Bitter Honey: Recuperating the Medical and Scientific Context of Bernard Mandeville by Phillip Hilton (review)

Mandeville (?1670–1733), was born and educated in the Netherlands, and migrated to England in the 1690s, where he practiced medicine in London. Like many practitioners, he never bothered to obtain the license of the London College of Physicians and therefore endured occasional prosecution from that body. His medical specialty, which he practiced throughout his career, was nervous diseases.

His Fable of the Bees, or, Private Vices, Publick Benefits, first published in 1714, became one of the most famous and influential works of moral and political philosophy of the century. In Mandeville’s view, vice and success were necessarily joined, and the passions rather than reason governed human nature.

But Mandeville also wrote about medicine. Mr. Hilton’s Bitter Honey, based on his 1999 Ph.D. dissertation at the University of New South Wales, seeks to place Mandeville in his scientific and medical context rather than the more usual political and literary one. He looks in particular at Mandeville’s 1711 Treatise of the Hypochondriack and Hysterick Passions, later revised as A Treatise of Hypochondriack and Hysterick Diseases (1730). Mr. Hilton has two goals: one is to find Mandeville’s scientific and medical influences, and the other is to detail Mandeville’s particular therapeutic ideas, which include the uses of satire to treat depression.

Mr. Hilton knows the secondary literature on Mandeville but less so the history of science and medicine. Unfortunately he did not update his bibliography; there are no references later than 1999, meaning that he misses relevant works on medicine and nervous disorders, including my own work on George Cheyne.

Mr. Hilton focuses on Mandeville’s four main medical influences: Thomas Willis, Locke, Thomas Sydenham, and Georgio Baglivi. He presents Willis as a mechanist and particularly an atomist, following Pierre Gassendi, and explains the ideas that led to Willis’s account of mental illness in his Two Discourses Concerning the Soul of Brutes. I would like to have seen something on the influence of the French physician Marin Cureau de la Chambre here, who wrote largely on questions of mind, body, and soul from the 1640s to the 1660s. Mr. Hilton interestingly connects Mandeville with the work of physician and early economist Nicholas Barbon (not, as we might think, a Frenchman but son of the parliamentarian Praisegod Barbon or Barebone). Both Barbon and Willis employed the Epicurean philosophy elaborated by Gassendi to argue for the primacy of appetites in human behavior.

A physician trained under Willis, Locke followed his teacher’s psychology. The neo-Hippocratic physician Sydenham does not fit into this Epicurean lineage; he was, instead, a Baconian empiricist whose influence lay in his emphasis on exact description and his skepticism about hypotheses. The Italian physician Giorgio Baglivi (1668–1707) put together these diverse influences in his popular textbook De praxi medica (translated into English as The Practice of Physick, 1704). Baglivi believed that observation was the critical function of a successful physician and indeed of a successful individual. But, following Willis’s mechanical model of the body, excessive external stimuli could lead the body to the disordered state of mental illness. Baglivi, says Mr. Hilton, believed that the physician might use any number of rhetorical and artistic skills to manipulate the patient’s imagination and therefore effect a cure.

Mr. Hilton uses the revised 1730 edition of Mandeville’s Treatise. The reader is immediately plunged into this work without much background other than that it consists of three dialogues among a physician, a husband, and a wife. With some reason, Mr. Hilton closely identifies the physician, Philopirio, with Mandeville, noting similarities in biography. Much of his discussion then focuses on what the Treatise reveals about Mandeville himself; we do not get back to Willis et al. for many pages. Rather we get interesting glimpses of Mandeville as a cynic, a Manichaean, and a Gnostic, but I began to lose track of where the book was going...