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