Hektoen International

A Journal of Medical Humanities

The legacy and maladies of Jonathan Swift

JMS Pearce
England, UK


Portrait of Johnathan Swift
Fig 1. Jonathan Swift

Jonathan Swift (Fig 1.) is best known for his popular Lemuel Gulliver’s: Travels into Several Remote Nations of the World published in 1726. (Fig 2.) Exciting adventures combine with satirical metaphors that parodied contemporary customs and politics. Lemuel Gulliver, the narrator, begins as a modern man but ends ironically as a mad misanthrope; his fate mirrors the complex life and purpose of its author.


Jonathan Swift (1667-1745)

In 1667, two years after the epidemic plague and one year after the Great Fire of London, Swift’s father died whilst his wife was pregnant with Jonathan. His uncle, the prosperous lawyer Godwin Swift, arranged his education at Kilkenny School and at Trinity College, Dublin, where he graduated BA in 1685/6. In 1689 he left Ireland to live with Sir William Temple, a relative of his mother, working as his amanuensis at Moor Park, Surrey, where he remained intermittently until Temple’s death in 1699. In 1690 Swift left for Ireland but soon returned to Moor Park. In 1692 with support from Temple, he received the degree of M.A. at Hart Hall (Hertford College) Oxford. He was ordained in the Anglican Church in 1695, and appointed vicar of Kilroot, near Belfast. He was Dean of St. Patrick’s Cathedral in Dublin from 1713 until his death.

Front page of Travels Into Several Remote Nations of the World by Johnathan Swift.
Fig 2. Travels into Several Remote Nations of the World published in 1726

Swift was a greatly admired author. Exuberant satire, wit and irony, and an incomparable command of parody characterize his writings.1 A Tale of a Tub and The Battle of the Books (1704) established his skills as a talented if controversial writer, who parodied Catholicism, Anglicanism, and dissenting religious sects, and the work of literary figures such as Dryden.

He criticized modern science and philosophy as inconsequential compared with wisdom of the ancient Greek and Roman writers, a hermeneutic reiteration in The Battle Of The Books. His poem The Legion Club (1736) shows his disdain for ineffectual members of the Irish Parliament. Not always derisive, his kindness and social conscience are shown in A Modest Proposal, aimed at combatting poverty, ignorance, and unsuitable housing, though sentiment is thinly veiled by grotesque ideas.

At a time when only half the population could read and write he staunchly advocated improvement in the English language and was a founder of the newspaper The Spectator. Literature was threatened by incondite pedantry, particularly “the irrationalities that disturb man’s highest faculties—reason and common sense.” He vehemently protested against neologisms, slang, and affectation.

He forged lasting friendships with the literati, Alexander Pope, John Gay, and Dr. John Arbuthnot, who formed the core of the Scriblerus Club (1713), whose purpose was to ridicule pretentious erudition and jargon.

Swift became politically active, at first as a Whig, later inclining towards the Tories. As a high churchman, although an eccentric, he was well reputed for his trenchant, controversial views on religion, Anglo-Irish politics,1,10 and for the quality of his prose and poetry. In 1714 he returned to Ireland.


Stella and Vanessa

Of his personal life it is clear he was devoted to Esther Johnson (Stella) but it seems he eschewed physical love, and there is scant evidence to support stories of a secret marriage. Indeed at times he showed scatological preoccupations that Samuel Johnson described as “delight in revolting ideas from which any other mind shrinks with disgust.”2 The Journal to Stella, Swift’s letters to Esther Johnson and her companion Rebecca Dingley, shows profound affection, often expressed in childish “little” language. He was later tormented by stygian grief and loneliness at Stella’s death in 1728. A conflicting liaison with Esther Vanhomrigh (Vanessa) appeared in his life from 1709 until her death in 1723. She expected him “to behave like a man,” but this was beyond his powers as shown in his long poem Cadenus and Vanessa:

Strange that a Nymph by Pallas nurs’d
In Love shou’d make Advances first . . .
He now cou’d praise, esteem, approve,
But understood not what was Love . . .
His want of passion will redeem,
With Gratitude, Respect, Esteem

Lord Brain described his literary genius but said it was marred by obsessional and emotional immaturity with many morbid fears. 3


Illness and Madness

From his early forties he suffered fits of violent vertigo, “tottering,” and curiously intermittent left-sided deafness, symptoms typical of Ménière’s disease that plagued him through much of his life—despite self-imposed walking and temperance. He had an attack of shingles in his left shoulder in 1712.

Black and white drawing of a cast of Johnathan Swift's cranium
Fig 3. Cast of Swift’s cranium

Jonathan Swift’s biographers1,2,10 were fascinated by an image of genius descending into madness.4, 5 Dryden had noted in Absalom and Achitophel (1681): “Great wits are sure to madness near allied, / and thin partitions do their bounds divide,” But it is clear Swift was sane and eloquent until his early seventies. He saw a metaphorical madness in poverty, social injustice, and religious creeds. He insisted on separating mental illness from eccentricity, individual expressions of liberty and reasoned divergence from orthodoxy: all aspects of his own personality. He argued that madness was only unconventional or antisocial thought—the stubborn Ignorance of the People:

. . . For, the Brain, in its natural Position and State of Serenity, disposeth its Owner to pass his Life in the common Forms, without any Thought of subduing Multitudes to his own Power, his Reasons or his Visions; and the more he shapes his Understanding by the Pattern of Human Learning, the less he is inclined to form Parties after his particular Notions; because that instructs him in his private Infirmities, as well as in the stubborn Ignorance of the People.6

The many accounts of this enigmatic, effulgent man are riddled with contradictions and paradox. He extols madness that cultivates religion and philosophy in a metaphorical essay, A Tale of a Tub (1710). In Section IX, A digression concerning the original, the use and improvement of madness in a commonwealth, he says:

. . . If the moderns mean by madness, only a disturbance or transposition of the brain, by force of certain vapours issuing up from the lower faculties; then has this madness been the parent of all those mighty revolutions that have happened in empire, philosophy, and in religion.6

After 1737 in his correspondence with Stella and Mrs. Whiteway he continually complained of despondency, failing memory, and difficulty in understanding. He became unduly quarrelsome and ill-tempered, losing several old friends. Only after the painful swelling of his left eye of 1742 did he become aphasic, withdrawn, and physically dependent. Wilson in 1958 collated the divergent opinions and vaguely concluded he had senile decay.7 Lewis in 1993 stated: “Swift’s last years were marked by . . . a progressive aphasia, and the inability to recognise anyone . . . to any alert clinician of the 1990’s, the signs and symptoms of Alzheimer’s disease are clear . . .”8 Crichton countered this, stating that Pick’s disease was more likely. Cerebrovascular disease has also frequently been suggested.3,7 The truth is that none of the evidence from his letters, limited autopsy, death mask, skull, or brain cast is diagnostic.4

Swift himself in 1731anticipated his own demise:

As Rochefoucauld his maxims drew . . .
See how the Dean begins to break
Poor Gentleman, he drops apace,
You plainly see it in his face;
That old vertigo in his head
Will never leave him till he’s dead;
Besides, his memory decays,
He recollects not what he says.

His failing memory may then have been depressive, for his writing shows no gross signs of dementia. Writing to Lord Orrery in 1738 he described “the shadow of the shadow of the shadow etc., etc., of Dr Swift. Age, giddiness, deafness, loss of memory, rage and rancour . . .” Thus depression more than dementia dominated his miseries at that date. On 26 July 1740, aged seventy-three, he wrote to his cousin Mrs. Whitehouse,3 obsessed by depressive forebodings of death—”If I live till Monday I shall hope to see you, perhaps for the last time.”

Front page of The Closing Years of Dean Swift's Life
Fig 4. The Closing Years of Dean Swift’s Life

By 1741 his understanding precluded sensible conversation. In 1742 he developed an agonizingly painful swelling of his left eye, described by Samuel Johnson in 1781 after Swift’s death. It subsided after a month but he rapidly became “nearly silent, in a hopeless state of infatuity.”9 Lord Brain suspected orbital cellulitis with local thrombophlebitis of the superior petrosal sinus, causing his aphasia.3 Later that year he became incapable, and guardians were appointed.10 He died in October 1745.

When Dr. John Whiteway performed an autopsy, the brain was found to be “loaded with water,” indicating cerebral atrophy. The body and skull were exhumed in 1835 and subjected to further examination from which Dr. Houston made a cast, drawn by Mr. Hamilton. (Fig 3.) It shows fronto-temporal atrophy consistent with dementia.

Oscar Wilde’s father, Dr. William Wilde (1849) in The Closing Years of Dean Swift’s Life, (Fig 4) citing an 1846 letter from Dr. W. Mackenzie, concluded:

Exophthalmus of the left eye . . . produced by an internal abscess, or intense inflammation of the anterior lobe . . . destroyed his memory, and rendered him at times ungovernable in his anger, as well as produced paralysis . . . That his not speaking was not the result either of insanity or imbecility, but arose either from paralysis of the muscles by which the mechanism of speech is produced, or from loss of memory of the things which he wished to express, as frequently occurs in cases of cerebral disease . . .9 (pp. 64-67)

This supports Russell Brain’s assessment. Bewley thought him physically and mentally fit for most of his seventy-eight years, but in old age he became depressed and latterly aphasic with terminal dementia.11



Swift was a rationalist—a free and reactionary thinker and prolific writer whose critical faculties and facility with his pen made him a brilliant observer, who vigorously derided religious and political affectation. His humor, irony, invective, and reasoning were unsurpassed. However the fierceness of his criticisms at times made him the object of awe, pity, and derision.

After years of depression, dysphasia,4 and apathetic withdrawal, he died in 1745, aged seventy-eight. In accordance with his wishes he was buried in St. Patrick’s Cathedral at the side of Stella. He left his fortune to found St. Patrick’s Hospital for Imbeciles, which opened in 1757 and continues as a teaching hospital at Kilmainham. This legacy reflected his revulsion at the lamentable mistreatment of lunatics.

Conall Morrison’s new play The Travels of Jonathan Swift gives a modern view of his life and its vagaries.

Swift wrote his own epitaph in Latin, translated:

Here is laid the Body
of Jonathan Swift, Doctor of Sacred Theology,
Dean of this Cathedral Church,
where fierce Indignation
can no longer
injure the Heart.
Go forth, Voyager,
and copy, if you can,
this vigorous (to the best of his ability)
Champion of Liberty


End note

  1. This was later published in 1739.



  1. Craik Henry. The Life of Jonathan Swift.  2 vols, 2nd edition. London. Macmillan 1894.
  2. Johnson, S. (1781/1891). Jonathan Swift. In: The lives of the poets. London: George Bell and Sons. Vol. 3, pp. 2–45.
  3. Brain WR. Jonathan Swift: L’Enfant terrible. In Some reflections on Genius and other essays. London. Pitman Co Ltd. Pp.23-33.
  4. Lorch M. Language and memory disorder in the case of Jonathan Swift: considerations on retrospective diagnosis, Brain 2006;129: 3127–3137. https://doi.org/10.1093/brain/awl246
  5. Pearce JMS. Mental illness in art. Hektoen Int. Summer 2019
  6. Jonathan Swift: A Tale of a Tub [I704] In: The Works of the Rev. Jonathan Swift, arranged by T. Sheridan, revised by J. Nichols. Vol. 3, pp. I45 ff. (Sect.IX: A Digression Concerning the Original, the Use, and Improvement, of Madness in a Commonwealth.) London, Johnson, 1803,
  7. Wilson TG. The Mental and Physical Health of Dean Swift. Med Hist. 1958; 2(3): 175–190.
  8. Lewis JM. Jonathan Swift and Alzheimer’s disease. Lancet. 1993 Aug 21;342(8869):504.
  9. Wilde WR. The closing years of Dean Swift’s with remarks on Stella. Dublin, Hodges and Smith, 1849. https://ia800303.us.archive.org/3/items/closingyearsdea01wildgoog/closingyearsdea01wildgoog.pdf
  10. Ricardo Quintana. Jonathan Swift. Anglo-Irish Author and Clergyman. Encyclopædia Britannica, Inc. 2019.
  11. Bewley TH. The health of Jonathan Swift.  J R Soc Med. 1998 Nov; 91(11): 602–605.




JMS PEARCE, MD, FRCP, is emeritus consultant neurologist in the Department of Neurology at the Hull Royal Infirmary, England.


Fall 2019  |  Sections  |  History Essays

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