Blood Pressure (3)
Liston marched straight outside, leaped onto a horse, and tore down the street at a full gallop. An actual mount, mind you, not a carriage.
And he rode terrifyingly well.
It was not altogether surprising. Horsemanship happened to be a standard subject in the medical curriculum back then, and Liston was a man blessed with absurd physical aptitude. Give a brute like that formal training, and this was the inevitable result.
“He's fast…” I muttered.
“Liston was always top of his class,” Blundell remarked casually. “Well… he had plenty of practical experience on the road, after all.”
“Practical experience?”
“You don't think Liston made his living in London from the very start, do you? Back when his technique was still unpolished, he toured the countryside operating in small hamlets. And back then… well, quite a few patients died under his knife.”
“Ah.”
Meaning he had killed even more people back then than when I first met him? That practically made him a serial slaughterhouse on legs. Small wonder the man rode like a demon possessed. If an angry mob of bereaved villagers had been chasing him from town to town, he would have had to ride like the wind just to keep his head on his shoulders. It would have been far stranger if he couldn't ride.
“Shall we find something to pass the time while we wait?” Blundell asked.
“Like what?”
“A game of cards, perhaps? Some rather exquisite merchandise just came into my possession.”
“Exquisite… merchandise?”
“Remember that trip to Paris where we made a few acquaintances? Surely you haven't forgotten the Hashish Club, have you?”
“Oh.”
No matter how blisteringly fast Liston rode, London was vast. Rushing across town and back in the blink of an eye was an utter impossibility. The city was not merely sprawling; it was a labyrinth of twisted cobblestone alleys choked with horses, carts, and suffocating crowds. We had plenty of dead time on our hands.
I had assumed we would simply indulge in some idle chatter, but Blundell produced an ornate wooden box with a thoroughly sly grin. The man had made quite a fortune lately after taking a handsome share of our blood transfusion business, so the box itself was remarkably lavish. But the contents resting inside looked far more alarming. No, scratch that—it didn't merely look alarming; it was downright illicit.
“Is that… hashish?”
“Indeed. Splendid stuff, this. Relaxes the sinews right down to the bone.”
I was sure it relaxed him, all right. Narcotics were not all stimulants that sent the nerves firing into mania. While pharmacology was never quite that black-and-white, methamphetamine and cocaine functioned as ferocious stimulants, whereas cannabis acted as a sedative.
“Must be why I find myself craving it so often lately,” Blundell mused.
People in my old life loved to argue that weed was non-addictive. What utter rubbish. It was addictive as hell. The nature of the dependency might differ, but just look at Blundell's face—the man was already wearing the dazed, blissed-out grin of a total fiend. Hashish was vastly more potent than ordinary raw cannabis, so it was only natural. Eventually, every civilized nation on Earth would regulate this garbage under strict narcotic laws. For now, however, Victorian society treated it like tobacco—a harmless, even refined leisure commodity for gentlemen of culture.
“Wait, Professor. Brother Blundell.”
“Hm? What is it?”
Blundell had already produced a small knife and was trimming the tip of the resin block with practiced ease. The instant my wretched assistants saw it, they sprang into motion like well-oiled automatons, scampering about to fetch a light. When I turned to see where on earth they had managed to spark a flame, I caught Joseph hastily grinding a spent wooden stick beneath his boot, desperate to hide it from my sight.
White phosphorus. The bloody maniacs were using white phosphorus matches again.
Lead paint on the walls, hashish on the table, and white phosphorus underfoot! What a glorious trifecta of nineteenth-century death traps!
“Doesn't that stuff muddle your senses?” I protested.
“Does it? It simply puts me in extraordinarily high spirits.”
“That's exactly my point! If you get euphoric for no earthly reason, how on earth are we supposed to measure blood pressure after this?”
“Ah, haha! Is that all you were fretting over?”
Fighting back a wave of dizzying exasperation, I tried to mount a rational argument. My expectations were lukewarm at best. In the past, I would have thrown my hands up and walked away, but surely the man had become somewhat enlightened by now. He couldn't go on living as an unrepentant embodiment of the barbaric nineteenth century forever, could he?
Yet Blundell merely offered a patronizing chuckle before waving a hand.
“Blood pressure holds no practical value whatsoever beyond satisfying idle curiosity. Oh, from a purely theoretical standpoint, I grant it might possess some minute academic charm, but that is all.”
“Excuse me? How could the rising and falling of arterial pressure possibly be meaningless?”
“Hahahahaha! My dear boy, you commune directly with the Lord God Almighty, yet here you are spouting such peculiar notions!”
Aren't your claims about meeting God the most peculiar notions in this room?
Swallowing that retort, I kept my mouth shut, mindful of the colossal theological fraud I had already perpetrated—and the many more I would inevitably have to invent in the days ahead.
Blundell pressed on with a hearty, booming laugh. “Consider how the Lord fashioned our mortal frames, Taepyeong!”
“Uh… yes?”
“Man is a creature of divine adaptation. When arterial pressure fluctuates, it is merely the vessel adjusting itself to changing external circumstance. It is entirely natural! An organic equilibrium ordained by Providence!”
“No, that's not—”
“At any rate, the matter bores me. How about you lads?”
Blundell's dismissive declaration left me utterly speechless. The so-called scientific consensus of the nineteenth century was a bewildering minefield—a bizarre mixture where half of their assumptions were accidentally correct and the other half were lethal garbage, making it maddeningly difficult to refute without sounding like a lunatic.
Meanwhile, every soul in the room besides myself—namely, my treacherous disciples—was darting their eyes back and forth between the block of hashish and my face. Their bodies were distressingly honest; Joseph and Alfred had already reached out and picked up their own portions. This was precisely why drugs were the devil's work.
“I-I am quite curious about blood pressure, Master!”
The lone hero who conquered the seductive temptation was… Colin. You absolute gem of an aristocrat. What a magnificent lad!
Overcome with paternal pride, I was vigorously patting Colin on the back when the door burst open. True to his word, Liston strode in, dragging two bewildered men behind him.
“Ugh, bloody hell! What in God's name is that stench?”
Liston screwed up his face in disgust at the sweet, heavy haze of burning resin drifting in from the adjoining parlor. It was a fair curse; the foul smoke smelled like burning weeds and rot. As much as I loathed tobacco, I would have taken a lungful of stale pipe smoke over this nauseating cloud any day.
“Eek!”
“S-Spare us, please! Have mercy, your honors!”
Liston had cursed merely out of reflex, but to the poor wretches who had been forcibly dragged here, the towering giant looked like an executioner. I quickly offered the two trembling men a gentle, reassuring smile and turned to Liston.
“Why did you bring two of them?”
“A-Are you only going to spare one of us?!”
“I have an ailing mother to feed, milord!”
A string of hysterical pleas echoed off the walls, but I tuned them out. Liston's answer took priority.
“One's a tanner, and the other's a blacksmith,” Liston explained gruffly.
“Aha. Right, excellent. Very good.”
Come to think of it, we truly did need both. Liston had sharp instincts when it came to practical brute work. I nodded in approval and turned back to the trembling pair. Curiously, they seemed even more terrified than before.
The reason was…
Goddammit…
I realized what it was. It was me. There were far too many ghastly rumors swirling around my name in this cursed city.
Naturally, the most famous and glorious title among them was Pyeong-god. Back home in Joseon or modern Korea, it sounded suspiciously like an obscene slur, but here in London, it was used with genuine reverence. Yet unlike the high-born aristocrats and wealthy patrons who sang my praises, the common folk and the wretches of the slums harbored wildly different legends.
What the devil is a ‘Heart Snatcher,’ anyway?
Whispers of me being an assassin from a Qing dynasty opium syndicate or a dark pagan shaman were already old news. The rumor that I was an arsenic murderer had fizzled out halfway, too. Right now, the most fashionable horror story was my supposed lust for human hearts. Plunging a massive syringe directly into a dying man's pericardium in the middle of what would become Trafalgar Square had clearly left a terrifying impression on the public consciousness.
To an ignorant onlooker, seeing an oriental doctor stab an iron spike into a man's chest to drain black blood must have looked like a demonic sacrificial rite. I was a man of profound empathy, so I could understand their horror. But it didn't stop me from feeling profoundly wronged.
Did the man die? No, he lived! I saved his life! Well… alright, so maybe I have killed a few people since arriving here…
It was a tragedy that, as a modern physician, I could no longer proclaim the noble boast of ‘I have only ever saved lives.’
Shaking off the bitter thought, I maintained my most benevolent, saintly expression and addressed the trembling artisans.
“The reason we invited you gentlemen here today is that we require your craftsmanship to manufacture a certain device.”
“A… a device, milord?”
“W-What manner of device might that be?”
Hearing the word ‘device,’ their stammering subsided just enough for them to cautiously turn their eyes toward me. But as they opened their mouths, a foul gust of unbrushed, rotting breath hit my nose like a physical blow. My face involuntarily twitched in disgust.
“Eeeek!”
“Mercy! Don't eat our hearts!”
Good heavens. I really needed to tackle the issue of oral hygiene in this blasted century. I managed to keep my own teeth clean through sheer willpower and crude improvised methods, but these two—and frankly, nearly every living soul in London—had never touched a toothbrush in their miserable lives. Never mind brushes; I doubted proper toothpaste even existed yet.
“No, no, calm down! We only need you to craft an instrument. You will be paid handsomely for your labor.”
“Wh-What? Truly?”
“Of course. Have you ever heard of me cheating a working man out of his wage?”
“W-Well, come to think of it… Even if you take our lives instead of our money—no, forgive me, forget I spoke!”
I had never cheated anyone out of their life either, but this was hardly the time to litigate street slander. The far more pressing catastrophe was that I had to instruct these two men on how to build a machine that even I had no clear idea how to manufacture from scratch.
An agonizing hour passed. Then two.
It took long enough that a hopelessly stoned Blundell had already stumbled out the door and staggered home in a haze of sweet-smelling smoke.
“Do you understand now?”
“Crystal clear, sir!”
“Yes, I understand as well!”
“So what are we building?”
“Just kill me now, please.”
“I don't understand a single bloody word, sir!”
No matter how many times I tried to explain the concept, it ended in complete failure. It was entirely expected. Even I didn't know the exact engineering! I was intimately familiar with the finished, mass-produced Mercury Sphygmomanometer of the twenty-first century, but how on earth was I supposed to know how the primitive prototypes were fabricated in a dingy workshop?
“Wait, wait a moment.”
As I sank into despair, Colin stepped forward. He had spent the last twenty minutes huddled in heated debate with Liston, his youthful face flushed with excitement.
“Master, could we perhaps assemble it in this manner?”
“In what manner?”
“Like this.”
“Ah… like that?”
The design he sketched out—or rather, the crude, cobbled-together diagram he presented—was remarkably intricate. A leather bladder wrapped tightly around the upper arm, pumped full of air to constrict the limb, while the internal pressure within the cuff was measured via an upright mercury column. The cessation and return of arterial blood flow would not be determined by an automated valve, but by the physician's own hand.
In short: keep a finger firmly on the radial pulse, pump until the throb vanishes, and read the mercury column the exact second the pulse reappears.
The readings are going to vary wildly depending on the examiner's touch…
Even so, my modern brain couldn't conjure up a better alternative for this era. Who in the world were the geniuses who first invented the sphygmomanometer in history? My deepest respects, you brilliant bastards. For now, Colin's crude contraption was the absolute best we could manage. Some future scholar could refine the damn thing later.
“Yes, this is brilliant. Can you manage this part?”
“Oh… aye, sir. That I can do.”
Since the tanner only had to stitch an airtight leather bladder, his face brightened considerably. The one whose expression resembled a condemned man walking to the gallows was, naturally, the blacksmith.
“So… what am I supposed to do with the quicksilver again?”
“Measure the pressure, man.”
“And what in the devil's name is pressure…?”
The poor smith had spent his life forging cleavers and horseshoes, only to be commanded to forge an atmospheric pressure gauge without a blueprint. It was enough to make any craftsman want to leap into the Thames. An ordinary patron would have been told to piss off, but Liston and I were hardly ordinary men. Together, we formed the most notorious surgical duo in the entire British Empire.
“I'll drag an instrument maker here by the collar,” Liston grunted. “You can work alongside him to hammer it out.”
“Ah, aye! If you provide a proper scholar, I'll forge whatever you need!”
And so, the work finally found its momentum. Liston spoke of dragging men by the scruff of their necks, but since we paid absurdly generous wages in gleaming gold, no one ever lodged a complaint. The design sounded feasible enough, so it seemed all we had to do now was wait for the prototype.
Yet if a day in London passed without incident, could it truly be called the nineteenth century? Of course not.
“It has been some time, Doctor.”
The Police Commissioner walked through the door.
“Ah, Commissioner! How is your mother-in-law's leg faring?”
“Splendidly, ever since you severed it. Following that mirror therapy of yours, she hasn't felt a single twinge of phantom pain.”
“Haha, marvelous news. If you ever have another relative in need of amputation, do send them my way.”
“I shall certainly keep you in mind.”
After exchanging pleasantries that would have sounded thoroughly psychotic to any normal bystander, the Commissioner turned grave and cut straight to the heart of the matter.
“A series of suspicious deaths has recently occurred across London. Poison is suspected. Have you heard anything of it?”
He was looking directly into my eyes.
Don't tell me… am I a bloody suspect?