Bride of the Wilderness
Page 17
Ash locked himself into a room and fasted, taking in nothing but water for two weeks, and prayed aloud day and night. One morning as he lay on the floor whose rough boards glistened with his tears, he realized that God intended him to become a physician, so as to unite healer and minister in the same person. Taking Betsy with him, he walked to London and apprenticed himself to a practitioner of medicine called Thomas Sydenham.
It was Sydenham who introduced scientific diagnosis and specific treatment into medical practice. He discovered new and gentler methods for treating fever. Though he was not the first to do so, he cured malaria, which had long ravaged Europe, with a potion of “Jesuit’s bark” —actually the bark of the cinchona, a tree that grew in Peru. Quinine was the first great specific; it cured malaria, and little else, though it was tried on nearly every other malady after a quack named Robert Talbor cured Charles II of malaria with it. Sydenham described scarlet fever, St. Vitus’ dance (Sydenham’s chorea), hysteria, smallpox, gout, and many other diseases and conditions, including malaria.
Ash was breaking the law by setting foot in London. He had been banned from the city for life, and the Five Mile Act made it illegal for a dismissed clergyman to come within five miles of a corporate body. Sydenham knew this; Ash’s case was a famous one. But Sydenham had been a physician to Cromwell’s troops in the Civil War, and he was sympathetic to a young man who had been whipped for defying the king. Charles I, after all, had been beheaded for insisting too much on the divine right of kingship, and Sydenham admired a man who would stand up to his monarch.
Sydenham, like his younger friend John Locke, was a writer as well as a physician. He received Ash in Will’s Coffeehouse in Covent Garden, a hangout for authors and wits. Bowls of coffee sweetened with sugar were set before them, but Ash let his go cold.
Sydenham asked him why: “Don’t you like politician’s porridge?”
“I like it very much,” Ash said. “But I have been fasting for two weeks and I fear that a stimulant will make me giddy.”
“Fasting? Why?”
“It brings one closer to God.”
“It deprives the body of sugar and causes hallucinations.”
Though Sydenham was already old, he had the clear eyes, the firm chin, and the steady hands of a man of forty. As Ash observed these qualities, Sydenham observed Ash. Then, with minute attention to detail, he took his history.
“What did you read at Cambridge besides theology?” he asked as his fiftieth question. Sydenham enunciated the word “Cambridge” daintily; he himself had been educated at Oxford.
“Greek and Latin, French and German,” Ash replied. “Mathematics. A certain amount of philosophy. Chemistry.”
Sydenham gave him a keen look. “Chemistry, eh?” he said. “What do you know about the circulation of the blood?”
“Little is understood. The ancients supposed that the arteries carried air to the body, and thus their name for them, arteria, or ‘windpipe,’” Ash said. “But Galen, while dissecting an ape, established that the arteries carried not air but blood. In our own time, William Harvey of London, in his great work Exercitatio Anatomica de motu cordis et sanguinis, told us that the heart is a pump which drives the blood into the arteries and thence into the tissues through smaller blood vessels, which return it to the veins after the flesh has been nourished. The veins carry it back to the heart, which pumps it out again.”
“You say that Harvey’s theory is a great work. But it has been violently attacked by dogmatists as being wrong.”
“Dogma does not matter in medicine. It is the observed and proven fact that matters. Blood moves through the body according to God’s design.”
“You are aware, I know, that Galen was Marcus Aurelius’ physician and a very fashionable doctor at Rome,” Sydenham said. “Do you know what his admirers called him?”
“Paradoxopoeus—the wonder worker,” Ash said. “It created jealousy.”
“Do you believe in wonders?”
“Only in God’s wonders, of which the human body is surely among the greatest.”
Sydenham studied Ash. It did not take a great diagnostician to see that this poverty-stricken young man was a mystic who had very recently undergone great trials. Ash was emaciated, unsteady, pale; his eyes, which shone with intelligence, were red-rimmed from weeping. Sydenham was not troubled that he was a little mad. Many, if not most, gifted physicians were.
“Are you married?” he asked.
“Yes.”
“Your wife has been a servant, I suppose.”
“An undercook.”
Whatever their own origins, ministers in Ash’s day were not encouraged to marry into the gentry, much less the aristocracy, but were expected to find their mates among the servant class. Clerical conjugality was a national joke. Hardly a popular play was performed anywhere in Britain in the seventeenth century that did not number among its characters a curate who married a cook after a laughable courtship.
“I do not need an apprentice, but I do need a maid of all work,” Sydenham said. “I’ll take you into the bargain. The course in physick normally lasts four years, but I no longer promise myself that far ahead. Two years should be enough for you. You will be entirely at my disposal all day, every day, except for two hours on Sunday. You and your wife will be given rooms at the top of my house, healthy food, and a stipend of two hundred pounds—half now and half at the end of your apprenticeship. Your wife will be paid an additional ten shillings per month. Is that satisfactory?”
“Yes. But I must have time to pray.”
In his relief at having interpreted God’s intentions correctly by coming to a man who accepted him so readily, Ash shouted out these words. He surprised even himself with their loudness. Sydenham leapt a little at the force with which they split the air. He handed Ash his bowl of cold coffee.
“There is one condition,” he said as Ash drank at last. “You must not pray in that amazing voice in my house. Talk to the Lord elsewhere, Mr. Ash.”
In Sydenham’s London, the three classes of specialist—physicians, apothecaries, and surgeons—were strictly separated, and in theory no man could practice more than one specialty. In practice, however, Sydenham himself, like many other practitioners, was both physician and apothecary. To these two skills, Ash added surgery after he had completed his studies with Sydenham. The old physician didn’t believe in it.
“You will hear them scream,” he told Ash. “They will never forget the pain and the fear, or forgive you for inflicting it upon them.”
Ash had found that Sydenham was right about this, as he was about so many other things. After observing the effects of operations for kidney and bladder stones and the trepanning of the brain, Ash decided that he would operate only to repair wounds. In such cases, shock sometimes masked or overcame the pain of surgery if it was undertaken quickly enough. That was why he had rushed Oliver into the house so quickly after he was stabbed by the woodman.
Even so, Ash worried about inflicting suffering. He experimented with ways to divert the patient’s attention until he was overcome, as he almost always was, by unconsciousness. While he tied Oliver Barebones to the table to prevent his doing violence to himself or his surgeon, Ash described the currently fashionable iatro-physical school of medicine, which argued that the body was a machine.
“Iatrophysiology is a relatively new theory, described by the Italian, Borelli, in his posthumous treatise De motu animalium,” Ash said. However it may have seemed to others, Ash’s voice did not sound particularly loud in his own ears, so he spoke to Oliver a little more distinctly than usual. “Borelli explains the functions of the body on mechanical principles. The bones are levers, the muscles are pulleys, the digestive system is a threshing machine, secretions are controlled by the tensions of the vessels, the blood circulates under pressure generated by the compression of the heart, and … Ah!”
Ash had located the wound in the brachial artery inside Oliver’s left biceps. Oliver lay on the table in th
e hall, his wrists and ankles tied to its legs. Though he was pale and his breathing was rapid, he did not cry out or try to twist away from the knife.
Ash had to work very fast because of the danger involved in depriving the arm of blood. He was a skillful and gentle surgeon who used only the sharpest instruments and cut as little as possible. Surgery on Oliver’s body was made more difficult than usual by the size and development of his muscles. Cutting delicately, Ash had enlarged the puncture wound. The artery was not completely severed. Holding the mouth of the wound open with his left hand, Ash tied off the upper end of the artery with a loop of silk thread with his right hand and stitched up the cut. Then he removed the ligature and watched the artery fill up with blood. It did not leak.
Now he fitted the fingers of his left hand into the incision, gazing intently into Oliver’s face for the first signs of the pain that he knew to be inevitable. Oliver ground his teeth but kept his eyes open.
“The muscles have been pierced by the knife,” Ash said, “but they have not been severed. The nerve is intact. The wound will heal satisfactorily, barring suppuration, and we will prevent that.”
Some physicians were pleased to see suppuration or “laudable pus” appear in a wound, but Ash did not subscribe to the theory that pus was a sign of good healing. He tried to prevent it, as Sydenham had taught, by leaving a clean incision and letting the wound drain.
Ash removed his bloody fingers from Oliver’s wound and gestured with them to Rose. The blood did not disturb her. Nothing about Ash disturbed her. She stood against the wall, next to a burning fire in the grate, watching him work. To Rose, of course, the odor of blood was very strong in the hot, airless room. She did not think about it; she thought about the questions she wanted to ask Ash about witches when the occasion arose. He would be able to tell her exactly what she wanted to know.
“Bring me two basins of hot water and towels,” Ash said brusquely.
Rose did so, dipping the boiling water out of a kettle that had been heating over the fireplace. Ash washed his hands in one bowl, and then scrubbed the area around the wound, using a lot of soap.
“Will you not sew it up?” Oliver asked.
“No. The knife was dirty. The wound must drain. Otherwise the animacules will do mischief.”
“Anima …” Oliver nodded sleepily. He did not understand a word.
Animacules were one of Ash’s great interests. He was one of the few men who knew that God had made complex creatures that were too small to be seen by the eye, and that these creatures were everywhere. He had spent half of the first hundred pounds Sydenham had given him on a microscope. It was an excellent device, made in Delft by a Dutchman named Anton van Leeuwenhoek, that could magnify an object five hundred times. Under Leeuwenhoek’s instrument, Ash studied muscle fiber and nerve tissue, and, above all, the animacules that lived as parasites on everything. He became convinced, watching these minute creatures wriggle under the lens, that animacules migrated from body to body, and even over the oceans from continent to continent, on the skin and clothes of travelers, carrying disease with them. In this fashion, syphilis, previously unknown in Europe, had come from America, while smallpox had traveled in the other direction. Ash had observed, by treating the animacules with a soapy solution while they were under the lens, that soap sometimes killed them.
Rose took away the basins and poured the pinkish water they contained out the window. Nothing was left to be seen of Montagu and his bullies—not even the dead oxen, which had been dragged away to be sold as beef. The yokels and Sir Cecil’s horses and mastiffs were gone. Someone had scavenged the shreds of Montagu’s silk costume out of the mud where the dogs had left it.
Ash’s voice began. Turning around, Rose saw that he had fallen to his knees beside the table, clasped his hands together, and started to pray. He continued for about an hour, never pausing, never searching for a word. Like a baby being sung to, Oliver fell asleep. From time to time, though he never stopped praying, Ash unclasped his hands and examined his patient, taking Oliver’s pulse, feeling his brow for signs of fever, rolling back his eyelid, touching the skin around the bruised lips of his wound.
Oliver woke and tried to sit up, but he was still tied to the table. Ash untied him. The two men seemed to like each other tremendously. Ash was tender with his patient. Oliver accepted whatever Ash did. Their sudden friendship mystified Rose. How could they behave with such trust, when they had only just met?
Ash made a gesture, and Rose helped him to walk Oliver up the stairs. In Rose’s bedchamber they removed what few clothes Oliver still had on, his breeches and stockings, and drew his nightclothes over his head. Rose stood over the bed. She had never before seen Oliver from above when he was lying down; always before he had been crouching over her, moaning her name. He looked quite shrunken in his nightcap, under the puffy feather bed, with his wounded arm lying useless on the coverlet.
On the table by the window, Ash mixed a prescription, depositing small quantities of half a dozen powders and herbs into a cup and mixing them together with water. He held the cup to Oliver’s lips.
“What I want is brandy,” Oliver said again.
“You shall have it,” Ash said.
Rose fetched a bottle of Nantes brandy. It burned Oliver’s throat, and when he spoke, his voice was hoarse and thin. His gaze was fixed on Ash.
“Montagu,” Oliver said. “Will he die?”
“Oh, yes,” Ash said. “And soon—in a week, perhaps two.”
“Poor man, to be such a bastard.”
“You must sleep,” Ash said.
While Oliver did so, Ash prayed again, much more quietly. A listener might have thought, as Ash certainly did, that God was in the room hearing every word and judging it, like a kindly but exacting schoolmaster. Rose went to sleep listening to Ash’s voice.
When Rose woke up, Ash was still seated by Oliver’s bed. Oliver was asleep, breathing deeply and snoring a little, his face unshaven and dumb as a dog’s. Ash had covered Rose with her fur-trimmed cloak as she slept. She stroked the collar and watched him.
Ash was reading Hobbes by the light of the fire. He was deathly gray again. She realized that he had looked different—brighter, more ruddy, soldierly, even—while he confronted Montagu and doctored Oliver.
“Mr. Ash?”
Ash marked his place and looked at her, waiting for whatever it was she was going to say. When the question came, he seemed surprised.
Rose asked, “Can witches take the form of cats?” “Witches? Yes, of course they can.”
Ash was clearly anxious to return to his book. But Rose wanted to know more.
“And can they travel from one person’s body into the body of another?”
“By what means?”
Rose took a breath. “By way of the natural entrances.”
“Of course. ‘Now the works of the flesh are manifest, which are these; adultery, fornication, uncleanness, lasciviousness, idolatry, witchcraft …’ Galatians, fifth chapter.”
“Then witches do exist?”
“Certainly they exist. We are told that they live in Exodus: ‘Thou shalt not suffer a witch to live.’”
“And one must resist, no matter whose body the witch may use as a hiding place?”
“Certainly. Leviticus is quite clear on the point: ‘And the soul that turneth after such as have familiar spirits, and after wizards, to go a-whoring after them, I will even set my face against that soul, and will cut him off from among his people.’”
As Ash recited flawlessly from the Bible—he must have the whole of the Scriptures committed to memory—Rose’s face glowed. She had never been in the presence of such a powerful mind. It enveloped her and made her want to draw closer to it, like the aura of kingship or great wealth or fame. Or even beauty. For the first time, Ash noted some sign of sensibility in this woman. Until now he had only seen her beauty, and it was not his experience or his belief that beautiful women, imprisoned in their vanity, were interested in the
nature of God.
“Witches exist because Satan exists,” Ash said. “And Satan exists because God exists. Therefore, if you believe in God and in His works, you must believe in Satan and in his works, and among the latter are witches.”
Ash had no difficulty in understanding the germ theory of disease, and at the same time in believing in witches. He examined Rose to see if she understood. He was sure that she did not, but it was clear that his answers had made her very happy. There was adoration in her eyes rather than intelligence.
Rose went to sleep again. Men’s voices, one voice whispering and two others shouting, woke her at dawn. She did not understand at first what she was doing on the floor, or what Praise God Adkins was doing in her bedchamber, but as soon as she saw Ash, she remembered everything.
Praise God’s clothes were covered with dust and his face was drawn by fatigue. Rose knew that he had gone to Portsmouth on business. She had thought it very cowardly of him to leave Oliver to face Montagu and his bullies alone. What had he found in Portsmouth that sent him flying back to London? He must have come all the way without stopping to rest.
Oliver appeared to be alive. In fact he was sitting up in bed. He had raised himself onto his good elbow and was clearing his throat and coughing and repeating Fanny’s name over and over again.
“Fanny?” Oliver said. “Not Fanny. I must go to Portsmouth at once.”
“You cannot be moved,” Ash said.
“Then I’ll move myself,” Oliver said. “Didn’t you hear what Praise God said? That beast Montagu tried to have her in the night. She jumped into the sea to save herself. I must go to her.”
“You have cut an artery,” Ash said. “It has not healed. If you go by coach to Portsmouth the jouncing will open the wound and you’ll bleed to death.”
“Then I’ll ride a horse and you will come with me to sew me up again, friend,” Oliver said. “You can save Fanny as you saved me.”
Moving ponderously, Oliver got to his feet. He was weaker than he thought, and he held on to Ash, head swimming, coughing violently.