HYPOCHONDRIASIS. 341 



their ordinary functions well. They go "the round of the doctors," if they can 

 afford it, and are always changing their medical attendant, being particularly anxious 

 to try any new drug that may for the time be fashionable. They take a strange 

 delight in talking about their ailments, and are very fond of using scientific terms 

 without, however, always quite understanding what they mean by them. A curious 

 feature is that although they do their best to nurse their malady, they always appear 

 to be most anxious to get rid of it, and have an unlimited faith in medicines, not- 

 withstanding repeated failures in treatment. Perhaps the most vivid picture extant 

 of a hypochondriac is contained in the autobiography entitled " Grace abounding 

 unto the Chief of Sinners," being the history of the feelings of " God's poor servant, 

 John Bunyan," as he styles himself. 



The precise symptoms complained of vary much, and they are liable to change 

 from time to time. Often enough there is a great but indescribable sensation of 

 uneasiness in the chest, or there is a burning pain at the pit of the stomach. A very 

 common delusion is that there is consumption or fatal heart disease, and a little^ 

 indigestion and consequent palpitation may serve to keep up this idea. In the case, 

 of persons whose family is strongly tainted with insanity these delusions may assume- 

 a far more serious character, and the patient may believe, for instance, that his 

 stomach is full of tadpoles, or that a serpent is writhing about in his entrails. The 

 judgment may even become affected to such a degree that the patient entertains most 

 preposterous ideas, as that he is made of glass, and is in constant danger of being 

 broken, or that he is being magnetised, or that people are conspiring to poison him. 

 The wife of a tradesman believed that she had become solid, so that there was no 

 room for any food, which, nevertheless, she continued to take. An idle country 

 gentleman was convinced that some stones that had been thrown in his face weeks 

 before had gone down his stomach, and could be heard rattling about in his inside. 

 These can hardly be regarded as simple cases of hypochondriasis, and many of these 

 people ultimately become insane. 



Hypochondriasis is pre-eminently a disease of adult and middle life. It is hardly 

 ever seen in young people, and rarely makes its first appearance after the age of" 

 fifty. It is confined almost exclusively to men, and in women is for the most part 

 replaced by hysteria. Beyond all other circumstances that favour its occurrence is- 

 the existence of a strong hereditary taint of insanity. No station in life gives; 

 immunity from hypochondriasis, but it is most frequently met with in those who, 

 having retired from business, find the time hang heavily on their hands for the want 

 of some active employment. So also those who from their social position have not 

 been brought up to any occupation suffer greatly ; those accustomed to sedentary 

 pursuits, who neglect to take sufficient exercise ; and those again who over-work 

 themselves mentally, or who suffer from prolonged anxiety or strain. Reading men 

 at the Universities are often tormented with great depression of spirits ; often the 

 conscience is over- sensitive, and the importance of becoming distinguished is exag- 

 gerated. Disappointment, loss of wealth, loss of husband, wife, children, friends, 

 of health, character, or. social position, are often assigned as causes of hypochon- 

 driasis, and in many cases the complaint appears to have originated in the moral 

 collapse consequent on an over-exhausting labour, or on the sudden revelation to the 



