Coleridge and the Doctors, 1795-1806 (review)

Samuel Taylor Coleridge's understanding of medical diagnosis, and of his own pattern of illness, was, according to Neil Vickers's impressive book, both complex and, in terms of Coleridge's characteristic modes of thought, typical. One particular characteristic, Vickers argues, was "not to choose between two overlapping but distinct medical hypotheses but to adhere to both at the same time with varying degrees of conviction" (p. 162), so that the "diagnoses of gout and scrofula," which were the abiding conditions, as Coleridge believed, of his life, "enabled him to entertain two mutually antagonistic theories without considering the conflict between them" (p. 162). Thus, gout "was a vehicle for quasi-materialist speculations about the relationship between physical infirmity and mental disturbance," while scrofula "was synonymous in his thinking with medical mentalism" (p. 162). Here, says Vickers, was the unsettled contradiction that underlay his deep and active interest in medical philosophy while also underpinning the relations between Coleridge the thinker, Coleridge the man, and Coleridge the patient. It is a contradiction, and indeed a relationship, that is fundamental to understanding Coleridge alongside the many medical men with whom he maintained friendships or had dealings, or whose works he read. These included many of the most prominent medical figures of his day, as well as writers from the classical period and, especially, from the eighteenth century. Here Vickers is particularly interested in, and argues convincingly for the significance of, the influences of Thomas Beddoes, Erasmus Darwin, and John Brown, as well as less-known figures such as Samuel Crumpe.

Perhaps no other English writer has paid such dedicated attention to his own illnesses as Coleridge, nor drawn such far-reaching significance from them. There were the gout and the scrofula, but also, from around 1801, his belief that he had epilepsy; and increasingly, of course, there were the accumulating symptoms of prolonged opium use. But here, says Vickers, the symptoms were everything: there was no contemporary concept of opium addiction, though there was, clearly, evidence of the effects of repeated consumption. Coleridge, however, "seems to have believed that the severity of his infirmities was such that the risk to his health of not taking opiates was greater than any of the risks" incurred by continued use (p. 95), including the social risk of being taken for a habitual drunkard—an "absolute nuisance" and a "rotten drunkard," as Wordsworth is reported to have told their mutual friend Basil Montague (p. 100). In a fascinatingly detailed narrative, Vickers then develops Coleridge as an opium user reading as many authorities as he can, observing minutely both the amounts taken and the effects on himself, and suffering the consequences in terms of physical well-being, social relations, and self-esteem. Given the drying-up of his poetic creativity, there is also a story to tell, from a medical perspective, about the pattern of opium use and his conviction of illness in relation to poetry, and indeed the absence of poetry, from a man more than usually intelligent, self-aware, and self-deluding. The final chapters of the book address "dejection" and "the pains of sleep" from this point of view.

Some books close down the subjects they explore: they spare others the trouble of revisiting the subject for the next half-century. But some, like this one, open avenues. Not only is a wealth of medical and contemporary interpretive detail gathered here into a coherent account, but the potential of the material is fully evident and capable of rich expansion. As Vickers puts it, "Coleridge's extraordinary ability to bring ideas from widely different domains into fruitful dialogue with one another constitutes one of the most exciting things about his thought" (p. 166). In terms of the historical relationship between contemporary medical knowledge and creative thought, the story is just beginning.