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Neil Vickers. Coleridge and the Doctors, 1795-1806

Michael John KOOY
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Neil VICKERS. Coleridge and the Doctors, 1795-1806. Oxford University Press, 2004, 186 pp., €72.33, ISBN 0199271178.

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1Coleridge’s medical case is, to say the least, interesting. Not only did he think he suffered from a range of complex diseases, often at the same time – gout, scrofula and epilepsy among them – but he also treated himself with very different remedies, from walking and special diets (“I sacredly abstain from Tea, which turns acid in my stomach”) to “wonder” drugs, the most wonderful of course being none other than opium itself. On top of this, he commented on his health profusely in his letters and notebooks, analysing his symptoms, recording the treatments, and despairing. This combination of disease, self-diagnosis and commentary makes Coleridge a prime subject for medical historians, not least because it lasted so long. Coleridge’s health broke down in 1801, more or less permanently: he was 29 (three years older than Keats when tuberculosis carried him off) and he lived to be 62. But it’s the breaking down of his health in the years 1800-3 that is most interesting, partly because in this period that Coleridge began to take opium in large and regular quantities, and partly because his notes on his own case are most extensive and variegated.

2Most of the commentaries on Coleridge’s health have taken opium as their starting point. Elizabeth Schneider, Alethea Hayter and Molly Lefebure, to name but a few, have tracked the course of the addiction with a mixture of fascination and moral revulsion (a staple feature of Coleridge’s reception since the mid-nineteenth century). Many commentators inevitably grow impatient with their subject’s evasions, denials and characteristic self-loathing.

3Neil Vickers, by contrast, begins not with the treatment but with the diseases, and manages to turn the whole story on its head. Focusing on those crisis years between 1800 and 1803, he asks: what disease or diseases did Coleridge suppose he was suffering from? How did he treat himself? And what justification was there in contemporary medical writing for his self-diagnoses and treatment regimes? It’s not just these questions (more about them in a moment) but the approach to answering them that makes this book distinctive. Vickers refuses to draw on modern medical terminology and historiography – that would be anachronistic – and so addiction theory, psychoanalysis and Foucault all fall by the wayside (and, along with them, a number of recent triumphalist accounts of Romantic materialism, for which Vickers has very little time). Instead he turns first to Coleridge’s notebooks and letters themselves, which he delves for their ruminations on disease, and then to the eighteenth-century medical treatises which Coleridge likely had read, by John Brown (controversial founder of Brunonian medicine), Erasmus Darwin, Thomas Beddoes, William Cullen, Andreas Röschlaub, Samuel Crumpe, and a Swiss aristocrat by the name of K. W. L. Von Drais. Nearly all of these have been forgotten ever since mechanistic models of human health and disease began to dominate allopathic medicine (though they retain a power both to describe disease and to address the mind-body problem which far surpasses that found in any twentieth-century medical textbook). Reading Coleridge with these texts in mind brings important results. More often than not, the apparently rhetorical turn of phrase in Coleridge’s medical notes and letters, which seems so suspect to us today – Coleridge once excused his poor productivity by saying that he suffered from a “disease in voluntary power” (a likely story!) – turns out to have medical authority squarely behind it (in this case, Erasmus Darwin’s notion of “volition”). Vickers carefully teases out the nuances of such words and phrases against a complex background of medical controversy and public debate, and the result is a new picture of Coleridge: not a pathetic drug addict, but a stoical, if quixotic, ill man.

4On opium itself Vickers is quite explicit. Drawing on contemporary medical treatises, he shows beyond doubt that medical opinion broadly favoured the use of laudanum (opium mixed with wine or spirits) to treat the gout Coleridge supposed he was suffering from. And though there was some concern over possible unwelcome effects, such as stomach pains and (for some) drunkenness, these needed to be weighed against the severity of the complaints themselves. Doctors who expressed strongest reservations about the use of opium tended to be humoralists (practitioners of increasingly discredited Galenic medicine), and these, as luck would have it, exerted no attraction on Coleridge in the 1790s. Among all medical men there was virtually no awareness of the addictive qualities of the drug, and no theory of addiction. Vickers shows that, in fact, the leading point of controversy about opium was not its danger but its character – was it a stimulant or a narcotic? Here is a case in point where the complexities of contemporary medical theory bear importantly on changes in Coleridge’s understanding of his own condition. Until about 1803, Coleridge followed Darwin and Beddoes, both Brunonians, in thinking of opium as a stimulant: it allowed one to draw on reserves of “vitality” that would otherwise be used up later in life. But later that year and into 1804 he became increasingly convinced that his main stomach complaint was psychically caused, and began to doubt the validity of Brunonian theory. Now it was a question of getting control of his thoughts, and his nightmares, in order to “treat” his symptom. At the same time, mysteriously to him, he was finding it difficult to throw off the opium. Could it be having a narcotic effect, as some medical writers claimed (and which is just what he needed)? By 1807 Coleridge was no longer calling opium a stimulant but a narcotic. What appears, then, to be an opportunistic change of mind turns out to be a switch of allegiance from one side to another in a contemporary medical debate.

5But for Vickers opium is only one part of a much larger and more interesting story: Coleridge’s complex accounting for his various diseases. Misdiagnosis was the norm. When in 1800 Coleridge took opium to treat his rheumatic fever, the result was stomach pain, which he took to be a change in the disease (rather than a consequence of the way he was trying to treat it, which in fact it was). Coleridge thought during these crisis years that he was suffering from a number of distinct, though related conditions. First, in 1801, from atonic, irregular gout (a disease of the joints which in exceptional cases attacked the stomach); this had developed from the rheumatic fever of the previous year. He treated this by, among other things, walking (Thomas Sydenham had prescribed this cure in the belief that this forced the gouty material out of the extremities). In addition Coleridge reported suffering from an impaired nervous system, which had been weakened by his “abstruse Researches” carried out on behalf of Tom Wedgwood. Later the same year he detected symptoms of scrofula (tuberculosis of the lymph glands), swayed in part by Beddoes’s view that this condition tended to develop in those who had eaten poorly in childhood and were troubled by misfortune. Then, in 1802-3, he started having occasional seizures by day and, more frequently, nightmares by night – symptoms, respectively, of hysteria and epilepsy, according to Erasmus Darwin. Darwin’s aetiology of the disease, which Coleridge took quite seriously, is worth recalling. Darwin held that all ideas have a material counterpart which remains circulating in the body; these are held in check by what he called “volition”, but only during the waking state. In sleep they circulate freely and in fact tend to accumulate in places like the stomach. In these circumstances, the “volition” intervenes when it can to set them circulating again, but sometimes disproportionately, and the result is a seizure. Coleridge thought his nightmares were a symptom of deficient “volition”.

6It should be plain from the examples I’ve just cited that Coleridge is, true to form, in two minds about things. To account for his scrofula he appeals to Beddoes’s mentalist hypothesis (disease is caused by states of mind and feeling, and can be treated by the same means), while to explain his epilepsy he refers to Darwin’s (albeit rather fanciful) materialism. For Vickers this isn’t just more evidence of Coleridge’s essential undecidibility, but an indication of a sincere attempt to grapple with a debate in the medical culture about which paradigm is more credible. His study begins with a survey of eighteenth-century medicine, whose prime characteristic is precisely this absence of consensus about the mind-body relation. Brunonians, who see disease as symptoms of systemic disbalance which can be rectified by introducing stimulants or narcotics, battle with modern day humoralists, who see the body as its own best medicine. Vickers is an excellent guide both to these debates and to Coleridge changing position in relation to them. His analysis is specialist but never purely technical, and in any case necessary. His point about Coleridge’s idealism can’t be made often enough: that it developed not out of a rejection of the material but as a way more fully to account for it.

7There are unexpected resonances of Coleridge’s medical reflections outside his notebooks and letters: in poems like “The Pains in Sleep” and “Dejection: An Ode”, and also in his poetic projects like the “Consolations and Comforts”, which would eventually become The Friend. Vickers offers suggestive readings of these texts. Rather than reading them for evidence of Coleridge’s medical condition, he sees them as working out the poet’s medical preoccupations. He also connects medicine to Coleridge’s theory of the imagination (controversially, in contrast to John Beer, Vickers sees the imagination as connected to the “vital” rather than to the “organic”), and to the theory of “double touch” (there is an excellent, clear discussion of this knotty subject in the last chapter). Altogether Vicker’s book is an erudite, elegantly written and utterly compelling re-assessment of Coleridge’s illnesses, an indispensable contribution to our knowledge of the poet and the period.

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Michael John KOOY, « Neil Vickers. Coleridge and the Doctors, 1795-1806 », E-rea [En ligne], 3.2 | 2005, document 8, mis en ligne le 15 octobre 2005, consulté le 21 juin 2018. URL :

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Michael John KOOY

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