by Paul J Croce
way he was critical of materialist science. What William James was learn-
ing in his classes clashed directly with the implicit medical curriculum of
his family’s sectarian therapies.
Chapter Two
Between Scientific and
Sectarian Medicine
If we are doctors, our mind- cure sympathies, if we are mind- curists, our
medical sympathies, are tied up.
William James, 1906
In October 1867, William James set his intellectual sights on Germany. Part
way through his medical training in Cambridge, and with the first glimmer-
ings of interest in psy chol ogy, he was eager to add greater understanding of
physiology. German scientists, including Emil du Bois- Reymond, Hermann
von Helmholtz, Karl Ludwig, and Wilhelm Wundt, were producing pioneering
insights into the bodily functions that shape mind and be hav ior. In order to
comprehend the new physiological psy chol ogy, James immersed in the lan-
guage to allow him to read the German texts and attend lectures. For the first
few months, he could “get no end of German” to prepare for his scientific stud-
ies; then he hoped to work in a laboratory for still more concrete physiological
understanding. 1 But his poor health stood in the way. He suffered from poor digestion, eye and back trou bles, and frequent discouragement that intruded
on his intellectual ambitions. So this young scientist, keen to learn cutting-
edge physiological science, turned to sectarian medicine.
Before heading to Berlin for his studies, James visited Teplitz, in Austrian
Bohemia near Dresden, where he repeatedly returned for the support of its water
cure during his eigh teen months in Eu rope. These were not sojourns to a lei-
surely spa, but earnest efforts to find health improvement so he could return to
his intellectual tasks. And he threw himself into the regimen of hydropathy, the
name that health- care prac ti tion ers used to describe their deliberate investi-
gations of the salubrious effects of water in many forms, at diff er ent tempera-
tures, in diff er ent amounts at diff er ent times, and with internal and external
use. Water cures served as James’s filling stations, where he would get strength
for doing his work, and then those very efforts would set his health back, re-
quiring his return to the water cure.
78 Young William James Thinking
In late January 1868, he was still suffering from his “old dorsal tricks,” and
Teplitz offered bathing, douching, mud baths, and other “sanatory exercises,”
including a poultice that “smells like tar.” He described, a typical day at the
water- cure spa in a letter to his fellow student of physiology Henry Bowditch:
“I bathe 20 minutes at 104 [degrees] Fahr[enheit], have a douche 5 minutes of a
slightly lower temperature, and ½ an hour’s mud- poultice as hot as I can bear”; he combined these precise treatments with long walks, mild foods, and plenty
of rest. And with scientific generalizations beyond his own situation, he pointed
out the therapeutic benefits of water cure “for gout, chronic muscular rheuma-
tism,” and even for “trou bles of the connective tissue whether traumatic or
not.” In explaining the specific purposes of these therapies, his words could
have been written by a water- cure practitioner explaining “congestion” and
the need to expel unhealthy matter from the body: the baths “remove ‘exuda-
tions’ f[ro]m sprained joints, old wounds &c, like a charm, and are likewise of
value in some ner vous diseases.” While embracing the water- cure treatment,
James kept reading, “chiefly nerve- physiology,” while hoping he could gain
enough health “to get doing some laboratory work this summer.” Bowditch
was completing his own M.D. at Harvard and making plans for a similar Eu-
ro pean research trip after his graduation in May 1868. James asked about his
friend’s “pro gress with the microscope” and even provided an insider’s recom-
mendation about which books provided the most facts in “ simple German,” and
which to postpone reading because they were like “molasses waist deep.” To
young William James, there was no contradiction in reading physiology texts
while practicing sectarian medicine— and, in fact, each practice might provide
insights for the other. 2
Q
In 1866, even after five years of scientific study, William James was still
perplexed about his career path. His study of chemistry, anatomy, physiol-
ogy, and natu ral history had convinced him that he was deeply drawn to
learning from the sciences, but he did not picture himself working long
term in any one of these fields. His private writings and discussions and the
expedition to Brazil had convinced him of his appetite for theoretical inqui-
ries, which were starting to give expression to his impatience with the ma-
terialism of scientific investigation, even as he was attracted to the concrete
practicality of scientific work. His vocational questions presented his first
attempts to mediate strongly compelling but contrasting positions, with
careful consideration of each major interest; he resolved to continue his
philosophical reflections, but as an avocation. Physiological study would al-
Between Scientific and Sectarian Medicine 79
low him to apply his speculative appetites to his fledgling interests in psy-
chol ogy, just as this field was itself becoming a science; and medicine would
offer a practical setting for the study of physiology. The healing profession
provided still more and deeper opportunities for mediation of his interests;
he would pursue both the scientific medicine in his schooling and the prac-
tice of alternative sectarian healing for his own health care. Rather than
choosing either scientific or sectarian medicine exclusively, James would
learn from both.
The only degree James ever received was his M.D. from Harvard, which
he earned in June 1869. Given his desultory path to the medical doctorate,
it is tempting to view his medical career as an insignificant way station
toward his well- known work, beginning with psy chol ogy in the next de cade.
And since he earned the degree about the same time he endured his deepest
personal and intellectual discouragements, his encounter with medicine
can seem like an accident of early misdirected vocational choices. These, in
fact, are the main messages of the conventional wisdom about James dur-
ing these years. He never practiced medicine anyway, so how impor tant
could an M.D. have been to him? He himself inaugurated this view as he
approached completion of the degree when he said with characteristic un-
derstatement, “I am ashamed of the fewness of the medical facts I know.”
And he added flatly upon receiving his degree, “I . . . am entitled to write
myself M.D., if I choose”— something he hardly ever did— “so there is one
epoch of my life closed,” while he announced his “intellectual hunger now-
a- days [for] psychological subjects.” James’s own son offered a dismissive
interpretation of his father’s medical education, and relatively few rec ords
survive from these years; for example, there is no extant copy of his medical
> thesis. 3
Yet James’s medical education gave him his first clear professional focus,
and it was the immediate setting for his steps into familial and intellectual
in de pen dence. He was glad for its “general educational value,” because it
enabled him, as he said with a keen social awareness that his social re-
former father would appreciate, “to see a little the inside workings of an
impor tant profession & to learn fm. it as an average example, how all the
work of human society is performed. ”4 Intellectually, it was the field that
bridged his study of the material facts of chemistry and anatomy with his
work evaluating life and consciousness in his personal and philosophical
reflections and, more tangibly, in physiology and psy chol ogy. In vocational
and personal terms, it provided his first exposure to work at asylums for the
80 Young William James Thinking
insane, at a time when his depression and uncertainties would sometimes
make him worry about his own mental stability. In addition, his medical
studies took place while he was in transition from residence at home to an
in de pen dent life. The field of medicine was the launching place for his
career.
Studying in a medical school meant departing from his family’s assump-
tions since the field was a key zone of transition toward the increased
authority of scientific materialism. Medical training was James’s way of
studying physiology; the laboratory research of that work immersed him in
increasingly materialistic assumptions about nature. Even as his studies
pulled him toward the scientific part of the medical profession and gave
him a professional platform for his future psychological work, healing had a
very diff er ent meaning in the James family, whose members practiced a
range of nonmainstream therapies, especially the sectarian systems of hy-
dropathy and homeopathy, that were widely popu lar at the time. These al-
ternative medicines had much in common with his curiosity for spirituality
and alternative mental conditions beyond the chemistry, physics, and anat-
omy that he was learning in his schooling, even as those sectarian medi-
cines also relied on natu ral facts. He could neither fully accept nor wholly
reject all these unorthodoxies, but he also felt the same way about main-
stream scientific medicine. They each laid claim to nature, even as they de-
fined its character in diff er ent ways. His early work in medicine, in both his
academic studies and his personal experience, would bring him to another
theater of his reflective tensions about the messages of science and religion,
and the roles of body and mind, with still more reasons to consider both
material and immaterial parts of life in relation.
Medical Science in Clinic and Lab
In the 1860s, medicine was in the midst of a revolution that would lead to
the modern scientific character of the mainstream field; and in Cambridge
and Germany, James experienced some of the most influential institutional
and intellectual developments that would spur these changes. Medicine was
shifting from a clinical field to a profession grounded in laboratory science,
and the science central to the new medicine was physiology. Young William
James looks in retrospect like a troubled soul, ambivalently shifting from
field to field in search of vocation and direction. However, a view of his
career path from outside his own reflective, often troubled consciousness or
from before the takeoff of his celebrated career in the 1870s would include
Between Scientific and Sectarian Medicine 81
no surprise for his early choices. After coursework in chemistry and physics,
and experience with natu ral history, he worked in anatomy and physiology,
including study in Germany, on the way to his degree in medicine. He was
heading toward authoritative understanding of the emerging university-
based, research- oriented wing of the healing profession.
James’s early medical education was rooted in the French clinical style,
which had been strongly influencing American medicine since the early
nineteenth century. The initial spurs to the French innovations were the
ideologies and experiences of the Revolutionary and Napoleonic eras: with
a nascent demo cratic professionalism, doctors became at once an educated
elite and a group in ser vice to the people; and the massive wars provided
ample opportunities to hone surgical and other medical techniques in the
urgency of crisis conditions. French doctors overturned previous specula-
tive theories and developed empirical approaches based on careful, clinical
observations at the bedsides of injured and sick patients. By the 1830s, French
clinics had become the envy of the world, and Paris became a magnet for
doctors in training— including many of the teachers at Harvard Medical
School, most notably Jeffries Wyman, Oliver Wendell Holmes, Se nior, Jacob
Bigelow, and Jacob’s son Henry Jacob Bigelow.
The French clinics brought great innovations in the practice of medicine,
including an insistence on better training in anatomy and pathology, statis-
tical recordkeeping from direct observations, the use of scalpels, and the
invention of the stethoscope, all of which extended the doctor’s empirical
reach, enabling a systematic correlation of symptoms with specific anatom-
ical prob lems in par tic u lar organs, discovered through careful examination
of patients or through autopsies after their death. This pro gress also brought
the first steps toward modern commodification of the body, with doctors
concentrating on body parts and on disease entities often with neglect of
personal attention to the patient as a whole living person. For good or ill,
the French clinics encouraged assessment of sickness in terms of uniform
diseases rather than as the specific conditions of individuals. The French
practices appealed to Americans’ keen commitments to Baconian empiricism
with careful fact gathering and the avoidance of hasty speculation. While
all physicians did not agree with the “French impulse,” clinical approaches
promised to bring realistic assessments of health and sound bases for thera-
peutic judgment. Also, clinical analy sis depended on the evaluation of
numerous patient cases to find patterns, and this coincided with the in-
creasingly probabilistic thinking throughout scientific and social thought.
82 Young William James Thinking
In all these fields, investigators assumed interchangeable uniformity of
parts and counted the prevalence of par tic u lar conditions. And just as pre-
Darwinian science gradually became tacitly more secular, so clinical medi-
cine, in its eagerness to assess facts and its identification of diseased parts
as the causes of par tic u lar symptoms, became increasingly materialistic. 5
Whether understood as scientific pro gress or as strides toward impersonal
treatment, these were the working assumptions that James encountered at
Harvard Medical School in the 1860s.
More than one thousand Americans studied medicine in Paris from the
1820s to the 1850s. When they returned brimming with enthu
siasm for the
French empirical observations and analyses, they helped to make clinical
practices the norm for mainstream medical practice by midcentury. Still,
for all of its epistemological advantages, the French school met with re sis-
tance from both unorthodox prac ti tion ers and mainstream doctors, because
it was perceived to focus too much on diagnosis without enough attention
to the doctor’s primary duty to heal. Nurtured by the American pride of
place distinct from Eu rope, Americans also put a strong emphasis on the
princi ple of specificity, the medical view that diseases were not uniform
entities but were specific to par tic u lar people, times, and places. According
to this outlook, medical treatment was a highly personalized art, with at-
tention to changes in diseases within individuals or specific circumstances.
By contrast, the French offered therapeutic “routinism,” with its numerical
observation of vast numbers of patients and a seemingly cold view of suffer-
ing; many French doctors even seemed downright eager for their patients’
deaths to enable autopsies for discovery of the bodily explanation behind
the symptoms. Many Americans resisted this moral coldness even as they
welcomed French clinical research and diagnostic insights. In fact, through-
out the early to middle nineteenth century, mainstream medical therapies
remained in general largely unreliable until substantial scientific improve-
ments in the late nineteenth century. James sympathized with this therapeu-
tic skepticism— hence his 1864 comment that “a doctor does more by . . . moral
effect” than with the remedy substances themselves.6 Mainstream medi-
cine remained restless for medical knowledge that would improve healing,
with clinical innovations increasingly regarded as only a way station to a
brighter therapeutic day.
The French clinics, born in a nation with a strong state and traditions of
hierarchy, were in fact difficult to replicate in the United States where there
were many fewer formal structures during the early to middle nineteenth
Between Scientific and Sectarian Medicine 83
century, including in medical education. On the American scene, most pro-
spective doctors took up an apprenticeship with a practicing physician.