Saturday. Just another workday when the Cholera is flowing. I woke early, at 6 a.m., and went to the office before anyone else. On the way, I went to the grocer’s and bought some supplies.

I started, as usual, in the cubby room, and I was happy to see that as of yesterday that cases of the Cholera were staying down: there were around eight new cases, and four were self-induced, the Heads of the Medical Societies. Equally reassuring was the number of deaths—down to twelve. Word must be getting out as to the seawater treatment.

I went to the upstairs office and put up a sign: Meeting in the Conference Room. 9 a.m.

Then I went to the conference room and got to work. I finished my task just before the first person, Cassandra Wherton, came into the room.

“Cass,” I said. “Good to see you. How’s it going with the sisters?”

“Fantastic,” she said. “We have been refining the data, and I am learning how to use the UKM without the sisters’s help. Interacting with the machine is very logical and mathematical. Like constructing a geometric or mathematical proof.”

“What you did with the animalcules and the Cholera was nothing short of amazing,” she continued, “but I think we can make use of the UKM moving forward for other outbreaks and epidemics. If you collect the right information, the UKM can analyze and show all sorts of trends and associations. The sisters used a Cholera-specific analysis, but I have been working on a universal methodology that can be used on any outbreak to explore, track, and graph the data. The only question is, once the outbreak is over, will I be able to continue to work on it?”

“I don’t know,” I said, “I will look into it. Assuming I still have a job when all this is over.” I was not reassured by the prior evenings conversation.

“Why wouldn’t you?”

“Well,” I said, “Most of the Heads of the Societies came down with the Cholera. My doing, sort of. I was the one to show them up. They will want someone specific to blame. They have the power and the support of the Crown. They will come seeking someone’s head. Moi.”

She paused a moment, then shook her head.

“I suspect you are right. I’m sorry.”

“Don’t be. We saved who knows how many lives. It’s worth it.”

“Still. It’s not fair,” she said.

“Neither is the Cholera.”

“So, what’s all this then?” she asked, pointing at my morning’s work.

I looked up from Cass. Everyone from the department had entered the room and had been quietly listening to our conversation.

“Welcome,” I said. “Good to see you all. It has been a hard couple of weeks, and, while the end may be in sight, we have one last push before the Cholera is gone.”

I pointed at the table, covered with numerous paper bags.

“Each of these sacks,” I said, “Has the right amount of sugar and salt to make ten gallons of the Cholera saltwater cure. Everyone who is going to the field today takes as many bags as you think you will need. When I was making the quarantine rounds, I could not help but note that those taking care of the victims did not have the time to go to the store or necessarily be able to find out about the saltwater cure. So, we can at least provide it. When handing out the bags, make sure to write on the bag the proper ingredients so they can make more if needed—one quart of boiled water, six teaspoons of sugar, and 1/2 teaspoon of salt. I did not have time to add the directions.”

“That’s all I had to say except thank you again for all your hard work during this terrible outbreak. If there are no questions, then take your supplies and get to work. There is Cholera to be cured.”

I chatted with my colleagues as they scooped up the bags and left to attend to the quarantine, and soon the room was empty except for Cass.

“You know,” she said. “That is a great idea.”

“It was cheap,” I said. “And the obvious thing to do.”

“Not to everyone. Stay strong. I’m off to the sisters.”

“Thanks,” I said. “I’m not worried. No good deed goes unpunished.”

The rest of the morning was spent in logistics and paperwork, talking to those who were going out into the field to attend to the quarantine. They confirmed what the cubby room had suggested: fewer cases, and most people were drinking the salt and sugar water when they had the Cholera.

And since the pump challenge and subsequent succumbing of the Society heads to diarrhea, most were also foregoing the services of the Societies. It looks like confidence in their abilities, at least as far as the Cholera went, was down.

That was fine for the Cholera, but what about other diseases? The Societies were still the only source of health care. If a lack of confidence in the Societies became widespread, what would take their place?

It was a scary thought, a city without health care.

But then, people had short memories, and in a month or two, most would forget all about the Cholera and the failure of the Societies.

At around 2 o’clock, Colvin came into the office. We shook hands, and I offered him a seat.

“I thought I would give you the heads up on the afternoon Extra,” he said. “It should be out in an hour or two, but I thought you would like to know the contents.”

He took in a deep breath.

“Two of the Society heads died of the Cholera late this morning. Watkinson of the Chiropractors and Cramond of the Humorists. Both, it appears, relied upon their Philosophy to treat their Cholera. It failed.”

I felt the blood drain from my face, and the knot in my stomach grow.

“Bloody hell,” I said. “I certainly didn’t want anyone to die. I feel partly responsible.”

“It wasn’t your fault,” he said. “They chose to drink the water.”

“But our investigations pointed to the water as the source of the Cholera. That is why they drank it.”

“They did not have to. They could have evaluated your evidence, recognized the potential validity of your observations, and acted more cautiously. You can’t stop human stupidity.”

“Yeah,” I said. “But I could have removed the pump handle myself and earlier. I observed, but I did not act. I still feel some guilt.”

“You’ll get over it.”

“I hope so.”

“But in the Extra, we will point out that, even for the Head of the Chiropractic Society, spinal manipulation did not prevent or treat the Cholera. And that bleeding as a response to the flux is probably why the head of the Humourist Society was the first to die. Sad. But it seems to me they went out of their way to have a bad outcome from the Cholera.”

“How are the others doing?” I asked.

“Fine. The Head of the Eastern Society had a mild case of diarrhea. The Naturopathy Head developed severe diarrhea but is doing fine, having declared that the saltwater cure is a Naturopathic medication. And your friend Bonham is doing just fine. No diarrhea at all.”

“You haven’t mentioned Pettenkofer, the Homeopath?”

“Did just fine. He says he has no diarrhea at all and is using this as evidence that Homeopathy is the one true Philosophy.”

“You’re kidding.”

“Serious as a heart attack.”

“I wonder how he avoided the Cholera?” I said.

“I do too. There is a rumor he had the Cholera as a child and so would have been protected, but I can’t get independent confirmation and Pettenkofer denies it. He says it is all due to the healing power of Homeopathy.”

I sighed. “I am glad he did not get sick and die, but it does make the conclusions of our natural experiment a little murky.”

“I have found in my investigations,” replied Colvin, ’“that life rarely provides clean answers to our problems. There are just bad solutions and less bad solutions.”

“Aren’t you the optimist,” I said. “But you seem happy with the outcome.”

“Neither happy nor disappointed,” he said. “I only side with the truth, as the best truth can be determined. The Medical Societies have too many contradictions, internal and external, to represent any small ‘’t’” truth, much less big “‘T’” Truth. Each Society says they represent the one true Philosophy, the only way to diagnose, treat, cure, or prevent any disease. Yet each is completely different in their approach. They can’t all be right. And the argument they are all different manifestations of the same universal cause of disease is ludicrous. So, if they can’t all be right, and as you demonstrated with the Cholera, they must all be wrong. At least until I get some hard information, as you provided with the animalcules, to convince me otherwise.”

“First,” Colvin continued, “it is the job of the Press to report the truth. And the truth here is that the Society’s approaches to the Cholera are a sham. A complete sham, Pettenkofer notwithstanding. Most people do not know it, and the Crown doesn’t care.”

“Wow,” I said. “That’s harsh.” 

“The truth often is. Well, I’ll see you later.”

Colvin left. I looked at my watch —3 o’clock. The paperwork was done, and people were coming back early from the field, with no more people to see for the quarantine. It looks like we were suddenly overstaffed for the Cholera. Which was good. And also encouraging, a few were returning with unused bags of salt and sugar, another sign the Cholera was declining.

I felt like I had nothing further to do at work, so I left early and wandered the city on a beautiful summer day. It was the weekend, after all.

As I walked the city, I bought a copy of the River Weekly Extra. It was an accurate summary of the day’s events: all the Medical Society Heads had the Cholera, and two had indeed died.

Society Heads Get Cholera

Two Die. Homeopathic Philosopher Spared

Kenton Pump Animalcules Probable Cause of the Cholera

Portland—Today, Tobin Watkinson head of the Chiropractic Society, and Elizabeth Cramond, head of the Humourist Society, tragically succumbed to the Cholera.

Both, along with the other heads of the Medical Societies, had consumed the water from the Kenton park pump in a vain attempt to demonstrate that the water could not be the source of the Cholera. Four of the five developed the Cholera within a day of drinking the water. Mr. Watkinson and Miss Cramond relied on their Medical Philosophy to prevent and cure their Cholera and failed. The two surviving Society heads took the salt and sugar cure and, as of press time, were recovering from the Cholera. Maxwell Pettenkofer, Head of the Homeopathic Society, was untouched by the Cholera.

When asked for comment, the Chiropractic and Humourist Societies both said they were mourning the loss of their colleagues and would not comment further.

The Naturopathic Society noted that the salt and sugar cure were a form of Naturopathic treatment and implied they were the origin of the idea. As we know from recent events, the salt and sugar treatment were first identified by the Ministry for Public Hygiene as a folk remedy originating in the Caribbean.

Mr. Pettenkofer was clear in his assessment, “Not only does my imperviousness to the flux confirm that the pump water is not the source of the Cholera, but it also demonstrates the superiority of the Homeopathic Philosophy to diagnose, treat, cure or prevent any disease.”

He had no comment on the possibility that Choleric nosodes were responsible for the spread of the Cholera to east county beyond noting it was false news.

Mr. Bonham, an employee of the Ministry for Public Hygiene, also did not develop the flux. He drank a glass of boiled pump water, proof that boiling removes the animalcules that cause the Cholera.

To recap what is known about the Cholera:

The main source of the Portland outbreak appears to be the water from the Kenton park pump. The pump is no longer functional due to vandalism by unknown persons.

Other water sources may be a source of the contagion, and there have been new cases downstream from Portland, suggesting the Cholera is using rivers to spread.

Boiling water inactivates the Cholera, rendering the water safe to drink.

Avoid Homeopathic nosodes; they may contain the Cholera animalcules.

Should you get the Cholera, the salt and sugar cure are the best treatment: one quart boiled water, 2 Tb sugar, 2 Tb table salt.

Continued on page 2.

Except for that contradictory statement from Pettenkofer—how could Homeopathy prevent a disease he said was not real—the article certainly made the Ministry look good. It was nice to have a Saturday with no stress, and I actually felt good as I strolled home.



  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at