Chapter 192: Hygiene Obsession [1]
The sailboat we boarded sliced through the sea, rocking just as violently as it had when we first arrived. The wind was strong, and the salt air was unpleasant on the tongue, but the breeze was sharp and invigorating. And then, there it was: the silhouette of London spreading out before us in the distance. That familiar black smoke curled into the sky.
Even though I had just spent the winter in Paris, March in London still felt bitterly cold. And this was not just from the natural chill. Between the factory chimneys belching smoke and household fireplaces burning nonstop, the air itself was thick and unwelcoming.
We may not realize it, but hundreds of people die just from the air.
I wondered if it was only in the hundreds, then shook my head. People in the nineteenth century had a resilience that defied my modern sense of what was survivable. That was especially true during the recent cholera outbreak.
Sap?
Even edible sap had been carelessly prepared and handed out. And yet, the death rate had remained under ten percent. That was astonishing, considering cholera usually killed forty to fifty percent of those it infected, and here, the entire medical system had collapsed. Conditions had already been terrible to begin with.
Only dozens of people died? Really…?
And still, despite being half-starved and malnourished myself, I survived.
“What are you thinking about?”
“Ah… It’s just been a while.”
“It has. I’ve written down everything that happened and sent it back in a letter, so our medical school will probably begin to change.”
“A change?”
“Things like the concept of miasma.”
“Ah…”
My way of thinking had shifted after all those conversations with Liston. Would it make a difference? I thought so. At least at our university, change seemed likely. Even if things had not changed yet, they would once we brought Dr. Liston into the fold.
But what about everywhere else?
There are still places manufacturing white phosphorus matches…
I heard that they were still making them even in areas under direct pressure from Liston himself. Sure, some factory owners changed industries simply because they did not want to die, but others insisted the efficiency of white phosphorus was too good to give up. People died, yes, but that was considered an acceptable loss. Their logic was simple: “People die anyway.”
Which… was not technically wrong.
Still, let’s not expect too much…
There were too many problems to count. Take the Paguette faction, for example. They had lived through the cholera catastrophe too, but even now, half of them, especially those in Montpellier, were still stubborn.
We made a fortune advancing anatomical education, yet the Londoners were still mocked as ignorant. The driver who told me that only confessed later. He said that if he had mentioned it at the time, Liston would have torn him limb from limb.
“Well, we’ll be arriving soon. Let’s go inside and eat.”
The navigator called us in. We already knew how much worse the rocking would get when the sailboat stopped, so we obediently headed below deck. Not long after, the ship lurched hard enough to feel as if we had struck something.
“I say this every time, but I really can’t get used to that.”
Even Liston looked a bit pale. He was probably remembering the navigator we had met earlier: thin, wiry, and clearly underfed. In truth, Liston himself was not physically robust either. He was on the lean side.
Considering the kind of food sailors received, it was not surprising. Their work demanded strength, but their teeth shattered from clenching, rot, and cavities, none of which were preventable in an era with no real dental hygiene. With teeth in such poor shape, it was nearly impossible to eat properly.
I should really look into dentistry too… But…
This damned era. So many problems felt inevitable. And because I was a doctor, my mind naturally circled back to medical ones. But if I tried to fix everything all at once, I would fail. That was not even a question. Solving things step by step was the only way forward.
And fortunately, there was one thing that gave me real hope.
“Anyway, let’s find disinfectant the moment we get back.”
That was not me speaking.
“I know. We have to find it. Maybe, maybe this is the key to puerperal fever!”
And that was not me either.
Those were the words of Liston and Blundell, two of the best doctors this century had to offer.
Had they gone mad?
Not at all.
“So, Professor, I’ll ask my father if he’s heard anything during trade.”
“I’ll help too. I might have overheard something while brewing.”
“Well, I’ll help as well! I’ll try anything I can get my hands on!”
Alfred. Joseph. And Colin, who frankly did not need to go this far.
That man… What was he even thinking? Pulling teeth to test anesthesia, drinking sewage to study miasma, and yet not only surviving but staying so enthusiastic that I could not predict what a terrifying man he would grow into.
Regardless, the important part was this: our group’s understanding of hygiene had finally clicked into place.
“The carriage is here. Aubergines.”
“Oh, that smell. The miasma is already hanging over the streets…”
Liston and Blundell pulled out the handkerchiefs they had bought earlier and covered their noses. They were even wearing gloves now. It was that filthy.
“Whew…”
“Ugh…”
“Oh my. Home sweet home.”
The others did not seem much better off.
What a waste of money…
Looking around, it was really—well, it was shit. Literal and metaphorical.
We had lived in absolute filth. Especially you, Liston. I should have taken a photo of your knife. Who else cut off limbs with a blade still caked in blood, fat, and rotting tissue?
“Oh my. Look at the Thames!”
“It’s shit. A disaster waiting to happen.”
“Actually, what is strange is why cholera didn’t break out during our experiments.”
“Well, isn’t that obvious? The Lord protects us.”
“Aha, I see. Frenchmen, now, they’re clearly not as favored by God as we are!”
“Ha ha ha ha ha!”
While they joked, I kept my thoughts to myself. I had not yet explained miasma in scientific terms, that not all airborne particles were pathogenic, that some were beneficial, and that not all bacteria were harmful. So their conclusions were drifting into odd territory.
Still… I can’t just start explaining everything.
Not because I feared being labeled a heretic. Not anymore. Not with this group. We had been through too much. We had built something dense and meaningful.
I still remembered how cold it had been during the cholera outbreak, and how moved I felt when Professor Blundell got sprayed with diarrhea and still did not flinch. It was disgusting, sure, but in that moment, I almost cried.
This is going to get messy…
Try telling all this to newly minted medical students who were just starting to grasp what a pathogen was. Were there really different types: bacteria, viruses, parasites, fungi? It was complex enough that there should be a separate department just for infectious diseases. Even I did not know everything, and I was a professor of surgery.
Better to keep quiet. I need to support them where they are.
So I said nothing. Our carriage clattered across the bridge over the Thames. This was the closest we could get to the water.
“Ugh.”
“It’s so filthy…”
“I really ought to bring this to Parliament.”
“Good idea. Put your weight behind it.”
The stench was overpowering. It was not just the smell. It was the water itself. Bits of who-knew-what floated by. I did not want to know. But at least Dr. Liston had resolved to speak to Parliament himself. If anyone could shake them into action, it was him.
“Of course, we’ve got one job before that.”
“Disinfection.”
“Right. Disinfection.”
Liston had clearly decided to tackle that first. He was wise. You could not fix everything. One step at a time.
“Whew. We’re here.”
“Finally. Hm.”
We arrived at the university after a very long absence. To my surprise, I felt welcomed. This place was now my academic home. If I felt this way, surely the others did too.
“…Hmm.”
“…Mmm.”
But something was off. Their reactions were oddly cold.
“The anatomy lab… that heap of miasma is right next to the patient ward. Barbaric.”
“The obstetrics and gynecology department is beside it too. What an insult!”
Ah.
That explained it.
Thoughts that had once existed only in my head were now being said out loud, and without hesitation. That alone made me feel oddly hopeful, even if a bit feverish.
“Hey, you bastards! Everyone out!”
“Yes, sir!”
“Oh, you’re back!”
“What’s going on?”
Liston burst through the door like a battering ram. The moment they heard him, everyone rushed out into the dim, gas-lit hallway. His presence alone felt like a gang boss coming home.
“Is this how you study? Are the bookshelves falling over with laziness?”
They looked stunned. For a man who used to say, “If you want to save a life, look at one more patient,” this was uncharacteristic.
As for me?
I’m thrilled.
Liston was saying all the things I had wanted to say but could not. There was no comfort like standing behind someone like him.
“There are rats! Kill them all! And start by scrubbing the floors! The dissection room, that cesspit, is the biggest problem of all. Do you have any idea how much miasma is in there?!”
There was no “after the lecture” or “after your shift.” He meant now. Unsurprisingly, while the students scrambled, the professors did not look happy.
“Uh, Professor Liston…”
One professor hesitantly approached me instead. Maybe he thought I would be more reasonable.
“But… why? Miasma is air. Poisonous air. This is London, a city weighed down by centuries of accumulated life. But cleaning the floor… What’s the point? Are we really saying bad smells are the problem? I mean, it’s not wrong, but…”
He trailed off.
That was why I used the past tense.
Because he shut up shortly after.
“Well, fine. So you don’t want to clean?”
“No, I do. I just—”
“Then do it! Complain after! Every second counts!”
“Uh—yes, understood!”
The professor took off running, broom in hand.