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Samuel Pepys and His Diary: a Digression, Mainly Medical

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Samuel Pepys and His Diary: a Digression, Mainly Medical SAMUEL PEPYS AND HIS DIARY: A DIGRESSION, MAINLY MEDICAL. H. S. CARTER, m.d., d.p.h. ' Ill a recently published essay appropriately entitled Feuestralia,' Sir Max Beerbohm has allowed his fancy to play agreeably for a few minutes on the subject of windows ; on windows as frames for those looking out, from the mother of Sisera peering through her lattice to Gladstone orating vehemently from the window of a railway carriage ; and on windows through which one may gaze at the world and the human spectacle, as on a play framed in the confines of a stage. Sir Max has always been fond of windows. Zuleika Dobson saw from her window the ' ' upturned and moonlit face of the Duke of Dorset just before she temporarily extinguished that nobleman with a well-aimed cascade of water : and most of Max's drawings are surely pictures seen through the window of his mind's eye which has a defining power sharply illuminating character or episode to the point of criticism. Magic casements ! Samuel Pepys, who as a boy saw Charles I. executed in Whitehall, leaned out of one and wrote down what he saw. He did more, for he turned his head and described for us naively the privacies of his own halls and apartments. Whoever is well acquainted with the diary of Samuel Pepys, and more so who, through Mr. Arthur Bryant's recent studies, also knows something of Pepys' later life, has seen a period of history unveiled ; has seen the observant Clerk of the Acts leaning from his seventeenth century window, and has had unrolled for him a panorama of the contemporary scene. He has had a view of the latter half of the seventeenth century, and for the nine and a half years of the Diary, window-seat pictures of the whole fascinating scene vividly recorded by Pepys from his point of vantage with garrulous persistence, considerable artistry, uninhibited comment and amazing self-revelation. Pepys was an acute observer and avid of the life around him. Here is a picture worthy of a painter, one only of many. On May-day, 1667, Pepys is 011 his way from his house in Seething Ivane to Westminster, when he sees ' Nell Gwynn : Thence to Westminster, in the way meeting many milk- maids with their garlands upon their pails, dancing with a fiddler before them : and saw pretty Nelly standing at her lodgings' door in Drury Lane in her smock sleeves and bodice looking upon one : she seemed a mighty ' pretty creature.' The old house in Drury Iyane, once the Cock and Magpie,' where Nell Gwynn was supposed to have lived was pulled down only in 1891. 212 PEPYS' DIARY?CARTER 213 Pepys had an insatiable curiosity and delighted in the company of men of learning as became one who afterwards was President of the Royal Society. Naturally, having been himself successfully cut for the stone and ever afterwards piously keeping the anniversary, he was interested in things medical as he was in everything else, and he set down in unvarnished language?veiled sometimes in the published version of his Diary by asterisks?accounts of his own and his wife's ailments, not neglecting intimate details ; of the illnesses and medical histories of his relatives, friends and acquaintances ; and occasionally of the state of the public health, for he lived through the Great Plague of 1665. MR. PEPYS. The medical matters of prime interest in the Diary are those relating to Mr. and Mrs. Pepys, and were long ago dealt with (d'Arcy Power, 1895, 1904, 1911), in the light of material then available. d'Arcy Power consulted Wheatley, the editor of the best edition of the Diary, and received some information about the suppressed passages. Lately (Bryant, 1935) we have a further account by Pepys in the form of a general survey of his life's ailments and the state of his health in his 45tli year, not previously published, in which he describes his eye trouble, his lithiasis, naso-pharyngeal catarrh, wind-colic and what Bryant calls ' scurvy, which manifested itself in shortness of breath, constant pain in ' the legs and joints, swellings of the thighs in wet weather and retching ' and spitting and loss of voice.' Pepys says he cannot remember his life without pain from the stone in his kidneys, with haematuria, until he was about 20 years old, when after drinking copiously of water on a hot summer's day in Cambridge, he had some days' pain and sensibly felt the stone move down the ureter into his bladder. This confirms d'Arcy Power's surmise that the stone in ' the bladder was of renal origin. Thereafter Pepys had many fits of stone ' in the bladder until in his 26th year, three years after his marriage, he had it successfully removed by Mr. Hollier (Hollyard), surgeon at St. Thomas's. Pithiasis ran in the family, for the Diary records his mother, ' in greater and greater pain from the stone,' his aunt at Brampton voiding a great stone, and his brother starting like he did with great pain and haematuria. lithotomy must have been a desperate under- taking in those days, though cutting for the stone dates back to classical times. No doubt the operators were very quick. Indeed Cheselden, who perfected the operation of lateral lithotomy some few years after Pepys' death, could extract a stone in under a minute. But the mortality must have been high, and men would no doubt postpone the operation until the stone was large and the discomfort unbearable. 214 GLASGOW MEDICAL JOURNAL Pepys probably had no soporific or narcotic draught by way of anaesthetic, for although niandragora or concoctions like Shakespeare's ' ' drowsy syrups were used by mediaeval surgeons, they were apparently unknown in Pare's time, and the use of them was discontinued in the seventeenth century. MacLaurin (1923) draws an effective picture of Mr. Pepys trussed with a rope in the lithotomy position and pretty Mrs. Pepys?then only about eighteen? trembling outside the door, horrified by her husband's yells. Perhaps it was like that, but Pepys got over it and apparently without much shock, for in his post-operative draught there was no musk, which, says d'Arcy Power, was the sovereign remedy for shock in those days. Mr. Hollier, according to John Evelyn, removed a stone as large as a tennis ball. He was a master of the art. Bryant says he cut thirty for the stone that year and all lived : but soon after, four died. Pepys' stone must have had the usual uric acid nucleus and laminae of urates. He was very proud of it and treasured it. In 1664 he ' had a case made for it which cost him twenty-four shillings, a great deal of money,' as he remarks. He was known to exhibit it to other sufferers who were allowed to take its dimensions, no doubt while Pepys, with much relish, was urging them to have the job done and get it over. Pepys was rewarded for his pluck, for he lived to be about 70, and it seems doubtful whether he ever, but once, suffered from typical renal colic, although a nest of seven stones was found in his left kidney post mortem. He seems never to have had haematuria after his operation, but he passed two small stones on 7th March, 1664-5 after much pain. He does record, however, several atypical attacks of pain with dysuria, at least once accompanied by fever and vomiting, and ever after his operation he was subject to recurrent transient attacks of epididymo-orchitis, sometimes even if he crossed his legs too quickly. His attacks of pain were usually accompanied by inability to void flatus and by constipation. Some of these seizures were rather like ileus, possibly due to reflex irritation caused by the stones in his kidney. Pepys resorted to enemata or clysters, as he calls them. One of his favourites consisted of small beer. As is usual, he attributed his illnesses to catching cold, too much wine, sitting in a draught, leaving off his periwig, etc. Judging by the amount of work he was able to get through before his retirement in 1089, and the difficulties he overcame, his health must have remained tolerable, but in 1(394 he told Evelyn that he was a good deal out of order, and a few years later he had a serious illness when his friends thought they were going to lose him. But he recovered and went to Clapham for his health. In the winter of 1699-1700 he had a return of his old trouble the stone, and gradually became more or less incapacitated until his death in 1703. Although Pepys seems to have got over his operation well, he suffered from sequelae. He had no children, and his sterility is attributed (by d'Arcy Power) to damage to his ejaculatory ducts. His recurrent orchitis PEPYS' DIARY?CARTER 215 was doubtless due to some permanent injury. None the less, his wife several times thought she was pregnant, as did, on one occasion, one of his light o' loves, much to Pepys' alarm. Pepys' frequent erotic adventures have been attributed to stimulation by his scarred perineum as well as to his addiction to wine, but probably his habits only differed from those of the man about town of the period in that he put them on record. Indeed his amours seem to have usually stopped half-way and been rather half-hearted on the whole. He avoided the regular hetairae, sticking more or less to respectable women of a lower social class, which is probably the reason why he escaped venereal disease, to which there are many allusions in the Diarv.
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