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Angina Pectoris and the Arnolds: Emotions and Heart Disease in the Nineteenth Century

Published online by Cambridge University Press:  17 May 2012

Fay Bound Alberti
Fay Bound Alberti
Affiliation:
Fay Bound Alberti, PhD, Department of History, Lancaster University
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Information
Medical History , Volume 52 , Issue 2 , April 2008 , pp. 221 - 236
Copyright
Copyright © The Author(s) 2008. Published by Cambridge University Press

References

1 On William Charles Lake (1817–1897), later dean of Durham, and on Thomas Arnold (1795–1842), see Oxford Dictionary of National Biography, Oxford University Press, 2004 (hereafter ODNB), vol. 32, pp. 249–50, and vol. 2, pp. 501–7.

2 Arthur Penrhyn Stanley, Life of Thomas Arnold, D.D. Headmaster of Rugby (1844, repr. London, John Murray, 1904), p. 655.

3 On Matthew Arnold (1822–1888) see ODNB, vol. 2, pp. 487–94.

4 Peter Mere Latham, Lectures on subjects connected with clinical medicine, comprising diseases of the heart, 2 vols, London, Longman, Brown, Green and Longmans, 1845–1846, vol. 2, p. 373–6; Stanley, op. cit., note 2 above, p. 655. Latham began his medical studies at St Bartholomew's Hospital and at the Public Dispensary in Carey Street, London. In 1815 he was elected physician to Middlesex Hospital; in 1824 he resigned this post to become physician at St Bartholomew's Hospital. See ODNB, vol. 32, pp. 624–5.

5 Latham, op. cit., note 4 above, vol. 2, p. 375.

6 The previous century saw many anatomical developments in England, in the work of Matthew Baillie, William and John Hunter, and in France with Xavier Bichat, Gaspard Laurent Bayle and Jean Nicolas Corvisart. See Russell C Maulitz, Morbid appearances: the anatomy of pathology in the early nineteenth century, Cambridge University Press, 1987.

7 See Christopher Lawrence, ‘Moderns and ancients: the ‘new cardiology’ in Britain, 1880–1930’, in W F Bynum, Christopher Lawrence and Vivian Nutton (eds), The emergence of modern cardiology, Med. Hist., Supplement No. 5, London, Wellcome Institute for the History of Medicine, 1985; Kirstie Blair, Victorian poetry and the culture of the heart, Oxford, Clarendon Press, 2006.

8 The Times, 25 March 1872, p. 7. For another contemporary account of the rise of heart disease, see also Herbert Davies, Lectures on the physical diagnosis of the diseases of the lungs and heart, London, John Churchill, 1851, pp.1–2.

9 This provides an interesting contrast to the literary depiction of heart disease, which at least one scholar has identified as gendered towards women. Blair, op. cit., note 7 above, p. 37. For an account of the gendering of heart disease in the modern age, see Gerdi Weidner, Mária S Kopp and Margareta Kristenson (eds), Heart disease: environment, stress and gender, NATO Science Series, Series I, vol. 327, Amsterdam and Oxford, IOS Press, 2002.

10 The Times, op. cit., note 8 above, p. 7.

11 Jean Nicolas Corvisart, An essay on the organic diseases and lesions of the heart and great vessels, trans. Jacob Gates (1806), facs. repr. New York, Hafner, 1962, pp. 27.

12 The etymological meanings of “passions” and “emotions” are not addressed here. By the time of Corvisart's writing, the two terms were used interchangeably. For a discussion of the history of “passions” and “emotions” as concepts, see Thomas Dixon, ‘Patients and passions: languages of medicine and emotion, 1789–1850’, in Fay Bound Alberti (ed.), Medicine, emotion and disease, 1700–1950, Basingstoke, Palgrave Macmillan, 2006, pp. 22–52.

13 Blair, op. cit., note 7 above; Lawrence, op. cit., note 7 above; idem, ‘“Definite and material”: coronary thrombosis and cardiologists in the 1920s’, in Charles E Rosenberg and Janet Golden (eds), Framing disease: studies in cultural history, New Brunswick, NJ, Rutgers University Press, 1992, pp. 51–82; Christopher Lawrence, Rockefeller money, the laboratory, and medicine in Edinburgh, 1919–1930, University of Rochester Press, 2005; Charles F Wooley, The irritable heart of soldiers and the origins of Anglo-American cardiology: the US Civil War (1861) to World War I (1918), Aldershot, Ashgate 2002.

14 To clarify, I use the term “functional” throughout this paper in the sense employed by Wooley, to “describe disorders of function of an organ or system without an obvious pathological lesion”. By contrast, “structural” heart disease refers to disorders that correlated with structural changes identified at autopsy. See Wooley, op. cit., note 13 above, p. 65. The explicit association of “functional” disease with emotional excess and neuroses was not made, as argued below, until the late nineteenth century.

15 See Christopher Crenner, Private practice in the twentieth-century medical office of Dr Richard Cabot, Baltimore, Johns Hopkins University Press, 2005, and the review by Christopher Lawrence, ‘Dr Cabot and Mr Hyde’, Med. Hist., 2006, 50: 247–51.

16 See Wooley, op. cit., note 13 above, p. 67.

17 Blair, op. cit., note 7 above, p. 30.

18 Charles E Rosenberg, ‘Body and mind in nineteenth-century medicine: some clinical origins of the neurosis construct’, Bull. Hist. Med., 1989, 63: 185–97; John Harley Warner, The therapeutic perspective: medical practice, knowledge, and identity in America, 1820–1885, Cambridge, MA, and London, Harvard University Press, 1986.

19 Lawrence, op. cit., note 7 above; Robert G Frank, ‘The tell-tale heart: physiological instruments, graphic methods and clinical hopes, 1854–1914’, in William Coleman and Frederick L Holmes (eds), The investigative enterprise: experimental physiology in nineteenth-century medicine, Berkeley and Los Angeles, University of California Press, 1988, pp. 211–90. For a recent critique of the traditional story of nineteenth-century medical development as increasingly reductionist and technologically defined, see Christopher Lawrence and George Weisz, ‘Medical holism: the context’, in Christopher Lawrence and George Weisz (eds), Greater than the parts: holism in biomedicine, 1920–1950, New York and Oxford, Oxford University Press, 1998, pp. 1–22.

20 Meriol Trevor, The Arnolds: Thomas Arnold and his family, London, Bodley Head, 1973; Nicholas Murray, A life of Matthew Arnold, London, Hodder and Stoughton, 1996; Park Honan, Matthew Arnold: a life, London, Weidenfeld & Nicolson, 1981.

21 Except where noted the following account is derived from Stanley, op. cit., note 2 above, pp. 655–6. See also Trevor, op. cit., note 20 above, p. 45.

22 Trevor, op. cit., note 20 above, p. 45.

23 Stephen Stansfeld and Michael Marmot (eds), Stress and the heart: psychosocial pathways to coronary heart disease, London, BMJ Books, 2002. As noted below, it is important to be aware of the historical specificity of concepts like “stress”. For an introduction, see Rhodri Hayward, ‘Stress’, Lancet, 2005, 365: 2001.

24 See Mark Harrison and Michael Worboys (eds), A disease of civilisation: tuberculosis in Britain, Africa and India, 1900–39, London, Routledge, 1997. For a contemporary perspective, see Benjamin Richardson, Diseases of modern life, London, Macmillan, 1876, p. 120.

25 See the discussion and review in Fay Bound Alberti, ‘Introduction: Medical history and emotion theory’, in Bound Alberti (ed.), op. cit., note 12 above, pp. xiii–xxviii.

26 Cary L Cooper and Philip Dewe, Stress: a brief history, Oxford, Blackwell, 2004; Fay Bound, ‘Keywords in the history of medicine: anxiety’, Lancet, 2004, 363: 1407.

27 Dixon, op. cit., note 12 above, and idem, From passions to emotions: the creation of a secular psychological category, Cambridge University Press, 2003.

28 Rosenberg, op. cit., note 18 above, p. 186.

29 On mind and body interaction prior to the nineteenth century, see Fay Bound Alberti, ‘Emotions in the early modern medical tradition’, in Bound Alberti (ed.), op. cit., note 12 above, pp. 1–23.

30 As Edwin Clarke and Stephen Jacyna have shown, Galenic models of the nervous system remained in place well into the nineteenth century. Not until the end of the century were they supplanted by modern ideas about how the “autonomic” nervous system originated—autonomy indicating independence of action, linked to the concept of the reflex. See Edwin Clarke and L S Jacyna, Nineteenth-century origins of neuroscientific concepts, Berkeley, University of California Press, 1987, p. 317.

31 For a detailed discussion of humoral theory, see Bound Alberti, op. cit., note 29 above.

32 Ibid. In theory this was a genderless process, although the types of emotion experienced were gendered, as men and women were naturally subject, as a result of their constitutional differences, to discretely different emotions. Moreover the organ itself was implicitly gendered; Robert Erickson has shown that the heart was often invoked as a masculine and phallic organ. See Robert Erickson, The language of the heart, 1600–1750, Philadelphia, University of Pennsylvania Press, 1997. Kirstie Blair has detailed the shift back towards women in gendering the Victorian heart, with its associated qualities of emotionalism, responsiveness and sympathy. See Blair, op. cit., note 7 above, p. 11.

33 John Coakley Lettsom, The works of John Fothergill, London, Charles Dilly, 1784, p. 375.

34 On the “non-naturals”, see Bound Alberti, op. cit., note 29 above, pp. 3, 15.

35 Ibid., p. 5.

36 For a history of “angina” and its terminology, see John Forbes, Alexander Tweedie and John Conolly (eds), The cyclopaedia of practical medicine, London, Sherwood, Gilbert and Piper, 1833–1855, vol. 1, p. 81. For William Heberden, see his ‘Some account of a disorder of the breast’, Med. Trans. Coll. Physicians, 1772, 2: 59–67, reprinted in his Commentaries on the history and cure of diseases, 2nd ed., London, T Payne, 1803.

37 Other heart diseases were classified from the late eighteenth century, including pericarditis (1799) and endocarditis (1809). See J O Leibowitz, The history of coronary heart disease, London, Wellcome Institute of the History of Medicine, 1970. See also Frederick A Willius and Thomas Keys (eds), Cardiac classics, London, Henry Kipton, 1941; Terence East, The story of heart disease, London, William Dawson, 1958; P R Fleming, A short history of cardiology, Amsterdam, Rodopi, 1997.

38 Heberden, op. cit., note 36 above, p. 59; Wooley, op. cit., note 13 above, p. 75. On the similar etymological origins of “anxiety” to describe a pressing sensation within the chest, see Bound, op. cit., note 26 above, p. 1407.

39 Latham, op. cit., note 4 above, vol. 2, p. 364.

40 Forbes, Tweedie and Conolly (eds), op. cit., note 36 above, p. 82.

41 Stanley, op. cit., note 2 above, pp. 656–7.

42 Wooley, op. cit., note 13 above, p. 67.

43 Ibid., p. 65.

44 Ibid., p. 66.

45 Allen B Weisse, ‘The elusive clot: the controversy over coronary thrombosis in myocardial infarction’, J. Hist. Med. Allied Sci., 2006, 61 (1): 66–78.

46 Heberden Commentaries, op. cit., note 36 above. For a discussion of the original autopsy, with Edward Jenner's reported comments, see Caleb Hillier Parry, An inquiry into the symptoms and causes of the syncope anginosa, commonly called angina pectoris, Bath, R Cruttwell, 1799, p. 6.

47 John Baptist Morgagni, The seats and causes of diseases, investigated by anatomy in 5 books, trans. Benjamin Alexander, London, 1769, vol. 3, bk 5, article 5, p. 504.

48 Ibid., p. 508.

49 Ibid., p. 504.

50 E Home, ‘A short account of the author's life’, in J Hunter, A treatise on the blood, inflammation and gun-shot wounds, London, J Richardson for George Nichol, 1794, pp. xiii–lxvii, on p. lxi. The case of John Hunter is dealt with more fully in my forthcoming book, Matters of the heart, ch. 2.

51 Thomas J Pettigrew, ‘John Hunter: from the Medical Portrait Gallery’, Lancet, 1838–39, ii: 119–20.

52 Allan Burns, Observations on some of the most frequent and important diseases of the heart, (London, Thomas Bryce, 1809), repr. New York, Hafner, 1964, p. 140.

53 James Hope, A treatise on the diseases of the heart and breast vessels, London J Churchill, 1839, p. 505, cited in Wooley, op. cit., note 13 above, p. 95.

54 R T H Laënnec, A treatise on the diseases of the chest and on mediate auscultation, ed. John Forbes, 2nd ed., London, T & G Underwood, 1827, p. 577 ftn. Parry's work was influential soon after that of Heberden. See Caleb Hiller Parry, An inquiry into the symptoms and causes of the syncope anginosa, commonly called angina pectoris, London, R Cruttwell, 1799.

55 Laënnec, op. cit., note 54, above, pp. 694–5.

56 See, for instance, Byrom Bramwell, Diseases of the heart and thoracic aorta, Edinburgh, Y J Pentland, 1884, p. 659.

57 Latham, op. cit., note 4 above, vol. 2, p. 376.

58 See Willius and Key (eds), op. cit., note 37 above, p. 114. On Joseph Hodgson, see ODNB, vol. 27, pp. 496–7. Thanks to Jonathan Reinarz for valuable discussions of the significance of Hodgson in relation to national and local medical practice.

59 Latham, op. cit., note 4 above, vol. 2, p. 377.

60 Ibid., p. 379.

61 Ibid., p. 361.

62 Ibid., p. 362.

63 Ibid., p. 361. This theme would recur throughout the century, being addressed by many physicians in the nineteenth century, and by William Osler in the twentieth century.

64 Ibid., pp. 385, 386–7.

65 Ibid., pp. 384–5.

66 Ibid., p. 405.

67 Ibid., pp. 406–7, 408.

68 Matthew Arnold, Selected letters of Matthew Arnold, ed. Clinton Machann and Forrest D Burt, London, Macmillan, 1993, p. 283.

69 Latham, op. cit., note 4 above, pp. 374, 376.

70 Ibid., p. 412.

71 Bound Alberti, op. cit., note 29 above, pp. 12–15.

72 The earliest OED reference to “sympathy” dates from 1579, and refers to such “sympathia” between “the bodye and the soule, that if either exceede the meane, the one suffereth with the other”. In 1655 Nicholas Culpepper also referred to “sympathy or consent from other parts”. See OED. By the nineteenth century the doctrine of “sympathy” had taken on a more specific materialistic meaning. On the scientific development of concepts of sympathy, see Clarke and Jacyna, op. cit., note 30 above, p. 102.

73 Corvisart, op. cit., note 11 above, p. 31.

74 Ralph Alderson, A chemical analysis and medical treatise on the Shap Spaw in Westmoreland, Kendal, R Lough, 1828, p. 55.

75 This is how the term is used by Blair, op. cit., note 7 above, p. 6.

76 Bramwell, op. cit., note 56 above, p. 38.

77 Ibid., pp. 16, 38–9. See also Elizabeth A Williams, The physical and the moral: anthropology, physiology and philosophical medicine in France, 1750–1850, Cambridge University Press, 1994, p. 50; Clarke and Jacyna, op. cit., note 30 above.

78 Lawrence, ‘“Definite and material”’, op. cit., note 13 above, and Lawrence, ‘Moderns and ancients’, op. cit., note 13 above. Clark and Jacyna have shown how important research into the nervous system was in early-nineteenth-century physiology, and the stakes were high, partly because debates focused on the location of mind, but also because they impacted upon similar debates in philosophy and theology. See op. cit., note 30 above, p. 6.

79 William Osler, Lectures on angina pectoris and allied states, New York, D Appleton, 1897, p. 10.

80 John Calthorp Williams, Practical observations on nervous and sympathetic palpation of the heart, London, Longman, Rees, Orme, Browne, 1836, p. 100, cited in Wooley, op. cit., note 13 above, p. 98.

81 Osler, op. cit., note 79 above, p. 8.

82 Ibid.

83 There is insufficient space to discuss this here, though it will be addressed in my forthcoming monograph, The heart and the matter. For an example of late-nineteenth- and early-twentieth-century discussions surrounding the status of angina pectoris, see The British Journal of Nursing, Jan. 18, 1908, pp. 42–3.

84 See Lawrence and Weisz, ‘Medical holism’, op. cit., note 19 above.

85 See Fay Bound Alberti, ‘The emotional heart’, in James Peto (ed.), The heart, New Haven,Yale University Press, 2007, pp. 125–42.