Clever sick notes

Originally a Greek term meaning "below the ribcage", hypochondria has connoted a mass of sometimes interrelated syndromes over the past 3,000 years: indigestion, then melancholia, then neurosis, then, blandly, a misplaced fear of illness based on misinterpretation of bodily symptoms - the modern definition as ratified by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

Thus, Brian Dillon's deeply engrossing compendium of "hypochondriac lives" is partly an exercise in etymological unravelling - even though, with the exceptions of Andy Warhol and Glenn Gould, his subjects lived long before their conditions had a chance to be pathologised away as examples of obsessive compulsive disorder, treatable with antidepressants and cognitive behavioural therapy. (Such is the prevailing orthodoxy.)

Almost all of the nine case studies in this book are writers, artists or performers, which would seem to chime with the 18th-century view of hypochondria as a "disease of the learned". But Dillon, with a horror of cliché, holds back from making explicit links between the romantic agony of creation and the sort of brooding body-consciousness that Dr Johnson's biographer James Boswell believed was "the concomitant of distinguished genius".

Actually, Dillon kicks things off with Boswell, for whom hypochondria was, he says, "a structuring principle masquerading as chaos". Essentially lazy, Boswell struggled to achieve a balance between working, sleeping and recreation (that is, outdoor sex with prostitutes) and ended up in a state of unhappy suspension between all three. Obsessed with his digestive system, he was fastidious about the punctuality of his bowel movements and followed John Locke's advice that one should "stool every day regularly after breakfast".

Charlotte Brontë's hypochondria, which afflicted her when she was 19 and teaching at Roe Head School, now looks more like a nervous breakdown - a "heavy gloom" connected to her frustration at not having enough time to write. It found its way into both Jane Eyre and, particularly, The Professor (her first novel, published posthumously in 1857).

Dillon includes some genuinely ill hypochondriacs (if that isn't a contradiction in terms) on the grounds that they enjoyed the drama of the sickroom. Florence Nightingale took to her bed upon returning from the Crimean war in 1856 and stayed there. A recent biography suggests she may have had brucellosis or "Mediterranean fever". Whatever it was, she used it as an excuse to withdraw from public life so that she could focus on her campaign to improve conditions for British soldiers.

Charles Darwin, by contrast, parlayed his illness (which may have been a tropical disease picked up on the Beagle) into a "freedom from public responsibility". Aged just 32, he moved to Down House in Kent, where he cultivated an almost comically neurasthenic persona, insisting that his wife, Emma, be on constant call in case he wished to be read to or accompanied on a walk.

Is it crass to call Marcel Proust the Michael Jackson of interwar Paris? Perhaps, but let's do it. By the time Proust died in 1922, the author of À la recherche du temps perdu was taking adrenalin to wake himself up, Datura stramonium (a hallucinogen) and iodides to relieve his terrible asthma, then heroin and the barbiturate Veronal to get to sleep.

Of the other case studies (Warhol, Glenn Gould, Daniel Paul Schreber, Alice James), the most fascinatingly perverse is James, younger sister of the more famous Henry and William, who was thrilled to be diagnosed with breast cancer ("To him who waits, all things come!") after years of chronic, non-specific invalidism. Dillon reflects that her "illnesses" were her own works in progress, her way of competing with her more talented siblings.

Dillon insists that Tormented Hope is a history of hypochondriacs rather than hypochondria, but he is being unduly modest. Rather, by refracting each life through contemporary perceptions of hypochondria, he shows how its meaning has shifted over time. As fans of his first book, In the Dark Room, will know, he is an uncommonly elegant and precise writer: there isn't a duff sentence here, or a misplaced word. What's more, he asks all the right questions. If I declare myself to be sick, does that mean I am sick? Is the desire to be sick itself an illness? The irony is that the answers don't ­really matter. As Dillon writes: "Hypochondria makes dupes of us all because death will have the last laugh."

John O'Connell is the author of "I Told You I Was Ill" (Short Books, £7.99)

Tormented Hope: Nine Hypochondriac Lives
Brian Dillon
Penguin Ireland, 288pp, £18.99

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