Through the Looking Glass

John Tenniel
illustration from Alice’s Adventures in Wonderland
by Lewis Carroll
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John Tenniel brought Lewis Carroll’s books to life with his engaging, and often humorous, illustrations. A political cartoonist at Punch magazine, Tenniel’s sharp style was well-suited to Alice’s Adventures in Wonderland. His illustrations became famous around the world as the novel and its sequel proved to be great successes—as they still are today. Here, Alice finds herself in a room that is much too small, or she is simply much too big. Named for this moment in the story, “Alice in Wonderland Syndrome” is a condition where one’s sense of body image and perceived scale is altered. This is thought to be an unusual variant of a migranious aura; Lewis Carroll himself was known to suffer from migraines.

John Tenniel’s illustrations are an integral part of Lewis Carroll’s story. Though he had a formal artistic training at the Royal Academy of Arts in London, Tenniel (1820-1914) became famous for his work as a political cartoonist and illustrator. As a cartoon artist at Punch magazine, beginning in 1850, Tenniel created cartoons that offered a satirical view on happenings around the world. Tenniel contributed to the magazine for over 50 years, being promoted to political cartoonist, and finally retiring in 1901. Many of his cartoons were controversial, even radical, dealing with subjects such as Irish nationalists, the working class, and the police force. He produced around 2,300 cartoons in all.

Alice’s Adventures in Wonderland by John Tenniel, a piece in the Neurology, Illustrated gallery at Tufts Medical Center in Boston, MA.In 1864, Carrol asked Tenniel to create the illustrations for his book Alice’s Adventures in Wonderland. Tenniel agreed, but he may have later regretted his choice—Carrol was a very exacting boss with specific requirements for the many illustrations. The book was first published in 1865, with 42 illustrations by Tenniel. A few years later, Carroll was able to persuade Tenniel to create illustrations for the sequel, Through the Looking Glass, which was published in 1871. Tenniel employed the same process to create the drawings in Alice as he did when making cartoons for Punch: first he would execute a pencil drawing, then a second version in ink, which was sent to an engraver, and finally turned into electrotype plates for printing. The books were published around the world, bringing great fame to both Carroll and Tenniel. Here we see a giant Alice in a much-too-small room, in a scene from early in the novel. It was this moment in the story that led to the naming of Alice in Wonderland Syndrome.

Alice’s Adventures in Wonderland by John Tenniel, a piece in the Neurology, Illustrated gallery at Tufts Medical Center in Boston, MA.Alice in Wonderland Syndrome is characterized by disturbing episodes of visual hallucinations and distortions in which body parts are perceived as being too big (macropsia) or too small (micropsia). Objects may appear too far away (teleopsia) or generally distorted in shape or size (metamophopsia). The most common cause of the syndrome is migraine. Most people consider migraine to be synonymous with headache. In fact, migraine is a complex set of physiological changes in the brain that come as attacks. About three-quarters of migraine patients only get a headache. It tends to be on one side (or at least more on one side than another), throbbing, worsened with movement, light (photophobia), sounds (sonophobia), or smells (osmophobia). Nausea and vomiting are common. Twenty-five percent of migraine patients also have auras which generally come before the headache (but can come at any time) and are most commonly described as flickering/flashing zig-zag lights that grow over several minutes and cause a temporary blindspot. However, other auras can be tingling, feelings of déjà vu, or complicated difficulty with speech. Some people even get the migraine aura without any headache at all (acephalgic migraine). Alice in Wonderland Syndrome is a migraine aura more common in children than in adults. Very rarely, the syndrome can be a symptom of a brain mass (like a tumor or abnormal blood vessels) or even brain infections. It has been suggested that Lewis Carroll himself, who was known to suffer from migraines, may have experienced symptoms of micropsia and/or macropsia. 


Blom, Jan Dirk.  “Alice in Wonderland syndrome:  A systematic review.”  Neurology:  Clinical Practice (June 2016):  1-13.