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’It was like &dquo;assisting at the creation- a universe formed out of nothing!&dquo;&dquo; According to her partner, the philosopher and biologist George Henry Lewes, this remark pleased George Eliot above all other early comments on Middle-march.2 The speaker was her real-life surgeon, Sir James Paget, and he refers to her creation of the fictional surgeon Tertius Lydgate, one of the novel’s two central protagonists. ’ Paget is astonished at George Eliot’s ’surprisingly deep’ insights into medical life. He finds it amazing that, while ’she had never even known a surgeon intimately’, she was able to create the ambitious, scientifically minded Lydgate, a practitioner of 1830, some forty years earlier, whose commitment to professional reform and to the new scientific medicine leads him into a losing conflict with provincial society and the local medical orthodoxy. George Eliot’s pleasure at the remark, we can guess, stemmed in part- but only in part- from the official endorsement which Paget gives to the lifelike qualities of the portrait, for the principle of historical accuracy combined with richly detailed specificity was a central component of her realistic technique. In preparation for the novel, she had read Pierre Victor Renouard’s Histoire de la
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