More than is the case with most medical
patients, however, should we suspect Smollett of being unduly
captious. The point as to how far his sketch of the French doctor
and his diagnosis was a true one, and how far a mere caricature,
due to ill health and prejudice, has always piqued my curiosity.
But how to resolve a question involving so many problems not of
ordinary therapeutic but of historical medicine! In this
difficulty I bethought me most fortunately of consulting an
authority probably without a rival in this special branch of
medical history, Dr. Norman Moore, who with his accustomed
generosity has given me the following most instructive diagnosis
of the whole situation.
"I have read Smollett's account of his illness as it appears in
several passages in his travels and in the statement which he
drew up for Professor 'F.' at Montpellier.
"Smollett speaks of his pulmonic disorder, his 'asthmatical
disorder,' and uses other expressions which show that his lungs
were affected. In his statement he mentions that he has cough,
shortness of breath, wasting, a purulent expectoration, loss of
appetite at times, loss of strength, fever, a rapid pulse,
intervals of slight improvement and subsequent exacerbations.
"This shortness of breath, he says, has steadily increased. This
group of symptoms makes it certain that he had tuberculosis of
the lungs, in other words, was slowly progressing in consumption.
"His darting pains in his side were due to the pleurisy which
always occurs in such an illness.
"His account shows also the absence of hopelessness which is a
characteristic state of mind in patients with pulmonary
tuberculosis.
"I do not think that the opinion of the Montpellier professor
deserves Smollett's condemnation. It seems to me both careful and
sensible and contains all the knowledge of its time. Smollett,
with an inconsistency not uncommon in patients who feel that they
have a serious disease, would not go in person to the Professor,
for he felt that from his appearance the Professor would be sure
to tell him he had consumption. He half hoped for some other view
of the written case in spite of its explicit statements, and when
Professor F - wrote that the patient had tubercles in his lungs,
this was displeasing to poor Smollett, who had hoped against hope
to receive - some other opinion than the only possible one, viz.,
that he undoubtedly had a consumption certain to prove fatal."
The cruel truth was not to be evaded. Smollett had tuberculosis,
though not probably of the most virulent kind, as he managed to
survive another seven years, and those for the most part years of
unremitting labour. He probably gained much by substituting Nice
for Montpellier as a place to winter in, for although the climate
of Montpellier is clear and bright in the highest degree, the
cold is both piercing and treacherous.
