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Fred arrives home feeling feverish and ill. His mother sends for Wrench, one of the local doctors, who do not feel his ailment, is serious. He hands over some powders and departs Next day, Fred is much worse, and Wrench, being out on is rounds, cannot be reached. Rosamond sees Lydgate on the street and suggests calling him in. Mrs. Vincy, unaware of medical etiquette, rushes to consult him, Lydgate knows it is a tricky situation, but has little option seeing Fred’s condition. He is convinced it is typhoid fever, and begins treatment.
The Vincys are furious with Wrench and no amount of tact use by Lydgate can disarm Wrench’s hostility to him. The incidents breed a lot of gossip among the townsfolk in which every fact is distorted, until someone even claims that Lydgate is Bulstrode’s illegitimate son!
The plot thickens with the conditions for a closer connection between Lydgate and Rosamond being prepared.
Lydgate's concern for his patients and his ignorance of small town politics enmeshes him in a hostile relationship with the other practitioners. The whole town’s curiosity and interference in even minor incidents is revealed here.