Note: When Dalrymple’s long-running BMJ column ended in 2012, he had a backlog of about 60 unpublished pieces, and he kindly gave them to us to post here at Skeptical Doctor. We are posting them on Wednesdays to coincide with the schedule of his old BMJ column. We hope you enjoy them.

When people speak of Shakespeare’s clinical acuity, the first exhibit is usually Mistress Quickly’s description of Falstaff’s death in Henry V. The very fact that Shakespeare puts so moving and sensitive a speech in the mouth of the hostess of a pub, The Boar’s Head, which is a den of persons of ill-repute, and whose very name is redolent of a certain sexual looseness, is testimony to the broadness of Shakespeare’s sympathies, his human understanding, his heartfelt rather than merely doctrinal tolerance.

The speech in its universally accepted form goes (in part) as follows:

A’ made a finer end and went away an I had been any Christom child; a’ parted even just between twelve and one, even at the turning o’ the tide: for after I saw him fumble with flowers and smile upon his fingers’ ends, I knew there was but one way; for his nose was as sharp as a pen, and a’ babbled of green fields.

I suppose this description will be familiar to any doctor who has attended a delirious patient; and in 1985, Dr Abraham Verghese, the celebrated physician and writer, published an article in which he said that Mistress Quickly’s depiction of Falstaff’s death was quite probably that of “the muttering delirium” of typhoid fever. Certainly such delirium is common in patients with typhoid: in one series of 959 successive cases 57 per cent displayed it.

But the symptomatology of Falstaff’s death is not pathognomonic of typhoid, for we have all seen delirious patients “fumble at flowers and smile at their fingers’ ends,” and “babble of green fields” from causes other than typhoid. And, interestingly, one of the symptoms in the description, the babbling of green fields, was the result of an emendation of the first printed text. The words “a’ babbled of green fields” might, or might not, have been Shakespeare’s.

The orginal text read “for his nose was as sharp as a pen, and a’ table of greene fields,” which hardly makes sense; it was Lewis Theobald (1688 – 1744), one of the first great Shakespeare scholars, who suggested the emendation which most people accept as inspired (seldom has a man’s lasting literary fame, or at least reputation, rested so importantly on a single word). And in the first edition of Theobald’s edition of Shakespeare, the emendation appears as “a’ babled of green fields.” The extra letter ‘b’ is a later accretion.

Theobald scored more than one hit in his numerous emendations of the texts that came down from the sixteenth and seventeenth centuries, but it is by “a’ babbled of green fields” that he is remembered. One of the methods he used was to imagine the text in Shakespeare’s sixteenth century handwriting and then imagine the errors that the compositors might have made in transferring what he had written to printers’ type.

I suspect (and hope) that Theobald was right, for his speculative version was inspired, but we will never know for certain. There is another interesting point, however. Mistress Quickly’s description, even without the emendation, is wonderfully accurate as well as sympathetic; and when she says “I knew there was no other way [except towards death],” she implies an intimate acquaintance with the process of dying. And since Shakespeare was nothing if not a very close observer of the world around him, and a realist, it must be supposed that the Mistresses Quickly of the time knew death as few people other than doctors and nurses know it nowadays. Knowledge, especially by acquaintance, can be lost as well as gained.