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. Apothecary, physician, and writer though he was, it was ultimately botany that was his ruling passion, as is made abundantly clear in his correspondence.[13] Wherever he lived—whether in the small house in St. James's Street or in the larger one on the Bayswater Road—he cultivated an herb garden that flattered his knowledge and ability. Connoisseurs raved about its species and considered it one of the showpieces of London. His arrogant personality alone prevented him from becoming the first Keeper of the Apothecary's Garden in Chelsea, although he was for a time superintendent to the Dowager Princess of Wales's gardens at Kensington Palace and at Kew. His interest in cultivation of herbs nevertheless continued; over the years Hill produced more than thirty botanical works, many of them devoted to the medical virtues of rare herbs such as "Spleen-Wort." Among these are The British Herbal (1756), On the Virtues of Sage in Lengthening Human Life (1763), Centaury, the Great Stomachic (1765), Polypody (1768), A Method of Curing Jaundice (1768), Instances of the Virtue of Petasite Root (1771), and Twenty Five New Plants (1773).[14] It is therefore not surprising that he should believe a specific herb to be the best remedy for a complicated medical condition. Nor is his reference to the Ancients as authority for the herbal pacification of an inflamed spleen surprising in the light of his researches: he was convinced that every illness could be cured by taking an appropriate herb or combination of herbs. Whereas a few nonmedical writers—such as John Wesley in Primitive Physick (1747)—had advocated the taking of one or two herbs in moderate dosage as anti-hysterics (the eighteenth-century term for all cures of the hyp), no medical writer of the century ever promoted the use of herbs to the extent that Hill did. In fairness to him, it is important to note that his herbal remedies were harmless and that many found their way into the official London Pharmacopeia. "The virtues of this smooth Spleen-wort," he insists, "have stood the test of ages; and the plant every where retained its name and credit: and one of our good herbarists, who had seen a wonderful case of a swoln spleen, so big, and hard as to be felt with terror, brought back to a state of nature by it" (p. [37]).[15] 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]).
Treatises on hypochondriasis did not cease to be printed after Hill's in 1766, but continued to issue from the presses into the nineteenth century. A good example of this is the tome by John Reid, physician to the Finsbury Dispensary in London, Essays on Insanity, Hypochondriasis and Other Nervous Affections (1816), which summarizes theories of the malady.[16] A bibliographical study of such works would probably reveal a larger number of titles in the nineteenth century than in the previous one, but by this time the nature and definition of hypochondria had changed significantly.
If John Hill's volume is not an important contribution in the history of medicine, it is a lucid and brief exposition of many of the best ideas that had been thought and written on the hyp, with the exception of his uninhibited prescribing of herbal medicines as cure-alls. An understanding of this disease is essential for readers of neoclassical English literature, especially when we reflect upon the fact that some of the best literature of the period was composed by writers whom it afflicted. It is perhaps not without significance that the greatest poet of the Augustan age, Alexander Pope, thought it necessary as he lay on his deathbed in May 1744 to exclaim with his last breath, "I never was hippish in my whole life."[17]
University of California,
Los Angeles
NOTES TO THE INTRODUCTION
[1] The text here reproduced is that of the copy in the Library of the Royal Society of Medicine, London. Title pages of different copies of the first edition of 1766 vary. For example, the title page of the copy in the British Museum reads, Hypochondriasis; a Practical Treatise On the Nature and Cure of that Disorder, Commonly called the Hyp and the Hypo. The copy in the Royal Society of Medicine contains, among other additions, the words "by Sir John Hill" in pencil, and "8vo Lond. 1766," written in ink and probably a later addition.
[2] Melancholy, hypochondriasis, and the spleen were considered in the seventeenth and eighteenth centuries to be one complex condition, a malady rather than a malaise, which is but a symptom. Distinctions among these, of interest primarily to medical historians, cannot be treated here. As good a definition as any is found in Dr. Johnson's Dictionary (1755): "Hypochondriacal.... 1. Melancholy; disordered in the imagination.... 2. Producing melancholy...." The literature of melancholy has been surveyed in part by C. A. Moore, "The English Malady," Backgrounds of English Literature 1700-1760 (Minneapolis, 1953), pp. 179-235. In medical parlance, "hypochondria" means the soft parts of the body below the costal cartilages, and the singular form of the word, "hypochondrium," means the viscera situated in the hypochondria, i.e., the liver, gall bladder, and spleen.
[3] See Samuel Clifford's The Signs and Causes of Melancholy, with directions suited to the case of those who are afflicted with it. Collected out of the works of Mr. Richard Baxter (London, 1716) in the British Museum.