Throughout much of his life, James Boswell suffered from a disease he called “hypochondria.” In a series of voluminous journals and in a weekly essay for the London Magazine, fittingly entitled “The Hypochondriack,” Boswell obsessively detailed the symptoms of his disease and just as obsessively wondered over its causes and possible cures. Beset by anxiety, doubt, and gloom, Boswell’s essays on hypochondria catalog nearly everything known and thought about the disease over the course of the eighteenth century. Although at times Boswell, often dejected and even anhedonic, appears to suffer mainly from what we would today call melancholy or depression, at other moments he evinces the same nervousness concerning the health of his mind and body that marks modern hypochondriacs.1 That is to say: mainly Boswell worries. He worries so much about an ingrown toenail that he experiences vivid dreams of it cutting deep into his flesh.2 He is cured of rheumatism but then worries that “a large pimple on one of [his] hands had turned to a sore.”3 He worries of “scorbutic eruptions on different parts of [his] body” and that the glances of strangers on a busy city street will cause him “acute pain on being accosted.”4 What he mainly worries about, though, is the state of his nervous system. He frets that the very medicine he has taken to cure himself will give him a “nervous fever.”5 He complains of the “uneasy tumult of [his] spirits” and longs to have them composed by the company of Dr. Johnson and other luminaries.6 The “hurry and agitation” of Parliament “hurt[s] [his] weak nerves.”7 He feels “wild ideas in confusion reel” through his “gloomy and tumult’ous brain” and considers that he is going mad.8 He broods, continually, on his relaxed nervous fibers and low spirits.9
It’s no accident that in such passages one might mistake Boswell’s musings for real medical science.10 Hypochondria, after all, is a disease that manifests in a peculiar way: one becomes his or her own physician (though certainly not an objective or competent one). And in the passages I’ve quoted above, Boswell essentially behaves as an amateur neurophysiologist. Of course, we ought to read his accounts of the episodes transpiring within his own nervous system with a skeptical eye. Boswell himself insists on this. He notes that many of his medical worries are unfounded, that they are the result of his “extreme sensibility” or are perhaps generated by the “creative gloom” of his fancy.11 “Strange how hypochondria perverts the judgment!” he proclaims.12 In his most extreme moments, he doubts that anyone—either the hypersensitive hypochondriac or the staid natural philosopher—could really know the workings of the mind or body: “The Psalmist’s reflection, that we ‘are fearfully and wonderfully made,’ is a stroke of just and aweful eloquence. In truth, man is in every part of his nature a mystery; and after all the observations and systems of philosophers, there is very little known with clear and distinct certainty.”13 But there is nothing reassuring about Boswell’s occasional realizations that he is imagining various maladies. As soon as he begins to doubt the reality of one worry, he generates another. For Boswell, the sense that one could not know with “clear and distinct certainty” the mechanisms of the body or mind does not dull his piercing speculations into its nature. Instead, it serves as an inducement for further medical theorizing. Faced with the inherent mystery of the body and nervous system, the hypochondriac still searches for new answers.
Because Boswell often admits that his accounts of his nerves and body are fanciful, we can say, then, that much of his writing on the disease constitutes a nervous fiction. It makes sense for a book about nervous fictions in early neuroscience to conclude with an account of hypochondria. As we will see, appreciating hypochondria means providing a sweeping summary of the natural philosophy I’ve surveyed in this book. Likewise, hypochondria, especially as it is exemplified in Boswell’s detailed writings, brings into relief some of the aspects of nervous fictions I’ve been tracking. All the markings of the form are evident in Boswell’s work. The hypochondriac greedily imbibes the terms of technical medical discourses and transforms them into characters in an internal drama. Likewise, he imagines his body as the site of an especially vivid spectacle, with malfunctioning nerves and sickly animal spirits all playing a part. Above all, the hypochondriac helps us see one of the most important qualities of the nervous fiction: that these works attempt to close a gap in our knowledge of mind and matter. Boswell’s work ceaselessly shuffles between skepticism (“man is in every part of his nature a mystery”) and speculation (his clinically precise accounts of the cerebral mechanisms that cause him pain or that plunge him into gloom). The hypochondriac demonstrates that the fictions and figures used to describe the body are generated by a fear that we cannot comprehend or tinker with the nervous mechanisms making us tick. Indeed, Boswell is particularly important for me because he had an evident fascination with, and an acute understanding of, the figurative language we use to name and know the brain and nerves.14 Boswell readily recognizes that many of the metaphors we use to describe the brain, mind, and their relationship ultimately try but fail to fill a void in knowledge. If anything, these metaphors obscure the psyche but please the hypochondriac by promising further opportunities for fiction. Nevertheless, at other moments, Boswell draws on a set of figures—metaphors that compare mind and brain to a watch and its casing—that more adequately figure the nature of mind. Describing mind and body as if they were a watch and its case may seem like an innocuous use of figure, but in Boswell’s hands it will become one of the most complex nervous figures I survey in this book.
Boswell’s writing also helps us see how hypochondria poses a problem for proper neuroscience: how to differentiate its own claims about the brain and body from fantasy and pathology. The hypochondriac makes detailed claims about cerebral fluids and nervous organs, but so does the natural philosopher. The hypochondriac’s theories about the workings of the nervous system cannot be confirmed, but as we have seen, attempts to capture an animal spirit or witness the vibrations of the nerves also escape empirical verification. The problem becomes even more acute when physicians admit to their own hypochondria or when we find one natural philosopher accusing a rival of suffering from the disease. In this respect, hypochondria causes neuroscience to become self-reflexive. To differentiate scientific claims about the brain and mind from the nervous fictions of hypochondria, neuroscientists worry over the state of the medical profession and the validity of their theories. Stranger still, texts on hypochondria in the eighteenth century frequently become obsessed with the rhetorical aspects of medical writing. In short, there’s something about hypochondria that makes physicians read like literary critics, that forces physiologists to become more concerned with similes than maladies. To explore this aspect of neuroscientific writing, I’ll read Boswell alongside one of the most rhetorically deft physicians of the period: Bernard Mandeville.
A passage from the journal Boswell kept during his visit to Holland—one of the most fraught periods of his life—gives us a glimpse into the hypochondriac’s state of mind: “I fell desperately in love with a young, beautiful, amiable, and rich widow [a Madame Geelvinck]. This passion tore and hurt my mind. I was seized with a severe cold. My nerves were relaxed, my blood was thickened. Low spirits approached. I heard of Charles’s death. It shocked me. It filled me with gloomy reflections on the uncertainty of life, and that every post might bring me accounts of the departure of those whom I most regarded.”15 The passage evinces all the qualities we’ve come to associate with hypochondria. Boswell appears morbidly sensitive to the shocks of life. Brooding on his love affair, he settles into a fitful depression. He reports on his ill health, worries over a cold, but then indulges in less certain, more far-flung, and so more troubling fears about the deaths of various loved ones. There is quite a bit more to say about Boswell’s affectively charged ruminations, but for the moment I want to draw attention to, and mark as odd, a few phrases in the entry that are easy to miss in the midst of Boswell’s ever-darkening gloom. Specifically, Boswell’s references to the state of his body—to the workings of his nerves, blood, and spirits—should strike us as strange. While there is nothing odd about Boswell’s ability to report on his feelings of love or fear, his corresponding ability to know, for example, that his nerves are relaxed or that his blood has become thickened points to an introspective power most lack.16 Boswell not only feels emotions more intensely than others; he feels facts about his nervous system that usually remain outside direct conscious awareness. In other words, Boswell tends to confuse two ways of talking about the mind and body, two discourses that denominate different realms of experience: subjective states of mind and more abstract accounts of bodily causes. The first can be known through mental insight; they are facts of phenomenal consciousness (“I am in love,” “I feel sad”). The second only become evident by examining the body and brain through scientific means; the nerves’ tension or the blood’s viscosity are specialized and theoretical terms designating objective physiological states rather than felt experiences. Nevertheless, for the hypochondriac, this distinction does not hold. Boswell feels the workings of his animal spirits and the laxity of his nerves as directly and intensely as he does any other cognitive or emotional state.
To be sure, by the later eighteenth century, when so much neuroscientific discourse has become demotic rather than specialized, Boswell’s insistence that his spirits are “low” and that his blood has become sluggish could be read as innocent idioms attempting to capture the complex interplay of body and mind—the sort of statements that Kinneir warned his fellow physicians not to take too seriously lest they find themselves chasing down sensitive animal spirits. And in many other writers these statements could be dismissed as such. But the force and rigor with which Boswell catalogs his nervous system speaks to a different relationship to body, mind, and language. To be a hypochondriac, he shows, is to be a strange sort of neurophysiologist. Just as the conventional neuroscientist explores the internal labyrinths of the brain and makes claims about the actions and events taking place within, Boswell similarly investigates the state of his nervous system, as if he were performing a dissection or experiment upon himself:
This was a dreary wet day, and my nerves were soaked in the moist ether, so that I was a little dreary myself.17
Yesterday morning after having been up all night and written sixteen or seventeen letters, and felt spirits bound in veins, kept post-horses waiting from six till nine, then was still in confusion.18
“My spirits,” thought I, “are worse now than ever. Formerly I could appear gay, though inwardly sad. Now I cannot. The garrison is now so weak that not only is there not a sufficient complement of men within it, but it cannot even furnish as many as to make a show upon the walls.”19
In these moments, Boswell directly feels what are in fact highly abstract, mainly conceptual entities. Properly speaking, animal spirits or vibrating nerves cannot be seen, much less subjectively experienced, even in the most extravagant neuroscientific systems of the eighteenth century. Such entities, according to the understanding of the time, can be reconstructed only through the faintest of empirical traces or through a series of complicated experiments. To use a contemporary example: Boswell’s claims about the state of his spirits or nerves would be analogous to someone today insisting that she can feel her neurons firing. (Certainly, in the midst of reading an insightful book on figurative language in early neuroscience, we might say that we feel as if our neurons are firing—but then we are back to metaphor.) In this respect, the hypochondriac’s neuroscientific method is unique. Like any other physiologist, he vigilantly observes the body and carefully catalogs the activities of the nerves. But because Boswell studies his own nervous system, he registers and records its mechanisms not from an objective distance but from within its confines. The same introspective tools that allow him to survey the dreary thoughts passing through his mind also tell him that his animal spirits are themselves dreary. In this sense, Boswell’s hypochondria allows for a strange twist in perspective: a third-person account of the body’s mechanisms becomes a direct, affective experience; subjective experience applies to sensations and to the underlying nervous mechanisms generating such sensations.
The hypochondriac’s existence as a neuroscientist of the self leads to a complicated state of affairs. Boswell directly feels the elements of speculative neurophysiological systems.20 However, as a result, Boswell’s feelings are heavily mediated by his nervous system. In effect, Boswell, the whole person, rarely feels directly happy or sad, thoughtful or vexed. Instead, his nerves or animal spirits experience thoughts or emotions that are only transferred to Boswell himself in a secondary moment. In short, Boswell lives out a nervous fiction. The stereotypical worries of the hypochondriac—the ruminations on the state of specific body parts, for example—result from the Rylean “Double Life Legend.” Just as in that “legend” outward actions are paralleled by fantasized inner events, the hypochondriac imagines that mental life is determined by internal agents or mechanisms thinking and feeling before he does. For instance, bodily fluids react to a death before Boswell himself can feel the shock: “The Duke of Rutland’s death agitated my blood by making me feel the changes in human life.”21 When a young lieutenant bores the diarist at a dinner party, Boswell notes that the rebuff must be registered first by his animal spirits and only then by his psyche: “Such entertainment, and a total suppression of animal spirits by his [the lieutenant’s] talking all himself, fretted me, and I was sulky though I did not show it.”22 Similarly, when Boswell attends a sermon, his physical spirits must be inspired before he can be spiritually uplifted: “He lectured very well. My spirits instantaneously recovered. Our minds, like our stomachs, are restored to soundness sometimes by one thing, sometimes by another, we know not by what operation.”23 Thanks to his theorizing about the state of his nerves and bodily fluids, Boswell becomes a person effectively shattered and pulled asunder. His mind is rarely the only site of thought and emotion; instead, his body parts bear mental qualities prior to, or even in place of, Boswell himself. In Boswell’s writing, as in so much early neuroscientific work, the self contains still smaller selves; spirits, homunculi, and networks of nerves feel and think in our place.
Since Boswell’s relationship to the world, and to himself, is mediated by (what he takes to be) the workings of his nervous system—since his nerves feel before he can—it follows that his volitions and desires must be routed through the mechanisms of his body and brain before they can be realized. Improving his mood or health, for example, necessitates carefully calibrating the machinery of his nervous system and the energies flowing through it. Like the more familiar and conventional experimentalist, the hypochondriac finds himself making small adjustments to a chemical apparatus in order to achieve certain results. Effectively, Boswell turns himself into an alembic. He recommends a French treatise “which professes to manage vapors in the human constitution, with the same facility that a good naturalist commands air to come and go in any material substance, and it may be useful to many patients.”24 And so staving off depression means balancing the spiritous substances flowing through him: “I am dissipating melancholy clouds, and filling my mind with fine, cheerful spirits.”25 On the one hand, Boswell’s alembic-like body affords him a certain sense of control: he can govern his psyche by adjusting himself like a machine. On the other hand, imagining the body in this manner introduces difference within the self. Boswell cannot simply feel happy or sad; instead, he must govern the internal equilibrium of his body in order to manage such mental states.
Hence, Boswell behaves as a neuroscientist studying his or her own body rather than some anonymous bit of flesh. He imagines the interior mechanisms of the body operating just as the physiologist would: the nerves vibrate, the blood pulses, the animal spirits trace paths through the cerebral labyrinth. But what licenses such theories? As we have seen, to make such claims about body, brain, and mind, the hypochondriac proceeds differently than the conventional neuroscientist. Given Boswell’s (presumptive) ability to feel not only his animal spirits or nerves but their precise movements and vibrations, we must assume that he has powers of perception—or more specifically powers of introspection—that others lack.26 This is less strange than it may seem. Throughout the eighteenth century, the hypochondriac is continually characterized as a being who feels more than others.27 For example, George Cheyne, in arguing against the stigma of hypochondria, explains that the disease usually only affects those with the “liveliest and quickest natural Parts, whose Faculties are the brightest and most spiritual, and whose Genius is most keen and penetrating, and particularly where there is the most delicate Sensation and Taste, both of Pleasure and Pain.”28 Boswell certainly thought of himself in such terms. He often comments on his hyperacute powers of sensibility, which he describes, like Cheyne, as both talent and curse: “Too much sensibility or quickness of feeling, so as to be ‘trembling alive all over,’ is doubtless a misfortune; and yet, without a good share of sensibility, how dull or insipid is life!”29 Boswell’s ability to track precisely the movements of his animal spirits or to pinpoint the oscillations of his vibrating nerves seems to result from his particularly acute sensibility. Importantly, Boswell implies that his sensations are so intensely detailed that they can point beyond themselves—to the hidden mechanisms at the foundation of those very sensations. Put differently, in the language of the hypochondriac, powerful moments of sensibility express not simply states of mind (e.g., pleasure); they can also reference or denominate the bodily machinery at the basis of such states (e.g., the quivering nerve causing such pleasure). In this respect, the hypochondriac does not need the traditional implements of neuroscience—the scalpel, microscope, or chemical apparatus—since his own sensorium is powerful enough to pry into the interiors of body and brain. As Vicesimus Knox notes, the hypochondriac’s senses often function as a microscope: “Thus acuteness of discernment serves to discover concealed blemishes, as the microscope sees a spot where the naked eye beheld nothing but beauty.”30
Except at other moments Boswell tells a different story both about his powers of introspection and about the nervous mechanisms supposedly whirring away beneath his skin. In these moments—we might call them more honest, even clearheaded—the hypochondriac admits he cannot be absolutely certain about the state of his nerves. Moreover, he notes that his mental powers, seemingly so in touch with the minute workings of his body in one instance, often become the source of torturous illusions and uncertainties in the next. And this is precisely because the very power of sensibility—the ability to feel things so finely—is in fact overwhelming: “Hypochondria affects us in an infinite variety of ways; for, a disordered imagination teems with a boundless multiplicity of evils; and the disorders of the body which I believe always attend the direful diseases, make such diversities of combination, that it is scarcely possible to specify all the sufferings of a Hypochondriack.”31 In this instance, an excess of introspective powers can begin to look like a lack. Boswell experiences so much stimuli, and experiences it so intensely, he cannot put his feelings into words or concepts.32 Before: Boswell’s powerful sensibility pointed beyond or beneath his phenomenal experience to the workings of precise internal organs; his cries were never simply an expression of pain but an index of the affliction suffered by some throbbing nerve. Now: Boswell worries that the very variety of his “disorders” escapes his ability to name them; his cries become directly emotive rather than a deeper sign of his nervous system gone awry.33 In this respect, Boswell frequently dwells on an internal darkness that seems to beset his psyche: “Was wonderfully pleased to find there was no mystery or difficulty in what my creative gloom had represented in such monstrous shapes. How humiliating it is that I am so much under the dominion of fancy!”34 At other times, Boswell’s inner eye glimpses a world of indistinct and foreboding shapes: “In passing, it occurs to me that much of human misery is for want of light enough. When there is a lueur, an imperfect light, we imagine we see hideous spectres. Full light shows us that there is nothing to fear; and fear is the great cause of our misery. How little is there of positive present evil. It is the imagination which torments us.”35 Given the hypochondriac’s tendency to lapse into moments of doubt and distraction, thanks to the very introspective powers that make him so certain of the state of his nerves in other instances, we often find Boswell curiously conflicted. The same writer who can pinpoint the rushing of the animal spirits through his nerves can also write the following: “A Hypochondriack may sometimes very reasonably ask himself, if the uneasiness which he feels be Love, or the Spleen?”36
Hypochondria, then, is a disease that doesn’t simply engage in the production of wild neuroscientific theories. At some point, hypochondria forces one to question the foundation of those theories, to wonder about the microscope-like mental faculties that presumably give one access to the hidden workings of the body. In these moments, the hypochondriac’s introspective powers are found faulty and his imagination becomes the source of shadows and phantoms rather than real facts about the nature of the nerves. Given this shift, we might assume that while hypochondria begins in the grip of a nervous fiction, it eventually results in a skeptical examination of such fictions as well as the very faculties that make such fictions possible. But this story, comforting as it might be, misses one more turn in the hypochondriac’s ever-shifting disease. Having abandoned one worrying nervous fiction, a new one soon takes its place. Consider a passage from Boswell’s Holland Journal:
What is the human mind? Let us calm our restless curiosity, for in this life we shall never know. While I have been crushed with a load of gloom, I have strove with severe intenseness of thought to find out the “Spirit of Man.” But all my thinking has been in vain. It has increased my disorder and turned my speculations inwards upon my own mind, concerning which distempered imagination has formed the most wild and dreary conjectures. I have been so cruelly dejected as seriously to dread annihilation. I have found my faculties decaying gradually, and have imagined that in a very little time the last spark of celestial fire would be totally extinguished. . . . I have thought, if my mind is a collection of springs, these springs are all unhinged, and the machine is all destroyed; or if my mind is a waxen table, the wax is melted by the furnace of sorrow, and all my ideas and all my principles are dissolved, are run into one dead mass. . . . Yet have I felt the generous resolve swelling in my bosom. I have said to the Demon of Hypochondria, as the bold Highlander in Fingal says to his Deity of fanciful conjecture, “Show thyself to me, and I will search thee with my spear.”37
The passage is worth quoting in full because it so nicely tracks Boswell’s turns of thought. More specifically still, the passage evinces Boswell’s tendency to waver between states of skepticism and speculation. For instance, Boswell begins his journal entry by emphatically delimiting our knowledge of the mind. Writing in a Lockean tenor, he maintains that our finite, human faculties cannot grasp the substance of thought—at least “in this life.” But at precisely this point the passage shifts. While granting that impossible speculations concerning the psyche only produce groundless “conjectures” that have “increased [his] disorder” (presumably hypochondria), Boswell nevertheless finds his “speculations” invariably focused “inwards upon [the] mind.” And, as predicted (by himself), Boswell’s plunge into his own interiority soon unleashes a series of “distempering” conjectures. Boswell begins to theorize. Turning “inward,” Boswell turns to metaphor and to the involved fantasies tropes can turn up. He worries that his “faculties” are “decaying,” and to emphasize this worry he reaches for a series of figures in order to illustrate the mechanisms of mind happening behind the scenes. He likens the mind to a machine or to a wax tablet—common descriptions of the psyche or its substance that seem to waver between literal and metaphorical significations. He frets over the “unhinged” substance he insisted a moment ago could never be grasped. In other words, Boswell’s hypochondria, momentarily quieted by a passing conviction that one cannot know the mind or its underlying substance, reasserts itself here by way of figure. And just when Boswell reaches his lowest point, he rallies and determines to hunt down “the Demon of Hypochondria” that presumably causes these very disordering speculations. Serving as an encapsulation of Boswell’s shifting hypochondriac imagination, the passage demonstrates how a certain form of skepticism invites further reflection and speculation. It insists that the psyche is obscure—and then entices us to illuminate that obscurity with further metaphorical imagery. It begins by maintaining that we cannot dissect the “spirit of man”—that is, we cannot uncover the substance or mechanism that makes the mind tick—and concludes, in explicit contradiction to its commencement, by vowing that one must “search” with a “spear” another spirit: the aforementioned “Demon of Hypochondria” that haunts the psyche of sufferers like Boswell.
In sum, the hypochondriac’s existence, as it is dissected in Boswell’s journals and periodical writing, can be characterized in the following manner. The hypochondriac, a strange sort of neuroscientist, theorizes about the inner workings of his body and (particularly) his nervous system. He feels the mechanisms that are normally evident only in abstract physiological writing. But for all his momentary certainty about the workings of his nerves, the hypochondriac often questions the basis of his speculations, and in doing so he comes to see his previous claims as fictions: the result of a particularly “creative” but “gloomy” sensibility. Yet even these moments of skepticism never last. Rather than rest content with a “surface-level” description of the mind—one that would concern, say, sensations rather than their physical causes—Boswell’s doubts plunge him ever “inward” in an effort to produce new nervous fictions. His skepticism is two-sided: perhaps, he thinks in a first moment, “creative gloom” alights on nothing real within the body, but then, he reflects in a second moment, maybe he has uncovered an uncertainty or gap in knowledge that can be fulfilled by further theories. For Boswell, skepticism’s first, pacifying moment—“What is the human mind? Let us calm our restless curiosity, for in this life we shall never know”—soon transforms into “restless curiosity” as he plays with metaphor and wonders whether the mind is more like machinery or more like wax. In this respect, the hypochondriac’s skepticism becomes an opportunity for ground clearing, an instance where old physiological theories are swept away in order for new ones to take their place.38 To characterize hypochondria as a disease where the sufferer only worries about some malady or bodily malfunction is too simple, then. Boswell worries over his nerves, to be sure, but he also worries that he is worrying over nothing, a state that sends him searching for new bodily maladies and figurative imagery. It is because hypochondria’s fantasies are compensatory—a reaction to a moment of not knowing—that they serve as exemplars of nervous fictions.
To be sure, Boswell attempts to escape this loop. He recognizes that his problems result from his tendency to curve “inwards upon [his] own mind.” Inwardness—in many senses of the term—is his real issue. He finds himself entangled in gloomy, anxious, self-involved meditations, even as he assumes that his keen sensibility can penetrate into the literal interiority of his body. Beset by unceasing uncertainty, and unable to trust his introspective powers, Boswell realizes that he must turn outward for help: “I think too closely. I am too concave a being. My thoughts go inwards too much instead of being carried out to external objects. I wish I had a more convex mind. And yet the happiness of a rational being is reflection. But I am too minute.”39 Ideally, getting out of his mind to converse with “external objects” will calm Boswell’s restless worrying and still the cycle of skepticism and speculation that continually sends him spinning. And just as mid-eighteenth neuroscience shifted its focus from single nervous systems to societies bound together by sympathy, Boswell attempts his own paradigm shift by “reflecting” on his symptoms with a compassionate audience. But here, too, he encounters a problem. As he notes throughout his writings, one of the very symptoms of hypochondria—and perhaps the most maddening—is a tendency to seek relief. The journals Boswell kept during his “Grand Tour” through Europe illustrate this aspect of the disease perfectly. Throughout these entries, Boswell continually relates moments when he confesses his hypochondria to anyone who will listen. He encounters an entirely sympathetic audience, since it turns out that hypochondriacs constitute much of his social circle. As a result, Boswell finds himself exposed to possible cures for his affliction—even as he learns of new bodily mechanisms he must agonize over and try to imagine. Boswell’s frequent meetings with Madame de Froment capture this dynamic:
At night Madame de Froment told me how hypochondriac she had been. “All my thoughts were gloomy. The beauties of Nature mocked me. I was in despair. Yet without any change in the external world I suddenly became perfectly happy. My imagination was gay. . . . I was delighted with everything I saw: the moon, the stars, the fields, the lake, all bore their most cheerful aspect. I said to myself, ‘Good heavens! Is it possible? Where does all this joy come from?’ The fact is, Sir, that our happiness depends on the way in which our blood circulates.”40
Boswell’s hypochondria does not always manifest as a purely subjective, meditative practice. It necessarily involves a society of patients who trade in physiological theories.41 But the theories Boswell imbibes promise as much trouble as relief. Hearing that better circulation can quiet the disease means that Boswell finds himself worrying about the velocity of his blood. More simply, searching for a cure by speaking with fellow hypochondriacs often exacerbates the malady. As he boasts (or complains) to a friend: “I pray you . . . give me consolation against the hour of antiquity. Both you and I must lay our account to suffer such hours. Let us assist each other. I study hypochondria as a science. I am always picking up more knowledge with regard to it.”42
Reaching out to fellow sufferers of hypochondria, then, may only exacerbate the disease—in fact, it may be the disease insofar as we understand that malady as the adoption, rejection, and then further adoption of various worrying physiological hypotheses. But if hypochondriacs cannot trust in themselves, or in their compatriots, then perhaps the authority of a medical professional can quiet their restless minds. Here, too, Boswell encounters a difficulty. During a dinner with the celebrated physician Alexander Monro secundus, Boswell hears the case of “poor MacLeod of Muiravonside, who is troubled with alternate fits of high and low spirits.”43 Boswell, recognizing something of his own sufferings in the story, asks to hear more:
I questioned him closely, and he said that when Muiravonside is low he lies most part of his time in bed; that he talks as sensibly as at other times, but says he is bedeviled; that he knows exerting himself would cure him, but that he cannot do it. I was struck with the representation of his case, dreaded that I might be just as he is, saw hypochondria in a despicable light, and was very uneasy. Affecting quite an easy curiosity, I asked Dr. Monro what could be the cause of it. He said I must learn that in the other world. For physicians themselves were subject to it, and could not tell. At present the stagnation of my spirits for want of objects to rouse them is, I suppose, my malady. I was excellent company tonight.44
Here Monro confirms the skepticism that Boswell himself sometimes entertains. Physicians do not know the source of hypochondria because they are hypochondriacs themselves. The medical theories that seek to explain hypochondria are, in this respect, generated by the disease itself.
Boswell’s (and Monro’s) claim that physicians themselves suffer from hypochondria was not unique. In fact, it’s common to find similar assertions during the period. Consider one of the earliest poems discussing hypochondria in the eighteenth century: Anne Finch’s “Of Spleen.” While Finch deals with the disease in ways we’ve come to expect—for example, it’s a disorder that takes on the appearance of other maladies—she also concludes her poem by lingering on the sad fate of Richard Lower, one of the anatomists who was instrumental in helping Willis remove, dissect, and study the brain, and who, in Finch’s telling, searched for the bodily origin of hypochondria only to succumb to it himself:
Not skilful Lower thy Source cou’d find,
Or thro’ the well-dissected Body trace
The secret, the mysterious ways,
By which thou dost surprize, and prey upon the Mind.
Tho’ in the Search, too deep for Humane Thought,
With unsuccessful Toil he wrought,
’Till thinking Thee to’ve catch’d, Himself by thee was caught,
Retain’d thy Pris’ner, thy acknowledg’d Slave,
And sunk beneath thy Chain to a lamented Grave.45
Finch’s description of Lower shifts as the passage progresses. The natural philosopher appears, at first, as an intrepid, clear-eyed explorer who is attempting, by searching out the internal secrets uncovered in a “well-dissected Body,” to observe and ideally to cure the very disease troubling him. But soon Lower’s theories about the body, brain, and mind are made to seem like fantasies. A symptom of “spleen,” Finch implies, is the belief that one has understood the basis of this mental disorder when, in fact, the disease tricks one into thinking so. Lower imagines he has “caught” hypochondria (i.e., understood its physiological workings), but rather it has “caught” him (i.e., made him a worried, depressed sufferer who perhaps spends his time fretting over the state of his physiology). When it comes to medical science, the poem registers a severe skepticism. Not only do physiologists like Lower search for things (like the source of hypochondria or spleen) that are necessarily “too deep for Humane Thought,” but, due to these diseases, they are tricked into thinking their distorted speculations have gotten to the “Source” of things.
That physicians themselves not only suffer generally from hypochondria but, more particularly, suffer from its physiological delusions is evident even in the strictly medical texts of the time. Richard Blackmore’s A Treatise of the Spleen and Vapours, another early eighteenth-century work on hypochondria, accords with Finch’s depiction of “splenetic” doctors weighed down and deluded by the disease. Blackmore begins his account by explicating his own theory of the nerves before revealing how these fibers produce “hypochondrical affections.” He insists that hypochondria is caused by “the irregular and disturbed Motions of the Spirits, and the irritable Disposition of the Nerves,” and that only these mechanisms can explain “the anomalous, inordinate, and sometimes enormous Appearances that accompany this Distemper.”46 To underline this point, Blackmore attacks older accounts of hypochondria, mainly as a means of separating his own, presumably correct account of the body, from previous, false speculations. These older theories, Blackmore notes, differ in nearly every detail from his own: rather than attributing the disease to animal spirits, or even to the nerves, older physicians argue that hypochondria results from literal “vapors” arising from the lower parts of the body. For Blackmore, these rival theories name nothing real within the body. Such theories “are arbitrary and precarious Hypotheses, the Inventions of Fancy and Imagination, unsupported by Reason and Anatomical Observation.”47 Moreover, these theories are produced by hypochondria. Blackmore maintains that, like Lower in Finch’s poem, the “vapor-theory” physiologists suffer from the disease they set out to diagnose. Hence, he faults “the extravagant and ill-concerted Scheme of those Physicians, who suppose the Spleen is a Receptacle of gross Feculencies, separated from the purer Blood; whence they imagine that dark Reeks and Exhalations rising to the superior Parts, especially the Brain, produce the Disorders that attend this Disease. These Authors, one would think, were in very whimsical Circumstances, and far gone in the Distemper which they endeavor to explain.”48
In Blackmore’s estimation, medical science must reckon with hypochondria as an uncanny double or internal contagion. It must cordon off mock medicine by differentiating the real thing from its pathological variant. But this is no easy task. Hypochondriacs can appear almost exactly like—and in many cases are—physiologists. They make claims about the body, brain, and nerves that seem solid and systematic but that, on closer examination, play with nervous fictions. As Blackmore suggests, theories of miasmic vapors emanating from the depths of the body in fact result from gloomy visions exuded from the psyche and projected back upon the body. In this sense, fantasies about the brain and nerves stem from the malfunctioning of those very organs. The real neuroscientist, on the other hand, presumably arrives at an understanding of hypochondria through careful observation and experiment. For example, in Blackmore’s case, accounting for the “spleen and vapors” means calculating the movements of animal spirits rather than imagining vapors. Still, as readers of this book know, there is a cutting irony in these efforts to separate real (modern, mechanistic, animal spirits–fueled) medical science from a hypochondriac (ancient, humoral, vaporous) variant, since just a few decades later, physicians like Blackmore would themselves be attacked for indulging in neurophysiological fantasies with their visions of fluid or particles traveling through porous nerves. The very people who seek to dispel false, hypochondriac medicine often can find themselves on the outs, eventually.
When we read eighteenth-century writing on hypochondria, it often seems that the real engine of neuroscientific theory change isn’t only discoveries about the nature of nerves or refined theories concerning the mind but efforts to separate real science from its false, hypochondriac double. A prevailing neurophysiological theory begins to look like fantasy to a new generation of doctors, but to explain the generation of such fantasies, this new set of physicians elaborates a novel natural philosophical system. Just as Sterne’s novels allegorize the transition from a mechanistic to vitalist conception of the nervous system, a survey of eighteenth-century medical writing on hypochondria plainly represents the epistemic breaks cleaving early neuroscience. Hence, Blackmore dismisses older, humoral conceptions of the body as delusions even as he institutes the animal spirits as the source of such delusions. John Purcell’s Treatise of Vapours concurs. Purcell explains the “dreadful Anguish of Mind” that forces hypochondriacs to “reflect on what can perplex, terrify, and disorder them most” by arguing that animal spirits become confined to well-worn cerebral pathways.49 “By the continual attention to their misfortunes,” writes Purcell, “the [hypochondriacs’] Spirits are detain’d in the Brain, to think fixedly upon them, and consequently are distributed but in a small quantity into the other parts of the Body, whereupon they become slack.”50 The mechanisms of Purcell’s nervous fiction should be familiar: the hypochondriac’s thoughts fixate on certain worries so the animal spirits, in parallel, obsessively trace a fixed set of cerebral pathways.
The rejection of such explanations by a later group of physicians should also be familiar. For this new group, unmasking the animal spirits as fantasy becomes an impetus for further medical theorizing. Arguing against the “endeavour to support sensation, upon the motion of fine Animal Spirits,” Nicholas Robinson, writing a few years after Purcell and Blackmore, advocates for the “Vibration of the Nerves” as the likeliest neural mechanism.51 For Robinson, like Cheyne, the nervous system, understood as a system of singing strings, can be likened to a musical organ. And to stave off hypochondria, Robinson reasons, we can play upon the nerves: “Now as it is evident, that the Spleen and Vapours arise from disorderly Sallies of the Passions, inferr’d from irregular Motions of the animal Fibres, so it follows, that nothing can give those surprizing Turns, in the Cure, as Sounds duly modulated; for these musical Sounds, consisting of a certain Degree of Motion, Impulse, and Reason, (being convey’d to the Seat of the common Sensorium) necessarily brace, skrew up, and restore the Machinulae of the finest Fibres.”52 Vaporous humors become animal spirits become vibrating fibers. Focusing on the specific mechanisms powering the period’s neurophysiology can make it seem like the eighteenth century enjoyed unceasing advancement in the construction of its natural philosophical systems. But if we attend carefully to the underlying process turning an outmoded contrivance (like the animal spirits) into a new apparatus (the vibrating nerves), we witness the same cycle playing out. Having claimed that rival systems result from hypochondria, the physiologist develops in kind a new theory of the malfunctioning bodily mechanisms that produce such fantasies in the first place—only to be accused of hypochondriac fantasizing by a different set of physicians.
In this light, we can see that writings on hypochondria in the eighteenth century reproduce the same drama unfolding internally in Boswell himself. Like Boswell, hypochondriac science ceaselessly turns from skepticism to speculation (and back again). First, an account of the nerves, body, and brain is put forth with a degree of conviction and certainty. In Boswell’s case, the theory is grounded in his acute powers of introspection, while in the case of the neurophysiologist such theories are derived from empirical observation or experimental evidence. Next, these theories are exposed as fantasies produced by hypochondria. Boswell notes that his imagination casts a strange light. Likewise, the neuroscientist notes that vapors or animal spirits denominate nothing real within the body. They are fantasies or perhaps metaphors. In this moment, the very idea of filling in an internal bodily space is doubted. But this moment soon turns into an enticement for further speculation—doubting one’s theories of the internal state of the body can produce a gap that needs to be filled. And Boswell will fill it with new theories he hears from hypochondriac friends; the neuroscientist will turn to vapors or animal spirits or vibrating nerves, etc.
To this end, writings on hypochondria raise a series of troubling questions about neurophysiology, its epistemological authority, and its ability to make accurate claims about the relationship between mind and matter. What appears like an accurate description of the nerves soon seems like the sort of fantasy created by a hypochondriac. Likewise, what can look like progress (i.e., the accumulation of ever more refined accounts of the nerves and their relationship to aspects of mind) also appears as repetition (i.e., the endless unmasking of fictions about the nerves and mind; the creation of new theories, soon to be unmasked in turn). And it is precisely thanks to such repetitions that hypochondria, or really the threat of hypochondria, causes neuroscience to grow strangely self-reflexive: to think about the justifications for its claims about the mind, to single out the false and groundless fantasizing posing as real neuroscience, and to ensure readers that they are getting the real thing from the natural philosopher. Hence, we find attacks on hypochondria posing as plain neuroscience but also proleptic defenses against possible accusations of fantasy or hypochondria. For example, George Cheyne, who readily admitted he suffered from the very disease he wrote about, always appears particularly protective about possible accusations of this nature: “Some good natur’d and ingenious Retainers to the Profession, on my Publication of my Book of long Life and Health, proclaim’d every where that I was turn’d mere Enthusiast, and resolv’d all Things into Allegory and Analogy.”53 Nevertheless, such proleptic defenses against charges of fancy, figure, fiction, and hypochondria must read more like defensive strategies, even paranoia, than reassuring accounts of the absolute veracity of certain neuroscientific theories.
To be sure, the cycle that I am pointing to here was delineated by at least a few physicians during the period. For instance, the aforementioned Bernard Mandeville not only diagnoses the weird loops inherent in hypochondria; he also goes beyond this insight by showing how our lack of knowledge about mind-matter interaction actually produces the need for supplementary metaphors. In this respect, as we will see, he anticipates some of Boswell’s own writings on tropes. Mandeville captures this dynamic in one of the most interesting and rhetorically complex medical texts of the time, his Treatise of the Hypochondriack and Hysterick Diseases. The work stages a dialogue between a hypochondriac patient, Misomedon, and his wise doctor, Philopirio, a clear stand-in for Mandeville himself. The dialogue begins, in fact, by replaying the repetitions in physiological thinking I’ve surveyed above. A stock hypochondriac, Misomedon is wracked by protean symptoms. He complains of stomach pains, headaches, and, of course, worrying delusions. “Strange roving thoughts,” he explains, “would slide through my Brain, and wild as well as ridiculous Fancies stole upon me, and for a while employ’d my Imagination.”54 A “lover of Antiquity,” Misomedon first visits a doctor with similar sensibilities.55 Subjected to a Galenist or humoral view of the body, Misomedon is bled, purged, and then, to “refrigerate” his liver, prescribed Epsom water.56 He next consults with a “Modern,” mechanistic physician, who changes Misomedon’s mind about ancient medicine by attacking it: “He told me; that the Heat of my Liver, the Coldness of my Stomach, and the Spleen being a fomes Ventriculi, were all Fopperies alike; Subterfugia . . . Figments, that had never had any existence, but in the Brains of their Inventors; good for nothing, but to shew the small Knowledge they had in Anatomy: As to Galen himself; that he had been a Conceited Busie-body . . . that he left us nothing of any Value or Certainty.”57 The passage could be lifted from Blackmore’s similar attacks on earlier anatomists. In the imagination of the Galenist, the liver may be hot and the stomach could be cold. But they are not so in the living body. Also like Blackmore, Misomedon’s new physician, having undermined previous medical theories, builds a novel system in their place. Soon Misomedon is convinced his problems result from an imbalance in his digestion.58 He is prescribed new medicine, finds it works for a time, suffers a relapse, finds his physician increasingly annoyed by his complaints, seeks out new physicians, suffers another relapse, and then determines to study “Physick” himself. Ultimately, he comes to curse medicine: “But how small is the reward for evolving so many Voluminous Authors, when the only benefit that I have reapt from my Labour, and the up-shot of all my Studies in Physick, is, that I know it to be a deceitful Art, that is never to be relied on! for if we consider, how strangely the greatest Physicians have disagreed in the most essential Points of their Art, the multitude of Opinions, Sects, and Fashions that have been among them; their hatred, animosities, and ridiculing of one another.”59 Misomedon’s attack on physiology pinpoints some of the troubling qualities I’ve surveyed above. As he explains, natural philosophers cannot seem to agree on the most fundamental aspects of the body and brain’s workings in the case of his disease. Organizing themselves into “sects and factions,” physicians spend their time mocking opponents rather than curing patients. Every sect stands convinced it has seen into the hidden interior of the body. Every faction insists its rivals are practicing deceit rather than penetrating into the truth of things.
Philopirio is sympathetic to Misomedon’s complaints. In fact, the physician agrees in large part with his patient’s assessment of his profession, and much of the dialogue finds Philopirio expounding on his science’s follies. In his estimation, medicine is plagued by combative schools. Systems are established and then overturned, without ever arriving at the deeper truths promised at their inception. “As to the Explication of [Nature’s] Operations,” he notes, “that often changes with the times, and looking back you may all along observe a fashion in Philosophizing as much as in wearing of Cloaths.”60 Well aware of this dynamic, Philopirio refuses to join in. Rather than advocate for his own physiological system—only to see it toppled in time—he stands against “all Hypotheses in general.”61 From this position, he remains outside the ceaseless cycles of fashionable philosophizing. Philopirio (very much speaking for Mandeville in this instance) advocates for a form of medical agnosticism or even skepticism that, as Phillip Hilton points out, owes much to Thomas Sydenham and his followers.62 Like Sydenham before him, Philopirio maintains that the physician should focus on readily observable symptoms rather than their occult causes. According to this view, every attempt to see beneath the visible surface of things, every effort to correlate, say, the hypochondriac’s fantasizing with cerebral mechanisms, risks a plunge into shadowy speculations. Consider Philopirio’s account of John Purcell’s aforementioned Treatise of Vapours:
We are altogether in the Dark, as to the real use the Liver, the Milt, and Pancreas are of to our Bodies. . . . If we consider, with how little certainty we can speak of Organs so Conspicuous, such gross and large Viscera, is it not amazing to see some Men made of no other Mold, nor assisted with more helps in Anatomy than you or I, suppose themselves so well acquainted with things invisible and almost incomprehensible, as this Author does in his little Book? Where he not only traces the Animal Spirits through the unknown Labyrinth of the Brain, even to an angle of incidence, but likewise determines Thought it self, comprehending the very Soul in the Mechanism of the Body.63
Philopirio’s insistence that physicians, despite their claims to the contrary, are not in touch with “things invisible and almost incomprehensible” sets clear limits on medical theorizing. Focus on the “conspicuous” rather than the “Dark,” he insists. But significantly this insight also serves as a further explanation of the period’s tendency to produce fictional accounts of body and mind. If certain bodily mechanisms are invisible to us, if we cannot really witness the physical organs that “determine Thought it self,” then the theories of someone like Purcell must be taken either as pure conjecture or veiled fiction.
Mandeville’s Treatise sets out to cure the fantasies of hypochondriacs like Misomedon, who broods on the temperature of his internal organs, and of neuroscientists like John Purcell, who “traces the Animal Spirits through the unknown Labyrinth of the Brain.” Mandeville, in the guise of Philopirio, attributes the fictions of both Misomedon and Purcell to the mutually constitutive relationship of “creatively gloomy” doctors and patients. Essentially, the hypochondriac demands new medical theories to obsess over, and the physician happily complies. In this respect, the physician and the hypochondriac remain stuck in an eternal loop: the physician, pretending to cure the hypochondriac, only provides new diseases to delve into; the hypochondriac, seeking relief from the physician, only aggravates the underlying malady.64 More specifically still, Mandeville attributes the patient’s and physician’s alliance to their shared sense of pride: “’Tis Pride that makes the Physician abandon the solid Observation of never-erring Nature to take up with the loose Conjectures of his own wandering Invention, that the World may admire the Fertility of his Brain; and it is Pride in the Patient, that makes him in love with the Reasoning Physician, to have an Opportunity of shewing the Depth of his own Penetration.”65 As Philopirio/Mandeville describes it, pride makes it seem as if one can penetrate into the necessarily unknown depths of the body—into those “things invisible and almost incomprehensible.” “Pride won’t allow,” he notes, “that it is possible, Nature should have Recesses beyond the Reach [of] Sagacity, and reckons the injurious Assertion an Affront to humane Understanding.”66 In this respect, prideful patients and physicians, by seeming to map these unreached “Recesses,” trade in fantasies unmoored from reality. For instance, the physician speaks in figure and metaphor not because these ornaments help enliven more abstruse scientific concepts for the public. Instead, this language makes it seem as if the doctor can speak the inexpressible, see the invisible, and cure the body’s mysterious malfunctioning organs: “The witty Philosopher, who can so exactly tell you which way the World was made, that one would think he must have had a hand in it, in his Talk cures all Diseases by Hypothesis, and frightens away the Gout with a fine Simile, but when he comes to practice oftener reasons a trifling Distemper into a Consumption.”67 Misomedon the hypochondriac, soon convinced by Philopirio, admits that the medical theories that obsess him are “only pieces of Wit, mere Jeux d’Esprit, study’d for Diversion and that no greater stress should be laid upon them, than upon Plays and Romances.”68 Ultimately, it is precisely because these theories are more like “Plays and Romances” than proper scientific accounts of the body that they can flourish and metamorphosize. Since medical theories must meet the standards of prideful, witty physicians and patients, rather than accord with observations derived from “never-erring Nature,” natural philosophers, like hack playwrights, find themselves chasing fads and producing always more extravagant fictions for their audience.
At its most extreme, Mandeville’s Treatise makes it appear as if medical practice is inherently entangled in fancy and figurative language. The Treatise underlines this point in an important exchange between Misomedon and Philopirio late in the dialogue. At one moment in their conversation, Philopirio refers to the workings of animal spirits in the stomach. Misomedon, thinking he has caught his interlocutor engaging in the same speculation he condemns in others, asks his physician what he means by “animal spirits.” Philopirio contends that the term, in his discourse, is a knowing figure, a catachresis employed in the absence of a more proper word. As he explains, he “only made use of the Name to express the Instruments of Motion and of Sense.”69 Philopirio remains resolutely uninterested “whether there were or were not animal Spirits . . . or whether the Nerves perform’d . . . by any Motion undiscoverable by us, or by any Juice, or Spirits, or Aether, or whatever it be.”70 In other words, by using “animal spirits,” Mandeville’s physician does not mean to denominate specific entities in the body. And in that respect, though he speaks about interior physical mechanisms, he cuts off more florid theorizing. In careful hands (like Philopirio’s), terms like “animal spirits” can be controlled, tamed, and used as knowing placeholders. But Philopirio almost immediately underlines the danger inherent in such speech acts: “Men must either be altogether silent about the Oeconomy of the Brain, and the Commerce between the volatile Particles that are employed in the Act of Thinking, and the rest of the Body; or giving Names to things inexpressible, utter the loose Conjectures of the Imagination. . . . [We have] no Idea of what we are ignorant of; that is, we don’t know the Figures nor the Properties of the things that are hid from us, and we are obliged to make Sounds for, and adapt Words to things that are inexpressible.”71 The passage appears to undercut Philopirio’s earlier language. Because we do not know the “Oeconomy of the Brain,” or the connection between the “Act of Thinking” and the bodily mechanisms that make it possible, when we speak of such things we must employ inherently figurative expressions by “giving Names to things inexpressible.” In doing so, however, we utter only the “loose Conjectures of the Imagination.” Although Philopirio hardly appears to indulge in such speculations when he speaks of the animal spirits in a cautious manner, the Treatise, at this moment, makes it seem as if medical theory faces a stark choice: be silent or speak in baseless figure and fiction.
Faced with this blunt binary, much of Mandeville’s Treatise advocates, incredibly, for silence. The Treatise resolutely stands against “the Speculative part of Physick.”72 Rather than forging new systems or playing with figure, Philopirio/Mandeville recommends that physicians focus on what they can observe directly:
The practical Knowledge of a Physician, or at least the most considerable Part of it, is the Result of a large Collection of Observations, that have been made not only on the Minutiae of things in human Bodies both in Health and Sickness, but likewise on such Changes and Differences in those Minutiae, as no Language can express; and when a man has no other Reason for what he does than the Dictates arising from the Observations he has collected, it is impossible that he can give you the one without the other: that is, he can never explain his Reasons to you, unless he could likewise communicate to you that Collection of Observations, of which his Skill is the Product.73
Significantly, observation, at a certain level of detail, exceeds all language.74 As Mandeville imagines it, medical empiricism can become so focused on minutiae that its knowledge can no longer be communicated—even to the patient. This may sound unappealing, but it follows at least in part from Mandeville’s analysis of hypochondria. If patient and physician frequently talk themselves into troubling speculations, then advocating for a medical practice that “no Language can express” is one way to break free of this cycle. Nevertheless, that extreme option only appears welcome when weighed against the plague of hypochondriac fiction, figure, and speculation. But as Philopirio’s own use of terms like “animal spirits” demonstrates, not all medical or metaphorical language necessarily works this way.
The hypochondriac’s fantasies concerning the internal workings of the body and brain survive—and even thrive—despite their subversion. As is evident both in Boswell’s personal account of the disease and in the history of “hypochondriac” physiology more generally, a moment that might seem like a cure or at least a coming to grips with one’s propensity to indulge in baseless speculations about, say, the tension of the nervous fibers or the activities of animal spirits never lasts long. Instead, this brief moment—a moment when the hypochondriac’s fantasies are exposed as fantasies and undermined—simply generates an opportunity for further theory and speculation. Hence, we continually find Boswell, having acknowledged the illusions wrought by his “gloomy” imagination, and having even granted that his worries express intense emotions rather than internal physiological mechanisms, abandoning one story about the state of his nerves only to adopt a new, even more complex account of the inner and invisible state of his body and brain. Likewise, throughout the seventeenth and eighteenth centuries, we see new medical schools and paradigms accusing their precursors of trading in entirely imaginative physiological theories, of creating metaphors rather than literal descriptions of the nervous system—only then to be accused of the same “hypochondriac” tendencies by subsequent natural philosophers. Curiously, in all these cases, an initial doubt about one’s ability to know and to explain the occluded interior of body and brain never sticks. Instead, this first moment of skepticism, rather than making one content with the “surface” level of things—with talk of emotion or descriptions of the body as it is—entices the hypochondriac ever inward. Skeptical doubts seem to reveal a gap in our knowledge of mind and body that one is tempted to fill with further fictions.
It’s telling, then, that one of the few physicians to comment directly upon the hypochondriac’s tendency to produce “pieces of Wit” emphasizes this gap. As we have seen, Bernard Mandeville, like Locke and Sydenham before him, resolutely maintains that we cannot know how, for example, the brain works to create certain mental effects. For him, every effort to explicate this inexplicable process necessarily results in figure and fiction. While the creation of such stories might please the “creative gloom” of hypochondriacs, it does nothing to explain the underlying reality of the body. As a result, the eighteenth century is subjected to a series of shifting theories that never settle into solid fact. Given this dynamic, Mandeville can make it seem as if, when it comes to understanding the mind, brain, and body, our choice is either metaphor or muteness. Boswell offers another option in his own hypochondriac figures. Although some of Boswell’s metaphors work just as Mandeville diagnoses—that is, they feed a false sense of pride by promising to finally reveal the inner dynamics of the nervous system—another set of figures offers a different sort of fantasy: one that quiets our need to locate the mind, by means of metaphor, within some physical interior.
For instance, Boswell begins Hypochondriack no. 67, “On Memory,” with a series of arguments close to Mandeville’s own. Like Mandeville, Boswell maintains at the outset of this essay that the mind’s relationship to the body is inherently obscure and that, following from this, the various theories purporting to illuminate that relationship must be understood as inapt or entirely imaginative metaphors. Also like Mandeville, then, Boswell reads figurative language as an index of uncertainty. One speaks in metaphors that seem to provide explanations of the body’s inner workings precisely in those moments when one cannot know or understand those mechanisms. Boswell sounds the theme of the essay early on: “In the researches which I have studied to make into the human mind, none of its faculties have appeared to me so very inexplicable as memory.”75 Typically, these “researches” into the “inexplicable” have troubled the hypochondriac Boswell, who, in order to “relieve [himself] from abstract speculation upon the subject,” composes a poem on the subject:
While metaphysics rack the sickly brain,
What Memory is can any man explain?
Can any man with any clearness tell
How is produced what we all know so well?
If human souls are of an essence pure,
How fix ideas in them to endure?
And if material, canst not thou, Monro,
The little cells of our ideas show?
Ah! no. For here we ever, ever find
That all philosophers alike are blind.76
Boswell’s poem appears to rehearse rather than “relieve” the troubling metaphysical riddles of the essay. As he notes, while the mind’s ability to recall past events is plainly evident, it remains unclear how the psyche “produces” this phenomenon “we all know so well.” The substance of thought—whether one imagines it as immaterial or material—appears incompatible with mental powers like memory.77 Those who would attribute memory to an incorporeal soul cannot explain, in turn, how this “essence pure” could retain ideas over time. Those who would explain memory by looking to the brain (like the doctor Alexander Monro secundus, referenced here) cannot demonstrate how the “cells” of that organ manage to hold ideas. Ultimately, the nature of memory remains one of those vexing problems that, as the poem points out, “rack the sickly brain” of the speculative hypochondriac.
As Boswell’s essay goes on to argue, however, various theories and models have been developed to explain memory and (presumably) to alleviate the torture of obscurity. Yet all these theories remain insufficient. For instance, the prevalent image of memory as a storehouse cannot illuminate the faculty:
But still we are left quite in the dark as to the essential nature of the faculty of Memory, and the manner in which its operations are performed. When we talk of a storehouse of our ideas, we are only forming an imagination of something similar to an enclosed portion of space in which material objects are deposited. But whoever actually saw this storehouse, or can have any clear perception of it when he endeavors by thinking closely to get a distinct view of it? It is “the fabric of a vision,” and every candid man who has fairly tried to get at it will confess that he can have no confidence that it exists.78
Importantly, for Boswell, the logic justifying such theories of the mind and its powers is inherently figurative or analogical. Memory, that most mysterious of faculties, is likened to a storehouse, a more familiar physical space. By comparing the unknown to the known, the figure may seem to cast some light on the shadowy mechanisms of the mind. According to this figurative logic, we will understand how the mind accesses its memories if we imagine the psyche as a repository or storehouse filled with ideational records. But Boswell insists that such comparisons are distortive, that they provide comfort and a measure of certainty at the cost of truth, and that ultimately they must be understood as an “imagination” or—to complete his paraphrase of The Tempest—“the baseless fabric of a vision.” After all, when one introspects, or even examines brain matter, memory’s supposed “storehouse” must remain unseen.
It’s in such passages that Boswell, writing in his more skeptical mode, begins to sound most like Mandeville. The substance of thought is marked as inherently unknowable, and the various theories concerning its nature are treated as compensatory but baseless figures. In fact, later in the essay, Boswell even advocates for a position of metaphysical quietude. In language redolent of Locke or Sydenham, Boswell explains that we must be content with surface-level experiences of memory and that we need not worry ourselves about how something “deeper” produces this power of mind:
Watts, in his Improvement of the Mind, says ‘Our Memory is our natural power of retaining what we learn, and of recalling it on every occasion.’ This is a good definition of a good memory. And we must be content to rest upon the surface without straining to pierce into causes which are hidden from us, and which have hitherto mocked the attempts of impatient philosophers. We should resolve to wait till a longer fathom line is granted us, and then we shall be able to sound depths which we cannot do in our present state of frail imperfection.79
Yet Boswell, the inveterate hypochondriac, cannot take his own advice. The essay, having established the impossibility of knowing the substance of the mind, and having exposed various attempts to do so as groundless fictions and metaphors, does not conclude on this resigned note. Once Boswell’s imagery suggests the very possibility of depths to be explored by a “fathom line,” he dives in. The essay soon introduces a flurry of increasingly complex speculative queries. Boswell wonders how the mind recalls old ideas if it does not “store” these images in some sort of substance: “If there be no substance in the mind on which impressions are made, how is it that by reiterated repetition we produce this effect, that ideas and words are now in it, and though forgotten or unobserved for a time, appear again in it? How is it that according to the common very expressive phrase, we get compositions by heart?”80 Boswell goes on to ask how the mind strengthens its memories while asleep, and he questions whether this ability can be attributed to the work of wakeful animal spirits: “How is it that ideas ripen in the mind, so that a man shall go to bed with a very imperfect possession of what he has laboured to get by heart, and shall awake in the morning able to repeat it with distinctness and facility? Has he been at work all night without being conscious of it. Have other spirits been making impressions on his sensorium.”81 He ponders the understanding’s ability to retain even the airiest and most abstract ideas, such as a sound or music: “And what shall we say to the preservation of tunes in the memory? How do they exist? It is clear there is no sound, and neither is there any sense: what is it then that does exist? the idea of a sound! Strange vapour of contemplation! Yet we are fully conscious of it. There needs no ghost to tell us it.”82 Although Boswell never ventures answers to these questions, the very act of posing them plunges him into the speculative abyss he worked hard to avoid earlier in the essay. The same Boswell who, at the outset of this issue of The Hypochondriack, argues forcefully for a cautious agnosticism and rejects comforting metaphors like the storehouse, now finds himself wondering over the nature of the mind’s retentive substance, the work of its animal spirits, and its capacity to capture snatches of sound. In short, Boswell’s essay on memory plays out, in a nutshell, the hypochondriac’s peculiarly shifting relationship to skepticism and speculation.
The “storehouse,” then, is not Boswell’s preferred metaphor of mind/brain. Or, rather, we could say that he likes the image only insofar as it fails to capture the substance of the mind and its underlying organs—and, in this respect, it serves as a sign of our nonknowledge and hence as a blank spot he can fill in with further imaginings and speculations. Unlike Mandeville, Boswell cannot knock down every physiological theory (which are really metaphors posing as proper theories) and rest content having done so. On the contrary, he chews through metaphors/theories in order to entertain new ones. But while Boswell picks up one metaphor only to then discard it in favor of a new one, this process gives an incomplete view of his relationship to figurative language. In fact, there is one metaphor—or really one type of metaphor—that Boswell privileges above all others, a metaphor that accurately (but somewhat paradoxically) captures the “proper” relationship of the mind’s connection to the brain. This is the metaphor of the watch. Allan Ingram has pointed out how prevalent watch and clockwork imagery is in Boswell’s metaphor-rich writing.83 Ultimately Ingram argues that Boswell’s frequent comparisons of his mind to a watch represent an effort “to regulate and moderate his wild mental processes.”84 My own reading stresses a different dimension of the figure. In fact, it’s not simply a watch that interests Boswell but a watch inside a case. As an emblem of mind and body (or brain), the watch and case become a metaphor that reveals that the mind cannot be located in a concealed interiority.
Consider a passage where Boswell introduces the watch as an ideal metaphor for the body’s relationship to the mind. The passage begins by noting that we cannot know how the mind interacts with the body so long as the mind—or what Boswell calls here “the conscious spirit”—remains embodied and so hidden away from direct inspection. Nevertheless, the watch metaphor allows us to see, as it were, the relationship between mind and matter: “What that power is by which the conscious spirit governs and directs the various mental faculties, is, it must be confessed, utterly inexplicable as long as our souls are enclosed in material frames. While a watch is shut up in its case, we cannot see how the operations of its curious machinery are carried on; and the operations of the mind may, I think, be very well assimilated to those of a watch, as that comparison probably suggests the justest conception of what we can only fancy.”85 At first it will seem the figure is perfectly calibrated to capture Boswell’s theory of mind and brain—a theory that alternately stresses skepticism or speculation depending on the hypochondriac’s changing mood. Nevertheless, it is also easy to misunderstand Boswell’s peculiar understanding of the image. Normally, comparing the mind and brain to a watch would serve as a means of making its workings more evident. Just as we can take apart a watch in order to expose the gears that make it tick, presumably we can look within the brain in order to perceive its underlying mechanisms. But Boswell resists this customary way of interpreting the figure. The watch serves as a fitting emblem for the psyche precisely because it veils its clockwork. We cannot see how the mind works so long as it remains “enclosed” in the body and brain; likewise, we cannot see the “curious machinery” of a watch at work so long as it remains “shut up in its case.” This is an admittedly odd reading of a figure that, in the hands of almost any other thinker, would suggest inherent intelligibility and clarity. But whenever Boswell draws upon the figure—as he does frequently both within The Hypochondriack and in his journals—he always stresses its concealing nature. For instance, when Boswell sets out to assure an older friend that he is mentally sound and ready to marry, he describes his mind like so: “I told him that I could not show him the inside of my mind as one does a watch, but that I was certainly conscious that my wheels now went calmly and constantly.”86 In this case, the figure of the watch conveys a Lockean point that we have seen Boswell articulate more explicitly in The Hypochondriack’s entry on memory: one cannot reveal the substance of mind, but we can be content with the more evident conscious experience produced (somehow) by that substance. Even in those rare instances where Boswell grants that it may be possible to peer into the mechanisms of the watch/mind, he worries that this act of prying into hidden depths will damage the psyche: “Should a man of great force of mind, impetuous in undertaking, and ardent in activity, examine himself frequently with nice attention, it might weaken and relax his powers, as taking it often to pieces will hurt the machinery of a watch.”87
On the one hand, then, Boswell’s preferred metaphor departs from the usual workings of such figures. Comparing the brain, mind, or their connection to some other entity (e.g., a machine, a state, a place) usually elucidates those entities and their relationships. But the watch metaphor, if anything, makes the psyche and its organs inherently mysterious, since the figure stresses the covered and disguised. On the other hand, Boswell himself insists that his metaphor operates like other tropes. In this instance, a more concrete or familiar object (the watch and its case) becomes a means of examining something otherwise strange (the mind and body):
To reason or even fancy, concerning what we do not see, from what we have seen, is pleasing to the mind. And my similitude between a watch in its case, and the soul in its material frame, will, I persuade myself, be agreeable to all my readers, whose dispositions are mild, and who like better to be pleased with what they read, than to attack it. An antient philosopher indeed, full of real or pretended honesty, declared it to be his wish that were a window in his breast, that every body might see the integrity and purity of his thoughts. It would truly be very pretty and amusing if our bodies were transparent, so that we could see anothers sentiments and passions working as we see bees in a glass-hive.88
In other words, the watch metaphor hinges on a paradox. The metaphor likens the seen to the unseen, but what this similitude really makes evident is that the mechanisms of mind necessarily stand out of sight. In this light, the watch metaphor accurately captures what Boswell takes to be the fundamental characteristic of thought and matter: that we cannot discover how the mental and material interact by prying into the substance of flesh, that we possess no window in our breast capable of revealing the gears producing our “sentiments and passions.” The watch metaphor, as complex and paradoxical as it may appear, represents a real advantage, for Boswell, over the other metaphors of mind and brain he surveys in his writing. While these other figures also compare the seen to the unseen—think of the storehouse standing in for memory—they nevertheless mask the psyche’s real nature by making it seem as if metaphor can reveal the inherently hidden mechanisms of mind. But for Boswell, only metaphors that reveal obscurity, that make plain a covering, properly capture the psyche.
Boswell’s watch metaphor is one of the oddest nervous figures I’ve surveyed in this book, since it’s so hard to know where to place it in the history of neuroscience and its figures. In one respect, it seems to belong to the tradition of neuroscientific speculation represented by Willis and other early natural philosophers. With his watch, Boswell figures brain and body as an enclosure containing the springs of our streams of ideas. To locate the source of mind within this structure, it would seem, we must look inward. Usually when figures want to convey this dynamic, they cast the brain as a machine (e.g., an alembic) or place (e.g., a state or castle), thereby seducing us to investigate these interiors for signs of thought. Nevertheless, Boswell’s watch disrupts precisely this dynamic by stressing an element in these figures usually left in the dark: the case or covering. To be sure, all enclosures have outer walls and borders that must be breached before their secrets are revealed, and normally we would assume that a piece of machinery, wrapped in an enigmatic covering, is precisely the sort of entity that Boswell’s hypochondriac imagination would fill with wild theories. Instead, in this case, Boswell insists that it’s precisely the watch’s covering that makes the metaphor work. Removing the case is, in some sense, to miss the very mental effects we mean to study, since we risk stilling the watch’s motion by doing so.
In this respect, Boswell’s watch metaphor best fits in the Lockean tradition. That tradition implores us to focus on the mind’s “surface” (its ideas, abilities, or effects) rather than its “depths” (the substance, physical or otherwise, that ultimately constitutes it). It does so, moreover, because it wants to stress that the mind is a power or activity (and so evident in its effects) rather than a container for still smaller minds or a collection of solid parts. In other words, by the logic of Boswell’s metaphor, it’s the ticking of the watch that matters most, not the otherwise inert gears at its center.89 Disassemble the watch, pry open its covering, and we might find that we have taken apart the very mechanism we set out to observe in the first place. (Hence, Boswell’s continual worry that relentless reflection on thinking substance “will hurt the machinery” of himself.) But Boswell’s metaphor also curbs the excesses of this more skeptical tradition. As we have seen, Mandeville, writing in the Lockean (or Sydenhamean) mode himself, argues that, since the “operations of the mind” are “shut up” in a “material frame,” we should just shut up about its deeper mechanisms. In place of the endless parade of fantasies and fictions about the workings of this hidden machinery, Mandeville recommends quiet observation, even silence. For fear of speaking in figures that might be taken for physiological facts, Mandeville is prepared to stop speaking altogether. Boswell, incapable of abating his metaphor-mad writing, must seek a different solution. He readily recognizes we are natural metaphor machines, that we will continue to figure the mind and its substance so long as we are able. His trick is to employ a figure that makes us want to watch the mind’s actions rather than speculate about its hidden mechanisms.
In 1790, the medical doctor James Adair published his Essays on Fashionable Diseases. Like Mandeville and Boswell before him, Adair was interested in the interplay of fantasy and physiology in hypochondria. And like those earlier thinkers, he was especially fascinated by the way that hypochondriac speculations could be so readily shaped by new medical knowledge and neuroscientific trends. “In the latter end of the last and beginning of this century,” Adair notes, “spleen, vapours, or hyp, was the fashionable disease.”90 But as Adair goes on to explain, by the end of the eighteenth century, thanks in part to the popularity of Whytt’s writing on the nervous system, a new disease had gripped the bodies and imaginations of his patients: “Before the publication of [Whytt’s work], people of fashion had not the least idea that they had nerves; but a fashionable apothecary of my acquaintance, having cast his eye over the book, and having been often puzzled by the enquiries of his patients concerning the nature and causes of their complaints, derived from thence a hint, by which he readily cut the Gordian knot ‘Madam, you are nervous!’”91
Hypochondria casts some of the clearest light on the tendency to fantasize about the workings of the nerves. In doing so, as Adair implies, it also makes us think about the history of these fantasies and about their future. At about the same time the fashionable set was discovering they had nerves, the nerves themselves were arguably undergoing another transformation. With the animal spirits giving way to sympathetic energies binding together nervous systems and societies, still another change was in order by the late eighteenth century. Thanks especially to Galvani’s experiments with muscular contraction, it became increasingly accepted that the nerves communicated through “animal electricity.”92 One might well wonder what sort of figures and fictions resulted from this new theory of nervous energy. And yet it’s also tempting, having surveyed more than a century’s worth of nervous fictions and at least one major paradigm shift in the understanding of the brain, to consider a still wider swath of history. After all, since the discovery of animal electricity in the late eighteenth century, we now know still more about the brain and nervous system. We have learned of neurons and of neuroplasticity. And so we could also ask what figures and fictions were generated by these still newer discoveries. But behind that question is yet another one: Do nervous fictions persist past the late eighteenth century? It is natural to ask, after all, whether the nervous fictions I’ve surveyed throughout this book are confined only to early neuroscientific writing, as if the field’s first, stumbling attempts to make sense of the mind’s relationship to the brain produced a series of fantasies that would need to be eradicated by later, more accurate representations of the nervous system.
I want to suggest, with a great deal of caution, that nervous fictions are still with us, that we can find them at work even in contemporary neuroscientific writing, and that thinking about the brain and mind necessarily means engaging with questions of figurative language more generally. To be sure, different conceptions of the nervous system will give rise to different nervous fictions in turn—as we have seen in the transition from mechanistic to vitalist vision of the nerves. And yet it’s also surprising how often the same fantasies remain in play. For instance, Maxwell Bennett and P. M. S. Hacker, in a work critiquing modern neuroscience’s tendency to engage in the aforementioned “mereological” fallacy, quote the following explanation of neurons from a modern researcher: “We seem driven to say that such neurons have knowledge. They have intelligence, for they are able to estimate the probability of outside events. . . . Neurons present arguments to the brain based on the specific features that they detect, arguments on which the brain constructs its hypothesis of perception.”93 The passage, I hope it will be clear, plays with the same figurative imagery that we might find in Willis (or one of his more immediate successors) and that someone like Cavendish, Locke, Sterne, Mandeville, or even Boswell would critique. Here the neurons behave like Willis’s animal spirits: like little minds that can ferry knowledge of the external world to a more central or higher intelligence (here the whole brain).
This is not to claim that neuroscience has made no real progress since Willis began to speculate about animal spirits navigating the nerves in the mid-seventeenth century. Clearly, the mechanisms of the nervous system are better understood today. But how to account, then, for the curious survival of these recurrent nervous fictions? One lesson we can draw from the texts I’ve surveyed throughout this book is that attempts to speak plainly about the mind, by reducing it to the brain, tend to produce not a literal account of the psyche but a series of unacknowledged metaphors. In this respect, as thinkers like Wittgenstein, Ryle, Sellars, and, later, Dennett all maintain, exploring the relationship between matter and mind often means thinking seriously about philosophical and conceptual questions as well as the nature of our language more generally. This, too, is a point already evident in seventeenth- and eighteenth-century writing. When one kind of metaphor, or a resulting fiction, proved intractable in neuroscientific research, then the solution was not to strip away figurative language but to turn to new tropes. If figurative language is an inescapable part of neuroscientific writing, then the question is not whether we should speak in metaphor but about speaking with the right kind of metaphors.