Greater than the Parts: Holism in Biomedicine, 1920-1950 (review)

The 1980s and 1990s have been marked by an efflorescence of things holistic. Holistic medical associations were formed in Britain, the United States, and numerous other countries. The word holistic came to be applied to a vast range of initiatives, ideas, activities, and commodities. Historians working on the early twentieth century, particularly in medicine, would need to exercise a kind of deliberate blindness to their own times and the materials before them not to notice that “holistic” ideas and agendas were important to many physicians and others during the early part of the century. Indeed, as the editors of this volume point out, the prevalence of such ideas and agendas leads to an impression that biomedical reductionism did not enjoy a steady and unproblematic rise from the nineteenth century through to the present day. Greater than the Parts is a useful and fascinating attempt to systematize that “vague feeling” into something more. It is bound to become a classic work on the history of modern Western medicine, and a source of scholarship on numerous topics aside from “holism.”

Having taken part in the 1995 Montreal conference that led to the compilation of this volume, I was chiefly interested in discovering whether the problem of “the H-word,” which vexed and preoccupied us then, had been solved. Charles Rosenberg’s closing discussion represents the most successful exposition of the potential and problems of “holism” as a historiographic tool within the volume. By presenting holism as an essential tension and paradox, Rosenberg does a great deal to bring the theme of the book to philosophical and historical life. Elsewhere, however, “holism” is presented as something altogether more concrete, and it may behoove historians working on this and earlier periods to use the adjective holistic rather than the nouns holism and holist. To do otherwise may represent a kind of historical reductionism. Certainly Lawrence and Weisz’s otherwise excellent and instructive introduction suffers from this adjective/noun confusion. Having admitted that the actors described in the volume did not use the term holism, their text is nevertheless chock-full of the words holism and holists. The advantages of this approach in terms of stylistic plasticity and word-count are obvious, but holism as objectified by them takes on the ability to act: “Holism also penetrated the natural sciences” (p. 11), for example.

That said, it must be stressed that this is an excellent and stimulating volume, and well worth reading in its entirety. It would be facile and unsatisfactory to attempt to review it chapter by chapter. The papers cover a vast range of medical disciplines in four countries (Britain, Germany, France, and the United States) over half a century; all of them are well written, and very little feels redundant or out of place. The editors and contributors succeed admirably in their aim to revise the “standard” account of biomedical reductionism in medicine, and the volume is rich in social, medical, and general historical context. What, then, of the potential or aim implied by the title, that a “whole” historical entity lies beyond or within each of the constituent chapters? Given the historiographic problems, my personal recommendation would be to begin with the concluding discussion by Rosenberg, and then to start once more at the beginning of the book. Thus armed, readers can take up the challenge of creating for themselves something greater than the parts—all of which are, in their own different ways, very good indeed.