After selling Diamond as meat for a small price, Fred begins to feel very ill and asks Mrs. Vincy to call Mr. Wrench. Wrench concludes that there is nothing seriously wrong, but when Fred remains very ill the next day, Mrs. Vincy anxiously wonders if she should call Dr. Sprague. At that moment Rosamond sees Lydgate stopping outside the house, and suggests that they invite him in as “they say he cures every one.” Lydgate determines that Fred has typhoid fever, and that Wrench prescribed him the wrong medication.
This is the first substantial evidence we have that Lydgate lives up to his reputation as a talented doctor. Amusingly, Lydgate would never have gotten a chance to demonstrate his medical prowess if it weren’t for Rosamond’s crush on him, as Mrs. Vincy wanted to call Dr. Sprague instead.
Lydgate says Fred must go to bed straight away and be given a nurse; he then gives very specific instructions for his treatment. Mrs. Vincy begs Lydgate to come back regularly, and Lydgate awkwardly suggests that he can come along with Mr. Wrench. Wrench is infuriated by this turn of events and by Mr. and Mrs. Vincy’s emotional declaration that Fred might have died if it had not been for Lydgate. The Vincys make Lydgate their family doctor, which prompts a great deal of dramatic gossip in Middlemarch. A rumor even spreads that Lydgate is Bulstrode’s illegitimate son.
This passage makes it comically clear how difficult Lydgate’s job of reforming medicine in Middlemarch will be. Instead of doctors being able to just get along with their jobs, social considerations, petty rivalries, and gossip abound. Amidst all this, it becomes difficult to assess who actually possesses the medical skill needed to heal people and save lives.