The Sickening Mind: Brain, Behaviour, Immunity and Disease. Paul Martin

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СКАЧАТЬ all. In a fit of anguish and shame she flees to a convent, locks herself away and announces that she will not leave until she is dead. Her health rapidly deteriorates:

      A burning fever, violent and almost continual delirium, an unquenchable thirst … The doctors say they are as yet unable to diagnose … As long as she is so deeply affected, I have scarcely any hope. The body is not easily restored to health when the spirit is so disturbed.

      The wretched Madame de Tourvel dies, destroyed by her grief and shame. No physical agent, other than Valmont, has intervened.

      Fate, however, wreaks its just revenge on the perfidious Vicomte de Valmont and Madame de Merteuil. Valmont is fatally injured in a duel. Soon afterwards, the correspondence of Valmont and Merteuil, detailing their devilish seductions, is revealed and becomes the topic of widespread gossip. Madame de Merteuil is publicly humiliated, and one day later is afflicted by a virulent attack of smallpox which leaves her horribly disfigured and blind in one eye.

      Another victim of physical decline brought on by seduction and shame is the eponymous heroine of Samuel Richardson’s eighteenth-century blockbuster Clarissa. (At over a million words, it is also the longest novel in the English language.) Clarissa, a young lady of refined sensibilities, is seduced and raped by a superficially charming but unscrupulous bounder. Naturally – for this is eighteenth-century England – the dishonoured Clarissa is rejected and ostracized by her family and society. As her mental state declines, so does her physical health. Clarissa retreats into solitude and dies from grief and shame. Once again, a character’s psychological and emotional state has been the prime cause of her death.

      There are of course innumerable other examples, all making similar points about the impact of emotions on health.³ We shall encounter a number of these in later chapters, and I hope it will be apparent that the notions they portray do bear some relationship to the reality revealed by modern science. However, at the risk of repeating myself, let me repeat myself: the fantasies of novelists are not the same as hard scientific evidence. Fortunately, there is plenty of that as well.

Invisible worms

       O Rose, thou art sick.

       The invisible worm

       That flies in the night

       In the howling storm,

      

       Has found out thy bed

       Of crimson joy,

       And his dark secret love

       Does thy life destroy.

       William Blake, ‘The Sick Rose’,

      Songs of Experience (1794)

      The sharp divide between those who proffer psychological explanations for diseases and those who reject such theories in favour of purely physical causes is reflected in attitudes towards two particular disorders: tuberculosis and chronic fatigue syndrome.

      Sir Peter Medawar, the Nobel Prize-winning immunologist and virtuoso science writer, once described tuberculosis as ‘an affliction in which a psychosomatic element is admitted even by those who contemptuously dismiss it in the context of any other ailment.’ There is abundant evidence, dating back hundreds of years, that the course and progression of tuberculosis are influenced by the sufferer’s mental state. The physical health of tuberculosis sufferers shows a tendency to deteriorate when they are subjected to severe stress or emotional upsets.

      Someone who is infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis, develops a protective immune response which can hold the bacteria in check and prevent them from multiplying. The resulting stalemate between body and bacteria can mean that the disease will remain dormant for years. But if something happens to compromise or weaken the body’s immune defences, the bacteria can run riot and cause a resurgence of disease.

      The importance of psychological factors in tuberculosis was widely acknowledged until well into this century. As early as 1500 BC, Hindu scripts described a wasting disease – almost certainly tuberculosis – of which one of the main causes was said to be sadness. Hippocrates, Galen and other medical luminaries of ancient Greece taught that grief, anger and other strong emotions played a major role in tuberculosis.

      Throughout the seventeenth, eighteenth and nineteenth centuries many eminent European physicians stated that the causes of tuberculosis (or phthisis, as it was then known) included mental states such as ‘a long and grievous passion of the mind’, ‘a mournful disposition of the soul’, ‘ungratified desires’, ‘profound melancholy passions’ or ‘disappointment in love’. During the eighteenth and nineteenth centuries, students of tuberculosis refined the theory of a link between the disease and a specific set of psychological characteristics. This was formalized in the concept of the tuberculosis-prone personality, or spes phthisica. As we shall see later, modern science has revived the concept of disease-prone personality types with the discovery of certain intriguing associations between personality traits, heart disease and cancer.

      More familiarly, we have the romantic nineteenth-century notion that consumption (as tuberculosis was then known) is caused – or, more accurately, exacerbated – by an artistic temperament. Consumptive artists or writers were believed to be consumptive primarily because of their excessive artistic and aesthetic emotions, which literally consumed them. Consumption came to be something of a status symbol among the chattering classes.

      Countless noted writers, artists and musicians of the nineteenth and early twentieth centuries did indeed suffer from consumption. Emily Brontë is but one example. She died of tuberculosis, a bitterly disappointed woman, within a year of Wuthering Heights being published to withering reviews. Other creative victims of tuberculosis included John Keats, Frédéric Chopin, Robert Louis Stevenson, Stephen Crane, Katherine Mansfield, Robert Tressell, D. H. Lawrence, George Orwell and Franz Kafka. It is said that Kafka’s health was weakened by his chronic unhappiness, his hypersensitive personality, his problematic relationship with his father and several unfortunate romantic tangles. He died in an Austrian sanatorium in 1924, aged forty-one.

      On the other hand, tuberculosis accounted for more than one in five of all deaths in the nineteenth century and was still common in Europe until well into this century. On statistical grounds it is hardly surprising that at least some prominent names were included among its victims.

      The fiction of the eighteenth and nineteenth centuries reflects this preoccupation with tuberculosis and the prevailing attitudes towards it. We can choose from a panoply of heroes and heroines who sink into tubercular decline in the aftermath of romantic tragedy. We have, for example, the ever popular tale of La Dame aux Camélias, Alexandre Dumas the younger’s tear-jerker about the passionate but doomed love affair between Armand Duval and the enchanting courtesan Marguerite Gautier.

      The young Duval meets Marguerite and is captivated by her. They become lovers. Marguerite is already consumptive, but under the healing influence of Armand’s love she abandons her dissolute lifestyle and her health improves. Meanwhile, Armand’s well-meaning father secretly persuades Marguerite that if she truly loves Armand she will leave him for his own good. Marguerite demonstrates her love for Armand by doing just that.

      The cynical Armand thinks Marguerite has abandoned him out of boredom so that she can resume her former life of late nights, promiscuity and wild СКАЧАТЬ