Fritz Dross: Krankenhaus and lokale Politik 1770–1850: Das Beispiel Düsseldorf,Krankenhaus and lokale Politik 1770–1850: Das Beispiel Düsseldorf by Fritz  DrossReview by: rev. by Mary LindemannIsis, Vol. 97, No. 2 (June 2006), pp. 361-362Published by: The University of Chicago Press on behalf of The History of Science SocietyStable URL: http://www.jstor.org/stable/10.1086/507374 .

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BOOK REVIEWS—ISIS, 97 : 2 (2006) 361

professional and amateur scientists like CharlesOtis Whitman, Wallace Craig, Edmund Selous,and Henry Eliot Howard, among others, butequally absent in their behaviorist and subjectiv-ist contemporaries (who were interested in be-havior modification in laboratory settings, on theone hand, and in the scientifically seemingly un-graspable animal experiential world, on theother). Ethology thus emerged both in continuitywith a tradition reaching back to Darwin and incontrast to paramount concerns of behavioralstudies in its day. Not surprisingly, ethologyerred in the direction of exaggerating a key in-sight: that animals have a panoply of instinctivebehaviors that have been forged by evolution be-cause of their adaptive value; indeed, the foun-ders of ethology insisted that innate behaviorpatterns, in their “fixity,” were just as useful forthe construction of phylogenies as morphologi-cal structures. Along with the identification ofsubject matter, ethologists constructed a set ofpractices and recommendations for its study: theobservation of behavior in wild, semiwild, and“free” contexts (of open nature or field stations),which allowed scientists intimate knowledge ofa species’ behavioral repertoire, or “ethogram.”

The success of ethology rested on its havinga productive subject matter around which itsfounders created a nexus of concepts—of innatereleasing mechanisms, fixed action patterns, re-leasers, and action-specific energy, amongothers—couched in theoretical schemes—ofproximate (physiological) and ultimate (evolu-tionary) causation—and accompanied by amethodological approach of observation and ex-perimentation in the field. The serendipity of Lo-renz’s and Tinbergen’s complementary scientificstyles (the former being more inclined to originaltheorizing, the latter to ingenious experiment de-sign) was also important in the discipline’s suc-cessful construction.

The question of whether ethology was suc-cessful is addressed in the closing chapters. It isa question that makes this case study particularlyfascinating. What is now referred to as “classicalethology,” the science as conceived and prac-ticed by its founders, is largely obsolete. Goneare the rigid separation of instinctive and learnedbehaviors, the reification of innate packages ofbehavior with their releasers, the postulation ofthe building of action-specific energies—inother words, a great portion of the original con-ceptual and theoretical armamentarium. At thesame time, Lorenz and Tinbergen succeeded ininstitutionalizing the study of natural behavior,which today has become a field with deep ties to

ecological and evolutionary thinking and withundisputed significance in conservation biology.

Lorenz and Tinbergen lived long enough tolament not only the abandonment of many oftheir descriptive and explanatory ideas but alsothe break of behavioral studies from a naturalistheritage, what with the post-1970s prominenceof quantitative formulations (a consequence, inlarge part, of the advent of the computer). Morethan institutionalizing the biological study of be-havior, however, Lorenz and Tinbergen also pre-pared the conceptual soil for the concept of the“gene”—as underlying generator of innate be-haviors—to enter the realm of behavioral ecol-ogy thinking. Despite themselves, the foundersof classical ethology paved the way for “cogni-tive ethology”—the scientific study of animalmind and consciousness—to emerge with thework of Donald Griffin, in the mid 1970s. Fi-nally, Lorenz and Tinbergen were pivotal in sus-taining the tradition, inaugurated for our era byDarwin, of couching human behavior in bio-logical terms—an endeavor driven as much bythe desire for self-knowledge and truth as sus-ceptible to pitfalls of delusion and fallacy.

EILEEN CRIST

Fritz Dross. Krankenhaus and lokale Politik1770–1850: Das Beispiel Dusseldorf. 400 pp.,bibl. Essen: Klartext Verlag, 2004. €24.90(cloth).

Hospital history has a surprisingly long lineage.Early descriptions served to attract donors. Pub-licity soon gave way to a fascination with archi-tecture. Then, in the last third of the twentiethcentury, scholars increasingly focused onbroader social contexts, shifting their gaze to-ward patients and practices rather than medicaltheories and practitioners. And, of course,Michel Foucault’s paradigm of an epistemolog-ical rupture with the “birth of the clinic” hasshaped much writing on hospitals as well as onmedicine more generally.

Fritz Dross’s detailed study of hospitals inDusseldorf follows many of these trends but alsotakes issue with the ways in which historianshave been (mis)directed by them. He distruststhe dominant interpretation that a new institution(the hospital as distinct from the old spital) sud-denly came to be acclaimed as the exemplar ofhow to care for the sick. As an institution of carebecame a place for cure, the new hospitals sup-posedly also created a space for medical profes-sionalization where physicians engaged in thedual processes of medicalizing patients and dis-ciplining bodies. Considerable work over the last

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362 BOOK REVIEWS—ISIS, 97 : 2 (2006)

decades on the medieval and early modern hos-pital had already dismantled part of this model,showing that medical care was never incidentalto premodern institutions. Dross would agree,but he goes further by seeking to introduce “newarguments into the discussion about continuityand discontinuity in the history of the hospitalaround 1800” (p. 11).

Dross’s analysis builds firmly on what histo-rians have come to call the “paradoxes of theearly modern state” (p. 19). The early modernstate rarely could enforce its will effectively,and, indeed, it crafted no “five-year plans” in thestyle of modern economies. As James Vannpointed out over twenty years ago, power wasfar more ambiguously located, and few magis-trates and rulers thought of the future as differ-ing significantly from the past (The Makingof a State: Wurttemberg, 1593–1793 [Cornell,1984]). Little consensus existed on the attributes,the goals, or even the desirability of reform pro-grams. Vigorous controversies characterized vir-tually everything about the building, staffing,and objectives of hospitals and poor relief. Notuntil after 1850 did the hospital gain general ac-ceptance as the preferred institution of healthcare. Under Dross’s probing, other pillars of theconsensus shake as well. In Dusseldorf, mem-bership in a medical elite depended on familyties and not on perceptions of professionalism.Physicians, poor relief reformers, and govern-ment officials disagreed on the best ways to suc-cor the poor and treat the ill. Thus, no allianceof powers produced the hospital. Instead, itevolved in a field of shifting ambitions and ex-pectations guided not by administrative andmedical desiderata but by the exigencies of eco-nomics. Dross nicely demonstrates this fluidityand indeterminancy in several ways, but perhapsmost effectively in his detailed examination ofthe long-term debate over whether the sick poorwere best cared for at home, through visiting (theKrankenbesuchanstalten), or in hospitals. Curi-ously, despite the eventual triumph of the hos-pital, the visiting solution was in the ascendanceat the turn of the century. The eventual successof the walls and wards solution, however, did notimmediately produce a new type of patient. Hos-pital records and particular cases reveal how thesocial and economic category of “poor” betterdescribed the typical patient than the medicalcategory of “ill.” The shift to hospitals was grad-ual, the possibilities were varied, and the out-come was uncertain.

The great strength of Dross’s work is its sen-sitivity to differences and alternatives. For in-stance, he distinguishes between various insti-

tutions—those that were well endowed and thusrelatively independent of poor relief and thosethat were not, those that were staffed by nursingorders, those that were relatively small or unusu-ally large. He situates these individual historieswithin the framework of broader social, eco-nomic, and political forces. He unravels the oftencompeting aspirations of local and territorialgovernments, although his explanations some-times leave the links between larger forces andthe hospitals obscure. Nonetheless, he adroitlyavoids the teleological trap that caught muchold-fashioned hospital history (in arguing thathospitals demonstrated medical progress) andmore modern studies that unite hospitals, phy-sicians, and the state in a plot to medicalize anddiscipline a populace.

Dross has produced a persuasive study, if alsoan overly long and unnecessarily dense one. Amore tightly constructed and crisply argued bookwould have better achieved his objectives. Un-fortunately, dissertation agonies remain all tooapparent. Dross fritters away pages in coveringall possibly relevant material and occasionallyleaves the reader unclear as to where he has beenand where he is going next. “Problematizing”eats up paragraphs that would have been betterdevoted to getting on with the story. But oneshould perhaps not criticize the author for thedefects of the genre. One should instead praiseDross’s judicious use of theory and admire hiswillingness to plumb archival depths. Thosequalities have produced a fine monograph, onefrom which every scholar interested in hospi-tals—or in urban governance more generally—can certainly profit.

MARY LINDEMANN

Anita Burdman Feferman; Solomon Fefer-man. Alfred Tarski: Life and Logic. vi � 425pp., table, notes, bibl., index. Cambridge: Cam-bridge University Press, 2004. $35 (cloth).

Alfred Tarski was a leading light in the devel-opment of mathematical logic in the twentiethcentury. Since mathematical logic shares fun-damental results, methods, and insights withmodern analytic philosophy, Tarski was wellknown in the philosophical community as wellas in the discipline of mathematics. Born inWar-saw in 1901 under the name “Teitelbaum,” Tar-ski found it impossible to land a university po-sition, despite the name change and his excellentrecord in mathematics throughout his school anduniversity years. Consequently, he taught highschool in Poland for more than ten years aftercompleting his Ph.D. During this period he

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