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Should the healthy elderly be taking daily aspirin?

It has become quite fashionable for healthy people to take low-dose aspirin daily to reduce the risk of heart attack and stroke (primary prevention) , although most of the evidence on which this is based comes from trials in people who have already suffered from cardiovascular disease (secondary prevention). It's not clear if the possible benefit outweighs the risk of bleeding for those who are healthy.

A new paper in the New England Journal of Medicine looks at the question in relation to older people (those over 70). The use of low-dose (100mg) enteric-coated aspirin over a median 4.7 year period did not prolong disability-free survival in this group. There was an increased incidence of serious bleeding in those taking aspirin (DOI: 10.1056/NEJMoa1800722).

Book review: Ludwig Wittgenstein, by Ray Monk

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Monk tells us in his introduction that people interested in Wittgenstein fall into two groups. Professional philosophers generally study his work without reference to his life, while the many readers who are fascinated by his life and personality find his philosophy unintelligible. Monk's aim is to bridge the gap between his life and his work and to show 'the unity of his philosophical concerns with his emotional and spiritual life'.

To accomplish this, he needed both to present a full account of the man and also to explain the main ideas of his philosophy. I should say he succeeds admirably in the first aim; as for the second, his success is perhaps only partial, but that was probably inevitable, because the difficulty of Wittgenstein's philosophy is different in kind from what is the case with most philosophers. The particular value of Monk's book is that he explains exactly where this difficulty lies. In fact, it has at least two roots.

First, philosophers' writing may be difficult either because they express themselves obscurely or because their ideas are intrinsically difficult to understand. Wittgenstein's difficulty is not exactly from either of these causes. He expresses himself very clearly, often in quite short sentences that are, in a sense, easy to understand; but he nearly always leaves you without the reference points you would expect. In particular, he completely refuses to announce any general conclusions, and this makes it hard to see the point of his remarks. 'As he himself once explained at the beginning of a series of lectures: "What we say will be easy but to know why we say it will be very difficult."'_(p.338)

Many non-professional readers probably get no further than dipping into the Tractatus, which is Wittgenstein's first published work and the only one to appear in his lifetime. It largely achieved its final form when Wittgenstein was a prisoner-of-war of the Italians at the end of the First World War. I found Monk's short paragraph describing this work to be illuminating (p.155).

In its final form, the book is a formidably compressed distillation of the work Wittgenstein had written since he first came to Cambridge in 1911. The remarks in it, selected from a series of perhaps seven manuscript volumes, are numbered to establish a hierarchy in which, say, remark 2.151 is an elaboration of 2.15, which in turn elaborates the point made in remark 2.1, and so on. Very few of the remarks are justified with an argument; each proposition is put forward, as Russell once put it, 'as if it were a Czar's ukase'. … [The propositions] are all allotted a place within the crystalline structure, and are each stated with the kind of finality that suggests they are all part of the same incontrovertible truth.

This exemplifies the difficulty described above. But there is a second kind of difficulty as well. To understand Wittgenstein seems to require a kind of moral seriousness on the part of the reader, particular in the case of his later work, the Philosophical Investigations, published posthumously.

Philosophical Investigations—more, perhaps, then any other philosophical classic—makes demands, not just on the reader's intelligence, but on his involvement. Other great philosophers' works—Schopenhauer's World and Representation, say—can be read with interest and entertainment by someone who 'wants to know what Schopenhauer said'. But if Philosophical Investigations is read in this spirit it will very quickly become boring and a chore to read, not because it is intellectually difficult but because it will be practically impossible to gather what Wittgenstein is 'saying'. For in truth he is not saying anything; he is presenting a technique for the unravelling of confusions. Unless these are your confusions the book will be of very little interest. (p.366)

Given this, there may be a temptation to wonder whether Wittgenstein's importance as a philosopher has been overstated. But this idea is hard to sustain in view of the impact that his ideas have had.

By 1939 he was recognised as the foremost philosophical genius of his time. 'To refuse the chair [of philosophy at Cambridge] to Wittgenstein', said C.D. Broad, 'would be like refusing Einstein a chair of physics.' Broad himself was no great admirer of Wittgenstein's work; he was simply stating a fact (p.414).

Long before this, Wittgenstein had had 'a decisive influence on Bertrand Russell's development as a philosopher—chiefly by undermining his faith in his own judgement.' (p.80) Their first encounter occurred in 1911, when Wittgenstein, then a student in aeronautical engineering at Manchester University, arrived unannounced at Russell's rooms in Trinity College, Cambridge. Russell later reported that 'an unknown German appeared, speaking very little English but refusing to speak German. He turned out to be a man who had learned engineering at Charlottenburg, but during this course had acquired, by himself, a passion for the philosophy of mathematics & has now come to Cambridge on purpose to hear me.' (p.38) Russell initially thought him a crank but later decided he was a genius. Looking back on their meeting three years later, Russell described it as 'an event of first-class importance in my life', which had 'affected everything I have done since'. (p.80)

Wittgenstein was at first 'passionately devoted' to Russell but later considered him to be 'not serious', which, for Wittgenstein, was a damning indictment that reflects a profound difference in temperament. Wittgenstein, unlike Russell, was fundamentally religious. As Monk makes abundantly clear, this theme runs through all Wittgenstein's philosophy. It appears as early as the Tractatus, where the concluding remarks are explicitly mystical and the book ends with the famous line: 'Whereof one cannot speak, thereof one must remain silent.' Before reading Monk's book I had been aware of this mystical element, but I hadn't realised the extent to which it pervades practically everything Wittgenstein wrote.

Religion first appears in the account of Wittgenstein's experiences during the First World War, when he volunteered to serve in the Austrian army in order to experience suffering. This, not surprisingly, altered his outlook on life permanently. At one point he came near to suicide (three of his brothers did kill themselves) but was saved by reading the only book he could find in a bookshop he visited: Tolstoy's Gospel in Brief. This brought about a religious conversion, albeit of a special kind.

One might expect that Wittgenstein, as a philosopher, would discuss intellectual arguments for God's existence, but that is something he very definitely rejected. Towards the end of his life he heard a radio discussion between A.J. Ayer and Father Copleston on 'The Existence of God'. His reaction was not what one might have anticipated.

Ayer, Wittgenstein said, 'has something to say but he is incredibly shallow'. Copleston, on the other hand, 'contributed nothing at all to the discussion'. To attempt to justify the beliefs of Christianity with philosophical arguments was entirely to miss the point. (p.543).

For Wittgenstein, religious belief is psychological: 'he does not see it as a question of whether Christianity is true but of whether it offers some help in dealing with an otherwise unbearable and meaningless existence. … And the "it" here is not a "belief" but a practice, a way of living.' (p.122)

Wittgenstein himself puts it like this:

Life can educate one to a belief in God. And experiences too are what bring this about; but I don't mean visions and other forms of experience which show us the 'existence of this being', but, e.g., suffering of various sorts. These neither show us an object, nor do they give rise to conjectures about him. Experiences, thoughts,—life can force this concept on us. (p.572)

Deciding how to live, and feelings of guilt at when he failed to live 'decently', preoccupied Wittgenstein throughout his life. At one point he insisted on making a formal 'Confession' to a number of his acutely embarrassed friends, although there is little information about what he actually confessed. He had a strong tendency to asceticism. As a young man he inherited vast wealth from his father but he gave it all away. He was attracted by the idea of becoming a monk at various times in his life and tried to do so on one occasion, but was told by 'an obviously perceptive Father Superior' that he was unsuited to this. He spent long periods living in semi-isolation in Norway, which no doubt reflects this side of his character.

A friend remarked on Wittgenstein's 'Hebraic' conception of religion, meaning the sense of awe which one feels throughout the Bible (p.540). I can see this, but it also occurs to me that Wittgenstein might have found Buddhism, at least its Theravada form, sympathetic, given its lack of emphasis on belief. So far as I know this didn't occur to him, which is perhaps surprising in view of his fondness for Schopenhauer, who was much attracted to Buddhism.

Although Wittgenstein was nominally a Roman Catholic, since that was his family religion, it seems to have left little trace in him; he was actually quite surprised to be told of the traditional Catholic belief in Transsubstantiation (the doctrine that the Host literally becomes the body and blood of Christ during the Mass). Two of his friends converted to Catholicism and he worried that he might have been partly responsible for this, unwittingly, by encouraging one of them to read Kierkegaard.

He has a brilliant simile to describe the difficulty of sustaining religious beliefs of this kind.

An honest religious thinker is like a tightrope walker. He almost looks as though he were walking on nothing but air. His support is the slenderest imaginable. And yet it really is possible to walk on it. (p.463).

He had the greatest respect for those who could perform this feat but he did not think he could emulate it himself. He also had a lot of respect for primitive magic, of the kind reported by anthropologists from remote parts of the world, saying: 'All religions are wonderful … even those of the most primitive tribes. The ways in which people express their religious feelings differ enormously.'

On the other hand, he had a profound distrust of science and he disliked books of popular science, such as Sir James Jeans's The Mysterious Universe, which he thought inculcated a kind of idol-worship of science and scientists. (I can imagine what he would have said about Richard Dawkins.) A fascinating sidelight on this comes from a series of lectures on mathematics which he gave at Cambridge, with the specific aim of countering the adulation of science. Among those who attended, at least for a time, was Alan Turing, who himself was lecturing on 'The Foundations of Mathematics' at the time. (p.417)

The lectures often developed into a dialogue between Wittgenstein and Turing, with the former attacking and the latter defending the importance of mathematical logic. Indeed, the presence of Turing became so essential to the theme of the discussion that when he announced he would not be attending a certain lecture, Wittgenstein told the class that, therefore, that lecture would have to be 'somewhat parenthetical'. (p.417)

There seems to have been no true meeting of minds between the two participants in these discussions, and ultimately Turing ceased attending.

When told by his doctor that he had only a few days to live, he replied: 'Good'. But his last recorded utterance was: 'Tell them I've had a wonderful life.'

In spite of his rejection of Catholic beliefs, his friends arranged for him to have a Catholic funeral. Monk thinks this may have been appropriate, 'for, in a way that is centrally important but difficult to define, he had lived a devoutly religious life.' (p.591)

%T Ludwig Wittgenstein
%S The Duty of Genius
%A Monk, Ray
%I Vintage
%C London
%G Epub ISBN 97811448112678
%P 582pp
%K biography
%O kindle version, downloaded from 2018

Book review: Beyond Weird, by Philip Ball

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Philip Ball is a science writer who was for many years an editor for physical sciences at the journal Nature. The subtitle indicates what his book is about. It is aimed at readers of books on popular science who have, Ball believes, been given a misleading impression of quantum physics, starting with the notion that it is 'weird', which Ball thinks is a cop-out. It's non-intuitive but not weird. The idea that it is

comes from our (understandably) contorted attempts to find pictures for visualizing it or stories to tell about it. Quantum physics defies intuition, but we do it an injustice by calling that circumstance 'weird'.

Quantum mechanics has the reputation of being probably the most obscure and difficult branches of science, but Ball insists that it isn't 'hard' in the way that car maintenance or learning Chinese are hard (his examples). That isn't to say that a slight readjustment of our intuitions will make everything suddenly explicable. 'Indeed, it is possible that we might never be able to say what quantum theory "means".'

Ball offers new ways of looking at all the hoary old chestnuts of popular accounts of quantum science: the double slit experiment, Schrödinger's cat, entanglement and non-locality (Einstein's 'spooky action at a distance') and the rest. On all these topics he makes one question the ideas one has acquired by reading popular accounts of them previously. His approach is based on work by a number of physicists in the last decade or two.

A central problem we are always told about in books of this kind concerns how the classical world of everyday objects, including us, emerges from the mysterious quantum world. This occurs thanks to something cryptically described as 'collapse of the wave function' Ball seeks to explain this, and much else, in terms of information. Quantum experiments take place within a wider classical environment, and what happens is that 'information gets out of the quantum system and into the macroscopic apparatus'.

There's then no longer any need for an ambiguous and contentious division of the world into the microscopic, where quantum rules, and macroscopic, which is necessarily classical. We can abandon the search for some hypothetical 'Heisenberg cut' where the two worlds impinge. We can see not only that they are a continuum but also why classical physics is just a special case of quantum physics.

On this interpretation there is no need for the radical 'many worlds' solution famously proposed by Hugh Everett III, according to which the world is continually splitting into different branches, in which innumerable copies of each of us continue to pursue different destinies. Ball treats this theory at some length and concludes that it is both unnecessary and unworkable.

Although this is mostly a book about theories, it does contain a quite lengthy discussion of quantum computers. This is included both as an illustration of the practical importance of quantum physics and also because Bell thinks that the questions it raises help to illuminate quantum physics. Perhaps the most striking thing to emerge from this is the fact that no one is entirely sure how these machines actually work. _

Ball is an experienced writer and he treats his subject with a light and often humorous touch, so the book isn't heavy reading even though one has to take it slowly because of the complexity and unfamiliarity of many of the ideas. Ball's usual method of approaching these is a little like a Socratic dialogue. Instead of coming straight out with what he thinks, he proposes possible answers to questions and then shows why they won't do, before offering an alternative; sometimes there are several stages in this process.

I've read a good many popular accounts of quantum theory in the past and had decided that I felt no great inclination to embark on any more. But I made an exception in this case and am glad I did, because I found I was genuinely being given a different way of thinking about the apparent paradoxes that swirl about the subject.

%T Children of Time
%A Tchaikovsky, Adrian
%I Pan Books
%C London
%D 2016
%G ISBN 978-1-4472-7331-8
%P 600pp
%K fiction
%O kindle version downloaded from, 2018

Book review: The Roots of Romanticism, by Isaiah Berlin

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In 1965 Berlin gave a series of six lectures on romanticism at The National Gallery of Art, Washington DC. He spoke with notes but no script. This volume has been edited by Henry Hardy, using transcripts as well as BBC recordings of the lectures, which gives the text an unusual degree of freshness and informality. Berlin had hoped to use the material as the basis for a full-length book but this didn't happen. The title of this compilation was chosen by Hardy.

'Romanticism' is notoriously difficult to define (a bit like 'religion') and Berlin explains at the outset that he isn't going to try. But, whatever it is, it's certainly important.

The importance of romanticism is that it is the largest recent movement to transform the lives and the thought of the Western world. It seems to me to be the greatest single shift in the consciousness of the West that has occurred, and all the other shifts which have occurred in the course of the nineteenth and twentieth centuries appear to me in comparison less important, and at any rate deeply influenced by it (p.1).

Before reading this book I had a vague idea that romanticism originated in England, with poets like Shelley, Keats, Coleridge and Wordsworth, and Berlin agrees that this is what most historians tell us; but he ascribes the primary role to Germany, and the book is mainly although not exclusively concerned with German writers.

Romanticism was a reaction to the values of the Enlightenment, with which France is particularly associated. We think of France in the late eighteenth century as characterised by reason, rejection of religion, and the advance of science—all of which culminated, perhaps unexpectedly, in the turmoil of the Revolution. Germany, meanwhile, was very different. While France was a unified, centralised and powerful state, Germany was split up into hundreds of small principalities and was, in consequence, relatively weak. Huge numbers of Germans had been killed by foreign troops, including those of France, in the Thirty Years War; nothing on this scale had been seen in Europe before. 'The truth about the Germans in the seventeenth and eighteenth centuries is that they constitute a somewhat backward province' (p.34).

There was also a class division between Germany and France, Most of the prominent German writers—Lessing, Kant, Herder, Schelling, Schiller, Hölderlin—were lower middle-class, whereas nearly all the French radicals were upper-class, and many from the nobility. Hence a social chasm existed between the German intellectuals and the French; when Herder came to Paris in the 1770s he was unable to meet any of the French cultural elite.

Against this background there developed in Germany a religious mood, the pietist movement, which Berlin sees as the root of romanticism. Pietism was a branch of Lutheranism and consisted in closely studying the Bible and attending to man's relation to God. So we get an emphasis on spirituality and contempt for learning. 'What occurred was a kind of retreat in depth.'

Why pietism should have lead to romanticism isn't immediately obvious, but Berlin thinks it was largely due to one man, of whom most people today probably haven't even heard: Hamann.

My reason for introducing the obscure figure of Johann Georg Hamann is that I believe him to have been the first person to declare war upon the Enlightenment in the most open, violent and complete fashion. Nevertheless, he was not entirely alone in this, even in his own lifetime (p. 46).

Hamann was born in obscurity and lived a dissolute life for a time, but when he was at the point of suicide he had a religious revelation and became a writer. He was not successful at this either—Berlin describes his style as unreadable—yet for some reason he had a very strong influence on a number of other writers who did have a profound influence in Europe, including Herder, Goethe, and Kierkegaard.

Hamann's fundamental doctrine … was that God was not a geometer, not a mathematician, but a poet; that there was something blasphemous in attempting to foist upon God our own human, logical schemes (p.48).

Yet another writer who appears in association with Hamann is Immanuel Kant, who was Hamann's neighbour and friend. I hadn't thought of Kant as a figure in the romantic movement and in fact he hated it, yet Berlin identifies him as one of the fathers of the movement, because of his 'virtual intoxication' with the idea of human freedom. For this reason he welcomed the French Revolution (likewise the American Revolution), and even the Terror did not lead him to revise his view completely.

This indicates the passion with which this normally very conventional, very obedient, very tidy, old-fashioned, somewhat provincial East Prussian professor nevertheless regarded this great liberating chapter in the history of the human race, the self-assertion of human beings against huge idols as he thought of them, standing over against them. … He is not normally thought of in these terms, but there is no doubt that his moral philosophy is firmly founded upon this anti-authoritarian principle (p.77).

Although Berlin concentrates mainly on literature, he also looks at music and painting and even economics. It is here that, for me, what he has to say resonates most strongly with our present situation. The Revolution showed people that they had been paying too much attention to the upper portion of society—economists, psychologists, moralists, writers—intellectuals of every kind; but these were merely the tip of 'some huge iceberg of which a vast section was sunk below the ocean'.

This invisible section had been taken for granted a little too blandly, and had therefore avenged itself by producing all kinds of exceedingly unexpected consequences (p.110).


This is a short book but a rich one, brimming with ideas and extremely readable. It has certainly very considerably changed how I think about the romantic movement. For me, at any rate, its great merit is that it has introduced me to a range of German writers who were previously little more than names to me. It also let me see Kant in a new way. Encouragement to further exploration comes in the shape of a reference section at the end, although Hardy warns us that identifying sources for this 'most effervescent of historians' is no easy task.

%T The Roots of Romanticism
%A Berlin, Isaiah
%I Vjntage
%C London
%G Epub ISBN 9781446496923
%P 148pp
%K literature, art history
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In memoriam: Dr Peter Fisher

I 've just received the sad news of the death of Dr Peter Fisher in a cycling accident in High Holborn, near The Royal London Hospital for Integrated Medicine, where he had been a leading clinician for many years.

Peter was a good friend and colleague in my years at the hospital, where he was consultant physician and Director of Research, as well as Editor-in-Chief of the journal Homeopathy. He was a convinced homeopath but always took an evidence-based approach to the subject; for example, he criticised opposition to vaccination on the part of some homeopaths as unscientific (and contrary to homeopathic principle).. Nevertheless he was largely responsible for changing the name of the hospital from The Royal London Homeopathic Hospital to its present form in 2010. This was a wise move which reflected the fact that the hospital now offers a range of complementary treatments, always in the wider context of modern clinical medicine.

Peter's death will be an irreplaceable loss to British homeopathy.

Book review: The Crossway, by Guy Stagg

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n 2013, following his partial recovery after a long period of mental illness, which included alcoholism and a suicide attempt, Guy Stagg set out on a pilgrimage from Canterbury to Jerusalem, following medieval pilgrim routes. Although an atheist, he hoped that the religious ritual of pilgrimage would somehow heal him after his illness. He walked for ten months and covered 5,500 km, passing through 11 countries if you include England.

This is a travel book in at least two senses: it narrates the author's arduous journey on foot and it also describes the accompanying inner journey through his own mind and memories. It's a long book—over 400 pages—and I have to say that I found reading it somewhat of a pilgrimage myself. I needed to take breaks in which I read other books to change the mood. Although there is certainly a sense of constant movement through different landscapes and variety in the encounters with people met on the way, this did not always counteract a sense of claustrophobia induced by the author's descriptions of his earlier depressive states.

This wasn't because of any lack of skill on Stagg's part—quite the contrary. He is a very 'literary' writer (some have compared him to Patrick Leigh Fermor) and the book is artfully constructed. The writing is complex and allusive and demands slow reading. The title reflects this, combining as it does multiple meanings within itself: the choosing of paths, suffering, Christ's cross, and a reference to the fact that in earlier times suicides were buried at crossroads rather than in consecrated ground; no doubt there are other meanings to be teased out as well.

Stagg began his journey on New Year's Day, which seems an eccentric choice, given that he would have to cross the Alps in midwinter on foot, but he felt that if he postponed starting until summer he would probably never go at all. The Saint Maurice pass in a snowstorm was quite as hazardous as one would expect, and even when he reached the other side the dangers didn't disappear. He nearly drowned trying to cross a river by a shaky footbridge and then was almost run over by a train when he used a railway bridge instead.

There is plenty of drama in the story, but Stagg's main interest is less in his adventures or misadventures than in the people he met along the way. Some of his encounters, related with deadpan humour, are very funny, but the dominant impression we get is of the extraordinary kindness of strangers. Often he stayed in monasteries or presbyteries, but also in private houses, and nearly always he was made welcome—until, ironically, he reached the Holy Land. The Turkish villagers were particularly hospitable and he acquired enough knowledge of their language to converse with them.

What one would expect to be the high .points of the journey, Rome and Jerusalem, were somewhat anticlimactic; especially Rome, where the Easter crowds occasioned panic and a psychological collapse. Later, in Greece, he went on an alcoholic spree in Thessaloniki and then was overwhelmed by a sense of failure. More than once, not surprisingly, he thought of giving up, and in fact decided he would do so when he reached Istanbul. But after making friends there and joining them in anti-government riots enlivened by tear gas, he changed his mind and went on.

So why didn't he give up? I don't think this was entirely clear, even to him. He no longer believed that the pilgrimage would heal him psychologically. But the root cause of his continuing seems to have been that he has, to a marked degree, what Thomas Nagel has called the religious temperament. He remained a convinced atheist but he found a deep meaning in religious ritual, at least in the form of the pilgrimage. His attitude to religious ceremony was more complex; he attended Catholic services in the monasteries where he stayed but what they meant to him is less clear..

He includes a good deal of historical information about the places he passed through. Some of this is well known (the First Crusade, the abolition of the Templars), some less so (the Bogomil heresy). He is evidently well read in this respect, which makes his reaction to Eastern Orthodox religion rather surprising. He apparently knew little about it in advance of his arrival in Greece and was disconcerted by its unfamiliarity, although his attitude changed somewhat after he spent a few days on Mount Athos. Here he met two Western converts to Orthodoxy who made the faith more comprehensible to hjm. He followed this up with a conversation with a monk in one of the monasteries he stayed at. The monk asked him to stay on indefinitely, and for a moment Stagg contemplated the possibility, before thanking the man hastily and making his escape.

He had to depart from his planned route after leaving Istanbul, owing to the civil war in Syria. He made a detour through Cyprus keeping to the high ground because of the heat. He crossed back to Lebanon, where he narrowly escaped a terrorist bombing in Tripoli. He reached Beirut, but then had to take a plane and several buses to Amman, before continuing his journey on foot over the Golan Heights into Israel.

The end of the book brings no final resolution or illumination. In an epilogue he describes leaving Jerusalem and heading south. He passes through Bethlehem but does not visit the Church of the Nativity because what he wants to see is the desert, which he describes as the most beautiful landscape he has ever seen. Arriving in the afternoon at an Orthodox monastery, he is refused accommodation because he has no letter from the Patriarch. He is advised to spend the night in a cave on the far side of the valley, which he does. Next day, he says, he will continue walking east.

%T The Crossway
%A Stagg, Guy
%I Picador (Macmillan)
%C London
%D 2018
%G ISBN 978-1-5098-4457-9
%P 416pp
%K travel
%O hardback

Book review: On Faith and Science, by Edward J. Larson and Michael Ruse

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The relation between religion and science has a long history and it has gone through various phases, some amicable, some not. At present, thanks partly to a loosely knit group of writers who have been called the new atheists—Richard Dawkins, Daniel Dennet, A.C. Grayling and others—relations are bad. But there are some non-believers who want to find common ground with religion, and Ruse has long been one of these; not that you would know it from this book, for both he and his co-author Larson are reticent about their own religious views.* No doubt this is due to a wish to appear even-handed, but I think it leads to a certain softening of focus throughout.

Both authors are distinguished academics. Larson is a historian; Ruse is primarily a philosopher of science who also has an interest in history, particularly that of the theory of evolution (see links to my reviews of books under his name in the list of authors). They write alternate chapters, although there is some flexibility, with some chapters containing contributions from both, and it isn't always easy to be sure who is writing at a given moment.

There are chapters looking at cosmology; physics; brain, mind, and soul; geology; evolution in general; and human evolution. The approach in these is historical; they look at how knowledge has evolved over time and how this has interacted with religion—mainly Christianity, but there is some reference to Judaism and Islam and a little to Hinduism and Buddhism. For each topic we get an outline of some of the religious issues that growth in our knowledge has given rise to. It is all done well enough, but there will be few surprises for anyone who is reasonably familiar with the subjects covered.

The last three chapters (7, 8 and 9) are a little different, in that they cover matters that are topical (and controversial) today: sex and gender, eugenics, and living on earth (which looks at global warming and other threats to our survival). In their closing paragraph the authors use the common ground they think exists between two very different people, Pope Francis and E.O. Wilson, to draw a moral for the relationship that ought to obtain between science and religion as it relates to our survival.

I'm sympathetic to the authors' wish to avoid facile condemnation of religion in the name of science, but I enjoyed reading this book less than I expected to. The tone is quite colloquial, almost to a fault, yet at the same time bland and a little flat. And at times the authors' evident desire to avoid giving offence becomes somewhat irritating. For example, they quote from Fritjhof Capra's 1975 book The Tao of Physics and remark that 'he remained an outlier among modern physicists', which seems a considerable under-statement; I wanted to know what they thought of it themselves. They are also fairly non-commital in their references to Richard Dawkins's book The God Delusion, about which Ruse has been scathingly critical elsewhere.

The book concludes with an eclectic annotated bibliography which is quite useful, although I was sorry to see no mention of Taner Edis's books, especially his The Ghost in the Universe, which to my mind is one of the best books on theism by a sceptic who nevertheless takes religion seriously. He has also written well on science and Islam, something touched on only briefly in the present book.

*Ruse has recently publicly identified himself as an atheist, although he prefers the term 'sceptic'. See Why I Think the New Atheists are a Bloody Disaster.

%T On Faith and Science
%A Larson, Edward J.
%A Ruse, Michael
%I Yale University Press
%C New Haven and London
%D 2017
%G ISBN 978-0-300-216717-3
%P 298pp
%K religion
%O hardcover

Book review: An Introduction to Western Medical Acupuncture (Adrian White, Mike Cummings, Jacqueline Filshie)

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This is a book about the modern medical version of acupuncture, often called Western medical acupuncture (WMA) which is widely practised by health professionals today. It is the second edition of the work (the first appeared in 2008) and is described as a companion to Medical Acupuncture: A Western Scientific Approach (Elsevier, Edinburgh, 2016), now also in its second edition. The authors are all among the foremost proponents of WMA in Britain and so are well placed to produce a book of this kind.

Its primary intended audience is health professionals who have recently completed a training programme in modern acupuncture and want to consolidate and extend their knowledge of the subject. But it will also interest more experienced practitioners, because it includes a large amount of up-to-date research evidence for acupuncture that is otherwise not easy to find gathered together in an accessible form.

The book has 19 chapters. Chapter 1 is an introduction and provides a description of WMA and how it differs from traditional Chinese medicine (TCM). The remaining chapters are divided into five sections: 1. Principles; 2. Effects Mechanisms Techniques; 3. The Evidence Base; 4. Practical Aspects; 5. Treatment Manual. There are also five detachable cards illustrating classical acupuncture points, myofascial trigger points, and pain referral zones. As this summary will indicate, there is a progressive shift in focus throughout the book, from evidence for acupuncture as a science-based treatment to the practical aspects, but this is not a rigid separation and even the more research-oriented sections bring out the practical implications of what they describe.

I shall now look at the individual sections in more detail.

Section 1 has three chapters (Chapters 2–4). The first is a preliminary overview of what WMA is and how it is thought to work. Acupuncture is mainly although not wholly a treatment for pain, and Chapter 3 looks at the modern understanding of pain mechanisms in the nervous system and how these relate to acupuncture. Chapter 4 describes some basic acupuncture techniques, to be elaborated later.

Acupuncture modernists always have to decide where they stand on the question of classical acupuncture points. Some, of whom I am one, prefer to avoid that terminology almost completely, but here the authors do use it, although with reservations. 'This book uses classical acupuncture point names as a convenient convention, though each point's effects are not as specific as traditionally believed, and nerves may be stimulated effectively almost anywhere in the body.'

What I found particularly welcome both in this section and throughout the book is the absence of dogmatism. The authors state their views but they recognise the existence of different approaches to treatment within the broad scope of modern medical acupuncture: 'nothing in acupuncture should be standardized—except safety.'

Section 2 is concerned with the mechanisms of acupuncture—how it works. A lot of new research on the question has become available since the first edition in 2008. The physiological mechanisms are discussed under a number of headings: local effects, segmental (spinal) effects, and general (central) effects. There is too much information here to summarise in a review, but this is an important section because it provides much of the support for the authors' treatment recommendation in later chapters.

This section includes a description of myofascial trigger points (MTrPs), which figure prominently in WMA. This is particularly useful for doctors, who are unlikely to have encountered the subject in their ordinary clinical training. It is treated here both theoretically and practically, including an account of how to diagnose and treat MTrPs.

The concluding chapter in this section is on traditional Chinese medicine (TCM). There is a succinct account of the ancient ideas and the authors consider how relevant, if at all, TCM concepts are to modern practice. 'A rational approach based on knowledge obtained scientifically can explain many of the concepts of TCM.'

The authors provide a fair summary of TCM but I question whether it is still necessary to include it in a book on WMA. I think we are rapidly approaching, or have already passed, the point where the subject can be regarded as of purely historical interest, in which case it could be omitted or at least relegated to an appendix.

Physiology is important in modern acupuncture but we also need clinical evidence of efficacy, and this is the subject of Section 3. Critics sometimes claim that acupuncture is 'just a placebo' because many trials find little or no difference between 'real' and 'sham' acupuncture. But this begs many questions, especially the problem of what constitutes a 'sham' acupuncture treatment. The authors show convincingly why it is so difficult to devise an adequate placebo treatment in acupuncture. Nor is this the only practical difficulty that attends clinical trials in this field. For example, 'blinding' of patients can be difficult (blinding of the practitioner is all but impossible). In spite of these difficulties there is good evidence of efficacy in at least some disorders.

Safety is a literally vital consideration in acupuncture and Section 3 concludes with a chapter reviewing the evidence on this question. The authors find that acupuncture is generally safe if done by adequately trained practitioners and is usually safer than most other treatments that are available. Aggravation of symptoms may occur but is seldom severe and is certainly not required for effective treatment, as is sometimes claimed, so the risk should be reduced as much as possible.

Questions of safety again figure prominently in Section 4. The first three chapters in this section (14, 15, 16) 'are essential reading for clinical practice'. They cover preparing for treatment, effective needling techniques, and safe needling. All the safety issues mentioned here are incontrovertible, but (as noted earlier) there is room for discussion about some of the techniques described.

For example, the authors advise the use of guide tubes for beginners because they make needle insertion easier. This is true, but many experienced acupuncturists dislike guide tubes and don't use them, and I'm not sure that it is necessary to impose them on beginners. I think that most newcomers to acupuncture quickly learn to insert the needles without them, at least the standard (30mm) needles; the longer (50mm) needles are probably best used with guide tubes, at any rate to start with.

On the question of how long the needles should be left in situ ('retention'), there is a widespread idea that this should be 20 minutes, and the authors think that this may be because it takes this length of time for beta-endorphin levels to reach a maximum in the central nervous system. However, they think that 10 minutes is often long enough for a clinical response. I should say that much briefer insertion is usually effective in most cases, and the authors do acknowledge the use of this technique by some practitioners. Needle retention is probably one of the most widely debated subjects in acupuncture.

The concluding chapter in Section 4 deals fairly briefly with other techniques often bracketed together with acupuncture, such as moxibustion, auricular acupuncture, and the use of lasers. The authors find little advantage in embarking on most of these.

Section 5 is a 'Treatment Manual' describing various possible approaches to try in different disorders. To avoid any misunderstanding, the authors emphasise that this section only makes sense if you have read everything that precedes it; they are not providing 'recipes' or rules to be followed without thought. 'You have discovered the principles of acupuncture in the previous chapters; here you find some guidelines to point you in the right direction.'

The book is very well produced, with abundant diagrams, and is written in an approachable style that makes it easy to read. Each chapter begins with headlines summarising its contents to indicate what the student should learn by reading it, and concludes with a useful review of its main message.

Some acupuncture enthusiasts want to emhasise what they perceive as its differences from mainstream medicine. The alternative view is that acupuncture should be reinterpreted in the light of modern knowledge and integrated with mainstream methods of treatment, and that is the present authors' opinion. 'It is time to reconsider acupuncture and its strange phenomena in ways that are credible to Western science.'

%A An Introduction to Western Medical Acupuncture (second edition)
%A White, Adrian
%A Cummings, Mike
%A Filshie, Jacqueline
%I Elsevier
%C Edinburgh
%D 2018
%G ISBN 978-0-7020-7318-2
%P viii + 234pp
%K acupuncture
%O illustrated; pull-out reference cards

Book review: Beyond Weird, by Philip Ball

Philip Ball is a science writer who was for many years an editor for physical sciences at the journal Nature. The subtitle indicates what his book is about. It is aimed at readers of books on popular science who have, Ball believes, been given a misleading impression of quantum physics, starting with the notion that it is 'weird', which Ball thinks is a cop-out. It's non-intuitive but not weird. The idea that it is

comes from our (understandably) contorted attempts to find pictures for visualizing it or stories to tell about it. Quantum physics defies intuition, but we do it an injustice by calling that circumstance 'weird'.

Quantum mechanics has the reputation of being probably the most obscure and difficult branches of science, but Ball insists that it isn't 'hard' in the way that car maintenance or learning Chinese are hard (his examples). That isn't to say that a slight readjustment of our intuitions will make everything suddenly explicable. 'Indeed, it is possible that we might never be able to say what quantum theory "means".' Continue reading

Book review: Man and the Natural World, by Keith Thomas

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It is becoming almost a chiché today to say that we are living through the sixth great extinction, in which an ever-increasing number of species are being driven to extinction by human activity. The writer and broadcaster David Attenborough has acquired the status of conscience of the nation by making television documentaries that bring home to a wide audience the effects of our way of life on the natural world. The latest example is his demonstration of pollution of the oceans by a deluge of plastic that is proving lethal to many of their inhabitants. The widespread media attention that all this gets today may make us think it is a modern phenomenon, but Thomas shows that its roots go back to the early modern period, when profound changes in outlook occurred.

In Tudor and Stuart England there was a long-established opinion that the world had been created for the sake of humans, and other species existed to provide for our needs and pleasures. Attitudes to animals largely depended on how well they fulfilled their appointed role. They might be useful for work, as in the case of dogs and horses, or they could provide food, as did pigs and poultry; some, such as oxen, could perform both roles. As for wild animals, some could be eaten, but others, such as rats, mice, and foxes, could not and in fact were merely a nuisance; these were 'vermin' and needed to be destroyed.

The story Thomas tells is how and why this view changed in the period under review, until it became almost the direct opposite of what it had been at the outset. There were many reasons for this, but an important one was the movement of the population from from rural to urban. In the early years of the period most people would have seen a wide range of different animals continually in their daily lives, but by the end of it such encounters would be much less frequent, although still more widespread than is the case today. This caused people to think of animals in a different way.

Much of the discussion is concerned with cruelty, which was widespread at the beginning of the period and was often horrific. Some of this was incidental cruelty; horses and oxen were frequently beaten unmercifully to make them work, but this was due to indifference to animal suffering rather than malice. Some, however was based on a desire to inflict pain as an amusement; and many men indulged in pastimes or 'sports' such as cock-fighting or the baiting of bears and other animals. Thomas doesn't spare us ample descriptions of all this. But even in the early part of the period there were exceptional people who saw things differently, and as time went by their number increased, until their way of thinking and feeling became the norm. Cruel sports, with the notable exception of fox-hunting, were progressively outlawed. This was a profound change.

By the later seventeenth century the anthropocentric tradition itself was being eroded. The explicit acceptance of the view that the world does not exist for man alone can be fairly regarded as one of the great revolutions in modern Western thought, although it is one to which historians have scarcely done justice.

One manifestation of this new sensibility was the development of vegetarianism. At first this was a very small movement, largely inspired by classical texts, and most converts to the cause, such as the young James Boswell, soon slipped back; but it grew progressively throughout the eighteenth century. Even those who continued to eat meat became increasingly squeamish about its implications; slaughterhouses were kept out of sight and attempts were made to kill animals more humanely. It was now felt necessary to justify meat-eating on ethical grounds and some rather dubious arguments were advanced for this purpose. As a lapsed vegetarian myself I found this rather uncomfortable reading.

The book focuses mainly on how people thought about animals, but it also looks on changing attitudes to trees and flowers. And there is a discussion of landscape which I found particularly interesting.

At the beginning of the period wild country, and especially mountains, were thought to be useless and were seen as places to avoid if possible; people who lived there were looked down on as barbarous. But the later seventeenth century saw a growth in nature mysticism and the beginning of mountain climbing as recreation. Thomas thinks that this was largely a reaction against the domestication of much of the land by gardeners and agriculturalists.

Once the new sensibility to wild landscape began it spread rapidly, taking on a quasi-religious tone._'Nature was not only beautiful; it was morally healing.'

By the end of the eighteenth century…the old preference for cultivated and man-dominated landscape had been decisively challenged. Encouraged by the ease of travel and by immunity from direct involvement in the agricultural process, the educated classes had come to attach an unprecedented importance to the contemplation of landscape and the appreciation of rural scenery.

This attitude in turn led to a desire to preserve the wild landscape in its pristine form.

What was notable about this new taste was was that the scenery which was most particularly admired was no longer the fertile, productive landscape, but the wild and romantic one. Henceforth there would be a growing concern to preserve uncultivated nature as an indispensable spiritual resource.

This concern is still very much alive today, and is being debated in the context of the National Parks; how far should they be 'left to nature'?. It is one aspect of the wider problem of how to reconcile modern civilisation with nature, which the people in the early modern period were already beginning to be troubled about.

On the one hand they saw an incalculable increase in the comfort and increasing well-being of human beings; on the other they perceived a ruthless exploitation of other forms of animal life. There was thus a growing conflict between the new sensibilities and the material foundations of human society. A mixture of compromise and concealment has so far prevented this conflict from having been fully resolved. But the issue cannot be completely evaded and can be relied upon to recur. It is one of the contradictions on which modern civilization may be said to rest. About its ultimate consequences we can only speculate.

%T Man and the Natural World
%S Changing _Attitudes in England 1500–1800
%A Thomas, Keith
%I Allen Lane
%C London
%D 1983
%G ISBN 07139 1227 8
%P 426pp
%K history
New Reviews | Titles | Authors | Subjects

Book review: Children of Time, by Adrian Tchaikovsky

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There is an abundance of ideas in this novel but the central concept is an evolutionary one: a population of spiders acquires a technological civilisation capable of space exploration. There is no question of aliens here; the spiders belong to a species named Portia labiata, which exists on Earth today.

The world on which the spiders live has been created by terraforming carried out by humans from Earth, and is one of a number of similar projects undertaken in the remote past by the 'Old Empire'. But civil war led to the destruction of that civilisation, and Dr Avrana Kern, the scientist in charge of the spiders' world, had been left on her own for millennia. (Individuals can live for centuries in a form of artificial hibernation, although by this time she has largely uploaded herself into a computer to ensure the survival of her monitoring capacity.)

The spiders' spectacular evolutionary advance came about by accident. Kern's plan had been to place monkeys on the planet and infect them with a virus that would accelerate their evolution dramatically. But things went wrong and the monkeys were destroyed en route to the planet; the virus instead infected the spiders and produced its evolutionary acceleration in them, although Kern doesn't know this.

Meanwhile a new civilisation has developed on Earth in the ruins of the old. It is not as technologically advanced as the Old Empire and is parasitic on what is left of its technology, including its space stations. The Earth has not recovered from the devastating war that ended the Old Empire and in fact is about to become uninhabitable, so the plan is to send out spaceships carrying thousands of emigrants in the desperate hope that at least one will find a terraformed planet and so ensure the survival of humans. One of these spaceships, the Gilgamesh, has found Kern's world and wants to settle there, but it encounters fierce resistance from Kern. If they are not allowed to land and settle it will probably be the end of humanity.

Most of the book is composed of alternating chapters, in which we see events through the eyes of individual spiders or, in the human world, through those of Holsten Mason, a historian or 'Classicist' whose responsibility it is to interpret communications and records written in the language of the Old Empire. Mason is in hibernation for much of the time but is woken up periodically when his services are required.

This is an ambitious book but I should say it largely succeeds in what it sets out to do. The characters, both human and arachnid, are three-dimensional and convincing; you do care what happens to them—even arachnophobes will probably find themselves emotionally involved. But what really distinguishes this book is the detailed account of how the spiders develop a technology based on the physical and mental resources available to them, using remarkable but not impossible inventiveness and adaptability.

In this respect the choice of Portia labiata was a good one. The real Portia is an astonishingly intelligent creature that hunts other spiders often bigger than itself and makes flexible plans, requiring foresight, for its attacks. This foresight continues to characterise the species throughout its evolution in the novel.

Some science fiction has elements of allegory, and I think that is true here. Spider and human society are alike in some ways but quite different in others; among the spiders females are completely dominant and the fatal human propensity to civil strife is lacking. To my surprise, by the end I found myself reminded of the episode in Gulliver's Travels in which Gulliver arrives in the land of the Houyhnhms. We could see the spiders in the role of the virtuous Houyhnhms and the humans on the Gilgamesh as the appalling Yahoos. But the contrast is not as stark as it is in Gulliver and, at the end, the humans are redeemed.

%T Children of Time
%A Tchaikovsky, Adrian
%I Pan Books
%C London
%D 2016
%G ISBN 978-1-4472-7331-8
%P 600pp
%K fiction
%O kindle version downloaded from, 2018

Book review: The Ends of Life: Roads to Fulfilment in Early Modern England, by Keith Thomas

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The past is a foreign country; they do things differently there.' So wrote L.P. Hartley in his novel The Go-Between, and that would be a good epigraph for Keith Thomas's scholarly but very readable study, in which he examines what the men and women of early modern England sought to make of themselves, what goals they pursued, and what were the objectives which, they believed, gave their lives meaning. Thomas uses the same metaphor as Hartley to describe his purpose in writing.

By asking how people made their choices and justified their actions, both to themselves and to others, I hope to advance the project on which I have been intermittently engaged for most of my scholarly life, namely that of constructing a retrospective ethnography of early modern England, approaching the past in the way an anthropologist might approach some exotic society.

We are often told that human nature doesn't change. But this is at best a half-truth; as Thomas shows, in earlier times people thought very differently from how we do today, so much so that we have to make a considerable imaginative effort to understand them.

The material is arranged under a number of headings: military prowess, work and vocation, wealth and possessions, honour and reputation, friendship and sociability, fame and the afterlife. In all these spheres of interest, beliefs and attitudes changed quite remarkably in the period under consideration, leading to an increasingly modern outlook after emergence from an essentially mediaeval way of thinking at the beginning of the period. Notable in this process was the development of individualism.

A striking example of this comes from changing attitudes to dress. At the beginning of the period dress codes were rigidly enforced according to social status; dressing above one's status was an offence, and so was dressing below it. But by the middle of the seventeenth century shifts in fashion, at least in high society, came and went at a bewildering speed.

A mid-seventeenth-century witness tells us that, in 1645 and 1646, the fashionable gallant was wearing 'a narrow brimmed hat, a long waist…breeches to his knees and boot-hosetops and jingling spurs'. In 1648 and 1649 a broad-brimmed hat, long breeches,'boots with the tops trailing on the ground, little spurs that must not jingle in the least. In 1652 and this present year 1653 we think it ridiculous to wear boots, but [only] shoes and stockings.'

The early modern period saw a great vogue for friendship, particularly among men. This was celebrated and idealised in literature, and relationships apparently reached an extraordinary intensity. Friends expressed passionate love for each other; they could kiss, wear the same clothes, and sleep in the same bed. To the modern reader all this irresistibly suggests homo-eroticism, but the intense affection of friendship was not seen in this light. Homosexuality, in contrast, was strongly condemned as 'filthy' and sodomy was a capital offence. 'Spiritual' friendship like this was always between men of similar age and class; friendship between older and younger men, or between superiors and subordinates, was disapproved of. This is because homosexuality was largely equated with pederasty.

For the most part Thomas is content to allow his witnesses to speak for themselves, but he does occasionally insert nice comments of his own. In his section on heaven and hell he tells us that one of the principal joys of the blessed was viewing the tortures of the damned below. Conversely, those suffering in hell were 'able to witness the simultaneous bliss of their friends and relations in heaven, rather like economy class passengers, huddled in the back of the aeroplane, catching an occasional glimpse behind the curtain of business-class travellers cosseted with hot towels and champagne'.

In this book Thomas's method of writing is similar to that of his earlier study, Religion and the Decline of Magic. In both he makes abundant use of mostly quite short contemporary quotations. In both books, too, he largely confines himself to England, with only a few glances to other parts of the British Isles or mainland Europe. He uses 'early modern England' to refer approximately to the period between 1530 and 1780; that is, from the Reformation to the American War of Independence, although he strays outside this time-frame on occasion.

While Thomas's writing is very readable, the huge number of quotations means that one has to take the book slowly, otherwise it can become indigestible. It is probably best approached by dipping into it and reading one section at a time rather than trying to take in too much at once; this is easy to do because each section is more or less self-contained and occupies a similar time-frame so the order in which they are read is not critical.

Although Thomas doesn't dwell on it, his book has implications for how we should think about ourselves. People in the sixteenth and seventeenth centuries were in a sense imprisoned in their psychological framework, as of course are we. It is tempting, if almost certainly futile, to try to imagine how a future Keith Thomas, writing two hundred years hence, would describe us in his book. But of one thing at least we can be certain: as Thomas puts it, rather sombrely, in his concluding section, the end is always inexorable oblivion. So carpe diem.

In the seventeenth and eighteenth centuries, the Christian religion, in its various forms, continued to enjoy ascendancy in England. Its message remained the traditional one, namely that it was to the next world, not this one, that human beings should look for their fulfilment. In practice, most of the population took a more secular view: they cherished life for its own sake, not merely as a preliminary to some future state. Highly aware of the satisfaction they could find in their work and their possessions, the affection of their friends and families, and the respect of their peers, they increasingly sought fulfilment in their daily existence. Here, all around them, were the ends of life.

%T The Ends of Life
%S Roads to Fulfilment in Early Modern England
%A Thomas, Keith
%I Oxford University Press
%C Oxford
%D 2009
%G ISBN 978-0-19-924723-3
%P xi+393pp
%K history
%O plate illustrations

Making Caps Lock work as Escape in the console on OpenBSD

I installed OpenBSD on a refurbished Dell Optiflex 3020 a couple of days ago, replacing the Windows 7 it arrived with. From something I'd read on the web I thought there would be some configuring needed to get the installation to work with EFI, but in fact it went smoothly out of the box.

A couple of minor things to say about the console.

1. I wanted Caps Lock to give me Escape in the console. The OpenBSD FAQ tells you how to do this with wsconsctl but I got a message saying that Caps_Lock was not a keysym. I found a fix for this at reddit (thanks, Kernigh).

2. Still on the console, I get messages about the mouse, saying _"wsmouse0 detached" . This seems to be a known bug but I don't have a satisfactory fix. I can stop the messages appearing by installing the mouse on the console but then it doesn't work in X. It's annoying but not serious since I normally start X immediatejy after logging in.

Probably the easiest solution is simply to unplug the mouse when you're in the console.

Book review: Religion and the Decline of Magic, by Keith Thomas

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Keith Thomas tells us that this book began as an attempt to make sense of why some now outmoded belief systems, which he terms collectively magical, were current in sixteenth and seventeenth century England. As he wrote he found that there was a close relationship between these beliefs and the religious ideas of the period; sometimes the two seemed to be closely connected, at others they were in conflict. He therefore enlarged the scope of his study to include an examination of these interactions. Inevitably the result was a very long book, even though he deliberately confined the discussion to England, with only brief glances at Wales; he made no attempt to include Scotland or Ireland, let alone continental Europe.

This is probably the most comprehensive and widely cited study of these subjects to have appeared in the last half-century. Although it is a scholarly work, it scores highly for readability.

The historical period spanned by the book includes the Reformation and this marks a boundary in how religious people viewed magical beliefs. In the pre-Reformation period the medieval Church 'acted as a repository of supernatural power which could be dispensed to the faithful to help them in their daily problems.' The priests, set aside from the rest of the population by their celibacy and consecration, and acting as mediators between man and God, were naturally seen as possessing special powers. Religious objects and rituals, especially the sacraments, came to assume magical properties in the eyes of the people. The result was inevitably a blurring of the line separating religion from superstition.

After the Reformation the Protestants tried to separate religion from its unwanted associates. Their success was only partial, but Thomas finds that the Reformation helped to introduce a new concept of what religion actually is.

Today we think of religion as a belief, rather than a practice, as definable in terms of creeds rather than in modes of behaviour. But such a description would have fitted popular Catholicism of the Middle Ages little better than it fits other primitive religions.

This seems to me a most illuminating comment.

A central feature of post-Reformation theology was its rejection of chance. Everything that happened, without exception, did so because it was permitted by God. Hence we get the idea of Providence—the notion that God will provide for the virtuous in this life.

Every Christian thus had the consolation of knowing that life was not a lottery, but reflected the working out of God's purposes. If things went wrong he did not have to blame his luck but could be assured that God's hand was at work; the events of this world were not random but ordered. … The correct reaction of a believer stricken by ill-fortune was therefore to search himself in order to discover the moral defect which had provoked God's wrath, or to eliminate the complacency which had led the Almighty to try him.

(Although Thomas does not make the point, this way of thinking is basic to the Old Testament, adherence to which was a prominent post-Reformation characteristic.)

We tend to think of our predecessors as having been strongly religious, yet complete ignorance of religious doctrine was surprisingly common both before and after the Reformation. This persisted as late as the early nineteenth century, when a new vicar at a Dorset church found only two male communicants. 'When the cup was given to the first he touched his forelock and said, "Here's your good health, sir." The second, better informed, said, "Here's the good health of our Lord Jesus Christ." At Chippenham a poor man took the chalice from the vicar and wished him a Happy New Year.

There is also a surprising number of reports of frank irreligion and scepticism about all aspects of Christianity, among both aristocrats and the lower orders. This is particularly remarkable in view of the harsh penalties, including burning at the stake, that awaited deniers, so there must have been many doubters who preferred to keep quiet about their views. We hear a lot about the decline of religious faith in modern times, but this may be an illusion.

We do not know enough about the religious beliefs and practices of our remote ancestors to be certain of the extend to which religious faith and practice have actually declined.

It may seem surprising that Thomas has three chapters on astrology, but this reflects the fact that this belief system achieved an astonishing level of prestige and intellectual credence in the sixteenth and early seventeenth centuries. Most Tudor monarchs, including Henry VIII, patronised astrologers, and Cardinal Wolsey was himself a practitioner. In fact, what needs explanation is how and why astrology eventually was discredited; Thomas discusses this in some detail.

Other sections look at ancient prophecies, witchcraft, ghosts and fairies, lucky and unlucky days, and omens. All the subjects are illustrated with an abundance of quotations, which are referenced in footnotes to the pages rather than in end notes, which makes them easier to consult.

Witchcraft, like astrology, is treated at length. Like most modern academics, Thomas finds little evidence to support the idea that the accused witches were Devil-worshippers or members of a pagan fertility cult. Most supposed witches were impoverished unhappy women who often disliked their neighbours and wished them ill, and may have pronounced curses on them. A number of sceptical contemporaries recognised that the curses had no objective validity but nevertheless thought that the accused deserved to be executed because they wished to commit murder even though the means they chose were ineffective. The poet John Donne was one of those who held this view.

Thomas concludes his study by saying, 'What is certain about the various beliefs discussed in this book is that today they have either disappeared or at least greatly decayed in prestige.' But he also says that 'If magic is to be defined as the employment of ineffective techniques that allay anxiety when effective ones are not available, then we must recognise that no society will ever be free of it.' Almost half a century has passed since this was written, and events have proved it prophetic. Magical healing, in the form of many kinds of alternative medicine, has increased enormously in popularity, and astrology is by no means extinct. Religion, on the other hand is declining. Perhaps there is now a place for a book called 'Magic and the Decline of Religion'.

%T Religion and the Decline of Magic
%S Studies in popular beliefs in sixteenth and seventeenth century England
%A Thomas, Keith
%I Weidenfeld and Nicolson
%C London
%D 1971
%G ISBN 297 00220 1
%P xviii+pp
%K history, religion

Breast screening error: disaster or blessing in disguise?

The NHS computer error that has resulted in some 450,000 women aged around 70 not having received an appointment for a final breast screen is obviously, and understandably, deeply worrying for the women concerned. Predictably, the media have headlined the estimate that up to 270 of them may have developed cancers that are more advanced and difficult to treat than they would have been if diagnosed earlier. But this depends on a number of assumptions. Leaving aside the fact that this is the upper limit of an estimated 135-270 range (compare the "up to" speeds quoted by ISPs - how many customers achieve them?), the situation, as usual, is more complicated than the headlines imply.

New Scientlst has a good discussion of the question (Why breast screening error stories are getting death stats wrong). This article makes the important point that, for some women, the failure to notify them may have done them a favour. The current NHS estimate is that, for every 200 women in the 50-70 age range screened, one will be spared an early death but three will have unnecessary treatment for cancers that would not have been a problem in their lifetime.

... it means that up to 800 women may have been saved from harm by not sending them their final screening appointment letter, as they avoided possible reduction in their life expectancy through unnecessary treatment.

The New Scientist article makes the important point that the women who received unnecessary treatment would never know this and would presumably be forever grateful, believing that their lives had been saved by the 'harrowing treatment process'. So this is an 'invisible' harm that is difficult to quantify.