George C. Grinnell, The Age of Hypochondria: Interpreting Romantic Health and Illness (Basingstoke: Palgrave Macmillan, 2010), xi + 202pp. ISBN 978-0-230-23145-0; £52.50 (hb).
Hypochondria is a highly suggestive topic for Romantic criticism, as well as for the period itself. The study of how minds and bodies might get entangled in all things psychosomatic (a coinage of Samuel Taylor Coleridge’s, of course) should offer challenges and rewards in Romanticists’ continued struggle to balance the significance of ideal or intellectual worlds against their troubled interaction with material or corporeal substrates, in the wake of the historicist ascendancy. There are also more immediate and pressing gains to be made. In wider contemporary discourse we have lost a sense of how ‘hypochondria’ or ‘psychosomatic’ describe a hugely important and still poorly understood sphere of interaction between body and mind, or have retained only an etiolated sense of these words which takes them to mean purely mental, imaginary, or factitious. The Romantic period did not have this problem because readers and authors were still able (in both clinical and lay writing) to draw on a wide range of medical cultures and sets of ideas, including various models of nervous sensibility or irritability, vitalism and even humoralism (if only in an literary–cultural afterlife bled of theoretical authority or therapeutic application) which could offer a richer sense of the entwining of mental and somatic health in (for example) stress and anxiety, the perception of pain, fatigue, digestive disorder, etc., than we may have even now.
It is therefore one of the most unfortunate deficiencies of George Grinnell’s opaque and difficult book The Age of Hypochondria that the reader never gets a clear history of what the term meant in the period, or the medical contexts from which it emerged. It is extremely surprising that the book barely mentions hypochondriasis as precursor to the later disease concept. When Grinnell discusses connections between hypochondria and melancholia, his account of both terms is based on theoretical concerns rather than a historical sense of what such categories meant to Romantic period patients, doctors, readers or writers. While the book does offer an extended account of Thomas Beddoes’ Hygëia (1802) and a range of references to medical writers such as Cheyne, Blackmore, Buchan, Reid, Rush and Trotter, it is largely to dissect the rhetoric of these writers rather than giving their ideas much shrift, and beyond the reference to standard authorities there is little reference to an evidentiary basis drawn from case work, non-literary records or first-person accounts from the period’s ‘worried well’ to support the book’s large claims about ‘the age’, let alone its appeals to the ‘lived experience’ of health and sickness (p. 42).
Conversely, neither is the book particularly attuned to contemporary clinical or therapeutic thinking on health anxiety, as it is often now called, which more recent literary–critical work by Catherine Belling has been.  Despite or perhaps because of this, the book is very assertive about the nature of hypochondria, both in the Romantic period and now. Demurring from speculation, Grinnell nevertheless repeatedly posits ‘this malady’ and offers numerous categorical definitions of what ‘it’ is: variously, both anxiety about health of a more or less debilitating or somatic sort, and ‘a figure for a class obsessed with well-being’ (p. 29); ‘imaginary disorders’ (p. 50) and ‘a real disease that produces illusions of infirmity’ (p. 51); and then, with increasingly rococo abstraction in the course of the book, ‘a mode of health that resists being resolved into presence’ (p. 53); ‘the disorder is, among other things, a somatization of the unpredictable reality of corporeality and efforts to materialize various social and personal conceptions of embodiment that are anything but illusory’ (p. 86); ‘it is a mode of being in the world that is constantly fighting to refocus attention away from the body’, ‘an abstracted state of the body’ (p. 102); and at the book’s most grandiose moments, ‘the last health of the body’, the ‘ungraspable finitude of well-being’ (p. 118). Elsewhere he freely diagnoses ‘the period’s hypochondria’ (p. 42) as if it were a universal state.
At times these kinds of argument do gain some traction. Grinnell shares with Belling and others the premise that hypochondria is a ‘malady of interpretation’ (p. 57), a problem of epistemology as much as of epidemiology. Uncertainty about what health is, and how it can be conceptualised or figured either in individual lives or in a public discourse, or how the well or ill body can be seen, imagined, known, understood or controlled, and what sort of metaphorical work it does for bodies politic, are all germane. Hypochondria is often a site of anxiety about this uncertainty, not only for its sufferers, and this is Grinnell’s theme. He makes good points about professional legitimacy and the challenges that the opacity of the hypochondriac body raised for the clinical gaze of medicine in his Beddoes chapter, and he offers some interesting readings of literary texts such as the passage in Biographia Literaria where Coleridge, that great valetudinarian, draws material from Buchan to position his readers as hypochondriacs, and where the ‘ambivalent infirmity of a healthy body models an interminable crisis in understanding which Coleridge evokes as a figure for the sort of suspended understanding he would like his audience to master’ (p. 67). Too often, however, here or in the later chapters which address varieties of what Grinnell takes to be the hypochondriacal mode in De Quincey, Mary Shelley’s The Last Man, Charles Brockden Brown’s Arthur Mervyn and the autobiography of Mary Prince, tangible arguments are lost beneath waves of highly abstract or rhetorical theorisation (as in some of the examples quoted above) and still less does one get any sense of the real, lifelong consequences that result when the fragile ‘fog of optimism and uncertainty that passes for most of us, most of the time, as good health’ (Brian Dillon) dissipates before more disquieting prospects.  The Age of Hypochondria seems at some level to realise this: there are repeated articulations of an idea that ‘health was always being abstracted as an object of knowledge that risked making the corporeal body disappear into language’ (p. 85); that its subjects ‘ignore the lived materiality of infirmity in favor of an imagined state of somehow purely rhetorical disease’ (p. 86) or ‘raise the specter of diseased bodies […] only to mark the flesh as something disappeared and replaced with discourse’ (p. 107). But this applies to nothing in the book so much as its own arguments.
1. A Condition of Doubt: The Meanings of Hypochondria (Oxford: OUP, 2012).
2. Brian Dillon, Tormented Hope: Nine Hypochondriac Lives (London: Penguin, 2010), p. 6.