Lovers and Livers: Disease Concepts in History

Geoff Hamilton is a Killam Postdoctoral Fellow at the University of
British Columbia.

In this adaptation of her 2002 contribution to the Joanne Goodman
Lecture Series at the University of Western Ontario, Jacalyn Duffin
contends that “diseases are ideas,” and that those ideas undergo
transformations according to “the tastes and preoccupations of
society.”

Her first chapter introduces competing disease concepts and
constructions, explaining how illness (the subjective response to
suffering) is converted into disease (the objective classification of
that suffering), and how symptoms (signs) can and have been variously
interpreted according to the vagaries of a particular historical period.
The next two chapters investigate two diseases (or disease ideas) that
serve as her central examples—lovesickness, which was once commonly
diagnosed but has now apparently become extinct, and hepatitis C, which
is no more than a few decades old.

Duffin is an exceptionally accessible and cogent writer, and this is a
fine general introduction to the intellectual history of disease as a
whole, as well as to the two specific diseases on which she focuses. The
book’s explanation of theoretical approaches (e.g., the rival
patient-based and cause-based theories of disease) is particularly clear
and helpful. The chapter on lovesickness provides an entertaining
entrance into a topic in social and literary history over the last
several hundred years, and convincingly uses this disease concept to
illustrate “the power of sociocultural preconvictions in deciding when
something is bad enough to be a sickness.” In writing on hepatitis C,
Duffin conveys the complex story of a relatively new disease, skilfully
explaining the tangled politics of its diagnosis, treatment, and public
reception. More broadly, her discussion provides an excellent basis for
understanding the importance of the shifting frames of
disease—“Creation of a disease draws attention, fosters empathy, and
provides a platform for discussion, a venue for research, and a promise
of cure”—and also of the recent proliferation of disease concepts in
a culture that at times seems plagued by medicalization.