Unlike Charles he did not lead his armies in person, but sat at home
and prayed, read the crystal, and organized. After the great battle
of St. Quentin, in which he defeated the French, he vowed to erect a
mighty church to the glory of St. Lawrence which should excel every
other building in the world; and for thirty years the whole available
wealth of Spain and the Indies was poured out on the erection of the
Escorial, which the Spaniards look upon as the eighth wonder of the
world, and who is to say that they are wrong? Situated about twenty
miles from Madrid, in a bleak and desolate mountain range, it reflects
extraordinarily well the character of the man who made it. Under one
almost incredible roof it combines a palace, a university, a monastery,
a church, and a mausoleum. The weight of its keys alone is measured in
scores of pounds; the number of its windows and its doors is counted in
hundreds; it contains the greatest works of many very great artists,
and the tombs of Charles V and his descendants. It stands in lonely
grandeur swept by constant bitter winds, a fit monument for a lonely
and morose king. Its architecture is Doric, and stern as its own
granite.
The character of Philip II has been described repeatedly, in England
mainly by his enemies, who have laid too much stress on his cruelty
and bigotry. Though he was fiercely religious, yet he loved art and
wrote poetry; though he would burn a heretic as blithely as any man,
yet he was a kind husband to his four wives, whom he married one after
the other for political reasons; though he was gloomy and austere,
yet he loved music, and was moved almost to tears by the sound of the
nightingale in the summer evenings of Spain. His people loved him and
affectionately called him “Philip the prudent”; they forgave him his
mistakes, for they knew that he worked always for the ancient religion
which they loved, and for the glory of Spain.
Unlike Charles his father, he was austere in his mode of life, and
always had a doctor at his side at meals lest he should forget his
gout. He was a martyr to that most distressing complaint, no doubt
inherited from his father. He lived abstemiously, but took too little
exercise; it would have been better for his health--and probably for
the world--had he followed his armies on horseback like Charles, even
if he had recognized that he was no great general.
His death, at the age of seventy-two, was proud and sombre, as befitted
the son of the Empress Isabel, who had scorned to cry when he was
born. We can understand a good deal about Philip if we consider him
as spiritually the son of that proud sombre woman rather than of his
glorious and energetic father. In June, 1598, he was attacked by an
unusually severe attack of gout which so crippled him that he could
hardly move. He was carried from Madrid to the Escorial in a litter,
and was put to bed in a little room opening off the church so that he
could hear the friars at their orisons. Soon he began to suffer from
“malignant tumours” all over his legs, which ulcerated, and became
intensely painful, so that he could not bear even a wet cloth to be
laid upon them or to have the ulcers dressed. So he lay for fifty-three
days suffering frightful tortures, but never uttering a word of
complaint, even as his mother had borne him in silence for the sake of
the great man who had begotten him. As the ulcers could not be dressed,
they naturally became covered with vermin and smelled horribly. Stoical
in his agony, he called his son before him, apologizing for doing so,
but it was necessary. “I want,” he said, “to show you how even the
greatest monarchies must end. The crown is slipping from my head, and
will soon rest upon yours. In a few days I shall be nothing but a
corpse swathed in its winding-sheet, girdled with a rope.” He showed no
sign of emotionalism, but retained his self-control to the last; after
he had said farewell to his son he considered that he had left the
world, and devoted the last few days of his life to the offices of the
church. The monks in the church wanted to cease the continual dirges
and services, but he insisted that they should go on, saying: “The
nearer I get to the fountain, the more thirsty I become!”
These seem to have been his last words; he appears to have retained
consciousness as long as may be.
Let us reason together and try if we can make head or tail of this
extraordinary illness. The first certain fact about Philip II is that
he long suffered from gout, apparently the real old-fashioned gout in
the feet. In the well-known picture of him receiving a deputation of
Netherlanders, as he sits in his tall hat beneath a crucifix, it is
perfectly evident that he is suffering tortures from gout and wearing
a large loosely fitting slipper. These unfortunate gentlemen seem to
have selected a most unpropitious moment to ask favours, for there
is no ailment that so warps the temper as gout. When a man suffers
from gout over a period of years it is only a matter of time till his
arteries and kidneys go wrong and he gets arterio-sclerosis. We may
take it, therefore, as certain that at the age of seventy-two Philip
had sclerosed arteries and probably chronic Bright’s disease like his
father before him. Gout, Bright’s disease, and high blood-pressure,
are all strongly hereditary, as every insurance doctor knows; that
is to say, the son of a father who has died of one of these three is
more likely than not to die ultimately of some cognate disease of
arteries or kidneys or heart, all grouped together under the name of
cardio-vascular-renal disease.
But what about the “malignant tumours”? “Malignant tumour” to-day means
cancer of one sort or another, and assuredly it was not cancer that
killed Philip. Probably the word “tumour” simply meant “swelling.” Now,
what could these painful swellings have been which ulcerated and smelt
so horribly? Why not gangrene? Ordinary senile gangrene, such as occurs
in arterio-sclerosis, neither causes swellings, nor is it painful,
nor does it smell nor become verminous; but diabetic gangrene does
all these things. Diabetes in elderly people may go on for many years
undiscovered unless the urine be chemically examined, and may only
cause symptoms when the arterio-sclerosis which generally complicates
it gives results, such as sudden death from heart-failure, or diabetic
gangrene. Thus a very famous Australian statesman, who had been known
to have sugar in his urine for many years, was one morning found dead
in his bath, evidently due to the high blood-pressure consequent on
diabetic arterio-sclerosis.
Diabetic gangrene often begins in some small area of injured skin, such
as might readily occur in a foot tortured with gout; it ulcerates,
is exceedingly painful, and possessed of a stench quite peculiar to
its horrid self. It does not confine itself to one foot, or to one
area of a leg, but suddenly appears in an apparently healthy portion,
having surreptitiously worked its way along beneath the skin; its first
sign is often a painful swelling which ulcerates. The patient dies
either from toxæmia due to the gangrene, or from diabetic coma; and
fifty-three days is not an unlikely period for the torture to continue.
On the whole it would seem that diabetic gangrene appearing in a man
who has arterio-sclerosis is a probable explanation of Philip’s death.
The really interesting part of this historical diagnosis is the way in
which it explains his treatment of the Netherlands. What justice could
they have received from a man tortured and rendered petulant with gout
and gloomy with diabetes?
Charles V had taken no care of himself, but had gone roaring and
fighting and guzzling and drinking all over Europe; Philip had led
a very quiet, studious, and abstemious life, and therefore he lived
nearly twenty years longer than his father. Possibly when he came to
suffer the torments of his death he may have thought the years not
worth his self-denial: possibly he may have regretted that he did not
have a good time when he was young, but this is not likely, for he was
a very conscientious man.
When Philip lay dying he held in his hand the common little crucifix
that his mother and father had adored when they too had died; his
friends buried it upon his breast when they came to inter him in the
Escorial, where it still lies with him in a coffin made of the timbers
of the _Cinco Chagas_, not the least glorious of his fighting galleys.
Arterio-sclerosis, high blood-pressure, hyperpiesis, and chronic
Bright’s disease--all more or less names for the same thing, or at
any rate for cognate disorders--form one of the great tragedies of
the world. They attack the very men whom we can least spare; they are
essentially the diseases of statesmen. Although these diseases have
been attributed to many causes--that is to say, we do not really know
their true cause--it is certain that worry has a great deal to do with
them. If a man be content to live the life of a cabbage, eat little,
and drink no alcohol, it is probable that he will not suffer from high
blood-pressure; but if he is determined to work hard, live well, and
yet struggle furiously, then his arteries and kidneys inevitably go
wrong and he is not likely to stand the strain for many years. Unless
a politician has an iron nerve and preternaturally calm nature, or
unless he is fortunate enough to be carried off by pneumonia, then
he is almost certain to die of high blood-pressure if he persists in
his politics. I could name a dozen able politicians who have fallen
victims to their political anxieties. The latest, so far as I know,
was Mr. John Storey, Premier of New South Wales, who died of high
blood-pressure in 1921; before him I remember several able men whom
the furious politics of that State claimed as victims. In England Lord
Beaconsfield seems to have died of high blood-pressure, and so did Mr.
Joseph Chamberlain. Mr. Gladstone was less fortunate, in that he died
of cancer. He must have possessed a calm mind to go through his furious
strugglings without his kidneys or blood-vessels giving way; that, and
his singularly temperate and happy home-life, preserved him from the
usual fate of statesmen.
Charles V differed from Mr. Gladstone because he habitually ate
far too much, and could never properly relax his mental tension.
His arterio-sclerosis had many results on history. It was probably
responsible for his extreme fits of depression, in one of which it
pleased Fate that he should meet Barbara Blomberg. If he had not been
extraordinarily depressed and unhappy, owing to his arterio-sclerosis,
he would probably not have troubled about her, and there would have
been no Don John of Austria. If he had not had arterio-sclerosis he
would probably not have abdicated in 1556, when he should have had many
years of wise and useful activities before him. If his judgment had
not been warped by his illness he would probably never have appointed
Philip II to be his successor as King of the Netherlands; he would
have seen that the Dutch were not the sort of people to be ruled by
an alien. And if there had been no Don John it is possible that there
would have been no Don Quixote. Once again, if Philip had not been
eternally preoccupied with his senseless struggle against the Dutch,
it is probable that he would have undertaken his real duty--to protect
Europe from the Turk. When one considers how the lives of Charles and
his sons might have been altered had his arteries been carrying a lower
blood-tension, it rather tends to alter the philosophy of history to a
medical man.
Again, when we consider that the destinies of nations are commonly
held in the hands of elderly gentlemen whose blood-pressures tend to
be too high owing to their fierce political activities, it is not too
much to say that arterio-sclerosis is one of the greatest tragedies
that afflict the human race. Every politician should have his
blood-pressure tested and his urine examined about once a quarter, and
if it should show signs of rising he should undoubtedly take a long
rest until it falls again; it is not fair that the lives of millions
should depend upon the judgment of a man whose mind is warped by
arterio-sclerosis.
Mr. and Mrs. Pepys
Samuel Pepys, Father of the Royal Navy, and the one man--if indeed
there were any one man--who made possible the careers of Blake and
Nelson, died in 1703 in the odour of the greatest respectability.
Official London followed him to his honoured grave, and he left behind
him the memory of a great and good servant of the King in “perriwig”
(alas, to become too famous), stockings and silver buckles. But
unhappily for his reputation, though greatly to the delight of a wicked
world, he had, during ten momentous years, kept a diary. It was written
in a kind of shorthand which he seems to have flattered himself would
not be interpreted; but by some extraordinary mischance he had left a
key amongst his papers. Early in the nineteenth century part of the
Diary was translated, and a part published. A staggered world asked for
more, and during the next three generations further portions were made
public, until by this time nearly the whole has been published, and it
is unlikely that the small remaining portions will ever see the light.
Pepys seems to have set down every thought that came into his
head as he wrote; things which the ordinary man hardly admits to
himself--even supposing that he ever thinks or does them--this stately
Secretary of the Navy calmly wrote in black and white with a garrulous
effrontery that absolutely disarms criticism. In its extraordinary
self-revelation the Diary is unique; it is literally true that there
is nothing else like it in any other language, and it is almost
impossible that anything like it will ever be written again; the man,
the moment, and the occasion can never recur. I take it that every
man who presumes to call himself educated has at least a nodding
acquaintance with this immortal work; but a glance at some of its
medical features may be interesting. The difficulties at this end of
the world are considerable, because the Editor has veiled some of the
more interesting medical passages in the decent obscurity of asterisks,
and one has to guess at some anatomical terms which, if too Saxon to
be printable in modern English, might very well have been given in
technical Latin. Let us begin with a brief study of the delightful
woman who had the good fortune--or otherwise--to be Pepys’s wife.
Daughter of a French immigrant and an Irish girl, Elizabeth Pepys was
married at fourteen, and her life ended, after fifteen somewhat hectic
years, in 1669, when she was only twenty-nine years of age. Pepys
repeatedly tells us that she was pretty--and no one was ever a better
judge than he--and “very good company when she is well.” Her portrait
shows her with a bright, clever little face, her upper lip perhaps a
trifle longer than the ideal, bosom well developed, and a coquettish
curl allowed to hang over her forehead after the fashion of the Court
of Charles II. She spoke and read French and English; she took the
keenest interest in life, and set to work to learn from her husband
arithmetic, “musique,” the flageolet, use of the globes, and various
accomplishments which modern girls learn at school. Mrs. Pepys imbibing
all this erudition from her husband, while her pretty little dog lies
snoring on the mat, forms a truly delightful picture, and no doubt our
imagination of it is no more delightful than the reality was three
hundred years ago. I suppose it was the same dog as he whose puppyish
indiscretions had led to many a fierce quarrel between husband and
wife; Pepys always carefully recorded these indiscretions, both of the
dog and, alas, of himself. It is clear that the sanitary conveniences
in Pepys’s house could not have been up to his requirements.
Husband and wife went everywhere together, and seem really to
have loved each other; the impression that I gather from Pepys’s
exceedingly candid description of her is that she was a loyal and
comradely wife, with a spirit of her own, and a good deal to put up
with; for though Pepys was continually--and causelessly--jealous of
her, yet he did not hold that he was in any way bound to be faithful
to her on his own side. So they pass through life, Pepys philandering
with every attractive woman who came his way, and Mrs. Pepys dressing
herself prettily, learning her little accomplishments, squabbling with
her maids, and looking after her house and his meals, till one day she
engaged a servant, Deb Willet by name, who brought a touch of tragedy
into the home. In November, 1668, Deb was combing Pepys’s hair--no
doubt in preparation for the immortal “perriwig”--when Mrs. Pepys came
in and caught him “embracing her,” thus occasioning “the greatest
sorrow to me that ever I knew in this world,” as he puts it.
Mrs. Pepys was “struck mute,” and was silently furious. Outraged Juno
towered over the unhappy Pepys, and so to bed without a word, nor slept
all night; but about two in the morning Juno became very woman; woke
him up and told him she had “turned Roman Catholique,” this being,
in the state of politics at that time, probably the thing which she
thought would hurt him more than anything else she could say. For
the next few days Pepys is sore troubled, and his usual genial babble
becomes almost incoherent. The wrong dating and the expressions of
“phrenzy” show the mental agony that he passed through, and there can
be no doubt that the joy of life passed out of him, probably never more
fully to return. The rest of the Diary is written in a style graver
than at first--some of it is almost passionate. He describes with much
mental agitation how he woke up in the middle of one night, and found
his wife heating a pair of tongs red-hot and preparing to pinch his
nose; gone for ever were the glad days when he could pull her nose, and
the “poor wretch” thought none the worse of the lordly fellow. Twice
had he done so, and, as he says, “to offend.” One would like to have
Mrs. Pepys’s account of this nose-pulling, and what she really thought
of it. Some people have found the struggle of Pepys to cure himself of
his infatuation for Deb humorous; to any ordinarily sympathetic soul
who reads how he prayed on his knees in his own room that God would
give him strength never again to be unfaithful, and how he appealed
again and again to his wife to forgive him, and how he, to the best
of his ability, avoided the girl, the whole business becomes rather
too painful to be funny, even though the unhappy man has the art of
making himself ridiculous in nearly every sentence. Finally, in a fury
of jealousy, she forced him to write a most insulting letter to Miss
Willet, a letter that no woman could ever possibly forgive, and Pepys’s
life appears to have settled down again. His sight failing him[9]--it
is thought that he suffered from hypermetropia combined with early
presbyopia--he abandoned the Diary just at the time when one would have
dearly liked to hear more; and we never hear the end either of Deb or
of their married happiness. Reading between the lines, one gathers
that probably Deb was more sinned against than sinning, and that Mrs.
Pepys had more real reason to be angry about many women of whom she
had never heard than about the young woman whose flirtation was the
actual _casus belli_. It is an unjust world. The two went abroad for
a six-months’ tour in France and Holland, and immediately after they
returned Mrs. Pepys fell ill of a fever; for a time she appears to
have fought it well, but she took a bad turn and died. Considering
her youth, the season of the year, and that they had just returned
from the Continent, the disease was possibly typhoid. Pepys erected an
affectionate memorial to her, and was later on buried by her side. He
took the last sacrament with her as she lay dying, so we may reasonably
suppose that she died having forgiven him, and it is not unfair to
imagine that the trip abroad was a second honeymoon. They were two
grown-up children, playing with life as with a new toy.
Mrs. Pepys was liable to attacks of boils in asterisks; and a Dr.
Williams acquired considerable merit by supplying her with plasters
and ointments. On November 16, 1663, “Mr. Hollyard came, and he and
I about our great work to look upon my wife’s malady, which he did,
and it seems her great conflux of humours heretofore that did use to
swell there did in breaking leave a hollow which has since gone in
further and further till it is now three inches deep, but as God will
have it did not run into the body-ward, but keeps to the outside of
the skin, and so he will be forced to cut open all along, and which
my heart will not serve me to see done, and yet she will not have no
one else to see it done, no, not even her mayde, and so I must do it
poor wretch for her.” Pepys is in a panic at the thought of assisting
at the opening of this subcutaneous abscess; one can feel the courage
oozing out at the palms of his hands as one reads his agitated words.
To his joy, next morning Mr. Hollyard, on second thoughts, “believes
a fomentation will do as well, and what her mayde will be able to do
as well without knowing what it is for, but only that it is for the
piles.” Evidently the “mayde’s” opinion was of some little moment in
Mrs. Pepys’s censorious world. Mr. Pepys would have been much troubled
to see his wife cut before his face: “he could not have borne to have
seen it.” Mr. Hollyard received £3 “for his work upon my wife, but
whether it is cured or not I cannot say, but he says it will never come
to anything, but it may ooze now and again.” Mr. Hollyard was evidently
easily satisfied. Of course, there must have been a sinus running in
somewhere, but it is impossible to guess at its origin. Possibly some
pelvic sepsis; possibly an ischio-rectal abscess. A long time before
he had noted that his wife was suffering from a “soare belly,” which
may possibly have been the beginning of the trouble, but there is no
mention of any long and serious illness such as usually accompanies
para-metric sepsis. On the whole, I fancy ischio-rectal abscess to
be the most likely explanation. Later on she suffers from abscesses
in the cheek, which “by God’s mercy burst into the mouth, thus not
spoiling her face”; and she had constant trouble with her teeth. It is
thus quite probable that the origin of the whole illness may have been
pyorrhœa, and no doubt this would go hard with her in the fever from
which she died. Possibly this may have been septic pneumonia arising
from septic foci in the mouth; but, after all, it is idle to speculate.
Mrs. Pepys never became pregnant during the period covered by the
Diary, though there were one or two false alarms. There is no
mention of any continuous or constant ill-health, such as we find in
pyo-salpinx or severe tubal adhesions; and such being the case, her
sterility may quite likely have been as much his fault as hers.