The Empire Trilogy (100 page)

“I'm perfectly willing to discuss the pathology of cholera with Dr Dunstaple,” said Dr McNab in a mild and gloomy manner, “but I doubt if there's anything to be gained by doing so publicly and in front of those who may tomorrow become our patients.”

“See! He tries to avoid the issue. Sir, there is everything to be gained from exposing a charlatan.”

The Magistrate's eye moved from one doctor to the other over the passive rows of tattered skeletons and he forgot for a moment that he was as thin and ragged as they were. What chance was there of this little community, riddled with prejudice and of limited intelligence, being able to discriminate between the strength of one argument and the strength of another? They would inevitably support the man who shouted loudest. But what better opportunity could there be of examining the fate of those seeds of reason that might be cast on the stony ground of the communal intelligence?”

“Dr Dunstaple, you will hardly make any progress if you continue to abuse Dr McNab in this way. If you insist on a public debate then I suggest you give us your views in a more suitable manner.”

“Certainly,” said Dr Dunstaple. His face was flushed, his eyes glinting with excitement; he seemed to be having difficulty breathing, too, and he spoke so rapidly that he slurred his words. “But first ladies and gentlemen, you should know that Dr McNab holds the discredited belief that you catch cholera by drinking...more precisely, that in cholera the morbific matter is taken into the alimentary canal causing diarrhoea, that the poison is at the same time reproduced in the intestines and passes out with the discharges, and that by these so-called rice-water' discharges becoming mingled with the drinking-water of others the disease is communicated from one person to another continually multiplying itself as it goes. I think that Dr McNab would not disagree with that.”

“I'm grateful to you for such an accurate statement of my beliefs.” Could it be that McNab was actually smiling? Probably not, but there had certainly been a tremor at each corner of his mouth.

“Let me now read to you the conclusion of Dr Baly in his
Report on Epidemic Cholera
, drawn up at the desire of the Royal College of Physicians and published in 1854. Dr Baly finds
the only theory satisfactorily supported by evidence
is that ‘which regards the cause of cholera as a matter increasing by some process, whether chemical or organic, in impure or damp air'...I repeat, ‘in impure or damp air'.” Dr Dunstaple paused triumphantly for a moment to allow the significance of this to seep in.

Many supporters of Dr McNab exchanged glances of dismay at the words they had just heard. They had not realized that Dr Dunstaple had the support of the Royal College of Physicians...and felt distinctly aggrieved that they had not been told that such an august body disagreed with their own man. Two or three of Dr McNab's supporters wasted no time in surreptitiously slipping their cards of emergency instructions from their pockets, crossing out the name McNab, and substituting that of his rival, before settling back to watch their new champion in the lists. The Magistrate noted this with satisfaction. How much more easily they were swayed by prestige than by arguments!

Meanwhile Dr Dunstaple was continuing to disprove Dr McNab's drinking-water theories.

“Ladies and gentlemen, the fact that cholera is conveyed in the atmosphere is amply supported by the epidemic in Newcastle in 1853 when it became clear that during the months of September and October an invisible cholera cloud was suspended over the town. Few persons living in Newcastle during this period escaped without suffering some of the symptoms that are inescapably associated with cholera, if not the disease itself. They suffered from pains in the head or indescribable sensations of uneasiness in the bowels. Furthermore, the fact of strangers coming into Newcastle from a distance in perfect health...and not having had any contact with cholera cases...being then suddenly seized with premonitory symptoms, and speedily passing into collapse,
proves
that it was the result of atmospheric infection.”

“What a fool! It proves nothing of the sort,” thought the Magistrate, stroking his cinnamon whiskers with excitement that bordered on ecstasy.

However, Dr Dunstaple had now adopted a less ranting and more scientific tone which the audience could not help but find impressive. Some of his oldest friends, who for years had been accustomed to seeing him, fat and genial, as the leading light of a pig-sticking expedition, were astonished to hear him now holding forth like a veritable Newton or Faraday and discussing the latest discoveries in medicine as fluently as if they were entries in the Bengal Club Cup or the Planters' Handicap. One or two of his supporters turned to direct malicious glances at Dr McNab, who was still leaning calmly against the ledge and listening attentively to what his prosecutor had to say. Louise, too, had dried her tears. Her father was not doing too badly and perhaps, after all, he might be right about McNab.

“When you inhale the poison of cholera it kills or impairs the functions of the ganglionic nerves which line the air-cells of the lungs...hence, the vital chemistry of the lungs is suspended; neither caloric nor vital electricity is evolved...hence, the coldness which is so typical of cholera. The blood continues to be black and carbonated...the treacly aspect of the blood in cholera is well known...and in due course the heart becomes asphyxiated. This is the true and basic pathology of cholera. The disease is, however, attended by secondary symptoms, the well known purging and vomiting which, because they are so dramatic, have frequently been taken by the inept as indicating the primary seat of the infection...I need hardly add that this is the view held by Dr McNab.”

Once again, heads turned in McNab's direction and the Magistrate's sharp eyes were able to detect a number of veiled smiles and smothered chuckles. McNab was frowning now, poor man, and looking worried as well he might with Dr Dunstaple, transformed into Sir Isaac Newton, mounting such an impressive attack. But Dr Dunstaple had now moved on to the treatment.

“What must it consist of? We must think of restoring the animal heat which has been lost and we must consider means of counter-irritating the disease...Hence, a warm bath, perhaps, and a blister to the spine. To relieve the pains in the head we might order leeches to the temples. An accepted method of counter-irritation in cholera is with sinapisms applied to the epigastrium...or, if I must interpret these learned expressions for the benefit of my distinguished colleague, with mustard-plasters to the pit of the stomach...”

There was subdued laughter at this sally. But the Doctor held up his hand genially and added: “As for medicine, brandy to support the system and pills composed of calomel, half a grain, opium and capsicum, of each one-eighth of a grain, are considered usual. I could continue to talk about this disease indefinitely but to what purpose? I believe I have made my point. Now let Dr McNab justify his curious treatments, or lack of them, if he can.”

Dr McNab was silent for such a long time that even those of his supporters who had remained steadfast throughout Dr Dunstaple's persuasive arguments and had not yet crossed his name from their emergency cards, began to fear that perhaps he had nothing to say. It surely could not be that McNab was confounded, utterly at a loss, for surely almost anyone could string a few medical terms together (enough to convince the survivors of Krishnapur if not the Royal College of Physicians) and save face. But still the silence continued. McNab's head was lowered and he seemed to be pondering in a lugubrious sort of way. His lips even moved a little, as if he were giving himself a consultation. At length, with a sigh and in a conversational tone which did not match Dr Dunstaple's oratory for effect, he observed: “Dr Dunstaple is quite wrong to suggest that there is an accepted treatment for cholera. The medical journals still present a variety of possible remedies, many of which sound most desperate and bizarre...missionaries report from China that they have been cured by having needles stuck into their bellies and arms, yet this is not thought too strange to mention...and almost every variety of chemical substance has been proposed at one time or another, all of which is a sure sign that our profession remains baffled by this disease.”

“Needles stuck in people's bellies to cure cholera, whatever next!” the audience appeared to be thinking. And the Magistrate, watching like a stoat, could see by the alarm on their faces that they were assigning this treatment to Dr McNab for no other reason than that he had happened to mention it. Here, in a test-tube before his very eyes, ignorance and prejudice were breeding like infusoria.

“In the greater number of epidemic diseases,” McNab went on, “the morbid poison appears to enter the blood in some way, and after multiplying during a period of so-called incubation, it affects the whole system. Such is undoubtedly the case in smallpox, measles, scarlet fever and the various kinds of continued fever...but it must be remarked that in these diseases the illness always begins with general symptoms, such as headache, rigors, fever and lassitude...while particular symptoms only appear afterwards. Cholera, on the other hand, begins with an effusion of fluid into the alimentary canal, without any previous illness whatsoever. Indeed, after this fluid has begun to flow away as a copious diarrhoea the patient often feels so little indisposed that he cannot persuade himself that anything serious is the matter.”

“Irrelevant!” muttered Dr Dunstaple loudly but McNab paid no attention and continued calmly.

“The symptoms which follow this affection of the alimentary canal are exactly what one would expect. If you analyse the blood of someone with cholera you'll find that the watery fluid effused into the stomach and bowels isn't replaced by absorption. The experiments of Dr O'Shaughnessy and others during the cholera of 1831–2 show that the amount of water in the blood was very much diminished in proportion to the solid constituents, as also were the salts...Well, the basis of my treatment of cholera is quite simply to try to restore the fluid and salts which have been lost from the blood, by injecting solutions of carbonate of soda or phosphate of soda into the blood vessels. Does that sound unreasonable? I don't believe so. At the same time I try to combat the morbid action by using antiseptic agents such as sulphur, hyposulphite of soda, creosote or camphor at the seat of the disease...that's to say, in the alimentary canal...”

“How eminently full of reason!” thought the Magistrate. “It will be too much for them, the dolts!”

“It's often been regretted by physicians that calomel and other medicines aren't absorbed in cholera...but this regret is needless, in my opinion, as they don't need to be absorbed. If calomel is given in cholera it should obviously not be in pills, as Dr Dunstaple suggests, but as a powder for the sake of better diffusion.”

To say that the audience had found Dr McNab's discourse dull would not be entirely accurate; they had found it soothing, certainly, and perhaps monotonous. Many of those present had found it hard to pick up the thread of what he was saying and instead had thought with a shiver: “Needles driven into your belly! Good heavens!” But Dr McNab had at least one attentive listener and that was Dr Dunstaple.

“Dr McNab has omitted to mention certain post mortem appearances which refute his view of cholera and support mine,” cried Dr Dunstaple waving his arms violently in his excitement and making thrusting gestures as if about to spear a particularly fine pig. “He hasn't mentioned the distended state of the pulmonary arteries and the right cavities of the heart. Nor has he mentioned the breathlessness suffered by the patient after he has inhaled the cholera poison!”

Dr McNab shrugged negligently and said: “These symptoms are obviously the result of the diminished volume of the blood...Its thickened and tarry condition impedes its passage through the pulmonary capillaries and the pulmonary circulation in general. This is also the cause of the coldness found in cholera.”

“Pure reason!” barked the Magistrate, unable to contain himself a moment longer.

“Nonsense!” roared Dr Dunstaple and started forward as if he meant to make a physical assault on Dr McNab. He was halted in his tracks, however, by a shout from the Padre.

“Gentlemen! Remember that you are in the presence of the altar. I must ask you to stop this quarrelling instantly, or to continue it in another place.” Furious, Dr Dunstaple now seemed on the point of turning on the Padre and mowing the wiry cleric down with his fists, but by this time Louise and Mrs Dunstaple had hastened to his side and now they dragged him away, hushing him desperately.

It was only to be expected that sooner or later the Collector's sense of duty would reassert itself. Sure enough, within a day or two of this regrettable difference of opinion between the two physicians word went round the garrison that he had been seen up and about again. On the first day of his reappearance he contented himself with walking about, avoiding people's eyes, or shovelling at the still melting ramparts like a man with a crime to expiate. But on the following day he had shaved the red stubble from his chin, was wearing a cleaner shirt, and was once more beginning to adopt a stern and overbearing expression. The Magistrate continued to give the orders which regulated the defence of the enclave, but in a subdued tone, as if referring them to the final authority of the Collector, should he wish to exercise it. It was not until the auction, however, on the third day, that it became clear that the roof of the Collector's collapsed will had once more been shored up with the stoutest timbers.

Food within the enclave had become so critically short by now that it was evident to the Magistrate that anything edible must now be used. So many people had died during the siege either from wounds or illness that a considerable quantity of private stores had accumulated. Their distribution could wait no longer. The Magistrate was in a position to order the confiscation of this food for the good of the community, to order that it should be equally divided among the survivors. But the relatives of the dead, when they heard what was afoot, raised a storm of protest and demanded that their rights to the stores should be respected. The Magistrate hesitated, stroking those terrible, radical, flaring whiskers of his...since he had shouted himself hoarse as a young man in 1832 he had been devoted to the radical cause, a supporter of Chartism, of factory reform, and of every other progressive notion which crossed his path. Now at last he had an opportunity to
act
, not merely to argue. Would he dare to grasp this chance and order the abolition of property within the community?