Poison, It's Poison [1]
A minor uproar had broken out.
This was precisely why local anesthesia was an absolute necessity. The trouble, of course, was that proper local anesthetics would not be synthesized until the middle of the twentieth century. How had the medical world managed until then?
With cocaine.
"Hmm, a headache? Why not try a pinch of cocaine?"
"Hmm, feeling melancholy? Why not try a pinch of cocaine?"
Such was the enduring legacy of Dr. Sigmund Freud, the godfather of psychiatry. In his younger days, that gentleman had been an absolute virtuoso of cocaine. He indulged so copiously that he even uncovered its numbing properties. In truth, snorting cocaine does not burn the nasal passages precisely because of that potent local anesthetic effect.
You have seen it in American crime dramas, haven't you? Whenever detectives test white powder, they dab a speck onto their gums. They aren't trying to get high on duty; they are testing whether their gums go numb. It didn't merely possess local anesthetic properties—it was terrifyingly, brutally potent.
'Still, I can hardly go around dispensing cocaine...'
To begin with, I wasn't even certain whether pure cocaine had been successfully isolated in this era. Purification was a remarkably delicate chemical process. Then again, science in this chaotic age progressed in fits and starts, so I couldn't rule it out entirely.
"Nngh..."
Even while my mind wandered, the intravenous fluid dripped steadily and ceaselessly into the veins of both patients. At this stage, there was no need for me to hover over them like a hawk. Why? Because my lads were masters of the craft now. Truly, in some respects, they might have been better at running a line than I was.
"Urgh!"
Meanwhile, the wretch who had collapsed on the floor was in a dreadful state, violently heaving and purging from both ends in an absolute tempest of misery. Sheets of cold sweat drenched him from head to toe, and his limbs trembled violently.
Was this truly just... chills? Was his core temperature merely plummeting? No, impossible.
'Potassium depletion... Bloody hell. That's why they die. That's why the heart arrests.'
Violent vomiting and diarrhea, as anyone could deduce, meant catastrophic fluid loss. And what poured out of him wasn't merely waste; broken down to the microscopic level, vital nutrients were being flushed away. When induced not by an ordinary bug but by a lethal poison like arsenic, the devastation was exponentially worse. (Though that Parisian cholera outbreak from the Seine had been remarkably virulent in its own right, no doubt due to the foul river water.)
Either way, the body hemorrhaged critical electrolytes, the most fatal loss being potassium. In a modern hospital, one would monitor the patient while infusing balanced saline solutions, but we had no such luxury here. What was I pumping into his veins? Plain, crude saltwater. Sodium chloride. NaCl. Not a single trace of potassium!
"Boys."
"Ah, yes! Does he look like he's about to perish? Shall we pray?"
"Should we chant Lord have mercy three times?"
At my call, Alfred, the softest-hearted of the lot, and Joseph, the most devout, stepped forward clutching crucifixes—the indispensable toolkit of any respectable physician in this barbaric century. Frankly speaking, compared to most nineteenth-century medical treatments, prayer was far more helpful and comforting. Whenever doctors actively tried to do something, the patient usually died.
Unfortunately for their piety, I was not that kind of doctor.
"Go buy some cabbage."
"Cabbage...?"
"Is this some sort of Joseon shamanism?"
"Ah... I've heard of JESA. It's a ritual performed for the dead, isn't it?"
Heh. Mad bastards, the lot of them.
Cabbage was a veritable treasure trove of nutrients. Packed with all manner of wholesome elements, it was particularly rich in potassium. Bananas would have been far better, of course, but I had yet to see a single banana in London.
"Could you just... buy it if I tell you to buy it?"
"R-Right."
"Understood. He's about to start cursing again."
"I shall fetch it at once, Master!"
"You stay lying down, you idiot."
The fortunate thing was that the moment I began trembling with quiet rage, everyone fell into line. In the end, only Joseph dashed out into the street... which was actually for the best. Saline had to be continuously brewed and administered; if I were left entirely alone, I would have had to do everything myself. Having Alfred, the Master of Infusions, by my side made the workload vastly more manageable.
"Wake up! Snap out of it!"
The moment Joseph returned with the cabbage, I shredded the leaves finely, boiled them into a concentrated broth, and let it cool thoroughly. Potassium is water-soluble; it leaches out with ease. The dilemma, however, was that I could not simply pump cabbage broth directly into a vein. If I did that...
"Why wake him? Can't we just pour it into the tube?"
"Absolutely not."
"Why ever not?"
Because he would die, that's why. The boys were innocently curious, but if one injected random concoctions into a vein out of curiosity, the patient ended up in a pine box. Fortunately, I had a convenient precedent to cite—though whether one could truly call it fortunate was another matter entirely.
"You remember what Professor Blundell used to do?"
"What? That professor dabbles in all sorts of peculiar things."
"Blood transfusions."
"Ah... that devil's sorcery..."
Lest anyone misunderstand, blood transfusion is one of the few truly miraculous weapons in a physician's arsenal to pull the dying back from the brink. But when performed without blood typing, or worse, by mixing blood from multiple donors into a single slurry, it became, exactly as Joseph said, the work of the devil.
"Right. But he didn't stop at blood, did he?"
"No... he injected plenty of other fluids."
"At least he mostly tested them on dogs."
"True enough. But nearly all of them died, didn't they?"
Blundell was a man of terrifying determination. To save a life, he would try every conceivable method under heaven. If a patient was on the threshold of death, he attempted anything imaginable—such as combining his own blood with his assistants' and transfusing the mixture into the dying. In a sense, it was profoundly noble. Who on earth volunteered their own blood like that?
'When there's no immediate emergency, he experiments on animals...'
Animal welfare societies did not exist in an era where human rights had barely gained a foothold. Besides, London crawled with such an absurd plague of stray dogs that a single stroll down an alley yielded a cartful of captured hounds. Naturally, Blundell's frail frame and clumsy hands were useless for catching them, requiring Liston's immense brawn to do the heavy lifting. In any case, Blundell had injected beer and every imaginable liquid into the veins of those captured beasts, and almost all of them had perished. Astonishingly, among the liquids he had tested was vegetable broth.
"They died back then. If even a hound couldn't survive it, how could a human endure it?"
"Aha... Then what do we do?"
"We make him drink it."
"I see. But will this..."
To be entirely honest, a few dogs had actually survived. Living creatures are surprisingly resilient. And a nineteenth-century Londoner was certainly no more delicate than an alley mongrel. Looking closely at this patient, he was the very lad who had previously downed raw Thames water and walked away completely unscathed.
'Should I just inject it...?'
No, absolutely not. No matter what, I was a twenty-first-century medical professional. I could not commit an act with such an obviously catastrophic outcome. Well... it was somewhat rich for me to preach ethics given how many times I had experimented on people, but still.
"Pyeong? Are you going to inject that?"
"No, no! Absolutely not!"
Whew. I had nearly slipped the broth into the IV line on pure impulse.
Narrowly banishing Satan's temptation, I slapped the patient's cheek. It sounded terribly cruel, but it wasn't out of malice. What was the greatest advantage of an intravenous drip? You could deliver precise quantities of water and dissolved solutes even to an unconscious patient. Furthermore, you knew the exact volume entering their circulation. Still, to get this broth into him, he had to be conscious enough to swallow.
"Hey! Wake up! If you don't wake up right this instant, I'm just going to pour this down your throat!"
"Good heavens... an absolute demon..."
"Even the hounds died from that..."
Amidst a chorus of muttered misunderstandings, the patient finally fluttered his eyes open. It was likely thanks to the saline already infused; once dehydration eased, blood flow to the brain naturally improved.
"Ugh... urgh. The taste is..."
"An Englishman complaining about taste? Stop whining and drink! It tastes better than most of your country's soups anyway!"
"Pyeong is insulting our cuisine again."
"He's not entirely wrong, though..."
Leaving behind a strangely deflated Alfred and Joseph, I forced the cabbage broth down the patient's throat by the cupful.
'Yes, this is the right way.'
Infusing electrolytes intravenously carried far more than just osmotic risks or infection hazards. For an electrolyte as potent as potassium, an uncontrolled intravenous surge could stop the heart dead. Since I couldn't measure the exact concentration in the boiled broth, an injection was out of the question. But when taken orally, it passed through the digestive tract; anything in excess would simply be purged or excreted. Truly, the human body was a marvelous machine. This was why modern physicians insisted that whenever enteral intake was possible, oral nutrition was far healthier than an intravenous drip.
"Drink!"
"Urgh. No more... I cannot..."
"A fellow who just emptied his bowels like an erupting geyser has no right to say 'no more'!"
"Oof... urgh. Aaargh!"
"See? Drink up!"
"Oogh."
Even while groaning, he was still soiling himself. Arsenic... a truly terrifying poison. The thought spurred me to issue fresh orders.
"Colin."
"Yes, Master."
"Bar the lecture hall. Don't let a single soul inside."
"Ah... yes, Master."
"And Joseph?"
"Yeah?"
"Open every window facing the street."
"Uh... right, good idea. Because the arsenic is dangerous, right?"
"Yes. There's no doubt about it."
"Understood."
Some busybodies were already snooping around outside. Well, calling it 'already' was an understatement—a considerable amount of time had passed. We had stayed up virtually the entire night. In the meantime, Colin had almost entirely recovered. Looking at that lad...
'He pulled his own tooth, drank raw river water, and bounced right back. Tough as iron.'
Was he born an aristocrat because of hardy lineage? He was extraordinarily robust, and on top of that, he possessed magnificent surgical hands. Mad experimental zeal paired with golden hands—born to be a surgeon, through and through.
"What is all this commotion?"
Liston, arriving late for morning rounds, strode into the infirmary.
"I saw young Colin blocking the students outside, warning them they'd meet their maker if they stepped a foot inside."
"Yes, take a look at this fellow."
"Oh, isn't this the lad who drank the river water and didn't even bat an eye? Look at him now, though. Hmm. Splendid."
"Yes. Wait, what?"
Splendid? What was this man on about?
Of course, after a night of aggressive rehydration, the patient's condition had improved dramatically. But that was only relative to his near-death baseline; objectively speaking, he was an absolute wreck. For starters, his trousers were soaked through with filth. I hadn't washed him yet for fear of contaminating the intravenous catheter site, so the stench was... astronomical. (I certainly wasn't leaving the dirty job for Joseph, Alfred, or Colin to handle, definitely not.)
"Why do you think I brought those items here in the first place?" Liston asked casually.
"To... to check whether they contained arsenic..."
"Haha, my boy! A green that vivid is obviously arsenic! If I merely wanted to verify that, I would have sent a swatch to a chemist."
"Then...?"
Come to think of it, something was profoundly amiss. Why had we laid those green dresses and artificial flowers out in the lecture hall? Those were quite expensive luxury goods. Liston's acquaintances knew him too well to steal them, but students would naturally flock over to gawk and touch...
"Wait... don't tell me?"
"I reflected on my methods after our little water-drinking experiment," Liston said with a self-satisfied grin. "We are civilized gentlemen, after all; how long can we go on forcing things down people's throats? The best method... is naturally when the subjects volunteer without even realizing they are test subjects."
"Wow..."
Liston... This man...
He was an absolute mastermind. What a terrifyingly brilliant bastard.
Operating this way meant zero legal liability and zero pangs of conscience! Granted, ordinary folk wouldn't imagine that finished consumer goods were dyed with lethal poison, but these lads were medical students. Ignorance was a sin.
"And just as I hoped... ah, did I say hoped? Haha! Just as I predicted, a patient manifested. Displaying symptoms identical to the guest lying in that hotel room."
"Yes, indeed."
"Of course, this alone won't immediately ban the use of green wallpaper across the realm. But it will at least sound an alarm for the public. And it will be of great assistance to our friend in the police."
"Which means we'll keep securing a steady supply of free cadavers."
"That is the crux of the matter, lad."
"Haha."
"Heh-heh."