Friday, December 9, 2022

‘Hypochondriac’ Charles Dickens developed at least 20 health conditions, doctor finds

Charles Dickens was a hypochondriac whose preoccupation with his own health failed to offset the effects of a “fast” life of overwork, stress, long-distance travel and indulgences.

That is according to a historian and retired GP who has written the first comprehensive study of the Victorian novelist’s medical history, describing 20 conditions and illnesses from which he suffered, from gout and gonorrhoea to obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).

Dr Nicholas Cambridge, who will give a free talk on his findings tomorrow, October 15, at the Charles Dickens Museum in London, said Dickens’ daily regime of brisk walks kept him fit during his younger years, boosted his mental wellbeing — and his story-plotting — and ensured that he was never overweight. It was not uncommon for Dickens to walk 20 or 30 miles, sometimes through the dead of night, and he was also a keen swimmer when he had the opportunity. Moreover, Dickens was not prone to ignore his maladies and consulted leading medical specialists while confiding in friends on matters from venereal disease to his anal fistula.

Charles Dickens as a young man, portrait painting in oil on canvas by Daniel Maclise, 1839. Photo: Alamy

Nevertheless, these relatively enlightened measures could not undo the effects of gruelling hours, strained family relationships and the cigars, port and rich food that he relied upon to unwind. These all contributed to the rapid ageing that is obvious from comparisons of portraits of Dickens in his 30s and 50s, and ultimately hastened his death from a stroke aged 58 in 1870. In addition, many of the treatments that Dickens turned to for his ailments would not be recommended today, including his prolific use of laudanum, a tincture of opium mixed with wine or water.

In spite of Dickens’ genuine illnesses, Cambridge said the fixation with his health evidenced in his 14,000 extant letters points to hypochondria.

He added: “He obviously tried to maintain a healthy lifestyle. He had his daily shower bath, he drank cold water morning and night, and used to go on long walks. On occasion he walked 30 miles from his home at Tavistock House in London all the way to Gad’s Hill in Kent in time for breakfast. But he also wrote his 15 novels, was editing two journals and went on demanding reading tours, both in America and over here. In fact, his ritualistic domestic routine and obsessive approach to work are consistent with him having had OCD. 

“Then, of course, he had a very demanding family. His parents wanted him to bail them out financially, his siblings and children as well. So, I think the stress and strain really took their toll. And he enjoyed a drink and smoking cigars, and clubbing — he was a member of the Garrick Club on a number of occasions. He really lived in the fast lane.”

In one letter to his wine merchant, cited by Cambridge, Dickens wrote: “The Port is excellent, and I shall be glad to take 6 dozen [bottles].” The port, along with the shellfish and mutton chops that Dickens consumed regularly, would have contributed to the gout that Cambridge said that Dickens always remained in denial about.

Cambridge said the most controversial details in his book, Bleak Health, which “upset” some people, concerned a sexually transmitted disease. He believes Dickens was suffering from gonorrhoea in 1859, after his separation from his wife Catherine the previous year. 

“On occasion he walked 30 miles from London all the way to Gad’s Hill in Kent in time for breakfast”

Dr Nicholas Cambridge

At this time, Dickens wrote to his friend and doctor Frank Beard: “My bachelor state has engendered a small malady on which I want to see you.” In a letter to novelist Wilkie Collins, he hinted that he was being treated with silver nitrate, which was injected in solution into the urethra to relieve the symptom of gonorrhoea whereby urination feels like passing shards of glass. Promising to try to visit Collins at the seaside resort of Broadstairs, Dickens joked: “Perhaps a tumble in the sea might — but I suppose there is no nitrate of Silver in the Ocean?”

Cambridge speculates that Dickens — whose books highlighted the dangers of the sex trade and who co-founded a home for “fallen women” — may have caught the disease from one of the many prostitutes who plied their trade in Covent Garden, where he often stayed above the offices of the journal All Year Round.

Dickens had learnt the cost of inaction from his father. Cambridge and his colleague Jonathan Goddard discovered that John Dickens also suffered from gonorrhoea and died from complications of the disease after ignoring the symptoms when treatment could have proved effective. They found John’s illness described as the case of “Mr D — a 65-year-old rather stout gentleman” in a book on diseases of the urethra by the London surgeon Robert Wade who had treated him. In a letter the day of John’s death, Charles Dickens wrote: “He had kept his real malady so profoundly secret, that when he did disclose it his state was most alarmingly advanced towards the sad end.”

Nancy swooning, an illustration by George Cruikshank for Dickens’ Oliver Twist. Dickens stated in the preface to one of the book’s editions that Nancy was a prostitute. Image: public domain, via Wikimedia Commons

In a letter sent on the day of his father’s death, Charles Dickens wrote: “He had kept his real malady so profoundly secret, that when he did disclose it his state was most alarmingly advanced towards the sad end.”

Among Cambridge’s own discoveries, he infers that Dickens almost certainly suffered from carbon monoxide poisoning on two visits to the United States. On his second visit for five months, he went on a demanding tour, giving 76 readings. He travelled long distances in unventilated railway carriages heated by stoves that burnt charcoal or anthracite coal. His symptoms included a persistent catarrh, headaches, poor sleep, loss of appetite, hair loss and lethargy. Towards the end of his tour, he adopted a largely liquid diet, including spoonfuls of rum and cream for breakfast and a pint of champagne around 3pm. Fortunately for the novelist, the damage was not lasting and he recovered on his voyage home.

A rail journey in England had more profound consequences. In 1865, he was returning from Paris by train with his mistress Ellen Ternan and her mother when their train derailed near Staplehurst in Kent. Dickens was in the only first class coach that did not tumble into a ravine, but was instead left dangling off a bridge at a steep angle. Ten people were killed and around 50 injured. Dickens tended to some of the dying. While he told Dr Beard the next day that he was “scarcely shaken”, his symptoms included a feeble pulse and he reported that he was “unfit for noise and worry”. Dickens also lost his voice for two weeks. He was wracked by nerves when travelling by express train thereafter and Cambridge believes he was suffering from PTSD.

The aftermath of the Staplehurst rail disasater, depicted in the Illustrated London News. Image: public domain, via Wikimedia Commons

Perhaps Dickens’ most painful condition was the trigeminal neuralgia that he called “rheumatism of the face”. He suffered at least ten episodes, which he described as “insupportable torture” affecting one side of the face. Even when dosed with laudanum, these attacks could put Dickens out of action for some time, causing him to “run away” to the seaside to recover. One of the earliest episodes may even have changed literary history by preventing the 20-year-old Dickens from attending a theatre audition.

While Dickens’ interest in medical matters did not bring him a long or comfortable life, Cambridge said that, by writing movingly of the plight of poor people in his novels and journals, he created pressure for public health measures that ultimately contributed hugely to the wellbeing of others. His illnesses, and those of his family, being documented in such detail, also shed light on health in Victorian Britain more widely.

Cambridge’s talk tomorrow (October 15) is at 48 Doughty Street, Dickens’ London home from 1837 to 1839. It will start at 1pm and includes a book signing.

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