Miller's The Body in Question

And still they gazed, and still the wonder grew

That one small head could carry all he knew.

The astonishment of Goldsmith's rustics gathered round the village parson could not exceed that of today's global villager gazing on the television image of Johnathan Miller's talking head. For very few heads can ever have been so thoroughly and variously charged as Miller's. A doctor of medicine, specially qualified in the history and philosophy of that discipline; co-author and performer in the funniest English revue of the century, Beyond the Fringe, and closely connected with the television satires of the early Sixties; witty journalist and essayist; lecturer of genius who can hold (this writer can testify) an audience spellbound for two hours while disdaining all use of notes; brilliantly innovative producer of Shakespeare whose version of The Merchant of Venice transposed to Edwardian England was a tour de force; author of a standard critical book on Marshall McLuhan; producer of Mozartian opera while simultaneously a science research fellow at London University, etc, etc: even the briefest resume of Miller's career makes him sound like some atrocious Wunderkind. Yet he has truly covered all this ground, and his successes have been marked enough to set the rancorous critics snapping at his heels. Just as Kenneth Clark's lectures on art history earnt him Private Eye's sobriquet "Lord Clark of Civilisation" so Miller has been dismissed as television's Boy Guru, not least because of his cheerful and unapologetic scientism.

Is he really a colossus triumphantly bestriding the widening chasm between the arts and sciences, or is he essentially a publicist lightweight whose gifts have been spread widely but thinly? Miller is probably about midway through his career. The publication of this book, a pop history of human physiology based on BBC-TV's three-part series to be shown here early this year, supplies us with a convenient opportunity to take stock, to gain a little perspective on his characteristic virtues and vices. Whatever the final judgement, his reputation as one of the liveliest intelligences of his generation is secure.

The virtues are manifold, and they find happy expression in such a work as this, an exercise in 'high vulgarisation' as the expressive if rather equivocal French phrase has it. One often hears it said, somewhat too readily, that given a sufficiently talented teacher every subject, no matter how recondite, can be offered at even the most popular level and yet retain academic decency. Notoriously the history of science - any science - has proven an exception to this; any such history, that is to say, which aspires to move past the familiar lists of names and dates of discovery into the much more difficult terrain of why a certain discovery was made in that time and place by that man. Miller does not flinch from this task.

His history is as much speculative as descriptive. The stringent reader will find this just as well, for the various chapters on the blood, the heart-lung system, immunology, heredity, and so on, while not exactly what every schoolboy knows, are unlikely to add much to the stock of knowledge of anyone who will pick it up in the first place.

The value of the book lies rather in its very frequent musings on the nature of creativity in science, and its odd asides. Miller's rare and distinctive gift as a teacher is that, though he simplifies, he never, ever patronises. He has perfected to a fine art the technique of not lecturing; of instead tactfully pretending to remind the reader of facts 'temporarily' forgotten, of intra-cultural connections that we might (almost) have thought of for ourselves.

Take for example Miller's chapter on cardiac physiology, which sets itself to tracing the history of the notion of the heart as a pump. To Galen living in the second century, no less than to Harvey in the sixteenth, any explanation of what the pulsing heard did invited - positively demanded - a technological metaphor. Galen was obliged to take his metaphor from the crafts of smelting and brewing. His theory of the heart's action therefore stresses conversion and purification of 'the spirits' and this in turn governed his observations, for it demanded the free passage of blood between the ventricles through pores which a careful probing would have revealed were not there. A millennium later Harvey was born into a world where deep mines requiring constant drainage were first being developed. Pumps lay all about him in infancy and childhood. Ergo.... This is a fair sampling of Miller's reasoning. He bounces us from the heart to mining engineering and back again with such panache that the suspicion grows that what really stimulates him is this almost Metaphysical yoking of ideas together by force, and not so much the inherent plausibility of explanation. Hardly a pause is taken to inquire whether, as a matter of brute mundane biography, Harvey ever saw a mine or was so signally impressed by its spouting machinery.

Any weakening link in the chain of argument is at once solidly welded up by a large print of a contemporary fire engine, the sort that Harvey might have, or ought to have, seen. Such is the buttressing role of the lavish and magnificent illustrations in this volume. By and large they have been chosen with commendable skill: whole libraries of painting, of anatomical drawing, must have been ransacked to accompany the text. Though usually highly supportive of it, or even indispensable to it as in the above case, occasionally they prove treacherous. For they are plentiful enough to underline nearly every paragraph, and for a writer who has a tendency to bludgeon a point into jelly the result can be unfortunate. That a pot or carving 'realises an idea which must be held before the mind's eye' is an unexceptionable remark but hardly profound. We are not inclined to linger over it. But we have no choice: the sentiment is surrounded by a whole page of photography of hands moulding and chiselling.

Yet Miller is also capable of an enviable concreteness and appositeness. Speaking of the inadequacies of a certain anatomical theory, he says that 'even when the theory has become an intellectual slum, perilously propped and patched, the community will not abandon the condemned premises'. This is florid writing, to be sure; it is even a little crass. A philosopher of science would wince. But it's vivid and it's memorable. For the vast audience for whom the invocation of Kuhnian paradigms would perplex and bore, it makes a point lightly and gracefully. The worst one can say of it is that it presents a problematic theory about scientific revolutions as an indisputable fact - surely one of the more venial sins in popular writing? Every great educator (and Miller is certainly that) needs something of the showman in his nature; even, perhaps, a little bit of the mountebank, so these are minor vexations, more than compensated for by Miller's zest and good-humoured intelligence.

More jarring, because it forms a strong undercurrent of assumption running right through the book and yet never dragged into the light for examination, is Miller's somewhat Whiggish 'goodies and baddies' version of the history of medicine. For him the theme of that history over the last four or five centuries is 'Excelsior!' - the forces of light, as represented by Harvey in anatomy, Mendel in genetics, Sherrington in neurology, have come to triumph over and to completely rout the sullen obscurantism of superstition and fraud. Now in itself this is not an unsympathetic emphasis. Coldly rational scepticism and reductivism in the medical arts has done more for mankind, on balance, than the same methodology applied to some other sciences - psychology, for example. Indeed, a statistical majority of us owe our lives to it and probably no small part of our happiness.

Who could possibly calculate how much money has been gulled from the credulous over the centuries - not from the greedy, but from the desperate, the pathetic, the excruciated - by cancer-cure artists, snake oil merchants and other saltimbanques? Miller's unspoken assurance that we would do better to place our shrinking flesh into the hands of a skeptical rationalist than of the greatest True Enthusiast ever born is hardly questionable. But where Miller's bright and unreflective optimism grates a little is over his unwillingness to notice, let alone investigate, the somewhat unpalatable fact that the extreme fringe medicine or even the decried nonsense of one generation speedily becomes the perfect orthodoxy of the next, complete with theoretical superstructure to make it respectable. The quack remedy of slapping on to an open wound some nauseous fungoid mould becomes in due course the establishment's antibiotic salve.

It is for this reason somewhat disquieting to find Anton Mesmer and Dr John Elliotson dismissed out of hand as the agents of darkness: pure charlatans of hypnosis. Perhaps Mesmer's cures were almost wholly psychosomatic - argument is still active about that, and he certainly did trick out his undoubted hypnotic talents with much mumbo-jumbo - but about Elliotson the truth is much more interesting and puzzling. Working in the 1830s, in the good old days of septic surgery without anaesthesia when the immediate post-operative mortality from shock and infection averaged 23% in the public hospital wards, it is agreed even by his critics that Elliotson reduced this among his hypnotised patients to less than 6%. How could this be? He did not know: we still do not know now, except that it has become clearer in the interim that the relationship between the will and the body's power against infection and stress is very much more complex and mysterious than nineteenth-century medicine could grasp. In this respect Miller writes as the natural heir to the tradition of T.H. Huxley and Tyndall.

To take up another of his obvious betes noires, how can people with a few needles stuck into unlikely places endure abdominal surgery, as the Chinese have demonstrated? Certainly not by lying back and thinking of Mao. Acupuncture, like hypnosis, is an unfortunate reality; unfortunate and discomfiting, because the acupuncturist's map of the nervous system has not the slightest point of contact with the most basic data of Western physiology. But we will look in vain for Miller's energetic grappling with this system of treatment with at least four millennia of development behind it. There is no mention of recent work attempting to chart the pressure points electrically. Acupuncture goes straight on to the junk-heap of scientific history: it is 'an hypothetical system which has no independent evidence in favour of it.' Not for the first time in reading Miller we are reminded of the legendary engineer who proved that the bumble-bee contravenes all the laws of aeronautics and therefore cannot fly.

A brief coda: it has to be mentioned that for such a luxurious and expensive production The Body in Question has a number of basic errors which should have been edited out. One of Miller's elaborate analogies, comparing the reactions of the nervous system with driving a car, is thrown into confusion by his misapprehension about which foot works the clutch. There is a certain mildly malicious pleasure in finding that even this polymathic Homer can occasionally nod.

***