The Siege of Krishnapur - J. G. Farrell [145]
“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