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John Armstrong’s The Art of Preserving Health

Adam Budd

Eighteenth-Century Sensibility in Practice

JOHN ARMSTRONG’S THE ART OF PRESERVING HEALTH

John Armstrong’s 2000-line poem The Art of Preserving Health was among the most popular works of eighteenth-century literature and medicine. It was among the first to popularize Scottish medical ideas concerning emotional and anatomical sensibility to British readers, doing so through the then-fashionable georgic style. Within three years of its publication in 1744, it was in its third edition, and by 1795 it commanded fourteen editions printed in London, Edinburgh, Dublin, and Benjamin Franklin’s shop in Philadelphia. Maintaining its place among more famous works of the Enlightenment, this poem was read well into the nineteenth century, with translations in French, German, and Italian. It remained a tribute to sustained interest in eighteenth-century sensibility, long after its medical advice had become obsolete and the nervous complaints it depicted became unfashionable.

Adam Budd’s critical edition includes a comprehensive biographical and textual introduction, and explanatory notes highlighting the contemporary significance of Armstrong’s classical and medical sources, and social references. Included in this study are discussions of Armstrong’s innovative medical training in charity hospitals and his close associations with the poet James Thomson and the bookseller Andrew Millar, evidence for the poem’s wide appeal, and a compelling argument for the poem’s anticipation of sensibility as a dominant literary mode. Budd also offers background on the “new physiology” taught at Edinburgh, as well as an explanation for why a Scottish-trained physician newly arrived in London needed to write poetry to supplement his medical income. This study also includes annotated excerpts from the key literary and medical works of the period, including poetry, medical prose, and georgic theory. Readers will come away convinced of the poem’s significance as a uniquely engaging perspective on the place of poetry, medicine, the body, and the book trade in eighteenth-century cultural history.

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John Armstrong’s The Art of Preserving Health

Eighteenth-Century Sensibility in Practice

ADAM BUDDUniversity of Edinburgh, UK

Copyright © Adam Budd 2011

Adam Budd has asserted his right under the Copyright, Designs and Patents Act, 1988, tobe identified as the author of this work.

British Library Cataloguing in Publication DataArmstrong, John, 1709–1779.

John Armstrong’s The Art of Preserving Health: eighteenth-century sensibility in practice.1. Health – Poetry. 2. Armstrong, John, 1709-1779. Art of preserving health. 3. Literature and medicine – Great Britain – History – 18th century. 4. Reason in literature. 5. Medicinein literature. 6. Medical education – Scotland – History – 18th century.I. Title II. Budd, Adam.821.6-dc22

Library of Congress Cataloging-in-Publication DataArmstrong, John, 1709–1779.

John Armstrong’s The Art of Preserving Health: eighteenth-century sensibility in practice /[John Armstrong]; by Adam Budd.

p. cm.Includes bibliographical references and index.ISBN 978-0-7546-6306-5 (alk. paper)1. Health—Poetry. 2. Armstrong, John, 1709–1779. Art of preserving health. 3. Litera-

ture and medicine—England—History—18th century. 4. Reason in literature. 5. Medicinein literature. I. Budd, Adam. II. Title.

PR3316.A6A8 2011 821’.6—dc22

2010048259

ISBN: 978-0-754-66306-5 (hbk)ISBN: 978-1-315-59051-6 (ebk)

Published 2016 by Routledge2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

First published 2011 by Ashgate Publishing

711 Third Avenue, New York, NY 10017, USA

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Contents

List of Figures viiPreface ixTextual Note and Abbreviations xixAcknowledgements xxi

General Introduction: Sensibility in Practice: Dr. John Armstrong’s The Art of Preserving Health 1

The Critical Text

The Art of Preserving Health 51

Contextual Documents

Poetry

Thomas Creech, “The Plague of Athens, from the Latin of Lucretius,” 1682 131

[Anne Finch,] “A Nocturnal Reverie,” 1713 139

James Thomson, “A Hymn on Solitude,” 1748 143

James Thomson, “Preface,” Winter. A Poem, 1726 147

Edward Young, “Night the First,” 1742 153

[Thomas Warton], The Pleasures of Melancholy. A Poem, 1747 165

Theory of the Georgic

Joseph Addison, “An Essay on the Georgics,” 1697 173

Virgil, The Georgicks, trans. John Martyn, 1741 185

Joseph Trapp, “Of Didactic or Preceptive Poetry,” 1711–9 201

Medical Documents

Richard Bradley The Plague at Marseilles Consider’d, 1720 219

George Cheyne, An Essay of Health and Long Life, 1724 223

[Anonymous], A Letter to George Cheyne, 1724 233

[John Tristram], The Ill State of Physick in Great Britain, 1727 239

John Armstrong’s The Art of Preserving Healthvi

[John Armstrong], “Preface,” A Full View of All the Diseases Incident to Children, 1742 251

Table 1: Selected Chronology of significant figures, events, and publications 255

Table 2: Chronology of Classical Texts 267

Bibliography 269Index 295

List of Figures

1 Sir Joshua Reynolds, John Armstrong, M.D. (1767), Art Gallery of South Australia, Adelaide. Mezzotint by E. Fisher reproduced with kind permission of the Trustees of the Wellcome Library, London. 47

2 [Armstrong, John]. The Art of Preserving Health. A Poem in Four Books. London: A. Millar, 1744. Title-page. 50

3 The Plague. London: F. Cogan, 1743. Title-page. 130

4 Thomson, James. Winter. A Poem. 2nd edn. London: J. Millan, 1726. Title-page. 146

5 [Warton, Thomas]. The Pleasures of Melancholy. A Poem. London: R. Dodsley, 1747. Title-page. 164

6 Virgil. The Georgicks of Virgil, with an English Translation and Notes. Trans. John Martyn. London: R. Reily, 1741. Title-page. 184

7 Trapp, Joseph. Lectures on Poetry Read in the Schools of Natural Philosophy at Oxford. Translated from the Latin. [1711–19.] Trans. W. Bowyer and W. Clarke. London: C. Hitch and C. Davis, 1742. Title-page. 200

8 Bradley, Richard. The Plague at Marseilles Consider’d: with Remarks upon the Plague in General. London: W. Mears, 1720. Title-page. 218

9 A Letter to George Cheyne, M.D. F.R.S. Shewing, the Danger of laying down General Rules To those who are not Acquainted with the Animal Oeconomy, &c. For Preserving and Restoring Health. Occason’d by his Essay on Health and Long Life. London: J. Graves, 1724. Title-page. 232

10 [Tristram, John]. The Ill State of Physick in Great Britain: Truly Represented to all Lovers of Health, and of their Country. And An Apology for the Regular Physicians. London: J. Roberts, 1727. Title-page. 238

11 [Armstrong, John]. A Full View of All the Diseases Incident to Children. London: A. Millar, 1742. Title-page. 250

Preface

Measured by any standard, one of the most popular publications of the eighteenth century was a long didactic poem by a long-forgotten physician—and it remains a key document in the cultural, social, and medical history of the Enlightenment.1 This edition of John Armstrong’s The Art of Preserving Health furnishes a critical text with a historical introduction to the poem and its author, edited texts selected from medical and literary documents of the period. This Preface explains why we should return to Armstrong, and indeed why we should do so with reference to the Contextual Documents that are featured in the pages that follow.

The Art of Preserving Health largely remains overlooked, even by most students of the eighteenth century, a hardcover edition of 1979 notwithstanding. But for more than a century after its appearance in 1744 it was praised by critics, cited approvingly by physicians, pirated widely by booksellers, quoted by diarists, and celebrated by generations of readers in Britain, America, and on the Continent. It was reprinted, all 1,700 lines of it, in the various multivolume Libraries of British Poetry that filled the shelves of early nineteenth century homes and in turn defined the classics of British literature. The lucrative copyright for The Art of Preserving Health was coveted by the London-based Scottish bookseller Andrew Millar (who also published the great poems of James Thomson and Edward Young, and the bestselling novels of Henry Fielding and Samuel Richardson), and in America it was for years the only work of literature or medicine to be sold by Benjamin Franklin. Readers commanded dozens of editions, printed on fine and cheap paper, bound in every format. Numerous translations were commissioned by publishers in France, Italy, and Switzerland. The changing tastes, interests, and education of readers help to explain why this poem has been neglected for so long, but they cannot detract from its historical importance.

John Armstrong (1709–79) was the first to graduate insignitus (“with distinction”) from Edinburgh’s new medical school, in 1732. Following his friend James Thomson and encouraged by the entrepreneurial David Mallet (née Malloch), Armstrong arrived in London soon afterward. But London’s Royal College of Physicians judged Edinburgh a “foreign” university awarding inferior degrees—so Armstrong was denied a license to practice legally in Britain’s most lucrative medical marketplace. On the advice of his Scottish friends, Armstrong took up his pen to display his credentials and attract potential patients. But turning to print was risky, particularly for physicians, for it could initiate a damaging pamphlet-war.2 Even with Swift and Pope in declining health, poetry remained a

1 For references not footnoted in the Preface, see the General Introduction.2 Holmes indicates that “medicine was beyond comparison the most pamphlet-ridden

of the late seventeenth- and eighteenth-century professions. From the avalanche of writings issuing from the leading polemicists among the physicians, apothecaries and surgeons of

John Armstrong’s The Art of Preserving Healthx

powerful form of public expression that could make or break careers. Pope had recently made the chilling claim:

Yes, I am proud; I must be proud to seeMen not afraid of God afraid of me. (“Epilogue to the Satires” 2: 208–9)

But Armstrong’s adoption of blank verse addressed potential patients directly, eliding critics whose attacks engaged only with prose, and escaping the “poetic warfare” of heroic couplets.3 His poem offers us a perfect merger of what Helen Deutsch has described as “[the] parallel processes of professionalization and popularization” required both of authors and physicians in Britain at this time.4 Armstrong’s welcome depiction of a sensitive doctor writing directly to his ailing patients marketed new thinking to English readers, cultivated at Edinburgh’s consumer-driven medical school, reflecting a new appreciation of the exchange-based relationship between those who provide and those who seek medical expertise. The Art of Preserving Health illustrates social and cultural reasons why the innovative course of training at Edinburgh threatened London’s medical elites.

Armstrong’s evocation of emotional and physical experience displayed his professional manner to an increasingly literate public. Doing this through an imitation of Virgil’s Georgics was also culturally savvy. Readers were enjoying a resurgent enthusiasm for the Georgics among critics, translators, poets, and even scientists.5 Addison had explained why the georgic was the best model for didactic poetry: “where the Prose-writer tells us plainly what ought to be done, the Poet often conceals the Precept in a description, and represents his Country-Man performing the Action in which he wou’d instruct his Reader.” This meant that “the georgic mode,” coupled with sensitive description of emotional and

Augustan England, one might well conclude that the pen was considered to be far mightier than the prescription, the powder and the poultice.” See G. Holmes, Augustan England: Professions, State and Society, 1680–1730 (New York: Harper, 1982) 167.

3 On the metrical strictures of “poetic warfare,” see Abigail Williams, Poetry and the Creation of a Whig Literary Culture 1681–1714, (Oxford: Oxford UP, 2005) 135–72; 177–8.

4 See Helen Deutsch, “Symptomatic Correspondences: The Author’s Case in Eighteenth-Century Britain,” Cultural Critique 42 (Spring 1999): 36. In Scotland, professorial physicians were paid by students through lecture fees, which was far more lucrative than writing books—especially books that put those lectures into cheap print. Since no formal medical lectures were offered at Oxford or Cambridge during the first half of the eighteenth century, and professors there were not paid on a per-student basis anyway, medical popularization through print carried very different professional consequences in England. This is the primary reason why Edinburgh’s greatest medical teachers, including Alexander Monro primus, Robert Whytt, and William Cullen were reluctant to see their lectures in print while they held professorial chairs.

5 For an overview of the range of related works catering to the georgic vogue of this period, see John Martyn, in Contextual Documents, note 1.

Preface xi

physical feelings, allowed Armstrong to emphasize his subjective experience to an inclusive readership.6 Readers of popular poets such as Anne Finch would have been familiar with poetical attempts to refine emotional sensibility by focussing on sensory experiences that register beyond words, that lead to

… silent Musings [that] urge the Mind to seekSomething, too high for Syllables to speak. (“Nocturnal Reverie” 41–2)

More innovative was Armstrong’s attempt to cultivate his readers’ physical sensibility by teaching them to identify the anatomical meaning of particular sensations—that is, to cultivate a reflective corporeal sensibility. Lest readers be troubled by the terrifying imagery of plague and fire that Armstrong had borrowed from Virgil’s own model, Lucretius, he reassured them by adopting four of Galen’s moderating elements for healthy living, called the “non-naturals,” as titles for his poem’s four books: Air, Diet, Exercise, and The Passions. These same titles structured the medical writings of countless popular authors, from the enduring Luigi Cornaro and Nicholas Culpeper to the more recent George Cheyne.7 But only at a glance, and at a distance of some three centuries, does The Art of Preserving Health seem to iterate conventions.

The Art of Preserving Health continues to pose challenges for historians, especially for its now-arcane classicism and its lexical peculiarities8; likewise, the

6 For a reading of sensibility that suggests literary depictions of a “man of feeling” exclude women readers from them thus envisioning themselves, see Ann Jessie Van Sant, Eighteenth-Century Sensibility and the Novel (Cambridge: Cambridge UP, 1993) esp. 110–120. Armstrong frequently warns readers against “unmanly” habits and anticipates male readers who share his own distinctly masculine temptations, see APH 4: 350–370; 386. But participation in what Karen O’Brien has called “the georgic mode” invited subjective reflection without prescribing an exclusively male readership; indeed the poem was recommended by men to women readers. On the georgic mode as a kind of expansive self-understanding, see K. O’Brien, “Imperial Georgic: 1660–1789,” The Country and the City Revisited, ed. G. Maclean et al. (Cambridge: Cambridge UP, 1998) 161. For its recommendations, see Hugh Smith, Letters to Married Women, (London: G. Kearsley, 1767) 236–7.

7 By the mid-eighteenth century, Cornaro’s treatise, variably titled Discourses on a Sober and Temperate Life, was among the most popular books ever published. For its high profile and strong praise; see Bacon, “A History of Life and Death” [1638] in The Philosophical Works of Francis Bacon, ed. P. Shaw (London: Knapton et al, 1733) vol. 3, 369; Addison, Spectator 195 (13 Oct. 1711). An elaborate subscription-list heads a new translation of 1742: see T. Smith, trans. Hygiasticon (London: C. Hitch, 1742); some thirty editions of Cornaro appeared before 1791 (rivaling APH). More than seventy editions of Culpeper’s The English Physician (1652) were published during the eighteenth century. On Cheyne, see prefatory note to his Essay of Health and Long Life, in Contextual Documents.

8 See, for example, Anita Guerrini’s speedy dismissal of the poem as a “poetic version” of Cheyne in Obesity and Depression in the Enlightenment: The Life and Times of George Cheyne (Norman, OK: U of Oklahoma P, 2000) 184.

John Armstrong’s The Art of Preserving Healthxii

text misleads literary historians by referencing events of mainly contemporary concern.9 Indeed, Armstrong held no high ambitions for himself as a poet or as a commentator. He was writing urgently and only for readers of his time. Our historical distance risks simplifying the complexity of Armstrong’s classical address to his patron:

Nor should I wander doubtful of my way, Had I the lights of that sagacious mind Which taught to check the pestilential fire,And quel the deadly Python of the Nile.O Thou belov’d by all the graceful arts.

Thou long the fav’rite of the healing powers,Indulge, O MEAD! a well-design’d essay,Howe’er imperfect: and permit that I My little knowledge with my country share. (APH 1: 53–63)

Now the Oxford DNB indicates that Armstrong is appealing to Richard Mead, the great (“fav’rite”) London physician and philanthropist (“belov’d by all the graceful arts”) and it confirms Mead as the author of the enduringly popular Discourse on the Plague (that “taught to check the pestilential fire”). Less evident is the socially allusive force of these lines—for contemporary references to plagues and epidemics terrified potential patients, fellow physicians, and shook the highest levels of the British government.10 Armstrong’s very mention of “the deadly Python of the Nile” reminded readers of the alarming epidemic that ravaged Sicily only months before this poem was printed; the infection was understood to have reached Europe from Egypt. A pamphlet published within months of Armstrong’s poem refers to “the very great Apprehensions and Fears which possess our Nation on Account of the present Plague” in Calabria and Cueta.11 Richard Bradley’s

9 For example, Bruce Boehrer correctly identifies Armstrong’s many rhetorical debts to Milton, but he misunderstands Armstrong’s practical instructions to readers as an effort to reach Milton’s far more elevated purposes: “by appropriating patterns of digestive and excremental imagery from Paradise Lost, Armstrong invests solemnly in language that—as Michael Lieb has shown--operates for Milton himself largely on the level of ‘cosmic realism’ (128) … The apparatus of Milton’s vast metaphysical drama is brought to bear on phlegm and flatulence.” But Armstrong was not seeking to reach or to evoke literary greatness; his readers were seeking practical instruction provided through fashionable stylistic conventions. See B. Boeherer, “English Bards and Scotch Physicians: John Armstrong’s Debt to Paradise Lost and the Dynamics of Literary Reception,” Milton Quarterly 32 (Oct. 1998): 100. For an insightful discussion of Armstrong in the context of current poetic developments that also made innovative use of the georgic, see David Fairer, English Poetry of the Eighteenth Century, 1700–1789, (London: Pearson, 2003) 97–8.

10 Robert Walpole was forced to resign from the leadership of the government in February 1742, in part for his perceived failure to support the military in the wake of the disaster at Cartagena. See General Introduction, note 161.

11 See The Plague No Contagious Disease, (London: J. Millan, 1744) 3.

Preface xiii

Plague at Marseilles Considered provided reports that were typical in newspapers of the day, but it still passed through four editions between 1719 and 1721, and another in 1727—eight full years after that outbreak. In 1743, a new anthology of plague narratives combined classical reports with recent testimonies from Sicily; the second half of that book reprinted new Acts of Parliament intended to reassure British readers of their relative safety from Continental infections.12

Armstrong’s reference to pestilence would also have reminded his readers of the recent catastrophe at Cartagena, in South America, that stunned Britons with a humiliating military defeat far from home, “beyond th’ Atlantic foam,” as Armstrong would put it later (APH 3: 628). It was at this point that the colonial War of Jenkins’s Ear expanded into a far more bloody European conflict, the War of Austrian Succession (1739–48). But for Armstrong’s first readers, the reference to pestilential fire was the most alarming point. At least 7,500 of the 10,000-strong British naval and military contingent that landed at Cartegena were struck down by yellow fever before they could engage the Spanish, let alone return to fight Spain’s hostile allies in Europe. Armstrong’s readers would have worried that this disaster was an omen of the future for Britain’s military, for no physician could propose a cure or treatment to such fatal diseases—indeed Dr George Martine, who had also trained in Edinburgh and had attended the expedition, was killed in the epidemic. Like Armstrong, Martine had been denied a license to practice by the protectionist censors of the London College, which led to his posting on the ill-fated Cartagena expedition. So Armstrong’s possessive reference to “my country” (APH 1: 63) challenged lingering resentment of the Acts of Union (1707) that made London a shared capital only to relegate Scots to commercial peripheries. Armstrong exposes the prejudice of the London College in his gentle appeal to the views of sympathetic readers in England and back at home in Scotland.13 The popular resonance of The Art of Preserving Health, together with contextual documents that include John Tristram’s The Ill State of Physick in Great Britain, yields insights into the shared views of authors and their readers, which they articulated through the emerging commercialization of literature and medicine.14

London physicians saw that their control of the medical market was shrinking well before Scottish-trained students began to arrive during the 1730s. The anonymous pamphlet A Letter to George Cheyne was printed twice in 1724, and reflects local physicians’ anxiety about the popularization of medicine through print. For this anonymous author, the culprits were those physicians, like Cheyne,

12 See The Plague (London: F. Cogan, 1743), in Creech, Contextual Documents.13 Unfortunately, in the wake of Jacobite rebellion of 1745, even normally restrained

journals such as the Gentleman’s Magazine would call for “the total extirpation” of all Jacobite citizenry, which Howard Weinbrot interprets as a thinly veiled attack on the Scottish people. See GM 16 (1746): 415; H. Weinbrot, Britannia’s Issue: The Rise of British Literature from Dryden to Ossian (Cambridge: Cambridge UP, 1993) 1.

14 On the scholarly importance of such study, see D. Harley, “Rhetoric and the Social Construction of Sickness and Healing,” Social History of Medicine 12 (1999): 407–35.

John Armstrong’s The Art of Preserving Healthxiv

whose popularity as authors enabled thousands of potential patients to pay just four shillings for his book and thus to forgo the typical one-guinea (or 21 shillings) charge for a medical consultation. The author makes the important point that, since every patient is constitutionally unique, “any general Rule laid down to any number of Men … must be destructive,” which is why it is medically safer for patients to retain a physician who will examine them and tailor his advice “on the conviction of his own Senses.” But the Letter resounds with fear of the economic threat that books such as Cheyne’s Essay of Health and Long Life posed to London’s medical elite.

Cheyne had claimed his book is “careful not to incroach on the Province of the Physician,” but surely this disingenuous slick-speaking offered cold comfort to his less entrepreneurial colleagues. For readers of Cheyne’s Essay of Health called for no less than six printings in the very year it was first published, with at least ten editions appearing by 1745, creating a vogue matched only by Richardson’s novel, Pamela (1740).15 The Essay reveals the degree to which Galen’s “non-naturals” were integrated into the teaching of one of the century’s most mathematically inclined Newtonian physicians. It also demonstrates a conventional intertwining of medical with religious and moral instruction, which Cheyne used to serve his purpose. Adopting Biblical rhetoric and visual cues for emphasis he preached: “He that wantonly transgresseth the self-evident Rules of Health, is guilty of Self-Murder.” Even the most charitable reader could assume this meant that not following Cheyne’s published advice will lead to moral and physical sin of truly theological proportions.

Armstrong’s poetic instructions marked a strident departure from the period’s most popular text of its kind. His approach to the rules of health is far less pious, and indeed he shares its difficulty:

’Tis hard, in such a strife of rules, to chuseThe best, and those of most extensive use; Harder in clear and animated song Dry philosophic precepts to convey (APH 1: 46–9)

Apart for Armstrong’s allusion here to Virgil, whose own uncertainty at the start of the Georgics only encourages sympathetic attention, these lines display Armstrong’s reverence for his patients. He does this by communicating his emotional vulnerability and proceeds by presenting his own physical weaknesses. Later in the poem, Armstrong goes so far to loosen assumptions about physicians’ immunity from temptations. Surely the following depiction of a sore head after a long night refers to personal knowledge:

15 See T. Keymer and P. Sabor, Pamela in the Marketplace: Literary Controversy and Print Culture in Eighteenth-Century Britain and Ireland (Cambridge: Cambridge UP, 2006).

Preface xv

Soon your heaven is gone; a heavier gloom Shuts o’er your head: and, as the thund’ring stream, Swoln o’er its banks with sudden mountain rain, Sinks from its tumult to a silent brook; So, when the frantic raptures in your breast Subside, you languish into mortal man; You sleep, and waking find yourself undone. (APH 4: 177–83)

This degree of candid self-reflection constitutes a central element of Armstrong’s instruction, as well as his gestures to classical poets who wrote on similarly challenging topics; like them, he teaches by eliciting sympathy. Two years earlier, Armstrong had displayed the practical advantages of his self-effacing approach to medical knowledge. His pioneering pediatric treatise, A Full View of All the Diseases Incident to Children (published anonymously, 1742) was the first book of its kind intended for lay readers who care for sick children—“the Parents, but especially Mothers.” Right from the start, his Preface responds to the therapeutic worry raised by Cheyne’s anonymous critic: can general advice provide an effective substitute for personal consultation? Armstrong states that the women who consult his book can be confident that his advice “is altogether founded upon Practice.” In an observation that is characteristically sympathetic and practice, he points to the fact that “Children have not the Power of Speech to describe their Complaints,” and that physicians are “not so clear as they could wish” when recommending treatments. Armstrong will describe the cures that have too long been held by the specialists whose “fear of doing Mischief,” paradoxically, has prevented them from administering them. Referring to medical treatments, he announces, “It is entirely upon Account of those Female Practitioners, that I have put all the Formulae into English, and having set down all the Articles and their Doses at full Length.” For Armstrong, popularization of medical knowledge is a humanitarian and practical matter, one that reflects the demands of patients more than the commercial worries of physicians—whether they be authors or not.

When James Boswell met with Hume in 1775, Hume said he admired “the truly classical” elements in Armstrong’s poem, and they concluded that “The Art of Preserving Health was the most classical Poem in the English Language.”16 These days, most of the popular literature of the eighteenth century that endures beyond classrooms, from the picaresque novels of Defoe and Fielding to the Romantic poems of Wordsworth and Coleridge, can do so in part because its authors did not require a classical education of their readers. Indeed, the evocative immediacy (or the “writing to the moment”) that distinguishes the sentimental novels that appeared alongside The Art of Preserving Health continue to attract readers in part because they employ a distinctly emotional and psychological realism. Samuel Richardson, for example, expressly designed his novels as “a new species of writing” that could appeal to as many readers as possible by adopting

16 See The Private Papers of James Boswell, eds. Ralph Heyward Isham et al. (New York: W. E. Rudge, 1928–34) vol. 2, 27.

John Armstrong’s The Art of Preserving Healthxvi

the speech, thoughts, and feelings of real people—just one reason why he always refused to call his works novels or fictions.17 Armstrong’s sophisticated blending of realistic with obscure language and classical imagery, in a poem that seeks to depict physical feeling and also to evoke emotional and intellectual responses, seems at odds with the other great didactic works of its time, and contributes to its neglect even among specialists of this period.

Armstrong’s contemporaries, including Thomas Gray, William Collins, and Samuel Johnson, published poems that displayed their command of the classics by referencing their ancient models in their subtitles and by adhering closely to Latin or Greek forms.18 Armstrong understated his debts to Virgil and Lucretius, partly because his primary concern was to win the approval of readers without classical training. At the same time, while his acute depictions of physical and visual perceptions at times suggest the “writing to the moment” familiar to readers of realistic novels, reading them as direct experience distorts their classical force:

Thro’ every nerve A sacred horror thrills, a pleasing fear Glides o’er my frame. The forest deepens round; And more gigantic still th’ impending trees Stretch their extravagant arms athwart the gloom. (APH 2: 366–70)

Like Lucretius in De Rerum Natura and Virgil in his Georgics, Armstrong used verse to display both his learning and his expertise by blending the language of physical feeling with mythological visions: this “sacred horror” that “thrills” depicts the amazement felt by poets touched by the divine muses who shape or distort his inspired perception of the natural world.19 Yet these lines also depict a corporeal experience meant to teach readers to identify the first symptoms of infection; for sacred, according to a revived poetic convention that follows Virgil, also means “accursed”; horror means “shudder.”20 The sublime vision of trees extending themselves toward “the gloom” refers to other classical imitations familiar to readers of Anne Finch, whose “Nocturnal Reverie” emphasizes the imaginative consequences of acute auditory and visual sensitivity. Poems contemporary with The Art of Preserving Health, such as Thomson’s “On Solitude” and Thomas Warton’s “The Pleasures of Melancholy” required evocations of near-silence and solitude, for such conditions emphasize the poet’s own corporeal feeling.

17 See my “Why Clarissa Must Die: Richardson’s Tragedy and Editorial Heroism,” Eighteenth-Century Life 31 (Fall 2007) 1–28.

18 See, for example, Johnson’s learned imitations of Juvenal that include London (1738) and The Vanity of Human Wishes (1749); Collins’s closely Pindaric Odes on Several Descriptive and Allegoric Subjects (1746); and Thomas Gray’s two famous Pindaric odes, “The Progress of Poesy” and “The Bard” (1748).

19 For a more recent example, see the lyrics to Leonard Cohen’s popular song “The Sisters of Mercy” in Stranger Music (Toronto: McClelland and Stewart, 1993) 109–10.

20 See APH 3: 506.

Preface xvii

Armstrong used classical conventions because he understood that they lent special didactic resonance: just like the practical instructions that contemporary scientists drew from Virgil (who followed Lucretius), these lines emphasize the dangers of moist air, and as Armstrong argues throughout his poem, it is this that transmits disease.21 And like recent medical publications that included classical and contemporary reports of disease, The Art of Preserving Health links current phenomena to ancient mystery—as he reveals at a particularly terrifying moment in the poem, “the salutary art was mute” as the sweating sickness raged in England (APH 3: 604). Only by preserving health in the present can we protect against diseases known even to the ancients. This combination of imaginative allusiveness and practical instruction comprises the classical manner that Hume and Boswell found distinctive in Armstrong.22 This poem’s illumination of contemporary social, cultural, and medical concerns retained its appeal long after it was first published, and long after it captured the attention of its lucrative first readers.

This book includes two chronological timelines (Tables 1 and 2) that chart the careers and publications of related medical, literary, and classical authors; those printed in bold are featured in this book.

21 See F. de Bruyn, “Reading Virgil’s Georgics as a Scientific Text: The Eighteenth-Century Debate between Jethro Tull and Stephen Switzer” ELH 71 (2004): 661–89.

22 For suggestive discussions of later developments in eighteenth-century poetry and criticism, that divided Greek and Roman “classicism” from antique “Gothicism,” see R. G. Terry, Poetry and the Making of the English Literary Past, 1660-1781, (Oxford: Oxford UP, 2001) 286–323.

Textual Note and Abbreviations

A bibliographical reference cites each copy-text selected for this edition, along with a prefatory biographical footnote on the author and translator (when appropriate).

Armstrong alludes frequently to Virgil’s Georgics and to Lucretius’s De Rerum Natura (“On the Nature of Things”), and authors of the Contextual Documents gesture to a wide range of classical sources. References to Latin texts cite the Loeb editions (which appear in the footnotes and in the Bibliography), but references to Horace’s Odes and Virgil’s Georgics cite David Ferry’s recent dual-language editions (1997 and 2005).

During the 1740s, readers could consult a number of reasonably-priced and frequently reprinted translations of Homer, Lucretius, and Virgil. By far the most popular were Alexander Pope (Iliad 1715–20; Odyssey 1726), Thomas Creech (1682), and John Dryden (1697):

Creech, trans. T. Lucretius Carus, 2nd edn (Oxford: Lichfield, 1683).

Dryden, trans. The Works of Virgil in English, ed. W. Frost and V. Dearing. The Works of John Dryden (London: U of California P, 1987) vol. 5.

Pope, Iliad The Iliad of Homer, 5th edn [1743], ed. S. Shankman (London: Penguin, 1996).

Pope, Odyssey The Odyssey of Homer, ed. M. Mack (New Haven: Yale UP, 1967) 2 vols.

Further abbreviations include:

Foxon D. F. Foxon, English Verse, 1701–50: A Catalogue of Separately Printed Poems (Oxford: Oxford UP, 1975) 2 vols.

Johnson Samuel Johnson, ed. A Dictionary of the English Language (London: W. Strahan et al, 1773) 2 vols.

Oxford DNB The Oxford Dictionary of National Biography, updated regularly http://oxforddnb.com

OED The Oxford English Dictionary, updated regularly http://oed.com

Spectator J. Addison et al. The Spectator, ed. D. F. Bond (Oxford: Clarendon P, 1965) 5 vols.

Complete citations appear in the footnotes and in the Bibliography.

Acknowledgements

The task of furnishing the biographical, social, and intellectual contexts that can illuminate a learned poem so long neglected as The Art of Preserving Health required research and advice that cannot be found in just one place—let alone in just one library or academic department. I am grateful to the colleagues, librarians, archivists, and friends, from Toronto to London to Edinburgh, who made such a challenging project so rewarding, and to the Social Sciences and Humanities Research Council of Canada, for its support.

At the earliest stages of this project, Roy Porter offered enthusiastic advice; Janice Thaddeus kindly promised me that the challenge would be worthwhile. Roy and Jan are sorely missed by a constellation of readers and friends. John Baird, Alan Bewell, Richard Greene, and Heather Jackson provided wise counsel at crucial stages. I also wish to thank my friends and colleagues, in particular Roseanne Carrara, Harold Cook, Jennifer Foy, Anna Greenwood, Craig Hanson, Gavin Kelly, Christopher Lawrence, Susan Manning, Juan Christian Pellicer, Beryl Pong, Richard Rodger, Lisa Rosner, Peter Sabor, Richard Sher, Jay Voss, Porterfield White, and Karina Williamson. I am grateful to archivists and librarians at the British Library, the Thomas Fisher Rare Book Library (Toronto), the National Library of Scotland, University of Edinburgh Library, and the Wellcome Library.

This book is for Nadine, Yael, and Sadie, the loves of my life.

General Introduction Sensibility in Practice: Dr. John Armstrong’s

The Art of Preserving Health

During the early spring of 1764 James Boswell was lonely and miserable, forced by his father to leave his literary friends in London to study law in Utrecht. After days of wandering along the rainy streets, Boswell decided to focus his energies by translating a Scottish legal textbook into Latin. Writing in his journal, Boswell reflected on others who choose to continue to dwell on their unhappiness:

They do not budge an inch to escape their woes. They fold their arms, they remain idle. Their blood becomes thick, their brains heavy, their thoughts dark. What a horrible situation! Dr. Armstrong, in his poem on The Art of Preserving Health, gives a description of that state which I have just described. He says,

The prostrate soul beneath A load of huge Imagination heaves. And all the horrors that the murderer feels With anxious flutterings wake the guiltless breast. (4:101–4)

It is impossible to translate into French his force of style, a force remarkable even in English. Rouse yourselves, wretched mortals!

These verses depict an imaginative poet sympathizing with his anxious reader—indeed its evocative power suggests that the poet himself was once thus frightened. By evoking sympathy and reflecting on its associated thoughts and feelings, Armstrong’s verse led Boswell to a therapeutic understanding: the source of his distress is ultimately imaginative and not physical. Boswell quoted these lines from memory, suggesting he had resorted to Armstrong’s poetical therapy before—and he would do so again in print, some years later.12

1 References to The Art of Preserving Health cite the first edition (London: A. Millar, 1744), as it appears in this edition; there are no significant variations among the many editions.

2 See Boswell in Holland, 1763–1764, ed. Frederick A. Pottle (New York: McGraw-Hill, 1956) 240. Boswell quoted these lines again in 1775, telling readers of the London Magazine that he “admires the expression very much,” because they suggest a fellowship among similarly afflicted readers: see The Hypochondriack, by James Boswell, ed. Margery Bailey, vol. 1, 2 vols (Stanford: Stanford UP, 1928) 139. The final line should read, “With anxious flutterings wake the guiltless breast.”

John Armstrong’s The Art of Preserving Health2

Challenging the Newtonian medical theory of the period, whose strictly physiological concerns have been described as “psychiatry without mind,”3 Dr. John Armstrong (1709–79) sought therapeutic effects when he published his four-part poem, The Art of Preserving Health, in 1744. The intellectual historian Peter Gay has observed that the Scientific Revolution “was a voyage into abstraction and specialization” that many Enlightenment figures managed to resist.4 Indeed, by voicing his defiance of “the mathematical physic” characteristic of Newtonian medical theory, in a poetic style that was suited both to offering specific instruction and imaginative excursion, Armstrong’s masterpiece—which remained hugely popular throughout a particularly innovative century—should now be recognized as a key literary example of that resistance.5 This Introduction and indeed this book display Armstrong’s debts to contemporary interest in the period’s energetic rediscovery of Virgil’s Georgics, a rediscovery of a text that, particularly during the years immediately following the death of Alexander Pope, encouraged young poets to develop their readers’ associations between emotional experience and practical conduct.6

Armstrong skillfully integrates an innovative appreciation of his patient’s feelings with wider respect for Virgil’s classical model by placing the reader in the position of the honorable Roman farmer. He does this in ways that accord with David Fairer’s recent discussion of “the georgic mode” in contemporary poetry: “the ‘Nature’ with which the Georgic poet works is the same ambiguous power

3 See Akihito Suzuki, “Psychiatry Without Mind in the Eighteenth Century: The Case of British Iatro-Mathematicians,” Archives internationales d’histoire de sciences 48 (1998): 120–146. See also A. Suzuki, Mind and Its Disease in Enlightenment British Medicine, PhD diss. University College London, 1992; Roy Porter, “Barely Touching: A Social Perspective on Mind and Body” in The Languages of Psyche: Mind and Body in Enlightenment Thought, ed. G. S. Rousseau (Berkeley: U of California P, 1990): 45–79. On social aspects of the clinical dimension, see Wayne Wild, Medicine-By-Post in Eighteenth-Century Britain: The Changing Rhetoric of Illness in Doctor-Patient Correspondence and Literature, PhD diss. Brandeis U., 2001.

4 See Peter Gay, The Enlightenment: The Science of Freedom (New York: Norton, 1969) 128. On the dominance of Newtonian discourse in contemporary medical theory, see the following articles by Anita Guerrini: “Archibald Pitcairne and Newtonian Medicine,” Medical History 31 (1987): 70–83; “James Keill, George Cheyne, and Newtonian Physiology, 1690–1740,” Journal of the History of Biology 18 (1985): 247–66; and “The Tory Newtonians: Gregory, Pitcairne, and their Circle,” Journal of British Studies 25 (1986): 288–311. See also T. Brown, “From Mechanism to Vitalism in Eighteenth-Century English Physiology,” Journal of the History of Biology 7 (1974): 179–216.

5 For a recent study of the particular suitability of georgic poetry for popularizing contemporary scientific concepts, see Frans de Bruyn, “Reading Virgil’s Georgics as a Scientific Text: The Eighteenth-Century Debate between Jethro Tull and Stephen Switzer,” ELH 71 (2004): 661–89.

6 For a recent survey of the prominence of georgic poetry among literary readers through the mid-eighteenth century, see Juan Christian Pellicer, “The Georgic,” The Blackwell Companion to Eighteenth-Century Poetry (London: Blackwell, 2008) 403–16.

General Introduction 3

the workers have to confront, a changeable force which nurtures and tortures while it tracks the cycle of the seasons.”7 Further, by borrowing familiar rhetoric and structural principles from Galenic medicine throughout his poem, Armstrong retained a traditional view of nature as a force that both harms and heals. But his deliberate focus on volatile emotional states (or “passions,”) opens up a new view of literary experience as a therapeutic force.

Armstrong’s Art of Preserving Health adopts and then adjusts poetic evocations of powerful feelings, such as the vision of terror that Armstrong’s close friend James Thomson provided in his great poem Winter (1726); this literary practice had provided a therapeutic harnessing of sublime imagery that tested current somatic theories of the mind.8 Similar contemporary literary examples are significant because, together, they show that the Art of Preserving Health retains historical importance not only for its powerful depiction of the knowledgeable physician as a feeling patient, but also for the way it encouraged its considerable numbers of eighteenth-century readers to think critically about the emotional meaning and pedagogical significance of this poet’s clinical depictions. This reflectiveness on real and imagined encounters between patients and physicians, this book suggests, is just the most evident way in which this poem signals the sympathetic abilities of its readers, which has seemed more characteristic of contemporary novels than didactic poetry.9 The Art of Preserving Health has been neglected by later generations of readers, yet its characterization and reflectiveness was without precedent in both the medical and literary material of the early eighteenth century.10 The first part of this Introduction will pave the way for a closer reading of the poem by charting Armstrong’s earlier writing, medical training, and pioneering medico-poetic career, to show why this poem touches so tellingly on many important elements of professional, literary, and intellectual life in London and Edinburgh during the 1740s.

7 See D. Fairer, “Persistence, Adaptation, and Transformations in Pastoral and Georgic Poetry,” in The Cambridge History of English Literature, 1660–1780, ed. J. Richetti (Cambridge: Cambridge UP, 2005) 259–86. See also D. Fairer, English Poetry of the Eighteenth Century, 1700–89 (London: Longman, 2003) 79–101.

8 Thomson involved Armstrong in The Castle of Indolence; he provided the final three stanzas of Canto One that personify Lethargy, Hydropsy, Hypochondria, and Apoplexy. See Liberty, The Castle of Indolence, and Other Poems, ed. J. Sambrook (Oxford: Clarendon P, 1986) 197–8. For Armstrong’s close friendship with Thomson and other London-based Scots, see Mary Jane W. Scott, James Thomson: Anglo-Scot (Athens, GA: U of Georgia P, 1988) 204–53.

9 In this respect, my discussion of the objective treatment of the subjective narrator will be indebted to Gabrielle Starr, Lyric Generations: Poetry and the Novel in the Long Eighteenth Century (Baltimore: Johns Hopkins UP, 2004). Starr does not mention John Armstrong nor any aspect of medical discourse.

10 For a suggestive discussion of reasons why so much Scottish poetry of this period remains neglected by readers and historians, see C. E. Andrews, “‘Almost the Same, but Not Quite’: English Poetry by Eighteenth-Century Scots,” The Eighteenth Century 47 (2006): 59–79.


Despite the thriving prejudices against Scottish physicians who took up practice in London in the years following Scotland’s political union with England (1707),11 John Armstrong’s innovative depiction of sympathy between ailing English patients and a wise Scottish physician and between a learned poet and receptive readers eventually won him a precious measure of patronage from the English medical establishment. Over the course of the next century, generations of eighteenth- and nineteenth-century readers across Britain, Europe, and America celebrated the heightened and innovative display of emotional and physical sensibility in The Art of Preserving Health. As we will see in further detail, this poem’s publication history, as well as its open debts to stylistic, conceptual, and professional controversies of the time, attest to its author’s unique position in the mid-eighteenth century’s transitional political, literary, and medical contexts.12 Critical approaches to eighteenth-century literary culture make frequent reference to the coinage of “sensibility,” a neurological term which was introduced by the Edinburgh physiologist Robert Whytt in 1751—yet its cultural influence was limited by bibliographical history, for Whytt’s highly technical treatise addressed a very limited audience of specialists who did not call for a second edition until 1763.13 Armstrong’s medical training between 1728 and 1732 at the University

11 See P. Langford, “South Britons’ Reception of North Britons, 1707–1820,” in T. Smout, ed. Anglo-Scottish Relations, from 1603 to 1900 (Oxford: Oxford UP, 2005) 143–69.

12 With regard to medical theory and practice, William Bynum has observed that “just as the intellectual origins of the French Revolution are sometimes traced from 1749, many of the concerns and attitudes of the late Enlightenment doctors seem to find a resting place around this date”: see W. F. Bynum, “Health, Disease, and Medical Care,” The Ferment of Knowledge, ed. G. S. Rousseau and Roy Porter (Cambridge: Cambridge UP, 1980) 220.

13 For suggestions that Whytt popularized the notion of sensibility beyond medical contexts, see G. J. Barker-Benfield, The Culture of Sensibility: Sex and Society in Eighteenth-Century Britain (Chicago: Chicago UP, 1992); Geoffrey Sill, The Cure of the Passions and the Origins of the English Novel (Cambridge: Cambridge UP, 2001); Ann Jessie Van Sant, Eighteenth-Century Sensibility and the Novel (Cambridge: Cambridge UP, 1993). Whytt coined this term to describe the actions of an immaterial “sentient principle” that directs purposeful but involuntary nervous reflexes: see An Essay on the Vital and Other Involuntary Motions of Animals (Edinburgh: Hamilton and Balfour, 1751). Whytt’s definition sparked a spirited debate with Albrecht von Haller over the relative nature of nervous “irritability,” which in Whytt’s view was constituted by neurological reflex rather than through local nervous sensitivity. See Roger French, Roger Whytt, the Soul, and Medicine (London: Wellcome Trust, 1969); Armstrong refers to “irritable nerves” twice in his poem, but he uses the term in the more general sense—for nerves were understood by nonspecialists to include muscles, ligaments, and neurological tissue (see APH 3: 448; APH 4: 447). Whytt discussed the controversy with Haller in his Physiological Essays of 1761; Haller’s side of the debate was not published in English until 1936. We should note that, as early as 1738, a regular contributor to Monro’s Medical Essays and Observations revised and Published by a Society in Edinburgh showed that involuntary actions (later termed reflexes) cast mystery rather than certainty on the mechanical relationship between mental will and physical experience, calling for further experiment and discussion. See William Porterfield, “An Essay concerning the Motions of Our Eyes, Part II” Medical Essays 4 (1738): 124–293.


of Edinburgh coincided with Whytt’s, and their shared course of study probably informed both men’s shared view that the mind responds both to internal (emotional) and external (physical) sensations.14 Literary and medical historians focus, sometimes exclusively, on the fashionable “nerve-doctor” George Cheyne when citing the scientific elements of sensibility’s moral dimensions—and it is true that after Cheyne’s death in 1743, one eulogist claimed that “his System has a peculiar Tendency to promote Virtue and Religion, to calm the Passions, refine the Mind, and purify the Heart.”15 But it is also important to note that despite the initial popularity of Cheyne’s Essay of Health and Long Life (1724) and The English Malady (1733), the former was not reprinted between 1745 and 1787, nor the latter after 1735.16 If we date “the age of sensibility” from the publication of Richardson’s novel Pamela (1740) to the publication of Wordsworth and Coleridge’s poems Lyrical Ballads (1798), then we should note that Cheyne’s and Whytt’s popularity among readers was quite muted throughout—keeping in mind that the social contacts of Samuel Richardson and Samuel Johnson, both of whom famously referred to Cheyne, were not representative of the wider reading public. Rather it was the conceptual program, humanitarian message, and unprecedented mode of cultural engagement achieved by Armstrong’s Art of Preserving Health that allowed it to reach beyond the range of most if not all popular treatises on these subjects well into the nineteenth century, at which

14 See Edinburgh University Library MSS DC.595.15 See Dr. Cheyne’s Account of Himself and of His Writings (London: Wilford,

1744) 27. For major literary studies that focus on Cheyne, see Janet Todd, Sensibility: An Introduction (London: Methuen, 1986), John Mullan, Sentiment and Sociability: The Language of Feeling in the Eighteenth Century (Oxford: Clarendon P, 1988); C. J. Barker-Benfield, The Culture of Sensibility: Sex and Society in Eighteenth-Century Britain (Chicago: U of Chicago P, 1992). At a recent symposium celebrating the 200th anniversary of the founding of the Royal Edinburgh Asylum, the medical historian Andrew Scull provided a keynote address that surveyed Scottish contributions to British psychiatry, citing Cheyne as the only worthy example. See A. Scull, “The Peculiarities of the Scots? Scottish Influences on the Development of English Psychiatry, 1700–1980,” unpublished paper, The History of Medicine in Scotland Symposium, Royal College of Physicians of Edinburgh, 10 October 2009.

16 Although The English Malady called for six editions in its first two years, the 1735 edition was its last. On Cheyne’s memoir of his fallen state before he underwent a religio-spiritual conversion, which he appended to this work, see Anita Guerrini, “Case History as Spiritual Autobiography: George Cheyne’s “Case of the Author,” Eighteenth-Century Life 19 (May 1995): 18–27. Cheyne’s popular authority has waned well before he completed his Essay on Regimen (1740), for as Robert Schofield has shown, “he had to indemnify his publishers for losses suffered on the first edition”: see Mechanism and Materialism: British Natural Philosophy in an Age of Reason (Princeton: Princeton UP, 1970) 61. See also Henry Fielding’s ridicule of Cheyne in his pamphlet, The Tryal of Colley Cibber …… and the Arraignment of George Cheyne, Physician at Bath, for the Philosophical, Physical, and the Logical Heresies Uttered in his Last Book on Regimen (London: n.p., 1740).


time the taste for didactic poetry met its fatal decline and the circulation of new discoveries turned the historical page.17

The Art of Preserving Health ranks among the most frequently reprinted books of the eighteenth century.18 In 1747, within three years of its release, The Art of Preserving Health entered its third edition and eighth impression. In the mid-1760s, the poet laureate Thomas Warton translated 50 lines of it into Latin, with lengthy annotations on its classical allusions.19 The “public favour” that continued to celebrate Armstrong’s achievement was jealously noted with some bitterness by Thomas Chatterton as late as 1770, who associated the Art with the sensational and yet scandalous pan-European publication of the Ossian forgeries a few years earlier.20 By the time the distinguished physician and editor John Aikin published his edition of the Art in 1795, with lengthy scholarly apparatus, the poem had called for more than 13 editions and 27 impressions in London, Edinburgh, Dublin, and notably at Benjamin Franklin’s shop in Philadelphia, where for some 20 years it was the only work of medicine or verse to carry his great American imprint.21 The Art was celebrated on the Continent, where it was translated into

17 On this decline, see K. Heinzelman, “Roman Georgic in the Georgian Age,” Texas Studies in Literature and Language 33 (Summer 1991): 182–214. As Karina Williamson has noted, Thomas de Quincey considered didactic poetry an oxymoron. See K. Williamson, “West Indian Georgic,” rev. of The Poetics of Empire, by John Gilmore, Essays in Criticism 73 (Winter 2000): 80–89.

18 For a recent discussion of Armstrong’s poem in the context of eighteenth-century georgic poetry, see David Fairer, “Persistence, Adaptations and Transformations in Pastoral and Georgic Poetry,” J. Richetti, ed., The Cambridge History of English Literature, 1660–1780 (Cambridge: Cambridge UP, 2005) 282–3. William J. Mahoney undertook a study of Armstrong’s life and work, but did not live to complete it: see his fragmentary George and John Armstrong of Castleton (Edinburgh: Livingstone, 1954). Lewis Knapp’s survey of Armstrong’s friendships, especially with Tobias Smollett and John Wilkes, does not discuss his writings: see “Dr. John Armstrong, Littérateur, and Associate of Smollett, Thomson, Wilkes, and Other Celebrities,” PMLA 59 (1944): 1019–58. The Art of Preserving Health has been noted as a historical curiosity in various medical journals. The first of these was Joseph Collins, “Literary Leanings of Eighteenth-Century Physicians,” Proceedings of the Charaka Club 4 (1916): 27–44; for the most recent, see William B. Ober, “John Armstrong, M.D.,” New York State Journal of Medicine 65 (1 Nov. 1965): 271–7.

19 See Thomas Warton, “De Ratione Salutis Conservandae,” The Poetical Works of the Late Thomas Warton, vol. 2, 2 vols (Oxford: the University Press, 1802) 273–6.

20 See Chatterton’s “Kew Gardens” (1770): “Alas! I was not born beyond the Tweed!/ To public favour I have no pretence,/ If public favour is the child of sense:/ To paraphrase on Home in Armstrong’s rhymes,/ To decorate Fingal in sounding chimes,/ The self-sufficient Muse was never known,/ But shines in trifling dulness all her own” (388–94). See The Complete Works of Thomas Chatterton, ed. Donald S. Taylor (Oxford: Clarendon P, 1971). Chatterton is ridiculing Armstrong’s depiction of his childhood in the Scottish Borders; see Art of Preserving Health 3: 72–99.

21 Through the mid-1740s, Franklin was establishing The Pennsylvania Hospital, which opened in 1751. Armstrong’s didactic poem would have suited his taste as well as


German once, and into French and Italian twice.22 On his German tour of 1822, Wordsworth recalled that the sublimity of the Danube had been suitably expressed a century earlier in Armstrong’s juvenilia, indicating this major poet’s familiarity even with Armstrong’s collected ands rather mediocre verse—which by then had appeared in numerous editions.23 The nineteenth-century essayist George Gilfillan wrote that “we well remember to have heard [the poet] Thomas Campbell reading [from The Art of Preserving Health] in the Common Room of Glasgow College with great enthusiasm, as he proposed it to the students as the subject of a prize translation into Latin verse.” This must have been after 1826.24

In his lectures on rhetoric (1784), Hugh Blair had ranked Armstrong’s Art with Pope’s Essay on Man and Boileau’s Art of Poetry as “of the highest species, ancient or modern.”25 In 1819, the publisher Thomas Campbell claimed that “The Art of Preserving Health is the most successful attempt, in our language, to incorporate material science with poetry.”26 Suggesting a reconciliation between Romanticism and didactic poetry, William Hazlitt included all two thousand lines of the poem in his Select Poets of 1825, and the American educator and medical reformer William

his current interests, for as Walter Isaacson recently suggested, Franklin’s philosophical outlook as “more practical than abstract”: see Benjamin Franklin: An American Life (New York: Simon and Schuster, 2003) 150. No other medical work was printed by Franklin until 1750; the next book of poems from his press was an ephemeral poem by Thomas Letchworth of 1766. See C. William Miller, Benjamin Franklin’s Philadelphia Printing, 1728–1766: A Descriptive Bibliography (Philadelphia: American Philosophical Society, 1974).

22 For the German translation, see Die Kunst, die Gesundheit zu erhalten (Zürich: Füeßly, 1788); the Italian edition, Igea ovvero l’arte di conservar la salut (Livorno: Masi, Tommaso, 1806), by the great translator of Milton, Lazzaro Papi, was his only English translation beyond the Milton canon. A second translation was composed by T. J. Mathias, La salute o l’arte di conservarla poema in quattro canti (Naples: Nobile, Agnello, 1824). The two French translations are Fragment du Poème anglais intitulé «L’Art de conserver la santé», trans. A.-L. Marquis (Rouen: Baudry, 1818) and the complete L’Art de conserver la santé, trans. N. B. Monne (Paris: Goujon, 1827).

23 See Wordsworth’s Memorials of a Tour on the Continent: “Before this quarter of the Black Forest was inhabited, the source of the Danube might have suggested some of those sublime images which Armstrong has so finely described.” See “The Source of the Danube,” Wordsworth’s Poetical Works, ed. E. De Selincourt and Helen Darbishire, vol. 3 (Oxford: OUP, 1951) 170, 473. Armstrong wrote his Imitations of Shakespeare, to which Wordsworth refers, in 1726, when he was 15.

24 See G. Gillfillan, Introduction, The Poetical Works of Armstrong, Dyer, and Green (Edinburgh: James Nichol, 1880), xxii. Gillfillan entered his second year at the University of Glasgow when the poet Thomas Campbell (1777–1844) became Rector: see Oxford DNB.

25 See H. Blair, Lectures on Rhetoric and Belles Lettres, 1784, vol. 2 (Delmar, NY: Scholars’ Facsimiles and Reprints, 1993) 362.

26 See Specimens of the British Poets, vol. 6 (London: John Murray, 1819) 345.


Andrus Alcott provided explanatory notes for a Boston edition in 1838.27 A Scottish edition of Armstrong’s poems, printed in 1858 and again in 1880, continued the tradition of describing Armstrong as an “eminent” British poet, quoting the Monthly Review’s assessment of 1770, that “The Art of Preserving Health … on account of the reputation it has so justly acquired, precludes all criticism.”28 Such claims were made in every major anthology of the time, each promising to render John Nichols’s prediction, made some 15 years after Armstrong’s death in 1779, that “this poem will transmit his name to posterity as one of the first English writers.”29 Tastes and interests change, and this did not come to pass, despite the fact that a modestly priced hardcover edition was published in New York precisely 200 years after Nichols’s pronouncement.30 Armstrong’s Art remains an essential document of important social changes that affected literary style, the medical profession, and the requirements of readers in the mid-eighteenth century.

Early Biography and Earliest Works

On 6 February 1732, John Armstrong became the first student to graduate M.D. insignitus (“with distinction,”) from the University of Edinburgh’s newly established medical school (1726).31 Joining a wave of ambitious and educated Scots following 1707, who included Armstrong’s lifelong friends David Hume, Thomson, David Malloch (soon Mallet), and Tobias Smollett, Armstrong moved directly from Edinburgh to England; he sought a medical license from London’s Royal College of Physicians shortly after his graduation.32 Armstrong’s medical education was unique among London physicians, largely because Edinburgh’s training curriculum emphasized practical expertise at the bedside over the Newtonian calculating that

27 See The Art of Preserving Health: A Poem, in Four Books. With a Critical Essay by J. Aiken M.D. and Notes by Dr. Alcott (Boston: George W. Light, 1838) 210.

28 See the Preface to The Poetical Works of Armstrong, Dyer, and Green, ed. George Gillfillan (Edinburgh: James Nichol, 1880). For an indication of the poem’s contemporary reception in America, see Poems of Established Reputation, Collected for the Use of the Colleges (Baltimore: Warner and Hannah, 1802).

29 See J. Nichols, Biographical and Literary Anecdotes of William Bowyer (London: Nichols, 1782) 279.

30 See The Art of Preserving Health, Aging and Old Age Collection, ed. Robert Kastenbaum et al. (New York: Arno P, 1979).

31 Armstrong graduated M.D. on 4 February 1732; he was the ninth to receive the M.D. at Edinburgh: see List of the Graduates in Medicine in the University of Edinburgh (Edinburgh: Neill, 1867) 2. John Nichols recalled that “he took his degree with much reputation”: see Literary Anecdotes of the Eighteenth Century, vol. 2, 9 vols (London: J. Nichols, 1812) 307.

32 On Thomson’s wide circle of London-based Scottish expatriates, see Mary Jane W. Scott, James Thomson: Anglo-Scot (Athens, GA: U of Georgia P, 1988) 204–53; for a cogent indication of London’s commercial attraction for Scots following the Union, see T. M. Devine, The Scottish Nation, 1700–2007 (London: Allen Lane, 1999) 25–6.


then characterized medical training elsewhere in Britain.33 Edinburgh’s flexible but rigorous curriculum, which the new faculty had imported from the famous medical school at Leiden, had swiftly elevated the quality of Edinburgh’s medical training above and beyond its older rival schools at Cambridge and Oxford—doing so, in part, by teaching medicine as a practical skill and not as a theoretical subject.34 Although obtaining clinical experience was compulsory at Edinburgh and attending lectures was not, the range of available professorial expertise at the new school enabled it to feature “the most extensive selection of medical lectures offered at any university in Britain, a source of pride to the faculty and convenience to the students.”35 Unlike at the other British universities, students at Edinburgh did not need to matriculate to take lectures but only to pay for those they wished to take—and in return the professors were encouraged to make their lectures as relevant as possible for the students. The submission of the M.D. dissertation at Edinburgh demonstrated intellectual mastery of a subject on which the candidate had developed clinical expertise, emphasizing the importance of graduating physicians with demonstrably practical and marketable skills.36 And during the first part of the century, Edinburgh was the only British university to require medical students to treat patients as a precondition for graduating M.D.37 The arrival in

33 On the distinctively clinical elements of medical training at Edinburgh, see Christopher Lawrence, Medicine as Culture: Edinburgh and the Scottish Enlightenment, PhD diss. University College London, 1984; John R. R. Christie, “The Origins and Development of the Scottish Scientific Community, 1680–1760,” History of Science 7 (1974): 122–41; Andrew Cunningham, “Medicine to Calm the Mind: Boerhaave’s Medical System, and Why It Was Adopted in Edinburgh,” in The Medical Enlightenment of the Eighteenth Century, ed. A. Cunningham and Roger French (Cambridge: Cambridge UP, 1990) 50–66. Gay emphasizes Boerhaave’s “principled caution” in the midst of the contemporary “esprit de système” that characterized the medical adoption of Newtonian principles during the early eighteenth century: see Gay, The Enlightenment, 135.

34 In several articles, Christopher Lawrence explains that “the medicine that was taught at the new school was virtually a copy of that expounded by Hermann Boerhaave at Leiden” (“Ornate Physicians” 154). See also Guenter B. Risse “Clinical Instruction in Hospitals: The Boerhaavian Tradition in Leyden, Edinburgh, Vienna, and Padua” Clio Medica 21 (1987–88) 1–19.

35 See L. Rosner, Medical Education in the Age of Improvement: Edinburgh Students and Apprentices, 1760–1826 (Edinburgh: Edinburgh UP, 1991) 47.

36 See John D. Comrie, History of Scottish Medicine to 1860 (London: Wellcome Historical Museum, 1927), 197.

37 Oxford did not retain a professor of medicine until 1770, the more senior physicians appointed to lecture “were useless as teachers and seldom in Oxford,” and thus students had to pay for private tuition from junior physicians outside the university. See L. S. Sutherland, “The Curriculum,” The History of the University of Oxford: The Eighteenth Century, ed. L. S. Sutherland and L. G. Mitchell (Oxford: OUP, 1986) 489; A. H. T. Robb-Smith, “Medical Education at Oxford and Cambridge Prior to 1850,” Evolution of Medical Teaching in Britain, ed. F. Poynter (London: Pitman, 1966) 40. See also Tristram, note 30. According to the single study of eighteenth-century medical teaching at Cambridge, “the first half century of the professorship was a period barren in regard to professing or discovery. I can see no


London of newly trained physicians from Scotland would threaten the Royal College of Physicians’ dynastic hold over the London trade in wealthy patients, and not only because these physicians had experience that was tailored to respond to the needs of paying patients.38 Scornful and dismissive attitudes among London’s gentlemen physicians toward those they treated would be challenged in a widening marketplace that could now include doctors who Geoffrey Holmes calls the openly “hardworking and often well-loved physicians” who arrived on the Great North Road.39 Unlike Oxford and Cambridge, Edinburgh accepted students from more diverse social and religious backgrounds, including Dissenters and Catholics, barber-surgeons and Cowgate apothecaries.40 Now this diverse and skilled group would claim a share of the commercial territory long held by a traditional and largely English elite.

While a medical student, Armstrong was a favorite of Alexander Monro primus,41 the celebrated anatomist who revolutionized medical teaching in Britain by championing the foundation of charity hospitals, lecturing at patients’ bedsides (in accessible English rather than exclusive Latin), teaching anatomy through dissection on cadavers (rather than through diagrams), and by tailoring the content of his clinical lectures to suit the professional needs of his students

traces of any research or of any teaching worthy of the name”; see Alexander Macalister, A History of the Study of Anatomy in Cambridge: A Lecture (Cambridge: n.p., 1891). Robb-Smith remarks that “there is little doubt that a high proportion of the Cambridge medical undergraduates had all their training elsewhere” (42). Although Cambridge named Britain’s first Professor of Anatomy in 1707, local hostility toward anatomists was so severe that in 1728 the Senate was forced to recognize that its first appointee had quietly vacated his post “sometime in 1722”; his successor also resigned, in 1735, declaring that “attendance upon the lectures will be inconsistent with my practice.” See J. A. Fairfax Fozzard, Professors of Anatomy in the University of Cambridge …… 1707–1968 (Cambridge: Fosslia, 1983) 13. There is no mention of eighteenth-century medical education in Victor Morgan’s History of the University of Cambridge 1546–1750 (Cambridge: Cambridge UP, 2004).

38 For a cogent introductory history of the College, its licensing policies, and hold over the medical trade in London, see Susan Lawrence, Charitable Knowledge: Hospitals Pupils and Practictioners in Eighteenth-Century London (Cambridge: Cambridge UP, 1996) 76–81; for the tensions immediately felt by its fellows, see Tristram, note 34.

39 Geoffrey Holmes mentions that it was largely due to the influx of Edinburgh graduates that, by 1740s, the traditional aristocracy of London physicians had largely disappeared from view. See G. Holmes, Augustan England: Professions, State, and Society 1680–1730 (London: Allen and Unwin, 1982) 235. On contemporary urban attitudes toward patients, see Joan Lane, “‘The Doctor Scolds Me’: The Diaries and Correspondence of Patients in Eighteenth Century England,” Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. Roy Porter (Cambridge: Cambridge UP, 1985) 205–48.

40 See J. B. Morrell, “The Edinburgh Town Council and its University, 1717–66,” The Early Years of the Edinburgh Medical School [1976] 56;

41 Armstrong’s name appears in Monro’s attendance record from 15 October 1728: see Edinburgh University Library MSS DC.595.


who paid a set fee for attending each lecture.42 Over the course of Monro’s career at Edinburgh, an impressive 4,464 medical students trained under his direction, spending an astounding £300,000 in fees earned largely through the local medical trade.43 Armstrong was among the first. A detailed study of Monro’s anatomical technique and careful structuring of his “moral theatre” has led the historian Anita Guerrini to describe his teaching as “a virtuous performance” designed to cultivate the moral and emotional sympathy of his students as they studied in his anatomy theater and trained in Edinburgh’s charity hospital: in both contexts, “a discourse of compassion and sensibility formed the context of Monro’s lectures.”44 Armstrong was Monro’s first medical student whose own research was accepted for publication in Monro’s newly founded journal; Medical Essays and Observations was finding its way into libraries across Europe, further preparing Armstrong to ply his trade among lucrative patients in London.45 A recent study of the correspondence between patients and physicians of this period observes that “educated upper-class patients considered themselves on an equal footing in discussing medical matters with physicians and easily adopted the fashionable rhetorical conventions of the day.”46 Since students at Edinburgh developed their expertise through clinical encounters with its local urban population, Armstrong enjoyed further advantages over his London-based colleagues, whose training at Oxford or Cambridge was based on textual studies and took place in village-sized towns outside the country’s major population centers.47 Writing in 1727, an Oxford medical graduate wondered aloud whether his own professors were “very indifferent” to the relationship between their text-based instruction and “the

42 See Anand C. Chitnis, “Provost Drummond and the Origins of Edinburgh Medicine,” The Origins and Nature of the Scottish Enlightenment (Edinburgh: J. Donald, 1982) 88.

43 See G. Holmes, Augustan England: Professions, State, and Society 1680–1730 (London: George Allen and Unwin, 1982) 180; J. B. Morrell, “The Edinburgh Town Council and Its University,” The Early Years of the Edinburgh Medical School, ed. R. G. Anderson and A. D. Simpson (Edinburgh: Royal Scottish Museum, 1976) 56.

44 See A. Guerrini, “Alexander Monro Primus and the Moral Theatre of Anatomy,” Eighteenth Century 47 (2006) 12. [1–18.]

45 See “An Essay of Penetrating Topical Medicines,” Medical Essays and Observations 2 (1734): 26–45. This was first article to be contributed by an Edinburgh student or graduate, and so suggests Armstrong’s standing among Monro’s coterie. On the founding of this journal and its function as the transactions of Monro’s “club,” see John Coakley Lettsom, ed., The Works of John Fothergill, vol. 2, 3 vols (London: C. Dilly, 1783–84) 367–8; on its reputation and importance, see R. Emerson, “The Philosophical Society of Edinburgh,” British Journal for the History of Science 18 (1979): 255–303.

46 See W. Wild, “‘Due Preparations’: Defoe, Dr Mead, and the Threat of Plague, Liberating Medicine, 1720–1835, ed. T. Connolly and S. Clark (London: Pickering and Chatto, 2009) 57.

47 On the specific innovations that were incited by such geography, see P. Wood, The Aberdeen Enlightenment: The Arts Curriculum in the Eighteenth Century (Aberdeen: Aberdeen UP, 1993) 61–2.


publick Exercises,” which has led to their “want of sufficient Salaries.”48 Such concerns were not likely to arise at Edinburgh, where the entrepreneurial faculty tailored the medical training curriculum in response to the needs of their paying patients.

Between 1729 and 1736, Monro and his students co-managed a campaign to fund the new Hospital for the Sick Poor (later The Royal Infirmary), Britain’s first charitable (“voluntary”) hospital outside London, the first fee-free hospital in Europe to maintain a formal association with a university, and the only hospital in Britain that was maintained by its medical students rather than by contributions paid by patrons.49 Monro’s emphasis on the moral and practical lessons drawn through clinical interaction with needy patients was signified even by the school’s dress code, for Monro helped to define the character of the new school by abandoning the English custom of students and faculty wearing gowns defining their rank and social class.50 A Hospital report of 1730 describes the chaotic yet egalitarian mingling of students, apprentices, patients, and teachers on its ward, which was such that “it is Difficult to advise on any case or perform any operation without the utmost Confusion”—but soon the Hospital would play a central role “in the process of reshaping and redirecting Edinburgh’s intellectual life.”51 Monro’s successful campaign and the student-funded structure of his entrepreneurial school

48 See Tristram, note 37. 49 On Monro’s composition of the campaign pamphlet, which charged that “humanity

and compassion naturally prompt us to relieve our fellow creatures when in such deplorable circumstances,” see An Account of the Rise and Establishment of the Infirmary or Hospital for Sick Poor, Erected at Edinburgh (Edinburgh: n.p, ca. 1730); on the Hospital’s unique financial arrangements, see C. Stevenson, Medicine and Magnificence, 114. See also P. M. Eaves-Walton, “The Early Years in the Infirmary,” The Early Years of the Edinburgh Medical School, ed. R. G. W. Anderson and A. D. C. Simpson (Edinburgh: Royal Scottish Museum, 1976) 71–80; Guenter B. Risse, Hospital Life in Enlightenment Scotland: Care and Treatment in the Royal Infirmary of Edinburgh (Cambridge: Cambridge UP, 1986) 25–33. See also G. Rosen, “An Eighteenth-Century Plan for a National Health Service,” Bulletin of the History of Medicine 16 (1944): 429–36; A. E. Clark Kennedy, The London: A Study in the Voluntary Hospital System, 2 vols (London: Pitman, 1962). On the wider European context, see J. Reinarz, “Corpus Curricula: Medical Education and the Voluntary Hospital Movement,” Brain, Mind, and Medicine: Essays in Eighteenth-Century Neuroscience, eds. H. Whitaker et al. (New York: Springer, 2007) 43–52.

50 See Jan Golinsky, Science as Public Culture (Cambridge: Cambridge UP, 1992) 16; L. Rosner, Medical Education in the Age of Improvement (Edinburgh: EUP, 1991) 30; see also T. Miller, The Formation of College English: Rhetoric and Belles Lettres in the British Cultural Provinces (Pittsburgh: U of Pittsburgh P, 1997) 159.

51 See Minute Book of the Infirmary 1 (2 November 1730): 35, in the Archives of the Royal Infirmary of Edinburgh; C. Lawrence, “Ornate Physicians and Learned Artisans Edinburgh Medical Men, 1726–1776,” William Hunter and the Eighteenth-Century Medical World, ed. W. F. Bynum and Roy Porter (Cambridge: Cambridge UP, 1985) 153. See also P. M. Eaves Walton, “The Early Years in the Infirmary,” The Early Years of the Edinburgh Medical School (Edinburgh: Royal Scottish Museum, 1976) 71–80.


would have taught Armstrong that success in medicine could only be possible through hard work and cooperative relationships with patients. This system was admired by Adam Smith, whose Wealth of Nations ridiculed the socially irrelevant “nonsense” taught at Oxford and attributed this to the fact that professors in England were not rewarded for lecturing on topics their students needed to learn.52 Despite the recently recognized involvement of political patrons such as Archibald Campbell (later third Duke of Argyll) in the teaching appointments that comprised Edinburgh’s medical faculty, in post-1707 Edinburgh there were no government-based patrons or established networks that could guarantee a prosperous medical career on the basis of mere reputation or scholarly mastery—it was successful practice with paying patients that mattered.53

This lesson chimed in with new intellectual currents. As Theodore Brown has shown, “it became clearer and clearer as the eighteenth century progressed that the subject matter of medicine could only be discovered by careful attention at the bedside rather than by mathematical or even experimental excursions.”54 Another 40 years would pass before the Edinburgh medical professor John Gregory emphasized the signal importance of the patient enjoying a truly one-on-one relationship with his patient, doing so in moral and emotional terms: “sympathy produces an anxious attention to a thousand little circumstances that may tend to relieve the patient,” Gregory taught, “an attention which money can never purchase: hence the inexpressible comfort of having a friend for a physician.”55 But even by the time Armstrong had graduated he would have had to earn the trust of patients, since his modest roots in a rural Scottish manse meant that it was success in the local trade that paid for his training—Armstrong would have learned that medicine was a moral profession.56 Unfortunately, the only surviving evidence of Armstrong’s manner as a physician relates to the poet and playwright James Thomson, who had lain on his deathbed, terrified, and died refusing to see

52 See A. Smith, An Inquiry into the Nature and Causes of the Wealth of Nations, ed. R. H. Campbell and A. S. Skinner, vol. 2, 2 vols. (Oxford: Clarendon P, 1976) 773.

53 The situation for Edinburgh physicians was similar for Scotland’s civil architects—not one of whom found work through government patronage through the eighteenth century. See C. Stevenson, Medicine and Magnificence (New Haven: Yale UP, 2000) 111. On Argyll, see R. L. Emerson, “The Founding of the Edinburgh Medical School,” Journal of the History of Medicine and Allied Sciences 59 (2004): 183–218; and Emerson, Academic Patronage in the Scottish Enlightenment (Edinburgh: Edinburgh UP, 2008) 290–298. For an outline of Campbell’s political career and extensive influence in Scotland during the first two-thirds of the eighteenth century, see Oxford DNB.

54 See T. Brown, “Medicine in the Shadow of the Principia,” Journal of the History of Ideas 48 (1987): 648.

55 See John Gregory, Lectures on the Duties and Qualifications of a Physician (London: T. Cadell, 1772) 19.

56 For students at Edinburgh seeing private patients to pay for their lectures, see J. Johnson, A Guide for Gentlemen Studying Medicine at the University of Edinburgh (London: J. Robinson, 1792) 32.


any physician but Armstrong—who unfortunately arrived an hour late.57 One consequence of Armstrong’s eventual success in London was his acquaintance with Charles Burney, who retained Armstrong as the Burney family’s physician for some 30 years; the novelist Frances Burney was still telling affectionate anecdotes about him 50 years after his death.58 By 1762 Armstrong seems to have been on familiar terms with Sarah Fielding, for he publicly supported her campaign to produce her famous translation of Xenophon even beyond the likes of London’s most prominent literary patrons, including Ralph Allen, Hester Mulso, and Henry Wortly Montagu.59 Armstrong’s ventures into the literary marketplace, with his peculiar range of satires, poems, translations, and treatises, reveal an unusually keen sensitivity to the clinical and economic basis of what medical practice entailed for a talented but professionally unwelcome entrant into London’s medical world.

When Armstrong arrived in London shortly after his graduation, he found that that the Royal College of Physicians, which had held the legal authority to regulate the practice of medicine in the capital since 1518, forbid Scottish-trained graduates from practicing within seven miles of the Tower.60 So although “the medical student

57 See A. D. McKillop, ed. James Thomson: Letters and Documents (Lawrence, KS: U of Kansas P, 1958) 204. It was also Armstrong who wrote to inform Thomson’s closest friends of his death; see D. Forbes, ed., Culloden Papers (London: T. Cadell, 1815) 306–8.

58 In 1795, nearly 20 years after Armstrong’s death, Dr. Burney wrote: “We knew Dr. Armstrong well …… those who were only acquainted with Armstrong’s taciturnity, and his great wig, formed an erroneous opinion of his intellectual powers …… but those who had enjoyed his company in social and convivial hours allowed him to have possessed an uncommon share of original wit, fancy, and pleasantry.” See Monthly Review 16 (1795): 71. Armstrong was the Burney family’s physician for more than 30 years: see Percy Scholes, The Great Dr. Burney, vol. 1, 2 vols (Oxford: OUP, 1958) 33; Roger Lonsdale, Dr. Charles Burney: A Literary Biography (Oxford: Clarendon P, 1965) 29–37. Frances Burney spoke with tenderness and affection for Armstrong throughout her life, recalling him when she herself was close to death, nearly 61 years after Armstrong had died: see F. D’Arblay, The Memoirs of Doctor Burney, vol. 1, 3 vols (London: Edward Moxon, 1832) 85. When Frances Burney and Frances Brooke were asked to name a virtuous author, Brooke said, “for Dr Armstrong I have a very particular regard. I have known him more than twenty years.” See Lars Troide, ed., The Early Journals and Letters of Fanny Burney, vol. 2, 3 vols (Oxford: Clarendon P, 1988) 5.

59 Armstrong signed for 12 copies of Fielding’s Xenophon’s Memoirs of Socrates, far more than any of the dozens of eminent supports indicated in the List of Subscribers. It is possible that Armstrong was among the physicians who treated Fielding through her various illnesses that delayed work on her translation (1758–62). Since each subscription copy was probably worth one guinea, Armstrong’s public level of support suggests some wealth and some ostentation.

60 Charles II’s mandate of 1676, that “no Person so presume to practice in any Part of the Kingdom, except Graduates at Oxford or Cambridge, under Penalty of five pounds per Month, with Imprisonment,” was designed to refuse Catholics entry into London’s respected community of physicians, and remained firmly in place during the 1740s. See An Address to the College (London: M. Cooper, 1747) 3. See also George Clark, A History


getting the full course of study at Edinburgh would be well turned out to practice among an élite and cultured clientele,” as Christopher Lawrence has shown, Armstrong’s medical training was a liability in London as far as retaining regular patients was concerned.61 Before he had left Edinburgh, Armstrong had declared his ambitions for London by dedicating his M.D. thesis to the eminent and reputably generous President of the Royal College of Physicians of London, Sir Hans Sloane; this was the first Edinburgh thesis to address anyone beyond Scotland.62 Within a year he read a paper before the Royal Society, possibly on Sloane’s invitation. But the event was not apparently successful, for although Armstrong’s manuscript numbers only several pages, the meeting adjourned before he finished speaking, and the paper was not printed in the Transactions (as was often the case).63

Roy Porter has explained that the previous generation of literary physicians who held “foreign” degrees, such as Richard Blackmore and George Cheyne “looked not to collective professional paths to glory, but to the personal favour of grandees.”64 But this avenue could not open for Armstrong. Unlike Blackmore, Armstrong was the first son of a minor Roxburghshire manse, whose family

of the Royal College of Physicians of London, vol. 2, 3 vols (Oxford: Clarendon P, 1966) 543–5; Geoffrey Holmes, Augustan England: Professions, State, and Society, 1680–1730 (London: G. Allen, 1982) 170; Susan Lawrence, Charitable Knowledge: Hospital Pupils and Practitioners in Eighteenth-Century London (Cambridge: Cambridge UP, 1996) 76–80. See also A Letter from a Physician in London to his Friend in the Country (London: A. Millar, 1753) 17, which attests to English efforts to ban Scottish physicians who attempt to acquire licenses to practice in London.

61 C. Lawrence, “Ornate Physicians and Learned Artisans Edinburgh Medical Men, 1726–1776,” 156.

62 Armstrong’s thesis, titled De tabes purulenta (“on the wasting of infected tissue”) was reprinted in Thesaurus medicus Edinburgensis novus: sive, dissertationem, ed. William Smellie, vol. 1, 4 vols (Edinburgh: C. Elliot and G. Robinson, 1785) 61–82. Other theses from Armstrong’s graduating class are dedicated either to members of the Edinburgh faculty or to physicians in nearby Scottish towns. By 1732 Sloane was the longest-serving President of the College, and stood out as among the most generous patrons of the various London hospitals, the London dispensary, and clinics for the poor: see George Clark, A History of the Royal College of Physicians of London, vol. 2 (Oxford: Clarendon P, 1964) 734; Oxford DNB. Oxford DNB. Monro’s annual journal Medical Essays and Observations, discussed above, was also dedicated to Sloane, suggesting a possible friendship between Sloane and Monro.

63 See the 3,000-word manuscript, BL Sloane MSS 4433.88. On the recto of the manuscript’s final page appears the following notation, dated 30 January 1734/5: “part of Dr Armstrong’s paper concerning alcalescent fluids was read. The remainder was deferred to another meeting.” The event was deemed of sufficient interest, however, for a full copy to have been recorded in the Society’s Register Book.

64 See R. Porter, “Laymen, Doctors, and Medical Knowledge in the Eighteenth Century: The Evidence of the Gentleman’s Magazine,” in Porter, ed., Patients and Practitioners: Lay Perceptions of Medicine in Pre-industrial Society (Cambridge: Cambridge UP, 1985) 287. See also S. Lawrence, Charitable Knowledge: Hospital Pupils and Practitioners in Eighteenth-Century London (Cambridge: Cambridge UP, 1996).


and friends held no connections to the court; unlike Cheyne, Armstrong was no socially mobile entrepreneur. Many years later, when Armstrong looked back over his lack of success in London during his early years there, he recalled with some bitterness that he “could never tell a heap of lies in his own praise, wherever he went, nor intrigue with nurses.”65 As Porter and others have shown, by the mid-eighteenth century “medicine was fundamentally a market-place trade, and the success and rank of individual practitioners and of medicine as an occupation depended immediately as well as ultimately on public esteem.”66 Armstrong cleverly realized that by writing medical works on various topics, in a range of styles that ranged from the nearly profane to the formally polite, he might earn public attention and hopefully collegiate esteem, balancing popular tastes with more elevated conceptual innovations. His various productions reveal a tangible ambivalence toward the views of the medical establishment, possibly because the College had the power to arrest him for practicing without a license. But as Wayne Wilde has shown, “[since] patients were indifferent to the institutional affiliations of the physician, a doctor’s professional stature with patients finally depended on his professional demeanor and skill in matching his rhetoric to prevailing social expectations.”67 A survey of Armstrong’s literary attempts to attract a clientele therefore suggests the tastes and expectations of contemporary medical patients.

By the time Armstrong published his first London work, a satire titled An Essay for Abridging the Study of Physick in December 1734, Armstrong seems to have sought two goals: to ingratiate the London medical establishment and to extend, at least in appearance, the pedagogical mission of a notable institution he had joined back in Scotland.68 The Medical Society of Edinburgh, which was founded by Monro and a small group of his students, sought to streamline medical knowledge by providing “more Authors, and fewer Books, to the greater advancement of Learning”; it was an important early contribution to the progressive social and intellectual goals of what became known as the Scottish Enlightenment.69 Armstrong’s pamphlet was a sarcastic celebration of extortionate quacks such as Joshua Ward who argued for methodical training and tested expertise in medical practice, and it did this through mock panegyric, classical allusion (primarily to Lucian) and witty dialogue. It was a daring production too, since at the time Ward

65 See Armstrong, Medical Essays (London: T. Cadell, 1773) 37; M. Pelling, “Medical Practice in the Early Modern Period: Trade or Profession?” The Professions in Early Modern England, ed. W. Prest (New York: Methuen, 1987) 90–128.

66 R. Porter, introduction to Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. R. Porter (Cambridge: Cambridge UP, 1985) 12.

67 See W. Wild, Medicine-By-Post: The Changing Voice of Illness in Eighteenth-Century British Consultation Letters and Literature (Amsterdam: Rodopi, 2006) 10.

68 An Essay for Abridging the Practice of Physick (London: for J. Wilford, 1735) was announced in the London Magazine 3 (Dec 1734): 671, and in Gentleman’s Magazine 4 (1734): 708.

69 See Medical Essays and Observations 1 (1733): vi. See also Davis D. McElroy, Scotland’s Age of Improvement: A Survey of Eighteenth-Century Literary Clubs and Societies (Washington State UP: Pullman, WA, 1969); J. R. R. Christie, “The Origins and Development of the Scottish Scientific Community, 1680–1760,” 132.


was Physician to the King.70 Two generations earlier, Armstrong might have gained entry into the London profession by petitioning for an English doctorate by royal mandate, but this practice had largely disappeared,71 and so satirizing the King’s faith in those who believe “Learning is no more necessary to a Physician than to a Fiddler” was more likely to please the College censors than offend anyone holding real power.72 At the same time, this tract’s title alluded to John Bellers’s An Essay towards the Improvement of Physick, a powerful pamphlet of 1714 that was among the first to link London’s staggering morality statistics to the physicians’ apparent lack of interest in treating the poor; in one among many pamphlets that Bellers wrote between 1703 and 1724, he argued that half of the city’s hundred thousand deaths each year could be prevented, “for want of timely advice and suitable medicines.”73 Armstrong’s formal exclusion from the profession enabled him to attack quackery in a way not available to those members of the establishment whom he sought to impress, yet to retain his implied commitment to treating those who required urgent care. Its wit and its values stood a fair test of time, for An Essay for Abridging the Study of Physick was reprinted in 1790.74

In 1736, Armstrong’s enterprising Scottish bookseller and lifelong friend Andrew Millar published The Oeconomy of Love, a sex manual in blank verse, which skillfully imitated Ovid’s Ars amatoria—an worthy classical model for learned readers but probably a hazardous one for a supplicating physician.75 It is

70 This pamphlet also illustrates Armstrong’s close attention to current medical controversies; his Essay was a swift response to Ward’s recent boast in the Grub Street Journal that he had cured 20,000 patients in the previous three years. See The Grub-Street Journal 257 (28 Nov. 1734): 1–2; see the notices of Armstrong’s Essay in the London Magazine 3 (Dec. 1734): 671; Gentleman’s Magazine 4 (1734): 708. The medical response to Ward’s boast of 1734 was sustained for at least two years: see A True and Candid Relation of the Good and Bad Effects of Joshua Ward’s Pill and Drop, Exhibited in Sixty-Eight Cases (London: J. Wilford, 1736). Further, the ironic style follows a very similar line of argument that Pieter Burman provided in his actual and sarcastic Oration …… against the Studies of Humanity, Shewing that the Learned Languages, History, Eloquence, and Criticick [sic] are not only Useless, but also Dangerous to the Studies of Law, Physick, Philosophy, and above all of Divinity (London: J. Roberts, 1721 and 1722). Burton gave this lecture in Leiden on 8 February 1720, upon his retirement from the position of Rector of the University. Armstrong refers to Burman as a human parable of fatal devotion to academic study in his poem (4: 54).

71 See C. Webster “The Medical Faculty and the Physic Garden,” The History of the University of Oxford: The Eighteenth Century, ed. L. S. Sutherland and L. G. Mitchell (Oxford: OUP, 1986) 687.

72 See An Essay for Abridging the Study of Physick (London: J. Wilford) 10.73 See An Essay towards the Improvement of Physick. In Twelve Proposals (London:

J. Morphew, 1714) 3.74 See The Repository: A Select Collection of Fugitive Pieces of Wit and Humour

(London: Dilly, 1790) vol. 3, 125–64.75 See Clive Hart and Kay Gilliland Stevenson, “John Armstrong’s The Oeconomy

of Love: A Critical Edition with Commentary,” Eighteenth-Century Life 19 (Nov. 1995): 38–69. It was noted in the Gentleman’s Magazine 6 (1736): 172, and London Magazine 5 (March 1736): 164, at one shilling.


tempting to read The Oeconomy of Love, like the learned work on venereal diseases that Armstrong was composing at the same time, as a speedy attempt to turn a profit from the capital’s astoundingly lucrative sex trade. Dan Cruickshank has shown that “a staggering one London woman in five was involved in one way or another with the sex industry,” whose economic importance rivaled brewing, construction, and the London docks: during the mid-eighteenth century, prostitution and its economic spin-offs “generated an estimated gross turnover of around £20 million per annum,” whereas the entire value of trade through the London docks in 1792 was worth £27 million.76 Armstrong’s publications sought to make the best from market forces, yet Oeconomy of Love is notable because it anticipates the sensitive relationship between the poet-physician and reader-patient that Armstrong promotes in The Art of Preserving Health. The didactic force of The Oeconomy of Love derives from its sympathetic evocation of shared experience in a clinical context, to which its salacious imagery and painful depictions constantly return. To discourage visits to brothels, Armstrong presented syphilis by its revealing its torments:

Nor from the holy Marriage-BedRefrain’d his loose Embraces, when the WifeOf wrong’d Urias he seduc’d; nor stoptTill Murder crown’d his Lust. Hence him the WrathOf righteous Heaven, awaking, long pursu’dWith sore Disease, and fill’d his Loins with Pain.All day he roar’d, and all the tedious NightBedew’d his Couch with Tears; and still his GroansBreathed musical in sacred song. (150–158)

Armstrong was hardly alone in his choice of blank verse to address such matters; for as John Butt has observed, “it was thought to lend an extraneous dignity to the inescapable vulgarities of a largely attractive theme.”77 Such subjective depictions of disease (and especially this particularly unmentionable disease), from the patient’s point of view, cannot be found among the books written by Armstrong’s fellow physicians. Not only does this sympathetic treatment of the suffering patient suggest an affinity with the physician, but it also implies an increasing moral acceptance of a disease that had long been invoked as sinful by physicians and moralists alike.78

Unfortunately for Armstrong, The Oeconomy of Love was so evocative of his medical knowledge and clinical abilities that it was censured as indecent and condemned for its licentiousness. The son of Armstrong’s friend Richard Davenport recalled that this poem “doubtless injured his practice among the reputable part of

76 See D. Cruickshank, The Secret History of Georgian London (London: Random House, 2009) 135, x.

77 John Butt, The Augustan Age (London: Hutchinson, 1950) 92.78 See A. M. Brandt, “Sexually Transmitted Diseases,” Companion Encyclopedia of

the History of Medicine, ed. W. Bynum and R. Porter (London: Routledge, 1993) 561–83; R. Porter, Bodies Politic: Death, Disease, and Doctors in Britain (Ithaca, NY: Cornell UP, 2001) 130–142.


mankind; for what husband or father would not hesitate to call in a physician whose chief fame arose from his having perverted his genius to rouse the passions and corrupt the morals of youth?”79 Like other vigorous expressions of sensibility, The Oeconomy of Love was misunderstood by readers who cited its impolite imagery rather than its dramatic depiction of sympathy across social divides.80 Toward the end of his life, Armstrong described The Oeconomy of Love as “a Poem upon a subject of no inconsiderable consequence to the health of mankind … some say, [it was] sufficient alone to have ruined [me] as a Physician.”81 Stylistically, the poem’s classical imagery and its Miltonic phrasing has left twentieth-century readers disagreeing whether this didactic poem is a parody or a treatise in its own right.82

More characteristic of a learned physician seeking professional recognition, and perhaps some redemption from his jeu d’esprit, Armstrong then produced two substantial translations of Latin medical texts. Armstrong’s first translation was the Continental anthology Aphrodisiacus, which Armstrong titled A Synopsis of the History and Cure of Venereal Diseases (1737).83 Shortly after the original Latin edition was printed in 1728, the scholarly physician William Cockburn had declared that “this Book has changed the Notions, as well as the Practice, of Physicians

79 Davenport, R. A. “The Life of John Armstrong, M. D.” The British Poets. Vol. 67 (Chiswick: J. Whittingham, 1822) 16. On contemporary links between polite rhetoric and moral character, see C. McIntosh, The Evolution of English Prose, 1700–1800: Style, Politeness, and Print Culture (Cambridge: Cambridge UP, 1998).

80 For other instances, see Ros Ballaster, Seductive Forms: Women’s Amatory Fiction from 1684 to 1740 (Oxford: Clarendon P, 1992). Armstrong’s professional alienation following the publication of this poem illustrates the inverse of Hammond’s claim that “politeness …… is to a large extent the executive arm of the novelization project …… which had a liberating, class-surpassing agenda that brought into being the ‘public sphere,’ within which access to political and cultural involvement was granted to greater numbers.” See Professional Imaginative Writing in England, 1670–1740 (Oxford: Clarendon P, 1997) 305.

81 Medical Essays (London: T. Cadell, 1773) 39. 82 See Armstrong’s preface to the 1768 edition, in which he attempted to distance

himself from sincere imitation. He noted that “this little juvenile Performance was chiefly intended as a Parody upon some of the didactic Poets; and, that it might be still more ludicrous, the Author in some Places affected the stately language of Milton”: see Preface, The Oeconomy of Love (London: T. Cadell, 1768). Knapp believed that “its seeming lack of humour has suggested to others that his intention was at least partly didactic.” See “John Armstrong: Littérateur and Associate of Smollett, Thomson, Wilkes, and Other Celebrities,” PMLA 59 (1944): 1021; See also The Oeconomy of Love, eds Hart and Stevenson, Eighteenth-Century Life 19 (Nov. 1995): 69. Bruce Boehrer argues simply that the poem is a failed adaptation of Paradise Lost; see “English Bards and Scotch Physicians: John Armstrong’s Debt to Paradise Lost and the Dynamics of Literary Reception,” Milton Quarterly 32 (1998): 98–104.

83 It was announced in London Magazine 6 (Feb. 1737): 112, and Gentleman’s Magazine 7 (1737): 30, 128. A large notice appears in The Craftsman 561 (2 April 1737): 3, suggesting Millar’s considerable investment in the publication.


all over Europe.”84 In his edition, Armstrong included a long introduction, notes, and commentary, displaying both his medical and lexical abilities. That this book brought the best available knowledge of familiar yet fatal diseases to lay readers expressed both the pragmatic and humanitarian ethos of his old Medical Society and training under Monro. Andrew Millar marketed Armstrong’s book by using language reminiscent of the Medical Society of Edinburgh (editors of the Medical Essays and Observations): “the substance of all these Writers is preserved in whatever is material, only by contracting Things of little Moment, and avoiding useless repetitions.”85 The Synopsis was clearly designed to appeal both to specialists and to lay readers, anticipating the broad pedagogical aims of William Buchan’s Domestic Medicine by 30 years.86

This volume reveals Armstrong’s scholarly ambitions too, since it was among the very few books to have brought the voice of Europe’s most famous physician to English readers unversed in Latin.87 For those British readers who knew of Hermann Boerhaave, “the Dutch Hippocrates,” it was likely as a paragon of genius and virtue; shortly after Boerhaave’s death in 1739, Samuel Johnson eulogized him in the Gentleman’s Magazine by pleading that “may those who study his writings, imitate his life; and those who endeavour after his knowledge, aspire likewise to piety!”88 Such praise was also sung by patients as pedestrian as the impoverished versifier Mary Barber as early as 1734.89 Armstrong dedicated his 519-page octavo to Alexander Stuart, “who had indisputable right to judge severely of the performance presented to him.”90 A fellow Scot, Stuart was among

84 See William Cockburn, The Danger of Improving Physick (London: J. Wilford, 1730) 18.

85 See the notice printed in the List of Books on the final page of Armstrong’s Full View of All Diseases Incident to Children (London: A. Millar, 1742).

86 See C. Lawrence, “William Buchan: Medicine Laid Open,” Medical History 19 (1975): 20–35.

87 Armstrong’s Synopsis was the first to translate Boerhaave’s long preface from Aphrodesiacus sive de lue venerea, 3 vols (Leiden: J.A. Langerak, 1728). The preface was partially translated in 1729, but despite its title did not include any part of the treatise itself: see A Treatise on the Venereal Disease and Its Cure in All Its Stages and Circumstances. Englished by J.B. M.B, of Christ-Church College (London: T. Cox, 1729). Whereas this anonymous edition numbers 80 pages, Armstrong includes the Latin preface and texts in their entirety, with notes, glossary, his own introduction, and index, totaling 519 octavo pages.

88 Samuel Johnson, “The Life of Dr Hermann Boerhaave,” The Major Works, ed. Donald Greene (Oxford: OUP, 1984) 70. Apart from “the Dutch Hippocrates,” Boerhaave was known throughout the century as, in the words of the Swiss anatomist Albrecht von Haller, communis Europae praeceptor. See G. A. Lindeboom, Herman Hoerhaave, The Man and His Work (London: Methuen, 1968).

89 When Barber pined for a cure for gout in the early 1730s, she recorded her vision of Boerhaave as the bedside-physician par excellence. See her short poem “Written at Tunbridge-Wells,” Poems on Several Occasions (London: C. Rivington, 1735) 223.

90 J. Armstrong, A Synopsis of the History and Cure of Venereal Diseases (London: A. Millar, 1737) iv.


those Fellows of the Royal College who voted on new licentiates.91 Armstrong chose an opportune time to address the causes and treatments of these diseases in such a public and serious manner: the establishment of the Lock Hospital for Venereal Cases in 1746 would signal, in a highly public way, the decline of moralistic attitudes toward these diseases among physicians and their patrons. By the late-1730s, these were increasingly recognized as physical rather than moral disorders.92 Drawing on Kevin Siena’s social history of venereal complaints and treatments from this period, it is likely that Armstrong designed his extensive and informative book not only to educate his readers but also to introduce himself as a trustworthy, compassionate, and widely knowledgeable physician worthy of gaining the confidence, privacy (and business) of infected patients.93 No evidence suggests that Armstrong received any encouragement from his London colleagues during this time; it is impossible to discern whether this scholarly book annoyed or impressed his colleagues.

Numerous literary works of the mid-eighteenth century sought to provide readers with an elevated sense of the their own moral conduct, yet their purchase yielded little or no benefit to worthy social causes.94 Indeed, Thomas Keymer has shown that “the eager celebration of charity and sensibility goes hand in hand with a market reticence about what real effect these sources of good will achieve.”95 Yet Armstrong’s next book, A Full View of the Diseases Incident to Children (1742) addressed “Nurses and old Women” explicitly, asked readers to attend to the sound of their child’s cough, and thus achieved a milestone in British medical history: Armstrong’s Full View was the first scholarly medical book that was explicitly intended for domestic use by women practitioners.96 In his Preface, Armstrong articulated both pragmatism and affection, remarking that “very young Children have not the Power of Speech to describe their Complaints” and so “most Physicians, either through Indolence or the Fear of doing Mischief … have commonly resigned

91 See G. Clark, A History of the Royal College of Physicians of London, vol. 2 (Oxford: Clarendon P, 1964) 554. By sending a copy of his M.D. thesis to Sloane in 1732, Armstrong had followed Stuart’s own example—he had done the same upon his graduation in 1711. See A. Guerrini, “‘A Scotsman on the Make’: The Career of Alexander Stuart,” The Scottish Enlightenment: Essays in Reinterpretation, ed. Paul Wood (Rochester: Rochester UP, 2000) 96–175.

92 See David Innes Williams, The London Lock: A Charitable Hospital for Venereal Disease, 1746–1952 (London: Royal Society of Medicine P, 1995).

93 See K. P. Siena, “The ‘Foul Disease’ and Privacy: The Effects of Venereal Disease on the Medical Marketplace in Early Modern London,” Bulletin of the History of Medicine 75 (2001): 199–224.

94 For one notable example, see my “Merit in Distress: The Troubling Success of Mary Barber,” RES 53 (2002): 24–7.

95 See T. Keymer, “Sentimental Fiction: Ethics, Social Critique, and Philanthropy,” 588; ed. G. F. Still, The History of Paediatrics (London: Dawsons, 1965) 370–371.

96 Medical care for children during the first part of the century was desperately inadequate: see G. Rosen, “A Slaughter of Innocents: Aspects of Child Health in the Eighteenth-Century City,” Studies in Eighteenth-Century Culture, ed. R. C. Rosbottom, vol. 5 (Madison: U of Wisconsin P, 1976) 293–316.


those little Patients to the Nurses and old Women” (v). Armstrong’s book marks a new level of meaningful encouragement to literate parents who were starting to realize that their children were more likely to survive infancy than they had done: as Lawrence Stone has shown, childhood mortality among the wealthy and literate in England dropped by more than 30 percent after 1750.97 And as Fernand Braudel has emphasized, the prolonged increase in the populations of Western Europe after 1750 was the first ever to have sustained itself beyond two centuries.98 This was due in part to the rapid spread of improved midwifery techniques among midwives after 1730, along with better nutrition and the disappearance (but not the lingering fear) of plague. These improvements in survival and longevity may have been due, in part, to the newly improved medical and social practices that enabled Armstrong’s pioneering book—which, in turn, characterizes an essential means by which new ideas and new practices spread: from reader to reader. Indeed, intellectual and commercial interests find a suggestive intersection in the joint wish of Andrew Millar and Armstrong to promote (and tap into) popular concern for children’s health, supporting the view that “the age of sensibility” ought to be defined by a new social acceptance of outward affection toward children.99 Armstrong’s Preface observes that “it is intirely upon Account of those Female Practitioners, that I have put all the Formulae into English, and have set down all the Articles and their Doses at full Length” (x).100 Roy Porter has remarked that “physicians had too

97 See L. Stone, The Family, Sex, and Marriage in England: 1500-1800 (Harmondwoth: Penguin, 1977) 56–9.

98 See F. Braudel, The Structures of Everyday Life: The Limits of the Possible, trans. S. Reynolds (London: Collins, 1981) 33. Braudel allows for the catastrophic effects of the two great European wars of the twentieth century; the consequential short-term drop in population was the result of explicit human intervention and not famine or disease.

99 See Stone, 59; on affection for children, the rise of the family as a loving unit, and the popularity of breastfeeding as historical examples of eighteenth-century sensibility, see R. Perry, “Colonizing the Breast: Sexuality and Maternity in Eighteenth-Century England,” Journal of the History of Sexuality 2 (1991): 204–34. For scientific reasons for this social shift, see A. Wilson, The Making of Man-Midwifery: Childbirth in England, 1660–1770 (London: U College London P, 1995). For a study that links demographic and social changes to changes in literary taste and moral concerns, see F. Donnalee, Speaking in Hunger: Gender, Discourse, and Consumption in “Clarissa,” (Columbia, SC: U of South Carolina P, 1988).

100 Both John Armstrong and his younger brother George (1719–89) took an unusually strident and sustained interest in pediatrics:

In 1767, George Armstrong, a London pediatrician [but not a formal MD], published An Essay on the Diseases Most Fatal to Infancy, which passed through thee editions (1771, 1777, 1778), enlarged by A. P. Buchan in 1808. In 1769, Armstrong established the first pediatric hospital in England, a Dispensary for Poor Children, which was discontinued in 1781, from lack of financial support. It was the only institution in which the children of poor parents were received without letters of admission, in cases of desperate illness. During the twelve years of its activity, 35,000 children were admitted and treated. Armstrong published an account of his Dispensary in 1772, but his philanthropy went unrewarded. He died in obscurity. See Arthur Abt, History of Pediatrics (Philadelphia: Saunders, 1965) 77.


long cynically monopolized medicine as a mystery, a closed shop whose shop-talk was a dead tongue,” yet following Monro’s example at Edinburgh’s charitable Hospital for the Sick Poor, Armstrong’s Full View translates the Latin sources into vernacular terms to include complete instructions for remedies that parents and nurses can dispense at home.101 Like his earlier Synopsis, which signaled a progressive change of attitude toward patients who suffered the corporeal scars of allegedly moral missteps, the Full View was intended to enable women to care for their children both at home and in consultation with physicians, using the best medical knowledge. Thomas Coram’s Foundling Hospital, the country’s largest charitable orphanage, had opened in 1741, only months before A Full Account was first sold in Millar’s shop.102

Armstrong’s first attempts at recognition through print were not evidently successful, and his prolific literary output between 1734 and 1742 suggests a lack of success in regular trade. Moreover, promptly upon the completion of his Synopsis, the better-known English physician William Barrowby (FRCP from 1718) translated Jean Astruc’s treatise on venereal diseases, which had long been acclaimed on the Continent, now subsuming Armstrong’s readership.103 The long-established English surgeon Daniel Turner (FRCP from 1711) had issued his own shorter edition of the Aphrodisiacus just months earlier.104 Armstrong’s pediatric anthology is of interest today for its progressive delivery of elite treatises for lay readers, but in the very year that it was printed, the prolific physician John Martyn, a longtime Fellow of the Royal Society, usurped the market with a full and revised translation of the set-piece of Armstrong’s anthology—including a new dissertation on venereal diseases.105 Thirty-two years later, the Full View

101 R. Porter, “Spreading Medical Knowledge: The Popularization of Medicine in Georgian England”, The Popularization of Medicine, 1650–1850, ed. Roy Porter (London: Wellcome Trust, 1992) 218.

102 See Ruth K. McClure, Coram’s Children: The London Foundling Hospital in the Eighteenth Century (New Haven: Yale University Press, 1981); see also W. H. McMenemey, “The Hospital Movement of the Eighteenth Century and Its Development,” The Evolution of Hospitals in Britain, ed. F. N. L. Poynter (London: Pitman, 1964), 43–71.

103 Jean Astruc’s De morbis venereis (Paris: n.p., 1737) appeared in London as A Treatise of the Venereal Disease in Six Books …… Now Translated into English by William Barrowby (London: W. Innys and R. Manby, 1737).

104 While he was at work on his edition, Armstrong learned that his project might be preempted by others: “I had gone too far in it to desist, before I knew that Dr. Turner was engaged in the same Design”: see the preface to A Synopsis of the History and Cure of Venereal Diseases (London: A. Millar, 1737). Turner’s Aphrodisiacus. Containing a Summary of the Ancient Writers on the Venereal Disease (London: John Clarke, 1736) is less than half the length of Armstrong’s edition.

105 See J. Martyn, trans. A Treatise of the Acute Diseases of Infants (London: T. Astley), 1742. Armstrong devoted more than half of his 263-page Full View to a translation of Walter Harris’s On the Diseases of Infants, the basis of Martyn’s work. G. F. Still has pointed out that, “in England, none of the writers already mentioned obtained such vogue in the seventeenth [sic] century as Walter Harris …… De Morbis Acutem Infantem seems to have


remained in stock at Millar’s shop, selling for a slightly higher price. Like all of Armstrong’s works of this period, though its medicine remained sound, it never sold well.106

Looking back at this period in his career, Frances Burney recalled that “Dr. Armstrong was as high, then, in the theory of his art, medicine, as he was far from lucratively prosperous in its practice.”107 By 1741, Britain being now at war, Armstrong sought to follow other Scottish physicians by petitioning, unsuccessfully, for a position in the army. That year Armstrong’s well-connected friend Thomas Birch accompanied him on three visits to Richard Mead, one of London’s wealthiest and most important physicians, indicating Armstrong’s ambition, some desperation, and the modest progress he had made among the capital’s medical establishment since his arrival 12 years earlier.108 Armstrong did not receive the commissions he sought, but he did not give up on Mead either; he would soon dedicate The Art of Preserving Health to him.

Why was this newly trained physician forced to plead for his abilities by resorting to the kinds of supplication normally associated with those whose skills can be valued only on the basis of taste? Why did Armstrong and his fellow Scottish graduates not simply prove the superiority of their training by demonstrating success at curing diseases, managing illnesses, and by presenting evidence of their patients’ recovery and survival? This is because the medical theory that informed professional practice in mid-eighteenth century London was much the same everywhere else in Western Europe. What differed was the style by which it was practiced and promoted. Cheyne’s enormous wealth and prominence among his English patients illustrates the importance of canny self-promotion rather than any special efficacy from the treatments he recommended; the same is true for Barrowby, Martyn, Mead, and Turner. Indeed, although Edinburgh brought its students into close acquaintance with patients, its actual training in medical

become the standard textbook of the period, and remained so for about fifty years.” See The History of Paediatrics (London: Dawsons, 1965) 189. Harris’s book passed through seven Latin editions between 1689 and 1720.

106 The endpaper advertisement listed in the second London edition of John Gregory’s Lectures on the Duties and Qualifications of a Physician (London: T. Cadell, 1772) indicates that Armstrong’s Full View was still offered at its 1742 price of three shillings. But a contemporary list shows it selling for four shillings. See A New and Correct Catalogue of All the English Books (London: n.p., 1767) 4.

107 F. Burney, ed., Memoirs of Doctor Burney, Arranged from His Own Manuscripts, vol. 1, 3 vols (London: E. Moxon, 1832) 18.

108 In a note written on 20 July 1741, Armstrong asked Birch “if it were convenient for you to carry me to Dr Mead’s again …… it is a mere trifle to what you have submitted to on my account,” and more than a year later he wrote to Birch once more, this time in the company of Joseph Spence (BL. Add. 4300.f.90). Porter has shown that “Georgian medicine worked less by professional rules than by patronage,” and Mead occupied a central place in the market for positions; see R. Porter, Body Politic Death, Disease, and Doctors in Britain (Ithaca, NY: Cornell UP, 2001) 111. See also J. Nichols, Literary Anecdotes of the Eighteenth Century, vol. 2, 9 vols (London: J. Nichol, 1812) 715.


therapeutics probably made little difference in terms of its graduates’ abilities to cure ailments—leaving aside the powerful influence of the placebo effect among their appreciative patients.109 It is helpful to note that placebo, in this particular context, was the term used to describe anything offered to please the patient.

Even for those physicians who were thoroughly versed in the advanced conceptual developments of the Scientific Revolution (those hailing from the Oxford of Sydenham and his medical disciple Locke, and from the Cambridge of Newton and his medical disciple Archibald Pitcairne),110 major conceptual shifts did not affect clinical practices.111 Roy Porter and David Wootton have shown that medical practice, even in the wake of great Newtonian discoveries, remained remarkably similar to the crude humoralist bloodletting and purging that was taught by Hippocrates, Galen, and Celsus, and which was largely retained by Western physicians until the mid-nineteenth century.112 Even though Monro was probably the most progressive teacher of anatomy in Britain, including historical

109 Based on studies of Monro’s manuscripts and related documents, Christopher Lawrence has shown that the faculty and students at Edinburgh agreed “that anatomy could be learned only from a master and not by dissection guided by a book,” but nonetheless “secrecy normally surrounded anatomical skills”—these could not be gleaned by observing the physician in clinical practice, nor did such observers seem to address those skills. See C. Lawrence, “Alexander Monro Primus and the Edinburgh Manner of Anatomy,” Bulletin of Medical History 62 (1988): 198.

110 On Locke’s relationship to Sydenham, see G. G. Meynell, “John Locke and the Preface to Thomas Sydenham’s Observationes Medicae,” Medical History 50 (1 January 2006): 93–110; on Newton and Pitcairne, see A. Guerrini, “Isaac Newton, George Cheyne and the Principia Medicinae,” The Medical Revolution of the Seventeenth Century, ed. R. French and A. Wear (Cambridge: Cambridge UP, 1989) 222–45.

111 See David Wootton Bad Medicine (Oxford: Oxford UP, 2006) 19–20 and passim. This was largely due to the fact that, even in the fields of moral and natural philosophy, the English university curricula resisted any changes to what Thomas Miller calls “its classical tradition embodied in a well-defined corpus of texts from which one could deduce all that that was worth knowing.” Some 50 years after Locke’s Essay of Human Understanding appeared, Cambridge and Oxford continued to exclude his inductive epistemology and experimental logic in favor of “the logic of the Schools.” Indeed Cambridge censured Locke’s logical theory in 1703, while Locke was taught and in some ways emulated in Scotland. See T. Miller, The Formation of College English (Pittsburgh: U of Pittsburgh P, 1997) 67.

112 For the last medical defense of therapeutic phlebotomy on Hippocratic principles, which was argued by an eminent American physician (a former President of the Carnegie Academy of Medicine and advisor to the International Congress on Tuberculosis), see W. F. Button, A Brief Summary of the Practical Value of Venesection in Disease (Philadelphia: Davis and Co.; London: S. Phillips, 1916). Button provides thorough references to the nineteenth-century medical literature, but venesection had become an eccentric medical practice in America and Britain by the 1870s, even though Hippocrates remained a respected figure among professors of medicine during the early twentieth century. See W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge UP, 1994); C. M. Smith, “Origin and Uses of Primimum Non Nocere [do no harm],” Journal of Clinical Pharmacology 45 (2005): 371–8.


surveys of his art to encourage his students to think critically about the role of anatomical knowledge in medical training, he nevertheless held Aristotle’s view that the human fetus arrives preformed within male sperm.113 As we will see, Armstrong’s own first lines in his Art of Preserving Health pay tribute to the ancients by name, including Hippocrates and then Celsus, and his descriptive terms for various diseases (including tertian and quartan fevers), internal fluids (including lymph and vital spirits), and disease-inducing winds (including the ancient names Eurus and Zephyr) are more than mere references to the classics, for they reveal a contemporary understanding of disease that had not changed significantly since the Greeks.114 Even though the Edinburgh manner of training physicians was innovative and appealing for its students and their patients, its conceptual basis and therapeutic system remained firmly Hippocratic.115 Reading Armstrong’s eighteenth-century imitation of Virgil entails developing an acquaintance with the very same medical terms and concepts that predate even the Roman poet’s own time.

The Oxbridge-trained London physicians who were alarmed by the immigration of Edinburgh graduates to their economic territory expressed their outrage by pointing to what they saw as the inferior quality of Scottish training, and not by referring to examples of poor practice. This is plainly evident in John Tristram’s energetic attack Scottish-trained doctors in his emblematic polemic, The Ill State of Physick in Great Britain (1727), included in this book. Similarly, Armstrong countered such national prejudice not by arguing for the relative efficacy of his

113 See J. Blackman, “Popular Theories of Generation: The Evolution of Aristotle’s Works: The Study of an Anachronism,” in J. Woodward and D. Richards, eds, Health Care and Popular Medicine in Nineteenth-Century England: Essays in the Social History of Medicine (London: Croom Helm, 1977) 56–88; C. Lawrence, “Alexander Monro primus and the Edinburgh Manner of Anatomy,” Bulletin of the History of Medicine 62 (1988): 215. See also Trapp, note 59 and Young, note 10.

114 See R. Porter, “Barely Touching: A Social Perspective on Mind and Body,” The Languages of Psyche: Mind and Body in Enlightenment Thought, Ed. G. S. Rousseau (Berkeley: U of California P, 1990) 45–79.

115 Herman Boerhaave, who trained the founding professors of the Edinburgh medical school, gave his inaugural lecture at Leiden (1701) under the title “In Praise of Hippocrates,” see E. Kegel-Brinkgreve and A. M. Luyendijk-Elsout, eds, Boerhaave’s Orations (Amsterdam: Brill, 1983) 58; A. Cunningham, “Medicine to Calm the Mind: Boerhaave’s Medical System and Why It was Adopted in Edinburgh,” The Medical Enlightenment of the Eighteenth Century (Cambridge: Cambridge UP, 1990) 54. Armstrong’s contemporary, William Cullen, described his studies under Monro in 1735–36: “I learned the system of Boerhaave …… I heard of no other names or writers on physic; and I was taught to think the system of Boerhaave to be very perfect, complete and sufficient”: see John Thompson, An Account of the Life, Lectures, and Writings of William Cullen, M.D., vol. 1 (Edinburgh: W. Blackwood and Sons, 1859) 118. See also Whytt’s transcription of “Physiological lectures by Mr Alexr Monro, Lect. 1st Monday March 13 1732,” composed one month after Armstrong’s graduation: “I shall as much as I can follow Mr Boerhaave’s method as being ye most regular and which perhaps may be of more use to you that attend, and to those that are to attend his Institutiones”; see Wellcome Library MSS. 6860.


technique or education, but simply by stating a political and therefore moral fact that touched on a newly sensitive point concerning Scottish entitlement to a shared British patriotism: “permit that I/ My little knowledge with my country share” (1: 60–61). Armstrong’s claim to a right to practice in Scotland’s newly created national capital rested on a view of politics and not therapeutics. Indeed, Armstrong’s tender description of the hills and dales in which he enjoyed his Scottish childhood makes a clear point of emphasizing his national origins and professional ambitions. Unlike his friend Thomson, whose nostalgia for the Scottish Borders suggests what Dustin Griffin has called “a patriotism [that] is at bottom a love of the green and pleasant homeland, to which the poet returns after every distant excursion,” Armstrong’s patriotism leads him directly to claim a professional career in London, with ready access to patients residing in English neighborhoods that include Hampstead, Epsom, and Greenwich.116 Both the Scots who sought a legitimate practice in their newly established capital, and the English-trained physicians who sought to exclude them, reduced themselves to ideological and territorial feuding, largely ignoring issues concerning medical efficacy or their patients’ interests.

Since physicians had no recourse to scientific evidence of their skills, many sought cultural authority through London’s expanding print culture, as suggested by Elizabeth Furdell’s study of the close proximity of booksellers’ shops to medical sites in London throughout the early modern period.117 The social historian Nicholas Jewson has shown that during the early to mid-eighteenth century, “the clinical encounter was a delicate process of negotiation” in which “physicians had no choice but to tailor their theories and remedies to meet the expectations and requirements of their genteel clients.”118 Such haggling over medical knowledge, which trained physicians had to offer to their untrained patients, overlapped with the more familiar tales of Grub Street hacks who modified their writing to suit the demands of London booksellers: despite Pope’s memorable branding of hired

116 See D. Griffin, Patriotism and Poetry in Eighteenth-Century England (Cambridge: Cambridge UP, 2002) 79. Griffin is referring to Thomson’s nostalgic depiction of rural life in The Seasons (1726–30); his study does not refer to Armstrong. It is important to consider Thomson’s notions of “liberty” and “freedom” as they embody his patriotism—which include depth and dimension that are not in evidence in Armstrong’s poetry of this period. On these crucial aspects of Thomson’s patriotism, see Annabel Patterson, Nobody’s Perfect: A New Whig Interpretation of History (New Haven: Yale UP, 2002) 159–62. The poem lists these and a dozen other assumed residential areas for Armstrong’s readers at various point; see 1: 312–14, passim.

117 See E. L. Furdell, “Location, Location, Location: Bookshops in London and Medical Controversy,” Publishing and Medicine in Early Modern England (Rochester, NY: U of Rochester P, 2002) 113–34; S. Shapin, “Trusting George Cheyne: Scientific Expertise, Common Sense, and Moral Authority in Early Eighteenth-Century Dietetic Medicine,” Bulletin of the History of Medicine 77 (2003): 263–97.

118 Nicholas Jewson, “Medical Knowledge and the Patronage System in 18th Century England,” Sociology 8 (1974): 376.


authors as an “idle trade,” its highly pressured market forced writers to respond quickly and ingeniously to their readers’ demands.119 Helen Deutsch has suggested that “medicine and literature underwent parallel processes of professionalization in the eighteenth century,” but in Armstrong’s case these processes were united.120 Armstrong’s first London works attempt to apply the social subtleties of the clinical encounter to an even more delicate relationship between an unlicensed Scottish physician and the censors of the Royal College—all the while seeking the attention of potential patients through print. Armstrong’s most successful publication probably deals with the preservation of health rather that the treatment of disease because the former offers the appealing promise of success in all three areas (commercial, professional, literary) while the latter, at this point in medical history, risks obvious failure.

In 1742, the formerly anonymous Oeconomy of Love appeared in its fifth edition, and it now included the incriminating subtitle A Poetical Essay by Dr. Armstrong.121 Armstrong’s medico-literary projects of this period represent each of the genres through which academic medical ideas found their way into print during the early eighteenth century. But their failure to win support sufficient to let Armstrong develop a legitimate medical career led him to perceive, correctly, that a wider circle of readers would be willing to consume medical instruction by couching it in the ornamented but cogent dress of neoclassical poetry, touching on morally benign matters of immediate social relevance. Only now did Armstrong seem to realize that he required a wealthy but not necessarily learned clientele. It was time to drop his concern for ingratiating his resentful colleagues, informing or entertaining his venereal patients, and expressing his pediatric worries, and to focus instead on winning the larger prize: affluent and reasonably healthy readers who sought confirmation of their conventional medical beliefs and reassuring depictions of emotional states that had been long neglected by physicians but which played an increasingly prominent role in the poetry and novels of this period.122

119 See A. Pope, Epistle to Arbuthnot l.126. See also B. Hammond, Professional Imaginative Writing in England, 1670–1740 (Oxford: Clarendon P, 1997) and Paula McDowell, The Women of Grub Street: Press, Politics, and Gender in the London Literary Marketplace, 1678–1730 (Oxford: Clarendon P, 1998).

120 See H. Deutsch’s suggestive article on ways through which “the male body served as a site upon which authorship was suffered, proven, and displayed as a disease” in “Symptomatic Correspondences: The Author’s Case in Eighteenth-Century Britain,” Cultural Critique 42 (Spring 1999): 35–80.

121 See the title page to the fifth albeit unauthorized edition (Dublin: n.p., 1742). Later in the century, more discretion seems to have been required: “The character of a physician ought to be that of a gentleman,” a later contemporary remarked, “he who undertakes to be a physician, must be chastity itself!” See Anne Digby, Making a Medical Living: Doctors and Patients in the English Market for Medicine 1720–1911 (Cambridge, CUP, 1994) 172.

122 The classic studies of this material include: J. Mullan, Sentiment and Sociability: The Language of Feeling in the Eighteenth Century (Oxford: Oxford UP, 1988); J. Todd, Sensibility: An Introduction (London: Methuen, 1986); Anne Jessie Van Sant, Eighteenth-Century Sensibility and the Novel: The Senses in Social Context (Cambridge: Cambridge UP, 1993). More recent studies include D. Lawlor, Consumption and Literature: The


Retaining his friendship with Andrew Millar, whose gift for scenting and then serving the tastes of readers enabled him to work as the sole publisher of the hugely successful novelist Samuel Richardson and his rival and satirist, the equally popular Henry Fielding. Millar remained at the centre of a brilliant circle of “anglo-Scots” that had included Armstrong for two decades.123 It is likely too that Hill, Mallet, and Edward Young, all seasoned authors who had encouraged Armstrong years earlier, gave him good examples of how to adapt one’s literary talents to suit the fickle market for books.124 Armstrong’s joint career as a physician-poet illustrates the essential affinity between literary style and medical treatment. The success of both relied on the agent’s responsiveness to a paying clientele and not on the objective superiority of any demonstrable therapeutics. For this reason, his skilled manipulation of classical and fictional modes entailed developing a uniquely reverential yet forceful didactic style.

When a young English doctor had considered taking up writing as a means to attract patients, Mead instructed him to “choose the subject by which you think you will get most money … but above all things, take particular care … that the language be well chosen, since you will have ten to one that [your patients] mind the language more than the ideas”—and he may have given this advice to Armstrong, too.125 Armstrong duly returned to poetry, but this time he adopted the elevated georgic mode, which as Ralph Cohen and others have observed, had “become a literary genre for exploring man’s experience, and leads to prose works such as the novel”126 (5). Yet unlike sentimental novels of this period that stressed

Making of the Romantic Disease (London: Palgrave, 2007); D. Shuttleton, Smallpox and the Literary Imagination 1660–1820 (Cambridge: Cambridge UP, 2007).

123 See Breane S. Hammond, Professional Imaginative Writing in England, 1670–1740 (Oxford: Clarendon P, 1997) 48; Ruthe and Martin Battestin, Henry Fielding: A Life (London: Routledge, 1989) 325.

124 See Thomas Cadell’s prefatory note to the first edition of Armstrong’s Miscellanies (London: T. Cadell, 1770): “Thomson showed [the poems] to his poetical friends, Mr Mallet, Mr Aaron Hill, and Dr Young, who, it seems, did great honour to [them]; and the first-mentioned Gentleman wrote to one of his friends at Edinburgh, desiring the author’s leave to publish it; a request too flattering to youthful vanity to be resisted. But Mr Mallet altered his mind” (vii). On professional authorship, see B. Hammond, Professional Imaginative Writing in England, 1670–1740 (Oxford: Clarendon P, 1997); Pat Rogers, Hacks and Dunces: Pope, Swift, and Grub Street (London: Methuen, 1972); Paula McDowell, The Women of Grub Street: Press, Politics, and Gender in the London Literary Marketplace, 1678–1730 (Oxford: Clarendon P, 1998); Clifford Siskind, The Work of Writing: Literature and Social Change in Britain, 1700–1830 (Baltimore: Johns Hopkins UP, 1998); Sandro Jung, David Mallet: Anglo-Scot (Newark, DE: U of Delaware Press: 2008).

125 Quoted in Harold J. Cook, The Decline of the Old Medical Regime in Stuart London (Ithaca: Cornell UP, 1986) 54.

126 See R. Cohen, The Art of Discrimination: Thomson’s “The Seasons” and the Language of Criticism (London: Routledge, 1964) 5. For a more recent elaboration, see April London, “Clarissa and the Georgic Mode,” Women and Property in the Eighteenth-Century English Novel (Cambridge: Cambridge UP, 1999) 17–27.


their ambiguous relation to reality, Armstrong’s readers understood and valued this poem’s practical value. As Paul Hunter has suggested, during the 1740s “poetry, even when it was luxurious, lascivious, or occasional, was thought to be ‘serious’ and demanding in a way that new novels were not.”127 The Art of Preserving Health was a guide to conduct on a theme of universal interest, properly suited to attracting professional advancement, popular attention, and hopefully some redemptive admiration. Like its classical model, the Art provided directions on practical matters such as where to build one’s house and which of the coldest winds to avoid, but also like Virgil’s Georgics the Art’s most important lessons were more subtle and probably more important: as Paula Backscheider has pointed out, “in this environment, poetry went far beyond bestowing cultural capital to purport to offer cultured ways to feel, think, and respond.”128 Armstrong designed his readers’ poetic responses to be therapeutic, too.

Georgic Poetry and Edinburgh Medicine

Eighteenth-century physicians had written poems on health before Armstrong, but none had offered medical advice in verse.129 Armstrong’s combination of clinical expertise and extensive experience with the London book market is evident in the sympathetic qualities of the poet-physician persona who narrates The Art of Preserving Health. Openly wondering whether his poem will persuade his reader to attend his theme, Armstrong proposed that the very act of composition affects him physically:

To you, ye delicate, I write; for youI tame my youth to philosophic cares,And grow still paler by the midnight lamps. (3: 7–10)

Study has long been associated with illness.130 But this representation of a physically vulnerable physician suggests that readers might have welcomed a

127 See P. Hunter, Before Novels: The Cultural Context of Eighteenth-Century Fiction (New York: Norton, 1990) 87.

128 See P. Backscheider, Eighteenth-Century Women Poets and Their Poetry (Baltimore: Johns Hopkins UP, 2005) 9.

129 These include Samuel Garth’s Dispensary (1699), an allegorical satire on disputes among fellows of the Royal College of Physicians; Blackmore’s long poem The Creation (1712) reached a sixth edition in 1727: cantos 6 and 7 include brilliant depictions of pulmonary anatomy, but without instruction. Edward Baynard’s doggerel Health, A Poem (London: J. Roberts, 1716) reached a seventh edition in 1742; Henry Baker’s Invocation of Health (London: the Author, 1723) is not didactic. Malcolm Flemyng printed a dissertation on hypochondria in Latin verse Neuropathia (York: C. Ward, 1730), thus without any popular pretence.

130 For an entertaining survey, see R. Porter, “Reading: A Health Warning,” Medicine, Mortality, and the Book Trade, ed. R. Myers and M. Harris (New Castle, DE: Oak Knoll, 1998) 131–52.


medical authority who is himself susceptible to the very environment they share.131 This was a shrewd and characteristically audacious approach for a supplicant seeking preferment from established physicians, since at first it seemed to validate proverbial notions that doctors are uncaring and insensitive; as an abidingly popular polemic called Health Restor’d … To Those that would Preserve Health, exclaimed: “A Patient that rejoyceth at the sight of a Physician is sicker in Mind than in Body, and every Patient that willingly takes what his Physician prescribes to him, if he be not his own Murderer, he is at least accessory to his own Death.”132 Armstrong then reshapes these prejudices by seeking to cultivate the reader’s own sensibility as a means to maintain health, doing so in place of prescribing or advertising specific regimens. Offering professional advice through verse gave readers the benefit of foregoing the customary one-guinea consultation fee, while its overtly literary style and self-characterization helped to avoid a costly pamphlet-war over its therapeutics.133 It also meant that patrons could support his ambitions without engaging in related or pedantic controversy.

Similarly, the Art’s dedication revealed Armstrong’s professional vulnerability in a style more characteristic of a poet seeking patronage than a physician seeking patients:

Indulge, O Mead! a well-design’d essay,Howe’er imperfect: and permit that IMy little knowledge with my country share,Till you the rich Asclepian stores unlock,And with new graces dignify the theme. (1: 59–63)

The uneasy fact that this physician must please, instruct, and impress his readers defines the practical requirements of this poem. Learned readers might have admired Armstrong’s “having to suit himself to his Readers, instructing them while he entertains them,” as a tutor of the previous year described Virgil’s didactic

131 George Cheyne and Francis Fuller described their own ailments, but they relegated their confessional “Author’s Cases” to appendices, assuring both themselves and their readers that their medical authority derived from their having been cured. See G. Cheyne The English Malady (London: J. Leake, 1733); F. Fuller, Medicina Gymnastica (London: R. Knapton, 1705). Both Fuller and Cheyne follow the medico-spiritual model of the best-selling Treatise of Temperance and Sobrietie by the self-described centenarian Luigi Cornaro, who insisted on a clear distinction between past “Errours” and current practice to testify to his regimen’s success.

132 Health Restor’d. or the Triumph of Nature over Physick, Doctors, and Apothecaries (London: J. Torbuck etc., 1740) 56–7. It was first published as The Doctor’s Physician (London: Joseph Hindmarsh, 1685).

133 For an overview of Georgian medical fees, see Anne Digby, Making a Medical Living: Doctors and Patients in the English Market for Medicine 1720–1911 (Cambridge: Cambridge UP, 1994) 185–96. On the fact that “medicine was beyond comparison the most pamphlet-ridden of the late-seventeenth and eighteenth-century professions,” see G. Holmes, Augustan Professions, 167–9.


posture.134 Others might have been intrigued and perhaps endeared by the prospect of a knowledgeable physician who requests rather than expects their attention. In fact this conventional poetic supplication to a potential patron expressed Armstrong’s real anxiety; years later, Armstrong told Frances Burney that “he had never been happy till he was able to live Independent of his Business, for that the pain and the anxiety attendant upon it were inconceivable.”135 Three months after the Art was published, James Thomson described his friend’s apprehension that Mead remained unwilling to assist him, characterizing it as Armstrong’s “Python of ill-Fortune, whose particular Delight is to feed on Men of Merit.”136

The poem’s four-book structure would have been familiar to many contemporary readers, and not only for its conventional division into Galen’s “non-natural” elements of Air, Diet, Exercise, and The Passions, or for invoking the four-book structure of Virgil’s Georgics.137 During the 1740s, translations, popularizations, and scholarly editions of Virgil were enjoying a renaissance among London readers. As Fran de Bruyn and Andrew Wallace have shown, the Georgics had long since established itself as a scientific and rhetorical model for instructors teaching subjects that ranged from agriculture to linguistics to statistical graphs.138 Reading Virgil for imaginative pleasure and reading Virgil for practical instruction was nothing new for British readers—for as early as the mid-sixteenth century, when English translations of Virgil’s Georgics first found their way into the hands of

134 See The Works of Virgil … for Use in the Schools (London: J. Davidson, 1743) vi. Another contemporary study of Virgil’s Georgics describes this posture according to a formula suited to Armstrong’s actual and textual position: “Virgil understands very well that it depended on the Success of the Work to shew that he deserv’d the Honour that was being done to him in being singled out by so great a Judge,” wrote an anonymous commentator in 1725, “this is the Tremor Oratoris of the Antients.” See William Benson, Virgil’s Husbandry, or an Essay on the Georgics (London: William and John Innys, 1725) ii.

135 See Early Journals and Letters of Fanny Burney, ed. Lars E. Troide, vol. 2, 4 vols (Kingston, Canada: McGill-Queen’s UP, 1988–2003) 39.

136 See Thomson’s letter to their mutual friend John Sargent, dated 24 July 1744, in A. D. McKillop, ed., James Thomson: Letters and Documents (Lawrence, KS: U of Kansas P, 1958) 172.

137 See Antionette Emch-Deriaz, “The Non-Naturals Made Easy,” in The Popularization of Medicine 1650–1850, ed. R. Porter (New York: Routledge, 1992) 134–59; and William Coleman, “Health and Hygiene in the Éncyclopedie: A Medical Doctrine for the Bourgeoisie,” Journal of the History of Medicine 29 (Oct. 1974): 399–421. On the non-naturals, see Peter H. Niebyl, “The Non-Naturals,” Bulletin of the History of Medicine 45 (1971): 486–92; L. J. Rather, “‘The Six Things Non-Natural’: A Note on the Origins and Fate of a Doctrine and a Phrase,” Clio Medica 3 (1968): 337–47.

138 See F. de Bruyn, “Reading Virgil’s Georgics as a Scientific Text: The Eighteenth-Century Debate between Jethro Tull and Stephen Switzer,” ELH 71 (2004): 661–89; F. de Bruyn, “From Georgic Poetry to Statistics and Graphs: Eighteenth-Century Representations and the ‘State’ of British Society,” Yale Journal of Criticism, 17 (2004): 107–39; A. Wallace, “Virgil and Bacon in the Schoolroom,” ELH 71 (2006): 161–85.


agricultural improvers, his poetic word was treated as literal advice.139 In his own georgic poem, Armstrong had taken his pedagogical cues directly from Boerhaave’s recently published Academical Lectures, which Monro had quoted extensively in his Edinburgh lectures: “the whole art of preserving Health is comprised of those Rules … directing us how to apply and adapt the several necessary Particulars of the Non-naturals.”140 Evoking the structure, tone, and imagery of Virgil with the rhetoric of Boerhaave and Galen, Armstrong combined familiar and powerful didactic models. Their enduring prestige among professional and lay readers my be partly responsible for the poem’s continued success, for the basic principle that physicians should moderate and balance those elements external or “non-natural” to the body continued to be taught in European medical schools well into the nineteenth century.141 Although eighteenth-century patients were likely to have expected their physician to attend to this ancient doctrine,142 Armstrong’s unusual depiction of the relevant symptoms and treatment from the patient’s point of view represented an advance that was uniquely in line with his training at Edinburgh. The progressive philosophy that energizes The Art of Preserving Health holds that evocative representations of physical and emotional sensibility should enable readers to attend to their own symptoms before they overwhelm them as disease. This brings together the moral elements of his Edinburgh training with his need to cater to his patients complaints in London, through the literary style reminiscent of the Georgics.

Armstrong professed this advice by advising readers to “fly, if you can, these violent extremes/ Of air, the wholesome is nor moist nor dry” (1: 185–6); on diet, he counseled them to “avoid the stubborn aliment, avoid/ The full repast … Learn a juster taste;/ And know that temperance is true luxury” (2: 54–5, 158–9). However, unlike typical Galenic treatises, Armstrong showed throughout that he too is subject to changes in external and internal nature.143 Armstrong counseled

139 See J. Thirsk, “Making a Fresh Start: Sixteenth-Century Agriculture and the Classical Inspiration,” Culture and Cultivation in Early Modern England (Leicester: Leicester UP, 1992) 19.

140 See Dr Boerhaave’s Academical Lectures, vol. 6, 6 vols (London: J. Rivington, 1743–57) 239.

141 Virginia Smith concludes that “nothing occurred until the late nineteenth century to disturb this macro-biological patter of inter-linked universal elements”; see “Prescribing the Rules of Health: Self-Help and Advice in the Late Eighteenth Century,” in Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. Roy Porter (Cambridge: Cambridge UP, 1985): 258. See also Lester King, The Philosophy of Medicine: The Early Eighteenth Century (Cambridge, MA: Harvard UP, 1978) 15–20; A. Lovejoy, The Great Chain of Being (Cambridge, MA: Harvard UP, 1936) 227–41.

142 The popular Bibliotheca Technologica: or, a Philological Library of Literary Arts and Sciences (London: J. Hodges, 1740) 419, defines “Physick” solely in terms of the non-naturals and the physician’s responsibility to modify them.

143 Cheyne’s An Essay concerning Health and Long Life (London: G. Strahan, and J. Leake, 1724) was divided into six sections, each dedicated to prescriptions relating to a non-natural element.


the importance of refreshing the body with water in an apostrophe to the naiads, who by the mid-1740s had become familiar classical features in Augustan verse.144 Like a mythological hero, Armstrong invoked the water-nymphs who then enable his digressive expression of sensory experience:

Now come, ye Naiads, to the fountains lead;Now let me wander thro’ your gelid reign.I burn to view th’ enthusiastic wildsBy mortal else untrod. I hear the dinOf waters thund’ring o’er the ruin’d cliffs.With holy rev’rence I approach the rocksWhence glide the streams renown’d in ancient song. (2: 352–8)

This reverential and solitary encounter with imaginary classical figures is, for Armstrong, as instructive for his readers as it is conventional in classical poetry. This evocative encounter with nature links the poet’s sensory imagery with the patient’s corporeal sensibility, showing that Armstrong maintains only a cursory adherence to conventional medical theory. Rather than merely following Galen’s rules concerning the non-naturals, readers of this poem learn to appreciate their own responses to the natural environment. For Armstrong, readers already possess the sensibility they require to preserve health, which is why his georgic is devoted to cultivating feeling through evocative imagery rather than teaching mere precepts that implies a fundamental numbness to feeling.

Like Virgil’s narrator who is both a working farmer and a polished poet, Armstrong constructs and then breaks though this mythological guise, showing that he too is subject to the elements that he describes, indeed that his own thirst is animated by the psychological associations aroused by the poem’s natural setting. Such combinations of physical and emotional feelings brings him within reach of a physiological sublime:

What solemn twilight! What stupendous shadesEnwrap these infant floods! Thro’ every nerveA sacred horror thrills, a pleasing fearGlides o’er my frame (2: 365–8)

By describing the glittering rivulet and the quality of light, the poet’s vision reflects his delight in emotional and corporeal sensibility. Armstrong’s practical intention, of course, is to encourage positive reactions to healthy impulses by communicating the very feelings associated with disease and healing. Twenty lines later, his poetic vision seems to enable physical touch, constituting a decidedly therapeutic event:

144 See John Byrom’s burlesque on “Dryads, Naiads, Nymphs, and Fauns” (1757) in “Remarks on a Pamphlet,” Miscellaneous Poems, vol. 2, 2 vols (Manchester: J. Harrop, 1773) 213.


O comfortable streams! With eager lipsAnd trembling hand the languid thirsty quaffNew life in you; fresh vigor fills their veins.No warmer cups the rural ages knew … (2: 386–9)

Anatomical imagery had earlier referred to the physician, but now Armstrong’s ambiguous diction allows for an ascription of feeling to the reader as well as to the stream. This shift is tempered by a gesture to a mythical world which is conventional enough—indeed in his essay on health, Francis Bacon instructed his reader to enjoy pleasing prospects and not suffer through painful reading—Armstrong’s evocative instruction operates through emotional modeling.

Armstrong did not dismiss the Newtonian language of mechanical physiology entirely. Indeed, he adopted its hydraulic imagery in his depiction of the patient’s “gross corporeal frame”:

By subtle fluids pour’d thro’ subtle tubesThe natural, vital, functions are perform’d. (4: 29–30)

By the mid-1740s, however, such hydraulic language had become a meaningless cliché; it is the emotionally dynamic nature of Armstrong’s imagery which revealed his attempt to refine his reader’s self-consciousness by representing his own state of mind. Looking back on this period 30 years later, Armstrong would ridicule “those mechanical physicians [who] very ingeniously discovered, that the various secretions performed by the different glands, were owing to the different angles at which their arteries were detached from the Aorta.”145 Armstrong’s rather more diplomatic poem teaches healthy behaviour through the evocation of his reader’s own reflections, tactfully revising contemporary Newtonian principles. In subsequent verses, Armstrong counsels that

… ’tis not Thought (for still the soul’s employ’d)’Tis painful thinking that corrodes our clay.All day the vacant eye without fatigueStrays o’er the heaven and earth; but long intentOn microscopic arts its vigour fails.Just so the mind … (4: 35–40)

145 J. Armstrong, Medical Essays (London: T. Cadell, 1773) 3. Armstrong was probably referring to the Oxford anatomist James Keill’s Anatomy of the Human Body Abridg’d (London: W. Keblewhite 1698), a standard textbook throughout the century, passing through 20 English editions and providing a source for physiological medical teaching as late as 1774: see Robert Schofield, Mechanism and Materialism: British Natural Philosophy in an Age of Reason (Princeton: Princeton UP, 1970) 54. It provided a notoriously confident formula for calculating the volume of certain glandular secretions, whose surplus was believed to cause disease, by determining the velocity of aortic force.


Armstrong then presents concluding digressions on diet, loneliness, and other topics, which attempt to lead his reader to experience the diverse visions that he counsels.

The previous generation of physicians counseled adjusting the non-naturals to counterbalance certain passions, but Armstrong sought to cultivate his reader’s sensitivity to the non-naturals by practicing a form of poetical inoculation. He used emotional modeling to personify and then to anatomize melancholy itself, which entailed appreciating the very experience of its affliction. It was these lines which inspired Bowell:

… the dim eye’d Fiend,Sour Melancholy, night and day provokesHer own eternal wound. The sun grows pale;A mournful visionary light o’erspreadsThe chearful face of nature: earth becomesA dreary desart, and heaven frowns above.Then various shapes of curs’d illusion rise,Whate’er the wretched fears, creating FearForms out of nothing; and with monsters teemsUnknown in hell. (4: 92–101)

This calculated appeal to terror intends to raise the passions, even “those fatal guests” “the Demon Fear,” so that readers can identify them as their own reification of therefore harmless anxiety (4: 120). Of interest here is not only Armstrong’s attention to subjective experience, and his subtle transition from defining melancholy as an abstract characterization to locating it as a powerful internal state of mind. Also, by recognizing and envisioning psychological aspects of anxiety, Armstrong encouraged readers to understand disease in a way that focused their attention beyond its visible, physical, effects. This was a therapeutic advance and subtle challenge to those physicians who still maintained the ancient belief that fear and anxiety could themselves cause plague which, as we will see, remained a significant domestic threat to Britain in the first half of the eighteenth century.146

146 Mead himself once wrote that “Fear, Despair, and all Dejection of Spirits, dispose the Body to receive the Contagion, and give it a great Power, where it is received, as all Physicians agree they do”: see A Discourse of the Plague (1720; London: A. Millar, 1744) 102. Even the noted precursor of Whytt, the anatomist Georgio Baglivi, whose “fundamental research concerning the fibres made him one of the most important students of muscle physiology,” wrote that “in the beginning of a Plague, many are seiz’d with it, and die of it, because they contract the Illness rather tho’ Fear and Concern for the Public Calamity, rather than by Contagion”: see The Practice of Physick (London: Bell, 1704), 179. See C. C. Gillespie, Dictionary of Scientific Biography (New York: Scribner, 1970–80) vol. 1, 392. See also Andrew Wear, “Fear, Anxiety and the Plague in Early Modern England,” Religion, Health and Suffering (London: Kegan Paul, 1999): 339–63; W. Bynum, “Fear,” Lancet 359 (9 Feb. 2002): 535; Margaret Healy, Fictions of Disease in Early Modern England (New York: Palgrave, 2001).


Perhaps the most medically innovative episode in the Art takes place in the final lines of the third book, at the precise structural point in Virgil’s own four-book Georgics, where Virgil emulated Lucretius’s famous attempt to teach his materialist philosophy by terrifying his reader.147 Lucretius closed his treatise in apparent mid-sentence, in a graphic retelling of the Plague of Athens during the Peloponnesian War; one scholar has described this technique as “committing philosophy on the reader.”148 Armstrong designed the final pages of his third book to evoke an even more powerful episode by combining details of two memorable epidemics—one of which, it was then believed, could return. Armstrong seems to have agreed with the Augustan physician William Charleton, who wrote that “they who are more naturally most apt to be moved by passions are more exposed to drink of the gall and wormwood of pain and remorse,” and he sought to use that sensibility as a means of achieving a kind of poetical inoculation against terror.149 Cultivating emotional sensibility by evoking the experience of suffering may have proved unsettling for more sensitive readers, but by adopting a powerful version of Lucretius’s device, such evocation would teach readers to distinguish urgent signs of infection from the imagery of more easily managed emotion.

In his detailed reading of a memorable scene in Thomson’s Winter, where the shepherd is overwhelmed by a snowstorm, Timothy Fulford remarks that “in Thomson’s poems the reader is comfortably insulated from nature’s cruelty.”150 This is partly due to the unlikely kinds of natural forces that Thomson’s poems depict, and also because its characterization of the authoritative narrator and passive peasant “neither disturbs the social hierarchy within which rural hardship was present.”151 It retains an aesthetic and emotional distance between the genteel reader and his suffering rustic. But Armstrong wants to arouse troubling emotions in his readers so that they can learn to manage their reactions to nature’s real dangers, and he will do so by bringing current and real sources of anxiety into his verse, reminding readers of current political events that would level and unite all British readers, and then by depicting death itself—the ultimate social leveler.

Perhaps no pairing of two catastrophes could upset readers more than those Armstrong chose for the Lucretian conclusion to his third book. Armstrong began

147 Virgil’s debt to Lucretius had been discussed at length during this period, from Addison (see Addison, note 30) onward. See also Monica Gale, Virgil on the Nature of Things: The Georgics, Lucretius, and the Didactic Tradition (Cambridge: Cambridge UP, 2000).

148 See Phillip Mitsis, “Committing Philosophy on the Reader: Didactic Coercion and Reader Autonomy in De Rerum natura,” Materiali e discussioni per l’analisi dei testi classici 31 (1993): 111–28.

149 See W. Charleton, The Natural History of the Passions (London: R. Wellington and E. Rumball, 1701) 169.

150 See T. Fulford, Landscape, Liberty, and Authority: Poetry, Criticism, and Politics from Thomson to Wordsworth (Cambridge: Cambridge UP, 1996) 26.

151 See T. Fulford, Landscape, Liberty, and Authority, 26.


by referring to the legendary sweating sickness, and his national allusion grounds it in an explicitly historical past:

Ere yet the fell Plantagenets had spentTheir ancient rage, at Bosworth’s purple field;While, for which tyrant England should receive,Her legions in incestuous murders mix’d,And daily horrors; (3: 534–8)

The outbreak of 1485 may not have seemed so distant to readers in 1744, since “The Sweat” had resurfaced in England as recently as 1718.152 There was widespread panic across Europe when bubonic plague killed half the population of Marseilles and some 242 localities in Provence between 1720 and 1722,153 keeping dozens of English works on plague in print for decades, including Mead’s Discourse on the Plague (1720), Defoe’s Journal of the Plague Year (1722), and dozens of urgent pamphlets.154 The plague had extinguished itself by the summer of 1722, only to terrorize correspondents across Europe again during a resurgence during the following winter.155 By 1736, readers of the widely circulated Gentleman’s Magazine would have to learn to immune themselves from such news, for it would report for government officials and eyewitnesses that between 11 February and 11 March, “100,000 Persons dy’d of the Plague at Grand Cairo; (7000 daily for some days).”156

A new outbreak of plague arrived in England shortly before the publication of Armstrong’s poem: Salisbury, and parts of London, were terrorized by local epidemics in 1740 and 1741—leading to medical publications on the topic printed, unusually, at Sarum.157 By 1743, British readers learned of a greater

152 See K. F. Kiple and K. C. Ornelas, “Sweating Sickness: An English Mystery,” Plague, Pox, and Pestilence: Diseases in History, ed. K. F. Kiple (London: Phoenix, 1997) 159.

153 The outbreak in Provence killed 119,811 from a population determined at 394,368; this is a higher number and higher mortality rate than those who died in the London epidemic of 1665. See M. Signoli et al., “Paleodemography and Historical Demography in the Context of an Epidemic: Plague in Provence in the Eighteenth Century.” Population 57 (Nov.-Dec. 2002): 837. [829–54]; A. Hardy, “The Medical Response to Epidemic Disease during the Long Eighteenth Century,” Epidemic Disease in London, ed. J. A. I. Champion (London: Centre for Metropolitan History, 1993): 65–70. Local memory of the catastrophe remains current in Marseille; in 1973 the Merseille Bibliothèque Municipale held an exhibition of 203 separately printed documents relating to the outbreak. See F. Cotton, La peste à Marseille (Marseille: Bibliothèque Municipale, 1973).

154 On the many London publications that document the event, see A. Zuckerman, “Plague and Contagionism in Eighteenth-Century England: The Role of Richard Mead,” Bulletin of the History of Medicine 78:2 (2004): 273–308. See also Bradley, note 3.

155 See M. Signoli, “Paleodemography,” 838.156 See GM 6 (May 1736) 292.157 See, for instance, John Barker’s Inquiry into the Nature, Cause and Cure of the

Present Epidemick Fever of 1740–2 (Sarum: Collins and Easton, 1743). See also B. W. Alexander, “The Epidemic Fever (1741–42),” Salisbury Medical Bulletin, 11 (1971) 24–9.


threat from Italy. In addition to separately published pamphlets and European newspapers circulating in London, the Gentleman’s Magazine reported from Sicily on 19 June that

The Plague continued to rage there in a most dreadful Manner, so that the Confusion and Terror of the People were not to be described; the dead Bodies lay in the Streets mangled by the Dogs for want of People to bury them … No Servants, Surgeons, nor Chaplains were left in the Hospitals.158

One eminent physician and friend of Mead, John Quincy, published a pamphlet that went so far as to argue that “a Fever from some Faults in the Non-naturals … [is] capable of exciting the like fementative Motions into a proper Subject, as gave Rise to the Fever of the first person seized” with the plague.159 Armstrong’s Art of Preserving Health offered timeless advice at a particularly frightening moment in British history, and it did so by deploying innovations in emergent literary and medical discourses concerning sensibility.

This episode in the Art addresses the consequences of epidemics for national identity, which is particularly salient given Armstrong’s exclusion from the capital’s highest medical institution for ultimately national reasons—English prejudice against Scots, as John Tristram tellingly revealed.160 The book closes with a powerful reference to the traumatic Carthagena Expedition, in which yellow fever and malaria killed 7,400 of the 10,000 British soldiers who landed there in April 1741—only three years before the Art went to press:161

… in the West, beyond th’ Atlantic foam,Her bravest sons, keen for the fight, have diedThe death of cowards and of common men:Sunk void of wounds, and fall’n without renown. (3: 628–31)

C. F. Mullett, “The English Plague Scare of 1720–23,” Osiris 2 (1936): 484–516. For an eyewitness report on this neglected chapter in English medical history, see J. Barker, An Inquiry into the Nature, Cause and Cure of the Present Epidemick Fever (London: T. Astley, 1742). A second edition appeared in 1743.

158 See GM 13 (July 1743): 391. See also London Gazette 8298 (31 Jan. 1743) 1. For extensive reports from Italy on the spread of plague at Messina, in European newspapers circulating in London, see The Annals of Europe for the Year 1743 (London: T. Astley, 1745) 170–172; 319–23.

159 See J. Quincy, An Essay on the Different Causes of Pestilential Diseases, and How they Become Contagious, 3rd edn (London: E. Bell, 1721).

160 See John Tristram, passim, later in this volume. 161 See David Chandler, The Oxford Illustrated History of the British Army (Oxford:

OUP, 1994) 112–13; Richard Harding, Amphibious Warfare in the Eighteenth Century: The British Expedition to the West Indies 1740–2 (London: Royal Historical Society, 1991) 83–120.


The ensuing outcry in Britain marked every genre of print during the early 1740s, sparking a vicious pamphlet war between critics and defenders of the commanding Admiral Edward Vernon, ultimately concluding with the collapse of Robert Walpole’s administration in February 1742.162 Yet the psychological consequences were probably more subtle and profound than those that created visible changes in government; as Priscilla Wald has observed, during periods of epidemic, “the interactions that make us sick also constitute us as a community … it is a contradictory but compelling story of the perils of human interdependence and the triumph of human connection and cooperation.”163 For Armstrong the connectedness that this particular plague evokes moved beyond the social, for he may have realized just how close he came to dying from yellow fever. The military commission that he had sought from Mead in 1741 had been awarded to George Martine, also a Scottish student of Monro’s, who died of yellow fever in the Cartagena outbreak later that year.164 Similarly, although Armstrong’s depiction of plague closely follows Lucretius, its meaning departs from Lucretius’ doctrine on tragedy, which was fundamental to contemporary aesthetic theory.165 For Lucretius, we enjoy depictions of suffering because the very act of apprehension reminds us, comfortingly, that we are only beholding and not experiencing it. Readers of the Art knew they were vulnerable to infection.

Abandoning the gently evocative style of previous episodes, and remaining pointedly silent on the event’s political importance, Armstrong’s depiction of the physical experience of infection culminates in worrying if prudent advice:

162 For a list of contemporary books and pamphlets relating to the disaster, see Cyril Hughes Hartmann, The Angry Admiral: The Later Career of Edward Vernon (London: Heinemann, 1953) 221–3. For a characterization of a survivor of the epidemic composed ten years afterward, see Charlotte Lennox, The Female Quixote, ed. Margaret Dalziel (Oxford: OUP, 1989) 275. On Smollett’s role in the dissemination of news concerning the catastrophe upon his own return from Carthagena, see Louis L. Martz, “Smollett and the Expedition to Carthagena,” PMLA 66 (1941): 428–46. Smollett devoted eight chapters of Roderick Random to the expedition, including “An Account of the Expedition against Carthagena” in his Compendium of Authentic and Entertaining Voyages (1756) and a detailed depiction of the event in his Complete History of England (1757–58); see L. Knapp, Tobias Smollett: Doctor of Men and Manners (Princeton: Princeton UP, 1949) 33–7. On Fielding’s mock-epic celebration of Vernon’s triumph at Porto Bello in 1739 (achieved despite Walpole’s failure to send sufficient reinforcements), see J. Fuchs, “Postcolonial Mock-Epic: Abrogation and Appropriation,” Studies in the Literary Imagination 32 (2000): 23–44.

163 See P. Wald, Contagious: Cultures, Carriers, and the Outbreak Narrative (Durham, NC: Duke UP, 2008) 2, 11.

164 See Martine in Oxford DNB.165 See B. Hathaway, “The Lucretian ‘Return Upon Ourselves’ in Eighteenth-Century

Theories of Tragedy,” PMLA 62 (1947): 672–89. Fulford discusses Thomson’s debts to John Dennis’s view that tragedy both shelters and reveals suffering to readers, but does not refer to Lucretius. See Landscape, Liberty, and Authority 24.


Soon as a not unpleasant horror glidesAlong the spine, tho’ all your torpid limbs;When first the heart throbs, or the stomach feelsA sickly load, a weary pain the loins;Be Celsus call’d: The fates come rushing on;The rapid fates admit of no delay. (3: 505–10)

This warning, and its gesture to mythical figures, quickly seems to depict a real threat when Armstrong adopts an ironic characterization of his reader to underline a troubling fact:

While willful you, and fatally secure,Expect to morrow’s more auspicious sun,The growing pest, whose infancy was weakAnd easy vanquish’d, with triumphant swayO’erpow’rs your life. For want of timely careMillions have died of medicable wounds. (3: 511–16)

This shift from the readers of the Art to the dead victims of recent infections does not lead Armstrong to depict the merely visual imagery of suffering. Emphasizing again the value of associating physical sensibility with the ability to interpret symptoms, Armstrong proceeds by describing suffering from the infected patient’s point of view, focusing on the futility of their struggle to survive:

Thro’ all the yielding pores the melted bloodGush’d out in smoaky sweats; but nought assuag’dThe torrid heat within, nor aught reliev’dThe stomach’s anguish. With incessant toil,Desperate of ease, impatient of their pain,They toss’d from side to side. In vain the streamRan full and clear, they burnt and thirsted still. (3: 551–7)

The reassuring georgic prelude to this episode had suggested attending to thirst as a means of managing the non-naturals, implying that a modest degree of self-consciousness will be sufficient to prevent disease. Armstrong now shows that the sweating sickness brought, and could yet bring, a fatal insatiability of natural appetites. He then emphasizes the social meaning of suffering, focusing on the personal consequences of watching others die: that sight brings only a horrific silence from the physicians, questioning the value of their expertise:

Thick and pantinglyThe breath was fetch’d, and with huge lab’rings heav’d.At last a heavy pain oppress’d the head,A wild delirium came; their weeping friendsWere strangers now, and this no home of theirs. (3: 560–563). . . . . .Where find relief? The salutary artWas mute; and, startled at the new disease,


In fearful whispers hopeless omens gave.To Heaven with suppliant rites they sent their pray’rs;Heav’n heard them not. Of every hope depriv’d;Fatigu’d with vain resources; and subduedWith woes resistless and enfeebling fear;Passive they sunk beneath the weighty blow. (3: 604–11)

This depiction of the helpless physician was audacious, for it referred back to Nicholas Culpeper’s famous reflection, made in the Preface to his enduring Pharmacopaeia (1649): “Send for them into a Visited House, they will answer They dare not come … Send for them to a poor Mans house, who is not able to given them their Fee, then they will not come.”166 Throughout the eighteenth and nineteenth centuries, readers had long been suspicious of the physician’s real motives, let alone his abilities, when tested with mortal infection. Writing as a distinctly sympathetic physician who feels illness too, Armstrong uses his poem to orchestrate therapeutic instruction through emotional evocation, providing a meaningful challenge to the clinical distance imposed by Newtonian medical theory. This particular vision of medical paralysis heightens the reader’s aesthetic response to the rest of the poem, a response which can only be consoled by enacting a therapeutic distinction of powerful imaginary impressions from those actual sensations that may eventually overwhelm as disease.

Armstrong’s suggestion that a troubled imagination could itself be the source of its own healing contradicted the teaching of Boerhaave and of other Newtonians from earlier in the century: indeed their focus on changing the non-natural “environment” was taken up by disciples whose lack of psychological empathy (let alone concern for the patient’s mental state) was so extreme that it led to treatments that included the patient’s immersion in water until a state of apparent death is reached, or the use of the spinning chair, along with other treatments designed to weaken the imagination by inducing real terror through physical punishment; today, reading the glorious descriptions of the apparatus designed by physicians to induce extreme fear is itself terrifying.167 Boerhaave

166 See “The Translator to the Reader,” N. Culpeper, A Physicall Directory, or A Translation of the London Dispensary (London: Peter Cole, 1649). Variant editions of this book appeared throughout the next two centuries, and indeed editions of Culpeper’s Herbal remain in print in 2011. One could argue that this book was the first model of medical popularization through print, for by translating the authorized medical recipes of the Royal College of Physicians from Latin into the English, Culpeper was extending their learning to those with sufficient means to purchase medications but not a medical consultation. See F. N. L. Poyner, “Nicholas Culpeper and His Books,” Journal of the History of Medicine and Allied Sciences 17 (1962): 152–67.

167 See B. P. M. Schulte, “The Concepts of Boerhaave on Psychic Function and Psychopathology,” Boerhaave and His Times, ed. G. A. Lindeboom (Leiden: E. J. Brill, 1970) 93–101. For a candid depictions of medical treatments that are now indistinguishable from torture see, among the others in the following collection, Patrick Blair’s “Cure of Mad Persons by the Fall of Water” (1725) in A. Ingram, ed. Patterns of Madness in the Eighteenth Century: A Reader (Liverpool: Liverpool UP, 1998) 73–5. Blair’s “cataratick way of cold


himself had cautioned against “making faces or grimacing at children” because the sight of the distortion could cause convulsion.168 In striking contrast, by seeking to replicate the subjective visions of his readers by depicting the imagery of his own mind, Armstrong participated in a therapeutic and humanizing “community of artist and audience” which, as Howard Weinbrot has argued, “is one of the bases of eighteenth-century psychology of response across the century and across genres”—that is, across what were literary and not medical genres until the publication of The Art of Preserving Health.169

Social Reception and Critical Legacy

Publication of The Art of Preserving Health in April 1744 initially brought Armstrong the success he sought; only four months after the Art was printed, his friend Patrick Murdoch reported that “the Doctor has got great reputation by his Poem.”170 Finally, in February 1746, Armstrong was appointed Physician to the newly founded Duke of Cumberland’s Hospital for injured soldiers, on Mead’s recommendation.171 He served there with three of the most distinguished medical men of the time, including William Cheselden, “the prince of Augustan surgeons”

Bathing” was emblematic of treatments ordered by respected physicians, supported by current scientific theory, imposed on unwilling patients through the eighteenth century from London to Edinburgh to America. As Richard Hunter and Ida Macalpine have pointed out, Blair’s method was an “improvement” on the “ducking treatment” recommended by the great medical reformer and disciple of Sydenham, Jan Baptist von Helmont (1580–1644), and Blair read his description to the Royal Society in 1725. The important Edinburgh medical professor and clinician William Cullen recommended Blair’s therapy as late as 1784, and it was taken up by Cullen’s great American pupil Benjamin Rush (signatory of the Declaration of Independence, whose image and name appears on the seal of the American Psychiatric Association); in 1796, Rush ordered the construction of a three-foot square chamber for the Pennsylvania Hospital, designed “to subject the patient to any degree of impression required, by directing the water to be thrown from the height of one, two, or three stories,” directly onto the restrained patient’s face. See R. Hunter and I. Macalpine, eds, Three Hundred Years of Psychiatry, 1535–1860 (Oxford: Oxford UP, 1963) 325–6. Incidentally, Blair’s sole manuscript survives in the British Library’s archives of the papers belonging to his friend John Martyn (see Contextual Documents), Banksian MSS. no. 103.

168 See Antonie Luyendijk-Elshout, “Of Masks and Mills: The Enlightened Doctor and His Frightened Patient,” Languages of Psyche: Mind and Body in Enlightenment Thought, ed. G. S. Rousseau (Berkeley: U of California P, 1990) 203.

169 See Howard Weinbrot, “Northrop Frye and the Literature of Process Reconsidered,” Eighteenth-Century Studies 24 (1991): 180.

170 Duncan Forbes, ed., Culloden Papers (London: T. Cadell, 1815) 306.171 Armstrong’s appointment was announced in the Gentleman’s Magazine 16 (1746):

108 and the Scots Magazine (Feb. 1746): 98. See also J. Nichol, Literary Anecdotes of the Eighteenth Century, vol. 3, 144. Armstrong’s appointment under Cumberland’s patronage, to care for his soldiers, should not be interpreted as an indication of his views concerning the Jacobite rebellion of 1745: Charles Burney had always maintained that Armstrong was the author of “The Tears of Scotland” (now attributed to Smollett), a moving condemnation


who had himself trained Alexander Monro, and who along with Mead attended Newton and later Pope on their deathbeds.172 Sir John Pringle, who also held the Professorship of Moral Philosophy at Edinburgh, was a physician to the hospital—and was said to have respected Armstrong until the poet’s death in 1779.173

This was the first London hospital appointment of an Edinburgh graduate.174 It had the potential of proving extremely useful for Armstrong, for although hospital staff did not receive a salary, “hospital appointments proved valuable career ‘leg-ups’ for ambitious practitioners, who could expect, through the hospital, to hobnob with the governors and gentry, and thereby gain powerful patrons and wealthy private patients.”175 The appointment also suggests Armstrong’s entry into a select intellectual coterie: “hospital wards were not simply symbols. They were concrete places where people generated, accepted, criticized, and disseminated particular kinds of knowledge, along with all the values, expectations, and rituals associated with what made “good” knowledge and practice.”176 But Armstrong’s self-

of Cumberland’s brutality. See The Monthly Review 16 (1795): 72; also John D. Short, “Smollett v. Armstrong,” Notes and Queries 213 (December 1968): 453–6.

172 The epithet is taken from G. Holmes, Augustan England: Professions, State, and Society 1680–1730 (London: G. Allen, 1982) 311. For Monro’s education, see the transcription of Monro’s manuscript memoir in H. D. Erlam, “Alexander Monro, primus,” University of Edinburgh Journal 17 (1953–54): 81–4. In the years leading to Newton’s death, “he placed himself in the care of Richard Mead and William Cheselden, two of the most prominent physicians in London;” see R. S. Westfall, Never at Rest: A Biography of Isaac Newton (Cambridge: Cambridge UP, 1980) 866. See Pope’s First Epistle of the First Book of Horace: “I’ll do what Mead and Cheselden advise,/ To keep these limbs, and to preserve these eyes” (51–2); see also Maynard Mack, Alexander Pope: A Life (New Haven: Yale UP, 1985) 805–11.

173 On Pringle’s admiration for Armstrong, see J. Nichols, Biographical and Literary Anecdotes of William Bowyer (London: Nichols, 1782) 282. In his memoirs, the Duke of Cumberland lists the hospital’s staff as “Doctor Pringle, Doctor Barker, and Doctor Armstrong: the surgeons were Mr Ranby, Mr Cheselden, and Mr Andrews”: see Historical Memoirs of … the Duke of Cumberland (London: T. Waller, 1767) 466. Dr. John Barker was a close friend of Henry Fielding and, like Armstrong, wrote a topical medical treatise, An Inquiry into the Nature, Cause and Cure of the Epidemic Fever of 1740–2 (1742), in a bid to obtain a license from the College, which he received in 1746. See William Munk, The Roll of the Royal College of Physicians, vol. 2, 3 vols (London: Royal College of Physicians, 1878) 158; M. C. Battestin and Clive T. Probyn, eds, The Correspondence of Henry and Sarah Fielding (Oxford: Clarendon P, 1993) 49.

174 London teaching hospitals did not admit Scottish graduates until the second half of the century: see “Physicians, Hospitals and Career Structures in Eighteenth-Century London,” in William Hunter and the Eighteenth-Century Medical World, ed. W. F. Bynum and Roy Porter (Cambridge, CUP, 1985) 114.

175 R. Porter, Disease, Medicine and Society in England, 1550–1860 (Cambridge: Cambridge University Press, 1995) 33.

176 See S. Lawrence, Charitable Knowledge: Hospital Pupils and Practitioners in Eighteenth-Century London 216; 217–20. According to Lawrence’s “Table of London Hospital Men, 1700–1815,” Armstrong did not hold another hospital post in London: see Lawrence, 217–20. No studies of the Duke’s Hospital have been published.


described refusal “to tell a heap of impudent lies in his own favour … nor intrigue with nurses” crippled his ability to prosper in London’s medical marketplace.177

Although there were no journals devoted to reviewing poetry during the mid-1740s,178 and surviving clinical reports from this period are scarce,179 evidence survives that readers respected Armstrong’s poetic authority and followed his advice. The Art of Preserving Health received serious consideration from physicians as well as from critics: in Dr. James Mackenzie’s magisterial History of Health and the Art of Preserving It (1758) and in Sir John Sinclair’s Code of Health and Longevity (1808), The Art of Preserving Health takes a central place among eighteenth-century touchstones.180 Dr. Hugh Smith, Physician to the prestigious Middlesex obstetrical Hospital, frequently quoted “the ingenious and learned Dr Armstrong,” notably in his Letters to Married Women (1774), observing that the Art’s evocative depictions match the exemplary force of Samuel Richardson’s heroines.181 As late as 1795, Charles Burney declared that “The Art of Preserving Health is one of the most agreeable and instructive poems in our language” (his emphasis).182 These views were evidently shared by more common readers, for a monument to Armstrong’s “learning, worth, and genius” was erected by subscription in his native Scottish village of Castleton in 1821.183

Today this poem is of interest for the humanitarian pedagogy that it adapted, as well as for its unique mode of cultural engagement with the nascent literary and scientific culture of sensibility. Recently, The Art of Preserving Health has been dismissed merely as “a poetic version” of Cheyne, but by depicting a sympathetic physician who himself remains tenuously subject to the very diseases he describes, Armstrong presented a leveling of medical knowledge unprecedented in the medical literature of the period—in a work whose popularity among readers and

177 See J. Armstrong, Medical Essays (London: T. Cadell, 1773) 38.178 The Present State of the Republick of Letters (1728–36), and The History of the

Works of the Learned (1737–43), the only British journals which featured reviews, had folded before Armstrong’s poem went to press. See Alvin Sullivan, ed. British Literary Magazines (London: Greenwood P, 1983) xix. See also Frank Donoghue, The Fame Machine: Book Reviewing and Eighteenth-Century Literary Careers (Stanford: Stanford UP, 1996); A. Forster “Review Journals and the Reading Public,” Books and Their Readers in Eighteenth-Century England: New Essays, ed. Isabel Rivers (Leicester: U of Leicester P, 2002) 171–90.

179 See William LeFanu, “The Lost Half-Century in English Medicine, 1700–1750,” Bulletin of the History of Medicine 46 (1972): 319–48.

180 On the importance of Sinclair’s Code of Health, see Virginia Smith, “Prescribing the Rules of Health: Self-Help and Advice in the Late Eighteenth Century,” in Patients and Practitioners: Lay Perceptions of Medicine in Pre-Industrial Society, ed. Roy Porter (Cambridge: Cambridge UP, 1985) 249–82.

181 See H. Smith, Letters to Married Women (London: G. Keasley, 1774) 246.182 See Monthly Review 16 (1795): 71.183 See W. A. Somerville, “Dr. John Armstrong, Poet and Physician,” Border Magazine

31 (April 1926): 49–51.


acclaim among colleagues was more extensive than anything that had appeared previously.184 That its poetical form enabled a greater measure of success from the medical establishment than Armstrong’s previous scholarly works, and that The Art of Preserving Health remained popular among readers well into the nineteenth century, suggests that this poem should be recognized as among the earliest and most enduring expressions of eighteenth-century sensibility across social strata. The Art of Preserving Health seeks to evoke an aesthetic experience that itself cultivates a refined sensibility, associating corporeal feeling with social concern, realizing an immediate vision of the moral medical project to which Armstrong contributed as a student in Edinburgh.

Unfortunately for Armstrong, however, the very forcefulness of his medico-literary method sapped the raison d’être of his professional career, leaving us with a sad biographical example of sensibility’s ultimate incompatibility with the Georgian medical world. By sharing his expertise so cheaply and expansively, it is possible that Armstrong may have discouraged patients from retaining him as a paid physician. In his topographical poem The Isle of Wight (1766), Henry Jones observed that Armstrong could not sustain the dual career of a physician-poet:

Armstrong to rules of health here sweet perswade,Dispense his learning and destroy his trade.185

After all, if the physician effectively circulates his art of preserving health, what trade will be left? In September 1767, not long after Jones’s poem appeared, the Scottish banker Thomas Coutts commissioned Joshua Reynolds to paint a portrait of his friend, and the painting depicts an exhausted and sullen figure; only seven years later, Frances Burney wrote that “he must be very old–& looks very ill,” but Armstrong was 65 at the time.186 Slouching in his chair, the physician-poet of Reynolds’s portrait gazes slightly upward, emphasizing his fatigue.187 Its epigraph, excerpted from The Art of Preserving Health, seems an attempt to justify Armstrong’s professional failure: “The Suffrage of the Wise,/ The Praise that’s worth Ambition is attain’d/ By Sense alone, and Dignity of Mind.” Ironically, the literary success of this medico-georgic poem might itself have condemned its

184 See A. Guerrini, Obesity and Depression in the Enlightenment: The Life and Times of George Cheyne (Lincoln: U of Nebraska P, 2000) 184.

185 See H. Jones, Vectis. The Isle of Wight (London: W. Flexney, 1766) 2: 267–8. 186 See Lars Troide., ed., The Early Journals and Letters of Fanny Burney, vol. 2

(Oxford: Clarendon P, 1988) 39. 187 See David Manning, Sir Joshua Reynolds: A Complete Catalogue of His Paintings

(New Haven: Yale, 2000), vol. 1, 65 and vol. 2, fig. 910; the portrait currently hangs in the Art Gallery of South Australia, Adelaide. The commission by Coutts is noted by Lewis Knapp, “John Armstrong: Littérateur and Associate of Smollett, Thomson, Wilkes, and Other Celebrities,” PMLA 59 (1944): 1056. R. Burgess lists five different mezzotints of the portrait; see Portraits of Doctors and Scientists in the Wellcome Institute, London (London: Wellcome Trust, 1973) 105.


poet to professional recognition but ultimately to commercial neglect by the very readers who he hoped would double as paying patients.

In a letter reporting the death of a mutual friend, Armstrong once suggested that the delicate sensibility celebrated in his Art reflects a vulnerability in his own character: “I have often been tempted to wish, that nature had made me a little more callous; but then we should lose sensations too that give perhaps the most

Fig. 1 Sir Joshua Reynolds, John Armstrong, M.D. (1767), Art Gallery of South Australia, Adelaide. Mezzotint by E. Fisher reproduced with kind permission of the Trustees of the Wellcome Library, London.

This figure has intentionally been removed for copyright reasons.To view this image, please refer to the printed version of this book


exquisite pleasures.”188 The Art of Preserving Health, read in the context of Armstrong’s dual career, presents these emotional and corporeal qualities in a body of work which sought to realize the virtuous social ambitions that novelists of sensibility could merely depict. Armstrong’s groundbreaking popularizations of medicine, which addressed the very readers who lacked access to medical expertise, also signify the complex professional, scientific, as well as literary context that brought The Art of Preserving Health to a dramatic, if now obscure, fruition.

188 See Armstrong’s letter to John Forbes of 3 Sept. 1748, in Culloden Papers (London: T. Cadell, 1815) 307.

Fig. 2 [Armstrong, John]. The Art of Preserving Health. A Poem in Four Books. London: A. Millar, 1744. Title-page.

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