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`Poor Tom' was a-cold but not schizophrenic
Seizure 2000; 9: 529–530
doi: 10.1053/seiz.2000.0453, available online at http://www.idealibrary.com on
LITERARY NOTE ‘Poor Tom’ was a-cold but not schizophrenic †§
‡
TIM BETTS & HANNAH BETTS †
Birmingham University Seizure Clinic, Queen Elizabeth Psychiatric Hospital, Birmingham, B15 2QZ; The Times, London E1 9XN, UK
‡ Journalist,
We have written before in Seizure about Shakespeare’s play King Lear and its reference to epilepsy1 . The play is, of course, a treasure house for those with an interest in the psychopathology of any age or those with an interest in Renaissance medicine. However, in breaking open the treasure house, it is possible that any jewels brought into the light of the 21st century are not always what they seem. In the British Medical Journal last year Altschuler (who works in San Diego) proposed that Shakespeare in ‘King Lear’ knew the ‘layered clothing sign of schizophrenia’2 . This view has gone unchallenged in the correspondence columns of the British Medical Journal, but we fear that it is wrong and we would not want it to become part of medical or psychiatric mythology. It is important to remember that apparent references to illnesses in Shakespeare’s plays can only be understood if the reader comprehends the culture and vernacular language of his time, the context in which the quoted line is appearing, any relevant subtext and the sources from which it may have been drawn (as we have recently shown in our analysis of the epilepsy reference in the same play)1 . Altschuler refers to the ‘many layered clothing sign of schizophrenia’. Itinerant people with schizophrenia sometimes present to medical care wearing many pieces of apparel, far more than they need: this clinical presentation has been taken as potentially diagnostic of the disorder itself. Altschuler suggested that Edgar portrayed as ‘Poor Tom’ in the play has chronic schizophrenia because he refers to his many layered clothing ‘who hath had three suits to his back and six shirts to his body’. In the play, for purposes of disguise, Edgar adopts the persona of a ‘Tom O’Bedlam’ (a wandering lunatic) and is simulating mental illness—his asides to §
the audience make it clear that it is a deliberate simulation, which he gives up without difficulty when he no longer needs it. The picture of simulated madness that Shakespeare draws is almost entirely taken from Samuel Harsnett’s polemical book about manipulated exorcism3 performed by Jesuit priests which Shakespeare had clearly read and in which there was much contemporary interest (references to which many of his audience would have recognized)4 . In the scene in question, probably the pivotal scene in the play, ‘Poor Tom’ is naked, or near naked, a fact which he (‘Poor Tom’s a cold’) and Lear himself (‘thy uncovered body’) allude to several times. ‘Poor Tom’s’ reference to his suits and shirts is in the past, not the present, tense and is probably a subtext message, echoed elsewhere in the play, about sexually unfaithful serving men. ‘Poor Tom’ is comparing his former rich state with his present wretched one: in Shakespeare’s time wandering lunatics and beggars were whipped from parish to parish until they reached the one in which they were born, which was then expected to take financial responsibility for them (a faint echo of care in the community?). Most clinicians who have worked as liaison psychiatrists in casualty will recognize the picture of the ‘many layered’ patient: but in cities less temperate than San Diego might wonder if the patients were merely cold, or had nowhere else to store their clothing, save on their backs, rather than immediately labelling them as schizophrenic. It is interesting, however, that the common contemporary perception of the ‘Tom O’Bedlam’ was of a fantastically dressed, often beribboned, person5 suggesting that even though Shakespeare did not describe the many layered patient his contempories did make
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some connection between state of clothing and state of mind. So, if you believe that the many layered patient is a sign of schizophrenia, can we call it ‘Tom O’Bedlam’s’ sign and leave Shakespeare out of it?
REFERENCES 1. Betts, T. and Betts, H. A note on a phrase in Shakespeare’s play “King Lear”: A plague upon your epileptic visage. Seizure 1998; 7: 407–409. 2. Altschuler, E. Shakespeare knew the layered clothing sign
T. Betts & H. Betts of schizophrenia. British Medical Journal 1999; 319: 520– 521. 3. Harsnett, S. A Declaration of Egregious Popish Impostures, to withdraw the Harts of Her Majesties Subjects from Their Allegeance, and from the Truth of Christian Religion Professed in England, under the Pretence of Casting Out Devils 1603. London, James Roberts. 4. Greenblatt, S. Shakespeare and the exorcists. In: Shakespeare: King Lear. A Selection of Critical Essays (Revised edition), (Ed. F. Kermode). London, MacMillan Press, 1992: pp. 258– 298. 5. Salkeld, D. Madness and Drama in the Age of Shakespeare. Manchester University Press, 1994: p. 26.
doi: 10.1053/seiz.2000.0453, available online at http://www.idealibrary.com on
LITERARY NOTE ‘Poor Tom’ was a-cold but not schizophrenic †§
‡
TIM BETTS & HANNAH BETTS †
Birmingham University Seizure Clinic, Queen Elizabeth Psychiatric Hospital, Birmingham, B15 2QZ; The Times, London E1 9XN, UK
‡ Journalist,
We have written before in Seizure about Shakespeare’s play King Lear and its reference to epilepsy1 . The play is, of course, a treasure house for those with an interest in the psychopathology of any age or those with an interest in Renaissance medicine. However, in breaking open the treasure house, it is possible that any jewels brought into the light of the 21st century are not always what they seem. In the British Medical Journal last year Altschuler (who works in San Diego) proposed that Shakespeare in ‘King Lear’ knew the ‘layered clothing sign of schizophrenia’2 . This view has gone unchallenged in the correspondence columns of the British Medical Journal, but we fear that it is wrong and we would not want it to become part of medical or psychiatric mythology. It is important to remember that apparent references to illnesses in Shakespeare’s plays can only be understood if the reader comprehends the culture and vernacular language of his time, the context in which the quoted line is appearing, any relevant subtext and the sources from which it may have been drawn (as we have recently shown in our analysis of the epilepsy reference in the same play)1 . Altschuler refers to the ‘many layered clothing sign of schizophrenia’. Itinerant people with schizophrenia sometimes present to medical care wearing many pieces of apparel, far more than they need: this clinical presentation has been taken as potentially diagnostic of the disorder itself. Altschuler suggested that Edgar portrayed as ‘Poor Tom’ in the play has chronic schizophrenia because he refers to his many layered clothing ‘who hath had three suits to his back and six shirts to his body’. In the play, for purposes of disguise, Edgar adopts the persona of a ‘Tom O’Bedlam’ (a wandering lunatic) and is simulating mental illness—his asides to §
the audience make it clear that it is a deliberate simulation, which he gives up without difficulty when he no longer needs it. The picture of simulated madness that Shakespeare draws is almost entirely taken from Samuel Harsnett’s polemical book about manipulated exorcism3 performed by Jesuit priests which Shakespeare had clearly read and in which there was much contemporary interest (references to which many of his audience would have recognized)4 . In the scene in question, probably the pivotal scene in the play, ‘Poor Tom’ is naked, or near naked, a fact which he (‘Poor Tom’s a cold’) and Lear himself (‘thy uncovered body’) allude to several times. ‘Poor Tom’s’ reference to his suits and shirts is in the past, not the present, tense and is probably a subtext message, echoed elsewhere in the play, about sexually unfaithful serving men. ‘Poor Tom’ is comparing his former rich state with his present wretched one: in Shakespeare’s time wandering lunatics and beggars were whipped from parish to parish until they reached the one in which they were born, which was then expected to take financial responsibility for them (a faint echo of care in the community?). Most clinicians who have worked as liaison psychiatrists in casualty will recognize the picture of the ‘many layered’ patient: but in cities less temperate than San Diego might wonder if the patients were merely cold, or had nowhere else to store their clothing, save on their backs, rather than immediately labelling them as schizophrenic. It is interesting, however, that the common contemporary perception of the ‘Tom O’Bedlam’ was of a fantastically dressed, often beribboned, person5 suggesting that even though Shakespeare did not describe the many layered patient his contempories did make
E-mail: [email protected] 1059–1311/00/070529 + 02
$35.00/0
c 2000 BEA Trading Ltd
530
some connection between state of clothing and state of mind. So, if you believe that the many layered patient is a sign of schizophrenia, can we call it ‘Tom O’Bedlam’s’ sign and leave Shakespeare out of it?
REFERENCES 1. Betts, T. and Betts, H. A note on a phrase in Shakespeare’s play “King Lear”: A plague upon your epileptic visage. Seizure 1998; 7: 407–409. 2. Altschuler, E. Shakespeare knew the layered clothing sign
T. Betts & H. Betts of schizophrenia. British Medical Journal 1999; 319: 520– 521. 3. Harsnett, S. A Declaration of Egregious Popish Impostures, to withdraw the Harts of Her Majesties Subjects from Their Allegeance, and from the Truth of Christian Religion Professed in England, under the Pretence of Casting Out Devils 1603. London, James Roberts. 4. Greenblatt, S. Shakespeare and the exorcists. In: Shakespeare: King Lear. A Selection of Critical Essays (Revised edition), (Ed. F. Kermode). London, MacMillan Press, 1992: pp. 258– 298. 5. Salkeld, D. Madness and Drama in the Age of Shakespeare. Manchester University Press, 1994: p. 26.