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BMJ. 2007 May 5; 334(7600): 957.
PMCID: PMC1865408
Between the Lines

Green tea and monkey business

Theodore Dalrymple, writer and retired doctor

The name Le Fanu is not unknown to medicine in this country. There is, for example, the medical correspondent of one of our major newspapers, which it would be wrong to advertise, and W R LeFanu, who was the librarian of the Royal College of Surgeons between 1929 and 1968. A man of immense erudition, which puts one's own ignorance to shame, he oversaw the removal of the library during the second world war to Shropshire, saving it from the destruction that the college itself suffered during the blitz. A bibliographer of distinction, especially in the field of Jennerian studies, he published a bibliography of Nehemiah Grew at the age of 86, in 1990.

Sheridan Le Fanu, the Irish writer of ghost stories, was an ancestor of his. Doctors featured very often in Le Fanu's stories; one book, In a Glass Darkly, published in 1872, is a series of the cases of one Dr Hesselius, a German specialist in “metaphysical medicine.”

In the first and most famous of these stories, Green Tea, Dr Hesselius is consulted by the Reverend Mr Jennings, a clergyman in easy circumstances who, alas, is haunted. Already interested in the supernatural—books about which he stays up all night studying while drinking green tea—he one day sees two red eyes staring at him on an omnibus, which he then makes out to belong to a spectral monkey through which his umbrella can pass without meeting any resistance. The monkey stays with him for the rest of his days and grows ever more intrusive, jumping on to the Bible when he tries to read from it in church, so that he is unable to continue the service, then uttering terrible blasphemies whenever the Reverend Jennings tries to pray, and finally issuing him with commands, including that to commit suicide. Eventually, he does kill himself, by cutting his throat.

Dr Hesselius's diagnosis of the Reverend Jennings's distemper is cautious. It is one of Le Fanu's themes that we can never fully or definitively interpret events, and Dr Hesselius is of like opinion. In this case, he goes in for what one might call agnostic multifactorialism. First was “the habitual use of such agents as green tea,” which disturb the equilibrium of the cerebral fluids. Interestingly, a National Institute of Health website informs us that when more than 8 to 10 cups of green tea per day are drunk, “symptoms of anxiety, delirium, agitation and psychosis may occur.” Nor is stopping the tea necessarily instantly beneficial in those with “affective disorder or schizoaffective disorder,” in whom withdrawal from the caffeine can cause “confusion, disorientation, excitement, restlessness, violent behaviour, or mania.”

In Dr Hesselius's opinion, one of the effects of the tea is to influence the brain so that “disembodied spirits may operate in communication more effectually.” He thus makes it unclear as to whether he believes the black monkey with red eyes is a hallucination pure and simple, or an actually existing entity.

But Dr Hesselius doesn't blame the tea alone. “[Jennings'] case was in the distinctive manner a complication, and the complaint under which he really succumbed, was hereditary suicidal mania.” So he was predisposed to kill himself, green tea and black monkey, or no green tea and black monkey.

As to therapy, Dr Hesselius says that iced eau de cologne applied to the forehead would inevitably have worked if applied long enough. What rubbish! Everyone knows that what the Reverend Jennings needed was an SSRI (selective serotonin reuptake inhibitor), because serotonin is the key to all human happiness and misery, and indeed to all behaviour whatsoever.

Everyone knows that what the Reverend Jennings needed was an SSRI


Articles from The BMJ are provided here courtesy of BMJ Publishing Group