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Violet sent word with the footman for the materials she would need, including two pots of water, one as near to scalding as possible and one that had been heated and cooled; strong lye soap; Dr. Warburg’s tincture for fevers; as much yarrow as could be found, dried or harvested fresh; St. John’s Wart salve; birch pollen; laudanum; as many freshly laundered scraps of linen as were available; and another cup of coffee.

The last was for Violet, who was more than exhausted. But she had only hours to try and help Darius, and she would start as soon as the supplies were brought up and she could wash her hands.

She made her way over to the heavy draperies blocking all sunlight from the room and pulled them back, exhaling a sigh of relief as the warm sun hit her face.

And then she cracked open the window to let in some air.

Fresh air was one of the practices she’d learned from the midwives, and she grinned, thinking of how that old surgeon would shudder and complain if he knew.

She inhaled and let her nostrils take in the scent of wildflowers and the sea. Something so beautiful could only be a boon for health.

And besides, as one of her favorite midwives had said, “Only dimwits try to fix what they can’t damn see. Open the drapes.”

Violet couldn’t agree more as she watched the golden rays of the sun light up the green rolling hills of Kent. Rosehips was gorgeous. But there was no time to waste in admiring the view. It was time to work.

She turned back to Darius and gave him a cursory, visual examination. She wouldn’t touch him until her hands were clean, but she would learn what she could while she waited.

Williams had told her that seven days ago Darius had been out with the tenants, which was a normal turn of events.

The man was not an absentee landowner. He’d come in for supper afterwards, but then claimed a headache and skipped the evening meal, retiring to his bed instead.

The Marquess had called the surgeon then, who paid a first visit to Darius five days ago.

The man diagnosed Darius with having taken the miasmata.

Violet shook her head in disgust. She could imagine the old geezer now, quoting Hippocrates and saying Darius had taken the vapors because he’d been out in the country with the poor.

Being poor was not synonymous with being ill or dirty, although Violet knew a surgeon for the aristocracy would never share that belief.

I hope he at least examined him properly , she thought and drummed her fingers against her thigh impatiently.

The surgeon had prescribed rest in a closed, darkened room to keep the miasma out, and arsenic for anemia if Darius did not begin eating again. And, of course, he let his blood.

That evening, Darius developed the fever, which grew steadily worse for four days before spiking yesterday. He then sank into a delirium, causing his father to call for the surgeon once more, and for Alistair. And finally for the vicar who would be arriving at any moment.

Violet shook her head in frustration.

Miasma, indeed. And arsenic. And bloodletting!

The surgeon was as likely to kill Darius as he was to help him. Bloodletting had been out of favor for years now, as had arsenic treatment. To stop those two treatments alone was worth the journey from Surrey.

But what was causing the fever?

She could rule out smallpox, as the man had no visible rash. Typhoid was unlikely—no one mentioned abdominal pain or vomiting. Cholera too would cause him to cast up his accounts regularly.

That left tuberculosis, diphtheria, and influenza as the most likely culprits. She doubted tuberculosis, as it was a wasting disease, and no one had mentioned him coughing.

Influenza or diphtheria?

Diphtheria was always probable, but Williams had reported no outbreaks of the scourge in this or any surrounding villages. She did recall one of her patients in London had told her of a wave of the deadly disease passing through the country not that long ago though.

The “children’s plague” as it was called, for it tended to take the young and vulnerable in just a few days. A bad strain of influenza would as well, but she suspected diphtheria, especially if he had lesions. She’d seen that form of the disease once before, in New York.

She kept studying Darius from afar, wanting badly to examine him. If he had either influenza or diphtheria, she ought to cover her face as well as continually wash her hands. It was still unknown exactly how the disease spread, so it would be best to take every precaution.

She thought of Alistair sitting in the enclosed room, holding his brother’s hand and shook her head. He’d put himself at risk. Likely, the whole family had.

But disease transmission could be unpredictable, and the Marquess and Marchioness had not fallen ill. So, there was hope. And she still didn’t know the exact cause of the fever. It may not be transmissible at all.

She wished she knew more about the surgeon.

Had he checked Darius’s mouth and throat for the gray membrane that was the most common sign of diphtheria?

She would have thought it likely he had, but then again, he’d diagnosed miasma of all things, and the second time he’d visited, he’d pronounced Darius a lost cause.

He may not have examined him closely at all.

Asshead.

And then there were the sores. The lesions Alistair had mentioned on Darius’s legs and chest that brought to mind the infection she’d seen on the foot of her patient in New York.

She pulled the chair close to the window and sat, drumming her fingers impatiently against its arm. Where was the footman?

The footman shook her awake sometime later. “Miss,” he whispered. “Miss, wake up.”

Violet startled awake.

“I’ve brought what you asked for, Miss.”

“Oh,” Violet said and took in the wide eyes of the young man. “Out, out.”

She hurried him to the door. “You found everything?” she asked while she was all but pushing him from Darius’s room.

“Aye,” he replied. “It’s all there. I had to track down my sister for some of it, the birch and yarrow and such.

That’s what took so long. She’s a midwife and was out birthing.

She has all the same medicines as you do though.

Or nearly so. Except for the Warburg’s tincture. I got that from the apothecary.”

Violet nodded. The footman was safely on the other side of the door now, and she had it open just a crack to speak with him.

“She was curious,” the young man went on, “if you were a midwife too, if you don’t mind me asking?”

Violet smiled. “I don’t mind at all. I’d be honored to be counted as a midwife, but alas it isn’t true. I’m a nurse. Thank you again for the supplies.” She shut the door before he could say more.

The footman had been meticulous in his gathering, and Violet nodded her head in approval as she cataloged her new supplies. Everything she asked for was here.

That didn’t surprise her, if his sister was a midwife. Violet had studied midwifery as eagerly as she had the work of surgeons and scientists and found their techniques to be sound. Many in fact had better outcomes than surgeons could produce.

But they were women, so no one ever noticed or adopted their techniques, a situation Violet hoped she could change with her new hospital.

She felt a twinge of guilt then for not yet having purchased her passage back to New York.

The longer she waited, the longer it would take to build her hospital and the more women would die needlessly from childbirth or other ailments.

She shook her head. That dream would have to wait a little longer. She had work to do here.

She wrapped a linen strip across her nose and mouth, another example of midwifery practice she’d adopted, and then she washed her hands with the lye mixture and the scalding water.

That technique she had learned from the writing of a Hungarian doctor, Ignaz Semmelwies.

The doctor had produced some very interesting studies on the benefits of hand washing while practicing in Vienna, which she’d studied avidly.

Violet tried not to flinch as the lye and hot water turned her hands a bright, screaming red. Handwashing hurt every single time. But it was a small price to pay for any potential benefit to her patients. And then, finally, with a few deep breaths to fortify herself, she went to inspect Darius.

The mid-afternoon sunlight did nothing to improve the look of him.

If he had been as hale as Alistair a week ago like Williams had said, the change in him now was shocking.

She laid her clean hand across his forehead and felt the heat from the fever ravaging his body.

He twisted and murmured in his delirium.

“What’s that you say?” she whispered to him. “Who are you calling for?”

“George.”

It was the only comprehensible word he’d spoken.

“Who is George?” she asked gently.

Darius’s eyes flew open as if he’d been startled but closed again just as quickly. Still, it had been long enough for Violet to see they were the same dark, almond-shape as Alistair’s. And they’d been filled with a look of such pain that it pierced her heart.

“Well,” she said, dipping a cloth into the chilled water and placing it over his forehead. “We won’t say that name again, now, will we? Is he your nemesis?”

She mixed a tea of birch pollen, yarrow, and laudanum and eased Darius’s body to a more upright position to administer it to him.

“This will help you sleep,” she told him as she adjusted his head and torso. He was too light, and it was far too easy for her to maneuver about. A man his size should be nearly impossible for her to adjust, and yet she could drag him around the sickbed like a ragdoll.

“What’s got hold of you, hm?”

But even as she asked the question, she was afraid she knew the answer. And if she was right, Darius would have the fight of his life on his hands.