The Mystery of 31 New Inn, R. Austin Freeman [uplifting books for women .txt] 📗

from his stupor. The beats were slow, feeble and slightly irregular, giving clear evidence, if any were needed, of his generally lowered vitality. I listened carefully to his heart, the sounds of which were very distinct through the thin walls of his emaciated chest, but found nothing abnormal beyond the feebleness and uncertainty of its action. Then I turned my attention to his eyes, which I examined closely with the aid of the candle and my ophthalmoscope lens, raising the lids somewhat roughly so as to expose the whole of the irises. He submitted without resistance to my rather ungentle handling of these sensitive structures, and showed no signs of discomfort even when I brought the candle-flame to within a couple of inches of his eyes.

But this extraordinary tolerance of light was easily explained by closer examination; for the pupils were contracted to such an extreme degree that only the very minutest point of black was visible at the centre of the grey iris. Nor was this the only abnormal peculiarity of the sick man's eyes. As he lay on his back, the right iris sagged down slightly towards its centre, showing a distinctly concave surface; and, when I contrived to produce a slight but quick movement of the eyeball, a perceptible undulatory movement could be detected. The patient had, in fact, what is known as a tremulous iris, a condition that is seen in cases where the crystalline lens has been extracted for the cure of cataract, or where it has become accidentally displaced, leaving the iris unsupported. In the present case, the complete condition of the iris made it clear that the ordinary extraction operation had not been performed, nor was I able, on the closest inspection with the aid of my lens, to find any trace of the less common "needle operation." The inference was that the patient had suffered from the accident known as "dislocation of the lens"; and this led to the further inference that he was almost or completely blind in the right eye.

This conclusion was, indeed, to some extent negatived by a deep indentation on the bridge of the nose, evidently produced by spectacles, and by marks which I looked for and found behind the ears, corresponding to the hooks or "curl sides" of the glasses. For those spectacles which are fitted with curl sides to hook over the ears are usually intended to be worn habitually, and this agreed with the indentation on the nose; which was deeper than would have been accounted for by the merely occasional use of spectacles for reading. But if only one eye was useful, a single eye-glass would have answered the purpose; not that there was any weight in this objection, for a single eye-glass worn constantly would be much less convenient than a pair of hook-sided spectacles.

As to the nature of the patient's illness, only one opinion seemed possible. It was a clear and typical case of opium or morphine poisoning. To this conclusion all his symptoms seemed to point with absolute certainty. The coated tongue, which he protruded slowly and tremulously in response to a command bawled in his ear; his yellow skin and ghastly expression; his contracted pupils and the stupor from which he could hardly be roused by the roughest handling and which yet did not amount to actual insensibility; all these formed a distinct and coherent group of symptoms, not only pointing plainly to the nature of the drug, but also suggesting a very formidable dose.

But this conclusion in its turn raised a very awkward and difficult question. If a large—a poisonous—dose of the drug had been taken, how, and by whom had that dose been administered? The closest scrutiny of the patient's arms and legs failed to reveal a single mark such as would be made by a hypodermic needle. This man was clearly no common morphinomaniac; and in the absence of the usual sprinkling of needlemarks, there was nothing to show or suggest whether the drug had been taken voluntarily by the patient himself or administered by someone else.

And then there remained the possibility that I might, after all, be mistaken in my diagnosis. I felt pretty confident. But the wise man always holds a doubt in reserve. And, in the present case, having regard to the obviously serious condition of the patient, such a doubt was eminently disturbing. Indeed, as I pocketed my stethoscope and took a last look at the motionless, silent figure, I realized that my position was one of extraordinary difficulty and perplexity. On the one hand my suspicions—aroused, naturally enough, by the very unusual circumstances that surrounded my visit—inclined me to extreme reticence; while, on the other, it was evidently my duty to give any information that might prove serviceable to the patient.

As I turned away from the bed Mr. Weiss stopped his slow pacing to and fro and faced me. The feeble light of the candle now fell on him, and I saw him distinctly for the first time. He did not impress me favourably. He was a thick-set, round-shouldered man, a typical fair German with tow-coloured hair, greased and brushed down smoothly, a large, ragged, sandy beard and coarse, sketchy features. His nose was large and thick with a bulbous end, and inclined to a reddish purple, a tint which extended to the adjacent parts of his face as if the colour had run. His eyebrows were large and beetling, overhanging deep-set eyes, and he wore a pair of spectacles which gave him a somewhat owlish expression. His exterior was unprepossessing, and I was in a state of mind that rendered me easily receptive of an unfavourable impression.

"Well," he said, "what do you make of him?" I hesitated, still perplexed by the conflicting necessities of caution and frankness, but at length replied:

"I think rather badly of him, Mr. Weiss. He is in a very low state."

"Yes, I can see that. But have you come to any decision as to the nature of his illness?"

There was a tone of anxiety and suppressed eagerness in the question which, while it was natural enough in the circumstances, by no means allayed my suspicions, but rather influenced me on the side of caution.

"I cannot give a very definite opinion at present," I replied guardedly. "The symptoms are rather obscure and might very well indicate several different conditions. They might be due to congestion of the brain, and, if no other explanation were possible, I should incline to that view. The alternative is some narcotic poison, such as opium or morphia."

"But that is quite impossible. There is no such drug in the house, and as he never leaves his room now, he could not get any from outside."

"What about the servants?" I asked.

"There are no servants excepting my housekeeper, and she is absolutely trustworthy."

"He might have some store of the drug that you are not aware of. Is he left alone much?"

"Very seldom indeed. I spend as much time with him as I can, and when I am not able to be in the room, Mrs Schallibaum, my housekeeper, sits with him."

"Is he often as drowsy as he is now?"

"Oh, very often; in fact, I should say that is his usual condition. He rouses up now and again, and then he is quite lucid and natural for, perhaps, an hour or so; but presently he becomes drowsy again and doses off, and remains asleep, or half asleep, for hours on end. Do you know of any disease that takes people in that way?"

"No," I answered. "The symptoms are not exactly like those of any disease that is known to me. But they are much very like those of opium poisoning."

"But, my dear sir," Mr. Weiss retorted impatiently, "since it is clearly impossible that it can be opium poisoning, it must be something else. Now, what else can it be? You were speaking of congestion of the brain."

"Yes. But the objection to that is the very complete recovery that seems to take place in the intervals."

"I would not say very complete," said Mr. Weiss. "The recovery is rather comparative. He is lucid and fairly natural in his manner, but he is still dull and lethargic. He does not, for instance, show any desire to go out, or even to leave his room."

I pondered uncomfortably on these rather contradictory statements. Clearly Mr. Weiss did not mean to entertain the theory of opium poisoning; which was natural enough if he had no knowledge of the drug having been used. But still—

"I suppose," said Mr. Weiss, "you have experience of sleeping sickness?"

The suggestion startled me. I had not. Very few people had. At that time practically nothing was known about the disease. It was a mere pathological curiosity, almost unheard of excepting by a few practitioners in remote parts of Africa, and hardly referred to in the text-books. Its connection with the trypanosome-bearing insects was as yet unsuspected, and, to me, its symptoms were absolutely unknown.

"No, I have not," I replied. "The disease is nothing more than a name to me. But why do you ask? Has Mr. Graves been abroad?"

"Yes. He has been travelling for the last three or four years, and I know that he spent some time recently in West Africa, where this disease occurs. In fact, it was from him that I first heard about it."

This was a new fact. It shook my confidence in my diagnosis very considerably, and inclined me to reconsider my suspicions. If Mr. Weiss was lying to me, he now had me at a decided disadvantage.

"What do you think?" he asked. "Is it possible that this can be sleeping sickness?"

"I should not like to say that it is impossible," I replied. "The disease is practically unknown to me. I have never practised out of England and have had no occasion to study it. Until I have looked the subject up, I should not be in a position to give an opinion. Of course, if I could see Mr. Graves in one of what we may call his 'lucid intervals' I should be able to form a better idea. Do you think that could be managed?"

"It might. I see the importance of it and will certainly do my best; but he is a difficult man; a very difficult man. I sincerely hope it is not sleeping sickness."

"Why?"

"Because—as I understood from him—that disease is invariably fatal, sooner or later. There seem to be no cure. Do you think you will be able to decide when you see him again?"

"I hope so," I replied. "I shall look up the authorities and see exactly what the symptoms are—that is, so far as they are known; but my impression is that there is very little information available."

"And in the meantime?"

"We will give him some medicine and attend to his general condition, and you had better let me see him again as soon as possible." I was about to say that the effect of the medicine itself might throw some light on the patient's condition, but, as I proposed to treat him for morphine poisoning, I thought it wiser to keep this item of information to myself. Accordingly, I confined myself to a few general directions as to the care of the patient, to which Mr. Weiss listened attentively. "And," I concluded, "we must not lose sight of the opium question. You had better search the room carefully and keep a close watch on the patient, especially during his intervals of wakefulness."

"Very well, doctor," Mr. Weiss replied, "I will do all that you tell me and I will send for you again as soon as possible, if you do not object to poor Graves's ridiculous conditions. And now, if you will allow me to pay your fee, I will go and order the carriage while you are writing the prescription."

"There is no need for a prescription," I said. "I will make up some medicine and give it to the coachman."

Mr. Weiss seemed inclined to demur to this arrangement,