Chapter 178: Cholera [3]
“You damn British bastards.”
“I keep getting diarrhea because I drank water!”
Concepts were crashing into each other. It sounded ridiculous, but this was reality. And absurd as it was, this scene played out against the backdrop of two thousand years of medical tradition. Ever since our great physician Hippocrates established the theory of the four humors, this line of thinking had never been seriously questioned.
“What did you say?”
“No, no. Nothing.”
I was trembling now. The French, faced with a sword-wielding master named Liston, were helplessly drinking water under duress. Even across the Channel, he was still making people drink water, now reinforced by my own insistence. But it was not seawater, at least. It was not salty.
They were vomiting and having diarrhea like their insides were collapsing. If we fed them seawater on top of that, they would die immediately. Due to osmotic pressure, water desperately trying to leave the body would be pulled back in—or even into the lungs. You had to get the concentration right. But there was no time for such precision. So we were roughly diluting it and forcing the water down, even though it tasted like vomit.
Compared to the French on the first floor, who had been drinking from the Seine, the patients on the second floor looked much better. I used to wonder if corpse water was the most dangerous kind in the world, but apparently, I was wrong. Whatever the Seine was carrying now, it was pure poison. I did not know what had happened to make it so. Sure, it was obviously a bad idea to use the same water source for both drinking and sewage, but still. How did it get this dirty?
I’ll have to investigate this once things calm down.
For now, the issue was limited to this hospital. But who knew? Maybe tomorrow it would become a citywide disaster. Didn’t most of Paris drink from the Seine? There were exceptions, of course. The wealthy had water delivered from upstream for their estates and restaurants, for the benefit of gourmets, aristocrats, and the rising bourgeoisie who cared about taste. But they were the minority.
Maybe… Paris really is about to become hell.
When people talked about mass death from environmental disasters, they usually referred to the London smog. But there were worse cases. And now that I thought about it, this was Paris.
Twenty thousand people died…
Cholera. Even in the twenty-first century, Korea still classified it as a Level 2 notifiable infectious disease. There was a reason. If not treated properly, cholera’s mortality rate could reach fifty percent. The good news was that it was easy to prevent. Proper sewage systems, clean drinking water, and boiling water were usually enough. But here? Not one of those precautions had been taken.
What was the original treatment plan again…?
You could not jump to conclusions. But even now, would they somehow come up with the right treatment for cholera? Of course not. This place specialized in killing people through ignorance.
If the infection spreads across the city, or even just a few more wards, it’ll become a matter of comparison.
Before, I had been terrified of people dying. I still was. But in the end, humans were creatures who could not tell the difference between feces and soybean paste until they tasted it. The reason I was able to suggest the new “miasma differentiation” theory was because of an experiment that Dr. Liston had inadvertently led. It would prevent future mistakes. This was the right approach.
“Hey. Why are you smiling so much? It’s creepy.”
I must have laughed. I was thinking that if I could save the lives of Londoners by sacrificing some Parisians, wasn’t that worthwhile? But apparently, Liston was watching. His expression darkened when he saw me grinning in a ward full of groaning patients. Blundell was whispering something to Joseph beside him, glancing at me. I heard it too. This building had high ceilings, and voices carried easily.
“See? I told you, he’s a villain.”
“Yeah, sometimes he really is scary.”
Ridiculous. But now was not the time to clear my name. And besides, wasn’t this mess turning into a valuable teaching opportunity? In London, corpse-contaminated water was far more lethal, but here in Paris, it was the Seine that was killing people.
“Professor.”
“Stop smiling like that. It’s even more unsettling.”
“Originally, the symptoms from drinking corpse water were worse, right?”
“Huh? Now that you mention it… But here? Yeah, you’re right. Maybe there really are different types of miasma. Is French sewage just that toxic?”
It was not a completely wrong guess. At least for now, the French seemed… poisoned. Likely full of cholera bacteria.
Antibiotics… Tetracycline, not penicillin.
Tetracycline was an old drug, derived from soil bacteria. It was not cutting-edge, but right now, I had nothing better. Still, the main treatment for cholera was not antibiotics. It was hydration. What we were doing right now, pumping water in, was correct. Of course, some would still die. This was a completely different situation from London.
“Yes, I think so too. Damn these French.”
“That’s the spirit. French bastards.”
One of the collapsed Frenchmen stirred at our words, but that was it. Diarrhea from E. coli or staph toxins was one thing. Cholera was on another level. Dehydration set in so quickly that you would think the body was dumping its fluids down a drain. And it was not just water. They lost electrolytes too, which caused convulsions. I was not sure if adding salt would help.
“Just drink it already!”
“Ugh…”
I pushed something resembling a funnel into the mouths of those refusing water and poured it in with all my strength.
“Are you torturing them?”
“Those cruel bastards… What was Pierre thinking, bringing them here?”
It must have looked like torture. On the second floor, people began murmuring. That was fine. Judging by what had happened in London, it was only a matter of time before they collapsed too. The water up there was only slightly better.
“Ugh…”
“Ahhh! It’s coming out!”
“Go to the hallway!”
“Nooo!”
We waited. And sure enough, the sounds of vomiting and diarrhea began to echo from above.
“Shall we head up?”
“Yeah.”
The strain here was different. Judging by the fatality rate, it was probably less than half of London’s. Maybe, with some luck, no one would die. The problem was that too many people had taken the water challenge, eager to prove they could match the British. The only silver lining was that they were all medical students, generally healthy ones. Though a few did look older.
We’ll be giving out awards as a group…
Awards? Could we even hold proper funerals? Was there ever a time when people did not get buried prematurely? Still, this was a hospital. Dead medical students usually went straight to the dissection table.
Should I call that lucky…?
I was still handing out water when morning came. Sunlight spilled across Paris, and I immediately noticed that the city looked different. The river’s color had changed. Foot traffic had decreased dramatically.
This… isn’t right.
Medical history was not a major subject. You barely skimmed a chapter before moving on. Events did not always get recorded unless they were huge. But the death of twenty thousand people from cholera? That stuck. Though, if I remembered correctly, it did not happen in 1830.
That said, before modern sewage and water treatment, it was not uncommon for large cities to lose over a thousand people a year to cholera. But judging by the way Paris felt this morning, this would not be one of those ordinary years.
“Pyeong.”
Liston stood beside me. Normally cheerful, he looked drained. He had stayed up all night helping treat nearly a hundred patients.
“Yes?”
“The city feels wrong. Too quiet.”
“I agree.”
“London was like this once. It was cholera.”
“Ah…”
I was surprised. Could he really tell just by the atmosphere?
No… Liston’s a genius. He lacks information, not insight.
A man like him would not overlook something this serious, an event tied so closely to medicine.
“Well, people here are vomiting and having diarrhea. Especially those on the first floor. It’s severe.”
“Then this is very serious.”
And finally, I felt it. A shared understanding. I could relate, at last, to a nineteenth-century doctor. Because yes, this was serious. Even five thousand deaths, let alone twenty thousand, would make it a public health disaster.
“We may have treated it wrong.”
“Sorry?”
But something was off. Our conversation did not quite align. There was no point pushing further, so I waited.
“Actually, the treatment getting the most attention is Saunders’ odor-removal liquid. Some say opium or ether helps. I’ve tried castor oil, but it wasn’t great. And others say the only way to stop diarrhea is by inducing more of it.”
I heard everything, but I had no idea how to respond. So many theories. So many wrong ideas. Fortunately, Liston had already been exposed to enough modern thinking that he might listen.
“Professor.”
“Go on.”
“Wasn’t that the treatment from back when people thought miasma was just bad smell?”
“Ah, the odor remover? Hmm… you’re right.”
“If it worked, would thousands still be dying every year?”
“You make a good point. And come to think of it, none of our patients have had convulsions yet. So what you’re saying is…?”
“I think this may be a different type of miasma. One that causes cholera. The symptoms are more intense, but if we dilute it properly, patients recover.”
The truth was, what mattered most was fluid balance. If we kept the body hydrated long enough, the immune system would take care of the cholera bacteria.
“Right. Good. Then let’s hire more people. At this rate, we’ll collapse.”
“Yes, sir!”
There was no need to say more. That alone was enough for the treatment to begin.