by Derry O'Dowd
‘And for loud or soft, how does that work?’
‘The keys respond to my touch, so, light.’
‘Or firm?’
‘As you say - here let me play for you.’
Catherine sat before the gleaming, waxed instrument and placed her fingers on the keys.
She took a moment as if pondering what to play for him, cleared her throat and bent her head, exposing her white neck and her dark clinging curls to him in doing so.
Her fingers flew over the keys, swooping, sliding, and resonating over the wings and soundboard.
As Catherine finished the piece and the last lingering notes softened into silence she looked over at James, who was sitting thoughtfully, quietly.
‘That was an inspired performance from my magnificent teacher,’ he said. ‘Bravissimo, Catherine.’
Flushed, she smiled at him and patted the piano stool, ‘Join me, James, we will do it together. Let us play a duet.’
He sat and she looked at him seriously.
‘Here, put your fingers as I show you. You will play the easy part. I will help you.’
She placed his fingers correctly on the keys. ‘Show me your hand, here, but lightly. First comes the chord of F major; then slowly stretching to reach the G position, follow by a lift to A minor; return but easily to F and finally the perfect chord. Play it, James, here for me from this key, from the middle C.’
Catherine opened her eyes to the sight of her candlelit bedchamber, and pulled the covers snug up under her chin. She sighed in the night’s stillness. She blew out the candle and lay her head on the plump pillow.
‘Bravissimo, Catherine,’ she whispered to the darkness.
‘Here are the case notes for our house visits,’ Smyley passed the pages to James as they sat in the study. ‘They are all within easy distance from us here by horse - Gerrard Street, Wardour Street, the East End and on to the docks.’
He picked a piece of lint from the arm of his chair, rolled it between his fingers and flicked it to the ground. ‘Forgive my loose hand; I always appear to be in a hurry and my writing tells it so,’ he smiled at James.
‘Not copperplate, my word, and me here to learn from the master! I pray that I may endeavour to interpret them,’ James parried, and bent his head to read, a smile on his face, as Smyley’s handwriting was as bad as promised.
He looked up some time later to see William Smyley coming towards him, sturdy leather pannier in one hand.
‘In here, James,’ he patted the makeshift case affectionately, ‘I place my blunt hook, a fillet, a lever and crochet, accompanied by scissors, lancets and my obstetric forceps. When out visiting patients I must carry all my requirements with me. Follow me down the house now and we shall pick up some treatments.’
On the ground floor William opened the door to a side room he used as an apothecary shop for his drug dispensing. Rows of neatly labelled bottles and containers stood on the shelves.
‘The contents are as expected, James. I refill the containers each evening,’ and he smiled as he picked up another pannier, this one full of remedies.
In the hallway, Eupham handed William his cloak and kissed him on the cheek. ‘Stay warm, my dear. And you too, James.’
‘Expect us late home,’ Smyley replied, gave her hand a squeeze and went out the door to where the horses stood, James following.
The men chatted amiably as they rode. The horses snorting, the cold air pluming their breaths into great wreathing clouds, panniers laid over their rumps.
On through the city they rode, past Lincoln’s Inn Fields, the Strand, Drury Lane and into Clare Market. The smell of meats assailed James’s nose, the ground slippery under the horses’ hooves, splattered as it was with innards and slick with blood and mucous here and there. An old crone stared up at him sightlessly; one rotten tooth stood lonely in her mouth as she held up an indefinable piece of raw meat to James, like a glorious offering in her gnarled paw. He hastened to catch up with Smyley, his horse losing its footing as he urged it forward over the slippery, frozen red ground.
They turned into Vere Street and stopped. William dismounted and rapped sharply at a door. Midwife Lee opened it and peered out to see who it was, relief crossing her face as she saw them.
‘Dr William, she is in great need. Her piles are most woeful!’ she said and ushered the men in.
Mrs Lacey stood by the dirty window wringing her hands in distress, belly straining her garments, pulling them taut.
‘She is eight months gone with her second child, and constipated when she goes to the stool. She has dreadful discomfort in her nether regions and dung gate for two days past,’ the midwife explained. ‘Excuse me for saying, but the piles are so gross in size they appear like cauliflowers for all the world, rotten cauliflowers all red and black.’
‘If gross excrement retained in the right gut be the cause of it,’ William opined, ‘an emollient enema of the decoction of mallows, pellitory, violets and oil of sweet almonds with fresh butter could be helpful.’
Midwife Lee looked doubtful.
‘Or you may anoint the piles with an anodyne remedy,’ offered James, ‘with hot stroking from the cow or linseed oil well beaten with water lilies, poppies and white broth mixed with the yolk of an egg and ground in a leaden mortar.’
‘Either way, we should examine and then prescribe,’ William reflected.
The midwife walked the suffering woman from the window, laid her on the pallet bed, and lifted her skirts and petticoats high as she faced her to the wall.
The woman cried out in pain, though the examination that followed was gentle. William and James exchanged glances with Midwife Lee. Simple diet and medications would not be sufficient to relieve the problem.
‘A draught of pain-relieving elixir and then the lancet, methinks,’ remarked William. ‘We must incise the haemorrhoids and release the retained blood clots.’
The woman shrank away from them in alarm, whimpering, her piles being so sore as to forbid any touch, however tender.
‘Then we should apply a decoction of rinds of pomegranate and province roses made with smith’s water and alum, to which is added dragon’s blood and terra sigillata,’ mused James before he moved off to one side with William as the woman drank the elixir that had been handed to her.
‘There is another option,’ he said quietly, out of earshot.
‘I agree,’ William replied with conviction.
As the mixture of brandy and opium - the laudanum of Paracelsus - took hold, the suffering woman relaxed and her shoulders slumped as though a great weight had been lifted from them.
William removed a jar from his pannier and looked at the Hirudo medicinalis creatures within as they sat in their slimy residue, a limpid, dark, softly seething mass. He lifted one out, holding it away from himself with finger and thumb, and looked at it as it wriggled slowly in his grasp.
With great care, the man-midwives gently applied twenty of the blood-sucking leeches to the hard fleshy areas of the prone woman’s piles and close by on her nether regions.
The creatures would do their job well, as organised as a small shadowy army, clinging on, feeding. As they gorged on the woman’s retained blood, they would bloat to many times their original size and then fall to the bed, replete with their magnificent meal, large black stains on the pale sheets.
The piles would bleed for a time yet, and more Hirudo would replace them, their sated brothers and sisters at rest again in the glass jar.
‘Tomorrow, on our return, there will be a change for the better. I will fit a small end of a pullet’s gut on a pipe and place the instrument deep in the fundament to apply a clearing enema. After that we must arrange a suitable diet,’ said William Smyley to Midwife Lee. She showed them to the door and out into the frigid day before turning back to her patient.
It was late afternoon by the time William and James reached the tenement where Mrs Roberts lay, tears standing shining in her great, sunken eyes.
‘Her fever has
lessened,’ said Midwife Peake, ‘but the pain in her breast grows ever more.’
Their journey had taken them into the mean, mired streets of the city, and it was with cloaks gathered tightly to them and horses needing to be calmed constantly against the woeful pleas of the disaffected that they turned off the wide street of Bishopsgate, past the London Workhouse in Half Moon Alley and on to their destination.
Mr Roberts was at his employment, while his children sat disconsolately in the tiny, barren room that served as kitchen and living quarters, shivering in the bitter cold, not talking or playing as ones their age should.
The tiniest child whimpered, her hair hanging lank in front of her eyes, breath whispering cloudy in the air, dirty feet and hands kissed blue by the cold. She drew her feet up under her skirts to try and warm them, toddler arms hugging herself, their plumpness taken too early by meagre rations. She sniffled and coughed as her siblings sat mute.
Mrs Roberts was huddled on a low bed in the chamber that was shared by the whole family, plus one, now that the new baby was here.
James and William walked towards her, the sickly sweating pale shadow of a woman and the crying baby that lay close by, tiny fists in the air, railing against the injustice of it all.
The men examined her gently. William pressed lightly with his fingertips on her inflamed breast, branded with a large red swelling on the pale flesh crossed with blue raised veins, and the woman winced and cried out in pain.
‘See there, the abscess has ripened,’ said James.
‘Just there,’ replied William, pointing with his index finger, ‘the centre is a little elevated and very soft so that it fluctuates. My experience in matters surgical is somewhat less than yours, James, but I feel the time is right to proceed.’
The two moved to a corner of the glum room.
‘We must use the lancet to make an incision in the form of a half moon. The cut must be large enough to ensure that we can evacuate all the purulent material while taking care not to open any great blood vessels.’
‘The vessels are mainly to the side are they not?’
James nodded. ‘Once drained, the abscess cavity should be cleansed. Tents or pledgits of lint dipped in oil of eggs or basilicon mixed with a digestive should be placed in the hollow that remains to fully purge the area.’
‘What of the other breast?’ enquired William.
‘I did not detect the presence of an abscess. However, the nipple is chafed and excoriated. We should apply honey of roses and put a little cap of wax or wood over the area so that the woman’s clothes may not stick to it. When the crisis is at end she may draw the nipple out with a fit instrument of glass or have another woman suck the teat to draw it out to fullness so that she may be able to feed again.’
12
To keep a good flow of milk in nurses and to ensure its goodness
Make a broth with lentils to which add ale, aniseed, barley, cinnamon, beaten eggs, parsnip, sugar, rice and wheat. A handful of each and a cup of ale will suffice. Mix with enough water to cover it, boil it to soften and pour off to cool. Let her drink freely of it.
Quinn Household Recipes and Remedies Book
* * *
James laid out the lancet, lint pledgits and jars of medicines while Mrs Roberts swallowed great spoonfuls of pain-relieving elixir, taking a thin finger and wiping up any liquid that spilled down the side of her mouth before placing the digit in her mouth and sucking to the last drop.
When content that the medicine was working, William and the midwife held the woman tightly. She squirmed under their hands, head twisting from side to side as her dirty hair snaked its way over the pillow.
James grasped her right breast firmly in his left hand, made the incision, and then plunged the lancet deep, releasing a putrid stream of pus, which made its way yellowly down her side. Mrs Roberts collapsed into a deep faint while James completed the task of cleansing, insertion of medicated compresses and binding of the breast.
Together with the midwife, James and William cleaned the mess and stayed with Mrs Roberts until she was so improved that she could sit up and ask for a drink, gabbering away in her relief, calling to the toddler in the other room to come for a cuddle, crooning in the child’s ear once she did, holding her as the child smiled and looked up at the strangers.
‘Now, as to feeding of your baby,’ started Smyley.
‘Well now, Doctor, I have that all seen to,’ said Midwife Peake and called out. A woman who had been waiting outside came into the room, the wet nurse. Rose by name, slim but well nurtured, dressed shabbily, but most importantly, clean. They questioned her, as she shifted and circled a booted foot on the floor.
James placed her age at about thirty as she herself was quite uncertain. Her own baby was almost four months old so there was no doubt but her milk was purified by now. Her womb had ceased its loss of discharge from the birth for some weeks past. Further questions revealed that her courses had not returned, neither was she with child as she had not yet lain with her husband.
In response to their further queries, it transpired that Rose was not subject to the king’s evil, nor any hereditary disease. She had no spot, nor the least suspicion of any venereal distemper, nor itch, scab, scald or other filth of like nature.
The midwife had chosen Rose for her dark hair, which meant that her milk would not be hot, sharp or evil smelling. Her teeth were in good enough order, William nodded happily as they looked in her mouth as she would no doubt often kiss the child while feeding and infect his tiny lungs if her breath was corrupted. No scars were present on her breasts, another good omen, and she had not been struck down with a breast abscess in the past. Rose was broad and her breasts were of good size, firm and strong as it was some hours since she had last fed her own child. The nipples were well shaped, of good texture and firm to the touch.
‘We must test the milk now,’ said James.
So Rose milked onto the midwife’s hand, pulling softly at her breast and nipple in imitation of a suckling infant. They judged the appearance of the milk not too watery nor too thick, and of good colour and fragrance. The midwife turned her hand slowly and the milk slid off gently.
She nodded to Rose and the woman milked again into a small pewter spoon, which was passed around and tested.
‘The milk is sweet and sugared without any acrimony or other strange taste,’ said James as William smiled at Midwife Peake.
‘You have chosen well,’ he said to her, ‘but what of–’
‘Her temperament is without fault: not quarrelsome nor melancholy but merry and cheerful, not given to gin nor excess of the pleasures of Venus.’ The midwife, well versed, knew what he had been about to ask.
‘Altogether the qualities we seek in a good wet nurse,’ William smiled at her once more. ‘Midwife Peake, we shall return again in three days’ time to check on your small charge and his mother.’
As the men left, James looked back to see the baby cradled in Rose’s arms, cheeks working furiously as it sucked deeply from her, satisfying his tiny body with the wholesome liquid, cries ceased.
James and William returned to the house in high spirits, James to write a letter home and William to write notes for the classes that he offered to both male and female midwives.
‘Eupham, are you home?’ shouted out William. ‘Eupham?’
She came out into the hall, eyes red from weeping, a piece of paper in her hand that she quickly hid behind her back.
‘Eupham, my dear, what is it? Are you not well?’ said Smyley, moving towards her.
She took a step back. ‘It is nothing William,’ her voice faltered.
‘What are you holding behind your back?’ he asked.
‘Oh. Oh, it is nothing, nothing at all!’ she replied.
‘Well then, let me see it.’
‘No, William.’
‘Eupham!’
James took in the scene uncomfortably. He knew enough of his hosts by now to see that this argument was out of character for
them both and it made him feel incredibly tense. He was about to make his escape when William turned Eupham and pulled the piece of paper out of her hand.
As his eyes scanned it he turned red, and then pale, and then the colour suffused his face again and the paper in his hand trembled. He let it fall to the floor. It fluttered gracefully like a leaf from a tree in October, before reaching the wood below. He strode out of the hall and they heard a door slam behind him.
James approached Eupham. She was trembling and crying again.
‘Come Eupham, let us sit and I will make us some tea and we can talk if you wish.’
She picked the piece of paper from the floor and balled it tightly in her fist.
Once they were seated, James opened her fist, took the damp paper from her hand and smoothed it out, laying it on the table. He read and his heart sank. It was a pamphlet, crudely written and crudely drawn to be sure, but its intent was unmistakable.
He looked up at Eupham who had her face buried in a large white handkerchief, from behind which her distress was audible. His teacher, William Smyley, was depicted wearing a nightgown of flowered calico with a nightcap of office, tied with pink and silver ribbon. Under it was written, ‘Would you have this man at your bed as you deliver forth a child?’
‘Oh Eupham,’ said James, ‘I think you had better tell me.’
She took the handkerchief from her face and James walked around to her side of the table and sat beside her, taking her hand. She turned her blotched face to him. ‘I am so angry, and sad, and one hundred other things I cannot put into words,’ she said tremulously at first, her voice growing as she went on. ‘William is such a good man! He cares for the poor, cares too much sometimes. He pays for much of it himself, did you know that? We pay for it. It is just as well we have no extra mouths to feed in our own home or our children would surely starve to death!’ she gulped. ‘Oh, I have said too much,’ and she burst into another noisy bout of crying.