Friday, August 26, 2005

Imagination

The Lancet: "Imagination

Lars Ole Andersen

Until a few centuries ago, imagination had a far more specific meaning than today's association with flights of fancy and artistic talent. It referred to how the mind and body could impose upon each other, and how disease could be influenced by the mind.

Imagination was the messenger that transferred and translated information from the senses into the mind. It also passed messages in the other direction: translating thoughts into a language amenable to the body through the spirits or passions. For instance, if a person saw a plague victim the imagination could create the same symptoms in the viewer, or if a pregnant woman was frightened by a deformed beggar the “maternal imagination” could cause the same deformity on the sensitive fetus. That which previously had been explained as a punishment from God was, from the 16th century, often explained as caused by the imagination.

From the 18th century, this secular notion of the imagination and disease was gradually replaced by biologically orientated explanations, such as fetal abnormality or genetic defect, while the “influence of the imagination” became part of superstition and folk belief. Even so, a medicalised and gendered version of imagination persisted. During the 19th century, dozens of articles in The Lancet referred to the effects of “maternal imagination” and “maternal impression”. At the same time, however, within the medical profession, the power of “imagination” was increasingly deprecated and circumscribed. Only “dangerous quacks” and fringe practitioners of mesmerism, homoeopathy, and the like were held to exploit patients' imaginations. It was not a power to be associated with qualified gentlemen practitioners. Despite attempts by physicians like John Haygarth (1740–1827) and the alienist Daniel Hack Tuke (1827–95) to reinsert imagination into the therapeutic armamentarium, it was largely consigned to the arts—as the inimitable ingredient for great literature and music.

In the 20th century, the notion of mind over body was thoroughly medicalised, but the name of the object involved was no longer imagination, but rather “suggestion”, “psychosomatics”, and “the placebo effect”. Imagination in medicine is gone, but somatic medicine more than ever is riddled with imagination."

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