David Hume (1711–1776) was an important Scottish Enlightenment philosopher known in part for his essays on human nature. In 1734, Hume wrote (although may not have sent) a letter to an unnamed physician, who was possibly the ‘proto-psychiatrist’ Dr George Cheyne, author of The English Malady. In this letter, Hume described losing his enthusiasm for philosophical works, as well as some somatic symptoms, such as hypersalivation:
‘about the beginning of Septr 1729, all my Ardor seem'd in a moment to be extinguisht, & I cou'd no longer raise my Mind to that pitch, which formerly gave me such excessive Pleasure. […] In this Condition I remain'd for nine Months.’
‘At last about Aprile 1730, when I was 19 Years of Age, a Symptom, which I had notic'd a little from the beginning, encreas'd considerably […]. It was what they call a Ptyalism or Watryness in the mouth.’
His physician had offered diagnostic advice, although Hume seems to have been slightly reluctant to accept the idea that he was suffering from the ‘Disease of the Learned’, as he felt his mood was not low:
‘Upon my mentioning it to my Physician, he laught at me, & told me I was now a Brother, for that I had fairly got the Disease of the Learned. Of this he found great Difficulty to perswade me, finding in myself nothing of that lowness of Spirit, which those, who labor under that Distemper so much complain of.’
His physician, however, suggested several methods of treatment:
‘upon his Advice, I went under a Course of Bitters, & Anti-hysteric Pills. Drunk an English Pint of Claret Wine every Day, & rode 8 or 10 Scotch Miles. This I continu'd for about 7 Months.’
Hume then proceeded to manage his symptoms through a combination of moderate study, regular diet and frequent exercise. He remained apprehensive about his recovery, and felt he lay some way short of ‘Vapors’ (a term that approximates a combination of hypochondriasis, functional symptoms and affective disorder):
‘The small Distance betwixt me & perfect Health makes me the more uneasy in my present Situation. Tis a Weakness rather than a Lowness of Spirits which troubles me, & there seems to be as great a Difference betwixt my Distemper & common Vapors, as betwixt Vapors & Madness.’
He was, however, wholly aware of the propensity of the hypochondriac for excessive focus on the body and symptoms:
‘I hope I have been particular enough in describing the Symptoms to allow you to form a Judgement; or rather perhaps have been too particular. But you know ’tis a Symptom of this Distemper to delight in complaining & talking of itself.’
At the end of his letter Hume asks his corresponding physician about his chances of recovery:
‘The Questions I wou'd humbly propose to you are: […] Whether my Recovery will ever be perfect, & my Spirits regain their former Spring & Vigor, so as to endure the Fatigue of deep & abstruse thinking?’
To which he may not have received a reply, but his career flourished.
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