Court Physician Research Articles

Hysteria and the Court Physician in Enlightenment France

Of the many reasons why hysteria exerts such great fascination over historians, none is more compelling than the fact that hysteria seems to come and go with changing cultural tempers. Although hysteria was once thought to be one of the most stable of disease entities, recent historical work has made clear that attention to, or even recognition of, hysteria has been far from constant. Michael Micale devoted a good section of his 1995 survey of the vast literature of hysteria to a construct he entitled "New Hysteria Studies"--the outpouring of work on hysteria by historians, psychotherapists, and cultural commentators of the last twenty-five to thirty years. 1 A similar construct might have been devised by a historian writing circa 1800, for between 1756 and the outbreak of the French Revolution in 1789, a cluster of works appeared that constituted a kind of "New Hysteria Studies" of Enlightenment medicine. 2 Some of these works focused directly on hysterical maladies, while others--nosologies and treatises on the physiology of sensibility--were more general in nature yet offered important discussions of the subject.

Wissenschaft, Medizin und Öffentlichkeit—Bemerkungen zu ihrem Wandel im 18. Jahrhundert

How did academic medicine come to dominate scientific and medical opinions in local public spheres far away from universities? This contribution—based mainly on material from Lubeck journals and printed books—deals with the transformation of the public sphere in eighteenth century. A closer look at publication strategies and carrers of physicians shows that the new forms of self-empowerment provided by the “Habermasian” public sphere could only prove successful because they ran together with traditional forms of representation such as titles and official posts. Local journals, books, instruments, and reputation could then provide “scientific capital” to be transformed into the “symbolic capital” of grades, titles and posts; which was in turn convertible into the “economic capital” of remunitions from patients or annual awards as town-, state- or court physicians. At the beginning of the nineteenth century professional organisation proved a still greater source of power than the individual strategies that had been developped before.

The Physician in Court: A View from the Bench

only lawyers and judges—and not even all of them—look forward to being in court. For the physician it is usually not an experience sought or savoured. Yet some physicians are in court more frequently than some lawyers because they are expert witnesses or because they have treated a person who is before the court in a civil or criminal case. There is also the physician who is sued and is thus a defendant. I believe it important that physicians know the basic ingredients of a civil action. I will be drawing on my experience as a trial judge for eight years and an Alberta Court of Appeal judge for five, and as a former professor in the faculties of law and medicine at the University of Alberta, to present the perspective from the bench on civil non-jury actions.

Aristotle: Form, function, and comparative anatomy

Aristotle: Form, function, and comparative anatomy

David Hume and the Danish Debate about Freedom of the Press in the 1770s

David Hume and the Danish Debate about Freedom of the Press in the 1770s John Christian Laursen When the reception history of David Hume’s political writings is written, there will have to be some discussion of their fate in “peripheral” countries like Denmark. Hume’s “Of Liberty of the Press” was translated into Danish as early as 1771. It is not widely known that Denmark was the first country officially to declare freedom of the press and that a lively debate broke out once such freedom was declared. Hume’s essay was put to work in that debate. The story of this translation provides insights into the influence of Hume’s ideas in peripheral countries in Europe, and of Denmark in continental European ideas. Among other things, here we have an example of Hume’s work used in a concrete propaganda battle. The Danish translation of Hume’s essay was published as the last of three supplemental essays in a 31-page pamphlet entitled Mr. F. A. de Voltaire’s Letter to His Majesty the King of Denmark concerning freedom of the press in his states, together with some essays of relevant content. 1 A copy can be found at the Royal Library in Copenhagen in volume twenty of the forty-five bound volumes of pamphlets and booklets from 1770 to 1773 which make up Luxdorph’s Collection of Press Freedom Writings. 2 These pamphlets, in German, French, and (mostly) Danish, were collected at the time by Bolle Willum Luxdorph, a Danish man of letters and court counselor. [End Page 167] The occasion for Voltaire’s letter and our pamphlet was King Christian VII’s declaration of freedom of the press in his territories (the Kingdoms of Norway and Denmark and the Duchy of Schleswig-Holstein) on 4 September 1770. It was in the form of a Cabinet Order to his Danish Chancellery, in the following words: We are fully convinced that it is as harmful to the impartial search for truth as it is to the discovery of obsolete errors and prejudices, if upright patriots, zealous for the common good and what is genuinely best for their fellow citizens, because they are frightened by reputation, orders, and preconceived opinions, are hindered from being free to write according to their insight, conscience, and conviction, attacking abuses and uncovering prejudices. And thus in this regard, after ripe consideration, we have decided to permit in our kingdoms and lands in general an unlimited freedom of the press of such a form, that from now on no one shall be required and obliged to submit books and writings that he wants to bring to the press to the previously required censorship and approval, and thus to submit them to the control of those who have undertaken the business until now of inspecting them; so have we graciously revealed and made known this our will concerning our kingdoms to our Danish Chancellery. Given at Friedrichsberg, the 4 September 1770. Christian. 3 The foregoing cabinet order was largely the idea of Johann Friedrich Struensee, court physician and soon to be Prime Minister for Christian VII. 4 Less than ten years earlier, two periodicals he was involved with when he lived in Danish Altona had been suppressed, 5 and when he came to power by a series of accidents, one of his first acts was to arrange for the king to declare freedom of the press. [End Page 168] Response to this declaration was immediate. In Denmark it led to a flurry of pamphlets on a myriad of topics, including the high cost of living and the salaries of ministers, 6 monopolies and trade issues (vol. III), coinage (vol. IV), civil servants, the public debt, the agricultural economy (vol. V), the abolition of tenant farmers’ work obligations (vol. VI), the Iceland trade (vol. VII), marriage law, breweries (vol. VIII), banks, lotteries (vol. IX), soldiers’ and sailors’ pay (vol. X), the Norwegian economy (vol. XI), the universities and academies (vol. XII), the power of women (vol. XIII), irreligion and impiety (vol. XIV), prophecies of doom (vol. XV), fables, allegories and libels (vols. XVI–XVIII), and the eternity of hell (vol. XIX). Many pamphlets discussed press freedom...

Giuseppe Cervi, Guillaume Jacobe y las relaciones entre la "Regia Sociedad de Medicina y demás Ciencias de Sevilla" y la "Royal Society of London" en 1736

The eighteenth century was the century of scientific institutions. Spain did not remain apart from this process, and among the earliest institutions was the Regia Sociedad de Medicina y demas Ciencias de Sevilla, which, although founded at the beginning of the century, really came into its own in the decade of the thirties. In this reappearance of the Sevillian Society Giuseppe Cervi, first court physician to Felipe V and one of the most relevant personages of the Spanish medical panorama of the era, played a key role. This article aims to study the circumstances that surrounded the election of Cervi as a member of the Royal Society of London--thanks to the efforts by the French physician Guillaume Jacobe, hired by the Regia Sociedad, undertaken during a stay in Paris in 1735. The career of this physician and his services to the Spanish medical institution are also further examined.

Die Promotionsarbeit des Joseph von Quarin als Spiegel des Standes der medizinischen Entomologie in der Mitte des 18. Jahrhunderts

Joseph von Quarin (1733-1814), court physician to the Emperor of Austria at the end of the 18th century, had studied medicine in Vienna and Freiburg im Breisgau. His Freiburg doctoral dissertation is still of great interest today. In a first chapter it defines the term <insect>, in a second it describes diseases insects can cause, and a final chapter discusses medical uses of insects. Quarin tried to unite traditional knowledge with new findings. His brief work is a survey of the knowledge of medical entomology in his time.

The view from Washington: an emergency physician in NHTSA's court.

The view from Washington: an emergency physician in NHTSA's court.

A 'misplaced chapter' in the history of photosynthesis research; the second publication (1796) on plant processes by Dr Jan Ingen-Housz, MD, discoverer of photosynthesis

In 1779, the Dutch physician Jan Ingen-Housz (1730–1799) obtained a leave-of-absence from his post as Court Physician to Empress Maria Theresa of Austria in order to do research (in England) on plants during the summer months. He performed more than 500 experiments, and described the results in his exceptional book Experiments Upon Vegetables (1779). In addition to proving the requirement for light in photosynthesis, Ingen-Housz established that leaves were the primary sites of the photosynthetic process. Later, Ingen- Housz published research papers on various subjects but aside from his 1779 book, he published only one more communication on photosynthesis and plant physiology. This was entitled 'An Essay on the Food of Plants and the Renovation of Soils'. The essay was published in 1796 as an appendix to an obscure British government report, which is rare and virtually unknown. The present paper describes the 1796 essay, which is particularly interesting in that it shows how Ingen-Housz's concepts were modified by new interpretations of chemical phenomena described in Lavoisier's great and revolutionary book Traité Élémentaire de Chimie (1789). Ingen-Housz not only discovered photosynthesis, but plant respiration as well, and the 1796 essay is testimony to his remarkable insights.

Andreas Vesalius

Andreas Vesalius was born in Brussels on December 31, 1514. After having spent some disappointing years at the Universities of Louvain and Paris, he graduated as Doctor of Medicine in Padua on December 5, 1537. The next day he was appointed as a teacher of both human anatomy and surgery. During the 6 years he held this chair, Vesalius engaged in impressive academic activities and published three masterly anatomic books: Tabulae Anatomicae Sex, De Humani Corporis Fabrica Libri Septem, and Epitome. The last two works contain anatomic woodcuts of incomparable artistic quality by Titian's pupils (by Stefan v. Calcar in particular). In 1544, at the age of 28, Vesalius gave up his chair and took up service as a court physician, first with Emperor Charles V and later with his son, Philip II of Spain. He died in 1564 on the small Greek island of Zante on return from a pilgrimage to the Holy Land. The gist of Vesalius' teaching was his conviction that valid anatomic knowledge could be gained only through dissection of the human corpse and not through the study of the traditional texts. Vesalius rid the study of human anatomy of mythic speculations, which had encrusted it for two millennia. Through Vesalius' work, human anatomy became an empirical science. Like Copernicus, Kepler, Bruno, and Galileo, Vesalius was one of the initiators of the new science. The tables of osteology and of the spine in Fabrica and Epitome are most impressive. Much of the nomenclature used for the spine today can be credited to him.

MOZART'S GOOD FRIEND DR LAUGIER

IN SEPTEMBER 1767 the Mozart family paid a visit to Vienna with a view to Wolfgang's taking part in the celebrations for the forthcoming marriage of the Empress Maria Theresa's daughter, Archduchess Maria Josepha, to King Ferdinand of Naples. On 17 October, a month or so after their arrival, Leopold Mozart wrote a letter to his friend and landlord Lorenz Hagenauer in which he refers to their seeing a good deal of a certain M. De L'Augier. However, it was not long before Leopold was horrified to find that a smallpox epidemic was raging in the city, to which the seventeen-year-old archduchess succumbed. Terrified for the lives of his children, Leopold says that he and Wolfgang left their lodgings and took refuge with someone he calls 'my good friend', who strongly advised that the whole family should remove themselves from Vienna immediately. There is reason to believe that the 'good friend' was M. De L'Augier.1 In his letters Leopold subsequently makes several enigmatic references to M. De L'Augier, but without explaining the identity of this clearly influential figure, who became involved in the young Mozart's musical career. In fact, he was Dr Alexandre-Louis Laugier (1719-74), a physician to the imperial court; a study of his life is therefore worthy of interest. We know little about Laugier's early years, but it is known that he was the son of an apothecary in Nancy and studied medicine at the University of Leiden, which boasted one of the most famous medical schools in Europe.2 He then went to Vienna, where he established himself as a doctor and rose rapidly in his profession; he became imperial court physician probably at the invitation of Gerhard van Swieten, personal physician to the empress, founder of the university's medical school and himself a product of Leiden. It is known that in 1749 Alexandre-Louis strongly supported the move of his younger brother, Dr Francois Robert Laugier (1722-93), to Vienna to take up the newly created chair of Botany and Chemistry at the university. The appointment proved to be disastrous, however, because the younger Laugier later quarrelled with his immediate superior, van Swieten, who reported that he was incompetent in his two subjects, ignorant of Latin and, moreover, indolent. In 1768 Francois Robert was dismissed from his post without a pension.3 In contrast, his elder brother retained the confidence of the royal family, was greatly sought after as a physician, and became a most influential figure in Viennese society.

ヨセフ・ナスィ

The Nasi family of Marranos (crypt-Jews) expanded its commercial activities not only in the Ottoman Empire but also in the Mediterranean world and Eastern and Western Europe during and after the Christian persecution. The Nasi family was led by Donna Gracia and her nephew and son-in-law, Don Joseph Nasi: the former claimed to have returned to Judaism during her refuge in Ferrara, but the latter returned to Judaism after his immigration to the Ottoman Empire.Joseph took advantage of various ways to develop his economic, political and communal activities. For example, the Nasi family set up its close relationship with the Ottoman court through the Jewish court physicians, especially Moshe Hamon, when they immigrated to Istanbul in the first half of the 1550s. Their economic success owed to commercial and intelligence networks, and to many other factors and agents, that they had inherited from the Mendes family.The Ottoman archives and Rabbinical Responsa show evidence of Joseph's aggressive attitude and of his commercial and intelligence networks at three points.The first was the Ancona Boycott, when Joseph attempted to take advantage of his Jewish faith and use Sephardic Rabbis as his propagandists. His ends were to spread his leadership over many independent Jewish communities, to improve the heretic status of Marranos, and to monopolize Mediterranean trades.The second point was the rebuilding of Tiberias. Gracia rebuilt the old Palestinian city mainly for her own pious motives, but Joseph seized on her plan as a good opportunity to extensively develop his economic activities. At the same time, this plan involved Jewish court physicians as Joseph's messengers to the Ottoman court.The last point was Joseph's friendship with Selim II, the eleventh Ottoman Sultan. The Sultan awarded him the “Dukalik: similar to the authorities of Sancakbeyi” of Naxos and Cyclades which gave him a uinque political status as well as commercial privileges in domestic and foreign trade.The conclusion must be drawn that Joseph Nasi was not a Jewish hero who had the character of a proto-Zionist, but a realistic businessman who gave precedence to his profits over his Jewish faith.

T. S. Eliot's Head and Heart

T. S. Eliot’s Head and Heart John Gordon “But I think if you are anaemic, as Tom is, there is glory in blood.” — Virginia Woolf, Diary 1 Historians of science have long observed that in demonstrating the circulation of the blood William Harvey was advancing what today would be called a paradigm, one of long-established authority. Harvey was an Aristotelian and royalist, in fact court physician to Charles I, to whom, calling him “the Heart of his Commonwealth,” he dedicated the 1628 treatise announcing his discovery. 2 It fit into Harvey’s sense of things that in its organization the body should be symmetrical, cyclical, and centered on the organ referred to in that treatise as the body’s “sovereign, the heart.” 3 Over three hundred years later, such a paradigm fit as well into the beleaguered royalism and classicism of T. S. Eliot, as he gave Harvey’s doctrine its most distinguished poetic expression: 4 Garlic and sapphires in the mud Clot the bedded axle-tree. The trilling wire in the blood Sings below inveterate scars And reconciles forgotten wars. The dance along the artery The circulation of the lymph Are figured in the drift of stars Ascend to summer in the tree We move above the moving tree In light upon the figured leaf And hear upon the sodden floor Below, the boarhound and the boar Pursue their pattern as before But reconciled among the stars. 5 Eliot was of course aware that such a paradigm had come to seem outmoded, an awareness signaled by the fact that this passage occurs in the division of “Burnt Norton” that in all four of the Four Quartets is deliberately written in what “East Coker” calls a “worn-out poetical fashion” (125). In fact, when Harvey’s monarch does make an appearance in Four Quartets, it is not in triumph, and certainly not as the vital [End Page 979] center of anything any longer of importance, but as the “broken king” (a phrase perhaps owing something to “broken heart”) whose memory helps sanctify the long-abandoned retreat where the narrator seeks to recover communion with that sense of harmony, of “the complete consort dancing together,” first sounded in the “Burnt Norton” passage. This communion is worn-out too, its realization thwarted on all sides by the modern world, as epitomized in “Little Gidding” by Eliot’s expression for the German bomber, “the dark dove with the flickering tongue” (140). That word “flicker” has appeared before, in “Burnt Norton,” when the evocation of Harveyian circularity is counterpointed by a descent into the subway’s “place of disaffection” lit by the “flicker” of an electric bulb. The subway passage, with its familiar blankness and sterility, reads like a transplant from The Waste Land, and in fact to a considerable extent it is just that, a transplant from one kind of organism into another, each with its own distinctive physiology. Seen from the vantage of the latter, The Waste Land and Four Quartets enact a classic opposition between head and heart, re-cast in the light of medical science as an opposition between brain and nervous system and heart and blood; between the flickering and the circulating; between what the doctors of Eliot’s youth had discovered about the way we work and what King Charles’s doctor had discovered; between a modern age of nerves and an older, nobler age of blood. After some initial resistance, medical science following Harvey adopted and extended his account of internal hydrodynamics. The living body was, in the words of one writer, “a hydraulick machine, in which there are numberless tubes properly adjusted and disposed for the conveyance of fluids of different kinds.” 6 This included the nerves, which were also thought to be tubes, transporting some subtle fluid. Failure to confirm this thesis experimentally, however, led to other theories — for a while the vibrating strings of musical instruments supplied the favored analogy — and eventually, around the middle of the eighteenth century, to the explanation that still prevails, that nerves were conductors of electricity. Meanwhile another change was underway which was to make such questions increasingly critical. The development is summed up in Stanley W...

Maimonides: Physician and Nephrologist

Maimonides (Moses ben Maimon) was born in 1135 in Cordoba, the son of a Jewish rabbi. After a seminomadic upbringing in Spain and North Africa during the rule of the Almohades, Maimonides settled in Fostate (Old Cairo), where he became renowned as a physician, eventually being appointed as court physician to Saladin and his son. Maimonides wrote both religious and medical treatises, the latter including the Medical Aphorisms of Moses in which he deals with almost all aspects of health and disease. His aphorisms on urine and the kidney were influenced by Galen, to whose contributions he added new dimensions. His aphorisms dealt with a variety of renal diseases recognized today.

Medicine in Tibet

Traditional medicine has been practiced in Tibet since the seventh century A.D., with the first hospital built at Melung in southeast Tibet between 708-833 A.D. Medical clinics were formed in the large monasteries, and the first medical college was built on the Chakpori (Iron Hill) in 1696 opposite the Potala in Lhasa. In 1916, the Mendzekhang (House of Medicine and Astronomy) was constructed near the Jhokang and remains the main centre for teaching traditional medicine in Tibet. Western medicine, introduced by the Chinese, is practiced in regional hospitals and by teams of traveling doctors which visit remote areas. High altitude studies are centered at the High Altitude Medical Research Institute in Xining and the Institute of Medical Science in Lhasa, whilst groups from the Academia Sinica Institute of Physiology in Shanghai have carried out fundamental work in association with Chinese expeditions to Tibet. Medicine in Tibet has followed traditional and western paths. Traditional medicine is closely linked to Buddhism, and contains many elements of the traditional medicine of India, whilst Chinese medicine has also had a considerable influence [1,2]. In the seventh century A.D., the Queen of Tibet, a Chinese Princess, brought with her from China to Lhasa a medical text. Three doctors, from India, China, and Persia, were invited to the court of the King of Tibet to translate the book into Tibetan. After the completion of their individual translations, a final version was agreed upon and named 'the weapon of the fearless one'. The final version consisted of seven chapters and became the standard medical text which was presented to the king. The Indian and Chinese doctors left Lhasa, but the Persian physician, Dr Galenos (either a Persian translation or pen name adopted by the doctor) remained and became Court Physician. He settled in Lhasa and had three sons, each of whom became a physician. The eldest was sent to the province of Tsang, whose capital is Shigatse, the middl.e one to south Tibet, and the youngest remained with his father in Lhasa. Each continued to practice medicine, as did an increasing number of Tibetans. Over the years, other medical texts were written and a code of conduct evolved, with one Court Physician, Champashila, acting as Regent of Tibet for a period. By the eighth century, an increasing number of non-Tibetan medical texts were being used, and doctors from different countries were again invited to Lhasa to produce individual translations. They came from India, Kashmir, China, Persia, Guze, Dolpo and Nepal, and their final work was used as the basis for training Tibetan doctors. Emphasis was placed on medicine. Except for minor procedures, surgery was banished following the death of the mother of one of Tibet's kings after an operation to lessen a 'water swelling' around the heart. It was during this period that Tibet had an outstanding physician, Yutok Yontan Gonpo, now considered to be the founder of traditional Tibe­ tan medicine.

Policing the health of London: the College of Physicians and the early Stuart monarchy.

While histories of public health sugggest that government intervention British is a product of the later nineteenth country, the work of George Rosen suggested that interventionist policies on behalf of the public good are to be associated with particular political outlooks. He pointed to the connection between ?absolutism? and medical police in Europe as the foundation for later public-health policies. with Rosen?s ideas in mind, we can see that under the early Stuarts there was indeed a growing association between government policy and medical police. While early Stuart medical police developed from ad hoc measures rather than a conscious programme, it was nevertheless premised upon principle of positive sovereignty on behalf of the public good that lay at the root of Stuary ideology. Working through the court physicians,(especially Theodore Turquet de Mayerne) and the London Copllege of Physicians, the monarchy supported or created policies to regulate medical practitioners and corporations, medicines and practices, and to help insitute plans for London to prevent or ameliorate plague eoidemics that helped stimulate plans for the New Incorporation. When opposition to monatchial polices took force in the early 1640s, measures for medical police were one of the grivances against the crown, and they were ended, not to be institured again until the nineteenth century.

THE FIRST JOURNAL DEVOTED EXCLUSIVELY TO PEDIATRICS (1834)

The first pediatric journal ever published appeared in 1834 and was known as the Analekten über Kinderkrankheiten; it was published in Stuttgart and lasted for only three years. During its short life this journal contained several notable articles which could stifi be read with interest by present-day pediatricians. Among the authors whose articles were published were: C. W. Hufeland (1762-1836), Court physician at Weimar and author of one of the most popular books of its time on personal hygiene, published in 1797; J. B. Bouillard (1796-1881), who in 1835 was the first to demonstrate the frequency and importance of heart disease coincident with acute articular rheumatism; and P. DuBois (1795-1871), who published the first detailed description of hyperemesis gravidarum in 1852.

The Physician in Court

To the Editor. —The average, sophisticated, informed, and well-educated hospitalized patient is usually familiar with his illness, including not only its signs and symptoms but also the reason for each diagnostic test, the rationale for therapeutic measures being used, and the prognosis of the disease. Physicians today are morally obligated and legally required to obtain informed consent from their patients for diagnostic procedures and planned therapeutic interventions. Nevertheless, many an acutely ill patient admitted to the hospital is anxious and nervous, tense, and frightened of the milieu where acute medical care is being rendered. Bottles hanging from intravenous stands with unknown solutions entering the patient's veins, the hiss of oxygen flowing by mask or nasal catheter into the patient's lungs, the beep-beep of the monitor attached to the patient's chest, the repeated measurement of pulse rate, blood pressure, temperature, and respirations, and the low murmuring of the physicians, nurses, and

Legal Implications of Patient Records

Significant changes have been made by the courts and legislatures on the rights of patients to review or acquire their own medical records. There are great dangers in writing any personal, unscientific comments into the record which could embarrass the physician in court. Attempts to prevent the patient from gaining access to his record is fraught with grave consequences.

Could Body-bound Immortality be Liveable?

Could body-bound immortality be liveable? I should like to approach this question via consideration and criticism of some arguments put forward by Professor Bernard Williams in his essay 'The Makropulos case'.' Williams distinguishes between two quite different types of immortality. These we may call body-bound immortality (BBI) and bodyindependent immortality (BII). As we might expect, someone enjoying BBI could do so only in a body of flesh and blood and bone; but it might be a moot point as to how far his body at any point during his immortal existence would have to be continuous with the body he was born with. Also, someone enjoying BII might hope to explore avenues of existence not open to the BBI case. But this, in Williams' view, would not be sufficient to make the BII case tolerable, even if we could accept that the BII case could qualify as a person, which he doubts. Williams argues that it is a Good Thing that we are not immortal, regardless of whether we favour BBI or BII. He also appears to take the more extreme view that it is virtually a necessary truth that immortality could not be enjoyed by a person. I shall suggest that his arguments are uncharacteristically weak, and that the elaboration of two simple distinctions can help to make the prospect of BBI more appealing than Williams allows. Williams illustrates the possibility of BBI by the case of EM, following a play by Karel Capek. EM's father, the court physician to a sixteenth century emperor, tried out on her an elixir of life. 'At the time of the action she is aged 342. Her unending life has come to a state of boredom, indifference and coldness. Everything is joyless: the end it is the same, she says, singing and silence. She refuses to take the elixir again; she dies; and the formula is deliberately destroyed by a young woman among the protests of some older men' (p. 82). The case of EM, Williams suggests, constitutes a strong (if fictional) argument in favour of the view that BBI could not be tolerable. Nevertheless, he admits, it is possible for someone to object that EM may have laboured under some contingent limitations (social, psychological, etc.) which might not be suffered by more fortunate and sanguine souls. But, against this possible objection, Williams argues that 'the supposed contingencies are not really contingencies; that an endless life would be a meaningless one; and that we could have no reason for living eternally a human life. There is no desirable or significant property which life would have more of, or have more unqualifiedly, if we lasted for ever' (p. 89). I In his book Problems of the Self (Cambridge University Press, I973), p. 82 ff. All page references are to this book.