I believe that the key to this extraordinary and confused narrative is to be found in the visit to Cæsar Hawkins thirty years before, when that competent surgeon was unable to satisfy himself as to whether he was dealing with a rupture or a hydrocele. It seems now clear that in reality it was both; and Gibbon, who was a corpulent man with a pendulous abdomen, lived for thirty years without taking care of it. But he lived very quietly; he took no exercise; he was a man of calm, placid, and unruffled mind; probably no man was less likely to be incommoded by a hernia, especially if the sac had a large wide mouth and the contents were mainly fat. But the time came when the intra-abdominal pressure of the growing omentum became too great, and the swelling enormously increased, first in 1787 and again in 1793. When Cline first tapped the swelling he was obviously aware that there was more present than a hydrocele, because he warned Gibbon that he would have to wear a truss afterwards, and moreover, though he removed four quarts of fluid, yet the swelling was only reduced by a half. Probably the soft irregular mass which he then left behind was simply omentum which had come down from the abdomen. But why did the swelling begin to grow again immediately? That is not the usual way with a hydrocele, whose growth and everything connected with it are usually indolently leisurely. Could there have been a malignant tumour in course of formation? But if so, would not that have caused more trouble? Nor would it have given the impression of being a soft irregular mass. However, the second tapping was longer and more painful than the first, though it removed less fluid; and Gibbon was more relieved. But this tapping was followed by inflammation. What had happened? Possibly Cline had found the epididymis; more probably his trochar was septic, like all other instruments of that pre-antiseptic period; at all events, the thing went from bad to worse, grew enormously, and severe constitutional symptoms set in. The ulceration and redness of the skin, which was no doubt filthy enough--surgically speaking--after thirty years of hydrocele, look uncommonly like suppurative epididymitis, or suppuration in the hydrocele. Thus Gibbon goes on for a few days, able to move about, though with difficulty, till he cheers up and seems to be recovering; then falls the axe, and he dies a few hours after saying that he thought he had a good chance of living for twenty years.