HYPOCHONDRIASIS. 



531 



gravity diminished, so that he dreads an involun- 

 tary ascent to the stars. Or his solid bulk is im- 

 agined to be so enlarged that it perplexes him to 

 think how he shall get through the door. Certain 

 untrue sensations in the lower limbs persuade him 

 that they are made of glass ; or his perceptions are 

 so compressed that he conceives himself to be a 

 piece of money. He often thinks himself dying, 

 and is occasionally satisfied that he is dead. 



Such is the disorder which medical writers call 

 hypochondriasis. It happens, oddly enough, that 

 the very errors of the faculty not unfrequently pro- 

 duce a great deal of comfort to persons labouring 

 under this disorder. Well persuaded themselves 

 that they labour under many grievous diseases, of 

 which some one is the chief, they are never so 

 happy as when they meet with a medical practi- 

 tioner who, either in his innocence or artfully, fixes 

 boldly on some organ as the fountain and origin of 

 all the patient's symptoms. The patient tells his 

 friends, with the air of a man comfortably relieved 

 from every doubt, that his new doctor has found 

 out his complaint, and that he has got a disease of 

 the mesenteric glands, or a scirrhus of the bowels, 

 or a softening of the brain. He now knows what 

 he is about, and can pursue a regular plan ; which 

 he does until he removes to some other fashionable 

 resort of the sick, calls in another doctor, and 

 finds out they were quite mistaken at Bath and 

 Cheltenham, and that he labours under some other 

 malady, but quite as incurable. In the mean time, 

 the worst part of the case is, that there is probably 

 some real disorder at the bottom of all these com- 

 plaints, and which requires for its detection and 

 management a rarer sagacity and a more skilful ap- 

 plication of medicine than is to be expected from 

 those who are the readiest to prey upon the weak- 

 ness and credulity of hypochondriac patients. 



By writers in general, hypochondriasis has been 

 considered as particularly common in England. 

 Admitting the fact, its explanation is not, we 

 apprehend, to be sought solely in our variable cli- 

 mate. The frequent gloominess of our sky, which 

 has been accused of " disposing all hearts to sad- 

 ness," is more than compensated for by its enliven- 

 ing mutability; and those who, ungrateful for the 

 gorgeous springs, the cool refreshing autumns, and 

 summers not intolerable, of our climate, have sung 

 the praises of warmer regions and a cloudless sky, 

 have in most instances had no opportunity of 

 making a comparison between the climate of Eng- 

 land and that of the over-rated South of Europe. 

 Certainly, hypochondriac maladies seem most to 

 affect the north-west portions of Europe ; but the 

 cause is perhaps to be found in the greater mental 

 activity, enterprise, and exposure to all the reverses 

 and fluctuations of fortune, which belong to the 

 state of society in these countries. 



Among trades, weavers and tailors are great hy- 

 pochondriacs; but shoemakers seem to be in this 

 respect pre-eminently wretched. Zimmerman 

 pointed out this fact, and ample experience has 

 verified it. Seated all day on a low seat ; pressing 

 obdurate last and leather against the epigastrium ; 

 dragging reluctant thread into hard and durable 

 stitches ; or hammering heels and toes with much 

 monotony; the cobler's mind, regardless of the ' 

 proverb, wanders into regions metaphysical and ! 

 political and theological; and from men thus em- | 

 ployed have sprung many founders of sects, reli- | 

 gious reformers, gloomy politicians, " bards, so- ' 

 phists, statesmen," and all other " unquiet things," . 



including a countless host of hypochondriacs. The 

 dark and pensive aspect of shoemakers in general 

 is matter of common observation. It is but jus- 

 tice to them, however, to say, that their acquisi- 

 tions of knowledge and their habits of reflection 

 are often such as to command admiration. The 

 hypochondrical cast of their minds is probably in 

 part induced by the imperfect action of the stomach, 

 liver, and intestines, in consequence of the position 

 in which they usually sit at work. General readers 

 may be glad to be informed that the regions under 

 the short ribs on each side are called by anatomists 

 the hypochondria, and that in these regions are 

 lodged some of the most important organs of di- 

 gestion, from a supposed impairment of which the 

 hypochondrical malady gained its appellation. It 

 has also been called the English malady, and the 

 Spleen, from its imaginary connection with a dis- 

 ease of that organ, which does not seem to be veri- 

 fied by experience. 



The most interesting and the most melancholy 

 hypochondriacs are to be found among men of cul- 

 tivated minds and sedentary habits, whose suffer- 

 ings appear but little in their works. Many a 

 page, which has made a thousand readers gay, has 

 been written in all the misery of hypochondriasis ; 

 and some of the finest productions of literature 

 have been produced at the price of an affliction 

 which seems to embody every other form of afflic- 

 tion. On persons of this kind, both the mental 

 and the bodily causes of hypochondriasis are ac- 

 cumulated. Neglect of exercise is combined with 

 frequent mental excitement, and a constitution of 

 peculiar sensibility is exposed to all the trials inci- 

 dental to men of little worldly wisdom and small 

 possessions. Depressing circumstances, a jaded 

 mind, a feeble body, and rebellious digestive or- 

 gans, thus conspire to call up all the demons of 

 hypochondriasis and of melancholy, and the days 

 of the unhappy victim become pretty equally di- 

 vided between mental brilliancy and a state border- 

 ing on moody madness. 



There are not many maladies of which the early 

 and proper treatment is more important than hy- 

 pochondriasis. Habit daily adds to the mental part 

 of the disorder; the corporeal derangements, 

 whether primary or secondary, become inveterate 

 by delay; the continual attention to sensations 

 heightens their force, and seems to impart an ac- 

 tivity to the extreme nervous branches, or in some 

 other way so to disturb both them and the small 

 blood-vessels, as actually to cause the superven- 

 tion of disorders, of which a long dread has been 

 entertained. The illustrious Laennec was of 

 opinion that long continued mental depression fa- 

 voured the development of pulmonary consump- 

 tion ; and an apprehension of the occurrence of 

 cancer has often been thought to dispose to cancer. 

 But if these terrible consequences should not fol- 

 low, the condition of the hypochondriac is yet ex- 

 ceedingly to be pitied. He is disqualified from many 

 or all of the duties of life ; his temper yields to 

 continual irritations ; his mind becomes weak and 

 habitually directed to trifles ; his feelings become 

 selfish and contemptible ; and his life is little better 

 than a long disease. 



The treatment must necessarily be partly mental, 

 and partly directed to the regulation of the disor- 

 dered bodily functions. To restore the proper 

 condition of the stomach, the liver, the duodenum, 

 or some other portion of the intestines, may re- 

 quire a skilful physician, and varied means ; only 



