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.

I believe that the key to this extraordinary and confused narrative is to be found in the visit to Cæsar Hawkins thirty years before, when that competent surgeon was unable to satisfy himself as to whether he was dealing with a rupture or a hydrocele. It seems now clear that in reality it was both; and Gibbon, who was a corpulent man with a pendulous abdomen, lived for thirty years without taking care of it. But he lived very quietly; he took no exercise; he was a man of calm, placid, and unruffled mind; probably no man was less likely to be incommoded by a hernia, especially if the sac had a large wide mouth and the contents were mainly fat. But the time came when the intra-abdominal pressure of the growing omentum became too great, and the swelling enormously increased, first in 1787 and again in 1793. When Cline first tapped the swelling he was obviously aware that there was more present than a hydrocele, because he warned Gibbon that he would have to wear a truss afterwards, and moreover, though he removed four quarts of fluid, yet the swelling was only reduced by a half. Probably the soft irregular mass which he then left behind was simply omentum which had come down from the abdomen. But why did the swelling begin to grow again immediately? That is not the usual way with a hydrocele, whose growth and everything connected with it are usually indolently leisurely. Could there have been a malignant tumour in course of formation? But if so, would not that have caused more trouble? Nor would it have given the impression of being a soft irregular mass. However, the second tapping was longer and more painful than the first, though it removed less fluid; and Gibbon was more relieved. But this tapping was followed by inflammation. What had happened? Possibly Cline had found the epididymis; more probably his trochar was septic, like all other instruments of that pre-antiseptic period; at all events, the thing went from bad to worse, grew enormously, and severe constitutional symptoms set in. The ulceration and redness of the skin, which was no doubt filthy enough—surgically speaking—after thirty years of hydrocele, look uncommonly like suppurative epididymitis, or suppuration in the hydrocele. Thus Gibbon goes on for a few days, able to move about, though with difficulty, till he cheers up and seems to be recovering; then falls the axe, and he dies a few hours after saying that he thought he had a good chance of living for twenty years.

Could the great septic hydrocele, connected with the abdomen through the inguinal ring, have suddenly burst its bonds and flooded the peritoneum with streptococci? Streptococcic peritonitis is one of the most appalling diseases in surgery. Its symptoms to begin with are vague, and it spreads with the rapidity of a grass fire in summer. After an abdominal section the patient suddenly feels exceedingly weak, there is a little lazy vomiting, the abdomen becomes distended, the pulse goes to pieces in a few hours, and death occurs rapidly while the mind is yet clear. The surgeon usually calls it “shock,” or thinks in his own heart that his assistant is a careless fellow; but the real truth is that streptococci have somehow been introduced into the abdomen and have slain the patient without giving time for the formation of adhesions whereby they might have been shut off and ultimately destroyed. That is what I believe happened to Edward Gibbon.

The loss to literature through this untimely tragedy was, of course, irreparable. Gibbon had taken twenty years to mature his unrivalled literary art. His style was the result of unremitting labour and exquisite literary taste; if one accustoms oneself to the constant antitheses—which occasionally give the impression of being forced almost more for the sake of dramatic emphasis than truth—one must be struck with the unvarying majesty and haunting music of the diction, illumined by an irony so sly, so subtle—possibly a trifle malicious—that one simmers with joyous appreciation in the reading. That sort of irony is more appreciated by the onlookers than by its victims, and it is not to be marvelled at that religious people felt deeply aggrieved for many years at the application of it to the Early Christians. Yet, after all, what Gibbon did was nothing more than to show them as men like others; he merely showed that the evidence concerning the beginnings of Christendom was less reliable than the Church had supposed. The Decline and Fall of the Roman Empire shows the history of the world for more than a thousand years, so vividly, so dramatically, that the characters—who are great nations—move on the stage like actors, and the men who led them live in a remarkable flood of living light. The general effect upon the reader is as if he were comfortably seated in a moving balloon traversing over Time as over continents; as if he were seated in Mr. Wells’s “Time Machine,” viewing the disordered beginnings of modern civilization. I believe that no serious flaw in Gibbon’s history has been found, from the point of view of accuracy. Some people have found it too much a chronique scandaleuse, and some modern historians appear to consider that history should be written in a dull and pedantic style rather than be made to live; furthermore, the great advance in knowledge of the Slavonic peoples has tended to modify some of his conclusions. Nevertheless, Gibbon remains, and so far as we can see, will ever remain, the greatest of historians. Though we might not have had another Decline and Fall of the Roman Empire, yet we might reasonably have looked for the completion of that autobiography which had such a brilliant beginning. What would we not give if that cool and appraising mind, which had raised Justinian and Belisarius from the dead and caused them to live again in the hearts of mankind, could have given its impressions of the momentous period in which it came to maturity? If, instead of England receiving its strongest impression of the French Revolution from Carlyle—whose powers of declamation were more potent than his sense of truth—it had been swayed from the beginning by Gibbon? In such a case the history of modern England—possibly of modern Russia—might have been widely different from what we have already seen.

Jean Paul Marat

IT has always been the pride of the medical profession that its aim is to benefit mankind; but opinions may differ as to how far this aim was fulfilled by one of our most eminent confrères, Jean Paul Marat. He was born in Neufchatel of a marriage between a Sardinian man and a Swiss woman, and studied medicine at Bordeaux; thence, after a time at Paris, he went to London, and for some years practised there. In London he published A Philosophical Essay on Man, wherein he showed enormous knowledge of the English, German, French, Italian, and Spanish philosophers; and advanced the thesis that a knowledge of science was necessary for eminence as a philosopher. By this essay he fell foul of Voltaire, who answered him tartly that nobody objected to his opinions, but that at least he might learn to express them more politely, especially when dealing with men of greater brains than his own.

The French Revolution was threatening; the coming storm was already thundering, when, in 1788, Marat’s ill-balanced mind led him to abandon medicine and take to politics. He returned to Paris, beginning the newspaper L’Ami du Peuple, which he continued to edit till late in 1792. His policy was simple, and touched the great heart of the people. “Whatsoever things were pure, whatsoever things were of good repute, whatsoever things were honest”—so be it that they were not Jean Paul Marat’s, those things he vilified. He suspected everybody, and constantly cried, “Nous sommes trahis”—that battle-cry of Marat which remained the battle-cry of Paris from that day to 1914. By his violent attacks on every one he made Paris too hot to hold him, and once again retired to London. Later he returned to Paris, apparently at the request of men who desired to use his literary skill and violent doctrines; he had to hide in cellars and sewers, where it was said he contracted that loathsome skin disease which was henceforth to make his life intolerable, and to force him to spend much of his time in a hot-water bath, and would have shortly killed him only for the intervention of Charlotte Corday. In these haunts he was attended only by Simonne Everard, whose loyalty goes to show either that there was some good even in Marat, or that there is no man so frightful but that some woman may be found to love him. Finally, he was elected to the Convention, and took his seat. There he continued his violent attacks upon everybody, urging that the “gangrene” of the aristocracy and bourgeoisie should be amputated from the State. His ideas of political economy appear to have foreshadowed those of Karl Marx—that the proletariat should possess everything, and that nobody else should possess anything. Daily increasing numbers of heads should fall in the sacred names of Liberty, Fraternity, and Equality. At first a mere 600 would have satisfied him, but the number rapidly increased, first to 10,000, then to 260,000. To this number he appeared faithful, for he seldom exceeded it; his most glorious vision was only of killing 300,000 daily.

He devoted his energies to attacking those who appeared abler and better than himself, and the most prominent object of his hatred was the party of the Girondins. These were so called because most of them came from the Gironde, and they are best described as people who wished that France should be governed by a sane and moderate democracy, such as they wrongly imagined the Roman Republic to have been. They were gentle and clever visionaries, who dreamed dreams; they advised, but did not dare to perform; the most famous names which have survived are those of Brissot, Roland, and Barbaroux. Madame Roland, who has become of legendary fame, was considered their “soul”; concerning her, shouts Carlyle: “Radiant with enthusiasm are those dark eyes, is that strong Minerva-face, looking dignity and earnest joy; joyfullest she where all are joyful. Reader, mark that queen-like burgher-woman; beautiful, Amazonian-graceful to the eye; more so to the mind. Unconscious of her worth (as all worth is), of her greatness, of her crystal-clearness, genuine, the creature of Sincerity and Nature, in an age of Artificiality, Pollution and Cant”—and so forth. But Carlyle was writing prose-poetry, sacrificing truth to effect, and it is unwise to take his poetical descriptions as accurate. Recent researches have shown that possibly Manon Roland was not so pure, honest, and well-intentioned as Carlyle thought—nor so “crystal-clear.” Summed up, the Girondins represented the middle classes, and the battle was now set between them and the “unwashed,” led by Robespierre, Danton, and Marat.

What manner of man, then, was this Marat, physically? Extraordinary! Semi-human from most accounts. Says Carlyle: “O Marat, thou remarkablest horse-leech, once in d’Artois’ stable, as thy bleared soul looks forth through thy bleared, dull-acrid, woe-stricken face, what seest thou in all this?” Again: “One most squalidest bleared mortal, redolent of soot and horse-drugs.” There appears to have been a certain amount of foundation for the lie that Marat had been nothing more than a horse-doctor, for once when he was brevet-surgeon to the bodyguard of the Compte d’Artois he had found that he could not make a living, and had been driven to dispense medicines for men and horses; his enemies afterwards said that he had never been anything more than a horse-leech. Let us not deprive our own profession of one of its ornaments. His admirer Panis said that while Marat was hiding in the cellars, “he remained for six weeks on one buttock in a dungeon”; immediately, therefore, he was likened to St. Simeon Stylites, who, outside Antioch, built himself a high column, repaired him to the top, and stood there bowing and glorifying God for thirty years, until he became covered with sores. Dr. Moore gives the best description of him. “Marat is a little man of a cadaverous complexion, and countenance exceedingly expressive of his disposition; to a painter of massacres Marat’s head would be invaluable. Such heads are rare in this country (England), yet they are sometimes to be met with in the Old Bailey.” Marat’s head was enormous; he was less than five feet high, with shrivelled limbs and yellow face; one eye was higher placed than the other, “so that he looked lop-sided.” As for his skin disease, modern writers seem to consider that we should nowadays call it “dermatitis herpetiformis,” though his political friends artlessly thought it was due to the humours generated by excessive patriotism in so small a body attacking his skin, and thus should be counted for a virtue. Carlyle hints that it was syphilis, thus following in the easy track of those who attribute to syphilis those things which they cannot understand. But syphilis, even if painful, would not have been relieved by sitting for hours daily in a hot bath.

Mentally he appears to have been a paranoiac, to quote a recent historical diagnosis by Dr. Charles W. Burr, of Philadelphia. Marat suffered for many years from delusions of persecution, which some people appear to take at their face value; the New Age Encyclopedia specially remarks on the amount of persecution that he endured—probably all delusional, unless we are to consider the natural efforts of people in self-defence to be persecution. He suffered from tremendous and persistent “ego-mania,” and appears to have believed that he had a greater intellect than Voltaire. Marat, whom the mass of mankind regarded with horror, fancied himself a popular physician, whom crowds would have consulted but for the unreasonable and successful hatred of his enemies. Possibly failure at his profession, combined with the unspeakable irritation of his disease, may have embittered his mind, and for the last few months of his life there can be little doubt that Marat was insane.