a little more of her side of the questions that arose. What did she
really think of her husband when he pulled her nose? Twice, too, no
less! Stevenson calls her “a vulgar woman.” Stevenson’s opinion on
every matter is worthy of the highest respect, as that of a sensitive,
refined, and artistic soul; but I cannot help thinking that sometimes
his early Calvinistic training tended to make him rather intolerant
to human weakness. His judgment of François Villon always seems to me
intolerant and unjust, and he showed no sign in his novels of ever
having made any effort to comprehend the difficulties and troubles
which surround women in their passage through the world. He understood
men--there can be no doubt of that; but I doubt if he understood
women even to the small extent which is achieved by the average man.
Personally I find Mrs. Pepys far from “vulgar”; generally she is simply
delightful. True, one cannot concur with her action over the letter to
Deb. It was cruel and ungenerous. But she probably knew her husband
well by that time, and judged fairly accurately the only thing that
would be likely to bring him up with a round turn, and again we have
not the privilege of knowing Deb except through Pepys’s possibly too
favourable eyes. Deb may have been all that Mrs. Pepys thought her,
and she may have richly deserved what she got. After all, there is
in every woman protecting her husband from the onslaughts of “vamps”
not a little of the wild-cat. Even the gentlest of women will defend
her husband--especially a husband who retains so much of the boy as
Pepys--from the attempts of wicked women to steal him, poor innocent
love, from her sacred hearth; will defend him with bare hands and
claws, and totally regardless of the rules of combat; and it is this
touch of cattishness in Mrs. Pepys which makes one’s heart warm
towards her. For all we know Deb Willet may have been a “vamp.” Mrs.
Pepys was certainly the “absolute female.”
Mr. Pepys suffered from stone in the bladder before he began to keep
a diary. He does not appear to have been physically a hero; had he
been a general, no doubt he would have led his army bravely from the
rear except in case of a retreat; but so great was the pain that he
submitted his body to the knife on March 26, 1658. Anæsthetics in
those days were rudimentary, relaxing rather than anæsthetizing the
patient. There is some reason to believe that they were extensively
used in the Middle Ages, and contemporaries of Shakespeare seem to have
looked on their use as a matter of course; but for some reason they
became less popular, and by the seventeenth century most people had to
undergo their operations with little assistance beyond stout hearts and
sluggish nervous systems.
Cutting for the stone was one of the earliest of surgical operations.
In ancient days it was first done in India, and the glad news that
stones could be successfully removed from the living body filtered
through to the Greeks some centuries before Christ. Hippocrates knew
all about it, and the operation is mentioned in that Hippocratic oath
according to which some of us endeavour to regulate our lives. At first
it was only done in children, because it was considered that adult
men would not heal properly, and the only result in them would be a
fistula. The child was held on the lap of some muscular assistant, with
one or two not less muscular men holding its arms and legs. The surgeon
put one or two fingers into the little anus and tried to push the
stone down on to the perineum, helped in this manœuvre by hypogastric
pressure from another assistant. He then cut transversely above the
anus, strong in the faith that he might, if the gods willed, open into
the neck of the bladder. Next he tried to push out the stone with his
fingers still in the anus; it is not quite clear whether he would take
his fingers out of the anus and put them into the wound or vice versa;
this failing, he would seize the stone with forceps and drag it through
the perineum. As time went on it was discovered that more than three or
four assistants could be employed, using others to sit on the patient’s
chest, thus adding the _peine forte et dure_ to the legitimate terrors
of ancient surgery and surrounding him with a mass of men. Imbued with
a spirit of unrest by the struggles of the patient the mass swayed
this way and that, until it was discovered that by adding yet more
valiants to the wings of the “scrum,” who should answer heave with
counter-heave, the resultant of the opposing forces would hold even the
largest perineum steady enough for the surgeon to operate; and men came
under the knife for stone. Next the patient was tied up with ropes,
somewhat in the style we used in our boyhood’s sport of cock-fighting.
What a piece of work is the Rope! How perfect in all its works--from
the Pyramids--built with the aid of the Rope and the Stick--to the
execution of the latest murderer. One might write pages on the
influence of the Rope on human progress; but for our purpose we may
simply say that probably Mr. Pepys was kept quiet with many yards of
hemp. Those who cut for the stone were specialists, doing nothing else;
their arrival at a patient’s house must have resembled an invasion,
with their vast armamentarium and crowds of assistants. By Pepys’s time
Marianus Sanctus had lived--yes, so greatly was he venerated that they
called him “Sanctus,” the Holy Man; Saint Marianus if you will. He it
was, in Italy in 1524, who invented the apparatus major, which made
the operation a little less barbarous than that of the Greeks. This
God-sent apparatus consisted mainly of a grooved staff to be shoved
into the bladder and a series of forceps. You cut on to the staff as
the first step of the operation; it was believed that if you cut in
the middle line in the raphe the wound would never heal, owing to the
callosity of the part; moreover, if you carried your incision too far
back you would cause fatal hæmorrhage from the inferior hæmorrhoidal
veins. Having, then, made your incision well to the right or left, you
exposed the urethra, made a good big hole in that pipe, and inserted a
fine able pair of tongs, with which you seized hold of the stone and
crushed it if you could, pulling it out in bits; or if the stone were
hard, and you had preternaturally long fingers, you might even get
it out on a finger-tip. It was always considered the mark of a wise
surgeon to carry a spare stone with him in his waistcoat pocket, so
that the patient might at least have a product of the chase to see if
the surgeon should find his normal efforts unrewarded. Diagnosis was
little more advanced in those days than operative surgery; there are
numbers of conditions which may have caused symptoms like those of a
stone, and it was always well for the surgeon to be prepared.
This would be the operation that was performed on Mr. Pepys. The
results in many cases were disastrous; some men lost control of their
sphincter vesicæ; many were left with urinary fistulæ; in many the
procreative power was permanently destroyed by interference with the
seminal vesicles and ducts. Probably some of us would prefer to keep
our calculi rather than let a mediæval stone-cutter perform upon us; we
are a degenerate crew. It is not altogether displeasing to imagine the
roars of the unhappy Pepys, trussed and helpless, a pallid little Mrs.
Pepys quaking outside the door, perhaps not entirely sorry that her own
grievances were being so adequately avenged, although the vengeance was
vicarious; while the surgeon wrestled with a large uric acid calculus
which could with difficulty be dragged through the wound. It is all
very well for us to laugh at the forth-right methods of our ancestors;
but, considering their difficulties--no anæsthesia, no antiseptics,
want of sufficient surgical practice, and the fact that few could
ever have had the hardness of heart necessary to stand the patient’s
bawlings, it is remarkable that they did so well and that the mortality
of this appalling operation seems only to have been from 15 to 20 per
cent. Moreover we may be pretty sure that no small stone would ever
be operated upon; men postponed the operation until the discomfort
became intolerable. It remained for the genius of Cheselden, when Pepys
was dead and possibly in heaven some twenty years, to devise the
operation of lateral lithotomy, one of the greatest advances ever made
in surgery. This operation survived practically unchanged till recent
times.
Pepys’s heroism was not in vain, and was rewarded by a long life free
from serious illness till the end. March 26 became to him a holy day,
and was kept up with pomp for many years. The people of the house
wherein he had suffered and been strong were invited to a solemn feast
on that blessed day, and as the baked meats went round and the good
wine glowed in the decanters, Mr. Pepys stood at his cheer and once
again recounted the tale of his agony and his courage. Nowadays, when
we are operated upon with little more anxiety than we should display
over signing a lease, it is difficult to imagine a state of things such
as must have been inevitable in the days before Simpson and Lister.
The stone re-formed, but not in the bladder. Once you have a uric
acid calculus you can never be quite sure you have done with it until
you are dead, and in the case of Mr. Pepys recurrence took place
in the kidney. When he died, an old man, in 1703, they performed a
post-mortem examination on his body, suspecting that his kidneys
were at fault, and in the left kidney found a nest of no less than
seven stones, which must have been silently growing in the calyces
for unnumbered years. Nor does it seem to me impossible that his
extraordinary incontinence--he never seems to have been able to resist
any feminine allurement, however coarse--may really have been due to
the continued irritation of the old scar in his perineum. There is
often a physical condition as the basis for this type of character, and
some trifling irritation may make all the difference between virtue and
concupiscence. This reasoning is probably more likely to be true than
much of the psycho-analysis which is at present so fashionable among
young ladies. Possibly also the sterility of Mrs. Pepys may have been
partly due to the effects of the operation upon her husband.
One unpleasant result to Mr. Pepys was the fact that whenever
he crossed his legs carelessly he became afflicted with a mild
epididymitis--he describes it much less politely himself, doubtless in
wrath. His little failing in this respect must have been a source of
innocent merriment to the many friends who were in the secret. He was
also troubled with attacks of severe pain whenever the weather turned
suddenly cold. At first he used to be in terror lest his old enemy had
returned, but he learned to regard the attacks philosophically as part
of the common heritage of mankind, for man is born to trouble as the
sparks fly upward. Probably they were due to reflex irritation from the
stones growing in the kidney. He does not seem to have passed any small
stones per urethram, or he would assuredly have told us. He took great
interest in his own emunctories--probably other people’s, too, from
certain dark sayings.
Considering the by no means holy living of Mr. Pepys, it is rather
remarkable that he never seems to have suffered from venereal disease,
and this leads me to suspect that possibly these ailments were not
so common in the England of the Restoration as they are to-day. It
seems impossible that any man could live in Sydney so promiscuously
as Mr. Pepys without paying the penalty; and the experience of our
army in London seems to show that things there must be much the same
as here (Sydney). I often wonder whether Charles II and his courtiers
were really representative of the great mass of people in England
at that time; probably the prevalence of venereal disease in modern
times is due to the enormous increase in city life; probably men
and women have always been very much the same from generation to
generation--inflammable as straw, given the opportunities which occur
mainly in cities and crowded houses.
Ignoble as was Pepys, he yet showed real moral courage during the
Plague. When that great enemy of cities attacked London he, very
wisely, sent his family into the country at Woolwich, while he remained
faithful to his duty and continued to work at the navy in Greenwich,
Deptford, and London. I cannot find in the Diary any mention of any
particular attraction that kept him in London during those awful five
months; he would, no doubt, have mentioned her name if there had been
such; yet candour compels me to observe that there was seldom any one
attraction for Mr. Pepys, unless poor Deb Willet may have somehow
mastered--temporarily--his wayward heart. But, as might have been
expected, he was little more virtuous during his wife’s absence than
before; indeed, possibly the imminent danger of death may have led him
to enjoy his life while yet he might, with his usual fits of agonized
remorse, whose effects upon his conduct were brief. We owe far more
to his organizing power and honesty--not a bigoted variety--than is
generally remembered. His babble is not the best medium for vigorous
description, and you will not get from Pepys any idea of the epidemic
comparable with that which you will get from the journalist Defoe;
yet through those months there lurks a feeling of horror which still
impresses mankind. The momentary glimpse of a citizen who stumbles over
the “corps” of a man dead of the plague, and running home tells his
pregnant wife; she dies of fear forthwith; a man, his wife, and three
children dying and being buried on one day; persons quick to-day and
dead to-morrow--not in scores, but in hundreds; ten thousand dying in a
week; the horrid atmosphere of fear and suspicion which overlay London;
and Pepys himself setting his papers in order, so that men might think
well of him should it please the Lord to take him suddenly: all give
us a sense of doom all the more poignant because recently we went
through a much milder version of the same experience ourselves. The
papers talked glibly of the influenza as “The Plague.” How different
it was from the real bubonic plague is shown by the statistics. In
five months of 1665 there died of the plague in the little London of
that day no less than about 70,000 people, according to the bills of
mortality; in truth, probably far more; that is to say, probably a
fifth of the people perished. There is no doubt that the bubonic plague
kept back the development of cities, and therefore of civilization,
for centuries, and that the partial conquest of the rat has been one
of the greatest achievements of the human race. What is happening in
Lord Howe Island, where it is exceedingly doubtful whether rats or men
shall survive in that beautiful speck of land, shows how slender is the
hold which mankind has upon the earth; and wherever the rat is able to
breed unchecked, man is liable to sink back into savagery. The rat,
the tubercle bacillus, and the bacillus of typhoid are the three great
enemies of civilization; we hold our position against them at the price
of eternal vigilance, and probably the rat is not the least deadly of
these enemies.
I need not go through the Diary in search of incidents; most of them,
while intensely amusing, are rather of interest to the psychologist
in the study of self-revelation than to the medical man. When Pepys’s
brother lay dying the doctor in charge hinted that possibly the trouble
might have been of syphilitic origin; Pepys was virtuously wrathful,
and the unhappy doctor had to apologize and was forthwith discharged.
I cannot here narrate how they proved that the unhappy patient had
never had syphilis in his life; you must read the Diary for that. Their
method would not have satisfied either Wassermann or Bordet. Another
time Pepys was doing something that he should not have been doing at
an open window in a draught; the Lord punished him by striking him
with Bell’s palsy. Still again, at another time he got something that
seems to have resembled pseudo-ileus, possibly reflex from his latent
calculi. Everybody in the street was much distressed at his anguish;
all the ladies sent in prescriptions for enemata; the one which
relieved him consisted of small beer! Indeed, one marvels always at
the extraordinary interest shown by Pepys’s lady-friends in his most
private ailments. London must have been a friendly little town in the
seventeenth century, in the intervals of hanging people and chopping
off heads.
But the great problem remains: Why did Pepys write down all these
intimate details of his private life? Why did he confess to things
which most men do not confess even to themselves? Why did he write
it all down in cypher? Why, when he narrated something particularly
disgraceful, did he write in a mongrel dialect of bad French, Italian,
Spanish, and Latin? He could not have seriously believed that a person
who was able to read the Diary would not be able to read the very
simple foreign words with which it is interspersed. Most amazing of
all: Why did he keep the manuscript for more than thirty years, a
key with it? One thinks of the fabled ostrich who buries his head in
the sand. The problem of Pepys still remains unsolved, in spite of
the efforts of Stevenson in _Familiar Studies of Men and Books_.
Stevenson was the last man in the world to understand Pepys, but more
competent exegetists have tried and failed. One can only say that
his failing sight--which Professor Osborne of Melbourne attributes
to astigmatism--has deprived the world of a treasure that can never
be sufficiently regretted. No man can be considered educated who has
not read at least part of the Diary; in no other way is it possible
to get so vivid a picture of the ordinary people of a past age; as we
read they seem to live before us, and it comes as a shock to remember
that poor Pall Pepys--his plain sister--and “my wife” and Mrs.
Batelier--“my pretty valentine”--and Sir William Coventry and Mercer,
and the hundreds more who pass so vividly before us, are all dead these
centuries.
If this little paper shall send some to the reading of this most
extraordinary book, I shall be more than satisfied. The only edition
which is worth while is Wheatley’s, in ten volumes, with portraits and
a volume of _Pepysiana_. The smaller editions are apt to transmute
Pepys into an ordinary humdrum and industrious civil servant.
Edward Gibbon
For many years it has been taught--I have taught it myself to
generations of students--that Gibbon’s hydrocele surpassed in greatness
all other hydroceles, that it contained twelve pints of fluid, and that
it was, in short, one of those monstrous things which exist mainly
in romance; one of those chimeras which grow in the minds of the
half-informed and of those who wish to be deceived. For a brief moment
this chimera looms its huge bulk over serious history; it is pricked;
it disappears for ever, carrying with it into the shades the greatest
of historians, perhaps the greatest of English prose writers. What do
we really know about it?
The first hint of trouble given by the hydrocele occurs in a letter by
Gibbon to his friend Lord Sheffield. It is so delicious, so typical
of the eighteenth century, of which Gibbon himself was probably the
most typical representative, that I cannot resist re-telling it. Two
days before, he has hinted to his friend that he was rather unwell;
now he modestly draws the veil. “Have you never observed, through my
inexpressibles, a large prominency _circa genitalia_, which, as it
was not very painful and very little troublesome, I had strangely
neglected for many years?” “A large prominency _circa genitalia_” is
a variation on the “lump in me privits, doctor,” to which we are more
accustomed. Gibbon’s is the more graceful, and reminds us of the mind
which had described chivalry as the “worship of God and the ladies”;
the courteous and urbane turn of speech which refuses to call a spade a
spade lest some polite ear may be offended.
Gibbon had been staying at Sheffield House in the preceding June--the
letter was written in November--and his friends all noted that “Mr.
G.” had become strangely loath to take exercise and very inert in
his movements. Indeed, he had detained the house-party in the house
during lovely days together while he had orated to them on the folly of
unnecessary exertion; and such was his charm that every one, both women
as well as men, seems to have cheerfully given up the glorious English
June weather to keep him company. Never was he more brilliant--never a
more delightful companion; yet all the time he was like the Spartan boy
and the wolf, for he knew of his secret trouble, yet he thought that no
one else suspected. It is an instance of how little we see ourselves as
others see us that this supremely able man, who could see as far into
a millstone as anyone, lived for years with a hydrocele that reached
below his knees while he wore the tight breeches of the eighteenth
century and was in the fond delusion that nobody else knew anything
about it. Of course, everybody knew; probably it had been the cause of
secret merriment among all his acquaintance; when the tragedy came to
its last act it turned out that every one had been talking about it all
the time, and that they had thought it to be a rupture about which Mr.
Gibbon had of course taken advice.
After leaving Sheffield House the hydrocele suddenly increased, as
Gibbon himself says, “most stupendously”; and it began to dawn upon
him that it “ought to be diminished.” So he called upon Dr. Walter
Farquhar; and Dr. Farquhar was very serious and called in Dr. Cline,
“a surgeon of the first eminence,” both of whom “viewed it and palped
it” and pronounced it a hydrocele. Mr. Gibbon, with his usual good
sense and calm mind, prepared to face the necessary “operation” and a
future prospect of wearing a truss which Dr. Cline intended to order
for him. In the meantime he was to crawl about with some labour and
“much indecency,” and he prayed Lord Sheffield to “varnish the business
to the ladies, yet I am much afraid it will become public,” as if
anything could any longer conceal the existence of this monstrous
chimera. It is hardly credible, but Gibbon had had the hydrocele
since 1761--thirty-two years--yet had never even hinted of it to
Lord Sheffield, with whom he had probably discussed every other fact
connected with his life; and had even forbidden his valet to mention it
in his presence or to anyone else. Gibbon, the historian who, more than
any other, set Reason and Common Sense on their thrones, seems to have
been ashamed of his hydrocele. Once more we wonder how little even able
men may perceive the truth of things! In 1761 he had consulted Cæsar
Hawkins, who apparently had not been able to make up his mind whether
it was a hernia or a hydrocele. In 1787 Lord Sheffield had noticed a
sudden great increase in the size of the thing; and in 1793, as we have
seen, it came to tragedy.
He was tapped for the hydrocele on November 14; four quarts of fluid
were removed, the swelling was diminished to nearly half its size,
and the remaining part was a “soft irregular mass.” Evidently there
was more there than a simple hydrocele, and straightway it began to
refill so rapidly that they had to agree to re-tap it in a fortnight.
Mr. Cline must have felt anxious; he would know “how many beans make
five” well enough, and his patient was the most distinguished man
in the world. Many students who have at examinations in clinical
surgery wrestled with Cline’s splint will probably consider that
Cline’s punishment for inventing that weapon really began on the day
when he perceived Gibbon’s hydrocele to be rapidly re-filling. The
fortnight passed, and the second tapping took place, “much longer, more
searching, and more painful” than before, though only three quarts of
fluid were removed; yet Mr. Gibbon said he was much more relieved than
by the first attempt. Thence he went to stay with Lord Auckland at a
place called Eden Farm; thence again to Sheffield House. There, in the
dear house which to him was a home, he was more brilliant than ever
before. It was his “swan song.” A few days later he was in great pain
and moved with difficulty, the swelling again increased enormously,
inflammation set in, and he became fevered, and his friends insisted
on his return to London. He returned in January, 1794, reaching his
chambers after a night of agony in the coach; and Cline again tapped
him on January 13. By this time the tumour was enormous, ulcerated and
inflamed, and Cline got away six quarts. On January 15 he felt fairly
well except for an occasional pain in his stomach, and he told some of
his friends that he thought he might probably live for twenty years.
That night he had great pain, and got his valet to apply hot napkins to
his abdomen; he felt that he wished to vomit. At four in the morning
his pain became much easier, and at eight he was able to rise unaided;
but by nine he was glad to get back into bed, although he felt, as
he said, _plus adroit_ than he had felt for months. By eleven he was
speechless and obviously dying, and by 1 p.m. he was dead.