First Comes Scandal (Rokesbys #4)(84)

“Ah, but is all of our blood necessary for survival?”

“Ah, but wouldn’t you think that more is better?”

“Not necessarily. Too much fluid in the body is called edema, and it can be very dangerous.”

“Edema?”

“Swelling,” he explained.

“This is like that ecchymosis thing,” she said with a slight curl of her lip. “Doctor-speak so the rest of us don’t know what you’re talking about.”

“You mean a bruise?” he asked innocently.

She swatted him on the shoulder.

“You’ll ecchymose me,” he pretended to whine.

“Is that a word?”

“Not even slightly.”

She chuckled, but then, ever tenacious, returned to the topic at hand. “You still haven’t said—why do you bleed patients?”

“It’s all about balance,” Nicholas said. “Of the humors.”

“Humors,” she repeated skeptically. “This is accepted scientific fact?”

“There are some competing theories,” Nicholas admitted. “And in some schools of thought bloodletting is falling out of favor. It depends a great deal on whether the physician is a devotee of heroic medicine or solidism.”

This, she seemed to find too much to accept. “Wait just a moment. Are you telling me that there is such a thing as heroic medicine?”

“Some would say all medicine is heroic,” Nicholas tried to joke.

“Stop that,” she said impatiently. “I want to hear more about this. It seems very self-congratulatory for a branch of science to label itself heroic.”

“I’m not entirely certain of the origin of the phrase,” Nicholas admitted. “It is also known as heroic depletion theory.”

“That’s not off-putting at all,” Georgie muttered.

“Likely why the more basic term has prevailed,” he replied.

“But what does it mean?”

“It follows the idea that good health is achieved when the body’s humors are in balance.” He explained further: “Black bile, yellow bile, phlegm, and blood.”

“All liquids,” she observed.

“Precisely. Which is why the theory stands in contrast with solidism, which follows the idea that it is the solid parts of the body that are vital and susceptible to disease.”

She frowned. He’d noticed she did this when she was in deep thought. He’d also noticed that he found this fascinating. When Georgie thought deeply on something, her face was in constant motion. Her brow might dip, or her eyes would dart from side to side.

She was not a passive thinker, his wife.

Then something occurred to him. “Were you ever bled?” he asked her. “For your breathing illness?”

“Twice,” she told him.

“And did it work?”

She shrugged. “According to the doctor it did.”

Nicholas did not find this reply satisfying. “What was his criteria?”

“For success?”

He nodded.

She looked at him frankly. “I’m not dead.”

“Oh, for heav—”

Georgie cut him off with a shake of her head. “According to my mother, that is the ultimate proof of cure.”

Nicholas smiled, although he didn’t really think this was funny.

“But,” Georgie continued, “I don’t think that the bloodletting had anything to do with my getting better. If anything, it made me feel worse. It was exhausting. And it hurt.”

“The exhaustion is to be expected. The body must work to produce new, healthier blood.”

“—that is more in balance with the other three humors,” she finished.

“That is the thought.”

She frowned, and an odd, growly sound came from the back of her throat. She was impatient, he realized.

“How do we know I wouldn’t have improved without the bloodletting?” she asked. “How do we know I wouldn’t have improved faster?”

“We don’t,” he admitted.

Georgie’s eyes met his and then held them in a piercingly direct manner. “Would you have bled me under the circumstances?”

“I can’t answer that,” he said. “I don’t know all the circumstances. I don’t know how labored your breathing was. Was it shallow, rapid? Did you have a fever? Muscle aches? Rigidity in your spleen?”

He paused for a moment, even though his questions were largely rhetorical. “It is dangerous to dispense medical advice when one does not have all the facts at hand.”

“I’m not sure the doctor had all the facts at hand,” Georgie muttered.

“He certainly had more than I do.”

She dismissed this with a little snort. “But think about it,” she said. “The difficulty was in my breathing. Whatever was wrong with me, it was in my lungs, not my veins.”

“Everything is connected,” he said.

She rolled her eyes. Hard. “You keep answering with platitudes that don’t explain anything.”

“Sadly, medicine is as much an art as a science.”

She wagged her finger at him. “Another platitude.”

“I didn’t mean it as such,” he said. “I swear. I wish we had more proof to guide our practices. I truly do. And I’m not sure I would choose to bleed a patient who was having difficulty breathing. At least not as a first measure.”