It would be helpful, for your own sakes, to imagine the author (this mule fellow) hunched at a writing desk with a quill. A physician walks sullenly out of the house, unsure if he’ll ever return. The author has been left at his desk to take a draught of an elixir that will hopefully address the unknown but incessant psychological issues (if you’ll recall, he once turned himself into a mule). This is the type of ailment where the author has frequent headaches and sometimes coughs up blood and the best medicine is simply a good deal of rest, but for whatever reason the author decided that the best rest is had somewhere else. He spent a month or so with his cousin in West Essexingtonshire who advised him to marry soon (at a time like this??). This cousin is of questionable repute, and the author only learned of his cousin’s existence upon leaving the orphanage where he was raised. It’s all moot, however, as upon the author’s return from the country he was accused of treason and imprisoned without trial in an island fortress off of Marseille. He spent many years there, plotting against his accusers, and eventually escaped and carried out his nefarious plans.
But again, now he’s at home, writing. And sick.
That sets the stage for all that follows.