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Diversity, Intercultural Encounters,
and Education
Routledge Research in Education
For a full list of titles in this series, please visit www.routledge.com.
56 International Case Studies of
Dyslexia
Edited by Peggy L. Anderson and
Regine Meier-Hedde
57 Schooling and the Making of
Citizens in the Long Nineteenth
Century
Comparative Visions
Edited by Daniel Tröhler,
Thomas S. Popkewitz and
David F. Labaree
58 Islamic Education and
Indoctrination
The Case in Indonesia
Charlene Tan
59 Beyond Binaries in Education
Research
Edited by Warren Midgley,
Mark A. Tyler, Patrick Alan
Danaher and Alison Mander
60 Picturebooks, Pedagogy and
Philosophy
Joanna Haynes and Karin Murris
61 Personal Epistemology and
Teacher Education
Edited by Jo Brownlee, Gregory
Schraw and Donna Berthelsen
62 Teacher Learning that Matters
International Perspectives
Edited by Mary Kooy and
Klaas van Veen
63 Pedagogy of Multiliteracies
Rewriting Goldilocks
Heather Lotherington
64 Intersectionality and “Race”
in Education
Edited by Kalwant Bhopal and
John Preston
65 The Politics of Education
Challenging Multiculturalism
Edited by Christos Kassimeris and
Marios Vryonides
66 Whiteness and Teacher
Education
Edie White
67 Multidisciplinary Approaches to
Educational Research
Case Studies from Europe and the
Developing World
Edited by Sadaf Rizvi
68 Postcolonial Perspectives on
Global Citizenship Education
Edited by Vanessa de Oliveira
Andreotti and Lynn Mario T. M.
De Souza
69 Education in the Black Diaspora
Perspectives, Challenges, and
Prospects
Edited by Kassie Freeman and
Ethan Johnson
70 Gender, Race, and the Politics of
Role Modelling
The Influence of Male Teachers
Wayne Martino and
Goli Rezai-Rashti
71 Educating for Diversity and
Social Justice
Amanda Keddie
72 Considering Trilingual
Education
Kathryn Henn-Reinke
73 Commitment, Character, and
Citizenship
Religious Education in Liberal
Democracy
Edited by Hanan A. Alexander and
Ayman K. Agbaria
74 Adolescent Literacies in a
Multicultural Context
Edited by Alister Cumming
75 Participation, Facilitation, and
Mediation
Children and Young People in
Their Social Contexts
Edited by Claudio Baraldi and
Vittorio Iervese
76 The Politics of Knowledge in
Education
Elizabeth Rata
77 Neoliberalism, Pedagogy and
Human Development
Exploring Time, Mediation and
Collectivity in Contemporary
Schools
Michalis Kontopodis
78 Resourcing Early Learners
New Networks, New Actors
Sue Nichols, Jennifer Rowsell,
Helen Nixon and Sophia Rainbird
79 Educating for Peace in a Time of
“Permanent War”
Are Schools Part of the Solution
or the Problem?
Edited by Paul R. Carr and
Brad J. Porfilio
80 The Politics of Teacher
Professional Development
Policy, Research and Practice
Ian Hardy
81 Working-Class Minority
Students’ Routes to Higher
Education
Roberta Espinoza
82 Education, Indigenous
Knowledge, and Development in
the Global South
Contesting Knowledges for a
Sustainable Future
Anders Breidlid
83 Teacher Development in Higher
Education
Existing Programs, Program
Impact, and Future Trends
Edited by Eszter Simon and
Gabriela Pleschová
84 Virtual Literacies
Interactive Spaces for Children
and Young People
Edited by Guy Merchant,
Julia Gillen, Jackie Marsh and
Julia Davies
85 Geography and Social Justice in
the Classroom
Edited by Todd W. Kenreich
86 Diversity, Intercultural
Encounters, and Education
Edited by Susana Gonçalves and
Markus A. Carpenter
Diversity, Intercultural
Encounters, and Education

Edited by Susana Gonçalves and

Markus A. Carpenter

NEW YORK LONDON

First published 2013
by Routledge
711 Third Avenue, New York, NY 10017
Simultaneously published in the UK
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
Routledge is an imprint of the Taylor & Francis Group,
an informa business
© 2013 Taylor & Francis
The right of Susana Gonçalves and Markus A. Carpenter to be identified
as the authors of the editorial material, and of the authors for their
individual chapters, has been asserted in accordance with sections 77 and
78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark Notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
Library of Congress Cataloging-in-Publication Data
Diversity, intercultural encounters, and education / Edited by Susana
Gonçalves and Markus A. Carpenter.
pages cm. — (Routledge research in education ; 86)
Includes bibliographical references and index.
1. Multicultural education—Cross-cultural studies. I. Gonçalves,
Susana, 1961– editor of compilation. II. Carpenter, Markus A., 1961–
editor of compilation.
LC1099.D56 2012
370.117—dc23
2012016924

ISBN13: 978-0-415-63833-3 (hbk)

ISBN13: 978-0-203-08407-6 (ebk)

Typeset in Sabon
by IBT Global.

Printed and bound in the United States of America on sustainably sourced

paper by IBT Global.
Contents

List of Figures and Tables ix

Preface xi
SUSANA GONÇALVES AND MARKUS A. CARPENTER

PART I
Challenges of Diversity and Intercultural Encounters

1 Seen at a Distance: How Images, Spaces and Memories Shape

Cultural Encounters 3
SUSANA GONÇALVES

2 Multicultural Society in Europe: Beyond Multiculturalism 41

MARIA LAURA LANZILLO

3 The UK’s Ad Hoc Multiculturalism and the Rise of Britishness 57

CHRIS GIFFORD, JAMIE HALSALL AND SANTOKH SINGH GILL

4 Media and Interculturality: Mapping Theories, Projects

and Gaps 72
SOFIA JOSÉ SANTOS

PART II
Identities Confronted and Renewed

5 Foundations of Culture of Conflict 91

DANIEL BAR-TAL AND EMAN NAHHAS

6 Intercultural Education: Learning from the Integrated

Catholic and Protestant Schools in Northern Ireland 113
CLAIRE MCGLYNN
viii Contents
7 On Being Invisible and Passing through Walls: Toward a
Pedagogy of Seeing and Being Seen 128
CHRISTINE BALLENGEE MORRIS AND B. STEPHEN CARPENTER II

8 Identities and Diversities among Young Europeans:

Some Examples from the Eastern Borders 141
ALISTAIR ROSS

9 Separate by Choice, or Degrees of Separation 164

MARKUS A. CARPENTER

10 The Mirrors’ Maze: On Emotional Aspects of Dealing with

Differences in a Multicultural Society 184
NILLY VENEZIA

PART III
Postcolonial, Post-Historical, Postmodern Scenarios
and Interrogations

11 “The Syndrome of Ernesto” and Multiculturalism:

On Being a Teacher in Mozambique 203
ANTÓNIO CABRITA

12 Memory, Hope and Post-Historical Politics in

Multicultural Horizons 217
FRANCISCO NAISHTAT

13 The Extinction of the Negative: Megamind, Mouffe and

the Antipolitics of Liberalism 229
CHAN NIN AND CHAN KWOK-BUN

Contributors 243
Index 251
Figures and Tables

FIGURES

1.1 Find the differences . . . (images taken from “The secret

museum of mankind”). 3
1.2 Seen at a distance. 5
1.3 My photo of the photo. 5
1.4 World’s fairs and landscapes of the modern metropolis. 15
1.5 Sculpted, wooden mask. 20
1.6 Images and captions from “The secret museum of
mankind”. 36
1.7 Images and captions from “The secret museum of
mankind” (continued). 37

TABLES

8.1 Distribution and Size of Focus Groups 143

Preface
Susana Gonçalves and Markus A. Carpenter

This book highlights some of the most poignant and challenging outcomes
of cultural diversity faced more or less palpably by everyone, everywhere
in today’s societies. The scope of the book’s theme is global, addressing
diversity and identity, intercultural encounters and confl ict and the inter-
rogations of a new sociopolitical order or paradigm. These topics are of
current interest particularly in the academic, sociopolitical, economic and
entrepreneurial spheres.
The original project behind this book is concerned with the challenges
and tensions rising from mass migration flows, unbalanced North–South
and East–West relations and the increasing multicultural nature of society.
The vertiginous beginning of the twenty-fi rst century has been marked by
an abrupt socioeconomic revolution:

• Planetary urbanization (for the fi rst time in history more than 50 per-
cent of the world’s population live in cities).
• Economic globalization, increase in the number of megacities (cities with
more than ten million inhabitants), the strengthening of lobbies, inter-
national holdings and franchising firms and the worldwide influence of
global cities (London, New York, Hong Kong, Singapore, Tokyo).
• The immense, transcontinental trail of labor migrants, refugees and
displaced people and the consequent recreation of cultural communi-
ties in foreign spaces.
• The transformation of the global village into a global metropolis (with
entire countries falling into categories within the global space such as:
metropolis favela, resort, shopping center, factory).
• The internationalization of humanism and barbarity on a plan-
etary scale (we need only recall the global causes and effects of
September 11, 2001).
• The infiltration of cybernetic synapses into people’s everyday lives,
which remake, transform and fictionalize us (YouTube, Facebook,
MySpace, Google, Skype, Wikipedia, Amazon, Second Life).
• The entrance of what were once science fictional devices into everyday
domestic reality (household robots, business and fi nancial transactions
xii Susana Gonçalves and Markus A. Carpenter
done through home computers, personal use of satellites—Google
Earth, Google maps—imaging satellites flying above the office, work-
ing online from home, cloning, virtual reality and 3-D cinema), Big
Brother’s surveillance cameras everywhere, the brave new world of
genetic engineering, conspiracy theories . . . everything related to a
fiction seemingly more real than reality, domesticated and wild at the
same time.

This is the world in which we live, are natured and nurtured. That is, the
rapid transformation of the social fabric, especially in urban areas, the
dynamics of new identities, often mixed, multiple and growing in a no-
man’s-land. Also, the rise of social confl ict and violence when social cohe-
sion and democracy fail turn the topic of rapid, unpredictable social change
into one of the most frequent and intense debates in the arena of social and
political sciences.
We believe that describing, explaining and understating such a complex
theme and its vast implications greatly benefits from a broad, multidis-
ciplinary and international perspective. We believe this comprehensive
approach is one of the main virtues of the book, lending novelty to its
exploration of concepts, the tentative explanations it offers and the ques-
tions it poses to refi ne our reasoning and understanding of the contempo-
rary world.
The fi rst part, “Challenges of Diversity and Intercultural Encounters,”
lays a theoretical and historical foundation for the issues surrounding mul-
ticulturalism and plural societies. Multiculturalism, in its various expres-
sions, influences all sectors of social and professional life, and has already
become a growing field of interest worldwide.
When differences are used to mobilize antagonism or orchestrated by
powers to promote opposition, hate and the submission of minority groups,
the potential of multiculturalism as a source of enduring confl ict becomes
real, as illustrated by a number of riots in multiethnic, multifaith and mul-
tilingual societies in recent years (for example, the Madrid train bombings
on March 11, 2004, from al-Qaeda terrorist inspiration; the Paris riots of
2005, underscored by cultural tensions; or the underground bombings in
London in 2006 and the more recent civil unrest all over the UK in August
2011; etc.).
The project of coexistence in a context of diversity can fuel separation
and stagnation, war and destruction; but it can also contribute to peace,
vitality and sustainable development, as an unbiased examination of his-
tory and peaceful intercultural situations rapidly confi rm. Education and
social policies, fair and wisely applied, are at the heart of the solution for
the challenges and tensions illustrated in the case studies presented in the
book relating results and lessons learned from real-world initiatives.
This part begins with a chapter by Susana Gonçalves on the intrica-
cies of perception, how time, place and vantage point influence how we
 Preface xiii
view outsiders. This informative chapter encapsulates the colonial period
of the late nineteenth and early twentieth centuries, providing historical
background and insight into the practices and motivations of the colonial
powers, showing how erroneous ideas and prejudices became validated
and institutionalized and serving as a justification for exploitation and
subvalorization of native cultures. During times of colonialism and impe-
rialism the fabrication of social images and identities owed much to instru-
ments such as public exhibitions, galleries and museums, photography,
literature and tourism. For clarification, a few concrete examples charged
with symbolism, which reveals their force as paradigmatic elements of
the dominant mentality of the day, are offered. The chapter fi nally brings
these flawed images of the Other into the present, showing how they have
evolved yet still operate in terms of recognition and awards the West
chooses to bestow upon developing countries. Susana Gonçalves uses the
work of distinguished scholars like Appadurai, Bhabha and Amartya Sen
to support her observations.
In “Multicultural Society in Europe: Beyond Multiculturalism,” Maria
Laura Lanzillo takes a detailed look at what is actually meant by “multi-
culturalism,” its desired outcome and actual results. She takes a careful,
theoretical approach to the term and how it has evolved in recent years. Her
chapter brings into focus the political and social approaches to the growing
multicultural reality, pointing out their flaws and suggesting paths for the
future. The author argues that the “contemporary debate on the question
of multiculturalism shows that there is currently no conception of freedom
in political thought, and the immediate effect this has is to confi ne each of
us to our own identity and culture.” After a review of the most important
doctrines on multiculturalism, the author shows that certain innovative
guidelines can currently be found in the field of postcolonial studies, in
deconstructivism and post-structuralism, or in feminist theory.
In Chapter 3, Chris Gifford, Jamie Halsall and Santokh Singh Gill focus
on the factors surrounding forms of inclusion and exclusion of ex-colonials
(particularly South Asians) in contemporary British society. The authors
argue that more progressive features of UK multiculturalism were enabled
by a relatively weak form of top-down national identity; however, this is
being replaced by a codification of what it means to be British. This chap-
ter particularly focuses on the precarious forms of inclusion and exclusion
of South Asian people as British citizens, often problematized in the dis-
courses of multiculturalism and cohesion. The chapter maps the nation’s
search for accommodation and social justice for these immigrants; it not
only examines government policy, but also gives a voice to the immigrant
concerns through data collected through questionnaires and surveys.
Media occupies a very central and persistent role in the global agenda.
Media’s discourse has the power to refi ne symbolic values and to create
truths, thus acting at the very heart of perceptions, behaviors and social
constructions. The discourse of the media is powerful enough to create and
xiv Susana Gonçalves and Markus A. Carpenter
regulate individual and collective ideas and to target peoples and groups
in multicultural, global and interconnected societies, forging distrust and
inequality. In “Media and Interculturality: Mapping Theories, Projects and
Gaps” Sofia José Santos examines the role the mass media play in trans-
mitting and propagating attitudes about developing countries. The chap-
ter aims at deconstructing the assumption of neutrality of media contents,
making visible and unsuitable the line drawn between North and South
concerning media performances and exploring the dynamics underlying
the relation between media and the management of diversity within mul-
ticultural societies. The author brings up the critical, but underanalyzed,
need for more diversity and “local” content, especially in the electronic
media, to preserve, strengthen and make available the richness of minor-
ity cultures. These contents hold genuine resources for their peoples and
those outside that culture, yet like the rainforest they are slipping away
without the wider world’s awareness of what is being lost. Naturally, the
chapter deals with types of media bias, but, more importantly, it defines
and explores the recent concepts behind “Peace Journalism.”
The second part of the book, “Identities Confronted and Renewed,”
offers a truly global perspective on a variety of multicultural issues and
specific cases from around the world. This part brings to reflection subjects
such as intractable confl icts, separation and exclusion of minority groups
and their impact on identity and the chronicle of educational efforts for
peaceful coexistence in countries fustigated by historical ethnic and politi-
cal splits and confl ict.
In Chapter 5, Daniel Bar-Tal and Eman Nahhas from Tel Aviv Univer-
sity address the foundations of cultures of conflict, focusing on interethnic
intractable conflicts. With precision and clarity, they cover the underpin-
nings of long-running conflicts and animosities in the Middle East, Sri
Lanka, Kashmir and Northern Ireland—these confl icts are taken by the
authors to illustrate the features of intractable confl ict, the evolution of the
culture of conflict, its nature and its consequences. It is a thought-provok-
ing presentation showing the surprising universality of the roots of conflict
within very diverse cultures. Understanding the emotional and mental pro-
cesses at work here is essential because “as a conflict begins in the human
mind, its ending also has to be initiated in the human mind.” Where long-
standing, violent and vicious intractable confl ict exists, societies develop
“cultures of conflict” that have tremendous influence on the way these
conflicts are managed, since they provide important foundations for their
continuation and prevent their peaceful resolution.
This chapter is fittingly followed by Claire McGlynn’s chapter on inte-
grated Catholic and Protestant schools in Northern Ireland. Northern Ire-
land is a particularly interesting context, not just because of the ongoing
division and the legacy of confl ict, but because of the compromises that
need to be made to fully include new migrants, particularly from East-
ern Europe. The majority of Catholic and Protestant children are educated
 Preface xv
separately, but the integrated schools represent a brave attempt to educate
children together in a challenging environment. The Catholic–Protestant
rift in that part of the world has deep historical roots and numerous com-
plexities not immediately apparent to the outsider. Drawing on qualitative
data collected over a period of more than ten years from the sixty-plus inte-
grated schools in Northern Ireland, McGlynn’s chapter critically examines
a variety of leadership approaches to diversity and considers their implica-
tions in the context of the wider debate around multiculturalism. The chap-
ter shows how practice should stem from theory and proper understanding
of a problematic situation.
Identity is a paramount dimension of being; not only is it the terrain
for the individual to make sense of his experiences, but it is also impor-
tant at the community level, thus implicated in group relations and power.
Through identity, individuals and communities preserve both individual
and collective experiences and a sense of cultural background, values and
patterns of behavior.
In their chapter, Christine Ballengee Morris and B. Steven Carpenter
refer to identity as a transitory self-centered mode of thinking grounded
in fragmentation and dualism. Identity impacts cultural and historical
frameworks that form how individuals are grouped and identified, and
are often based on race, gender, sexual orientation, religion, nationality,
socioeconomic status, narratives and history, to name a few. The issue of
being assigned an invisible identity as well as constructing such an identity
for oneself can be examined as a theoretical discourse as much as a liv-
ing one. In this chapter, the authors have offered descriptions of bi- and
multiracial subjects and situations in which invisibility has been assigned
to or assumed by racial and cultural “Others.” Bi- and multiracial people
can and often do assume different identities depending on the social and
cultural context. While such a statement might sound empowering for mul-
tiracial people, they are not always in control of how and when they are
identified. Ultimately this chapter raises questions of how identity forma-
tion can be addressed through education. The authors deal with “A Peda-
gogy of Seeing and Being Seen.” Through a set of stories they reveal ways
educators, and in turn students, can transform tools of oppression into
tools of inquiry, liberation and hope, making constructive meaning out of
cultural and racial ambiguities.
In Chapter 8 Alistair Ross discusses “Identities and Diversities among
Young Europeans.” This very contemporary chapter focuses on the youth
from the Eastern border of the European Union—Estonia, Latvia, Lithu-
ania, Poland, the Czech Republic, Slovakia, Hungary and Turkey—their
increased mobility and the multiple identities they choose to adopt. The
information it contains is built upon what was learned from more than
eighty focus groups of young people during 2010–2011. The location of
these countries and the time of this analysis are critical: these countries
have all recently joined the Union or are negotiating membership and the
xvi Susana Gonçalves and Markus A. Carpenter
young people, aged between twelve and nineteen, have all grown up in very
different times from the years in which their parents and grandparents were
socialized. Alistair Ross’s research is set within the theoretical framework
of multiple identities, and the ways in which aspects of both globaliza-
tion and Europeanization have made it more likely for young people to
express a diversity of identities. Results show that these young people have
fewer attachments to their national identity than their parents, ascribing
this to the different experiences of national struggle that their parents went
through. Their sense of national identity is largely cultural, rather than
focused on national institutions. Their European identity is, in many cases,
concerned with the European institutions that give them access to travel,
study and possible work. Some of the Turkish young people were more
concerned with their national identity, but minorities expressed other iden-
tities and looked to Europe to help them extend their human rights. In all
countries, many of these young people considered themselves to be at the
eastern limits of Europe and were concerned not to let countries further
east become members of the European Union.
Sociologists and anthropologists have highlighted many factors that fig-
ure into ethnicity and cultural identity. Research shows that the complicated
notion of identity can be very fluid and hardly depends upon the fixed and vis-
ible alone. In this increasingly complex world we are all becoming “hybrids,”
if for no other reason but the mere fact that we must understand and accom-
modate “difference.” In Chapter 9 Markus A. Carpenter touches upon the
situations of long-established ethnic groups in the United States who, through
a combination of religious, cultural and racial factors, have chosen (or were
assigned) degrees of separation or attempted integration. The chapter exam-
ines two distinct minority groups in the United States: the Amish and the
Native Americans. The Amish immigrated to America for religious/social rea-
sons and for the most part have maintained an amicable but strong separation
from American society. A brief look at the concessions made to them within
the larger, national context would prove interesting. The Amish are a pecu-
liarly American phenomenon; an ethnic and faith community that is thriv-
ing despite its rejection of modernity. The Native Americans as a “colonized
minority” have had an ambiguous relationship with the white Euro-American
settlers from first contact to the present and a greater influence upon even the
form of American government than is normally recognized. They have been
the object of measures to both promote integration and to maintain separa-
tion with interesting results. Both groups are beneficiaries of “legal pluralism,”
which has allowed them to maintain many of their traditional ways within the
larger culture. It has been and continues to be an interesting process of nego-
tiation between these groups and the dominant culture. A willed separation,
accommodation and shifting personal identities, balanced between a historic
and lived past and the present, are at play here.
Why is it so intimidating to deal with differences, diversities, multicul-
turalism? What kind of emotional mechanisms do people create in order
 Preface xvii
to “protect” themselves from seeing the other as he or she is? Nilly Venezia
addresses these questions as a starting point for her chapter, where she
shares her fi ndings from a training course for a multicultural group of kin-
dergarten teachers in Israel. The author describes a group dealing with the
emotional aspects of accepting differences. In her words, “[There were]
fifteen educators who found themselves in a mandatory training program
and helped me to go through this fascinating journey, beginning from try-
ing to ‘digest’ each other, the unfamiliar facilitators and participants, the
courage to create awareness to stereotypes and prejudice and the attempt
to translate the learning into practical daily work. I decided to write it in
a ‘storytelling’ fashion with the hope that people would read and identify
with its subject matter, each and every one according to its particular rel-
evance for them.” Chapter 10 is an excellent study in intercultural group
dynamics and concerns, preparing teachers to create a space for acceptance
of differences and uniqueness in their classrooms partially by experiencing
the creation of this space in their training group. The chapter has a very
practical yet analytical tone and takes a fresh approach to training teachers
for the intercultural classroom.
Finally, the last part of the book, “Postcolonial, Post-Historical, Post-
modern Scenarios and Interrogations,” brings to light a philosophical
debate on today’s conditions of existence. Between the old imperial pow-
ers and the dissolving twentieth-century order there are dangers such as
the reconstruction of history as fiction, avoiding remembrance of tragedy
and oppression, the disillusion and absence of hope and a discourse of cul-
tural relativism that turns into passivism and the alienation of the Other.
The destructive power of extreme liberalism also creates monsters such as
extreme poverty, exclusion and mass manipulation.
The aforementioned problems are all dark facets of a destructive path of
development conducted by imperial grasp and selfish motives, placing the
interests of economic elites, military power and blind greed over citizens’
well-being. This part of the book is a reflection on such dangers and wor-
ries, also comprising the hope grounded on enlightening critical thought
and the power of the word and dialogue.
Chapter 11 is a thought-provoking reflection on the author’s teach-
ing experience in Mozambique. Taking the delightful fable of Ernest (by
Machado de Assis) as a metaphorical guide for his chapter, António Cabrita
expands on the idea that the world is perceived in accordance with the
ambient in which we live and operate, and that its various tools for reading
do not provide any hierarchical valuation of the different narratives. Every
multicultural narrative is sustained on this constructionism, with no differ-
ence or any hierarchy in the approach to truth and reality. The author leads
us smoothly through a handful of historical episodes and anecdotes in order
to touch the heart of his thesis—the idea that intercultural comparison
and information is an intellectual tool for any people and cultural group,
helping avoid the traps of superstition, fallacious views and detrimental
xviii Susana Gonçalves and Markus A. Carpenter
perspectives toward the Other that make cultures look at each other with
disdain, thus justifying the asymmetries of power and domination. Being a
teacher in Mozambique, the author takes his teaching experience as a basis
to discuss the dangers of turning cultural relativism into a refusal to learn
about the Other, to use information about otherness as a source to question
one’s own identity roots and filiations, a menace inaudibly reinforced by
the postmodern excess of information, image and individualism.
Francisco Naishtat looks at social movements and collective actions in
the contemporary era of multicultural postmodernity. Naishtat’s subject is
broad and elusive, but he deals with the evolution of hope and ideas of uto-
pian in society and makes sense of where modern societies are headed. His
work is tightly connected to capitalism, poverty, exclusion and fragmented
solidarity, which contribute to some of the most deplorable conditions of
existence in postmodern societies. The pursuit of justice and the struggle for
democracy and the fight against deprivation are common to the struggles
for the recognition of differences (the emphasis put on the fragmentation
of language, multiculturalism, plurality of ways of life) and the struggles
of the excluded, the “without” movements—“without rights,” “without
land,” “without roof,” “without job,” “without papers,” etc. These move-
ments demand political openness, truth and hope. How can we tackle the
hope issue from a pluricultural, political standpoint? How can we revive a
discourse of hope without falling into the traps of pensée unique, fetishism,
religious fundamentalism or theocracy? From a “post-history” philosophical
perspective, Naishtat deals with this issue in relation to the multicultural and
the global dimension of politics and analyzes how memory and hope can be
the pillars of democracy and justice. Democracy and justice, in between the
shade of postmodernity and the shade of globalization and its biopolitical
governance, make plausible a dimension of profane hope. Profane hope, the
opposite of estrangement and alienation, is rather a horizon of action and
understanding at the same time, an active movement that makes the pres-
ent concrete and the future a possibility. As such, utopia and hope have the
power to create a historical world and to bring in a possible future.
From Hong Kong, Chan Nin and Chan Kwok-bun also focus on how glo-
balization and multiculturalism have changed the political landscape. They
cleverly utilize parts of the narrative of the recent DreamWorks’ animated
feature film Megamind as metaphors and illustrations of contemporary cur-
rents of change in the world at large, offering a critique of the current state of
political liberalism. This chapter converges with certain emerging tendencies
in critical thought, many of which take their cues from the synthesis of Freud,
Hegel, Marx and Jacques Lacan, among others. The chapter demonstrates
that, in the words of the authors “the ‘antipolitics’ of liberal democracy, hav-
ing evacuated politics of all meaningful content and reduced it to a techno-
cratic accessory for the ‘servicing of goods’ (Lacan’s phrase), is ill-equipped to
remedy the implosion of meaning that it has engendered and enforced across
the world. As such, another politics must be invented.”
 Preface xix
This book is an original and organic work, coherent yet wide-ranging
and international in scope. The works of this prestigious group of authors
stem from a combination of similar motivations, diverse expertise and a
variety of viewpoints and approaches to an increasingly relevant social
issue. Working from the most diverse locations on the planet, like Bolo-
gna, Belfast, London, Pennsylvania, Tel Aviv, Maputo, Buenos Aires or
Hong Kong, these social scientists came together to share their reasoning
and most up-to-date fi ndings to make this book what we believe to be a
fi ne vehicle to promoting attitudes of informed criticism, understanding
and self-reflection.
Part I

Challenges of Diversity and

Intercultural Encounters
 1 Seen at a Distance
How Images, Spaces and Memories
Shape Cultural Encounters
Susana Gonçalves

Slovakia Australia Bulgaria New Guinea, Muscat, Oman

(Emu tribe) Melanesia

Figure 1.1 Find the differences . . . (images taken from “The secret museum
of mankind”).

SEEN AT A DISTANCE: THE SECRET MUSEUM OF MANKIND

La Habana, 2004, a pleasant morning in the Plaza de Armas. I was brows-
ing the secondhand book market searching for the unusual, leafing through
books here and there. Suddenly, two book covers from the pile of antiques
riveted my attention, triggering an avalanche of thought and feeling that
comes flooding back as I begin to write this chapter.
The first book was an old edition of A Relíquia (The Relic) by the Portu-
guese writer Eça de Queiroz. A picturesque but easy to follow tale written
after the author had served as Portuguese Counsel to Cuba (1873–1875) and
distinguished himself by fighting for the rights of the Chinese immigrant com-
munity (the coolies from Macao). This ambassador-writer and his novel are
evoked by the phrase “Over the stark nakedness of truth, the diaphanous veil
of fantasy” (Sobre a nudez forte da verdade, o manto diáfano da fantasia),
which decorates the wall of the charming Egyptian Colonnade, the same café
frequented by Eça, located next to the Plaza de Armas and the Hotel Ambos
4 Susana Gonçalves
Mundos, where another writer, Hemingway, decades later wrote part of For
Whom the Bell Tolls.
The second discovery was The Secret Museum of Mankind: Five Volumes
in One. This was a very curious hard-bound book, its pages yellowed by
age and permeated by an intense smell of dust. Opened to the first page I
saw it was published in New York, by Manhattan House. There was not
another word concerning its publication. There was no date, no introduction,
no authors or intention. Instead, what followed were five hundred pages full
of captioned photographs presenting portraits of peoples from every corner of
the globe. The book falls in between anthropology and ethnocultural voyeur-
ism, and the photographs appear to date from the latter nineteenth to early
twentieth century. After buying the book, I eagerly searched the Internet for
information surrounding its publication and found nothing. I did, however,
find two or three badly worn copies for sale on eBay, if I recall.
I was intrigued by the enigma of this book for about six years: Who took
the photos? Who backed this project? For what purpose and readership was
it intended? Close examination permitted only a few general assumptions.
Obviously the photographs could not have been taken by only one photogra-
pher; they were of different styles, periods and resolution. All five continents
were represented through very diverse groups of peoples. More than one life-
time would have been necessary for the same person to have assembled such
a record of the parade of humanity from around the world.
What one may see and read in the book is truly all of humanity from
a certain epoch, although through the less than perfect eye of the camera
and further distorted through stigmatizing, culturally myopic and overtly
racist captions. The book was a product of the colonial era at its peak when
the world was “civilizationally divided” between the developed peoples
(Anglophone North America and Western Europe) and the savage-primi-
tive-exotic-appalling-excitable hordes occupying other areas of the globe,
the same then being “discovered” and “civilized” by the industrious white
man in his glorious project of exploration of new worlds.
When I decided to illustrate this chapter with images from this book, I
returned to the Internet to search for information. Hellás! After six years I
found there everything (see http://ian.macky.net/secretmuseum/). Six years
had passed between my stroll in Plaza de Armas and my stroll on Google
and I now held two worlds in my hands: the book, a concrete testimony to
an obscure colonial past, and the virtual world, a parallel dimension and
one of the most powerful vehicles and mediums of globalization.
This chapter is about the archives of memory, the images of the Other
and the movement that creates and reduces distances; it is also about the
encounters from journeys and the adjustments made by individuals and
peoples after their experiences and cultural encounters.
Following the steps of flâneurs of another time—Eça de Queiróz, Hem-
ingway, the photographs from the cited secret museum, the first tourists and
explorers of modern times—I will write as someone flowing through time
and space, jumping between cultural landscapes, imagined communities and
 Seen at a Distance 5
identities under construction and submitted to cultural transfusions. The com-
prehension of intercultural relations will function better if we explore the trails
left by other explorers, trying to see them through their own cultural purity
or integrity, even if we suspect this purity only exists in museums, archives,
maps and other constructions of “memory and desire” (cf. Appadurai, 2003).
In social sciences, regardless of how committed one may be to logic and scien-
tific detachment, one invariably runs the risk of some degree of hybridism or
cultural fusion.
The colonial period, especially from the closing of the nineteenth cen-
tury through the early twentieth, is full of significant episodes in the fields
of the sciences, arts, social movements and tendencies that help us better
understand the complex mosaic of social encounters and how these influ-
ence identity and structure images of the Other. Based upon one of these
historical episodes, I hope the analysis offered here may contribute to a
better understanding of the roots and reasons of some of the tensions and
challenges faced by contemporary multicultural society.

SEEN AT A DISTANCE . . .

Figure 1.3 My photo of the photo.

Figure 1.2 Seen at a distance. “Seen at
a distance her load might be mistaken
for a headdress instead of a basket of
variously feathered fowls.”
The photo and the caption from The Secret
Museum of Mankind.
Shown at the National Geographic exhibi-
tion “The Greatness of Little Portugal—
Portugal 100 Years Ago”.
From July 31st to August 14th you can
see a free exhibition of images of Portu-
gal taken by National Geographic maga-
zine over the decades. [. . .] Called “The
Greatness of Little Portugal,” the exhibit
starts with 100-year-old photos of Por-
tugal and there’s a special focus on the
Lisbon of the 1920s. These images come
from articles and photojournalistic reports
published in the American magazine, with
the Lisbon photos reproduced from a
1922 article titled “Lisbon, the City of the
Friendly Bay.” (Announcing worldwide
the exhibition in Lisbon—text available
at the Lonely Planet website: http://www.
lonelyplanet.com.)
6 Susana Gonçalves
The underlying metaphor of this chapter’s title, seen at a distance, is bor-
rowed from one of the photographic captions from the cited Secret Museum
of Mankind (see Figure 1.2). A half-dozen years ago when I fi rst leafed
through Secret Museum I didn’t pay sufficient attention to this image. Now,
being more attentive to the details of these photos, I realized the incred-
ible coincidence of having seen only a few days earlier this same, early
twentieth-century photograph of the woman from Lisbon with the basket
of chickens on her head. By chance, I had visited an exhibition of National
Geographic photographs: “The Greatness of Little Portugal—Portugal 100
Years Ago.” Possessed by what now seems like a premonitory impulse, I
photographed the photograph because I found it humorous. I was amused
by the woman’s rustic dress, the numb simplicity of her posture and gaze
for the camera . . . the ostentatious mound of chickens on her head, just as
placid before the photographer as their owner.
Something seemed to flow in this encounter, this look, this sense of the
Other mediated by the camera. The woman, unexpectedly carrying chick-
ens, the photographer, burdened with his tripod camera, and I—one hun-
dred years later—carrying my own load of tourist gear made here and there
(Japanese digital camera, American sport shoes, Afro-ethnic adornments,
inspirational world music flowing directly from my iPod into my ears).
I didn’t escape; I guess the same happened to the woman and the pho-
tographer, culturally unscathed from this cultural encounter. All of us, the
photograph, the peasant and me, carried a cultural legacy—habits, lifestyle
and cultural consumption influenced by a certain era and socioeconomic
class. What each of us saw in the Other was fi ltered by distances of time,
context and mind-set. In my case, the distance of one hundred years is also
the distance of a World Wide Web, complex worldview and a Portuguese-
European-postcolonial mind-set.

THE OBSERVER’S PERSPECTIVE:

TOURIST, SCIENTIST, BUSINESSMEN, COLONIZER

Seen at a distance . . . between the National Geographic photograph and

the peasant woman there was an ocean of differences: the unavoidable
geographic distance (America–Europe); economies (a country experienc-
ing growth, the other in decline); the language (we can only imagine both
peoples understanding each other’s language); education; culturally condi-
tioned lifestyles; the power, attitude and purpose behind the gaze (which
can be more a matter of objectification than observation—who initiates the
gaze and for what purpose).
Griffin (1993) and other critical theorists consider “photograph to be
‘linguistically reflective’ and ‘inauthentic,’ saying more about the picture
taker than the picture.” For them, “The camera does not act; it has no
agency. It is the picture taker who decides what to photograph and which
 Seen at a Distance 7
perspective to capture” (Sanders, 2007, p. 182). So, what’s in this photog-
raphy? What do we see?
In my case, I didn’t see a poor woman with a hand on her hip and a
basket on her head. I saw a provocative object of study: I saw the woman
and the photographer in front of her. The image, in every aspect, carried
a vestige of a particular time, community, mentality and all this called for
comparative analysis:

• I saw a Lisbon of that period: rural, uncultured and preindustrial, in

comparison to a shining New York of parties, opportunities and the
furor of big business.
• I saw the stagnation and retarded economic development of Portugal
(in spite of the progressive revolutionary ideas of the First Republic) in
contrast to the golden prosperity of America’s “Roaring Twenties.”
• I also saw the resemblances, the same intellectual closure:
ƒ On one side of the Atlantic Ocean, the U.S.: the contradictions
between liberty and equality and the rise of intolerance towards
blacks and immigrants (a powerful Ku Klux Klan, racial segrega-
tion, discriminatory immigration laws).
ƒ On the other side of the same ocean, Portugal: the rise of a lifeless
Catholicism, the all too convenient miracles of Fatima, the infor-
mal pact between a conservative and castigating church and cer-
tain political factions that would soon control the Portuguese state
and the begin a half century of totalitarianism.

Between the historical fact, scientific neutrality and the innocuous his-
torical document, there are some aspects that are not merely factual, neu-
tral or innocuous. I would like to offer a few examples to aid understanding
of the construction of otherness or alterity during the colonial period in an
attempt to shed some light on the dominant mentality of the recent past,
perhaps helping us better understand the present. That is, the postcolonial,
global and culturally more hybrid periods we inhabit.
While observing the photo of the peasant woman, it was very difficult
for me to see her and myself as members of the same group. I was viewing
her from afar, from an emotional and cultural distance that permits one to
see the Other as different, referring to “them” instead of “us.”
This division of people into cultural groups could well be a mental con-
struct—for some authors have begun to use the concept of “essentialism”
to describe terms such as culture, tribe and social group as “false identi-
ties,” others speak of a continuum, noting that the transition or cultural
frontier between one group and another (or one language and another like
Dutch and German) is a difficult entity to differentiate (cf. Burke, 2009).
This big factory of conjectures concerning the otherness exists in the cul-
tural imagination, a dynamic process colored and influenced by ideological,
political and social convictions. The form in which we see the Other is also
8 Susana Gonçalves
the result of psychological, mental and emotional processes stemming from
the construction of social identity. These same processes allow us to feel a
sense of individuality, different from all others while still seeing ourselves
as members of specific social groups with which we share characteristics,
needs, interests and various links.
The ability to see the members of the groups that we belong to as being
like us is not a linear function of cultural symbolism, but is dependent
upon social, economic and ideological factors. It is a question of cultural
comparison/contrast modeled less on historic, geographical and national
belongings than daily experiences and the intersubjectivities affecting pro-
cesses of psychological organization of identity. Perceived differences can
turn the ones near us distant and the ones that are distant near.
A study by Triandis, Bontempo and Villareal (1988) gave evidence to
more similarity between rural regions of Western Europe (like Greece
or southern Italy) and rural China than to other national regions or
the most technologically developed countries in Europe. Another study
(Haidt, Koller & Dias, 1993) showed a greater degree of similarity
between judgments by subjects from different countries but of the same
social class than between people from different classes within the same
country. These studies show that it is important to understand socioeco-
nomic development (in the individual or society) in order to understand
the evolution of culture and its values.
Some cultural psychology theories (e.g., Fiske et al., 1998; Markus &
Kitayama, 1991; Miller & Bersoff, 1999; Kitayama et al., 1997; Shweder,
1982) consider it possible to distinguish two main models—individual-
ism versus collectivism—associated with civilizational and geographi-
cally circumscribed groups. These contrasting representations have the
power to effect psychological organization and practices of identity for-
mation and they are historical constructs found in historical texts and
in the daily practices of those cultures (or cultural entities) (Kitayama et
al., 1997).
Strauss (2000) rejects the large-scale classifi cation of cultures like
the individualism–collectivism dichotomy. Instead, this author opts to
defi ne culture as a group of public practices and shared mental struc-
tures that only call for a response to the question of who shares these
practices and structures. This methodology takes into account the fact
that individuals from the same time and place are exposed to a variety
of ideologies and experiences (derived from the particular influences of
family, ethnicity, gender, class, education, religion, exposure to ideolo-
gies and the mass media, as well as lifestyle choices) each of which has
distinct psychological effects. It’s not necessary for these experiences to
be consistent, constant or spatially or temporally contiguous (Strauss,
2000, p. 91).
Coming back to the aforementioned photo, it is worth saying that the
peasant and I are at a distance in terms of identity and identification. When
 Seen at a Distance 9
we speak of the link of national identity we are assuming a base that is
irrelevant in daily life. In the abstract, national identity (as in an old nation-
state like Portugal) carries sufficient weight for people to recognize they
are part of the same, yet broader community. However, these basic, more
general elements that are a part of national identity or ethnicity (language,
traditions, geographical boundaries, national symbols—national anthem,
flag—some shared collective memory) are not sufficient by themselves to
create a sense of equality and solidarity originating in a feeling or percep-
tion that we are with a member of our own clan/club/community/nation.
Viewed from a certain distance the Other may seem more or less similar
to us. However, when we draw closer, as the author of the cited caption
suggests, we may discover that what we took as a hat, that is, an element
of familiarity, turns out to be anything but, grotesque and inexplicable—a
half a dozen chickens instead of a hat. The disparate element makes clear
a difference we did not expect, proving that the Other is not as similar to
us as we thought. This is the broader message taken from the captioned
photograph: “Seen at a distance her load might be mistaken for a headdress
instead of a basket of variously feathered fowls.”

SOCIAL IDENTITY, COGNITIVE DISTORTIONS AND MENTALITY

An individual’s position within their groups of belonging and in relation to

groups of comparison is determined by one’s social identity (Tajfel, 1983).
Social identity is partially constructed through errors in both perception
and social information. I’m referring to the phenomena associated with
social simplification, such as:

• Group favoritism and distortion resulting from protection of one’s

own group (“We Portuguese adapt better to other cultures than other
nationalities!”): the tendency to favor our group using the most posi-
tive labels to describe it (by association the positive qualities of the
group become our own).
• Fundamental error in attribution (“Our team won not by luck but
by sheer talent!”): the tendency to overestimate the relation between
behavior and outcome and underestimate the influence of situations
on behavior (Ross, 1977, 1981)—we take the complete picture into
account only when it is to our advantage and compatible with our
beliefs and bias; the error of irrevocable attribution is also possible
(“The other team won because this time they were lucky!”), or one
may attribute external causes for undesirable results or other desir-
able results (Pettigrew, 1979).

But identity is also defi ned by comparison (criteria like race, religion,
sex, intelligence, social class, etc.). That is, what we are linked to and what
10 Susana Gonçalves
we are not; our group inclusions and identifications (Us), also defi ne our
groups of exclusion (Them). This leads to the attribution of more negative
characteristics to groups we have no affinities for than to those we do, espe-
cially if we feel the need to somehow elevate ourselves through comparison.
Resulting cognitive distortions are:

• Confirmatory distortion (“I knew the robber had to be a Gypsy!”):

the tendency to only search for and retain information that confi rms
our beliefs and prejudices.
• Homogeneity of the out-group (“Of course all Gypsies have a police
record!”): the tendency to believe members of an out-group are all the
same in certain (usually undesirable) characteristics.
• Illusory correlation (“If he’s a Gypsy, he’s dangerous!”): the tendency
to prejudge, attributing certain characteristics on the basis of group
association (Chapman & Chapman, 1982).

These errors and generalizations form the base of stereotyping, preju-

dice and intergroup discrimination. We easily manage to distinguish per-
sons on the basis of their similarities and differences. Placing people in
categories leads both to exaggerations of uniformities within groups and
differences between groups. Our categories, however, differ according
to our level of knowledge about the objects, situations or persons. For
example, a marine biologist fi nds more differences between two differ-
ent species of fi sh than a common observer. His specialization permits
him to discriminate characteristics that a nonexpert simply cannot iden-
tify, seeing little beyond scales and fi ns. The same simplification occurs
when we observe people from different groups. For any group, the less we
know about them, the more uniform their members seem and the more
we depend upon this perceived uniformity for our understanding of them.
If we aren’t Chinese, have never lived or visited there or had any contact
with Chinese people then it is normal to see them within broad, stereo-
typical categories (yellow skin, short of stature, almond-shaped eyes, love
to gamble, ceremonious).
Many stereotypes and prejudices concerning social, religious, ethnic
groups are not directly linked to individual experience. They are col-
lective ideas and beliefs culturally transmitted as the result of historical
relations between groups (economic, political, military or situations of
dominance or submission). These same errors in perception and cogni-
tive bias assume greater strength when allied with mentalities that seek
to justify them through religious, political, economic or even scientific
argumentation. The rhetoric of colonial discourse was based on this
confluence of psycho-sociological factors and the construction of spe-
cious, but clever arguments and the selection of “practical proofs” that
served to magnify the superiority and further the agenda of the coloniz-
ing culture.
 Seen at a Distance 11

FORMATION OF IDENTITIES AND IMAGINARY IDENTITIES

Appadurai (2003) reminds us that collective memory does not only have a
humanistic function in preserving a cultural heritage; it also occurs in our
private lives—today, people may use cyberspace as a huge storehouse of
memories via personal and community sites and people often defi ne and
construct themselves through this virtual space.
Collective memory is not only stored in the individual, but is also archived
through written texts, images, museums, maps and other forms of pres-
ervation—material, spiritual and symbolic for collective access. Whether
digitally or cybernetically preserved, people have always had a tendency to
perpetuate the more fleeting elements of their experience: creating photo
albums, lists and databases, recording their own memories and discoveries,
cataloguing and creating their personal taxonomies of affective, cognitive
and aesthetically significant objects.
Among these reservoirs of memory or souvenirs, people and commu-
nities preserve and often re-create memories and the past. These stores
of memory, as indicated, are important for the collective and individ-
ual. Photo albums are passed down from generation to generation in
families, and, on the collective level, there is registry and protection of
national (in museums, for example) and world heritage items and sites
as deemed worthy by national and transnational authorities (such as
UNESCO) charged with protecting what is labeled as relevant to collec-
tive memory.
But the preserved, in Appadurai’s perceptive analysis, is also forward-
looking, serving as a source of inspiration and desire. The past we seek to
preserve (which we often alter) is frequently intended to project a desired
future, position or statute, an idealized image of a people for the future.
“The archive returns to its more general status of being a deliberate site
for the production of anticipated memories by intentional communities”
(Appadurai, 2003, p. 17).
As locus of desire, the archive permits certain communities to be
strengthened and aligned around an identity that derives less from the past
and history than from an illusion of the past, a certain possible past, enliv-
ened and made real by the action of its totemic symbols, heraldry, rituals,
images, texts and other memorials.

The only new fact in the world of electronic mediation is that the
archive of possible lives is now richer and more available to ordinary
people than ever before. Thus, there is a greater stock of material
from which ordinary people can craft the scripts of possible worlds
and imagined selves. This does not mean that the social projects that
emerge from these scripts are always liberating or even pleasant. But
it is an exercise in what I have recently called the capacity to aspire.
(Appadurai, 2003, p. 19)
12 Susana Gonçalves
The author elaborates further on memory and imagination, the past
and aspiration:

The archive as a deliberate project is based on the recognition that all

documentation is a form of intervention, and thus, that documenta-
tion does not simply precede intervention, but is its fi rst step. Since all
archives are collections of documents (whether graphic, artifactual
or recorded in other forms), this means that the archive is always
a meta-intervention.
This further means that archives are not only about memory (and
the trace or record) but about the work of the imagination, about
some sort of social project. These projects seemed, for a while, to have
become largely bureaucratic instruments in the hands of the state, but
today we are once again reminded that the archive is an everyday tool.
Through the experience of the migrant, we can see how archives are
conscious sites of debate and desire. And with the arrival of electronic
forms of mediation, we can see more clearly that collective memory is
interactively designed and socially produced. (p. 24)

The relations that Appadurai establishes between memory and imagina-

tion, desire, aspiration and collective identity, in reference to immigrant
communities in the era of globalization, also applies to other communities
and periods and helps us understand the fascination of particular images,
texts and objects exhibited in public space (and museums), as well as their
influence over the perceptions and images upon their communities. Emerg-
ing from the aftereffects of colonialism (a process that has taken decades),
perhaps we may fi nd sufficient distance to begin to fairly and honestly ana-
lyze the ethical presuppositions, stereotypes and ideologies of production
of this epoch.
During the eras of colonialism and imperialism the fabrication of social
images and identities owed much to instruments such as public exhibitions;
the gallery and museum; salon and social clubs; news bulletins; advertizing;
serial publications; and, more recently, radio, cinema and television. The
colonial discourse stirred in every continent, creating powerful archives
of mental images and comparisons: civilized–primitive, moral–savage,
capable–dependent.
Photography, literature, tourism and museum objects were all decisive
elements in this monumental work of construction. A few concrete exam-
ples are here offered in hope of clarification. The examples chosen are prod-
ucts of the colonial era charged with conotational symbolism, revealing
their force as paradigmatic elements of the dominant mentality of the day:

a) —A special type of attraction: the human zoos at the end of the nine-
teenth and beginning of the twentieth century.
b) —A mass publication: National Geographic.
Another random document with
no related content on Scribd:
partial unconsciousness, or even by more marked congestive
symptoms. The pain may seem to fill the whole cranium, may be
located in a cerebral region, or fixed in a very limited spot. Heubner
asserts that when this headache can be localized it is generally
made distinctly worse by pressure at certain points, but my own
experience is hardly in accord with this. Any such soreness plainly
cannot directly depend upon the cerebral lesion, but must be a reflex
phenomenon or due to a neuritis. According to my own experience,
localized soreness indicates an affection of the bone or of its
periosteum. In many cases, especially when the headache is
persistent, there are distinct nocturnal exacerbations.
39 Book Y., p. 88, 1879.

It will be seen that there is nothing absolutely characteristic in the

headache of cerebral syphilis; but excessive persistency, apparent
causelessness, and a tendency to nocturnal exacerbation should in
any cephalalgia excite suspicion of a specific origin—a suspicion
which is always to be increased by the occurrence of slight spells of
giddiness or by delirious mental wandering accompanying the
paroxysms of pain. When an acute inflammatory attack supervenes
upon a specific meningeal disease it is usually ushered in by a
headache of intolerable severity.

When the headache in any case is habitually very constant and

severe, the disease is probably in the dura mater or periosteum; and
this probability is much increased if the pain be local and augmented
by firm, hard pressure upon the skull over the seat of the pain.

Disorders of Sleep.—There are two antagonistic disorders of sleep,

either of which may occur in cerebral syphilis, but which have only
been present in a small proportion of the cases that I have seen.
Insomnia is more apt to be troublesome in the prodromic than in the
later stages, and is only of significance when combined with other
more characteristic symptoms. A peculiar somnolence is of much
more determinate import. It is not pathognomonic of cerebral
syphilis, yet of all the single phenomena of this disease it is the most
characteristic. Its absence is of no import in the theory of an
individual case.

As I have seen it, it occurs in two forms: In the one variety the patient
sits all day long or lies in bed in a state of semi-stupor, indifferent to
everything, but capable of being aroused, answering questions
slowly, imperfectly, and without complaint, but in an instant dropping
off again into his quietude. In the other variety the sufferer may still
be able to work, but often falls asleep while at his tasks, and
especially toward evening has an irresistible desire to slumber, which
leads him to pass, it may be, half of his time in sleep. This state of
partial sleep may precede that of the more continuous stupor, or may
pass off when an attack of hemiplegia seems to divert the
symptoms. The mental phenomena in the more severe cases of
somnolency are peculiar. The patient can be aroused—indeed in
many instances he exists in a state of torpor rather than of sleep;
when stirred up he thinks with extreme slowness, and may appear to
have a form of aphasia; yet at intervals he may be endowed with a
peculiar automatic activity, especially at night. Getting out of bed;
wandering aimlessly and seemingly without knowledge of where he
is, and unable to find his own bed; passing his excretions in a corner
of the room or in other similar place, not because he is unable to
control his bladder and bowels, but because he believes that he is in
a proper place for such act,—he seems a restless nocturnal
automaton rather than a man. In some cases the somnolent patient
lies in a perpetual stupor.

An important fact in connection with the somnolence is that it may

develop suddenly without marked premonition. Thus in a case
reported by J. A. Ormerod40 a man who had been in good health,
save only for headache, awoke one morning in a semi-delirious
condition, and for three days slept steadily, only arousing for meals;
after this there was impairment of memory and mental faculties, but
no more marked symptoms.
40 Brain, vol. v. 260.
Apathy and indifference are the characteristics of the somnolent
state, yet the patient will sometimes show excessive irritability when
aroused, and will at other periods complain bitterly of pain in his
head, or will groan as though suffering severely in the midst of his
stupor—at a time, too, when he is not able to recognize the seat of
the pain. I have seen a man with a vacant, apathetic face, almost
complete aphasia, persistent heaviness and stupor, arouse himself
when the stir in the ward told him that the attending physician was
present, and come forward in a dazed, highly pathetic manner, by
signs and broken utterances begging for something to relieve his
head. Heubner speaks of cases in which the irritability was such that
the patient fought vigorously when aroused; this I have not seen.

This somnolent condition may last many weeks. T. Buzzard41 details

the case of a man who after a specific hemiplegia lay silent and
somnolent for a month, and yet finally recovered so completely as to
win a rowing-match on the Thames. I have seen a fair degree of
recovery after a somnolence of four months' duration.
41 Clinical Lectures on Dis. Nerv. Syst., London, 1882.

In its excessive development syphilitic stupor puts on the symptoms

of advanced brain-softening, to which it is indeed often due. Of the
two cases with fatal result of which I have notes, one at the autopsy
was found to have symmetrical purulent breaking down of the
anterior cerebral lobes; the other, softening of the right frontal and
temporal lobes, due to the pressure of a gummatous tumor, and
ending in a fatal apoplexy.

This close connection with cerebral softening explains the clinical

fact that apoplectic hemorrhage is very apt to end the life in these
cases of somnolent syphilis. But a prolonged deep stupor in persons
suffering from cerebral syphilis does not prove the existence of
extensive brain-softening, and is not incompatible with subsequent
complete recovery. As an element of prognosis it is of serious but not
of fatal import.
Paralysis.—When it is remembered that a syphilitic exudation may
appear at almost any position in the brain, that spots of encephalic
softening are a not rare result of the infection, that syphilitic disease
is a common cause of cerebral hemorrhage, it is plain that a specific
palsy may be of any conceivable variety, and affect either the
sensory, motor, or intellectual sphere. The mode of onset is as
various as the character of the palsy. The attack may be
instantaneous, sudden, or gradual. The gradual development of the
syphilitic gumma would lead us, a priori, to expect an equally gradual
development of the palsy; but experience shows that in a large
proportion of the cases the paralysis appears suddenly, with or
without the occurrence of an apoplectic or epileptic fit. Under these
circumstances it will be usually noted that the resulting palsy is
incomplete; in rare instances it may be at its worst when the patient
awakes from the apoplectic seizure, but usually it progressively
increases for a few hours, and then becomes stationary. These
sudden partial palsies probably result from an intense congestion
around the seat of disease or from stoppage of the circulation in the
same locality; whatever their mechanism may be, it is important to
distinguish them from palsies which are due to hemorrhage. I believe
this can usually be done by noting the degree of paralysis.

A suddenly-developed, complete hemiplegia or other paralysis may

be considered as in all probability either hemorrhagic or produced by
a thrombus so large that the results will be disorganization of the
brain-substance, and a future no more hopeful than that of a clot. On
the other hand, an incomplete palsy may be rationally believed to be
due to pressure or other removable cause; and this belief is much
strengthened by a gradual development. The bearing of these facts
upon prognosis it is scarcely necessary to point out.

Although the gummata may develop at almost any point, they

especially affect the base of the brain, and are prone to involve the
nerves which issue from it. Morbid exudations, not tubercular or
syphilitic, are rare in this region. Hence a rapidly but not abruptly
appearing strabismus, ptosis, dilated pupil, or any paralytic eye
symptom in the adult is usually of syphilitic nature. Syphilitic facial
palsy is not so frequent, whilst paralysis of the nerve from rheumatic
and other inflammation within its bony canal is very common.
Paralysis of the facial nerve may therefore be specific, but existing
alone is of no diagnostic value. Since syphilitic palsies about the
head are in most instances due to pressure upon the nerve-trunks,
the electrical reactions of degeneration are present in the affected
muscles.

There is one peculiarity about specific palsies which has already

been alluded to as frequently present—namely, a temporary,
transient, fugitive, varying character and seat. Thus an arm may be
weak to-day, strong to-morrow, and the next day feeble again, or the
recovered arm may retain its power and a leg fail in its stead. These
transient palsies are much more apt to involve large than small brain
territories. The explanation of their largeness, fugitiveness, and
incompleteness is that they are not directly due to clots or other
structural changes, but to congestions of the brain-tissues in the
neighborhood of gummatous exudations. Squint due to direct
pressure on a nerve will remain when the accompanying monoplegia
due to congestion disappears.

Motor palsies are more frequent than sensory affections in syphilis,

but hemianæsthesia, localized anæsthetic tracts, indeed any form of
sensory paralysis, may occur. Numbness, formications, all varieties
of paræsthesia, are frequently felt in the face, body, or extremities.
Violent peripheral neuralgic pains are rare, and generally when
present denote neuritis. Huguenin, however, reports42 a severe
trigeminal anæsthesia dolorosa, which was found, after death from
intercurrent disease, to have depended upon a small gumma
pressing upon the Gasserian ganglion. A somewhat similar case has
also been reported by Allen McLane Hamilton.43
42 Schwiez. Corr. Blät., 1875.

43 Alienist and Neurologist, iv. 58.

The special senses are liable to suffer from the invasion of their
territories by cerebral syphilis, and the resulting palsies follow
courses and have clinical histories parallel to those of the motor
sphere. The onset may be sudden or gradual, the result temporary
or permanent. Charles Mauriac44 reports a case in which the patient
was frequently seized with sudden attacks of severe frontal pain and
complete blindness lasting from a quarter to half an hour; at other
times the same patient had spells of aphasia lasting only for one or
two minutes. I have seen two cases of nearly complete deafness
developing in a few hours in cerebral syphilis, and disappearing
abruptly after some days. Like other syphilitic palsies, therefore,
paralyses of special senses may come on suddenly or gradually, and
may occur paroxysmally.
44 Loc. cit., p. 31.

Among the palsies of cerebral syphilis must be ranked aphasia. An

examination of recorded cases shows that syphilitic aphasia is
subject to vagaries and laws similar to those connected with other
specific cerebral palsies. It is usually a symptom of advanced
disease, but may certainly develop as one of the first evidences of
cerebral syphilis. Coming on after an apoplectic or epileptic fit, it may
be complete or incomplete: owing to the smallness of the centre
involved and the ease with which its function is held in abeyance, a
total loss of word-thought is not so decisive as to the existence of
cerebral hemorrhage as is a total motor palsy. Like hemiplegia or
monoplegia, specific aphasia is sometimes transitory and
paroxysmal. Buzzard45 records several such cases. Mauriac46 details
a very curious case in which a patient, after long suffering from
headache, was seized by sudden loss of power in the right hand and
fingers, lasting about ten minutes only, but recurring many times a
day. After this had continued some time the paroxysms became
more completely paralytic, and were accompanyed by loss of the
power of finding words, the height of the crises in the palsy and
aphasia being simultaneously reached. For a whole month these
attacks occurred five or six times a day, without other symptoms
except headache, and then the patient became persistently paralytic
and aphasic, but finally recovered. To describe the different forms of
specific aphasia and their mechanism of production would be to
enter upon a discussion of aphasia itself—a discussion out of place
here. Suffice it to say that every conceivable form of the disorder
may be induced by syphilis.
45 Loc. cit., p. 81.

46 Aphasie et Hemiplégia droite Syphilit., Paris, 1877.

Owing to the centres of speech being situated in the cortical portion

of the brain, aphasia in cerebral syphilis is very frequently associated
with epilepsy. Of course right-sided palsy and aphasia are united in
syphilitic as in other disorders. If, however, the statistics given by
Tanowsky47 be reliable, syphilitic aphasia is associated with left-
sided hemiplegia in a most extraordinarily large proportion. Thus in
53 cases collected by Tanowsky, 18 times was there right-sided
hemiplegia, and 14 times left-sided hemiplegia, the other cases
being not at all hemiplegic. Judging from the autopsy on a case
reported in Mauriac's brochure, this concurrence of left-sided
paralysis and aphasia depends partly upon the great frequency of
multiple brain lesions in syphilis, and partly upon the habitual
involvement of large territories of the gray matter secondarily to
diseased membrane. An important practical deduction is that the
conjoint existence of left hemiplegia and aphasia is almost diagnostic
of cerebral syphilis.
47 L'Aphasie syphilitique.

Probably amongst the palsies may be considered the disturbances

of the renal functions, which are only rarely met with in cerebral
syphilis, and which are probably usually dependent upon the specific
exudation pressing upon the vaso-motor centres in the medulla.
Fournier speaks of having notes of six cases in which polyuria with
its accompaniment, polydipsia, was present, and details a case in
which the specific growth was found in the floor of the fourth
ventricle. Cases have been reported of true saccharine diabetes due
to cerebral syphilis,48 and I can add to these an observation of my
own. The symptoms, which occurred in a man of middle age, with a
distinct specific history, were headache, nearly complete hemiplegia,
and mental failure, associated with the passage of comparatively
small quantities of a urine so highly saccharine as to be really a
syrup. Under the influence of the iodide of potassium the sugar in a
few weeks disappeared from the urine.
48 Consult Servantié, Des Rapports du Diabète et de la Syphilis, Paris, Thèse, 1876;
also, case reported by L. Putzel, New York Med. Record, xxv. 450.

Epilepsy.—Epileptic attacks are a very common symptom of

meningeal syphilis, and are of great diagnostic value. The
occurrence in an adult of an epileptic attack or of an apoplectic fit, or
of a hemiplegia after a history of intense and protracted headache,
should always excite grave suspicion.

Before I had read Fournier's work on Nervous Syphilis I taught that

an epilepsy appearing after thirty years of age was very rarely, if
ever, essential epilepsy, and unless alcoholism, uræmic poison, or
other adequate cause could be found was in nine cases out of ten
specific; and I therefore quote with satisfaction Fournier's words:
“L'épilepsie vraie, ne fait jamais son premier dêbut à l'âge adulte, à
l'âge mûr. Si un homme adulte, au dessus de 30, 35, à 40 ans, vient,
à être pris pour la première fois d'une crise épileptique, et cela dans
la cours d'une bonne santé apparente, il y a, je vous le répète, hui
ou neuf chances sur dix pour que cette épilepsie soit d'origine
syphilitique.”

Syphilitic epilepsy may occur either in the form of petit mal or of haut
mal, and in either case may take on the exact characters and
sequence of phenomena which belong to the so-called idiopathic or
essential epilepsy. The momentary loss of consciousness of petit
mal will usually, however, be found to be associated with attacks in
which, although voluntary power is suspended, memory recalls what
has happened during the paroxysm—attacks, therefore, which
simulate those of hysteria, and which may lead to an error of
diagnosis.

Even in the fully-developed type of the convulsions the aura is only

rarely present. Its absence is not, however, of diagnostic value,
because it is frequently not present in essential epilepsy, and it may
be pronounced in the specific disease. It is said that when in an
individual case the aura has once appeared the same type or form of
approach of the convulsion is thereafter rigidly adhered to. The aura
is sometimes bizarre: a severe pain in the foot, a localized cramp, a
peculiar sensation, indescribable and unreal in its feeling, may be
the first warning of the attack. An aura may affect a special sense.
Thus, I have at present a patient whose attacks begin with blindness.

In many, perhaps most, cases of specific convulsions, instead of a

paroxysm of essential epilepsy being closely simulated, the
movements are in the onset, or more rarely throughout the
paroxysm, unilateral; indeed, they may be confined to one extremity.
This restriction of movement has been held to be almost
characteristic of syphilitic epilepsy, but it is not so. Whatever
diagnostic significance such restriction of the convulsion has is
simply to indicate that the fit is due to a cortical organic lesion of
some kind. Tumors, scleroses, and other organic lesions of the
brain-cortex are as prone to cause unilateral or monoplegic epilepsy
when they are not specific as when they are due to syphilis.

Sometimes an epilepsy dependent upon a specific lesion implicating

the brain-cortex may be replaced by a spasm which is more or less
local and is not attended with any loss of consciousness. Thus, in a
case now convalescent in the University Hospital, a man aged about
thirty-five offered a history of repeated epileptic convulsions, but at
the time of his entrance into the hospital, instead of epileptic attacks,
there was a painless tic. The spasms, which were clonic and
occurred very many times a day, sometimes every five minutes,
were very violent, and mostly confined to the left facial nerve
distribution. The trigeminus was never affected, but in the severer
paroxysms the left hypoglossal and spinal accessory nerves were
profoundly implicated in all of their branches. Once, fatal asphyxia
from recurrent laryngeal spasm of the glottis was apparently averted
only by the free inhalation of the nitrite of amyl. The sole other
symptom was headache, but the specific history was clear and the
effect of antisyphilitic remedies rapid and pronounced.
It is very plain that such attacks as those just detailed are closely
allied to epilepsy; indeed, there are cases of cerebral syphilis in
which widespread general spasms occur similar to those of a
Jacksonian epilepsy, except that consciousness is not lost, because
the nervous discharge does not overwhelm the centres which are
connected with consciousness.49 On the other hand, these epileptoid
spasmodic cases link themselves to those in which the local brain
affection manifests itself in contractions or persistent irregular clonic
spasms. Contractures may exist and may simulate those of
descending degeneration,50 but in my own experience are very
rare.51
49 Case, Canada Med. and Surg. Journ., xi. 487.

50 Case, Centralbl. Nerv. Heilk., 1883, p. 1.

51 A case of syphilitic athetosis may be found in Lancet, 1883, ii. 989.

The clonic spasms of cerebral syphilis may assume a distinctly

choreic type, or may in their severity simulate those of hysteria,
throwing the body about violently.52 It is, to my mind, misleading, and
therefore improper, to call such cases syphilitic chorea, as there is
no reason for believing that they have a direct relation with ordinary
chorea. They are the expression of an organic irritation of the brain-
cortex, and are sometimes followed by paralysis of the affected
member; in other words, the disease, progressing inward from the
brain-membrane, first irritates, and then so invades a cortical centre
as to destroy its functional power.53
52 See Allison, Amer. Med. Journ., 1877, 74.

53 Case, Chicago Med. Journ. and Exam., xlvi. 21.

Psychical Symptoms.—As already stated, apathy, somnolence, loss

of memory, and general mental failure are the most frequent and
characteristic mental symptoms of meningeal syphilis; but, as will be
shown in the next chapter, syphilis is able to produce almost any
form of insanity, and therefore mania, melancholia, erotic mania,
delirium of grandeur, etc. etc. may develop along with the ordinary
manifestation of cerebral syphilis, or may come on during an attack
which has hitherto produced only the usual symptoms. Without
attempting any exhaustive citation of cases, the following may be
alluded to.

A. Erlenmeyer reports54 a case in which an attack of violent

headache and vomiting was followed by paralysis of the right arm
and paresis of the left leg, with some mental depression; a little later
the patient suddenly became very cheerful, and shortly afterward
manifested very distinctly delirium of grandeur with failure of
memory. Batty Tuke reports55 a case in which, with aphasia,
muscular wasting, strabismus, and various palsies, there were
delusions and hallucinations. In the same journal56 S. D. Williams
reports a case in which there were paroxysmal violent attacks of
frontal headache. The woman was very dirty in her habits, only ate
when fed, and existed in a state of hypochondriacal melancholy.
Leiderdorf details a case with headache, partial hemiplegia, great
psychical disturbance, irritability, change of character, marked
delirium of grandeur, epileptic attacks, and finally dementia,
eventually cured by iodide of potassium.57 Several cases illustrating
different forms of insanity are reported by N. Manssurow.58
54 Die luëtischen Psychosen.

55 Journ. Ment. Sci., Jan., 1874, p. 560.

56 April, 1869.

57 Medicin Jahrbucher, xx. 1864, p. 114.

58 Die Tertiäre Syphilis, Wien, 1877.

That the attacks of syphilitic insanity, like the palsies of syphilis, may
at times be temporary and fugitive, is shown by a curious case
reported by H. Hayes Newington,59 in which, along with headache,
failure of memory, and ptosis in a syphilitic person, there was a brief
paroxysm of noisy insanity.
 59 Journ. Ment. Sci., London, xix. 555.

DIAGNOSIS.—In a diagnosis of cerebral syphilis a correct history of the

antecedents of the patients is of vital importance. Since very few of
the first manifestations of the disorder are absolutely characteristic,
whilst almost any conceivable cerebral symptoms may arise from
syphilitic disease, treatment should be at once instituted on the
appearance of any disturbance of the cerebral functions in an
infected person.

Very frequently the history of the case is defective, and not rarely
actually misleading. Patients often appear to have no suspicion of
the nature of their complaint, and will deny the possibility of syphilis,
although they confess to habitual unchastity. My own inquiries have
been so often misleading in their results that I attach but little weight
to the statements of the patient, and in private practice avoid asking
questions which might recall unpleasant memories, depending upon
the symptoms themselves for the diagnosis.

The general grounds of diagnosis have been sufficiently mapped out

in the last section, but some reiteration may be allowable. After the
exclusion of other non-specific disease, headache occurring with any
form of ocular palsy or with a history of attack of partial monoplegia
or hemiplegia, vertigo, petit mal, epileptoid convulsions, or
disturbances of consciousness, or attacks of unilateral or localized
spasms, should lead to the practical therapeutic test. Ocular palsies,
epileptic forms of attacks occurring after thirty years of age, morbid
somnolence, even when existing alone, are sufficient to put the
practitioner upon his guard. It is sometimes of vital importance that
the nature of the cephalalgia shall be recognized before the coming
on of more serious symptoms; any apparent causelessness,
severity, and persistency should arouse suspicion, to be much
increased by a tendency to nocturnal exacerbations or by the
occurrence of mental disturbance or of giddiness at the crises of the
paroxysms. Not rarely there are very early in these cases curious,
almost indefinable, disturbances of cerebral functions, which may be
easily overlooked, such as temporary and partial failures of memory,
word-stumbling, fleeting feelings of numbness or weakness,
alterations of disposition. In the absence of hysteria an indefinite and
apparently disconnected series of nerve accidents is of very urgent
import. To use the words of Hughlings-Jackson, “A random
association or a random succession of nervous symptoms is very
strong warrant for a diagnosis of a syphilitic disease of the nervous
system.” Cerebral syphilis occurring in an hysterical subject may be
readily overlooked until fatal mischief is done. When any paralysis
occurs a study of the reflexes may sometimes lead to a correct
diagnosis. Thus in a hemiplegia the reflex on the affected side in
cerebral syphilis is very frequently exaggerated, whilst in hysteria the
reflexes are usually alike on both sides. When both motion and
sensation are disturbed in an organic hemiplegia, the anæsthesia
and motor paralysis occur on the same side of the body, whilst in
hysteria they are usually on opposite sides.

In all cases of doubtful diagnosis the so-called therapeutic test

should be employed, and if sixty grains of iodide of potassium per
day fail to produce iodism, for all practical purposes the person may
be considered to be a syphilitic. No less an authority than Seguin
has denied the validity of this, but I believe, myself, that some of his
reported cases were suffering from unsuspected syphilis. I do not
deny that there are rare individuals who, although untainted, can
resist the action of iodide, but in ten years' practice in large hospitals,
embracing probably some thousands of cases, I have not met with
more than one or two instances which I believed to be of such
character. Of course in making these statements I leave out of sight
persons who have by long custom become accustomed to the use of
the iodide, for although in most cases such use begets increase of
susceptibility, the contrary sometimes occurs. Of course the
physician who should publicly assert that a patient who did not
respond to the iodide had syphilis would be a great fool, but in my
opinion the physician who did not act upon such a basis would be
even more culpable.

PROGNOSIS.—Cerebral meningeal syphilis varies so greatly and so

unexpectedly in its course that it is very difficult to establish rules for
predicting the future in any given case. The general laws of
prognosis in brain disease hold to some extent, but may always be
favorably modified, and patients apparently at the point of death will
frequently recover under treatment. The prognosis is not, however,
as absolutely favorable as is sometimes believed, and especially
should patients be warned of the probable recurrence of the affection
even when the symptoms have entirely disappeared. The only safety
after the restoration of health consists in an immediate re-treatment
upon the recurrence of the slightest symptom. The occurrence of a
complete, sudden hemiplegia or monoplegia is sufficient to render
probable the existence of a clot, which must be subject to the same
laws as though not secondary to a specific lesion. If a rapid decided
rise of temperature occur in an apoplectic or epileptic attack, the
prognosis becomes very grave. An epileptic paroxysm very rarely
ends fatally, although it has done so in two of my cases.

The prognosis in gummatous cerebral syphilis should always be

guardedly favorable. In the great majority of cases a more or less
incomplete recovery occurs under appropriate treatment, and I have
seen repeatedly patients who were unconscious, with urinary and
fecal incontinence, and apparently dying, recover. Nevertheless, so
long as there is any particle of gummatous inflammation in the
membrane the patient is liable to sudden congestions of the brain,
which may prove rapidly fatal, or he may die in a brief epileptic fit. On
the one hand there is an element of uncertainty in the most favorable
case, and on the other so long as there is life a positively hopeless
prognosis is not justifiable.

PATHOLOGY.—Gummatous inflammation of the brain probably always

has its starting-point in the brain-membranes, although it may be
situated within the brain: thus, I have seen the gummatous tumors
spring from the velum interpositum in the lateral ventricle. The
disease most usually attacks the base of the brain, and is especially
found in the neighborhood of the pons Varolii and the optic tract. It
may, however, locate itself upon the vault of the cranium, and in my
experience has seemed to prefer the anterior or motor regions. The
mass may be well defined and roundish, but more usually it is
spread out, irregular in shape, and more or less confluent with the
substance of the brain beneath it. It varies in size from a line to
several inches in length, and when small is prone to be multiple. The
only lesion which it resembles in gross appearance is tubercle, from
which it sometimes cannot be certainly distinguished without
microscopic examination.

The large gummata have not rarely two distinct zones, the inner one
of which is drier, somewhat yellowish in color, opaque, and
resembles the region of caseous degeneration in the tubercle. The
outer zone is more pinkish and more vascular, and is semi-
translucent.

On microscopic examination the most characteristic structures are

small cells, such as are found in gummatous tumors in other portions
of the body. These cells are most abundant in the inner zone, which,
indeed, may be entirely composed of them. In the centre of the
tumor they are more or less granular and atrophied; in some cases
the caseous degeneration has progressed so far that the centre of
the gumma consists of minute acicular crystals of fat. In the external
or peripheral zone of the tumor the mass may pass imperceptibly
into the normal nerve tissue, and under these circumstances it is that
it contains the spider-shaped cells or stellate bodies described by
Jastrowitch, and especially commented upon by Charcot and
Gombault and by Coyne. These are large cells containing an
exaggerated nucleus and a granular protoplasm, which continues
into multiple, branching, rigid, refracting prolongations, which
prolongations are scarcely stained by carmine. Alongside of these
cells other largish cells are often found without prolongations, but
furnished with oval nuclei and granular protoplasm. Amongst these
cells will be seen the true gummatous cells, as well as the more or
less altered neuroglia and nerve-elements. In the perivascular
lymphatic sheaths in the outer part of the gumma is usually a great
abundance of small cells. The spider-shaped cells are probably
hypertrophied normal cells of the neuroglia, and have been
considered by Charcot and Gombault as characteristic of syphilitic
gummata of the brain. In a solitary gumma, however, of considerable
size from the neighborhood of the cerebellum, studied by Coyne and
Peltier, there were no stellated cells. Coyne considers that their
presence is due to their previous existence in the normal state of the
regions affected by the gumma. Exactly what becomes of syphilitic
gumma of the brain in cases of recovery it is difficult to determine. It
is certain that they become softened and disappear more or less
completely, and it is probable that the cicatrices or the small
peripheral cysts which are not rarely found in the surfaces of the
brain are sometimes remnants of gummatous tumors. In a number of
cases collected by Gros and Lancereaux there were small areas of
softened tissue or small calcareous and caseous masses or cerebral
lacunæ corresponding to the cicatrices of softening or imperfect
cysts, coincident with evidences of syphilis elsewhere. V. Cornil also
states that he has found small areas of softening with well-
established syphilitic lesions of the dura mater and cranium, but
believes that the lacunæ or cysts depend rather upon chronic
syphilitic lesions of cerebral arteries than upon gummatous
inflammation.

When a gummatous tumor comes in contact with an artery, the latter

is usually compressed and its walls undergo degeneration. The
specific arteritis may pass beyond the limit of the syphilome and
extend along the arterial wall. Not rarely there is under these
circumstances a thrombus, and if the artery be a large one
secondary softening of its distributive brain-area occurs.

TREATMENT.—The treatment of cerebral syphilis is best studied under

two heads: First, the treatment of the accidents which occur in the
course of the disease; second, the general treatment of the disease
itself.

It must be remembered that in the great majority of cases in which

death occurs in properly-treated cerebral syphilis the fatal result is
produced by an exacerbation—or, as I have termed it, an accident—
of the disease. Under these circumstances the treatment should be
that which is adapted to the relief of the same acute affection when
dependent upon other than specific cause. In a large proportion of
cases the acute outbreak takes the form either of a meningitis or
else of a brain congestion. In either instance when the symptoms are
severe free bleeding should be at once resorted to. The amount of
blood taken is of course to be proportionate to the severity of the
symptoms and the strength of the patient. I have seen life saved by
the abstraction of about a quart of blood, whilst in other cases a few
ounces suffice. Care must be, of course, taken not to mistake a
simple epileptic fit for a severe cerebral attack; but when this fit has
been preceded by severe headache and is accompanied by stupor,
with marked disturbance of the respiration, measures for immediate
relief are usually required; and if the convulsions be perpetually
repeated or if there be violent delirious excitement, the symptoms
may be considered as very urgent. In taking blood the orifice should
be large, so as to favor a rapid flow, and the bleeding be continued
until a distinct impression is made upon the pulse. In some cases
which I have seen in which the action of the heart continued to be
violent after as much blood as was deemed prudent had been taken,
good results were obtained by the hypodermic injection of three
drops of the tincture of aconite-root every half hour until the
reduction of the pulse and the free sweating indicated that the
system was coming under the influence of the cardiac sedative.

Of course, I do not mean to encourage the improper or too free use

of the lancet in these cases, but in the few fatal cases which I have
seen I have almost invariably regretted that blood had not been
taken at once very freely at the beginning of the acute attack. In
most of these cases the symptoms had progressed too far for good
to be achieved before I reached the patient. After venesection, or in
feeble cases as a substitute for it, the usual measures of relief in
cerebral congestion should be instituted. I shall not occupy space
with a discussion of these measures, as they are in no way different
from those to be employed in cases not syphilitic.

The most important part of the treatment of cerebral syphilis itself is

antisyphilitic, and the practitioner is at once forced to select between
the iodide of potassium and the mercurial preparations. In such
choice it must be remembered that even a very small amount of
syphilitic deposit in the brain may at any time cause a sudden
congestion or other acute attack, and is therefore a very dangerous
lesion. I have seen a cerebral syphilis which was manifested only by
an epileptic attack occurring once in many months, and in which
after death the affected membrane was found to be not larger than a
quarter of a dollar, and the deposit not more than an eighth of an
inch in thickness, suddenly produce a rapidly fatal congestion; and I
have known a case fast progressing toward recovery suddenly
ended by the too long continuance of the arrest of respiration during
an epileptic fit. I have, myself, no doubt of the superiority of the
mercurials over the iodide of potassium as a means of producing
absorption of gummatous exudates; and as these exudates in the
brain are so very dangerous, a mercurial course should in the
majority of cases of cerebral syphilis be instituted so soon as the
patient comes under the practitioner's care. When, however, there is
a history of a recent prolonged free use of the mercurial, or when
there is marked specific cachexia, the iodide should be chosen.
Cachexia is, however, a distinctly rare condition in cerebral syphilis,
the disease usually developing in those who have long had apparent
immunity from the constitutional disorder. In my opinion the best
preparation of the mercurial for internal use is calomel. It should be
given in small doses, one-quarter of one grain every two hours,
guarded with opium and astringents, so as to prevent as far as
possible disturbance of the bowels, and should be continued until
soreness of the teeth, sponginess of the gums, or other evidences of
commencing ptyalism are induced. After this the dose of the
mercurial should be so reduced as simply to maintain the slight
impression which has been created, and the patient should be kept
under the mercurial influence for some weeks.

A very effective method of using the mercury is by inunction, and

where the surroundings of the patient are suitable the mercurial
ointment may be substituted for the calomel. It should be applied
regularly, according to the method laid down in my treatise on
therapeutics. I have sometimes gained advantage by practising the
mercurial unction and at the same time giving large doses of iodide
of potassium internally.
After a mercurial course the iodide of potassium should always be
exhibited freely, the object being not only to overcome the natural
disease, but also to bring about the complete elimination of the
mercury from the system. There is no use in giving the iodide in
small doses; at least a drachm and a half should be administered in
the twenty-four hours, and my own custom has been to increase this
to three drachms unless evidences of iodism are produced. The
compound syrup of sarsaparilla covers the disagreeable taste of the
iodide of potassium better than any other substance of which I have
knowledge. Moreover, I am well convinced that there is some truth in
the old belief that the so-called “Woods” are of value in the treatment
of chronic syphilis. I have seen cases in which both the iodide of
potassium and the mercurials had failed to bring about the desired
relief, but in which the same alteratives, when given along with the
“Woods,” rapidly produced favorable results. The old-fashioned
Zittmann's decoction, made according to the formula of the United
States Dispensatory, may be occasionally used with very excellent
effect. But I have gradually come into the habit of substituting a
mixture of the compound fluid extract and the compound syrup of
sarsaparilla in equal proportions. The syrup itself is too feeble to
have any influence upon the system, but is here employed on
account of its flavor. A favorite method of administration is to furnish
the patient with two bottles—one containing a watery solution of the
iodide of potassium of such strength that two drops represent one
grain of the drug, and the other the sarsaparilla mixture above
mentioned. From one to two drachms of the solution of the iodide
may be administered in a tablespoonful of the sarsaparilla well
diluted after meals. When the patient has been previously
mercurialized, or there is any doubt as to the propriety of using
mercurials, corrosive sublimate in small doses may be added to the
solution of the iodide, so that one-tenth to one-fifteenth of a grain
shall be given in each dose. I have never seen especial advantage
obtained by the use of the iodides of mercury. They are no doubt
effective, but are not superior to the simpler forms of the drug.
 Syphilitic Disease of the Brain-Cortex.

The psychical symptoms which are produced by syphilis are often

very pronounced in cases in which the paralysis, headache,
epilepsy, and other palpable manifestations show the presence of
gross brain lesions. In the study of syphilitic disease of the brain-
membranes sufficient has been said in regard to these psychical
disturbances, but the problem which now offers itself for solution is
as to the existence or non-existence of syphilitic insanity—i.e. of an
insanity produced by specific contagion without the obvious
presence of gummatous disease of the brain-membranes. Very few
alienists recognize the existence of a distinct affection entitled to be
called syphilitic insanity, and there are some who deny that insanity
is ever directly caused by syphilis. It is certain that insanity often
occurs in the syphilitic, but syphilis is abundantly joined with
alcoholism, poverty, mental distress, physical ruin, and various
depressing emotions and conditions which are well known to be
active exciting causes of mental disorder. It may well be that syphilis
is in such way an indirect cause of an insanity which under the
circumstances could not be properly styled syphilitic.

If there be disease of the brain-cortex produced directly by syphilis,

of course such disease must give rise to mental disorders; and if the
lesion be so situated as to affect the psychic and avoid the motor
regions of the brain, it will produce mental disorder without paralysis
—i.e. an insanity; again, if such brain disease be widespread,
involving the whole cortex, it will cause a progressive mental
disorder, accompanied by gradual loss of power in all parts of the
body, and ending in dementia with general paralysis; or, in other
words, it will produce an affection more or less closely resembling
the so-called general paralysis of the insane, or dementia paralytica.

As a man having syphilis may have a disease which is not directly

due to the syphilis, when a syphilitic person has any disorder there is
only one positive way of determining during life how far said disorder
is specific—namely, by studying its amenability to antisyphilitic
treatment. In approaching the question whether a lesion found after