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Journal of the History of the

Neurosciences: Basic and Clinical
Perspectives
Publicat ion det ails, including inst ruct ions f or aut hors and
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The Organism: A Holistic Approach to

Biology Derived from Pathological Data in
Man by Kurt Goldstein
a a
St ephen Pow & Frank W. St ahnisch
a
Depart ment of Communit y Healt h Sciences, Facult y of Medicine
& Depart ment of Hist ory, Facult y of Art s, Universit y of Calgary, AB,
Canada
Published online: 10 Jul 2014.

To cite this article: St ephen Pow & Frank W. St ahnisch (2014) The Organism: A Holist ic Approach
t o Biology Derived f rom Pat hological Dat a in Man by Kurt Goldst ein, Journal of t he Hist ory of t he
Neurosciences: Basic and Clinical Perspect ives, 23: 3, 330-332, DOI: 10. 1080/ 0964704X. 2013. 860512

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 Journal of the History of the Neurosciences, 23:330–332, 2014
Copyright © Taylor & Francis Group, LLC
ISSN: 0964-704X print / 1744-5213 online
DOI: 10.1080/0964704X.2013.860512

Book Review

Kurt Goldstein. The Organism: A Holistic Approach to Biology Derived from Pathological
Data in Man; Foreword by Oliver Sacks. New York: Zone Books, 2000. 424 pp.
$US 26.95. ISBN 0-9422-9997-3.

Kurt Goldstein. The Organism: A Holistic Approach to Biology Derived from Pathological
Data in Man (Germ. 1934), transl. by Henry E. Garrett. New York: American Book
Company, 1939. 533 pp. ISBN n.des., out of print.
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Oliver Sacks (b. 1933), professor of neurology at New York University (NYU), is the
author of a number of popular books that describe unusual clinical neurological condi-
tions — as in The Man Who Mistook His Wife for a Hat (1985) — as well as his attempts to
rehabilitate such patients — most notably in Awakenings (1973). His accessible works on
neurological and psychiatric cases have done much to draw public interest to these fields
and have also instigated growing awareness and fascination with the history of modern clin-
ical neuroscience. Moreover, it is mostly owing to Sacks’ efforts to rerelease the English
translation of the work The Organism (Germ.: Der Aufbau des Organismus. Einführung in
die Biologie unter besonderer Beruecksichtigung der Erfahrungen am Kranken Menschen)
that the contributions of German-born physician Kurt Goldstein (1878–1965) to neurol-
ogy, psychology, and larger biological themes have not fallen in the twenty-first century
into complete, and largely undeserved, obscurity. The hardcover (1995) and subsequent
paperback (2000) releases by Zone Books of what might be called the “Sacks edition” of
Goldstein’s magnum opus have reintroduced a new generation of scientists and laymen to
some powerful insights concerning the physiological interplay in the human and animal
nervous systems between their parts and the whole.
Referring to this monograph as an edition is admittedly not entirely accurate, as Sacks
is not claiming to be its editor per se. Moreover, despite the recent publication date, this
volume does not represent a new translation of the original German text as it appeared
in the Dutch publishing house of Martin Nijhoff in The Hague in 1934; the body text is
identical with that which appeared in the first and only English translation, published in
1939 by the American Book Company in New York, with the exception of a few, almost
imperceptible changes. As the book’s cover indicates, Sacks defines his own role as the
author of the foreword (pp. 7–14), in which he describes his encounter of The Organism
during his medical training in the 1950s. He had been astounded at the “forgotten figure”
(p. 7) of Goldstein and his profound understanding of the reactions of patients to injury
and illness—an understanding that Sacks saw being overlooked in the dry textbooks of
neurology but that was nonetheless vital to the rehabilitation of patients. Having estab-
lished why Goldstein’s work remains important today, Sacks’ foreword proceeds to lay out
the neuroscientific milieu from which it emerged, characterized by a conflict between the
majority of brain researchers who favored concepts of localization of function, and those
whose viewpoints leaned more toward generalizable functional interactions between neural
regions. Sacks’ historical section, which amounts to a Who’s Who of the leading figures
330
 Book Review 331

of nineteenth- and early-twentieth-century neurosciences, offers a useful background for

any reader attempting to contextualize Goldstein’s original work. While not resiling from
his view that The Organism presents ground-breaking arguments, Sacks concludes by
observing that Goldstein had provided details of the antecedent philosophical ideas and
neurological views which influenced his own.
Though it initially appears that Sacks only added brief contextualization to an other-
wise pre-existing monograph on holist neurology, his relationship with the final product that
Zone Books published actually goes much further, and the changes he made are not always
explicitly introduced and clarified. For example, he chose to include Goldstein’s preface
(pp. 17–22) from a very rare 1963 reprint of The Organism that was otherwise unchanged
from the 1939 version. This amounts to an editorial choice on the part of Sacks, since he
could have simply used the earlier and much more available version and thus omitted the
later preface. Thankfully he did include it, as it illustrates Goldstein’s attitude, near the end
of his life, regarding the relevance of his work three decades after its release. More impor-
tantly, however, Sacks made extensive changes to the endnotes and index of the book (often
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by introducing modern neurological literature that could not have been known to Goldstein
and his contemporaries), and this is where the gravest problems emerge. Such problems,
however, are not entirely his fault and have much to do with the unusual and constrained
circumstances in which Goldstein produced the original version of the book in his exile at
the University of Amsterdam.
As a neurologist at the Frankfurt Institute for Research into the Consequences of Brain
Injuries from 1916 onward, Goldstein and his collaborators had worked with countless
brain-injured vetrans of the First World War with the purpose of returning them to some
level of function in society. That these patients adapted and seldom suffered complete loss
of a field of performance convinced him that previous mechanistic notions of brain func-
tion were incorrect (Stahnisch & Hoffmann, 2010). Goldstein’s attempts to disseminate his
ideas in Germany came to an end with the rise of the Nazis, who targeted him immediately
in 1933 as a Jewish academic with important socialist leanings. Exiled, he took up a brief
residence in Amsterdam from 1934 to 1935 where, with the support of the Rockefeller
Foundation, he dictated The Organism to a secretary. An anxious refugee, most of his
library inaccessible, and much of his life’s work destroyed, the footnotes of the result-
ing manuscript were often inaccurate or even missing in many places. Goldstein excused
this by arguing that he was not attempting a tractate on the history of medicine (p. 31), but
it is doubtful that he had any choice but to rely on his foregoing paper manuscripts and
even upon his memory in places. These unusual circumstances at least partially explain the
frequent errors found in the notes and index of the English translation, completed in 1939,
four years after Goldstein had migrated to the United States.
Sacks apparently undertook some effort to improve on the deficiencies he noticed in
the older translation. For instance, the 1939 version has no notes at all for Chapter XII and
the concluding remarks. The Sacks version does include four endnotes for these sections,
including an endnote from William Stern’s (1871–1938) General Psychology (p. 412), pub-
lished in 1938. One must conclude from this and other examples that Sacks sometimes
inserted his own ad hoc notes where he thought this appropriate. On the other hand, Sacks
was as willing to remove material. For example, Muenster psychologist Wolfgang Metzger
(1899–1979) was erroneously listed in the index to the 1939 version’s as “E. Metzer”; in
the Sacks edition, all reference to Metzger in the index has simply disappeared. Many other
individuals are only mentioned in the Sacks index by their last names. For instance, we
have a scientist listed as “Anderson” (p. 413), and two others identified only as “Walsh” and
“Wacholder” (p. 422). In such cases, it appears that Sacks did not even attempt to identify
 332 Book Review

the specific individuals. As a generalization, these last names do not prove particularly
helpful in identifying the sources that Goldstein was using.
It is very unfortunate that it remains difficult to identify the individuals whose research
helped Goldstein write The Organism, because even if the author did not intend to publish
a cultural history of theoretical neurology, his book is now extremely valuable as such.
It is the product of a period that saw the exodus of a huge number of mostly Jewish-
German scientists and academics from their homeland, with up to one third of all professors
released from their academic posts in the first two years of Nazi rule (Peters, 1992), and its
pages indirectly recount a story of displacement and shattered professional relationships.
Fortunately, the body text of the 1939 version has been faithfully reproduced. However,
this English version is not simply a translation of the German: It contains additional mate-
rial not found in Goldstein’s original publication, such as a detailed account of a particular
patient’s sexual disorder (p. 253), and sections discussing the work of American neurol-
ogists and psychiatrists (pp. 155–170) presumably added to make American readers more
receptive to Goldstein’s innovative work. Chapters VI and VII, representing a single chapter
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in the German original, have been divided along thematic lines for clarity.
If the content of the book were to be broadly characterized, the initial six chapters will
probably appeal more to the biologist. This first half delves heavily into physiology and
reflexology, with Goldstein challenging the idea that discovering all the “part processes”
of the nervous system and reducing them to their mechanistic laws will result in a fuller
understanding of life (p. 69). The remaining seven chapters, discussing Gestalt psychology
and epistemology and providing an interesting challenge to prevailing psychoanalytical
notions, will appeal to those coming from a philosophical perspective. The text thereby
reflects a longstanding tension in the author between his humanistic and scientific lean-
ings, upon which he had frequently reflected (Goldstein, 1967). A highlight of the book
is Chapter VI in which Goldstein provides a number of illustrative examples of patients
and animals suffering cortical damage but quickly adapting in order to “cope” with their
milieu (the “catastrophic reaction” as he famously called it). Goldstein’s statement that
“patients (as well as observers) are surprised to see what performances they [the brain
injured patients] can accomplish if one makes greater demands on them” (p. 197) reveals a
curiously modern outlook on the intriguing possibilities for neurological rehabilitation.

Stephen Pow and Frank W. Stahnisch

Department of Community Health Sciences
Faculty of Medicine & Department of History
Faculty of Arts
University of Calgary, AB
Canada

REFERENCES
Goldstein K (1967): Autobiography. In: Riese W, ed., A History of Psychology in Autobiography.
New York, Appleton Century Crott, Vol. V, 147–166.
Peters U (1992): Psychiatrie im Exil. Duesseldorf, Kupka.
Stahnisch FW, Hoffmann T (2010): Kurt Goldstein and the neurology of movement during the
interwar years— Physiological experimentation, clinical psychology, and early rehabilitation.
In: Hoffstadt C, Peschke F, Schulz-Buchta A, Nagenborg M, eds., Was bewegt uns? Menschen
im Spannungs feld zwischen Mobilitaet und Beschlunigung. Bochum, Freiburg, Projektverlag,
pp. 283–311.