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Mary Anne Evans was born on 22 November 1819 at South Farm near Nuneaton in Warwickshire, the youngest child of Robert and Christiana. She was known as Mary Anne/Ann until 1837, changing this to Marian in 1850, then to Marian Evans Lewes in 1854, reflecting the surname of her lover, George Lewes (1817–1878), whose forename was echoed in the pseudonym George Eliot. Marian was besieged by illnesses. Beginning with her mother’s painful death from breast cancer in 1836, she nursed her father for two years prior to his death in 1849 and later cared for Lewes’s son, Thornton, who died of tuberculosis of the spine in 1869. George Lewes remained married to Thornton’s mother, Agnes, during his 25-year relationship with Marian which met with disapproval in social circles. Lewes was an intermittent invalid, looked after by Marian during bouts of earache, headache, lumbago, crippling gout and enteritis. Marian’s own health was fragile and she did not cope well with pain; ‘I think no-one bears physical pain so ill as I do or is so thoroughly upset by it mentally’. Headaches that lasted for days, hemicrania (which she described as ‘a message of Satan’), hysteria, rheumatism, palpitations, bilious attacks and neuralgia, ‘this swamp of miseries’, afflicted her from 1849. ‘I triumph over all things in the spirit but the flesh is weak and disgraces itself by headaches, backaches and vomiting’, all of which interrupted her writing and prompted thoughts of suicide. ‘I felt quite sure that life was unendurable and that I must consider the most feasible method of suicide as soon as the revises have gone to press’ she wrote in June 1852. Anxiety about her work affected her health but once a book was published she bloomed, enjoying interludes in the countryside, beside the sea or on the Continent. Having eloped with Lewes to Weimar, Germany, in 1854, the couple felt healthy and happy; they paid homage at Goethe’s monument (Lewes’s Life of Goethe was published the following year) and were befriended by the composer Franz Liszt and his muse, Princess Sayn-Wittgenstein. In this cultured, avant-garde atmosphere Marian thrived. ‘I am really strong and well and have recovered the power of learning in spite of old age and grey hairs’, she wrote. Contemporaries commented on Marian’s unusual features. The phrenologist George Combe (1788– 1858) was intrigued by the abnormally large size of her skull: ‘in her brain development the intellect greatly predominates’. The author Henry James described Marian as ‘magnificently ugly . . . this great horsefaced blue-stocking’ (Figure 1). No-one doubted her intellect. Sir James Paget (1814–1899), surgeon extraordinary to Queen Victoria, who attended Marian regularly, admired her medical knowledge and literary genius but he could offer little to ease her ailments apart from opiates and fomentations. Sir Andrew Clark (1826–1893), ‘St Andrew’, as Lewes dubbed him, confirmed in 1874 that Marian suffered from a kidney calculus. ‘The dear man came up to us last night after his late dinner and long day’s work’ to examine Marian. The next morning Mrs Clark, ‘the buglewoman of the Scotch corps’, brought Scotch oatmeal to make a nourishing gruel. Marian faced her diagnosis stoically, acknowledging ‘the presence of that admirable substance called gravel in the place where it is least wanted, even less than in one’s boot’. Marian also consulted Sir Erasmus Wilson (1809–1894), a dermatologist and advocate of hydrotherapy who masterminded the transfer of Cleopatra’s Needle from Egypt to London. She found Robert Willis (1799–1878) ‘a valuable person’, while Dr Neil Arnott (1788–1874), physician extraordinary to Queen Victoria, was ‘nice’ (he invented the Arnott stove, ventilator and water-bed). The surgeons Robert Dunn, G.W. Mackenzie and William Parson were called upon when their more illustrious colleagues were unavailable. Treatments included ‘blue devils’ (calomel pills), hydrochloric acid, nitric acid, copious doses of quinine, ‘steel’, a course of mercury and tonics, and leeches, those ‘sweet little creatures’. In addition to her consultants, Marian knew Dr George Rolleston (1829–1881) and watched him dissect a brain. Sir Benjamin Brodie (1783–1862), Professor of chemistry, demonstrated innovative techniques at his