Susanna GREGORY - A Poisonous Plot

‘I am not in a position to say – yet,’ replied Michael. ‘Now tell me about Letia.’

‘Shirwynk summoned me too late to save her,’ said Nigellus, treating the monk to an unpleasant look. ‘Personally, I think he did it deliberately, because he wanted her dead. When I arrived, she was so dizzy that she barely knew her name.’

‘You mean she was delirious?’ asked Bartholomew.

Nigellus shot him a disdainful glance, and when he spoke, it was as if he was addressing an annoying and particularly stupid child. ‘No, because she was not suffering from hallucinations. You cannot have one without the other. Surely you know that?’

‘Actually, it is perfectly possible to be in an acute confused state without delusions,’ said Bartholomew, surprised that Nigellus might think otherwise. ‘What were her other symptoms?’

‘She was hot and she had vomited, but those were irrelevant to my diagnosis. Dizziness is a serious and often fatal condition, and it was obvious to me that she was going to die.’

Bartholomew did not bother to argue. ‘And Lenne?’ he asked.

‘Metal in the mouth, a disease described by Hippocrates. I prescribed garlic, not only to remove the taste, but to rebalance the humours. Garlic is hot and wet in the second degree, as I am sure you know.’

Bartholomew knew no such thing, and was also sure that Hippocrates would never have considered ‘metal in the mouth’ a disease. He regarded his colleague intently, trying to decide whether Nigellus was simply a terrible physician, or a very clever one attempting to conceal his crimes with a show of bumbling ineptitude.

‘Brother Arnold,’ he said eventually. ‘You claimed he died of insomnia.’

‘Yes, which can be deadly in elderly patients, as the Greek physician Xenocrates says. If they do not have access to the rejuvenating powers of sleep, they sicken and die. And before you ask, Irby was suffering from a loss of appetite, another dangerous disease.’

‘It takes longer than a few hours for a loss of appetite to prove fatal,’ said Bartholomew, whose only knowledge of Xenocrates was that the infinitely more famous and trustworthy Galen had criticised him for making ‘remedies’ out of particularly unpleasant ingredients.

‘Irby had a pre-existing condition that required a regular intake of nutrients,’ Nigellus flashed back. ‘When he failed to eat, he fell into a torpid state, and that was the end of him.’

Bartholomew struggled to understand what might actually have happened. ‘Did he suffer a sudden loss of weight, accompanied by excessive urination and–’

‘Hah! You do know of the ailment. Your training is not as flawed as I was beginning to fear. His urine was sweet on my tongue, and was obviously abnormal.’

‘You tasted it?’ Bartholomew was repelled.

Nigellus’s composure slipped a little. ‘Of course, as the great Aretaeus of Cappadocia recommended we do. Why? How do you do it?’

‘By seeing whether it attracts ants,’ replied Bartholomew, regarding him askance.

Nigellus waved a dismissive hand, although a flush in his cheeks indicated his chagrin at having been found lacking. ‘But Yerland is the one who will prove my innocence. I did not give him medicine for his headache, you did. Ergo, you are the one who should be sitting here, not me.’

‘You gave him nothing at all?’ asked Michael.

‘No – I have one cure for headaches: sleeping in a darkened room. I have learned through the years that they either get better on their own or they become worse and the patient dies. Nothing the medicus does affects the outcome one way or the other, so I never bother to try.’

‘Did Segeforde have a headache, too?’ asked Bartholomew.

‘He had a pallor,’ replied Nigellus. ‘So all I did for him was recommend an early night.’

‘Now what about this debilitas you have been diagnosing?’ asked Michael. ‘Matt tells me that there is no such sickness.’

Nigellus scowled. ‘Of course there is, and his remark does nothing but underline the fact that I am a better, more experienced medicus than he. He claims to have University degrees, but all I can say is that he cannot have paid much attention in class. I, on the other hand, listened to every word my tutors told me.’

‘When did you study at Oxford?’ asked Michael, aiming to make enquiries to see if Nigellus was telling the truth about his education.

‘Before you were born,’ came the sharp response. He shot Bartholomew an unpleasant sneer. ‘When medical students were of a much higher calibre.’

‘ Similia similibus curantur ,’ persisted Michael, while Bartholomew felt himself begin to lose patience with Nigellus, and struggled against the urge to turn on his heel and march out. ‘Irby wrote it just before he died. What did he mean?’

‘Clearly, he was reflecting on the best way to counteract the stench caused by Edith Stanmore’s dyeworks.’ The speed of Nigellus’s response indicated that he had already given the question serious consideration. ‘He was pondering whether creating odours of his own would neutralise hers.’

‘Can you prove that?’ asked Michael.

‘Can you dis prove it?’ Nigellus flashed back. ‘You think I harmed all these people, but you have no evidence to support your theories, or you would not be here now, fishing for answers.’

Michael stood, refusing to rise to the bait. ‘Thank you for your time. You will no doubt be seeing more of us in the coming days.’

‘I cannot wait,’ said Nigellus acidly. ‘However, do not forget to ask Tynkell how much money is in the University Chest. You will need every penny once Stephen is through with you.’

‘Well?’ asked Michael once they were outside. ‘He had an answer for everything, but only a fellow medicus will know whether his replies were reasonable.’

‘There is something to be said for treating headaches by sending the patient to rest in a dark room, although I suspect he misremembered the sources he quoted.’

‘That does not answer my question.’

‘Letia’s high temperature and sickness should have formed part of Nigellus’s diagnosis, but he chose to ignore them. And it is common knowledge that patients with Irby’s condition can slip into a fatal decline if they fail to eat. Nigellus should have taken steps to prevent it.’

‘So ineptitude rather than malice killed Irby and Letia? What about the others?’

Bartholomew shrugged. ‘He assumed the symptoms exhibited by Lenne and Arnold were diseases, and elected to treat those rather than identify the underlying causes. They might have lived if he had approached them differently, but they might not. We will never know.’

‘Then what about the damage to stomachs and livers that you found in the three Zachary men and Lenne?’ Michael was sounding exasperated. ‘You said that might be evidence of poison.’

‘Yes – might be evidence of poison. But I cannot prove it.’

‘I am not very impressed with your help in this matter, Matt. If you do not give me something useful soon, I may be forced to let him go.’

‘Well, if you do, it should be on condition that he does not practise medicine again. Do you have the authority to enforce that?’

‘Yes, but only temporarily. He will contest my decision and Stephen will argue that he be permitted to trade until the case is resolved in court. Thank God we have Irby’s note – the only truly compelling piece of evidence against him.’

Bartholomew was thoughtful. ‘His explanation of the note made no sense: if Irby had been reflecting on how best to combat the reek from the dyeworks, why did he address his letter to me, the brother of the owner? Why not Nigellus, the medicus in his hostel? Or one of his colleagues?’