“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 drinkingwater 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.