The 1931 novella Confidence Africaine (African Secret), by Nobel Prize winner Roger Martin du Gard, prompts these thoughts in Dalrymple’s BMJ column (subscription required):
Does illness have a meaning beyond itself? For most of history, people have thought so. It was a divine or other vengeance, a punishment for wickedness, individual or collective. The purely naturalistic attitude to illness is psychologically difficult to maintain consistently. Even the most thorough of rationalists, struck down unexpectedly by malady, are inclined to protest that they did not deserve it, and that they had no bad habits, exercised vigorously, and ate fresh food, for example.