Medicine musica: the eighteenth-century rationalization of music and medicine
Daisy Fancourt, MMus
Roehampton University, London, United Kingdom
Instruments de musique, 1770
Legends of music's healing powers on both the mind and the body are estimated to go as far back as Paleolithic times, when music was believed to be a magic that could drive away the angry spirits that caused illness.1 It wasn't until the beginnings of learned medicine in the Greek-Roman, Arabic, Indian, and Chinese traditions that theories of music's medicinal qualities began to be recorded. But from here on, they became a popular topic for discussion. In the Greek tradition alone, the Mycenean god Pajawo of 2000 BC used holy song to cure disease, and Apollo combined roles as healer and musician. And even amongst mere mortals, The Odyssey told of the bleeding of Odysseus’s wounds from a wild boar only being stopped with a musical incantation; and the poet Pratinas in the 6th century BC recorded a plague in Sparta being quelled by the music of the composer Thaletas.
Such engaging tales held their own across continents and centuries, often with significant similarities between beliefs. Tarantism, the theory that snakebites could be cured by singing and dancing, was recorded by Bolus of Mendes in Greece in the 4th century BC. But it also surfaced with the Romans, in Medieval Hindu traditions, and even in some southern parts of Italy up until the 1950s, showing a pervasive trust in music's powers. What all these tales had in common was their purpose: to explain the unexplainable and give hope where none was left.
This is all a far cry from today's use of music in medical settings, either as psychological therapy, a communicational tool, pain relief or stress management. Music's medicinal potential is tested through cell counts, brain scans and levels of drug consumption; measured on depression and quality-of-life scales; or evaluated through in-depth case studies and psychological assessments. Music activities are managed by Music-Medicine institutes, Arts-in-Health centres, and Music Therapy organizations. This is not to say that the beautiful or mysterious side of music has been squashed by science, turned into a mathematical equation, or dispensed like a pill. Far from it: renowned and creative arts organizations are collaborating increasingly with health sectors to deliver diverse and innovative projects for patients. But the quality of the scientific input has deepened in an attempt to scrutinise claims on music's health benefits and stop the wilder tales from discrediting the discipline.
So at what point in history did we switch in our stance from fantastical, superstitious tales to more measured accounts of music's potential? At what point did our view of music as medicine become rational? This question is difficult to answer for three reasons. First, because scientific discussions of music have been around for thousands of years, such as the famous writings of Plato. However, theories that actually consider the ways that music can be used in applied settings, such as health care, for therapeutic effects need to be sifted out and separated into their own sub-category. Secondly, because even after medics and musicians had taken the first steps to viewing the medicinal powers of music in more realistic terms, the fabulous stories on the power of music continued to hold their thrall. And thirdly, because the growth of this new discourse was scattered and sporadic. There was no unified discipline or clear path. Nevertheless, some of the most important early steps towards this more measured view took place during the eighteenth century "Age of Enlightenment," amidst a wave of other intellectual, scientific and technological advances. For the purposes of this article, I have chosen one key individual who gives a fascinating insight into how these developments took place, the obstacles to their reception in eighteenth-century society, and the far-reaching impact they are still having today: Richard Brocklesby and his 1749 treatise Reflections on the Power of Musick.
Born in 1722, Brocklesby was educated in Ireland and Scotland before setting up his own practice in England. He achieved modest recognition in his lifetime, succeeding the father of military medicine, John Pringle, as Surgeon General of the British Army in 1758, and being awarded a prestigious Croonian lectureship at the Royal College of Physicians in 1763. However, for the most part his contributions have been forgotten, and of the facts that are still circulated about him, many are scant or incorrect. Historians2 have either claimed that Brocklesby was the first and only eighteenth-century scholar to discuss music as a therapy (when Richard Browne’s treatise was published twenty years earlier3), or omitted Brocklesby altogether, and cited Charles Burney in 1789 as the first to describe a more scientific and experimental approach to music in medicine (when Brocklesby explicitly discusses the ‘every day’ arrival of ‘new proofs from repeated experiments.’4) What are overlooked are the ways in which Brocklesby’s treatise was seminal: he took a new attitude to music in medicine, breaking with the myths, arguing with out-dated scientific theories, and proposing new ways that music exerted an effect on both the mind and the body, many of which we still rely on today. As such, he has never received the recognition he deserves, so hopefully by illuminating that contribution here, we can pay credit to a remarkably insightful scientist.
In his treatise, Brocklesby is enthusiastic about music's therapeutic potential for illnesses that "have hitherto too frequently eluded the ordinary powers of medicine"5 and keen to show its widespread practice in America, Africa, Asia and Europe. However, he warns against "superstitious and fabulous accounts" of music's effects, explaining that the tales passed down from ancient times "partly consist in an elegant exaggeration of physical truths."6 He also takes a critical view of society for being so gullible, labelling it a "surprising readiness . . . to deceive [itself], and be imposed on, with the grossest improbabilities, and silliest delusions that folly could entertain or craft could devise."7 Indeed, his criticisms turn to condemnation as he brands the Ancient Greeks as a people who "amplify'd" truths,8 and calls Egypt"'the parent country of extravagant belief."9
A prime example of Brocklesby's scepticism is in the case of the famous musical "tarantism" as a cure for snakebites. In an attempt to debunk the myths, he explains that some of the cases "cured" by music were not actually snake bites at all, but "other causes" that were misdiagnosed.10 For the other cases, he writes "it is to be presumed . . . that those who under such circumstances supposed themselves cured by musick, would have recovered without any other remedy . . . in fact having received no infection."11 This more realistic interpretation has since been confirmed by historian Ernesto de Martino,12 and other explanations have been proposed, such as the music and dancing causing the victim to sweat out the snake’s poison. Whatever the reason, Brocklesby’s refusal to accept this musical "cure" simply on the basis of it being an engaging tale, and his logical, scientific attempts to explain it show an enlightened attitude to music in medicine. Brocklesby also moves music from an arena where beliefs are simply aired as "truth," to one where proper scientific debate can take place.
In line with this, having rid himself of the less believable accounts of music's healing potential, Brocklesby then puts forth some of his own theories on the more realistic ways that music can be used in medical settings. The depth of Brocklesby’s insight is shown in the fact that some of the theories he explains have, in the last few decades, become firmly established as musical and medical concepts. For example, his discussion of Master Stanley, a two-year-old child who responds innately to happy and sad music by becoming either happy or sad himself, parallels the concept of the "music-child," coined by Paul Nordoff and Clive Robbins in the 1950s to describe the inherent responsiveness to music in every human being. And Brocklesby's discussion of how music can help"'to cheer the sinking spirits of pregnant women," so that she "may be freed of the numerous train of ills, that usually attend the fair sex in this condition"13 fits in with contemporary research into the use of music to help improve symptoms of post-natal depression amongst new mothers.14 Finally, he looks in detail at the use of music to treat fevers. Brocklesby contends that "the remedy, which of all others bids fairest to relieve the patient, is musick: as it awakes the attention in the most agreeable manner, and relieves the anxious mind . . . and gradually reduces the mental faculties to the due standard of common sense.15 Over the last couple of decades, scientists have noted that patients' heart rates can decrease with calming music, skin temperature can be lowered,16 and pain levels can be decreased, all of which help control symptoms of fever.17 Music has also been shown capable of providing psychological distraction by relieving anxiety and stress, which can help prevent symptoms worsening.18 So again Brocklesby's discussion of music is substantiated by twenty-first-century science, showing a much more realistic and rational view of music in medicine.
The final section of Brocklesby’s treatise considers what sort of music is most effective in medicine, showing an attempt to understand better the mechanisms that cause positive effects on health. This is a question which is still at the forefront of research, mainly because individual taste and experience plays such a large factor that there is no single type of "healing" music. However, there is a growing consensus that certain features in a composition can contribute to its psychologically and physiologically relaxing effect; features that Brocklesby identifies with remarkable foresight. If we compare his theories with more recent research, this is shown with real clarity.
First, Brocklesby notes that "the most generally affecting compositions in musick, are made up of divers notes, whose vibrations regularly coincide with each other, and are called by musicians, unison notes.”19 He calls this "consonancy," which is "the charms of sound."20 This has been corroborated by more recent evidence, showing that major modes and predominantly consonant harmonies cause the greatest level of relaxation in listeners.21 Brocklesby also highlights the importance of regular "rythmus" (metrical beat) in bars, which he believes causes "a superior pleasure" in the listener22 compared to works that "perplex . . . with such obscurity and intricacy that the audience . . . lose the connexion."23 Research from America has since confirmed that a regular phrase structure and calm pulse, preferably around 60-70bpm encourages the heart to slow to match this rhythm, which in turn reduces stress and anxiety.24 Brocklesby also discusses the benefits of "unity of design" or "symmetry" which he argues is "pre-established in the mind," so when it is lacking in compositions, "the pleasure abates in proportion."25 Recent music psychology research has shown that listeners subconsciously look for parallel passages in music, and the recognition that arises from repetition and symmetry has the most calming effects on blood pressure and hormones.27
Brocklesby might have lacked the scientific understanding, particularly of the more complex neuroscience concepts, to explain or even understand fully his theories. But the clear correlation between his statements and experiments from the last couple of decades highlights the comprehensiveness of his ideas. His treatise is not content simply to take ‘music’ as a broad concept but really digs deep into why and how this works, laying down guidelines that are still considered in the application of music in hospitals today.
Through examining the contribution of Brocklesby, we can see some of the early, decisive efforts that took place to forge a new, rational position for music within the field of medicine. In fact, it is a testament to music's healing properties that such a prominent physician felt it worth wrestling the legitimate claims on music's powers from the clutches of centuries of myth, fabrication and superstition. However, it seems his stance remained rather uncommon in the eighteenth century. One of the century's best-selling English books, published twenty-five years after Brocklesby's treatise, made a number of satirical references to music's magical powers. John Bicknell's Musical Travels thro' England of 1774 joked about music conquering enemies, conjuring food and making cows jump over moons. So whatever steps Brocklesby took to a realistic consideration of music in medicine, this alone was not enough to turn the general opinion. There is a sense that Brocklesby recognized this as he discussed 'how difficult a matter it is for a private man, even of great abilities, to establish any opinion, when the sentiments of his contemporaries do not nearly coincide with his own.28
Benjamin Franklin's glass armonica
Of course, an obvious explanation is that Brocklesby's treatise was simply not well enough known at the time. But worryingly, there may well have been a link between Brocklesby's rational theories and the hysterical tales surrounding the infamous instrument the "armonica." Tales of this instrument have been documented in a number of journals, including a rich and vibrant article in Hektoen International. Essentially, the centuries-old theory that the sound from rubbing glasses filled with liquids could produce healing effects on the listener was given a new lease-of-life in the 1750s, when scientist and founding father of the United States, Benjamin Franklin, invented his own version of the instrument. Franklin himself is purported to have cured listeners by playing the armonica, including Princess Izabella Czartoryska of Poland, who on her deathbed in 1772, went on to live another 60 years. And another notorious figure, the German physician Franz Mesmer, caused a scandal by playing the armonica at his séances to heal patients, leading to claims that the armonica's music could wake the dead. The sensation was short-lived, as in 1784 King Louis XVI ordered an investigation of the wild claims, and the lack of scientific evidence found, along with further fears that the armonica was causing fainting, convulsions and even death caused its rapid demise. By 1830, the armonica was all but forgotten.
This whole scenario is exactly the sort of "superstitious and fabulous account" that Brocklesby warned against. Yet a copy of Brocklesby’s treatise was found in the collection of Benjamin Franklin, the inventor of the armonica. And whilst researching for this article, two letters were found, exchanged between Franklin and Brocklesby discussing the Seven Years War (in which Franklin was military chief and Brocklesby Surgeon General) which imply that a more substantial link existed between the two men. This suggests that either Franklin ignored Brocklesby's rational critique of music in medicine in favour of the more fashionable myths. Or, perhaps worse, that Franklin still managed to take Brocklesby's theories, however rational they were, as encouragement that music possessed innate magical qualities. Either way, it shows the tidal wave of misconception that Brocklesby, and doubtless other scientists, had to battle against.
Consequently, it is no wonder that the rationalization of music in medicine took such a long time to establish. With every measured step forwards, a scandalous tale forced two steps backwards. But Brocklesby's contribution was not in vain. Far from it, he signalled the early stages of a more scientific discourse and took an important step in clawing back the elements of sense surrounding music from the jumble of sensational tales. It is on these foundations that scientists and musicians of the previous two centuries have built, and from these tantalizing early stages that the modern discipline of music-in-medicine has grown. We may still have to fight with improbable claims about music and false results of music’s effects on health, but for the most part they are overwhelmed by grounded theories and practice. So we owe a debt of gratitude to individuals such as Richard Brocklesby for holding onto their faith in the genuine scientific effects of music on health and giving arts and science the chance to form such a powerful partnership, the benefits of which are still being discovered today.
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1. West 2000, 51.
2. Eg Rorke 2001, 66.
3. Richard Browne's Medicine Musica: or a mechanical essay on the effects of singing, musick and dancing on human bodies was published in 1729.
4. Brocklesby 1749, 1.
5. Ibid., 1.
6. Ibid., 5-6.
7. Ibid., 6.
8. Ibid., 7.
9. Ibid., 8.
10. Ibid., 58.
11. Ibid., 67.
12. Martino 1959.
13. Brocklesby 1749, 75.
14. Eg Friedman 2010.
15. Brocklesby 1749, 49
16. In Hodges 2009.
17. Staricoff 2002, 38-40.
18. Friedrich 2004, 1555.
19. Brocklesby 1749, 15.
20. Ibid, 16.
21. Muir 2010.
22. Brocklesby 1749, 77.
23. Ibid, 78.
24. Honing 2012.
25. Brocklesby 1749, 79.
26. Sloboda 1988, 240.
27. Janata 2012.
28. Brocklesby 1749, 64.
DAISY FANCOURT, MMus studied music at Christ Church, Oxford where she was an Academic scholar and Joan Conway scholar, graduating with a double first. She went on to receive a distinction in her masters at King's College, London where she was both an SMA and World ORT scholar, specializing in the links between music and medicine. Daisy now works on the integration of music into NHS hospitals to support the treatment of different illnesses. She has previously worked on arts programmes in Birmingham Children's hospital, Oxford's John Radcliffe Hospital, and now manages the performing arts at the Chelsea and Westminster Hospital in London. She is also currently undertaking a PhD in psychoneuroimmunology and is a research associate with the Centre for Performance Science, part of the Royal College of Music, researching the impact of music on the immune systems of hospital patients.