International encyclopedia of the social sciences volume 10

International Encyclopedia of the

SOCIAL SCIENCES

Associate Editors Heinz Eulau, Political Science Lloyd A. Fallers, Anthropology William H. Kruskal, Statistics Gardner Lindzey, Psychology Albert Rees, Economics Albert J. Reiss, Jr., Sociology Edward Shils, Social Thought

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International Encyclopedia of the

SOCIAL SCIENCES DAVID L. S I L L S EDITOR

VOLUME

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International Encyclopedia of the SOCIAL SCIENCES

[CONTINUED]

MARRIAGE i. FAMILY FORMATION ii. COMPARATIVE ANALYSIS in. MARRIAGE ALLIANCE

Robert F. Winch Gloria A. Marshall Louis Dumont

FAMILY FORMATION

The beginning of family formation may be either marriage or parenthood. It should not be concluded from the fact that sexual intercourse is a prerequisite for pregnancy that all peoples regard marriage or the establishing of a man-woman relationship as the first step in family formation. Indeed, according to Bohannan (1963, p. 73) the matricentric family, consisting of a woman and her children, is "both more nearly universal and more elementary than is the nuclear family," consisting of a marital couple plus any children they may have. In some societies it is thought proper that marriage should precede pregnancy, while in others the reverse sequence is regarded with favor; in the extreme case marriage is viewed as irrelevant to family formation. However, it seems safe to assert that in most societies the nuclear family is thought to be well launched only when both conditions are met. Cultures also vary according to whether they emphasize marital solidarity over lineal solidarity or vice versa. Societies with strongly developed extended family systems emphasize lineal solidarity over marital solidarity. In such societies family formation is scarcely a meaningful concept: since the marriage of a man and woman and the coming of their progeny represent the carrying on of a continuous line, these events may signal the establishing of a new household but not the formation of a new family.

In this article the topic of family formation will be treated with reference to the nuclear family. Marriage will therefore be considered as the focus of the process of family formation, and mate selection as one of its most problematic features. Definitions. From the functional point of view, the family is the one social system that all societies look to for the replacement of their members. However, from the structural point of view, the word "family" is used to refer not only to the marital couple and their children but also to the larger kin group; accordingly, it will be necessary to draw some structural distinctions. The "extended family" includes a nuclear family plus lineal and collateral kinsmen; to the extent that a society emphasizes rights and obligations among kinsmen who are not in the same nuclear family, it is spoken of as having an "extended family system." On the other hand, a "nuclear family system" is said to exist in a society in which the rights and obligations among those in the larger kin group are given little emphasis relative to the claims among members of the same nuclear family. It should be emphasized that the term "family," whether it applies to a nuclear or an extended family, is not equivalent to the term "household" —the aggregate of persons occupying a common dwelling unit, whether or not those persons are kinsmen. In Western societies the nuclear family is frequently also a household while the parental couples are in their younger and middle years and before their children attain adulthood. However, many other arrangements are possible, and some are institutionalized. For example, in South Africa it has been the practice for decades for the husbandfather to be away from his nuclear family for years at a time. A common type of household among 1

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Negroes in the Caribbean and in the United States consists of a working woman, her children, and her mother. In traditional China the ideal household included the nuclear family of the head of the household plus his unmarried daughters, his sons with their nuclear families, his sons' unmarried daughters, his sons' sons with their nuclear families, and so on through all living generations; in practice, however, not many Chinese families could afford households of such size. Marriage may be denned as a culturally approved relationship of one man and one woman (monogamy), of one man and two or more women (polygyny), or of one woman and two or more men (polyandry), in which there is cultural endorsement of sexual intercourse between the marital partners of opposite sex and, generally, the expectation that children will be born of the relationship ("polygamy" is the term that subsumes both polygyny and polyandry). "Homogamy" refers to the marriage of persons of similar characteristics, which is also known as "assortative" or "assertive" mating; "heterogamy" is the marriage of persons of different characteristics; and "hypergamy" is a marriage in which the husband is of higher social status than the wife. The term "endogamy" refers to marriage between persons belonging to the same social group, whereas in "exogamy" the partners come from different groups. Marriage and legitimacy. By definition marriage is a relationship within which sexual intercourse is legitimate In general, a woman who cohabits with a man has a legitimate status in relation to that man only if she is known to be married to him. Common-law marriage (recognized in the United Kingdom and in the United States) and the consensual union (recognized in the Caribbean) are forms of man-woman relationship that carry less than full cultural approval and legitimacy. Points of interest to American, as well as to English, courts in establishing whether or not a common-law marriage exists include: mutual agreement of the man and woman to take each other as husband and wife; cohabitation and presentation of themselves as a married couple to friends, neighbors, and the general public; and reputation, that is, the recognition by the community that the two are husband and wife. The Caribbean pattern of the consensual union differs from the common-law marriage of AngloSaxon countries in that the former is not a legally recognized marriage. Various writers have held that except for this lack of legal sanction the consensual union carries no social stigma and therefore is quite as acceptable among the people prac-

ticing it as is legal marriage. More recent analyses by Blake (1961) and by Goode (1960), however, have concluded that there is general recognition among Caribbean societies that consensual unions are less legitimate and hence less desirable than legal marriages. Goode argues that whereas legal marriage is recognized throughout Caribbean societies as the legitimate form, there is variation among the social strata of these societies in the degree of norm commitment, with the consequence that persons in the lower strata tend to be generally less committed to familial norms than persons in the upper strata. The more frequent occurrence of consensual unions among the lower social strata than among the upper is seen as a reflection of the class-linked variation in the degree of commitment to familial norms. [See CARIBBEAN SOCIETY.] Legitimacy affects the offspring of the marriage as well as the spouses themselves. In asserting what he called the "principle of legitimacy," Malinowski (1929) stated that in all societies a socially recognized father has been regarded as indispensable to the child. A legal marriage, then, gives a woman a socially recognized husband and her children a socially recognized father. According to Zimmerman (1947), the penalties attached to illegitimacy vary directly with the power of the extended family; thus, the penalties are heavy in societies characterized by the extended-family system and light where the nuclear family prevails. From a sociological point of view, the significance of legitimacy is that it is a necessary condition for the family to carry out its function of positionconferring. In this sense, the critical meaning of bastardy is not that the child has low status but rather that he lacks any position and status in his society. [See ILLEGITIMACY.] Variations in familial organization. Cultural expectations pertaining to marriage are affected by variations in familial organization. In Western civilization it appears that the power of the family and the size of the effective kin group (i.e., of the familial structure) have varied inversely with the complexity of the society of which the effective kin group is a part. Zimmerman (1947), who extensively analyzed the civilizations of ancient Athens and Rome, reports that in the early stages of both of these civilizations (i.e., when both societies were relatively simple) there existed what he calls the "trustee" type of familial organization; whereas in their late (and, to Zimmerman, decadent) stages, Athens and Rome developed much more complex societies and simpler familial structures, which he describes as "atomistic." The kernel of Zimmer-

MARRIAGE: Family Formation man's distinction lies in the locus of power. Where the trustee type of family exists, much power is located in the extended family. The head of the family, as the responsible center of familial authority, influences the behavior of the family members, and the extended family feels responsible for the behavior of its members. Where the atomistic type of family prevails, much power is located outside the kin group in specialized institutions. As the family loses power, its structure shifts from the extended family system to the nuclear family system. In the process of making this shift, according to Zimmerman, the divorce rate goes up and the birth rate goes down. Arguing that there are other lines of development than those of the West noted by Zimmerman, Goode (1963) holds, as we shall see below, that whether the divorce rate goes up as a society becomes more complex depends on the nature of the familial structure at the start of the process. One way of formulating variation in the family's power and size is to speak of its functioning as a political unit. Moreover, the family may show variation in other kinds of functioning. In some settings the family is the basic economic unit that creates and distributes goods and services. In many settings it is the principal social unit responsible for socializing and educating the young. And in some settings, especially where ancestor worship is practiced, the family carries out the religious function. In general, as societies become more complex, specialized societal structures develop for the carrying out of these functions, with the result that the family loses some of its functions; indeed such a state of affairs is the meaning of societal complexity. Taking account of Asian and African as well as Western societies, Goode (1963) agrees that most family systems of the world are moving toward a small-family system based on the nuclear family. Because the traits of non-Western family systems are so varied, however, he believes there will be marked differences in the direction of this change as the predicted convergence takes place. Thus, in African tribal societies where matrilineal systems are strong and divorce is common, Goode reasons that urbanization will be accompanied by a reduction in the conditions that have made divorce easy. Mate selection The functional emphasis in modern sociology leads the observer to anticipate that criteria for the choice of a mate will be related to the roles the mate is expected to enact and, perhaps, that the mate will be chosen by the incumbent of that social position most influenced by the quality of the mate's

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performance. There is some evidence to support such a set of functional expectations, but of course the empirical world is always less tidy than the social scientist's model. The extended family system. In the extended family system it is common for members of the nuclear family to work in teams of kinsmen. Under this condition the mate-selective process is frequently a means of recruiting workers, and hence the members of the extended family have a lively interest in the work-related qualifications of a kinsman's prospective mate. Thus it is not unusual for responsible senior members of the extended family to select a son's spouse and to employ such familially relevant criteria as the industry and prospective fecundity of a potential daughter-in-law. For families of higher status, the standing of a girl's family becomes more important than her manual skills. Irrespective of status, however, the extended family system makes the procuring of a mate a matter of moment to a wide circle of kinsmen. It is consistent with this kind of family organization that mate selection should be a task calling for experienced perception and shrewd bargaining. Moreover, in order that their plans should not be thwarted by the passions of the young, the older people institute devices such as early marriage and efficient chaperonage (Goode 1959). On the other hand, where the extended family is not highly functional and where the nuclear family system prevails, it is frequently thought to be inappropriate for members of the extended kin group to exhibit lively interest in the marital choices of family members, and even the influence of parents is reduced. Under these conditions the criteria for mate selection are more likely to include attributes having primary appeal to the nubile pair—physical beauty, sexual attractiveness, and congeniality. The response to one or more of these attributes comes to be subsumed under the rubric of love. The diminution of relatives' influence in mate selection is not, of course, a categorical matter but rather one of degree. By their own religion, ethnicity, and social status, as well as by their own choice of location of residence and of schools, parents continue to influence their youngsters' choice of spouses. Traditional China provides an example of mate selection carried on by the family for familial purposes. When a son married, the preferred arrangement was for him to bring his bride into his parental home. The parents expected the bride to perform two important functions: to bear children, preferably sons, and to assist her mother-in-law in the performance of domestic chores. As the boy

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MARRIAGE: Family Formation

was growing up, he looked to his parents to provide him with a wife. The parents expected the son to accept whatever bride they chose, and they condemned vigorously any disposition on the son's part to make his own marital selection, especially if the son tried to do so on the basis of love. It was generally agreed that young people of marriageable age were too inexperienced to have sound judgment in such an important undertaking. Since most of the bride's time was to be spent assisting her husband's mother, functional considerations dictated that the latter was the most interested party in the marriage; appropriately, therefore, she was usually the most active person in selecting her son's wife. Thus, arranged marriages were customary, and it was not unusual for a young man to meet his bride for the first time at the wedding ceremony. Traditional China made extensive use of the "go-between," or marriage broker. This occupation served two useful functions: marriage brokers made it their business to have extensive and detailed information about marriageable young people; and they made it possible for families to enter into and break off negotiations without loss of face (Hsu 1948; Lang 1946; Levy 1949). With industrialization came pressure for changes in Chinese family law. This was evident as early as the Boxer Rebellion at the beginning of the twentieth century, and new codes were promulgated in 1930 and 1931 (well before the communist revolution in China) that reflected Western standards —more emphasis on the nuclear family and less on the extended family, a reduction in male authority, and a closer approximation to legal equality of the sexes. However, the law retained a feature of Chinese filial piety: the obligations to one's parents superseded the obligations to one's children. In these matters the communist revolution has represented not so much a break with the past as a continuation of trends already under way (Yang 1959). Although reliable information on postrevolutionary China is still scanty, it appears that whereas the communist regime officially deplores both Western and traditional Chinese ways, love marriages are common, and the influence of the extended family is continuing to wane. The nuclear family system. As specialized social structures spring up, take over functions from the family, and become societally important and individually rewarding, the resulting reduction in the functional importance of the extended family removes incentives for maintaining an extended family system. At the same time there are four functions inherent in the nuclear family that come to the fore as being relevant in mate selection.

These functions are: providing emotional gratification in the marital and parental relationships; providing identity and a social status in the societal system to individuals who enter the family by birth, adoption, or marriage—a function to be known here as position-conferring; performing such tasks as cleaning, bringing in supplies, and disposing of waste products, which may be subsumed under maintenance of the household; and child rearing, especially with respect to the parental functions of nurturance and control. Of these four functions emotional gratification is most explicitly recognized in American culture as relevant to mate selection, and apparently this is so, to an increasing degree, in the middle-class subcultures of western Europe. There can be little doubt that convictions are widespread in the United States and western Europe that a couple should be "in love" before considering marriage and that legal codes are obsolete if they fail to provide for divorce on the ground of chronic marital conflict. Love as a mate-selective criterion invites idiosyncratic interpretation in the sense that, for instance, one man may be attracted to a demurely diffident girl whereas another finds the vivaciously extroverted girl irresistible. As a mate-selective criterion, position-conferring (especially when phrased as status-conferring) evokes ambivalent responses. In many middle-class settings a girl who is thought to have married for money rather than for love risks social condemnation (Indian culture, by contrast, has had the tradition that it is good for a girl to marry into a subcaste of higher standing than her own). If a girl marries for love plus status improvement, however, she is said to have married "well," and the durability of the Cinderella legend suggests that there is little novelty in this theme. The woman's social status depends so largely on her husband's occupational performance that, for her, mate selection is sometimes spoken of as a "mobility bet." Such evidence as exists on this matter for the United States indicates that most marriages are between persons of roughly equal social status. Although all four of the functions mentioned above are relevant to mate selection, a young couple considering marriage can usually check the suitability of each other only with respect to emotional gratification. This may have something to do with the emphasis given love as a criterion. In the premarital setting of early adulthood the other three functions can usually be no more than the focuses of guesswork. It is difficult for a young woman to foresee how a particular man will fare in the occupational sweepstakes and in being a

MARRIAGE: Family Formation model for their sons. Predictions are similarly difficult for the young man with respect to how a woman will manage their house and mother their children. Where marriages are voluntary rather than arranged, there is need of some means for marriageable young men and women to meet and to select each other. The practice of dating is societally rational in the sense that it affords this opportunity. On the other hand, dating as a prelude to mate selection has been criticized on the ground that the leisure-time activities of dating fail to provide an adequate setting in which to test prospective spouses with respect to maritally relevant criteria, especially with respect to the functions of household maintenance and child rearing. In sum, a reduction of functions in the extended family is accompanied by a reduction in the rights and obligations among extended kin that constitute the extended family system. This reduction in the significance of blood relationships shifts the emphasis from the extended family to the nuclear family. Marital solidarity replaces cognatic (both lineal and collateral) solidarity, and love becomes a criterion of mate selection. Principles of preferential mating Let us designate as "ego" a person of reference, that is, a person from whose point of view we shall consider certain relationships. All societies designate categories of persons whom ego may not marry, and frequently there are additional categories of persons whom it would be regrettable, but not totally forbidden, for ego to marry. Usually there are implicit, if not explicit, categories of persons whom it would be desirable for ego to marry. These negative and positive expectations can be subsumed under the "principle of incest avoidance" and the "principle of ethnocentrism." We shall speak of the set of persons whom ego is permitted to marry in any given sociocultural setting as ego's field of eligible spouse candidates or, in shorter form, as ego's "field of eligibles." European social scientists use the term "isolate" to refer to the field of eligibles. The principle of incest avoidance. Every society has a prohibition against incest, that is, against sexual relations between persons who are closely related. Although the precise relationships that are viewed as incestuous vary from one society to another, they regularly include the mother-son, the father-daughter, and the brother-sister relationships, that is, all heterosexual relationships within the nuclear family except, of course, the marital relationship. The principle of incest avoidance re-

5

fers to the set of prohibitions existing in every culture to prevent ego from marrying someone too close to him in the kinship system. Just how the principle of incest avoidance works out varies from one setting to another. In traditional China it was prohibited for ego to marry anyone with the same surname, and in that populous land with few surnames this rule proscribed hundreds of thousands of otherwise eligible spouse candidates. In northern India there was a tradition that marriage was not possible with someone removed from ego by less than seven degrees on the father's side or less than five degrees on the mother's; a more common rule in India prohibits marriage between relatives linked to a common ancestor within five degrees on the father's side and three on the mother's (Goode 1963, p. 210). In some societies ego is encouraged to marry a cross-cousin (e.g., mother's brother's daughter) but prohibited from marrying a parallel cousin (e.g., mother's sister's daughter). Prior to 1793 it was illegal in Connecticut for ego to marry the sister of his deceased wife; but among the ancient Hebrews there was the custom of the levirate, by which a man was enjoined to marry the widow of his deceased brother if the brother had died without a son. The record shows a very few isolated cases where persons of opposite sex from the same nuclear family were permitted to marry. An example is the brother-sister marriage among the Ptolemies of ancient Egypt. Apparently the practice in these few exceptions functioned to keep power within ruling families. [See INCEST.] Ethnocentrism and homogamy. Whereas the principle of incest avoidance prevents ego from marrying someone too close to him in the kinship system, the principle of ethnocentrism prevents his marrying someone too different from him with respect to a number of social characteristics. In other words, ethnocentrism is a force tending toward endogamous and homogamous marriages. Sumner ([1906] 1959, chapter 1) used the term ethnocentrism to refer to the set of attitudes shared by members of a tribe or other social group to the effect that the members of that group and any others like them were seen as the center of the civilized world and had, therefore, the correct and desirable set of social characteristics. Thus, ethnocentric attitudes lead to the condemnation of outsiders to the degree that they are recognized as differing from one's group. The minimum degree of social distance on the Bogardus scale is indicated by an affirmative response to the query as to whether or not the respondent would be willing to accept a person with a specified characteristic to

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MARRIAGE: Family Formation

close kinship by marriage. Traditionally, the castes of India have been endogamous, as have the subaltern categories of subcaste, section, and subsection. According to Kapadia ([1955] 1958, p. 118), these endogamous restrictions limited a Hindu's field of eligibles to 50 to 300 families. In 1949, however, the Hindu Marriages Validity Act stipulated that no marriage of Hindus could be invalidated because of caste or sect differences between the parties concerned. Expert opinion is divided as to the likelihood that caste endogamy will break down. In accordance with the principle of ethnocentrism there is evidence that in American society ego tends to select a spouse similar to himself with respect to race, religio-ethnic identification, socioeconomic status, and other social characteristics. In the United States the most conspicuously homogamous dimension of mate selection is race. Interracial marriages are still prohibited by law in a number of the Southern states; moreover, even where such laws do not exist, or where they have been repealed, there is little evidence of enthusiasm for such marriages. Various studies have shown the proportion of racially heterogamous marriages to be under one per cent. [See ASSIMILATION.] The second dimension of ethnocentric preference and prohibition is that of religio-ethnic identification, which includes cultural as well as religious elements. Classifying the 1957 population of the United States into the three major religious categories (Protestant, Catholic, and Jewish), the U.S. Bureau of the Census found that approximately 94 per cent of the married persons had spouses in the same religious categories as themselves. If religious endogamy had not been practiced, and if, therefore, matings had been entirely random with respect to religious affiliation, the proportion having spouses in the same religious category as themselves would have been about 56 per cent (Winch [1952] 1963, p. 331). There is evidence that in heterogeneous communities the probability that ego will marry outside his religious category is greater when his category constitutes a small proportion of the community rather than a large proportion. If the religious category has a highly distinctive ethnic identity (e.g., Catholics who are Spanish-speaking in an English-speaking community), the probability of ego's marrying endogamously is increased. A third dimension of ethnocentric preference is that of socioeconomic status. Commonly used indexes of socioeconomic status are occupation, income, and number of years of schooling. Numerous studies have shown that people tend to select their spouses from their own socioeconomic strata

with respect to all three of these indexes (several are cited in Winch [1952] 1963, pp. 336-338). Other characteristics with respect to which people tend to mate homogamously are age, previous marital status, and location of residence. Systematic research supports the common observation that young people tend to select young mates and older people choose older spouses. No doubt it is partially because of this fact that there is a tendency for people to marry others who are like themselves with respect to previous marital status: divorced men tend to marry divorcees; single persons tend to marry those who have not previously been married; and widows and widowers tend to marry each other. Another common-sense observation that has been supported by research concerns residential propinquity: ego is more likely to marry someone living nearby than someone living far away (Winch [1952] 1963, pp. 322-324, 339-345). Since people are not randomly distributed through communities but rather tend to live near and to work with others of similar social characteristics, one would expect mate selection to be somewhat homogamous, whether or not there are any sanctions enforcing endogamy. Of course there are sanctions of varying degrees of intensity: for example, in American culture sanctions are quite intense with respect to race, less so with respect to religion and socioeconomic status, and virtually nonexistent with respect to residential propinquity. Homogamy may also be considered on a more psychological level. For example, there is evidence that spouses tend to resemble each other in level of intelligence, in values (e.g., religious and aesthetic), and in attitudes (e.g., toward birth control and toward communism). When spouses are tested by paper-and-pencil methods, they appear to resemble each other somewhat, but not greatly, with respect to traits of temperament and personality. However, data gathered by other methods, such as interviews and projective methods, lead to the contrary conclusion that, at least in such traits as dominance and dependence, spouses tend to be complementary rather than similar. At present this seeming paradox is unresolved, although the answer may be that the homogamy apparent in paperand-pencil tests is an artifact resulting from the effort of people to represent themselves to be as attractive as possible—what is called the "social desirability" effect (Winch 1958; [1952] 1963, chapter 18). Differentiation of sex roles The simple fact that only women can bear children causes every society to recognize some differentiation between the behavior of men and of

MARRIAGE: Family Formation women. Beyond the behavioral differences that are directly attributable to anatomy and physiology, however, cultures vary greatly in the degree to which they view human behavior as being properly sex differentiated. From a study of 224 societies, Murdock (1937) has found that men tend to engage in such active and mobile tasks as hunting, fishing, trapping, and lumbering, whereas women tend to specialize in more sedentary but equally important tasks, such as gathering fuel and fruits and cooking and preserving meat and fish. More generally, it is possible to conceptualize two criteria that distinguish masculine from feminine tasks. Tasks assigned to men usually require physical exertion and strength, or spatial mobility and absence from home for considerable periods of time, or both. By contrast, feminine activities are typically less demanding of great strength, although perhaps requiring a considerable output of energy, and will involve only a few hours at a time away from home. Analysis of these differences leads to the conclusion that the sharpness with which a culture distinguishes between masculine and feminine sex roles will be related to the importance it attaches to tasks requiring one or both of the two masculine task characteristics. Military activity is one obvious example that involves both of the masculine criteria; thus it is argued that a highly militaryoriented culture will be one that draws a sharp distinction between properly masculine activities and those that are properly feminine. The converse inference is that to the degree that a society's important tasks do not call for either of the criteria distinguishing masculine activities, there will be no basis for developing highly differentiated sex roles. As nonhuman power has taken over most of the heavy tasks in the industrial societies, the proportion of the total labor force that is classified as "white collar" has greatly increased. And whitecollar occupations, especially those not requiring travel, can be carried on as well by women as by men. Thus, if Western cultures have been "feminized" over the past century or so, as some writers have claimed, the present analysis would interpret such a trend as a consequence of the increased use of nonhuman power. Sex dominance in the marital dyad. What are the conditions that result in the dominance of one spouse over the other? The opportunity for dominance exists in a dyad when resources desired by one member are controlled by the other, that is, when one is dependent upon the other. Resources may be viewed broadly to include both material goods, such as food, and intangibles, such as a compliment.

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Where no organizational feature exists to determine otherwise, it appears that men have usually dominated women. The reasons for this originate in the two criteria differentiating masculine from feminine pursuits and in their anatomical and physiological bases. A woman with small children has greater need of a man to take care of her than the man has need of her. His care may be viewed as a resource, and by granting or withholding that resource, the man can dominate the woman. This is a state of affairs that has been remarked by social scientists from Aristotle through E. A. Ross and Willard Waller and is perhaps best known to contemporary readers under the rubric of the "principle of least interest": that is, the person in a relationship who has the least to lose through the termination of the relationship is in a position to demand more from others and thus to dominate them in exchange for his continued participation. Aside from this situation of unilateral dependence, other possibilities are mutual interdependence, where the resources are not available to either one unless they cooperate, and mutual independence, where each has control over his own resources. With respect to organizational features, W. G. Sumner and A. G. Keller have remarked that where the bridal couple lives has bearing on which is the dominant sex and therefore that matrilocal marriage is a condition favorable to the relative standing of women. In traditional China, the favored pattern was patrilocal, and a wife was expected to obey her husband; masculine dominance was mitigated, however, in the case of adoptive marriage. According to this pattern, a man having no son might seek a young man (who was usually of somewhat lower social rank) to take the older man's family name, marry the older man's daughter, and live matrilocally. Studies of marriage During the second quarter of the twentieth century there was a good deal of concern about the state of the family in the Western world. There was evidence that divorce rates had risen, that the family had lost functions to other social structures, that the birth rate had fallen, that certain totalitarian regimes were trying to bring about the disintegration of the family, and that broken families were spawning delinquent children. Family disorganization was widely viewed as a social problem; probably for this reason, numerous studies were undertaken to discover the determinants, or at least some correlates, of what was variously called marital "adjustment," marital "happiness," and marital "success." Although these studies did not undertake to dis-

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MARRIAGE: Comparative Analysis

tmguish very sharply among the three terms just noted, it does seem useful to differentiate them as follows. There are two kinds of marital adjustment, one pertaining to the role and the other to the psyche of the performer. An actor is adjusted to a marital or any other kind of role to the degree that he knows the expectations that define the role and, under the appropriate conditions, can produce the behaviors expected. On the other hand, he is adjusted psychically to the degree that the energy he invests in the role performance is commensurate with the gratification derived from it. Marital "happiness" refers to the subjective response of the actor to marriage and thus is related to psychic adjustment; however, one can be psychically adjusted when both output of energy and input of gratification are low, whereas presumably happiness requires at least a moderately high level of gratification. The term marital "success" implies the existence of a goal of marriage, and whatever goals there may be—avoidance of divorce, procreation, personality development of the spouses— seem to be more clearly conceived by those who write about marriage than by the participants whose behavior the writers describe. Much of the research on marriage has been concerned with marital adjustment—that is, both with the aptitude to carry out the marital role and with the capacity to derive commensurate gratification from the performance. Kirkpatrick has surveyed a large number of studies and has reported the variables he finds that have correlated most consistently with what is here called marital adjustment. He has divided these variables into two sets: those that were clearly operating before the marriage and those that may or may not have been. Presumably the determinants of marital adjustment are more likely to come from the former set. Kirkpatrick ([1955] 1963, p. 389) presents the following premarital factors as having shown the strongest and most consistent association with high marital adjustment: happiness of parents' marriage; adequate length of acquaintance, courtship, and engagement; adequate sex information in childhood; personal happiness in childhood; approval of the marriage by parents and others; adjustment in engagement and normal motivation toward marriage; ethnic and religious similarity of the spouses; high social and educational status; maturity (marriage in the late twenties rather than in the teens or early twenties); similar chronological age of the spouses; and harmonious affection with parents during childhood. Factors that may have become operative during marriage, rather than before, and therefore are regarded as part of the complex of marital adjust-

ment rather than among its determinants are early and adequate orgasm capacity, especially of the wife; confidence in the spouse's affection and satisfaction with degree of affection shown; equalitarian rather than patriarchal marital relations, with special reference to the role of husband; mental and physical health; and harmonious companionship based on common interests and accompanied by a favorable attitude toward the marriage and the spouse (Kirkpatrick [1955] 1963, p. 394). ROBERT F. WINCH [See also FAMILY; NUPTIALITY; and the biographies of BURGESS; MALINOWSKI; SUMNER; WALLER; WESTERMARCK.] BIBLIOGRAPHY BLAKE, JUDITH 1961 Family Structure in Jamaica: The Social Context of Reproduction. New York: Free Press. BOHANNAN, PAUL 1963 Social Anthropology. New York: Holt. GOODE, WILLIAM J. 1959 The Theoretical Importance of Love. American Sociological Review 24:38-47. GOODE, WILLIAM J. 1960 Illegitimacy in the Caribbean Social Structure. American Sociological Review 25: 21-30. GOODE, WILLIAM J. 1963 World Revolution and Family Patterns. New York: Free Press. Hsu, FRANCIS L. K. 1948 Under the Ancestors' Shadow: Chinese Culture and Personality. New York: Columbia Univ. Press. KAPADIA, KANAILAL M. (1955)1958 Marriage and Family in India. 2d ed. Bombay: Oxford Univ. Press. KIRKPATRICK, CLIFFORD (1955) 1963 The Family as Process and Institution. 2d ed. New York: Ronald Press. LANG, OLGA 1946 Chinese Family and Society. New Haven: Yale Univ. Press. LEVY, MARION J. 1949 The Family Revolution in Modern China. Cambridge, Mass.: Harvard Univ. Press. MALINOWSKI, BRONISLAW (1929) 1962 Marriage. Pages 1-35 in Bronislaw Malinowski, Sex, Culture and Myth. New York: Harcourt. MURDOCK, GEORGE P. 1937 Comparative Data on the Division of Labor by Sex. Social Forces 15:551—553. SUMNER, WILLIAM GRAHAM (1906) 1959 Folkways: A Study of the Sociological Importance of Usages, Manners, Customs, Mores, and Morals. New York: Dover. -* A paperback edition was published in 1960 by New American Library. WINCH, ROBERT F. (1952) 1963 The Modern Family. Rev. ed. New York: Holt. WINCH, ROBERT F. 1958 Mate-selection: A Study of Complementary Needs. New York: Harper. YANG, CH'ING-K'UN 1959 The Chinese Family in the Communist Revolution. Cambridge, Mass.: M.I.T. Press. ZIMMERMAN, CARLE C. 1947 Family and Civilization. New York: Harper. II COMPARATIVE ANALYSIS

Every society has rules governing the assumption of the conjugal roles of husband and wife; there are also discernible rights accruing to and obligations incumbent upon the individuals who assume

MARRIAGE: Comparative Analysis these roles. Marriage in all societies thus brings about a change in the jural status of the parties to the contract. Where marriage is defined by the state, it is possible to describe most of its jural entailments by reference to one or more legal codes adopted by that state. However, among many of the peoples studied by anthropologists, the jural tenets governing marriage cannot be ascertained by reference to codes laid down by a state and hence must be derived from the study of the recurrent patterns of behavior and of folk models that prescribe ideal behavior. Marriage entails not only a change in the jural status of the individuals who enter the roles of husband and wife but also a change in the lawful status of specifiable consanguineal kinsmen of the individual partners. In fact, it is the linkage of groups as well as of individuals that is crucial to the formulation of the difference between marriage and its social analogues. Only marriage creates (or maintains) affinal relationships between the kinsmen of individuals who claim the roles of husband and wife (see Fortes 1959, p. 209). Even where it is socially admissible for individuals to presume conjugal status—that is, where they may assume the husband-wife roles without their actions being legitimated according to prevailing jural rules— this presumption of status does not generate lawful relations of affinity between kinsmen of the "spouses" concerned. The importance of affinity to an understanding of marriage is made clear through a consideration of the nature of kinship. The social relations subsumed under the concept of kinship are of two fundamental types which, though referable to the biological processes of heterosexual mating and procreation, cannot be reduced to biology. Those social relationships based on parenthood and descent or, more precisely, on parenthood and filiation, are generally termed consanguineal relationships. All persons related by socially defined direct or shared descent are consanguineal kinsmen (P. Bohannan 1963, chapter 4). These "blood relatives" are distinguished in all societies from affinal relatives, i.e., those whose kinship status is fundamentally grounded "in law." Human mating is everywhere socially regulated, and adult mating for the purpose of procreation is normally preceded by the creation of jurally derived kinship ties between the mating pair and between certain of their respective consanguineal relatives. The continuance of publicly acknowledged affinal kinship depends on adherence to prescriptions and proscriptions delimited by the particular society under consideration. Whereas many societies make no provision for the legal severance of consanguineal

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kinship bonds, they all provide for the severance —"by law"—of those which are based "in law." Societies differ considerably with respect to the rules governing the way in which the roles of husband and wife should be assumed, with respect to the specific rights and obligations which accrue to persons in these roles, and with regard to the behavioral and jural attributes of the other affinal roles created by marriage. Nonetheless, most anthropologists have regarded the institution of marriage as a universal in human societies, and many have attempted to provide definitions of marriage sufficiently general to encompass its various manifestations. The fact that marriage is closely linked to parenthood has led many scholars, including Westermarck, Malinowski, and Radcliffe-Brown, to propose definitions of marriage which center on what Malinowski termed "the principle of legitimacy." Thus, Radcliffe-Brown writes: "Marriage is a social arrangement by which a child is given a legitimate position in the society, determined by parenthood in the social sense" (1950, p. 5). The general, though by no means universal, acceptance of this formulation is indicated by the fact that Notes and Queries on Anthropology defines marriage in an essentially similar, but by implication more limited, manner: "Marriage is a union between a man and a woman such that children born to the woman are the recognized legitimate offspring of both partners" (British Association for the Advancement of Science 1951, p. 110). Edmund R. Leach was among the first to argue that a definition of marriage in terms of legitimacy is too limited. In his opinion, any attempt at a universal definition of marriage is inevitably "vain," since the "institutions commonly classed as marriage are concerned with the allocation of a number of distinguishable classes of rights" (1961a, p. 107). Leach suggests that in most cases the institution of marriage serves to allocate rights to either or both spouses; in some cases it serves primarily to allocate rights to the husband and his wife's brothers. Despite Leach's arguments against a universal definition of marriage, his formulations stimulated two fresh attempts at universal definitions. Prince Peter of Denmark suggested that in light of Leach's propositions, marriage should be defined as "the socially recognized assumption by man and woman of the kinship status of husband and wife" (Peter, Prince of Denmark 1956). The task of the anthropologist would then be to ascertain and delineate the particular rights and obligations associated with these kinship roles in the particular societies being studied.

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MARRIAGE: Comparative Analysis

H. Fischer (1956) called this definition tautological, on the grounds that the Oxford and Webster dictionaries defined "husband" and "wife" respectively by phrases such as "a married man" and "a married woman." In a discussion of Nayar marriage, Gough agrees and reaffirms the heuristic value of a definition of marriage based on "the principle of legitimacy." In an attempt to overcome the difficulties inherent in any formulation which defines marriage as a union of "a man and a woman" and in an attempt to provide a substantive definition for the concept of legitimacy, Gough suggests that marriage be defined as "a relationship established between a woman and one or more other persons, which provides that a child born to the woman under circumstances not prohibited by the rules of the relationship is accorded full birthstatus rights common to normal members of his society or social stratum" (1959, p. 32). Her effort to refine the older, more general "principle of legitimacy" definition has yielded one which, on close examination, is equally inadequate. Operating with such a definition, no investigator could classify as married any particular woman who had assumed the jurally recognized kinship role of wife but who had not borne children. Of course, the conditions under which a child would be accorded "full birth-status rights" could be elicited by the investigator. However, for any given case, the researcher would have to await the birth—or perhaps the conception—of a child before he could ascertain whether conditions entailed in the husband-wife relationship had been violated. Furthermore, Cough's definition implies that in any society each person having "full birth-status rights" is the child of a relationship which can be termed marriage. Among various peoples of the world, "full birth-status rights" accrue to persons born of relationships which are not recognized as marriage according to prevailing jural rules. If a universal definition of marriage is to be formulated, it would seem that the one proposed by Prince Peter should serve as a model, Fischer's criticism of Prince Peter's definition may be disregarded, since dictionary definitions are usually unsatisfactory bases for discussions of roles. The roles of husband and wife must be defined in terms of the essential rights and obligations and the behavioral attributes entailed in them in any particular society. Gough and Fischer are justified in their concern that confronted with different forms of mating, the anthropologist employing Prince Peter's definition would be unable to decide which institutions should be referred to as "marriage," as "concubinage," etc. However, if the statement were

modified so as to define marriage as the jurally valid and socially (or publicly} recognized assumption of the kinship roles of husband and wife, there would be few or no problems concerning the distinction between marriage and its socially recognized alternatives. Such a proviso emphasizes that the publicly acknowledged kinship roles created by marriage—as opposed to its alternatives—derive support from the juridico-political domain of the society. Of course, there may be more than one jurally valid way of assuming the roles of husband and wife—as is the case in some present-day African states which recognize marriages contracted according to one or more sets of "customary laws" as well as marriages contracted in accordance with legal codes based on European models. It would appear that the cross-cultural study of marriage must rest on the premise that all societies recognize kinship roles which are founded "in law" as well as those which are based ultimately on actual, assumed, or presumed genetic relationships. Fundamental to the understanding of the concept of "lawfully based" kinship is the fact that human mating is everywhere subject to socially derived regulations. While it is normally expected that marriage will lead to parenthood, the roles of husband and wife need not be defined by reference to children who will come to be regarded as legitimate offspring of individuals in these roles. The roles of husband and wife should be defined in terms of the rights and obligations which attach to them, and marriage must be defined as the lawfully or jurally recognized assumption of these roles. Choice of spouses In all societies, socially derived limitations are placed on the range of persons from among whom spouses may be chosen. Regulations which prescribe marriage outside a stipulated group are referred to as rules of exogamy. Kin groups such as lineages, or territorial groups such as bands or villages, may constitute exogamous units. Societies possessing corporate unilineal descent groups usually prescribe that a person select as spouse someone from a descent group other than his own. In some cases the selection may be made from among persons within the descent group but outside specified degrees of relationship. Among the Gisu of east Africa, for example, it is the minimal patrilmeage, comprising persons who trace their descent from an ancestor three to five generations removed from the oldest living generation, which constitutes the exogamous unit. Every society prohibits heterosexual mating between certain "close" consanguineal relatives. This

MARRIAGE: Comparative Analysis prohibition is referred to as the incest taboo, and ordinarily it proscribes mating between relatives who stand to each other in the relationships of mother and son, father and daughter, and brother and sister. In many societies the incest taboo is extended to various other kinsmen in the parental and filial generations. Among some royal or ruling groups, as in dynastic Egypt and in Polynesia, relatives ordinarily prohibited from mating may be preferred as marriage partners. The mating of close relatives is also permitted in some societies on specified ritual occasions. A rule of endogamy exists where the field of possible spouses is limited to persons within an individual's territorial and/or social group. The castes of traditional India are the most often cited example of endogamous groups. Other societies also prescribe marriage among persons of the same social stratum. Among the Swazi of south Africa, where lineage exogamy prevails and where royalty marries royalty, there are frequent subdivisions of the royal lineage so as to make possible otherwise prohibited marriages. A number of studies indicate that in the absence of explicit prescriptions, it is posssible to discover endogamous tendencies within social or territorial groups of various size and scale. In addition to proscriptions associated with incest and exogamy, societies usually prohibit marriage between certain other categories of persons. In some instances slaves cannot marry freemen. Where age sets are a feature of social organization, as among the Nuer, a man may be prohibited from marrying the daughter of another man in his age set. Societies which prescribe that a spouse be chosen from among one or more designated categories of persons have been said to possess closed marriage systems. Those in which such prescriptions do not exist have been characterized as having open marriage systems. The designation of a marriage system as "closed" is not meant to suggest total absence of choice in the process of mate selection. This point is illustrated by Klass (1966), who shows that in Bengal (and in other parts of India), while caste affiliation delimits the broad category of persons from which a spouse is chosen, a man who must choose husbands for his daughters or "wards" does so from within a relatively narrow selection of eligible males known to certain of his kinsmen. The most frequently cited closed marriage systems are found among the indigenous societies of Australia. Some of these societies, for example the Kariera, practice what anthropologists term "symmetrical cross-cousin marriage," wherein pairs of

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local groups engage in the "simultaneous or nearly simultaneous exchange of women" (Leach 196la, p. 59). The male members of the two groups concerned exchange their "sisters" for "wives." Ideally, a male ego marries his mother's brother's daughter, who may at the same time be his father's sister's daughter and the sister of his own sister's husband. Among the Murngin of Australia is found a type of asymmetrical cross-cousin marriage wherein marriage with the mother's brother's daughter is preferred and marriage with the father's sister's daughter is proscribed. In this society and others practicing matrilateral cross-cousin marriage, a localized descent group gives wives to one or more other such groups and receives wives from a different set of such groups. In Murngin society there are descent groups which are allied through ties of kinship and ritual. Moreover, each pair of such allied groups stands in balanced opposition to another similar pair with which it exchanges women on a nonexclusive basis. Since men do not marry within their own moiety, any male ego and his mother's brother are in opposite moieties. Ego's group receives wives from and gives prestations to his mother's brother's group. Ego's mother's brother's group receives wives from and gives prestations to the group with which ego's group is allied. This latter group is the one containing ego's mother's mother's brother, who, of course, stands in the relationship of mother's brother to ego's own mother's brother. It can be said, therefore, that in Murngin society the "mothers' brothers" stand in the relation of "wife givers" to their sisters' sons (see Leach 196la, pp. 68-72). Claude Levi-Strauss, Edmund R. Leach, Louis Dumont, and others have discussed the economic and political implications of this and other forms of "cousin marriage." Leach (1961a, pp. 54-104) has shown that where matrilateral cross-cousin marriage prevails, there exist permanent status differences between wife-giving and wife-receiving groups and has demonstrated that the marriage system is not insulated from other domains in the society. In fact, he argues that marriage alliance in such situations is but one of "many continuing relationships between paired local descent groups." Political and economic relationships are reflected in and sustained by the system of matrilateral cross-cousin marriage. In open marriage systems, the only group of persons unequivocally proscribed as marriage partners are those to whom the incest taboo is extended. There are no normative prescriptions relating to groups from which spouses should be chosen. Nonetheless, many studies indicate that demo-

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MARRIAGE: Comparative Analysis

graphic, ecological, and sociological factors enter into the choice of spouse. Age, residential propinquity, class, religion, ethnicity, education, and occupation have been isolated as important determinants in the choice of marital partners. Likewise, parents and peer groups are often instrumental in delimiting for each individual the field from which a spouse will be chosen. The transfer of rights at marriage Marriage involves the allocation of rights and obligations among the parties to the agreement. A number of anthropologists have attempted to classify the various rights which are known to be allocated at marriage in different societies. In discussing the jural element in marital and other kinship relations, RadclifFe-Brown (1950, p. 12) distinguishes personal rights (jus in personam') from possessive rights (jus in rent}. A right in personam confers on an individual or a group the power to order the performance of certain duties by another individual or group. Rights in rent constitute claims on an object or person such that any encroachment on the object or person constitutes a violation of the "possessor's" rights. In most societies husbands and wives have personal rights in each other: either spouse may claim certain duties of the other. It is also common to find that a husband has "possessive" rights in relation to his wife. Her seduction, her abduction, or her murder would constitute a serious infringement of her husband's rights. In an important contribution to the literature on marriage, Laura Bohannan (1949) distinguishes two classes of rights in females which may be allocated at marriage. Rights in uxorem (rights in a woman as wife) are distinguished from rights in genetricem (rights in a woman as mother). In her discussion of Dahomean marriage, Bohannan shows that rights over a woman's sexual powers and certain of her domestic services were transferred from a woman's patrilineage to the man or woman who made the appropriate bridewealth payments. In most of the "types" of Dahomean marriage, rights to any children a woman might bear during the course of her marriage were also transferred from a woman's patrilineage to that of her husband. Distinct classes of marriage payments were necessary to the transfer of each of these two classes of rights. However, in certain "types" of marriage, rights in genetricem were retained by the woman's natal patrilineage; this might occur in cases where a lineage was faced with a shortage of male heirs and one of the daughters of the lineage was given in marriage to

a man who agreed to make all the bride-wealth payments except those which would have given him jural authority over children of the marriage. Moreover, the marriage of a woman of the royal lineage never involved the transfer of rights in genetricem to the lineage of her hub and (L. Bohannan 1949). Even though it is usually rights in women which are in the forefront of marital negotiations, Leach has pointed out that marriages also serve to allocate rights in and over men (196la, pp. 107-108). He suggests that a marriage may serve to do the following: (1) To establish the legal father of a woman's children. (2) To establish the legal mother of a man's children. (3) To give the husband a monopoly of the wife's sexuality. (4) To give the wife a monopoly of the husband's sexuality. (5) To give the husband partial or monopolistic rights to the wife's domestic and other labor services. (6) To give the wife partial or monopolistic rights to the husband's labor services. (7) To give the husband partial or total rights over property belonging or potentially accruing to the wife. (8) To give the wife partial or total rights over property belonging or potentially accruing to the husband. (9) To establish a joint fund of property—a partnership—for the benefit of the children of the marriage. (10) To establish a socially significant "relationship of affinity" between the husband and his wife's brothers. Leach thus focuses attention on rights in and regarding children, sexuality, domestic and economic services, and property. In the last instance, he suggests that marriages may establish between groups of men mutual interdependencies which could entail any of the above rights as well as others of a political nature. Where there are corporate kin groups, the allocation of rights at marriage is usually effected by and between at least two such groups. In the case of first marriages, it is usual that the groups into which the husband and wife were born are parties in this rearrangement of social relations. Where recruitment to the corporate kin groups is based on patrilineal descent, normally the rights over a woman's sexuality and procreative capacities that are held by her natal group are transferred

MARRIAGE: Comparative Analysis at marriage to the groom and his natal group. Thus, whereas prior to marriage any sexual offense against a woman constitutes a violation of rights held by her kin group, after marriage such an offense is an infringement of the groom's rights. Similarly, whereas children born to a woman outside marriage would fall under the jural authority of her natal kin group, those born after marriage are subject to the authority of, and have rights in, the groom's kin group. Total rights over the bride's domestic and economic services are seldom transferred from her natal group to her husband or his kin group. The woman herself, as an adult member of the society, may retain some control over the dispensing of these services. Often her kin group retains the right to call upon these services. Among the Yoruba of Nigeria, for example, rights in the bride's sexuality, rights over her procreative powers, and partial rights over her domestic services are acquired at marriage by the groom and his patrilineage. However, a woman maintains control over her economic powers and resources, and her natal lineage retains the right to call upon her domestic services in certain circumstances. She is called upon to buy and prepare food at times when deities associated with her lineage must be propitiated, and on the death of a member of her lineage, she is expected to be of service in various ways. This raises another point: in most societies possessing corporate patrilineages, a married woman does not usually relinquish all her rights in her natal lineage. She may retain some proprietary rights therein, and she usually remains under the religious protection of her lineage ancestors. Moreover, a woman's lineage may have the right to reclaim control over her sexual and procreative powers should there be a breach of the marital agreement on the part of her husband. While these statements are generally true, there are some patrilineal societies in which a married woman becomes virtually "absorbed" into her husband's lineage. According to Gluckman (1950), a married woman among the Zulu of south Africa had virtually no rights outside her husband's lineage; once a woman was married, her natal lineage forfeited virtually all authority over her. Whatever rights are transferred to the husband or his lineage may be temporarily or permanently reallocated by him or his lineage. The most common example of this is the practice of "wife-lending" found among the Kipsigis and others. The fact that a man may permit another to have access to his wife's sexuality is proof of his monopoly over her sexual capacities. In some societies, a man

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who is impotent may choose a sexual partner for his wife in order that she may bear children. Where this is so, the husband is the lawful father of the children, even though he is not the genitor. Where a female is permitted to assume the role of husband, she bestows her rights of sexual access to her wife on a man of her own or of her wife's choice. In matrilineal societies, rights over the procreative capacities of women are held in perpetuity by their kin groups while partial or total rights in their sexuality are transferred at marriage to their husbands. Customarily, the husbands also attain rights to the domestic services of their wives. Among the Bemba of east central Africa, for example, a husband has monopoly over his wife's sexuality, but the children of any marriage belong to their mother's matrilineage and are therefore under the jural authority of the adult males of that group. A wife keeps her husband's house and contributes her labor to his agricultural pursuits. Marriages and the exchanges of goods and/or services occasioned thereby are sometimes processual events extending over considerable periods of time. The rights and obligations entailed in the marriage may be allocated in serial fashion, the timing of their transfer being dependent on the transfer of the appropriate goods and services. In such cases, the exchange of goods and services may commence during the period of betrothal and continue even after the formal transfer of certain rights has taken place. Where goods and services are exchanged as part of the marriage procedure, certain of these may be regarded as necessary prestations without whose exchange a transfer of rights will not take place. Others are contingent prestations which, although part of the contract, are not essential to the exchange of jural authority and the assumption of marital rights and obligations. As Fortes says, they constitute the "means of winning and preserving the goodwill of those with the power to transfer marital rights" (1962, p. 10). The most general terms used to describe prestations entailed in the marital contract are those of bridewealth (or bride-price) and dowry. The former refers to gifts presented by the groom's kin group to that of the bride, and the latter describes gifts made by the bride's kin group to that of the groom. The dowry is the more familiar to Westerners, since for centuries it has been a part of the marriage contract in Europe. However, both bridewealth and dowry have been reported for various parts of the world. Throughout history, the transfer of rights at

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MARRIAGE: Comparative Analysis

marriage has been enshrined in ritual and ceremony. This is a correlate of the fact that marriage transactions are always "publicly" acknowledged. The ceremonies which take place in effect call forth "the public" to bear witness to the lawfulness of the transactions. The sanctions which emanate from the jural domain of the society are strengthened by the incorporation of rituals associated with the religious realm of the society. Concurrent marriages. The transfer of rights at marriage and the rituals associated with this transfer signify the assumption of new roles by the parties involved. In societies which permit polygyny or polyandry—marriages entailing a plurality of wives or of husbands, respectively—one of the partners to a marriage assumes the role of co-wife or co-husband along with the role of husband or wife. In polygynous marriages, the husband usually acquires the same categories of rights in each of his wives. In patrilineal societies, a man is the legitimate father of all his wives' children, even though his rights over the wives' sexuality may be assigned to or "usurped by" other men. The children of polygynous marriages may or may not have equal claims on their father's property. In any case, each wife considers herself the guardian of her children's rights within the family created by the polygynous marriage. Where polyandry is practiced, by definition a man does not have exclusive rights in his wife's sexuality. He may or may not have claims over the children which she bears him. Among the Sinhalese, rights over the wife's sexuality are partially vested in the first husband. The sexual rights of the other husbands are exercised with the consent of the first husband and the wife. A husband has claims over those of the wife's children whom he has fathered, and the children have legitimate claims over the property of their respective fathers. All the children have equal claims to the properties owned by their mother. Among the Nayar of south India, a ritual marriage ceremony, called the tali rite, bestowed upon a group of men of appropriate caste the right of access to a woman's sexuality. The completion of the tali rite marked a girl's transition to womanhood. Thereafter, when she attained appropriate age, she could begin to enter into relationships, termed sambandham unions, with a number of men, for whom she might bear children. Rights over a Nayar woman's procreative powers were retained by her matrilineage, which had jural authority over her children. Nonetheless, in order for a child to have "full birth-status rights" in his

mother's lineage, he had to have an acknowledged father. A man acknowledged the paternity of a child by bearing certain expenses associated with its delivery. This man could be any one of those with whom the mother had entered into a sambandham union. In cases of doubtful paternity, a woman's current "visiting husband" could be forced by an assembly of persons in the neighborhood to make the birth payments. "But if no man of appropriate rank could be cited as potential father, woman and child were expelled from their lineage and caste" (Gough 1959, p. 30). The levirate and the sororate. In many societies, an individual may assume the role of husband or wife in order to secure rights for a kinsman. Where the "true" levirate prevails, upon the death of a husband, it is the duty of one of his brothers to marry the widow, and any children born to the union are counted as the progeny of the deceased man. Certain of the "ghost marriages" found among the Nuer resemble the levirate. A man could marry a woman "to the name of" a brother who died childless, and the offspring of the union would be designated as children of the deceased. These practices differ from the custom of adelphic widow inheritance, wherein a man marries his deceased brother's widow and bears children who are counted as his own. Where the "true" sororate prevails, the husband of a barren woman marries her sister, and at least some of the children born to the union are counted as those of the childless wife. The term "sororate" is also used in reference to the custom whereby, upon the death of a wife, her kin supply a sister as wife for the widower. In the latter case, however, any children born to the woman are recognized as her own. Affinal relationships. The transfer of rights at marriage not only signals the couple's assumption of new conjugal roles but also serves to establish or perpetuate affinal relationships between consanguineal kinsmen of the spouses. Often associated with affinal roles are behavioral attributes commonly subsumed under the categories of "joking relationships" and "avoidance relationships." Radcliffe-Brown (1952, pp. 90-116) has argued that the respect implied in avoidance practices and the formalized disrespect demonstrated by joking relationships are expressions of alliance or consociation. The actors in roles characterized by joking or by avoidance have divergent interests which could generate conflict between them and thereby undermine the bases of their common interests. The institutionalization of avoidance and joking serves to minimize the chance of the development of openly hostile relations between the parties.

MARRIAGE: Comparative Analysis The most widespread of the avoidance practices are those which restrict contact between a husband or wife and the mother-in-law and/or father-in-law. Such restrictions on contact may also extend to actual or classificatory brothers or sisters of the father-in-law or mother-in-law. Among the patrilineal Swazi of south Africa, a wife is prohibited from coming into face-to-face contact with her husband's father and those of his male relatives of the same generation resident in the compound. A man behaves in similar fashion toward his motherin-law, but the likelihood of such contact is minimized by their residence in different compounds and often in different villages. Joking relationships most commonly exist between a man or woman and affinal relatives of opposite sex in the spouse's generation. These relationships are characterized by the use of intimate names, the use of language otherwise considered lewd or abusive, and, in some cases, by indulgence in sexual play. Affinal relatives are often expected to give assistance to one another in times of exigency. In many societies where political functions are vested in roles defined primarily by kinship criteria, affinal relatives serve to minimize open conflict between their respective consanguineal kin groups. They might serve, as among the Tiv of Nigeria, as emissaries of peace in cases of latent or open conflict between two lineages. The linkage of individuals through marriage leads to the creation of new groups or, in Nadel's terminology, to the creation of new sets of bounded social relationships and thereby constitutes a phase in the developmental cycle of kin groups. As Radcliffe-Brown has pointed out, the eventual result of most marriages is that new sets of individuals are linked through common descendants. Ultimately, the fission of kin groups can often be traced to relations generated by marriage. This process is evident in many societies where lineages (or, for that matter, ramages) are a feature of social organization. When adult members of a lineage segment occupy a common residence along with their spouses and children, the process of incorporation of additional coresidents through marriage often eventually leads to the founding of households in other locations. In the course of time, the founders of such households and their descendants may come to form new lineage segments. Postmarital residence In some societies, spouses are expected to live together throughout the period of their marriage; in

15

others, they may be members of separate domestic groups and only visit each other's residences. The "residence rules" outlined by anthropologists refer to situations in which husbands and wives are members of the same domestic unit. Neolocal residence predominates when couples establish independent domestic units after marriage. Residence is characterized as virilocal when most couples in a society join a domestic group in which the husband resided prior to marriage or in which he rather than the wife has proprietary or other claims. Residence is called uxorilocal when couples join the domestic group to which the wife was attached prior to the marriage or in which the wife rather than the husband has claims. The above terms may be compounded with others to describe more precisely the nature of the domestic group joined by the couple. Thus, viripatrilocal residence refers to domicile in a domestic group whose core includes the groom's father. Uxorimatrilocal residence refers to domicile in a group whose core includes the bride's mother. The term avunculocal is used to describe residence in a group whose core includes the groom's mother's brother. Data collected by Goodenough (1956) and J. L. Fischer (1958) among the Nakanai of New Britain show that the classification of postmarital residence patterns is not as straightforward as some might assume. Their data also illustrate that there is no simple correlation between particular residence rules and particular rules for recruitment to descent groups. Goodenough shows that in this matrilineal society, a man takes his bride to live in the village in which his father resides. The couple lives there so long as the groom's father is alive, and they may remain after the father's death, particularly if the father is without sisters' sons who would be his jural heirs. More often, however, after the father's death, the couple moves to the residence of the husband's matrilineage, in which he has hereditary land rights. A man whose father is deceased takes his bride to live with the group which includes the man who acted as father-surrogate at the time of the marriage. Goodenough shows that even where ideal residence patterns suggest one or more prevailing modes of residence, the actual choices which couples make may depend on economic and other factors. Fischer, who also worked on the island of Truk and who arrived at a classification of residences significantly different from Goodenough's, has suggested that residence be elicited for individuals than rather for married couples. He suggests that every person in a household has a "kin sponsor"

16

MARRIAGE: Comparative Analysis

and that his relationship to this sponsor most appropriately describes the residence pattern for that individual. While Fischer's suggestion has some merit for the classification of residence patterns for entire populations, attention cannot be shifted from the fact that in most societies the major spatial arrangements of individuals are associated with marriage. Moreover, the kinds of rearrangements which do occur have important implications for many kinds of social relations. It has been shown, for example, that the study of the developmental cycle of domestic groups touches on virtually all aspects of social structure and that postmarital residence patterns are crucial to the understanding of the development of domestic groups (Goody 1958). Alternatives to marriage Marriage is a process or event signifying the assumption of the roles of husband and wife in accordance with jural tenets prevalent in the society or stratum of society to which the parties belong. In contemporary societies, marriages are contracts which must be formally legitimized by the state. A state may provide that for purposes of inheritance, or for other specified purposes, persons who are not legally married to each other but who share a common domicile and who otherwise demonstrate a claim to conjugal status may be accorded some or all rights associated with legal marriage. Similarly, a state may choose to recognize marriages contracted according to rules formulated prior to its existence by some or all of the groups which constitute it. Such is the case in various parts of the world where formerly autonomous or semiautonomous political entities have come together to form modern nation-states. Unions other than lawful marriage are known to have existed in stateless societies as well as in states which did not make the legitimization of marriages their official concern. Yet it seems particularly characteristic of modern societies that there are individuals who, for various reasons, assume some or all of the obligations and rights associated with the roles of husband and wife without entering into legal marriage. Reference has already been made to the fact that one of the crucial ways in which such unions differ from marriage is that they do not create lawful kinship ties between consanguineal relatives of the couple. These "consensual unions" occur in different frequencies in different modern societies. In the United States, in the Caribbean, and in other areas where such unions occur with relatively high fre-

quency among certain socioeconomic classes and/ or ethnic groups, research has centered primarily on family organization, and consensual unions are often regarded as but one aspect of over-all "family instability." The result is that while many hypotheses have been offered to account for the matrifocal or matricentric family which, in some areas, is one structural correlate of consensual unions, few students have offered hypotheses which explicitly attempt to account for the origin and/or persistence of such unions. M. G. Smith (1962) has presented a wealth of statistical data in support of his hypothesis that specific mating patterns underlie the various forms of family organization in the Caribbean. He has demonstrated that the pattern of consensual mating underlies the matrifocal family in that area. However, he does not deal with the origin and persistence of the mating patterns themselves. Nevertheless, the data suggest that demographic and economic factors are important determinants of these patterns. For example, where the sex ratio is altered by the necessity that males migrate to find work, women often enter into extramarital unions with single or married men who remain behind. Such alliances may or may not entail coresidence. Consensual unions may constitute a stage in the development of domestic groups and as such are not so much alternatives as preludes to marriage. In parts of the Caribbean where great prestige is attached to church marriages followed by festivities requiring the outlay of large sums of money, couples often assume the roles of husband and wife by mutual consent until such time as they can afford a religious marriage ceremony. Thus, many couples establish a common domicile and bear children before they enter into matrimony "before the eyes of man and of God." This raises an important point. Even though, in most parts of the modern world, marriages may be contracted without religious ceremonies, historically marriage was the concern of religious institutions before it became the official concern of the state, and most religious doctrines still include prescriptions and proscriptions regarding marriage. Where the influence of religious tradition is particularly strong, civil marriages may be regarded as little more than alternatives to or complements of "true marriage." One of the consequences of this, as evidenced in parts of the Caribbean, is that couples enter into extramarital relationships until such time as they can finance the religious and convivial ceremonies as well as fulfill the legal requirements for marriage.

MARRIAGE: Comparative Analysis Marital stability and divorce The ambiguities entailed in the concept of marital stability have been succinctly stated by David Schneider: Stability may be defined in terms of the change of rules or expectations over time or in terms of the degree to which the rules or expectations are conformed to. Stable marriage may be defined as stable jural relations irrespective of conjugal relations, as stable conjugal and jural relations, or simply as stable conjugal relations. (1953, p. 56) Thus, divorce, defined as the lawful dissolution of jural ties established at marriage, may occur relatively infrequently even though separation and other breaches in conjugal relations occur relatively frequently. In traditional Nuer society, the jural bonds established by marriage were stable; divorce, signified by the return of bridewealth, was rare. On the other hand, conjugal separation was relatively frequent. Max Gluckman (1950) was one of the first anthropologists to deal with the factors which contribute to the jural stability of marriage in preindustrial societies. His data on the Lozi and the Zulu led him to the hypothesis that the stability of jural relations established by marriage is correlated with the presence of patrilineages. He argued that where the "principle of father-right" prevailed, as among the Zulu, there was a complete and final transfer of women into their husbands' lineages (from which their children obtained their legal rights), and he suggested that this fact accounted for the virtual absence of divorce in such societies. In a reconsideration of the Gluckman hypothesis, Fallers pointed out that not all patrilineal societies provide for the absorption of women into their husbands' lineages. He suggests that where women retain rights in their natal patrilineages, patriliny contributes to the jural instability of marriage by dividing the loyalties of spouses. Fallers (1957) found among the Busoga a relatively high incidence of divorce, which he attributed in part to the fact that loyalties to natal lineages undermined the bonds established at marriage. Leach (1961a, pp. 114-123), Cohen (1961), and others have contributed to the discussions of marital stability begun by Gluckman, Schneider, and Fallers. However, there is yet to be undertaken the quantitative and comparative analyses required for a definitive statement on the determinants of stability in the jural aspects of marriage. Whether the aim is to isolate the determinants of differential rates of divorce within a single society or to account for the differences in the divorce rates

17

reported for various societies, care must be taken to insure that the data utilized are in fact representative of the populations discussed. Moreover, more attention must be given than has been in the past to the limits of the utility of numerical data, which, at best, can be considered reliable for relatively short time spans. The separation of spouses is usually taken as an index of instability in conjugal relations. However, it should be obvious that separation can only be taken as indicative of the disintegration of conjugal bonds when the coresidence of spouses is a societal norm. Even in these cases, separation does not always signal instability in conjugal relations. Among the Yoruba, it is common to find women living and working in one place while their husbands live and work in another. So long as these women are not known to have committed adultery, and so long as they fulfill certain responsibilities to their husbands and their husbands' lineages, their conjugal relations are not necessarily impaired. The distinction drawn by Schneider between stability in conjugal relations and stability in the jural aspects of marriage relations is useful in the analysis of marriage in contemporary societies. For example, it would be useful to make such a distinction in discussions of marriage patterns in the Caribbean and in the United States. As has been pointed out, among some of the lower-class populations in these areas, consensual mating is common. Not all the parties to consensual unions are persons who have never been legally married. In fact, where the economics of divorce are a deterrent to the lawful dissolution of marriage, consensual unions are often an alternative to divorce and remarriage. Hence, the jural relations established at marriage are often maintained even though conjugal relations are completely or partially severed. Most of the societies whose marriage systems are described in the anthropological literature are now incorporated into independent states. The very existence of these states signals changes in the rules regarding the establishment of marital contracts, since all contemporary states reserve the right to define what types of union constitute legal marriage. There is general agreement that the economic and demographic changes taking place in the "developing areas" are also effecting changes in traditional marriage systems. However, Goode (1963) has pointed out the difficulties involved in isolating cause—effect relationships between changes in a society's family patterns, including marriage, and

18

MARRIAGE: Comparative Analysis

changes in its economic organization. Considerable refinement in research strategies is necessary before it will be possible to state with confidence the extent to which, the precise ways in which, and the specific points at which the spread of industrial technologies and the growth of cities impinge upon or serve to undermine traditional family structures and marriage patterns. Some of the studies of marriage found in the anthropological literature provide convenient points of departure for investigations of changes in the rules and behavior associated with marriage in different parts of the world. However, it is obvious that analyses of changing patterns of marriage require the collection of a larger body of quantifiable data than is available in most existent anthropological studies of marriage. Whereas most of the marriage systems described in the anthropological literature lent themselves to representation in terms of mechanical models, such models are becoming increasingly inadequate as representations of particular systems and as bases for comparative studies. The rules governing the establishment of marriage contracts, the factors influencing the choice of spouses, the rights and obligations entailed in conjugal roles, and the behavior of persons in these roles are sufficiently variable in any one system to require partial or total representation by means of statistical models. With the construction of such models, we can begin the assessment of the directions and rates of change in marriage systems and the isolation of the specific variables which account for these changes. GLORIA A. MARSHALL BIBLIOGRAPHY

BOHANNAN, LAURA 1949 Dahomean Marriage: A Revaluation. Africa 19:273-287. BOHANNAN, PAUL 1963 Social Anthropology. New York: Holt. BRITISH ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE 1951 Notes and Queries on Anthropology. 6th ed. London: Routledge. -» The first edition was published in 1874. The sixth edition was revised and rewritten by a committee of the Royal Anthropological Institute of Great Britain and Ireland. CHRISTENSEN, HAROLD T. (editor) 1964 Handbook of Marriage and the Family. Chicago: Rand McNally. CLARKE, EDITH 1957 My Mother Who Fathered Me: A Study of the Family in Three Selected Communities in Jamaica. London: Allen & Unwin. COHEN, RONALD 1961 Marriage Instability Among the Kanuri of Northern Nigeria. American Anthropologist New Series 63:1231-1249. EVANS-PRITCHARD, E. E. 1951 Kinship and Marriage Among the Nuer. Oxford Univ. Press.

FALLERS, L. A. 1957 Some Determinants of Marriage Stability in Busoga: A Reformulation of Gluckman's Thesis. Africa 27:106-123, FISCHER, H. T. 1956 For a New Definition of Marriage. Man 56:87 only. FISCHER, JOHN L. 1958 The Classification of Residence in Censuses. American Anthropologist New Series 60: 508-517. FORTES, MEYER 1959 Descent, Filiation and Affinity: A Rejoinder to Dr. Leach. Man 59:193-197, 206-212. FORTES, MEYER (editor) 1962 Marriage in Tribal Societies. Cambridge Papers in Social Anthropology, No. 3. Cambridge Univ. Press. GLUCKMAN, MAX 1950 Kinship and Marriage Among the Lozi of Northern Rhodesia and the Zulu of Natal. Pages 166-206 in A. R. Radcliffe-Brown and Daryll Forde (editors), African Systems of Kinship and Marriage. Oxford Univ. Press. GOODE, WILLIAM J. 1963 World Revolution and Family Patterns. New York: Free Press. GOODE, WILLIAM J. (editor) 1964 Readings on the Family and Society. Englewood Cliffs, N.J.: PrenticeHall. GOODENOUGH, WARD H. 1956 Residence Rules. Southwestern Journal of Anthropology 12:22-37. GOODY, JACK R. 1956 A Comparative Approach to Incest and Adultery. British Journal of Sociology 7:286-305. GOODY, JACK R. (editor) 1958 The Developmental Cycle in Domestic Groups. Cambridge Papers in Social Anthropology, No. 1. Cambridge Univ. Press. GOUGH, E. KATHLEEN 1959 The Nayars and the Definition of Marriage. Journal of the Royal Anthropological Institute of Great Britain and Ireland 89:23-34. KLASS, MORTON 1966 Marriage Rules in Bengal. American Anthropologist New Series 68:951-970. LAWRENCE, WILLIAM; and MURDOCK, GEORGE P. 1949 Murngin Social Organization. American Anthropologist New Series 51:58-66. LEACH, EDMUND R. 1961a Rethinking Anthropology. London School of Economics and Political Science, Monographs on Social Anthropology, No. 22. London: Athlone. LEACH, EDMUND R. 1961i» Asymmetric Marriage Rules, Status Difference, and Direct Reciprocity: Comments on an Alleged Fallacy. Southwestern Journal of Anthropology 17:343-351. LEVI-STRAUSS, CLAUDE 1949 Les structures elementaires de la parente. Paris: Presses Universitaires de France. LOWIE, ROBERT 1933 Marriage. Volume 10, pages 146154 in Encyclopaedia of the Social Sciences. New York: Macmillan. MALINOWSKI, BRONISLAW (1929) 1962 Marriage. Pages 1—35 in Bronislaw Malinowski, Sex, Culture and Myth. New York: Harcourt. MOGEY, JOHN (editor) (1962) 1963 Family and Marriage. Leiden (Netherlands): Brill. -> First published in Volume 3 of the International Journal of Comparative Sociology. PETER, PRINCE OF DENMARK 1956 For a New Definition of Marriage. Man 56:48 only. RADCLIFFE-BROWN, A. R. 1950 Introduction. Pages 185 in A. R. Radcliffe-Brown and Daryll Forde (editors), African Systems of Kinship and Marriage. Oxford Univ. Press. RADCLIFFE-BROWN, A. R. 1951 Murngin Social Organization. American Anthropologist New Series 53:37-55.

MARRIAGE: Marriage Alliance RADCLIFFE-BROWN, A. R. (1952) 1961 Structure and Function in Primitive Society: Essays and Addresses. London: Cohen & West; New York: Free Press. RADCLIFFE-BROWN, A. R.; and FORDE, DARYLL (editors) 1950 African Systems of Kinship and Marriage. Published for the International African Institute. Oxford Univ. Press. SCHNEIDER, DAVID M. 1953 A Note on Bridewealth and the Stability of Marriage. Man 53:55-57. -> For the ensuing discussion on this topic, see the articles numbered 122, 223, and 279 in Volume 53 of Man, by E. E. Evans-Pritchard, Max Gluckman, and E. R. Leach, respectively; see also the articles numbered 96, 97, and 153 in Volume 54 of Man, by Max Gluckman, William Watson, and E. R. Leach, respectively. SCHNEIDER, DAVID M. 1965 Some Muddles in the Models: Or, How the System Really Works. Pages 25-85 in Conference on New Approaches in Social Anthropology, 1963, Cambridge, The Relevance of Models for Social Anthropology. Edited by Michael Banton. Association of Social Anthropologists, Monograph No. 1. London: Tavistock. SMITH, M. G. 1953 Secondary Marriage in Northern Nigeria. Africa 23:298-323. SMITH, M. G. 1962 West Indian Family Structure. Seattle: Univ. of Washington Press. WINCH, ROBERT; McGiNNis, ROBERT; and BARRINGER, HERBERT (editors) (1953) 1962 Selected Studies in Marriage and the Family. Rev. ed. New York: Holt. Ill MARRIAGE ALLIANCE

All societies prohibit marriage with certain relatives, but some societies complement this prohibition by prescribing, or preferring, marriage with other relatives. In this way two kinds of cousins are sometimes distinguished, marriage being prohibited between those who are children of siblings of the same sex ("parallel cousins"), while it is prescribed between children of siblings of opposite sex ("cross-cousins"). This disposition is generally accompanied by exogamy. This article attempts to sum up recent developments in the theory of crosscousin marriage. Descent and alliance The expression "marriage alliance," in which "alliance" refers to the repetition of intermarriage between larger or smaller groups, denotes what amounts to a special theory of kinship, a theory developed to deal with those types of kinship systems that embody positive marriage rules, though it also affords certain general theoretical insights regarding kinship. Two points may be noted at the outset: (1) The combination of the positive marriage rule with exogamy, or at the very least with a prohibition against marriage between parallel cousins, is essential to the type of system under description here; a preference for marriage with

19

the father's brother's daughter, as found among some Islamic peoples, is a quite different phenomenon. (2) The approach here presented is essentially common to several writers, though an element of personal interpretation is inevitable. In the initial stages of kinship studies, the reconstruction of fanciful marriage rules (or mating arrangements) as having supposedly existed in the past was widely used in order to explain seemingly strange ways of classifying relatives (kinship terminologies). This practice has brought discredit, in the eyes of some, to the study of both marriage rules and terminologies. In 1871 Lewis Henry Morgan made two assumptions: (1) terminology reflects behavior, and hence, (2) if a terminology cannot be understood from present behavior, it must be because the behavior it reflects belongs to the past. [See the biography of MORGAN, LEWIS HENRY.] Quite apart from the difficulty of reconstructing past behavior, anthropological thought in this matter is still ethnocentric. The underlying assumption is that all peoples entertain the same ideas about kinship; their classifying of relatives in different ways is, therefore, due to differences in behavior. Fully excusable in Morgan, such an assumption is less so today. W. H. R. Rivers recognized the link between an actual marriage rule (symmetrical cross-cousin marriage) and a certain type of terminology (often called "bifurcate merging"). For Rivers, the marriage rule was the cause, the terminology the effect, and he saw his task as explaining the marriage rule itself. [See the biography of RIVERS.] Once again, terminology reflects behavior, and again historical speculation is called in, this time to discover the "origin" of one item, which is in fact essentially a normative trait. In our time the different features of a kinship system are, in practice, often considered in isolation or are hierarchized according to what is assumed to be their degree of reality or determinativeness. This tendency, if not found in such crudity as in the past, still exerts considerable pressure even on the best minds, and that it constitutes a major obstacle to the understanding of certain kinship systems can be shown by the example of Australian kinship, a classical subject for kinship theory. In Australian section systems, descent is overstressed; the reasons that may elsewhere justify this emphasis are here misplaced, for it prejudices the consideration of other elements in the system. In writing about Australian kinship systems, authors vie with each other in stressing that in

20

MARRIAGE: Marriage Alliance

A,

K

r

n

-A L—J

di

Ac,

A8' C,

D, KARIERA

ARANDA (North)

AMBRYM (Balap)

Figure 1

symmetrical cross-cousin marriage arrangements, double descent is always present or implied. This is unobjectionable in itself, but in the literature it is accompanied by a bias which makes itself obvious by repetition, whether it be in B. Z. Seligman's attempt to reduce the "type of marriage" to "forms of descent" (1928, p. 534), however strange the latter forms may appear, or in Radcliffe-Brown's overemphasis upon descent, or in Murdock's outbidding of Radcliffe-Brown in this respect. Radcliffe-Brown was not content with finding an underlying matrilineal exogamy in his classic Australian patrilineal systems and with seeing in what is now called "double descent" a widespread principle of Australian kinship. He claimed that his second kind of exogamous group actually "existed," whereas he had only inferred it (1931, pp. 39, 439); the point is insisted upon by Goody (1961, pp. 6 ff). It is perplexing later on to find Murdock opposing Radcliffe-Brown, while praising the same discovery in others; but the crux of the matter is that in Murdock's opinion Radcliffe-Brown had not gone far enough in stressing descent and descent groups, for Radcliffe-Brown had maintained, at another level, the primacy of individual relationships and marriage rules over the arrangement of groups (Murdock 1949, pp. 51 ff.). Actually, the hypothesis of underlying matrilineal exogamy among the Kariera and Aranda accounts for the allocation of alternate generations to different groups. Among them, the patrilineal group is conceived not as a unity over a continuous series of generations but as a duality made up of two alternate generation-sections, called by different names and following different marriage rules (the grandson falling back, so to speak, into the grand-

father's section). This is the simple, concrete sociological fact, widespread in Australia. If we take this for granted, together with intermarriage between the named sections, we can in each case draw a simple diagram of the whole tribe. In Figure 1 the sign [=] denotes intermarriage in both directions, the letters A, B, etc., represent patrilineal groups, and the numbers 1 and 2 are used for the two alternating generation-sections in each patrilineal group. The system of Ambrym (Balap) is easily represented in the same fashion (Deacon 1927). All three systems represent variations on the same theme, the number of patrilineal groups being respectively two, four, and three, the number of sections four, eight, and six. Each of the three systems may be conceptualized as forming a single whole through a regular chain of intermarriage and patrilineal descent. The differences in the arrangement follow necessarily from the numbers of groups (for details, see Dumont 1966). I do not pretend that a second unilineal principle cannot be said to underlie these systems, but only that the above is a simpler view of them. Let us now turn to the general theory that, like the above analysis, recognizes intermarriage as a basic element in those systems which possess a preferential or prescriptive marriage rule. Levi-Strauss We must neglect the scholars who had previously advanced the distinction and description of the types of cross-cousin marriage (e.g. Fortune 1933; Wouden 1935) and start with the general theory of Levi-Strauss. His monumental book Les structures elementaires de la parente (1949) goes far beyond our limits. Josselin de Jong (1952) has

MARRIAGE: Marriage Alliance provided an able summary of the book, while Leach (1961) and Needham (1960) have sympathetically, but sharply, criticized its detail. Our concern here is only with its leading ideas. From the present point of view, the work is first of all a comparative study of positive marriage rules, informed by a general theory of kinship. Preferential marriage rules and marriage prohibitions are accounted for within an integrated body of theory. The prohibition of incest is recognized as universal; it is seen as a basic condition of social life. A man cannot take in marriage the women who are his immediate kin; on the contrary, he has to abandon them as wives to others and to receive from others his wife or wives. Levi-Strauss considers this situation as a universal principle which lies beyond sociological explanation—and which implies an opposition between consanguinity and affinity as the cornerstone of kinship systems. He views marriage as predominantly a process of exchange (between one man and other men or between one domestic group and others), and he sees in positive marriage rules devices through which this exchange is directly regulated, giving rise to what he has called "elementary" structures. Let us note that a kinship system is viewed here, starting from its basis in the incest prohibition, as an entirety resting on an opposition and not as a mere collection of features in which one feature might, for a priori reasons, be considered to determine the others. Abstractly, a kinship system is taken as combining a number of features (descent, inheritance, residence, affinity), and an effort is made to characterize the whole by the relations that prevail between the different features. Thus, a system is called harmonic if all transmission between generations takes place in one and the same line, dysharmonic if some features are transmitted patrilineally, others matrilineally. The rule of crosscousin marriage, where it exists, correlates with this. Theoretically three types may be distinguished: bilateral, matrilateral, and patrilateral. In bilateral cross-cousin marriage, the spouse is at the same time mother's brother's child and father's sister's child. Two intermarrying groups exchange women as wives and thus constitute a self-sufficient unit. Levi-Strauss has called this form "closed" or "restricted" exchange (echange restreint} and correlated it with dysharmonic transmission. In opposition to this type, he has stressed the quite different properties and implications of matrilateral crosscousin marriage. This type had been less clearly recognized by previous writers, though he does not consider the Dutch literature on Indonesia in which the type had been characterized (e.g. Fischer 1935;

21

1936; Wouden 1935). In this type, a man marries his mother's brother's daughter; a given line B takes wives from a line A and gives wives to a line C, generation after generation. Intermarriage is thus asymmetrical, and if the society is conceived as a number of discrete groups giving and receiving women in marriage, the simplest system is that of a circle: at the end of the series, Z receives from Y and gives to A (called the "circulating connubium" by the Dutch scholars). This is what LeviStrauss calls "generalized exchange." In opposition to the closed type, it requires at least three groups and may accommodate any number of groups. This type correlates with harmonic transmission, which may be either matrilineal or patrilineal. Here the identity of the intermarrying group emerges from the network of relationships, for one group is not closely dependent on any other single group, nor are two successive generations distinguished. Relatives belonging to different generations within the same group of affines are terminologically equated. Since intermarriage is directionally oriented—a group does not receive wives from the group to which it gives its daughters—there is a probability of difference of status between wife-givers and wife-takers. For a discussion of the further consequences, see Leach (1961, chapter 3; cf. Fischer 1935). The third type, the patrilateral, is only cursorily treated in Levi-Strauss's treatise; it appears there as a kind of abortive crossbreed between the first two types and is omitted here because it is somewhat controversial (Needham 1958Z?; Lane 1962). Some of the objections that have been leveled at Levi-Strauss's theory can be briefly mentioned. One, forestalled by Levi-Strauss, is that he argues exclusively about viripotestal societies; another is that his idea of marriage is naive, although this is beside the point, since he was actually concerned solely with the forms and implications of intergroup marriage. A more radical criticism can be directed at the fundamental character and explanatory value of "exchange" in Levi-Strauss's scheme (discussed in Wolfram 1956). To view the prohibition of incest as the basis for the opposition between consanguinity and affinity appears tautological to those who think of consanguinity itself as fundamental and self-explanatory or appears insufficient to those who would like a psychological explanation. Viewing marriage as an exchange may be questioned on two counts. First, it introduces an arbitrary analogy between women and chattels, women being supposed, for instance, to be universally the most prized of "valuables." Second, "exchange" here tends to be given so wide and inde-

22

MARRIAGE: Marriage Alliance

terminate a meaning as to be practically devoid of content. While this is true of "indirect exchange" and even more so of "reciprocity," the notion of exchange is certainly useful within limits. In still another critique of Levi-Strauss, Homans and Schneider (1955) argue, in the last analysis, that to look at kinship systems as wholes having explanatory value in relation to their parts is to resort to "final causes." This critique has itself been carefully refuted by Needham (1962). Developments Since 1949 the Levi-Straussian theory has been tested and has undergone partial modifications and developments. To mention only the major themes, we have first the clear-cut distinction, advocated by Needham, between prescription and preference in marriage rules. He claims that prescription alone has "structural entailments" in the total social system, and that Levi-Strauss has dealt only with prescription or at any rate should have done so (Needham 1962). "Prescription" is here defined more as the characteristic of a system than as simply a marriage rule: it involves the combination of a rule prescribing some relatives and prohibiting others, a corresponding terminological distinction, and a sufficient degree of observation of the rule in practice (Needham 1958a, p. 75; 1958£>, p. 212). The advisability of the distinction has been challenged by R. B. Lane (1962, p. 497). At first sight the distinction seems justified, and there is no objection to isolating a clear-cut type of "prescriptive alliance." That there is a danger of underestimating the importance of other types is apparent from the exacting criteria by which the author excludes the recognition of forms of patrilateral intermarriage as "prescriptive" in his sense (Needham 1958£>), These latter forms, like preferential marriage in general, do have "structural entailments" of a kind, as we shall see. Moreover, the two forms are not easily distinguishable; the distinction, so presented, is more one of levels than of systems (for a recent clarification of this question, see Maybury-Lewis 1965). The main development has probably been a refinement of the concept of alliance and the substitution of a more structural for a more empirical notion. At the start the theory, although anchored in the notion of complementarity, was in large part concerned with the exchange or circulation of women between the major exogamous components of the society. To begin with, three authors have asserted that the units which may be said to exchange women are, in concrete cases, smaller than

the exogarnous units. In 1951 Leach sternly insisted—with empirical, if somewhat dogmatic, good sense—that the agents arranging marriages are as a rule the males of the local descent groups, as distinct from the wider exogamous units and from the "descent lines" used in terminological diagrams and often unwittingly reified by the analyst into actual groups (see Leach 1961, p. 56; cf. Needham 1958a). Quite logically, Leach went on to criticize the assumption that a matrilateral marriage rule should necessarily result in the groups intermarrying "in a circle," an idea which Needham, on the other hand, tried to refine (1958a; 1962). A criticism from Berting and Philipsen may also be noted: to be meaningful, they suggest, the "marriage cycles" must be limited in number, and the people themselves must be aware of them (Needham 1961, p. 98). While such "alliance cycles" (Needham) do meaningfully exist in some cases, their existence does not exhaust the function or meaning of marriage alliance. On this all our authors agree, for Levi-Strauss (1962, p. 333) himself recently recognized—if my interpretation is correct—that "conscious rules" have emerged from recent research as more important than their results in terms of "exchange." Leach had pointed out that, in the absence of cycles, the basic relationship is "one of the many possible types of continuing relationship between paired local descent groups" (1961, p. 101). Elsewhere, while marriage alliance does not result in a system of exchange at the level of the group as a whole, it is an integral part of the system of categories and roles as conceived by the people studied (Dumont 1957, pp. 22, 34). Needham has gone furthest in submitting LeviStraussian structuralism to criticism from the inside and in referring the "mediating" concepts of exchange and reciprocity back to that of (distinctive) opposition (1960, p. 103). The more fundamental "integration" is not that of groups but rather that of the categories as it occurs within the social mind: the marriage rule is part and parcel of this system of ideas. Like everything else, social relationships are defined by classification. Studying the "symbolic order" of the Purum and others, Needham (1958a) found that asymmetrical intermarriage, although it could not function with less than three intermarrying or "alliance groups," can be dualistically conceptualized (wife-givers and wife-takers) in accordance with an over-all dualist scheme. Here are found "structural entailments" different from the group arrangements on which attention had first focused. The expression "mar-

MARSH, GEORGE PERKINS riage alliance" thus covers both the general phenomenon of mental integration and the particular phenomenon of group integration. In its restricted field this truly structural theory alone transcends the bias inherent in our own culture. Such expressions as "cross-cousin marriage" are technically useful but basically misleading. Real understanding is reached when the marriage rule understood as marriage alliance is seen as giving affinity the diachronic dimension that we tend to associate only with descent and/or consanguinity. By this means we are able to transcend the limitations of thinking based upon our own society and make comparisons in terms of the basic concepts involved (consanguinity and affinity). Much remains to be done. Certainly the implications of marriage alliance for status, economy, and political organization (i.e., the physiology of the system) should be worked out (Leach 1961, chapter 3). But even regarding the morphology, our analyses are as yet imperfectly structural; we still take too much for granted in the study of terminologies. Before attempting ambitious (^constructions, the basis in comparative data must be strengthened and extended, and we must obtain a clearer view of the limits of the logical integration of features, or conversely, of the plasticity and tolerance of systems, which can in some cases go so far as to deny in effect the ideological primacy postulated above in principle. Louis DUMONT BIBLIOGRAPHY

DEACON, A. BERNARD 1927 The Regulation of Marriage in Ambrym. Journal of the Royal Anthropological Institute of Great Britain and Ireland 57:325-342. DUMONT, Louis 1957 Hierarchy and Marriage Alliance in South Indian Kinship. London: Royal Anthropological Institute. DUMONT, Louis 1966 Descent or Intermarriage? A Relational View of Australian Section Systems. Southwestern Journal of Anthropology 22:231-250. FISCHER, H. T. 1935 De aanverwantschap bij enige volken van de Nederlands-Indische Archipel. Mensch en maatschappij (Amsterdam) 11:285-297, 365-378. FISCHER, H. T. 1936 Het asymmetrisch cross-cousinnuwelijk in Nederlandsch Indie. Tijdschrift voor Indische taal-, land- en volkenhunde 76:359-372. FORTUNE, R. F. 1933 A Note on Some Forms of Kinship Structure. Oceania 4:1-9. GOODY, JACK R. 1961 The Classification of Double Descent Systems. Current Anthropology 2:3-26. -> Includes comments by 13 scholars on pages 13-21; see especially R. B. Lane's comments on page 16. HOMANS, GEORGE C.; and SCHNEIDER, DAVID M. 1955 Marriage, Authority, and Final Causes: A Study of Unilateral Cross-cousin Marriage. Glencoe, 111.: Free Press.

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JOSSELIN DE JONG, JAN P. B. DE 1952 Levi-Strauss's Theory on Kinship and Marriage. Mededelingen van het Rijkmuseum voor Volkenkunde, No. 10. Leiden (Netherlands): Brill. LANE, ROBERT B. 1962 Patrilateral Cross-cousin Marriage. Ethnology 1:467-499. LEACH, EDMUND R. 1961 Rethinking Anthropology. London School of Economics and Political Science, Monographs on Social Anthropology, No. 22. London: Athlone. LEVI-STRAUSS, CLAUDE 1949 Les structures elementaires de la parente. Paris: Presses Universitaires de France. LEVI-STRAUSS, CLAUDE (1962) 1966 The Savage Mind. Univ. of Chicago Press. -» First published in French. MAYBURY-LEWIS, DAVID H. P. 1965 Prescriptive Marriage Systems. Southwestern Journal of Anthropology 21:207-230. MURDOCH, GEORGE P. 1949 Social Structure. New York: Macmillan. -> A paperback edition was published in 1965 by the Free Press. NEEDHAM, RODNEY 1958a A Structural Analysis of Purum Society. American Anthropologist New Series 60:75-101. NEEDHAM, RODNEY 1958b The Formal Analysis of Prescriptive Patrilateral Cross-cousin Marriage. Southwestern Journal of Anthropology 14:199-219. NEEDHAM, RODNEY 1960 A Structural Analysis of Aimol Society. Bijdragen tot de taal-, land- en volkenkunde (The Hague) 116:81-108. H> Text is in Dutch and English. NEEDHAM, RODNEY 1961 Notes on the Analysis of Asymmetric Alliance. Bijdragen tot de taal-, land- en volkenkunde (The Hague) 117:93-117. NEEDHAM, RODNEY 1962 Structure and Sentiment: A Test Case in Social Anthropology. Univ. of Chicago Press. RADCLIFFE-BROWN, A. R. 1931 The Social Organization of Australian Tribes. Oceania 1:34-63, 206-246, 322341, 426-456. SELIGMAN, BRENDA Z. 1928 Asymmetry in Descent, With Special Reference to Pentecost. Journal of the Royal Anthropological Institute of Great Britain and Ireland 58:533-558. WOLFRAM, E. M. S. 1956 The Explanation of Prohibitions and Preferences of Marriage Between Kin. Ph.D. dissertation, Oxford Univ. -> See especially Chapter 8, "The Explanation of Incest and Marriage Regulations." WOUDEN, F. A. E. VAN 1935 Sociale structuurtypen in de Groote Oost. Leiden (Netherlands): Ginsberg.

MARSH, GEORGE PERKINS George Perkins Marsh (1801-1882), an American geographer, is known today primarily as the founding father of the conservation movement. His contemporaries regarded him as the most comprehensive American scholar of the time. His enduring contributions to knowledge stemmed from an unusual combination of historical and ecological insights. As a social historian, Marsh broke new ground in treating the story of mankind as the history of the use and misuse of resources.

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MARSH, GEORGE PERKINS

As an ecologist, he saw the history of nature commingled with that of man and traced the motives, the techniques, and the consequences of man's impact on the earth. Although he was not a trained naturalist, Marsh manifested an extraordinary awareness of the fragile interdependence of all aspects of nature, physical and biological, and of their multiform significance for mankind. The scion of a patrician family in frontier Vermont, Marsh graduated from Dartmouth College and practiced law in Burlington, meanwhile engaging in business—farming, lumbering, woolen manufacturing, railroad development, marble quarrying—and in politics. He served in the state legislature and for six years in Congress. As a reward for services to the Whig and Republican parties, he was appointed United States minister to Turkey from 1849 to 1853 and to Italy from 1861 to 1882, the latter an unequaled tenure of office. This diplomatic career gave him an opportunity to travel widely and made possible the leisure essential for his scholarly work. Marsh's first contributions were in linguistics. Attracted by new developments in the study of Teutonic languages, folklore, and cultural origins, he edited the first Icelandic grammar in English, delved into the history and literature of Old Norse and related tongues, and became the American promoter for C. C. Rafn's monumental Antiquitates americanae, a collection of Icelandic sagas bearing on the Iceland-Greenland-Vinland settlements. Marsh's historical studies of the English language were the standard texts during the 1860s, and he was in continual demand as editor, adviser, and critic of dictionaries, including the New English Dictionary. Familiarity with an extraordinary range of source materials in twenty languages made Marsh a first-rate, if not profoundly original, etymologist. His work as a scientific middleman was of more lasting significance. In the House of Representatives, Marsh helped to create, to staff, and to shape the Smithsonian Institution, guiding its early ventures in archeology and in natural science and guarding its research endowment against congressional incursions. He himself added animal specimens from Turkey, Egypt, and Palestine to the Smithsonian collections. On his return from Turkey he strongly urged the introduction of camels as beasts of burden in the American West—an enterprise initially successful but aborted by the Civil War. A utilitarian zeal directed and inspired Marsh's best work. As early as the 1840s he publicly advocated measures of physical improvement and

conservation: the establishment of nurseries for forestry research and the regulation of logging to prevent excessive and flashy runoff and consequent flooding and desiccation. Not until he returned to Italy in 1861, however, did Marsh bring together the materials he had long been collecting into a systematic analysis of man's manipulation of the natural environment. Published in 1864, Man and Nature showed how man differs from nature, how nature operates within itself, and what happens to woods and waters, mountains and deserts, when men clear, farm, dam, and build. In surveying man's impact, conscious and unconscious, Marsh did not overlook the improvements but stressed the accompanying and resulting damage. Technology had enabled man to derange natural balances and might ultimately, Marsh feared, reduce the surface of the earth "to such a condition of impoverished productiveness, of shattered surface, of climatic excess, as to threaten the depravation, barbarism, and perhaps even extinction of the species" ([1864] 1965, p. 44). Man and Nature was the first book to controvert the American myth of an inexhaustible earth. Its immediate impact was more moral than practical, but by 1907, when it had gone through three editions, the basic principles of Man and Nature were embodied in the national conservation program. In geography, Marsh is also important as an early and effective critic of environmental determinism, then popularized in the works of Arnold Guyot. How could man be viewed as the product of environment, when man himself had the power to alter that environment—and had in fact done so over most of the earth's surface? The mistakes man had made through ignorance or greed could, Marsh thought, in most cases be rectified by applying scientific principles of land management, by avoiding waste, and by public control of resources. DAVID LOWENTHAL [For discussion of the subsequent development of Marsh's ideas, see CONSERVATION.] WORKS BY MARSH

1856

The Camel: His Organization, Habits, and Uses, Considered With Reference to His Introduction Into the United States. Boston: Gould & Lincoln. (1860a) 1885 Lectures on the English Language. Rev. ed. New York: Scribner. 1860& The Study of Nature. Christian Examiner 68: 33-62. H» An unsigned article. (1862) 1898 The Origin and History of the English Language, and of the Early Literature It Embodies. Rev. ed. New York: Scribner. (1864) 1965 Man and Nature: Or, Physical Geography as Modified by Human Action. Edited by David Lowenthal. Cambridge, Mass.: Harvard Univ. Press. -> See

MARSHALL, ALFRED the introduction to the 1965 edition by David Lowenthal. Revised editions were published between 1874 and 1907 as The Earth as Modified by Human Action. WORKS ABOUT MARSH

KOOPMAN, HARRY L. 1892 Bibliography of George Perkins Marsh. Burlington, Vt.: Free Press Association. LOWENTHAL, DAVID 1958 George Perkins Marsh: Versatile Vermonter. New York: Columbia Univ. Press. MARSH, CAROLINE C. 1888 Life and Letters of George Perkins Marsh. Vol. 1. New York: Scribner.

MARSHALL, ALFRED Alfred Marshall (1842-1924) is one of the great names in the development of contemporary economic thought, and the book by which he is most widely known—Principles of Economics—is one of the high points in the literature of social science. His influence was enormous; so much so that the first 25 years of twentieth-century economics may be described as the "age of Marshall" and subsequent developments as extensions of and countermovements to his influence. Moreover, even when due allowance is made for the natural progress of economic science since Marshall's time, it is remarkable how much of the Marshallian framework remains. These well-known points require restatement because the positive effects of the Marshallian influence are questioned today as perhaps never before. One could agree with criticisms if they were merely objections to the view sometimes expressed that "it's all in Marshall," meaning that little or no progress has been made in economics since he wrote. It would indeed be deplorable if scientific ideas worked out almost one hundred years ago were still the last word. (An analogy with the positions of Marx and Freud is appropriate here.) However, much of the contemporary criticism goes deeper than this; it argues that the Marshallian tradition checked the development of economics by diverting attention from real issues (by which is primarily meant macrotheory) much as Ricardo was alleged to have done in an earlier generation. The merit of these criticisms will be examined carefully later in this article. Alfred Marshall was born in Clapham—then a leafy London suburb—in 1842. His father, John Marshall, held the respectable middle-class position of cashier in the Bank of England, and the family lived in modest comfort. Marshall's father was of a rather severe, evangelical frame of mind, almost a textbook example of what is loosely called Victorianism, and closely supervised his son's education. This paternal control and repression had a marked and lasting effect on Marshall; his

25

pronounced tendency toward hypochondria, his unwillingness to commit himself unequivocally in print without massive documented qualification, his fear of indolence and idleness, and his ultimate rejection of "pure pleasure" activities (such as mathematics) have their roots in the experiences of his early years. His education was planned as basically a preparation for ordination in the Anglican church. He was expected to go up to Oxford with a classics scholarship, which would lead to a fellowship and a church living. However, he rejected this plan—rebelling not against orthodox theology but against further study of the classics— and with funds borrowed from an uncle proceeded to St. John's, Cambridge, where he read mathematics. Marshall was one of the best mathematics students of his generation in England (in 1865 he was second wrangler in the tripos examination). This is an important point to bear in mind in evaluating his ambivalent attitude toward the use of mathematical methods in economics—in any event, his criticisms were not based on ignorance. Marshall came into economics with much more mathematics training than did Jevons or Walras. After graduation Marshall was elected to a fellowship in mathematics and gradually came under the influence of a group of philosopher-dons who were increasingly concerned with the social problems of industrial England. Marshall's interests centered initially on philosophy and ethics, which were then still at the frontier of social science, but worry about social conditions and the realization that poverty was at the root of many social evils led him into economics. Indeed, to Marshall the problem of poverty was not only central to the study of economics but its ultimate rationale. As he later wrote in the Principles, "the study of the causes of poverty is the study of the causes of the degradation of a large part of mankind" ([1890] 1961, vol. l,p. 3). In 1877 he married Mary Paley, a former student of his and one of the first women to be educated at Cambridge. Upon his marriage he was forced to resign his fellowship. He was for a short while principal and professor of political economy at the then University College of Bristol, became a fellow at Balliol in 1883 (after the requirement of celibacy had been eliminated), and the following year returned to Cambridge, to the chair of political economy vacated by Henry Fawcett; there he reigned until his retirement in 1908, when he was succeeded by his star pupil, A. C. Pigou. Marshall's published output was not large, especially considering that he was active almost until the time of his death. Several books—The Pure

26

MARSHALL, ALFRED

Theory of Foreign Trade and The Pure Theory of Domestic Values (1879a), Principles of Economics (1890), Industry and Trade (1919), Money, Credit & Commerce (1923), and The Economics of Industry (1879b), written jointly with Mary Marshall (which he tried to have withdrawn for complex personal reasons not bearing on its merit), a handful of articles, mainly reprinted in the Memorials of Alfred Marshall (1925), edited by Pigou; and a series of official memoranda and evidence before royal commissions (contained in Official Papers, a volume published in 1926) make up his total written contribution. Marshall's reluctance to commit himself to print —the Principles did not appear until he was 48— makes it difficult to assess his originality. Ideas first published in the 1890s, such as Marshall's statement of the theory of marginal utility, had been worked out and presented orally by him in the late 1860s, i.e., before the publication of the theory in the works of Jevons, Walras, and Menger. As J. M. Keynes put it in his famous obituary of Marshall, "The task of expounding the development of Marshall's economics is rendered difficult by the long intervals of time which generally separated the initial discovery and its oral communication to pupils from the final publication in a book to the world outside" (1924, p. 322). Intellectual background. Efforts to disentangle the various influences on Marshall's thinking as an economist are made difficult by his modesty—his desire to emphasize the continuity of thought—and also by his rather confused accounts of these influences. Marshall's first reading in economics was Ricardo and Mill; he described his early efforts as attempts to translate the ideas of these writers into differential equations. The most important single influence was surely Mill's Principles of Political Economy (1848), and a good way to get perspective on Marshall's contribution is to compare the two Principles. Also, what little mathematical economics then existed was open to Marshall, although it was not to most of his contemporaries. He clearly learned a lot from Cournot —especially about the use of continuous functions in economics. Thiinen's Der isolierte Staat (18261863), with its hints of marginal productivity analysis, was also influential. German (Hegelian) philosophy and the historical school of economists are commonly mentioned as influencing him (Marshall studied in Germany for a year). However, it is difficult to see concrete evidence of these systems of thought in his work. There is no dialectic and no historicism, although in his concern with empirical investigation he was closer to the histor-

ical school than to the English classical school. His emphasis on the continuity of growth and his perpetual references to biology suggest the influence of social Darwinism—acquired through Herbert Spencer. Methods Much of the discussion of Marshallian economics deals with his methods of analysis. These methods are not particular hypotheses or models proposed by Marshall but, rather, represent ways of setting up a problem or partitioning it so that it can be solved. The central Marshallian method is usually termed "partial analysis" or "partial equilibrium analysis" and is often loosely referred to as the ceteris paribus approach. The Marshallian partial equilibrium approach is frequently contrasted with the method of general equilibrium associated with Leon Walras, and the contrast is usually considered unfavorable to Marshall. Indeed, this approach is sometimes regarded as one of the major weaknesses Marshall bequeathed to economic science. Since the question of partial versus general equilibrium has loomed so large in the literature, some discussion of the central issues is imperative. As Marshall realized, the general equilibrium approach is not de facto a fruitful approach to such practical problems as measuring the effect of an import duty on the price of a commodity or the effect of a fall in the final product price on the demand for a particular grade of labor. It is not very helpful to be told that "everything depends on everything else" and that a change in one parameter will have effects throughout an economic system. Partial analysis is a method by which an economy is partitioned so that the main effects of a parameter shift in a particular micromarket can be highlighted without considering the spillover into other markets; hence, this method also ignores the feedback effects from the spillover. There are, of course, obvious dangers inherent in this method, but the answer lies, not in the general equilibrium approach, but in better specification of the partial model. [See ECONOMIC EQUILIBRIUM and the biography of WALRAS.] Let us take a specific example to illustrate the use of the ceteris paribus approach of partial equilibrium analysis and the related concept of comparative statics. We can draw up a demand schedule for a commodity and show the amount demanded per unit of time as a decreasing function of the price of the good. The relationship is ceteris paribus, i.e., it assumes that other factors influencing demand—such as the price of substitutes—are given, as are factors such as incomes, tastes, and expec-

MARSHALL, ALFRED tations. In a free market, if an equilibrium exists it will be where supply equals demand. If one of the ceteris paribus conditions is relaxed, the demand curve shifts, and the new partial equilibrium solution is then considered. This leads to the comparison of the two sets of equilibrium values of the variables under discussion. The method of comparing equilibrium solutions is called comparative statics because it does not permit the tracing of the time paths (between the two points of equilibrium) of the variables involved. [See STATICS AND DYNAMICS IN ECONOMICS.]

Marshall's ultimate objective was to develop a full-fledged theory of dynamic change and growth. In the preface to his Principles he wrote, "The main concern of economics is ... with human beings who are impelled, for good and evil, to change and progress. Fragmentary statical hypotheses are used as temporary auxiliaries to dynamical—or rather biological—conceptions: but the central idea of economics, even when its Foundations alone are under discussion, must be that of living force and movement" ([1890] 1961, vol. 1, p. xv). The immediate objective of Marshall's formal analysis was more limited: namely, the comparison of static equilibrium positions. Yet, even within this restrictive framework he was able, by his use of the timeperiod concept, to approximate dynamic analysis. His approach was to divide the adjustment, say, of price to changing demand or supply conditions into a series of adjustment periods. These periods should be regarded as measured by operational, not clock, time—the market period for one sector or industry may be (in terms of clock time) a longer one than the market period for another industry. The important consideration is which ceteris paribus assumptions are relaxed in successive periods. Marshall's time division is as follows: the market period, the short period, and the long period. The market period takes the production of the commodity in question as fixed, so that supply can vary only if sellers have a reserve price for their own product. The condition for equilibrium (for all time periods) is that the market be cleared, i.e., that demand equal supply. Short-run equilibrium considers supply to be partially adaptable, in the sense that increased production can occur but capital equipment and certain other overhead items are held constant. In modern economics, analysis of this short period with partial adaptation is equivalent to an analysis of the law of variable proportions, although it is not certain that Marshall himself was precisely clear about the distinction between variable proportions and returns to scale. The Marshallian long period allows for optimal capital stock adjustment. The

27

market is cleared within a framework in which supply can be considered to be fully adaptable because all factors (excluding entrcpreneurship) have adjusted to the situation. It was by means of this differential adjustment of supply that Marshall restated, within the supply and demand framework, his theory of value. The classical emphasis on costs is now seen as a particular hypothesis: that in longrun adjustment there are constant returns to scale. Figure 1 illustrates this. SS is the fixed-stock supply curve (on the assumption of zero reserve price); S'S' the short-run supply curve and S"P the long-run supply curve. With demand at DD, the long-run price is OP. Now let demand rise to D'D'. Then long-run equilibrium price will again be OP, but price will pass through the stages OP" and OP', and quantity will increase. [See DEMAND AND SUPPLY.] PRICE

QUANTITY

Figure 1

Marshall also hinted at the analysis of a fourth time period, in which factor supplies are allowed to adjust to changes in their underlying determinants. In the absence of innovation, in this period the economy reaches the full equilibrium solution for a stationary state. Marshall was cautious and basically skeptical about the use of mathematics and theoretical statistics in economics; for better or worse, he did not foresee the mushrooming of mathematical economics and econometrics. The Marshallian attitude— which became embodied in the Cambridge tradition and especially in the work of Pigou and Keynes— is seen in the Principles, where the mathematical statements are in footnotes and in a mathematical appendix. The grounds for minimizing the formal use of mathematics in the final presentation (although not in preparation) were twofold: first, the need to communicate; and second—and much more important—the fear that sets of equations necessarily omit or distort many relevant influences

28

MARSHALL, ALFRED

and considerations. Marshall set out the matter squarely in a letter to A. L. Bowley dated February 27, 1906: [A] good mathematical theorem dealing with economic hypotheses was very unlikely to be good economics: and I went more and more on the rules— (1) Use mathematics as a shorthand language, rather than as an engine of inquiry. (2) Keep to them till you have done. (3) Translate into English. (4) Then illustrate by examples that are important in real life. (5) Burn the mathematics. (6) If you can't succeed in 4 burn 3. This last I did often. ([1925] 1956, p. 427) Marshall had grave doubts as to the reasonableness of the assumptions underpinning the then existing techniques of theoretical statistics (which meant, basically, regression analysis) when applied to social science data. He had no doubts, however, about the need to be steeped in the empirical facts of any situation under analysis. He always emphasized deep statistical and historical knowledge of the area being investigated and referred again and again to the complexity of economic problems and the naivete of simple hypotheses. Like Adam Smith, Marshall had a profound knowledge of the workings of economic systems. When asked, for example, by the Gold and Silver Commission of 1887/1888, "Do you speak with knowledge . . . of the working classes?" he replied (somewhat pompously but with all honesty), "I speak from personal observation ranging over many years, and a study of almost everything of importance that has been written on the subject" (Official Papers, p. 99). Marshall's oft-quoted definition of economics— "the study of man in the ordinary business of life" —was not an attempt to demarcate the discipline precisely from other social sciences. Marshall's basic view on the scope of economics is best expressed in the sentence "The less we trouble ourselves with scholastic inquiries as to whether a certain observation comes within the scope of economics, the better" ([1890] 1961, vol. 1, p. 27). He used the term "ordinary business of life" to emphasize the point that economics is not the study of the workings of a fictional economy populated by abstract economic men: it is concerned with the real world around us. Contributions to theory Marshall's central theoretical contribution was the working out of the rigorous economics of the stationary state. For Marshall this was not, of course, the ultimate end of economics—it was indeed but the preface. To point the way to the conclusion—the working out of a full-fledged growth

model — Marshall interlarded his stationary-state framework with bits and pieces of the dynamic process-. It is this mixture that makes Marshall's Principles such difficult reading for some. Theory of demand. Marshall developed utility theory for two reasons: first, to place restrictions on demand functions; and second, to create what he hoped would be powerful tools of welfare economics. The Marshallian demand curve relates the demand for a commodity per unit of time to its own price. The relationship is ceteris paribus; in particular, other prices and incomes are assumed constant. There are certain ambiguities in this statement of inclusions within ceteris paribus, but for the moment these are set aside. Marshall's generalized "law of demand" states that the price of a good and the quantity demanded are inversely related. This restriction on demand functions is derived a priori from the form of the utility function that he postulated, which is laid out most clearly in the mathematical appendix to the Principles. He used an additive, cardinal utility function; this means that one may think of utility as being a measurable quantity (although in practice Marshall spoke of it as being only indirectly measurable, at the margin, by price) and also that the total utility that a consumer derives from his consumption of goods and services is the sum of the individual utilities derived from the consumption of each item in his budget. Symbolically, we have

where Ui is the utility derived from the consumption of the ith commodity and 17 is total utility. The basic restriction given by the additive nature of the function is that interrelationships between goods are excluded (all cross-partial derivatives are zero). Further, the law of diminishing marginal utility operates with respect to each good; this means that extra units consumed of a given commodity will increase total utility at a decreasing rate. Thus, the addition to total utility induced by the nth unit of a commodity will be less than the increase in utility induced by the (n — l)st unit. In terms of the function above,

dU

d?U

dX;

It is assumed that the consumer seeks to maximize utility, given incomes and prices. The principle of substitution comes into full play here. By substituting at the margin, a consumer reaches his maximum utility point. Maximizing the utility function, subject to the budget constraint (i.e., that the quan-

MARSHALL, ALFRED titles of all goods and services purchased multiplied by their respective prices equals total income), yields the well-known Marshallian first-order conditions for a maximum. These can be stated in the following equivalent terms: for all i and j ,

w

— • • • — X,

(3) Mt/i = Pi A, for all z. Here Pi represents the price of commodity i, and the constant term X represents the marginal utility of income. A fall in the price of commodity i must lead to more of the commodity's being bought; this must be so to keep the equalities listed in eqs. (1) to (3). That formulation (as Marshall realized) avoids the implications of the income effects of a price change—this is the purpose of assuming constant marginal utility of income. [See UTILITY.] Rigorously applied, the Marshallian assumptions appear to restrict elasticities of demand to unity, but it is clear from the body of the Principles that Marshall did not contemplate this restriction. Strictly speaking, a ceteris paribus demand curve requires that real income be held constant as price changes, so as to eliminate from the analysis the income effect of the price change. Holding money income constant is insufficient, since the real value of money income is its command over commodities and if commodity prices change, this changes also. Marshall solved this problem intuitively, by talking in terms of money income but postulating small changes in the prices of commodities that make up a small portion of the consumer's budget, so that the error involved in using money income is "of the second order of small quantities" ([1890] 1961, vol. 1, p. 132). Milton Friedman has since put the demand curve on a more satisfactory analytic footing. But for Marshall the object of demand theory was not just to place testable restrictions on demand functions; he also regarded the demand curve and the allied concept of consumer surplus as powerful tools of welfare economics. We shall consider this aspect after we have looked at Marshall's contribution to production theory and the theory of the firm. Theory of production. Marshall spoke in terms of "real costs" when considering costs of production. By "real" he meant ultimately the disutility of both the labor and the waiting involved in producing and bringing a commodity to market. The emphasis on real cost seems to contrast with the Austrian notion of opportunity cost, but in fact it

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is easy to reconcile the two concepts. In any case, in spite of Marshall's emphasis, he rather too easily assumed the equality of real and money costs and proceeded with his analysis in terms of the latter. Central to his theory of cost and production is the principle of substitution, which works here the same way it does in his consumer theory. The entrepreneur substitutes at the margin until the total cost of a given output is at a minimum or, what is the same thing, until the output from a given set of inputs is maximized. [See COST.] Marshall was confused about the so-called laws of production and especially about the distinction between what has come to be called "variable proportions" and returns to scale; so, of course, was the whole profession until Viner's classic article of 1931. Marshall tended to compare decreasing returns with increasing returns, as though they were similar. Although he postulated that diminishing returns were historically connected with agriculture and with a situation in which the labor-capital input had grown relative to (fixed) land, he did not see the logical connection between the principle of substitution and the law of variable proportions. Increasing returns, looked at in an analytic manner, occur where increase in output is proportionately greater than the simultaneous increase of all inputs. In the course of his discussion of increasing returns, Marshall made the crucial distinction between internal and external economies, from which the whole notion of externality started. Internal economies are "those dependent on the resources of the individual houses of business" in an industry, while external economies are "dependent on the general development of the industry." Internal economies, where present, produce a falling long-run marginal cost curve for a firm, and hence threaten the stability of competition. Marshall realized this, and his "life cycle" theory of entrepreneurship was meant as a partial explanation of the survival of competition. External economies, on the other hand, are compatible with competition but raise serious welfare problems. [See EXTERNAL ECONOMIES AND DISECONOMIES.] Central to Marshall's discussion of the theory of the firm is the concept of the representative firm —a notion which is not only tenuous and vague but apparently unnecessary for Marshall's own purposes, as critics like Lionel Robbins were quick to point out. Marshall's definition of the representative firm gets us nowhere; it is only by specifying the problem with which he was trying to cope that we see the purpose of the concept. Two questions in particular worried Marshall. First, in the real world, firms clearly are capable of

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expanding at falling marginal cost, yet industries do not become monopolized. Marshall's answer lies partially in the representative firm. The second, a closely related problem, concerns the estimate of the supply price of a product where industry output is taken as a given but the group of firms making up the industry are in a life cycle of birth, growth, decay, and death. According to Marshall's theory, the entrepreneurial life cycle prevents the continuing expansion of any one firm— an idea more appropriate to the days of small business than to those of the large corporation, where management is not dynastic. But apart from Marshall's exercise in social evolution, we still have the interesting problem, with disequilibrium at the firm level, of estimating supply price and, more generally, the industry supply curve. In contemporary economics the static solution to these problems, under perfect competition, is to sum the firms' marginal cost curves to obtain the industry supply curve. This supply price is equal to any firm's marginal cost; for Marshall, however, with his continual search for the dynamic solution, this answer was inadequate. A firm picked at random would not necessarily be typical in the sense that its costs would correctly reflect the sustainable degree of efficiency and level of economies for its aggregate output. It might be a firm about to disappear or one in the very early stages of growth. The answer, Marshall believed, was to identify a "typical" or representative firm. [See FIRM, THEORY OF THE.] What is the typical market structure in Marshall's world? Nowhere in his work do we find the perfectly elastic demand curve of the current textbook version of perfect competition. It is clearly not monopoly (for Marshall reserves this case for special treatment), but it is doubtful whether, as has recently been suggested, the typical Marshallian market can be interpreted as monopolistically competitive in Chamberlin's sense. In spite of Marshall's remark that in the short run firms may have to lower price to increase sales, his basic view is that price is a parameter in the typical firm's plans. Theory of distribution. Marshall's theory of distribution is outlined on two levels. On the assumption of fixed coefficients (such as Walras assumed in the first edition of the Elements), Marshall worked out his theory of joint demand. In this case there is no substitution within a given productive process; the principle of substitution is inoperative, and hence the marginal productivity theory is not applicable. To divide up the total product among the cooperating factors in the case of fixed proportions, Marshall used the law of derived demand: "The demand schedule for any factor of production

of a commodity can be derived from that of the commodity by subtracting from the demand price of each separative amount of the commodity the sum of the supply prices for corresponding amounts of the other factors" ([1890] 1961, vol. 1, p. 383). But at best this is a clumsy approach, and it did not represent Marshall's basic position. More generally he worked out a complete marginal productivity theory, and although he expressly denied that it was a theory of distribution, we must take this as typical Marshallian caution. His objections to regarding marginal productivity as a theory of wages were twofold: first, supply conditions must be included in the analysis; and second, to the extent to which labor and capital are in fixed proportions, it is not possible to identify the marginal product. The concept of quasi rent, which filled an important gap in classical analysis, is also important for Marshallian distribution theory. Rent theory explained the return to fixed land, but there was nothing in classical analysis to explain the return to capital equipment already in existence. Marshall used the term "quasi rent" to explain rewards to any factors in inelastic supply and specifically applied the analysis to capital equipment in the short run. [See RENT.] Equilibrium conditions. We have already discussed Marshall's division of the problem of price determination into a series of different time-period equilibrium positions. The general rule is that the longer the period of adaptation allowed, the more responsive is supply to price changes. To the extent to which long-run supply is perfectly elastic, Marshall saw a correlation with the classical cost-ofproduction theory of value. We have still to consider Marshall's conditions for market stability; PRICE

O

QUANTITY

MARSHALL, ALFRED PRICE

-QUANTITY

Figure 3

these appear to differ significantly from those laid down by Walras and Hicks, which are commonly studied in elementary dynamics. Marshall's conditions for a micromarket to be stable are as follows: (a) for quantity smaller than equilibrium quantity, demand price must be greater than supply price; (£>) for quantity larger than equilibrium quantity, demand price must be less than supply price. If a market that has "normal" demand and supply relationships, i.e., a downward-sloping demand curve and an upward-sloping supply curve, is stable in the Walras-Hicks sense, it is also stable in Marshall's sense. Divergences of interpretation occur, however, in other cases. Figure 2 shows a market where both stability conditions are satisfied. At price P l5 which is above equilibrium, excess demand is negative (the Hicksian condition) and quantity bought is less than equilibrium, with demand price, OPi, greater than supply price, OP 2 . The market shown in Figure 3 is stable in terms of Marshall's conditions but unstable in terms of the Walras-Hicks conditions (e.g., for price above equilibrium it has excess demand). Which specification is correct cannot be determined a priori but is a matter for empirical investigation. It is clear that the two solutions assume different behavioral reactions of buyers and sellers. More important, perhaps, the notion of a supply curve has to be specified much more carefully. [See DEMAND AND SUPPLY and ECONOMIC EQUILIBRIUM.] Marshall also attempted to formalize and explain Mill's work on the conditions for equilibrium—and the suitability of equilibrium—in foreign trade. He did this by using the techniques of offer curves. His work in this field was not formally published until 1923, when parts of it were appended to his Money, Credit & Commerce. However, it was circulated Privately, through the efforts of Henry Sidgwick.

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Welfare economics. Marshall's contributions to welfare economics, while suggestive in terms of contemporary thought, contain some of his most doubtful analysis. Here Marshall relaxed his customary caution in the face of complex situations, in an effort to promote certain policy measures. In general his welfare economics supported the classical view that a regime of free markets maximizes welfare (utility). Marshall called this the doctrine of maximum satisfaction; his demonstration consisted of showing that for each micromarket the sum of surpluses is maximized. A monopolized market involves a suboptimal position because the sum of surpluses is lessened. The surpluses summed include both consumer and producer surpluses, or rents. In Figure 4 the free market price is P0 with quantity Q 0 . The sum of consumer surplus and producer surplus is CAB. Let the market be monopolized and price and output be PI , Qi; total surplus is then reduced to BCDE. [See CONSUMER'S SURPLUS.] However, Marshall stated two important exceptions to the doctrine of maximum satisfaction and free competition. First, he considered it to be an empirical fact that although utility is an increasing function of a person's real income, the rate of increase diminishes. As Marshall put it bluntly in the mathematical appendix to the Principles, "Every increase in his means diminishes the marginal degree of utility of money to him" ([1890] 196J, vol. 1, p. 838). Thus, it followed that, all other circumstances being the same, a redistribution of income from rich to poor would increase total satisfaction. Much more important, perhaps, is Marshall's second ground for modifying the doctrine of maxPRICE

O

QUANTITY

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imum satisfaction. This is that satisfaction can be increased by taxing increasing-cost industries and subsidizing decreasing-cost industries. His analysis runs entirely in terms of consumer surplus, with all its weaknesses, and can easily be seen to depend on the slopes of the supply curves. However, the whole theory of externality and divergences between private and social benefits developed from Marshall's discussion, especially his exposition of the decreasing-cost case. Monetary theory. Marshall is sometimes alleged to have neglected the monetary and, more generally, the aggregative framework within which his theory of value worked. This is a mistaken view. In his Principles Marshall is at pains to make clear that the core of that book presupposes a monetary framework, and he deals explicitly with this framework in other contributions. The two important sources for his views on money are Money, Credit & Commerce, written toward the end of his life, and, much more important, his Official Papers. This latter consists of a series of memoranda and evidence presented before royal commissions. Official Papers contains the core of Marshall's monetary theory. The most important elements of his contributions in this area are the following: the so-called Cambridge equation and his development of a credit cycle through disequilibrium between real and monetary interest rates. Marshall is often regarded as the founder of the Cambridge approach to monetary theory. In essence, this theory postulates a stable demand function for money, with real income (or wealth) as the prime argument in the function. Ceteris paribus, such an approach will give a proportionate relationship between changes in the supply of money and changes in the general level of prices. [See MONEY, article on QUANTITY THEORY.] This approach was formalized by Pigou (1917) in a famous article [see the biography of PIGOU] and elaborated by Keynes in his Tract on Monetary Reform (1923). Marshall made it absolutely clear, however, that changes in the other factors—in the volume of activity and the demand for money—may well dominate the relationship, especially in periods of economic crisis. His other contribution to the field is the spelling out of a mechanism connecting real and money rates of interest, through which divergences between the two generate a credit cycle. The view, mentioned at the beginning of this article, that Marshall diverted economics from a proper consideration of macroeconomics is largely a result of Keynes's treatment of Marshall in The General Theory (1936). His treatment there con-

trasts widely with his assessment of Marshall's monetary economics in his famous obituary of Marshall. The reasons for this dramatic volte-face are complex and cannot be discussed here; all that can be said is that in retrospect the "Keynesian revolution" appears to be more an extension of the Marshallian tradition than an attempt to reverse it. BERNARD CORRY [For the historical context of Marshall's work, see the biographies of COURNOT; JEVONS; MENGER; MILL; RicARDO; THUNEN; for discussion of the subsequent development of his ideas, see the biographies of KEYNES, JOHN MAYNARD; PIGOU; ROBERTSON.] WORKS BY MARSHALL (1879a) 1930 The Pure Theory of Foreign Trade and The Pure Theory of Domestic Values. Series of Reprints of Scarce Tracts in Economic and Political Science, No. 1. London School of Economics and Politcal Science. -» Privately printed in 1879. (1879&) 1889 MARSHALL, ALFRED; and MARSHALL, MARY P. Economics of Industry. London: Macmillan. (1890) 1961 Principles of Economics. 9th ed. 2 vols. New York and London: Macmillan. -» A variorum edition. The eighth edition is preferable for normal use. 1919 Industry and Trade: A Study of Industrial Technique and Business Organization, and of Their Influences on the Conditions of Various Classes and Nations. London: Macmillan. (1923) 1960 Money, Credit & Commerce. New York: Kelley. (1925) 1956 Memorials of Alfred Marshall. New York: Kelley. -» Contains essays on Marshall by J. M. Keynes, F. Y. Edgeworth, C. R. Fay, E. A. Benians, and A. C. Pigou; selections from Marshall's writings; and a bibliography of his works prepared by J. M. Keynes. Official Papers. London: Macmillan. 1926. -» Papers dated 1886-1903. SUPPLEMENTARY BIBLIOGRAPHY

KEYNES, JOHN MAYNARD 1923 A Tract on Monetary Reform. London: Macmillan. KEYNES, JOHN MAYNARD (1924) 1951 Alfred Marshall: 1842-1924. Pages 125-217 in John Maynard Keynes, Essays in Biography. New ed. -> First published in Volume 34 of the Economic Journal. A paperback edition was published in 1963 by Norton. KEYNES, JOHN MAYNARD 1936 The General Theory of Employment, Interest and Money. London: Macmillan. -» A paperback edition was published in 1965 by Harcourt. MILL, JOHN STUART (1848) 1961 Principles of Political Economy, With Some of Their Applications to Social Philosophy. 7th ed. Edited by W. J. Ashley. New York: Kelley. PIGOU, A. C. (1917) 1951 The Value of Money. Pages 162-183 in American Economic Association, Readings in Monetary Theory. Philadelphia: Blakiston. PIGOU, A. C. 1953 Alfred Marshall and Current Thought. London: Macmillan. SCHUMPETER, JOSEPH A, (1941) 1965 Alfred Marshall, 1842-1924. Pages 91-109 in Joseph A. Schumpeter,

MARSILIUS OF PADUA Ten Great Economists From Marx to Keynes. New York: Oxford Univ. Press. SCOTT, WILLIAM R. 1925 Alfred Marshall, 1842-1924. British Academy, London, Proceedings 11:446-457. STIGLER, GEORGE J. 1941 Production and Distribution Theories: 1870 to 1895. New York: Macmillan. -> See especially Chapter 4. THUNEN, JOHANN H. VON (1826-1863) 1930 Der isolierte Staat in Beziehung auf Landwirthschaft und Nationalokonomie. 3 vols. Jena (Germany): Fischer. VINER, JACOB (1931) 1952 Cost Curves and Supply Curves. Pages 198-232 in American Economic Association, Readings in Price Theory. Chicago: Irwin. -» First published in Volume 3 of the Zeitschrift fur Nationalokonomie.

MARSILIUS OF PADUA Marsilius of Padua (c. 1275-c. 1343) is known primarily as the author of the Defensor pads, a bold antipapal tract dedicated to Emperor Louis iv of Bavaria in 1324 during his controversy with Pope John xxn. Although contemporary condemnations name John of Jandun as coauthor, internal evidence and incongruence with John's known political statements (Gewirth 1948) argue for its ascription to Marsilius alone. The Defensor is revolutionary in denying the clergy jurisdiction of any kind and in subordinating them completely to the state. The political concepts it brings to the support of these contentions are neither so "modern" nor so original as has sometimes been claimed. All are anticipated in some fashion somewhere in the long and complex medieval tradition. Yet, because Marsilius' argument leads him to special emphases, and because he richly develops, with ingenious use of Aristotle, ideas briefly enunciated by canonists and by other publicists, he is the first to present in elaborated theoretical form views that were to be fundamental to much of modern political thought. Even though the teaching of the Defensor is not free of ambiguity, no other medieval writing offers so vigorous or so complete a theory of popular sovereignty. Jurisdiction in state and church. Marsilius argued that clerical pretensions to rule destroy the state (civitas or regnum), which, with its specialization of economic, military, governmental, and priestly "parts," is indispensable to "living and to living well." The survival of the state depends on effective government by a single unified "ruling part1' (pars principans^), and since the proper function of the clergy is not government but teaching (Christ having forbidden them all coercion), clerical rule of any sort, over anyone, destroys the unity of the government and deprives men of "the sufficient life." In this world divine law is without

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direct sanction. It is only by authority of the human legislator that infractions can be brought to judgment. All that is "truly law" on earth is the expression of the will of the legislator—the citizens of each community as a whole or their "weightier part" (valentior pars'), the citizen body including all free adult males. The "weightier part" is weightier through "quality" as well as quantity of persons, but Marsilius argued that the more people who participate in legislation, the better the laws will be. Legislation by the multitude normally results in justice, because all but the singularly malicious or ignorant naturally wish to preserve the state and are able to discern the common benefit and to judge proposals. The legislator also establishes or selects the government or ruler. This may be one man or several but should in almost every instance be elective rather than hereditary. The legislator has the power to correct and even to depose the ruler. Although at times Marsilius seems to imply that the delegation of power to the ruler is all but absolute, his statements on correction and deposition are unequivocal. Denying the divine institution of the papacy and of the episcopacy, Marsilius provides that in a Christian community the legislator select from candidates those to be priests and bishops, appoint them to pastorates, and control their exercise of office. A general council, elected by the several legislators of the Christian world and composed of both clerics and learned laymen (the laymen voting if the clerics are not unanimous), determines the articles of faith. Only by decree of the human legislator do conciliar decisions become binding. For convenience the council or "the faithful human legislator without a superior" appoints a "head bishop" to act as president and executive secretary of the council. Custom alone argues the choice of the bishop of Rome. Although early in the Defensor Marsilius expressed a preference for a plurality of sovereign states, the idea of a "primary" or "universal" "faithful human legislator" and "a ruler by its authority" suggests the empire, and in the Defensor minor of 1342, written at the court of Louis, the "human legislator" becomes the "Roman prince." Formation of Marsilius' views. In the molding of Marsilius' concepts the fifth book of Aristotle's Politics played a significant part. Also of importance in the genesis of his attitudes was his youth in Padua, a city sovereign de facto, republican in constitution, and often in conflict with the clergy. His being a physician and not a lawyer or theologian no doubt had much to do with the freshness

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of his attack. Acquaintance with the work of French publicists seems probable from his years at the University of Paris, and familiarity with corporation law, from his position as rector of the university in 1313 (Lewis 1963, p. 564). Although he associated with Averroists, their influence on his ideas of church and state is impossible to ascertain. Influence. Papal condemnations, including the excommunication of Marsilius (and John of Jandun) in 1327, established the reputation of the Defensor for the next three centuries. A principal charge in papal attacks on Wycliffe, and later on Luther, was that they borrowed Marsilius' doctrine. In the circumstances, conciliarist writers used the Defensor with caution. It was first printed (in Basel in 1522) to serve the Protestant cause, and in 1535 Thomas Cromwell paid most of the cost of printing an English translation. Through Richard Hooker, who cited it and shared some of its doctrines, it probably had an influence on John Locke, and so, indirectly, played an important part in carrying ideas of popular sovereignty from the medieval to the modern world. JANE E. RUBY [For the historical context of Marsilius' work, see the biographies of AQUINAS; ARISTOTLE; GERSON.] WORKS BY MARSILIUS (1324) 1951-1956 Marsilius of Padua: The Defender of Peace. Translated and introduced by Alan Gewirth. 2 vols. New York: Columbia Univ. Press. -» Volume 1: Marsilius of Padua and Medieval Political Philosophy. Volume 2: The Defensor pads. Volume 2 was written in 1324, and first printed in 1522 as Defensor pads. (1342) 1922 The "Defensor minor" of Marsilius of Padua. Edited by C. Kenneth Brampton. Birmingham (England): Cornish. SUPPLEMENTARY BIBLIOGRAPHY GEWIRTH, ALAN 1948 John of Jandun and the Defensor pads. Speculum 23:267-272. LAGARDE, GEORGES DE (1934) 1948 Marsile de Padoue, ou le premier theoriden de I'etat laique. 2d ed. Paris: Presses Universitaires de France. LEWIS, EWART 1963 The "Positivism" of Marsiglio of Padua. Speculum 38: 541-582. PREVITE-ORTON, CHARLES W. (1935) 1937 Marsilius of Padua. British Academy, London, Proceedings 21: 137-183. SCHOLZ, RICHARD 1937 Marsilius von Padua und die Genesis des modernen Staatsbewusstseins. Historische Zeitschrift 156:88-103. .

MARX, KARL Karl Marx the Prussian family when foreshadowed

(1818-1883) was born in Trier in Rhineland. His alienation from his he had scarcely passed adolescence the social isolation of his later years.

His father, a lawyer, was as concerned as he was impressed with his son's "demonic genius," as he called it, and feared that young Marx's passion for poetry and philosophy would consume him both physically and morally. The elder Marx and his wife were Jewish, but for social reasons they were converted to Christianity. The younger Marx's awareness of his ethnic background aroused in him a certain self-consciousness; this may have been one source of his sense of marginality, his ambivalence toward society, and eventually of his conflicting qualities—thinker and prophet, scientist and moralist. Although Marx received his doctorate in philosophy from the University of Jena at the age of 23, his association with the Young Hegelians, and with Bruno Bauer in particular, precluded his appointment to a university position in Germany; indeed, Bauer lost his own post at the university in Bonn as a result of questioning the historicity of the New Testament. Marx thus became a "degraded bourgeois," deprived of a stable source of income and dependent for his livelihood and that of his wife and children on the generosity of his lifelong friend, Friedrich Engels, the son of a wealthy cotton manufacturer. (Marx's wife, Jenny von Westphalen, was of noble parentage but had no dowry.) At the age of 25, Marx left Germany and, except for a brief stay in Cologne in 1848-1849, lived the rest of his life in exile: in Paris from 1843 to 1845, in Brussels from 1845 to 1848, and finally in London. As early as 1845 he renounced his Prussian citizenship, and since he failed to acquire British citizenship by naturalization, for the greater part of his life he was something of a pariah. Intellectual background. Marx's childhood and youth fall in that period of European history when the reactionary powers of the Holy Alliance were attempting to eradicate from post-Napoleonic Europe all traces of the French Revolution. There was, at the same time, a liberal movement in Germany that was making itself felt. The movement was given impetus by the July Revolution in France, and its chief representatives were the poets of the Junge Deutschland, among them Ludwig Borne and Heinrich Heine. In the late 1830s a further step toward radical criticism was made by the Young Hegelians, that group with which Marx became formally associated when he was studying law and philosophy at the University of Berlin. Although he was the youngest member of the Young Hegelians—who included, in addition to Bauer, such thinkers as Ludwig Feuerbach, Arnold Ruge, and Moses Hess—Marx inspired their confidence, respect, and even admiration. They saw in him a "new Hegel," or rather a powerful anti-

MARX, KARL Hegelian, who might successfully turn the dialectics of the master against his own conservative teachings in the fields of religion, politics, and law. Marx had already showed his determination to do so in his doctoral dissertation (1841), which dealt with the philosophical positions of Democritus and Epicurus; especially in the supplementary notes, he made his earliest attempt at a radical, albeit muted, criticism of Hegel, asserting, as Epicurus had argued against Democritus, that what is needed is a morally clear way of life rather than ideology or empty hypotheses. The intensive study of Spinoza, Leibniz, and Hume provided Marx with a spiritual armory for the elaboration of a positive conception of democracy that went far beyond the notions held at that time by radicals in Germany. It was from Spinoza rather than from Hegel that Marx learned to reconcile necessity and freedom. Therefore, when he undertook to destroy Hegel's metaphysics of "the State," Marx was well prepared to integrate a rational ethics with his own sociological and revolutionary doctrine. His early rejection of Hegel's political philosophy was unconditional and permanent; yet stripped of its "idealistic" content, Hegel's dialectic continued to influence Marx as a way of analyzing his subject matter, namely society. Marx's adherence to a radical view of democracy was also based on the study of such historical events as the revolutions in England, France, and America. From these historical studies he concluded that democracy must normally and inevitably culminate in communism, following a transitory stage of proletarian democracy (the "dictatorship of the proletariat"). After his conversion to communism Marx began his prolonged studies of economics; but while he was still developing from a liberal into a communist, he learned more from Spinoza and Feuerbach, Saint-Simon and Babeuf, Thomas Hamilton and Tocqueville, Weitling and Proudhon, Owen and Fourier, than from Smith or Ricardo. Contributions to socialist thought. Although the epoch to which Marx belonged has its beginnings in the French Revolution, its historical dimensions coincide with those of the whole era of industrial and social revolutions and extend into our own time; hence the lasting appeal of a body of teachings that is by no means free from theoretical ambiguities. The originality of Marx's thought lies in his immense efforts to synthesize, in a critical way, the entire legacy of social knowledge since Aristotle. His purpose was to achieve a better understanding of the conditions of human development and with this understanding to accelerate the actual process by which mankind was moving toward an "associa-

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tion, in which the free development of each is the condition for the free development of all" (1848). The desired system would be a communist society based on rational planning, cooperative production, and equality of distribution and, most important, liberated from all forms of political and bureaucratic hierarchy. This dual commitment—to scholarly understanding and to political action—-created constant difficulty for Marx. He was often aware that his intense passion for reading and studying interfered with his activity on behalf of the political movement with which he identified himself. In his scholarly work the exposition and analysis are frequently interrupted by partisan outbursts of irony and sarcasm, by bitter indictments of the capitalist class and the social system based upon its dominance. Political economy was only one of the socialscientific disciplines that Marx intended to explore and then subject to criticism; the others were law, morals, and politics. He intended to treat each of these disciplines (and perhaps others also) in "separate pamphlets." But the thoroughness with which he undertook his studies of the great economists and the delays in his scholarly work that arose from the need to make a living as a penny-a-liner prevented him from elaborating even one of these projects. Capital, subtitled "A Critique of Political Economy," although a work of enormous dimensions, is the fruit of only partially completed research. However, before the age of thirty, Marx produced a number of works which together provide a relatively adequate outline of his "materialist conception of history." Among these, the most important are The Holy Family (1845a), The German Ideology (in collaboration with Engels, 18451846), The Poverty of Philosophy (1847), and The Communist Manifesto (1848). To these must be added an unfinished work, first published in 1932 with the title Economic and Philosophical Manuscripts of 1844 (see 1844a), which shows with particular clarity the connections between the various ideas Marx was later to elaborate in Capital. In these works, Marx sketched out his theory of society and history. He repudiated Hegelian and post-Hegelian speculative philosophy, and building on Feuerbach's anthropological naturalism, he developed instead a humanist ethics based on a strictly sociological approach to historical phenomena. Drawing also on French materialism and on British empiricism and classical economics, Marx's theory sought to explain all social phenomena in terms of their place and function in the complex systems of society and nature, without recourse to what he considered metaphysical explanations ("primary causes"). Clearly outlined in these early

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writings, this eventually became a mature sociological conception of the making and development of human societies. At the beginning of A Contribution to the Critique of Political Economy (1859), Marx summed up in a dozen aphorisms the general results of the investigation he had undertaken in the 1840s and asserted that these results were the "guiding thread" of his further studies. Here are the beginning and the end of this justifiably celebrated and controversial passage: In the social production which men carry on they enter into definite relations that are indispensable and independent of their will; these relations of production correspond to a definite stage of development of their material powers of production. The sum total of these relations of production constitutes the economic structure of society—the real foundation, on which rise legal and political superstructures and to which correspond definite forms of social consciousness. The mode of production in material life determines the general character of the social, political and spiritual processes of life. It is not the consciousness of men that determines their existence, but, on the contrary, their social existence determines their consciousness. . . . In broad outlines we can designate the Asiatic, the ancient, the feudal, and the modern bourgeois methods of production as so many epochs in the progress of the economic formation of society. The bourgeois relations of production are the last antagonistic form of the social process of production . . . ; at the same time the production forces developing in the womb of bourgeois society create the material conditions for the solution of that antagonism. This social formation constitutes, therefore, the closing chapter of the prehistoric stage of human society. ([1859] 1913, pp. 11-13) Marx's "materialistic method" is well exemplified by his treatment of the concept of "alienation"—a spiritual concept in Hegel's philosophy that had already been modified in Feuerbach's anthropology. In the "Paris Manuscripts of 1844" (1844a), Marx conceived of alienation as a phenomenon related to the structure of those societies in which the producer is divorced from the means of production and in which "dead labor" (capital) dominates "living labor" (the worker). A systematic elaboration of the concept appears in Capital under the heading "fetishism of commodities and money." But the ethical germ of this conception can be found as early as 1844 in the two essays Marx published in the Deutsch—franzosische Jahrbucher: "On the Jewish Question" (1844b) and "Contribution to the Critique of Hegel's Philosophy of Right" (1844c). There Marx unequivocally rejected and condemned "the state" and "money," and he invested the proletariat with the "historical mission" of emancipating society as a whole. The identity of Marx's early

political views with the theoretical analysis in Capital is evident in the manner in which the argument of Capital is brought to a close. Describing the "historical tendency of capital accumulation," Marx quoted the prophetic statement in the Communist Manifesto: "What the bourgeoisie . . . produces, above all, are its own gravediggers. Its fall and the victory of the proletariat are equally inevitable." Similarly, in ending the preamble of his inaugural address to the International Working Men's Association (1864), Marx launched the same summons that ends the Manifesto: "Workingmen of all countries, unite!" Although this summons seems to contradict his assertion of the "historical necessity" of communism, in the very real unity of sociology and ethics the contradiction vanishes. The proletariat is enjoined to unite in order to transform society, and its recognition of the consequences of such unity for the achievement of its historical mission becomes part of the "historical necessity" of the process; by this recognition, the proletariat confirms the process. In accordance with the maxim, formulated in his "Theses on Feuerbach" (1845b), that man must prove the truth of his thinking in practice, Marx neglected his scientific work for long periods in order to participate in the class struggles of his time. He did so not without regret, for he considered his scholarly studies the most valuable form of participation in the social struggle. His more direct intervention was, of course, mainly literary in character—his several hundred articles in German, British, and American newspapers and journals; and the various addresses and manifestoes he wrote for the Working Men's International. Among his writings on the political events of his time are some unquestionable masterpieces of this genre: The Class Struggles in France (1850); The Eighteenth Brumaire of Louis Bonaparte (1852); Secret Diplomatic History of the Eighteenth Century (1856); Herr Vogt (I860); "Address" to the First International (1864); The Civil War in France (1871); the Critique of the Gotha Programme (1875). In every line he wrote, whether intended for publication or not, his ultimate singleness of purpose is clearly evident. This is particularly true of his magnum opus, Capital, whose scope transcends its outline of political economy as well as its critique of economics. At the same time that Marx defined the ultimate aim of the work as "[laying] bare the economic law of motion of modern society," he had in mind a thorough and systematic criticism of a type of society, namely capitalism. In spite of its truncated

MARX, KARL character, Capital is monumental in its construction and grandiose in its purpose. It is in Capital (even more than in Marx's philosophical writings) and particularly in the posthumously published Grundrisse (1857-1858), that the serious student will find the key to Marx's dialectical method as it contrasts with the method of Hegel. Moreover, Capital, to a greater extent than Marx's political writings, reveals the reason for the celebrated "failure" of Marxian predictions: the reason lies not so much in the inadequacy of Marx's social and economic theory as in the expectations he based on it. However, in the last analysis these expectations rest on the individual search for perfection and liberty. Marx's influence. Marx's teachings have been expanded and diffused in two ways that are, in effect, opposed to each other. The first is "Marxism" as an ideology, i.e., a dogmatic systematization of Marx's ideas for political purposes, expressed as party doctrine or state religion, and disseminated by its supporters; the second form is a growing body of research and scholarly activity in various branches of the social sciences that has been illuminated by Marx's theoretical discoveries. When Marx himself noticed that his admirers were showing the first signs of "Marxism," he rebuked them unequivocally and asserted, as Engels reported in several letters (e.g., to Bernstein and Conrad Schmidt): "I am not a Marxist." However, he tolerated and even supported Engels' efforts to win acceptance for Capital in academic circles. Inadvertently, Engels thus became the first "Marxist" and the cofounder of the Marxist ideology, whose manifesto was Engels' Anti-Diihring (1878). Marx was thereafter acclaimed as the founder of the new science of socialism and was credited by Engels with two scientific discoveries—the materialistic concept of history and the theory of surplus value. Engels' efforts to popularize Marx's ideas led to the schematization of some of Marx's basic propositions; he claimed to have extended Marx's methodological and critical approach, so that it embraced nature as well as history. With their followers, the distortion of Marx's thought went further still. While Marx considered his general theory to be a scientific method of investigating the transient nature of every economic system and placed his confidence in proletarian class consciousness as an agency of change, "Marxism," Particularly in its Leninist version, has become a Party ideology. This transformation is reflected in the substitution of the coercive direction of political elites for the spontaneous activity and con-

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sciousness of the producing class; paradoxically, these "Marxist" elites have transformed Marx's theoretical propositions into norms of political action. The relevance of Marx's theories for the social sciences has been the subject of much fruitful debate. In a kind of osmotic process, Marx's theories have been incorporated into the social sciences at the same time that they have stimulated important countertheories. A significant event in this process was Sorel's critique of Durkheim (Sorel 1895), in which he praised the "materialist theory of sociology" according to which the various social systems—political, philosophical, religious— must be considered as interdependent and as having a common base; Sorel believed that what Marx assigned to sociology as its major subject for investigation was the underlying system of production and exchange and the conflict of classes. Marxist social science developed in Germany, stimulated by the work of Rudolf Stammler (1896), and it was in response to Stammler that Max Weber began his influential studies of the Marxian thesis concerning the relationship between the economy and other social institutions. In Italy Marxist theories were discussed in several universities under the leadership of Antonio Labriola, Giovanni Gentile, and Benedetto Croce, and in France such discussions were stimulated by Francois Simiand. Thomas G. Masaryk, while he was a university professor in Prague, produced a large work of analysis and criticism of Marx's sociological method and hypotheses (1898). The international character of the "debate with the ghost of Marx" may be further illustrated by the fact that in tsarist Russia numerous books and periodicals paid increasing attention to "scientific socialism" even before Plekhanov and Lenin appeared on the scene. In the United States the influence of Marx's ideas is evident in the writings of Albion W. Small, George H. Mead, Thorstein Veblen, and Joseph Schumpeter, among others. Since World War i, Marx's theories have not only stimulated sociological work in general but have also given impetus to a new field of sociological inquiry, the sociology of knowledge, exemplified by the works of Max Scheler and Karl Mannheim. The process of incorporating Marx's ideas into the social sciences in Western countries contrasts vividly with the unsure attempts by "Marxist" regimes to invent and decree a "Marxist" sociology. The efforts of these regimes unwittingly confirm one of Marx's major hypotheses—that the dominant ideas of a society are those of its ruling class. MAXIMILIEN RUBEL

38 [See

MARX, KARL also COMMUNISM; ECONOMIC THOUGHT, article

On SOCIALIST THOUGHT; MARXISM; MARXIST SOCIOLOGY; SOCIALISM; and the biographies BERNSTEIN; DURKHEIM; ENGELS; HEGEL; HUME; LENIN; LUKACS; MANNHEIM; MASARYK; MEAD; PROUDHON; SAINTSIMON; SCHELER; SCHUMPETER; SlMIAND; SMALL;

SOREL; SPINOZA; ToCQUEVILLE; VEBLEN; WEBER, MAX.] MARX'S WRITINGS WORKS BY MARX (1841) 1927-1929 Uber die Differenz der demokratischen und epikureischen Naturphilosophie. Pages 3—144 in Karl Marx and Friedrich Engels, Historisch-kritische Gesamtausgabe: Werke, Schriften, Briefe. Section 1, Volume 1, part 1: Werke und Schriften bis 1844. Frankfurt am Main (Germany): Marx-Engels Verlag. -» Written in 1841, the text with some notes was first published posthumously in 1902. (1843) 1953 Kritik des hegelschen Staatsrechts. Pages 20-149 in Karl Marx, Die Friihschriften. Stuttgart (Germany) : Kroner. (1844&) 1964 Economic and Philosophic Manuscripts of 1844. New York: International Publishers; London: Lawrence & Wishart. -> Written in 1844 but first published posthumously in German in 1932. Sometimes referred to as the "Paris Manuscripts of 1844." (1844&) 1963 On the Jewish Question. Pages 1-40 in Karl Marx, Early Writings. London: Watts. -> First published in Volume 1/2 of the Deutsch-franzosische Jahrbiicher. (1844c) 1963 Contribution to the Critique of Hegel's Philosophy of Right: Introduction. Pages 41-59 in Karl Marx, Early Writings. London: Watts. -> First published in Volume 1/2 of the Deutsch-franzosische Jahrbiicher. (1844d) 1963 Early Writings. Translated and edited by T. B. Bottomore. London: Watts. -> First published in German. Contains "On the Jewish Question"; "Contribution to the Critique of Hegel's Philosophy of Right"; and "Economic and Philosophic Manuscripts." (1845a) 1956 The Holy Family. Moscow: Foreign Languages Publishing House. -> First published as Die heilige Familie. (1845k) 1935 Theses on Feuerbach. Pages 73-75 in Friedrich Engels, Ludwig Feuerbach and the Outcome of Classical German Philosophy. New York: International Publishers. -> First published in German. (1845-1846) 1939 MARX, KARL; and ENGELS, FRIEDRICH The German Ideology. Parts 1 and 3. With an introduction by R. Pascal. New York: International Publishers. -> Written in 1845-1846, the full text was first published in 1932 as Die deutsche Ideologic and republished by Diet/ Verlag in 1953. (1847) 1963 The Poverty of Philosophy. With an introduction by Friedrich Engels. New York: International Publishers. -> First published as Misere de la philosophic. (1848) 1964 MARX, KARL; and ENGELS, FRIEDRICH The Communist Manifesto. New York: Washington Square Press. -> First published in German. (1849) 1962 Wage Labour and Capital. Volume 1, pages 74-97 in Karl Marx and Friedrich Engels, Selected Works. Moscow: Foreign Languages Publishing House. -» First published as "Lohnarbeit und Kapital" in the Neue Rheinische Zeitung. (1850) 1964 The Class Struggles in France: 1848-1850. New York: International Publishers. -» A series of

articles first published as "Die Klassenkampfe in Frankreich 1848 bis 1850" in the Neue Rheinische Zeitung: Politisch-okonomische Revue. (1852) 1964 The Eighteenth Brumaire of Louis Bonaparte. New York: International Publishers. -> First published in German. (1856) 1899 Secret Diplomatic History of the Eighteenth Century. Edited by Eleanor Marx Aveling. London: Sonnenschein. -> First published as "Revelations of the Diplomatic History of the Eighteenth Century" in the Sheffield Free Press. (1857-1858) 1953 Grundrisse der Kritik der politischen Okonomie. Berlin: Dietz. -» Written in 1857-1858; first published posthumously by the Marx-EngelsLenin Institute, Moscow, in 1939-1941. A partial English translation was published in 1965 as Pre-capitalist Economic Formations by International Publishers. (1857-1859) 1959 MARX, KARL; and ENGELS, FRIEDRICH The First Indian War of Independence: 1857-1859. Moscow: Foreign Languages Publishing House. -> A collection of articles written for the New York Daily Tribune. Also includes articles dated 1853 and notes from a manuscript of the 1870s. (1859) 1913 A Contribution to the Critique of Political Economy. Chicago: Kerr. -> First published as Zur Kritik der politischen Okonomie. (1860) 1953 Herr Vogt. Berlin: Dietz. (1861-1863) 1952 Theories of Surplus Value: Selections. New York: International Publishers. -> A selection from the volumes first published between 1905 and 1910 as Theorien iiber den Mehrwert, edited by Karl Kautsky, taken from Karl Marx's preliminary manuscript written between 1861-1863 for a projected fourth volume of Capital. (1861-1866) 1961 MARX, KARL; and ENGELS, FRIEDRICH The Civil War in the United States. 3d (Centennial) ed. New York: International Publishers. -> A paperback edition was published in 1964 by Citadel Press. (1864) 1937 Address and Provisional Rules of the Working Men's International Association. Pages 27-44 in Founding of the First International: A Documentary Record. New York: International Publishers. (1867-1879) 1925-1926 Capital: A Critique of Political Economy. 3 vols. Chicago: Kerr. ->• Volume 1: The Process of Capitalist Production. Volume 2: The Process of Circulation of Capital. Volume 3: The Process of Capitalist Production as a Whole. The first volume was published in 1867. The manuscripts of Volumes 2 and 3 were written between 1867 and 1879. They were first published posthumously in German in 1885 and 1894. (1871) 1963 The Civil War in France. With an introduction by Friedrich Engels. Moscow: Foreign Languages Publishing House. -> First published in English. A paperback edition was published in 1964 by International Publishers. (1875) 1959 MARX, KARL; and ENGELS, FRIEDRICH Critique of the Gotha Programme. Moscow: Foreign Languages Publishing House. -» Written by Marx in 1875 as "Randglossen zum Programm der deutschen Arbeiterpartei." First published with notes by Engels in 1891. SELECTIONS FROM MARX'S WORKS

Die Friihschriften. Stuttgart (Germany): Kroner, 1953. Marx on China, 1853-1860: Articles From the New York Daily Tribune. With an introduction and notes by Dona Torr. London: Lawrence & Wishart, 1951. MARX, KARL; and ENGELS, FRIEDRICH Revolution in Spain. New York: International Publishers, 1939. -> A collec-

MARX, KARL tion of articles first published in the New York Daily Tribune, Putnam's Magazine, the New American Encyclopedia, and Der Volkesstaat. MARX, KABL; and ENGELS, FRIEDRICH The Russian Menace to Europe: A Collection of Articles, Speeches, Letters and News Dispatches. Edited by Paul W. Blackstock and Bert F. Hoselitz. Glencoe, 111.: Free Press, 1952. -* Contains materials written between 1848-1894. MARX, KARL; and ENGELS, FRIEDRICH Karl Marx and Frederick Engels on Britain. Moscow: Foreign Languages Publishing House, 1953. -» Contains a collection of the most important writings of Marx and Engels, written between 1844-1895, dealing with England. MARX, KARL; and ENGELS, FRIEDRICH Karl Marx and Frederick Engels; Letters to Americans 1848-1895: A Selection. New York: International Publishers, 1953. MARX, KARL; and ENGELS, FRIEDRICH Karl Marx and Frederick Engels: Selected Correspondence. Moscow: Foreign Languages Publishing House, 1956. Contains material dated 1843-1895. MARX, KARL, and ENGELS, FRIEDRICH On Colonialism. Moscow: Foreign Languages Publishing House, 1960. -» Contains a collection of works by Marx and Engels written between 1850-1894. MARX, KARL; and ENGELS, FRIEDRICH Selected Works. 2 vols. Moscow: Foreign Languages Publishing House, 1962. Selected Writings in Sociology and Social Philosophy. 2d ed. Edited by T. B. Bottomore and M. Rubel, with a foreword by Erich Fromm. New York: McGraw-Hill, 1964. -» Contains works written by Marx between 1844-1875. COLLECTED

WORKS

MARX, KARL; and ENGELS, FRIEDRICH Historisch-kritische Gesamtausgabe: Werke, Schriften, Briefe. 12 vols. Edited by David Rjazanov and V. Adoratskij, commissioned by the Marx-Engels Institute, Moscow. Frankfurt am Main, Berlin, and Moscow: Marx-Engels Verlag, 1927-1935. MARX, KARL; and ENGELS, FRIEDRICH Karl Marx, Friedrich Engels: Werke. Vols. 1-. Berlin: Dietz, 1956-.-* Volumes 1-19, 22-31 of a contemplated 36-volume edition. SUPPLEMENTARY BIBLIOGRAPHY

ADLER, MAX 1922 Die Staatsauffassung des Marxismus: Ein Beitrag zur Unterscheidung von soziologischen und juristischen Methoden. Marx-Studien, Vol. 4, part 2. Vienna: Wiener Volksbuchhandlung. ADLER, MAX (1930-1932) 1964 Soziologie des Marxismus. 3 vols. Vienna: Europa. -» First published as Lehrbuch der materialistischen Geschichtsauffassung. Volume 1: Grundlegung der materialistischen Geschichtsauffassung. Volume 2: Natur und Gesellschaft. Volume 3: Die solidarische Gesellschaft. Archiv fur die Geschichte des Sozialismus und der Arbeiterbewegung. -> Published between 1910-1930. BERLIN, ISAIAH (1939) 1963 Karl Marx: His Life and Environment. 3d ed. New York: Oxford Univ. Press. BERNSTEIN, EDUARD (1899) 1909 Die Voraussetzungen des Sozialismus und die Aufgaben der Sozialdemokratie. Stuttgart (Germany): Dietz. [BLECH, WILLIAM J.] 1939 Elements of Marxian Economic Theory and Its Criticism, by William J. Blake [pseud.]. New York: Cordon. BUKHARIN, NIKOLAI I. (1921) 1965 Historical Materialism: A System of Sociology. Translated from the 3d Russian edition. New York: Russell. -> First published as Teoriia istoricheskogo materializma.

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DRAPER, HAL 1962 Marx and the Dictatorship of the Proletariat. Institut de Science Economique Appliquee, Cahiers Fifth Series: Etudes de Marxologie 6:5—73. DUNAYEVSKAYA, RAYA 1958 Marxism and Freedom From 1776 Until Today. New York: Bookman. ENGELS, FRIEDRICH (1878) 1959 Anti-Diihring: Herr Eugen Diihring's Revolution in Science. 2d ed. Moscow: Foreign Languages Publishing House. -» First published as "Herrn Eugen Diihrings Umwalzung der Wissenschaft" in a series of articles in Vorwdrts (Leipzig). Translated from the 3d German edition of 1894. ENGELS, FRIEDRICH (1892) 1925 Marx, Heinrich Karl. Volume 6, pages 496-500 in Handwdrterbuch der Staatswissenschaften. 4th ed. Jena (Germany): Fischer. FROMM, ERICH (editor) 1961 Marx's Concept of Man. New York: Ungar. GURVITCH, GEORGES (1950)1963- La sociologie de Karl Marx. Volume 2, pages 220-322 in La vocation actuelle de la sociologie. 2d ed., rev. Paris: Presses Universitaires de France. HILFERDING, RUDOLF (1904) 1949 Bohm-Bawerk's Criticism of Marx. Pages 119-196 in Eugen BohmBawerk, Karl Marx and the Close of His System. NeW York: Kelley. -» First published in German. HIRSCH, HELMUT 1963 Marxiana judaica. Institut de Science Economique Appliquee, Cahiers Fifth Series: Etudes de Marxologie 7:5-22. HODGES, DONALD C. 1965 Engels' Contribution to Marxism. Socialist Register 2:297-310. HOOK, SIDNEY (1936) 1958 From Hegel to Marx: Studies in the Intellectual Development of Karl Marx. New York: Humanities. -> A paperback edition was published in 1962 by the University of Michigan Press. KAMENKA, EUGENE 1962 The Ethical Foundations of Marxism. London: Routledge; New York: Praeger. KAUTSKY, KARL (1906) 1918 Ethics and the Materialist Conception of History. Chicago: Kerr. -* First published in German. KELSEN, HANS (1920) 1923 Sozialismus und Staat: Eine Untersuchung der politischen Theorie des Marxismus. 2d ed., enl. Leipzig: Hirschfeld. KORSCH, KARL (1923) 1930 Marxismus und Philosophic. 2d ed. Leipzig: Hirschfeld. KORSCH, KARL (1938) 1963 Karl Marx. New York: Russell. LICHTHEIM, GEORGE (1961) 1964 Marxism: An Historical and Critical Study. 2d rev. ed. London: Routledge. LUKACS, GYORGY (1919-1922) 1923 Geschichte und Klassenbewusstsein: Studien iiber marxistische Dialektik. Berlin: Malik. MARCUSE, HERBERT (1941) 1955 Reason and Revolution: Hegel and the Rise of Social Theory. 2d ed. New York: Humanities; London: Routledge. -» A paperback edition was published in 1960 by Beacon. Marxismusstudien. 4 vols. Evangelische Studiengemeinschaft, Schriften. 1954-1962 Tubingen (Germany): Mohr. MASARYK, THOMAS G. (1898)1964 Die philosophischen und soziologischen Grundlagen des Marxismus: Studien zur socialen Frage. Osnabriick (Germany): Zeller. MATTICK, PAUL 1962 Marx and Keynes. Institut de Science Economique Appliquee, Cahiers Fifth Series: Etudes de Marxologie 5:113-212. MAYER, HENRY 1960 Marx, Engels and the Politics of the Peasantry. Institut de Science Economique Appliquee, Cahiers Fifth Series: Etudes de Marxologie 3:91-152.

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MARXISM

MEHRING, FRANZ (1918) 1948 Karl Marx: The Story of His Life. London: Allen & Unwin. -> First published in German. A paperback edition was published in 1962 by the University of Michigan Press. NAVILLE, PIERRE 1957 De Valienation a la jouissance: La genese de la sociologie du travail chez Marx et Engels. Paris: Riviere. NIKOLAEVSKII, BORIS I.; and MAENCHEN-HELFEN, OTTO 1936 Karl Marx: Man and Fighter. Philadelphia: Lippincott. OLLMAN, BERTELL 1967 Marx's Conception of Human Nature. Unpublished manuscript. PAGE, CHARLES (1940) 1964 Class and American Sociology: From Ward to Ross. New York: Octagon Books. PLAMENATZ, JOHN P. (1954) 1961 German Marxism and Russian Communism. 3d ed. London: Longmans. PLEKHANOV, GEORGII V. (1895) 1947 In Defense of Materialism: The Development of the Monist View of History. London: Lawrence & Wishart. -> First published in Russian. POPPER, KARL R. (1945) 1963 The Open Society and Its Enemies. 4th rev. ed. 2 vols. Princeton Univ. Press. -» Volume 1: The Spell of Plato. Volume 2: The High Tide of Prophecy: Hegel, Marx and the Aftermath. RUBEL, MAXIMILIEN 1956 Bibliographic des oeuvres de Karl Marx: Avec en appendice un repertoire des oeuvres de Friedrich Engels. Paris: Riviere. -» A Supplement was published in 1960. RUBEL, MAXIMILIEN 1957 Karl Marx: Essai de biographie intellectuelle. Paris: Riviere. SCHUMPETER, JOSEPH A. (1942) 1950 Capitalism, Socialism, and Democracy. 3d ed. New York: Harper; London: Allen & Unwin. -> A paperback edition was published by Harper in 1962. SOREL, GEORGES 1895 Les theories de M. Durkheim. Devenir social 1:1-26, 148-180. STAMMLER, RUDOLF (1896)1924 Wirtschaft und Recht nach der materialistichen Geschichtsauffassung: Eine sozialphilosophische Untersuchung. 5th ed. Berlin: de Gruyter. WEBER, MAX (1907) 1922 R. Stammlers "Uberwindung" der materialistischen Geschichtsauffassung. Pages 291-359 in Max Weber, Gesammelte Aufsdtze zur Wissenschaftslehre. Tubingen (Germany): Mohr. ZEITLIN, IRVING MORDECAI 1967 Marxism: A Re-examination. Princeton: Van Nostrand. Zeitschrift fur Sozialforschung. -> Published between 1932 and 1941. Title changed to Studies in Philosophy and Social Science with Volume 8, No. 3. It represented (until 1938) a serious attempt to develop a Marxian sociology in nondogmatic terms.

MARXISM This article deals with the origins and development of the political doctrine of Karl Marx. Marxism is also discussed in ECONOMIC THOUGHT, article On SOCIALIST THOUGHT; MARXIST SOCIOLOGY; SOCIALISM; and in the biography of MARX. Contemporary political and economic aspects are discussed in COMMUNISM; COMMUNISM, ECONOMIC ORGANI-

ZATION OF. Also related are PLANNING, ECONOMIC, article on EASTERN EUROPE; WORKERS. The biographies of BERNSTEIN; ENGELS; FANON; KAUTSKY; LANGE; LENIN; LUKACS; LUXEMBURG; MAN; MILLS; OssowsKi; and TROTSKY describe different intellectual developments after Marx. For the biographies of other socialist thinkers, see under SOCIALISM. Like other schools of socialism that arose in the early nineteenth century, Marxism was a response to the economic and social hardships accompanying the growth of Western industrial capitalism. If in recent decades it has attracted most of its adherents in countries hardly touched by industrial capitalism, this is the result of a tortuous ideological history. The intellectual heritage from which Marxism drew its insights, attitudes, and concepts is a synthesis of many ideological currents of the early and middle nineteenth century. They include the basic assumptions of the democratic faith and the slogans of the French Revolution; indeed, Marxism asserts that this revolution was betrayed by the very class which made it and will only be fulfilled by the proletariat through socialism. Hence, Marxism also embraces the syndrome of attitudes associated with workers' protest movements and socialism. Further, Marxism embodies the empiricism or "materialism" of Bacon, Hobbes, and Helvetius. From Rousseau and the romantics it has taken a strongly ambivalent attitude toward past and present institutions, together with a strong commitment to historicism and its Hegelian form —dialectics. Finally, this mixture is seasoned with the anthropocentrism of Feuerbach, the economic doctrines of Smith and Ricardo, and the class-war theories of Michelet and other historians of the French Revolution. As a syndrome of attitudes, Marxism might be described as a synthesis of radicalism, optimism, and a commitment to science: it is radical in criticizing contemporary social institutions and practices as stupid and inhuman; it is optimistic in expecting, eventually, the creation of a "good society" worthy of man's highest potentials; it is committed to science not only because it wishes to analyze society but also because it is convinced that the scientific investigation of the social forces active in the contemporary world will confirm both its radicalism and its optimism. Doctrine Marxism is a dialectical theory of human progress. It regards history as the development of man's effort to master the forces of nature and, hence, of

MARXISM production ("economic interpretation of history"). Since all production is carried out within social organization, history is the succession of changes in social systems, the development of human relations geared to productive activity ("modes of production"), in which the economic system forms the "base" and all other relationships, institutions, activities, and idea systems are "superstructural." History is progress because man's ability to produce, his "forces of production," continually increase. It is regression because in perfecting the forces of production man creates a more and more complex and oppressive social organization, seemingly beyond human control (the "production relations"), the central feature of which is the division of society into classes. Classes are defined by their relations to the essential means of production: the ruling class is that group of men who own the means of production; those who are propertyless are forced to function as the laboring class. Like Rousseau, Marx was profoundly interested in exploring the inequalities of men because he shared his belief that there can be no democracy as long as there are inequality and special interests. Progress, thus, is a mixed blessing. Nor is it unilinear, for in the history of man different elements of the complicated social system continually become dysfunctional to each other. In particular, the production relations, originally in tune with a given state of the forces of production, lag behind the latter and come to retard their further development. From a promoter of progress the ruling class turns into a useless parasite. But when the old production relations have turned into a dead shell, mankind assures the march of progress by remaking the social system in revolutionary violence, giving leadership to the class wielding the most advanced means of production. According to the Marxist scheme of history, mankind has gone through three or four major modes of production since an initial golden age of primitive communism: ancient slave society, feudalism, and capitalism (to which Marx added, in some of his works, Asiatic society as a distinct mode of production). Capitalism, the last form of society torn by a class struggle, represents the peak of human development so far. On the one hand, it has created and amassed unprecedented wealth, which, if used rationally, could assure the material wellbeing of all mankind. Yet, by virtue of its own laws of operation, capitalism cannot utilize its means of production rationally but must match the accumulation of capital with the accumulation of misery and chaos. Again, while it has promoted constitutional government and the rights of man, the

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formal rights and equalities of liberal regimes are vitiated by actual inequalities and ultimate dehumanization: formally free, man has been converted into a commodity, whose labor power, talents, and personality are for sale on the free market. The resolution of these contradictions will be produced by capitalism itself. Its own economic laws not only produce chaos and crisis but also narrow the social basis of capitalism by casting the mass of the population into the proletariat. At a crisis point the exploited will rise in revolution, expropriate the ruling class, replace commodity production with an economy based on national planning, and abolish all class divisions in society. Supporting the optimistic prognosis of revolutionary Marxism is the image of the proletariat as the "chosen people," who, because of their place in society, their state of organization, and their spontaneous grasp of reality ("class consciousness") can be expected to rise above all narrow interests, loyalties, and ideologies and liberate mankind forever from the curse of property and class. Development Marxist doctrine was spelled out concisely in the Communist Manifesto. This pamphlet was written shortly before the outbreak of the 1848 revolution, which Marx and Engels were confident would lead to the socialist revolution of the proletariat. The failure of 1848 forced them to explain what had prevented this act of deliverance. In subsequent political commentaries, they emphasized complicating factors left out of the more abstract analysis of capitalism: the role of precapitalist classes in European politics, especially the petty bourgeoisie; the baneful role of demoralized workers (Lumpenproletariaf); the role of the state as an independent political force; and the role of nations. Many ideas contained in these political writings were never fully integrated with general Marxist theory. Indeed, Marx's major work on the capitalist system remained a fragment; and he died before he had time to give a systematic presentation of such a central concept as social class. Another task made necessary by the failure of 1848 was to elaborate a political strategy for the proletarian movement. Here Marxism came to emphasize the differences between long-range and short-range objectives. Socialism was defined as the maximal goal, while the minimal goal was the liberation of capitalism from feudal and absolutist residues of a political, economic, or social nature. A more intermediate goal—the dictatorship of the proletariat—received scant mention in Marx's writings.

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Problems of political strategy became more important because, after inauspicious beginnings, Marxist doctrine was in time accepted as the party ideology of the European labor movement. There is irony in this merger because the workers' movement which finally accepted Marxist ideology was in many ways different from the proletariat as Marx and Engels had described and idealized it in 1847-1848. It tended toward reformism, had faith in constitutional democracy, and, as the first mass party of modern history, became thoroughly bureaucratized. Ulam (1960) cogently argues that Marxism at that time was no longer a suitable ideology for the European labor movement. Hence, its adoption raises puzzling questions which cannot be pursued here. Suitable or not, the merger of the ideology with the movement was a turning point because, with it, Marxism became a formal ideology, a guide to thought and action, a holy writ and catechism. Henceforth, it tended toward doctrinal rigidity. The growing discrepancy between revolutionary theories and actual party policies lent Marxism a note of hypocrisy, while a widening gap between assumptions and reality had the effect of ideological blinders on those who wanted to use Marxism as a tool for comprehension. Moreover, once Marxism was accepted as party doctrine, its adherents, beginning with Engels, extended the doctrine into areas of inquiry to which Marx himself had not applied it. Marx had thought to encompass with his theory contemporary society and all of human history. Engels sought to integrate Darwinian theory and all natural science with Marxism and to raise Marxist theories to the level of a universal philosophy. For Marx the ultimate determinant of the course of history was man and his needs, but for Engels it came to be matter and its motion. Yet, it was the ideas of Engels which set the tone for orthodox Marxism of both the social democratic and communist persuasions. The sociopsychological dynamics behind both this extension of the doctrine and its transformation into a holy writ still need to be explored. Conflicting interpretations As soon as Marxism was accepted as the doctrine of the European labor movement, it became a matter of controversy among its followers, partly because the work of Marx and Engels had remained unfinished in many details, but even more because of social changes that had occurred. The ensuing debates dealt with issues of strategy, focusing on the problem of maturity, i.e., the task of defining the point at which a society might be

ripe for the proletarian revolution. Engels alluded to the problem by wondering about the paradox that the proletarian revolution might be impossible as long as it was necessary and unnecessary once it became feasible. Problems of organization and tactics also provided material for controversies. Discussions of these and many related issues are still going on within Marxism, even though the same questions are asked in changing circumstances. Of the controversies raging before World War I, the bitterest was unrelated to strategy or organization. It arose instead out of the growing unrealism of Marxist doctrine. The spread of economic prosperity and constitutional government belied Marxist prognoses about the intensification of crises and misery; and the revolutionary slogans of the Communist Manifesto sounded incongruous when uttered by the moderate leaders of the Second International. To resolve the discrepancy, the "revisionists" proposed a thoroughgoing change of Marxist doctrines so as to make them reflect current conditions, modern scientific insights, and social democratic aims and policies. Revisionism came close to being a repudiation of Marxist ideas; and it can be regarded as the first in a long series of steps away from Marx made by democratic socialists since the turn of the century. Their antagonists in the Second International insistently upheld the letter of Marxist doctrines, identifying loyalty to the writ of Marx with loyalty to the workers' movement. The method of bridging the gap between theory and reality was by denying its existence, meanwhile reinterpreting Marx's revolutionary theories so as to make them yield reformist counsel. For most Marxists committed to democratic socialism, this was an ideological rear-guard action, because the predominant trend in the socialist movement has been to follow the revisionists in their repudiation of Marx. While the revisionists sought to change theories in order to align them with reality and the orthodox denied the need for such realignment, a radical wing of the Marxist movement, which arose after the turn of the century, attempted to bridge the gap between theory and practice by leading the workers' movement back to the revolutionary orientation of the Communist Manifesto. This wing became the nucleus of communism; most of its leaders joined communist parties, if only for short periods. The radical Marxists asserted that despite profound changes in the capitalist world since the days of Marx—especially "imperialism" (the export of

MARXISM capital and of capitalism to dependent countries overseas)—the basic contradictions of capitalism had remained; hence also the inevitability and necessity of the revolution Marx had predicted. Disagreements among the radicals arose over many issues, the most divisive one being the question of organization. One faction, of which Rosa Luxemburg was the outstanding spokesman, saw the roots of "reformism," i.e., democratic socialism, in the bureaucratization of the workers' movement, which they thought stifled revolutionary initiative and proletarian class consciousness. Against them, Lenin and his Bolsheviks believed that revolution making should be subject to rational management (bureaucracy), and they held, moreover, that by itself, spontaneously, the proletariat would not be able to attain class consciousness; hence their emphasis on leadership by an enlightened elite organized in bureaucratic fashion in the party, which should function as the general staff of the proletarian revolution. Leninist Marxism thus focuses on the task of manipulating the masses through leaders who have acquired insight into the politically necessary and possible by applying Marxist categories to the analysis of their society. New ideological problems were bound to arise when a Marxist party was founded in Russia toward the end of the nineteenth century, because most of the conditions to which Marxism originally had been a response were absent in that country. The very fact that Marxism could find acceptance among Russian revolutionaries is an interesting ideological development, which deserves explanation in another context. Russia's economic backwardness and repressive political system exacerbated problems of timing, leadership, organization, political alliances, and related issues, considerably straining the entire framework of Marxist concepts. For instance, the notion that the bourgeoisie cannot fulfill the ideological promises of the bourgeois revolution was a central tenet of Marx and Engels. But Lenin's idea that the bourgeoisie will not carry out or even initiate "its own" revolution (which will instead have to be accomplished by the proletariat and its allies) requires very bold use of Marxist class terminology. In its mature form Bolshevism takes even greater liberties with the original Marxist conception when it assigns to colonial and other dependent nations a significant role in the hoped-for "proletarian" revolutions. Underdeveloped nations here assume some of the traits which Marx had attributed to the industrial workers of the West. But as a consequence, the "proletarian revolution" itself turns into something very different from what Marx had assumed

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it to be. Originally thought of as the act of taking over the mature industrial establishment created (and mismanaged) by capitalism, it now can take over nothing but a backward economy and culture; this leads to the paradoxical conclusion that the proletarian state (a "superstructural" phenomenon) will have to begin constructing its own economic "base," making use of "capitalist" methods in doing so. In their controversies over policy and organization, the different factions of Russian Marxism emphasized those portions of the ideology which seemed to support their views, at the expense of other portions. Lenin and his Bolsheviks were so intent on reaching their goal, the proletarian revolution, that they amended Marx's revolutionary timetable beyond recognition; this led to the accusation that they were Blanquists rather than Marxists. The more cautious Mensheviks, in turn, seemed so concerned with following the timetable provided by Marx that Lenin accused them of postponing socialism and the revolution ad calendas Graecas and thus betraying the cause of the proletariat. The schism which split Russian Marxism into two hostile social-democratic parties was extended to the entire world-wide movement in the years from 1914 to 1920. Disagreements over the proper attitudes a Marxist should take toward the war and the Russian Revolution divided Marxism irreconcilably into socialists and communists, each creating their own international federation of parties. The most important issue between them was their difference of attitude toward the Bolshevik seizure of power and method of governing. The communists regarded their state as the pioneer of the international workers' movement. The socialists saw in it an ill-timed and irresponsible adventure which discredited the Marxist movement. In subsequent decades, the communist-socialist split hastened the process by which democratic socialism came to dissociate itself from Marxist ideology. [See SOCIALISM.] Marxism as the ideology of a ruling party Once in power, the Russian communists sought to use Marxism as a guidebook for the further road toward socialism and for managing a proletarian dictatorship. The difficulties they encountered and the sketchiness of the hints Marx and Engels had provided for solving these problems led to new and sharp controversies among the communists themselves, in which the broadest spectrum of Marxist concepts was once again discussed from divergent points of view. With Stalin's rise to power

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the debate was forcibly closed, and his own views were imposed as dogma over all communist parties. The substance of this dogma, based on Leninist principles, might be summarized as follows: Marxism is both scientific truth and ideology—-the ideology of the working class. The Communist party alone possesses full scientific insight and expresses the true interests of the workers. Hence, only he who is loyal to the party can be loyal to the proletariat, in tune with the course of history, or capable of grasping the truth. Nothing can be true which contradicts the party. Further, official Soviet doctrine justifies the communist state, its policies and social structure, as a proletarian dictatorship and a true democracy engaged in "constructing socialism." Marxism here has turned into a theory of state defending, as virtually perfect, a regime violating all the libertarian and egalitarian values expressed by Marx. The success with which Marxist concepts have been used to fashion a conservative and authoritarian doctrine of this kind is a major achievement in ideology making. In the Soviet Union this has recently been supplemented by a program for the "transition to communism," which is an obvious attempt to tone down expectations. Calling for little significant change in present-day Soviet society, it signals the withering away of Utopia on this branch of Marxist ideology. Finally, contemporary communist ideology incorporates a program for the further spread of the "proletarian" revolution. But although the workers in the industrialized countries have not been written off formally, in effect the communist movement has now substituted the colonial and other dependent nations in the historic role which Marx attributed to the proletariat of the capitalist world. The function of the ideology in communist political systems has been the subject of much controversy. Many scholars (echoing communist dogma) see Marxism-Leninism as the master plan guiding all communist thought, actions, and institutions. Others assert that it is no more than rationalization which easily adapts to any changes in policy. However contradictory, both theories have some plausibility but are easily refuted in their exaggerated forms. Marxist ideology, as amended by Lenin and his successors, did inspire the men who made communist revolutions and has influenced communist regimes and institutions even more directly than the ideas of Rousseau and Locke have shaped the institutions of the French and American republics. Although the ideology becomes primarily rationalization after the communist seizure of power, it

does remain the language of politics, meaning not only a code of communications for the political elite but also the conceptual frame of reference used for cognitive and ethical self-orientation. It thus determines both analysis and action, if only negatively, that is, as ideological blinders and as a brake ("bad conscience") on freedom of action. [See IDEOLOGY.] A doctrine which is meant to serve as a useful aid to cognition must be realistic and flexible, whereas a doctrine functioning as a communications code need only be rigid. These and other conflicting functions of the ideology strain it. Primarily, perhaps, the ideology functions as a legitimation device, implying not only an exercise in public relations to attain legitimacy among the citizens but, even more important, a continual attempt by the party leaders to convince themselves of their own legitimacy; more generally, it functions as an ideological exoskeleton for insecure bureaucrats in a vast and powerful administrative machine. The implication is that communist leaders in making doctrinal pronouncements speak more to themselves than to their citizenry, and least of all to the outside world. This phenomenon of self-encouragement or self-legitimation, observable in all societies, has been unduly neglected by contemporary communications theory. Ideological strains Since World War n, communist parties have come to power in close to a dozen countries of eastern Europe, Asia, and the Caribbean area. These various Marxist-Leninist regimes came to power by widely divergent methods and, once installed, faced very different tasks because of the great differences in the cultures, economic development, political traditions, and social structures of the countries concerned. If to these variations in national interests and outlooks of the several communist regimes one adds the bitter memory of past disagreements and injuries, plus the normal political rivalries between groups and personalities within a large group of states, it is not astonishing that sharp conflicts arose in the communist camp, straining relations between the different regimes and within each communist party. Given the relations between politics and ideology within the communist movement, these disagreements sooner or later had to become doctrinal and thus turned into questions of fundamental principle. Hence, the dialogue between Tito and Stalin, between Khrushchev and Mao, and between revisionists and dogmatists in every communist party led to a discus-

MARXISM sion of not only basic problems in revolutionary strategy and socialist construction but also of the most fundamental concepts of Marxism-Leninism. The resulting differences within the communist world are today as deep as the schism between Mensheviks and Bolsheviks half a century ago. Moreover, the issues under discussion are similar to those which divided Russian Marxism at that time, even though the circumstances and the concrete reference points have changed. The unity of the communist movement is as irretrievably gone as was the unity of European Marxism at the time of the October Revolution. As a result, what 15 years ago seemed well-established dogma is now subject to doubt. Within some of the communist societies, party dogmas today are also being criticized in the name of science, while the practices of communist governments and the rhetoric which justifies them are challenged in the name of Marxist humanism. In short, official ideology is assailed from several directions. Two tendencies are likely to result from this multiple onslaught. Official ideological output may turn increasingly into empty, meaningless political oratory, ritually incanted on suitable ceremonial occasions but as removed from life as Sunday sermons and Independence Day speeches. At the same time, a genuine dialogue conducted between and within the several communist parties over a sufficient period of time might serve to reinvigorate Marxist ideology, especially in communist parties that have not yet come to power, even though it may also lead many former adherents to repudiate this ideology. [See the articles under COMMUNISM,] Marxism in the noncommunist world Although the communist movement (or movements, as one must now write) claims to be the legitimate heir of Marxist ideology, Marxism continues to exist, in the Western world, as a noncommunist ideology. To be sure, most socialist parties have gone far in severing their ties with Marxism. Yet interest in it has increased in certain intellectual circles. Most of this is roundly critical and, especially in its recent intensified form, is a function of the cold war. The variety of points of view from which Marxism, or what is understood to be Marxism, has been criticized cannot be summarized here. But some of the recent interest has been sympathetic. This may have been stimulated by the collaboration of many diverse elements with communists and socialists during and shortly after World War n. In addition, political, economic, racial, and other difficulties that have beset the

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Western world since the war have increased many intellectuals' awareness of defects in their social system. For anyone focusing his attention on negative aspects of contemporary social life, Marxism offers considerable attraction, principally because of two elements: one is the message of inevitable doom derived from the analysis of the capitalist economy; the other is the humanist ethic of Marxism—the emphasis on the evil features of a commercial civilization, the romantic anger at institutions and practices that degrade, oppress, or exploit some men, and the sanguine belief in the inherent goodness of mankind, which under favorable circumstances can and will free itself from inhibiting and corrupting institutions. In the last decade or two interest in this humanist philosophy of Marx and in the early writings in which it is expressed has increased rapidly. Finally, there is some increase in the interest social scientists have in Marx as a precursor of contemporary social science : some of his methodological contributions are only now receiving recognition. ALFRED G. MEYER BIBLIOGRAPHY

See the bibliographies following the articles on EN GELS; LENIN; and MARX for their major works. BLOOM, SOLOMON F. 1941 The World of Nations: A Study of the National Implications in the Work of Karl Marx. New York: Columbia Univ. Press. CHAMBRE, HENRI (1959)1963 From Karl Marx to Mao Tse-tung: A Systematic Survey of Marxism-Leninism. New York: Kennedy. -> First published in French. COLE, G. D. H. 1953-1960 A History of Socialist Thought. 5 vols. New York: St. Martins; London: Macmillan. H> Volume 1: Socialist Thought: The Forerunners 1789-1850, 1953. Volume 2: Marxism and Anarchism 1850-1890, 1954. Volume 3: Second International 1889-1914, 2 parts, 1956. Volume 4: Communism and Social Democracy 1914-1931, 2 parts, 1958. Volume 5: Socialism and Fascism 19311939, 1960. DANIELS, ROBERT V. 1960 The Conscience of the Revolution: Communist Opposition in Soviet Russia. Russian Research Center Studies, No. 40. Cambridge Mass.: Harvard Univ. Press. FETSCHER, IRING (1956) 1959 Von Marx zur Sowjetideologie. 4th ed. Frankfurt am Main: Diesterweg. Fundamentals of Marxism-Leninism. 2d ed., rev. (1959) 1963 Moscow: Foreign Languages Publishing House. -» First published as Osnovy marksizma—leninizma. GAY, PETER 1952 The Dilemma of Democratic Socialism: Eduard Bernstein's Challenge to Marx. New York: Columbia Univ. Press. -» A paperback edition was published in 1962 by Collier. GREGOR, A. JAMES 1965 A Survey of Marxism: Problems in the Philosophy and Theory of History. New York: Random House. HAIMSON, LEOPOLD H. 1955 The Russian Marxist &the Origins of Bolshevism. Russian Research Center

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Studies, No. 19. Cambridge, Mass.: Harvard Univ. Press. KOLARZ, WALTER (1959) 1964 Books on Communism: A Bibliography. 2d ed. New York: Oxford Univ. Press. LABEDZ, LEOPOLD (editor) 1962 Revisionism: Essays on the History of Marxist Ideas. New York: Praeger. LEHMBRUCH, GERHARD (1956) 1958 Kleiner Wegweiser zum Studium der Sowjetideologie. Bonn: Gesamtdeutscher Verlag. -> A revised and enlarged edition of H. Gollwitzer and G. Lehmbruch's Kleiner Wegweiser zum Studium des Marxismus—Leninismus. LICHTHEIM, GEORGE (1961) 1964 Marxism: An Historical and Critical Study. 2d ed., rev. London: Routledge. -> A paperback edition was published by Praeger in 1965. MARCUSE, HERBERT (1941) 1955 Reason and Revolution: Hegel and the Rise of Social Theory. 2d. ed. New York: Humanities; London: Routledge. -> A paperback edition was published in 1960 by Beacon. MARCUSE, HERBERT 1958 Soviet Marxism: A Critical Analysis. New York: Columbia Univ. Press. -* A paperback edition was published in 1961 by Vintage. MEYER, ALFRED G. 1957 Leninism. Russian Research Center Studies, No. 26. Cambridge, Mass.: Harvard Univ. Press. -» A paperback edition was published in 1962 by Praeger. MITRANY, DAVID 1951 Marx Against the Peasant: A Study in Social Dogmatism. Chapel Hill: Univ. of North Carolina Press. PLAMENATZ, JOHN P. (1954) 1961 German Marxism and Russian Communism. New York: Longmans. RAMM, THILO 1955 Die grossen Sozialisten als Rechtsund Sozialphilosophen. Stuttgart: Fischer. ROSENBERG, ARTHUR (1932) 1939 A History of Bolshevism: From Marx to the First Five Years' Plan. London and New York: Oxford Univ. Press. -> First published in German. RUBEL, MAXIMILIEN 1956 Bibliographie des oeuvres de Karl Marx: Avec en appendice un repertoire des oeuvres de Friedrich Engels. Paris: Riviere. -> A 74page supplement was added in 1960. SCHORSKE, CARL E. 1955 German Social Democracy, 1905-1917: The Development of the Great Schism. Cambridge, Mass.: Harvard Univ. Press. SCHWARTZ, BENJAMIN I. 1951 Chinese Communism and the Rise of Mao. Cambridge, Mass.: Harvard Univ. Press. TIMASHEFF, NICHOLAS S. 1946 The Great Retreat: The Growth and Decline of Communism in Russia. New York: Button. TUCKER, ROBERT C. 1961 Philosophy and Myth in Karl Marx. Cambridge Univ. Press. ULAM, ADAM B. 1960 The Unfinished Revolution: An Essay on the Sources of Influence of Marxism and Communism. New York: Random House. WETTER, GUSTAVO A. (1948) 1959 Dialectical Materialism: A Historical and Systematic Survey of Philosophy in the Soviet Union. New York: Praeger. -» First published as II materialismo dialettico sovietico.

MARXIST SOCIOLOGY Karl Marx introduced into the social sciences of his day a new method of inquiry, new concepts, and a number of bold hypotheses to explain the rise, development, and decline of particular forms

of society; all of which came to exercise, in the later decades of the nineteenth century, a profound and extensive influence upon the writing of history, political science, and sociology. Marx was also a man of action, a revolutionary, whose political creed stood in a complex and uneasy relationship to his scientific investigations, and his followers, the Marxists of various hues, have tended toward one or the other limit of his ideas, to doctrinal exposition, or to the furtherance of a science of society. Marxist sociology has been one of the principal battlefields in this conflict between objective science and political commitment. Marx's contributions On the side of scientific method, Marx made two important contributions. One was to adopt, and to maintain consistently in his work, a view of human societies as wholes or systems in which social groups, institutions, beliefs, and doctrines are interrelated and have to be studied in their interrelations rather than treated in isolation, as in the conventional separate histories of politics, law, religion, or thought. The second contribution was the view of societies as inherently mutable systems, in which changes are produced largely by internal contradictions and conflicts, and the assumption that such changes, if observed in a large number of instances, will show a sufficient degree of regularity to allow the formulation of general statements about their causes and consequences. Historical materialism. Marx's ideas, which played an essential part in the formation of modern sociology, had been adumbrated in the works of earlier thinkers as diverse in other respects as Hegel, Saint-Simon, and Adam Ferguson, all of whom greatly influenced Marx; and they resemble in some aspects the ideas which Comte and Spencer propounded in their attempts to lay the foundations of sociology. But Marx elaborated his conception of the nature of society, and of the appropriate means to study it, in a more precise, and above all more empirical, fashion than did his predecessors. He introduced an entirely new element by attributing to the characteristics of the economic system and to the derived relations between social classes a predominant influence in determining the structure of each society. It was this feature of Marx's method, to be known subsequently by the somewhat misleading term "historical materialism," which was widely accepted by later sociologists as offering a more promising starting point for exact and realistic investigations of the causes of social change than could be found in such notions as the three stages of man's intel-

MARXIST SOCIOLOGY lectual development (Comte) or the process of superorganic evolution (Spencer). Social class and social conflict. Marx's theories followed to a great extent from the above methodological conceptions, which he referred to as the "guiding thread" in his studies (1859, preface). The significance of the economic system of society was elaborated in a theory which traced the formation of the principal social groups—the classes—to the forms of ownership of the means of production and the forms of labor of nonowners. The idea of social change resulting from internal conflicts was developed in a theory of class struggles which made social classes the principal, if not the sole, agents of political activity; and this conception in turn led to the distinction between ruling and oppressed classes and to a distinctive theory of the state. The conviction that social changes display a regular pattern led Marx to construct, in broad outline, a historical sequence of the main types of society, proceeding from the simple, undifferentiated society of "primitive communism" to the complex class society of modern capitalism; and he sketched an explanation of the great historical transformations which demolished old forms of society and created new ones in terms of economic changes which he regarded as general and constant in their operation. Although this theoretical scheme was intended to have a universal character, Marx actually employed it in a partial manner. His own researches were limited almost entirely to the nineteenthcentury capitalist societies, and he gave only fragmentary accounts of the other types of society, in brief allusions in Capital, in newspaper articles and correspondence, and in manuscripts which were published after his death (see especially 18571858). Furthermore, some of his most important theoretical ideas were derived immediately from the observation of modern societies, and they fit closely only these particular societies. His theory of social classes applies in the main to the formation and development of the modern bourgeoisie and proletariat; it is not so helpful when applied to the phenomena of a caste system. Clearly, the theory of social conflict originated in an interpretation of the French Revolution, the materials for which had been prepared by earlier historians, and it was developed further by observation of the class struggles which accompanied the growth of the labor movement in western Europe. The concept of ideology, similarly, originated in Marx's criticism of some contemporary social doctrines—utilitarianism, the "critical philosophy" of the Young Hegelians, political economy in some

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of its aspects—which he regarded as concealing or distorting the real relationships between men and the actual social conflicts in the European societies of his time (Marx & Engels 1845-1846). It is not a concept which Marx brought, or tried to bring, within the framework of a general sociological theory of knowledge. This intense preoccupation with the origins and development of industrial capitalism is, indeed, a feature of Marx's theories which helps to account for the interest which they still excite. It has enabled Marxists to represent his thought as a modern philosophy that is closely linked with the progress of science and industry, and it has enabled sociologists to discover in it the elements of a theory of industrialization and economic growth. Marx's influence in the nineteenth century Marx's scientific writings were not widely noticed or criticized during his lifetime, and he became known principally as the author of a political doctrine expounded in the Communist Manifesto in 1848 and as one of the animators of the International Working Men's Association. Furthermore, the early expounders of his ideas, other than Friedrich Engels, were themselves political leaders of the growing working class movement in Europe— men such as August Bebel, Karl Kautsky, and Eduard Bernstein in Germany; Jules Guesde and Paul Lafargue in France—rather than scholars. Only in the late 1880s did Marx's theories begin to claim the serious attention of academic social scientists. The first major work of sociology to recognize his importance and to display the influence of his thought was Ferdinand Tonnies' Community and Society (1887). In this book Tonnies expounded his distinction between two forms of society—"community" (Gemeinschaft) and "association" (Gesellschaff)—which has become one of the classic themes of sociology. His debt to Marx is indicated by the importance which he assigned to the system of production in determining these different forms of society and by the character of his analysis of modern capitalism. Much later Tonnies published an excellent short study of Marx's life and work (1921), in which he examined more fully the nature and limitations of Marx's contribution to sociology. A more general recognition by the German academic world of Marx's importance as a sociological thinker became apparent in the 1890s with the publication of a long essay by Werner Sombart on Marx's theory of modern capitalism, books by Rudolf Stammler and Thomas G. Masaryk on the methodological foundations of his theories, and

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numerous discussions in scholarly journals. At this time Marx's work also began to be discussed by eminent scholars in other European countries: in Italy by Antonio Labriola (1895-1896), Benedetto Croce (in several essays which are collected in Croce 1900), Giovanni Gentile, and Vilfredo Pareto; and in France by Georges Sorel, who expounded Marx's theories in a number of articles from 1894 onward and published in his journal, Le devenir social, some notable essays on Marx by European scholars as well as his own reviews, from a Marxist standpoint, of the work of contemporary sociologists. Marx's sociology also figured prominently in the contributions to the first international congress of sociology held in 1894. Divergence of Marxism and sociology By the beginning of the twentieth century, therefore, Marx had been generally accepted as the author of a profound and original system of sociology, yet in the following period the influence of Marxism upon sociology diminished rather than increased. Many of the writers who had first drawn attention to the importance of Marx's theories— among them Croce, Sorel, and Pareto—now became severe critics of Marxist thought and advanced new social and historical theories which, however much they might owe to the initial shock which Marx's ideas had produced, were conceived in an entirely different fashion. On the other hand, a number of influential Marxist thinkers came to regard more critically the claims of sociology as a positive science and to insist more strongly upon the character of Marxism as a revolutionary social philosophy. In the early 1900s only the small but distinguished group of thinkers who became known later as the Austro-Marxists were engaged in an attempt to set forth and develop the sociological elements in Marx's thought. Max Adler (1925), a philosopher deeply influenced by Neo-Kantianism, represented Marx as having established the epistemological foundations of social science, as Kant had done for the natural sciences; he saw in Marxism a sociological system of causal explanation. Another member of the group, Karl Renner (1904), produced what is still the outstanding Marxist contribution to the sociology of law, a study of the effect of economic forces and social changes upon the working of modern legal institutions. The writings of the Austro-Marxists, however, did not arrest the growing divergence between Marxism and sociology, which appears most clearly in the contrast between the work of Max Weber and Pareto in sociology and the fresh expositions of

Marxist thought by Karl Korsch and Gyb'rgy Lukacs. Sociology—Weber and Pareto. Marxism was unquestionably one of the strongest influences upon the work of Max Weber, much of which is devoted either to testing, in a particular context, some part of Marx's theories, or to reassessing in a more general way his concepts and methods. In the first of these directions, Weber's best-known study is that on the origins of modern capitalism (1904-1905), which is intended to show that a body of religious ideas (the Protestant ethic) played a vital part in the development of European capitalism, alongside the economic changes and the rise of a new class, through the inculcation of new attitudes toward wealth, science, and work. From this first revision of Marx's economic interpretation of history, Weber went on to examine on a wider scale the social influence of religious ideas, to amend and supplement the Marxist theory of classes, to outline a radically different theory of political power, and to suggest an interpretation of modern European history as a movement, not toward socialism but, rather, toward greater bureaucratic regulation. In the sphere of methodology, Weber's preoccupation with historical materialism is evident in his discussion (1907) of a book by Stammler and especially in an editorial in the Archiv fur Sozialwissenschaft und Sozialpolitik in 1904, in which he observed that while the materialist conception of history should be rejected as a comprehensive Weltanschauung, the interpretation of historical events from the aspect of their economic conditioning or relevance may be accepted as a useful methodological principle, above all in the study of modern societies. The impression made by Marxist ideas is equally clear in the earlier writings of Pareto, who singled out, as Marx's chief contribution to sociology, the theory of class conflict (1902-1903). This provided the basis for Pareto's own later elaboration of the idea of the struggle between elites for political power, which became the vital element in an interpretation of history directly opposed to that of Marx. Pareto replaced the idea of the progressive development of class systems by a cyclical theory of the rise and fall of elites, and concentrated attention upon the conditions of social equilibrium rather than the causes of social change. Marxist philosophy. Both Weber and Pareto aspired, though in different ways and with varying success, to establish sociology as an objective social science. Korsch and Lukacs, on the other hand, questioned the possibility, and also the value, of

MARXIST SOCIOLOGY such an objective science, and they expounded Marxism as a philosophy of society which approaches every problem from the point of view of the working class. Korsch, in Marxismus und Philosophie (1923), began by criticizing those thinkers who had regarded Marxism either as a set of methodological rules or as a system of universal causal laws, that is, as a general sociology in the positivist sense. According to him, Marxism includes both empirical and philosophical elements, but the latter are those which distinguish it clearly from other social theories. It is empirical in the sense that it deals with real social movements in modern society and is not in flagrant contradiction with actual events; it is philosophical in the sense that it interprets the facts by means of a conception of history as a process which will terminate in a "classless society." Because of this vision of the future which it contains, it is above all a theory of social revolution which expresses the outlook, and reflects the practical social activity, of a revolutionary class. In similar fashion Lukacs argued, in several of the essays collected in Geschichte und Klassenbewusstsein (1919-1922), that Marxism is not to be regarded as an objective interpretation of man's social history—still less as a scientific theory of social evolution—but as an interpretation, from the standpoint of the revolutionary working class, of the historical origins and development of capitalist society. Both writers insisted upon the opposition between Marxism and sociology. For them, Marxism is essentially a theory of history concerned with unique sequences of events and taking account both of objective conditions and of subjective human strivings. Sociology, on the other hand, by its ambition to establish general social laws, in the first place turns man into an object and discounts the subjective aspects of human action and, second, substitutes for the view of society as a historical process the conception of an unvarying system of social relationships which is to be discovered in every form of society. This idea of Marxism did not find favor with the orthodox Marxist-Leninists, whose opinions were authoritatively expressed at that time through the Third Communist International. However, there were few scholars among the orthodox who attempted to set out an alternative version or to meet the sociological criticisms of Marxism on their own ground. The most important of them was undoubtedly Nikolai Bukharin, whose exposition of historical materialism (1921) is noteworthy for the serious attention which it gives to the difficulties arising from the claim that Marxism is at the same

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time an objective social science and the doctrine of a particular social class, and for its discussions of some of the more important criticisms of Marx. During the early 1900s, the intellectual and political influence of Marxism and the discussions of Marx's sociological theories were largely confined to the continental European countries. In Britain, Marxism made little impact upon sociology, either then or later. The influence of Marxism was greater in the early development of American sociology, but it was soon overshadowed. Thorstein Veblen is the most notable of those who turned to Marx as a source of powerful and radical ideas, which he then developed in his own fashion in theories of the influence of technology upon social structure (1899) and of the rise to power of the engineers (1921). Albion W. Small, who assigned to Marx a place as the Galileo of the social sciences, also played a large part in introducing Marxist ideas and was himself strongly influenced by Marx in working out his theories of social conflict. Marxist influence since the 1930s In the period from the early 1930s to the present day, the lines of thought distinguished above have continued and have been enriched by new studies. A number of Marxist writers have upheld the opposition between Marxism and sociology, and they have found new evidence for their views in Marx's early manuscripts, which began to be published in 1932. Thus, Korsch expounded his ideas more fully, but in the same form, in a study of Marx (1938) that was contributed to a series on the great sociologists. A few years later Herbert Marcuse (1941), in a study of the relations between Marx and Hegel, represented Marx's thought as the culminating achievement of the Hegelian dialectical method, as a "critical philosophy" of society which Marcuse contrasted with the positive philosophy and sociology of Comte. The same general view of the nature of Marx's thought, inspired in this case by Lukacs, is to be found in the work of Lucien Goldmann on the methods of the social sciences (1959) and on the social context and the literary expression of Jansenism in France (1955); and it has recently been expounded at length by Jean-Paul Sartre (1960), who argued that sociology, as an empirical discipline, either stands opposed to, or must be comprehended within, Marxism, which alone makes possible an understanding of the historically changing totality of social life. Mainstream of sociology. In the mainstream of sociological thought, many writers continued to turn to Marx's work as a source of specific ideas and problems which they could develop along new

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lines. One of the most important ideas which was thus reassessed was that of ideology. It had already attracted the attention of Marxist writers at the end of the nineteenth century, and Franz Mehring's Die Lessing-Legende (1893) is the first major attempt to make use of Marx's theories in the interpretation of literary styles. But it was not until a quarter of a century later that Marxist literary criticism revealed its full scope in the work of Lukacs, beginning with the publication of Die Theorie des Romans (1920) and continuing with his studies of nineteenth-century European realism (1935-1939) and of the historical novel (1947). Another Marxist writer who was greatly preoccupied with problems of ideology in a broader sense is Antonio Gramsci, much of whose work was done during his imprisonment by the Italian fascist government and has become generally known and influential only since the 1950s. Gramsci was especially concerned with the nature of the cultural dominance exercised by a ruling class, to which he attributed much greater importance than other Marxists had done, and, on the other hand, with the means by which the working class in a capitalist society might resist bourgeois cultural influences while developing its own forms of expression in literature, art, and thought. The notion of "social hegemony" which he introduced was meant to emphasize the interdependence of economic, political, and cultural elements in class conflicts; and his studies of the role of intellectuals, of the educational system, and of other aspects of culture (Gramsci 1949), inspired by this idea, were highly original contributions to the discussion of the old Marxist problem of the relations between "base" and "superstructure" in social life. The notion of ideology also provided the central theme in the work of Karl Mannheim, who envisioned his task as the elaboration of a general sociology of knowledge from Marx's one-sided criticism of bourgeois ideologies, as a means of understanding the ideological and political conflicts of the twentieth century. Mannheim's writings were symptomatic of a deep concern with the problems of ideology which has lasted until the present time and has produced a number of notable works, from the brilliant critical study by Ernst Griinwald (1934) to the historical survey, dealing at length with Marx and Nietzsche, by Hans Earth (1945). Theories of class structure. Mannheim was exceptional in attributing such overwhelming importance to the problems of ideology, and it is through other concepts—particularly those of class and conflict—that Marx has had his chief influ-

ence upon modern sociology. All the major theories of class structure, from those of Max Weber, Joseph Schumpeter, and Theodor Geiger up to those of the present day, have begun from Marx's formulation of the question and have been more or less strongly influenced in their conclusions by Marx's own results. Among recent writers, few have been prepared to abandon entirely Marx's model of the class system; but most of them have introduced modifications and have questioned Marx's explanations and predictions. Raymond Aron (1950; 1964), C. Wright Mills, and Ralf Dahrendorf (1959) reject, as inconsistent with the evidence, the constant association between economic ownership and political power which is a basic postulate of Marx's theory, and they draw attention in particular to the alternative bases of political power in societies where private ownership of industrial wealth is nonexistent. Marshall (1934-1962), Lockwood (1958), Lockwood and Goldthorpe (1963), and Mills (1951) examine the changing composition of the main social classes during the past century, especially the changes in the position of the middle classes, and show how these changes affect the relations between classes in a manner of which Marx's theory takes no account. Class conflict. Most recent sociologists have criticized Marx's theory of class conflict, especially that part of it which asserts the inevitability of working-class revolutions in capitalist societies and the eventual cessation of conflict in a society without classes. The critics, such as Dahrendorf (1959) and Aron (1964), argue that the growing differentiation of functions and the increasing separation between the economic, political, and other spheres in the advanced industrial societies have removed the basis for the coalescence of industrial, political, and ideological conflicts in massive class struggles, and that revolutionary movements have in fact disappeared from these societies. At the same time, they assert that some forms of conflict are unavoidable in any large and complex society and that a society without intergroup conflict, such as Marx envisaged, is sociologically impossible. The work of these writers shows, however, the extent to which the Marxist theory of conflict has influenced recent sociology; it has restored to the center of attention the problems of conflicting interests and values and of the strains produced by social change, which had been neglected in those theories, previously in the ascendant, that were chiefly concerned with consensus, integration, and social order. Communist countries. It might have been anticipated that with the spread of Marxism as a po-

MARXIST SOCIOLOGY litical creed in eastern Europe and Asia after 1945, there would be some revival of Marxist sociology in the countries concerned. However, so far this has not taken place. The later years of Stalin's rule were not propitious for any kind of sociology, and Soviet Marxism became increasingly occupied with adapting conventional formulas to political circumstances rather than with developing philosophical or sociological arguments; it was even less concerned with encouraging empirical investigations into Soviet society. Since Stalin's death there has been a resurgence of sociological research in communist countries, but it is not in any obvious respect inspired by Marxist ideas. Much of the research is concerned with problems which are to be found in all industrialized, or rapidly industrializing, societies—technological change, productivity, urban growth, delinquency, education, and leisure—and it is carried out by the same methods that are used elsewhere. Only in a few instances, where there is some significant difference in the institutional setting of the problems, as in studies of the workers' councils in Yugoslavia, does the Marxist theoretical system appear to have any importance in shaping the investigations. In the sphere of theoretical sociology, the contributions from communist countries have been few, and they have often revealed the difficulty of maintaining the Marxist system intact. A good example may be found in one of the most distinguished of these contributions: the last work published by the Polish sociologist Stanislaw Ossowski (1957), in which a profound reappraisal of Marx's theory of class leads to conclusions which do not differ widely from those reached by sociologists elsewhere. Ossowski recognizes that substantial changes have occurred in the class structure of capitalist countries, and he observes, in particular, that in all the modern industrial societies the political authorities increasingly determine the system of social stratification, rather than being determined by it, as a rigorous Marxist view would maintain. He also considers and criticizes the arguments which have been put forward, on opposite sides, for regarding both the United States and the Soviet Union as "classless societies." Perhaps his most important Contribution, however, is to distinguish the various conceptions of class which were incorporated into Marx's theory, to establish the tentative character of Marx's synthesis, and to show its potentialities for further development so long as it is not accepted as dogma. Ossowski's book may be seen, to some extent, as the harbinger of a more creative Period of Marxist thought in communist countries.

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Defining Marxist sociology The record of the encounter between Marxism and sociology since the 1880s shows plainly that while they are distinct, and even opposed, they have never ceased to have a powerful influence upon each other. Marxism is more than a system of sociology; it is a philosophy of man and society, as well as a political doctrine. Sociology, as it has mainly developed in the present century, is an attempt to describe impartially, to measure exactly, and to connect by means of scientific generalizations the diverse phenomena of social life. Even if it be held that a "philosophical anthropology" underlies every major system of theoretical sociology, as Karl Lowith does in his illuminating comparison of Weber and Marx (1932), Marxism still retains a distinctive character; no other body of social thought has become, in this way, the unique doctrine of a political movement and finally the orthodoxy of a ruling party. No other theory, therefore, has been so liable to end in dogmatic assertion and estrangement from social science. Betwixt Marxism and sociology, the place of Marxist sociology is variable and uncertain. In one sense, Marxist sociology could be regarded as the sociology of those thinkers (for example, Nikolai Bukharin and Max Adler) who, on other grounds, are Marxist in their general philosophical or political outlook. It would then be of the same kind as any other school of sociology—let us say Thomist or Hindu sociology—which is based directly upon a philosophical world view. But it would still be affected by, and would have to respond to, the findings of empirical social research; and at some stage Marxists would be led to consider, as has happened in recent years, whether in fact there can be a separate Marxist sociology any more than there can be a separate Marxist physics. In a broader sense, however, Marxist sociology might be regarded as including the work of all those thinkers who attach prime importance, in the investigation and explanation of social events, to the role of economic interests, relations between classes, and intergroup conflicts, without necessarily agreeing with the particular conclusions that Marx himself reached. But this category may seem too broad, since it would include those, from Weber and Pareto up to the recent sociologists discussed above, who have acknowledged Marx's outstanding importance as a thinker and have turned to his work for concepts and hypotheses, but who have revised or rejected so much of his system that it would be eccentric to refer to them as Marxists.

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Lastly, Marxist sociology may be treated as a methodology, as a persistent critique of the aims and methods of the social sciences. In this form it has undoubtedly been prominent and important, as the writings of Lukacs, Marcuse, and Sartre bear witness; but here it becomes not so much Marxist sociology as Marxist "anti-sociology." T. B. BOTTOMORE [See also ALIENATION; KNOWLEDGE, SOCIOLOGY OF; LEISURE; MARXISM; STRATIFICATION, SOCIAL, articles on SOCIAL CLASS and THE STRUCTURE OF STRATIFICATION SYSTEMS; and the biographies of CROCE; LENIN; LUKACS; LUXEMBURG; MANNHEIM; MARX; MILLS; OSSOWSKI; PARETO; SOMBART; TONNIES; TROTSKY; WEBER, MAX.] BIBLIOGRAPHY ADLER, MAX 1925 Kant und der Marxismus. Berlin: Laub. ARON, RAYMOND 1950 Social Structure and the Ruling Class. British Journal of Sociology 1:1-16, 126-143. ARON, RAYMOND 1960 Classe sociale, classe politique, classe dirigeante. European Journal of Sociology 1: 260-281. ARON, RAYMOND 1964 La lutte de classes. Paris: Gallimard. EARTH, HANS 1945 Wahrheit und Ideologic. Zurich: Manesse. BUKHARIN, NIKOLAI I. (1921) 1926 Historical Materialism: A System of Sociology. London: Allen & Uriwin. -> First published as Teoriia istoricheskogo materializma. CROCE, BENEDETTO (1900) 1922 Historical Materialism and the Economics of Karl Marx. London: Allen & Unwin; New York: Macmillan. --> First published as Materialismo storico ed economia marxistica. DAHRENDORF, RALF 1959 Class and Class Conflict in an Industrial Society. Stanford Univ. Press. -> A greatly revised and expanded edition of a book first published in German in 1957. FROMM, ERICH (editor) 1961 Marx's Concept of Man. New York: Ungar. GOLDMANN, LUCIEN 1952 Sciences humaines et philosophic. Paris: Presses Universitaires de France. GOLDMANN, LUCIEN 1955 Le dieu cache. Paris: Gallimard. GOLDMANN, LUCIEN 1959 Recherches dialectiques. Paris: Gallimard. GRAMSCI, ANTONIO (1919-1937) 1959 The Modern Prince, and Other Writings. New York: International Publishers. GRAMSCI, ANTONIO 1949 Gli intellettuali e I'organizzazione della cultura. Turin: Einaudi. GRUNWALD, ERNST 1934 Das Problem der Soziologie des Wissens. Vienna and Leipzig: Braumiiller. KORSCH, KARL (1923) 1930 Marxismus und Philosophic. 2d ed. Leipzig: Hirschfeld. KORSCH, KARL 1938 Karl Marx. London: Chapman. LABRIOLA, ANTONIO (1895-1896) 1908 Essays on the Materialistic Conception of History. Chicago: Kerr. H> First published in Italian. LICHTHEIM, GEORGE 1961 Marxism: An Historical and Critical Study. New York: Praeger.

LOCKWOOD, DAVID 1958 The Blackcoated Worker. London: Allen & Unwin. LOCKWOOD, DAVID; and GOLDTHORPE, J. H. 1963 Affluence and the British Class Structure. Sociological Review 11:133-163. LOWITH, KARL (1932)1960 Max Weber und Karl Marx. Pages 1-67 in Karl Lowith, Gesammelte Abhandlungen zur Kritik der geschichtlichen Existenz. Stuttgart: Kohlhammer. LUKACS, GYORGY (1919-1922) 1923 Geschichte und Klassenbewusstsein: Studien iiber marxistische Dialektik. Berlin: Malik. LUKACS, GYORGY (1920)1963 Die Theorie des Romans: Ein geschichtsphilosophischer Versuch iiber die Formen der grossen Epik. 2d ed., enl. Neuwied am Rhein (Germany): Luchterhand. LUKACS, GYORGY (1935-1939) 1964 Studies in European Realism. New York: Grosset & Dunlap. -> Contains essays first published in Hungarian and German. First published in English in 1950. LUKACS, GYORGY (1947) 1965 The Historical Novel. New York: Humanities. -> First published in book form in Hungarian as A tortenelmi regeny. Parts 1 and 2 first appeared in 1937 in volumes 7, 9, and 12 of Liter-aturnyi kritik. MARCUSE, HERBERT (1941) 1955 Reason and Revolution: Hegel and the Rise of Social Theory. 2d ed. London: Routledge. -> A paperback edition was published in 1960 by Beacon. MARCUSE, HERBERT 1958 Soviet Marxism: A Critical Analysis. New York: Columbia Univ. Press. -» A paperback edition was published in 1961 by Vintage. MARSHALL, T. H. (1934-1962) 1964 CZass, Citizenship, and Social Development: Essays. Garden City, N.Y.: Doubleday. -> A collection of articles and lectures first published in England in 1963 under the title Sociology at the Crossroads and Other Essays. A paperback edition was published in 1965. MARX, KARL (1844) 1963 Early Writings. Translated and edited by T. B. Bottomore. London: Watts. MARX, KARL (1844-1875) 1964 Selected Writings in Sociology and Social Philosophy. 2d ed. Edited by T. B. Bottomore and M. Rubel with a foreword by Erich Fromm. New York: McGraw-Hill. MARX, KARL (1845) 1956 The Holy Family. Moscow: Foreign Languages Publishing House. -> First published as Die heilige Familie. MARX, KARL (1857-1858) 1953 Grundrisse der Kritik der politischen Okonomie. Berlin: Dietz. -> Written in 1857-1858. First published posthumously by the Marx-Engels-Lenin Institute, Moscow, in 1939-1941. A partial English translation was published as Precapitalist Economic Formations in 1965 by International Publishers. MARX, KARL (1859)1913 A Contribution to the Critique of Political Economy. Chicago: Kerr. -*• First published as Zur Kritik der politischen Okonomie. MARX, KARL; and ENGELS, FRIEDRICH (1845-1846) 1939 The German Ideology. Parts 1 and 3. With an introduction by R. Pascal. New York: International Publishers. -» Written in 1845-1846; first published in German in 1932. MEHRING, FRANZ (1893) 1953 Die Lessing-Legende: Zur Geschichte und Kritik des preussischen Despotismus und der klassischen Literatur. Berlin: Dietz. MILLS, C. WRIGHT 1951 White Collar: The American Middle Classes. New York: Oxford Univ. Press. -> A paperback edition was published in 1956.

MASARYK, THOMAS G. OSSOWSKI, STANISLAW (1957) 1963 Class Structure in the Social Consciousness. London: Routledge; New York: Free Press. -» First published as Struktura klasowa w spolecznej swiadomosci. PARETO, VILFREDO (1902-1903) 1965 Les systemes socialistes. 3d ed. Paris: Droz. -* Constitutes Volume 5 of Pareto's Oeuvres completes. RENNER, KARL (1904) 1949 The Institutions of Private Law and Their Social Functions. London: Routledge. -> First published in German in Marx-Studien under the pseudonym J. Karner. SARTRE, JEAN-PAUL 1960 Critique de la raison dialectique, precedee de question de methode. Paris: Gallimard. -» An English translation of the prefatory essay, "Question de methode," was published in 1963 by Knopf as Search for a Method. TONNIES, FERDINAND (1887) 1957 Community and Society (Gemeinschaft und Gesellschaft). Translated and edited by Charles P. Loomis. East Lansing: Michigan State Univ. Press. -> First published in German. A paperback edition was published in 1963 by Harper. TONNIES, FERDINAND 1921 Marx: Leben und Lehre. Jena (Germany): Lichtenstein. VEBLEN, THORSTEIN (1899) 1953 The Theory of the Leisure Class: An Economic Study of Institutions. Rev. ed. New York: New American Library. -» A paperback edition was published in 1959. VEBLEN, THORSTEIN 1921 The Engineers and the Price System. New York: Huebsch. WEBER, MAX (1904-1905) 1930 The Protestant Ethic and the Spirit of Capitalism. Translated by Talcott Parsons, with a foreword by R. H. Tawney. London: Allen & Unwin; New York: Scribner. -» See especially pages 35-92. First published in German. The 1930 edition has been reprinted frequently. WEBER, MAX (1904-1917) 1949 The Methodolgy of the Social Sciences. Glencoe, 111.: Free Press. ->• First published in German. See especially pages 50-113, "Objectivity in Social Science and Social Policy." WEBER, MAX (1907) 1922 R. Stammlers "Uberwindung" der materialistischen Geschichtsauffassung. Pages 291-359 in Max Weber, Gesammelte Aufsdtze zur Wissenschaftslehre. Tubingen (Germany): Mohr. WIATR, JERZY J. 1964 Political Sociology in Eastern Europe: A Trend Report and Bibliography. Current Sociology 13, no. 2.

MASARYK, THOMAS G. Thomas G. Masaryk (1850-1937), Czechoslovakian statesman and social theorist, was born in Hodonin on the Moravian-Slovakian border. His father, a Slovak, was a coachman on one of the imperial estates; his mother came from a small Moravian town. He studied first at the Gymnasium in Brno, but after a conflict with the Roman Catholic church he left there and attended the Gymnasium in Vienna. Later, at the University of Vienna he wrote his dissertation, "Das Wesen der Seele bei Hato" (1876), under the philosopher Franz Brentano. In 1877 he studied with Gustav Theodor Fechner at the University of Leipzig, but Masaryk

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was influenced less by Fechner than by Charlotte Garrigue, a music student whom he met at Leipzig and later married. She came from a well-to-do American Unitarian family, whose religious faith had been shaped by Theodore Parker, and her religious views helped Masaryk define his own. Through her he also gained an understanding of English philosophy and American society: Locke, Hume, Mill, and Spencer influenced his thought, and American institutions guided his social and political aspirations. Masaryk acknowledged the extent of his debt to his wife by taking Garrigue as his middle name. In 1879 Masaryk became Privatdozent of philosophy at the University of Vienna. His interests centered on sociology and on Czech political life. His first important book was Der Selbstmord als sociale Massenerscheinung der modernen Civilisation (1881). In this work he attempted to deal with suicide as a social phenomenon and to support his conclusions statistically. According to Masaryk, Europe was then in a period of high suicide rates. This could be directly attributed to a decline of monotheistic religion and thus was the "fruit of progress, of education, of civilization" (p. 146). When the Czech university was established at Prague in 1882, Masaryk was called there as extraordinary professor of philosophy. He held his post for 32 years. During those years he helped to form the political and moral ideas of a significant part of the Czech and South Slav intelligentsia, although before 1914 he was not popular among the Czechs. His opposition to the Catholic church, on the one hand, and to Marxism, on the other, his pronounced Westernism, and his "realistic" moderation in political and national demands prevented him from exercising a wider influence. While a professor in Prague, Masaryk published his Versuch einer konkreten Logik: Klariftkation und Organisation der Wissenschaften (1885), his last scholarly work. From then on, most of his work was more directly concerned with moral and political education. He founded and edited several journals, among them Athenaeum and Nase doba ("Our Epoch"), and a political weekly, Cas ("Time"). He was active politically as a member of the Austrian Reichsrat, representing first the Young Czech party, from 1891 to 1893, and later, from 1907 to 1914, the tiny Progressive party (more generally known as the Realist party), which he had founded. Masaryk's political activities reflected the themes of his writings published during these years, in which he discussed Czech nationalism and deplored the deficiencies of the Marxist approach to basic social problems (1895; 1896; 1898). He knew

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Russia from both studies and travels and wrote two volumes interpreting Russian culture, history, and religion (1913). He planned but never completed a third volume, on Dostoevski, whom he regarded as the key author for an understanding of Russia and whose philosophy and outlook he totally rejected. Masaryk's own nationalism revived and extended the ideas underlying the work of the first modern Czech historian, Frantisek Palacky. Masaryk saw the Czech national awakening in the nineteenth century as a continuation of the Hussite reformation of the fifteenth. And the movement of the Bohemian Brethren, in his view, encompassed the highest aspirations of the Czech nation and of the whole of mankind. This vague, moral nationalism was sharply criticized by professional Czech historians like Jaroslav Goll and Josef Pekaf. In 1914 Masaryk left Prague, and during World War i he became the leading propagandist urging the establishment of independent small nations (1918) and the identification of Czech national traditions with those of Western democracy. He made London the center of his activities and in 1917-1918 visited Russia and the United States. It was his plan to create a Czechoslovakia in which Czechs and Slovaks would be united on the strength of ethnic principles and Germans and Magyars would be included on the basis of historical principles; his views prevailed at the Versailles peace conference. He was elected the first president of Czechoslovakia in 1918 and was continuously reelected until he resigned in 1935 for reasons of ill health. Until 1948 he was revered as the "father of his country," but because of his strong antiBolshevik stand the post-1948 communist regime has been sharply critical of him. HANS KOHN WORKS BY MASARYK

1876

Das Wesen der Seele bei Plato. Ph.D. dissertation, Univ. of Vienna. 1881 Der Selbstmord als sociale Massenerscheinung der modernen Civilisation. Vienna: Konegen. (1885) 1887 Versuch einer konkreten Logik: Klarifikation und Organisation der Wissenschaften. Vienna: Konegen. -» First published as Zdkladove konkretni logiky. (1895) 1935 Ceskd otdzka: Snahy a tuzby ndrodniho obrozeni (The Czech Question: Efforts and Aspirations Towards the National Rebirth). 4th ed. Prague: Cin. (1896) 1920 Karel Havlicek: Snahy a tuzby politickeho probuzeni (Karel Havlicek: Efforts and Aspirations Towards the Political Awakening). 3d ed. Prague: Laichter. (1898) 1935 Otdzka socidlni: Zdklady marxismu sociologicke a filosoficke (The Social Question: The Sociological and Philosophical Foundations of Marxism). 3d ed. Prague: Cin.

(1913) 1955 The Spirit of Russia: Studies in History, Literature and Philosophy. Rev. & enl. ed., 2 vols. New York: Macmillan. -> First published in German. 1918 The New Europe: The Slav Standpoint. London: Eyre & Spottiswoode. (1925) 1927 The Making of a State: Memories and Observations, 1914-1918. New York: Stokes; London: Allen & Unwin. -> First published as Svetovd revoluce za vdlky a ve vdlce, 1914—1918. (1931-1933) 1944 Masaryk on Thought and Life: Conversations With Karel Capek. New York: Macmillan. First published as Hovory s T. G. Masarykem. SUPPLEMENTARY BIBLIOGRAPHY

Festschrift Th. G. Masaryk zum 80. Geburtstage. 2 vols. 1930. Bonn: Cohen. LUDWIG, EMIL (1935) 1936 Defender of Democracy: Masaryk of Czechoslovakia. New York: Robert McBride. First published as Gesprdche rn.it Masaryk: Denker und Staatsmann. NEJEDLY, ZDENEK (1930-1935) 1949-1950 T. G. Masaryk. 2d ed., 2 vols. Prague: Orbis. SETON-WATSON, ROBERT W. 1943 Masaryk in England. New York: Macmillan.

MASS BEHAVIOR See COLLECTIVE BEHAVIOR and NOMENA.

MASS PHE-

MASS COMMUNICATION See COMMUNICATION, MASS. MASS CULTURE See COMMUNICATION, MASS; MASS SOCIETY. MASS MEDIA See COMMUNICATION, MASS. MASS PHENOMENA The term "mass phenomena" as it is used in this article is intended to cover the same range of behavior as that denoted by two frequently used similar expressions: "collective behavior" and "mass behavior." Under this general rubric a number of more specific terms have commonly been employed to refer to the five major subtypes of mass phenomena: (1) apathy, (2) panic, (3) mob, (4) craze, and (5) social movement. These major subtypes are in turn divisible into still finer subclassifications, denoted by a miscellany of terms which have come to be used conventionally to describe local varieties of unique forms. Thus some mob situations are commonly labeled "riots," as in "race riots," and certain others are referred to as "lynchings"; some social movements are called "revitalization movements," and these are still further classified by local terms, such as "cargo cults" (Oceania), "nativistic move-

MASS PHENOMENA ments" (American Indians), etc. The nomenclature for mass phenomena is so vast and so intricately related to varying criteria that there is no reason to review or attempt to rationalize it in detail here. It should be noted that there are also other terms, like "mass hysteria," which crosscut this natural historian's nomenclature. These terms draw attention to certain psychological or social attributes which several types of mass phenomena have in common and which they sometimes share with behavior that is not included under the category of mass phenomena. Definition. Although there seems to be an intuitive recognition by most observers that all of these forms of human behavior have something in common which justifies treating them as a unit, the efforts to define this commonality are not always in agreement. Smelser has provided a definition in his book, Theory of Collective Behavior: "we define collective behavior as mobilization on the basis of a belief which redefines social action" ([1962] 1963, p. 8). Brown (1954) in his discussion of the varieties of mass phenomena suggests a set of dimensions for their classification (size, frequency and regularity of congregation, frequency and regularity of polarization of attention, and continuity of identification of individuals with the group), but he provides no definition. Any definition must not only state common features of the various referents of the term but must also state common features which nonmembers of the class do not possess. Certainly the term "mass phenomenon" cannot be taken to refer to all attributes of a large group of people (however "large" may be defined); otherwise, we should have to include culture, acculturation, culture change, population growth, voting behavior, rumor circulation, and many other social and cultural attributes and processes under the rubric of mass phenomena. Neither can we comfortably include all situations in which a large group of people is collected in one place, or in which many people are simultaneously the target of communication: not all audience or crowd behavior will fall within the intuitive boundaries of the concept. Nor can we be satisfied with a definition that emphasizes a single psychological or social process—such as fear or mobilization—without regard to the size (or "mass") of the group involved. If we keep these considerations in mind, it would appear that Smelser's definition is nearly adequate to our needs. But its emphasis on mobilization makes it difficult to include the disaster syndrome (including shock, apathy, disorientation, and the very opposite of mobilization of a

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group for action). Thus I suggest the following, somewhat less analytical, definition: "Mass phenomenon" signifies that class of social event in which a large number of people at the same time behave in a way which constitutes a notable interruption of their routine, socially sanctioned role behavior. The varieties of mass phenomena. Let us now consider how the characteristics recognized by the above definition are manifested in the subclasses of mass phenomena to which I have referred. Apathy and the disaster syndrome. The disaster syndrome occurs after a major catastrophe, usually physical, has destroyed important features of a group's natural and/or cultural environment, frequently with severe casualties. In this case the interruption of routine behavior implies the virtual cessation of any kind of adaptive behavior. Initially, the surviving population appears to be in a state of shock: people are passive, emotionally numb, relatively insensitive to physical pain, apathetic, disoriented, unable to understand the magnitude of the disaster, and unresponsive beyond minimal survival action; little mutual aid is undertaken, and remedial action is often trivial. After minutes or hours—and perhaps longer—as aid enters from outside the disaster area, the survivors become less apathetic and enter into a suggestible stage in which, under leadership, they can begin to engage in rescue, repair, and other useful activities. Eventually the syndrome moves into a euphoric stage of mutual aid in reconstruction, and at last it tapers off into the culturally standardized routine. [See also DISASTERS. For discussion of the disaster syndrome see Wallace 1956a.] Panic. Panic occurs when a group is subjected to an overwhelming and imminent threat to which escape appears to be the only effective response, and when escape routes are perceived to be inadequate to accommodate all of the group before the impact of the threatened event. In such a situation, the group structure disintegrates into an "every-man-f or-himself" state of anarchy: individual escape tactics are apt to be chosen impulsively, with little foresight and with restricted attention to the real environment; jamming is likely to occur at the exits from the situation, with attendant injury, loss of life, and increased slowing of the escape flow. The interruption here is twofold: first, the abandonment of group structure by individuals (even though the group itself may have had a plan for handling the problem by reducing the threat or by orderly escape); and second, the severe constriction of perceptual and cognitive functions of individuals under the stress of fear.

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Mob. The mob is an angry group which attacks and attempts to injure or destroy an object (usually a person or persons or some item of material culture identified with some human being or group). It differs from a military or police force insofar as the members of the mob are not performing socially sanctioned roles and insofar as the attack is not undertaken as an implementation of a rational policy concerted by the mob's members (although, to be sure, there may be a leader who, unknown to the rank and file, is exciting and directing the mob, carrying out a policy of his own or of some other group). The interruption of routine behavior here is the abandonment of the socially sanctioned roles of peaceable, law-abiding private citizens and the assumption of primitive judgmental and punitive roles which are carried out with minimal concern for justice (as locally defined) or for long-term consequences. Craze. The craze is a short-lived rush, by many persons, to worship, to touch, or to acquire some object (human or material) or characteristic of value. In its milder forms it may be referred to as a "fad"—a clothing style, a type of haircut, a dance; in more extreme expression it may be termed a "craze" (proper)—such as the adulation of a popular singer by thousands of screaming fans, a kind of financial investment, or a rush to settle new lands or to exploit unclaimed mineral resources. The interruption here is the abandonment of previous objects of interest and the substitution for them, by many people at the same time, of a standardized object. [See FASHION.] Social movement. The social movement (or revitalization movement), whether religious or political and whether revolutionary or reformative, is by definition an organized effort to induce the members of a community to abandon certain customs or practices and to adopt different ones. The participants in the movement, starting with the prophet or leader, then his disciples, and eventually at least some followers, do in fact change their ways and the distribution of their energies. In every social movement, therefore, there is an interruption of a routine and the substitution of a new pattern of behavior, rationalized by reference to an ideology. The aim of the movement, of course, may be to accomplish a much more extensive interruption and to institute a much more pervasive new system than ever is accomplished. [See SOCIAL MOVEMENTS.] Phenomena not considered. It may be pointed out that in the above discussion we have left out certain phenomena which are included in some treatments. Thus, for instance, we have not treated

crowds per se as examples of mass phenomena, because many crowds are engaged in perfectly routine, standardized activities. Thus, for instance, we do not treat as a mass phenomenon the audience at sports events, at theaters, and at religious ceremonials because it is an organized group interacting with another group (the performers) in a patterned, culturally institutionalized way, even in cases (as at political rallies, voodoo rituals, or Holy Roller types of religious revival) where the behavior is excited or hysterical in a technical sense. Similarly, crowds on arteries of transportation, in markets, or in military units, however poorly or well organized, are not treated as mass phenomena, because the behavior involved is perfectly explicable and predictable from a knowledge of the culture. Nor do we consider the gross characteristics and social activities of vast aggregates —like "the masses," "the consumer," "the proletariat," "the Negro," or "the Southern white"— as mass phenomena in themselves. The reader may, however, note that while the behaviors which have been treated as mass phenomena do have in common the feature of interruption of routine, they range from the nonpurposeful, inactive, maladaptive extreme of the disaster syndrome, through grades of increasingly purposeful, active, adaptive behavior, to the social movement, which is eminently purposeful, active, and adaptive. In the next section we shall take up the question of explanation, not only for the mass phenomenon in general, but for the occurrence of its varieties. Explanations of mass phenomena. Explanations —and predictions—of mass phenomena usually invoke a mixture of psychological and sociological principles. Sometimes efforts are made to provide purely sociological explanations; these efforts, however, are generally justified by pointing out the deficiencies of early psychological theories that postulated "herd instincts," "the group mind," and the atavistic vulnerabilities of civilized men. Although such appeals to supposed universal psychological tendencies are fruitless as guides for research, the "pure" sociological approach merely reintroduces psychology through the back door via definitions of "social" concepts in terms of sentiments, goals, values, needs, and so forth. It seems wisest to make use explicitly of both psychological and sociological variables, evaluating the utility of each by more or less operational criteria. On the most generic level, the following conditions seem to be required for the occurrence of any mass phenomenon: (1) a certain type of information must be presented to the members of

MASS PHENOMENA the target group, approximately simultaneously; (2) the type of information which is presented must describe a difference between the individual's present situation and that which either has obtained in the past or very probably will obtain in the future; (3) the difference must be sufficient to constitute a dramatic gain, or loss, of important values (such as life, health, or self-respect); (4) the present or future loss must be perceived as avoidable, or the future gain as achievable, if something is done. The resultant action is, in fact, the behavior described as the mass phenomenon. Further conditions need to be specified before it is possible to predict what that action will be. Important classes of such conditions are, first, the precise nature of the threat, disaster, or future gain; and, second, the existing cultural system of the target group—its goals, its fears, its ontological beliefs, its social organization, and its modal personality structure. Apathy and the disaster syndrome. In a major disaster or in a situation of threat from which no escape route can at the moment be perceived, the mass action is, in effect, no action, or apathy: the only relief from the awareness of an unchangeable contrast between good past and bad present, or good present and bad future, is denial or withdrawal from awareness of reality as thus defined. The disaster syndrome, the cultural situation of universal demoralized individual behavior resulting from anomie, and the fictional social condition of an impending world's end described in Nevil Shute's popular novel On the Beach are examples of the apathetic response. It is worth noting that panic does not occur under these conditions. Panic. Where the catastrophe has not yet occurred and there is still a possibility—but a narrow and diminishing one—of escape, panic occurs instead of apathy. The action involved is frequently precipitate physical flight, but other activities may represent the appropriate mode of escape: the selling of property, as in a financial crash or in a neighborhood threatened with invasion by an unwanted social group; or the hoarding of food in anticipation of shortages. Mob. Where a catastrophe may occur but is not imminent, and where its likelihood is believed to be increased by the actions or inaction of some other person or group who is not believed to be responsive to the fears of the threatened group, a likely response is mob action. Mob action is also likely where an important goal is believed to be achievable but blocked by the action or inaction °f some nonresponsive social group. The critical factor here seems to be the group's belief that the

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disparity between present and future (whichever way the balance lies—good present and bad future or bad present and good future) can be resolved only if some weak and evil persons are injured or destroyed. In the mob situation, furthermore, it is possible for the group to find relief for their feelings of guilt in scapegoating, that is, attributing to others those faults, often irrelevant to the precipitating issue, whose recognition in themselves would cause the members of the mob to feel further discomfort. [See PREJUDICE.] Craze. In the craze, the members of the group seem to be driven by both a hope for some desirable thing and a fear of being left behind while others enjoy themselves. In a sense the craze is a "positive" panic: the urgency of the situation lies not in the imminence of danger, escape from which becomes less likely with each passing moment, but in the availability of a benefit, access to which may be reduced in the near future. Social movement. The social (or revitalization) movement is the most positive, most organized, and most deliberate of the mass phenomena. In polar contrast to apathy, the participants in such a movement must maintain an effective social organization over considerable periods of time. The social movement defines the present as a transfer point between an undesirable past and a glorious future. It mounts a carefully calculated campaign, by a mixture of religious and political procedures, to transform society from an evil to a good condi' tion. In the social movement, the character of the existing culture is closely relevant to what happens. Prevailing beliefs about the mechanisms of change are apt to determine the form of—but not to precipitate—the movement. Thus, among Jews the belief in a Messiah, and among Muslims the belief in the Mahdi, have heavily colored the movements that have occurred among these peoples; the Melanesian "myth dream" of their ancestors returning with cargo and the Christian concept of the millennium have shaped many of the movements in their respective parts of the world. [See MlLLENARISM; NATIVISM AND REVIVALISM.]

It should finally be pointed out that mass phenomena of different types can follow one another in sequence in a given group. Thus, an apathetic phase following the awareness of disaster may be succeeded by a revitalization movement; a rioting mob may be swept by panic; an enthusiastic meeting of participants in a craze may turn into a riot if the object of the craze is withheld; and so on. It follows from the definition and from the general statement of conditions that a mass phe-

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nomenon, once established, can readily be transmuted in form as the nature of the information given to the group is varied. ANTHONY F. C. WALLACE [Directly related is the entry COLLECTIVE BEHAVIOR. Other relevant material may be found in GROUPS; INTERACTION; SOCIAL PSYCHOLOGY.] BIBLIOGRAPHY The bibliography on mass phenomena is extensive and diffuse. Smelser 1962 contains the most useful general bibliography on the topics considered in this article, except for the subject of apathy, which is not treated. The National Academy of Sciences-National Research Council has published a series of monographs on disaster behavior, including the apathetic reaction, and maintains a large card catalogue of works on disaster. See also the bibliographies of COLLECTIVE BEHAVIOR and DISASTERS. BLUMER, HERBERT 1957 Collective Behavior. Pages 127158 in Joseph B. Gittler (editor), Review of Sociology: Analysis of a Decade. New York: Wiley. BROWN, ROGER W. 1954 Mass Phenomena. Volume 2, pages 833-876 in Gardner Lindzey (editor), Handbook of Social Psychology. Cambridge, Mass.: AddisonWesley. FESTINGER, LEON; RIECKEN, HENRY W.; and SCHACHTER, STANLEY 1956 When Prophecy Fails. Minneapolis: Univ. of Minnesota Press. QUARANTELLI, ENRICO 1954 The Nature and Conditions of Panic. American Journal of Sociology 60:267-275. SMELSER, NEIL J. (1962) 1963 Theory of Collective Behavior. London: Routledge; New York: Free Press. WALLACE, ANTHONY F. C. 1956a Tornado in Worcester. Washington: National Research Council. WALLACE, ANTHONY F. C. 1956b Revitalization Movements. American Anthropologist New Series 58:264281.

MASS SOCIETY "Mass society" is best understood as a term denoting a model of certain kinds of relationships that may come to dominate a society or part of a society. Terms like "mass production" and "mass communication" refer to activities that are intended to affect very large numbers of people who are seen, for these purposes, as more or less undifferentiated units of an aggregate or "mass." Similarly, a "mass society" is one in which many or most of the major institutions are organized to deal with people in the aggregate and in which similarities between the attitudes and behavior of individuals tend to be viewed as more important than differences. Societies or institutions organized in this way are said to have a "mass character," and the life of individuals in such societies is said to be governed primarily by "mass relations." The structure of mass society Large populations do not by themselves produce mass relations, although mass relations are less

likely among small populations. In the past, large societies were divided into many segments with relatively clear boundaries separating each segment from the other. Even though a society contained thousands of villages, all of them much alike, it was not a mass society because human relations centered on the village and supported the integrity of the village as a social unit. Unlike the village-based society, the mass society does not help to sustain spontaneously evolving and durable social units. "Mass" in its simplest sense means an aggregate of people without distinction of groups or individuals. In mass production, for example, workers are organized according to the logic of specialization and control rather than as members of social groups or as distinct persons, and production is geared to a market of similarly undifferentiated people. Mass production, of course, involves a highly structured mass, by virtue of the division of labor and administrative organization, and it is therefore to be distinguished from the unstructured mass represented, for example, by the aggregate of unemployed workers. Moreover, some industries have more of a mass character than others: the assembly-line system of automobile factories is much more conducive to the emergence of the mass than is the craft-based system of printing (Blauner 1964). Nevertheless, the mass character of the market is a decisive factor in the organization of most manufacturing industries. It is not so much the large size of the population as it is the large scale of activities that favors mass relations. Where the scale of activity is very great, it is more likely that the social relations which individuals bring with them or develop will be easily ignored or transformed by the dictates of technical efficiency or effective control. Thus, mass relations are likely to emerge where large-scale activities predominate, as in nationwide organizations, markets, audiences, and electorates. The decline of community. Large-scale activities favor the emergence of the mass because they tend to develop at the expense of communal relations. The local community comes to provide for fewer of its members' needs and therefore cannot maintain their allegiance. The rural community no longer is isolated and self-sufficient. As it becomes dependent on the city, and particularly on national markets and organizations, the rural community loses its significance and cohesion. The city does not develop the communal life that was formerly provided by the rural community. The individual who migrates to the city does not enter the community as a whole, nor is he likely to enter a subcommunity of the city. The urban subcommunity loses its coherence as a result of the increasing

MASS SOCIETY tie and specialization of common activities. Inad of affiliation with a community, the urban ident frequently experiences considerable social lation and personal anonymity. Ethnic and religious groups also tend to lose :ir coherence as their members are drawn into ge-scale organizations and arenas. Individuals rive less of their social identity, style of life, and ;ial values from their ethnic and religious back)und. As ethnic cultures come in contact with iss culture, they cease to preserve their unique alities. Religious groups tend to de-emphasize 5ir theological and liturgical differences. The parular religious affiliation loses its significance for th religious and secular beliefs and conduct, en if people continue to associate primarily with religionists, this has little influence on the quality their lives or on the manner of their participan in the larger society. Like local, ethnic, and religious communities, iss-based communities tend to lose their imrtance and coherence where the whole population incorporated into large-scale activities. Social isses weaken as sources of distinctive values, fles of life, and social identity; and they increasgly resemble one another in the beliefs, values, id interests of their members. Class distinctions e leveled, and class boundaries are blurred. Class nsciousness and class solidarity dissolve into ass consciousness and mass solidarity. The lower asses are increasingly brought into arenas of comunication, politics, and consumption previously nited to the higher classes. Class differences in >portunities and modes of participation that reain are no longer believed to be desirable or :rmanent. Common symbols of the good life and rights and obligations replace class-differentiated incepts. Classes remain as categories of people ho differentially share in common ways of life .ther than as self-conscious groups with distincve ways of life. Status strivings and anxieties )ound, but this testifies to the ambiguity of status here fixed social hierarchies no longer exist. The ascendance of organization. Mass organiitions replace communal groups as the charactertic units of society. Mass organizations are large id formal, but some large and formal organizaons exhibit more of a mass character than do :hers. The additional features that constitute a lass character include a membership that is strucired primarily by administrative devices rather lan through social relations, and, correlatively, stivity that is mobilized from the center rather lan generated through various groups within the fganization (Selznick 1952). Mass organizations o not build on the primary relations of members,

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nor do they support and facilitate primary relations among members. The result is a relatively unmediated and depersonalized relationship between the membership and the organization. Where the organization seeks a highly active membership, as in certain kinds of mass parties, intense identifications with the organization may be created. Most mass organizations do not seek a mobilized membership, however, and do not possess the symbols or other resources for mobilization. Instead, they are content with passive support from their members, who in turn acquire little social identity from the organization. Solidarity tends to be weak under these conditions, and symbolic or personal gratifications correspondingly slight. Unlike membership in communities, membership in mass organizations tends to be a fragile bond because relations are impersonal and leveled. This weakness is indicated by high rates of mobility of members, as they respond to opportunities for greater benefits and to new interests elsewhere. As mass organizations replace communities, so do "mass arenas" displace local arenas. Mass arenas, including national markets and electorates, are spheres of activity common to all sections of the population. Like mass organizations, mass arenas are managed from the center rather than structured through social relations. They are managed primarily through the mass media of communication, since only in this way can an entire population be presented simultaneously with the same objects of attention. People participate in mass arenas by selecting from among the alternatives presented through the mass media. Since the alternatives are standardized in order to reach the entire population simultaneously and since they are directed to individuals as undifferentiated members of the society, participation transcends the individual's social relations (Blumer 1939). Mass equalitarianism. Pervading all kinds of mass relations is a common normative orientation of equalitarianism. All members of mass society are equally valued as voters, buyers, and spectators. Numerical superiority therefore tends to be the decisive criterion of success. In the political realm this means the number of votes; in the economic realm it is the number of sales; and in the cultural realm it is the size of the audience. Mass equalitarianism is strengthened by the attenuation of the social bases of inequality, notably membership in ethnic and religious groups and especially in social classes. In contrast to the equalitarianism of small numbers, as in friendships, mass equalitarianism emphasizes the similarities of individuals rather than the uniqueness of persons. Mass equalitarianism is also linked to the bu-

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reaucratization of organization. Mass organization simultaneously encourages the bureaucratic centralization of governing powers and the leveling of social differences among the governed (Weber 1906-1924). The incorporation of all sections of the population into large-scale activities summons centralized organization for coordination and control. Mass bureaucracies favor the leveling of social differences in the interest of efficiency. By treating everyone alike, according to functionally rational rules and procedures, mass bureaucracies foster equalitarianism. However, bureaucratic recruitment on the basis of professional competence raises new hierarchies. To be sure, careers open to talent are in greater harmony with equalitarian beliefs than is selection according to family and property. But professional elites are nevertheless elites and thereby introduce new social distinctions. This is a source of strain in modern society; in the political realm, for example, there is a tension between planning by experts and participation by mass electorates [see ELITES]. Mass equalitarianism is expressed in the populist character of mass society. Whatever is believed to express the popular will or to meet the most widely shared expectations is considered legitimate (Shils 1956). Political regimes strive to be popular regimes, whether they are dictatorial or constitutional. While this popular legitimation of authority centers in the polity, it pervades all kinds of social institutions. Populism places a premium on the capacity of leaders to create and placate popular opinion. Those who are effective in mobilizing large numbers of people have great power, and this generally means the leaders of mass parties. The mass leader seeks to embody and reflect popular desires; masses, not elites, are the ultimate sources of legitimation in mass society. This leads elites to make themselves readily accessible to popular pressures: that is, they are forced to be responsive not only to periodic expressions of public opinion through regular channels such as elections, but also to momentary and ad hoc representations of whatever is claimed to be popular. Leaders, of course, do not seek merely to respond to mass opinion. They also try to control it. Since they lack firm bases of independent authority, their control tends to take the form of manipulation and mobilization rather than command. The very presence of large numbers of only loosely organized and committed people summons efforts of leaders to manipulate and mobilize them. For if elites are highly accessible to mass pressures, so are masses readily available for mobilization by elites. People are receptive to direct appeals from remote elites, because they are poorly attached to proximate sym-

bols and relationships and increasingly caught up in distant events and activities (Kornhauser 1959). Mass movements. As mass society develops, there is a growing cleavage between those who continue to be integrated in local groups and those who have already been incorporated into mass relations. In part this is a difference between the old classes and the new classes—craftsmen versus industrial workers, independent entrepreneurs versus industrial managers, free professionals versus members of professional staffs, and so forth. Increasingly isolated from the larger society, members of the declining classes readily come to believe that they are the victims of it. More generally, the locally attached, in their resentment of the ascendancy of big cities, big government, big business, and big labor, become receptive to the appeals of mass movements directed against the forces of mass society. Then there is the growing number of people who have been detached from communal relations but who are not, or not yet, incorporated into mass relations. It is likely to include, among others, new migrants to the cities, new workers in the factories, and, generally, the younger and newly mobile members of the society. In the absence of strong group ties, they are less constrained and more restless than those who continue to be rooted in communal groups or those who have been fully incorporated into mass relations. These poorly attached and unintegrated people are readily available for activistic modes of intervention in political life and for participation in mass movements that promise them full membership in the national society. Thus, modern mass movements are characteristically composed of people who either seek entry into mass society or seek to reverse the processes of mass society. Like mass organizations, mass movements do not build on existing social relations but instead construct direct ties between participants and leaders. When a mass society has successfully incorporated most sections of the population into its central institutions, mass movements may become less widespread. In a highly developed mass society, mass participation is institutionalized in the form of mass organizations, especially mass parties, but also mass unions and similar associations, universal suffrage, extensive publicity of political men and events, and the official symbolism of popular government [see SOCIAL MOVEMENTS]. Criticism of mass society Early critics. The concept of mass society had its major intellectual origin in the nineteenth-

MASS SOCIETY century criticism of the revolutionary changes in European (and especially French) society. Many thinkers believed that the decisive social tendency was the change from aristocratic to democratic society. It was not simply that a shift occurred in the class composition of governing groups. More fundamental was the shift that these thinkers perceived in the bases of social order. Formerly, standards of value and conduct had been assumed to exist as part of a natural order of society; in democratic society, by contrast, the arbitrary will and opinion of the masses were replacing established standards. Early representatives of this kind of social criticism of the democratization of society were Catholic thinkers like Joseph de Maistre and the vicomte de Bonald. Following the ascendancy of portions of the middle classes, marked by such events as the accession in 1830 of Louis Philippe, the bourgeois king, in France and the passage of the 1832 Reform Act in England, liberal thinkers adopted mass society ideas, not to defend the old order but to assess the strengths and weaknesses of the new order. Thus, Tocqueville (1835) moved from a fairly hopeful analysis of the possibilities of preserving standards in a democratic society (in light of his examination of America) to a more pessimistic view of the matter following the 1848 revolution in France. Even so influential a liberal thinker as J. S. Mill found himself in wide agreement with Tocqueville's more pessimistic diagnosis of democratic culture. Burckhardt and Nietzsche, among many other late nineteenth-century romantic thinkers, sought to interpret changes in European society as the erosion of culture. Ortega (1930) later formulated a highly popular version of this view. This aristocratic criticism of the development of nineteenth-century society profoundly influenced democratic criticism of the development of twentieth-century society. Where the first centered on the intellectual defense of elite values against the rise of mass participation, the second developed as a defense of democratic values against the rise of totalitarianism. The defensive posture of the aristocratic thinkers was adopted by democratic thinkers who, having won the nineteenth-century war of ideas and institutions, now sought to preserve their gains against the totalitarian challenge. Thus, such students of totalitarianism as Lederer (1940), Mannheim (1935), Fromm (1941), Neumann (1942), Arendt (1951), and Kornhauser (1959) s ee in the fragmentation of society the opportunity for new forms of domination based on the mobiuzation of large populations. Two kinds of analysis closer to the social sci-

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ences have contributed significantly to the development of the idea of mass society during the past century. One is the effort to distinguish between traditional and modern societies, a line of analysis that has become a central theoretical perspective of sociology. An early formulation of this perspective was Maine's distinction between societies dominated by status relations of kinship and those dominated by contract relations of individuals. Tonnies (1887), in his highly influential analysis of Gemeinschaft and Gesellschaft, elaborated Maine's thesis. Further evolution of this line of analysis is to be found in Durkheim's theory of social solidarity and anomie (1893; 1897) and in Max Weber's treatment of traditional and bureaucratic authority (Weber 1906-1924). What made this kind of sociological theory relevant to the idea of mass society was its analysis of the atomization and depersonalization of social organization resulting from modernization. This became a central thesis of urban sociology, as in the writings of Simmel (1902— 1903), Park (1916-1939), and Wirth (19331953). [See COMMUNITY-SOCIETY CONTINUA.] The development of mass psychology provided still another source of ideas about mass society (Reiwald 1949). Gustave Le Bon, Scipio Sighele, and Gabriel Tarde were leading students of mass behavior at the turn of the century. In their analysis of the heightened suggestibility and manipulability of people no longer constrained by communal ties and traditional authorities, these theorists contributed to the social psychology of mass society. This line of analysis was given a more sociological and less polemical cast by American students of what came to be called "collective behavior" (Blumer 1939) [see COLLECTIVE BEHAVIOR]. Many of these themes from sociology and social psychology were drawn together in Mannheim's critical analysis (1935) of the effects of the "fundamental democratization" and "growing interdependence" of society. A common perspective unites these theories and makes them part of the history of the idea of mass society. It is a view of modern society as containing certain fundamental pathological tendencies, which are believed to inhere in its development. The theory of mass society adds to such concepts as "democratic society," "urban society," and "industrial society" an emphasis on the socially disintegrative effects of democratization, urbanization, and industrialization. Foremost among these effects are the decline of community and authority and the spread of pseudo-community and pseudoauthority. Pseudo-community. During the 1920s and 1930s, a number of American sociologists reported on

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various aspects of modern life and generally stressed the anonymity and atomization of persons in contemporary society. Following World War n, this portrait of modern life was subject to considerable criticism on the grounds that primary relations are much in evidence in the factory, the army, and other allegedly impersonal organizations. Kinship networks, neighborhood bonds, and local activity were observed in a number of urban and suburban settings, and primary-group mediation of mass communications was shown to prevail over completely atomized audiences. Such observations suggest that the decline of community is at most relative to the condition of premodern society (Greer 1958). There is much more to the problem of community than the question of the mere presence or absence of personal attachments and communal bonds. Students of mass society assert that the functions of primary groups are weakened under conditions of modern society, not that primary groups are absent. The decreasing role of primary relations in the social organization of mass society and their increasing isolation from the larger society weaken them as sources of meaning and support for the individual in the larger society. Moreover, they are more easily broken because they receive less support from the institutional framework of society. Both weaknesses stem from the attenuation of the links between primary relations and the major functional areas of society. The isolation of primary relations creates the need for more inclusive bonds of solidarity and gives rise to a search for new forms of community. The barriers to community thrown up by the mass character of society heighten receptivity to the appeals of pseudo-community. This hypothesis has been applied to otherwise widely diverse social contexts. The German middle-class youth movement at the beginning of the century made the "return to Gemeinschaft" its cardinal article of faith. The Nazi movement subsequently inscribed the "folk community" on its ideological banner and won many adherents on the strength of this appeal. The totalitarian mass movement is only the most dramatic and extreme case of pseudo-community. Much more mundane cases have been examined in the context of American life. For example, campaigns of mass persuasion exploit themes of community and personalization (Merton 1946), and programs of "human relations" in industry exploit unfulfilled needs for social bonds and participation in the interest of greater worker efficiency (Mayo 1933). These ideologies and programs simulate but do not create community, and consequently they

make people more available for manipulation and mobilization. They exploit a general dilemma facing the individual in mass society: either he demands highly personalized meaning from the mass enterprise and suffers frustration, or he withholds commitment to it and suffers loss of identity. "Social alienation," "false personalization," "enforced privatization," and similar notions found in the writings on mass society point, however unsteadily, to the pathology of community in modern society (Nisbet 1953; Riesrnan 1950). This concern with the quality of social relations—the fabrication of symbols and relations, the exploitation of unfulfilled needs for personal response, and related matters—marks the perspective of mass analysis. As a perspective, it invites attention to the various distorted forms and expressions of the search for community, to the social conditions that promote them, and to the consequences for individuals and institutions that flow from them. Pseudo-authority. The decline of authority accompanies the decline of community. For the loosening of the various cohesive groupings that make up a society is at the same time the dissolution of the authority of these groups over the individual. Traditional standards and customary authorities anchored in kinship, church, and community are replaced by bureaucratic systems of legal and political control. The rationalization of authority liberates the individual from the often harsh and always close constraints of the cohesive group; however, it also removes the direction and support supplied by such a group but not by the large and impersonal bureaucracy. Many students of such relatively democratic political societies as those of England and the United States have been quick to criticize this conception of the bureaucratic society on the grounds that it fails to see the pluralist character of these societies, especially the dispersion of power and authority among diverse and independent social groups. Thus, interest-group activity and influence are found to be extensive on all levels of government; power and authority in many local communities are observed to be widely distributed among competing groups; and party loyalties are reported to possess considerable stability. Such findings appear to contradict notions of contemporary society as a condition of social and political atomization (Bell 1960). Mass theorists question, however, whether these observations in fact confirm a continuing vitality of social pluralism, or whether the pluralist group structure is not itself subject to the forces of mass society. Social pluralism undoubtedly receives a

MASS SOCIETY certain impetus from the elaborate functional differentiation of the large-scale industrial society: the proliferation of specialized occupational groups is the principal case in point. But since these associations are specialized, tend to be nationwide, and often do not incorporate the work group or other social relations of the individual, they are transformed into mass organizations (Nisbet 1953; Selznick 1952). Moreover, the interests underlying the formation of diverse organizations tend to be creatures of a complex and specialized economy that splits the person from the role, so that they possess only a limited capacity to elicit broad or deep personal commitment. If the interests are not very substantial and distinct, the organized representation of interests that constitutes a pluralist system will be correspondingly insubstantial and amorphous. The affluent society and welfare state also reduce the urgency of these interests. New sources of disaffection appear in the mass society, but they are not readily articulated and mitigated by means of pluralist organization and bargaining. Whether or not mass theorists are correct in this particular argument, the general principle is clear: "the differentiation . . . which disintegrates is very different from that which brings vital forces together" (Durkheim [1893] 1960, p. 353). The functional differentiation of structures may increase efficiency, but it simultaneously may disintegrate what was a viable social entity without creating the conditions for the formation of new social entities. A great deal depends upon whether a given social function can sustain a social identity or whether the function is so specialized or otherwise limited that it cannot provide sufficient meaning to summon commitment. As organizations become very large, specialized, and removed from the network of social relations of their members, they lose their authoritative character. The modern trade union, for example, appears less capable of providing meaning and identity to its members than occupational associations of former times, so that its power may seem more arbitrary and less authoritative. When similar processes occur in the church, profession, corporation, and other secondary groups, the society begins to lose its pluralism and experiences a general dissolution of authority. The decline of authoritative standards and leadership creates anxiety and insecurity; feelings of aimlessness and lack of social direction become widespread. Such a state of anomie generates the quest for new authority and heightens receptivity to pseudo-authority. As in the case of the search

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for community, mass analysts try to identify the symptoms and consequences of inappropriate and inauthentic responses to genuine needs for authoritative standards and direction. The rise of charismatic leadership testifies to this need. But of greater significance is the quality of this leadership—whether it is the carrier of new values or merely the popularity of a demagogue or celebrity. Where mass media of communication and the techniques of manipulation and mobilization are highly developed, it hardly suffices to say that popular enthusiasm is sufficient to demonstrate a charismatic relationship. The conditions of mass society facilitate the fabrication of charisma in the absence of value commitment on the part of either leaders or masses. More generally, whenever the claim to authority is based substantially on the manipulation of symbols rather than on the invoking of standards, one may speak of pseudo-authority. What concerns mass analysts are situations in which there is a marked discrepancy between the symbols and the substance of authority. The claim that public opinion is authoritative under conditions of modern mass democracy is a case in point. Where public opinion becomes a slogan for whatever is believed to be popular, rather than a process and product of public deliberation and discussion, it is a form of pseudo-democracy. This is a powerful tendency in mass society because of the difficulties of making and eliciting personal responses in mass arenas and bureaucratic institutions. The ease of mass manipulation and the difficulty of public deliberation favor the symbols of democracy without the substance, especially where the symbols are widely stereotyped in terms that do not invite close scrutiny or comparison with actual experience (Selznick 1952). The most extreme manifestation of manipulated and mobilized opinion is found in totalitarian systems. The unanimous elections, the staged demonstrations, and the mass indoctrination programs reveal the possibilities of pseudo-democracy. Totalitarianism itself is greatly facilitated by the existence or creation of masses of people who are not attached to independent social groups. Indeed, the study of totalitarianism is instructive because it shows how the effort to mobilize a whole population actually requires the destruction of bonds of authority and community and their replacement by ideological organizations. However, the ultimate reliance of totalitarian regimes on the use of force testifies to the limits of this strategy of mobilization. Moreover, mass conditions do not by themselves produce totalitarianism. The existence of

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modern technology plus the availability of large numbers of socially unintegrated people make totalitarianism possible, but a number of other conditions must be present to prepare the way for totalitarianism. Theories of mass society are sometimes said to be prophecies of despair (Bell I960; Shils 1962). But they need not be so construed. That the mass analyst tends to be a pathologist of contemporary society in no way denies the existence in that society of creative and value-sustaining social forces. Properly incorporated into social science, the concepts of mass society invite analysis of the conditions under which mass processes are strong or weak. Thus, mass analysis may take on new significance in alerting students of non-Western societies to certain pathologies of social development. Perhaps more important for social thought than any particular proposition of mass society is the concern this perspective represents for assessing the quality of culture and social institutions. If social science is to pursue this kind of inquiry, however, it will have to renew its communication with the humanities. For if the idea of mass society has greatly influenced social science, its formulation and development have been to a considerable extent the work of philosophy, history, and literature. WILLIAM KORNHAUSER [See also COMMUNICATION, MASS; DEMOCRACY; TOTALITARIANISM; and the biographies of BURCKHARDT; DURKHEIM; MAINE; MANNHEIM; MAYO; ORTEGA Y GASSET; TOCQUEVILLE; TONNIES; WEBER, MAX.] BIBLIOGRAPHY ARENDT, HANNAH (1951) 1958 The Origins of Totalitarianism. 2d ed., enl. New York: Meridian. BELL, DANIEL (1960) 1962 The End of Ideology: On the Exhaustion of Political Ideas in the Fifties. 2d ed., rev. New York: Collier. BLAUNER, ROBERT 1964 Alienation and Freedom: The Factory Worker and His Industry. Univ. of Chicago Press. BLUMER, HERBERT (1939) 1951 Collective Behavior. Pages 167-222 in Alfred M. Lee (editor), New Outline of the Principles of Sociology. 2d ed., rev. New York: Barnes & Noble. DURKHEIM, EMILE (1893) 1960 The Division of Labor in Society. Glencoe, 111.: Free Press. -» First published as De la division du travail social. DURKHEIM, EMILE (1897) 1951 Suicide: A Study in Sociology. Glencoe, 111.: Free Press. ->• First published in French. FROMM, ERICH (1941) 1960 Escape From Freedom. New York: Holt. GREER, SCOTT (1958) 1964 Individual Participation in Mass Society. Pages 329-342 in Roland Young (editor), Approaches to the Study of Politics: Twenty-two Contemporary Essays Exploring the Nature of Politics

and Methods by Which It Can Be Studied. Evanston, 111.: Northwestern Univ. Press. KORNHAUSER, WILLIAM 1959 The Politics of Mass Society. Glencoe, 111.: Free Press. LE BON, GUSTAVE (1895) 1947 The Crowd. New York: Macmillan. -> First published as Psychologie des foules. LEDERER, EMIL 1940 State of the Masses: The Threat of the Classless Society. New York: Norton. MANNHEIM, KARL (1935) 1940 Man and Society in an Age of Reconstruction: Studies in Modern Social Structure. New York: Harcourt. ->• First published as Mensch und Gesellschaft im Zeitalter des Umbaus, MAYO, ELTON (1933) 1946 The Human Problems of an Industrial Civilization. 2d ed. Boston: Harvard Univ., Graduate School of Business Administration, Division of Research. -> A paperback edition was published in 1960 by Viking. MERTON, ROBERT K. 1946 Mass Persuasion: The Social Psychology of a War Bond Drive. New York: Harper. NEUMANN, SIGMUND (1942) 1965 Permanent Revolution: Totalitarianism in the Age of International Civil War. 2d ed. New York: Praeger. -»• First published as Permanent Revolution: The Total State in a World at War. NISBET, ROBERT A. 1953 The Quest for Community: A Study in the Ethics of Order and Freedom. New York: Oxford Univ. Press. ORTEGA Y GASSET, JOSE (1930)1961 The Revolt of the Masses. London: Allen & Unwin. -> First published in Spanish. PARK, ROBERT E. (1916-1939) 1952 Human Communities: The City and Human Ecology. Collected Papers, Vol. 2. Glencoe, 111.: Free Press. REIWALD, PAUL 1949 De I'esprit des masses. Neuchatel and Paris: Delachaux & Niestle. RIESMAN, DAVID 1950 The Lonely Crowd: A Study of the Changing American Character. New Haven: Yale Univ. Press. -> An abridged paperback edition was published in 1960. SELZNICK, PHILIP (1952) 1960 The Organizational Weapon: A Study of Bolshevik Strategy and Tactics. Glencoe, 111.: Free Press. SHILS, EDWARD 1956 The Torment of Secrecy: The Background and Consequences of American Security Policies. Glencoe, 111.: Free Press. SHILS, EDWARD 1962 The Theory of Mass Society. Diogenes 39:45-66. SIMMEL, GEORG (1902-1903) 1950 The Metropolis and Mental Life. Pages 409-424 in Georg Simmel, The Sociology of Georg Simmel. Edited and translated by Kurt H. Wolff. Glencoe, 111.: Free Press. -> First published in German. TOCQUEVILLE, ALEXIS DE (1835) 1945 Democracy in America. 2 vols. New York: Knopf. -> First published in French. A paperback edition was published in 1961 by Vintage and by Schocken. TONNIES, FERDINAND (1887) 1957 Community and Society (Gemeinschaft und Gesellschaft). Translated and edited by Charles P. Loomis. East Lansing: Michigan State Univ. Press. -> First published in German. A paperback edition was published in 1963 by Harper. WEBER, MAX (1906-1924) 1946 From Max Weber: Essays in Sociology. Translated and edited by Hans H. Gerth and C. Wright Mills. New York: Oxford Univ. Press. WIRTH, Louis (1933-1953) 1956 Community Life and Social Policy: Selected Papers. Univ. of Chicago Press.

MATHEMATICS MATHEMATICAL STATISTICS See STATISTICS.

MATHEMATICS The history of mathematics, and to some extent its content, can be thought of as involving three major phases. Ancient mathematics, covering the period from the earliest written records through the first few centuries A.D., culminated in Euclidean geometry, the elementary theory of numbers, and ordinary algebra. Equally important, this phase saw the evolution and partial clarification of axiomatic systems and deductive proofs. The next major phase, classical mathematics, began more than 1,000 years later, with the Cartesian fusion of geometry and algebra and the use of limiting processes in the calculus. From these evolved, during the eighteenth and nineteenth centuries, the several aspects of classical analysis. Other contributions of this phase include nonEuclidean geometries, the beginnings of probability theory, vector spaces and matrix theory, and a deeper development of the theory of numbers. About a hundred years ago the third and most abstract and demanding phase, known as modern mathematics, began to evolve and become separate from the classical period. This phase has been concerned with the isolation of several recurrent structures of analysis worthy of independent study —these include abstract algebraic systems (for example, groups, rings, and fields), topological spaces, symbolic logic, and functional analysis (Hilbert and Banach spaces, for example)—and various fusions of these systems (for example, algebraic geometry and topological groups). The rate of growth of mathematics has been so great that today most mathematicians are familiar in detail with the major developments of only a few branches of the subject. Our purpose is to give some hint of these topics. The reader interested in a somewhat more detailed treatment will find the best single source to be Mathematics-. Its Content, Methods, and Meaning, the translation of a Russian work (Akademiia Nauk S.S.S.R. 1956). Other general works are Courant and Robbins (1941), Friedman (1966), and Newman (1956). More specific references are given where appropriate. We do not here discuss Probability, mathematical statistics, or computation, even though they are especially important Mathematical disciplines for the social sciences, because they are covered in separate articles in the ^cyclopedia.

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Ancient mathematics The history of ancient mathematics divides naturally into three periods. In the first period, the pre-Hellenic age, the beginnings of systematic mathematics took place in ancient Egypt and in Mesopotamia. Contrary to much popular opinion, the mathematical developments in Mesopotamia were deeper and more substantial than those in Egypt. The Babylonians developed elementary arithmetic and algebra, particularly the computational aspects of algebra, to a surprising degree. For example, they were able to solve the general quadratic equation, ax2 + bx + c — 0. An authoritative and readable account of Babylonian mathematics as well as of Greek mathematics is presented by Neugebauer (1951). The second period of ancient mathematics was the early Greek, or Hellenic, age. The fundamentally new step taken by the Greeks was to introduce the concept of a mathematical proof. These developments began around 600 B.C. with Thales, Pythagoras, and others, and reached their high points a little more than a century later in the work of Eudoxus, who is responsible for the theory of proportions, which in antiquity held the place now held by the modern theory of real numbers. The third period is the Hellenistic age, which extended from the third century B.C. to the sixth century A.D. The early part of this period, sometimes called the golden age of ancient mathematics, encompassed Euclid's Elements (about 300 B.C.), which is the most important textbook ever written in mathematics, the work on conies by Apollonius (about 250 B.C.), and above all the extensive and profound work of Archimedes on metric geometry and mathematical physics (Archimedes died in 212 B.C.). The second most important systematic treatise of ancient mathematics, after Euclid's Elements, is Ptolemy's Almagest (about A.D. 150). Ptolemy systematized and extended Greek mathematical astronomy and its mathematical methods. The mathematical sophistication of Archimedes and the richness of applied mathematics evidenced by the Almagest were not equaled until the latter part of the seventeenth century. Classical analysis The intertwined and rapid growth of mathematics and physics during the seventeenth, eighteenth, and nineteenth centuries centered in a major way on what is now called classical analysis : the calculus of Newton and Leibniz, differential and integral equations and the special func-

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tions that are their solutions, infinite series and products, functions of a complex variable, extremum problems, and the theory of transforms. At the basis of all this are two major ideas, function and limit. The first evolved slowly, beginning with the correspondence, established in the Cartesian fusion of the two best-developed areas of ancient mathematics, between algebraic expressions and simple geometric curves and surfaces, until we now have the present, very simple definition of the term "function." A set f of points in the plane (ordered pairs of numbers) of the form (x,y) is called a function if at most one y is associated with each x. If (x, z/) is a member of f, it is customary to write y = f(x~); x is sometimes called the independent variable and y the dependent variable, but no causal meaning should be read into this terminology. The notion and notation may be generalized to more than one independent variable; if g is a set of ordered triples (x, y, z) with at most one z associated with each pair (x,y), then z = g(x, y} is called a function of two arguments. Since the most general notion of function can relate any two sets of objects, not just sets of numbers, it is sometimes desirable to emphasize the numerical character of the function. Then f is said to be a real-valued function of a real variable; here the term "real" refers to real numbers (in contrast to complex numbers, which will be discussed later). Although a real-valued function has been defined as a set of ordered pairs of numbers, (x,y), where the domain of x is is an unspecified set of numbers, the subsequent discussion of functions is mostly confined to the familiar case in which the domain of x is an interval of numbers. Even when the discussion applies more generally, it is helpful to keep the interval case in mind. A desire to understand limits was apparent in Greek mathematics, but a correct definition of the concept eluded the Greeks. A fully satisfactory definition, which was not evolved until the nineteenth century (by Augustin Louis Cauchy), is the following: b is the limit of f at a if and only if for every positive number e there is a positive number 8 such that, when the absolute value of x - a is less than 8 and greater than 0 (that is, 0 < x — a < 8 ) , the absolute value of f ( x ) — b is less than e (that is, \f(x) — b < e). In other words, b is the limit of f at a if x can be chosen sufficiently close to a (but not equal to a) to force f ( x ) to be as close to b as desired. Symbolically, this is written lim^af(^:) = b. The limit of f at a may exist even though f(#) is not defined; moreover, when f(«) is defined, b may or may not equal f(a~). If it does—that is, if f(#) is "near" /(a) whenever x is "near" a—then f is

)h

ffx +

Kx)

Figure I — Approximation of the derivative of f(x)

said to be continuous at a. If f is continuous at each a in an interval, f is said to be continuous over that interval. The calculus. The calculus defines two new concepts, the derivative and the integral, in terms of function and limit. They and their surprising relationship serve as the basis of the rest of mathematical analysis. The derivative. The first definition arises as the answer to the question "Given a function f, what is its slope (or, equivalently, its direction or rate of change) at any point x?" For example, suppose that y = f ( x ) represents the distance, y, that a particle has moved in x units of time; then what is the rate of change of distance—the instantaneous velocity—at time x? If h is a short period of time, then an approximate answer is the distance traversed between x and x + h, that is, f(x + h) — f ( x ) , divided by the time, h, taken to travel that distance (see Figure 1). The approximation is better the smaller the value of h, which suggests the definition of the rate of change of f at x as the limit of this ratio as h approaches 0, that is, ,. LT\Lx 'v" lim - - -

h

This limit, if it exists, is denoted by f ' ( x ) (or by d f ( x } / d x or by dy/dx) and is called the derivative of f at x. If f (#) exists, then f can be shown to be continuous at x, but the converse is not true in general. One of the earliest and most important applications in the social sciences of the concept of a derivative has been to the mathematics of marginal concepts in economics. For example, let x represent output, C(x) the cost of output x, and R(x) the revenue derived from output x; then C'(x^) and

MATHEMATICS R'(#) (or dC(x*)/dx and dR(x}/dx~) are the marginal cost and marginal revenue, respectively. Marginal utility, marginal rate of substitution, and other marginal concepts are defined in a similar fashion. Many of the fundamental assumptions of economic theory receive precise formulation in terms of these marginal concepts. The integral. The second concept in the calculus arises as the answer to the question "What is the area between the graph of a function f and the line y — 0 (the horizontal axis, or abscissa, of the coordinate system) over the interval from a to b?" (Regions below the abscissa are treated as negative areas to be subtracted from the positive ones above the abscissa; see Figure 2.) The solution, which will not be stated precisely, involves the following steps: the abscissa is partitioned into a finite number of intervals; using the height of the function at some value within each interval, the function is approximated by the resulting step function; the area under the step function is calculated as the sum of the areas of the rectangles of which it is composed; and, finally, the limit of this sum is calculated as the widths of the intervals approach zero (and, therefore, as their number approaches infinity). When this limit exists, it is called the Riemann integral of f from a to b and is symbolized as f l f ( x ) dx. It can be shown that the Riemann integral exists if f is continuous over the interval; it also exists for some discontinuous functions. For more advanced work, the concept of the length of an interval is generalized to the concept of the Lebesgue measure of a set, and the Riemann integral is generalized to the Lebesgue integral. Roughly, the vertical columns used to approximate the area in the Riemann integral are replaced in the Lebesgue integral by horizontal slabs. Although the interpretation of the integral as an extension of the elementary concept of area is f(x)

figure 2 - Approximation of the integral of f(x)

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important, even more important is its relation (called the fundamental theorem of the calculus) to the derivative: Consider F(#) = f x j ( u ) du as a function of the upper limit, x, of the interval over which the integral is computed; it can then be proved that the derivative of this function, F'(x), exists and is equal to f ( x ) . Put another way, the rate of change at x of the area generated by f is equal to the value of f at x; or put still another way, the operation of taking the derivative undoes the operation of integration. This fact plays a crucial role in the solution of many problems of classical applied mathematics that are formulated in terms of derivatives of functions. Introductions to the calculus and elementary parts of analysis are Apostol (1961-1962) and Bartle (1964). Implicit definitions of functions. An algebraic equation such as 2x2 — 5x — 3 = 0 implicitly defines two numbers (namely, the two values of x, 3 and — £) for which the equality holds. Other algebraic equations implicitly define sets of numbers for which they hold. A functional equation is an equality stated in terms of an unknown function; it implicitly defines those functions (as in the algebraic case, there may be more than one) that render the equality true. Ordinary differential equations. Suppose it is postulated that the amount of interest (that is, the rate of change of money at time t) is proportional to (that is, is a constant fraction, k, of) the amount, f(£), of money that has been saved. (This is the case of continuous compound interest.) Then f satisfies the equation f (t) = fef(t). This is a simple example of an ordinary differential equation, the solution of which is any function having the property that its derivative is k times the function. The solutions are f(t) = f(0) exp(fct), where f ( 0 ) denotes the initial amount of money at time t = 0. Another simple economic example is the differential equation that arises from the assumption that marginal cost always equals average cost (that is, dC(x}/dx — C(x}/x} which has the solution that average cost is constant, that is, that C(x} = kx for some constant, k. Some laws of classical physics are formulated as second-order, linear, ordinary differential equations of the form where f" is the derivative of f (f" is called the second derivative of f ) and P, Q, and R are given functions. If, for example, f denotes distance, then this differential equation asserts that at each time t, a linear relation holds among distance, velocity,

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and acceleration. A vast literature is concerned with the solutions to this class of equations for different restrictions on P, Q, and jR; most of the famous special functions used in physics — Bessel, hypergeometric, Hankel, gamma, and so on — are solutions to such differential equations (see Coddington 1961). Partial differential equations. Many physical problems require differential equations a good deal more complicated than those just mentioned. For example, suppose that there is a flow of heat along one dimension, x. Let f ( x , t ) denote the temperature at position x at time t. With t fixed, one can find the rate of change (the derivative) of temperature with changes in x; denote this by df(x,£)/dx and its second derivative with respect to x by d-f(x,t~)/dx-. These are called partial derivatives. Similarly, holding x fixed, the derivative with respect to t is denoted by df(x,t~)/dt. According to classical physics, temperature changes due to conduction in a homogeneous one-dimensional medium satisfy the following partial differential equation : dfx,t dt

k pa-

dx~

where fe is the thermal conductivity, p the density, and cr the specific heat of the medium. Problems involving two or more independent variables (usually, time and some or all of the three space coordinates) — fluid flow, heat dissipation, elasticity, electromagnetism, and so on — lead to partial differential equations. Their solution is often very complex and requires the specification of the unknown function along a boundary of the space. This requirement is called a boundary condition. (See Akademiia Nauk S.S.S.R. [1956] 1964, chapter 6.)' Integral equations. Some physical problems lead to integral equations. In one type, functions g and K of one and two variables, respectively, and a constant, X, are given, and the problem is to find those functions, f, for which

This equation is called Fredholm's linear integral equation or the inhomogeneous linear integral equation. Basically, it asserts that the value of some quantity f at a point x is equal to an impressed value, g ( x } , plus a weighted average of its value at all other points. Integral equations arise in empirical contexts for which it is postulated that the value of a function at a point depends on the behavior of the function over a large region of its domain. Thus, in the example just considered the value of f at x depends on the in-

tegrand K ( x , y } f ( y ) integrated over the interval (a,b). There is a large body of literature dealing with the solution of various types of integral equations, especially those of interest in physics and probability theory. Functional equations. Although both differential and integral equations (and mixtures of the two, called integrodifferential equations) are examples of functional equations, that term is often restricted to equations that involve only the unknown function, not its derivatives or integrals. A simple, well-known example is f(xy) = f(x) + f(y), which implicitly defines those functions that transform multiplication into addition. If f is required to be continuous, then the solutions are Kf*dz/z, where K is a positive constant; this integral is called the natural logarithm. The choice of K is usually referred to as the selection of the base of the logarithm. Difference equations are functional equations of special importance in the social sciences. They arise both in the study of discrete stochastic processes (in learning theory, for example) and as discrete analogues of differential equations. Here the unknown function is defined only on the integers (or, equivalently, on any equidistant set of points), not on all of the real numbers, and so the function is written fn = f ( n ) , where n is an integer. The equation states a relation among values of the unknown function for several successive integers. For example, the second-order, linear difference equation — the analogue of the secondorder, linear, ordinary differential equation, described above — is of the form In some probabilistic models of the learning process it is postulated (or derived from more primitive assumptions) that the probability of a particular response on trial n + 1, denoted by p n+1 , is some function of pn and of the actual events that occurred on trial n. The simplest such assumption is the linear one, that is, pn+1 — ap» + ft, where a and (3 are parameters that depend upon the events that actually occur. If there is a run of trials during which the same events occur, so that a and ft are constant, then the solution to the above first-order, linear difference equation is

When different events occur on different trials, the equation to be solved becomes considerably more complex. An introduction to difference equations is Goldberg (1958). Given a functional equation — in the most gen-

MATHEMATICS eral sense—the answer to the question of whether a solution exists is not usually obvious. Exhibiting a solution, of course, answers the question affirmatively, but often the existence of a solution can be proved before one is found. Such a result is known as an existence theorem. If a solution exists, it is also not usually obvious whether it is unique and, if it is not unique, how two different solutions relate to one another. A statement of the nature of the nonuniqueness of the solutions is known, somewhat inappropriately, as a uniqueness theorem. Some rather general existence and uniqueness theorems are available for differential and integral equations, but in less well understood cases considerable care is needed to discover just how restrictive the equation is. A general work on functional equations is Aczel (1966). Three other areas of classical analysis. Three other branches of classical analysis will be briefly discussed. Extremum problems. For what values of its argument does a function assume its maximum or its minimum value? This type of problem arises in theoretical and applied physics and in the social sciences. In its simplest form, a real-valued function f is defined over some interval of the real numbers, and the problem is to find those x0 for which f(x 0 ) is a maximum or a minimum. If f is differentiate and if x0 is not one of the end points of the interval, a necessary condition is that f (x 0 ) — 0; moreover, x0 is a local maximum if f"(x0~) < 0 and a local minimum if f"(^o) > 0. (These statements should be intuitively clear for graphs of simple functions.) From these results it is easy to find, for example, which rectangle has the maximum area when the perimeter is held constant: it is the square whose sides are each equal to a quarter of the perimeter. A much more difficult and interesting problem— the subject of the calculus of variations—is to find which function (or functions) f of a given family of functions causes a given function F of f (known as a functional) to assume its maximum or minimum value. For example, let f be a continuous function that passes through two fixed points in the plane, and let F ( f ) be the surface area of the body that is generated by rotating f about the abscissa. A question that may be asked is "For which f (or f's) is F ( f ) a minimum?" A major tool in the solution of this •*-problem is a second-order, ori. cunary differential equation, known as Euler's e quation, that f must necessarily satisfy (just as the solution JCQ to the simpler problem necessarily satisfies f (*<,) = 0). (See Akademiia Nauk S.S.S.R. [1956] 1964, chapter 8.)

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Within the past twenty years new classes of extremum problems have been posed and partially solved; they are mainly of concern in the social sciences, and they go under the names of linear, nonlinear, and dynamic programming. An example of a linear programming problem is the following diet problem. Each of several foodstuffs, f , , f 2 , • • • , fk, contains known amounts of various nutritional components, such as vitamins and proteins. Let fa be the amount of component j in food fi, j = 1, 2, • • • , n, and let a-, be the minimum amount of component j acceptable in the diet. If Xi is the amount of food fi in the diet, the diet will be acceptable only if the following n inequalities are fulfilled: Xifu + x2f2j +

h xkfkj ^ a},

j = 1, 2, • • • , n.

If PI denotes the price of food f i , the problem is to choose the xt so as to minimize the cost, x1pl + x~,p2 + • • • + xkpk, while fulfilling the above linear inequalities. [See PROGRAMMING.] Functions of a complex variable. One of the most beautiful subfields of analysis is the theory of functions of a complex variable, which was developed in the nineteenth century, starting with the work of Cauchy. It has been significant in the growth of several two-dimensional, continuous physical theories, including parts of electromagnetism, hydrodynamics, and acoustics, but so far its applications in the social sciences have been mainly restricted to mathematical statistics, as in the concept of the characteristic function of a probability distribution. A complex number, z, is of the form z = x + iy, where x and y are real numbers and i— \/ — l. Sums and products are defined in such a way that the resulting arithmetic reduces to that of the ordinary numbers when y — 0. Because a point (x,y~) in the plane can be (usefully) identified with the complex number x + iy, functions from the plane into the plane can be interpreted as complex-valued functions of a complex variable. If the derivative of such a function exists at all points of a region, derivatives of all orders exist and the function can be expressed as a convergent power series of the form a0 + a j Z + a 2 z 2 + • • • for some circle of z's within that region. It is clear from this result that the mere supposition that the derivative exists is a much stronger condition for complex-valued functions than for ordinary numerical functions. Such functions, which are called analytic, are very strongly constrained—among other things, specifying an analytic function over a small region determines it completely—and this fact has been

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effectively exploited to solve many two-dimensional problems of theoretical and practical interest. Interestingly, the theory cannot be neatly generalized beyond two dimensions. An introductory work on functions of a complex variable is Cartan (1961). Integral transforms. Suppose that f is any continuous, real-valued function defined over an interval from a to b and that K is a fixed, continuous, real-valued function of two variables, the first of which is also on the interval from a to b; then I(f,y)= $£K(x,y)f(x)dx is called an integral transform of f. If K satisfies certain restrictions, knowing I is equivalent to knowing f. Nevertheless, if K is carefully chosen, / may have convenient properties not possessed by f. For example, if a = 0, b~<x>, and K(x,y~) = e~xv, then I, which is then known as the Laplace transform and which is closely related to the moment-generating function of statistics, has the property that it converts certain integrals (convolutions) of two functions into multiplications of their transforms. In statistics such a convolution represents the distribution of the sum of two independent random variables. Another well-known and important example is the Fourier transform, which is used widely in statistics, and to a lesser extent in probabilistic models of behavior, to obtain a probability distribution from its characteristic function. Theory of numbers Despite several intellectual crises that led mathematicians to introduce new types of numbers into mathematics, it was not until about a hundred years ago that numbers were treated as being something other than intuitively understood. The natural numbers, 1,2,3, • • • , and their ratios, the positive rationals, are ancient concepts. The Greeks first noted their incompleteness when they showed that they are inadequate to represent \/2, the length of the diagonal of a square whose side is of length 1. Certain irrational numbers had to be added, and later 0, negative numbers, and complex numbers were added so that certain classes of equations would all have solutions. To clarify this patchwork and to understand the uniqueness of the additions, nineteenth-century mathematicians undertook the axiomatization of various aspects of the number system. Perhaps the most subtle step was the definition of irrational numbers in terms of sets of rational numbers (roughly, the set of all rationals less than the irrational to be defined). The axiomatization of numbers is not really the mainstream of the "theory of numbers." When one sees a book or course with that title, it usually refers to the study of properties of the natural numbers, mainly the prime numbers. Recall that

an integer is prime if it is divisible only by 1 and itself; the first few primes are 3, 5, 7, 11, and 13. In addition to the many results that can be proved directly (some of which were known to the ancients), such as that every integer can be represented uniquely as the product of powers of primes and that there are infinitely many primes, other results have depended upon the application of deep results from analysis. For example, parts of the theory of functions of a complex variable were used to show that the number of primes not larger than n divided by the number n/lnn, where Inn is the natural logarithm of n, that is, f^dx/x, is a ratio that approaches 1 as n becomes large. Not only has this work greatly increased the depth of understanding of integers, but it has fed back into analysis and was one of the factors leading to the development of parts of contemporary abstract algebra. Many applications of mathematics (for example, in statistics) involve counting the number of distinct events or objects that satisfy certain conditions; often these counting problems are quite difficult. Theorems providing explicit formulas or recursion schemes are called combinatorial theorems. One of the earliest important examples was the binomial theorem for the expansion of (a + b) n , which is now part of every elementary algebra course. [See PROBABILITY, article on FORMAL PROBABILITY.] A general introduction to the theory of numbers is Ore (1948). Algebra Classically, algebra was the theory of solving equations expressed in terms of the four arithmetical operations—addition, subtraction, multiplication, and division. The linear and quadratic equations of elementary algebra are familiar examples. Historically, the expression of mathematical problems in the form of equations, using letters to stand for the unknown numbers, was a major step in clarifying and simplifying the mathematical nature of many kinds of problems. Perhaps the most important consequence of the introduction of letters and the use of equations was the extension of routine methods of calculation to quite complicated settings. The introduction of algebraic equations probably ranks in importance in the history of ideas with the earlier invention, probably first by the Babylonians, of the place-value system of notation for numbers; such a system was needed to develop simple algorithms for performing arithmetical computations. The general theory of algebraic equations, the elementary parts of which are studied in high

MATHEMATICS school, has a long and distinguished history in mathematics. The proof by Niels Henrik Abel in 1824 that solutions of an algebraic equation of degree five or greater, where the degree is the highest exponent of any term in the equation, cannot be expressed in terms of radicals (that is, expressions definable in terms of square roots) was one of the most important mathematical results of the first half of the nineteenth century. Another result of basic importance is the fundamental theorem of algebra, which was first proved in the eighteenth century but which was proved rigorously only in the last half of the nineteenth century. This theorem asserts that every algebraic equation always has at least one root that is a real or a complex number. Also of great significance were the proofs that not all numbers are roots of algebraic equations; numbers that are not such roots are called transcendental numbers. The most famous proofs of this sort are Charles Hermite's (in 1873) that e is transcendental and F. Lindemann's (in 1882) that TT is transcendental. Orderings. Much of the work in algebra during the present century has been devoted to generalized mathematical systems that are characterized not in terms of the four fundamental arithmetical operations but in terms of generalizations of these operations and of the familiar ordering relations of "less than" and "greater than." In a number of the social sciences the theory of binary relations has received extensive application. From an algebraic standpoint a binary relation structure may be characterized as consisting of a set A and a set R of ordered pairs (x,y~), where x and y are both elements of A. Such an R is called a binary relation on A. A relation R is said to be a partial ordering of A when it is reflexive, antisymmetric, and transitive—that is, when it satisfies the following three properties: reflexive: for every x in A, xRx; antisymmetric : for every x and y in A, if xRy and yRx, then x — y; transitive: for every x, y, and z in A, if xRy and yRz, then xRz. If R is also connected in A (that is, if for any two elements x and y in A with x ^ y, either xRy or yRx) then R is said to be a complete or simple ordering or, sometimes, a linear ordering of A. The concept of a complete ordering is a direct abstraction of the order properties of "C' with respect to the real numbers. A familiar use of the concept of an ordering relation is in utility theory, particularly in the classical theory of demand in economics, in which it is assumed that each individual has an ordering relation over the set of commodity bundles °r, more generally, over the set of alternatives with which he is presented. The general concept of ordering relations also has far-ranging applications

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in the theory of measurement within psychology and sociology, and more general binary relations have been extensively applied in anthropology in the study of kinship systems. Partial orderings can be extended in another direction by imposing additional conditions to obtain lattices, which have also been used in the social sciences. In a different direction, but still within the framework of binary relations, is the theory of graphs, in which no restrictions are placed on the binary relation, R. Applications of graph theory have been made to social-psychological and sociological problems, especially to provide a mathematical method for representing various kinds of relationships between persons. Groups, rings, and fields. Another direction of generalization of classical algebra has been to what are called groups, rings, and fields. A group is a set A together with a binary operation, o, satisfying the following axioms. First, the operation o is associative, that is, for x, y, and z in A, x o (y o z) = (x o y ) oz. Second, there is an element e, called the identity, of the set A such that for every x in A, xoe = eox = x. And, finally, for each element x of A there is an inverse element x-1 such that x o x-1 = e. It is obvious that if A is taken as the set of integers, o as the operation of addition, e as the number 0, and the inverse of x as the negative of x, then the set of integers is a group under the binary operation of addition. The theory of groups has had profound ramifications in other parts of mathematics and in the sciences, ranging from the theory of algebraic equations to geometry and physics. The reason for the fundamental importance of group theory is perhaps best summarized by stating that a group is the appropriate way to formulate the very important concept of symmetry. In the range of applications of group theory just mentioned, the underlying thread is the concept of symmetry, whether it is in the symmetry of the roots of an equation or the symmetry properties of the fundamental particles of physics. As a simple example, consider the finite group of rotations 90°, 180°, 270°, and 360°. A square does not change its apparent orientation under such a rotation about its center, but an equilateral triangle does. This group of rotations is the symmetry group of rotations for a square but not, of course, for an equilateral triangle. Although the methods and results of group theory have not yet had special applications of depth in the social sciences, they are important to many of the general mathematical results that have been applied. The theories of rings and fields represent rather direct generalization of arithmetical properties of the number system. The theory of groups is fun-

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damentally a generalization of the concept of a single binary operation, such as addition or multiplication, whereas rings and fields are algebraic systems that have two fundamental operations. The most familiar example of a field or of a ring is the set of rational numbers or of real numbers with respect to the operations of addition and multiplication. Boolean algebras. Algebraic aspects of the theory of sets have been studied under the heading of Boolean algebras. The concept of an algebra of sets, that is, a collection of sets closed under union and complementation, is fundamental in the modern theory of probability, where events are interpreted as sets of possible outcomes and numerical probabilities are assigned to events. [See PROBABILITY, article on FORMAL PROBABILITY.] Isomorphism and homomorphism. It should be mentioned that certain very general mathematical concepts find their most natural definition and application in modern algebra. One of the most important concepts is that of the isomorphism of two mathematical systems. An isomorphism is a oneto-one mapping of a system A onto a system B in which the operations and relations of A are preserved under the mapping and have the same structure as the operations and relations of system B. If the mapping is not one-to-one but the operations and relations are preserved, then it is called a homomorphism. A well-known application of the concept of isomorphism in the social sciences is in theories of fundamental measurement in which one shows that an appropriate algebra of empirical operations is isomorphic to some numerical algebra. It is this isomorphism that permits the direct application of computational methods to the results of measurement. Introductory works on algebra, both for this and for the next section, are Birkhoff and MacLane (1941) and Mostow, Sampson, and Meyer (1963). Vector spaces and matrix algebra Linear algebra is one of the most important generalizations of classical elementary algebra. The objects to which the operations of addition and multiplication are applied are now matrices, vectors of an ti-dimensional space, and linear transformations (an n x n matrix is a particular representation of a linear transformation in ^-dimensional space). More particularly, linear algebra arises as a generalization of the linear equations so familiar in elementary algebra, and historically one of the most important tasks of linear algebra has been to find solutions of systems of linear equations. As many research workers in the social sciences know,

the numerical solution of linear equations can be an extremely laborious and difficult affair when the number of equations is large. The set of coefficients of a system of linear equations gives rise to the concept of a rectangular array of numbers, which is precisely what a matrix is. An algebra of matrices in terms of addition and multiplication may be constructed; the distinguishing feature of this algebra, as compared with the algebra of the real numbers, is that multiplication is not commutative—that is, AB is not usually equal to BA, and the product of two nonzero matrices can be zero. The intuitive geometric concept of a vector may be represented by a column or row of n numbers, and an algebra of vectors, which bears a close resemblance to the algebra of numbers, may be constructed. Simple (linear) transformations of vectors, such as rotations and stretches of the coordinate system in space, can be interpreted as multiplication by matrices. The interaction between the geometrical intuitions about w-dimensional space and the algebraic techniques of calculation provided by linear algebra and the theory of matrices have made them powerful tools in the application of mathematics to many parts of science. These applications have been particularly prominent in statistics (for example, in factor analysis), as well as in economics, where it is often useful to treat n-dimensional bundles of commodities as vectors. Topology and abstract spaces Intuitively, a topological transformation of a geometrical figure or object is a deformation that introduces neither breaks nor fusions in the object. Put more exactly, a topological transformation is one that is one-to-one, is continuous, and has a continuous inverse. If one starts with a circle— perhaps the best example of a simple closed curve —one can deform it topologically into an ellipse or into the shape of a crescent, but one cannot deform it topologically into a figure eight, for example, because then two distinct points of the circle are fused as the intersection point of the eight. Also, one cannot deform it into a straight line segment, because to do so would introduce a break in the circle. Many familiar qualitative geometrical properties are topological invariants in the sense that they are not altered (are invariant) under topological transformations. Examples are the property of being inside or outside a closed figure in the plane; the property of a surface being closed, such as the surface of a sphere or an ellipsoid; or the property of the dimension of an object. For example, the surface of a sphere cannot be

MATHEMATICS topologically transformed into a one-dimensional curve or a three-dimensional sphere. We shall not attempt here to give an exact definition of continuity as it is used in topology; we simply remark that it is a reasonable generalization of the concept of continuity used in analysis. Topological methods and results have far-reaching applications in many branches of mathematics, but as yet the methods themselves have not been directly applied in those parts of the social sciences concerned extensively with empirical data. The most direct applications have been in economics, where topological fixed-point theorems have been of great importance in investigating the conditions guaranteeing the existence of a stable equilibrium in a competitive economy. The classical example of a fixed-point theorem—first proved by L. E. J. Brouwer, at the beginning of this century—states that for every topological mapping of an n-dimensional sphere into itself there is always at least one point that maps into itself, that is, remains fixed. Familiar examples of such mappings are rotations in two or three dimensions for which the center of the rotation is the fixed point of the transformation. Topological space. As a typical example of abstraction in modern mathematics, the initial concept of a topological transformation of familiar geometrical figures has led to the general abstract notion of a topological space. Roughly speaking, a topological space consists of a set, X, and a family, 0, of subsets of X, called open sets, for which the following four conditions are satisfied: the empty set is in 0; X is in 9; the union of arbitrarily many sets each of which is in fj is also in 0; and the intersection of any finite number of sets from 0 is also in 0. The concept of an open set is a generalization of the notion of an open interval of real numbers (an interval that does not include its end points). For example, the natural topology of the real line is the family of open intervals together with the sets that are formed from arbitrary unions and finite intersections of open intervals. Generally speaking, the notion of open set is used to express the idea of continuity. The important thing about a continuous function is that it does not jumble neighboring points too much, and this requirement may be expressed by requiring of a topological transformation that open sets be mapped into open sets and that the inverse of an open set be an open set. Metric space. Other kinds of abstract spaces have come into prominence in the development of topology. Perhaps the most important is the concept of a metric space. A set, X, together with a

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distance function, d, that maps pairs of points into real numbers is called a metric space if d satisfies the following conditions: d(x, y) = 0 if and only if x — y, that is, the distance between x and y is 0 if and only if x and y are the same point; d(x, z/) ^ 0, which asserts that distance is a nonnegative real number; d(x, y ) = d ( y , x), that is, distance is symmetric; and, finally, d(x,y~) + d ( y , z~) ^ d(x, z), which is known as the triangle inequality. The concept of a metric space has had important applications in many parts of mathematics and is a fundamental concept in modern mathematics. It has been applied in recent work in scaling theory in psychology and sociology, particularly to the problems of multidimensional scaling, and also in certain areas of mathematical economics [see SCALING]. It is clear that the notion of a metric space generalizes, in a very natural way, the concept of distance in Euclidean space. A typical metric problem raised in the social sciences is this: Given data in the form of "distances" among a finite set of points, what is the smallest dimensional Euclidean space within which the points can be embedded so that these distances equal the Euclidean or some other preassigned metric of that space? Recently this problem has been effectively generalized by permitting certain transformations of the "distances" that preserve their metric property. Little has yet been done about embeddings in non-Euclidean spaces. An introductory work on topology is Hocking and Young (1961). Foundations As was remarked above, the concept of a rigorous mathematical proof originated in ancient Greek mathematics. The modern formal axiomatic method, characteristic of twentieth-century mathematical research and one of the most important topics to be clarified in modern research on foundations of mathematics, is conceptually very close to the approach followed in Euclid's Elements. The main difference is that the primitive concepts of the theory are now treated as undefined or meaningless. All that is assumed about them must be formally expressed in the axioms. In contrast, in the Elements primitive concepts such as those of point and line are given an interpretation or meaning from the very beginning. This modern conception originated with David Hilbert, who provided the first complete, modern axiomatization of geometry in 1889. It is customary to say that the concepts of the theory are implicitly defined by the axioms. What is not recognized often enough is that the collection of axioms together explicitly de-

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fines the theory embodied in the concepts. Thus, in slightly more exact phrasing, the axioms of Euclidean geometry define the theory of Euclidean geometry by defining the phrase "is a model of Euclidean geometry." Iri the same fashion, the axioms of group theory define the theory of groups by specifying what kinds of objects are called groups or, in other words, what kinds of objects are models of the theory of groups (here we are using the term "model" in the logical or mathematical sense). A more particular aim of foundational research has been to provide a set of axioms that would serve as a basis for the main body of mathematics. At least three major positions on the foundations of mathematics have been enunciated in the twentieth century; they differ in their conception of the nature of mathematical objects. Intuitionism. Intuitionism holds that in the most fundamental sense mathematical objects are themselves thoughts or ideas. The intuitionist holds that one can never be certain that he has correctly expressed the mathematics when it is formalized as a mathematical theory. As part of this thesis, the classical logic of Aristotle, in particular the law of excluded middle, has been challenged by Brouwer and other intuitionists because it permits the derivation of purely existential, n on constructive statements about mathematical objects. In particular the validity of classical reductio ad absurdum proofs depends upon this logical law. Although intuitionists express themselves in a way which suggests a psychological analysis of mathematics, it should be emphasized that their conception of mathematical objects as thoughts has not been seriously explored by any intuitionists from the standpoint of scientific psychology. Platonism. A second view of mathematics, the Platonistic one, is that mathematical objects are abstract objects that exist independently of human thought or activity. Those who hold that set theory or logic itself provides an appropriate foundation for mathematics (adherents of logicism) usually adopt some form of Platonism in their basic attitude. From the standpoint of working mathematics, set theory—and thus Platonism—has been the most influential conception of mathematics in this century. Set theory itself originated in the late nineteenth century with the revolutionary work of Georg Cantor. Its foundations were called into question by Bertrand Russell's discovery of a simple paradox which arises in considering the set of all objects that are not members of themselves. If it is supposed that to every property there corre-

sponds the set of objects having this property, then a contradiction within classical logic may easily be derived by considering the set whose members are those and only those sets that are not members of themselves. An apparently satisfactory foundation for set theory, which avoids this and related paradoxes, was formulated in 1908 by Ernst Zermelo, and with suitable technical extensions it provides a satisfactory basis for most of the mathematics published in this century. Formalism. The third influential position on the foundation of mathematics, called formalism, was developed by Hilbert and others. This view is that the primary mathematical objects are the symbols in which mathematics is written. This carries to the extreme the development of the axiomatic method begun by the Greeks. Under the formalist account the interpretation and use of mathematics must then be given from outside pure mathematics. From a psychological or behavioral standpoint, there is much that is appealing about formalism, but again little effort has yet been made to relate the detailed results and methods of formalism to theoretical or experimental work in scientific psychology. Relevance of research on foundations. In view of the high degree of agreement about the validity of most published pieces of mathematics, the skeptical social scientist may question the real relevance of these varying views about the foundations of mathematics to working mathematics itself. There is a highly invariant content of mathematics recognized by almost all mathematicians, including those concerned with the foundations of mathematics, and this invariant content is essentially untouched by radically different philosophical views about the nature of mathematical objects. A reasonable conjecture is that future research in the foundations of mathematics will attempt to capture this invariant content by concentrating on the character of mathematical thinking rather than on the nature of mathematical objects. One other important aspect of foundational research in the twentieth century is the fundamental work on mathematical logic, in particular the attempt by Gottlob Frege, A. N. Whitehead, Bertrand Russell, and others to reduce all of mathematics to purely logical assumptions. These efforts have led to great clarification of the nature of mathematics itself and to vastly increased standards of precision in talking about mathematical proofs and the structure of mathematical systems. Of major importance were the deep results of Kurt Godel (1931) on the logical limitations of any formal system rich

MATHEMATICS enough to express elementary number theory. His results show that any such formal system must be essentially incomplete in the sense that not all true sentences of the theory can be proved as theorems. An introductory work on foundations is Kneebone (1963). Mathematics applied to social sciences Applications of mathematics to specific social science problems are described, and detailed references are given, elsewhere in this encyclopedia. That material is not repeated here; several reasonably general references are Allen (1938), Coleman (1964), Kemeny and Snell (1962), Luce (1964), Luce, Bush, and Galanter (1963-1965), Samuelson (1947). Suffice it to say that these applications involve only fragments of the whole of mathematics, and they have not been as successful as those in the physical sciences. The reasons are many, among them these: the effort so far expended is much less; the basic empirical concepts and variables have not been isolated and purified to the same degree; mathematics grew up with and was to some extent molded by the needs of physics, and so it may very well be less suited to social science problems if these problems are of a basically different character from those of physics; a typical social science problem appears to involve more variables than one is accustomed to handling in physics; and, finally, social scientists are generally not extensively trained in mathematics. A social scientist who attempts to formulate and solve a scientific problem in mathematical terms is often disappointed with the mathematics he can find. This may happen simply because a mathematical system appropriate to his problem does not seem to have been invented, or, as is more common, the definite and often quite complex mathematical system that he happens to want to understand in depth has not been investigated in any detail. In this century especially, mathematicians have tended to focus on very general classes of systems, and the theorems concern properties that are true of all or of large subclasses of them; however, these results do not usually provide much detailed information about any particular member °f the class. As an example, the axioms of group theory are not categorical—that is, two groups need not be isomorphic. Therefore, theorems about groups in general tell one little about the specific properties a particular group. But this is what is of interest a particular group is used to represent an erm pirical structure, as in modern particle physics.

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When this happens, it is necessary for the applied mathematician to carry out considerable mathematical analysis to achieve the understanding he needs to answer scientifically interesting questions. We have already discussed two parts of mathematics in which highly specific systems have been explored in depth: classical analysis and matrix algebra. A primary motivation for this detailed work was the needs of physical science. In fortunate instances, a problem may be formulated in terms of one of these systems, in which case specific results can sometimes be extracted from the existing literature. Examples where this has been done are in the application of matrix algebra to factor analysis and of Markov chains (a part of probability theory) to several areas, including learning, social interaction, and social structure [see FACTOR ANALYSIS; MARKOV CHAINS]. Theory as detailed as this, however, is not typical of contemporary mathematics. We have in mind such active areas as associative and nonassociative algebras, homological algebra, group theory, topological groups, algebraic topology, rings, manifolds, and functional analysis. The generality of contemporary mathematics can be seductive in that it invites sophistic treatments of scientific problems. It is often not difficult to find some general branch of mathematics within which to cast a specific social or behavioral problem without, however, actually capturing in detail the various constraints of the problem. Without these constraints few explicit results and predictions can be proved. Nevertheless, the real emptiness of such endeavors can be shrouded for the unwary in the impressive symbolism and ringing terms of whatever mathematics it is that is not being seriously used. If the growth of the social sciences parallels at all that of the physical sciences, they will study in detail various systems, which, although of peripheral mathematical interest, are of substantive interest. Indeed, some examples already exist, including these: (1) Just as classes of maximum and minimum problems have been formulated and solved in the physical sciences, other classes have arisen in the social sciences, such as linear, nonlinear, and dynamic programming, game theory, and statistical decision theory. (2) Various mathematical structures that may correspond to (parts of) empirical structures have been investigated, for example, aspects of the theory of relations and the closely related theory of graphs, matrix algebra, and concatenation algebras, which arose in the study of grammar and syntax. (3) Underlying the

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success of much physical theory is the fact that many variables can be represented numerically. The theories that account for this in physics are not suitable for the social sciences, but alternative possibilities are under active development, particularly in terms of theories of fundamental and derived measurement. The mathematics is reasonably involved, although for the most part the proofs are self-contained. (4) Although the theory of stochastic processes is a well-developed part of probability theory, a number of the processes that have found applications in the social sciences had not previously been studied by probabilists; their properties have been partially worked out in the social science literature. Among the most prominent examples are the nonstationary processes that have arisen in learning theory. Some of these postulate that on each trial one of several operators Qj transforms a response probability into the corresponding probability on the next trial. Two special cases have been most adequately studied. One assumes that the Ch are linear operators and the other assumes that the operators commute with one another—that is, Q;Q/ = Q,Q,. [See LEARNING.] As increasing use is made of mathematics in the social sciences, one may anticipate the investigation of very specific mathematical systems and, ultimately, the isolation of interesting abstract properties from these systems for further study and generalization as pure mathematics. R. DUNCAN LUCE AND PATRICK SUPPES BIBLIOGRAPHY

ACZEL, J. 1966 Lectures on Functional Equations and Their Applications. New York: Academic Press. AKADEMIIA NAUK S.S.S.R., MATEMATICHESKII INSTITUT (1956) 1964 Mathematics: Its Content, Methods, and Meaning. Edited by A. D. Aleksandrov, A. N. Kolmogorov, and M. A. Laurent'ev. 3 vols. Cambridge, Mass.: M.I.T. Press. -» First published in Russian. ALLEN, R. G. D. (1938)1962 Mathematical Analysis for Economists. London: Macmillan. APOSTOL, TOM M. 1961-1962 Calculus. 2 vols. New York: Blaisdell. BARTLE, ROBERT G. 1964 The Elements of Real Analysis. New York: Wiley. BIRKHOFF, GARRETT; and MACLANE, SAUNDERS (1941) 1965 A Survey of Modern Algebra. 3d ed. New York: Macmillan. CARTAN, HENRI (1961) 1963 Elementary Theory of Analytic Functions of One or Several Complex Variables. Reading, Mass.: Addison-Wesley. -» First published in French. CODDINGTON, EARL A. (1961) 1964 An Introduction to Ordinary Differential Equations. Englewood Cliffs, N.J.: Prentice-Hall. COLEMAN, JAMES S. 1964 Introduction to Mathematical Sociology. New York: Free Press.

COURANT, RICHARD; and ROBBINS, HERBERT (1941) 1961 What Is Mathematics? An Elementary Approach to Ideas and Methods. Oxford Univ. Press. FRIEDMAN, BERNARD 1966 What Are Mathematicians Doing? Science 154:357-362. GODEL, KURT (1931) 1965 On Formally Undecidable Propositions of the Principia mathematica and Related Systems. I. Pages 4-38 in Martin Davis (editor), The Undecidable: Basic Papers on Undecidable Propositions, Unsolvable Problems and Computable Functions. Hewlett, N.Y.: Raven. -> First published in German in Volume 38 of the Monatshefte filr Mathematik und Physik. GOLDBERG, SAMUEL 1958 Introduction to Difference Equations: With Illustrative Examples From Economics, Psychology, and Sociology. New York: Wiley. -» A paperback edition was published in 1961. HOCKING, JOHN G.; and YOUNG, GAIL S. 1961 Topology. Reading, Mass.: Addison-Wesley. KEMENY, JOHN G.; and SNELL, J. LAURIE 1962 Mathematical Models in the Social Sciences. Boston: Ginn. KNEEBONE, G. T. 1963 Mathematical Logic and the Foundations of Mathematics: An Introductory Survey. New York: Van Nostrand. LUCE, R. DUNCAN 1964 The Mathematics Used in Mathematical Psychology. American Mathematical Monthly 71:364-378. LUCE, R. DUNCAN; BUSH, ROBERT R.; and GALANTER, EUGENE (editors) 1963-1965 Handbook of Mathematical Psychology. 3 vols. New York: Wiley. MOSTOW, GEORGE; SAMPSON, JOSEPH H.; and MEYER, JEANPIERRE 1963 Fundamental Structures of Algebra. New York: McGraw-Hill. NEUGEBAUER, OTTO (1951) 1957 The Exact Sciences in Antiquity. 2d ed. Providence, R.I.: Brown Univ. Press. NEWMAN, JAMES R. (editor) 1956 The World of Mathematics. 4 vols. New York: Simon & Schuster. ORE, 0YSTEIN 1948 Number Theory and Its History. New York: McGraw-Hill. SAMUELSON, PAUL A. (1947) 1958 Foundations of Economic Analysis. Harvard Economic Studies, Vol. 80. Cambridge, Mass.: Harvard Univ. Press.

MAURRAS, CHARLES Charles Marie Photius Maurras (1868-1952), French man of letters, was born in Martigues, near Marseille. He entered public life supporting both Frederic Mistral's Felibrige and Jean Moreas, with whom he joined in 1891 in founding the Ecole Romane, a literary movement designed to defend "a common ideal of Romanity." He became the apostle of integral nationalism, having coined the term in 1900. Reacting against the dominant relativism and eclecticism of his time, Maurras set out from skeptical and agnostic premises to find some solid basis for thought, style, and action in historical realities which, he argued, having worked in the past, might be expected to work again. He rediscovered the classical ideals of order, hierarchy, and discipline

MAURRAS, CHARLES and insisted that they alone provide an escape from nihilism into the positive realm of "organizing empiricism"—a method of solving current problems in terms of past experience. Transferred from literary to sociopolitical grounds, Maurras's empirisme organisateur turned o him against what he considered the dissolvent and anarchic qualities of liberal individualism which had triumphed in the French Revolution. He thought France was in a state of decadence and attributed this to its abandonment of traditions identified with the old regime, campaigning against Protestants, Jews, and metics—all those alien agents of change and corruption to whom the revolution had given free rein in France. When, in the late 1890s, the scandals that periodically shook the Third Republic culminated in the Dreyfus affair, Maurras set out to elaborate a doctrine which might spark a reaction against the existing disorder and provide the basis of a national revival. Based upon penetrating if frequently unhistorical criticism of the republic and parliament, his critique asserted the necessity of a return to the historical sources of French intellectual and political success: the classical tradition of the seventeenth century and the monarchy. True patriotism, conscious of these conditions of national prosperity and greatness, demanded, he believed, a return to the stability and continuity which only hereditary monarchy could provide. This was the program of integral nationalism to which he soon converted the founders of the Ligue d'Action Franchise, a young, pragmatic, and patriotic movement dedicated to France's political and intellectual regeneration. Henceforth, the story of Maurras was that of the Action Franchise; he became its moving spirit, and most of his writings were published in the review (1899-1914) and the newspaper (1908-1944) of that name. Despite his insistence that politics must take precedence over everything else (Politique d'abord!), the Action Frangaise was less a political than a didactic and literary movement. The doctrine it taught combined traditionalism, regionalism, and corporatism and elaborated the picture of a society that was free of democratic sham, individualistic anarchy, and the struggles of political parties and that was ruled in a stable way by a monarch and by an elite of talent and birth who would consider °nly the interests of the nation, not those of particular interest groups. The negative aspects of Maurrasist doctrine were more convincing than its program, and its criticism of the republic and tts institutions provided rich ammunition for all other critics. When written into legislation at Vichy

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(particularly in 1940-1941), Maurras's views proved anachronistic and unworkable. Nevertheless, the Action Frangaise provided an intellectual structure to which the French right could refer; Maurras's doctrine synthesized the ideas of nineteenth-century conservatives from Bonald to La Tour du Pin and influenced several generations of France's middle and upper classes. Its newspaper never ceased to warn against Germany, against a Red peril—not so much a peril of social revolution as of national disunity—against the popular front of 1936, and, thereafter, against war and warmongers—at a time of national division and unpreparedness to which its own campaigns had contributed a good deal. A steadfast supporter of Philippe Petain after 1940, though as steadfastly anticollaborationist (his ideas inspired much of Vichy's nationalist isolationism), Maurras was condemned in 1945 to life imprisonment. In prison, as out, his pugnacity and the stream of his writings never ceased. When his sentence was commuted in 1952 to forced residence in a private clinic, Maurras publicly thanked President Vincent Auriol, congratulating him for finally granting him the freedom that was his due and suggesting the expiatory execution of the minister "responsible for the excesses committed at the Liberation." He died a few months later, still bellicose but reconciled with the church he had abandoned as a youth. Maurras's destructive effect on the democratic and parliamentary ideology has been immense, his constructive influence slight. Yet his ideas affected the nationalists of all Latin nations, and there are strong traces of Maurrasism in Salazar's Portugal and de Gaulle's France. The Action Frangaise has been and still is well represented in the Academic Frangaise (in 1964, by three of its leaders), and many still respect its ideas in the breach if not in the observance. Still, the movement Maurras led is now but a memory and a sect. Responsible for much of its success between the wars, Maurras also bears the responsibility for its eventual failure. His intellectual elitism made for overemphasis of the written word, and his authoritarianism brought him into conflict with the Roman Catholic church he professed to admire (not for its Christianity but for its enduring power) and with the royalty he professed to serve (less out of personal loyalty than for theoretical reasons). The deafness which rid him at an early age of faith in God or nature grew steadily worse, isolating him and encouraging his pessimistic and intolerant dogmatism. Younger followers deserted, were excommunicated, or simply drifted away. But this very dogmatism gave him

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the strength needed to repeat tirelessly and to elaborate endlessly ideas which have left their mark on France and on the Latin world. EUGEN WEBER [See also NATIONALISM.] WORKS BY MAURRAS

1931 Au signe de Flore. Paris: Oeuvres Representatives. 1950 Le Mont de Saturne. Paris: Quatre Jeudis. Oeuvres capitales. 4 vols. Paris: Flammarion, 1954. SUPPLEMENTARY BIBLIOGRAPHY

BUTHMAN, WILLIAM 1939 The Rise of Integral Nationalism in France. New York: Columbia Univ. Press. DIMIER, Louis 1926 Vingt ans d'Action Francaise. Paris: Librairie Nouvelle. JOSEPH, ROGER; and FORGES, JEAN 1953 Biblio-iconographie generale de Charles Maurras. 2 vols. Paris: Roanne. MASSIS, HENRI 1961 Maurras et noire temps. Paris: Plon. NOLTE, ERNST 1963 Der Faschismus in seiner Epoche. Munich: Piper. ROUDIEZ, LEON 1957 Maurras jusqu'a I'Action Francaise. Paris: Bonne. TANNENBAUM, EDWARD R. 1962 The Action Frangaise. New York: Wiley. WEBER, EUGEN 1962 Action Francaise. Stanford Univ. Press. WRIGHT, GORDON (1960)1962 France in Modern Times. London: Murray; Chicago: Rand McNally.

MAUSS, MARCEL Marcel Mauss (1872-1950), French sociologist, was born in Epinal (Vosges) in Lorraine, where he grew up within a close-knit, pious, and orthodox Jewish family. Emile Durkheim was his uncle. By the age of 18 Mauss had reacted against the Jewish faith; he was never a religious man. He studied philosophy under Durkheim's supervision at Bordeaux; Durkheim took endless trouble in guiding his nephew's studies and even chose subjects for his own lectures that would be most useful to Mauss. Thus Mauss was initially a philosopher (like most of the early Durkheimians), and his conception of philosophy was influenced above all by Durkheim himself, for whom he always retained the utmost admiration; by Kant, to whose work Durkheim introduced him; and by two philosophers at Bordeaux, O. Hamelin, a rationalist, and the more empirically minded A. Espinas, then concerned with the collective origin of arts, customs, and technology—subjects about which Mauss was later to write. The philosophical atmosphere was Neo-Kantian. Mauss placed third in the national agregation competition of 1895 and decided to devote himself to research.

He studied the history of religion at the Ecole Pratique des Hautes Etudes under Louis Finot, Sylvain Levi, Auguste Carriere, and A. Meillet in the Section des Sciences Historiques et Philologiques and under Alfred Foucher, Israel Levi, and Leon Marillier in the Section des Sciences Religieuses. Meillet and Levi, together with Celestin Bougie, were among his closest friends. In 1897-1898 he made a study tour to Leiden, Breda, and Oxford, where he worked with Tylor. He then studied Sanskrit and Indian texts and, as Foucher's assistant from 1900 to 1902, taught the history of the religion and philosophy of pre-Buddhist India, in 1901 succeeding Marillier to the chair in the history of the religion of "noncivilized" peoples, which he occupied for the rest of his career. He taught, in addition, at the College de France from 1930 to 1939. In 1925 he helped to found, and then became joint director of, the Institut d'Ethnologie de 1'Universite de Paris, which, by virtue of the instruction it provided and the publications it sponsored, contributed considerably to the development of field work by younger anthropologists. Mauss lectured at the Institut on ethnography until 1939, encouraging field workers to "take trouble to be exact, complete" and to have a sense for "facts and the relations between them," for "proportions and connexions" (1947, p. 5). (Apart from a brief voyage to Morocco, Mauss himself did no field work.) Mauss worked very closely with Durkheim. In addition to their major joint work, "De quelques formes primitives de classification" (Durkheim & Mauss 1903), he compiled statistical tables for Durkheim's study of suicide, and they collaborated in writing reviews. It was, on the whole, Mauss who, with his greater sense of the concrete, had an eye for the illuminating fact, while the theoretical interpretation generally originated with Durkheim. The notion of "total social facts," commonly attributed to Mauss (Levi-Strauss [1950] 1960, pp. xxiv ff.), was, according to Georges Davy (1958), born of their collaboration arising from the study of some documents of Boas and was subsequently applied by Mauss. It is indicative of the cooperative nature of the work done by the brilliant young scholars whom Durkheim had assembled around the journal Annee sociologique (published in 12 volumes between 1898 and 1913) that almost all of Mauss's major work in this period was written in collaboration: with Hubert he published "Essai sur la nature et la fonction du sacrifice" in 1899, "Esquisse d'une theorie generale de la magie" in 1904, and "Introduction a 1'analyse de quelques phenomenes religieux" in 1908; with Beuchat he

MAUSS, MARCEL published "Essai sur les variations saisonnieres des societes eskimos" in 1906; and with Fauconnet he published an important encyclopedia article on sociology in 1901. Mauss also took a major part in editing the Annee from the time of its foundation, directing the religious sociology section with Hubert, collaborating on several other sections, and contributing a vast number of reviews and notes, to which he rightly attached great importance. World War I tragically decimated the Annee sociologique group, and, after Durkheim's own early death, Mauss inherited the leadership of the group. He twice revived the journal (in the 1920s and in the 1930s) and devoted much of his time to editing posthumously published works by Durkheim, R. Hertz, Hubert, and others, thereby reducing his own output. Mauss's most important post-World War i writings may be divided into two broad categories. First, there are the major ethnological studies: the great Essai sur le don of 1925, "Effet physique chez 1'individu de 1'idee de mort suggeree par la collectivite (Australie, Nouvelle-Zelande)" of 1926, "Les techniques du corps" of 1936, and "Une categoric de 1'esprit humain: La notion de personne, celle de 'moi'" of 1938. Second, there are writings of a methodological and programmatic character on the social sciences: "Rapports reels et pratiques de la psychologic et de la sociologie," which was a presidential address to the Societe de Psychologic in 1924, "Divisions et proportions des divisions de la sociologie" of 1927, and "Fragment d'un plan de sociologie generate descriptive" of 1934. In addition, Mauss published other brief studies on a variety of subjects, among them the origins of the notion of money, the Melanesian potlatch, contract among the Thracians, joking relationships, the "Legend of Abraham," forms of civilization, social cohesion in polysegmentary societies, technology, the problem of nationality, and the sociology of Bolshevism. Mauss also led an active political life. Like Durkheim, he supported Dreyfus and Zola, and he was a leading member of the Dreyfusard Groupe des Etudiants Collectivistes. He was closely associated with the socialist leaders, in 1904 helping them to found L'humanite, to which he contributed, taking Part in strikes and supporting socialist candidates in elections. He was also much involved in the popular universities" and the cooperative movements. The evolutionary, pluralist, and liberal quality of his socialism, akin to that of Jaures, can be seen in the "Conclusions" to The Gift ([1925] 1954, Pp. 63-81), where he stressed both the loss in terms of the quality of human relationships that

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occurs when exchange becomes purely economic and the need to restore the older themes of "freedom and obligation in the gift, of generosity and self-interest in giving" (ibid., p. 66). Although Mauss is chiefly known as an ethnologist and historian of religion, he was in fact a polymath, one of the last encyclopedic minds, and had an extraordinary range of ethnographic and linguistic knowledge (his pupils said "Mauss knows everything"). Levy-Bruhl (1951, p. 4) described his conversation and lectures as full of "new and fruitful ideas of which others made theses and books." His career was brutally ended by the German occupation, which for a second time deprived him of friends and colleagues and affected the balance of his mind. He never completed projected books on money, prayer (but see Mauss 1909), and the nation (the manuscripts of which were probably destroyed), and he never synthesized his many-sided and scattered work. Contributions to theory. Mauss's theoretical contributions derive mainly from his concrete application and refinement of Durkheim's precept, "The essential thing is to unite not many facts, but facts at once typical and well-studied," as well as the precept laid down in the article written with Fauconnet (which was a sort of Durkheimian charter) that the sociologist must connect "collective representations" (i.e., collective ways of acting and thinking) with features of the social structure or with one another (1901, p. 172). Thus the study of the Eskimos explores the relations between morphological factors, on the one hand, and legal and moral systems, domestic economy, and religious life on the other. Mauss related the crowded conditions in which the Eskimos lived in the winter to the development among them of a real community of ideas, to "a strong religious and moral unity of mind," which he contrasted with the social atomization, the extreme "moral and religious impoverishment" that accompanied the dispersal in summer ([1906] 1960, p. 470). Similarly, the classic study with Durkheim of primitive classification attempts to find the origin of classifications (such as space, time, hierarchy, number, class, etc.) in the social structure by establishing formal correspondences between social and symbolic classifications among Australian aborigines, among the Zuni, and in traditional China: thus "even ideas so abstract as those of time and space are, at each point in their history, closely connected with the corresponding social organization" (Durkheim & Mauss [1903] 1963, p. 88). The elucidation of these formal correspondences is of considerable theoretical interest and suggestiveness, however

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questionable may be the causal chain that is postulated, the causal role given to affectivity, and the differentiation of cognitive operations from the content of thought (see Needham 1963). It was the first sociological study of classification and opened up the question, still immensely fruitful, of the relationship between symbolic classification and social structure. Other examples of Mauss's practice of Durkheimian precepts are the study of magic, analyzed as a social phenomenon and defined as "every rite which does not form part of an organised cult" being "private, secret, mysterious and tending at the margin towards the forbidden rite" (Hubert & Mauss [1904] 1960, p. 16); the study of sacrifice, analyzed as "a means of communication between the sacred and profane worlds, through the mediation of a victim, that is, of a thing that in the course of the ceremony is destroyed" (Hubert & Mauss [1899] 1964, p. 97); the study of the concept of the self, offering no more than a sketch of "the series of forms which this concept has assumed in the life of men in societies, according to their systems of law, their religions, their customs, their social structures and their modes of thought" (Mauss [1938] 1960, p. 335); and the studies of the social determinants of mourning rites (Mauss 1921), of the lust to die, and of uses of the body. It is, however, The Gift that must rank as Mauss's masterpiece. It is the supreme example of the study of "total social facts," being concerned with a limited range of social phenomena seen as a totality, with "wholes, with systems in their entirety" ([1925] 1954, p. 77), namely, "prestations," or systems of exchange, which are "in theory voluntary, disinterested and spontaneous, but are in fact obligatory and interested" (ibid., p. 1). He focused on a comparative study of forms of contract and exchange in Polynesia, Melanesia, and northwest America, with supplementary reference to evidence from early Roman, Hindu, and Germanic literature. The central hypotheses of the study are that "the archaic form of exchange," with its three obligations of giving, receiving, and repaying, is an aspect of almost all societies (and should be resurrected in our own), that it maintains and strengthens social bonds (cooperative, competitive, and antagonistic), and that by studying it concretely in its totality in the societies chosen, "we have been able to see their essence, their operation and their living aspect, and to catch the fleeting moment when the society and its members take emotional stock of themselves and their situation as regards others" (ibid., pp. 77-78). Gift exchange is revealed as at once religious, legal, moral, economic, aesthetic, morphological, and mythological in significance:

the obligations it involves are symbolically expressed in myth and imagery and take the form of an interest in the objects exchanged, but these objects "are never completely separated from the men who exchange them; the communion and alliance they establish are well-nigh indissoluble. The lasting influence of the objects exchanged is a direct expression of the manner in which subgroups within segmentary societies of an archaic type are constantly embroiled with and feel themselves in debt to each other" (ibid., p. 31). Apart from its considerable ethnographic interest, The Gift was the first systematic and comparative study of gift exchange and the first elaboration of the relation between patterns of exchange and the social structure. In general, it may be said that Mauss's theoretical contributions result from putting Durkheimian sociology to work, de-emphasizing its least acceptable features (the latent mysticism of the group, the crowd psychology, the identification of historical origin and analytical simplicity) and demonstrating its considerable explanatory power. Influence. Mauss's influence is particularly difficult to measure because of his deep involvement in collaborative work with Durkheim and others. He was the Durkheimians' ethnographic adviser, and his part in the studies of magic, social morphology (1906), and primitive classification was of crucial importance in the development of Durkheim's own sociology of religion and knowledge. One may likewise assert, but not measure, his influence on other Durkheimians (such as Marcel Granet) and upon those who came under their collective influence, including historians (such as Lucien Febvre and Marc Bloch) and psychologists (such as Charles Blondel). He had a direct influence, however, on French ethnology, inspiring such figures as A. Metraux, M. Leenhardt, M. Griaule, G. Dumezil, R. Bastide, and L. Dumont. He has been a major influence on Levi-Strauss, who has written about him in terms which overstate Mauss's theoretical divergence from Durkheim (Levi-Strauss 1945; 1950). LeviStrauss values above all Mauss's method, best illustrated in The Gift, of treating a total social fact as a symbolic system to be deciphered. Levi-Strauss sees this approach as "inaugurating a new era for the social sciences" ([1950] 1960, p. xxxv), for it may be generalized to the whole of social life. Thus social life may be understood as a system of transactions between groups and between individuals, the rationale of which can be established by techniques analogous to those of structural linguistics. According to Levi-Strauss, it is the great misfortune of modern ethnology that Mauss did not exploit his

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discovery; he himself applied it in his theory of the exchange basis of cross-cousin marriage, which, he maintains, shows that in the field of kinship "the analogy with language, so strongly affirmed by Mauss, has permitted the discovery of precise rules, according to which there are formed, in any society whatever, cycles of reciprocity, whose mechanical laws are thenceforth known, permitting the use of deductive reasoning and offering the promise of a vast science of communication of which anthropology will be a part" ([1950] 1960, p. xxxvi). Leacock (1954) sees Mauss's work as more oldfashioned, condemning particularly its sociologism and evolutionism. The Gift is Mauss's best-known work outside France, and indeed it is the only one that has made any impact in the United States; its theoretical suggestiveness seems by no means spent. Also influential have been the seminal studies of magic, sacrifice, and, increasingly, primitive classification. Mauss's influence is especially hard to identify in these areas because his work has entered into the common theoretical inheritance, often operating through the medium of colleagues and disciples. He appears particularly to have influenced the following anthropologists: A. R. Radcliffe-Brown, B. Malinowski (both of whom in different ways distorted his somewhat refined Durkheimianism), E. E. Evans-Pritchard, R. Firth, M. J. Herskovits, W. Lloyd Warner, and R. Redfield, among others. More generally, his influence is especially apparent in the anthropological work emanating from Oxford (via Evans-Pritchard) and in the work of the Leiden school (especially F. D. E. van Ossenbruggen and J. P. B. de Josselin de Jong). But the rich possibilities of his work have still to be fully exploited. STEVEN LUKES [See also ETHNOGRAPHY; EXCHANGE AND DISPLAY; MAGIC; MYTH AND SYMBOL; RITUAL; SOCIAL STRUCTURE; and the biographies of BLOCK; DURKHEIM; FEBVRE; GRANET; HERSKOVITS; MALINOWSKI; METRAUX; POLANYI; RADCLIFFE-BROWN; REDFIELD.] WORKS BY MAUSS (1899) 1964 HUBERT, HENRI; and MAUSS, MARCEL Sacrifice: Its Nature and Function. Univ. of Chicago Press. -» First published as "Essai sur la nature et la fonction du sacrifice" in Volume 2 of Annee sociologique. (1899-1905) 1909 HUBERT, HENRI; and MAUSS, MARCEL Melanges d'histoire des religions. Paris: Alcan. -» A collection of previously published articles. See especially the preface. 1901 FAUCONNET, PAUL; and MAUSS, MARCEL Sociologie. Volume 30, pages 165-176 in La grande encyclopedic: Inventaire raisonne des sciences, des lettres et des arts. . . . Paris: Societe Anonyme de La Grande Encyclopedie.

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(1903) 1963 DURKHEIM, EMILE; and MAUSS, MARCEL Primitive Classification. Translated and edited with an introduction by Rodney Needham. Univ. of Chicago Press. -» First published as "Do quelques formes primitives de classification" in Volume 6 of Annee sociologique. (1904) 1960 HUBERT, HENRI; and MAUSS, MARCEL Esquisse d'une theorie gencrale de la magic. Pages 1141 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» First published in Volume 7 of Annee sociologique. (1906) 1960 Essai sur les variations saisonnieres des societes eskimos: Etude de morphologic sociale. Pages 389-477 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» With the collaboration of H. Beuchat. First published in Volume 9 of Annee sociologique. 1908 HUBERT, HENRI; and MAUSS, MARCEL Introduction a 1'analyse de quelques phenomenes religieux. Revue de I'histoire des religions 58:163-203. 1909 La priere. I: Les origines. Unpublished manuscript. -> The beginning of a larger work; distributed privately. 1921 L'expression obligatoire des sentiments: Rituels oraux funeraires australiens. Journal de psychologie 18:425-434. (1924) 1960 Rapports reels et pratiques de la psychologie et de la sociologie. Pages 281-310 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» First published in Journal de psychologie normale et pathologique. (1925) 1954 The Gift: Forms and Functions of Exchange in Archaic Societies. Glencoe, 111.: Free Press. -» First published as Essai sur le don: Forme et raison de I'echange dans les societes archa'iques. (1926) 1960 Effet physique chez 1'individu de 1'idee de mort suggeree par la collectivite (Australie, NouvelleZelande). Pages 311-330 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -> First published in Journal de psychologie normale et pathologique. 1927 Divisions et proportions des divisions de la sociologie. Annee sociologique New Series [1924—1925]: 98-173. 1934 Fragment d'un plan de sociologie generale descriptive. Annales sociologiques Series A 1; 1-56. (1936) 1960 Les techniques du corps. Pages 363-386 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» First published in Journal de psychologie. (1938) 1960 Une categorie de 1'esprit humain: La notion de personne, celle de "moi." Pages 331-362 in Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» First published (in French) in Volume 68 of the Journal of the Royal Anthropological Institute of Great Britain and Ireland. 1947 Manuel d'ethnographic. Paris: Payot. -» Based on a course given annually from 1926 to 1939 at the Institut d'Ethnologie de 1'Universite de Paris. Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France, 1960. -> A collection of essays first published between 1904 and 1938. SUPPLEMENTARY BIBLIOGRAPHY

DAVY, GEORGES 1958 In Memoriani: Emile Durkheim. Annee sociologique 3d Series [1957-1958] :vii-x. GUGLER, JOSEF 1961 Die neuere franzosische Soziologie: Ansdtze zu einer Standortbestimmung der Soziologie. Neuwied (Germany): Luchterhand.

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GUGLER, JOSEF 1964 Bibliographic de Marcel Mauss. Homme 64:105-112. -» The most complete bibliography of Mauss's publications (excluding those in socialist journals and the numerous notes and reviews in the Annee sociologique and the Notes critiquesSciences sociales). Includes not only his writings but also summaries of his comments at meetings of academic societies and congresses. LEACOCK, SETH 1954 Ethnological Theory of Marcel Mauss. American Anthropologist New Series 56:5873. -> Selected bibliography appended. LEVI-STRAUSS, CLAUDE 1945 French Sociology. Pages 503-537 in Georges Gurvitch and Wilbert E. Moore (editors), Twentieth Century Sociology. New York: Philosophical Library. LEVI-STRAUSS, CLAUDE (1950) 1960 Introduction a 1'oeuvre de Marcel Mauss. In Marcel Mauss, Sociologie et anthropologie. 2d ed. Paris: Presses Universitaires de France. -» The most important study of Mauss to date. Contains a selected bibliography. LEVY-BRUHL, H. 1951 In Memoriam: Marcel Mauss. Annee sociologique 3d series [1948-1949]: 1-4. MERLEAU-PONTY, MAURICE (1953) 1960 De Mauss a Claude Levi-Strauss. Pages 145-169 in Maurice Merleau-Ponty, Eloge de la philosophic, et autres essais. Paris: Gallimard. NEEDHAM, RODNEY 1963 Introduction. In Emile Durkheim and Marcel Mauss, Primitive Classification. Univ. of Chicago Press.

MAXIMUM LIKELIHOOD See ESTIMATION. MAYO, ELTON While the published writings of Elton Mayo (1880-1949) now seem to be mainly of historical interest, he personally had an enormous influence in the development of industrial sociology and psychology and in the stimulation of men who have made major contributions to research and theory. Mayo was particularly influenced by the writings of the psychologist Pierre Janet. He combined an interest in psychoneuroses and what he termed "obsessive thinking," derived from his study of Janet, with the approach to culture and social structure of the social anthropologists Bronislaw Malinowski and A. R. Radcliffe-Brown. In research methods he adapted the interviewing methods of clinical psychologists to the field methods of the anthropologists and brought them to bear on studies of industrial organizations. Mayo was born in Adelaide, Australia, the second of seven children. He came from a family of professional men. In the process of finding his vocation, Mayo ranged widely in space and experience: from medical student to newspaperman to laborer to businessman, from Scotland to west Africa and back to Australia. From the printing business, he turned to the study of psychology at Adelaide Uni-

versity. A psychiatric treatment program he and a collaborator organized toward the end of World War i to deal with soldiers suffering from shell shock led to his appointment in 1919 to the newly established chair of philosophy at the University of Queensland. Rockefeller and Carnegie foundation grants brought him to the United States and supported his first research in human relations in industry, which he began while at the University of Pennsylvania. The site of his first research in this field was a textile mill. The most productive period of his life began in 1926, when he accepted a position at Harvard University's Graduate School of Business Administration. In association with Lawrence J. Henderson, an eminent biological chemist and devotee of Pareto, Mayo organized a research team to study the psychological and social problems of industrial workers. The aim from the beginning was to follow these problems wherever they led, without regard to customary disciplinary boundaries. In 1927 Mayo launched the now famous Western Electric research program. He worked particularly with Fritz J. Roethlisberger, William J. Dickson, and T. North Whitehead, and it was they who produced the principal research reports of the studies carried on at the Hawthorne Works in Chicago. As director of the program, Mayo had the task of handling the diplomacy involved in making such an unprecedented research effort acceptable within a company, and he also made important contributions to the design of the research program and to the interpretation of the results (see Management and the Worker by Roethlisberger & Dickson 1939). While Mayo was primarily interested in problems of individual adjustment, he recognized the necessity of examining such individual problems in the context of organizations and social structure. He was instrumental in bringing W. Lloyd Warner to Harvard and worked closely with him in launching the Yankee City study. At the same time, Warner became consultant to the Western Electric research program and there stimulated the analysis of problems of group and organizational structure. In all his writings Mayo was concerned with two basic ideas, one dealing with the nature of society, the other dealing with the problems of individuals. He argued that the industrial revolution had destroyed traditional society in which people responded to each other in terms of established routines. The breakdown in these traditional understandings had led to widespread conflict in industry and society. The traditions of old could not

MEAD, GEORGE HERBERT be re-established, and, therefore, the only solution must be to build an adaptive society in which an administrative elite, trained in social understandings and skills, would resolve human as well as technical problems. He saw workers suffering from a form of anomie, the failure to find a satisfactory place for themselves in the world of work, with a consequent involvement in obsessive reveries in which they brooded unproductively over their problems. For dealing with these problems of obsessive thinking, he had great faith in the therapeutic relationship in which the individual is encouraged to talk out his problems freely to an interested listener. Although Mayo directed the Western Electric research program, the principal research fruits of that program bear little relation to Mayo's ideas about social integration, obsessive thinking, and psychotherapy. To be sure, Management and the Worker does devote chapters to the personnelcounseling program, a direct outgrowth of Mayo's ideas, but that program was later abandoned by the company and never served as a model for other companies. Furthermore, few research men today consider a personnel-counseling program of much importance in dealing with problems of human adjustment in industry. The principal fruits of the Western Electric studies are found in those parts of Management and the Worker which deal with informal relations among workers, with workermanagement relations, and with the methods for gathering systematic observational and interviewing data upon behavior in organizations. These contributions provided the foundation for the very rapid development of research on organizational behavior in the two decades following publication of that book in 1939. Mayo, as the father of research on the human problems of industry, also became the principal target for attack. Critics argued that there was no place in his philosophy for conflict, that he sought to achieve organizational harmony through the subordination of individual and group interests by the administrative elite, and that he did not understand the role of unions in a free society. Mayo's supporters replied that he had no illusions about the possibility of establishing perfect harmony in any industrial society. He simply observed that there is so much destructive conflict that it is well to seek better ways of handling human problems. While Mayo has been charged with being antiunion, it might be more accurate to say that he was simply indifferent to unions. In his most productive period of work with Western Electric, the company had only a weak company union. Al-

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though unions had become a prominent part of the industrial scene long before Mayo's death, he did not think they fundamentally altered those human problems of industry that interested him, and he never integrated unions into his thinking about industry. Mayo was not a systematic theoretician. He had a wide-ranging mind and creative social abilities. Few men have contributed as much as he to the establishment of new fields of social research and teaching. He was a behavioral scientist long before the term became popular. WILLIAM F. WHYTE [See also GROUPS, article on THE STUDY OF GROUPS; INDUSTRIAL RELATIONS; ORGANIZATIONS, article on THEORIES OF ORGANIZATIONS; WORKERS; and

the

biographies of HENDERSON; JANET; MALINOWSKI; RADCLIFFE-BROWN.] WORKS BY MAYO (1933) 1946 The Human Problems of an Industrial Civilization. 2d ed. Boston: Harvard Univ., Graduate School of Business Administration. -> A paperback edition was published in 1960 by Viking. 1945 The Social Problems of an Industrial Civilization. Boston: Harvard Univ., Graduate School of Business Administration. 1947 The Political Problem of Industrial Civilization. Boston: Harvard Univ., Graduate School of Business Administration. 1948 Some Notes on the Psychology of Pierre Janet. Cambridge, Mass.: Harvard Univ. Press. SUPPLEMENTARY

BIBLIOGRAPHY

BENDIX, REINHARD; and FISHER, LLOYD H. 1949 The Perspectives of Elton Mayo. Review of Economics and Statistics 31:312-319. HOMANS, GEORGE C. 1949 Some Corrections. Review of Economics and Statistics 31:319-321. ROETHLISBERGER,

FRITZ J.;

and

DlCKSON,

WlLLIAM J.

(1939) 1961 Management and the Worker: An Account of a Research Program Conducted by the Western Electric Company, Hawthorne Works, Chicago. Cambridge, Mass.: Harvard Univ. Press. -> A paperback edition was published in 1964 by Wiley. URWICK, LYNDALL F. 1960 The Life and Work of Elton Mayo. London: Urwick. WARNER, W. LLOYD et al. 1941-1959 Yankee City Series. 5 vols. New Haven, Conn.: Yale Univ. Press.

MEAD, GEORGE HERBERT The work of George Herbert Mead (1863-1931), one of the leading figures in pragmatism, has had a profound impact on the development of American social science. Despite the lavish praise of Dewey and Whitehead, most philosophers tended to neglect him, because his ideas were not readily accessible during his lifetime. He was reluctant to set down in writing views that were still being

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formed; he published no books, and many of his articles dealt with education, psychology, and sociology. Communicating most effectively in oral discourse, Mead developed his thoughts in extemporaneous lectures at the University of Chicago, where he taught from 1893 to the time of his death. Although his style was involved and labored and even his admirers acknowledged difficulties in deciphering his sentences, the classes were wellattended; and his influence upon colleagues and students, especially in sociology and social psychology, is readily discernible in their writings. Four posthumous volumes have been pieced together by devoted students from stenographic notes of his lectures, fragmentary manuscripts, and tentative drafts. Pragmatism represents an attempt to reformulate conceptions of man and his place in the universe in terms of the revolutionary implications of scientific method and of evolutionary theory. Mead viewed evolution as the process of meeting and solving problems and scientific method as the evolutionary process grown self-conscious. The characteristics of various species develop as organisms come to terms with life conditions, and Mead wanted to account for the emergent properties of man—thinking in abstractions, self-consciousness, and purposive and moral conduct. He contended that these attributes rest on the development of language, a form of social interaction that evolves among human beings as they meet the exigencies of living in groups. Thus, Mead's central hypothesis made social psychology basic to his philosophical work. His approach was behavioristic, although not in the narrow sense of John B. Watson: man is to be studied in terms of his deeds, covert as well as overt. Since, however, each person is involved in a succession of joint enterprises with others, his acts can best be regarded as segments of larger transactions. Social psychology is the study of regularities in individual behavior that develop from participating in groups. Mead also stressed the temporal dimension—the extension of individual and group activities over time. Analysis of the "act" Society is an ongoing process and consists of social acts. By social act Mead meant a transaction involving two or more persons among whom there is a division of labor. The contributions of various individuals are coordinated to achieve objectives that bring gratifications of some sort to each. Unlike the instinctive cooperation found among social insects, concerted action among human beings is characterized by a high degree of flexibility. The

participants build up a social act as they continuously adjust to one another and to the demands of the developing situation. Should there be drastic environmental change, entirely novel patterns may emerge. Such concurrence among separate and independently motivated individuals is made possible by role taking, the ability of each to visualize his own performance from the standpoint of the others. Each person is able to comprehend the entire transaction, locate himself within it, and regulate his own contributions to fit into the larger pattern. Coordination depends, then, on the selfcontrol of each actor. In highly institutionalized transactions, collaboration is facilitated insofar as the participants share a common perspective; each of them takes the role of a generalized other. The execution of a social act is a communicative process; transactions of all kinds develop in the reciprocating adjustments of the participants. Mutual orientation is built up and maintained in a continuous interchange of gestures. A gesture is any perceptible sound or movement which indicates to a second party the inner experiences or intentions of the first; any act may become a gesture when an observer responds to it in terms of what it represents. Speech, which consists of vocal gestures, is of special importance. Since a speaker is able to hear his own remarks in much the same manner as his audience, the establishment of mutual understanding becomes easier. A gesture that has the same meaning for two or more people is a significant symbol, and language consists of such conventional sounds. Those who are associated in common activities eventually develop a universe of discourse, which facilitates their subsequent collaboration. Although each deed is a fragment of a larger social act, it is also an episode in the life of an individual. Mead's basic unit of analysis is the act, which is initiated by some want and is directed toward its satisfaction through the use of suitable elements of the environment. All behavior can be broken down, for purposes of analysis, into a series of acts. Each act has a history; it is constructed as an organism makes a succession of adjustments to conditions (external and internal) that are unT dergoing constant change. Overt behavior is usually only the final phase of an act; in most cases it is preceded by a number of preparatory adjustments, including various subjective experiences. An act is teleological; it is not a mere sequence of passing events but an organized whole directed toward an end. To study such processes Mead proposed the concepts of impulse, perception, manipulation, and consummation. An impulse is a disturbance, any lack of adjustment between the organism and its

MEAD, GEORGE HERBERT milieu—pique over an imagined slight, hunger pangs, or concern over a difficult task to be faced. Consummation is the elimination of the disturbance. In his study of motivation, then, Mead developed an approach resembling some of the more recent tension-reduction models. His scheme was comprehensive, and his concepts made it possible to show the relationship between organic needs, external stimulation, conscious intent, and overt movements. Between the terminal points of the act lie perception and manipulation; it is through these processes that various features of the environment become involved in the act. An organism is in continuous interaction with its milieu, and activity is redirected in response to a succession of sensory cues. Perception is selective: not everything in the environment is noticed. An object is something that is essential to the completion of the act, and a person is sensitized to whatever will enable him to carry out activity that is already under way. Both perception and manipulation rest upon hypotheses. An object is approached in terms of expectations: a person anticipates what would happen if he were to move forward and touch it. For this reason Mead referred to perception as a "collapsed" or "telescoped" act. What is perceived depends in part upon what is anticipated; these hypotheses are then tested and confirmed in manipulation, the handling of objects as tools. The hypotheses upon which perception and manipulation rest are derived from the meanings of objects. For pragmatists meaning is primarily a property of behavior and only secondarily a property of the objects themselves. Meanings are stable relationships between an organism and a class of objects, defined in the manner in which the latter are characteristically handled. Physical attributes are important because they set limitations upon what can be done. Most meanings are subject to social control in that the anticipated reactions of other people place additional restrictions on usage. Approaching sacred objects without sufficient deference, for example, elicits outraged protests. Such expectations are incorporated into the organization of the act. Members of each species select out of their environment objects that are essential to their survival and organize responses toward them; the world view of human beings is necessarily anthropomorphic and social. But pragmatism is fiot solipsistic. Reality is objectified through activJ ty, but the orientations which support such activity are subject to reality testing. Hypotheses that turn out to be unreliable are rejected, and objects are redefined. Once an act is under way, it generally proceeds

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to consummation. One of the major contentions of pragmatists is that thinking is a form of behavior that occurs when activity is interrupted. The interference may arise from an external barrier, a disability of the organism, or an absence of necessary objects. When an act is blocked, a number of secondary adjustments take place, including emergency mobilization (emotion) and conscious reflection; and through these processes a delayed act may eventually be completed. Any impulse that is not immediately consummated is transformed into an image, which serves as the basis for reflection. Images are acts that fail to issue in overt behavior, acts that are innervated but not carried out. Each image may be regarded as a plan of action, one possible way of completing the interrupted act. A perplexed individual experiences a succession of images, and reflective thought is an imaginative rehearsal—a comparison and evaluation of alternative routes to consummation. Mentality may be regarded as the ability to anticipate the consequences of projected lines of action and to respond to them prior to commitment to overt action. Thinking, then, is problem-solving activity in which trial and error takes place in the imagination. Once a person has mastered a language, images and objects may be designated by symbols; alternative plans of action are labeled, and their consequences are examined verbally. Consciousness is inner discourse, sub vocal linguistic communication. While thinking is a private experience, it takes place through significant symbols; it is therefore behavior organized from the standpoint of a generalized other. The use of language transforms the effective environment to which human beings adjust. By using words, one can manipulate meanings outside the contexts in which they have developed and even make up more complex meanings. Foresight and planning are greatly facilitated. With symbols one can isolate certain experiences and hold on to them, pick out other relevant meanings, or emphasize a particular image while rejecting others. Language also makes possible the formulation of complex plans, broad schemes in which diverse and even antagonistic tendencies may be coordinated and a sequence of operations performed. Mind for Mead was internal symbolic communication, and it is this type of cognitive activity that computer engineers are now attempting to reconstruct. Modern decision theory describes regularities in the selection process. Analysis of the "self" Mead is best known for his theory of the self. The self is not one's body but a perceptual object. Since most acts are components of larger trans-

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actions, the actors are interdependent; the impulses of one cannot be consummated without the cooperation of his associates. Each participant therefore becomes concerned over the possible reactions of the others to himself, for he cannot afford to do anything that will jeopardize their support. Each person forms an object of himself through role taking, by reviewing his intended conduct from the standpoint of those with whom he is involved in a common venture. Mead's discussion was rendered unnecessarily difficult by his use of the term "self" to designate three different referents: (1) the perceptual object formed of oneself in a particular historical context, (2) the process of self-control, and (3) one's personality. Voluntary conduct is constructed in a sequence of adjustments in which a person responds to himself as well as to the rest of his perceptual field. To study this process Mead proposed the concepts of the / and the Me; these terms refer not to agents but to phases of activity. The "Me" is the object one forms of oneself from a conventional standpoint, and the "I" is the reaction of the unique individual to the historical situation as he perceives it. Typical inclinations to react differ from person to person; in fact, the succession of "I's" constitutes the basis of individuality. In speaking of behavior as being built up in the interaction of the "I" and the "Me," Mead was stressing the seriated character of human conduct. If an impulse (I) is not immediately carried out, it is transformed into an image (Me), which in turn elicits another reaction (I). For example, if a man believes that his wife is disparaging his efforts (Me), he may want to beat her (I). As he refrains from striking, he imagines himself administering the beating (Me). Since he views himself from the standpoint of a group in which wife beaters are condemned, he reacts with disgust (I), and this inhibits one route to consummation. Frustrated and hurt (Me), he reacts with determination to demonstrate his competence through a superlative performance (I). Thus, an individual's line of conduct is constructed as he adjusts to a succession of organic states, perceptual objects, images, and anticipated reactions of other people. Self-control is part of the ongoing social current; each person adjusts in advance to the situation in which he is involved and thereby facilitates cooperation. In this process self-consciousness provides the basis for corrective measures. For Mead, as for Norbert Wiener, autonomy depends upon feedback; without it one becomes a creature of impulse or is subject to drift or external control. A crucial feature of feedback in self-control is that the object is formed from a standpoint shared with other people. The

fact that all participants control themselves from the same perspective (generalized other) makes concerted action possible. A human being is not born with a mind and self-discipline; these capacities develop gradually as the child comes to terms with the demands of group life. The meanings of objects and gestures are products of experience; appropriate ways of handling things and of speaking are shaped largely by the consistent responses of elders, who provide instructions, serve as models, and reinforce the accepted modes of conduct. Mead emphasized two especially important contexts for socialization. In play young children assume specific roles and imitate individuals they know—mother, postman, salesclerk. In so doing they begin to appreciate the perspectives of others. By repeating such role taking the child is able to build up an orientation toward himself as an object of a certain sort. But effective self-control develops only in the game— or in any other enterprise that requires teamwork. In games the responses of others are organized, and activity proceeds according to rules. The contributions expected of each player are standardized into impersonal roles. Furthermore, successful participation requires the ability to assume multiple positions vis-a-vis oneself: one must be ready to take the role of any other player. Through repeated participation in such transactions, the child learns to adopt a point of view that is shared by all other participants (generalized other), a perspective that transcends that of particular individuals. Although Mead saw human beings as inextricably involved in groups, he stressed the importance of individuality. Each person, although a product of society, retains his distinctiveness, for he incorporates the generalized other from a unique standpoint. As one develops the capacity for conscious communication, one achieves greater independence from others and greater discreteness as an individual. For each person self-realization is attained through the consummation of a distinct set of impulses; what brings fufillment to one individual will not necessarily satisfy another. Furthermore, each person has a unique impact upon his community. Even when he is complying with conventional norms, he does so in his own style. The contributions of a genius are often striking and extensive and therefore more readily discernible, but everywhere allowances have to be made for the idiosyncrasies of the less talented. Thus, through self-assertion, each individual alters somewhat the social pattern in which he participates. As a social philosopher Mead had a deep bias toward amelioration through understanding. The

MEDICAL CARE: Ethnomedicine son of a Congregationalist minister in Ohio, he may have been influenced by the climate of opinion of his community, a station of the Underground Railroad and locale of the first college to admit women. He believed that progress takes place through the constant meeting and solving of problems. Social institutions, like everything else in nature, are continually evolving, but men can direct this process through intelligent action. Scientific method provides the most efficient way of solving problems and should be used to facilitate human adaptation. The ideal society is one in which there is maximum participation by all members, one in which each person understands all the others and still retains his individuality. This ideal, while imperfectly realized, is constantly being approximated. Mead believed that history is on the side of progress and that eventually a brotherhood of man will emerge. Since pragmatism is an application of scientific method to philosophical problems, it is not surprising that Mead's position is so much like the developing outlook of the natural and social sciences. Mead was a thinker who was ahead of his time. His views on matter, space, time, and relativity are similar to those of modern theoretical physics; and his discussion of meaning resembles P. W. Bridgman's work on operational definitions. Many of the ideas Mead developed at the turn of the century are now widely accepted in social psychology: the selective and seriated character of perception, cognition through linguistic symbols, role enactment, decision processes, autonomy through feedback, personal identity, reference groups, and socialization through participation. Because of the congruence of Mead's views with current trends, it seems likely that increasing attention will be directed to his work. Many implications of his position still remain to be explored. TAMOTSU SHIBUTANI [For the historical context of Mead's work, see INTERACTION, article on SOCIAL INTERACTION; SOCIOLOGY, article on THE DEVELOPMENT OF SOCIOLOGICAL THOUGHT; and the biographies of DARWIN; DEWEY; HEGEL; JAMES; MARX; PARK; PEIRCE; SMITH, ADAM; SULLIVAN; THOMAS. For discussion of the subsequent development of Mead's ideas, see COMMUNICATION; DEVIANT BEHAVIOR; KNOWLEDGE, SOCIOLOGY OF; ROLE, article on SOCIOLOGICAL ASPECTS; SELF CONCEPT; SEMANTICS AND SEMIOTICS; SYSTEMS ANALYSIS, article on SOCIAL SYSTEMS; and the biographies of ANGELL; BECKER; BURGESS; COOLEY; FOLLETT; MERRIAM; MEYER; WALLER.] WORKS BY MEAD (1932) 1959 The Philosophy of the Present. La Salle, 111.: Open Court. 1934 Mind, Self and Society From the Standpoint of a

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Social Behaviorist. Edited by Charles W. Morris. Univ. of Chicago Press. -» Contains a complete bibliography. 1936 Movements of Thought in the Nineteenth Century. Univ. of Chicago Press. 1938 The Philosophy of the Act. Univ. of Chicago Press. Selected Writings. Edited with an introduction by Andrew J. Reck. Indianapolis, Ind.: Bobbs-Merrill, 1964. SUPPLEMENTARY BIBLIOGRAPHY

BLUMER, HERBERT 1966 Sociological Implications of the Thought of George Herbert Mead. American Journal of Sociology 71:534-544, 547-548. CLAYTON, ALFRED S. 1943 Emergent Mind and Education: A Study of George H. Mead's Bio-social Behaviorism From an Educational Point of View. New York: Columbia Univ., Teachers College. KOLB, WILLIAM L. 1944 A Critical Evaluation of Mead's "I" and "Me" Concepts. Social Forces 22:291-296. LACUNA, GRACE A. DE 1946 Communication, the Act, and the Object, With Reference to Mead. Journal of Philosophy 43:225-238. LEE, GRACE C. 1945 George Herbert Mead: Philosopher of the Social Individual. New York: King's Crown Press. NATANSON, MAURICE 1956 The Social Dynamics of George H. Mead. Washington: Public Aifairs Press. -> Contains an extensive list of secondary sources. STRONG, SAMUEL M. 1939 A Note on George H. Mead's The Philosophy of the Act. American Journal of Sociology 45:71-76.

MEAN VALUES See STATISTICS, DESCRIPTIVE, article on LOCATION AND DISPERSION.

MEASUREMENT See CONTENT ANALYSIS; ECONOMETRICS; EVALUATION RESEARCH; PANEL STUDIES; PSYCHOMETRICS; SCALING; SOCIOMETRY; STATISTICS; STATISTICS, DESCRIPTIVE, article on LOCATION AND DISPERSION; STRATIFICATION, SOCIAL, article on THE MEASUREMENT OF SOCIAL CLASS; SURVEY ANALYSIS.

MECHANISMS See DEFENSE MECHANISMS and FUNCTIONAL ANALYSIS. MEDIATION See DIPLOMACY; LAROR RELATIONS; INTERNATIONAL CONFLICT RESOLUTION; NEGOTIATION.

MEDICAL CARE i. ETHNOMEDICINE n. SOCIAL ASPECTS in. ECONOMIC ASPECTS

Charles C. Hughes William A. Glaser Rashi Fein

ETHNOMEDICINE

Judging from paleopathological evidence, diseases of one kind or another have always afflicted

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man. Indeed, given the nature of life and the nature of disease, it could not be otherwise; for disease is but an expression of man's dynamic relationship with his environment. And even as there has always been sickness, accident, deformity, and anxiety to trouble man, so, too, has there been an organized, purposeful response by society to such threats. In all human groups, no matter how small or technologically primitive, there exists a body of belief about the nature of disease, its causation and cure, and its relations to other aspects of group life. There also exist therapeutic and preventive practices, many of which are empirically efficacious by standards of modern medicine, although often not for the reasons advanced by folk belief. The variability of societies and cultural systems impedes easy generalization about the nature of "primitive" or "folk" medicine (cf. Ackerknecht 1942&), but one common characteristic is its close integration with other institutions of the society. Religion, medicine, and morality are frequently found together in the behavioral act or event, and "folk medicine" becomes "social medicine" to an extent not found in industrialized societies. The term "ethnomedicine" will be used to refer to those beliefs and practices relating to disease which are the products of indigenous cultural development and are not explicitly derived from the conceptual framework of modern medicine. In this light, most of the following discussion focuses on the non-Western, nonindustrialized societies of the world, although it is clear that in "modern" societies as well there exist beliefs and practices relating to disease and its treatment which are based on magical or religious conceptions rather than on those of scientific medicine. Theory of disease. Man, everywhere, devises or divines causes for the significant events in his life. The afflictions which beset body and mind are explained in both naturalistic and supernaturalistic terms. A cut finger, a broken limb, a snake bite, a fever, the halting speech and wandering mind of senility—all may be regarded as sometime hazards in life. To explain such events there is always some conceptual framework founded in common-sense empiricism. But often a wound does not heal, a sickness does not respond to treatment, and the normally expected and predictable does not happen. In such cases another order of explanation is employed, one which attempts to come to terms with the more basic meaning of the event in metaphysical perspective. For most non-Western societies this transcendent explanation for the occurrence of disease tends to figure more pervasively in the total body of medical lore and practice than does

the empirical framework. One reason is the greater incapacitation and mortality from disease in the underdeveloped world than in highly industrialized societies. In addition, this reality is coupled with the comparative inadequacy of ethnomedical techniques and knowledge for dealing with these com* mon threats to the existence of the group and the person. Widespread throughout the world are five basic categories of events or situations which, in folk etiology, are believed responsible for illness: (1) sorcery; (2) breach of taboo; (3) intrusion of a disease object; (4) intrusion of a disease-causing spirit; and (5) loss of soul (Clements 1932). Not every society recognizes all five categories; indeed, many groups are selective in the emphasis placed upon one or a combination of causes. For example, the Eskimo most frequently trace the origin of diseases to soul loss and breach of taboo, while the malevolence of sorcerers or witches is especially emphasized in many African cultures. Usually, however, these categories are more useful in analytically characterizing the etiological beliefs of a particular group than in describing the content of an entire belief system. This would be the case where a disease is believed to be caused by the intrusion of an object which contains a spirit, and it is the latter to which primary causative influence is attributed (e.g., Hallowell 1935). The Greeks were not alone in viewing disease as a manifestation of disharmony in man's over-all relation to the universe. "Health" is rarely, if ever, a narrowly restricted conception having its locus only in the well-being of the individual body. In discussing conceptions of illness among a west African people, Price-Williams gives a modern illustration : In common with a great many other people, Tiv do not regard "illness" or "disease" as a completely separate category distinct from misfortunes to compound and farm, from relationship between kin, and from more complicated matters relating to the control of land. But it would be completely erroneous to say that Tiv are not able, in a cognitive sense, to recognize disease. As Bohannan has said: "The concept of a disease is not foreign to the Tiv: mumps, smallpox, . . . yaws and gonorrhoea are all common and each has a name." What is meant is that disease is seldom viewed in isolation. (1962, p. 125) Such a notion is widely found, as in certain American Indian groups, where bodily or mental affliction is often viewed as an indicator of moral transgression, in thought or in deed, against the norms of society. Indeed, man is frequently thought of as continuous with both the social and nonsocial

MEDICAL CARE: Ethnomedicine aspects of his environment, and what happens in his surroundings affects his bodily well-being. Not only a person's own actions, therefore, but also those of kinsmen or neighbors can cause sickness. Such an etiological conception has obvious implications for treatment. For example, if the curative technique includes magically based dietary restrictions, they may apply to all members of the patient's family; a breach of the restriction by any of these people will undermine the patient's health. Similarly, as among the Thonga of South Africa, sexual relations between any of the inhabitants of the patient's village can aggravate his condition, and some Eskimo groups feel that the patient's family should do no work during the period of convalescence for fear of giving offense to the spirit causing the sickness. The belief that by his own actions a man can influence the state of his fellow's health also has malevolent implications, as in the practice of witchcraft and sorcery. Frequently this may be an important factor deciding the success or failure of attempts at introducing new medical programs in underdeveloped societies. Cassel (1955) cites as an illustration the Zulu, who believe that only sorcerers and witches have the ability to transmit disease, particularly diseases which show themselves in symptoms normally associated with pulmonary tuberculosis. Progress in one community's acceptance of a Western-styled health program was brought to an abrupt halt when a physician tried to introduce the medical concept of contagion. He traced the course of tuberculosis through a family, showing how one person had been the original source of the disease in the group and had therefore been the agent responsible for sickness in all the others. The cautious cooperation of the family elder immediately turned into a hostile rejection, which was assuaged only after the doctor had retracted his apparent accusation that the daughter of the family was a witch. A theory of disease implies a theory of normality. Yet the "normal" is in no way easy to define for all times and places. Aside from questions of a "statistical" versus a "functional" basis for normality, there is the cultural definition. Afflictions common enough in a group to be endemic, though they be clinical deformities, may often be accepted simply as part of man's natural condition. Ackerknecht (1946), for example, has noted that the Thonga believe intestinal worms, with which they are pervasively affected, to be necessary for digestion; the Mano, also of Africa, feel that primary and secondary yaws are so common that they say, "That 18 no sickness; everybody has that." North Ama-

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zonian Indians, among whom dyschronic spirochetosis is prevalent, accept its endemicity to such an extent that its victims are thought to be normal, and individuals who have not had the disfiguring disease are said to be looked upon as pathological and consequently unable to contract marriage. It is culture, not nature, that defines disease, although it is usually culture and nature which foster disease. Recent behavioral science research has attempted to go beyond a "phenomenological" orientation in investigation of cultural theories of disease and has sought analytic categories which would relate particular emphases in a theory of disease to other aspects of social and cultural life. A striking example of this type of investigation is the work of John Whiting and Irvin Child (1953). Using a wide sample from the ethnographic "laboratory," these investigators found high correlations between certain aspects of child-rearing practices and dominant themes in etiological beliefs related to disease, more particularly, between the hypothesized degree of anxiety generated during the socialization process—the degree of "negative fixation"— and a theory of disease which reflects these anxieties. Thus, harsh weaning is highly associated with oral explanations for onset of disease: these would include consumption of food, drink, or poison by the sick individual or oral activity on the part of others, such as incantations and spells. Societies in which independence training is characteristically fraught with emotional hazards tend also to have "dependence" explanations of illness. These include soul loss or spirit possession. "Aggression explanations" for disease are highly associated with societies in which training for handling aggressive impulses leaves a residue of unresolved anxiety, and they are expressed in theories which ascribe the cause of a disease to the patient's disobedience or aggression toward spirits, to aggressive wishes on the part of the patient or another person, to introjection of poison other than by mouth, or to harm by magical weapons or objects. Theory and practice of treatment. Therapeutic practices in ethnomedicine address themselves to both supernatural and empirical theories of disease causation. Ackerknecht has said that primitive medicine is "magic medicine" (1942b); certainly much of it is, and, insofar as supernatural causes are involved, therapeutic regimes are based on countervailing supernatural powers or events. Thus, the powerful shaman or healer attempts to recover the soul lost or stolen by a human or supernatural agent. The intrusion of a disease object or diseasecausing spirit is treated by extraction or exorcism,

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and diseases which come as punishment for breach of taboo are usually treated by divination or confession of the infraction. Forgiveness and re-establishment of harmony with the moral and supernatural order are thus important outcomes of the therapy. In folk medicine, however, there is more to treatment than magical or religious ritualization, however effective this may be psychosocially in providing emotional catharsis and reassurance. All human groups have a pharmacopoeia and at least rudimentary medical techniques; some groups, indeed, are exceptional in their exploitation of the environment for medicinal purposes and in the degree of their diagnostic and surgical skills (Ackerknecht 1942b; Sigerist 1951; Laughlin 1963). The trephining done by the Inca, Masai surgery, the anatomical knowledge of the Aleut and the Eskimo, and the extensive drug repertory of west African tribes are familiar examples. In addition to trephining, numerous other types of surgery and bonesetting are found, as well as massages, bloodletting, dry cupping, bathing, inoculation, and cauterization. It has been estimated that from 25 to 50 per cent of the non-Western pharmacopoeia is empirically effective. In fact, our knowledge of the therapeutic efficacy of a large number of modern drugs is derived from the experience of primitive peoples: opium, hashish, hemp, coca, cinchona, eucalyptus, sarsaparilla, acacia, kousso, copaiba, guaiac, jalap, podophyllin, quassia, and many of the tranquilizers and psychotomimetics now used in psychiatric therapy and research. A great part of the task of folk medicine, however, and especially of preventive medicine, is borne by cultural practices which, although oriented to different social purposes, have important functional implications for health. Thus, notable hygienic purposes are served by many religious and magical practices, such as avoidance of the house in which a death has occurred, theories of contagious "bad body humors" which necessitate daily bathing, distinctions of "hot" and "cold" food and water which require boiling or cooking, hiding of fecal and other bodily waste through fear of their use by sorcerers or witches, and numerous others. Other cultural practices inadvertently relevant to health have a more general ecological basis. These may include customs regarding cosmetics and clothing or house styles and settlement patterns. Regardless of their value to the archeologist, the middens of ancient sedentary communities have rather baleful implications for the public health of the times. Changing economic incentives and circumstances which disrupt the adaptation of a cultural activity to its environment frequently

create health hazards. May (1960) provides a striking illustration of the intersection between cultural and ecological factors in North Vietnam. Dwellers on the plains lived in low, squat houses in which they sheltered their cattle on one side and did their cooking on the other. When these rice growers moved into the hills they constructed houses according to the same general plan. In the hills, however, the incidence of malaria among them became so high as to limit further such movement, despite governmental encouragement. The people themselves ascribed the calamity to the ill will of the hill deities. In fact, however, the incidence of malaria was low among the indigenous hill people, who constructed their houses on stilts, sheltered their animals underneath, and did their cooking inside the house. Several factors were apparently instrumental in the latter case in keeping down the spread of malaria from the mosquito vector found in the hills; flight ceiling of Anopheles minimus is restricted to about ten feet above the ground, and, despite its preference for human blood, the presence of animals underneath the house and of smoke inside the house (where the cooking was done) created an unrealized protection for human inhabitants. The study of folk medicine has important theoretical implications for the persistent question of a "magical" versus a "scientific" orientation among non-Western peoples. Erasmus (1952), utilizing data from South American Indian populations, contends that the inductive epistemological framework of folk medicine is essentially similar in structure to that of modern scientific medicine, but that the latter differs chiefly in its amenity to generalization and degree of predictive success. In folk medicine the chances of "natural" recovery are in favor of predictive successes, but, more often than in modern medicine, the theoretical propositions lying behind such predictions are merely coincidentally rather than functionally related to the phenomenon in question. Thus, the recooking, before eating, of food that has been left standing overnight is done on the basis of the need to dispel the dangerous quality of "coldness" in the food, but in fact such recooking destroys enterotoxin-producing staphylococci. The possible implications for a sociology of knowledge are apparent: so long as any activity or set of activities produces a sufficiently high proportion of predictive successes, there will be little elaboration or alteration of the conceptual framework orienting the activity. Cognitive frameworks relating to disease are instruments in the total process of adaptation; they change, evolve, and respond when their viability and acceptability are

MEDICAL CARE: Ethnomedicine challenged. Only when folk etiology fails too often and in too many areas to give pragmatic and especially psychodynamic satisfaction does it yield to other frameworks, autochthonous or adopted from outside. Disease, medicine, and culture. Some knowledge of diseases, their classification and etiology, is part of all cultural systems (e.g., Lieban 1962; Rubel I960; Price-Williams 1962). Investigators have analyzed disease categories in an attempt to understand the structure of the conceptual world of different peoples. The use of componential analysis, the investigation of semantic interrelationships of terms, has been applied to words for sicknesses (cf. Frake 1961). Aside from illustrating the extent to which concern with disease is elaborated in a folk nosology, such work also emphasizes a more general point: an effective cultural response to disease requires patterned discrimination and categorization of disease symptoms, even if treatment is based largely on methods of trial and error. Diagnostic categories, however crude, serve the purpose of directing sustained attention and reflection to the appearance of disease syndromes, thus providing empirical data for inferences about the probable effectiveness of one type of treatment or another. Undoubtedly this constitutes a kind of inadvertent experimental approach (see, e.g., Laughlin 1963; Erasmus 1952). Theories of disease generally have major relevance to the moral order, that is, to the control of man's behavior in society. Disease is frequently seen as a warning sign, a visitation from punishing agents for a broken taboo, a hostile impulse, or an aberrant urge to depart from the approved way. In a series of classical papers, Hallowell (e.g., 1963) has analyzed the function of anxieties over sickness among the Ojibwa Indians of North America, and other investigators have looked at the same problem in different cultural settings (e.g., Lieban 1962). Sickness is often interpreted as the supernaturals' way of indicating an act or intention of socially disruptive behavior. Especially in societies lacking strong centralized sociopolitical institutions, the occurrence and imminence of disease— with the belief that it represents punishment for aberrant, dissocial impulse or action—can be functionally important in maintaining group cohesion a nd restraining disruptive tendencies. The therapeutic practices attendant upon occurrence of disease may also have socially cohesive re sults. Although such therapy may often be medically effective, it may serve ancillary functions in tne total organization of the society. Typically, the curative session (and often the diagnostic occasion as well) involves not only the patient and the

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healer but also the patient's family and neighbors. Often the therapy involves confession by the patient, and under such conditions the confession may well relieve him of diffuse as well as focused anxieties and guilt. When followed by concrete expiatory acts, it may also give him a chance to participate in his own treatment through action. (It is doubtful whether such curative rites do more than provide temporary symptom relief—but the same can be said of much modern psychotherapy.) At the same time group cohesion is often enhanced, for such confessions dramatize fundamental social values by illustrating the harm that can come from social deviance. They provide a setting in which all participants are enveloped in the aura of forgiveness and, through stress on the protection afforded by adherence to group values, assurance of good health. In short, the therapeutic context is usually explicitly a social context, and during the course of the therapy the reciprocal psychosocial involvement of the patient with his fellows is ritually underscored. As noted above, if therapeutic directives for behavior are issued, they frequently apply to the group, or selected members of the group, as well as to the patient; and if successful recovery is as dependent upon good thoughts as upon effective techniques—as frequently happens—then the assembled company must be devoid of ill wishes and hostilities toward not only the patient but also each other. The curative rite may thus serve in multiple ways as an occasion for reintegration of the group around common social values. The practice of folk medicine is variously institutionalized. In all societies some rudimentary medical knowledge is an aspect of enculturation, but beyond this general protection there is always a specialist. Sometimes the specialist's role is a fulltime activity, but more frequently it is combined with other principal roles appropriate for the practitioner. In some societies there are more complex social arrangements than the simple dyadic relationship between healer and patient. Even as the kin and covillagers of the patient may be explicitly involved in the curative process, so too there may be a society of healers or several societies of healers devoted to diagnosis and cure of various diseases. In west Africa there are found, for example, specialized associations of healers of smallpox or snake bite; each association possesses its own rules of qualification, initiation, and procedure (Harley 1941). Folk medicine in change. Folk medicine does not easily change under the impact of sustained contact with the industrialized world, or even as a result of deliberate attempts to introduce new conceptions of disease and hygiene. Paul (1955), Fos-

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ter (1962), and others have documented the variety of factors that may impede or altogether prevent the successful introduction of a modern health program, even of so simple an innovation as the boiling of drinking water. Such factors include ecological considerations, as well as functional efficiency in domestic tasks, the social structure, the status and prestige of the innovator, and the perception of threat or advantage to the recipient. The proper role of the healer may be differently defined; in India, for example, the medical practitioner must assure the patient of recovery, and any admission of uncertainty (even couched in the form of probability) is not allowed. Rudimentary physical testing may be impossible or difficult in a non-Western context. In societies where blood, for example, is thought of as a nonregenerative substance, to take samples for testing is tantamount to inflicting deliberate harm. It has been found to be easier to introduce behavioral changes than changes in belief about the nature of illness, its cause, and prevention. Domestic hygiene and community health may be bettered by the public health worker who influences a change in habits while not disturbing the underlying belief system. One reason for this has been mentioned above: belief systems, particularly those centered on critical areas of social value, serve more than a single cognitive function. Because they interrelate with religious and magical systems, as well as with the moral order of the society, they impart a deeper sense of resignation and acceptance of events than does an alien concept treating of a germ theory of illness. The value system of a culture provides a more satisfying answer to the question, "Why did I and not my neighbor get sick?" than does an explanation phrased in terms of communicability of a disease, thresholds of resistance, host, agent, and environment. Yet in many instances modern medicine does get accepted; and one of the reasons is its demonstrably greater effectiveness in the treatment and prevention of many diseases. But even such acceptance is often compromised by the existence of alternative diagnostic and therapeutic frameworks: one relating to those diseases for which it is felt modern medicine is more effective, and the second relating to diseases conceived to be unamenable to modern medical treatment. The first is often applied to sicknesses introduced by the Europeans (such as tuberculosis, measles, smallpox, and others of a communicable nature), while in the second group are traditionally endemic diseases and, especially, ailments having a large component of psychological or psychophysiological involvement.

But in the extremity of fear for a patient's life even such distinctions as these are often disregarded, and the ill person may be taken to a modern medical facility after indigenous healers have done their best—taken either to be cured or left to die. Every hospital, and not just those in nonWestern, "underdeveloped" countries, will admit patients brought too late for the course of disease to be halted even by the most advanced techniques of scientific medicine. Disease being an unequivocal threat to life, adaptive responses are many and sometimes override ingrained belief, either of folk medicine on the one hand or modern medicine on the other. In this light, given the avowedly limited role of scientific medicine in society—together with the inevitability of disease—elements of folk medicine will no doubt everywhere persist, even as they do in Europe and the United States, so long as there is uncertainty of outcome or technical ineffectiveness in alleviating pain, prolonging life, and guaranteeing cure. CHARLES C. HUGHES [See also HEALTH and ILLNESS. Directly related are the entries ANTHROPOLOGY, article on APPLIED ANTHROPOLOGY; MAGIC; POLLUTION; RELIGION.] BIBLIOGRAPHY ACKERKNECHT, ERWiN H. 1942a Primitive Medicine and Culture Pattern. Bulletin of the History of Medicine 12:545-574. ACKERKNECHT, ERWIN H. 1942fe Problems of Primitive Medicine. Bulletin of the History of Medicine 11:503521. ACKERKNECHT, ERWIN H. 1946 Natural Diseases and Rational Treatment in Primitive Medicine. Bulletin of the History of Medicine 19:457-497. ACKERKNECHT, ERWIN H. 1965 History and Geography of the Most Important Diseases. New York: Hafner. CASSEL, JOHN 1955 A Comprehensive Health Program Among the South African Zulus. Pages 15-41 in Benjamin D. Paul (editor), Health, Culture, and Community. New York: Russell Sage Foundation. CLEMENTS, FORREST E. 1932 Primitive Concepts of Disease. California, University of, Publications in American Archaeology and Ethnology 32, no. 2:185252. DUBOS, RENE (1959) 1961 Mirage of Health, Utopias, Progress, and Biological Change. New York: Harper. DUBOS, RENE 1965 Man Adapting. New Haven: Yale Univ. Press. ERASMUS, CHARLES J. 1952 Changing Folk Beliefs and the Relativity of Empirical Knowledge. Southwestern Journal of Anthropology 8:411-428. FOSTER, GEORGE M. 1962 Traditional Cultures, and the Impact of Technological Change. New York: Harper. FRAKE, CHARLES O. 1961 The Diagnosis of Disease Among the Subanun of Mindanao. American Anthropologist New Series 63:113-132. HALLOWELL, A. IRVING 1935 Primitive Concepts of Disease. American Anthropologist New Series 37:365368.

MEDICAL CARE: Social Aspects , A. IRVING 1963 Ojibwa World View and Disease. Pages 258-315 in lago Galdston (editor), Man's Image in Medicine and Anthropology. New York Academy of Medicine, Institute of Social and Historical Medicine, Monograph No. 4. New York: International Universities Press. GEORGE W. 1941 Native African Medicine: With Special Reference to Its Practice in the Mano Tribe of Liberia. Cambridge, Mass.: Harvard Univ. Press. HUGHES, CHARLES C. 1963 Public Health in Non-literate Societies. Pages 157-233 in lago Galdston (editor), Man's Image in Medicine and Anthropology. New York Academy of Medicine, Institute of Social and Historical Medicine, Monograph No. 4. New York: International Universities Press. KUHN, THOMAS S. 1962 The Structure of Scientific Revolutions. Univ. of Chicago Press. LAUGHLIN, WILLIAM S. 1963 Primitive Theory of Medicine: Empirical Knowledge. Pages 116-140 in lago Galdston (editor), Man's Image in Medicine and Anthropology. New York Academy of Medicine, Institute of Social and Historical Medicine, Monograph No. 4. New York: International Universities Press. LIEBAN, RICHARD W. 1962 The Dangerous Ingkantos: Illness and Social Control in a Philippine Community. American Anthropologist New Series 64:306-312. MAY, JACQUES M. 1960 The Ecology of Human Disease. New York Academy of Sciences, Annals 84:789-794. -> A paper delivered at a conference on culture, society, and health held and sponsored by the New York Academy of Sciences and the Research Institute for the Study of Man. PAUL, BENJAMIN D. (editor) 1955 Health, Culture, and Community: Case Studies of Public Reaction to Health Programs. New York: Russell Sage Foundation. PRICE-WILLIAMS, D. R. 1962 A Case Study of Ideas Concerning Disease Among the Tiv. Africa 32:123131. RUBEL, ARTHUR J. 1960 Concepts of Disease in MexicanAmerican Culture. American Anthropologist New Series 62:795-814. SIGERIST, HENRY E. 1951 A History of Medicine. Volume 1: Primitive and Archaic Medicine. New York: Oxford Univ. Press. WHITING, JOHN W. M.; and CHILD, IRVIN L. 1953 Child Training and Personality: A Cross-cultural Study. New Haven: Yale Univ. Press. -» A paperback edition was published in 1962. II SOCIAL ASPECTS

Medical care is the application of scientific knowledge and technique to solving the physical a nd emotional problems of man. To a physician, medical care denotes the body of diagnostic and therapeutic theory and procedure developed to understand, cure, and prevent diseases. A social scientls t, however, defines medical care as a system of social institutions in a larger social structure. Since me dical care is given by specialized personnel, it Presents to the social scientist several problems in e sociology of professions. Since much medical ar e is given in organized settings, it can also be

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studied from the viewpoint of the sociology of formal organizations. The demand for medical care Medical institutions cannot originate without a market. Anthropological evidence suggests that recognition of physical and emotional problems by potential patients is universal among the world's populations: whether he is a Western city dweller or a peasant in an underdeveloped country, the human being is aware of discomfort and an inability to perform his normal social roles. However, the decision to take practical action and the choice of remedies vary widely according to the social system and according to the individual's statuses in each social system. Religion and science. The meaning of illness and the practical action deemed appropriate in a society derive from the prevailing bodies of religious and scientific thought. In many underdeveloped countries, widespread beliefs attribute injuries and illness to alienation from divine forces or from social obligations. For remedies appropriate to the imputed causes, large numbers of people may rely on personal rituals or on the guidance of priests and folk practitioners. Where Western medical institutions have been imported into such societies by governments or missionaries, they may be used by only the small minority that is urban and Westernized (Williams & Scharff 1960, p. 18). Extensive public use of medical care depends on widespread acceptance of certain doctrines about God and man: human life on earth should be preserved; the alleviation of physical discomfort does not contradict divine intent but may even serve God's will; practical action to save life is not inconsistent with divine purpose or church obligations. These doctrines have been prominent in Christianity, classical Islam, and Judaism. For these reasons, public utilization of therapeutic and preventive medicine has been widespread in the ancient Middle East and in the modern West. As Western religions spread in Asia, Africa, and Latin America, or as contrary traditional religions are redefined to tolerate or encourage the alleviation of discomfort by practical secular action, public utilization of scientific medical institutions increases. In many societies, the prevailing religious and scientific beliefs define illnesses differently and, thus, teach a range of responses. For example, externally visible injuries and infections may be attributed to mundane events, while internal physical and mental malfunctions are believed to originate supernaturally. Since direct physical remedies are considered appropriate for the former and magical or propitiatory methods are alone believed effica-

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cious for the latter, the population may bring its surgical and infectious problems to the Westernstyle doctor and hospital, while retaining clergymen and folk practitioners for internal and mental illnesses. The referral of particular categories of people is often a function of religious belief. For example, folk religion in some Arab and Asian countries assumes that the evil eye and divine wrath fall particularly heavily upon babies and children. Therefore, pediatric illnesses may be thought irremediable; few children are brought for medical care; and pediatrics remains an undeveloped specialty in medicine (Cameron I960; Williams & Scharff 1960, pp. 18, 32,34). Other social determinants. The demand for medical care varies with other broad characteristics of society, such as the general levels of urbanization, literacy, prosperity, and industrialization. Poverty breeds disease and neglect, and consequently the world's numerous underdeveloped countries have potentially huge numbers of patients (Brockington 1958, part 2). Illiteracy prevents many citizens from learning, where to find medical care, and services are often inaccessible in the rural areas, where much of the population lives. However, as information spreads about the availability and efficacy of medical installations, public use increases. As urbanization rises, so does the number of patients; in the cities of underdeveloped countries, vast throngs of ill persons tax the outpatient clinics and inpatient wards of public hospitals (McGibony 1961, pp. 51-52; Mazen 1961, pp. 40, 72, 273275). Within each country, social class and literacy appear to correlate with the use of medical care. The lower and poorer social classes may have the greatest number of physical and mental problems. But the higher classes make greater use of medical services because of their greater understanding of medical services, their social sophistication, and their ability to pay (Kadushin 1964). The problem varies by social class: for example, in the developed countries, coronary disease and ulcers are found more often among the upper class, infections and tuberculosis more often among the lower class (Freeman et. al. 1963, chapter 14 passim; Susser & Watson 1962, chapter 3). Family structure. The demand for medical care is affected in several ways by family structure. In the Muslim countries and in some others, religion and custom decree that women are to work and live solely within the family circle. Therefore, women hesitate to visit the hospital and particularly to become inpatients, since this would involve

immodest contact with male strangers. More men than women use medical services in the Muslim countries, but the opposite is true elsewhere, particularly in the West (compare Mazen 1961, pp. 213-214 and Fehler 1961, p. 397). Medical specialties involving female modesty, particularly obstetrics and gynecology, are developed far more in the West than in the countries with sheltered women. In preindustrial societies, the breadwinner is indispensable to provide current income, and the mother cannot easily be spared from her family duties. Thus, young adults may postpone medical care, particularly if inpatient hospitalization is likely, and medical services are used predominantly by children, the elderly, and severely ill young adults. However, in some underdeveloped countries, babies and young children occupy such a subordinate position in the family that they are brought for medical care much less often than adults (Stever 1961, p. 335). In general, the utilization of medical services is higher in the industrial countries, not only because family nursing is deemed less efficacious than expert hospital or clinic treatment, but also because employers expect efficient performance and because urban living conditions make home care difficult. The modernization of underdeveloped countries includes the establishment of Western-style medical institutions and the propagation of Western health norms, and consequently the foregoing cross-national differentials in the utilization of medical care will diminish. Medical practice Since every society has the functional problems of explaining illness to the sick and their families and of guiding practical action, each society develops a body of medical theory from its basic ideas about the universe, life, and man. These theories vary in their empirical utility and in their implications for remedial treatment. Some of the principal civilizations—notably, European, Islamic, Indian, and Chinese—derived considerable and still influential systems of medical theory from their religions and ontologies (Castiglioni 1927). Each of the principal medical traditions became institutionalized in the form of a theoretical literature, recognized practitioners, and educational techniques for transmitting knowledge and remedial skill from one generation of practitioners to the next. Much of the training has been didactic, but some—particularly in the Greek-Islamic-Western tradition—has made the neophyte an apprentice or observer of a practitioner at work. Western medicine. Transmitted to Europe by certain medieval Italian universities, Greek-Islamic

MEDICAL CARE: Social Aspects medicine ultimately proved the most productive in empirical knowledge and in therapeutic success. Several characteristics of European thought and society seem to have been crucial conditions for its growth. First, much of Western scientific thought has been inductive and empiricist, and some of this thinking contributed to medicine. Thus, although deductive and metaphysical theory was not absent from Western medicine, and although the speculative system builders vigorously fought new trends, simultaneously there developed a medical tradition of observation, experimentation, and critical verification of facts and therapies. Western medical knowledge and remedies—particularly in recent centuries—have been under continuous revision in the light of new evidence, to a degree found in no other medical tradition. Furthermore, the empiricist spirit of Western medicine has resulted in a tradition of medical education in hospital wards and experimental laboratories, to a degree found nowhere else (Shryock [1936] 1947, especially chapters 1-11). Second, religions in much of the world insist on preserving the complete body of the deceased person, usually as a condition for his heavenly salvation. But Christianity distinguishes more clearly between soul and body, and it pictures the salvation of the soul while the body rots. Therefore, Christianity has been able to tolerate the widespread use of autopsies, while most other religions discourage them, and much of the physiological and therapeutic knowledge of Western medicine has resulted from post-mortem examinations. Potentially productive medical traditions in other societies, such as Islam, have been stunted because the dominant religions forbade autopsies. A third reason for the greater success of the Western medical tradition has been the West's technical inventiveness. This approach industrialized the West's economy. But even before the industrial revolution, the West's gadget-consciousness introduced into its medical research and practice extremely fruitful diagnostic and therapeutic devices, such as the microscope and thermometer. During the nineteenth and twentieth centuries, the industrial revolution has enabled Western medicine to e rnploy even more complex devices, such as the ^ ray or the anesthetic equipment essential for thoracic surgery, which could not be invented by the world's numerous preindustrial societies. Finally, the West has had a long tradition of u reaucratic organization. In this respect, of course, the West has not been unique; but its disjrictive achievement was to apply such methods to tte financing, staffing, and dissemination of med-

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ical care. Nationwide systems of public health regulation, hospitals, medical education, and health insurance evolved under the auspices of churches, governments, and voluntary associations. All the foregoing variables—cumulative scientific knowledge, technology, and extensive formal organization—have combined in recent centuries to produce a highly developed system of medical care in the West and, increasingly, through cultural diffusion, in other societies. Doctor and patient The individual doctor renders medical care to the individual patient in a variety of settings: the patient's home, the doctor's office, hospitals, or poly clinics. The relationship between doctor and patient in the West is thought of by social scientists as a special case in the sociology of professional-client relationships. American sociologists' thinking about the doctor-patient confrontation has been greatly influenced by a theoretical model suggested by Talcott Parsons (Parsons 1958; Parsons & Fox 1952). The sick person, according to this model, is temporarily exempt from his normal social roles but is expected to perform certain well-defined patient roles. The doctor specializes in diagnosing and solving the patient's problems in accordance with the social norms of his profession, and he has the social responsibility of controlling the patient for the good of society and of the patient himself. The patient is expected to obey the doctor and strive for recovery in accordance with the expectations of each stage of his treatment. Gradually the dependence of patient upon doctor diminishes, and the patient resumes his normal family and economic roles. Parsons' analysis pictures an intelligent and ambitious patient and presupposes the achievementoriented social system of the West. Research needs to be done in order to determine its applicability in non-Western societies with different values and with large proletariats possessing less ambition and more pessimistic medical prognoses. [See PROFESSIONS.] Occasionally social scientists have observed the relationships between doctor and patient in hospitals and private offices, and they have attempted to trace the clinical consequences of the social structures governing this two-person interaction. For example, the class differences between doctor and patient have been found to affect the success of their clinical relationship: since the less educated patient is less able to communicate with the doctor in the latter's own vocabulary, he is asked to give fewer reports, and he receives fewer explana-

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tions and fewer instructions for home care than do patients of higher social classes (Freeman et al. 1963, chapter 11 passim). Another example of research on the social conditions governing relations between doctor and patient is Burling's finding that the patient's confidence in the doctor increases if the patient is not socially isolated but enjoys close personal relations with family members and with other patients (Burling et al. 1956, chapter 3). Many of the clinical decisions of the doctor have been found to depend on his own social relations within the medical profession and within the larger, lay community. For example, the doctor's ethnicity, family origins, and prior educational career—as well as his professional skill—affect the types of colleague networks and hospitals that he will join, and these contacts will determine the quality of his facilities, the skill of his consultants, and the affluence of his practice (Hall 1946). Adoption of new drugs—and possibly other innovations —by the individual doctor occurs earlier and more often if the doctor is closely related to a network of colleagues, and the adoption pattern for the network is led by certain doctors with a proclivity for adopting new things generally (Coleman et al. 1959). The hospital In many societies, all patients are treated in their homes by family members, with occasional visits by the priest or medicine man or with occasional visits by the patient to the medicine man. Among a few preindustrial peoples—such as the early Hebrews and some contemporary African tribes—the medicine man maintains beds where he can watch and treat patients in proximity to his own medical supplies or religious shrines. However, only a few civilizations have produced hospitals in large number and as important centers of medical care. Certain conditions in the social structure seem essential for the existence of an extensive and important hospital system. The society must have skill in creating and running organizations. The religious and other social beliefs must legitimize the diversion of substantial resources for the treatment and maintenance of sick strangers. Sick people and their families must accept the idea of living away from home under the control of strangers. Finally, the society must produce and train enough people qualified to work in hospitals and must motivate them to care for sick strangers. Extensive hospital programs occurred in the past under the ancient Hebrews, in ancient India during a period of synthesis between Buddhism and Hinduism, and in medieval Islam. Religion was a

powerful motive in all three societies, since it taught that human life should be saved, that illness was a remediable blight upon life, and that scientific knowledge could properly be applied in cornbating disease. Resources were readily available for hospitals, and the Hebrew and Muslim religions preached that private charity for the poor and sick were necessary conditions for salvation. Islam and India were ruled by governments which recognized that large cities could not be run efficiently without therapeutic and custodial centers. Furthermore, both Islam and India, during the periods of their hospital programs, had experience in creating networks of formal organizations—in Islam as a result of ecclesiastic work and in both countries as a result of powerful and active governments. However, the hospital programs soon declined in all three societies because the necessary social conditions were incomplete. Hospitals require dedicated staffs, and none of these religions preached the duty or desirability of lifetime careers of caring for sick strangers. In fact, the caste taboos of Brahmanical Hinduism discouraged a large number of employees from working in the same place and from giving all necessary care to the general public. None of these countries had monastic traditions, and thus, the church could not run hospitals when the state was conquered by foreigners— in the Hebrew and Muslim cases—or when the state lost interest in running hospitals—as in India and the unconquered parts of Islam. The role of Christianity. Christianity has been far more conducive to the development of hospitals than other world religions. Like the others that encouraged limited hospital programs, Christianity preached the value of human life and the desirability of preserving it through applied science. But above all, Christianity provided the doctrinal and organizational basis for hospital staffs. Humble and charitable care of the sick and poor was commended as one of the principal paths to salvation. Instead of sheltering women and thus discouraging nursing careers—as did Islam—Christianity encouraged unmarried women to do charitable work among the public and even to live away from home if necessary. Not only did Christianity legitimize hospital employment by laywornen; the Catholic church organized brotherhoods of monks and orders of nuns who nursed hospital inpatients as their apostolic mission. Employing bureaucratic procedures learned in large part from the government of the Roman Empire, the church organized hospitals, financed them through its extensive fund-raising machinery, and maintained themThus, Christianity's ecclesiastic structure produced

MEDICAL CARE: Social Aspects a continuity in hospital affairs regardless of the fluctuations in state policy. For many centuries, European hospitals were run by the church or by associations of laymen affiliated with the church, and they were staffed by nuns. For much of their history they were custodial institutions, where sick and dying people were maintained and given religious guidance. Greek-Islamic therapy was introduced when some of the medieval nursing monks attended southern Italian medical schools. Thereafter, hospital systems created and maintained by the church also became the workshops of doctors and centers of medical education. European hospitals became secularized as the function of religion changed in Western social structure, as medical science became more successful and influential, and as lay governments became more powerful and more responsive to their citizens' demands for social welfare. In the late Middle Ages the church forbade monks to practice surgery and restricted their other medical work; lay physicians were welcomed into the hospitals and soon commanded all their medical practices (Rosen 1963). Secularization of hospitals. Between the Reformation and the present day, many church-affiliated hospitals have been taken over by governments, and many new hospitals have been created by governments or by secular owners. Even after these transfers to government, Catholic nuns and Protestant deaconesses continued to work in hospitals; however, a new occupation of trained lay nursing arose in the late nineteenth century, and these nurses have been taking over the numerous jobs that cannot be filled by the now contracting religious orders. Church-affiliated hospitals staffed by nuns can still be found in countries where the church must seek new converts and retain the loyalty of its own communicants, such as in nonChristian societies and in the Western countries with mixed religions (for example, Germany, Holland, Switzerland, and the United States). As Western medical care spreads throughout the world, so does the Western hospital in its present secularized form. However, a serious obstacle is the recruitment of enough lay graduate nurses in non-Christian societies. Christian values seem to De an important recruitment motivation for lay nurses, just as they have been for nursing nuns. It is evident from unpublished research by the Present author that underdeveloped countries without large Christian minorities have great difficulty ln staffing their hospitals. The rise of scientific medicine. Since the hosPital is organized to protect and treat sick people,

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its goals, structure, and functions depend on the current state of medical science. As a result of the great medical advances of recent centuries, the Western hospital has been transformed. Previously, the hospital was a charitable establishment to care for the helpless and protect society from the infected. In order to perform such work, only a small staff of supervisors and unskilled attendants was needed; only a few doctors visited, to give quick treatments or to perform occasional clinical experiments. Since these were custodial institutions for the poor and since the wealthy could afford home visits by doctors, the higher classes were treated and housed in their homes. Because infection and pain were common in hospitals, much of the public avoided surgery and feared hospitalization. Modern medicine learned to classify diseases and distinguish among the treatments for each; the hospital needed to separate patients according to disease for distinctive treatment by category, and therefore, modern hospitals became departmentalized. The understanding of sterile technique and the introduction of antiseptics reduced cross-infections, made surgery and obstetrics safe, and increased therapeutic success and public confidence. Surgery also became more successful and popular because of the introduction of anesthetics. Surgical facilities grew in hospitals, and surgeons gained prestige and wealth. The wards became places for continuing treatment and were recognized as places of potential but preventable cross-infections. Scientific nursing education was introduced, closer controls were instituted over lower nursing ranks, and nursing staffs were greatly increased in size. The introduction of laboratories, operating theaters, and many ancillary services increased the size of paramedical staffs and raised the cost of hospitals. Since medical specialists needed to treat their patients by means of these facilities, members of higher social classes were hospitalized. The physical appearance of existing hospitals was improved, and private hospitals originated. Since specialty training required acquaintance with the advanced techniques found in hospitals, large and disciplined medical staffs were created, and many hospitals added educational and research goals to their mission of patient care. To administer such large and complex organizations, there developed new occupations specializing in hospital management; to supply the hospitals there arose new and immensely profitable pharmaceutical and equipment industries. Hospital organization. Within individual countries—and particularly in the United States—social scientists have studied interpersonal processes within hospitals, using the same concepts that they ap-

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ply to any other organizations. For example, American sociologists have long been interested in latent social processes and in the entire set of functions and dysfunctions resulting from certain institutional arrangements. Thus, American medical sociologists have not only studied the manifest hospital structure and its successes but have pointed out the presence of latent processes with paradoxical outcomes. The hospital, they say, is manifestly dedicated to the provision of means for treating patients successfully. However, every organization requires an administrative structure to arrange its resources economically and to control deviant behavior. Thus, therapeutic and administrative structures exist simultaneously in the hospital, each with its own priorities and personnel. Emphasizing one set of goals (such as administrative order) is dysfunctional for maximization of the other structure's goals (such as patient care), and conflicts occur between the two lines of authority (such as the lay administrators and the doctors). Several studies of mental hospitals note the dilemma of combining organizational imperatives and therapy: the custodial structure necessary to control patients and maintain order is dysfunctional for mental care. [See ORGANIZATIONS, article on ORGANIZATIONAL GOALS; see also Freeman et al. 1963, chapter 10, and Reader 1959.] A specialist in administrative medicine might primarily study the formal organization of hospitals, but sociologists—whether observing factories, schools, or hospitals—search for the informal social structures that may substantially deviate from the formal chain of command and that may powerfully influence the system in action. Some American medical sociologists have been participantobservers in hospital wards. They have described the informal social system among patients, and they have identified how this informal ward society alternately raises and lowers the morale of individual patients and alternately supports and disturbs each patient's relationships with the hospital staff (e.g., Fox 1959). From such research in mental hospitals has come the advice that the individual patient's recovery depends not only on treatment received during the hours reserved for formal therapy but also on harmonious relationships involving all patients and staff members throughout the day. The successful "therapeutic communities" are said to have democratic decision making, full communication of ideas and grievances, stable and rewarding careers among staff members, a proper balance between freedom and control, and an ideal combination of self-reliance and group support (Stanton 1954).

Quality of medical care From the viewpoint of the social sciences, medical care is a strategic area for studying the institutionalization of social values and of applied scientific technique. However, from the viewpoint of the public and of an increasing number of medical practitioners, the proper task of the social sciences is to evaluate and improve the quality of care. Therefore, many medical organizations have retained social scientists to gather information and give advice. Some of the resultant studies deal with the training of doctors and nurses: the formal and informal organization of the curriculum, of the student community, and of the hospital are found to promote student learning in some ways and to inhibit it in others; and this information has been used by curriculum planners and administrators in the improvement of their instruction. Determinants of good care. Several studies have attempted to locate elements in the social organization of medical care that affect the quality of treatment. Usually this research involves collaboration by physicians and social scientists: the former identify the actions constituting "good medical care," while the social scientists contribute knowledge about research techniques and ideas about the possible determinants of good care. For example, O. L. Peterson and his associates (1956) observed the work of general practitioners and concluded that class standing in medical school, length of preparatory education, exposure to refresher courses, and other experiences are strongly related to several indicators of good care. Contrary to common beliefs, involvement in medical society affairs, prestigious hospital appointments, hours of work, and certain other variables were found to have little relationship to good care in this sample. In an ambitious study of ten hospitals, Basil S. Georgopoulos and Floyd C. Mann (1962, chapters 5 and 8) discovered that certain social attributes of the hospital correlated more strongly with quality of care than did other commonly credited determinants, such as the volume of material facilities, size of budget, number of beds, and ratio of personnel to beds. The organizational characteristics associated with good care were: high coordination throughout the hospitals, harmonious relations among departments and between doctors and nurses, lower absenteeism among graduate nurses, and efficient but congenial management. In another organizational study of hospitals, MeMn Seeman and John W. Evans (1961) found that the informal social organization of the ward affects the clinical performance of interns and nurses: where

MEDICAL CARE: Social Aspects power inequalities and other forms of social distance are greater, efficiency and skill are lower. Some social research methods have been used to gather expert opinions about the nature and sources of good care. For example, Milton C. Maloney and his associates (1960) used survey techniques to get a sample of expert opinion about the quality of care: they asked doctors about the care the doctors obtained for themselves and for their families. These expert judges preferred treatment by fulltime specialists in metropolitan medical centers. Doubtless applied social research will become an increasingly recognized fact of medical care in all countries. Modern medicine is devoting more attention to the "stress diseases" and other medical conditions that seem related to social roles. The organizational problems of medical care are rising because of increased costs, scarcities of personnel and of services, and because of the demands by social planners for greater efficiency and economy in medical administration. Teamwork among clinicians, administrators, and social scientists may consequently become commonly accepted as the means to a common goal of better quality care. WILLIAM A. GLASER [Directly related are the entries HEALTH; MEDICAL PERSONNEL; PUBLIC HEALTH. Other relevant material may be found in MENTAL DISORDERS, TREATMENT OF; MENTAL HEALTH; PSYCHIATRY.] BIBLIOGRAPHY Interest in social determinants of medical care first entered the literature of the field through the writings of several leading medical historians (e.g., Sigerist 1960; Shryock 1936) and through research in epidemiology and public health (see the bibliographies for the articles on these two topics). Sociologists, social psychologists, and other social scientists began to write about medical care only in recent decades. Much of their work has been designed to provide practical information for psychiatric hospitals, the curriculum committees of medical and nursing schools, epidemiologists, and other medical practitioners with practical Problems requiring knowledge of the facts. However, some research has been designed by social scientists to test hypotheses derived from their own disciplines. The voluminous American literature is summarized in Freeman et al. 1963, and some of the principal studies are reprinted in Jaco 1958. Research by social scientists is also well advanced in Great Britain, where a group of specialists in social administration" provide facts and advice about all aspects of social policy, including health (Susser & Watson *962). Similar work is beginning elsewhere: for examPte, Konig & Tonnesmann 1958 summarizes the research ln Germany. Bibliographies of the American and European hterature are provided by Freidson 1961/1962 and Pearsall 63. Much of the social research on the quality of care is summarized by Anderson & Altman 1962. Several writers on public health and administrative mediCln ehave summarized the health problems and forms of wedical organization in the world (e.g., Brockington 1958). s yet, no social scientist has written a general survey of

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the variations in the social organization of medical care throughout the world. As social scientists have written more about medical care, their ideas have become more widely accepted in the writings of clinicians, and particularly by psychiatrists. An increasing number of writings by physicians, nurses, and medical administrators about the proper management of medical organizations and about the proper treatment of patients incorporate concepts and generalizations about the effects of the patient's family settings, the community's culture, the social relationships between patient and clinician, the personality traits of persons experiencing stress and social isolation, and so on (e.g., Balint 1957). ANDERSON, ALICE J.; and ALTMAN, ISIDORE 1962 Methodology in Evaluating the Quality of Medical Care: An Annotated Selected Bibliography, 1955-1961. Univ. of Pittsburgh Press. BALINT, MICHAEL 1957 The Doctor, His Patient and the Illness. London: Pitman Medical Publishers. BROCKINGTON, C. FRASER 1958 World Health. Harmondsworth (England): Penguin. -» Includes an account of the first ten years of the World Health Organization. BURLING, TEMPLE; LENTZ, EDITH M.; and WILSON, ROBERT N. 1956 The Give and Take in Hospitals: A Study of Human Organization in Hospitals. New York: Putnam. CAMERON, ALICK 1960 Folk-lore as a Medical Problem Among Arab Refugees. Practitioner 185:347-353. CASTIGLIONI, ARTURO (1927) 1958 A History of Medicine. 2d ed. New York: Knopf. -> First published as Storia della medicina. COLEMAN, JAMES; MENZEL, HERBERT; and KATZ, ELIHU 1959 Social Processes in Physicians' Adoption of a New Drug. Journal of Chronic Diseases 9:1-19. FEHLER, J. 1961 Verweildauer im allgemeinen Krankenhaus. Krankenhaus (Stuttgart, Germany) 53:397— 403. Fox, RENEE C. 1959 Experiment Perilous. Glencoe, 111.: Free Press. FREEMAN, HOWARD E.; LEVINE, SOL; and REEDER, LEO G. (editors) 1963 Handbook of Medical Sociology. Englewood Cliffs, N.J.: Prentice-Hall. FREIDSON, ELIOT 1961/1962 The Sociology of Medicine: A Trend Report and Bibliography. Current Sociology 10/11:123-192. GEORGOPOULOS, BASIL S.; and MANN, FLOYD C. 1962 The Community General Hospital. New York: Macmillan. HALL, OSWALD 1946 The Informal Organization of the Medical Profession. Canadian Journal of Economics and Political Science 12:30-44. JACO, E. GARTLY (editor) 1958 Patients, Physicians and Illness: Sourcebook in Behavioral Science and Medicine. Glencoe, 111.: Free Press. KADUSHIN, CHARLES 1964 Social Class and the Experience of 111 Health. Sociological Inquiry 34, no. 1: 6780. KONIG, RENE; and TONNESMANN, MARGARET (editors) 1958 Probleme der Medizin-Soziologie. Cologne (Germany) : Westdeutscher Verlag. McGiBONY, JOHN R. 1961 Health Care in India: Its Patterns and Problems. Hospitals 35, no. 10:40-44; no. 11:47-52. MALONEY, MILTON C.; TRUSSELL, RAY E.; and ELINSON, JACK 1960 Physicians Choose Medical Care: A Sociometric Approach to Quality Appraisal. American Journal of Public Health 50:1678-1686.

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MAZEN, AHMED KAMEL 1961 Development of the Medical Care Program of the Egyptian Region of the United Arab Republic. Ph.D. dissertation, Stanford Univ. PARSONS, TALCOTT 1958 Definitions of Health and Illness in the Light of American Values and Social Structure. Pages 165-187 in E. Gartly Jaco (editor), Patients, Physicians and Illness: Sourcebook in Behavioral Science and Medicine. Glencoe, 111.: Free Press. PARSONS, TALCOTT; and Fox, RENEE (1952) 1958 Illness, Therapy, and the Modern Urban Family. Pages 234-245 in E. Gartly Jaco (editor) Patients, Physicians and Illness: Sourcebook in Behavioral Science and Medicine. Glencoe, 111.: Free Press. -> First published in Volume 8 of the Journal of Social Issues. PEARSALL, MARION 1963 Medical Behavioral Science: A Selected Bibliography of Cultural Anthropology, Social Psychology, and Sociology in Medicine. Lexington: Univ. of Kentucky Press. PETERSON, OSLER L. et al. 1956 An Analytical Study of North Carolina General Practice: 1953-1954. Journal of Medical Education 31, no. 12, part 2. READER, GEORGE G. 1959 Medical Sociology With Particular Reference to the Study of Hospitals. Volume 2, pages 139-152 in World Congress of Sociology, Fourth, Transactions. London: International Sociological Association. ROSEN, GEORGE 1963 The Hospital: Historical Sociology of a Community Institution. Pages 1-36 in Eliot Freidson (editor), The Hospital in Modern Society. New York: Free Press. SEEMAN, MELVIN; and EVANS, JOHN W. 1961 Stratification and Hospital Care. American Sociological Review 26:67-80, 193-204. SHRYOCK, RICHARD H. (1936) 1947 The Development of Modern Medicine. New York: Knopf. SIGERIST, HENRY E. 1960 On the Sociology of Medicine. New York: MD Publications. STANTON, ALFRED H. 1954 The Mental Hospital: A Study of Institutional Participation in Psychiatric Illness and Treatment. New York: Basic Books. STERN, BERNHARD J. 1941 Society and Medical Progress. Princeton Univ. Press. STEVER, ROBERT C. 1961 Medical Impressions From India and Nepal. Journal of Medical Education 36: 330-337. SUSSER, MERVYN W.; and WATSON, WILLIAM 1962 Sociology in Medicine. Oxford Univ. Press. WILLIAMS, CICELY D.; and SCHARFF, J. W. 1960 An Experiment in Health Work in Trengganu, Malaya. Beirut: American Univ., School of Public Health. Ill ECONOMIC ASPECTS

The economic aspects of medical care encompass a broad and diverse area. It can include discussion of medical care utilization by various income groups, licensing arrangements, incomes of practitioners, fee structures, and so forth. This discussion will be limited to three topics: (1) some of the special characteristics that distinguish medical care from other goods and services; (2) the various alternative mechanisms for financing medical care services utilized at the present time;

(3) general economic problems related to alternative patterns of financing. Special characteristics Medical care, although generally viewed as a consumption commodity, has come to have a special status among the wide variety of such goods and services. This status affects its organization, the amount of resources it commands, and the patterns used in its financing. Social-psychological factors. The view that medical care is somehow "different" is mainly an outgrowth of what may be called social-psychological factors. Medical care is felt to be (and obviously often is) intimately related to health and to life itself. The public associates medical care with dramatic lifesaving procedures, with the treatment of potentially fatal illness, and with the alleviation of suffering and pain. Since life is not considered a luxury commodity, those things which are believed to be associated with its preservation, e.g., medical care, have come to be considered a "human right." As a consequence, it is felt that the amount of medical care received—that the right to life or the prevention of pain—should not depend on the individual's income and purchasing power. Actual practice, of course, is often at wide variance with beliefs and declarations in this area. Unpredictability of need. A number of significant economic distinctions between medical care and most other goods also impel the public to the view that the financing and organization of medical care should be treated differently from the financing of other goods and services. Perhaps of primary importance is the fact that illness, and consequently the need for care, is unpredictable for the individual, although it is predictable for the group. The individual, therefore, finds it impossible to anticipate the frequency of medical care, the amount he will need, and the costs that will be associated with such care. Furthermore, the economic burden imposed may be extreme—the illness may be severe and the economic consequences catastrophic. Not knowing the costs, he cannot save the appropriate amount in advance of an illness of unknown severity that may occur at some unknown time and with unknown frequency. This matter assumes increased significance, since real limitations exist on the possibility of postponing medical care purchases. Although postpayment over a period of time would be a possible remedy for part of the problem, difficulties with that device are many: (1) illness may affect both short-run and long-run earning power and thus make such postpayment difficult, perhaps impossible; (2) the service rendered can-

MEDICAL CARE: Economic Aspects not be repossessed if there is a failure to meet payments; (3) the individual may feel that he has little or nothing to show for the medical care received, i.e., he is no better off than before he became ill and is simply back to the pre-illness state, to which he feels he might have returned even without the care; (4) treatment may involve discomfiture and pain, neither of which is certain to make one feel well disposed to those who rendered the treatment and thus to meeting periodic payments to the provider of care; (5) the individual does not consider that he is continuing to derive benefits from the service rendered in the past— as contrasted with the continuing pleasures derived from the purchase of consumer durables and other goods. Externalities. A second characteristic of medical care services not shared by most other commodities involves externalities. These are present when benefits (or costs) accrue to others because the individual takes a particular action. The purchase of some types of medical services clearly involves such externalities. This is most evident in the case of communicable disease. All of us derive benefits from the immunization of others and from the prevention and treatment of the communicable diseases that affect them. The benefits to society, therefore, exceed the individual consumer's benefits. Conversely, there are costs to individuals when disease is not controlled in some other part of the population. The matter of externalities can be viewed even more broadly if we include satisfaction as well as dollar benefits in our consideration. If others are crippled, sick, or disabled, and if we are made uncomfortable by knowing about or seeing these conditions, then the benefits to society of rehabilitation or cure exceed the benefits accruing to the individual who is rehabilitated or cured. The increase in social satisfaction should, therefore, also be included in the calculus. Economic theory has shown that where positive externalities (external benefits) exist, the individual underinvests in the commodity, from society's standpoint. Thus the private sector underinvests, insofar as there is insufficient philanthropy or absence of compulsion. This characteristic becomes one of the bases for public intervention in the health sector and is one of the reasons that government is often the major financing agent for certain types of health expenditures. [See EXTERNAL ECONOMIES AND DISECONOMIES; WELFARE ECONOMICS.] Investment. Yet another special feature of medial care is implied by the use, in the preceding Paragraph, of the term "invest." Medical care is in Part a consumption commodity, but also in part

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an investment good. The purchase of medical care today increases the level of health and thus raises productivity in the future. Such sacrifice of current consumption in order to raise future output is the essence of all investments. Thus, the term "investment" need not be applied solely to expenditures on material capital. Accordingly, the analysis of public policy toward medical care can be cast in an investment framework. Quality assessment problems. An additional significant distinction between medical care and other services is the consumer's relative inability to judge the quality of the product he is purchasing. This matter has even greater importance when it is recognized that sins of omission or commission on the part of the physician or persons working under his direction may have serious and nonreversible consequences. Even ex post evaluation of quality by the consumer is difficult, and the satisfaction or dissatisfaction with the medical care provided may, therefore, be based on various extraneous factors. Since medical care may involve more serious matters than are involved in the purchase of other consumer goods, and since the search to find quality care is more difficult than with other goods, some measure of protection is afforded the consumer by licensing arrangements. In this manner authorities "guarantee" some presumed minimum level of competence. The economic issues in such licensing arrangements are many, since, depending on the standards set and the responsibility of those who provide licenses, supply may be artificially and unnecessarily restricted, with consequent increase in prices for services and in incomes of practitioners not sufficiently compensated for by increase in quality of care. [See LICENSING, OCCUPATIONAL.] Alternative financing mechanisms The special characteristics of medical care have played a role in inducing governments to participate actively in the medical care sector. The form that such participation has taken has differed greatly and is a product of institutional and ideological constraints. Nevertheless, the role of government in the health sector and in financing health care is acknowledged in all countries. This role often takes the form of government participation in funding or distributing medical care for specific categories in the population. These categories of persons may be defined by specified health characteristics (e.g., the blind, the disabled), by age characteristics (e.g., the aged, children), by economic status (e.g., the indigent, the medically indigent), or by other special characteristics that define

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a particular population group (e.g., veterans, migrant workers). On occasion, combinations of these characteristics are utilized to determine eligibility, and individuals must then meet more than one criterion. Government participation and support, of course, need not be confined to categories of persons and in some countries covers the total resident population. Voluntary insurance (United States). Voluntary health insurance has developed as one method of financing designed to meet the problem of unpredictability of illness and the need for medical care. The insurance principle lends itself to application in the health area, although it is relatively difficult to apply to certain health expenses and to certain population groups. This type of financing is most highly developed in the United States, where hospital insurance and surgical-medical insurance are provided both by nonprofit plans and by commercial insurance companies. The expansion of private voluntary health insurance in the United States began in the 1930s with the development of Blue Cross plans for hospital coverage (with backing by the American Hospital Association) and Blue Shield plans for surgical-medical insurance (with backing by the organized medical profession). These plans are nonprofit and serve local areas (usually entire states), although national coordination is provided. Commercial insurance companies entered the field in the late 1930s, largely through group coverage and utilizing arrangements for reimbursement of charges up to specified amounts rather than for provision of specified services (as in the nonprofit hospitalization plans). Commercial carriers competed successfully with the Blue Cross and Blue Shield plans. In part this was because the "Blues" used community rating: the rates charged for each of the various contracts offered were the same for all groups in a community. Commercial carriers used experience rating, wherein the rates charged any single group varied with the experience of that group. As a consequence, low-risk groups and individuals often found it advantageous to deal with a commercial carrier where premiums reflected their own experience and utilization of services rather than the average experience, including that of the high risks, in a community. The greater the number of low risks who left the "Blues," the higher the insurance rates rose for those remaining. Thus those who previously found themselves on "the margin" now found it advantageous to shift to commercial carriers. This mechanism could, in theory, continue indefinitely. It is one of the important considerations in the social insurance area and is often used to argue

for a compulsory element in social insurance. As a result of the force of this process, experience rating is now widely used even by those plans which originally rejected it on philosophic grounds. With experience rating, high-risk groups (e.g., the aged) find that the rates charged are higher than would be the case under community rating and that it becomes more difficult to participate in the plan. This problem, as well as a number of other conditions, led the United States to institute, effective in 1966, a public system of health insurance, as part of its social insurance system, providing for limited financing of some medical care for persons 65 years of age and older. The pressure for such a system of insurance was also heightened by the fact that the aged often are not members of groups eligible for group insurance coverage. Insurance rates for individuals are significantly higher than group rates (and not only because the employer frequently pays a portion of the premium under group coverage). The high medical expenses of the aged and their relatively low financial resources compound the problems of finance. [See AGING, article on ECONOMIC ASPECTS.] It is estimated that in 1965 about 80 per cent of the civilian population in the United States had some insurance protection against the costs of basic hospital care, about 75 per cent had some surgical expense protection, and almost 60 per cent were eligible for some additional coverage for in-hospital physician visits. Although the benefits met about 70 per cent of the total cost of hospital care, only about one-third of total consumer expenditures for personal health care were met by insurance. In the United States, health expenditures are financed largely by the private sector: of the $37,000 million of national health expenditures in 1964 (5.8 per cent of the gross national product), 74 per cent came from the private sector and only 26 per cent from the government—equally divided between the federal government on the one hand and state and local governments on the other. About 50 per cent of all personal health service expenditures were paid for by the recipient of the services (or his family), while third parties (government, insurers, etc.) paid for the remainder. The problem of high-risk groups under experience rating in a voluntary insurance plan can be solved by a compulsory insurance program or direct government provision or financing of services. However, the traditional arguments that are used by those who favor approaches involving more government participation go beyond the solution of the difficulties that some groups and individuals face under experience rating. They include matters such as ease and economic efficiency of administration,

MEDICAL CARE: Economic Aspects comprehensiveness of care, coverage of the total population (including those groups that voluntary insurance finds it difficult or inefficient to reach or whose economic status is so low as to inhibit purchase of insurance), more ready control of inflation in medical care costs, increased equity in financing of care, and more possibility of increasing emphasis on certain aspects of medical services, e.g., preventive care. The success with which any of these objectives would be met would depend upon the particular characteristics of the health insurance or financing plan. The social security characteristic of a plan does not in itself guarantee comprehensiveness of coverage, quality of service, control of inflation in medical care prices, equity in financing, and so forth. Just as the voluntary private health insurance system can take many different forms and thus meet different problems, raise different issues, and resolve basic questions in different ways and with varying degrees of success, so too can each alternative basic system for financing or providing care. National Health Service (United Kingdom). One type of approach to the financing and provision of medical care services is that employed in the United Kingdom under the National Health Service. Medical care services (rather than reimbursements) are provided all residents. The major costs of the program are financed out of general revenues, although small weekly contributions are paid by workers and employers. Some cost sharing by the patient for medicines and selected other items is also provided for. All residents are eligible for such services as general and specialized care, dental care, and hospitalization. The services are provided by doctors and druggists who are under contract to the National Health Service and by public hospitals owned by the central government. The physician receives a payment for each person on his rolls. This capitation method of payment of physicians encourages patients to have a continuing relationship with a particular general practitioner. The capitation method of payment, as contrasted with a payment for services rendered, is considered not only to be a good financial arrangement but also to represent a basic philosophical approach to medicine which is believed to have advantages that go beyond ease of administration. The United Kingdom thus has a pattern of financing and organizing medical care substantially different from that of the United States, or from that which the latter will employ for those 65 years °f age and over. Perhaps 85 per cent of all health e xpenditures in the United Kingdom are paid for by third parties, a much larger percentage than in the United States. The amount of resources allocated

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to health services in the United Kingdom (4.2 per cent of a lower GNP) also differs from that in the United States (as indicated previously, 5.8 per cent of GNP). It is not clear, however, what part of these, and other, intercountry differences is attributable to differences in relative price levels (i.e., the relative costs of health services as compared with other goods and services in each country), differences in efficiency in the health sector, differences in levels of health and "needs," differences in quality of care, and differences in real resources devoted to health care. But it is clear that there do exist wide differences in the percentage of GNP devoted to health services in various countries. The significance and implications of these differences have yet to be thoroughly examined, but they do not seem to be related to the prevailing patterns or sources of finance or to the significance of the government sector in the health area. Basic alternatives. The three main patterns of nonmarket provision of medical benefits in the various countries are (1) provision of direct services through facilities owned and operated by the government or by a social insurance fund; (2) services provided to patients, with the provider of services being paid directly by the government or fund; ( 3) reimbursement of fees paid directly by patients to providers of the services. As will be discussed below, the need for rationing of services still remains under the various arrangements, and patients are, therefore, often called upon to share the costs of the services rendered. While a number of countries provide comprehensive medical services to all residents (although patients may pay part of the cost of the service provided), and an additional number of countries provide various selected therapeutic services, the particular benefits available and the mechanisms by which care is financed, provided, and organized differ greatly. In some countries medical services are provided to parts of the population under social insurance arrangements; in others, benefits are provided through membership in sickness funds to which employees, government, and (in some countries) employers contribute and in which membership is compulsory for certain categories of persons. Particular financing mechanisms are not necessarily tied to particular organizational arrangements, and thus many different combinations exist. Economic problems Need for rationing. Whatever the organizational pattern for distributing and financing medical care, the absence of a perfectly operating market for medical care presents certain difficulties. Although medical care is often viewed as a

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basic human right, few scientific standards exist to define the amount of care that an individual "needs" or should utilize (i.e., the health benefits associated with given amounts of care). However great the public dissatisfaction with the medical care received, it is a fact that some individuals tend to utilize more services than they require or are believed to require. Furthermore, changes in the price of medical care services do tend to change levels of utilization. Declines in price are associated with increases in usage. Although an increase in utilization is often one of the purposes of government in creating systems that reduce price or provide insured health benefits, allocation problems remain. If society were to allocate sufficient resources to medical care so that no choice need be made between care for the individual who is dying but can be saved and the hypochondriac who wants reassurance (that is, if we were prepared to meet all increases in, and levels of, utilization), then rationing of medical resources would not be required. But such a situation is neither conceivable nor, given competing demands on resources, desirable. Thus rationing becomes imperative, and since society is willing to make some interpersonal utility comparisons regarding who needs care, the rationing scheme must incorporate the public's judgments. Nevertheless, since there is little scientific agreement on desirable utilization rates (or on the relationship between utilization rates and levels of health), it is difficult to agree upon, set, and control such rates and to develop medically "optimal" rationing devices. In the absence of control of usage, budgetary, physical, and personnel shortages often appear, particularly because consumers often demand more care than the authorities have estimated would be the case. Attempts to balance resource limitations (including budgetary considerations) against the private decisions to visit physicians, to enter hospitals, and to utilize medical care in quantities determined by the individual (the balancing of "scarcity" and "human right") have always been necessary and have seldom been easy to achieve. Were the health sector treated as most other services are generally treated, this particular problem would not exist. If consumers, out of their own budgets and without public or private subsidization, chose to "overutilize" services (judged by some scientific standard), this would be fully acceptable. The price mechanism would serve as a rationing device and, however "foolish" some might feel these expenditures to be, the consumer would be sovereign. Since government plays a role in the health

field, even if in many cases it is limited to support for construction of physical resources (e.g., hospitals), or to training of personnel (e.g., supporting education), or to financing of certain types of care (e.g., for needy or aged persons), the government must be involved in the development of rationing devices to replace market forces. The same need exists, of course, when private physicians offer charity care. Controlling utilization. The problem of "overutilization" (which can be viewed as the problem of scarcity) arises in all medical care financing mechanisms. The mechanisms of control when there is governmental involvement or control by a voluntary insurance carrier may, of course, differ. It is true that for many services waiting time, inconvenience, and even loss of income serve as deterrents to use. Even so, the use of "free" (but not costless) services may exceed the necessary, or "need," level. Therefore, additional monetary deterrents are often used, in the attempt to control overutilization. In particular, they are used to influence the consumer's choice between different types of care, e.g., office calls rather than house calls, home care rather than hospital care. Payment of some percentage of the costs (e.g., of hospital care) or in the form of some fixed charge (e.g., for a house call) is often instituted in order to induce the consumer to ration the care he seeks and in order to lead him toward those types of care which utilize less of society's economic resources. Such charges are also often made for prescription drugs. Since the use of such drugs is governed largely by the physician rather than by the patient, these charges may be instituted primarily as a device to cut the costs financed by the program rather than in order to change consumer behavior (although they do this as well). The difficulty, sometimes unrecognized, with these procedures is that the money deterrent has a differential impact on individuals, depending greatly upon their "taste" and need for medical care, the accessibility of medical care, their total income, and the prices of other goods and services. What may be a small deterrent for some (perhaps the "optimal" deterrent from the point of view of the third party that finances the service or from the point of view of society) may represent a great deterrent for others and a trivial deterrent for still others. Income and price considerations thus reenter the medical market place, although with less impact than would be the case in the absence of third-party payments. Furthermore, it is clear that the conflict recurs between encouragement to use services in the "correct" quantities and rationing of

MEDICAL PERSONNEL: Physicians care. No single level of fixed charges applying to all members of the population and designed to deter unnecessary use, but not to inhibit necessary use, can be the correct level for each individual. The operational consequences of the fixed charge will vary with a number of institutional considerations. It cannot be presumed that the consequences are necessarily severe (if maintaining accessibility is the primary goal) or are necessarily minor (if cutting utilization is the primary goal). The fixed charge in third-party payments does illustrate the fact that it is difficult to define that part of medical care which society considers a luxury and that part which is considered a need. With scarce resources a trade-off between goals is required—and difficult to determine. Future developments in the provision and financing of medical care will be related to developments in medicine itself and to the acquisition of additional knowledge concerning the relationship between medical care and health and between health and productivity. The growing ability of medicine to prevent illness and to care for and rehabilitate the sick will bring increased pressures on the health sector. In most nations the role of government in health is likely to increase. In part this will take the form of intervention in the financing of services via social insurance or other arrangements. The financial responsibility, as well as the special characteristics, of medical care outlined earlier will result in government's assuming an increasing responsibility in the determination of the total amount of manpower and resources devoted to health and medical care and to the allocation of resources within the health sector itself. The meeting of this responsibility will involve an increased reliance on new evaluative techniques. In recent years, partly as a result of the pressures for health expenditures and for planning of medical care in the less developed countries, and partly as a result of the refinement of benefit-cost analysis, the analysis of medical care has acquired an increasingly analytic economic content. In this approach, health and medical care are viewed in an economic context, and medical care programs are evaluated in relation to their cost and.their potential impact on productivity through lower levels of morbidity and mortality. The economic value of man as a producer lies at the heart of the analysis, and the costs of various diseases are calculated in terms of the direct costs of treatment and medical care and the indirect costs to the economy of loss of productive power. Decisions concerning the allocation of resources

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to the health sector will, of course, not be based solely on the measurement of pecuniary costs and benefits. Nevertheless, such measurements are of assistance. It can, therefore, be anticipated that as understanding of the methodology of benefit-cost analysis grows, it will be increasingly used in governmental evaluation, planning, and budgeting processes. RASHI FEIN BIBLIOGRAPHY

The World Health Organization (Geneva) periodically issues publications on the level of health and on the financing and organization of health services in particular countries. KLARMAN, HERBERT E. 1965 The Economics of Health. New York: Columbia Univ. Press. Social Security Bulletin. -» Published since 1938. Regularly contains articles on the economic aspects of medical care. U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 1964 Social Security Programs Throughout the World: 1964. Washington: Government Printing Office. WINSLOW, CHARLES E. A. 1951 The Cost of Sickness and the Price of Health. Geneva: World Health Organization.

MEDICAL PERSONNEL i. PHYSICIANS ii. PARAMEDICAL PERSONNEL

Eliot Freidson Eliot Freidson

PHYSICIANS

The physician is the most prominent among members of the generally recognized professions. He is seen by the public as possessing a higher standard than any other professional, and by the sociologist as the virtual prototype of his kind. While it would be a great mistake to confound what is peculiar to medicine with what is characteristic of professions in general, the study of physicians does offer the sociologist the opportunity to test both the truth and the utility of various orientations toward the concept of a profession. One orientation sees a profession as an aggregate of people finding identity in sharing values and skills absorbed during the course of intensive training through which they all have passed in order to become professionals. In this view the professional is primarily a particular kind of person; one determines whether or not an individual "is" a professional by determining whether or not he has internalized certain given professional values. One explains a "bad" professional by reference to his inferior education, his defective character, or

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similar variables. In short, one explains the behavior of members of a profession by reference to individual attributes and experiences bearing on conformity to a given set of norms. Another orientation sees the profession as a group of workers joined together on the most general level by virtue of sharing a particular position in society and by common participation in a given division of labor. More specifically, the behavior of the profession is interpreted by reference to the way in which its work life is organized and the pressures toward conformity or deviance implicit in that organization. Here, the general assumption is that one defines a professional by his status, irrespective of the norms to which he subscribes, and explains his behavior by reference to the work structure in which he participates. One difficulty in assessing the virtues of each of these orientations is the fact that there has been little attempt at testing them by sustained and detailed analysis of any single profession. And there has been little of the comprehensive comparative analysis that must be the ultimate goal of the sociology of medicine. Furthermore, because one of the marked characteristics of established professions is their relative freedom from lay intervention, from the conventional discipline exercised by industrial employers, and from the detailed directives of crafts unions, both organization and structure have been difficult to perceive. Professional organization is usually taken to be synonymous with the formal professional association, and the actual organization of work or practice has gone largely unnoticed. This article, by attempting a detailed analysis of the medical profession and by focusing particularly on the way the performance of medical work is controlled, will try to clarify both the sociological characteristics of the medical profession and some of the issues germane to the sociology of the professions. (For a more extended analysis, see Freidson 1966.) Because of the paucity of systematic empirical studies from other countries, it is regrettably necessary to run the risk of parochialism and concentrate on medicine in the United States. Medicine and the state The foundation on which the analysis of a profession must be based is its relationship to the ultimate source of power and authority in modern society—the state. In the case of medicine, much, though by no means all, of the profession's strength is based on legally supported monopoly over practice. This monopoly operates through a system of licensing that bears on the privilege to hospitalize

patients and the right to prescribe drugs and order laboratory procedures that are otherwise virtually inaccessible to the layman. It is the state that grants this monopoly, the exact form of which varies widely throughout the world. In the United States the profession, through its private associations, has very largely been given the right to determine how political and legal power bearing on medicine shall be exercised (see especially Hyde et al. 1954). In such countries as Great Britain, where the state has set up a national health system, representatives of the independent and private professional associations sit on both policy-making and administrative boards and negotiate with the state on various issues influencing practice (Stevens 1966). In the national health system of the Soviet Union there is no really private or independent representation of the profession that can negotiate with the state, although advisory and administrative councils do include physicians (Field 1967). Clearly, the economic and political autonomy of the medical profession varies from country to country. What seems invariant, however, is its technological or scientific autonomy, for everywhere the profession appears to be left fairly free to develop its special area of knowledge and to determine what are "scientifically acceptable" practices. In national state health systems, although laymen do serve in policy-making and administrative positions, physicians tend to be administrative heads of practicing units and to be responsible for the determination of technical standards of equipment, procedures, and performance. Thus, while the profession may not be everywhere free to control the terms of its work, it is free to control the content of its work. Similarly, it is free to control the technical instruction of its recruits. Medical training The medical profession, quite as much as most sociologists, considers medical education to be the major single factor determining the performance of the practicing professional. By the content of his education the student is "socialized" to become a physician. The assumption is that in the course of such an education a new kind of person is created. Medical education in the United States is perhaps unparalleled by any other conventional professional training in its duration, its detail, and its rigidity. Medical school lasts four years after undergraduate college, followed by a fifth year of supervised practice in an accredited teaching hospital (the internship), and even more years for those seeking certification as specialists. It would seem

MEDICAL PERSONNEL: Physicians reasonable to think that such intensive exposure in fact molds the student into a particular kind of person. The Columbia University study of medical education (Merton et al. 1957) sought to demonstrate that the student, in the course of his training, develops a conception of himself as a doctor, absorbs the knowledge he needs in order to be secure enough to deal with patients without too much anxiety, and attains the capacity to cope with basic uncertainty in clinical practice. Nonetheless, the students' perspective on their educational experience differs from that of their instructors. Indeed, one may expect there to be some kind of conflict between students and faculty by the very nature of their different roles. It is the unique contribution of the University of Kansas study (Becker et al. 1961) that it demonstrated the clash of perspectives in medical school and showed that the differences in orientation leading to "restriction of production" are not limited to industrial organizations. The consequences of this for the educational process were followed up in some detail. But the study also emphasized that the existence of this clash of orientations did not mean that there was nothing in common between the performance of students and the demands of faculty. It was discovered that two dominant values, held by the faculty, were adopted by the students and used by them to guide their learning experience and select their careers. These were the values of medical responsibility and of clinical experience (ibid., chapters 12 and 13). The value of medical responsibility refers to the traditional ideals of medicine, according to which the physician holds the life of a patient in his hands. It is the personal responsibility held by the physician working directly with a patient that requires him to take the blame for bad results. In the Kansas study, it was found that this value was impressed on the student by frequent faculty lectures about the way in which mistakes of omission or commission endanger the patient's life. Furthermore, faculty members frequently asked students how they would handle an emergency so as to avoid serious consequences to the patient. The value also featured in the organization of the training hospital, where the hierarchy of medical staff was ordered by differential access to medical responsibility, so that the unlicensed student was restricted to routine work having little relationship to life-or-death issues and the highest-status person was free to carry out the most complicated and dangerous procedures. Clinical experience refers to first-hand contact patients and disease. Such contact is the

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ultimate justification for deciding to use one procedure for a treatment rather than another, and the experience so gained is valued because it provides a basis for therapeutic choice that is believed to be superior not only to the abstract considerations posed in textbooks but even to general, scientifically verified knowledge. It was observed in the course of the Kansas study that argument from experience was unanswerable except by the same type of argument from someone with greater experience. These two values, Becker and his colleagues argued, order the choices the student makes from the range of experience offered by the medical school. These choices limit and direct his efforts in ways not anticipated or approved by the faculty. One of the student's most difficult problems is to select from the enormous mass of facts presented to him the information he is really to learn, for he cannot learn all of it. The idea of clinical experience, it was suggested, guides his selection of facts and information, leading him to discount basic science and focus on classes in which instructors give practical information not found in books— information that adds to his store of vicarious experience. By the same token, he struggles for personal clinical experience in his training, seeking opportunities for expanding it and deprecating routines he has already mastered. Similarly, he seeks tasks in which medical responsibility is apparent—reflecting some risk or danger—and avoids those in which it is not. And, finally, he responds positively to some patients as cases presenting him with valued responsibility and experience, and to others negatively as cases that take up a great deal of time without any valuable recompense (Becker et al. 1961, chapters 14 and 16). The evidence seemed to show that choice of career also hinges on how far specialties provide the opportunity for medical responsibility and clinical experience. Thus, a desirable specialty is one which offers a wide variety of experience and in which responsibility is symbolized by the possibility of killing or disabling patients in the course of making a mistake. Internal medicine, general surgery, and pediatrics are therefore the most popular specialties, although the potentially "mechanical" character of surgery and the necessity of liking to work with children in pediatrics qualify their desirability for some students. At the other extreme, specialties like dermatology and allergy are unpopular because they are thought to involve little danger (and therefore little responsibility) or little variety (ibid., chapter 20). National surveys of medical students in the United States have accumu-

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lated a fair amount of data on specialty choice, most of whicn are compatible with this interpretation of the values underlying the choices of the majority of students. In the case of those choosing the less popular specialties—the best-investigated of which is public health (Coker et al. 1966)— specification of more detailed patterns of values is of course necessary. Empirical types of practice Unmentioned in the course of the discussion of medical training is one element of great relevance to performance: the technical knowledge and skill learned by the student. Here, it is necessary to say only that the student does in fact gain command over a great deal of knowledge and skill; what we must dwell on is the fact that this knowledge and skill is not necessarily retained or used after graduation from medical school. While in a modern industrial country like the United States all physicians share the same basic technical education, they do not all practice in the same way. In the few systematic studies of medical practice that have been made, the association found between medical education and subsequent performance was at best very weak. While the available evidence is scanty and poor, it points to variation in the organization of practice—that is, in the organized setting in which the professional works —as a more important influence than medical education or variation in performance. (For a summary of this material, see Freidson 1963; for the parallel case of the lawyer, see Carlin 1966.) Indeed, the analysis of work organization or practice is a critical problem for the sociology of the professions. The central issue in the analysis of work is how performance is controlled. This issue constitutes a special problem for the analysis of professional work because professions, unlike other occupations, have successfully gained freedom from control by outsiders. Indeed, a profession is said to control its own performance. This is a rather unusual arrangement, worth understanding both in itself, as one type of control, and in its bearing on how, in our complex world, freedom and autonomy can be joined with responsibility. Let us examine the various organized practices in which medical work takes place to see how control over performance can be exercised. (For a more extensive examination, see Freidson 1963.) One type of practice that is frequently held up as the ideal by professionals is one in which the individual is an entrepreneur, free to do what his own conscience and knowledge dictate. This is so-

called solo practice. While pure forms of solo practice are quite rare—invoking it as a norm reflects the individualistic ideology of the profession more than it reflects reality—we might ask what conditions must be met to assure that individuals practicing entirely on their own conform to professional standards. Assurance of adequate performance on the part of solo practitioners seems to require exceedingly careful recruitment policies and extraordinarily effective educational procedures. In essence, the practitioner must be able to resist all temptations to ethical or technical lapses by virtue of his inner resources alone, resources which must also motivate him to continue to keep up-to-date. In solo practice the burden of control rests solely on individual motivation and capacity. Much more common than solo practice in the United States today is practice involving a loose network of interdependent practitioners who refer cases to each other—an informal organization that has been described as a "colleague network" (Hall 1946). Backed by a stable clientele relatively loyal to them, the practitioners in such a network control access to that clientele and thus access to work on the part of new young practitioners. In the rather well-organized case he studied, Hall showed how an "inner fraternity" of practitioners controlled access to practice settings and desirable patients and how, through the mechanism of sponsorship, newcomers were obliged both to take on minor tasks and to turn to their sponsors for consultation. While it may be doubted that professional services in large cities can be wholly dominated by any single informal fraternity, the sociometric studies of Coleman and his colleagues (1966) suggest that there are systematic and persistent patterns of interrelationships among practitioners even in so loosely organized a system as exists in the United States. These patterns of interaction suggest two of the most important prerequisites for control of the practitioner's performance by colleagues rather than by clients: by referring patients to each other, each practitioner has the opportunity to observe some of the other's performance; by being economically and technically interdependent, each practitioner has some leverage to influence the other's performance. Finally, one may mention the less primitive structures of practice that are characteristic of some European countries and are represented in the United States by large group practices and university clinics. These are essentially bureaucratic organizations, although the variations in actual administrative detail are countless. We may point to one logically distinct type of bureaucracy that has

MEDICAL PERSONNEL: Physicians received some theoretical attention in the literature because of its systematic deviation from the classical rational-legal model of bureaucracy. It has been called professional bureaucracy, and it has been characterized as a form of organization in which the hierarchy of professional practitioners is set apart from the hierarchy of the administration itself or (as in many European countries) a form of organization in which all important positions of organizational authority are filled by professionals. In both cases, professional work is free from the exercise of the authority of nonprofessionals even though the working professionals are technically subordinates in a bureaucratic system and lack the freedom of the entrepreneur. The exact theoretical importance of such a logical construct and the degree to which it mirrors enough of reality to be useful are by no means clear, but by pointing to the bureaucratic elements of organization it does indicate that here, more than in other forms of practice, physicians are in a position of interdependence that implies opportunities to observe and to exercise influence over one another's performance. Of all the types of practice reviewed, the bureaucratic type provides the best opportunity for professional self-regulation. Indeed, this is the type exemplified by high-prestige academic institutions in the United States and elsewhere. Analytical types of practice Thus far, it has been suggested that there is a range of practice organizations, from purely individual practice to bureaucratically organized practice. To understand how colleagues or clients may gain access to observe and influence performance, it is useful to distinguish those features of practice which determine both the source and the content of control. In this way it becomes possible to analyze the differential significance in the division of labor of various forms of specialization. The lay client's perspective on the service he seeks differs from that of the colleague group of professionals: this may be taken as axiomatic. Let us therefore distinguish practices by the degree to which they are amenable to lay or colleague control. It is clear that two types of medical practice form the logical extremes of the medical division of labor. At one extreme is practice wholly dependent on lay choice for its existence: it may be called client-dependent Practice. Such a practice survives by using its own resources to attract and satisfy a lay clientele. Since the client uses lay standards in deciding that he fieeds professional services and in evaluating the services he gets, the practice must conform to lay standards in order to be patronized. Furthermore,

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when wholly dependent on client choice, the practice cannot be observed by colleagues, nor is its survival dependent on their cooperation. In consequence, all the pressure on the practice is toward conforming to lay rather than professional standards. At the other extreme is colleague-dependent practice. It does not attract its own lay clientele but, rather, obtains clients through the referrals of other colleagues. Thus, in order to survive it must honor the prejudices of colleagues, and so is likely to conform more to professional than to lay standards. How closely do actual practices conform to these logical types? The logical extreme of clientdependent practice does not seem fully applicable to any professional practice, although the "independent" solo neighborhood or village general practitioner comes close to it. Also close are specialists who must attract a clientele directly and do not have to make everyday use of hospital facilities— for example, in urban areas in particular, some internists, pediatricians, ophthalmologists, and gynecologists. In these instances lay standards may be expected to have some force. Empirical examples of the logical extreme of colleague-dependent practices are easier to find in modern medicine. Specialists like pathologists and radiologists, for instance, are almost completely dependent upon colleague referrals and therefore have little need for such client-oriented techniques as a good bedside manner. Here, we should expect considerably greater pressure to honor colleague rather than lay or patient standards. This typology is based on the division of labor within the profession and is therefore applicable to analysis of the control of performance of individual practitioners in any kind of organized practice, from solo to bureaucratic. It might be pointed out, however, that in bureaucratically organized practice it is frequently the organization as a unit, not individual practitioners, that attracts a clientele and that all practitioners in the organization are therefore dependent on it for their work. Insofar as the organization is of the "professional" type discussed above, this means that dependence on it is actually dependence on the colleagues running it. Encouragement to meet professional standards of performance will therefore be considerably stronger than encouragement to meet lay standards. And insofar as work is at once more visible and amenable to control in such an organization than in less well-organized forms of practice, it is here that we should expect to find the highest professional standards. Indeed, it is the general opinion of teachers of medicine in the United

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States, Great Britain, and elsewhere that this is the case, although adequate evidence tc test this opinion has not yet been gathered. All else being equal, then, we may hypothesize that colleague-dependent practices, in which the physician's performance is observable to and his work dependent on colleagues, will also be most likely to conform to professional standards. Insofar as bureaucratic practice is colleague-dependent, the same conclusion may be drawn for it. But this conclusion masks several assumptions the truth of which is not self-evident: first, that colleagues will exert control over performance; second, that the mechanisms of control used by colleagues are effective; third, that standards are homogeneous throughout the profession. The remainder of this article will explore these assumptions. Professional regulation Variation in the organization of medical practice bears on such necessary conditions for the exercise of professional regulation as the observability of performance to colleagues and the structural vulnerability of the practitioner to control by colleagues. However, while observability and dependence are necessary conditions for the effective exercise of supervision, they are not sufficient. What is needed in addition is the willingness to exercise supervision and exert effective influence over performance. What slender evidence there is suggests that rather less influence over performance is exercised than the organization of practice actually allows, and that the little regulation which does exist has properties that establish and maintain organized differences in performance standards. The basic property of the system of control that seems to exist in the United States is its reliance upon what Carr-Saunders and Wilson, speaking of British medicine, call the "boycott"—that is, the refusal by individual practitioners to enter into a referral or collaborative relationship with those of whom they do not approve (1933, p. 403; see also Hyde et al. 1954). This device does not control the boycotted person's behavior so much as it pushes him outside the boundaries of observability and influence, to practice as he wishes in the company of those with similar standards. There seems to be a certain reluctance to exert active influence over another's performance—a reluctance that results in avoiding him rather than in seeking to change him. There is, unfortunately, little systematically collected empirical information bearing on the process of supervision and control among physicians. A study by Freidson and Rhea (1963; 1965) of a

large academically oriented group practice in the United States indicated that while performance was visible along the axes dictated by the interdependence of specialties within the over-all division of labor, each practitioner tended to keep his complaints about others to himself, so that what he could observe of others' performance in the division of labor was not transmitted to other colleagues. Since bits of information were scattered piecemeal through the colleague group, no really organized control of performance could be initiated unless a man behaved so outrageously as to personally offend everyone. Furthermore, attempts at control were largely individual and hortatory, and there were no control devices intermediate between remonstration and outright ejection from the organization (the latter being the structural equivalent of the boycott). While the physicians studied were aware of the looseness of supervision and control in this ostensibly well-organized practice, they were inclined to feel it adequate and appropriate for ordinary circumstances. Another American study (Goss 1961; 1963) is particularly instructive because it was done in a setting into which supervision was built. There were clear bureaucratic as well as professional supervisory responsibilities allocated through hierarchical ranks. The superior physician in the hierarchy had the right and perhaps even the obligation to review case records and evaluate case management. Furthermore, he had the right to give advice to subordinates about the way a case should be handled, even when advice was not solicited. However, even though the supervisor was officially responsible for the care given to patients in his unit and therefore had the formal right to order that certain procedures be followed for a case, he very rarely gave such orders. Instead, he gave advice, which incurred no obligation to obedience. The only obligation the subordinate had was to consider the advice in the light of his personal experience with and responsibility for the case. So long as he could justify his management of the case by reference to medical knowledge and his clinical experience, and so long as it was he who took personal responsibility for the outcome, he could reject the advice of his superior. In short, even here, where supervisory inspection of performance was routine, the exercise of control over performance was quite loose and permissive. If this is so in hierarchically organized practice settings, it should be even more the case in the informal, small-scale community practices that are far more common in medicine. Thus, we may say that the medical profession, which has gained freedom

MEDICAL PERSONNEL: Physicians from regulation by others, regulates itself in ways whose effectiveness is not self-evident. The analytical problem here is to understand what contributes to shaping this peculiar process of regulation and to point up its structural consequences. Professional values Obviously, when a social structure permits certain kinds of behavior but that behavior does not occur, we must explore the situation further to explain why it does not. Our first question might be why, in such a loose system, the physician does not routinely abuse his privilege. Here, the internalization of general professional values postulated by Parsons (1951, chapter 10) seems a plausible explanation. Parsons defines the professional as someone who is supposed to be recruited and licensed on the basis of his technical competence rather than his ascribed social characteristics; to use generally accepted scientific standards in his work rather than particularistic ones; to restrict his work activity to areas in which he is technically competent; to avoid emotional involvement and to cultivate objectivity in his work; and to put his client's interests before his own [see PROFESSIONS]. These normative expectations are intended by Parsons to apply to all professions, not only to medicine, since he treats the medical practitioner as the archetype of the professional. But it may be objected that the same expectations are applicable to all technical service occupations, not only to professions. Plumbers, too, are supposed to be recruited and licensed on the basis of achievement, to employ universalistic standards in their work, to be functionally specific and affectively neutral. And while plumbers are expected to make enough money from their work to gain a decent income (just as are physicians), they are not expected to do this by cheating the customer. Thus, such values constitute only the most general foundation of conscientiousness in occupational practice. Our second question, however, may be more specific to the medical profession. Why, if it so conscientious, does it not exercise more regulation over its members' performance? Such an extraordinarily loose regulatory structure has been explained by Carr-Saunders and Wilson (1933, pp. 399-400) and by Parsons (1951, pp. 470-471) by reference to the character of professional work. Instead of a se t routine, medicine requires the exercise of complex judgment; instead of caution, the taking of risks. Therefore, regulation can only be loose. But °* all the old established professions medicine is the one most based on fairly precise and detailed scientific knowledge. Indeed, the practice of medi-

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cine involves considerably less uncertainty than many other technical occupations. As the use of the doctrine of res ipsa loquitur in American courts implies, there are some very clear rights and wrongs in medicine, even if there are also some uncertainties, and these rights and wrongs have not brought forth any formal regulatory mechanisms from the profession as such (as opposed to concrete organizations like teaching hospitals, in which regulatory mechanisms do exist). Without denying that there is a degree of uncertainty, we must conclude that the precision possible in much of modern medicine and the trivial routine of much of everyday medical practice call into question the adequacy of explaining the peculiarly loose structure of controls to be found in the profession by reference to the character of its work. However, it may be that the peculiar nature of the work of the practicing professional encourages a characteristic sense of uncertainty that reflects considerably more special values than those described by Parsons. One such value is that of independence, or autonomy, which is significant for physicians in countries as different as Finland and the United States. Insofar as this value refers to social and economic independence, it reflects the entrepreneurial and individualistic ideology of the bourgeoisie, who are the prime source from which physicians are recruited in virtually all industrial countries. Insofar as the value refers to technical or professional independence—that is, the freedom to practice one's craft without interference, advice, or regulation by others—it seems more closely related to a state of mind encouraged by the character of professional work. The aim of the practitioner is not knowledge but action, and while successful action is the aim, the tendency is to assume that any action at all is better than none. Furthermore, to take action requires faith in oneself and even a will to believe in whatever one does instead of maintaining a skeptical detachment. Dealing with individual and concrete cases, the practitioner is inclined to emphasize indeterminacy rather than lawful regularity and to be radically pragmatic, relying more on the results he associates with his own actions than on theory. These seem to be the orientations that contribute to the emphasis on clinical experience mentioned earlier in connection with medical education. Given that the work of the medical practitioner is with individuals and that it is believed to be based on individual clinical experience, it follows that responsibility for the work can be perceived only as individual and personal. In assuming that

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responsibility, the practitioner does gain gratitude for success, but he also gains reproach for failure. Given the risk of blame, he evidences a certain sensitivity and defensiveness in the face of any outsider's evaluation of his performance. This defensiveness is manifested in imputing more uncertainty to the work than in fact exists and in insisting on using his own personal, clinical experience as the ultimate criterion for evaluating his own performance. Thus, collective responsibility for regulation is diminished, and the inclination to rely on individual responsibility and personal experience is augmented. These, of course, are merely suggestions of the complex task that has still to be done in picking out and interrelating strands of what might be called the ideology of the practicing professional. Instead of dwelling on values of such generality that they have doubtful analytical utility for understanding the quality of professional self-regulation, sociologists should determine the specific values attached to different types of professional work. Such an approach would supply one of the critical elements for an adequate explanation of the peculiarities of professional organization. Informal organization of the profession Even without detailed information it seems possible to suggest that the notion of informal organization serves as a vital link between the formal structure given to the American medical profession by the national, state, and county medical associations (see Hyde et al. 1954) and professional performance in the concrete setting of medical practice. By focusing on the characteristic way in which practitioners assert control over each other's performance, one can delineate the relation of one local practice to another and the loose groupings of practices that both carve up a community and extend outside its boundaries. When these informal groupings and the mechanisms of control they express are seen to be intertwined with the formal structure of the profession as a whole, much more of the character of the profession can be understood than by reference to formal associations and codes alone. Recalling that ordinarily the ultimate mechanism of control is the personal boycott, we can begin to indicate the informal structure of the profession by following out the implications of the boycott's operation on the interrelations of practitioners. Let us assume that individual practitioners are free to select the work they will undertake and to choose the colleagues with whom they will work in the division of labor. In this situation, control of professional standards is exercised largely by

willingness to work with one man and to exclude another. But since exclusion as such neither changes a man nor prevents him from working, one may assume that he will eventually find a circle whose standards are such that he is not excluded. There is thus a tendency for the control process to develop a stable set of colleague networks or fraternities. Each network, by the nature of its creation, is fairly homogeneous within itself. Its members share about the same professional standards, participate in each other's work, and participate in, if not dominate, the particular organizations and practices in which they work. But while each colleague network is likely to be fairly homogeneous, many differences are likely to exist between networks by virtue of the process of selection and rejection that differentiates them into separate networks. Thus there is not only likely to be little interaction between many contiguous networks, but also marked differences in technical and normative standards and in the practices and institutions in which the members of each network participate. In a structure of this nature there is comparatively little opportunity for those in one network to be very much aware of the existence of other standards; and even when awareness may exist, there is little leverage by which one network could influence another because each has severed connections with the other and is independent of the other. Since it is a segregating process that leads to and maintains such networks, and since the individual's behavior is less regulated by such a process than classified and assigned to a selfmaintaining collectivity of like people, we can see how within a single profession, even one quite free of lay interference, organized variations in professional performance can occur. While there are certainly social links between adjacent fraternities in the form of practitioners with connections in both, it does not seem to require a very large city to find individual practitioners who know nothing about each other. The characteristic control mechanism of professional regulation, then, paradoxically operates to place offenders beyond the control of those who disapprove of their performance. Moreover, the informal organization of internally homogeneous colleague networks segregated from interaction with each other sustains, if not reinforces, the differences in standards between networks. Apart from civil suit, which is a nonprofessional source of control over practice, and regulatory devices established in the limited milieu of teaching hospitals, all that is left to concerned members of the profession in the United States is exhortation and,

MEDICAL PERSONNEL: Physicians it is hoped, instruction by means of articles in professional journals that may or may not be read and that, if read, may or may not be influential on behavior. What has been suggested, in short, is that the disjunctive process of social control characterizing the concrete, everyday practice of American physicians creates an informal structure of relatively segregated, small circles of practitioners, the extremes of which are so isolated from each other that the conditions necessary for each influencing the other's behavior are missing. Furthermore, the mechanism of control that produces and sustains this situation is no aberration—rather, it is characteristic of the profession, an outcome of its organization and of the way it sees itself and its work. The consequence is that a single profession can contain within itself, and even encourage, markedly different ethical and technical standards of performance, limited in a very superficial way by the minimal standards imposed by selective recruitment, a basic core of training required for licensing, and the writings of the leaders of the medical profession. Tasks of a sociology of medicine The problems of analysis described in this article are not unique to the sociology of medicine but affect the sociology of professions in general. If they can be solved for medicine, we will have taken a long step toward solving them for all professions. The central problem here, as in the study of society in general, is social control. The problem is particularly important for the professions because by definition they are free of the controls common to most occupations. In addressing the problem of control, it was necessary to assess the role of the state and of politico-legal institutions, the manifest and latent functions of professional education, the organization of work, the control processes operating in work, and the norms or values that bear on the exercise of social control in work. The outcome of that analysis was the suggestion that a fragmented structure underlies the serene fagade of unity and homogeneity implied by the notion of a single profession joined by common values and a community of identity. To extend, correct, and refine such a trial analysis of the organization of medical work is one of the prime tasks of a sociology of medicine. In the course of extending it, one would be led quite naturally into a more detailed examination of another fliajor problem of analysis: the client-practitioner relationship. This problem, too, might be seen as one of control. The practitioner wants the client to Se ek him out for professionally appropriate reasons,

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without visiting quacks and without untoward delay. He wants the client to accept his recommendations and follow them scrupulously. In seeking compliance on the part of his client, the professional cannot always rely on his influence as an expert. The character of this influence and of practitioner—client interaction has barely been explored in other than psychological terms, and poses a challenge both to the taxonomy of types of social influence and to the conceptualization of social interaction. Finally, we may mention a problem of analysis that has not yet received much attention—the role of the professional in creating and defining his own work. In the case of medicine (more than of law or religion) this analytical problem has been confounded by the reification of "scientific knowledge," a viewpoint in which disease is taken to exist independently of human action and the physician is regarded as merely a diagnostician and therapist of what is objectively "there." However, disease that exists independently of human awareness and action is irrelevant to the sociologist, while biologically nonexistent "disease" in which people believe is quite relevant. What is sociologically relevant is a social definition of disease or any other kind of deviance, not the biological fact or fancy. If this premise be adopted, then it follows that physicians are responsible for the social creation of disease in the course of "discovery" and diagnosis [see HEALTH]. It would follow, further, that in medical practice the social organization of work biases the way in which diseases are created and shapes the way in which patients are managed and even created by diagnosis. Thus, a major task of the sociology of medicine is to study the causes and consequences of physicians' conceptions of disease, showing how disease as a social object is created or formed by medical institutions (Scheff 1966). If this task should be performed as something independent of the conventional study of the process of scientific discovery, and with different premises, we will have come a long way toward understanding the social institutions of medicine as one of the modern professions. ELIOT FREIDSON [See also HEALTH; ILLNESS; MEDICAL CARE; PROFESSIONS; PUBLIC HEALTH; SCIENCE, article on SCIENTIFIC COMMUNICATION; and the biography of HENDERSON.] BIBLIOGRAPHY BECKER, HOWARD S. et al. 1961 Boys in White: Student Culture in Medical School. Univ. of Chicago Press. CARLIN, JEROME 1966 Lawyers' Ethics: A Survey of the New York City Bar. New York: Russell Sage Foundation.

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CARR-SAUNDERS, ALEXANDER; and WILSON, P. A. (1933) 1964 The Professions. London: Cass. COKER, ROBERT E. JR. et al. 1966 Medical Careers in Public Health. Milbank Memorial Fund Quarterly 44:143-258. COLEMAN, JAMES S. et al. 1966 Medical Innovation: A Diffusion Study. Indianapolis, Ind..- Bobbs-Merrill. FIELD, MARK G. 1967 Soviet Socialized Medicine: An Introduction. New York: Free Press. FREIDSON, ELIOT 1961/1962 The Sociology of Medicine: A Trend Report and Bibliography. Current Sociology 10/11:123-192. FREIDSON, ELIOT 1963 The Organization of Medical Practice. Pages 299-319 in Howard E. Freeman, Sol Levine, and Leo G. Reeder, Handbook of Medical Sociology. Englewood Cliffs, N.J..- Prentice-Hall. FREIDSON, ELIOT 1966 The Sociology of Medicine: A Structural Approach. Unpublished manuscript. FREIDSON, ELIOT; and RHEA, BUFORD 1963 Processes of Control in a Company of Equals. Social Problems 11:119-131. FREIDSON, ELIOT; and RHEA, BUFORD 1965 Knowledge and Judgment in Professional Evaluations. Administrative Science Quarterly 10:107-124. Goss, MARY E. W. 1961 Influence and Authority Among Physicians in an Out-patient Clinic. American Sociological Review 26:39-50. Goss, MARY E. W. 1963 Patterns of Bureaucracy Among Hospital Staff Physicians. Pages 170-194 in Eliot Freidson (editor), The Hospital in Modern Society. New York: Free Press. HALL, OSWALD 1946 The Informal Organization of the Medical Profession. Canadian Journal of Economics and Political Science 12:30-44. HYDE, DAVID R. et al. 1954 The American Medical Association: Power, Purpose, and Politics in Organized Medicine. Yale Law Journal 63:938-1022. MERTON, ROBERT K. et al. (editors) 1957 The StudentPhysician. Cambridge, Mass.: Harvard Univ. Press. PARSONS, TALCOTT 1951 The Social System. Glencoe, 111.: Free Press. SCHEFF, THOMAS J. 1966 Typification in the Diagnostic Practices of Rehabilitation Agencies. Pages 139-147 in Marvin B. Sussman (editor), Sociology and Rehabilitation. Washington: American Sociological Association. STEVENS, ROSEMARY 1966 Medical Practice in Modern England: The Impact of Specialization and State Medicine. New Haven: Yale Univ. Press. II PARAMEDICAL PERSONNEL

The term "paramedical" refers to occupations whose work is both organized around tasks of healing and ultimately controlled by the authority of physicians. Ultimate control by medical authority is manifested in a number of ways. First, much of the technical knowledge learned by paramedical workers during the course of their training and used during the course of their work tends to be discovered, enlarged upon, and approved by physicians. Second, the tasks performed by paramedical workers tend to assist, rather than directly replace, the focal tasks of diagnosis and treatment. Third,

paramedical workers tend to be subordinate in that their work tends to be performed at the request or "order" of, and is often supervised by, physicians. Finally, the prestige assigned to paramedical occupations by the general public tends to be less than that assigned to physicians. The paramedical occupations may be distinguished from established professions by their relative lack of autonomy, responsibility, authority, and prestige. However, the fact that they are by definition organized around an established profession and in varying degrees partake of some, but never all, of the elements of professionalism allows us to distinguish them from many other occupations and, indeed, argue that they represent a sociologically distinct form of occupational organization. Furthermore, it may be noted that paramedical occupations are not adequately distinguished by reference to their health-related tasks. Occupations usually called paramedical do participate in a functional division of labor, but what is distinct about this division of labor is that it is ordered by the authority of a prime profession. Other occupations which may actually perform some of the same technical tasks but which stand in a different relationship to the dominant profession (as does, for example, a herbalist compared to a pharmacist) are not called paramedical, but rather quack or irregular. Differences between the paramedical and the quack do not necessarily arise from the actual tasks each performs, but rather from the relations each has to the dominant profession. Thus, the paramedical worker is less easily distinguished technologically, by the relation of his work to that of others, than sociologically, by his relation to medical authority. However, distinct as it is, this "paraprofessional" pattern is not common. For example, while there is a fairly elaborate division of labor revolving around law, it would not be appropriate to use the term "paralegal" for bailiffs, accountants, clerks, real estate brokers, and bankers in the same way that we use "paramedical" for nurses and laboratory technicians. Nor does the prefix seem properly employed to designate the division of labor connected with any other established profession. Medicine alone seems to have imposed such definite order on the occupations surrounding it. We can but guess the reasons for this, citing such variables as the comparative specificity and technical complexity of the tasks involved, which can only be exercised in a medical setting. Whatever the reason, this mode of organizing a division of labor is taxonomically distinct, and if it is true that labor is in general being "professionalized," the paramed-

MEDICAL PERSONNEL: Paramedical Personnel ical model may become more widespread in the future. Both practically and conceptually it is worth close study. How did it develop? What are its present characteristics? Development of the division of labor A division of labor in the task of diagnosing and treating human ills has always existed in one form or another in every human society. There have always been diagnosticians, herbalists, midwives, and nurses, even if only on a part-time, amateur basis. However, the distinctive division of labor labeled paramedical—which is to say, one organized around the authority of the medical profession —is relatively new and is complex only in the highly industrialized societies of the world where the modern medical profession arose. Even in these countries it varies a great deal in the completeness of its integration around and control by the medical profession. Unfortunately, there are few adequate cross-national comparisons of the organization of health workers to provide even the basic descriptive information necessary for analysis, and so much of the indication of the types and sources of variation must be based on scattered bits of information (for one comparison, see Glaser 1966). In Europe a distinctly paramedical division of labor, organized around the authority of a medical man, had begun to emerge at least by the time of the development in cities of the corporate guild and the university. The city provided the population density necessary for the support of a variety of full-time specialists, thereby allowing true occupations to arise. The guild provided the health-related occupations with a workable type of organization through which a distinct occupational identity, visible to officials and public alike, could slowly be established and through which they could press for exclusive rights to that identity and the work it involved. However, the right to have something of a monopoly of title and function—that is, to be licensed—and to control in a fairly strict way access into and progress through the occupational career was obtained from the state. Thus, the occupation gained organization, but it also became subject to assignment, by a political process, to a relatively well denned official position in a larger division of labor—a position that could involve enforced subordination to members of quite another guild. The significance of the university in this situation is that occupations trained in one had a stronger claim, by virtue of their aura of learning an d science, to a superordinate position in the occu pational structure. University training gave phy-

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sicians and surgeons a strong political position for persuading the state to subordinate to them such competitors as apothecaries, grocers, and barbers, and to allow them to prosecute irregular practitioners. This could be so even when it was doubtful that the actual knowledge and skill of the average university-trained practitioner in those days equipped him to practice any better than his selftaught or apprenticed competitor. With the development of the university and the guild in European cities, then, there arose a rudimentary structure of full-time health workers, organized, at least in part, under the supervision of physicians and surgeons. For centuries this organization was highly unstable, weakened from within by undisciplined competition and from without by the persistence of a great variety of irregular practitioners (see King 1958; Turner 1959). As is the case with the health services in the nonindustrial countries of today, the medical division of labor was fairly stable only in those parts of cities where a well-to-do gentry was likely to patronize it. In the city slums and in the countryside the poor and the peasantry persisted in relying on their own folk remedies, their own, largely part-time practitioners, and, on occasion, itinerant irregulars; the first two being part of their own culture, the last exploiting the naivete of that culture. There were in essence two health systems: the dominant one was rooted in the peasant culture, while the other, which was available only to a minority, owed its greater prestige to its origins in the learned traditions of Western civilization. Before the latter could become at once stable and universal, the former had to be destroyed or at least severely restricted. Not until the twentieth century in Europe and North America did anything emerge resembling a stable and extensive division of labor dominated by physicians, that is to say, a genuine paramedical division of labor. In the nonindustrial countries of the world today, such a structure does not yet exist to any great degree. Modern developments. The prime prerequisite for the development of a stable and extensive division of labor that is distinctively paramedical seems to be the eradication of great qualitative differences in culture and education among the major social strata of a society. This seems to be so because health services are used mostly on a voluntary basis. People choose to use one health service rather than another, and if only one organized service is available, they can choose not to use it and rely on their own informal resources instead. In this sense, while the application of political power can drive out of practice all but officially li-

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censed workers, it cannot make people use them. It seems no mere coincidence that the irregular health services declined greatly in industrialized countries about the same time that the institution of compulsory universal education arose. Contributory to this process, but by no means enough by itself (as experience in nonindustrial countries today indicates), was the rise of scientific medicine, which was capable for the first time in history of alleviating many complaints and symptoms consistently and predictably. By the twentieth century the medical profession was at last able to establish a secure mandate to provide a central health service. In England the rural general practitioner had been drawn into regular medical ranks. In Russia the feldsher had been in part replaced by and in part subordinated to the physician. In the United States the many different kinds and qualities of practitioners, all democratically calling themselves doctor, had been reduced to some uniformity. Control over the focal tasks of diagnosis and prescription was thereby secured (Sigerist 1935), and by virtue of its major role as arbiter in the application of new scientific discoveries, the profession could order around itself the proliferating new technical personnel. Some historical specialties, such as dentistry, survived fairly independently of the paramedical division of labor. Others, such as pharmacy and optometry, were not fully integrated into the paramedical division of labor, remaining at least partially independent of it. Still others, such as bonesetting and, in the United States, midwifery, were taken over by the physician himself, laymen and amateurs being driven out of practice. Others, the most prominent of which is nursing, maintained an ancient function while being brought firmly under medical control. And finally, with some few exceptions, such new specialties as laboratory technology, which arose with the new medical science and technology inside the walls of the hospital and medical school, developed unequivocally as part of an established paramedical division of labor. Today's paramedical division of labor is therefore a specifically historical construction, with some functionally related occupations falling inside it and some outside it; not all of the very old or the very new occupations fall inside it. The source of whatever order may be found in this division of labor seems to lie in the character of the relationships to be found between medicine, other occupations, and prospective lay clientele—central to which, perhaps, is the possibility of functional autonomy. Relations with the medical profession. The interoccupational relations of paramedical workers

can be seen clearly only as part of a larger, evolving structure that embraces physicians, health workers who are not part of the paramedical division of labor, and the institutions in which medical and nonmedical health services are provided. One of the major variables mediating interoccupational relations in the health services seems to be functional autonomy—the degree to which work can be carried on independently of organizational or medical supervision and to which it can be sustained by attracting its clientele independently of organizational referral or referral by other occupations, including physicians. On the whole, the more autonomous the occupation and the greater the overlap of its work with that of physicians, the greater is the potential for conflict, legal or otherwise. Such conflict is to be seen between chiropractors and physicians in the United States, homeopaths and physicians in the Soviet Union, and "native" practitioners and physicians in virtually all nonindustrial countries. The most interesting conflicts, however, occur within the paramedical division of labor during the course of the growth of new occupations capable of attaining functional autonomy. In the United States, where the movement toward professional status is strong and extensive and there are not enough physicians to perform all the traditional functions demanded of them, such conflict is common; it focuses on the question of whether or not nonphysicians are to be allowed to offer health services independently of medical supervision. The outcome has been, in such increasingly successful cases as that of the clinical psychologist, virtual independence in practice, limited only by the legal inability to prescribe drugs. Impelled by the force of professionalization, the growth of new techniques and new occupations to practice them seems to be giving a new shape to the paramedical division of labor. Some years ago it could be visualized quite simply as a pyramid, with the physician at the apex. However, in the present-day United States the pyramid seems to be changing into a less clear-cut structure, at the top of which is a plateau along which are ranged physicians as well as other relatively autonomous, but consulting and cooperating, new professionals, Recruitment and training Obviously the paramedical division of labor is a stratified system, the occupations of which are in varying degrees integrated around the work of the physician. All occupations in the system are given less prestige than the physician by the society at large. It follows that the socioeconomic status of those recruited into all paramedical occupations is

MEDICAL PERSONNEL: Paramedical Personnel likely to be lower than the status of those recruited into medicine itself. Furthermore, there is a hierarchy of prestige and authority among the ranks of paramedical workers; nurses, for example, are higher than attendants and technicians. This hierarchy is also likely to be reflected in the socioeconomic backgrounds of the workers. In the grossest comparison between physicians and paramedical workers, the latter are to a disproportionate degree women and from the less valued ethnic, racial, and religious groups. With the special exception of sex, those differences in background and personal characteristics are also likely to be ranged in an order corresponding to the general hierarchy of prestige and authority. Variability of training. Training follows a variable pattern, its order roughly paralleling the prestige, independence, and imputed responsibility of the work (see Wardwell 1963). Patterns of training range from the one extreme of professional schools associated with universities, requiring a full higher education before several years of training, to the other extreme of brief, informal, on-thejob training. Between these extremes are many types of training, varied according to the length of study, the formality and abstractness of the curriculum, and the type of institutional arrangement, such as attendance at hospital training schools or proprietary technical schools, apprenticeships in various institutions, and the like. In the United States, where the university is a considerably less clearly defined institution than elsewhere, more paramedical education with professional trappings is to be found. In Europe technical training schools quite separate from the university are more likely to exist, for the education of even the high-prestige, more independent paramedical occupations. The paramedical ranks tend to be ordered by the length and type of training required by the occupation: the longer the training and the more formal and the closer to the university it is, the higher is the occupation's position in the division of labor. It follows from this that the higher the position, the greater must be the investment of time and energy in training, the less casual can be the recruitment, and the greater must be the commitment to the occupation. Recruitment to the many low-skill positions in the paramedical division °f labor seems, by and large, to be a simple function of the demand for unskilled service workers willing to do unpleasant work. Recruitment to the higher-skill positions, however, is considerably more Problematic, especially in those occupations traditionally filled by women. The position of women. Nursing is a fairly ^ell-documented example of problems of recruit-

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ment and training in the paramedical occupations (see Corwin & Taves 1963). The problem in nursing is not that of attracting people to undergo training as such, for quite a few women begin training; it lies in recruiting women who will stay in training and subsequently pursue a lifetime career in the occupation. The essential difficulty here is that women are likely to be torn between the commitment to work and the commitment to marriage and family. This conflict has been discerned in nursing students and seems to be closely related to school dropouts and subsequent job turnover. Leaders of nursing in the United States have attempted to contend • with the problem by emphasizing the professional qualities of the occupation, presumably hoping to create a stronger "professional" commitment to work that might outweigh family considerations (Strauss 1966). The problem, however, seems to be inherent in the position of women in the labor force and does not seem soluble by professionalization. Even in the case of that most professional of professions, namely medicine, only a modest proportion of women in the United States who are qualified to practice medicine actually do so. One might therefore suspect that a more likely solution for a social system such as that of the United States would be found in changing the organization of the job so as to accommodate it to the demands of marriage and family. In European countries the position of women in the medical and paramedical labor force is quite different, apparently because of national differences in the occupational roles of women that make a professional career highly desirable among women of the haute bourgeoisie, small but significant differences in the class system, and, finally, the level of industrialization and the general standard of living. The last consideration brings up another aspect of recruitment and training in the paramedical division of labor. Clear evidence is lacking, but general opinion seems to be that it is becoming more and more difficult to recruit people to the paramedical jobs that require considerable investment of time and money in technical training. If this is so, it might be understood as a symptom of a larger process of advanced industrialization. Emphasis on professionalism. In the earlier stages of industrialization, the health services constituted a major and conspicuous source of social and economic mobility to which those willing and able to invest in specialized training could aspire. However, in later stages the demand for skilled technical services has developed markedly

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in other segments of the economy, thereby providing a considerably wider universe of opportunity than that which existed earlier. As older, fairly closely organized systems, requiring relatively extensive investment in training but offering relatively inflexible career lines, the health services, medical as well as paramedical, seem handicapped in competing for a limited pool of potential workers. Part of the pervasive emphasis on professionalism within the paramedical division of labor in the United States seems to be an attempt to increase the attractiveness of the work and thereby aid in recruiting the best possible workers. However, the emphasis on professionalism is likely to be strong only during the course of training, which is where the leaders of the occupation are most likely to be influential. Inasmuch as professionalism tends to emphasize intellectual and technical skill, there is the danger of dissatisfying students whose motives for entering the occupation are not so much intellectual as humanitarian— a danger that has been observed in nursing schools. Furthermore, inasmuch as professionalism tends to emphasize the dignity and autonomy of the worker, it is likely that upon leaving school and entering the everyday institutions of work, which are generally not controlled by the leaders of the occupation, the erstwhile student, who has been imbued with professionalism, is in for what has been called "reality shock." If the student's indoctrination has been thorough, his relations with other occupations in the paramedical hierarchy are likely to be somewhat difficult and personally disillusioning. Paramedical personnel in the hospital It has been implied that the greatest opportunity for developing functional autonomy seems to exist for those occupations that can operate outside the walls of such medically organized institutions as clinics and hospitals. The nursing profession, whose leaders in the United States have with great energy sought to establish unique skills and fully professional status, seems fated nonetheless to remain subject to the doctor's orders, in part because a nurse's work is largely carried out in the hospital. In this, however, the nurse is not unique: the largest part of the paramedical division of labor grew up within such organizations and may be expected to persist and proliferate within them in the future. It is for this reason that once we leave the broad societal level of analysis of the paramedical division of labor to undertake the analysis of everyday work, we find ourselves

in the community agency, the clinic, and, most extensively studied of all, the hospital. All hospitals are complex organizations coordinating a number of tasks and forming the focus for a number of distinct, usually overlapping goals. Given the fact that hospitals are fairly stable and spatially fixed, it is no accident that the paramedical occupations working within them have been studied far more than those working outside in the community at large, where the bulk of health services are actually provided. Thus, we have a severely limited view of paramedical as well as medical work. Among studies of hospital personnel, the nurse in the general hospital is the most frequent subject, and the attendant or aide in the mental hospital ranks second. We have little systematic empirical information about virtually all other paramedical workers. Handicapped as we are, the nurse and attendant between them do present us with a view of the range of workers, from the most professional to the least. By reviewing their respective positions, we can obtain some hints about the kinds of analytical problems posed by the work of paramedical personnel. The nursing profession. It is difficult to speak of nursing as a single occupation, because the training and work situations of nursing are so variable. Training in the United States can vary from a three-year hospital-nursing-school program to a four-year college program and even to programs leading to the doctorate (Davis et al. 1966). On the job, nurses in some American and European hospitals are preoccupied with bedside patient care and virtually all housekeeping tasks; however, in larger American teaching hospitals nurses are characteristically engaged in supervising the lesser personnel who give bedside care and do the housekeeping. Furthermore, there are major differences in the organization of hospitals in which nurses work: in most hospitals throughout the world the medical staff constitutes the only significant hierarchy, but in some of the larger American hospitals the medical hierarchy is paralleled by that of a nonmedical administrative staff. In the latter case the nurse's traditional subordination to the physician becomes complicated by subordination to another hierarchy. The two lines of authority may make quite different, even opposing, demands on her, thereby introducing into her work more strain than has existed traditionally (see Croog 1963). However, the problem of two lines of authority in hospitals has been overemphasized, particularly in light of the fact that the development of an administrative hierarchy provides the nurse with a

MEDICAL PERSONNEL: Paramedical Personnel better opportunity for mobility than exists when a medical hierarchy alone is present. The possibility of moving up into an administrative hierarchy is common for many occupations, including medicine, but it seems particularly significant for paraprofessional occupations. By their nature such occupations are technically subordinate: success within the occupation does not remove that subordination, and movement into the superordinate occupation is not usually possible. Only by forsaking the particularistic skills of the occupation and moving into administrative positions can that subordination be escaped. While administrative positions may in fact not be superordinate to professional staff positions, they may at least run parallel to the professional positions and attain equality with them. We can therefore understand why it is that nurses who are preoccupied with attaining a fully independent status attempt to pass over as "dirty work" the skills of bedside care (i.e., what was once called nursing) to lesser workers and to specialize in administrative work (see Hughes 1958). Recalling the problems involved in recruiting students who can become committed to nursing as a career and the attempt to create such commitment by emphasizing professionalism, we are led into an interesting dilemma: if women become committed to nursing by becoming "professionalizes," their commitment makes them prone to forsake the work for which they were recruited in the first place. That dilemma, however, is more characteristic of nursing in the United States than elsewhere, reflecting a national emphasis on social mobility and professionalization. Furthermore, it refers to one of the better-established paramedical occupations and more particularly to those members of the occupation in the United States who have been trained in and work in the high-prestige, academically oriented institutions. As such, it is hardly representative of the total range of paramedical occupations and their dilemmas. The cross-national comparison presented by William Glaser (1963) suggests that the more common problems of paramedical occupations are not really represented by American nursing studies. What is needed most is insight into the less trained, less mobile occupations. Unfortunately, about all we have to provide us with this insight are studies of attendants and aides in American mental hospitals. The attendant. The essential problem posed by the hospital attendant, and presumably by other relatively untrained personnel in similar positions lr i the division of labor, is his failure to satisfy

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the expectations of his professional supervisors. This difficulty may be the more important because the attendant is in the most continuous and intimate contact with the patient and therefore may in fact have greater influence on the patient than the supervising professionals. Thus, his "custodial" orientation to his patients is deplored, and a more "therapeutic" orientation is expected. The cause of the attendant's deficiencies seems to stem from at least two sources. First, his job is, in the most immediate sense, one of keeping order—minimizing dirt, destruction or waste of property, and personal injury and allowing housekeeping, therapeutic, and other services to be carried out on a predictable and efficient schedule. In the nature of the case this is a custodial responsibility, requiring something of a custodial attitude. If health institutions are to be run relatively economically, such an attitude on the part of those responsible for the hour-by-hour care of resident patients seems necessary and inevitable. It is the second element that is more variable— the way in which the attendant perceives his patients, their illness, and his relationship to them. Almost by definition, as a paramedical worker without formal training, the attendant is likely to adopt a view similar to that of the layman. The problem is not lay attitudes as such but which lay attitudes the attendant adopts. A great many studies of American state mental hospitals suggest that attendants adopt an attitude of punitiveness and contempt toward patients and of antagonism toward the expectations of the professional staff. Part of this attitude, as noted already, stems from the job the attendant has to do, as well as from the feeling that the more remote professional staff does not really understand how difficult it is to keep order or even how to keep order. Another part, however, seems to reflect more than anything else the average "unenlightened" American layman's conception of the mentally ill (see Strauss et al. 1964). Attendants from other cultures may have entirely different conceptions of the mentally ill and behave quite differently, as Caudill's analysis of the tsukisoi in Japan (1961) and Parsons' discussion of a Neapolitan hospital (1959) suggest. Even in the United States, when the illness involved is not as stigmatized as mental illness, lay attitudes of unskilled aides can be supportive rather than punitive, sympathetic rather than hostile. In this sense, precisely what is "unprofessional" about such lower-order workers can be as much a virtue as a vice. Indeed, that same less-professional character

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enables the paramedical worker to accomplish what the professional cannot, that is, the paramedical worker can draw into treatment patients who would otherwise be evasive and hostile to organized health services. Many studies from around the world, particularly those summarized by Simmons (1958), indicate that patients of humbler origins than that of physicians feel more comfortable dealing with such paramedical workers as nurses, feldshers, and midwives, who are closer to their own class and culture. Furthermore, lowerstatus patients seem more easily "educated" by paramedical personnel than by physicians, not only because they can enter into rapport more easily but also because they are more prone to "speak the same language" and to adjust themselves to the patient's expectations. This lesser social distance from patients seems to be particularly critical in circumstances where the contact between patient and health worker is voluntary and casual, rather than forced and desperate, and where status differences are quite marked, linguistically, culturally, and socially. Indeed, it appears that it is the need on the part of lower-status patients for consultants who are more nearly equal to them and who operate in a manner compatible with their culture that modern irregular practitioners have risen to serve. To the extent that paramedical personnel become professionalized, they may lose their advantage in dealing with lower-status patients. However, to the extent that the paramedical worker's success with those patients is predicated on lay attitudes, his relations with supervising professionals are certain to be problematic. This is one of the major dilemmas of paramedical work. ELIOT FREIDSON [See also MENTAL DISORDERS, TREATMENT OF, article On THE THERAPEUTIC COMMUNITY.] BIBLIOGRAPHY CAUDILL, WILLIAM 1961 Around the Clock Patient Care in Japanese Psychiatric Hospitals: The Role of the tsukisoi. American Sociological Review 26:204—214. CORWIN, RONALD G.; and TAVES, MARVIN J. 1963 Nursing and Other Health Professions. Pages 187-212 in Howard Freeman et al., Handbook of Medical Sociology. Englewood Cliffs, N.J.: Prentice-Hall. -> A review of many American studies of nursing. CROOG, SIDNEY H. 1963 Interpersonal Relations in Medical Settings. Pages 241-271 in Howard Freeman et al., Handbook of Medical Sociology. Englewood Cliffs, N.J.: Prentice-Hall. -» A review of studies of interoccupational relations in American hospitals. DAVIS, FRED et al. 1966 Problems and Issues in Collegiate Nursing Education. Pages 138-175 in Fred Davis

(editor), The Nursing Profession: Five Sociological Essays. New York: Wiley. FREIDSON, ELIOT 1961/1962 The Sociology of Medicine: A Trend Report and Bibliography. Current Sociology 10/11:123-192. -» Contains a brief review of the field and a fully annotated and classified international bibliography. GLASER, WILLIAM A. 1963 American and Foreign Hospitals: Some Sociological Comparisons. Pages 37-72 in Eliot Freidson (editor), The Hospital in Modern Society. New York: Free Press. -> A sketch of the different international settings in which paramedical personnel work. GLASER, WILLIAM A. 1966 Nursing Leadership and Policy: Some Cross-national Comparisons. Pages 1-59 in Fred Davis (editor), The Nursing Profession: Five Sociological Essays. New York: Wiley. HUGHES, EVERETT C. 1958 Men and Their Work. Glencoe, 111.: Free Press. -* Seminal essays on the study of occupations, many referring to paramedical and medical workers. KING, LESTER S. 1958 The Medical World of the Eighteenth Century. Univ. of Chicago Press. H> Contains a few excellent essays on interoccupational relations in English medicine of the sixteenth through the eighteenth centuries. PARSONS, A. 1959 Some Comparative Observations on Ward Social Structure: Southern Italy, England and the United States. Ospedale psichiatrico 2:3—23. SIGERIST, HENRY E. 1935 The History of Medical Licensure. Journal of the American Medical Association 104:1057-1060. SIMMONS, OZZIE G. 1958 Social Status and Public Health. Pamphlet No. 13. New York: Social Science Research Council. STRAUSS, ANSELM 1966 The Structure and Ideology of American Nursing: An Interpretation. Pages 60-180 in Fred Davis (editor), The Nursing Profession: Five Sociological Essays. New York: Wiley. STRAUSS, ANSELM et al. 1964 Psychiatric Ideologies and Institutions. New York: Free Press. TURNER, ERNEST S. 1959 Call the Doctor. New York: St. Martins. -> A social history of medicine in England, somewhat popular, but containing more data on practice and practitioners than conventional academic studies. WARDWELL, WALTER I. 1963 Limited, Marginal and Quasi-practitioners. Pages 213-239 in Howard Freeman et al., Handbook of Medical Sociology. Englewood Cliffs, N.J.: Prentice-Hall. -> A review of American materials on pharmacists, dentists, podiatrists, optometrists, clinical psychologists, osteopaths, chiropractors, and others.

MEDICAL PSYCHOLOGY See CLINICAL PSYCHOLOGY. MEDICAL SOCIOLOGY

See EPIDEMIOLOGY; HEALTH; ILLNESS; MEDICAL CARE; MEDICAL PERSONNEL; MENTAL DISORDERS, TREATMENT OF, article On THE THERAPEUTIC COMMUNITY; MENTAL HEALTH, article on THE CONCEPT; PUBLIC HEALTH. Related material may be found under OCCUPATIONS AND CAREERS; PROFESSIONS.

MEINECKE, FRIEDRICH MEINECKE, FRIEDRICH Friedrich Meinecke (1862-1954) was the most important German historian to follow Ranke and Burckhardt. He developed Dilthey's concept of history of ideas; he followed the philosophy of historicism, first outlined by Ernst Troeltsch and Benedetto Croce, to its logical conclusion; and finally, he achieved a synthesis of historical thought and political action by becoming one of the moral leaders in Germany's return to democracy after 1945. Sources of thought. Meinecke was born in the town of Salzwedel in Prussian Saxony but was brought up in Berlin in solid, middle-class surroundings. As a student, he was stirred by the personality of Bismarck and influenced by the sense of discipline and courage found in the Prussian state. But Meinecke was impressed by the classical humanism of German literature and music, poetry, and philosophy as well as by the spirit of Potsdam. After leaving the Gymnasium, Meinecke entered the University of Berlin, determined to become a historian. There he was initiated into the techniques of historical methodology which Leopold von Ranke and his school had perfected. Meinecke accepted not only their methods but also their general frame of reference; i.e., that the proper subject of study for the historian is conflict among the great powers. He attended the lectures of Johann G. Droysen and Wilhelm Dilthey; Heinrich von Sybel and Heinrich von Treitschke directed his scholarly pursuits. A speech defect from which he suffered throughout his life made Meinecke choose the career of secluded archivist rather than academic teacher, and in "this dusty trade" he felt at home for many years. Among his fellow archivists was one of the masters of institutional and comparative history, Otto Hintze, who exercised considerable influence on Meinecke. Although Meinecke was shy and withdrawn by nature, his special gifts were soon recognized. In 1893 he was asked to become editor of the Historische Zeitschrift, Germany's most important historical review. History of ideas. In these early years of apprenticeship, Meinecke was already concerned with the world of political ideas. He formulated the task of the historian in this manner: "Ideas, carried and transformed by living personalities, [constitute] the canvas of historical life" (Erlebtes 1 • • p. 117). This sentence represents the core of Meinecke's Ideengeschichte. He first put this conv iction to the test when he wrote the biography

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(1896-1899) of Hermann von Boyen, the Prussian minister of war who, in 1814, introduced military conscription. It was a pioneering attempt to make the arid facts of military history a part of the history of ideas. Meinecke's biography established Boyen's niche in history and Meinecke's own reputation as one of the most promising talents in Germany's academic world. His appointment as professor of modern European history at Strasbourg in 1901 was evidence of his immediate recognition. There, in the southwestern corner of Germany, Meinecke encountered some of the best minds then active in that country: Max Weber, Ernst Troeltsch, Heinrich Rickert, and many others, and they made him aware of the limitations of his earlier perspectives. One of Meinecke's characteristics was his never-failing capacity for growth; in Strasbourg, and after 1908 in Freiburg, he shed much of his Prussian parochialism. For more than a decade Meinecke remained fascinated by the problems and paradoxes of German history, especially the years from 1789 to 1848. In his next work, Weltbiirgertum und Nationalstaat (1908), he endeavored to show how cosmopolitanism and nationalism had become deeply intertwined in the complex development of nineteenthcentury Germany. He showed how both elements could be found in the ideas of Fichte, Novalis, Schlegel, Hegel, and Ranke, and how early German nationalism was made up of politically inconsistent cultural components. As Meinecke saw it, the universalistic tendencies of German thinkers were put to the test in 1848, and the revolution failed because of the incapacity of many Germans to come to grips with the realities of power politics. In this perspective, Bismarck and what he stood for became essential to the German quest for national unity. Hegel, Ranke, and Bismarck were the great liberators who freed the German mind from its romantic mists and created a realistic attitude toward the state. Meinecke thus traced the philosophical and literary origins of the ideology of the nation-state and went beyond the traditional borderlines of political history. His works were soon recognized as masterpieces in a new field, the biography of ideas or, as it were, of two ideas. He was at his best when analyzing the major polarities in Western thought: order and freedom, nationalism and universalism, power and ethics, "is" and "ought," uniqueness and recurrence. He became the historian of political ideas par excellence, founding a new school of historical thought, and developing a unique style—

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subtle, sensitive, and highly expressive of the countless vacations and mutations which political ideas produce as they develop. In Freiburg, Meinecke moved into the political arena for the first time. Abandoning the conservative leanings of his earlier years, he joined the right wing of the liberal party, the National Liberals. His goal was the widening of the foundation of the nation-state to include the ever-growing masses of industrial labor. His initial attempt was timorous and lacking in energy; he approved of representative government, not as an end in itself, but as a means to an end—that of enabling Germany to play her role as a world power. The nature and justification of power. In 1913 Meinecke accepted an appointment at the University of Berlin. At the outbreak of World War I he was at first uncritically committed to Germany's imperialistic aspirations. Only slowly did it dawn on him that this conflict harbored consequences surpassing by far the significance of previous engagements between feuding European nations. As the horizon around Germany grew darker, however, Meinecke's perceptions became more piercing. His keen political analysis and counsel, in turn, began to be sought after by the more thoughtful statesmen of Germany; Richard von Kuhlmann, secretary of state in the Foreign Office, and Theobald von Bethmann-Hollweg, the hapless chancellor, discussed with Meinecke the unsolved problems of Germany's domestic situation and the chances for a negotiated peace. He began to work for a peace by compromise and without territorial gains for any of the great powers. He also bent his efforts toward more equitable political representation for the working class. But although his advice was heard in many quarters, it was little heeded. More important than Meinecke's remedies for specific problems, however, was his emergent comprehension that the nation-state in which he had so strongly believed was no longer a sufficient answer to the political exigencies of the twentieth century. New questions crowded his mind: what was power? what was Germany's relationship to the rest of the Western world? what lay behind the great conflict that seemed to be splitting the Occident? Meinecke could not accept the MarxistLeninist interpretation of the crisis, since world revolution and the revolt of the masses appeared to him as the predominant threats to Western civilization. On the other hand, by the time the war ended he realized that the old, aristocratic Germany was doomed. The downfall of imperial Germany in 1918 filled him with grief but not with despair. He

accepted the Weimar Republic as a necessity and was ready to work for a new democratic Germany. Meinecke's doubts about the nature and justification of power, aroused by World War I, were crystallized in his book Machiavellism (1924). Meinecke admitted that it was the extreme manifestations of power politics during World War i that had opened his eyes to the dangers of politics divorced from any ethical code. The Treaty of Versailles only served to deepen the lesson; it led him into a historical investigation of theories of the nature and function of power in human life, beginning with Machiavelli, through Bodin and Rohan, to Frederick the Great, Hegel, Ranke, and Treitschke. There are those who consider the book to be a history of Machiavellianism; others view it as an attempt to surmount the teachings of Machiavelli. Neither of these interpretations hits the mark; more nearly, the book is Machiavellianism considered with a guilty conscience. Meinecke could not subscribe to Burckhardt's and Acton's thoroughgoing condemnation of power; neither could he any longer assent to the idolatry of power found in Hegel and Treitschke. The result is a dichotomy, a separation of ethics and power that defies reconciliation: the creed of the statesman, said Meinecke, must embody both the interest of the state and the fundamental moral principles of mankind. Historicism. There is a mood of philosophical reflection in Machiavellism which foreshadows an even more complex enterprise—a study of the genesis of historical thought. In Berlin, Meinecke lived in close contact with Troeltsch, who considered the historical outlook in its most comprehensive sense as characteristic of the twentieth century. In 1922 Troeltsch published Der Historismus und seine Probleme. After Troeltsch's death in 1923, his work on this subject was continued by Meinecke. However, Meinecke's perspective was somewhat narrower: as a historian he was more interested in the origins of historical thought than in its significance for the future of Western civilization. In 1936 he published Die Entstehung des Historismus ("The Origins of Historicism"). It is the third of his significant contributions to the history of ideas, completed when Meinecke was well past his seventieth year but dating back to very early reflections on the element of individuality, or uniqueness, in historical life. German historians had long been hostile to positivistic attempts to reduce human development to "scientific laws"; such attempts, they contended, violate two of the most precious elements in his-

MEINECKE, FRIEDRICH tory: spontaneity and uniqueness. Meinecke shared this interpretation of human life and traced it from the late seventeenth century to the twentieth. He defined "historicism" in the following manner: "the essence of historicism consists in replacing a general and abstract contemplation of human affairs by an individual one" (eine individualisierende Betrachtung) ([1936] 1959, p. 2). He did not hesitate to call this concentration on uniqueness the highest achievement in the contemplation of things human. This was an extreme stand, denying both the sociological ideal-type (as Max Weber conceived it) and the ethical norm of universal validity. Die Entstehung des Historismus begins with an analysis of Shaftesbury, Leibniz, and Vico; it moves into an evaluation of the historiography of the Enlightenment, with special emphasis on Voltaire, Montesquieu, Hume, and Gibbon. From English preromanticism it switches to Moser, Winckelmann, Herder, and Goethe, and it ends with an epilogue on Ranke. Critics have pointed out, with justice, that this history of historicism ends at the moment when the movement really came into its own and that it describes its growth but not its flowering. Likewise, the problem of relativism (inherent in the idea of uniqueness) versus absolute and perennial values is stated by Meinecke but by no means elucidated or solved. Nevertheless, the book marks an important advance in the long discussion among historians, social scientists, and philosophers of the proper subject and the meaning of history. The German catastrophe. Meinecke might have tried to answer some of these questions more conclusively had it not been for the general conditions of his time. When this book on historicism was published, Hitler had triumphed in Germany. Meinecke had fought with courage against the rise of National Socialism, both in the press and from his chair at the University of Berlin. Some of his close associates were ousted and silenced. Many of Meinecke's students were obliged to flee the country, and in 1935 Meinecke relinquished the editorship of the Historische Zeitschrift. But he was perhaps most oppressed by the foreboding of a second world war. His correspondence clearly reveals that he was one of the few German scholars who never compromised with the authorities and who had the courage to state frankly in his letters what he was not allowed to say in public. An indefatigable worker, Meinecke spent these Years working on his memoirs; they hold a certain c harrn but do not rank with his contributions to

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intellectual history. The war did not spare him: he suffered the same privations, the hunger, and bombings, as millions of others. Finally he fled from Berlin, shortly before it fell to the Russians. Once more his mind turned to the enigma of German history, especially to the questions that have puzzled so many observers: how could the advent of Hitler be explained? and further, to what extent was Germany responsible for the greatest retrogression in European civilization since the days of the Black Death? Meinecke's answers were given in a small book, The German Catastrophe (1946). He began his analysis with the statement that National Socialism must be understood against the background of our entire Western civilization, against the conflict between the old society and the new industrial masses. And he did not spare those forces which had once elicited his praise: the Prussian state and the German bourgeoisie. The Prussian state, he wrote, had permeated the nation with its militaristic attitude; the bourgeoisie had closed its mind to democratic forms of government, which alone could have brought a reconciliation between itself and the working class. He accounted for the success of a demoniac figure like Hitler by indicating the German social interests which had tried to manipulate the "revolution of nihilism" only to become its victims. This new approach, an attempt to combine intellectual and social history, is also apparent in other essays that Meinecke wrote after 1945, especially in his comparison of Burckhardt and Ranke (1948a) and in his appraisal of the revolution of 1848 (1948&). They reveal, if nothing else, an indomitable will to continue the task of the historian in a world changed beyond recognition from the well-grounded security into which Meinecke had been born. When a large part of the student body revolted against the oppression of the communist-controlled University of Berlin, it found in Meinecke the leader to head an independent institution—the Free University of Berlin. To have heralded and ushered in so momentous an action is surely one of Meinecke's titles to lasting fame. His contributions to modern historiography have proved surprisingly durable and have reached well beyond the confines of Germany. They have been emulated, corrected, and improved in Austria, Italy, and, more especially, in the United States, where some of his students carry on his work. GERHARD MASUR

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[See also HISTORY; NATIONALISM; POWER; and the biographies of BURCKHARDT; CROCE; DILTHEY; HEGEL; HINTZE; MACHIAVELLI; RANKE; TREITSCHKE; TROELTSCH.] WORKS BY MEINECKE 1896—1899 Das Leben des Generalfeldmarshalls Hermann von Boyen. 2 vols. Stuttgart: Cotta. (1908) 1962 Weltburgertum und Nationalstaat: Studien zur Genesis des deutschen Nationalstaates. Edited with an introduction by Hans Herzfeld. Munich: Oldenbourg. (1924) 1962 Machiavellism: The Doctrine of Raison d'Etat and Its Place in Modern History. New York: Praeger. -» Originally published as Die Idee der Staatsrdson in der neueren Geschichte. Contains a general introduction to Friedrich Meinecke's work by Werner Stark. (1936) 1959 Werke. Volume 3: Die Entstehung des Historismus. Munich: Oldenbourg. -> The translation of the extract in the text was provided by Gerhard Masur, (1946) 1950 The German Catastrophe: Reflections and Recollections. Cambridge, Mass.: Harvard Univ. Press. -> First published in German. A paperback edition was published in 1963 by Beacon. (1948a) 1954 Ranke and Burckhardt. Pages 141-156 in Hans Kohn (editor), German History: Some New German Views. Boston: Beacon. -> First published in German. (19486) 1951 Year 1848 in German History: Reflections on a Centenary. Pages 668-686 in Herman Ausubel (editor), Making of Modern Europe. Volume 2: Waterloo to the Atomic Age. New York: Dryden, -> First published as "1848: Eine Sakularbetrachtung." Erlebtes: 1862-1919. Stuttgart: Koehler, 1964. -» The translation of the extract in the text was provided by Gerhard Masur. Werke. 6 vols. Munich: Oldenbourg, 1957-1962. -» Volume 1: Die Idee der Staatsrdson in der neueren Geschichte. Volume 2: Politische Schriften und Re den. Volume 3: Die Entstehung des Historismus. Volume 4: Zur Theorie und Philosophic der Geschichte. Volume 5: Weltburgertum und Nationalstaat: Studien zur Genesis des deutschen Nationalstaates. Volume 6: Ausgewdhlter Briefwechsel. SUPPLEMENTARY BIBLIOGRAPHY

STERLING, RICHARD W. 1958 Ethics in a World of Power: The Political Ideas of Friedrich Meinecke. Princeton Univ. Press. ->• Contains a bibliography of Friedrich Meinecke's writings and books and articles about him.

MEMORY See FORGETTING and LEARNING.

MENGER, CARL Carl Menger (1840-1921), economic theorist and founder of the Austrian school of marginal analysis, was both the most influential and the least read of the major figures who gave economic theory the shape it preserved from about 1885 to

1935. There is little doubt that it was his immediate disciples who cast microeconomic theory into the form which, in its essentials, it still retains. Of the three founders of modern utility analysis, he alone not only based his work on a long tradition and presented the outlines of his theory in a form which for some time could not be bettered, but also succeeded in creating a school which continued to develop his ideas. Menger exerted a widespread influence, mainly through his avowed disciples in many countries, despite the fact that his two main books were not reprinted for 50 years or translated into English for 79 years. His work also had an effect on the only important rival school of the period—the neoclassical Cambridge tradition. At an early stage, Alfred Marshall, founder of the Cambridge school, had evidently studied Menger's work much more assiduously than is suggested by the few references to Menger (most of which were dropped from later editions) in Marshall's Principles. (Marshall's personal copy of Menger's Grundsatze, with a detailed marginal commentary in Marshall's hand, is preserved in the Marshall Library at Cambridge.) Menger was born in Neu Sandec, Galicia (then in the Austrian part of Poland), the descendant of a professional family that had earned the prefix "von" (Menger himself dropped it in early adulthood). In the well-stocked library of his father, a practicing lawyer, Menger and his two brothers became acquainted early with the literature on social and economic questions; one brother, Anton Menger, was a legal philosopher and historian of socialist doctrine. Menger studied law at the universities of Vienna and Prague and finally took his doctorate at the University of Cracow in 1867. Apparently he had done some journalistic work in Vienna and Lemberg before taking the degree, and afterward he entered the press section of the prime minister's office in Vienna, a position which was frequently a springboard to high public office. In that position, apparently as a result of having to write market reports, Menger developed an interest in price theory. The recent publication of his annotations to Rau's Grundsatze der Volkswirthschaftslehre ([1870] 1963) suggests that it was mainly his critical analysis of this textbook exposition of classical doctrine that led Menger, from 1867 on, to develop his own value theory. In his extensive reading, Menger must have found ample material in the early nineteenth-century German and French economic literature on which to build a fully developed utility analysis. (The utility tradition was not as strongly preserved in the English literature.) It noW

MENGER, CARL appears that the literature on which he was able to draw included also the work of an Austrian economist, J- Kudler (whose textbook, Die Grundlehren der Volkswirthschaft 1846, he had probably used at the university), and one work by Cournot. Menger's sources, however, did not include the work of the author who had the most completely anticipated him, Gossen's Entwickelung der Gesetze des fnenschlichen Verkehrs . . . , published in 1854. The results of Menger's studies appeared in his principles of Economics (1871), the work on which his fame mainly rests. Described as the "first, general part" of an intended comprehensive work on economic theory, it remained his sole major publication in this field during his lifetime. In somewhat copious but always clear language, it provided a much more thorough account of the relations between utility, value, and price than is found in any of the works of Jevons and Walras, who at about the same time laid the foundation of the "marginal revolution" in economics. The book gained for Menger first a lecturership and, in 1873, the position of extraordinary professor at the University of Vienna. For some years he published nothing more, apparently because of his appointment in 1876 as tutor to the 18-year-old crown prince of Austria, the ill-fated Archduke Rudolf. For two years Menger accompanied Rudolf on extensive travels through Germany, France, and the British Isles. He seems to have assisted the crown prince in the composition of a pamphlet (anonymously published in 1878) which attempted a critical examination of the role played by the higher Austrian aristocracy. The pamphlet caused some stir when in 1906, 17 years after the death of the archduke, his authorship was discovered. The real beginning of Menger's long and very effective career as a teacher came with his appointment in 1879 to a full professorship at the University of Vienna. During the next 24 years he expended most of his energy on his general lectures to law students (which he appears to have rewritten every year), and he was particularly attentive to those few students who voluntarily chose economics as their field of special work. His teaching w as interrupted only twice by bursts of literary activity. The first of these was connected with his second major book, Problems of Economics and Sociology (1883). Here he undertook to vindicate J16 importance of theory in the social sciences. lfl is was an effort that seemed necessary to him in ^ew of the complete indifference or even hostility , ich most of his German colleagues, influenced y the antitheoretical attitude of the "younger hislc al school" in economics, had shown toward his

125

attempt in the Principles to reconstruct economic theory. To understand the aim of the Problems and the nature of the great controversy to which it gave rise, it is necessary to appreciate the character of the school against which it was directed. The "younger historical school" is somewhat misnamed: unlike von Savigny and the older historical school of jurisprudence, or even Roscher and the "older historical school" in economics, this "younger" school was not interested in history as the study of unique events but regarded historical study as the empirical approach to an eventual theoretical explanation of social institutions. Through the study of historical development it hoped to arrive at the laws of development of social wholes, from which, in turn, could be deduced the historical necessities governing each phase of this development. This was the sort of positivist-empiricist approach which was later adopted by American institutionalists (differing from similar, more recent efforts only in that it made little use of statistical technique), and which is better described (as by Popper) as historicism. It was against this use of history as a means of discovering empirical laws that Menger undertook to defend what he considered to be the proper function of theory—reconstructing the structure of social wholes from their parts by the procedure called methodological individualism by Schumpeter, or the "compositive method" by Menger himself. It is essentially what today is called microtheory. Menger was greatly interested in history and the genesis of institutions, and he was anxious mainly to emphasize the different nature of the task of theory and the task of history proper and to prevent a confusion of their methods. The distinction, as he elaborated it, considerably influenced the later work of Rickert and Max Weber. Perhaps the most important part of his discussion was the clear recognition, first, that the object of all social theory is the tracing of what are now usually called the unintended consequences of individual actions (Menger's term was the unbeabsichtigte Resultante), and, second, that in this effort the genetic and the functional aspects could not be separated ([1883] 1963, pp. 163, 180, 182, 188). In expounding and illustrating this view he went far beyond the limit of economics and dealt particularly with the genesis of law. The nature of the dispute has often been confused by the fact that Menger, in arguing against what he regarded as the dominant pseudohistorical school in economics, maintained ideas which had reached him through the historical school in law.

126

MENGER, CARL

These ideas can be traced back to Mandeville, David Hume, and the later eighteenth-century Scottish philosophers, although the degree to which Menger was directly acquainted with these eighteenth-century sources is not clear. It is worth noting that Menger always had a great interest in the history of economic theory and used it with much didactic skill in his lectures as an introduction to the problems of modern economic theory. The Problems was unfavorably and condescendingly reviewed by Gustav Schmoller, the head of the younger historical school of economists; Menger replied to Schmoller's criticism in a passionate brochure, Die Irrthumer des Historismus in der deutschen Nationalokonomie (1884). This was the beginning of the celebrated Methodenstreit (dispute on method). Emotions ran high; younger men on both sides joined in; and the dispute produced a cleavage between German and Austrian economics, traces of which were to be felt for decades. In a number of articles during the following few years Menger dealt mainly with problems arising out of the dispute, except for his only other contribution to pure economic theory, the article "Zur Theorie des Kapitals," published in 1888 (see Collected Works, vol. 3, pp. 133-183). Menger emerged a second time from his academic seclusion in 1892 to join the discussion on the reform of the Austrian currency. His active participation in discussions of policy was foreshadowed in the very same year by his article on money (see Collected Works, vol. 4, pp. 1-2) for the new German encyclopedia of political science. The article was itself a substantial treatise, which devoted much space to the evolution of money but also emphasized the factors determining the amount of money held by individuals, and which laid the foundations for a theory of the value of money on which later Austrian economists, such as Wieser, Von Mises, and Weiss were able to build. No less important, however, are his memorandum and his oral evidence to the Austrian currency commission and various articles which he published in 1892 and in the next few years. But while such special occasions led Menger to literary production, his teaching appears to have precluded progress on the great treatise which he hoped would replace his first work. Therefore, in 1903, he prematurely resigned his professorship in order to devote himself entirely to this task. But although he continued to work on it during the remaining 18 years of his life and at one stage seems to have come close to his goal, he continued his efforts after his powers had begun to fail, with the result that he left nothing that was readily

publishable at his death. His son included part of the manuscript material in a second edition of the Grundsatze, which appeared in 1923. But the publication of more of the manuscript material has proved to be a very difficult task which so far has not been accomplished. Menger built up over the years one of the greatest private libraries in the field of social science, which in 1911 he estimated at something like 25,000 volumes. The sections dealing with the social sciences and anthropology were sold after his death to the Commercial University (now Hitotsubashi University) in Tokyo, which published a catalogue of it in two parts, one in 1926 and the other in 1955. In an assessment of Menger's influence it should be noted that his ideas were introduced into anthropology by Richard Thurnwald, one of his students. FRIEDRICH A. VON HAYEK [For the historical context of Menger's work, see ECONOMIC THOUGHT, articles on THE HISTORICAL SCHOOL, THE AUSTRIAN SCHOOL,

and

THE INSTITUTIONAL

SCHOOL; and the biographies of COURNOT; GOSSEN.; JEVONS; SCHMOLLER; WALRAS. For discussion of the subsequent development of Menger's ideas, see UTILITY; and the biographies of THURNWALD; VON MISES, LUDWIG; WEBER, MAX; WIESER.] WORKS BY MENGER (1870) 1963 Carl Mengers erster Entwurf zu seinem Hauptwerk Grundsatze geschrieben als Anmerkungen zu den Grundsatzen der Volkswirthschaftslehre von Karl Heinrich Ran. With an Introduction by Yuzo Yamada. Tokyo: Bibliothek der Hitotsubashi Universitat. -> Written in 1870 and published posthumously. (1871) 1950 Principles of Economics: First General Part. Edited by James Dingwall and Bert F. Hoselitz, with an Introduction by Frank H. Knight. Glencoe, IllFree Press. -» First published as Grundsatze der Volkswirthschaftslehre. The second complete German edition was published in 1923. (1883) 1963 Problems of Economics and Sociology. Edited with an introduction by Louis Schneider. Urbana: Univ. of Illinois Press. -» First published as Untersuchungen uber die Methode der Socialwissenschaften und der politischen Oekonomie insbesondere. 1884 Die Irrthumer des Historismus in der deutschen N«tionalokonomie. Vienna: Holder. 1892 Beitrage zur Wdhrungsfrage in Oesterreich-UngarnJena (Germany): Fischer. Carl Mengers Zusdtze zu Grundziige der Volkswirthschaftslehre. With an introduction by Emil Kauder. Tokyo' Bibliothek der Hitotsubashi Universitat, 1961. -> Published posthumously. The Collected Works of Carl Menger. 4 vols. Series of Re" prints of Scarce Tracts in Economic and Politic3* Science, No. 17-20. London School of Economics and Political Science, 1933-1936. -> Volume 1: Grundsatze der Volkswirthschaftslehre (1871) 1934. Voluitt6 2: Untersuchungen uber die Methode der Social^lS'

MENTAL DISORDERS: Genetic Aspects senschaften . . . , (1883) 1933. Volume 3: Kleinere Schriften zur Methode und Geschichte der Volkswirthschaftslehre (1884-1915) 1935. Volume 4: Schriften iiber Geldtheorie und Wdhrungspolitik . . . (1889-1893) 1936. Contains a biographical introduction by von Hayek in Volume 1, and a complete list of Menger's known writings in Volume 4 1933-1936. SUPPLEMENTARY BIBLIOGRAPHY

ANTONELLI, ETIENNE 1953 Leon Walras et Carl Menger a travers leur correspondance. Economie appliquee 6:269-287. BLOCK, HENRI S. 1937 La theorie des besoins de Carl Menger. Paris: Librairie Generale de Droit et de Jurisprudence. BLOCK, HENRI S. 1940 Carl Menger: The Founder of the Austrian School. Journal of Political Economy 48: 428-433. FEILBOGEN, S. 1911 L'ecole autrichienne d'economie politique. Journal des economistes Sixth Series 31:5057, 214-230, 375-388. HOWEY, RICHARD S. 1960 The Rise of the Marginal Utility School: 1870-1889. Lawrence: Univ. of Kansas Press. KAUDER, EMIL 1953 The Retarded Acceptance of the Marginal Utility Theory. Quarterly Journal of Economics 67:564-575. KAUDER, EMIL 1957 Intellectual and Political Roots of the Older Austrian School. Zeitschrift fur Nationalokonomie 17:411-425. KAUDER, EMIL 1959 Menger and His Library. Keizai kenkyu (Economic Review), Hitotsubashi University 10:58-64. KAUDER, EMIL 1961 Freedom and Economic Theory: Second Research Report on Menger's Unpublished Paper. Hitotsubashi Journal of Economics 2:67—82. KAUDER, EMIL 1962 Aus Mengers nachgelassenen Papieren. Weltwirtschaftliches Archiv 89:1-28. SCHUMPETER, JOSEPH A. (1921) 1960 Carl Menger: 1840-1921. Pages 80-90 in Joseph A. Schumpeter, Ten Great Economists, From Marx to Keynes. New York: Oxford Univ. Press. -> First published in German in Volume 1 of Zeitschrift fur Volkswirtschaft und Sozialpolitik, New Series. STIGLER, GEORGE J. 1941 Production and Distribution Theories: The Formative Period. New York: Macmillan. -> See especially pages 134-157 on "Carl Menger." WEISS, FRANZ X. 1924 Zur zweiten Auflage von Carl Mengers Grundsdtzen. Zeitschrift fur Volkswirtschaft und Sozialpolitik New Series 4:134-154. WIESER, FRIEDRICH 1923 Karl Menger. Volume 1, pages 84-92 in Neue osterreichische Biographie: 1815-1918. Vienna: Wiener Drucke. YEAGER, LELAND B. 1954 The Methodology of Henry George and Carl Menger. American Journal of Economics and Sociology 13:233-238.

MENTAL ABILITY

See INTELLIGENCE AND INTELLIGENCE TESTING. MENTAL DISORDERS

General considerations underlying the study of Cental disorders are discussed in the articles under ^s heading. Concepts of direct relevance are also discussed in ANXIETY; DEFENSE MECHANISMS;

727

STRESS. General categories of mental disorders are reviewed in the articles NEUROSIS; PSYCHOSIS; specific disorders are discussed in CHARACTER DISORDERS; DEPRESSIVE DISORDERS; HYSTERIA; OBSESSIVE-COMPULSIVE DISORDERS; PARANOID REACTIONS; PHOBIAS; PSYCHOPATHIC PERSONALITY; PSYCHOSOMATIC ILLNESS; SCHIZOPHRENIA. Methods of assessing mental disorders are discussed in ELECTROENCEPHALOGRAPHY; INTERVIEWING, article On PERSONALITY APPRAISAL; PERSONALITY MEASUREMENT; PROjECTivE METHODS. The treatment of mental disorders is discussed under CLINICAL PSYCHOLOGY; COUNSELING PSYCHOLOGY; INTERVIEWING, article on THERAPEUTIC INTERVIEWING; MENTAL DISORDERS, TREATMENT OF; PSYCHIATRY; PSYCHOANALYSIS. Social problems that can be considered as aspects of mental disorders are discussed in DRINKING AND ALCOHOLISM; DRUGS; SEXUAL BEHAVIOR, articles on HOMOSEXUALITY and SEXUAL DEVIATION; SUICIDE. i. 11. in. iv. v. vi.

GENETIC ASPECTS ORGANIC ASPECTS BIOLOGICAL ASPECTS EPIDEMIOLOGY CHILDHOOD MENTAL DISORDERS EXPERIMENTAL STUDY

Eliot Slater Joseph M. Wepman Joel Elkes Ernest Gruenberg Britton K. Ruebush George Talland

GENETIC ASPECTS

People who are related to one another by blood tend to resemble one another in, among other things, their mental make-up and their liability to mental illness. Both genetic and environmental factors may play a part in this resemblance. The most widely accepted view of the nature of the interaction between heredity and environment has been called the diathesis-stress theory (Rosenthai 1963). In its application to mental illness this view suggests that the susceptibility to mental illness, insofar as it is genetically based, varies along a continuum ranging from high to low extremes, most people clustering about an average of moderate susceptibility. Environmental stresses, also, vary from severe to slight. Accordingly, when a mental breakdown occurs, a combination of both factors is involved; thus, we should expect a high rate of breakdown among normal individuals subjected to severe stress, and a high rate also among very susceptible people placed under even mild stress. Such a quantitative relationship has been shown to hold in fact, e.g., in the neurotic illnesses of combat troops (Symonds 1943). Whether psychotic illnesses follow the same general law is a matter more difficult to decide.

128

MENTAL DISORDERS: Genetic Aspects

Personality deviations and neurotic illness Twin studies. An important part of the work in the field of personality deviations and neurotic illness has been studies of twins. One-egg, or monozygotic (MZ), twins, whose entire genetic equipment is identical, are of the same sex and are very much alike in physical characteristics. Twoegg, or dizygotic (DZ), twins ordinarily resemble each other no more than any pair of brothers or sisters and are as likely to be of opposite sexes as of the same sex. As a rule only the same-sexed DZ twin pairs are taken by investigators for comparison with MZ pairs. Twin pairs are said to be concordant when it is found that the twin of a proband (index case) with a particular deviation also shows the same anomaly. Concordance rates are usually given as percentages. Genetic hypotheses lead one to suppose that concordance rates should be much higher in MZ than in DZ pairs and that variability within MZ pairs should be smaller than within DZ pairs. Table 1 lists the percentage of concordances found for a variety of conditions, in which the statistics are based on at least thirty pairs. Criminality and delinquency. Much effort has been put into the investigation of criminality and behavior disorder. The results of Rosanoff in juvenile delinquency are noteworthy (Rosanoff et al. 1934; 1941). There are high rates of concordance both in MZ and in DZ twin pairs, and little difference between them. This suggests that the similarity in the twins' behavior is due to common factors in their environment. It is at least possible that each of the twins constitutes part of the stress factor for his twin partner. The same suggestion arises from the observations of behavior disorder and neurotic traits in school children. Shields found that in these children the degree of neurotic reaction was more noticeably related to environmental factors than genetic constitution; the hereditary

factor showed itself in the type of reaction (1954). [See CRIMINOLOGY; DELINQUENCY; PSYCHOPATHIC PERSONALITY.]

Adult neuroses. Concordance rates are lower in neurotic adults, both in the MZ and in the DZ pairs. The greatly increased variability within both kinds of pairs can be put down to the much wider range of experience, and wider variety of stresses, to which adults are subjected. Male homosexuality. At the opposite extreme are Kallmann's findings of 100 per cent concordance in MZ pairs, as against 12 per cent concordance in DZ pairs, for male homosexuality. This would suggest that in these cases the genetic factors account for the greater part of the variance. Some caution in interpretation is needed, however. The importance that the genetic contribution acquires here may be due to the fact that there was a predominance of the more constitutional type of homosexual in the sample studied by Kallmann and his team. [See SEXUAL BEHAVIOR, articles on SEXUAL DEVIATION and HOMOSEXUALITY.] Studies of relatives. Attempts to estimate the importance of hereditary factors in causing neurotic illness have been made by investigating the frequency of such illnesses among the relatives of neurotic patients. Findings have varied greatly from observer to observer. One of the early workers, Brown (1942), started by investigating the first-degree relatives of patients who had been diagnosed as suffering from obsessional neurosis, anxiety neurosis, and hysteria, as well as those of a control group. Among the relatives of all groups he found individuals suffering from obsessional neurosis, anxiety neurosis, and hysteria, as well as from other personality deviations of a kind not easily named and classified. There were three significant findings: the relatives of the control group had much less psychiatric abnormality than the relatives of any of the other three groups; all three diagnoses were represented among the relatives of

Table 1 — Concordance rates for personality deviation and behavior disorders in monozygotic and same-sexed dizygotic twins PER CENT OF CONCORDANCE

Number of pairs

lnvesfigafor('sj

MZ

DZ

Male homosexuality Adult crime

63 216

100

12

Juvenile delinquency Childhood behavior disorder Behavior disorder or marked neurotic traits in school children Neurosis, psychopathic personality Alcoholic addiction

67 107

Kallmann 1952 Lange 1929; Rosanoff et al. 1934; Kranz 1936; Stumpfl 1936; Borgstroem 1939 Rosanoff etal. 1934; 1941 Rosanoff et al. 1934; 1941

68 85 87

35 75 43

74 25 65

50 14 30

Deviation

41 37 82

Shields 1954 Slater 1953 Kaij 1960

Source: Shields & Slater 1960, p. 327, table 8.6-

MENTAL DISORDERS: Genetic Aspects all three patient groups; among those relatives who were classifiable under the three named diagnoses, it was found that there was a tendency for them to be in the same diagnostic category as the related patient. For example, of the nine obsessional relatives discovered, seven were related to the obsessional patients. This finding suggests a certain degree of specificity, which is best seen in the investigations which have been made on the relatives of obsessional patients (Luxenburger 1930; Lewis 1936; Riidin 1953). Among the 100 parents of 50 obsessional patients Lewis found that 37 showed pronounced obsessional traits in one form or another; 21 per cent of the 206 siblings also showed obsessional traits. [See OBSESSIVE-COMPULSIVE DISORDERS.] At the opposite pole are the findings in the relatives of patients diagnosed as suffering from "hysteria." The best family study was made by Ljungberg (1957), who found that among the fathers, brothers, and sons of hysterics, 2 per cent, 3 per cent, and 5 per cent respectively were themselves hysterics; and among the mothers, sisters, and daughters, 7 per cent, 6 per cent, and 7 per cent respectively. His observations also suggested that hysterical symptoms were not necessarily associated with hysterical personalities, and of the 363 hysterics whose personality structures were analyzed, 55 per cent were found to be nondeviant. Similar conclusions were reached by the writer (Slater 1961) from a study of 24 pairs of twins, 12 MZ and 12 DZ, in which the proband had been diagnosed as suffering from hysteria. In none of these pairs was there a co-twin who had ever been diagnosed as suffering from hysteria, though abnormalities of personality and psychiatric illness were common. Among the relatives of these pairs the incidence of hysteria was even lower than in Ljungberg's material, and the anomalies found to be most noticeably in excess were manic-depressive and endogenous affective psychoses. [See HYSTERIA.] It seems probable that environmental factors are more important than genetic ones in determining whether or not a man breaks down with a neurotic illness. But it would seem that genetic factors influence the predisposition to such breakdown, help to determine whether the personality is a stable °ne, and, in the event of breakdown, have a large e ffect on the type of symptoms which are likely to be shown. Manic-depressive illness The risk of affective psychoses in the first-degree Datives of manic-depressive patients is shown in

129

Table 2 — Per cent of manic—depressive disorders among relatives of manic-depressive patients NUMBER OF Investigator Banse 1929 Roll and Entres 1936 Slater 1938 Stromgren 1938 Sjogren 1948 Kallmann 1950 Stenstedt 1952 Fonseca 1959

PROBANDS

NATURE OF RELATIONSHIP Parents

Siblings

80

10.8

18.1

83 138 77

13.0 15.5 7.5

45

7.0

3.6

75 216 60

23.4 7.4 22.8

23.0 12.3 18.9

Children

10.7 15.2 10.7

9.4 21.7

Table 2. It will be seen that there is much variation in the data reported by different observers. Nevertheless, these risk figures are all very much higher than would be expected of a sample taken from the general population, in which the incidence level is probably of the order of 0.4 per cent. Approximately 15 per cent of the first-degree relatives of manic-depressives may themselves have affective disorders of the same generic group. Single-gene explanation. One explanation suggests that there is a single dominant autosomal gene which predisposes a spontaneous variation in mood. Most people with such a tendency are likely to remain healthy throughout their lives, though their cyclothymic temperament may be clearly recognizable both to themselves and to their families. If such cyclothymic individuals are subjected to stresses, the spontaneous swing of mood into depression or elation may go so far and last so long that medical treatment becomes necessary; and then the patient may be stigmatized as a "manicdepressive." The genetic hypothesis proposes, in fact, to account for only a part of the causation. Environmental factors and threshold effects must also be playing a part. The theory requires that 50 per cent of the first-degree relatives of manicdepressives should be gene carriers; if only 15 per cent of the relatives show themselves as such, this can be put down to low penetrance of the gene. [See DEPRESSIVE DISORDERS.] Polygenic explanation. A single-gene hypothesis, however, is not the only possibility; polygenic inheritance is an alternative explanation. Edwards (I960; 1963) has drawn attention to the fact that, in the case of common conditions, it is not easy to distinguish between the expected consequences of a single gene with diminished penetrance and of multifactorial inheritance with a threshold effect. Assuming that the predisposition to a condition, such as schizophrenia or diabetes, is quantitatively graded, with a normal distribution, Edwards suggests that when p — the frequency of the disorder, the incidence of the disorder in the first-

130

MENTAL DISORDERS: Genetic Aspects

degree relatives of persons suffering from the disorder will be approximately \/p. If the frequency of manic-depressive illness in the general population is approximately 0.004, then the frequency of manic-depressive illness in the first-degree relatives of manic-depressives should be about 6 per cent to 7 per cent. The observations are about double that figure, but it is not possible to say that observation and expectation, on the multifactorial hypothesis, are irreconcilable. Schizophrenia Extensive investigations of the hereditary factor in schizophrenia have been made by Kallmann and his associates in the New York State Psychiatric Institute and Hospital (Columbia University). A synopsis of the results obtained is given in Table 3. These risk figures should be compared with the estimated risk of schizophrenia for a member of the general population of 0.9 per cent. Environmental effects show up: association with a schizophrenic proband in the same home virtually doubles the risk of schizophrenia for step-sibs and spouses; and there is a greater risk for the nonseparated MZ co-twin of a schizophrenic than for an MZ co-twin who has lived apart from the proband for five years or more. However, the table also shows the risk of schizophrenia running up steeply with increasingly close degrees of blood relationship. In view of these figures it is difficult and, the writer feels, unrealistic to dispute the conclusion that genetic factors play a significant role in the causation of schizophrenia. The risk figures published by Kallmann are somewhat higher than those obtained by other workers but are in the main reconcilable with them. The writer, for instance (Slater 1953), found a risk of Table 3 — Per cent of risk of schizophrenia among relatives of schizophrenics Nature of relationship

Per cent risk

Not related by blood, step-sibs Not related by blood, spouses First cousins Nephews and nieces Grandchildren Half-sibs Parents Full-sibs Dizygotic co-twins DZ co-twins of same sex Children with one schizophrenic parent Children with two schizophrenic parents Monozygotic co-twins MZ co-twins living apart for at least 5 years MZ co-twins not so separated

1.8 2.1 2.6 3.9 4.3 7.1 9.2 14.2 14.5 17.6 16.4 68.1 86.2 77.6 91.5

Source: Adapted from Kallmann 1950.

76 per cent for the MZ co-twin and 14 per cent for the DZ co-twin, in a sample of 41 MZ and 115 DZ pairs. However, it is noteworthy that Essen-Moller (1941) in Sweden found larger differences within MZ pairs than were found by other workers, and investigations in Norway and Finland show tendencies in the same direction. Thus Kringlen (1966) collected 50 MZ and 94 same-sexed pairs, with concordance rates of 38 per cent and 14 per cent; and Tienari (1963) found that none of the 16 male MZ pairs he studied were concordant. It is possible that what is diagnosed as schizophrenia in Scandinavia is not quite the same as schizophrenia in Germany, Britain, the United States, and Japan. That there may be peculiar features about the gene distributions in northern lands is also suggested by the work of Book (1953). In a remote part of Sweden north of the Arctic circle, in a population of farmers and lumbermen, he found a high incidence of schizophrenia, in a predominantly catatonic form; the incidence of schizophrenia in the relatives of probands, however, was also high, suggesting an intermediate gene with 20 per cent penetrance in the heterozygote. The possible preva lence of different genetic predisposing factors for schizophrenia in different parts of the world is a possibility which deserves investigation. The findings of Tienari, by themselves, are anomalous and should not be taken as throwing doubt on the results obtained by others; they should be considered in relation to those of other observers, summarized in Table 4. In this table the figures relating to schizophrenia are derived from work in Germany, the United States, Sweden, and England. To these should be added the results obtained by the Japanese workers Kurihara (1959) and Inouye (1961). Inouye found concordance for schizophrenia in 60 per cent of 55 MZ pairs and in 12 per cent (two pairs) of the DZ pairs. Kurihara also found that 29 of 45 MZ pairs were concordant for schizophrenic symptomatology, but none of the 9 DZ pairs were. The twin work on schizophrenia has been analyzed and discussed critically by Rosenthal in a number of papers (1962a; 1962b; 1963). He concludes that concordance rates have been artificially inflated by the sampling methods employed. Cases have been largely taken from standing populations and include an unrepresentative proportion of severe cases; if genetic factors are connected with reduced chances of remission (which has yet to be shown), this sampling would obviously bias the results. Clearly, sampling from consecutive admissions, or better still from birth registers, would be an improvement. Rosenthal criticizes standards

MENTAL DISORDERS: Genetic Aspects Table 4

Concordance rates for mental disorders in scrme-sexed twins

Type of disorder

dizygotic

Number Pairs of studies reported

and

monozygotic

PER CENT OF CONCORDANCE

MZ

DZ

Relative increase*

Mental defective

5

Child and juvenile Schizophrenic

5 5 6

569 209 728 184

94 87 69 70

65 53 13 28

.83 .73 .63 .58

7 6

214 231

54 66

7 32

.50 .50

5 3

103 56

43 44

23 27

.26 .24

Affective Epileptic Criminal Neurotic Senile

e relative increase in concordance associated with identity of genetical constitution, between theoretical limits of 1 and 0: (MZ — DZ)/(100 — DZ). Source: Adapted from Essen-Moller 1963.

of diagnosis, both of zygosity and clinical classification, and considers that these diagnoses should be made independently of one another by different observers. Not all recorded work is equally open to such criticism; it is, for instance, a considerable safeguard to publish protocols in full, as the writer did, to make them available to rediagnosis by the reader. [See SCHIZOPHRENIA.] Etiological theories. Rosenthal classifies the etiological theories of schizophrenia into (1) monogenie-biochemical, (2) diathesis-stress, and (3) life-experience theories, his own views inclining to a theory of the second type. This is no place for the discussion of the difficult problems involved, but the writer inclines to a theory of the first type. It can be shown (Slater 1958) that a monogenic theory fits fairly well with the empirically obtained figures for the frequency of schizophrenia in the siblings of schizophrenics, in the children of one schizophrenic parent, and in the children of parents both of whom had schizophrenic illnesses. These data can be reconciled with a gene of intermediate type, manifesting itself in all homozygotes but in only 26 per cent of heterozygotes; all but 3 Per cent of schizophrenics would be heterozygous for the gene. This hypothesis clearly involves a massive environmental contribution in the causation of manifest illness and therefore differs from theories of type (2) only in supposing that the element of specificity in determining the type of Psychosis is provided by the genetic constitution, une may expect that decisive support or refutation °f type (1) theories will depend on biochemical investigations. "resenile and senile dementias Inheritance in Huntington's chorea is dependent °n an autosomal dominant gene. Its incidence in tne sexes is about equal. The age of onset, according

I 31

to Panse (1942), extends from early childhood to the late sixties, with a mean at age 36; Wendt and his colleagues estimate the mean age of onset at 44 (1960). These estimates mean that most of the children of gene carriers are born before the parent has developed the disease. Elimination of the pathogenic gene by processes of natural selection is, accordingly, very slow. The disease is slowly progressive and fatal, with a mean duration of 13 years (Wendt et al. 1960). Unusual forms of presenile dementia are Pick's disease and Alzheimer's disease; both have a genetic basis. Compared with Huntington's chorea, they occur later in life, with a mean age of onset of 55, and with about seven years as the mean duration. Although the conditions are distinct pathologically, they are often difficult to distinguish clinically. According to Sjogren (Sjb'gren et al. 1952), the genetic factor in Pick's disease is most probably a dominant major gene, its manifestation subject to modifying genes; in Alzheimer's disease Sjogren thinks multifactorial inheritance more probable. The problem of genetic determination in senile dementia is even more difficult. The most generally accepted opinion in the past has been that senile dementia is but one aspect of senescence and that specific genetic causation is improbable. However, this established viewpoint has been challenged by the work of Larsson, Sjogren, and Jacobson (1963). In a large study in Stockholm they found that senile dementia was not correlated with senescence. The relatives of patients suffering from senile dementia were not more than normally subject to other conditions, although their risk of senile dementia itself was increased; no instances of Pick's or Alzheimer's disease were found among them. There did not appear to be special factors for longevity whose presence or absence was connected with senile dementia. No evidence could be found of environmental factors of a sociomedical kind playing a part in determining the onset of senile dementia. Furthermore, there was no secular change in the incidence of the disease. Particularly in favor of an explanation in terms of a single gene rather than multifactorial inheritance were the variations in geographical distribution and the absence of intermediate states between senile dementia and normal aging in the siblings and children of the probands. [See AGING.] The morbidity risk for senile dementia was found to be greatly increased among the relatives of the patients. These researchers consider that the best working hypothesis for the explanation of their findings is that of an autosomal major domi-

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nant gene. This gene would be subject to diminished penetrcince, the manifestation rate increasing with age. Only a minority even of the gene carriers would ever develop senile dementia; and since the calculated gene frequency was 0.12, the great bulk of the population would be immune. ELIOT SLATER [Directly related are the entries GENETICS; PSYCHOLOGY, article on CONSTITUTIONAL PSYCHOLOGY. Other relevant material may be found in SCHIZOPHRENIA.] BIBLIOGRAPHY

BANSE, J. 1929 Zum Problem der Erbprognosebestimmung: Die Erkrankungsaussichten der Vettern und Basen von Manisch-Depressiven. Zeitschrift fur die gesamte Neurologie und Psychiatric 119:576-612. BOOK, J. A. 1953 A Genetic and Neuropsychiatric Investigation of a North-Swedish Population: I. Psychoses. Acta genetica et statistica medico. (Basel) 4:1-100. BORGSTROEM, C. A. 1939 Eine Serie von kriminellen Zwillingen. Archiv fur Rassen- und Gesellschaftsbiologie 33:334-343. BROWN, FELIX W. 1942 Heredity in the Psychoneuroses. Royal Society of Medicine, Proceedings 35:785-790. EDWARDS, J. H. 1960 The Simulation of Mendelism. Acta genetica et statistica medica (Basel) 10:63-70. EDWARDS, J. H. 1963 The Genetic Basis of Common Disease. American Journal of Medicine 34:627-638. ESSEN-MOLLER, ERIK 1941 Psychiatrische Untersuchungen an einer Serie von Zwillingen. Acta psychiatrica et neurologica scandinavica Supplement 23. ESSEN-MOLLER, ERIK 1963 Twin Research and Psychiatry. Acta psychiatrica scandinavica 39, fasc. 1:65-77. FONSECA, ANTONIO F. DA 1959 Andlise heredo-clinica das perturbacoes afectivas: Estudo de 60 pares de gemeos a seus consanguineos. Universidad de Porto (Portugal): Faculdade de Medicina. INOUYE, EIJI 1961 Similarity and Dissimilarity of Schizophrenia in Twins. Volume 1, pages 524-530 in World Congress of Psychiatry, Third, Montreal, Proceedings. Univ. of Toronto Press. KAIJ, LENNART 1960 Alcoholism in Twins: Studies on the Etiology and Sequels of Abuse of Alcohol. Stockholm: Almqvist & Wiksell. KALLMANN, FRANZ J. 1950 The Genetics of Psychoses: An Analysis of 1,232 Twin Index Families. American Journal of Human Genetics 2:385-390. KALLMANN, FRANZ J. 1952 Comparative Twin Studies on the Genetic Aspects of Male Homosexuality. Journal of Nervous and Mental Disease 115:283-298. KRANZ, HEINRICH 1936 Lebensschicksale krimineller Zwillinge. Berlin: Springer. KRINGLEN, EINAR 1966 Schizophrenia in Twins: An Epidemiological-Clinical Study. Psychiatry 29:172184. KURIHARA, M. 1959 A Study of Schizophrenia by Twin Method. Psychiatria et neurologia japonica (Seishin shinkeigaku zassfet) 61:1721-1741. -» Text in Japanese; title and summary in English. LANGE, JOHANNES (1929) 1931 Crime as Destiny: A Study of Criminal Twins. London: Allen & Unwin. -> First published as Verbrechen als Schicksal. LARSSON, TAGE; SJOGREN, TORSTEN; and JACOBSON, GEORGE 1963 Senile Dementia: A Clinical Sociomedical and Genetic Study. Copenhagen: Munsgaard.

LEWIS, AUBREY 1936 Problems of Obsessional Illness. Royal Society of Medicine, Proceedings 29:325-336. LJUNGBERG, L. 1957 Hysteria: A Clinical, Prognostic and Genetic Study. Acta psychiatrica et neurologica scandinavica Supplement 112. LUXENBURGER, H. 1930 Psychiatrisch-neurologische Zwillingspathologie. Zeitschrift fur die gesamte Neurologie und Psychiatric 56:145-180. PANSE, FRIEDRICH 1942 Die Erbchorea: Eine klinischgenetische Studie. Leipzig: Thieme. ROLL, A.; and ENTRES, J. L. 1936 Zum Problem der Erbprognosebestimmung: Die Erkrankungsaussichten der Neffen und Nichten von Manisch-Depressiven. Zeitschrift fur die gesamte Neurologie und Psychiatric 156:169-202. ROSANOFF, AARON J.; HANDY, L. M.; and PLESSET, I. R. 1941 The Etiology of Child Behavior Difficulties, Juvenile Delinquency and Adult Criminality, With Special Reference to Their Occurrence in Twins. Sacramento: California State Printing Office. ROSANOFF, AARON J.; HANDY, L. M.; and ROSANOFF, I. A. 1934 Criminality and Delinquency in Twins. Journal of Criminal Law and Criminology 24:923-934. ROSENTHAL, DAVID 1962a Familial Concordance by Sex With Respect to Schizophrenia. Psychological Bulletin 59:401-421. ROSENTHAL, DAVID 1962t> Problems of Sampling and Diagnosis in the Major Twin Studies of Schizophrenia. Journal of Psychiatric Research 1:16-34. ROSENTHAL, DAVID (editor) 1963 The Genain Quadruplets: A Case Study and Theoretical Analysis of Heredity and Environment in Schizophrenia. New York: Basic Books. RUDIN, EDITH 1953 Ein Beitrag zur Frage der Zwangskrankheit, insbesondere ihrer hereditaren Beziehungen. Archiv fur Psychiatric und Nervenkrankheiten 191: 14-54. SHIELDS, JAMES 1954 Personality Differences and Neurotic Traits in Normal Twin Schoolchildren: A Study in Psychiatric Genetics. Eugenics Review 45:213-245. SHIELDS, JAMES; and SLATER, ELIOT (1960) 1961 Heredity and Psychological Abnormality. Pages 298-343 in Hans J. Eysenck (editor), Handbook of Abnormal Psychology: An Experimental Approach. New York: Basic Books. SJOGREN, TORSTEN 1948 Genetic-Statistical and Psychiatric Investigations of a West Swedish Population. Acta psychiatrica et neurologica scandinavica Supplement 52. SJOGREN, TORSTEN; SJOGREN, HAKON; and LINDGREN, AKE G. H. 1952 Morbus Alzheimer and Morbus Pick: A Genetic, Clinical and Patho-anatomical Study. Acta psychiatrica et neurologica scandinavica Supplement 82. SLATER, ELIOT 1938 Zur Erbpathologie des manischdepressiven Irreseins: Die Eltern und Kinder von Manisch-Depressiven. Zeitschrift fur die gesamte Neurologie und Psychiatric 163:1-47. SLATER, ELIOT 1953 Psychotic and Neurotic Illnesses in Twins. Medical Research Council Special Report NO. 278. London: H.M. Stationery Office. SLATER, ELIOT 1958 The Monogenic Theory of Schizophrenia. Acta genetica et statistica medica (Basel) 8:50-56. SLATER, ELIOT 1961 The Thirty-fifth Maudsley Lecture: Hysteria 311. Journal of Mental Science 107:359-381STENSTEDT, AKE 1952 A Study in Manic-Depressive

MENTAL DISORDERS: Organic Aspects Psychosis. Acta psychiatrica et neurologica scandinavica Supplement 79. STROMGREN, ERIK 1938 Beitrage zur psychiatrischen Erblehre. Acta psychiatrica et neurologica scandinavica Supplement 19. STUMPFL, FRIEDRICH 1936 Die Urspriinge des Verbrechens dargestellt am Lebenslauf von Zwillingen. Leipzig: Thieme. SYMONDS, C. P. 1943 The Human Response to Flying Stress. British Medical Journal [1943]: 703-706, 740744. -^ Lecture 1: "Neurosis in Flying Personnel." Lecture 2: "The Foundations of Confidence." TIENARI, P. 1963 Psychiatric Illnesses in Identical Twins. Acta psychiatrica scandinavica 39 (Supplement 171). -» The entire issue is devoted to Tienari's study. WENDT, G. G.; LANDZETTEL, I.; and SOLTH, K. 1960 Krankheitsdauer und Lebenserwartung bei der Huntingtonschen Chorea. Archiv fur Psychiatric und Nervenkrankheiten 201:298-312. II ORGANIC ASPECTS

Traditionally, description of the organic syndromes, in relation to their effect upon the central nervous system and behavior generally, has included such generalizing conditions as cerebral arteriosclerosis, acute and chronic alcoholism, presenile and senile conditions, degenerative neural diseases, and developmental mental deficiencies, as well as conditions producing more focal disorders such as head injuries, brain tumor extirpations, and cerebrovascular accidents (the boxer who is punch-drunk or the stroke patient). The trend in recent literature, however, confirms what is a notably progressive shift in emphasis away from strictly clinical or case description, as exemplified by texts in psychiatry and neurology, toward more varied studies, which consider psychodiagnostic and psycholinguistic phenomena in the context of clinical observations. With these important changes in the study of organic pathology has also come a voluminous growth in the literature. Within this literature (see Wepman 1961) can be found the continuing traditional interest of the neurologist and psychiatrist, as seen, for example, in the recently published American Handbook of Psychiatry (Arieti 1959). However, the great breadth of the field can be noted in the work of experimental psychologists using both animal and human subjects; in the Decent neurophysiologie research on such central nervous system areas as the reticular formation, the limbic lobes, and the association tracts; in the dramatic electrode stimulation studies of cortical factions carried on during neurosurgery; in the e laboration of new psychodiagnostic signs by psychometric researchers; and in the growing group of neurophysiological theories related to brain func-

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tion. Additional examples, from the more applied fields, are rehabilitation for brain-impaired persons and the not inconsiderable addition of research on language disabilities. As can be seen, the literature of neuropsychology is rich and varied. Within it, the reader will find, however, that there are more unknowns than knowns, more questions than answers, more theories than facts. While a great deal has been written about the behavior of the brain-impaired, very few facts have been demonstrated. For example, it is generally accepted that in thought, emotional control, and intellection, the role of the central nervous system is crucial. Yet the precise manner in which the nervous system and the human brain work to fulfill this function is undetermined and vague. A leading neurophysiologist once described the human brain as a "black box" that must function in certain well-prescribed ways in order to produce all that it does in human behavior but unfortunately is not available for viewing. Nevertheless, the great concentration of attention by so many trained observers, the extensive studies of clinical cases, the host of theories, the wide and growing application of differential diagnostic techniques, and the increasing activities of both language therapists and psychotherapists treating patients suffering from brain impairment have all produced a considerable body of knowledge available for better understanding of organic mental disorders. The following is an attempt to describe some of the more prominent behavioral phenomena commonly associated with neural impairment and includes major sources of data and references in order to facilitate and encourage further investigation by the reader. Common behavioral manifestations Alteration in thought, personality changes, and changes in language comprehension and usage take on many forms following cortical insult. By and large, however, most investigators agree that individual patterns of behavior in the brain-impaired differ from those of the unimpaired more in degree than in type. Table 1 presents the reader with a list of the most common indications of brain impairment. While space limitations preclude extensive comment on the relative merit of individual signs of organicity as indicators of organic psychopathology, some generalizations about them are warranted. Many of these signs appear as the result of a disordering process producing abnormal behavior; others are the product of the retained ability to function of what is left of the nervous system; and

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MENTAL DISORDERS: Organic Aspects Table I — Behavioral symptoms of the brain-impaired PSYCHOD/AGNOST/CALLY ELICITED SYMPTOMS

Memory loss (especially immediate memory) Reduced association of ideas Perseveratiort of thought and language Feelings of inadequacy Egocentricity Hyperirritability Overfatiguability Euphoria Catastrophic overreaction Reduced initiative Lack of spontaneity Impulsive behavior Regressive behavior Fluctuating ability Situational or fixed anxiety

Poor attention and concentration Memory loss Abstract—concrete imbalance Poor ability to organize and preplan Difficulty in forming generalizations Inability to categorize Lowered general intelligence Psychomotor retardation Perplexity (questioning one's own ability) Psychological impotence (recognition of errors without the ability to alter responses) Egocentricity Anxiety Specific modality disabilities in learning Body-image distortion Spiral afterimage reactions Delayed response patterns

still others derive from the altered self-concept of the people involved (their reactions to their impairment). At any rate, these signs, while not necessarily pathognomonic of the brain-injured, are rather useful indicators of the likelihood that a cortical impairment has occurred. Research comparing known brain-impaired subjects with normal individuals and subjects with thought disorders (for example, schizophrenics) has consistently shown that pathological conditions, while frequently unlike normal states, are most often like each other (Chapman 1960). In fact, the argument has been advanced that the very presence of so many socalled organic signs in schizophrenia may indicate that this psychiatric condition is indeed an organic psychosis. Thus, behavioral symptoms can be viewed as frequently occurring telltale indicators of pathology but cannot themselves be viewed as differentially diagnostic signs of organic pathology. It should also be pointed out that most of the signs used as organic indicators have not been found by research studies to occur in every organic condition. In part this is true, the present writer feels, because few of the studies have been really comparable. Research populations differ in so many ways (for example, age of subjects and location and extent of lesion or impairment) that the signs said to be associated with brain pathology in one study may be completely lacking in an equally well attested study of another group of braininjured patients. A final source of inconsistency is related to subjects with a known brain injury but who differ in behavior from other such subjects even though neuropathies may be alike, the location of damage is thought to be the same, and the amount or size of the lesion is thought to be

LANGUAGE D/STURBANCES Aphasia Agnosia Apraxia Dysarthria

roughly equal. The generalization must be made, therefore, that brain-impaired patients differ from one another not only in the size and location of their structural defect but also in the behavioral aftereffects of similar neurological impairment. Certain commonalities do exist, however, and it is to these that students of brain pathology turn in attempting to gain a greater understanding of cortical function and dysfunction. The remainder of this article will be concerned with a more particular discussion of the behavioral signs appearing in Table 1 in relation to organic disorder, with emphasis upon the literature and major sources of data. Shortage of space unfortunately limits consideration to only the most prominent and generally elicited signs appearing in each of the three categories arbitrarily designated as clinically observed behavior, psychodiagnostically elicited behavior, and psycholinguistic disturbance patterns. Clinically observed behavior. Many of the signs enumerated in the category of clinically observed behavior can be related to certain basic processes that seem to underlie the signs themselves. Lack of control over behavior. Most notable among these processes is the concept of "control." Since the central nervous system is generally considered a major determinant in the control of behavior as the individual seeks to adapt to his environment, loss of memory and similar behavior may be best understood, in this context, as a loss of selective control over recall of events from the past. Further, memory loss in organic conditions is said to be most severe in the area of recall of very recent events, for example, when the individual must select (control) the appropriate impressions from a variety of recent ones. Related to the

MENTAL DISORDERS: Organic Aspects recall aspect of memory loss is the loss of capacity to attend, concentrate, or exert simple control over one's ideas. Impulsiveness, emotionality, and rigidity. Similarly, many clinicians have observed that the brainimpaired are often impulsive and emotionally labile. They react catastrophically to noncatastrophic events, or they become easily frustrated. At the other extreme, the brain-impaired often display tendencies toward rigidity or repetition in thought and language, find it difficult to shift from one idea to another, and are frequently inflexible in behavior. In each case then, these signs point to the patient's inability to regulate his behavior in a flexible fashion. Lack of adequate inhibition and sufficient control brings about these overt behavioral patterns, which have been termed symptoms of brain damage. With adequate control, the unimpaired behave with intent, behave appropriately, and behave purposively. The impaired, having lost control, show abnormalities of behavior in all three areas. (Note: The writer feels it is unnecessary to discuss clinically observed symptoms more extensively here, as they are generally self-explanatory; however, more detailed consideration may be found in the references cited in the bibliography.) Psychodiagnostically elicited symptoms. The loss of perceptual ability is a basic process that frequently affects the brain-impaired. This loss of function is especially noticeable in the capacity to learn through specific sense modalities. Consequently, it is most often described in relation to problems of children with known neurological deficiencies. But it seems equally true in all adults with brain damage, where perceptual deficiencies have been noted as being modality-bound rather than generalized. Auditory perception, for example, may be affected by brain impairment or by failure of certain portions of the nervous system to develop, while other perceptual abilities may remain intact (Wepman 1960). Some children, it has been noted, fail to develop language at the time expected of them (that is, by two or three years of age). This is not because of any lack of general intelligence or because of deafness or emotional instability but rather because they are unable to learn in situations that involve the auditory pathway. Other children, who do speak adequately, have been observed having difficulty in learning to read at the expected age. Again, this may be caused by no other reason than their inability to use the visual modality in learning, and this despite the Measurable adequacy of their visual acuity. [See HEARING; VISION.]

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These auditory and visual agnosias in children are paralleled by similar disturbances of transmission of input stimuli following cortical insult in adults. Perceptual learning disability along specific modality lines has become the center of attention for many students of behavior in brain-impaired children and adults. As Table 1 implies, many signs of organic brain impairment can be elicited by psychometric and projective assessment. In some instances these are found to duplicate the clinically observed signs. But in others, they are observed only when the subject is under the stress and scrutiny of formal testing. Verbal and nonverbal functioning. The use of psychological tests as a means of isolating behavioral indicators of brain impairment continues to be a source of considerable research. Babcock (1941) noted in her studies of the brain-injured that certain intellectual faculties seem better retained after trauma than others. She then proposed to study subjects and evaluate their product in terms of these better retained areas (verbal behavior) as compared with the abilities that are less well retained (visually stimulated abstraction ability). A similar differentiation was used in the ShipleyHartford Scale (Shipley 1940) and the HuntMinnesota Test for Brain Impairment (Hunt 1943). Some support for this notion also seemed to follow from the characteristics of the tests used. Vocabulary retention, or verbal ability, as measured by most tests, is statistically well equated with general intelligence, is known to have a high test-retest reliability, and is generally a stable measure. In contrast, the tasks of visual abstraction are less stable, have less reliability over time, and are therefore more likely to be susceptible to change as a result of organic conditions affecting the nervous system. Wechsler followed the concept of retained as opposed to sensitive functions, not in a comparison of verbal versus nonverbal behavior, but in empirically determined responses to various subtests in his intelligence scale. From the results of his studies of an aging population, he devised a deterioration index (1955). By and large, this approach has fallen into disfavor among psychologists, however, since confirming research for the deficiencies found by the original author has been lacking (Kass 1949). Those who argue against the use of the verbal versus the nonverbal differential, or, as the believers in perceptual disabilities put it, "the differential between aurally stimulated verbal behavior and visually stimulated nonverbal behavior,"

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seem to this writer to be correct in their conclusion —'but for the wrong reasons. In none of the research reported on the many indexes of deterioration was any attempt made to isolate the location of the organic condition, even to the rather loose degree of determining the hemisphere affected. Yet many language studies (Wepman 1951; Ettlinger et al. 1956) and the work of such researchers as Reitan and Reed (1962), Milner (1954), Bauer and Wepman (1955), and others have reported each of the two hemispheres differentially responsible for various intellectual tasks. [See INTELLIGENCE AND INTELLIGENCE TESTING.] In conclusion, therefore, it would be expected that the verbal-nonverbal paradigm would be successful. When damage has occurred to the left brain (the apparent site of integrations necessary for verbal behavior) it would seem that subjects should do less well with verbal than with nonverbal material. When, on the other hand, notable damage occurs in the right hemisphere, which, according to many studies, is the locus of control and integration for nonverbal thought, the expectancy would then be that nonverbal material would present greater difficulty. To the degree that such a distinction can be made in psychological tests— and it can be in many of them—the tendency for the effects of brain damage to be depicted seems high. Re-examining known organically impaired subjects from this viewpoint shows this differentiation to be a meaningful one. The degree to which this approach can be used in differential diagnosis where brain damage is suspected but not certain, however, still needs research verification. The qualitative approach for the delineation of personality disorganization, using projective tests as the source of data, has proven of value in the hands of many psychologists (Aita et al. 1947; Baker 1956; Hughes 1948; Piotrowski 1937). Unfortunately, most of the results reported are the subjective interpretations of individual examiners and are barely or not at all confirmed in replicated studies. Where such studies have been attempted, few of the signs found diagnostic by one examiner have been elicited by others. For the purposes of demonstrating some of the psychodynamic processes affected in many brain-injured subjects, however, the different projective techniques have proven of considerable value. Yet even here it seems important to point out the individual variability in behavioral reactions. Since brain-injured subjects differ so markedly, for example, in their responses to their traumas, or with respect to their selfconceptions, it has been found to be of little value

to look for commonality of reaction in personality change. Abstract and concrete functioning. Goldstein, perhaps more than any other student of brain disorders, has postulated both specific disabilities and changes in basic attitudes and thought processes as a result of organic conditions. He pointed out that ". . . even in cases of circumscribed cortical damage, the disturbances are scarcely ever confined to a single field of performance. In such intricate syndromes, we deal not only with a simple combination of disparate disturbances but also with more or less unitary, basic change that affects different fields homologously and expresses itself through different symptoms . . ." ([1934] 1939, pp. 15-16). Of all the symptomatology noted in the study of the organic psychopathologies, none has had greater impact or perhaps stirred greater controversy than Goldstein's concept of the shift from the abstractive to the concrete mode of thought (Goldstein & Scheerer 1941). With his co-workers, he postulated both theory and methods for determining the loss of categorical, abstracting behavior. The concept, by and large, has received greater acceptance than the methods. Today almost every clinician studying the behavior of the brain-impaired patient concedes the correctness of Goldstein's observation that organic brain disease impairs abstract functioning. The many Goldstein tests, however, have been less successfully used by other examiners. Changes in intellectual performance. Finally, some attention should be directed toward the concept of changes in general intellectual level as a consequence of brain impairment. Essentially, there are two types of change that have been widely noted. In some patients, over-all intellectual level seems grossly affected, as in conditions that to a certain degree affect the nervous system in its entirety. A good example is the deterioration that accompanies progressive cerebral disease and that is demonstrated by progressive generalized intellectual decline. In other patients, the condition is localized and affects intellectual ability within fairly circumscribed areas. It can be shown in most cases of brain disorder that one or the other of these two forms of intellectual loss occurs. In certain types of localized damage that affect only specific functions, as in the limited agnosias and apraxias affecting language, it may be held that no intellectual loss need be predicated. However, even here a loss must be considered to occur, since the deficiency in those functions immediately affected makes adaptation to the environment more difficult and more circumscribed. Thus, even very minor

MENTAL DISORDERS: Organic Aspects brain damage that functionally affects only the capacity to read or write and that might not affect the individual's capacity to think or perform on intelligence tests would still have its deleterious effect upon the totality of behavior and, consequently, upon intelligence. It would make the patient a less efficient organism and would thus make adaptation to life a more complex task for him. Generalized deterioration, whether progressive or not, rarely permits alterations in behavior through therapy and rehabilitation. On the other hand, focalized injuries that produce limitations of intellectual ability can frequently be offset by proper training and therapeutic rehabilitation (Harlow 1953). Organic language disturbances. Language function and dysfunction have also become the focus of attention of many researchers in recent years. Loss of the ability to comprehend and use language has an extensive literature of its own. Aphasia, a loss of ability to utilize verbal symbols, is a relatively common aftereffect of brain damage, especially when that damage affects the left cortical hemisphere. There have been widely different approaches to the study of the language syndromes. Schuell and Jenkins (1959) have postulated that language is a unitary process that may be lost in varying degrees. They have concluded from their studies that the language deficit may be measured along a continuum of severity of dysfunction. This would include difficulties with a variety of individual tasks, such as the abilities to speak, read, and write. Wepman and Jones (1961), on the other hand, contend that language is divisible into a series of different linguistic processes and that each process may be differentially affected. Five types of symbolic loss of language—five types of aphasia—have been described in this research: global, jargon, pragmatic, semantic, and syntactic. Partial support for this viewpoint is seen in the insightful work of Jakobson (Jakobson & Halle 1956), who related certain observed aphasic disturbances, noted above as semantic and syntactic aphasia, to two basic linguistic processes. He pointed out that there are two basic types of aphasia, differentiated according to whether the deficiency is in the selection and substitution of Words or in their combination and contexture. Further support for this linguistic differentiation also comes from other sources. The research of Goodglass and his co-workers on agrammatism and paragrammatism (Goodglass & Hunt 1958; Goodglass & Mayer 1958) confirmed the Jakobson dis-

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tinction. The work of Luriia (1947; 1958) in the Soviet Union goes far beyond the linguistic approach, identifying the process changes with neural constructs and specific localization of damage. Also included in his work is a description of five very similar types of language disturbance (1958). The conception of aphasia as representing disorders along a continuum of severity and the psycholinguistic classification of aphasic types as discussed above are fairly recent developments. In contrast, traditional neurological literature treats language disturbances as receptive or expressive disorders, closely related to specific neurological substrata. Indeed, a fair proportion of the literature on the whole field of brain damage is given over to discussions of the question of localization of function in the nervous system. Harlow's review of literature dealing with the higher functions of the nervous system (1953) is devoted solely to the difference of opinion concerning localization. Discussing Hebb's brilliant Organization of Behavior (1949), the Hixon Symposium on Cerebral Mechanisms in Behavior (Jeffress 1951), and Fulton's Functional Localization in Relation to Frontal Lobotomy (1949), as well as research devoted to specific architectonic divisions of the cortex, Harlow concludes in part that "the data would appear to be almost overwhelmingly opposed to any theory of cortical localization of intellectual function which is anatomically precise or temporarily static" (1953, p. 512). Writers in the field vary from a position of extreme belief in punctate localization to the opposite view of equipotentiality or mass action. Somewhere between these two polar viewpoints rest the opinions of most present-day exponents of the role of the cortex in relation to behavior. Recent reports of psychodiagnosticians studying the behavior of patients with known brain damage give some credence to a gross type of localization. Reitan and his co-workers (Reitan & Reed 1962), as mentioned earlier, have been able to show that subjects with left brain damage, when tested by such scaled instruments as the Wechsler Adult Intelligence Scale, show a greater deficit in performing verbal tasks, and less deficit, if any, in performing nonverbal tasks. The opposite findings were reported on patients with known right brain damage; that is, they did better on verbal tasks than on nonverbal ones. This general finding bears out what has previously been said about language disorders following brain injury; that is, symbolic verbal behavior is found to be disturbed only in left brain-injured subjects (Wepman 1951).

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It is the viewpoint of most students of brain function that while there is a type of localization of function within the nervous system, the end product, which is an individual's behavior, is the result not of the functioning of any localized section or subsection but of the integrated nervous system as a whole. For example, Penfield and Rasmussen (1950), by their ingenious placement of electrodes during neurosurgery, have demonstrated that while aphasic arrest does occur more frequently when Broca's area (the third prefrontal convolution of the left cortex) is stimulated electrically, a similar arrest of language occurs when widely scattered areas of the parietal and even the temporal lobes are stimulated. From such studies it would appear that while a high concentration of cells in Broca's area may be responsible for a type of word-finding ability, other areas subserve the same function but in a less concentrated way. Behavior, it is held, is a far too complex process to be conceptualized as the product of any localized area of the brain. It is much more reasonably thought of as the integration of perceptual, conceptual, mnemonic, and motor processes—with factors of motivation, emotion, and the processes of feedback playing their various roles. Organic mental disorders can thus be best described as the results of a variety of conditions— disease processes, traumas, agenesis, deteriorations, etc. These conditions in turn produce alterations in the consequent behavioral patterns of the brainimpaired. Certain specific signs of alteration are more commonly seen in the behavior of the impaired than in the unimpaired. These signs are recognizably not pathognomonic of the neural disorder. Yet, by their consistency of occurrence, they are often the best indicators available of brain damage in those in whom pathological behavior is noted. Many of these indications are admittedly seen only clinically and rarely verified by research. Others are elicited through more organized and scientific psychological and linguistic studies. JOSEPH M. WEPMAN [Other relevant 'material may be found in LANGUAGE, article on SPEECH PATHOLOGY; NERVOUS SYSTEM; SCHIZOPHRENIA.] BIBLIOGRAPHY AITA, JOHN A.; REITAN, RALPH M.; and RUTH, JANE M. 1947 Rorschach's Test as a Diagnostic Aid in Brain Injury. American Journal of Psychiatry 103:770-779. ARIETI, SILVANO (editor) 1959 American Handbook of Psychiatry. 2 vols. New York: Basic Books. BABCOCK, HARRIET 1941 The Level-efficiency Theory of Intelligence. Journal of Psychology 11:261-270.

BAKER, GERTRUDE 1956 Diagnosis of Organic Brain Damage in the Adult. Pages 318-428 in Bruno Klopfer (editor), Developments in the Rorschach Technique. Volume 2: Fields of Application. New York: World Book. BAUER, ROBERT; and WEPMAN, JOSEPH M. 1955 Lateralization of Cerebral Functions. Journal of Speech and Hearing Disorders 20:171-177. CHAPMAN, LOREN J. 1960 Confusion of Figurative and Literal Usages of Words by Schizophrenics and Brain Damaged Patients. Journal of Abnormal and Social Psychology 60:412-416. ETTLINGER, GEORGE; JACKSON, C. V.; and ZANGWILL, O. L. 1956 Cerebral Dominance in Sinistrals. Brain 79: 569-588. FULTON, JOHN F. 1949 Functional Localization in Relation to Frontal Lobotomy. New York: Oxford Univ. Press. GOLDSTEIN, KURT [1934] 1939 The Organism. New York: American Book. -» First published in German, GOLDSTEIN, KURT; and SCHEERER, MARTIN 1941 Abstract and Concrete Behavior: An Experimental Study With Special Tests. Psychological Monographs 53, no. 2. GOODGLASS, H.; and HUNT, J. 1958 Grammatical Complexity and Aphasic Speech. Word 14:197-207. GOODGLASS, H.; and MAYER, J. 1958 Agrammatism in Aphasia. Journal of Speech and Hearing Disorders 23:99-111. HALSTEAD, WARD C. 1947 Brain and Intelligence. Univ. of Chicago Press. HARLOW, HARRY 1953 Higher Functions of the Nervous System. Annual Review of Physiology 15:493-514. HEBB, DONALD O. 1949 The Organization of Behavior. New York: Wiley. HUGHES, ROBERT M. 1948 Rorschach Signs for the Diagnosis of Organic Pathology. Rorschach Research Exchange 12:165-167. -> Now called Journal of Projective Techniques. HUNT, HOWARD F. 1943 A Practical Clinical Test for Organic Brain Damage. Journal of Applied Psychology 27:375-386. JAKOBSON, ROMAN; and HALLE, MORRIS 1956 Fundamentals of Language. The Hague: Mouton. JEFFRESS, LLOYD A. (editor) 1951 Cerebral Mechanisms in Behavior: The Hixon Symposium. New York: Wiley. KASS, WALTER 1949 Wechsler's Mental Deterioration Index in the Diagnosis of Organic Brain Disease. Kansas Academy of Science, Transactions 52:66-70. LASHLEY, KARL S. 1929 Brain Mechanisms and Intelligence: A Quantitative Study of Injuries to the Brain. Univ. of Chicago Press. LURIIA, ALEKSANDR R. 1947 Travmaticheskaia afaziia (Traumatic Aphasia). Moscow: Academy of Medical Science. LURIIA, ALEKSANDR R. 1958 Brain Disorders and Language Analysis. Language and Speech 1:14-34. MILNER, BRENDA 1954 Intellectual Functions of the Temporal Lobes. Psychological Bulletin 51:42-62. PENFIELD, WILDER; and RASMUSSEN, THEODORE 1950 The Cerebral Cortex of Man. New York: Macmillan. PIOTROWSKI, ZYGMUNT A. 1937 The Rorschach Ink Blot Method in Organic Disturbances of the Central Nervous System. Journal of Nervous and Mental Diseases 86:525-537. REITAN, RALPH M.; and REED, HOMER B. 1962 Consistencies in Wechsler-Bellevue Mean Values in Brain-

MENTAL DISORDERS: Biological Aspects damaged Groups. Perceptual and Motor Skills 15:119121. SCHUELL, HILDRED; and JENKINS, J. J. 1959 The Nature of Language Deficit in Aphasia. Psychological Review 66:45-67. SHIPLEY, WALTER C. 1940 A Self-administering Scale for Measuring Intellectual Impairment and Deterioration. Journal of Psychology 9:371-377. TEUBER, HANS L. 1950 Neuropsychology. Pages 30-52 in Recent Advances in Diagnostic Psychological Testing. Springfield, 111.: Thomas. WECHSLER, DAVID 1955 Wechsler Adult Intelligence Scale (WAIS). New York: Psychological Corp. WEPMAN, JOSEPH M. 1951 Recovery From Aphasia. New York: Ronald Press. WEPMAN, JOSEPH M. 1960 Auditory Discrimination, Speech and Reading. Elementary School Journal 60: 325-333. WEPMAN, JOSEPH M. 1961 A Selected Bibliography on Brain Impairment, Aphasia, and Organic Psychodiagnosis. Chicago: Language Research Associates. -» Lists over a thousand items collected from 220 recent American journals and books. WEPMAN, J. M.; and JONES, L. V. 1961 The Language Modalities Test for Aphasia. Chicago: Education—Industry Service. Ill BIOLOGICAL ASPECTS

In 1884 the founding father of neurochemistry, J. W. L. Thudichum, wrote: Many forms of insanity are unquestionably the external manifestations of the effects upon the brain substance of poisons fermented within the body, [in the same way that] mental aberrations accompanying chronic alcoholic intoxication are the accumulated effects of a relatively simple poison fermented out of the body. These poisons we shall, I have no doubt, be able to isolate after we know the normal chemistry to its uttermost detail. And then will come in their turn the crowning discoveries to which all our efforts must ultimately be directed, namely, the discoveries of the antidotes to the poisons, and to the fermenting causes and processes which produce them. (1884, p. xiii)

Thudichum anticipated trends which we would regard as very modern in our day. Two premises are explicitly stated. An aberrant biological product (or "a product fermented in the body") leads to aberrant behavior; and knowledge of normal chemistry "to the uttermost detail" is an essential prerequisite to the isolation of such a product. Thudichum's own crowning achievement was an analysis of the brain in terms of its chemical buildln g blocks, the so-called lipoproteins, which are complexes formed between fatty bodies (lipids) and proteins. This work still stands as a classic. Yet this approach—what one might call a clockw °rk approach—reflects the hopes and limitations an age. In the Victorian era, governed by the rule, the clock, and the kilogram, an under-

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standing of the chemical machinery was regarded as a reasonable basis for the understanding of mental disorder and thus, by inference, of mental order. Attitudes have great viability; similar approaches (with somewhat better reason) are with us to this day. They aim at an understanding of the chemistry of the strange detector we carry in our skull. But of environment, forever playing upon this detector, and so often disrupting and distorting it, chemistry will tell us nothing. Nor can chemistry, in its old and classic form, tell us much of how environment is transcribed and coded by nervous tissue. Yet in man the brain in some strange way internalizes and stores environment; it models it in sight and sound and uses these models as predictors; it transmits information from generation to generation by a symbolic (nongenetic) process, which is a radically new departure in evolution. Neurochemistry thus poses problems very different from those posed by classical chemistry or even by modern physical chemistry. It demands a revision of attitudes, and perhaps like no other field in biology is forcing a confrontation of biological process with the emerging concepts of system theory. In short, any attempt at understanding the brain as a chemically mediated organ of information forces an encounter between somatic transaction and symbolic process. This field one can, justifiably, term psychobiology. Principles of regional brain organization We may be a long way from understanding the nature of the chemical control processes which enable the brain to function as an integrating, "feeling," information-storing, predicting, and computing organ, but we have also come some way since Thudichum. Thudichum's analysis involved the analysis of the brain as a single organ. However, the brain, unlike the liver, is not a homogeneous organ; and in terms of anatomical arrangement, cell population, and chemistry it shows a regional economy which reflects the course of its own evolution. The distinctive attribute of the human and primate brain is the size and structure of its cortex. Its contribution to the analysis of secondary signaling (that is, symbolic) systems has been extensively studied by the Pavlovian school. Yet work since the 1940s has also emphasized the role of some developmentally older subcortical centers buried deep in the brain and the relationship of these structures to the cerebral cortex. The brain centers in question are the hypothalamus, the reticular activating system, the rhinencephalic ("smell brain") formation (also known as the limbic system), and the caudate

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and lentiform masses (the corpus striatum). Each of these systems has received its share of extensive review; and accumulated experience, using a variety of techniques with each, has steadily emphasized three separate, though related, trends. The first is the discrete neuroanatomic and cellular suborganization of these systems; the second, the interconnectedness between the systems themselves and between the systems and relatively distant elements at high cortical and spinal levels; and the third, the reciprocal, complementary, yet mutually exclusive relationship which some patterns represented in these systems bear to each other. These findings are relevant when considered in relation to the regional chemistry of these structures. [See NERVOUS SYSTEM, article on STRUCTURE AND FUNCTION OF THE BRAIN.]

There is little doubt of the anatomical heterogeneity and cytological differentiation of the hypothalamus, where small areas measuring hardly more than a few millimeters in diameter control the central representation of the autonomic nervous system and the appetitive drive systems (fight, flight, hunger, thirst, sex). Similarly, more recent studies have emphasized the remarkable anatomical and cytoarchitectonic differentiation within the reticular activating system, governing wakefulness, sleep, and focused attention. Elements in the structure of the limbic system have similar differentiation. Each of these systems thus encompasses a mosaic of subsystems which in a manner only poorly understood at present are fitted into one another. This understanding, however, is being steadily enhanced by mounting knowledge of the anatomical connections and electrophysiological properties. These connections are in both directions between the hypothalamus and the reticular formation, the limbic system and the hypothalamus, and between these structures and the cortex. [See ATTENTION; SLEEP.] The term "limbic system midbrain circuit" is entirely apt (Nauta 1958). In a way still poorly understood, the limbic system would appear to be an intermediate between discrete analysis of diverse signals at high levels and the discharge of a limited genetically coded stereotyped response known as "affective" behavior. It appears to participate in and to modulate both. There is a tremendous convergence of information in this area. There are structural counterparts of this convergence; in the olfactory bulb, for example (which in man can be regarded as a homologue of the hippocampus), the messages of about 50 million receptors are reduced to 150 thousand in mitral cells and finally reach the brain through

the axons of a mere 45,000 pyramidal cells. These cells and their branchings thus have the structural features which make for an extraordinary funneling and filtering of information (Green 1964). It is, incidentally, in these areas too that a rich, tessellated, terrazzo-like apposition of shared membranes, a virtual mosaic, is found. These junctional areas are also highly localized electrical generators. It is usually found convenient to speak of the reticular formation and the hippocampal amygdaloid cell assemblies as areas that control sleep, wakefulness, and the states between wakefulness and sleep. Yet there is evidence that these areas are pre-eminent in their relation to patterns of emotional expression of autonomic functioning and, also, that interference in these areas may be important for the process of "recall" and possibly for the process of registering the memory trace. Seen dimly, then, and in broadest silhouette, the functions covered by the terms "consciousness," "affect," and at any rate "recall" thus appear to be subserved by congruent or at least intimately connected systems (Elkes 1966). That we are "aware," that we are "responsive," that we are "appropriate," that we can plan a piece of behavior and be sequent rather than random, confused, and "in-con-sequent" in its execution may well be due to some elements and processes vested by evolution in these remarkable cell groups. Somehow, they appear to have the ability to build short-term representational systems of temporarily related events and to use them in the construction of appropriate responses. These models, these tiny maps in time, may be intercellular or cellular; at this stage we do not know. We may thus regard the brain as a mosaic of what have appropriately been called "biased homeostats" (Pribram & Kruger 1954). The bias, handled by genetically coded "Yes-No" drive systems, keeps changing constantly in the light of ongoing events. To allow adequate comparison of events, slow-fading traces must be available to set up such transient comparisons. It is possible that the socalled after discharges (slow-fading electrical discharges) for which the cells—particularly of the hippocampus—are noteworthy provide a medium for the establishment of such traces. In a manner which is only just beginning to be understood, the coincident is detected and the concurrent arranged into an appropriate action that is consequent. Whereas internal perception and comparison may be multiple, action and preparation for action are essentially serial: it requires a rigorous regulation of construction of events at the time; it demands apprehension of the redundant and, above all, a selective inhibition of those elements which are

MENTAL DISORDERS: Biological Aspects judged irrelevant; a construction of subsets which carry meaning by ignoring but also can carry coded traces of what they ignore. Inhibition is thus the agent of structure in the central nervous system. This is borne out by all that we know of reciprocal inhibition in the spinal cord and all that is being learned of the organization of sensory processes. All evidence coming from visual, auditory, and the somatosensory fields points to the operation of highly patterned inhibitory processes reciprocating with the excitation. Delay of the immediate response—that is, the reduction of the immediate reactivity—is merely the giant child of inhibition, a vast and pervasive function woven by evolution into the nervous tissue as a device for judging relevance and for structuring time. Time, indeed, would appear to be the main axis around which the nervous system constructs its model of reality. It does so by judging what is relevant in time and "banking" what is irrelevant. The higher nervous system is remarkable for its ability to ignore; accurate adaptive performance is attained by ignoring all that is adjudged irrelevant. Somehow, then, in such transactions the simultaneous has to be changed to the successive, and global or random apprehension likewise has to be transformed into rank-ordered sequential responses. It has been observed by Pribram and Kruger (1954) that it may be the role of the limbic system to provide the context in which drive stimuli are reinforcing and then to reverse the context-content relationship between the drive stimuli and reinforcing events. Thus affective connotation becomes a label and a gating device. Affect gates the emergence of memory traces into preconscious knowing and conscious action. The events and the internal representation may be highly varied and complex; the affective response patterns, however, are finite. Seen very broadly, the anatomy of the neuraxes reflects these requirements. For we are dealing here with two great vertical systems and one, so to speak, horizontal system. First, there is the so-called specific afferentefferent system which in particular preserves information coming from receptors in a point-to-point ^presentation; second, there is the core of the midline structures comprising the massive facilitatory and inhibitory structures and characterized by a §reat variety of cells which serve as a mixing pool for each sense modality. Connected with both syserns are the elements of the limbic system in which the indications for somewhat longer traces of activity • (the so-called "after discharges") are ocated and which makes this information availfor reference, for comparison, and for label-

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ing. It is possible that the caudate and the striatal nuclei may have somewhat similar properties. In man the vast neocortical mantle provides a tremendous reservoir of cells for the storage of recorded traces of events and for their use in the shaping of new events, either symbolic or actual, i.e., those expressed in action. It is also well to recall that wherever we look in the central nervous system, extracellular space is scarce; nonneuronal (socalled) glial structures and membranes predominate. In fact (although this may prove to be an extravagant generalization), we may look upon the central nervous tissue as an array of growing, polymerizing protein fibers and a mosaic of lipid—protein membranes. Studies have shown the power, the growth, and the specificity of connection formation in the peripheral nervous system. There is also evidence of the presence of nerve growth factors promoting the growth of nerve fibers (Levi-Montalcini & Angeletti 1961). It would seem that, scaled down and compressed to an enormously faster time scale, we may be dealing in the central nervous system with the growth and evolution of macromolecular forms, which by their interaction determine what we know as symbolic form. The junctional sites between cells, and particularly the enormous and highly ordered membranes existing in the central nervous system, may play a part in the initial construction of trace models capable of acting as recognizers, and hence as organizers and ultimately as decision points—organizers, that is, of coincidences, of sequences of pattern, that is, patterns in time. [See TIME, article on PSYCHOLOGICAL ASPECTS.] Central neurohumoral substances It may very well be asked why one should emphasize structural features in the context of a statement on the biological background of mental disorder. The partial answer is that the anatomical and functional attributes have some suggestive chemical correlates. For it is precisely in the areas just mentioned (the hypothalamus, the midline gray area, and elements of the limbic system, the amygdala, the hippocampus, the reticular activating system, and certain layers of the cortex) that one repeatedly encounters a number of small molecules which appear to have evolved for a role in the organization of control systems in the central nervous system. These molecules are acetylcholine, and possibly other choline esters; gamma aminobutyric acid, a derivative of glutamic acid; histamine, also found in the skin and released in injury of all tissues; catecholamines such as dopamine, norepinephrine, and epinephrine, mediators of

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sympathetic system responses at peripheral effector sites; and indoles such as serotonin. All these molecules show a regional gradient in their distribution. Histamine, for example, is found principally in the midline diencephalic structures; norepinephrine is present in the hypothalamus and in the periventricular gray matter; serotonin is present in both diencephalic and limbic structures. Two further features should be emphasized concerning these substances. First, they are representative members of families of compounds. As chemical mapping proceeds, related members of these various subgroups, their precursors, and their products are identified. Second, the metabolic pathways of each of these compounds—within and without the brain —are steadily being defined more clearly. New and elegant techniques are capable of demonstrating these materials in situ in the brain. These studies show that the intercellular and pericellular economies of these substances are organized very precisely. The molecules are transported into cells or their precursors by the energy-yielding system; once synthesized, they are transported and packaged into granular particles or "vesicles" inside cells; they are carefully stored in equilibrium at these sites and are released in response to electrical stimulation by mechanisms still poorly understood. Moreover, all work so far on how the psychoactive drugs act—be they tranquilizers, stimulants, or the so-called hallucinogenic compounds—suggests that all substances interfere in varying ways and to varying degrees with the uptake, storage, and release of the catecholamines (such as epinephrine and dopamine), indolic substances (such as serotonin), and possibly histamine in the areas that have been mentioned. The precise action profiles of these drugs are different, and it is upon such subtle differences in action that variation in therapeutic effect may well depend. This, then, puts an end to the simple "clock model" of an earlier day. For we are not only dealing with families of compounds, but we are also considering multiple binding sites of organelles exquisitely sensitive to local subcellular conditions. The uneven distribution of these chemicals at neuronal decision points, the trigger (or selective suppressor) function of certain elements, and the anatomically imposed economy in terms of convergence and occlusion all suggest that we are dealing with transaction sites at highly localized subcellular levels which need not necessarily be reflected in gross over-all shifts. These sites are evidently unevenly distributed in nonhomogeneous cell populations. Their state at any one time depends exquisitely upon the short-term history of preceding or

coincidental events. It is impossible to think in terms of a mechanistic spatial localization, i.e., in terms of points. Rather, one is forced to think in terms of convergence, coincidence, stochastic processes, and probabilities of interaction in time. It was earlier suggested that inhibition is the agent of structure in the nervous system and that the silence in the central nervous system is, so to speak, informed silence. The chemical computer we carry in our skulls apparently writes its chemical text of experience in proteins; and some small molecules appear to play a key part in the transcription or readout. Much work on the biology of mental disorder centers on the identification of the normal molecules mentioned above and of their deviant metabolites. Chemical aspects of mental development Chemical factors certainly operate in the development of the nervous system. Some of these are general; others are more special. Of the general factors, oxygen supply is one and hormones are another. Cerebral ischemia, i.e., restriction of blood supply, even for a short time in the developing animal, causes marked forms of mental deficiency. Yet in the adult animal, oxygen supply and fuel consumption are not necessarily related to mental functioning: they may be, but they need not be. A major advance in methodology (Kety & Schmidt 1948) has made it possible to make exact measurements of blood flow, oxygen consumption, and glucose consumption in the conscious human brain, in a variety of functional states in the normal brain and in various forms of mental disorder. These studies have shown quite clearly that in normal man the major substrate for oxidation is glucose and that the rate of energy utilization of the human brain is on the order of a mere 20 watts— eloquent testimony to the efficiency and miniaturization of the brain-computer, weighing about three pounds. These same studies also showed that general anesthesia reduces cerebral oxygen consumption to about 40 per cent; in contrast, normal sleep did not show such reduced oxygen consumption. Similarly, in studies of schizophrenia and of the effects of LSD-25 and other hallucinogenic drugs there were no changes in over-all total oxygen consumption. First and last, the brain is an organ of information. To be sure, energy is needed to keep the living computer going, to synthesize the building blocks, particularly proteins and lipoproteins essential for its development. However, information storage and retrieval are evidently low-energy processes.

MENTAL DISORDERS: Biological Aspects Another equally general factor concerned in intellectual development and mental functioning is presented by a number of hormones, of which thyroxin can serve as a useful example. Hypothyroidism due to an iodine deficiency leads to a mental deficiency syndrome known as cretinism. Hyperthyroidism (an excess of thyroxin) leads to striking hyperirritability and various signs of overactivity of the autonomic nervous system. There is much experimental evidence (Sokoloff & Kaufman 1959) that thyroxin may exert its action on the brain through influencing protein synthesis. It is relevant that although thyroxin does not stimulate protein synthesis in the mature brain, it does significantly do so in the newborn brain. The main structural defect in experimentally induced cretinism (produced by thyroid deficiency) is a deficiency in the proliferation of fine nerve fibrils (dendrites) in the immature cerebral cortex. Here again, a structural feature stresses the importance of connectivity between neurones (the so-called neuropile) rather than mere number of cells. The pathology of phenylpyruvic oligophrenia (phenylketonuria, PKU) may serve as a useful example of the way in which a specific and genetically determined metabolic error—a so-called biochemical lesion—may profoundly affect the development of higher nervous function. In 1934 A. Z. Foiling observed in the course of an investigation of mentally defective children that some of them excreted phenylpyruvic acid in the urine and that there appeared to be a relation between the anomaly and the imbecility. This was the first demonstration of a metabolic error definitely associated with a form of mental defect and also with physical characteristics (blond hair and blue eyes). In phenylketonuria the subject is unable to oxidize a normally occurring essential amino acid (phenylalanine) to tyrosine at a normal rate. Because of this inability, phenylalanine accumulates in the tissues, rises in the blood stream, and spills over in the urine. This error also mobilizes other metabolic routes which normally play little part in the metabolism of these amino acids. In 1953 it was definitely shown that enzymic extracts prepared from the livers of phenylketonuric patients failed to further the oxidation of phenylalanine to tyrosine (Jervis 1953; Wallace, Moldave & Meister 1957). Extracts of normal livers do so quite readily. Furthermore, the use of radioactively labeled phenylalanine showed that the phenylketonuric can convert this phenylalanine to tyrosine at only a fraction of the normal rate. The most striking result of this deficient oxidation mechanism is the a Ppearance in the urine of phenylpyruvic acid, a

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compound which is readily detected through the greenish color it acquires when it reacts with ferric chloride. This provides a ready screening test for the deficiency in the newborn. The striking decreased pigmentation seen in phenylketonuria— blue eyes and blond hair—may be due to the decreased formation of melanin pigment, through inhibition of an enzyme known as tyrosinase. The abnormal metabolites of phenylalanine also apparently interfere with the synthesis of catecholamines important for brain functions. This may account for the lowered level of epinephrine and norepinephrine in the plasma of the phenylketonuric. Whether excess of phenylalanine or one of its breakdown products or an interference with some of the biosynthetic processes of catecholamines accounts for the mental defect remains uncertain. However, the concept opens up an inviting area for producing experimental phenylketonuria in the laboratory by means of "loading" the system with phenylalanine and also suggests a way of treating or preventing the disorder by withdrawing the offending amino acid from the diet. The first attempt to relieve phenylketonuria by such dietary means followed only four years after the discovery of the syndrome (Penrose & Quastel 1937). A new approach to the problem was introduced in 1951, when, for the first time in the field of mental deficiency, diets specifically low in one amino acid (namely, phenylalanine) were introduced (Woolf & Vulliamy 1951). The so-called synthetic phenylalanine-low diets have now been used with varying success in a number of studies. They result in a sharp lowering of urinary phenylpyruvic acid and plasma phenylalanine. The patients so treated show a striking reduction in seizures and spasticity and increased responsiveness in motor development. There is also a darkening of the hair. Reversal to full phenylalanine natural diet leads to relapse. It has also become unambiguously clear that treatment must be introduced as early as possible and that improvement falls off sharply if this regimen is introduced beyond the stage of infancy. The developing nervous system is a vulnerable one. [See MENTAL RETARDATION.] These studies are mentioned because in a sense they represent a prototype of approach which is now being applied, with some modest success, in other studies of the biological basis of mental disorder. The steps are as follows: An empirical finding—a deviant metabolite in urine—leads to a suspicion of a metabolic defect. The natural history of the disorder suggests a genetic basis for this defect. A biochemical lesion—a specific biochem-

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ical defect—is defined. Since the metabolic pathways are interrelated, this single defect leads to consequences only indirectly related to the primary defect, yet very pertinent to the total pathology. The correction of the defect by reducing the metabolic load forms the basis of therapy. An animal model for this disorder is developed, and, finally, the fit of the model in terms of detection and prevention is tested. However, there is still a large no man's land between evidence and inference. The effects of the deviant metabolites on the development of the nervous system, and particularly those areas concerned with perception, coordination, control of motor activity, and maturation of intellectual function, remain largely unknown. Schizophrenic disorders The facts cited above point to the complexity of the field of disorder when it is seen in terms of available biochemical facts and biochemical hypotheses alone. These complexities are compounded many times over in an attempt to relate known biochemical facts to the group of disorders known as the schizophrenias. It is by now generally accepted that we may be dealing, in this group, with a number of very different disorders, sharing a general symptomatology but quite possibly in need of a radical regrouping. The role of genetic factors is reviewed elsewhere [see MENTAL DISORDERS, article on GENETIC ASPECTS]. Careful genetic psychosocial studies of twins, on a national and international scale, are now proceeding, and such studies (particularly of families in which twins are discordant for schizophrenia) may contribute some of the facts which are needed to separate, on a conceptual basis, nature from nurture. Equally, careful longitudinal studies—prospective rather than retrospective—are needed (starting, preferably, in early infancy) to establish the role of genetic "givens" in the autonomic reactivity patterns which have been claimed to be deviant among schizophrenics. These suggest an instability of hormonal control and diminished compensatory physiological responses: peripheral vasoconstriction, capillary abnormalities in the nail bed, and abnormal pupil responses have been implicated as such signals. Yet the one measure which reliably distinguishes schizophrenic populations from normal is their state of readiness in the face of oncoming stimuli (Rodnick & Shakow 1940). This anticipatory set or "set index" suggests that in schizophrenia one may be dealing with a disorder of the attention process. How much this disorder represents the collusion between a genetically determined insta-

bility in homeostatic control and a defensive homeostatic withdrawal from stressful stimulus situations and thus, ultimately, a learned pattern of adaptation (enhanced, for example, by the double message structure found in schizophrenogenic families) still remains a matter of conjecture. [See ATTENTION; REACTION TIME; SCHIZOPHRENIA; STRESS.] Nor does the difficulty of relating biochemical varibles to clinical states end there. Even when the data are from the observation of schizophrenics in a hospital ward, there are a number of sources of errors which have seriously affected investigation (Kety 1959). These include long hospitalization, diet (including dietary iodine and protein deficiency), various therapeutic maneuvers (including medication), and the actual circumstances—stressful or otherwise—accompanying the drawing of the biochemical sample. Also, as in all other fields of psychobiology, subjective bias has cast a pall over many painstaking studies. All these reservations notwithstanding, there are, however, some findings largely attributable to the striking advances in present-day methodology. These advances are essentially three in number. First, the refinement of protein fractionation procedures (derived from the needs of blood transfusion and of plasma substitutes); second, the advance of microfluorometric techniques for the detection of very small quantities of catecholamines, indole derivatives, and their metabolites; and third, the development of radioactive tracer techniques and particularly the advent of the liquid scintillation counter, which makes it possible to follow a particular compound through a metabolic maze. As always, it is a moot question whether technical methods or intuitive insights are the more powerful propellants of science. Evidently, in our age they are inextricably connected. In 1957 it was first reported that a serum fraction obtained from schizophrenic patients, when injected into carefully selected nonschizophrenic prisoner volunteers, led to the development of symptoms of thought disorder, autism, depersonalization, paranoid ideas, hallucinations, and catatonic stupor which were likened to schizophrenia (Heath et al. 1958). Attempts to replicate this finding by injection of material prepared according to similar instructions, however, were not successful (see Conference on Neuropharmacology 1959). This finding, however, seems to this writer less pertinent than the various lines of investigation which were stimulated by the finding. A number of groups have now independently obtained evidence which suggests at least the possibility that

MENTAL DISORDERS: Biological Aspects an abnormal protein may be present to a greater extent in the blood of schizophrenics than in normals and that this substance may be capable of producing behavioral metabolic changes in some animal tests. There is also evidence that there is an antigenic abnormality in the pooled serum of chronically ill schizophrenic patients (Haddad & Rabe 1963) and that plasma from schizophrenic patients affects learning and retention of learning in the rat (Bishop 1963). Similarly, serum of schizophrenic patients has been shown to affect cortical (electrically evoked) responses of animals (German 1963). However, it is of more than suggestive significance that in these various studies plasma derived from normal individuals put under stress produced somewhat similar responses. It is therefore possible that one may be dealing here with a small molecular constituent liberated during stress and attached to one of the plasma fractions; the constituent may not be a unique characteristic of schizophrenia. Another approach to the problem is the characterization of various serum protein fractions, rather than total proteins, in terms of electrophoretic and immunochemical properties. There is evidence from double-blind studies that there may be abnormal protein fractions in a considerable proportion of schizophrenic patients (Fessel & Grunbaum 1961). A cognate approach to the above are the findings of another group (Frohman et al. 1960), who reported that when red blood cells of chickens are incubated with plasma or plasma fractions of some schizophrenic patients, there is an increase, compared with normal controls, of the lactate-pyruvate ratio. This finding, however, still awaits full confirmation, for the difference (in the lactate-pyruvate ratio) is seen only when the subjects have been engaged in moderate exercise before the blood samples are drawn. It may be that these serum factors, while responsive to stress in normals, may be greatly increased in schizophrenics subjected to stress. The serum factor apparently influences the stability of the red cell membrane, the rupture of which may alone account for the changes in the lactate-pyruvate ratio. Broadly, then, the conclusion at this stage is that there is evidence of a plasma protein abnormality *n schizophrenia capable of producing measurable behavioral, immunological, electrophysiological, a nd biochemical responses in suitable test preparations; and that this abnormal constituent may in fact contain a small molecular substance released by, or related to, physiological stress. There are, however, a number of other small which are increasingly being implicated

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in the search for a biochemical factor (the so-called psychotoxic factor) in schizophrenia. As early as 1952 Osmond and Smythies pointed out that there is a close chemical similarity between the drug mescaline, derived from a Mexican cactus plant, and epinephrine and its precursor dopamine, both of which are usually found in the brain. Mescaline is a methylated derivative of dopamine. The mental changes produced by mescaline bear some resemblance to those seen in schizophrenia. The same paper concluded that "it is extremely probable that the final stage in the biogenesis of epinephrine is a transmethylation of norepinephrine, the methyl groups arising from methionine or choline" (a well-known methyl donor). It is just possible that a defective transmethylation of norepinephrine might lead to methylation of one or both of its hydroxyl groups instead of its amino group. This defective methylation could thus give rise to a mescaline-like toxic substance—Thudichum's "internally fermented psychotoxic." There is no denying the attractiveness of this hypothesis, for it relates the metabolism of epinephrine, a hormone liberated during stress, to the pathology of a condition in which stress tolerance and responsiveness to stress are markedly altered or reduced. This suggestion that there may, in schizophrenia, be a disturbance of the transmethylation process is supported by the fact that a number of drugs (such as dimethyltryptamine, DMT) producing profound mental changes in man are in fact methylated congeners of normal body metabolites. On the basis of such findings it was indeed suggested by Hoffer and his colleagues (1957) that substances which would compete for methyl groups and act as methyl acceptors could competitively inhibit the abnormal process. The vitamins niacin and niacinamide are such substances, and some beneficial results following the administration of large doses of these vitamins in schizophrenia have been reported (Hoffer et al. 1957). These findings still await confirmation. A more direct approach to the problem was to administer large doses of L-methionine, a powerful methylating agent, and a number of other amino acids to chronic schizophrenic patients (Pollin et al. 1961). The changes seen in some patients following the administration of this material were striking; there was a brief and sharp intensification of the psychotic symptoms. This finding has since been confirmed by three other groups and suggests that methylation of aromatic compounds may indeed lead to substances which greatly affect brain function. Another piece of evidence along the same line is the reported occurrence in the urine of schizophrenic

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patients of a substance 3-4-dimethoxy-phenyl-ethylamine (Friedhoff & Van Winkle 1962), suggested in 1952 by Osmond and Smythies as possibly an abnormally methylated and toxic metabolite. This compound is indeed the dimethyl derivative of dopamine, the precursor of epinephrine, and in structure is closely related to mescaline (the trimethyl derivative of this substance). It is only fair to say, however, that the finding of this compound in urine is still subject to confirmation. The presence of the compound may be related to dietary factors and there is, so far, only preliminary evidence that the substance identified in the urine is indeed produced in the body. Once again, then, one can but say that we are at the beginning; yet the pieces are showing some fit. Affective disorders The relation of the midbrain structures and certain elements of the limbic system to the regulation of the visceromotor and affective states has already been mentioned. It is also clear that catecholamines and indoles play a dominant role in these highly specialized and all-pervasive regulatory centers. The past few years have seen increasing evidence to suggest a possible link between affective disorders (i.e., depression or elation of mood) and changes in the metabolism of catecholamines in the central nervous system. Most of the evidence so far is inferential, yet the advent of pharmacological agents which strikingly affect mood by interfering with the storage, release, and disposition of catecholamines in the central nervous system and at peripheral sites has added an important segment to the body of evidence. [See DEPRESSIVE DISORDERS.] Quite early it was reported, in a carefully controlled metabolic study, that clinical manifestations of periodic catatonic excitement and stupor were correlated with a change in the nitrogenous constituents of the urine (Gjessing 1938; Gjessing et al. 1958). Longitudinal studies have shown that the urinary excretion of norepinephrine is increased in the manic phase and decreased in the retarded depression phase in manic-depressive ("cyclic") patients (Strom-Olsen & Weil-Malherbe 1958). Yet urinary epinephrine represents only a small fraction of the total metabolites of epinephrine. However, it is now possible to study and identify most other breakdown products of epinephrine and to draw up a full balance sheet of catecholamine metabolites in man. Such studies of urinary metabolites in depressed patients and normal controls suggest as a reasonable hypothesis that "some, if not all, depressions are associated

with an absolute or relative deficiency of catecholamines . . . at functionally important receptor sites in the brain" (Schildkraut 1965, p. 509). The major inferential evidence so far derives not from physiological studies in the natural untreated states but from the results of pharmacological intervention. In this respect, three groups of drugs are of particular import, namely, reserpine (a major tranquilizer exerting its effect by depleting serotonin and norepinephrine sites in the brain and peripheral sites); the monoamine oxidase inhibitors, which are powerful antidepressants and inhibit the destruction of naturally occurring amines (epinephrine, serotonin, and the like) by oxidation; and various imipramine-like compounds which, in a way not yet clearly understood, interfere with the local economy of catecholamines at intracerebral sites. Reserpine has been found to induce severe depression in patients, yet whether reserpine-induced depression is a valid pharmacological model of the naturally occurring clinical state remains to be seen. In animals, reserpine induces sedation, which is associated with a decrease in the brain levels of norepinephrine, dopamine, and serotonin. The level of sedation correlates well with the depletion of catecholamines in the brain and, furthermore, shows a rise in level of catecholamines with a return of normal motor behavior. Furthermore, the administration of dihydroxy-phenylalanine and dopamine promptly reverses the reserpine-induced sedation in animals and restores normal behavior and norepinephrine level, while an administration of the corresponding serotonin precursor (5-hydroxy-tryptophan) does not. In man, dopamine has been reported to counteract the sedating effect of reserpine. Thus catecholamine depletion (i.e., depletion of dopamine, epinephrine, and norepinephrine) may be of major importance in reserpine-induced sedation in animals; reserpineinduced depression in man may possibly have a similar basis. The gross picture is reversed for the antidepressive agents. Administration of monoamine oxidase inhibitors, such as iproniazid, and other clinically effective antidepressives both produced behavioral excitation in animals and correlated well with elevated levels of brain norepinephrine. The behavioral stimulation is less related to an elevation of brain serotonin. The mood-elevating properties of amphetamine (benzedrine) are well known. It may be that amphetamine acts by releasing active norepinephrine from its anchoring sites. Furthermore, the "rebound" effect following amphetamine intoxication (which shows clinically in depression) is reflected in a temporary depletion of norepineph-

MENTAL DISORDERS: Biological Aspects rine stores available for continued release. Imipramine, another antidepressant, does not inhibit the enzymes involved in metabolic reactivation of norepinephrine and may interfere with the uptake of norepinephrine into peripheral tissue. There is also some evidence that imipramine inhibits norepinephrine uptake in the brain. These findings are indicative of the kind of subcellular organization that one is compelled to consider. Little is known as yet of the physiological (rather than pharmacological) factors which govern the storage and release of substances at these subcellular sites. One would naturally suspect ionic shifts, although evidence in this respect so far is very circumstantial. The metallic ion lithium is used in the treatment of manic behavior. Evidence of the role of hormones in these transactions is also at present hardly more than suggestive. There is, however, a respectable body of evidence recently reviewed (Ramey & Goldstein 1957) which indicates a close physiological interaction between the adrenocortical steroids and the catecholamines. The two groups of stress hormones would seem to operate physiologically as one functional unit, the steroids maintaining the integrity and responsiveness of tissues in the process of reacting to norepinephrine. Indeed, many actions of epinephrine, norepinephrine, and dopamine are not elicitable in the absence of steroids. Equally, and perhaps more significantly, many actions attributable to the steroids may in fact be more accurately ascribed to the catecholamines. There is some clinical data available on the relation of plasma hydrocortisone levels to mood. There is, for example, a significant linear relationship between an increase in anxiety, anger, and plasma hydrocortisone levels; moreover, and perhaps less expected, severe depression is accompanied by elevated plasma hydrocortisone levels; and deeply retarded underactive patients show hormone levels higher than those of less depressed groups. Depression would thus appear to be an active stress response; the retarded tearless state, the final phase of an active, adaptive process. This phase is largely inhibitory, in contrast with the excitatory component commonly seen in the so-called agitated depressive syndromes. It would be idle to speculate at present on the possible effects of various degrees of adrenocortical mobilization on the binding and releasing of epinephrine and norepinephrine in trigger areas of the brain. It may even be that the reverse is true and that the differential proportion of amines in the brain ftiay affect the degree of adrenocortical mobilization. In closing, however, it would be safe to surmise

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that affective behavioral responses may have peculiar chemical topology in some nodal areas of the brain and that some small molecules, particularly catecholamines and indoles, may by virtue of differential storage, release, and disposition determine the particular pattern of response which is selected by the organism in the light of adaptive need. The affective responses are very simple and are relatively stereotyped. The symbols which produce them are infinitely more complex. We do not know what factors go into determining the responsiveness of the affective apparatus during an early developmental period, i.e., how much depends on certain genetic "givens" (enzyme proteins); how much is learned (incorporated into the plastic biological system during an early developmental period). Yet even in this area there is some suggestive evidence. For example, animals reared in isolation show a different pattern in the metabolism of actively labeled dopamine from animals which are forced to interact (Welch & Welch 1965). Could, one might ask, the coldness and unresponsiveness of the sociopath have a biochemical basis? Could such an understanding yield, in time, appropriate additive therapies? Could learning be modified by chemical means, even in the adult? Could the affective disorders yield to specific chemotherapy? Is there a rational basis for a so-called biological theory of the schizophrenias? More important, could the slowly evolving principles of psychobiology be applied equally to states of mental well-being and ill-being? We know little about the physiology of these states, yet it is clear that whatever direction neurobiology takes, it cannot go it alone. It deals with the machinery and not with information; information is symbolic and social. Whatever hopes there may be for the brain sciences, they remain inseparable from education and social change. Human development, human learning, human communication, human socialfield dependence remain the heart of the study of mental health. In these, the neurobiologist must take his modest place. JOEL ELKES [Directly related are the entries DRINKING AND ALCOHOLISM, article on PSYCHOLOGICAL ASPECTS; DRUGS, articles on PSYCHOPHARMACOLOGY and DRUG ADDICTION: ORGANIC AND PSYCHOLOGICAL ASPECTS; EvOLUTION, article on EVOLUTION AND BEHAVIOR; GENETICS, article on GENETICS AND BEHAVIOR; LEARNING, article on NEUROPHYSIOLOGICAL ASPECTS; MENTAL DISORDERS, TREATMENT OF, article on SOMATIC TREATMENT. Other relevant material may be found in ANXIETY; DEPRESSIVE DISORDERS; DRIVES,

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article on PHYSIOLOGICAL DRIVES; EMOTION; HOMEosxAsis; INIANCY, article on THE EFFECTS OF EARLY EXPERIENCE; MENTAL RETARDATION; NERVOUS SYSTEM; SCHIZOPHRENIA; SENSES; STRESS.] BIBLIOGRAPHY

BISHOP, M. P. 1963 Effects of Plasma From Schizophrenic Subjects Upon Learning and Retention in the Rat. Pages 77-91 in Robert G. Heath (editor), Serological Fractions in Schizophrenia: A Research Symposium. New York: Harper. CONFERENCE ON NEUROPHARMACOLOGY, FOURTH, SEPTEMBER 25-27, 1957, PRINCETON, N.J. 1959 Neuropharmacology: Transactions. Edited by Harold A. Abramson. New York: Josiah Macy, Jr. Foundation. ELKES, J. 1966 Psychoactive Drugs: Some Problems and Approaches. Pages 4-21 in P. Solomon (editor), Psychiatric Drugs. New York: Grune. FESSEL, W. J.; and GRUNBAUM, B. W. 1961 Electrophoretic and Analytical Ultra-centrifuge Studies in Sera of Psychotic Patients: Elevation of Gamma Globulins and Macroglobulins, and Splitting of Alpha Globulins. Annals of Internal Medicine 54:1134-1145. F0LLING, A. 1934 Excretion of Phenylpyruvic Acid in Urine as Metabolic Anomaly in Connection With Imbecility. Nordisk medicinsk tidskrift (Stockholm) 8:1054-1059. FRIEDHOFF, A. J.; and VAN WINKLE, E. 1962 The Characteristics of an Amine Found in the Urine of Schizophrenic Patients. Journal of Nervous and Mental Disease 135:550-555. FROHMAN, CHARLES E. et al. 1960 Further Evidence of a Plasma Factor in Schizophrenia. A.M.A. Archives of General Psychiatry 2:263-267. GERMAN, G. A. 1963 Effects of Serum From Schizophrenics on Evoked Cortical Potentials in the Rat. British Journal of Psychiatry 109:616-623. GJESSING, L.; BERNHARDSEN, A.; and FR0SHAUG, H. 1958 Investigation of Amino Acids in a Periodic Catatonic Patient. Journal of Mental Science 104:188-200. GJESSING, R. 1938 Disturbances of Somatic Functions in Catatonia With a Periodic Course, and Their Compensation. Journal of Mental Science 84:608-621. GREEN, J. D. 1964 The Hippocampus. Physiological Reviews 44:561-608. HADDAD, R. K.; and RABE, AUSMA 1963 An Antigenic Abnormality in the Serum of Chronically 111 Schizophrenic Patients. Pages 151-157 in Robert G. Heath (editor), Serological Fractions in Schizophrenia: A Research Symposium. New York: Harper. HEATH, R. G. et al. 1958 Behavioral Changes in Nonpsychotic Volunteers Following the Administration of Taraxein, the Substance Obtained From Serum of Schizophrenic Patients. American Journal of Psychiatry 114:919-920. HOFFER, A. et al. 1957 Treatment of Schizophrenia With Nicotinic Acid and Nicotinamide. Journal of Clinical and Experimental Psychopathology 18:131158. JERVIS, G. A. 1953 Phenylpyruvic Oligophrenia Deficiency of Phenylalanine-oxidizing System. Society for Experimental Biology and Medicine, Proceedings 82: 514-515. KETY, SEYMOUR S. 1959 Biochemical Theories of Schizophrenia. Science New Series 129:1528-1532, 1590-1596.

KETY, SEYMOUR S. 1960 Measurement of Local Blood Flow by the Exchange of an Inert, Diffusable Substance. Volume 8, pages 228-236 in Methods in Medical Research. Edited by H. D. Bruner. Chicago: Year Book Publishers. KETY, SEYMOUR S.; and SCHMIDT, C. F. 1948 Nitrous Oxide Method for the Quantitative Determination of Cerebral Blood Flow in Man: Theory, Procedure and Normal Values. Journal of Clinical Investigation 27: 476-483. LEVI-MONTALCINI, RITA; and ANGELETTI, PIETRO U. 1961 Biological Properties of a Nerve-growth Promoting Protein and Its Antiserum. Pages 362-377 in International Neurochemical Symposium, Fourth, Varenna, Italy, 1960, Regional Neurochemistry; the Regional Chemistry, Physiology, and Pharmacology of the Nervous System: Proceedings. Edited by Seymour S. Kety and Joel Elkes. New York: Pergamon. NAUTA, W. J. 1958 Hippocampal Projections and Related Neural Pathways to the Mid-brain in the Cat. Brain 81:319-340. OSMOND, H.; and SMYTHIES, J. 1952 Schizophrenia: A New Approach. Journal of Mental Science 98:309315. PENROSE, LIONEL; and QUASTEL, JUADA H. 1937 Metabolic Studies in Phenylketonuria. Biochemical Journal 31:266-274. PERSKY, H. et al. 1958 Relation of Emotional Responses and Changes in Plasma Hydrocortisone Level After Stressful Interview. A.M.A. Archives of Neurology and Psychiatry 79:434-447. POLLIN, WILLIAM; CARDON, PHILIPPE V. JR.; and KETY, SEYMOUR S. 1961 Effects of Amino Acid Feedings in Schizophrenic Patients Treated With Iproniazid. Science New Series 133:104-105. PRIBRAM, K. H.; and KRUGER, L. 1954 Functions of the "Olfactory Brain." New York Academy of Sciences, Annals 58:109-138. RAMEY, E. R.; and GOLDSTEIN, M. S. 1957 The Adrenal Cortex and the Sympathetic Nervous System. Physiological Reviews 37:155-195. RODNICK, E. H.; and SHAKOW, D. 1940 Set in the Schizophrenic as Measured by Composite Reaction Time Index. American Journal of Psychiatry 97:214225. SCHILDKRAUT, JOSEPH J. 1965 The Catecholamine Hypothesis of Affective Disorders: A Review of Supporting Evidence. American Journal of Psychiatry 122: 509-522. SOKOLOFF, Louis; and KAUFMAN, SEYMOUR 1959 Effects of Thyroxine on Amino Acid Incorporation Into Protein. Science New Series 129:569-570. STROM-OLSEN, R.; and WEIL-MALHERBE, H. 1958 Humoral Changes in Manic—Depressive Psychosis With Particular Reference to the Excretion of Catechol Amines in Urine. Journal of Mental Science 104: 696-704. THUDICHUM, JOHN W. L. 1884 A Treatise on the Chemical Constitution of the Brain. London: Balliere. WALLACE, H. W.; MOLDAVE, K.; and MEISTER, A. 1957 Studies on Conversion of Phenylalanine to Tyrosine in Phenylpyruvic Oligophrenia. Society for Experimental Biology and Medicine, Proceedings 94:632633. WELCH, BRUCE L.; and WELCH, ANN MARIE 1965 An Effect of Aggregation Upon the Metabolism of Dopa-

MENTAL DISORDERS: Epidemiology mine-l-H3. Pages 201-206 in Symposium on Binding Sites of Brain Biogenic Amines, Galesburg, 111., 1963, Biogenic Amines. Progress in Brain Research, Vol. 8. Amsterdam: Elsevier. WOOLF, L. I.; and VULUAMY, D. G. 1951 Phenylketonuria With Study of Effect Upon It of Glutamic Acid. Archives of Disease in Childhood 26:487-494. IV

EPIDEMIOLOGY

"Epidemiology" refers to the science which studies "the mass phenomena of disease" (Greenwood 1935) by determining the distribution of conditions or diseases and the factors which determine these distributions (Lilienfeld 1959); that is, it is "the study of the distribution and determinants of disease prevalence in man" (MacMahon et al. 1960). The analysis that epidemiology makes of these findings results in a "medical ecology" (Gordon 1952). Epidemiology relates observed distributions of disorders to the environments in which people live—the physical, biological, and social environments. "Mental disorder" is used in this article to refer to the full range of psychic conditions identified by psychiatrists or competent social authorities as abnormal or needing improvement. This is a broader range than would be used in planning or conducting any single inquiry but permits consideration, where necessary, of studies of delinquency, criminality, military desertion, and group fads (such as fish swallowing), as well as any conventional psychiatric diagnostic category or an individual symptom or special syndrome recognized in psychiatry. Uses of epidemiology Seven uses of epidemiology can be distinguished (Morris 1957): (1) knowledge regarding historical trends helps to distinguish disorders that are on the increase from those that are disappearing; (2) community diagnosis of the size, location, and distribution of a condition aids in planning health programs for the community; (3) from accumulated records of the ages at which individuals contract a disease, individual risks can be calculated (a basic tool in calculating insurance premiums), and knowledge of contingency risks aids in estimating the effects of host factors in determining the distribution of cases; (4) knowledge of the attributes of cases not in treatment enlarges the clinical picture by making our concept of a disorder less dependent on the clinician's limited perspective on cases; (5) occasionally, new syndromes are identified because clinically dissimilar

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cases are found to arise from a particular common background or because clinically similar cases are found to arise in two or more distinct sets of circumstances; (6) the working of health services can be studied in terms of their successes and failures, their selection of cases for treatment, and their deleterious effects on the people they seek to serve; and (7) in the search for causes of disorders, data on the factors associated with the distribution of a disorder supplement laboratory and clinical data in the elucidation of causal mechanisms—at times the crucial breakthrough in our understanding of the way in which a condition is caused is made by epidemiological inquiry (this occurred with cholera, pellagra, and lung cancer). Historical trends. Historical trends are important but difficult to study. The Group for the Advancement of Psychiatry reviewed psychiatric knowledge recently (1961). The use of old data gathered for another purpose is sometimes tried. It is difficult to identify two groups at two different points in time which can be considered different time samples of the same population. If the questions are asked broadly enough and if the population being considered has some sort of continuing dimensions, an approximation of trends can sometimes be established. Two studies are noteworthy because they are particularly well done. Goldhamer and Marshall (1949), in a superb study of the admission of psychotics to mental hospitals in Massachusetts during a hundred-year period, found evidence to contradict the widely held view that schizophrenia is becoming more common. In spite of the work's excellence, the implications of the findings remain uncertain, mainly because the data depend entirely on records of cases admitted to mental hospitals and because the population "sample" was taken from an area (Massachusetts) that was the first in North America to be industrialized and was subject to gross emigration and immigration during the time period observed. With the hope of showing that an inverse relationship between intelligence and fertility was leading to a decrement in the national average intelligence quotient (IQ), a survey of Scottish intelligence tested "all" 11-year-olds on one day in 1930 and repeated almost the same procedure on one day in 1949. The findings were negative, according to the publications (Scottish Council for Research in Education 1953), but reinterpretation of the differences between the methods used in the two surveys suggests that the prevalence of very low scores among Scottish 11-year-olds may actually have decreased (Gruenberg 1964).

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Community diagnosis. Many studies of particular communities have been carried out for diagnostic purposes; some outstanding examples are mentioned later in this article, in the section on case-finding methods. Since community diagnosis, by its nature, is done for a particular community, it is no more reasonable to borrow the diagnosis of one community and apply it to another than to borrow a neighbor's X ray because he had a similar cough. The general picture will be more or less the same, but the details which differentiate one community from the other may be crucial. Techniques for making rapid and relevant surveys of communities to aid mental health planning are sadly lacking. A few demographic facts are often used (as in the American Psychiatric Association's consultations) to infer what the findings would be. From the health service's point of view, enumeration of cases that do not distinguish preventable or curable conditions from nonpreventable or noncurable cases are of little value. One learns only that the problem is small, big, very big, or enormous, depending on how one defines the problem. The American Public Health Association's Mental Disorders (1962) is a milestone because it indicates the conditions for which it is currently important to be able to enumerate cases. As the technology of treatment and prevention grows, this list will grow. This analysis also indicates that the social-breakdown syndrome is important in evaluating the benefits of a comprehensive community mental health service (e.g., Gruenberg 1966). Similarly, future studies for community diagnosis, as well as for analysis of health services, will require techniques for counting cases of conditions for which something can be done. The calculation of individual risks. The risk of a child's being Mongoloid is dependent on its mother's age at the time of birth, but not its father's (Penrose 1949). If a woman has German measles while pregnant, there is an increased risk of her child's being brain-damaged; this increased risk is highest if the infection occurs during the third month of pregnancy (Hill et al. 1958). If a young child is removed from his parental home for months, there is an increased risk of nightmares, bed-wetting, and some other neurotic symptoms; if the mother leaves the child's home for several months, the increased risk is much less or nonexistent (Douglas & Blomfield 1958, pp. 112-113). Calculating individual risks is frequently helpful; it should not be confused with measuring the incidence of a condition (number of new cases arising during a unit of time in a defined popula-

tion, divided by the number of people in the defined population), or with measuring the prevalence (number of cases present at one point in time in a defined population, divided by the number of persons in that population at that point in time). Enlarging the clinical picture. The clinical picture of a condition is almost automatically enlarged by follow-up studies. Follow-up studies of persons identified at about the age of 12 or 13 as mentally retarded are needed now because many cross-sectional prevalence studies have shown an age distribution of cases indicating a rapid fall in prevalence after age 14 that is incompatible with the definition of the condition, which includes the concept of a fixed, permanent state. [See MENTAL RETARDATION.]

The Medical Research Council Unit for Research on the Epidemiology of Psychiatric Illness provides psychiatric care in a general hospital ward in Edinburgh to which are routinely brought, regardless of severity, all self-poisoning cases in the city of Edinburgh. This comprehensive experience has made the clinicians aware of self-poisoning cases with intent at self-destruction by people who do not exhibit evidence of any psychiatric disorder; they find that the severity of need for psychiatric attention has no relation to the probability that the self-poisoning would lead to death. Thus, looking at all cases of self-poisoning is beginning to provide a different picture of the range of clinical findings. Syndrome identification. The study of population distributions of cases resulted in separating typhus ("jail fever") from typhoid (water- and food-borne). Psychiatry has not made progress this way. Yet, certain diagnostic categories have been set up in terms of the age or personal characteristics or situations of the cases (e.g., involutional melancholia, combat fatigue, dementia praecox, senile dementia); such a classification short-circuits epidemiological inquiry. The course of disorders has been a key criterion in characterizing manicdepressive psychoses, dementia praecox, and mental retardation. Patients discourteous enough to violate the rules have simply had their diagnoses changed. Such practices hinder progress. "Puerperal psychoses" have been in and out of fashion, but pregnancy has not yet been shown to be associated with psychoses (Pugh et al. 1963). Involutional melancholia is confined to certain age levels and is out of favor at present. These illustrations indicate the special problems of classification in psychiatry, where entities like the Ganser syndrome in prisoners and combat fatigue in soldiers gain currency in each generation.

MENTAL DISORDERS: Epidemiology The social-breakdown syndrome is a new sociogenic entity. Its identification arose from observations that can be loosely termed clinical epidemiology (Pickles 1939). A community served by a single mental hospital that undergoes radical reform of patient care and breaks down barriers between hospital and community services stops producing new cases of severely deteriorated, helpless, vegetating individuals. Similar reforms elsewhere lead to similar observations. As a result of these observations, clinicians with a broad (population) perspective change their views of the disorders. Disturbances in capacities to fill social roles come to be seen as extrinsic to the mental disorders of the patients and of secondary importance in comparison with the society's customs and attitudes regarding mental disorders which result in rejections and degrading behavior toward the ill. This sequence of observations leads to a reformulation of clinical syndromes that puts together manifestations previously thought to be due to several different disorders and that attributes these manifestations to a series of particular social events likely to occur in the presence of any of these disorders. Like any other conclusion derived from unsystematic observations, it may gain currency because it fits the prevailing preconceptions of many people, without being further established. Unless systematic evidence is obtained, its validity remains untested. The new sociogenic social-breakdown syndrome is best examined as a promising hypothesis. In order to test the sociogenic hypothesis, the syndrome must be defined operationally and case-finding techniques developed. These must be kept separate from the specification of the social conditions suspected of favoring the syndrome's appearance. Recent investigations have shown that these are soluble problems and confirm the hypothesis in large part; further investigation will also make clearer which mental disorders make people particularly susceptible to the noxious social forces [Gruenberg 1966; see also PSYCHIATRY, article on SOCIAL PSYCHIATRY]. Working of health services. Much of the data gathered on the distribution of mental disorders can be studied to help us understand how hospitals and clinics work. This can be a productive approach to data gathered for other uses. When a population is surveyed for cases similar to those that have gone to a hospital, many unhospitalized cases are found. This suggests that social forces control admissions; if so, these social forces may account

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partly, or entirely, for variations in admission rates. This proved to be a productive hypothesis in studying the distribution of admissions for the elderly (Mental Health Research Unit 1959-1960) and could be used to interpret many findings (e.g., Paris and Dunham 1939; Goldhamer and Marshall 1949). Readmission rates can also be looked at this way. Freeman and Simmons (1963) found that the types of homes to which mental hospitals released patients did not affect the probability of return to the hospitals; from this they concluded that reasons for rehospitalization are unrelated to the social environment. However, the same data can be approached by starting with the assumption that a hospital staff releases only certain patients and, in deciding which to release, takes the family situation into account; if this is true, the data can be used to argue that the observed lack of difference only shows that the various staffs are equally competent in evaluating the suitability of different types of homes for their patients. Thus, the plan to see whether variations in home living arrangements affect the probability of rehospitalization by studying a cohort of patients released from hospitals to varying home situations is irrelevant to the question. The plan is suitable for an evaluation of the hospitals' release policies with regard to different types of home situations. Obviously, volunteer subjects cannot be assumed to be randomly selected subjects; it is just as important—but sometimes more difficult—to perceive that subjects have been selected by someone else or by some agency. It is necessary to realize that when a bureaucracy selects subjects, the data reflect the behavior of the bureaucracy. The same principle applies to analysis of first mental-hospital admission rates. Preventive trials. The most important studies of health services are those which are carried out in the form of a preventive trial when the health services seek to prevent a particular disorder. The population given the service is selected so that there is a comparable control population to whom service is not given (Pasamanick et al. 1964). The study then becomes a crucial experiment for the health service; it can also be a crucial experiment, if all goes well, for testing an etiological hypothesis. The preventive trial is often thought to represent the last stage of inquiry and to be justified only when much other evidence has been accumulated. But when the preventive procedure advocated is believed to be harmless and generally thought to be desirable and when its supply cannot satisfy all demands, the preventive trial is justified

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even if prior evidence is very weak. It is wrong to assume that preventive trials are inherently more expensive, more dangerous, or more difficult than passive studies; such research can be easier and cheaper. However, creating the opportunity for preventive trials and ascertaining that the design of the study is being adhered to throughout pose difficult problems. The search for causes. Each use described above generates data with implications for causes. Outstanding today are the efforts to identify the mechanisms which lead to what Pasamanick has called the "continuity of fetal damage," ranging from death to mild brain damage followed by reading disabilities, impulsive behavior disorders, and other syndromes. Fetal damage has been linked to rubella, to the effects of poverty, and to early complications of pregnancy. Several lines of evidence suggest its linkage to very mild or moderate malnutrition of the mother during the first few months of gestation (MacMahon & Sowa 1961). The hypothesis of schizophrenogenic mothering is being pursued (Lidz & Fleck 1960). Current work is clarifying the nature of the hypothesis and may do more [see SCHIZOPHRENIA]. Maternal deprivation, as Bowlby (Bowlby et al. 1956) named a hypothetic ally pathogenic experience, has been investigated a number of times (e.g., Douglas & Blomfield 1958). These studies, like those of Pasamanick, not only look for causes but relate dissimilar clinical syndromes to one set of causes. Many investigations are required before the relationships become clarified and before the credibility of the hypothesis can be appraised. Bowlby's own study has weakened the initial hypothesis. Hunt (1965) has recently pointed to some further weaknesses in the hypothesis [see INFANCY, article on THE EFFECTS OF EARLY EXPERIENCE]. Down's syndrome (Mongolism, trisomy-21) is not only a major cause of serious mental handicap, but the new and growing knowledge regarding the associated chromosomal abnormality supports the notion that some particular cause or group of causes must be at work and that other chromosomal abnormalities may have the same causes. It is complicated to investigate these conditions, and social phenomena have not yet been implicated. Too often efforts to find the determinants of the distribution of a mental disorder are launched as one-shot investigations, without the researchers' knowing what the distribution of cases is. This procedure assumes that if the distribution is found to be that predicted in the hypothesis, then the hypothesis has been proved, and if not, then it has been disproved. Such a course is not absolutely

doomed to failure, but it is not likely to lead to the gathering of data that can rule out alternative explanations of the observed distributions. Tools and techniques Case finding. Hospital and state school records, clinic outpatient records, records of private practitioners, and key-informant methods have all been used repeatedly in case finding. Hospital records have been used to study firstadmission rates in relation to various hypotheses. Faris and Dunham (1939) pioneered the analysis of first-admission rates in terms of the modern social ecology of a city. Using the census-tract classification of Chicago, based on the University of Chicago sociology department's methods of characterizing urban land use, they allocated the first admissions to mental hospitals to the census tract of origin. They predicted correctly the now wellestablished fact that the first-admission rates for schizophrenia are highest in the central, deteriorated section of the city and decline with the distance of neighborhoods from the center. This was a startlingly successful fusion of Durkheim's ideas, urban sociology, and a hypothesis about the social origins of schizophrenic syndromes. Even more startling were the failure of manic-depressive psychoses to fall into such a pattern and the existence of a different pattern for organic psychoses. These different patterns tend to confirm the importance of the psychiatric diagnosis in spite of the skepticism of many psychiatrists regarding the objective nature of their diagnoses. These findings have been confirmed in other cities. A literature has developed seeking to account for the high first-admission rates of schizophrenics from the city's center. The straightforward notion that the depersonalized, socially isolated part of the city favored the development of schizophrenic disorders has not been universally accepted. Attempts to demonstrate that the disproportionate concentration of schizophrenic cases coming to hospitals from the central part of the city is due to consequences of schizophrenic disorders rather than the pathogenic nature of these neighborhoods can be thought of as studies of the "drift hypothesis." This states that schizophrenics tend to drift into the rooming-house areas of cities at a higher rate than do other people, producing the concentration of cases found there. Sanua (1963) points to the main studies of this hypothesis and to the conflicting evidence, citing Morrison's (1959) finding that patients had a lower social-class status than their fathers, whose social-class distribution was similar to that of the

MENTAL DISORDERS: Epidemiology general population. The inference that schizophrenia causes downward social mobility does not necessarily follow from this observation; since occupational levels tend to rise with age, schizophrenics may accumulate in lower occupational categories because they fail to climb the occupational ladder as fast as other young people. If downward mobility (or failure to rise with one's generation) is really at the root of the phenomenon, then the etiological theory advanced by Faris and Dunham does not hold. Their observations would remain, however, and require explanation. A more recent study, Social Class and Mental Illness, by Hollingshead and Redlich (1958), found that in New Haven the prevalence of treated cases was related to social class. The authors asserted that their data show a gradient of prevalence rates which falls from a high rate in the lowest social class to a low rate in the upper social classes. Miller and Mishler (1959), however, state (correctly, I believe) that the New Haven data show only a very high rate for the lowest social class and that the observed figures in other classes do not demonstrate a gradient of rates. The difficulties of interpreting such studies are compounded by the reliance of the studies on clinical records of cases in treatment and by the social factors affecting hospital-utilization patterns. To obviate the weaknesses of relying solely on clinical records, a method centering on a structured household-interview questionnaire derived in part from the Cornell neuropsychiatric inventory has been developed; this method has not yet been systematically calibrated (Macmillan 1959), but it holds out a promising potential. Its first important use for case finding on a large scale was by Stouffer (Stouffer et al. 1949) in World War n. It was one of the methods used in the first large-scale metropolitan survey, the Midtown Manhattan Study (Langner & Michael 1963). One population of over two thousand has been personally interviewed by psychiatrists at both the beginning and the end of a decade (Essen-Mb'ller 1956). Participant-observers with a psychiatric background have been useful (e.g., Eaton 1955). Finding cases of severe deterioration (severe social-breakdown syndrome) has been carried out by means of a semistructured interview by specially trained public health nurses, psychiatric social Workers, and graduate behavioral-science students. Another method involves interviewers' filling out structured questionnaires—together with answers to open-ended questions—after they have been trained to complete the protocols following open-

153

ended interviews; these protocols are then evaluated by psychiatrists, who categorize the individuals (Mental Health Research Unit 1959-1960). A method similar in principle was used in the following years in the age groups under 60 in Stirling County and in midtown Manhattan (A. Leigh ton 1959; Hughes et al. I960; D. Leighton et al. 1963; Langner & Michael 1963). Cases derived from nonmedical-service-agency records were identified by Lemkau and associates (1941-1942) in the Eastern Health District in Baltimore and in the survey of the mentally retarded in Onondaga County, New York State, by the Mental Health Research Unit staff, under the direction of the program director (Goodman et al. 1956). All of these are useful devices. In practice all are complicated to use and none are easily applied with precision and accuracy. None of them have been adequately calibrated against a standardized ultimate criterion. Such a criterion requires a set of explicit objective criteria for identifying a case, a standardized method of observation, and an estimate of observer variability (Cochrane et al. 1951). The methods of household sampling of populations, highly developed by social scientists, have been used in a number of studies; their most extensive use currently is in the continuous National Health Survey (U.S. National Health Survey 1958). Sorting populations. The use of statistical techniques in planning and interpreting studies has developed to a very high level, borrowing from general statistical theory, agricultural research, genetic research, social science, and economics. Epidemiologic inquiries have contributed devices for age standardization and for adjustment of data, which have in turn been used by those fields (Hill 1937). The study of case aggregations in neighborhoods, households, and families has developed a whole series of techniques. Some of these depend on the concept of primary-case (or proband) rates and secondary-case rates. In the study of mental disorders this has been most frequently associated with genetic hypotheses, and in these instances the concept of lifelong expectation of manifesting the disorder has been developed. In this field the formulas of Wilhelm Weinberg and the mathematician G. H. Hardy (1908) and of Stern (1943) are particularly appropriate. They depend, however, on estimates of differential death and migration rates, whose validity is hard to judge from existing data. The study of familial and household aggregations is not confined to genetic hypotheses, however, as is shown in a review of the literature

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(Gruenberg 1950) and by Bleuler's review of studies on schizophrenia (1955); a review of the knowledge regarding group disorders brings together concepts from psychiatry, social psychiatry, and social psychology (Gruenberg 1957). Populations have commonly been characterized by age and sex and time ever since the Hippocratic writings on times, places, and persons. Variations in incidence and prevalence rates by age and sex are frequently interpreted as though age and sex were causative factors. Generally they are not mechanisms by which disorders are produced but convenient ways of classifying populations which develop disorders at different rates. The suspected mechanisms which are distributed according to age and sex also need to be looked into, as was done recently by Langner and Michael (1963). Categorizing the population according to previous illnesses is a frequent but not highly standardized procedure. Except for body typing, the categorizing of populations according to physical characteristics has not been used in inquiries regarding mental disorders. Studies attempting to link genetic characteristics to certain disorders have focused on blood types. It is to be expected that in the next decade other physical characteristics will prove relevant to mental disorder epidemiology. Categorizing populations by their social characteristics is almost standard nowadays in epidemiological inquiry in all fields. The social environment has usually been regarded as important by epidemiologists, and this recognition has been increased greatly by advances in methods of characterizing socioeconomic status and other social variables. The complexity of socioeconomic classifications in a rapidly changing society has made this type of categorizing hard to standardize; attention will probably become more focused on specific characteristics of individuals, some of which are incorporated into indices of socioeconomic status. One study showed that hospital-admission rates for elderly persons were unrelated to economic levels of neighborhoods but were closely related to the frequency of multiplefamily dwellings in neighborhoods; yet no correlations with socioeconomic status (a composite index) could be found [see Gruenberg 1953; see also AGING]. The conduct of studies. The list of references makes it clear that contributions to the epidemiology of mental disorder have been made by workers with various professional backgrounds; there is no reason to expect this to be altered in the future. Technical expertness in such work does not develop from any one course of professional training but is acquired by experience in conducting and inter-

preting the findings of investigations. Too many investigations have been conducted with the hope of testing a hypothesis about the determinants of the distribution of a disorder in a single investigation. The opportunity for refining a hypothesis and going back with experienced investigators to the same population rarely occurs. But such steps can be expected to yield larger returns in knowledge than a proliferation of single investigations. These defects in the social organization of research are being rectified by the creation of permanent laboratories for conducting investigations. The first such laboratory was created at Syracuse, New York, in 1950, on a pilot basis, by the New York State Department of Mental Hygiene and was made permanent in 1955. Since then the Medical Research Council of Great Britain has created one in the University of Edinburgh department of psychiatry; the Danish government has set up one at Aarhus; and the Swedish government, one at Lund. The U.S. National Institute of Mental Health finances one at the Columbia University department of psychiatry. These improvements in social support should lead to a more rapid exploitation of advances as they are made and thus should speed up the acquisition of knowledge. But it is to be expected that a larger number of contributions to our understanding of mental-disorder epidemiology will continue to come from workers who are not labeled epidemiologists and who will in many instances not regard their work as particularly relevant to mental health. The epidemiologist will continue to be interested in getting answers to his questions and will, hopefully, judge new contributions on their merits rather than on their author's school of thought or previous conditions of servitude (i.e., degree sequences). In the context of this encyclopedia it may be well to point out that all disorders, whatever the causes, have distributions that reflect social factors. This universal proposition follows from the simple fact that all classes of causes have such social distributions. For example, Goldberger (1964) showed that pellagra is due to a nutritional deficiency by studying its incidence in different social groups in southern mill towns. MacMahon and Roller (1957) showed that the higher leukemia death rate among whites, as compared to nonwhites, may well be due to more exposure to diagnostic radiation among Jews (who apparently use medical specialists at a higher rate). Gelfand and his associates (1957) showed that naturally acquired immunity to polio viruses occurs at early ages most frequently i*1

MENTAL DISORDERS: Epidemiology low-income groups. Book (1961) reviewed accumulations of genes in particular linguistic and social groupings. Roueche (1954) describes how poisons can spread through socially isolated parts of a population. Sometimes the social forces are considered the main factors (as in "diseases of poverty" and in "diseases of affluence," such as coronary heart disease) and sometimes the intermediate variables that help unravel the chain (as in pellagra). But in understanding every distribution of disorders, knowledge of social forces plays some role. ERNEST GRUENBERG [Directly related are the entries EPIDEMIOLOGY and PUBLIC HEALTH. Other relevant material may be found in POPULATION; PSYCHIATRY; SAMPLE SURVEYS.] BIBLIOGRAPHY AMERICAN PUBLIC HEALTH ASSOCIATION, TECHNICAL DEVELOPMENT BOARD, PROGRAM AREA COMMITTEE ON MENTAL HEALTH 1962 Mental Disorders: A Guide to Control Methods. New York: The Association. BLEULER, M. 1955 Research and Changes in Concepts in the Study of Schizophrenia: 1941-1950. Isaac Ray Medical Library, Bulletin [1955]: 1-132. BOOK, JAN A. 1961 Genetical Etiology in Mental Illness. Pages 14-45 in Milbank Memorial Fund, Causes of Mental Disorders: A Review of Epidemiological Knowledge, 1959. New York: The Fund. BOWLBY, JOHN et al. 1956 The Effects of Mother-Child Separation: A Follow-up Study. British Journal of Medical Psychology 29:211-247. COCHRANE, A. L.; CHAPMAN,

P.

J.;

and

OLDHAM, P.

D.

1951 Observers' Errors in Taking Medical Histories. Lancet IB: 1007-1009. DOUGLAS, JAMES W. B.; and BLOMFIELD, J. M. 1958 Children Under Five. London: Allen & Unwin. EATON, JOSEPH W. 1955 Culture and Mental Disorders: A Comparative Study of the Hutterites and Other Populations. Glencoe, 111.: Free Press. ESSEN-MOLLER, ERIK 1956 Individual Traits and Morbidity in a Swedish Rural Population. Acta psychiatrica et neurologica scandinavica Supplement 100. PARIS, ROBERT E. L.; and DUNHAM, H. WARREN (1939) 1960 Mental Disorders in Urban Areas: An Ecological Study of Schizophrenia and Other Psychoses. New York: Hafner. FREEMAN, HOWARD E.; and SIMMONS, OZZIE G. 1963 The Mental Patient Comes Home. New York and London: Wiley. GELFAND, HENRY M. et al. 1957 Studies on the Development of Natural Immunity to Poliomyelitis in Louisiana. American Journal of Hygiene 65:367-385. GOLDBERGER, JOSEPH 1964 Goldberger on Pellagra. Edited by Milton Terris. Baton Rouge: Louisiana State Univ. Press. -* Reprint of 17 papers. OI -DHAMER, HERBERT; and MARSHALL, ANDREW W. (1949) 1953 Psychosis and Civilization. Glencoe, 111.: Free Press. -» First published as The Frequency of Mental Disease: Long-term Trends and Present Status.

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GOODMAN, M. B. et al. 1956 A Prevalence Study of Mental Retardation in a Metropolitan Area. American Journal of Public Health. 46: 702-707. GORDON, JOHN E. 1952 The Twentieth Century—Yesterday, Today, and Tomorrow (1920). Pages 114167 in Franklin H. Top (editor), The History of American Epidemiology. St. Louis, Mo.: Mosby. GREENWOOD, MAJOR 1935 Epidemic and Crowd Diseases. London: Williams & Norgate. GROUP FOR THE ADVANCEMENT OF PSYCHIATRY, COMMITTEE ON PREVENTIVE PSYCHIATRY 1961 Problems of Estimating Changes in Frequency of Mental Disorders. New York: The Group. GRUENBERG, ERNEST M. 1950 Review of Available Material on Patterns of Occurrence of Mental Disorders: Major Disorders. Pages 176-196 in Milbank Memorial Fund, Epidemiology of Mental Disorder. New York: The Fund. GRUENBERG, ERNEST M. 1953 Community Conditions and Psychoses of the Elderly. American Journal of Psychiatry 110:888-896. GRUENBERG, ERNEST M. 1957 Socially Shared Psychopathology. Pages 201-229 in Alexander H. Leighton, John A. Clausen, and Robert N. Wilson (editors), Explorations in Social Psychiatry. New York: Basic Books. GRUENBERG, ERNEST M. 1964 Epidemiology. Pages 259306 in Harvey A. Stevens and Rick Heber (editors), Mental Retardation. Univ. of Chicago Press. GRUENBERG, ERNEST M. (editor) 1966 Evaluating the Effectiveness of Mental Health Services. Milbank Memorial Fund Quarterly 44, no. 1, part 2. HARDY, G. H. 1908 Mendelian Proportions in a Mixed Population. Science 28:49-50. HILL, A. BRADFORD (1937) 1961 Principles of Medical Statistics. 7th ed. London: Lancet. HILL, A. BRADFORD et al. 1958 Virus Diseases in Pregnancy and Congenital Defects. British Journal of Preventive and Social Medicine 12:1-7. HOLLINGSHEAD, AUGUST B.; and

REDLICH,

FREDERICK

C.

1958 Social Class and Mental Illness: A Community Study. New York: Wiley. HUGHES, CHARLES et al. 1960 People of Cove and Woodlot: Communities From the Viewpoint of Social Psychiatry. The Stirling County Study of Psychiatric Disorder and Sociocultural Environment, Vol. 2. New York: Basic Books. HUNT, J. McV. 1965 Traditional Personality Theory in the Light of Recent Evidence. American Scientist 53: 80-96. LANGNER, THOMAS S.; and MICHAEL, STANLEY T. 1963 Life Stress and Mental Health. Volume 2 of The Midtown Manhattan Study. New York: Free Press. LEIGHTON, ALEXANDER H. 1959 My Name Is Legion: Foundations for a Theory of Man in Relation to Culture. The Stirling County Study of Psychiatric Disorder and Sociocultural Environment, Vol. 1. New York: Basic Books. LEIGHTON, DOROTHEA et al. 1963 The Character of Danger. The Stirling County Study of Psychiatric Disorder and Sociocultural Environment, Vol. 3. New York: Basic Books. LEMKAU, PAUL; TIETZE, CHRISTOPHER; and COOPER, MARCIA 1941-1942 Mental-hygiene Problems in an Urban District. Mental Hygiene 25:624-646; 26:100-119, 275-288. LIDZ, THEODORE; and FLECK, STEPHEN 1960 Schizophrenia, and Human Integration, and the Role of the

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Family. Pages 323-345 in Don D. Jackson (editor), The Etiology of Schizophrenia. New York: Basic Books. LILIENFELD, ABRAHAM M. 1959 A Methodological Problem in Testing a Recessive Genetic Hypothesis in Human Disease. American Journal of Public Health 49: 199-204. MACMAHON, BRIAN; and ROLLER, ERNEST K. 1957 Ethnic Differences in the Incidence of Leukemia. Blood: The Journal of Hematology 12:1-10. MACMAHON, BRIAN; PUGH, THOMAS F.; and IPSEN, JOHANNES 1960 Epidemiologic Methods. Boston: Little. MACMAHON, BRIAN; and SOWA, JAMES M. 1961 Physical Damage to the Fetus. Pages 51-110 in Milbank Memorial Fund, Causes of Mental Disorders: A Review of Epidemiological Knowledge, 1959. New York: The Fund. MACMILLAN, ALLISTER M. 1959 A Survey Technique for Estimating the Prevalence of Psychoneurotic and Related Types of Disorders in Communities. Pages 203218 in American Psychiatric Association, Epidemiology of Mental Disorder. Washington: The Association. MENTAL HEALTH RESEARCH UNIT, NEW YORK STATE DEPARTMENT OF MENTAL HYGIENE, SYRACUSE, NEW YORK 1959-1960 A Mental Health Survey of Older People. Parts 1-3. Psychiatric Quarterly Supplement 33:45-99, 252-300; 34:34-75. MILLER, S. M.; and MISHLER, E. G. 1959 Social Class, Mental Illness, and American Psychiatry: An Expository Review. Milbank Memorial Fund Quarterly 37: 174-199. MORRIS, JEREMY N. (1957)1965 Uses of Epidemiology. 2d ed. Baltimore: Williams & Wilkins. MORRISON, S. L. 1959 Principles and Methods of Epidemiological Research and Their Application to Psychiatric Illness. Journal of Mental Science 105: 999-1011. PASAMANICK, BENJAMIN et al. 1964 Home vs. Hospital Care for Schizophrenics. Journal of the American Medical Association 187:177-181. PENROSE, LIONEL S. (1949) 1963 The Biology of Mental Defect. 3d ed. London: Sidgwick & Jackson. PICKLES, WILLIAM N. 1939 Epidemiology in Country Practice. Bristol (England): Wright; Baltimore: Williams & Wilkins. PUGH, THOMAS F. et al. 1963 Rates of Mental Disease Related to Childbearing. New England Journal of Medicine 268:1224-1228. ROUECHE, BERTON 1954 Eleven Blue Men. Boston: Little. SANUA, VICTOR D. 1963 The Etiology and Epidemiology of Mental Illness and Problems of Methodology, With Special Emphasis on Schizophrenia. Mental Hygiene 47:607-621. SCOTTISH COUNCIL FOR RESEARCH IN EDUCATION, MENTAL SURVEY COMMITTEE 1953 Social Implications of the 1947 Scottish Mental Survey. Univ. of London Press. STERN, CURT 1943 The Hardy-Weinberg Law. Science 97:137-138. STOUFFER, SAMUEL A. et al. 1949 The American Soldier. Studies in Social Psychology in World War II. Vols. 1 and 2. Princeton Univ. Press. -» Volume 1: Adjustment During Army Life. Volume 2: Combat and Its Aftermath. U.S. NATIONAL HEALTH SURVEY 1958 Health Statistics, Series A. Volume I. Washington: Government Printing Office.

CHILDHOOD MENTAL DISORDERS

Early conceptions of mental disorders in children are reflected in several clinical papers on child-rearing practices from the sixteenth, seventeenth, and eighteenth centuries (see Kessen 1965). These precursors of present ideas about causality failed to receive widespread acceptance and scientific interest, however, until recently. Even Kraepelin's influential Psychiatric, first published in 1893, did not discuss mental disorders in children in any of its many editions. Scientific interest in deviant mental processes in children has flowered in the twentieth century, stimulated in large part by theories of mental functioning advanced by Freud, Piaget, Watson, and others which emphasized developmental and dynamic factors as well as notions of environment causality and learning. Further, interest in mental disorders in children has increased with the resurgence of scientific interest in children's behavior in general in the twentieth century, particularly since the late 1940s. Resources for the diagnosis and treatment of mental disorders in children have multiplied in the United States and in Europe since the 1950s. In the United States, the establishment of the National Institute of Mental Health and the National Institute of Child Health and Development and the allocation of federal funds for the development of plans for organizing and providing comprehensive mental health services in local communities have stimulated the growth of relevant programs of service, professional training, and research. A federally supported conference of professional organizations and interested agencies was held in 1964 to insure and to plan for the provision of diagnosis and treatment of mental disorders in children under federally sponsored community health programs (American Psychiatric Association 1964). Definition, predisposition, precipitation. The definition of disorders of mental functioning in children varies depending upon one's conception of mental functioning in general. Most professionals—including psychologists, psychiatrists, and social workers—with special training in the diagnosis and treatment of mental disorders in children currently emphasize a multidimensional approach. This approach encompasses psychosomatic considerations; developmental capacities and vulnerabilities; constitutional and genetic factors; the internal personality system, including cognitive perceptual, and affective mechanisms and the fluidity and plasticity of the child's personality

MENTAL DISORDERS: Childhood Mental Disorders characteristics; and psychosocial considerations, including parent-child relationships, family interactions, and sociocultural influences. This approach also stresses the need to assess and capitalize upon the healthy and adaptive facets of the child's personality. A conceptual framework which encompasses all of the above aspects of the child's functioning inclusively and systematically has not been developed. However, the Committee on Child Psychiatry of the Group for the Advancement of Psychiatry has prepared (in unpublished form) what appears to be the best available approximation of such a framework (Committee on Child Psychiatry 1965). The present discussion of mental disorders in children leans heavily upon its work. Mental disorder can be defined as a failure in the child's attempt to maintain an adaptive equilibrium between physiological, psychological, and interpersonal systems; there is a close relationship between physical and psychological factors. In the child with certain constitutional or experiential predispositions, disordered mental functioning may be precipitated and sustained by physical, psychological, or social stimuli. Biochemical stimuli or stressful insufficiencies of chemical substances may disrupt the child's physiological equilibrium as well as associated perceptual, cognitive, and emotional systems. In addition, the child's restitutive efforts involve an interaction between physiological, psychological, and social systems. Stimuli of a psychological nature may also precipitate mental disorder. Such stimuli include conscious or unconscious thoughts and feelings which arouse anxiety in the child because of their association with stressful past or present experiences. They involve the cognitive system in that they are represented in symbolic form in memory and thinking, and the perceptual apparatus. Thoughts, memories, and feelings triggered by anxiety-arousing psychological stimuli lead to the child's employment of psychological defenses or compensating behaviors as he seeks to avoid a breakdown in adaptation or equilibrium. Stressful social stimuli in the child's environment Jttay also precipitate disorder. Such stimuli include the loss, or threat of loss, of close interpersonal r elationships and the frustration of basic needs re sulting from disturbances in relationships within the family. The nature and severity of the mental disorder Precipitated by physical, psychological, or social lrn uli, or of interactions among them, is contine § nt upon the stressfulness of the stimuli as well

157

as upon genetic and constitutional factors (for example, temperament, body build), previous experience, and the developmental level of the child. Stressful stimuli initially disruptive of one of these systems may, and often do, have repercussions in other systems. Thus mental disorders in children may be precipitated by disruptions of a physical, social, or psychological nature, but the child's defensive efforts or attempts at restoration of ego functions or compensatory behavior almost always involve all three systems. For example, a stressful thought or fantasy may lead to emotional conflict which triggers "signal anxiety." This signal, warning of possible breakdown in adaptation or mental equilibrium, leads to the establishment of psychological defenses or adaptive interpersonal behaviors. If emotional conflict and anxiety are severe or become chronic, physiological concomitants may develop. Such physiological symptoms are reversible if the underlying emotional conflicts are resolved; chronic unresolved conflict and anxiety may lead, however, to serious strain and even breakdown of weakened physiological systems or organs. [See ANXIETY; CONFLICT, article on PSYCHOLOGICAL ASPECTS; STRESS.] In the first several months of life the immaturity of the physical and mental systems results in the infant's responding in a global manner to lack of gratification of his needs or to stressful stimuli. The very young infant shows little differentiation of emotional response; he tends to respond to stressful stimuli with general symptoms of distress (for example, crying, global motor activity). However, there is increasing evidence of systematic individual differences in response even at this early level of development (Murphy 1962). Individual differences in stress thresholds, modes of expressing distress, and secondary reactions to distress—including the number of organ systems involved and the intensity of their involvement—may be prognostic in infants of a predisposition to mental disorder in later childhood (Korner 1964). In children predisposed by stressful experiences and by personality structure, continued emotional conflict may lead to the chronic use of psychological defenses and maladaptive social behaviors known as symptoms of mental disorder. Particular constellations of such symptoms define the different types of mental disorder in children. In general, these clusters of clinical symptoms can be assigned to one of three general divisions: psychoneuroses, personality or character disorders, or psychoses. Some of the physical or psychological symptoms in each cluster may result from the child's attempt to maintain equilibrium or adaptation in the face

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MENTAL DISORDERS: Childhood Mental Disorders

of current stressful events or to compensate for the disturbance, to make restitution, or to obtain gratification of physical, psychological, or interpersonal needs. Other symptoms in each clinical picture may define the new equilibrium resulting from the child's adaptive and compensating efforts. They may include partial restriction or malfunctioning of perceptual, cognitive, social, or physiological functions, rigid reliance upon defense mechanisms such as repression and denial, or a more severe breakdown in adaptive efforts. Anna Freud (1965), Erik Erikson (1950), and many others have emphasized that in addition to the physical and personality characteristics and the experiences of the child, it is important to consider both his developmental level and "lines" or continuities of development. Thus, the notion of a state of psychological equilibrium in the child is only a relative one, with such states stable and definable only at cross-sectional points in time during his growth. These "states" interact systematically, and lines of development such as that from "dependency to emotional self-reliance and adult object relationships" may be observed (A. Freud 1965). Interpersonal or psychological events may have stressful effects upon a relatively immature mental apparatus, whereas the same stimuli may be handled without disruptive anxiety by an older child or adult. In addition, the child may defend against anxiety resulting from such stimuli through regression to a more immature level of adaptation. Or, such stimuli may reinforce fixations of personality development which partially preclude further development in one or more areas of functioning (for example, learning). Thus the child's developmental level partially determines his capacities and modes of coping with potentially stressful stimuli of a physical, social, or psychological nature and partially determines the type and severity of mental disorder. For example, certain intrauterine viral infections during early pregnancy are more likely to produce congenital anomalies than such infections occurring later in gestation. In addition, a prolonged lack of adequate mothering is particularly damaging to infants in the second half of the first year. The research of Spitz (1946), Bowlby (1960a; 1960b), Provence and Lipton (1962), Piaget (Flavell 1963),Escalona andHeider (1959), and Heider (1960), as well as recent animal research by ethologists (Ostow 1959), suggests that serious and perhaps irreversible defects in social and intellectual development may follow if the child fails to receive sufficient interpersonal or perceptual stimulation during appropriate develop-

mental phases, including those of early infancy. Such defects may predispose the child to one or another type of mental disorder, but knowledge of the specific nature of such relationships depends upon future research. [See INFANCY, article on THE EFFECTS OF EARLY EXPERIENCE.]

Freud's concept of emotional conflict as amplified by Anna Freud, Hartmann, Erikson, and others is central in contemporary theories of mental disorder in children, particularly with respect to the development of psychoneuroses. As the infant or preschool child develops relationships with people and as his mental functions become more complex, he may show a variety of reactive disturbances in behavior, such as temper tantrums, aggressive behavior, and crying. These disturbances are reactive to environmental stress, primarily conflicts with parents over the control (socialization) of basic sexual and aggressive drives, and are the early precursors of internalized emotional conflict. In the early years, these disturbances are generally transient and reversible in response to positive changes in the environment, although as a result of continued disturbances in parent-child relationships, they may become chronic and fixed. Reactive disorders are also seen in the older child; the symptoms may include anxiety, unrealistic fears, shyness, feelings of inadequacy or loneliness, disturbances in attentional processes and learning, and inappropriate social behavior. If the child's emotional conflicts are especially anxiety-arousing and unresolved, they later lose their conscious nature and are repressed and internalized. The conflicts are then inaccessible to further attempts at resolution, including new efforts made possible by the development of more powerful and complex cognitive and other ego functions: the capacities for greater independence in the gratification of needs, a longer attention span, improved reality testing, increased ability to think abstractly as well as concretely, and further differentiation and integration of perceptual and motor functions—together with further differentiation of the emotions, more effective repression of anxiety and other affects, and the internalization and symbolic representation of conflict. Because of their relative inaccessibility to conscious problem-solving efforts, emotional conflicts in the child may become self-perpetuating and lead to the establishment or chronically maladaptive behavior learned in early periods of development. Depending upon his experiences and his own developmental capacities, however, the child instead resolve conflicts established earlier, or new conflict facing him in a crisis situation, a

MENTAL DISORDERS: Childhood Mental Disorders thereby achieve a higher level of differentiation and structure of personality. If such resolution and mastery is prevented, temporary regression, longterm arrest in cognitive or emotional function and development, or decompensation or adaptive failure may occur. Thus, unconscious conflicts, with associated alternating experiences of anxiety and employment of maladaptive psychological defenses, may become firmly established components of the personality, leading to structural rigidity and brittleness and presenting the model of psychoneurosis in the child. Psychoneurotic disorders. A variety of symptoms and patterns of symptoms may be observed in the psychoneurotic mental disorders of children. These symptomatic reactions to neurotic conflict may fluctuate and change with changes in development and socialization. The psychoneuroses are not characterized by extreme personality disorganization and grossly distorted reality testing. Although psychoneurotic symptoms of internalized emotional conflict may be observed in children as young as three or four years, fully structured neurotic disorders are not ordinarily seen in children until the early school-age period. The typical childhood neurosis develops in a youngster who has already evolved a conscience or superego, who has achieved an internalization of conflict and the use of a variety of defense mechanisms, including repression of affects from consciousness, and who manifests symptoms symbolically relevant to the underlying conflicts. Several relatively independent types of psychoneurotic disturbances in children have been defined, including anxiety, phobic, conversion, dissociative, obsessive-compulsive, and depressive disorders. Detailed descriptions of these disorders are discussed elsewhere [see ANXIETY; DEPRESSIVE DISORDERS;

OBSESSIVE-COMPULSIVE

DISORDERS;

PHOBIAS; see also Committee on Child Psychiatry 1965]. The well-known cases of "Frankie" (Bornstein 1949) and "Little Hans" (Freud 1909) are illustrative of the phobic type of neurotic disorder in which the defense mechanism of displacement is prominent. Here the child unconsciously displaces the meaning or content of the underlying emotional conflict onto an object or situation in his environment which is symbolically relevant. The fears derived from the internalized conflict are experienced in a distorted and irrational manner. The child avoids stimuli which reactivate or intensify his displaced conflict, and he often projects his sexual, hostile, and other unacceptable feelings onto the external feared objects such as animals, lrt , elevators, or situations such as school. Mild

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and transient fears, fearful reactions to stressful experiences (reactive disorders), and common developmental crises involving separation anxiety in children should be carefully distinguished from phobic psychoneurotic disorders, with their internalized and structured nature. [See DEFENSE MECHANISMS.]

Remission of symptomatic behaviors without treament may be observed in some of the milder psychoneurotic disorders as the child masters the developmental tasks and crises of later stages (Nagera 1966). However, such disorders ordinarily require psychotherapeutic intervention with the child and his family. The prognosis for response to treatment is good. Treatment requires assessment of the balance of external and internal forces involved in the disorder (Haworth 1964). Depending upon the balance of such forces, therapeutic intervention may be made primarily through manipulation of the environment, or the therapist may focus upon achieving intrapsychic changes in the child and other family members, leading to the resolution of interpersonal conflict, the relieving of neurotic symptoms, the promoting of further development in the mental apparatus, and the learning of more adequate social responses and modes of coping with stressful stimuli (Kessler 1966). Personality disorders. The personality disorders differ from psychoneurotic disorders in children in the following ways. In personality disorders, chronic (fixed) pathological trends and traits are prominent, and they are ego-syntonic—that is, they are not perceived by the child as anxiety-arousing or as a source of distress. Most of the personality disorders in children appear to involve strong fixations and/or disturbances in earlier psychological and psychosexual development, related to crises and conflicts involving wishes for dependency and autonomy, the handling of sexual and aggressive impulses and behaviors, and sex role identification. The types of personality disorder which have been defined (Committee on Child Psychiatry 1965) include the anxious personality, compulsive personality, hysterical personality, overly dependent personality, oppositional personality, overly inhibited personality, overly independent personality, isolated personality, distrustful personality, personality with discharge disorder (impulse-ridden or neurotic types), and sociosyntonic personality disorder. Discharge disorders. The discharge-disorder category includes many children who are classified in other systems as delinquent, acting-out, psychopathic, or sociopathic. Children in this general

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category tend to act out directly their feelings and impulses in an antisocial and often highly destructive manner. Two subcategories have been defined which distinguish between an impulse-ridden group and a group in whose discharge disorder neurotic conflict plays an important role. There is a central tendency in both of these subgroups to discharge rather than delay or inhibit antisocial impulses, but the sources of the tendency to discharge differ. The child with an impulse-ridden personality shows low frustration tolerance and difficulty in controlling or channeling sexual and aggressive impulses; his interpersonal relationships tend to be shallow, he experiences little anxiety or guilt, and there is considerable deficiency in conscience development and in the development of flexible and complex defense mechanisms. He tends to have a history of extreme emotional deprivation. The neurotic personality disorder subgroup, on the other hand, has achieved a more complex level of personality development. The child in this subgroup has developed the capacity to internalize conflict, and his antisocial behavior tends to be reactive to such conflicts and to have unconscious symbolic significance to such conflicts. These children experience some anxiety and guilt, and their interpersonal relationships, while ambivalent, are warmer and more meaningful than those of children with impulse-ridden personality [see DELINQUENCY, article on PSYCHOLOGICAL ASPECTS; PSYCHOPATHIC PERSONALITY]. Developmental deviations. It is important to distinguish between the diagnoses of psychoneurosis and personality disorder, and developmental deviations. Some behaviors (for example, sexual deviations), often part of a neurotic and personality disorder, may also be related primarily to delay, acceleration, or unevenness in development and should be classified as developmental deviations rather than as neuroses or personality disorders. Psychotic disorders. Psychotic mental disorders in children are characterized by marked and pervasive deviations from mental functioning normal for the child's age. In general, these disorders usually include chronic and severe impairment or deterioration of emotional relationships, preoccupation with inanimate objects, failure to develop speech or loss of speech for purposes of communication, bizarre behavior and unusual motility patterns, extreme mood swings and intensity of affective experience and expression (as in sudden temper outbursts, panic, etc.), and failure to develop or loss of a sense of individual identity. There are generally severe disturbances in perceptual and cognitive development and functioning, but with

onset in later childhood certain areas of intellectual functioning and achievement may be adequate or better. Some of the symptoms seen in childhood psychosis—such as some of the disorders in thinking, affect, perception, motility, speech, object relations, and reality testing—represent efforts at restitution or compensation for the psychotic process. Autism and symbiotic psychosis. Childhood psychoses do not tend to crystallize into as many varieties or subtypes as is the case with adult psychoses (Kessler 1966). Two major subtypes have been defined in early childhood: infantile autism and symbiotic or interactional psychotic disorder. Age of onset in infantile autism is the first few months of life as the infant fails to develop a normal emotional attachment to a mother figure. He remains emotionally aloof, speech development is delayed or absent, feeding and sleeping problems and stereotyped motor and motility patterns are prominent, and the child responds to relatively slight changes in his environment with intense outbursts of anger or anxiety. Some intellectual functions are intact, but their use is impaired by the defective reality testing and lack of communication. Age of onset of symbiotic psychosis is after the first year or two of life. The child develops a normal emotional attachment to his mother but fails to achieve separation and individuation. Intense and prolonged dependency upon the mother (or between mother and child) is prominent in the early history. The disorder is usually precipitated by some real or fantasied threat to the mother-child relationship. Symptoms include marked and severe separation anxiety, clinging (sometimes indiscriminately), regression (for example, giving up speech, loss of bowel control), gradual withdrawal from object relations, autistic behavior, and distortions in perceptual and cognitive functioning. Childhood schizophrenia. Childhood schizophrenia or "schizophreniform" psychotic disorder occurs in middle childhood—ages 6 through 12 or 13. The disorder may be of gradual or relatively acute onset. Where onset of the disorder is gradual, the development of neurotic symptoms is followed by regression to use of the primitive defenses of marked denial and projection. Low frustration tolerance, hypochondriacal tendencies, and inappr°' priate outbursts of temper or panic are often observed, and these are followed by withdrawal, increasing involvement in private fantasy, emotional aloofness, disorders in thinking and perceptionautistic behavior, and a breakdown in reality testing (e.g., Goldfarb 1961). The prognosis is more

MENTAL DISORDERS: Childhood Mental Disorders favorable if the psychosis is an acute reaction to a developmental crisis. Few adultlike hallucinations are experienced by psychotic children until ages 9 or 10 at least. However, bizarre motor behavior (for example, whirling), self-mutilation and suicidal attempts, and inappropriate mood swings are seen with some frequency in these cases. Occasionally, some of the symptoms more characteristic of adult psychoses are seen in children. These include ideas of reference, somatic delusions, catatonic behavior, and paranoia. [See SCHIZOPHRENIA.] Parent-child relations. In diagnosing neurosis, personality disorder, or psychosis in children, the healthy, positive responses and capacities as well as psychopathological trends should be assessed, along with the positive and negative physical, social, and psychological determinants of the child's behavior (A. Freud 1965). Current views of the diagnosis and treatment of mental disorders in children stress the importance of parent-child relationships, family processes, and sociocultural influences, while remaining cognizant of contributing and predisposing genetic and constitutional factors. Disturbances in parent-child relationships have been implicated in a variety of children's mental disorders, including unusual fluctuations in mood, psychoneuroses, certain psychotic disorders, and "antisocial" personality disorders, as well as disorders in which both physical and psychological functions are disturbed, such as marasmus or failure to thrive in infants, ulcerative colitis, asthma, and disturbances in perceptual, cognitive, and sensory-motor functions related to structural changes in the central nervous system. The connection between type of mental disorder and specific characteristics of parent-child relationships is complex and not clearly understood. Research on certain personality factors characteristic of parents of psychotic and neurotic children (such as that of Sarason et al. 1960) shows that parents of children with high anxiety differ in certain personality traits from parents of children with low anxiety, and the "superego lacunae" shown by Johnson and Szurek (1952) in the parents of some kinds of antisocial children indicate the probability of some specificity in the relationsnip between parent-child interaction variables and type and severity of mental disorder. In addition to the quality of the parent-child re lationship, other family variables may predispose a nd contribute to the development of mental disorders in children (e.g., Ross 1964). For example, Ss of a family member, lack of family cohesive-

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ness, distorted and neurotic communication patterns, deviant role functions, conflicting value orientations, or poor integration with the community may serve as stressful stimuli which upset the functioning of the family and lead to a reactive disorder, developmental deviation, neuroses, personality disorder, or psychoses in the child. One of the characteristics of the healthy family is the capacity to respond adaptively to crisis. Serious illness, economic losses, death of a parent, removal to a new community, and other such stressful events tend to be disruptive of family equilibrium and established modes of functioning and relating. Such disruptions may be temporary and through mastery lead to a higher level of functioning, or they may continue and result in family disintegration or pathology in one or more family members. There is some indication of a specific relationship between type of family disruption and type of mental disorder in the child. For example, certain types of delinquent acting-out tend to occur in families with little cohesiveness and faulty disciplinary practices (e.g., Bandura & Walters 1959; McCord et al. 1961). Certain patterns seem characteristic in families of children suffering from schizophrenia or certain types of autism (e.g., Lidz & Fleck 1960). However, as is the case with other variables which have been implicated to some degree in mental disorders of children, the establishment of clear-cut relations between family variables and individual child disorders depends upon further research. Sociocultural variables have also been implicated in the etiology of children's mental disorders. Variations in child-rearing practices and attitudes have been noted in different ethnic and social-class groups and cultures, as have incidence and type of disorder and attitudes and responses to treatment (e.g., Whiting 1963; Clinard 1957). However, the social and psychological mechanisms mediating the relationship between sociocultural variables and mental disorder are still poorly understood. Potentially stressful events for families and individuals include movement from rural to urban areas; shifts in socioeconomic conditions and traditional customs, attitudes, and interpersonal functions; and the acculturation of primitive or previously relatively isolated cultures. Children who experience such events without adequate preparation are particularly vulnerable to mental disorder (Kessler 1966). The economic, religious, and educational status of the family also seems related to the manner in

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which the other family members react to mental disorder in a child, just as stereotypes of these groups tend to affect the treatment plans and services offered by agencies and clinicians. BRITTON K. RUEBUSH [Directly related are the entries MENTAL RETARDATION; PSYCHIATRY, article on CHILD PSYCHIATRY. Other relevant material may be found in DEVELOPMENTAL PSYCHOLOGY; INFANCY.] BIBLIOGRAPHY

AMERICAN PSYCHIATRIC ASSOCIATION 1964 Planning Psychiatric Services for Children in the Community Mental Health Program. Washington: The Association. BANDURA, ALBERT; and WALTERS, RICHARD H. 1959 Adolescent Aggression. New York: Ronald Press. BORNSTEIN, BERTA 1949 The Analysis of a Phobic Child: Some Problems of Theory and Technique in Child Analysis. Psychoanalytic Study of the Child 3/4:181-226. BOWLBY, JOHN 1960a Separation Anxiety. International Journal of Psycho-analysis 41:89-113. BOWLBY, JOHN 1960t> Grief and Mourning in Infancy and Early Childhood. Psychoanalytic Study of the Child 15:9-52. CHESS, STELLA 1959 An Introduction to Child Psychiatry. New York: Grune. CLINARD, MARSHALL B. (1957) 1963 Sociology of Deviant Behavior. Rev. ed. New York: Holt. COMMITTEE ON CHILD PSYCHIATRY, GROUP FOR THE ADVANCEMENT OF PSYCHIATRY 1965 A Proposed Classification of Psychological Disorders in Childhood. Unpublished manuscript. CRAMER, JOSEPH B. 1959 Common Neuroses of Childhood. Volume 1, pages 797-815 in American Handhook of Psychiatry. Edited by Silvano Arieti. New York: Basic Books. ERIKSON, ERIK H. (1950) 1964 Childhood and Society. 2d ed., rev. & enl. New York: Norton. ESCALONA, SIBYLLE; and HEiDER, GRACE 1959 Prediction and Outcome. New York: Basic Books. FLAVELL, JOHN H. 1963 The Developmental Psychology of Jean Piaget. Princeton, N.J.: Van Nostrand. FREUD, ANNA 1965 Normality and Pathology in Childhood: Assessment of Development. New York: International Universities Press. FREUD, SIGMUND (1909) 1955 Analysis of a Phobia in a Five-year-old Boy. Volume 10, pages 3-149 in Sigmund Freud, The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: Hogarth; New York: Macmillan. -» First published in German. GOLDFARB, WILLIAM 1961 Childhood Schizophrenia. Cambridge, Mass.: Harvard Univ. Press. HAWORTH, MARY R. (editor) 1964 Child Psychotherapy. Practice and Theory. New York: Basic Books. HEIDER, GRACE 1960 Vulnerability in Infants. Menninger Clinic, Bulletin 24:104-114. JOHNSON, ADELAIDE M.; and SZUREK, S. A. 1952 The Genesis of Antisocial Acting Out in Children and Adults. Psychoanalytic Quarterly 21:323-343. KESSEN, WILLIAM 1965 The Child. New York: Wiley. KESSLER, JANE W. 1966 Psychopathology of Childhood. Englewood Cliffs, N.J.: Prentice-Hall.

KORNER, ANNELIESE F. 1964 Some Hypotheses Regarding the Significance of Individual Differences at Birth for Later Development. Psychoanalytic Study of the Child 19:58-72. LIDZ, THEODORE; and FLECK, STEPHEN 1960 Schizophrenia, Human Integration, and the Role of the Family. Pages 323-345 in Don Jackson (editor), The Etiology of Schizophrenia. New York: Basic Books. Me CORD, WILLIAM; Me CORD, JOAN; and HOWARD, ALAN 1961 Familial Correlates of Aggression in Nondeliquent Male Children. Journal of Abnormal and Social Psychology 62:79-93. MURPHY, Lois 1962 The Widening World of Childhood: Paths Toward Mastery. New York: Basic Books. NAGERA, H. 1966 Early Childhood Disturbances, the Infantile Neurosis, and the Adult Disturbances. New York: International Universities Press. OSTOW, MORTIMER 1959 The Biological Basis of Human Behavior. Volume 1, pages 58-87 in Silvano Arieti (editor), American Handbook of Psychiatry. New York: Basic Books. PROVENCE, SALLY; and LIPTON, ROSE 1962 Infants in Institutions. New York: International Universities Press. Ross, ALAN O. 1964 The Exceptional Child in the Family. New York: Grune. SARASON, SEYMOUR et al. 1960 Anxiety in Elementary School Children. New York: Wiley. SPITZ, RENE 1946 Anaclitic Depression. Psychoanalytic Study of the Child 2:313-342. WHITING, BEATRICE B. (editor) 1963 Six Cultures: Studies of Child Rearing. New York: Wiley. VI EXPERIMENTAL STUDY

Mental disorders vastly extend the normal range and variety of human behavior available for psychological study. They present familiar patterns in exaggerated form or in unusual combinations, incompletely developed, or disorganized. Although these derangements are often accompanied by seemingly arbitrary and unique manifestations, there is enough regularity in them to allow for prediction from one occasion to another and for generalization within groups of persons. Experiments help to determine lawful relations in this area, as they do in other fields. Since mental derangements are often accompanied by considerable discomfort or distress, they call first for caretaking and administrative action which, if feasible, includes treatment and rehabilitation. In addition, mental disorders provide a source of information about the mechanisms of normal, as well as impaired, function. We are apt to take for granted our ability to execute the many intricate operations necessary for the coordinated and complete performance of even quite simple movements and mental processes. Only when these operations break down, become inefficient, or fail to develop do we recognize the contribution of one or another mechanism to normal functioning. Any

MENTAL DISORDERS: Experimental Study systematic examination of mental disorders involves the identification of the mechanisms or processes that are damaged in function. From this follows the determination of their part, typically in interaction with other mechanisms or processes, in the behavior disorder or symptoms. Such an analysis, often performed implicitly and schematically, constitutes the diagnosis. When it is explicit and precise, when it allows for prediction (i.e., prognosis) and is followed up by observations on the patient's progress, it can contribute to knowledge of mental function in general, as well as of psychopathology in particular. Experimental techniques are better suited to the study of disorders in cognitive and motor function than to the study of disorders in emotions, but, with some ingenuity, these techniques have been made to serve in the exploration of affective and motivational anomalies as well. Experiments can serve to test a specific hypothesis or merely to verify the fact that some type of behavior does occur. More particularly, they are employed to determine the conditions under which such behavior occurs and the factors that influence its magnitude or frequency. Experimental techniques have been used not only to explore phenomena relevant to mental disorders but also to bring about such derangements (by drugs, fatigue, etc.) and to treat others that have emerged in the course of development or as a result of accident. Thus, experimentation is appropriate at every stage of the evolution and remission of mental disorders. Its special virtue lies in its capacity to refine « clinical observations, to evalute their accuracy and delineate the boundaries of their validity, and to sort out the several sources that contribute to the effects under investigation. An experiment may be necessary, for example in diagnosis, to decide whether a patient's sensory or motor function has been completely lost or is available in extreme emergencies, as happens with hysterical conversion symptoms. Experimental procedures are also widely used to determine the extent of an incapacity. These rnay include procedures such as perimetry of visual fields and determination of dark adaptation, or performance tasks, such as memorizing pairs of nonsense words and sorting designs. Psychological tests used in diagnosis also have their origin in experimental procedure and retain some of its features—the objective tests more so than the projective. For example, certain aspects °f the test situation are always standardized, e.g., the content and phrasing of the questions, the instructions given, the perceptual information presented, the method of recording the patient's re-

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sponses, the format of the protocol taken for the record. In other respects clinical tests may not satisfy the requirements of control and reproducibility that distinguish the experimental from other methods of observation. Also, clinical test scores are evaluated against pre-established population norms, an advantage over the experimental method in determining the baseline and the extent of the deviation, that may have significance for psychopathology. In standardized tests, however, a significant clue could be missed if it emerges, not against the background of average performance, but in the unique pattern of the particular patient's function and dysfunction. Here the flexibility of the experimental method, its resources of manipulation and control, and, above all, its rationale of specifying functions by operations offer the investigator a considerable gain. [See PERSONALITY MEASUREMENT; PROJECTIVE METHODS.] Although this article is concerned with the psychological study of mental disorders, it should be remembered that these disorders furnish subjects for experimental investigation by other disciplines, e.g., pathology, biochemistry, and neurophysiology. Even within psychology, the spectrum of experimental techniques and problem areas covers a wide range, from physiology to the social sciences. Experiments in autonomic and endocrine function, for instance, belong within its boundaries and have been of especial interest to students of unconscious psychic processes. At the other end, experiments in role playing, in group processes, and in the restructuring of social systems, such as hospital wards, have been undertaken jointly or alternately by psychologists and social scientists. The middle ground is marked by experiments in psychophysical measurement and perceptual judgment, by the several conditioning techniques, and by the immense variety of performance tasks—from simple motor responses to the solution of syllogistic problems, from the retention of nonsense syllables over a few minutes to the enduring acquisition of a new skill. [See PSYCHIATRY, article on SOCIAL PSYCHIATRY.] As in other areas of research, in the study of mental disorders the experimental approach implies that as many as possible of the conditions that bear upon the subject under investigation are held constant, while the others are controlled by the design of the research. Only a few, and preferably only one, of the conditions is allowed to vary, and that one is varied systematically, so that its effect on the outcome can be evaluated, whenever possible in some quantified terms. The purpose of an experiment is not just to discover whether an

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anticipated result can be discerned but also to give an estimate of its magnitude and of the probability that it could be reproduced under similar circumstances. In this methodological sense, "experiment" means something very different from the improvised trial or casual exploration to which the name is also applied. Ventures of that type are not unknown in the study of mental disorders, especially in the study of treatment and rehabilitation programs. They may be successful and even valuable in suggesting hypotheses or in demolishing an established misconception, but they are not experiments in the sense that their results can be attributed to a specific variable in the total situation. Certain guesses at the hidden meaning of a patient's obscure statement are experimental in this improvisational sense. Even though they may solve a riddle, there is no certainty that they hold the only solution or, indeed, that the riddle has been posed. Like other intuitive observations, such stabs at interpretation or intervention can supply hypotheses for subsequent testing. Historical aspect. The experimental method was introduced into the study of mental disorders soon after it appeared in general psychology. Kraepelin, the great system builder in clinical psychiatry, had worked with Wundt, and in due course he founded an experimental psychological laboratory at his research institute in Munich. Its program was outlined as far back as 1894, while Kraepelin was in Heidelberg, and appeared in print as the first in a series of reports under the title Psychologische Arbeiten (Kraepelin 1896). Periodic publications on research conducted by Kraepelin himself, and, under Kraepelin's editorship, on work done by his associates and students, followed during the first quarter of the twentieth century and constitute a record of eight volumes [see KRAEPELIN]. Kraepelin credited Gabriele Buccola, an Italian, with the first psychophysical experiments on patients with mental disorders and also noted the beginnings of such research in Russia and the United States. Another neuropsychiatrist whose prolific experimental activity started before the turn of the century was Paul Ranschburg, a Hungarian, most noted for his research in memory disturbances. By 1902 Ranschburg had established a permanent laboratory in Budapest, with government support, for the study of abnormal mental function. In America, Shepard Ivory Franz set up the first laboratory dedicated to the experimental study of behavior in mental patients, at the McLean Hospital in Belmont, Massachusetts, in 1904. The apparatus came from Leipzig, and Franz's first ex-

periments were concerned with the association areas in the brain, aphasia, memory defects, and especially with the physiology of manic-depressive psychosis. Psychological research was typically introduced into mental hospitals via physiology, with experiments on fatigue, speed of reaction, and time judgment. Significantly, Franz's laboratory was established for research in pathological physiology. When in 1907 he transferred his activities to the Government Hospital for the Insane in Washington, D.C., F. L. Wells succeeded him at McLean, heading a laboratory in pathological psychology. Wells was indeed less interested than Franz in cerebral localization, and his work in clinical psychology is best remembered for experiments in reaction time, the design of psychometric tests, and the pioneer use of psychogalvanic measurement. Kraepelin's experimental program encompassed all the principal approaches to mental disorders. He studied normal function, in order to establish baselines, isolate distinct mental processes, and perfect techniques for their measurement. The same processes were also investigated in patients with various mental diseases and with mental disturbances brought on by drugs, fatigue, or sleep deprivation. The ultimate goal was to gain a clearer understanding of mental illness in order to determine its etiology and render its treatment more effective and more amenable to evaluation. Kraepelin's methodological goals have proved understandably uncongenial to the currently dominant school of psychiatry. One clue to his unpopularity is his definition of psychology as a branch of physiology, i.e., physiology of the mind. It is a definition that today few, even among his admirers, would accept, although the concepts underlying it inspired his research. The definition implied that mental function can be measured; that deranged mental function differs from the normal in some quantifiable properties; that operations allowing for the exact assessment of the speed, the regularity, or the frequency of certain incidents in performance can serve as diagnostic and prognostic devices. This view entailed neither an atomistic model of personality nor a denial of psychogenic etiology. Kraepelin unequivocally declared that the physician concerned with mental disorders aims at forming a total picture of his patient and that the vast majority of these disorders originate from inside— genetic disposition being one of the prime determining factors. Experimental psychologists of the present day, while paying homage to his pioneer work, nonetheless adopt a critical attitude toward Kraepelin's contribution, for two reasons. One is the structuralist theory he inherited from Wundt,

MENTAL DISORDERS: Experimental Study which has proved to be of limited value—especially Wundt's concept of apperception, which played an important part in the theory of Kraepelin's school. Second, Kraepelin himself and several of his associates—-although not all, Ernst Griinthal being a notable exception—worked with extremely small samples of subjects. Typically, the investigator himself, not only dubiously representative of the general population but also far from naive in regard to the anticipated effects of the experimental treatment, was the only subject. Kraepelin and an associate's report of impaired performance attributed to a daily dose of alcohol no larger than two quarts of beer is the envy of later experimentalists who, like the author, have been unsuccessful in demonstrating impairment with much larger doses of alcohol [see DRINKING AND ALCOHOLISM, article on PSYCHOLOGICAL ASPECTS]. Theory and operationalism. While the program expounded by Kraepelin has been adapted by experimentalists to other psychological theories and to the requirements of representative sampling and stricter control, laboratory research on problems related to mental disorders has branched in other directions as well. Hughlings Jackson's hierarchic model of dissolution of function (1884) has stimulated innumerable experiments, especially with neurological patients, and Pavlov's theory of conditioning has been applied to mental disorders of every kind. Whether tied to a theoretical position or concerned only with the problem in hand, experimental studies of neurological patients have enriched, refined, and at times corrected our notions about sensory and motor function and higher mental processes. Since the purpose of most investigators has been to isolate the damaged function from those that remain intact or to arrive at a differential determination of deficit, the general approach to neurological disorders has been operational. The experimenter defines the function that seems impaired, selects operations that involve the function, and sets the patient experimental tasks that test these operations. As a rule, the more closely defined these operations, the more informative they are to the investigator. This scale of value may, however, be reversed by his commitment to a theory couched in such global constructs that each and any derangement in function serves as an illustration of the general Principle. A classical instance of that view, advanced by a clinician who was also a notable experimenter, is Goldstein's principle of abstraction. Goldstein conceived of abstraction as a composite function, central to which is the ability to categorize concrete instances. Its impairment is cited to ac-

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count for disorders in speech and in thought, for the psychopathology associated with lesions in diverse areas of the brain, and for disorders that occur without known cerebral damage, such as schizophrenia. [See GOLDSTEIN.] Werner's developmental principle was another such general concept, which inspired experimental attacks on mental derangements as diverse as aphasia, the psychoses, and mental deficiency. Implicit in Werner's principle is the notion that seemingly instantaneous events in perception and thought in fact evolve by steps over a microscopic time scale. The evolution of these processes is usually too rapid to be open to inspection, but with appropriate experimental techniques it can be demonstrated in some instances of disturbed mental function. This was done, for example, by Klaus Conrad, a clinical psychiatrist and ingenious experimenter, who derived quite specific neuropsychological formulations from the broad and formal gestalt laws of integration and differentiation. In the aphasias, amnesias, and other cognitive derangements, experiments with the tachistoscope and memory drum (laboratory instruments for the regular, and very short, presentation of visual displays) merely extended the routine neurological examination and psychological testing. Students of the psychoses and psychoneuroses, on the other hand, could not always admit the relevance of experimental techniques. The psychoanalytic school, which in one version or another has undoubtedly been the most influential force in psychiatry and its ancillary professions in the United States, relies on analogy rather than on operational constructs. This applies even more emphatically to the existentialist and other metaphysical doctrines of psychiatry. In these theories explanation is more often by retrodiction than by prediction; the antecedent events are reconstructed without an exact weighting of the factors that contributed to the outcome or an analysis of their interaction. [See PSYCHOLOGY, article on EXISTENTIAL PSYCHOLOGY.] Animal research. To be sure, certain key concepts in psychoanalytic theory, such as conflict, have been subjected to laboratory experiments. The effects of stress interviews, frustration, pain, and vexation have been studied with human subjects, but for obvious reasons the threat to health and human dignity had to be well below the level at which lasting mental disorders are likely to develop. Most of the laboratory studies, therefore, have been done with infrahuman species. A powerful stimulus to such studies was the almost undivided sway of learning theory in American experimental psychology following the behaviorist

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revolution. If mental disorders, or so many of them, are not diseases but, rather, clusters of maladaptive habits and drives, persistently faulty perceptions or thoughts, and stunted social skills, then the laws of learning and conditioning may explain the emergence of symptoms and lead to successful methods of treatment. Attempts to reconcile the clinical formulations of Freud with an experimentally based academic theory appealed strongly to Hull and his school, whose learning theory shared with psychoanalysis a hedonic principle of motivation. It is, perhaps, disappointing that experiments concerning the development of defense mechanisms have been largely equivocal (see Sears 1943; Miller 1944), although this is hardly surprising in view of the fact that most of them employed rats for subjects. [See CONFLICT, article on PSYCHOLOGICAL ASPECTS; LEARNING THEORY; STRESS; and the biog-

raphy of HULL.] While there is unquestionable elegance in the graphic representation of gradients and the equilibrium point between a rat's approach to food and avoidance of shock and there is quite live evidence of regression, fixation, and other maladaptive habits in the experimentally induced neuroses of cats, dogs, pigs, and sheep trapped in a physical or psychological harness (Liddell 1944), the leap from the laboratory to the human family setting is still a long one. It has been quite spectacularly shortened by Harlow's experiments with monkeys (1958; 1962). The affectionate display directed by infant monkeys toward their surrogate mothers— cloth dummies—was not only comparable with their responses to the natural mothers but also uncannily reminiscent of the behavior of human infants. Since these observations were made in a laboratory, several influences on the growth of affectional responses could be controlled and systematically varied. Furthermore, the situation seemed more likely to produce a lasting mental disturbance similar to those that afflict man than did the traditional procedure of inducing experimental neurosis in social isolation. As the monkeys grew up, some of them indeed developed marked personality disorders. Rather surprisingly, however, this outcome could not be traced to the artificial surroundings of the laboratory or to the substitution of a cloth dummy for the mother or, indeed, to her replacement by surrogates who rejected the clinging infant with a violent mechanical thrust or a concentrated blast of air. The infant experience that seemed chiefly to account for the adult monkey's psychopathology was deprivation of contact with other infants. [See AFFECTION; INFANCY.]

Mental disorders and brain function. The problems of generalizing from infrahuman animals to man will be briefly considered below. At this juncture another problem demands attention: the relationship of mental disorders to disturbed brain function. The conception that behavior disorders develop as a result of infantile deprivation or other stressful life experiences makes no explicit assumptions about alterations in the organism by which such effects could be mediated over time. It is, of course, tacitly assumed that learning, whether it results in greater efficiency or is maladaptive, involves some enduring organic changes, more particularly in the central nervous system. What these changes are is unknown, partly because of the inadequacy of current neurological techniques and partly because of the inadequacy of neuropsychological concepts. These two factors are as closely related as are technology and theory in other domains. After many false attributions and an occasional correct guess in past centuries, it is now pretty universally agreed that the organ of the mind is the brain. The traditional metaphysical controversies about the relationship of body and mind have not been so completely resolved. They may be dismissed as irrelevant to the problem of mental disorders, but there survives a prejudice from the days when body and mind were regarded as two distinct substances, coordinate but not coequal in value or power. In the chain of being, man occupied a position intermediate between that of inanimate matter and the soulless animals, with whom he shared the bodily attributes, and that of the several classes of spiritual beings, whom he resembled by virtue of his mental faculties. His mind received credit for very extensive powers over the body, while control in the reverse direction was thought to be more limited in scope and also to be a likely avenue to sin. Moral judgments have changed, but clinicians are still apt to regard brain damage as but one of several causes of mental disorder and quite readily attribute disturbances in visible and tangible behavior to psychic processes that, at least by implication, take place outside the bodily dimensions. The implication is made by the rough division between organic and functional disorders that has been established in the usage of psychiatrists and neurologists, as well as of clinical psychologists. "Organic" refers to brain damage, and that term is understood to stand for such structural impairment of brain tissue as can be observed directly or by means of currently available neurological tech-

MENTAL DISORDERS: Experimental Study niques, e.g., electroencephalography, pneumography, angiography, etc. "Functional," by elimination, does not refer to organic or brain function. A classificatory principle as incompatible with present-day scientific notions as this is can be defended only on pragmatic grounds. It may, indeed, help with the prescription of treatment, but it introduces an unnecessary division into the research on mental disorders. Localization of brain function. On the one hand, investigations of patients with brain lesions tend to be focused exclusively on the topographical localization of the damaged function. Preoccupation with specialized centers or areas discourages the search for functional systems in the brain or, for that matter, in behavior and experience. On the other hand, psychological concepts have been derived without reference to systems and processes within the organism, and it is hardly astonishing that they do not always fit exactly the neurologist's model. Derangement of function, especially when it can be determined independently by neurological techniques and by experimental studies of behavior, furnishes the most revealing clues about mechanisms and systems common to neurology and psychology. The concepts and patterns that will be meaningful in both disciplines need not correspond to those presently current in either. For example, if future research confirms the author's experimental and clinical observations about the close association of an extremely severe memory disorder with a general lack of spontaneity in the patient's behavior—although no comparable deficit in reasoning or intelligence is found—these two seemingly unrelated psychological functions could be properly subsumed under a common concept. Moreover, if evidence accumulates that this combined deficit occurs with lesions in a certain fairly well defined subcortical system of the brain, such a concept should be meaningful in the language of neural as well as of behavioral processes. Although the accomplishment of experimental studies aimed at this objective is but modest to date, the advance has been considerable (a good share of that achievement being the result of investigations of disordered mental function; see Boring 1929; Flugel 1933; Hebb 1949; 1958) since G. Spurzheim, who ranks next to Franz Joseph Gall as the founder of phrenology, drew his spuriously detailed map of some thirty-odd brain areas that subserved as many mental faculties, with mirrorlike duplication in the two hemispheres. More reliable evidence for the functional subdivision of the brain came first from Paul Broca's clinical

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observations and shortly afterward from Luigi Rolando's experiments with electrical stimulation. Pierre Flourens, another pioneer in experimental research in this area, however, arrived at different conclusions in his studies using the extirpation technique. Phrenology survives today in the mosaic theory of the brain. An opposite point of view was forcefully advanced by Goldstein, whose concept of abstraction has already been mentioned, and, for a while, by Lashley, who derived the laws of mass action and equipotentiality from ablation experiments. These laws imply that the size, rather than the site, of brain damage determines the disturbance in behavior and that—outside the sensory and motor areas—any part of the cortex can potentially subserve any learned behavior. [See BROCA; FLOURENS; GALL; LASHLEY.] Laboratory studies of human patients have led to formulations intermediate between the two poles. Teuber, who conducted extensive and carefully designed experiments on a group of patients with combat injuries, the majority with gunshot wounds in the brain, demonstrated that these lesions result in both specific and general impairment of perceptual function (Teuber & Liebert 1958). Halstead reached a somewhat different, intermediate position, from studies of patients with lesions in the various lobes of the cortex (1947). Statistical analysis of his experimental results showed that no intellectual function is uniquely dependent on a single region of the brain but that these areas differ in their importance for one or another function. Experimental techniques have been extensively used to test hypotheses about cerebral dominance and the division of function between the hemispheres. In this context one again meets spokesmen of extreme as well as intermediate positions. At one pole is the opinion that man has two brains, that one hemisphere all but completely duplicates the function of the other. Indeed, experiments have repeatedly shown that the surgical removal of a diseased hemisphere or its decay through atrophy may cause little discernible loss of intellectual ability. Opponents of this view attribute a high degree of specialization to each half. Speech, for example, has been associated with the left hemisphere since Broca's time, and, correspondingly, control over manipulative skills has been attributed to the right hemisphere. The proposition that cerebral dominance is thus manifested and that it is reversed in left-handed persons has been tested by many experimenters. Zangwill's survey (1960) of these studies reached the conclusion that the speech area is not invariably contralateral to the dominant

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hand. Nor is representation exactly identical in the two hemispheres when (as, for example, in sensory function) the rule of contralaterality obtains. Semmes and her associates (1960) have demonstrated this for somatosensory function, while experiments determining the two-point discrimination and pressure thresholds were used in Teuber's study of disabled veterans (Teuber & Liebert 1958). Pathological damage to the brain that corresponds exactly to a functional impairment is the exception and so far has not been found typical of mental disorders. Lesions in the visual or auditory cortex offer the closest examples. Students of mental illness have been especially interested in the frontal lobe, which seems to play an important part in such emotional disturbances as depression and distress over pain. A functional severance of the prefrontal cortex from the central nervous system has been successfully applied in treating these complaints. Experimental studies, however, have been inconclusive in assigning a particular function or ability to the frontal lobe. Advocates of the mosaic theory of brain function have found more encouragement in the temporal lobe. Penfield, the neurosurgeon, exposed the temporal cortex in several patients while removing a focus of epileptic discharge (1954). Applying electric stimulation to clearly marked points, he was able to elicit repeatedly—although not always—the same sensation or evoke recall of the identical episode from the past. These recollections appeared to be as sensorially sharp as the original experience, even though the patient was fully aware of his immediate surroundings in the operating room. At first it seemed that the site where the organism stores its discrete memories had been discovered in the temporal lobe, and although later interpretations have been more cautious, they do not diminish the significance of these experimental findings, especially for the demonstration that experiences and memories are classified in the nervous system according to abstract principles. This deeply hidden surface of the cortex and the adjacent subcortical regions are undoubtedly implicated in some of the processes of memory. Milner's reports with Penfield (Milner & Penfield 1955) and with Scoville (Scoville & Milner 1957), as well as other investigators' reports on patients who had lesions from surgery or disease in those areas, have noted grave defects in memory for recent events. Memory for remote events—like those which emerged under stimulation of the temporal cortex —is less consistently and less severely affected. Newer techniques in brain surgery, such as electro-

coagulation, have widened the area of experimental investigation of neuropsychological processes. Experiments performed with chronically implanted electrodes allow for the simultaneous recording of neuroelectric activity at deep brain centers and of overt behavior, as well as for electric stimulation. The subject in such investigations, however, is always a sick person, whose function is often influenced by drugs as well as the disease. Alternatively, the subject of an investigation may be a healthy monkey or cat, animals whose brains as well as behavioral repertoire have a good deal in common with man, although not quite as much as would satisfy many students of mental disorders. [See NERVOUS SYSTEM, article on BRAIN STIMULATION.] Clinical research. There are well-established anatomical differences between the brain of man and that of even the highest subhuman primate; there is also reason to believe that some structures or neurophysiological systems are identical but serve different functions at the two different phylogenetic levels. Whether the accomplishments of the rat or the ape in learning and problem solving furnish an informative analogy for man's feats in forming unique memories and operating with symbols remains a debatable issue. Many experiments tracing the relationships between derangements in behavior and in the brain can be carried out only with human patients, because the psychological defect is entirely in the use of language. The variety of aphasias distinguished in clinical observation and confirmed by experimental tests are proof not so much of an ingenuity in classificatory exercises as of the scientific endeavor to expand our knowledge of significant lawful relationships. [See LANGUAGE, article on SPEECH PATHOLOGY; PERCEPTION, article on SPEECH PERCEPTION.] Kinsbourne and Warrington's investigation of six patients with a reading disability (1962) is an example of the contribution experimental procedures can make in a clinical situation. These patients were right-handed, and they were known to have brain lesions in the right (i.e., minor) hemisphere. Paralexic errors, which their defects first seemed to exemplify, are regarded as aphasic in origin and are therefore attributed to damage in the dominant hemisphere. It appeared significant that the errors observed in these patients also differed from those commonly made in reading, in that they tended to occur with the first letters of a word. The investigators designed experiments to test the hypothesis that the reading errors arose from a perceptual derangement. By means of a

MENTAL DISORDERS: Experimental Study tachis to scope, they exposed to the patients brief glimpses of whole and fragmented words and geometrical figures. It became apparent that the patients had an abnormal field of perception, in which fine discriminations were restricted to the right side, although gross operations, such as judging the length of words, were unaffected. Unaware of their disability, the patients attempted to complete what they could read of a word, always in a leftward direction. Experimental checks ruled out the possibility that the disability arose from faulty fixation or defective eye movements, and the investigators therefore attributed it to an abnormal distribution of visual attention—to an unconscious neglect of space. They also recognized that their findings may have implications for reading disabilities that originate from a failure to execute the normal operation of forward completion. [See READING DISABILITIES; VISION, article on EYE MOVEMENTS.] Multidisciplinary contributions. Experiments following the trail between mental disturbances and cerebral dysfunction, in either direction, have the advantage of a clearly defined objective. The pursuit itself, however, may become exceedingly complex and involve—over and above the neurological and psychological considerations—such diverse disciplines as biochemistry, genetics, social science, and history (the patient's life history, as well as the history of the disease process). These disciplines have indeed appeared more promising for research in schizophrenia than have the neural sciences. Experimental studies of schizophrenia in the biochemistry laboratory, although varied, allow for a broad, threefold classification. Their goal is (1) to determine the chemical causes of the mental disorder; or (2) to assess metabolic, and particularly endocrine, function in patients, at different stages of their illness, under induced stress, special experimental conditions, or in the standard hospital setting; or (3) to form a part of a pharmacological treatment program. These experiments often include investigations of physiological and/ or psychological function as well. Experimental studies of schizophrenia, manicdepressive psychosis, and the neuroses are typically confined to the verification of clinical observations. The major exception to this trend has been research stimulated by theories that do not distinguish between functional disturbances attributed to brain damage and those due to psychological factors. Followers of Hughlings Jackson and Head, of Pavlov and the gestalt school, of Goldstein, Werner, ar *d Schilder, have exerted an influence in that

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direction. More recently, models built around the activating properties of a subcortical neural system have served as a comprehensive conceptual frame work for disordered mental function. Theories that transcend the boundaries of established brain damage and psychogenic dysfunction employ loose and not fully operational constructs. Goldstein's principle of abstraction is an example, and, indeed, several experimenters have produced partial evidence against it. Some of these support Cameron's proposition (1947) that distractibility is an important source of concrete thinking in schizophrenia and that in several instances of mental disorder abstraction is manifested but is masked by the use of inappropriate, overinclusive, bizarre concepts, especially when they concern the social context. Of course, the conclusions of these experiments are limited by the extent to which their operations represent abstractness and concreteness in thinking. Uncertainty and disagreement about adequate correspondence between behavior under laboratory control and hypothetical mechanisms or processes—in personality dynamics or neural function alike—present the most difficult problem to the experimental psychologist investigating mental disorders. Laboratory techniques. Experimental reports about the slow responses, sluggish work rate, and straying attention of depressed or schizophrenic patients arc unlikely to arouse much controversy. In these instances, behavior observed in the laboratory does not conflict with clinical impressions, although inferences drawn from the two sets of data to underlying mechanisms may clash, whether they concern hypothetical psychic mechanisms, such as defenses against impulses, or hypothetical neural mechanisms, such as cortical arousal. Experimental techniques have also been used as a subsidiary procedure to clinical interviewing, e.g., the measuring of motor and autonomic responses in tests of word association or perception. If a patient seems to be unusually disturbed or ill at ease when discussing—or keeping silent about— certain topics, such suggestive impressions can be confirmed by the relatively exact measurement of his psychogalvanic response or hand movements. Evidence thus obtained may help in delineating and exploring his areas of conflict. This technique —popularly known as the lie detector—was systematically explored for the purpose of psychological research by Luriia in Moscow in the 1920s (1932). Other investigators, in the United States as well as in the Soviet Union, have further developed this technique, following clues from the patient's auto-

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nomic and skeletal behavior and measuring the latency, rhythm, and amplitude of his responses in structured interviews or during his performance of an experimental task. Laboratory techniques have also been used in the study of the regularity of grossly distorted perceptions in patients with mental disorders. Estimates of the patient's body or of its parts; of the size and distance of objects, especially when the judgment involves the perceptual constancies; and of his dependence on external cues for accurate assessment of the vertical dimension have added to our knowledge of the effects of mental disease or of particular diagnostic types, but have neither promised nor succeeded in getting at the roots of these disorders. Malmo and his associates (1951) have questioned the wisdom of resorting to tests of perception, and especially of concept formation, in order to establish characteristic differences between normal persons and neurotic or psychotic patients. In an experiment demanding difficult perceptual judgment under time pressure, it was demonstrated that groups representing these three classes barely differed in their accuracy. They did differ, though, in the regularity and duration of the motor response by which they indicated their judgment (this was simply pressing a button with the right thumb). They also differed in the frequency and magnitude of the synchronous response with the left hand and in the motor activity of their left hand between responses. The experimenters presented these results in support of the thesis that disproportionate motor disturbance is typical of patients with mental disorder under any stressful situation, and not only when the stress is specific to their emotional problem. This line of reasoning is very congenial to Eysenck (1947; 1961), who has undertaken the most ambitious and extensive experimental research in mental disorders, with the purpose of establishing a reliable psychiatric nosology. Experimental studies have played an important part in this program and have contributed data to the factor analyses from which three personality dimensions were derived. One of these represents introversion-extroversion and accounts for certain individual differences in normal, healthy persons, as well as for the two types of disorders into which Eysenck groups the neuroses. The other dimensions represent the magnitude of a patient's neurotic and psychotic disturbance. The three dimensions are orthogonal to each other (i.e., independent), so that the extent of a patient's psychotic derangement is unrelated to the magnitude or type of his

neurotic abnormality. Most of Eysenck's earlier experiments demanded performance of some task, but more recently he has preferred laboratory methods that call for judgments on perceptual illusions or aftereffects. Some of these procedures, such as assessing the afterimage of a rotating spiral, have been widely used by clinical psychologists for diagnostic as well as research purposes. Induction and treatment. Experimental techniques have also been used for the induction and treatment of mental disorders. While the development of a lasting experimental neurosis in an animal may be a perfectly justified venture, with human subjects the derangement of mental function can be considered only if it is a reversible process of short duration. Various psychotomimetic drugs have been used for this purpose, producing effects that have been reported as pleasant by some, disagreeable by others, and weird by most persons undergoing the experience. Perception and thought processes are distorted in fairly predictable fashion, but it remains a matter of debate whether the abnormal effects thus induced are the same as, similar to, or different in character from those of, for example, schizophrenia. Sleep deprivation, extreme fatigue, anoxia, starvation, heat and cold, excessive sensory stimulation (e.g., continuous noise) and its opposite, sensory and social isolation, have been among the experimental devices used to induce transitory mental disorders. [See DRUGS; PERCEPTION, article on PERCEPTUAL DEPRIVATION.] The application of experimental techniques to the treatment of mental disorders has received its strongest impetus from theories of conditioning. The therapeutic goal is to retrain the patient by progressive weakening of the maladaptive habit or symptom or by reinforcement of an adaptive response. From isolated experiments with laboratory techniques to cure enuresis or hysterical tics or paralysis, or to reach autistic or mentally defective children, there has now developed a recognized practice of behavior therapy. Its methods—desensitization, satiation, counterconditioning, reciprocal inhibition, operant and avoidance conditioning— were formulated and first tested with animals. Now they are applied by clinicians, whose relationship to the patient may not be very different from the psychotherapist's. Also, like the latter, the behavior therapist can combine psychological treatment with pharmacological treatment. [See LEARNING, articles on CLASSICAL CONDITIONING, INSTRUMENTAL LEARNING, and AVOIDANCE LEARNING; LEARNING THEORY; MENTAL DISORDERS, TREATMENT OF, article On BEHAVIOR THERAPY.] Drug therapy and electroshock treatment have

MENTAL DISORDERS: Experimental Study many of the features of a research experiment. The agents administered to bring about certain effects, i.e., improvement in the patient's condition, are under control. The amount given, the duration of treatment, and the avenue by which the agent is administered can be varied, within limits, and the manifestation of side effects, as well as of the principal outcome, can be evaluated and related to the input variables. Opportunities to explore these relationships have been thoroughly exploited by experimenters. [See ELECTROCONVULSIVE SHOCK; MENTAL DISORDERS, TREATMENT OF, article OH SOMATIC TREATMENT.]

The use of experiments in evaluating process and outcome in psychotherapy is far more limited. In individual and group therapy alike, too many of the relevant influences are outside the scope of controlled manipulation. Hypnotherapy offers more attractive possibilities; indeed, all research related to hypnosis seems to be relevant to an understanding of mental derangements and, in the light of Orne's findings, to an accurate assessment of experimental findings in psychology. Orne's experiments (1959) have shown that behavior under hypnosis depends very largely on the current notions about hypnotic effects and, also, that subjects volunteering for psychological experiments tend to have very definite ideas about how they are expected to behave in the laboratory, ideas which may exert a considerable influence on what they do or accomplish there. [See HYPNOSIS.] Experiments in human behavior, whether they reflect normal or disordered mental function, pose certain problems that are of little or no concern to experimenters in other biological sciences. The patient or control subject does not ever merely react to stimuli. The best the experimenter can achieve is to elicit, with his instructions and setting, an unprejudiced cooperation and to rely on observations that allow the least possible latitude for subjective interpretation. In the course of his work he may make new and significant clinical observations or discover lawful relationships that explain some phenomena of the mental disorders. His special contribution, however, is the testing of such observations and the definition of clinical terms by operations that are reproducible and open to inspection by all who will take the trouble to look. GEORGE TALLAND \uirectly related are the entries EXPERIMENTAL DESIGN; PSYCHOANALYSIS, article on EXPERIMENTAL STUDIES. Other relevant material may be found in

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ANXIETY; DEPRESSIVE DISORDERS; DRUGS; FATIGUE; MENTAL DISORDERS, TREATMENT OF; NERVOUS SYSTEM; SCHIZOPHRENIA; SLEEP; STRESS; and in the biographies of GOLDSTEIN; KRAEPELIN; LASHLEY.] BIBLIOGRAPHY

BORING, EDWIN G. (1929) 1950 A History of Experimental Psychology. 2d ed. New York: Appleton. -» See especially pages 50-60, "Phrenology and the Mind-Body Problem," and pages 61-79, "Physiology of the Brain: 1800-1870." CAMERON, NORMAN A. 1947 The Psychology of Behavior Disorders: A Biosocial Interpretation. Boston: Houghton Mifflin. CONRAD, KLAUS 1954 New Problems of Aphasia. Brain 77:491-509. CONRAD, KLAUS 1960 Die Gestaltanalyse in der psychiatrischen Forschung. Nervenarzt 31:267-273. EYSENCK, HANS J. 1947 Dimensions of Personality. London: Routledge. EYSENCK, HANS J. (editor) 1961 Handbook of Abnormal Psychology. New York: Basic Books. FLUGEL, JOHN C. (1933) 1964 A Hundred Years of Psychology: 1833-1933. With an additional part, 1933-1963, by Donald J. West. New York: Basic Books. GOLDSTEIN, KURT (1934) 1939 The Organism: A Holistic Approach to Biology Derived From Pathological Data in Man. New York: American Book. -> First published as Der Aufbau des Organismus. GOLDSTEIN, KURT 1942 Aftereffects of Brain Injuries in War, Their Evaluation and Treatment: The Application of Psychologic Methods in the Clinic. New York: Grune. HALSTEAD, WARD C. 1947 Brain and Intelligence. Univ. of Chicago Press. HARLOW, HARRY F. 1958 The Nature of Love. American Psychologist 13:673-685. HARLOW, HARRY F. 1962 The Heterosexual Affectional System in Monkeys. American Psychologist 17:1—9. HEAD, HENRY et al. 1920 Studies in Neurology. 2 vols. London: Hodder & Stoughton. -> Consists mainly of papers published in Brain between 1905 and 1918. See especially Volume 2, pages 533-800, "The Brain." HEBB, DONALD O. 1949 The Organization of Behavior: A Neuropsychological Theory. New York: Wiley. HEBB, DONALD O. 1958 A Textbook of Psychology, Philadelphia & London: Saunders. JACKSON, J. HUGHLINGS (1884) 1958 Evolution and Dissolution of the Nervous System. Volume 2, pages 45—75 in J. Hughlings Jackson, Selected Writings . . . . Edited by James Taylor. New York: Basic Books. -> First published in 1884 in Lancet. KING, HENRY E. 1954 Psychomotor Aspects of Mental Disease. Cambridge, Mass.: Harvard Univ. Press. KINSBOURNE, M.; and WARRINGTON, ELIZABETH K. 1962 A Variety of Reading Disability Associated With Right Hemisphere Lesions. Journal of Neurology, Neurosurgery, and Psychiatry 25:339-344. KRAEPELIN, E. 1896 Der psychologische Versuch in der Psychiatrie. Volume 1, pages 1-91 in E. Kraepelin, Psychologishe Arbeiten. Leipzig: Englemann. KRECH, DAVID 1962 Cortical Localization of Function. Pages 31—72 in Leo Postman (editor), Psychology in the Making. New York: Knopf. LASHLEY, KARL S. 1929 Brain Mechanisms and Intelligence: A Quantitative Study of Injuries to the Brain. Univ. of Chicago Press.

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LIDDELL, H. S. 1944 Conditioned Reflex Method and Experimental Neurosis. Volume 1, pages 389-412 in Joseph McV. Hunt (editor), Personality and the Behavior Disorders: A Handbook Based on Experimental and Clinical Research. New York: Ronald. LURIIA, ALEKSANDR R. 1932 The Nature of Human Conflicts; or, Emotion, Conflict and Will: An Objective Study of Disorganization and Control of Human Behaviour. New York: Liveright. MAGOUN, HORACE W. (1958) 1963 The Waking Brain. 2d ed. Springfield, 111.: Thomas. MALMO, ROBERT B. et al. 1951 Motor Control in Psychiatric Patients Under Experimental Stress. Journal of Abnormal and Social Psychology 46:539-547. MILLER, NEAL E. 1944 Experimental Studies of Conflict. Volume 1, pages 431-465 in Joseph McV. Hunt (editor), Personality and the Behavior Disorders: A Handbook Based on Experimental and Clinical Research. New York: Ronald. MILNER, BRENDA; and PENFIELD, WILDER 1955 The Effect of Hippocampal Lesions on Recent Memory. American Neurological Association, Transactions 80: 42-48. ORNE, MARTIN T. 1959 The Nature of Hypnosis: Artifact and Essence. Journal of Abnormal and Social Psychology 58:277-299. OSGOOD, CHARLES E. (1953) 1959 Method and Theory in Experimental Psychology. New York: Oxford Univ. Press. PENFIELD, WILDER 1954 Studies of the Cerebral Cortex of Man: A Review and an Interpretation. Pages 284309 in Council for International Organizations of Medical Sciences, Brain Mechanisms and Consciousness. Edited by J. F. Delafresnaye. Oxford: Blackwell. RANSCHBURG, PAUL 1939 Les bases somatiques de la memoire. Pages 513-531 in Centenaire de Th. Ribot: Jubile de la psychologie scientifique francaise, 18391939. Agen (France): Imprimerie Moderne. SCHILDER, PAUL 1942 Mind: Perception and Thought in Their Constructive Aspects. New York: Columbia Univ. Press. SCOVILLE, WILLIAM B.; and MILNER, BRENDA 1957 Loss of Recent Memory After Bilateral Hippocampal Lesion. Journal of Neurology, Neurosurgery, and Psychiatry 20:11-21. SEARS, ROBERT R. 1943 Survey of Objective Studies of Psychoanalytic Concepts. Bulletin No. 51. New York: Social Science Research Council. SEMMES, JOSEPHINE et al. 1960 Somatosensory Changes After Penetrating Brain Wounds in Man. Cambridge, Mass.: Harvard Univ. Press. TALLAND, GEORGE A. 1965 Deranged Memory. New York: Academic Press. TEUBER, HANS L. 1964 The Riddle of Frontal-lobe Function in Man. Pages 410-444 in Symposium on the Frontal Granular Cortex and Behavior, Pennsylvania State University, 1962, The Frontal Granular Cortex and Behavior. Edited by J. M. Warren and K. Akert. New York: McGraw-Hill. TEUBER, HANS L.; and LIEBERT, ROBERT S. 1958 Specific and General Effects of Brain Injury in Man. Archives of Neurology and Psychiatry 80:403-407. WEISENBURG, THEODORE; and MCBRIDE, KATHARINE 1935 Aphasia: A Clinical and Psychological Study. New York: Commonwealth Fund. WERNER, HEINZ (1926) 1957 Comparative Psychology of Mental Development. Rev. ed. New York: International Universities Press. -+ First published in German.

Psychological ZANGWILL, O. L. 1960 Cerebral Dominance and Its Relation to Psychological Function. Edinburgh: Oliver & Boyd.

MENTAL DISORDERS, TREATMENT OF i. ii. in. iv. v. vi.

PSYCHOLOGICAL TREATMENT CLIENT-CENTERED COUNSELING GROUP PSYCHOTHERAPY BEHAVIOR THERAPY SOMATIC TREATMENT THE THERAPEUTIC COMMUNITY

Kenneth M. Colby John Butler Jerome D. Frank Joseph Wolpe Heinz E. Lehmann Robert N. Rapoport

PSYCHOLOGICAL TREATMENT

Within the context of this article, the term "psychological treatment" means psychotherapy and "mental disorder" means mental distress. Psychotherapy consists of a group of communicative methods for exchanging semantic information with the aim of relieving mental distress. Mental distress consists of behavior patterns subjectively experienced as painful and judged by subjective and objective observers to be inappropriate to a context. Although there are now several psychotherapeutic approaches in Western culture, only a few can be considered as seriously developed alternatives whose methods continue to be evaluated and improved through systematic study. These approaches can be subdivided into three schools—psychoanalytic-psychodynamic, learning theory, and clientcentered. Although many similarities and differences can be found among these schools, depending upon how one compares them, there is agreement regarding a number of essential components in mental distress and its treatment by psychotherapy (Ford & Urban 1963). Modern psychotherapy was derived mainly from the efforts of Josef Breuer and Sigmund Freud, toward the end of the nineteenth century, to systematize a "talking cure" from the hypnotic techniques of the time. From this beginning several methods have evolved, none showing a clear-cut superiority over the others. They share many presuppositions regarding the nature of man and a delineation of individual psychotherapy as a private two-person relationship limited to talking and listening, the intent of which is to relieve the mental suffering of a patient in an enduring way. This private and intimate relationship, peculiar to Western man at this time, is notable as much for what it does not contain as for what it does. For example, it is a regularly repeated human communion that is unaccompanied by food and drink. Presuppositions are vaguely held and seldom

MENTAL DISORDERS, TREATMENT: Psychological examined beliefs. Beliefs concerning the nature of man underlie the articulated suppositions of psychotherapy. This Menschanschauung, as it might be called, presupposes that man's suffering is an outcome of his experience, that mental suffering should be relieved, that man has some degree of freedom of choice and decision, that he can control himself to some extent, that he can be changed by experience, that one man can help another to change, and so on. A complete inventory of such presuppositions has never been attempted, and perhaps because of the tacit nature of such beliefs, no inventory could be complete. It is of obvious importance that these beliefs are held by both therapist and patient. The more clearly held beliefs of therapists make up the specifiable suppositions and assumptions of psychotherapy theory. A therapist operates with a theory of the pathology (Greek, pathos, suffering) of mental processes and a theory regarding techniques that can bring about beneficial change in them. Here the term "theory" refers to a rough framework of notions expressed in a language containing everyday and special terms. A therapist's theories do not represent formal systematized bodies of tested and established hypotheses, such as those found in some natural sciences. This is not so much due to the youth of the field as to its nature. Therapy is not a science but a practical healing art. Practical arts consist of techniques for achieving ends valued as good. Procedures and rules for achieving ends can be aided by basic scientific knowledge that increases our understanding of the subject matter or augments the power of techniques. The effective utilization of techniques remains in the hands of a skilled artisan whose work represents the conduct of an artistic rather than a scientific activity. Theories of mental distress A therapist's theories begin with conceptual notions about the subject matter to which his techniques will be applied. Mental suffering involves a set of conditions judged to be qualitatively or quantitatively inappropriate to a context. This judgment ts made both by an internal observer, a patient, a nd by an external observer, a therapist, both of whom hold beliefs about ideal or desirable types of behavior for various contexts. The judgments that something is out of order are arrived at not by consulting experimental or statistical evidence, but b y comparison of the patient's behavior with ideal types. This comparative method uses a concept of Desirable behavior that represents an idealization,

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a useful fiction, and not the extreme of an observable range. The chief empirical indications of mental distress, some or all of which are evident to both observers, are negative affects, thought distortions, and constrictions. Common negative affects, subjectively experienced and reportable as intense and not in keeping with an external situation, are anxiety, anger, depression, shame, and guilt. For example, a person may experience great anxiety in a classroom where there is no evident threat. Or he may become repeatedly enraged at frustrations that he judges to be trivial. Or he may enter a prolonged depression over the death of a loved one and even feel, inexplicably, guilt over the loss. Thought distortions have a great range of severity and variety of content. Common are beliefs that one is inferior, that one deserves admiration, that a disaster is about to occur, that one is being looked at or talked about, that people are dangerous, that one's body is defective, and that the opposite sex is hostile. These beliefs are often accompanied by the patient's own judgment that they are unwarranted or unjustified to this degree. Yet this judgment seems powerless to correct the thought distortion. Constrictions involve limitations of feelings or behavior required by and congruent with contexts. These limitations include avoidance of the opposite sex, sexual impotence or frigidity, inability to enjoy life, and an incapacity to experience either joy or grief. Such constrictions have far-reaching consequences and lead to repetitions of old patterns in novel situations requiring discriminations and new behaviors. There is great variation in how much distress an individual can stand. Most applicants for therapy have experienced enduring distress of more than mild severity which has not disappeared in the course of time. A patient seeks expert help for the negative affects, thought distortions, or constrictions that trouble him, and it is these phenomena from which a therapist attempts to release a patient by modifying the processes that generate them. For more than five thousand years there have been attempts to classify symptoms, descriptions, and behavior patterns into disease categories (Menninger et al. 1963). All these efforts have failed to produce reliable categories. The growing modern view is that we are not dealing with disease entities in the medical sense but with states of experiencing that require conceptualizations different from those found in traditional medicine. Today, various schools of psychotherapy have

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reached moderate agreement on which elements are essential in descriptions of mental distress. Theories of the underlying pathological processes also agree insofar as they consider mental conflict, anxiety and other negative affect processes, and the ontogenesis of distress in parent-child relations to be crucial variables. The current uncertainty and disputes center on the problem of determining the best techniques for relieving distress and producing change. Although a crude theory of distress exists, we lack a theory both of mental change and of how change comes from external social influence. Hence there exists a profusion of techniques derived from clinical experience, but they lack a satisfactory theoretical underpinning. Theories and techniques of therapy Techniques of therapy are purely semantic, involving a communicative exchange of meaningful information. Treatment procedures are limited to conversations of various types, and there is a limit to what a therapist and patient can do with any purely semantic technique. These limitations are set by the nature of the therapist-patient relations, by what can take place in talking and listening, and by the topics chosen to be talked about. The relation between therapist and patient represents a working collaboration guided by a contract with stated and implied terms, usually involving payment of a fee for the therapist's services. Although the relation becomes intimate and emotionally arousing, it remains extremely one-sided, with the patient doing most of the talking. Disclosure is exchanged for confidentiality and neutral interest. The therapist's skills in listening and talking involve a general attitude of benevolent acceptance and specific acts of eliciting, focusing, clarifying, reflecting, and interpreting those relevant topics initiated by the patient. Criteria of relevance vary somewhat among therapy schools, but again there are limitations imposed by the regularities of deep human concerns—e.g., relations to significant other persons and the self to the self—and by what can in fact be said about them by therapists. There exists a difficulty between and within schools of therapy in examining the facts of therapeutic conversation. When discussing therapeutic approaches, each school uses its own notions and language. But it is an open secret among cognoscenti that this talking about therapy is highly unrelated to the talking that takes place in therapy. Official discussions about therapy tend to call up school allegiances and personal commitments. With an increasing use of tape recordings, movies, and television, we are in a position to observe what

therapists actually do rather than relying on what they say they do. As already emphasized, theories regarding processes of mental change are not as developed as theories of mental distress. Every therapy school could use a theoretically justified set of principles for achieving change. The technical rules and principles currently used have come from long clinical experience and common-sense knowledge about human behavior. As an example of the latter, if you want a person to tell you about his inner painful thoughts, do not frighten him. This simple but effective principle is used by all schools. For its skillful applications, a therapist must be able to accept and control himself when stirred by feelings that can lead one person to attempt to frighten another. Most of the rules for conducting therapeutic conversations are of this simple type. Some schools try to justify their techniques by appealing to fanciful metatheories or to animal experiments having no relevance to human behavior. But thus far technical rules are entirely empirical and justified only by clinical experience. This does not mean they are all wrong or can be easily dismissed, but because they lack a theoretical basis, it is difficult to sort out which techniques are truly effective and which can be dispensed with. For the time being, then, techniques must be learned through the oral tradition of apprenticeships in which empirical knowledge is passed on from the more experienced to the less experienced in the course of studying representative examples of clinical problems. And like the skills of all practical arts, they are performed by some people better than by others. Until theories of change are worked out, a therapist must rely, in his practice, on simple rules and on a tacit knowledge that comes with clinical experience. The type of guides he needs most are decision rules that tell him what to say and when and how to say it in order to achieve his shortrange and long-range goals. It is important to distinguish techniques from goals. Much of the therapy literature is clear about goals (although what the language refers to may be obscured observationally), but it remains quite opaque as to how these ends are to be achieved technically. When one discusses the details of the therapist's utterances, all therapists say much the same things. And it is these utterances to which a patient responds, not the theory of the therapist's school. It is also noteworthy that statements about goals often refer to the way the patient should be rather than to what a therapist should do to help him become this way. It is easy enough to state a goal of therapy as

MENTAL DISORDERS, TREATMENT: Psychological an enduring relief of the mental distress a patient suffers. With such relief comes a positive gain in the form of a new ability to enjoy experiences. All schools, in addition, seek goals or subgoals assumed to be necessary to achieve the over-all end of enduring relief. They are variously termed as self-realization, personality growth, self-knowledge, full-functioning, enlightenment, etc. Here differing therapy approaches seem to be saying equivalent things about ideal types of mental functioning. Utopian or not, they play a part in the presuppositions and suppositions regarding therapy's ends. Statements about goals represent assertions of value systems striving to achieve the good (London 1964). A therapist's values regarding "the good" and "the right" in human conduct inevitably clash with other value viewpoints. Each therapist-patient pair must work out this difficult problem of values in a manner that provides some consonance with the values of the patient and the community in which he wants to live. It is this problem of values about what constitutes proper conduct, bound up with the ends of therapy, that contributes great difficulties in answering questions about the effectiveness of psychotherapy. How the techniques of psychotherapy actually work to affect a patient remains mysterious. Changes observable to both subjective and objective observers take place in the form of reduction of negative affect, correction of thought distortions, liberation from constrictions, or a combination of these. Processes that generate such changes are difficult to understand and facilitate in our present state of knowledge. For far-reaching and enduring mental changes to occur, we assume some sort of scrutiny, and revision in belief systems must take place in which information is used to counteract and correct other information. This process is facilitated by the haven and support provided by a benevolent therapist, who functions as an ideal friend or parent and who occasionally can offer alternative views to be tried out by the patient first in safe thought-experiments and later in actual behavior. This is about as much as we think we know of mental change, an area in which dependable knowledge is very difficult to obtain. Trends Historically, the treatment of mental distress has involved the use of physical methods, such as drugs a nd electric shock, and semantic methods, such a § individual psychotherapy (Walker 1957). Hospital treatment has mainly utilized the former methods, whereas outpatient clinics and private practice have relied mainly on the latter.

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No great change in the techniques of semantic methods has gained much acceptance in the past few years. In classical psychoanalytic treatment a couch, free association, and several visits per week for two to three years, or more, are still used. In less-intensive therapies a patient is seen faceto-face for several weeks or months. One trend in the field of psychotherapy concerns the matter of personnel and training. Since the early part of the twentieth century, the official (i.e., sanctioned by an accrediting organization) practice of psychotherapy has been by psychiatrists. But with the growing numbers of trained clinical psychologists and social workers, increasingly more therapeutic work is being carried on by individuals who do not have medical degrees. This trend is consistent with modern views regarding the nature of the "disease." If persons who seek therapy are not viewed as suffering from diseases in the medical sense, then it does not require medically trained personnel to deal with them. Medicine must either redefine "disease" to include human behavior patterns or concede some of its traditional territory to the nonmedical therapist. Since territorial dominance is what it is in male animals, the dispute will be a long one. This issue will become crucial as more and more people seek therapy. The growth of therapy is not so much associated with the prestige of science as it is with a growing change in attitude that facilitates criticism of socially acquired beliefs. Therapy provides a sanctioned way of participating in social criticism within the microcosm of the self, of repudiating acquired beliefs, and of liberating the self. With our increasing prosperity and with a rapid lessening in shame over seeking help, it is estimated that one out of seven persons will eventually apply for therapy. Medicine, psychology, and social work alone will not be able to meet the demand of millions of people. It is obvious that other manpower resources must be trained (Schofield 1964). Whether there has been any progress in the field of therapy over the past several years is an open question, partly because "progress" is such an evaluative term. Through clinical experience therapists have slowly learned much about what is not considered progress, and this represents a gain of information. It is agreed that we need more powerful and efficient methods as well as more knowledge about the differential application of semantic techniques. Furthermore, because patients tend to select therapists from schools about which they feel more comfortable, the various therapy approaches may be dealing with different classes of

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problems and patients, making outcome comparisons across schools worthless. When a practical art tries to improve its methods, it often turns to science for help. Psychotherapy, relying purely on semantic techniques, turns to the behavioral sciences of psychology, sociology, ethology, etc. As yet there has been no great help for the therapist from these areas, but the hope is that scientific research can contribute to a therapist's knowledge in order to make therapy more effective. Research A historical example of mutually benefiting relations between science and practical art can be found in Louis Pasteur's contribution to wine making. Although the process of fermentation was not well understood, wine had been made for thousands of years, and the results had been unpredictable. At the request of wine makers, Pasteur undertook a systematic study of the process of fermentation and discovered the role of bacteria. With this understanding it became possible to control fermentation by regulating the activity of bacteria. Nowadays the making of a great wine still requires intuitive art, but the making of a predictably sound wine is rather straightforward. Like a wine maker, a psychotherapist follows a set of rules for achieving his goal—the relief of mental distress. As mentioned, these rules come from a body of clinical knowledge accumulated through the empirical experience of thousands of practitioners over many years. Why does a therapist believe in these rules when so few (if any) of them rely on scientific knowledge? One must here consider the nature of scientific, clinical, and common-sense knowledge. Scientific knowledge consists of reliable data and tested and confirmed (i.e., not disproved) hypotheses. Depending heavily on measurement and replication, it is precise and highly plausible in the face of the evidence. But it is also limited, lacking in scope and full of errors as history has demonstrated. Clinical knowledge stems from the slow accumulation of data and rough conceptions deriving from the astute observations and powerful intuition of generations of practitioners. Consensus develops through trial and error, and clinicians gradually come to agreement about the suitability of a technique. Common-sense knowledge consists of everyday observations and inferences at a low degree of refinement; it is often fallible and dubitable, but since it is not entirely unevaluated knowledge, it is indispensable. Refined common-sense knowledge becomes scientific knowledge, which then becomes part of common sense

again. If we had no scientific or clinical knowledge, we would still be able to manage human affairs about as well as we do today, using only commonsense knowledge of human behavior. A person has powerful aids of introspection and empathy in thinking and feeling about the behavior of other persons. Scientific research in the problems of therapy should be able to cast light on some of the difficulties in the art. Ideally, one would like to have explanations of everything regarding mental distress and its relief. But this is not likely, nor is it even necessary for the art to improve. Not everything in therapy is a major problem. Only certain aspects merit a scientific study, and only certain questions deserve the labor required to attain a satisfactory answer. Is psychotherapy effective? A useful and apparently simple question to ask and answer would be, "Is psychotherapy effective?" This has turned out to be such a difficult question for research to answer that we now must consider the question unanswerable when posed in this form. Thousands of therapists by now have treated millions of patients. Some patients report they are better, a few that they are worse, and some say they are the same. Therapists believe they help a majority of their patients. Therapists continue to be trained and to practice, and patients continue to seek therapy. There seems to be no widespread doubt that therapy is helpful, or at least that it is in some cases. But there is no satisfactory statistical evidence as yet that therapy benefits a population of patients. Are all these people, therapists and patients, unwittingly deceiving themselves and one another? The issue is reduced to statistical evidence versus clinical knowledge with its elements of common sense. The failure of statistical evidence to demonstrate a phenomenon may reflect the weaknesses in our current tools of demonstration. Also a failure to reject the null hypothesis (which is what statistics attempts) does not establish the null hypothesis. On the other hand, therapists should realize better than anyone the weaknesses and uncertainty of clinical and common-sense knowledge. The question of therapy effectiveness should be rephrased, because what the terms "therapy" and "effectiveness" refer to has never been operationally explicit. On the one hand, the term "therapy' does not refer to a homogeneous set of events. Unless the therapy can be observed by others, there is no guarantee that a therapist is doing what he should be doing and no estimate of how competently he is doing it. On the other hand, the term

MENTAL DISORDERS, TREATMENT: Psychological "effectiveness" also initiates a snarl, because patients enter therapy with varying severity of mental distress and what is judged improvement for one patient may not be judged improvement for another. Furthermore, therapeutic goals contain values about desirable behavior, and unless judges share similar value systems, it is impossible for them to agree on whether the result of therapy was good or right. Certainly every therapist has had at least one experience in which the outcome was judged favorable by himself, other clinicians, the patient, and others who know the patient. Such an experience carries the high conviction that therapy can benefit individual cases, and if it can happen to one patient, it should be able to happen to others. But to how many others in a population and what population? And perhaps it would have happened anyway "spontaneously." There is often mention of spontaneous remission in the literature, but as yet no one has presented any evidence that such a phenomenon exists. Candid therapists admit they do not benefit all patients and wish that those who are helped could be helped more. The issue of effectiveness remains unsettled, but therapists are convinced that therapy has the potential to relieve mental distress. What is really needed is an improvement in methods to make therapy not only more powerful but more efficient. Resistance and transference. If research is to help a practical art, it should address itself to crucial difficulties in that art. A crucial difficulty in all therapy involves a process known as "resistance." This term was derived from nineteenth-century electrodynamics, whose terms Freud used metaphorically in conceptualizing mental processes in terms of a flow of current through a circuit. The term refers to those hindrances a patient presents to explorations, scrutiny, and change. Clinical theory explains this phenomenon on the ground that a patient, although suffering distress, has achieved a mental state that is almost tolerable in many respects. Because the patient views any change in this state as a threat of even greater suffering, attempts to change are warded off and the state is defended for a long time. It is this fear of change and of being hurt that therapists believe to be a ftiajor factor in limiting the efficiency and effectiveness of therapy. Greater knowledge is needed about this process and its relation to "transference," i.e., the feelings and beliefs a patient deVe lops about his therapist. Technical rules for dealln g with transference and resistance may still be , but they should be based on a greater £j

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understanding of what we are dealing with. Animal ethology and experimental psychology has already begun to indicate much about social bonds and social influence, especially between adults and their offspring (Scott 1962). Most research in therapy thus far has concentrated on the therapy situation itself, studying it directly as it exists in nature or studying experimental analogues. Naturalistic attempts to find common denominators among therapeutic approaches have not led us very far, because the comparisons have been too superficial and experimental attempts to duplicate the therapy situation have not brought about anything new. All this is ordinary research clearing up aspects of existing paradigms (Colby 1964). Sooner or later a new paradigm will appear, and extraordinary research will begin using surprisingly different presuppositions and suppositions. It is between the crevices of a Menschanschauung that new paradigms are discovered. One attempts to forecast the future by extrapolating present trends and by predicting those discoveries or inventions needed to fulfill human wishes. The main trend in the profession of psychotherapy presently concerns the development of a therapist who is not a medical practitioner. With the admission that current training systems cannot meet the increasing social demand, a new type of therapist will emerge trained in the best way that can be agreed upon by psychiatry, clinical psychology, and social work. All kinds of impediments will be raised by organization officials, but the need is clear and reasonable men will eventually yield to it. The second forecast involves discoveries and inventions needed by therapists who wish to improve their methods. The need for a theory of mental change has already been emphasized. This will be a fresh theory, not an amalgamation of current theories. For years there has been a demand for some sort of rapprochement between learning theory and psychoanalytic theory. A satisfactory combination seems unlikely as long as learning theory does not concern itself with such higher mental processes as symbol manipulation or with the fact that people think, talk meaningfully, and have awareness. Also, unless psychoanalytic theory develops novel concepts, no further contributions can be expected from it. The sorts of discoveries needed are those that can be provided by basic behavioral science or by a genius in the field of clinical observations and inference. Psycho-

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therapy, as we know it now, will change markedly if vigorously and boldly worked on. The inventions needed are recording apparatuses providing rapid information retrieval, voice-recognizing devices, automated analyses of natural language, and computerized training devices for the learning of therapy. There is also the interesting question of whether a future computer might do as well, if not better, than a person in providing individualized therapeutic conversation for certain classes of problems (Colby et al. 1966). If a computer will be able to treat with semantic techniques thousands of patients an hour, this would be one answer to the problems of (a) the countable hundreds of thousands of hospitalized patients who never have an opportunity to talk with a therapist and (£>) the uncounted millions of patients who could benefit prophylactically or remedially from therapeutic conversation. KENNETH M. COLBY [See also CLINICAL PSYCHOLOGY. Other relevant material may be found in ANXIETY; INTERVIEWING, article on THERAPEUTIC INTERVIEWING; PSYCHIATRY; PSYCHOANALYSIS, article on THERAPEUTIC METHODS; STRESS.] BIBLIOGRAPHY COLBY, KENNETH M. 1964 Psychotherapeutic Processes. Annual Review of Psychology 15:347-370. COLBY, KENNETH M.; WATT, JAMES B.; and GILBERT, JOHN P. 1966 A Computer Method of Psychotherapy: Preliminary Communication. Journal of Nervous and Mental Disease 142:148-152. FORD, DONALD H.; and URBAN, HUGH B. 1963 Systems of Psychotherapy: A Comparative Study. New York: Wiley. LONDON, PERRY 1964 The Modes and Morals of Psychotherapy. New York: Holt. MENNINGER, KARL; MAYMAN, MARTIN; and PRUYSER, PAUL 1963 The Vital Balance: The Life Processes in Mental Health and Illness. New York: Viking. SCHOFIELD, WILLIAM 1964 Psychotherapy: The Purchase of Friendship. Englewood Cliffs, N.J.: PrenticeHall. SCOTT, J. P. 1962 Critical Periods in Behavioral Development. Science New Series 138:949-958. WALKER, NIGEL (1957) 1963 A Short History of Psychotherapy in Theory and Practice. New York: Noonday Press. II CLIENT-CENTERED COUNSELING

Client-centered counseling and psychotherapy as a distinctive point of view and as a radical departure from current practices can be dated rather precisely to December 1940, when Carl R. Rogers, its leading exponent, presented a paper at the University of Minnesota on the attitude and orienta-

tion of the counselor. The paper later became the second chapter of his controversial book, Counseling and Psychotherapy (1942). The controversy engendered by this book centered as much upon what the counselor or psychotherapist was not to do in the psychotherapeutic situation as upon what he was to do. According to Rogers, he was not to guide or to reassure or support; he was not to interpret and was not to use an entire armamentarium of what were labeled "directive" standard techniques. Psychotherapeutic interventions, particularly interpretive explanations, were categorized as dangerous. It was recommended instead that the therapist stress what were called nondirective techniques, responding directly to the present, expressed attitudes of the client (reflection of feeling), and that the therapist convey his unequivocal respect for and acceptance of the client as he presented himself in the immediate present. Rogers postulated that when the therapist demonstrates acceptance and permissiveness and shows understanding of the client's expressed attitudes and feelings, a process of personal change in the client would occur, in which the following stages could be observed: release of expression, achievement of insight, and development of capacities for making choices and of acting on the choices made. The main task of the therapist was to allow the stages to evolve, to facilitate a natural and inherent sequence, not to set the sequence into motion. Rogers also recognized that the therapist had his own propensities to become emotionally involved with his client in ways which resulted in directiveness and that, therefore, the therapist should work at circumscribing these propensities in himself. He stressed the complete abdication of power in the therapeutic relationship, in contrast with current and standard techniques, in a manner which seemed to many to strike directly at the heart of the current practice of psychotherapy in medicine, in social work, in nonmedical settings, and in vocational psychology as well. Pained and angry responses from the ranks of these helping professions were immediate, intense, and longsustained. Personal change in psychotherapy Counseling and Psychotherapy was almost entirely theory-free and empirical in tone, and intentionally so. In 1942, Rogers was a clinical professor formulating his clinical experience for the benefit of clinical students; like many clinicians he was somewhat scornful of current psychological theories, regarding them as sparse and simplistic compared with the richness and complexity of the

MENTAL DISORDERS, TREATMENT: Client-centered Counseling clients with whom he worked. The storm of controversy ensuing upon the publication of Counseling and Psychotherapy stimulated a flow of research and theoretical development by Rogers, his associates, and their students which has not yet abated. The development of theory and research in all areas until approximately 1956 was summarized and integrated by Rogers (1959, pp. 184-252). The approach to understanding personality, psychotherapy, and interpersonal relationships is entirely phenomenological. Technique is minimized and the necessary and sufficient conditions for inducing psychotherapeutic personality change are stated to be the following: 1. Client and therapist are in contact. 2. The client is in a state of incongruence: there is a discrepancy between his perceived self and his actual experience. He is vulnerable or anxious. 3. The therapist is congruent in the relationship with his client: his perceptions of this relationship are accurate symbolizations of the actual experience. 4. The therapist is experiencing unconditional favorable regard toward his client. 5. The therapist is experiencing an empathic understanding of the client's internal frame of reference. 6. The client perceives, at least to a minimal degree, the unconditional favorable regard of the therapist for him as well as the empathic understanding of the therapist. It is noticeable that no techniques and no behavior prescriptions appear in this account. Everything is couched in terms of the experience of the client and of the therapist. Nonetheless, most responses of client-centered therapists continue to be reflections of feeling based on their perception of the internal frame of reference of the client. The behavior of client-centered therapists follows from this premise: The probability that the client will perceive the therapist as prizing (positively valuing) and understanding him is maximized when the therapist manages to convey his prizing attitude of unconditional favorable regard and when the therapist communicates his empathic understanding to the client in a consistent way. Basic concepts. The theory of personality presented is also phenomenological and shows the influence of gestalt theory. The only motive postulated in the theoretical system is the actualizing tendency: the inherent tendency of the organism to develop all of its capacities in ways serving to maintain or enhance the organism. The actualizing tendency reflects in large part the tendency to develop autonomy and to lessen heteronomy, or

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control by external forces. The actualizing tendency is a property of the total organism. The self concept is the consistent conceptual gestalt (organization) derived from the perceptions of the "I" or the "me" that are developed in interaction with significant others. The ideal self concept denotes the self concept to which the individual aspires. The self-actualizing tendency is a subsystem of the basic organismic actualizing tendency and is a consequence of the development of the self concept. Self-actualization is the actualization of that portion of the experience of the organism which is symbolized in the self concept. When self-experience and the remainder of the experience of the organism are congruent, then the actualizing tendency remains relatively unified. If self concept and experience are incongruent, then self-actualization and actualization tendencies are incongruent. In this case, the individual is maladjusted: his self concept reflects a conflict between self-actualizing motives and actualizing motives. [See SELF CONCEPT.]

The self concept does not direct the organism; indeed, the self concept derives from the actualizing tendency and is but one aspect of the tendency of the organism to react and behave so as to maintain and enhance itself. Motives or needs such as the need for favorable recognition from others and the need for self-esteem arise out of the organism's experiences in relation to interpersonal transactions and their vicissitudes. In a broad sense, "experience," in Rogers' view, is the organism's receiving the impact of sensory or physiological events happening at the moment; experience is what happens to the organism, including what happens within it. However, in a more restricted meaning "to experience" for Rogers also denotes the accurate symbolization in awareness of the sensory or physiological events. The theory presented by Rogers, although containing many propositions, is basically simple. It concerns the development and self-development of the organism, the accurate symbolization in awareness of experience, and the perception of threat, with consequent defenses and effects upon interpersonal behavior. The development of an accurate self concept is held to be a basic capacity of the organism. An inaccurately symbolized self concept emerges because the individual, in the course of development, begins to have a need for favorable regard from others and an analogous and consequent need for favorable self-regard but perceives himself as being only conditionally prized or loved by others. He incorporates this conditional prizing into his

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self concept and subsequently evaluates experiences on the basis of conditional prizings instead of in terms of the basic actualizing tendency. Perception of unconditional prizing by others leads, on the other hand, to satisfaction of the needs for favorable regard and self-regard in a way that is congruent with the basic actualization tendency. Development under optimal conditions of unconditional prizing leads to a person who is fully functioning, open to experience, and psychologically adjusted. Some comments on the theory are in order. As stated before, it is relatively simple, having neither the comprehensiveness, say, of psychoanalytic theory nor the seemingly rigorous and elegant simplicity of behavior theory. Not too much is said about motivation, and the defense mechanisms, such as repression, denial, and reaction formation, are taken for granted: they have been discussed and investigated elsewhere. The theory was developed to account for what other theories neglected and to stress a view of human nature and experience not currently dominant in Western culture, namely, that the individual inherently actualizes and self-actualizes, is personal and subjective, is not at the mercy of individual drives, and has inherent capacities for realistic adaptation and unrestricted experiencing. He is often conditionally valued by significant others early in life and often responds by evaluating his self in terms of these conditional prizings. The individual has a history that results in various degrees of congruence between the actualization and the self-actualization tendencies: the lower degrees of congruence are maladjustive; the higher degrees approximate the fully functioning, fully experiencing individual, who evaluates autonomously and is personally creative. [See DEFENSE MECHANISMS.] Clinical and empirical foundations. Despite its phenomenological language, Rogers' theory has the virtue of being close to and being derived from clinical observation. When the client is in the psychotherapeutic situation, when he is unconditionally prized and is well understood by the therapist as he presents himself, he does change his self concepts, he does react more openly, he does abandon maladaptive strategies, maneuvers, and symptoms in relation to the therapist. He usually does not develop a "transference neurosis," and his expressive style changes. The organization and use of language changes, and the individual comes to act differently with others than before. Observations of such changes led to the theory. What is not observationally based is the theoretical prediction of the increase in congruence between self concepts and experience. What is observed is that self con-

cepts change and that the individual expresses himself as being in some ways more like the person he wants to be. However, the congruence of self concept and ideal concept is suspect because it is observed that some individuals claim to have congruent selves and ideals when obviously such is not the case; i.e., interpersonal behavior is not consistent with the claim, and worse, other persons, such as paranoid individuals, seem to have congruent self concepts and ideal concepts but are clearly psychologically maladjusted; thus the recourse by Rogers to the discrepancy between self concept and experience and between self-actualization and the actualization tendency, even though such discrepancies are not actually observed in the psychotherapeutic interaction. In general, theoretical statements by writers within the client-centered orientation, with the exception perhaps of Raimy (1943) and Snygg and Combs (1949), have the same clinical-empirical and action-oriented flavor as those of Rogers. Complex behavior is considered. Little attempt is made to provide careful definitions in the sense in which terms such as stimulus, response, drive, and response generalization are carefully defined in, say, behavior theory because the primary referents can be pointed to in recordings, motion pictures, etc. This discriminability of primary referents is conceived to be an advantage. Considerable difficulty has been encountered by behavior theorists in defining such terms as stimulus, response, and response generalization unambiguously even for simple situations, and when they are applied as behavior therapy, the specification of reinforcing stimuli and of response generalization has been so vague that it seems safe to say that for some of the better-known studies it would be easy to obtain quite different results using the same reinforcing stimuli described by the investigators. The therapy process. Rogers' specifications of the necessary and sufficient conditions of personality change in psychotherapy are to a large extent understood by client-centered therapists in terms of the predominant conduct of therapists: unconditional prizing behavior, mostly expressed nonverbally, and reflections of feeling as communications of manifest themes that occurred in the client's communications. The communicative behavior of clients includes the nonverbal, gestural, expressive components of communication which are linguistic in nature and which serve to modify the meaning of symbols and signs. What happens in the psychotherapeutic hour when the therapist conducts himself in the manner mentioned above? Numerous studies, most of

MENTAL DISORDERS, TREATMENT: Client-centered Counseling them cited by Rogers (1959), have been addressed to this question. While these studies are satisfactory in a certain sense, they do not really describe the events at all well. Hence, a naturalistic description will be attempted. The communicative behavior of the client usually, in contrast with psychotherapies in which the psychotherapist's responses are interventive, shows thematic unity. Thematic unity is also evident in the sequence of responses. Along with this, the voice qualities change, and language usage also changes in such a way that the client appears to be more expressive and integrated in his communicative behavior, to be using a richer and more figurative language. When the therapist accurately symbolizes the themes in a client response, he is in actuality amplifying and developing them through his own language and voice qualities. Often these responses of the therapist are met by the client with "Yes, yes," "That's it exactly," or "Exactly," spoken with considerable emphasis. The theme voiced by the therapist (but voiced by the client immediately before) is then elaborated and developed with considerably more differentiation in both language and voice, creating an impression of supple and spontaneous flexibility. This is true even for quite disturbed clients communicating initially in a passive way and with the passive voice, and using such phrases as "This comes to mind." As the therapist's language becomes richer and more apt, as he makes more use of his voice, as his expressive gestures become more explicit, the more thematic is the development, the more figurative is the speech, and the more closely knit, congruent, and spontaneous become the interchanges of the client and the therapist. This behavioral process, so difficult to describe but so denotable in audio and photographic reproductions of psychotherapy interviews, at its best has the kind of literary quality one might ascribe to recitations of the ancient Greek bards, whose recitations were worked out anew in each encounter with an audience. Published reports of client-centered therapy are, unfortunately, poor representations of the process described. Later theoretical development Theory development since 1956 has largely concentrated upon developing the phenomenological perspective (Shlien 1962), with much stress on the experiencing process in relation to personality change (Gendlin 1964). Gendlin (1962) has written a philosophical treatise on personal experiencing that stresses the relation of experiencing to the creation of meaning. This work developed out of his training as a philosopher and his extensive en-

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counters with client-centered psychotherapy. In extending his concept of experiencing to the understanding of concepts and values (1963; 1964), psychotherapy (1961), and personality change (1964), Gendlin has concluded that changes may occur in psychotherapy even before concepts have been attained that accurately represent feelings referred to by the client. This occurs because the therapist's responses themselves may lead to symbolic completions, closures, and elaborated themata even when the client does not perceive the therapist as prizingly understanding. In emphasizing the influence of the therapist in promoting closure, Gendlin is in effect changing Rogers' conditions for personality change. Dissatisfied with the postulational character of the actualization tendency, Butler and Rice (1963) have proposed that adient motivation, the need for experience, is the primitive base for the actualization and self-actualization tendencies. On the basis of studies of preference for complexity or novelty, of stimulus deprivation and of neurophysiological processes, they propose that adience is rewarded by thinking processes as well as by environmental transactions. The self-actualizing, fully functioning person autonomously creates experience for himself, and he can autonomously reinforce and extinguish behavior (learn) without moving a muscle. [See STIMULATION DRIVES.] With respect to psychotherapy, Butler and Rice maintain that a stimulating, expressive communicative style on the part of the psychotherapist enriches the experience of the client, focuses associations by reflections of feeling, and leads to symbolic completions and thema development. A "difficult" client with a poor prognosis may lower the responsive participation of the therapist, thus creating an experientially impoverished environment matching his inner experiencing, with the consequence that enrichment of experience may not ensue. Clients with poor prognosis are just those who, in the therapeutic interaction, are likely to create the conditions leading to lack of progress and no constructive personality change. Butler and Rice maintain that the therapist who can sustain a participative, stimulating, and responsive expressive style is likely to induce progress in therapy even when such progress seems improbable. Evidence supporting their hypotheses has been presented by Wagstaff (see Butler et al. 1963) and Rice (1965.) Research Research on client-centered psychotherapy has been summarized or cited extensively in Rogers (1959; 1960), Seeman (1956; 1965), Butler

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(1958), and Grummon (1965). Attention here will be centered on the proposition that the changes noted in psychotherapy are due to the psychotherapeutic encounter rather than to spontaneous remission or other extrapsychotherapeutic agents. All work cited has been discussed in Rogers (1959), except when cited by year. Early studies tended to be confined to content analyses of transcripts of therapy interviews. These studies showed that, to a considerable extent, therapists did, indeed, consistently employ the techniques they claimed to use (Porter, Snyder, Seeman, Strom). Furthermore, for clients it was demonstrated that there was a change in the proportion of responses indicating insight, self-exploration, and integration (Porter, Snyder, Curran, Stock, Hoffman); that there were decreasing proportions of distress and discomfort responses and increasing proportions of favorable responses to self (Raimy, Assum, & Levy; Kauffman & Raimy; Zimmerman); that decreasing self-exploration was exhibited when therapists complied with requests for guidance, information, and support (Bergman 1951); that there occurred an increasing acceptance of self and others (Sheerer); and that there was an increased correspondence between ideal self and self concept for cases evaluated as successful, whereas this did not occur in cases evaluated as unsuccessful (Aidman 1951; Bowman 1951). In later studies, control techniques and measuring devices suggested by theory and research results were employed. Self-ideal relations were found to increase during the course of psychotherapy for the client group as a whole, the increase being greater for the group of clients judged to be definitely improved in terms of both therapist ratings and Thematic Apperception Test (TAT) ratings (Butler & Haigh 1954). The therapist's judgments were made independently of the TAT ratings and of the tested self-ideal relations. There was a significant increase in the variability of the selfideal correlations at the end of therapy and at the end of a follow-up period, indicating that self-acceptance was decreasing for some clients and increasing for others. The majority of the changes reflected increasingly self-ideal correspondence, however. Butler showed that 11 of the clients serving as their own controls, to whom tests were administered 60 days prior to therapy, immediately before therapy, and 60 days or less after therapy began, changed their self-descriptions significantly more during the in-therapy period than during the notherapy period (Butler 1964a). Another control feature is the rating of clients

on a scale measuring maturity of behavior (Rogers 1954). Friends of the clients who were not informed that the clients were in therapy and who knew nothing of the research, made these ratings. In general, mean ratings on these scores did not change significantly between pretherapy, therapy termination, and follow-up testing. However, when the clients were stratified on the basis of therapist rating on a nine-point scale of success, the mean increase on maturity scores from pretherapy to therapy termination was statistically significant for clients whose ratings were in the 7-9 range, while there was a statistically insignificant decrease for clients rated in the 1-5 range. For the period between pretherapy and follow-up testings there was a significant increase in average maturity ratings for clients in the 7-9 range and a significant decrease in average maturity ratings for clients in the 1-5 range. The findings are remarkable because the groups used were very small and the therapist rated clients solely on the basis of interview behavior, while the lay observers presumably did not know their friends were in psychotherapy and knew nothing of the research. Comparable ratings on normal controls showed no mean change in score between testing periods. In a later study of many of the same clients, Butler (1964Z?) related self-reports, ratings by independent lay observers, and ratings by therapists. His results indicate that the vantage points of clients, therapists, and observers provide similar information, although the judgments are made on different bases. While this particular group was small, cross validation with another group yielded the same conclusion about the effects of psychotherapy on selfdescription. Cartwright and Vogel (1960) reported on a group of clients for whom they individually matched periods of waiting for therapy with intherapy testing points. The wait periods varied from 4 to 24 weeks. They found statistically significant differences in the variability of self-descriptions indicative of adjustment (highly related to selfideal correspondence) during the treatment period over and above those obtaining in the waiting period. Psychotherapy was held to account for the increase in the variability of self-description scores. In another study reported by Butler (1964a), the self-ideal correlations of clients with good and poor prognoses were compared with those of clients with good and poor prognoses who were not receiving psychotherapy. The treatment group received ten weeks or less of psychotherapy, whereas the control group received no psychotherapy for a tenweek period. Analysis of covariance of the self-

MENTAL DISORDERS, TREATMENT: Client-centered Counseling ideal correlations revealed that those of the treatment group changed more than those of the notreatment control group and that the majority of the changes were in the direction of increased correspondence of self concepts and ideal concepts. When clients are matched on prognosis and are randomly assigned, one can infer from these findings that self-acceptance does change in, and as a result of, client-centered psychotherapy. One can also infer that changes in self-acceptance are related in some way, not necessarily linearly, to changes in maturity of interpersonal behavior as seen by lay observers, to psychodynarm'c changes as reflected in indexes derived from projective tests, and to changes in personal integration and level of adjustment as perceived by therapists. No single study provides perfect control, but the progressive character of the results and the relationships of the measures lend considerable weight to the hypothesis that self-acceptance changes as a result of client-centered psychotherapy and that other changes, particularly maturity of interpersonal behavior, are associated with self-acceptance and the process of psychotherapy. A particularly interesting study was conducted by Bills (1950). After a 30-day control period in which none of 18 third-graders who were retarded readers received play therapy, eight received clientcentered play therapy and ten received no treatment. An analysis of covariance showed a statistically significant difference in gain in reading score for the treated group compared with the untreated group. Bills's study bears on the question of what kinds of behavior are affected by psychotherapy, adding reading to the list of self-re gar ding behavior, interpersonal behavior, and projective behavior. [See READING DISABILITIES.] Research in client-centered psychotherapy since Rogers completed his survey (1959) has centered largely upon the conditions of psychotherapy as provided by the psychotherapist and upon therapist characteristics. Wagstaff has found three factors of expressive style in client verbal behavior, two of which are related to various criteria of outcome of psychotherapy (Butler et al. 1962; 1963); and Rice, analyzing responses of the therapists of the clients studied by Wagstaff, has found three factors of therapist vocal and lexical style, two of which are also related to various outcome criteria (1965). These studies support the hypothesis of Butler and Rice, alluded to earlier, that clients with poor prognoses deleteriously affect the responsiveness of their therapists. Duncan (1965), studying a variety of discrete paralinguistic behaviors in both client and thera pist, found significant relationships, on the one

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hand, between one aspect of therapy "process" (patterns of voice quality) and the therapist's judgments of the process, and, on the other hand, between this process and client test performance both before therapy and after 20 interviews. Gaylin (1965) devised a Rorschach function score designed to measure psychological health. Obtaining this score for pretherapy and post-twentieth-interview Rorschachs, he found that those clients with high ratings of improvement by their therapists exhibited improved scores; those with low ratings, poorer scores. Gaylin's function score also correlated significantly with paralinguistic factors studied by Duncan. Truax and Carkhuff (1963), working with Rogers, have presented evidence to show that when therapists dealing with hospitalized patients provided high levels of warmth, empathy, and congruence, patients improved; when they did not, patients became worse. Client-centered psychotherapists hypothesize that the person is motivated largely by actualizing and self-actualizing tendencies which result in favorable personality change under proper interpersonal conditions initiated by the therapist. The results of studies of the psychotherapeutic situation and its effects strongly support these hypotheses. These studies also show that changes observed in psychotherapy are reflected in interpersonal relationships and in favorable and enduring changes in the structure of self concepts. In addition, the techniques and qualities of client-centered therapists significantly affect performances in other types of situations. Although there are a few studies suggesting that client-centered psychotherapy compares favorably with other approaches (e.g., Shlien et al. 1962), it would be premature to claim that clientcentered psychotherapy is more efficacious than other psychotherapies. This is due in part to the lack of systematic research on personal change in psychotherapy. Furthermore, different approaches to psychotherapeutic treatment, such as behavior therapy, apparently have goals somewhat different from those stated for client-centered psychotherapy. These circumstances render systematic comparisons difficult, if not impossible, at the present stage of development of research on psychotherapy. Currently, an opinion on the relative efficacy of various forms of psychotherapy must be regarded as just that and no more. JOHN BUTLER [Directly related are the entries CLINICAL PSYCHOLOGY; COUNSELING PSYCHOLOGY; IDENTITY, PSYCHOSOCIAL;

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SELF CONCEPT. Other relevant material may be found in GESTALT THEORY; PERSONALITY, article on PERSONALITY DEVELOPMENT; PERSONALITY: CONTEMPORARY VIEWPOINTS, article on A UNIQUE AND OPEN SYSTEM; PHENOMENOLOGY; PSYCHOLOGY, article

On EXISTENTIAL PSYCHOLOGY;

SYMPATHY AND

EMPATHY; THINKING, article On COGNITIVE ORGANIZATION AND PROCESSES.] BIBLIOGRAPHY

AIDMAN, TED 1951 An Objective Study of the Changing Relationship Between the Present Self and Wanted Self-picture as Expressed by the Client in Clientcentered Therapy. Ph.D. dissertation, Univ. of Chicago. AXLINE, VIRGINIA M. 1947 Play Therapy: The Inner Dynamics of Childhood. Boston: Houghton Mifflin. BARRINGTON, BYRON 1961 Prediction From Counselor Behavior of Client Perception and of Case Outcome. Journal of Counseling Psychology 8:37-42. BERGMAN, DANIEL V. 1951 Counseling Method and Client Responses. Journal of Consulting Psychology 15:216-224. BILLS, ROBERT E. 1950 Non-directive Play Therapy With Retarded Readers. Journal of Consulting Psychology 14:140-149. BOWMAN, PAUL H. 1951 A Study of the Consistency of Current, Wish and Proper Self-concepts as a Measure of Therapeutic Progress. Ph.D. dissertation, Univ. of Chicago. BUTLER, JOHN M. 1952 The Interaction of Client and Therapist. Journal of Abnormal and Social Psychology 47:366-378. BUTLER, JOHN M. 1958 Client-centered Counseling and Psychotherapy. Volume 3, pages 93-106 in Progress in Clinical Psychology. Edited by Daniel Brower and Lawrence E. Abt. New York: Grune. BUTLER, JOHN M. 1964a Self-acceptance as a Measure of Outcome of Psychotherapy. Unpublished manuscript. -> Paper delivered at the First International Congress of Social Psychiatry. BUTLER, JOHN M. 19646 Self Concept Change in Psychotherapy. Acta psychologica 23:119 only. -> Volume 23 contains the Proceedings of the Seventeenth International Congress of Psychology held in Washington in 1963. BUTLER, JOHN M.; and HAIGH, GERARD V. 1954 Changes in the Relation Between Self-concepts and Ideal Concepts Consequent Upon Client-centered Counseling. Pages 55-75 in Carl R. Rogers and Rosalind F. Dymond (editors), Psychotherapy and Personality Change: Co-ordinated Research Studies in the Clientcentered Approach. Univ. of Chicago Press. BUTLER, JOHN M.; and RICE, LAURA N. 1963 Adience, Self-actualization and Drive Theory. Pages 79-110 in Joseph M. Wepman and Ralph W. Heine (editors), Concepts of Personality. Chicago: Aldine. BUTLER, JOHN M.; RICE, LAURA N.; and WAGSTAFF, ALICE K. 1962 On the Naturalistic Definition of Variables: An Analogue of Clinical Analysis. Volume 2, pages 178-205 in Conference on Research in Psychotherapy, Research in Psychotherapy. Edited by Lester Luborsky and Hans Strupp. Washington: American Psychological Association. BUTLER, JOHN M.; RICE, LAURA N.; and WAGSTAFF, ALICE K. 1963 Quantitative Naturalistic Research: An Introduction to Naturalistic Observation and Investigation. Englewood Cliffs, N.J.: Prentice-Hall.

CARTWRIGHT, DESMOND 1957 Annotated Bibliography of Research and Theory Construction in Client-centered Therapy. Journal of Counseling Psychology 4 : 82-100. CARTWRIGHT, ROSALIND D.; and VOGEL, JOHN 1960 A Comparison of Changes in Psychoneurotic Patients During Matched Periods of Therapy and No Therapy. Journal of Consulting Psychology 24:121-127. DUNCAN, STARKEY D. JR. 1965 Paralinguistic Behaviors in Client-Therapist Communication in Psychotherapy. Ph.D. dissertation, Univ. of Chicago. GAYLIN, N. L. 1965 Psychotherapy and Psychological Health: A Rorschach Structure and Function Analysis. Ph.D. dissertation, Univ. of Chicago. GENDLIN, EUGENE 1961 Experiencing: A Variable in the Process of Therapeutic Change. American Journal of Psychotherapy 15:233-245. GENDLIN, EUGENE 1962 Experiencing and the Creation of Meaning: A Philosophical and Psychological Approach to the Subjective. New York: Free Press. GENDLIN, EUGENE 1963 Experiencing and the Nature of Concepts. Christian Scholar 46:245-255. GENDLIN, EUGENE 1964 A Theory of Personality Change. Pages 100-148 in Symposium on Personality Change, University of Texas, Personality Change. Edited by Philip Worchel and Donn Byrne. New York: Wiley. GENDLIN, EUGENE 1965 Values and the Process of Experiencing. Unpublished manuscript. GRUMMON, DONALD L. 1965 Client-centered Therapy. Pages 30-90 in Buford Stefflre (editor), Theories of Counseling. New York: McGraw-Hill. RAIMY, VICTOR C. 1943 The Self-concept as a Factor in Counseling and Personality Organization. Ph.D. dissertation, Ohio State Univ. RICE, LAURA N. 1965 Therapist's Style of Participation and Case Outcome. Journal of Consulting Psychology 29:155-160. ROGERS, CARL R. 1942 Counseling and Psychotherapy: Newer Concepts in Practice. Boston: Houghton Mifflin. -> See especially pages 19-47, "Old and New Viewpoints in Counseling and Psychotherapy." ROGERS, CARL R. 1954 Changes in the Maturity of Behavior as Related to Therapy. Pages 215-237 in Carl R. Rogers and Rosalind F. Dymond (editors), Psychotherapy and Personality Change: Co-ordinated Research Studies in the Client-centered Approach. Univ. of Chicago Press. ROGERS, CARL R. 1959 A Theory of Therapy, Personality, and Interpersonal Relationships, as Developed in the Client-centered Framework. Volume 3, pages 184256 in Sigmund Koch (editor), Psychology: A Study of a Science. New York: McGraw-Hill. ROGERS, CARL R. 1960 Significant Trends in the Clientcentered Orientation. Volume 4, pages 85-99 in Progress in Clinical Psychology. Edited by Lawrence E. Abt and Bernard F. Riess. New York: Grune. ROGERS, CARL R. 1961a On Becoming a Person: A Therapist's View of Psychotherapy. Boston: Houghton Mifflin. ROGERS, CARL R. 1961b A Theory of Psychotherapy With Schizophrenics and a Proposal for Its Empirical Investigation. Pages 3-19 in J. G. Dawson, H. K. Stone, and N. P. Dellis (editors), Psychotherapy With Schizophrenics: A Reappraisal. Baton Rouge: Louisiana State Univ. Press. ROGERS, CARL R.; and DYMOND, ROSALIND F. (editors) 1954 Psychotherapy and Personality Change: Co-

MENTAL DISORDERS, TREATMENT: Group Therapy ordinated Research Studies in the Client-centered Approach. Univ. of Chicago Press. ROGERS, CARL R.; and KINGET, G. MARIAN 1960 Psychotherapie en menselijke verhoudingen: Theorie en praktijk van de non-dire ctieve therapie. Utrecht (Netherlands): Spectrum. -» A French translation was published in Louvain by Presses Universitaircs de France in 1962. SEEMAN, JULIUS 1956 Client-centered Therapy. Volume 2, pages 98-113 in Progress in Clinical Psychology. Edited by Daniel Brower and Lawrence E. Abt. New York: Grune. SEEMAN, JULIUS 1965 Perspectives in Client-centered Therapy. Pages 1215-1229 in Benjamin B. Wolman (editor), Handbook of Clinical Psychology. New York: McGraw-Hill. SHLIEN, JOHN M. 1961 A Client-centered Approach to Schizophrenia: First Approximation. Pages 285-317 in Arthur Burton (editor), Psychotherapy of the Psychoses. New York: Basic Books. SHLIEN, JOHN M. 1962 Toward What Level of Abstraction in Criteria? Pages 142-154 in Conference in Research in Psychotherapy 1961, Research in Psychotherapy. Washington: American Psychological Association. SHLIEN, JOHN M.; MOSAK, HAROLD H.; and DREIKERS, RUDOLF 1962 Effect of Time-limits: A Comparison of Two Psychotherapies. Journal of Counseling Psychology 9:31-34. SNYGG, DONALD; and COMBS, ARTHUR W. 1949 Individual Behavior: A New Frame of Reference for Psychology. New York: Harper. ->• A revised edition was published in 1959. TRUAX, CHARLES B.; and CARKHUFF, ROBERT R. 1963 For Better or Worse: The Process of Psychotherapeutic Personality Change. Pages 118-157 in Academic Society on Clinical Psychology, Montreal, 1963, Recent Advances in the Study of Behaviour Change: Proceedings of the Academic Assembly on Clinical Psychology. . . . Montreal: McGill Univ. Press.

Ill GROUP PSYCHOTHERAPY

Group psychotherapies are based on the recognition that, with proper guidance, certain types of persons with psychiatric disorders can help each other. In all forms of group therapy, patients and a therapist repeatedly meet to conduct certain activities within the framework of a special group structure and code. Their emotionally charged interactions with the leader and with each other may help to correct their faulty communication behavior and their distorted perceptions of themselves and others, leading to improved social and personal functioning and to relief of psychic distress. Group healing methods are as old as individual ones. From earliest times, sufferers have sought relief through group activities at religious shrines, and many continue to do so. Group therapies began to emerge as recognized and legitimate forms °f psychotherapy, however, only in the 1920s.

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Many early practitioners exploited the instructional and inspirational potentialities of groups in a purely empirical way; but two pioneers, Trigant Burrow and J. L. Moreno, offered theoretical rationales that, although not in the mainstream of psychiatric thought, had considerable influence. According to Burrow (Riese & Syz 1963), mental disorder was a disturbance in communication, created largely by a person's "privately cherished and secretly guarded" image of himself; the aim of group therapy was to enable him to express himself as he really was by exposing the socially determined basis of his self-image. Moreno (1959) stressed the freeing of spontaneity through encouraging the patient to act out his problems, with the aid of other patients as well as of therapists, in the presence of a vicariously participating audience. In the 1930s psychoanalysts began to experiment with group therapy based on psychoanalytic theory. During World War H, psychotherapists in the armed forces were forced to resort to group methods to handle the enormous load of patients. These methods proved so successful that they spread with almost explosive rapidity. Many modifications were introduced and applied to an ever increasing variety of psychiatric conditions in many different settings. By the 1950s, group therapy in the United States had assumed the dimensions of a movement and had two professional associations, each with a journal devoted to promulgating it. The wide popularity of group therapies may be partly due to the fact that they offer a type of intimacy characteristic of the family and other primary groups. The urbanization and mobility of modern life have reduced opportunities for such relationships, and the shallow, transient, competitive sociability of residential development, office, and club is not an adequate substitute. Characteristics of group therapy Therapeutic groups are conducted in outpatient clinics, private offices, social agencies, mental hospitals, and correctional institutions. Leaders are characteristically psychiatrists, psychologists, psychiatric social workers, or ministers. Some groups are conducted by their own members, without professional guidance. Most forms have a single leader, often with an observer to record what occurs; but some have cotherapists—usually a man and a woman—who try to take different functional roles, such as "father" and "mother." Composition of therapy groups. Most therapy groups consist of from 7 to 25 strangers selected according to a principle such as age, institutional

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residence, or diagnostic category. Examples are groups composed of children, adolescents, mature adults, or the aged; of alcoholics, psychotics, or neurotics; or of persons whose only common feature is residence in the same mental hospital or correctional institution. Increasing efforts are being made to group patients within these broad categories in such a way as to maximize their communication potential. It has been noted that groups tend to elicit certain group roles in predisposed members. For example, one repeatedly finds monopolists, nonparticipants, therapist's assistants, members who try to hold the stage by constantly complaining, and others who try to dominate by moralizing (Rosenthal et al. 1954). This raises the possibility of balancing groups by selecting prospective members with regard to their predilections for different group roles. Observation of patients' actual group behavior seems to be a more reliable way of determining this than individual interviews and psychological tests. To this end, assignment of patients to therapeutic groups may be based on their behavior in a diagnostic group, to which all patients are briefly assigned, where this is administratively possible. A recent trend toward treatment of family groups as a unit is based on the view that the member officially labeled the patient is in reality the victim of a disturbed communication network in which other family members are also involved (Bell 1961; Satir 1964). This approach seems especially promising when the patient is chronologically or psychologically immature, as in the case of a child, an adolescent, or a schizophrenic. Therapists meet privately with patients before the first group meeting to determine their suitability for inclusion and to prepare them for the group; they meet again, later, to evaluate the patients' readiness for discharge. The extent of private patient-therapist contacts at these and other times varies widely, depending on the therapist's conceptualization of treatment; but it is generally agreed that such meetings must be limited if they are not to drain important material from the group sessions. This limitation also holds for meetings of patients between formal sessions, since such informal meetings create opportunities for antitherapeutic as well as therapeutic encounters. With family groups and married couples, such meetings are of course unavoidable; and they seldom can be completely prevented in groups of strangers. Extra group meetings foster growth of group cohesiveness and give members opportunities to interact away from the inhibiting presence of the therapist,

which may be advantageous. On the other hand, by diminishing the members' "social incognito," they may inhibit candid expression of feeling in the group and may foster "acting-out" of personal problems through, for example, exploitative or anxiety-relieving sexual behavior, thereby removing the problems from the helpful scrutiny of the group. Some therapists deal with this problem by prescribing meetings in their absence, so that these become part of treatment; all try to set the ground rule that there be no secrets from the group. The knowledge that anything occurring in an extragroup encounter may be reported to the group usually has an inhibitory effect on antitherapeutic activities. Leader-centeredness or group-centeredness. Methods of group therapy can be ordered with reference to their degree of leader-centeredness or group-centeredness. Since group members are chosen by the therapist and initially expect help only from him, all groups begin as leader-centered. Throughout the duration of some groups the therapist continues to be seen as the sole therapeutic agent, and the group as merely the arena in which members interact with him and each other. Groupcentered approaches attribute considerable therapeutic effects to properties of the group itself. Some groups have no official leader. In others, the leader encourages patients to rely increasingly on each other and deliberately tries to foster a group code and group attributes, such as cohesiveness, that have therapeutic potential. Actually, in therapy groups as in all others, leader behavior, member behavior, and group processes continuously interact. For example, a controlled study of group therapy with hospitalized patients found that intrapersonal exploration by the patients was associated with certain aspects of the therapist's style of leadership and with certain properties of the group itself (Truax 1961). Degree of activity structure. Groups can also be roughly classified in terms of the extent to which their activities are organized. Some, such as Alcoholics Anonymous, therapeutic social clubs, and Recovery, Incorporated (Wechsler 1960), rely on tightly structured, prescribed activities; others, often termed interview or free-interaction groups, create an ambiguous situation and place responsibility for what occurs on the members. In general, the more structured the group, the larger its size can be. Free-interaction groups. To illustrate the range of group therapies, three divergent types may be briefly described. Free-interaction groups typically consist of up to eight adult outpatients and a pro-

MENTAL DISORDERS, TREATMENT: Group Therapy fessional leader. These groups seek to create a code and a climate that foster development of greater self-reliance, spontaneity, and maturity in the members. They encourage free expression of feeling and discussion of personal problems, relying primarily on the shared experiences of the participants to help each find better solutions to his own problems. The responsibility for choice of topic and conduct of the meeting lies largely with the members. The therapist creates and maintains the ground rules and therapeutic atmosphere, facilitates members' interactions, and clarifies the meanings of their behavior (Foulkes & Anthony 1957; Mullan & Rosenbaum 1962). Alcoholics Anonymous. Alcoholics Anonymous is a self-selected, group-oriented organization based on the single criterion of self-confessed alcoholism. Meetings are conducted by the members in a highly structured fashion, and consist chiefly of testimonials about how wretched they were when they drank and how much better they are since they have stopped. Other prescribed activities include making restitution to persons they have harmed and being available to alcoholics who ask for help. The considerable therapeutic effect of these groups lies in the unique degree of support and mutual understanding that alcoholics can give each other. Therapeutic social clubs. Therapeutic social clubs, used chiefly for hospitalized patients or those making the transition back to the community, are run along parliamentary lines, and plan and conduct projects financed by dues. The therapist selects the members and attends all meetings, but remains in the background. The central purpose of these clubs is to combat the vicious circle of impaired social skills, withdrawal, and further social impairment by helping members to improve their social abilities (Bierer 1944). Results of group therapies Evaluation of the results of group therapies, as of all other forms of psychotherapy, is hampered by the absence of a satisfactory classification of psychiatric disorders and inadequate criteria of improvement, but certain clinical impressions are sufficiently widespread to warrant mention. Because of the tensions created by early meetings, especially in unstructured, group-centered approaches, the drop-out rate is higher than in individual psychotherapy, unless the therapist makes special efforts to maintain the patient's commitment to treatment. Particularly prone to leave are Patients with such socially unacceptable problems as sexual deviations; those needing strong support froman authority figure; the excessively shy, sen-

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sitive, or suspicious; and those with high dominance but low popularity (Taylor 1961). About two-thirds of those who remain in treatment improve, as in individual psychotherapy. Group therapy may be especially helpful to patients who are inadequately socialized, including those who express their personal problems in somatic symptoms rather than words, schizophrenics, and sociopaths. Certain obsessional patients, whose verbal and conceptual skills act as defenses against experiencing emotions in analytic-type therapies, may profit from the strong emotional reactions triggered by group processes. Group treatment may aid families and married couples whose communications have become frozen in self-perpetuating, self-aggravating patterns, and who have become so busy defending themselves that they no longer "hear" each other. As they repeatedly display their pathological interaction patterns in a setting that offers support and encourages self-examination, each family member may come to understand how he contributes to the problems of the others and learn to modify his behavior. Therapy groups and group dynamics Although controlled experimentation with therapy groups obviously is very difficult, they provide a source for hypotheses concerning all small-group functioning; and some data obtained from experimental studies of small groups may cast light on the phenomena of therapy groups. The following discussion reviews some possible relationships between the two fields that afford areas for research (Kelman 1963). Distinctive features. Most therapy groups represent subcultures that are demarcated from the culture of the community at large in certain important respects. One is the ground rule that what is said or done in a group meeting is confidential with respect to the outside world. In contrast to other types of groups, admission is secured by confession of failure in some aspects of living. Status within the group is related to skill in playing the role of patient, as defined by the group code, and to demonstration of clinical improvement. Another distinguishing feature of most therapy groups is that members are expected to express their feelings about themselves, persons outside the group, other group members, and the leader candidly and freely. At the same time, acting on feelings is interdicted or carefully controlled, as in psychodrama. Finally, therapy groups demand that patients in conflict keep in communication. Such a group code maximizes opportunities for

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learning and modification of attitudes and behavior. The protected atmosphere encourages patients to express their real feelings, uninhibited by the norms of ordinary social intercourse. Encouragement to verbalize feelings helps patients to differentiate them. Since the group is tolerant and there is little carry-over into daily life, penalties for failure are mitigated, thus encouraging freedom of experimentation. In daily life, antagonists customarily stop communicating, thereby leaving their mutual distortions unchanged. Maintenance of communication despite conflict encourages verbalization, enables each antagonist to gain fuller understanding of the other's position and his own, and helps each to learn to stand his ground despite opposition. Member-leader and member-member interactions. All forms of psychotherapy support patients' self-esteem, arouse them emotionally, and offer them new cognitions. These features give them courage to examine and modify their habitual attitudes, supply the motive power for doing so, and guide their efforts, thereby enabling them to correct maladaptive attitudes and behavior and to progress in self-development. Therapeutic groups have certain potential advantages with respect to these goals. Successful therapy groups overcome members' demoralizing sense of isolation by enabling them to discover that others have similar problems. Furthermore, in contrast to private treatment, in which all help flows from therapist to patient, members of therapy groups find that they can help each other. This counteracts the damage to self-esteem resulting from having been derogated by family and friends. An important aspect of both the supportive and the influencing power of therapy groups lies in the cohesiveness successful ones develop, growing out of members' discovery of common problems, experience of mutual helpfulness, and a history of shared crises and triumphs. This is manifested by therapy groups' reluctance to disband and their resistance to the admission of new members. The danger that cohesiveness will produce pressure on members toward artificial conformity of behavior is reduced by the fact that the group task is to help each member develop in accordance with his own inner needs, so that the group norms encourage diversity. Therapy groups arouse members emotionally in ways not available to individual therapy. One is rivalry for the leader's attention and approval, which, incidentally, seems to be more acute when the leader and members are of different sexes.

The central initial position of the therapist is illustrated by the finding that in a given group those patients who experience a "better" relationship with him relative to other patients show more improvement and are less likely to drop out than are those who experience a "worse" one, regardless of the absolute goodness of the relationship (Parloff 1961). The protective atmosphere of therapy groups and their norm of open expression of feelings facilitate expressions of anger toward the therapist. However, since members depend on him for help, prolonged, unanimous condemnation of him cannot occur. Whether a phase of scapegoating the leader is a necessary step in the development of group cohesiveness, as some believe, remains a question for research. Members also arouse a wide range of hostile and friendly feelings in each other, based on more or less unconscious distortions as well as genuine differences or similarities in background, life experience, and values. In addition, many patients seem to benefit from vicarious emotional participation in problems of others. From the cognitive standpoint, members also serve as models for each other; as sources of feedback, the value of which is increased by the fact that it is less distorted by the rules of social intercourse than are reactions from friends and acquaintances; and as representatives of attitudes existing outside the group. Acceptance by other members carries more weight than acceptance by the therapist, because they are viewed as being more like ordinary people. Because group members represent the outside world, transfer of insights obtained through group experiences to daily life is easier than it is in private psychotherapy. Commitment to the group and awareness that one will report back to it help to sustain changes in attitude. On the other hand, the necessity of constantly dealing with the reactions of other members may hamper progress in patients who need to withdraw into reverie or fantasy or to subject their problems to leisurely scrutiny. Group development and group issues. Wellestablished therapy groups differ from new ones in many ways, including greater freedom of expression among members and a greater tendency for topics to carry over from one session to the next; but whether therapy groups exhibit regularities of development similar to problem-solving groups remains open despite some experimental evidence in support of this possibility (Psathas 1960). The developmental process in therapy group8

MENTAL DISORDERS, TREATMENT: Behavior Therapy can be viewed from the standpoint of the progression of group preoccupations, or issues influencing the members at more or less unconscious levels. It has been suggested, for example, that initial meetings of therapy groups are dominated by three antitherapeutic "basic assumptions": dependency, fight-flight, and pairing, and that group progress can be judged by members' success in overcoming the obstacles these "basic assumptions" present to achievement of the therapeutic goal of increased self-realization (Bion 1961). Another theory conceptualizes group progress in terms of the successive emergence and resolution of "focal group conflicts." A well-nigh universal example of this in early meetings of free-interaction groups is the conflict between the desire to achieve therapeutic gain by becoming committed to the group and exposing one's feelings to it and the fear that by so doing one is exposing oneself to rejection and ridicule (Whitaker & Lieberman 1964). Viewed in a larger perspective, group therapies exploit the universal human tendency to validate subjective experiences by comparing them with experiences of other persons who are perceived as similar. The standards, structure, and processes of therapy groups facilitate these comparisons and help members to correct the distortions thus brought to light. Since each group member deviates in a different way but shares attitudes consistent with the social norms of the community, the attitudes and values of the group as a whole tend to foster improved social adjustment of each member. The advantages and limitations of group psychotherapy as compared with private methods of psychotherapy require further exploration, but it seems probable that the potentialities of group approaches have not yet been fully realized. JEROME D. FRANK [Other relevant material may be found in GROUPS and SOCIOMETRY.]

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FOULKES, SIEGMUND H.; and ANTHONY, E. J. 1957 Group Psychotherapy: The Psycho-analytic Approach. Baltimore: Penguin. KELMAN, HERBERT C. 1963 The Role of the Group in the Induction of Therapeutic Change. International Journal of Group Psychotherapy 13:399-451. -> Includes discussion by Saul Scheidlinger. MORENO, JACOB L. 1959 Psychodrama. Volume 2, pages 1375-1396 in American Handbook of Psychiatry. Edited by Silvano Arieti. New York: Basic Books. MULLAN, HUGH; and ROSENBAUM, MAX 1962 Group Psychotherapy: Theory and Practice. New York: Free Press. PARLOFF, MORRIS B. 1961 Therapist-Patient Relationships and Outcome of Psychotherapy. Journal of Consulting Psi/chology 25:29-38. POWDERMAKER, FLORENCE B.; and

FRANK, J. D.

1953

Group Psijchotherapy: Studies in Methodology of Research and Therapy. Cambridge, Mass.: Harvard Univ. Press. PSATHAS, G. 1960 Phase Movement and Equilibrium Tendencies in Interaction Process in Psychotherapy Groups. Sociometry 23:177-194. RIESE, W.; and SYZ, H. 1963 Phyloanalysis: Theoretical and Practical Considerations on Burrow's Groupanalytic and Socio-therapeutic Method. Acta Psychotherapeutica et Psychosomatica: International Journal of Psychotherapy and Psychosomatics (Basel) 11 (Supplement): 5-88. -» Part 1, "Phyloanalysis (Burrow)—Its Historical and Philosophical Implications," by W. Riese, is on pages 5-36. Part 2, "Reflections on Group- or Phylo-analysis," by H. Syz, is on pages 37-88. ROSENTHAL, DAVID; FRANK, J. D.; and NASH, E. H. 1954 The Self-righteous Moralist in Early Meetings of Therapeutic Groups. Psychiatry 17:215-223. SATIR, VIRGINIA 1964 Conjoint Family Therapy. Palo Alto, Calif.: Science and Behavior Books. SLAVSON, SAMUEL R. (editor) 1956 The Fields of Group Psychotherapy. New York: International Universities Press. TAYLOR, FREDERICK K. 1961 The Analysis of Therapeutic Groups. Oxford Univ. Press. TRUAX, CHARLES B. 1961 The Process of Group Psychotherapy: Relationship Between Hypothesized Therapeutic Conditions and Intrapersonal Exploration. Psychological Monographs 75, no. 7. WECHSLER, HENRY 1960 The Self-Help Organization in the Mental Health Field: Recovery, Inc.; A Case Study. Journal of Nervous and Mental Disease 130:297-314. WHITAKER, DOROTHY STOCK; and LIEBERMAN, MORTON A. 1964 Psychotherapy Through the Group Process. New York: Atherton.

BIBLIOGRAPHY

, JOHN E. 1961 Family Group Therapy: Methods for Psychological Treatment of Older Children, Adolescents, and Their Parents. U.S. Public Health Service Monograph. Publication No. 826. Washington: Government Printing Office. , JOSHUA 1944 A New Form of Group Psychotherapy. Mental Health (London) 5:23-26. ION, WILFRED R. 1961 Experiences in Groups, and Other Papers. New York: Basic Books. -» Seven of these papers were published in Human Relations from !948 to 1951. , RAYMOND J. 1957 Methods of Group Psychotherapy. New York: McGraw-Hill.

IV BEHAVIOR THERAPY

The term "behavior therapy" was introduced by A. A. Lazarus in 1958 and popularized by H. J. Eysenck (1960). It refers to psychotherapeutic methods that are directly based on experimentally established principles of learning. Although "behavior therapy" is broadly synonymous with "conditioning therapy" and with "behavioristic psychotherapy," it more specifically denotes the methods

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that have developed from learning theory since the 1940s. While the principles of learning upon which behavior therapy is based have stemmed mainly from the work of Clark L. Hull (1943)—who in many respects united the lines of study begun by Ivan P. Pavlov in Russia and by Edward L. Thorndike and John B. Watson in the United States—a distinctive group of techniques based on B. F. Skinner's operant conditioning paradigm (1938) has been emerging in recent years. Experimental neuroses, first produced in Pavlov's laboratories, provided the primary data from which Hullian learning theory evolved behavior therapy. Ironically, there could have been no such evolution in the Soviet Union because of the pervasive acceptance there of Pavlov's view that a neurosis is due to the establishment of a chronic pathological focus in the central nervous system. Among those who in the 1920s and 1930s tried to apply principles of learning to clinical problems, foremost mention must be made of Mary Cover Jones (1924), who was the first deliberately to invoke the counterconditioning method that dominates present-day behavior therapy (and whose work moldered in the dust for most of the ensuing quarter of a century). She treated children's phobias by having the patient eat in the presence of a feared object. At first, the object was at a distance. Then, as his anxiety diminished, the patient was placed closer and closer to it. Guthrie (1935) realized the wide applicability of this principle, stating that the rule for overcoming an undesired response is to control the situation so that the cue to the undesired response is present while "other behavior prevails." Dunlap (1932) originated the technique of negative practice, in which the extinction mechanism is used to overcome unadaptive motor habits like tics through instigating their repeated evocation in the absence of reinforcement. Approaching experimental neuroses from the standpoint of modern learning theory, Wolpe (1952; 1958) demonstrated that the behavior observed in neurotic states had all the attributes of learned behavior. The manifestations of anxiety and agitation were similar in detail to the behavior originally evoked in the situations of conflict or noxious stimulation that were used to precipitate the neurosis; the neurotic responses were conditioned to and remained under the control of stimuli present at the time of causation; and neurotic responses of smaller intensity could be evoked, in accordance with the principle of primary stimulus generalization, by other stimuli similar to those to which the neurotic reaction had been directly at-

tached. The most marked and constant neurotic responses were autonomic responses typical of anxiety. These failed to undergo extinction no matter how often or for how long the animal was exposed to the experimental situation, but they could consistently be removed if the animal could be induced to eat in the presence of anxiety-evoking stimuli. Since the animal's eating was inhibited if anxiety was strong, food had to be offered first in the presence of generalized stimuli that aroused anxiety weakly; and then reciprocally, the eating would inhibit the anxiety, and repeated feedings would diminish it to zero. The same treatment in successively more "severe" situations eventually enabled the animal to eat without anxiety in the cage where the neurosis had been induced. The methods of behavior therapy These therapeutic experiments suggested the generalization that the reciprocal inhibition mechanism is the basis of the psychotherapeutic effects obtained by counterconditioning methods, so that if any response that inhibits anxiety can be made to occur in the presence of anxiety-evoking stimuli, it will on each occasion to some extent weaken the conditioned connection between these stimuli and the anxiety responses. This idea was subsequently widely applied in the treatment of human neuroses. Not only eating but a considerable number of other responses in human beings are incompatible with anxiety and thus lend themselves to therapeutic application. The use of some of these responses is briefly described below, followed by a short account of some methods employing different learning mechanisms. (For further details of many techniques of this type, see Wolpe 1958; Eysenck 1960; 1964; Wolpe & Lazarus 1966.) Counterconditioning methods. The group of counterconditioning (reciprocal inhibition) methods is applied mainly, but by no means entirely, to the elimination of unadaptive anxiety-response habits such as fear of crowds, of praise, or of criticism. Such habits are the crux of most neuroses, and when they are overcome, treatment of "defenses against anxiety" and other secondary processes becomes irrelevant. Assertive responses. Assertive responses are used to countercondition neurotic fears aroused IB» interpersonal interchanges. The term "assertive is employed here a good deal more broadly than IB common parlance and includes not only responses of a more or less aggressive nature but also others expressing affection, liking, admiration, and revulsion—almost any feeling other than anxiety (Salte* 1949; Wolpe 1958). Aggressive kinds of assertioB

MENTAL DISORDERS, TREATMENT: Behavior Therapy are, however, very commonly required. For example, there are many patients whom unjust criticism renders hurt and helpless. The therapist applauds the anger and resentment that they inevitably feel in the situations they inadequately handle and gives detailed instructions for the appropriate expression of these feelings. Such expression reciprocally inhibits the anxiety, and repetition of such expression brings about a cumulative conditioned inhibition of anxiety. Sexual responses. Sexual responses are employed to overcome habits of anxiety inappropriately evoked in sexual situations. For example, the male patient usually complains of impotence or premature ejaculation, both of which are generally due to anxiety interfering with the predominantly parasympathetic responses that subserve penile erection. The emotional components of the sexual response (sexual feelings) usually remain adequate in the patient so afflicted. The therapist, having ascertained at what stage in the sexual approach anxiety begins to be experienced, instructs the patient (who must have secured the cooperation of his sexual partner) to take his sexual approach no further than this stage of minimal anxiety on repeated occasions—until the anxiety has decreased to zero. He is then directed to go on to the next stage in the same way. Advances continue to be made step by step until normal intercourse is achieved, usually from three to six weeks after the start of therapy. Although the principle is simple, the detailed tactics must always be adjusted to the individual case (see Wolpe 1958; Wolpe & Lazarus 1966). Desensitization and muscle relaxation. Relaxation, long a popular prescription for nervous disturbances, first achieved scientific respectability through the work of Edmund Jacobson (1938), who showed its autonomic effects to inhibit those effects characteristic of anxiety. Jacobson treated neurotic patients by giving them very extensive training in relaxation and then instructing them to relax at all times all muscles not in use (differential relaxation). A similar program promulgated by Schultz (Schultz & Luthe 1950) has been widely adopted in Europe. It would seem that when improvement occurs, it is because persistent relaxation provides the possibility of reciprocal ^hibition of anxiety aroused by stimuli that appear ln the course of daily life. Systematic desensitization, one method of using ^ep muscle relaxation to decondition neurotic anxiety, is much more economical of time and effort and affords detailed control of the therapeutic process. Training in deep muscle relaxation

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occupies only part of each of about six sessions. The greater part of these sessions is devoted to the construction of anxiety hierarchies. If a particular patient is neurotically anxious about high places and about being rejected, situations relating to each of these areas are listed in descending order of intensity of anxiety reaction, each list constituting a hierarchy. In the actual desensitization procedure, the patient is made to relax as deeply as possible, and then the least disturbing scene from one of his hierarchies is presented to his imagination for a few seconds. Presentations are repeated until he no longer has any disturbance, and the same procedure is followed all the way up the hierarchy. Almost invariably there is transfer of this effect when the patient is exposed to the real situation. In individuals who are not disturbed upon imagining situations that disturb them in reality, desensitization requires the exploitation of real stimuli, being then called "desensitization in vivo." Other modes of desensitization. Other inhibitors of anxiety may also be employed therapeutically in a systematic way. An anxiety-inhibiting effect is produced by the emotions spontaneously aroused in some patients by the therapeutic situation itself (see below). In behavior therapy this has been mainly used for desensitization in vivo. For example, in cases of anxiety in social situations characterized by tremor of the hand while lifting a teacup, patient and therapist repeatedly raise first an empty glass and then a progressively fuller one, until all signs of shaking disappear at each stage; and later they repeat the sequence before an audience. Lazarus and Abramovitz (1962) have reported the desensitization of children's phobias by the use of what they call "emotive imagery." The patient is made to expose himself in imagination to phobic stimuli of increasing intensity in contexts of pleasant emotional excitement. Recently, use has been made of the observation that anxiety can be inhibited through cutaneous stimulation by nonaversive galvanic shocks. The mechanism of this effect may well turn out to depend on afferent collateral inhibition (Eccles 1957) as may also that of the technique of inhibiting anxiety through the arousal of a dominating motor response evoked by mild electric current (Wolpe 1954; 1958). Avoidance conditioning. Avoidance (aversive) conditioning is the application of the reciprocalinhibition principle to the overcoming of responses other than anxiety. It is employed largely to treat obsessional behavior. The agents commonly used

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have been strong faradic stimulation of the forearm and drug-induced nausea, either of which must be administered in an appropriate time relation to the stimulus to which avoidance conditioning is desired. Avoidance conditioning has been effectively used in cases of obsessional thinking, compulsive acts, fetishism, arid homosexuality. It has been least successful in homosexuality, which is often based on neurotic interpersonal anxiety and in such cases should be treated by deconditioning the anxiety (Stevenson & Wolpe 1960). Avoidance conditioning has also been applied with limited success in the treatment of addiction, especially alcoholism. [See LEARNING, article on AVOIDANCE LEARNING.] Experimental extinction. Techniques based on the extinction mechanism—the breaking of habits through repeated performance of the relevant act without reinforcement—were introduced by Dunlap (1932) under the name "negative practice" and in recent years have again been employed occasionally in the treatment of such motor habits as tics. In the course of large numbers of forced evocations of the undesired movement, spontaneous evocations of it are progressively lessened. Certain therapeutic measures have given the appearance of applying the extinction principle to the elimination of emotional reactions (e.g., Malleson 1959). The patient is exposed to anxiety-arousing stimuli, either in reality or in imagination, at the greatest possible strength. In some cases this leads to the decline and ultimate elimination of the anxiety response habit, but more often it does not. It is very doubtful that such improvement is really due to experimental extinction; and a form of inhibition has been suggested as the possible mechanism (Teplov et al. 1956). Both clinically and experimentally, the elicitation of a high-intensity anxiety response ordinarily tends to increase the habit strength of that response. Positive reconditioning. While the overcoming of unadaptive autonomic response habits is usually the central task of behavior therapy, very frequently there is also a need to form adaptive motor habits. Such conditioning is often part and parcel of the measures employed to break down the anxiety habit, as, for example, in the case of assertive training. But motor habits often need to be changed even where anxiety is not involved. For instance, a man who has repeatedly spoiled courtships by overeager behavior might be taught to "play it cool." If the new behavior is successful, it naturally tends to replace the old. In enuresis nocturna, waking is conditioned to the imminence of urination, and this makes possible the subsequent conditioned in-

hibition of urination during sleep (Eysenck I960 p. 377). In recent years Skinnerian operant conditioning techniques have been used to remove and replace undesirable habits. Anorexia nervosa has been successfully treated by providing social rewards— such as the use of a radio or permission to receive company—contingent upon the patient's eating, while withdrawing these rewards when the patient fails to eat (Bachrach et al. 1965). Several varieties of psychotic behavior have been treated on the same principle (e.g., Ayllon 1963), bringing about major and lasting changes in chronic schizophrenic patients, some of whom have been continuously hospitalized for decades. The results of behavior therapy The most distinctive feature of behavior therapy is that it enables the therapist to plan therapeutic strategy and control its details, in contrast to merely setting a framework for transactions with the patient and hoping that beneficial effects will emerge. The behavior therapist can specify the reactions to be overcome and the means to be employed in overcoming them, and he can often state the quantitative relations to be expected between defined therapeutic operations and amount of habit change (Wolpe 1963). Statistical data. Two fairly extensive studies (Wolpe 1958; Lazarus 1963) have evaluated the results of behavior therapy in terms of R. P. Knight's five criteria: symptomatic improvement, increased productiveness, improved adjustment and pleasure in sex, improved interpersonal relationships, and the ability to handle ordinary psychological conflicts and reasonable reality stresses (Knight 1941). From these reports it appears that over 80 per cent of unselected neurotic patients exposed to the available techniques either recover or improve markedly. These results must be compared with the 60 per cent "cured" or "greatly improved" among the completely analyzed patients studied by the Central Fact-Finding Committee of the American Psychoanalytic Association. While the psychoanalyzed patients were treated an average of four times a week for three to four years—i.e., about seven hundred sessions—the average course of behavior therapy covers about thirty sessions (Wolpe & Lazarus 1966, p. 156). A fairly constant number of neurotic patients (about 40 per cent) improve markedly with therapies other than behavior therapy. It is suggested that these nonspecific improvements are due to emotional responses in the therapeutic situation

MENTAL DISORDERS, TREATMENT: Somatic that reciprocally inhibit the anxiety responses evoked by verbal stimuli during interviews. Such nonspecific effects presumably also account for part of the favorable results of behavior therapy. Depth of the effects of behavior therapy. It is sometimes stated as a criticism of behavior therapy that it does not attempt to deal with the "basic dynamic conflict" that is alleged to underlie neurosis. This would be an important objection if a neurosis really had such a conflict as its basis. But there are facts that are hard to reconcile with this idea. For example, a corollary of such an objection would claim that unless the dynamic conflict is resolved, relapse or symptom substitution will sooner or later occur. But a survey (Wolpe 1961) of the results of follow-up studies on neuroses successfully treated by a variety of methods not concerned with the "dynamic conflict" revealed only a 1.6 per cent incidence of relapse or symptom substitution. Weighing the evidence, it seems reasonably certain that neuroses can be considered to be nothing but habits and that therefore a therapy able to break these habits must be considered fundamental. JOSEPH WOLPE [See also LEARNING, articles on CLASSICAL CONDITIONING, INSTRUMENTAL LEARNING, REINFORCEMENT. Other relevant material may be found in ANXIETY; CLINICAL PSYCHOLOGY; CONFLICT, article on PSYCHOLOGICAL ASPECTS; NEUROSIS; PSYCHIATRY; and in the biographies of GUTHRIE; HULL; PAVLOV; THORNDIKE; WATSON.] BIBLIOGRAPHY AYLLON, T. 1963 Intensive Treatment of Psychotic Behaviour by Stimulus Satiation and Food Reinforcement. Behaviour Research and Therapy 1:53-61. BACHRACH, A. J.; ERWIN, W. J.; and MOHR, J. P. 1965 The Control of Eating Behavior in an Anorexic by Operant Conditioning Techniques. Pages 153-163 in Leonard P. Ullmann and L. Krasner (editors), Case Studies in Behavior Modification. New York: Holt. DUNLAP, KNIGHT 1932 Habits. New York: Liveright. ECCLES, JOHN C. 1957 The Physiology of Nerve Cells. Baltimore: Johns Hopkins Press. EYSENCK, HANS J. (editor) 1960 Behaviour Therapy and the Neuroses: Readings in Modern Methods of Treatment Derived From Learning Theory. Oxford. Pergamon. EYSENCK, HANS J. 1964 Experiments in Behaviour Therapy. New York: Macmillan. GUTHRIE, EDWIN R. (1935) 1952 The Psychology of Learning. Rev. ed. New York: Harper. 1943 Principles of Behavior. New York: ; CLARK L. Appleton. JACOBSON, EDMUND 1938 Progressive Relaxation. Univ. of Chicago Press. J°NES, MARY C. (1924) 1960 A Laboratory Study of Fear: The Case of Peter. Pages 45-51 in Hans J. Eysenck (editor), Behaviour Therapy and the Neu-

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roses: Readings in Modern Methods of Treatment Derived From Learning Theory. Oxford: Pergamon. KNIGHT, R. P. 1941 Evaluation of the Results of Psychoanalytic Therapy. American Journal of Psychiatry 98:434-446. LAZARUS, ARNOLD A. 1963 The Results of Behaviour Therapy in 126 Cases of Severe Neuroses. Behaviour Research and Therapy 1:69-79. LAZARUS, ARNOLD A.; and ABRAMOVITZ, ARNOLD 1962 The Use of "Emotive Imagery" Li the Treatment of Children's Phobias. Journal of Mental Science 108:191195. MALLESON, NICOLAS 1959 Panic and Phobia: A Possible Method of Treatment. Lancet [1959], no. 1:225227. SALTER, ANDREW (1949)1961 Conditioned Reflex Therapy. 2d ed. New York: Capricorn Books. -> A paperback edition was published in 1961 by Putnam. SCHULTZ, JOHANNES H.; and LUTHE, W. (1950) 1959 Autogenic Training. New York: Grune. -» First published in German. SKINNER, B. F. 1938 The Behavior of Organisms. New York: Appleton. STEVENSON, IAN; and WOLPE, JOSEPH 1960 Recovery From Sexual Deviations Through Overcoming Nonsexual Neurotic Responses. American Journal of Psychiatry 116:737-742. TEPLOV, BORIS M. et al. (1956) 1964 Pavlov's Typology: Recent Theoretical and Experimental Developments From the Laboratory of B. M. Teplov, Institute of Psychology, Moscow. Compiled, edited, and translated by J. A. Gray, with an editorial introduction by H. J. Eysenck. Oxford: Pergamon. -» First published in Russian. WOLPE, JOSEPH 1952 Experimental Neuroses as Learned Behavior. British Journal of Psychology 43:243-268. WOLPE, JOSEPH 1954 Reciprocal Inhibition as the Main Basis of Psychotherapeutic Effects. A.M.A. Archives of Neurology and Psychiatry 75:205-226. WOLPE, JOSEPH 1958 Psychotherapy by Reciprocal Inhibition. Stanford Univ. Press. WOLPE, JOSEPH 1961 The Prognosis in Unpsychoanalyzed Recovery From Neurosis. American Journal of Psychiatry 118:35-39. WOLPE, JOSEPH 1963 Quantitative Relationships in the Systematic Desensitization of Phobias. American Journal of Psychiatry 119:1062-1068. WOLPE, JOSEPH; and LAZARUS, A. A. 1966 Behavior Therapy Techniques. Oxford: Pergamon.

SOMATIC TREATMENT

Somatic treatment comprises all therapeutic procedures which are based primarily on physical means of influencing the human organism. The agents employed may be mechanical, electromagnetic, or chemical in nature, but they are all characterized by their potential to change the energy balance within the physiochemical system of cerebral dynamics. Defined negatively, somatic treatment of mental disorders may be said to be essentially independent of social and psychological factors, and it would be expected to be generally effective regardless of individual differences in per-

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sonality structure, in personal interactions, and in transactions! processes inherent in the treatment situation. Organic and functional mental disorders. Mental disorders are traditionally divided into two categories—the organic and the functional. Organic mental disorders are characterized by the presence of demonstrable morphological or metabolic abnormalities, which are necessary factors for the establishment of their clinical and pathological diagnosis. Mental disorders for which physical cerebral pathology cannot be demonstrated are denned as functional in nature. Since it is in the organic mental disorders that somatic pathology has been clearly established, it would appear plausible to expect here the best results of somatic treatments. However, the most significant progress with somatic therapies has so far been made by psychiatry in the field of functional mental disorders, just since the mid-1930s. The most spectacular exception to this statement was the discovery of malaria treatment for general paresis of the insane, or dementia paralytica, an inflammatory brain disease caused by syphilis. The discoverer of this therapy, Wagner-Jauregg, received the Nobel Prize in 1927, thus becoming the first psychiatrist to be so honored. However, because of the discovery of penicillin as the specific cure for syphilis, general paresis is no longer a significant mental disorder in many parts of the world. It remains a fact that the major breakthroughs in the somatic treatment of mental disorders have occurred only fairly recently and in the field of functional psychoses—namely in schizophrenia and in manic-depressive psychosis and other depressions. These therapeutic advances have been achieved through shock therapies and still more recently through pharmacotherapy. Throughout the history of psychiatry there have been those who have predicted that some day scientists will discover the physical substrate of all mental disorders. At that time, the argument goes, we might be able to approach all psychiatric treatment with the same scientific detachment that characterizes a surgeon performing an appendectomy or a physician treating a case of pneumonia with modern antibiotics. This hope of finding some kind of "magic bullet" for every mental disorder is not likely ever to be fulfilled. First of all, it is by no means certain that physical substrates or lesions will be discovered for every psychological disorder. Even more important, however, is the well-established fact that in the realm of behavior, physical and psychological fac-

tors are so closely interwoven that a mental disorder—which is essentially a disorder of behavioral manifestations—will seldom respond to somatic therapy alone, without any consideration of psychological and interpersonal factors, even if its primary cause is clearly a physical one. Are somatic treatments cures? The action of few of the major successfully employed somatic therapies is clearly understood, and none of the therapies are specific cures. This is not surprising, since these treatment methods are most effective in the functional psychoses, and this class of mental disorders is characterized by the fact that no definite physical or psychological cause has consistently been established by the many investigators who have searched intensively for the final common physical path of these disorders for nearly a century. A truly curative treatment, however, can be undertaken only if the cause of an illness is known. Otherwise, even the most successful treatment of a disease—for instance, insulin therapy of diabetes mellitus—can only be symptomatic, supportive, or compensatory in nature. A comprehensive approach Psychiatry is fundamentally a pragmatic science. Its raison d'etre and essential goal are the improvement or cure of mentally disordered patients. While psychiatry has developed major theoretical frameworks of its own, e.g., psychoanalysis, and has assimilated others from behavioral sciences for its own use, e.g., learning theory, most of the major advances in psychiatric somatic therapy originated in empirical observations, and the underlying mechanisms through which these treatments became effective were usually inadequately or even erroneously understood. The present methodological situation in the treatment of mental disorders is characterized by a highly dynamic state of flux. The two extreme positions of those who "believe" only in the psychodynamic approach to and resolution of the problems posed by mental disorders and regard a physical approach to mental disorders as methodologically naive and grossly inappropriate, and those who consider any other than a clearly somatic orientation and therapeutic approach to mental disorders as unscientific and doomed to failure, are no longer clearly defined. Today it is generally accepted that all psychodynamic processes depend on a neurophysiological substrate; consequently, psychoanalysts have in recent years shown much interest in neurophysiological research and the pharmacotherapeutic approach to mental disorders. On the other hand, even in their laboratory experi-

MENTAL DISORDERS, TREATMENT: Somatic ments, behavior researchers are now clearly acknowledging the important role of individual personality differences, nonquantifiable psychodynamic factors, and interpersonal transactions. Therapeutic revolution in psychiatry. During the decade between 1950 and 1960 the therapeutic and administrative approach and the social attitudes toward the mentally ill underwent changes of such magnitude that one would be justified in speaking of a quiet revolution. In the United States there was a spectacular decrease of mental hospital populations. In the eight years between 1956 and 1964, i.e., since systematic drug therapy became widely established, there was a decrease of 54,000 patients instead of an anticipated increase of 82,000 patients confined in mental hospitals. One of the by-products of this decrease in mental illness and suffering is a probable saving of more than one billion dollars ("What Tranquilizers . . ." 1964). Thousands of mental patients who only 15 years ago would have remained hospitalized for months, years, or often indefinitely, are now functioning in the community as the result of two new developments : (1) modern drug therapy for mental disorders for which there has been no precedent, and (2) a more progressive and tolerant attitude of mental hospital administrations coupled with increased social acceptance of the former mental patient. The second development is not entirely new, but in the past, if such liberal attitudes emerged they eventually disappeared because there were no effective physical treatments supporting them. Historical treatment methods. During the more than two thousand years that elapsed between the time the somatic nature of mental disorders was first proclaimed by Alcmaeon and Hippocrates and the time it was reasserted by Wilhelm Griesinger at the beginning of the nineteenth century, medicine applied innumerable somatic treatment procedures and remedies, none of which survived because none was ever systematically explored and tested for its efficacy under controlled conditions (Zilboorg 1941; Haisch 1959; Kalinowsky & Hoch 1961). Bloodletting, purging, and induced vomiting w ere therapeutic mainstays in the treatment of niental disorders for many centuries. Physical threats, restraint, solitary confinement in the dark, whipping, periodic submersion under water, violent spinning of the mental patient on specially constructed revolving chairs, were all frequently a Pplied. Many of these procedures, particularly when applied to severely excited patients, resulted, °t course, in rapid "symptomatic improvement,"

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because the patients fainted or became utterly exhausted and remained quiet for some time. Some of these uncritically employed treatment methods have sometimes been referred to as forerunners of modern shock therapies—for instance, the sudden pouring of ice water over the naked patient, burning of the scalp with scalding water, or the sudden plunging of the unsuspecting patient into a lake from a room with a trap-door device. However, the shock induced by these methods was primarily psychological. In contrast to this, modern somatic shock therapy is based on the induction of physiological shock. A certain semantic confusion exists if no clear distinction is made between the biological and the experiential aspects of shock. The old treatments aimed at causing surprise and fear in the patient, while modern shock therapy tends to avoid conscious distress of the patient and aims at the production of a specific state of physiological stress. Countless substances were prescribed as remedies for mental disorders, involving not only a great variety of the basic elements such as mercury, phosphorus, copper, iron, etc., but also chemical compounds—for instance, salts of silver, iodine, or lead. A host of organic chemical compounds was employed, most of which were derived from plants. In ancient times and during the Middle Ages the helleborus plant was thought to possess special powers for the treatment of mental illness. Other treatments, which involved the drinking of the blood of a recently beheaded criminal or concoctions and distillates made from toads, snails, and salamanders, as well as the wearing of precious metals, crystals, and gems, were based on ideas and principles developed by magic and later elaborated on in the symbolic systems of alchemy. Even in prehistoric times, surgical trepanations of the skull were performed, as a number of archeological findings prove. It is likely that the opening of the skull was not always undertaken because of increased intracranial pressure—the modern indication for such surgery—but more often to provide an escape for the evil spirits which were thought to possess the brain of an insane person. Scientific rationale and evaluation. At first glance one might conclude that not much that is new has been added to the modern repertoire of somatic treatment methods in psychiatry, since basic patterns of shock therapy, chemotherapy, and even psychosurgery were traced out many centuries ago. However, it must be remembered that the number of possible physical treatment modalities at our disposal is limited and that the value of a therapeutic procedure does not lie in its incidental

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application but in the fact that its indication is based on a well-established rationale and that the results of the treatment have been assessed by scientific methods. Evidence of favorable results of any specific treatment procedure must be provided through objectively controlled and statistically evaluated clinical experiments. A rationale for psychiatric treatment was not seriously considered in scientific terms until the nineteenth century, and evaluation of treatment results based on controlled and statistically processed observations came into being only in the twentieth century. The scientific groundwork for a successful therapeutic attack on mental disorders was laid at the turn of the twentieth century. This groundwork is founded on three major achievements: (1) the introduction of a clinically valid and useful classification of mental diseases by Kraepelin; (2) the discovery of the principles of a consistent and comprehensive psychodynamic theory by Freud; (3) the progress made by many researchers in bacteriology, cellular pathology, neurophysiology, and chemistry. In the first decade of the twentieth century it was shown that the spirochete, which is the causative agent in syphilis, is present in the brains of patients with general paresis. Soon after the syphilitic etiology for this mental disorder became firmly established, August von Wassermann discovered a practical serological procedure which made it possible to prove objectively the presence or absence of syphilis. Until Wassermann's test became available, many patients, particularly those afflicted with dementia due to the effects of chronic alcoholism on the brain, had been misdiagnosed as suffering from general paresis. Malaria treatment—first breakthrough. In 1917 Wagner-Jauregg, at the University of Vienna, announced results of tests using deliberately induced malaria fever as a treatment for nine patients diagnosed as suffering from general paresis. Six of these patients improved greatly and three of them were cured. Until then, general paresis had been an incurable disease which invariably led to complete dementia and a miserable death. For thirty years Wagner-Jauregg had thought about this kind of treatment, ever since he had observed that the course of a psychosis was often favorably influenced by intercurrent infectious diseases. However, this general observation and even Wagner-Jauregg's idea of imitating this "experiment of nature" and inoculating paretic patients with tertian malaria could not have assumed the status of a scientific procedure until he had, at his disposal, a reliable method—namely, Wassermann's serological test—

which enabled him to make an objective diagnosis and select a homogeneous sample of patients for his experiment. Had he tried the experiment twenty years earlier, he might have inadvertently chosen a group of patients whose diagnosis in 50 per cent of the cases was alcoholic dementia and only in the other 50 per cent, general paresis. Under those conditions, to draw valid conclusions about the efficacy of his malaria treatment in cases of general paresis he would have had to employ a much larger sample, and this would have proved difficult, since he was using an untried, somewhat hazardous procedure (Wagner-Jauregg 1946). A variety of unsuccessful treatments. Around 1920 a group of clinicians conceived of focal infections in tonsils, teeth, and the intestines as the cause of many diseases, including the functional psychoses, and for a few years a great deal of unnecessary surgery was performed with the idea of removing the infectious foci. However, the theory was soon disproved, and this kind of surgical treatment was shown to be valueless or even harmful. A number of other therapeutic efforts were aimed at duplicating the spectacular results of the malaria treatment of general paresis, and, in several places, particularly in Europe, fever was induced artificially through injections of sulfur, typhoid vaccine, or foreign protein in patients suffering from various functional psychoses. Other attempts in the same direction, namely, to produce a systemic irritation and thereby a general mobilization of biological defenses, consisted of producing large blisters on the skin through the use of vesicantia, of making sterile abscesses in the muscles through the injection of turpentine oil, and of creating an aseptic meningitis by means of horse-serum injections into the spinal canal. Although short-term improvements in psychotic states were often observed in response to some of the procedures, no lasting remissions in the major psychoses could be achieved by any of them. The advances made in endocrinology suggested the therapeutic use of various hormones. Again, this approach did not prove to be fruitful. Most frequently employed in these therapeutic trials were the male sex hormone, testosterone, and the female sex hormones, estrogen and progesterone. However, some promising results in this field were obtained with the hormone of the thyroid gland in the treatment of mental and emotional disorders secondary to hypothyroidism. Castration. Castration was used in the nineteenth century and earlier because of the mistaken belief that such surgery on the genital organs would prove beneficial in certain psychiatric dis-

MENTAL DISORDERS, TREATMENT: Somatic orders, particularly those with hysterical manifestations. In modern times, castration of recidivist male sex offenders is a legal therapeutically employed procedure in some countries, particularly in Scandinavia. A recent review of results of this procedure in this particular group of psychiatric patients has shown that the treatment is often effective, but since it has so many drawbacks of a moral, psychological, and medical nature—not the least being its irreversibility—it is not likely to become a widely accepted procedure (Tappan 1951). Pharmacotherapy and psychopharmacology Around 1930 new interest was aroused in the use of various drugs in mental disorders. Loevenhart and others (1929) reported interesting experiments with injections of small doses of potassium cyanate and with the inhalation of carbon dioxide in stuporous patients. Patients who had been mute and motionless for weeks would suddenly, under the influence of these drugs, begin to talk and move about. Within a short time, however, they would invariably relapse into their previous stuporous condition. These therapeutic procedures were hardly more than provocative laboratory experiments. Their mechanism of action was not well understood, and their therapeutic action could not be sustained. New synthetic drugs which had become available at that time were given widespread application in psychiatric disorders. Benzedrine, one of the early representatives of the group of amphetamine compounds, produced marked stimulation of the central nervous system and had certain euphorizing effects (Myerson 1936). However, the early hopes that this drug might prove to be a specific agent counteracting depression were not fulfilled. Therapeutic experiments with photosensitization of depressed patients through the administration of hematoporphyrine, a hemoglobin derivative, seemed to give promising results at first but eventually proved to be disappointing. Amobarbital, a barbiturate, when given intravenously, was shown to produce the same tantalizing effect of relieving stupor states temporarily as did potassium cyanate injections and carbon dioxide inhalations. Nitrogen metabolism. Gjessing, in a series of beautifully designed and very carefully controlled experiments conducted at a Norwegian mental hospital, demonstrated that a certain type of schizophrenia, which he named "periodic catatonia," was characterized by recurrent attacks of stupor or excitement and was associated with a defective regulation of nitrogen metabolism (Gjessing et al. 1958). Patients afflicted with it either accumulated

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or lost nitrogen beyond the normally permitted biological limits, and at the critical points of change in the nitrogen balance of the body, psychotic episodes would occur. Gjessing showed that a small amount of thyroxin would enable these patients to maintain their nitrogen balance within normal limits and thus remain free from psychotic attacks. His brilliant work was greeted with great enthusiasm as another milestone on the road toward effective and scientifically grounded somatic treatment in psychiatry. Unfortunately, its practical importance is limited, since the mental disorder for which this treatment is indicated is comparatively rare. Pellagra and phenylketonuria. Two more important therapies must be mentioned—both the outcome of systematic, scientific research. One has led to the almost complete disappearance of a mental disease that formerly was fairly frequent in certain parts of the world, while the other one has opened up exciting vistas for a practical therapeutic and preventive approach to mental deficiency. In 1938 Elvehjem demonstrated that the socalled "black tongue" in dogs was a deficiency disease caused by a lack of nicotinic acid, a component of the vitamin B complex, in the food (see Woolley et al. 1938). Soon afterward, the first cases of pellagra in humans, which seemed to be closely related to the black-tongue disease, were successfully treated with nicotinic acid. Pellagra is a disease which produces manifestations in the skin, intestines, and the brain. In the past, many patients suffering from pellagra psychosis could be found in mental hospitals in certain parts of the world— for instance, in the south of the United States, where nutritional conditions were particularly bad among the lower classes. Today one rarely sees a patient with psychosis due to pellagra, and in the few instances where such a diagnosis is made, the condition readily responds to treatment with nicotinic acid. The modern antibiotic treatment of general paresis with penicillin—which has superseded Wagner-Jauregg's original malaria treatment—and the supplementary vitamin therapy with nicotinic acid of pellagra psychosis are the only two truly curative treatments of mental disorders at our disposal today. A recently developed treatment that has opened fresh possibilities for an attack on mental deficiency is really a preventive one. It consists of the reduction of a certain amino acid—phenylalanine—in the food intake of infants and young children in whom the diagnosis of phenylketonuria has been made. In 1934 Foiling showed that a certain small

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group of mental retardates was characterized by the excretion of an abnormal metabolite, namely, phenylpyruvic acid, in the urine. Later it was shown that these patients were afflicted with an "inborn error of metabolism," and, lacking certain essential enzymes—in particular, phenylalanine hydroxylase—were unable to metabolize phenylalanine, which is a component of normal food intake, to tyrosine. Because of this metabolic inadequacy, another metabolic product—phenylpyruvic acid— accumulates in their system. It seems that the increased blood level of phenylalanine is highly toxic for the developing brain. By carefully eliminating most phenylalanine from the food of a patient in whom the diagnosis has been made early enough —that is, before the toxic excess of phenylalanine can exercise its damaging influence on the developing brain, up until the fourth or fifth year of life— it is possible to prevent or at least reduce the intellectual damage inflicted upon individuals who carry this genetic error of metabolism [Ragsdale & Koch 1964; "Mental Deficiency. . ." 1961; see MENTAL RETARDATION]. Disulfiram in alcoholism. When it was noted accidentally that people who had been exposed to a certain chemical (disulfiram) reacted during a period of several hours with considerable discomfort, flushing, nausea, palpitation, and vertigo to any amount of alcohol they consumed afterward, this substance was soon introduced into the therapeutic armamentarium of psychiatrists for treatment of alcoholism. The mechanism of disulfiram consists of the blocking of an enzyme which is essential for the metabolic breakdown of products of alcohol in the body. Accumulation of acetaldehyde in the body causes unpleasant toxic effects if any alcohol is taken while the enzyme action is blocked by disulfiram. This drug can serve as a self-imposed chemical restraint for the problem drinker. As long as he takes it, he knows he cannot drink alcohol without rapidly producing an alarming reaction. If the patient is motivated well enough to take his medication regularly, this treatment can be a valuable aid in the comprehensive treatment program required for the psychiatric management of alcoholics [see DRINKING AND ALCOHOLISM]. Psychotropic drugs and neuroleptic effects. The latest chapter of somatic therapy in psychiatric disorders began in the early 1950s with the introduction of a new class of drugs. These drugs are designated as psychotropic or psychoactive substances, because their principal action is manifested in the realm of human behavior and experience. A whole new scientific discipline has

developed under the name of psychopharmacology. Its principal task is the study of psychoactive drugs [Lehmann 1963; see DRUGS]. Although psychoactive drugs are as old as civilization—alcohol, caffeine, and opium fall into this category-—the new type of psychoactive drugs, first systematically applied in 1951, was characterized by a particular quality which has been termed "neuroleptic" by the French psychiatrists Jean Delay and Pierre Deniker, who were pioneers in proving the value of pharmacotherapy in psychiatry. A neuroleptic drug is a substance which produces distinct neurological effects in addition to its psychotropic action. The neuroleptic action may manifest itself in various ways, but it appears most frequently in the form of extrapyramidal symptoms. Extrapyramidal symptoms may occur as drug-induced Parkinsonism, which is characterized by muscular rigidity, a masklike face, tremor, and a shuffling gait, or sometimes they may occur as severe muscular dystonia or akathisia—a term denoting motor restlessness, which makes it impossible for the patient to sit or stand still. Such a neuroleptic quality had never before been observed with any psychoactive drugs. In fact, there had been no experimental way of producing extrapyramidal symptoms consistently by pharmacological means. However, the neuroleptic action is only a side effect of the new drugs, whose principal action is their marked therapeutic effect on such psychotic symptoms as hallucinations, delusions, autistic thought-disorder, and psychotic stupor and withdrawal. For this reason, these drugs have often been referred to as antipsychotic or, more recently, as psychotostatic in their action. Up until a few years ago none of the clinically applied psychoactive drugs—mainly hypnotics, sedatives, and stimulants—had been effective in reducing specifically psychotic manifestations. In addition to their neuroleptic and their antipsychotic action some of the new drugs also possess an unusual sedative action which is characterized by their pronounced effect on psychomotor tension and agitation, without inducing any clouding of consciousness or impairment of cognitive processes. Until recently, clouding of consciousness and impairment of judgment had been almost synonymous with the notion of powerful sedation (Lehmann 1961; 1966). Although the name "tranquilizer" was given to these new drugs and became a popular label for them soon after they appeared on the clinical scene, when generally applied it may sometimes be a misnomer, since a number of the new drugs

MENTAL DISORDERS, TREATMENT: Somatic which possess neuroleptic and antipsychotic properties may not tranquilize, but, instead, exercise a mild stimulant action. Rauwolfia and phenothiazine derivatives. The first two substances which were clinically employed and systematically studied in the treatment of acute manic and schizophrenic psychoses were the rauwolfia and the phenothiazine derivatives. Rauwolfia derivatives are related to the principal active ingredient of the plant R. serpentina, which was used for centuries in India for the treatment of mental disorders. However, it was given in doses which today we would consider inadequate. The phenothiazine derivatives, on the other hand, are synthetic products of a systematic search by pharmacologists for certain compounds with pronounced effects on the central nervous system. The first rauwolfia derivative studied extensively in psychiatric patients was reserpine, and the first phenothiazine derivative was chlorpromazine. In the few years since their introduction into psychiatry a tremendous number of clinical and experimental observations has been reported, and a great number of other rauwolfia and phenothiazine derivatives with similar properties have been developed by the pharmaceutical industry. It has become evident that for clinical purposes the phenothiazine derivatives present the advantages of being more reliable and producing fewer undesirable side effects than the rauwolfia derivatives. The latter, however, still play an important role as standard drugs for certain psychopharmacological experiments. Evaluation of neuroleptics. Many of these new drugs have the particular tranquilizing effect which has been described above, and they do not, like most other sedatives, lead to addiction, even in predisposed individuals. All of the clinically applied neuroleptics counteract specific psychotic manifestations in acute mental breakdowns, and they were soon found to be effective therapeutic agents even in chronic psychotic states. A considerable number of regressed, chronic schizophrenics, some of whom had vegetated for ten or twenty years as hopeless human derelicts in the back wards of mental hospitals, responded to treatment with the new antipsychotic drugs, although they had previously failed to show any favorable response to repeated courses of insulin-coma and electroconvulsive treatment. The atmosphere of mental hospitals all over the world has changed rapidly since the new drugs were introduced, since treatment with phenothiazine derivatives often renders an acutely psychotic individual rational and cooperative within a matter

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of hours or days instead of weeks and months, as had been the rule prior to the drug era. As psychiatrists learned to employ the new tranquilizers it became possible to reduce violent and destructive behavior to a minimum. The construction of new hospitals has been profoundly influenced by these therapeutic developments in that facilities for seclusion and restraint are no longer considered to be essential features of every mental hospital. Perhaps the most important function of the new drugs is their role in the maintenance treatment of psychotic patients in remission. It is now possible to maintain a psychotic patient who has been rendered symptom-free through the use of antipsychotic drugs indefinitely in this compensated, and for all practical purposes, recovered state, provided the patient is carefully observed and continues to take antipsychotic medication regularly and in adequate doses. There are as yet no objective methods to determine which patients may eventually be able to discontinue maintenance medication and which will have to remain on it indefinitely. There are four therapeutic functions for neuroleptic drugs with antipsychotic or psychotostatic activity. The drugs may be used as: (1) symptomatic sedatives; (2) therapeutic agents in acute psychotic conditions; (3) therapeutic agents in chronic psychotic conditions; (4) maintenance agents in former psychotic patients in remission. Older somatic treatments had been known to provide sedation effectively (e.g., the barbiturates or scopolamine), and insulin-coma or electroconvulsive treatment was effective in acute psychotic conditions. However, there had been no therapeutic procedures which could promise any real hope for chronic schizophrenic patients, and there had never been any drug that could maintain former psychotic patients symptom-free. At least 70 per cent of all patients suffering acute schizophrenic breakdowns respond favorably to modern pharmacotherapy. Pharmacotherapy is simpler and at least as effective as insulin-coma therapy and consequently has replaced the latter in most psychiatric clinics today. Drug treatment of functional psychoses is neither merely symptomatic nor capable of curing the mental disease. The function of such treatment has been characterized as compensatory in nature. In this respect it resembles such therapeutic procedures as insulin treatment for diabetes or anticonvulsant therapy for epilepsy: as long as the treatment is administered the patient's symptoms will remain in abeyance. The drugs seem to counteract and neutralize the behavioral effects of a somatic substrate in psy-

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chotic conditions without, however, being able to eliminate this physical substrate. Today many different phenothiazine derivatives are used in the treatment of psychotic conditions— in particular in the therapy of schizophrenia. One "ay easily become confused by the many generic names and the innumerable trade names under which these drugs appear on the international markets. Common to most of them is the phenothiazine nucleus; their differences depend on the chemical structure of the side chain attached to this nucleus. Carefully controlled observations have shown that the therapeutic effectiveness of the great majority of phenothiazine derivatives appears to be roughly equal. The derivatives differ, however, in the dose which is required to produce therapeutic effects and also in the side effects which accompany their administration. Recently, another chemical class with neuroleptic and antipsychotic properties is being studied intensively—the butyrophenones. There seems to be little doubt that equally or more effective new psychotostatic drugs will be developed in the future. Other psychoactive drugs. While the mainstream of therapeutic activity has been going in the direction of treating psychotic manifestations, a number of new chemical substances with other interesting psychoactive properties have also been developed since 1955. These new drugs can be considered under three headings: (1) minor tranquilizers. (2) antidepressants, (3) psychotomimetics. Minor tranquilizers. Minor tranquilizers are sedatives which do not possess antipsychotic properties. In other words, they can sedate a tense and excited patient but they cannot counteract such specific psychotic manifestations in the cognitive and perceptual field as delusions, thought disorder, and hallucinations. Drugs which do have antipsychotic effects—for instance, phenothiazine or butyrophenone derivatives—are sometimes referred to as major tranquilizers. While a considerable number of new minor tranquilizers have appeared on the market, there is, so far, no convincing evidence that these new substances have accomplished anything that is essentiallv different from the achievement of the older well-known sedatives. Minor tranquilizers which are useful adjuncts to the treatment of anxiety and emotional tension are also characterized by the fact that they usually induce drowsiness and postural ataxia, exert an anticonvulsant action, and may lead to habituation and psychological addiction. In contrast, major tranquilizers do not induce postural ataxia, and only rarely do they induce persistent drowsiness. Major tranquilizers also tend to lower the brain's

convulsive threshold and they do not lead to habituation and addiction (Berger & Ludwig 1964). Antidepressants. The early hopes that the new stimulants (such as the amphetamines), which had been introduced in the 1930s, would be useful in the treatment of severe depressive states were not fulfilled. A depressed person is frequently in a state of heightened arousal, and giving him stimulants might only increase his anxiety and agitation without affecting the fundamental symptom of all depression—namely, the depressive mood. To fill the gap that existed in the pharmacotherapy of mental disorders characterized by depression, another type of psychoactive substance was developed a few years after the discovery of the psychotostatic drugs (major tranquilizers)—the antidepressant drugs (Lehmann 1965). These may be divided into two major groups: (1) the mono-amine-oxidase inhibitors, (2) antidepressants with no mono-amineoxidase inhibiting activity—also referred to as tricyclic antidepressants. Mono-amine-oxidase is an enzyme which degrades the so-called neurohormones, nor adrenalin and serotonin. There is indirect clinical and experimental evidence that the distribution and balance of these neurohormones in the brain is significantly related to emotional states. It has been observed clinically that chemical substances which inhibit mono-amine-oxidase and thereby allow noradrenalin and serotonin to build up in the brain may successfully reduce the duration of a depression from several months or years to a period of three or four weeks. While this observation has provided a pharmacological model in the systematic search for new antidepressant drugs, the mono-amine-oxidase inhibitor model certainly does not account in full for the physical substrate of depressive states, since a number of other substances with no enzyme inhibiting activity but a close chemical resemblance to the phenothiazines have proved to be equally effective in the treatment of severe depression. Our knowledge of the specific indications for each type of antidepressant—for instance, which should be prescribed for reactive depressions and which for endogenous, agitated, or retarded depressive states —is still incomplete. Nevertheless, antidepressant drug therapy represents a considerable step forward in psychiatric treatment, and antidepressant drugs are effective in about 60 per cent of all depressive conditions. This reduces the number of patients who otherwise would have to be given electroconvulsive therapy. It takes from one to three weeks for antidepressant drugs to manifest their therapeutic action, and they

MENTAL DISORDERS, TREATMENT: Somatic are, therefore, slower acting than the antipsychotic drugs. Some, but not all, antidepressants have stimulating effects. The mono-amine-oxidase-inhibiting drugs tend to produce mild euphoria, while the tricyclic antidepressants that do not inhibit monoamine-oxidase merely eliminate depressive symptoms without inducing euphoria. Like many other psychoactive drugs, antidepressants frequently produce side effects; the monoamine-oxidase inhibitors are particularly prone to do this. It is interesting to note that all effective antidepressants may potentiate psychotic symptoms—for instance, hallucinations and delusions —and may sometimes even induce a toxic psychotic state. Recently, the distinction between antipsychotic and antidepressant drugs, which at first appeared to be quite clear-cut, has lost some of its sharpness. There are depressed patients, particularly the anxious depressed, who respond to major tranquilizers, and there are schizophrenic psychotics who respond favorably to antidepressants. Patients who respond in this different manner cannot yet be clearly distinguished in advance from the patients who show average response tendencies. Psychotomimetics. Psychotomimetics are drugs which experimentally induce states of psychotic disintegration accompanied by thought-disorder and perceptual disturbances. Some representatives of this class of drugs have been known for a considerable time—for instance, marijuana, an ingredient of the hemp plant, and mescaline, the active component of the Mexican peyote cactus (Unger 1963). Other psychotomimetic substances have been developed more recently—for instance, lysergic acid diethylamide, a synthetic ergot compound, and psilocybin, which is derived from Mexican mushrooms. These strange substances have received a great deal of public attention in recent years and have stirred up considerable controversy. Preliminary clinical trials with some of the psychotomimetics, or hallucinogens as they are sometimes called, suggest that they may prove to be useful in the treatment of alcoholism and character disorders. However, these results will have to be confirmed, and a methodology for systematic therapy with these substances still needs to be developed. In the meantime, these substances provide interesting tools for the experimental study of the Psychotic process, since it is possible to induce "model psychoses" in volunteer subjects, who will, for a period of hours, undergo experiences which seem to be closely related to the experiential world of the schizophrenic. Unfortunately, these chem-

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icals, which, like any powerful drug, carry a dangerous physical potential, have become a rallying issue of almost political importance for a small but vociferous group of intellectuals who claim the right to administer these drugs to themselves and to others according to their own, nonmedical judgment. It appears that under the influence of such substances, states of ecstatic exaltation can be fairly easily induced. Viewed in an objective clinical and psychopharmacological perspective, the development, understanding, and administration of psychotomimetic drugs must be judged to be still in the experimental stages. Prolonged sleep treatment In 1922 Klaesi introduced prolonged sleep therapy into the therapeutic armamentarium of the psychiatrist (Klaesi 1922). This treatment method, which consisted of keeping patients asleep with the help of hypnotic drugs throughout most of the day for a period of several weeks, has held its place in the treatment of certain psychiatric conditions. Originally introduced for the treatment of schizophrenia, depressions, and manic states, it is now mostly given to patients suffering from long-standing psychoneuroses and psychosomatic conditions. It is particularly popular with psychiatrists in Soviet Russia, where Pavlov's teachings determine the basic theoretical approach to psychiatry. In Pavlov's conceptual framework, prolonged sleep is viewed as a form of protective inhibition that can successfully counteract the pathological excitation of the higher central nervous processes that manifest themselves as symptoms of pathological behavior. A variety of hypnotic and sedative drugs are used for sleep therapy. They are given at regular intervals either by mouth or by injection. This therapy does not produce any unpleasant experiences for the patient, but it requires careful, continuous nursing care in order to avoid circulatory collapse or other untoward effects in the patient, who has to be kept inactive for long periods of time. [See SLEEP.] The use of sleep-producing drugs in psychiatric patients may be variously determined according to the different theoretic orientations of the therapist. While the Russian psychiatrists think in terms of physiological protective inhibition, a psychiatrist from the West may be more interested in the psychodynamic aspects of sleep therapy—e.g., disinhibition, abreaction, or anaclitic dependency. Another method of inducing therapeutic sleep makes use of a rather weak continuous electrical current that is passed through the brain and produces relaxation and sleep which may be sustained

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for several hours without eliciting pain, shock, or convulsions. As with drug-induced prolonged sleep, Russian psychiatrists invoke the concept of protective inhibition for this kind of electrically induced alteraH .on of consciousness, and the therapeutic procedure is more widely employed in countries in the Russian sphere of influence than in Western countries. However, neither its technical application nor its therapeutic effects are as reliable as electroconvulsive treatments. Recent claims for success with electrically induced sleep are made mainly for neurotic states and for a variety of psychosomatic disorders (see Clapp & Loomis 1950; Giljarowskii et al. 1956; Wageneder & Hafner 1965). Shock therapies A new era of somatic therapy in mental disorders began around 1935 with the discovery of two types of physiological shock therapy: (1) the hypoglycemic coma treatment, or insulin-shock therapy, developed by Sakel, a young German psychiatrist; and (2) the convulsive therapy, or pentylenetetrazol-shock treatment, developed by Meduna, a psychiatrist at the University of Budapest. Sakel started his experiments two years prior to Meduna's (Kalinowsky & Hoch 1961; Sakel 1958; Meduna 1935). Insulin-coma treatment. The principle of insulin-shock treatment lies in the production of the deep coma that results from a severe lowering of the blood-sugar level following an injection of insulin. The brain depends for its metabolism mainly on carbohydrates. A reduction of the blood-sugar supply, therefore, lowers brain metabolism relatively more than that of any other organ. Sakel had been treating patients addicted to morphine with small doses of insulin as a relief measure during their withdrawal from the narcotic; he observed that sometimes they had inadvertently slipped into a deep coma and after having been aroused from it had appeared much improved. He was an imaginative man who, without much other justification, generalized from these specific observations to the bold hypothesis that schizophrenic patients would benefit from hypoglycemic coma therapy. He was also a courageous man, for, at that time, a coma produced by an overdose of insulin was still considered to be a dangerous complication. At any rate, in 1933 Sakel presented his first promising report with insulin-coma therapy in one hundred schizophrenic patients from the University Clinic of Vienna. His findings were soon confirmed in other European countries, and the treatment was rapidly adopted all over the world. It constituted

the first effective major therapeutic advancement in the management of schizophrenia (Sakel 1958). Insulin-coma therapy of schizophrenia is most effective in patients who have been sick for not more than six months to a year. After this time it rapidly loses its effectiveness. Patients have to be treated in specially equipped hospital units for several months. They receive an injection of insulin while in the fasting state early in the morning. Within one to two hours they fall asleep and eventually go into a deep coma from which, at the end of three or four hours, they are aroused by an injection of glucose into the blood stream or by the infusion of a sugar solution into the stomach. A recent refinement of technique consists in the administration of glucagon, a substance which rapidly mobilizes available carbohydrate stores in the body and, therefore, reduces the need for large amounts of sugar to be administered through intravenous injection or stomach tube. The amount of insulin required for each patient to induce coma differs considerably and might change from day to day. The medical and nursing staffs administering insulin-coma treatment have to be well trained and experienced. Usually not more than ten or twenty patients can be treated on any one day. All these factors make the treatment a rather expensive procedure which requires considerable vigilance on the part of the staff and is by no means entirely without risk. Nevertheless, in competent hands, insulin treatment produces 70 per cent to 75 per cent remissions in acute schizophrenia, and it was the favored treatment for this disease until the advent of pharmacotherapy. Subcoma insulin treatment. A modification of insulin-coma therapy consists of the administration of smaller doses of insulin, which will produce a state of lowered blood-sugar level (hypoglycemia) without, however, bringing about a deep coma. The patients are rendered sleepy, and a state of deep relaxation is produced. At the termination of each treatment—which lasts from two to three hours with the patient lying quietly in a darkened room—the patient feels hungry but relaxed. A course of subcoma insulin treatment usually lasts for several weeks. Indications for this type of therapy are conditions of neurotic anxiety and increased tension. Patients often respond to the treatment with improved sleep, gain of weight, a feeling of increased well-being, and a reduced need for sedatives. Drug-induced convulsive treatment. Insulinproduced hypoglycemia sometimes leads to convulsions. It had been observed that patients often

MENTAL DISORDERS, TREATMENT: Somatic appeared to improve more rapidly after they had had a convulsion. Meduna theorized that there existed a biological antagonism between epilepsy and schizophrenia because these two diseases do not often occur simultaneously in the same patients. He had transfused schizophrenic patients with the blood of an epileptic and vice versa, hoping to see an improvement in the patients treated in this manner. When he obtained no results, he conceived of the idea of producing epileptiform convulsions in schizophrenic patients by injecting them intramuscularly with camphor in oil. Later he used the synthetically produced drug pentylenetetrazol, instead. This drug is water soluble and can be injected into a vein. When this is done the patient experiences for a short time an agonizing state of apprehension and panic and then, within a minute or two, loses consciousness and has a typical epileptiform convulsion of the grand mal type. The treatment is given every other day until a series of 10 to 25 or more convulsions has been produced. With his first group of schizophrenics treated with pentylenetetrazol, Meduna could report almost 90 per cent remissions. However, a considerable number of patients relapsed within a few weeks, and the over-all results of pentylenetetrazol-convulsive treatment in schizophrenia were not quite as favorable as those obtained with insulin-coma therapy. Often the two treatments could be combined for best results (Meduna 1935). It did not take long before it became evident that convulsive therapy was highly effective in depressive states—in fact, more so than in schizophrenia—and in the treatment of severe depression convulsive therapy still plays an important role. Electroconvulsive treatment (ECT). In 1938 Cerletti and Bini in Rome treated a patient with an improved modification of the convulsive treatment method, namely with convulsions produced through the application of an electrical current instead of the administration of convulsant drugs (Cerletti 1950). This method soon supplanted the pentylenetetrazol treatment, since it was simpler and, above all, did not produce the unpleasant subjective effects of the drug. A patient who receives electroshock therapy may remain comfortably in his own bed. Two electrodes are applied to the temples, and even if no anesthetic is given the Patient never feels any pain, since the passage of the current—about 100 volts for 0.3-0.5 secondscauses immediate loss of consciousness. After regaining consciousness the patient might remain rather confused for thirty minutes to an hour. A depressed person usually begins to show defi-

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nite improvement after the first four or five treatments, but additional treatments are required to prevent a relapse of depressive symptoms. Six to twelve treatments—administered over a period of two to four weeks—are the usual number for a course of ECT in acute depressions. If electroshock therapy is given to schizophrenic patients, twenty or more treatments are usually administered. After three to five electrically induced convulsions, one observes a change in the patient's electroencephalogram in the direction of a general slowing of the electrical brain rhythms. At about the same time the patient develops an acute amnestic syndrome. He shows impairment of recent memory, and after a large number of treatments— or also if treatments are given at closely spaced intervals, for instance, every day or several times a day—the patient might become greatly confused. Sometimes such confusion is deliberately induced in the course of "regressive" or "depatterning" shock therapy, in the hope that the complete shattering of the patient's mental processes will be followed by a reconstitution and reintegration of his mental functioning but with a selective permanent destruction of the more recently acquired pathological manifestations [Cameron et al. 1962; see ELECTROCONVULSIVE SHOCK]. Within two to four weeks after discontinuation of electroshock therapy, memory functions and electroencephalographic indices tend to return to their normal levels. Although the human organism is able to tolerate convulsions amazingly well at any age, in elderly persons there is some danger of either producing or triggering off permanent impairment of memory due to physical brain changes. The aged are, of course, already predisposed to such organic brain damage. In younger persons there seems to be little or no danger of any permanent brain damage due to electroconvulsive treatment. Several modifications of the standard treatment method have been proposed, mostly with the intention of reducing confusion and amnesia following ECT. One of the most promising is the unilateral application of the current, which seems to produce less memory impairment than the standard method (Cannicott 1962). It has been demonstrated that the induction of paroxysmal seizure discharges in the brain is the essential factor in electroconvulsive therapy. All muscular, autonomic, and metabolic responses which can be observed during and after the convulsions seem to be secondary and carry little or no therapeutic value.

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The violent muscular contractions which accompany the seizure discharges of the brain can easily lead to fractures of the vertebrae or of other bones in the trunk or the extremities, and for this reason electroconvulsive therapy today is almost always preceded by the administration of a muscle relaxant—either curare or one of its analogues, or more frequently, succinylcholine—which is injected into a vein together with a short-acting barbiturate to produce a superficial anesthesia as well as muscular relaxation. Immediately following these injections artificial respiration is established for a few minutes; the electrical shock is administered; and the convulsion ensues. However, suppressed by the muscle relaxant, the convulsion consists of hardly more than a flickering of the eyelids or a movement of the toes, although the electrical and physiological effects on the brain are not essentially altered. Electroshock therapy, which should be referred to as electroconvulsive therapy (ECT), is today the most reliable treatment of severe depressive states. It produces favorable results in about 90 per cent of the cases, while treatment with antidepressant drugs is effective only in about 60 per cent of depressive conditions. Electroconvulsive treatment is most successful in involutional melancholia, an endogenous depressive condition usually associated with agitation and occurring in patients of the involutional age, i.e., between forty and sixty years. Electroconvulsive treatment is less effective when marked anxiety or many hypochondriacal symptoms are associated with the depressive state. While ECT is still the most reliable treatment for severe depressive states and is also often remarkably effective in states of acute psychotic excitement or schizophrenic disintegration, it should be clearly understood that this type of therapy does not seem to influence the long-term development of a psychopathological process. Various studies have shown that ECT does not prevent depressive or psychotic relapses; nor does it seem to reduce the number of such relapses or prolong the normal intervals in recurrent mental diseases. The main value of this dramatic therapy lies in the fact that it leads to a rapid disappearance or amelioration of depressive or psychotic symptoms and that it may reduce the duration of a severe depression from nine to twelve months to three to six weeks, Although most manic-depressive episodes terminate eventually in spontaneous recovery, the everpresent danger of suicide in depressed patients can be eliminated with ECT, and the value of saving a patient a great deal of unnecessary suffering and

restoring him early to useful functioning in the community is, of course, sufficient justification for employing this kind of therapy whenever it is indicated as the most suitable therapeutic approach. If the mental disease is not of a periodic nature, as in manic—depressive psychosis, but tends to be chronic, as for instance, schizophrenia, then ECT is much more limited in its value, because although regular repeated maintenance treatment with ECT is possible, it is more hazardous and not as practical as the continuous suppression of psychotic symptoms with pharmacotherapy. Psychosurgery In 1936, almost simultaneously with the introduction of the shock therapies, another dramatic somatic therapy was introduced into psychiatry by the Portuguese neuropsychiatrist Antonio Egas Moniz—the surgical procedure of prefrontal lobotomy. Basing his work on accumulated data from neurophysiological and experimental psychological research, Moniz theorized that the frontal lobes were essentially related to the higher mental processes, which were necessary components of normal cerebral and behavioral functioning. In particular, certain processes of abstraction, inhibition, and time projection had been thought to find their representation in the frontal and prefrontal lobes. Moniz severed the connections between the frontal lobes and the thalamus through small cuts of the fiber tracks responsible for these connections. He showed that his operation was often followed by improvement, particularly in early schizophrenia but also in chronic states of depression or in obsessive-compulsive ruminations that had not yielded to any other treatment. [See NERVOUS SYSTEM, article on STRUCTURE AND FUNCTION OF THE BRAIN; OBSESSIVECOMPULSIVE DISORDERS.] This operation is not followed by any deterioration of intellectual performance, but it leads to a marked reduction in the intensity of the person's emotional involvement, imagination, and creative productivity. If an insufficient amount of brain substance is cut there will be no adequate relief of symptoms. If exactly the right amount of brain substance is destroyed, the therapeutic result might enable the patient to function better after the operation than he ever functioned before. If the surgeon destroys too much brain substance, the patient might develop into an apathetic slob or an irresponsible psychopath, being left either without ambition or without any consideration for others. Unfortunately, it is not possible to calculate precisely where and how much to cut. However, a

MENTAL DISORDERS, TREATMENT: Somatic great deal of progress has been made in perfecting this particular neurosurgical procedure, so that the probability of a good therapeutic response is heightened and the probability of personality deterioration is minimized. Most of the results with this kind of therapy were collected in the United States prior to 1955 and particularly in Britain, where the interest in prefrontal lobotomies still persists and is probably higher than anywhere else. On the North American continent interest in psychosurgery has sharply declined since the introduction of modern drug therapy for mental disorders. There are probably two principal reasons for the disinclination of most American psychiatrists to submit their patients to a prefrontal lobotomy or to any other type of surgical interference with the brain: (1) Since neurons cannot regenerate, any artificially produced morphological changes in the brain—in particular any loss of substance—would be irreversible; (2) Several careful follow-up studies have brought out evidence that marked personality changes supervened eventually in almost all lobotomized patients, even if the therapeutic gain outweighed the personality deficit due to the operation (Greenblatt et al. 1950; Petrie 1952; Rylander 1939). One general consequence of a prefrontal lobotomy is a certain loss of subtleness and complexity in the patient's personality; he usually loses some of his creative imagination; he dreams less; and his dreams tend to become much simpler in structure; and on the whole he becomes less sensitive. However, for intractable conditions of chronic depression or for chronic obsessive-compulsive psychoneurosis which has been refractory to any other type of therapy, prefrontal lobotomy would still have to be seriously considered as a last resort, which, nevertheless, may often yield surprisingly good results. Mechanisms of action The rationale for a therapeutic procedure is easily understood if the etiological factors of the condition to be treated are known and if the treatment is specifically aimed at eliminating these etiological factors. This would apply to the modern penicillin treatment of general paresis, which kills the trepanoma pallidum and thus eliminates the causal factor of syphilis, which in turn is responsible for the psychosis. But the modus opcrandi °f Wagner-Jauregg's malaria treatment of general Paresis was not so easily understood because it c °nstituted an unspecific attack on the disease, and a number of theories have been proposed to exPlain its effect. It was thought, for instance, that

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the physical hyperthermia factor produced by malaria might kill the trepanoma pallidum, and it was also put forward that malaria therapy was effective because it mobilized general biological defenses in an unspecific manner, thus enabling the organism to deal successfully in its own way with the brain disease. Many theories have been offered to explain the therapeutic action of insulin-coma treatment, ranging from a conception of reduced cerebral metabolism, which is equivalent to partial anoxia, to the idea that the artificially induced regression of the patient to an infantile level and the nursing care he is receiving during the coma treatment from doctor and nurse constitute a re-enactment of the patient's infantile situation without the traumatic factors which supposedly prevailed originally in his infancy. Theories to explain the effects of electroconvulsive treatment also involve physical and psychodynamic concepts and range from neurophysiological, biochemical, and endocrinological hypotheses to the proposal that the induced amnesia is responsible for the "unlearning" of recently acquired pathological behavior patterns and also to the suggestion that the patient experiences symbolic death and resurrection under the magic influence of the doctor administering the treatment. There is no generally accepted theory for the action of modern psychopharmacological agents. It has already been mentioned that the therapeutic action of one group of antidepressants, namely the mono-amine-oxidase inhibitors, has been explained on the basis of competitive affinity of the drug and hormones to essential receptor sites on an enzyme. The neuroleptic major tranquilizers seem to act on the brain's reticular activating system, the diencephalon, and the extrapyramidal system and possibly produce their effects through an influence on synaptic transmission in the subcortical structures of the brain. Minor tranquilizers apparently affect more prominently the cerebral cortex and parts of the limbic system in the subcortical structures. The action of psychotomimetics still poses a very puzzling phenomenon: these drugs may lead to desynchronization and imbalance between the transmission of impulses through the primary sensory paths and their processing through the associative systems of the brain. Treatment practices in clinical psychiatry A general principle may be formulated, stating that somatic treatment is the primary therapeutic approach to the psychoses, with psychotherapy playing an auxiliary role, and that psychotherapy

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is the primary therapeutic approach to the psychoneuroses, v;ith somatic treatment serving as an adjutant (Kline & Lehmann 1962). This would mean that the treatment of psychoses is less complex and demands less personal skill and experience from the therapist than the treatment of psychoneuroses. The recently developed pharmacotherapy of schizophrenia, manic states, and depressive conditions makes it now possible for a nonspecialist physician to treat a psychotic patient successfully outside a mental hospital. This is of particular significance for the organization of psychiatric services in underdeveloped countries, where the impossibility of constructing mental hospitals and finding enough well-trained specialists has prevented the build-up of such services until now. That modern pharmacotherapy can indeed provide the nucleus for a successful psychiatric service organization in a country where such services were nonexistent before has been demonstrated in Haiti, where a wellfunctioning psychiatric clinic with preventive, therapeutic, and rehabilitative functions has recently been set up within a short time and at minimum expense of financial means and trained manpower. Such shortcuts have become possible only since rapidly effective and self-administered therapeutic agents that can also maintain the patient symptom-free following the acute treatment phase have been made available in the form of antipsychotic and antidepressant medication. Ready availability, ease, and continuity of administration are the main advantages of drug treatment over insulin-coma and electroconvulsive therapy. Insulin-coma therapy, although still a valuable treatment for schizophrenic patients who do not respond to drug therapy, is no longer given at most psychiatric treatment centers because the necessary, specially equipped insulin-treatment units have been dissolved. Electroconvulsive treatment is simple to administer but also requires some special apparatus and technical skill on the part of the therapist; besides, it cannot be given continuously because of its cumulative effects on a patient's memory. However, it is still widely used in the treatment of acute or chronic manic or schizophrenic psychoses, particularly when they do not respond to drug therapy. Prefrontal lobotomy—sometimes also referred to as leucotomy— is rarely performed today except in cases manifesting depressive or obsessive—compulsive symptoms which have failed to respond to any other treatment. Pharmacotherapy has in many instances replaced these older methods of somatic treatment. Different national cultures seem to have shaped

different therapeutic attitudes, and in certain countries preferences and dislikes for particular modes of treatment are clearly evident. In a very broad sense it may be stated that psychiatric orientation on the North American continent is characterized by a much heavier bias toward a psychodynamic—more specifically, Freudian psychoanalytic—approach to theory and practice than psychiatry in other parts of the world. European schools of psychiatry place more emphasis on genetic-constitutional and physicochemical factors in their speculation on the etiology of mental disorders as well as in their clinical approach to them. In the Soviet Union, psychosurgery, in the form of prefrontal lobotomy, has been officially ruled out as a permissible treatment method. In Britain, on the other hand, there is still greater interest in this type of therapy than in most other countries. In German-speaking countries, where the influence of an existentialist orientation is fairly strong, electroconvulsive therapy seems to be disliked— possibly because of the radically disrupting effect such treatment has on the continuity of a patient's orientation toward his problems and his experience of the world in which he lives. In countries where psychiatric services must be created de novo, the practical advantages and the comprehensive effectiveness of modern pharmacotherapy have made it the favorite choice of somatic treatment for mental disorders. It should again be recalled that the undoubted effectiveness of modern somatic treatment applies only to psychotic disorders, in particular to those of functional origin. Physical methods, including drug therapy, are of very limited value for the therapeutic management of psychoneuroses and character disorders. In accordance with modern concepts one may view mental disorders as the resultants of multifactorial functions and forces. The complex factors interacting with each other may be categorized under the headings: (1) genetic factors—constitutional personality matrix, idiosyncratic and, within wide limits, independent of time; (2) situation al factors—idiosyncratic and time-dependent; (3) physicochemical factors—general and independent of time. Somatic treatment of mental disorders is aimed only at the physicochemical sector of the human behavioral complex. The indirect repercussions of physical treatment may, however, bring about a change of balance in the entire organism and thus result in therapeutic effects which seem to go f ar beyond simple physical changes, HEINZ E. LEHMANN

MENTAL DISORDERS, TREATMENT: Therapeutic Community [Other relevant material may be found in DEPRESSIVE DISORDERS;

DRUGS;

ELECTROCONVULSIVE

SHOCK;

NERVOUS SYSTEM, article on STRUCTURE AND FUNCTION OF THE BRAIN; NEUROSIS; PSYCHIATRY; PSYCHOSIS; SCHIZOPHRENIA.] BIBLIOGRAPHY BERGER, F. M.; and LUDWIG, B. J. 1964 Meprobamate and Related Compounds. Volume 1, page 103 in Maxwell Gordon (editor), Psychopharmacological Agents. New York: Academic Press. CAMERON, D. E.; LOHRENZ, J. G.; and HANDCOCK, K. A. 1962 The Depatterning Treatment of Schizophrenia. Comprehensive Psychiatry 3:65-76. CANNICOTT, S. M. 1962 Unilateral Electro-convulsive Therapy. Postgraduate Medical Journal 38:451-459. CERLETTI, UGO 1950 Old and New Information About Electroshock. American Journal of Psychiatry 107: 87-94. CLAPP, JOHN S.; and LOOMIS, EARL A. 1950 Continuous Sleep Treatment: Observations on the Use of Prolonged, Deep, Continuous Narcosis in Mental Disorders. American Journal of Psychiatry 106:821-829. F0LLING, A. 1934 Excretion of Phenylpyruvic Acid in Urine as Metabolic Anomaly in Connection with Imbecility. Nordish medicinsk tidskrift (Stockholm) 8: 1054-1059. GILJAROWSKII, VASILII et al. 1956 Elektroschlaf. Berlin: VEB Verlag Volk und Gesundheit. G JESSING, L.; BERNHARDSEN, A.; and FR0SHAUG, H. 1958 Investigation of Amino Acids in a Periodic Catatonic Patient. Journal of Mental Science 104:188-200. GREENBLATT, MILTON; ARNOT, ROBERT; and SOLOMON, HARRY C. (editors) 1950 Studies in Lohotomy. New York: Grune. HAISCH, ERICH 1959 Irrenpflege in alter Zeit. Ciba-Zeitschrift 8, no. 95:3142 only. KALINOWSKY, LOTHAR B.; and HOCH, PAUL H. 1961 Somatic Treatments in Psychiatry. New York: Grune & Stratton. KLAESI, J. 1922 Uber die therapeutische Anwendung der "Dauernarkose" mittels Somnifen bei Schizophrenen. Zeitschrift fur die gesamte Neurologic und Psychiatric 74:557-592. KLINE, NATHAN S.; and LEHMANN, H. E. 1962 Handbook of Psychiatric Treatment in Medical Practice. Philadelphia: Saunders. LEHMANN, H. E. 1961 New Drugs in Psychiatric Therapy. Journal of the Canadian Medical Association 85: 1145-1151. LEHMANN, H. E. 1963 Psychopharmacology: A Discussion of Current Problems. Ohio State MedicaZ Journal 59:1091-1097. LEHMANN, H. E. 1965 The Pharmacotherapy of the Depressive Syndrome. Journal of the Canadian Medical Association 92:821-828. LEHMANN, H. E. 1966 Pharmacotherapy of Schizophrenia. Pages 388-411 in American Psychopathological Association, Psychopathology of Schizophrenia. Edited by Paul Hoch and Joseph Zubin. New York: Grune. LOEVENHART,

ARTHUR

S.;

LORENZ,

WILLIAM

F.;

and

WATERS, RALPH M. 1929 Cerebral Stimulation. Journal of the American Medical Association 92:880882. MEDUNA, L. J. 1935 Versuche iiber die biologische Beeinflussung des Ablaufes der Schizophrenic. Part 1:

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Campher- und Cardiazolkrampfe. Zeitschrift fur die gesamte Neurologie und Psychiatrie 152:235-262. Mental Deficiency and Phenylketonuria. 1961 Journal of the American Medical Association 178:838 only. MYERSON, ABRAHAM 1936 Effect of Benzedrine Sulphate on Mood and Fatigue in Normal and Neurotic Persons. Archives of Neurology and Psychiatry 36:816-822. PETRIE, ASENATH 1952 Personality and the Frontal Lobes: An Investigation of the Psychological Effects of Different Types of Leucotomy. Philadelphia: Blakiston. RAGSDALE, N.; and KOCH, R. 1964 Phenylketonuria Detection and Therapy. American Journal of Nursing 64, no. 1:90-96. RYLANDER, GOSTA 1939 Personality Changes After Operations on the Frontal Lobes. Acta psychiatrica and neurologica Supplement 20. SAKEL, MANFRED 1958 Schizophrenia. New York: Philosophical Library. TAPPAN, PAUL W. 1951 Treatment of the Sex Offender in Denmark. American Journal of Psychiatry 108:241— 249. UNGER, SANFORD M. 1963 Mescaline, LSD, Psilocybin and Personality Change: A Review. Psychiatry 26: 111-125. WAGENEDER, F. H.; and HAFNER, H. 1965 Elektroheilschlaf: Eine neue Therapieform. Anaesthesist 14:126129. WAGNER-JAUREGG, JULIUS VON 1946 The History of the Malaria Treatment of General Paralysis. American Journal of Psychiatry 102:577-582. -> A translation by Walter L. Bruetsch of an earlier manuscript by Wagner-Jauregg. What Tranquilizers Have Done. 1964 Time April 24: 43-44. WOOLLEY, D. W. et al. 1938 Anti-black Tongue Activity of Various Pyridine Derivatives. Journal of Biological Chemistry 124:715-723. ZILBOORG, GREGORY 1941 A History of Medical Psychology. New York: Norton. VI THE THERAPEUTIC COMMUNITY

The term "therapeutic community" designates a method of treatment which attempts to use a hospital's social environment as an integral part of the treatment approach. It belongs to the general approach often referred to as "milieu therapy." As such, it is related to the field of social psychiatry, which attempts to incorporate sociocultural perspectives into psychiatry. The first use of the term "therapeutic community" was by Thomas Main (1946) in his description of the experimental units developed during World War H in England for the treatment of various kinds of wartime psychological casualties. The felicitous phrase, mentioned almost casually in Main's report, was picked up and made into a selfconscious, organizing concept in the work of Maxwell Jones (1952), with whose name the concept is generally associated. Although the idea of the therapeutic community was forged in the exigencies of war, it was devel-

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oped to its fullest elaboration in its postwar applications. In essence, it represents a critique of prior psychiatric theories and practices in that it advocates radical changes in psychiatric hospitals to make them therapeutic rather than merely custodial or even psychologically damaging, and it is based on a new combination of ideas that have emerged from psychoanalysis and the social sciences. Accordingly, it is important to consider the complex of ideas associated with the term "therapeutic community" in the context of an appreciation of its precursors both in and out of psychiatry in Europe and America. There are two sets of precursors: those against which the therapeutic community idea represented a protest and those from which it drew its own creative elements. Characteristics of therapeutic communities There have been numerous attempts to find a quintessential definition of the therapeutic community idea as it has evolved and been applied in various settings (e.g., Jones 1952; Jones & Rapoport 1955; Rapoport et al. 1961; Research Conference . . . I960; Schwartz et al. 1964). A number of key ideas are distinguishable that differentiate the therapeutic community approach from other forms of milieu therapy or administrative psychiatry. Some or all of the elements described below are employed in units designated as therapeutic communities. In any given setting, these elements may be part of a focal treatment method, they may be secondary elements with other methods more focally applied, or they may be a part of the general background or atmosphere against which various methods may be applied. The holistic view. Conceptualizing the organization in system terms, according to a "holistic" view of the entire hospital or unit, is an integral part of most therapeutic community ventures. As the concept suggests, the hospital or unit is seen as a "community," of more or less closed corporate character. The emphasis is on understanding how behavior is affected by and affects the over-all functioning of the hospital as a. social system. This element of the therapeutic community idea is taken to contrast with the tendency of the old-fashioned mental hospital (with its associated theories emphasizing constitutional determination and therapeutic pessimism) to regard individual patients in depersonalized, asocial, atomistic terms. By conceptualizing the hospital as a special type of community in which the patient can be helped, therapeutic community practitioners seek, at the very least, to sustain a social definition of the nature of the patients' conditions and potentialities. They

hold that this social definition is a prerequisite of therapeutic effectiveness. The new community in the hospital is seen as belatedly providing a "good" substitute for the earlier pathogenic environment in which the patients' socially unadaptive tendencies developed. Identification with the hospital community is seen as a steppingstone to identification with society at large. Permissiveness. In contrast with the restrictive environment of the old-fashioned mental hospital, which was prisonlike or even punitive in character, the therapeutic community allows patients to express themselves relatively freely, even if this means the enactment of behavior that would be morally repugnant in ordinary settings. The degree to which this "acting out" can be tolerated is, of course, limited by several factors: the capacity of the institution to endure disruptive behavior, the exercise by the staff of their responsibilities for the care and protection of their patients, and the degree to which the expressive behavior may be taken to be in the interests of therapy. But some degree of permissiveness has become a hallmark of the therapeutic community. Underlying the application of permissiveness is the theoretical viewpoint that psychiatric disorder is the manifestation of maladaptive responses to earlier situations which have formed a covert, often unconscious framework for the individual's contemporary behavior. Success in attempting to change the latter is seen as depending, to some extent, on uncovering the former. Permissive standards of patient role prescription thus create a deliberate, rather than a careless, set of ambiguities in the structuring of hospital role relationships. The hospital social structure can, in this context, be seen to act somewhat as a "social screen" onto which patients project their covert behavioral tendencies; these tendencies can then be subjected to group analysis. In addition, involvement of patients in one another's treatment responsibilities helps the staff to allow more permissiveness by providing a more diffuse base of social controls. Increasing patient participation. In old-fashioned mental hospitals the patients were treated as objects, led passive lives removed from ordinary social activities, and had little or no voice in the conduct of the affairs of the institution in which they lived. In therapeutic communities, by contrast, patient participation is encouraged. This trend seems to have several components: "democratization," which implies the increase of patient participation in policy decisions relating to the general administration of the organization (for example* by patient government); "egalitarianism," which

MENTAL DISORDERS, TREATMENT: Therapeutic Community implies a reduction of status differentiation between staff and patients, with an emphasis on sharing of the facilities and resources of the institution (usually accompanied by the use of familiar terms of address, the forgoing of titles, uniforms, etc.); and "harnessing of patients for therapy" through attempts to use their intimate knowledge of one another, their communications, and insight potentials (for example, by the emphasis on group therapy sessions as a major treatment method). Broadening the base of therapy. In the therapeutic community a broader range of activities, relationships, and qualities of the patient's environment are considered relevant to the course of his treatment. Conventional medical thinking has always defined treatment in terms of what the doctor does—giving an injection, applying electrical shock therapy, or even subjecting the patient to "analysis" in a therapeutic "hour." Proponents of the therapeutic community, however, recognize that many experiences, relationships, and characteristics of the patient's life in the hospital can have a critical effect on his treatment. Activities previously thought of as purely diversionary or recreational have come to be seen as part of a program of treatment, and subordinate ranks of hospital personnel have become important links in the human communications network through which treatment is provided. Likewise, patient roles which had been seen as relatively unimportant or even troublesome, such as the leader of an informal patient clique, have become parts of the organizational and interactional process which therapeutic community practitioners seek to harness for therapy. Rehabilitation. Another feature of therapeutic communities is their orientation toward patient rehabilitation, which is based on an optimistic view of therapeutic potentialities. Therapeutic communities seek to reproduce within the hospital a microcosm of the ordinary world of the patient so as to enhance the possibilities for rehearsing social roles while still in the hospital. Thus there is an emphasis on training or retraining individuals to take social roles outside the hospital, not by forcing conformity to ordinary role requirements but, rather, by providing the opportunity for learning what kinds of problems interfere with the individual's capacity to perform acceptably in these roles. This emphasis is seen in the development of "realistic" workshops in the hospital and in the tendency to confront patients continually with others' perceptions of their behavior. This optimistic view of rehabilitation is reflected in what has come to be known as a "therapeutic atmosphere," which to some extent consists of a

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series of new attitudes toward the patient and the hospital. These attitudes emphasize, for example, the positive elements in personality rather than the sick parts and thinking from the outset in terms of pathways back to a normal existence in the community rather than in terms of a long and hopeless removal in the artificial and impersonal life of the mental hospital. To some extent this "atmosphere" seems to have been made up of a set of attitudes held by the psychiatric leader: a sense of innovative change, high valuation of the work and people involved in it, optimism, and a feeling for the social significance of the therapeutic enterprise. There has been an impression by some observers (for example, see World Health Organization, Expert Committee on Mental Health 1953) that this charismatic quality of the leader contributes a major share to the success of therapeutic communities. To the extent that sophisticated practitioners of the therapeutic community approach have been aware of the importance of this sense of innovative change (akin to the "Hawthorne effect" in industry), they have sought to develop a continuing sense of challenge. They have looked to positive elements of the therapeutic community concept on which to build after many of the inequities of the old hospital system have given way to widespread reform. History of the concept Ingredients of the therapeutic community concept within psychiatry stem from the reformist stance taken over a century ago, when, in keeping with the trends emanating from the French Revolution, mental patients in country after country were brought under the benign aegis of medicine. Philippe Pinel in France, William Tuke in England, Vincenzo Chiarugi in Italy, Johann Reil in Germany, and Benjamin Rush in the United States were leaders among scores of hospital superintendents who attempted to redefine the ailments of mental patients. With the development of "moral treatment," physicians sought to treat psychologically disturbed individuals with compassionate understanding and close attention to their personal needs, thoughts, and feelings. The custodial system. The "moral treatment" approach declined in the latter part of the nineteenth century, to be replaced by a custodial, incarcerative system accompanied by deep-seated attitudes of therapeutic pessimism. The reasons for the change included the influx into urban areas of individuals who had few if any ties and who were disturbed and disfranchised through their experiences with urbanization and industrialization. Hospitals were overloaded, their patients were not inte-

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grated into the local communities, and as costs mounted, the tendency was to remove them to the outskirts of major urban concentrations. Patients were held there with prisonlike restraints for their own and society's security. Concurrently, a theory of psychopathology developed which attributed the more serious mental disorders (which were thought to be on the increase) to brain lesions, the cure of which was yet to be discovered by medicine. The fact that the moral treatment proponents had not developed a theory of etiology and therapy to underpin their efforts left them without a rationale to support a concerted program of care in the face of the new influx of intractable patients and competing etiological theories. Their effectiveness was based on their norms of personal conduct as genteel members of the relatively small, intimate communities of their times. Reformist movements. Thus a combination of factors—ranging from fiscal to theoretical—led to the build-up of large custodial mental hospitals, which were stocked with chronically disturbed, neglected mental patients and ill-trained, pessimistic staffs. The therapeutic community approach found its immediate impetus in the reaction against this situation. The reformers were motivated in part by the ancient injunction Primum non nocere; as Florence Nightingale put it, "It may seem a strange principle to enumerate as the very first requirement in a hospital that it should do the sick no harm." The forces of institutionalization and neglect, as much as the innate pathology of the individual patients, were increasingly seen as having played a part in bringing them to their predicament. As compared with their predecessors, the new reformist movements were better equipped by modern theory and research methods to implement new approaches to mental patient care. The new theoretical orientation stressed the growth potentialities of the mentally ill. One of the fortunate by-products of the great depression was a new recognition that individuals could not entirely control the social forces affecting their lives. This recognition negated the view that casualties of the social process were constitutionally defective. World War n led to the mobilization of new talents and energies, accompanied by a revised sense of federal responsibility for the care of the nation's casualties. The changes have been so great in the period following World War n, particularly in the fields of social psychiatry, that they have been termed by such partisans as Moreno (1934) and Dreikurs (1955) the "third revolution" in psychiatry—the first having been that associated with the early reformers and the second with the psychoanalytic movement.

Of particular relevance to the therapeutic community approach were the efforts of August Aichhorn in Austria, Jacob Moreno and Harry Stack Sullivan in America, Ernst Simmel in Germany, and Wilfred Bion and others associated with the Tavistock Clinic and Institute in England. Aichhorn's work (1925) was influential in applying the psychoanalytic conception of permissiveness to the administration of an adolescent treatment institution. His work has been carried on and developed in the United States by such men as Bettelheim (1950) and Redl (Redl & Wineman 1952); Moreno stressed the importance of "psychodrama," or the use of role playing for both diagnostic and therapeutic purposes. Harry Stack Sullivan's Interpersonal Theory of Psychiatry (1953) was a pioneering effort to revise psychoanalytic theory so that it would take sociocultural processes into account in therapy, and while he did not directly influence the early therapeutic community innovations, his work was important in the development of parallel efforts such as those of Rioch and Stanton (1959), Stanton and Schwartz (1954), and Artiss (1962) and in laying some of the groundwork for American acceptance of the therapeutic community idea. Ernst Simmel (1929) noted that the transference relationship, so vital to psychoanalytic therapy, could be developed in a hospital setting with reference to social roles and, therefore, be displaceable to some extent from one individual incumbent in the role to others. The Tavistock group, influenced particularly by Bion (1961), developed many of the notions of group dynamics that informed the efforts of Maxwell Jones and his colleagues with therapeutic community experiments. A prior effort that resembled the therapeutic community method and provided ingredients for its subsequent development as a well-formulated approach was the "total push" method of Abraham Myerson (1939). This was an eclectic approach which optimistically sought to harness whatever resources and methods were at hand to reorient the staff's activity into a more holistic attack on the problems of psychiatric rehabilitation. Ideology of the therapeutic community. It is interesting to consider the question of why such a movement, with its Utopian emphasis on the healing power of the community, should have developed at this point in history. It may be conjectured that the movement to establish therapeutic communities is essentially a reaction against the anomic by-products of rapid social change attendant on increasing industrialization and urbanization. It represents an attempt to restore what Edward Sapir referred to as a "genuine culture," at least within

MENTAL DISORDERS, TREATMENT: Therapeutic Community the limited and more manageable sphere of (lie mental hospital world. The fact that the segregated mental hospital system displayed a remarkable degree of cultural lag and at the same time was associated with an idealistic, science-minded group of professional practitioners, gave unusual leverage for rapid implementation of this program once the conditions were favorable. The wartime mobilization of effort seems to have galvanized the profession to action that was directed toward reducing the cultural lag. The scientific ingredients of the new method were at hand, and the ideological emphasis on the corrective power of the tight-knit, intensively interacting community seems to be explainable in terms of a reaction against the anomic effects of modern society. Social science and the therapeutic community Social science has affected the development of therapeutic communities both indirectly, through the interest of innovating psychiatrists in social science concepts such as "culture" and "social structure," and directly, through the participation of social scientists in research on hospitals using this method of treatment. The Rapoport study. Although there were several prior social science studies on mental hospitals of various kinds (see Belknap 1956; Dunham & Weinberg I960; Rowland 1938; and Henry 1954 on the old-fashioned mental hospital; Stan ton & Schwartz 1954 and Caudill 1958 on psychoanalytically oriented hospitals), the first social science study of a hospital styling itself a therapeutic community was the study by Robert N. Rapoport and his associates (1961) of the British unit under Maxwell Jones. The latter had advocated setting up such a unit, as a result of his wartime experiences with soldiers suffering from war neuroses and from the difficulties of returning to normal social life after such deprivations as prolonged prison camp internment. When the unit became established, it gained a wide reputation as the first fully developed therapeutic community. In seeking to repeat their wartime successes with intensive resocialization methods, Jones and his staff developed a unit for the treatment of a variety of patients with problems of social maladjustment. They reported that their extension of the therapeutic community method was effective. Indeed, they advocated its application not only to the treatment of "psychopathic" personality disorders but also to the treatment of all sorts of behavioral adjustment problems, including those of imprisoned criminal offenders. Since the method was essentially one of harnessing the social processes of

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institutional community life, the collaboration of a social scientist was sought. Rapoport and his colleagues, following Caudill (1958) in viewing the hospital as a form of small society, observed that the culture of this society emphasized four principal themes—permissiveness, democratization, communalism, and rehabilitation (through reality confrontation). Analysis of the program of activities and prescriptions for social roles in relation to these themes led to certain conclusions of a structural-functional nature. For example, one structural recommendation focused on the importance of incorporating into the formal ideology a conceptual distinction between "treatment" (measures aimed at improving the organization of the individual personality structure) and "rehabilitation" (measures aimed at improving the individual's adjustment to his social role relationships). This distinction was shown to be important in avoiding certain potential conflicts between overt and covert role prescriptions, among ideological themes in their spheres of possible contradiction, and between intrahospital and external norms for social behavior. One of Rapoport's functional recommendations was that treatment should concentrate on the hitherto relatively unrecognized process of "oscillations" in the state of over-all organization and functioning of the system. It was pointed out that all social systems are subject to variations in their state of organization and that systems with the properties of the unit are subject to particularly great swings in the state of "collective disturbance" —due to their permissiveness, the properties of their patients, and their emphasis on maximizing intercommunication. The tendency in the unit, as among practitioners generally, was to view these swings toward states of great collective disturbance with alarm and to attempt to avoid them wherever possible. However, Rapoport found evidence to support the view that the oscillatory process could be therapeutically very useful if appropriately harnessed. In the stage of social reorganization following the critical turning point of maximum disorganization, patients were observed to involve themselves more meaningfully in the constructive social processes and thereby to learn modes of social adaptation which could serve them in their subsequent relationships. The technique of managing these processes in the interests of therapy was shown to involve an interest in and alertness to their special properties; thus the Rapoport study recommended an avoidance of such pitfalls as "collusive anxiety" (premature intervention and imposition of authoritative staff social controls)

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and "collusive denial" (lack of recognition of the state of disorganization and consequently the failure to intervene at the social-psychologically critical point). In addition, an analysis was made of the "careers" of a cohort of patients, and several conclusions were drawn, principal among which were the following. There was a relationship between the patient's acceptance of unit culture (as measured by change in profile scores on the ideological themes) and his perceived improvement in the unit (as measured by the patient, by the physician, and by the nursing staff); moreover, acceptance of unit cultural norms (and thus manifestation of clinical improvement) was far less likely to occur among patients who left the unit in less than six months than among those who stayed at least six months. The persistence of improvement in social functioning in the community for a year following discharge was more likely to be seen among certain types of "improved" patients than among others. Married patients did better than unmarried, and patients whose dominant personality defenses did not involve aggressive behavior did well in the permissive atmosphere of the unit. However, the fact that patients suffer setbacks in relationships outside the unit following discharge points up the importance of being alert to cultural discontinuities between treatment unit and community; in therapeutic communities the sense of contrast with the segregated mental hospitals may tend to obscure the contrast between such communities and their surrounding cultural context. In conclusion, Rapoport and his colleagues listed 30 principles for the formation of therapeutic communities, attempting to formulate them in sufficiently flexible terms to make them adaptable to a wide range of therapeutic contexts (R. N. Rapoport et al. 1961). Holistic and segmental studies. In considering the place of the Rapoport study of the therapeutic community among social science studies of the mental hospital generally, a useful distinction might be made between holistic studies and segmental studies. The study by Belknap (1956) and some other earlier studies of the state mental hospital, as well as Goffman's study (1961), may be thought of as cases at the custodial extreme of the continuum (described by Greenblatt et al. 1955) which ranges from custodial to therapeutic care; the Rapoport study is a holistic analysis of a case at the therapeutic extreme. Brown and Wing (1962) present a study of three hospitals representing three points along the continuum and provide further evidence to support the contention that changes in

the over-all organization of the hospital are reflected in changes in patients' behavior. Segmental studies would be those which focus on part processes. Even the Stanton and Schwartz classic study, The Mental Hospital (1954), is essentially a collection of segmental analyses of part processes, most notable among which is the demonstration of a relationship between covert disagreement among staff members and clinical excitation of patients. Gilbert and Levinson (1956) are particularly concerned with the relationship between the espousal of a custodial ideology and certain personality types, notably the "authoritarian personality." The other form of segmental research is seen in the replication studies, such as that of Carstairs and Heron (1957), who studied a British mental hospital, using the same measures as Gilbert and Levinson (1956) and their colleagues; they found that in Britain, as in the United States, higherstatus staff members are more likely than lowerstatus members to have a low "custodial ideology" score. Working with a greater cultural contrast, Stein and Getting (1964) found that the culturally prescribed role of the physician in Latin America countervails this tendency for liberalism to be easier for higher-status, relatively disengaged people. The role of the psychiatrist in Latin America is still oriented to the more authoritarian norms of physician conduct (reminiscent of the earlier period in Europe and the United States), and therefore their scores on the "custodial ideology" measures were less differentiated from their lower-echelon staff members than was found to be true in England and America. Another type of segmental study involves focal concentration on process. Many of the processes indicated in the earlier holistic studies (e.g., Caudill's "linked open systems," or "transactions," Rapoport's "oscillations," and Stanton and Schwartz's "covert disagreements") have become the focuses for subsequent studies seeking to replicate, refute, or extend their relevance into other contexts. Some segmental process studies seek further development of these earlier insights, particularly of the dynamics of inducing changes in hospital structures. For example, a study by Isabel Menzies (1960) seeks to elucidate a specific type of psychological barrier to the accomplishment of social changes. She concentrates her attention on the deep intrapersonal functions served by the conventional role prescriptions, such as those of the nursing role, and the built-in resistances of participants in the change process that work against their conscious wishes for change and modernization. Agnew and Hsu

MENTAL DISORDERS, TREATMENT: Therapeutic Community (1960-1961) approach the problem of understanding and overcoming resistances to change by using social structure as a point of departure; they suggest that the "democratization" theme of therapeutic communities may be most applicable to the phase of steady functioning following the institutionalization of the new system. In order to break through the rigidities of the older system, a measure of authoritative behavior may succeed where the democratic mode would be rejected. Clinical applications. Social science contributions of a more indirect kind can be seen in the clinical reports by psychiatrists on attempts to apply the therapeutic community idea to other contexts and in the course of so doing to evaluate and modify it to suit the circumstances (see Wilmer 1958; Scher 1958; Stainbrook 1955; Clark 1964). To some extent, the attention given to the therapeutic community idea in psychiatry has diminished as a consequence of the great development and immediate successes of new pharmacological treatments, even while the former was gaining general, if ancillary, acceptance. However, there is some reason to believe that interest in the therapeutic community dimensions of treatment will once again receive prominence as research reveals the limitations of a simplistic pharmacological approach (Klerman 1960). Lessons of the therapeutic community There are several ways in which the development of the therapeutic community emphasis in psychiatry may be seen as relevant to social science. Milieu therapists have provided opportunities for social scientists to observe the intimacies of an important form of institutional life that might otherwise have been inaccessible. Thus, the field of hospital studies and the entire field of comparative institutions have been enriched. Furthermore, the therapeutic community investigations have contributed to the already active trends in social science toward interdisciplinary collaboration. Epitomized in the work of Stan ton and Schwartz (with their demonstration of the connection between structured conflict in the environment and emotional upset in the individual) and of Caudill (with his conception of "linked open systems"), research in the milieu therapy-oriented hospital demands interdisciplinary approaches. The subsequent work by Robert N. Rapoport and his colleagues (1961) in the more labile environment of an innovating, experimental therapeutic community provided opportunities to examine unusually fluid social systems. This research has fed into the general trend toward developing more pro-

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cessual modes of social science analysis and thus has become associated with numerous other approaches, such as general systems theories and the crisis theories. The experimental therapeutic communities were useful for such analyses because of their positive orientation toward flexibility and change and their relatively unstable functioning due to their tendency to de-emphasize authority hierarchies, to permit disruptive behavior by patients, and to encourage expressive communication. The resulting phenomenon, described in the mental hospital literature as "collective upsets," tends to be particularly notable in the therapeutic community. The "oscillatory tendency," as Rapoport termed it, was observed to have a discernible periodicity, to be affected by specific organizational events, and thus to have properties in common with other systems, as described, for example, in cybernetics. The oscillatory process was also observed to engender therapeutic potentials if properly harnessed, particularly in its phase of social reorganization. This interest in harnessing the energies that become available at critical turning points is shared by those social scientists who have been studying the process of critical role transitions (Rhona Rapoport 1963). The importance of ritual at times of transition in primitive societies has long been recognized by sociologists and anthropologists, notably Arnold van Gennep. In the more complex situations of modern secular society, the mechanisms used to cope with these status transitions are of a more deliberate, rational kind, aiming at adaptation to changing situations as well as accommodating existing needs and expectations. The processes of oscillation within a complex organizational framework can, in this sense, be seen as resembling the pattern of alternation between periods of stable functioning and critical transition followed by reorganization that characterizes the life cycle. From the viewpoint of the more analytic or fragmentary approaches, the quasi-experimental situation represented by the therapeutic community approach, particularly in its innovating stages, has been an attraction that has only begun to yield the kinds of results of which it is potentially capable. Contemporary issues As the therapeutic community concept has gained wider acceptance, the range of issues confronting social scientists in relation to research in this field has changed somewhat. There is still much to be desired by way of sheer evaluation of the effectiveness of the method; however, the types of research concern seem to be shifting. Rather

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than asking what the therapeutic community is and how well it works, the questions are being posed more in terms of what aspects of the approach are most relevant for what types of persons under what conditions, including conditions of concurrent use of other forms of therapy. Furthermore, the possibility of the initial efficacy of the method as a novelty stimulus—akin to the medical "placebo effect" or the "Hawthorne effect" as recognized in industrial research—has relevance not only for evaluation of the method but also for the type of interest which it has for social scientists. Many of the early social scientists were interested in it as an innovating experiment with some of the characteristics of a Utopian reformist movement. However, as the method has gained acceptance and has become to some extent routinized within the psychiatric profession, its appeal for social scientists has changed. The emphasis has shifted, to some extent, from the more macrosociological or holistic, anthropological type of approach to the more structured, quasi-experimental approaches that are more characteristic of the social psychologist. However, the holistic researcher still has scope for analyzing the range of problems associated with application of the concept in different subcultural and structural situations—in large state mental hospitals, prisons, delinquent groups, depressed slum neighborhoods, schools, and industrial work groups. The concept can also be applied to different national and cultural settings, and to functional processes related to the persistence of innovations. In the context of these new and contrasting over-all situations, analyses will be fruitful on both the holistic level and on the level of part processes. Such issues as optimal size of the hospital unit, degree of social differentiation, type of authority structure, degree of interlinkage of subsystems, and flexibility versus fixity of value hierarchy can be tested in various contexts in relation to therapeutic effectiveness. The issues involved in doing systematic evaluative research in this field have hardly been broached and present a major challenge. On the side of implications for social theory, one can only note a great hiatus in work already done. Goffman's linking of the old-fashioned mental hospital to the larger class of "total institutions" (1961) is the most creative effort available in the hospital research field, but it relates not to therapeutic communities but, rather, to the polarity against which they are reactions. Therapeutic communities of the future will probably turn out to be far more differentiated and can therefore be expected to provide materials for un-

derstanding many kinds of dynamic processes. It would seem that their contribution to social science might be expected to lie in two spheres: first, the reciprocal relationship between personality and social structure, and second, the relationship between stability and structure on the one hand, and fluidity and change on the other, in the functioning of institutions designed to "process" a continuous flow of people while the organization maintains continuity and reliable functioning. These are challenges faced by social scientists in increasingly numerous fields of investigation, and the degree to which the therapeutic community will be a fruitful arena for investigation of these issues will depend on a complex of many factors other than the intrinsic interest which it presents. ROBERT N. RAPOPORT BIBLIOGRAPHY

AGNEW, PAUL C.; and Hsu, FRANCIS L. K. 1960-1961 Introducing Change in a Mental Hospital. Human Organization 19:195-198. AICHHORN, AUGUST (1925) 1935 Wayward Youth. New York: Viking. H> First published as Verwahrloste Jugend. ARTISS, KENNETH 1962 Milieu Therapy in Schizophrenia. New York: Grune & Stratton. BELKNAP, IVAN 1956 Human Problems of a State Mental Hospital. New York: McGraw-Hill. BETTELHEIM, BRUNO 1950 Love Is Not Enough: The Treatment of Emotionally Disturbed Children. Glencoe, 111.: Free Press. BIERER, JOSHUA 1960 Past, Present and Future. International Journal of Social Psychiatry 6, no. 1/2:165173. BION, WILFRED 1961 Experiences in Groups, and Other Papers. New York: Basic Books. BROWN, ESTHER L. 1961-1964 Newer Dimensions of Patient Care. 3 vols. New York: Russell Sage Foundation. -> Volume 1: The Use of the Physical and Social Environment of the General Hospital for Therapeutic Purposes. Volume 2: Improving Staff Motivation and Competence in the General Hospital. Volume 3: Patients as People. BROWN, G. W.; and WING, J. K. 1962 A Comparative Clinical and Social Survey of Three Mental Hospitals. Pages 145-168 in Paul Halmos (editor), Sociology and Medicine. Sociological Review Monograph No. 5. Univ. of Keele (England). CARSTAIRS, G. M.; and HERON, ALASTAIR 1957 The Social Environment of Mental Patients: A Measure of Staff Attitudes. Pages 218-230 in Milton Greenblatt et al. (editors), The Patient and the Mental Hospital. Glencoe, 111.: Free Press. CAUDILL, WILLIAM 1958 The Psychiatric Hospital as a Small Society. Cambridge, Mass.: Harvard Univ. Press. CLARK, DAVID 1964 Administrative Therapy: The Role of the Doctor in the Therapeutic Community. London: Tavistock. CONFERENCE ON COMMUNITY MENTAL HEALTH RESEARCH, THIRD, WASHINGTON UNIVERSITY, ST. Louis, 1961 1964 The Psychiatric Hospital as a Social System: Proceedings. Edited by Albert F. Wessen. Springfield, 111.: Thomas.

MENTAL HEALTH: The Concept DREIKURS, RUDOLF 1955 Group Psychotherapy and the Third Revolution in Psychiatry. International Journal of Social Psychiatry I , no. 3:23-32. DUNHAM, H. WARREN; and WEINBERG, S. KIRSON 1960 The Culture of the State Mental Hospital. Detroit, Mich.: Wayne State Univ. Press. GILBERT, DORIS; and LEVINSON, DANIEL 1956 Ideology, Personality and Institutional Policy in the Mental Hospital. Journal of Abnormal and Social Psychology 53:263-271. GOFFMAN, ERVING (1961) 1962 Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Chicago: Aldine. GREENBLATT, MILTON; LEVINSON, DANIEL; and WILLIAMS, RICHARD (editors) 1957 The Patient and the Mental Hospital: Contributions of Research in the Science of Social Behavior. Glencoe, 111.: Free Press. GREENBLATT, MILTON; YORK, RICHARD H.; and BROWN, ESTHER L. 1955 From Custodial to Therapeutic Patient Care in Mental Hospitals. New York: Russell Sage Foundation. HAMBURG, DAVID A. 1958 Therapeutic Hospital Environments : Experience in a General Hospital and Problems for Research. Pages 479-491 in Symposium on Preventive and Social Psychiatry, Waiter Reed Army Institute of Research, April 1957. Washington: Government Printing Office. HENRY, JULES 1954 The Formal Social Structure of a Psychiatric Hospital. Psychiatry 17:139-151. JONES, MAXWELL (1952) 1953 The Therapeutic Community: A New Treatment Method in Psychiatry. New York: Basic Books. -> First published as Social Psychiatry: A Study of Therapeutic Communities. JONES, MAXWELL; and RAPOPORT, ROBERT N. 1955 Administrative and Social Psychiatry. Lancet [1955], no. 2:386-388. KLERMAN, GERALD L. 1960 Staff Attitudes, Decisionmaking, and the Use of Drug Therapy in the Mental Hospital. Pages 191-214 in Research Conference on the Therapeutic Community, Manhattan State Hospital, Ward's Island, N.Y., 1959, Proceedings of the Conference. Edited by Herman Denber. Springfield, 111.: Thomas. -> Includes 2 pages of discussion. LEVINSON, DANIEL; and GALLAGHER, EUGENE 1964 Patienthood in a Psychiatric Hospital: An Analysis of Role, Personality, and Social Structure. Boston: Houghton Mifflin. MAIN, T. F. 1946 The Hospital as a Therapeutic Institution. Menninger Clinic, Bulletin 10:66-70. MENZIES, ISABEL 1960 A Case-study in the Functioning of Social Systems as a Defense Against Anxiety. Human Relations 13:95-122. MORENO, JACOB L. (1934) 1953 Who Shall Survive? Foundations of Sociometry, Group Psychotherapy and Sociodrama. Rev. & enl. ed. Beacon, N.Y.: Beacon House. MYERSON, ABRAHAM 1939 Theory and Principles of the "Total Push" Method in the Treatment of Chronic Schizophrenia. American Journal of Psychiatry 95:1197-1204. RAPOPORT, RHONA 1963 Normal Crises, Family Structure and Mental Health. Family Process 2:68-80. RAPOPORT, ROBERT N. et al. 1961 Community as Doctor: New Perspectives on a Therapeutic Community. Springfield, 111.: Thomas. RAPOPORT, ROBERT N.; and RAPOPORT, RHONA 1957 Democratization and Authority in a Therapeutic Community. Behavioral Science 2:128-133.

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RAPOPORT, ROBERT N.; and RAPOPORT, RHONA 1959 Permissiveness and Treatment in a Therapeutic Community. Psychiatry 22:57-64. REDL, FRITZ; and WINEMAN, DAVID (1951) 1964 Children Who Hate. New York: Free Press. REDL, FRITZ; and WINEMAN, DAVID 1952 Controls From Within. Glencoe, 111.: Free Press. RESEARCH CONFERENCE ON THERAPEUTIC COMMUNITY, MANHATTAN STATE HOSPITAL, WARD'S ISLAND, N.Y., 1959 1960 Proceedings of the Conference. Edited by Herman Denber. Springfield, 111.: Thomas. RIOCH, DAVID; and STANTON, ALFRED 1959 Milieu Therapy. Psychiatry 22:65-72. ROWLAND, HOWARD 1938 Interaction Processes in the State Mental Hospital. Psychiatry 1:323-337. SCHER, JORDAN M. 1958 The Structured Ward: Research Method and Hypothesis in a Total Treatment Setting for Schizophrenia. American Journal of Orthopsychiatry 28:291-299. SCHWARTZ, MORRIS S. et al. 1964 Social Approaches to Mental Patient Care. New York: Columbia Univ. Press. SIMMEL, ERNST 1929 Psycho-analytic Treatment in a Sanatorium. International Journal of Psycho-analysis 10:70-89. SIVADON, PAUL 1958 Technics of Sociotherapy. Pages 457-464 in Symposium on Preventive and Social Psychiatry, Walter Reed Army Institute of Research, April 1957. Washington: Government Printing Office. STAINBROOK, EDWARD 1955 The Hospital as a Therapeutic Community. Neuropsychiatry 3:69-87. STANTON, ALFRED H.; and SCHWARTZ, MORRIS S. 1954 The Mental Hospital: A Study of Institutional Participation in Psychiatric Illness and Treatment. New York: Basic Books. STEIN, WILLIAM; and GETTING, E. R. 1964 Humanism and Custodialism in a Peruvian Mental Hospital. Human Organization 23:278-282. SULLIVAN, HARRY STACK 1953 The Interpersonal Theory of Psychiatry. Edited by Helen Swick Perry and Mary Ladd Gawel. New York: Norton. WILMER, HARRY A. 1958 Social Psychiatry in Action: A Therapeutic Community. Springfield, 111.: Thomas. WORLD HEALTH ORGANIZATION, EXPERT COMMITTEE ON MENTAL HEALTH 1953 Report, Third. Technical Report Series, No. 73. Geneva: World Health Organization.

MENTAL HEALTH Morris S. Schwartz and Charlotte Green Schwartz

i. THE CONCEPT H. SOCIAL CLASS AND PERSONAL ADJUSTMENT

William H. Sewell

THE CONCEPT

The meaning of the term "mental health" is ambiguous; not only is it difficult to agree on its general application, but even in a single context it may be used in many different ways. This lack of agreement will probably continue because the term has been adopted for a variety of purposes. One conclusion, however, can be reached: "mental health" is not a precise term but an intuitively ap-

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MENTAL HEALTH: The Concept

prehended idea that is striving for scientific status while also serving as an ideological label. Problems of definition The word "mental" usually implies something more than the purely cerebral functioning of a person; it also stands for his emotional-affective states, the relationships he establishes with others, and a quite general quality that might be called his equilibrium in his sociocultural context. Similarly, "health" refers to more than physical health: it also connotes the individual's intrapsychic balance, the fit of his psychic structure with the external environment, and his social functioning. It is not surprising that the combination of two such terms produces an elastic and ambiguous concept. Another ambiguity attends this phrase. In common usage "mental health" often means both psychological well-being and mental illness. Definitions obviously vary with the perspective of the definers, the point of reference used, and the values considered important. Thus, the psychoanalytic perspective focuses on the intrapsychic life of the individual. Freud defined mental health in his programmatic statement: "Where id was, there shall ego be" (1932, p. 112). Here the value is awareness of unconscious motivations and self-control based upon these insights. The interpersonal frame of reference, on the other hand, is more concerned with the functioning of individuals in interpersonal situations. Sullivan identifies a person's drive toward mental health as those "processes which tend to improve his efficiency as a human being, his satisfactions, and his success in living" (1954, p. 106) and places major value on effective and efficient social functioning. The social relatedness perspective is exemplified by Fromm, who focuses on the individual's relationship with the larger social environment. The mentally healthy person is the productive and unalieiiated person; the person who relates himself to the world lovingly, and who uses his reason to grasp reality objectively; who experiences himself as a unique individual entity, and at the same time feels one with his fellow man; who is not subject to irrational authority, and accepts willingly the rational authority of conscience and reason; who is in the process of being born as long as he is alive, and considers the gift of life the most precious chance he has. ([1955] 1959, p. 275) Here the values are humanism, individualism, freedom, and rationality. The most comprehensive and definitive summary of the multiplicity of criteria used in defin-

ing mental health is that of Jahoda (1958). She rules out certain criteria as unsuitable because they are unsatisfactory for research purposes. "Absence of disease," for instance, is rejected as a criterion, not only because of the difficulty in circumscribing disease but also because common usage of the term "mental health" now includes something more than the mere absence of a negative value. "Statistical normality" is also considered unsuitable on the grounds that the term is unspecific, bare of content, and fails to come to grips with the question. Finally, "happiness" and "well-being" are ruled out because they involve external circumstances as well as individual functioning. Jahoda then summarizes what are to her the acceptable sets of criteria in current use. These are attitudes toward the self, which include accessibility of the self to consciousness, correctness of the self concept, feelings about the self concept (self-acceptance), and a sense of identity; growth, development, and self-actualization, which include conceptions of self, motivational processes, and investment in living; integration, which refers to the balance of psychic forces in the individual, a unifying outlook on life, and resistance to stress; autonomy, which refers to the decision-making process, regulation from within, and independent action; undistorted perception of reality, including empathy or social sensitivity; environmental mastery, including the ability to love, adequacy in interpersonal relations, efficiency in meeting situation requirements, capacity for adaptation and adjustment, efficiency in problem solving, and adequacy in love, work, and play. Since Jahoda's statement is a summary and not an attempt to integrate the criteria currently used in defining or identifying mental health, various difficulties (many recognized and discussed by her) attend her presentation. The criteria are overlapping, and the relationship between criteria is not spelled out (for example, the degree to which they are independent). Moreover, no method is indicated for identifying satisfactory indexes for the criteria, thus making it impossible to measure the degree of a particular criterion or even to discover its presence or absence. Ambiguities and different levels of specificity characterize the different criteria, and the impact of the social situation and the relevance of the society as context criterion are largely ignored. Jahoda does not attempt a solution for these difficulties. She simply recognizes the impossibility of arriving at a "correct" definition and of attaining a consensus, because values underlie the defi-

MENTAL HEALTH: The Concept nitions proposed and because the concept is used for different purposes. Jahoda's analysis of mental health as a concept deals mainly with the problems it poses for the empirical researcher: whether— and if so, how far—the various criteria can be integrated into one criterion or a set of criteria; the kinds of criteria that are required by different definitions; whether and how one might distinguish between "optimal" and "maximal" mental health; and operationalizing the definitions used. She deals minimally with the approach that the student of society would take: the meaning of this concept in society, its various functions, the ways in which it constitutes and expresses societal values, and the nature of the kinds of social environments that influence a person's psychological well-being. Nevertheless, her work represents the best summary of the current major definitions and the controversy connected with them. Aspects of the mental health controversy Discussions of the concept of mental health naturally reflect the interests of the principal groups involved in the mental health movement. One of the leading issues is whether "mental health" and "mental illness" should be conceptualized on the same continuum or on different continua that cut across each other. The conventional medical view holds that mental health is the absence of mental illness, that both terms represent the extreme ends of the same continuum, and that the difference between the two states is one of degree. A contrary view is that mental health is qualitatively different from mental illness and that a person can be both mentally healthy and mentally ill at the same time. Jahoda, as an advocate of the concept of "positive mental health," maintains that the absence of certain qualities does not imply the presence of others. For example, the absence of hallucinations does not imply the presence of accurate self-appraisal; conversely, the presence of creativity does not exclude the presence of severe anxiety. But if mental health and mental illness are placed on different continua, then it becomes necessary to specify their relationship. For this reason, Conrad (1952) has suggested that "negative health," or the absence of pathology, be used as an interstitial term. A related issue is whether mental health is to be seen as a relatively constant and enduring function of personality or as a momentary function of person and situation. For instance, Klein (1960) distinguishes "soundness" from "well-being": the former refers to the level of integration of the gen-

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eral, more enduring personality structure, and the latter to the individual's current state of equilibrium. This distinction may be a useful way of identifying two different kinds of mental health. There also are differences of opinion on whether the concept of mental health is ever value-free. Some authors—medically oriented professionals— view psychological health as analogous to physical health, which, they maintain, can be evaluated by objective medical standards, without regard to the patient's sociocultural context. Another view maintaining that mental health is a value-free concept equates it with the statistically normal: mentally healthy behavior is that which is considered average or conventional behavior for a particular population. Here, good mental health is evaluated in terms of adjustment to and acceptance of current societal norms. Clearly, these criteria are not valuefree. Indeed, many students of the field maintain that criteria of mental health cannot be established in complete independence from the particular values and ideology of the society or group in which they are formulated and applied. According to this view, the study of definitions of mental health becomes a branch of the sociology of knowledge. But such an approach, although sociologically meaningful, cannot settle the question of which criteria are the most useful for therapy and mental health research. Some of those who maintain that all definitions of mental health are culture-bound hold that multiple criteria should be used, depending upon the values cherished by each society or subculture. Thus, criteria for mental health in the lower classes may have to be different from those for the middle classes, and those for citizens of Japan would have to differ from those for India or the United States. The issue here is that of the relation of the mental health of a person to the nature of the society in which he lives. Although this issue is rarely discussed, its clarification and resolution are critical in identifying the field of interrelated variables that are relevant to the study of mental health. What is needed is nothing less than a complete theory of the relation between the individual and society. Other students of the field hold that the criteria for mental health, though value-laden, can transcend situational or cultural boundaries and that an area of general value consensus can be arrived at. For example, M. B. Smith has suggested that universal criteria for mental health might be "identified with the stability, resilience, and viability— in a word the system properties—of these external and internal subsystems of personality" (1959,

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pp. 680-681). Similarly, Fromm (1955) insists that criteria for mental health must be based on some concept of a universal human nature rather than on the values of particular cultures or societies. In summary, mental health can be viewed either as an ideal-type concept or as an empirical construct referring to a state that actually occurs. In the former view, mental health is an ideal to be striven for but never fully attained; it serves, however, as a standard against which to measure any particular individual. In the latter view, mental health is realistically attainable, though there is much dispute about the frequency with which it is encountered. Mental health as a movement and a profession The emergence of the concept of mental health is closely related to the growth of the mental hygiene movement in the United States and to the development of psychotherapeutic practice and personality research. As an explanatory construct, "mental health" emerged out of the concern with "mental hygiene" that gained its first adherents at the beginning of the twentieth century. Originally, this social movement focused on improving the wretched conditions in mental hospitals and providing better care and treatment for the mentally ill wherever they might be. In the 1920s interest shifted to promoting "mental hygiene" and establishing child-guidance clinics. The term "mental health" began to replace "mental hygiene" in the 1930s, and by the late 1940s it assumed an independent status with a growing and enthusiastic social movement operating in its name. This shift in terms signified the beginning of the era of concern with the prevention of mental disorders rather than merely care and treatment and the broadening of focus to include all forms of social and psychological maladjustment rather than just the severely emotionally disturbed or psychotic. The movement began to promote "positive" mental health as a goal distinct from the elimination of mental illness. The popularity of mental health as a desired value in the United States is in part related to its advocacy by those in the mental health movement and in part to the growth of psychoanalytic theory and acceptance of psychotherapeutic practice in the past several decades. The orthodox psychoanalytic viewpoint that mental health is a property of individuals and a function of intrapsychic development and dynamics is still dominant. It maintains that an individual acquires good mental health as a consequence of fortunate early socialization; psy-

choanalysis or some other form of psychotherapy is a corrective for unfortunate early development. Thus, the individual remains the unit of analysis, and psychological health is seen as a function of the individual's unique, private intrapsychic development and life history. Subsequently, the unit of analysis was extended to include the patterning of an individual's interpersonal relations. Recently, another view of mental health was put forward by the proponents of social psychiatry [see PSYCHIATRY, article on SOCIAL PSYCHIATRY]. Only a few authors, such as Fromm (1955) and Frank (1948), take a comprehensive view of mental health as a function of the total society—its dominant ideologies, assumptions, norms, values, institutions, and general style of life. Such a perspective is largely ignored or considered irrelevant by the great majority of ideologists, practitioners, and researchers in the field of mental health. Ideologists, practitioners, researchers. Action in the name of mental health has occasioned the development of three distinct groups whose membership may overlap but whose interests and functions are separable: they can be called the ideologists, the practitioners, and the researchers. The ideologists are primarily interested in promoting psychological well-being as a value and in encouraging action to prevent and eliminate mental illness. Well-developed mental health organizations, both private and public, now exist in the United States at the national, state, and local levels. In 1960 the National Association for Mental Health reported that, in addition to the state mental health associations, there were some eight hundred affiliated local mental health associations in 42 states, with a total registered membership and volunteer participation exceeding one million persons (Ridenour 1963). In addition, a network of federal governmental agencies, led by the National Institute of Mental Health (NIMH), spent a vast sum for research, training, education, demonstration, and the building and development of treatment facilities (during the fiscal year 1964/1965 the NIMH alone spent over $200 million). The NIMH also maintains links with the privately sponsored branches of the mental health movement. In addition to the federal government, each state and many cities and counties have a department of mental health or a mental health officer. Private and governmental agencies often join with practitioners to educate the public about mental illness and health, to urge persons to become concerned about their own and others' psychological health, and to collect funds for research.

MENTAL HEALTH: The Concept The importance of the mental health movement has enhanced the prestige and power of its practitioners, who range from psychoanalysts to marriage counselors. They have gradually widened their sphere of operation and now function in institutions such as schools, courts, and industry. Although many of their activities are undertaken in the name of mental health, little work is directed toward mental health as distinct from mental illness. Primarily, their concern is treatment; secondarily, it is research; it is only minimally prevention. The interests of researchers in mental health span the entire range of human behavior from circumscribed biochemical problems to existential problems of living. Despite the increasing number of research projects over the past decade, etiological problems remain unsolved and the field awaits conceptual clarification. Mental health and American values The mental health concept is related to current and traditional American values in three ways. First, it reflects and embodies many of these values; second, it functions to preserve certain of them; finally, it is a highly valued end in itself. In fact, mental health has become so esteemed that in some circles it has taken on the characteristics of a secular religion. In the twentieth century, human health is prized as it has been in no other. In the United States, in particular, we have moved from valuing sheer physical health to cherishing the psychological well-being of the total person. In pursuing these goals, we have relied on medicine, psychology, and social science to produce more valid knowledge and techniques with which to serve this value. Science and medicine, in turn, are values that are used to promote psychological health as a social and ethical goal. Thus, the importance of health, the faith in science and medicine, the reliance on technology to produce means for the ends declared desirable by experts, and the development of professional skill and specialization as attributes of the technology all combine to maintain and reinforce mental health as a value. The high degree of acceptance of this value also seems related to its congruence with the Protestant ethic. Kingsley Davis (1938) has suggested that the mental health movement took over the Protestant ethic as a system of conscious preachment and unconscious premises and that it bases itself upon fftuch the same values. But we suggest that the Movement has done more than take over the Protestant ethic—it has dressed it up in a modern scientific cloak. Thus it serves as a new ideology that

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recommends, in nonreligious, quasi-scientific terms, a way of dealing with personal troubles and anxieties without the necessity for becoming involved in broader social issues or societal reconstruction. In any case, its popularity among middle-class, college-educated Americans cannot be denied. For some ideologists of the movement, "mental health" has become a mystique and a secular religion. Dicks, for example, proposes that it be conceived of as a new value in our world that is "comparable to the notions of 'finding God,' 'salvation,' 'perfection' or 'progress' which have inspired various eras of our history, as master-values which at the same time implied a way of life. . . . Some of the attributes of a secular priesthood or therapeutae are attached to us, and it is questionable whether we ought to divest ourselves of them even if the community would let us" (1950, pp. 3-4). Thus, for the mental health enthusiast, "mental health" becomes the standard for evaluating human behavior. Further, the mental health idea implies a new conception of moral and social progress in the form of self-correctability, self-perfectibility, inner growth, personal fulfillment, and inward and outward harmony, or the like. We are told that in the same way that we have achieved physical comfort—-through the instrumental application of knowledge and understanding—we can achieve psychological mastery over the self. This idea of progress embodies a new conception of success. No longer is it sufficient to measure achievement in tangible coin; we are persuaded to evaluate ourselves in terms of self-development and maturity. But there are no clear guidelines as to the means of reaching this goal or even to knowing that one has reached it. Orientations toward mental health. Orientations toward mental health as a desirable objective, as a subject matter, and as a field of work, knowledge, and inquiry oscillate between two poles. On the one hand, mental health is seen as a restricted and circumscribed "state of being" and as the subject matter of a field of work that is a specialty among other specialties. The individual or his immediate social environment is the unit for analysis, attempted control, and change. On the other hand, mental health is seen as the sum total of the individual personality, and the field of work associated with it is a superordinate, all-inclusive science of man. In the more restricted orientation, the acquisition of mental health is viewed as a technical problem that is to be solved under the direction and leadership of experts. Mental health technology is seen as being contained in and developed and

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transmitted by practitioners who claim special skills and expertise and who are legitimated by the society as the vehicle for the ethical application of knowledge about mental health. Operational techniques and procedures are established, and frames of reference and explanatory theories are developed and fiercely adhered to. In general this orientation stresses the separateness of persons and encourages them to seek inner tranquility and self-actualization on a private basis; psychological well-being is seen as a function of personality dynamics, which, in turn, are supposed to be primarily a function of early experience and only secondarily of later interpersonal relations. [For an approach that stresses primarily social factors, see PSYCHIATRY, article on SOCIAL PSYCHIATRY.] By contrast, those who take an all-encompassing view of mental health phenomena claim as their province the entire range of human thought and behavior; they believe that the human panorama is to be interpreted within the mental health framework rather than vice versa. These contrasting orientations have different advantages and disadvantages in achieving mental health objectives. The psychotherapeutic orientation is far more specific about the nature of the phenomena to be affected, be they biochemical, individual, or social; it therefore affords greater opportunity for intervention and control. However, by restricting the variables to be dealt with, it may neglect significant and, perhaps, crucial phenomena. By contrast, the broader orientation opens up greater possibilities of discovering the various interconnections between the variables involved. However, its very diffuseness and scope make it a poor guide for scientific research or social action. The functions of mental health ideology. The mental health ideology and movement function, in general, whether deliberately or inadvertently, to preserve and enhance certain values in American society. Outstanding among these is the humanistic value that emphasizes the importance of the individual as well as his development and fulfillment. Thus, the mental health movement contributes to and reinforces certain aspects of American democratic ideals and also promotes a form of "inwardness" by emphasizing introspection and selfawareness. By focusing on changing the individual rather than the society, the mental health movement directs effort away from social reconstruction and thereby functions to preserve the status quo and those middle-class values that are an intrinsic part of it. This is not to deny that some practitioners use the mental health idea as a vehicle for achieving social reform; but they are interested

only in specific social changes which they hope to effect in the name of mental health, such as changes in child-rearing practices in the family or in the ways in which students are handled in public school. For the ideologists, the conception provides a Weltanschauung of self-betterment to which they can devote themselves at a time when sociopolitical ideologies are unfashionable in the United States. Thus mental health is put forward as the panacea for all social problems and for the wholesale improvement of mankind. For the practitioner, on the other hand, the concept of mental health usually serves as a goal—albeit an ambiguous one— against which he can measure the current functioning of his patients and toward which he can direct his and their efforts; it is an implicit or explicit standard against which he measures the success and failure of his efforts and those of his colleagues. Problems for the future Despite the expansion of the mental health movement and the prestige of the professionals involved with it, little is known about how to achieve mental health. Moreover, the mechanisms for applying this meager knowledge and effecting the ends sought are extremely inadequate. Of the many issues that need resolution, three are central. The first is the necessity for conceptual extension beyond the individual intrapsychic life, interpersonal relations, and limited social contexts. For no matter how sophisticated, discerning, or scientific is our understanding of human beings as individuals, this framework is insufficient for understanding mental health, which also needs to be seen as a function of social roles, institutions, and communities. The second problem concerns this very scope of the mental health conception, which, because it involves a number of aspects of human living, demands an integration of the biochemical, psychological, social, and philosophical disciplines that is not yet in sight. The third problem involves the difficulties in intervention, implementation, and control that would remain even if conceptual expansion and the integration of relevant disciplines were achieved. Even if mental health can be achieved by rational planning, how much planning of this kind is desirable? Would it not threaten other cherished values, or have consequences that we cannot now foresee? From one perspective, the problem of mental health is identical with the eternal question of how to lead the good life. Perhaps this is not subject matter for academic disciplines, whether they be expanded or integrated, but rather

MENTAL HEALTH: The Concept an emergent from the human condition, in its infinite complexity, only a part of which can be planned for. Perhaps we need to raise the issue of how much mental health can be achieved by science and planning. It may be that the ultimate goal of positive mental health for all will continue to elude us as one of our persistent human limitations. MORRIS S. SCHWARTZ AND CHARLOTTE GREEN SCHWARTZ [Directly related are the entries on HEALTH; ILLNESS; LIFE CYCLE; MENTAL DISORDERS, TREATMENT OF, article on THE THERAPEUTIC COMMUNITY; PSYCHIATRY, article on SOCIAL PSYCHIATRY; PSYCHOANALYSIS. Other material relevant to the concept of mental health may be found in MENTAL DISORDERS; and in the biographies of FREUD; RANK; REICH; SULLIVAN.] BIBLIOGRAPHY CAPLAN, GERALD 1964 Principles of Preventive Psychiatry. New York: Basic Books. CLAUSEN, JOHN A. 1956 Sociology and the Field of Mental Health. New York: Russell Sage Foundation. CONRAD, DOROTHY C. 1952 Toward a More Productive Concept of Mental Health. Mental Hygiene 36:456473. DAVIS, KINGSLEY 1938 Mental Hygiene and the Class Structure. Psychiatry 1:55-65. DICKS, HENRY V. 1950 In Search of Our Proper Ethic. British Journal of Medical Psychology 23:1-14. EATON, JOSEPH W. 1951 The Assessment of Mental Health. American Journal of Psychiatry 108:81-90. Educational Practices. 1960 Pages 111-170 in Pennsylvania Mental Health, Incorporated, Mental Health Education: A Critique. Philadelphia: The Corporation. FELIX, ROBERT H. 1957 Evolution of Community Mental Health Concepts. American Journal of Psychiatry 113:673-679. FRANK, LAWRENCE K. 1948 Society as the Patient: Essays on Culture and Personality. New Brunswick, N.J.: Rutgers Univ. Press. FRANK, LAWRENCE K. 1953 The Promotion of Mental Health. American Academy of Political and Social Science, Annals 286:167-174. FREUD, SIGMUND (1932) 1965 New Introductory Lectures on Psycho-analysis. New York: Norton. -» First published as Neue Folge der Vorlesungen zur Einfiihrung in die Psychoanalyse. FROMM, ERICH 1947 Man for Himself: An Inquiry Into the Psychology of Ethics. New York: Holt. FKOMM, ERICH (1955) 1959 The Sane Society. New York: Holt. GINSBURG, SOL W. 1955 The Mental Health Movement: Its Theoretical Assumptions. Pages 1-29 in Ruth Kotinsky and Helen Witmer (editors), Community Programs for Mental Health: Theory-Practice Evaluation. Cambridge, Mass.: Harvard Univ. Press. GURSSLIN, O. R. ; HUNT, R. G.; and ROACH, J. L. 19591960 Social Class and the Mental Health Movement. Social Problems 7:210-218. HARTMANN, HEINZ 1939 Psychoanalysis and the Con-

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cept of Health. International Journal of Psycho-analysis 20:308-321. JAHODA, MARIE 1955 Toward a Social Psychology of Mental Health. Pages 296-322 in Ruth Kotinsky and Helen Witmer (editors), Community Programs for Mental Health: Theory-Practice Evaluation. Cambridge, Mass.: Harvard Univ. Press. JAHODA, MARIE 1958 Current Concepts of Positive Mental Health. Joint Commission on Mental Illness and Health, Monograph Series, No. 1. New York: Basic Books. JAHODA, MARIE 1963 Mental Health. Volume 3, pages 1067-1079 in Encyclopedia of Mental Health. New York: Watts. KLEIN, DONALD C. 1960 Some Concepts Concerning the Mental Health of the Individual. Journal of Consulting Psychology 24:288-293. LEUBA, CLARENCE 1960 The Mental Health Concept. American Psychologist 15:554—555. LEWIS, AUBREY 1953 Health as a Social Concept. British Journal of Sociology 4:109-124. MASLOW, ABRAHAM H. 1962 Toward a Psychology of Being. Princeton, N.J.: Van Nostrand. THE MIDTOWN MANHATTAN STUDY 1962 Mental Health in the Metropolis: The Midtown Manhattan Study, by Leo Srole et al. Vol. 1. New York: McGraw-Hill. NUNNALLY, JUM C. JR. 1961 Popular Conceptions of Mental Health: Their Development and Change. New York: Holt. OFFER, DANIEL; and SABSHIN, MELVIN 1966 Normality: Theoretical and Clinical Concepts of Mental Health. New York: Basic Books. OPLER, MARVIN K. (editor) 1959 Culture and Mental Health: Cross-cultural Studies. New York: Macmillan. REDLICH, F. C. 1952 The Concept of Normality. American Journal of Psychotherapy 6:551-569. RIDENOUR, NINA 1963 The Mental Health Movement. Volume 3, pages 1091-1102 in Encyclopedia of Mental Health. New York: Watts. RUMKE, H. C. 1955 Solved and Unsolved Problems in Mental Health. Mental Hygiene 39:178-195. SCOTT, WILLIAM A. 1958 Research Definitions of Mental Health and Mental Illness. Psychological Bulletin 55:29-45. SEELEY, JOHN R. 1955 Social Values, the Mental Health Movement, and Mental Health. Pages 599-612 in Arnold Rose (editor), Mental Health and Mental Disorder. New York: Norton. SMITH, M. BREWSTER 1950 Optima of Mental Health. Psychiatry 13:503-510. SMITH, M. BREWSTER 1959 Research Strategies Toward a Conception of Positive Mental Health. American Psychologist 14:673-681. SMITH, M. BREWSTER 1961 "Mental Health" Reconsidered: A Special Case of the Problem of Values in Psychology. American Psychologist 16:299-306. SULLIVAN, HARRY STACK 1954 The Psychiatric Interview. Edited by Helen Swick Perry and Mary Ladd Gawel. New York: Norton. -> Published posthumously. WEGROCKI, HENRY J. (1948) 1953 A Critique of Cultural and Statistical Concepts of Abnormality. Pages 691-701 in Clyde Kluckhohn and Henry A. Murray (editors), Personality in Nature, Society, and Culture. 2d ed., rev. & enl. New York: Knopf. WORLD FEDERATION FOR MENTAL HEALTH, SCIENTIFIC COMMITTEE 1962 Identity: Mental Health and Value Systems. Edited by Kenneth Soddy. London: Tavistock.

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MENTAL HEALTH: Social Class and Personal Adjustment ii

SOCIAL CLASS AND PERSONAL ADJUSTMENT

If personality is seen as referring to the relatively enduring needs, motives, attitudes, values, belief systems, and self-conceptions that characterize the behavior of the individual, there is good reason to expect a substantial relationship between social class (one's position in the stratification structure) and personality. The basis for expecting such a relationship rests on widely accepted assumptions regarding man and society. Human personality is to a large extent a product of the social learning experiences that the individual undergoes in the sociocultural environment in which he lives. Moreover, there seems to be almost complete agreement among social scientists that the early experiences of the individual are of critical importance in personality development and in later adjustment, although there is considerable disagreement as to the dynamics of the relationship between early experience and later personality. It is also generally accepted that personality continues to develop throughout the life cycle (although probably at a less rapid rate than in childhood) in response to learning experiences and environmental pressures which the person encounters in the performance of his social roles. Finally, it is readily apparent that one of the most pervasive aspects of the social structures impinging on the individual throughout his life cycle is the stratification system of his society. This last observation is true not only because all societies have a system of stratification in which the members are differentiated into strata of unequal status but also because of the unique function of the family as a status ascription and socialization agency. Because in all societies the child is accorded the same status as his parents, the family of origin serves as the main link between the child and society. Since the family is the major agency charged with the early socialization of the child, its position in the stratification structure will to a large extent determine the social learning influences to which the child will be subjected during the most formative periods of his life. Moreover, the family's position in the stratification structure will greatly affect the child's choice of associates outside of the family, which in turn will go far in determining the social opportunities he will encounter throughout his life. Thus the stratification system may be seen as one of the most important and continuous social contexts in which the individual's developmental history takes place; certainly, one's position in it should have a substantial bearing on his personality. This is not to say, how-

ever, that personality is wholly determined by social class. The possible influences on personality development to which the individual is subjected are many and varied and are by no means all classlinked. The two principal sources of research evidence on the relationship between social class and personality are studies of social class and the socialization of the child and studies of social class and mental illness. In the past 25 years many studies in both of these areas have appeared. Fortunately, reviews of much of this literature are available (Bronfenbrenner 1958; Dunham 1961; Sewell 1962; Mishler & Scotch 1963) so that only major trends and more recent developments are covered here. Social class and socialization In one of the early studies of social class and personality, Davis and Dollard (1940) attempted to show how the social structure influences the nature of the learning process by which Negro children are trained to take on the behavior appropriate to their position in the social stratification system of the southern United States. The authors trace the process by which the child learns and acquires from his parents, his family's social clique, his peers, and his interactions with white adults the needs, motives, cognitions, attitudes, values, and behavior patterns of the class subculture of which he is a member. These results were based mainly on informal observational procedures and, consequently, are suggestive rather than definitive; but they stimulated many subsequent studies of social class and child rearing. Perhaps best known is the study by Davis and Havighurst (1946) of middle-class and lower-class Negro and white children in Chicago. Using interviewing procedures, they found that the social class differences were much greater than the race differences and clearly indicated that middle-class mothers were more restrictive than lower-class mothers in the critical early training of the child. For instance, middle-class mothers were more likely to bottlefeed, follow a strict nursing schedule, restrict the sucking period, wean earlier and more abruptly, and begin and complete toilet training earlier than lower-class mothers. They also followed stricter regimens in other areas and expected their children to assume responsibilities earlier. These differences in early feeding and toilet training were widely interpreted by psychoanalytically oriented writers as evidence that middle-class child-training practices were baneful to middleclass children and were likely to produce maladjusted adults. Subsequent and more carefully

MENTAL HEALTH: Social Class and Personal Adjustment designed studies of social class differences in childrearing practices have failed to confirm the findings of the Chicago study. In fact, on many points, the results of later studies (see, for instance, Sears, Maccoby & Levin 1957) have contradicted those of the Chicago study—particularly on toilet-training and infant-feeding practices—and have shown that lower-class mothers are more restrictive and punitive in relation to basic needs than middleclass mothers. Urie Bronfenbrenner (1958), on the basis of a detailed examination of data from a number of studies covering a 25-year period, concluded that lower-class mothers have probably become more restrictive in infant feeding and toilet training since World War n, while middleclass mothers have become more permissive, with the result that the gap between them has tended to close. However, throughout this period, middleclass mothers have been consistently more permissive toward the child's expressed needs and wishes, less likely to use physical punishment, and more accepting and equalitarian in dealing with the child than have lower-class mothers. Thus, it would appear that there is little evidence from these studies to support the view that the lower-class child undergoes socialization experiences that are more favorable to his later personality than does the middle-class child; if anything, the evidence points in the opposite direction. Possibly as a result of these findings, and because empirical research has cast doubt on the importance of toilet training and infant-feeding practices for later personality (Sewell 1952), recent studies of social class and personality development have tended to place less emphasis on infant training and more stress on parent-child relationships extending into childhood and adolescence. Several studies illustrating this trend may be briefly mentioned. Kohn (1959a; 1959b) finds that middleclass parents emphasize internalized standards of conduct, including honesty and self-control, while working-class parents stress respectability, obedience, neatness, and cleanliness. Middle-class parents tend to respond to misbehavior in terms of the child's intent and to take into account his motives a nd feelings, while lower-class parents focus on the child's actions and respond in accordance with the seriousness of the act. Moreover, there is evidence that middle-class parents are less authoritarian in their relations with their adolescent children than lower-class parents but have higher expectations °f them (Elder 1962). Rosen (1961) finds that not On ly do middle-class junior-high-school boys have higher achievement motives and values than lowerclass boys, but that middle-class parents put more Pressure on them to succeed, teach them to believe

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in success, and create conditions in which success is possible. Studies of lower-class adolescent boys, on the other hand, testify to the influence of peer groups and of the lower-class culture of the community, especially in socialization to delinquent roles (Miller 1958). Still other studies have shown that middle-class adolescents are trained to defer their gratifications and lower-class youths to satisfy their current needs (Schneider & Lysgaard 1953). Finally, many other studies show that middle-class parents, in comparison with lower-class parents, place more stress on values which result in high levels of aspiration and achievement in the educational and occupational spheres (Kahl 1953). Another quite different recent emphasis in socialization research has been renewed interest in cognitive development. Studies thus far reported indicate that lower-class children suffer from cognitive deficits that may seriously impede their later adjustments to school and adult roles (Deutsch 1963; Hess & Shipman 1965). Much more needs to be done to discover the full range of class differences in socialization practices and especially to determine their effects on personality development and adjustment in the various classes. Studies, not reviewed here, relating socioeconomic status to scores on personality tests indicate a low but positive correlation between social class and the personality adjustment of the child (Sewell 1962, pp. 348-349). Some good work on socialization and social class is being done, but much more is needed using better samples, a wider range of socialization practices, and better datagathering and data-analysis techniques. Social class and mental illness The largest body of evidence on the relation of social class to personality comes from the findings of a number of studies of social aspects of mental illness. One of the most important of these is the study by Faris and Dunham (1939), who found, among other things, an inverse association between socioeconomic characteristics of Chicago census tracts and first admission rates for schizophrenia. Since the publication of this research, similar studies of American, European, and Asian cities have essentially replicated these results (Dunham 1961, pp. 274-290). Ecological studies of this kind have been criticized because of bias arising from socioeconomic selection in first admissions to mental hospitals; the possibility that mentally ill persons have drifted from the better into the poorer areas of the city after the onset of their illness; and reliance on purely ecological correlations. Studies (Clark 1948; 0degaard 1956) based on the association between occupation or income and admission

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MENTAL HEALTH: Social Class and Personal Adjustment

rates for psychoses, especially schizophrenia, generally conlirm the results of the ecological studies, but are also subject to the criticism that admission rates to mental hospitals tend to be selective of lower-class persons. Hollingshead and Redlich (1958), in their study of social class and mental illness in New Haven, improved on the earlier studies by obtaining detailed classifications of all cases in treatment with a psychiatrist or under the care of a psychiatric clinic or mental hospital, by carefully assessing individual socioeconomic status, by taking a city-wide control sample of normal persons for comparative purposes, and by computing rates for treated cases of various types of mental illness by class status. Most of their findings are for treated prevalence and therefore understate the total prevalence of mental illness in the community, but they clearly indicate that the lower classes have much higher rates for psychiatric illness, especially for psychoses. Other evidence collected by Hollingshead and Redlich indicates that diagnosis and treatment favor the higher social classes, with the consequence that members of the lower social classes tend to be diagnosed more readily as psychotics, to receive less individually oriented treatment, and to remain in custodial care for much longer periods of time. Because this piling-up of cases might explain the higher treated prevalence rates of the lower classes, incidence rates (based on the number of patients who entered treatment during the interval of observation) were computed. Again the lowest social class had the highest rates, although the differences between the other classes were no longer as marked. Moreover, while there was no relationship between social class and the incidence of neuroses, the inverse relationship of class membership and psychoses remained, with the rate for the lowest class being twice that for the next highest class and almost three times as high as for the two highest classes. This finding is particularly impressive because it confirms the results of the earlier ecological and correlational studies. But even the study just described is seriously defective because it is based only on treated cases. Evidence has been mounting for some time that the prevalence and incidence of mental illness in the community are much greater than the treated rates because many cases are either not treated or are handled by others than psychiatrists, mental health clinics, and mental hospitals. This is apparently true even for quite serious forms of mental illness. Recently, attempts have been made to obtain more satisfactory evidence concerning total prevalence of mental illness by means of sample

surveys in which clinical examinations or symptoms inventories are used to determine mental health status. Obviously, the magnitude of the rate will depend on the inventories and the cutting points used in determining who is and who is not mentally ill. The results of the Midtown Manhattan Study (1962; 1963), based on a large probability sample of adults, are especially informative in that a consistent inverse relationship is found between socioeconomic status and poor mental health and a direct relationship between status and absence of significant symptoms of mental pathology. Of all of the many variables tested, socioeconomic status was the one most clearly associated with mental health. Moreover, this relationship held whether parental socioeconomic status or the person's own socioeconomic status was taken as the status measure, and it persisted when age and sex were controlled. The finding of an inverse relation between socioeconomic status of parents and impaired mental health is particularly significant because it indicates that successively lower parental status carries for the child progressively greater likelihood of inadequate personality adjustment in adulthood. The finding that one's current socioeconomic status is even more closely related to one's mental health suggests that the effects of low socioeconomic status are probably cumulative in that the vulnerable personalities developed by some low-status children prevent their upward mobility and destine them to the further burdens and stresses that low socioeconomic status adults typically encounter in the United States. Moreover, lower-class persons tend toward socially disturbing psychotic adaptations that further complicate their adjustment to an already stressful environment, while higher-status persons tend to respond to stress with mild neurotic responses that are socially more adaptive. Thus, the cumulative effects of unfavorable childhood and adult experiences on the lower-class person may result in a higher degree of vulnerability not only to mental illness but also to the development of more serious psychiatric symptoms. Another important finding of the Midtown Manhattan Study is that those who are downwardly mobile present more symptoms of mental disturbance than those who are nonmobile, with those who are upwardly mobile having the fewest symptoms of all. Evidence indicates that downward mobility is associated with the character disorders, or personality-trait disturbances, while upward mobility tends to be associated with neurotic behavior. These findings confirm the conclusions of earlier studies based on clinical observations (Hollingshead & Redlich 1958). The task of unraveling

MENTAL HEALTH: Social Class and Personal Adjustment cause and effect in this area is indeed challenging and demands further research; whereas mobility may result in some types of psychiatric illnesses, it is also likely that certain personality characteristics —including psychiatric symptoms—may help determine who rises or falls in the stratification system (Dunham et al. 1966). The one finding from the studies of social class and mental illness which comes through most clearly is that the lowest social class has the highest incidence and prevalence of major psychiatric illness. The explanations offered for this finding vary considerably, but they may be conveniently subsumed under three general notions. First is the claim that class variations in rates of mental illness are due to the way in which a social system functions over time to sort and sift persons with certain personality characteristics or vulnerabilities into social class positions. Second, it is argued that differences in the extent and nature of environmental stress in the various classes account for differences in rates. Finally, some authors argue that class differences in socialization, especially early socialization, are responsible for differing rates of mental illness among the various social classes. As we have seen in our examination of the research evidence so far available, it is clear that no one of these explanations has ever been subjected to anything approaching a scientifically adequate test. It may be concluded that there are good theoretical reasons for expecting an association between social class and personality development and adjustment. However, studies to date do not indicate a sizable relationship but suggest that lower-class status is associated with socialization experiences that foster the development of needs, motives, attitudes, belief systems, self-conceptions, cognitive modes, and styles of coping with stress which result in personality maladjustment. Much more needs to be known about the socialization experiences that members of the various classes undergo, particularly how these affect personality systems. Finally, more systematic and theoretically informed studies of the role of social class in the etiology of mental illness are greatly needed. WILLIAM H. SEWELL [See also ACHIEVEMENT MOTIVATION; LIFE CYCLE; MENTAL DISORDERS, article on EPIDEMIOLOGY; PERSONALITY; PERSONALITY MEASUREMENT; PSYCHIATRY, article on SOCIAL PSYCHIATRY; SOCIAL MOBILITY; SOCIALIZATION; STRATIFICATION, SOCIAL.] BIBLIOGRAPHY BRONFENBRENNER, URIE 1958 Socialization and Social Class Through Time and Space. Pages 400-425 in

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Society for the Psychological Study of Social Issues, Readings in Social Psychology. 3d ed. New York: Holt. CLARK, ROBERT E. 1948 The Relationship of Schizophrenia to Occupational Income and Occupational Prestige. American Sociological Review 13:325-330. DAVIS, ALLISON; and DOLLARD, JOHN (1940) 1953 Children of Bondage: The Personality Development of Negro Youth in the Urban South. Prepared for the American Youth Commission. Washington: American Council on Education. DAVIS, ALLISON; and HAVIGHURST, ROBERT J. 1946 Social Class and Color Differences in Child Rearing. American Sociological Review 11:698—710. DEUTSCH, MARTIN 1963 The Disadvantaged Child and the Learning Process. Pages 163-179 in Work Conference on Curriculum and Teaching in Depressed Urban Areas, Columbia University, 1962, Education in Depressed Areas. Edited by Harry A. Passow. New York: Columbia Univ., Teachers College. DUNHAM, H. WARREN 1961 Social Structures and Mental Disorders: Competing Hypotheses of Explanation. Milbank Memorial Fund Quarterly 39:259-311. DUNHAM, H. WARREN et al. 1966 A Research Note on Diagnosed Mental Illness and Social Class. American Sociological Review 31:223-227. ELDER, GLEN H. 1962 Adolescent Achievement and Mobility Aspirations. Chapel Hill: Univ. of North Carolina, Institute for Research in Social Sciences. PARIS, ROBERT E. L.; and DUNHAM, H. WARREN (1939) 1960 Mental Disorders in Urban Areas: An Ecological Study of Schizophrenia and Other Psychoses. New York: Hafner. HESS, ROBERT D.; and SHIPMAN, VIRGINIA C. 1965 Early Experience and the Socialization of Cognitive Modes in Children. Child Development 36:869-886. HOLLINGSHEAD, AUGUST B.; and REDLICH, FREDRICK C. 1958 Social Class and Mental Illness: A Community Study. New York: Wiley. KAHL, JOSEPH A. 1953 Educational and Occupational Aspirations of "Common Man" Boys. Harvard Educational Review 23, no. 3:186-203. KOHN, MELVIN L. 1959a Social Class and the Exercise of Parental Authority. American Sociological Review 24:352-366. KOHN, MELVIN L. 1959fo Social Class and Parental Values. American Journal of Sociology 64:337—351. THE MIDTOWN MANHATTAN STUDY 1962 Mental Health in the Metropolis: The Midtown Manhattan Study, by Leo Srole et al. Vol. 1. New York: McGraw-Hill. THE MIDTOWN MANHATTAN STUDY 1963 Life Stress and Mental Health: The Midtown Manhattan Study, by Thomas S. Langner and Stanley T. Michael. Vol. 2. New York: Free Press. MILLER, WALTER B. 1958 Lower Class Culture as a Generating Milieu of Gang Delinquency. Journal of Social Issues 14, no. 3: 5-19. MISHLER, ELLIOT G.; and SCOTCH, NORMAN A. 1963 Sociocultural Factors in the Epidemiology of Schizophrenia. Psychiatry 26:315-351. 0DEGAARD, 0. 1956 The Incidence of Psychoses in Various Occupations. International Journal of Social Psychiatry 2:85-104. ROSEN, BERNARD C. 1961 Family Structure and Achievement' Motivation. American Sociological Review 26: 574-585. SCHNEIDER, Louis; and LYSGAARD, SVERRE 1953 The Deferred Gratification Pattern: A Preliminary Study. American Sociological Review 18:142-149.

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MENTAL HOSPITALS

SEARS, ROBERT R.; MACCOBY, E. E.; and LEVIN, H. 1957 Patterns of Child Rearing. Evanston, 111.: Row, Peterson. SEWELL, WILLIAM H. 1952 Infant Training and the Personality of the Child. American Journal of Sociology 58:150-159. SEWELL, WILLIAM H. 1962 Social Class and Childhood Personality. Sociometry 24:340-356.

MENTAL HOSPITALS See MENTAL DISORDERS, TREATMENT OF, article On THE THERAPEUTIC COMMUNITY.

MENTAL ILLNESS See ILLNESS; MENTAL DISORDERS; MENTAL HEALTH; PSYCHOSOMATIC ILLNESS.

MENTAL RETARDATION Mental retardation is a problem of serious social concern. In view of the large number of persons considered to be mentally retarded, such concern is certainly justified. Using the conventional criterion of 3 per cent of the population, the U.S. President's Panel on Mental Retardation (1963) estimated that almost 5.5 million children and adults in the United States are mentally retarded. The criterion for mental retardation established in the "Manual on Terminology and Classification in Mental Retardation" (Heber 1959) and adopted by the American Association on Mental Deficiency as well as the Biometrics Branch, National Institute of Mental Health, is that all those at least one standard deviation below the population mean intelligence quotient (IQ) are considered retarded. If one accepts this criterion, and many do not, there are almost 30 million mental retardates in the United States. If the more conservative estimmate is employed, mental retardation is twice as prevalent as blindness, polio, cerebral palsy, and rheumatic heart conditions combined (Doll 1962). The typical textbook pictures the distribution of intelligence as normal or Gaussian in nature, with approximately the lower 3 per cent of the distribution encompassing the mentally retarded. A common class of persons is thus constructed, a class defined by intelligence-test scores below 70. This schema has misled many laymen and students and has subtly influenced the approach of experienced workers in the area. For if one fails to appreciate the arbitrary nature of the cutoff point of 70, it is but a short step to the formulation that all those falling below this point compose a homogeneous class of "subnormals." Since the conceptual distance between "subnormal" and "abnormal," with

its age-old connotation of disease and defect, is minimal, the final step is to regard retardates as a homogeneous group of defective organisms, immutably different from those persons possessing a higher IQ. The view that mental retardates represent a homogeneous group is seen in numerous research studies where comparisons between retardates and normals are made on the basis of IQ classification alone. The view that mental retardates, as a group, are "different" is most vividly encountered in comparative studies where mental retardates are conceptualized as occupying a position on the phylogenetic scale somewhere between monkeys and children of average intellect. It is of some interest to note that people deficient in respect to intelligence-test performance are usually not called "mental deficients" but rather are commonly referred to as "mental defectives." The defect orientation to mental retardation originally emphasized the notion of moral defect and stemmed anywhere from the belief that retardates were possessed by a variety of devils to the empirical evidence of their exhibiting an inordinately high incidence of socially unacceptable behaviors, such as crime and illegitimacy. More recently, the notion of defect has referred to defects in either physical or cognitive structures. This defect approach has a certain unquestionably valid component. There is a sizable group of retardates who suffer from a variety of known physical defects. Mental retardation may be due to such factors as a dominant gene (as in epiloia), a single recessive gene (as in gargoylism, phenylketonuria, amaurotic idiocy), infections (such as congenital syphilis, encephalitis, rubella in the mother), chromosomal defects (as in mongolism), toxic conditions (such as radiation in utero, lead poisoning, and Rh incompatibility), and cerebral trauma. For a complete listing of the many types of mental retardation the reader is referred to the "Manual on Terminology and Classification in Mental Retardation" (Heber 1959). The diverse etiologies noted above have one factor in common: in every instance examination reveals an abnormal physiological process, that is, there are specific or related defects in physiological functioning. Such persons are abnormal in the orthodox sense, since they suffer from a known disease defect. However, in addition to this group, which forms a minority of all retardates, there is the group labeled "familial," or more recently "undifferentiated," which comprises approximately 75 per cent of all retardates. This group presents the greatest mystery and has been the object of the

MENTAL RETARDATION most heated disputes in the area of mental retardation. The diagnosis of familial retardation is made when an examination does not reveal the physiological manifestations noted above and when retardation exists among parents, siblings, or other relatives. As will be seen in a later section, several theoreticians have extended the defect notion to this type of retardate. On the basis of differences in performance between retardates and normals on some experimental task rather than on physiological evidence, they have advanced the view that all retardates suffer from some specifiable defect over and above their general intellectual retardation. However, these theoreticians differ as to the specific nature of the defect. The experimental paradigm employed to demonstrate such defects involves equating groups of normals and retardates on Mental Age (MA), thus roughly controlling for general intellectual level, and demonstrating differences in performance between the two groups on some experimental task. This more general defect approach thus lends support to the conceptualization of the mentally retarded as a homogeneous group of physiologically defective persons. Some order can be brought to the area of mental retardation if a distinction is maintained between physiologically defective retardates, with known etiologies, and familial retardates, whose etiology is unknown. For the most part, work with physically defective retardates involves investigation into the exact nature of the underlying physiological processes, with prevention or amelioration of the physical and intellectual symptoms as the goals. Jervis (1959) has suggested that such "pathological" mental deficiency is primarily in the domain of medical sciences, whereas familial retardation represents a problem to be solved by behavioral scientists, including educators and behavioral geneticists. Diagnostic and incidence studies of these two types of retardates have disclosed two striking differences. The retardate having an extremely low IQ (below 40) is almost invariably of the defective type. (This does not mean that one cannot find defective retardates at every level of retardation. In fact, brain-damaged individuals may be found at every point along the IQ continuum.) Familial retardates, °n the other hand, are almost invariably mildly retarded, usually with IQs above 50. The defect position emphasizes the innate, if not immutable, difference between retardates and normals. The problem of definition. The decision of whether a person is considered retarded is often based not upon his intellectual characteristics but u Pon legal and occupational factors as well as his

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general level of social adjustment. The matter has been put most succinctly by Maher who stated: What constitutes mentally retarded behavior depends to a large extent upon the society which happens to be making the judgment. An individual who does not create a problem for others in his social environment and who manages to become self-supporting is usually not defined as mentally retarded no matter what his test IQ may be. Mental retardation is primarily a socially defined phenomenon, and it is in large part meaningless to speak of mental retardation without this criterion in mind. (1963, p. 238) This emphasis on social factors in defining mental retardation may lead to more confusion than clarity as indicated by the discrepancies found among various incidence and survey studies. The data of Table 1 would indicate that the incidence fluctuates not only across age categories but also according to the locality. If mental retardation is defined strictly in terms of IQ, and assuming a certain constancy of IQ score, we would expect no difference in the incidence of mental retardation at different ages. The standardization data of the Wechsler-Bellevue Scale confirm this expectation. Table 1 — Percentage of persons classified as mentally retarded LOCALITY

AGE Under 5 5-9 10-14 15-19

England and Wales

Baltimore, Maryland

Onondaga County (Syracuse), New York

0.12 1.55 2.65 1.08

0.07 1.18 4.36 3.02

0.45 3.94 7.76 4.49 Source: Jervis 1959, p. 1290.

The incidence figures reported in Table 1 are understandable if one realizes that they reflect diagnoses based on some combination of IQ and the success of the individual in meeting social demands. For example, the extremely low incidence under 5 years of age may reflect the minimal social demands made on young children. The highest incidence obtained at the 10-14 age level occurs when the child is faced with school and more demanding intellectual tasks. It is probably in this age range that the relationship between IQ scores and meeting societal expectancies (i.e., successful school performance) is greatest. Stated somewhat differently, it is probably in this age range where the use of either the IQ or the child's success in meeting social demands would result in his being classified as mentally retarded. A test-score orientation to mental retardation results in the view that approximately 3 per cent of the population is mentally retarded. The social competence viewpoint,

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however, results in a much smaller incidence. Data obtained through surveying representative samples of large populations or the entire population of certain limited regions in England and Scandinavia indicate that about 1 per cent or less of adults are classified as mentally retarded (e.g., Fremming 1947). Armed with the information that a person's social adequacy has much to do with whether or not he is considered retarded, we begin to get some inkling of the arbitrariness involved in such a classification. The nature of intelligence Whether mental retardation is defined by an intelligence-test score or by the person's social competence, which many claim reflects his intelligence, the essential aspect of mental retardation is lower intelligence than that displayed by the modal member of an appropriate reference group. There is little agreement, however, when the question precipitated by this statement is raised, namely, "What is the nature of intelligence?" We cannot avoid this question by invoking the very unsatisfying cliche that "intelligence is what an intelligence test measures," since it is perfectly apparent that the test constructor must have some definition of intelligence in mind, either explicitly or implicitly, before he can select test items. However, some consensus can probably be found for the view that intelligence is a hypothetical construct which has as its ultimate referent the cognitive processes of the individual. Given this, we are still faced with the unresolved issue of whether intelligence represents some single cognitive process which permeates every intelligence test or nontest behavior or whether it represents a great variety of relatively discrete cognitive processes which can be sampled and then summated to yield some indication of the amount of intelligence a person possesses [see INTELLIGENCE AND INTELLIGENCE TESTING]. In either case, the more important questions involve an understanding of exactly how such cognitive processes develop over the life span and exactly how innate and environmental factors interact to influence such development. Approached in this way, the problem of defining intelligence becomes one with the problem of the nature of cognition and its development. Cognitive versus psychometric approach. It follows that if we are to understand the nature of intelligence, we must consult those workers intent on investigating the nature and development of cognitive processes (e.g., thought, memory, concept formation, and reasoning) rather than focus

on the work of test constructors and psychometricians. There has been little cross-fertilization between these two groups, which have approached the investigation of intellective functioning quite differently. The former group of investigators utilizes a variety of techniques and, through extremely detailed analyses, attempts to tease out the intricacies of man's cognitive functioning. These theorists have tried to evolve a theory of human cognition and its development. If intelligence tests had been developed by this group, psychology might have avoided the perplexing state of affairs encountered in trying to define intelligence. Tests devised by such a group would, by necessity, be indicators of the formal features of the cognitive structure at various times in the life cycle. Recently, workers within this framework (e.g., Laurendeau & Pinard 1963) have taken an interest in the problem of assessment. Although the task of providing an acceptable theory of the development of cognition is far from finished, Laurendeau and Pinard have been able to take the first step toward the construction of an intelligence test based on the formal features of cognition that were isolated by Piaget [see DEVELOPMENTAL PSYCHOLOGY, article on A THEORY OF DEVELOPMENT].

From a historical point of view, the practical demands of society for a test which would measure intellectual functioning meant that intelligence became the province of the second group, namely, the testers and psychometricians. Furthermore, for a variety of reasons, American thinking was not receptive to the approach taken by the cognitive theorists. The practical and empirical nature of the work of the testers can be seen in the efforts of Alfred Binet, whose intent was not to investigate the nature of intelligence but rather to discover those test items which would discriminate between successful and unsuccessful school performance. As has been pointed out, Binet viewed his empirically selected tests as a social screening device rather than as a theoretical interpretation of the nature of intelligence. The success of Binet's tests in predicting school achievement led workers to the belief that such tests were inextricably bound to man's intelligence or cognitive functioning. For the psychometricians, it then became clear that the nature of intelligence could be understood by examining the nature of the tests that were employed to measure it. By discovering the correlations obtained between subtests within a given battery or across different tests, it was felt that the structure of intellect would be revealed. Despite the statistical rigor involved, no very satisfactory

MENTAL RETARDATION theory of intelligence has come out of the correlational or factor-analytic methods. There is, in fact, little agreement among workers even with regard to the one constant theoretical issue throughout this body of work, namely, the global versus the specific nature of intelligent behavior. It should be emphasized that the weakness of current theories of intelligence has led to a conceptual impasse in the area of mental retardation. If there is no satisfactory theory of intelligence, then the essential aspect of mental retardation must escape us and we must be content with superficial statistical and social approaches to this complex problem. We do not necessarily have to await a completed theory of intelligence, however, to cut through much of the complexity, disputation, and confusion encountered in the area of mental retardation. Some clarification appears possible through the simple process of reorienting or restructuring our approach to intellectual retardation. A rather sizable step forward is taken if our commitment to a simple test approach is abandoned in favor of a concern with cognitive processes. The process-content distinction. The plea is not that we abandon tests, for every cognitive theorist must eventually employ tests, as denned in the broadest sense. The plea is that workers in the field turn their attention from the superficial content of tests (i.e., the right or wrong answer) and come to grips with the problem of the cognitive structures and processes that give rise to content. It is this distinction between structure and content that has for too long escaped most workers in the area of mental retardation. Conventional tests are viewed by process-oriented cognitive theorists as too analytic and artificial in character and as measuring an end product and not a process (Laurendeau &Pinard 1963, p. 481). In general, however, Piaget's approach, with its developmental and normative emphasis, has had very little appeal to workers in the area of mental retardation, since such workers are committed to the study of individual differences. In this context, the test-constructing efforts of Laurendeau and Pinard appear very promising, since these followers of Piaget have formulated the states of cognitive development in terms of the nature of the cognitive operations achieved, thus emphasizing the nature of the cognitive structure and its accompanying processes. In their work we thus see a bridge beween a truly cognitive approach to intelligence and the need in the area of mental retardation for an instrument with which to make individual comparisons. The focus on the content of test behaviors has

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been carried over to many nontest behaviors, and often an insufficient distinction is made between intelligence and intelligent behavior. It is the author's view that intelligence must refer to the formal characteristics of the cognitive structure and the processes that accompany it, whereas intelligent behavior should refer to the content of behavior in respect to the appropriateness (often defined in a relatively arbitrary manner) with which an organism carries out an act. (See Maher 1963, for another discussion of this distinction between intelligence and intelligent behavior.) For example, in a sheltered workshop the author recently encountered a retardate working with a surprisingly complex piece of machinery. His ability to use this machinery defied current knowledge concerning the capabilities of the retarded. The director of the workshop explained that the retardate had been taught to operate the machine through a shaping process not unlike that employed by B. F. Skinner in training pigeons to play Ping-pong. It was also learned that the retardate could handle the machine quite adequately provided its position was not changed. To emphasize this point, the machine was rotated on its axis approximately 90°; the retardate then became somewhat agitated and was no longer able to operate the equipment. (Piaget has also commented that remarkable intellectual feats performed by children on some task or other cannot be repeated following relatively minor alterations in the task stimuli.) In terms of the finished product, the retardate was behaving just as intelligently as an operator with a normal IQ. However, this accomplishment does not indicate that the retardate has become normal in intelligence. It is obvious that he is using a much more primitive cognitive process to achieve his intelligent behavior than is the normal person. This example should also make it clear that process analyses demand that the investigator make a more careful analysis of the content than that provided by a superficial "product" or criterion of correctness. Social competence and mental retardation. The content approach is expressed also in the social competence definition of mental retardation. What are the intellectual demands of social competence? We do not know, and very little effort is made to discover what they might be. In the area of mental retardation, social competence usually means the ability to maintain oneself without too frequent contact with state schools, state hospitals, welfare agencies, and police officers. Though social competence defined in this way reflects certain cognitive abilities, it may also reflect a variety of factors reminiscent of nonintellectual aspects of intelli-

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gence-test performance. We refer here to factors such as luck, social values, attitudes toward other people, and emotional needs that are relatively independent of intellectual level. Thus, present intelligence tests may predict social competence better than an ideal intelligence test because of the overlap of nonintellectual variables which influence both intelligence-test scores and social competence. Social competence does not inevitably reflect normal intellectual functioning any more than its absence in the emotionally unstable, the criminal, or the social misfit reflects intellectual subnormality. Social competence is much too heterogeneous a phenomenon and reflects too many nonintellectual factors to be of great value in understanding mental retardation. The basic problem is that the concept of social competence is so value laden, and its definition so vague, that it has little heuristic utility. Windle (1962) has pointed out that the social competence definition of mental retardation is applicable only to institutionalized populations, whereas quite different definitional criteria must be employed with noninstitutionalized retardates. The only clear and acceptable operational definition of social competence would appear to be related to whether the individual has managed to function outside an institutional setting. Even Heber (1962), who has made the strongest case for employing social competence, has admitted that objective measures of adaptive behavior are presently unavailable. He has also stated that the present ambiguity of the social competence construct is such that in practice intelligence-test performance must remain "the most important and heavily weighted of the criteria used." There is a further problem with the social competence construct related to a fallacy which has permeated much of our thinking concerning the retarded. We have somehow come to believe that it is impossible for anyone who is "truly" retarded to meet the complex demands of our society. The bulk of retardates who have MAs in the 9-12 range (remembering that an MA of 16 is the upper limit for an individual of average IQ), have the intellectual wherewithal to meet the minimal demands of our society. This becomes immediately apparent if one raises the question of how much intellectual ability is required to arise in the morning, dress oneself, catch a bus or walk to a single location, perform some undemanding sort of labor, and return home. Indeed in the 1920s and 1930s it was discovered that there were no less than 118 occupations in our society suitable for individuals having MAs from 5 to 12. As late as 1956 it was noted that 54 per cent of jobs require no schooling beyond the elementary level (Whitney 1956).

Another major aspect of social competence is the ability of the individual to abide by the values of the society, that is, obey laws, and so on. While the incidence of crime among the retarded is higher than among the nonretarded, this increase of incidence is not very great, especially if one controls for social class. Here again it is an error to view obedience to the law as somehow beyond the ability of the retarded. One simply has to apply the concept of the stages of moral development as investigated by Jean Piaget (1932): fairly young children are capable of a morality based on absolutism, that is, the rules inhere in the very fabric of existence and are not to be broken under any circumstances. Individuals who never achieve a higher stage of moral development are certainly not developmentally adequate, but neither are they likely to break many laws. In order to make social competence a useful indicator of cognitive functioning, we must thus abandon some simplistic notion of social competence in favor of a variety of continua theoretically based upon the cognitive demands of the social requirements involved. Such indexes could then be considered independent indicators of intellectual functioning. Empirical efforts of this sort may be seen in the Vineland Social Maturity Scale and the Worcester Scale of Social Attainment. A more theoretical effort may be found in the work of Phillips and Zigler (1964) where both intelligence test scores and conventional social competence indexes are combined into an index of developmental or maturational level. The nature-nurture issue Attention is now turned to the role of cognitive capacity in mental retardation. Maher (1963) believes that the concept of capacity has considerable heuristic value for workers in the area of mental retardation. Intellectual capacity means something akin to Hebb's (1949) intelligence A, that is, an innate potential for the development of intellectual functions. Those who have argued that the intellectual capacity notion is a relatively useless one (e.g., Ferguson 1956) appear to be invariably committed to an environmentalistic or learning orientation. Maher's position is that the capacity concept has value as related to "the differences between individuals in rate of acquisition of responses under similar learning conditions. Such a concept necessarily implies the existence of structural differences between individuals and is incompatible with a. psychology of the empty organism . . ." (1963, p. 250). It is in this last sentence that we see the theoretical value of the capacity concept, since it

MENTAL RETARDATION forces us to conceptualize individuals as biological organisms innately differing in respect to the potential manifestation of a multitude of traits. Thus the concept of capacity is intimately related to the biological concept of the genotype. There has been an interesting effort to make intelligence, and thus mental retardation, a matter of acquired skills and transfer phenomena in the classical learning theory sense (see Ferguson 1956). Although Ferguson appears to abhor a biological concept of intelligence, he nevertheless falls back upon it in dealing with those aspects of early learning which do not reflect transfer effects. In addition, his treatment of transfer as a uniformly manifested phenomenon overlooks differences in ability to transfer from one task to another which may very well be a reflection of biological capacity. Given such an orientation, we can derive the optimistic view that complete control over learning experiences would do away with individual differences and, thus, mental retardation, at least of the nondefective variety. Such a view, though appealing, flies in the face of what has been observed. Herculean efforts of teaching and training have not resulted in marked change in the intellectual level of most retardates. The environmentalist, while acknowledging the importance of biological capacity, treats human behavior as the outgrowth of an infinite number of experiences. It is of interest to note that one environmentally oriented theorist (McCandless 1964) has argued that although heredity and environment interact in the production of intelligent behavior, we need only concern ourselves with environment, since "we can do something about environment." This approach implies that the manipulations of environments are expected to have constant results and, furthermore, ignores the obvious possibility that children with particular capacities will need specific environmental events in order to maximize their cognitive development. The one group that has seriously considered the nature of the interaction between genotype and experiences in producing certain behaviors (phenotypes) has been the behavior geneticists. Employing infrahuman subjects, these investigators have presented evidence that the effects of particular experiences and the behaviors to which they give rise depend upon the biological nature of the organism (e.g., Hirsch 1963). The attempt to determine the proportion of variance attributable to heredity or to environment is full of difficulties (H. Jones 1946). Despite the shortcomings of the nature-nurture work on intelligence, it is still possible to derive certain con-

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clusions. (For more complete reviews of this work the reader is referred to H. Jones 1946; McCandless 1964.) Studies of parent-child and of sibling resemblances in intelligence, a variety of twin studies, and studies on children in foster homes have made it clear that inherited intellectual endowment is a much more important factor in intelligence than those who are environmentally oriented would have us believe. At the same time one must not forget the importance of environmental factors to manifest intelligence. The role of environment is evident even in extreme cases where a known gene defect is the cause of mental retardation. In the case of genetically determined phenylketonuria, subnormal intelligence occurs only in an environment which provides phenylalanine in the diet of the affected individual. A specific change in the environment (i.e., withholding phenylalanine from the diet) will prevent the occurrence of subnormal intelligence. An issue in the nature—nurture controversy of special pertinence to mental retardation concerns the degree to which the environment may produce individual differences in intelligence in contrast to affecting the absolute achievement level of man. It is one thing to assert that the environment may play a role in determining the range of individual differences found among men. It is another thing to assert that environmental events can cause the individual with a normal intellectual endowment to become retarded or, for that matter, shift the entire range of intelligence in such a way that no individual would display that degree of intellectual impairment that we now label retarded. Different environments (e.g., rural versus urban, racial-cultural, social class) are associated with differences in intelligence. To what extent such differences reflect environmental as opposed to inherited factors remains an open issue. The position of the majority seems to be nurture oriented, and the argument advanced is that it is the social class or cultural environment which produces retardation. To state the matter more simply, the hereditarian asserts that one is in a lower socioeconomic class because one is less intelligent, whereas the environmentalist asserts that one is less intelligent because one is in the lower socioeconomic class. More specifically, mental retardation is sometimes seen as a major consequence of social deprivation. Such a view assumes that children are capable of "normal" intellectual functioning if we but expose them to enough "cultural enrichment." Environmental factors and IQ changes. A matter of considerable import in testing the above

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hypotheses is the magnitude of change that could be effected as a result of changes in the environment. Many investigators have been relatively pessimistic in their conclusions. McClearn (1962) has pointed out that the magnitude of the difference in IQs attributable to environmental factors, though statistically significant, has been so minute as to be practically negligible. In support of the environmentalistic point of view, however, instances can be found where rather marked improvements in IQ have been reported following some type of environmental manipulation. The reader is referred to the review by McCandless (1964), whose statement is perhaps one of the strongest in favor of the environmentalistic position. Other studies have indicated that when a geographic area is subjected to social improvement, such as better schools and improved communication, there is a tendency for the IQs of all the inhabitants to improve. Wheeler's study of Tennessee mountain children (1942) is of considerable interest. Testing over three thousand subjects in 1930, he found that IQs progressively declined from a mean of 95 at age 6 to a mean of 74 at age 16. Testing a new sample ten years later, he found a mean increase in IQ of approximately 10 points at every age level. However, the steady decline with age, from a mean of 103 at age 6 to a mean of 80 at age 16, was again discovered, despite the general increase. There has been a certain inconsistency in studies that have attempted to relate IQ changes to environmental factors. In some instances, significant correlations have been found between various subjective ratings of the "goodness" of the environment and increase in IQ (e.g., Thorpe 1946). But in other instances no environmental correlates could be found to account for changes in the IQ (e.g., H. Jones 1946). Jones has given some especially striking case histories of children who have manifested marked changes in IQ without the apparent involvement of environmental factors. A continuing problem has been the failure to designate just what constitutes a good environment for optimal intellectual development. Little has been added to the implicit view that the American middle-class home represents some sort of standard. A related matter, of course, is the problem of defining cultural or social deprivation. The social deprivation concept has been loosely applied to certain events in early childhood which are characterized as antecedent to certain social behaviors. There is little agreement about either the early events or the resultant behaviors. Major

dimensions of childhood deprivations that have been suggested are social isolation, cruelty and neglect, institutional upbringing, adverse childrearing practices, and separation experiences across a wide range of severity. Even factors such as these need much further definition and clarification. The view that, given a fairly standard environment, it is extremely difficult to improve the quality of cognitive functioning is consistent with the bulk of findings resulting from efforts to improve children's performance on Piaget-type tasks. Of course, familial retardates do not come from what we consider standard environments. Even with these children there is considerable evidence that no great intellectual improvement is produced through environmental manipulation, and this holds true for a variety of techniques. The reader is referred to E. E. Doll's excellent history of mental retardation (1962) for evidence on this point. Binet, with his concept of "mental orthopedics," and Jean M. L. Itard, with his great faith in the possibility of improving the quality of intellect, were responsible for the philosophy underlying the early work with retardates in this country. After several years of employing a variety of techniques, many of which are today being rediscovered, it became apparent that this optimism was unwarranted. In the early days, training schools in this country were just what the name implies. They became custodial institutions only when it became apparent that many retardates could not be trained to a level that would make them self-sustaining in the society at large. A reaction appears to have set in at this time, and the view that we could do nothing for retardates except provide them with a comfortable domicile became dominant. There is much for contemporary workers to learn from this marked swing in attitude toward the retarded. It suggests that undue optimism is dangerous, since it breeds undue pessimism. The conclusion that may be reached concerning the relevance of the heredity and environment controversy for mental retardation has been well stated by Penrose, who after a lifetime of work with the retarded wrote: The most important work carried out in the field of training defectives is unspectacular. It is not highly technical but requires unlimited patience, good will and common sense. The reward is to be expected not so much in scholastic improvement of the patient as in his personal adjustment to social life. Occupations are found for patients of all grades so that they can take part as fully and usefully as possible in human affairs. This process, which has been termed sociali-

MENTAL RETARDATION zation, contributes greatly to the happiness not only of the patients themselves but also of those who are responsible for their care. ([1949] 1963, p. 282) It is perhaps within this area of socialization that we can do a great deal to enhance the everyday effectiveness of the retarded. Personality and character traits were discovered to be more influenced by environment than was intellectual level (e.g., Leahy 1935). Such findings bolster the argument that there are many modifiable factors which are important in the determination of social adjustment. It is not rare to encounter individuals with the same intellectual make-up demonstrating quite disparate social adjustments. Perhaps the question is not how to improve the cognitive functioning of familial retardates but rather how to maximize the adjustment of such individuals, whatever their intellectual capacity may be. That considerable change in performance can result from the manipulation of nonintellective (i.e., motivational) factors will be made clear in subsequent passages. A two-group conception. Hirsch has asserted that we will make little headway in understanding individual differences in intelligence and many other traits unless we incorporate into our thinking the fact that to a large degree such differences reflect the inherent biological properties of man. As Hirsch has noted, we can no longer make the "gratuitous uniformity assumption that all genetic combinations are equally plastic and respond in like fashion to environmental influences . . . ," and he added that "without an appreciation of the genotypic structure of populations, the behavioral sciences have no basis for distinguishing individual differences that are attributable to differences whatsoever where there is a common history" (1963, p. 1442). Work in population genetics appears capable of bringing considerable order to the area of mental retardation. We need simply to accept the generally recognized fact that the gene pool of any population is such that there will always be variations in the behavioral or phenotypic expression of virtually every measurable trait or characteristic of man. From the poly genie model advanced by geneticists, we would deduce that the distribution of intelligence would be a symmetric bell-shaped curve, which is characteristic of such a large number of distributions that we have come to refer to it as the normal curve. This theoretical distribution is a fairly good approximation of what is actually encountered in the observed distribution of intelligence. In the poly genie model of intelligence (see Hirsch 1963; Penrose 1949), the genetic foundation of intelligence is not viewed as

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dependent upon a single gene. Rather, intelligence is viewed as the result of a number of discrete genetic units. (This is not to assert, however, that single-gene effects are never to be encountered in mental retardation. As noted earlier, certain relatively rare types of mental retardation are the products of such simple genetic effects.) A variety of specific polygenic models have been advanced that generate theoretical distributions of intelligence that are congruent with observed distributions (e.g., Burt & Howard 1956). Again caution is in order. An environmentalistic model positing five environmental factors acting additively would also generate an approximation to a normal curve. However, such a model appears much less capable of encompassing the raw data encountered in investigations of intelligence. An aspect of polygenic models of special interest for the area of mental retardation is that they generate IQ distributions ranging approximately from 50 to 150. Since an IQ of approximately 50 appears to be the lower limit for familial retardates, it has been concluded (e.g., Burt & Howard 1956; Penrose 1949) that the etiology of this form of retardation reflects the same factors that determine "normal" intelligence. Approached in this way, the familial retardate can be seen as normal, where "normal" is defined as representing an integral part of the distribution of intelligence that we would expect from the normal manifestations of the genetic pool in our population. Within such a framework, it is possible to refer to the familial retardate as less intelligent but it would make no sense to say that he is abnormal. He is just as integral a part of the normal distribution as are the 3 per cent of the population that we view as superior or that more numerous group of individuals that we consider to be average. The two-group conception of mental retardation calls attention to the fact that the second group of retardates, those who have known physiological defects, represents a distribution of intelligence with a mean which is considerably lower than that of the familial retardates. Such children, for the most part, fall outside the range of normal intelligence, that is, they have an IQ below 50, although there are certain exceptions; brain-damaged children with IQs as high as 150 have been found. Thus the empirical distribution of intelligence may best be represented by two curves. Considerable clarity could be brought to the area of mental retardation if we were to do away with the practice of conceptualizing the intelligence distribution as a single continuous normal curve. The more appropriate representation is to depict the intelligence of

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the bulk of the population, including the familial retarded, as a normal distribution having a mean IQ of 100 with lower and upper limits of approximately 50 and 150. Superimposed on this curve would be a second nearly normal distribution having a mean IQ of approximately 35 and a range from 0 to 70. The first curve would represent the poly genie distribution of intelligence; the second would represent all those individuals whose intellectual functioning reflected factors other than the normal polygenic expression (i.e., those retardates for whom there is an identifiably physiological defect). This two-group approach to the problem of mental retardation has been supported by Penrose (1949) among others. The very nature of the empirical distribution of IQs below the mean, especially in the 0-50 range (see Penrose 1949) seems to demand such an approach. This distribution is exactly what we would expect if we combined the two distributions discussed above, as is the general practice. This two-group approach is of particular significance to the issue of mental retardation, since it calls for a reappraisal of the entire concept of normality. Hirsch has pointed out that such a concept, as presently employed, is of little value: Implicit in our use of "normal" is reference to some region of a distribution arbitrarily designated as not extreme—for example, the median 50 percent, 95 percent, or 99 percent. We choose such a region for every trait. Among n mathematically independent traits— for example, traits dependent on n different chromosomes—the probability that a randomly selected individual will be normal for all n traits is the value for the size of that region raised to the nth power. Where "normal" is the median 50 percent and n = 10, on the average only one individual out of 1024 will be normal (for ten traits). (1963, p. 1437) Thus, if we consider the whole person with his many variable physiological and psychological systems, it would be extremely rare to find an individual we would consider normal. Indeed, if we were to find him, his very normality would be considered abnormal in the sense that he represented a rare event. In the area of mental retardation the concept of abnormal should be confined to those cases with known physical defects wherever these cases may be found in the distribution of intelligence. A two-group approach makes the problem of the etiology of the familial retarded just as assailable as the problem of etiology in pathological retardation. In respect to the etiology of familial retardates, McClearn has stated that "these individuals undoubtedly represent the lower tail of the distribu-

tion generated by assortment of the polygenes underlying 'normal' intelligence, and should no more be considered abnormal than those whose intelligences are an equal distance above the mean" (1962, p. 186). Once we adopt the position that the familial mental retardate is not defective or pathological but is essentially a normal individual of low intelligence, then the problem of familial retardation becomes part of the general problem of developmental psychology. In terms of cognitive development, the familial retardate would then be viewed as progressing from one intellectual stage to the next in the same sequence as is encountered in other children. He would, of course, progress from stage to stage at a slower rate than other children, and the final stage that he achieves would be lower than that achieved by the more intelligent members of the population. In terms of cognitive functioning alone, the familial retardate with a chronological age (CA) of 10 and an MA of 7 would be conceptualized as being cognitively similar, that is, at the same developmental level as a child with a CA of 7 and an IQ of 100. (The reader must remember that the MA, which is invariably based on the IQ, can be considered only a very rough indicator of the cognitive or developmental level; however, to date, it represents the most adequate measure available.) To say that two such hypothetical children are cognitively similar is not to assert that they will necessarily behave exactly the same on the intellective and nonintellective tasks with which society confronts them. If nothing else, the retardate is three years older, and if the performance involves lifting weights, or a task that he has encountered much more frequently than the 7-year-old normal child, we would expect the retardate to be superior. Furthermore, performance on even cognitive tasks reflects the wide variety of factors that are the product of the past history of the child rather than his cognitive ability alone. To the extent that these two children have different histories, have experienced different environments, and have developed different values and motives, we would expect differences in performance. It is no great mystery that a group of children with IQs of 70 and a group with IQs of 100 matched on chronological age differ on a variety of tasks. These children are at different developmental levels, and such differences are exactly what a developmentalist would expect. The mystery is the repeated demonstration that even when groups are matched on MA, the retardate does less well, or at least behaves differently, than the MA-

MENTAL RETARDATION matched "normal" child. Two distinctly different explanations for this phenomenon have been advanced. One view is that these differences reflect a variety of experiential or motivational differences. The second position is that the familial retardate is really not a normal individual developing at a slower rate but is rather an inherently different or abnormal type of organism who, at every level of development, is suffering from some defect in his physiological or cognitive structure. These hypothesized defects are then viewed as producing differences in behavior even in those instances where the MA is equated. In the next section we shall consider the defect orientation, and the motivational position will be discussed further in the final section. The defect and difference orientation This section deals with those theoretical and empirical efforts that have advanced the view that all retardates, including those conventionally diagnosed as familial, suffer from some specifiable defect. These efforts are in opposition to the view that the familial retardate suffers from nothing more than a slower and more limited rate of cognitive development. The evidence typically offered by the difference, or defect, theorist is that even when groups of normals and retardates are matched on MA, which grossly controls for differences in the rate of development, the two groups behave differently. This difference in behavior is advanced as proof of the existence of some physiological or cognitive defect which itself is responsible for the slower rate of development. Where the hypothesized defect is an explicitly physiological one, it would appear to be a simple matter to obtain direct validation for the defect's existence. Such evidence would come from biochemical and physiological analyses as well as from pathological studies of familial retardates. A number of such studies have, of course, been carried out. Although there is an occasional report of some physical anomaly, the bulk of the evidence has indicated that the familial retardate does not suffer from any gross physiological defects. Indeed, if such evidence were readily available, the defect theorist would give up his reliance on the more ambiguous data provided by studies examining molar behavior. The failure to find direct evidence for the existence of a physiological defect in the familial retarded has not deterred—and probably should not deter—theorists from postulating such defects. In spite of the negative physiological evidence, such workers as Spitz (1963) maintain that all retardates, including familials, are physically defec-

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tive and that our failure to discover defects in the familial retarded is due to the relatively primitive nature of our contemporary diagnostic techniques. It is perfectly legitimate for these workers to assert that, although presently not observable, the physical defect that causes familial retardates to behave differently from normals of the same MA will some day be seen. These theorists operate very much like the physicists of a not-too-distant era who asserted that the electron existed, even though it was not directly observable. Analogously, defect theorists in the area of mental retardation validate the existence of a defect by first asserting that its existence should manifest itself in particular phenomena, that is, in particular behaviors of the retarded. They then devise experiments in which, if the predicted behavior is observed, the existence of the hypothesized defect is confirmed. This approach is legitimate and has become increasingly popular. The majority of theories in the area of mental retardation are basically defect theories. It should be noted that these theories differ among themselves. One difference involves the theoretician's effort to relate the postulated defect to some specific physiological structure. The theoretical language of some defect positions is explicitly physiological, that of others is nonphysiological, while that of others has remained extremely vague. Such differences are related to the specific nature of the defect postulated. Particular defects that have been attributed to the retarded include the relative impermeability of the boundaries between regions in the cognitive structure (Kounin 1941; Lewin 19261933); primary and secondary rigidity caused by subcortical and cortical malformations, respectively (Goldstein 1943); inadequate neural satiation related to brain modifiability or cortical conductivity (Spitz 1963); malfunctioning disinhibitory mechanisms (Siegel & Foshee I960); improper development of the verbal system resulting in a dissociation between verbal and motor systems (Luria 1963; O'Connor & Hermelin 1959); and the relative brevity in the persistence of the stimulus trace (Ellis 1963). Luria and verbal mediation theory. Some of the more influential of the defect positions will be examined here, turning first to the position of the Russian investigator, A. R. Luria, whose work has influenced investigators in England and the United States. In respect to Russian efforts it should be noted that, given the political philosophy of the U.S.S.R., workers in the area of mental retardation have no alternative but to accept a defect position. As in the United States, the Russians di-

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vide the retarded into three groups, although they use the older terms "idiot," "imbecile," and "debile." However, the generic term for mental retardation is "oligophrenia." The practice, followed in this article, of distinguishing between the group of approximately 25 per cent of retardates having known organic impairments and that larger group having unknown etiologies is simply not permitted by Soviet investigators. Although this section of the article is directed at illuminating differences of opinion concerning this larger group, there is a general consensus in the United States that this type of retardate, which we conventionally classify as familial, is the product of complex genetic determinants and cultural deprivation. In contrast, as the subcommittee of the President's Panel which recently visited the U.S.S.R. has noted (see Mental Retardation in the Soviet Union 1964), Soviet philosophy does not accept the view that mental retardation is determined by genetic factors, nor is cultural causation considered a possible explanation. Thus workers in this area attribute all grades of mental retardation to central-nervous-system damage, suggesting that it occurs initially during the intrauterine period or during early childhood and then results in a disturbance of the child's subsequent mental development. It is clear, then, that in the Soviet Union the diagnosis of mental retardation necessarily involves the specification of a defect in some neurophysiological system, and it is noteworthy that professionals, including researchers and teachers, working with the retarded are called "defectologists." Knowledgeable visitors (see "Mental Retardation in the Soviet Union" 1964) have pointed out that, given such an approach, diagnosticians will go to great lengths to "discover" some slight indication of possible organicity. However, in observing the pupils in the Soviet schools for the debile, it was apparent that those in attendance were primarily retardates who would be diagnosed as familial in the United States. With rare exceptions, these were the children of unskilled workers and in some instances were actually the children of the graduates of such schools. Consistent with the over-all Russian philosophy, general intelligence tests have been banned since 1936 by the Communist party because such tests are considered to be methods which discriminate against the peasants and the working class in favor of the culturally advantaged. Diagnosis in mental retardation is made by neurologists and psychophysiologists, who rely heavily on gross

pathological signs in the case of the severely retarded and minor physical defects, minute examinations of electroencephalograph (EEC) patterns, and certain qualitative (nonstandardized) tests of perception, conditioning, and concept formation (with special emphasis on the identification of specific types of language disorders) in the case of the more mildly retarded. Luria's efforts and the difficulties they pose for non-Russian workers can only be understood in terms of such an orientation toward mental retardation. In his work on verbal mediation, Luria has demonstrated that the behavior of retardates resembles that of chronologically younger normal children in that the verbal instructions do not result in the smooth regulation of motor behavior. His findings clearly indicate that on all his tasks requiring verbal mediation, the retarded subjects have considerable difficulty. In light of these behavioral data, Luria has inferred that the major defect in the retarded child involves both an underdevelopment or a general "inertness" of the verbal system and a dissociation of this system from the motor or action system. The general effect of this dissociation, vaguely conceptualized as a disturbance in normal cortical activity, is that a verbal response cannot serve as an adequate regulator of voluntary behavior. Unfortunately, it is impossible to utilize Luria's data to throw any light on the issue of whether the cognitive processes of retardates, typically diagnosed as familial, differ from normal children of the same MA. As noted earlier, a Russian defectologist would not accept this as a legitimate question. Since there is no concern with the IQ, there is no way to determine the MAs of the retardates and normals compared in Luria's work. Furthermore, the etiological question of whether his retarded subjects are of the physiologically impaired or the familial-cultural type remains unanswered. However, in light of Luria's discussion of "profound atrophic changes . . . expressed in the underdevelopment of the complex neuron structures of the first and third strata of the cortex" and his classification of these retardates as imbeciles rather than debiles, it would appear that these subjects probably suffer from gross physiological impairment. It must be concluded, then, that these data have extremely limited relevance to the issue of whether those retardates whom we conventionally classify as familial suffer from some physiological defect. We must therefore look to English and American workers for more adequate tests of the basic prop-

MENTAL RETARDATION osition that all retardates, including the familial, differ from normals in the degree to which they employ verbal cues in regulating voluntary behavior. For example, O'Connor and Hermelin (1959) have found no significant difference between normals and retardates in the number of trials required to learn a size discrimination. However the finding that retardates required significantly fewer trials to learn a reversal was interpreted as supporting Luria's position. O'Connor and Hermelin reasoned that on the original learning task the normal child employs both motor and verbal mediational responses in his learning, while the retarded child relies primarily on the motor response. When the reversal is introduced, the normal child must unlearn both the original motor and verbal responses. The retardate, having to unlearn only the motor response, would thus be expected to learn the reversal problem more easily. The findings of O'Connor and Hermelin are troublesome in light of their inconsistency with earlier studies (e.g., Stevenson & Zigler 1957) in which mental retardates were not found to be superior on a discrimination reversal task. In an effort to resolve this discrepancy, Balla and Zigler (1964) ran a reversal-learning study involving several different reversal tasks and different types of retardates at different MA levels. This study provided no support for the Luria position. Milgram and Furth (1963) compared retarded and normal children of the same MA on a series of concept tasks assumed to vary in the degree to which language might facilitate performance. Their findings were consistent with expectations derived from Luria's position. However, in an experiment comparing retardates and normals of the same MA on their ability to employ verbal mediators, Rieber (1964) obtained findings that were inconsistent with those that would be derived from Luria's theory. It thus appears that the evidence to date which has been mustered to support Luria's position remains equivocal. Spitz and cortical satiation theory. Another major defect position is that of Herman Spitz (1963), who has extended the Kohler-Wallach cortical satiation theory to the area of mental retardation. Spitz has argued that all retardates suffer from inadequate neural satiation which is related to brain modifiability or cortical conductivity, and has tested this position by comparing normals and retardates of the same CA. Again it should be noted that no direct physiological evidence has been presented to indicate that familial retardates suffer from inadequate neural or cortical function-

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ing. Furthermore, there is direct physiological evidence (Lashley et al. 1951) which calls into question the validity of the entire Kohler-Wallach position [see GESTALT THEORY]. As in the case of the earlier gestalt workers, Spitz has primarily employed perceptual tasks to test his position. His extensive program of research has now been summarized (Spitz 1963), and any complete review would be beyond the scope of this paper. Spitz's most convincing evidence has been obtained on those perceptual tasks (e.g., figural aftereffects and Necker cube reversals) that are thought to be sensitive to hypothesized cortical satiation effects. The heuristic value of Spitz's position can be seen in his recent efforts to extend his postulates beyond the visual perception area and to employ them to generate specific predictions concerning the phenomena of learning, transposition, generalization, and problem solving. Spitz has noted a number of studies in these various areas which lend credence to his basic position. He has also been quite explicit in noting the limitations of his view. He has pointed out that, contrary to his theory, cortical satiation as measured by his perceptual indexes does not "in general correlate with IQ, but rather only differentiates the average performance of two distinct groups." The extensive overlap between normals and retardates on his tests of satiation led him to conclude that "the satiation variable must be only a very small one in the total complex of intelligent behavior." Spitz has also been appropriately concerned with the fact that the test-retest reliability of the scores of his retardates is not impressive. Furthermore, he has noted that the lack of any correlation of individual scores across certain of his satiation tasks is troublesome for his position. Across modalities and even in the same modality, correlations have been moderate or nonexistent. In addition to these concerns, Spitz has been sensitive to the issue of how accurately the subject's response, often a verbal report, reflects the perceptual response being investigated. (See Spivack 1963 for a discussion of this problem in respect to research with the retarded.) Adding to these difficulties is the fact that several investigators have now discovered that responses to cognitive and perceptual tasks are influenced by a variety of motivational factors (e.g., Zigler & deLabry 1962; Zigler & Unell 1962). In addition certain aspects of Spitz's work have come in for criticism on the grounds that his findings are inconsistent with those of other investigators.

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Spivack (1963) has voiced this concern in a review of research on perceptual processes in the retarded, noting that certain of Spitz's findings "are in marked contrast to the findings of others." Of more importance to the central question of this section is the conclusion that Spitz's data throw little light on the issue of whether familial retardates are inherently different from normals of the same MA. Taking a stand reminiscent of the Russian position, Spitz has argued that the distinction between familial and organic retardates is misleading. In Spitz's view, all retardates suffer from brain damage in the broader sense, and he has argued (see Garrison 1966) that retardates be conceptualized as belonging to a common class. Therefore his work has been characterized by a relative lack of concern with the problem of etiology, and we have little way of assessing whether the differences he reports are a product of gross organic pathology or may actually reflect the cortical phenomena that Spitz postulates. That one finds differences between normals and retardates matched on CA is not very surprising, since we are dealing with groups who are at different developmental levels (as defined by MA). One would be tempted to say that Spitz's work has little relevance to the central issue of this section except for the fact that he has been quite explicit in his view that the differences he obtains are not developmental phenomena but reflect a physical deficit that should manifest itself even in comparisons with MA-matched normals. The Lewin-Kounin formulation. The final defect position that we shall discuss is that of Lewin (1926-1933) and Kounin (1941). This position is different from the other defect views in that the defect postulated is one in the cognitive structure rather than the physical structure of the retardate. The Lewin-Kounin formulation has had considerable impact not only on our conceptualization of the retarded but also on the treatment and training practices that have been employed over the years. (For a more complete historical review and critique of the Lewin-Kounin formulation, the reader is referred to Zigler 1962.) In Lewin's general theory the individual is treated as a dynamic system with differences among individuals derivable from a diversity of (1) structure of the total system, (2) material and state of the system, or (3) meaningful content of the system. The first two of these factors play the most important role in Lewin's theory of retardation. Lewin viewed the retarded child as having a lessdifferentiated cognitive structure, that is, having fewer regions or cells, than a normal child of the

same CA. Thus, in terms of structure, the retarded child resembles a normal younger child. In relation to the material and state of the system, Lewin stated that even though a retarded child corresponded in degree of differentiation to a normal younger child, these children were not to be regarded as entirely similar. He considered "the major dynamic difference between a feebleminded and normal child of the same degree of differentiation to consist in a greater stiffness, a smaller capacity for dynamic rearrangement in the psychical systems of the former." (Degree of differentiation was later operationally defined as MA.) Although Lewin undoubtedly felt that lack of differentiation could lead to rigid behaviors (e.g., pedantry, fixation, stereotypy, inelasticity, perseveration), he was quite clear that this lack of differentiation was not what he meant by rigidity. To Lewin, lack of differentiation referred to the number of regions within the total system, while rigidity was defined in terms of the fluidity between regions. (By rigidity, Lewin was referring to the nature of the boundary between cells in the cognitive structure.) It follows from Lewin's theory that an individual whose system is characterized by either lack of differentiation or rigidity, or both, is more likely to emit behaviors commonly referred to as rigid. The failure to draw a clear distinction between the meaning of rigidity as he employed it and rigid behaviors as such appears to be a major factor leading to the subsequent controversy in the area. The clearest experimental support for the position that familial retarded individuals are more rigid than normal individuals having the same degree of differentiation is contained in the work of Kounin (1941; 1948). Kounin, building upon Lewin's work, advanced the view that rigidity is a positive, monotonic function of CA. Again, it is imperative to note that by rigidity Kounin, like Lewin, referred to "that property of a functional boundary which prevents communication between neighboring regions" and not to rigid behaviors as such. Kounin (1941) offered the findings of five experiments in support of his theory. In these experiments he employed three groups, older familial retarded individuals, younger familial retarded individuals, and normals. Noting the inadequacies of Lewin's own experimental efforts, Kounin instituted certain experimental controls. He defined the degree of differentiation as the MA of an individual and controlled for this factor by equating the three groups on MA. He also attempted to reduce what he later referred to as "motivational factors

MENTAL RETARDATION (such as low success expectation and hesitance to enter unfamiliar regions) that might produce those very types of behavior that are sometimes lumped together in the pseudo-descriptive category of behavioral rigidity" (Kounin 1948). To control for these factors, Kounin attempted to make each subject feel confident and secure in the experimental tasks by having them engage in each of the activities prior to the experiment proper. As Kounin predicted, the three groups differed in certain instruction-initiated tasks (e.g., drawing cats until satiated and then drawing bugs until satiated, lowering a lever in order to release marbles and then raising the lever to release marbles). As predicted from the Lewin-Kounin formulation, the normals showed the greatest amount of transfer effects from task to task, the younger retarded a lesser amount of transfer, and the older retarded the least amount of transfer. That is, on the drawing task the retarded individuals drew longer on the second task following satiation of the first task than did normals, and the older retardates longer than the younger. On the lever-pressing task, the greatest number of errors, that is, lowering rather than raising the lever on part two, were made by the normals, the least number by the older retarded, with the younger retarded falling between these two groups. One should note that on this last task the lesser rigidity, as defined by Lewin and Kounin, of the normals results in a higher incidence of a behavioral response often characterized as rigid (i.e., perseverative responses). Furthermore, this lack of influence of one region upon another in the performance of the retarded would only be predicted in those cases where the retarded individual is "psychologically" placed into a new region by employing an instructional procedure. In those instances where the individual must, on his own, move from one region to another, the LewinKounin formulation would predict that such movement would be more difficult for the retarded than for the normal individual. This prediction was also confirmed by Kounin in his concept-switching experiment in which the child was asked first to sort a deck of cards, which could be sorted either on the basis of color or form, and then to put the cards together some other way. Here the normals evidenced the least difficulty in shifting, the older retarded the most difficulty, and the younger retarded group again fell between the other two groups. Thus, when a movement to a new region is self-initiated, it is the retarded who evidence the higher incidence of perseverative responses. The Lewin-Kounin theory of rigidity is a con-

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ceptually demanding one in that it sometimes predicts a higher and sometimes a lower incidence of "rigid" behaviors in retarded as compared to normal individuals. However, the fact that it generates specific predictions as to when one or the other state of affairs will obtain is a tribute to the theory. Kounin thus offered impressive experimental support for the view that, with MA held constant, the older or more retarded (or both) an individual is, the more will his behaviors be characterized by dynamic rigidity, that is, greater rigidity in the boundaries between regions. This model and its experimental support was so impressive that until fairly recently very few further experimental tests were attempted. However, recent explicit tests of the model (Balla & Zigler 1964; Stevenson & Zigler 1957; Zigler & Unell 1962) have failed to provide support for it. Much evidence now indicates that the differences found by Kounin were not a product of the inherent rigidity of retardates, but rather reflected a number of motivational differences between normal children and institutionalized retardates of the same MA. These motivational factors will be discussed in the final section. Motivational and emotional factors A recurring theme in the present article has been the importance of a variety of nonintellective factors as determinants of the level at which the retarded functions. We shall never comprehend the behavior of the retarded if we assume that every behavior he manifests is the immutable product of his low intelligence. Furthermore, we must go beyond the overly simplistic theories that have been advanced, such as the view that all retardates manifest a highly similar pattern of behavior which is determined by their common defect. Indeed, a striking feature encountered when groups of retardates are observed is the variety of behavior patterns displayed. Clearly, we are not dealing with a homogeneous group of simple organisms. Once we concern ourselves with the total behavior of the retarded child, we find him an extremely complex psychological system. To the extent that his behavior deviates from the norms associated with his MA, he is even more difficult to understand than the normal individual. It is unfortunate that so little work emanating from a personality point of view has been done with the retarded. Some progress has been made, however, and much of the recent work supports the view that it is not necessary to employ constructs other than those used to account for the behavior of normal individuals in explaining the

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behavior of the familial retarded. It appears that many of the reported differences between retardates and normals of the same MA are a result of motivational and emotional differences which reflect differences in environmental histories and are not a function of innate deficiencies. That personality factors are as important in the retardate's adjustment as are intellective factors has been noted (e.g., Penrose 1949; see also Windle 1962 for an especially comprehensive review of the importance of nonintellective factors in the prognosis of mental retardation). Many of the early workers in this country felt that the difference between social adequacy and inadequacy in that large group of borderline retardates was a matter of personality and character rather than intelligence. A number of studies have confirmed this view (see Windle 1962). Perhaps the best of these is the comprehensive study by Weaver (1946) of the adjustment of 8,000 retardates inducted into the U.S. Army, most of whom had IQs below 75. Of the total group, 56 per cent of the males and 62 per cent of the females made a satisfactory adjustment to military life. The median IQs of the successful and unsuccessful groups were 72 and 68 respectively. Weaver concluded that "personality factors far overshadowed the factor of intelligence in the adjustment of the retarded to military service." This tendency to overemphasize the importance of the intellect in adjustment has been made clear by Windle (1962). On the basis of a survey, he found that most institutions presume that intelligence is the critical factor in adjustment after release. Windle goes on to point out that the vast majority of studies (over 20) on outcome "after release from institutions have reported no relation between intellectual level and later adjustment." In examining this literature we find that the factors which led to poor social adjustment include anxiety, jealousy, overdependency, poor self-evaluation, hostility, hyperactivity, and failure to follow orders even when requests were well within the range of intellectual competence. It is hardly surprising that retardates evidence such difficulties in light of their atypical social histories. The specific atypical features of their socialization histories and the extent to which they are atypical may vary from child to child. Two sets of parents who are themselves familially retarded may provide quite different socialization histories for their children. At one extreme we may find a familially retarded child who grows up in an abysmal home environment and who is ultimately institutionalized, not because of lack of intelligence but

because his own home represents such a poor environment. That many borderline retardates are institutionalized for just such reasons has been confirmed by Kaplun (1935) in a study of 642 highgrade retardates; Zigler's recent finding (1961) that a positive relationship exists between the institutionalized familial retardate's IQ and the amount of preinstitutional deprivation he experienced provides further support for this claim. This latter finding does not indicate that social deprivation produces greater intelligence but rather that our institutions contain borderline retardates who would not be institutionalized except for their extremely poor home environments. At the other extreme, the familially retarded set of parents of an institutionalized child may have provided him with a relatively normal home, even though it might differ in certain important respects (e.g., values, goals, and attitudes) from the typical home in which the families are of average or superior intelligence. In the first example the child not only experiences a quite different socialization history while still living with his parents, but he also differs from the child in the second situation to the extent that institutionalization affects his personality structure. Given the penchant of many investigators for comparing institutionalized retardates with children of average intellect who live at home, the factor of institutionalization becomes an extremely important one. One cannot help but wonder how many differences discovered in such comparisons reflect some cognitive aspect of mental retardation as opposed to the effects of institutionalization, the factors that led to the child's institutionalization, or some complex interaction between these factors and institutionalization. To add even more complexity, the socialization histories of both institutionalized and noninstitutionalized familial retardates differ markedly from the history of the brain-damaged retardates. The brain damaged do not show the same gross differences in the frequency of good versus poor environments as do familials. In the face of such complexity, we need not consider the problem unassailable, nor need we assert that each retarded child is unique and that it is therefore impossible for us to isolate the ontogenesis of those factors which we feel are important in influencing the retardate's level of functioning. Once we conceptualize the retardate as occupying a position on a continuum of normality, we can allow our knowledge of normal development to give direction to our efforts. This does not mean that we ignore the importance of the lowered intelligence per se, since per-

MENTAL RETARDATION sonality traits and behavior patterns do not develop in a vacuum. However, in some instances the personality characteristics of the retarded will reflect environmental factors that have little or nothing to do with intellectual endowment. For example, many of the effects of institutionalization may be constant regardless of the person's intelligence level. In other instances, we must think in terms of an interaction; that is, given his lowered intellectual ability, a person will have certain experiences and develop certain behavior patterns differing from those of a person with greater intellectual endowment. An obvious example is the greater amount of failure which the retardate typically experiences. But again what must be emphasized is that the behavior pattern developed by the retardate as a result of such a history of failure will not differ in kind or ontogenesis from those developed by an individual of normal intellect who, by some environmental circumstance, also experiences an inordinate amount of failure. By the same token, if the retardate can somehow be guaranteed a more typical history of success, we would expect his behavior to be more normal, independent of his intellectual level. Within this framework, the author will discuss the personality factors which have been known to influence the performance of the retarded. Caution is needed in evaluating the role of motivational and emotional factors in the performance of the retarded. Performance on a task is most appropriately conceptualized as a function of two types of factors, intellective (i.e., cognitive) and nonintellective (i.e., motivational). The contribution of each factor will vary with the nature of the task. Motivational factors will more readily influence a perseveration task (e.g., how long a retardate will continue to put marbles into a box) than they will a discrimination-learning or concept-formation task. It has been demonstrated that the performance of retardates on tasks of the latter type is also influenced by motivational factors (Butterfield & Zigler 1965a; Zigler & deLabry 1962), but this should not be interpreted as evidence that basic intellectual capacity has been changed. Rather, these demonstrations suggest ways in which one may help the mentally retarded to utilize their intellectual capacity optimally. As such, they should not be viewed as manipulations which can make the retarded "normal" in their intellectual functioning. Anxiety. Considerable evidence has now been collected indicating the importance of anxiety on performance for a wide variety of tasks (Taylor 1956). The attenuating effects of anxiety on per-

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formance appear to be a function of both the taskirrelevant defensive responses employed by the person to alleviate his anxiety and the drive features of anxiety itself. The drive approach to anxiety (Taylor 1956), which has received considerable confirmation, conceptualizes high anxiety as beneficial on extremely nondemanding tasks (e.g., classical eyelid conditioning) but detrimental on complex tasks where a variety of responses are available to the person. The higher anxiety level of retardates, as compared to normals, has now been noted by several investigators (e.g., Garfield 1963) who have either demonstrated or suggested that the heightened anxiety level of retardates could well have produced certain of the differences between retardates and MA-control normals reported in the literature. Work with retardates that has either focused on anxiety or raised the anxiety issue in a post hoc manner is of considerable value "in that it applies concepts and techniques to the study of retarded individuals, which for the most part had not been applied or seen as relevant for this group" (Garfield 1963, p. 594). [See ANXIETY.] The facts that anxiety level affects the performance of retardates much as that of normals and that retardates might have higher levels of anxiety than normals tell us little about the ontogenesis of anxiety in retardates. To understand their atypical anxiety levels, we must examine the relatively atypical experiences of the retarded, as well as a variety of other motivational states which influence their performance. Social deprivation. It has now become increasingly clear that our understanding of the performance of the institutionalized familial retardates will be enhanced if we consider the inordinate amount of preinstitutional social deprivation they have experienced (Clarke & Clarke 1954; Kaplun 1935; Zigler 1961). A series of recent studies (Green & Zigler 1962; Zigler 1961; Zigler & Williams 1963) has indicated that one result of such early deprivation is a heightened motivation to interact with a supportive adult. (In the process of conducting these studies, a social deprivation scale was constructed which promises to bring some added objectivity to the social deprivation concept.) These studies suggest that, given this heightened motivation, retardates exhibit considerable compliance with instructions when the effect of such compliance is to increase or maintain the social interaction with the adult. Compliance is apparently reduced in those instances where it leads to terminating the interaction. It now appears that the perseveration so frequently noted in the behavior of the retarded is

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primarily a function of this motivational factor rather than the inherent cognitive rigidity suggested by Lewin (1926-1933) and Kounin (1941). Evidence on this latter point comes from findings indicating that (1) the degree of perseveration is directly related to the degree of preinstitutional deprivation experienced (Zigler 1961) and (2) institutionalized children of normal intellect are just as perseverative as institutionalized retardates, while noninstitutionalized retardates are no more perseverative than noninstitutionalized children of normal intellect (Green & Zigler 1962). The finding that institutionalization (or the social history factors leading to institutionalization) is the crucial factor in determining the child's response to social reinforcement on a simple task has also been found by Stevenson and Fahel (1961). The heightened motivation to interact with an adult, stemming from a history of social deprivation, would appear to be consistent with the often-made observation of certain behaviors in the retarded, such as seeking attention and wishing for affection (Doll 1962). It is impossible to place too much emphasis on the role of overdependency in the institutional familial retarded and on the socialization histories that give rise to such overdependency. Given some minimal intellectual level, the shift from dependence to independence is perhaps the single most important factor necessary for the retardate to become a self-sustaining member of our society. It appears that the institutionalized retardate must satisfy certain affectional needs before he can cope with problems in a manner characterized by individuals whose affectional needs have been relatively satiated. These affectional needs can best be viewed as ones which often interfere with certain problem-solving activities. Because the retardate is highly motivated to satisfy such needs through maximizing interpersonal contact, he is relatively unconcerned with the specific solution to these problems. Of course the two goals will not always be incompatible, but in many instances they will be. Some evidence that this attenuating aspect of retarded behavior can be overcome has been presented by McKinney and Keele (1963), who found improvement in a variety of behaviors in the mentally retarded following an experience of increased mothering. Zigler and Williams (1963) have provided some evidence on the interaction between preinstitutional social deprivation and institutionalization in influencing the child's motivation for social interaction and support. It was found that although institutionalization generally increased this motivation, it was increased much more for children

coming from relatively nondeprived homes than for those coming from more socially deprived backgrounds. Change in IQ scores. An unexpected finding of the Zigler and Williams study was that a general decrease in the IQs of retardates was discovered between the administration of two IQ tests, the first of which occurred at the time of admission five years prior to this follow-up study. This change in IQ, discovered in the context of a study employing the amount of preinstitutional social deprivation as an independent variable, is reminiscent of a finding by Clarke and Clarke (1954). These investigators found that changes in the IQs of retardates following institutionalization were related to their preinstitutional histories. They discovered that children coming from extremely poor homes showed an increase in IQ which was not observed in children coming from relatively good homes. Zigler and Williams, however, found that the magnitude of the IQ change in their subjects was not significantly related to preinstitutional deprivation. Although this finding appears inconsistent with that of Clarke and Clarke, it should be noted that some support for a relationship was suggested, since the only subjects in the Zigler and Williams study who evidenced an increase in IQ were the highly deprived group. The failure of Zigler and Williams to replicate the findings of Clarke and Clarke may be due to two factors: the subjects used by Clarke and Clarke were older and had been institutionalized at a later age than the retardates employed by Zigler and Williams and the IQ changes reported by Clarke and Clarke took place during two years of institutionalization, while the IQ changes reported in the Zigler and Williams study were based on five years of institutionalization. This latter factor becomes increasingly important in view of E. C. Jones and Carr-Saunders' finding (1927) that normal institutionalized children show an increase in IQ early in institutionalization and then a decrease in IQ with longer institutionalization. The work of Clarke and Clarke, Jones and CarrSaunders, and others, dealing with changes in IQ following institutionalization has given central importance to the degree of intellectual stimulation provided by the institution in contrast to that provided by the original home. This orientation suggests that it is the actual intellectual potential of the person which is altered. The Zigler and Williams study, however, suggests that the change in IQ reflects a change in the child's motivation for social interaction. That is, as social deprivation, resulting from increased length of institutionaliza-

MENTAL RETARDATION tion, increases, the desire to interact with the adult experimenter increases. Thus, for the deprived child the desire to be correct must compete in the testing situation with the desire to increase the amount of social interaction. This argument would appear to provide the conceptual framework for Clarke and Clarke's finding that highly deprived subjects evidence an increase in IQ with relatively short institutionalization, while the less deprived subjects demonstrate no greater increase than a test-retest control group. One would further expect that with continued institutionalization all children would exhibit a decrease in IQ, the phenomenon found by Jones and Carr-Saunders (1927) and one that appears in the Zigler and Williams study. Direct support for this view comes from the finding in the Zigler and Williams study of a positive relationship between the magnitude of the decrease in IQ and the child's motivation for social interaction. It should be noted that the Jones and CarrSaunders (1927) study involved institutionalized children of approximately average intellect, thus indicating that the dynamics under discussion here are the same for both normal and retarded children. Furthermore, the position advanced here is quite consistent with the findings for normal children obtained by Barrett and Koch (1930); these investigators found that the greatest increase in IQ was obtained by children who showed the greatest improvement in their personality traits or by children who evidenced a marked change in the nature of their relationship with the examiner. Conversely, what must be emphasized in respect to lowered IQs is not the lowered test scores per se but rather that the factors which attenuate these test scores will, in all probability, reduce the adequacy of many problem-solving behaviors performed in a social situation. Although there is considerable observational and experimental evidence that social deprivation results in a heightened motivation to interact with a supportive adult, it appears to have other effects as well. Again, the nature of these effects is suggested in those observations of the retarded that have emphasized their fearfulness, wariness or avoidance of strangers, or their suspicion and mistrust. The experimental work done by Zigler and his associates on the behavior of the institutionalized retarded has indicated that social deprivation results in both a heightened motivation to interact with supportive adults (positive-reaction tendency) as well as a reluctance and wariness to do so (negative-reaction tendency). That both of these tendencies are influenced by the quality of past relationships with adults and are amenable to ex-

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perimental manipulations has been demonstrated in recent studies employing both normal and retarded children (e.g., Shallenberger & Zigler 1961). However, little work has been done on the range of behaviors that might be influenced by the negativereaction tendency. Failure and performance. Another factor frequently mentioned as a determinant in the performance of the retarded is their high expectancy of failure (Cromwell 1963). This failure expectancy has been viewed as an outgrowth of a lifetime characterized by frequent confrontations with tasks for which the retarded are intellectually ill-equipped to deal. That failure experiences and the failure expectancies to which they give rise affect a wide variety of behaviors in the intellectually normal has now been amply documented. Of special interest to workers in the area of mental retardation is Lantz's finding (1945) that a relatively simple failure experience prevented children from profiting by practice which ordinarily leads to improvement on intelligence-test scores [see ACHIEVEMENT MOTIVATION]. The results of experimental work employing the success—failure dimensions with retardates are still somewhat inconsistent. The work of Cromwell and his students (reviewed in Cromwell 1963) has lent support to the general proposition that retardates have a higher expectancy of failure than do normals. This results in a style of problem solving for the retardate which causes him to be much more motivated to avoid failure than to achieve success. However, the inconsistent research findings suggest that this fairly simple proposition is in need of some further refinement. One investigator found that retardates performed better following success and poorer following failure as compared to a control group. Another investigator (Heber 1957) found that the performances of normals and retardates were equally enhanced following both a failure and a success condition, although in the success condition the performance of retardates was enhanced more than that of normals. Conversely, Kass and Stevenson (1961) found that success enhanced the performance of normals more than that of retardates. Another study also found that failure had a general enhancing effect for both normals and retardates but that failure enhanced the performance of normals more than that of retardates (Gardner 1958). In a recent study by Butterfield and Zigler (1965a), one factor which may have produced this type of inconsistency was isolated. These investigators found that both normal and retarded children reacted differentially to success and failure experiences as a

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function of their responsivity to adults, that is, their desire Lo gain an adult's support and approval. The nature of the difference between normals and retardates in their reaction to success or failure experiences appeared to be determined by this desire for approval. Among high-responsive subjects, failure, as compared to success, attenuated the performance of retarded subjects while improving the performance of normal subjects. Among low-responsive subjects, failure, as compared to success, attenuated the performance of normals while improving the performance of retardates. Debilitating effects of prolonged failure on the performance of the retarded have been found by Zeaman and House (1962). These investigators discovered that following such failure, retardates were unable to solve a simple problem, although they had previously been able to do so. Assuming a failure set in retardates, Stevenson and Zigler (1958) confirmed the prediction that retardates would be more willing to "settle for" a lower degree of success than would normal children of the same MA. The fear of failure in the mentally retarded also appears to be an important factor in differences that have been found between normals' and retardates' achievement motivation (Jordan & DeCharms 1959). Recent studies (Green & Zigler 1962; Turnure & Zigler 1964) have indicated that the high incidence of failure experienced by retardates generates a cognitive style of problem solving characterized by outer-directedness. That is, the retarded child comes to distrust his own solutions to problems and therefore seeks guides to action in the immediate environment. This outer-directedness may explain the great suggestibility so frequently attributed to the retarded child. Evidence has now been presented indicating that, compared to normals of the same MA, the retarded child is more sensitive to verbal cues given by an adult, is more imitative of the behaviors of both adults and peers, and engages in more visual scanning. Furthermore, certain findings (Green & Zigler 1962) suggest that the noninstitutionalized retardate is more outer-directed in his problem solving than the institutionalized retardate. This makes considerable sense if one remembers that the noninstitutionalized retardate does not reside in an environment adjusted to his intellectual shortcomings and should therefore experience more failure than the institutionalized retardate. Turnure and Zigler (1964) have suggested that the distractability so frequently encountered in the retarded reflects, in part, this outer-directed style of problem solving. This interpretation is of par-

ticular interest, since distractability has often been viewed as a neurophysiologically determined characteristic of the retarded rather than the reflection of a style of problem solving emanating from the particular experiential histories of such children. Work on the outer-directedness of the retarded also appears related to the locus of control work done by Cromwell and his associates (Cromwell 1963). These investigators found that retardates, as compared to normals, manifest an external locus of control, that is, they attribute certain events caused by their own behavior to outside forces over which they have little control. (This internal-control versus external-control dimension has been employed by Cromwell to bring some further order to the inconsistent findings in the success-failure literature.) The reinforcer hierarchy. Another nonintellective factor important in understanding the behavior of the retarded is the retardate's motivation under various types of incentives. That performance by normals and retardates on a variety of tasks is influenced by the nature of the incentive is certainly well documented. The social deprivation work discussed earlier in this section indicates that retardates have an extremely high motivation for attention, praise, and encouragement. Several investigators (e.g., Cromwell 1963; Zigler 1963) have suggested that in normal development the effectiveness of attention and praise as reinforcers diminishes with maturity and is replaced by the reinforcement inherent in the information that one is correct. This latter type of reinforcer appears to serve primarily as a cue for the administration of self-reinforcement [see LEARNING, article on REINFORCEMENT]. Zigler and his associates (Zigler 1962; Zigler & deLabry 1962; Zigler & Unell 1962) have argued that a variety of experiential factors in the history of the retarded cause them to be less motivated to be correct for the sake of correctness than normals of the same MA. Stated somewhat differently, these investigators have argued that the position of various reinforcers in the reinforcer hierarchies of normal and retarded children of the same MA differ. To date, the experimental work of this group has centered on the reinforcement which inheres in being correct. It is this reinforcer that is the most frequently dispensed, immediate incentive in most real-life tasks. Furthermore, it is a frequently used incentive in many experimental cognitive and perceptual tasks on which retardates and normals are compared, and it also seems to be the most important incentive in the typical test situation. When such an incentive is employed in experimental studies, one wonders how many of the differences

MENTAL RETARDATION found are attributable to differences in capacity between retardates and normals rather than to differences in performance which result from the different values that such incentives might have for the two types of subject. Clearest support for the view that the retardate is much less motivated to be correct than is the middle-class child, so typically used in comparisons with the retarded, is contained in a study by Zigler and deLabry (1962). These investigators tested middle-class, lower-class, and retarded children equated on MA on a concept-switching task (Kounin 1941) under two conditions of reinforcement. In the first condition, similar to that employed by Kounin, the only reinforcement dispensed was the information that the child was correct. In the second condition, the child was rewarded with a toy of his choice if he switched from one concept to another. In the "correct" condition these investigators found, as Kounin did, that retardates were poorer in their concept switching than were middleclass children. That this was not a simple matter of cognitive rigidity was indicated by the finding that lower-class children equated with the middleclass children on MA were also inferior to the middle-class children. In the toy condition this inferiority disappeared, and retarded and lower-class children performed as well as the middle-class children. This study highlights an assumption that has been noted as erroneous by many educators; namely, that the lower-class child and the retarded child are motivated by the same incentives that motivate the typical middle-class child. An intriguing avenue of further research is the degree to which the position of various reinforcers in the hierarchy can be manipulated. General effects of institutionalization. No discussion of motivational factors in the performance of the retarded would be complete without some mention of the effects of institutionalization. The institutionalization variable has probably contaminated more research in the area of mental retardation than any other single variable. Given our general lack of knowledge concerning the effects of institutionalization on human behavior, the extent of this contamination cannot be determined. That the effects of institutionalization on the behavior of retardates are considerable has been suggested by several investigators (e.g., McCandless 1964; Windle 1962). In view of the general consensus concerning the importance of institutionalization, it is amazing that more work has not been done to investigate its effects on retarded children. Some fairly clear findings with retardates have demonstrated that institutionalization causes a

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decrement in the quality of language behavior (Lyle 1959), reduces the level of abstraction on vocabulary tests (Badt 1958), interferes with the ability to conceptualize an emotional continuum (Iscoe & McCann 1965), and increases the child's orientation toward punishment (Abel 1941). These studies, though suggestive, have shed little light on the specific aspects of institutionalization which affect such behaviors or on the exact nature of the process through which behaviors are affected. Whether the deficiencies in the behavior of the institutionalized retardate are motivational in nature or reflect an actual change in intellectual capacity is still an open question. Evidence that institutions for the retarded differ in their effects on behavior has recently been reported by Butterfield and Zigler (1965b). It was found that children residing in a cold, restrictive institution showed a higher motivation for adult support and approval than children residing in an institution having a warm, accepting social climate. These investigators are presently conducting a cross-institutional longitudinal study of six state schools for the retarded in an effort to isolate the institutional factors and psychological processes underlying such effects. Much of this work on motivational and emotional factors in the performance of the retarded is very recent. The research conducted on several of the factors discussed in this section is more suggestive than definitive. It is clear, however, that these factors are extremely important in determining the retardate's general level of functioning. Furthermore, these factors seem much more open to environmental manipulation than do the cognitive processes discussed earlier. An increase in knowledge concerning motivational and emotional factors and their ontogenesis and manipulation holds considerable promise for alleviating much of the social ineffectiveness displayed by that sizable group of persons who must function at a relatively low intellectual level. EDWARD ZIGLER [Directly related are the entries ACHIEVEMENT TESTING; INTELLIGENCE AND INTELLIGENCE TESTING; other relevant material may be found in CREATIVITY, article on GENIUS AND ABILITY; INFANCY, article on THE

EFFECTS

OF

EARLY

EXPERIENCE;

SYSTEMS

ANALYSIS, article on PSYCHOLOGICAL SYSTEMS; THINKING; and in the biographies of BINET and MONTESSORL] BIBLIOGRAPHY ABEL, THEODORA M. 1941 Moral Judgments Among Subnormals. Journal of Abnormal and Social Psychology 36:378-392.

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BADT, MARGIT 1958 Levels of Abstraction in Vocabulary Definitions of Mentally Retarded School Children. American Journal of Mental Deficiency 63:241-246. BALLA, DAVID; and ZIGLER, EDWARD 1964 Discrimination and Switching Learning in Normal, Familial Retarded, and Organic Retarded Children. Journal of Abnormal and Social Psychology 69:664-669 BARRETT, HELEN E.; and KOCH, HELEN L. 1930 The Effect of Nursery-school Training Upon the Mental Test Performance of a Group of Orphanage Children. Journal of Genetic Psychology 37:102-122. BURT, CYRIL; and HOWARD, MARGARET 1956 The Multifactorial Theory of Inheritance and Its Application to Intelligence. British Journal of Statistical Psychology 9:95-130. BUTTERFIELD, EARL C.; and ZIGLER, EDWARD 1965a The Effects of Success and Failure on the Discrimination Learning of Normal and Retarded Children. Journal of Abnormal Psychology 70:25-31. BUTTERFIELD, EARL C.; and ZIGLER, EDWARD 1965£> The Influence of Differing Institutional Social Climates on the Effectiveness of Social Reinforcement in the Mentally Retarded. American Journal of Mental Deficiency 70:48-56. CLARKE, A. D.; and CLARKE, A. M. 1954 Cognitive Changes in the Feebleminded. British Journal of Psychology 45:173-179. CROMWELL, RUE L. 1963 A Social Learning Approach to Mental Retardation. Pages 41-91 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGrawHill. DOLL, EUGENE E. 1962 A Historical Survey of Research and Management of Mental Retardation in the United States. Pages 21-68 in E. Philip Trapp and Philip Himelstein (editors), Readings on the Exceptional Child. New York: Appleton. ELLIS, NORMAN R. 1963 The Stimulus Trace and Behavioral Inadequacy. Pages 134-158 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGrawHill. FERGUSON, GEORGE A. 1956 On Transfer and the Abilities of Man. Canadian Journal of Psychology 10:121131. FREMMING, KURT H. (1947) 1951 The Expectation of Mental Infirmity in a Sample of the Danish Population: (Based on a Biographical Investigation of 5,500 Persons Born in the Years 1883-1887). London: Eugenics Society. -» First published in Danish. GARDNER, WILLIAM I. 1958 Reactions of Intellectually Normal and Retarded Boys After Experimentally Induced Failure: A Social Learning Theory Interpretation. Ann Arbor, Mich.: University Microfilms. GARFIELD, SOL L. 1963 Abnormal Behavior and Mental Deficiency. Pages 574-601 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGraw-Hill. GARRISON, M. (editor) 1966 Cognitive Models and Development in Mental Retardation. American Journal of Mental Deficiency 70, no. 4 (Monograph Supplement). GOLDSTEIN, KURT 1943 Concerning Rigidity. Character and Personality 11:209-226. GREEN, CALVIN; and ZIGLER, EDWARD 1962 Social Deprivation and the Performance of Retarded and Normal Children on a Satiation Type Task. Child Development 33:499-508.

HEBB, DONALD O. 1949 The Organization of Behavior: A Neuropsychological Theory. New York: Wiley. HEBER, RICK F. 1957 Expectancy and Expectancy Changes in Normal and Mentally Retarded Boys. Ann Arbor, Mich.: University Microfilms. HEBER, RICK F. 1959 A Manual of Terminology and Classification in Mental Retardation. American Journal of Mental Deficiency 64, no. 2 (Monograph Supplement). HEBER, RICK F. 1962 Mental Retardation: Concept and Classification. Pages 69-81 in E. Philip Trapp and Philip Himelstein (editors), Readings on the Exceptional Child. New York: Appleton, HIRSCH, JERRY 1963 Behavior Genetics and Individuality Understood. Science 142:1436-1442. ISCOE, IRA; and McCANN, BRIAN 1965 Perception of an Emotional Continuum by Older and Younger Mental Retardates. Journal of Personality and Social Psychology 1:383-385. JERVIS, GEORGE A. 1959 The Mental Deficiencies. Volume 2, pages 1289-1313 in American Handbook of Psychiatry. Edited by Silvano Arieti. New York: Basic Books. -» See especially Table 1 on page 1290. JONES, E. CARADOG; and CARR-SAUNDERS, A. M. 1927 The Relation Between Intelligence and Social Status Among Orphan Children. British Journal of Psychology 17:343-364. JONES, HAROLD E. (1946) 1954 The Environment and Mental Development. Pages 631-696 in Leonard Carmichael (editor), Manual of Child Psychology. New York: Wiley. JORDAN, THOMAS E.; and DECHARMS, RICHARD 1959 The Achievement Motive in Normal and Mentally Retarded Children. American Journal of Mental Deficiency 64:457-466. KAPLUN, DAVID 1935 The High-grade Moron: A Study of Institutional Admissions Over a Ten Year Period. Journal of Psychoasthenics 40:69-91. -» Now called the American Journal of Mental Deficiency. KASS, NORMAN; and STEVENSON, HAROLD W. 1961 The Effect of Pretraining Reinforcement Conditions on Learning by Normal and Retarded Children. American Journal of Mental Deficiency 66:76-80. KOUNIN, JACOB S. 1941 Experimental Studies of Rigidity. Character and Personality 9:251-282. -> Part 1: The Measurement of Rigidity in Normal and Feebleminded Persons. Part 2: The Explanatory Power of the Concept of Rigidity as Applied to Feeble-mindedness. KOUNIN, JACOB S. 1948 The Meaning of Rigidity: A Reply to Heinz Werner. Psychological Review 55:157166. LANTZ, BEATRICE 1945 Some Dynamic Aspects of Success and Failure. Psychological Monographs 59, no. 1; Serial no. 271. LASHLEY, K. S.; CHOW, K. L.; and SEMMES, JOSEPHINE 1951 An Examination of the Electrical Field Theory of Cerebral Integration. Psychological Review 58:123— 136. LAURENDEAU, MONIQUE; and PINARD, ADRIEN 1963 Causal Thinking in the Child: A Genetic and Experimental Approach. New York: International Universities Press. LEAHY, ALICE M. 1935 Nature-Nurture and Intelligence. Genetic Psychology Monographs 17:236-308. LEWIN, KURT (1926-1933) 1935 A Dynamic Theory of Personality: Selected Papers. New York: McGrawHill.

MERCANTILISM LURIA, A. R. 1963 Psychological Studies of Mental Deficiency in the Soviet Union. Pages 353-387 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGraw-Hill. LYLE, J. G. 1959 The Effect of an Institutional Environment Upon the Verbal Development in Imbecile Children. 1: Verbal Intelligence. Journal of Mental Deficiency Research 3:122-128. MCCANDLESS, BOYD R. 1964 Relation of Environmental Factors to Intellectual Functioning. Pages 175-213 in Harvey A. Stevens and Rick F. Heber (editors), Mental Retardation: A Review of Research. Univ. of Chicago Press. MCCLEARN, GERALD E. 1962 The Inheritance of Behavior. Pages 144-252 in Leo Postman (editor), Psychology in the Making. New York: Knopf. McKiNNEY, JOHN P.; and KEELE, TINA 1963 Effects of Increased Mothering on the Behavior of Severely Retarded Boys. American Journal of Mental Deficiency 67:556-562. MAKER, BRENDAN A. 1963 Intelligence and Brain Damage. Pages 224-252 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGraw-Hill. Mental Retardation in the Soviet Union. 1964 Canada's Mental Health Supplement no. 42. MILGRAM, NORMAN A.; and FURTH, HANS G. 1963 The Influence of Language on Concept Attainment in Educable Retarded Children. American Journal of Mental Deficiency 67:733-739. O'CONNOR, N.; and HERMELIN, B. 1959 Discrimination and Reversal Learning in Imbeciles. Journal of Abnormal and Social Psychology 59:409-413. PENROSE, LIONEL S. (1949) 1963 The Biology of Mental Defect. 3d ed. London: Sidgwick & Jackson. PHILLIPS, LESLIE; and ZIGLER, EDWARD 1964 Role Orientation, the Action-Thought Dimension, and Outcome in Psychiatric Disorder. Journal of Abnormal and Social Psychology 68:381-389. PIAGET, JEAN (1932) 1948 The Moral Judgment of the Child. Glencoe, 111.: Free Press. -> First published in French. RIEBER, MORTON 1964 Verbal Mediation in Normal and Retarded Children. American Journal of Mental Deficiency 68:634-641. SHALLENBERGER, PATRICIA; and ZIGLER, EDWARD 1961 Rigidity, Negative Reaction Tendencies, and Cosatiation Effects in Normal and Feebleminded Children. Journal of Abnormal and Social Psychology 63:20-26. SIEGEL, PAUL S.; and FOSHEE, JAMES G. 1960 Molar Variability in the Mentally Defective. Journal of Abnormal and Social Psychology 61:141-143. SPITZ, HERMAN H. 1963 Field Theory in Mental Deficiency. Pages 11-40 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGraw-Hill. SPIVACK, GEORGE 1963 Perceptual Processes. Pages 480511 in Norman R. Ellis (editor), Handbook of Mental Deficiency: Psychological Theory and Research. New York: McGraw-Hill. STEVENSON, HAROLD W.; and FAHEL, LEILA 1961 The Effect of Social Reinforcement on the Performance of Institutionalized and Noninstitutionalized Normal and Feebleminded Children. Journal of Personality 29: 136-147. STEVENSON, HAROLD W.; and ZIGLER, EDWARD 1957 Dis-

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scrimination Learning and Rigidity in Normal and Feebleminded Individuals. Journal of Personality 25: 699-711. STEVENSON, HAROLD W.; and ZIGLER, EDWARD 1958 Probability Learning in Children. Journal of Experimental Psychology 56:185-192. TAYLOR, JANET A. (1956) 1963 Drive Theory and Manifest Anxiety. Pages 205-222 in Martha T. Mednick and Sarnoff A. Mednick (editors), Research in Personality. New York: Holt. -> First published in the Psychological Bulletin. THORPE, Louis P. (1946) 1955 Child Psychology and Development. 2d ed. New York: Ronald Press. TURNURE, JAMES; and ZIGLER, EDWARD 1964 Outerdirectedness in the Problem Solving of Normal and Retarded Children. Journal of Abnormal and Social Psychology 69:427-436. U.S. PRESIDENT'S PANEL ON MENTAL RETARDATION 1963 A Proposed Program for National Action to Combat Mental Retardation. Washington: Government Printing Office. WEAVER, THOMAS R. 1946 The Incidence of Maladjustment Among Mental Defectives in Military Environment. American Journal of Mental Deficiency 51: 238-246. WHEELER, LESTER R. 1942 A Comparative Study of the Intelligence of East Tennessee Mountain Children. Journal of Educational Psychology 33:321-334. WHITNEY, E. ARTHUR 1956 Mental Deficiency: 1955. American Journal of Mental Deficiency 60:676-683. WINDLE, CHARLES 1962 Prognosis of Mental Subnormals. American Journal of Mental Deficiency 66, no. 5 (Monograph Supplement). ZEAMAN, DAVID; and HOUSE, BETTY J. 1962 Approach and Avoidance in the Discrimination Learning of Retardates. Child Development 33:355-372. ZIGLER, EDWARD 1961 Social Deprivation and Rigidity in the Performance of Feebleminded Children. Journal of Abnormal and Social Psychology 62:413-421. ZIGLER, EDWARD 1962 Rigidity in the Feebleminded. Pages 141-162 in E. Philip Trapp and Philip Himelstein (editors), Readings on the Exceptional Child. New York: Appleton. ZIGLER, EDWARD 1963 Social Reinforcement, Environmental Conditions and the Child. American Journal of Orthopsychiatry 33:614-623. ZIGLER, EDWARD; and DELABRY, JACQUES 1962 Conceptswitching in Middle-class, Lower-class, and Retarded Children. Journal of Abnormal and Social Psychology 65:267-273. ZIGLER, EDWARD; and UNELL, EARL 1962 Conceptswitching in Normal and Feebleminded Children as a Function of Reinforcement. American Journal of Mental Deficiency 66:651-657. ZIGLER, EDWARD; and WILLIAMS, JOANNA 1963 Institutionalization and the Effectiveness of Social Reinforcement: A Three Year Follow-up Study. Journal of Abnormal and Social Psychology 66:197-205.

MENTAL TESTING See INTELLIGENCE AND INTELLIGENCE TESTING. MERCANTILISM See under ECONOMIC THOUGHT.

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MERCIER DE LA RIVIERE MERCIER DE LA RIVIERE

Pierre Paul Mercier de la Riviere (1720-1793), French physiocrat, was born at Saumur (Indre et Loire), the son of a president tresorier of France. After studying law, at the age of 27 he became a member of the parlement of Paris and remained there for 12 years. He then served for several years as intendant of Martinique. Recalled as a result of policy differences with respect to free trade (he had admitted English ships to the island, in violation of the pacte colonial}, he returned to the parlement in 1764 and in semiretirement wrote his masterpiece, L'ordre naturel et essentiel des societes politiques (1767). The basic ideas of the physiocrats, and especially of Quesnay, their leader, are to be found in Mercier's work. In his Ordre naturel, Mercier built on the ideas presented by Quesnay in his "Despotisme de la Chine." Mercier stressed the political aspects of physiocracy rather than the agricultural ideas of the school. For him, the law of property, which is based on the physical order of nature, is unique and universal, underlying all other laws. It is a law that may be directly apprehended by all men, and one that governs the essential order of society. The proper character of political institutions derives from this basic importance of the law of property. The sovereign, according to Mercier, is by definition co-owner of the fixed wealth of the society; in the eyes of his subjects he is no more than a large proprietor who has no privileges at the expense of others but, rather, is linked to his subjects by a common interest in maximizing the value of common property. The proportion of fixed wealth that is to be used as public revenue, or taxes, is thus determined by the natural law of property, provided that government takes the form of personal and legal despotism (as opposed to arbitrary despotism). Since under personal and legal despotism the despot embodies that fundamental unity of society which is based on the law of property, it is in the direct interest of such a despot to keep taxes within the limits of the portion required by the law of property. Mercier proposed that the sovereign have both executive and legislative powers, for if legislative power is in the hands of a representative assembly, there necessarily arise parties with irreconcilable private interests. However, Mercier did advocate an independent judiciary, with the right to register laws, a suspensive veto of laws, and control of their constitutionality. In contrast with the law of property, which provides the security requisite to liberty, the laws enacted by the sovereign create no funda-

mental rights: they assure only the fulfillment of private contracts. Thus Mercier envisioned a political order that is in harmony with nature. Every man becomes an instrument of the welfare of his fellows; no one can profit or become rich at the expense of others. Luxury, "that monster," will disappear, and peace will be established among nations. The system of government that Mercier envisioned requires a mature public opinion as a final check on the consistency of the sovereign's conduct with the law of property. Mercier's De I'instruction publique (1775) described the system of national education necessary to raise public opinion to the appropriate level of maturity. To be sure, the "nation" that Mercier wished to educate was made up only of landowners and farmers; as a physiocrat, he considered commerce and industry as unproductive and unworthy of participation. It is hard to assess the influence that Mercier had, since it merges with that of the entire school of Quesnay. Mercier is undoubtedly at least the most widely read of Quesnay's disciples, because his works have been most accessible to the general public. Mercier did not get along with Catherine the Great when he visited Russia at her invitation; however, the king of Sweden commissioned, and presumably profited from, Mercier's work on public education. FREDERIC MAURO [For the historical context of Mercier's work, see ECONOMIC THOUGHT, article on PHYSIOCRATIC THOUGHT; and the biography of QUESNAY.] WORKS BY MERCIER

(1767) 1910 L'ordre naturel et essentiel des societes politiques. Paris: Geuthner. 1770 L'interet general de I'etat . . . . Amsterdam and Paris: Desaint. 1775 De /'instruction publique: Ou, considerations morales et politiques sur la necessite, la nature et la source de cette instruction, ouvrage demande pour le roi de Suede. Stockholm and Paris: Didot. 1789 Essais sur les maximes et loix fondamentales de la monarchic francoise . . . . Paris: Vallat-La-Chapelle. 1790 Palladium de la constitution politique: Ou, regeneration morale de la France . . . . Paris: Baudouin. SUPPLEMENTARY BIBLIOGRAPHY

JOUBLEAU, F. 1858-1859 Notice sur P.-P. Lemercier de la Riviere. Academic des Sciences Morales et Politiques, Paris, Seances et travaux 46:439-455; 47:121150, 249-265. LARIVIERE, CHARLES DE (1897) 1909 Mercier de la Riviere a Saint-Petersbourg en 1767. Pages 71-132 in Charles de Lariviere, La France et la Russie au XVIII* siecle: Etudes d'histoire et de litterature franco-russe. Paris: Soudier.

MERGERS RICHNER, EDMUND 1931 Le Mercier de la Riviere: Ein Fiihrer der physiokratischen Bewegung in Frankreich. Zurich: Girsberger. SILBERSTEIN, LOTTE 1928 Lemercier de la Riviere und seine politischen Ideen. Berlin: Eberling. WEULERSSE, GEORGES 1910 Le mouvement physiocratique en France de 1756 a 1770. 2 vols. Paris: Alcan. WEULERSSE, GEORGES 1950 La physiocratie sous les ministeres de Turgot et de Necker (1774-1781). Paris: Presses Universitaires de France. WEULERSSE, GEORGES 1959 La physiocratie a la fin du regne de Louis XV: 1770-1774. Paris: Presses Universitaires de France.

MERGERS A merger is the combination into a single business enterprise of two or more previously independent enterprises. The combination may take a number of forms. Among these are the outright purchase of the assets of one company by another for cash or for the stock or debt of the acquiring company. A holding company may be created, with the stock of the combining companies exchanged for that of the parent company. The stock of the merging companies may be held in trust, though this has been generally superseded by corporate arrangements. Combinations have been effected by long-term lease. The legal and financial forms the merger takes are governed largely by tax, corporate charter, and other legal provisions that introduce unique elements in each case. While such factors are of some influence in shaping the broad pattern of mergers, they are probably much less important than underlying forces of economic change and competition. Mergers represent a formal, as against an informal, form of combination. Independent and competing enterprises may pursue a common course of action by various arrangements falling short of outright merger. These range from conscious parallelism of action to contractual agreements governing prices, production, conditions of sale, marketing, and other major business policies. Many of these less formal arrangements may achieve the same purpose as a merger in organizing an industry. However, their effects are likely to be less permanent, enforceability is less absolute, and they are vulnerable to the charge of conspiracy. Probably only a small fraction of all mergers, certainly of recent mergers, have had the reduction or elimination of competition as a principal motive. Other reasons for merging are to achieve a more efficient integration of successive stages in production and marketing, to diversify into new products and markets, to take advantage of a fa-

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vorable investment opportunity, to minimize taxes when liquidating a business, and to acquire a talented person or a promising patent. In the case of many mergers of very small enterprises, the purpose may be simply to gain the benefits of specialization in management, one partner to the merger becoming responsible for production, the other for marketing and sales. The great variety of objectives in mergers suggests that convenient generalizations about their underlying causes may not be easy to find. Certain patterns in mergers have been observed, however, which offer some guides to promising lines of inquiry. The following discussion must be confined largely to the United States because of the lack of statistical information about other countries. Merger movements. One outstanding characteristic of mergers in the United States is the highly episodic nature of their occurrence. In three periods—1898 through 1902, 1926 through 1930, and 1957 through 1961—industrial mergers occurred on so extensive a scale that they are best described as waves or movements (see Figure 1). This tendency of a fundamental form of enterprise expansion to show vast and widely separated peaks of activity has probably interested students more than the examination of individual mergers. The first recorded merger movement of major proportions occurred as the United States entered the twentieth century, its peak years being 1898 through 1902. For a number of industries it represented the formal consolidation of companies that had already achieved a certain degree of policy coordination through agreements to avoid active competition, agreements that had shown distressing tendencies to break down. For a few important companies it represented merely a change in legal form, from trust to holding company, of an earlier merger. Most importantly, however, it involved the consolidation of companies in a large number of previously dispersed industries into single companies in which control was tightly centralized. It transformed many industries formerly characterized by many small and medium-size firms into those in which one or a few large corporations occupied dominant positions. During the first merger wave such industrial giants as U.S. Steel, American Tobacco, International Harvester, DuPont, Anaconda Copper, Corn Products, American Smelting and Refining, Otis Elevator, Allis-Chalmers, and American Sugar Refining were created. The second large movement took place in the last half of the 1920s, its peak years being 1926 through 1930. To some degree it represented consolidation in the important new industries that had

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MERGERS

Turn-of-the-century movement 2,000r-

Late 1920s movement

Latest movement

Figure 1 — Firm disappearances by merger, United States, annually, 1895—1961 a. Logarithmic scale. b. The two series are not directly comparable and are presented on the same chart only to provide historical perspective. Sources: For 1895-1920, Nelson 1959, pp. 152-153; for 1919-1939, Thorp 1941, pp. 231-234; for

1940-1954, U.S. Federal Trade Commission 1955,

p. 33; 1955-1961, U.S. Federal Trade Commission data.

appeared since the first merger wave. It also reflected attempts in some industries to restore the levels of concentration achieved three decades earlier by firms whose leading positions had been eroded in the meantime. Among the prominent companies created by merger in this period were National Steel, National Dairy Products, United Aircraft, Owens-Illinois, and Caterpillar Tractor. As Figure 1 indicates, the third large movement was probably underway in the early 1960s. There was a short merger revival immediately following World War n, which was confined mainly to the two years 1946 and 1947. However, merger activity did not return to sustained high levels until the mid-1950s. The pattern of recent mergers has been more varied, with product diversification and tax minimization playing a more prominent role than in the earlier movements (Butters et al. 1951). The current revival of merger activity, while large, is not as large as the earlier merger movements. In the five turn-of-the-century years, 1898 through 1902, at least 2,700 firms disappeared into the manufacturing and mining mergers reported in the financial press—and reporting was not as

comprehensive as it has since become. In the peak years of the late 1920s, 1926 through 1930, mergers claimed 4,800 firms. By contrast, in the five years 1957 through 1961 there were about 2,900 disappearances. Since the number as well as the size of industrial firms has grown considerably in the past six decades, the most recent levels of merger activity are relatively lower than suggested by the absolute comparisons. Mergers and competition. The three merger movements have had varied effects on the intensity and form of competition in markets. The turn-ofthe-century movement, as indicated above, succeeded in consolidating thousands of small and medium-size companies into relatively few large ones. In literally dozens of cases the merged firm attained a dominant share of its industry. The avowed goal of many mergers was monopolistic control of a market, and this goal was realized in many instances. The effect was to transform competition from that among many firms into that in which one firm was large enough, through force of size, to maintain orderly, and profitable, conditions in a market. The result was a major reduction in the

MERGERS amount of competition as it had been known in the nineteenth century. The merger wave of the late 1920s, superimposed on an industrial structure still showing the effects of its giant predecessor wave, had a necessarily different effect on competition. Some observers have speculated that its pattern was influenced by judicial interpretation. Antitrust policy, while generally permissive toward mergers in this period, may have made the largest companies in an industry less eager to engage in mergers which would markedly increase their leadership of an industry [see ANTITRUST LEGISLATION]. Such action might be considered predatory and lay the company open to the charge of being a "bad trust." Since well-behaved colossi were generally free from antitrust attention, an industry's largest company might think twice before taking action which might jeopardize its reputation. The second- , third- , or fourth-ranking companies might have felt less restricted. This may have accelerated the formation of industries in which the leadership was shared by several large firms. However, until direct evidence on the number and size of mergers in this period becomes available, such an interpretation must remain largely speculative. The pattern of several-firm leadership of industry—oligopoly—is now characteristic of many of our leading industries [see OLIGOPOLY]. It is still a much-debated question whether the oligopolistic industry is competitive enough, though there is more general agreement that the existence of several big firms in an industry signifies more active competition than that of one huge, dominant firm. Certainly the merger wave of the 1920s produced an increase in industrial concentration, if by this is meant simply the centralizing of the control of markets into a smaller relative number of enterprises. It remains to be established, however, whether the more common result was the substitution of oligopoly for industries having only one clear leader or its substitution for decentralized industries having many firms and the more classical variety of competition. The most recent merger revival has been even more complex in its effect on competition. Unlike the two earlier merger waves, the goal of most recent mergers has not been the union of two or more firms producing the same product at the same stage °f fabrication. This type—the horizontal merger— has the immediate effect of reducing the number °f independent firms selling the product in question. A study by the Federal Trade Commission suggests that horizontal mergers may be accounting for about two-fifths of recent merger activity (U.S.

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Federal Trade Commission 1955, chapter 3). They amounted to about three-fourths of the turn-of-thecentury merger activity (Nelson 1959, p. 103) and probably much more than half of that of the 1920s. The over-all effect on competition of recent horizontal mergers has therefore been considerably less than the horizontal mergers of three and six decades earlier. It would be difficult to see how it could be greater. Given the existing levels of concentration, established in no small part in the earlier movements, the recent merger movement could only maintain or slightly increase this level. To change it greatly would mean the creation of monopolies or near-monopolies in many industries, and this is clearly contrary to public policy. The strengthening of major oligopolies by merger has recently received greater discouragement from antitrust authorities. In 1958 the courts ruled against the proposed merger of the Bethlehem and Youngstown steel companies, whose effect would have been to make the second largest steel company, Bethlehem, more nearly equal to the largest company, U.S. Steel. Bethlehem, with 15 per cent of the industry, would have had 19 per cent had it acquired Youngstown, thus bringing it closer to U.S. Steel's share of 30 per cent. A comprehensive study by the National Industrial Conference Board has characterized recent antitrust orientation as follows: The Board's study finds that, contrary to popular impression, enforcement has focussed, not on the size of the acquiring or acquired company, as such, but on market effects. Indeed, only 2% of the acquisitions recorded for 1958 and 1959 for the 300 largest manufacturing corporations had resulted in a merger case by March, 1960. . . . up to the present time, a merger has been most vulnerable if the acquiring corporation's sales and assets exceed $10 million and it is one of the first companies in its field, if the acquired unit is also one of the major organizations in its field, and if a high percentage of the output of the products or services in question is concentrated in relatively few companies. Vulnerability is greatest if the two companies operate in the same field. (Bock 1960, pp. 9-10; italics added) Approximately one-fifth of recent merger activity has involved the combining of firms at successive stages in the production and distribution of a particular product—the vertical merger. The effect of a vertical merger on competition is not likely to be great, unless it provides the merged company with a stranglehold on one of the stages of production. If this is the result, then the relevant combination is fundamentally a horizontal one. The relatively crude evidence available suggests that it is unlikely

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that the latest vertical mergers have produced any appreciable diminution in competition. Finally, about two-fifths of recent mergers have had the diversification of products or production processes as a goal. In the first movement, by contrast, there were virtually no mergers for diversification. Diversification objectives cover a broad range. Some companies hope to achieve economies in marketing through production of a broader line of products. Others seek economies in production by acquiring products capable of being produced by the company's existing production facilities. Still others diversify simply to avoid having their fortunes dependent on a single product or industry. The competitive effects of a diversified merger are not likely to be great. If the merged products did not directly compete with one another before the merger, the fact that they are now produced by the same company can have only indirect effects on competition in their separate markets. The above general review of the competitive consequences of the three merger movements should amply illustrate that we continue to possess only the crudest notions of the effect of mergers on competition. Considerable work remains to be done in classifying mergers; the simple horizontalvertical-diversified taxonomy is only a beginning. Beyond this, however, lie challenging conceptual problems for which the tools of economic analysis are appropriate. Many problems are related to the appropriate economic sector in which to measure competition and have relevance to other factors in the structure and performance of industries. Many, however, have their basis in the unique characteristics of the merger and the role that considerations of competitive factors play in the merger decision. Mergers and business cycles. Although merger history has been dominated by the three large waves, mergers have occurred in measurable amount in every year. One of the periods of lowest activity observed in the twentieth century was the decade from 1905 through 1915, following the huge turn-of-the-century wave. Even during this period there were important mergers. In 1908 General Motors was formed, and in 1911 what is presently International Business Machines. Both were consolidations of several prominent firms in their fields. The great depression of the 1930s saw mergers at probably their lowest ebb; yet even then there were some important chemical and electronics mergers. The historical pattern of merger activity is notable, therefore, not only for its great waves but also for the presence of cycles in mergers. The cycles

are most pronounced as part of the great movements, but they also may be observed during the two-to-three-decade intervals of lowered activity. For the six-decade period from 1895 through 1954 12 clear merger cycles have been identified. During the same period the National Bureau of Economic Research identified 14 cycles in general economic activity, and the merger cycle conformed to the general business cycle in 11 of the 12 cases. When it did not conform, the cycle in general business was either very short, very mild, or both (Nelson 1959, chapter 5). The cyclical responsiveness of mergers to business activity raises a number of questions. One set relates to the role of mergers as a form of business investment. The balancing of the cost of the firms to be acquired with the discounted expected value of the future earnings of the merged firm involves the same kind of calculation required when deciding to organize a new business or build another plant. Like private investment, merger activity has been shown to respond in a positive and sensitive fashion to the business cycle. Both merger activity and private investment in new plant and equipment reach their highest points before the peak in general business activity. Both seem to bear a fairly close relationship to movements in stock prices, which suggests that an important factor is the possibility of financing the purchase of either a new plant or another company under conditions favorable to the issuance of new equity securities. Firms expanding by merger, as in other forms of firm growth, frequently turn to public sources for the needed extra funds. The issuance of new securities is most necessary when the acquired firm is purchased for cash; however, when the purchase is made by exchange of stock, new securities may be issued to increase working capital. Even when there is only the exchange of stock, the organizers of the merger are likely to be sensitive to the recent trend of the stock market, because ratios of exchange are often based on the relative market prices of the two securities. Although both are generally responsive to stock price rises and other manifestations of economic expansions, merger activity and plant and equipment investment are not wholly synchronous. One examination has found that merger activity reaches its peak earlier in a cyclical expansion than do contracts for industrial and commercial construction and orders for manufacturers' durable equipment (Nelson 1966, p. 58). This pattern of timing refutes the theory that businesses turn to mergers only after other profitable forms of investment have been exhausted.

MERGERS What might explain the earlier peak in mergers than in internal expansion? One hypothesis might be that, although nothing in the basic decision to invest in merger or new plant would predict when in an expansion each is more likely to occur, delays in the construction of new plants may result in merger plans coming to fruition sooner than plantbuilding programs. Indeed, delays encountered in plant-building may encourage firms to accelerate merger efforts in order to achieve growth targets on schedule. Mergers by large firms. In the histories of a majority of the largest industrial corporations there has been at least one merger important enough to have had a significant effect on the subsequent rate and direction of company growth (Nelson 1959, p. 4). Some mergers have made companies leaders in their traditional industries, while others have created diversified enterprises. Some have given large companies commanding leads in expanding new industries, while others have consolidated into fewer firms the control of stationary or declining industries. One could claim that the attrition of time has nullified the effects of at least the earlier of these mergers, so that the structure and performance of these companies is now little different from what it would have been had no mergers taken place. This may have been true, almost by definition, of the least successful mergers, but it strains credibility to argue that the forces molding industry structures have been so pervasive as to make it generally true. Assuredly the structure of the aluminum industry from 1900 through 1940 would have been different had not early patent mergers succeeded in making Aluminum Company of America the only company in the field at that time. A problem that continues to need solution is that of measuring with some precision the part that mergers have played in the growth of firms. Recent studies provide some idea of its magnitude, and evidently it has not been small. The most comprehensive examination made to date has been that of J. Fred Weston. Investigating 74 large industrial firms, he found that, at a minimum, 22.6 per cent of the 1900-1948 growth of these companies could be assigned to merger (1953, p. 14). Weston regards this as a minimum estimate because he explicitly counted as growth by merger only the addition of the acquired firm at the time of the merger. This assumes that the part of the now-enlarged company representing the new acquisition did not continue to grow after the merger, and so contributed nothing to the postmerger growth of the combined firm. While necessary in setting a lower limit

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to the range of estimates, the assumption leads, among other things, to the unlikely inference that mergers are organized by pessimistic men. It is difficult to measure the growth-enhancing effects of any major restructuring of an enterprise, and that produced by a merger is no exception. One approach to measurement might be to compare observed growth with that predicted by simple models of firm growth. One such model might assume that, for the merger to have been neutral in its effect on growth, the acquired firm would have grown at the same rate as its industry. Alternatively, one might assume that merging firms (acquiring and acquired) each would have grown at the same rate as the merged firm. Perhaps most plausible would be the assumption that the merging firms would have grown at the same rate as other similar firms that did not merge. Other models could be developed, and much could be learned of the effects of mergers in the process of developing and testing them. None has yet been used on a comprehensive scale to measure the merger component in large-firm growth. The interest of many students has been in the role of mergers in producing high concentration in major industries, for this is where the implications for antitrust policy have greatest relevance [see INDUSTRIAL CONCENTRATION]. To study the role of mergers in concentration, one must focus on the firm's share of its industry and on horizontal mergers that directly affect this share. For 25 of his 74 companies Weston presented measures of mergers' effects on industry shares. In this formulation he assumed that, in the absence of merger, the acquiring firm would have maintained its premerger share of the industry, that is, it would have been able to grow as fast as the industry. This assumption probably assigns too little of postmerger growth to the acquired firm, for enhancement of growth potential must be a primary reason for acquiring a rival firm. Despite this bias toward understatement, the calculated contribution to growth was impressive. He found that, under the above assumption, most of the companies' increase in market share was assignable to merger. Indeed, for 11 of the 25 companies, mergers accounted for more than their increase in market share, that is, the companies witnessed a decline in the shares of markets that mergers had initially given them. These findings led Stigler, in his review of the Weston study, to conclude: "He [Weston] lends support to the opinion that merger has been the basic method by which individual firms have acquired high shares in major industries in the United States" (1956, p. 40).

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International comparisons. Though crude and incomplete, merger statistics for the United States are incomparably more abundant than those for other countries. The only comprehensive time series on mergers known to the writer is that for Great Britain during the large wave of amalgamations it, too, experienced at the turn of the century (Macrosty 1907). Reasons for the paucity of merger statistics in other countries are not hard to find. Absence of antitrust laws, especially those directed at mergers, means that government agencies have had no need to collect data on which to base policy. Also, cartelization rather than amalgamation seems to have been the more common form of combination in European industry, and merger activity may not have been sufficiently large or widespread to engage the interest of economists. With the acceleration of European economic integration, mergers may begin to receive more attention. The creation of a tariff-free market as large or larger than that of the United States may compel major changes in the firm-structures of industries, and it seems probable that mergers should emerge as important instruments for effecting any such change. The experience of the United States suggests that availability of data provides no sure guarantee that public policy toward mergers will always be enlightened. However, there are some indications that lags in assembling merger data have made the evolution of policy more tortuous, erratic, and probably less successful. An early beginning to the assembling of data on Common Market mergers could aid considerably in the development of appropriate public policies toward mergers; policies, one hastens to add, that may be expected to depart in significant respects from the United States example. RALPH L. NELSON BIBLIOGRAPHY

Current data on the number, size, and industry of mergers are available from the Office of Information of the Federal Trade Commission. Comprehensive lists of mergers may be found in National Industrial Conference Board, Conference Board Record (see Bock 1960, pages 107-119 for a discussion of these data). BOCK, BETTY 1960 Mergers and Markets: An Economic Analysis of Case Law. Studies in Business Economics, No. 69. New York: National Industrial Conference Board. -» See especially pages 107-119, "Data on Merging Companies." BUTTERS, JOHN K.; LINTNER, JOHN; and CARY, WILLIAM L. 1951 Effects of Taxation: Corporate Mergers. Boston: Harvard Univ., Graduate School of Business Administration, Division of Research. MACROSTY, HENRY W. 1907 The Trust Movement in British Industry. London: Longmans.

MARKHAM, JESSE W. (1955) 1966 Survey of the Evidence and Findings on Mergers. Pages 141—182 in Universities-National Bureau Committee for Economic Research, Business Concentration and Price Policy: A Conference. National Bureau of Economic Research, Special Conference Series, No. 5. Princeton Univ. Press. NATIONAL INDUSTRIAL CONFERENCE BOARD Conference Board Record. -» Published since 1944. Previously published under the titles Conference Board Business Record and Conference Board Business Management Record. NELSON, RALPH L. 1959 Merger Movements in American Industry: 1895-1956. National Bureau of Economic Research, General Series, No. 66. Princeton Univ. Press. NELSON, RALPH L. 1966 Business Cycle Factors in the Choice Between Internal and External Growth. Pages 52-70 in William W. Alberts and Joel E. Segall (editors), The Corporate Merger. Univ. of Chicago Press. STIGLER, GEORGE J. 1956 The Statistics of Monopoly and Merger. Journal of Political Economy 64:33-40. THORP, WILLARD L. 1941 The Structure of Industry. U.S. Temporary National Economic Committee, Investigation of Concentration of Economic Power, Monograph No. 27. Washington: Government Printing Office. -» See especially pages 227-234, "The Merger Movement." U.S. FEDERAL TRADE COMMISSION 1955 Report on Corporate Mergers and Acquisitions: May 1955. Washington: Government Printing Office. WESTON, J. FRED 1953 The Role of Mergers in the Growth of Large Firms. Berkeley: Univ. of California Press.

MERRIAM, CHARLES E. The life of Charles Edward Merriam, Jr. (18741953), American political scientist, represents and reflects many of the changes which have taken place not only in the field in which he achieved his reputation but also in American society in the twentieth century. His generation was perhaps the first to experience with enthusiasm the headlong rush of history and of industrial technology, which so depressed Henry Adams, and to return to the relentless faith in social study characteristic of eighteenth-century democratic thought. Merriam was determined to retain for America in the twentieth century the vision that Alexis de Tocqueville had had in the nineteenth: that the political course of Western society was set irrevocably toward ever more democratic government and that the United States could lead the way. To this vision Merriam added his own conviction that the observable weaknesses in modern government are the result of too little rather than too much democracy. His belief that the sources of such weaknesses can be found by an examination of the actual workings of politics, and that the methods of such examination have to be scientific, formed the basis of his approach to

MERRIAM, CHARLES E. politics and of his efforts to reorganize political science. His commitment to democracy and to scientific method gave impetus to his lifelong efforts to bring scientific knowledge to the service of government, and his conception of scientific method facilitated the development of interrelationships among the social sciences. Merriam was born in Hopkinton, Iowa, the second son of the local postmaster, who was also keeper of the general store. His mother, Margaret Campbell Kirkwood Merriam, was a devout Scottish Presbyterian who had been educated in Scotland to be a schoolteacher, although family responsibilities and chronic ill health prevented her from teaching. The Merriam family was deeply involved in Iowa politics; Merriam's father, however, never had the political career he hoped for. Like his father and his elder brother, Merriam was educated first at Lenox College in Hopkinton. His father planned a legal career for him, preparatory to a life in politics, but a brief period at the law school of Iowa State University convinced him that legal training lacked a proper concern for ethics, and he rebelled. He decided to study political economy and social science at Columbia University, then a rapidly growing center of American social science. At Columbia he was influenced by William A. Dunning, John W. Burgess, and E. R. A. Seligman, among many others. The introduction to the modern historical and comparative method that Merriam received at Columbia took much of the edge off his later pilgrimage to Germany to hear Otto von Gierke and Hugo Preuss. Conception of political theory Merriam's acceptance in 1900 of a position as decent in political science at the University of Chicago began his long career at that university. His doctoral thesis, History of the Theory of Sovereignty Since Rousseau, was published in 1900, but it was the publication, in 1903, of A History of American Political Theories that first established him in his profession. Dedicated to Dunning, the book follows Dunning's pseudo-biological methods of historical classification and description, grouping Writers in orderly, if somewhat stilted, fashion by Period and major concern. But it is the first work in which the practicing politicians of the colonial, early federal, and pre-Civil War periods are classified as "theorists." Merriam was also among the first to call attention to the fact that John Locke had exercised a stronger influence over American Political history than had Rousseau. The work may now seem dated and quite static, but much of later discussion of American political thought is based

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on the analysis it contains. Like its sequel, American Political Ideas (1920), it demonstrates Merriam's particular interest in broadening the definition of political theory to include not only the more traditionally recognized theorists whose writings were already part of the canon of political thought, but also the practitioners of politics, whose actions and intentions permanently affect the life of the community even though they may have given little attention to the formulation of doctrine. Indeed, for Merriam political theory came to embrace the study of society itself, as is shown in the memorial volume for Dunning, A History of Political Theories, Recent Times (1924), that he and H. E. Barnes edited: the volume includes, in systematic arrangement, essays in philosophy, sociology, psychology, and anthropology, all of which fields Merriam considered directly relevant to political theory. Involvement in politics With his background of family involvement in Iowa politics, Merriam could scarcely have avoided a similar interest in Chicago. To be sure, his conception of involvement in the political life of the city hardly coincided with that of President William Rainey Harper of the University of Chicago and of successive university administrators. Harper preferred to exert influence on the community through adult education, while Merriam saw city politics as a suitable area for applying new technical skills to the operations of government. Merriam's first opportunity for direct involvement in Chicago politics came in 1905, when the City Club of Chicago asked him to do a study of the city's municipal revenues. The success of the report, particularly among the club's membership of prominent local businessmen, led to Merriam's appointment by the mayor in 1907 as secretary of the Chicago Harbor Commission, whose purpose was to study the city's water transportation facilities (part of an effort to make the new Chicago city plan effective). The work succeeded not only in bringing Merriam to public attention but also in acquainting him with some of the city's most complex problems of business policy and political obfuscation. The work raised issues of land use, public utilities, private enrichment at public expense, and graft. Chicago's unusually high consciousness of its physical layout and its growing determination to make use of its remarkable lake frontage gave Merriam a rich education in some of the newly developing problems related to urban planning. As a result of his investigations, Merriam and his supporters were able to secure his nomination as alderman in the city's first primary and his elec-

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tion to the City Council in 1909. He promptly introduced an ordinance for a commission on city expenditures, becoming chairman of the commission upon its creation. By 1910, the commission had so successfully exposed fraud in Chicago city purchasing that it achieved a national reputation among reform groups interested in the reorganization of financing in local government. Merriam's work also came to the attention of Julius Rosenwald, who was already noted for his philanthropies but had hitherto avoided involvement in politics. Rosenwald financed the commission after the City Council angrily stopped its funds. He also backed Merriam's unsuccessful campaign for mayor in the 1911 election. Although Merriam ran on the Republican ticket, his identification as a progressive and a reformer alienated party regulars, who preferred the risk of Democratic victory to the possibility of party repudiation of their control of local politics. Although Merriam was active in the formation of the national Progressive party in 1912, his unwillingness to support it after the election, even though he continued to respect and support its aims, was typical of the growing group of "realists" among the reformers. They had come to look upon a party as having a complex social base as well as a political one, and therefore as less amenable than some reformers had hoped to modification by such political methods as the initiative, referendum, recall, and direct primary elections. Merriam had published his Primary Elections in 1908. Unlike so many of the studies of structural reform, the book called attention to the fact that structural reorganization by itself is not enough, that politics ultimately depends upon which groups of citizens are interested, or willing to be made interested, in the outcome of political events. Merriam's political activities, couched as they were in the imagery of the scholar-politician made popular by the successful candidacy of Woodrow Wilson, brought him also a national reputation. His desk became an informal clearinghouse of information for groups interested in the new methods of reform in local politics: primaries, budget and accounting systems, commissions of investigation and management, and the like. Re-elected to the Chicago City Council in 1913, he served until 1917, meanwhile continuing his teaching at the university. His career came to exemplify the new pragmatic voice of the academy, dedicated not only to the historical understanding of political structure but also to the discovery of useful methods for improving the conduct of politics. World War i took Merriam to Italy, where he

served briefly as the American high commissioner of public information, an office used by the Wilson administration to circumvent the more traditional diplomatic service. The position gave Merriam a sharp awareness of the problems involved in international exchanges of information, a field scarcely touched upon by Americans. Several of the postwar projects in which he was interested—most notably a series on civic education in various countries and a study of international reporting in American news media—were products of his months in Italy. Organization of research His return to Chicago politics after the war was unsuccessful; as an internationalist, he was swimming against the tide. The postwar period marked his ascendancy in the academic profession, an ascendancy which was nonetheless paralleled by an increasing sense of political frustration. His influence within the American Political Science Association was at its peak, and he led the movement for more research in politics and for closer relations with other disciplines, particularly psychology. He became president of the association in 1924. The founding of the Social Science Research Council in the same year was the culmination of his efforts to encourage greater interaction among the various fields. During this period he also did his most successful graduate teaching, and the students from this period, among them V. O. Key, Jr., and H. D. Lasswell, have been among his most influential. Through his friendship with young Beardsley Ruml, Merriam had an influence on the Rockefeller Foundation, and Ruml's striking ability to give organizational reality to Merriam's ideas was the source of much of Merriam's effectiveness during the period. The Rockefeller Foundation financed a committee on local community research at the University of Chicago; a faculty board headed by Merriam and Leonard White used the funds to finance research projects by students and colleagues, often in fields far removed from local community study. The founding of the Public Administration Clearing House in 1931 fulfilled another dream of Merriam's: the bringing together of the research and reform organizations directly involved in professional work in public service. It also brought Louis Brownlow to Chicago, thereby establishing a working friendship which proved enormously influential to both men. Yet the frustration of these years is also clear. Merriam's concern with the nature of leadership and the psychology of voting behavior was a re-

MERRIAM, CHARLES E. sponse in part to his disappointment with the course taken by the Republican party after World War i. The years from 1920 to 1928 saw the tacit repudiation by successive administrations of most of the ideals and programs of the progressives. Only Secretary of Commerce Herbert Hoover seemed concerned with these ideals, and his election to the presidency raised some hope for a return to them. At the University of Chicago, successive presidents frustrated Merriam's efforts to finance research; they saw these efforts as a threat to their own more traditional fund-raising needs. Merriam was tempted, in 1923, to accept a chair at Columbia and again, in 1927, to take a post with the Rockefeller Foundation in Paris, but each time he ultimately decided to remain at Chicago. Conception of a science of politics New Aspects of Politics was published in 1925. More obviously characteristic of his method of work than many of his other books, New Aspects is a collection of papers written and revised between 1920 and 1924. The papers were, in turn, built on notes of his comments at meetings and conferences of social scientists. This method of gradual accretion, accumulation, and revision was the one most often employed by Merriam but it was usually obscured by the final revision. Other such books are Chicago (1929) and Four American Party Leaders (1926), the latter, again characteristically, paralleling work done by his students. More than any of his other writings, however, New Aspects reveals the hortatory Merriam, suggesting directions for future investigation and pointing out to colleagues and students the possibilities inherent in a science of politics that was one of the new sciences of society. The essays also indicate his opposition to deterministic theories of history and politics, not only Darwinism and the economic theories of Charles A. Beard but also the behavioristic determinism in the very psychology, sociology, and anthropology whose methods he urged upon his colleagues. It was not the principles and predictions of these sciences which appealed to Merriam but the usefulness of their methods for the enrichment of the science of politics. Yet in spite of his rejection of deterministic views of history, he nonetheless depended upon a kind of "tendential" history that moves in trends and directions which are observable without being prescriptive. His attitude toward history is clearly related to the concepts of process then current in the pragmatic philosophies of John Dewey, George Herbert Mead, and, perhaps most of all, T. V. Smith. While the essays seem to describe new

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directions of change, these directions are in effect consistent with the traditions of American government and the trends of American politics. Merriam seems to have seen his own role in very classical terms: to provide a modern basis for the kind of "whole man" theories of politics that had marked the history of political theory. Theories of the state, such as those of Hobbes and Locke and of many of their predecessors, had been based on investigations under way in psychology and physics. By Merriam's day, psychology and physics, like all of the natural sciences, had changed far more radically since the eighteenth century than had theories of the democratic state. This lag meant that democracy seemed increasingly destined to bear the brunt of the critical disillusion produced by the more recent scientific investigations of the nature of man. Merriam sought to provide a basis for restating a theory of the democratic state which would be consistent both with the traditions of democratic theory and with the revolutions in scientific doctrine, aware all the while that no modern theorist could ever again claim the universal knowledge which had made possible the comprehensive ambitions of classical theory. Such an endeavor now required a social science community, ambitious for the same ends and willing to be tolerant of a multiplicity of approaches. In Political Power (1934a) he sought to apply to American democracy European ideas about the sociological and psychological factors underlying political organization. European, and particularly German, theories of power analysis were given a specifically American setting and generalized in Merriam's characteristic fashion. Hitler's rise to power, like the ambitions of the Kaiser, shocked American scholars: Merriam had a deep respect for the quality of nineteenth-century German scholarship and sought to reconcile its traditional commitments with current events in Germany and in his own country. National planning By the 1930s, Merriam was once again in a position to exert political influence. He was a member of President Hoover's Research Committee on Social Trends, and the report of that committee, published in 1933, introduced Merriam's influence into the New Deal. The report had recommended the establishment of a high-level governmental agency for planning; and the appointment within the Department of the Interior of a national resources committee in 1933 brought Merriam a direct and influential role in the Roosevelt administration; it was a continuing role, since, in 1939,

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the committee became the National Resources Planning Board, with Merriam still a member. In its own day the National Resources Planning Board was better-known to those who criticized it than to those who used the information it produced. Although more than two decades have passed since its demise in 1943, its place in the history of the New Deal has yet to be determined. Over seventy major and minor reports on subjects ranging from land and water resources to labor, industry, education, and science, to mention only the most obvious categories, are largely unknown to (or ignored by) historians, despite the fact that they represent perhaps the best example extant of the transformation of turn-of-the-century progressivism into the professionalized government and social science of the post-New Deal generation. President Roosevelt often used these reports as the basis for proposals to Congress and as a means of testing public response to far-reaching experimental programs. Roosevelt also considered giving the reports wider public circulation to stimulate public interest in government, but the necessity of keeping the board out of politics made any scheme difficult to realize. Merriam was also a member in 1936 and 1937 of the President's Committee on Administrative Management, the so-called Brownlow Committee. His work on the report of the committee gave both practical structure and theoretical base to his concepts of national planning and the relation of national planning to executive organization. The last decade of his life was spent in what might be called active retirement. He continued to influence policy in the department of political science at Chicago, and the loose intellectual community which had come to be known as the Chicago school was maintained. He spent a year, 19481949, on President Truman's Loyalty Review Board, and he undertook various lecture obligations, among them the Walgreen series at the University of Chicago (twice during this period) and a series on public administration at the Maxwell School of Syracuse University, in 1947. He intended these lectures to serve as first drafts for several books: an autobiography, a study of government and the economic order, and a work on politics and administration. They remained among the manuscripts left unfinished at his death. Political theory and political behavior Merriam's official retirement from the University of Chicago came in 1940. During the 1930s his writings reflected his gradual return to the problem he had considered fundamental earlier in his

career but which had been overshadowed for a time by his interest in the study of political behavior, namely, the relation between political theory and democratic government. While Merriam's reputation remains bound to his work in political behavior, his fundamental interest throughout his life was theory. To be sure, theory, for him, needed ultimately to be based upon behavior, and behavior had been neglected by nineteenth-century students in the field: the bringing together of theory and behavior gave Merriam's work the appearance of shifts in focus—from theory to political behavior and back again to theory. His own experience in politics had led him to the observation and analysis of political action, using new methods and concepts imported from fields outside of politics. From the beginning it was his aim to bring new materials to the study of politics and to make it consistent with his ideals of political behavior; and in his later years he sought to fulfill this aim in his theoretical writings, an aim culminating in Systematic Politics (1945). The title reflects what could be called the paradox of Merriam's intellectual life: that he viewed politics as systematic and scientific but could find successful elaboration of its organization only in descriptive statements of political experience, his own and others', rather than in the structure of political theory itself. Though committed to bridging what he felt to be the gap between theory and practice, his best formulations of theory were virtually indistinguishable from practical examples. His book Chicago: A More Intimate View of Urban Politics (1929) is the best example. In Systematic Politics he attempted explicitly to separate theory from practice, thereby extending theory. However, only to those who knew the practical politics in which it had properly been imbedded could the book reveal much; to those who did not, it seemed a bit antiquated. For the post-1945 political scientist, Systematic Politics seems either unsystematic or unpolitical, depending upon whether the critic is committed to the older sense of system which Merriam had sought to revise or to the newer sense of politics which Merriam had sought to create. To assess the career of Merriam apart from the times in which he lived is apt to involve some rather complex distortions. His writings do not constitute a corpus of the importance ordinarily associated with the great in any field. Yet he deserves the accolade as few of his generation do. Merriam was in many ways a publicist of the persuasion of Walter Lippmann, Herbert Croly, and Walter Weyl, but instead of trying to give specialized knowledge of political science wide circulation, as they did, he

MERRIAM, CHARLES E. sought to transcend the academic disciplines for their common benefit, to keep social scientists mindful not only of one another's increasingly specialized problems but also of the broad public responsibility which, as citizens, they shared. Merriam is often called the father of behavioral study in politics, but he did not always relish recognizing his offspring, and his offspring in turn often looked upon him askance. Behavioral study emerged from World War n with a revised canon of method, often wholeheartedly committed to quantification (which Merriam had always viewed with much suspicion) and deeply influenced by the rapid development of new machinery for the collection and analysis of data. The war, too, had dampened reform ardor, as World War i had done. A shocking confrontation with reality had created a generation which, to Merriam, often seemed cynical and mechanistic. He had urged science upon them; but they were using science to question the very principles from which he himself had derived the necessity of scientific method. His own interest in behavioral study was rooted in the conviction that the arena of politics is the proper source of information and generalization about politics and political reform. All of the newly developed social sciences should be brought to bear on the re-examination of old generalizations about politics, the destruction of demonstrably useless ones, and the construction of new ones whose utility would continue to be tested by experience. But it should always be recognized that the social sciences serve rather than control the process of democratic politics. In the continuing relationship between political science and practical politics, the political scientist will always question the adequacy of the politician's knowledge, while the politician will question the validity of the "science" offered to him. Merriam dealt with these reservations by subjecting science to politics and by basing politics on his unshakable belief in democracy. Democratic government, whatever the details of its form, was for him the only government ultimately consistent with the nature of man. He avoided the question of whether or not this principle can be determined behaviorally, convinced as he was that observable weaknesses in the operation of democratic governments were the result of the still-existing nondemocratic elements, not of the essential nature of democracy. The accomplishments of Merriam's career rest as much on the insights to which he directed the attention of others as on the work which can be directly attributed to him. He used his optimism as a device for encouraging investigation and his

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entrepreneurial energies as a means of making that investigation possible. Through his efforts others were enabled to explore frontiers which he himself could see only dimly and to penetrate barriers which he himself could not reach. Much of his reputation must ultimately depend on the roads he marked and the maps he drew. More confident of the end than others were apt to be, and far more certain of the Tightness of the direction, he pointed the way. BARRY D. KARL [For the historical context of Merriam's work, see POLICY SCIENCES; POLITICAL BEHAVIOR; POLITICAL SCIENCE; and the biographies of BEARD; DEWEY; MEAD. For discussion of the subsequent development of Merriam's ideas, see the biography of KEY.] BIBLIOGRAPHY

A bibliography of Merriam's writings through 1941 can be found in White 1942. Studies of aspects of his work can be found in the highly critical Crick 1959 and in Karl 1963. The Merriam papers at the University of Chicago contain a significant amount of unpublished material and constitute an extraordinarily rich source of information on the period during which he lived. WORKS BY MERRIAM

1900 History of the Theory of Sovereignty Since Rousseau. New York: Columbia Univ. Press. 1903 A History of American Political Theories. New York: Macmillan. 1906 Report of an Investigation of the Municipal Revenues of Chicago. City Club of Chicago. (1908) 1928 MERRIAM, CHARLES E.; and OVERACKEH, LOUISE Primary Elections: A Study of the History and Tendencies of Primary Election Legislation. Rev. ed. Univ. of Chicago Press. 1920 American Political Ideas: Studies in the Development of American Political Thought, 1865-1917. New York: Macmillan. (1922) 1949 MERRIAM, CHARLES E.; and GOSNELL, HAROLD F. The American Party System: An Introduction to the Study of Political Parties in the United States. 4th ed. New York: Macmillan. 1924 MERRIAM, CHARLES E.; and BARNES, HARRY E. (editors) A History of Political Theories, Recent Times: Essays on Contemporary Developments in Political Theory. New York: Macmillan. 1924 MERRIAM, CHARLES E.; and GOSNELL, HAROLD F. Non-voting: Causes and Methods of Control. Univ. of Chicago Press. (1925) 1931 New Aspects of Politics. 2d ed. Univ. of Chicago Press. 1926 Four American Party Leaders. New York: Macmillan. 1929 Chicago: A More Intimate View of Urban Politics. New York: Macmillan. 1931a The Making of Citizens: A Comparative Study of Methods of Civic Training. Univ. of Chicago Press. 1931k The Written Constitution and the Unwritten Attitude. New York: Smith. 1934a Political Power: Its Composition and Incidence. New York: McGraw-Hill.

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1934£> Civic Education in the United States. Report of the Commission on the Social Studies, American Historical Association, Part 6. New York: Scribner. 1936 The Role of Politics in Social Change. New York Univ. Press. 1939a The New Democracy and the New Despotism. New York: McGraw-Hill. 1939Z? Prologue to Politics. Univ. of Chicago Press. 1941a On the Agenda of Democracy. Cambridge, Mass.: Harvard Univ. Press. 1941£> What Is Democracy? Univ. of Chicago Press. (1945) 1962 Systematic Politics. Univ. of Chicago Press. 1963 MERRIAM, CHARLES E.; PARRATT, SPENCER D.; and LEPAWSKY, ALBERT The Government of the Metropolitan Region of Chicago. Univ. of Chicago Press. SUPPLEMENTARY

BIBLIOGRAPHY

CRICK, BERNARD 1959 The American Science of Politics: Its Origins and Conditions. Berkeley: Univ. of California Press. KARL, BARRY D. 1963 Executive Reorganization and Reform in the New Deal: The Genesis of Administrative Management, 1900-1939. Cambridge, Mass.: Harvard Univ. Press. -» See especially pages 37-81, "Charles Edward Merriam: Politics, Planning, and the Academy." The Limits of Behaviorialism in Political Science: A Symposium. Edited by James C. Charlesworth. 1962 Philadelphia: American Academy of Political and Social Science. RANNEY, AUSTIN (editor) 1962 Essays on the Behavioral Study of Politics. Urbana: Univ. of Illinois Press. WHITE, LEONARD D. (editor) 1942 The Future of Government in the United States: Essays in Honor of Charles E. Merriam. Univ. of Chicago Press. -> A bibliography of Charles E. Merriam's writings, complete through 1941, appears on pages 269-274.

MESMER, FRANZ ANTON Franz Anton Mesmer (1734-1815) was the originator of the doctrine of animal magnetism, later called mesmerism. Son of a gamekeeper on the estate of a bishop, Mesmer studied divinity first at Dillingen and then at Ingolstadt, where he acquired the degree of doctor of philosophy. He next went to Vienna to study law, and there he appears to have obtained a second doctoral degree. He received his third and final doctoral degree, in medicine, in 1766. Having become by then a man of independent means, Mesmer for a time followed his inclination to be a dilettante in a variety of scientific fields and was especially active as a patron of the musical arts. Himself a versatile musician, he was a friend of Gluck and a patron of young Mozart. What evidence there is shows Mesmer to have been a sensitive, sincere, well-educated man, of superior intelligence and possessed of an inquisitive and intuitive spirit, of imagination and enthusiasm, and of a genuine love for his fellow men.

Granted that he may have had unduly strong and erroneous convictions, that he may have been somewhat mystical and at times flamboyant, there is nevertheless little basis for believing that he was ever a charlatan or a quack. Universal fluid and animal magnetism. The origins of Mesmer's notions of animal magnetism are often said to go back to his 1766 doctoral thesis in medicine, "De planetarum influxu," which was concerned with the influence of the planets on the human body. In it he attempted to apply the writings of Newton and Descartes to older ideas, propounded by such men as van Helmont, Paracelsus, and Wirtig. His thesis was that there is a universal fluid permeating all things; it is in a perpetual state of flux and reflux and serves as a medium through which all coexisting objects continuously interact. In particular, it is through this fluid that the planets influence human beings. As might be expected, Mesmer did have something to say in his thesis with regard to the medical aspects of this influence, but he did not then appear to have developed the notion of "animal magnetism." During the summer of 1774, however, he was given an opportunity to witness a remarkable cure effected through the application of magnets. Intrigued, he himself began to experiment on a few patients, with some remarkable successes. In his efforts to find the true basis of these cures, whose source, he hypothesized, must lie in something other than the scientifically known physical properties of magnets, he returned to some of his earlier ideas about the universal fluid. Strongly impressed by the success of Johann Gassner, a popular healer of the day, in obtaining cures solely through the touch of the hands, Mesmer arrived at the notion that the universal fluid manifests itself in living organisms, particularly man, in a way quite analogous to the manner in which physical magnetism manifests itself in natural magnets. According to this analogy, there are like and unlike animal magnetic poles, which can be transmitted (or induced), changed, destroyed, and reinforced. Health depends upon a proper distribution and balance of such poles or, in other words, upon a proper distribution or concentration of the vital fluid. Mesmer attributed to physical magnets powerful animal magnetic properties, parallel to their physical properties, which enable them to affect the distribution of animal magnetism in other objects, particularly human beings. Moreover, he believed that some human beings are like physical magnets, in that they are powerful sources of animal magnetism, and can influence objects and humans. Since illness is the result of an inadequate distribution or a lack of

MESMER, FRANZ ANTON animal magnetism, a cure can be produced by altering the inadequate distribution through use of a powerful source of animal magnetism. This, in essence, is the doctrine of animal magnetism as Mesmer propounded and applied it. Mesmerism. However, in the hands of Mesmer's students and their students, at least three elements soon entered into the picture to distort the doctrine into "mesmerism." It is difficult to tell whether these were independent factors or whether each one followed more or less as a consequence of preceding ones. In any event, a critical departure was the discovery of "artificial somnambulism," a rather spectacular "nervous" condition that was presumably brought about by the use of animal magnetism and that produced in many individuals all sorts of unusual and often paranormal faculties. Another change was the increasing tendency to equate animal magnetism with the universal fluid discussed in Mesmer's thesis, rather than to consider it only one manifestation of that fluid. Last, animal magnetism became increasingly associated with various physical and paraphysical forces, so that, for instance, it was used to explain table tilting and turning during spiritualistic seances. In fact, in the hands of the mesmerists animal magnetism became a multif aceted biophysical entity which could account for just about anything. For Mesmer, animal magnetism was and remained a biophysical agency belonging to the Newtonian scheme of things, of interest primarily as a way to understand illnesses and a way to cure them rationally. For the mesmerists, animal magnetism became an occult agent, used primarily to bring about the somnambulistic state and other spectacular and extramedical effects. Mesmer himself noted this unfortunate development during the course of his life but was unable to stem its progress. Charges of malpractice. Mesmer's successful but unconventional use of magnets was unacceptable to the relatively small and select group of practicing Viennese physicians, and in 1778 he was forced to leave Vienna, following what now appear to have been poorly founded accusations of malpractice. From Vienna he moved to Paris, where he enjoyed great popularity as a practitioner for several years but again met with increasing opposition and hostility on the part of the medical profession, which labeled him an impostor and a charlatan. The final blow was dealt Mesmer when, in 1784, a commission, of which Benjamin Franklin was a member, was appointed by the French government to investigate Mesmer's claims and concluded that animal magnetism did not exist. The commission did recognize that Mesmer had

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effected numerous cures, but it preferred to ascribe them to as yet unknown physiological causes. It is worth noting that the commission itself never directly accused Mesmer of charlatanism; this accusation came from less well-informed professional men of his time. Forced to leave Paris by the attacks of the medical profession, Mesmer moved to Switzerland, where he lived out the remainder of his days as a medical doctor. Assessment. Today we know, of course, that Mesmer's animal magnetism is not a scientifically valid concept; but in the light of what constituted science, especially medical science, in his day, it probably seemed to have some validity. We cannot overlook the fact that Mesmer did observe the apparent cure of illnesses by some unknown principle or agent. He tried to find an explanation for these cures that was compatible with the best general scientific writings of his time, such as those of Descartes and Newton. Seen in retrospect, Mesmer appears more a somewhat tragic figure—a product and a victim of his time—than a villain. He lived in an era of widespread superstitition, gullibility, and relative ignorance even among the upper classes, and of complete illiteracy among the common people. Black magic was still a thing to be feared, and wise men spoke seriously of the influence of the planets, advocated the intensive use of leeching, bleeding, and poultices as quasi-universal remedies, and talked learnedly of the circulation of the phlegm. Yet, significant strides were being made in the direction of modern science: Newton died just before Mesmer was born, and such men as Lavoisier, Gay-Lussac, Gauss, and Ampere were Mesmer's contemporaries. Most unfortunately for Mesmer, however, the comte de Saint Germain and Cagliostro also were his contemporaries. These charlatans succeeded in linking their names to the practice of mesmerism, thus bringing it into their own suspect orbit of intrigue and infamy. Finally, rather unwisely, Mesmer left much of the conduct of his affairs in the hands of students and friends who, however well-meaning they were, may have done him more harm than good through their overenthusiasm and personal inadequacies. ANDRE M. WEITZENHOFFER [See also HYPNOSIS.] WORKS BY MESMER

(1779) 1957 Memoir of F. A. Mesmer, Doctor of Medicine, on His Discoveries: 1799. Mount Vernon, N.Y.: Eden. -» First published as Memoire sur la decouverte du magnetisme animal. 1781 Precis historique des faits relatifs au magnetismeanimal jusques en avril 1781. London.

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MESSIANIC MOVEMENTS WORKS ABOUT MESMER

BERTRAND, ALEXANDRE 1826 Du magnetisme animal en France et des jugements qu'en ont portes les societes savantes . . . Paris: Bailliere. GOLDSMITH, MARGARET L. 1934 Franz Anton Mesmer: A History of Mesmerism. Garden City, N.Y.: Doubleday. ZWEIG, STEFAN (1931)1932 Mental Healers: Franz Anton Mesmer, Mary Baker Eddy, Sigmund Freud. New York: Viking. H> First published as Die Heilung durch den Geist: Mesmer, Mary Baker Eddy, Freud.

MESSIANIC MOVEMENTS See MASS PHENOMENA; MILLENARISM; NATIVISM AND REVIVALISM; SECTS AND CULTS; SOCIAL MOVEMENTS.

METHODENSTREIT See ECONOMIC THOUGHT, article on THE AUSTRIAN SCHOOL; and the biographies of MENGER and SCHMOLLER.

METRAUX, ALFRED Alfred Metraux (1902-1963) was a pioneer in South American ethnohistory, a student of African culture in the New World, and a specialist in the field of race relations. He was also instrumental in promoting the role of the social sciences in the United Nations and its specialized agencies. Born in Lausanne, Switzerland, Metraux spent most of his childhood in Argentina, where his Swiss father was a well-known surgeon practicing in the city of Mendoza. He received his secondary and university education in Europe, studying at the Gymnasium in Lausanne, and in Paris at the Ecole Nation ale des Chartes, the Ecole Nationale des Langues Orientales, the Ecole Pratique des Hautes Etudes, and finally the Sorbonne, from which he received a doctoral degree in 1928. He also studied briefly in Goteborg, Sweden. Among his teachers were Marcel Mauss, Paul Rivet, and Erland Nordenskiold. Metraux also acknowledged the influence of Father John M. Cooper of the Catholic University of America, Washington, B.C., with whom he corresponded for many years. It was Cooper who introduced him to the American school of cultural anthropology, and Metraux was to combine the best of both the European and the American traditions of historical anthropology in his work. His professional career was equally cosmopolitan. He was the first director, from 1928 to 1934, of the Institute of Ethnology at the University of Tucuman in Argentina. In 1934/1935, he led a French expedition to Easter Island. From 1936 to 1938 he was a fellow of the Bishop Museum in

Honolulu, and the following year he became the Bishop Museum visiting professor at Yale University. In 1939 he returned for a year to Argentina and Bolivia for field research as a fellow of the Guggenheim Foundation. Then he went back to Yale, where he worked with South American data on the Cross Cultural Survey (now Human Relations Area Files). In 1941 he joined the staff of the Bureau of American Ethnology of the Smithsonian Institution, and there he played an important role from 1941 to 1945 by editing and writing for the monumental Handbook of South American Indians (Steward 1946-1959). In addition, Metraux taught at the University of California at Berkeley, the Escuela Nacional de Antropologia e Historia of Mexico, the Colegio Nacional de Mexico, the Facultad Latino-Americana de Ciencias Sociales in Santiago, Chile, and the Ecole Pratique des Hautes Etudes in Paris. From 1946 until his retirement in 1962, Metraux served in various capacities for the United Nations and for UNESCO. As a representative of UNESCO he took part in the Hylean Amazon Project in 1947/1948 and in the Marbial Valley (Haiti) anthropological survey in 1949/1950. In cooperation with personnel from the International Labour Office, he studied the internal migrations of the Aymara- and Quechua-speaking Indians of Bolivia in 1954. He was primarily responsible for the publication by UNESCO, between 1950 and 1958, of a series of pamphlets, monographs, and books on the concept of race and on race and minority relations. As a staff member of the department of social science of UNESCO he was constantly in touch with social science research throughout the world. Metraux contributed most to the social sciences in the field of ethnohistory. Perhaps no other writer contributed more pages to the Handbook of South American Indians. Most of these contributions are derived from documentary sources and are models of judicious historical reconstruction. His two books on the Tupinamba (1928&; 1928k) are classics in the ethnohistory of the South American Indian. In these two books, he drew upon a wide range of sixteenth- to eighteenth-century sources, written in French, Portuguese, and Spanish, to present a coherent picture of the material and socioreligious life of the extinct coastal tribes of Brazil known generically as the Tupinamba. His books are a contribution not only to South American ethnography but also to Brazilian history. The Tupinamba were the first Brazilian Indians encountered by the Portuguese upon their arrival in the New World. Their language, Tupi-Guarani, became the lingua franca for missionaries, and their names for the flora,

MEYER, ADOLF fauna, and topographical features became part of the Portuguese language as spoken in Brazil. From these coastal Indians, the Europeans learned to adapt to the New World environment, and much of the Indians' religious belief and mythology became a part of Brazilian folklore. Metraux was also a sensitive and indefatigable field researcher among primitive and peasant societies of Latin America. He published numerous monographs and articles reporting upon his field research over a period of 25 years (see Wagley 1964 for his complete bibliography). His major field research was carried out in the Argentine Chaco and in Haiti. One piece of work in the Chaco stands out, his study of the mythology of the Toba and Pilaga Indians (1946), in which he made use of his vast knowledge of South American ethnology to draw parallels in theme and plot between Chaco mythology and that of the Andean region. Making a Living in the Marbial Valley, Haiti (1951) is a careful and detailed ecological study stressing the effects of minifundia (overparcelization), soil erosion, and overpopulation on the peasant society of one Haitian valley. In this report, such aspects of social life as cooperative work groups, marriage and household groups, and religion and religious organizations are shown in relation to the ecological adjustment. He also wrote often for the public at large, both books and articles in a variety of journals. Most of his popular writing was originally in French, later translated into English. It was always solidly based upon his own bibliographical and field research; this is also true of his books on Easter Island (1940; 1941). In these books he disagreed with the theories both of American Indian and of Asian origin of the Easter Island stone sculpture. He took the view that the Easter Islanders are both physically and culturally Polynesian and that their art forms are likewise of local origin. Similarly, his book on Haitian voodoo (1958) is based upon many field trips to Haiti as well as on written sources. It is a study of the persistence of African fetish cults and African belief in Haiti and the relationship of this African religion, derived mainly from the Dahomeans of west Africa, to Catholicism. He gave an objective picture of voodoo as an orderly and complex religious system rather than a wild set of heathen orgies, as it had often been described [see CARIBBEAN SOCIETY]. CHARLES WAGLEY [See also HISTORY, article on ETHNOHISTORY; and the biographies of COOPER; MAUSS; NORDENSKIOLD; RIVET.]

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WORKS BY METRAUX 1928a La civilisation materielle des tribus Tupi-Guarani. Paris: Geuthner. 1928fo La religion des Tupinamba et ses rapports avec celle des autres tribus Tupi-Guarani. Paris: Leroux. 1940 Ethnology of Easter Island. Bernice P. Bishop Museum, Bulletin No. 160. Honolulu (Hawaii): The Museum. (1941) 1957 Easter Island: A Stone-age Civilization of the Pacific. New York: Oxford Univ. Press. -» First published as L'lle de Pdques. 1946 Myths of the Toba and Pilagd Indians of the Gran Chaco. American Folklore Society, Memoirs, Volume 40. Philadelphia: The Society. 1951 Making a Living in the Marbial Valley, Haiti. Paris: UNESCO. (1958) 1959 Voodoo in Haiti. New York: Oxford Univ. Press. -> First published as Le voudou ha'itien. SUPPLEMENTARY BIBLIOGRAPHY

STEWARD, JULIAN H. (editor) (1946-1959) 1963 Handbook of South American Indians. 7 vols. U.S. Bureau of American Ethnology, Bulletin No. 143. New York: Cooper Square. WAGLEY, CHARLES 1964 Alfred Metraux, 1902-1963. American Anthropologist New Series 66:603-613.

METROPOLITAN GOVERNMENT See under CITY.

MEYER, ADOLF Adolf Meyer (1866-1950) was the dominant figure in American psychiatry during the first four decades of this century. He was a major force in molding psychiatry into its current form, but his teachings have become so solidly incorporated into American psychiatric theory and practice that the sweep and depth of his influence are often overlooked. He gave American psychiatry its pluralistic and instrumental orientation; its holistic approach to human problems; its conceptualization of psychiatric disorders, including schizophrenia, as reaction patterns rather than discrete disease entities; its concern with the psychotherapy of the psychoses. His contributions have been eclipsed, but not displaced, by those of Freud and by the ascendancy of psychoanalysis. Meyer was born in Niederweningen, near Zurich, Switzerland, and emigrated to the United States soon after receiving his doctoral degree in 1892. He filled, in succession, the positions of neuropathologist at Kankakee State Hospital in Illinois, clinical director at Worcester State Hospital in Massachusetts, and chief of the Pathological Institute of New York's state mental hospitals. He increasingly became convinced that the essential pathology of mental disorders is to be found in the person and not in the brain cells. When the Johns

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Hopkins Medical School decided to establish a department of psychiatry in 1908, Meyer was the obvious and unanimous choice for the new professorship. He remained at Hopkins until his retirement in 1941, by which time he had long been recognized as the dean of American psychiatrists. The cultural setting may have determined the orientation of psychiatry in the United States. In a country in which people were undergoing rapid acculturation, the importance of environmental influences upon personality change was more apparent than in Europe. Even though Meyer was a Swiss, he was particularly suited by birth and training to introduce a characteristically American pragmatic, pluralistic, and instrumental approach into psychiatry. He was born into a family that considered itself the spiritual heir of Kleinjogg (Jakob Gujer), a folk philosopher who had practiced and taught an "instrumental" approach to farming and communal living, combating the superstitions and the confining traditional usages of the farmer. Meyer had gained an exceptional grounding in neuroanatomy and neuropathology under Constantin von Monakow and Auguste Forel and, while studying abroad, was attracted by Thomas H. Huxley's evolutionary and ecological approach to biology and by Hughlings Jackson's concepts of the integration of the nervous system. Soon after his arrival in the United States he came under the influence of those men who had shaped the American philosophical and sociological tradition—Charles Peirce, William James, John Dewey, G. H. Mead, and C. H. Cooley. Meyer fused these various influences into a new conceptualization of human behavior, which he termed psychobiology, or ergasiology. He recognized that the Jacksonian concepts of the evolution and integration of the nervous system needed to be extended to include the highest level of integration through mentation: what man thinks affects his functioning down through the cellular and biochemical level, but, conversely, his thinking and feeling can be affected by the functioning of the organism at all levels of integration. Psychobiology offered an approach to the mind-body problem that obviated the need for the unsatisfactory mindbrain parallelism that had directed scientific attention to the study of the brain, to the neglect of the processes of living. Meyer made a number of fundamental contributions to neuroanatomy and neuropathology, including the discovery of the temporal-lobe detour of the optic radiations, termed "Meyer's loop," and his studies of central neuritis and aphasia; and he introduced the construction of plasticine models

into the teaching of neuroanatomy. However, he increasingly directed his attention to problems of the essentially human aspects of behavioral integration. Although Meyer welcomed the development of psychoanalysis and particularly its emphasis upon early childhood experiences and upon the role of symbolization, he considered the focus upon instinctual vicissitudes and unconscious motivations as unduly limited and neglectful of the total person. He increasingly opposed the premature oversystematizations in Freud's theorizing. Meyer insisted upon studying the problems of human adaptation and integration in their total complexity. Meyer's conception of psychiatric disorders as types of reaction patterns that are exaggerations of, aberrations from, or substitutions for, more normal and workable ways of living profoundly influenced the course of psychiatry. He turned away from psychiatry's efforts to become part of the mainstream of medical science by discovering some unknown biological or neuroanatomical basis for insanity, and chose instead to examine how people's ways of living and thinking can go astray. Of particular moment was his extension of this reactionpattern concept to schizophrenia, as outlined in his 1906 paper "Fundamental Conceptions of Dementia Praecox" (Collected Papers, vol. 2, pp. 432437), which emphasized that schizophrenia can result from deterioration of habit patterns, including habits of thinking. At the time, he stood almost alone in considering that schizophrenia may be a disorder of the personality rather than of the brain or its metabolism. His dynamic concept of schizophrenia also led to his insistence that patients suffering from schizophrenic reactions are amenable to psychotherapy and resocializing measures. At the Henry Phipps Psychiatric Clinic of the Johns Hopkins Hospital, which opened in 1914, Meyer developed the first significant teaching and research psychiatric hospital that was an integral part of a medical school. It provided the model for medical school teaching and residency training in psychiatry for the next quarter century. A large proportion of the outstanding psychiatric teachers and investigators in the United States and Great Britain trained under Meyer, spreading his orientation throughout the English-speaking world. Meyer was a man of broad vision, and his energy was sufficient to turn vision into reality. When he retired, psychiatry was on the verge of the vast expansion that followed World War u. Meyer had guided and nurtured it through its immaturity, propounding a psychiatry that had roots in both

MICHELS, ROBERT the biological and behavioral sciences, countering premature theoretical closures by his insistence upon a holistic and pluralistic approach, and fostering a psychotherapeutic approach to the psychoses. THEODORE LIDZ [For the historical context of Meyer's work, see the biographies of COOLEY; DEWEY; JAMES; MEAD; PEIRCE. For discussion of the subsequent development of his ideas, see MENTAL DISORDERS, article on BIOLOGICAL ASPECTS; PSYCHIATRY; SCHIZOPHRENIA.] WORKS BY MEYER

Collected Papers. 4 vols. Edited by Eunice Winters. Baltimore: Johns Hopkins Press, 1950-1952. -» Volume 1: Neurology. Volume 2: Psychiatry. Volume 3: Medical Teaching. Volume 4: Mental Hygiene. The Commonsense Psychiatry of Dr. Adolf Meyer. Edited by Alfred Lief. New York: McGraw-Hill, 1948. -» Consists of 52 selected papers. WORKS ABOUT MEYER

BLEULER, M. 1962 Early Swiss Sources of Adolf Meyer's Concepts. American Journal of Psychiatry 119:193196. CAMPBELL, C. MACFIE 1937 Adolf Meyer. Archives of Neurology and Psychiatry 37:715-731. EBAUGH, FRANKLIN G. 1937 Adolf Meyer: The Teacher. Archives of Neurology and Psychiatry 37:732—741.

MICHELS, ROBERT Robert Michels (1876-1936) belongs to that generation of European sociologists which tried to apply the insights of the founders of sociology to the understanding of twentieth-century Western society. Michels' standing in sociology is assured by his brilliant monograph Political Parties (191 la), in which he formulated the problem of oligarchical tendencies in organizations. Like Schumpeter, Geiger, Mannheim, Lukacs, de Man, and Ortega, he grappled with the problems of democracy, socialism, revolution, class conflict, trade unionism, mass society, nationalism, and imperialism, and with the role of intellectuals and of elites. He dealt more extensively than did these contemporaries of his with the politics of the working class, and he studied some topics that interested them little, such as eugenics, feminism, sex, and morality. More passionately committed than they were, he found himself deeply involved in the ideological and national conflicts of his time, and his work probably suffered from this involvement. Michels' background was cosmopolitan: he was born in Cologne, into a bourgeois-patrician family with a German-French-Belgian background. He attended the Gymnasium in Berlin and, after serving

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in the army, studied in England and at the Sorbonne. He then went to Munich, where he attended lectures by the economist Lujo Brentano, and in 1897 he studied in Leipzig with Erich Brandenburg, Karl Lamprecht, and others. The following year he went to the University of Halle, studying with Michael Conrad and Hans Vaihinger and with Theodor Lindner, whose daughter he later married; in 1900 he completed his dissertation in history. Until World War I he was in close touch with the intellectual and political worlds of Belgium and France. Although he studied in England and taught in the United States, his interest in and understanding of the Anglo-Saxon world remained limited; his outlook was that of a continental European. As a young Dozent at the University of Marburg, he became a socialist and participated in the Social Democratic party congresses of 1903, 1904, and 1905. He left the party in 1907 but attended the Stuttgart congress of that year as a delegate of the Italian Socialist party (he had become a libero docente at the University of Turin). A few months later he also resigned from the Italian Socialist party. Because of his socialist views, it was impossible for Michels to qualify for a position at a German university. Max Weber strongly deplored this stand on the part of the German universities and showed a great deal of personal interest in the young Michels. He admitted him to what he called the salon des refuses in Heidelberg, and in 1913 he asked Michels to become coeditor of the Archiv fur Sozialwissenschaft und Sozialpolitik. Weber surely made a profound impression on Michels. It was partly Weber's influence and partly the security gained from his academic position at Turin that led Michels to shift from short and somewhat journalistic writings to more substantial publications in scholarly journals. Michels described his own political evolution in an autobiographical essay, "Eine syndikalistisch gerichtete Unterstromung im deutschen Sozialismus" (1932a); he also recorded his perception of the external events of the first ten years of the twentieth century, in the introduction to the Italian edition of Political Parties. His political views were influenced by Arturo Labriola and Enrico Leoni, whom he met in 1902, and by the French syndicalists Georges Sorel, Hubert Lagardelle, Edouard Berth, Paul Delesalle, and Victor Griffuelhes, with whom he became increasingly friendly after 1904. Disturbed by the state of the labor movement, Michels was attracted to the idea of revitalizing it by fusing the ideas of Marx, Proudhon, and Pareto. In particular he deplored the way calculations of

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parliamentary advantage dominated party life and led to the abandonment of every vigorous idea and every energetic course of action. The contrast between the revolutionary statements that were made by the Social Democratic party in general and by August Bebel in particular and the cautious policy they actually pursued was brought home to him by the failure of the Ruhr strike in 1905 (Weber was also disturbed by this contrast). In a long and welldocumented article (1907) Michels analyzed the socialist ideological position, particularly with respect to pacifism and the general strike to avert war; by a neat juxtaposing of texts, he made plain the extent to which radical statements and actual policy diverged. Michels' involvement in German politics provided him with insights for his critique of the Social Democratic party and of the trade unions. It is clear from his autobiography that his descriptions of the demagogic orator, of party congresses, of the characteristics required for leadership, and, especially, of the intellectual in politics and of the class renegade are largely based on his own experiences. But his involvement was not motivated solely by intellectual concerns; it was related to his love for passion, for action, for youth, for principle irrespective of consequences, and for symbolic gestures. Indeed, his early political stance—his intellectual evolution toward a voluntaristic outlook— was the basis of his later affinity with fascism. His political life seems discontinuous and inconsistent if Political Parties is read only as the work of a disappointed democrat or a disillusioned regular member of the Social Democratic party. In fact, the life of a syndicalist Michels makes more sense than that of a purely Marxist-socialist Michels. Michels refused to support Germany in World War i, and this led to what must have been a painful break with Weber. In 1914 he moved to Basel, where he became professor of economics. In 1926 he taught a course in political sociology at the University of Rome. The following year he was a visiting professor in the United States, and after that he became professor of economics at the University of Perugia. He died in 1936 in Rome. His life was that of a romantic, a frustrated politician, a patriot of an adopted country, and a scholar; it reflected as have few others the conflicts of loyalty and the intellectual ambivalences of the first decades of the twentieth century. "Political Parties" In the years between 1906, when he first published in Weber's Archiv, and 1910, when Political Parties was completed, Michels' life contained ele-

ments that have often produced classic works: a deeply felt and probably painful personal experience—his involvement with the revolutionary cause and its interference with his academic career —and the impact of major intellectual figures, particularly Max Weber and Mosca. (Michels had become friendly with Mosca in Turin.) The starting point of Michels' classic study of political parties is the hypothesis that in organizations committed to the realization of democratic values there inevitably arise strong oligarchic tendencies, which present a serious if not insuperable obstacle to the realization of those values. "It is organization which gives birth to the domination of the elected over the electors, of the mandatories over the mandators, of the delegates over the delegators. Who says organization says oligarchy" ([191 la] 1962, p. 15). Thus Michels summed up his famous "iron law of oligarchy." The nature of leadership. Michels was dissatisfied with "psychological" (i.e., motivational) explanations of the oligarchic tendencies in organizations. His whole analysis emphasized the constraints derived from organizational needs— the growth of the organization, the need to make rapid decisions, the difficulties of communicating with the members, the growth and complexity of the tasks, the division of labor, the need for fulltime activity—and from the consequent processes of selection of leadership and development of knowledge and skills. These processes, in turn, lead to the emergence of stable leaders, whose professionalization, combined with their consciousness of their own worth, leads to oligarchy. The important point is that the leaders' deviation from norms they themselves accept is not the result of their motivation. The fact that conformity to certain norms may indirectly lead to deviation from other norms accepted by the same person has, of course, been emphasized by social scientists since Marx. Michels studied the special case of men who, despite their commitment to democracy, often acted in ways not conforming to their values because of the demands of organization and other factors of political life. While Michels often referred to the "psychological predispositions" of both the masses and the leaders, he saw these predispositions as fundamentally serving to reinforce or, occasionally, to weaken the organizational factors, even though at times they also seemed to him to function independently. Significantly, when he presented his theory schematically in a chart (191 la, p. 382), he did not stress the manipulative or illegitimate actions of the leaders (which he discussed at length elsewhere in Political Parties)

MICHELS, ROBERT but concentrated instead on the factors influencing the active and effective participation of the members in decision making. Leaders and followers. In organizations with formally democratic constitutions—such as the German working-class parties, which Michels examined closely—elections (and to a lesser extent referenda) determine who shall act in the name of the members. Elections presumably also assure the accountability of the leaders to the members. Michels' concern in a large part of Political Parties is with the way the leaders take advantage of the incompetence and emotionality of their followers to hold on to power and become a de facto oligarchy. When they establish such an oligarchy, they are no longer willing to submit their power to free electoral confirmation. In his later writings (1927a; 1933a) Michels made a virtue of what initially he had seen only as an iron law; he was carried away by his preference for decisive leadership and an elite unhampered by the "numerical maximum, mortal enemy to all freedom of program and thought" (1927a, p. 765). By this time he saw no difference between elected representatives and charismatic leaders to whom the mass voluntarily sacrifices its will in conscious admiration and veneration (1928a, p. 291). Furthermore, he believed that "leaders never give up their power to the 'mass' but only to other, new leaders" ("die Fiihrer weichen menials der 'Masse' sondern immer nur anderen, neuen, Fiihrern"; 1928a, p. 291). He did not seem to realize that it does make a difference whether leaders are displaced by elections, in which the majority decides who shall lead, or by death or violent revolution. Furthermore, de facto oligarchy is not necessarily identical with de jure oligarchy, or dictatorship. The fact that de facto oligarchs need to manipulate their followers in the ways that Michels, Mosca, and Pareto described certainly makes "oligarchic" or corrupt democracies like Italy in the Giolittian period, from 1900 to 1914 very different from dictatorships like Italy under Mussolini. The inability of Michels to work out in his later writings a clear conception of the new elitist parties—the Fascists and the Bolsheviks—and his tendency to see them only as manifestations of the same general tendency to oligarchy are partly a result of this confusion. Michels was not satisfied with electoral accountability as a criterion of democracy; in fact, he considered this de jure aspect insignificant compared to the de facto circumstances that affect the electoral process. He therefore constantly returned to Another dimension: the degree of responsiveness

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of (stable) leadership to the expectations and desires of the constituency. Presumably, if democratic leaders do not respond to the expectations and desires of their constituents, they will be defeated at the polls. Also, according to democratic theory, the wishes of the constituency will coincide with its interests, and democracy is the best way of assuring the satisfaction of those interests. Much of Political Parties, however, argues that leaders are responsive, not to the desires or interests of their constituents, but to the interests of the organization or to their own interests. (Michels noted perceptively that this identification is often unconscious.) This lack of responsiveness does not result, according to Michels, from a divergence between the interests of the leaders and those of their constituents but from the apathy and ignorance of the constituents—demonstrating what he called the incompetence of the masses—and from the general unwillingness of the leaders to overcome this passivity. (Only when new leaders challenge the old, raising real or spurious issues, are any attempts made to mobilize and inform the constituency.) In his discussion of the responsiveness of the leadership to its followers, Michels was only dimly aware of what Carl Friedrich has called the "rule of anticipated reactions": when leaders have neither the time nor the technical means to ascertain the wishes of their constituency, or when those wishes have not crystallized, the leaders are generally guided by some sense of what their constituents' desires might be. This capacity to anticipate is characteristic of any leadership, but especially of democratic leadership. Another dimension constantly present in Michels' analysis, as in all discussions of oligarchy and democracy, is the nature of the responsibility of the leaders to their followers: are leaders responsible only to their constituency, or are they responsible also to the larger whole of which their constituency is a part? are they responsible to the party membership or to the electorate? The problem of responsibility to a larger unit—the society as a whole—rather than to a particular constituency becomes especially acute when a party is in power, rather than in the opposition; this was a problem socialist leaders had not faced at the time Political Parties was written. Party ideology and party policy. Michels was much concerned with two questions (which are somewhat confused in his brilliant chapter "The Conservative Basis of Organization"): can a revolutionary party follow a revolutionary policy? and can a democratic party follow a democratic policy? He felt that the answer to the first question is

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clearly negative if a revolutionary party hopes to achieve its goals by obtaining an electoral majority. To the question about democratic parties, his answer was less clear-cut. While he did assert that "within certain narrow limits, the Democratic Party, even when subject to oligarchic control, can doubtless act upon the state in the democratic sense" ([191 la] 1962, p. 333), he also tended to argue that if democratic parties are not internally democratic, then democracy is impossible. Lipset (1962) and Sartori (1960) have pointed out, however, that competition between parties makes the politically "organized" minority (within each party) dependent at times and to a degree on the "nonorganized" majority. This competition assures the citizen of a degree of participation and power. Michels conceived of an ideal party as a purely ideological group, open only to those who share the goals of the founding members and identify their interests with the original conception of the interests of the group. According to Michels, the sole cause of deviation from party ideology is oligarchy. It is in the nature of oligarchy to sacrifice ideological purity to the methodical organization of the masses for electoral victory. By such methods, not merely does the party sacrifice its political virginity, by entering into promiscuous relationships with the most heterogeneous political elements, relationships which in many cases have disastrous and enduring consequences, but it exposes itself in addition to the risk of losing its essential character as a party. The term "party" presupposes that among the individual components of the party there should exist a harmonious direction of wills towards identical objectives and practical aims. Where this is lacking, the party becomes mere "organization." ([191 la] 1962, p. 341) The contrast between the party as an ideologically pure expression of interests (Michels had in mind primarily class interests) and the reality of modern mass parties is in many ways similar to that between sect and church in the sociology of religion of Ernst Troeltsch. Just as Troeltsch identified primitive Christianity with a sectlike conception, so did Michels identify the early socialist party with an ideal party. Michels' ideal party is elitist—a group sharing a commitment to an ideological understanding of class interest. His conception did not encompass either organizations with specific substantive goals or modern mass parties. Lipset and Sartori have noted that the more specific the substantive goal of an organization, the more difficult it may be to find commitment to a procedural goal, such as

democracy. The narrower the substantive goals, the less likely it is that the members have either the need or the time to participate and influence policy. This would explain why there is less democracy in trade unions than in parties. As for mass democratic parties, Michels believed that since these are "open" and do not require a declaration of faith in party principles, they cannot be "true" parties. He accurately pinpointed the open quality of modern parties as one of their basic characteristics, but his indignation at some of the consequences of this phenomenon prevented him from analyzing it and seeing that it is inevitable, given a society that has moved from closed and established status groups to voluntary, open organizations that compete for power in a system of universal suffrage. Characteristics of oligarchy. Michels used the term "oligarchy" or "oligarchic tendency" to cover several aspects of political behavior that are conceptually quite distinct and that may or may not coexist in organizations, parties, or trade unions: (1) the emergence of leadership; (2) the emergence of professional leadership, and its stabilization; (3) the formation of a bureaucracy, that is, an appointed, regularly paid staff with distinct duties; (4) the centralization of authority; (5) the displacement of goals, particularly the shift from ultimate goals (e.g., achieving a socialist society) to instrumental goals (i.e., perpetuating the organization ): with the growth of "conservative tendencies" in revolutionary parties, the survival of the organization takes precedence over the revolution itself, and increased emphasis is placed on satisfying the immediate needs of the members, through such activities as collective bargaining or participation in municipal government ("reformism"); and the addition of goals (e.g., ameliorating the condition of the working class); (6) increased ideological rigidity—conservatism, in the sense of adherence to policies and ideas that have been rendered obsolete by changed circumstances, and intolerance toward attempts to revise such policies or ideas; (7) the growing difference between the interests and/or points of view of the leaders and of the members, and the precedence of the leaders' interests over those of the members; (8) the decrease in the members' opportunities to participate in policy decisions, even when they are willing to participate; (9) the co-optation of emergent opposition leaders by the existing leadership; (10) the "omnibus" tendency of parties, the shift from appeals to the membership to appeals to the electorate and from appeals to a class electorate to

MICHELS, ROBERT appeals to a broader electorate—such shifts may produce a more moderate program, while opposition as a matter of principle is replaced by competition with other parties, and disloyal opposition to the social and political system is replaced by loyal opposition and even by participation in governing. While the first nine of these characteristics may be found in very different types of organizations, the tenth is valid only for revolutionary parties or for organizations in a "democratically competitive political system" (and perhaps particularly in its parliamentary variety). If, as the list suggests, the label "oligarchic tendencies" is used to cover so many different things, it becomes quite meaningless. Such critics as Cassinelli (1953) and Dahl (1958) therefore have tried to define the meaning of "oligarchy"— or of related concepts, like "ruling class"—in more precise and operational terms. They have also endeavored to show that some of the processes may be independent, rather than closely linked. Finally, they feel it is essential to clarify which of these tendencies are inherently incompatible with democracy and which can coexist with it. Many factors favoring oligarchy seem to be especially characteristic of working-class organizations. In such organizations it is difficult for leaders to return to manual work in the factory after assuming leadership that implies a middleclass position; also, the workers' lack of education, their limited access to information, their frequent apathy, together with their predisposition to authoritarian attitudes, all contribute to the development of oligarchy. Evidence of such "oligarchic" tendencies in organizations with equalitarian, democratic, even revolutionary, ideology is nevertheless not proof of the validity of the iron law of oligarchy in all organizations. Other works In 1908 Michels published II proletariate e la borghesia nel movimento socialists italiano (1908a), a work which he hoped would contribute to what is today called political sociology. Its content is similar to that of recent books in this field: discussions of the social composition of the Socialist party in parliament, of delegates to party congresses, of candidates in municipal elections, and of local party organizations, followed by an ecological analysis of electoral participation and of Socialist strength in the electorate. Michels was particularly original in his attempt to sketch what We would now call the "political culture" of Italy

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in general and, specifically, that of the working class, making constant comparisons between Italian and German society. His combination of structural and psychological perspectives in this part of the book still stands as an example to sociologists who analyze the relationships between classes and the political manifestations of these relationships. The last part of the book is devoted to syndicalist currents and to comparisons between Italy and France. The discussion of the role of intellectuals in political parties, particularly in working-class parties, is linked with an analysis of the Italian occupational and academic structure. In the same year that Political Parties was published, there also appeared Michels' Die Grenzen der Geschlechtsmoral (1911Z?). Such subjects as feminism, the female worker, sexual morality in different societies, and birth control had always interested him; many years later, in 1928, he published a book, Sittlichkeit in Ziffern? (1928fr), presenting the available statistical data on various aspects of sex and family life and social deviance. Uimperialismo italiano (1912) is concerned with the violent upheavals the Tripoli war of 19111912 (in which Italy took several coastal cities and towns from the Turks) produced in Italian values. (The war led to a crisis in Michels' life, which he described in the introduction.) In the book, he dealt with the suffering caused by war, the moral impact of war propaganda, and the sacrifice of long-held values to rhetorical appeals, as well as with the failure to see the similarity between the motives of the Arabs defending their homeland and those of the fighters for the Risorgimento. He interpreted Italian imperialism partly in politicopsychological terms but mainly as resulting from demographic pressure and from the social and cultural loss due to overseas migration. Thus, he asserted that the imperialismo della povera genie was qualitatively different from the imperialism of other nations. In the 1920s and early 1930s he produced a number of books and many articles, dealing with nationalism, Italian socialism and fascism, elites and social mobility, the role of intellectuals, the history of the social sciences, and other subjects not so closely related to his central interests. "Psychologic der antikapitalistischen Massenbewegungen" (1925a) remains one of the most interesting and well-documented systematic treatments of working-class protest. He often returned to the problem of oligarchy and democracy (1927a,1928a; 1933a) but added little to the original formulation of 1911; his writings merely became

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more antidemocratic in tone as a result of his tendency to see the new totalitarian parties as confirmation of his iron law of oligarchy. Assessment of Michels' contributions The chief basis of Michels' work, in addition to his personal experience, was secondary sources and contemporary accounts from magazines and newspapers. In many cases he did not analyze these secondary materials in a systematic way, and he never made an effort to develop a new methodology. His lack of sustained effort in the collecting of data and his reliance on scattered, piecemeal information gathered by others deprive his works of the unity characteristic of good monographs and of great books based on a single theme, although they often contain much valuable information. Originality. At the time that he wrote, Michels' work was not unique; a number of his contemporaries and immediate predecessors had formulated some of the same ideas and expressed similar sentiments. In footnotes, dedications, and later writings, he acknowledged the influence of, and intellectual affinity with, Mosca, Ostrogorskii, and Bryce; these men, in turn, acknowledged the coincidence of views. Like his immediate predecessors—Sorel, Pareto, Mosca, and Weber—Michels challenged the prevalent democratic and socialist climate of opinion. But his basic confrontation was with Marx. Thus, he wrote: . . . the defects of Marxism are patent directly as we enter the practical domains of administration and public law, without speaking of errors in the psychological field and even in more elementary spheres. . . . The problem of socialism is not merely a problem in economics. In other words, socialism does not seek merely to determine to what extent it is possible to realize a distribution of wealth which shall be at once just and economically productive. Socialism is also an administrative problem, a problem of democracy, and this not in the technical and administrative sphere alone, but also in the sphere of psychology. [191 la] 1962, pp. 349, 350)

In underlining the sociopsychological aspects of political behavior—the problem of power and its abuse; the susceptibility of the masses, particularly of the lower classes, to charismatic appeals; and the importance of organization and its constraints in fostering oligarchic and dictatorial tendencies— Michels was trying to break away from the vulgarMarxists, who saw the economic structure (of capitalism) only as a restriction of freedom. Viability of democracy. Michels' views on democracy have been the subject of much discussion.

Mosca (1912) presented Michels as an ademocratic theorist; others have gone further, arguing that his later writings and his attitude toward fascism provide evidence that he was actually antidemocratic; and finally, some have attributed to him a positive appraisal of the compatibility of organization and democracy. Such very different interpretations suggest two possibilities that are not mutually exclusive. First, Michels had, in fact, no clear-cut assessment of the viability of democracy, although his more ambitious formulations of the iron law of oligarchy suggest that his view was predominantly negative. Second, the commentators do not have in mind the same problems Michels did. In common with many intellectuals, Michels tended to define democracy in terms of what he considered favorable to the interests of the people, and he concluded that if the people express preferences for, support, or acquiesce in policies not compatible with their interests, this must be the result of oligarchic manipulations. To some he has therefore appeared as a disappointed democrat whose disillusionment ultimately led him to adopt an ademocratic and even antidemocratic elitist stance (see May 1965). Studies inspired by Michels Michels' theories have inspired considerable empirical research intended to support, specify, or challenge them. Much of that research has been done in Anglo-Saxon countries or by scholars trained there. The recent interest in general theories of organization, concerned with such processes as bureaucratization, goal displacement, and cooptation—as distinct from a concern with specific groups, like parties, unions, pressure groups, government agencies, and corporations—has also contributed to a renewed interest in Michels. In this theoretical development Union Democracy, a study of the International Typographical Union (I.T.U.) by Lipset, Trow, and Coleman (1956), has had a central place. Alone among American unions the I.T.U. has had, for over fifty years, a functioning two-party system at the national level. Its history seems to show that Michels' iron law of oligarchy is not, after all, universal: if even one exception can be found, there may be others. The study seeks to explain how the I.T.U. has maintained a system of democratic self-government. By examining the processes that have maintained democracy in a small society, the authors hoped to illuminate the relevant processes in the larger society. Although Union Democracy represents an important challenge to Michels' ideas, a large number

MICHELS, ROBERT of studies of secular and religious organizations have confirmed Michels' theories, discovering processes similar to those he described. Thus, Harrison has shown (1959) that the American Baptist Convention, which is committed to the independence of its local churches and to the advisory nature of its larger organization, clearly manifests oligarchic tendencies. The growth of the organization and the increased complexity of tasks, the lack of means to ascertain the sentiments of the members on issues not directly relevant to them, specialization in pastoral work, the indifference of many of those concerned with organizational goals—all strengthen the leadership and increase its independence. The recent literature on political parties has also been influenced by Michels' early classic. The basic books by Maurice Duverger (1951) and Sigmund Neumann (1956) have summarized and taken issue with it, while stressing its pathbreaking character. Monographic studies by Robert T. McKenzie (1955), Renate Mayntz (1959), and Samuel J. Eldersveld (1964) have been explicitly directed to the questions Michels raised. Although Eldersveld, on the basis of careful research, challenged Michels' thesis, research on political parties generally confirms Michels' observation that they are less oligarchic than single-purpose organizations concerned with more technical problems. JUAN J. LINZ [See also DEMOCRACY; ELITES; OLIGARCHY; PARTIES, POLITICAL. Other relevant material may be found in LEADERSHIP; ORGANIZATIONS; POLITICAL SOCIOLOGY; SOCIAL MOVEMENTS; VOLUNTARY ASSOCIATIONS; and in the biographies of BRYCE; MOSCA; OSTROGORSKII; PARETO; SOREL; WEBER, MAX.] WORKS BY MICHELS 1905-1906 Proletariat und Bourgeoisie in der sozialistischen Bewegung Italiens: Studien zu einer Klassenund Berufsanalyse des Sozialismus in Italien. Archiv fur Sozialwissenschaft und Sozialpolitik 21:347-416; 22:80-125, 424-466, 664-726. 1906 Die deutsche Sozialdemokratie: I. Parteimitgliedschaft und soziale Zusammensetzung. Archiv fur Sozialwissenschaft und Sozialpolitik 23:471-556. 1907 Die deutsche Sozialdemokratie im internationalen Verbande: Eine kritische Untersuchung. Archiv fur Sozialwissenschaft und Sozialpolitik 25:148-231. 1908a II proletariato e la borghesia nel movimento socialista italiano: Saggio di scienza sociografico-politica. Turin: Bocca. 1908b Die oligarchischen Tendenzen der Gesellschaft: Ein Beitrag zum Problem der Demokratie. Archiv fur Sozialwissenschaft und Sozialpolitik 27:73-135. 1908c Le syndicalisme et le socialisme en Allemagne. Pages 21-28 in Syndicalisme et socialisme. Edited by Hubert Lagardelle. Paris: Riviere.

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(1911a) 1962 Political Parties: A Sociological Study of the Oligarchical Tendencies of Modern Democracy. With an introduction by Seymour M. Lipset. New York: Free Press. -> First published as Zur Soziologie des Parteiwesens in der modernen Demokratie. The 1911 German edition and the Italian translations include a graphic schema of Michels' theory, not included in the English editions. 1911fo Die Grenzen der Geschlechtsmoral: Prolegomena, Gedanken und Untersuchung en. Griinwald: Frauenverlag. (1912) 1914 L'imperialismo italiano: Studi politicodemografici. Rev. & enl. ed. Milan-. Societa Editrice Libraria. -> First published in German. 1914 Probleme der Sozialphilosophie. Leipzig: Teubner. 1922 La teoria di C. Marx sulla miseria crescente e le sue origini: Contributo alia storia delle dottrine economiche. Turin: Bocca. 1924a Elemente zur Soziologie in Italien. Kolner Vierteljahrshefte fur Soziologie 3:219-249. 1924b Lavoro e razza. Milan: Vallardi. 1925a Psychologic der antikapitalistischen Massenbewegungen. Section 9, part 1, pages 241-359 in Grundriss der Sozialokonomik. Tubingen: Mohr. 1925b Nachtrag zu Robert Michels' Aufsatz: Elemente zur Soziologie in Italien. Kolner Vierteljahrshefte fur Soziologie 4:331 only. 1925c Sozialismus in Italien: Intellektuelle Stromungen. Munich: Meyer & Jessen. 1925d Sozialismus und Fascismus in Italien. Munich: Meyer & Jessen. 1926 Soziologie als Gesellschaftswissenschaft. Lebendige Wissenschaft, Vol. 4. Leipzig: Kroner. (1927a) 1949 The Sociological Character of Political Parties. Pages 134-155 in Robert Michels, First Lectures in Political Sociology. Minneapolis: Univ. of Minnesota Press. -*• First published in Volume 21 of the American Political Science Review. 1927b Bedeutende Manner: Charakterologische Studien. Leipzig: Quelle & Meyer. -» Biographical studies of Bebel, de Amicis, Lombroso, Schmoller, Max Weber, Pareto, Sombart, W. Miiller—seven of whom Michels knew personally. (1927-1936) 1949 First Lectures in Political Sociology. Translated with an introduction by Alfred de Grazia. Minneapolis: Univ. of Minnesota Press. -> Includes a translation of Corso di sociologia politica. 1928a Grundsatzliches zum Problem der Demokratie. Zeitschrift fur Politik 17:289-295. 1928b Sittlichkeit in Ziffern? Kritik der Moralstatistik. Munich: Duncker & Humblot. 1928c Die Verelendungs-theorie: Studien und Untersuchungen zur internationalen Dogmengeschichte der Volkswirtschaft. Leipzig: Kroner. -» An excellent scholarly study of the historical development of the idea of immiserization. 1929 Der Patriotismus: Prolegomena zu seiner soziologischen Analyse. Munich: Duncker & Humblot. 1930a Authority. Volume 2, pages 319-321 in Encyclopaedia of the Social Sciences. New York: Macmillan. 1930b Italien von heute: Politische und wirtschaftliche Kulturgeschichte von 1860 bis 1930. Zurich: Fiissli. (1931) 1949 Patriotism. Pages 156-166 in Robert Michels, First Lectures in Political Sociology. Minneapolis: Univ. of Minnesota Press. -» First published in Handworterbuch der Soziologie. 1932a Eine syndikalistisch gerichtete Unterstromung im deutschen Sozialismus (1903-1907). Pages 343-

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364 in Festschrift fur Carl Griinberg zum 70. Geburtstag. Leipzig: Hirschfeld. 1932b Intellectuals. Volume 8, pages 118-126 in Encyclopaedia of the Social Sciences. New York: Macmillan. 1933a Studi sulla democrazia e sull'autoritd. Perugia, Universita, Facolta Fascista di Scienze Politiche, Collana di Studi Fascisti, 24-25. Florence: "La Nuova Italia." 1933b Historisch-kritische Untersuchungen zum politischen Verhalten der Intellektuellen. Schmollers Jahrbuch fur Gesetzgebung, Verwaltung und Volkswirtschaft im Deutschen Reiche 57:807-884. 1934 Umschichtungen in den herrschenden Klassen nach dem Kriege. Stuttgart: Kohlhammer. SUPPLEMENTARY BIBLIOGRAPHY

BUKHARIN, NIKOLAI I. (1921) 1965 Historical Materialism: A System of Sociology. Translated from the 3d Russian edition. New York: Russell. -> First published as Teoriia istoricheskogo materializma. BURNHAM, JAMES (1943) 1963 The Machiavellians, Defenders of Freedom. Chicago: Regnery. CASSINELLI, C. W. 1953 The Law of Oligarchy. American Political Science Review 47:773-784. DAHL, ROBERT A. 1958 Critique of the Ruling Elite Model. American Political Science Review 52:463-469. DUVERGER, MAURICE (1951) 1962 Political Parties: Their Organization and Activity in the Modern State. 2d English ed., rev. New York: Wiley; London: Methuen. -> First published in French. ELDERSVELD, SAMUEL J. 1964 Political Parties: A Behavioral Analysis. Chicago: Rand McNally. GOULDNER, ALVIN W. 1955 Metaphysical Pathos and the Theory of Bureaucracy. American Political Science Review 49:496-507. HARRISON, PAUL M. 1959 Authority and Power in the Free Church Tradition: A Social Case Study of the American Baptist Convention. Princeton Univ. Press. LINZ, JUAN J. 1966 Michels e il suo contributo alia sociologia politica. Pages vii-cxiii in Robert Michels, La sociologia del partito politico nella democrazia moderna. Bologna: Carlino. LIPSET, SEYMOUR M. (1954) 1960 The Political Process in Trade-unions. Pages 357-397 in Seymour M. Lipset, Political Man: The Social Bases of Politics. Garden City, N.Y.: Doubleday. LIPSET, SEYMOUR M. 1962 Introduction. Pages 15-39 in Robert Michels, Political Parties: A Sociological Study of the Oligarchical Tendencies of Modern Democracy. New York: Free Press. LIPSET, SEYMOUR M. 1964 The Biography of a Research Project: Union Democracy. Pages 96-120 in Phillip E. Hammond (editor), Sociologists at Work: Essays on the Craft of Social Research. New York: Basic Books. LIPSET, SEYMOUR M.; TROW, MARTIN A.; and COLEMAN, JAMES S. 1956 Union Democracy: The Internal Politics of the International Typographical Union. Glencoe, 111.; Free Press. H> A paperback edition was published in 1962 by Doubleday. MCKENZIE, ROBERT T. (1955) 1963 British Political Parties: The Distribution of Power Within the Conservative and Labour Parties. 2d ed. New York: St. Martins. MAY, JOHN D. 1965 Democracy, Organization, Michels. American Political Science Review 59:417—429. -» One of the most important studies of Michels' work.

MAYNTZ, RENATE 1959 Parteigruppen in der Grossstadt: Untersuchungen in einem Berliner Kreisverband der CDU. Cologne: Westdeutscher Verlag. MOMMSEN, WOLFGANG 1959 Max Weber und die deutsche Politik, 1890-1920. Tubingen: Mohr. MOSCA, GAETANO (1912) 1949 La sociologia del partito politica nella democrazia moderna. Pages 26—36 in Gaetano Mosca, Partiti e sindicati nella crisi del regime parlamentaro. Bari: Laterza. -» A review of Michels' Political Parties. First published in Volume 1 of II pensiero moderno. NEUMANN, SIGMUND (editor) 1956 Modern Political Parties: Approaches to Comparative Politics. Univ. of Chicago Press. NIPPERDEY, THOMAS 1961 Die Organisation der deutschen Parteien vor 1918. Diisseldorf: Droste. PERUGIA, UNIVERSITA, FACOLTA DI GIURISPRUDENZA 1937 Studi in memoria di Roberto Michels. Annali, Vol. 49. Padua: CEDAM. -» Contains a bibliography of Michels' writings on pages 37-76. RITTER, GERHARD A. 1959 Die Arbeiterbewegung im Wilhelminischen Reich: Die Sozialdemokratische Partei und die freien Gewerkschaften, 1890-1900. Berlin (West Berlin) Freie Universitat, Friedrich Meinecke Institut, Studien zur Europaischen Geschichte, No. 3. Berlin-Dahlem: Colloquium Verlag. ROTH, GUENTHER 1963 The Social Democrats in Imperial Germany: A Study in Working-class Isolation and National Integration. Totowa, N.J.: Bedminster Press. SARTORI, GIOVANNI 1960 Democrazia, burocrazia e oligarchia nei partiti. Rassegna di sociologia 1:119-136. SARTORI, GIOVANNI (1962) 1965 Democratic Theory. New York: Praeger. -> Based on the author's translation of his Democrazia e definizione (1957). SCHORSKE, CARL E. 1955 German Social Democracy, 1905-1917: The Development of the Great Schism. Harvard Historical Studies, Vol. 65. Cambridge, Mass.: Harvard Univ. Press. SCHUMPETER, JOSEPH A. (1942) 1950 Capitalism, Socialism, and Democracy. 3d ed. New York: Harper; London: Allen & Unwin. -> A paperback edition was published by Harper in 1962. WEBER, MAX 1905 Bemerkungen im Anschluss an den vorstehenden Aufsatz. Archiv fur Sozialwissenschaft und Sozialpolitik 20:550-553. -> Comments on the article "Die soziale Zusammensetzung der sozialdemokratischen Wahlerschaft Deutschlands," by R. Blank.

MIDDLE AMERICAN SOCIETY Middle America is a cultural and geographical region comprising Mexico, Central America, and Panama. Central America is composed of Guatemala, British Honduras (or Belize), Honduras, El Salvador, Nicaragua, and Costa Rica. Because of its size and many problems shared with the other countries, Panama is sometimes considered a part of Central America, although it was formerly a part of Colombia. The term Mesoamerica, coined by Paul Kirchhoff (1943), refers to a cultural subregion within Middle America, specifically the areas occupied by the pre-Columbian high cultures

MIDDLE AMERICAN SOCIETY [see URBAN REVOLUTION, article on EARLY CIVILIZATIONS OF THE NEW WORLD]. Mesoamerica was bordered on the south by a line that runs approximately from the Gulf of Nicoya (Costa Rica) to the mouth of the Motagua River (Guatemala). To the north, it included the areas set off by the northern borders of the Mexican states of Veracruz (including adjacent San Luis Potosi), Queretaro, Guanajuato, Jalisco, Durango, and the southern portions of Chihuahua and Sonora. Today Mesoamerica is a region of distinctive Indian populations surrounded by national civil populations. Culturally, the northern border of Middle America could be extended to include those portions of the southwestern United States that were formerly part of Mexico and that still have a significantly large and growing Spanishspeaking population. The processes of economic and social development are presently affecting each inhabitant of Middle America, whether he cuts coupons in Mexico City's plush pedregal or cuts sugar cane in the Pacific lowlands of Central America. Inextricably woven into the process of development is the very high population growth rate and a social structure dominated by a concern for power but technologically still heavily primitive and agrarian. It is this challenge of primitive technology, on the one hand, and the growing concern for control of one's fellow man, on the other, that is shaping the development process in Middle America today. The heavily mercantilist export pattern that dominated the nineteenth-century political economy has continued, although industrialization and the national exploitation of mineral resources have made marked advances in Mexico. Cultural components Indians and mestizos. The contemporary Middle American population is predominantly mestizo, a mixture of Spanish and American Indian. (In much of this region, as elsewhere in Latin America, the term is also used to refer to the parallel cultural mixture.) In southern Mexico, Guatemala, and adjacent Honduras and El Salvador, the term Ladino is used to refer to non-Indian peoples, especially to those of Spanish-American culture. The concept of the plural society, often used in describing the societies of the Caribbean, is less applicable in Middle America, where its usage tends to obscure the continuing processes of integration and acculturation. In contrast to Guyana, where two distinctive ethnic groups contend for political dominance, Middle America is SpanishAmerican, and existing ethnic enclaves may be

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seen as a cultural pluralism that is gradually undergoing social integration. The term "ladinoization" (ladinizacion) (Adams 1957) has been applied to this cultural process in those areas where ladino is in use; elsewhere, "mestizo-ization" (mestizaje} is the more general term for the acculturation process. The Indians now form a very minor percentage of the total population of all countries except Guatemala. "Indian," in the sense used here, refers to that sector of the population that retains the use of an Indian language (whether bilingually or monolingually) and specific forms of social organization that are considered by the Spanish-American population to be Indian. However, many of the specific customs that differentiate Indians from non-Indians today are of Spanish colonial origin, not indigenous origin—religious organizations such as the cofradia; many elements in the men's costume, such as short trousers and split-side trousers; representational dances of the Christians and the Moors; much of the paraphernalia of the church and its rituals, etc. Similarly, many cultural traits of Indian origin are now common to the way of life of the national population—the basic diet of corn tortillas, which is supplemented by beans, yucca, and squash; basic agricultural tools such as the digging stick; and rural constructions such as ranches, which are made of adobe, poles, and wattle-and-daub and have grass or palm roofs. Traits of Indian origin have tended to survive in matters pertaining to direct adaptation to the habitat, whereas traits of Spanish origin have dominated in matters pertaining to social organization and ideas and values. The decline of the Indian component of the total population has been steady since the conquest; however, three major aboriginal patterns may be distinguished, each with a separate history regarding relations with the non-Indian population. Numerically and culturally the most important of the three patterns has pertained to the sedentary agriculturalist population of Mesoamerica. This population was organized under native states, and at the time of the conquest some of these provided an already "domesticated" population which the Spanish empire was able to take over and harness to its needs. The process of adaptation to the requirements of Spanish colonial activity, however, led to a continuing and sometimes precipitous decline of the Indian population lasting until about the middle of the eighteenth century. At that time, the combination of forced labor, wars, and disease had completed its work. It is reasonable to suppose that the two and one-half centuries of conquest

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had led to a severe natural selection of the Indian population and that the survivors formed a genetically different population than had originally encountered the Spaniards. The Spanish empire itself became so weak that colonial segments were perforce acting with more local autonomy; the Indian population increased from that time on. By the time of independence in 1821, the Spanish, Creole, and mestizo populations were still outnumbered by the Indians, but they were increasing more rapidly. The ratio of non-Indians to Indians showed a relative decline of the Indian population in spite of its absolute growth, but this also meant that the Indian was increasingly brought into faceto-face contact with the growing mestizo population. This process, combined with government action of the nineteenth century designed to reduce the organizational strength of the Indian population, caused a series of sharp acculturation situations that continue into the present. The aggressive retention of "Indian" cultural traits in the nineteenth century was in part a response to efforts to disorganize the Indians so as to convert them into a more controllable labor force. The Mexican reform laws and the later efforts of Justo Rufino Barrios in Guatemala sought to break the control that the church held over extensive lands as well as what might be termed the "eminent domain" over communal lands jealously guarded by the Indians. These efforts did succeed in challenging the church to a considerable degree and in shattering some Indian enclaves, but it also led many Indian communities to adopt a defensive posture with respect to the efforts of both government and private entrepreneurs to obtain the lands. The over-all cultural result, however, is that while the Indian population continues to increase in number, sectors of it that have been subject to special economic disintegration or political penetration rapidly acculturate and cease, in a cultural sense, to be Indian. This evidently has happened in El Salvador, where in the early 1930s an abortive revolution among the Indians was put down with such violence that the Indians over a wide region gave up their Indian costumes and tried to become ladinos in order to avoid further reprisals. The Mexican revolution caused severe acculturation in a number of instances, and Mexican government action against the Yucatan Indians and the Yaqui brought about similar shifts. The sudden progressive liberalism of the Arevalo—Arbenz period in Guatemala, from 1946 to 1954, caused a series of acculturative changes that continued thereafter.

The rapid decline of the Mexican Indian culture in recent years, coupled with growing nationalism, has led the national government to try to preserve certain of the native craft industries. Here again, the actual products in many instances are of colonial Spanish origin, but in the contemporary world they are marketed as "Indian." The Folk Art Museum of Mexico has achieved considerable success in providing a broader market for these industries, thereby strengthening their role in the local economy. Many of the Indian towns are becoming less and less distinctive as the demands and needs of the national scene impinge on the local organizational structure. Although the tribes and lesser states to the south of Mesoamerica acculturated early to the efforts of the Spanish, in Costa Rica, Panama, and Honduras, where the population was much more sparse, the conquest and colonization led to severe losses in the aboriginal population, and, in many instances, flight into refuge areas. The contemporary Indians of Panama, especially the Cuna and Guaymi, are in fact the descendants of a number of distinctive groups, the remnants of which fled to avoid the pressures of European colonial rule. So far as can be determined, the surviving Jicaque, Sumu, Paya, and Mosquito of Honduras and the Nicaraguan Atlantic coast have somewhat similar histories. The last mentioned have long been racially mixed with Negroes, although their culture remains distinctively Indian. To the north of Mesoamerica, the Spanish mission system brought under control various Indian populations, but as in the south, the Indian populations were sparse, and the effects of colonial control led to a much more severe destruction of the native cultures. By the nineteenth century, pressures from the north created by the expanding Anglo-American agricultural population increasingly forced bands of horse-riding "barbarians" into northern Mexico. Mexican efforts to control these bands, even with the loss of Texas and the greater southwest to the United States, were generally weak, since the northern frontier area was only sparsely settled by Mexicans far removed from the more central concerns of the government. Culturally, the proximity of northern Mexico to growing centers of the United States led to an economic orientation toward the north, which tended by the early twentieth century to differentiate both the culture and society of northern Mexico from those in the center and south, and the continued interchange of population across the border has contributed to a growth of the Latin American population in the southwestern part of the United States. Northern Mexico, earlier a dry and sparsely

MIDDLE AMERICAN SOCIETY populated area, today is one of the fastest-growing major regions in the republic, and one in which the Mexicans are achieving pronounced success in regional economic development. In the general picture of ethnic distributions in Middle America today, the national mestizo, or Latin American, population is predominant in all but a few areas. Central Mexico, sectors of southern Mexico and Yucatan, and adjacent Guatemala contain the largest remaining Indian populations. Small enclaves are to be found scattered in western Mexico and in the remaining Central American countries. Other ethnic groups. In addition to the Indian and mestizo populations, there are a number of other ethnic components that should be mentioned, either because of their past importance or because they remain today as ethnic enclaves. Negro slaves were brought into Mexico and various parts of Central America during the colonial period in an attempt to provide labor to substitute for the declining Indian population. In general, the settlement of these imported peoples was localized, and evidence of their presence survives today in a Negroid physical component in a few communities. Just prior to the end of the colonial period, the British shipped an entire population of "Black Caribs" from the Lesser Antilles to the northern coast of Honduras. Communities of these distinctive peoples today dot the littoral from British Honduras to southern Nicaragua. In spite of their name, they retain an Arawakan language and a culture that is more characteristic of the Antilles than the mainland. During the building of the Isthmian railway in Panama, the construction of the canal, and the two world wars, many English-speaking Antillean Negro laborers came to Panama and today form an important sector of the urban population. Their language and culture contrast with the Spanish-American culture of the mainland Negroid population. During the nineteenth and twentieth centuries, Chinese have settled in many areas along the west coast of the New World; in the early days they were imported as labor, and in more recent years they have immigrated for independent motives. This population is usually occupied in commerce in larger towns and cities. In recent years Chinese have mixed increasingly with the mestizo population. European populations of more recent origin include the English Bay Islanders off Honduras, the English of British Honduras, and the English, Spanish, German, and North American agricultural and commercial entrepreneurs who have been investing in the countries of Middle America during the past 150 years. In some instances, these peoples

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have maintained strong connections with their homelands, and even though technically nativeborn nationals, they are considered by many mestizos to be still essentially foreign. Indian culture change. The surviving Indian population of Middle America is being acculturated, although the process is uneven. It is hastened by economic and political events and slowed by the continuing social, commercial, or geographic isolation of many of the groups. Acculturation occurs as the individual removes himself from the context of the Indian community by migrating to the city or to a plantation as a laborer; it occurs also as entire communities undergo pressures leading to a breakup of the older social structure. Thus the decline of the religious and political system of the highland Indians has been due primarily to political pressure from the government and an inability of the older ritual organization to hold the community together. The formation of sindicatos and gremiales (labor unions and organized interest groups) and cooperatives that include Indians has led to a new patterning of relationships that is increasingly pertinent to the way of life in some regions. A few community organizations have resisted the pressures for change. The campesinos (countrymen) of Jalapa, Guatemala, persist in regarding themselves as "Indian" although they have no distinctive Indian costume and speak only Spanish. In this case, the basis for cohesion lies in the campesinos' attempt to maintain their communal lands inviolate from the encroachments of neighboring ladinos. Generally speaking, however, poverty and political weakness characterize the Indians. This political inferiority is somewhat overcome when the Indian is economically successful. In a few places, such as Quezaltenango (Guatemala), and Tehuantepee (Mexico), a distinctive Indian middle class has emerged, composed of merchants who were long dominant in the market and are now among the major retailers in the city as well. This group has a heightened interest in forms of Indian organization that could prove politically viable within the nation. Racial differences make almost no difference in the acculturation process. An individual is socially classified principally by his conduct. Indian physical appearance is significant only in terms of being one of a number of traits that may identify an individual as being "Indian." When behavior changes, however, physical appearance is taken as indicative of genetic history, not current social allocation. The same holds true concerning people of Negroid extraction in Panama. Although an Anglo-Caribbean background gives them some cultural differences, when they assimilate into the Spanish-speaking

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Panamanian population their skin color carries no further social or cultural meaning. Recent historical background The termination of the Spanish empire in Middle America occurred in 1821. Mexico was formed of what had formerly been the viceroyalty of New Spain, but it also included Chiapas, the southern area that had been part of the captaincy-general of Guatemala. The Central American federation included the area from Guatemala through Costa Rica; and Panama was considered part of Gran Colombia. Politically, the federation disintegrated into its component parts in 1838. Although attempts have been made to reconstitute a Central American union, nothing has come of it to date. Independence did not bring social or economic revolution to Middle America. Colonial mercantilism evolved naturally (and, in fact, had already done so through illicit trade) into an agrarian mercantilism whereby the Middle American countries gained their principal national income from the export of hacienda-produced crops, the extraction of forest and other products growing wild in the habitat, and from the continuing though much reduced mining. The governments alternated between a continuing conservatism, wherein the church played a strong stabilizing part and controlled a significant sector of the state territory, and the emergence of nineteenth-century liberalism, directed toward trying to exploit resources in order to foster economic growth. The collapse of the Central American federation marked the end of liberalism in Guatemala until the third quarter of the century, but liberalism continued in the other Central American states and in Mexico. The private hacienda flourished during the nineteenth century; the hacendado essentially ran his private regional state when under the conservatives and received the overt support of the government when under the liberals. The condition of the mass of the population was basically of little concern to both conservatives and liberals. The last half of the century saw the ascendancy of liberalism, with the government of Porfirio Diaz in Mexico and that of Justo Rufino Barrios in Guatemala. The latter was killed in 1885, in an unsuccessful attempt to reconstitute the Central American union by force, but Diaz continued to lead Mexico until the revolution in 1910. Middle America, like the rest of Latin America, constituted a part of the world's hinterland at the time of the industrial revolution in northern Europe and North America. Industrialization in Mexico was encouraged primarily by foreigners, since it was

they who had direct contact and experience with the process. By 1880, 400 factories in Mexico employed 80,000 laborers, and the mining population had risen to 70,000. Heavy industry was underway by the turn of the century; there were steel plants in Monterrey, and oil was extracted under foreign concessions. Although there were a number of attempts, some fairly active, to establish labor organizations during the latter part of the nineteenth century, it was not until the revolution that they became significant. Although by 1900 some industry had begun, the predominant pattern of life in Middle America continued to be a rural one. The few nascent industries in a sense constituted an extension of the northern industrial effort into the Middle American region. Industrialization was not growing up within Middle America but rather being thrust upon it in a relatively advanced form. This led to a secondary development, wherein the technology was basically borrowed and the society had to make major readjustments to incorporate it. For example, the exploration for and extraction of oil were achieved with a well-developed technology, so that the labor force did not grow with the complexity of the industry but rather had to be trained specifically to handle certain kinds of tasks. The same was true for the steel plants. The development of labor organizations essentially followed European, and to some degree, North American counterparts: the organizations placed emphasis on anarchist philosophies, but they were unable to organize effectively much beyond the level of mutual benefit societies. The entire process of industrialization involved an essentially rural laboring population. Differing from an urban proletariat, the laboring force moved to industry from the country and in many instances moved back to the country. Although the life of the workers in the countryside was extremely harsh, and perhaps even harsher in the mining sectors, conditions in the cities were not so much better that they attracted a great number of people. There was no enclosure movement to force people off the land; indeed, the growing haciendas had to compete for the available labor, and the rural population was needed in the rural area. The developing industries found that they had to adapt to the customs of the rural population rather than the reverse. The regional hegemony that provided haciendas with control over their labor was not so easily achieved by the new industries. Involving as it does the adaptation of a population to different and complex cultural forms, the process of creating an organized and urbanized work force has proved to be the basic difficulty

for the economic development of the Middle American countries, just as it has proved to be elsewhere in Latin America. The fact that the countries had been politically independent for over half a century did not have the same significance as in Europe and North America, where the societies had been evolving as an intrinsic part of the growing demands of the technological and economic changes and advances. The very success of Diaz' economic development program can be measured to some extent by the degree of degradation to which the Mexican campesino was increasingly subjected. Mexico continued to be marked by strong regional ties and controls exercised as much by regional bosses as through derivative power of the central government. The Mexican revolution erupted in 1910 and shook the country for almost a decade. It is pertinent for understanding Middle America and its role in recent world history to recognize that this revolution was the first major successful social revolution to reflect the incredibly complex conflicts that were engendered by the industrial revolution. The fact that this occurred in a society controlled by an agrarian (although industrializing) oligarchy, not by the industrialists themselves, made the contrast between the conditions of the laboring population and those of the upper sector of the society especially visible. In the years that followed the initial outbreak, the Mexican revolution succeeded in eliminating much of the agrarian oligarchy, and it turned over much of the land to the hacienda laborers and neighboring communities of campesinos. It established a new set of community lands called after the earlier form, ejido, and, by retaining title, placed the recipients of this land under direct governmental control. The small subsistence landholder has not been supplanted, however, and the population expansion has brought increasing agrarian problems in its wake. None of the other Middle American countries has successfully undertaken such revolutionary reforms. The 1952 agrarian reform law of Guatemala lasted for two years and was then rescinded, and most of the expropriated lands were returned to their original owners. The role of foreign countries in this process must be noted, especially that of the United States. During the nineteenth century, Middle America and the Caribbean continued to be objects of competition and some conflict between various European countries and the United States. The French intervention in Mexico came, significantly, after the United States' war with Mexico. In Central America, the British continued their territorial claims, which survive today in the colonial residue

of British Honduras. U.S. policy in the Caribbean was an attempt to exclude European interests, and following the war with Spain at the end of the century, the United States began a program of "superpaternalism," developing complete economic control of Cuba, retaining Puerto Rico as U.S. territory, and attempting to control the external financial affairs of Haiti and Nicaragua. At the turn of the century the United States had developed its interests in the banana industry in a number of countries, and, following the separation of Panama from Colombia, the Panama Canal was built. The weakness of the Central American governments was reflected in the continuing action of the U.S. Marines in Nicaragua that led to the establishment of the Somoza dictatorship in the 1930s; the strong influence of the banana companies (and growing coffee interests) in the governmental affairs of Honduras, Guatemala, and Costa Rica; and the maintenance of U.S. control over the Panama Canal. Mexico's concern for its own internal affairs and its desire to gain control of dominant foreign economic interests and nationalize its oil resources led that country to pay scant attention to the nations to the south, leaving the United States as the only major foreign power. Today, Mexico is finally capitalizing on its economic successes and in fact has challenged Guatemalan claims to the colony of British Honduras. In a very real sense, the Mexican revolution culminated in the expropriation of foreign-held lands and interests under Cardenas, head of state from 1934 to 1940, and in the great increase in agrarian reform activity. World War n brought to the Central American countries the same opportunity and cause for nationalistic development that occurred in Africa and Asia. During the period 1946-1954 Guatemala attempted to shed the controls exercised by the United States and to initiate strong national self-identification. This period in Guatemala was followed by a gradual shift toward the slower development that was occurring in Costa Rica and El Salvador after these two countries had ousted their dictators. Panama also has made a significant effort to provide national controls exclusive of foreign influence; Honduras and Nicaragua have showed somewhat less interest. Among themselves, the five countries of Central America (Panama being excluded) have formed a "common market" organization that is scheduled, should things occur more or less as planned, to create a single economic entity of the entire region. Significantly, this union was initially encouraged by the Economic Commission for Latin America,

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an organization generally free of U.S. influences, although subsequently the United States has supported it with technical and economic aid. Social organization Although Middle America had several urban centers prior to the Spanish conquest and industry has become an integral part of the Mexican economy and a growing sector in the smaller Central American countries, the greater portion of the Middle American population is still agrarian in orientation, and much of the growing urban population has immediate rural origins. During the nineteenth century agrarian mercantilism created and perpetuated an upper class that lived on the land and a small service, commercial, and administrative class in the cities and towns. This pattern has continued. The middle-income group has expanded as the major cities have grown. The countryside and towns have an upper socioeconomic sector that is allied with the middle-income sector of the cities. The lower sector forms a continuous population from countryside to city, although there tends to be a sharp cultural differentiation between city dwellers of the second and later generations and those who have themselves made the move. Since so many migrants are recent, the poorer sectors of the city have a distinctly rural flavor. Guatemala City had no slums in 1950, but today it has a variety of shack towns. Mexico City has been the recipient of such migrants for some decades. Many are swallowed up in the older sections of the cities, moving in with earlier-arrived relatives until such time as they can be on their own. All the growing major Middle American cities are faced with the problem of rural migrants for whom there is not enough work and insufficient housing. For the rural migrants, the major destinations other than the cities are frontier areas such as the Atlantic regions of Panama, Costa Rica, Nicaragua, Honduras, and Guatemala, and the northern and southern states of Mexico. Mexican migration to the United States over the past years has been large, although recent legislation has led to a severe restriction in numbers. These population movements are creating broad kinship networks over great areas, extending from North American cities to the rural areas of Mexico. The household remains the basic kin unit, and migration to rural and urban areas establishes a chain of such households. Many Middle American rural communities have colonies in the major cities, and these serve to indoctrinate the newcomer, helping him to adjust to the exigencies of urban life. Advice from friends and relatives similarly leads

people to seek out a better life in the frontier areas. This kind of broad geographical network has been long established among wealthier peoples, but among the poor it is fairly new. It has not led to a disintegration of kinship as a major relational system, but many specific obligations and responsibilities have changed. In the middle-income groups, women are increasingly emancipating themselves from the pattern of male dominance and the traditional restrictions that limited the range of their contact to female relatives and the nuclear family. This older pattern has not entirely disappeared, but it has always been less effective among the poorer people, especially in the cities, where there is a high proportion of households headed by women who have to earn a living and support their children without the aid of a regularly employed man. Under these circumstances, when women carry the major economic responsibilities of the family, there is little room for the older restrictions. Urban organization. The plan of Middle American towns and cities generally follows a rectangular grid pattern, with one or more plazas. The major Catholic church and the municipal government building are found on the central or oldest plaza. In former years the houses of families in the upper social strata were generally located in or near this center. These houses were built with patios, the number of patios being some measure of the wealth and prominence of the family. The major cities today have grown far beyond this pattern; the automobile and bus have made possible middle-income and wealthy residential suburbs; projects have been developed for middle-income white-collar workers; and severe slums have grown up along the margins and in crevices of unoccupied land in almost all sections of the city. Workshops and house industries may be found in the older sections of the cities, but they are also scattered in the growing middle-income and lowerincome districts. The traditional centralism of Latin American countries is evident in the fact that the capital city in every Middle American country, with the possible exception of Honduras, is also the major commercial center, and it is five to ten times as large as the next largest center in the country. In Mexico some provincial centers have been growing more rapidly than the national capital. Regional industrial centers are of major importance, as are some regional educational institutions. In the Central American countries the national capital still dominates, although there is significant growth of some provincial centers, such as Escuintla in Guatemala and San Pedro Sula in Honduras.

MIDDLE AMERICAN SOCIETY Metropolitan Mexico City is one of the major cities of the world. Guadalajara, Monterrey, Puebla, Ciudad Juarez, Guatemala City, Panama, San Salvador, and Managua each exceed 200,000 in population. Industrial development in Mexico has been able to absorb a significant number of the rural and provincial immigrants, but there are still very many who lack basic skills and can enter the industrial labor force only in a completely unskilled capacity. This is also true in the smaller cities. The basically rural orientation of the migrants makes it difficult to organize them into syndicates or unions, although in Mexico such organizations have become large over the years and have played an important part in the consolidation of the single Mexican political party. The organization of labor in Middle America dates back to the last century, but it has achieved strength mainly in Mexico, where well over two million men are involved. There are fewer than fifty thousand organized workers in each of the other countries, and of these, only in Costa Rica and El Salvador do unions have affiliations with an international organization. Unions have been under severe government control, and in Mexico especially the right to strike and the arbitration of demands are determined by what the government considers to be the national welfare. In many industrial and commercial firms there is still a strong paternalistic relationship between management and labor, but government action and the establishment of unions have done much to reduce this in Mexico and Guatemala. While in Mexico and Guatemala government has attempted to balance industrial developments with the welfare of the general population, elsewhere private investment interests continue to be a stronger influence. In Panama and El Salvador the controlling oligarchies may not participate directly in political administration, but they effectively dominate the economic systems of the two countries. In Nicaragua, the Somoza family has, since the 1930s, exercised a political control that has enabled it to obtain ownership or interest in many of the enterprises of the country. In Guatemala, Honduras, and Costa Rica those who possess the wealth of the country exercise considerable influence, but they do not seem to have the same degree of political control as their counterparts in Panama, El Salvador, and Nicaragua. Agrarian structure. Only in Mexico has industrialization advanced to a point where it has assumed a significant role in the national economy; industry and commerce have each equaled or bettered the agrarian portion of the gross domestic

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product. In the other countries, manufacturing is less than half as large as the agrarian production, and commerce seldom reaches even a third. Furthermore, the greater part of the national wealth in these countries is still dependent upon agrarian products, of which there is generally only one or a few export crops. In 1960 coffee was the principal agricultural export in four of the countries (Costa Rica, El Salvador, Guatemala, Nicaragua) and was the second most important export in all the rest. Bananas are the major export of Honduras and Panama and the second most important in Costa Rica and Guatemala. Cotton occupies first place in Mexico and second in Nicaragua. This emphasis on one main crop in the Central American countries is a continuation of the nineteenth-century agrarian dependence, and much in the social structure reflects a similar continuation from that period. There has been a serious attempt to experiment with other crops that might require new forms of social organization, but except in Mexico it has had relatively little effect on the over-all picture. In all countries of Middle America over half the economically active population is involved in agriculture, and in all but Mexico and Panama approximately one-half or more of all wage earners are so occupied. In Mexico, approximately one-third of the wage earners are in agriculture, and in Panama, because of the ready availability of free land, only 13 per cent are so employed. Subsistence agriculture, which emphasizes corn and beans (except in Panama, where rice is especially important), is still the basis of life for a large proportion of the population. The subsistence agriculturalist still depends primarily on a few basic tools, such as the digging stick, the hoe, or the plow for planting, and the axe and the machete for clearing land, the last also being used for general work and occasionally as a weapon. The seasonal round of activity characteristically allows time for many subsistence farmers to earn wages as seasonal laborers on plantations or coffee fincas; there is also a period just before the first harvest that is known as the "hunger period." Those who do not migrate seasonally usually have some crop or craft that provides a cash income, and in many regions, whole communities will specialize in the production of squash, onions, wheat, vegetables, fruits, flowers, or some other marketable produce for the cities. Scientific large-scale agriculture is increasing, but it has yet to achieve any degree of stabilization. Heavy dependence on a single crop makes the enterprise subject to the whims of the world

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market, and the use of pesticides, fertilizers, and herbicides is merely beginning. The most successful advance in this area has been the Mexican irrigation projects—the Rio Grande, the Fuerte, the Papaloapan, the Tepalcatepec, and the Grijalva— Usumacinta. Developments in agriculture are bringing economists, engineers, agronomists, and other technicians into important professional positions in Mexico, and they are assuming a new kind of control within the social structure. While Mexico alone has taken the major steps toward industrialization of agriculture, it too has extensive areas populated by small-scale subsistence agriculturalists, and the number of these people is increasing. Although agrarian reform was instituted shortly after the Mexican revolution and well over 115 million acres of land have been reallocated to small holders, there are still some very large holdings. Cline (1962, p. 220) estimated that in 1950, fewer than one thousand landholders still received 35 per cent of the total agricultural income. None of the other Middle American countries has been able to carry through any significant land reform. Guatemala's attempt during the Arbenz regime, which lasted from 1950 to 1954, ended when Arbenz was exiled and has been replaced by rural colonization projects. The contemporary agrarian structure is under three forms of pressure. First, the increase in rural population materially reduces the amount of land available per capita. Second, there is a demand for large-scale agricultural enterprises, since industrialization can best develop this way. Third, popular political efforts are aimed at reforming the entire tenure structure. To this, a fourth may be added, in Mexico—a gradual inflation that is making small-scale production increasingly noncompetitive at the national level. Rural social organization. The lower sector of the agrarian social structure is composed of peasant farmers, small-scale subsistence agriculturalists (whether renting or owning land), and a variety of regular and seasonal agricultural wage laborers; the upper sector includes both corporately controlled agricultural entrepreneurs and individuals. The classic latifundia and minifundia are still in existence today, although the economic structure behind them has tended to change their appearance. Population increase in the rural areas has exacerbated the minifundia problem (i.e., the progressive diminution of land size due to equal inheritance in a population expanding through natural increase) and has led to an increase in demand for seasonal work. The latifundia is becoming more profit-oriented. The nineteenth-

century-style hacienda, the private regional domain of its owners, has disappeared from much of the area. This development has occurred in part because of the laws protecting labor, but even more because of the appearance of younger aggressive agrarian entrepreneurs, who in some instances have developed large-scale plantations, often converted from the older haciendas and utilizing new crops. Others rent land and produce fast-growing crops that promise at the moment to be profitable on the world market. The speculator shows essentially no interest in the care of the land or the welfare of the laborer, and usually disappears, either wealthy or bankrupt, as soon as the market becomes unfavorable. The basic landholding system is still private, with the exception of the ejido system in Mexico. This system, however, involves only about a quarter of the Mexican farming population. Community landholdings are found in scattered areas. They may be lands dating back to old grants, but probably just as common are those which have been more recently created out of land purchased by a community. Community land as such, however, must not be confused with the Mexican ejido. The former is controlled by the members of a community (not necessarily all members), whereas ejido lands are controlled by the federal government. The two are structurally different, just as the profit-oriented plantation is structurally distinct from the disappearing hacienda. Except in very poor communities (and communities composed almost entirely of Indians) there tends to be a fairly evident local upper socioeconomic sector. Indian communities, especially those that have retained a corporate quality through collective interest in community lands or a strong local religious-political-administrative system, can seldom be differentiated into strata, although differences of wealth and prestige do exist and play an important role in the operation of the Indian community organization. In mestizo and ladino communities and those Indian communities with a significant non-Indian population, there is often a group of families that traditionally have taken responsibility for government and public leadership, and they usually have control of major local resources or manage them for those who do. Rural community organization varies with many factors, but among the more important are whether the communities are composed primarily of landowning farmers or rural laborers; whether or not they are expanding rapidly; whether they are old or of fairly recent origin; and whether or not the farmers have rights to community land of some

MIDDLE AMERICAN SOCIETY kind. Old communities of independent farmers with collective rights to the land tend to be fairly exclusive and maintain fairly close internal ties insofar as the land can support them. As the population grows and opportunities for wage labor become increasingly necessary for survival, there is a tendency to slough off population, sending people to plantations, the cities, or frontier areas. People in new communities, even when there is community land, tend to identify with the nation, neutralizing an otherwise strong attachment to the village. Where there is no basis for corporate community involvement, such as land held in common, the orientation of each of the members will be toward his own self-interest. From the point of view of national growth, rural organizations not based on the community are more important. Among these are the campesino federations of Mexico and Guatemala, the rural labor unions, and cooperatives. The Confederation Nacional Campesina is the largest Mexican rural "interest" group and is fundamentally composed of all the ejidatarios. A similar attempt to organize peasants and wage laborers in Guatemala was made during the Arbenz period, but it collapsed with his downfall. Recently it has been reinitiated under Christian-Democratic efforts. Rural labor unions, though underdeveloped, are usually organized on specific farms. Access to judicial action in protection of labor's rights has been established in all countries, although the bias of the courts varies considerably. Recent years have seen a sudden proliferation of cooperatives, primarily of a producer type in handicrafts, and increased marketing of extractive products and farm produce. In Mexico the government has succeeded in obtaining and retaining a fairly strong degree of control over rural organizations; in the rest of Middle America landholders have a stronger lien on the government's interests and have been fearful of such organizations. As a result, they have been fewer in number and less successful. Power and prestige structure The liberal power structure of nineteenthcentury Middle America had an agrarian base oriented toward the export of a few basic crops and depending on northern industrial centers for necessary tools and the luxuries enjoyed by the small upper sector. At the head of government there was in each country a strong individual who tried variously to develop the country or his own fortunes through encouraging the expansion of exportation. This was particularly true in Mexico

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and Guatemala; less so elsewhere. In Nicaragua, power was thin and essentially balanced between the colonial cities of Leon and Granada; in Honduras the north coast was often beyond the effective control of the government of Tegucigalpa. The center of population in Costa Rica, the meseta central, and the population of Panama growing up around the transit zone were both effectively separated from all other centers by miles of uninhabited land. Local leaders, because of distance from the capital, often exercised more power than the central government could bring to bear. Economically, some regions were all but independent from the capital. In a country as small as Guatemala, coffee production in the western part of the country developed a regional society, which included many Germans in the administrative sector. The port of Champerico was used as the area's point of entry and exit. A similar society in the north, Alta Verapaz, exported directly through the Rio Dulce. The capital city had hardly any contact with people or products from either of these societies. Similarly, northern Mexico, Yucatan, and other regions were in many respects relatively independent of what was occurring in the country at large, and sometimes they had closer relations with foreign centers than with their own country's capital. In the provincial areas, political control was generally held by large landholders, not necessarily having extraordinary wealth themselves, but relatively much wealthier than the rural population surrounding them. They either belonged, or considered themselves to belong, to a society that reached into urban parts of the world, and their homes usually were combinations of the special riches of their region and clothing, pianos, and other articles of varying luxury imported from Europe or the United States. Some areas were specifically under the control of members of the clergy, and others were still under the corporate control of organized Indian villages. The liberal governments were concerned with strengthening the central government, thereby weakening the local and regional power centers. Strengthening of the central governments has come about through a number of means. Federal or national troops of police frequently were established to roam the country and keep order, helping the regional power holders but at the same time making them increasingly dependent upon centralgovernment action. The church was neutralized by Barrios in Guatemala in the 1870s, and in Mexico it was effectively restricted in the nineteenth century and later most specifically by the

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expropriations following the revolution. Debt peonage was abolished in Guatemala, and a vagrancy law was substituted, thereby bringing the labor force under government control rather than control by local landholders. Alliances with foreign interests provided the government with an income independent of the rest of the country. While this substituted one kind of regional control for another, it placed governments in a position where they did have more funds. The professionalization of the military started in Mexico in the nineteenth century and in the Central American countries proceeded gradually, providing government with a more dependable military arm. In Mexico, however, military leaders had grown so powerful during the revolution that the immediate problem was how to extract the power from the military without destroying it as a necessary government arm. This was accomplished over the decades following the revolution, and now the Mexican military is essentially fragmented into a great number of small units; officers are rotated so that the possibility of collusion among them is severely reduced; and the early revolutionary generals are now replaced by younger officers. However, the trend toward a more powerful military, evident elsewhere, could occur in Mexico. More important than specific changes in the controls exercised by the Mexican government have been the significant gains in economic development that have established new bases of power within the country. In addition, the entire revolutionary situation created new political and governmental tasks and responsibilities and has led to an expanding bureaucracy and party organization, thereby providing thousands of positions by which individuals may participate in economic and political action. This may be thought of as an expansion of the base of power within the area and, as such, an increase in the amount of power that is available for people to manipulate. In the Central American countries specific relations within the power structure are more varied. There have been no revolutions to completely displace the older landowning oligarchy, but in part this has been the case because such an oligarchy was not always dominant. In the early twentieth century, Nicaragua, Honduras, and Costa Rica had a fairly large proportion of small and medium farmers; concentration on export crops—first coffee, then cotton and other field products—has led to the accumulation of lands in relatively fewer hands. At the same time, however, the economic development that has occurred in the wake of cash cropping has provided the same expansion of the power base that has occurred in Mexico, and the

sector of the society that operates in this framework has concomitantly expanded. This broadening of the power structure has produced what many have considered to be an emerging middle class, middle sector, or middle mass. Considering economic measurements, i.e., the income gradient of the population, and the growing white-collar sector, these terms are applicable. This development, however, has been accompanied by an unfortunate tendency to attribute the origin of all new things to the members of this middle class: they are presumed to possess the ideology of nationalism; they are expected to produce industrial and commercial entrepreneurs; and they are thought to be the potential source of a stable political society in the Western tradition. While there is something to recommend these suggestions, they have become intellectual blinders to the fact that changing power bases have also served to perpetuate features of the nineteenthcentury oligarchic structure. The vast gulf between the ways of life of the older upper and lower classes produced a system of prestige behavior that identifies certain forms of behavior with the upper sector and certain others with the lower. Manual labor, or earning a living with one's hands, is generally regarded as the mark of a person of low prestige; work, in this sense, is not regarded as a goal of those individuals who aspire to a better way of life. Socially, this idea has led to a continuation of an apparent dichotomy between those who are satisfied with work as a means of employment of time and those who reject it. The idea is no longer clearly congruent with differences in income, because there are craftsmen and farmers with moderate holdings who, through the organization of workshops and employment of labor, have succeeded in achieving considerably more wealth, both in land and in cash, than the average white-collar worker. Also, while the per capita income of the countries has increased, there is no evidence of a significantly wider distribution of wealth among members of the lower classes. White-collar workers do not generally enjoy a large income but regard it as important that they not be marked as manual workers. The means to social mobility do not stem from the power that accrues from wealth but rather from the ability to control the behavior of others in a variety of ways. This, in turn, has perpetuated a series of what have been termed "vertical" relationships in the society. Through kinship, friendship, reciprocal help, influence, using one's position to achieve a slightly better one, and so on, there continues to be a strong set of interdependencies that relate people

MIDDLE AMERICAN SOCIETY high in the power structure downward, in separate lines, to many people lower in the structure. Since power always works two ways, these are the very lines that are used by people lower down to better their positions. In spite of new wealth and the growth of an economic middle class, Middle American society is still recognizably divided into two prestige sectors, many characteristics of which are derived from the past. While the power base has expanded, there seems to have been little to change the orientation toward work and wealth that has characterized the lower sector or the upper sector's orientation toward power manipulation in order to achieve a better position in the prestige system. The orientation toward work in the low?r sector is not necessarily manifested by a devotion to work. Among wage laborers it is often quite the reverse; the economic development process has not yet materially raised their standard of living, and they have recognized that work does not mean upward mobility. Work is seen as a necessary means to survival, measured by cash income. Working for additional income is not seen as crucial, since the amount of income such work makes available will have no material effect on the person's access to power. By the time a person may in fact achieve an income that will permit him such access, he has learned that money is still not enough: power is exercised through a variety of exchange devices and vertical relationships. The lower sector may be seen, then, as a survival sector, whereas the upper sector, having mastered survival, seeks political position, use of luxury goods (although not necessarily their ownership), ownership of land (the continuation of the old symbol of power), and leisure. The power structure of the countries of Middle America has not fundamentally changed in shape, although there have been important shifts in emphasis. It has conserved certain features that used to be thought peculiar only to agrarian states. Many of these features appear to be viable in a situation of economic development and, as such, are responsible for many of the characteristics that have been called "Latin American" by those who have equated progress with the ways of life of Europe and the United States. Government and political organization The formal administrative structures of Mexico and the Central American countries differ in details, but they are basically the same in manner of operation. The Central American countries are divided into departments or provinces, the adminis-

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tration of each of which tends to be nominal, since most power is vested in the national executive and the congress. The minimal unit of territorial and administrative organization within the national structure is the municipio (distrito in Panama, canton in Costa Rica). There may be several small towns within a municipality, but they are completely subordinate to the capital, which gives its name to the entire territory. All the Middle American countries are constitutional republics and have legal systems based on civil law. Only Mexico is technically a federal republic. Even in Mexico, however, the president has the power to remove any state government that is felt to be unequal to its tasks, and so in effect the central government exercises considerable power over the states. The mode of election of the congresses and their specific breadth of responsibility and authority vary. Congresses are generally responsible for major legislation, usually supporting the executive policies. Situations such as have occurred in Brazil, Chile, and Argentina, where the congress may oppose the president for extended periods, have not been common in Middle America. Overt dictatorship began to decline following World War n, when some dictators resigned, as in Guatemala, El Salvador, and Honduras, and others were killed, as in the case of Somoza in Nicaragua. But violence has accompanied both constitutional and nonconstitutional rulers, with the recent exception of Mexico. Since World War n the military has played a central part in establishing or removing the executive in Guatemala, El Salvador, Honduras, Nicaragua, and Panama (where the national police function as an army). Following the 1948 revolution in Costa Rica the president disbanded the army entirely. The judiciary operates at the local level through justices of the peace, who are in some instances also the local administrative officers. The courts of each country are based on civil law rather than constitutional law. There are special courts, such as labor courts, in some countries where the government felt that the regular courts would tend to operate unfairly with respect to a particular sector of the society. Although all the countries of Middle America have political parties, these are by no means similar. Both Honduras and Nicaragua have a twoparty system, Nicaragua's dating from the nineteenth century. For the past thirty years, however, Nicaragua has been controlled by the Somoza family. Mexico has had basically a single party for the past 35 years, but the party is so organ-

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ized that it has sectors representing most of the major groups in the country—ejido families, rural unions, industrial and labor unions, civil servants, cooperatives, small proprietors, merchants, professionals, etc. While there have been opposition parties, none has been able to win sufficient support or success to retain a consistent front of opposition to the main party. There has been some continuity to party organization in the other countries, but for the most part, parties have arisen and been especially important at the time of elections. The major political process of recent years has been that referred to as "politicization," the recognition of the state as the ultimate authority and the recognition of legitimacy of certain governmental processes. Elections in all countries have become regular events, even though in all but Mexico and Panama they have been interrupted by coups d'etat that have displaced the duly elected officials or put off elections that apparently were not going to be favorable to the army. Since university education in Middle America is still available for relatively few people, it is in the secondary schools that the real politicization takes place. In the schools there are usually strongly nationalistic opinions, and the students are generally willing to turn out, or be turned out, for demonstrations of a political nature. University students also become involved in these activities, and frequently the police and army are called upon to restrain demonstrators. The party organization in Mexico has done much to facilitate the political participation of a wide segment of the population, as have the political events of recent years in Guatemala, Costa Rica, and Panama. Nevertheless, a large portion of the populations, especially the rural sectors, still do not participate in the political process because structures are not developed to keep an electorate interested and governments tend to inhibit popular participation, being afraid of a popular swing to support of either a demagogue or a leftist. The major ideologies that operate in most countries involve some combination of nationalism (sometimes openly coupled with anti-U.S. positions, sometimes merely subtly so), promotion of economic development, and promotion of democratic and constitutional procedures (governments recently taken over by the military always immediately profess plans to return to these procedures). In general, all governments recognize, at least on paper, the need for social development and the responsibility the state has in this development. Incumbent governments and the military in the Central American countries have dealt with opposi-

tion either by stopping an election if the opposition looked too promising or by outlawing the opposition's participation in the constitutional procedures. The Roman Catholic church has played an important role in politics. It was restricted by the revolutionary government of Mexico, and only in the most recent years has it gradually become again a political influence of some importance. The Barrios regime set the number of priests to be permitted in Guatemala. As a result, Guatemala has the lowest ratio of priests to Catholic population of any country in the Western hemisphere, and during the Arbenz period the church's hostility did not deter much of the population from supporting the government. The efforts of Protestant missionaries have increased in recent years, and although they have not been marked with overwhelming success, they have stimulated the Catholic church to improve the quality of its own clergy. The role of Catholicism has remained one of participation by the clergy in political action rather than involvement with political ideology. The influence of foreign powers in Middle America has a long history, but in recent years the United States has been most in evidence. The United States has retained the control over the Panama Canal and has exercised strong influence over a number of the governments, especially those of Guatemala and Nicaragua. Concerned that the incumbent Arbenz government was being taken over by "communists" the United States provided funds, equipment, and administrative aid in the "liberation" of Guatemala by Castillo Armas in 1954. The Central American republics have increasingly been integrated into a Central American common market, and steps are taken annually to promote this development. This does not include either Panama or Mexico. Such a development does not mean that there will be a serious move toward Central American political union, since the conditions for this eventuality are not politically attractive for the external relations of the small countries, nor would it necessarily resolve their internal political problems. Mexico is a member of the Latin American Free Trade Association and therefore is not involved in the Central American Common Market. The smaller union has been undertaken with the view of providing a more viable entity that might ultimately participate in the Free Trade Association. Research on Middle America In the nineteenth century, most research in what today would be regarded as social science

was natural-history reporting. Much of it was of high quality, such as the work of Alexander von Humboldt, John L. Stephens, Ephraim George Squier, A. P. Maudsley, and others. Otto Stoll, Eduard Seler, Walter Lehmann, Franz Blom, and Franz Termer have maintained a long tradition of Germanic scholarly work. French interest has concentrated more in Mexico, stemming in part from France's political interests during the period of Maximilian. Spanish scholarship, as well as that of the Middle Americans themselves, has until recent years focused on the colonial period. U.S. interest, while scattered through the nineteenth century, was marked by the major studies of Hubert H. Bancroft on Mexico and America. It matured into specific disciplinary concentrations in economics and anthropology early in the present century. The indigenismo movement stimulated work in Mexico, principally under Manuel Gamio, Jose Vasconcelos, Moises Saenz, and others. In Latin America this movement had little effect beyond the boundaries of Mexico, with the exception of the Andes region and Brazil. Interests stemming from philosophical traditions marked sociological studies until the period of World War n, when more empirical research began. Political science, marked by national and international biases, may be said to have started about the same time. Besides the national libraries and archives of the region, other important research collections for the area are those at the University of California at Berkeley; the University of Texas in Austin; the Middle American Research Institute of Tulane University in New Orleans; the Library of Congress; the Institute Ibero-Americano of Berlin; and the libraries of Seville, Barcelona, and Madrid. There are still many important private collections. Research needs in Middle America are of two major types: (1) those concerned with preserving records of now disappearing entities; and (2) those emerging from concern with problems attendant on contemporary society. Among the first are ethnographic studies of gradually (and in some instances rapidly) disappearing indigenous cultures, especially in Mexico and Guatemala, as well as studies of ways of life that are being crowded out by population expansion and urbanization. The second includes the entire range of issues in economics, sociology, and political science having to do with the continuing adjustment of societies to the rapidly changing modern world. Contemporary understanding of Middle America is still fettered by a Euro-American intellectual inheritance that °ften obscures elements in the empirical situation. The advancing technology of the social sciences

is gradually being applied to Middle American studies. What is most lacking is the development of new concepts for use in studying an increasingly complex evolutionary picture. RICHARD N. ADAMS BIBLIOGRAPHY

ADAMS, RICHARD N. 1957 Cultural Surveys of Panama— Nicaragua-Guatemala-El Salvador-Honduras. Pan American Sanitary Bureau, Scientific Publication No. 33. Washington: The Bureau. AGUIHRE BELTRAN, GONZALO 1946 La poblacion negra de Mexico, 1519-1810: Estudio etnohistorico. Mexico City: Ediciones Fuente Cultural. ARRIOLA, JORGE Luis (editor) 1956 Integration social en Guatemala. Guatemala City: Seminario de Integracion Social Guatemalteca. CLINE, HOWARD F. 1962 Mexico: Revolution to Evolution, 1940-1960. New York: Oxford Univ. Press. Cosfo VILLEGAS, DANIEL 1955-1965 Historia moderna de Mexico. Vols. 1-8. Mexico City: Editorial Hermes. Handbook of Middle American Indians. Edited by Robert Wauchope. Vol. 1—. 1964—. Austin: Univ. of Texas Press. -» Four volumes have been published to date. KIRCHHOFF, PAUL (1943) 1952 Mesoamerica: Its Geographic Limits, Ethnic Composition and Cultural Characteristics. Pages 17-30 in Sol Tax et al., Heritage of Conquest: The Ethnology of Middle America. Glencoe, 111.: Free Press. ->• First published in German in Volume 1 of Acta americana. LEWIS, OSCAR 1961 The Children of Sanchez: Autobiography of a Mexican Family. New York: Random House. MEXICO, ClNCUENTA ANOS DE REVOLUCION

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Cin-

cuenta anos de revolution. 4 vols in 1. Mexico City: Fondo de Cultura Economica. MIRO, CARMEN A. 1964 The Population of Latin America. Demography 1, no. 1:15-41. PARKER, FRANKLIN D. 1964 The Central American Republics. New York: Oxford Univ. Press. SCOTT, ROBERT E. (1959) 1964 Mexican Government in Transition. Rev. ed. Urbana: Univ. of Illinois Press. SILVERT, K. H. 1954 A Study in Government: Guatemala. Tulane University, Middle American Research Institute, Publication No. 21. New Orleans, La.: The Institute. Statistical Abstract of Latin America. -> Published since 1960 by the Center of Latin American Studies of the University of California. TAX, SOL et al. 1952 Heritage of Conquest: The Ethnology of Middle America. Glencoe, 111.: Free Press. UNITED NATIONS 1964 The Economic Development of Latin America in the Post-war Period. New York: United Nations. WEST, ROBERT C.; and AUGELLI, JOHN P. 1966 Middle America: Its Lands and Peoples. Englewood Cliffs, N.J.: Prentice-Hall. WHETTEN, NATHAN L. 1948 Rural Mexico. Univ. of Chicago Press. WHETTEN, NATHAN L. 1961 Guatemala: The Land and the People. New Haven: Yale Univ. Press. WOLF, ERIC R. 1959 Sons of the Shaking Earth. Univ. of Chicago Press.

MIDDLE EASTERN SOCIETY See NEAR EASTERN SOCIETY.

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MIGRATION: Social Aspects MIGRATION

i. SOCIAL ASPECTS ii. ECONOMIC ASPECTS

William Petersen Brinley Thomas

SOCIAL ASPECTS

In its most general sense "migration" is ordinarily defined as the relatively permanent movement of persons over a significant distance. But this definition, or any paraphrase of it, merely begins to delimit the subject, for the exact meaning of the most important terms ("permanent," "significant") is still to be specified. A person who goes to another country and remains there for the rest of his life, we say, is a migrant; and one who pays a two-hour visit to the nearest town is not. Between these two extremes lies a bewildering array of intermediate instances, which can only partly be distinguished by more or less arbitrary criteria (Lacroix 1949). Permanence of movement. What should be the minimum duration of stay that differentiates a migration from a visit? With respect to international migration, the recommendation of the United Nations (and the practice of a number of countries) is to define removal for one year or more as "permanent," and thus as migration, while a stay for a shorter period is classified as a visit. Note that the data reflect not behavior but statements about future behavior; and persons have been known to lie to immigration officials or to change their minds. This kind of ambiguity often makes it difficult to interpret migration statistics. For example, according to a critical analysis of United States immigration statistics (Kuznets & Rubin 1954, table 7), during the height of the mass immigration of 1890-1910 about forty per cent of the foreign-born returned. Conclusions from uncorrected immigration data, therefore, are likely to be grossly inaccurate. Remigrants—those who leave their country of origin for a period and then return to it—ordinarily differ from the emigrants who remain abroad, but not necessarily according to any consistent pattern. Particularly during an economic depression, some immigrants left the new country when they lost their jobs (Berthoff 1953, p. 73). Sometimes, on the contrary, it was the relatively successful that returned, either to find wives (Borrie 1954) or to retire. The rise of nationalism in the old country often attracted back some of the incompletely assimilated migrants (Saloutos 1956). A small percentage of the subsidized emigrants to Australia and Canada have returned to Britain, and

the especially careful studies made of these groups are largely inconclusive (Appleyard 1962a; 1962i>; Richmond 1966). Almost by definition, remigrants are less able to acculturate to their new environment than immigrants who remain there, but few valid generalizations can be added to that truism. The ambiguity pertains also to the definition of internal migrants (Hamilton 1961; Taeuber 1961). Particularly in a federal country like the United States, "permanence" of movement is defined, in effect, by laws stipulating the meaning of domicile with respect to marriage and divorce, suffrage, and other prerogatives reserved to "bona fide residents." Surveys by the U.S. Bureau of the Census show that each year approximately one person in five moves to a new residence (compare Wilber 1963). However, according to a detailed analysis of one particular community (Goldstein 1954), a sizable proportion of this large percentage is made up of persons who move more than once during a year and who are atypical also in other ways. A study of repeated migration in Denmark suggests that the phenomenon is not restricted to any one country (Goldstein 1964). More generally, when one speaks of migratory birds, or migrant laborers, or nomads, the connotation is not of a permanent move from one area to another, but rather of a permanently migratory way of life, which often means a cyclical movement within a more or less definite area. Nomads (the word derives from the Greek for pasturing') typically follow their herds back and forth over a region delimited either by natural boundaries or by neighbors sufficiently powerful to repel incursions. Similarly, agricultural laborers often move with the growing season, and shepherds (in what is termed transhumance) alternate between high mountain pastureland in the summer and lowlands in the winter. Commutation, the daily "journey to work" (Liepmann 1944), constitutes a similar cycle within a smaller compass. One must not accept the common notion that such a separation of place of residence from place of work is peculiar to modern industrial societies. Many of the burghers of ancient Athens, fourteenth-century London, and preindustrial cities generally were part-time agriculturists (Petersen 1961, pp. 348-353). In many presently underdeveloped countries, particularly India and Pakistan, a peasant who migrates to the city often leaves his family in the village, to which he therefore returns periodically. In Africa south of the Sahara the temporary separation of male industrial or mine workers from village life has been institutionalized into the standard pattern (Mitchell 1961). In sum, whether short-term re-

MIGRATION: Social Aspects movals should be included in migration depends on the purpose of the statistics being collected. Thus, no particular specification of the duration of stay suits all purposes, and each analyst has to adapt the available data to his needs as best he can. "Significant" distances. The meaning of migration also varies according to how a "significant" distance is defined. The word derives from the Latin migrare, to change one's residence, but by current definitions it means rather to change one's community. A person who moves from one home to another in the same neighborhood, and who therefore retains the same social framework, is not deemed a migrant. If we regard a nation as a community, then by this criterion all international movements are included under the rubric "migration." Partly because of this rationale, partly because the two sets of statistics are separately collected, the distinction between international and internal migration sets the framework of most analyses. It is worth emphasizing, therefore, that in a general discussion of the phenomenon the distinction is more or less irrelevant. Not only do some types of migration fall outside of this dichotomy (prehistoric wanderings, for instance), but some of the most important and interesting characteristics of migrants apply whether or not they cross an international border (labor mobility, urbanization, migratory selection, acculturation, etc.). Moreover, there are often greater cultural differences within the boundaries of a nation than between nations. In practice, geographical distance is generally taken as a rough measure of whether the migrant crosses into another community. Thus, the U.S. Bureau of the Census divides the mobile population between "movers," who have changed their residence within a single county, and "migrants," who have crossed a county line, and it subdivides the latter category according to whether they move within a single state, to an adjacent state, or to a nonadjacent state. This kind of classification passes over the fact that a fanner who moves to a town in the same county probably changes his way of life more than one who crosses the nation but remains a farmer. To take a more striking example, the tens of thousands of refugees who fled from East to West Berlin have traversed the most significant boundary line in Europe while remaining within the confines of a single city. Models of migration It is reasonable to suppose that the number of migrants within any area homogeneous with respect to all the other factors that affect the propensity

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to migrate will be inversely related to the distance covered. One can express this relation in an equation, as follows: M = oX/D', where M stands for the number of migrants, D for the distance over the shortest transportation route, and X for any other factor that is thought to be relevant; a and b are constants, usually set at unity. In one version of this equation, the so-called P,P5/D hypothesis, the populations of the end points of the movement are taken as the X factor (Zipf 1949). Another variation is the familiar proposition that the number of persons going a given distance is directly proportional to the number of employment opportunities at that distance and inversely proportional to the number of intervening opportunities (Stouffer 1940). When "opportunities" were defined operationally as the number of in-migrants, the hypothesis could be validated in a number of instances. According to a detailed comparison of the two, Stouffer's formulation is better than Zipf s, since, in effect, measuring opportunities corrects the total population figures for the amount of unemployment in the two areas (Anderson 1955). (For other models, see Ldvgren 1956; Thomllnson 1961; Heide 1963; Tabah & Cataldi 1963.) A proposition about migration between only two points is too simplistic a unit, however, to be a useful building block for more elaborate theories. These have in general started from other premises. An important example is the three-volume study Population Redistribution and Economic Growth: United States, 1870-1950 (Kuznets 1957-1964), in which the available data concerning the regional distribution of the developing national economy and data concerning internal migration are combined into a unified analysis of the interaction between the two. This kind of analysis is not limited to migration within a single country. A shorter work in the same broad perspective analyzes the post-1945 migration to Switzerland (Mayer 1966). According to several studies of the transatlantic movement, if conditions in the home country build up a propensity to emigrate, the volume, direction, and timing of the movement are set largely by the business cycle in the receiving country (e.g., D. S. Thomas 1941). A later work, however, challenged this interpretation and placed more emphasis on the unity of "the Atlantic economy" and the importance of "push" factors (B. Thomas 1954). Noneconomic motives. In most of the supposedly general models of migration, it is presumed that movement is generated mainly by economic forces. This may not always be a reasonable postulate. Whether the correlation between business

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cycles and migratory movements is positive or negative, for example, sometimes depends only on how broadly the study is conceived. While the rise of Europe's urban-industrial civilization brought a great increase in population and thus a pressure to emigrate, it also resulted in a general rise in the level of aspiration. Young men who were better off than their fathers were nonetheless dissatisfied, and many sought to better themselves overseas. Thus, it may be true to say that for certain periods the dominant motivation of emigrants from particular countries was economic, even though these countries had, by and large, far better conditions than those from which very few persons left. This paradox is not limited to economic factors: religious oppression, or the infringement of political liberty, was often a motive for European emigration, but before the rise of modern totalitarianism those who left came predominantly from precisely those countries least marked by such stigmata. An increasing propensity to emigrate spread east and south from northwest Europe, together with democratic institutions and religious tolerance. The anomaly that those who emigrated "because" of persecution tended to come from countries where there was less of it than elsewhere can be analyzed only by separating personal motivation from social causation. According to a recent survey of British emigrants' motives, they tended to rationalize their general feeling of insecurity and inadequacy into more specific economic factors (Appleyard 1964). At least in the United States, internal migration is also less motivated by economic factors than is usually assumed. At one time, the U.S. Bureau of the Census asked a sample of migrants who had moved during one year why they had moved ("Postwar Migration" . . . 1947; compare "Reasons for Moving . . ." 1966, which showed similar responses). Only 22.6 per cent said it was to take a job or to look for work. Family migration constituted 61.7 per cent (i.e., moving with the head of the family or to join him, moving because of a change in marital status); 6.4 per cent said it was because of housing problems. Health, climate, education, and miscellaneous motives accounted for the remaining respondents. This conclusion has been generally validated by the few other studies made of internal migrants' motivation (e.g., Rossi 1955). Migratory selection That migration is both related to economic trends and yet not, in any simple sense, caused by them, should not occasion any surprise. The same

is true of many other complex social phenomena. It would be no contribution to substitute for purely economic causes a list of other "factors," ranging from the spirit of adventure to the development of transportation facilities; nor would it be a great improvement to divide such a list between circumstances at home that repel and those abroad that attract, that is, between "push" and "pull" factors. Given a sedentary population and an inducement to leave home, typically some persons go and some stay behind. Push and pull factors, in short, do not exert their force equally. The self-selection by which migrants differentiate themselves from the sedentary population is called migratory selection (or, by some authors, selective migration). An analysis of this process can afford a better understanding of why a migration takes place. It is a valuable extension of the Stouffer-Zipf generalization, for example, to go beyond the counting of heads and differentiate among the types of migrants. It is not sufficient, even in an analysis restricted to economically motivated migrations, to posit job opportunities in general: potential migrants with specific skills go to places where there are openings specifically for them. Thus, among white migrants within the United States, those seeking higher-status positions generally have to move greater distances than those with lower levels of skill. And some job-seeking migrants are also strongly motivated by noneconomic factors: among American Negroes important reasons for moving have been to get out of the rural South (hence the high rate of urbanization), and preferably to get out of the South altogether (hence the shift to the North and West). Negroes, therefore, move greater distances than would be expected from the level of skill in the jobs that they typically seek (Rose 1958; compare Stub 1962; Taeuber & Taeuber 1965). It is possible to analyze migratory selection by a number of demographic and social characteristics in addition to occupation and race; and although the conclusions from different studies vary widely, some tentative generalizations are possible (D. S. Thomas 1938; Petersen 1961, pp. 592-603). In both internal and international movements adolescents and young adults predominate; for not only do the young adapt more easily, but since they are close to the beginning of their working life, they can more readily take advantage of new opportunities. It is feasible, therefore, to analyze migration by cohorts (Eldridge 1964). One can argue a priori that either the less or the more intelligent will tend to migrate: since the

MIGRATION: Social Aspects more intelligent will have succeeded at home, the less intelligent will seek their fortunes elsewhere; on the other hand, the more intelligent will respond first to any stimulus to migrate, while the duller will remain behind. Various studies have seemed to validate one or the other of these propositions. It is possible to reconcile the contradiction by postulating that a selection by intelligence is in fact one by actual or potential occupational level (Hofstee 1952; compare Lee 1966). Thus, since urban occupations are generally more demanding, ruralurban movements typically select the more intelligent. This is not true, however, of agriculturists who move to manual jobs in the cities, such as Negroes in the United States (D. S. Thomas 1938, pp. 111-121), or in general of migrants who make no substantial change in vocational level. Effects on populations. For the two areas concerned, migratory selection determines the significance of the movement almost as much as the number of migrants. Consider the ramifications of what can be taken as the most fundamental question in migration theory: If X persons leave country A and migrate to country B, what changes take place in the size of the two populations (Petersen 1955, chapter 9)? The common-sense answer, that country A is decreased and country B is increased by X, is true only in the short run. If the typically young migrants have their children in their new country, its fertility rate may go up, while that of their native country goes down. Since the remaining population of country A will then be older on the average, its death rate may go up, while that of country B goes down. In short, after a generation the transfer of X persons will in fact amount to X plus a certain proportion based on the migration's effects on the population structures, and rates of population growth, of the two countries. At a third level of analysis, however, this increment, and indeed X itself, may be canceled out. For Mai thus, thus, emigration was a slight palliative, a partial and temporary expedient, with no permanent effect on population size (Maithus 1798, book 3, chapter 7). This is likely to be true of any country where the mortality of infants and children is high (so that emigration would reduce the mortality slightly), or where marriages and conceptions are put off because of economic pressure (so that a lesser pressure, the consequence of emigration, would result in a higher fertility). If one includes such indirect effects, the change in the population of the immigration country is also difficult to estimate. Immigration to the United States, for example, accelerated urbanization and

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industrialization; and these changes, in turn, increased the upward social mobility of the native population and thus tended to accelerate the secular decline of the birth rate. In sum, even the simplest question—How many persons migrated?—cannot be fully answered merely by counting heads. Unlike mortality and fertility, migration has no biological dimension: it cannot be analyzed, even in preliminary terms, independently of its cultural context. Accordingly, there are no "laws" of migration in the sense of universal generalizations; the highest level of abstraction possible is the contrast of various types of migrants (Heberle 1955). Migration typologies In a study of migrants to Aberdeen—that is, of movement within the single country of Scotland over only a few years—it was found useful to classify respondents into a number of types. These included professionals seeking careers, young persons seeking education, workers taking specific jobs, casual workers looking for employment, former commuters moving for greater convenience, family migrants joining heads of families, and return migrants (Illsley et al. 1963, pp. 238-240). The conclusions to be drawn differed for these various classes. If this is so for movements within a relatively homogeneous area, then it is manifestly the case for migration in its most general terms, encompassing the whole world and all of human history. In constructing a general typology, one should begin by choosing the criteria by which the types are to be distinguished (Petersen 1964, pp. 271-290). Perhaps the most fundamental is the distinction between innovating migrants, who move in order to achieve the new, and conservative migrants, who move in response to a change in their circumstances, hoping by migrating to retain their way of life in another locus. Within each of these two broad classes, one can distinguish types of migration according to the force impelling the movement. An ecological push results in what might be termed a primitive migration—not a wandering of primitive tribes as such, but one dependent on a people's inability to cope with natural forces. When the activating agent is the state or some equivalent institution, the movement is forced or impelled migration, depending on whether the prospective migrants retain some power to decide whether to leave or not. A movement of adventurous pioneers, deviant religious or political groups, or similar individually motivated persons can aptly be termed

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free migration. Its importance is not in its size, which is never large, but in the example it sets for others. If the ensuing flow develops into a broad stream, an established pattern for whole social classes, an example of collective behavior, we speak of mass migration, similar to what has been termed "chain migration" (MacDonald & MacDonald 1964). Then individual motivations become correspondingly less important—indeed, the individuals involved may not be able to give a rational account of their decision to migrate. The motives they ascribe are likely to be trivial or, more probably, the generalities that they think are expected (Hansen 1940a, pp. 77-78). Uses of typological method. The value of such a typology is in its utility: Does it help in solving analytical problems? The typology suggests, first of all, that migratory selection ranges along a continuum, from total migration at one extreme (food gatherers or nomads) to total nonmigration at the other. Intermediate instances, moreover, cannot be arranged along a single dimension. Sometimes it is the age or the sex or the occupation of the potential migrant that is relevant, but if an ethnic or social minority leaves to escape persecution or is shipped off to concentration camps, then the only pertinent characteristic is how the state defines "Jew" or "kulak," for example. For more than a century various governments, concerned about the depopulation (real or supposed) of villages, have sought measures to counteract it. It would increase understanding of the process merely to ask whether this is a conservative or an innovating migration: Do these agriculturists want better conditions within their present way of life, or do they move to cities for the sake of urban amenities? Perhaps the most useful distinction in the typology is that between mass migration and all other types, for it emphasizes the fact that the nineteenth-century exodus from Europe does not constitute the whole of the phenomenon. When this type of migration declined after World War i, largely because of new political limitations imposed by both emigration and immigration countries, this was very often interpreted as marking the end of significant human migration altogether (e.g., Forsyth 1942). It was rather, in large part, a change to neomercantilist migration, in which the welfare of the national state becomes the main criterion for judging whether the movement is desirable and in which state agencies foster or impede, force or prevent, the migration. The "natural" right of the passportless person to move about has been supplanted by the "natural" right of the state to control that movement (Petersen 1955, chapter 1).

In the present age of total wars and totalitarian regimes, political motivations have set not only "Europe on the move" (Kulischer 1948) but also, partly as reverberations of European influences, much of the rest of the world. To take a notable example, the partition of British India into the nations of India and Pakistan was accompanied by one of the largest migrations in human history, in part induced by terrorists on both sides, in part arranged under state auspices. Many analysts prefer to omit this type of movement from their purview. In a United Nations publication, for example, international migration is defined as "the noncoerced migrations, which constitute the great majority of all migratory movements in normal times, and which are closely related to economic and social factors. . . . Specifically, 'migration' excludes population transfers, . . . deportations, refugee movements, and the movements of 'displaced persons'" (United Nations 1953, p. 98). That an international body which includes some of the states most responsible for forced migrations should exclude them from its demographic analyses is understandable; but there is no reason why independent scholars should accept this arbitrary and misleading definition. The number of refugees in the world today depends of course on how that term is defined. Data on "refugees" are compiled mainly by the various agencies set up to aid them, and the resultant totals considerably understate the number of persons who have migrated because of political stress and sought refuge elsewhere. The major world-wide agency, the office of the U.N. High Commissioner for Refugees, has a narrowly restricted prime mandate: to assist persons who do not want to return to their country because of actual or feared racial, religious, or political persecution; and it may also extend its "good offices" to certain other limited categories. This definition does not include several numerically important classes of uprooted peoples: (1) those who have fled from local political disturbances but remain within the boundaries of the same state; (2) those who are forcibly moved about within the boundaries of a single state (see, for example, Conquest I960); (3) those who have been forced to "return" to what is now defined as "their" country, after having lived "abroad" sometimes for generations. Thousands of refugees remain as hard-core cases from World War I, the Spanish Civil War, and World War n. It has been estimated, probably conservatively, that about forty million persons became refugees in the dozen years following 1945 (Rees 1957); the implication of the figure can be better grasped when it is recalled that the usual

MIGRATION: Social Aspects estimate for the total migration from all of Europe from 1800 to 1950 is only one and a half times as large, that is, sixty million. WILLIAM PETERSEN [See also POPULATION; REFUGEES; and the biographies Of KULISCHER; WlLLCOX.j BIBLIOGRAPHY

ANDERSON, THEODORE R. 1955 Intel-metropolitan Migration: A Comparison of the Hypotheses of Zipf and Stouffer. American Sociological Review 20:287-291. APPLEYARD, R. T. 1962a The Return Movement of United Kingdom Migrants From Australia. Population Studies 15:214-225. APPLEYARD, R. T. 1962Z? Determinants of Return Migration: A Socio-economic Study of United Kingdom Migrants Who Returned From Australia. Economic Record 38:352-368. APPLEYARD, R. T. 1964 British Emigration to Australia. London: Weidenfeld & Nicolson. BERTHOFF, ROWLAND T. 1953 British Immigrants in Industrial America: 1790-1950. Cambridge, Mass.: Harvard Univ. Press. BORRIE, WILFRID D. 1954 Italians and Germans in Australia: A Study of Assimilation. Melbourne: Cheshire. CANADA, DEPARTMENT OF CITIZENSHIP AND IMMIGRATION 1961 Citizenship, Immigration, and Ethnic Groups in Canada: A Bibliogr