FOOTNOTES:
[I.] Pythagoras passed a black-smith shop one day and was struck with the beauty of the two sounds he heard coming from it. He entered the shop, studied the sounds closely and found that the two notes were an octave apart. This observation stimulated him to a detailed study of music which led to his musical philosophy. He believed that all nature and knowledge were contained in harmonic numbers, and that the world had been made in a musical harmonic accord. He invented a sacred quartenary of harmonic numbers to explain the phenomena of life. But Roussier believed that Pythagoras adapted his system from the Chinese.[70]
CHAPTER ONE
HISTORY OF MUSIC IN MEDICINE
“Music exalts each joy, allays each grief,
Expels Diseases, softens ev’ry pain,
Subdues the rage of poison and the plague,
And hence the wise of ancient days ador’d
One pow’r of Physic, Melody and Song.”
“The Art of Preserving Health”
by John Armstrong (1709-1779)
In many fields of endeavor a scholar occasionally appears who not only makes a personal contribution to the knowledge and advancement of his subject but summarizes previously gained information so well that his work becomes at once a milestone and a beacon. In the field of music, such a man was Charles Burney, who began to publish a General History of Music in 1776. This book was so thorough and scientifically critical that his conception is as modern as tomorrow. After listing all the instances of music as a therapeutic agent, he concludes:
“Yet men delight in the marvellous; and many bigoted admirers of antiquity, forgetting that most of the extraordinary effects attributed to the music of the ancients had their origins in poetical inventions, and mythological allegories, have given way to credulity so far as to believe, or pretend to believe, these fabulous accounts, in order to play them off against modern music, which according to them, must remain in a state far inferior to the ancient, till it can operate all the effects that have been attributed to the music of Orpheus, Amphion and such wonder-working bards.”[15]
It is well to begin a study of music in medicine with Burney’s restrained enthusiasm lest we fall into the error of building impossible temples of healing on the thin ice of untested claims. We shall begin with prehistoric times.
The use of music against disease is as old as music itself. In fact, early history of music is intimately associated with healing. The wishful thinking of primitive peoples called upon magic for assistance, and magic is almost universally associated with words, chanted words, in rhythmic incantation. Chateaubriand believed that the chant was the offspring of prayers. Among primitive peoples, the medicine-man combined the offices of priest, physician and magician, and although all three functions were closely related, their functions were dissociated on occasion. For instance, there were special songs for the invocation of natural phenomena, for group activities, and for accompaniment of healing rituals. “The belief in the efficacy of musical magic is one of the most important facts in the history of civilization.”[19]
Although no records exist, it is fair to assume that the truly primitive peoples of today have not changed markedly from their ancient customs, and that they resemble to some extent the status of prehistoric men. The universality of certain folkways among widely scattered tribes of primitive peoples today lends validity to this theory.
For such studies we need look no further than our own continent. Even though certain magical practices have been banned by law, the American Indians number amongst their tribesmen, those who remember and to some extent still use music in healing. Several investigators have become interested in this study, but chief among them is Frances Densmore who has analyzed and recorded the songs of many Indian tribes. Among the Teton Sioux she found[21] that the sick appealed to the tribal medicine man who gave the case some thought and claimed to find the cure in dreams. “All treatment of the sick was in accordance with dreams.” The patient was then placed in a dark tent and the medicine man sang his dream song, as well as songs addressed to the sacred stones. The use of herbs of the agency of magic might accompany the song. An example of one of the songs used to cure wounds has the following text:
“Behold all these things
something elk-like
you behold
you will live”
Words like these have a certain sophistication which we may assume constitutes a more recent development.
For many centuries primitive peoples have had different concepts of the exact nature of disease, but for many of them it connotes some connection between a demoniacal spirit and counter-spirits. There were a great many methods employed to drive out the evil spirits. The idea that music was efficacious in these cases persisted for centuries. Martin Luther said, “The devil is a saturnine spirit and music is hateful to him and drives him away from it.”
Densmore points out that among the Iriquois[22] the word orenda is used to designate the universal indwelling spirit. Nothing was regarded by the Indian as supernatural, in our use of the term, but many Indians desired an orenda stronger than their own. When a medicine man began to treat a sick person the result depended upon the power of his orenda. Orenda could be put forth in song. Those who possessed orenda strong enough to do wonderful things were called medicine men. They were consecrated to their work, and the safety, success and health of their people depended on their efforts.
In completing her analysis of Indian medicine songs, Densmore concludes that they suggest “the confidence which the medicine man felt in his own power, and which he wished to impress on the mind of his patients.”
Wallaschek[79] lists many examples of the healing use of music among primitive tribes. Among the Wasambara in East Africa, the doctor arrives with a small bell in his hand which he rings from time to time. The patient sits before him on the ground and the doctor begins speaking in a singing tone: “Dabre, dabre.” He repeats this several times and the patient sings a simple response. In Australia, Wallaschek found a tribal doctor shaking a bundle of reeds, an action otherwise used during a song to mark time. In Borneo, the natives perform recitatives and songs in order to catch the soul of the patient which is supposed to have run away before the evil spirit. The Wallawalla Indians in this country believe that song influences the cure of a patient, and all the convalescents are directed to sing for several hours daily. In British Columbia the doctor sings when he visits the patient, while a chorus of people intones a song outside the house.
With the dawn of civilization, intellectual activity became more progressive but folkways die hard.
“The ancient Egyptians called music ‘physic for the soul,’ and had faith in its remedial virtues. We may presume that the incantations presented in the medical papyri were likewise to be emitted with the proper voice and therefore contain an element of music. The Persians regarded music as an expression of the good principle Ahura-Mazda and are said to have cured various maladies by the sound of the lute”[24]. “The Lacedemonians agreed with the Egyptians and confined the possessors of music to one family, and their priests like those of Egypt were taught medicine and music, and initiated into religious mysteries”[28].
The martial and moral values of music were appreciated by most of the early civilizations. Both Confucius and Plato believed that music was the most certain means of reforming public mores and sustaining them at a high level.[25] Although many histories on effects of music quote the scripture as evidence of the Hebrew use of music in healing, the passage quoted[63] is subject to various interpretations. It simply says that after listening to David play on the harp, Saul was “refreshed and well,” this could refer more to loss of fatigue than cure of a disease.
The great poets have always sung the praises of their beloved sister muse. In Homer there is a story relating how the flow of blood from Ulysses’s wound was stopped, charmed by the use of music.[13] Now it is very possible that the blood of the famed warrior coagulated in its wound during a musical interlude, but then, all wounds except those involving a large artery will cease bleeding in about twenty minutes. Homer also stressed good music and song as a means of elevating the spirit and of overcoming depression of the soul or mind, agony, anguish, anger and sorrow. He gives as an example the story in which Chiron heals the sick with melody.[57] Cato[13] spoke of luxated joints which were eased by the harmony of sound. We cannot be sure of the diagnostic acumen of the observer, but for active people the most common traumatic joint trouble is a “locked” knee. Most knees which contain disturbed cartilage will unlock after a relatively short period of rest. In each of these instances, music was an environmental coincidence. Such observations would only begin to assume scientific medical value if they could be repeated many times under identical or similar conditions. They were not.
We may now return to the episodes related by Burney in his commentary. Martianus Capella, an ancient author on music, assures us that “I have often cured disorders of the mind as well as the body with music”[58]. He also claimed that the Aesclepiades, the state-recognized priests of medicine, cured deafness by the sound of the trumpet. “Wonderful, indeed!”, says Burney, “that the same noise which would occasion deafness in some should be a specific for it in another.” In Plutarch’s book De Musica it is related that Thaletas the Cretan delivered the Lacedemonians from the pestilence by the sweetness of his lyre.
“Thaletas, a famous lyric poet, appeared by command of an oracle and all the songs he sang were prayers to the Gods. The disease probably reached its highest pitch of malignity before he came, and began to subside with his coming; but its disappearance was attributed to the music of Thaletas.”
Many other cures are cited. Xenocrates employed the sound of instruments in the cure of maniacs; and Appolonius Dyscolos claimed that music was a sovereign remedy for dejection of the spirits and a disordered mind, and that the sound of a flute would cure epilepsy and sciatic gout. Athenaeus rendered the cure for gout more certain by playing music in the Phrygian mode, while Aulus Gellius insisted that the music be soft and gentle, the opposite of the furious Phrygian. Coelius Aurelianus introduced a concept which reappeared at several widely separated times. He called it loca dolentia decantare, or enchanting the disordered places. He claimed that the pain was relieved by causing a vibration in the fibres of the affected part. There is little doubt that music causes a physical vibration of the air, but the force that such vibrations could have on most tissues is negligible. Other writers recommended that the instrument be held against the part to be treated for direct transmission of the vibrations, but if physical excitement is desired this can be accomplished more uniformly by applications known as manipulation or massage. Such manipulations are known to be helpful in some conditions, but not curative in painful conditions such as sciatica.
Nearchus, who accompanied Alexander the Great in his conquests, reported that in India the only remedy against the bite of a serpent was a chant[70]. Galen, one of the soundest physicians of ancient Rome, recommended music as an antidote to the bite of vipers and scorpions[7], and for centuries music was recommended for the bite of a tarantula. In the seventeenth century three physicians named Mead, Burette and Baglivi explained this use of music. They said that it threw the patient into a violent fit of dancing which brought out a plentiful perspiration, and with it the poison. Since perspiration consists of water and a few simple salts, such activity would increase the concentration of the poison in the circulating blood, and neither the explanation nor the treatment is acceptable[28]. Music was recommended not only for the bites of the reptiles and insects; Desault recommended it in the treatment of hydrophobia[23]. Not all bites are poisonous, and it is likely that in the case of the two patients mentioned the cure was more for fright than bite.
The effects of music on the mind were too obvious to escape the ancients. When the armies of Greece took the field, they were accompanied by the best musicians, who by their martial strains inspired the soldiers with a kind of mechanical courage never experienced by their enemies.
The distinction between mental health and disease was not advanced among the ancients, but they did recognize varieties of insanity such as delirium, melancholy and mania. Many physicians recommended music in the treatment of mental disease, and Quarin spoke of a single case of epilepsy cured by music. With the exception of severe epilepsy, many patients who suffer from the symptoms which bear this name have only occasional attacks and these disappear spontaneously, making the music simply another coincidence.
Celsus, who was a great medical authority not only in his own time but in subsequent centuries wrote of the mentally ill, “We must quiet their demoniacal laughter ... and sooth their sadness by harmony, the sound of cymbals and other noisy instruments”[16]. Areteus, another great physician of ancient Rome, prescribed music for “corybantism, a disease of the imagination”[24]. The great Dutch physician, Boerhaave[11], said, “I do not know if all that one tells us of the charms and enchantments could not be attributed to the effects of music, in which the ancient physicians were well versed.” References continued to appear concerning the magical relationship between music and healing. Robert Grosseteste (1175-1253 A.D.) said that disease and even wounds and deafness could be cured by music based upon a knowledge of astrology and mathematics[75].
During the early part of the Christian Era, most of the arts were sustained by the Church, and as a result the finest works in painting and music were available to the average man only within places of worship. Not until the Renaissance did serious music take on a secular character. Music until then was largely identified with religion, and as such was considered to have an influence on the soul. Bacon advanced as a rule of health that people “recreate their spirits every day with a piece of good music.”[13] He went a step further in his Sylva Sylvarum.
“Seeing then the mind is so powerful an agent in particular disease, I see no reason why the efficacy of music should not be tried in many disorders which arise in the animal constitution; for music composes the irregular motion of the animal spirits and more especially allays the inordinate passion of grief and sorrow.”[7]
The restful and joyful qualities of music were praised by Shakespeare:
“But sweet music can minister to minds diseased
Pluck from the memory a rooted sorrow
Raze out the written troubles of the brain
And with its sweet oblivious antidote
Cleanses the full bosom of all perilous stuff
Which weighs upon the heart.”
Henry Beacham wrote in his “The Compleat Gentleman” in 1634 that
“the exercise of music is a great lengthner of life, by stirring and reviving the spirits, holding a secret sympathy with them; besides the exercise of singing opens the breast and pipes; it is an enemy to melancholy and dejection of the mind, which St. Chrysostome truly called ‘Devil’s Bath’. Besides the aforementioned benefit of singing, it is a most ready help for a bad pronunciation, and distinct speaking, which I have heard confirmed by many great Divines; yea, in myself have known many children to have been aided in their stammering in speech by it alone.”
In the dark ages there was very little added to the knowledge of medicine, but during the Renaissance physicians became more progressive and articulate. Among these was the famous Willis who said that
“Music not only is a delightful phantasy, but dispels sadness from the grieving heart; and it also allays fevered passions and excessive commotion of the breast.”[81]
Characteristic of the use of music as an aid to healing is an anecdote quoted by Burney. Farinelli was one of the great operatic singers of his day and his fame was equally great in all of western Europe and England. One of the countries he visited was Spain. “It has often been related, and generally believed, that Philip V. King of Spain, being seized with a total dejection of spirits which made him refuse to be shaved, and rendered him incapable of attending council or transacting affairs of state; the Queen who had in vain tried every common remedy that was likely to contribute to his recovery, determined that an experiment should be made of the effects of music upon the King, who was extremely sensible to its charms. Farinelli was summoned and on his arrival her Majesty contrived that there should be a concert in the room adjoining the King’s apartment, in which the singer performed one of his most captivating songs. Philip appeared at first surprised, then moved; and at the end of the second air, made the virtuoso enter the royal apartment. He plied him with compliments and caresses and asked him how he could sufficiently reward such talents, assuring him that he could refuse him nothing. Farinelli, previously instructed, only begged that his majesty would permit his attendants to shave and dress him, and that he would endeavor to appear in council as usual. From this time the King’s disease gave way to medicine, and the singer had all the honor of the cure. “The King,” according to the London Daily Post of September 26, 1736, “settled a pension of 3,150 pounds sterling, per annum, on Signor Farinelli, to engage him to stay at court.”
A great number of references during the sixteenth and seventeenth centuries attests to the wondrous workings of music against mental disturbances. Wilhelm Albrecht[1] reported a patient who was suffering from melancholia. Many remedies had been tried, when as a last resort the physician requested that a certain ritournello be played. As soon as the patient heard it, he began to laugh with all his might and hopped out of his bed completely cured. More interesting is the observation of Champlain[17] who wrote on his return from America, “It is the custom in America when one is sick, to divert them with loud music, to prevent brooding about the condition and thus help restore health.”
Mozart was not the first to call the flute “magic.” To Democritus was attributed the story of abolishing plague with its music. Jean-Baptiste Porta claimed that one could cure all disease with music, provided that one used a flute made of the wood of the plant which was a known specific for the disease to be treated. Thus one could cure mental disease with flutes made of hellebore stems. One could return some vigor to the impotent with flutes made of orchid stems, and fainting could be cured by playing on a flute made of cinnamon wood.[67]
Philippe Pinel, the physician credited with being the first to accord the mentally ill humane treatment reported at least one instance of the use of music in the treatment of epilepsy.
“During the attacks, the sense of hearing, far from being deadened, seemed to have acquired more keenness. A skilful musician played on the violin at the patient’s side during her paroxysm. Although she then appeared insensible to the charm of music, she was so strongly effected by it, that she admitted after having recovered entire consciousness, that the music had thrown her into a state of rapturous delight.”
Literature abounds with many accounts of the use of music by lesser medical lights. Sauvages[18] mentioned a young man who had attacks of intermittent fever accompanied by violent headaches which could be soothed only by the sound of a drum played loudly. This same patient did not like music when in good health. Instances of this nature may be explained on the basis of counter-irritation, wherein a new disturbance superimposed upon an old one may counteract it.
In the eighteenth century, Brocklesby[13] summarized the known literature of music in relation to health and disease and, considering the status of medicine in his day, made a fair appraisal of its value.
During the last century Hector Chomet[18], a Parisian physician, became interested in music and its application to disease. He wrote a short article setting forth his views, which he was to deliver to a group of medical men in Paris, but was put off time and again by his colleagues and by political upheavals. Each time, before replacing his paper on the shelf, Chomet made additions. This work grew to be the important thing in his life, and when he could contain himself no longer, he published a book on the subject which showed considerable research but which unfortunately contained as much invention as fact. Not content with the known and proved existence of blood and lymph as the chief body fluids, he added another—the “sonorous fluid,” which was influenced for the good or bad by the vibrations of musical sounds.
At about the turn of the century Eva Vescelius, a woman of great charm, beauty and perseverance, reintroduced the use of music for mental disease under the guidance of a physician. There is little doubt that she gave great joy to many patients, but a differentiation must be made between personal attention and therapeutics. In her works[78] on the subject one can read enthusiastic accounts of past performances, but unfortunately her explanations and claims are pure phantasy, to wit:
“For fever, high pulse, hysteria, arrest the attention, play softly and rhythmically to bring pulse and respiration to normal. Tests with instruments will prove that music will do this. Do not change too abruptly from one key to another; modulate and pause and let the musical impression be absorbed. Select songs that depict green fields and pastures new, the cool running brook, the flight of birds, the blue sky, the sea.
“Fear is dissipated by music awakening in the listener the consciousness of the all enveloping Good. A high nervous tension is relieved and nerves are relaxed under the spell of a composition that swings the body into normal rhythmic movement. Sluggish conditions of body and mind are eliminated by the rhythmic waltz, polka or mazurka—music affecting the motor system. Insomnia is cured by the slumber-song, the nocturne, or the spiritual song that assures one of the Divine protection.”
The use of music in hospitals is by no means limited to the application to mental disease. Recreation is needed to avoid boredom, for as Shakespeare said:
“Sweet recreation barr’d, what doth ensue
But moody moping and dull melancholy
Akin to grim and comfortless despair
And at her heels a huge infection troops
Of pale distemperatures and foes to life.”
The use of music as a diversion in hospitals received a great impetus in the First World War but made its greatest leap forward with the introduction of the portable bedside radio.
The use of music as an exercise for poorly moving joints and weakened muscles is recent and may be said to have received its great impetus in the Second World War (described in the Boston Sunday Post, February 11, 1945; A-5).