No reader of seventeenth- and eighteenth-century English literature needs to be reminded of the interest of writers of the period in the condition-"disease" is too confining a term-hypochondriasis. Their concern is apparent in both the poetry and prose of two centuries.
Hypochondriasis A Practical Treatise (1766)
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Decade di alberi curiosi ed eleganti piante delle Indie Orientali by John Hill. Swedenberg, Jr. No reader of seventeenth- and eighteenth-century English literature needs to be reminded of the interest of writers of the period in the condition—"disease" is too confining a term—hypochondriasis. From Robert Burton's Brobdingnagian exposition in The Anatomy of Melancholy to Tobias Smollett's depiction of the misanthropic and ailing Matthew Bramble in Humphry Clinker , and, of course, well into the nineteenth century, afflicted heroes and weeping heroines populate the pages of England's literature.
There is scarcely a decade in the period that does not contribute to the literature of melancholy; so considerable in number are the works that could be placed under this heading that it actually makes sense to speak of the "literature of melancholy. Bennett and Miss Bates in the novels of Jane Austen. So great in bulk is this literature in the mid eighteenth century, that C.
Moore has written, "statistically, this deserves to be called the Age of Melancholy. The ancient Greeks had theorized about hypochondria: hypochondriasis signified a disorder beneath hypo the gristle chondria and the disease was discussed principally in physiological terms.
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The belief that hypochondriasis was a somatic condition persisted until the second half of the seventeenth century at which time an innovation was made by Dr. Thomas Sydenham. In addition to showing that hypochondriasis and hysteria thought previously by Sydenham to afflict women only were the same disease, Sydenham noted that the external cause of both was a mental disturbance and not a physiological one.
He also had a theory that the internal and immediate cause was a disorder of the animal spirits arising from a clot and resulting in pain, spasms, and bodily disorders.
By attributing the onset of the malady to mental phenomena and not to obstructions of the spleen or viscera, Sydenham was moving towards a psychosomatic theory of hypochondriasis, one that was to be debated in the next century in England, Holland, and France. Once the theory of the nervous origins of hypochondria gained ground—here I merely note coincidence, not historical cause and effect—the disease became increasingly fashionable in England, particularly among the polite, the aristocratic, and the refined.
Students of the drama will recall Scrub's denial in The Beaux' Stratagem of the possibility that Archer has the spleen and Mrs. Sullen's interjection, "I thought that distemper had been only proper to people of quality. Professor Donald Davie has written that he has often "heard old fashioned and provincial persons [in England and Scotland] even in [my] own lifetime say, 'Oh, you give me the hyp,' where we should say 'You give me a pain in the neck'"; and I myself have heard the expression, "You give me the pip," where "pip" may be a corruption of "hyp.
It was also used as a synonym for "lunacy," as the anonymous author of Anti-Siris , one of the tracts in the tar-water controversy, informs us that "Berkeley tells his Countrymen, they are all mad, or Hypochondriac , which is but a fashionable name for Madness. The mental causes are noted as well in an anonymous pamphlet in the British Museum, A Treatise on the Dismal Effects of Low-Spiritedness and are echoed in many similar early and mid-eighteenth century works. Some medical writers of the age, like Nicholas Robinson, had reservations about the external mental bases of the hyp and preferred to discuss the condition in terms of internal physiological causes By mid century the condition known as the hyp was believed to be a real, not an imaginary ailment, common, peculiar in its manifestations, and indefinable, almost impossible to cure, producing very real symptoms of physical illness, and said to originate sometimes in depression and idleness.
It was summed up by Robert James in his Medicinal Dictionary London, : If we thoroughly consider its Nature, it will be found to be a spasmodico-flatulent Disorder of the Primae Viae , that is, of the Stomach and Intestines, arising from an Inversion or Perversion of their peristaltic Motion, and, by the mutual consent of the Parts, throwing the whole nervous System into irregular Motions, and disturbing the whole Oeconomy of the Functions No disease is more troublesome, either to the Patient or Physician, than hypochondriac Disorders; and it often happens, that, thro' the Fault of both, the Cure is either unnecessarily protracted, or totally frustrated; for the Patients are so delighted, not only with a Variety of Medicines, but also of Physicians On the contrary, few physicians are sufficiently acquainted with the true Genius and Nature of this perplexing Disorder; for which Reason they boldly prescribe almost everything contained in the Shops, not without an irreparable Injury to the Patient article on "Hypochondriacus Morbis".
This is a more technical description than Hill gives anywhere in his handbook, but it serves well to summarize the background of the condition about which Sir John wrote. Hill's Hypochondriasis adds little that is new to the theory of the disease. It incorporates much of the thinking set forth by the writings mentioned above, particularly those of George Cheyne, whose medical works The English Malady and The Natural Method of Cureing the Diseases of the Body, and the Disorders of the Mind Depending on the Body Hill knew.
He is also conversant with some Continental writers on the subject, two of whom—Isaac Biberg, author of The Oeconomy of Nature , and Rene Reaumur who had written a history of insects —he mentions explicitly, and with William Stukeley's Of the Spleen In the first four sections almost every statement is commonplace and requires no commentary for example, Hill's opening remark: "To call the Hypochondriasis a fanciful malady, is ignorant and cruel. It is a real, and a sad disease: an obstruction of the spleen by thickened and distempered blood; extending itself often to the liver, and other parts; and unhappily is in England very frequent: physick scarce knows one more fertile in ill; or more difficult of cure.
Wild thoughts; a sense of fullness" and causes the poor and damp English climate and the resultant clotting of blood in the spleen of the illness. Sections V-VIII, dealing with causes and cures, are less commonplace and display some of Hill's eccentricities as a writer and thinker. He uses the section entitled "Cures" as a means to peddle his newly discovered cure-all, water dock, which Smollett satirized through the mouth of Tabitha Bramble in Humphry Clinker Hill also rebelled against contemporary apothecaries and physicians who prescribed popular medicines—such as Berkeley's tar-water, Dover's mercury powders, and James's fever-powders—as universal panaceas for the cure of the hyp.
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However scientifically correct Hill may have been in minimizing the efficacy of current pills and potions advertised as remedies for the hyp, he was unusual for his time in objecting so strongly to them. Less eccentric was his allegiance to the "Ancients" rather than to the "Moderns" so far as chemical treatment i. Still more idiosyncratic, perhaps, is Hill's contention p. Virtually every writer I have read on the subject believed that onset of the hyp was caused by one of the six non-naturals—air, diet, lack of sufficient sleep, too little or too much exercise, defective evacuation, the passions of the mind; and although some medical writers emphasized the last of these, few would have concurred with Hill that the fetid air of London was less harmful than the clearer air at Highgate.
All readers of the novel of the period will recall the hypochondriacal Matt Bramble's tirade against the stench of London air. Beliefs of the variety here mentioned cause me to question Hill's importance in the history of medicine; there can be no question about his contributions to the advancement of the science of botany through popularization of Linnaeus' system of bisexual classification, but Hill's medical importance is summarized best as that of a compiler. His recommendation of the study of botany as a cure for melancholics is sensible but verges on becoming "a digression in praise of the author," a poetic apologia pro vita sua in Augustan fashion: For me, I should advise above all other things the study of nature.
Let him begin with plants: he will here find a continual pleasure, and continual change; fertile of a thousand useful things; even of the utility we are seeking here. This will induce him to walk; and every hedge and hillock, every foot-path side, and thicket, will afford him some new object. He will be tempted to be continually in the air; and continually to change the nature and quality of the air, by visiting in succession the high lands and the low, the lawn, the heath, the forest.
He will never want inducement to be abroad; and the unceasing variety of the subjects of his observation, will prevent his walking hastily: he will pursue his studies in the air; and that contemplative turn of mind, which in his closet threatened his destruction, will thus become the great means of his recovery pp. Hill was forever extolling the claims of a life devoted to the study of nature, as we see in a late work, The Virtues of British Herbs Judicious as is the logic of this recommendation, one cannot help but feel that the emphasis here is less on diversion as a cure and more on the botanic attractions of "every hedge and hillock, every foot-path side, and thicket.
Since Hill devotes so much space to the virtues of this herb and concludes his work extolling this plant, a word should be said about it.
Throughout his life he was an active botanist. Apothecary, physician, and writer though he was, it was ultimately botany that was his ruling passion, as is made abundantly clear in his correspondence. James's Street or in the larger one on the Bayswater Road—he cultivated an herb garden that flattered his knowledge and ability. Connoisseurs raved about its species and considered it one of the showpieces of London. His arrogant personality alone prevented him from becoming the first Keeper of the Apothecary's Garden in Chelsea, although he was for a time superintendent to the Dowager Princess of Wales's gardens at Kensington Palace and at Kew.
His interest in cultivation of herbs nevertheless continued; over the years Hill produced more than thirty botanical works, many of them devoted to the medical virtues of rare herbs such as "Spleen-Wort. Nor is his reference to the Ancients as authority for the herbal pacification of an inflamed spleen surprising in the light of his researches: he was convinced that every illness could be cured by taking an appropriate herb or combination of herbs. Whereas a few nonmedical writers—such as John Wesley in Primitive Physick —had advocated the taking of one or two herbs in moderate dosage as anti-hysterics the eighteenth-century term for all cures of the hyp , no medical writer of the century ever promoted the use of herbs to the extent that Hill did.
In fairness to him, it is important to note that his herbal remedies were harmless and that many found their way into the official London Pharmacopeia. Treatises on hypochondriasis did not cease to be printed after Hill's in , but continued to issue from the presses into the nineteenth century. A good example of this is the tome by John Reid, physician to the Finsbury Dispensary in London, Essays on Insanity, Hypochondriasis and Other Nervous Affections , which summarizes theories of the malady. If John Hill's volume is not an important contribution in the history of medicine, it is a lucid and brief exposition of many of the best ideas that had been thought and written on the hyp, with the exception of his uninhibited prescribing of herbal medicines as cure-alls.
An understanding of this disease is essential for readers of neoclassical English literature, especially when we reflect upon the fact that some of the best literature of the period was composed by writers whom it afflicted. It is perhaps not without significance that the greatest poet of the Augustan age, Alexander Pope, thought it necessary as he lay on his deathbed in May to exclaim with his last breath, "I never was hippish in my whole life. Title pages of different copies of the first edition of vary.
Distinctions among these, of interest primarily to medical historians, cannot be treated here. As good a definition as any is found in Dr. Johnson's Dictionary : "Hypochondriacal Melancholy; disordered in the imagination Producing melancholy In medical parlance, "hypochondria" means the soft parts of the body below the costal cartilages, and the singular form of the word, "hypochondrium," means the viscera situated in the hypochondria, i.
Collected out of the works of Mr. Richard Baxter London, in the British Museum.
London, , had been published six months earlier than Hypochondriasis and had earned Hill a handsome profit. See G. He mentions it in passing in The British Herbal , I, and may have sold it as early as when he opened an apothecary shop. Secondary literature on hypochondria is plentiful. Works include: R. Gillespie, Hypochondria London, , William K. James M. Osborn Oxford, , I, I am indebted to A.
Morris, M. To call the Hypochondriasis a fanciful malady, is ignorant and cruel. The blood is a mixture of many fluids, which, in a state of health, are so combined, that the whole passes freely through its appointed vessels; but if by the loss of the thinner parts, the rest becomes too gross to be thus carried through, it will stop where the circulation has least power; and having thus stopped it will accumulate; heaping by degrees obstruction on obstruction. Health and chearfulness, and the quiet exercise of mind, depend upon a perfect circulation: is it a wonder then, when this becomes impeded the body looses of its health, and the temper of its sprightliness?
Its slightest state brings with it sickness, anguish and oppression; and innumerable ills follow its advancing steps, unless prevented by timely care; till life itself grows burthensome. The disease was common in antient Greece; and her physicians understood it, better than those perhaps of later times, in any other country; who though happy in many advantages these fathers of the science could not have, yet want the great assistance of frequent watching it in all its stages.