WHEN MOST OF us hear the term "medical history," we probably think of the forms we have to fill out during a doctor's visit: The catalog of past illnesses, chronic pains, allergies, injuries, surgeries, and genetic quirks that accrue into a medical record. Anne Harrington uses the term differently. She believes that diseases have histories, the same way political institutions or art forms do, and that as people have changed the way they think about certain diseases, they've changed the way they feel when they have them.
It's one of the arguments Harrington, a professor and chair of Harvard's department of the history of science, makes in her new book, "The Cure Within," a history of mind-body medicine in the Western world. Looking at everything from the placebo effect to the evolution of hypnosis, from biofeedback to exorcism to psychotherapy to shell shock to the gospel of Norman Vincent Peale, she traces the ways in which certain ideas have emerged again and again: That illness is the body's way of working through psychological trauma, that positive thinking can cure us, that the pace and atomization of modern life make us sick.
Harrington isn't out to debunk the germ theory of medicine - she isn't trying to prove that it's simply our mind-set, rather than microbes and mutations, that makes us ill. And in her book she largely avoids taking sides on the questions of what works and what doesn't. But the history she traces yields ample evidence of the power and tenacity of the belief that the mind can cripple the body - and heal it.
It's a belief that Harrington herself shares. She has been not merely a chronicler of the history of mind-body medicine, but a participant in the debates around it. She has helped design protocols to test the idea that group therapy sessions help late-stage cancer patients live longer, has participated in an investigation into trance states, and has helped facilitate discussions between neuroscientists and Tibetan Buddhist monks.
"I am not a skeptic," Harrington says, "about the mind-body connection."
IDEAS: One of the things I learned reading the book is that there's no word for "hot flashes" in Japanese because menopausal women there don't get them.
HARRINGTON: This is the work of an anthropologist named Margaret Lock, who looked at older Japanese women and found that this very common symptom of menopause in Western countries didn't seem to be widely known in Japan.
IDEAS: How does she explain that?
HARRINGTON: Some people said maybe this really has to do with the fact that they eat a lot more soy, and we know that soy contains chemicals that closely mimic the action of estrogen. But they did further studies that were able to rule that out, according to Lock, and so we're left with at least the possibility that it might have something to do with the fact that in Japan there's a different understanding of what it means to be an older woman, and that the body is listening to the culture.
IDEAS: Are there other examples you've found of this sort of thing?
HARRINGTON: Another area is stress. There's really quite compelling evidence that we've only been stressed in the way that we now experience the phenomenon since the postwar era, and that before that people responded to the trials and challenges of modern life with quite a different complex of symptoms
IDEAS: What were those?
HARRINGTON: It was fatigue, it was exhaustion. Instead of being overwrought and blowing their top they would take to their beds. They couldn't stand bright lights. That doesn't look like our stress, but it all made perfect sense within a certain kind of script at the time that told people what it was like to suffer from what was called "bad nerves." People were "nervous" back then; today we're "stressed."
IDEAS: What did people think caused "bad nerves"?
HARRINGTON: They had some idea of their nerves having been depleted beyond their ability to regenerate, that they'd used up all their nerve energy. And the remedies for nervousness were very different than the remedies that we apply to make ourselves less stressed. They involved in some instances giving patients electrical stimulation because they literally were trying to replenish their nerves. Or in the case of men it involved sending them out of the nerve-depleting world of modern civilization, out into the wilderness.
IDEAS: Like Teddy Roosevelt?
HARRINGTON: Exactly, Teddy Roosevelt was the classic case. He suffered from bad nerves as a young man so he was sent off to hunt and fish in the wilderness to regain his strength.
IDEAS: Aside from professional interest, are any of these things that you do for yourself?
HARRINGTON: At the moment I'm reasonably healthy, but back some years ago when I had just finished my PhD, I was going through a really, really difficult time in my life, and I became quite acutely ill and was admitted to a hospital - I was in Germany - and then had the experience that a lot of people have in which they know they're very ill but the medical profession doesn't find anything wrong with them. The doctor became rather patronizing....
Now I didn't respond by immediately reaching out and trying to find mind-body practitioners because I didn't have those at my disposal, but I bet if I'd been in a different stage of my life or a different culture I would have.
IDEAS: And today?
HARRINGTON: The thing that has stuck with me probably more than anything else is a kind of meditative practice, the use of deep breathing to calm my nerves, which can frequently get rattled in various kinds of settings. I also use a lot of placebo medicine with my 3-year-old. It's very simple: it's kisses and Band-Aids.
IDEAS: What's the ritual?
HARRINGTON: Any mother will tell you. You very seriously inspect where the bump is. He has to tell you exactly where it is, and the kiss has to be in exactly the right place, the Band-Aid has to be brought in with a great amount of gravity and put on just the right place and then we look at it together and we ask him how he feels now and he almost always feels better. And then at the right point we can take the Band-Aid off and he's well again. It might even come off an hour later - sometimes he just needs a Band-Aid.
Drake Bennett is the staff writer for Ideas. E-mail firstname.lastname@example.org.