Flesh in the Age of Reason (60 page)

The eighteenth century brought the birth of the ‘consumer society’. Among the items consumed in greater range and larger quantities were food and drink; this brought growing anxiety about the harmful consequences of abuse, notably drunkenness. Alcohol had traditionally been viewed as a good thing: drinking was convivial, wine nutritious, invigorating and medicinal. But, as with everything, excess was bad. Drunkenness had traditionally been viewed, like fornication or swearing, as a failure of self-control on the part of the individual which it was his duty to correct. This viewpoint was somewhat challenged by the gin craze of the 1730s and 1740s – the product of dirt-cheap rot-gut – which forced public opinion to confront the phenomenon of mass and lethal intoxication.

Partly in the light of that craze, the suggestion gathered support that habitual drunkenness was not simply a personal weakness of will: it needed to be understood in terms of a tyranny of habits which, reinforced by the chemistry of alcohol, became ever more ingrained and difficult to combat – indeed, engulfed the personality.

The Scottish doctor George Cheyne for one ventured to explain how old soaks succumbed to ‘cravings’:

They begin with the weaker wines; These, by Use and Habit, will not do; They leave the Stomach sick and mawkish; they fly to stronger Wines, and stronger still, and run the Climax from Brandy to Barbados Waters, and double-distill’d Spirits, till at last they find nothing hot enough for them.

Thus, the penal servitude of ‘Necessity upon Necessity’ set in, whereby ‘Drams beget more Drams… so that at last the miserable Creature suffers a true Martyrdom’.

Somewhat later, the Quaker physician John Coakley Lettsom adumbrated the nature of progressive dependence. He displayed the fatal cycle leading from tippling for stimulus, relief or exhilaration; to low spirits, which were the inevitable after-effects; which in turn could be expunged only by further bouts of yet heavier drinking. ‘Those of delicate habits, who have endeavoured to overcome their nervous debility by the aid of spirits,’ he cited as an example:

many of these have begun the use of these poisons from persuasion of their utility, rather than from love of them: the relief, however, being temporary, to keep up their effects, frequent access is had to the same delusion, till at length what was taken by compulsion, gains attachment, and a little drop of brandy, or gin and water, becomes as necessary as food; the female sex, from natural delicacy, acquire this custom by small degrees, and the poison being admitted in small doses, is slow in its operations, but not less painful in its effects.

Eventually, such dependence would set in that ‘neither threats nor persuasions are powerful enough to overcome it and the miserable sufferer is so infatuated, as in spite of locks and keys, to bribe by high rewards the dependent nurse, privately to procure the fatal draught’.

By 1804 it was possible to cast habitual drunkenness as a ‘disease’. In his
Essay Medical Philosophical and Chemical on Drunkenness
, published in this year, Thomas Trotter – perhaps blessed with unrivalled experience with drunks, having served as physician to the Navy – stated point-blank that the ‘habit of drunkenness’ was indeed a ‘disease’ – indeed, he went on, it was a ‘disease of the mind’, ‘like delirium’. Moralists and parsons, he condescendingly added, had
been well-meaning in their exposés of drunkenness as vice or sin, but now, at last, ‘it had been set within its rightful domain’, medicine, to be managed by ‘the discerning physician’. By mid-century the precise notion of ‘alcoholism’ had been formulated.

Other morbid personality traits commanded growing attention.
A Treatise of the Hypochondriack and Hysterick Diseases
(1730) penned by the fabulist of the bees, Bernard de Mandeville, pondered the fictional case of the liberally educated ‘Misomedon’, who had sufficient leisure to dwell upon his pains, and enough book-learning to be expert at fantasizing the workings of disease and drugs. Partly thanks to unscrupulous physicians, his life became a battle with ‘diseases’ which, though imaginary, materialized in time, as needless physicking took its toll.

Blasé doctors blamed the rise of such hypochondria upon the democratization of information which, they alleged, encouraged the laity to meddle in a matter, health, that was too hot for them to handle. Self-dosing, mocked the Bath physician Dr James Adair, had become the fad among those ‘who are sick by way of amusement and melancholy to keep up their spirits’. Yet ‘no disease is more troublesome,’ he added, ‘either to the Patient or Physician, than hypochondriac Disorders; and it often happens, that, thro’ the Fault of both, the Cure is either unnecessarily protracted, or totally frustrated; for the Patients are so delighted, not only with a Variety of Medicines, but also of Physicians.’ Therein lay the catch, for the paradox of hypochondria was that the doctor’s intervention would, all too easily, merely reinforce that dependency from which the hypochondriac needed to escape. Hypochondria thus represented the faddish enculturation of sickly sensibility.

Hysteria developed similarly – indeed, the two were often represented as brother and sister. By the eighteenth century, hysteria, which had earlier been judged a somatic malady of women – a disease of the womb – was typically deployed to identify the volatile physical symptoms associated with hypersensitivity, a lability thought especially common in ‘the sex’, but – significantly, in a culture in which enlightened politeness was blamed for making men ‘effeminate’ – not
exclusively so. The diagnosis signalled superiority in status, while also marking a mysterious
je ne sais quoi
, a malady that was intermittent and unpredictable, lacking tangible physical causes.

This ‘coming-out’ of the hypochondriac and hysteric constitutes an important symptom, the pathological downside of Enlightenment individualism. Polite society encouraged cultural narcissism: within the permitted degrees of conventional polish, the
literati
were expected to become
glitterati
. Yet such a licence had its price. The tension between the invitation to shine and the need for polite conformity bred anxieties, in turn somatized into physical complaints, which, through the conscious or insensible manipulation of the sick-role, could be variously owned and disowned. Sickliness provided a social alibi, while suffering might purchase the privilege of being different.

The new prominence of hypochondria also registers a health culture disrupted by commercialization. Sick people were consulting more doctors, more often, and paying them fatter fees, while still seeking out quacks and irregulars, and obtaining cascades of medication, stimulants and sedatives from apothecaries, nostrum-mongers and druggists. They were also devouring piles of books claiming to make
Every Man his Own Physician
, and investing in well-stocked proprietary medicine-chests. The profession deplored these perversions, while actually profiting nicely from them. Many medical bigwigs, it was observed, prostituted their art by pandering to the whims of the worried well, the pseudo-sick and valetudinarians, thereby appropriating for themselves the ‘lucrative part’ of the ‘
sick-trade
’.

The commercialization of health brought a further turn of the screw: commodification. As discussed earlier (
Chapter 13
), people had always eaten and drunk themselves to destruction. Critics now complained that sufferers – many of whom had read books which might just as well have been titled
Every Man his Own Poisoner
or
Every Man his Own Hypochondriac
– were
medicating
themselves to death – or at least indiscriminately swallowing stimulants and painkillers to relieve their (often imaginary) distempers, only to become dangerously habituated to their use. Drug-dependency was beginning to take shape.

The late Georgian age is seminal for encouraging addiction and conceptualizing the phenomenon. Trotter put his finger on it in noting that modern man was simultaneously ‘the
creator
of his own
temperament
’ and thereby ‘the
creature of habit
’. Producer and product, man was the sum of all the stimuli encircling and determining him: here was the insight of Locke extended to items of consumption. Moreover, with the mobilization of market society, man the consumer assumed importance. There was an escalation in consumption of tea, coffee, tobacco, sugar, ardent spirits, fortified liquors (above all, port and brandy), bitters, tonics, narcotics, sedatives, quack, patent and proprietary medicines – most being widely regarded as deleterious, habit-forming and even poisonous and destructive. Opium use, for instance, rose staggeringly. ‘I think amazing quantities are consumed every year,’ it was remarked in 1796, ‘and am of opinion, that there is twenty times more opium use now in England only, than there was fifteen or twenty years since.’ The explanation was simple: opiates were far the most effective painkillers, and the ‘age of feeling’ was arguably lowering the pain threshold. Certainly the Georgians seized upon opiates for their remarkable analgesic properties, George Cheyne praising the poppy as ‘a certain
Relief
, if not a Remedy, even to our most
intense Pains
and
extreme Miseries
’ – indeed ‘a standing and
constant Miracle
’. Doctors made light of the suspected harmful consequences – Sir Richard Blackmore specifically denied that opium was addictive – and hence prescribed freely. Not surprisingly, dozens succumbed to narcotic addiction – not merely such notorious cases as Coleridge and Thomas De Quincey, but also Robert Clive, Samuel Johnson’s wife Tetty, his bosom friend Topham Beauclerk, William Wilberforce, and somewhat later, most of Tennyson’s brothers.

Leading physicians deprecated drug-dependency as one of the evils of the age. The irony is that, precisely because of their advanced involvement with experimental chemistry, and their ardent humanitarianism, progressive physicians must shoulder much of the responsibility for drug-induced human tragedies. The circles around Thomas Beddoes were, for instance, eager to experiment, as we shall see, with narcotics, from nitrous oxide (laughing gas) to opiates. ‘Do bring
down some of the Hyoscyamine pills,’ his friend and patient Coleridge on one occasion begged Tom Wedgwood, ‘and I will give a fair trial of Opium, Henbane, and Nepenthe.’ As we saw in the last chapter, the entrepreneur’s son grew hooked: ‘I cannot do it – my spirits become dreadful – the dullness of my life is absolutely unsupportable without it.’

Fears of a dependency society were percipiently analysed by Trotter. His
View of the Nervous Temperament
(1811) paraded a kind of ‘Addict’s Progress’. High-stress living weakened the nerves; the enfeebled constitution then needed the crutch or solace of drugs and stimulants, thereby precipitating a downward spiral of deteriorating health. Trotter pessimistically surveyed a ‘nervous society’ in the making – a drug-culture in which the habits of civilization themselves became disease: ‘All nervous persons are uncommonly fond of drugs… Among some well-meaning people, this inordinate desire for medicine has frequently become of itself a disease.’

Under such circumstances, the putatively clear distinction between disease and medicine broke down. Medicating habits caused pain, and the craving for artificial stimulants was viewed, by Trotter and others, as a ‘disease of the mind’. It was no accident that Coleridge defined addiction as ‘the desire of a desire’. Enlightened introspectiveness about consciousness – the urge to create a new science of mind for a new society – led to the formulation of a category of disorders rooted in mental disturbances. Madness, as we saw in
Chapter 18
, was refigured as a mental disorder, and masturbation, alcoholism, nymphomania and drug-addiction all came to be seen as maladies of the mind. The championing of mind as an engine of liberation revealed its shadow side: mind’s self-imprisoning potential.

Classic among such cases of an identity in thrall to dependency is Samuel Taylor Coleridge. Fired by revolutionary fervour and hounded by creditors, this Anglican clergyman’s son quit Jesus College, Cambridge, without a degree in 1793, gravitating to the company of fellow radicals in Bristol, notably Robert Southey, and throwing himself into poetry, preaching and pamphleteering. The youthful friends projected a New World utopian community on the
banks of the Susquehannah in Pennsylvania, untainted by the Old.

Although their plans predictably fell through, young Coleridge, on angel wings, continued to serve the cause of enlightenment. With its Baconian masthead ‘
KNOWLEDGE IS POWER
’, his
Watchman
periodical declared in 1796: ‘
A PEOPLE ARE FREE IN PROPORTION AS THEY FORM THEIR OWN OPINIONS
.’ Having made ‘a diligent, I
may
say, an intense study of Locke, Hartley and others’, he had espoused the progressive creed of Unitarianism, determinism and materialism, enthusing to Southey about the ‘corporeality of
thought
’. Radical intellectuals like Godwin, Darwin and Priestley had, as he saw it, paved the way for revolution both political and mental: moral improvement was inevitable; and, guided by a ‘small but glorious band… of thinking and disinterested Patriots’, society was to make the world paradisiacal again. His
Religious Musings
(1794) presented a ‘Vision’ of human destiny moving to a ‘blest future’.

His views, of course, underwent a turn-about with the new direction taken by the French Revolution. ‘I have snapped my squeaking baby-trumpet of Sedition,’ he announced in 1798. Tellingly, having named his first son Hartley, Coleridge christened his second Berkeley, to signal in the clearest possible way his rejection of his erstwhile materialism in favour of idealism. He had ‘overthrown the doctrine of Association, as taught by Hartley,’ he assured his friend Tom Poole in 1801, ‘and with it all the irreligious metaphysics of modern Infidels – especially, the doctrine of Necessity.’