Today I have the lovely Maria Grace in my Georgian parlour, talking about a subject close to my heart: nerves. We all remember Jane Austen’s Mrs Bennet and her whimsical illnesses, but what of those who suffered genuine problems? What were the treatments available and how were they viewed at the time?
It’s interesting to see from Maria’s article that some modern day stereotypes date back to the early nineteenth century. It seems some doctors considered those affected by panic attacks to blame – they were “indolent” and didn’t go out in “cheerful company” enough. How infuriating!
Take it away, Maria.
The fine sensibility prized by women in the 18th century gave rise to an epidemic of nervous disorders in the early 19th century. Maladies of affluence and sophistication, nervous disorders paraded one’s wealth, refinement and sensibility. Women were particularly susceptible to nervous because of their ‘more delicate physiological network’. In fact, ‘Nerves’ were a woman’s claim to superior social status, the mark of being a lady.
The wealthy and indolent were not the only suffers though. Given that during the early 19th century people lived in a world where a small ache or upset stomach could be the harbinger of something far worse, or even fatal, it is not really surprising that hysterical diseases, hypochondria and melancholy—what we would call depression—were prevalent, especially when legitimized as disorders by respected doctors.
While doctors agreed that they existed, “there’s no Disease puzzled Physicians more than the Vapours, and Hysterick Fits. These complaints are produced by so many Causes, and appear in so many various Shares, that ’tis no easy Matter to describe them.” (Tennet) “The Annual Review” said that after doctors started taking nervous disorders seriously, everyone was taking medication for them, outdoing each other with exaggerated symptoms and buying an array of medical equipment to deal with them. How strangely 21st century it all sounds.
Symptoms and Types of Nervous conditions
According to William Buchan in his book Domestic Medicine, 1790, “Of all diseases incident to mankind, those of the nervous kind are the most complicated and difficult to cure. A volume would not be sufficient to point out their various appearances. They imitate almost every disease; and are seldom alike in two different persons, or even in the same person at different times. Proteus-like, they are continually changing shape; and upon every fresh attack, the patient thinks he feels symptoms which he never experienced before. Nor do they only affect the body; the mind likewise suffers, and is often thereby rendered extremely weak and peevish.”
The symptoms of nervous disorders were often thought to begin in the stomach which was thought to be the center of the nervous system. Buchan suggested, “They generally begin with windy inflations or distensions of the stomach and intestines, the appetite and digestion are usually bad; yet sometimes there is an uncommon craving for food, and a quick digestion. The food often turns sour on the stomach; and the patient is troubled with vomiting of clear water, tough phlegm, or a blackish colored liquor resembling the grounds of coffee. Excruciating pains are often felt about the navel, attended with a rumbling or murmuring noise in the bowels.”
These symptoms might be accompanied by difficulty breathing; violent palpitations of the heart, sudden flushes or a sense of cold in various parts of the body, pains throughout the body, variable pulse, fits of crying and convulsive laughing, poor sleep and night-mares.
Progression of the disease would bring headaches, body cramps, mental disturbances including terror, sadness, weak memory and failure of judgment. “Nothing is more characteristic of this disease than constant dread of death. This renders those unhappy persons who labour under it peevish, fickle, impatient, and apt to run from one physician to another; which is one reason why they seldom reap any benefit from medicine, as they have not sufficient resolution to persist in any one course till it has time to produce its proper effects.” (Buchan)
By the beginning of the 19th century, hysteria was no longer attributed to a wandering womb, but the nervous system. Other forms of nervous conditions were also recognized including: melancholy, nightmare, swoons, low spirits, hysteric affections and hypochondriac affections.
Causes of Nervous Disorders
Doctors did not agree as to the cause of nervous conditions. Some, like Tennet, argued the stomach was at core of the disorder. “Because the Stomach is suspected to be much in Fault, I would have That cleans’d in the first Place, with a Vomit of Indian Physick; the next Day, purify the Bowels, but a Purge of the same; which must be repeated 2 Days after.”
Others, including Buchan believed the causes more complex. Indolence and other things that relaxed or weakened the body like drinking tea, frequent bleeding or purging could lead to nervous disorders. While those things which hurt digestion could contribute to the problem, unfavorable postures of the body and intense application to study were equally likely to cause difficulties. “Indeed few studious persons are entirely free from them. Nor is this at all to be wondered at; intense thinking not only preys upon the spirits, but prevents the person from taking proper exercise, by which means the digestion is impaired, the nourishment prevented, the solids relaxed, and the whole mass of humours vitiated. Grief and disappointment likewise produce the same effects.” (Buchan)
Treatments for Nervous conditions
In many ways, the recommended treatments for nervous disorders were quite progressive. They included a multipronged approach that included diet, exercise, and adjustments of daily routine as well as medication.
Since digestive troubles were considered a large contributor to nervous disorders, careful attention to diet was a major part of treatment. “Persons afflicted with nervous diseases ought never to fast long. Their food should be solid and nourishing, but of easy digestion. Fat meats, and heavy sauces, are hurtful. All excess should be carefully avoided. …Wine and water is a very proper drink at meals: but if wine sours on the stomach, or the patient is much troubled with wind, brandy and water will answer better…All weak and warm liquors are hurtful, as tea, coffee, punch, &c. People may find a temporary relief in the use of these, but they always increase the malady, as they weaken the stomach and hurt digestion.”
As some doctors argue today, exercise was seen as superior to all medicines. Horseback riding and walking were considered ideal, but simply being quick about one’s business and active in their chores was recommended as well. When these were too much, even riding in a carriage could produce beneficial effect.
“A change of place, and the sight of new objects, by diverting the mind, has a great tendency to remove these complaints. For this reason a long journey, or a voyage, is of much more advantage than riding short journeys near home. Long sea voyages have an excellent effect; and to those who can afford to take them, and have sufficient resolution, we would by all means recommend this course.” (Buchan)
Patients were also advised to avoid great fires and seek cool dry air to brace and invigorate the body, though chills were to be avoided. Regular cold baths as well as frequently rubbing the body with a special brush, or a coarse linen cloth should be incorporated into the patient’s routine. Further, “they ought likewise to be diverted, and to be kept as easy and cheerful as possible. There is not anything which hurts the nervous system, or weakens the digestive powers, more than fear, grief, or anxiety.” (Buchan)
Though not seen as actual cures, a number of medicines might be recommended to render the patient’s life more comfortable. Mild purgatives to relieve constipation were recommended as were elixirs to improve digestion and strength the stomach.
Though laudanum was easily available, doctors cautioned against their overuse as opiates “only palliate the symptoms, and generally afterwards increase the disease (and) habit render them at last absolutely necessary.”
Avoiding Nervous Disorders
Not only were doctors concerned with treating nervous conditions, they also advised in how these disorders might be avoided. “Excessive grief, intense study, improper diet, and neglect of exercise, are the great sources of this extensive class of diseases…Grief indulged destroys the appetite and digestion, depresses the spirits, and induces a universal relaxation and debility of the whole system… (While) misfortunes indeed are not to be avoided, but surely their effects, by a vigorous and proper exertion of the mind, might be rendered less hurtful…
The effects of intense study are pretty similar to those occasioned by grief. It preys upon the animal spirits, and destroys the appetite and digestion. To prevent these effects, studious persons ought… never study too long at a time; nor attend long to one particular subject, especially if it be of a serious nature. They ought likewise to be attentive to their posture, and should take care frequently to unbend their minds by music, diversions, or going is to agreeable company.” (Buchan)
Attention should be paid with regard to proper diet, which avoided extremes of all forms. Regular exercise and fresh air should be a part of one’s routine. “BUT the most general cause of nervous disorders is indolence. The active and laborious are seldom troubled with them. They are reserved for the children of ease and affluence, who generally feel their keenest force. All we shall say to such persons is that the means of prevention and cure are both in their own power. If the constitution of human nature be such, that man must either labor or suffer diseases; surely no individual has any right to expect an exemption from the general rule.” (Buchan)
Buchan, William. Domestic Medicine: Or, A Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines, 11th ed. , 1790
Parissien, Steven. Regency Style. Phaidon Press Limited (2000)
Sales, Roger. Jane Austen and Representations of Regency England. Routledge (1994)
Shoemaker, Robert B. Gender in English Society 1650-1850 Pearson Education Limited (1998)
Tennet, John . Every Man his own Doctor: or, The Poor Planter’s Physician, Williamsburg, VA, 1736.
Wilson, Ben. The Making of Victorian Values, Decency & Dissent in Britain: 1789-1837
The Penguin Press (2007)
Wiltshire, John - Contrib. to Jane Austen in Context. Cambridge University Press (2005)
Though Maria Grace has been writing fiction since she was ten years old, those early efforts happily reside in a file drawer and are unlikely to see the light of day again, for which many are grateful.
She has one husband, two graduate degrees and two black belts, three sons, four undergraduate majors, five nieces, six cats, seven Regency-era fiction projects and notes for eight more writing projects in progress. To round out the list, she cooks for nine in order to accommodate the growing boys and usually makes ten meals at a time so she only cooks twice a month.
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