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Genetics in the Madhouse

Genetics in the Madhouse: The Unknown History of Human Heredity

Theodore M. Porter
Princeton University Press
2018
447 pp.
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Decades before Gregor Mendel studied pea plants or Thomas Hunt Morgan cultivated fruitflies, an isolated but vital international community gathered enormous bodies of data on hereditary traits. As Theodore Porter describes in his fascinating and original Genetics in the Madhouse, physicians and state officials tasked with overseeing insane asylums throughout the 19th century attempted to understand the origins and nature of madness and, in so doing, laid the foundations for human genetics research today.

Between 1789 and 1900, populations of the insane or “feeble-minded” grew explosively in industrialized Europe and North America. Some 19th-century observers argued that it was a sociological artifact produced by new medical-legal systems and better diagnosis, whereas others put the blame on the social upheaval of industrialization. As patient numbers increased and governments demanded demonstrations of the efficacy of asylum “cures” to justify footing the exponentially growing bills, doctors and administrators turned to new methods of recordkeeping and data organization.

Handwritten narratives of patients’ personal histories of madness were captured in account books and then in a succession of preprinted forms, cards, and charts, which placed familial relationships at the forefront of asylum diagnosis. Standard forms simplified data-sharing, allowing administrators to plot correlations between patterns of familial inheritance and specific types of madness or to conduct national censuses of hereditary insanity. By following the technologies of paperwork and data collection, Porter has unearthed a radically new history of human genetics, one that evokes not the double helix but the humble filing cabinet.

The eugenics movement of the early 20th century did not emerge abruptly from an attempt to apply newly rediscovered Mendelian principles to human beings, Porter reveals, but rather as an extension of the legal and scientific technologies that had been practiced in state-run asylums, prisons, and special schools for the better part of a century. Key early figures of eugenics such as Francis Galton, Karl Pearson, and Charles Davenport were not the precursors of a new science, he argues, but the inheritors of long-running medical-statistical tradition. After the Nazis, eugenics may have been repudiated by scientists and state officials, but the practices of pedigree charting and obsessive data-gathering inherited from the 19th century remained a part of the new human genetics and have been carried forward to the present day.

Genetics in the Madhouse is the result of detailed, painstaking work on the data collection practices of many far-flung and forgotten asylum physicians and state statisticians. Yet, sometimes, the reader begins to feel as if they, too, are being sucked into an endless sea of filing cabinets, statistical tables, and handwritten medical reports. However, part of Porter’s argument is that the narrative of genetic science has not been clean or straightforward, either in its 19th-century origins or in its contemporary incarnations. Genetics is inescapably intertwined with messy, multivalent subjects like health and race, law and education, poverty and warfare.

As a data science, human heredity has a long history, one that current researchers, physicians, policy-makers, and engaged citizens would be well served to keep in mind.

About the author

The reviewer is at the Department of History, Princeton University, Princeton, NJ, USA.