Introduction "An Exclusive Privilege … to Complain": Framing Fashionable Diseases in the Long Eighteenth Century

[A]s people of fashion claim an exclusive privilege of having always something to complain of; so the mutual communication of their ailments is often a topic of conversation; the imagination frequently suggests a similarity of disease, though none such really exists, and thus the term becomes soon completely fashionable.

—James M. Adair, "On Fashionable Diseases" (1812)

It was during the course of the long eighteenth century especially that British and European medical commentators drew critical attention to the novel, modish prominence of certain diseases. Practitioners who afforded conspicuous coverage to fashionable diseases ranged (most famously) from the respectable Bath physician James M. Adair (1728–1802) and the Lausanne doctor of sedentary and literary maladies Samuel Auguste Tissot (1728–97) to the rather more obscure Montpellier emigré, London-based quack M.D., Marmaduke Venel (fl. 1808–16).² Lay and medical observers alike had often before and have often since recognized how constructions of both illness and its treatment are profoundly colored by shifting fashions. Just as gout commonly took on the culturally- and rather gender-exclusive mantle of a "patrician malady" during the Georgian era,³ the manner and mode of melancholy became a somewhat cultish discourse for British writers and elite sufferers during the Elizabethan period.⁴ Victorian Britain scholars such as Lorna Duffin have stressed how middle- and upper-class women (the nervous and consumptive especially) were constructed as innately frail, delicate, and sick, requiring invalid care and bed rest, not activity and work.⁵ Similarly, for modern America, scholars such as Ann Wood controversially argue that it was in the nineteenth century that "ill health in women [nervous women in particular] had become positively fashionable and was exploited by its victims and practitioners as an advertisement of genteel sensibility and an escape from the too pressing demands of bedroom and kitchen."⁶ While this assessment rather crudely underplays fashionable nervousness in men and over-emphasizes the contrast with the eighteenth century, when "women … did not [routinely] talk of themselves as sick," it nonetheless echoes accounts offered by a number of leading scholars underlining the social construction of fashionable diseases in past societies.⁷

The persuasiveness of such interpretations of the meaning of disease has to some extent been challenged by subsequent generations of interdisciplinary critique.⁸ Inspired by and departing from earlier perspectives, for example, scholars such as Diane Herndl contend that the sickly, invalid woman emerged in nineteenth-century Britain (much more than coincidentally) at the very time that she "became a predominant literary figure," in part at least "because women's health was genuinely worse."⁹ In a broader study of European notions of melancholy, Jennifer Radden, meanwhile, has elucidated the tensions, if not incompatibilities, between historical and contemporary accounts framing melancholic illness. Radden points to the contradictions pervasive in cultural representations of melancholy and depression, which are depicted both as replete with values and meaning, and integral to selfhood, and also as alienating to, and compromising of, the self (a trope often found in "recovery" or "survivor" oriented illness narratives).¹⁰ Analysts who focus on later twentieth- and twenty-first-century clinical contexts, meanwhile, have repeatedly revisited the link between fashion and medicine, debating in particular how influential fashions in medicine and health care have been on recent diagnostic, therapeutic, commercial, and medical research trends—and even patient/community behavior—with respect to conditions like fibromyalgia, multiple chemical sensitivities, reactive hypoglycemia, ASD (Autism Spectrum Disorders) and ME/CFS (Myalgic Encephalopathy/Chronic Fatigue Syndrome). Other researchers have highlighted the psychogenic character of such conditions, the typical lack of relation in their symptoms to distinct physiological systems, the range of vague somatic expressions associated with them, and their strong dependency on shifting historical and cultural factors.¹¹ These studies likewise point to how the fashionability of such conditions and syndromes was fundamentally reflected in how fluid their clinically accepted definitions were over time. Other provocative recent studies, for example by Tuzikow and Holburn, have sought to explicate and to critique the genesis and actual basis of "fad...