Whilst the concept of an unfashionable disease is one that is generally well established in common thought (think HIV in the 1980s), the idea that certain diseases are fashionable might seem at first quite obscure. However, last week, the Edinburgh International Science Festival took us on a historical tour of several diseases and their social implications at the time, with a dedicated event taking place at the historically and architecturally esteemed Royal College of Physicians in Edinburgh. Fashionable Diseases was exciting, interactive and wonderfully thought provoking. The event, rather unsurprisingly, had sold out, and upon arrival we were divided into groups of four where we made our way through the labyrinth of the College, negotiating with a network of corridors as we entered our first room: ‘Gout’.
A disease which arises from a disturbance in our metabolic homeostasis of uric acid, gout is a terribly painful inflammatory arthropathy commonly affecting our first metatarsal bone, or as it’s more commonly known, the big toe. All of this sounds like the opposite of glamorous, so it is strange to think that such a rigorous (and dare I say aesthetically displeasing) disease was historically so desirable. Peculiarly, a positive diagnosis of gout carried a sort of ‘social cachet’ – but why? Frankly, the answer lies in what can only be described as scientific disillusion. Gout is correlated with weight and cholesterol levels, so historically it would have mainly affected those in power; figures of authority, including our very own King Henry VIII, were amongst those who would meet the criteria for its diagnosis – wealthy, regal and outrageously gluttonous.
Of course, this disqualified the impoverished from a positive diagnosis; instead, what they were left to settle for was the wholly unfashionable disease of ‘rheumatism’. And so, much like today, when we worship (like the good heretics we are) the Kardashians’ latest fashion accessories, the diseases of the rich, at least throughout the Early Modern and Romantic period, were largely desirable at the time; a big red toe was indeed à la mode.
This was just one example of what was considered a fashionable disease in the past and, as we were swiftly reminded, it was not solely the diseases of the body that were considered attractive. Disorders of the mind, particularly melancholia, also had desirable traits. Rooted in or associated with creativity and a tendency towards introspection, a diagnosis of melancholia was in a sense favourable. Indeed, our historical fascination with the disposition was so radical that, in the 17th century, Robert Burton sought to anatomise the condition, confirming its existence in empirical thought. To be melancholic at the time was almost synonymous with thoughtfulness and profound conceptual insight.
But what of it? Why should we dedicate our time exploring the historical progression of certain diseases? Truthfully, it is an incredibly rewarding exercise with genuine instructive value; at the most elementary level, it reminds us that illness carries a meaning which exceeds a purely pathological state. But, beyond this, it encourages us to reassess, and in turn reconstruct, our own preconceptions that we impute upon sufferers of disease. In reality, the processes in illness are indiscriminate; as mortal creatures, it is an inevitability, and Fashionable Disease was a subtle yet important reminder of this.
This report was written by Haris Haseeb and edited by Teodora Aldea.