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The Hypochondriacs

Nine Tormented Lives

by Brian Dillon

Hardcover, 280 pages, Farrar Straus & Giroux, List Price: $25 |


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The Hypochondriacs
Nine Tormented Lives
Brian Dillon

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Book Summary

A history of hypochondria as reflected by nine historical figures explores the relationship between the mind and body as it is mediated by the fear of illness, providing insight into the mental states of such individuals as Charlotte Brontèe, Charles Darwin and Andy Warhol.

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Excerpt: The Hypochondriacs

1. James Boswell’s English Malady

‘He is a convalescent whom the last relapse will infallibly destroy.’

Jean-Jacques Rousseau, Correspondence générale de J.-J. Rousseau

On Saturday, the 6th of August 1763, James Boswell, who was then two months short of his twenty-third birthday, was received on board the Prince of Wales packet-boat at Harwich, on the coast of Essex. The ship was bound for the Dutch port of Helvoetsluys; from there, the young man was to travel north to Leyden, and thence east to the university town of Utrecht where, at the insistence of his father, Lord Auchinleck, he was to study law. Boswell’s hopeful mood as he set out – a promised tour of Paris and the German courts lay at the end of his stay in Holland – was shadowed by a sense that this term of study in a less than teeming town was a parental punishment for his recent dissolution in London. His first flight from his native Scotland had been alarming enough, as far as his father was concerned: the eighteen-year-old had quickly converted to Catholicism and at the same time, as if testing the strength of his new piety, acquired a taste for bought sex that he would pursue, for much of his life, with the force of a vocation. Hastily recalled to Scotland by his father, he languished for two years, studying desultorily and dreaming of escape. In the second year, he fathered an illegitimate son whom he never saw.

His second adventure in the capital commenced in November 1762. Lord Auchinleck had grudgingly agreed to his son’s returning to London to seek a commission in His Majesty’s Foot Guards, a scheme that came to nothing. Instead, as we know from his journals, Boswell further indulged his physical appetites but also began, under the tutelage of Samuel Johnson, whom he first met in May 1763, to picture for himself a more ordered and serene existence. He determined on a life of study, and of writing, that would keep at bay both carnal chaos and the periodic melancholy that had already threatened him in the months since his arrival in London. He felt, in the days before his departure, that his London life, with its diverting extremes of physical pleasure and intellectual play, but its prospects too for moral improvement, was about to be snatched away. On the first of the month, trying to reconcile himself to his father’s plan, he wrote in his journal: ‘Resolve now study in earnest. Consider you’re not to be so much a student as a traveller. Be a liberal student. Learn to be reserved. Keep your melancholy to yourself, and you’ll easily conceal your joy.’

Dining at the Turk’s Head with Johnson two days earlier, Boswell had been unable to hide the nostalgia that had seized him even before leaving England, and he was flattered and consoled to discover that his famous friend planned to see him off at Harwich. But seated again at the same establishment on the 3rd of August, suffering a feverish headache and feeling heavy from a bout of insomnia the night before, he was scarcely able to listen as Johnson discoursed at length upon the Convocation of the Church of England. The following day, Boswell’s last in London, his mind shrank, agitated, gloomy and dejected, from the prospect of leaving the city, and he had to remind himself, not for the first or the last time, to be manly, steady and dignified, to commit himself to the care of his merciful Creator.

It was in this confused state that he travelled by coach with Johnson to Harwich the next day. They stayed overnight at Colchester, where the elder man, observing a moth burn itself to death as it fluttered about a candle flame, remarked: ‘That creature was its own tormenter, and I believe its name was Boswell.’ The human subject of this comparison does not record his own response in The Life of Samuel Johnson, but moves the scene at once to Harwich, where, exploring the town, the pair had one of the most celebrated exchanges in English literature. On leaving the local church, they began to dispute about George Berkeley’s philosophical doctrine concerning the reality of matter, and in particular his positing its non-existence in the absence of our sensing it. The notion, said Boswell, was impossible to refute; Johnson replied by suddenly kicking a large stone (‘till he rebounded from it’, notes his companion) and announcing: ‘I refute it thus.’ It was soon time for Boswell to embark, and we may wonder whether it occurred to him, as the Prince of Wales pulled away from the shore, that his solid friend, on whom he kept his eyes fixed for a considerable time, had something of the same stone about him as he strolled the beach, ‘rolling his majestic frame in his usual manner’, and whether, as the animated shape on the shoreline shrank and started to move inland, Boswell questioned the reality of knowledge, of friendship, of home, or of the strange sensations that had troubled his mind and body in recent days. At length, the figure on the beach had vanished, and then too the land itself.

His ship docked in Holland at midday on the 7th of August. After a day or two at the house of Archibald Stewart, an acquaintance in Rotterdam, Boswell went to Leyden, where he began to feel ‘low-spirited’, and so set out swiftly for Utrecht. It was a journey of nine hours in a trek schuit, an exceedingly slow-moving horse-drawn boat. Solitude and the sluggish pace of three miles an hour did nothing for his mood, and he began, he wrote later, to brood over his own dismal imaginations. His father, in one of the moments of crushing pedantry that characterize his communications with his son, had asked him to observe closely the agricultural habits of the Dutch, but it is doubtful whether, as his covered craft pushed between the pastures of central Holland, Boswell paid much attention to the species and number of the livestock he passed, or to the crops awaiting harvest. He may not even have noticed, as the sun sank towards a Saturday evening, the tower of Utrecht’s medieval cathedral rising to meet him. On arriving in the cathedral square, however, he would have been struck at once by its curious aspect: the tower was connected to the cathedral proper only by a pile of overgrown rubble, bony and pale in the fading light. The nave had collapsed during a storm in August 1674, and almost a century later the debris had still not been cleared away. Boswell faced the prospect of lodging next door to a ruin – his hotel, the Nouveau Château d’Anvers, stood across the square from the amputated campanile. A deep melancholy, he writes, now fell upon him. He was shown to a bedroom on an upper floor and left to dine there alone among its cheerless old furnishings. On each hour, the thirty-five bells of an elaborate carillon, housed in the octagonal lantern of the cathedral tower and timed by adjustments to a vast metal drum below, tolled out the same dreary psalm. As the clangorous tune subsided again, Boswell, in his solitude, thought himself old, miserable and abandoned, and he ‘groaned with the idea of living all winter in so shocking a place’.

He woke the next day in an even more pitiful state. Alone, knowing nobody and with nothing to occupy him until the academic term started, he sank into even deeper despair, and sincerely believed that he was going mad. Eventually, he ran out into the streets around the louring wreckage of the cathedral. He groaned aloud as he turned from the square, cried out as he crossed the city’s turbid canals and wept openly in the faces of passing strangers. He seems to have written nothing in the days to come and we have to rely on the letters he wrote in the following weeks to reconstruct his agony, a suffering with which he had been intermittently familiar since the age of seventeen – though on reflection he thought he might date its onset to an illness at the age of twelve – and which he already knew by the names of melancholy and hypochondria. The first is the term he uses, in a letter of the 16th August to his friend William Temple, to describe a wretchedness that, he says, nobody who has not suffered it can fully comprehend. ‘I have been melancholy’, he writes, ‘to the most shocking and most tormenting degree.’ After two days in this condition, in a city that seemed to embody his state of mind, he resolved to quit Utrecht, and returned to Rotterdam. Staying again with Stewart, he confided his collapse to the young merchant, whom he hardly knew. Stewart contrived schemes to distract and amuse his dismal fellow Scot, but none of them worked. Boswell was gripped by a conviction that his father would learn of his affliction and impute it, once more, to his son’s innate idleness and dissipation. The thought made him waver, even in writing to Temple, a trusted friend, between declarations of his utter failure (as scholar, gentleman and son) and frantic efforts to pass the episode off as a distemper that time would heal. He almost convinced himself of this, asking Temple to ‘wait patiently to see what time will produce’, before falling once again, in the last sentence of the letter, into abjection: ‘O dear! I am very ill.’

‘Good God! What distracted horrors did I now endure!’ wrote Boswell of the ensuing weeks of chaos and irresolution. He could not decide which European city might be his best hope of solace. He thought of going to Berlin, Geneva or Paris. Most of all, he thought about London, and his former happiness there – conveniently forgetting the countless journal entries that record his battle, during the previous year, against hypochondriacal or melancholic symptoms. In the end, he decided on a tour of Dutch cities in the company of John Morgan, an American who had graduated recently from the medical faculty at Edinburgh. They travelled north, to Gouda, Amsterdam and Haarlem, but when their rough circuit of the country took them back to Utrecht, the city still seemed so terrible to Boswell that he could not stay, and they returned to Rotterdam.

Before setting out on the tour, Boswell had written to a friend, George Dempster, whom he knew to be in Paris, hoping that they might meet soon, in Brussels. He now discovered that Dempster, on receipt of his letter, had left immediately for Brussels and, finding no sign of his friend, remained there patiently for five days. Two letters were waiting for Boswell on his return, in which Dempster, more in exasperation than in anger, describes him as a ‘mass of sensibility’, asks him to think of his time in Holland as ‘the dark watery passage which leads to an enchanted and a brilliant grotto’ and advises that journal-keeping and ‘debauching a Dutch girl’ might be the likeliest remedies for his malaise. In fact, Boswell was by now feeling rather better, which improvement he attributed, as he set out from Rotterdam to Utrecht on the 5th of September, to reading Johnson’s essays and taking regular exercise. As he readied himself to return to the scene of his collapse, he appears to have known that his problems were temporal and textual, his illness a matter of irregular habits of body and mind, and its cure close at hand in the form of his books and his own diaries. His hypochondria, as he learned to call it, was bound up, in short, with the time he spent, or did not spend, reading and writing.

In late September, in a letter to John Johnston, a friend from his time at the University of Edinburgh, Boswell described again the catastrophic events of early August. As if unsure of his ability to flesh out in words the full horror of his suffering, he asked his friend to ‘pause here a little to figure for yourself what I endured’. In truth, his prose pictures were vivid enough. But Boswell, whose self-portrait in letters and diaries is his first consciously literary project, was already in the habit of stepping back from his sentences to gauge their effect, and of casting his own examined life in a number of genres at once. The vast bulk of what he wrote about himself in Holland has been lost. His London journal affords a remarkably detailed report of the previous year of his life: his search for a profession, his adventures in the city’s brothels and the beginnings of his friendship with Dr Johnson. There remains no such record of his time in Holland. Boswell kept up his journal-writing, but on leaving Utrecht in June 1764 he entrusted all his papers to a friend, the Reverend Robert Brown, requesting that the whole cache be sent on to him in Scotland. It seems that Brown passed the parcel to a young army officer, who took it as far as London; but when the papers arrived at Auchinleck, the Dutch journal was missing. What we lack, in consequence, are Boswell’s nocturnal thoughts, set down at length at the end of the day. What we have instead, alongside his letters, are his morning memoranda: notes that typically open with a review of the previous day’s events and go on to outline a plan of study, a physical regime or a set of social engagements for the day ahead. He was generally less at ease with himself first thing in the morning, less likely to forgive the lapses of the day before, more apt to look on the day to come as a chance to redeem or cure himself.

Boswell’s writing habits constitute the real drama of his months in Utrecht, the nexus where his hopes, his fears and his hypochondria are subtly convolved. From the moment of his return to Utecht, his morning memoranda recount a struggle between his unruly body and the rigorous abstraction of time. Once again, he was housed in full view of the half-ruined cathedral, at an inn called the Cour de l’Empereur, where he engaged a servant and sent for a tailor to come and measure him for ‘a Leyden suit of green and silver’. His thoughts then turned to how best to fill his time in the fortnight or so before lectures began. (Boswell had only to cross the square to attend them: the law faculty occupied rooms around the cathedral’s cloister.) Temple had written, advising him to spend six hours a day reading; Stewart wrote too, inquiring whether he was still tormented by ‘the dreadful bell ’ and recommending another regime – on waking, he was to thrust his head out of the window and open his mouth wide to the morning air, then proceed to dance and caper about the room for twenty-five minutes. After devouring three pints of porridge and milk, he must turn to his law books; by way of recreation, he might later allow himself to read the Spectator or Johnson’s journal the Rambler. Boswell had meanwhile begun to draw up the first of many timetables for himself. From mid September, the tone of his memoranda is both pedantic and urgent:

FRIDAY 16 SEPTEMBER . . . Latin till breakfast, something till eleven, then dress and at twelve French, then walk and dine. Afternoon, journal &c. But next week you go to lectures, which will employ two hours and one in writing notes, about which you need not be exact. Mem. worthy father. Guard against liking billiards. They are blackguard, and you’ll have high character with Count Nassau &c., if you don’t play. Be easy and natural, though a little proud. Write out full mem. that this is your winter to get rid of spleen and become a man.

A mania for planning, and for rewriting his plans, overcomes Boswell at this point; his plans even contain, as here, reminders to copy out further plans. No spare hour is left unaccounted for – ‘something till eleven’, he writes, as if to say ‘anything’ – and no aspect of his daily life escapes prescription or censure. On the 18th, a Sunday, he tells himself to be shaved and dressed at half past eight (the memoranda were generally written as soon as he awoke), to go to church after breakfast and then return to his rooms and attend to his journal. ‘Keep up to plan,’ he tells himself. Time and again, however, as the autumn mornings darken, he finds that he has to recall his sluggish mind to his journal, to his plan of study, or to the very memoranda in which he is setting out his schedule. Boswell was trying, and failing, to keep up with himself.

In fact, his plans had been falling apart from the outset. His body, for a start, seemed to revolt against the rigours of the diurnal round. His digestive system – ever a source of obsession for writers of his century – was either overtaxed, leaving him feeling heavy and lethargic, or underworked. ‘Never want dinner,’ he wrote: ‘you will hurt your health.’ Early in October he would address the subject from the other end: ‘from this day follow Mr. Locke’s prescription of going to stool every day regularly after breakfast. It will do your health good, and it is highly necessary to take care of your health.’ (Here is Locke, in Section 24 of Some Thoughts Concerning Education: ‘if a man, after his first eating in the morning, would presently solicit nature, and try whether he could strain himself to obtain a stool, he might in time, by a constant application, bring it to be habitual.’) Irregularity of all sorts was precisely the problem. No matter how carefully he laid his plans in the morning – assuming, that is, that he woke early enough, and with sufficient energy to write them down – his life was a series of lapses. Billiards and bad diet were only the beginning; the more fundamental problem was his failure to find a moral and intellectual framework. With his spirits, as he thought, rallying after his melancholy fit, even a good mood could be dangerous: ‘Your happiness is not produced by dissipation and gaiety, and so may vanish suddenly. It is wrought out by philosophy and pious resolutions of doing your duty as a man, with fortitude. Never forget this strong period of your life.’

‘The mind of most men will grow uneasy without some actual plan,’ wrote Boswell to Temple at the end of September. His schemes now began to proliferate, as if he hoped that a profusion of plans would keep his mind so fixed on the future that present pleasures, or pains, could not distract him from his course. He seemed to think that he could parse his life, like a sentence or an equation, before living it, that his every thought and action composed a prospectus for the man he might become. The tense he lived in was the future perfect: what will have been.

His days began with a prose sketch of what he hoped to achieve by nightfall, accompanied, almost always, by an acknowledgement that the previous day’s plan had come to nothing: ‘from this time let plan proceed: seven to eight, Ovid; eight to nine, French version; ten to eleven, Tacitus; three to four, French; four to five, Greek; six to seven, civil law; seven to eight, Scots; eight to ten, Voltaire. Then journals, letters, and other books.’ Occasionally, things seemed to go well – ‘you go on charmingly. Be steady and firm’ – and he could allow himself some small relaxation of his routine. Six hours a day, he reflected, were sufficient to read the legal texts and literary works that he had set himself, and to bring his journal up to date. He might allow himself three hours off for amusement in the evenings. But for the most part he found himself falling behind in his studies, so that his memoranda make for a curious reading experience: anxious and repetitive, their content almost unchanging but the tone increasingly harried and staccato. As he felt his self-control slipping, his sentences became shorter and their mood strictly imperative: ‘after church, journal all evening, to bring it up once clear. Then you’ll be quite regular. Never desist an hour from plan . . . This morning read from breakfast till college, Van Eck, so as to bring him up . . . Be temperate and rise at seven each morning . . . Take constant exercise . . . Bring up journal clear, and after this clear it every three days.’

His rage for routine reached its apogee about the middle of the month. The memorandum for the morning of the 15th is not unusual: Boswell instructs himself again to bring his journal up to date, to ‘attain tranquillity’ and try to appear less giddy in company than he had the night before at a dinner hosted by Count Nassau. (That dinner, in the entry for Friday the 14th, is itself the subject of some fraught and detailed forethought: he plans to appear ‘quite the man of fashion’ in scarlet and gold, white silk stockings and handsome pumps, brandishing an elegant toothpick case, a present from an unnamed lady.) But the references to his plan have begun to be capitalized; it seems that some more definitive document has superseded daily revisions to his regime. The manuscript in question is headed ‘Inviolable Plan / to be read over frequently’. It begins with a brief description of his present predicament: though determined to make himself a man, worthy of the title of Laird of Auchinleck, he has had his resolutions undone by ‘a fit of the spleen’. He believed he had ‘a real distemper. On your first coming to Utrecht you yielded to that idea. You endured severe torment. You was pitiful and wretched. You was in danger of utter ruin.’ And yet: ‘this severe shock has proved of the highest advantage’. Idleness, he has come to realize, is his ‘sole disease’; resolution and diligence have already seen it off to some extent. He has begun to take command of himself; piety, hard work and vigilance have started to shape his character. He determines now to continue in this dignified fashion; he acknowledges that trifles, fancies and antipathies may still distract him, but trusts that temperance will see him through.

Excerpted from The Hypochondriacs by Brian Dillon.
Copyright © 2009 by Brian Dillon.
Published in 2009 by Faber and Faber,Inc..
All rights reserved. This work is protected under copyright laws and reproduction is strictly prohibited. Permission to reproduce the material in any manner or medium must be secured from the Publisher.