   Many scholars have argued (e.g. Bynum 1994, Carter 2003, Whitbeck 1977) that in the nineteenth century medicine changed in many ways, including a shift in thinking about disease. Instead of seeing disease as the identification of symptoms, it was the linkage of symptoms to distinct pathologies, understood as departures from normal function, that came to define disease. Heinrichs (2001, 271), for example, insists that psychiatry needs to employ this basic medical outlook, and therefore needs a developed theory of how the mind/brain works that can be used to identify psychological abnormalities and explain how they arise. Andreasen (2001, 172–76) embraces the strong interpretation. She argues that psychiatry, now emerging as a form of cognitive neuroscience, is for the first time able to identify the specific pathophysiologies that underpin the symptoms of mental illness. This development fits the pattern suggested by Hempel (1965), who expected psychiatry, as it matured, to develop a theory-driven classification scheme based on an understanding of the objective nature of mental illness rather than just pragmatic factors (Hempel 1965; See Fulford et. al 2006: 324–341: Thornton 2008: 169–74).