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Opinion

When I use a word . . . . Remembrance of things past

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o873 (Published 01 April 2022) Cite this as: BMJ 2022;377:o873
  1. Jeffrey K Aronson
  1. Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford
  1. Twitter @JKAronson

A single word with medical relevance sums up remembrance of things past, the phrase that Shakespeare coined in Sonnet 30, which C K Scott Moncrieff used for his 1922 translation of the title of Proust’s novel À la recherché du temps perdu. The word is “anamnesis.”

The Oxford English Dictionary lists only two meanings of “anamnesis”: (a) the recalling of things past; recollection, reminiscence; and (b) that part of the Eucharistic canon in which the sacrifice of Christ is recalled and pleaded.

Antedatings of the examples that the dictionary gives of the uses of these words are available.

Furthermore, other meanings could be added. The first meaning could be supplemented by being specifically designated as referring to the patient’s history. A modern immunological meaning, a reaction to an antigen that stimulates production of an antibody to another antigen previously encountered, could be added, and the dung beetle known as Deltochilum Eschscholz, or Anamnesis Vigors could also be included.

Anamnesis

A single word with medical relevance sums up remembrance of things past, the phrase that Shakespeare coined in Sonnet 30, which C K Scott Moncrieff used for his 1922 translation of the title of Proust’s novel À la recherché du temps perdu.1 The word is “anamnesis.”

The IndoEuropean root MEN reflected various aspects of the workings of the mind, including thought and memory. The Latin words mens (mind), memini (I remember), and mentio (remembrance), give us mind, mental, amentia, dementia, mention, and memento; comminisci (to contrive by thought) and reminisci (to recall or recollect) give us comment and reminisce.

The Greek word μαίνεσθαι (to rage, be furious, be in a frenzy, be inspired) gives us manic, maniac, and a myriad manias. From μανής (an ardent admirer) comes balletomane; a mentor is an adviser, from Μέντωρ, Odysseus’s guide; μένος (spirit, force, or passion) gives us the Eumenides, which means well spirited or gracious, a euphemistic name for the Furies, Alecto, Megaera, and Tisiphone, who punished human crimes by relentless harassment.

The o-grade form of MEN, MON, gave the Latin word monēre (to remind, warn, advise), from which we get admonish, demonstrate, monition and premonition, monitor, monster, monument, and summon. The Greek derivative μοῦσα gives us muse, museum, and music; μνήμων (mindful) gave the Greeks the goddess of memory, Mnemosyne, mother of the Muses, and gives us mnemonics; μνήμη (memory) gives us amnesia and amnesty.

Reduplication of MEN gives the Greek verb μιμνήσκειν (to remember), from which, adding the prefix ἀνὰ (whose many meanings include on, up, and through), came the verb ἀναμιμνήσκειν, literally to bring up in the memory, to remind or remember thoroughly, and the noun ἀνάμνησις, giving us, by direct transliteration, anamnesis. The Greek term ἀναμιμνήσκειν νοσήματος, literarily to recall a disease, meant to have a relapse.

Platonic anamnesis

According to Plato ἀνάμνησις was the idea that humans are born with innate knowledge, rediscovery of which occurs during inquiry and learning. In Plato’s dialogue Meno, Socrates asserts that knowledge is not required for virtue and that there is a distinction between belief and knowledge. In Phaedo, which ends with an account of the death of Socrates, Plato, using Socrates’ voice, invokes Plato’s theory as one of four arguments that the soul is immortal. Plato also tells us, in Phaedrus, that in perceiving beauty we induce anamnesis. Furthermore, the theory of anamnesis solves the paradox of learning: if we do not understand something, we cannot learn about it—to begin to learn we need to understand and to begin to understand we need to learn; anamnesis lets us pick ourselves up by the bootstraps.

Modern meanings

The Oxford English Dictionary (OED) lists two meanings of anamnesis:

a. the recalling of things past; recollection, reminiscence;

b. that part of the Eucharistic canon in which the sacrifice of Christ is recalled and pleaded.

The dictionary dates meaning (b) from 1894, but it can be antedated by a much earlier instance, from The Unbloody Sacrifice and Altar, Unvail'd and Supported (2nd edition, 1724) by John Johnson, in a section on the Eucharist: “Now an Anamnesis of Food must either signifie an Acknowledgment of God’s Goodness, in providing Meat and Drink for Mankind, which is what our Adversaries would have; or it must denote the Eucharistical Bread and Wine.”

Meaning (a) is first attested in the OED in a definition from The mysterie of rhetorique unvail'd by John Smith Gentleman (1657): “Anamnesis … Remembrance, or a calling to mind … is a figure whereby the speaker calling to mind matters past, whether of sorrow, joy, &c. doth make recital of them for his own advantage, or for the benefit of those that hear him.” Smith followed this definition with five biblical examples illustrating forms of anamnesis.

This extract could be taken to describe the patient’s tale, but the fact that “anamnesis” can be specifically used to refer to an individual’s medical history, according to the Platonic view that anamnesis is knowledge that can be discovered by inquiry, and not merely any recollection or reminiscence, deserves separate notice. The OED’s second citation under meaning (a) illustrates this specific meaning: “diagnosis from the Anamnesis, that is, from the story which the patient tells of his illness.” This appeared in 1876, in a translation by J Van Duyn and EC Seguin of a passage from the 6th German edition of A Manual of General Pathology by EL Wagner, professor of general pathology and pathological anatomy in Leipzig.

However, the example in the OED that illustrates this specific meaning can be antedated by several earlier examples.2 The earliest instance that I have found is from 1773, in an English translation by Colin Hossack of Herman Boerhaave’s Aphorismi de Cognoscendis et Curandis Morbis (1709): “Aph[orism] LXXIV. From what has been said the diagnosis, prognosis, and anamnesis of this disease are evident; nor is it difficult to perceive the method of cure.” [In the original “Ex his diagnosis, prognosis, anamnesis mali huius patet, nec vero, fanatio quid indicet, obscurum est.”]

There are also early 19th century instances, one from Miscellanies on Homoeopathy (1839) and several examples in two articles by Dr Thomas Laycock in the London Medical Gazette of 1846. The reviewer of a text by Dr A Siebert, a translation of Technik der Medicinischen Diagnostik, which comes between Laycock’s papers, defines “anamnesis” in a footnote as “the retrospective examination of a patient, involving all the facts connected with his physical and moral condition before he comes under treatment.” Elsewhere, it is clear that by “examination” he means taking the history.

Another meaning of anamnesis that is not to be found in the OED is from immunology, referring to a reaction to an antigen that stimulates production of an antibody to another antigen previously encountered. Here is an early instance of the adjectival form3: “Sera from a number of cases of pneumonia and minor respiratory diseases such as the common cold were tested because of the possibility that such respiratory diseases might bring about an anamnestic response and in this way give false positive tests for epidemic influenza.” The SARS coronavirus, for example, epidemic in 2003–4,4 later induced anamnestic responses to other coronaviruses.5

“Anamnesis” is not commonly used in English language bioscience publications these days. PubMed currently lists 638 papers with “anamnesis” in the titles, omitting those referring to the immunological use; only 79 (12%) are in English, many by foreign authors. Most of the rest are in German (287, 45%), and 22 other languages are represented, including Slavonic (14%), Romance (13%), and Scandinavian (6.4%) languages. The pre-1773 instances that I have found are mostly in either Latin or German; if in English, they typically refer specifically to Aristotle's theory or to a genus of dung beetles, Deltochilum Eschscholz, also called Anamnesis Vigors. All this suggests that the medical meaning most probably came to England via continental Europe, in translations from either Latin or German texts.

There is, however, earlier evidence implying medical relevance of the term, since “anamneticks” can be found, for example, in The New World of Words: or, Universal English Dictionary (1706) by Edward Philips, defined there as “medicines that restore the memory.” The same definition was given in the first edition of A New General English Dictionary by Thomas Dyche (1735); in later editions that was amended to “medicines that are helpful to, or restore the memory.”

Since then the word has changed and has become “anamnestics,” with an intrusive s. This is seen in the phrase “anamnestica signa,” found in many 18th and 19th century medical dictionaries, such as Dictionarium Medicum Universale: or, A New Medicinal Dictionary by J Barrow (1749), where it was defined as “commemorative signs, or those by which we discover the preceding state of the body; as demonstrative signs are those which shew the present; and prognostics signs those which show the future state”; for example, a hemiplegia because of a previous stroke or heart failure because of an old heart attack.

The meaning of the noun “anamnestic” has also extended from a medicine to a sign or symptom, as illustrated by an OED citation from Chambers’s Cyclopaedia of English Literature (1753): “Anamnestics, in medicine, are used by some writers to denote those signs which help to discover the past state of a patient's body.”

I’d love to know what medicines 18th century physicians used to improve the memory.

Footnotes

  • Competing interests: None declared.

  • Provenance and peer review: Not commissioned; not peer reviewed.

References

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