Coleridge’s hypochondria

“Living thoughts,” wrote Coleridge, “spring up like turf under his feet.” Davy was equally inspired by his new friend’s expansive notions of poetry and philosophy.

On one subject, however, they differed profoundly. For Davy, pain was a distraction; for Coleridge, a source of endless fascination. In one letter to his friend, Coleridge wrote: “I want to read something by somebody expressly on pain… it is a subject that exceedingly interests me.”

Davy maintained that “a firm mind might endure in silence any degree of pain”, and he relished any opportunity to demonstrate “the supremacy of mind over matter”. He was a fearless, often reckless experimenter: when he cut his finger to the bone in a laboratory accident, his first reaction was to dip it in a bottle of his newly discovered gas, nitrous oxide, and to note that the dripping blood turned purple.

In his report on nitrous oxide in 1800, Davy observed that inhaling the gas temporarily eased the pain of his laboratory injuries, and proposed that as it “appears capable of destroying physical pain, it may probably be used with great advantage during surgical operations”. But the suggestion, one among a handful of speculative applications, went no further.

Davy’s lack of interest in pain was matched by the surgeons of his generation, who dismissed anaesthetics as quackery that preyed on the patient’s fear of suffering. Medical orthodoxy was supported by the religious view that pain was a Divine necessity, and enduring it a moral test.

Diseases as signs of the times

Coleridge’s letters and notebooks, by contrast, are filled with minute observations of his rheumatism, boils, fevers, neuralgia and particularly his “treacherous bowels”, which inflicted on him an endless series of agonies. He would bury himself for hours in medical textbooks, and emerge with a self-diagnosis of kidney stones or bladder cancer.

The pair met through the radical physician Thomas Beddoes, who was Davy’s employer in Bristol in the search for therapeutic applications of gases, and Coleridge’s mentor in political activism and the latest medical theories. Beddoes was a pioneer of social medicine, and in his three-volume survey of the nation’s health, ‘Hygeia’ (1802), he identified hypochondria as a new type of occupational disease.

Just as workers in industrial towns such as Birmingham were contracting lung diseases, he observed that hypochondria was becoming endemic among the “middling and affluent classes”. Medical fads and anxieties, encouraged by idleness, disposable income and predatory private doctors, blurred the lines between health and illness.

Excessive attention to minor symptoms created negative feedback loops that could turn slight breathlessness into alarming chest pains, or (as with Coleridge) a bout of indigestion into weeks of infirmity.

Beddoes recorded the rise of hypochondria in his own practice and found himself prescribing more narcotic drugs such as opium and ether: palliatives that were effective at reducing anxiety but compounded the condition if their use became habitual.

This was precisely what befell Coleridge. He kept his opium habit a secret for years, and when this was no longer possible, he pleaded medical necessity. Many of his friends had their doubts, notably his former secretary Thomas De Quincey, who judged that Coleridge’s opium use was a “surreptitious seeking for pleasure”: despite his protestations of illness, he was not medicating pain but merely the ennui we must all endure as part of the human condition.

Opium gave Coleridge immediate relief, but it extracted a terrible price. It could give him a radiant glow and wonderful fluency at the dinner table, but these raptures were followed by the insomnia and skin-crawling hypersensitivity he describes in poems such as ‘The Pains of Sleep’ (1803), and the torments of constipation, a shameful metaphor for the writer’s block that opium also induced.

Coleridge was all too aware of the judgements being passed on him, yet he dwelt deeply on his pains, their causes and their meanings, and particularly their effects on his mental world. “My spirits are low,” he wrote to a friend in 1804, “but this I well know is a symptom of bodily disease, and no part of sentiment or intellect.”

The fashion for compassion

Imagination was the key to Coleridge’s philosophy, the link between mind and matter, and interrogating his bodily constitution was inseparable from his creative life. As Humphry Davy wrote in 1808, when his invitation to Coleridge to lecture at the Royal Institution provoked a nervous collapse, the poet’s “excessive sensibility” was “the disease of genius”. Coleridge loved to invent words, and the term he coined for the connections between mind and body was an enduring one: “psycho-somatic”.

As the 19th century advanced, Coleridge’s interest in pain and illness became more in tune with the times. “Sensibility” – what we might today call empathy or compassion – was increasingly valued as a mark of character. A progressive “middling class” led campaigns against displays of cruelty and suffering, from bear-baiting to Bedlam visits to public executions.

The “language of feeling” explored by Davy and Coleridge’s generation of Romantic poets bore fruit in the popular novel, in which authors such as Charles Dickens invited their readers to share the suffering experienced by the less fortunate. Some physicians and religious authorities continued to argue that pain was a necessity, but for many it had come to seem barbaric to withhold analgesics such as ether and opium from patients, especially those suffering chronic or terminal illness.

Fifty years after Davy’s and Beddoes’ experiments, nitrous oxide and ether finally found the defining medical application for which they had been searching: anaesthesia. British surgeons were initially reluctant to adopt the newfangled American discovery – a “Yankee dodge” – but public opinion tipped in its favour when Queen Victoria was administered chloroform in 1853 during the birth of her eighth child, Leopold. She pronounced the experience “delightful beyond measure”.

By this point, to inflict pain needlessly seemed reprehensible, and anaesthesia was hailed as the medical discovery of the century. Coleridge had died in 1834, a gentleman invalid fondly remembered by the staff of T H Dunn’s pharmacy on Highgate Hill, which he visited for his regular supply of opium tincture.

But in this new climate, his “hypochondriac delights” – his biographer Richard Holmes’s perceptive phrase – appear not simply as a moral flaw, but a prescient injunction to pay more attention to our embodied selves.