The Posture Theory homepage The Alexander Leeper Hypochondria Controversy ©
The ancient Greeks coined the word hypochondria because of their assessment that the many and varied symptoms were caused by a disorder originating beneath the cartilages of the lower ribs, however throughout the twentieth century the prevailing view was that the set of symptoms were related to a fear of imaginary illnesses which produced an unwarranted and irrational interest in health. Nevertheless in my assessment the primary factor which generated an interest in health was the fact that doctors were unable to provide a plausible explanation for a persons symptoms and because the person had not achieved a cure despite the fact that they had diligently followed medical advice and taken the prescribed treatment for many years.
This page contains two primary quotes. The first quote represents the medical opinion about hypochondria which prevailed throughout the twentieth century with some minor variations on the general theme, and which was generated by the medical literature and is evident from the newspaper, radio, and television portrayal of the complaint, and which generated the common public understanding (misconception) of the condition. This specific medical opinion was published in London in1928, during the lifetime of Alexander Leeper, and was widely distributed as a medical reference book for the general public. Thirteen doctors contributed to this book which was called "The Modern Family Doctor".
The second quote gives an account of the actual life and achievements of Alexander Leeper who was described as having "massive hypochondria". He kept extensive diaries in which he recorded everything about his life and his health.
By comparing these two quotes the extremes of the discrepancy can be clearly seen, and are very easily found in the biographies of other famous people such as Charles Darwin, the genius, Florence Nightingale, the founder of modern nursing, Howard Hughes, the American Billionaire, Napoleone, the French Emperor, and Moliere, the French author of comedy plays.
At the end of this page I provide some other relevant quotes which will be of interest to people who wish to study this subject.
The achievements of Alexander Leeper are too numerous to be
comprehensively covered in a brief essay but I will describe
some of them.
In 1871 R.T. Tyrrell, professor of Greek, described him as
the best viva voce translator that he had ever met, and Arthur
Palmer, professor of Latin, described him as the best classic
he had ever examined and believed that he would eventually come
to be regarded as one of the most distinguished scholars produced
by the University of Dublin in modern times. The professor of
Greek at Queen's University in Galway praised his special aptitude
as a teacher.
Le Malade Au Petit Papier
(The Malady of the Little Piece of Paper)
"Axel Munthe, describing his patients at his practice in the Avenue de Villiers, says they would produce from their pockets little pieces of paper and read out an interminable list of symptoms and complaints - le malade au petit papier, as Charcot used to call it".
From: Hysteria, Hypnosis & Healing: the work of J.M. Charcot (1971) p. 56
After many years of consulting physicians and of receiving various treatments, all of which failed, and after seeking explanations for their symptoms and not being given any, some 19th Century patients methodically prepared detailed written descriptions of their symptoms in an attempt to assist the doctor in making an accurate diagnosis so that an effective remedy could be determined.
Such written accounts were referred to as 'le petit papier' (the little piece of paper) and have since been used for diagnosing hypochondria 'le malade au petit papier' on the basis of a misinterpretation that they represented a morbid and unnecessary interest in health. M.B.
The confused facial expression of a doctor talking to a hypochondriac as depicted in The Marshall Cavendish Encyclopedia of Family Health (1988) p.772. (The patient has a considerable forward curve in his upper spine and appears to be complaining about shoulder pain which is often caused by sideways curvature of the spine.This is a common form of postural pain where there is usually no x-ray evidence of injury or disease.) Doctors often shrug their shoulders and present a facial expression of confusion and uncertainty when dealing with patients who have the symptoms of hypochondria. They also often ask for more detailed information about the severity of symptoms, when they occur, what factors aggravate the symptoms and what relieves them. Many patients write those details down on paper so that they do not forget to mention them at the next consultation.
They assume that the doctor is giving their condition serious consideration. M.B.
The hypochondriac ..."He constantly seeks medical aid and undergoes any treatment recommended; he is a thoroughly good patient. Any new treatment suits him, but never does any good; nevertheless he comes back to his doctor to whom he is usually faithful . . . He is incurable, but should be taken care of and humoured by doctors, or he may fall into the hands of quacks and be fleeced."
From: The Common Neuroses 2nd Edition (1937) p.60
"Letters and autobiographies from earlier centuries reveal deep preoccupation with matters of health and with attempts to plumb the sources of sickness".
In fact "stethoscopes, ophthalmoscopes, and other gadgetry were not introduced till after 1800" so doctors had no instruments to aid in diagnosis, and, it was considered undignified to do physical examinations by touching or exposing the patients body, so the patients description of symptoms was the primary means of determining the cause of disease.
"This was achieved through the sick person relating his 'history': when and how the complaint had started, what might have precipitated it, the characteristic pains and symptoms, and whether it was new or recurrent. The patient would also recite the main features of his lifestyle - eating and sleeping habits, bowel motions, details of emotional upsets, and so forth".
Treatment was usually only a matter of managing the disease with rather ineffectual drugs and the placebo affect.
Reference: The Cambridge Illustrated History of Medicine (1996) p. 96-97
"George Cheyne, a well-known eighteenth century physician, considered that one-third of his patients suffered from hypochondriasis, in those days an all embracing term, and in 1807 Trotter was of the opinion that it was two-thirds (Singer and Underwood)
Hypochondria is one of the most dreaded diseases in medical practice".
From: Health, Sickness, and Society (1976) p. 410 & 774.
Since the influence of emotions on body functions has been recognised doctors have been less confused by many syndromes. "Although there are no over-all reliable statistics to support the following claim, many outstanding internists have estimated that as many as 50 per cent to 60% per cent of the patients whom they see suffer primarily from emotional disturbances." "This observation has tended to cut down the number of fruitless laboratory examinations" and the previous tendency to blame the symptoms on some minor physical defect. It has also decreased the tendency to overtreat the illnesses where all too often the procedure had very serious damaging effects on the patient's life.
In fact these practical considerations were more important to the doctor than the principles of psychiatry.
Reference: The Specialties In General Practice (1951) p.710.
According to the above quote, the idea that some syndromes have an emotional basis is just medical opinion which has no statistical or scientific basis, and is accepted primarily because it is convenient for the practical administration of confusing illnesses. M.B.
Book Details And Costs
The Health Biographies Of Alexander Leeper, Robert Louis Stevenson, And Fanny Stevenson FULL COLOR HARD BACK COVER 250 PAGES with 18 pages on Alexander Leeper, 90 on Robert Louis Stevenson, and 95 on Fanny Stevenson and a 29 PAGE INDEX FEATURING MORE THAN THREE THOUSAND ENTRIES
Costs: A$34.90 within Australia, NZ$49.90 to New Zealand, U.S$24.90 to the United States, & U.K.£17.90 to the United Kingdom (cost per book includes postage).
Orders to: M.A.Banfield, Unit 6, No.6, Hartman Ave., Modbury, South Australia 5092 Phone/Fax +61 (08) 82635735 - - - - - - - - - email: firstname.lastname@example.org *** Alternatively this book is available in many Australian Public Libraries. ***
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Also see The Alexander Leeper Hypochondria Controversy http://users.chariot.net.au/~posture/TheLeeperHypoControversy.htm.