The Posture Theory homepage The Alexander Leeper Hypochondria Controversy ©

 (Extracts from "The Health Biographies of Alexander Leeper, Robert Louis Stevenson, And Fanny Stevenson" and "The Posture Theory 11th edition")

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 prevailing account of hypochondria in the twentieth century

The stage of adolescence is the period of "man in the making" and lasts about 10 years, during which time the higher mental qualities are formed and character and conduct take their final shape. "It is the critical period of life and the good or evil habits now acquired remain until the end."
With the arrival of manhood there should be altruism which is the quality that organised society is built upon, and as Martial said long ago men should be able "To look on death with placid eye, And neither fear nor wish to die."
"With the neurasthenic and hypochondriac it is quite the opposite. "To both a morbid fear of death is ever present, although usually not admitted, perhaps not even realised. This obsession colours the entire outlook on life."
Most children develop into mature adults with courage and wisdom but neurasthenics and hypochondriacs remain childlike, egoistic, and self-centered, and they may be specious, plausible, and good at making excuses.
If the minds of these patients is deeply probed they can be found to have had all healthy inclinations starved and withered, and to be like unweeded gardens "in which envy, hatred, malice, and spite have been allowed to flourish", and they are so self-absorbed that there is no room for outside interests.
These patients have "no kindliness of heart, no love of country" and no generosities, and if they have any friends at all they have no real affection for them. They vegetate in selfishness and are usually moral and physical cowards. "Although history for him has no meaning, and literature no existence, and ignorant of his own ignorance, and most ignorant of what he's most assured, yet he has very decided opinions, and is good at making a platitude plausible by making it pompous, but he never really thinks; he only thinks he thinks."
In vengeance for this nature might bring about what is politely called a nervous breakdown, and the patient may whine that fate has been unkind and that he has inherited weak nerves from his parents or race. He may acquire a thorough knowledge of the latest pseudo-scientific jargon but he cannot be persuaded to understand "that his condition is the logical outcome of his wretched scheme of existence, that having graduated in the school of selfishness, he has simply educated and qualified himself for the misery which now knocks at his door. Nature does not return good for evil; she gives blow for blow."
The only hope for this type of person is to take up religion, purge their souls, read the New Testament, pray to God, admit to the sins of their wretched lives, and to start working to improve their character.
Otherwise trying to convince these patients that their health concerns are unfounded is like trying to reason with an ass.
The conclusion to be deduced is that the conditions of neurasthenia and hypochondria are "the result of a process of wrong thinking, wrong living, and wrong feeling."

Reference: The Modern Family Doctor (1928) p.157-158.



 Alexander Leeper's life and achievements

 Alexander Leeper

Alexander Leeper has been described as having "massive hypochondria". He kept extensive diaries in which he recorded everything about his life and his health.

The achievements of Alexander Leeper are too numerous to be comprehensively covered in a brief essay but I will describe some of them.
He showed signs of brilliance from the age of 5 and was first educated by his father at home and then sent to private schools.
At the age of 13 he topped his class in Classics, French, and Scripture.
He later sat for and passed an entrance exam for the Indian Civil Service, but he did not pursue that course probably because he would have been rejected on the grounds of his poor health.
In 1865 he won a scholarship to study at Trinity College Dublin (University of Dublin), where he completed a degree in Classics.

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.
In 1872 he sat for an open scholarship to St. John's college of Oxford University, and was granted a special exhibition of 100 pounds a year for 5 years which was the equivalent value of the scholarship. In 1874 he gained a "first" in Classical Moderations.
In Australia he became the Second Master of Melbourne Grammar School, where he was also Senior Master of Classics, and he established the school library, museum, and newspaper.
He was also appointed principal of Trinity College Melbourne, and later changed the title to Warden, and developed the college as a role model for other colleges associated with the Melbourne University.
He was on the Council of the Melbourne University where he recommended reforms which were implemented, and he was on the state Council of Public Education.
In 1880 he delivered the main speech, about university colleges, at the Social Sciences Congress, which was a by-product of an International Exhibition.
He was one of the Trustees of the Public Library, Museums, and National Gallery from the 1880's, and was president from the 1920's until his retirement.
In 1896 Alexander Leeper drew up the draft constitution for the Library Association of Australasia and became its new chairman and delivered speeches at its Biennial Conferences.
He "was a lover of books and a firm believer in the educational influence of the Public library", and he suggested that there should be a closer relationship between libraries and educational institutions. He insisted on the need for administrative ability in librarians, and recommended that "Universities should honour librarians more, giving them status as professors."
In 1908 he represented the Diocese of Melbourne at the Pan-Anglican Congress which was held in London, and which was attended by 200 bishops. He was also chairman of the Central Church League, and a lay canon at St. Paul's Cathedral.
He was involved in the production of plays and acted in some of them, and was the director of a play called The Wasps by Aristophanes which was presented by the combined colleges as the jubilee production of the Melbourne University. He also represented the Melbourne Shakespeare Society while in the U.K.
He was president of the Classical Association of Victoria which had 300 members, which made it the largest Classical Association in the British Empire.
He had many famous, wealthy, and influential friends, and for a short time he was a member of the Melbourne Club and was involved with the Navy League.
He traveled widely throughout the United Kingdom, Europe, the Middle East, Norway, the United States, Australia, and New Zealand, and he attended meetings of the Australian Institute of International Affairs.
He was also a leader of patriotic causes, especially during World War 1 when he argued against Home Rule for Ireland, in favour of retaining it within the British Empire.
He also contributed to many charities especially the Society to Assist Persons of Education, and he visited Old Colonists Homes and was acquainted with Stanley Greg Smith who was secretary of the Charity Organisation Society, and he distributed their tickets to the needy.

Reference: Doubts and Certainties A Life of Alexander Leeper (1997).

 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.


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