Bhupaticharan, the husband, was once a man of robust health, but now he was like a giant tree felled by a storm. His face had a bluish tinge, his skin was stretched, and his tongue and breath were chilled. The muscles in his limbs were flaccid; his eyes were sunken. A closer look revealed that his eyeballs had contracted and his cornea was flattened. It was obvious that he was suffering from cholera.
What he had revealed in a faint voice was this –
There had been a severe ache in his stomach, accompanied by vomiting and diarrhoea, since late last night. The stool was yellow in colour to begin with, gradually turning into nothing but a gush of liquid. He had experienced thirst all night, but drinking water only led to more vomiting and diarrhoea.
“Where does your water come from?”
“Opposite our house...the tank at Hedua...”
“Do you drink it directly? Without boiling it, I mean?”
“Yes, the water from the Hedua tank is clean.”
“There have been some cases of cholera in this area, have there not?”
“Yes, you have been correctly informed.”
Amodini, the wife, was thin. About eighteen or nineteen. One could be forgiven for mistaking her for a corpse at first sight. Her eyes were sunken but glittering. Continuous vomiting since the early hours of the morning had left her nails and lips soiled and ashen. Her skin was cold and stretched, and her tongue and breath, too, were chilled.
“Frothy, like rice starch. Frequent cramps in the arms and legs...” There had been so many spasms in her legs that the calf muscle had been displaced. She was in far worse condition than her husband, but despite being only half-conscious, she kept summoning the cooks to supervise the meals. She was drinking water repeatedly to quench her unbearable thirst, leading to more vomiting. She, too, had cholera.
Both of them had mustard paste plastered on their stomach. Warm water bottles on their hands and feet. Their bodies were being massaged with dry ginger paste in a bid to warm them.
They had called the family doctor, Ishan Chandra Roy. Gauging the seriousness of their condition, Ishan had requested Dwarikanath to pay a visit.
“What medicines have they been given, doctor?”
“A small dose of calomel with opium to stop the vomiting, magnesium to mitigate the stomach ache, and semolina and camphor and ammonia with hot brandy for nutrition...
“How much calomel?”
“Ten grains every half an hour...the thing is...as you know, Dr Ghoshal, if the vomiting and diarrhoea can be stopped somehow they will survive.”
“True.” Dwarika nodded.
“Yes, the medicines are more or less...”
Brandy was the only ingredient Dwarika was not in favour of.
It was stopped.
He then proceeded to do what Ishan Chandra had not done yet.
Both the patients had lost considerable quantities of salt, which had to be replenished. A syringe and two stout bottles with different solutions in each emerged from the doctor’s bag. The third bottle remained inside. Dwarikanath had prepared each of these solutions personally, on the basis of his daily research findings, and his own judgement. Twenty-five per cent of the first solution was pure sodium chloride and sodium sulphate, the remaining one thousand parts being water. The second comprised three parts soda, three parts sodium iodide, and a thousand parts water.
Drawing up some of the first solution into the syringe, he injected it slowly and carefully into Bhupaticharan’s vein. The patient was silent. He had lost even the strength to moan with pain. Using a thicker needle, Dwarikanath injected the second solution directly into Amodini’s peritoneal cavity. It was a difficult manoeuvre, but Dwarikanath had done it many times, without erring even once. He did not err this time either.
Bhupaticharan sat up in bed half an hour later. He was feeling much better. Telling him to lie down again, Dwarika went into the other room with Ishan. Amodini was conscious too, but she had not recovered to the extent Bhupati had.
“My throat is parched, Daktar babu,” she said. “Water tastes bitter...may I have coconut water?”
Dwarikanath agreed before Ishan could speak. Coconut water was a hundred times better and safer than water from the tank at Hedua.
It was the middle of the afternoon by the time Dwarika explained everything to Ishan and left. The patients would survive if they could somehow battle on for another eighteen to twenty-four hours – but would they? Bhupaticharan might, but it would be difficult for Amodini. The thin eighteen-year-old’s face was haunting Dr Ghoshal. Was she to die, then? The desire to live was clear in her hollow eyes, but her mournful smile told another story. Her body was the colour of death. Dwarika was saddened.
As he was getting into his brougham, he told Panchanan, who hadn’t even seen the patients, “She won’t live, you know, Panchu.”
Panchu called out his warning as the carriage came to an abrupt halt, and Dwarika became alert once again. “We’re at Maniktala, sir...” Panchanan informed him.
“I had just sent someone to fetch you...” Ishan said as soon as Dwarika entered.
He proceeded to give details; Bhupaticharan was having cramps in his limbs. He had been writhing with pain in his stomach, and had been given morphia subcutaneously. But his pulse had suddenly weakened at six-thirty in the evening. He had been semi- conscious then, and was almost entirely unconscious now. Hot-water bottles had been applied to his feet and hands, and he had even been rubbed down with a warm, dry flannel. But none of this had helped.
Bhupati’s father was standing next to him, slapping himself on the forehead. Within the house there was a chorus of tearful wailing. Dwarikanath was irked; here both births and deaths were greeted with the same cacophony. Turning to Ishan, he said, “Stop all this... they have not died yet...and take this man away...” Bhupati’s father was led out of the room.
Dwarika swiftly took the third bottle out of his bag. It held pure saline solution. Among the things delivered to him from abroad every month were two fixtures. One was St Julien cigarettes, and the other, pure powdered salt. Buying distilled water from the chemist, he would personally mix this powdered salt with it in the appropriate proportion to prepare the solution.
He injected five pints of the saline solution slowly into Bhupati’s vein. The patient recovered consciousness a quarter of an hour later. His pulse grew much stronger. Dwarika felt a surge of joy as he felt it beating strongly. Bhupati sat up in bed, as he had in the afternoon, and told the doctor he was feeling much better now.
Ishan’s voice was laced with happiness. “It’s true, Dr Ghoshal... this is why everyone follows your instructions scrupulously.”
A maid ran in from the next room to tell Dwarika. “She’s collapsed after passing stool twice...thakrun is unconscious...”
Amodini couldn’t be said to have lost consciousness entirely. Her eyes were closed, but her lips were moving; she wanted to say something. Ishan laid his ears near her mouth, and then turned to Dwarika, startled. She was saying that she should be cremated on a sandalwood pyre at Nimtala. Even with her past, present, and future about to pass into oblivion, she was worrying about rituals.
Dwarikanath gave her the same injection. Not in her vein but in her abdominal cavity. Amodini recovered in little over an hour. A faint twinkle appeared in the corner of her eye. She asked for coconut water
If only some more time could be made to elapse this way! After that the body would be able to use its own powers to defend itself from the attack of the comma bacillus. This particular germ seemed to pour poison into the intestine, sucking out fluids from the blood, and water and salt from the other cells. The blood began to coagulate, the body grew inanimate, and gradually the patient slipped into unconsciousness. Followed by death. Still, some of those afflicted survived if saline solution could be introduced into their veins. It was a battle to ensure his patients’ survival that Dwarikanath was waging.
Excerpted with permission from A Ballad Of Remittent Fever, Ashoke Mukhopadhyay, translated from the Bengali by Arunava Sinha, Aleph Book Company.
Disclosure: Arunava Sinha is a consulting editor for the Books and Ideas section of Scroll.in.