Chapter One
Leicester, September 1857
“IN HER CONDITION,” DOCTOR PARWINE WAS SAYING from the other side of the room, “she must particularly beware foul miasmas.”
The atmosphere in the room was neither foul nor miasmic, Jonas Grantham thought, only gloomy and tense. The girl—and, unfortunately, she was a girl, no matter the situation she’d found herself in—sat stiffly on a chair across the room. Her hair was dark and unbound; her figure showed no sign of the changes that would shortly come to her. She didn’t cry, although Jonas supposed that most girls in her situation would weep. She simply stared straight ahead, hands folded. Maybe she didn’t understand what had happened to her.
He’d seen her a time or two before. He remembered her playing with the other girls just a few years ago, rolling a hoop down the street and shrieking with laughter, ribbons trailing after her.
She still looked more child than woman, but there was no hint of laughter about her now.
“Foul miasmas,” the girl’s mother breathed. “What are foul miasmas?”
“Miasmas,” Parwine intoned, “are the cause of all disease, and are particularly noxious to…” He glanced down at the girl, and then narrowed his eyes. “To expecting mothers,” he finished. “There are a number of miasmas which one must avoid. There is the idio-kino miasma, produced by…”
Jonas Grantham barely restrained himself from a roll of the eyes. In a matter of weeks, he was due to start his course of medical instruction at King’s College in London. He’d beat out students with pedigrees from Oxford and Cambridge to win a prized three-year Warneford scholarship. He was itching for the first lecture—scheduled for the first of October at eight P.M., a mere six days and seven hours from this moment—and ignoramuses like Parwine made his hands itch all the more.
Truly, miasmas? In this modern day and age? The theory of miasmas had been conclusively disproven three years past. Only benighted fools still spouted that gibberish. But Jonas had asked to spend time with Doctor Parwine. He had an agreement in place to take over the man’s practice as soon as he’d finished his education. Parwine had been most specific: He could come along, see how things were managed, but as an untutored (the older man’s words) youth, he was expected to keep silent. So here Jonas stood, listening to an old man ramble on about miasmas.
“Finally,” Parwine was saying, “there is the perkoino miasma, the cause of yellow fever—but surely you will not expose your daughter to that.”
Her parents exchanged glances. “No, doctor, of course not. But what is to be done?”
The last weeks following the man about had not been totally useless. Jonas had learned a great deal about how not to be a physician from Parwine. The doctor maundered on and on with medical terminology that none of his patients understood, all of it supposition that had been rejected by scientific men within the last decades. It took all of Jonas’s self-control—never excellent under ideal circumstances—to keep his mouth shut. He kept telling himself to respect his elders, and so far he’d managed. Barely.
Parwine frowned. “For the prevention of nausea and vomiting, which is so often associated with this delicate condition, I suggest a solution of lettuce water and prussic acid. Take it liberally and there shall be no ill symptoms. I shall leave a direction for such with the apothecary.”
Jonas straightened from his post against the wall and took a step forward, before he checked himself.
He had started reading the medical texts for his course of study, had already begun to commit compounds and cures to memory. Prussic acid was a poison. Some suggested it in minute quantities for the headache; others as a palliative for cancerous growths. But for a pregnant woman? He couldn’t remember reading any such thing. Still, it could exist. And there was that old dictum, that the difference between a cure and a poison was the dose. He bit his lip.
“But, Doctor,” the father repeated, “what is to be done with my daughter? She is…she is only fifteen.”
Parwine looked the girl up and down. “What do you think?” he finally said, in his quiet, gentle voice. “Treat her with Christian kindness. Now that you know what she is, quietly put her away.”
The wife gasped and burst into tears. The girl’s father gripped the seat, his knuckles whitening. “No,” he said in denial.
The only one who didn’t respond was the girl herself.
“I’ve seen it a hundred times,” Parwine said with a shake of his head. “Once a girl is ruined, her life is over. Even if you can conceal the truth of her unfortunate state from those around her, the girl is worth nothing. Her life will follow one of two paths. If she acquires no moral sense, she will continue on in her sluttish ways, a burden of humiliation on all who know her. One of the moral diseases will shortly find her, and she will perish in ignominy.”
“No.” Her father’s hand fell on the girl’s shoulder. “No,” he repeated, this time with greater certainty. “That’s not going to happen to my little girl.”
“Then accept the other path your daughter could tread. If there is any hint of goodness in her, her shame will consume her. She will never be loved; she will go into a decline. Likely she will die early and thus expiate her sin. There is nothing to be done at this juncture except to recognize the truth. Your daughter is already dead. It is only a matter of time until the condition manifests itself.” Parwine gave the man a nod. “I can only treat the symptoms of this disease,” he intoned. “There’s nothing to be done about the cause—moral decay.”
The father pulled a handkerchief from his pocket and dabbed angrily at his eyes. The only dry-eyed one among them was the girl. She stared across the room almost defiantly.
God damn that superstition. Jonas damned himself, too, for agreeing to keep silent as a condition of these visits. He hadn’t chosen to become a doctor so that he could foretell the death of children. He’d been seduced by the stories—the stories of John Snow saving hundreds of lives by careful observation, of men who noticed the world around them and cared and thought, men who set aside irrationality in favor of cures supported by statistical research.
Parwine gathered up his things and motioned for Jonas to follow.
I have seen no scientific study that suggests that life is foreshortened by moral decay, he imagined himself saying to her father as he crossed the room to the exit.