Carl Westphal’s classic paper on ‘Agoraphobia’ of 1871 laid the foundations for the rapid development of work on phobias, fears and obsessions which sprang up in the last decades of the nineteenth century. This essay explores the intersection of medical and literary discourses of pathological fear as they emerged in the latter half of the century, looking particularly at the ways in which psychiatry turned to literature for case studies of phobia and obsession. I consider the work on fear of, amongst others, American psychologist G. Stanley Hall, and the Italian Angelo Mosso, before focusing on the role played by George Borrow’s neglected work, Lavengro (1851) in the development of late nineteenth-century psychiatric models of fear.