick nerves in a new psychological idiom.
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MODERNITY, RISK, SOCIAL INSURANCE The political, economic, and social shocks of the founding years of the empire were inscribed in much of the early discourse on nervousness, which rehearsed, obsessively and repetitively—in the manner of a classic traumatic neurosis—the upheavals of those years: the war and unification of 1870–71; the crash of 1873; the subsequent processes of urbanization and industrialization; the expansion of the nation’s railway and communication networks. To the generation that lived through these events, it seemed self-evident that, whatever the final reckoning, they had exacted a cost, measured in the rise of modern nervousness. Yet from the beginning, this connection between modernity and nervousness was treated with skepticism by some doctors. By the 1890s, this skepticism was gaining ground among a younger generation. For this generation, whose coming of age had occurred in the 1880s, unification was a fait accompli. What was now in question was the seemingly more elusive goal of reconciling the needs of political and industrial power with those of social peace. The rise of an organized working class had given rise to both pioneering welfare initiatives and anxieties about national decline and degeneration. These anxieties gave a darker cast to the discourse about nervousness, whose spread was seen as jeopardizing the Social Darwinist ideal of a fit and efficient body politic and Germany’s great-power status. Increasingly oriented to a collectivist rather than a liberal framework of medicine, the new generation was also increasingly skeptical of the Griesinger school’s materialism.4 Its members were less inclined to accept at face value the theory of a straightforward relation between modernity and sick nerves. Was nervousness, asked Alfred Grotjahn in 1908, genuinely on the rise, or was it merely gaining more attention as a result of a pervasive process of medicalization or of modern social policy?5 Grotjahn himself was in little doubt about the answer to his question. He took it as a demonstrable fact that neurasthenia had become a “mass phenomenon” and proposed that the solution to this problem lay in “more stability in social relations, less Americanism, less tempo in industrial development.”6 This statement seems to speak to what has often been described by scholars as a fatal ambivalence about industrial modernity characteristic of the German mandarin class.7 Yet Grotjahn’s remark may also be seen less as evidence of cultural pessimism than as evidence of a pragmatic faith in social engineering. While it is certainly the case that terms like Americanism and tempo operated as code words
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within conservative discourse about the pathological aspects of the modernizing process, they also served as leitmotifs for those, such as Grotjahn, who, as we shall see, entertained visions of a higher, more rational order based on advances in the field of social hygiene. Grotjahn’s use of the term mass phenomenon points to another fact that deserves attention: namely, that the 1890s marked the emergence of mass society, with its attendant problems, in Germany.8 The nation’s modernization process reached a new threshold in that decade, marked, among other things, by Berlin’s transformation into a world city, the explosive growth of the Social Democratic Party following the lifting of Bismarck’s ban in 1890, and the appearance of an organized women’s movement. The emergence of urban planning, sociology, and new theories of crowd psychology can be taken as an indicator that German society had reached a turning point in its development. By 1900, society as such, along with the “social question”—the problems of housing, poverty, and health facing Germany’s urban workers—had become a scientific object of the first order.9 Neurology’s status as a discipline straddling both medicine and social science invited practitioners in the field to respond to these problematic developments. Nowhere is this clearer than in the work of Willy Hellpach, a pioneering figure in the field of social psychology who published widely on topics belonging to the border area between mental illness and social pathology. Hellpach was a student of the psychologist Wilhelm Wundt, who along with Karl Lamprecht presided over an intellectual scene in Leipzig that was a center of resistance to the progressive materialism of the Berlin school.10 In a series of works written in the early 1900s, Hellpach explored at length the relation of nerves to modern German life. He identified the year 1877–78 as the turning point in the empire’s history. The developments of that year—the protective tariff, the ban on the Social Democrats, the split in the national liberals, and the first appearance of political anti-Semitism—had their roots in the crisis of political economy that had begun in 1873. A new appreciation of the dislocations of the modernization process had coincided, Hellpach noted, with the arrival in 1880 of the Beardian doctrine of nerves. Germany had subsequently entered a new phase of its transition to industrial modernity, the phase of “organized capitalism.” One manifestation was a search for new techniques of integration, or “socialization processes.”11 In a society convulsed by the changes of the previous decade, social insurance offered itself as an exemplary solution to the social question. Yet, in Hellpach’s view, enactment of the nation’s insurance
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laws had decidedly paradoxical consequences. These laws had exposed the proletariat to new ideas about rational care of the body and the virtues of a healthy, moral, middle-class life. For many workers, this new form of “state socialism” had ended much of the existential uncertainty of modern life. Yet it had also eroded the sovereignty of the individual. The result, in Hellpach’s estimation, had been a sapping of the nation’s will.12 By the turn of the century the bourgeois idiom of Nervenleben, he wrote, had thoroughly colonized the proletariat’s Weltanschauung: “In the soil of the proletariat an occupational psychosis proliferates. . . . I mean that form known as accident neurosis (pension hysteria).”13 Hellpach’s use of the term hysteria in this context is significant insofar as it suggests that what had been merely a latent feature of the earlier discourse about nerves—the stigmatization of the nervous as less than fully masculine—was becoming more explicit. No longer a monopoly of the bourgeoisie, nervousness had been transformed into a mass condition. The price of this transformation, however, was the loss of both its anchorage in the body and the boundaries between neurasthenia and hysteria. It was precisely a symptom of these losses that Hellpach continued to insist on drawing a rigorous distinction between the middle-class, male character of neurasthenia and the proletarian, female character of hysteria.14 Stripped of its traditional organic bonds, German society had acquired artificial, mechanistic ones, whose nature and function Hellpach, a Catholic liberal, analyzed in tones that betrayed the consternation felt by many German elites, dismayed by the “materialist” world picture of the worker masses. Yet Hellpach nevertheless conveyed a sense of faith in the future of technological modernity. He celebrated the role of the expert, especially the physician and the engineer, in creating a healthy and rational society, free of risk and accident. For Hellpach, indeed, every accident represented an opportunity to acquire the knowledge needed to prevent future accidents: “The machine diminishes the irrational element of everyday life—every technological catastrophe is ultimately a lesson in how it is to be avoided in the future, and more generally a stimulus to the further perfection of the machine.”15 Hellpach’s reference to accidents conjured up one of the great topoi of German modernity. Prior to the emergence of the metropolis at the end of the nineteenth century, the experience of modernity in Germany was most closely associated with the railway. Wolfgang Schivelbusch has described how the railway journey transfigured both the physical and the mental landscapes of late nineteenth-century Europe.16 The speed with
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which the railway burst upon European consciousness was quite unparalleled. During the second half of the nineteenth century, Germany’s railway network virtually doubled in size every decade. As the nation’s leading economic sector, this expansion acted as a catalyst for other branches of Germany’s industrial base. Harnessing the forces of steam and electricity, the railway symbolized mastery over the natural landscape, bringing distant points closer together and reducing travel time dramatically. This destruction of the traditional coordinates of space and time, as Schivelbusch shows, was experienced as a violent process, one accompanied by considerable anxiety. One expression of this crystallized in the medical literature on so-called railway spine and in the liability laws created in 1871. The birth pangs of the new nation thus coincided with the transformation of the railway into the central site of a discourse about risk and its management. In the railway and its calamities—in which man’s technological creations seemed to turn uncannily against him—Germans saw an image of both the modernization process and its dangers. “Railway spine” was first described by the English doctor John Erichsen in 1866. According to Erichsen’s account, the syndrome originated in a shock to the nervous system caused by the prolonged agitation of railway travel or by an accident.17 “It must . . . be obvious,” wrote Erichsen, “that in no ordinary accident can the shock be so great as in those that appear on railways.”18 Erichsen’s explanation of the unique horror of this syndrome echoed the account given by German author Max Maria von Weber in 1860, when he linked the pathologies of the railway journey to the electrical concussions continually inflicted on the traveler’s nervous system.19 Following Erichsen’s lead, a large body of literature describing the consequences of railway travel and accidents appeared in Germany during the 1870s. In 1879 Berlin doctor Johannes Rigler published a paper that summarized the results of his experience with patients suffering railway spine. As Rigler told it, the event in most cases involved a physical shock, caused by an intense stimulus, resulting in a functional disturbance of the nerves.20 He left open the question of whether this shock could also be psychological in nature. In his own contribution to this literature, Carl Westphal left less doubt that the operative mechanism in the shock caused by the collisions and derailments of the railway was primarily a physiological one.21 It was through the accounts of these physicians that shock was first introduced into German neurology. Esther Fischer-Homberger has dated its first appearance in the German literature to 1870, thereby making it
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exactly contemporaneous with the moment of unification.22 In its clinical meaning the term signified a sudden concussion or jolt of such force that, despite leaving no visible trace, it produced serious disturbances of the nervous system. Crystallized in the experience of shock, the railway accident became a primal scene of German modernity, anxiously replayed, as Westphal noted, in its victims’ dreams.23 Shock soon entered into broader consciousness of the new kinds of risk to which modern life exposed individuals. It became a crucial term in conceptualizing the social and psychological dislocations of industrial society. By bringing the accident into a clear causal relation with the traumatic reaction, the notion of shock played a key role in the construction of railway spine and, later, traumatic neurosis as externally produced conditions. This model stressed somatic causes, without precluding psychological factors such as fear.24 In fact the term shock proved highly elastic. The precise nature of the relation between soma and psyche in the genesis of the disorder would be debated by doctors for decades to come. But it was arguably the mechanistic underpinnings of the notion of shock that made it such a powerful heuristic for the dislocations of modern life. For all its discursive force, however, the term’s ambiguity invited challenge. Both as clinical and as cultural phenomenon, shock remained a fragile construct. By 1871, the problem of railway trauma had compelled the new nation to make its railway companies legally liable for their passengers’ safety and health. These liability laws became the precursor to Germany’s social insurance legislation, laying the foundations for a system of social policy and medical hygiene that attempted to manage the injuries of modern life. One immediate result of the liability laws was a rash of compensation claims on the part of victims. By 1879, Rigler noted that train collisions had become seven times and derailments twelve times more dangerous than before. The possibility that this increase reflected the influence of the liability laws was not lost on Rigler. Nevertheless he felt that the incidence of fraud was relatively minor and remained optimistic about medical science’s capacity to distinguish between true and false claims, recommending electrical examination in ascertaining the effects of such events.25 Similarly, Wilhelm Erb argued that touching the accident victim’s body with an electrode was the best way of getting to the underlying truth: “In several medico-legal cases I have succeeded, by a careful quantitative electrical examination, in determining the almost solitary positive fact that indicated the actual existence of disease, thus securing justice to the patient.”26 Westphal treated the prob-
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lematic effects of railway-related shock as an issue that university doctors, with their sophisticated instruments and methods of observation, were uniquely well-equipped to adjudicate: “The great difficulty of the question, whether in a given case the claimed illness is real or invented, has often forced the respective railway doctor to commit the patient for a lengthy and thorough period of observation at a hospital.”27 Not for the last time, we see in the interaction between railway accidents and liability claims the enigma confronting medical experts in the specter of modern nervousness. Were people truly more neurotic than in the past, or had definitions of what constituted neuroticism simply become broader? Should it be regarded as an artifact of the medical gaze? Was it fraud on the part of patients or a form of veiled workplace protest? In posing such questions, doctors were inevitably drawn into larger debates about industrial modernity and its risks, shocks, and afflictions. The passage of Germany’s social insurance laws in the 1880s only intensified such questions. The first of these laws was enacted in 1884, during a period of general restructuring in German society. In the wake of the economic crash of 1873, the distress experienced by Germany’s working classes and the growing strength of the socialists culminated in Bismarck’s banning of the Social Democrats in 1878. This was followed in 1884 by passage of social insurance legislation. Conceived by Bismarck as a means of counteracting the spread of socialism, these laws were designed to alleviate the stresses of industrialization and to reconcile labor and capital in the interests of social stability.28 They sought to deradicalize and integrate workers into German society by binding them to the state. This restructuring of social and economic relations mirrored the decline of liberalism as a political force and the emergence of a new kind of state-oriented social policy. Social insurance was conceived of as the cornerstone of a rational order, superior to the Manchesterism that German elites collectively deplored. A central function within this new order was assigned to medical specialists, who were entrusted with administering the nation’s public health policy and welfare system. In their hands, health and hygiene became the leitmotifs of the new social order that emerged to fill the void left by the collapse of traditional social relations in the course of industrialization. Health, as Alfons Labisch puts it, became a virtual obligation, “binding on all,” the means whereby lower social strata would internalize middle-class values and be integrated into the productivist German order.29 Tonio Bödiker, first head of the Reich Insurance Office, described workers’ insurance as similar in the
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“moral sphere” to steam power and electricity in the material sphere: “an integral part of mankind’s cultural progress.”30 To a society convulsed by the shocks of the industrialization process, insurance offered itself as an exemplary regime of social integration, a powerful new apparatus that would fundamentally alter the relation between the German state and its population. It interpellated Germany’s workers as members of a new community, bound together, as Greg Eghigian has written, by a “contractual order of mutual obligations that entitled patients to benefits and imposed a responsibility on them to rejoin the productive community.”31 This new order was grounded in a thermodynamic calculus that treated labor power as a resource to be wisely managed and augmented.32 Indeed, social insurance virtually forged a new model of citizenship, based on the recasting of social relations that marks the advent of what Michel Foucault has identified as “the politics of the body,” or biopower.33 The laws passed in 1884 covered sickness, disability, and accidents. Unlike the sickness and disability funds, which both employers and employees contributed to, accident insurance funds were the responsibility of employers alone. The funds were administered by occupational associations (Berufsgenossenschaften). The system as a whole was overseen by regional insurance courts under the auspices of the Reich Insurance Court, located in Berlin, which acted as final arbiter on insurance matters. A network of doctors, hospitals, and other facilities provided care and educated the population in matters of hygiene and preventive care. The development of the vast bureaucracies needed to administer this system and the complex body of law that regulated it mirrored the transition to a new stage of highly centralized, “organized” capitalism. Social insurance rested on a momentous redefinition of the nature of risk in the modern world.34 The new laws defined risk in mechanized industry as a social rather than an individual burden and institutionalized this definition through a system that collectively redistributed the burden.35 The implicit trade-off of this socialization of risks was the obligation to become healthy and productive. In projecting a more rational form onto industrial society, social insurance defined a new social body in place of the individual body of the bourgeois patient. But this redefinition had unforeseen consequences. Intended to cushion the shocks and conflicts produced by industrialization, insurance, writes Eghigian, had perverse effects: “By recognizing a social obligation to compensate injury, social insurance educated millions of Wilhelmine workers in a sense of entitlement that only further politicized them.”36
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Initially, only industrial workers, who were felt to be the most vulnerable to socialist agitation, were covered, but after 1900, insurance was extended to most trades. Because of both its link to Bismarck’s repressive policies and its lack of comprehensiveness, the Social Democratic Party (Sozialdemokratische Partei Deutschlands, SPD) initially opposed social insurance, but over time the party found it advantageous to participate in the administration of the insurance system. Given the system’s constant expansion, Socialist doctors were able to enter it in growing numbers after the lifting of the anti-Socialist laws in 1890. From that point onward, they gained increasing influence over the insurance funds, especially in large cities. Nowhere was this truer than in Berlin, a development that led to the later perception that social insurance had become a Socialist stronghold there.37 Berlin had a far higher percentage (almost double) of insured workers than the rest of Germany.38 In the insurance courts, German workers learned to articulate their newfound rights and press their claims with great tenacity. In their hands, the new legislation became a tool for redressing the uneven distribution of the costs of the modernization process. In writing that one could “speak with justice of a nervous age,” SPD leader August Bebel sanctioned the view that Germany’s workers should become “advocates of nerves,” voicing a conviction echoed in Social Democratic publications long after the backlash against social insurance had set in.39 The terms of this backlash were already hardening by the early 1900s, when an official of the Imperial Railway noted that, during the 1880s, a “huge change had occurred in the worker’s relation to the employer and in his political outlook generally,” which had “prepared the ground for the insurance laws of 1884.”40 He observed with astonishment that railway personnel seemed to think that state welfare was a “right,” a view that betrayed the lingering novelty attached to the premises on which social insurance rested. Although the vision of a system for rationally managing society’s resources held wide appeal, the implicit challenge to traditional notions of individual responsibility made the laws anathema to many liberals. Conservatives, for their part, remained deeply skeptical of the link between modernity, risk, and illness.41 Was the “modernity of risk” born out by statistics? And if so, did the statistics reflect an increase in real dangers, as the Social Democrats argued, or simply more accurate record keeping?42 Willy Hellpach, though he acknowledged that in modern factories workers were subjected to an exhausting work process that privileged productivity over well-being, claimed that mechanized industry was in fact less hazardous than non-
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industrial work.43 The participants at an international medical congress held in 1907 agreed that the industrial workplace imposed an inhuman tempo on workers: “Chronic fatigue and exhaustion is observed in all factories where the intensity of labor is regulated by the machine.” Such conditions, they claimed, undoubtedly magnified the risk of accident. Anson Rabinbach concludes that, although mechanized industry was indeed less dangerous than nonindustrial work, the modernity of risk was confirmed insofar as “accidents involving machinery rose more rapidly than others.” Thus the passage of the accident insurance laws attested to “the power of a perception of reality that far outweighed all arguments to the contrary.”44
HERMANN OPPENHEIM AND TRAUMATIC NEUROSIS In the arena of railway medicine, an important watershed was reached with the recognition of traumatic neurosis as a compensable illness. Germany’s accident insurance laws had initially covered only material injuries, but in 1889 the Reich Insurance Office extended coverage to traumatic neurosis. The key figure in this development was Hermann Oppenheim, professor of neurology at Berlin’s Charité. One of the most eminent figures in his field, Oppenheim was picked by his mentor, Carl Westphal, as his successor as director of the Psychiatric and Neurological Clinic of the Charité but was passed over, most likely because he was Jewish.45 His academic career thwarted, he subsequently went into private practice, following the trajectory of many Jewish doctors. Before doing so, however, he would leave a lasting mark on the discourse about sick nerves. From the mid-1880s on, Oppenheim had been intensively engaged with the problem of railway-related trauma. His 1886 Habilitation thesis was titled “Die Bedeutung der Schock für Krankheiten des Nervensystems” (The Significance of Shock for Diseases of the Nervous System).46 A product of the “school of Westphal,” he worked within the materialist paradigm shared by the members of this school. To Oppenheim, the nervous agitation, sleeplessness, tremors, visual disorders, and other symptoms shared by victims of railway and factory accidents represented the direct result of a physical jolt that caused a microscopic alteration to the nervous system. He also remained sensitive, however, to the psychological and emotional dimension of nervous trauma. Indeed, he acknowledged that the psychological consequences of an accident could play a significant role in traumatic neurosis: “In the genesis of this
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illness physical trauma is only partly responsible. An important, and in many cases the major, role is played by the psyche: terror, emotional shock.”47 Oppenheim simply insisted that physical shock and emotional shock were both directly caused by the accident and had similar effects on the nervous system. These effects he explained through an electrical model, according to which a concussion was converted into electrical signals that were propagated through the body via the nerves.48 In a similar fashion, emotional shock could be converted into physical shock through electricity coursing though the body. The resulting disease picture, he argued, was coherent and distinct from other related nervous conditions. Oppenheim’s views on the subject, published in his landmark Die traumatische Neurosen in 1889, were controversial from the beginning and embroiled him in bitter debates with leading German doctors.49 He was also drawn into a controversy with Jean-Martin Charcot when he challenged the Frenchman’s belief that hysteria could be found in men as well as women, including male victims of train accidents. According to Oppenheim, the victims of railway accidents looked more like Beard’s neurasthenics than Charcot’s hysterics.50 Like Oppenheim, Charcot relied on an electrical model of shock but described the resulting lesions as purely functional, while the German argued that they resulted in material, albeit invisible, injuries to the nervous system. For Charcot, hysteria originated in an unconscious, neuromimetic materialization of psychological conflict. The illness’s material quality—that is, the bodily symptom—was thus, according to the Frenchman, merely its outward form, an externalized representation of an internal, psychological conflict.51 Oppenheim, on the other hand, though he later came to place more emphasis on psychological factors, remained wedded to a somatic interpretation stemming from his commitment to patients’ rights.52 He also felt that Charcot overemphasized the role of neuropathic disposition or heredity. According to Paul Lerner, Oppenheim feared that Charcot’s views of traumatic hysteria “placed too great an emphasis on the subject’s ideas and thoughts and thus blurred the distinction between sickness and simulation.”53 For Oppenheim, functional neuroses were directly caused by trauma and were not merely hysterical reactions precipitated by a traumatic event. In essence Oppenheim had identified a syndrome that resembled neurasthenia in most respects but was the result of a single momentary shock to the system rather than prolonged overexertion. For railway accident victims, this was a crucial development insofar as it validated their claims to have suffered a material injury.
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Formal recognition of traumatic neurosis as compensable illness was followed by its spread to Germany’s working classes, under the auspices of a network of insurance boards, certifying physicians, and courts of arbitration. If nervousness had once been a part of the cultural property of the bourgeoisie, it now became a mass condition.54 By the early 1890s, working-class patients were showing up in droves in public hospitals, complaining of nervous ailments. Passage of the accident insurance laws made treatment affordable for these patients, entitling them not just to sick leave and compensation but also a pension if permanently disabled. The legislation dramatically expanded the patient population and altered its social makeup, as Berlin nerve doctor Theodor Benda noted in 1891: “That neurasthenia and hysteria are not the privilege of the roué and the salonnière is known to everyone who is acquainted with the clientele of the polyclinics for the nervously ill. And as for the most modern nervous disorder, traumatic neurosis, poor people constitute the main contingent.”55 Although they never represented more than a small fraction of the total number of accident insurance claims, victims of traumatic neurosis nevertheless commanded a disproportionately large place in the medical literature. Otto Brähmer, an expert in railway hygiene, wrote in 1896 that “there is certainly no medical theme that has occupied the men of science and practice as much as [traumatic neurosis] since the liability laws.” For every one hundred personnel, Brähmer wrote, fifty-nine had at some point in their career been at least partly incapacitated by nervous illness—by far the largest such category.56 Such figures, it must be said, are difficult to evaluate, as no formal statistics were ever collected on the number of claims made by accident neurotics. Figures compiled by the Reich Insurance Office in 1902 indicate that of the total number of over 150,000 patients who received accident insurance payments that year, more than 14,000 had suffered from some kind of (unspecified) nervous disorder.57 One study conducted in the early 1900s suggested that victims of accident neurosis among railway personnel represented around 3 percent of all accident insurance claims.58 However inconclusive these figures may be, what seems certain is that they were never large enough to constitute a major drain on the resources of the social insurance system as a whole. Nevertheless, the encounter between German social policy and traumatic neurosis opened a veritable Pandora’s box of issues. Traumatic neurosis emerged within a highly charged social space constituted by the convergence of social insurance, clinical medicine, and a
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new politics of the body as the site of labor power. Within the context of the contentious labor relations of the late nineteenth century, the stakes involved in its diagnosis—granting the employee a pension or mandating his return to work—could not have been more significant. As such they placed a high premium on claims for epistemological certainty. But this was exactly what remained elusive to physicians in their interactions with accident neurotics, a class of patient seen as notoriously capricious. These interactions, therefore, also became the site of a negotiation in which what was at stake was the claim of medical science itself to play a privileged role in administering the new German social order. At the heart of the rulings made by insurance boards and medical experts lay the question of how to discriminate between legitimate and illegitimate claims. In their role as expert witnesses, doctors had to exercise extreme care when assessing the signs of illness. A growing body of medical literature sprang up, offering practitioners advice on how to conduct examinations and identify malingerers. For almost simultaneously with the codification of traumatic neurosis came evidence that patients were becoming expert at simulating it. This discovery opened up divisions within the medical profession that often ran along class lines. Some doctors were accused of coaching patients in the art of simulating nervous disorder or of running “clinics for malingering”; others, of compromising their professional objectivity by showing bias in favor of employers. Intended to ease workplace conflict, social insurance led in practice to a highly litigious environment and to the politicization of doctor-patient interactions.59 These developments complicated the disease picture associated with traumatic neurosis in many ways. Accident insurance law compensated work-related neuroses within strictly defined limits. Entitlement to benefits was made contingent upon proof of direct causal connection to an accident, while long-term occupational hazards such as chronic overexertion were expressly exempted from coverage. This narrow definition of the compensable event, as Eghigian writes, conformed to the positivist orientation of contemporary clinical medicine in favor of monocausal interpretations and discrete, localizable injuries. In keeping with this orientation, social insurance practice developed an epistemology of traumatic neurosis that “privileged the visible, the observable, and the scientifically verifiable.”60 Failure to receive objective confirmation, to be “outwardly visible,” generally resulted in the claim’s rejection.
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Though in the consideration of claims the German system assumed a straightforward relation between the accident and the resulting trauma—mediated by the role of shock—in practice, this relation remained difficult to define. One issue that plagued insurance administrators was how to define an accident.61 Was it a discrete event that caused an injury to an otherwise healthy individual or merely the agent provocateur that triggered an underlying weakness—in which case, the patient was not entitled to a payout? A similar issue arose in regard to another puzzling dimension of accident-related trauma: the frequent development of symptoms days or weeks after the incident, which suggested to some experts that shock should be understood not simply as an event (Ereignis) but as an experience (Erlebnis) that unfolded over time.62 Medical experts accordingly advised limiting the amount of time that elapsed between the accident and the medical examination; carefully circumscribing the event in time and place made it easier, they felt, to rule out the impact of subjective fears and wishes or preexisting conditions. But this way of framing the issue inevitably prejudiced the outcome of the examination. One railway doctor, following through the logic of this approach, pointed out that if the accident could be eliminated as instigating factor, then the neurosis could be dismissed too; without accident, there was no compensable condition—even in cases in which the patient was demonstrably not well.63 Publication of Oppenheim’s book on traumatic neurosis provoked an almost immediate backlash.64 Pointing to inconsistencies in the disease picture and evidence of fraud, critics argued that traumatic neurosis was a dubious construct and that its causes lay less in the direct consequences of the trauma than in the wish for compensation. The temptation created by the insurance laws was, they argued, too great for workers to resist. Not content with casting doubt on the reality of the patient’s malady, critics implicated their fellow colleagues in the spread of proletarian nervousness. Overdiagnosis of accident neuroses, they argued, was rampant; lengthy courses of treatment seemed to multiply and intensify symptoms rather than eliminate them. What Oppenheim regarded as genuine workplace trauma, his critics saw as merely an effect of the “suggestive” influence of the insurance laws. As nerve medicine became caught up in the calculus of social insurance, many doctors, writes Fischer-Homberger, increasingly regarded functional neurosis as an “artifact of insurance practice, medical opinion, or simulation.”65
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RAILWAY MEDICINE AND THE THEORY OF PSYCHOGENESIS Within German medical circles Oppenheim soon found himself relatively isolated on the question of traumatic neurosis. One figure who supported his views was Leipzig neurologist Paul Möbius. Though Möbius disagreed with Oppenheim about the malady’s underlying basis, which he saw as psychogenetic, he was convinced of the authenticity of the disease picture and critical of those who saw malingering in every case of accident neurosis. He argued that it was no coincidence that most patients diagnosed as malingerers were workers. Möbius also noted parallels between prevailing attitudes toward simulation and male hysteria. The attitudes of German doctors toward both, he felt, reflected the extreme narrowness of their views. Whereas patients diagnosed as neurasthenics tended still to be largely middle-class, the frequency with which workers were labeled simulants, he suggested, reflected the medical establishment’s nonrecognition of the existence of male hysteria.66 While iconoclasts such as Möbius and Freud found in Charcot’s views support for their belief in the authentically psychogenetic origins of nervous illness, in the hands of one group of specialists, the railway doctors, this theory took on decidedly different implications. The field of railway medicine would play a central role in recasting the discourse on modern nervousness. Responsibility for dealing with claims stemming from the traumatic consequences of railway accidents fell to a class of physicians who, as the market for private practitioners became saturated, found work as expert examiners for the state railway system or the occupational associations. Although these doctors lacked the prestige of university doctors, as employees of the railway companies, they were nevertheless at the center of important currents in medical psychology. As Eric Caplan has shown in the case of England and the United States, these physicians were interested in the theory of psychogenesis for a simple reason: it made contesting liability easier for their companies. A key figure in promoting this theory was Herbert Page, a physician employed by an English railway company. Inspired like Charcot by surgeon James Paget’s theories of nervous mimicry, according to which nervous disorders imitate organic diseases, Page stressed the role that fear and suggestion played in the genesis of accident neurosis. This factor, he argued, explained why the symptoms of shock were not always proportionate to the severity of the injury. Neural mimesis also explained the ability of some patients to multiply symptoms so prodigiously in the absence of serious trauma. Page’s views were at odds with those of Erichsen, who had
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insisted on the somatic nature of railway spine and had treated shock as a physiological occurrence. Emphasizing the cerebral rather than spinal origins of railway shock, Page brought the condition closer to purely psychological processes. Page’s theories weakened the connection between accident and illness and made it easier to exonerate railway companies from payments.67 The theory of psychogenesis opened up a new front in the debates about traumatic neurosis. From the moment this theory emerged as a viable alternative, the battle between so-called somaticists and psychogenicists would be waged virtually without interruption until the mid-1920s, when the leaders of the German psychiatric establishment finally succeeded in dealing the death blow to Oppenheim’s construct. In the “revision of the neurosis question,” the psychogenic interpretation finally gained the upper hand, and shock was dethroned as the central concept in the etiology of traumatic neurosis.68 But this shift was already well underway by the turn of the century.69 At the annual meeting of the Association of German Railway Doctors in 1901, for instance, the audience heard a report on leading psychiatrist Emil Kraepelin’s views on traumatic neurosis. The speaker told his listeners of Kraepelin’s view that the term traumatic neurosis was ill chosen; that the causes of such disturbance lay less in the accident itself than in the question of compensation; and that in most cases some form of predisposition was present.70 Railway doctors welcomed such inferences because they made it easier to shift liability to the patient. As one put it: “The trauma itself does not play the main role; rather, it is the conscious and unconscious ideas, of which suggestion and autosuggestion occupy the first place, that are played out in the internal mental life of the patient and promoted to a large extent by the creation of the accident insurance law. The trauma represents simply a triggering, form-giving occasion.”71 The neurosis, in short, was simply a latent condition triggered by an unfortuitous event. Yet, although the Association of German Railway Doctors began to promote a psychogenic concept of neurosis, the courts were slow to respond to this shift. Disagreement over diagnoses remained lively and gave rise to endlessly tangled claims processes. This had consequences for both patients and doctors. As patients worked their way through the insurance bureaucracy, seeking second and third opinions—and often meeting with reversals of earlier judgments—doctors seeking to supplement their income were provided with numerous professional opportunities.72 One such figure was Emanuel Mendel’s son, Kurt Mendel, a private practitioner with an office in Berlin’s Augsburgerstrasse. Mendel
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wrote to the Reich Insurance Office to request work as an expert examiner, citing both his experience with accident neurotics gained as his father’s assistant and his publications on the topic of “querulants.”73 When another former assistant of Mendel’s, Paul Schuster, began working as an expert examiner at the nerve sanatorium Lankwitz, outside Berlin, the clinic’s director also lobbied the Reich Insurance Office for referrals.74 Yet another such figure was Siegfried Placzek, a former assistant at the Charité who became an expert examiner for the Imperial Railway. At a congress held in Berlin in 1908, Placzek addressed the “terrible increase” of accident neuroses among railway employees and called upon doctors to fight the widespread belief among nerve invalids that they had a “privileged right” to a pension.75 Concerning the relation between accident and neurosis, he reminded his listeners that “[t]emporal succession is no proof of causal connection.” Placzek served as director of the Hasenheide clinic in Berlin’s Neukölln district before moving to a new position at the Waldsanatorium on Berlin’s outskirts in Neubabelsberg. His move triggered competition between the two clinics when his former employer wrote to the Reich Insurance Office to request that accident neurotics be sent there for treatment. Placzek subsequently wrote to inform the office of his new clinic, which he described as preferable because of its distance from the “noisy hustle and bustle of the center of the city.”76
ELECTRICITY AS DIAGNOSTIC AGENT The transformation of sick nerves into a mass phenomenon coincided with the weakening of the therapeutic optimism that had marked neurology’s early years. One symptom of this was the critique of electrotherapy that emerged in the 1890s. Though many doctors continued to use electrical current, primarily for its suggestive value, the growing consensus was that prolonged treatment was counterproductive and could even delay rather than hasten the patient’s return to work. Rather than curing the patient by eliminating symptoms, lengthy treatment seemed to “fix” the symptoms in his mind. A 1906 survey conducted by the editors of one medical journal canvassed opinion from several dozen leading doctors on this subject. Virtually across the board the doctors reported pessimism concerning the results of treatment with electricity. Month-long treatments with “electrifying machinery,” reported one, exercised the same kind of unhealthy influence over the patient’s mind that frequent contact with other patients in waiting rooms and clinics did. At the same time, however, he reported that patients continued to demand
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it, indeed, to see it as a virtual right of the treatment to which they were entitled.77 Despite whatever privately held doubts they may have had concerning the therapeutic value of electrical current, doctors continued to offer it to many of their clients.78 Electrotherapy continued to enjoy an aura of scientific respectability among patients and to be a profitable business for doctors.79 Increasingly, however, practitioners were counseled to administer electrical current as sparingly as possible to avoid the unfortunate side effects of indiscriminate treatment. On the other hand, electrodiagnosis—the use of electrical current to evaluate the patient’s condition—continued to be held in high scientific regard. Young nerve doctors made electrical apparatus an indispensable feature of their office equipment, and electrodiagnosis became the bread and butter of many who, in the highly competitive world of turn-of-thecentury medicine, developed sidelines working as expert examiners for insurance companies. By the 1890s they were able to mobilize an impressive array of techniques for testing the bodies of nervous patients. One of the most complete surveys of these techniques was compiled by Alfred Goldscheider, doctor at the Hospital am Urban, in Berlin. In his text, Goldscheider offered minutely detailed instructions for using electrodiagnostic methods to evaluate patients with nervous disorders. He divided the body into discrete zones and meticulously inventoried the range of normal and pathological responses to electrical stimulation for the nerves of each zone. Anatomical drawings depicted the localization of the body’s “stimulus points,” while scales showed the range of values obtained from testing normally excitable nerves and then deviations in either direction.80 In effect Goldscheider sought to turn the nervous body into a surface on which signs could be elicited, captured, and inscribed. Based on the most advanced scientific method, these signs replaced the patient’s own complaints with symptoms defined as reliable and nonfalsifiable. Determining their presence or absence became the sine qua non of the expert examiner’s job, the central task in distinguishing between legitimate and illegitimate illnesses. Their perceived value rested on a distinction, fundamental to late nineteenth-century positivism, between the patient’s “subjective” feelings and the “objective” signs of medical science.81 Symptoms such as headache, hypersensitivity, and weakness were considered insufficient indicators unless correlated with physiological changes in the body’s energy levels, areas of anesthesia, or changes in the visual field. But with diagnosis as with therapy, doctors using electrical current
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had to exercise caution. Inexpert diagnosis could confuse an already murky disease picture in numerous ways. Overly liberal application of current could “fix” morbid ideas in the suggestible patient’s mind. In their examinations of difficult cases doctors thus had to walk a fine line, being mindful of their patients’ needs and at the same time remaining focused on the new social legislation, which, as one railway doctor put it, had made the “question of the objective proof of subjective complaints especially urgent.”82 Physicians had to get at the truth of the patient’s condition, but in doing so they had to avoid alienating him and provoking a desire to embellish his story or invent entirely new complaints. If used too harshly, electrical current could be experienced as a form of torment, with disastrous consequences for the claims process, to say nothing of the patient’s recovery. Oppenheim felt the use of electricity to diagnose simulation was a form of torture, and Möbius also saw the practice as ethically questionable.83 Once the situation had deteriorated to the point that he had come to see his doctor as a persecutor, the patient might be beyond help, and any satisfactory resolution of the claims process might become impossible. Paul Schuster advised doctors to avoid using such methods in any way that the patient might find painful or overbearing. “Avoid any word or statement that the patient might use to further build up his nervous ideas,” he wrote. “A simple interjection, a murmur, a ‘Hmmm’ . . . creates the point of departure for hypochondriac ideas and entire ideational complexes.” But if such innocent exchanges could be problematic, how much more so, continued Schuster, were the effects of examination methods such as strong electrical current: “The patient will often later claim that this made his symptoms worse. I need hardly say that everything which might seem coercive and serve to unmask suspected malingerers, is categorically to be avoided.”84 To circumvent such eventualities, doctors sometimes resorted to subterfuge. One doctor writing in the early 1900s observed that electrotherapy had been so contaminated by suggestion that it had begun to make patients’ illnesses worse rather than better. In such cases, he went on, “the patient often allegedly feels some kind of pain after electrization, which also promptly appears when the doctor treats him, without his knowledge, without turning on the current.”85 Specialist Alfred Saenger wrote of employing the following method in especially questionable cases: “If the patient claims not to feel anything on a certain part of his body, I hook him up to an influence apparatus and, without giving him any prior warning, apply high-tension discharges to the alleged spot. Everyone with normal sensitivity will start back and spasm under the
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sudden first impression of the influence sparks.”86 In some doctors’ minds, it was enough merely to put a malingerer in the same room with such apparatus to ferret out his bad conscience.87 By opening an expanded field of professional opportunities, railway medicine’s transformation into a contested field proved to be a boon to doctors. Yet despite the steady work this expansion afforded to expert examiners, a growing dislike of the bureaucracy surrounding insurance practice developed among many German doctors. This development led to the formation in 1900 of the so-called Hartmannbund, a medical association that sought to defend doctors’ interests against the increasing intrusion of social insurance into medical practice and came close, in 1910, to organizing a strike to protest the growing influence of the state’s welfare bureaucracies over the profession.88 The animus that formed against traumatic neurosis cannot be considered apart from this distaste that doctors felt for social insurance and its intrusion into medical practice. This development was only exacerbated by what would become one of the strangest chapters in the history of German social insurance. Evidence that the examination process could become pathogenic in its own right crystallized in the debates surrounding the problem of so-called pension neurosis (Rentenneurose), or nervous illness stemming from the traumatic experience of the pension claims process itself.89 The first accounts of this syndrome appeared in the late 1890s. According to these accounts, the process of applying for compensation was often so trying that in some cases it could produce a neurosis more severe than that produced by the original precipitating event itself. The delays, reversals, appeals, and disappointments involved in the claims process were experienced by some patients as a traumatic Erlebnis far outweighing the original event (Ereignis). This, as one doctor observed pointedly, was especially the case when the link between accident and neurosis was tenuous in the first place and the claims process was going badly.90 Although in 1902 the Reich Insurance Office handed down a decision that disqualified pension neurosis as a compensable illness, the German medical community continued grappling with the problem right up to the war.91 Many doctors persisted in regarding it as an authentic illness, albeit one caused not by an accident but by the law itself.92 At congresses railway doctors and other specialists debated the merits of proposed changes in the legislation that would put the burden of proof more firmly on the claimant, despite concerns that this would make the claims process even more onerous.93 In an article written in 1913 Otto Nägeli pressed the case against social insurance in the following terms: “Social welfare against ac-
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cidents and illness is a failure insofar as . . . it is responsible for making people nervously ill.” For Nägeli there was no longer any question of a somatic basis to nervous illness; rather, it was a purely psychological condition rooted in the “energy-crippling side effects of the insurance laws.”94 The Social Democratic paper Vorwärts was quick to defend workers from charges that they were abusing the rights to which social legislation entitled them. Its editors frequently questioned the bias behind criticisms of the laws and were especially critical of the tendency to trace nervous illness to factors other than accident, such as alcohol and heredity.95 Nor were they alone in challenging the view that the system was succumbing to an epidemic of fraud. In 1906 Ludwig Merzbacher published the results of a study indicating that the incidence of false claims—around 0.9 percent—was far lower than critics alleged.96 Though Merzbacher’s sample was small, his conclusions were echoed by insurance administrators who canvassed opinion throughout the system. In 1913 the president of the Reich Insurance Office, a Dr. Kauffmann, reported on the results of his own informal survey to the Interior Ministry. Having met with representatives of the occupational associations and the regional insurance agencies on the subject of so-called pension addiction and pension hysteria, Kauffmann was able to vouchsafe that the problem was nowhere near as bad as was frequently claimed in the “exaggerated attacks on German social insurance.”97
ACCIDENT NEUROTICS AS SIMULANTS Concerns that social insurance was engendering a crisis of fraud crystallized around the figure of the malingerer, or simulant. Simulants were profoundly irksome figures onto whom doctors projected a wide gamut of pathologies, from mendacity and litigiousness on the one hand to alcoholism, hereditary weakness, and work shyness on the other. Estimates of the number of malingerers varied widely, ranging between 5 and 30 percent of all patients.98 But statistical data scarcely convey the gravity with which German doctors saw the problem. To the late nineteenth-century medical mind, simulation was a kind of virus introduced into the body politic, and it threatened to enfeeble the social contract embodied in the nation’s insurance laws, the productivist ideal underpinning that contract, and medical science itself. Even the clumsiest malingerers hid behind an ever-shifting screen of lies and exaggerations that made it difficult, if not impossible, to diagnose them. The most inveterate of them turned it into an art form, becoming veritable masters
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of deception (Meister-Simulanten) capable of crafting a repertoire of artful disguises that, by some accounts, could fool entire roomfuls of experts.99 Pension claims filed by suspected simulants often dragged on for years, one result of which was that railway medicine came to be seen by insurers as an insatiable consumer of resources and money. According to Schuster, such patients essentially became advocates for their diseases, treating them as a commodity that could be converted into cash or engaging in a form of “pension speculation.”100 Conducted in this register, the discourse about simulation reveals connections to a host of anxieties about the fate of traditional conceptions of selfhood in the modern era. The modern money economy and its networks of exchange and circulation radically destabilized notions of the self, enmeshing the individual in a social field in which even disability could be transformed into a commodity.101 Drawing on Simmel, Peter Fritzsche has suggested that the new urban type of the turn of the century was a person without a stable sense of identity or memory, characteristics that, as innumerable commentators of the period noted, this type shared with the German capital. The essayist Arthur Eloesser noted that Berlin tried to overcome the cultural head start of older European capitals by resorting to “simulations, surrogates, imitations,” and Simmel observed that, confronted by the hypertrophy of objective culture, the metropolitan type resorted to producing “extremities and peculiarities and individualizations,” which had to “be over-exaggerated merely to be brought into the awareness of the individual himself.”102 The emergence of simulation as a problem of turn-of-the-century medicine compelled physicians to confront questions concerning not simply the unstable epistemological status of the disease picture surrounding traumatic neurosis but their own methods and claims to knowledge as well. The problem of simulation—beginning with Charcot’s work on hysteria, which he made virtually synonymous with simulation—entangled physicians in an ongoing crisis of legitimacy.103 These developments reflected an important shift in the social topos of modern nervousness. To reiterate a point already made, simulation was always potentially present in cases of functional neurosis.104 “All neurotics are simulators,” wrote Freud; “they simulate without knowing it, and that is their illness.”105 In the office-hour visits of the private practitioner, the implications were not serious; the nature of this setting encouraged private nerve specialists to refrain from treating their patients as malingerers. But when the setting shifted to the public hospital or nerve clinic, where the clientele was made up of patients who required
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not simply treatment but also assessment of their right to insurance compensation and their ability to work, the issue of simulation took on serious implications. Like hysterics, malingerers were believed to mimic organic diseases, the difference being that with hysterics, doctors generally felt this process occurred on an unconscious, neuromimetic level, while with malingerers they believed the process to be conscious. What separated the true neurotic from the malingerer was intention. But intention was difficult to pin down in the courts, and experts often fell back on other criteria in their judgments. Neurologist Ludwig Bruns, a figure who sided with Oppenheim, pointedly raised the question of class bias in the rhetoric concerning the distinction between sickness and malingering: “Why should one automatically believe a middle-class neurasthenic and not a working-class neurasthenic making an insurance claim?”106 As Joanna Bourke has argued in her analysis of the British medical establishment’s treatment of shell-shocked soldiers, this class dimension was overlaid by a gender dimension. A slippage occurred between neurasthenia and malingering, in which hysteria supplied the middle term. To the medical gaze, simulation assumed the aspect of weakness (male hysteria) or of an individualized workplace protest, centered on the body; the claimant was stigmatized as one who, by exaggerating or inventing symptoms, no longer abided by the terms of the compact enshrined in insurance laws.107 An article in the conservative publication Der Kompass spelled out the case against workers’ abuse of accident insurance. “It was well-known,” ran the article, “that the Social Democratic press offers workers advice on how to gather the proofs necessary to receive a pension.” It was also allegedly well-documented that workers resisted the efforts of the occupational associations to restore, by means of a “rational treatment in a well-run institution, their ability to work”; such efforts were perceived as a form of “pension squashing.” It was understandable, the piece concluded, that many observers should be led to the conclusion that the empire’s social legislation had led to an increase in both the number of reported accidents and the incidence of simulation.108 The organ of the accident insurance associations complained that even in cases in which simulation was proven in a follow-up examination, the doctor’s hands were tied, since there was no legal possibility of lowering the pension.109 But what critics perceived as evidence of a systematic campaign to live parasitically off the state was, from patients’ perspective, simply a matter of receiving an education in the rights that the laws entitled them to. Representatives of insured workers responded to charges of malingering
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with the argument that, to the extent it existed at all, work shyness was the product not of simulation but of the accident’s consequences, and they pointed to court decisions supporting this view.110 They called into question the objectivity of doctors, repeatedly drawing attention to the narrowness with which the disease picture surrounding accident neurosis was constructed and arguing that insurance practice viewed this picture through a lens that made the patient’s testimony inherently suspect.111 As the editor of one respected text on malingering took pains to point out, the issue could not simply be reduced to a matter of fact versus fiction. Between these two extremes lay many intermediate forms, a taxonomy ranging from unconscious exaggeration and half-conscious embellishment to deliberate fabrication. Accident neurasthenia, he suggested, was neither simply one nor the other but a real malady, if one whose spread was bound up with insurance legislation.112 But if not consciously simulated, then how? At what level in the patient’s being was the mechanism to be located?113 Unable to resolve this question, doctors fell back on their faith in the objectivity of their methods. So pronounced was this Zwang zur Objektivierung, as Moser calls it, that even slight anomalies were enough to prejudice the outcome, as Oppenheim observed in the case of a locomotive driver diagnosed as a malingerer because of the incongruity between his symptoms: “While the patient felt no sensation of pain at all from needle pricks, in response to the electrical current his muscles twitched in normal fashion.”114 Oppenheim stood virtually alone in his view that the incidence of malingering was overstated; he felt simulation of the complete disease picture was “possible only for artists.” From a trickle in the 1880s, the literature on this subject grew into a small flood by the early 1900s, and from the turn of the century onward, the problem was debated regularly at international medical congresses. At one end of the spectrum stood Oppenheim and Möbius, who diagnosed simulation in roughly 5 percent of their patients. At the other end stood Adolf Seeligmüller and Friedrich Schultze, who put the figure closer to 30 percent. Seeligmüller, a doctor in Halle, was a particularly tenacious critic who placed much of the blame for the problem on the new urban clinics created to cope with these patients and on the doctors (“coaches in simulation”) who staffed them: “[M]any of these tricky malingerers have studied in the universities of simulation, in the clinics and hospitals.”115 Seeligmüller also blamed the incidence of simulation on the SPD and the materialist worldview it promoted among workers, which lent itself to the false “materiality” of the traumatic neurosis disease pic-
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ture.116 He cast the problem in highly alarmist terms, as a conspiracy of mass shirking that, left unchecked, would sap Germany’s economic vitality and competitive drive. Seeligmüller’s response to these issues was to propose the creation of provincial hospitals as a form of prophylaxis against malingering. These would be especially equipped for observing accident victims and unmasking malingerers.117 Seeligmüller coupled his attack on simulation with an attack on socialism, arguing that many urban clinics, particularly those in Berlin, were hotbeds of SPD activity. In his proposed provincial clinics—far removed from Germany’s socialist-infested cities—doctors would avail themselves of state-of-the-art methods for examining patients and evaluating their claims. Medical experts working in these settings could identify reliable signs by which the malingerer could be unmasked. Seeligmüller’s own favored methods included the socalled Zitterprobe, a test designed to determine the authenticity of the nervous tremors that Oppenheim had included in the disease picture surrounding traumatic neurosis.118 Seeligmüller’s proposal was quickly taken up by both supporters and critics. Skeptics questioned the emphasis on diagnosis at the expense of treatment. The function of such hospitals, according to one account, would be to determine “whether objective symptoms existed for the injured party’s complaints” and, when these were found missing, “to reject his claims as those of a malingerer.”119 But, as the account continued, this view rested on an overly narrow construction of the disease picture; the simple absence of “objective symptoms” could not be the sole criterion for determining whether simulation was present or not and thus for deciding the legitimacy of the patient’s claims. In many cases, exaggeration might well be present, but not outright simulation. The piece concluded by cautioning against the premature assumption of malingering in the absence of objective symptoms. Even doctors who welcomed Seeligmüller’s proposal by calling for the creation of a “network of such institutions extending across Germany,” as one did, cautioned that the purpose of these institutions should be primarily to provide therapy and only secondarily to serve as a line of “emergency defense against increasing Simulanthentum.”120 Others argued that the incidence of malingering did not justify the expense of such institutions and that such a public investment would be better spent on treating genuinely ill patients. The organ of the occupational associations argued that such a plan deserved consideration, albeit less for the pur-
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pose of unmasking malingerers than for “general hygienic purposes.” The inadequate training and the overburdening of expert examiners, as well as overcrowding in the institutions where accident victims were treated, had led to a crisis situation, particularly in Berlin, with bad consequences for the ultimate goal: restoring patients’ capacity for work.121 A certain number of doctors continued to believe that the issue was wildly overblown. Addressing the possibility that workers might fabricate illness to get into sanatoriums, Berlin physician Theodor Benda wrote: “First of all, most uneducated patients do not know the symptoms of a nerve illness. Second, even when the simulant is able to learn the symptoms of, say, hysteria, he could never deceive a practiced neurologist.”122 Yet even doctors sympathetic to workers voiced dismay at the ease with which patients incorporated so-called objective symptoms into their somatic repertoire: “Here too the situation was different only two years ago. Then it hardly ever transpired that one examined an injured patient who had already been tested for such disturbances. One worked, so to speak, on virgin territory; today the situation is reversed, and the author has even encountered situations in which the person to be examined has brought his anesthesia to his attention in advance.”123 It was these growing doubts about the disease picture surrounding traumatic neurosis that finally compelled the faculty at Berlin’s Charité to take up the issue, at the Reich Insurance Office’s request. In its 1897 opinion, the Charité faculty began by noting that functional neurosis was often accompanied by symptoms that were not “consciously simulated” before going on to say that a certain degree of exaggeration could not be ruled out. Its presence was conditioned by the patient’s “misfortune that his profound feeling of illness lacked objective correlates.” Anxious for a favorable verdict regarding his claim, the patient tried to overcome this lack by the strength of his presentation. Thus the invalid could easily “exaggerate his genuinely abnormal condition—again in the perception that he would be otherwise unable to give his disturbances a convincing expression.”124 Built into the examination was an incentive to overact the invalid’s role that, under certain circumstances, could lead to simulation. Nonetheless, the opinion argued that electrodiagnostic and other tests could be used to rule out simulation in most cases. In conclusion the report noted that there no longer appeared to be solid grounds for drawing sharp distinctions among traumatic neurosis, neurasthenia, and hysteria. Yet the idea had taken hold in the medical community that traumatic neurosis was untreatable, leading to a full pension. For that reason, the opinion predicted, the traumatic neurosis diagnosis would be
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more and more avoided by doctors and replaced by the less politicized diagnosis neurasthenia.
DISORDERS OF THE VISUAL FIELD The 1897 opinion of the Charité faculty paid close attention to one particular symptom known as shrinkage of the visual field.125 Earlier studies of the relation between nervous and visual disorders had by the 1890s flowered into a major topic of medical interest. The Charité opinion could point to a large body of literature on the subject, while noting that leading nerve doctors, including Oppenheim, Eduard Hitzig, and Emanuel Mendel, were deeply divided over the meaning of this symptom.126 Much of this literature took for granted the notion that modern life overtaxed the visual apparatus. As Georg Simmel noted of the Berlin Trade Exhibition in 1896, urban life and the modern industrial division of labor privileged the eye over the other senses but, in doing so, besieged it with so many new demands that it became overburdened. George Miller Beard had identified weakness of the eye as one of the most characteristic symptoms of neurasthenia. Beard felt that the exhaustion of eyesight caused by excessive reading and writing was especially prevalent in Germany, a view shared by German doctors.127 Writing about shrinkage of the visual field, neurologist Hermann Wilbrand linked it to urban conditions, describing it as “a typical product of the social misery of the metropolis.”128 Wolfgang Schivelbusch, who makes the railway central to the history of the modernization of perception, has shown that railway travel was also implicated in this crisis of spatial and visual perception. Schivelbusch notes that on railway journeys the sheer intensification of the number of objects perceived in a given unit of time, “the quantitative increase of the impressions that the perceptual apparatus receives and processes,” resulted in perceptual overload.129 In a discussion of German railway workers, Waldemar Zimmermann stressed the enormous demands made on the eyesight of locomotive drivers and declared that in no other branch of the service were disturbances of the eyesight so likely to occur.130 In Germany, interest in nervous disorders of the eye crystallized around shrinkage of the visual field. Doctors believed that gradual narrowing of the visual field correlated closely with fatigue. Tests represented the visual field as a series of concentric circles, in which loss of vi-
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sual focus was measured on a numeric scale. In the early 1890s, the possibility of identifying the true nature of nervous illness came to be focused on the eye, and the visual field syndrome was endowed with a privileged status within the neurasthenic disease picture. Because it could be represented only in terms of a mathematical formula, doctors believed it was impossible to falsify. Ludwig Bruns argued that patients would have to be trained in ophthalmology to imitate the condition, and he hoped that, by making it a standard part of medical examination, patients would finally be able to avoid the charge of simulation. “Or,” he asked pointedly, “will patients seeking pensions be able to rehearse these symptoms as well, either by themselves or with the help of private teachers in simulation?”131 Not all doctors, however, were so easily persuaded. By 1892, as Bruns was forced to admit, the visual field test was already considered the “most hotly contested symptom of traumatic neurosis.” A doctor writing in 1904 warned that “[w]ith all hysterics and neurasthenics visual field tests should be treated with the greatest caution,” and some doctors openly doubted the symptom’s existence.132 The construction of this symptom as authentic sign of nervous illness and its later dismantling open a window onto the unstable epistemology of late nineteenth-century nerve medicine. Early descriptions of visual field anomalies had been published in the 1860s in the work of Helmholtz, Fechner, and Griesinger on the basis of their own autoexperiments. P. J. Möbius, who treated Fechner for the eye troubles he endured most of his life, agreed with Beard that disorders of the visual sense were a leading indicator of modern nervousness. It was not by chance that scientists seized upon this syndrome; vision enjoyed a privileged status, not only as dominant sense, but also as epistemological model and as metaphor for the conscious self. Psychologists such as Wundt and Théodule Ribot compared consciousness to a “field of light” or “point of light” that contracted under conditions of stress, illness, and madness.133 For Pierre Janet, the restriction of field of vision was analogous to the restriction of field of consciousness.134 Janet noted that hysterical symptoms such as suggestibility and anesthesia could be accounted for by contractions of the field of consciousness, a condition found most often among children, women, and invalids. Charcot researched hysterical disturbances of the visual field among his patients at the Salpêtrière, concluding that with patients so afflicted the intensity of the sensation in relation to the stimulus was abnormally high and that abnormal fatigue expressed itself in shrinkage of the visual
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field. His results inspired German doctors to follow suit.135 By the 1890s, visual field tests were being widely used in examinations of patients suffering from traumatic neurosis.136 A minor industry sprang up devoted to so-called hysterical disturbances of the visual field. At the Charité this test was used regularly in the examination of nervous patients.137 Physicians soon brought these tests to the attention of medical authorities. In communications with the Reich Insurance Office, eye specialist Albert Nieden promoted his methods of “unmasking simulation of eye diseases.” Nieden presented himself as a firm supporter of the theory of traumatic neurosis as a distinctive disease picture, a picture that was “manifest above all in the eye, through concentric narrowing of the visual field and associated signs of fatigue.”138 Nieden claimed to have found such symptoms in approximately half of the cases he had examined.139 Electrical stimulation of the eye was frequently employed in examination of a patient’s visual field.140 Wilhelm Koenig, an assistant of Westphal’s during the 1880s who became a physician at Berlin’s Dalldorf asylum, published the results of his own extensive visual field tests on nervously ill patients. Koenig started from the premise that studying the relationship between fatigue and eyesight might shed light on the simulation problem. He reported having produced experimentally induced disturbances of the visual field through galvanization of the head. The disturbances usually consisted of a type of nervous weakness of the eye, with symptoms including increased sensitivity, excitability, even hallucinations. Koenig hypothesized that “[e]lectrical testing of the visual field provides grounds for testing the attention of invalids.”141 His conclusions were echoed by specialist Alfred Saenger, who stated unequivocally that visual field tests held the key to ruling out simulation.142 But dissenting voices were heard as well. In the early 1890s Adolf Strümpell began cautioning that so-called objective symptoms were only relatively objective. In 1898, an article in a journal for accident medicine opined that it was “a fact that insured individuals often simulate the symptoms of traumatic neurosis, and especially the shrinkage of the visual field.”143 One expert examiner noted in 1904 that patients who simulated visual disturbances could often be unmasked only by the most practiced eye doctors.144 By the end of the decade, earlier claims for these tests had all but disappeared from the literature.145 Insurance specialist Paul Horn summarily rejected the existence of concentric narrowing of the visual field.146 The history of this symptom illustrates the pressure placed on the disease picture surrounding traumatic neurosis by the encounter between
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railway medicine and social insurance. In their role as expert examiners, doctors attached great weight to their diagnoses, treating them as natural, real, and objective. Yet the fate of the visual field tests demonstrates how contingent this appearance of naturalness was, and it fueled growing doubts concerning the notion of infallibly objective signs.147 Growing skepticism about these tests in turn reflected a deeper crisis in the methods and results of nerve medicine. By the early 1890s Charcot was defending himself against charges that he had invented hysteria; critics of traumatic neurosis, meanwhile, were arguing that the symptoms described by Oppenheim were in fact caused by him. One result of these developments was a gradual shift in the practitioner’s object of focus. In part this shift was driven by the emergence of new diagnostic schemes that were elaborated by psychiatrists endeavoring to reclaim the territory they had lost to the neurologists in previous decades. The fin-de-siècle “repsychologization” of psychiatry, as FischerHomberger calls it, was a development that proceeded on several fronts.148 One of these led from Charcot to Freud. Another led to the paradigm shift in university psychiatry, spearheaded by a new generation of doctors. Reacting against the materialism of the Berlin school, these psychiatrists, led by Emil Kraepelin, endeavored to restore the “will” to its proper place in mental life. It was Kraepelin’s belief that the role of external influences in mental disturbances was commonly overestimated; he tended to link defects of the will to underlying hereditary weaknesses and psychopathology.149 Similarly, Hellpach identified the problem of the will as the core of hysteria.150 A third arena in which the restructuring of the somatic paradigm gained ground was the field of railway medicine. This development can be seen by looking once more at the views of expert railway examiner Siegfried Placzek. At a congress held in Berlin in 1908, Placzek pronounced existing procedures for examining employees obsolete, including the visual field tests. Echoing a theme voiced by others at the congress, he argued that these methods led to too many false results.151 Swamped with patients and overburdened by the competing requirements of these methods, the average railway doctor was simply not equipped to cope with the demands of processing endless claims, whose inflation reflected social insurance’s elevation of the “accident” to a principle of entitlement for all the injurious experiences of modern life. In Berlin, he warned darkly, special offices even existed to inform invalids of how to conduct themselves during examinations so as to obtain the most favorable result.152
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To combat this problem, Placzek favored adopting the intelligence tests currently used by Theodor Ziehen, director of the Psychiatric and Neurological Clinic of the Charité. Measuring intelligence, memory, and attention—all markers of mental performance—these tests offered a more efficient means of evaluating patients on a mass basis. Their emergence around the turn of the century and their use on groups such as army recruits represented, as Ian Hacking has argued, a shift in psychology’s object of inquiry from bodies to populations.153 They also reflected a growing interest in the hereditary components of mental illness, which Weindling identifies as a hallmark of the new psychiatric paradigm that emerged around 1900.154 Placzek argued that the incidence of nervous illness among railway personnel was indeed “shockingly high” but that in many cases it reflected the presence of a preexisting condition. Hence, an urgent need existed for accurate medical information about personnel before they entered service.155 In particular, he cited the need for data about the intelligence of railway personnel, whose jobs required concentration over long periods of time. Placzek singled out the need for information concerning the faculty of attention, which he defined as a “psychological condition of expectation (or tension), guided by the will.” This condition protected the self against an “excess of onrushing stimuli,” a state of sensory overload that affected workers in key positions and culminated in the “epochal illness neurasthenia.”156 Placzek illustrates the role of railway doctors in recasting the somatic paradigm by introducing a new idiom of “the will” and “attention” into medical discourse. Railway doctors such as Placzek found it expedient to treat the materiality of the patient’s symptom as, in some sense, a myth and to trace it back to underlying wishes or preexisting causes, deep structures of heredity or psychopathology, whose presence was established through new methods of psychological testing. The fate of the visual field tests also illuminates another aspect of the relation between malingering and traumatic neurosis. As we have seen, issues of class were frequently overlaid with issues of gender, insofar as diagnosis was often framed in terms of a negotiation between the subjective unreliable aspects of patients’ complaints and the powerfully normative gaze of the physician. For railway employees, being denied a pension also meant being stigmatized as a malingerer or worse, as a male hysteric, with all that implied (including alcoholism, sexual excess, and effeminacy).157 Visual field tests, like intelligence tests after them, enmeshed the patient within a larger discourse about the population, whose dominant val-
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ues—discipline, efficiency, productivity—were coded male. In being diagnosed as fit or unfit for duty, the employee found himself at risk of being cast out of the productive social order.158 Insofar as the problem of modern nervousness came to be discursively situated in the space defined by two modes of perception, the evolution of the visual field as symptom also reveals a self-reflexive dimension. Didi-Hubermann has shown how Charcot’s research at the Salpêtrière rested on a distinction between the “hysterical” vision of his patients and the elaborately formalized gaze of the clinic itself.159 Charcot depicted himself as an absolutely objective recording eye, likening himself to the cameras and inscription devices that he employed in his clinic.160 A similar opposition structured the discourse about traumatic neurosis in Germany, particularly as the problem of simulation moved to the forefront of insurance practice. On the one hand, physicians staked their claims to expertise on a scientific gaze amplified by instruments and tests and purified of personal bias or history.161 On the other hand, they critiqued the somatic paradigm in terms of its naive visuality, its own “contracted visual field.” Textbooks formalized medical views about simulation and how to detect it, providing instructions on the characteristically exaggerated symptoms that gave away the inveterate malingerer; specialized examination techniques; the proper demeanor of the doctor; the abnormal thought processes of the neurotic; and so on. Ludwig Becker, author of a respected text on malingering, devoted considerable attention to the “primitive” or “naive” thought processes of the accident neurotic. For the typical accident victim, he wrote, the effects of an accident were nothing short of providential. In the course of being examined over and over again, both by his physicians and by himself, the patient gradually discovered “something in his body that he had not earlier noticed.” Each new examination or careless utterance by the doctor acted as a stimulus to his imagination, strengthening the conviction that something in him had changed, until finally he “persuaded himself that ‘the accident,’ that event which now represented a turning point in his life, had been the cause of all these conditions in his body.”162 More significant than the accident itself, he wrote, was the resulting experience of it, which produced a disturbance within the patient, who in the accident’s wake became wholly focused on himself and his symptoms. This phenomenon—a kind of concentric narrowing of the field of consciousness—became one of the dogmas of accident insurance practice.163 For Alfred Grotjahn the principle feature of “accident hysteria” was “the concentrated attention with which the patient follows his compensation
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claims . . . and observes his physical symptoms.”164 Jena doctor Otto Binswanger likewise stressed the impact of the nation’s accident insurance laws on neurasthenia’s “uncanny” spread: “Modern legislation compels the worker who has been injured by trauma to a heightened selfobservation. . . . Morbid oversensitivity is cultivated, the ultimate result of which is that the weak-willed worker is no longer able to master the morbid impressions or to offset, through regular, methodical exercises, the consequences of the accident on his physical energies.”165
RURAL NERVE CLINICS AND THE REGENERATION OF LABOR POWER The developments traced above, coupled with growing concerns over the effectiveness and cost of standard therapies, eventually resulted in the creation of a new kind of therapeutic space, the so-called Nervenheilstätten. These rural, public nerve sanatoriums, which provided care for working-class patients, multiplied rapidly around Germany’s cities during the years between 1900 and 1914. Indeed, despite the mounting skepticism surrounding Oppenheim’s disease construct, these clinics did perhaps more than anything else to ensure its widespread institutionalization throughout Germany society. They did so by forging a connection between the invalid’s “rights of nerves” and his obligation to become productive again. Their emphasis was on treating the invalid by putting him to work at light tasks such as carpentry; using work as a way to combat the patient’s perceived obsession with his symptoms, nerve sanatoriums prepared his return to the workforce. The first experiment in work therapy came with the creation of Haus Schönow, a sanatorium located on the outskirts of Berlin. In a pamphlet published in 1896, Leipzig doctor P. J. Möbius called for a response to the problem of proletarian neurasthenia. He argued that private clinics were too expensive for most patients and that the spread of neurasthenia to new classes had created a pressing demand for public sanatoriums. Möbius connected this demand to a critique of contemporary medical science that built upon his earlier attack on electrotherapy. Because it treated the patient as a passive object, a machine, electrotherapy robbed him of the necessary “will” to recover and cultivated boredom and passivity. The “mechanical worldview” of modern medical science left it incapable of addressing its patients’ real needs.166 Möbius’s solution to the “soullessness” of the modern world was work. The problem, as he saw it, was not work as such but alienated modern work. The goal of work therapy was to help the patient to “cure
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himself” by rediscovering a sense of purposefulness and meaning in labor. The ideal forms of employment, according to Möbius, were those of a preindustrial kind, such as gardening and carpentry, which, by engaging “all the different organs,” restored the patient to Hand und Land. This model harkened back to early nineteenth-century moral treatment, but Möbius, by endeavoring to restore the patient’s connection to the production process from which he had been alienated, resurrected it within a distinctly modern context. At the same time, by transforming older forms of labor into new forms of leisure or edifying activities to be cultivated in the worker’s free time, this model forged affinities with the life reform movement.167 Though Möbius felt the simulation issue was overblown, his interest in work therapy cannot be considered apart from it. Treatment as such was easier to justify, as the director of Haus Schönow noted, if geared toward making the patient Arbeitsfähig and reintegrating him into the labor force.168 Möbius’s initiative bore fruit with the 1898 creation of a foundation to establish Schönow. A Berlin banker who had been treated by Hermann Oppenheim contacted Möbius to inform him that he wanted to donate one hundred thousand marks toward the creation of a sanatorium designed according to his principles. Following a meeting with Möbius, Oppenheim, and his banker-patient, Max Laehr, formerly head of the Charité’s clinic for nervous diseases, was named director of the institution. Laehr circulated a petition among Berlin’s medical and business communities soliciting contributions. The fundraising campaign proceeded rapidly, and the new institution opened its doors to its first patients on 19 October 1899. In a letter accompanying invitations to the opening ceremonies, Laehr spelled out the purpose: “Given the conditions of modern life, steps can be taken against the increasingly widespread nervous illnesses, which sap the nation’s energies, only in special, public institutions devoted to fighting these illnesses.”169 Located on the outskirts of Berlin in the suburb Zehlendorf, Haus Schönow occupied a plot of land attached to the Asyl Schweizerhof, created by Laehr’s father, Heinrich Laehr, in the 1850s. It included separate buildings for male and female patients, with space for up to 160. Costs per day ranged from two to seven marks, though some free beds were maintained. Haus Schönow’s bylaws specified that only patients with some prospect of recovery were to be admitted.170 Most patients suffered from an assortment of mild nervous disorders. Among the patients treated there, four groups predominated: workers, trades people, civil servants, and teachers. Sixty percent of the costs were
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born by the patients themselves; the rest, by health insurance companies or occupational associations. By 1928, over twenty thousand patients had passed through Haus Schönow, a significant number staying for only short visits, reflecting its function as a clearinghouse for the Reich Insurance Office. The Reichsbahn provided the single largest group of patients.171 The impulse behind Schönow’s creation soon met with interest from official quarters.172 In 1902 the Imperial Health Office, under the direction of Heinrich Köhler, who sat on Schönow’s board of directors, commissioned a lengthy report on combating the problem of mass nervousness. The report enumerated the causes behind the nation’s crisis of sick nerves: “especially the general harmful influences of modern social and vocational life, in the face of which we stand powerless.” Overburdening from school-age onward, the obstacles to marriage posed by the conditions of modern life, premature sexual activity, and heredity, along with an array of other injurious influences (worries, professional setbacks, alcohol, and myriad other “Reizen”), all contributed to the nation’s current state of nervous emergency.173 The report checked off a litany of warnings about the dangers of allowing nervousness to spread unchecked, stressing the need to treat nervous patients separately from mentally ill patients and to prevent treatable neuroses from turning into chronic illnesses. Given all these factors, early intervention was not only advisable but imperative: “Prevention offers a very wide field,” since nervous illness should not be allowed to develop “but should be combated as early as possible.” Yet, the report continued, despite widespread recognition of the problem, “[t]he direct combating of these illnesses . . . has not received the attention it should have from state and society, given the importance of the situation.” The report advocated making public institutions available to those who could not afford private clinics. The virtue of institutions such as Haus Schönow, the report concluded, was that early diagnosis, a period of rest followed by light work, and careful separation of nervously ill from mentally ill patients might halt the progress of the illness before it became acute and untreatable.174 In 1902, the Reich Insurance Office followed suit by creating its own pioneering convalescence institution, the Beelitz Heilstätten, just south of Berlin.175 This institution coupled the model created at Schönow with the precedent established by the Berlin Regional Insurance Office’s (Landesversicherungsamt, LVA) existing network of tuberculosis sanatoriums. At Beelitz, pavilions for both TB and neurotic patients were com-
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bined in one complex. The extensive grounds were designed according to garden city principles. Between 1897 and 1903, Beelitz reported a rise from 18 to 40 percent in patients suffering from neurasthenia. By 1912, close to three thousand people were being treated on an annual basis at this sanatorium, mostly cases of neurasthenia, hysteria, and anemia. Treatment consisted of a mixture of hydrotherapy, electrotherapy, and work therapy. The annual report for that year described nervous weakness as the biggest problem; illnesses of the nervous system, it reported, led to the highest percentage of sick days by far.176 As the first public institution of its kind, Beelitz became the prototype for a wave of similar institutions over the next decade.177 Although the accident insurance laws had originally prohibited putting employees back to work during the duration of their convalescence, in the early 1900s the Ministry of Public Work, in response to a petition by doctors, issued a decree rectifying this situation.178 The way was thereby cleared for the institutionalization of work therapy.179 By 1907, one account described a ring of such institutions encircling Berlin, and across Germany similar institutions were created on the basis of the work-therapy model.180 This model was embraced by railway doctors, whose main concern was with the ever-rising costs of patients with accident neurosis, costs that by now were considered higher than with any other illness, including tuberculosis.181 A 1906 survey of doctors revealed that many now felt measures compelling patients to work were wholly justified.182 Many welcomed the introduction of work therapy as a logical solution to the difficulties posed by treating accident neurotics.183 In a talk delivered to the Reich Insurance Office in Berlin, Franz Windscheid, director of a clinic for accident neurotics near Leipzig, extolled the virtues of work therapy in combating what he perceived as the chief problem with such patients: paralysis of the will. Windscheid stressed the impossibility of disentangling accident neurosis from the insurance laws, once the accident had come to form the “center of gravity of [the patient’s] thoughts.”184 He fell into an “incessant self-observation,” viewing every sensation, whether physical or mental, through the lens of the accident’s consequences. As the most effective method of treatment, Windscheid singled out work therapy, which he used almost exclusively at his own clinic. This form of treatment, he felt, offered the surest way of balancing the patient’s interests against those of the nation.185 A few voices were raised against the work-therapy model. Institutions such as Haus Schönow not infrequently had to defend themselves against
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the charge that they functioned as hotels, if not training schools, for malingerers. To fend off such accusations, the directors of these clinics sometimes went to the other extreme—to such an extent that they acquired reputations for imposing an Arbeitszwang on patients. In the 1920s Max Laehr was forced to defend Haus Schönow against accusations that it had become a “work sanatorium,” where patients labored under a form of “work compulsion.”186 Some doctors worried that these sanatoriums were places where workers were exposed to critiques of the values of bourgeois society. Among the patients at Beelitz, for instance, socialist reading groups formed; patients read Nietzsche as well.187 Beelitz was seen in some quarters as a hothouse of “pension speculation,” and invalids from Berlin and its environs were, by some accounts, particularly resistant to work therapy.188 Insurance administrators combated concerns regarding such tendencies by defending the sanatoriums as places where workers were educated in the rational, methodical conduct of life. Friedrich Zahn, an expert on social insurance, flatly rejected the implication that insurance injured the worker’s sense of responsibility. On the contrary, he argued, insurance was a pedagogical instrument that helped teach workers the virtues of hygiene and the importance of exercise—in short, a certain duty to the body and to society.189 Removing invalids from the metropolis, not least from the political agitation common there, was essential to the regeneration of their nervous forces.190 Beyond any danger of contamination—whether by nervousness or by socialism—these institutions were places in which workers were exposed to eminently middle-class values. Far from a work strike, a stay in a sanatorium was the prerequisite for the worker’s recuperation of his labor power. This view was generally seconded by workers, who appreciated the opportunity for a paid leave in rural surroundings. Nineteenth-century hospitals had been associated with loss of patients’ rights, but the Nervenheilstätten partly destigmatized the experience of institutionalization for the lower classes.191 Yet if the Nervenheilstätten movement may be seen as an expression of the social contract embodied in the nation’s insurance system, by the eve of the Great War there were signs that this contract was strained to the breaking point. Patient discontent within sanatoriums was increasing, while medical and political authorities were becoming increasingly concerned about what they perceived as the counterproductive effects of stays at such institutions. This is illustrated by a controversy that erupted in 1912 at Beelitz. The origins of the controversy lay in the administra-
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tion’s concern that Social Democratic patients were attempting to recruit others to the party and, in particular, to coerce them into buying subscriptions to the party organ Vorwärts. In a letter written to the president of Brandenburg and Berlin, the head of the Reich Insurance Office, Richard Freund, described measures taken against the distribution of Vorwärts and against political agitation within the sanatorium.192 Shortly thereafter the president of Brandenburg and Berlin wrote to the head of the Ministry of the Interior to reassure him that the measures seemed to be working.193 These steps had been taken in response to what the authorities perceived as the growing politicization of patients at the sanatorium, symbolized by a telegram sent to the Reichstag containing a petition signed by four hundred patients protesting the banning of Vorwärts. As reported in the pages of the Norddeutsche allgemeine Zeitung, the Social Democrats were guilty of trying to impose a “Koalitionszwang” on other patients, interrogating each new patient about his party affiliation.194 An editorial in the Catholic Der Germania accused them of imposing a “reign of terror” on other patients. The medical compulsion of the nineteenth-century public hospital had been exchanged for the “straitjacket of Social Democratic organization.” Yet another article described an institution deeply divided along political lines, relating that in some wings of the sanatorium red songs (“Workers, close the ranks”) were sung, while in others patriotic songs dominated.195 For their part, the editors of Vorwärts depicted the matter as an attempt to censor the reading materials of patients and a politically motivated effort to discredit a bastion of social insurance. In a series of articles, they examined at length conditions at Beelitz. One account depicted it as the crown jewel within the Berlin LVA’s network of institutions, offering a glowing description of the surrounding countryside and the buildings and grounds making up the sanatorium. The entire complex, with its patients, staff, gardens, and woodworking shops, could, according to this account, be considered a model cooperative enterprise, a well-run city in its own right. As such it represented a standing reproach to the capitalist social order, a monument to the “victims of Unkultur” that pointed to a future socialist order. The freedom and harmony that reigned at Beelitz were contrasted with the authoritarian institutions of the empire, in particular the Junker-dominated parliament. For the editors of Vorwärts, recovery was not synonymous with returning to work; rather, workers were exhorted to regain their health in order to fight on behalf of a fair electoral system.196
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Vorwärts also warned darkly of the administration’s encroachment on patients’ freedom. Fearful that workers were being broken of the habit of work, the administration was placing new restrictions on visiting rights and reading habits. Men and women were to be kept strictly separate; male patients could receive visits only from mothers or wives, and female patients from fathers or husbands. Gambling and alcohol were not allowed. All political, religious, and social differences of opinion among the patients were to be set aside. Agitation was strictly banned, as was the distribution of newspapers, tracts, and newsletters. Meetings of any kind were expressly forbidden without prior approval.197 The editors of Vorwärts described this state of affairs as symptomatic of a loss of trust and warned that without trust between administration and patients there could be no cure.198 Disputes such as this strengthened the belief of those who viewed social insurance as a red stronghold. The head of the Reich Insurance Office, Richard Freund, lamented the current state of affairs at Beelitz and chalked it up to the growing strength of the SPD. Referring to the new socialist majority in the committees of the Berlin LVA, Freund wrote in his letter to the president of Brandenburg: “I doubt that there is any political authority in the whole empire that finds itself in such dire political straits.”199
ALFRED GROTJAHN AND THE DEGENERATIONIST VISION Nowhere is the complex mixture of motives and interests embodied in the Nervenheilstätten movement better illustrated than in the writings of Alfred Grotjahn.200 Grotjahn, who started his career as a nerve doctor and expert examiner in Berlin, began widening the scope of his attention to the field of social hygiene in the early 1900s, staking out the terrain that would eventually bring him an appointment as the first socialist full professor of medicine in Germany. His interests encompassed a wide range of social problems, including mental illness, alcoholism, and venereal disease. Grotjahn’s interest in issues of reproduction and heredity was also evidenced by his membership in the Berlin Society for Sexual Science and Eugenics, which he cofounded in 1908. By 1910, he had positioned himself at the forefront of many of the most important currents in the field of social hygiene.201 At the center of Grotjahn’s concerns lay the specter of degeneration and all that it conjured. While this included the whole field of what he called “social pathology,” his early experience as a nerve doctor re-
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mained paradigmatic for him. As Paul Weindling has written, Grotjahn, entering the field when medicine was practiced under the sign of “a nervous age,” embraced neurology as a discipline that linked biology with social science.202 His views reflected the shift then underway in the field. Neurasthenia’s transformation, he wrote, from an illness of the capitalistic Bürgertum into a “proletarian mass phenomenon” reflected work conditions in areas such as the railway or telephone exchanges, which coupled mechanical, monotonous activity with a high degree of responsibility.203 At the same time, he argued, many neurotics attributed their ailments to the social milieu when in fact they were primarily due to inherited weakness.204 These types, who belonged to the “army of psychopaths” that inhabited Germany’s big cities, passed for normal yet were marked by a tendency to react in pathological fashion to the onrushing stimuli of the urban environment. Grotjahn thus coupled two quite different explanatory schemes: one that focused on external causes (modern industry); the other, on internal causes (heredity). To combat both, he argued for a highly rationalized system of health care that combined humane treatment with eugenic measures. Grotjahn was a pronounced advocate of the sanatorium movement, defending it against its critics, who, he felt, greatly exaggerated the negative side.205 Grotjahn saw these sanatoriums as a natural emanation of the social contract underpinning the insurance laws. Indeed, he projected onto them an image of a rational society ordered according to hygienic principles. It was essential to the success of the cure, in his view, that workers participate directly in its administration rather than remain its passive objects. A humane system of care had to resolve the conflict between freedom and compulsion that plagued contemporary psychiatry. New laws were needed to protect patients’ rights, and institutional life needed to reflect a greater sensitivity to the needs of patients. “Experience shows,” he wrote, “that subjective satisfaction is . . . much greater in a self-administering body than under a purely authoritarian style of management, which has no inner connection to the patients or the circles from which the patients come.”206 Looked at in this light, social insurance and its network of institutions represented nothing less than an investment in labor power. The virtue of work therapy, in his view, lay in balancing the interests of patients with those of the state. Not only did it restore the broken connection to the production process, from which emanated all feelings of self-worth; it also helped defray some of the costs of convalescence. Indeed, in his view, Haus Schönow had not gone far enough in introducing economi-
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cally useful work. There, work served less an economic than a therapeutic and pedagogical function compared with other sanatoriums, where it had been made more central.207 Yet work was not to be turned into an odious kind of occupational therapy, in which the patient spent an hour each day at superfluous tasks, and it was not to be degraded into a form of “mechanical” therapy, like electricity. The treatment, he stressed, should reflect the desire to “make use of the invalid’s subjective condition through physical work appropriate to the energies of the inmates and at the same time to keep down the costs of operating the sanatorium.”208 Grotjahn remained a life-long supporter of social insurance, continuing to defend its civilizing value well after the backlash against it had set in.209 In his eyes, social insurance, like no other institution, was endowed with what Nikolas Rose has identified as the capacity “to bind the citizen to the obligations of the social order,” to enmesh him in “the network of expectations and routines that make up the social body.”210 Yet concern about the German system’s overburdening and its potential “negative selection” of the “unfit” led him also to propose screening measures for beneficiaries. Social insurance on its own could not resolve the “social question”; it needed to be complemented by a program of eugenics that included registration and monitoring of those identified as incorrigibly “work shy” or burdened by congenital weaknesses. Practical necessity, as well as the long-term interests of society as a whole, dictated rational allocation of medical resources; using resources on patients whose chances of recovery were minimal was wasteful, a premise from which flowed the obvious conclusion: the need for the earliest possible diagnosis and intervention. Psychopathology, alcoholism, and other forms of perceived hereditary degeneration were to be combated through an apparatus of finely grained observation of the social body. If in Grotjahn’s mind work therapy replaced the method of treating the patient as object by treating him as subject, it did so within the framework of a system that prioritized treatment of patients on the basis of their perceived value to society and that, moreover, exposed patients to new forms of surveillance and intervention.211 For Grotjahn, the society of citizen neurotics that congregated in Nervenheilstätten was one that subordinated class conflict to the fight against the common threat of degeneration. Yet Grotjahn’s belief in a therapeutic model of the social contract was couched in terms that sanctioned a thoroughgoing rationalization of medical practice under the sign of national competitiveness and efficiency: “The nation that is first able to put the whole question of medical institutions in the service of weeding out the somatically and psy-
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chically unfit on a humane basis will, over the decades, have a growing advantage over all other peoples. The specter of physical degeneration that haunts even fully mature societies sub specie aeternatis will lose its horror for that nation.”212 Statements such as this—which anticipated his later calls for mass institutionalization of 30 percent of the population on genetic grounds—have led scholars such as Karl-Heinz Roth to argue that Grotjahn’s attempts to fuse social policy with Social Darwinism mark him as a precursor to Nazi racial science.213 In truth Grotjahn’s proposals are disturbing, despite his consistent rejection of racial hygiene. Yet to read the specter of Nazism back into his writings is to impose a teleological framework on what was a historically specific discourse, one, moreover, that was mobilized by race hygienists, social reformers, feminists, life reformers, and socialists alike as part of a broad response to the problems of industrialization and urbanization.214 Rather than the straight line that Roth draws between Grotjahn’s work and Nazi medicine, a trajectory with numerous possible outcomes thus seems more accurate to assert. What is nevertheless clearly reflected in Grotjahn’s work is the reorientation occurring in German medicine and the pressures operating on the therapeutic scene. The implications of the shift from the patient’s individual body to the social body are spelled out in the biological metaphors he applied to the Nervenheilstätten, which he saw as organisms (“Anstalts-organismus”) or virtual cellular microcosms of the social body.215
THE POLITICS OF TRAUMATIC NEUROSIS By the early 1900s the backlash against traumatic neurosis was gaining ground among a growing number of doctors. If Grotjahn still tried to strike a balance between socioeconomic and hereditary explanations, others increasingly recast the problem of mass nervousness in terms that alleviated society of responsibility for either producing or treating it. It became an article of faith among many physicians that the authenticity of a neurosis could be ascertained only when there was no question of a pension at stake.216 The issues surrounding it, they felt, had become entangled in layers of class resentment. Traumatic neurosis had become a kind of myth of the industrial world, one rooted in the materialism of late nineteenth-century medicine.217 Seen in this light, it was a construct needing demystification. Symptomatic of this backlash were the semantic changes occurring in medical practice. After 1911, the new director of the Psychiatric and
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Neurological Clinic of the Charité, Karl Bonhoeffer, began using pension neurosis—no longer a diagnosis entitling the patient to compensation but a term of stigmatization—in cases in which he felt he could not rule out simulation. A survey of case records indicates that by 1914 neurasthenia had been largely replaced by Rentenneurose. The patient Paul U. was admitted to the Charité in June. He complained of nervous symptoms stemming from an accident in 1907. U. had been extensively examined and had spent time in a sanatorium for accident neurotics. Repeated medical opinions failed to substantiate his claim that he deserved a pension. No objective findings could be made; according to the examining doctor, it could only be assumed that his nervous ailment originated in the fright he had experienced in connection with the accident, complicated by his wish for a pension. The patient, according to his file, “placed particular emphasis on his subjective complaints”; these, however, lacked objective corroboration, and the doctor diagnosed U.’s as a case of pension neurosis.218 A similar fate befell the switchman Herman T., who in July 1914 was sent to the Charité by the Reichsbahn. T. complained of headaches and dizziness stemming from an accident five years earlier and a subsequent electrical shock he had experienced while on the job in the midst of a thunderstorm. Again, examination turned up nothing to support his claims. T. was diagnosed as a pension neurotic.219 The case of electromechanic Georg B. illustrates well the slippage between neurasthenia and pension neurosis. B. was sent to the Charité in October 1914 by the Reich Insurance Office for an expert opinion. It was his third visit to the Charité. In 1910, B. had had several examinations, which had found possible evidence of nervous weakness linked to the fright caused by an accident he had suffered. Alongside the subjective symptoms he complained of (headaches, anxiety, intense excitability), objective symptoms (neuralgia, shaking hands, unsteady gait) were also present. His pulse, his heightened tendon reflex, and his shaking spoke for the “credibility of his complaints.” The result had been a diagnosis of neurasthenia; compensation was set at 30 percent of his former wage. But B.’s was an obstinate case. Over the next two years, his complaints worsened—partly because of the consequences of another accident—even while a second set of doctors determined that his condition was improving. By the time he arrived at the Charité in 1914, B. had seen a total of nine doctors. This time, examination failed to support the patient’s claim that he was ill, and he was released as “cured” with the diagnosis pension neurosis.220 The perceived prevalence of cases like B.’s reinforced the impression
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that social insurance had unleashed a plague of fraudulence on German society. Yet for an increasing number of critics, the issue was something deeper than simply a certain percentage of workers faking their maladies. Behind differences of opinion about the disease picture surrounding accident neurosis lay a growing consensus concerning the failures of German social policy.221 The desire for a pension had become a pathogenic factor far outweighing the actual incidence of accidents; social insurance was itself afflicted with a kind of neurotic overburdening, or, as one doctor put it, a “degenerative” condition with “energy-crippling side effects” that threatened to erode the foundations of German society.222 This line of argument fed into a growing antimaterialist critique that marked middle-class discourse from the 1890s on.223 Seen against the backdrop of the SPD’s unrelenting growth, the social insurance system’s expansion created the specter of a creeping form of “state socialism”— a development that was especially pronounced in Berlin, which was increasingly perceived as a stronghold of socialized medicine. Schmiedebach argues that the psychogenic paradigm that emerged at this time must be viewed in this context.224 To conservative doctors, the disease picture surrounding traumatic neurosis, this “myth” of the industrial world, shared affinities with the socialist world picture. Social insurance, the working classes, and traumatic neurosis were all implicated within a perceived “crisis of materialism” sapping the nation’s vital forces. Insurance had replaced the organic bonds of German society with mechanistic ties that imposed a bureaucratic straitjacket on doctors, absolved patients of responsibility for their well-being, and jeopardized the nation’s future.225 Two decades of criticism culminated with the 1912 publication of Berlin political economist Ludwig Bernhard’s text The Undesirable Results of German Social Legislation. Bernhard saw the problem of accident neurosis as symptomatic of the larger failures of social insurance. By bringing the “patient’s body” into relation with the “great political questions of the day,” this legislation had forged a unique entity: a single enormous “insurance community.” In doing so, it had implanted in the minds of Germany’s workers an exaggerated sense of their rights and of the state’s role in protecting them from the existential anxieties of everyday life. Bismarck’s legislation had led to an epidemic of “pension mania” or “pension addiction” quite distinct from any real risk. On the issue of simulation, Bernhard warned: “Altogether, insured workers find themselves in an especially ‘favorable’ position in the domain of simulation, indeed I might almost say an unassailable position.”226 In Bern-
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hard’s view, the obvious solution to this dilemma lay in reforming the laws. Arguing along Social Darwinist lines, he wrote that the new German insurance community had lifted the intolerable burden of the “struggle for existence,” thus alleviating its citizens of responsibility for making their way in the modern world. In doing so, it institutionalized dependence and weakness. As we shall see in the next chapter, the outbreak of war would be greeted by Germany’s physicians as a providential opportunity to shore up a polity threatened with emasculation by the increasing bureaucratization of modern life and to free the neurotic worker from the clutches of both his symptoms and the welfare state. Industrialized war, however, would usher in an unparalleled epidemic of male hysteria.
FOUR
Electrotherapy and the Nervous Self during Wartime
A
medical opinion issued in 1925 by the Psychiatric and Neurological Clinic of Berlin’s Charité hospital reviewed the case of war veteran Franz M. In the course of his service M. had suffered a nervous breakdown and been treated with electricity at Haus Schönow in Berlin-Zehlendorf in 1917. After the war he received a modest pension from the welfare bureaucracy that administered psychological disability claims, yet throughout the 1920s, his condition grew progressively worse as he became entangled in repeated exchanges with that bureaucracy in an effort to have his pension adjusted to a level commensurate with his disability. Frustrated in these efforts, M.’s interactions with doctors became increasingly adversarial, and the electrical treatment administered in 1917 would ultimately become integrated into a disease picture that took on distinct persecutory features.1 Extreme though it was—by 1925 he seemed to be in the grip of a fullblown psychosis—the case of Franz M. echoes those of many of Germany’s soldier-patients during and after the Great War. By the end of the war, the breakdown of morale in the armies of the Central powers was accompanied by charges that doctors were using brutal methods of treating soldiers suffering from war neuroses. Especially controversial was the so-called Kaufmann method, an aggressive form of treatment that combined elec127
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trical current with verbal suggestion, which often took the form of shouted commands. This method, although unpleasant and often painful—even resulting in death in a handful of cases—was conceived of as a type of suggestive treatment by the doctors who practiced it. Electrical machines, as Paul Lerner has shown, were used to enhance the doctor’s authority and ability to influence the patient’s will to recover. For a variety of reasons—speed, standardization, and ease of operation by nonexperts— “Kaufmannization” became the preferred method of a system whose chief objective was reintegrating the patient-soldier into the war effort.2 The German psychiatric profession’s embrace of Kaufmannization as a cornerstone of a system of mass treatment for the nation’s soldierneurotics represents a complex reconfiguration of the relation among nerves, shock, and electricity. Its significance hinges on its appearance at a turning point in the history of the “electrical method”: a moment when its enlistment in a system of mass suggestive, disciplinary treatment was linked to the triumph of a psychogenic theory of neurosis. For most of its previous history, the electrical method of treatment had rested on a somatic model of nervous illness. The collapse of this model, within a context of wartime emergency, was reflected in the discovery of electrotherapy’s value as a means of influencing the patient’s will. Once used to treat the patient’s body, electrical current was now used to act on his mind.
INDUSTRIALIZED WARFARE AND THE NEUROSES OF WAR In the field of psychiatry, as in most areas of German society, the Great War marked a watershed. By the eve of the war, the social conflicts that had wracked Wilhelmine Germany seemed to be reaching a crisis point. Even as international conflict enveloped the country from without, many Germans—alarmed by the transformation of the SPD into the nation’s largest party—felt the nation was being undermined by social tensions from within.3 In terms that reflected the widespread medicalization of German public discourse, this fear of internal weakness and crisis was frequently articulated in an idiom of nervous degeneration.4 Doctor and physiologist Heinrich Boruttau, echoing a standard critique of Wilhelmine society, wrote in 1916 that the course of modern cultural development had resulted in “all kinds of exhaustion and overburdening” and in an increase of nervous and mental illness.5 The spread of nervous illness to the nation’s workers and the resulting fierce debates surrounding working-class neurosis and pension claims gave an even more pronounced cast to such concerns.
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The declaration of war in August 1914 was welcomed as the antidote to this crisis of nerves and to the nation’s underlying class discontents. War promised to deliver German society from the social pathologies and the spiritual malaise of industrial modernity into disciplined action and national solidarity. In a 1910 speech that was repeatedly echoed following the war’s outbreak, Kaiser Wilhelm II exhorted his subjects with the following call to arms: “The next war and the next naval battle will demand of you healthy nerves. It is through nerves that its outcome will be decided.”6 The kaiser’s call to rally the nation against the enemy was thus also a call to rally internally against the specter of physical and moral degeneracy. German doctors likewise embraced war as a form of hygiene for an enervated nation. The war, according to Albert Eulenburg, would be “a steel bath” equipped with “an almost all-powerful healing force” for “nerves that had withered and languished in the long years of peace and one-sided professional activity.”7 Germans saw in war an opportunity to overcome deep social divisions and forge new bonds. Born amid war, the Kaiserreich was now offered a chance to complete the unfinished business of nation building in a new war. The news that war had been declared produced scenes of nearhysterical celebration in the streets of Berlin. Huge crowds gathered outside the palace to cheer the kaiser wildly. Leading psychiatrist Alfred Hoche likened the newly mobilized nation to a “single, unified, closed organism” in which individual differences were submerged within a “higher order.” Hoche infused a familiar trope with a Nietzschean metaphorics of the will: “The telegraph lines are the nerve endings of this great new body, through which identical feelings, identical strivings of the will oscillate at the same moment without regard for time and space.”8 Despite their antiwar stance, the Social Democrats accepted the kaiser’s call for a Burgfried (social truce) and voted to support the war. Socialist Alfred Grotjahn was among those who succumbed to “war fever,” though he soon came to regret his support for the war.9 Indeed, the deliverance promised by war proved short-lived. Within months, war enthusiasm yielded to the reality of fully technological military engagement.10 If in the nineteenth century the railway accident had offered the iconic image of modern technology’s destructive power, then the Great War, with its machine guns, artillery, and gas, confronted European society with an altogether more gigantic scale of destruction. The mobilization plans laid in place prior to the war unleashed forces that quickly acquired a momentum of their own; the frantic exchange of telegrams preceding the war’s outbreak also imposed their own logic on
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the course of events.11 The war, with its “rationalized slaughter,” came to be imagined as an immense runaway locomotive, with dreadful consequences for body and mind. As one scholar of war neurosis puts it, in the minds of German doctors, “it was as if one hundred colossal railway smashups were taking place every day for four years.”12 Far from liberating soldiers from mechanized society, war intensified its hold over individual combatants.13 The war, as an extreme instance of the speed and technological complexity that marked modern life, created an environment that was frequently imagined in electrical tropes: “It often seems to me as though it were the vibrating, shuddering air that with a noiseless spring leaps upon us; or as though the front itself emitted an electrical current which awakened unknown nerve-centers.”14 The consequences of modern technology for the self were brought home with dramatic force: “A generation that had gone to school on a horse-drawn streetcar now stood under the open sky in a countryside in which nothing remained unchanged but the clouds, and beneath those clouds, in a force-field of destructive currents and explosions, was the tiny, fragile human body.”15 As the German offensive stalled on the western front, the nation’s soldiers succumbed en masse to the traumas of trench warfare. Instead of the war of movement and action that had been foreseen, this became a war of paralysis and immobility; the immobility of trench warfare, argues Eric Leed, reduced soldiers to passivity in the face of mechanized slaughter. Increasingly the response was mental illness.16 Industrialized warfare, as Germany’s medical establishment soon learned, produced nervous breakdown on an industrial scale. Over six hundred thousand soldiers would eventually be treated for neurological disorders.17 Although these disorders often resembled the symptoms of neurasthenia— exhaustion, anxiety, melancholia, sleeplessness—the overwhelming number took forms that more closely resembled those of hysteria: paralysis, catatonia, blindness, stuttering or mutism, and, most iconically, the trembling and twitching of the so-called Kriegszitterer. The demands on both psychiatric resources and the nation’s pension system, two sectors already perceived as overburdened prior to the war, mounted precipitously. It was only a matter of time before these developments brought about significant changes within German psychiatry. Well before the war, as we have seen, practitioners had begun a concerted campaign against the clinical picture surrounding traumatic neurosis. Pointing to inconsistencies in this picture and to evidence of fraud, they argued that it was a dubious medical construct, a myth rooted in a naive faith in materialist explanatory schemes. They were backed up by
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critics of the welfare system, who regarded accident insurance as little more than a form of institutionalized shirking—one whose administration, moreover, had been taken over and skillfully manipulated by the Social Democrats, who dominated the insurance boards in Berlin and other large cities. Though the fragile social compromise embodied in Germany’s social insurance system remained in place up to the war, debates about costs, combined with the manpower crisis facing the German army and industry, would soon precipitate a crisis. The debate over war neurosis picked up where the prewar debate over accident neurosis had left off.18 In a context of national emergency, however, the debate took on a very different cast. Traditional qualms about subordinating individual patients’ needs to national interests were set aside, and a new medical consensus was forged under the pressure of concerns about morale, pension payments, and manpower shortages. In most forms of war neurosis, doctors concluded, there was no question of genuine disability but only a wish to flee the front or receive a pension. German doctors took it upon themselves to prevent a general breakdown among the rank and file, as Emil Kraepelin later recalled: “As psychiatrists, we all agreed to aim at counteracting the generous granting of pensions, because we feared a fast increase in patients and their claims. . . . Due to the length of the war more inferior persons had to be recruited and battle fatigue increased. . . . Public sympathy was aroused by the apparently badly injured Kriegs zitterer who attracted general attention on the streets and were showered with gifts.”19 Though few denied the uniquely destructive character of this war, German doctors drew a distinction between the authentic physical wounds suffered by men at the front and the altogether more baffling nervous and psychological maladies that seemed to afflict those at the front and, tellingly, those behind the lines in equal measure. While granting that the demands of this new kind of war often led to nervous illness, they rejected this as sufficient explanation for the epidemic dimensions of the problem. Moreover, the symptoms’ closer resemblance to those of hysteria than to those of neurasthenia aroused widespread skepticism. In response to the perceived crisis of malingering within the ranks, psychiatrists adopted a unified stand against the older picture of traumatic neurosis as somatic disorder and enthroned a new psychogenic theory in its place. The effect was to shift the emphasis from the battlefield experience to the soldier’s inner world, to his “will,” “attitude,” or “hereditary disposition.” If this psychologization of neurosis represented, in some respects, a conceptual advance, in practice it was often abused. According to Klaus Doerner,
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the new psychogenic theory represented both a scientific judgment and “a contribution to military morale and to the economy, since it offered a tool for fighting the pension claims of veterans.”20 Thus a momentous shift occurred in German medical thinking about the origins and nature of the neuroses of war. Doctors rallied around a view that emphasized less the traumatizing effects of modern war than the weakness and nervous predisposition of the invalid. If in the nineteenth century the referent of the discourse about nerves was most often technology, then in this war—in which the forces of modern technology created an indescribably destructive environment—technology as referent receded into the background, to be replaced by other referents: individual weakness, psychopathology, the wish for a pension. Hermann Oppenheim was among the few to note the paradox this shift had led his colleagues into. He found it “inconceivable . . . that doctors trained in neurology and psychiatry could disregard to such an extent the effect of the war’s violent mental and psychical traumas, and assume that they left only a fleeting impression on the nervous system.”21 The implications of the shift to explanations stressing personal weakness and the wish for a pension would be played out in doctor-patient interactions long into the postwar period. Well into the 1930s, psychiatrists at Berlin’s Charité were still being consulted on cases of war-related psychological disability. In 1936 the services of the Charité were requested by the Reich Public Assistance Court (Reichsversorgungsgericht, RVG) in the case of the veteran Martin W., in order to help determine whether the recently deceased W. had died as the result of an illness that could be traced back to a nervous disorder suffered during his military service.22 The twelve-page opinion submitted by the Charité doctor was based on an examination of documents supplied by the public assistance office of Nürnberg and the RVG, in addition to case histories provided by the municipal hospital in Nürnberg. A complicated picture emerged from this collection of documents. W. had originally been diagnosed in February 1917 as suffering from “hysteria following grenade shock.” During one of the campaigns of the preceding year he had been buried in the rubble of a grenade explosion and had been left briefly unconscious. He emerged from this experience physically uninjured yet suffering from violent trembling (Zittern) in all of his limbs, intense headaches and backaches, and disturbed sleep. He was shuttled from one field hospital to another and examined and reexamined by a series of doctors. These examinations revealed no objective findings, but the symptoms persisted. The patient was treated with
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strong electric current, but this only seemed to worsen his condition. As a result of his diagnosis, W. received a pension. Subsequent examination in 1921 showed that the patient’s twitching remained so intense that his simplest reflexes could not be tested. Moreover, the patient now complained of nervous fits, sometimes followed by unconsciousness. The examining doctor confirmed the hysteria diagnosis, although he also suspected an organic illness, perhaps multiple sclerosis. Six years later W. was back in the examining room for yet another series of tests. By now his condition had taken a decided turn for the worse. As a result of cost-cutting measures taken by the Labor Ministry, his psychological disability pension had been cut off the preceding year.23 W. submitted a claim to have it restored. Once again tests revealed no objective findings. But the examining doctor noted that W.’s complaints were presented in an “exaggerated” fashion. His trembling intensified during the examination, as did the other symptoms, including his stumbling gait, although when he thought he was not being observed, the doctor noted, he walked without trouble. W. was diagnosed as a case of pension neurosis. Subsequent examinations in 1927 and 1934 were marked by conflicts between patient and doctor. W. was described as truculent and threatening, stating that if war broke out again he would shoot everyone. He finally died in 1935 from unknown causes possibly related to an embolism. Following this, his widow filed a claim. The opinion issued by the Charité’s doctor stated that there could be no doubt that W.’s neurosis was related to his wish for a pension and not to his military service. The facts, wrote the doctor, pointed to evidence of a preexisting condition: As so often happens, this hysterical condition had, in connection with the wartime experience, developed in a man who doubtless had already shown signs of a psychopathic constitution. According to testimony provided by the patient in the first field hospital where he received treatment, he had always been a sensitive and easily agitated man, with a tendency to tremble and burst into tears. . . . In short, the patient’s death had nothing to do with the experiences sustained during his military service.24
The patient’s overly sensitive nature was now held up as a evidence of a preexisting condition that outweighed the effects of his military service. Noteworthy is the doctor’s conclusion that he suffered from hysteria rather than neurasthenia or traumatic neurosis. Diagnosis of traumatic neurosis virtually guaranteed a pension, while hysteria—by attributing disease to the patient’s psyche or predisposition—made it substantially harder to be granted one.
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THE 1916 WAR CONFERENCE In September 1916, faced with what they perceived to be an unprecedented crisis of nerves in the ranks, German psychiatrists convened at a congress in Munich to discuss solutions to the problem. The agenda for this gathering was set not just by the tremendous logistical problems resulting from the mass outbreak of shattered nerves but also by the manpower shortage that had become an ever more pressing issue both at the front and behind the lines. As Paul Lerner has shown, the proceedings at this congress would culminate in the final dismantling, at least as far as the psychiatric community was concerned, of Oppenheim’s traumatic neurosis construct.25 What was at stake can be gleaned from the postwar comments of Oswald Bumke: “Historical developments have transformed a concept originally understood in purely somatic terms into a primarily psychological one. From my point of view this represents a step toward progress and one that also has practical implications. How could we ever have mastered the war neuroses proceeding from Oppenheim’s position?”26 In the later recounting of Ewald Stier, an assistant at the Psychiatric and Neurological Clinic of Berlin’s Charité at the outset of the war, the war became the occasion not merely for a shattering conflict between two armed camps but also for a showdown between two opposing scientific positions. Karl Bonhoeffer, the clinic’s director, had argued in a paper published in 1911 that hysterical reactions were always rooted in a specific “orientation of the will,” thus establishing a crucial alternative to Oppenheim’s traumatic neurosis construct, according to which Shockerlebnisse stemming from accidents produced organic and lasting changes in the central nervous system.27 Even before the war, Bonhoeffer had virtually abandoned the diagnosis of traumatic neurosis for that of pension neurosis. Stier depicted this scientific disagreement as nothing less than a clash between two worldviews, with Oppenheim’s position representing the now discredited materialism of the nineteenth century that was rooted in the world of the private nerve clinic and Bonhoeffer’s position representing the psychogenic view of the university psychiatrists now in ascendancy.28 The stakes in this disagreement were both scientific and national, according to Stier, who lumped both the French and Jews together in the materialist camp: “Almost without exception the private clinics were in Jewish hands and were in the final analysis money-making enterprises.”29 Stier, a military psychiatrist with a post at the Charité, was part of a
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generation of doctors whose careers were made by the war. His military background was reflected in the authoritarian views he took on the issue of pensions and malingering.30 After the war he would play a leading role in the campaign to dismantle the entitlements for traumatic neurosis, and by the time the Nazis came to power he was regarded as the “Nestor” of German military psychiatry.31 His retrospective account of the events at the war conference, written in 1936, was perfectly attuned to the new political dispensation and its preparations for war. It also suggests the extent to which the campaign against traumatic neurosis was laden with nationalist and anti-Semitic undertones. As Lerner has suggested, Oppenheim’s identity as a Jew and private clinician increasingly marked him as an outsider in a profession that was being radicalized by the war.32 At the outset of the war, Stier wrote, Oppenheim’s “pseudomalady accident neurosis” still claimed adherents and was rapidly extended to the neuroses of war. Men diagnosed with this condition were simply stamped with the label “victims of war,” entitled to sympathy, convalescence, and finally a pension. The consequences for military discipline and fighting capacity had been disastrous in Stier’s eyes, and the final reckoning had been only a matter of time: “At the memorable war conference of German psychiatrists in Munich in September 1916, the opposing viewpoints collided with unprecedented intensity; Oppenheim left the congress early; and a new era began for the psychiatric evaluation and treatment of the psychopathic reactions.”33 Subsequent developments had simply confirmed the correctness of this judgment. For Stier, the “mass experiment of the war” had resulted in a tremendous “advancement of our general scientific knowledge,” not least in the realm of mental illness, where the war had driven home the lesson that neurosis was not somatic but mental. In reality, as we saw in the previous chapter, this lesson was not new; it had been held by an increasing number of physicians who dealt with the interrelated problems of accident neurosis and pensions prior to the war. What was new was the scale of the problem and the emergency conditions of wartime, which together acted to weaken the sense of obligation doctors felt toward their patients and to shift their priorities to collectivist solutions. Also new was the consensus that now reigned in German psychiatry, which reflected the profession’s reorganization and centralization under military direction. As the case of Martin W. illustrates, the hysteria diagnosis—which stigmatized the soldier as weak and effeminate and cast doubt on the existence of a direct relation between the war and the nervous disorder— would henceforth be employed with increasing frequency.
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One consequence of this shift was that German doctors increasingly resorted to explanations that displaced the focus from the traumatic effects of war itself onto the soldier. Most doctors fell in behind the position of Bonhoeffer, who believed that psychopathic disposition played the crucial role in the etiology of war neurosis.34 Bonhoeffer’s predecessor at the Charité, Theodor Ziehen, had devoted his tenure in Berlin to inventorying the forms of the psychopathic personality, and by the time Bonhoeffer arrived in Berlin the diagnosis had become codified in both psychiatric discourse and in law, in the form of a new mental health care law recognizing psychopathy as an inherited disorder.35 According to the new doctrine of psychopathic constitution, long-lasting severe neuroses of the kind found among many soldiers constituted evidence of an inborn, degenerative tendency—a conclusion that shifted the responsibility to the patient himself. Chief among the factors that now loomed large in the psychiatric response to the neuroses of war was the problem of psychic contagion. Concern about troop discipline prompted Bonhoeffer to caution against indiscriminately mixing neurotic soldiers and healthy troops because of the possibility that the latter would learn to simulate neurotic symptoms.36 The fear that hospitals behind the front would become breeding grounds for the contagious influence of war neuroses ultimately led to a complete reorganization of the system for treating psychiatric casualties, with the emphasis now placed on channeling the patients through as quickly as possible in order to return them to the front or, more often, to the labor force.37 In an article published in 1918, Stier put it this way: “Because of the great suggestive influence exercised by every neurotic with acute symptoms over the healthy people around him, each individual treatment must—exactly as with the treatment of a man carrying an infectious disease—also prevent the patient from becoming a center of infection and prevent the often observed reinfection of others.”38 In Stier’s estimation, the decisive thing for the success of a treatment was the doctor’s quickest possible intervention, by means of “vigorous countersuggestion,” in producing in the patient a mental state that allowed no room for the “fixing” of wishes and hopes that the illness might become the means of returning home, a determination of psychological disability, or the granting of a pension. It was vital to short-circuit any of the psychological mechanisms that might reinforce the false belief that the conditions of war were responsible for the proliferation of neurotic illness and thus encourage Germany’s soldier-patients in their pathological and unpatriotic obsession with pensions. For Stier it was an
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article of faith that Rentenwünsche always dominated the disease picture and that the “struggle for a pension” was damaging to the patient’s health.39 In keeping with this view, Stier singled out as crucial the decision made in the war’s third year to replace the term Nervenshock (nervous shock) with the term Nervenschreck (nervous fright) on the injury tables in the army’s nerve stations. The purpose of this decision was to prevent these simple classifications from exercising a “damaging suggestive influence” over the soldier’s weakened mind. It must never be forgotten that these signs are studied with the greatest interest by every reasonably intelligent man whose health allows him to read, and that their contents serve as the basis for arriving at their own judgment concerning their condition. The terms “nervous shock,” “nervous illness,” or even “concussion” can under certain circumstances have a bad effect on the individual. For only when he sees them does it become clear to him what he “lacks,” only then does he realizes that he has become nervously “ill,” or that he has suffered the dreadful condition, known to him by rumor or sight, of a “nervous shock”; and it cannot fail to materialize that this knowledge immediately awakens wishes and thoughts of home that from then on dominate his thoughts, and lead more or less consciously to his fixation on the symptoms.40
The doctors of the army’s nerve stations (Nervenlazarette) were unanimous, Stier claimed, in their view that the diagnoses posted on the injury tables were responsible for implanting “injurious illness beliefs” in patients and awakening intense resistance to treatment. It would be best to avoid the use of these terms altogether, he continued; better still would be to employ a course of active countersuggestion and to use, in place of shock, the term fear (Schreck or Schreckwirkung). In addition to being scientifically more accurate, claimed Stier, this term had the advantage of playing on the soldier’s sense of shame and honor. Stier thus forged a rhetorical link between the patient’s belief in somatic etiology and his pathological condition. Stier deemed it a further essential feature of the conditions in the Nervenlazarette that they depended on the personality of the psychiatrist in charge and on his ability to marshal all the requisite forms and arts of suggestive influence within a total treatment regime. At stake here was not simply the patient’s recovery but the recuperation of his labor power; indeed, the two were essentially identical. The patient’s entitlement to a pension had to be weighed carefully against his future service to the nation, whether at the front or behind the lines. Stier urged the
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greatest care in the terminology used in these deliberations, since the pensioning process could exercise a damaging influence over a man’s health and ability to work and could transform an otherwise useful, active member of the nation into a social parasite. “Rejection,” he counseled, “is the best counterweight to the problem, well known from accident praxis, of ‘pension neurosis,’ to which the nervous reactions of wartime bear a close resemblance.”41
KAUFFMANNIZATION Stier depicted the clinical setting as a force field, a charged space within which a multitude of influences—from the patient’s own “illness beliefs” and the damaging effects of the pensioning process to the countersuggestive forces marshaled by the doctor—competed to lay claim to the patient’s mind. Foremost among the types of treatment to which Stier alluded was the method of suggestive electrotherapy known as Kaufmannization. Its mobilization amid the conditions of mass nervous breakdown in the German army represents a significant reconjugation of the relation among electricity, shock, and nerves. Previous chapters of this study have connected the construction of sick nerves as emblematic disease of modernity to the use of electrical current as exemplary medium of treatment. One aspect of the recasting of “nerves” as “neuroses” was the German medical establishment’s loss of faith in the presumed somatic effects of electrotherapy. Its members continued to use current for diagnostic purposes, despite criticism that using electrodiagnosis to unmask malingerers could become a form of torture. At the same time, doctors began noting that electricity had become part of the disease picture presented by some patients, who claimed that imaginary enemies sent electrical currents through their nerves.42 Such delusions became increasingly common in the psychiatric literature; alongside the benign figure of the doctor using electrodes to treat the fatigued body, there now appeared a new, more treacherous image of the doctor wielding electrical apparatus as a persecutor. This image would become widespread during the war. By 1916, under pressure from the army high command, the German psychiatric profession had been reorganized to meet the demands of total war. The problem of nervous breakdown in the ranks had forced doctors to overhaul both the diagnostic framework surrounding the neuroses of war and the existing system for treating nervously ill soldiers. Of
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particularly urgency, given the manpower crisis facing the nation, was the need for an effective system of mass treatment. For a number of reasons electrotherapy recommended itself as the treatment of choice. Unlike hypnosis—also widely used during the war—it took no great skill to wield electrical apparatus, which thus facilitated a high degree of standardization in the treatment of psychiatric casualties. For untrained doctors, electrical apparatus supplied the charisma required by the hypnotist. Moreover, it was fast: though some treatments could take several hours, most took no more than fifteen minutes. This permitted an almost industrial processing of patients, making it ideal for military purposes.43 This form of electrotherapy was different from earlier forms in that, although conceived of as a type of suggestive treatment, it employed a high-voltage form of current that could be extremely painful.44 In a handful of cases, fatalities occurred. Indeed, pain was held to be essential to the success of the cure, for it supplied the coercive means necessary to force the patient to confront the illusory nature of the relief sought by his “flight into illness.” Fritz Kaufmann, the physician who popularized the use of electrosuggestion to treat war neurotics and whose name became synonymous with the method, first successfully treated a patient (a twenty-year-old girl with hysteria) with electricity and suggestion at Wilhelm Erb’s Heidelberg clinic in 1903.45 Kaufmann resolved his misgivings concerning the potential problems involved in incorporating suggestion into the clinical setting by limiting the treatment to a single session, making it clear to the patient that the session would not end until she gave up her symptoms. He returned to this method during the war when it became clear to him that conventional methods relying on rest and exercise were accomplishing little. Echoing concerns that had become common among prewar practitioners, Kaufmann felt that these methods were counterproductive in that they gave patients a positive incentive to remain ill. Many patients, he wrote, left the field hospitals after lengthy treatments completely unable to function and in possession of a generous pension, a situation that led to “unhappy consequences for the patient’s family,” deprived “the state of vital labor power,” and “overburdened the military finances.”46 Under such circumstances it appeared obvious to Kaufmann that the origins of the soldier’s neurosis lay in a wish: to escape the war or to win a pension. In terms borrowed from both railway and military idiom, Kaufmann described his method as a form of “surprise attack” designed to overwhelm the patient:
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From our everyday experience we know that an innervation that has been knocked off the rails by a psychic shock can be restored to the right track by a new psychic shock. We are now in a position . . . to artificially produce such a shock in the patient with a strong electric current and to use this method in combination with the assistance of verbal suggestion in the form of orders to cure.47
The combination of electrical current and verbal suggestion, in the form of military orders, was designed to restore the sense of duty and discipline, whose breakdown had precipitated the soldier’s inner derailment. Significant here was Kaufmann’s adaptation of the shock trope—abandoned by doctors in their thinking about the etiology of the war neuroses—to the needs of the therapeutic setting.48 In German military hospitals, shock, as Paul Lerner has written, was used to undo or reverse the effects of the original trauma. A further important component of the treatment was the emphasis on strict military discipline, in the belief that the suggestive effect of the method was enhanced by the maintenance of hierarchical military relationships.49 This made it unsuitable for use on officers, since it depended on the subordination of one man’s will to another.50 While not denying that the treatment could be unpleasant, Kaufmann felt that, given the national emergency, a certain level of pain was an acceptable price to pay to break patients of their obstinate and morbid fixation on their own symptoms. Although debate about the potential for abuse did occur within the German medical community, it remained muted, and skeptics became marginalized when practitioners of the method were able to report astounding success rates of 90 percent or even better. Incorporated into the treatment regime employed at the army’s nerve stations, Kaufmannization rapidly gained a reputation as a miracle cure, with some doctors reporting that they had been able to treat successfully dozens of patients at a time in a single setting. Five minutes of electrical current and suggestion—so they claimed—were all that was required to restore the power of speech and movement to patients who had been reduced to mute, trembling shells of their former selves. Employed in virtually an assembly-line fashion, Kaufmannization was soon heralded even by skeptics as having “revolutionized” the treatment of war neurotics.51 Widespread adoption of the Kaufmann method significantly reconfigured the clinical setting in a number of ways. First, it signaled a consequential shift in the status of the condition under treatment. No longer did electrical current implicitly confer legitimacy on the somatic, hence authentic, nature of the condition it treated, as it did for the method’s
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nineteenth-century practitioners. Rather than acting on the body, it acted on the mind, and in so doing positioned patients as objects of a system in which the goals of treatment and of military discipline were completely fused. Treatment in this context meant not simply the restoration of health but also the recuperation of labor power. Doctors embraced the method because it resolved the pension and labor shortage problems simultaneously.52 Their concern was with getting patients back to the front or rehabilitating them for service in munitions factories behind the lines. Second, although for all practical purposes this method ignored the difference between real nervous illness and the simulated kind—treating both in the same fashion—its use nevertheless rested on an underlying distinction between the two. Moreover, this distinction was framed in political terms insofar as class differences became projected onto the differential diagnosis of neurotic symptoms. German doctors did not reject out of hand the view that war could produce nervous disorders. Ewald Stier, for instance, did not doubt that extreme demands on body and mind during war led to neurasthenic conditions, marked by sleep disorders and heightened excitability—conditions he considered treatable.53 He only disputed the notion that it could lead to long-lasting and untreatable conditions in anyone who was not already burdened by a psychopathic constitution. Though Stier acknowledged that treatable nervous disorders could be found among the rank and file, like most doctors, he tended to diagnose hysteria more often among soldiers and to reserve neurasthenia for officers. Such views were widely echoed by German psychiatrists. Robert Gaupp defined neurasthenia as “nervous exhaustion of those who are originally healthy” and differentiated it from all forms of “inborn, constitutional nervousness and psychopathy.”54 Gaupp did not hesitate to project this distinction onto differences in rank and class, citing a wartime study by Willy Hellpach, who found that out of 300 nervously ill officers, 159 had neurasthenia, and 22 hysteria; while among 300 nervously ill soldiers, 137 had neurasthenia, and 87 hysteria.55 Such distinctions carried a highly charged meaning given the fact that most doctors were officers; and most patients, working-class men. In a context in which class tensions were being reproduced in the doctor-patient interaction and in which the success of the cure was predicated on absolute acquiescence to military authority and discipline, these distinctions were fraught with implications. Evidence of how use of electrical current could be bound up with subtle distinctions between authentic neurosis and malingering is provided
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by the testimony of one doctor, Michael Kozlowski, who faced charges of abusing his patients following the war. Underlying Kozlowski’s statement of self-defense was an implicit contrast between genuine nervous exhaustion and the simulated nervous malady of his soldier-patients, whom he described as “hysterics and malingerers, shirkers who, strong and often well-nourished, lay around for months or even years in different military hospitals or with good luck cheated their way through to escaping military service altogether.”56 Kozlowski’s response to the plaintiff’s claim that the electrical treatment was inhumane read: “Faradization could not go on for long, because the physician became physically exhausted through bending forward and through constant observation of the pulse and of the patient’s entire condition.” In explaining how innocuous the procedure was and how unjust the plaintiff’s charges against him were, he noted that frequent pauses occurred, during which the patient was assigned walking exercises and he, the doctor, employed verbal suggestion. “It is really necessary,” he wrote in conclusion, “to have seen the whole procedure, which is mentally and physically very exhausting for the physician, and to understand the manner of working and the context of the nonfaradic methods used, in order to realize the nonsense of these assertions of Herr Kauders.”57 The implicit contrast drawn here between the physician’s role and the patient’s served to undermine the patient’s claims. A final point to be made concerns the consequences of the decoupling of nervous from technological breakdown. As we saw previously, German doctors at least at the outset tended to see the war as a technological catastrophe, an accident in perpetuity (“als technische Katastrophe, als Unfall im Permanenz”), and to understand their patients’ nervous maladies as the predictable result.58 By the second year of the war, however, the focus of their attention had begun to shift. Rejecting the notion that war itself was the cause of their soldier-patients’ nervous breakdowns, they stressed instead the role of predisposing factors and pensions. The logical consequence of this shift was that they began to deploy a form of technological warfare against the epidemic of “sick nerves,” aligning their work discursively with the effects of battlefield combat. As Paul Lerner has written, Kaufmannization “reproduced the psychologically damaging experience of modern warfare in the treatment room. Not only did it supply the shocks and terror that characterized the mechanized battlefield, but it also extended military discipline and the need to conform to strict codes of honor and masculinity into the therapeutic realm.”59
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Touching the patient’s body with an electrode became a way not simply to cure but to override the patient’s “will to sickness” with a more powerful “will to health.” This becomes clear in the following account of a session, given by a soldier suffering mutism: The current was switched on. At first I had a prickly feeling, which suddenly burst into intense pain. . . . The moment the doctor’s suggestions began, I felt like an object with no will of its own, being fought for by two opposing powers. Gradually my own came into play as a result both of my own reasoning and the doctor’s means of domination. . . . I held on to the doctor’s scolding as a lifeline, clung to it tightly, and pulled my nerves along with me. So the two of us pulled until I could understand and speak.60
Citing this account, Doris Kaufmann cautions against judging Kaufmannization too facilely in terms of a persecutor-victim relation. There is no doubt that, for many patients, the combination of electrical current and verbal suggestion constituted a genuine lifeline. Kozlowski noted strange contradictions in the behavior of Kauders, the patient who brought the suit against him, describing him as someone who “always went around, or rather crept around, extremely slowly and carefully, giving as the reason that the slightest jolting, either from walking quickly or from any kind of quick movement, immediately caused terrible pains in the head.” Nevertheless, on the treatment table Kauders would demand that Kozlowski “put the electrodes on his head, which allegedly hurt terribly at the slightest vibration! and was thus of the opinion that the jolting—the direct jolting—of his head by this ‘very strong’ current could do him some good!”61 Though Kozlowski’s testimony is clearly exculpatory and should be treated skeptically, it points to a paradox in the attitudes of patients toward the Kaufmann method, one that complicates the tendency to depict wartime doctor-patient relations in persecutor-victim terms. In his history of the sciences of psy—those sciences that have acquired jurisdiction over mental life—Nikolas Rose also cautions against reductive interpretations of the relation between scientist and subject. Emphasizing the role of these sciences in supervising the construction of the self, he further stresses the crucial importance of self-supervision, or self-discipline, in the formation of the modern self. Rose poses as a central issue the need to understand how “the language and evaluation of the experts come to be introjected by individuals as norms and standards, both rewarding and persecuting.”62 Rose’s remarks become highly germane when we turn to look at instances in which doctors refined the Kaufmann method in ways designed
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to encourage the patient to internalize its effects. One solution to the asymmetry in the therapeutic setting was conceived by Fritz Mohr, a doctor whose relatively humane approach to treatment of war neurosis included a form of psychoanalysis.63 Mohr’s solution was to allow the patient himself to control the amount of electricity delivered to the body with the aid of a special contrivance invented for this purpose. This device made these self-administered electric shocks the means of both a cure and a process of “self-discipline and training” (Selbsterziehung und Übung). Mohr described electrical current as a “pedagogical medium,” explaining, “I allow the patient himself gradually to strengthen the current on the faradic apparatus,” and demanding of the patient only that he “continue with this stronger current as long as he can endure it.”64 Far from resisting this method, patients, he found, turned it into a kind of sport by trying to determine how much current they could endure. This increased their “tolerance for unpleasant psychological and physical demands considerably, whereas the current applied by the doctor often frequently brought out an attitude of defiance and resistance.” By making the patient a participant in his own disciplining, Mohr’s technique turned the patient into both subject and object of the cure.
TECHNOLOGIES OF THE NERVOUS SELF IN WARTIME The reorganization of wartime psychiatry, whose most visible symbol was the mass deployment of suggestive electrotherapy, mirrored the more general process of rationalization in German society that began in the late nineteenth century and was accelerated by the war. As Paul Lerner has shown, the system of processing and treating neurotics adopted by German psychiatrists in wartime was modeled on the principles of rationalization that had been embraced in the peacetime industrial workplace.65 This system brought about a high degree of standardization and centralization in the psychiatric profession that paralleled processes occurring throughout Germany as the nation was reorganized to meet the demands of total war. War concentrated tremendous power in the hands of the central government. As the German state put the nation on a war footing, national power became ever more consolidated in Berlin. The capital was made the nerve center of a vast militaryadministrative apparatus, housed in structures built to accommodate the new bureaucracies created to coordinate arms production and the allocation of resources.66 Symbolic of this apparatus was the new Office of War Raw Materials, overseen by Walther Rathenau. It was not by
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chance that Rathenau, head of the giant electrical concern AEG and a committed Taylorist, received this appointment, given that it was in the electrical industry that the rationalization movement had made the most headway. The needs of a wartime state—mass mobilization, increasing intervention in all aspects of society—furthered a process of bureaucratization whose hallmarks, as Max Weber recognized, were ultimately military in origin.67 Weber was of two minds about this process, believing that “[t]o bureaucratization belongs the future” and simultaneously that the future was increasingly jeopardized by this process. As Detlev Peukert has written, Weber’s anatomy of the Western process of rationalization was thus also an attempt at uncovering “the pathogenesis of the Modern.”68 In Weber’s eyes the essence of this ambivalent process lay in the need for increasing social discipline. The ever closer coordination of military and social objectives in modern times was carried out in accordance with an ideal of efficiency and discipline, originating in the military domain (“The discipline of the army gives birth to all discipline”) but rapidly extending to the economic sphere. In Weber’s eyes, this economic form of discipline reached its peak in the scientific management movement, wherein the “psychophysical apparatus of man is completely adjusted to the demands of the outer world, the tools, the machines.”69 In all the warring countries, the tremendous demands of the Great War, as Joanna Bourke has written, intensified state surveillance and disciplining of the body.70 Germany was no different in this respect; the mass mobilization of the German nation created an urgent need for new techniques of managing human body and mind.71 A key role in meeting this need was played by scientific institutes such as the Kaiser Wilhelm Institute for Labor Physiology (KWI), established in Berlin 1913. Spearheaded by Max Rubner, a leading physiologist who numbered among his accomplishments the demonstration of the validity of the law of energy conservation for biology, the KWI became a kind of counterpart to Rathenau’s Office of War Raw Materials. Its agenda was defined by the need for reliable data concerning the physical and psychological aspects of combat and industry. Rubner placed fatigue research and psychotechnics at the center of what he envisioned as a more humane version of scientific management than that practiced by the Americans.72 A striking application of discipline in the Weberian sense—one that bears affinities to Mohr’s ideas concerning the use of electricity as means of self-discipline—can be found in the work of a scientist affiliated with the KWI, Heinrich Boruttau. This Berlin doctor and physiologist pub-
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lished widely on the subject of electrophysiology, including several standard works on the medical applications of electricity as well as a biography of Emil Du Bois-Reymond.73 During the war he played a key role in one of the official investigations conducted into fatalities resulting from the use of electrical current in the army’s nerve stations.74 He chalked them up to insufficient technical knowledge on the part of practitioners and explicitly rejected the more aggressive uses of electrical current, though he endorsed its use in general.75 It was in his work Die Arbeitsleistungen des Menschen, published in 1916, that Boruttau made perhaps his most significant contribution to the German war effort. As the war entered its third year with no end in sight, this book laid out a highly programmatic vision of the connection between the science of work and the crisis facing the nation. Precisely the war, he explained in his preface, illuminated the necessity for accurate measures of human performance and methods for improving on it: “[T]he world war, whose sheer magnitude overshadows all history and tradition, throws precisely onto the performance of the human organism itself, as well as onto . . . the construction and destruction of other natural forces, a light that will further arouse interest in the tasks of physiology and hygiene of work, as well as in the tasks that will await us after this war.”76 At the center of Boruttau’s book stood a vision of the body as a thermodynamic system, whose full potential it was the task of work physiology to unlock. He identified this vision with a scientific tradition that he traced back, via Angelo Mosso and Etienne-Jules Marey, to Helmholtz and Du Bois-Reymond. These scientists had bequeathed to modern society both a profound appreciation of the great energy principle—the law of the conservation of energy—and a multitude of resources for quantifying the capacities of the human organism: myograph, ergograph, dynamometer, and time-and-motion studies.77 The modern science of work aspired to put these resources into service on behalf of the project of optimizing human labor power and improving performance. Precisely insofar as the war broke with “history and tradition,” Boruttau welcomed it as an opportunity to implement this project. By contrast with the exhaustion and nervous disorders that plagued Wilhelmine society, he saw the war in regenerative terms: The “splendid physical conditions and health of our army in the present war suggest that battle is not necessarily as injurious as the decades-long exhaustion of contemporary bourgeois existence!” Nonetheless, he acknowledged the unprecedented demands that war made on the nation’s troops: “Activities imposing utmost exertion of the attention, constant
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use of sensory organs, uninterrupted presence of mind accompanied by physical stress . . . lead to fatigue and exhaustion, failure and breakdown of the entire organism.”78 For Boruttau, war revolutionized the whole question of work by driving home the necessity of putting it on a scientific footing.79 His program drew on a wide variety of scientific methods and discourses, including statistical measures of labor power, nutritional studies, Taylorism, and psychotechnics. Taken together, these represented the elements of a comprehensive program for the rational management and mobilization of the body’s energies. To combat the effects of fatigue and exhaustion and to promote efficiency, Boruttau stressed above all the vital principle of training (Übung). This principle worked simultaneously on two registers, facilitation and inhibition, which together formed the basis for all learning, including military training (Erziehung), in other words, “all forms of physical ‘drill’ ”: “For training the will, for presence of mind, order, obedience, and discipline, inhibitory processes play the main role in repressing what should not be, in switching off impressions that would disrupt the object of the activity—often a bigger role than the activity itself, whose regulation through the intensity of the innervation can be accomplished through training.”80 Boruttau’s concept of Übung privileged the role played by the nervous apparatus in conditioning and augmenting the body’s economy of forces. At the heart of his book lay a consequential shift from work understood as mechanical activity to a conception of work that stressed its psychological dimensions. Citing Rubner, Boruttau observed that the cultural development of mankind made human performance as pure mechanical labor increasingly less important than mental labor. More and more, men simply monitored the mechanical work performed by machines, yet under conditions that nevertheless imposed great strain on their nerves, mind, and senses. The main emphasis here, according to Rubner, “lay more in the nervösen Gebiet and in the performance of the brain; the work depends above all on the correct function of the senses, cognitive ability and the will”:81 It is essentially nervous processes, in which the mechanical component remains relatively minor . . . that produce a tremendous increase in the mechanical labor performed by men, that bring about an endless multiplication of products, and thereby a constant improvement in the conditions of existence of mankind, a process that is continuous and that . . . will not be interrupted by the current war: on the contrary, the experiences of this war prove the absolute necessity of the best and most complete organization of
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labor, whether peaceful or military, that is to say constructive or destructive, in the interests of victory and the further development of culture.82
For Boruttau the modernity of mental work was confirmed by the parallel between nervous and telegraphic systems.83 By means of a meticulous quantification of the “electrical changes” occurring in the laboring body, Boruttau envisioned a hitherto unprecedented degree of control over the body’s vital energies. Just how far he was prepared to go in this rationalization of the self becomes clear in the following: “By avoiding . . . unnecessary processes of mental association, by switching off recollections that represent an unnecessary ballast for the memory, in short by avoiding unnecessary detours of the thought processes, efficiency will be accomplished and this will result in an increase in knowledge, an intensification of mental performance according to the principles of an improved economy of the underlying material and energetic processes.”84 Conceiving the war in essentially thermodynamic terms, Boruttau welcomed it as inaugurating a hitherto undreamed of degree of rationalization of human resources. For Boruttau, all detours of the thought processes and ballast of the memory represented hindrances to a streamlined optimization of mental forces. In this “war of exhaustion,” in which the physical and mental fitness of troops became the decisive factor, the nation best able to mobilize and augment its resources would be victorious. He expressed the fervent hope that Rubner’s institute would provide Germany with the decisive advantage in the war, leading to its victory and its rightful “place in the sun.”85 A harbinger of the postwar cult of rationalization, Boruttau’s book situated the electrical treatment of war neuroses within a larger set of discourses and technologies of the nervous subject, which took as their aim the rationalization of human labor power in both peacetime and war. It rearticulated the thermodynamic basis of the social contract underpinning the German nation, now established on an emergency footing. If nervous breakdown represented a failure or inversion of the work ethic, then it was the experts’ task to reinscribe the principles of efficiency and discipline into the body, its muscles, and above all its nerves. It was logically consistent with this objective that the users of the Kaufmann method conceived of their work no longer simply in terms of restoring the soldier to health but in terms of recuperating his labor power. Like Mohr, Boruttau forged a connection between rehabilitation of body and mind and the subject’s ability to internalize and augment his own welfare and bodily efficiency. If Boruttau rejected the brutalization of sol-
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diers by electrical current, then he also envisioned a rigorous conditioning of the soldier according to the requirements of the “drill,” here given the full range of meanings that Klaus Theweleit has found in it. For Theweleit the term drill refers to techniques for producing the military subject, the subject who, like that described by Mohr, ultimately derives pleasure from his own disciplining.86 Coupling the cure with the restoration of military hierarchy in the form of shouted commands, the Kaufmann method sought to repair what Weber identified as the essence of discipline: “the consistently rationalized, methodically trained, exact execution of the received order.”87 Its widespread deployment anticipates the later reconfiguration of the war, in the writings of war veteran Ernst Jünger, in terms of a form of discipline that penetrated to “life’s finest nerve”: “Its realization is the task of total mobilization: an act which, as if through a single grasp of the control panel, conveys the extensively branched and densely veined power supply of modern life towards the great current of martial energy.”88 Total mobilization imposed on the soldier the binding obligation to become the manager of his bodily economy of forces, to take part in his own disciplining.
THE CRITIQUE OF ELECTROTHERAPY What would happen, however, if the drill went wrong, as was the case in the fatalities investigated by Boruttau? This was the problem facing German military medicine as the war entered its final phase and as the breakdown of morale in the ranks and opposition to the war’s prolongation led to conflicts between soldiers and officers. Doctor-patient interactions were affected by this breakdown as well. In the increasingly adversarial relations that marked the clinical setting, the disciplinary features of Kaufmannization became more and more pronounced, even as its therapeutic powers seemed to diminish. Doctors resorted to increasingly coercive methods of treatment to get patients back to work. Stier, as we have seen, advocated humiliation— shaming the patient as a means of curing him—or throwing especially hard cases into lunatic asylums in order to frighten them into giving up their symptoms.89 In an effort to break the will of his most obstinate patients, Kozlowski turned the therapeutic scene into a virtual spectacle. He dismissed his patients’ screams as faked, and as we saw earlier, employed deception to unmask the malingerer: “Actually I was grateful for the exaggerated behavior and the excessively loud screams of those un-
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dergoing electrical treatment, by which they used to give the illusion of suffering allegedly great pains; and I preferred it when the malingerer, on being touched with the brush, raised a fearful howl of pain, although the current had been cut off without his knowledge, so that he could not be feeling anything.” Far from seeing these screams as evidence of a self in distress, he reported that they had a therapeutic effect on other patients whom he had ordered “to watch the faradization at close quarters,” so that “quite suddenly many lame men began at once to walk steadily.” At the same time, “the malingerer, on receiving the treatment, was at once unmasked.”90 By the war’s end, according to some estimates, malingering, which had at first been relatively rare, had become a mass phenomenon.91 Dismayed by the extent of the problem, German doctors abandoned earlier scruples in their dealings with soldiers. The result was that, among soldiers, psychiatrists came to be seen as “pension squeezers,” interested only in squashing their patients’ psychological disability claims, and the Kaufmann method came to be seen as a form of torture.92 This led, in the war’s latter stages, to conflicts in the army’s nerve stations, resistance on the part of patients, and debate in the War Ministry and the Reichstag.93 Popular representations of psychiatrists in the postwar era frequently depicted them as sadists doing the bidding of officers by inflicting strong electrical current on soldiers.94 Mounting concern over troop morale and the public image of military psychiatry finally prompted the War Ministry, in 1917, to impose tight restrictions on the use of electrical current.95 In a handful of cases, commissions were appointed to investigate charges of physical and psychological abuse of patients. Kozlowski, who worked during the war as an assistant to the director of the Viennese Psychiatric Clinic, Julius Wagner-Jauregg, was at the center of one of these cases, which has become well-known because of Sigmund Freud’s participation in the trial as expert witness. Kozlowski, as we have seen, was accused by his former patient Kauders of using electric current as a form of torture. Kauders was an Austrian citizen who resided in Berlin at the outset of the war. Soon after being drafted into military service, he suffered a serious injury that left him unconscious. His initial diagnosis of neurasthenia had subsequently been changed to hysteria. He had been shuttled around from one clinic to another, passing briefly through Haus Schönow, outside Berlin, before winding up at Wagner-Jauregg’s clinic in Vienna, where he was subjected to the electrical treatment that prompted him to bring his case to the attention of the authorities.
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In his letter to the commission, Kozlowski defended himself vigorously. He described the situation in the clinic in the darkest of terms, depicting it as overrun by “hysterics and malingerers,” and his own actions as little short of heroic. By means of suggestive electrotherapy, he boasted, he had “unmasked a whole host of hysterics and Army dodgers.”96 Freud’s testimony in this case dwelled on the profoundly contradictory position in which doctors had been placed by their service to the state. Freud described the decision to employ suggestive electrotherapy in the following terms: It seemed expedient to treat the neurotic as a malingerer and to disregard the psychological distinction between conscious and unconscious intentions, although he was known not to be a malingerer. . . . Just as he had fled from the war into illness, means were now adopted which compelled him to flee back from illness into health, that is to say, into fitness for active service. For this purpose, painful electric treatment was employed, and with success.
Despite its apparent success, however, this procedure, he continued, “bore a stigma from the first” insofar as it primarily aimed not at the patient’s recovery but at restoring his fitness for service. This entangled the doctor in an irreconcilable “conflict between the claims of humanity . . . and the demands of a national war.”97 Freud concluded by contrasting the methods of psychoanalysis with those of suggestive electricity. Claiming that he was “in a position to bring forth conclusive evidence of the final breakdown of the electrical treatment of the war neuroses,” he cited the work of Ernst Simmel, a Berlin neurologist whose success with the talking cure had led to discussions in German military circles regarding the feasibility of opening clinics specializing in the psychoanalytic treatment of war neuroses. With some regret, Freud reported that the end of the war had put an end to this plan.98 The potential consequences of this breakdown of the electrical treatment of the war neuroses are echoed in a famous contemporary clinical description. Its provenance makes it doubly relevant, since it was authored by a figure who worked with both Wagner-Jauregg and Freud, namely, Viktor Tausk, who delivered his paper “On the Origin of the Influencing Machine in Schizophrenia” to the Vienna Psychoanalytic Society in January 1918. Tausk served during the war as a military psychiatrist, and though his paper does not explicitly refer to the Kaufmann method, there is every reason to believe that he had observed its use first hand.99 The paper described a type of persecutory delusion Tausk had
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encountered among schizophrenic patients. The influencing machine, he wrote, was “a machine of mystical nature . . . [consisting] of boxes, cranks, levers, wheels, buttons, wires, batteries and the like.”100 Tausk’s patients attributed “marvelous powers” to this machine: it made them “see pictures” and experience sexual emissions. The machine—sometimes called a suggestion apparatus—was usually operated by a physician and exercised its influence by means of electricity or suggestion. This type of persecutory delusion, common in schizophrenia, bore only an indirect relation to war neurosis. Yet Tausk was among a growing number of doctors who argued, on the basis of their work with war neurotics, that the difference between neurosis and psychosis was one of degree and not of kind.101 During the 1920s, as many doctors noted, wartime neuroses often turned into psychoses.102 What Tausk’s account draws attention to is the possibility of the cure going wrong, of discipline becoming traumatic: the possibility that the machines operated by doctors can, under certain circumstances, take on persecutory features and become a part of the disease picture itself.
MEDICAL AUTHORITY, CLASS WAR, AND PENSION PSYCHOSIS Looked at in this light, the breakdown of the electrical treatment of the war neuroses to which Freud referred meant more than simply the failure of a particular method of treatment. It meant the collapse of an entire system for processing and rehabilitating psychiatric casualties for wartime service, along with the hierarchical and authoritarian relationships on which that system was predicated. Freud himself was in no doubt as to the meaning of this.103 “With the end of the war,” Freud noted at the end of his memorandum, “the war neurotics, too, had disappeared—a final but impressive proof of the psychical causation of their illnesses.” Indeed, the dramatic disappearance of the neuroses of war in its immediate aftermath, during the outbreak of revolutionary fervor that gripped the defeated nation, was likened by one commentator to the “greatest Kauffmannization of the mind without current.”104 Yet Freud’s optimism proved premature: the war neurotics’ disappearance from the scene was only temporary; the outlet they found in the political revolution turned out to be short-lived, and the 1920s would be marked by relapses on a grand scale. The uncanny figure of the Zitterer would haunt the streets of Berlin throughout this era, as bitter conflicts were waged over the issues of psychological disability pensions.
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Many psychiatrists, indeed, perceived the events of the revolution themselves in terms of an outbreak of mass psychosis. Linking nervous and political breakdown, they fashioned a version of the stab-in-theback legend that pitted hysterics, psychopaths, and malingerers against the empire’s political, military, and scientific establishment.105 One doctor reported that the Nervenlazarett in Berlin-Schöneberg had been besieged and overrun by both war and revolution hysterics.106 The scenes of disorder on the streets of Berlin prompted Karl Bonhoeffer to observe that the revolutionary government represented not the dictatorship of the proletariat but the “dictatorship of the psychopaths.”107 And for many of his psychiatric colleagues, who found themselves the object of personal attacks and public recrimination, the revolution exposed frightening divisions in German society. In the deepest sense the breakdown of the electrical treatment of the war neuroses, along with the entire apparatus of military hierarchy and discipline, also exposed the consequences of the breakdown of the social contract built around traumatic neurosis. In the Weimar period—to paraphrase Joanna Bourke, writing about English soldiers—men perceived as shirkers were deemed not worthy of active membership in the wider body politic.108 Some doctors reacted to revolution and to their drastic loss of prestige by drawing ominous conclusions. Already radicalized by the war, the revolution and its aftermath drove many doctors permanently into the camp of political reaction. The distaste for dealing with war neurotics became coupled with an intensifying reaction against social insurance and its alleged “negative selection” of the weak. Alfred Hoche advocated the use of euthanasia on those whose congenital defects made them “unworthy of life.”109 On the basis of his wartime experiences, Ewald Stier would begin considering the measures that ultimately led him, in the mid-1930s, to propose interning the mentally ill in concentration camps.110 The “mass experiment” of the war, in his eyes, had exposed fundamental divisions between the “healthy and valuable” part of the population and those who believed physical and mental exertion could produce mental illness and lasting damage to mental health and capacity for work.111 Unfortunately, he went on, “[t]he postwar Social Democratic state possessed neither the strength nor the will to oppose illegitimate pension claims forcefully.” Even later, he continued, as scientific experts began to oppose the granting of psychological disability claims more forcefully, Germany’s leaders abandoned the fundamental basis of the pension system—the demonstration of causal connection between trauma and disability—and made the concept of temporal relation ade-
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quate for a psychological disability claim. The economic and moral consequences had been debilitating for the nation.112
FROM WAR NEUROSIS TO PENSION PSYCHOSIS At war’s end Max Weber reiterated his dire prognosis concerning the increasing bureaucratization of everyday life, warning of the dangers of a future society of civil servants (Beamtengesellschaft).113 This prognosis became part of the fierce postwar battles surrounding the war neurosis issue, as doctors and patients reacted to the new social landscape forged by war and its aftermath.114 Even after changes in the law were made in 1926—of which more in the next chapter—the tangle of issues surrounding military service, psychological trauma, and disability claims continued to plague psychiatrists. According to Stier, nearly half of all pensioned vets claimed that they suffered from some sort of nervous ailment.115 Though not all of these men claimed pensions solely on the basis of their nervous maladies, when one considers that pension payments consumed nearly one-third of the Weimar government’s entire budget during a period of chronic economic instability, it becomes clear that the issue loomed large.116 Patients claiming pensions found themselves caught up in an often Kafkaesque ordeal; the endless examinations, reexaminations, reversals, and pension adjustments often led to the worsening of their condition and to growing disenchantment with the pension bureaucracy. Many claimed that their treatment replicated the psychological violence they experienced at the front.117 For their part psychiatrists fought the granting of pensions with growing determination, while becoming increasingly critical of the overbureaucratization of the pension-claims system.118 By the end of the 1920s, figures on both sides were referring to the situation in terms of a “pension war.” The “unhappy history” of Germany’s administration of war-related pensions, as Bessel calls it, greatly weakened the fabric of a society that had only slender reserves of loyalty to draw on.119 Everyday welfare practice contributed significantly to the destabilization of the Weimar system.120 It is against this backdrop that we return to the case history with which we began. The case of Franz M., evaluated at the Charité in 1925 by Bonhoeffer’s assistant Dr. Kraft, encapsulates many of the themes explored in this chapter. During his four-year military service, M. had been hospitalized several times for a number of ailments.121 During one of the campaigns of the summer of 1915, he had suffered a “nervous shock” following which he remained for close to a month in a convalescence
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home. A subsequent period of hospitalization brought him first to a Lazarett in Buch, outside of Berlin, and then to Haus Schönow in BerlinZehlendorf.122 Here he was submitted for “observation of his mental state.” Intelligence tests elicited some peculiar answers; he referred, for example, to a flashlight as a “laterna magica.”123 At Haus Schönow, M. received treatment with electricity and worked in the garden. Following his release from service at the end of the war, M. returned to his home in the Magdeburg area and applied for a pension, claiming that he was unable to continue in his former profession as steelworker because of his wartime injuries. A pension was awarded, though at a much lower level than the one he felt entitled to, and he submitted another claim in 1921. While his earlier claim had been based on the lingering effects of a hernia and a detached cornea suffered during the war, this time he added details concerning his nervous troubles: “My nervous disorder is the result of a nervous shock, which I suffered on July 3, 1915, with the Reserve Field Artillery Column 64.” M. complained that part of the skull felt as though it was “pressing up against his nose”; he suffered from “colossal headaches” and was easily agitated, especially during the examination. Medical examination revealed nothing unusual beyond “small testicles, feminine type, and a tendency toward corpulence.” His application was turned down and his pension remained fixed at the original level. Two years later, in 1923, M. was informed that as a result of a change in the law his pension would be paid off in the form of a capital settlement. Deeply unhappy with this decision, he wrote a letter to the pension board, casting his situation in starkly political terms: “You think that you can just dictate and I will dance. Dictatorship has always been fought in the Prussian Republic and I will now fight your decision too. I am not happy with such a pittance, I give notice of my intent to appeal and regard the M. 600,000 as a partial payment.” Perhaps as a result of this setback, M.’s condition worsened. He was again hospitalized the following year, this time suffering from acute agitation and persecutory delusions. The examining doctor noted that the patient now showed a tendency to “flight of ideas” tinged with violence: “A prewar accident suffered at the Krupp steelworks had had political causes. He was a German national and was being harassed. . . . He felt that if he had remained in Altenweddingen, blood would have flowed in streams.” Hallucinations followed: M. reported that he “felt electricity in bed”; he also “felt the influence of the doctor’s ‘suggestions,’ which now held him by force”; he believed that the doctor spent the night in
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the cellar and from there influenced him by means of electricity and suggestion. At one point he lost consciousness, which aroused the suspicion of epilepsy, though his doctor rejected this diagnosis. A lengthy statement by the patient revealed that he was “sexually crippled” and considered himself lucky that his wife had not left him yet. He also stated that whereas prior to the war he’d been a machine minder, he was now reduced to tending oxen. Following a several-month stay, during which his condition gradually improved, M. was released. The court in Magdeburg determined that, while hysterical in nature, M.’s complaint had nothing to do with his military service and was instead rooted in a psychopathic constitution. Once again M. appealed, noting simply that he had entered the war as a healthy man and had been released at war’s end as a cripple. The patient was reexamined yet again, and this time was observed to be very mistrustful. “A few minutes after entering the examining room, he became uneasy, looked around and said: ‘Here we go again with the motor, with the electricity.’ ” M. was firm in his belief concerning the electrical effects on his body; he could not be convinced otherwise, stating that the doctor “could charge the entire room with electricity.” Further hallucinations were reported, including one of a frankly miraculous nature: “[H]ere the sun shines in the middle of the night, I have seen several signs in the sky, once in the morning while trying to plant some beans I saw a giant clear eye on the horizon.” Again the patient claimed to be under the influence of the doctor, who was transmitting ideas to his mind. The examining doctor was now convinced that M. was in the throes of a severe psychosis and that the earlier hysterical disease picture was now to be regarded as the earliest manifestation of this more serious illness. Given that a psychological disability pension had been granted on the basis of the earlier diagnosis of hysteria, the doctor felt that the patient was entitled to the continuation of this pension on the basis of this new and more serious diagnosis. M.’s case was finally submitted to the Charité for a final determination of whether the patient’s current condition could be traced to his military service. The Charité examination, conducted by a Dr. Kraft, reached far back into the patient’s medical past. From his family and childhood history emerged several salient facts. His father was a drinker, and his mother had always been easily agitated and irritable. The patient himself had stuttered as a child and had had difficulty in school; had been a heavy drinker; and had been prone to agitation and fighting. Nevertheless, there was no objective finding, though Kraft did note the small
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testicles and lack of well-developed other secondary sex characteristics. “When we survey the documents from the military period and from M.’s pension dispute, as well as the testimony in the case histories and the opinions, there can be no doubt that we are dealing with a psychopathic personality. . . . A product of this psychopathic constitution seems to have been the nervous shock of 3.7.1915.” A later accident, involving a fall from a wagon that had resulted in a minor injury, had been exploited by the patient in a fashion that was typical for such personalities, who seized upon the opportunity to escape the difficulties of life through a “flight into illness.” This made the determination of a war-related disability pension scientifically untenable. Concerning the patient’s persecution fantasies, Kraft offered the following explanation: Regarding the anxiety felt by M. in the Lazarett during the examination, and his explanation that it was “because of the electric current,” this is not difficult to understand with such a person in this situation—one thinks of the method of treating war neurotics with electric current, which is widely known among the soldiers—and the assumption of one of the experts that this was a case of true paranoia has . . . no basis.
If M.’s case seemed initially to fit the war neurosis disease picture, Kraft went on, it now bore all the marks of a full-blown case of pension neurosis. The obstinacy with which the patient clung to his claim was itself a typical symptom of the disease picture associated with this condition. Despite the apparent severity of M.’s condition, Kraft saw no reason to concur with the earlier opinion that he suffered from a true mental illness such as schizophrenia. All of the persecutory ideas, he wrote, could be seen as the psychological by-products of a pension neurosis, the willful creations of an inveterate malingerer, a man who during his time in the nerve station had doubtless had opportunity to observe and learn from truly mentally ill patients. This supposition, according to Kraft, was only strengthened by the patient’s behavior on entering the examination room, after an eight-month period during which he had been symptom-free, when he looked around and exclaimed, “Here we go again with the motor, with the electricity.” In conclusion, Kraft found M.’s claims that his illness was related to his military service implausible and held that his “abnormal reactions” were the product of an inborn psychopathic constitution. Neither his military service nor the accident he’d suffered could cause such reactions; at most they served as the scaffolding on which the psychopath hung his
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reactions. In the unlikely circumstance that schizophrenia were present, this too had no causal relation with his military service, since it was an endogenous illness, independent of external influences. On the basis of the scientific insights the war offered in this area, Kraft concluded that a causal relation between severe trauma and schizophrenia could definitely be ruled out: “Of course there can be no question of such a relation, neither with the ‘nervous shock’ of 1916, nor with the ‘nervous state of emergency’ of 1918 [at Haus Schönow], to say nothing of the ‘state of agitation’ in 1924.” This final passage illustrates a striking feature of this case history, which concerns the way that, in the doctor’s mind, its elements became interwoven with the trials of the German nation itself—even to the point of mistakenly dating the original shock to 1916 rather than to 1915. The correlation between the dates of the patient’s states of nervous emergency and those of the German nation’s greatest tribulations—the shift to total war in 1916, the revolution of 1918 (M. was released from Haus Schönow ten days before the November revolution), and the aftermath of the great inflation—illustrate how the discursive link between social and nervous breakdown imposed itself on the doctor’s retrospective reconstruction of the case history.124 It is not by chance—as Kraft himself points out—that the patient’s persecutory fantasies crystallized around his electrical treatment. Yet Kraft skims over this point in a way that elides the profound conflicts surrounding the method, merely remarking that the method was “widely known among the soldiers.” As we have seen, there was a great deal bound up in this method, both for psychiatrists—who invested their greatest hopes for a resolution to the problem of the war neuroses in it—and for soldiers, who by war’s end had come to see Kaufmannization as the very embodiment of an authoritarian and sadistic regime that treated soldiers as cannon fodder. If, for figures such as Mohr and Boruttau, the war necessitated a kind of training or “drill,” in which electrical current could be enlisted as a “pedagogical medium,” a means of helping the soldier-patient internalize the principles of performance and efficiency, the case of Franz M. illustrates the consequences of a failure of the drill. Here the cure itself assumed traumatic features that were grafted onto the original shock.
REPUBLIC OF ZITTERERS In 1918 Stier sketched the following picture of conditions in Berlin at war’s end:
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The sad and shocking (erschütternde) picture of the neurotic who goes about supporting himself on crutches and canes, stuttering, trembling and fidgeting, which one encounters everywhere now, has quickly led to the belief among our people that the supposed causes of these conditions, the “concussion” and the “nervous shock,” are the most fearful war injuries there are, and that these poor victims of the war are deserving of the highest degree of sympathy and assistance.125
For Stier and many of his colleagues, however, assistance—whether private or public—was not the solution; it merely worsened the problem, insofar as it encouraged the Kriegszitterer in his neurotic, sickly dependence on the welfare of others. Stier’s statement illustrates how the postwar discourse about the relation between psychological disability and social insurance revolved around this figure. By the early 1920s, the Berlin police were posting warnings about the Zitterer who populated the city’s street corners and subway stations, describing them as malingerers who pretended to suffer from the nervous trembling that marked the true war neurotic.126 According to one circular released by the Interior Ministry, the Gliederschütteler (literally, “limb tremblers”) who could be found on the capital’s major thoroughfares—Unter den Linden, Friedrichstrasse, and Tauentzienstrasse—not only created traffic holdups but contributed as well to a general sense of disorder.127 In the war’s immediate aftermath, by one account, so many of these men were in Berlin that they had overflowed the confines of the city’s main hospital, Buch, and taken to the streets, where at least initially they had awakened the undeserved pity of passersby. Now, however, their ability to simulate the nervous effects of grenade explosions and other battlefield experiences had been exposed, and with the posting of these warnings, many of these men had simply disappeared. The “mass epidemic had been cured.”128 The public campaign against war veterans and their maladies did not meet without resistance. Throughout the 1920s, patients such as Franz M. claiming war-related psychological disability relentlessly pressed their claims on Germany’s medical establishment and pension bureaucracy, necessitating endless examinations, reexaminations, and pension adjustments.129 With remarkable tenacity, they continued to articulate their claims on the state in the idiom of nerves, at a time when that idiom was being dismantled by the medical establishment. Among the wives of veterans, according to Karl Bonhoeffer, the connection between war and nervous illness was taken for granted long after psychiatrists had rejected any such connection.130 Such fallacies, he argued, were to be vigorously
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combated. Yet the views of Stier, Bonhoeffer, and their fellow doctors were contested throughout the 1920s by veterans’ organizations.131 Most prominent among these was the Reichsbund der Kriegsbeschädigten, a Social Democratic organization and Weimar’s largest war victims’ organization, representing the interests of war veterans and dependents with over six hundred thousand members. The Reichsbund’s position was spelled out in an article titled “Nerven!” which appeared in the July 1926 issue of its publication Der Reichsverband.132 Under an epigram that ironically echoed Kaiser Wilhelm II’s exhortation to the German people—“To the nation with the strongest nerves will go the victory”—the article reviewed the complex tangle of issues that were the legacy of a war explicitly fought under the sign of nerves. The direct impetus for the article was provided by a talk recently given by Ewald Stier to judges and members of the Reich Public Assistance Court. According to Stier and the majority of doctors, so the article ran, one did not need to look far for the causes of Germany’s defeat. It lay in the stigma of heredity and personal weakness, a judgment all too many soldiers had had the misfortune of hearing. Presenting themselves to doctors with nervous symptoms, they found that in the absence of any verifiable organic nervous injuries, the verdict was: “The man suffers from an inferior constitution; he is a psychopath, hereditarily burdened.” The article went on to review Stier’s opinions regarding the history of the traumatic neurosis construct, from its origins in industrial accidents to the current medical front against it. The nineteenthcentury view that neurosis originated in an accident or other traumatic occurrence had been replaced, among German medical elites, by a new conviction that it originated in the wish for a pension and in the pensionclaims process itself. “Hysteria,” so the article ran, “is possible only if a certain orientation of the will is present—to be taken for sick, to not have to work, to receive a pension, to be taken care of, to receive special consideration from others.” The article took issue with Stier’s assertions. It noted, among other things, that medical opinion was not as unified behind Stier’s position as he had led his audience to believe and that the claim that no accident neurosis existed before the passage of the social insurance laws was absurd. It also argued that Stier’s opinion was compromised by his tendentious, one-sided view of the evidence, which had led many organizations to reject him as an expert examiner. The article concluded by suggesting—as counterweight to Stier’s emphasis on pension neurosis—that German psychiatrists were themselves suffering from a “Gutachter-neurose.”133
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The intertwined issues of war-related psychological disability and accident neurosis would plague Weimar from its inception to its demise. The debate surrounding these issues crystallized around the disturbing Schreckbild of the Zitterer, in whose twitching body the shocks of industrialized warfare were inscribed. The Zitterer, as George Grosz wrote in his memoir of the Weimar period, was an essentially uncanny figure; it was difficult to tell whether he was real or fake.134 In peacetime, although the war veteran continued to loom large in this discourse, a new figure would emerge as central to the psychiatric attack on the laws that made traumatic neurosis a compensable illness. The Reichsverband article mentioned this figure in passing with a reference to a study of telephone operators that Stier had conducted in the mid-1920s. In the following chapter we turn to a different kind of influencing machine, the telephone system; to what Stier would refer to as the “army of civil servants” (Beamtenheere) that staffed it; and to the final chapter in the intertwined histories of nerves, electricity, and shock.135
FIVE
Psychiatrists, Telephone Operators, and Traumatic Neurosis, 1900–1926
I
n his history of the giant electrical firm founded by his father, Georg Siemens records the following incident. The installation of a new switchboard system in Berlin’s Lützowstrasse—Exchange Number 4, the biggest of its kind yet, with ten thousand subscribers—was interrupted one day in the summer of 1902 when the female operators succumbed to a collective nervous breakdown: Everything went well at first. But as the morning wore on and the hour of maximum traffic density approached . . . it became evident that the operators, not being familiar with the new apparatus, were unable to cope with the traffic. The calls piled up and the wrong connections multiplied, while the faulty cables occasioned crosstalk to add to the confusion. By about 11 o’clock some thousands of inherently nervous Berlin businessmen had become little short of raving mad, and the telephone operators had lost their heads. Suddenly one of the operators tore her ‘phone set from her head and fell into hysterics, an example which was infectious. A few minutes later, the room was a mass of screaming and howling women, some of whom jumped up from their seats and rushed out. In the midst of the tumult the Director of Telegraphs stood with arms raised to the heavens wailing: “My poor girls! My poor girls!”1
This scene of technological and nervous breakdown introduces us to a new variant of accident neurosis that entered medical consciousness 162
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around 1900. Following its first appearance in the medical literature, the so-called telephone accident and its consequences for the operator’s body and psyche developed into a major preoccupation of German medicine. For close to three decades, experts would grapple with the riddle of a syndrome whose defining feature was a profusion of symptoms combined with, as one doctor writing in the 1920s put it, “a complete absence of externally visible injury.”2 The turn-of-the-century construction of Germany’s large telephone exchanges gave these spaces an important place within the iconography of modern life. For contemporaries already obsessed with speed and complexity, exchanges seemed to suggest a future in which technology and the human body would become ever more closely fused into a single organism. But if Berlin was an experimental station for the future, it was also a laboratory for new forms of stress, affliction, and anxiety. By 1900 the German capital’s image as a site of shock and disorientation had imprinted itself deeply within medical and popular consciousness. This process of “inner urbanization” was greatly hastened by the spread of the telephone.3 In his memoir of his childhood in Berlin, Walter Benjamin described the telephone as “an infernal machine . . . shrilling from the darkness”; for the young boy, the corner of the hallway where it stood was a site emanating terror.4 Benjamin recalled the change his father underwent when using this uncanny “mediating agency.” Normally a courteous man, the telephone brought out an irritable quality in his father, who engaged in repeated altercations with operators. But if telephoning had unpleasant effects on callers’ behavior, it seemed to produce a genuine psychopathology among the female operators who staffed Germany’s exchanges. This new species of technological malady rapidly became a major topic of scientific discourse and inquiry. Medical and industrial experts, physiologists, and experimental psychologists weighed in on the subject of the so-called Fräulein von Amt, examining the effects of switchboard work on her body, senses, and psyche and exploring her sexual behavior, her attitudes toward marriage, and her leisure activities. Operators became emblematic figures of the German discourse on technological modernity and its discontents. But if, in the prewar era, this discourse identified neurotic operators as symbolic of the potential for technological crisis in modern life, in the aftermath of the Great War doctors recast operators’ maladies as symptomatic of another kind of pathology, one that was rooted in the failures of the modern bureaucratic social state.
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1900–1914: EARLY ACCOUNTS OF SWITCHBOARD NEUROSIS The employment of women at the switchboard paralleled their entry into new white-collar jobs in offices and department stores as part of the industrial restructuring and bureaucratization of the late nineteenth century.5 Because of health concerns and unease about conflicts between work and traditional gender roles, this process proceeded haltingly, but the rise and expansion of the telephone system in the 1890s brought women into the workforce in large numbers. By 1911, almost twenty thousand women—over 80 percent of them telephone or telegraph operators—were employed by the Reichspostministerium (RPM), the ministry that oversaw Germany’s communications system, making it second in size only to the Reichsbahn in terms of female employment. Aside from providing inexpensive labor, women operators were prized for their melodious voices and courteous behavior. The work itself was highly desirable, offering financial independence and social respectability to young, unmarried women or childless widows of the lower middle classes.6 Themselves often the daughters of civil servants, they became part of an expanding class of new white-collar female employees, with a moderate degree of education and a relatively privileged status vis-à-vis many other female workers. Controversy surrounding women’s employment persisted, however. Two issues in particular—the novelty and demands of switchboard work and the belief that women were less well-equipped to withstand these demands—framed the medical discourse about operators, which in other respects recapitulated much of the discourse surrounding the urneurotic of the nineteenth century, the railway accident victim.7 At the center of this discourse stood the problem of shock. As we have seen in earlier chapters, shock occupied a central place in the phenomenology of traumatic neurosis. In the case of operators, the electrical current with which switchboard work brought them into contact seemed to actualize the shock paradigm. The belief that women were more susceptible than men both to nervous disorders and to real or imagined “influences”— whether electrical, magnetic, or otherwise—strengthened the discursive link between nerves and electricity forming the imaginative kernel of the problem of switchboard neurosis. Well into the 1900s, doctors remained fascinated by electricity’s workings on the body in general and on women’s bodies in particular. The expansion of electrical industries in the 1890s soon stimulated medical inquiry into the phenomena surrounding accidents in these in-
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dustries. As Viennese physiologist Stefan Jellinek wrote in 1903 in his book Elektropathologie, the field of “electrical trauma” demanded rigorous scientific research insofar as it fell under the accident insurance laws.8 Jellinek defined electrical trauma as resulting from the “transfer of electricity to the body.” He regarded the theory of traumatic neurosis as inadequate; though not discounting the psychological effects of such trauma, he described these as secondary: “Breach of the human organism by the electrical current causes a violent psychological stimulus, even hyperstimulus (Überreiz), which exists in close relation to the shock effect.”9 Electrical charges, he went on, were registered by the nerves in the same way that they were registered by sensitive measuring instruments; indeed, the nervous system was “unquestionably the most sensitive reagens for electrical current.”10 Berlin neurologist and sexologist Albert Eulenburg extended Jellinek’s definition to include the indirect as well as the direct effects of electricity on the nervous system. Eulenburg compared the consequences of electrical accidents with those “of accident neuroses, the post-traumatic neuroses and hysteria in general.” Eulenburg’s patients tended to be young female telephone operators. Their symptoms were those of classic hysteria: hypersensitive hearing, dizziness, fearfulness, and local paralyses. Because most operators held the receiver to their left ear, symptoms tended to be localized on that side of the body: “The apparent localized nature of the sensory and motoric disturbances which are left behind . . . should be linked to the holding of the headpiece, and its rapid operation with the left hand, whereby circumscribed place [feelings] and muscle feelings are produced and the ideational groups associated with them are autosuggestively extended over a broad pathogenic area.”11 If one queried the operator what had happened, wrote neurologist Martin Bernhardt, one invariably received the following response: “I received an electric shock (Ich habe Strom bekommen).”12 This became the single most frequently cited line in the literature on telephone-related nervous trauma.13 What happened in the so-called telephone accident? What was the relationship between nervous and technological breakdown? Medical opinion on this question was divided into two camps: one emphasizing the occupational hazards associated with switchboard work; the other, a weakness or predisposition in the operator herself. In the first camp were those who viewed the psychological effects as secondary to the physical trauma, whether this was an electrical shock or a loud, earsplitting noise. The risk of accident in these early years of telephonics was
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not altogether imaginary. The lines were poorly insulated and during storms could become charged with atmospheric electricity. Another hazard was posed by the small cranks with which telephones were equipped. Impatient callers used these to gain the operator’s attention by sending a signal through the line. If the caller pressed it at the moment his call was being put through, the operator could receive a slight shock.14 A further oft-cited factor was general exhaustion. The intense yet monotonous nature of the work, which required answering up to 150 calls an hour for eight or more hours a day, wore down operators’ strength and left them vulnerable to mild shocks. In the second camp were those medical men who stressed factors only indirectly related to the work itself: shock construed as a purely psychological phenomenon; psychic contagion; or hereditary predisposition. Some experts described telephone exchanges as pervaded by a veritable fear of electricity, a kind of telephonophobia—analogous to siderodromophobia, or fear of trains—heightened by newspaper stories about lightning flashes, high-current injuries, and the electrocutions in the United States.15 This, according to Bernhardt, explained why outbreaks of hysteria, in which an operator’s fit spread through the workforce by means of suggestion and contagion, were so common: “If the atmosphere in the workplace was, if I may be allowed to so express myself, impregnated with fear; if one of the operators tore her telephone from her head and sank back pale and weak into her chair, this could trigger among the other women—who were perhaps already nervous and anxious girls to begin with—even with an insignificant disturbance . . . an outbreak of nervous anxiety.”16 As the RPM’s originally male workforce was supplemented or in some cases replaced entirely by female personnel, statistics on accident and illness rates mounted.17 One report produced by the RPM in 1901 showed that nervous ailments represented 17.9 percent of all illnesses among operators.18 Throughout the early 1900s the steady increase of such numbers fueled ongoing disputes between administration and personnel about the causes and financial implications of these disorders. The RPM’s authorities worried that the money saved on employing women would ultimately be lost in covering the costs of rest cures, while their doctors theorized that “female operators are much less resistant to the effects of electric current than men” and that “the female nervous system seems to be more sensitive than that of the male to the extraordinarily demanding telephone service.” Operators countered by arguing that the high statistics on illness among the female personnel were en-
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tirely due to the nerve-destroying demands of the work. In Reichstag debates about female employment, telephone operators, and references to the “nerve-shattering field of telephonics” figured prominently. One member of the Reichstag summed up the situation by saying simply, “Speaking by telephone causes nervousness.”19
SOCIAL INSURANCE AND THE PATHOGENESIS OF THE TELEPHONE ACCIDENT Despite the differences of opinion about switchboard neurosis, a combination of factors contributed to the legitimization of the disease picture surrounding it. Arguably the single most important element in the construction of this disease picture was accident insurance law itself. This law, as we have seen, compensated work-related neuroses within strictly defined limits. Entitlement to benefits was made contingent upon proof of direct causal connection to an accident, while long-term occupational hazards such as chronic overexertion were expressly exempted from coverage. This narrow definition of the compensable event helps to explain the form taken by the operator’s standard presenting complaint: “I have received an electric shock.” Stressing the singularity of a sudden accidental occurrence, this complaint—reiterated time and again in doctors’ examining rooms—became part of a clinical picture of nervous breakdown inextricably linked with a moment of technological breakdown: the so-called telephone accident. In 1901 a new law entitled RPM employees who had suffered an accident resulting in an inability to work a pension of up to two-thirds of their original salary.20 It further entitled them to rest cures paid for by the state and coverage of all medical treatment deemed necessary. Following the precedent established by the Reichsbahn, an extensive legal and medical infrastructure was set up to deal with the accident insurance claims filed by the RPM’s personnel. Administrative responsibility for this system was in the hands of the RPM, which hired the certifying physicians and processed claims. The process of filing a claim remained, for the most part, an internal one handled by the RPM’s medical experts (Postvertrauensärzte), though in difficult cases the opinion of a higher authority such as a university psychiatrist was sought. Not surprisingly, given the often bewildering profusion of symptoms in combination with the oft-noted “complete absence of externally visible injury,” such opinions were sought on a regular basis. By 1912, according to one estimate, claimants appealed one out of every three accident insurance decisions.21 One prominent figure in the discourse was Hans Kurella, professor at
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Breslau, a neurologist, criminologist, sexologist, and editor of a journal devoted to medical electricity, which he used as a forum for his view that electricity had a leading role to play in the “battle between medicine and neurasthenia.”22 Kurella viewed electrical workplace trauma as a form of experiment carried out on the living human body, and he devoted much space in his journal to the topic. Reviewing the findings of one expert examiner who had concluded that the concept of the telephone accident was a medical impossibility, Kurella dismissed them as compromised by the physician’s ties to the RPM. Working with documents he had received from the RPM, he surveyed a large number of case histories involving telephone operators.23 In most, Kurella found clear evidence of physiological trauma (Nervenreiz or Shock), though he did not rule out psychological trauma. This could take the form of either genuine fright or shock brought on by autosuggestion. He diagnosed one operator’s condition as the result of “fear” (Schreckwirkung) complicated by “electrical shock” (Shockwirkung).24 In another case, Kurella cited the operator’s exquisite sensitivity to all types of electricity as evidence of underlying pathology.25 He performed a delicate balancing act by both insisting on the organic nature of the illness and recommending a counterphobic course of treatment aimed at weakening the autosuggestive consequences of the accident. The role of predisposition, he explained, should be weighed against the demands of the work itself. Yet despite this evenhandedness, Kurella’s writings were marked by slippage in which responsibility for this species of technological malady could easily be located in the operator herself. In the end, he concluded, while the telephone in itself had no harmful consequences for a healthy ear, for an already unhealthy one it could have serious consequences.26 Such ambiguities contained the seeds of interminable legal battles. In the prewar literature, the case of the Berlin operator Klara W. stands out as particularly Kafkaesque. Beginning in 1893, when W. first suffered an accident, she became entangled within a chain of legal proceedings that dragged on for a period of twelve years. The first physician to examine her observed the following symptoms: “nervous irritation . . . loss of hearing in the left ear and loss of sense of smell in the left nostril, loss of sensitivity in the left eyelid, shrinking of the visual field in the left eye . . . lowering of the sense of feeling on the left side of the face, the neck and a part of the left upper arm.”27 The doctor concluded that Klara W. had sustained a genuine physical trauma. However, a second examining doctor in the employment of the RPM diagnosed her as a malingerer “fully capable of working.” After examinations by eight different physicians
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had failed to resolve W.’s claim for compensation, the eminent university psychiatrist Carl Wernicke was commissioned in 1905 by the Reich Supreme Court to issue a final opinion. A former student of Westphal’s, Wernicke’s opinion spelled out the differences between his views and those of the RPM’s medical experts. If predisposition existed, it was acquired, not hereditary, he argued: The nervous predisposition that in the opinion of the court counselor forms the precondition is in the present case by all appearances acquired through occupational activity. . . . [In my view] the injured areas on the scalp, the swelling of the left side of the tongue, the throat and the left arm . . . finally, the disturbed balance and the irregularity of the pulse make it much more likely that the electrical charge affected the nervous system itself. . . . In other words, the symptoms observed on W., partly transitory, partly permanent, make it likely that in addition to severe hysteria she suffers from the physical consequences of an electrical jolt.28
On the basis of Wernicke’s report, the court found in the patient’s favor, declaring her two-thirds unfit for work and setting her pension accordingly.
THE INSTITUTIONALIZATION OF TELEPHONE ACCIDENT NEUROSIS One by-product of Germany’s accident insurance legislation, as we have seen, was the creation of a network of institutions for convalescing employees. These were generally modeled on Haus Schönow, the sanatorium in Berlin-Zehlendorf, whose opening in 1899 had been attended by the head of the RPM, General Viktor von Podbielski. The first of many sanatoriums created by the RPM for its female workforce was located at Misdroy, on the Ostsee. This was a convalescent home for women afflicted with ailments ranging from anemia to writer’s cramp and nervous disorders. The first annual report released by the sanatorium in Misdroy in 1904 cited the following rationale for the institution’s creation: “Our era is especially rich in exhausted, overworked, and nervous individuals needing convalescence, not least among the female employees, who often have to exert themselves beyond their capacities in the constant worry over their existence.”29 As was the case with the Reichsbahn, the RPM also subcontracted its treatment needs to private sanatoriums. An arrangement between the RPM and a spa located at Bad Oeynhausen provided for board and medical treatment of sick and injured employees. Another such subcontract was concluded with the Birkenhof Sanatorium near Greiffenberg, advertised as a convalescence home for nervous invalids, alcoholics, and
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emotionally disturbed individuals, offering “[t]reatment of nervous illness according to modern principles (Möbius).”30 The response to such initiatives was positive. A memo sent from a local examining doctor to the Hamburg Oberpostdirektion (OPD) in 1901 reported that the results of employing convalescing patients at light jobs had been encouraging and predicted that this would accelerate the return of employees to the workforce.31 An article in one operators’ trade journal also welcomed the initiative while downplaying the significance of work therapy.32 In an era inscribed by the “stamp of nervousness,” the article ran, the lack of adequate facilities for convalescence had serious implications given that the “so-called nervous disturbances formed the recruitment material for more severe forms of mental illness.” Without proper treatment, mental illness, suicide, and enormous demands on the pension fund would be the inevitable result. The article cited Haus Schönow and Baden’s recently established state-run nerve clinic Rasemühle as an indication of better things to come. It concluded by predicting, not without a hint of pride, that the telegraph service would continue to supply a steady stream of patients. The creation of these state-run sanatoriums illustrates the existence of a compromise between administration and personnel. While disputes about wages, hours, and status persisted—female civil servants were not guaranteed lifetime employment until after the war—the law of 1901 granted recognition of the personnel’s right to health and yielded a number of concrete gains: a system of annual medical checkups, convalescent leaves, and nerve clinics in rural environments. Yet this compromise remained provisional. Demands for more funds for convalescence homes formed a source of friction between personnel and administration.33 As with the Reichsbahn’s personnel, this process of institutionalization seems to have led to a backlash against costs and the supposed incentives to malingering created by state benevolence.34 Among doctors, operators earned notoriety for their “querulousness.” As one expert put it, there were more malingerers among postal workers than among railway workers because “[p]ostal accident neurotics believed they could count on the Social Democrat–dominated Reichstag to put their ailments on the national agenda, whereas railway workers could not count on such support from the Social Democrats in the Landtag.”35 The relation between work and health was a focal point of operators’ early organizational efforts. In 1912 their regional associations unified under an umbrella organization, the Verband der deutschen Post- und Telegraphen beamtinnen, led by Else Kolshorn and Hedwig Rüdiger, di-
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rectors of the Berlin association.36 One of its main orders of business was to collect funds for new convalescence homes. In its publications, Der Fernsprecher and Unter der Reichsadler, the Verband also aired its demands for improved pay and benefits. Some articles stressed the need for solidarity in the face of the administration’s ever-intensifying demands; others exhorted the employees to find new ways of raising funds for convalescent institutions.37 The Verband also showered the administration with petitions for better working conditions, benefits, and pay increases, making the case that the statistics on illness among female personnel and “the well-known nerve-shattering nature of the demands placed on the operator” had an economic explanation and solution.38
MENTAL LABOR To make sense of the subsequent course of debates about operators’ nervous illnesses, let us look more deeply into some of the discursive elements shaping both their consciousness of themselves as a group and the terms in which they framed their claims on the authorities. An article published in one trade journal in 1902 offers a glimpse into the personnel’s beliefs concerning the demands of their work and the benefits to which it entitled them. The article referred to a study commissioned by the RPM canvassing the opinions of its medical experts. The study had concluded that employment in the telephone service posed no threat to a healthy operator but that it could easily cause nervousness among less robust women. This conclusion, the article observed, reversed the true state of affairs in the telephone service: “What overexertion of all mental faculties is required of a telephone operator! Speaking, listening, connecting, in rapid, unceasing succession the operator carries out her task, completely exhausted by the time she leaves the office, in search of rest after the strain. Sleeplessness, or hearing telephone voices during her sleep—these are the first signs of severe nervousness.”39 Their special affinity for nervous breakdown, noted by experts such as Krafft-Ebing, was a mark of their status as a new class of “brain workers.”40 Another article put this into further perspective by suggesting a relationship of hierarchy between the railways and the telegraph lines. The author described the telegraph as the “soul” of the entire railway system and thus, by implication, of the nation as a whole.41 Such formulations suggest that this new class of white-collar employees was marked by a consciousness of itself as a special group, loyal to the state and for that very reason insistent upon the rights that the state’s
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social policies guaranteed them. They enjoyed entitlements that most female laborers, who worked on a temporary basis, did not. This sense of themselves as part of the “new middle class,” a special category of salaried worker with legal privileges in the areas of insurance and labor rights, would eventually be recognized in the Angestelltenversicherungsgesetz passed in 1911. This law defined them as a higher stratum in relation to the working class, serving as a “buffer” against socialism, and gave their identity as “mental laborers” a class dimension.42 Though this status remained, as we shall see, highly circumscribed, it nevertheless afforded telephone operators certain privileges—particularly in the area of welfare—that they clung to jealously. Mental labor, according to an article in Der Fernsprecher, took its toll on the employee’s nervous system and necessitated a new regard for the “hygiene of mental labor,” which included, among other prescriptions, avoidance of politics, which only “agitated the soul.”43 Referring to the inevitable disturbances associated with this new branch of work, another article rejected the attempt to psychologize them by identifying them with the “old complaint” hysteria.44 Yet another article wove the motifs of mental work and the operators’ nervous ailments together with their function as a “buffer.” It described the process of connecting a call as one involving the interaction of three “nerve bundles”—the caller, the operator, and the called—and argued that, given the inherent difficulties of this task, the nervous disorders of the female personnel of the telephone exchange, “that eternal buffer state,” were easily understandable.45 The tenacity and success with which operators articulated their claims on the state suggests that the disease picture surrounding the telephone accident, as a coded form of workplace protest, spoke to deep anxieties in German society about the conditions of the modern workplace and about the effects of rationalization on all parts of social life. Evidence of the ways in which rationalization was shaping conceptions of the self emerges in one of the central images of the discourse about operators. An article published in the same journal in 1905 provides another revealing glimpse into the collective psychology of this new class of mental laborers, or brain workers.46 According to the author, the employees of the telegraph exchange worked under conditions that posed a constant threat to their well-being. The noise in such exchanges, wrote the author, was frightful; the danger of “nervous overstimulation and nervous collapse,” ever present. But this in itself was no different from the conditions facing employees in other branches of transportation. The unique feature of the telegraph exchange was the threat not just of illnesses of
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the peripheral nervous system but of deeper disturbances: “derangement of important motor-nerve fibers,” “paralyses,” and “functional disturbances of the sensory organs and the brain.” The causes, the author went on to say, were the “stray currents” with which the air in the telegraph exchange was “impregnated” and which exercised a “magnetic influence” over everything in the room. Those with strong nervous constitutions might be able to withstand this influence, but weaker individuals would rapidly succumb: It has been scientifically proven—Du Bois-Reymond, who died 10 years ago, performed path-breaking investigations in this field—that electric currents circulate in our nerves, probably produced by chemical processes taking place in the body’s interior. One can easily imagine that by means of a strong overcharge of the nerves with electricity, entering the body from outside, functional disturbances or even chronic overstimulation and overburdening, ending in loss of feeling, may result.
The author proceeded to draw an analogy between “overloaded nerves” and electric wires and then, anticipating objections, posed the following rhetorical question: It will be asked: “What do nerves have to do with conducting lines?” The nerves are clearly no conducting lines, nevertheless there is a close connection between the two. Our tools, apparatus and transportation technology are nothing other than unconscious representations and imitations of our bodily organs and bodily equipment. . . . The telegraph wire is a copy of the nerve fiber and the nervous system. What holds true for one must therefore hold true for another.
Given this kinship, it was only natural, concluded the author, to assume that excessively strong current could bring about failure in the one just as in the other. Technological and nervous breakdowns were, indeed, intimately linked. At the heart of this disease picture and the operators’ claims, there existed a complex discursive relationship between nerves, wires, and electricity. In classic hysterical form, operators were materializing or literalizing a specific metaphoric construct.47 Their disorders referred to one of the master tropes of nineteenth-century psychology: namely, the analogy of the nervous system to a telegraph or telephone system. By the turn of the century, when operators first began attracting medical attention, this analogy had a lengthy history behind it extending back to midcentury physiologists such as Helmholtz. Linked with a set of practices and technical resources, it became emblematic of a new style of materialist thought that explained organic functions in terms of electrical and chem-
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ical processes.48 This model also helped to enshrine a vision of the body as a thermodynamic system or dynamo, whose labor power it became one of the key projects of modern society to unlock. It thus formed part of a distinctively modern discursive system that helped to establish the very possibility of a scientific psychology. It is not by chance that Carl Wernicke, the psychiatrist whose examination resulted in the awarding of benefits to Klara W., subscribed to this model. In his widely read psychiatric textbook, Wernicke described sensory-motor units as traveling along so-called association fibers within the brain and nervous system, like electrical pulses along a telegraph line.49 This analogy also found its way into and became encoded within more popular versions of the discourse of scientific psychology. As the following example taken from an article in Der Fernsprecher suggests, the switchboard functioned as a model for a popular theory of the nervous system’s role in mediating the operations of the mind and the body: “As in a telephone station all lines are unified and a connection between two speakers must go via the station, so everything in the human organism . . . goes through the brain. All movements are dependent on the normal function of the brain and naturally, of course, on the normal function of telegraph wires and nerves.”50 A sampling of the articles in these journals suggests that the notion of a connection between nerves and electrical wires had permeated the operators’ collective consciousness. These women, who were acutely aware of their modernity and of the place of nerves within the new economy of mental labor, had internalized this imagery as part of their own self-representation as members of Germany’s industrial vanguard. They believed they were plugged directly into the apparatus they operated and that their nervous systems shared the same structure and mode of functioning as this machinery. In support of their belief in the essential identity between electrical and nervous systems, they adopted a form of popular Helmholtzianism, invoking the great physiologist and his colleague Du Bois-Reymond as authorities. But, as analogy for the nervous system, the telegraph system— with all its connotations of progress—was here implicated in a darker vision of modernity. In appropriating this language, operators wedded it to their own sense of being uniquely at risk, virtually programmed for nervous breakdown. Yet even while such images were imprinting themselves on the operators’ minds, they were being abandoned by many leading medical practitioners and psychologists. By the turn of the century, specialists in these fields were turning to a new, less materialist paradigm, one that rejected
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the nineteenth-century body-machine for an ostensibly more humanistic vision of the “whole person” and recuperated terms such as will and soul. The protest that the science of the soul had been degraded into a purely mechanical form of expertise was widespread by 1900.51 Drawing on the thought of Bergson and Nietzsche, the fin-de-siècle intellectual reaction against materialism sought to restore “life” and the “will” to their proper place within the sciences of man.52 The debate over accident neurosis thus became caught up in what Karl Jaspers called the conflict between mechanistic and anthropological worldviews. As we shall see, the resulting paradigm shift would play a crucial role in the recasting of accident neurosis as a disease not of work but of personal weakness.
SWITCHBOARDS AS SEXUALIZED SPACES Another of the persistent motifs within this medical story centered on the “sexual question.” Here we encounter remnants of earlier discourses on hysteria. Although the old uterine theory of the origins of hysteria had been superseded by a new neurological paradigm, it remained to some extent latent within the new model. The genital conception of hysteria, which envisioned overstimulation radiating by means of reflex action across the nervous system, lent itself readily to the telegraph analogy we have just been considering.53 The belief in the weakness of the female nervous system that was enshrined in medical texts of the late nineteenth century rested on the idea that the female body was less resistant to internal and external stimuli. It is no coincidence that many of the medical figures who took an interest in telephone operators—Kurella, Eulenberg, Bernhardt—combined expertise in neurology, electrotherapy, gynecology, and sexology. Eulenburg, for instance, was deeply interested in the connection between neurosis and female sexual disorders, as was Kurella, who noted, among other things, that some “accidents” seemed to coincide with the operator’s period.54 Conservative physicians such as Berlin gynecologist Ernst Bumm worried that women who overtaxed their brain would damage their reproductive organs.55 The most sustained effort to put the connection between operators’ nervous and sexual disorders on a scientific footing was that of industrial expert H. L. Eisenstadt. He used data collected by the Verband mittlerer Reichspost und Telegraphenbeamten to construct a statistical study of the health problems in the Reichspost. Eisenstadt, who classified all employees of the RPM as mental laborers, wrote that such work frequently led to “mental overburdening” and from there to “high-grade nervous-
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ness.” It was no surprise that nervous illness was rampant, he wrote: “Nervousness has increased so much among the personnel of the Reichspost that it can almost be described as a specifically postal illness.”56 Yet Eisenstadt then proceeded to throw into doubt the assumption of a causal connection between illness and work per se. The high rates of nervous illness found among these women, he wrote, were better interpreted as symptoms of “social degeneration.” It was not intensified mental labor (or living in cities, another frequently cited cause) that lay at the root of nervousness; rather, the causes lay in alcoholism and sexual pathology. Eisenstadt cited Alfred Grotjahn, Albert Moll, and Sigmund Freud as the most important authorities in this new branch of “social pathology,” also mentioning the work of the Berlin Society for Sexual Science and Eugenics.57 Basing his analysis on the work of these figures, Eisenstadt argued that the assumption of a direct causal connection between work and illness was generally wrong. A far more significant role was played by sexual disorders. He speculated that the inability of this new class of mental laborer “to sublimate her sexual impulses into appropriate channels” had unfortunate consequences for her psychic well-being. Unlike teachers, for instance, the work of the postal employee meant exposure to “ongoing excitations.” The difference between the two, he theorized, could be compared to the difference between a railway passenger gazing out the window and a locomotive driver. The result was a form of “psychic castration,” or disturbance of the sexual drive. So-called traumatic castration was invariably connected with sexual neurasthenia. Eisenstadt’s gloomy conclusion: “Mental work can only flourish on the steely health of the soul, which is being made impossible through modern sexual pathology.”58 Gender also became linked to the perceived problem of psychic contagion. As one doctor who had been called in to offer an opinion on the condition of a hysterical operator warned, such cases could not be judged on their individual merits: There is a danger that the S. case, which is discussed by all of her former fellow employees, will become the accepted thing. A similar case has already developed with operator B., an acquaintance of S.’s. On this occasion the doctor voiced the suspicion that the illness of B.—who had demonstrated symptoms of nervousness for many years—had arisen through induction [i.e., contagion]. One sees this often with hysterics. He mentions this so that the two cases don’t become the accepted thing and set off an epidemic among the nervously overstrained operators.59
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The convergence of electricity, hysteria, and psychic contagion in such formulations suggests an effort to conceptualize the dynamics of the exchange in terms borrowed from the realm of crowd psychology.60
THE CRITIQUE OF SOCIAL INSURANCE The factors enumerated above—the epistemic shift within turn-of-thecentury medicine, the growing prominence of sexological and epidemiological discourses, the mounting statistics on illness—led to a gradual readjustment of the RPM’s attitude toward its personnel’s welfare. Underlying this shift were concerns about the drain on its budget and doubts about the effectiveness of traditional methods of treatment. The RPM’s doctors began to argue that the usual response (a stay at a rural clinic) was not merely pointless but counterproductive.61 Lengthy courses of treatment simply inculcated within the operator a consciousness of herself as ill. The true pathogen, according to the most outspoken of the RPM’s expert examiners, was the insurance claim process itself. A production-line examination milieu had turned the act of presenting one’s complaint— “Ich habe Strom bekommen”—into a standardized procedure. Patients had become all too aware that producing an event—that is, an accident—was a precondition to moving on to the next phase of their legal proceeding. Meanwhile, overworked physicians struggled to force patients’ experience into a model in regard to which there was little consensus. If patients’ petitions for a pension were denied or granted only at a certain percentage of their full salary, they often requested a new examination or tried to submit a second opinion alongside that of the original examining doctor. The RPM and its regional offices, or Oberpostdirektionen (OPDs), did their best to block these endless maneuverings. In one such case an operator’s request for a second opinion was rejected with the following rationale: “In the view of the OPD, under the present circumstances there is no reason for a second medical examination paid for by the state. Further concession to the wishes of J. also seems—apart from the costs—undesirable insofar as the number of workplace accidents in the local telephone exchanges has risen conspicuously. In the last three years, among 56 female employees there have been 18 accidents.”62 Acquiescing to such requests was seen as lending the pathology undeserved legitimacy. The desire for repeated examinations, lengthy stays in sanatoriums, or early retirement with a pension was, it was argued, a symptom of malingering and pension neurosis.
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Armed with statistics about high rates of employee turnover, accidents, and malingering, policy makers, industrial experts, and doctors all weighed in on the crisis of “nerves” within Germany’s telephone industry. By the end of the first decade of the century, the RPM’s medical experts began to advocate a new program of medical screening whose guiding assumption was that the hysterical operator was not the victim of an accident or overwork but of an overwrought nervous system bearing the imprint of suggestion, hereditary predisposition, or sexual pathology. This conclusion was already anticipated in a memo sent from the RPM to the Berlin OPD in 1904, which recommended shortening the trial period for employees from three years to one: “Discharge of operators who, on the basis of examination, are determined to be not adequately robust after such a long trial period, would lead to enormous demands on the Reich budget.”63 The memo further stressed the need for obtaining reliable information about the presence of hereditary predisposition. Another memo sent from the RPM to the Berlin OPD in 1905 reiterated the need for such measures, painting a dire picture of the situation among the personnel: “The average annual number of sick days among the telegraph operators continues to rise. The corresponding increase of service costs and the necessity of early retirement, as well as consideration for the personnel themselves, necessitate the earnest consideration of remedial measures.”64 The memo advised thorough medical examination to screen applicants for anemia, hysteria, nervousness, or other hereditary weakness. It concluded with the following recommendation: “The personal files gathered by the OPD . . . are to be sent to the [examining] doctor, along with comments by the head of the department and the supervisory staff concerning perceptions of any signs of nervousness, hysteria, frequent poor appearance, loss of weight, loss of attention in performing duty, lowered resistance against sudden loud noises, currents, light electrical charges, and so on.”
SURVEILLANCE Telephone exchanges were one of the first outposts for the new forms of workplace organization imported from the United States under the name “scientific management.” Coordinating the rapid and precise actions of hundreds of operators to avoid interruption or breakdown of service was a feat that demanded absolute concentration on the part of the employees. By 1910, exchanges had become minutely regulated and thoroughly rationalized spaces, and the degree of supervision exercised over per-
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sonnel was unparalleled in any other branch of industry.65 Under constant pressure to improve service, the directors of Berlin’s biggest exchanges continually experimented with new methods of surveillance. Operators’ speed in answering calls was timed and monitored, as were their interactions with callers. On 2 October 1911 the Berliner Lokaler Anzeiger reported the existence of a new secret monitoring system in the Berlin telephone network: As of today a new device has been introduced into the telephone system, which is intended to subject the operation of the telephone exchanges to ongoing secret surveillance. . . . The monitors can tune into the telephone themselves and are in a position to hear everything that the operator says, naturally also what the caller says to her. Everything, even the slightest offense, every impoliteness on the part of the operator, bad connections . . . and so on, will be noticed by the monitor, and daily comments will be made on the records and sent to the relevant telephone offices and the OPD, on the basis of which steps will be taken against those responsible.66
Another local paper reported further details about this new system, which employed a modified galvanoscope. This contrivance enabled the monitor to time the operator’s speed in answering incoming phone calls: “[W]ith the monitor all electrical processes in the individual connections—the call, the answer, the connection, the link to the desired party, the coupling of the telephone with two linked parties, the signal of one of the parties—can be observed.”67 Several Reichstag members protested this heightening of workplace discipline: “This form of monitoring seems to be an overreaction. It is already an irritating and fatiguing job, to sit for hours so to speak ‘under the microphone.’ ”68 But the remorseless demand for efficiency, combined with concerns about operators’ moral and mental well-being, kept up the pressure for new techniques of measuring performance.69 By 1914, implementation of new safety measures had lessened the risk of accident per se. Yet pressure to improve service within the nation’s communications system continued to mount steadily, as did the incidence of sick days. The unremitting sense of pressure created by the RPM’s efficiency drive also affected doctor-patient relations. In many of the archived case histories from this period, the insurance proceeding itself figures as the pathogenic agent. This is illustrated by the case of the telephone operator Theodora F., whose medical files were sent to Berlin to be evaluated by the RPM, which was growing increasingly sensitive to complaints regarding its doctors. In 1911 Fräulein F. had suffered an accident in which she had received an “electric shock in the left ear.” She
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was unable to work for almost two months. Six months after returning to her job, a second accident had followed, described as “crackling in the receiver as a result of atmospheric electricity.” As a result of this second “nervous shock,” F. entered the Sanatorium Rasemühle, in the Rhineland, where she stayed for over two months. Her diagnosis was “general nervous exhaustion of a hysterical character resulting from accident.” In 1913, a new opinion was commissioned. By this time, the strain of repeated examination had begun to tell on the patient; she reportedly burst into tears at the beginning of her meeting with the RPM’s expert and was inconsolable throughout the examination. The examiner determined that she was unfit for work; her pension was set at 50 percent of her salary. F. immediately appealed this as too low. At this point she was submitted to the University of Göttingen’s Psychiatric Clinic under the observation of its head, Doctor Friedrich Schultze, a figure who since the 1890s had vigorously disputed the reality of traumatic neurosis.70 Her presenting symptoms revealed that F.’s condition had taken on a new, more serious dimension. She described being plagued by a sense of constant anxiety, a feeling that someone was standing behind her with a knife in his hand. She reported dreaming of “terrible uncanny things.” Her period had become irregular, was much stronger, and was accompanied by terrible pains in the abdomen. All these complaints, which had developed after the second accident, had significantly worsened as a result of the many examinations. She had the feeling that she was being treated badly, “worse than the others”; she reported being constantly harassed by one official, who spoke to her in an “ironic tone.” She claimed that she would have recovered her health long ago were it not for the constant examinations. Schultze observed other anomalies. Her left leg moved awkwardly, but “[w]hen F. believes she is not being observed,” noted Schultze, “no disturbance can be perceived.” Again, the strain of the examination itself seems to have become unbearable to the patient; she repeatedly burst into tears and was upset the entire time she was being observed. At the same time, she complained a great deal about the amount at which her pension had been set. Schultze concluded that there was no reason to believe that F. had suffered a genuine injury. Her symptoms and general behavior suggested a functional neurosis of hysterical character: “The entire disposition of Fräulein F., the presence of numerous so-called signs of degeneration, indicate that, regarding her nervous system, she is a case of a hereditarily inferior personality.” Yet Schultze felt unable to dispute
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the claim of a connection between accident and illness: “Given that previous disturbances had not appeared, and given the temporal connection between their appearance and the accidents, it cannot be denied that there is a causal connection between the accidents and the hysterical neurosis; at the very least a worsening must be admitted.” His hands tied by the insurance laws, he concurred in fixing her ability to work at 50 percent. But he also stressed that further treatment was not only pointless but might worsen her condition. The only course of action was to allow Fräulein F. to return to work on a provisional basis. If this failed, her pension should be fixed at 50 percent of her present salary.
1914–1926: FROM SHOCK TO SCHRECK The Great War marked an interregnum in the conflicts between the Reichspost and its personnel. Yet this period of national crisis left its mark on the issues surrounding operators’ nervous disorders. The war reconfigured the doctor-patient relationship in ways that had significant consequences for pension claimants. In its aftermath, inspired by their success at combating war neurosis, German doctors pursued an increasingly hard line on the problem of accident neurosis, using the new professional authority granted to them by the state to intervene more and more aggressively in debates about social insurance. Already heated by war’s end, these debates acquired added fuel by virtue of the new republic’s constitutionally guaranteed welfare system, on which, to a great extent, its identity and legitimacy were staked.71 This system defined vast new areas for state intervention and responsibility, from the war wounded and widows to youth welfare and housing. The state’s interventionist machinery and bureaucracy grew dramatically to meet this expansion of responsibilities. Yet in a context of intermittent and sometimes catastrophic economic crisis—broken only by the five-year interlude of Americanfinanced stability between 1924 and 1929—the legitimacy of this fragile system was continually at issue. Pension payments for soldiers, widows, and others affected by the war ultimately consumed about one-third of the Weimar regime’s budget, engendering tremendous conflict around entitlement claims.72 For patients this meant that questions about treatment and pensions were caught up in the ongoing calculus of costs and benefits that became part of the logic of the rationalization movement, one of the Weimar period’s defining features. The process of rationalization, which had been greatly accelerated by the war, came into its own during the 1920s. In
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the narrow sense of the term, rationalization referred to changes in workplace technology, organization, and labor designed to promote efficiency and productivity while minimizing conflict.73 In a broader sense, as Detlev Peukert has argued, the postwar rationalization movement envisioned a process of social, economic, and cultural reorganization that encompassed changes in work and gender roles, urban planning, aesthetic practice, and thought.74 Wartime destruction and postwar turmoil cleared away resistance to organizational changes in the workplace and opened a wide field to the prophets of the rationalization movement. One of the founding compromises of the Weimar Republic, the so-called Zentralarbeitsgemeinschaft, institutionalized a new spirit of cooperation between labor and business on which the rationalization experts were able to capitalize. As Peukert has written, the new Weimar order assigned science the role of mediator between capital and labor in order to solve, through a stepby-step restructuring of society, the problems of industrial civilization. The new principle of social regeneration was found in “Americanism.” The enthusiasm for all things American that overtook postwar Germany encompassed mass culture, domestic appliances, and architecture, but above all rationalization in the workplace: Taylorism, Fordism, and psychotechnics.75 Changes in the sphere of industrial relations mirrored changes in the sphere of gender relations. In Germany, as has often been noted, much of the postwar sense of rupture crystallized around the figure of the young, emancipated, self-aware New Woman. The war greatly accelerated the feminization of Germany’s labor force, and this process, together with the new Weimar constitution, which gave women the vote, seemed to many to turn the old German gender order on its head. The result was an intense fascination with the figure of the New Woman.76 Sophisticated and self-seeking, she was a product of the culture of “new sobriety,” seeking advice from sex-counseling clinics, using contraceptives, and attending movies in the leisure time afforded by the new eighthour day. She took up a consciously rational, modern lifestyle suited to the accelerated pace of urban life. To conservatives, she symbolized the reversal of gender roles brought on by the wartime breakdown of patriarchal social relations, changes in the workplace, and the crisis of male hysteria in the ranks. This reversal was viewed with considerable dismay by Germany’s moral guardians, who as Richard Bessel writes, “became particularly worried after the war by the liberating effects of ‘high wages’ and shorter working hours upon young women who . . . were
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thereby tempted into spending a large part of the day and night in places of entertainment and in the streets.”77 In the war’s aftermath, psychiatrists evoked scenes of moral anarchy involving young women dancing frenziedly in Berlin’s streets and clubs.78 Yet if social conservatives saw such phenomena as symptomatic of social and moral crisis, modernists welcomed the new postwar dispensation without nostalgia for lost values or traditions.79 Americanism and the New Woman came together in one of the key works of Weimar cultural analysis, psychotechnician Fritz Giese’s Girlkultur. This text, published in 1925, offered an analysis of the English precision-dance team the Tiller-Girls, who had been widely imitated by the many American groups that enjoyed success in postwar Germany. For Giese it was these women—rather than the endlessly glorified Fordist methods of production—that exemplified the American phenomenon. At a time when Germany was experiencing a sharp break with the past, the Tiller-Girls seemed emblematic of the future and of the new human types that would people it. In their tightly choreographed movements and serialized forms, Giese discerned something like a pure distillation of the modern era. The Tiller-Girls beckoned Germany on to a new era of sobriety, functionalism, and eugenic consciousness. Giese concluded that any hope of national recovery from the “Shockwirkung” of the war and the postwar breakdown rested on close study of the American model and its techniques for organizing the masses.80 If Giese’s book coded mass society as female, it was nevertheless a new, positive image of femininity that he identified with the Tiller-Girls, one lacking any trace of sentimentality or pathology.81 Like few other texts of this period, Girlkultur reveals how the American model tantalized industrial experts with visions of a new social order. The writings of Giese—whose major empirical study of this period, as we shall see, was devoted to telephone operators—also convey particularly well the contours of the transformed public domain that Peukert, following Weimar cultural critic Siegfried Kracauer, identifies as a hallmark of the 1920s. The common image of this new postwar configuration and of its economic, political, and cultural dimensions was that of the patterned and regimented mass, or what Kracauer called the “mass ornament.”82 Its appearance at this moment was the product of a constellation of factors: the lingering impressions created by wartime mobilization, the influx of women into the workforce, new patterns of consumption and leisure, and the increasing importance of the new mass media. In Kracauer’s writings as in Giese’s, the Weimar masses were coded female.
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Among their members were telephone operators, typists, and salesgirls, all of them part of the new salaried classes (Angestellten), whose aesthetic counterparts were the Tiller-Girls. For Kracauer they epitomized the serialized individuals and “girl-clusters” of modern society, part of a class on whom the effects of the modernizing process were imprinted especially sharply.83 It was precisely the relatively privileged position that such employees enjoyed vis-à-vis other workers along with their resulting status consciousness that led Kracauer to see them as victims of “intellectual homelessness.”84 Yet Kracauer’s analysis underestimates the extent to which these women, by working within the terms of the social contract embodied in the German welfare system, were able to obtain a modicum of power—a power that eventually made them a target of the conservative backlash against that system. Nowhere were the contours of this restructured and contested public arena more clearly drawn than in Berlin. “Sombart once observed,” wrote Kracauer, “that our big German cities today are not industrial cities but cities of salaried employees and civil servants. If that holds true for any city it does for Berlin. . . . Only in Berlin, where links to roots and the soil are so reduced that weekend outings can become the height of fashion, may the reality of salaried employees be fully grasped. It also comprises a good part of Berlin’s reality.”85 As a result of wartime and postwar restructuring, Berlin’s physiognomy underwent a profound transformation. If the city emerged from the war no longer as Germany’s political capital, it became the center of national life in every other respect—indeed, one of the great world cities. Its annexation of outlying suburbs in 1920 turned Berlin into a city of four million inhabitants, making it the world’s third largest metropolis after London and New York. At the same time, the city embarked upon the process of headlong social, cultural, and scientific experimentation that made it, in Chancellor Gustav Stresemann’s phrase, “a metropolis of brain power.”86 Berlin’s technological and cultural brilliance during the 1920s seemed to realize the promise of the electrified phantasmagoria conjured up by the Trade Exhibition of 1896. New power stations built in the late 1920s became widely photographed icons of functionalist design, while movie theaters, display windows, and advertising columns deployed electricity to lure the new consumer masses.87 Yet the glamour surrounding electricity took on an element of danger as well: these advertising techniques aimed to shock the passerby, conducting a form of “technological war on the senses” that suggested continuities between the war and postwar urban experience.88
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Given the relative absence of room for political and economic maneuver that plagued the republic from its inception to its demise, Berlin’s transformation into a city of hypermodern urbanity was tinged with fever, a hothouse air of unreality. The expansion of the public sector resulting from the state’s assumption of vast new responsibilities for its citizens’ welfare fueled the growth of the salaried masses but also awakened widespread antipathy toward the increasing bureaucratization of the everyday. At the same time, the breakdown of patriarchal relations that made Weimar Berlin, in Peter Gay’s phrase, the classic city of the “outsider as insider” also ensured that those groups most closely identified with the new dispensation—Jews, New Women, and socialists—would be blamed once the luster wore off the rationalization movement.89 Berlin embodied the ambiguous mixture of crisis and promise that was Weimar. As the center of Weimar’s newly transformed public domain, Berlin and everything it stood for became the target of conservative backlash when, after 1929, “Americanism” underwent its own crisis. It was against this backdrop that operators—as representative New Woman and as one of the most visible faces of the rationalization movement—also became the target of backlash.90 The feminization of work during and after the war was especially pronounced in Berlin, where women found employment in sectors such as the machine tool industry, on the city’s trams, and then in the expanded public sector.91 Operators, too, participated in these gains. Between 1911 and 1924 their numbers increased from twenty thousand to sixty-five thousand. At the same time, the demands made on them increased dramatically: the number of calls an operator was expected to take in an hour increased from 150 to 500.92 This intensification of the tempo of their work was not accompanied by any material improvement in status. In the war’s immediate aftermath this led to discontent and finally to a strike by operators that cut central state authorities off from the rest of the nation and was ended only with the help of a loyal military telegraph unit.93 The realization of the social paralysis that such work stoppages caused led, in the postwar era, to an intense search for discipline and reliability. Modernist visions of a planned society, such as Giese’s, circled obsessively and anxiously around disturbing scenarios of technological, social, and nervous breakdown. Thus the greater democratization of the Weimar period was combined with increasing state intervention in everyday life and with intrusive forms of regulation.94 The emancipation enjoyed by the operator qua New Woman was coupled with a high degree of regimentation; the
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promises and anxieties of the rationalization movement were inscribed vividly on her body.
THE PSYCHOLOGIZATION OF ACCIDENT NEUROSIS On 25 July 1922, a memo discussing the question of reducing working hours in the telephone service was sent from the Munich branch to the RPM: “The number of work hours does not seem of so much importance . . . as their distribution throughout the day and the week. That the undivided 8-hour workday has a very different impact on the nervous system of the telephone operator than the divided, I hardly need to mention.”95 The author of the memo went on to say that observations made in the Munich section suggested a further conclusion. This concerned the need to distinguish between the physiological effects of current and the merely “psychological” excitations of the hearing membrane. “Acoustical shocks” attributable to anomalous disturbances of high-tension power lines often reached a degree of strength that posed a health threat. On the other hand, the mere passage of current from the power line to the human body did not in itself necessarily cause an injury. The author argued that the loud detonations sometimes associated with current were “not capable of producing an industrial accident in the sense defined by the Reich Insurance Ordinance or the Accident Welfare Law.” It was of the utmost importance to uphold this distinction in order to separate authentic from frivolous cases of telephone accident. One could assume, warned the author, “that the accidents which have mounted in such shocking numbers in the Dortmund region must for the most part be attributed to mass suggestion, based on unfounded fear of harmless currents.” Here we encounter in nuce the strategy adopted by the RPM’s experts in their postwar dealings with operators. Whereas prior to the war the medical discourse had been marked by a plurality of voices and points of view, the experience of the war resulted in a significant narrowing and hardening of views. If prewar practitioners had remained divided over the etiological significance of switchboard work itself, emphasis now shifted more confidently to the primacy of fear and suggestion in the genesis of the malady.96 In those cases in which simple fear seemed inadequate as an explanation, experts argued that overburdening had a hereditary explanation.97 Looming behind this shift was an emerging consensus about the need to revise the nation’s accident insurance legislation. The continuities between medical approaches to the challenges of war
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and to those of postwar society can be seen most clearly in the work of Ewald Stier, the military psychiatrist and professor in Berlin who played a leading role in debates about neurotic telephone operators and pension issues. Responsibility for shifting the emphasis from somatic to psychological explanations was largely Stier’s. An especially outspoken critic of Oppenheim’s traumatic neurosis construct, he had worked closely with the War Ministry in formulating a coordinated response to the epidemic of war neurosis. The aftermath of the war left him, like many other physicians, disaffected from the Social Democratic state, which he saw as lacking the will to address the problem of rampant pension neurosis.98 In the early 1920s Stier received a commission to study the health problems of the Reichpost personnel. This led to a ten-year-long engagement with the problem of nervously afflicted operators.99 Stier’s investigations led him to a number of conclusions, the cumulative effect of which was to call into question the causal relation between accident and illness. For our purposes the chief issue here concerns what Stier identified as the core of the problem: the alleged role of electricity in the genesis of the operators’ maladies. It was precisely the connection between overwork and “shock,” as Stier stressed in his communications with the RPM, that formed the weak link in the disease picture surrounding accident neurosis. Citing a large body of scientific research on brain injury as well as on medical usage of electricity in treating psychiatric casualties during the war, Stier contended that it was impossible that electrical current had the effects attributed to it by the personnel. The physical jolt (Stromwirkung) cited by operators—if indeed it occurred at all—could be understood only as triggering an already existing latent pathology. Shock (Shockwirkung) was, in fact, merely a kind of fright (Schreckwirkung), a form of “psychic infection” rooted in morbid fear and the desire for a pension.100 Not work conditions but attitude and psychophysical predisposition held the key to the operators’ maladies. Stier placed great stress on the need for educating personnel about industrial safety in general and the harmlessness of electrical current in particular. Here we return to the imaginative kernel of the problem: the oneto-one correspondence, first established by nineteenth-century physiologists, between nervous action and electrical current. This correspondence was part of the scientific apparatus bolstering the claims of the operators, who steadfastly maintained that exposure to current posed a threat to their nervous equilibrium. Operators held to the conviction that, in the accident, they had “Strom bekommen,” and their representatives constantly gathered evidence of electricity’s effects on the
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body to support the claim of a connection between technological and nervous breakdown.101 Prompted by a petition from the Verband, the minister for welfare wrote to the RPM, asking it to investigate whether electric current posed a threat to operators. The RPM pointed out that such investigations had already been conducted: “It was found that the amount of electricity that, by means of the condensator created by the telephone and the ear, is transmitted to the individual can be measured with the help of sensitive instruments, but that it is small, and that in no case did even sensitive subjects have a sensation that electrical current had been transmitted.”102 Tests showed that the amount of current, if any, that entered the ear of the operator was so small that it remained well “below the stimulus threshold.”103 RPM head Ernst Feyerabend wrote the editors of Unter den Reichsadler to notify them of these findings, asking them to print his letter in order to alleviate fears among the personnel about the hazards of electricity: “Charges of this magnitude never reach the stimulus threshold of the nerves.”104 In his own extensive analysis, Stier stressed the decisive role of endogenous factors in the genesis of traumatic neurosis. By this he meant defects, either hereditary or acquired, that lowered resistance to the exogenous factors (i.e., electrical shocks), which merely triggered a latent, underlying pathology: “Only on the basis of the resulting irritability and oversensitivity of the entire nervous and psychic apparatus do functional disturbances occur, under the influence of especially strong or simply normal stimuli, which are subjectively perceived by the victim as especially tormenting.”105 Viewed from this perspective, the allegedly physiological basis of the disorder (Shockwirkung) revealed its actual nature as a purely psychological experience (Schreckwirkung). Stier suggested that the so-called fright effect could be observed in its pure form only in experiences for which there was no question of liability (such as in a thunder clap): the “psychic reaction is so much the stronger, the more intense the stimulus is, the less expected its onset is, and the more ‘nervous,’ that is, constitutionally irritable and sensitive, the individual is.” Moreover, he continued, “we can further see that the psychological reaction and duration of the disturbance is especially large, when the sensory stimulus immediately associates with anxiety and fear ideas.”106 Close observation of such “nervous shocks,” concluded Stier, showed that they were without long-lasting consequences. The impression that frightening experiences often had long-lasting effects Stier attributed to the temporal interval between “direct and real
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fright effects” on the one hand and “hysterical disturbances and subjective complaints” on the other. In this interval, “wishes and desires” came into play: the wish for promotion to a better position, for a long stay at a sanatorium, for a pension. As far as Stier was concerned, it was enough to establish the existence of such an interval to reject the claim of liability in the case of a telephone accident. In cases in which these wishes preexisted the accident—in which the individual was “prepared” for the accident—this interval could be quite short, and it required a trained observer to perform the diagnosis. Ultimately Stier reduced the personnel’s beliefs concerning the injurious power of electricity to popular conceits without foundation in scientific fact. In the late 1920s he summarized his view of what was at stake in the case of the neurotic operator: “With good reason I used the so-called telephone accident as a starting point from which to consider the question of accident neurosis, inasmuch as the very weak currents used in telephony could not produce brain damage, and the picture we saw could be represented as a psychological reaction in its purest form.”107 For Stier, in other words, the telephone syndrome distilled the phenomenon of the industrial accident to its essence. In so doing it demonstrated, with the precision of a laboratory experiment, the impossibility of traumatic neurosis as clinical syndrome. Finding no evidence of organic brain damage, Stier turned the affliction into a purely psychological disorder. This conclusion was consistent with the stress he placed on the conceptual distance that lay between contemporary medicine on the one hand and nineteenth-century psychology and its residues in popular opinion on the other.108 Committed to a view that placed the “whole person” back at the center of medicine and thus restored the primacy of will in mental life, he regarded the neurotic’s alleged inability to work as, above all, a question of will (Willensfrage).109 Ultimately, in decoupling neurosis from accident, Stier was also severing it from its roots in nineteenth-century somaticist medicine. The “pseudoillness” of traumatic neurosis, he argued, was rooted in a myth of mechanical causality, a kind of false materialism that reflected the “materialist worldview” shared by employees under the sway of socialism. In their naive insistence that they “had received an electric shock,” the operators simply demonstrated that they suffered from a disease of literal-mindedness, the hysterical symptom par excellence. Stier’s deconstruction of the clinical picture surrounding accident neurosis was coupled with a series of recommendations concerning profes-
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sional jurisdiction. While he felt that examination by a neurologist was necessary for establishing the objective findings and ruling out the presence of actual physiological trauma, he felt that responsibility for determining the role of wishes and subjective factors belonged in the hands of psychiatrists, who were better equipped to detect malingering. In a thinly veiled reference to the private—and often Jewish—practitioners exemplified by Oppenheim, he pointedly argued that any experts with a “material interest” in the question of diagnosis be replaced by physicians who had no compunction about delivering a verdict of simulation: For an unjustly granted pension damages not only the Reich’s budget, but it also fixes in the mind of the patient claiming nervous illness the false belief that she has been judged medically and legally sick and incapable of working, thus crippling her energy to overcome her complaints and often even turning a person fully capable of work into a social parasite, thus robbing the collective of a valuable source of labor power.110
Stier’s analysis laid the groundwork for professional consolidation around a new consensus on traumatic neurosis. The emphasis shifted to medical evaluation of applicants to determine the presence of neuropathic constitution and complete avoidance of any medical treatment of the accident’s consequences that might reinforce the patient’s suggestibility. A chorus of medical experts expanded on Stier’s recommendations. One physician stressed the importance of subjecting the operator to a thorough neurological examination as quickly as possible following the “accident,” to minimize the possibility that the so-called Nervenerschütterung might acquire some basis in a spurious physiological trauma.111 Another stressed the need to combat the popular belief that electricity posed a health threat. Yet another belabored the importance of preventing the operator’s already overheated imagination from developing in morbid directions. Otherwise, he warned sarcastically, it was too easy for what began as simple loud noises to gradually become currents and finally end up as lightning bolts.112 Similarly, it was crucial to avoid stimulating the “suggestibility” and “false ideas” that crowded the operator’s imagination and lowered her resistance to “psychic infection.” Every aspect of the patient’s interaction with examining doctors and insurance agents was charged with the possibility of contagion. As one doctor put it, even the insurance forms were endowed with uncanny powers of heightening the patient’s morbid consciousness: “I urgently advise against allowing every victim, real or al-
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leged, to fill out the lengthy neurological forms that you have sent me; that could easily lead to a situation in which only slightly injured persons are encouraged to believe, through the suggestive effects of the enormous apparatus that is thereby set in motion by them, that theirs is a case of serious illness.” It was a well-known fact, he explained, that psychological contagion was rampant in the large exchanges, where “every hysteric, who has the gift for making herself interesting, can in a short time throw half a telephone exchange into a state of intense nervous agitation.”113 The implications of this shift away from nerves as object of clinical analysis can be gleaned from an opinion submitted to the RPM in Berlin by Dr. Martin Reichardt of the Psychiatric Clinic of the University of Würzberg. Written in 1919, Reichardt’s opinion reviewed the case of Anna M., the victim of a telephone accident in 1908. Throughout his report, Reichardt stressed the distance separating postwar from prewar medical thinking. At the time of the accident, he wrote, views about this type of disorder were not nearly as unified as they were now. Prewar medicine was still dominated by the “traumatic neurosis model,” whose demise compelled doctors to review cases such as M.’s from a fresh perspective.114 The examination undergone by Anna M. prior to being taken on as employee had given her a clean bill of health. Reichardt pointed out, however, that in most cases a predisposition to hysteria or nervousness could not be established by objective medical examination. Her intense reaction to the accident was proof in itself, argued Reichardt, of such a predisposition. This aspect of her behavior had been downplayed by the two doctors who had originally seen her, although one had described Anna M. as having a “sensitive nature” and of demonstrating signs of “nervous overstimulation” and “agitation.” But Reichardt questioned the conclusions of these doctors. The original complaint had claimed that Anna M. had been physically injured by electrical current, but a later version claimed that the illness had been caused by “crackling noises.” This already undermined the physiological explanation and suggested, according to Reichardt, that hers was a case of pure fright: “A transfer of electricity is no longer claimed. The cause of the nervous shock is not directly, but only indirectly, the strong current.” From the medical point of view, absolute clarity about the progression of the patient’s symptoms was of the utmost importance: “It is a commonly observed fact that, especially in liability cases, the nervous symptoms are
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later represented by the individual as much stronger.” On the basis of the available evidence, Reichardt found no reason to assume any kind of “shock effect.” Reichardt then proceeded to demonstrate that the two previous opinions had been riddled with errors. He disparaged the term Nervenerschütterung, which one of the original doctors had used, as a popular concept without scientific validity. Moreover, all the “objective symptoms” that had been observed during Anna M’s earlier examination were, according to Reichardt, unreliable. Shrinkage of her visual field; loss of sensitivity on her left side; heightened reflexes; and neuralgic sites—these were all purely subjective: “They are very close to normal suggestion on the one hand and in part also conscious exaggeration and simulation on the other.” The same was true of an attack of hysteria that the patient had apparently suffered during an eye examination. The exhaustion that the tests of her visual field seemed to indicate was the product of autosuggestion. In short, concluded Reichardt, the accident in 1908 had been completely harmless: “The actual cause of the [patient’s] condition is not the accident, but on the one hand her psychopathic weakness of will and lack of will to health, and on the other hand the suggestive effects of the compensation proceedings.” Reichardt ended by stating categorically that there could be no question of “nervous trauma”; rather, her condition was caused by mental predisposition, defect of will, and suggestibility. In Reichardt’s review of this case, shock lost its bodily referents or coordinates, becoming transformed into a purely psychological event. He wrote that, to the extent it was to be taken at face value, Anna M.’s illness was to be understood as the result of not accident but repetitive work and overexertion, thus displacing the burden onto the patient herself by implying that inability to withstand the strenuous conditions of her work was a matter of constitutional or acquired defect—which, given that neither was compensable, amounted to the same thing. Acknowledging that workplace conditions left much to be desired, Reichardt nevertheless reminded his reader that the consequences of overwork were not covered under the nation’s accident insurance laws.115
OPERATORS RETALIATE As self-appointed leader of the medical crusade against accident neurosis, Stier’s views made him a lightning rod for attacks from the operators.
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Following publication of his views, Stier became embroiled in a polemic with the editors of Unter den Reichsadler. In a series of articles that appeared throughout 1923 and 1924, Stier was accused of making it impossible for employees to receive a fair judgment in their pension hearings. Stier’s defense was to reiterate his claim that current medical expertise backed up his position. The Verband responded by attacking Stier’s credibility. An article entitled “How Professor Stier Treats Accident Victims” argued that Stier’s views were compromised by his ties to the RPM. The article also reported stories of appalling treatment suffered at his hands. One operator described her encounter with Stier in the following terms: “The examination was conducted in such a way as to intentionally incite my excited nerves to the utmost. Every word was meant to irritate and agitate me, making me more ill than I already was.”116 Among the operators, Stier earned the reputation of being a monster. Accused to her face of feigning her symptoms in order to get a pension, one operator responded by saying, “I don’t want a pension, I only want to be employed.” Stier’s cryptic response: “The Reichspost knows nothing of employment, it only knows work!” The patient lodged a complaint against Stier. Operators dubbed this type of adversarial interaction “the Stier system.” It was no wonder, continued the editorial, that such examinations left patients highly agitated. Stier’s examinations could be more traumatic than the original incident itself. The Verband perceived a larger danger looming behind the Stier system, namely, that Stier’s position was being used in the service of an attack on the nation’s accident insurance laws. The nation’s financial emergency could not be used, argued one editorial after another, to interpret away a branch of public law. The Verband wrote to the RPM on 2 November 1923—in the midst of that year’s catastrophic hyperinflation—to express its objection to Stier’s position. The scientific basis of Stier’s views was not universally acknowledged, argued the organization. Moreover, the matter was not simply a medical one but also a legal one. The organization requested that the cases under review by Stier be submitted for a second opinion by a neutral doctor. In an internal memo, an official of the RPM conceded the point. In Berlin alone, he pointed out, there were over twenty court cases pending in which the RPM’s decision was based on Stier’s position. The decision of the court would ultimately have to determine whether the RPM would adhere to his position.117
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FROM NEUROSIS TO RATIONALIZATION If science could not resolve the medical issues surrounding the telephone accident, it held out the promise of another solution: psychotechnics. During the Weimar period, representatives of this branch of social engineering promised to use science to conjure away the workplace conflicts that had wracked Wilhelmine Germany and to usher in a streamlined new order of social harmony and productivity. Advertising itself as modern, rational, and humane, a means of winning workers’ consent, psychotechnics was made a cornerstone of the rationalization movement that swept Germany in the 1920s.118 It was with good reason that Siegfried Kracauer designated telephone operators as “natural subjects for industrial psychology.”119 From its inception psychotechnics was closely linked to the discovery of mental labor as a category of modern work that imposed new demands on the senses, nerves, and mind. No doubt this was one reason that switchboard operators, who were seen as exemplary mental laborers, served as a special object of study for the new science. Psychotechnics was first extensively employed during the Great War to test the perceptual skills of pilots, truck drivers, and railway personnel. Working under the auspices of the Kaiser Wilhelm Institute for Labor Physiology, most of the key figures in the Weimar psychotechnics movement first gained practical experience with the methods of the new science during the war. Briefly, psychotechnics was a form of psychological Taylorism according to which tasks were analyzed and broken down into their component parts; the time necessary to perform each, measured; and a profile of the specific psychophysical demands associated with each, constructed. Performance was correlated with fatigue, monotony, and other variables such as hand-eye coordination or attention. The resulting profile was then used to establish a general norm that helped workers to internalize the regularity imposed by machines.120 The principles of this science of workplace efficiency had been outlined before the war by Hugo Münsterberg.121 Münsterberg, the German psychologist who had taught at Harvard since the 1890s, devised aptitude tests for several clients, including Bell Telephone. He viewed telephone exchanges as a kind of laboratory affording doctors the opportunity to study the attributes of the “normal” or “ideal” employee as well as the conditions leading to psychophysical overload and breakdown. For Münsterberg, telephone operators could be considered exemplary subjects of a case study in the problem of human adaptation to the
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rhythms of the industrial workplace, in which “the rapidity of movement of electrical machines upsets subjective rhythmic experience.”122 German scientists modified Münsterberg’s approach in keeping with a cautious embrace of Americanism.123 The German version of this science of work added a concern for the worker’s satisfaction (the element of “human economy,” which included categories such as performance differentials and job satisfaction) to its American counterpart, which for Germans connoted little more than deskilling, monotony, and maximization of productivity. Initial psychotechnical investigations in the field of telephony were carried out by Fritz Giese. Born in 1890, Giese studied under psychologist Wilhelm Wundt at Leipzig. After serving during the war in a hospital for soldiers with brain injuries, he created an institute for applied psychology in Halle, before becoming a professor in Stuttgart. In addition to teaching and lecturing on psychotechnics and work science, he published on numerous subjects ranging from the cultural analysis of Girlkultur to the psychology of gender differences and to a late study of Nietzsche. He was a technocrat and a modernist who in the 1930s embraced the Nazi movement.124 Giese conceived of psychotechnics as a select branch of social engineering that would compensate for some of the “irrationalities” of capitalist methods of production.125 In war-battered Germany, maximizing labor power, Giese felt, held the key to national regeneration; and psychotechnics, the key to maximizing labor power. In 1919 Giese was presented with an opportunity to test his claims when he was commissioned by the RPM to study its personnel in Berlin. From March to August of that year he conducted psychotechnical studies at the city’s exchanges.126 The results were published in 1923. Early in Giese’s book a key image appears that serves as a leitmotif of his entire project. The image unites two kinds of information in the graphical form of curves: the first, the energy curve, illustrating peak hours of electricity usage throughout Berlin; the second, the fatigue curve, measuring operators’ performance throughout the day. By superimposing these curves on one another, Giese showed that demand and performance closely matched during most of the morning shift, but in the afternoon, as fatigue set in, they increasingly diverged.127 With this image, Giese’s studies established the raison d’être for psychotechnics. Its parameters were defined by a vision of the body conceived of as a thermodynamic system, traversed by flows of energy and fatigue, and by a vision of a new urban order, an electropolis, a rational, yet crisis-prone, product of industrial civilization. Each is rendered in the scientific short-
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hand of the curve: a pure line distilling both operator’s capabilities and the metropolis’s energy consumption into graphical form.128 While this image conveys a manifest sense of scientific reason and order, it also suggests the possibility of disrupted service and systemic breakdown.129 Most often in Giese’s text this possibility was lodged within the problem of fatigue, which he placed squarely in the center of his analysis.130 Far more than simply a physiological condition, fatigue was a “psychosociological” phenomenon influenced by a complex set of factors, including work hours, pauses, wages, monotony, attitude, satisfaction, and nervous disposition. Each of these factors required comprehensive study. For instance, he wrote, it was important to “be clear about what it means . . . to call ‘Amt’ sometimes 770 times per hour, and one must multiply this number daily by 7, in order to convey through this trifling point a sense of the monotony of this work.”131 Fatigue, in his view, formed the horizon of the operator’s being: “It would be an entire treatise in itself to go more deeply into the general problem of fatigue in the telephone service.”132 In the big exchanges in Berlin the operators worked constantly at the limit of their capacities, and the least departure from accepted routine could hasten the onset of exhaustion or, in the worst cases, complete breakdown. Among the operators, noted Giese, the effects of fatigue resulted in a stratification of the workforce and a form of “counterselection,” which he proposed to offset with wageincentive programs: Currently we are very far from giving fatigue a value, or rather diminishing it, through the incentive of differentiated remuneration. The more industriously and skillfully an operator works, the more quickly she will get rundown, the more severely she will be exploited. The operators in Berlin call the section of the pensioners and occasional users the “sanatorium”—here work the lethargic and less-skilled operators. The more robust personnel work in the business quarter: perhaps for their own pleasure, but surely not to their own advantage or that of social progress in general.133
Giese stressed his own role as representative of a nonpartisan approach that, by transposing the work at the switchboard into the objective language of science, could conjure away the difficult social problems surrounding fatigue, performance, and wages, thereby winning workers’ consent. Using Münsterberg’s research as his point of departure, Giese followed the basic Taylorist strategy of disassembling work into parts and then reassembling them for optimal efficiency. He established the existence of close to twenty different elements of switchboard work, including visual recognition of incoming call, inserting the jack into the
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correct place on the switchboard, answering the caller, and so forth. Each element engaged a different combination of the operator’s mental and sensory faculties: hearing, vision, attention, and memory. Giese calculated the time necessary to perform these tasks and the psychophysical profile associated with each. Out of these calculations he created norms for selecting candidates and for improving the efficiency of those already employed. But Giese’s research went considerably beyond what he perceived as the limitations of the “human-motor” model favored by his American counterpart.134 Labor power could not be reduced to mere calculations of energy expenditure; it was a cultural problem that engaged the worker’s entire being, including her satisfaction, health, mental wellbeing, and general moral sensibility as well as her relation to the larger social body. By situating the problem of labor within a more organically conceived notion of the self and of questions of national regeneration, Giese’s investigations opened up a wide discursive field.135 On the objective side, Giese showed that the “work curve” was determined by variables ranging from demand to the equipment itself, work hours, and more sociological factors. Variations in phone usage between one district and another, for instance, reflected the complex urban topography of the capital city. The district of Wilmersdorf, with its demimonde and its bars and clubs, produced a work curve sharply at variance with that of Berlin’s central business district. A further condition distinguishing Berlin from other cities was rooted in the freedom enjoyed by adolescents in the capital, where even the children “ring each other up” so as “to chatter about some triviality or other”—a “burdening of the exchange” that reflected conditions that were “purely sociological (and in part even racial-biological).” Psychotechnics could not ignore such factors, and for this reason, he concluded, the scientist “must always proceed along cultural-psychological lines.”136 In keeping with this conclusion, Giese was prepared to go very far in gathering data about the subjective side of telephony. In addition to charting the operator’s reaction times, attention, and attitude, he also studied the effect of daydreaming, menstruation, and “moral character” on performance. It was not just conduct in the workplace that was at issue; the free time available to these women since the passage of the eight-hour day made their leisure activities—whether filmgoing, attending lectures, or sporting activities—a vital area of research. Each of these variables had its own regularity, its distinctive curve, to be charted and made part of the fine mesh of psychotechnical analysis.
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This may be illustrated by considering one of the tests he administered to the Reichpost personnel, which involved measuring the operator’s response to sexual stimuli. The operator was hooked up to a pneumograph and given an album of postcards depicting erotic scenes. Through a peephole, the investigator watched while the subject leafed through the album. The pneumograph matched the process of turning from one picture to the next to her respiration curve. From this curve Giese extracted what he called “ethical-erotic diagnoses” of the personnel.137 Such diagnoses reflected the administration’s desire for information about the moral character of the personnel, including their romantic and private life. While the results seemed to indicate to Giese that many of the women suffered from ethical defects, he remained certain that specialized training could turn them into disciplined, dependable workers capable of the most exacting concentration and responsibility. In addition to the tests and training regimens he designed, Giese advocated making physical culture an important aspect of workplace hygiene. Exercise and fitness programs had been introduced into the workplace in many sectors of German industry in the 1920s, partly as a way of alleviating stress and monotony.138 Giese conceived of gymnastics as crucial to the task of fortifying the body against the onrushing demands of modernity, and he devoted a virtually endless stream of writings to the subject. Both Taylorism and gymnastics, he wrote in one article, approached the same task from different sides: training the body and its movements in order to promote purposeful activity and minimize fatigue. By strengthening the muscles, increasing the body’s capacity for performance through training, and raising tolerance for fatigue, gymnastics promoted the “Taylorization of the body.”139 Heightening the worker’s awareness of physical activity as a time-and-motion-based process, physical culture could teach the worker to internalize the new rhythms of the modern workplace. This emphasis on physical culture was a key feature of Giese’s “Germanization” of Taylorism. Believing that the principles of Taylor and Münsterberg were incomplete, he felt that the German science of work should augment them with a concern for the “whole person,” body and mind. Gymnastics, by strengthening the body-mind connection and thereby countering the “one-sidedness” of modern work, would help to offset the specialization that was a consequence of the modern division of labor. A similar desire may also be detected in his approach to the issue of discipline and how best to achieve it without sacrificing the worker’s well-being or consent. If Giese positioned the operator as the object of
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an intrusive gaze in the case of his “ethical-erotic diagnoses,” here he sought to train the eye of the operator herself on her own performance. This meant, in the first place, establishing the legitimacy of psychotechnics vis-à-vis the RPM’s existing methods of workplace surveillance. Using questionnaires he polled supervisors concerning the performance of operators. He then compared these judgments with the results of his own tests. Giese found the supervisors’ judgments unreliable and, in more than 50 percent of the cases, contradicted by his own observations. Moreover, given the surreptitious nature of the existing monitoring system, they created discontent among the personnel.140 Giese’s own methods drew upon the entire repertoire of modern techniques of aptitude testing, making use of graphical devices such as kymographs, tachistoscopes, and pneumographs.141 Though here we cannot consider all the methodological implications that flowed from the use of such devices, one at least should be highlighted. It concerns Giese’s efforts to recast the issue of discipline and can be posed as follows: while the Reichpost’s methods remained external to the subject, Giese sought to fashion a form of internalized discipline and, in so doing, to find a middle ground between what he described as the extremes of dogmatic Bureaucratismus and “revolutionary freedom.”142 This may be best illustrated by considering one test he administered, involving a device called a self-registering attention-measuring apparatus. This consisted of a series of kymographs attached to the operator’s fingers by electrical wires. The results of the operator’s work were displayed on a meter that was visible to her, thus enabling her both to observe the measurable progress of her own performance and, in principle, to improve on it.143 In essence it allowed the operator to read her own personal-curve, an innovation that, coupled with wage incentives, was intended to promote efficiency.144 By simplifying the test so radically that it could be virtually selfadministered, Giese enlisted the subject as consenting partner in her own rationalization. Striving to win the workers’ consent, Giese’s approach— by making the total individual, body and soul, its object—represented a radical intensification of the principles of work science, a way of inscribing the principle of efficiency into the very core of the operator’s being. “In the German view,” wrote an industrial expert cited by Siegfried Kracauer in his study of Germany’s salaried masses, “work must lead to an unfolding and realization of one’s person. It must be viewed as service to the great tasks of the national community to which we belong.” “But what is the use of prating about personality,” commented Kracauer, “if work is increasingly becoming a fragmentary function?”145
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Kracauer here put his finger on the paradox of a science that sought to address itself to the “whole person” and at the same time inscribe that person ever more deeply into a mechanistic domain of registration, measurement, and selection. Increasingly cognizant of the contradictions to which rationalization led, Giese’s transformation of the laboring self into a smoothly functioning mechanism found its counterpart in another aspect of his project that would later become explicit as he became less enamored of Americanism and embraced National Socialism.146 Giese’s underlying ambivalence about the cultural implications of rationalization emerges from his tendency to exempt attributes such as courage and nobility—the masculine, warrior virtues—from psychotechnical analysis and experimentation. The compensatory function of this idealization of the sovereign male self may be traced back to the wartime inversion of gender roles and the subsequent influx of women into public life, exemplified by the Tiller-Girls, who so fascinated him. Locating them in the space between emancipation and regimentation, between Bureaucratismus and “revolutionary freedom,” Giese sought to decode the message these women harbored for Germany’s future. Beyond his interest in questions of work per se, Giese’s attempt to fathom the operator’s moral being was conditioned by the profound anxieties awakened by Weimar’s feminized mass urban culture.
THE RISE AND FALL OF PSYCHOTECHNICS AT THE SWITCHBOARD Following Giese’s departure from Berlin for a new position at Halle, the initiative in Berlin was taken up by other figures. All shared a commitment to rationalization and a belief that their field contained a blueprint for Germany’s economic regeneration. They also believed their approach to optimizing labor to be superior to the purely economic rationality of Taylorism, though Georg Schlesinger, head of the Institute for Industrial Psychotechnics at the Technical University in Berlin-Charlottenburg, was known as the “German Taylor” for his enthusiasm for scientific management.147 The leadership of his institute would later be assumed by Walter Moede, who shared Schlesinger’s tendency to side with employers’ interests. Other figures included Hans Rupp of the University of Berlin’s Psychological Institute and Otto Lipmann, whose background was in academic psychology and whose political tendencies were socialist. Lipmann, head of the Berlin-based Institute for Occupational and Economic Psychology, took seriously the field’s claims to mediate be-
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tween labor and capital and tried to preserve the worker’s well-being and satisfaction.148 In the early 1920s, psychotechnicians spearheaded an ambitious aptitude-testing program throughout German industry. This program was embraced by industry, the state, academia, and trade unions as integral to the project of national reconstruction. A key meeting at the Labor Ministry (Reichsarbeitsministerium, RAM) in 1920, with representatives from the RPM, the Reichsbahn, and several institutes for applied psychology in attendance, gave the go-ahead to this undertaking.149 By 1922, 170 psychological testing stations had been created across Germany. A veritable psychotechnical craze was born, attended by great fanfare and a flurry of publications in leading journals. German trade unions endorsed the rationalization movement in the belief that science guaranteed “the best relation between labor power and the labor process.” Labor’s support affirmed its vital role in the creation of a scientifically regulated society from which conflict would be banished.150 The RPM stood at the forefront of this rationalizing campaign. In early May 1919, Hans Rupp of the Psychological Institute reported to the RPM the results of his visit to several telephone exchanges as well as the training school for telegraph employees. On the basis of his site visits and subsequent discussions with Lipmann, Rupp devised a set of procedures for testing the prospective operators, designed for inclusion in the existing curriculum.151 These tests measured skills such as facility with numbers, reaction times, and memory. Students were asked to connect and disconnect calls while the tempo of the calls was increased. Rates of error were plotted as a function of time. A second test evaluated students’ ability to remember different numbers under pressure. At the flashing of a light on the switchboard, the examiner shouted out the source of the incoming call; this was immediately followed by new calls and shouts, which students recorded on a piece of paper. In yet another test, subjects listened to a report over a phone and then wrote it down providing as much detail as possible. These were usually reports of emergencies or disasters, such as train accidents. Points were deducted for each missing or incorrect word, and students were assigned ratings on the basis of overall evaluation of their performance.152 In December 1919, Rupp submitted a report on the results of tests to date. More circumspect than Giese, he nevertheless expressed optimism that the tests would soon become an integral branch of work science alongside time-and-motion and cinematographic studies.153 That same month a letter from the Berlin OPD to the RPM broached the idea of setting up a psychotechnical testing station at the local telegraph training
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school.154 These initiatives led to a program, spearheaded by the RAM, to integrate psychotechnics into all branches of German industry. In April of the following year these proposals were further aired at a meeting held at the RAM, with representatives of the RAM, the RPM, and the Ministry of Transportation in attendance as well as Schlesinger, Lipmann, and Moede. Discussion centered on locomotive drivers and operators and dealt with questions of performance, fatigue, and accident protocols, and more broadly with the need to find solutions to the “psychosocial problems” of “regenerating work strength” and of “overstraining attention.”155 This meeting cleared the way for the Research Society for Industrial Psychotechnics to create an experimental laboratory in the Telegraph Apparatus Office.156 This was rapidly followed by further expansion. Under Rupp’s supervision, a fully operational psychological testing station was set up at the headquarters of the OPD in June 1922. Over the next two years, six more of these stations were created in Hamburg, Breslau, Leipzig, Frankfurt, Cologne, and Stuttgart. These developments were accompanied by an outpouring of research results in leading psychotechnical journals. The aim was to rationalize in all areas, as well as to screen out unsuitable candidates. Initial results seemed to justify the investment in this undertaking. Yet despite the seemingly propitious circumstances surrounding this match, the marriage of psychotechnics and the telephone operator did not go as smoothly as hoped. By 1926, all but one of the experimental laboratories—the original one in Berlin—had been discontinued.157 At the end of the 1920s, this too was closed. German psychotechnics increasingly reoriented itself toward characterological studies, which shifted the focus away from performance and psychological “functions” and toward leadership qualities, strength of character, and willpower.158 The official reason given for the cutbacks was the disappointing results and the costs. In addition to the state’s unstable financial circumstances and the general disillusionment with rationalization that set in after the world economic crisis in 1929, another major reason had to do with divisions within the field itself. In the late 1920s, a controversy erupted within the field of psychotechnics involving charges that some members had compromised the field’s scientific legitimacy through excessive partisanship on behalf of employers, using psychotechnical methods to ferret out malingerers and troublemakers.159 Yet even before the crisis, as early as the mid-1920s, psychotechnics seems to have lost the legitimacy it had previously enjoyed among German workers. The trade
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unions’ withdrawal of support by 1925 became an important factor in the breakdown of the social consensus around psychotechnics. This gradual breakdown may be illustrated by looking at the switchboard operators’ reception of the new science. Operators’ attitudes were, at least initially, favorable. Prior to the war, their publication Unter den Reichsadler had given a positive review of Hugo Münsterberg’s Psychology and Industrial Efficiency. The review accepted at face value his claim to offer a solution to the problems of the modern workplace, even defending psychotechnics against accusations that it would turn work into a soulless occupation that would “drain human labor power dry.”160 In the Berlin dailies of the previous year, charges leveled against confusion in the city’s exchanges had made an issue of operators’ gender. Referring to these reports, the review cited Münsterberg’s work to suggest that such charges reflected a traditionalist outlook. By turning switchboard work into an object of scientific analysis, Münsterberg demonstrated that the demands of the work itself, rather than the women who performed it, caused most of the problems in service. Furthermore, the article pointed out that, although Münsterberg had established 150 calls per hour as the upper limit for most operators, this was far exceeded by the periods of 600 calls per hour that sometimes occurred in Berlin. The consequences of such overload were spelled out in a passage from Münsterberg’s text and highlighted in the review: It is only natural that such rapid and yet subtle activity under such high tension . . . can be carried out only by a relatively small number of human nervous systems. The inability to keep attention at such a high point for a long while, or to perform such rapid movements, or to retain the numbers correctly, does not lead to fatal accidents like those in the case of the unfit motorman, but it does lead to fatigue and finally a nervous breakdown of the employees and to confusion in the service.161
If confusion existed, the problem lay not with the women themselves but with the effects of overwork. While the charges in the press located the causes of such breakdown in an explicitly gendered weakness or hysteria, Münsterberg’s studies seemed to liberate the subject from the topos of the feminine constitution. Operators thus perceived in the new science a nonpartisan spirit, which they welcomed as an ally in their disputes with traditionalists. In the conflict between tradition and modernity, they believed psychotechnics to be on their side. This attitude continued into the postwar era, with operators remaining generally receptive to the arguments of the rationalization experts. They acknowledged the principle of “the right man for the right job” as
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the most effective way of organizing modern labor, despite the hardship it meant in individual cases.162 As Ursula Nienhaus has written, these women saw themselves as an industrial vanguard and, as such, accepted the rationality of factory mechanisms and time-and-motion-studied work. This attitude toward rationalization was consistent with their status as mental laborers, part of the most modern branch of work. Moreover, at least during the early 1920s, with the nation still feeling the aftershocks of the war, they were prepared to accept the necessity of calls for personal sacrifice, efficiency, and streamlining of the labor process. Interpellated by both state and science as members of a community faced with a crisis defined in essentially thermodynamic terms, they responded in the same terms.163 Operators recognized themselves as beneficiaries of the larger cultural project of rationalization, even if they sometimes questioned the manner and speed of its implementation. Only when this project became linked with an attack on their jobs did they begin to regard psychotechnics more skeptically. Following the fiscal emergency of 1923, the German state stepped up its rationalization campaign and began cutting back public-sector employment. At the same time, in a shift reflecting intensifying postwar concerns about population decline, the RPM began to restructure its workforce by tying employment to marital status. The contracting labor market and the new campaign against Doppelverdiener hit female employees hard. The operators responded by writing to the RPM in November 1923, in the midst of that year’s catastrophic hyperinflation, to voice their objection to cutbacks and intensified rationalization.164 But to little avail. In 1924, thirteen thousand female employees (18 percent of their total) were let go by the RPM.165 Faced with a loss of job security, operators began to realize that they were also faced with the erosion of their status as a special class of Beamtinnen with privileges that set them apart from other workers. In an article published in 1924, their leader Else Kolshorn suggested that “overrationalization” was being used in the service of engineering a more docile workforce. The “systematic repression” of the female personnel, as she described it—particularly the uncompensated release of “troublemakers” and the newly married and ailing operators whose health was impaired by their “nerve-shattering” jobs—was facilitated by the scientifically intensified work of the remaining personnel.166 By the mid-1920s, operators had begun chafing openly at the testing regime. RPM minister Feyerabend wrote to the Verband to defend the
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experiments with aptitude testing. Conceding that it was too early to draw firm conclusions about their ultimate value, he nevertheless expressed qualified approval of the initial results of the tests. At the same time, he addressed one of the operators’ chief concerns by stressing that the testing laboratories would serve the needs of the workplace, not the goal of pure research. Approached in this spirit, he promised, work science could make important contributions not simply to overall efficiency but also to the welfare of the personnel.167 But these reassurances did little to allay their concerns. In 1925 one internal memo summed up the situation: “The workforce is adamantly opposed to the psychotechnical aptitude tests. . . . [T]hey question the need for administering the tests to those already employed. They feel that such employees should not be psychotechnically tested at all, if no consequences for the employment of the personnel are to ensue, and the tests simply serve the purpose of research.” Within the RPM, opposition was chalked up to “radical elements” in the workforce.168 But opposition had by this time become widespread. For the employees, it was not only the neutrality of the tests that was in question; the entire rationale for them had become suspect. From 1925 onward, Unter den Reichsadler’s coverage of rationalization, its ends and means, took an increasingly critical tone. The dismantling of the psychological testing stations was accompanied by steppedup rationalization of the workforce and further automation of service. The catastrophic economic situation that developed in Germany after 1929 further deepened the sense of disillusionment, especially as it became clear that America, the promised land of rationalization, had not been spared a similar fate.169 While the administration steadfastly denied that “overburdening” existed in the telephone system, and its doctors mounted a campaign designed to stigmatize operators claiming nervous illness as malingerers, editorials in the operators’ publication painted a picture of a deeply demoralized workforce, afflicted by a virtual epidemic of shattered nerves.170 One article after another described conditions in the workplace as intolerable and suggested that the “human economy” of the scientific managers had degenerated into an inhuman form of workplace discipline that, despite paying lip service to the notion of German work science, merely reproduced all the worst features of Taylorism. Rationalization not only did not eliminate the underlying problems of the workplace; it also produced new irrationalities: pathological exhaustion, bad connections, “confusion,” and worse.171
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REVISION OF THE NEUROSIS QUESTION In the meantime, the campaign against accident neurosis had shifted to a new front. In early 1924 Ewald Stier produced another lengthy report based on his observation of approximately one hundred current and former employees of the RPM. Much of this material went back to the early 1900s; in some cases, former operators had been pensioned off as many as twenty years earlier. In virtually every case, Stier concluded, the original symptoms had entirely disappeared and the operator was fit for duty; in those where this was not the case, Stier claimed to have found evidence of hereditary nervousness, suggesting that the employee should never have been hired in the first place. He welcomed aptitude tests as a technique of selection useful in screening out below-average applicants, especially those prone to nervous overexcitement. In his conclusion, Stier returned to a point he had made in earlier writings on this subject: that the best way of preventing the problem from spreading any further lay in changing the nation’s accident insurance laws so that “the nervous consequences of accident, which are not conditioned by discernible organic changes in the central nervous system, shall be expressly excluded from the liability of the state.”172 This statement points to a shift in focus from the nexus between nervous systems and technology to that between insurance bureaucracy and nervous illness. Stier’s response to operators’ charges concerning his rough treatment was to cite these as exhibit number one in his case against the pathology of social insurance itself. This strategy became central to the medical backlash against the inflation of accident neurosis claims and the Kafkaesque bureaucratic processes they spawned. Stier used his case studies of the operators as the empirical basis for a broader study of what he called the “sociology of neurosis.” Arguing that he could not find a single case of telephone accident dating from before 1901, Stier depicted it as the misbegotten offspring of the insurance law amended that year.173 To underline this correlation, he drew attention to the social composition of the personnel. Many operators, he noted, were daughters of civil servants, part of an ever-expanding sector of public employees. Their regularity and homogeneity in terms of gender, age, class origin, education, and social status suggested the existence of a strong sense of group identity. They also indicated that a more structural explanation for the inflation of claims existed in what Stier characterized as a collective personality deformation linked with their status as employees of the state. He traced increased nervous illness
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among employees of the civil service to the tendency of “weak” individuals to seek out jobs offering special protections against existential insecurity. The result was a parasitic interaction between nervous affliction and welfare bureaucracy.174 Stier’s reduction of the problem to these terms voiced his profession’s increasing hostility toward the large government agencies that were perceived as having gained control over German medicine.175 His attack on the disease picture surrounding accident neurosis was in this sense inextricably bound up with escalating debates about the Weimar Republic’s Sozialpolitik. These disputes about welfare and public spending went to the heart of the republic’s identity as a state.176 They became inseparable from a growing critique of Weimar’s “planned economy” that—as Kracauer characterized it—blamed the republic’s problems on a “crippling bureaucratization” that “stifled élan” and transformed employees into a “single inert mass.”177 Within the medical profession, welfare was now widely regarded as something pathological: overbureaucratized, mechanistic, and afflicted, as Eghigian has suggested, with a kind of neurotic overburdening that, moreover, was gendered female.178 Weimar’s expanded public health sector was stigmatized as a stronghold of socialism, “Jewish medicine,” and female social workers.179 Stier’s engagement with the problem of the telephone operators thus formed an episode within a national debate about the character of the welfare state itself—an episode particularly revealing of the stresses and fractures beginning to appear in the “soaring modernist edifice” that welfare reformers sought to create during the Weimar period.180 His writings of the late 1920s demonstrate an increasing willingness to intervene aggressively in policing the health of the German body politic. Questioning whether Berlin’s marriage counseling centers were fulfilling their purpose—to prevent the reproduction of the kind of “degenerative psychopaths” that he found common among operators—he argued that only compulsory sterilization could help to control the problem.181 At the same time, he placed increasing emphasis on prophylactic measures such as physical culture and rational care of the body, making organized athletic activities a central reference point.182 At the expense of treatment facilities, which he viewed as counterproductive because they worsened the conditions they sought to cure, Stier proposed that the authorities take steps to promote exercise and other hygienic measures among the workforce. In increasing numbers Stier’s professional colleagues seconded his views, suggesting that the claims process itself, rather than the work, was
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the true pathogen, the occasion, as one doctor put it, for the operator to “set in motion a gigantic apparatus,” thus gratifying her desire for attention.183 Perversely, the very mechanisms created to cushion the shocks of industrial society were becoming implicated in a more general social crisis. Telephone operators, it seemed, had succeeded in making of nervous breakdown itself an utterly rationalized event, indeed, had virtually commodified it. Intense lobbying of the German legal community followed. On 2 December 1924 in a two and a half hour talk given to a hundred judges in the lecture hall of the Psychiatric and Neurological Clinic of the Charité, Stier laid out the issues facing the medical and legal establishment. Armed with freshly gathered statistics, he argued that the causes of neurosis should be looked for in fantasy and morbid wish.184 Backed up by further studies, Stier’s argument received support from the leaders of German academic psychiatry, including Oswald Bumke in Munich and Karl Bonhoeffer in Berlin. A major statement in support of Stier’s position came from Bumke, who delivered a talk entitled “Revision of the Neurosis Question” at the annual conference of the Society of German Neurologists held in 1925. Bumke’s overview of the history of the neurosis concept laid out the two opposing schools of thought that, he argued, had dominated German medicine since the 1870s. One took the view that neurosis was the result of accident-caused trauma to the nerves; the other interpreted neurosis as only indirectly, if at all, linked to an accident, viewing it instead as a psychological illness whose causes were to be traced chiefly to predisposition, sexual disorders, or the insurance proceeding itself. Bumke counted himself an advocate of the second view and was happy to report that it was in ascendance. In Bumke’s highly revisionist account, this view had already been widely accepted as early as the late 1870s: “Then in 1880 Beard, with his neurasthenia, entered the picture. With one blow, the somatic perspective gained the upper hand once again. There is surely no other case in the history of medicine in which a single term has had such an enormous scientific impact and at the same time been the cause of so many new illnesses.” Bumke portrayed the previous half century as an unfortunate chapter in the history of psychiatry, which the profession was only now emerging from: “Historical developments have finally transformed what was originally an almost purely somatic concept into a primarily psychological one. From my point of view this is a sign of progress. . . . If we hadn’t disposed of traumatic neurosis, we would be in no position to think about making the accident neurotic an impossibility by changing our social laws.”185
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The authorities of the RPM followed these developments closely, as did the Reich Insurance Office (RVA), which solicited opinions, organized conferences, invited guest speakers to speak to its members, and consulted eminent doctors on the Rentenneurose question.186 Other prominent doctors fell in behind Stier’s position. Karl Bonhoeffer, head of the Psychiatric and Neurological Clinic at Berlin’s Charité, wrote a lengthy paper recapitulating the by now familiar list of pathogens: hereditary predisposition; interaction between fright effect and expectation; popular misconceptions about traumatic neurosis that inverted the causes of the illness. Bonhoeffer’s paper, which was circulated within the RPM, cited two important moments in the history of traumatic neurosis: the 1897 opinion of Berlin’s medical faculty, in which Oppenheim’s concept of traumatic neurosis had been dealt the first blow; and the war, which had finished the job. According to Bonhoeffer, codified law offered no well-formulated definition of the causal connection between trauma and neurosis, so “[i]t is advisable . . . to avoid the designation ‘traumatic neurosis,’ given that the adjective ‘traumatic’ in normal medical usage signifies a causal connection. The term ‘Rentenneurose’ seems to be the best substitute, in that it expressly emphasizes the psychological connection.”187 The accent, he concluded, should be placed on the “absence of an adequate causal connection between accident and functional disturbance.” Defining such a connection in the narrowest possible terms, Bonhoeffer sought to remove what he regarded as the single most important factor in the etiology of neurosis, the inducement to pension. By the mid-1920s, momentum behind the campaign to change the laws governing accident neurosis became unstoppable. The position associated with Stier, Bumke, and Bonhoeffer had gained widespread acceptance. The RVA had familiarized itself with Stier’s view and circulated the Obergutachten submitted by Bonhoeffer. Stier’s position became the basis of the decision handed down on 24 September 1926 by the RVA, which changed Germany’s accident insurance laws.188 Traumatic neurosis would no longer be recognized as a compensable illness. In the end, as one of the RPM’s experts put it, “[t]he causes of the emergence of the so-called accident neuroses lie in our laws.”189
AFTER SHOCK The consequences of this reversal were immediately felt by the operators. A series of articles in the liberal daily Vossische Zeitung makes clear what
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was at stake in the abandonment of the traumatic neurosis model. The disqualification of this model, with its assumption of organic trauma, left the operator with little legal recourse. But as one author wrote, the “dismantling of the neuroses” (Abbau der Neurosen) did not take into account the still considerable divergence in medical opinion on the matter. Twenty-five years of debate had done little to resolve the underlying nature of a condition that was “knowable only by its effects.”190 The article cited Frankfurt psychologist Kurt Goldstein as its authority for the view that “the manifestations of functional and organic ailments are completely identical”—a view that offered considerably more room for debate than Stier’s supposedly ironclad position. According to representatives of the Verband, the authorities were simply using Stier’s position as a fig leaf for their desire to cut costs.191 In the wake of the 1926 decision, many operators lost their pensions, and others found it exceedingly difficult to receive a sympathetic hearing.192 Indeed, if we are to believe Stier, the entire problem seems to have vanished almost overnight. On the basis of a questionnaire he distributed to various public authorities, he reported in 1929 to the Labor Ministry the virtual disappearance of so-called fear neuroses among operators, railway personnel, and other state employees. Not the least welcome aspect of this in his eyes was the disappearance of what he described as the “specter of the Zitternden, those people who yammer and complain incessantly about 1000s of ailments.”193 Although Germany in the Wilhelmine era had been able to reach a fragile social consensus concerning the relation between modernity and its discontents, this consensus, amid the very different conjunctures of the Weimar era, came unraveled and was reconstituted on a new basis. Prewar views surrounding the causes and treatment of nervous affliction yielded to the conviction that personal weakness and the pathologies of the German welfare state lay at the heart of the problem. The key to this shift was furnished by dismantling one of the cornerstones of prewar psychiatry. At precisely the time that Freud was resurrecting what he called the “old, naïve theory of shock” in his own writings, German psychiatrists were jettisoning it as a mythical remnant of an outdated worldview.194 But if shock was in some sense a myth, it was a rational, concrete myth, one whose origins lay in the all too real dislocations and stresses of technological modernity. With remarkable ease, the decision of 1926 conjured away the problem of accident neurosis and, with it, the specter of the Zitterer. The result of this resolution of the problem was
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the effective decoupling of modernity and nervous discontent. If such discontent was the price of civilization, and social insurance the price of managing this discontent, then the price had become too high. The “revision of the neurosis question” was thus also a revision of one of the fundamental compromises that had underwritten German society since the 1880s.
Conclusion
T
he discourses of risk of modern times represent an aspect of what the sociologist Ulrich Beck calls “reflexive modernity”: the scientifically grounded response to those existential risks unleashed by industrialization.1 Virtually since the moment of German unification, the new nation’s social policy assumed a relation between modernization and risk and assumed, moreover, that it lay within society’s ability to rationally manage the shocks, accidents, and afflictions of the modern era. The cornerstone of this program was social insurance, which proponents saw as the answer to the social question: a means of addressing the social pathologies associated with industrialization and urbanization; a means of creating a productive, risk-free society; and ultimately an expression of the civilizing process. Despite mounting stresses and criticisms, the new “insurance community” forged by this legislation remained intact up to the Great War. But in the wake of total war, military defeat, and revolution, followed later by economic catastrophe, German society’s faith in its ability to manage its own discontents within the existing framework was badly shaken. Germans emerged from the war, as Peter Fritzsche has suggested, traumatized by the sense that the production of wealth promised by the nineteenth-century gospel of progress had been overtaken by the production of risk.2 Even as the nation embraced a new cult of modern212
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ization—Americanism—the aftermath of the war unleashed a tremendous debate over the source and nature of risk in the modern world and the limits of society’s responsibility for its own discontents. One sees this illustrated in the medical profession’s response to war neurosis, which became intensely stigmatized in the war’s aftermath. “If a person’s got sick nerves, then he’s healthy,” pronounces a character in Alfred Döblin’s novel of the 1920s, Berlin Alexanderplatz, which tells the story of a veteran whose war traumas are reactivated by his experiences on the streets of Weimar Berlin but who finds himself treated as a malingerer by the doctors at Berlin’s Buch hospital. By the end of the Weimar period, nervousness, once recognized as an authentic disease of modernity and one whose management society assumed partial responsibility for, was being increasingly pathologized as a marker of degeneracy, and the responsibility for it shifted back onto the individual.3 It was not by chance that neurasthenia lost medical validity precisely at this historical juncture. In the specter of the Kriegszitterer who haunted the capital’s street corners and subway station entrances, it threatened to become ubiquitous and in a form, moreover, in which the threat of some kind of stigmatized or emasculated otherness could not be kept at bay. The nineteenth-century belief that modern metropolitan life bombarded individuals with exciting and dangerous stimuli, weakening their resistance and will and in so doing “unmanning” them, culminated during the war with the discourse about male hysteria. In the postwar climate this belief found its consummate expression in the psychiatric discourse about telephone operators, who became highly visible faces of the urban mass culture of the 1920s. The postwar specter of generalized nervous and social breakdown helped shatter the German insurance community. In a forum on traumatic neurosis and pensions held at the Labor Ministry in 1929, Ewald Stier, the psychiatrist who had done perhaps more than anyone else to dismantle this diagnosis, confessed in a moment of rare honesty that it was possible that everyone could be “hystericized.”4 It was precisely this disturbing possibility that fueled the backlash against nervousness and the social contract forged around it. Nervousness could no longer be assimilated into a workable narrative of the modernizing project and thus had to be decoupled from it. Even those medical professionals who once welcomed social insurance and saw it as an expression of a superior, uniquely German response to the modernizing process now began to see it as problematic, even pathological. Equally important, they began to entertain more rad-
214 CONCLUSION
ical solutions to the social question and to the disenchantment of modern life wrought by the social state and its bureaucracies. This was true even of some who remained unwavering in their support of insurance, such as Alfred Grotjahn, whose postwar estimate that one-third of the population was of “inferior” stock reflects the reencoding of the discourse about nerves in a new language of biological and hereditary stigma.5 That such views found wide resonance across the political spectrum attests to the intensifying search for means of reducing social welfare costs; it attests as well to the increasing desocialization of risk that marked late Weimar society.6 One also sees evidence of this traumatized new postwar sensibility in a change in the public image of electricity. Without losing its mystique, it became transformed after the war from utopian symbol of progress into a far more ambivalent symbol, a transformation that appeared most clearly in the general public revulsion against Kaufmannization and those who wielded it. In Berlin Alexanderplatz the form of high-current treatment used for war neurotics is referred to as “modern torture,” and the sadistic application of electricity to soldiers also became a motif of postwar Dada, specifically in the work of Georg Grosz, himself a victim of war neurosis. Even while the electrification of German society, and particularly of Berlin, reached unprecedented new levels throughout the 1920s, the public appreciation of the risks of modern life became increasingly attached to electricity.7 One site where this is evoked particularly clearly is Fritz Lang’s film Metropolis. Here electricity figures both in the efforts of the mad—and unmistakably Jewish—scientist Rotwang to bring to life a demonic robot and in the massive electrical short-circuit that is precipitated by an industrial accident in the central dynamo room (itself precipitated by the exhaustion of the worker at the control panels), threatening the world of the metropolis with catastrophe.8 In its meditation on the seemingly uncontrollable risks of the modernization process, Metropolis expresses a deeply ambivalent postwar sensibility that both celebrated and demonized Americanism and its faith in science and technological rationalization. The cinema itself became a central topos of this new sensibility, insofar as its emergence as an increasingly important cultural institution in the first decades of the twentieth century was woven into the public discussion about the benefits and dangers of electrification and into the psychiatric thematization of “growing nervousness.” Standard early accounts of the dangers of cinematic spectatorship held that the “excitements” of the typical film scenario, coupled with the intensity and rapid succession of filmic images,
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engendered a more “intense viewing experience” than customary under normal circumstances and could lead to an overburdening of the nervous system.9 Such concerns were inevitably multiplied by the war, which made the nervous and mental health of the nation as a whole an issue of intense concern.10 The postwar collapse and the moral panic it engendered significantly heightened apprehensions concerning the relation between the cinema and its audience, leading to demands for censorship of the new medium and greater regulation of the public sphere.11 According to one psychiatrist writing in 1920, sensationalistic films often led to hysterical fits among war neurotics and in some cases actually produced neurosis. The cinema’s suggestive effect, this doctor argued, exercised a powerful hypnotic influence over its audience, which was a concern that other experts tied to particular social groups seen as “at risk” (war neurotics, young women, adolescents).12 In a 1925 memo to the Imperial Health Office, the minister of the interior concurred, arguing that popular films, which worked on the audience’s mind through “excitement, surprise, suspense,” exercised a dangerous influence over those of tender age: “The number of nervous children nowadays is quite shocking. The filmic experience often follows them into their dreams, exciting them pathologically, robbing them of their sleep, and making them oversensitive to all sense impressions.”13 At the same time that medical scientists expressed concerns about the effects of popular films on the nervous and mental development of adolescents, they also welcomed film as an instrument of scientific research and public enlightenment. They embraced the medium’s potential for helping to construct a rationally ordered society to replace the one left in ruins by the war, showering the Imperial Health Office with information on a wide variety of educational films, ranging from topics such as alcoholism, sexually transmitted diseases, and accident prevention to the treatment of soldiers with brain injuries.14 These films became part of a broad program of mental hygiene for the masses, a program that received considerable sanction from a state that had finally abandoned its initial suspicion towards the new medium for an appreciation of the cinema’s unrivaled power as a tool for mobilizing and directing the collective energies of the masses.15 This view of film as a force that could further the rationalization of society and at the same time acquire a dangerous power over its audience—an audience construed as female, hysterical, and highly suggestible—is explicitly thematized in many films of the Weimar period.16 As the product of a highly technologized civilizing process that brought
216 CONCLUSION
both new benefits and new risks, the cinema is part of the larger narrative whose contours this study has traced. Perhaps there is no more effective statement of the dangers of overcivilization in the Weimar period than Lang’s Metropolis, whose representation of the scientifically regulated society of the future is organized around the possibility of a massive, traumatic breakdown that threatens this society with its demise. The industrial accident that forms the central scene of this film puts the turn-of-the-century project of fashioning a new, more rational form for the metropolis in extreme jeopardy—a jeopardy whose origins, in Lang’s vision, lie in the scientifically intensified and rationalized organization of labor that drives the metropolis’s underground workers to exhaustion. Paul Virilio has identified the accident as intrinsic to all technological systems; to paraphrase him, to invent the train is to invent the derailment. It is thus also to create the anxiety that surrounds such events, an anxiety that, as Lang’s film demonstrates, resonates deeply within the social imaginary of modern civilization. Yet Lang’s film also points to the possibility that the popular cinema may play a role in repairing or reconstituting the technological web and the corresponding perceptual and behavioral forms that, according to Schivelbusch, are torn by the kind of massive breakdown staged in Metropolis.17 As Miriam Hansen has written, film became in the early twentieth century one of the social discourses by means of which society “sought to come to terms with the traumatic impact of modernization.”18 In mediating the experience of modern life, it assumed a crucial role in binding shock or in controlling the anxiety that, according to Freud, helped to ward off shock.19 Insofar as Metropolis dramatizes the potential for crisis that modern society harbors within itself, it stands at the far end of the process of development, whose origins we first began tracing in the 1896 Berlin Trade Exhibition. Lang’s film’s contributions to the discourse about modern civilization initiated by the Trade Exhibition may be measured in the intense interest surrounding the film’s production, which became an event and a spectacle in its own right. Film critic Willy Haas celebrated Metropolis as not just a technological masterpiece but also a testament to the technical and organizational possibilities of modern industrial society. The sheer labor involved, the tremendous forces mobilized, “the superhuman energy and tenacity” of its director, all excited Haas’s enthusiastic admiration: “One and a half years of nerve-wracking work! A 1,000 wonderfully conceived and executed, thoroughly worked-out details!”20 The year-long buildup that accompanied this “superhuman” project made the details of its production—from the electric flashlight
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that Rotwang uses to pursue Maria in the catacombs, to the power plant on the Neubabelsberg set, which supplied energy for the whole undertaking, to the on-set precautions taken in case filming was interrupted by an “accident”—topics of great public interest. This held true as well for the elaborate (and electrically enhanced) spectacle-making surrounding its theatrical release, which almost overshadowed the film itself, generally regarded at the time as a disappointment.21 Haas spoke for many in concluding that the final product suffers from crippling defects, above all a “profound lack of inner form.” The “hyper-American, utopian, urban mechanism” it represents lacks any inner life. The film is plagued by the same soullessness as the society it depicts and is haunted by a similar possibility of breakdown: ultimately, in Haas’s eyes, the film’s lack of inner form brings the “entire precision machinery of this calculated world . . . to a standstill.”22 Lang’s depiction of the world of the metropolis as a soulless mechanism internalized the imagery of Berlin that was increasingly common in the right-wing press of the late 1920s, when Berlin became a metaphor and an incarnation of a purely mechanical society, more American than German, and—as the movie’s scenes of hysterical mobs led by women remind us—a site of conservative fantasy regarding the masses.23 In this sense too, it stands at the far end of a trajectory that began in the late nineteenth century. The two events—Lang’s 1927 film and the 1896 Trade Exhibition—frame a view of Berlin as site and object of a discourse about the costs of the civilizing process. While the Trade Exhibition demonstrated how those risks could be managed within the “insurance community” created by Bismarck’s social legislation, this community was unraveling by the time of Lang’s 1927 film, and seemingly the threat of risk could no longer be contained. In Metropolis, as in the Trade Exhibition, industrial civilization stages its ultimate triumph and contemplates its shadow side; but in the film, this shadow side threatens civilization with its demise. Science and the rationalization process have assumed a demonic form, manifest both in the dehumanized figures of the workers and, most vividly, in Rotwang’s mechanical vamp. Symptomatic of this is the sentimentalized treatment of the longing for a mediating agent (“the heart”) that can repair the rift between “head” and “hand” and reinfuse the inert mechanism with a “soul.” To the extent that Metropolis overcomes this rift, it does so in a fashion that Siegfried Kracauer, partly echoing his teacher Simmel’s observations regarding the 1896 Trade Exhibition, saw in generally negative terms. Beyond offering what was already a standard lament about mass
218 CONCLUSION
culture—that it compensates its audience for the “one-sidedness” and “nervousness” of their existence through distractions, narcosis, hypnosis —Kracauer suggested that Metropolis fashions a new collective image of society to replace the one broken by the modernizing process.24 The distance between the Trade Exhibition and Metropolis may in one sense be measured in the very different allegories of labor that each projects. On the one hand, the Trade Exhibition’s poster of the worker’s hand holding the hammer has been turned into the film’s dehumanized and reified workers (the “hands” of the city). On the other, the telephone operators who in 1896 were allegorized as technologized ornamental nymphs have undergone a double transformation, appearing in the film as a robotvamp on the one hand and as the ornamental patterning of the feminized crowd on the other. Purged of its negative aspects (the vamp), the “mass ornament” into which Metropolis finally transforms the crowd assumes, in Kracauer’s eyes, contours that are unmistakably National Socialist.25 In the mass ornament, the Weimar body politic achieved a selfrepresentation that was fully defended against the shock that is inscribed in the body of the Zitterer, against the specter of internal weakness and degeneration. It is this other, stigmatized body that forms the subject of Georg Grosz’s poem “Kaffeehaus,” a poem that, as Brigid Doherty has written, was probably composed in Berlin in 1917, following Grosz’s release from a military mental hospital near the capital, where he had been sent to be treated (most likely with electricity) for his “shattered nerves.”26 Grosz’s poem links the experience of the front and that of the metropolis, implicating both in what Doherty calls its diagnosis of universal neurasthenia: Waiter! A glass of seltzer please— I am a machine whose pressure gauge has gone to pieces! And all the cylinders run in circles— See: we are all neurasthenics!27
The poem’s reference to a broken pressure gauge anticipates the scene of industrial accident in Metropolis and, in so doing, asserts a continuity between the experience of psychic breakdown and that of social breakdown, a continuity that would become a core part of Weimar’s social imaginary. In disavowing neurasthenia, the German medical establishment sought to banish the specter of a neurotically overburdened body politic and to forge in its place a new national community, defended against the shocks of the modernizing process.
Notes
INTRODUCTION 1. Friedrich Nietzsche, Human, All Too Human (New York 1986), 116. 2. According to Erwin Ackerknecht, “Only since the 18th century has it been possible to suffer from ‘nerves.’ ” Ackerknecht, Short History of Psychiatry (New York 1968), 37. 3. On Paris, Vienna, and hysteria, see Mark Micale, “Charcot and the Idea of Hysteria in the Male,” Medical History 34 (1990): 364. 4. Benjamin observed of Karl Kraus that “[h]e found that [the nerves] were just as worthy an object of impassioned defense as were property, house and home. . . . He became an advocate of nerves.” Walter Benjamin, “Karl Kraus,” in Reflections (New York 1978), 261. 5. Oswald Bumke, “Die Revision der Neurosenfrage,” Zentralblatt für die gesamte Neurologie und Psychiatrie 41 (1925): 671. All translations from German sources are my own unless otherwise noted. 6. Sigmund Freud, Civilization and Its Discontents (New York 1961). 7. On the growing authority of medical professionals, see, for instance, Alfons Labisch, Homo Hygienicus: Gesundheit und Medizin in der Neuzeit (Frankfurt 1992); and Claudia Huerkamp, Die Aufstieg der Ärzte im 19. Jahrhundert (Göttingen 1985). 8. Thomas Mann, The Magic Mountain (New York 1969), 178–81. 9. See Joachim Radkau, Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich 1998); and Michael Hau, The Cult of Health and Beauty in Germany: A Social History (Chicago 2003). 219
220 NOTES TO PAGES 5–9
10. The case of Daniel Paul Schreber is paradigmatic here. See his Memoirs of My Nervous Illness (Cambridge, MA 1988). 11. See Michel Foucault, Discipline and Punish: The Birth of the Prison (New York 1979), esp. 184–92. 12. See, for instance, Peter Gay, The Tender Passion (New York 1986), 329–90. 13. See Abraham’s letter to Freud, 27 Oct. 1918, in A Psychoanalytical Dialogue: The Letters of Sigmund Freud and Karl Abraham, 1907–1926, ed. Hilda C. Abraham and Ernst L. Freud (New York 1965), 279–80. 14. This argument was first made by Esther Fischer-Homberger in Die traumatische Neurose: Vom somatischen zum sozialen Leiden (Bern 1975). 15. On the war, see B. Ulrich and B. Ziemann, eds., Frontalltag im Ersten Weltkrieg: Wahn und Wirklichkeit (Frankfurt 1994); Daniel Pick, War Machine: The Rationalization of Slaughter in the Modern Age (New Haven, CT 1993); Klaus Theweleit, Male Fantasies, vol. 1–2 (Minneapolis, MN 1987–89); and Modris Eksteins, The Rites of Spring: The Great War and the Birth of the Modern Age (New York 1989). 16. Alfred Döblin, Berlin Alexanderplatz (New York 1931), 385. 17. Siegfried von Weiher, Berlins Weg zur Elektropolis : Technik- und Industriegeschichte an der Spree (Göttingen 1987). For more on the history of Berlin during this period, see Annemarie Lange, Berlin zur Zeit Bebels und Bismarcks (Berlin 1976); J. Boberg, T. Fichter, and E. Gillen, eds., Exerzierfeld der Moderne: Industriekultur in Berlin im 19. Jahrhundert (Munich 1984); and David Clay Large, Berlin (New York 2000). 18. Dieter Langewiesche, Liberalismus im Deutschland (Frankfurt 1988); James Sheehan, German Liberalism in the Nineteenth Century (Chicago 1978). 19. On socialist imaginings of an electrically driven future, see August Bebel, Die Frau und der Sozialismus (Berlin 1974), 428–37. On Jews and Berlin, see Peter Gay, “The Berlin-Jewish Spirit,” in Freud, Jews and Other Germans (New York 1978); Brian Ladd, The Ghosts of Berlin: Confronting German History in the Urban Landscape (Chicago 1997), 111–15; and Emily D. Bilski, ed., Berlin Metropolis: Jews and the New Culture, 1890–1918 (Berkeley, CA 1999). 20. On this distinction see Anna Querrien, “The Metropolis and the Capital,” in Zone 1/2: The Contemporary City, ed. M. Feher and S. Kwinter (New York 1986), 221. 21. This tendency was exemplified by the work of Peter Gay and Georg Mosse. See Gay, The Tender Passion. Mosse’s views on the subject of nerves can be found in many of his works; see, for instance, his “Masculinity and the Decadence,” in Sexual Knowledge, Sexual Science: The History of Attitudes to Sexuality, ed. R. Porter and M. Teich (Cambridge 1994), 134–57; and George Mosse, The Image of Man: The Creation of Modern Masculinity (New York 1996). 22. See, for instance, Elaine Showalter, The Female Malady: Women, Madness, and English Culture, 1830–1980 (New York 1986); Sander Gilman, Freud, Race and Gender (Princeton, NJ 1993); and Mark Micale, Approaching Hysteria: Disease and its Interpretations (Princeton, NJ 1995). Much of this new work can be found in R. Porter and S. Gilman, eds., Hysteria beyond Freud (Berkeley,
NOTES TO PAGES 10–15 221
CA 1993); and in M. Micale and P. Lerner, eds., Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age 1870–1930 (Cambridge 2001). 23. Joachim Radkau, Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich 1998), 458. 24. Paul Lerner, Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany 1890–1930 (Ithaca, NY 2003), 250. 25. Greg Eghigian, Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany (Ann Arbor, MI 2000). For other recent work on the history of the German welfare state, see, for instance, David Crew, Germans on Welfare: From Weimar to Hitler (New York 1998); and Young-Sun Hong, Welfare, Modernity and the Weimar State, 1919–1933 (Princeton 1998). 26. Francois Ewald, “Insurance and Risk,” in The Foucault Effect: Studies in Governmentality, ed. Peter Miller, Graham Burchell, and Colin Gordon (London 1991), 209. For another approach to the problem of risk in modern society, see Ulrich Beck, Risk Society: Towards a New Modernity (London 1992). 27. Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990). 28. Detlev Peukert, The Weimar Republic: The Crisis of Classical Modernity (New York 1989), 82. 29. Detlev Peukert, Max Webers Diagnose der Moderne (Göttingen 1989). 30. Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870–1945 (Cambridge 1989). See also Detlev Peukert, “The Genesis of the ‘Final Solution’ from the Spirit of Science,” in Nazism and German Society 1933–1945, ed. D. Crew (London 1994), 274–99; Peter Weingart, Jürgen Kroll, and Kurt Bayertz, Rasse, Blut, und Gene: Geschichte der Eugenik und Rassenhygiene in Deutschland (Frankfurt 1992); and Sheila Faith Weiss, Race Hygiene and National Efficiency: The Eugenics of Wilhelm Schallmayer (Berkeley, CA 1987). 31. See, for instance, Cornelie Usborne, Frauen Körper—Volks-Körper: Geburtenkontrolle und Bevölkerungspolitik in Weimarer Republik (Münster 1994); Atina Grossmann, Reforming Sex: The German Movement for Birth Control and Abortion Reform 1920–1950 (New York 1995); Mary Nolan, Visions of Modernity: American Business and the Modernization of Germany (New York 1994); and Lerner, Hysterical Men. 32. Wolfgang Schivelbusch, The Railway Journey: The Industrialization of Time and Space in the 19th Century (Berkeley, CA 1986). 33. Friedrich Kittler, Discourse Networks 1800/1900 (Stanford, CA 1990). In his foreword to Kittler’s book, David Wellbery defines discourse networks as “linkages of power, technologies, signifying marks, and bodies.” See Wellbery, foreword, in Kittler, Discourse Networks, xiii.
1. BERLIN ELECTROPOLIS 1. See Illustrierter amtlicher Führer durch die Berliner Gewerbe-Ausstellung 1896 (Berlin 1896), 5. 2. Paul Lindenburg, Pracht-Album Photographischer-Aufnahmen der Berliner Gewerbe-Ausstellung 1896 (Berlin 1896), 154.
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3. Ibid., 158. See also Illustrierter amtlicher Führer, 8–9. 4. Maximilien Harden, “Ausstellung,” Die Zukunft, 6 June 1896, 6. 5. See Albert Eulenburg, “Die Nervosität unser Zeit,” Die Zukunft, 15 Aug. 1896, 302–18. 6. Georg Simmel, “The Berlin Trade Exhibition” (1896), in Simmel on Culture, ed. D. Frisby and M. Featherstone (London 1997), 255–56. 7. Ibid. 8. Georg Simmel, “Infelices Possidentes!” (1893), in Simmel on Culture, ed. Frisby and Featherstone, 261. 9. Lindenburg, Pracht-Album Photographischer-Aufnahmen, 742. 10. For an analysis of the 1900 Paris World’s Fair in similar terms, see Paul Rabinow, French Modern: Norms and Forms of the Social Environment (Cambridge, MA 1989), 229ff. 11. Fritz Kuhnemann et al., Berlin und seine Arbeit: Amtlicher Bericht der Berliner Gewerbe-Ausstellung (Berlin 1898); on the recent developments in the field of healthcare, 735; on the uses of electric light and current, 735; on the spread of neurasthenia, 733. 12. For more on electrification, see Wolfgang Schivelbusch, Disenchanted Night: The Industrialization of Light in the 19th Century (New York 1988). 13. Siegfried Giedion, Mechanization Takes Command (New York 1948), 542. 14. Ibid., 559–60. 15. Friedrich Nietzsche shared in the general fascination with electricity; his letters from this period repeatedly expressed the belief that he was absorbing electricity from the atmosphere: “Each cloud contains some form of electric charge that suddenly takes hold of me, reducing me to utter misery.” In 1881 he wrote to his friend Overbeck that he himself ought to be on display at the Paris exhibition. Cited in Ronald Hayman, Nietzsche: A Critical Life (London 1980), 235. 16. Schivelbusch, Disenchanted Night, 67. For more on the history of electrification and its reception during this period, see the essays in Klaus Plitzner, ed., Die Elektrizität in der Geistesgeschichte (Bassum 1998). 17. Nerve doctor and psychologist Willy Hellpach described the 1890s as a period of technological awakening that could be compared only with the electrical experiments by Galvani and Volta a century earlier. See Hellpach, Wirken und Wirren: Lebenserrinerungen, vol. 1 (Hamburg 1948–49), 189. 18. Lindenburg, Pracht-Album Photographischer-Aufnahmen, 170. For more on the electrical nymphs that populated technical publications at the turn of the century, see Tilmann Buddensieg, Industriekultur: Peter Behrens and the AEG, 1907–1914 (Cambridge, MA 1984), 32–33; and on the connection between women and images of electricity, see Maria Osietzki, “Weiblichkeitsallegorien der Elektrizität als ‘Wunschmaschinen,’ ” Technikgeschichte 63 (1996): 47–70; and Christoph Asendorf, Batteries of Life: On the History of Things and Their Perception in Modernity (Berkeley, CA 1993), 165–66. On the connection among nerves, electrical wires, and the curvilinear line of turn-of-the-century Jugendstil ornament, see Walter Benjamin, The Arcades Project (Cambridge, MA 1999), 558. 19. Annemarie Lange, Berlin zur Zeit Bebels und Bismarcks (Berlin 1976), 219–37. 20. Ibid. See also J. Boberg, T. Fichter, and E. Gillen, eds., Exerzierfeld der
NOTES TO PAGES 22–24 223
Moderne: Industriekultur in Berlin im 19. Jahrhundert (Munich 1984); and Gerhard Masur, Imperial Berlin (London 1971). 21. Hans-Ulrich Wehler, The German Empire 1871–1918 (Leamington Spa 1985), 41ff.; Hans-Ulrich Wehler, “Der Aufstieg des organisierten Kapitalismus und Interventionsstaates in Deutschland,” in Organisierter Kapitalismus, ed. H. Winkler (Göttingen 1973); Hans Rosenberg, “Political and Social Consequences of the Great Depression of 1873–1896 in Central Europe,” Economic History Review 13 (1943): 58–73. 22. For a discussion of the Trade Exhibition in these terms, see Paul Thiel, “Berlin präsentiert sich der Welt,” in Die Metropole: Industriekultur in Berlin im 20. Jahrhundert, ed. J. Boberg, T. Fichter, E. Gillen (Munich 1986), esp. 20–21. 23. Siegfried von Weiher, Berlins Weg zur Elektropolis: Technik- und Industriegeschichte an der Spree (Göttingen 1987). 24. Schivelbusch, Disenchanted Night, 75. 25. On the expansion of the German electrical industry, see Lange, Berlin zur Zeit Bebels und Bismarcks, 486–93; Weiher, Berlins Weg zur Elektropolis; and Thomas Hughes, “Berlin: The Coordination of Technology and Politics,” in Networks of Power: Electrification in Western Society, 1880–1930 (Baltimore 1983), 175–200. 26. Egon Friedell, A Cultural History of the Modern Age (New York 1932), 341. 27. Weiher, Berlins Weg zur Elektropolis. By the end of the first decade of the twentieth century, the AEG alone employed in and around Berlin “a populace of 150,000 souls,” in the admiring words of the young Le Corbusier, who worked for a time in the offices of AEG house architect Peter Behrens. Tilmann Buddensieg, ed., Berlin 1900–1933: Architecture and Design (New York 1987), 148. 28. See Buddensieg, Industriekultur. 29. Friedrich Kittler, Discourse Networks 1800/1900 (Stanford, CA 1990); see also Stephen Kern, The Culture of Time and Space 1880–1918 (Cambridge, MA 1983); and Asendorf, Batteries of Life. 30. Lange, Berlin zur Zeit Bebels und Bismarcks, 575. 31. Between 1856 and 1906, the proportion of newspaper articles covering events occurring within the previous twenty-four hours increased from 11 to 95 percent. Peter Fritzsche, Reading Berlin 1900 (Chicago 1996), 181–83. 32. Ibid., 210. 33. Peter Gay, “The Berlin-Jewish Spirit,” in Freud, Jews and Other Germans (New York 1978), 171. 34. Brian Ladd, The Ghosts of Berlin: Confronting German History in the Urban Landscape (Chicago 1997), 112–18. See also the essays in Boberg, Fichter, and Gillen, eds., Die Metropole. 35. Walter Benjamin, Charles Baudelaire: A Lyric Poet in the Age of High Capitalism (London 1973), 132. 36. Alfred Döblin, “Berlin Program” (1913), cited in Harald Jähner, “The City as Megaphone in Alfred Döblin’s Berlin Alexanderplatz,” in Berlin: Culture and Metropolis, ed. C. Haxthausen and H. Suhr (Minneapolis, MN 1990), 142. 37. Peter Behrens, “On Art and Technology” (1910), reprinted in Buddensieg, Industriekultur, 218. On the impermanence and absence of monumentality that marked Berlin’s architecture, see Simmel, “The Berlin Trade Exhibition.”
224 NOTES TO PAGES 24–28
38. Karl Scheffler, Berlin: Ein Stadtschicksal (Berlin 1910), 267. 39. David Clay Large, Berlin (New York 2000), 49. 40. See Klaus Bergmann, Agrarromantik und Großstadtfeindlichkeit (Meisenheim am Glan 1970). 41. “Die Electrotechnik also Kulturträger,” Die Zukunft, 26 May 1893, 425; “Die elektrische Strassenbahnen,” Die Zukunft, 12 Aug. 1893, 329–32. 42. For instance, on the collaborative efforts of the AEG’s Rathenau and Behrens to bring about a reconciliation of technology and culture, see Buddensieg, Industriekultur. 43. Max Weber, “Bureaucracy,” in From Max Weber: Essays in Sociology, ed. H. H. Gerth and C. W. Mills (New York 1946), 228. 44. Siegfried Kracauer, The Salaried Masses: Duty and Distraction in Weimar Germany (New York 1998), 32. 45. Siegfried Kracauer, “The Mass Ornament,” in The Mass Ornament (Chicago 1995), 75–86. 46. Fritzsche, Reading Berlin 1900. See also John Czaplicka, “Pictures of a City at Work, Berlin, circa 1890–1930,” in Berlin: Culture and Metropolis, ed. Haxthausen and Suhr, 3–36. 47. Cited in Thomas Hughes, ed., Ein Mann vieler Eigenschaften: Walther Rathenau und die Kultur der Moderne (Berlin 1990), 16. 48. Egon Friedell, “Prolog vor dem Film” (1912), in Kino-Debatte: Texte zum Verhältnis von Literatur und Film 1909–1929, ed. Anton Kaes (Munich 1978), 43. 49. Janet Ward, Weimar Surfaces: Urban Visual Culture in 1920s Germany (Berkeley, CA 2001), 101. 50. Eulenburg, “Die Nervosität unser Zeit,” 303–5. 51. Alfred Goldscheider, Die Bedeutung der Reize für Pathologie und Therapie im Lichte der Neuronlehre (Leipzig 1898), 62. 52. See Willy Hellpach, Nervenleben und Weltanschauung (Wiesbaden 1906), 18. 53. Willy Hellpach, Nervosität und Kultur (Wiesbaden 1902), 75. 54. Hermann Grün, “Erkrankungen der Arbeiter in elektrische Zentralen und der Elektromonteure,” in Handbuch der Arbeiterkrankheiten, ed. Theodor Weyl (Jena 1908), 284. 55. Lewis Mumford draws on Simmel in lamenting the new city and “the loss of form, the loss of autonomy, the constant frustration and harassment of daily activities, to stay nothing of gigantic breakdowns and stoppages.” See Mumford, The City in History (New York 1961), 544, 552. 56. Georg Simmel, “The Metropolis and Mental Life” (1903), in On Individuality and Social Forms, ed. D. Levine (Chicago 1971), 328. 57. Berliner Lokaler-Anzeiger, 8 Apr. 1904. 58. See, for instance, Hans Kurella, “Elektropathologie,” Zeitschrift für Elektrotherapie und ärztliche Elektrotechnik 6 (1904): 295. Kurella warns of the dangers associated with the expansion and increasing density of the network of telephone lines and electrical streetcars. In a later issue he devoted a lengthy article to the topic of telephone-related nervous breakdown. See Kurella, “Elektrische Gesundheits-Schädigung am Telephon,” Zeitschrift für Elektrotherapie 7 (1905): 238–61.
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59. Wolfgang Schivelbusch, The Railway Journey: The Industrialization of Space and Time (Berkeley, CA 1986), 162. 60. Hugo Münsterberg, Psychology and Industrial Efficiency (Boston 1913), 98. 61. Emmanuel Roth, “Ermüdung durch Berufsarbeit,” in Bericht über der XIV International Kongress für Hygiene und Demographie, vol. 4 (Berlin 1908), 612. 62. Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990), 11. 63. Cited in Paul Cranefield, “The Organic Physics of 1847 and the Biophysics of Today,” Journal of the History of Medicine and Allied Sciences 12 (1957): 409. See also Paul Cranefield, “The Philosophical and Cultural Interests of the Biophysics Movement of 1847,” Journal of the History of Medicine (1966): 1–7; E. G. Boring, History of Experimental Psychology (New York 1950); and Tim Lenoir, “Social Interests and the Group of 1847,” in Science in Reflection, ed. E. Uhlmann-Margalit (Dordrecht 1988), 169–91. 64. Walter Riese dates the end of the doctrine of the soul to 1850. See Riese, A History of Neurology (New York 1959), 90. 65. See F. A. Lange, History of Materialism (New York 1974). That this new doctrine never succeeded in wholly displacing other conceptions of the self is suggested by the memoirs of Daniel Paul Schreber, which evidence the competition between the doctrine of the soul and that of the nerves. See Schreber, Memoirs of My Nervous Illness (Cambridge, MA 1988). 66. Hermann von Helmholtz, On the Sensations of Tone (New York 1863), 148–49. 67. For more on this, see Tim Lenoir, “Models and Instruments in the Development of Electro-physiology, 1845–1912,” Historical Studies in the Physical and Biological Sciences 17, no. 1 (1986): 1–54. 68. Dolf Sternberger, Panorama of the 19th Century (New York 1977), 26–27. 69. For the history of efforts to conceptualize the body and brain in terms of technical advances, see Rabinbach, The Human Motor, 56–61; Georges Canguilhem, “History of the Reflex,” in Ideology and Rationality in the History of the Life Sciences (Cambridge, MA 1988); Georges Canguilhem, “The Role of Analogies and Models in Biological Discovery,” in Scientific Change: Historical Studies in the Intellectual, Social, and Technical Conditions for Scientific Discovery and Technical Invention, ed. A. C. Crombie (New York 1963), 507–20; and Philipp Sarasin, Reizbare Machinen: Eine Geschichte des Körpers 1765–1914 (Frankfurt 2001), 344–55. 70. See W. G. Bringmann and R. D. Tweney, eds., Wundt Studies: A Centennial Collection (Toronto 1980), 152. 71. Werner Siemens, “Die Elektrizität im Dienste des Lebens,” Elektrotechnische Zeitschrift 1 (1880): 16–23. 72. Ernst Kapp, Grundlinie einer Philosophie der Technologie (Braunschweig 1875). Both Siemens and Kapp allied this metaphor to the nationbuilding project, using it to overlay an image of unity onto the still-fragmented nation. Its power as organizing trope spanned the political spectrum; according to Anne Harrington: “Both romantic and materialist programs of unification
226 NOTES TO PAGES 31–33
were haunted by an image of a fragmented Germany and sought synthesis and integration.” Harrington, Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler (Princeton, NJ 1997), 10. 73. See Carl Wernicke, Der aphasische Symptomencomplex (Breslau 1874); and Adolf Meyer, “Review of Recent Problems of Psychiatry,” in The Collected Papers of Adolf Meyer, ed. Eunice E. Winters, vol. 3 (Baltimore, MD 1950), 335. 74. Bundesarchiv, Abteilung Berlin-Lichterfeld (hereafter cited as BAL), R 86/1273, Kurt Hartmann, Die Nervenpflege 1 (1906). 75. Dolf Sternberger refers to the poetry of “psychophysical telegraphy”: “The peculiar mythology of nerves, the nervous cult of the fin de siècle, with its utter awareness of refinement and pure soulful-ness, preserved this image of telegraphic variations. . . . The blend of the technological and the organic goes much further, especially into the science of man, into physiology and psychology; and just as the technological apparatus was metaphorically combined with the organic body into a single figure, the human body, in contrast, is permeated with apparatus-like elements. It is the language of telegraphy, coming into . . . play whenever the nervous system is described.” Sternberger, Panorama of the 19th Century (New York 1977), 26–27. 76. Schreber brings the conflation of body and machine (in particular nerves and wires) to a point of maximum intensity. Schreber, Memoirs of My Nervous Illness, 140. 77. “Edison über Gesundheitspflege,” Der Fernsprecher 1 (1911): 18. 78. Henri Ellenberger, Discovery of the Unconscious (New York 1970), 447. For more on Fechner, see Boring, History of Experimental Psychology. 79. Canguilhem, “History of the Reflex,” 54. See also Horst Gundlach, Reiz: Zur Verwendung eines Begriffes in der Psychologie (Bern 1976), 50. 80. According to Möller: “The phenomenon of excitability was first demystified around 1850 when it was learned that it was a question of a property which could be imitated by machines. . . . With the improvement of electrical registration techniques, physiological research into stimulus-response shifted increasingly to the bio-electrical phenomena of excitation.” Hans-Jürgen Möller, Die Begriffe “Reizbarkeit” und “Reiz” (Stuttgart 1975), 51. 81. See Kurt Goldstein, The Organism (New York 1995), 124. In this tradition, according to Goldstein, “[p]hysiology means . . . results obtained by an electrical method.” This method underlay the filiations between the group of 1847 and three figures who form a bridge to late nineteenth- and early twentieth-century psychology: Wundt (who studied with Helmholtz); Freud (Brücke); and Pavlov (Ludwig). 82. See Erwin Ackerknecht, Rudolf Virchow: Doctor, Statesman, Anthropologist (New York 1981). 83. Wilhelm Griesinger, Pathology and Therapy of Mental Illness, 2nd ed. (New York 1861), 6. Leibbrand and Wettley point to Griesinger’s exchange of letters with Robert Mayer in the early 1840s, when Mayer worked on his own version of the law of conservation of energy: “In intellectual-historical terms, medicalenergeticist thinking begins here.” Werner Leibbrand and Anne-Marie Wettley, Der Wahnsinn: Geschichte der abendländischen Psychiatrie (Munich 1961), 512. 84. Karl Lamprecht, Über die jüngsten deutschen Vergangenheit (Leipzig 1902).
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85. Griesinger, Pathology and Therapy of Mental Illness, 138. For more on Griesinger, see Leibbrand and Wettley, Der Wahnsinn; and Klaus Doerner, Madmen and the Bourgeoisie: A Social History of Insanity and Psychiatry (Oxford 1981). And, for a recent study of late nineteenth-century German psychiatry, see Eric Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca, NY 2004). 86. Doerner, Madmen and the Bourgeoisie, 176. 87. See Leibbrand and Wettley, Der Wahnsinn, 516; and Erna Lesky, The Viennese Medical School of the 19th Century (Baltimore, MD 1976), 8–12. 88. Doerner, Madmen and the Bourgeoisie, 335. See also Schivelbusch, The Railway Journey, 134–49. 89. “Die Neurasthenie der Weichensteller,” Zeitschrift für Bahnärzte 2 (1905): 31–32. 90. Zeitschrift für Bahnärzte 3/4 (1908–1909): 60. 91. M. Schormaier, “Telegraphisten-Krankheit,” Elektrische Rundschau 10 (1884): 152–54. 92. On the late nineteenth-century interest in attention, see Jonathan Crary, “Attention and Modernity in the Nineteenth Century,” in Picturing Science, Producing Art, ed. P. Galison and C. Jones (New York 1998), 475–500. 93. Osietzki, “Weiblichkeitsallegorien der Elektrizität als ‘Wunschmaschinen.’ ” 94. Lindenburg, Pracht-Album Photographischer-Aufnahmen, 3. 95. Thiel, “Berlin präsentiert sich der Welt,” 20–21. 96. Henri Bergson, Matter and Memory (New York 1994), 14. 97. Emil Kraepelin, Über geistige Arbeit (Leipzig 1894). 98. Bundesarchiv, Abteilung Potsdam (hereafter cited as BAP), Reichspostministerium (hereafter cited as RPM) 47.01, 17138, “Die Nervenkrankheiten und ihre Bekämpfung,” Bl. 27. 99. Lamprecht, Über die jüngsten deutschen Vergangenheit. See also Willy Hellpach, “Sozialpathologie als Wissenschaft,” Archiv für Sozialwissenschaft 21 (1904): 294. 100. Max Laehr, “Die Nervosität der heutigen Arbeiterschaft: Ein Beitrag zur Beantwortung der Frage nach dem Zusammenhange zwischen Nervosität und moderner Kultur,” Allgemeine Zeitschrift für Psychiatrie 66 (1909): 3. 101. This motif of protest lay at the core of Wagnerism’s central place within the discourse on nerves. See Leibbrand and Wettley, Der Wahnsinn, 559. See also Friedrich Nietzsche, Selected Letters (London 1985), 145, 210; Friedrich Nietzsche, Ecce Homo (New York 1967), 258; Richard Krafft-Ebing, Über gesunde und kranke Nerven (Vienna 1903), 71; and Hellpach, Nervosität und Kultur, 145. 102. See Wehler, The German Empire; Paul Weindling, Health, Race and German Politics between National Unification and Nazism 1870–1945 (Cambridge 1989); and Martin Doerry, Übergangsmenschen: Die Mentalität der Wilhelminer und die Krise des Kaiserreichs (Munich 1986). 103. Max Nordau, Degeneration (Lincoln, NE 1995). 104. The term degeneration originated with the Frenchman Morel in the 1850s. According to Morel, degeneration afflicted both individuals and genera-
228 NOTES TO PAGES 38–41
tions: the nervousness of the first generation turned into the neurosis of the second, followed by psychosis in the third and idiocy in the fourth. This theory had an extraordinary resonance in late nineteenth-century European society, where it constituted, according to Pick, an “endeavor to ‘scientize’, objectify, cast off whole underworlds of political and social anxiety.” Daniel Pick, Faces of Degeneration: A European Disorder 1848–1918 (Cambridge 1989), 10. For more on the place of degeneration in the medicine and politics of the late nineteenth century, see Robert Nye, Crime, Madness and Politics in Modern France: The Medical Concept of National Decline (Princeton, NJ 1984); and J. E. Chamberlin and S. Gilman, eds., Degeneration: The Dark Side of Progress (New York 1985). 105. See, for instance, Sheila Faith Weiss, Race Hygiene and National Efficiency: The Eugenics of Wilhelm Schallmayer (Berkeley, CA 1987); Michael Hau, The Cult of Health and Beauty in Germany: A Social History (Chicago 2003); and Joachim Radkau, Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich 1998). 106. Weiss, Race Hygiene and National Efficiency, 45. 107. BAL, R 86/1273, Dr. Sturm, Rottet die Nervosität aus! 108. BAL, R 86/1273, Dr. Hartmann, Die Nervenpflege 1 (1906). 109. See Weindling, Health, Race and German Politics between National Unification and Nazism, 220–35; Karl-Heinz Roth, “Schein-Alternativen im Gesundheitswesen: Alfred Grotjahn (1869–1931),” in Erfassung zur Vernichtung: Von der Sozialhygiene zum “Gesetz über Sterbehilfe,” ed. K.-H. Roth (Berlin 1984), 31–56. 110. Alfred Grotjahn, Soziale Pathologie (Berlin 1912), 3–10. 111. See Greg Eghigian, Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany (Ann Arbor, MI 2000), 25. On turn-of-the-century German sociology, see Harry Liebersohn, Fate and Utopia in German Sociology, 1870–1923 (Cambridge, MA 1988); Arthur Mitzman, Sociology and Estrangement: Three Sociologists of Imperial Germany (New Brunswick, NJ 1987); David Frisby, Fragments of Modernity: Theories of Modernity in the Work of Simmel, Kracauer, and Benjamin (Cambridge, MA 1986); and Detlev Peukert, Max Webers Diagnose der Moderne (Göttingen 1989). 112. Doris Kaufmann, “Science as Cultural Practice: Psychiatry in the First World War and Weimar Germany,” Journal of Contemporary History 34, no. 1 (January 1999): 131. See also Detlev Peukert, “The Genesis of the ‘Final Solution’ from the Spirit of Science,” in Nazism and German Society 1933–1945, ed. D. Crew (London 1994), 274–99. Peukert cites Grotjahn specifically as an example of the ambivalent tendencies that drove the development of the human sciences. 113. Rabinow, French Modern. 114. BAL, R 86/1273, Reichstag petition of Georg Wetzer, “Verbesserung des Irren- bzw. Nervenkranken Fürsorge,” 10 May 1908. 115. Alfred Grotjahn, Erlebtes und Erstrebtes: Errinerungen eines sozialistischen Arztes (Berlin 1932), 90. 116. Ibid., 147. 117. Karl-Heinz Roth is among those who make Grotjahn complicit with Nazi atrocities. See Roth, “Schein-Alternativen im Gesundheitswesen: Alfred Grotjahn (1869–1931).” On the discontinuities between the eugenics movement
NOTES TO PAGES 42–44 229
and Nazi racial science, see Weiss, Race Hygiene and National Efficiency; and Atina Grossmann, Reforming Sex: The German Movement for Birth Control and Abortion Reform 1920–1950 (New York 1995). See also Paul Weindling, “Eugenics and the Weimar Welfare State,” in The State and Social Change in Germany 1880–1980, ed. Eve Rosenhaft (New York 1990), 131–60. 118. Nordau, Degeneration, 455. 119. By the end of the nineteenth century, writes Arlene Tuchmann, the Wissenschaftler was defined as one who manipulated sophisticated instruments. In medicine such instruments represented “objective” sources of information that freed the physician from the patient’s “subjective” reports. See Tuchmann, Science, Medicine, and the State in Germany: the Case of Baden, 1815–1871 (New York 1993), 15. See also Stanley Joel Reiser, Medicine and the Reign of Technology (Cambridge 1978). 120. Friedrich Nietzsche, The Will to Power (New York 1968), 230, 431. 121. See Georges Didi-Hubermann, L’Invention de l’hysterie (Paris 1982). 122. George Miller Beard, American Nervousness, Its Causes and Consequences (New York 1880). 123. Foucault’s arguments contra the “repressive hypothesis” are germane here. Foucault observes that sexology originated in the “self-examination” of the privileged classes. See Michel Foucault, History of Sexuality, vol. 1 (New York 1990), 120. 124. Radkau, Zeitalter der Nervosität, 458. 125. Gosling also suggests that the presence of self-experience within the discourse about nerves gave the illness credibility and made these doctors more sensitive to their patients. See Frances Gosling, Before Freud: Neurasthenia and the American Medical Community (Urbana, IL 1987). 126. On Möbius, see Francis Schiller, A Möbius Strip: Fin-de-Siècle Neuropsychiatry and Paul Möbius (Berkeley, CA 1992). 127. For Hellpach’s Nervenkrise, see his memoir, Wirken und Wirren, 275. 128. See, for instance, Gosling, Before Freud; and Peter Gay, The Tender Passion (New York 1986), 329–90. 129. Hence the mythic status of Meynert’s famous death-bed scene, reported by Freud, in which the great doctor, after having doubted Freud’s demonstration of the authenticity of male hysteria for years, confessed that he himself was a classic example of this condition. Sigmund Freud, The Interpretation of Dreams (New York 1965), 474. According to Mark Micale, the epistemic shift within Freud’s work was a product of his “willingness to integrate his own experience of illness into his scientific development.” See Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton, NJ 1995), 255. 130. On the difference between treating a patient as an object and as a subject, see Ruth Leys, “Traumatic Cures,” Critical Inquiry 20 (1994): 623–62. 131. See Ellenberger, Discovery of the Unconscious, 418–570; Henri Ellenberger, “Fechner and Freud,” in Beyond the Unconscious: Essays of Henri Ellenberger, ed. M. Micale (Princeton, NJ 1993), 89–103; Micale, Approaching Hysteria, 255; and Kenneth Levin, “Freud’s Paper ‘On Male Hysteria’ and the Conflict between Anatomical and Physiological Models,” Bulletin of the History of Medicine 48 (1974): 377–97.
230 NOTES TO PAGES 44–46
132. Freud’s collaborator Breuer expressed reservations about Freud’s fascination with machine models, writing, “I am anxious not to drive the analogy of an electrical system to death.” In a key passage, Breuer rejected the conventional analogy between nervous and communications systems: “We ought not to think of a cerebral path of conduction as resembling a telephone wire which is only excited electrically at the moment at which it has to function (that is . . . when it has to transmit a signal).” Breuer proposed a modification of the telephone metaphor, suggesting that the cerebral conduction should be likened “to a telephone line through which there is a constant flow of galvanic current” or to “a widely ramified electrical system for lighting and the transmission of motor power. . . . In just the same way there is a certain amount of excitation present in the conductive paths of the brain when it is at rest but awake and prepared to work.” The constant presence of excitation in the nervous system, according to Breuer, produced a state of “expectation”: “In ordinary life,” he wrote, “we call this ‘nervous.’ ” Joseph Breuer and Sigmund Freud, Studies in Hysteria (New York 1955), 193ff. 133. See Siegfried Bernfeld, “Freud’s Earliest Theories and the School of Helmholtz,” Psychoanalytic Quarterly 13 (1944): 341–62. But see also Paul Cranefield, “Freud and the ‘School of Helmholtz,’ ” Gesnerus 23, no. 1 (1966): 35–39. 134. Michel Foucault, preface, in Georges Canguilhem, The Normal and the Pathological (New York 1989), 20; see also Rabinow, French Modern, 8. 135. “The ultimate distance between the ‘neutral’ scientific observer and the object observed, was the claim that the object could not share in the same perceptual strategies as the observer.” Sander Gilman, Freud, Race and Gender (Princeton, NJ 1993), 41. For more on the late nineteenth-century scientist’s attempted transcendence of personal origins, history, and subjectivity, see ibid., passim. 136. Simmel, “The Metropolis and Mental Life,” 326. 137. This aspect of Simmel’s theory closely anticipates Freud’s later concept of the “stimulus shield.” For a discussion of Simmel’s relation to Freud, see Schivelbusch, The Railway Journey, 164–67. 138. Simmel, “Female Culture,” in On Women, Sexuality and Love (New Haven, CT 1984), 76. Known to his friends as the neurasthenic philosopher, Simmel sought relief from symptoms of nervousness in frequent trips abroad, as he wrote in a letter to Edmund Husserl: “I am thinking of going . . . to Lugano. My nerves urgently require a few weeks of fresh air.” Leo Baeck Archives, Georg Simmel Papers, letter, Simmel to Husserl, 12 Mar. 1907. 139. Simmel, “Female Culture,” 76. 140. Georg Simmel, “Auszüge aus dem Lebenserrinerungen,” in Äesthetik und Soziologie um die Jahrhundertwende: Georg Simmel, ed. H. Böhringer and K. Gründer (Frankfurt 1976), 265. 141. In some cases, “the simple continuation of an increase in the stimulus beyond this threshold results in the disappearance of the sensation.” Others produced an “extreme form of discrepancy between cause and effect which is brought about by the mere quantitative increase of the cause, namely, the direct transformation of the effect into its opposite.” Georg Simmel, The Philosophy of Money (London 1990), 262. 142. Ibid.
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2. ELECTROTHERAPY AND THE NERVOUS SELF IN NINETEENTH-CENTURY GERMANY 1. Albert Eulenburg, “Welcher besondere Vortheil ist von der Influenzelektrizität zu erwarten?” in Elektrotherapeutische Streitfragen, ed. Ludwig Edinger (Wiesbaden 1892), 67. 2. Symptomatic of this neglect are the comments of Peter Gay, who writes disparagingly of “the electrical metaphors to which 19th century writers were addicted.” Gay, The Tender Passion (New York 1986), 339. But see Francis Schiller, “Neurology: The Electrical Root,” in Historical Aspects of the Neurosciences, ed. F. Clifford Rose and W. F. Bynum (New York 1982), 1–11; Edward Stainbrook, “Use of Electricity in Psychiatric Treatment During the 19th Century,” Bulletin of the History of Medicine 22 (1948): 156–77; and Erwin Ackerknecht, “Experiment und Klinik in der Geschichte der Neurologie,” Bulletin der schweizerischen Akademie der medizinischen Wissenschaften 21 (1965): 51–56. 3. Wilhelm Erb, Handbook of Electro-therapeutics (New York 1886), 6–8. 4. G.-B. Duchenne de Boulogne, The Mechanism of Human Facial Expression (New York 1990), 9. Duchenne’s researches caused a sensation in Parisian society, and his public demonstrations were attended by artists and members of the French literati. His works were also incorporated into the curriculum for teaching artistic anatomy at the École des Beaux-Arts. See Cuthbertson, “The Highly Original Dr. Duchenne,” ibid., 251. See also Georges Didi-Hubermann, L’Invention de l’hysterie (Paris 1982). 5. The “aliveness” of the patient who was his chief subject was somewhat in question: this patient suffered from virtually complete loss of feeling in his facial muscles, and Duchenne described working with this “old toothless man” as similar to working with an “irritable cadaver.” Duchenne, The Mechanism of Human Facial Expression, 43. 6. Robert M. Young, Mind, Brain and Adaptation in the 19th Century: Cerebral Localization and Its Biological Context from Gall to Ferrier (Oxford 1970), 235. See also Michael Hagner, “Die elektrische Erregbarkeit des Gehirns,” in Die Experimentalisierung des Lebens, ed. H.-J. Rheinberger and M. Hagner (Berlin 1993), 104–5. 7. The literature on neurasthenia includes: George Miller Beard and A. D. Rockwell, A Practical Treatise of the Medical and Surgical Uses of Electricity including Localized and General Electrization (New York 1871); Joachim Radkau, “Die wilhelminische Ära als nervöses Zeitalter; oder, Die Nerven als Netz zwischen Tempo- und Körpergeschichte,” Geschichte und Gesellschaft 20 (1994): 211–41; Joachim Radkau, Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich 1998); Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990), 146–178; Anson Rabinbach, “Neurasthenia and Modernity,” in Incorporations, ed. J. Crary and S. Kwinter (New York 1992), 178–89; F. C. Gosling, Before Freud: Neurasthenia and the American Medical Community 1870–1910 (Urbana, IL 1987); Janet Oppenheim, Shattered Nerves: Doctors, Patients and Depression in Victorian England (New York 1991); Tom Lutz, American Nervousness 1903 (Ithaca, NY 1991); and Gay, The Tender Passion, 329–90.
232 NOTES TO PAGES 51–54
8. Charles Rosenberg, “The Place of Beard in 19th Century Psychiatry,” Bulletin of the History of Medicine 36 (1962): 250. In early accounts, Beard cited Du Bois-Reymond’s experimental demonstrations of the symptoms of nervous exhaustion. See George Miller Beard, “Neurasthenia or Nervous Exhaustion,” Boston Medical and Surgical Journal 80 (1869): 218. 9. For the impact of energeticism on late nineteenth-century medical thought, including psychiatry, see Werner Leibbrand and Anne-Marie Wettley, Der Wahnsinn: Geschichte der Abendländischen Psychopathologie (Munich 1961), 512ff. 10. Sterling Library, Yale University, George Miller Beard Papers, Box 1, journal entry of Mar. 1858. 11. Ibid., journal entry of 28 Apr. 1858. 12. Ibid., journal entry of 30 Aug. 1858. See also Gay, The Tender Passion, 342. 13. Ibid., Edison to Beard, 10 Apr. 1878; and Edison to Grace Beard, 15 Oct. 1908. For more on the relation between Beard and Edison, see Edison’s papers, which contain remnants of the correspondence between the two men during the years 1874–81. See Edison, The Papers of Thomas A. Edison, vol. 2, ed. R. V. Jenkins (Baltimore, MD 1991), 321, 675. 14. George Miller Beard, American Nervousness, Its Causes and Consequences (New York 1880), 114. 15. Sigmund Freud, “An Autobiographical Study,” in The Freud Reader, ed. Peter Gay (New York 1989), 9. Freud, of course, later referred to The Interpretation of Dreams as his own “Egyptian dreambook.” Sigmund Freud, Freud’s Complete Letters to Wilhelm Fliess (Cambridge, MA 1985), 368. 16. Max Nonne, “Wilhelm Erb,” in Grosse Nervenärzte, vol. 1, ed. K. Kolle (Stuttgart 1955), 78. 17. For background, see Arlene Tuchmann, Science, Medicine, and the State in Germany: The Case of Baden, 1815–1871 (New York 1993). 18. Nonne, “Wilhelm Erb,” 69. 19. Ibid., 76. 20. Cited ibid., 71–72. 21. Ibid., 77. 22. Lawrence McHenry, Garrison’s History of Neurology (Springfield, IL 1969), 343. 23. The simultaneous discovery of the tendon reflex in 1875 by Erb and Carl Westphal symbolized this break with the purely descriptive examination that was previously the norm. G. Ritter, “Entwicklungsgeschichte der neurologischen Semiologie,” Der Nervenarzt 37 (1966): 508. 24. Erb, Handbook of Electro-therapeutics, 64, 130. 25. See Hagner, “Die elektrische Erregbarkeit des Gehirns,” 104–5. Hagner shows that Hitzig’s discovery of cortical excitability was rooted in his electrotherapeutic practice rather than in his physiological experimentation. 26. Erb, Handbook of Electro-therapeutics, 74. 27. See Heinz-Peter Schmiedebach, “Post-traumatic Neurosis in NineteenthCentury Germany: A Disease in Political, Juridical and Professional Context,” History of Psychiatry 10, no. 1 (1999): 38. For biographical material on Westphal, see Otto Binswanger, “Zum Andenken an Carl Westphal,” Deutsche medizinische Wochenschrift 16 (1890): 205–7, 227–31.
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28. K. Leonhard, “Über die Geschichte der Nervenklinik der Charité,” Zeitschrift für ärztliche Fortbildung 54 (1960): 492–95. See also Volker Hess and Eric Engstrom, “Neurologie an der Charité zwischen medizinischer und psychiatrischer Klinik,” in Neurologie in Berlin, ed. Rolf Winau (Berlin 2000), 99–110; and, for an overview, Eric Engstrom, Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice (Ithaca, NY 2004). 29. Karl Bonhoeffer, “Die Geschichte der Charité in der 19. Jahrhundert,” Zeitschrift für die gesamte Neurologie und Psychiatrie 168 (1940): 58. 30. Universitätsarchiv der Humboldt Universität zu Berlin (hereafter cited as HUB), Charité 850, Bl. 30–31. Throughout the next two decades other university doctors followed Westphal’s lead in creating electrotherapy wards at their clinics. See Theodor Billroth, The Medical Sciences in Germany (New York 1924), 70. Erna Lesky traces the use of electricity at the Charité to Griesinger’s personal relationship with Moritz Benedikt, the Viennese specialist who also trained Freud in its use. Lesky, The Vienna Medical School of the 19th Century (Baltimore, MD 1976), 351. 31. “At various sites electrical outlets are located such that the apparatus for constant and alternating current, as well as electrically powered influence machines, vibrating apparatus, and so forth, can be put to use.” F. Jolly, “Erläuterungen zum Neubau der Psychiatrischen und Nervenklinik der Kgl. Charité,” Charité-Annalen 31 (1902): 343. 32. Schmiedebach has shown that the high percentage of these publications devoted to developments in electrodiagnosis and -therapy worked to promote the neurological orientation at the expense of psychiatry. See Heinz-Peter Schmiedebach, Psychiatrie und Psychologie im Widerstreit: Die Auseinandersetzung in der berliner medizinisch-psychologisch Gesellschaft (1867–1899) (Husum 1986), 136, 158. 33. G. Zilboorg, History of Medical Psychology (New York 1967), 441. Emil Kraepelin, who felt that psychiatry and neurology should be kept separate, complained about the neurologically oriented hiring practices emanating from Berlin during this period. Kraepelin, Memoirs (Berlin 1987), 29. 34. Carl Westphal, “Die Agoraphobie, eine neuropathische Erscheinung,” Archiv für Psychiatrie und Neurologie 3 (1871): 133–61. See also Anthony Vidler, “Psychopathologies of Modern Space: Metropolitan Fear from Agoraphobia to Estrangement,” in Rediscovering History: Culture, Politics and the Psyche, ed. M. Roth (Stanford, CA 1994), 11–29. 35. The traumas of such events offered specialists “manifold opportunities for expanding knowledge in the field of neurology, given the limits on experimentation.” Ackerknecht, “Experiment und Klinik in der Geschichte der Neurologie,” 51. 36. In the United States, the Civil War had a similar impact: neurologists Hammond, Mitchell, and Beard all worked in field hospitals during that war. John Spillane suggests that the term neurasthenia probably originated during the Civil War. See Spillane, Doctrine of the Nerves: Chapters in the History of Neurology (New York 1980). On the Franco-Prussian War, see Hans W. Walser, “Die Ärzte und der Krieg am Beispiel des deutsch-französischen Krieges von 1870/71,” Clio Medica 2 (1967): 103–20. 37. Max Nonne, “Therapeutische Erfahrungen an den Kriegsneurosen in den
234 NOTES TO PAGES 56–60
Jahren 1914–1918,” in Geistes- und Nervenkrankheiten, ed. K. Bonhoeffer (Leipzig 1922), 104. 38. Expert opinion took it as an article of faith that the war of 1870–71 had given rise to more nervous illness. See, for instance, Richard Krafft-Ebing, Über gesunde und kranke Nerven (Vienna 1903), 69; and Gerhard Voss, “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten, Selbstmord und Verbrechen,” in Krankheit und soziale Lage, ed. M. Mosse und G. Tugendreich (Berlin 1913), 408–9. 39. Traumatische, idiopathische und nach Infektionskrankheiten beobachtete Erkrankungen des Nervensystem bei der deutschen Heeren im Krieg gegen Frankreich 1870/71, Hrg. von d. Militär-Medizinal-Abteilung der Königlich Preussiche Kriegsministeriums (Berlin 1886), v. 40. Hagner, “Die elektrische Erregbarkeit des Gehirns.” 41. Carl Westphal, “Einige Fälle von Erkrankungen des Nervensystems nach Verletzung auf Eisenbahnen,” Charité-Annalen 5 (1880): 379–89. 42. Rabinbach, The Human Motor, 43. 43. Klaus Doerner, Madmen and the Bourgeoisie: A Social History of Insanity and Psychiatry (Oxford 1981), 274. 44. See Andrew Abbott, The System of Professions: An Essay on the Division of Expert Labor (Chicago 1988), 284. 45. S. T. Stein, Lehrbuch der allgemeine Elektrization des menschlichen Körpers (Leipzig 1886), 49–51. 46. On the German bourgeoisie, see D. Blackbourn and R. Evans, The German Bourgeoisie: Essays on the Social History of the German Middle Classes from the Late 18th to the Early 20th Century (London 1991); and Jürgen Kocka, Die Bildungsbürgertum im 19. Jahrhundert (Stuttgart 1989). 47. Voss, “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten, Selbstmord und Verbrechen,” 401. 48. Esther Fischer-Homberger, Die traumatische Neurose: Vom somatischen zum sozialen Leiden (Bern 1975), 21–26. 49. By the late 1880s, leading doctors, including both Janet and Freud, felt that hysteria was much less common than neurasthenia. See Erwin Ackerknecht, A Short History of Psychiatry (New York 1968), 9. 50. Paul Weindling, Health, Race and German Politics between National Unification and Nazism 1870–1945 (Cambridge 1989), 39–44. See also Philip Pauly, “The Political Structure of the Brain: Cerebral Localization in Wilhelmine Germany,” International Journal of Neuroscience 21 (1983): 145–50; and Hagner, “Die elektrische Erregbarkeit des Gehirns,” 115 fn. 50. 51. Erb wrote of neurasthenia that “this disease is essentially, for the male sex, that which corresponds with spinal irritation in the female sex.” Erb, Handbook of Electro-therapeutics, 370. 52. According to Francis Gosling, American neurologists held similar views: “Men became neurasthenic because of the external pressures of civilization; women, more sheltered from the world, were nevertheless prone to nervousness because they were inherently weaker.” Gosling, Before Freud, 46. The argument that neurasthenia was simply the male version of hysteria is made most strongly
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by Elaine Showalter in The Female Malady: Women, Madness and English Culture, 1830–1980 (New York 1985). 53. Erb, Handbook of Electro-therapeutics, 62. 54. Although a view widely held by German doctors, statistical data failed to support it. See Voss, “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten, Selbstmord und Verbrechen,” 404–5, which cites the results of studies carried out in Vienna and Berlin. See also Sander Gilman’s discussion of Jewish neuroticism in “The Image of the Hysteric,” in Hysteria beyond Freud, ed. S. Gilman and R. Porter (Berkeley, CA 1993), 402–36. 55. For this and the following two quotations, see Wilhelm Erb, “Spinal Nervous Weakness,” in Cyclopedia of the Practice of Medicine, ed. H. von Ziemssen (Leipzig 1876), 369–82. 56. Erb, Handbook of Electro-therapeutics, 290. 57. See Hannah Decker, Freud in Germany: Revolution and Reaction in Science 1893–1907 (New York 1977), 78. 58. Constantin von Monakow, “Die Neurosenfrage einst und heute,” in 50 Jahre Neurologie (Zürich 1924), 53. See also Hans-Ulrich Eulner, Die Entwicklung der medizinischen Fachspezialitäten im deutschen Bereich (Stuttgart 1970). 59. According to Rabinbach: “It is not so much in the results of electrotherapy as in its theoretical premises that the implicit connection between exhaustion and the new theory of energy conservation becomes fully transparent. . . . The principle of Helmholtz and the other pioneers of energy conservation now formed the basis for a union of medical science and electrical technology.” Rabinbach, The Human Motor, 56. 60. Ackerknecht, A Short History of Psychiatry, 82. 61. Abbott suggests that it took the medical breakthroughs of the late nineteenth century to remove some of the odium associated with mental distress and illness; prior to then, “angst and maladjustment were not subjectively real categories of experience.” Abbott, The System of Professions, 281. 62. Stein did not live to see the exhibition, dying in 1891 on the eve of its opening. His idea was carried out by his friend Leopold Sonnemann, founder of the Frankfurter allgemeine Zeitung. See the obituary notice in FAZ, Leo Baeck Archives, Sigmund Theodor Stein Papers. 63. Doerner, Madmen and the Bourgeoisie, 333. See also Michael Hubenstorf’s comments on Moritz Benedikt, in “Elektrizität und Medizin,” in Technik und Medizin, ed. Rolf Winau (Düsseldorf 1993), 244–46; and, on Hermann Oppenheim, see Paul Lerner, “From Traumatic Neurosis to Male Hysteria: The Decline and Fall of Hermann Oppenheim, 1889–1919,” in Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, ed. M. Micale and P. Lerner (Cambridge 2001), 140–71. 64. This is one reason that psychoanalysis, which in its early days was largely made up of neurologists, was referred to as the Jewish science. 65. Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (New York 1992), 218–19; Michael Kater, “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany,” Journal of Contemporary History 20 (1985): 689.
236 NOTES TO PAGES 63–67
66. “Prof. Dr. Eulenburg,” Die Hygiene 2 (1912): 21. 67. See, for instance, Albert Eulenburg, “Elektrotherapie und Suggestionstherapie,” Berliner medizinische Wochenschrift 8 (1892): 157–61, 191–96. 68. See, for instance, Albert Eulenburg, “Entartung,” Die Zukunft (23 Sept. 1893): 602–12; Albert Eulenburg, “Die Nervosität unser Zeit,” Die Zukunft (15 Aug. 1896): 302–18; and his exchange with P. J. Möbius on the subject of Nervenheilstätten in Die Zukunft (24 Dec. 1898): 27–31, 171–74. 69. Bernd Holdorff, “Die nervenärztlichen Polikliniken für Nervenkranke vor und nach 1900,” in Winau, Neurologie in Berlin, 132. 70. For more on Mendel, see Shorter, From Paralysis to Fatigue, 218–19; and Holdorff, “Die nervenärztlichen Polikliniken für Nervenkranke vor und nach 1900,” 130. 71. Holdorff, “Die nervenärztlichen Polikliniken für Nervenkranke vor und nach 1900,” 134–35. 72. On “accredited guides,” see Nikolas Rose, Governing the Soul: The Shaping of the Private Self (London 1989), 46. 73. See, for instance, Albert Eulenburg, “Schulnervosität,” Die Gartenlaube 12 (1896). 74. Radkau, Zeitalter der Nervosität, 107; Radkau, “Die wilhelminische Ära als nervöses Zeitalter,” 211–41. For more on lifestyle reform, see Michael Hau, The Cult of Health and Beauty in Germany: A Social History (Chicago 2003). On the history of private clinics, see Edward Shorter, “Private Clinics in Central Europe 1850–1933,” Social History of Medicine 3 (1990): 159–95; Edward Shorter, “Women and Jews in a Private Nervous Clinic in Late 19th Century Vienna,” Medical History 33 (1989): 149–83; and Erwin Ackerknecht, “Private Institutions in the Genesis of Psychiatry,” Bulletin of the History of Medicine 60 (1986): 387–95. 75. Hubenstorf, “Elektrizität und Medizin”; B. Binder, “Die Inszenierung einer elektrischen Welt auf die Frankfurt Internationale Elektrotechnische Austellung von 1891,” Hessische Blätter für Volks- und Kulturforschung 24 (1989): 36. 76. Shorter, From Paralysis to Fatigue, 220. 77. See Paul Lerner, Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany 1890–1930 (Ithaca, NY 2003), 32. 78. See Willy Hellpach, Wirken und Wirren: Lebenserrinerungen, vol. 1 (Hamburg 1948), 363ff., quotation from 413. 79. See Geheimes Staatsarchiv Preussischer Kulturbesitz, Berlin (hereafter cited as GSA) Rep. 76, VIII B, 4394, letter from Elektrizitäts-Gesellschaft Sanitas, containing a three-page list of medicoelectrical devices. 80. Michel Foucault, The History of Sexuality, vol. 1 (New York 1990), 44. 81. Paul Berger, Führer durch die Privat Heil-Anstalten Deutschlands, Österreichs und der Schweiz (Berlin 1889–90), 5. 82. Ibid., 26. 83. For another example, see the periodical Zeitschrift für Elektrotherapie und ärztliche Elektrotechnik. 84. G. C. Schwarz, Über Nervenheilstätten und die Gestaltung der Arbeit als Hauptheilmittel (Leipzig 1903), 35.
NOTES TO PAGES 68–72 237
85. BAL, R 89/6904, Bericht Haus Schönow. 86. Landesarchiv Berlin (hereafter cited as LA), Pr. Br. 44, 124, “Genesungsheim für Beamtinnen.” 87. GSA, Rep. 76, VIII B 4394, “Die Elektrizität als Heilmittel in Sanatorium Johannisbad.” 88. Berger, Führer durch die Privat Heil-Anstalten Deutschlands, Österreichs und der Schweiz, 99. 89. Shorter, “Private Clinics in Central Europe 1850–1933”; Radkau, “Die wilhelminische Ära als nervöses Zeitalter.” 90. Krankenblätterarchiv, Psychiatrische und Nervenklinik der Charité (hereafter cited as KBA der Charité), 1896, Aufnahme 857. 91. Wilhelm Erb, “Über die neuere Entwicklung der Nervenpathologie und ihre Bedeutung für die medizinische Unterricht” (1880), in Gesammelte Abhandlungen (Wiesbaden 1910), 267, 272. 92. Otto Binswanger, Die Pathologie und Therapie der Neurasthenie (Jena 1896), 371. 93. See BAL, R 89/22555, Obergutachten 1886–94. Between 1888 and 1894, for example, Emanuel Mendel evaluated thirty-six insurance claims; Oppenheim, six; and Albert Eulenburg, three. 94. KBA der Charité, 1893, Aufnahme 8260. 95. E. Hecker, “Über das Verhältnis zwischen Nerven- und Geisteskrankheiten in Bezug auf ihr Behandlung in getrennten Anstalten,” Deutsche medizinische Wochenschrift 7 (1881): 121–25, 137–41. 96. Nonne, “Wilhelm Erb,” 76. 97. Didi-Hubermann calls the Salpêtrière a “giant optical machine” for observing hysterics. For studies of Charcot’s work, see Didi-Hubermann, L’Invention de l’hysterie; and Mark Micale, “Jean Martin Charcot and ‘les nevroses traumatiques’: From Medicine to Culture in French Trauma Theory of the Late 19th Century,” in Traumatic Pasts, ed. Micale and Lerner, 172–90. 98. J.-M. Charcot, “De l’electricité statique, particulièrement dans ses appels au traitement de l’hysterie,” Progrés médical 17 (1881): 315–16, 333–35, quotation from 315. 99. Jean-Martin Charcot, Clinical Lectures on Diseases of the Nervous System (London 1991), 14. 100. Ibid., 222–23. See Mark Micale, “Charcot and the Idea of Hysteria in the Male: Gender, Mental Science and Medical Diagnosis in Late 19th Century France,” Medical History 34 (1990): 379. 101. Charcot, “De l’electricité statique, particulièrement dans ses appels au traitement de l’hysterie.” 102. Rudolf Stintzing, Die Elektro-Medizin (Munich 1883), 21. 103. The power of the doctor to frame and elicit symptoms that his patients then experience has been discussed by many scholars, most of whom take Charcot as exemplary. See Shorter, From Paralysis to Fatigue, 166; Jan Goldstein, Console and Classify: the French Psychiatric Profession in the 19th Century (New York 1987); and, most extensively, Sander Gilman, Seeing the Insane (Lincoln, NE 1996). 104. For more on both doctors, see Henri F. Ellenberger, The Discovery of
238 NOTES TO PAGES 73–76
the Unconscious: The History and Evolution of Dynamic Psychiatry (New York 1970), 85–101. 105. Erb, Handbook of Electro-therapeutics, 293. 106. P. J. Möbius, “Über neuere elektrotherapeutische Arbeiten,” Schmidt’s Jahrbücher 228 (1891): 83. For more on Möbius, see Francis Schiller, A Möbius Strip: Fin-de-Siècle Neuropsychiatry and Paul Möbius (Berkeley, CA 1992). 107. The Grotjahn Papers, at Universitätsarchiv der Humboldt Universität zu Berlin, contains a casebook from Grotjahn’s neurological practice. It includes notes on the various treatments he prescribed. 108. Alfred Grotjahn, Erlebtes und Erstrebtes: Errinerungen eines sozialistischen Arztes (Berlin 1932), 86–87. For an overview of his early career, see Paul Weindling, “Medical Practice in Imperial Berlin: The Casebook of Alfred Grotjahn,” Bulletin of the History of Medicine 61 (1987): 391–410. 109. A report issued by the Imperial Health Office in 1902 showed that the number of patients suffering from illnesses of the nervous system had jumped from 98,121 to 161,222, a rise of 64 percent over the preceding decade. The vast majority of these cases fell into the category of functional neurosis. BAP, RPM 47.01, 17138, “Die Bekämpfung der Nervenkrankheiten,” Bl. 21–46. 110. Freud, cited in Kurt Eissler, Freud as an Expert Witness: The Discussion of War Neuroses between Freud and Wagner-Jauregg (Madison, CT 1986), 66. 111. For more on debates over “objective symptoms,” see FischerHomberger, Die traumatische Neurose, 127–28. 112. One doctor writing in the early 1900s observed that electrotherapy had been so contaminated by suggestion that it had become counterproductive, making patients’ illnesses worse rather than better; in such cases, “the patient often allegedly feels some kind of pain after electrization, which also appears when the doctor treats him, without his knowledge, without turning on the current.” Dr. Windscheid, “Über das Wesen und die Behandlug von Nervenkrankheiten nach Unfällen,” Amtliche Nachrichten der Reichs-Versicherungsamt (15 July 1907): 454. 113. Adolf Strümpell, “Über die traumatischen Neurosen,” Congress für innere Medizin (1893): 94. 114. “Just as Berlin was the epicenter of the organically oriented nervedoctors, so Leipzig in the 1880s became that of the psychologically oriented school.” Shorter, From Paralysis to Fatigue, 241. 115. See the series of articles by Möbius, “Über neuere elektrotherapeutische Arbeiten,” in Schmidt’s Jahrbücher (1888–93). 116. For more on this event, see the exhibition catalog “Eine neue Zeit . . . !” Die Internationale Elektrotechnische Ausstellung 1891 (Frankfurt 1991); Binder, “Die Inszenierung einer elektrischen Welt,” 31–44. 117. See “Die Poesie der elektrotechnische Ausstellung,” Die Gartenlaube 37 (1891): 619–22. 118. Ludwig Edinger, ed., Elektrotherapeutische Streitfragen (Wiesbaden 1892), 7. 119. Ibid., 59. 120. Edinger later claimed that the participants had succeeded in separating
NOTES TO PAGES 77–84 239
the genuine from the suggestive effects of medical electricity. See Leo Baeck Archives, Ludwig Edinger Papers, “Memoirs.” 121. Edinger, ed., Elektrotherapeutische Streitfragen, 10. 122. Ibid., 67. 123. Binder, “Die Inszenierung einer elektrischen Welt.” 124. Edinger, ed., Elektrotherapeutische Streitfragen, 13. 125. Doerner, Madmen and the Bourgeoisie, 307. 126. Wilhelm Erb, Über die wachsende Nervosität unserer Zeit (Heidelberg 1893). Here, I am citing the pamphlet that was generated from the original article. 127. P. J. Möbius, “Über neuere elektrotherapeutische Arbeiten,” Schmidt’s Jahrbücher 213 (1889): 87. 128. Fritz Kaufmann, “Die Planmässige Heilung komplizierter psychogener Bewegungsstörungen bei Soldaten in einer Sitzung,” Münchener medizinische Wochenschrift 63 (1916): 802–4. 129. Doerner, Madmen and the Bourgeoisie, 307. 130. Cited in Eissler, Freud as an Expert Witness, 394.
3. RAILWAY ACCIDENTS, SOCIAL INSURANCE, AND THE PATHOGENESIS OF MASS NERVOUSNESS, 1889–1914 1. “Obergutachten der medizinischen Fakultät der Universität Berlin, betreffend traumatische Neurose,” Amtliche Nachrichten der Reichsversicherungsamts (hereafter cited as RVA/AN) 10 (1897): 479. 2. BAL, R 89/15113, “Bericht ü. d. auss. Vert. d. Westfälischen Vereinigung berufs genossenschaftlichen Verein. Tagesordnung über Rentensucht und Rentenhysterie,” Bl. 7. 3. BAP, RPM 47.01, 14575/1, Bl. 234. 4. See Alfons Labisch, “From Traditional Individualism to Collective Professionalism,” in Medicine and Modernity: Public Health and Medical Care in Nineteenth- and Twentieth-Century Germany, ed. M. Berg and G. Cocks (Cambridge 1997), 35–54; and Paul Weindling, Health, Race and German Politics between National Unification and Nazism 1870–1945 (Cambridge 1989). On the growing antimaterialism of the Wilhelmine middle classes, see Martin Doerry, Übergangsmenschen: Die Mentalität der Wilhelminer und die Krise des Kaiserreichs (Munich 1986). 5. Alfred Grotjahn, Krankenwesen und Heilstättenbewegung im Licht der sozialen Hygiene (Leipzig 1908), 194. 6. Alfred Grotjahn, Soziale Pathologie (Berlin 1912), 415. 7. Fritz Ringer, The Decline of the German Mandarins: The German Academic Community 1890–1933 (Cambridge, MA 1969). 8. Detlev Peukert, The Weimar Republic: The Crisis of Classical Modernity (New York 1989), 84ff. On the beginnings of the discourse of the “mass” in the 1890s, see Geoff Eley, introduction, in Society, Culture, and the State in Germany 1870–1930, ed. Eley (Ann Arbor, MI 1997), 33–36. On late nineteenthcentury urban reform movements, see Andrew Lees, Cities, Sin, and Social Reform in Imperial Germany (Ann Arbor, MI 2002).
240 NOTES TO PAGES 84–87
9. The publication in 1900 of Simmel’s Philosophy of Money may be taken as one indicator of this. Grotjahn’s personal papers evidence his interest in questions of mass psychology. They include clippings on the writings of crowd theorist Gustav Le Bon; Simmel on fashion; Willy Hellpach on mass epidemics; wartime panics; and advertising. See HUB, Grotjahn Papers, “Notizen zur Problem der Massenpsychologie.” 10. On the cultural ideology of the Leipzig school, see Woodruff Smith, Politics and the Sciences of Culture in Germany 1840–1920 (New York 1991); and on Lamprecht, see Roger Chickering, Karl Lamprecht: A German Academic Life (1856–1915) (New Brunswick, NJ 1993). 11. Willy Hellpach, Nervosität und Kultur (Berlin 1902), 133. For more on socialization processes in Germany, see Hans-Ulrich Wehler, The German Empire 1871–1918 (Leamington Spa 1985), 118. According to Wehler, the individual’s “enmeshing” with society results in the operation of history both as external force acting upon and as internalized force within the individual. 12. Willy Hellpach, Nervenleben und Weltanschauung (Wiesbaden 1906), 20–22. 13. Ibid., 14. 14. Willy Hellpach, Grundlinien einer Psychologie der Hysterie (Leipzig 1904). Hellpach’s views reflect those of his teacher Karl Lamprecht, the Leipzig historian who felt that modern society’s processes of socialization had to combine Gebundenheit with “Männlichkeit and consciousness of freedom.” Lamprecht, Über die jüngsten deutschen Vergangenheit, vol. 2 (Berlin 1902), 514–17. 15. Hellpach, Nervenleben und Weltanschauung, 37. On the German cult of the engineer, see Jeffrey Herf, Reactionary Modernism: Technology, Culture, and Politics in Weimar and the Third Reich (Cambridge 1984). 16. Wolfgang Schivelbusch, The Railway Journey: the Industrialization of Time and Space in the 19th Century (Berkeley 1986). For contemporaneous accounts, see Otto Brähmer, “Eisenbahnhygiene,” in Handbuch der Hygiene, vol. 6, ed. Theodor Weyl (Jena 1897); and “Eisenbahn,” in Handwörterbuch der Staatswissenschaften, vol. 3, ed. Johannes Conrad (Jena 1911). 17. See Ralph Harrington, “The Railway Accident: Trains, Trauma and Technological Crisis in 19th Century Britain,” in Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, ed. M. Micale and P. Lerner (Cambridge 2001), 31–56; Schivelbusch, The Railway Journey, ch. 9. 18. Cited in Eric Caplan, “Trains, Brain and Sprains: Railway Neuroses and the Origins of Psychoneuroses,” Bulletin of the History of Medicine 69 (1995): 392. 19. See Esther Fischer-Homberger, Die traumatische Neurose: Vom somatischen zum sozialen Leiden (Bern 1975), 40. 20. Johannes Rigler, Über die Folgen der Verletzungen auf Eisenbahnen, insbesondere die von der Rückenmarks, mit Hinblick auf das Haftpflichtgesetzes (Berlin 1879), 9. 21. Carl Westphal, “Einige Fälle von Erkrankungen des Nervensystem nach Verletzungen auf Eisenbahnen,” Charité-Annalen 5 (1880): 741–51. 22. Fischer-Homberger, Die traumatische Neurose, 35. Shock was already well known, however, in other contexts. Helmholtz’s experiments on the speed of the nervous impulse involved administering an electric shock to his arm. For
NOTES TO PAGES 87–90 241
an account of the term’s history, see Fischer-Homberger, ibid., 36–56; Schivelbusch, The Railway Journey, 134–49; and, for a contemporary account, G. H. Groeningen, Über den Shock (Wiesbaden 1885). 23. Westphal, “Einige Fälle von Erkrankungen des Nervensystem,” 743. 24. While doctors assumed the existence of a lesion in railway spine, during the 1870s this lesion underwent a process of shrinkage and virtual disappearance in neurological discourse, until it was converted into a completely hypothetical entity, the “functional lesion.” Fischer-Homberger, Die traumatische Neurose, 21. 25. Rigler, Über die Folgen der Verletzungen auf Eisenbahnen, 43. 26. Wilhelm Erb, Handbook of Electro-therapeutics (New York 1886), 74. 27. Westphal, “Einige Fälle von Erkrankungen des Nervensystem,” 379. 28. See Gerhard Ritter, Social Welfare in Germany and Britain (Leamington Spa 1986); Florian Tennstedt, Vom Proleten zum Industriearbeiter: Arbeiterbewegung und Sozialpolitik in Deutschland, 1800 bis 1914 (Cologne 1983); and Ute Frevert, Krankheit als politisches Problem 1770–1880: Soziale Unterschichten in Preussen zwischen medizinischer Polizei und staatlicher Sozialsicherung (Göttingen 1984). 29. Alfons Labisch, “Doctors, Workers and the Scientific Cosmology of the Industrial World: The Social Construction of Health and Homo hygienicus,” Journal of Contemporary History 20 (1985): 605. 30. Cited in Ritter, Social Welfare in Germany and Britain, 8. 31. Greg Eghigian, Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany (Ann Arbor, MI 2000), 119. 32. Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990). 33. Michel Foucault, The History of Sexuality, vol. 1 (New York 1978), 135–45; Michel Foucault, “The Politics of Health in the 18th Century,” in Power/Knowledge, ed. C. Gordon (New York 1980), 166–82. 34. For more on this, see Francois Ewald, “Insurance and Risk,” in The Foucault Effect: Studies in Governmentality, ed. Peter Miller, Graham Burchell, and Colin Gordon (London 1991), 197–210. 35. Anson Rabinbach, “Social Knowledge, Social Risk, and the Politics of Accidents in Germany and France,” in States, Social Knowledge, and the Origins of Modern Social Policies, ed. D. Rueschmeyer and T. Skocpol (Princeton, NJ 1996), 52. See also Paul Rabinow, French Modern: Norms and Forms of the Social Environment (Cambridge, MA 1989). Contemporary cultural historian Karl Lamprecht cited these efforts at controlling risk as an instance of what he called the neue Gebundenheit that characterized the social relations of Imperial Germany. Lamprecht, Über die jüngsten deutschen Vergangenheit, vol. 2, 288, 469. 36. Eghigian, Making Security Social, 71. 37. Ritter, Social Welfare in Germany and Britain, 73–77; Tennstedt, Vom Proleten zum Industriearbeiter, 432–70. 38. Paul Weindling, “Medical Practice in Imperial Berlin: The Casebook of Alfred Grotjahn,” Bulletin of the History of Medicine 61 (1987): 402. 39. August Bebel, Die Frau und der Sozialismus (Berlin 1974), 182. See, for instance, BAL, R 89/343, “Nervenerkrankung durch Alkoholvergiftung oder in-
242 NOTES TO PAGES 90–93
folges des Unfalls?” Vorwärts (29 Nov. 1907). On “advocates of nerves,” see Walter Benjamin, “Karl Kraus,” in Reflections (New York 1978), 261. 40. Dr. Lentze, “Zur Regelung der Haftpflichtsansprüche bei traumatische Neurose und verwandten Krankheiten,” in Archiv für Eisenbahnwesen (Berlin 1907), 674. 41. Rabinbach, “Social Knowledge, Social Risk, and the Politics of Accidents in Germany and France,” 79. 42. Weindling, Health, Race and German Politics between National Unification and Nazism, 17. 43. Hellpach, Nervenleben und Weltanschauung, 31. 44. Rabinbach, “Social Knowledge, Social Risk, and the Politics of Accidents in Germany and France,” 61. 45. For a discussion of Oppenheim’s life and career, see Paul Lerner, “From Traumatic Neurosis to Male Hysteria: The Decline and Fall of Hermann Oppenheim, 1889–1919,” in Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, ed. M. Micale and P. Lerner (Cambridge 2001), 140–71; and Paul Lerner, Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany 1890–1930 (Ithaca, NY 2003), 27–39. 46. Lerner, “From Traumatic Neurosis to Male Hysteria,” 144. 47. Hermann Oppenheim, Die traumatische Neurosen nach den in der Nervenklinik der Charité in den letzten 5 Jahren gesammelten Beobachtungen (Berlin 1889), 178. 48. George Drinka, The Birth of Neurosis: Myth, Malady and the Victorians (New York 1984), 114–18. 49. For these debates, see BAL, R 89/342, documents pertaining to Oppenheim’s book Der Fall N., published in 1896. 50. Hermann Oppenheim, “Wie sind diejenige Fälle von Neurasthenie aufzufassen, welche sich nach Erschütterungen des Rückenmarks, insbesondere nach Eisenbahnunfälle entwickeln?” Deutsche medizinische Wochenschrift 14 (1888): 166–70. 51. See Mark Micale, Approaching Hysteria: Disease and Its Interpretations (Princeton, NJ 1994), 182. See also Jean Starobinski, “A Short History of Body Consciousness,” Humanities in Review 1 (1982): 22–39. For more on Charcot’s “science of shock” and his views on train collisions, shock nerveux, and hysteria, see Georges Didi-Hubermann, L’Invention de l’hysterie (Paris 1982), 152. 52. See Heinz-Peter Schmiedebach, “Post-Traumatic Neurosis in NineteenthCentury Germany: A Disease in Political, Juridical and Professional Context,” History of Psychiatry 10, no. 1 (1999): 27–58. 53. Lerner, “From Traumatic Neurosis to Male Hysteria,” 145. 54. Greg Eghigian, “Die Bürokratie und das Enstehen von Krankheit: Die Politik und die ‘Rentenneurosen’ 1890–1926,” in Stadt und Gesundheit: Zum Wandel von “Volksgesundheit” und kommunaler Gesundheitspolitik im 19. und frühen 20. Jahrhundert, ed. J. Reulecke and A. Gräfin zu Castell Rüdenhausen (Stuttgart 1991), 203–23; Greg Eghigian, “The German Welfare State as a Discourse of Trauma,” in Traumatic Pasts, ed. Micale and Lerner, 92–112; Gabrielle Moser, “Der Arzt im Kampf gegen ‘Begehrlichkeit und Rentensucht’ im Kaiserreich und in der Weimarer Republik,” Jahrbuch für kritische Medizin 16 (1992): 161–83.
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55. Theodor Benda, Öffentliche Nervenheilanstalten (Berlin 1891), 9. Later works in this vein include P. Leubuscher and W. Bibrowicz, “Die Neurasthenie in Arbeiterkreisen,” Deutsche medizinische Wochenschrift 21 (1906): 820–24; P. Schönhals, Über die Ursachen der Neurasthenie und Hysterie bei Arbeitern (Berlin 1906); and G. Heilig, Fabrikarbeit und Nervenleiden (Berlin 1908). 56. Brähmer, “Eisenbahnhygiene,” 245–51. 57. See BAP, RPM 47.01, 17138, “Die Nervenkrankheiten und ihre Bekämpfung,” Bl. 21–46. 58. W. Zimmermann, “Zur sozialen Lage der Eisenbahner in Preussen,” Schriften des Vereins für Sozialpolitik 99 (1902): 237. See also K. Schwechten, Die Krankheits, Sterbe- und Invalidisierungsfälle bei der Preussische Eisenbahngemeinschaft (Berlin 1909). The latter notes that personnel suffering nervous illnesses claimed the second highest number of sick days. 59. See Eghigian, Making Security Social, 77–94. 60. Ibid., 83. 61. See Karl Figlio, “What Is an Accident?” in The Social History of Occupational Health, ed. Paul Weindling (London 1985), 180–206. 62. Paul Lerner and Mark Micale, “Trauma, Psychiatry, and History,” in Traumatic Pasts, ed. Micale and Lerner, 20. 63. Dr. Windscheid, “Über das Wesen und die Behandlug von Nervenkrankheiten nach Unfällen,” RVA/AN 7 (1907): 449. By the early 1900s it was becoming common for doctors to recommend that the term accident be eliminated as part of a revision of the social insurance laws. See BAL, R 89/15112, Dr. Armin Steyerthal, Der Tag, 19 Dec. 1909. See also BAL, R 86/1277, A. Pries, “Unfallversicherung im Deutschen Reich,” regarding the failure of the laws to give a precise definition of the term accident or to distinguish between sudden and gradual effects. 64. Oppenheim’s views came under intense attack at the 1890 Berlin Medical Congress. See Fischer-Homberger, Die traumatische Neurose, 69–72. 65. Ibid., 58. 66. P. J. Möbius, “Bemerkungen über Simulation bei UnfallNervenkranken,” Münchener medizinische Wochenschrift 37 (1890): 887–88. 67. According to Caplan: “One of the great ironies in the development of psychotherapy in the U.S. concerns this vital role played by economically and culturally conservative railway surgeons. It was these surgeons—not liberal psychiatrists, or even progressive neurologists—who were the leading exemplars . . . of a revised psychogenic paradigm.” Caplan, “Trains, Brain and Sprains,” 413. 68. See the collection of documents in BAL, R 89/15114. 69. Fischer-Homberger, Die traumatische Neurose, 44. 70. Ärztliche Sachverständige Zeitung 7 (1901): 253. In the seventh edition of his psychiatric text, Kraepelin wrote that “an important factor in traumatic neurosis is the influence of accident insurance.” Kraepelin, Psychiatry, 7th ed. (1903; New York 1907), 476. 71. Dr. Mittelshäuser, “Die Unfallneurosen im Lichte der sozialen Frage,” Zeitschrift für Bahnärzte 1 (1906): 52. 72. Schmiedebach, “Post-Traumatic Neurosis in Nineteenth-Century Germany,” 39. 73. BAL, R 89/22555, letter, Kurt Mendel to RVA, 15 May 1913; BAL, R
244 NOTES TO PAGES 98–101
89/15112, Kurt Mendel, “Über Querulantenwahnsinn und ‘Neurasthenia querularia’ bei Unfallverletzten,” offprint. 74. BAL, R 89/22555, letter, Nervenheilstätt Lankwitz in Berlin-Lankwitz to RVA, April 1913. For biographical details on Schuster, see B. Holdorff, “Die Nervenärztlichen Polikliniken für Nervenkranke vor und nach 1900,” in Neurologie in Berlin, ed. Rolf Winau (Berlin 2000), 130, 134. 75. Siegfried Placzek, “Über die Gefahren nervenkranker Eisenbahnbediensteter für den Eisenbahnbetrieb,” in Bericht über die XIV Internationale Kongress für Hygiene, vol. 4 (Berlin 1908), 430–44, 596–609. 76. BAL, R 89/22553: Krankenhaus Hasenheide to RVA, 21 Sept. 1912; and Placzek to RVA, 11 Oct. 1912. 77. Arthur Leppmann, “Die Behandlung schwerer Unfallneurosen: Eine Umfrage, veranstaltet von der Redaktion der Aerztlichen SachverständigenZeitung,” Aerztlichen Sachverständigen-Zeitung (1906): 415–18, 438–41, 473–81. 78. BAL, R 89/22555, letter, Nervenheilstätt Lankwitz in Berlin-Lankwitz to RVA, April 1913, notifying RVA that it is open for business and listing a wide range of electrotherapeutic apparatus on the premises. 79. Hans Kurella, editor of the Zeitschrift für Elektrotherapie und aerztliche Elektrotechnik, relentlessly promoted the view that electricity had a vital role to play in the “battle against neurasthenia.” 80. Alfred Goldscheider, Diagnostik der Krankheiten der Nervensystems (Berlin 1897). See also Heinrich Boruttau, Die Elektrizität in der Medizin und Biologie (Wiesbaden 1906); and Ludwig Mann, “Rapport über den gegenwärtigen Stand der Elektrodiagnostik,” Zeitschrift für Elektrotherapie 4 (1902): 274–83. 81. See Max Offner, Mental Fatigue (Baltimore, MD 1911), 16–18. 82. Dr. Cornelius, “Der objektive Nachweis der subjektiven peripher nervösen Beschwerden,” Zeitschrift für Bahnärzte 3–4 (1908–9): 315. 83. Fischer-Homberger, Die traumatische Neurose, 70, 121. 84. BAL, R 89/15112, Paul Schuster, “Welche Vosichtsmassregeln sind bei der Untersuchung des Nervensystems Unfallverletzter zu beobachten?” offprint. 85. Windscheid, “Über das Wesen und die Behandlug von Nervenkrankheiten nach Unfällen,” 454. 86. Alfred Saenger, Die Beurteilung der Nervenerkrankungen nach Unfall (Stuttgart 1896), 71. 87. “The quiet purring of an electrical apparatus sounded from a distance. Psychological or physical expressions of anxiety or pain manifested only to a very minor degree: [the patient] merely gazed, with a somewhat anxious expression in the direction of the apparatus.” Paul Flechsig, “Sammlung ärztlicher Gutachten,” RVA/AN 5 (1903), 174. 88. On the medical backlash against social insurance, see Moser, “Der Arzt im Kampf gegen ‘Begehrlichkeit und Rentensucht’ im Kaiserreich und in der Weimarer Republik”; Eghigian, “Die Bürokratie und das Enstehen von Krankheit: Die Politik und die ‘Rentenneurosen’ 1890–1926”; Schmiedebach, “Post-Traumatic Neurosis in Nineteenth-Century Germany”; and Michael Kater,
NOTES TO PAGES 101–103 245
“Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany,” Journal of Contemporary History 20 (October 1985): 677–701. 89. See BAL, R 89/15112, “Inwieweit ist der durch einen Rechtstreit hervorgerufene krankhafte Zustand eines verletzten eine Entschädigungspflichtige Unfallfolge?” RVA/AN 7 (1911). 90. Windscheid, “Über das Wesen und die Behandlug von Nervenkrankheiten nach Unfällen,” 449. 91. For a detailed discussion, see Eghigian, “Die Bürokratie und das Enstehen von Krankheit: Die Politik und die ‘Rentenneurosen’ 1890–1926.” 92. Psychiatrist Ernst Schulte wrote that he had observed cases in which the so-called struggle for a pension had led patients to suicide. BAL, R 89/15112, Schulte, letter and offprint to RVA (n.d.). 93. BAL, R 89/15113, “Bericht über der auss. Vert. der Westfalischen Vereinigung berufsgenossenschaftlichen Verein” (Tagesordnung: Rentensucht und Rentenhysterie, 6–33). 94. BAL, R 89/15113, Dr. Nägeli, “Über den Einfluss von Rechtsansprüchen auf Neurose,” 24 Mar. 1913. 95. BAL, R 89/343, “Nervenerkrankung durch Alkoholvergiftung oder infolges des Unfalls?” Vorwärts 279 (29 Nov. 1907). This article described increasingly pronounced efforts among occupational associations and expert examiners to ascribe nervous illness to causes other than accident. See also BAL, R 89/15112, “Die Hysterie als Unfallfolge,” Vorwärts 236 (9 Oct. 1912). 96. L. Merzbacher, “Einige statistische Bemerkungen über Unfallneurosen,” Centralblatt für Nervenheilkunde und Psychiatrie 29 (1906): 905–12. 97. BAL, R 89/15113, memo, Dr. Kauffmann to Staatssekretär des Innern, “Erörterungen über die krankhafte Rentensucht bei den Arbeitern,” 23 Apr. 1913. 98. Esther Fischer-Homberger suggests that the breadth of this difference can be explained only in terms of class tensions. Fischer-Homberger, Die traumatische Neurose, 71. 99. See BAL, R 89/15193, “Mit einem Meister-Simulanten,” Der Germania, 16 June 1912. 100. BAL, R 89/15112, P. Schuster, “Welche Vorsichtsmassregeln sind bei der Untersuchung des Nervensystems Unfallverletzter zu beobachten?” offprint, 1912; Schuster, “Die traumatische Neurosen,” in Deutsche Klinik, ed. Ernst von Leyden (Berlin 1906), 1019. 101. See Ewald, “Insurance and Risk,” 205. On the thematization of simulation in the fin de siècle, see Vanessa Schwartz, Spectacular Realities: Early Mass Culture in Fin-de-Siècle France (Berkeley, CA 1998), 203; and Friedrich Kittler, Discourse Networks 1800/1900 (Stanford, CA 1990), 304ff. Kittler suggests that Daniel Paul Schreber’s Memoirs of My Nervous Illness (Cambridge, MA 1988) could be titled “Memoirs of My Simulation of Nervous Illness.” 102. Peter Fritzsche, Reading Berlin 1900 (Chicago 1996), 31; Arthur Eloesser, cited in David Clay Large, Berlin (New York 2000), 49; Georg Simmel, “The Metropolis and Mental Life” (1903), in On Individuality and Social Forms, ed. D. Levine (Chicago 1971), 338. 103. According to Didi-Hubermann, Charcot’s work “shook the epistemo-
246 NOTES TO PAGES 103–7
logical foundations of neuropathology.” Didi-Hubermann, L’Invention de l’hysterie, 81. 104. Breuer and Freud make this point in their discussion of the case of Anna O., who worries at one point that she has simulated her illness. Joseph Breuer and Sigmund Freud, Studies in Hysteria (New York 1955), 46. 105. Freud, cited in Kurt Eissler, Freud as an Expert Witness: The Discussion of War Neuroses between Freud and Wagner-Jauregg (Madison, CT 1986), 54. 106. L. Bruns, “Neuere Arbeiten über ‘traumatischen Neurosen,’ ” Schmidt’s Jahrbücher 239 (1892): 29–30. 107. Joanna Bourke, Dismembering the Male: Men’s Bodies, Britain and the Great War (London 1995), 81. 108. BAL, R 89/636, “Missbrauch der Unfallversicherung,” Der Kompass 2 (1896). 109. BAL, R 89/636, Die Berufsgenossenschaft, 10 June 1896. 110. BAL, R 89/15112, “Die Hysterie als Unfallfolge,” Vorwärts 236 (9 Oct. 1912). 111. “Setting the notion of proof within the confines of a strict empiricism called subjective experience and expression into question.” Eghigian, Making Security Social, 83. 112. Ludwig Becker, Die Simulation von Krankheiten und ihre Beurteilung (Leipzig 1908), 3–4. 113. Brähmer noted that it was unfortunate that no autopsies had been performed on railway personnel suffering from nervous illness. Brähmer, “Eisenbahnhygiene,” 253. Schuster suggested that, given the role of electrical conduction in the nervous system, the pathology of electrical accidents might provide a clue to the nature of traumatic neurosis. Schuster, “Die traumatische Neurosen,” 985. It was perhaps in this spirit that Schuster later investigated the neuroses of telephone operators. See Schuster, “Die Krankheiten der Telephonangestellten,” in Handbuch der Arbeiterkrankheiten, ed. T. Weyl (Jena 1908), 289–95. 114. Moser, “Der Arzt im Kampf gegen ‘Begehrlichkeit und Rentensucht’ im Kaiserreich und in der Weimarer Republik,” 181; Oppenheim, Die traumatische Neurosen nach den in der Nervenklinik der Charité, 27. 115. Adolf Seeligmüller, “Zur Frage der Simulation von Nervenleiden nach Traumen,” Neurologisches Centralblatt 8 (1889): 570–72. 116. For more on this line of argument, see Schmiedebach, “Post-Traumatic Neurosis in Nineteenth-Century Germany,” 47ff. 117. BAL, R 89/637, letter, Seeligmüller to Imperial Health Office (Kaiserliche Gesundheitsamt, KGA), 26 July 1890, and offprint of article. 118. Fischer-Homberger, Die traumatische Neurose, 63. 119. BAL, R 88/637, “Die Errichtung von Unfallkrankenhäusern zur Entlarvung der Simulation,” Die Berufsgenossenschaft 5 (1891). 120. BAL, R 89/637, offprint from Munich doctor Max Grunewald. 121. BAL, R 89/637, “Die Errichtung von Unfallkrankenhäusern zur Entlarvung der Simulation,” Die Berufsgenossenschaft 5 (1891). 122. Benda, Öffentliche Nervenheilanstalten, 18. 123. Ludwig Bruns, “Neuere Arbeiten über die ‘traumatischen Neurosen,’ ” Schmidt’s Jahrbücher (1891): 83.
NOTES TO PAGES 107–10 247
124. “Obergutachten der medizinischen Fakultät der Universität Berlin,” RVA/AN (1897): 479ff. 125. Historians of psychiatry note that a shift from a reflex action to a central nervous system paradigm took place around 1870. This mirrored a shift in focus from the motor to the sensory side of the nervous system. See Edward Shorter, From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era (New York 1992), 130, 267; and Fischer-Homberger, Die traumatische Neurose, 52. 126. “Obergutachten der medizinischen Fakultät der Universität Berlin,” RVA/AN (1897): 481. 127. George M. Beard, American Nervousness, Its Causes and Consequences (New York 1880), 45. 128. H. Wilbrand, Über typische Gesichtsfeldanomalien bei functionellen Störungen des Nervensystems (Leipzig 1891), 14. 129. Schivelbusch, The Railway Journey, 57, 64. 130. Zimmermann, “Zur sozialen Lage der Eisenbahner in Preussen,” 234. 131. Bruns, “Neuere Arbeiten über die ‘traumatischen Neurosen’ ” (1892), 28. 132. Ibid., 27; O. Rapmund, Das beamtete Arzt und ärztliche Sachverständige (Berlin 1904), 471. 133. See William James, “Review of Wundt’s Principles of Physiological Psychology,” in Wundt Studies: A Centennial Collection, ed. W. G. Bringmann (Toronto 1980). According to Allan Young, Ribot “analogized the sense of self to the field of vision. Perception went from sharp at the center to less precise at the periphery.” Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton, NJ 1995), 29. 134. Pierre Janet, “Le Retricissement du champ de la conscience,” in L’Automatisme psychologique (Paris 1899), 190–200. For Janet, narrowing of the field of consciousness was a sure sign of degeneration. 135. According to Oppenheim, Charcot reproduced under hypnosis the symptoms associated with shrinkage of the visual field. Oppenheim, Die traumatische Neurosen nach den in der Nervenklinik der Charité, 6. 136. One journal cites the results of an 1896 study of visual field tests carried out on several hundred workers suffering from traumatic neurosis. See “Gesichtsfeldstörungen,” Zeitschrift für Unfallheilkunde 3 (1896): 218. See also “Zur Diagnostik der Sehstörungen mit besonder Berücksichtigung des Simulationsfrage,” Zeitschrift für Unfallheilkunde 3 (1896): 218, 341. 137. The Charité’s Krankenblätterarchiv contains the results of thousands of such visual field tests. 138. BAL, R 89/342, 16 Jan. 1895, A. Nieden, “Referate über die Simulation von Augenleiden und die Mittel ihrer Entdeckung.” 139. BAL, R 89/637, 1 June 1893, A. Nieden, Sonderabdruck, “Über die Simulation von Augenleiden.” 140. See A. Engelskjön, “Elektrische Gesichtsfelduntersuchung,” Archiv für Psychiatrie 15 (1885). 141. W. Koenig, Über Gesichtsfeldermüdung bei Erkrankung der Centralnervensystem (Leipzig 1893), 10. 142. Alfred Saenger, Die Beurteilung der Nervenerkrankungen nach Unfall (Stuttgart 1896), 53.
248 NOTES TO PAGES 110–13
143. W. Fuchs, “Gutachten über den Direktor N.,” Monatsschrift für Unfallheilkunde 5 (1898): 48. 144. Rapmund, Das beamtete Arzt und ärztliche Sachverständige, 471. See also “Über Sehproben und Simulationsentlarvungsapparat,” Zeitschrift für Bahnärzte 3–4 (1908–9): 54. 145. At a medical congress held in Berlin one railway doctor reported that in ten years of clinical experience he had never observed any special railwayrelated disorders of the eye. Bericht über die XIV Internationale Kongress für Hygiene und Demographie, vol. 4 (Berlin 1908), 598. 146. BAL, R 89/15112, P. Horn, “Über nervose Erkrankungen bei Eisenbahnunfällen,” 1911. 147. See Didi-Hubermann, L’Invention de l’hysterie, 76; Young, The Harmony of Illusions, 9. 148. Fischer-Homberger, Die traumatische Neurose, 8. See also Lerner and Micale, “Trauma, Psychiatry and History,” 10. 149. See, for instance, Emil Kraepelin, Psychiatrie: Ein Lehrbuch für Studierende und Ärzte, 5th ed. (Leipzig 1896), 349. On Kraepelin’s desire to keep psychiatry and neurology separate and on his complaints about the neurologically oriented hiring practices emanating from Berlin during this period, see his Memoirs (Berlin 1987), 29. See also Volker Roelcke, “Biologizing Social Facts: An Early 20th Century Debate on Kraepelin’s Concepts of Culture, Neurasthenia, and Degeneration,” Culture, Medicine, and Psychiatry 21 (1997): 383–403. 150. See Fischer-Homberger, Die traumatische Neurose, 133. See also Lerner, Hysterical Men, 36–39. 151. Placzek, “Über die Gefahren nervenkranker Eisenbahnbediensteter für den Eisenbahnbetrieb,” 608–9. 152. Siegfried Placzek, “Referat,” Zeitschrift für Bahnärzte 3–4 (1908–9): 27. 153. For more on this epistemic shift, see Ian Hacking, Rewriting the Soul: Multiple Personality and the Sciences of Memory (Princeton, NJ 1995), 216–17. On intelligence testing, see Kurt Danziger, Constructing the Subject: Historical Origins of Psychological Research (Cambridge 1990), 142–46; and Nikolas Rose, Governing the Soul: Shaping the Private Self (London 1989). 154. Weindling, Health, Race and German Politics between National Unification and Nazism, 381. 155. S. Placzek, “Psychische Untersuchungsmethoden,” Zeitschrift für Bahnärzte 3–4 (1908–9): 272. 156. Ibid., 275; Placzek, “Über die Gefahren nervenkranker Eisenbahnbediensteter für den Eisenbahnbetrieb,” 442. 157. Ute Frevert, “Professional Medicine and the Working Classes in Imperial Germany,” Journal of Contemporary History 20 (1985): 651. See also Eghigian, Making Security Social, 268. 158. Crary identifies the classification of the capacities of the laboring human subject, including those of the eye, as one of the nineteenth century’s major scientific undertakings. See Jonathan Crary, Techniques of the Observer: On Vision and Modernity in the Nineteenth Century (Cambridge, MA 1992). 159. Didi-Hubermann, L’Invention de l’hysterie, 132.
NOTES TO PAGES 113–16 249
160. See Daphne de Marneffe, “Looking and Listening: The Construction of Clinical Knowledge in Charcot and Freud,” Signs 17 (1991): 71–111. 161. Specialists in accident medicine employed photography in the belief that “while the patient’s attention is occupied by the photography, he often forgets to simulate.” Zeitschrift für Unfallheilkunde 1 (1894): 3–8. See also “Über Sehproben und Simulations-entlarvungsapparat,” Zeitschrift für Bahnartze 3–4 (1908–9): 54. 162. Becker, Die Simulation von Krankheiten und ihre Beurteilung, 4. 163. See BAL, R 89/343, “Der Gedanke an sich selbst als Teil der Krankheit,” Die Nation 30 (1903). 164. Grotjahn, Soziale Pathologie, 478. 165. Otto Binswanger, Die Pathologie und Therapie der Neurasthenie (Jena 1896), 112. 166. Möbius, who treated Fechner for eye problems, wrote that Fechner had told him that “religious thoughts” saved him from despair during his own nervous illness. P. J. Möbius, Über die Behandlung von Nervenkranken und die Errichtung von Nervenheilstätten (Leipzig 1896), 9. 167. See Joachim Radkau, “Die wilhelminische Ära als nervöses Zeitalter; oder, Die Nerven als Netz zwischen Tempo- und Körpergeschichte,’ ” Geschichte und Gesellschaft 20 (1994): 211–41; and Michael Hau, The Cult of Health and Beauty in Germany: A Social History (Chicago 2003). 168. Max Laehr, the director of Haus Schönow, later wrote that the emphasis on work therapy had helped to overcome the scruples of many of its donors. Max Laehr, “Die Heilstätte für Nervenkranke ‘Haus Schönow’ 1899 bis 1927,” Psychiatrische-Neurologische Wochenschrift 30 (1928): 5. 169. BAP, RPM 47.01, 17138, “Die Nervenkrankheiten und ihre Bekämpfung,” Bl. 1. 170. This was meant to remove the stigma of treatment in large hospitals, which were associated with restraints and warehousing of patients. For an account by one nervous patient who reported appalling treatment at the Charité, see HUB, Charité 911, “KKM2,” P. R., Die Tribune, 4 May 1910. 171. During the year 1912, for instance, Haus Schönow’s staff issued fifty-eight medical opinions for a variety of state offices and private corporations: two for the Reich Insurance Office; three for the army; three for the Postal Ministry; three for the Reichsbahn; seven for the Regional Insurance Office; thirteen for a variety of Berufsgenossenschaften; fifteen for various private insurance companies; and two for other convalescence institutions. In addition, Haus Schönow provided seventyeight briefer opinions for the Regional Insurance Office. Of the patients that various authorities sent for periods of convalescence there, ninety-two came from life insurance institutions; fourteen from Berufsgenossenschaften in various branches of industry, including the chemical industry, the printing industry, the electrical industry, and the street car industry; twenty-four from the Reichsbahn; ten from the Reich Postal Ministry; and seven from the sick funds of the AEG and Siemens. 172. On hand at the opening ceremonies were President Heinrich Köhler of the Imperial Health Office; chief military doctor Viktor von Schjerning; and Theobald von Bethmann-Hollweg, then president of Brandenburg Province and later chancellor.
250 NOTES TO PAGES 116–18
173. BAP, RPM 47.01, 17138, “Die Nervenkrankheiten und ihre Bekämpfung,” Bl. 21–46. 174. Ibid., Bl. 32. 175. See Richard Freund, Die Arbeiterheilstätten der Landesversicherungsanstalt Berlin bei Beelitz (Berlin 1902); and Leubuscher and Bibrowicz, “Die Neurasthenie in Arbeiterkreisen.” 176. BAL, R 89/6754, “Verwaltungsbericht” (1912), 77–87. 177. BAP, RPM 47.01, 10509, pamphlet, Erholungsheim für deutscher Lokomotivbeamten zu Münden (Berlin 1904). 178. See BAL, R 89/6705, RVA conference on work therapy in Lungenheilstätten, 25 Oct. 1901. Möbius’s ideas seem to have been taken up in the TB sanatoriums as well. See Schwechten, in Bericht über die XIV Internationale Kongress für Hygiene und Demographie, vol. 4 (Berlin 1908), 597. 179. BAL, R 86/1277, “Landkolonien für Unfallverletzte und Invalide und ihre innere Organization.” 180. See BAL, R 89/6705, Report from LVA Rheinprovinz on Heilstätte Roderbirken. 181. BAL, R 89/6705, reports on results of work therapy, 1912; BAL, R 89/6754 “Verwaltungsbericht” (1912), 77–87; Dr. Gilbert, “Die Häufung der traumatische funktionelle Nervenkranken und deren Behandlung,” Zeitschrift für Bahnärzte 1 (1905): 6. 182. Leppmann, “Die Behandlung schwerer Unfallneurosen,” 479. 183. According to one doctor, a locomotive driver suffering neurasthenic dizziness could benefit from spending an hour each day at the controls of a fast train. The guiding principle was the “earliest possible habituation of the accident neurotic to perform work.” Zeitschrift für Bahnärzte 1 (1905): 10. 184. Windscheid, “Über das Wesen und die Behandlug von Nervenkrankheiten nach Unfällen,” 446–54. 185. Ibid., 454. 186. Laehr, “Die Heilstätte für Nervenkranke ‘Haus Schönow,’ ” 21. 187. Adolf Levenstein, who conducted several studies of workers’ attitudes, cited a letter he had received from one worker confiding the contents of his correspondence with a colleague, then a patient at Beelitz. The worker had counseled his friend to read Nietzsche during his recuperation, for Nietzsche, unlike Marx, paid attention to more than just economic questions. Nietzsche’s works, speculated Levenstein, seemed to resonate within the “excitable psyche of the worker,” who was the victim of “an atomized mode of work.” Adolf Levenstein, Friedrich Nietzsche im Urteil der Arbeiterklasse (Leipzig 1914). See also his Die Arbeiterfrage, mit besondere Berücksichtigung der sozial-psychologische Seite des modernen Grossbetriebs und der psychophysischen Einwirkungen auf der Arbeiter (Munich 1912). 188. BAL, R 89/6705, Bergmannswohl Unfall-Nervenheilanstalt der Knapps-Berufsgenossenschaft, 8 Oct. 1912. 189. Cited in Ritter, Social Welfare in Germany and Britain, 110. 190. BAL, R 86/1277, “Landkolonien für Unfallverletzte und Invalide und ihre innere Organization.”
NOTES TO PAGES 118–23 251
191. BAL, R 86/1273, Reichstag petition, Georg Wetzer, “Um Verbesserung des Irren bzw. Nervenkrankenfürsorge,” 10 May 1908. 192. BAL, R 89/6754, Freund to Oberpräsident der Provinz Brandenburg und Berlin, 18 Dec. 1912. 193. BAL, R 89/6754, Oberpräs. der Provinz Brandenburg und Berlin to Ministerium des Innerns, 29 Dec. 1912. 194. BAL, R 89/6754, Norddeutsche allgemeine Zeitung, 17 Jan. 1913. 195. BAL, R 89/6754: Der Germania, 17 Jan. 1913; Westdeutsche ArbeiterZeitung, 15 Feb. 1913. 196. BAL, R 89/6754: Vorwärts (5 Sept. 1912); Vorwärts (11 May 1912). 197. BAL, R 89/6754, copy of new Hausordnung at Beelitz. 198. BAL, R 89/6754, Vorwärts (26 Jan. 1913). 199. BAL, R 89/6754, Freund to Oberpräsident der Provinz Brandenburg und Berlin, 18 Dec. 1912. 200. For more on Grotjahn, see Weindling, “Medical Practice in Imperial Berlin”; Weindling, Health, Race and German Politics between National Unification and Nazism, 220–35; and Karl-Heinz Roth, “Schein-Alternativen im Gesundheitswesen: Alfred Grotjahn—Integrationsfigur etablierter Sozialmedizin und nationalsozialistischer ‘Rassenhygiene,’ ” in Erfassung zur Vernichtung: Von der Sozialhygiene zum “Gesetz über Sterbehilfe,” ed. K.-H. Roth (Berlin 1984), 31–56. 201. HUB, Grotjahn Papers. See, for instance, Folder 261, Versicherungsfragen, “Die objectiv notwendige und die subjective befriedigende Leistungen in ihrer Beziehung zur Vereinheitlichung der Arbeiterversicherung”; Folder 267, Materialsammlung zur Hedonisierung; and Folder 342, Psychopathologie. 202. Weindling, “Medical Practice in Imperial Berlin,” 400. See also Grotjahn, Erlebtes und Erstrebtes: Errinerungen eines sozialistischen Arztes (Berlin 1932), 89. 203. Grotjahn, Soziale Pathologie, 412. 204. Ibid., 479. 205. Grotjahn, Erlebtes und Erstrebtes, 136–38. 206. Grotjahn, Krankenwesen und Heilstättenbewegung im Licht der sozialen Hygiene (Leipzig 1908), 404. 207. Ibid., 117, 200. 208. Ibid., 4. 209. Ritter, Social Welfare in Germany and Britain, 27. 210. Rose, Governing the Soul, 63–64. 211. For more on the relation between subjectivity and techniques of (self-) monitoring, see ibid. 212. Grotjahn, Krankenwesen und Heilstättenbewegung im Licht der sozialen Hygiene, 205. 213. Alfred Grotjahn, Leitsätze zur sozialen und generativen Hygiene (Karlsruhe 1921), 26; Roth, “Schein-Alternativen im Gesundheitswesen.” Peukert singles out Grotjahn as exemplary of what he describes as the ambivalent logic of the human sciences: the continuity between humanitarian social reform and authoritarian social (and racial) engineering. Detlev Peukert, “The Genesis of the ‘Final Solution’ from the Spirit of Science,” in Nazism and German Society 1933–1945, ed. David Crew (London 1994), 285.
252 NOTES TO PAGES 123–28
214. See Daniel Nadav, “Julius Moses und Alfred Grotjahn: Das Verhalten zweier sozialdemokratischer Ärzte zu Fragen der Eugenik und Bevölkerungspolitik,” in Der Wert des Menschen: Medizin in Deutschland 1918–1945, ed. C. Pross and G. Aly (Berlin 1989), 143–52; and Cristoph Kaspari, “Der Eugeniker Alfred Grotjahn und die ‘Münchner Rassenhygieniker’: Die Streit um ‘Rassenhygiene oder Eugenik,’ ” Medizinhistorische Journal 24 (1989): 306–32. 215. Grotjahn, Krankenwesen und Heilstättenbewegung im Licht der sozialen Hygiene, 405. Regarding his use of biological analogies in society and politics, see Grotjahn’s introduction to Soziale Pathologie. On the implications of the shift from liberal to collectivist, eugenic frameworks, see Weindling, Health, Race and German Politics between National Unification and Nazism, esp. 14–20; and Sheila Weiss, Race Hygiene and National Efficiency: The Eugenics of Wilhelm Schallmeyer (Berkeley 1987). 216. Ärztliche Sachverständige Zeitung 7 (1901): 146. 217. This is a view captured by Bumke’s later remark that in Oppenheim’s youth, doctors had used the term brain when they meant “soul” (Seele). Oswald Bumke, “Die Revision der Neurosenfrage,” Zentralblatt für die gesamte Neurologie und Psychiatrie 41 (1925): 671. 218. KBA der Charité, 1914, Intake 430. 219. Ibid., Intake 468. 220. Ibid., Intake 682. 221. Eghigian, “Die Bürokratie und das Enstehen von Krankheit.” 222. BAL, R 89/15113, “Bericht ü. d. auss. Vert. d. Westfälischen Vereinigung berufsgenossenschaftlichen Verein. Tagesordnung über Rentensucht und Rentenhysterie,” Bl. 7. 223. Doerry, Übergangsmenschen; Ringer, The Decline of the German Mandarins. 224. Schmiedebach, “Post-Traumatic Neurosis in Nineteenth-Century Germany,” 56. See also Fischer-Homberger, Die traumatische Neurose. 225. On the medical backlash against social insurance, see Kater, “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany”; and Eghigian, “Die Bürokratie und das Enstehen von Krankheit”; and, for discussion of this issue during the Weimar period, see David Crew, Germans on Welfare: From Weimar to Hitler (New York 1998); and Young-Sun Hong, Welfare, Modernity and the Weimar State, 1919–1933 (Princeton, NJ 1998). 226. Ludwig Bernhard, The Undesirable Results of German Social Legislation (New York 1914), 50. See BAL, R 89/15113, review of Bernhard’s Unerwünschte Folgen der Sozialpolitik, followed by Sonderabdruck in Zeitschrift für Bahnärzte 5 (1913).
4. ELECTROTHERAPY AND THE NERVOUS SELF DURING WARTIME 1. HUB, Charité Nervenklinik Bestand, Akte 19. 2. See Paul Lerner, Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany 1890–1930 (Ithaca, NY 2003),102–13. 3. Volker Berghahn, Modern Germany: Society, Economy, and Politics in the Twentieth Century (Cambridge, UK 1982), 36–37.
NOTES TO PAGES 128–32 253
4. Joachim Radkau, Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler (Munich 1998), 387–495. 5. Heinrich Boruttau, Die Arbeitsleistungen des Menschen, Einführung in die Arbeitsphysiologie (Leipzig 1916), 81. 6. Cited in Bernd Ulrich, “Nerven und Krieg: Skizzierung einer Beziehung,” in Geschichte und Psychologie: Annäherungsversuche, ed. Bedrich Loewenstein (Pfaffenweiler 1992), 164. 7. Albert Eulenburg, “Kriegsnervosität,” Die Umschau 19 (1915): 1. 8. Cited in Lerner, Hysterical Men, 51. 9. Alfred Grotjahn, Erlebtes und Erstrebtes: Errinerungen eines sozialistischen Arztes (Berlin 1932), 157ff. 10. On the war and its impact, see Jürgen Kocka, Facing Total War: German Society 1914–1918 (Cambridge, MA 1984); B. Ulrich and B. Ziemann, eds., Frontalltag im Ersten Weltkrieg: Wahn und Wirklichkeit (Frankfurt 1994); G. Hirschmann and G. Krumeich, eds., “Keiner fühlt sich hier mehr als Mensch”: Erlebnis und Wirkung des Ersten Weltkrieges (Essen 1994); Daniel Pick, War Machine: The Rationalization of Slaughter in the Modern Age (New Haven, CT 1993); and Modris Eksteins, The Rites of Spring: The Great War and the Birth of the Modern Age (New York 1989). 11. Kern argues that these telegrams shaped the pace and structure of diplomacy during the July crisis. See Stephen Kern, The Culture of Time and Space, 1880–1918 (Cambridge, MA 1983), 274–75. 12. Allan Young, The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder (Princeton, NJ 1995), 41. 13. Eric Leed, No Man’s Land: Combat and Identity in World War I (Cambridge 1979). 14. Ernst Jünger, Storm of Steel (New York 1975), 118. 15. Walter Benjamin, “The Storyteller,” in Illuminations (New York 1968), 84. 16. Leed, No Man’s Land, 163–92. See also Elaine Showalter, The Female Malady: Women, Madness, and English Culture, 1830–1980 (New York 1986); and Journal of Contemporary History 35 (2000), a special issue devoted to shell shock. 17. This figure refers to both the field and the reserve armies. See Doris Kaufmann, “Science as Cultural Practice: Psychiatry in the First World War and Weimar Germany,” Journal of Contemporary History 34, no. 1 (January 1999): 125. 18. According to Robert Whalen, “German doctors approached the war as a colossal industrial accident.” Whalen, Bitter Wounds: German Victims of the Great War 1914–1939 (Ithaca, NY 1984), 89. 19. Emil Kraepelin, Memoirs (Berlin 1987), 164. 20. Klaus Doerner, Madmen and the Bourgeoisie: A Social History of Insanity and Psychiatry (Oxford 1981), 307. For more on the war neurosis issue, see Karl-Heinz Roth, “Die Modernisierung der Folter in den beiden Weltkriegen: Der Konflikt der Psychotherapeuten und Schulpsychiater um die deutschen ‘Kriegsneurotiker’ 1915–1945,” 1999: Zeitschrift für Sozialgeschichte 3 (1987): 8–75; and Esther Fischer-Homberger, Die traumatische Neurose: Vom somatischen zum sozialen Leiden (Bern 1975), 105–70. 21. Hermann Oppenheim, “Zur Frage der traumatischen Neurose,” Deutsche Zeitschrift für Nervenheilkunde 1–4 (1917): 33.
254 NOTES TO PAGES 132–36
22. HUB, Charité Nervenklinik Bestand, Akte 22. 23. On these cost-cutting measures, see Jason Crouthamel, “War Neurosis vs. Savings Psychosis: Working Class Politics and Psychological Trauma in Weimar Germany,” Journal of Contemporary History 37, no. 2 (2002): 163–82. 24. HUB, Charité Nervenklinik Bestand, Akte 22. 25. For a discussion of these events, see Paul Lerner, “From Traumatic Neurosis to Male Hysteria: The Decline and Fall of Hermann Oppenheim,” in Traumatic Pasts: History, Psychiatry and Trauma in the Modern Age, 1870–1930, ed. Mark S. Micale and Paul Lerner (Cambridge 2001), 163–67. 26. Oswald Bumke, “Die Revision der Neurosenfrage,” Zentralblatt für die gesamte Neurologie und Psychiatrie 41 (1925): 677. 27. Karl Bonhoeffer, “Wie weit kommen psychogene Krankheitszustände und Krankheitsprozesse vor, die nicht der Hysterie zuzurechnen sind?” Allgemeine Zeitschrift für Psychiatrie 68 (1911): 371–86. 28. A striking echo of this interpretation occurs in the writings of Freud’s follower Sándor Ferenczi. In arguing for the correctness of the psychoanalytic approach, Ferenczi contrasted the new psychogenic interpretation of war neurosis with the old “organic-mechanical explanations,” which, he stated, roughly corresponded with the “materialist view of history among sociologists” and which had failed utterly to offer convincing explanations of or cures for the neuroses of war. See Ferenczi, “Die Psychoanalyse der Kriegsneurosen,” in Zur Psychoanalyse der Kriegsneurosen (Leipzig, 1919), 9–30. Cited in Lerner, Hysterical Men, 177. Ferenczi argued that the symptoms of war neurosis were hysterical conversions, or materializations, of psychic conflicts. For more on Ferenczi, see Lerner, Hysterical Men, 176–87; and, for an insightful discussion of this notion of materialization as it relates both to the neuroses of war and to the use of shock as a formal principle in postwar Dadaism, see Brigid Doherty “ ‘See: We Are All Neurasthenics!’ or, The Trauma of Dada Montage,” Critical Inquiry 24, no. 1 (1997): 82–132. 29. Ewald Stier, “Psychiatrie und Heer,” Der deutsche Militärärzt 1 (1936): 19; Ewald Stier, “Wie kann der Enstehung von Kriegsneurosen bei Feldarmee vorgebeugt werden?” Deutsche militärärztliche Zeitschrift 47 (1918): 65. 30. On the social militarization of German physicians, see Michael Kater, “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany,” Journal of Contemporary History 20 (1985): 677–701. 31. Roth, “Die Modernisierung der Folter in den beiden Weltkriegen.” Details about Stier are scarce. His Charité file, which ends in 1944, sheds little light on his career, and I have been unable to find any eulogies. See HUB, Personalakten, 64a, Stier. 32. Lerner, Hysterical Men, 85. 33. Stier, “Psychiatrie und Heer.” 34. See Karl Bonhoeffer, “Über die Bedeutung der Kriegserfahrungen für die allgemeine Psychopathologie und Atiologie der Geisteskrankheiten,” in Handbuch der ärztlichen Erfahrungen im Weltkrieg 1914–1918, ed. O. von Schjerning, vol. 4: Geistes- und Nervenkrankheiten, ed. K. Bonhoeffer (Leipzig 1922), 3–44. 35. Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870–1945 (Cambridge 1989), 381.
NOTES TO PAGES 136–42 255
36. Karl Bonhoeffer, “Psychiatrie und Krieg,” Deutsche medizinische Wochenschrift 40 (1914): 1777–79. 37. See Lerner, Hysterical Men, esp. 124–62. 38. Stier, “Wie kann der Enstehung von Kriegsneurosen bei Feldarmee vorgebeugt werden?” 63. See also Ewald Stier, “Rentenversorgung bei nervösen und psychisch erkrankten Feld-zugsteilnehmern,” in Handbuch, vol. 4: Geistesund Nervenkrankheiten, ed. Bonhoeffer, 168–95. 39. Stier, “Wie kann der Enstehung von Kriegsneurosen bei Feldarmee vorgebeugt werden?” 67. 40. Ibid., 65. See also Stier, “Psychiatrie und Heer,” 17. At the 1916 conference, among the elements to come under attack in the disease picture associated with traumatic neurosis was the central notion of shock. According to one participant, Robert Wollenberg, “[t]he shock theory of Herr Oppenheim is not supported by what we’ve learned from the war neuroses.” Cited in Lerner, “From Traumatic Neurosis to Male Hysteria,” 165. 41. Stier, “Wie kann der Enstehung von Kriegsneurosen bei Feldarmee vorgebeugt werden?” 67. 42. “The sufferer from delusion of persecutions imagines someone is . . . hurling currents of electricity at him.” Max Nordau, Degeneration (1892; Lincoln, NE 1993), 553. According to one doctor, modern man had replaced his fears of diabolical persecution with fears centered on electricity, telegraphy, and hypnosis. G. Voss, “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten,” in Krankheit und soziale Lage, ed. M. Mosse and G. Tugendhat (Berlin 1913), 406. 43. Lerner, Hysterical Men, 102–13. 44. See “On the Apparatus Used for Electrical Treatment of So-Called War Neuroses,” in Kurt Eissler, Freud as an Expert Witness: The Discussion of War Neuroses between Freud and Wagner-Jauregg (Madison, CT 1986), 378–82. 45. Fritz Kaufmann, “Die Planmässige Heilung komplizierter psychogener Bewegungsstörungen bei Soldaten in einer Sitzung,” Münchener medizinische Wochenschrift 63 (1916): 802–4. 46. Ibid., 802. 47. Ibid. 48. See Peter Riedesser and Axel Verderber, Maschinengewehre hinter der Front: Zur Geschichte der deutsche Militärpsychiatrie (Frankfurt 1996), 42–74. 49. Lerner, Hysterical Men, 104–6. 50. Eissler, Freud as an Expert Witness, 307. 51. Lerner, Hysterical Men, 110. The reference to skeptics relates to Kurt Goldstein. 52. Ibid. 53. Stier, “Psychiatrie und Heer,” 18. 54. Cited in Robert Gaupp, “Neurasthenie und Schreckneurosen,” in Handbuch, vol. 4: Geistes- und Nervenkrankheiten, ed. Bonhoeffer, 89. 55. On the diagnosis of neurasthenia among officers and hysteria among soldiers, see Leed, No Man’s Land, 163; and Joanna Bourke, Dismembering the Male: Men’s Bodies, Britain and the Great War (London 1995), 112–16. 56. “Dr. M. Kozlowski’s Letter to the Commission,” in Eissler, Freud as an Expert Witness, 390–95. Elsewhere Kozlowski cites the “self-sacrificing work of the
256 NOTES TO PAGES 142–46
physicians at the Wagner-Clinic.” Joanna Bourke writes that, among British military doctors, those who used electrotherapy were more liable to view the sufferer as a malingerer and so used it coercively. See Bourke, Dismembering the Male, 116. 57. Kaufmann also observed that his method made severe demands on the doctor’s “nerves.” Kaufmann, “Die Planmässige Heilung komplizierter psychogener Bewegungsstörungen bei Soldaten in einer Sitzung.” 58. Ulrich, “Nerven und Krieg,” 179. 59. Lerner, Hysterical Men, 106. 60. Cited in Doris Kaufmann, “Science as Cultural Practice,” 139. 61. “Dr. M. Kozlowski’s Letter to the Commission,” 390–95. 62. Nikolas Rose, Governing the Soul: The Shaping of the Private Self (London 1989), 152. 63. See Eissler, Freud as an Expert Witness, 324–25. 64. Fritz Mohr, “Aus der Praxis der Psychotherapie,” Medizinische Klinik 42 (1917): 1116–19. For a related approach, see Gustav Oppenheim, “Zur Behandlung des Zitterns,” Neurologisches Zentralblatt 36 (1917): 620–24. 65. Lerner, Hysterical Men, 124–62. 66. David Clay Large, Berlin (New York 2000), 129; J. Winter and J.-L. Robert, eds., Capital Cities at War: London, Paris, Berlin 1914–1919 (Cambridge 1997). On the German war economy, see Gerald Feldman, Army, Industry and Labor (Princeton, NJ 1966). 67. Max Weber, “Bureaucracy,” in From Max Weber: Essays in Sociology, ed. H. H. Gerth and C. Wright Mills (New York 1946), 211. 68. Detlev Peukert, Max Webers Diagnose der Moderne (Göttingen 1989), 89. 69. Weber, “The Meaning of Discipline,” in From Max Weber, ed. Gerth and Mills, 261. 70. Bourke, Dismembering the Male, 171. 71. Roger Cooter and Steve Sturdy, “Of War, Medicine and Modernity,” in War, Medicine and Modernity, ed. R. Cooter, S. Sturdy, and M. Harrison (Phoenix Mill, UK 1998), 2. 72. On Rubner’s Institute for Labor Physiology during the war, see Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990), 253–65. 73. See, for instance, Heinrich Boruttau, Die Elektrizität in der Medizin und Biologie (Wiesbaden 1906); Heinrich Boruttau, Handbuch der gesamten medizinischen Anwendungen der Elektrizität (Leipzig 1909); Heinrich Boruttau, Emil Du Bois-Reymond (Vienna 1922). 74. BAL, R 89/13931, “Unfälle und Gesundheitsschädigungen durch elektrischen Strom.” See also Staatsbibliothek Preussischer Kulturbesitz, Berlin, Heinrich Boruttau Papers, Box 5, “Electro-Physiologisches” (“Der Tod durch Starkstrom und die Rettungsfrage”). My thanks to Carolin Unger for helping me to locate this material. 75. Heinrich Boruttau, “Todesfälle durch therapeutische Wechselstromanwendung und deren Verhütung,” Deutsche medizinische Wochenschrift 43 (1917): 808–9. 76. Boruttau, Die Arbeitsleistungen des Menschen, iii. 77. Ibid., 5.
NOTES TO PAGES 147–52 257
78. Ibid.: on the “exhaustion of contemporary bourgeois existence,” see 81; on “activities imposing utmost exertion,” see 68. 79. One of the KWI’s researchers issued a programmatic statement on the need to apply scientific methods to the study of work processes, particularly its mental aspects; for this, see Zentrales Staatsarchiv, Potsdam (hereafter cited as ZsTA), Rep. 76, VL. Sekt. 2, Tit. 23, LITT A., No. 115, Kaiser-Wilhelm Institut für Arbeitsphysiologie, Adolf von Harnack, “Abschrift,” 5 Nov. 1913. My thanks to Anson Rabinbach for making this material available to me. 80. Boruttau, Die Arbeitsleistungen des Menschen, 63–64. 81. Ibid., 82. 82. Ibid., 77. For Rubner’s views on “mental labor,” see ZsTA, Rep. 76, VL. Sekt. 2, Tit. 23, LITT A., No. 115, KWI Arbeitsphysiologie, Max Rubner, “Das arbeitsphysiologische und arbeitshygienische Institut,” 16 May 1912. 83. See Boruttau, Die Arbeitsleistungen des Menschen, 67. 84. Ibid., 71. 85. Ibid., 84. 86. See Klaus Theweleit, Male Fantasies, vol. 1–2 (Minneapolis. MN 1987–89). On Theweleit’s concept of drill, see also Matt Price, “Lives and Limbs: Rehabilitation of Soldiers in the Aftermath of the Great War,” Stanford Humanities Review 5 (1996): 101–18. 87. Weber, “The Meaning of Discipline,” 253. For the echoes with Foucault’s concept of discipline, see his Discipline and Punish: The Birth of the Prison (New York 1978), 135–69. 88. Ernst Jünger, “Total Mobilization,” in The Heidegger Controversy, ed. R. Wolin (Cambridge, MA 1993), 126–27. 89. Eissler, Freud as an Expert Witness, 313. 90. Cited ibid., 394. 91. Ibid., 100; Richard Bessel, Germany after the First World War (Oxford 1993), 47. 92. On the crisis of medical ethics, see Esther Fischer-Homberger, “Der erste Weltkrieg und die Krise der ärztlichen Ethik,” in Medizin und Krieg, ed. J. Bleker and H. P. Schmiedebach (Frankfurt 1987), 122–32. 93. For a discussion, see Lerner, Hysterical Men, 194–208. 94. Doherty, “ ‘See: We Are All Neurasthenics!’ or, The Trauma of Dada Montage.” 95. Erwin Loewy-Hattendorf, Krieg, Revolution, und Unfallneurosen (Berlin 1920), 10. 96. Cited in Eissler, Freud as an Expert Witness, 393. 97. Sigmund Freud, “Memorandum on the Treatment of War Neurotics” (1920), in Eissler, Freud as an Expert Witness, 214. 98. Wagner-Jauregg argued that psychoanalysis was impractical because it took too long to achieve results. Electrotherapy had the virtue of speed and of being operable by nonexperts. See Eissler, Freud as an Expert Witness, 91. 99. For details on Tausk’s life, see Kurt Eissler, Viktor Tausk’s Suicide (New York 1982). 100. Viktor Tausk, “On the Origin of the Influencing Machine in Schizophrenia,” Psychoanalytic Quarterly 2 (1933): 519–56.
258 NOTES TO PAGES 152–54
101. See Eissler, Viktor Tausk’s Suicide. 102. Lerner, Hysterical Men, 172, 228. 103. On the connection between the doctor’s authoritarian personality and the success of the cure on the one hand and the breakdown of both at the end of the war on the other, see Loewy-Hattendorf, Krieg, Revolution, und Unfallneurosen, 16. 104. His view was echoed by Ernst Simmel, who argued that neurosis represented an internal defense against psychosis. Cited in Lerner, Hysterical Men, 211. 105. Doris Kaufmann, “Science as Cultural Practice,” 220. See, for instance, Robert Gaupp, “Der nervöse Zusammenbruch und die Revolution,” Blätter für Volksgesundheitpflege 19 (1919): 43–46. 106. Helenfriederike Stelzner, “Psychopathologisches in der Revolution,” Berliner klinische Wochenschrift 39 (1919): 934. 107. Cited in Lerner, Hysterical Men, 194. 108. Bourke, Dismembering the Male, 77. 109. Weindling, Health, Race and German Politics between National Unification and Nazism, 395–96; Robert Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge, MA 1988), 178–79; P. Weingart, J. Kroll, and K. Bayertz, eds., Rasse, Blut, und Gene: Geschichte der Eugenik und Rassenhygiene in Deutschland (Frankfurt 1998). 110. Stier, “Psychiatrie und Heer.” See also Achim Thom, ed., Medizin unterm Hakenkreuz (Berlin 1989), 366. 111. According to Jason Crouthamel, left-wing organizations claimed that psychiatrists tried to control the memory of the war by depicting it as a strengthening experience that separated the strong-willed from the weak and, in particular, the hysterical proletariat from steel-nerved officers. See Crouthamel, “War Neurosis vs. Savings Psychosis,” 177. 112. Stier, “Psychiatrie und Heer,” 18. 113. Peukert, Max Webers Diagnose der Moderne, 49. 114. See BAL, R 89/15113, “Die zukünftige Begutachtung die traumatische Neurosen,” “Das Kriegsende und die Neurosenfrage,” Sonderabdruck, 11 June 1919. 115. Stier, “Rentenversorgung bei nervösen und psychisch erkrankten Feldzugsteilnehmern,” 186. 116. Whalen, Bitter Wounds, 16. 117. Crouthamel, “War Neurosis vs. Savings Psychosis,” 169. 118. On overbureaucratization as a pathological feature of the Weimar welfare system, see Whalen, Bitter Wounds; Detlev Peukert, The Weimar Republic: The Crisis of Classical Modernity (New York 1992), 130–40; Greg Eghigian, Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany (Ann Arbor, MI 2000), esp. ch. 7; and Young SunHong, Welfare, Modernity and the Weimar State, 1919–1933 (Princeton, NJ 1998), esp. 219–24. 119. Richard Bessel, “State and Society in Germany in the Aftermath of the First World War,” in The State and Social Change in Germany, 1880–1980, ed. W. R. Lee and E. Rosenhaft (New York 1990), 226. 120. David Crew, “The Ambiguities of Modernity: Welfare and the German
NOTES TO PAGES 154–63 259
State from Wilhelm to Hitler,” in Society, Culture, and the State in Germany 1870–1930, ed. Geoff Eley (Ann Arbor, MI 1996), 319–44. 121. HUB, Charité Nervenklinik Bestand, Akte 19. The account of M. that follows is all taken from these records. 122. Haus Schönow had been requisitioned by the military as a Nervenlazarett during the war. See BAL, R 89/6904, 15er. Bericht Haus Schönow. 123. Relevant here are Tausk’s remarks on the laterna magica, which he describes as a typical feature of the delusions surrounding the “influencing machine.” See Tausk, “On the Origin of the Influencing Machine in Schizophrenia.” 124. On pension narratives and postwar constructions of the war’s memory see Lerner, Hysterical Men, 223–48; Crouthamel, “War Neurosis vs. Savings Psychosis.” See also George Mosse, Fallen Soldiers—Reshaping the Memory of the World Wars (New York 1990). 125. Stier, “Wie kann der Enstehung von Kriegsneurosen bei Feldarmee vorgebeugt werden?” 62. 126. BAL, R 3901, Reichsarbeitsministerium (hereafter cited as RAM)/Film 36137, “Betreff: Massnahmen gegen den Bettelunfuge, insbesondere den Strassenbettel der Kriegsverletzten,” Polizeipräsident Richter to the Interior Ministry, Berlin, 24 July 1922. My thanks to Jason Crouthamel for making this material available to me. 127. BAL, R 3901, RAM/Film 36137, Interior Ministry, 6 Apr. 1921. 128. BAL, R 3901, RAM/Film 36137, “Eine Massenepidemie geheilt,” Deutsche Tageszeitung (n.d.). See also BAL, R 3901, RAM/Film 36137, Dr. Arthur Stern, “Die Schüttler,” Berliner Tageblatt (n.d.). 129. See HUB, Charité Nervenklinik Bestand, Akte 18, 27. 130. Doris Kaufmann, “Science as Cultural Practice,” 142. 131. For accounts of these battles, see Crouthamel, “War Neurosis vs. Savings Psychosis.” 132. BAL, R 89/15114, “Nerven!” Der Reichsverband, Organ des Reichsverbandes Deutscher Kriegsbeschädigter und Kriegshinterbliebener 7 (1926). 133. See BAL, R 89/15114, documents from 1924–26, including: Stier’s “Ärztliche Leitsätze zur Frage der Unfallneurose”; an exchange of letters among Wilhelm His, the RVA, and the Labor Ministry; and an offprint of Bonhoeffer’s article “Beurteilung, Begutachtung und Rechtsprechung bei den sogenannten Unfallneurosen.” 134. See George Grosz, An Autobiography (New York 1983), 122. For Grosz’s own exposure and reaction to the Kaufmann method during the war, see Doherty, “ ‘See: We Are All Neurasthenics!’ or, The Trauma of Dada Montage.” 135. Ewald Stier, “Soziologie der Nervosität,” in Handbuch der sozialen Hygiene, ed. A. Gottstein (Berlin 1927), 626.
5. PSYCHIATRISTS, TELEPHONE OPERATORS, AND TRAUMATIC NEUROSIS, 1900–1926 1. Georg Siemens, History of the House of Siemens (New York 1977), 161. 2. BAP, RPM 47.01, 14575/1, Bl. 288.
260 NOTES TO PAGES 163–66
3. See J. Boberg, T. Fichter, and E. Gillen, eds., Die Metropole: Industriekultur in Berlin im 20. Jahrhundert (Munich 1986), 29. According to Siemens, given the permanent state of tension within the “highly-strung Berlin public,” setting up a telephone exchange as large as Number 4 was a “nervewracking experience for all concerned” (138). 4. Walter Benjamin, “A Berlin Chronicle,” in Reflections (New York 1978), 38. 5. Ute Frevert, Women in German History: From Bourgeois Emancipation to Sexual Liberation (New York 1989); Carole Elizabeth Adams, Women Clerks in Wilhelmine Germany: Issues of Class and Gender (Cambridge 1988). 6. See Josephine Levy-Rathenau, Die deutsche Frau im Beruf, vol. 5, in Handbuch der Frauenbewegung, ed. H. Lange and G. Bäumer (Berlin 1912), 69–77. The literature on operators includes Ursula Nienhaus’s excellent Vater Staat und seine Gehilfinnen: Die Politik mit der Frauenarbeit bei der deutschen Post (1864–1945) (Frankfurt 1995); Ursula Nienhaus, “Unter dem Reichsadler: Postbeamtinnen und ihre Organisation 1908–1933,” 1999. Zeitschrift für Sozialgeschichte des 20. und 21. Jahrhunderts 3 (1990): 56–79; Ursula Holtgrewe, “Die Arbeit der Vermittlung: Frauen am Klappenschrank,” Hessische Blätter für Volks- und Kulturforschung, n.s., 24 (1989): 113–24; and Helmut Gold and Annette Koch, eds., Das Fräulein vom Amt (Munich 1993). 7. See Dietrich Milles, “Nervenbelastung oder nervöse Veranlagung—das medizinische Urteil über Telephonunfälle und Telefonistinnenkrankheiten,” in Das Fräulein vom Amt, ed. Gold and Koch, 94–108; and K. Podoll, “Der Telephonunfall—ein Beitrag zur Geschichte der traumatischen Neurosen,” Fortschritte der Neurologie und Psychiatrie 59 (1991): 387–93. 8. Stefan Jellinek, Elektropathologie (Stuttgart 1903), 195. 9. Stefan Jellinek, “Tod durch Elektrizität,” Wiener klinische Wochenschrift 44 (1905): 1188. 10. Stefan Jellinek, “Pathologie, Therapie, und Prophylaxe der elektrische Unfälle,” Deutsche medizinische Wochenschrift 10 (1907): 421. See also Jellinek, Elektropathologie, 18. 11. Albert Eulenburg, “Über Nerven- und Geisteskranken nach elektrischen Unfällen,” Berliner klinische Wochenschrift 42 (1905): 31. See also Albert Eulenburg, “Gutachten über einen schweren und eigenartigen Fall elektrischer Verunglückung,” Ärztliche Sachverständigen Zeitung 3, no. 7 (1901): 45–51. 12. Martin Bernhardt, Die Betriebsunfälle der Telephonistinnen (Berlin 1906), 9. 13. For a sampling of the literature, see E. Ewald, “Traumatische Neurose nach einem Unfall im Telephonbetriebe,” Monatschrift für Unfallheilkunde 1 (1894): 216–17; Paul Schuster, “Die Krankheiten der Telephonangestellten,” in Handbuch der Arbeiterkrankheiten, ed. T. Weyl (Jena 1908); and Rudolf Foerster, “Unfälle am Telephon und ihre Verhütung,” Berliner klinische Wochenschrift 48 (1911): 1688–99. 14. If the crank was turned three times, current could reach a strength that, as one doctor noted, was considered too high for use in electrotherapy. The RPM posted warnings to users, but these were often ignored, leading to blacklists against callers who terrorized operators in this way. 15. The first electrocution took place in New York State in 1891. George M.
NOTES TO PAGES 166–71 261
Beard’s collaborator, electrotherapist A. D. Rockwell, designed one of the first electric chairs. 16. Bernhardt, Die Betriebsunfälle der Telephonistinnen, 34. He cautioned against putting exchanges under the supervision of an “excitable” man who, by his general air of haste, could plunge an entire workforce into nervous agitation. 17. BAP, RPM 47.01, 17138, “Krankheitsstatistik.” On the “predilection” of women to nervous crisis, see BAP, RPM 47.01, 3267, Bl. 90; BAP, RPM 47.01, 3268, Bl. 61; LA, Pr. Br. 44, 38, Bl. 152; and LA, Pr. Br. 44, 56, letter 25 Feb. 1914. 18. BAP, RPM 47.01, 3166, Bl. 29–31. 19. BAP, RPM 47.01, 3166, Stenographische Berichten der Reichstag, session 13 Feb. 1908. See also sessions 24 Apr. 1907 and 7 Feb. 1913. 20. See BAP, RPM 47.01, 14575/1, re Abf. 2 der Unfallfürsorgegesetz für Beamtinnen von 18 June 1901, Bl. 288. 21. Greg Eghigian, “The German Welfare State as a Discourse of Trauma,” in Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, ed. M. Micale and P. Lerner (Cambridge 2001), 92–112. 22. Hans Kurella, editorial, Zeitschrift für Elektrotherapie und ärztliche Elektrotechnik 1 (1899): 193. 23. Hans Kurella, “Elektrische Gesundheits-Schädigung am Telephon,” Zeitschrift für Elektrotherapie 7 (1905): 238–61. 24. Hans Kurella, “Elektropathologie,” Zeitschrift für Elektrotherapie 6 (1904): 238. 25. Ibid., 261. 26. Kurella, “Elektrische Gesundheits-Schädigung am Telephon,” 14. 27. Carl Wernicke, “Obergutachten über der Verletzung einer Telephonistin durch Starkstrom,” Monatschrift für Psychiatrie 17 (1905), Ergänzungsheft 2. 28. Ibid., 9–10. 29. BAP, RPM 47.01, 12632. Patients with tuberculosis, mental illnesses, epilepsy, and other “untreatable” chronic illnesses were excluded. 30. LA, Pr. Br. 44, 123, Bl. 19. See also Eulenburg’s introduction to Bad Oeynhausen’s annual report. 31. BAP, RPM 47.01, 3080, memo, Dr. Schmalfuss to OPD, 10 Nov. 1901, Bl. 149. 32. Zeitschrift fur Eisenbahn-Telegraphen-Beamte 14 (1904): 107. 33. See Nienhaus, “Unter dem Reichsadler: Postbeamtinnen und ihre Organisation 1908–1933.” These problems were common to postal workers elsewhere. See Bobst Library, New York University, Tamiment 99, Folders 1–6, on the International Association of Postal, Telegraph, and Telephone Personnel. 34. See H. L. Eisenstadt, Beiträge zu den Krankheiten der Postbeamten (Berlin 1909), esp. ch. 19. 35. Zeitschrift für Bahnärzte 2 (1905): 167. 36. LA, Pr. Br. 44, 56, Vereins und Verbandsangelegenheiten der Beamtinnen. 37. LA, Pr. Br. 44, 125, Bl. 36. 38. LA, Pr. Br. 44, 56, Bitte um Besoldungsaufbesserung aller Post- und Telegraphengehilfinnen, 25 Feb. 1914.
262 NOTES TO PAGES 171–75
39. “Einschränkung des weiblichen Personals,” Zeitschrift fur EisenbahnTelegraphen-Beamten 6 (1902): 43. 40. The author cited Krafft-Ebing’s Nervosität und neurasthenische Zustände (1902) in support of the view that operators were prone to nervous illness. “Zur Dienst und Ruhezeit,” Zeitschrift fur Eisenbahn-Telegraphen-Beamte 19 (1903): 152. 41. “Die Seele des Eisenbahnbetriebes,” Zeitschrift fur EisenbahnTelegraphen-Beamte 24 (1905): 188–89. 42. See Nienhaus, Vater Staat und seine Gehilfinnen, 331. For more on this new class of employees, see Siegfried Kracauer, The Salaried Masses: Duty and Distraction in Weimar Germany (1930; New York 1998); and Jürgen Kocka, Die Angestellte in der deutsche Geschichte (Göttingen 1989). 43. “Spezielle Hygiene des Geistesarbeit von Beamten und Beamtinnen,” Der Fernsprecher 3 (1911): 67. 44. “Gesundheitsschädigungen am Telephon,” Der Fernsprecher 2 (1911): 22. 45. “Die Nerven am Telephon,” Der Fernsprecher 7 (1911): 17. 46. “Die Nervosität der Beamten,” Zeitschrift fur Eisenbahn-TelegraphenBeamte 23 (1905): 179–81. 47. Eric Santner invokes the notion of “literalization” in his study of Schreber, especially in connection with Schreber’s fascination with mechanistic brain models. See his My Own Private Germany: Daniel Paul Schreber’s Secret History of Modernity (Princeton, NJ 1996), 75ff. For more on the hysteric’s materialization of psychic conflicts, see Ruth Leys, Trauma: A Genealogy (Chicago 2000); and Jean Starobinski, Literatur und Psychoanalyse: Die Geschichte der imaginären Ströme (Frankfurt n.d.); and, for a discussion of electrical models and the relation between physiology and psychology in Freud, Jean Starobinski, “A Short History of Body Consciousness,” Humanities in Review 1 (1982): 22–39. 48. For instance, one of the antecedents for Helmholtz’s experiment on the velocity of the nerve impulse was a telegraphic device invented by his friend Siemens. See Timothy Lenoir, “Models and Instruments in the Development of Electrophysiology, 1845–1912,” Historical Studies in the Physical and Biological Sciences 16 (1986): 1–54. 49. See Carl Wernicke, Der aphasische Symptomencomplex (Breslau 1874). For further instances of this analogy, see Dolf Sternberger, Panorama of the Nineteenth Century (New York 1977), 26–27. The widely read scientist and author Ernst Haeckel routinely invoked variations on this motif. See his Riddle of the Universe at the Close of the Nineteenth Century (New York 1900), 162. 50. “Wie gewinnt man Energie, geistige Frische und Lebensfreude,” Der Fernsprecher 10 (1912): 162. See also “Gesundheitsschädigungen am Telephon,” Der Fernsprecher 2 (1911): 22; and, for a variant inspired by Thomas Edison’s view of the body as a “dynamo-machine,” “Edison uber Gesundheitspflege,” Der Fernsprecher 1 (1911): 18. 51. An American studying in Germany in the 1890s noted that the profusion of telegraphic equipment used in experimental psychology made it sometimes difficult to tell which field he was working in, psychology or telegraphy. See M. Sokal, A. Davis, and U. Merzbach, “Laboratory Instruments in the History of Psychology,” Journal of the History of the Behavioral Sciences 12 (1976): 59.
NOTES TO PAGES 175–79 263
52. Scholars have noted that by 1900 the limitations of the telegraph analogy for the nervous system could no longer be ignored by scientists, given its inability to account for phenomena such as regeneration. See Donna Haraway, Crystals, Fields and Fabrics: Metaphors of Organicism in 20th Century Developmental Biology (New Haven, CT 1976); and Georges Canguilhem, “Machine and Organism,” in Incorporations, ed. J. Crary and S. Kwinter (New York 1992), 44–69. On the holistic turn in German psychology, see Anne Harrington, Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler (Princeton, NJ 1997); and Mitchell Ash, Wholism and the Quest for Objectivity: Gestalt Psychology in German Culture 1890–1967 (Cambridge, MA 1995). 53. How easily this conception could be reactivated is made clear by the observations of one American doctor, writing in the late 1890s: “The genital organs of women . . . are nothing more or less than a central telegraphic office, from which wires radiate to every nook and corner of the system, and over which are transmitted messages, morbific or otherwise, as the case may be; and it should be remembered right here that telegraphic messages travel both ways over the same wire; that there are both receiving and sending offices at each end of the line.” Cited in F. G. Gosling, Before Freud: Neurasthenia and the American Medical Community 1870–1910 (Urbana, IL 1987), 98. 54. Kurella’s journal included dozens of advertisements for electrogynecological devices. Concerning the views of gynecologists of this period, one scholar has written: “The sexual organs were especially sensitive to the effects of electrical current—thus the men of this discipline fantasized, and used their current as an instrument of manipulation against ‘unruly female genitalia.’ ” Michael Hubenstorf, “Elektrizität und Medizin,” in Medizin und Technik (Dusseldorf 1993), 247. 55. Michael Kater, “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany,” Journal of Contemporary History 20 (October 1985): 688. 56. H. L. Eisenstadt, Beiträge zu den Krankheiten der Postbeamten (Berlin 1909), 128. 57. On the Berlin Society, see Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870–1945 (Cambridge 1989), 102–6. 58. Eisenstadt, Beiträge zu den Krankheiten der Postbeamten, 194. 59. BAP, RPM 47.01, 14577, Bl. 271. 60. For a contemporary theory of psychic contagion and the paths by which it was propagated through society, see Willy Hellpach, Die geistigen Epidemien (Frankfurt 1906). On the connection between Schockwirkung and psychische Infektion, see also G. Voss, “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten,” in Krankheit und soziale Lage, ed. M. Mosse und G. Tugendreich (Munich 1913), 411. 61. BAP, RPM 47.01, 14577, Bl. 167. 62. Ibid., Bl. 65. 63. BAP, RPM 47.01, 3165, memo, 16 Apr. 1904, Bl. 148. 64. BAP, RPM 47.01, 3166, memo, 20 Mar. 1905, Bl. 29–31. 65. Nienhaus, Vater Staat und seine Gehilfinnen, 110–13.
264 NOTES TO PAGES 179–82
66. BAP, RPM 47.01, 5109, “Schule für Fernsprechgehilfinnen und Telegraphenbeamten.” 67. BAP, RPM 47.01, 5109. The rationale behind this device was that nervous callers tended to become impatient if their call was not immediately put through, setting off a chain reaction. 68. BAP, RPM 47.01, 5109, Reichstag Sitzung 36, 27 Mar. 1912, Abg. Bruhn. 69. Notes on such devices can be found throughout the archives. The director of the telephone exchange in Tegel invented a contrivance called a neuroscope, which, by taking electrical readings of the nerve endings on the scalp, purported to determine the individual abilities of the test subject from the strength of the reactions. The proposed method suffered from a certain inexactitude, as an official of the RPM pointed out, notably about the location of the so-called stimulus points for obtaining readings. BAP, RPM 47.01, 14509, letter, Apr. 1929. This device was a variant on the so-called Bissky method, used to obtain electrodiagnostical readings of character. 70. BAP, RPM 47.01, 14577, OPD Oldenburg to RPM in Berlin, 26 May 1914, Bl. 167–74. 71. Detlev Peukert, The Weimar Republic: The Crisis of Classical Modernity (New York 1992), 129–46; David Crew, “The Ambiguities of Modernity: Welfare and the German State from Wilhelm to Hitler,” in Society, Culture and the State in Germany 1870–1930, ed. G. Eley (Ann Arbor, MI 1997), 319–44; Young-Sun Hong, Welfare, Modernity and the Weimar State, 1919–1933 (Princeton, NJ 1998). The Verband enthusiastically greeted passage of the Weimar constitution as the “freest in the world” for women. See Nienhaus, Vater Staat und seine Gehilfinnen, 69. 72. Robert Whalen, Bitter Wounds: German Victims of the Great War, 1914–1939 (Ithaca, NY 1984), 11. 73. On Weimar-era visions of all-embracing rationalization, see Peukert, The Weimar Republic; Annemarie Tröger, “The Construction of a Female Assembly Line Proletariat,” in When Biology Became Destiny, ed. R. Bridenthal, A. Grossmann, and M. Kaplan (New York 1984), 237–70; and Mary Nolan, Visions of Modernity: American Business and the Modernization of Germany (New York 1994). 74. Peukert, The Weimar Republic, xiii. For a succinct expression of this broader meaning of rationalization, see S. Giedion, Mechanization Takes Command: A Contribution to Anonymous History (New York 1969), 44. 75. See Alf Lütke, Inge Marssolek, and Adelheid von Saldern, eds., Amerikanisierung: Traum und Alptraum in Deutschland des 20. Jahrhunderts (Stuttgart 1996); Detlev Peukert, “ ‘Amerika,’ oder die Traum der Rationalisierung,” in Max Webers Diagnose der Moderne (Göttingen 1989); and Nolan, Visions of Modernity. 76. On the New Woman, see Atina Grossmann, “Girlkultur or Thoroughly Rationalized Female,” in Women in Culture and Politics, ed. J. Friedlander (Bloomington, IN 1986), 62–80; Atina Grossmann, “The New Woman and the Rationalization of Sexuality in Weimar Germany,” in Powers of Desire: The Politics of Sexuality, ed. A. Smitow, C. Stansell, S. Thompson (New York 1983), 153–71; K. von Soden and M. Schmidt, eds., Neue Frauen: Die zwanziger Jahre (Berlin 1988);
NOTES TO PAGES 183–85 265
Bridenthal, Grossmann, and Kaplan, eds., When Biology Became Destiny; Nolan, Visions of Modernity, esp. ch. 10; and Katharina von Ankum, ed., Women in the Metropolis: Gender and Modernity in Weimar Culture (Berkeley, CA 1997). 77. Richard Bessel, Germany after the First World War (Oxford 1995), 248. See also Cornelie Usborne, Frauen Körper—Volks-Körper: Geburtenkontrolle und Bevölkerungspolitik in Weimarer Republik (Münster 1994). 78. See, for instance, Helenfriederike Stelzner, “Psychopathologisches in der Revolution,” Berliner klinische Wochenschrift 39 (1919): 933–34. 79. Peter Fritzsche, “Landscape of Danger, Landscape of Design: Crisis and Modernism in Weimar Germany,” in Dancing on the Volcano, ed. T. Kniesche and S. Brockmann (Columbia, SC 1994), 29–46. 80. Fritz Giese, Girlkultur: Vergleiche zwischen amerikanischem und europäischem Rhythmus und Lebensgefühl (Munich 1925), 13, 142. 81. For more on the postwar feminization of the masses, see Andreas Huyssen, “Mass Culture as Woman: Modernism’s Other,” in After the Great Divide: Modernism, Mass Culture, Postmodernism (Bloomington, IN 1986), 44–62; Klaus Theweleit, Male Fantasies, vol. 1: Women, Floods, Bodies, History (Minneapolis, MN 1987); and Eve Rosenhaft, “Women, Gender, and the Limits of Political History in the Age of ‘Mass’ Politics,” in Elections, Mass Politics and Social Change in Modern Germany, ed. L. Jones and J. Retallack (Cambridge 1992), 149–74. 82. Peukert, The Weimar Republic, 161–63. 83. Ibid., 157. 84. Siegfried Kracauer, “The Mass Ornament,” in The Mass Ornament (Chicago 1995), 79. 85. Kracauer, The Salaried Masses, 32. 86. David Clay Large, Berlin (New York 2000), 185. 87. Ibid., 208. 88. Janet Ward, Weimar Surfaces: Urban Visual Culture in 1920s Germany (Berkeley, CA 2001), 93. 89. See Renate Bridenthal, Atina Grossmann, and Marion Kaplan, introduction, in When Biology Became Destiny, 1–29. 90. Bessel suggests that the political culture of the Weimar Republic generally was “colored by an underlying hostility towards women which had its roots in a reaction to the wartime undermining of patriarchal social and economic relations.” Bessel, Germany after the First World War, 272. 91. Large, Berlin, 131. 92. Nienhaus, Vater Staat und seine Gehilfinnen, 87–93, 110–13. 93. Frank Thomas, “The German Telephone System,” in The Development of Large Technological Systems, ed. R. Mayntz, T. Hughes (Frankfurt 1988), 192. Harry Kessler’s memoirs contain an account of a strike that shut down Berlin’s power stations in January 1919, knocking out phone service and plunging the city into darkness for several hours: “Fourteen hundred workers at the electricity plants brought the machine of national administration to a halt to a degree never achieved by the Spartacists’ armored cars, machine-guns, and marauding methods.” See Berlin in Lights: The Diaries of Count Harry Kessler, ed. Charles Kessler (New York 1999), 61.
266 NOTES TO PAGES 185–94
94. Peukert, Max Webers Diagnose der Moderne. 95. BAP, RPM 47.01, 14575/1, “Schreckwirkung als Ursache nervöser Störung,” Bl. 18. 96. See BAP, RPM 47.01, 3268, Bl. 61. 97. See BAP, RPM 47.01, 14575/1, Bl. 31. 98. Ewald Stier, “Psychiatrie und Heer,” Der deutsche Militärärzt 1 (1936): 18. 99. Ewald Stier, “Die Schreckwirkung als Ursache nervöser Störungen, mit besonderer Berucksichtigungen der sogennanten Telephonunfälle im Fernsprechdienst,” BAP, RPM 47.01, 14575/1, Bl. 1–4; Ewald Stier, Über die sogennante Unfallneurosen (Leipzig 1926); Ewald Stier, “Soziologie der Nervosität,” in Handbuch der sozialen Hygiene, ed. A. Gottstein (Berlin 1927), 615–26; Ewald Stier, “Vortrag,” in Arbeit und Gesundheit, Schriftenreihe der Reichsarbeitsministerium, vol. 13 (Berlin 1929), 44–53. 100. BAP, RPM, 47.01, 14575/1, Stier, Bl. 3–4. 101. “Die Unfälle der Fernsprechbeamtin,” Unter den Reichsadler, 14 June 1923. That confusion over this question still existed at official levels is suggested by a memo describing conditions at one of the telegraph offices in Dortmund: “As a result of the excessive service demands, the nerves of practically all the women employed in the telephone office . . . are so overstimulated and overexcited that even a normal current is enough to produce an enormous condition of agitation.” BAP, RPM 47.01, 14575/1, Bl. 30, Bl. 72–77. 102. BAP, RPM 47.01, 14575/1, Bl. 72. 103. Ibid., Bl. 76–77. 104. Ibid., Bl. 105. 105. Ibid., Bl. 3–4. 106. Ibid. 107. Stier, “Vortrag,” 44. 108. Ibid., 45. 109. Stier, “Soziologie der Nervosität,” 632. 110. BAP, RPM 47.01, 14575/1, Stier, “Bericht zur Frage der behördlichen Vorbeugungen der sogennanten Telephonunfälle und ihrer Folgen” (n.d.). 111. BAP, RPM 47.01, 14575/1, Bl. 38. 112. Ibid., Bl. 36. 113. Ibid., Bl. 29. 114. Ibid., Bl. 34–43. 115. Ibid., Bl. 35. 116. “Wie Professor Dr. Stier Unfallverletzte behandelt,” Unter den Reichsadler, 27 Sept. 1923, 77. 117. BAP, RPM 47.01, 14575/1, memo, 31 May 1924, Bl. 125. 118. See Peter Hinrichs and Lothar Peters, Industrieller Friede? Arbeitswissenchaft und Rationalisierung in der Weimarer Republik (Cologne 1976); and Peter Hinrichs, Um die Seele des Arbeiters: Arbeitspsychologie, Industrie- und Betriebssoziologie in Deutschland (Cologne 1981). 119. Kracauer, The Salaried Masses, 37. See also Horst Gundlach, “Psychotechnische Untersuchungen bei der deutsche Reichspost,” in Das Fräulein vom Amt, ed. Gold and Koch, 109–19; and Holtgrewe, “Die Arbeit der Vermittlung,” 121ff.
NOTES TO PAGES 194–97 267
120. Anson Rabinbach, The Human Motor: Energy, Fatigue and the Origins of Modernity (New York 1990), 209. 121. Münsterberg opined that, through psychological experimentation, “a system of rules and prescriptions may be worked out which may be used as patterns and which will not presuppose any scientific knowledge, any more than an understanding of principles of electricity is necessary for one who uses the telephone.” Hugo Münsterberg, Psychology and Industrial Efficiency (Boston 1913), 165. 122. Ibid., 212. 123. For more on German debates about work science and anxieties about the cultural consequences of Americanism, see Rabinbach, The Human Motor, 189–93, 264; and Nolan, Visions of Modernity, 84–90, 108–27. 124. For biographical details on Giese, see Ulfried Geuter, The Professionalization of German Psychology in Nazi Germany (Cambridge 1992), 215–36; and F. Schulz, “Giese,” in Neue deutsche Biographie, vol. 6 (Berlin 1964), 378–79. For a fascinating contextualization of Giese’s work, see Cornelius Borck, “Electricity as a Medium of Psychic Life,” Science in Context 14, no. 4 (2001): 565–90. 125. Fritz Giese, Theorie der Psychotechnik (Braunschweig 1925), 23. 126. He later continued his research at Halle and Leipzig. See BAP, RPM 47.01, 5110, letters from Giese to RPM, 21 Nov. 1919 and 8 June 1920. 127. Fritz Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst (Leipzig 1923), 22–23. On the significance of graphical devices in the “psy” sciences, see also Nikolas Rose, Governing the Soul: The Shaping of the Private Self (London 1990), 65ff. 128. For more on the significance of the “curve,” see BAP, RPM 47.01, 5110, report, “Über die Kurve der möglichen Rangverschiebungen,” 30 June 1920. 129. Many of the rationalization projects of this era circle obsessively around scenarios, both real and imagined, of stoppages and breakdowns. At a 1920 meeting at the Labor Ministry, psychologist Georg Schlesinger reported that in Munich, telephone service in entire neighborhoods was occasionally shut down because of overloading of the personnel. A note scribbled in the margin of the minutes of this meeting in the RPM archives contains the following question: “Where did Schlesinger get this unbelievable story?” See BAP, RPM 47.01, 5110, 26 Apr. 1920. The possibility that such incidents might represent a form of work stoppage worried the authorities; some operators certainly represented their nervous breakdowns in such terms. See, for instance, “Als meine Nerven streikten,” Unter den Reichsadler 23 (1931): 186. 130. Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 30–31. 131. Ibid., 24. 132. Ibid., 30–31. 133. Ibid., 31. 134. Regarding Rubner’s rejection of the “vulgar machine model” of the human body, see ZsTA, Rep. 76, VL. Sekt. 2, Tit. 23, LITT A., No. 115, KWI Arbeitsphysiologie, Max Rubner, “Das arbeitsphysiologische und arbeitshygienische Institut,” 16 May 1912. 135. Giese dismissed Münsterberg’s tests as simplistic. Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 43. See also BAP, RPM
268 NOTES TO PAGES 197–201
47.01, 5110, letter, 5 May 1919, for a comparison of Münsterberg’s techniques and those adopted in Germany. For more on how this reflected a broader shift in the psy sciences, see Rose, Governing the Soul, 65–70. 136. Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 23. 137. Ibid., 57–60. 138. Joan Campbell, Joy in Work, German Work: The National Debate 1800–1945 (Princeton, NJ 1989), 228–42. 139. Fritz Giese, “Gymnastik und Taylorsystem,” in Weibliche Körperbildung und Bewegungskunst auf Grundlage des Systems Mensendieck, ed. Giese (Munich 1924), 156. 140. Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 15. For an expression of the operators’ discontent, see “Kontrollbeobachtung im Fernsprechbetrieb,” Unter den Reichsadler 14 (1922): 86–88. Surreptitious forms of surveillance, it was argued, turned the employees into “soulless machines.” 141. See BAP, RPM 47.01, 5110, for a two-page list of apparatus and methods. 142. See Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 16, 32. See also BAP, RPM 47.01, 13524, “Psychotechnische Eignungsprüfung,” 1924–26. 143. Giese, Berufspsychologische Beobachtungen im Reichstelegraphendienst, 47. For a fuller description see Fritz Giese, Handbuch der psychotechnischer Eignungsprüfungen (Jena 1927), 206. Giese extracted a general norm from his research on operators, obtained from the so-called telegram test, which measured ability to condense messages into telegram form as an indicator of the subject’s internalization of the principles of work economy. This test became incorporated into the examination used for selecting candidates for employment. The tests, according to one advocate, could “also be used for purposes of training.” See BAP, RPM 47.01, 5110, report, 30 June 1920, IV-75. 144. For an account of similar methods used in other branches of industry, see Geuter, The Professionalization of German Psychology in Nazi Germany, 88. 145. See Kracauer, The Salaried Masses, 44. 146. See Rabinbach, The Human Motor, 283–84; and Andreas Killen, “Weimar Psychotechnics between Americanism and National Socialism,” unpublished manuscript. 147. See S. Jaeger and I. Stäuble, “Die Psychotechnik und ihre gesellschafltichen Entwicklungs-bedingungen,” Die Psychologie des 20. Jahrhunderts, ed. F. Stoll (Zürich 1981), 53–94. For more on Schlesinger, see K. Hausen, “Georg Schlesinger und die Rationalisierungs bewegung in Deutschland,” in Wissenschaft und Gesellschaft, vol. 1, ed. R. Rürup (Berlin 1979), 315–34. 148. Geuter, The Professionalization of German Psychology in Nazi Germany, 86. On Lipmann, see Anson Rabinbach, “Betriebspsychologie zwischen Psychotechnik und Politik während der Weimarer Republik: Der Fall Otto Lipmann,” in Betriebsärzte und produktionsbezogene Gesundheitspolitik, ed. Dietrich Milles (Bremerhaven 1992), 41–64. 149. See BAP, RPM 47.01, 5110, Niederschrift über die Verhandlung, betreffend Förderung der Arbeitswissenschaft in den Verkehrsverwaltungen, 26 Apr. 1920, RAM.
NOTES TO PAGES 201–7 269
150. Rabinbach, The Human Motor, 279; Nolan, Visions of Modernity, 6. 151. BAP, RPM 47.01, 5110, letter, Stumpf to RPM, 5 May 1919. 152. BAP, RPM 47.01, 13524, “Psychotechnische Eignungsprüfung,” Bl. 2. 153. BAP, RPM 47.01, 5110, letter, Rupp to OPD, 24 Dec. 1919. 154. BAP, RPM 47.01, 5110, letter, Berlin OPD to RPM, 24 Dec. 1919. 155. BAP, RPM 47.01, 5110, transcript of meeting at RAM, 26 Apr. 1920. 156. BAP, RPM 47.01, 5110, letter, 31 Aug. 1920. 157. For a chronology of these developments, see BAP, RPM 47.01, 14509, letter and report, dated 15 Oct. 1927. 158. See Geuter, The Professionalization of German Psychology in Nazi Germany, 86; Rabinbach, The Human Motor, 278–88. 159. Rabinbach, “Betriebspsychologie zwischen Psychotechnik und Politik während der Weimarer Republik,” 59–60. Moreover, the results of the psychotechnical methods were simply disappointing. In a letter written to the minister of the interior in response to an inquiry regarding the advisability of establishing a central Reich office for psychotechnics, a representative of the RPM wrote that such a venture seemed premature on the basis of the results to date. BAP, RPM 47.01, 14509, letter, 12 Mar. 1928. Continuing automation may also have made psychotechnics increasingly redundant. 160. “Professor Hugo Münsterberg in ‘Psychologie und Wirtschaftsleben,’ ” Unter den Reichsadler 6 (1914): 101–4. 161. Ibid., 104. See also Münsterberg, Psychology and Industrial Efficiency, 98. 162. See “Die psychotechnische Auslese,” Unter den Reichsadler 13 (1921): 373. 163. See, for instance, “Die Erhaltung der Körperkräfte,” Unter den Reichsadler 11 (1919): 268. 164. See BAP, RPM 47.01, 14575/1, Bl. 125. See also Nienhaus, Vater Staat und seine Gehilfinnen, 142–51. 165. See Nienhaus, Vater Staat und seine Gehilfinnen, 74. 166. Else Kolshorn, “Die Lage der weibliche Post- und Telegraphenbeamtinnen,” Archiv für Frauenarbeit 1 (1924): 80–81. See also BAP, RPM 47.01, 14509, letter, Verband to RPM, 10 Nov. 1925. 167. BAP, RPM 47.01, 14575/1, Bl. 106. 168. BAP, RPM 47.01, 14509, report, with letter of 3 June 1926. 169. On the crisis of rationalization after 1929, see Nolan, Visions of Modernity, 227–35; and Peukert, Max Weber’s Diagnose der Moderne, 70–91. 170. See “Überlastung liegt nicht vor,” Unter den Reichsadler 20 (1928): 179–80. Many of these articles depict the switchboard itself as a kind of persecutory agent. See Killen, “Weimar Psychotechnics between Americanism and National Socialism.” 171. See “Die Rationalisierung bei der deutsche Reichspost in der Tätigkeitsgebieten des weiblichen Personals,” Unter den Reichsadler 20 (1928): 345–47. 172. BAP, RPM 47.01, 14575/1, Bl. 110–17. 173. Stier, Über die sogennante Unfallneurosen, 14. See, however, Ewald, “Traumatische Neurose nach einem Unfall im Telephonbetriebe,” 216–17. 174. Stier, Über die sogennante Unfallneurosen, 25; Stier, “Soziologie der Nervosität,” 620.
270 NOTES TO PAGES 207–12
175. By way of strengthening this point, he remarked (erroneously) that telephone accidents were completely unknown in the United States. Stier, Über die sogennante Unfallneurosen, 20. 176. Peukert, The Weimar Republic, 123–26. 177. Kracauer, The Salaried Masses, 97. 178. On the backlash against social welfare, see Hong, Welfare, Modernity and the Weimar State, 1919–1933, 239–76; Crew, “The Ambiguities of Modernity”; and Greg Eghigian, Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany (Ann Arbor, MI 2000), 233–70. 179. On “Jewish medicine,” see Robert Proctor, Racial Hygiene: Medicine under the Nazis (Cambridge 1988), 162–66. 180. Weindling, Health, Race and German Politics between National Unification and Nazism. 181. Stier, “Soziologie der Nervosität,” 629. On the background to this, see Gisela Bock, Zwangsterilisation im Nationalsozialismus (Opladen 1986); and Weindling, Health, Race and German Politics between National Unification and Nazism. 182. Stier, “Soziologie der Nervosität,” 626. On sports, see Kracauer, The Salaried Masses, 76; and Nienhaus, Vater Staat und seine Gehilfinnen, 324. 183. BAP, RPM 47.01, 14575/1, Bl. 29. 184. Ibid., Bl. 183. 185. Oswald Bumke, “Die Revision der Neurosenfrage,” Zentralblatt für die gesamte Neurologie und Psychiatrie 41 (1925): 671, 677. 186. BAP, RPM 47.01, 14575/1, memo of 9 Dec. 1925, Betreffend Tagung der Gesellschaft deutscher Nervenärzte. 187. BAP, RPM 47.01, 14575/1, Bl. 163, Bonhoeffer, “Beurteilung, Begutachtung und Rechtsprechung bei den sogenannten Unfallneurosen.” 188. See BAL, R 89/15114, documents from 1924 to 1926: Stier’s “Ärztliche Leitsätze zur Frage der Unfall neurose”; exchange of letters among Wilhelm His, the RVA, and RAM; and offprint of Bonhoeffer’s “Beurteilung, Begutachtung und Rechtsprechung bei den sogenannten Unfallneurosen.” 189. BAP, RPM 47.01, 14575/1, Bl. 234. 190. “Abbau der Neurosen,” Vossische Zeitung, 24 Nov. 1927. 191. BAP, RPM 47.01, 14575/1, Bl. 252ff. Well into the 1930s, operators and other personnel continued to press the case for the old, materialist explanation of traumatic neurosis. See BAL, R 89/15114. 192. BAP, RPM 47.01, 14575/1, Bl. 272–75. 193. Stier, “Vortrag,” 47–48. On the meeting regarding the Neurotikerfrage held at the RAM on 6–8 Apr. 1929, see BAP, RPM 47.01, 14575/1, Reichsversorgungsblatt 5 (1929). 194. Sigmund Freud, Beyond the Pleasure Principle (1922; New York 1961), 25.
CONCLUSION 1. Ulrich Beck, Risk Society: Towards a New Modernity (London 1992). 2. Peter Fritzsche, “Landscape of Danger, Landscape of Design: Crisis and
NOTES TO PAGES 213–15 271
Modernism in Weimar Germany,” in Dancing on the Volcano: Essays on the Culture of the Weimar Republic, ed. T. Kniesche and S. Brockmann (Columbia, SC 1994), 29–46. 3. Alfred Döblin, Berlin Alexanderplatz (New York 1976), 385. For resistance to the dismantling of the somatic paradigm of traumatic neurosis, see the collection of documents in BAL, R 89/15114, especially the articles by Max Levy-Suhl, a socialist doctor with a practice in Berlin-Wilmersdorf. See also BAP, RPM 47.01, 14577/1, letter from Verband der Telefonistinnen to RPM, 21 Feb. 1930, containing a brief history of the traumatic neurosis concept from Oppenheim to Stier. 4. Ewald Stier, “Vortrag,” in Arbeit und Gesundheit, Schriftenreihe der Reichsarbeitsministerium, vol. 13 (Berlin 1929), 53. 5. See Gisela Bock, Zwangsterilisation im Nationalsozialismus (Opladen 1986), 45. 6. See Detlev Peukert, “The Genesis of the ‘Final Solution’ from the Spirit of Science,” in Nazism and German Society 1933–1945, ed. D. Crew (London 1994), 274–99; Paul Weindling, Health, Race and German Politics between National Unification and Nazism, 1870–1945 (Cambridge 1989); and P. Weingart, J. Kroll, and K. Bayertz, eds., Rasse, Blut, und Gene: Geschichte der Eugenik und Rassenhygiene in Deutschland (Frankfurt 1998). 7. On electrification in the 1920s, see Janet Ward, Weimar Surfaces: Urban Visual Culture in 1920s Germany (Berkeley, CA 2001), esp. 92–141. 8. On Lang’s “childlike pleasure” in electricity and his efforts to find a visual representation of it in the film, see Thomas Elsaesser, Metropolis (London 2000), 47. More generally on Lang’s Metropolis and on the postwar thematization of technology out of control, see Andreas Huyssen, “The Vamp and the Machine: Fritz Lang’s Metropolis,” in After the Great Divide: Modernism, Mass Culture, Postmodernism (Bloomington, IN 1986), 65–81; and Anton Kaes, “Metropolis: City, Cinema, Modernity,” in Expressionist Utopias: Paradise, Metropolis, Architectural Fantasy, ed. T. Benson (Los Angeles, 1993), 146–65. On Rotwang’s coding as “Jewish,” see Kaes, “Metropolis,” 155, 162. 9. BAL, R 86/943, “Die Gesundheitsschädlichkeits des Kinos,” Vorwärts, 27 Mar. 1913. More generally on the public debate over the cinema, see Anton Kaes, ed., Kino-Debatte: Texte zum Verhältnis von Literatur und Film 1909–1929 (Munich 1978). 10. A crucial text was Hugo Münsterberg’s The Photoplay: A Psychological Study (1916; New York 2002). The founder of psychotechnics and of modern film theory saw both fields in terms of their usefulness for binding subjects into new regimes of work and leisure. 11. Richard Bessel, Germany after the First World War (Oxford 1995); 220–53; Cornelie Usborne, Frauen Körper—Volks-Körper: Geburtenkontrolle und Bevölkerungspolitik in Weimarer Republik (Münster 1994), 106–11. 12. BAL, R 86/943, “Gefahren des Kino im Urteil des Ärztes,” Vorwärts, 16 Sept. 1920. 13. BAL, R 86/943, Reichsminister des Innern to RGA, Betreff: Novella zum Lichtspielgesetz, 30 June 1925. 14. BAL, R 86/943, all the following: letter from Bild- und Film-Amt to KGA, 31 Aug. 1918; Curt Thomalla to RGA, “Medizinische Kinematographie,”
272 NOTES TO PAGES 215–18
17 Jan. 1923; letter, Ufa to RGA, 11 Jan. 1923; and letter, Kossofilm to RGA, 31 July 1923. See also BAP, RPM 47.01, letter from Universum-Film to RPM concerning educational film on telephony depicting electrical pathways from caller to the telephone exchange, 26 Nov. 1919. 15. On Weimar mental and nervous hygiene, see BAL, R 89/6904, Einladung zur Sonderschau Gesunde Nerven, Erste Ausstellung für psychische Hygiene im Gesundheitshaus Kreuzberg, 10 Oct. 1929. For more on the German state’s attitudes toward the cinema, see Gary Stark, “Cinema, Society, and the State: Policing the Film Industry in Imperial Germany,” in Essays on Culture and Society in Modern Germany, ed. Gary Stark and Bede Karl Lackner (Arlington, TX 1982), 160–65. 16. On the “hypnotic” effects of Weimar cinema, see Siegfried Kracauer, From Caligari to Hitler: A Psychological History of the German Film (Princeton, NJ 1947); and Siegfried Kracauer, The Salaried Masses: Duty and Distribution in Weimar Germany (New York 1998), 94. For an analysis of the problematic gender aspects of Kracauer’s film criticism, see Patrice Petro, Joyless Streets: Women and Melodramatic Representation in Weimar Germany (Princeton, NJ 1989). 17. Wolfgang Schivelbusch, The Railway Journey: The Industrialization of Space and Time (Berkeley, CA 1986), 162. 18. Miriam Hansen, “America, Paris, and the Alps: Kracauer (and Benjamin) on Cinema and Modernity,” in Cinema and the Invention of Modern Life, L. Charney and V. Schwartz (Berkeley, CA 1995), 366. 19. See Sigmund Freud, Beyond the Pleasure Principle (New York 1961); and for Benjamin’s reception of Freud, see Walter Benjamin, Charles Baudelaire: An Epic Poet in the Era of High Capitalism (London 1973), 113–17. Regarding Freud, Ulrich Beck writes: “In risk society, as opposed to class society, the commonality of anxiety takes the place of the commonality of need.” Beck, Risk Society, 48–49. 20. Willy Haas, “Metropolis” (1927), in The Weimar Republic Sourcebook, ed. Anton Kaes, Martin Jay, and Edward Dimendberg (Berkeley, CA 1994), 623–25. 21. See Kaes, “Metropolis”; and Ward, Weimar Surfaces, 166–67. 22. For more on the making of Metropolis, including the on-set preparations for an accident, see Siegfried Kracauer, “Calico-World” (1926), in The Mass Ornament (Cambridge, MA 1995), 281–90. 23. See Klaus Bergmann, Agrarromantik und Großstadtfeindlichkeit (Meisenheim am Glan 1970); and on the film’s imagery of the masses, see Huyssen, “The Vamp and the Machine.” On the representation of Berlin as a woman, see Patrice Petro, “Modernity and Mass Culture in Weimar,” New German Critique 40 (1987): 115–18; and for more on the right-wing imagery of the masses, see Klaus Theweleit, Male Fantasies, vol. 1: Women, Floods, Bodies, History (Minneapolis 1987). 24. On Lang’s ornamental treatment of the crowd, see Kracauer, From Caligari to Hitler, 162–64; and on the “mass ornament,” see Kracauer, “The Mass Ornament,” in The Mass Ornament, 75–86. 25. As such, this disciplined new social community represents what Walter Benjamin would call the organization and innervation of the collective body in
NOTES TO PAGE 218 273
a new physis. Walter Benjamin, “Surrealism,” in Reflections (New York 1979), 192. On the continuities and discontinuities between the turn-of-the-century ornament and the Weimar mass ornament, see Hansen, “America, Paris, and the Alps,” 384. Writing in the 1940s, Adorno suggested that nothing would be left to resist the collective identities of the modern world “should it once prove possible to do away with nerves entirely.” Theodor Adorno, Minima Moralia (New York 1974), 146. 26. See Brigid Doherty “‘See: We Are All Neurasthenics!’ or, The Trauma of Dada Montage,” Critical Inquiry 24, no. 1 (1997): 93–97. 27. George Grosz, “Kaffeehaus,” in Grosz-Berlin: Autobiographisches, Bilder, Briefe, und Gedichte, ed. M. Beyer and K. Riha (Hamburg 1993), 59.
Selected Bibliography
ARCHIVAL SOURCES Bobst Library, New York University Tamiment 99, Folders 1–6, the International Association of Postal, Telegraph, and Telephone Personnel. Boston Public Library Münsterberg, Hugo. Papers. Bundesarchiv, Abteilung Berlin-Lichterfeld (BAL) Imperial Health Office collection. Reichsarbeitsministerium collection (RAM) (Reich Ministry of Labor). Bundesarchiv, Abteilung Potsdam (now Berlin) (BAP) Reichspostministerium collection (RPM) (Reich Postal Ministry). Geheimes Staatsarchiv Preussischer Kulturbesitz, Berlin (GSA) Rep. 76 VIII B, 4394, Medizinische und ärztliche Schriften. Landesarchiv Berlin (LA) Pr. Br. 44, Akten betr. Beamtinnen. Leo Baeck Archives Edinger, Ludwig. Papers. Simmel, Georg. Papers. Stein, Theodor Sigmund. Papers. Psychiatrische und Nervenklinik der Charité, Berlin Krankenblätterarchiv (KBA). Staatsbibliothek Preussischer Kulturbesitz, Berlin Boruttau, Heinrich. Papers. 275
276 SELECTED BIBLIOGRAPHY
Sterling Library, Yale University Beard, George Miller. Papers. Universitätsarchiv der Humboldt Universität zu Berlin (HUB) Charité 850. Charité 911. Charité Nervenklinik Bestand: Akten betr. Gutachtertätigkeit. Grotjahn, Alfred. Papers. Zentrales Staatsarchiv, Potsdam (ZsTA) Rep. 76.
PERIODICALS Amtliche Nachrichten der Reichsversicherungsamt Ärztliche Sachverständige Zeitung Der Fernsprecher Elektrotechnisches Zeitschrift Sozialistische Monatsheft Unter den Reichsadler Vorwärts Zeitschrift für Bahnärzte Zeitschrift fur Eisenbahn-Telegraphen-Beamte Zeitschrift für Elektrotherapie und ärztliche Elektrotechnik Zeitschrift für Unfallheilkunde
PRIMARY SOURCES “Abbau der Neurosen.” Vossische Zeitung, 24 Nov. 1927. Abraham, Hilda C., and Ernst L. Freud, eds. A Psychoanalytical Dialogue: The Letters of Sigmund Freud and Karl Abraham, 1907–1926. New York 1965. Altenloh, Emilie. Soziologie des Kinos. Jena 1914. Beard, George Miller. American Nervousness, Its Causes and Consequences. New York 1880. Bebel, August. Die Frau und der Sozialismus. Berlin 1974. Becker, Ludwig. Die Simulation von Krankheiten und ihre Beurteilung. Leipzig 1908. Benda, Theodor. Öffentiche Nervenheilanstalten. Berlin 1891. Berger, Paul. Führer durch die Privat Heil-Anstalten Deutschlands, Österreichs und der Schweiz. Berlin 1889–90. Bericht über die XIV Internationale Kongress für Hygiene und Demographie. Berlin 1908. Bernhard, Ludwig. Undesirable Results of German Social Legislation. New York 1914. Bernhardt, Martin. Betriebsunfälle der Telephonistinnen. Berlin 1906. Binswanger, Otto. Die Pathologie und Therapie der Neurasthenie. Jena 1896. Bonhoeffer, Karl. “Psychiatrie und Krieg.” Deutsche medizinische Wochenschrift 40 (1914): 1777–79. ———. “Über die Bedeutung der Kriegserfahrungen für die allgemeine Psy-
SELECTED BIBLIOGRAPHY 277
chopathologie und Atiologie der Geisteskrankheiten.” In Handbuch der ärztlichen Erfahrungen im Weltkrieg 1914–1918, ed. O. von Schjerning, vol. 4: Geistes- und Nervenkrankheiten, ed. K. Bonhoeffer, 3–44. Leipzig 1922. ———. “Wie weit kommen psychogene Krankheitszustände und Krankheitsprozesse vor, die nicht der Hysterie zuzurechnen sind?” Allgemeine Zeitschrift für Psychiatrie 68 (1911): 371–86. Boruttau, Heinrich. Die Arbeitsleistungen des Menschen, Einführung in die Arbeitsphysiologie. Leipzig 1916. ———. Die Elektrizität in der Medizin und Biologie. Wiesbaden 1906. ———. “Todesfälle durch therapeutische Wechselstromanwendung und deren Verhütung.” Deutsche medizinische Wochenschrift 43 (1917): 808–9. Brähmer, Otto. “Eisenbahnhygiene.” In Handbuch der Hygiene, vol. 6, ed. Theodor Weyl. Jena 1897. Breuer, Joseph, and Sigmund Freud. Studies in Hysteria. New York 1955. Bruns, Ludwig. “Neuere Arbeiten über die ‘traumatischen Neurosen.’ ” Schmidt’s Jahrbücher 239 (1892): 81–85. Bumke, Oswald. “Die Revision der Neurosenfrage.” Zentralblatt für die gesamte Neurologie und Psychiatrie 41 (1925): 669–77. Charcot, Jean-Martin. Clinical Lectures on Diseases of the Nervous System. London 1991. “Die Poesie der Elektrotechnische Ausstellung.” Die Gartenlaube 37 (1891): 619–22. Döblin, Alfred. Berlin Alexanderplatz. New York 1976. Duchenne de Boulogne, G.-B. The Mechanism of Human Facial Expression. New York 1990. Edinger, Ludwig, ed. Elektrotherapeutische Streitfragen. Wiesbaden 1892. Eisenstadt, H. L. Beiträge zu den Krankheiten der Postbeamten. Berlin 1909. Erb, Wilhelm. Handbook of Electro-therapeutics. New York 1886. ———. “Spinal Nervous Weakness.” In Cyclopedia of the Practice of Medicine, ed. H. von Ziemssen. Leipzig 1876. ———. Über die wachsende Nervosität unserer Zeit. Heidelberg 1893. Eulenburg, Albert. “Die Nervosität unser Zeit.” Die Zukunft, 15 Aug. 1896, 302–18. ———. “Elektrotherapie und Suggestionstherapie.” Berliner medizinische Wochenschrift 8 (1892): 157–61, 191–96. ———. “Gutachten über einen schweren und eigenartigen Fall elektrischer Verunglückung.” Ärztliche Sachverständigen Zeitung 3 (1901): 45–51. ———. “Kriegsnervosität.” Die Umschau 19 (1915): 1–3. ———. “Über Nerven- und Geisteskranken nach elektrischen Unfällen.” Berliner klinische Wochenschrift 42 (1905): 30–33, 68–70. Ewald, E. “Traumatische Neurose nach einem Unfall im Telephonbetriebe.” Monatsschrift für Unfallheilkunde 1 (1894): 216–17. Foerster, Rudolf. “Unfälle am Telephon und ihre Verhütung.” Berliner klinische Wochenschrift 48 (1911): 1688–99. Freud, Sigmund. Beyond the Pleasure Principle. New York 1961. ———. Civilization and its Discontents. New York 1961. ———. Freud’s Complete Letters to Wilhelm Fliess. Cambridge, MA 1985.
278 SELECTED BIBLIOGRAPHY
———. The Interpretation of Dreams. New York 1965. Freund, Richard. “Das Heilverfahren der Landes-Versicherungsanstalt Berlin im Jahre 1900.” Soziale Praxis 12 (1902). ———. Die Arbeiterheilstätten der Landesversicherungsanstalt Berlin bei Beelitz. Berlin 1902. Gaupp, Robert. “Nervöse Zusammenbruch und die Revolution.” Blätter für Volksgesundheitspflege 19 (1919): 43–46. Giese, Fritz. Berufspsychologische beobachtungen im Reichstelegraphendienst. Jena 1923. ———. Girlkultur, Vergleiche zwischen amerikanischem und europäischem Rhythmus und Lebensgefühl. Munich 1925. ———. Handbuch der psychotechnischer Eignungsprüfungen. Jena 1926. ——— ed. Weibliche Körperbildung und Bewegungskunst auf Grundlage des Systems Mensendieck. Munich 1924. Goldscheider, Alfred. Die Bedeutung der Reize für Pathologie und Therapie im Lichte der Neuronlehre. Leipzig 1898. Griesinger, Wilhelm. Pathology and Therapy of Mental Illness, 2nd ed. New York 1965. Groeningen, G. H. Über den Shock. Wiesbaden 1885. Grosz, Georg. An Autobiography. New York 1983. ———. “Kaffeehaus.” In Grosz-Berlin: Autobiographisches, Bilder, Briefe, und Gedichte, ed. M. Beyer and K. Riha, 59. Hamburg 1993. Grotjahn, Alfred. Erlebtes und Erstrebtes: Errinerungen eines sozialistischen Arztes. Berlin 1932. ———. Krankenhauswesen und Heilstättenbewegung im Lichte der Sozialen Hygiene. Leipzig 1908. ———. Leitsätze zur sozialen und generativen Hygiene. Karlsruhe 1921. ———. Soziale Pathologie. Berlin 1912. Grün, Hermann. “Erkrankungen der Arbeiter in elektrische Zentralen und der Elektromonteure.” In Handbuch der Arbeiterkrankheiten, ed. T. Weyl. Jena 1908. Haas, Willy. “Metropolis” (1927). In The Weimar Republic Sourcebook, ed. A. Kaes, M. Jay, and E. Dimendberg, 623–25. Berkeley, CA 1994. Hecker, E. “Über das Verhältnis zwischen Nerven- und Geisteskrankheiten in Bezug auf ihr Behandlung in getrennten Anstalten.” Deutsche medizinische Wochenschrift 7 (1881): 121–25, 137–41. Heilig, Gerhard. Fabrikarbeit und Nervenleiden. Berlin 1908. Hellpach, Willy. Die geistigen Epidemien. Frankfurt 1906. ———. Nervenleben und Weltanschauung. Wiesbaden 1906. ———. Nervosität und Kultur. Berlin 1902. ———. Wirken und Wirren: Lebenserrinerungen, vol. 1. Hamburg 1948. Helmholtz, Hermann von. On the Sensations of Tone. New York 1863. Jellinek, Stefan. Elektropathologie. Stuttgart 1903. ———. “Pathologie, Therapie, und Prophylaxe der elektrische Unfälle.” Deutsche medizinische Wochenschrift 10 (1907): 374–78, 421–24. ———. “Tod durch Elektrizität.” Wiener klinische Wochenschrift 18 (1905): 1139–44, 1184–89.
SELECTED BIBLIOGRAPHY 279
Jünger, Ernst. Storm of Steel. New York 1975. Kapp, Ernst. Grundlinie einer Philosophie der Technologie. Braunschweig 1875. Kaufmann, Fritz. “Die Planmässige Heilung komplizierter psychogener Bewegungsstörungen bei Soldaten in einer Sitzung.” Münchener medizinische Wochenschrift 63 (1916): 802–4. Kleemann, Kurt. Die Sozialpolitik der Reichs-Post und Telegraphenverwaltung gegenüber ihren Beamten, Unterbeamten, und Arbeitern. Jena 1914. Koelsch, Franz. “Elektrizitätsindustrie.” In Handwörterbuch der Sozialhygiene, vol. 1, ed. A. Grotjahn and I. Kaup. Jena 1912. Koenig, Wilhelm. Über Gesichtsfeldermüdung bei Erkrankung der Centralnervensystem. Leipzig 1893. Kolshorn, Else. “Die Lage der weibliche Post- und Telegraphenbeamtinnen.” Archiv für Frauenarbeit 1 (1924): 79–85. Kraepelin, Emil. Memoirs. Berlin 1987. ———. “Psychiatrische Randbemerkungen zur Zeitgeschichte.” Süddeutsche Monatsheft (1919): 171–83. ———. Psychiatry. 7th ed. 1903; New York 1907. ———. Über geistige Arbeit. Jena 1894. Krafft-Ebing, Richard. Über gesunde und kranke Nerven. Vienna 1903. Kuhnemann, Fritz, et al. Berlin und seine Arbeit: Amtlicher Bericht der Berliner Gewerbe-Ausstellung. Berlin 1898. Kurella, Hans. “Elektrische Gesundheits-Schädigungen am Telephon.” Zeitschrift für Elektrotherapie 7 (1905): 238–61. ———. “Elektropathologie,” Zeitschrift für Elektrotherapie 6 (1904): 238. Laehr, Max. “Die Heilstätte für Nervenkranke ‘Haus Schönow’ 1899 bis 1927.” Psychiatrische-neurologische Wochenschrift 30 (1928): 5–23, 39–46. ———. “Die Nervosität der heutigen Arbeiterschaft.” Allgemeine Zeitschrift für Psychiatrie 66 (1909): 1–18. Lamprecht, Karl. Über die jüngsten deutschen Vergangenheit, vol. 1–2. Berlin 1902–4. Lange, F. A. History of Materialism. New York 1974. Leppmann, Arthur. “Die Behandlung schwerer Unfallneurosen. Eine Umfrage, veranstaltet von der Redaktion der Aerztlichen Sachverständigen-Zeitung.” Aerztlichen Sachverständigen-Zeitung (1906): 415–18, 438–41, 473–81. Leubuscher, P., and W. Bibrowicz. “Die Neurasthenie in Arbeiterkreisen.” Deutsche medizinische Wochenschrift 31 (1905): 820–24. Levy-Rathenau, Josephine. Die deutsche Frau im Beruf. Berlin 1912. Lindenburg, Paul. Pracht-Album Photographischer-Aufnahmen der Berliner Gewerbe-Ausstellung 1896. Berlin 1896. Loewy-Hattendorf, Erwin. Krieg, Revolution, und Unfallneurosen. Berlin 1920. Mann, Thomas. The Magic Mountain. New York 1969. Merzbacher, Ludwig. “Einige statistische Bemerkungen über Unfallneurosen.” Centralblatt für Nervenheilkunde und Psychiatrie 29 (1906): 905–12. Möbius, P. J. “Bemerkungen über Simulation bei Unfall-Nervenkranken.” Münchener medizinische Wochenschrift 37 (1890): 887–88. ———. Über die Behandlung von Nervenkranken und die Errichtung von Nervenheilstätten. Leipzig 1896.
280 SELECTED BIBLIOGRAPHY
———. “Über neuere elektrotherapeutische Arbeiten.” Schmidt’s Jahrbücher 213–38 (1888–93). Mohr, Fritz. “Aus der Praxis der Psychotherapie.” Medizinische Klinik 42 (1917): 1116–19. Monakow, Constantin von. “Die Neurosenfrage einst und heute.” In 50 Jahre Neurologie, 51–100. Zürich 1924. Münsterberg, Hugo. Psychology and Industrial Efficiency. Boston 1913. Nietzsche, Friedrich. Ecce Homo. New York 1967. ———. Human, All Too Human. New York 1986. ———. Selected Letters. London 1985. ———. The Will to Power. New York 1968. Nonne, Max. “Therapeutische Erfahrungen an den Kriegsneurosen.” In Handbuch der ärztliche Erfahrungen im Weltkrieg, 1914–1918, ed. O. von Schjerning, vol. 4: Geistes- und Nervenkrankheiten, ed. Karl Bonhoeffer, 102–21. Berlin 1922. Nordau, Max. Degeneration. 1892; Lincoln, NE 1993. Oppenheim, Hermann. Die traumatischen Neurosen nach den in der Nervenklinik der Charité in den 5 Jarhen 1883–1888 gesammelten Beobachtungen. Berlin 1889. ———. “Wie sind diejenige Fälle von Neurasthenie aufzufassen, welche sich nach Erschütterungen des Rückenmarks, insbesondere nach Eisenbahnunfälle entwickeln?” Deutsche medizinische Wochenschrift 14 (1888): 194–96. Placzek, S. “Über die Gefahren nervenkranker Eisenbahnbediensteter für den Eisenbahnbetrieb.” In Bericht über die XIV Internationale Kongress für Hygiene und Demographie, vol. 4, 430–53, 596–609. Berlin 1908. Rigler, Johannes. Über die Folgen der Verletzungen auf Eisenbahnen, insb. die von der Rückenmarks, mit Hinblick auf das Haftpflichtgesetzes. Berlin 1879. Roth, Emanuel. “Ermüdung durch Berufsarbeit.” In Bericht über die XIV Internationale Kongress für Hygiene und Demographie, vol. 4, 612–20. Berlin 1908. Saenger, Alfred. Die Beurteilung der Nervenerkrankungen nach Unfall. N.p. 1896. Scheffler, Karl. Berlin: Ein Stadtschicksal. Berlin 1910. Schönhals, P. Über die Ursachen der Neurasthenie und Hysterie bei Arbeitern. Berlin 1906. Schormaier, M. “Telegraphisten-Krankheit.” Elektrische Rundschau 10 (1884). Schreber, Daniel Paul. Memoirs of My Nervous Illness. Cambridge, MA 1988. Schuster, P. “Die Krankheiten der Telephonangestellten.” In Handbuch der Arbeiterkrankheiten, ed. T. Weyl, 289–95. Jena 1908. Schwarz, G. C. Über Nervenheilstätten und die Gestaltung der Arbeit als Hauptheilmittel. Leipzig 1903. Schwechten, K. “Die Krankheits, Sterbe- und Invalidisierungsfälle bei der Preussisch-Hessische Eisenbahngemeinschaft.” Archiv für Eisenbahnwesen (1909). Seeligmüller, Adolf. “Zur Frage der Simulation von Nervenleiden nach Traumen.” Neurologisches Centralblatt 8 (1889): 570–72. Simmel, Georg. “The Berlin Trade Exhibition” (1896). In Simmel on Culture, ed. D. Frisby and M. Featherstone, 255–58. London 1997. ———. “The Metropolis and Mental Life” (1902). In On Individuality and Social Forms, ed. D. Levine, 324–39. Chicago 1971.
SELECTED BIBLIOGRAPHY 281
———. On Women, Sexuality and Love. New Haven, CT 1984. ———. The Philosophy of Money. London 1990. Stein, S. T. Lehrbuch der allgemeine Elektrization des menschlichen Körpers. Leipzig 1886. Stier, Ewald. “Psychiatrie und Heer: Ein Ruckblick.” Der deutsche Militärärzt 1 (1936): 15–20. ———. “Rentenversorgung bei nervösen und psychisch erkrankten Feldzugsteilnehmern.” In Handbuch der ärztliche Erfahrungen im Weltkrieg, 1914–1918, ed. O. von Schjerning, vol. 4: Geistes- und Nervenkrankheiten, ed. Karl Bonhoeffer, 168–95. Berlin 1922. ———. “Soziologie der Nervosität.” In Handbuch der soziale Hygiene, vol. 5, ed. A. Gottstein, 615–33. Berlin 1927. ———. Über die sogenannten Unfallneurosen. Leipzig 1926. ———. “Vortrag.” In Arbeit und Gesundheit, Schriftenreihe der Reichsarbeitsministerium, vol. 13, 44–53. Berlin 1929. ———. “Wie kann der Enstehung von Kriegsneurosen bei der Feldarmee vorgebeugt werden?” Deutsche militärärztliche Zeitschrift 47 (1918): 60–72. Stintzing, Rudolf. Die Elektro-Medizin. Munich 1883. Tausk, Viktor. “On the Origin of the Influencing Machine in Schizophrenia.” Psychoanalytic Quarterly 2 (1933): 519–56. Traumatische, Idiopathische und nach Infektionskrankheiten beobachtete Erkrankungen des Nervensystem bei der deutschen Heeren im Krieg gegen Frankreich 1870/71. Hrg. von d. Militär-Medizinal-Abteilung der Königlich Preussiche Kriegsministeriums. Berlin 1886. Voss, Gerhard. “Der Einfluss der sozialen Lage auf Nerven- und Geisteskrankheiten, Selbstmord und Verbrechen.” In Krankheit und soziale Lage, ed. M. Mosse und G. Tugendreich. Berlin 1913. Weber, Max. From Max Weber: Essays in Sociology. Edited by H. H. Gerth and C. Wright Mills. New York 1946. Wernicke, Carl. “Obergutachten über der Verletzung einer Telephonistin durch Starkstrom.” Monatschrift für Psychiatrie 17 (1905), Ergänzungsheft. Westphal, Carl. “Die Agoraphobie, eine neuropathische Erscheinung.” Archiv für Psychiatrie und Neurologie 3 (1871): 133–61. ———. “Einige Fälle von Erkrankungen des Nervensystem nach Verletzungen auf Eisenbahnen.” Charité-Annalen 5 (1880): 379–89. Wilbrand, Hermann. Die Erholungsausdehnung des Gesichtsfeldes. Wiesbaden 1896. ———. Über typische Gesichtsfeldanomalien bei functionellen Störungen des Nervensystems. Leipzig 1891.
SECONDARY SOURCES Abbott, Andrew. The System of Professions: An Essay on the Division of Expert Labor. Chicago 1988. Ackerknecht, Erwin. “Experiment und Klinik in der Geschichte der Neurologie.” Bulletin der schweizerischen Akademie der medizinischen Wissenschaften 21 (1965): 51–56.
282 SELECTED BIBLIOGRAPHY
———. “Private Institutions in the Genesis of Psychiatry.” Bulletin of the History of Medicine 60 (1986): 387–95. ———. Short History of Psychiatry. New York 1968. Asendorf, Christoph. Batteries of Life: On the History of Things and Their Perception in Modernity. Berkeley, CA 1993. Ash, Mitchell. Wholism and the Quest for Objectivity: Gestalt Psychology in German Culture 1890–1967. Cambridge, MA 1995. Beck, Ulrich. Risk Society: Towards a New Modernity. London 1992. Benjamin, Walter. The Arcades Project. Cambridge, MA 1999. ———. Charles Baudelaire: A Lyric Poet in the Age of High Capitalism. London 1973. ———. Illuminations. New York 1968. ———. Reflections. New York 1978. Bergmann, Klaus. Agrarromantik und Großstadtfeindlichkeit. Meisenheim am Glan 1970. Bernfeld, Siegfried. “Freud’s Earliest Theories and the School of Helmholtz.” Psychoanalytic Quarterly 13 (1944): 341–62. Bessel, Richard. Germany after the First World War. Oxford 1993. Binder, B. “Die Inszenierung einer elektrischen Welt auf die Frankfurt Internationale Elektrotechnische Austellung von 1891.” Hessische Blätter für Volksund Kulturforschung 24 (1989): 31–44. Blackbourn, David, and R. Evans, eds. The German Bourgeoisie: Essays on the Social History of the German Middle Classes from the Late 18th to the Early 20th Century. London 1991. Boberg, Jochen, T. Fichter, and E. Gillen, eds. Exerzierfeld der Moderne: Industriekultur in Berlin im 19. Jahrhundert. Munich 1984. ———, eds. Die Metropole: Industriekultur in Berlin im 20. Jahrhundert. Munich 1986. Bock, Gisela. Zwangsterilisation im Nationalsozialismus. Opladen 1986. Borck, Cornelius. “Electricity as a Medium of Psychic Life.” Science in Context 14, no. 4 (2001): 565–90. Boring, E. G. History of Experimental Psychology. 2nd ed. New York 1950. Bourke, Joanna. Dismembering the Male: Men’s Bodies, Britain and the Great War. London 1995. Bridenthal, R., A. Grossmann, and M. Kaplan, eds. When Biology Became Destiny. New York 1984. Buddensieg, Tilmann. Industriekultur: Peter Behrens and the AEG, 1907–1914. Cambridge, MA 1984. ———, ed. Berlin 1900–1933: Architecture and Design. New York 1987. Canguilhem, Georges. Ideology and Rationality in the History of the Life Sciences. Cambridge, MA 1988. ———. “Machine and Organism.” In Incorporations, ed. J. Crary and S. Kwinter, 44–69. New York 1992. ———. The Normal and the Pathological. New York 1989. Caplan, Eric. “Trains, Brain and Sprains: Railway Neuroses and the Origins of Psychoneuroses.” Bulletin of the History of Medicine 69 (1995): 387–419.
SELECTED BIBLIOGRAPHY 283
Chamberlin, J., and S. Gilman, eds. Degeneration: The Dark Side of Progress. New York 1985. Cooter, R., S. Sturdy, and M. Harrison, eds. War, Medicine and Modernity. Phoenix Mill, UK 1998. Cranefield, Paul. “Freud and the ‘School of Helmholtz.’ ” Gesnerus 23, no. 1 (1966): 35–39. ———. “The Organic Physics of 1847 and the Biophysics of Today.” Journal of the History of Medicine and Allied Sciences 12 (1957): 407–23. ———. “Philosophical and Cultural Interests of the Biophysics Movement of 1847.” Journal of the History of Medicine 1 (1966): 1–7. Crary, Jonathan. “Attention and Modernity in the Nineteenth Century.” In Picturing Science, Producing Art, ed. P. Galison and C. Jones, 475–500. New York 1998. ———. Techniques of the Observer: On Vision and Modernity in the Nineteenth Century. Cambridge, MA 1990. Crew, David. “The Ambiguities of Modernity: Welfare and the German State from Wilhelm to Hitler.” In Society, Culture, and the State in Germany 1870–1930, ed. Geoff Eley, 319–44. Ann Arbor, MI 1996. ———. Germans on Welfare: From Weimar to Hitler. New York 1998. Crouthamel, Jason. “War Neurosis vs. Savings Psychosis: Working Class Politics and Psychological Trauma in Weimar Germany.” Journal of Contemporary History 37, no. 2 (2002): 163–82. Danziger, Kurt. Constructing the Subject: Historical Origins of Psychological Research. Cambridge 1990. Decker, Hannah. Freud in Germany: Revolution and Reaction in Science 1893–1907. New York 1977. Didi-Hubermann, Georges. Invention de l’hysterie. Paris 1982. Doerner, Klaus. Madmen and the Bourgeoisie: A Social History of Insanity and Psychiatry. Oxford 1981. Doerry, Martin. Übergangsmenschen: Die Mentalität der Wilhelminer und die Krise des Kaiserreichs. Munich 1986. Doherty, Brigid. “ ‘See: We are all Neurasthenics!’ or, The Trauma of Dada Montage.” Critical Inquiry 24 (1997): 82–132. Drinka, George. The Birth of Neurosis: Myth, Malady and the Victorians. New York 1984. Egighian, Greg. “Die Bürokratie und das Enstehen von Krankheit: Die Politik und die ‘Rentenneurosen’ 1890–1926.” In Stadt und Gesundheit. Zum Wandel von ‘Volksgesundheit’ und kommunaler Gesundheitspolitik im 19. und frühen 20. Jahrhundert, ed. J. Reulecke and A. Gräfin zu Castell Rüdenhausen, 203–23. Stuttgart 1991. ———. “The German Welfare State as a Discourse of Trauma.” In Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age 1870–1930, ed. M. Micale and P. Lerner, 92–112. Cambridge 2001. ———. Making Security Social: Disability, Insurance, and the Birth of the Social Entitlement State in Germany. Ann Arbor, MI 2000. Eissler, Kurt. Freud as an Expert Witness: The Discussion of War Neuroses between Freud and Wagner-Jauregg. Madison, CT 1986.
284 SELECTED BIBLIOGRAPHY
Eksteins, Modris. The Rites of Spring: The Great War and the Birth of the Modern Age. New York 1989. Eley, Geoff, ed. Society, Culture, and the State in Germany 1870–1930. Ann Arbor, MI 1997. Ellenberger, Henri. The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry. New York 1970. Elsaesser, Thomas. Metropolis. London 2000. Engstrom, Eric. Clinical Psychiatry in Imperial Germany: A History of Psychiatric Practice. Ithaca, NY 2004. Ewald, Francois. “Insurance and Risk.” In The Foucault Effect: Studies in Governmentality, ed. Peter Miller, Graham Burchell, and Colin Gordon, 197–210. London 1991. Figlio, Karl. “What Is an Accident?” In The Social History of Occupational Health, ed. Paul Weindling, 180–206. London 1985. Fischer-Homberger, Esther. Die traumatische Neurose: Vom somatischen zum sozialen Leiden. Bern 1975. Foucault, Michel. Discipline and Punish: The Birth of the Prison. New York 1979. ———. History of Sexuality, vol. 1. New York 1990. ———. Preface. In Georges Canguilhem, The Normal and the Pathological. New York 1989. Frevert, Ute. Krankheit als politisches Problem 1770–1880: Soziale Unterschichten in Preussen zwischen medizinischer Polizei und staatlicher Sozialsicherung. Göttingen 1984. ———. “Professional Medicine and the Working Classes in Imperial Germany.” Journal of Contemporary History 20 (1985): 637–58. ———. Women in German History: From Bourgeois Emancipation to Sexual Liberation. New York 1989. Fritzsche, Peter. “Landscape of Danger, Landscape of Design: Crisis and Modernism in Weimar Germany.” In Dancing on the Volcano, ed. T. Kniesche and S. Brockmann, 29–46. Columbia, SC 1994. ———. Reading Berlin 1900. Chicago 1996. Gay, Peter. Freud, Jews and Other Germans. New York 1978. ———. The Tender Passion. New York 1986. Geuter, Ulfried. The Professionalization of German Psychology in Nazi Germany. Cambridge 1992. Giedion, Siegfried. Mechanization Takes Command: A Contribution to Anonymous History. New York 1948. Gilman, Sander. Freud, Race and Gender. Princeton, NJ 1993. Gilman, Sander, and R. Porter, eds. Hysteria beyond Freud. Berkeley, CA 1993. Gold, Helmut, and Annette Koch, eds. Das Fräulein vom Amt. Munich 1993. Goldstein, Jan. Console and Classify: The French Psychiatric Profession in the 19th Century. New York 1987. Goldstein, Kurt. The Organism. New York 1995. Gosling, Frances. Before Freud: Neurasthenia and the American Medical Community. Urbana, IL 1987. Grossmann, Atina. “Girlkultur or Thoroughly Rationalized Female.” In Women in Culture and Politics, ed. J. Friedlander, 62–80. Bloomington, IN 1986.
SELECTED BIBLIOGRAPHY 285
———. Reforming Sex: The German Movement for Birth Control and Abortion Reform 1920–1950. New York 1995. Gundlach, Horst. “Psychotechnische Untersuchungen bei der deutsche Reichspost.” In Das Fräulein vom Amt, ed. H. Gold and A. Koch, 109–19. Munich 1993. ———. Reiz: Zur Verwendung eines Begriffes in der Psychologie. Bern 1976. Hacking, Ian. Rewriting the Soul: Multiple Personality and the Sciences of Memory. Princeton, NJ 1995. Hagner, Michael. “Die elektrische Erregbarkeit des Gehirns.” In Experimentalisierung des Lebens, ed. H.-J. Rheinberger and M. Hagner, 97–115. Berlin 1993. ———. Ecce Cortex: Beiträge zur Geschichte des modernen Gehirns. Göttingen 1999. Harraway, Donna. Crystals, Fields and Fabrics: Metaphors of Organicism in Twentieth-century Developmental Biology. New Haven, CT 1976. Harrington, Anne. Reenchanted Science: Holism in German Culture from Wilhelm II to Hitler. Princeton, NJ 1997. Hau, Michael. The Cult of Health and Beauty in Germany: A Social History. Chicago 2003. Haxthausen, C., and H. Suhr, eds. Berlin: Culture and Metropolis. Minneapolis, MN 1990. Herf, Jeffrey. Reactionary Modernism: Technology, Culture, and Politics in Weimar and the Third Reich. Cambridge 1984. Hinrichs, Peter. Um die Seele des Arbeiters: Arbeitspsychologie, Industrie- und Betriebssoziologie in Deutschland. Cologne 1981. Holtgrewe, Ursula. “Die Arbeit der Vermittlung. Frauen am Klappenschrank.” Hessiche Blätter für Volks- und Kulturforschung, n.s., 24 (1989): 113–24. Hong, Young-Sun. Welfare, Modernity, and the Weimar State. Princeton, NJ 1998. Hubenstorf , Michael. “Elektrizität und Medizin.” In Technik und Medizin, ed. Rolf Winau, 241–57. Düsseldorf 1993. Hughes, Thomas. Networks of Power: Electrification in Western Society, 1880–1930. Baltimore, MD 1983. ———, ed. Ein Mann vieler Eigenschaften: Walther Rathenau und die Kultur der Moderne. Berlin 1990. Huyssen, Andreas. “Mass Culture as Woman: Modernism’s Other.” In After the Great Divide: Modernism, Mass Culture, Postmodernism, 44–62. Bloomington, IN 1986. Jaeger, S., and I. Stäuble. “Die Psychotechnik und ihre gesellschaftlichen Entwicklungs-bedingungen.” In Die Psychologie des 20. Jahrhunderts, ed. F. Stoll, 53–94. Zürich 1981. Kaes, Anton. “Metropolis: City, Cinema, Modernity.” In Expressionist Utopias: Paradise, Metropolis, Architectural Fantasy, ed. T. Benson, 146–65. Los Angeles, 1993. ———, ed. Kino-Debatte: Texte zum Verhältnis von Literatur u. Film 1909–1929. Munich 1978. Kater, Michael. “Professionalization and Socialization of Physicians in Wilhelmine and Weimar Germany.” Journal of Contemporary History 20 (1985): 677–701. Kaufmann, Doris. “Science as Cultural Practice: Psychiatry in the First World
286 SELECTED BIBLIOGRAPHY
War and Weimar Germany.” Journal of Contemporary History 34, no. 1 (January 1999): 125–44. Kern, Stephen. The Culture of Time and Space 1880–1918. Cambridge, MA 1983. Killen, Andreas. “From Shock to Schreck: Psychiatrists, Telephone Operators, and Traumatic Neurosis in Germany 1900–1926.” Journal of Contemporary History 38, no. 2 (April 2003): 201–20. ———. “Weimar Psychotechnics between Americanism and Nazism.” Unpublished manuscript. Kittler, Friedrich. Discourse Networks 1800/1900. Stanford, CA 1990. Kocka, Jürgen. Facing Total War: German Society 1914–1918. Cambridge, MA 1984. Kracauer, Siegfried. The Mass Ornament. Chicago 1995. ———. The Salaried Masses: Duty and Distraction in Weimar Germany. New York 1998. Labisch, Alfons. “Doctors, Workers and the Scientific Cosmology of the Industrial World: The Social Construction of ‘Health’ and the ‘Homo Hygienicus.’ ” Journal of Contemporary History 20 (1985): 599–615. ———. Homo Hygienicus: Gesundheit und Medizin in der Neuzeit. Frankfurt 1992. Ladd, Brian. The Ghosts of Berlin: Confronting German History in the Urban Landscape. Chicago 1997. Lange, Anne-Marie. Berlin zur Zeit Bebels und Bismarcks. Berlin 1976. Large, David Clay. Berlin. New York 2000. Leed, Eric. No Man’s Land: Combat and Identity in World War I. Cambridge 1979. Leibbrand, Werner, and Anne-Marie Wettley. Der Wahnsinn: Geschichte der abendländischen Psychiatrie. Munich 1961. Lenoir, Timothy. “Models and Instruments in the Development of Electrophysiology, 1845–1912.” Historical Studies in the Physical and Biological Sciences 17, no. 1 (1986): 1–54. ———. “Social Interests and the Group of 1847.” In Science in Reflection, ed. E. Uhlmann-Margalit, 169–91. Dordrecht 1988. Lerner, Paul. “From Traumatic Neurosis to Male Hysteria: The Decline and Fall of Hermann Oppenheim, 1889–1919.” In Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age, 1870–1930, ed. M. Micale and P. Lerner, 140–71. Cambridge 2001. ———. Hysterical Men: War, Psychiatry, and the Politics of Trauma in Germany 1890–1930. Ithaca, NY 2003. Lesky, Erna. The Viennese Medical School of the 19th Century. Baltimore, MD 1976. Leys, Ruth. “Traumatic Cures.” Critical Inquiry 20 (1994): 623–62. Lunbeck, Elizabeth. The Psychiatric Persuasion: Knowledge, Gender and Power in America. Princeton, NJ 1994. Lütke, Alf, Inge Marssolek, and Adelheid von Saldern, eds. Amerikanisierung: Traum und Alptraum in Deutschland des 20. Jahrhunderts. Stuttgart 1996. Lutz, Tom. American Nervousness 1903. Ithaca, NY 1991. McHenry, Lawrence. Garrison’s History of Neurology. Springfield, MA 1969.
SELECTED BIBLIOGRAPHY 287
Micale, Mark. Approaching Hysteria: Disease and Its Interpretations. Princeton, NJ 1995. ———. “Charcot and the Idea of Hysteria in the Male: Gender, Mental Science, and Medical Diagnosis in Late 19th Century France.” Medical History 34 (1990): 363–411. Micale, M., and P. Lerner, eds. Traumatic Pasts: History, Psychiatry, and Trauma in the Modern Age 1870–1930. Cambridge 2001. Milles, Dietrich. “Nervenbelastung oder nervöse Veranlagung—das medizinische Urteil über Telephonunfälle und Telefonistinnenkrankheiten.” In Das Fräulein vom Amt, ed. H. Gold and A. Koch, 94–108. Munich 1993. Möller, Hans-Jürgen. Die Begriffe “Reizbarkeit” und “Reiz.” Stuttgart 1975. Moser, Gabrielle. “Der Arzt im Kampf gegen ‘Begehrlichkeit und Rentensucht’ im Kaiserreich und in der Weimarer Republik.” Jahrbuch für kritische Medizin 16 (1992): 161–83. Nadav, Daniel. “Julius Moses und Alfred Grotjahn: Das Verhalten zweier sozialdemokratischer Ärzte zu Fragen der Eugenik und Bevölkerungspolitik.” In Der Wert des Menschen: Medizin in Deutschland 1918–1945, ed. C. Pross and G. Aly, 143–52. Berlin 1989. Nienhaus, Ursula. “Unter dem Reichsadler: Postbeamtinnen und ihre Organisation 1908–33.” 1999: Zeitschrift für Sozialgeschichte des 20.–21. Jahrhunderts 3 (1990): 56–79. ———. Vater Staat und seine Gehilfinnen: Die Politik mit der Frauenarbeit bei der deutschen Post (1864–1945). Frankfurt 1995. Nolan, Mary. Visions of Modernity: American Business and the Modernization of Germany. New York 1994. Oppenheim, Janet. Shattered Nerves: Doctors, Patients and Depression in Victorian England. New York 1991. Osietzki, M. “Weiblichkeitsallegorien der Elektrizitat als ‘Wunschmaschinen.’ ” Technikgeschichte 63 (1996): 47–70. Peukert, Detlev. “The Genesis of the ‘Final Solution’ from the Spirit of Science.” In Nazism and German Society, ed. D. Crew, 274–99. New York 1994. ———. Max Webers Diagnose der Moderne. Göttingen 1989. ———. The Weimar Republic: The Crisis of Classical Modernity. New York 1989. Pick, Daniel. Faces of Degeneration: A European Disorder 1848–1918. Cambridge 1989. Plitzner, Klaus, ed. Die Elektrizität in der Geistesgeschichte. Bassum 1998. Podoll, K. “Der Telephonunfall—ein Beitrag zur Geschichte der traumatischen Neurosen.” Fortschritte der Neurologie und Psychiatrie 59 (1991): 387–93. Proctor, Robert. Racial Hygiene: Medicine under the Nazis. Cambridge, MA 1988. Querrien, Anna. “The Metropolis and the Capital.” In Zone 1/2: The Contemporary City, ed. M. Feher and S. Kwinter, 218–25. New York 1986. Rabinbach, Anson. “Betriebspsychologie zwischen Psychotechnik und Politik während der Weimarer Republik: Der Fall Otto Lipmann.” In Betriebsärzte und produktionsbezogene Gesundheitspolitik, ed. Dietrich Milles, 41–64. Bremerhaven 1992. ———. The Human Motor: Energy, Fatigue, and the Origins of Modernity. New York 1990.
288 SELECTED BIBLIOGRAPHY
———. “Neurasthenia and Modernity.” In Incorporations, ed. Jonathan Crary and Sanford Kwinter, 178–89. New York 1992. ———. “Social Knowledge, Social Risk, and the Politics of Accidents in Germany and France.” In States, Social Knowledge, and the Origins of Modern Social Policies, ed. D. Rueschmeyer and T. Skocpol, 48–89. Princeton 1996. Rabinow, Paul. French Modern: Norms and Forms of the Social Environment. Cambridge, MA 1989. Radkau, Joachim. Das Zeitalter der Nervosität: Deutschland zwischen Bismarck und Hitler. Munich 1998. ———. “Die wilhelminische Ära als nervöses Zeitalter; oder, Die Nerven als Netz zwischen Tempo- und Körpergeschichte.” Geschichte und Gesellschaft 20 (1994): 211–41. Riedesser, Peter, and Axel Verderber. Maschinengewehre hinter der Front: Zur Geschichte der deutsche Militärpsychiatrie. Frankfurt 1996. Riese, Walter. History of Neurology. New York 1959. Ritter, Gerhard. Social Welfare in Germany and Britain. Leamington Spa 1986. Roelcke, Volker. “Biologizing Social Facts: An Early 20th Century Debate on Kraepelin’s Concepts of Culture, Neurasthenia, and Degeneration.” Culture, Medicine, and Psychiatry 21 (1997): 383–403. Rose, Nikolas. Governing the Soul: The Shaping of the Private Self. London 1989. Rosenberg, Charles. “The Place of Beard in 19th Century Psychiatry.” Bulletin of the History of Medicine 36 (1962): 245–59. Roth, Karl-Heinz. “Die Modernisierung der Folter in den beiden Weltkriegen: Der Konflikt der Psychotherapeuten und Schulpsychiater um die deutschen ‘Kriegsneurotiker’ 1915–1945.” 1999: Zeitschrift für Sozialgeschichte 3 (1987): 8–75. ———. “Schein-Alternativen im Gesundheitswesen: Alfred Grotjahn (1869–1931).” In Erfassung zur Vernichtung: Von der Sozialhygiene zum “Gesetz über Sterbehilfe,” ed. K.-H. Roth, 31–56. Berlin 1984. Rowbottom, Margaret, and Charles Susskind. Electricity and Medicine: History of Their Interaction. San Francisco 1984. Santner, Eric. My Own Private Germany: Daniel Paul Schreber’s Secret History of Modernity. Princeton, NJ 1996. Schiller, Francis. A Möbius Strip: Fin-de-Siècle Neuropsychiatry and Paul Möbius. Berkeley, CA 1992. ———. “Neurology: The Electrical Root.” In Historical Aspects of the Neurosciences, ed. F. Clifford Rose and W. F. Bynum, 1–11. New York 1982. Schivelbusch, Wolfgang. Disenchanted Night: The Industrialization of Light in the 19th Century. New York 1988. ———. The Railway Journey: The Industrialization of Time and Space in the 19th Century. Berkeley, CA 1986. Schmiedebach, Heinz-Peter. “Post-Traumatic Neurosis in Nineteenth-Century Germany: A Disease in Political, Juridical and Professional Context.” History of Psychiatry 10, no. 1 (1999): 27–58. ———. Psychiatrie und Psychologie im Widerstreit: Die Auseinandersetzung
SELECTED BIBLIOGRAPHY 289
in der berliner medizinisch-psychologisch Gesellschaft (1867–1899). Husum 1986. Shorter, Edward. From Paralysis to Fatigue: A History of Psychosomatic Illness in the Modern Era. New York 1992. ———. “Private Clinics in Central Europe 1850–1933.” Social History of Medicine 3 (1990): 159–95. Showalter, Elaine. The Female Malady: Women, Madness, and English Culture, 1830–1980. New York 1986. Siemens, Georg. History of the House of Siemens. New York 1977. Stainbrook, Edward. “Use of Electricity in Psychiatric Treatment during the 19th Century.” Bulletin of the History of Medicine 22 (1948): 156–77. Starobinski, Jean. “A Short History of Body Consciousness.” Humanities in Review 1 (1982): 22–39. Steen, Jürgen, ed. “Eine Neue Zeit . . . !” Die Internationale Elektrotechnische Austellung 1891. Frankfurt 1991. Steiner, Andreas. Das nervöse Zeitalter: Das Begriff der Nervosität bei Laien und Ärzten in Deutschland und Österreich um 1900. Zürich 1964. Sternberger, Dolf. Panorama of the 19th Century. New York 1977. Tennstedt, Florian. Vom Proleten zum Industriearbeiter: Arbeiterbewegung und Sozialpolitik in Deutschland, 1800 bis 1914. Cologne 1983. Theweleit, Klaus. Male Fantasies, vols. 1 and 2. Minneapolis, MN 1987–89. Tröger, Annemarie. “The Construction of a Female Assembly Line Proletariat.” In When Biology Became Destiny, ed. R. Bridenthal, A. Grossmann, and M. Caplan, 237–70. New York 1984. Tuchmann, Arleen. Science, Medicine and the State: The Case of Baden 1815–1871. New York 1993. Ulrich, Bernd. “Nerven und Krieg: Skizzierung einer Beziehung.” In Geschichte und Psychologie: Annäherungsversuche, ed. Bedrich Loewenstein, 163–91. Pfaffenweiler 1992. Ulrich, B., and B. Ziemann, eds. Frontalltag im Ersten Weltkrieg: Wahn und Wirklichkeit. Frankfurt 1994. Usborne, Cornelie. Frauen Körper—Volks-Körper: Geburtenkontrolle und Bevölkerungspolitik in Weimarer Republik. Münster 1994. Ward, Janet. Weimar Surfaces: Urban Visual Culture in 1920s Germany. Berkeley, CA 2001. Wehler, Hans-Ulrich. “Der Aufstieg des organisierten Kapitalismus und Interventionsstaates in Deutschland.” In Organisierter Kapitalismus, ed. H. Winkler, 36–57. Göttingen 1973. ———. The German Empire, 1871–1918. Leamington Spa 1985. Weiher, Siegfried von. Berlins Weg zur Elektropolis: Technik- und Industriegeschichte an der Spree. Göttingen 1987. Weindling, Paul. “Eugenics and the Weimar Welfare State.” In The State and Social Change in Germany 1880–1980, ed. Eve Rosenhaft, 131–60. New York 1990. ———. Health, Race and German Politics between National Unification and Nazism 1870–1945. Cambridge 1989. ———. “Medical Practice in Imperial Berlin: The Casebook of Alfred Grotjahn.” Bulletin of the History of Medicine 61 (1987): 391–410.
290 SELECTED BIBLIOGRAPHY
Weingart, Peter, Jürgen Kroll, and Kurt Bayertz. Rasse, Blut, und Gene: Geschichte der Eugenik und Rassenhygiene in Deutschland. Frankfurt 1992. Weiss, Sheila Faith. Race Hygiene and National Efficiency: The Eugenics of Wilhelm Schallmayer. Berkeley, CA 1987. Whalen, Robert. Bitter Wounds: German Victims of the Great War 1914–1939. Ithaca, NY 1984. Winau, Rolf, ed. Neurologie in Berlin. Berlin 2000. Young, Allan. The Harmony of Illusions: Inventing Post-Traumatic Stress Disorder. Princeton, NJ 1995. Young, Robert M. Mind, Brain and Adaptation in the 19th Century: Cerebral Localization and Its Biological Context from Gall to Ferrier. Oxford 1970.
Index
Ackerknecht, Erwin, 56, 62 AEG (Allgemeine ElektrizitätsGesellschaft), 22, 24, 67, 68, 145 agoraphobia, 55–56, 70 Americanism, 182, 183, 185, 195, 213, 214 Angestelltenversicherungsgesetz, 172 Antineurasthin, 38 anti-Semitism, 37, 84, 134 Association of German Railway Doctors, 97 Baudelaire, Charles, 23 Beard, George Miller, 2, 4, 42, 49, 50–52, 59, 65, 73, 108, 208 Bebel, August, 90 Beck, Ulrich, 212, 272n19 Becker, Ludwig, 113 Beelitz Heilstätten, 116–20 Behrens, Peter, 24 Benda, Theodor, 93, 107 Benedikt, Moritz, 69, 76 Benjamin, Walter, 3, 12, 20, 23, 163 Berger, Paul, 66 Bergson, Henri, 36, 175 Berlin, 8–9, 163; as “American” city, 24; as Beamtenstadt (Sombart), 3, 25, 184; as capital of the electrotechnical industry, 15; as capital of the second industrial revolution, 20–26; as center of neurological teaching, 54; conservative imagery of, 217; as Elektropolis, 22; as “giant electrical
motor” (Friedell), 26; as Industriestadt (Rathenau), 3, 25; as Socialist stronghold, 90, 125; transformation from Handwerkstadt, 22, 35; as wartime capital, 144; during Weimar period, 184–85; as “woman,” 272n23; as world city, 15, 16 Berlin Alexanderplatz, 7, 213, 214 Berlin Regional Insurance Office (Landesversicherungsamt, LVA), 116, 119, 120 Berlin Society for Sexual Science and Eugenics, 64, 73, 120, 176 Berlin Trade Exhibition (1896), 15–20, 22, 25, 35, 46, 184, 216, 217, 218 Bernhard, Ludwig, 125–26 Bernhardt, Martin, 54, 64, 165, 166, 175 Bernheim, Hyppolite, 71, 72 Bessel, Richard, 154, 182 Binswanger, Otto, 69, 84, 114 Bismarck, Otto von, 37, 40, 88 Bonhoeffer, Karl, 124, 134, 136, 153, 159–60, 208, 209 Boruttau, Heinrich, 128, 145–49, 158 Boulogne, Duchenne de, 50 Bourke, Joanna, 104, 145, 153 Brähmer, Otto, 93 brain-work. See mental labor Breuer, Joseph, 230n132 Brücke, Ernst, 29 Bruns, Ludwig, 104, 109 Buch hospital, 159, 213 Bumke, Oswald, 3–4, 6, 134, 208
291
292 INDEX Bumm, Ernst, 175 bureaucratization, 145, 154, 164, 181, 185, 206–7 Caplan, Eric, 96 Charcot, Jean-Martin, 42, 44, 49, 69, 71–72, 74, 92, 96, 103, 109, 111, 113 Charité Neurological and Psychiatric Clinic (Berlin), 33, 54, 68, 70, 81–82, 91, 107, 110, 112, 123–24, 127, 132–33, 134, 154, 208, 209 cinema, 214–16 clinics: private, 63–64, 66, 68, 103, 134; provincial, 106; university, 55, 134. See also nerve clinics contagion (psychic), 136, 166, 176–77, 190 crowd psychology, 84, 177, 240n9 Dalldorf asylum (Berlin), 110 degeneration, 36, 38, 41, 42, 120, 123, 128, 176, 213, 227–28n104 Didi-Hubermann, Georges, 113 Döblin, Alfred, 7, 9, 23–24, 213 Doerner, Klaus, 33, 57, 63, 78, 131 Doherty, Brigid, 218 Du Bois-Reymond, Emil, 8, 29–30, 146, 173, 174 Edison, Thomas, 20, 32, 51–52 Eghigian, Greg, 10, 89, 94, 207 Eisenstadt, H. L., 175–76 electricity, 15–20, 24; and Berlin, 8, 22; effects of on self, 26–29; public image of, 214; and telephone operators, 164, 173, 186, 187–88; and trauma, 165; as treatment, 5–6; and women, 222n18 electrocutions, 166 electrodiagnosis, 53–54, 87, 98–101, 110, 138 electropathology, 165 electrotherapy, 65, 66–68; at the Charité, 55, 233n30; conference on (Frankfurt, 1891), 75–78; critique of, 75–78, 98, 114, 149–52; Kaufmannization, 127–28, 138–44, 146, 148, 149, 150, 152, 214; influence machine, 48, 72, 77; and neurasthenia, 50, 168; and neurology, 62; and suggestion, 79; and World War I, 49 Eloesser, Arthur, 103 Erb, Wilhelm, 49, 52–54, 61, 69, 71, 73, 76, 77–79, 87 Erichsen, John, 86, 96 eugenics, 38, 41, 121–23, 207, 214
Eulenburg, Albert, 16, 17, 26, 48, 54, 63–64, 76, 77–78, 129, 165, 175 euthanasia, 153 Ewald, Francois, 10 fatigue, 11, 147, 166, 196 Fechner, Gustav Theodor, 32, 46, 109 Ferenczi, Sandor, 254n28 Der Fernsprecher, 171, 172, 174 Feyerabend, Ernst, 188, 204 First International Electricity Exhibition (Paris, 1881), 20; Nietzsche on, 222n15 Fischer-Homberger, Esther, 86, 95, 111 Fordism, 182 Foucault, Michel, 6, 45, 89 Franco-Prussian War, 56 Fraulein von Amt. See telephone operators Freud, Sigmund, 4, 6, 9, 10, 14, 44–45, 49, 52, 63, 72, 74, 103, 150–51, 152, 176, 216, 230n132 Freund, Richard, 119, 120 Friedell, Egon, 22, 26 Fritsch, Gustav Theodor, 50 Fritzsche, Peter, 25, 103, 212 Gaupp, Robert, 141 Gay, Peter, 185 Giedion, Siegfried, 19 Giese, Fritz, 183, 185, 195–200 Girlkultur, 183, 195 Goldscheider, Alfred, 26–27, 54, 99 Goldstein, Kurt, 210 Griesinger, Wilhelm, 16, 33–34, 36, 54, 57, 109 Grosz, George, 161, 214, 218 Grotjahn, Alfred, 38–41, 73–74, 83–84, 113, 120–23, 129, 176, 214, 228n112, 251n213 gymnastics, 198 Haas, Willy, 216–17 Hacking, Ian, 112 Hansen, Miriam, 216 Harden, Maximilien, 16 Hartmann, Kurt, 31, 38 Hartmannbund, 101 Haus Schönow, 67, 114–15, 116, 117–18, 121, 127, 150, 155, 158, 171 Hecker, Ewald, 70 Hellpach, Willy, 27, 43, 66, 84–85, 90, 111, 141 Helmholtz, Hermann von, 8, 29–30, 53, 60, 109, 146, 173, 174 Hitzig, Eduard, 50, 56, 108
INDEX 293 Hoche, Alfred, 129, 153 Horn, Paul, 110 human sciences, 6, 45, 228n112 hypnosis, 139 hysteria, 42, 50, 71, 153, 175, 213; as female malady, 60; history of, 2; male, 10, 44, 61, 72, 92, 96, 104, 112, 182, 229n129; and simulation, 71, 103; and social class, 84, 85, 141; and telephone operators, 165, 166, 176–77; war, 44, 130, 133, 135, 142, 160 Imperial Health Office, 36, 116, 215 Imperial Insurance Office. See Reich Insurance Office industrial psychology. See psychotechnics Institute for Industrial Psychotechnics, 200 intelligence tests, 112 International Electricity Exhibition (Frankfurt, 1891), 20, 48, 63 Janet, Pierre, 109 Jaspers, Karl, 175 Jellinek, Stefan, 165 Jews, 2, 185, 235n64; and Berlin, 8, 23, 63; “Jewish medicine,” 3, 207; and nervousness, 60, 79; and neurology, 63, 91, 134, 190 Jolly, Friedrich, 55 Jünger, Ernst, 149 Kaiser Wilhelm Institute for Labor Physiology (KWI), 145, 148, 194 Kapp, Ernst, 30–31 Kaufmann, Doris, 39, 143 Kaufmann, Fritz, 79, 139–40 Kaufmannization. See electrotherapy Kittler, Friedrich, 22, 221n33 Koenig, Wilhelm, 110 Köhler, Heinrich, 116 Kolshorn, Else, 170, 204 Kozlowski, Michael, 80, 142, 143, 149, 150–51 Kracauer, Siegfried, 12, 25, 184, 194, 199–200, 207, 217–18; on the “mass ornament,” 25, 183, 218 Kraepelin, Emil, 36, 76, 97, 111, 131 Kriegszitterer, 130, 131, 152, 159, 161, 210, 213, 218 Kurella, Hans, 167–68, 175 Labisch, Alfons, 88 Laehr, Max, 36, 67, 115, 118 Lamprecht, Karl, 33, 84 Lang, Fritz, 28, 214, 216, 217, 271n8
Laquer, Leopold, 76, 77, 78 law of conservation of energy, 11, 17, 20, 32, 145, 146, 226n83, 235n59. See also thermodynamics Leed, Eric, 130 Leipzig, 75, 84 Lerner, Paul, 10, 92, 128, 134, 135, 140, 142, 144 Lipmann, Otto, 200, 201, 202 Ludwig, Carl, 29 Magic Mountain, The, 5 malingering. See simulation Mann, Thomas, 5, 10 Marey, Etienne-Jules, 146 Mendel, Emanuel, 54, 63–64, 108 Mendel, Kurt, 97–98 mental labor, 35, 49, 67, 147–48, 171–75, 194; and neurasthenia, 36, 51, 58–59, 60 Merzbacher, Ludwig, 102 Metropolis (Lang), 28, 214, 216, 217, 218 Meynert, Theodor, 31, 44 Möbius, Paul Julius, 43, 73, 75, 79, 96, 109, 114–15 Moede, Walter, 200, 202 Mohr, Fritz, 144, 145, 148, 149, 158 Moll, Albert, 176 Morel, Benedict-Augustin, 227–28n104 Mosso, Angelo, 146 Münsterberg, Hugo, 29, 194–95, 198, 203, 271n10 Nägeli, Otto, 101–2 National Socialism, 9, 11, 41, 123, 200, 218 nerve clinics, 114–20, 121, 169–71 nerves: compared with telegraph/telephone wires, 30–31, 148, 173–75, 222n18, 226nn75,76, 230n132, 263n52; and electricity, 51, 138, 164, 165, 173, 187, 246n113; relation to neurosis, 78, 138; “rights of” (Benjamin), 3, 90, 114, 219n4 nerve stations, 137, 140, 149, 153 nervous breakdown: and technological breakdown, 28, 165, 173, 185, 188, 213, 267n129 neurasthenia, 51, 208; and bourgeoisie, 6, 42, 58–59, 61, 65; causes of, 6–7; and gender, 61; as mass phenomenon, 6, 38, 40, 82, 83, 114, 116, 121; and mental labor, 36, 51; and modernity, 4, 34, 42; and psychogenesis, 49; relation to hysteria, 42, 43, 50–51, 60–61, 92, 234nn49,52;
294 INDEX neurasthenia (continued) relation to insanity, 34; and social class, 19, 36, 85, 104, 121, 141; and social insurance, 7; somatic theory of, 49, 65; universal, 218; and war, 130, 141 neurology, 50, 52, 61–62, 121; and electrotherapy, 62; and relation to psychiatry, 190, 248n149 neurosis: and accidents, 40, 56, 162, 181; causes of, 132, 142; debates about, 94–98, 130, 134, 142; and gender, 104, 112; pension (Rentenneurose), 101, 124, 138, 154, 155–58, 160, 209; psychogenic theory of, 96–98, 125, 131, 187, 189, 208, 254n28; relation to psychosis, 152; and social class, 93, 112, 141; and social insurance, 92–94, 97; somatic theory of, 91–92, 270n191; statistics on, 93, 166, 238n109; switchboard, 167; traumatic, 56, 82, 91–95, 105, 107, 123–26, 130, 134, 160, 164, 190, 209, 210–11; war, 10, 130, 131, 133, 152, 181, 213. See also simulation New Woman, 12, 182–86 Nieden, Albert, 110 Nienhaus, Ursula, 204 Nietzsche, Friedrich, 1, 118, 175, 250n187; on First International Electricity Exhibition (Paris, 1881), 222n15; on psychology, 42 Nonne, Max, 52, 56 Nordau, Max, 37, 41–42 Office of War Raw Materials, 144 Oppenheim, Hermann, 49, 56, 63, 64, 81, 91–92, 95, 96, 105, 108, 111, 115, 134, 135, 190, 209 organized capitalism, 22, 35, 84, 89 Page, Herbert, 96–97 Paget, James, 96 Paris, 2 Peukert, Detlev, 11, 145, 182, 183 Pick, Daniel, 37 Placzek, Siegfried, 98, 111–12 Postvertrauensärzte, 167, 177, 178, 186 Potsdamer Platz, 23 psychiatry, 112, 134, 153; in asylums, 62; and neurology, 62, 111, 190, 248n149; and November revolution, 153; popular views of, 150; rationalization of, 135, 138–39, 144; and views on heredity, 111–12, 136, 160, 187, 188, 191, 206
psychoanalysis, 151, 235n64 psychology, 41–42 psychopathy, 136, 153, 156, 160, 207 psychotechnics, 35–36, 145, 147, 182, 194–205 Rabinbach, Anson, 11, 29, 31, 57, 91 Rabinow, Paul, 39 racial science, 9, 12, 41, 123 Radkau, Joachim, 9–10, 43 railway, 34, 85, 108, 171; accidents, 12, 82, 85–87, 92, 95–98, 164, 243n63; companies, 87; medicine, 96–98, 111–12; spine, 59, 86 Rathenau, Walther, 3, 25, 144–45, 224n42 rationalization, 11–12, 25, 144, 145, 148, 172, 181–82, 185, 186, 194–205 Reichardt, Martin, 191–92 Reich Insurance Court, 89, 169 Reich Insurance Office (RVA), 81, 91, 93, 98, 101, 102, 107, 110, 117, 119, 120, 124, 209 Reich Interior Ministry, 102, 119, 159 Reich Labor Ministry (RAM), 133, 201, 202, 210, 213 Reich Public Assistance Court, 132, 160 Reichsbahn, 116, 124, 164, 167, 170, 201 Reichsbund der Kriegsbeschädigten, 160 Reichspost, 175, 176, 181, 187 Reichspostministerium (RPM), 164, 166, 167, 175, 177, 178, 179, 186, 188, 193, 201, 204, 209. See also Postvertrauensärzte Reichstag, 40, 119, 150, 167, 170, 179 Rentenneurose. See Neurosis, pension Ribot, Theodule, 109 Rigler, Johannes, 86, 87 risk, 12, 86, 89, 90–91, 212–13 Rose, Nikolas, 122, 143 Rosenberg, Charles, 50 Roth, Emmanuel, 29 Roth, Karl-Heinz, 123 Rubner, Max, 145, 148, 149 Rüdiger, Hedwig, 170 Rupp, Hans, 200, 201, 202 Saenger, Alfred, 100, 110 salaried masses, 25, 172, 184, 185 Salpetriere Hospital (Paris), 42, 50, 71 Schallmayer, Wilhelm, 38 Scheffler, Karl, 24 Schivelbusch, Wolfgang, 12, 22, 28, 85–86, 108, 216 Schlesinger, Georg, 200, 202, 267n129
INDEX 295 Schmiedebach, Heinz-Peter, 54 Schreber, Daniel Paul, 31, 225n65 Schreck. See shock Schultze, Friedrich, 105, 180–81 Schuster, Paul, 98, 100, 103 Schwarz, G. C., 67 scientific management, 145, 178 second industrial revolution, 21; of the mind (Kittler), 22 Seeligmüller, Adolf, 105–6 self-registering attention-measuring apparatus, 198 sexology, 175–76 Siemens, Georg, 162 Siemens, Werner, 8, 30 Siemens (company), 22, 29, 67 shock, 12, 83, 86–87, 92, 95, 97, 137, 155, 168, 240n22, 255n40; electric, 140, 144, 164, 165, 166, 179; Freud on, 210, 216; psychic (Schreck), 137, 166, 168, 187–88, 192 Shorter, Edward, 63, 65, 75 Simmel, Ernst, 151 Simmel, Georg, 9, 12, 16–17, 28, 45–47, 103, 108, 217, 224n55 simulation (of neurosis), 74, 75, 94, 102–8, 113, 141, 150, 168, 190, 245n101 Social Darwinism, 36, 83, 123 Social Democratic Party, 8, 36, 84, 88, 90, 105, 106, 119, 125, 128, 129, 131, 153, 170, 187 social hygiene, 39 social insurance, 10, 18, 39–40, 69, 82, 84–85, 88–91, 121, 122, 167–69, 212; critique of, 82, 90, 101–2, 104, 123–26, 130–31, 154, 177–78, 206–9, 213–14; as pathogenic, 179–80, 190–91, 207–8; revision of law governing accidents, 209 Sombart, Werner, 3, 25, 184 Stein, Sigmund Theodor, 62–63, 67 Stier, Ewald, 134–35, 136–38, 141, 149, 153, 154, 158–59, 160, 161, 187–91, 192–93, 206–10, 213 Stresemann, Gustav, 184 Strümpell, Adolf, 75, 110 Sturm, Engelbert, 38 suggestion, 72–73, 75, 76–77, 97, 140, 152 surveillance, 178–179, 199, 264n69 talking cure, 7, 44 Tausk, Viktor, 151–52 Taylorism, 145, 147, 182, 194, 198, 205
telegraph operators, 34–35 telephone accidents, 28, 162–63, 167–69, 177, 179, 180, 186, 189, 270n175 telephone exchanges, 162, 166, 172–73, 178–79 telephone operators, 20, 28, 161, 162–63, 164, 165, 166, 185–86, 192–93, 213, 218; as New Woman, 184, 185; and social insurance, 167–71, 206–10; as symbol of mental labor, 35, 171–75, 194; and psychotechnics, 194–205 Telephonophobia, 166 thermodynamics, 10, 29, 31, 51, 59, 89, 146, 148, 174, 204. See also Law of conservation of energy Theweleit, Klaus, 149 Tiller Girls, 183, 184, 200 time-and-motion studies, 146, 204 Unter der Reichsadler, 171, 188, 193, 203, 205 Verband der deutschen Post- und Telegraphenbeamtinnen, 170–71, 188, 193, 204, 210 Vienna, 2 Vienna Psychoanalytic Society, 151 Virchow, Rudolf, 32, 39 Virilio, Paul, 216 visual field disorders, 108–14, 192 Vorwärts, 102, 119–20 Vossische Zeitung, 209 Wagner-Jauregg, Julius, 74, 80, 150, 151 Weber, Max, 11, 24, 145, 149, 154 Wehler, Hans-Ulrich, 22 Weindling, Paul, 12, 112 Wernicke, Carl, 31, 169, 174 Westphal, Carl, 54–57, 87, 88–89, 91 Wetzer, Georg, 40, 43 Wilbrand, Hermann, 108 Wilhelm II, 9, 129, 160 Windscheid, Franz, 117 work therapy, 114–20, 121–22, 170 World War 1, 6, 7, 44, 127–30, 144–45, 181 Wundt, Wilhelm, 30, 84, 109, 195 Zahn, Friedrich, 118 Zentralarbeitsgemeinschaft, 182 Ziehen, Theodor, 112, 136 Zimmermann, Waldemar, 108 Zitterer. See Kriegszitterer
WEIMAR AND NOW: GERMAN CULTURAL CRITICISM Edward Dimendberg, Martin Jay, and Anton Kaes, General Editors 1. Heritage of Our Times, by Ernst Bloch 2. The Nietzsche Legacy in Germany, 1890–1990, by Steven E. Aschheim 3. The Weimar Republic Sourcebook, edited by Anton Kaes, Martin Jay, and Edward Dimendberg 4. Batteries of Life: On the History of Things and Their Perception in Modernity, by Christoph Asendorf 5. Profane Illumination: Walter Benjamin and the Paris of Surrealist Revolution, by Margaret Cohen 6. Hollywood in Berlin: American Cinema and Weimar Germany, by Thomas J. Saunders 7. Walter Benjamin: An Aesthetic of Redemption, by Richard Wolin 8. The New Typography, by Jan Tschichold, translated by Ruari McLean 9. The Rule of Law under Siege: Selected Essays of Franz L. Neumann and Otto Kirchheimer, edited by William E. Scheuerman 10. The Dialectical Imagination: A History of the Frankfurt School and the Institute of Social Research, 1923–1950, by Martin Jay 11. Women in the Metropolis: Gender and Modernity in Weimar Culture, edited by Katharina von Ankum 12. Letters of Heinrich and Thomas Mann, 1900–1949, edited by Hans Wysling, translated by Don Reneau 13. Empire of Ecstasy: Nudity and Movement in German Body Culture, 1910–1935, by Karl Toepfer 14. In the Shadow of Catastrophe: German Intellectuals between Apocalypse and Enlightenment, by Anson Rabinbach 15. Walter Benjamin’s Other History: Of Stones, Animals, Human Beings, and Angels, by Beatrice Hanssen 16. Exiled in Paradise: German Refugee Artists and Intellectuals in America from the 1930s to the Present, by Anthony Heilbut 17. Cool Conduct: The Culture of Distance in Weimar Germany, by Helmut Lethen, translated by Don Reneau 18. In a Cold Crater: Cultural and Intellectual Life in Berlin, 1945–1948, by Wolfgang Schivelbusch, translated by Kelly Barry 19. A Dubious Past: Ernst Jünger and the Politics of Literature after Nazism, by Elliot Y. Neaman
20. Beyond the Conceivable: Studies on Germany, Nazism, and the Holocaust, by Dan Diner 21. Prague Territories: National Conflict and Cultural Innovation in Franz Kafka’s Fin de Siècle, by Scott Spector 22. Munich and Memory: Architecture, Monuments, and the Legacy of the Third Reich, by Gavriel D. Rosenfeld 23. The Ufa Story: A History of Germany’s Greatest Film Company, 1918–1945, by Klaus Kreimeier, translated by Robert and Rita Kimber 24. From Monuments to Traces: Artifacts of German Memory, 1870–1990, by Rudy Koshar 25. We Weren’t Modern Enough: Women Artists and the Limits of German Modernism, by Marsha Meskimmon 26. Culture and Inflation in Weimar Germany, by Bernd Widdig 27. Weimar Surfaces: Urban Visual Culture in 1920s Germany, by Janet Ward 28. Graphic Design in Germany: 1890–1945, by Jeremy Aynsley 29. Expressionist Utopias: Paradise, Metropolis, Architectural Fantasy, by Timothy O. Benson, with contributions by Edward Dimendberg, David Frisby, Reinhold Heller, Anton Kaes, and Iain Boyd Whyte 30. The Red Count: The Life and Times of Harry Kessler, by Laird M. Easton 32. The Dark Mirror: German Cinema between Hitler and Hollywood, by Lutz Koepnick 33. Rosenzweig and Heidegger: Between Judaism and German Philosophy, by Peter Eli Gordon 34. The Authority of Everyday Objects: A Cultural History of West German Industrial Design, by Paul Betts 35. The Face of East European Jewry, by Arnold Zweig, with fifty-two drawings by Hermann Struck. Edited, translated, and with an introduction by Noah Isenberg 36. No Place Like Home: Locations of Heimat in German Cinema, by Johannes von Moltke 37. Berlin Alexanderplatz: Radio, Film, and the Death of Weimar Culture, by Peter Jelavich 38. Berlin Electropolis: Shock, Nerves, and German Modernity, by Andreas Killen