by Mike Hogan
He smiled. “We thought about duffing them up and nicking the lot, but it wouldn’t have been right, like. What with him being already such a open-handed young gent.”
Holmes nodded.
“They joined up with us,” said Wiggins. “He put us on to some good lays: the parcel dodge, the dead faint, the dizzy German -”
“The parcel dodge I know,” said Holmes. “You follow a messenger from the parcel office on his round, or maybe the delivery boy for a hatter. He delivers the package. When the messenger is out of sight, you run up to the door of the house and tell the servants that the delivery from so-and-so shop was an error, and that their goods are on the way. You take custody of the delivered package and wish them good day. Is that it, Wiggins?”
“Exact, sir. Bobby could do it just right. He had the looks, see, and all his teeth.”
“Scoundrel,” I muttered. I could not imagine where this catalogue of nefarious tricks would lead us.
“The dizzy German?” asked Holmes, smiling at me.
“We changed it, like, to the dizzy Yankee-Doodle on account of Bobby doing a posh Yankee to a ‘T’, and the Buffalo Bill posters all over town. Bobby gets dolled up in his gent’s finery, with his gloves and such, and he goes up West with his manservant, Aaron. He picks out a walking stick, or a silk cravat or whatever, and asks the price. They say two or three quid, and Bobby offers a couple of fivers. He says he never could understand this English money. Aaron gives the assistant a wink over his master’s shoulder. Bobby walks out with the loot. Aaron gets a tip from the assistant and everyone’s happy.”
“I don’t understand,” I said with a puzzled frown. “The boy paid ten pounds for goods worth two or three.”
I got five pitying looks.
“Master Spencer-Churchill? Can you solve Doctor Watson’s conundrum?” Holmes asked.
“Fake money, sir,” he said shyly.
“Very well. Bobby and Aaron became valuable members of your gang. Come to the meat of the matter.”
“A week ago, he and Aaron buggered off. Or at least that’s what we -”
The sitting-room door crashed open. Our pageboy staggered into the room looking pale and clutching his throat.
“Watch your valuables, gents,” said Wiggins, jumping up. “It’s the Dead Faint.”
“Doctor,” said Billy as I helped him to a chair. “Mrs Hudson - she’s dead.”
He slipped into unconsciousness.
2. Element of Danger
The Science of Diagnostics
I left Holmes with Billy and ran downstairs. Mrs Hudson was on the floor in the hall in her street clothes.
“She just dropped, sir, right there,” said Bessie. “She was going for a fine turbot to be seethed for the gentlemen’s tea, kept special at the fish shop. She reached to open the front door, and she dropped like a stone. And now she’s - oh, Doctor.”
I knelt and checked Mrs Hudson’s pulse; it was racing.
“Help me put her on the couch in the waiting room.”
“Is she dead, sir?”
“She is not.”
We stretched Mrs Hudson out on the sofa so recently vacated by Lady Randolph. I sent Bessie to my room for my medical bag. Holmes appeared at the door.
“She is alive,” I said in reply to his questioning look. “Her breathing is irregular, and her pulse is abnormally fast and reedy. She may have had a seizure of some sort. How is Billy?”
“Revived.”
Bessie returned with my medical bag.
“I have some sal volatile.”
“Never mind, Watson,” said Holmes. “Cognac sufficed. Billy snorted, woke, drank, and asked for a refill. I have planted him on the window seat in the alcove.”
I pulled my stethoscope from my bag and checked the patient’s vital signs. I was amazed that the hale Mrs Hudson of less than an hour previously was now febrile, pale, and in a coma-like condition.
“Whatever malady this is, Holmes, it has acted with astonishing swiftness. I can see no signs of typhus, cholera or the ague. The best we can do is to make her comfortable and observe how the disease, if disease it is, manifests itself. I shall also examine Billy.”
“You think that his fainting spell was not a reaction to Mrs Hudson’s sudden attack. That his condition and Mrs Hudson’s have the same cause.”
“I do not know, Holmes. That is why I must examine the boy.”
I turned to Bessie. “Did Mrs Hudson complain of any ailment today, or in recent days?”
“Oh, no sir, she was right bonnie, but for the heat. It was an awful freezing winter, and now it’s been terrible hot the last few days.”
I immediately checked the patient’s skin for dryness and reached for my thermometer case.
“Might it be heat-stroke?” asked Holmes.
“It is possible; the last few days have been sweltering, and then there was a chill breeze this afternoon.” I turned up the cuffs of my jacket and rolled up my sleeves. “Bessie will loosen her clothes, and I will check her temperature.”
“I shall withdraw,” said Holmes.
I returned to the sitting room upstairs an hour or so later to find that Holmes and Spencer-Churchill were alone. The boy sat at our dining table with a dozen reference and commonplace books piled before him. He wrote furiously in one of Holmes’s notebooks.
“I hope that your Irregulars did not take advantage of our disarray to take souvenirs again,” I said in an acid tone.
“No, no, Watson,” said Holmes from his usual chair by the fireplace. “Wiggins gave his word they’d touched nothing. Spencer-Churchill watched them like a kite hawk as he noted the details of the case. How is your patient?”
“She is awake, and I venture to say that she is more comfortable. It may well have been a heat syncope. However, she has exhibited other symptoms, a furred tongue, for example, that led me to suspect another cause. Mrs Hudson is a robust woman, and the effect of the disease has been strangely speedy.”
“Should she be transferred to a hospital?” asked Holmes.
“I cannot think what a hospital would offer over skilled home-nursing. I have sent for a lady-nurse who has proven herself entirely reliable. I will ask for Doctor Roose and Mr Philpot to attend. Have you a couple of telegram forms?”
I wrote out my messages.
“I’ll call for Billy - oh.”
“He’s lying down in the alcove. I can go to the telegraph office,” Spencer-Churchill said eagerly.
“Thank you. It is a matter of the gravest urgency. Billy will tell you where the nearest office is.”
“Why, it’s on the corner, Doctor. It’s beside the silver and glass emporium.”
I gave him the forms and money, and he slipped out the door.
“That was good observation by the boy,” said Holmes as the door closed behind him. “Pass me the notebook.”
He read for a moment.
“A childlike, round hand, but legible. He has noted all the salient facts, though he does include more ‘l’s in moleskin than is usual.”
He tossed the notebook back onto the table.
“Have you formed an opinion on the nature of the malady that has laid Mrs Hudson low?”
“I have several causations in mind,” I answered. “I need to examine Billy.”
I drew back the curtains of the alcove where Billy reclined on the window seat.
“Billy, how do you feel?”
“All right, sir; as well as can be expected.”
I took his temperature; it was normal. “But you felt poorly earlier, before you fainted.”
He avoided my eyes and reddened. “Wasn’t a faint, sir. I stumbled on the carpet.”
“Were you well before that?”
“Top-hole, sir, mostly. I had a w
art come up on my big toe day before yesterday, but Mrs H burnt it off with a red-hot poker.”
I sighed. “Did you eat luncheon with Mrs Hudson and Bessie today, as you usually do?”
He looked blankly up at me.
“The doctor means dinner,” Holmes called from his chair by the fireplace. “Did you eat dinner at twelve or so, as usual?”
“I did,” answered Billy.
“Describe the meal,” I said.
“Nice bit of rabbit stew, with dumplings done in the juice. Very tasty.”
“And you all ate the same?”
“Well, I had a bit more than the ladies. Mrs H says I need building up.”
“Ha! I’d say you need a new pageboy uniform, young man. You are popping out of the sleeves and cuffs of that one. All right, get along with you downstairs. I’ll have an errand for you soon.”
I lit a cigar and settled in my usual armchair as Spencer-Churchill returned and handed me the telegraph receipts and change.
“You suspect food poisoning, Watson?” Holmes asked as he stubbed out his cigar. “Or perhaps one of these new-fangled germs?”
“Food poisoning is possible, but I would expect symptoms that have not yet presented themselves: gastric pain, for example, or vomiting and other evacuations. The body, as we physicians have recently come to realise, puts up its own fight against disease. It attempts to expel toxins: vis medicatrix naturae.”
“Nature’s own power of healing,” said Holmes, smiling at Spencer-Churchill.
He steepled his hands and gave me a considering look.
“Watson, I have been remiss. You have frequently referred to the science of detection, of which I am the foremost practitioner, and we have discussed its intellectual foundation and methods. I have never asked you about the philosophy of your profession. I am afraid that I have taken it for granted. It is clear to me that medicine must offer opportunities for exercising the same faculties of logical inference as the science of detection. I track down the fell murderer by his motive and methods. You pursue the deadly disease agent by its signs and symptoms.”
I helped myself to a whisky and splashed in soda water from the gasogene while I considered Holmes’s remark.
“Philosophy, Holmes? Yes, we may say that there is a philosophy of medicine. I am no mere empiric. However, I must confess to you that much of my business is trial and error; many of my remedies are mere placebos. I would throw out half the Materia Medica if I could keep only two medicines of whose effectiveness I am convinced: opium and -”
The bell rang downstairs.
I jumped up. “That will be Mrs Levine.”
I caught a look between Holmes and Spencer-Churchill.
“She is a Jewess. She is the District Nurse in one of the vilest sets of streets off the Waterloo Road in Lambeth. She can walk unmolested through the darkest, filthiest courts inhabited by the toughest and most despicable Irish drunkards. She is universally respected and admired; indeed, they treat her with the respect they would accord to a bishop of their own faith. She is a most remarkable woman.”
I briefed Mrs Levine and together we examined our patient again. I returned to the sitting room and reported to Holmes.
“Mrs Hudson is awake and wracked with head- and stomach-aches; she is evacuating copiously. Now we have data, Holmes. The problem is that these symptoms are associated with several illnesses. But, nausea, vomiting, diarrhoea, abdominal cramps, and fever, together with the sudden onset of the malady, do suggest at least one likely cause.”
I called down the stairs for Billy.
“As you intimated, Holmes,” I said, as I returned to my usual chair, “medical symptomatology may be said to parallel your science of detection. It is a matter of acute observation, weighing the evidence for or against a diagnosis, and finding a cause that fits the evidence. When we peel away the impossible, what is left, however unlikely, must be the true cause.”
Holmes regarded me with a look of scepticism. He seemed prepared to accept the connection between the science of deduction and the science of symptomatology, except when the latter was practised by his co-lodger.
“Tainted rabbit or tainted dumplings,” he said with an impertinent smirk as Billy brought up a tray of coffee.
“Possibly,” I answered stiffly. “I have prepared samples of both to send off for analysis. Ah, Billy, go to the public commissionaire’s station; get Peterson for choice. Tell him to take this package to Herr Voelcker at 11, Salisbury Square. This will cover cab fare, hourly payment for the commissionaire, and thruppence tip.”
He left with the package and money. I turned back to Holmes.
“I have included samples of her evacuations -”
“Did you use a stomach pump?” asked Spencer-Churchill.
“Nature provided an efficient alternative. I should describe Mrs Hudson’s evacuations as -”
Holmes held up a restraining hand.
“Suffice it to say, then, that no intervention was necessary.”
Twenty minutes later, there was another knock on the door and Billy returned.
“Package sent, Doctor, and a Mr Philpot is waiting at the back door.”
“The back door, Watson?” said Holmes. “This Mr Philpot is a strangely retiring sort of medical specialist.”
I smiled. “Mr Philpot is not a physician, Holmes. He is a plumber.”
The Miasmatic Plumber
I left Holmes and Spencer-Churchill to mull on that as I went into the backyard with Billy. A stooped elderly man in a leather jerkin waited there, attended by two boys carrying toolboxes and lengths of pipe.
After mutual salutations, I outlined the medical situation.
Mr Philpot scratched his chin.
“Could be, Doctor, might well be. I’ll need to investigate, like.”
“Get on, then, Mr Philpot. Billy will be your guide to the house.”
There was a knock at the front door, and Bessie opened it for Doctor Roose. I left the plumber and hurried along the corridor to greet him.
We shook hands. “Thank you so much for coming at such short notice, Doctor.”
“Not at all, Doctor,” he said, removing his gloves.
I took Doctor Roose’s top hat, noting the stethoscope coiled inside the crown that, with the faint smell of ether, were the marks of the general practitioner.
I showed my colleague into the waiting room where Mrs Hudson lay in a bed made up on the sofa. We examined the patient again, extremely thoroughly. The doctor’s calm and methodical bedside manner impressed me deeply. He led Mrs Hudson through the days and hours before the onset of the disease, if disease it was, and elicited information on her diet, her health, and her doings with the calm assurance that he doubtless extended to his far more august patients. Mrs Hudson answered in a weak voice, sometimes stumbling over words and misplacing thoughts.
I felt a profound unease as I looked down at her. She was restless, groaning occasionally, and clearly in pain, despite the opium draught that I had administered earlier. I took her damp and trembling hand in mine and squeezed it in a reassuring gesture. Mrs Hudson looked up at me, smiled, and then grimaced as a spasm of pain wracked her body. I coughed to disguise a half-sob. It was impossible for me to maintain a professional distance with someone who had shared so many of our adventures. I ordered Nurse Levine to administer an increased dose of opium, squeezed Mrs Hudson’s hand again, and assured her that all would be well. I was touched, and embarrassed to a degree, that my assurances seemed to calm her.
Doctor Roose and I left the patient in the waiting room and crossed the hall to Mrs Hudson’s private sitting room.
“She was perfectly well this morning,” Doctor Roose summarised. “She had a fainting spell, or seizure, at lunchtime, and now she is confused, febrile, and nauseous. There was a copious evacuati
on.”
“There was indeed.”
He took out a cigar case and offered me one.
“I concur with your suspicions of food poisoning, Doctor Watson, although it is a puzzle that the boy was hardly affected, and the maid not at all.”
I explained that Billy was rendered dizzy and faint, although he denied it out of masculine bravado, and that he and Bessie had strong constitutions.
“I should have said the same for Mrs Hudson, Doctor,” I said. “If I had not just left her in such a pitiful condition.”
“Fluids,” said Doctor Roose. “We must replace those lost fluids.”
He buttoned up his gloves.
“That is the key,” he said with the professional gravitas that had won him so many aristocratic clients.
Billy showed in Mr Philpot.
I introduced Doctor Roose and desired the plumber to give his report.
“It might be best, Doctors,” said Philpot, puffing up like a pigeon, “was I to show you the evidence.”
We followed him out of the room and along the corridor to the room opposite the kitchen.
“That, gentlemen,” said Philpot gravely, “is the lady’s bedroom; it is where, you have to understand, she habitually sleeps.”
He led us out into the backyard.
“Now, next to that plane tree is your cess-pit. The boys sounded it, and it’s in good nick, but full, or nearly so. If I was you, Doctor, I’d get the night-soil men to pump it out. I know a reliable firm, sir. I shall send you their card.”
He indicated a pipe that ran up the wall of the house and disappeared into the eaves.
“That’s your four-inch soil pipe, all right, tight and proper, with a neat water trap and ventilating chamber; everything hunky-dory and Bristol fashion.”
He shook his head.
“I was fair foxed for a while, I will admit, gents.” He chuckled wryly. “But as the Lord says, ‘There is nothing covered, that shall not be revealed; and hid, that shall not be known’.”
