“If you mean their authors, it’s my understanding that Emanuel Timonius and Jacob Pylarinus are physicians of high standing in Turkey and the Levant.”
“Italians!” sneered Dr. Douglass. “Exiled in infidel territory and letting themselves be led into folly by a gaggle of old Greek women.”
“The Romans and the Greeks,” said Boylston, “have been counted wise before now. In any case,” he added, “Dr. Timonius may be Italian by birth, but he’s part British by training. He possesses a degree from Oxford, I believe, and he, too, is a Fellow of the Royal Society.”
Dr. Douglass drew every inch of his dignity together. “Every other medical practitioner in this town, sir, has rejected the operation as a dangerous bit of Oriental quackery. Are we to understand that you regard your judgment as trumping such a heavy weight of opinion?”
Boylston folded his arms and considered Dr. Douglass. “I regard it the right of every doctor in this town,” he said at last, “to weigh the evidence and draw his own conclusion.”
“And on what did you base your conclusion?”
“Experience,” said Boylston.
“What experience?” challenged Dr. Douglass.
“There’s a small army of people right here in Boston who’ve undergone the operation in Africa—”
“Africans!” snorted Dr. Douglass. “Idiots!” He snapped his fingers. “The greatest race of liars on the earth.”
Chuckles sputtered around them. “Anyone who can talk may lie, sir,” said Boylston quietly, and the amusement dropped out of the air like lead. Somewhere in the brightness, a bee buzzed. “I have made it my business to speak to as many of these African inoculees as I could discover, and I am satisfied that they are not lying.”
“They can barely blunder their way through English,” said Dr. Douglass, exulting in incredulity. “And yet you trust them when they tell you that they possess medical knowledge of the utmost importance and intricacy?”
Rustling and scraping filled the air as chairs were drawn closer, men leaned forward, and necks swiveled and craned. Boylston held Dr. Douglass’s glare until the fidgeting settled down.
“Do you believe there are lions in Africa, Doctor?”
Dr. Douglass shrugged. Perhaps the man was mad. “The merest school-child knows that to be true.”
“Have you been to Africa?”
“No.”
“Then on what grounds do you believe such a preposterous claim as that there are cats as large as ponies there, scampering about in packs?”
Once again, snickers crackled around the edges of the room.
“On authority,” said Dr. Douglass coldly. “Learned authority. Not the hearsay of slaves.”
“I don’t consider either personal or eyewitness experience to be hearsay,” said Boylston, “regardless of the accent it’s delivered in. Especially when backed with physical evidence, like the scars of inoculation incisions, lack of scarring elsewhere, and apparent immunity.” He leaned on the chair back and smiled. “I’ve got at least as much evidence that inoculation is not only common but successful in Africa, Doctor, as either of us has that there are lions there.”
The crowd’s amusement bubbled into open laughter. Boylston turned his attention to his audience. “Why should it be any more unlawful to learn of Africans how to help against the smallpox, than to learn of our Indians how to help against snakebite? Shouldn’t we have the humility to take knowledge where and how we find it?”
Heads began to nod.
“In any case,” added Boylston, turning back to Dr. Douglass, “if you absolutely refuse to consider the evidence of African experience, I can now offer you my own.”
“Yours, sir!” exploded Dr. Douglass. “I was not aware that you risked your own life. I heard only that you had risked your son’s.” Ha! he thought. That struck home.
“It is a lasting regret,” said Boylston, “that I could not test the safety of the operation on myself first. As you no doubt can see, sir, that was not possible.”
The first true thing the man has said all morning, thought Dr. Douglass. Boylston’s face was as cratered and pitted as a battlefield.
“I wrestled with doubts, I assure you. In the end, I decided that the danger of my son contracting smallpox in the common way was far greater than the danger of inoculating him.” Again, Boylston turned his attention to the men around them. “So as you know, I inoculated my youngest son and two slaves. I’m happy to report that on all three of them, the experiment has succeeded.”
Surprise rose in swelling murmurs.
“I must say, sir,” interjected Dr. Douglass, “I have heard otherwise. One of your slaves had no reaction whatsoever, is that not true?”
“He had a slight reaction. We have since decided that he must have had smallpox before.”
“How convenient,” said Dr. Douglass. “I have also heard that you yourself admitted that your son was at death’s door.”
Boylston glanced at George Stewart, who looked as if he had been sucking lemons and enjoying it. “My son had a high fever,” he acknowledged. “Higher than either Dr. Timonius or Dr. Pylarinus led me to expect.”
“So high, in fact,” retorted Dr. Douglass, “that neither vomits nor purges could control it. Nor did blistering, saffron, hot cordials, or suppedanea.” He threw down the Latin like a challenge.
“I don’t know who fed you that nonsense,” said Boylston, “but I hope that no one who knows me well would credit such a cluttered course of treatment. Besides, I have never found that laying fresh kidneys to the soles of the feet really helped to draw off fever. Have you?”
“The evidence,” growled Dr. Douglass, “is inconclusive.”
Boylston shrugged. “I dosed Tommy with nothing but a little ipecac, and sure enough the fever went off. Within a day, the rash had come all the way out, as kind and distinct as you could wish.”
“But it did not come all the way out, did it?” asked Dr. Douglass. “Your son’s rash was anomalous, was it not? So light and superficial, in fact, that it must be seriously considered whether it was the proper smallpox at all, or something more akin to the chicken pox.”
“It was the smallpox,” said Dr. Boylston.
Crowing in his soul, Dr. Douglass pounced. “And how could you, sir, possibly know?”
Confusion crinkled Boylston’s forehead. There was a moment of uncomfortable silence, and then, off to the left, Dr. Clark cleared his throat. To no one in particular, the once and would-be future speaker of the House said, “Let us confine ourselves to the facts. Dr. Boylston has more experience with that distemper than any medical man in this town, with the possible exception of myself.”
Dr. Douglass threw a look of reproach in Clark’s direction; if he wanted Dr. Douglass to win this battle, he could at the very least keep from helping Boylston back up, just when Dr. Douglass had pinned him. “Dr. Boylston, sir, told me himself that he had not seen so much as a single case of smallpox before he inoculated his son.”
Boylston stepped forward, looking oddly stricken. “I believe, sir, I owe you an apology. A few weeks back, you asked me very particularly whether I had yet seen one case of the smallpox. I was in the middle of saying, no, one and twenty, when the conversation went elsewhere. We parted before I could correct the error. I must beg your pardon for having forgotten it till now.”
Cold needled Dr. Douglass’s face, and nausea twirled through his stomach. How had he gone so wrong in estimating the cunning of this charlatan? He reviewed his strategy of attack and made a quick decision. He was not without mercy. If the man had shown the slightest respect for his betters, the least meekness in owning his ignorance and allowing himself to be taught, Dr. Douglass assured himself, he would have dealt with him gently.
As it was, he would destroy him.
He bowed stiffly. “Let us move on to discuss the procedure itself,” he said smoothly, “since that is something that we can both agree occurred.” Boylston nodded. “Perhaps,” continued Dr. Douglass, “you
could oblige the company by describing exactly what you do.”
Boylston obliged better than he had dared to hope; apparently the credulous fool followed Timonius to the letter—even down to the preposterous barbarity of the nutshell, though latterly he had at least replaced that joukerypawkery with the more proper dressing of a cabbage leaf. As Boylston finished, Dr. Douglass gave him a genuine smile: he had set up his own annihilation almost perfectly.
Clasping his hands behind him, Dr. Douglass paced in front of his prey. “You admit, then, that you deliberately infect your patients with a lethal substance?”
Boylston frowned. “That’s an exaggerated way of putting it, sir.”
Douglass dismissed this objection with a wave. “Accurate, sir. No more than accurate. I have it on the authority of the Royal Society’s own experiments that the insertion of foreign matter into the mass of the blood causes terrible disorders, and not infrequently, death.”
“What experiments?” said Boylston. “What sort of matter?”
Dr. Douglass spread his hands. “It does not matter what sort of matter, sir.” There. If he wanted jests and jibes, let him eat that pun. “They have tried snake venom and tobacco oil, known noxious substances, but they have also tried the agreeable balm of new milk to equally injurious effect. So how are we to suppose that death itself can be avoided when such malignant filth as smallpox is injected into the blood?”
“I do not inject smallpox in quantity into the blood,” insisted Boylston. “I apply a single droplet externally, by incision.”
Douglass waved off these qualifications. “After injecting your patients with purulent smallpox, do you keep them under quarantine?”
“I have no power to declare or enforce quarantine. I can only advise.”
“And what is it you advise?”
“That they should keep a clean, cool diet and a quiet life until the fever rises, and then they should keep to their chambers, if not to their beds, to avoid infecting others.”
“So you inoculate, and then let the infected wander freely about?”
“Do you let your patients wander freely about, Dr. Douglass?” retorted Boylston. “Or do you station guards from some private army at their doors?”
“I am not responsible for infecting them in the first place,” snapped Dr. Douglass. “In short, sir, you admit that you inject your patients with small-pox and that having infected them, you allow them to wander about infecting entire unsuspecting neighborhoods.” He stopped his pacing, glaring at Boylston with contempt. “Are you aware that these actions are perilously close to the definitions of poisoning, and of spreading infection?”
He took a step toward the man. “Are you aware that both acts are, by the penal laws of England, felonies?”
Another step brought him menacingly close to his foe. “If anyone should perish from your work, it is hard to see, sir, how you will avoid a charge of murder.”
Sepulchral silence settled upon the room, except that one of the doves high up in the dome suddenly flapped her wings in a flutter of pink and gray, before subsiding into a steady drip of anxious cooing.
Boylston stared down his nose at Dr. Douglass. “Do you use antimony?”
“It is not I who am on trial here.”
“Nor,” said Boylston, “am I. I am merely trying, as you have done, to determine certain standards and definitions. Do you use antimony?” he repeated.
“Yes,” scowled Dr. Douglass.
“How about spirit of vitriol, sir? Sulfuric acid?”
“Yes.”
“Aren’t these both strong poisons?”
“In quantity, yes.”
“So you, too, poison, at least by your standards. Do you let blood?”
Dr. Douglass grunted assent.
“Where do you make your incisions, sir?”
“In the arms or wrists. Occasionally in the neck.”
“But isn’t the cutting of wrists and throats, sir, murder?”
“Not when done in measure.”
“Precisely. Not when done in measure. Inoculation is no different.”
“No different!” exclaimed Dr. Douglass, whirling away. “You inject filth—”
Boylston cut him off. “I make no claim that smallpox matter is not poisonous. But inoculation uses only a tiny drop of what fills the whole skin in even the lightest case of natural smallpox. There is good evidence that in such minute quantity it may prove one of mankind’s greatest benefits. To my son, and two of my slaves, it already has.”
“It may,” snarled Dr. Douglass, feeling the situation bucking away from him. “In three cases, you say, it has. But is it infallible, sir? May it not ever cause harm?”
“A purge or a vomit may harm,” said Boylston, his voice like steel. “Do you plan to give up those remedies on the same basis?”
“But is it infallible?” cried Dr. Stewart, jumping up from his seat in the back row. “Can you give your word that no one will die from it?” Around him, several others took up the cry. Hugh Kennedy, Francis Archibald, John Gibbins. Dr. Cooke had to bang on the desk with his gavel several times to silence the room.
Boylston’s eyes singled out Dr. Stewart. “It is medicine, George,” he said. “Not divinity. If it’s practiced long enough, no doubt it’ll harm someone. Can you—can any of you—give your word that you’ve never once known a patient to die from a purge or a vomit?”
He swept his eyes across the crowd, most of the men at edges of their seats, a few standing. “You have heard Dr. Douglass make a mighty bustle about malignant filth being infused into the mass of the blood, as if there were no difference between injecting a quart of poison into a large artery and applying a drop small enough to fit on the point of a needle to a scrape in the skin.
“The degree of difference, Dr. Douglass claims, is immaterial; I believe it is crucial. It is not just in quantity, though, that inoculation differs from poisoning, but in intent. Poisoning aims to cause death. Inoculation aims to prevent it.
“I will not do you the disservice of claiming that we have sailed into safe harbor. I will not tell you that nothing will ever go wrong. We are yet but learners, after all—starters, really—imperfect in knowledge and practice. So far, I have to admit that the fever has proved more intense than advertised, and in some cases the pustules more numerous.
“In the main, though, inoculation falls out just as Timonius and Pylarinus report. Just as they have written, the worst case of inoculated smallpox I have witnessed—my son’s—has proved far, far better than the least case of that distemper received in the common way.”
Boylston took a deep breath. “Inoculation, gentlemen, is the first real weapon we have ever discovered in the fight against the speckled monster. Should we toss it away because we don’t yet know how to wield it perfectly? Or should we run to learn its secrets?” He paused and again scanned the room.
“I cannot tell you what to think in your heart of hearts. But I can tell you what I know, in mine: if only we can steel ourselves to accept this blessing and make ourselves more expert in its practice, we may save hundreds, even thousands, of lives.”
Behind his desk, Mr. Cooke sighed. His belly was rumbling, but they were nowhere near ready for any vote whose outcome he would appreciate. Dr. Douglass had promised the selectmen an easy victory. Easy was clearly out of reach. At this rate, victory itself was no certainty. It would do no harm to give the doctor some time to settle down and review his strategy.
He brought the gavel down and announced a dinner recess. They would reconvene, he said glowering at Dr. Douglass, at four o’clock.
As he stepped into the street, Zabdiel plucked off his hot, scratchy wig and thrust it in a saddlebag. Without pausing to chat, he mounted his horse and rode north to Salutation Alley.
Cheever’s house was on the left, on the southern side of the narrow lane. In the cauldron of summer, the coolest rooms were those downstairs, right at the front. Even so, it surprised him that Cheever answered the door himself. He must hav
e been watching out for him. “Apparently,” said Zabdiel, “you’re feeling better.”
“I’d be good as new if you hadn’t blistered my back into tatters this morning,” said Cheever. His eyes betrayed him, though; his good cheer was nothing more than a thin, forced mask.
“Or you might still be broiling,” said Zabdiel. “Sit still, man, long enough for me to take your pulse. You’re worse than a two-year-old.” The fever had entirely gone off; his pulse was normal. He drew his friend to the window to inspect his face: there were three or four flecks on his forehead.
“The eruption’s begun,” said Cheever.
“It has,” nodded Boylston.
“How long before you’ll know whether it’s from the inoculation?”
Or from Sarah. They both recognized that implication.
“A day or two,” said Zabdiel.
Cheever gave him a wan smile. “It’s not me I’m worried about,” he said. His face pinched. “Come and see Sarah.”
In a darkened chamber upstairs, she lay moaning on the bed, her breath rasping in her throat. Her blisters had begun thickening into pustules two days ago, but still they were filling and spreading. If it went on much longer at this rate, thought Zabdiel, she would certainly flux in her face, and possibly over her body as well. Worse, he discovered that the sores in her nose and mouth had fluxed that morning, while he was stuck chattering in the Town House.
“I thought I could help,” said Cheever from the doorway. “But I can’t touch her, I can’t even breathe near her, without putting her in agony.” He stopped and looked away. When he started again, his voice was harsh and low. “When I come near her now, she shudders. When I drip water down her throat, she screams. But if I don’t give her water, she’ll die. I can’t help her, Zabdiel.”
Zabdiel laid his hand on his friend’s shoulders. “You’re doing all any man can do,” he said quietly. “Far more than most would dare.”
It was all the comfort he could give.