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LE JOURNAL CANADIEN DES SCIENCES NEUROLOG1QUES
Historical Viewpoint:
The Neurology of Alice in Wonderland
T.J. MURRAY
SUMMARY: Charles Dodgson, better On July 4, 1862 an unusual picnic loving, warm person who showered a
known as Lewis Carroll, author of the took place. The Reverend Charles great deal of affection on young
famous Alice stories, developed migraine Dodgson, a thirty-year-old don at Ox- Charles.
and associated visual symptoms late in life. ford, took the three Liddell children, Alice Liddell's son, Captain Har-
There has been considerable speculation Ina, Alice, and Edith, for a row on the greaves, described Dodgson in the New
that the bizarre phenomena and weird Isis River towards Godstow. As York Times as:
visual imaginery in Alice stories was direct-
ly related to the author's migraine. Dodgson was well known among "this shy young man, rather tall,
This paper reviews several aspects of the children for his spontaneous and amus- so straight he leaned over
character and health of Lewis Carroll in- ing stories, he began a narration. backwards with one shoulder
cluding his shy, introspective personality, Robinson Duckworth, a second cha- higher than the other; thin and
his stuttering and his attraction to young perone, later said that the story of Alice pale, with dark wavy hair that
girls. It is concluded that there is no con- was composed as they rowed along for wanted cutting; rather good-
nection between the visual symptoms of the benefit of little ten year old Alice looking, despite incongruities of
migraine and the phenomena described in Liddell. At the end of the day Alice form movement - the young man
the Alice stories which were written over 25 said "Oh Mr. Dodgson, I wish that you
with the 'two profiles', the
years before the author developed migraine would write out Alice's adventures for
in his mid-fifties. crooked smile, the trembling up-
me!" The next day Dodgson made an per lip, the housemaid's knee and
RESUME: Charles Dodgson, mieux connu outline and from then on continued to jerky gait, the stammer, the high-
sous le nom de Lewis Carroll et auteur compose and illustrate the tale "Alice's pitched voice, the low precise
d'Alice au pays des merveilles, developpa Adventures in Wonderland". He com- speech, the one deaf ear, but also
dans la cinquantaine des maux de tete du pleted an unillustrated version in 1863 with the blue eyes that held yours,
genre migraine et des symptomes visuels and a beautifully handwritten, il- and the change from a warm
relatifs a ses migraines. On a souvent as- lustrated copy for Alice as an early kindly glance to a suppressed
socie les bizarreries et les fantasmes des Christmas present in November, 1864.
contes d'Alice aux migraines de I'auteur. twinkle, while the large white
When later published, the Alice stories hands gripped yours with unex-
Cette anamnese fournit des renseigne- became some of the most popular and
ments sur I'individualite et la sante de most translated writings in the English pected strength - it was to surprise
Lewis Carroll, y compris sur sa timidite, a good many persons, including
son caractere introverti, son begaiement et language. Published under the pseu- himself
son attrait envers lesfillettes. On en a done donym Lewis Carroll, the stories made (Hargreaves, 1945).
conclu qu'il n'y a aucun rapport entre les their shy author famous, as well known He had a marked stutter and stam-
symptomes visuels relatifs a ses migraines today as in Victorian times. mer that caused trembling of his upper
et le phenomene decrit dans les contes lip. He had great difficulty giving
d'Alice ecrits 25 ans avant que I'auteur,
alors cinquantenaire, developpa ses mi- sermons and seldom did so but when
graines. The Life and Health of Lewis Carroll he did, they were composed in such a
Charles Lutwidge Dodgson was way that none of the words which
born in 1832, and educated at Rugby caused him to stammer would appear.
and Christ Church, Oxford. In 1861 he In 1897, in the last year of his life, he
decided to become a minister and took gave a long sermon lasting three-
deacons' orders, but shyness and stut- quarters of an hour and later wrote in
tering prevented him from seeking the his diary "It has been the most for-
priesthood. He spent the rest of his life midable I've ever had to preach".
as a teacher of mathematics at Oxford, Havelock Ellis (1945), in a study of
publishing some contributions on British genius, wrote on thirteen emi-
mathematics, logic and games. nent Englishmen, including Dodgson,
Dodgson's mother and father were Charles Lamb and Kingsley, all of
From the Department of Medicine (Neurology), first cousins. He was the eldest son, the whom stuttered, stating "There can be
Dalhousie University, Halifax, Nova Scotia. third of eleven children, most of whom no doubt whatever as to the abnormal
Reprint Requests to: Dr. TJ. Murray, Head, Divi-
sion of Neurology, Dalhousie University, 5849
stuttered. His father was a stern prevalence of stammering among
University Avenue, Halifax, Nova Scotia, B3H 4H7. Archbishop but his mother was a very British persons of ability". It is also of
NOVEMBER 1982 — 453
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interest that the dodo in Alice in sense, to Kenneth Burke's essay (1972) orientation and reversals are very often
Wonderland represents Dodgson as the interpreting the acts and symbols large- symbolizations for the inability to find
duck represents Duckworth. The dodo ly as excremental images, to Shane a definite direction in one's sexuality,
refers to his stuttering way of starting Leslie's theory (1972) that they are and for a wavering between the hetero-
to pronounce his own last name. reflexions on contemporary ecclesi- and homosexual impulses. He feels that
There is some argument as to astical history. Florence Becker Len- Dodgson creates a world without real
whether he was left-handed. In the Vic- non (1945) felt that the stories repre- love, that the absurd and cruel kings
torian Age left-handedness was not en- sented unresolved Oedipal conflicts; and queens in the stories were parental
tirely respectable but his sister, Louisa, Martin Grotjahn (1947) believed that symbols and that the disagreeable
said he may possibly have been Alice represented a symbolic equation animals around him represented his
because she was. Certainly in his for the phallus and her adventures were many brothers and sisters.
photographs he can be seen using a a return to the mother's womb. Geza It is interesting to ponder what this
dominant right hand. Roheim (1972) felt that the Alice story quiet, reserved, shy deacon of the
Dodgson as a child was not very was clearly one of oral trauma, with church would have felt had he read
healthy. His mother writes in her diary her manipulations of time, food, words these theories. Dodgson himself main-
of a serious attack of whooping cough and realities being highly schizo- tained that his books meant nothing.
and says that he got over this quite phrenic. Goldschmidt (1972) sug- However, he recognized that the words
well. Towards the end of his Rugby gested the whole story could be ex- we use suggest more than we mean by
days he suffered from mumps. Already plained by "the desire for complete them, so it is possible that the words of
slightly deaf in the right ear, the mumps virility, conflicting with the desire for an author do represent more than even
appeared to have caused further abnormal satisfaction". he planned.
deterioration. The theories became "curiouser and Gardner (1960) in "The Annotated
Dodgson was healthy most of his curiouser". Goldschmidt (1972), and Alice" suggested that there was
adult life, fond of exercise and long Schilder (1938) were intrigued by the something preposterous about examin-
walks. He recorded in his diary a walk tremendous amount of anxiety in Alice ing these books in academic detail.
to Hastings, eighteen miles away, in stories, even though Alice herself Chesterton (1960) also voiced his
five hours and twenty-five minutes, seemed aloof, and unperturbed by the "dreadful fear" that the Alice story had
with an average pace of three and anxiety and frenzy around her. already fallen into the heavy hands of
three-quarter miles per hour. In the last Goldschmidt says that the anxiety is to scholars and was becoming "cold and
year of his life he acquired a Whiteley a great extent related to eating or drink- monumental like a classical tune".
exerciser to develop his arm muscles. ing and this represents oral aggres- Gardner (1960) excused himself by
He liked to work hard and to retire siveness and cruelty. This seems an saying no joke was funny unless you
physically fatigued. over interpretation of the situation as see the point of it, and many of the
He was prone to brief periods of Alice is controlled and calm in this most interesting things in Alice might
mild depression, recurrent since his bizarre world of unexpected frenzy. only be understood if the times and
teens. Even at a young age he was Heath (1974) noted that she took all habits of England and Oxford in the
writing poetry of solitude and despair. the strangeness for granted, remained 1800s were also understood. He also
His poems at age 21, when he was still aloof, even snobbish, and did not see or says that the children of today find
seriously affected by his mother's appreciate the author's jokes. Alice difficult to understand, and that
death, are quite sad and depressing. Phyllis Greenacre (1955), in a very the immortality of these books has con-
He often stayed awake late at night detailed study suggested that Dodgson tinued, not because of children, but
but did not complain of insomnia. He really hated his mother but loved his because adults, scientists and math-
commented in one of his books on father, a seeming contradiction to ematicians in particular, seem to relish
"sleepless nights", and when this was everything known about him. She the stories. Heath (1974), in fact, sug-
later interpreted by others as insomnia believed that this explained the obvious gests children are the least likely to
he corrected this in a later edition. He mother symbols, with the Queen of understand them.
did invent a lot of games and math- Hearts and the Red Queen being Fensch (1972) interpreted the stories
ematical puzzles for people to do in heartless, cruel creatures while The as equivalent to the confused, sur-
bed, intended in part to occupy the time King of Hearts and the White Knight realistic world of an LSD trip.
and to keep one's mind on lofty and are father symbols and very pleasant, Although his essay, "Lewis Carroll -
moral matters. kind fellows. She also argues that Alice The First Acid Head", is unconvincing,
herself is the major mother symbol, and there was a song by Grace Slick (1972)
Alice Analyzed feels that there is an unresolved and of the Jefferson Airplane called "White
The analyses of the Alice stories reversed Oedipus complex involved. Rabbit" which again relates to the psy-
have been numerous (Goldschmidt, His pleasure in mirror writing and chodelic nature of Alice's adventures
1972; Greenacre, 1955; Grofjahn, reversals has been related to his phy- and a suggestion that it is a drug ex-
1947; Phillips, 1972; Schilder, 1938; sical asymmetry and perhaps his left- perience. She repeats "Go ask Alice"
Taylor, 1952) and range from sugges- handedness. Goldschmidt adds the un- which has been adopted as the title of a
tions that they are just playful non- usual suggestion that left and right dis- recent novel on teenage drug problems.
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Migraine It is conceivable that the visual other items left at the time of his death,
" 'I am very brave, usually.' He phenomena he experienced in his fifties there was a human skull and a skeleton
went on in a low voice: 'Only to- and sixties were due to transient cerebral of a hand and foot. Although interested
day I happen to have a head- ischemia. Visual phenomena of many in medical science he had definite ideas
ache'." forms can occur with vertebrobasilar about animal research and published a
Tweedle Dum ischemia, and headache occurs with number of dissertations on the evils of
both carotid and vertebrobasilar vivisection, indicating that he did not
ischemia episodes. It is more likely accept the argument that animal ex-
Dodgson's name often appears on
however that the phenomena represent perimentation was justified to relieve
lists of famous migraineurs. He
an unusual late onset of migraine as human suffering.
diagnosed his own migraine. It has
described by Miller Fisher (1980). Late
been suggested that the visual pheno-
onset migraine can resemble transient Dodgson's Relationship with
mena that he had with migraine may
cerebral ischemic attacks. The Young Girls
have been responsible for the fantastic
neurological phenomena may be Psychoanalysts have made much of
visual imagery, alteration of body
dramatic and prolonged with minimal his relationship with small girls. It is
image, and other bizarre phenomena in
or absent headache. clear that this quiet, shy bachelor with
the Alice stories.
The suggestion that the visual a stern father and doting mother, had a
The first reference to migraine comes life-long love for little girls, a disdain
imagery in the Alice stories may have
from the edited Dodgson diaries for small boys and an inability to relate
been related to the author's migraine
published by his nephew, S.D. Col- to adult women. Because he had a hob-
has appealed to many neurologists.
lingwood (1898). In 1888, at age fifty- by of photographing little girls in the
Patients with migraine may perceive
six, he had his first episode which he nude and was the author of strange
distortions in the size or shape of ob-
described in his diary. books about bizarre and complex
jects or, rarely, changes in their own
"This morning on getting up, I ex- body image or in the perception of peo- creatures, he has been a frequent target
perienced a curious optical effect - ple around them. Although this theory for psychoanalysts. Many papers com-
of 'seeing fortifications' - discus- is interesting to contemplate as one ment on the relationship to his mother,
sed in Dr. Lathan's book on reads the Alice stories, there is no con- to Alice and to other small girls. Taylor
'bilious head-ache'. In this in- vincing evidence to support it. Dodg- (1952) makes two assumptions: that
stance it affected the right eye on- son's initial migraine headache seems Dodgson was normal, although
ly, at the outer edge and there was to have occurred about twenty-eight peculiarly retiring and secretive, and
no head-ache." years after he first wrote the stories, that his books had definite meanings,
Six months later it occurred in the left and they appear to be just fanciful and and were not merely "nonsense".
eye and a year later he had similar Taylor suspects there was a great dis-
imaginative story telling.
symptoms in association with an appointment in his life which has been
Unfortunately, he seldom consulted eliminated from the diaries and
episode of synovitis of the knee. a physician so we do not have any con-
Altogether, about six episodes of writings. He feels that Dodgson was in
firmation of his diagnosis. In 1852 he love with Alice and that the breakdown
migraine-like phenomena were noted in did consult Edward Hamilton, an Edin-
his diaries. Only vague references are in that relationship was the great disap-
burgh Phrenologist, who read his head pointment of his life. Although there
made to headache and the clearest bumps and gave an interesting report
description is of recurrent visual ex- was a long list of little girls in his life,
on the character of the client, although none ever replaced his first love, Alice
periences. it did not bear on our question about Liddell. Mrs. Liddell seemed to sense
It would be unusual for classical his headaches (Hamilton 1954). The that there was something wrong in this
migraine or typical migraine of any report ends on an interesting note: "As relationship and began to discourage
type to begin at age fifty-six. Dodgson a medical man you could excel. Do not Dodgson's attention to her daughters.
wrote a detailed diary and there are ac- stress the brain too much at time (sic) Later she seemed to regard him with
curate notes and interviews with people because it is not firmly knit yet. Upon some distaste, and burned all his early
who knew him throughout his life, so it the whole a good head." letters to Alice. There is a cryptic
is likely that earlier episodes would The phrenologist was accurate in reference in Dodgson's diary on Oc-
have been recorded had they occurred. noting Dodgson's strong love for tober 28, 1862 to his being out of Mrs.
Unfortunately, he does not describe the children, his refinement, and his excel- Liddell's good graces "ever since Lord
characteristics of his headaches and the lent logical mind. It has also been sug- Newry's business". The explanation
suspicion of migraine has always been gested that he probably could have behind Lord Newry's business remains
based on the occurrence of visual for- been a good physician and he certainly a mystery to this day.
tification scintillations. Dodgson was had a great interest in medicine, keep-
well read in medical matters and he ing a large library of books on Some may question whether Dodg-
decided that the description of his medicine, pathology, anatomy and son loved Alice, which was likely, and
visual phenomena fitted the pattern of other aspects of science. Along with whether he contemplated marriage with
"bilious headache", or migraine out- telescopes, a microscope, mathematical her, which was unlikely. Dodgson was
lined in Dr. Latham's book. instruments, geometrical solids and twenty years older than Alice and she
Murray NOVEMBER 1982 — 455
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later married a gentleman by the name be seventeen. He wrote a mock Alice, assisted in this effort. At the
of Hargreaves. Dodgson himself later apology to the mother but she replied Lewis Carroll Centenary in London in
stated that he always remembered sternly, "We shall see that it does not 1932 it was decided to initiate a more
Alice as a child. He later wrote letters recur". It appears that Alice herself substantial memorial in the form of an
to Alice but always addressed them to was not always happy with Carroll's entire children's ward at St. Mary's
"Dear Mrs. Hargreaves". attention and there was some an- Hospital, Paddington. This was
Isa Bowman, a little girl who played tagonism towards him by the mother launched by a letter to the Times in
Alice on stage, was one of Dodgson's and sisters in the Liddell family. March 1932 signed by Ramsey Mac-
most favorite child-friends. One after- He lost all fondness for these young Donald, Stanley Baldwin, J.M. Barry,
noon while walking hand-in-hand with women when they reached woman- Alice Hargreaves, Walter De Le Mare,
her in Christ Church Meadows he ex- hood. He wrote, "About nine out of A.A. Milne and many others. The suc-
plained how rivers flow downhill to the ten, I think, of my child-friendships get cess of this appeal was partly due to the
sea. The essence of the relationship shipwrecked at the critical point 'where enthusiasm of Professor B.J. Col-
seemed to be his ease and comfort with the stream and river meet', and the lingwood, Professor of Physiology at
a small child, for the relaxed and happy child-friends once so affectionate, St. Mary's Medical School, and a
interval was suddenly broken with the become uninteresting acquaintances, nephew of Dodgson. In Dodgson's Will
appearance of another university don. whom I have no wish to set eyes on he stated "Now that my nephew,
Carroll's ease in conversation and his again." Bertrum Collingwood, is studying for
relaxed manner disappeared and he the medical profession, I should like
was transformed back to the awkward, Later Life and Death him to have what he likes of the books
shy, stuttering Reverend Charles In 1889 and 1890 he had a series of on the subjects of anatomy, phy-
Ludwidge Dodgson. For the remainder medical problems including a boil, syn- siology, pathology and kindred sub-
of the walk the little girl said he ovitis in one knee, and later the other, jects."
"became difficult to understand and ague, cystitis and lumbago, raising a
talked in a nervous and pre-occupied question about Reiter's syndrome. Conclusion
manner". In 1891 he fell unconscious after The self-diagnosed migraine of
He thought the naked bodies of little morning chapel and awoke an hour Charles Dodgson had it's onset at age
girls, unlike those of little boys, to be later on the floor of the stalls, his nose 56 and was characterized mainly by
extremely beautiful. With their bleeding. He reports, "It is thefirsttime visual symptoms. These visual symp-
mother's permission, he often sketched I fainted away. I sent for Dr. Brooks. I toms were not the basis of the bizarre
and photographed them in the nude. To had some headache afterwards, but felt happenings in The Alice stories, as is
prevent future embarrassment to the very little the worse." sometimes suggested, since they were
girls, he requested that after his death He spent that Christmas at Christ written over twenty-five years before
the pictures be destroyed or returned to Church and had further symptoms of his migraine began.
the children or their parents. None of joint pains and episodic visual distur-
these photographs have survived. bances. There are no more entries on
Although he was always careful to his health, except to say that he was BIBLIOGRAPHY
state that he would not in any way up- later feeling quite healthy and fit. At the BURKE, K., 1972. The Thinking of the Body.
set or disturb a child with his nude New Year in 1897 he came down with In: Aspects of Alice, pp. 340-343, ed. by
photography, and always obtained the flu and was too ill even to read the Phillips, R., Victor Gollancz Ltd., London.
permission from the mothers, there is family prayers. During the next week CHESTERTON, G.K., 1960. Quoted by
some indication that the mothers were he developed symptoms of pneumonia Gardner M. In: The Annotated Alice, p. 7,
not always happy with him or his in- and asked his sisters to read a hymn Clarkson N. Potter.
terest in their daughters. There is no which ended "thy will be done". On COLLINGWOOD, S.D., 1898. The Life and
suggestion however, that there was ever January 13 he said, "Take away these Letters of Lewis Carroll, p. 459, ed. by Col-
any impropriety. Unlike Humbert pillows - I shall need them no more". lingwood S.D., T. Fisher Unwin London.
Humbert, the narrator of Vladimir The next day he slipped into a coma DODGSON, C.L., 1953. The Diaries of Lewis
Nabokov's novel, "Lolita", Carroll did and died. He was buried in the Guild- Carroll. Vol. 2. ed. by R.L. Green. Cassell,
not pursue young girls for any sexual London.
ford cemetery under a simple white
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Simon and Schuster, New York.
Although he loved many young girls, Carroll.
there is no indication that he had any Audrey Fuller, age fourteen, wrote a FENSCH, T., 1972. Lewis Carroll - The First
love relationship with an adult woman. Acidhead. In: Aspects of Alice, pp. 421-424,
letter to the St. James Gazette sug- ed. by Phillips, R., Victor Gollancz Ltd.,
He wrote some rather Victorian letters gesting that a fitting memorial for London.
of passion to some young girls and this Lewis Carroll would be to raise money
FISHER, M., 1980. Late-life Migraine Accom-
did not always please the mothers. In for a cot in the Children's Hospital at paniments as a Cause of Unexplained Tran-
one instance he kissed a girl he thought Great Ormond Street. Many letters sient Ischemic Attacks. Can. J. Neur. Sci. 7,
to be fourteen, but who turned out to from friends and supporters, including 9-17.
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