Morton Richard 163798

M orton was raised in Suffolk, England and eventually attended medical school at Oxford before earning his fellowship in London in 1678. Morton was credited with writing the first medical description of "nervous consumption" in 1689, which is known today as anorexia nervosa (Pearce 2004: 191). It is with Morton that the clinical history of anorexia nervosa begins; prior to that, the distinction between "fasting" and pathologies of eating was not clearly differentiated (Gutierrez 2003).

In his written account of his patients, published in Phthisiologia, translated to English in 1694, subtitled A Treatise of Consumptions, Morton characterized the illness as a wasting condition due to emotional turmoil. For Morton, this was seldom seen in England; it seemed to be an "American" disease, "most frequently amongst those that have lived in Virginia, after they have come over hither" (Morton 1694: 4). Moreover, he claimed that the disease was the result of "violent Passions of the Mind, the intemperant drinking of Spirituous Liquors, and an unwholsom Air, by which it is no wonder if the Tone of the Nerves, and the Temper of the Spirits are destroy'd" (Morton 1694: 5). The cure for this disease that "does almost always proceed from Sadness, and anxious cares" is "very good Air" but "because the Stomack in this Distemper is principally affected, a delicious diet will be convenient, and the Stomack ought not to be too long accustomed to one sort of Food" (Morton 1694: 8). Fasting diseases are disease of the spirit and the stomach, cured by healthy living and a better diet.

In order to illustrate his argument, Morton described two case histories. He saw them in the light of his understanding of consumption (tuberculosis), noting that "I do not remember that I did ever in all my Practice see one, that was conversant with the Living so much wasted with the greatest degree of consumption (like a Skeleton only clad with skin)" (Morton 1694: 9). He makes a differential diagnosis, noting that there is neither cough nor fever in these patients. Nevertheless, they demonstrate self-starvation, emaciation, a refusal to gain weight, body image distortion, and a denial of illness—the symptoms that, centuries later, would define anorexia nervosa.

Mr. Duke's daughter, the first documented patient, was a twenty-year-old woman who presented a two-year history of weight loss and amenorrhea ("suppression of her Monthly Courses" [Morton 1694: 9]). One contributing factor, according to Morton, was that "she was wont by her studying at Night, and continual poring upon Books" to be exposed to unhealthy night air. She died a few months after consulting Morton, having been "taken with a Fainting Fit" (Morton 1694: 9). The second patient, the sixteen-year-old son of Reverend Minister Richard Steele, "fell gradually into a total want of appetite, occasioned by his studying too hard, and the Passions of his Mind" (Morton 1694: 10). Morton advised him to give up his studies, go to the country, ride, and drink milk. The patient recovered his health to a certain degree. According to Morton, both Miss Duke and young Mr. Steele were documented to have severe weight loss resulting from emotional causes. Morton was the first to record observations regarding eating disorders not tied to physical illness and to argue their intractability.

SLG/Jessica Elyse Rissman

See also Anorexia

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