Historical perspectives on music as a cause of disease

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Historical perspectives on music as a cause of disease James Kennaway1 School of History, University of Newcastle, Newcastle, UK Corresponding author: Tel.: 0191 208 7844; Fax: 0191 208 5242, e-mail address: [email protected]

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Abstract The relationship between music and medicine is generally understood in the benign context of music therapy, but, as this chapter shows, there is a long parallel history of medical theories that suggest that music can cause real physical and mental illness. During the seventeenth and eighteenth centuries, the idea of music as an expression of universal harmony was challenged by a more mechanistic model of nervous stimulation. By the 1790s, there was a substantial discourse on the dangers of musical overstimulation to health in medicine, literature, and etiquette books. During the nineteenth century, the sense of music as a pathogenic stimulant gained in influence. It was often linked to fears about sexuality, female gynecological health, and theories of hypnosis and degeneration. In the twentieth century, the debate on the medical perils of the wrong kinds of music became overtly politicized in Germany and the Soviet Union. Likewise, the opponents of jazz, particularly in the United States, often turned to medicine to fend off its supposed social, moral, and physical consequences. The Cold War saw an extensive discourse on the idea of musical “brainwashing,” that rumbled on into the 1990s. Today, regular media panics about pathological music are mirrored by alarming evidence of the deliberate use of music to harm listeners in the context of the so-called War on Terror. Can music make you ill? Music therapy is a common if perhaps rather neglected part of medicine, but its diametric opposite, the notion that music might lead to real mental and physical illness, may seem improbable. In fact, over the last two hundred years, there have been many times when as much was written about the medical dangers of music as about its potential benefits. Since the eighteenth century, fears about music’s effects on the nerves and the mind have created a remarkably extensive discourse on pathological music based on a view of both music and the causation of disease as matters of nervous stimulation (Kennaway, 2010, 2012a). From concerns about young ladies fainting from excessive stimulation while playing the keyboard in the Georgian period and Victorian panics about Wagner to the Nazi concept of “degenerate music” and Cold War anxieties about musical brainwashing, the debate on the medical dangers of music has generally combined a theoretical and terminological basis in the medicine of the period concerned with broader agendas about gender, sexuality, race, and social order. Each generation has tended to regard the music it grew up with as the epitome of rationality and healthy mindedness while ascribing hair-raising medical consequences to newer music. This debate has continued right up to the present day, with the depressing difference that, with the systematic use of music in torture in the so-called War on Terror, the idea that music can be bad for you has become a much more realistic prospect. Progress in Brain Research, ISSN 0079-6123, http://dx.doi.org/10.1016/bs.pbr.2014.11.017 © 2015 Elsevier B.V. All rights reserved.

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Although the debate about music’s ill effects has largely been bogus, there are ways in which music can in fact adversely affect health. Most directly of all, there is of course the power of sheer volume to cause psychological strain and hearing damage. It was only really with the advent of the modern age, with its industrial noise, expanded orchestras, and amplified sound systems, that this became a widespread concern. Although the high-decibel sound can include music, it is not its character as music that causes health problems, so it falls rather outside our purview. Medical problems that do relate to specifically to music itself include the rare conditions of arousal-related arrhythmia and musicogenic epilepsy, but in both of these contexts, music is essentially a trigger rather than a fundamental cause of sickness (Sharp, 1997; Viskin, 2008; Wieser et al., 1997). There is a long history of medical accounts of musical hallucinations, which are certainly sometimes associated with serious medical conditions, but they are by no means always experienced as pathological (Berrios, 1990; Evers and Tanja, 2004). It should also be remembered that it is quite possible that many of the accounts of music causing disease refer to real physical symptoms and suffering, albeit generally with a psychosomatic rather than direct physiological explanation. This kind of psychological impact of music has meant it has been linked to a variety of culturally bound syndromes. Having said that, it is also clear that the most of the discourse on pathological music is basically fallacious. Over and over again, fundamentally moral objections to music relating to sexuality, gender, social order, and self-control have been clear beneath a veneer of medical language.

Keywords music, nerves, hypnosis, brainwashing, hysteria, neurasthenia

1 FROM THE HARMONY OF THE SPHERES TO NERVOUS STIMULATION A systematic discourse on music as a cause of disease emerged only during the eighteenth century. Before that, there were only a handful of Humanist anecdotes— Quintilian’s account of a musician driven mad, the effect of Timotheus’ lyre on Alexander the Great, the case of Erik I of Denmark, and so forth (de Lorry, 1765, pp. 2:114; Quintilianus, 1922, pp. VIII, 3:6.5-7.1; Tissot, 1781, p. 728; Weiss and Taruskin, 1984, pp. 12–15). The fact that so few stories were involved reflects profound assumptions about music’s association with order and health, and the distance from any systematic theory is emphasized by the fact that they were mostly drawn from Antiquity, a period when, it was long believed, music had far more power than among contemporaries. However, the modern debate on pathological music has been profoundly influenced by the ethical critique of music that was common from the Classical period. In particular, Plato’s ideas on the subject of music and morals proved highly influential. Although his ideas on music varied over time, he argued in The Laws and The Republic that laxity in musical harmony and genre was a threat to morality, manhood, and the state, drawing on the ideas of Damon of Oa. Famously, he advocated banning all modes except the Dorian and the Phrygian on ethical grounds. Christianity added another level

ARTICLE IN PRESS 1 From the harmony of the spheres to nervous stimulation

of hostility toward musical sensuality, creating its own moral critique. From the Church Fathers until the present day, a lively debate has continued about what kind of music, if any, was acceptable in a religious context. The development of an ostensibly medical rather than moral debate on the dangers of music in the eighteenth century depended on a shift away from the Pythagorean and Neoplatonic conceptions of music as an aspect of universal order that had dominated much discussion of the subject. In the sixteenth and seventeenth centuries, the idea of music as an expression of abstract ratio and universal harmony was undermined by a “disenchanted” worldview and by models of music as a form of nervous stimulation. Anatomists from Gabriele Falloppio (1523–1562) to Antonio Maria Valsalva (1666–1723) achieved real advances in the understanding of the ear and the auditory nerves. The medical discussion of music reflected this focus, as one sees in the crucial shift from earlier works on the music therapy such as Musurgia Universalis (1650) by Athanasius Kircher (1601–1680) and Disputatio Effectus Musicae in Hominem (1714) by Michael Ernst Ettm€uller (1673–1732) that still tended to stress bringing the soul and body into harmony to the mid-eighteenth-century works such as Richard Browne’s Medicina Musica (1729) and Die Verbindung der Musik mit der Arzneygelarheit (1745) by Ernst Anton Nicolai (1722–1802) that stressed the power of music over the nerves. For the most part, this medical approach to understanding musical listening did not at first led to substantial interest in music’s potential dangers to health. Not only works on music therapy but also more general dietetic books, such as The History of Health, and the Art of Preserving It (Mackenzie, 1760, p. 380) by James Mackenzie (1682–1761), suggested music as a healthy activity and raised no doubts as to its benign effects. Indeed, in the context of the eighteenth-century culture of sensibility, it was assumed that music acted to the refine the nerves and that the ability to play and appreciate music was an aspect of possessing the sensitive nerves of the social and intellectual elite. For instance, William Smith suggested in his Dissertation Upon the Nerves that if listeners’ nerves were “too gross,” then music would cause no pleasure (Smith, 1768, p. 122). The Irish aesthetician Daniel Webb (1718–1798) concurred, arguing that, although “we have no direct nor immediate knowledge of the mechanical operations of the passions,” music’s effects on the nerves were such as to “act in aid of the moral sense, to regulate the measures and proportions of our affections; and by counteracting the passions in their extremes, to render them the instruments of virtue, and the embellishments of character” (Webb, 1769, pp. 4, 37). The mid-eighteenth century did produce occasional examples of anxiety about music’s impact on health, but they generally related to its indirect psychological and emotional power and not to its direct physiological effects. Avoiding emotional excess had long been a key part of traditional medical regimen in the context of the “Passions of the Soul,” one of the so-called six non-naturals that can be traced back to Galen. Musical passion, if carried too far, could cause disease by over-exciting the body and mind, in what could be thought of as “moral physiology.” For instance, in the 1780s, the famous Swiss physician Samuel Auguste Andre´ Tissot (1728–1797), who was generally very positive about music, writing that it “encourages virtue,

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calms passions and heals moral and physical sicknesses,” worried a little about its ability to “excite passions to a great degree” (1781, p. 728).1 He gave examples of the results of such excessive emotional excitement, including a young man experiencing fainting fits when he heard music and a child having involuntary muscle spasms at the keyboard (p. 737).

2 MUSIC AND OVERSTIMULATED NERVES (1790–1850) By the 1790s, however, expressions of fears about music’s medical effect were transformed by the sense of music as a direct nervous stimulant, similar to other menaces and panaceas of Enlightenment medicine such as coffee, tea, and electricity. Thereafter, the direct power of the music on the body, not just the emotional impact of the music, became the basis for a systematic debate on music’s pathological consequences. Music came to be incorporated into medical theories that saw nervous stimulation as a modern pathology and source of vice, creating a debate that would prove remarkably long lasting. The nervous stimulation model of medicine developed during the eighteenth century, drawing on the work of the likes of Thomas Willis (1621–1675). Even at the time of Dr. Johnson’s Dictionary (1755), “nervous” had meant “sinewy,” but in the wake of George Cheyne’s The English Malady (1733) and those of a similar ilk, the word took on its modern connotations of anxiety, stress, and illness. The work of the Swiss physician Albrecht von Haller (1708–1777) on the distinction between sensibility and irritability in living tissue sparked further interest in the subject. By the final decades of the eighteenth century, a systematic medicine of stimulation was coming to dominate discussions of many illnesses. One leading proponent, the Edinburgh physician William Cullen (1710–1790), went as far as to suggest that “the generality of morbid affections is so dependent on the nervous system, that almost every disease might be called nervous” (Spillane, 1981, p. 163). In that context, debates on the dangers of music reflected an increasing focus on direct neurological stimulation rather than emotional strain. Another Scottish doctor, James Makittrick Adair (1728–1802), in his A Philosophical and Medical Sketch of the Natural History of the Human Body and Mind (1787), outlined a clear view of aural stimulation as a threat to health: The sense of hearing is exceedingly and painfully acute in some persons . . . Some sounds are universally grating to every ear, as the rasping of a file; some persons are peculiarly disturbed by particular sounds, owing to a depraved state of the auditory nerves; and indeed to depravity of one or other of the external senses in diseases, we may attribute many extraordinary and untoward symptoms. Adair (1787, pp. 40–41) 1

“Wenn die Musik Tugenden bef€ ordern, Leidenschaften stillen und moralische und physische Krankheiten heilen, so ist es kein Wunder, dass sie auch die Leidenschaften in einem hohen Grad zu beleben vermochte.”

ARTICLE IN PRESS 2 Music and overstimulated nerves (1790–1850)

The period from the 1790s provides countless examples of music being discussed in terms of “doses” that if given in excess would lead to all kinds of serious medical problems, especially among physicians influenced by the work of John Brown (1735–1788). For instance, Peter Lichtenthal (1780–1853), an Austrian physician with close links to the Mozart family, wrote in his Der Musikalische Arzt (The Musical Doctor) (1807) that music’s great power as a stimulant meant that a doctor who understands Brown’s system would know how great a dose of music a patient requires and what noises might lead to “headaches, disquiet, fear and even fainting” (Lichtenthal, 1807, pp. 161–162).2 Because of this approach, accounts of people literally dying of music became much more common by the early nineteenth century. To give just one example of many, in 1837 The Penny Satirist magazine reported a story from the Athenaeum about “Sensibility to Music” that involved a musical fatality: The published fact of the female who died from hearing too much music, we do not imagine to be well known in this country; we therefore give a sketch of it taken from the Surgical Repertory of Turin. A woman, twenty-eight years of age, who had never left her village or heard a concert, was present at a three day fete in 1834, and dancing was carried on the sounds of a brilliant orchestra. She entered into the amusement with ardour, and was delighted; but the fete once finished she could not get rid of the impression which the music had made upon her. Whether she ate, drank, walked, sat still, lay down, was occupied or unoccupied, the different airs which she had heard were always present, succeeding each other in the same order as that in which they were executed. Sleep was out of the question, and the whole body being deranged in consequence of this, medical art was called in, but nothing availed, and in six months this person died without having for one moment lost the strange sensation; even in her last moments she heard the first violin give some discordant notes, when, holding her head with both hands, she cried, “Oh! what a false notes, it tears my head.” Anon (1837, p. 2)

As this story suggests, the dangers of music, it seems, were particularly acute for women. It had long been a commonplace that women have “weak” nerves, but whereas that had been part of a claim to superior sensibility for much of the eighteenth century, by 1800, it put them at the heart of the debate on pathological music. Similarly, an article entitled “Extracts from the Note-Book of a Physician” in The New Monthly Magazine in 1839 also suggested the musical habits of the female elite were linked to serious medical problems: Music, the greatest of female accomplishments, fosters that morbid susceptibility; and the close, sedentary application, requisite for the acquirement of this fascinating art to the extent regarded essential, in the present day, aids in producing those disturbances, in the whole economy of the system, which are favourable to 2

“Kopfschmerz, Unruhe, Angst, ja sogar Ohnmachten.”

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hypochondriasis. Thence, in female education, the great importance of balancing the powers of the intellect and the force of emotions. If means to produce this be not adopted, hysteria is likely to occur, the paroxysms of which are almost always followed by depression of spirits and hypochondriasis. Anon (1839, p. 198)

One instrument in particular was thought to be especially dangerous for women—the glass armonica. Using the same principle that produces tones from wine glasses containing different amounts of liquid, the glass armonica had been developed over the eighteenth century, notably by Benjamin Franklin (1706–1775). It had a wave of popularity in the last decades of the century and soon became the subject of widespread medical anxiety because of its supposedly irritating impact on the nerves. Many of Europe’s most famous performers on the instrument were believed to have been harmed by it (Finger, 2006, pp. 235–250).3 In the 1830s, Peter Joseph Schneider (1791–1871), who was an ardent supporter of music therapy, suggested that “Tender women are not uncommonly brought to fainting by the armonica. Bach knows of a woman who was laid out breathless ever time she heard its music for longer periods” (Schneider, 1835, pp. 194–195).4 The French psychiatrist Jean-Pierre Falret (1794–1870) in his 1822 De l’hypochondrie et du suicide even suggested that there was evidence linking it to suicide (Falret, 1822, pp. 23–24). The supposed medical dangers of the instrument were one reason why it soon went out of fashion. The medical dangers of music became a significant literary theme for the first time in the work of the German Romantics. Their view of music as a sublime art, a realm of genius and madness with overwhelming powers over the body and soul, was a more suitable context than the cult of sensibility for such an agenda. E. T. A. Hoffmann (1776–1822), to give just one example, often discussed themes of music and madness, especially in his Kreisler stories. The Story of Krespel (1818), for instance, is an ironic take on music, eroticism, and death, which later formed the basis of Act II of Offenbach’s Tales of Hoffmann. Antonia, the daughter of the councilor, dies because she sings. As a doctor tells her father: Perhaps it may be that she has exerted herself too much in singing when overyoung, or her inherited temperament may be the cause. But Antonia has an organic disease of the chest. It is that which gives her voice its extraordinary power, and its most remarkable timbre, which is almost beyond the scope of the ordinary human voice. At the same time it spells her early death. If she goes on singing, six months is the utmost I can promise her. Hoffmann (1980, p. 44)

This combination of the glamor of musical talent, young female bodies, and the ironic or moralizing medical angle was to have a big future. 3

See also the chapter “Benjamin Franklin and His Glass Armonica: From Music as Therapeutic to Pathological” by Finger and Zeitler. 4 “Nicht selten werden durch die Harmonika za¨rtliche Frauenzimmer bis zur Ohnmacht bewegt. Dem Bach ist ein Ma¨dchen bekannt, welches, so oft es seine Musik la¨ngere Zeit h€ orte, von Athemlosigkeit hingestreckt wurde.”

ARTICLE IN PRESS 3 Pathological music (1850–1914)

3 PATHOLOGICAL MUSIC (1850–1914) In the second half of the nineteenth century, the debate on the medical dangers of music developed in several new directions. In particular, it was incorporated into broader medical discussions of the nervous strain of modernity, with its apparent sexual indiscipline, noise, competition, and political tensions. The idea of music as a potential threat to health recurred in the context of the diagnosis of neurasthenia, in the science of hypnosis, in gynecology and the emerging science of sexology, and in the context of the theory of degeneration (Kennaway, 2009, 2010, 2011, 2012a,b). Increasingly, concerns were raised not only about the problem in relation to a pampered and supposedly physically ailing elite, as had often been the case during the eighteenth century, but also about the effect of musical stimulation on the masses. At the same time, “modern” music in particular was being singled out as especially dangerous. Enlightenment anxieties about music generally referred to an excess of listening or playing, but the nineteenth century often focused on specific composers’ work as pathological. More than any other musician, Richard Wagner became the focus of a remarkable debate on music’s physiological and psychological effects. The perils posed by overstimulated nerves in the eighteenth century generally related to the lifestyle of an idle elite, as set out in Cheyne’s English Malady. However, during the nineteenth century, the terminology associated with the concept of neurasthenia set out by the American physician George Beard (1839–1883) tended to link nervous strain to the strains of hard work, capitalism, and city. Beard put the fatigue caused by modernity at the heart of discussions of nervousness, as well as focusing more on its sexual origins. Time and time again, critics of music’s effects turned to the language of neurasthenia and fatigue, especially in the context of education. The development of state education and a shift from a focus on individual nerves to the degeneration of the masses meant that educationalists and physicians of the years before the First World War often discussed the strain of music on all pupils, not just the daughters of the elite. For example, Paul Berger in his 1897 Die Nervenschwa¨che (Neurasthenie) wrote that “When one considers how much work and time is spent and wasted playing the piano, added to the amount of mental and physical stress that school involves, then the development of hysteria and neurasthenia among the female sex” is not surprising. It could lead to “nervous weakness, vanity, a passion for finery, effusive ideas, an inclination to romantic adventures, as well as an anxious mental life. . .the initial stages of nervous exhaustion” (Berger, 1897, p. 27).5 5

“Wenn man bedenkt, wieviel Arbeit und Zeit auf das Klavierspiel verwendet und verschwendet wird und man die Summe geistiger und k€ orperliche Belastung, wie sie die Schule erfordert, hinzunimmt, so erscheint die Entwicklung von Hysterie und Neurasthenie beim weiblichen Geschlecht als ein Vorkommnis, das gegen€ uber den vielfachen Beg€ unstigungen, wie sie die moderne Erziehung und Schule mit sich bringt, schlechterdings als noch relativ selten bezeichnet werden muss. In vielen Fa¨llen finden wir allerdings gewissermassen nur leise Andeutungen, eine in der Entwicklung so zu sagen gehemmte Nervenschwa¨che. Eitelkeit, Putzsucht, € uberschwengliche Ideen, Hang zu romantischen Abenteurn, dabei ein unruhiges, von nichts ber€ uhrtes seelisches Leben sind jene Initialstadien der Nervenersch€opfung, die weniger Gegenstand a¨rztlicher als gesellschaftlicher Beobachtung bilden.”

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Along with neurasthenic fatigue, the sense that music was capable of robbing listeners of self-control and leaving them vulnerable to the manipulation of others or their own hidden instincts was an important strand of medicalized concern about music during the nineteenth century. Already from the 1780s, music, especially from the glass armonica, played an important role in the treatments of Franz Anton Mesmer (1734–1815), the Marquis de Puyse´gur (1751–1825), and their followers in the world of “animal magnetism” (Finger, 2006, pp. 235–250). By the 1840s, the semioccult “magnetic sleep” of Puyse´gur was being recast in more respectable scientific terms as hypnosis. Nineteenth-century medical interest in such trance states reached a peak in the 1880s with the work of Jean-Martin Charcot (1825–1893) and his colleagues Paul Regnard (1850–1927), Paul Richer (1849–1933), Alfred Binet (1857–1911), and Charles Fe´re´ (1852–1907) at the Pitie´-Salpeˆtrie`re Hospital in Paris, which often involved sound and music. These experiments, using tuning forks, gongs, and lullabies, appeared to trigger catatonic states in their hysterical female patients (Binet and Fe´re´, 1905, pp. 88–89; Kennaway, 2012a,b; Regnard, 1881, pp. 261–262; Richer, 1881, pp. 599–600). As far as Charcot was concerned, these states were a matter of automatic neurological and physiological reactions, related to epilepsy, and little to do with psychology (Charcot, IX, p. 294). Although the ideas of Charcot’s rival Hippolyte Bernheim (1840–1919) that linked hypnotic trance states to suggestion rather than higher reflex action eventually won out, the Salpeˆtrie`re model proved very influential, not just in scientific circles. Nietzsche’s critique of Wagner of the 1880s drew heavily on Fe´re´’s work in particular, for instance, and trashy novels, such as Trilby (1894) by George du Maurier (1834–1896), popularized the association of music, hypnosis, sexuality, and illness (Nietzsche, 1969 VI. pp. 17, 21, Kennaway, 2005; Du Maurier, 1995). Fears about music’s powers to cause illness by undermining self-control continued to be linked to questions of sexuality, especially as far as women were concerned. The dangers of music were increasingly related not only to a rather vague sense of “weak nerves” but also directly to female gynecological health. Two diametrically opposed theories were advanced on the topic. One, which was especially common in France, was that music was a sensual pleasure that would lead to premature or excessive menstruation and sexualization (Briquet, 1859, p. 608, Kennaway, 2011). The German physician Eduard Reich’s (1836–1919) System der Hygiene (1871) set out his view along these lines, with the author arguing that “An excess of music will cause significant excitement in the whole nervous system and in particular in the imagination, and thereby contribute in a considerable number of cases to the premature beginning of the sex drive and the premature start of menstruation” (Reich, 1871, p. 252).6 The other theory, most widespread among American gynecologists, 6 “Von dem Verha¨ltnisse der Musik zum Geschlechts-Leben und insbesondere zur Menstruation ist ¨ bermass der Musik wird das ganze Nervensystem und wird insbekaum irgendwo die Rede. . . Durch U sondere die Phantasie in bedeutende Aufregung versetzt, und hierdurch in einer nicht geringen Zahl von Fa¨llen nicht wenig zu fr€ uhzeitigem Erwachen des Geschlecht-Triebes, zu fr€ uhzeitigem Erscheinen der Menstruation beigetragen.”

ARTICLE IN PRESS 3 Pathological music (1850–1914)

suggested that music was like arithmetic and would so strain the mind of young women that it would delay or prevent menstruation altogether, causing infertility. For instance, an 1896 article in the American Journal of Obstetrics & Gynecology related Dr. Joseph Taber Johnson’s (1845–1921) “case of a young girl who became so much enthused and so nervous over music that she almost went into spasms” to elucidate the power of music to postpone menstruation (Anon, 1896, p. 571). For some observers, music’s powers over female sexuality went further. For instance, the 1907 book Le Langage Musical et ses Troubles Hysteriques by the Argentine psychiatrist Joseph Ingegnieros (1877–1925) outlined a number of accounts of female sexual medical complaints linked to music. He discussed cases of “hysterical hypermusia” (exaggerated musical ability), “hysterical paramusia” (musicophobia with convulsions), and pathological associations of music and the “genital instinct” (Ingegnerios, 1907, pp. 162, 166, 171). One case relates to a so-called “melosexual” young lady who achieves “complete sexual satisfaction in ‘musical onanism,’ (i.e., masturbation) which unfortunately had led to ‘sexual neurasthenia’” (Ingegnerios, 1907, p. 172). Another case recounted by Ingegnieros involved what he called “genital-musical morbid association” in a 33-year-old woman who became especially musical during menstruation (Ingegnerios, 1907, pp. 175–177). Another recurring theme in debates about the possible medical consequences of music related to male homosexuality. Over the centuries, music had often had associations with effeminacy, from Plato’s warnings in The Republic that music could create weak warriors to Christian worries about the danger of weakness and sensuality raised by music in the mass. In the nineteenth century, as same-sex attraction was recategorized in medical terms in the work of Karl Heinrich Ulrichs (1825–1895) and Richard von Krafft-Ebing (1840–1902) as a condition rather than simply a sin, there was an extensive debate on the supposed homosexuality of famous musicians, from Wagner to Schumann, and the connection between music and “Uranian love” was given a medical rationale (Anon, 1900; M€obius, 1906, p. 41; Moll, 1910, pp. 64–65; Morris, 2002; Stekel, 1917–1918). The noted English sexologist Havelock Ellis (1859–1939), for instance, in his Studies in the Psychology of Sex, wrote that “The musician has not been rendered nervous by the music, but owes his nervousness (as also, it may be added, his disposition to homosexuality) to the same disposition to which he owes his musical gifts.” Homosexuality was linked, he argued, to “genito-musical synaesthesia” (Havelock Ellis, 1921, p. 295). In his extensive interviews with homosexuals, Krafft-Ebing seemed to have come across several who linked their “condition” to music. For instance, in his 1890 Neue Forschungen auf dem Gebiete der Psychopathia Sexualis, one of his interviewees explained how he had been influenced by a famous singer into his homosexual lifestyle, and others linked their sexuality to listening to the music of Richard Wagner (von Krafft-Ebing, 1890, pp. 4, 60). Such discussions of inborn pathological predispositions related to broader theories that linked musical talent to degenerate heredity. The notion that musicians and composers were biologically weaker specimens recurred many times over the nineteenth century. Already in 1826, Richard Phelps suggested in an article in The

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Monthly Magazine that “Among the various classes of artists, for example, musicians are perhaps the most subject to those wayward fancies which mark the hypochondriac; witness Viotti, Sacchini, Mozart and others; while the effect upon minds gifted with undue sensibility is strikingly illustrated by the melancholy and passionate desire of revisiting” (Phelps, 1826, p. 40). However, the scientific discussion of degenerate musical genius really began with the work of the French psychiatrist Jacques-Joseph Moreau de Tours (1804–1884), who set out a theory of genius as a neurological flaw. His La Psychologie morbide das ses rapports avec la philosophie de l’histoire de l’influence des neuropathes sur la dynamisme intellectuel (1859) described Beethoven as “bizarre,” Mozart as “not normal,” and Paganini as “nervous” and noted that Donizetti suffered from general paralysis of the insane (pp. 541–555). Richard Wagner was the subject of an intense debate about his supposed degeneration and madness for years after the publication of Theodor Puschmann’s (1844–1899) speculative Richard Wagner: Eine Psychiatrische Studie (Puschmann, 1872; Vetter, 1992). The important Italian psychiatrist and criminologist Cesare Lombroso (1835–1909), famous for his work on the criminal almost as a separate species, asserted in 1894 that Wagner suffered from sadism, absentmindedness, megalomania, and effeminacy and had a giant head (Lombroso, 1894, pp. 139, 126). In the decades before the First World War, there was a boom in pathographies of composers (Feis, 1910, pp. 80, 56–58, 72–80). The decades between the 1880s and the 1920s were the golden age of literary discussions of the theme of pathological music (Kennaway, 2007). Marcel Proust’s A la Recherche du Temps Perdu (1913–1927), for instance, contains many allusions to the subject. In the first volume, Swann’s Way, the pretentious salonnie`re Madame Verdurin makes a claim to great esthetic sensitivity by ostentatiously protesting about the effect of certain pieces of music on her nerves: If the pianist suggested playing the Ride of Valkyries, or the Prelude to Tristan, Mme. Verdurin would protest, not that the music was displeasing to her, but, on the contrary, that it made too violent an impression on her. ‘Then you want me to have one of my headaches? You know quite well, it’s the same every time he plays that. I know what I’m in for. Tomorrow, when I want to get up—nothing doing!’

Similarly, when discussion turns to the (fictional) sonata by the composer Vinteuil, Madame Verdurin screams: No, no, no, not my sonata!. . .I don’t want to be made to cry until I get a cold in the head, and neuralgia all down my face, like last time. Thanks very much, I don’t intend to repeat that performance. You’re all very kind and considerate, it is easy to see that none of you will have to stay in bed for a week. Proust (2005, p. 247)

The idea of pathological music recurs many times in the work of Thomas Mann (1875–1955) (Kennaway, 2014). For instance, in the short story Tristan (1903), a stranger lures a young woman in a sanatorium with just a touch of TB into playing the piano. Playing Chopin and Wagner’s Tristan und Isolde has such a violent effect

ARTICLE IN PRESS 4 Twentieth-Century blues: pathological music (1900–1945)

on her nerves that she is left at death’s door (Mann, 1903). In The Magic Mountain (1924), Mann returned to the theme. In particular, the character of Settembrini articulates a suspicion of music’s ambivalent irrationality that owed much to Nietzsche’s work on Wagner, comparing its dangers to opium (Mann, 2002, pp. 172–176). Another prominent example of the theme of pathological music in the fiction of the period can be found in Robert Musil’s masterpiece Der Mann ohne Eigenschaften (The Man Without Qualities) (1930–1943), with its references to “sickly piano playing” (Musil, 1957, p. 621).7 One character says of another, “If she had played on the piano, become excited and has tears in her eyes, would she not be quite right to refuse to get on a tram and go to the hospital and to behave there as if it was ‘only music’ and real tears” (Musil, 1957, p. 1428).8 Typically, Wagner is the main culprit, and throughout the book, one sees the strong influence of Nietzsche’s Wagner books, albeit further ironized, as Musil writes of “the surging spine-music of the Saxon magician” and “Wagner intoxication” (Musil, 1957, pp. 629, 728).9 Like Thomas Mann, Musil drew on the medical debate on Wagner’s nervous music to symbolize a whole morbid romantic strand in German and indeed European culture.

4 TWENTIETH-CENTURY BLUES: PATHOLOGICAL MUSIC (1900–1945) In the early twentieth century, the medical profession generally lost interest in the discourse on pathological music. The work of Freud and his supporters undermined the nervous stimulation model that had been the basis of much discussion on the subject for over a century. A subtler view of music’s psychological effects left less room for speculation about its health impact. Nevertheless, beyond medicine, the debate thrived more than ever, continuing to focus on sexuality, self-control, and order, but became more political and more preoccupied with race. This racial dimension of the debate on music’s medical dangers has two distinct but related elements. On the one side, there is anti-Semitism. It is striking that in the arguments about Wagner as a threat to health, it is politically liberal Jews and others revolted by the composer’s noxious anti-Semitic views that were at the forefront of the medicalized critique. It was only in the 1890s that the right-wing racial politics associated with Wagner were combined with theories of degeneration and nervous overstimulation to attack Jewish composers such as Gustav Mahler (1860–1911) and Arnold Schoenberg (1874–1951). The twentieth-century discourse of “racial hygiene” in music gave the debate on pathological music a more sinister aspect that was to reach fruition during the Nazi period. 7

“Sie h€orte dabei ihres Gatten krankes Klavierspiel.” “Wenn sie am Klavier bis zur Leidenschaft gespielt hat, aufgeregt ist und Tra¨nen in den Augen hat: ist sie nicht vollkommen im Recht, wenn sie sich weigert, in die Tram zu steigen, auf die Klinik zu fahren und sich dort so zu benehmen, als ob das ‘nur Musik’ und nicht wirkliche Tra¨nen gewesen waren!?” 9 “die wogende R€ uckenmarksmusik des sa¨chsischen Zauberers an.” “Wagner Rausch.” 8

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Even before 1914, the rhetoric of musical order had become more overt, and the language of medicine was often used in debates between proponents of supposedly healthy Neoclassicism such as Max Reger (1873–1916) and the supporters of the so-called Neue Musik (New Music). In the aftermath of defeat and revolution, the music criticism of the Weimar Republic took on an increasingly political tone. Bitter disputes involving terms like “Musikbolschewismus” (musical bolshevism) and psychiatric rhetoric were common. The music of Arnold Schoenberg and his followers in the so-called Second Viennese School was often the main target for the language of pathology and by no means only at the level of metaphor or hyperbole. Leading German music journals regularly published articles attacking Schoenberg in medical terms. One discussed his music as a “brain secretion,” in which “the soul is extirpated in violent, pathological self-mutilation created in delusion and has had its place taken by the sick brain” (Friedland, 1924, p. 555).10 Another responded to a suggestion in an Italian paper that violence was the only justified response to such music by saying that “That is wrong. One doesn’t hit the sick, one isolates them, keeps them away from the healthy and prevents the sickness from spreading” (Hilmes, 2003, p. 742).11 With the advent of the Nazi regime in Germany, the whole debate on pathological music gained not only political overtones but also actual political traction. Even before 1933, Nazi policy had reflected the Right’s medicalized hostility to certain music. When the Nazi Wilhelm Frick (1877–1946) became minister for education in the province of Thuringia in 1930, he was able to push through a measure titled “Wider die Negerkultur, f€ ur deutsches Volkstum” (Against Negro Culture, for the German Folk), aimed to prevent the “contagion by alien anti-culture” (Bollenbeck, 2005, p. 102).12 After 1933, the Nazi regime issued decrees to ensure strict censorship by the Reichsmusikkammer (The Reich Music Institute) to prevent “undesirable and harmful music” infecting healthy German ears (Wulf, 1963, p. 140).13 Protecting the German people from pathological music had become state policy. Hans Severus Ziegler’s Entartete Musik (degenerate music) exhibition in Dusseldorf in 1938 marked the high point of the whole discourse of sick music. Inspired by the 1937 Munich exhibition of the so-called degenerate art, it reflected the mixture of anti-Semitism, racist views of African American music, and the rhetoric of psychopathology that had been fermenting over the last 30 years. Its warnings of the perils of modern music and jazz, examples of “Jewish cheek and complete mental idiotification,” lacked all esthetic coherence (D€umling and Girth, 1988, p. 135).14 . . .ihr die Gehirnsekrete eines Sch€ onberg f€ ur ‘irrational’ ausgebt, jenes Musikers, bei dem durch gewaltsame, im Wahn ver€ ubte pathologische Selbstverst€ ummelumg die Seele extirpiert wurde und das kranke Gehirn ihren Platz ergriffen hat!” 11 “Ein italienische Blatt scheib k€ urzlich nach Anh€ orung des Pierrot Lunaire, darauf ga¨be es nur eine Antwort: Pr€ ugel. Das ist falsch, einen Kranken schla¨gt man nicht, man isoliert ihn, man ha¨lt ihn vom Gesunden fern und verhindert die Ausbreitung des Krankheitsstoffes.” 12 “Verseuchung durch fremdrassige Unkultur.” 13 ‘Anordnung € uber unerw€ unschte und scha¨dliche Musik in amtliche Mitteilungen der Reichsmusikkammer von 15.1.1938, 1. 14 “j€ udischer Frechheit und v€ olliger geistiger Vertrottelung.” 10

ARTICLE IN PRESS 4 Twentieth-Century blues: pathological music (1900–1945)

Indeed, in general, Nazi policy on degenerate music was opportunistic and pragmatic. Modernism was excoriated as sick, but Stravinsky was tolerated because of his well-known right-wing views and Bartok was accepted because of diplomatic relations with Hungary. The Soviet Union displayed a similar hostility to avant-garde music, albeit generally without such an overt anti-Semitic element. Policy was subject to dramatic changes according to the whims of Stalin and political necessity. The peak of the campaign against modernist music was between 1948 and the death of Stalin in 1953, when the so-called Zhdanov Doctrine of anti-imperialist realism made life very uncomfortable for composers such as Shostakovich, Prokofiev, and Khachaturian. Tikhon Khrennikov (1913–2007), a prominent Soviet composer from the 1930s and Secretary of the Union of Soviet Composers from 1948 to 1991, was a leading critic of “Formalism,” often drawing on medical language to attack supposedly hysterical bourgeois diversions from real socialist music. He wrote that The operas of Hindemith, Krenek, Alban Berg, Britten. . .and Menotti are mere concatenations of hideous sounds marked by complete disregard of natural human singing. The music openly harks back to the primitive barbaric cultures of prehistoric society and extols the eroticism, psychopathic mentality, sexual perversion, amorality and shamelessness of the twentieth-century bourgeois hero. Thomson (1951, pp. 161–162).

Just as in Nazi Germany, such medicalized rhetoric often had serious consequences for the musicians involved. The other aspect of the increasingly racialized debate on music and medicine related to African American music, starting with ragtime. The supposed essential differences between the nervous system of people of African and European descent had been discussed since the work of eighteenth-century anatomists, including Johann Friedrich Blumenbach (1752–1840) and Samuel Thomas von S€ommerring (1755–1830). A surprisingly early example of music played by people of African descent causing nervous strain can be found in the picaresque 1771 novel The Expedition of Humphry Clinker by the Scottish former naval surgeon Tobias Smollett (1721–1771). The character Jery Melford describes “Two negroes, belonging to a Creole gentleman,” who play discordant sounds on a French horn that would “have discomposed the organs of an ass.” This music has a terrible effect on “the irritable nerves of uncle” (Smollett, 1859, p. 65). During the nineteenth century, in the face of the growing Abolitionist movement, American supporters of slavery increasingly turned to the argument that black nerves were thicker and their brains smaller, making them sensual and more responsive to rhythm—an essentialist theory that has by no means lost all influence today. The boom in jazz in the years after the First World War led to a substantial debate in the medical and musical press about its effect on the body and on mental health. It became the focus for a huge amount of anxiety about race, sexuality, and order in the disrupted postwar social fabric. In the pages of America’s leading music journal, The Etude, for instance, there was a fierce debate on the subject, with assertions, such as

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“the habitual playing of jazz is very dangerous to many piano students,” being thrown around (Anon, 1924). Just as in the nineteenth century, the medical rationale for these attacks on music often related to the supposed overstimulation of the nerves. Already in 1917, the author of an article in The Literary Review suggested that “Jazz music is the delirium tremens of syncopation” (Anon, 1917, p. 28). Jazz was represented as both savage and primitive and quintessentially modern and nervous. The association of jazz with African Americans and urban music venues, full of an apparently new breed of unchaperoned flappers, raised all sorts of fears about sexuality and social control. Thus, Noe¨l Coward’s 1927 song Dance, Little Lady ascribed the effects of “this insane/Music in your brain” to “Nigger melodies” that “Syncopate your nerves/Till your body curves.” Without Coward’s ironic wink, a school doctor at a high school for girls published a scientific warning against jazz dance that suggested that “continued exposure to this influence may tear to pieces our whole social fabric” (Wagnleitner, 1994, p. 209). And in 1925, The New York Times even implied that jazz was the cause of the murder of a mother by a jazz fiend daughter (Anon, 1925).

5 PATHOLOGICAL MUSIC (1945–PRESENT) The catastrophic defeat of Nazism and the gradual decline of explicitly racist politics did not mean the end of paranoia about music’s effects on health. The Cold War that succeeded it proved an equally fertile soil for such anxieties. In particular, the rise of the concept of “brainwashing” in the wake of the Korean War (1950–1953) laid the foundation for much subsequent concern about music. Although the idea of brainwashing has roots in Chinese thought and nineteenth-century work on hypnosis, its modern sense of “menticide,” the total abolition of individual autonomy by outside manipulators, in many ways dates to the 1950s, when the CIA reacted to apparent Communist success in converting American POWs by alleging a campaign to hypnotize the men concerned. The CIA and others also began investing serious money in the so-called MK-ULTRA program to see if they could achieve similar effects themselves, often using music and sound. The role of music in the brainwashing scenes in Anthony Burgess’s (1917–1993) novel A Clockwork Orange (1962) reflects the considerable impact these ideas had on culture beyond medicine. The protagonist Alex, given to habits of “ultra-violence,” is forced to watch footage of Nazi atrocities while listening to Beethoven in an attempt to wipe his old personality and create a new one.15 These fears became part of the broader culture wars of the 1960s. American religious conservatives often turned to the language of musical brainwashing to explain the social and cultural changes around them. In a series of books, David Noebel set 15

Alex himself expresses some skepticism about music’s “civilizing” effect. “Civilized my syphilised yarbles,” he exclaims. “Music always sort of sharpened me up” (Burgess, 1962, pp. 41–42).

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out the dangers of what he portrayed as literally a Kremlin plot to destroy America. In his Rhythm, Riots and Revolution (1966), for example, he quoted a “prominent physician” named Dr. Granville F. Knight to the effect that There is no question in my mind about the hypnotic effects of the so-called “sleepy songs” found among these records. Hypnotic induction by means of these records could easily place young children in a most receptive mood for suggestions of various sorts. These might include suggestions about world citizenship, against patriotism and nationalism or anything else which the teacher felt should be inculcated in the minds of young children. Noebel (1966, p. 39)

The implicit role of race in much of this discourse can be guessed at from arguments, such as that “Beat music” has its origins in “the heart of Africa, where it was used to incite warriors to such a frenzy that by nightfall neighbors were cooked in carnage pots!” (p. 78). It is a disturbing thought that in recent years, the well-documented systematic use of music in torture and the development of serious acoustic weapons have made even lurid language of this sort look trivial. The use of music in war to galvanize one side and intimidate the enemy is of course nothing new, but over the past few decades, the pressure in democratic states to find nonlethal weapons and torture methods that leave no bruises has led to a boom in the deliberate use of music to inflict pain. Partly because more overtly authoritarian regimes have more direct methods of achieving the same ends, it has been countries like the United States, Britain, and Israel that seem to have been pioneering this trend. In particular, captives held in the context of the “War on Terror” and the occupation of Iraq and Afghanistan appear to have subjected to music played very loud for a very long time in shipping containers and the like (Bayoumi, 2006; Cusick, 2008; Moss, 2006; Wolfendale, 2009; Worthington, 2008). The music concerned tends to be either “futility music,” such as highly repetitive children’s songs, or heavy metal or rap songs chosen to offend the cultural sensitivities of prisoners. Although the topic has often been treated as a joke in the media, there seems little doubt that such treatment must be regarded as illegal in international law. Beyond real concerns about music’s role in modern combat and interrogation, the contemporary situation provides a surprisingly high number of examples of essentially bogus medical anxiety about music. In 2010, for instance, there was a minipanic about the so-called i-dosing or digital drugs. American TV news reports and the Daily Mail suggested that teenagers listening to binaural beats downloaded from the Internet with (entirely misleading) names such as “digital marijuana” would experience effects analogous to actual drugs (Bates, 2000). Similarly, the US TV network Fox News also discussed the potential medical consequences of the Korean pop hit “Gangnam Style.” In April 2014, the Daily Mail reported a study by scientists at the University of Arkansas that appeared to demonstrate that subjects enjoyed food more when they heard jazz music and less when they listened to rap music. The headline “Want to Slim Down? Don’t Listen to Jazz Music” raised the prospect of that

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modern “fashionable disease” obesity being linked to the wrong musical choices (Anon, 2014). Not all recent panics were limited to the usual media organizations. Serious scientific journals continue to publish articles on related subjects. A 2014 article in the Proceedings of the Royal Society of London B suggested that women’s musical preferences depended on their level of fertility over the monthly cycle. At times when conception was most likely to occur, it was reported that women show a more pronounced preference for complex music (Charlton, 2014). Just as in parallel studies from the nineteenth century, the role of cultural attitudes is entirely neglected, as if the female subjects were in a state of nature. The first moral of the tale is perhaps that a truly scientific understanding of the benefits and dangers of music in terms of health demands that we always be on the watch for glib mechanistic models of music’s impact. Music certainly can have powerful effects on the mind and body of listeners that in turn sometimes have medical consequences, but the listener is not just a passive recipient of nervous stimulation. A serious model of listening must take into account psychological and cultural factors—not, alas, something that contemporary work on the neuroscience of music always manages. Without such an approach, there is always the risk of attributing a crude physiological or neurological basis to complex social behavior. Second, the history of pathological music offers so many examples of the authority of medicine egregiously being used to further social agendas (particularly relating to the position of women) that it should serve as a warning about the importance of critical thinking about the interpretation of scientific evidence. Finally, the advent of the instrumentalization of music in warfare and interrogation arguably requires not a just scientific but a moral and political response.

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