Charles Darwin suffered from terrible flatulence, varying from "slight" to "considerable", "baddish", "sharp" and, on bad days, "excessive". We know this because he kept meticulous records of his bodily state. The pianist Glenn Gould (another flatulence sufferer) also generated "voluminous archives of his symptoms", from blood-pressure statistics to pulse rates.
Hypochondriasis, Brian Dillon tells us in this ingenious and intriguing book, is characterised by an intense scrutiny of the body. We should all listen to our bodies, of course, but the nine people examined here were hypersensitive, possessing a heightened awareness of having a body and of being embodied in the world.
Dillon accepts that hypochondria is to some extent a chimerical illness, but there are enough similarities and convergences to just about string these disparate lives together, although clearly Daniel Paul Schreber – who experienced "divine miracles" and was convinced that he was turning into a woman – was insane. As Dillon observes, there is something rather impressive about Schreber's delusions and "the prodigious unreality of the mental world he inhabited", although in his classic 1911 case study, Sigmund Freud saw only a paranoiac who could not admit his homosexuality.
In Tormented Hope Dillon looks beyond the comic stereotype of the hypochondriac to the tragicomic reality. He also makes a strong case for there being a link between "health anxiety" and creativity, following the philosopher Gilles Deleuze's observation that many great artists have frail health, the idea of the writer or artist being simultaneously the médecin and the malade of a civilisation. Charlotte Brontë's hypochondria, he shows, was displaced on to Lucy Snowe or Jane Eyre, and Proust's was an essential aspect of his art. Dillon is a self-confessed hypochondriac and his conclusion that "the power of imagination . . . is in itself a kind of pathology" has profound implications for literature.
A major theme here is seclusion or, more accurately, reclusion. Darwin was a semi-invalid for much of his adult life, although the nature of his malady remains a mystery. His debility had its advantages: "It meant that he could retreat from the world," says Dillon, "the better to pursue his scientific inquiries." Florence Nightingale's illness was similarly undiagnosed, but like many Victorian women she probably welcomed a stay in the sickroom: "The invalid fled into an interior world, a kind of secret garden from which she had so far been barred by convention."
In her essay "On Being Ill" Virginia Woolf wondered why the sickbed has not been among "the prime themes of literature", and indeed, as Dillon shows us, Marcel Proust's bed was "a well-provisioned craft in which he set sail on a darkened ocean" (a far cry from Heinrich Heine's Matratzengruft or "mattress-grave").
A morbid fear of illness often conceals a fear of death. "A Hypochondriack fancies himself at different times suffering death in all the various ways in which it has been observed," wrote James Boswell, "and thus he dies many times before his death." An exception to this is Alice James (Henry James's sister), who was perversely happy at being told she had breast cancer because her "career as an invalid" had reached its apotheosis.
Dillon quotes from a 17th-century thesis which observes that hypochondriacs can suffer spasms as a result of "sudden Outcry, or the very opening of a Door". When Andy Warhol's silver wig was snatched from his head at a book signing, he complained that "It hurt. Physically." A more extreme example is Gould's response to being patted on the shoulder by a Steinway employee in 1959. He recoiled, muttering: "Don't do that; I don't like to be touched," and later claimed that this incident had resulted in a problem with his left hand. It was the excuse he needed to withdraw from public performances, and his recording studio, like Proust's bedroom, became a refuge, "a technological cocoon that finally satisfied his urge to separate himself physically from his public".
Warhol's obsession with his red nose is reminiscent of another of Freud's famous patients, the so-called Wolf Man, who became convinced that his nose had been disfigured by electrolysis. The problem that hypochondriacs wrestle with on a daily basis, according to Dillon, is the imperfectability of the body. They unreasonably expect their bodies to be perfect (and in Warhol's case, unattainably beautiful) and are disturbed when they don't match this ideal. "The hypochondriac's historical mistake is to imagine a condition of bodily being that is physically and psychically null or neutral, a state of simultaneous (therefore impossible) vigour and inertia." They seek the achieved body, but our bodies are dynamic systems susceptible to decay.