The Speckled Monster by Jennifer Lee Carrell Page B

unspotted,” came the answer.
    The same could no longer be said for her. As she watched, the red bumps filled with a clear liquid that gradually thickened to opalescent grayish white; now they began to look like large flat pimples that might be called “pocks.” A ring of red circled the base of each one, while their centers sank in a small dimple.
    At last she saw what the doctors had been quietly worried about: hour by hour, the pocks went on growing, running into each other until large sections of skin looked to be covered by a single marbled blister. She could not see it, but her face swelled so much that her finely carved features began to submerge, the skin pulling taut over nose, ears, chin, and cheeks; her eyes squeezed into slits. Those who did glance at her face thought she looked unnaturally old or young: the disease was transforming her into a grotesque gigantic changeling, wrapped in a tight gray caul that veiled all her features.
    At last, the doctors issued a diagnosis: she had the confluent smallpox. The news skittered around London and winged north to the armies burning Scotland: Lady Mary is exceedingly full and will be very severely marked .
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    However much they irritated her, Lady Mary was lucky in having Dr. Mead and Dr. Garth at her bedside. Besides being known for compassion, they were both moderates in an age when medicine was unabashedly aggressive; in attempting to be heroic, it was more often horrific.
    A very few practical men had begun systematically observing their patients and describing symptoms that clustered into specific maladies. The most eminent physicians of the day, however, were abstract philosophers who snipped and stretched experience to fit theory, in their case a modified version of the ancient Greek theory of the four humors. Good health, in this system, was a perpetual circus act, balancing ever-shifting quantities of blood, black bile, green bile, and phlegm, as well as the oppositions of hot and cold, moist and dry. Imbalances tipped people into the morass of sickness; restoring a patient to health meant bringing them back into balance.
    To do so, doctors tried to relieve whatever the body was producing in too much abundance by either repressing or removing it, while nurturing the growth of whatever they judged to be lacking. It was the relief side of this equation into which medicine had long put most of its efforts and its faith—though relief proves a bizarrely inopportune word for their ministrations.
    Any and all possible bodily emissions were sometimes thought necessary to force. The most commonly practiced “evacuation” was bloodletting: slitting veins open at the wrists, arm, groin, or in serious cases, the jugular, to let poisons escape with the blood. If all else failed—or, in the delicate cases of infants, right at the beginning—doctors applied leeches to the temples or behind the ears. They also induced sweating, salivating, and blistering, and they administered clysters, or enemas, and ferocious laxatives and diuretics. An unholy array of emetics produced immediate and sometimes prolonged vomiting. Many, if not most, of the medicines they put into a body were designed to send something else shooting out of it, making eighteenth-century medicine a leaky, spraying, spewing art.
    It was an art, furthermore, divided into three territories with jealously—though often unsuccessfully—guarded boundaries. Physicians were university men with medical doctorates. High (and highly expensive) priests of the mysteries of diagnosis, they solemnly prescribed treatments but rarely provided them, though things were changing in progressive and ruthlessly practical places like Edinburgh, or the University of Leiden over in Holland. In London, any procedure, such as bloodletting, that involved cutting was still by law the purview of the surgeons—historically, a specialized branch of the razor-bearing brethren of barbers, with whom they