Thomas Beddoes and the physiology of Romantic medicine.

Publication: Studies in Romanticism

Publication Date: 22-JUN-06

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THOMAS BEDDOES HAS RECENTLY RECEIVED CONSIDERED ATTENTION Alternatively as a medical practitioner whose German interests had "a decisive influence on" his friend Samuel Taylor Coleridge, (1) or as an advocate of public hygiene "devoted to the value of health." (2) As a figure who represents the porous borders among discourses of well-being, politics, and literature, he compellingly embodies a Romantic medicine that sought to produce health as a social ideal. But Beddoes is also a thinker of the way in which Romantic medicine was itself haunted by a dis-ease that suggested the impossibility of something as basic as health. My task in this essay is to examine the ways in which Beddoes' elaboration of hypochondria in the Romantic period structures a medically-inflected understanding of wellbeing. While the literary and philosophical contours of Romantic hypochondria need to be further parsed in works by Schelling, Mary Shelley, de Quincey, and Hegel--not to mention those texts by more palpable hypochondriacs like Wordsworth, Coleridge, and Shelley--I want to attend to a still under-read but crucially important medical text by Beddoes that sought to understand the conceptual physiology of hypochondria and its implications specifically for a sense of Romantic health. The three volumes of Thomas Beddoes' Hygeia: or Essays Moral and Medical, on the Causes Affecting the Personal State of our Middling and Affluent Classes (1802-3) constitute a text that deserves to be read on its own merits for the rich examination it offers of the contours of a deployment of health in Georgian Britain. Hygeia offers a capacious understanding of the "physical or ideal pleasure and pain" affecting the minds and bodies of the middle classes in Britain, and assigns particular priority to nervous disorders among an increasingly hypochondriacal society. (3) But this is already to pose several concerns at once, each of them crucial for understanding the concept of Romantic health that Beddoes will develop and the ways in which the illness of hypochondria provides a conceptual reserve upon which he draws as he works and unworks the possibility of health.

Beddoes, the prominent and controversial Bristol physician, opens Hygeia with a gesture that is, in retrospect, expressive of much more than simple humility. Admitting the difficult task he has set himself in a work that proposes to treat medically the ills of the increasingly wealthy merchant classes in Britain, Beddoes remarks, "a writer in my situation finds himself obliged to fix upon an imaginary standard of capacity" (1:7). If Beddoes must imagine himself to be capable of providing care, the work of his text likewise dictates that he imagine much more than just medical expertise. Medical advice flourished in the Romantic era, and the particular project of Hygeia bears patient consideration of the ways in which it sought not so much to target an already existing bourgeois clientele but to produce that readership as the object of the medical treatments it offered. This also means, as Beddoes indicates, that the physician responsible for such a health must appear capable of caring for a bourgeois body politic, which is to say, capable of diagnosing what constitutes specifically bourgeois wellbeing and illness.

Beddoes' foray into what could only provisionally be called a medical anthropology of "the anatomy and physiology of external prosperity" among the British middling classes (1:29) is, moreover, anticipated by an entire genre of medical manuals that sought to provide members of the bourgeoisie with the capacity to manage their own health much as they took care of their own economic or intellectual well-being. Beddoes' own complicated relationship with these texts in Hygeia informs his efforts to model--in a performative dissemination of medical advice--a reorganization of medical practice in Georgian England. But it is worth noting from the outset he does not position such instructive medical texts and their ideologies of self-reliance as the standard against which his own advice might be measured. While the proper professionalization of medicine in Britain is a fantasy Beddoes in particular nurtures, the source of his capacity to understand how to treat medically the disorders of the bourgeoisie must be assumed already to exist. What is significant about this assumption of a medical understanding that does not, properly speaking, belong to Beddoes is that it furnishes the basis for a unified conception of the healthy body. As Beddoes will explore with greater precision in his discussions on hypochondria, bourgeois health has as its basis the collapse of a medical understanding with what, in a different context, Max Weber has called "another understanding, like our own yet unlike it (for it has produced precisely what we do not understand)." (4)

The text anatomizes Romantic medicine, moreover, making it a powerfully reflexive account for Romanticism not just of medicine but also of the techniques by which healthy bodies--or any bodies, perhaps--are produced as objects of normative regulation. The medical discourses of which Hygeia is both symptomatic and critical compose in this context a medicine "physical in its application but disciplinary in its regulative force" (Youngquist 122). In conceiving of a "healthy subject" I am adapting Judith Butler's counter-intuitive insistence that gender is not something that a subject simply or naturally has, but rather is discursively produced. In an on-going process, gender functions as a regulatory norm producing the bodies that it governs. Such a theoretical model, moreover, meaningfully describes the ways in which normative notions of health produce a healthy bourgeois subject primarily by forcefully producing others as infirm. (5)

The text promises to fix the reader's "attention severally upon the modes in which [health] is forfeited, on the advantages that accompany its possession, and the consequences that accompany its loss" (1:19). Expressed with such economic calculation, health appears not just as the object of "study" but a product that Beddoes himself is making available to the acquisitive classes. Locating himself among the merchant class in this opening chapter in which he invites his readers to embark on the task of securing their own health, Beddoes participates in an on-going production of bourgeois health that is rigorously historical, even if Beddoes might not have understood it that way. This history is also, furthermore, part of a history of the ways in which "health" is persistently troubled by hypochondria.

At the end of a century in which the "imagination was coming increasingly to be regarded, by philosophers and poets alike, as the seat of interaction between mind and matter," the disease of hypochondria, associated as it was "with disturbances of the imagination," was advanced to explain any number of pathologies." For instance--and this is simplifying her rich argument considerably--Susan Meld Shell notes the ways in which hypochondria is deployed as a figure for Kant's thinking on questions of bodily materiality and willfulness. But such a perspective is by no means the only one held in reserve by something called Romantic hypochondria. In Hygeia, hypochondria is deployed most consistently as a marker of the conceptual instability of health. While questions of the body's relation to the powers of the mind do arise, Beddoes' attention is drawn much more to the ways in which hypochondria inflects medical representations of well-being. The Bristol physician's particular understanding of the dis-ease reflects the political effects of shifts in the epidemiology of hypochondria over the course of the century. Hypochondria had long been stigmatized as a disease of aristocratic idleness. By century's end, this sense of the disease had been further specified as "a sort of occupational hazard of civilization" that was increasingly identified as particularly English (266). Hypochondria was first given a national inflection in George Cheyne's influential The English Malady (1733), a text that also identified hypochondria, along with melancholia, as a class-specific disease that beset the English aristocracy. But during the decades following the publication of Cheyne's text hypochondria underwent a considerable segmentation. No longer were hypochondria and melancholia so closely linked--though they were also not as distinct as we understand them to be now--nor was this disease of the spleen or hypochondrium any longer conceived of simply as a physical malady. The alterations that hypochondria underwent throughout the eighteenth century were expressive of more than just etiology, however. As the disease became increasingly characteristic of the mercantile classes who defined themselves in and through the practices of trade that structured Britain's civilizing enterprises abroad, hypochondria emerged as a symptom of "the commerce and consumerism of eighteenth century life" (Lawrence 15). Classified in part as a disease of affluence and intellectual refinement, this new Romantic hypochondria which was neither a mental disorder nor a disease of the body but both simultaneously was a consequence of "a class-specific form of social life." (7) As Peter Logan Melville notes, the dis-ease of hypochondria confirmed the relative prosperity of the bourgeoisie: "The hypochondria of the retired tradesman followed from his sudden loss of acquisitive activity. The lower class, by virtue of its poverty and constant labour, was still immune to the diseases of wealth, and so the fear of a nervous epidemic was singularly focused on the middle classes and its social environment" (1-2). But as a figure for the medicalization of British mercantilism, hypochondria also posed questions of the nature of disease itself.

At the level of bodily effects, hypochondria implied a pathological experience of any number of perhaps imaginary or genuine physical discomforts with which the sufferer became intensely preoccupied. Beddoes notes the hypochondriac is tormented by every ailment from "distressingly tense" indigestion, to "cholic," to "overpowering fits of anxiety and breathlessness" and "a painful cramped" heart (8:79). But the symptoms that are most characteristic of hypochondria are "the signs of derangement in the sensitive power" (8:79). This pathological tendency of the hypochondriac to misperceive illness or its severity is a curious gesture worth dwelling upon at this moment for at least several reasons. If Beddoes in some sense promises to diagnose the causes of infirmity for the middle classes, his Hygeia is symptomatic of a greater inability to discern what might finally constitute well-being. Hypochondria for Beddoes marks a dis-ease in the distinction between health and illness, a persistent indicator of something wrong in the very notion of well-being. So while Romantic medicine may have embodied what Paul Youngquist has called "a moral economy of health" (xxiii) that regulated bodies, health itself was haunted by hypochondria. Indeed, hypochondria emerges in this period as the pathological other to a normalizing Romantic taxonomy of health and illness. That is to say, the problem that in some sense structures Beddoes' concern with medical practice and healthy bodies is the difficulty of stabilizing an inconsistent opposition of health and illness.

My reading of Beddoes' text unfolds in several sections, each of which is populated by the disparate figures of illness that embody forms of hypochondria in Hygeia. I begin by examining Beddoes' reflexive attempts to understand himself as a physician capable of securely diagnosing illness. Further pursuing hypochondria as a disease capable of affecting the conceptual stability of something called health, my argument examines a medical pathology structured by the impossibility of finally bringing the illness of hypochondria to sight.

Something In The Air

In his Notice of Some Observations Made at the Medical Pneumatic Institution (1799), a text Beddoes wrote primarily to establish for his investors the path-breaking research into gases conducted at his newly founded Institute, he remarks on experiments then just completed:

after the first moments of surprise it was impossible not to recognize the expressions of the most extatic pleasure. I find it entirely out of my power to paint...

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