by John Mullan
The difficulty of distinguishing between the merest hypochondria and the first signs of a fatal ailment produces a comic coup with the death of Mrs Churchill in Emma. For much of the novel illness, so-called, has appeared to control Frank Churchill’s movements. He is about to enjoy the ball that he has begun to organise in Highbury when a letter arrives. ‘Mrs. Churchill was unwell—far too unwell to do without him’ (II. xii). He must leave immediately for Yorkshire. Later he writes to Mrs Weston from Mrs Churchill’s home to say that she is ‘recovering’, but that ‘he dared not yet, even in his own imagination, fix a time for coming to Randalls again’ (II. xiii). Frank Churchill is eventually liberated to return by Mrs Churchill’s ill health. She and her husband decide to travel to London, as Mr Weston reports: ‘she has not been well the whole winter, and thinks Enscombe too cold for her—so they are all to move southward without loss of time’ (II. xviii). Mr Weston has ‘not much faith in Mrs. Churchill’s illness’, he tells Mrs Elton, before half-recollecting that hypochondria is made possible by the reality of death around the corner. ‘“I hope,” said he presently, “I have not been severe upon poor Mrs. Churchill. If she is ill I should be sorry to do her injustice.”’ His self-correction is like a reminder of the paradox at work in all the novels: most people are merely imagining themselves ill; however, anybody might die at any time. The former is possible because of the latter. On Frank Churchill’s next visit to Highbury we get intimations that Mrs Churchill’s condition is no longer a mere malade imaginaire. ‘That she was really ill was certain; he had declared himself convinced of it’ (III. i). Now she has decided that she cannot stand the noise of London and is moving to Richmond. ‘Mrs. Churchill had been recommended to the medical skill of an eminent person there, and had otherwise a fancy for the place.’ We are still in the balance between illness and ‘fancy’, but one or the other is manoeuvring her adopted son closer and closer to Highbury.
Fancy bested by reality might seem to be the pattern of Sense and Sensibility. After Willoughby’s abrupt departure, Marianne performs the business of suffering, complete with insomnia, headaches and inability to speak (I. xvi). After she is rejected by him in London, however, her affliction becomes real. Austen ensures that her almost fatal illness has its origins in her own self-indulgent folly (‘imprudence’ is Austen’s unhesitating word): Marianne pleases herself with a twilight walk in the grounds of the Palmers’ country house, where the grass is ‘the longest and wettest’, and then sits around in wet shoes and stockings (III. vi). Disappointment in love may have weakened her, but she sets her own sickness in train. Once she is ill Elinor forces ‘proper medicines’ on her (III. vii), but what might these be? The apothecary is sent for, ‘pronouncing her disorder to have a putrid tendency’ and ‘allowing the word “infection” to pass his lips’. On his second visit he admits ‘His medicines had failed’, but he is full of confidence in some further treatment or other. This confidence is his business. Mrs Jennings, meanwhile, assumes that the illness will be fatal. Sir John Middleton tells Willoughby in the lobby of the Drury Lane Theatre that Marianne is ‘dying’ (III. viii). Mrs Dashwood arrives in ‘terror’, convinced that Marianne is ‘no more’ (III. ix). Much later Marianne’s own self-diagnosis seems to confirm this. ‘My illness, I well knew, had been entirely brought on by myself, by such negligence of my own health, as I felt even at the time to be wrong. Had I died,—it would have been self-destruction’ (III. x).
In recent decades, critics and readers have been willing to find Marianne a victim rather than a culprit. Perhaps the most influential has been Tony Tanner, whose introduction to the Penguin Classics edition of Sense and Sensibility scintillatingly invokes Freud and Foucault to argue that socialisation makes Marianne ill. She suffers from ‘neurosis brought on by repression’. Illness is the price she pays for bending her nature to society: ‘sickness is precisely the cost of her entry into the sedate stabilities of civilised life envisaged at the end’.1 The problem with this argument is that it is Marianne’s proud sensibility, rather than her eventual socialisation, that makes her susceptible. Marianne’s sickness begins with being ‘hysterical’. Even after her recovery, her susceptibility remains, producing her ‘hysterics’ when a servant announces that ‘Mr. Ferrars is married’ (III. xi). ‘Hysterics’ might not have the pejorative force that it now has, but the other Austen characters with whom it is associated are models of self-indulgence. In Persuasion Mary Musgrove has to be kept from ‘hysterics’ when her son breaks his collarbone (I. vii). Finding excuses to go out in the evening, she brandishes her ‘hysterical’ symptoms as an excuse for not looking after her son: ‘I am not at all equal to it. You saw how hysterical I was yesterday.’ When Louisa Musgrove has her accident, Mary suffers from ‘hysterical agitations’ (I. xii) and continues to be ‘hysterical’ the next day (II. i).
Austen’s characters live with the expectation of illness.
Marianne’s fellow hysterics are a dubious crew. ‘My mother was in hysterics,’ Jane Bennet tells Elizabeth on the confirmation of Lydia’s elopement (II. v). Mrs Bennet subsequently embarks on an enumeration of her symptoms: ‘such tremblings, such flutterings, all over me, such spasms in my side, and pains in my head, and such beatings at heart, that I can get no rest by night or by day’ (III. v). In Sense and Sensibility Marianne seems to share her susceptibility with the appalling Fanny Dashwood, who falls into what Mrs Jennings calls ‘violent hysterics’ when she hears of Edward’s engagement to Lucy Steele (III. i). Mrs Jennings returns from one of her daily visits to her daughter Charlotte, who has recently given birth to her first child, and brings the report, which she has had from the doctor, Mr Donavan, attending her daughter. He has been called to see Mrs John Dashwood, and readily gossips with Mrs Jennings about his other patient’s condition. Mr Donavan, opportunist attendant of family disappointment, has, says Mrs Jennings, returned to the Dashwood residence in Harley Street so that ‘he may be within call’ when Mrs Ferrars is told the news – ‘for your sister was sure she would be in hysterics too’. A wonderful little comic subplot: what does the doctor say to his medical friends? ‘What! Is Fanny ill?’ asks Elinor (III. i). One hardly knows the answer.
Austen’s characters live with the expectation of illness. In Persuasion, when Anne is in a stir of emotions after reading the letter to her from Captain Wentworth, everybody assumes that she must be ill. Comically, Mrs Musgrove first wishes that her servant Sarah – evidently the illness specialist – were available, and then, really thinking of her own daughter, tries to assure herself that this is not another case of a fall (II. xi). Yet there really is such a thing as illness, which we suddenly remember when we hear Lady Denham in Sanditon opine, ‘It would be only encouraging our Servants and the Poor to fancy themselves ill, if there was a Doctor at hand’ (Ch. 6). Failure to understand the seriousness of an illness is a special quality of the foolish or ill-judging. So, as her son Tom’s fever goes, Lady Bertram thinks her son out of danger. Edmund and his father, however, note some new ‘hectic symptoms’ and, advised by the physician, fear for Tom’s lungs. Tom Bertram has been brought near death (and into penitence) by an illness that is entirely self-inflicted. He has gone from London to Newmarket (for the races and gambling), ‘where a neglected fall, and a good deal of drinking, had brought on a fever’ (Mansfield Park, III. xiii). His friends desert him and his ‘disorder’ becomes worse and worse. It is the proper lesson for a young man who is always talking of some ‘particular friend’ or other.
Yet the expectation of illness is the reflex of the hypochondriac. In Emma Mr Woodhouse sees illness everywhere. ‘But poor Mrs. Bates had a bad cold about a month ago’ (I. xii). He and his daughter Isabella embark on a contest of judgements from their favoured quacks: Mr Wingfield thinks that there has never been such an autumn for colds; Mr Perry does not call it a ‘sickly season’. Isabella’s hypochondria comes in useful when Emma wishes to speed Harriet out of Highbury. She has ‘a tooth amiss’, and so must be sent to London to a dentist
. (Jane Austen herself endured a series of unpleasant visits to a fashionable London dentist in 1813: see Letters, 87 & 88) ‘Mrs. John Knightley was delighted to be of any use; any thing of ill health was a recommendation to her’ (III. xvi). Hypochondria makes a person a sure topic of conversation, so that when Emma and Harriet visit Miss Bates she must, on a cold day, make ‘anxious enquiries after Mr. Woodhouse’s health’ (II. i) – rather than envying him his untroubled affluence. He calls himself ‘a sad invalid’ (II. xiv), but in fact there is no evidence that he is in anything but robust health.
Mr Woodhouse and his eldest daughter are joined by Mary Musgrove, who invites her sister Anne to stay because she already foresees ‘that she should not have a day’s health all the autumn’ (I. v). ‘I am so ill I can hardly speak’ is the wonderfully self-contradicting complaint of this garrulous hypochondriac (I. v). In her first conversation with Anne she reveals that she has been out to dinner the day before, despite her supposedly delicate condition. Between the two sisters there is something like an acknowledgement of the real cause of Mary’s indisposition. ‘You know I always cure you when I come,’ says Anne. In her wonderfully self-revealing, blithely contradictory letter to Anne in Bath, Mary cannot decide if she is ill (‘I am far from well’) or just about to be ill (‘I dare say I shall catch it’), though all is summed up by the true egomania of self-pity in the final sentence: ‘my sore-throats, you know, are always worse than anybody’s’ (II. vi).
Hypochondriacs have their different ways in Austen. In her final, uncompleted novel Sanditon she created a family of hypochondriacs, the Parker siblings. The chief sufferer appears to be Diana Parker, who writes letters that detail the horrors of her ‘Spasmodic Bile’ (Ch. 5) and lament her incapacity, but who is active to the point of mania. She is the very opposite of what she pretends to be. Meanwhile her portly brother Arthur has joined in the same family business of being ill, but only as a cover for his own indolence and greed. He pretends to be self-denying for the sake of his constitution while industriously brewing himself thick hot chocolate and explaining to Charlotte why he needs plenty of butter on his toast in order to safeguard ‘the Coats of the Stomach’. He is but a glutton in not very complete hiding, responsible for one of the great lines in the oeuvre. ‘The more Wine I drink (in Moderation) the better I am’ (Ch. 10). Diana, meanwhile, is too expert on her ailments to trust any practitioner. ‘We have entirely done with the whole Medical Tribe’ (Ch. 5). Theirs is what Charlotte calls ‘the habit of self-doctoring’.
Medical practitioners do not come in for the anti-medical satire of Sterne or Smollett. The nameless ‘surgeon’ who is summoned to attend Louisa Musgrove in Persuasion is presumed to be competent and authoritative, though he can only predict, not intervene (I. xii). A surgeon is a specialist that only a town would afford. In the opening chapter of Sanditon, Mr Heywood is thoroughly amused by the notion that there might be a surgeon living in his village. The novel is kicked into life by Mr Parker’s search for ‘some medical Man’ to establish at Sanditon, whose presence ‘would very materially promote the rise and prosperity of the Place’ (Ch. 2). A surgeon is a cut above an apothecary, though not genteel in the eyes of some: in The Watsons the wealthy Miss Edwards loves Emma Watson’s brother Sam, but Emma’s sister Elizabeth assures her that marriage is impossible. ‘Her father and mother would never consent to it. Sam is only a Surgeon you know’.2
The ‘intelligent, gentlemanlike’ Mr Perry, the apothecary in Emma, is first seen tactfully failing to contradict Mr Woodhouse’s absurd opinion that wedding cake is harmful. He agrees that it ‘might certainly disagree with many—perhaps with most people, unless taken moderately’ (II. ii). Thus the joke about ‘all the little Perrys being seen with a slice of Mrs. Weston’s wedding-cake in their hands’. Their father is a man who makes his handsome living from bending to the prejudices of his clients. No wonder he is called ‘intelligent’ (a rare adjective in Austen’s lexicon) – the only other men called ‘intelligent’ by Austen are Mr Allen and Henry Tilney, though Mr Knightley uses the word of Robert Martin. At just the time that Emma was published the status of the apothecary was a question of public debate.3 Physicians and surgeons, with their respective Royal Colleges, did all they could to establish their professional superiority to the apothecaries who were often the first resort of genteel patients, especially outside large towns. Mr Woodhouse says that ‘there is not so clever a man any where’ (I. xii), and we are inclined to agree. He is certainly profiting handsomely from all these hypochondriacs: ‘he is always wanted all round the county’. Naturally, when Emma steps for a moment out of Ford’s the draper’s shop the first person she sees is ‘Mr. Perry walking hastily by’ (II. ix). He is always around and always busy.
The plot of Emma turns on Mr Perry’s increasing affluence, Frank Churchill blurting out his knowledge of Mr Perry’s ‘plan of setting up his carriage’ (III. v). His charges are clearly large. Miss Bates talks of her niece being so ill that ‘we will call in Mr. Perry. The expense shall not be thought of’ (II. i). Being poor, Miss Bates is the only character who actually mentions Mr Perry’s bills. She thinks that he is ‘so liberal’ that he might offer not to charge them, but they will insist: ‘He has a wife and family to maintain, and is not to be giving away his time.’ There seems little danger of this. Miss Bates’s little meditation on the propriety of charging and paying fees speaks for the size of those fees. It seems likely that Mr Perry inspires confidence by being expensive. Frank Churchill even tries a joke about the lucrative business of tending to the ailing inhabitants of Highbury, suggesting that if a ball were to be held at the Crown instead of at Randalls there would be less danger of anyone catching a cold. ‘Mr. Perry might have reason to regret the alteration, but nobody else could’ (II. xi). Mr Woodhouse replies ‘rather warmly’, deeply offended at the suggestion that his apothecary relishes minor ailments: ‘Mr. Perry is extremely concerned when any of us are ill.’ Near the end of the novel Mrs Weston speaks of her recent worries about her baby daughter’s health, and how she nearly called for Mr Perry. The listening Mr Woodhouse commends her for thinking of Mr Perry and regrets only that she did not call this minister to anxiety. ‘She could not be too soon alarmed, nor send for Perry too often’ (III. xviii). Mr Perry, charging for each call-out, would be grateful if this became accepted wisdom. What does he imagine that Perry can actually do? For he goes on to say that, though the baby girl does now seem well, ‘it would probably have been better if Perry had seen it’. His logic is as incontrovertible as it is nonsensical.
On the crucial evening of Mr Knightley’s proposal, Emma is liberated for her walk in the garden by the fact that Mr Perry has ‘a disengaged hour to give her father’ (III. xiii). Perhaps he has been summoned (the bad weather of the previous day has afflicted Mr Woodhouse); perhaps he simply calls when time is available to him, knowing that he will always find a welcome (and, presumably, a payment for his consultation). Mr Knightley has looked into the dining room, where patient and apothecary are sequestered, and found ‘he was not wanted there’. The length of his visit – ‘I should like to take another turn. Mr. Perry is not gone’ – also provides the pretext for the further circuit of the Hartfield grounds that gives him the opportunity for his declaration. The next day Emma receives a note from Mrs Weston in which she says that she ‘felt for your father very much in the storm of Tuesday afternoon’, but has been reassured by Mr Perry ‘that it had not made him ill’. Mr Perry’s visit has been a kind of precautionary measure.
Perhaps it is only in Persuasion that we get a picture of illness that is neither imaginary nor self-inflicted. This is the novel in which the flesh is frailest – there is the Musgrove child with his broken collarbone, Captain Harville with his wound, Louisa Musgrove and her head injury – and death is closest. Though Anne’s old school friend Mrs Smith has come to Bath, the very oasis of hypochondriacs, there is no doubt that she has been ill. As one critic notes, she is ‘the first invalid in Jane Austen’s novels whose
distresses are indubitably real’.4 She had been ‘afflicted with a severe rheumatic fever, which finally settling in her legs, had made her for the present a cripple’ (II. v). The reality check is made sharper when Mrs Smith’s account of her friendship with Mrs Rooke, her nurse, prompts Anne to some pious reflections about the virtues to which illness prompts sufferers and those who care for them. ‘A sick chamber may furnish the worth of volumes.’ Mrs Smith speaks ‘more doubtingly’, putting Anne right: sickness reveals the ‘weakness’ of ‘human nature . . . and not its strength’. Mrs Smith even explains how this allows Mrs Rooke to sell her patients the handicraft items that she has made – just at the point where ‘they have recently escaped from severe pain, or are recovering the blessing of health’.
There are certainly Austen characters who are made ill by others. When Fanny Price in Mansfield Park gets a headache it is because she has been forced into labour by Lady Bertram and Mrs Norris (I. vii). When Jane Fairfax in Emma is ailing, it is because of Frank Churchill. ‘Jane caught a bad cold, poor thing! So long ago as the 7th of November,’ says Miss Bates (we are now well past Christmas) (II. i). ‘I am afraid we must expect to see her grown thin, and looking very poorly.’ Her niece is indeed suffering. Jane Fairfax is ill as a response to her life’s vicissitudes. No wonder the Campbells are sorry for her: ‘She had never been quite well since the time of their daughter’s marriage’ (II. ii). She has the ‘slight appearance of ill-health’ that makes her seem a little too thin. ‘Jane caught no cold last night,’ announces Miss Bates to Emma, as if this were in itself a lucky achievement. Jane Fairfax’s illnesses are further evidence of the true state of her affections – and her relationship with Frank Churchill. No sooner does he leave Highbury, summoned by Mrs Churchill, than we hear that she has been ‘Particularly unwell . . . suffering from headache’ (II. xii). Miss Bates says that, had there been a ball at the Crown, her niece would have been too ill to attend, but we should know that this is not true, for if Frank Churchill had stayed in Highbury there would have been no illness. When Emma visits the Bates home after the Box Hill outing, she overhears Miss Bates saying ‘I shall say you are laid down upon the bed, and I am sure you are ill enough’ (III. viii).
