Breaking into the Bon Ton

Between October 2008 and August 2009, a band of teenage fashion bandits broke into the homes of celebrities, and stole close to $3 million dollars worth of high-end designer goods and clothes (including underwear), jewellery, cash and all manner of ephemera such as perfume, make-up and, in one instance, a hand gun. Because of the nature of the goods taken the gang was subsequently dubbed by the media as ‘the Bling Ring’. Targets included actors Orlando Bloom and Lindsay Lohan and a swathe of reality television celebrities. The first to be hit was Paris Hilton, whom the gang subsequently robbed five times in total. Nick Prugo, who committed the first Hilton robbery along with ringleader Rachel Lee, later claimed that they targeted Hilton because she was ‘dumb […] Like, who would leave a door unlocked? Who would leave a lot of money lying around?’1 However Hilton was not picked simply because she was presumed to be stupid but also because she represents a desirable elitism as encapsulated by the name of one her range of designer goods; bon ton.2 In the eighteenth century the term ‘ton’ was borrowed from the French word meaning ‘taste’ or ‘the highest style’. The full phrase ‘le bon ton’ translates as ‘ in the fashionable mode’, and was used interchangeably with the term ‘beau monde’ (‘the beautiful world’). As Hannah Grieg notes, the ‘precise criteria that denoted membership of the beau monde were endlessly debated [...] involving pedigree, connections, manners, language, appearance, and much else besides [...] the eighteenth-century beau monde therefore laid claim to what might be described as the “it” factor: an elusive yet exclusive form of social distinction.’ 3 The precise nature of membership might not be easily defined, but may generally be indicated by the display of expensive commodities.

Though taste may not be an epithet commonly applied to Hilton, she is a fashion icon to many, rich and famous; the two latter terms are not mutually exclusive when considering her as the group’s primary target. By acquiring the personal belongings of Hilton and the like, the gang not only acquired the appearance of wealth but also entry-level status into ranks of the social elite. The female bling-ringers had much in common with Hilton; modelling, appearances on reality television, various brushes with the law, being ‘papped’ by the paparazzi (usually entering and leaving police stations). Now they had her clothes, jewellery, money and ‘free’ access to her house, their relationship with Hilton was on a more intimate footing – they were now part of her circle by proxy. Nancy Jo Sales, journalist and author of The Bling Ring (2013), notes:

A 2007 survey by the Pew Research Centre found that 51 percent of 18-to-25 year olds said that their most important life goal – after becoming rich – was becoming famous. [...] Given the choice of becoming stronger, smarter, famous or more beautiful, [teenage] boys chose fame almost as often as they chose intelligence, and [teenage] girls chose it more often. [...] TV shows most popular with 9-to-11-year-olds have “fame” as their number one value, above ‘self-acceptance’ and ‘community feeling.’ 4

Sales reflects upon this desire for fame for its own sake as a new phenomenon. However, though the demographic may be new, the desire for fame for its own sake is not. In the early eighteenth century ‘Mr. Spectator’ commented upon what he viewed as a worrying development.

Issue number 255 of The Spectator observes ‘It was necessary for the World, that Arts should be invented and improved, Books written and transmitted to Posterity, Nations conquered and civilised’, and that these improvements are generated by ‘some common Principle of Action working equally with all Men [...] Ambition or a Desire for Fame.’ 5 Therefore the active pursuit of fame has potential benefits as ‘great Endowments are not suffer’d to lie idle and useless to the Publick’. According to ‘Mr. Spectator’, only those with the greatest of abilities are endowed with benevolent ambition whereas ‘those are generally most unsuccessful in their Pursuit after Fame, who are most desirous of obtaining it.’ 6 Should the ill-equipped be successful in their empty pursuit of fame for its own sake, then they must prepare themselves for the corrupting effects of maintaining their new-found status upon the seeker. In order to keep the fame-monster alive, the fame-seeker will undergo a ‘tumult in the soul, ultimately leading to a dangerous personality change. The thirst for fame, as opposed to fame bestowed upon merit, will ‘naturally betray [the fame-seeker] into indecencies as are lessening to his reputation’. 7 What, one can only wonder, would ‘Mr. Spectator’ make of the origin of reality-television’s current reigning monarch Kim Kardashian’s ‘fame’! If not thoroughly corrupted into committing acts of indecency, such as the releasing of sex tapes (the case with both Hilton and Kardashian) or burglary, the aspirant will suffer from a permanent inflammation of the mind and a violent hurry of thought, and much worse. Humankind is not physically equipped to process the effects of fame and so the consequences are comparable with drug addiction:

Fame [...] is so wholly foreign to our Natures that we have no Faculty adapted [...] to it, nor any Organ in the body to relish it [...] It may indeed fill them for a while with a giddy kind of pleasure but [...] it does not so much satisfy the present Thirst, as it excites fresh Desires, and set the Soul on new enterprises. 8

Enslaved by public opinion or restlessly striving for recognition if not adoration, the fame-seeker is subject to fits of melancholy and his natural rest and repose of mind is completely destroyed, while offering very little happiness in the short term. The emphasis upon the corrupting influence of fame echoes Alexander Pope’s conclusion to The Temple of Fame, also written in 1711 but published much later. Pope’s speaker implores: ‘Then teach me, Heav’n! To scorn the guilty Bays; / Drive from my breast that wretched Lust of Praise; / Unblemish’d let me live, or die unknown, / Oh grant an honest Fame, or grant me none!’9 Not a maxim that would have been endorsed by the Bling Ring, nor would they have recognised ‘Mr. Spectator’s’ assertion that fame is hard won but easily lost. In fact it appears that, for the Bling Ring, the exact opposite is true, especially as their shopping shenanigans have now been turned into two films, the most recent directed by Sofia Coppola and featuring none other than Ms Hilton herself – a level of recognition beyond even their wildest dreams.

Leigh Wetherall Dickson

Back to post[1] Quoted in Nancy Jo Sales, ‘The Suspects Wore Louboutins’, Vanity Fair, March 2012, [accessed 3 February 2015]

Back to post[2] [accessed 3 February 2015]

Back to post[3] Hannah Grieg, The Beau Monde: Fashionable Society in Georgian London (oxford: Oxford University Press, 2013), p. 3.

Back to post[4] Nancy Jo Sales, The Bling Ring (London: HarperCollins, 2013), p. 27; p. 30.

Back to post[5] The Spectator, 8 Volumes (London, 1712) Vol. IV, p. 18 (First pub. Saturday 22 December, 1711).

Back to post[6] The Spectator, Vol. IV, p. 19.

Back to post[7] The Spectator, Vol. IV, p. 20.

Back to post[8]The Spectator,Vol. IV, p. 27 (first pub. Monday 24 December 1711).

Back to post[9] Alexander Pope, ‘The Temple of Fame’, Pope; Poetical Works, ed. Herbert Davis (Oxford: Oxford University Press, 1985) p. 146, ll. 521-4.

Making the Most of Madness

Madness has always been the most fashionable of afflictions. That is to say, unlike cancer, or cholera, or even the plague, it has been the most malleable, the most subject to interpretation by the society in which it takes place, the most available to being fashioned – into, perhaps, a curse, or a gift, from the gods; a comment and stigma on the society, or the individual, or the family; or perhaps a genetic or a chemical failure taking on mental dimensions. The utterances of the mad, too, have variously been taken as divine revelations or prophecies, as shrewd or satiric insights (‘Though this be madness, yet there is method in’t’ as Polonius puts it in Hamlet)1, or as gobbledegook and ignored accordingly. The eighteenth century in Britain saw an increasingly rapid professionalization of medicine – a dragging of the whole business of dealing with the sick into a scientific age and a gradual stripping it of its accumulation of superstitions, bits and pieces of magic and ritual, a freeing from the remnants of beliefs inherited from classical and medieval times. Not that this was a process accomplished overnight, but with medical training being put on a systematic basis, with the leading universities in Britain, after the example of the continent, taking medicine seriously, and increasingly expecting practical training (this particularly the case in Scotland), and with English, rather than Latin, becoming the norm for published medical works, doctors and doctoring were coming down to earth, coming face to face with reality, and making serious efforts to understand what was going on before their eyes.

The treatment of madness, as so often, tended to lag behind – unfashionable, at least in this respect. But change did follow. One major area was in confinement. As Roy Porter puts it, ‘Whereas in 1660 it had been exceptional for a lunatic to be put in a madhouse, by the beginning of the nineteenth century confinement was becoming increasingly normal, indeed the resort progressive opinion was recommending.’2 In 1660, he argues, little was different from ‘the Tudor and Stuart centuries’: an ‘unknown but small number of the disturbed’ had been ‘under lock and key’. ‘By the 1810s’, however,

official figures indicate that around 2590 lunatics were confined in licensed houses for the mad, and almost as many again in other places of custody such as houses of correction, workhouses and gaols. The real totals were higher.
(p. 111)3

Confinement, certainly, kept people off the streets, it made them easier to observe and to treat – primitive though that treatment sometimes was – and, in a professional age, it above all made them more profitable, at least in the booming trade of private madhouses that flourished as the century progressed. Confinement acted in some degree as a reassurance to the wider public that madness was under some sort of control, rather than being allowed to wander freely in society, though that was to an extent countered by the fear, especially in London, that the Bethlem bailiffs, or the men from St Luke’s, might pick you up in the night and cart you away as a madman!

But confinement also changed, in rather subtle ways, the meanings of madness, what it was capable of being made into. James Carkesse, back in the late seventeenth century, writes (poetically) of his being confined in Finsbury madhouse, a private establishment run by Dr Thomas Allen. (He adopts the doctor’s voice for this poem.)

Moreover I him in the Hole,
        As under a Bushel , confin’d;
Lest God’s Word, the Light of the Soul,
        In my Mad-house should have shin’d:
Ne’re the less into the Dungeon,
        He let the Rayes of the Sun,
And i’th’Pit, where him I did plunge in,
        Made Night and Day meet in one.4

There are many models, pre-eminently Biblical, but also, of course, classical, for the lone voice of truth shunned and misunderstood by its society. Those who speak certain truths are never welcomed with open arms. The act of confinement, however, is an unmistakeable consolidating factor. Society has judged, and in judging and acting in this way has actually confirmed the madman’s view of himself: ‘I must be right, otherwise they would never have confined me. And not only am I right, but I am being persecuted for being right. I’ll carry on, then.’

In this sense, confinement laid open the way for madness to find ways of making the most of itself, of a process of self-fashioning that was to last for the entire eighteenth century and beyond.


Allan Ingram

Back to post[1] William Shakespeare, Hamlet, ed. Harold Jenkins (London: Methuen & Co., 19820, II ii 205-6, p. 248.

Back to post[2] Roy Porter, Mind-Forg’d Manacles: A History of Madness in England from the Restoration to the Regency (London: Athlone Press, 1987), p. 155.

Back to post[3]Porter references William Llewelly Parry-Jones, The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries (London: Routledge & Kegan Paul, 1971), p. 54, for these figures.

Back to post[4] James Carkesse, Lucida Intrervalla: Containing divers Miscellaneous Poems (1679) in Patterns of Madness in the Eighteenth Century: A Reader, ed. Allan Ingram (Liverpool: Liverpool University Press, 1998), p. 25.

Musical Nervousness as a Fashionable Disease


Music and the Nerves

I first became interested in the ‘fashionable diseases’ of the long eighteenth century when I was working on my book Bad Vibrations: The History of the Idea of Music as a Cause of Disease. In that period, especially in Britain, the notion that music was a matter of nervous stimulation became widespread, bringing thinking on music into the wider debate on nervousness, sensuality and sensibility. Until the 1790s, music was generally depicted as refining rather than damaging the nerves with the context of the Cult of Sensibility. Thereafter, however, musical nervousness became a full-blown fashionable disease, with a moral-medical critique of its excesses and the whiff of emotional and spiritual superiority.

By the eighteenth century British contributions to the discussion of music’s physical effects, such as Richard Browne’s 1729 Medicina Musica and Richard Brocklesby’s 1749 Reflections of Antient and Modern Musick, tended to assume that music’s power over emotions was experimentally verifiable, that the body worked on Newtonian principles, and that the nerves were responsible for music’s impact.1 There was an extensive debate about how the nerves transmitted sound to the brain, with a variety of theories on the nature of the nerves co-existing, with models of animal spirits, nervous fluid, electrical, vibrating and oscillating nerves all competing and often being combined. The idea of ‘sympathetic vibration’ between music and literally vibrating nerves was one model of the impact of sound that proved highly influential. Although George Cheyne also turned to the language of tightened strings, likening the embodied soul to a ‘Musician in a finely fram’d and well-tun’d Organ-Case… these nerves are like Keys’, he preferred the idea of nervous fluid.2

Although more hostile voices such as John Gregory complained that modern music had lost its moral purpose, Enlightenment aestheticians and physicians often explicitly stated that music refined listeners’ nerves and their morals.3 For example, Nicholas Robinson in his 1729 A New System of the Spleen suggested that ‘it would not be improper sometimes, to try upon those Diseases, that are supposed to have a very great Dependance on the Mind; (as the Hypochondriack Melancholy) and discover whether it is possible, by its Impulses to work a Change in those finest Nerves and Animal Fluids, that are too subtle to come under the Influence of the choicest Medicines’.4 Similarly, eighteenth-century dietetic books, such as John Fothergill’s Rules for the Preservation of Health of 1762 or James Mackenzie’s 1760 The History of Health, and the Art of Preserving It recommended music as a healthy exercise and raised no doubts as to its beneficial effect.5 In aesthetics, too, this physiological model of music’s positive effects was common. The Irish writer Daniel Webb argued in his 1769 Observations on the Correspondence between Poetry and Music that its impact of the nerves meant that it was ‘destined to act in aid of the moral sense, to regulate the measures and proportions of our affections; and by counter-acting the passions in their extremes, to render them the instruments of virtue, and the embellishments of character’.6

From Musical Sensibility to Musical Pathology

However, by 1800 there had been a marked hardening of attitudes towards music’s effect on the nerves as the sensibility model of music refining the nerves was challenged on several fronts. In terms of medicine, music became incorporated into a late Enlightenment model of the aetiology of disease that saw stimulation as the principal cause of sickness. Much later than other ‘luxuries’ such as the novel or coffee, music became subject to a developing medical critique of modern lifestyle and culture as sick. The emergence of a critique of music’s effect on health was part of a growing medical hostility towards sensibility and the lifestyles of the indulgent rococo lifestyle of the elite. The French Revolution, especially the Terror and chaos of the 1790s, made making sensibility’s defence of individual feeling against social convention much less palatable to mainstream opinion.

This social and medical critique of music can be seen in the work of the radical Bristol physician Thomas Beddoes. In his Hygëia of 1802, one sees the view of music as a potential cause of neuropathological conditions. At one point he implies that a young man’s death was brought on in part by the strain of music.7 Elsewhere in the book he outlines his ideas on the effect of music in more detail:

Even when it charms, it co-operates with weights, already suspended with too little consideration upon the nervous system, and all pulling in the same direction… The SAVOYARD [sic] rustic, who carols as she trudges, is, I can well conceive, all the better for her elegant accomplishment. But the English Miss, with whom already almost every occupation is sedentary, and every pleasure passive, must, I fear, be the worse – the worse for the acquirement of the art, and for the delight it yields, when acquired…. I will not suppress my suspicion, that the largest pack of hounds we have, turned out mad upon the country, might possibly have committed less ravage, than that rage for excelling in music, which, of late years, we have seen invading families, and imposing the necessity of such strictness of application upon the girls’.8

At the same time, the expansion of the middle class meant that the elite associations of sensibility were not only under attack, they were becoming diluted, and the physicians and writers that fretted about its medical consequences noticed the phenomenon spreading. By 1833, the Scottish physician David Uwins explained how social mobility and modern lifestyles, including music, were leading to sickness. ‘Pianos, parasols, Edinburgh Reviews, and Paris-going desires’, he wrote, ‘are now found among a class of persons who formerly thought these things belonged to a different race; these are the true sources of nervousness and mental ailments’. 9 As the century wore on, medical critiques of music would increasingly focus on the masses and less on the elite.

Musical nervousness was a fashionable disease not only in the sense of seemingly being a sudden ubiquitous diagnosis, it was also modish itself and could come with considerable prestige. The glamour associated with the over-sensitive, nervous and sickly musician was a common theme throughout the Romantic period. An article on hypochondria in 1826, for instance, suggested that, ‘Among the various classes of artists, for example, musicians are perhaps the most subject to those wayward fancies which mark the hypochondriac; witness Viotti, Sacchini, Mozart and others; while the effect upon minds gifted with undue sensibility is strikingly illustrated by the melancholy and passionate desire of revisiting.10 As is so often the case, the fashionable diseases of the Georgian period thus set the scene for subsequent developments. Discussion of music, the body and health up until today has continued to reflect ambivalent attitudes about sexuality, class, creativity and the ‘medical marketplace’.

James Kennaway

Back to post1. Richard Browne, Medicina Musica; or a Mechanical Essay on the Effects of Singing Music, and Dancing on Human Bodies (London, 1729), p.33.
Back to post2. George Cheyne, The English Malady (London, 1733), p. xviii, 4.
Back to post3.Richard Brocklesby, Reflections on Antient and Modern Musick (London, 1749), p.11.
Back to post4.Nicholas Robinson, A New System of the Spleen, Vapours, and Hypochondriack Melancholy (London, 1729), pp. 143-44.
Back to post 5.John Fothergill, Rules for the Preservation of Health (London, 1762), p. 57, James Mackenzie, The History of Health, and the Art of Preserving It (Edinburgh, 1760), p. 380.
Back to post 6.Daniel Webb, Observations on the Correspondence between Poetry and Music (London, 1769), p. 37.
Back to post 7.Thomas Beddoes, Hygëia (Bristol, 1804), Essay Seventh, p. 92.
Back to post 8.Ibid., Essay Third, pp. 53-4.
Back to post 9. David Uwins, A Treatise on those Disorders of the Brain and Nervous System (London: Renshaw and Rush, 1833), p. 51.
Back to post 10.Richard Phelps, “On Hypochondriasis” The Monthly Magazine (July 1826), pp. 40-44.

Health and Society in Georgian Spas

As part of the ‘Fashionable Diseases’ Leverhulme Trust project, we have held five workshops in the first year. The last of these in November 2013 was entitled ‘Fashion and Illness in Georgian Bath.’ Although Bath is well-known as the eighteenth-century centre for fashionable society, it is easy to forget that it only became so due to its identity as a health resort. As with other spas in Britain and Europe at this time, people originally travelled to Bath for the healing effects of the waters. Phyllis Hembry explains in The English Spa, 1560-1815 that in the Medieval period the waters of many spas were thought to be miraculous while from the Elizabethan period onwards, more emphasis was placed on the chemical properties of the mineral salts and water1. By the eighteenth century many spas throughout Britain and Europe were popular resorts for those hoping to cure various illnesses as well as for more preventative measures. As the wealthy upper and moneyed middle classes toured the spas for their health, the towns began to provide better amenities and increased entertainment for recreation. It is only because of the health tourism that spas like Bath, Tunbridge, Cheltenham, Bristol and others became such popular eighteenth-century social centres.

What I find most interesting in late eighteenth-century novels set in spa towns is the curative effect, not of the waters themselves, but of the society. In an article entitled ‘In the Bowels of the Novel: The Exchange of Fluids in the Beau Monde’ Daniel Cottom argues that ‘Even writers concerned to puff the medicinal virtues of the waters would allow that the social life to be found at the spas, in promenades, and sightseeing and such, was no inconsiderable contribution to the process of the cures that might be found there.’ 2 Society was an important element of the holistic health benefits of the spas. This seems to me to be particularly relevant to sufferers of melancholy. When many puritans suffered from what was commonly termed ‘religious melancholy,’ Anglican ministers like John Langhorne (1735-79) argued that, amongst other causes such as too much prolonged study, their denial of music and lively enjoyments was partially to blame. In Letters on Religious Retirement, Melancholy and Enthusiasm, Langhorne writes,

[An] amiable person, about the age of nineteen, [...] had been induced by a maiden aunt to go several times to a conventicle. I observed her chearfulness abated, and imputed the change to want of health; till one evening, when I visited her, and, thinking to divert her melancholy humour, ventured to ask her for a song – She started at the proposal, and – ‘What,’ says she, ‘would you have me sing? enough has been given to vanity’ – ’Twas in vain that I represented to her, the innocence of such an amusement – in vain that I told her, it was necessary for the mind to suspend its attention, and vary its persuits. [...] At length her Melancholy affected her constitution; and she languished away in the bloom of life, a Sacrifice to FANATICISM.3

In contrast to puritan nonconformist sects, many Anglicans believed and strongly argued that society was a necessary part of a balanced lifestyle. Languishing in isolation or in ‘religious retirement’ could lead to a downward spiral of melancholy and declining health.

While Bath may have become a target for eighteenth-century satire as a place of dissolute behaviour and pompous fakery, it is interesting how the society nevertheless has the power to heal even the most cynical and virtuous of heroines. In Annick Cossic’s workshop, she spoke of how in Austen’s Persuasion, Anne Elliott’s features begin to revive and her beauty restore after many years of suffering from love melancholy and isolation from her family. Cossic argues that this is partially due to the social circles she becomes part of in Lyme Regis and Bath, before it is finally cured by the longed-for engagement with Captain Wentworth. 4

The same could be said of Burney’s Evelina. After a childhood spent in isolation is ended by her entrance into society in London, where she falls in love with Lord Orville, Evelina finds herself back at home, separated from her love under unfavourable terms, and removed from all of the lively enjoyments of London society. What ensues is a deep and affecting illness from love melancholy. Robert Burton had given a large section of his 1621 Anatomy of Melancholy to defining love melancholy as a recognized illness. Here Evelina suffers both mentally and physically from this unrequited love, hopelessness and isolation. The proposed cure is, not Bath with its more dissipated, overly indulgent social scene, which comes in for some severe criticism in the novel, but rather its smaller but conveniently close neighbour, Bristol Hotwell. No sooner does Evelina arrive in Bristol than she finds herself ‘already better [...] in regards to mere health’ though she has not yet even taken the waters.5 Then at the first sight of Lord Orville, despite not yet clearing up the confusion that led to her despair, she is

restored at once to spirits and tranquillity, is no longer sunk in her own opinion, nor discontented with the world; – no longer, with dejected eyes, sees the prospect of passing her future days in sadness, doubt, and suspicion! – with revived courage she now looks forward, and expects to meet with goodness, even among mankind.6

Although Evelina has been sent to Bristol for the waters, her ailment stems from isolation and unrequited love, and her cure is not from the waters of the spa, but rather from its society and the love she finds there.

Spas like Bath and Bristol Hotwell, and later seaside resorts such as Brighton, Margate and Lyme Regis, provided not only health and society, but also health through society for the characters of these novels. The fact that they were fashionable social centres should not detract from their impact as health resorts. The two are not mutually exclusive. Rather the combination of health and society in the spa towns could well be seen as a holistic approach to wellbeing.

Anita O’Connell

To listen to Professor Annick Cossic’s workshop on ‘Fashion and Illness in Georgian Bath’ or any of our other workshops, visit our ‘Podcasts’ page.

There will be more workshops, as well as a major conference, in 2014. Please continue to watch our website for more details:

Back to post 1. Phyllis Hembry, The English Spa, 1560-1815: A Social History (London: Continuum, 1989) p. 1-10.

Back to post 2. Daniel Cottom, ‘In the Bowels of the Novel: The Exchange of Fluids in the Beau Monde,’ NOVEL: A Forum on Fiction 32.2 (1999), p. 171.

Back to post 3. John Langhorne, Letters on Religious Retirement, Melancholy and Enthusiasm (1762) in David Walker and Anita O’Connell, eds, Volume One: Religious Writings, Depression and Melancholy, 1660-1800, gen. eds. Leigh Wetherall Dickson and Allan Ingram (London: Pickering and Chatto, 2012), p. 146-7.

Back to post 4. Annick Cossic, ‘Fashion and Illness in Georgian Bath,’ podcast from workshop on Fashionable Diseases, See Jane Austen, Persuasion, ed. James Kinsley, Oxford World’s Classics (Oxford: Oxford UP, 2004).

Back to post 5. Frances Burney, Evelina, or The History of a Young Lady’s Entrance into the World, ed. Edward A. Bloom, Oxford World’s Classics (Oxford: Oxford UP, 2002; 2008), p. 269.

Back to post 6. Burney, Evelina, p. 278.

Welcome to Fashionable Diseases Blog

As this is the first project blog, I thought I’d begin by saying ‘welcome’ to the project – I hope you’ll feel able to join in our discussions in some way, whether through the website, or at our various workshops and conferences. The second thing I’d like to do is to talk about where I got the idea of fashionable diseases, and what on earth that idea might mean.

The title’s easy enough – I work in eighteenth-century literary and cultural studies, and in 2003 I included, in an anthology of literature and science, a piece by a physician called James Makittrick Adair (1728–1801). His essay, first published in 1786, is called on fashionable disease’. At first it was published as part of a collection called Medical Cautions, for the Consideration of Invalids; those especially who resort to Bath, but later reprinted many times and even published as a freestanding volume. It’s obviously a catchy title, and had certainly caught my eye enough to want to publish it, not least because Adair was a popular high society doctor working at the fashionable resort of Bath, and had a lively style calculated to appeal to a general audience. Many medical texts in the eighteenth century were still written in Latin, so even to write in English was a popularizing move. Adair saw himself as an iconoclast, a truth-teller among the money-grabbing liars of the medical industry at the time.

Many people respond to such a title by thinking that fashionable disease must imply that the disease is not real – either faked, or imaginary, hypochondriacal in the modern sense of the term (in the eighteenth-century and before hypochondria was thought of as a real condition of the body, which affected the mind as a consequence. It was only later that the negative implications of hypochondria came to the fore). Adair certainly portrays some patients, particularly women, as being at least easily manipulated by the medical industry – ironically so, given that he ended up specializing in the diseases of Georgian women rather than criticizing them.

Adair talked about the way in which some diseases were apparently displaced by other ones. According to him (and other authors agreed), Spleen and Vapours gave way to the ‘nerves’, which in turn ceded to ‘bilious’ disorders (an unlikely fashion!). The diseases he invoked here were the kinds of disease that, although many took them extremely seriously and indeed many patients suffered greatly in their course, were often associated with the possibility of fakery. As Alexander Pope put it in the early eighteenth century, for fashionable women each new night dress could bring a new disease (so they could show off their fashionable clothing with ‘becoming woe’ while suitably draping themselves across a chaise longue).

But there are other ways of looking at the idea of fashionability in disease: in my book on consumption and literature, I discuss the way in which patients –bizarrely to us today- wanted to be consumptive in order to benefit from the disease’s long-standing associations with genius, creativity, beauty (in women) and piety. Melancholy was another condition that involved a great deal of genuine suffering, but also had the image (if not the reality) of a certain glamour. Could any poet of the late eighteenth century afford to be without at least a tinge of melancholia?

These are not the only meanings of ‘fashionable disease’, but my intention in this first blog is to scotch the idea that fashionable disease only has negative connotations. Historically, and even today, cultures generate – or at least shape – diseases that perform a certain type of function for people, and sometimes that function can be in some way positive. Fashionable disease is a complicated subject to say the least, and that is why we need this project.

Clark Lawlor