530 



HYPOCHONDRIASIS. 



ders especially, tliere is little or nothing in common. 

 Hysterical patients may indeed be hypochondrical, 

 and hypochondriacs may be hysterical ; but the 

 mobility, the superexcitability of the hysteric con- 

 stitution is still broadly distinguished from the dull 

 mono-maniacal fancies of the hypochondrical tem- 

 perament. Hysteria seldom appears in men ; hy- 

 pochondriasis much more frequently in men than 

 in women. Hysteria is a disease of the weak, the 

 restless, the excitable ; hypochondriasis, of the se- 

 date and contemplative. Hysteria is often linked 

 with inordinate passions, and fostered by luxury; 

 bypochondriasis assails those whose minds, after 

 being severely bent to one pursuit, are allowed to 

 fall into relaxation and comparative indolence. 

 Whatever exalts the sensibility, as poetry, music, 

 the fine arts, may dispose to hysteria ; but in many 

 of these things the harassed hypochondriac finds 

 temporary relief. Hypochondriasis affects the re- 

 tired man of business, the disbanded soldier, the 

 sailor paid off; hysteria affects young females, com- 

 monly in the prime of life, and whose profoundest 

 application is to the perusal of the newest romance. 

 A comfortable looking gentleman, of easy for- 

 tune, whose house, whose equipage, whose dinners, 

 whose general condition, seem calculated to excite 

 the envy of his toiling neighbours, begins, about 

 the age of forty-five, or fifty, to lose his cheer- 

 fulness, to forego his customary exercises, to make 

 his diet a subject of careful study, to regard with 

 especial dislike any wind that approaches within a 

 few points of the east, and to clothe himself in 

 superabundant raiment. His conversation has un- 

 dergone a change. From discourse relating to the 

 sports of the field, or grave discussions of the corn 

 laws and currency question, he perpetually devi- 

 ates to the subject of his own health. He eats 

 well three times a day, but complains of loss of 

 appetite. He looks smooth and ruddy, but tells you 

 that he loses flesh daily. His countenance assumes 

 a melancholy cast, and all his meditations tend to- 

 wards the subject of his digestive organs. He ac- 

 quires an unhappy habit of feeling his own pulse, 

 and he often walks to the looking-glass to inspect 

 his tongue. He is very particular in the matter of 

 his excretions, keeps a journal of his symptoms 

 and feelings, and weighs himself once a week. 

 There is nothing of which he is more convinced than 

 that by his sensations he can trace his food through 

 all the curves of his bowels down to one particular 

 point, where he strongly suspects the intestinal 

 canal ends in something very much like a cul-de-sac. 

 If this unfortunate gentleman is blest with an 

 apothecary largely endowed with the gift of listen- 

 ing to him the patient unfolds a tale of sufferings 

 various and distressing: all his sensations, per- 

 verted from their proper ends, seem to have be- 

 come the instruments of annoyance. All the 

 powers of language are employed to describe the 

 various perplexities which wait upon the functions 

 of digestion and assimilation ; the stomach has no 

 capacity for suffering which is not called into ac- 

 tivity ; it is craving or vexed with nausea ; it is 

 distended, overloaded, aching, gnawing, burning, 

 and drawn up with spasms ; whilst the sympathetic 

 intestines are seized with sudden pains and inde- 

 scribable griefs, which lead the sufferer at length to 

 believe that every viscus in his body is turned up- 

 side down. Every particular connected with the 

 supposed history of his case seems to him worth 

 preserving. It may be that the alterative pills of ; 

 the excellent apothecary, and his infallible black I 



draught, fail to give relief. But kind friends and 

 neighbours, overflowing with compassion, fill the 

 house with medicines of their own recommenda- 

 tion, and which are spoken very highly of in ad- 

 vertisements. Some of these are rather violent, 

 and bring the patient to so faint a condition that 

 he passes quickly to the other stages of a disorder 

 which is now advanced to a very promising hypo- 

 chondriasis. The patient then, perhaps, experi- 

 ences a division of his pains, without much dimin- 

 ution of them. No longer concentrated on the first 

 passages, they are dispersed over the whole economy. 

 Wherever, in the universal frame of his body, there 

 is a nerve or a blood-vessel, there is there also 

 some uneasy irregularity. His head alone is af- 

 fected with as many maladies as would fill an hos- 

 pital. Flashes of light affect his eyes ; the noise 

 of waters is in his ears ; stabs of pain affect his 

 temples; invisible bonds bind his aching brow; 

 upon the vertex sits a load heavier than that 

 carried by the strongest porter ; the foot of a giant 

 presses on his neck and shoulders. In these sen- 

 sations there is frequent variety, but rare relief. 

 All at once loud bells ring within the chambers of 

 the inner ear ; or the sound of artillery, or voices 

 as of a multitude, break in upon the silence of the 

 hypochondriac's parlour. Then his eyes become 

 fantastically affected ; the landscape is enveloped 

 in smoke ; the columns of the morning paper move 

 enechellon; the patient is quite convinced that he 

 is growing blind. It is incredible bow much he 

 suffers from the noise of children ; the servants 

 shut the doors with a violence that distracts him ; 

 and all his friends have acquired an unaccountable 

 trick of talking loud. 



In all this, although its detail conveys even to 

 the most compassionate hearer an idea of fancy and 

 exaggeration, there is much real and pitiable suffer- 

 ing. Yet this is but a part of the woes of a hy- 

 pochondriac. His very heart does not beat as it 

 used to beat: it throbs, and jumps, and flutters, 

 and sometimes seems to come to a complete stand- 

 still. When he lies on his left side, it knocks 

 against his ribs as if it would come out of his tho- 

 rax; and when he turns for relief to his right, the 

 heart turns too, and keeps up the same disturbance. 

 Then every particle of his skin has acquired an in- 

 tensity of feeling; a current of air, an open door, 

 torments him ; the halo of fresh atmosphere which 

 comes into his close room with friends who have 

 been riding or walking out of doors feels raw and 

 irritating to his organs of respiration, and chills his 

 blood. Easy chair, or comfortable sofa, he can 

 find none. He loads himself with under-waist- 

 coats of all denominations, and in numbers with- 

 out number. He cannot always open his mouth 

 with impunity, for the fog penetrates to his 

 stomach and refrigerates the vital organs, so that 

 he does not recover it for the whole day. 



The mind, which has not been quite free from 

 impairment from the first, now becomes more 

 gravely affected. Reading and all mental occupa- 

 tions become irksome ; every view of the past is 

 tinctured with sadness; the future prospect is 

 without hope ; and the fear of death is for ever 

 impending. 



" The sun prows pale ; 

 A mournful visionary light oVrspreads 

 '1 he cheerful face of nature : earth becomes 

 A dreary desert, and heaven frowns above." 



Strange fancies introduce themselves among the 

 sufferer's thoughts. Sometimes he supposes him- 

 self to be expanded like a balloon, and his specific 



