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Lydgate’s new methods aroused mixed reactions throughout the region. Amongst the general public, his wish to "cut up" Mrs. Goby who died of mysterious causes created opposition, while among his medical colleagues, the maximum outrage was attracted by his decision not to dispense drugs himself. His enemies felt giving pills, and syrups was the only tangible proof of treatment to most patients. They also argued that prescribing from a druggist would not ensure a good quality of medicine. Unknown to Lydgate, his attempts to explain his methods in simple ways to patients was talked about and distorted beyond recognition. Finally, the unspoken cause for resentment was his curing many patients whose conditions they mis-diagnosed, and his being asked to attend the houses of the gentry of Freshitt and Tipton.
Meanwhile, the entire men of substance except Lord Medlicote refuse to fund the New Hospital. Hence Bulstrode becomes its sole supporter and Lydgate comes to be seen as Bulstrode’s man. Farebrother gives him some friendly advice: to keep some distance between himself and Bulstrode and not to get into debt. He accepts this positively. At home, he is quite content, though Rosamond offends him by wishing he were not a medical man. He insists he should not be separated from medicine.
In this part of the novel, George Eliot has given her writing immense depth and a contemporary texture. She has researched the medical research and controversies of the period and also given substance to Lydgate’s character.
His finest qualities - a pioneering spirit, lack of conceit, and the toughness to carry on regardless of opposition are brought out here. Yet, he is repeatedly called an "emotional elephant" in the matter of his attitude of placid acceptance of his wife.