Edward Gibbon was less fortunate. I’ve just read “Decline and Fall of an Author,” an essay published in the journal Australian Doctor in 2006. The writer is Dr. Jim Leavesley, a retired GP and medical historian in Australia who describes two of Gibbon’s many ailments, gout and a massive hydrocele. The historian was notably obese and sedentary. In 1772, at the age of thirty-five, Gibbon developed what he called “a dignified disorder” – gout, which Leavesley describes as “a malady as widespread and significant to 18th-century gentlemen as is coronary thrombosis in the 21st century.” In his Flesh in the Age of Reason (2003), Roy Porter writes:
“Gout, of course, is a story in itself, being the keynote malady of eighteenth-century gentlemen and men of letters, the lord of diseases and the disease of lords, one of those rare afflictions it was a positive ‘honour’ to acquire, it being a mark of good family and fine living.”
The attacks of gout, agonizingly painful, grew frequent and plagued Gibbon while he was writing The History of the Decline and Fall of the Roman Empire. There was no effective treatment for the disease. Gibbon treated it with Madeira. Despite the pain, he was proud of his gout. The condition that would eventually kill him was the hydrocele – a swelling of the scrotum caused by an accumulation of fluid around the testicles. He first noticed it at age twenty-four, while serving in the Hampshire militia. Porter writes:
“Gibbon was obviously ashamed about that particular protuberance. It grew bigger and bigger and, as contemporaries noted, he pretended to be unaware of it—though it drew attention to itself not only on account of its magnitude, but because it interfered with urination: he reeked and his presence became disagreeable.”
How humiliating and how human for this paragon of the Enlightenment and master of English prose. None of us is always rational. All of us conveniently delude ourselves. On Nov. 11, 1793, Gibbon wrote to Lord Sheffield: “Have you never observed through my inexpressibles a large prominency circa genitalia, which, as it was not at all painful and very little troublesome, I had strangely neglected for many years?”
Sheffield acted quickly and took Gibbon to see Dr. Henry Cline, a prominent surgeon. Leavesley writes: “He removed 4.5L of fluid on 14 November 1793, reducing the swelling by half. Two weeks later 3.4L were evacuated. Within a few days the hydrocele was painful, ulcerated and a fever set in. But on 13 January 1794, 6.8L were withdrawn, making a grand total of 14.7L.” For American readers, that's almost four gallons. Gibbon collapsed and died on Jan. 16, 1794. He was fifty-seven. Porter writes that Gibbon was “a man publicly happy to ignore his mortal coil. There is no immortal soul -- and no tears are lost over that. There remains nevertheless a hope of immortality through ‘literary fame.’ He would not go to heaven . . . But his books might last . . . His mind will thus live on."
A footnote: Some twenty years later, John Keats would attend lectures at Guy’s Hospital in London given by Dr. Cline.