In the morning (18th) a consultation was proposed, to which Dr. Lucca Vaga and Dr. Freiber, my assistant, were invited. Our opinions were divided. Bruno and Lucca proposed having recourse to antispasmodics and other remedies employed in the last stage of typhus. Freiber and I maintained that such remedies could only hasten the fatal termination; that nothing could be more empirical than flying from one extreme to the other; that if, as we all thought, the complaint was owing to the metastasis of rheumatic inflammation, the existing symptoms only depended on the rapid and extensive progress it had made in an organ previously so weakened and irritable. Antiphlogistic means could never prove hurtful in this case; they would become useless only if disorganization were already operated; but then, when all hopes were fled, what means would not prove superfluous?
We recommended the application of numerous leeches to the temples, behind the ears, and along the course of the jugular vein, a large blister between the shoulders, and sinapisms to the feet. These we considered to be the only means likely to succeed. Dr. Bruno, however, being the patient’s physician, had, of course, the casting vote, and he prepared, in consequence, the antispasmodic potion which he and Dr. Lucca had agreed upon. It was a strong infusion of valerian with ether, etc. After its administration the convulsive movements and the delirium increased; yet, notwithstanding my earnest representations, a second dose was administered half an hour after; when, after articulating confusedly a few broken phrases, our patient sank into a comatose sleep, which the next day terminated in death.
Lord Byron expired on the 19th of April, at six o’clock in the afternoon. Interesting as every circumstance relative to the death of so celebrated a person may prove to some, I should, nevertheless, have hesitated in obtruding so much medical detail on the patience of the reader, had not the accounts published by Dr. Bruno in the Westminster Review, and many of the newspapers, rendered it necessary that I should disabuse the friends of the deceased; and at the same time vindicate my own professional character, on which the imputation has been laid of my having been the cause of Lord Byron’s death by putting off, during four successive days, the operation of bleeding.
I must first observe that, not knowing a syllable of English, although present at the conversation I had with Lord Byron, Dr. Bruno could neither understand the force of the language I employed to surmount his lordship’s deep-rooted prejudice and aversion for bleeding, nor the positive refusals he repeatedly made before I could obtain his promise to consent to the operation. Yet he boldly states that I spoke to Lord Byron in a very undecided manner of the benefits of such an operation, and that I even ventured to recommend procrastination; and these, he says, are the reasons that induced him to consent to the delay—as if he were himself indifferent to such treatment, or as if a few words from me were sufficient to determine him! Conduct like this it is not difficult to appreciate: I shall therefore forbear abandoning myself to the indignation such a falsehood might naturally excite; nor shall I repel his unwarrantable accusation by relating the causes of that deep-rooted jealousy which Dr. Bruno entertained against me from the day he perceived the preference which Lord Byron indicated in favour of English physicians. This narrow-minded, envious feeling, as I could prove, prevented him from insisting on immediately calling me, or other medical men at Missolonghi, to a consultation. Had he done so, he would have exonerated himself from every responsibility; but his vanity made him forget the duty he owed to his patient, and even to himself. For I did not see Lord Byron (medically) till I was sent for by his lordship himself, without any participation on the part of Dr. Bruno. I can refute Dr. Bruno’s calumnies, not only from the testimony of others, but even from his own. For the following extract from the article published in the Telegrapho Greco, announcing the death of Lord Byron, was at the request of Count Gamba (himself a witness of whatever took place during the fatal illness of his friend) composed by the doctor:
‘Notwithstanding the most urgent entreaties and representations of the imminent danger attending his complaint made to him from the onset of his illness, both by his private physician and the medical man sent by the Greek Committee, it was impossible to surmount the great aversion and prejudice he entertained against bleeding, although he lay under imperious want of it’ (Vide Telegrapho Greco, il di 24 Aprile, 1824).
As to the assertion confidently made by Dr. Bruno, that, had his patient submitted at the onset of his malady to phlebotomy, he would have infallibly recovered, I believe every medical man who maturely considers the subject will be led to esteem this assertion as being founded rather on presumption than on reason. Positive language, which is in general so misplaced in medical science, becomes in the present case even ridiculous; for, if different authors be consulted, it will appear that the very remedy which is proclaimed by some as the anchor of salvation, is by others condemned as the instrument of ruin. Bleeding (as many will be found to assert) favours metastasis in rheumatic fevers; and, in confirmation of this opinion, they will remark that in this case, as soon as the lancet was employed, the cerebral symptoms manifested themselves on the disappearance of the rheumatic; while those who incline to Dr. Reid’s and Dr. Heberden’s opinion will observe that, after each successive phlebotomy, the cerebral symptoms not only did not remain at the same degree, but that they hourly went on increasing. In this dilemmatic position it is evident that, whatever treatment might have been adopted, detractors could not fail to have some grounds for laying the blame on the medical attendants. The more I consider this difficult question, however, the more I feel convinced that, whatsoever method of cure had been adopted, there is every reason to believe that a fatal termination was inevitable; and here I may be permitted to observe, that it must have been the lot of every medical man to observe how frequently the fear of death produces it, and how seldom a patient, who persuades himself that he must die, is mistaken. The prediction of the Scotch fortune-teller was ever present to Lord Byron, and, like an insidious poison, destroyed that moral energy which is so useful to keep up the patient in dangerous complaints. ‘Did I not tell you,’ said he repeatedly to me, ‘that I should die at thirty-seven?’
There is an entry in Millingen’s ‘Memoirs of Greece’ which has not received the attention it deserves—namely, a request made by Byron on the day before his death. It is given by Millingen in the following words:
‘One request let me make to you. Let not my body be hacked, or be sent to England. Here let my bones moulder. Lay me in the first corner without pomp or nonsense.’
After Byron’s death Millingen informed Gamba of this request, but it was thought that it would be a sacrilege to leave his remains in a place ‘where they might some day become the sport of insulting barbarians.’