The Fiery Cross - Diana Gabaldon [550]
“The meat’s greasy,” Jamie said, “but that’s good—” He stopped abruptly as he shifted his weight, with a muffled groan as he moved his leg.
I could feel the steps of the process of amputation, echoing in the muscles of my hands and forearms; the tensile severing of skin and muscle, the grate of bone, the snap of tendon, and the slippery, rubbery, blood-squirting vessels, sliding away into the severed flesh like . . . snakes.
I swallowed. No. It wouldn’t come to that. Surely not.
“Ye need fat meat. You’re verra thin, a muirninn,” Jamie said softly, behind me. “Too thin, for a woman breeding.”
I turned round, swearing silently to myself once more. I’d thought so, but had hoped I was wrong. Three babies in four years! And a one-handed husband, who couldn’t manage the man’s work of a homestead and wouldn’t do the “women’s work” of baby-minding and mash-brewing that he could handle.
Marsali made a small sound, half-snort, half-sob.
“How did you know? I havena even told Fergus yet.”
“Ye should—though he kens it already.”
“He told you?”
“No—but I didna think it only the indigestion that troubled him, whilst we were hunting. Now I see ye, I ken what it is that’s weighin’ on him.”
I was biting my tongue hard enough to taste blood. Did the tansy oil and vinegar mixture I’d given her not work? Or the dauco seeds? Or, as I strongly suspected, had she just not bothered to use either one regularly? Well, too late for questions or reproaches. I caught her eye as she glanced up, and managed—I hoped—to look encouraging.
“Och,” she said with a feeble smile. “We’ll manage.”
The leeches were stirring, bodies stretching slowly like animated rubber bands. I turned back the quilt over Jamie’s leg, and pressed the leeches gently onto the swollen flesh near the wound.
“It looks nastier than it is,” I said reassuringly, hearing Marsali’s unguarded gasp at the sight. That was true, but the reality was nasty enough. The slashmarks were crusted black at the edges, but still gaped. Instead of the sealing and granulation of normal healing, they were beginning to erode, the exposed tissues oozing pus. The flesh around the wounds was hugely swollen, black and mottled with sinister reddish streaks.
I bit my lip, frowning as I considered the situation. I didn’t know what kind of snake had bitten him—not that it made much difference, with no antivenin for treatment—but it had plainly had a powerful hemolytic toxin. Tiny blood vessels had ruptured and bled all over his body—internally, as well as externally—and larger ones, near the site of the wound.
The foot and ankle on the injured side were still warm and pink—or rather, red. That was a good sign, insofar as it meant the deeper circulation was intact. The problem was to improve circulation near the wound, enough to prevent a massive die-off and sloughing of tissue. The red streaks bothered me very much indeed, though; they could be only part of the hemorrhagic process, but it was more likely that they were the early signs of septicemia—blood poisoning.
Roger hadn’t told me much of their night on the mountain, but he hadn’t had to; I’d seen men before who’d sat through the dark with death beside them. If Jamie had lived a night and a day since then, chances were he would go on surviving—if I could control the infection. But in what condition?
I hadn’t treated snakebite injuries before, but I’d seen sufficient textbook illustrations. The poisoned tissue would die and rot; Jamie could easily lose most of the muscle of his calf, which would cripple him permanently—or worse, the wound could turn gangrenous.
I stole a look at him under my lashes. He was covered with quilts and so ill he could barely move—and yet the lines of his body were drawn with grace and the promise of strength. I couldn’t bear the thought of mutilating him—and yet I would do it if I must. To cripple Jamie . . . to leave him halt and half-limbed . . . the thought made my stomach clench and sweat break out on