GEORGE CHEYNE AND HIS WORK
Cheyne's fame grew with the publication of his Essay on Gout in 1719 - a work that was much published and well-received. The book that really made Cheyne's name was his next, An Essay on Health and Long Life in 1724. It ran to nine editions in Cheyne's lifetime, was translated into several European languages and established him as one of the best-known doctors in the country. A forerunner of the self help book, the Essay was unusual in that it focused on prevention rather than cure and encouraged readers to take responsibility for their own health, rather than relying on doctors. He believed that obesity and nervous disorders resulted from a combination of heredity and lifestyle. During the 1720s he was still enormously fat and must have cut a strange figure - a celebrity doctor, famous for advocating a frugal lifestyle, who was himself obese. He had regained all the weight he had lost after his initial London crisis and more.
The final crisis came in the late 1720s, when Cheyne claims his weight reached 32 stone. In his autobiography he describes how although he had cut down on alcohol, ate no supper and only green tea for breakfast, "by these means every dinner necessarily became a surfeit and a debauch, and in ten or twelve years, I swelled to such an enormous size, that upon my last weighing I exceeded 32 stone. My breath became so short, that upon stepping into my Chariot quickly, and with some effort, I was ready to faint away for want of breath". His skin broke out in ulcers and he was filled with self-loathing. Eventually his family and friends persuaded him to seek medical advice in London and, although the doctors he saw there had little to suggest that he did not already know, he gradually began to moderate his diet once again and gradually recover his mobility and his spirits.
From around 1728, although still a big man, he no longer suffered from extreme obesity or the depression that accompanied it. The 1730s were a time of health, happiness and prosperity for Cheyne. He and his family including son John and daughters Frances and Peggy, lived in a grand new house in Monmouth Street, a new street just outside Bath's old west gate.
His next book The English Malady 1733, included case histories of some of his patients and a lengthy account of his own battle with obesity and depression. To Cheyne the English Malady was melancholy,not obesity itself, but obesity was one symptom of that melancholy a lowness of spirits, anxiety, insomnia and nervous agitation which was the result of modern, urban life and immoderate and luxurious lifestyle. As Roy Porter points out, when diseases were labelled by nationality it usually signified contempt and dread; syphilis, for example, was known to the British as the French disease and to the French as the Spanish disease. By calling his syndrome 'the English malady', Cheyne was in fact flattering his readers. He saw the syndrome as arising from English wealth, civilization and refinement. Just as today's celebrities talk of food intolerances, burn-out and exhaustion and check into health spas, clinics and retreats, so the eighteenth century elite also believed themselves particularly susceptible to nervous disorders and dietary complaints.
The rich tended to eat too much rich food and exercise too little. Their breeding and education made them naturally refined and more sensitive, both physically and mentally, and more vulnerable to nervous disorders. The English Malady includes case studies and Cheyne's own autobiography. The patients described in the case notes are not all suffering from problems of digestion and obesity, although diet forms a significant part of the treatment for all. Rather they suffer from a combination of nervous and physical symptoms. To Cheyne, mind, body and sprit were intimately linked and a better diet and more healthy regime a necessary part of treatment for a wide range of mental and physical illness.
Cheyne's patients included Alexander Pope, Samuel Richardson, Robert Walpole's daugher, the Earl and Countess of Huntingdon, the Earl of Essex, the Earl of Bath and numerous other wealthy and well-connected visitors to Bath. Cheyne's Essay on Regimen published in 1740 was dedicated to Lord Huntingdon. It consists of six essays which set out Cheyne's philosophy including an opening essay on the importance of diet.
During his last decade of life, from 1733 to 1743, Cheyne enjoyed great success. There are 30 surviving letters written by Cheyne to the Countess of Huntingdon between 1730 and 1739, 82 letters to Samuel Richardson between 1733 and 1743. The Countess suffered a range of symptoms including lowness of spirits, 'heats' and abdominal pains all made worse if not the direct result of her almost continual state of pregnancy. Richardson's ailments were more relevant to our story - city-living, overwork, too little exercise and too much rich food and drink caused him distress and depression. Cheyne suggested purging, vomiting, moderation in diet, diversion and exercise ( especially on a ' chamber horse' - a chair suspended on a plank supported at both ends and on which Richardson could bounce ).
The Natural Method of Cureing the Diseases of the Body and the Diseases of the Mind depending on the Body 1742, was Cheyne's last work. In April 1743 he died a 'good' and relatively peaceful death in Bath and was buried at the Church in Weston, where his brother was vicar.
THE ENGLISH MALADY (Extracts)
I was born of healthy Parents, in the Prime of their days by disposed to corpulence… I passed my youth in close study … but upon the slightest excesses I always found slippery bowels, or a spitting to be the crise, whence afterwards upon reflection I concluded that my glands were naturally lax and my solids feeble.
Upon my coming to London, I all of a sudden changed my whole manner of living… being naturally of a large size, a cheerful temper, and tolerable lively imagination .. I soon became caressed by them and grew daily in bulk and friendship with these gay gentlemen… and thus constantly dining and supping … my health was in a few years brought into great distress, by so sudden and violent a change. I grew excessively fat, short-breathed, lethargic and listless.
My appetite being insatiable I sucked up and retained the juices and chyle of my food like a sponge and thereby suddenly grew plump, fat, and hale to a wonder, but indeed too fast. However, for near twenty Years, I continued sober, moderate, and plain in my diet and in my greatest health drank not about a quart or 3 pints at most of wine any day … never tasting any supper and at breakfast nothing but green tea, without any eatable, but by these means every dinner necessarily became a surfeit and a debauch, and in ten or twelve years I swelled so such an enormous size that upon my last weighing I exceeded 32 stone. My breath became so short that upon stepping into my chariot quickly and with some effort I was ready to faint away for want of breath and my face turned black…. I was not able to walk above one pair of stairs at a time, without extreme pain and blowing, being forced to ride from door to door in a chariot even here at bath and if I had but an hundred paces to walk was obliged to have a servant follow me holding a stool.
About this time, my legs broke out all over in scorbutic ulcers, the ichor of which corroded the very skin where it lay any time and the fore parts of both legs were one continued sore.
Since our wealth has increased and our navigation has been exteneded we have ransasked all the parts of the globe to bring together its whole stock of materials for riot, luxury, and to provoke excess. The tables of the rich and great (and indeed those who can afford it) are furnish’d with provisions of delicacy, number, and plenty, sufficient to provoke, and even gorge, the most large and voluptuous appetite. … Invention is racked to furnish the materials of our food the most delicate and savoury possible: instead of the plain simplicity of leaving the animals to range and feed in their proper element, with their natural nourishment, they are physicked almost out of their lives and made as great epicures as those feeding on them, and by stalling, cramming, bleeding, laming, sweating, purging, and thrusting sown such unnatural and high seasoned foods into them, these nervous diseases are produced in the animals themselves even before they are admitted as food to those who complain of such disorders.
LETTERS OF DR CHEYNE TO SAMUEL RICHARDSON
Bath, January 12, 1740
Your present complaint as you very accurately describe it, is entirely nervous from wind … and is of no manner of dangerous consequence. If it comes to any height so as to produce terror or confusion or inattention to business your only present relief is a tea spoonful or two of the tincture of soot and assa foetida made on peony water in a cold infusion drunk any time in a glass of pepper mint water simple. This will make you break wind plentifully and so relieve you. I wonder you get not the chamber horse which is now so universally known and practised in all the studious professions in London. It is certainly admirable and has all the good beneficial effects of a hard trotting horse except the fresh air. (Only remember the board ought to be as long as the room will permit 18 or 20 feet - 16 at least - and the chair you sit on with a cushion on the board as a bottom to it with a two armed hoop and with a foot stool that with a sliding board may be raised higher or lower.) It may be bought for a couple of pounds and is more necessary for children or aged persons than a bed or a cradle. You may dictate, direct, or read in it and it rides double better than single. I have found great benefit by it. I desire you begin your cold bath forthwith; it cleanses as well as contracts. Your diet is quite right, being that of the temperate healthy which though it may admit disorders can produce no first mortal distemper.
Your sincere well wisher and thankful servant, George Cheney
Be sure to take a scotch or gum pill or two once a week.
Bath, December 23, 1741
I am sorry to find you so perplexed and puzzled about a thing of no manner of consequence. If you enter upon a vegetable diet, will you not live lighter than 9 parts of 10 of most of the people of Great Britain? If the regimen be proper it cannot be entered upon too soon or followed too strictly.