Berlin Electropolis: Shock, Nerves, and German Modernity (review)

Around the middle of the nineteenth century, as telegraph cables began to girdle the planet and the potential utility of electricity seemed endless, the eminent German physiologist Emil Du Bois-Reymond established that the human nervous system, too, communicated by electrical signals. Since the nervous system was regarded by physicians as the supreme governor of the organism, the human body itself now came to be seen as analogous to an electric battery.

Batteries, of course, were not inexhaustible, and if the body was driven too hard, then, like any battery, it could run down. The stress and strain of modern, industrial life did exactly that, claimed the New York neurologist George Miller Beard in the 1870s: the exhaustion of nervous energy produced neurasthenia, a debilitating condition characterized by a galaxy of symptoms ranging from headache and pervasive fatigue to tooth decay and dyspepsia. Neurasthenia was confined, he argued, almost entirely to "brain-workers," whose nervous energy was being depleted by the general acceleration of life. Although Beard himself doubted whether such a modern malady could occur anywhere other than America, the concept of neurasthenia crossed the Atlantic quite rapidly. The association of the disease with "brain-workers," however, was often qualified in Europe, and much attention was given to the precipitation of neurasthenia by accidents (especially on the railroad), trauma, or shock.

The role of electricity was paramount not only in explaining but also in treating neurasthenia. As Andreas Killen shows in this superbly researched and engagingly written book, it seemed obvious to nineteenth-century physicians that the best way to replenish the nervous energy of neurasthenic bodies was to subject them to electrical therapy. A diverse range of machines was designed to administer electrotherapy, virtually all "nervous" patients were subjected to it, and many a physician grew rich on the proceeds.

Neurasthenia was diagnosed most commonly in urban and industrial centers; Killen focuses his study on Berlin, which, at the end of the nineteenth century, was "command center of the most dynamic economy on the Continent and . . . home to a progressive, materialist school of medicine" (p. 2). But late nineteenth-century Germany was modern not just in economic or medical terms—it also boasted of the finest health and social insurance system in the world. "Nervous" injuries and their consequences were as eligible for compensation as physical traumas, and Killen shows in rich and instructive detail how this eligibility was to become highly controversial in the twentieth century.

As cases of "traumatic neurosis" multiplied, the welfare system became overburdened, and in the turbulent, economically troubled years after World War I (which, of course, had produced countless nervous invalids), the Beardian construct of neurasthenia crumbled fast. Many German physicians now argued that rather than being an understandable reaction of healthy nerves to shock or the relentless demands of modern life, neurasthenia was a manifestation of innate constitutional deficiencies, which were not covered by the insurance system. The so-called traumatic neurosis, it was suggested, was nothing more than a variety of hysteria or degeneracy.

Killen explores the medical and social discourses involved in this transformation, establishing that the early twentieth-century German reconceptualization of neurasthenia was part of a backlash against the welfare state. His argument is solid and persuasive. But neurasthenia, of course, was reconceptualized or explained away elsewhere too during this period, including in countries with negligible welfare provisions. Although Berlin Electropolis does not shed any light on such questions, its comprehensive and thoughtful exploration of the German debates on neurasthenia should stimulate historians to assess when, how, and why this supposedly archetypal disorder of modernity was eliminated from the medical discourse of other national medical traditions.