Mr. Fletcher has omitted to state that on the second day of Lord Byron’s illness his physician, Dr. Bruno, seeing the sudorific medicines had no effect, proposed blood-letting, and that his lordship refused to allow it, and caused Mr. Millingen to be sent for in order to consult with his physician, and see if the rheumatic fever could not be cured without the loss of blood.

Mr. Millingen approved of the medicines previously prescribed by Dr. Bruno, and was not opposed to the opinion that bleeding was necessary; but he said to his lordship that it might be deferred till the next day. He held this language for three successive days, while the other physician (Dr. Bruno) every day threatened Lord Byron that he would die by his obstinacy in not allowing himself to be bled. His lordship always answered: ‘You wish to get the reputation of curing my disease, that is why you tell me it is so serious; but I will not permit you to bleed me.’

After the first consultation with Mr. Millingen, the domestic Fletcher asked Dr. Bruno how his lordship’s complaint was going on. The physician replied that, if he would allow the bleeding, he would be cured in a few days. But the surgeon Mr. Millingen, assured Lord Byron from day to day that it could wait till to-morrow; and thus four days slipped away, during which the disease, for want of blood-letting, grew much worse. At length Mr. Millingen, seeing that the prognostications which Dr. Bruno had made respecting Lord Byron’s malady were more and more confirmed, urged the necessity of bleeding, and of no longer delaying it a moment. This caused Lord Byron, disgusted at finding that he could not be cured without loss of blood, to say that it seemed to him that the doctors did not understand his malady. He then had a man sent to Zante to fetch Dr. Thomas. Mr. Fletcher having mentioned this to Dr. Bruno, the latter observed that, if his lordship would consent to lose as much blood as was necessary, he would answer for his cure; but that if he delayed any longer, or did not entirely follow his advice, Dr. Thomas would not arrive in time: in fact, when Dr. Thomas was ready to set out from Zante, Lord Byron was dead.

The pistols and stiletto were removed from his lordship’s bed—not by Fletcher, but by the servant Tita, who was the only person that constantly waited on Lord Byron in his illness, and who had been advised to take this precaution by Dr. Bruno, the latter having perceived that my lord had moments of delirium.

Two days before the death a consultation was held with three other doctors, who appeared to think that his lordship’s disease was changing from inflammatory diathesis to languid, and they ordered china,[78] opium, and ammonia.

Dr. Bruno opposed this with the greatest warmth, and pointed out to them that the symptoms were those, not of an alteration in the disease, but of a fever flying to the brain, which was violently attacked by it; and that the wine, the china, and the stimulants, would kill Lord Byron more speedily than the complaint itself could; while, on the other hand, by copious bleedings and the medicines that had been taken before he might yet be saved. The other physicians, however, were of a different opinion; and it was then that Dr. Bruno declared to his colleagues that he would have no further responsibility for the loss of Lord Byron, which he pronounced inevitable if the china were given him. In effect, after my lord had taken the tincture, with some grains of carbonate of ammonia, he was seized by convulsions. Soon afterwards they gave him a cup of very strong decoction of china, with some drops of laudanum. He instantly fell into a deep lethargic sleep, from which he never rose.

The opening of the body discovered the brain in a state of the highest inflammation; and all the six physicians who were present at that opening were convinced that my lord would have been saved by the bleeding, which his physician, Dr. Bruno, had advised from the beginning with the most pressing urgency and the greatest firmness.

F. B.

Mr. Finlay and myself called upon him in the evening, when we found him lying on a sofa, complaining of a slight fever and of pains in the articulations. He was at first more gay than usual; but on a sudden he became pensive, and, after remaining some few minutes in silence, he said that during the whole day he had reflected a great deal on a prediction which had been made to him, when a boy, by a famed fortune-teller in Scotland. His mother, who firmly believed in cheiromancy and astrology, had sent for this person, and desired him to inform her what would be the future destiny of her son. Having examined attentively the palm of his hand, the man looked at him for a while steadfastly, and then with a solemn voice exclaimed: ‘Beware of your thirty-seventh year, my young lord—beware!’

He had entered on his thirty-seventh year on the 22nd of January; and it was evident, from the emotion with which he related this circumstance, that the caution of the palmist had produced a deep impression on his mind, which in many respects was so superstitious that we thought proper to accuse him of superstition. ‘To say the truth,’ answered his lordship, ‘I find it equally difficult to know what to believe in this world and what not to believe. There are as many plausible reasons for inducing me to die a bigot as there have been to make me hitherto live a freethinker. You will, I know, ridicule my belief in lucky and unlucky days; but no consideration can now induce me to undertake anything either on a Friday or a Sunday. I am positive it would terminate unfortunately. Every one of my misfortunes—and God knows I have had my share—have happened to me on one of those days.’

Considering myself on this occasion, not a medical man, but a visitor, and being questioned neither by his physician nor himself, I did not even feel Lord Byron’s pulse. I was informed next morning that during the night he had taken diaphoretic infusions, and that he felt himself better. The next day Dr. Bruno administered a purgative, and kept up its effects by a solution of cream of tartar, which the Italians call ‘imperial lemonade.’ In the evening the fever augmented, and as on the 14th, although the pains in the articulations had diminished, the feverish symptoms were equally strong, Dr. Bruno strongly recommended him to be blooded; but as the patient entertained a deep-rooted prejudice against bleeding, his physician could obtain no influence whatever over him, and his lordship obstinately persevered in refusing to submit to the operation.

On the 15th, towards noon, Fletcher called upon me and informed me that his master desired to see me, in order to consult with Dr. Bruno on the state of his health. Dr. Bruno informed me that his patient laboured under a rheumatic fever—that, as at first the symptoms had been of a mild character, he had trusted chiefly to sudorifics; but during the last two days the fever had so much increased that he had repeatedly proposed bleeding, but that he could not overcome his lordship’s antipathy to that mode of treatment. Convinced, by an examination of the patient, that bleeding was absolutely necessary, I endeavoured, as mildly and as gently as possible, to persuade him; but, in spite of all my caution, his temper was so morbidly irritable that he refused in a manner excessively peevish. He observed that, of all his prejudices, the strongest was against phlebotomy. ‘Besides,’ said his lordship, ‘does not Dr. Reid observe in his Essays that less slaughter has been effected by the warrior’s lance than by the physician’s lancet? It is, in fact, a minute instrument of mighty mischief.’ On my observing that this remark related to the treatment of nervous disorders, not of inflammatory ones, he angrily replied: ‘Who is nervous, if I am not? Do not these words, besides, apply to my case? Drawing blood from a nervous patient is like loosening the chords of a musical instrument, the tones of which are already defective for want of sufficient tension. Before I became ill, you know yourself how weak and irritable I had become. Bleeding, by increasing this state, will inevitably kill me. Do with me whatever else you please, but bleed me you shall not. I have had several inflammatory fevers during my life, and at an age when I was much more robust and plethoric than I am now; yet I got through them without bleeding. This time also I will take my chance.’

After much reasoning and entreaty, however, I at length succeeded in obtaining a promise that, should his fever increase at night, he would allow Bruno to bleed him. Happy to inform the doctor of this partial victory, I left the room, and, with a view of lowering the impetus of the circulatory system, and determining to the skin, I recommended the administration of an ounce of a solution of half a grain of tartarized antimony and two drachms of nitre in twelve ounces of water.

Early the next morning I called on the patient, who told me that, having passed a better night than he had expected, he had not requested Dr. Bruno to bleed him. Chagrined at this, I laid aside all consideration for his feelings, and solemnly assured him how deeply I lamented to see him trifle with his life in this manner. I told him that his pertinacious refusal to be bled had caused a precious opportunity to be lost; that a few hours of hope yet remained; but that, unless he would submit immediately to be bled, neither Dr. Bruno nor myself could answer for the consequences. He might not care for life, it was true; but who could assure him, unless he changed his resolution, the disease might not operate such disorganization in his cerebral and nervous system as entirely to deprive him of his reason? I had now touched the sensible chord, for, partly annoyed by our unceasing importunities, and partly convinced, casting at us both the fiercest glance of vexation, he threw out his arm, and said in the most angry tone: ‘Come; you are, I see, a d——d set of butchers. Take away as much blood as you will, but have done with it.’

We seized the moment, and drew about twenty ounces. On coagulating, the blood presented a strong buffy coat. Yet the relief obtained did not correspond to the hopes we had anticipated, and during the night the fever became stronger than it had been hitherto. The restlessness and agitation increased, and the patient spoke several times in an incoherent manner. The next morning (17th) the bleeding was repeated; for, although the rheumatic symptoms had completely disappeared, the cerebral ones were hourly increasing, and this continuing all day, we opened the vein for the third time in the afternoon. Cold applications were from the beginning constantly kept on the head; blisters were also proposed. When on the point of applying them, Lord Byron asked me whether it would answer the same purpose to apply both on the same leg. Guessing the motive that led him to ask this question, I told him I would place them above the knees, on the inside of the thighs. ‘Do so,’ said he; ‘for as long as I live I will not allow anyone to see my lame foot.’

In spite of our endeavours, the danger hourly increased; the different signs of strong nervous affection succeeded each other with surprising rapidity; twitchings and involuntary motions of the tendons began to manifest themselves in the night; and, more frequently than before, the patient muttered to himself and talked incoherently.

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?’