An Insider s Guide to Clinical Medicine 1st Edition

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An Insider s Guide to Clinical Medicine 1st Edition
Archith Boloor Digital Instant Download
Author(s): Archith Boloor, Anudeep Padakanti
ISBN(s): 9789389587876, 9389587875
Edition: 1
File Details: PDF, 73.56 MB
Year: 2019
Language: english
 An Insider’s Guide to
CLINICAL MEDICINE
An Insider’s Guide to
CLINICAL MEDICINE

Archith Boloor
MBBS MD (Internal Medicine)
Associate Professor
Department of Medicine
Kasturba Medical College
Manipal Academy of Higher Education
Mangaluru, Karnataka, India
[email protected]

Anudeep Padakanti
MBBS MD (Internal Medicine)
Department of Medicine
Kasturba Medical College
Manipal Academy of Higher Education
Mangaluru, Karnataka, India
[email protected]

Foreword
Chakrapani M
Headquarters
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© 2020, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of
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An Insider’s Guide to Clinical Medicine
First Edition: 2020
ISBN 978-93-89587-87-6
Printed at
 In fond memory of
Dr Sitamahalakshmi
Foreword

Medicine is a science and an art. Clinical examination is fast

becoming a forgotten art in the face of technological onslaught. This
book is an important step in bringing the students back to the basics
of clinical medicine. This book will be valuable for examination
preparations. It is a comprehensive compilation of clinical signs for
students of internal medicine—both undergraduates and
postgraduates. Illustrations are self-explanatory and help in
understanding difficult concepts.
Dr Archith has been actively and extensively involved in the
clinical teaching of undergraduate and postgraduate students for
many years. He has been a popular teacher among medical
students and has received “best teacher award” many times at
Kasturba medical College, Mangaluru, Karnataka, India. He has
understood the limitations of the present clinical examination books
and also identified the knowledge gap that needs to be cleared for
undergraduate and postgraduate students. His student Dr Anudeep,
an enthusiastic learner and teacher has initiated the process of
compiling this wonderful book.
 Many common concepts which are very pertinent and relevant for
university clinical examinations are discussed in detail in this book.
Coverage of the topics are comprehensive, contemporary, and clear.
The authors have done extensive research while compiling the
details in the book and has presented it in a very convenient to
understand format by giving the details of many of these concepts in
the form of tables and bullet notes. This will help the student in
remembering the important points. They have explained the basic
concepts, and this will help the student in understanding and then
performing the clinical examinations.
Information compiled in the book is evidence-based and
experience enhanced by an eminent teacher. They have taken the
feedback from all the stakeholders including teachers and students
before finalizing the final version of this book. This book can be
strongly recommended for students, teachers and practising
physicians.

Chakrapani M MD
Professor
Department of Medicine
Formerly, Head and Associate Dean
Kasturba Medical College
Manipal Academy of Higher Education
Mangaluru, Karnataka, India
[email protected]
Preface

The clock had struck a solid 1:30 PM. The examiner was hungry, the
last student was jittery and in between them lay a central nervous
system (CNS) case that was going to determine whether a four-and-
half-year ripe child of medicine would be prefixed with a “Dr” or not.
The examiner was more bored than he could care to admit.
Lakshman, aged 32, hailing from Shivamogga, Karnataka with chief
complaints of bilateral lower limb weakness was being presented for
the 14th time that day. The same boring questions had been asked
in the same uninspired fashion.
“List the causes of neck pain”, the examiner asked.
A little taken aback but the student realized that the question was
within the realm of a CNS case. After gathering his thoughts for a
moment, he began listing out, “Meningitis causing neck muscle
spasm, cervical spondylosis, cervical spondylolisthesis...” his voice
trailing off in response to the examiner’s unimpressed face.
”Go ahead, what else?”
Not to lose face in front of the examiner, the student once again
reset his thoughts, and a few umms and ahhs later continues:
”Sir, other cervical causes like cervical intraepithelial neoplasia,
cervical cancer, etc. can also cause neck pain”.

Jokes apart, getting psyched for an exam is an absolutely normal

and foreseeable predicament. We often notice the most brilliant
students fumbling to show off years’ worth of hard work simply
because the psyche overpowers their preparation. As the saying
goes “For most diagnoses, all that is needed is an ounce of
knowledge, an ounce of intelligence, and a pound of thoroughness.”
With that very thought in mind, it is our pleasure to present to you a
simple, comprehensive and exam-oriented clinical manual: A
compass to guide you through the art of clinical medicine.
The practical examinations pose a real challenge to the medical
student: He has to finish writing an entire case sheet, elicit the
expected clinical findings and finally arrive at a proper diagnosis. All
this to be done before the examiner has even made eye-contact with
the student. The catch here being the limited availability of what we
all take for granted: Time. One asks the wrong questions, examines
the wrong systems, latches on to the wrong points and before we
realize, we are knee-deep in heaps of unorganized information that
has no head or tail. Having been in the same shoes at some point in
the past, this book was made to solve those problems: complete
case sheets on all organ systems, with added emphasis on the
common examination cases have been incorporated. We hope it will
teach the reader to anticipate questions that are asked in different
contexts. The book is as visually charged as we could possibly make
it because we believe that seeing is learning. We have dealt with
spot and short cases which are meant to test a student’s take on the
bigger picture of diseases. The diagnostic clues given in this book
will help the student to arrive at a definitive decision sooner. X-rays,
spotters and instruments are dealt with extensively and in exquisite
detail.
We have read several clinical books in an attempt to make this
one different. In doing so, we have found that this is one single guide
which can be safely relied upon to deal with the practicals of Final
MBBS Part II. We hope that the fruit of our labor becomes as close
to your bookshelf as it is to our hearts. Any suggestions and/or
constructive criticism is always welcome, and we hope you enjoy
reading An Insider’s Guide to Clinical Medicine.

Archith Boloor
Anudeep Padakanti
Remembering the Father of Modern
Medicine

Medicine is a science of uncertainty and an art of probability.

The best preparation for tomorrow is to do today’s work superbly

well.

Every patient you see is a lesson in much more than the malady
from which he suffers. Listen to your patient. He is telling you the
diagnosis.

He who studies medicine without books sails an uncharted sea, but

he who studies medicine without patients does not go to sea at all.

The good physician treats the disease; the great physician treats the
patient who has the disease.

We are here to add what we can to life. Not to get what we can from
life. Too many men slip early out of the habit of studious reading and
yet that is essential.

One of the duties of the physician is to educate the masses not to

take medicine.

The practice of medicine is an art. Not a trade; a calling. Not a

business: A calling in which your heart will be exercised equally with
your head.
Happiness lies in the absorption in some vocation which satisfies the
soul. To have striven. To have made the effort. To have been true to
certain ideals------ this alone is worth the struggle.

Acquire the art of detachment, the virtue of method and the quality of
thoroughness but above all the grace of humility.

Sir William Osler,

(July 12, 1849 – December 29, 1919)
Acknowledgments

It was our long-standing dream to write a clinical book that would

encompass all the relevant matter needed for a student with due
emphasis on clinical methods. Incorporating many years of clinical
teaching and an astute understanding of the actual needs of a
medical student, this book has been compiled to cater to their unmet
needs. It has been a Herculean task of reading, writing, rewriting and
editing this vast amount of information into this concise textbook.
When we began this work, almost a year ago, little did we
anticipate the shape our ideas would finally take in the form of this
“An Insider’s Guide to Clinical Medicine”. This endeavor of ours
would have been impossible without the constant support and
encouragement of our well wishers.
Firstly, we thank all our students : undergraduates, postgraduates
for having kindled in us this idea, for compiling our notes and most
importantly, for asking the questions whose answers have taken the
form of this book.
This book would not have seen the light of day without the
constant persuasion of Dr Vivek Koushik, Dr Abu Thajudeen and Dr
Nikhil Kenny Thomas. They are and will continue to be the pillars of
strength on whom our life and this book would gain sustenance…
Thank you.
We profusely thank Dr Chakrapani M, for writing the foreword for
this edition. Sir is the embodiment of a true teacher of clinical
medicine and we thank him for his constant support and inputs
during this process.
We thank Dr Sheetal Raj for the chapter on Comprehensive
Geriatric assessment. We thank Dr Sriraksha Nayak and Dr Vaddi
Rohit, for compiling the chapter Approach to Psychiatric illness.
We thank Dr Kaushiki Kirty, Dr Vishnu B Chandran, Dr Rama
Kishore Yalampati and Dr Navyashree HC, for helping us with inputs
and proofreading.
Also, we convey our sincere thanks to Shri Jitendar P Vij (Group
Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group
President), Dr Madhu Choudhary (Publishing Head–Education), Ms
Pooja Bhandari (Production Head), Ms Sunita Katla (Executive
Assistant to Group Chairman and Publishing Manager), Dr
Aakanksha Shukla Sirohi (Development Editor), Mr Rajesh Sharma
(Production Coordinator), Ms Seema Dogra (Cover Visualizer), Mr
Laxmidhar Padhiary (Proofreader), Mr Kapil Dev Sharma
(Typesetter), Mr Manoj Pahuja (Graphic Designer) and their team
members, for publishing the book in the same format as wanted, well
in time.
Special thanks to Dr Ashwini MV, Dr G Suresh Reddy, Dr
Lakshmi Nivedana B Dr Sriram M, Dr Pranjal Sharma, Dr Tejaswini
Lakshmikeshava, Dr Nagendra C, Dr Thejus Bhaskar, Dr
Mohammed Shaheen, Dr Jane Mendonca and Dr Madhav Hande,
for helping us with the clinical images, editing, proofreading and
designing of this book. They have lived our dream with us.
We are especially grateful for the ongoing encouragement from
the management and administration of our university, the Manipal
Academy of Higher Education (MAHE), Manipal, Karnataka, India.
We are grateful to our family members, colleagues and friends
who have supported us all along the way.
A very special gratitude goes out to all our teachers, who are
solely responsible for what we are today and for having ignited the
passion of teaching in us.
Lastly, we thank God Almighty, for making us what we are,
guiding us through our life, and helping us in bringing this book to
you all.
Contents

1. Prerequisites for Practical Examination and Common

Examination Cases
2. General Examination
A. Case Sheet Format
B. Vitals Examination
C. Physical Examination
D. Anthropometry
3. Respiratory System Examination
A. Case Sheet Format
B. Diagnosis Format
C. Discussion on Cardinal Symptoms
D. Discussion on Examination
E. Summary of Findings in Common Respiratory Diseases
4. Cardiovascular System Examination
A. Case Sheet Format
B. Diagnosis Format
C. Discussion on Cardiac Cycle
D. Discussion on Cardinal Symptoms
E. Discussion on Examination
F. Summary of Findings in Common Cardiovascular Diseases
5. Gastrointestinal System
A. Case Sheet Format
B. Diagnosis Format
 C. Discussion on Cardinal Symptoms
D. Discussion on Examination
6. Nervous System
A. Case Sheet Format
B. Diagnosis Format
C. Discussion on Cardinal Symptoms
D. Discussion on Examination
i. General Examination in Neurology
ii. Higher Mental Functions
iii. Cranial Nerves
iv. Motor System Examination
v. Reflexes
vi. Sensory System Examination
vii. Cerebellum and Coordination
viii. Gait
ix. Approach to Involuntary Movements
x. Meningeal Signs, Skull, and Spine
E. Approach to Common Neurological Cases
7. Rheumatology
A. Case Sheet Format
B. Diagnosis Format
C. Discussion on Symptommatology and Examination
8. Comprehensive Geriatric Assessment
Case Sheet Format
Diagnosis Format
Discussion
9. Approach to Psychiatric Illness
Case Sheet Format
Diagnosis Format
Discussion on Examination
Discussion on Diseases and Diagnostic Criteria
Other documents randomly have
different content
 On reaching Pesth I had a little pleasure party all to myself, in
accordance with a promise made to myself while soaking in the Danube
mud. I took a bath, drank two glasses of Tokay and slept twenty hours—not,
however, without visions of boiling waters and lakes of mud. After which I
set out on the war-path of concert-promoting, greatly helped by the
kindness of Count Raday, superintendent of the National Theatre.
Now the Hungarians are nothing if not patriotic. In every shop window
things are ticketed hony (national) and, by the advice of an amateur in
Vienna, who had brought me a volume of Hungarian national airs, I chose
the Rakoczy March and arranged it as it now stands as finale to the first part
of my Faust.
No sooner did the rumour spread that I had written hony music than
Pesth began to ferment.
How had I treated it? They feared profanation of that idolised melody,
which for so many years had made their hearts beat with lust of glory and
battle and liberty; all kinds of stories were rife, and at last there came to me
M. Horwath, editor of a Hungarian paper—who, unable to curb his
curiosity, had gone to inspect my march at the copyist’s.
“I have seen your Rakoczy score,” he said, uneasily.
“Well?”
“Well; I feel horribly nervous about it.”
“Bah! why?”
“Your motif is introduced piano, and we are used to hearing it started
fortissimo.”
“Yes, by the gipsies. Is that all? Don’t be alarmed. You shall have such a
forte as you never heard in your life. You can’t have read the score
carefully; remember the end is everything.”
All the same, when the day came my throat tightened, as it did in times
of great excitement, when this devil of a thing came on. First the trumpets
gave out the rhythm, then the flutes and clarinets, with a pizzicato
accompaniment of strings—softly outlining the air—the audience
remaining calm and judicial. Then, as there came a long crescendo, broken
by the dull beats of the big drum (as of distant cannon) a strange restless
movement was perceptible among them—and, as the orchestra let itself go
in a cataclysm of sweeping fury and thunder, they could contain themselves
no longer.
Their overcharged souls burst with a tremendous explosion of feeling
that raised my hair with terror.
I lost all hope of making the end audible,[22] and in the encore it was no
better; hardly could they contain themselves long enough to hear a portion
of the coda.
Horwath, in his box, was like one possessed, and I could not resist a
smiling glance at him to ask—
“Are you still afraid or are you content with your forte?”
It was lucky that this was the end of the programme, for certainly these
excitable people would have listened to nothing more.
As I mopped my face in the little room set apart for me, a poorly dressed
man slipped quietly in. He threw himself upon me, his eyes full of tears,
and stammered out:
“Ah, monsieur—the Hungarian—poor man—not speak French—
Forgive, excited—understood your cannon—Yes, big battle—Dogs of
Germans!” Striking his chest vehemently—“In heart of me you stay—ah,
French—Republican—know to make music of Revolution!”
I cannot describe his frenzy; it was almost sublime.
After that, of course, the Rakoczy ended every concert, and on leaving I
had to present the town with my MS.
Later on I sent them a revised version, as some young Hungarians did
me the honour to present me with a silver crown of most exquisite
workmanship.
When I got back to Vienna, the amateur who had given me the idea of
writing the march came to me in comical terror.
“For mercy’s sake,” he begged, “never tell that I gave you the idea. The
excitement of it has reached Vienna, and I should get into dreadful trouble if
it were known.”
Of course I promised silence, but, as this terrible affair is long since done
with, I may now add that he was called—— No, I only wished to frighten
him. I won’t tell!
 I had not intended to include Prague in my round, but someone sent me
the Prague Musical Gazette with three appreciative articles on my King
Lear by Dr Ambros. I wrote to thank him and mentioned my doubts of my
reception by his fellow-citizens who, I had been told, would hear no one but
Mozart. His kind reply swept away my misgivings and made me as eager to
go as I had hitherto been the reverse. Of Prague my recollections are
golden. I gave six concerts, and at the last, had the great joy of having Liszt
to hear my Romeo and Juliet.
At the close of the performance as I begged him to be my interpreter in
thanking the artists for their devotion and patience in spending three weeks
over my works, two or three of them came up to us and spoke to him.
“My office is changed,” he said, turning to me; “these gentlemen request
me to convey to you their thanks for the pleasure you have given them and
their joy in your pleasure.”
This was indeed a red-letter day for me! There are not many such in my
life.
As the music lovers of Vienna had given me a banquet and a silver-gilt
baton, those of Prague gave me a supper and a silver cup.
But this same cup poured out such floods of champagne that Liszt, who
had made a charming and touching speech in my honour, was shipwrecked
therein. At two o’clock in the morning Belloni, his secretary, and I were
hard at work in the streets of Prague trying to persuade him to wait till
daylight to fight a Bohemian who had drunk more than he had. We were
rather anxious about him, as he had to give a concert at noon next day, and
at half-past eleven was still asleep. At length he was awakened, jumped into
a carriage, walked on to the platform, and played as I verily believe he had
never played before. There certainly is a Providence over—pianists.
I cannot express my tender regrets for those good Bohemians.
“O Prague! when shall I see thee again?”
 XXX

PARIS—RUSSIA—LONDON

While trailing round Germany in my old post-chaise I composed my

Damnation de Faust. Each movement is punctuated by memories of the
place where it was written. For instance, the Peasant’s Dance was written by
the light of a shop gas-jet one night when I had lost myself in Pesth, and I
got up in the middle of the night in Prague to write the song of the angelic
choir.
Thinking that my foreign tour might have enhanced my home reputation,
on my return to Paris I ventured to put it in rehearsal, going to enormous
expense for copying and for the hire of the Opera Comique. Fatal reasoning!
The indifference of the Parisians to art had increased by leaps and bounds,
the weather in November 1846 was vile, and they preferred their warm
homes to the unfashionable Opera Comique.
It was twice performed to half empty houses and elicited no more
attention than if I had been the least of Conservatoire students. Nothing in all
my career has wounded me as this did. The lesson was cruel but useful; I
vowed that never again would I trust to the tender mercies of Paris.
I did not keep my vow, for later on I could not resist letting it hear my
Childhood of Christ, which proved a great success.
[Berlioz does not mention the domestic troubles that added greatly to his
dejection. His wife was paralysed and his son Louis, brought up in a divided
household, naturally gave him anxiety, as the following letter shows]:

To Louis Berlioz.
“October 1846.—Your mother is a little better, but she is still in bed and
unable to speak. As the least agitation would be fatal to her, do not write to
her as you have done to me.
“You talk of being a sailor. Do you wish to leave me? for, once at sea,
God knows when I shall see you again. Were I but free I would go with you,
and we would seek our fortunes in India or some far-off land, but to travel
one must have money, and only in France can I get my living—such as it is.
 “I am speaking to you as if you were grown up. You must think over what
I say and you will understand. But remember that, whatever happens, I am
and always shall be your best and most devoted friend. It would indeed be
sad if, when you came to be twenty years of age, you found yourself useless
both to society and yourself. Good-bye, dear child. My heartfelt love.”
Faust was my ruin. After two days of unutterable misery I decided to
retrieve my fortunes by a tour in Russia, if I could but collect enough money
first to pay my debts. Then did my kind friends rally round me and apply
healing balm to my wounded spirit.
M. Berlin advanced me a thousand francs from the Débats funds; one
friend lent me five hundred, others six or seven; M. Friedland, a young
German I had met in Prague, twelve hundred, and Hetzel a thousand.
So, helped on all sides, I was able, with a clear conscience, to leave for
Russia on the 14th February 1847, feeling that few men have been so blessed
as I in the devoted generosity and kind-heartedness of my single-minded
friends.
The time for concert-giving in Russia is Lent—March—as then the
theatres are all closed. The cold was intense, and during my whole
fortnight’s journey I never lost sight of the snow, and made only one short
stop in Berlin to beg a letter of introduction to the Empress of Russia from
her brother, the King of Prussia, which, with his invariable kindness, he sent
me at once.
Before leaving Paris, Balzac said to me:
“Be sure at Tilsit to hunt up the post-master, M. Nernst. He is a clever,
well-read man and may be useful to you.”
So at Tilsit I walked into his office and there found a big man perched on
a high stool.
“M. Nernst?” I said, taking off my hat.
“Yes, monsieur; to whom have I the honour of speaking?”
“To Hector Berlioz.”
“No! not really?” He bounced off his stool and landed before me, cap in
hand.
How well I remember my poor father’s happy pride in this story! “Not
really?” he would repeat, and his laughter would ring out again and again.
 We had a cordial meeting-ground in our mutual friendship with Balzac,
and after some hours’ rest I set out, warmed and comforted, in a horrible iron
sledge wherein I endured a martyrdom till, four days later, I reached St
Petersburg.
Hardly had I shaken off the traces of my journey when M. Lenz, an old
acquaintance, came to take me to Count Michael Wielhorski, from whom I
received a most flattering welcome. He and his brother, by their love of art,
their great connections and immense fortune, have made their palace a sort
of little Ministry of Fine Arts.
By them I was introduced to Romberg, General Guédéonoff,
superintendent of the Imperial theatres, and General Lwoff, aide-de-camp to
the Emperor, a composer of rare talent.
Not to go into too many details, my visits both to St Petersburg and
Moscow were the greatest success financially as well as artistically. My first
concert (at which I was summoned, hot and dishevelled with my exertions,
to the box of the Emperor, who was most gracious) made eighteen thousand
francs; the expenses were six thousand, the balance was mine.
I could not resist murmuring, as I turned to the south-west, “Ah, dear
Parisians!”
I must just recall one of my red-letter days—the performance of Romeo
and Juliet in St Petersburg.
No wretched bargaining, no limitation of rehearsals here!
I asked General Guédéonoff:
“How many rehearsals can your Excellency allow me?”
“How many? Why! as many as you want. They will rehearse until you are
satisfied.”
And they did; consequently it was royally, imperially, organised and
performed.
The vast theatre was full; diamonds, uniforms, helmets shone and
glittered everywhere. I, too, was in good form, and conducted without a
single mistake—a thing that, in those days, did not happen often.
I was recalled more times than I could count, but I must own that I paid
small heed to the public, the divine Shakespearean poem that I myself had
made affected me so deeply that, the moment I was free, I fled to a quiet
room in the theatre, where my dear, good Ernst found me in floods of tears.
 “Ah! nerves!” said he, “I know too well what it is.”
And, holding my head, he let me sob like a hysterical girl for a quarter of
an hour.
Despite its warm reception, I doubt that my symphony was rather over
the heads of the audience, therefore, when it was to be repeated, on the
advice of the cashier of the theatre, I added two scenes from Faust.
I heard of a funny incident at this second performance. One lady present
sat and was bored with most exemplary patience; she would not have it
thought that she could not understand this feast of music. Proud of having
stayed to the end, she said, as she left her box:
“Yes, it is a tremendous thing, but quite intelligible. In that grand
introduction I could absolutely see Romeo driving up in his gig!!!”
I spoke of Ernst just now—great artist and noble friend. He has been
compared to Chopin—a comparison both true and false.
Chopin could never bear the restraints of time, and, I think, carried his
independence too far; he simply could not play in time. Ernst, while
employing rubato, kept it within artistic limits, retaining always a dignified
sway over his own caprices.
In Chopin’s compositions all the interest centres in the piano, his
orchestral concerto accompaniments are cold and practically useless. Ernst is
distinguished by quite the opposite—his concerted music is not only brilliant
for the solo instrument, but the symphonic interest is thoroughly grateful and
sustained.
Even Beethoven allowed the orchestra to overpower the soloist, and, to
my mind, the perfect system is that adopted by Ernst, Vieuxtemps and Liszt.
Chopin was the delicate refined virtuoso of small gatherings, of groups of
intimate friends. Ernst was master of crowds; he loved them, and, like Liszt,
was at his very best with two thousand hearers to conquer.

The Great Feast being over, there was nothing to keep me in St

Petersburg, which, however, I left with great regret.
Passing through Riga, I thought I would give a concert. The receipts
hardly covered the expenses (I think I was twelve francs to the good), but it
procured me the friendship of some pleasant artists and amateurs, amongst
them the post-master, who turned out to be a constant reader of my
newspaper articles. He looked me dubiously up and down, and said:
“You don’t look a firebrand, but from your articles I should have expected
quite a different sort of man, for, devil take me! you write with a dagger, not
a pen!”
The King of Prussia wishing to hear my Faust, I arranged to stay ten days
in Berlin. The Opera House was placed at my disposal, and I was promised
half the gross receipts. The orchestra and choruses were capital, but I cannot
say as much for the soloists, who were feeble in the extreme. The King of
Thule ballad was hissed, but whether this was due to me or to the singer I
cannot say—probably both—for the stalls were filled with a malicious
crowd who objected to a Frenchman having the audacity to set to music a
German classic.
However, by the time we got to the Danse des Sylphes I was in a bad
temper and refused the encore they gave it.
The royalties were apparently satisfied; the Princess of Prussia said many
nice things and the King sent me the Red Eagle by Meyerbeer and invited
me to dinner at Sans Souci. I met with a cordial reception, gave him news of
his sister in Russia and finally ventured to say after dinner was over: “Ah,
sire, you are the true king of artists. Without you could Spontini and
Meyerbeer have gained a hearing? Was it not at your suggestion that
Mendelssohn composed his Antigone music? Did not you commission him
to write the Midsummer Night’s Dream? Does not your known love of art
incite us all to do our best?”
“Well, perhaps so,” he answered, “but there’s no need to say so much
about it.”
But it is true. Now there are two other sovereigns who share his interest
—the Grand Duke of Saxe-Weimar and the blind young King of Hanover.

On returning to France I took my boy to see his relations at La Côte

Saint-André. Poor Louis! how happy he was; petted by relations and old
servants and wandering about the fields, his little hand thrust in mine.
In a letter I had yesterday he says that that fortnight was the happiest of
his life. And now he is at the blockade of the Baltic, on the eve of a naval
battle—that hell upon the sea! The mere thought of it maddens me; yet he
chose it himself—this noble profession. But we did not expect war then.
 Dear noble boy! at this minute they may be bombarding Bomarsund—it
will not bear thinking of, I must turn to other things—I can write no more.

From Paris and its usual weary round of jealousy and intrigue, it was a
comfort to turn to London, whence I received the offer of an engagement to
conduct the grand English Opera for Jullien. In his usual rôle of madman he
got together orchestra, chorus, principals and theatre, merely forgetting a
repertoire. To cover expenses he would have had to take ten thousand francs
a night and this he expected to net out of an English version of Lucia di
Lammermoor!

To Tajan Rogé of St Petersburg.

“London, November 1847.—Dear Rogé,—Your letter should have been
answered sooner had it not been for the thousand and one worries that
overwhelmed me the minute I set foot in Paris.
“You can have no idea of my existence in that infernal city that thinks
itself the home of Art.
“Thank heaven I have escaped to England and am, financially, more
independent than I dared to hope.
“Jullien, the manager here, is a most intrepid spirit and seems to
understand English people; he has made his fortune and is going to make
mine, he says. I let him have his own way since he does nothing unworthy of
art and good taste—but I have my doubts.
“I have come alone to London; you may guess my reasons. I badly
needed a little freedom which, so far, I have never been able to get. Not one
coup d’état but a whole series was necessary before I succeeded in shaking
off my bonds. Yet now, although I am so busy with rehearsals, my loneliness
seems very odd.
“Since I am in a confidential mood, will you believe that I had a queer
little love affair in St Petersburg with a girl—now don’t laugh like a full
orchestra in C major! It was poetic, heart-rending, and perfectly innocent.
“Oh, our walks! oh, the tears I shed when, like Faust’s Marguerite, she
said: ‘What can you see in me—a poor girl so far beneath you?’ I thought I
should die of despair when I left St Petersburg, and was really ill when I
found no letter from her in Berlin. She did promise to write, probably by
now she is married.
 “I can picture it all again—the Neva banks, the setting sun. In a maze of
passion I pressed her hand to my heart, and sang her the Love Song from
Romeo.
“Ah me! not two lines since I left her.
“Good-bye; you at least will write to me.”

To Auguste Morel.
“76 Harley Street, London, 31st November 1847.—Jullien asks me
confidentially to get your report on the success of Verdi’s new opera.[23] We
begin next week with the Bride of Lammermoor, which can hardly help
going well with Madame Gras and Reeves. He has a beautiful voice, and
sings as well as this awful English language will allow.
“I had a warm reception at one of Jullien’s concerts, but shall not begin
my own until January.
“Your friend, M. Grimblot, has given me the entrée to his club, but
heaven only knows what amusement is to be found in an English club.
Macready gave a magnificent dinner in my honour last week; he is charming
and most unassuming at home, though they say he is terrible at rehearsal. I
have seen him in a new tragedy, Philip van Artevelde; he is grand, and has
mounted the piece splendidly.
“No one here understands the management and grouping of a crowd as he
does. It is masterly.”

“8th December.—The opening of our season was a success. Madame

Gras and Reeves were recalled frantically four or five times, and they both
deserved it.
“Reeves is a priceless discovery for Jullien; his voice is exquisite in
quality, he is a good musician, has an expressive face, and plays with
judgment.”

“14th January.—Jullien has landed us all in a dreadful bog, but don’t

mention it in Paris, as we must not spoil his credit. It is not the Drury Lane
venture that has ruined him; that was done before; now he has gone off to
the provinces and is making a lot of money with his promenade concerts,
while we take a fair amount each night at the theatre, none of which goes
into our pockets, for we are not paid at all. Only the orchestra, chorus, and
work-people are paid every week in order to keep the thing going somehow.
“If Jullien does not pay me on his return, I shall arrange with Lumley to
give some concerts in Her Majesty’s Theatre, for there is a good opening
here since poor Mendelssohn’s death.”

“12th February 1848.—My music has taken with the English as fire to
gunpowder. The Rakoczy and Danse des Sylphes were encored. Everyone of
importance, musically, was at Drury Lane for my concert, and most of the
artists came to congratulate me. They had expected something diabolic,
involved, incomprehensible. Now we shall see how they agree with our Paris
critics. Davison himself wrote the Times critique; they cut half of it out from
want of space; still the remainder has had its effect. Old Hogarth of the Daily
News was truly comical: ‘My blood is on fire,’ said he; ‘never have I been
excited like this by music.’ ”
Jullien, coming finally to the end of his resources, was obliged to call a
council of war. It consisted of Sir Henry Bishop, Sir George Smart, Planché,
Gye, Marezeck, and myself.
He talked wildly of the different operas he proposed to mount, and finally
came to Iphigenia in Tauris, which, like many others, is promised yearly by
the London managers. Impatient at my silence he turned upon me:
“Confound it all! surely you know that?”
“Certainly I know it. What do you want me to tell you?”
“How many acts there are, how many characters, what voices and, above
all, the style of setting and costume.”
“Take a pen and paper and I will tell you. Four acts, three men: Orestes,
baritone; Pylades, tenor; Thoas, high bass; a grand woman’s part, Iphigenia,
soprano; a small one, Diana, mezzo-soprano. The costumes you will not like,
unfortunately; the Scythians are ragged savages on the shores of the Black
Sea; Orestes and Pylades are shipwrecked Greeks. Pylades alone has two
dresses—in the fourth act he comes in in a helmet——”
“A helmet!” cried Jullien, excitedly; “we are saved! I’ll write to Paris for
a golden helmet with a pearl coronet, and an ostrich plume as long as my
arm. We’ll have forty performances.”
“Prodigious!” as good Dominie Sampson says.
 Needless to say, nothing happened. Reeves, the divine tenor, laughed at
the bare idea of singing Pylades, and Jullien quitted London shortly after,
leaving his theatre to go to pieces.
 XXXI

MY FATHER’S DEATH—MEYLAN

Already saddened on my return to Paris by the havoc and ruin caused by

the Revolution, it was but my usual fate to suffer in addition, the terrible
sorrow of losing my father.
My mother had died ten years before, and, bitter as was that blow, it was
but light in comparison with the wrench of parting with this dearly loved and
sympathetic friend.
We had so much in common, our tastes were similar in so many ways,
and, since he had gladly acknowledged himself in the wrong over my choice
of a profession, we had been so entirely at one.
Ah! that I could have gratified his ardent wish to hear my Requiem, but it
was not to be.
I pass over the sorrow of my home-coming, the meeting with my grief-
worn sisters, the sight of his empty chair, of his watch—still living, though
he was dead!
A strange wish to indulge the luxury of grief crept over me; I must drink
this wormwood cup to the dregs; I must revisit Meylan—the early home of
my Mountain Star—and live over again my early love and sorrow.
Even now my heart beats faster as I recall my journey. Thirty-three years
ago and I, a ghost, come back to my early haunts! As I climb through the
vineyards the thoughts, the aspirations, the desires of my childish days
crowd in upon me.
Here did I sit with my father, playing Nina to him on my flute; there did
Estelle stand.
I turn and take in the whole picture; that blessed house, the garden, the
valley, the river, and the far-off Alpine glaciers.
Once more I am young; life and love—a glorious poem—lie before me;
on my knees I cry to the hills, the valleys, the heavens: “Estelle! Estelle!”
Bleed, my heart, bleed! but leave me still the power to suffer!
I rise and wander on, noting each familiar point. Here is her cherry tree;
there still flowers the plant of everlasting pea from which she plucked
blossoms. Sweet plant! bloom on in thy solitude! Good-bye! good-bye!
Good-bye to my childhood, to my lost love—Time sweeps me on; Stella!
Stella!
The cold hand of Death lies heavy on my heart, yet around me are soft
sunlight, solitude, and silence.

Next day I asked my cousin Victor:

“Do you know Madame F——?”
“The lovely Estelle D——, do you mean?”
“Yes, I loved her so when I was twelve—I love her yet.”
“You idiot,” said Victor, laughing, “she is fifty-one, and has a son of
twenty-two.”
He laughed again, and I laughed too, but mine was the cry of despair, an
April gleam through the rain.
“Nevertheless I want to see her.”
“Hector, I beg you will do no such thing. You will make a fool of yourself
and upset her.”
“I want to see her,” I repeated doggedly, with clenched teeth.
“Fifty-one!” he cried again, “you had much better keep your bright, fresh,
youthful memory of her.”
“Well, then, I will write.”
He gave me a pen, and subsided into an armchair in fits of laughter, while
my incoherent, despairing letter was composed. I sent it, but no reply came.
When next I go to Grenoble I mean to see her.

In May 1851 I was commissioned by Government to judge instruments at

the London Exhibition, and wrote to Joseph d’Ortigue in June 1851—
“I want to tell you of the extraordinary impression made on me by the
singing of six thousand Charity School children in St Paul’s Cathedral. It is
an annual affair, and is, beyond compare, the most imposing, the most
Babylonian ceremony I ever witnessed.
“It was a realisation of part of my dreams, and proof positive of the
unknown power of vast musical masses.
“This fact is no more understood on the Continent than is Chinese music.
 “By-the-bye, France is easily first in the manufacture of musical
instruments. Erard, Sax and Vuillaume lead; all the others are of the reed-
pipe and tin-kettle tribe.”

To Lwoff.
“January 1852.—It is impossible to do anything in Paris, so next month I
shall go back to England, where, at least, the wish to love music is real and
persistent. If I can be of the least use to you in my newspaper articles,
commend me, dear master. It will be a pleasure to tell our few earnest French
readers of the great and good things that are done in Russia. It is a debt I
shall gladly pay, since I never shall forget the warmth of my reception and
the kindness of your Empress and your great Emperor’s family.
“What a pity he himself does not like music!”

To J. d’Ortigue.
“London, March 1852.—Just a line to tell you of my colossal success.
Recalled I know not how often, and applauded both as composer and
conductor. This morning, in the Times, the Morning Post, the Advertiser, and
others, such effusions as never were written before about me! Beale is wild
with joy, for it really is an event in the musical world. The orchestra at times
surpassed all that I have heard in verve, delicacy and power.
“All the papers except the Daily News puff me, and now I am preparing
Beethoven’s Choral Symphony, which, so far, has been sadly mutilated here.
“But can you believe that all the critics are against the Vestal, of which
we performed the first part yesterday?
“I am utterly cast down at this lapsus judicii—am I not weak?—and am
ashamed of having succeeded at such a cost. Why can I not remember that
the good, the beautiful, the true, the false, the ugly, are not the same to
everyone?”

“May 1852.—You speak of the expenses of our concerts; they are

enormous. Every impresario in London expected to lose this year. In fact
Beale, in the programme of the last concert, actually told the public that the
Choral Symphony rehearsals had swallowed more than a third of the
subscription.
 “However, it has had a miraculous effect, and my success as conductor
was great also; indeed, it was such an event in the musical world that people
greatly doubted whether we should carry it through.”

“June 1852.—I leave to-morrow. How I shall regret my glorious chorus

and orchestra! Those beautiful women’s voices!
“If only you had been here to hear our second performance of the Choral
Symphony. The effect in that enormous Exeter Hall was most imposing.
“Paris once more! where I must forget these melodious joys in my daily
task of critic—the only one left me in my precious native land!
“A naïf Birmingham amateur was heard the other day regretting that I had
not been engaged for the Birmingham Festival. ‘For I hear,’ said he, ‘that
Berlioz really is better than Costa!!!’ ”

To Louis Berlioz.
“1852.—You say you are going mad! You must actually be mad to write
me such letters in the midst of the strenuous fatigue of my present life.
“In your last letter from Havana you say you will arrive home with a
hundred francs. Now you say you owe forty. Now remember! I shall take no
notice in future of the nonsense you talk.
“You chose your own profession—a hard one, I grant you, but the hardest
part is over. Only five more months, and you will be in port for six months
studying, after which you will be able to earn your own living.
“I am putting aside money for your expenses during those six months. I
can do no more.
“What is this about torn shirts? Six weeks in Havana, and all your clothes
ruined! At that rate you will want dozens of shirts every five months. You
must be laughing at me.
“Please weigh your language in writing to me. I do not like your present
style. Life is not strewn with roses, and I can give you no career but that
which you yourself chose. It is too late to alter now.”

To J. d’Ortigue.
“January 1854.—Yes, dear d’Ortigue, you are right. It is my
ungovernable passion for Art that is the cause of all my trouble, all my real
suffering. Forgive me for letting you read between the lines. I knew it would
hurt you, and yet I could not hold back the words that burnt me, although I
might have known that your opinions on Art would be in accord with your
religious feelings.
“You know that I love the beautiful and the true, but I have another love
quite as ardent—the love of love.
“And when for some idea, some misunderstanding, I feel that my love
may be lessened, something within me bursts asunder, and I cry like a child
with a broken toy.
“I know it is puerile, but it is true, although I do my best to cure myself.
Like a true Christian, you have punished me by returning good for evil.
“Your notes are capital, and I think I shall be able to use them, though
never did I feel less in the mood for writing.
“I cannot make a beginning. And I am sad—so sad! Life is slipping away.
I long to work, and am obliged to drudge in order to live. Adieu, adieu.”
 XXXII

POOR OPHELIA

I would I were done with these wearisome reminiscences! When I have

written a few pages more I shall have said enough to give a fair sketch of the
mill-round of thought, work and sorrow wherein I am fated to turn, until I
cease to turn for ever. However long may still be the days of my pilgrimage,
they can but resemble those that are past. The same stony roads, the same
Slough of Despond, with here and there a blessed oasis of

Montmartre Cemetery

rest or a mighty rock that I may painfully climb, thereon to forget, in the
evening sunshine, the cold rains of the plain beneath. So slow are changes in
men and things that one would need to live two hundred years to mark any
difference.
Nanci, my sister, died of cancer, after six months’ frightful suffering.
Adèle, worn out with the fatigue and anxiety of nursing, nearly followed her.
Why had no doctor the humanity to put an end to that awful martyrdom
with a little chloroform? They administer it to avoid the pain of an operation
that lasts, perhaps, an hour, and they refuse it when they know cure to be
impossible, to spare months of torture, when death would be the supreme
good. Even savages are more humane.
But no doubt my sister would have refused the boon had it been offered.
She would have said, “God’s will be done!” Would not God’s will have been
as well interpreted by a calm, swift death as by these months of useless
agony?

My wife, too, died—mercifully without much suffering.

After four years’ death-in-life, unable to speak or move, she passed
quietly away at Montmartre on the 3rd March 1854. Her last hours were
sweetened by Louis’ presence. He was home on leave from Cherbourg four
days before she died.
I had been out for two hours when one of her nurses came to tell me all
was over, and I returned but to draw aside the shroud and kiss her pale
forehead.
Her portrait, painted in the days of her radiant beauty, and which I had
given her the year before, hung above her bed, looking calmly down on the
poor shell that had once enshrined her brilliant genius.
My sufferings were indescribable. They were intensified by one feeling
that has always been the hardest for me to bear—that of pity.
Again and again I went over Henriette’s troubles and their crushing
weight bore me to the earth. Her losses before our marriage, her accident, the
fiasco of her second appearance, her lost beauty and renown, our home
quarrels, her jealousy—not, in the end, without cause—our separation, her
son’s absence, her helplessness and dreary years of retrospection, of
contemplating approaching death and oblivion.
Oh, the pity of it! It turns my brain.
 Shakespeare! Shakespeare! Thou alone couldst have understood us both,
thou alone couldst have pitied us—poor children of Art—loving, yet
wounding each other through our love! Thou art our God, if that other God
sits aloof in sublime indifference to our torments. Thou art our father. Help
us! Save us!

De profundis ad te clamo!

Alone I went about my sorrowful task.

The Protestant pastor lived at the other side of Paris and I went to him
that evening. As my cab passed the Odéon I thought of how, in that theatre
twenty-six years before, my poor dead wife had burst like a meteor upon
Paris and had come forward, trembling and awed at her own success, to
receive the plaudits of all that was best and brightest in France. Ophelia!
Ophelia!
Through that door I saw her pass to a rehearsal of Othello. I was nothing
to her then. She would have thought the prophet mad who pointed out a
worn, distraught, unknown youth and said:
“Behold your husband!”
Yet he it is, my poor Ophelia, he who loved and suffered with you, who
tends you on this last long journey.

“... Forty thousand brothers

Could not, with all their quantity of love,
Make up my sum.”

Shakespeare! Shakespeare! The waters have gone over me. Father!

Father! where art thou?

Next day, out of love for me, came d’Ortigue, Brizeux, Léon de Wailly,
some artists brought by good Baron Taylor and other kind friends to
accompany Henriette to her last rest. Twenty-five years earlier all intellectual
Paris would have been there—now, he, who loved her and had not the
courage to go with her to the little Montmartre God’s-acre, sits and weeps
alone in her deserted garden, and her young son wanders afar on the dreary
ocean.
 They turned her face towards the north, to that England she never saw
again, and her humble grave bears only—
Henriette Constance Berlioz-Smithson, born at Ennis, Ireland, died at
Montmartre, 3rd March 1854.
The papers barely noticed her death, but Jules Janin remembered and
wrote in the Débats:
“These stage divinities how soon they pass!
“How short a time it seems since we sat with Juliet on that balcony above
the Verona road. Juliet, so fair, so ethereal, listening dreamily as Romeo
speaks, her golden voice vibrating with the undying poetry of Shakespeare,
the whole world bound by her magic spells!
“She was barely twenty, this Miss Smithson, and, without knowing it, she
was a poem, a passion, a revolution—By her absolute truth she conquered.
“She it was who gave the lead to Dorval, Malibran, Victor Hugo and
Berlioz. To her Delacroix owed his conception of sweet Ophelia.
“Now she is dead and her dream of glory—that glory which passes so
rapidly—is over and done.
“In my young days they used to sing a funeral dirge to Juliet, wherein
recurred, like an old Greek chorus, the heart-breaking refrain, ‘Throw
flowers! Throw flowers!’

“ ‘Juliet is dead. Throw flowers!

Death lies upon her, softly as frost on April grass. Throw flowers!
Her love song is a funeral knell. Throw flowers!
Her marriage feast the feast of Death. Throw flowers!
Her marriage blossoms deck her tomb. Throw flowers!’ ”

Liszt wrote from Weimar as only he can write:

“She inspired you, you loved and sang of her. Her work is done!”

To Louis Berlioz.
“6th March 1854.—My poor dear Louis,—You know all. I am alone and
writing to you in the large sitting-room next to her deserted bedroom. I have
just been to the cemetery where I laid two wreaths upon her grave—one for
you and one for myself. The servants are still here and are arranging things
for the sale; I want to realise as much as possible for you.
 “I have kept her hair.
“You will never know how much we made each other suffer; our very
suffering bound us one to the other. I could neither live with her nor without
her.
“Alexis and I talked much of you yesterday. How I wish you were more
rational! It would make me so happy to feel that you were sure of yourself.
“I shall be able to do more for you now than has hitherto been possible,
but I shall take every precaution to prevent your squandering money. Alexis
agrees that I am right.
“At present I am penniless and shall be for at least six months; I must pay
the doctor and the sale will bring in but little. The King of Saxony’s director
wishes me to be in Dresden next month and I shall have to borrow money
for my journey.”

“23rd March.—Your letter is an unexpected pleasure, dear boy. With

seventy francs a month you can easily save, if you give up your habit of
squandering money. Tell me whether you can get back the watch you
pawned at Havre. My father gave it to you. If you cannot, I will buy you
another. I have had a watch chain made for you of your mother’s hair; keep
it carefully. I also had a bracelet made for my sister, the rest of the hair I
shall keep.
“Did you see Jules Janin’s touching words on your poor mother and his
exquisite reference to my Romeo ‘Throw flowers?’ I hope for another letter
from you before Saturday.
“God grant that my German trip may bring in something! The
Montmartre house is not let and I may have to pay rent there a year longer.”

What more can I say of the two great passions that influenced my life?
One was a childhood’s memory—yet not to be despised since, with my love
for Estelle, awoke my love of nature. The other—coming in my manhood
with my worship of Shakespeare—took possession of me and overwhelmed
me completely. Love of Art and the artist intermingled, each acting upon and
intensifying the other.
Those who cannot understand this will still less understand my vague
poetic longings at the scent of a lovely rose, the sight of a beautiful harp.
Estelle was the rose that bloomed alone, Henriette the harp that shared my
music, my joys, my sorrows and of which alas! I snapped so many, many
strings!

To Louis Berlioz.
“October 1854.—I am sad this morning, dear Louis. I dreamt that we
were walking—you and I—in the garden at La Côte, and not knowing
exactly where you are, my dream troubles me.
“I have some news that will not, I think, surprise you. Two months ago I
married again.
“I could not live alone, neither could I desert the woman who, for
fourteen years, has been my companion.
“My uncle and all my friends agree with me.
“I need not tell you that your interests are safe. If I die first my wife will
have but a quarter of my small fortune and even that I know she intends to
leave to you.
“If you still have any painful thoughts of Mademoiselle Recio I know you
will hide them for my sake.
“We were married very quietly without fuss or mystery. If you mention
this in your letters, write nothing that I cannot show to my wife; I must have
no cloud in my home. But your own heart will tell you what to do.
“Admiral Cécile tells me he has received your letter. You cannot enter the
Marines until the end of your three years’ cruise.
“I am overwhelmed with rehearsals and arrangements for producing my
new work, the Childhood of Christ. It bristles with difficulties.
“Good-bye, dear Louis.”
 XXXIII

DEAD SEA FRUIT

The end of my career is in sight, or if not the end, yet are my feet set on the
steep slope leading to the goal; worn and tired, I am consumed by a burning
fire that sometimes rages with such violence as to frighten me.
I begin to know French, to write fairly a page of verse, prose or score; I
love an orchestra, and can direct it; I worship Art in every form. But I belong
to a nation that cares for none of these things. Parisians are barbarians; not
one rich man in ten has a library, no one buys books—they hire feeble
novels at a penny a volume from circulating libraries—this is sufficient
mental food for all classes. For a few francs a month they hire from the
music shops the flat and dreary compositions with which they overflow.
What have I to do with Paris? That Paris—the apotheosis of industrialism
in Art—that casts a scornful eye upon me, holding me only too honoured in
fulfilling my calling of pamphleteer, for which alone, it holds, I came into
the world. I know what I could do with dramatic music, but to try it would be
both useless and dangerous.
There is no suitable theatre; I must be absolute dictator of a grand
orchestra; I must have the eager good-will of all, from prima-donna to scene-
shifter; my theatre must be a gigantic musical instrument.
I could play it.
But this will never be; it would give too much scope to the cabals of my
foes, and not only should I have to face the hatred of my critics but also the
vindictive fury caused by my original style.
People would naturally ask, “If he becomes popular, where will our
compositions be?”
I proved this at Covent Garden, where a crew of Italians nearly wrecked
Benvenuto Cellini by hissing from beginning to end. Costa was credited with
this cabal, since I had fallen foul of him in newspaper articles for the
liberties he took with the scores of the great masters. However, guilty or not,
he knew how to quiet my doubts by doing his best to help me during my
rehearsals.
 Indignant at my treatment, the artists of London tried, unsuccessfully, to
arrange a testimonial concert for me, and through my good friend Beale
offered me a present of two hundred guineas, the subscription list being
headed by Messrs Broadwood. Although greatly moved at the kindly
generosity of the present, I was unable to accept it. French ideas would not
permit.
For three years I have been worried by the vision of a grand opera to
which I want to write both words and music, as I have done in the Childhood
of Christ.
So far I have resisted temptation. May I hold out until the end![24]
To me the subject is magnificent, soul-stirring, which means that the
Parisians would find it flat and wearisome.
Even if I could believe they might like it, where should I find a woman
with beauty, voice, dramatic talent and fiery soul to fill the chief part? The
very thought of hurling myself once more against the obstacles raised by the
crass stupidity of my opponents makes my blood boil. The shock of our
collision would be too dangerous, for I feel I could kill them all like dogs.
Even from concert-giving in Paris I am excluded, for, thanks to the
machinations of my enemies in the Conservatoire, the Minister of the
Interior at the prize-giving took occasion to state that in future the hall of the
Conservatoire (the only possible one for my purpose) would be lent to no
one. The no one could only be me, for, with two or three exceptions in
twenty years, I was the only one who so used it.
Although most of the executants in this celebrated society are my friends,
they are overborne by a hostile chief and a small clique; my compositions,
therefore, are never given. Once, six or seven years ago, they did ask me for
some excerpts from Faust, then tried to damn them by sandwiching them
between Beethoven’s C minor Symphony and Spontini’s finale to the Vestal.
Fortunately they were disappointed, the Sylph scene was enthusiastically
encored; but Girard, who had conducted the whole thing clumsily and
colourlessly, pretended he could not find the place, so it was not repeated.
After that they avoided my works like the plague.
Of all the millionaires in Paris none thinks of doing anything for music.
Paganini’s example was not followed, and the great artist’s gift to me stands
alone.
 No; a composer of classical music must be absolutely independent or
must resign himself to all the miseries from which I suffered—to incomplete
rehearsals, to inconvenient concert halls, to checks of every foreseen and
unforeseen kind, and to the rapacity of the hospital tax-gatherers, who seize
one-eighth of the gross receipts. Usually I am willing and anxious to make
every possible sacrifice, but sometimes occasions arise when such sacrifices
cease to be generous and become criminal.
Two years ago, when there was still some hope of my wife’s recovery,
and therefore expenses were greatly increased, I dreamt one night of a
symphony.
On waking I could still recall nearly all the first movement, an allegro in
A minor. As I moved towards my writing-table to put it down, I suddenly
thought:
“If I do this I shall be drawn on to compose the rest, and, since my ideas
always expand, it will end by being enormously long; it will take me three or
four months; I shall write no articles, and my income will fail. When the
symphony is written I shall, weakly, have it copied and so incur a debt of a
thousand or twelve hundred francs.
“Then I shall be impelled to give a concert that it may be heard; the
receipts will hardly equal half the expenditure, and I shall lose money. I have
not got it. My poor invalid will be without necessary comforts, and my son’s
expenses on board ship will not be met.”
With a shudder of horror I threw aside my pen, saying:
“To-morrow I shall have forgotten the symphony.”
But no! Next night that obstinate motif returned more clearly than before
—I could even see it written out. I started up in feverish agitation, humming
it over and—again my decision held me back, and I put the temptation aside.
I fell asleep and next morning my symphony was gone for ever.
“Coward!” cries the young enthusiast, “brave all and write! Ruin
yourself! Dare everything! What right have you to push back into oblivion a
work of art that stretches out to you its piteous hands crying for the light of
day?”
Ah, youth, youth! never hast thou suffered as I suffer, else wouldst thou
understand and be silent.
Never was I backward, when I stood alone, to bear the brunt of my own
actions, never did I fail when my wife stood beside me, alert and hopeful, to
help me on, to face with me privation and suffering in the cause of Art. But
when she lay half dead, a doctor and three nurses in attendance, when I knew
that my musical venture must end in disaster, was I cowardly to hold back?
Did I not do more honour to my divine goddess, Music, in crediting her with
sweet reasonableness than in treating her as an all-devouring Moloch, greedy
for human victims?
If I have lately been carried away in writing my trilogy The Childhood of
Christ, it is that I no longer have these heavy calls upon me, and also that,
owing to my warm and generous reception in Germany, I can count upon the
performance of my works.
Since writing this, M. Benazet of Baden has invited me several times to
conduct the annual festival there, and, with unequalled generosity, has given
me carte blanche in the engagement and payment of my performers.
Each year Germany receives me more cordially; I have been there four
times during the last eighteen months.
So interested were the blind King of Hanover and his Antigone, the
Queen, in my rehearsals that they would appear at eight o’clock in the
morning and sometimes stay till noon, as the King said:
“In order the better to get at the heart of my meaning and to grasp more
thoroughly my new ideas.”
How warmly, too, he spoke of my King Lear—of the storm, the prison
scene, the fateful sorrows of sweet Cordelia.
“I did not believe there was anything so beautiful in music,” he said, “but
you have enlightened me. And how you conduct? I cannot see you but I feel
it. I owe much to Providence,” he added, simply; “this love of music is a
compensation for all I have lost.”
I never saw Henriette in that part, which was her best, but from her recital
of some scenes I can imagine what it must have been.
On my last visit to Hanover the Queen asked me to include two pieces
from Romeo in my programme, and the King desired me to return next
winter to superintend a theatrical performance of the same work, allowing
me to requisition artists from Brunswick, Hamburg, and even Dresden.
It was the same with the Grand Duke of Saxe-Weimar, who said, as I took
my leave:
“M. Berlioz, shake hands with me and remember my theatre is always
open to you.”
 M. de Lüttichau, superintendent to the King of Saxony, has offered me
the post of director when it shall be vacant.
Liszt strongly advises me to accept, but I cannot say. Time enough to
decide when the place is at my disposal.
At present in Dresden they talk of reviving Benvenuto Cellini, which
Liszt has already given in Weimar, and of course I should have to go and
superintend the first performances.
Blessed Germany, nursing mother of Art; generous England; Russia, my
saviour; good friends in France, and you—noble hearts of all nations whom I
have known—I thank and bless you all; your memory will be my comfort to
my latest hour.
As for you, idiots and blind! You, my Guildenstern, Rosencrantz, Iago
and Osric! You, crawling worms of all kinds! Farewell, my friends—I scorn
you; may you be forgotten ere I die!
Note.—This was originally the ending of Berlioz’ Mémoires, but his
correspondence was voluminous after this date and he also added some
chapters to his Life.

To Auguste Morel.
“June 1855.—You ask me to describe my Te Deum, which is rather
embarrassing. I can only say that its effect both on the performers and
myself was stupendous. Its immeasurable grandeur and breadth struck
everyone, and you can understand that the Tibi omnes and Judex would have
even more effect in a less sonorous hall than the church of St Eustache.
“I start for England on Friday. Wagner, who is directing the old London
Philharmonic (a post I was obliged to refuse, being engaged by the other
society) is buried beneath the vituperations of the whole British press. He
remains calm, for he says that in fifty years he will be master of the musical
world.”
“July.—“My trip to London, where, each time, I become more
comfortably established, was a brilliant success.
“I mean to go back next winter after a prospective short tour through
Austria and Bohemia—at least if we are not at war with Austria.”
“I do nothing but correct proofs from morning to night, and see, hear,
know nothing.”
 “Meyerbeer ought to be pleased with the reception of the Etoile du Nord
at Covent Garden. They threw him bouquets, as though he were a prima-
donna.”

To Richard Wagner.
“September 1855.—Your letter has given me real pleasure. You do well to
deplore my ignorance of German, and I have often told myself that, as you
say, this ignorance makes it impossible for me to appreciate your writings.
Expression melts away in translation, no matter how daintily it is handled.”
“In true music there are accents that belong to special words, separated
they are spoilt.”
“But what can I do? I find it so devilishly hard to learn languages; a few
words of English and Italian are all I can manage.”
“So you are busy melting glaciers with your Nibelungen! It must be
glorious to write in the presence of great Mother Nature—a joy withheld
from me, for, instead of stimulating, the sea, the mountain peaks, the glories
of this beautiful earth absorb me so completely that I have no room, no
outlet for expression. I only feel. I can but describe the moon from her
reflection at the bottom of a well.”
“I am sorry I have no scores to send you, but you shall have the Te Deum,
Childhood of Christ and Lélio as soon as they come out. I already have your
Lohengrin and should be delighted if you would let me have Tannhäuser.
“To meet as you suggest would be indeed a pleasure, but I dare not think
of it. Since Paris offers me but Dead Sea fruit I must of necessity earn my
bread by travelling for bread—not pleasure.
“No matter. If we could but live another hundred years or so we might
perhaps understand the true inwardness of men and things. Old Demiurge
must laugh in his beard at the continual triumph of his well-worn, oft-
repeated farce.
“But I will not speak ill of him, since he is a friend of yours and you have
become his champion. I am an impious wretch, full of respect for the Pies.
Forgive the atrocious pun!
“P.S.—Winged flights of many tinted thoughts crowd in upon me and I
long to send them, were there but time.
“Write me down an ass until further orders.”
 XXXIV

1863—GATHERING TWILIGHT

Nearly ten years since I finished my memoir and during that time my life
has been as full of incident as ever.
But since, for nothing on earth would I go through the labour of writing
again, I must just indicate the chief points.
My work is over; Othello’s occupation’s gone. I no longer compose,
conduct, write either prose or verse. I have resigned my post of musical
critic and wish to do nothing more. I only read, think, fight my deadly
weariness of soul and suffer from the incurable neuralgia that tortures me
night and day.
To my great surprise I have been elected a member of the Academy and
my relations with my colleagues are, throughout, pleasant and friendly.
In 1855 Prince Napoleon desired me to arrange a great concert in the
Exhibition building for the day upon which the Emperor was to distribute the
prizes.
I accepted on condition that I had no pecuniary responsibility, and M.
Ber, a generous and brave impresario, came forward and treated me most
liberally.
These concerts (for there were several besides the official one) brought
me in eight thousand francs.
In a raised gallery behind the throne I had placed twelve hundred
musicians, who were barely heard. Not that that mattered much on the day of
the ceremony, for I was stopped at the most interesting point of the very first
piece (the Imperial Cantata which I had written for the occasion) because
the Prince had to make his speech and the music was lasting too long!!
However the next day the paying public was admitted and we took
seventy-five thousand francs. This time I brought the orchestra down into the
body of the hall, with fine effect.
I sent to Brussels for an electrician I knew, who made me a five-wired
metronome so that by the single movement of my left hand, I could mark
time for the five deputy conductors placed at different points of the
enormous space.
The ensemble was marvellous.
Since then most of the theatres have adopted electric metronomes for the
guidance of chorus-masters behind the scenes. The Opera alone refused; but,
when I undertook the supervision of Alcestis, I introduced it.
In these Palais de l’Industrie concerts the finest effects were obtained
from broad, grand, simple and somewhat slow movements, such as the
chorus from Armida, the Tibi omnes of my Te Deum and the Apotheosis of
my Funeral Symphony.

Letters to Ferrand and Louis Berlioz from

1858 to 1863.
To Humbert Ferrand.
“November 1858.—I have nothing to tell you, I simply want to write. I
am ill, miserable (how many I’s to each line!) Always I and me! One’s
friends are for oneself, it ought to be oneself for one’s friends.
“My dejection melts away as I write; for pity’s sake let us write oftener!
These years of silence are insupportable.
“Think how horribly quickly we are dying and how much good your
letters do me!
“Last night I dreamt of music, this morning I recalled it all and fell into
one of those supernal ecstasies.... All the tears of my soul poured forth as I
listened to those divinely sonorous smiles that radiate from the angels alone.
Believe me, dear friend, the being who could write such miracles of
transcendent melody would be more than mortal.
“So sings great Michael as, erect upon the threshold of the empyrean, he
dreamily gazes down upon the worlds beneath.
“Why, oh, why! have I not such an orchestra that I, too, could sing this
archangelic song!
“Back to this lower earth! I am interrupted. Vulgar, commonplace, stupid
life! Oh! that I had a hundred cannon to fire all at once!
“Good-bye. I feel better. Forgive me!”
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