John Hill

“ One established doctrine holds place in all these writers; that whatever by a hasty fermentation dissolves the impacted matter of the obstruction, and sends it in that state into the blood, does incredible mischief: but that whatever medicine softens it by slow degrees, and, as it melts, delivers it to the bowels without disturbance; will cure with equal certainty and safety. ”

“ The great and general caution is that the diet be at all times of a kind loosening and gently stimulating; light but not acrid. Veal, lamb, fowls, lobsters, crabs, craw-fish, fresh water fish and mutton broth, with plenty of boiled vegetables, are always right; and give enough variety.
Raw vegetables are all bad: sour wines, old cheese, and bottled beer are things never to be once tasted. Indeed much wine is wrong, be it of what kind soever. It is the first of cordials; and as such I would have it taken in this disease when it is wanted: plainly as a medicine, rather than a part of diet. ”

“ Hill also rebelled against contemporary apothecaries and physicians who prescribed popular medicines—such as Berkeley's tar-water, Dover's mercury powders, and James's fever-powders [Pg vii] —as universal panaceas for the cure of the hyp. "No acrid medicine must be directed, for that may act too hastily, dissolve the impacted matter at once, and let it loose, to the destruction of the sufferer; no antimonial, no mercurial, no martial preparation must be taken; in short, no chymistry: nature is the shop that heaven has set before us, and we must seek our medicine there" (p. 24) . ”

“ SECT. VIII. The Medicine. 'Tis the ill fate of this disease, more than of all others to be misunderstood at first, and thence neglected; till the physician shakes his head at a few first questions. None steals so fatally upon the sufferer: its advances are by very slow degrees; but every day it grows more difficult of cure.
That this obstruction in the spleen is the true malady, the cases related by the antients, present observation, and the unerring testimonies of dissections leave no room to doubt. ”

“ A light supper, which will leave an appetite for a milk breakfast, is always right; this will not let the stomach be ravenous for dinner, as it is apt to be in those who make that their only meal.
One caution more must be given, and it may seem a strange one: it is that the patient attend regularly to his hours of eating. We have to do with men for the most part whose soul is the great object of their regard; but let them not forget they have a body. ”

“ In the first four sections almost every statement is commonplace and requires no commentary (for example, Hill's opening remark: "To call the Hypochondriasis a fanciful malady, is ignorant and cruel. It is a real, and a sad disease: an obstruction of the spleen by thickened and distempered blood; extending itself often to the liver, and other parts; and unhappily is in England very frequent: physick scarce knows one more fertile in ill; or more difficult of cure.") ”

“ Nature has sometimes made a cure herself, and we should watch her ways; for art never is so right as when it imitates her: sometimes the patient's own resolution has set him free. This is always in his power, and at all times will do wonders.
The bleeding of the piles, from nature's single efforts, has at once cured a miserable man; where their cessation was the cause [Pg 23] of the disorder. A leprosy has appeared upon the skin, and all the symptoms of the former sickness vanished. ”

“ It is happy a disease, wherein the patient must do a great deal for himself, falls, for the most part, upon those who have the powers of reason strongest. Let them only be aware of this, that the distemper naturally disposes them to inactivity; and reason will [Pg 10] have no use unless accompanied with resolution to enforce it.
Though the physician can do something toward the cure, much more depends upon the patient; and here his constancy of mind will be employed most happily. No one is better qualified to judge on a fair hearing what course is the most fit ”

“ The belief that hypochondriasis was a somatic condition persisted until [Pg iii] the second half of the seventeenth century at which time an innovation was made by Dr. Thomas Sydenham. In addition to showing that hypochondriasis and hysteria (thought previously by Sydenham to afflict women only) were the same disease, Sydenham noted that the external cause of both was a mental disturbance and not a physiological one. He also had a theory that the internal and immediate cause was a disorder of the animal spirits arising from a clot and resulting in pain, spasms, and bodily disorders. ”

“ Even what the vulgar call the most abject things will shew a wonderful utility; and lead the mind, in pious contemplation higher than the stars. The poorest moss that is trampled under foot, has its important uses: is it at the bottom of a wood we find it? ”

“ Spleen-wort gives out its virtues freely in a tincture; and a small dose of this, mixing readily with the blood and juices, gradually dissolves the obstruction; and by a little at a time delivers its contents to be thrown off without pain, from the bowels. Let this be done while the viscera are yet sound [Pg 40] and the cure is perfect. More than the forty days of the Greek method is scarce ever required; much oftener two thirds of that time suffice; and every day, from the first dose of it, the patient feels the happy change that is growing in his constitution. ”

“ Being now thin, it mixes itself readily with the blood again, and brings on putrid fevers; destroys the substance of the spleen itself, or being thrown upon some other of the viscera, corrodes them, and leads on this way a swift and miserable death. If it fall upon the liver, its tender pulpy substance is soon destroyed, jaundices beyond the help of art first follow, then dropsies and all their train of misery ”

“ No disease is more troublesome, either to the Patient or Physician, than hypochondriac Disorders; and it often happens, that, thro' the Fault of both, the Cure is either unnecessarily protracted, or totally frustrated ”

“ His food no more turns putrid on his stomach, but yields its healthful nourishment. The swelling after meals therefore vanishes; and with that goes the lowness, and anxiety, the difficult breath, and the distracting cholick: he can bear the approach of rainy weather without pain; he finds himself more apt for motion, and ready to take that exercise which is to be assistant in his cure; life seems no longer burthensome. His bowels get into the natural condition of health, and perform their office once at least a day ”

“ Bleeding would have answered nature's purpose, if she could not have opened of herself the hæmorrhoidal vessels; but he who should give medicines for that purpose, might destroy his patient by too great disturbance. If a natural looseness may perform the cure, so may an artificial; when the original source of the disorder points that way. ”

“ Air and exercise, as they are the best preservers of health, and greatest assistants in the cure of all long continued diseases, will have their full effect in this; but there requires some caution in the choice, and management of them. It is common to think the air of high grounds best; but experience near home shews otherwise: the Hypochondriac patient is always worse at Highgate even than in London. ”

“ If the mind tire upon this, from the repeated use, another of nature's kingdoms opens itself at once upon him; the plant he is weary of observing, feeds some insect he may examine; nor is there a stone that lies before his foot, but may afford instruction and amusement. ”

“ The greatest portion of Hill's concluding section combines advertisement for the powder medicine he was himself manufacturing at a handsome profit together with a protest against competing apothecaries: "An intelligent person was directed to go to the medicinal herb shops in the several markets, and buy some of this Spleen-wort; the name was written, and shewn to every one; every shop received his money, and almost every one sold a different plant, under the name of this: but what is very striking, not one of them the right" (p. 42) . ”

“ The watery part of the blood is its mild part; in the remaining gross matter of it, are acrid salts and burning oils, and these, when destitute of that happy dilution nature gives them in a healthy body, are capable of doing great mischief to the tender vessels in which they are kept stagnant. ”

“ Milk ought to be a great article in the diet: and even in this there should be choice. The milk of grass-fed cows has its true quality: no other. There are a multitude of ways in which this may be made a part both of our foods and drinks, and they should all be used. ”

“ The middle period of life is that in which there is the greatest danger of an attack from this disease; and the latter end of autumn, when the summer heats have a little time been over, is the season when in our climate its first assaults are most to be expected. ”

“ When the obstruction is great and of long continuance, if it be thus hastily moved, the consequence is, equally, a sudden and a miserable death, whether, like the matter of a cancer, it remains in its place ”

“ Let him invite himself abroad, and let his friends invite him by every innocent inducement. For me, I should advise above all other things the study of nature. Let him begin with plants: he will here find a continual pleasure, and continual change; fertile of a thousand useful things ”

“ Despite the plethora of materia scripta on the subject it makes sense to reprint Hill's Hypochondriasis, because it is indeed a "practical treatise" and because it offers the modern student of neoclassical literature a clear summary of the best thoughts that had been put forth on the subject, as well as an explanation of the causes, symptoms, and cures of this commonplace malady.
[Pg ii] No reader of seventeenth- and eighteenth-century English literature needs to be reminded of the interest of writers of the period in the condition—"disease" is too confining a term—hypochondriasis. ”

“ The Geometrician or the learned Philosopher of whatever denomination, whose course of study fixes his eye for ever on one object, his mind intensely and continually employed upon one thought, should be warned also that he is in danger ”

“ Real grief has often brought it on; and even love, for sometimes that is real. Study and fixed attention of the mind have been accused before; and add to these the stooping posture of the body, which most men use, though none should use it, in [Pg 21] writing and in reading. ”

“ This stood alone for the cure of the disease; and from its virtue received the name of Spleen-wort [21] . O wise and happy Greeks! authors of knowledge and perpetuators of it! With them the very name they gave a plant declared its virtues: with us, a writer calls a plant from some friend; that [Pg 37] the good gardener who receives the honour, may call another by his name who gave it. We now add the term smooth to this herb, to distinguish it from another, called by the same general term, though not much resembling it. ”

“ Diseases that come on slowly must have time for curing; an attention to the first appearances of the disorder will be always happiest; because when least established it is easiest overthrown: but when that happy period has been neglected, he must wait the effects of such a course as will dilute and melt the obstructing matter gradually ”

“ The same time of the year always increases the disorder in those who have been before afflicted with it; and it is a truth must be confessed, that from its first attack the patient grows continually, though slowly, worse; unless a careful regimen prevent it.
The constitutions most liable to this obstruction are the lean, and dark complexioned; the grave and sedentary. Let such watch the first symptoms ”

“ Is there a weed more humble in its aspect, more trampled on, or more despised than knot grass! no art can get the better of its growth, no labour can destroy it; 'twere pity if they could, for the thing lives where nothing would of use to us ”

“ The pulse becomes low, weak, and unequal; and there are frequent palpitations of the heart, a little dark-coloured urine is voided at some times; and a flood of colourless and insipid at others; relieving for a moment, but increasing the distemper: there is in some cases also a continual teazing cough, with a choaking stoppage in the throat at times ”

“ He will be tempted to be continually in the air; and continually to change the nature and quality of the air, by visiting in succession the high lands and the low, the lawn, the heath, the forest. He will never want inducement to be abroad ”

“ While Hill's rules and regulations regarding proper diet (Section VII) are standard, several taken almost verbatim et literatim from Cheyne's list in The English Malady (1733) , his recommendation (Section VIII) of "Spleen-Wort" as the best medicine for the hypochondriac patient is not. Since Hill devotes so much space to the virtues of this herb and concludes his work extolling this plant, a word should be said about it. Throughout his life he was an active botanist. ”

“ Motion preserves the firmness of the parts, and elasticity of the vessels; it prevents that aggregation of thick humours which he is most to fear. A sedentary life always produces weakness, and that mischief always follows: weak eyes are gummy, weak lungs are clogged with phlegm, and weak bowels waste themselves in vapid diarrhœas. ”

“ These symptoms do not all appear in any one period of the disease, or in one case, but at one time or other all of them, as well as those which follow: the flesh becomes cold to the touch, though the patient does not himself perceive it; the limbs grow numbed and torpid, the breathing dull and slow, and the voice hollow ”

“ What the weak moss performs upon the rock the loathed toadstool brings about in timber: is an oak dead where man's eye will not find it? this fungus roots itself upon the bark, and rots the wood beneath it ”