Adelia, an orphan raised by an atheist Jewish doctor, is a medical student but not an unusual one, as women students and teachers were regularly admitted to the Salerno Medical School. She has mastered the art of death, which today we call forensic medicine, making her, historically, the earliest fictional female coroner likely to turn up in any novel. She is calmly looking forward to a life of teaching, research and solving crimes in her home city when history intervenes. A series of terrible child murders in the English town of Cambridge has been blamed on the local Jews, who seek protection from King Henry II and are hiding in Cambridge Castle. Loath to sacrifice the income from taxes paid by prosperous Jewish merchants, Henry wishes to shield them from harm and appeals to his fellow royal and cousin, the King of Sicily, to send his best master of this frightful new science to help find the real killer(s), which should exonerate the Jews. But in backward England a woman doctor is unheard of and any female openly engaging in curative measures might be labeled a witch. Therefore, Adelia must travel with two companions, Mansur, a Muslim, who is really her bodyguard, and Simon of Naples, a clever and quick-witted Jew chosen to establish the innocence of his English co-religionists. Their combined detective work forms the essence of the story.
Adeliaâs medical knowledge
As the three Sicilians travel towards Cambridge with a group of English pilgrims, Adeliaâs medical competence is quickly tested. Prior Geoffrey of St. Augustineâs canonry of Barnwell is suffering great pain from urinary retention and is unable to walk. When his attendants, asking to borrow the cart in which the odd-looking threesome are traveling, discover inadvertently that one of them is a doctor and assume, of course, that it is Simon, they bring the overweight and suffering prior to him for help. Hiding the cart in the woods so that no one can view the procedure, Adelia, guarded by Mansur and helped by Simon, uses a sturdy reed plucked from a nearby stream as a medieval catheter to successfully relieve the blockage in the priorâs urethra, even though she has never before done the procedure, having only heard of it from her stepfather. Her knowledge of male anatomy is clear when she warns her partially recovered patient the next day that the retention could happen again.
âMen have a gland that is accessory to the male generative organs. It surrounds the neck of the bladder and the commencement of the urethra. In your case I believe it to be enlarged. Yesterday it pressed so hard that the bladder could not function.â6
She offers to show him how to use the reed if needed, which he eschews, and advises him to eat less and exercise. (It seems this staple of medical advice has been given out by physicians for centuries.) The benefit of this encounter, however, is clear; Adelia and company have acquired a powerful protector in Prior Geoffrey.
Once in Cambridge, the prior arranges for Adelia to examine the remains of the murdered children so that she can determine how they were killed. This she does secretly, although she is watched by Sir Rowley Picot, King Henryâs tax collector and ex-Crusader, whom she quickly puts to work helping her.
Prior Geoffrey also arranges for the Sicilians to live in one of the cottages abandoned by the Jews. He even supplies a local servant, the wily woman Gylthia and her grandson, Ulf, who are valuable in explaining local customs and personalities. No sooner do they move in than the locals assume that Mansur, wearing a traditional kaffiyeh, is the doctor, Arab medicine being well regarded even here, and immediately start asking for help for their various ills. Thus a new medical practice is born and serves as an excellent cover while Adelia and Simon continue their investigation of the child murders.
Adelia remains involved in treating the locals, quietly imparting her knowledge to the fake doctor Mansur. The remedies and procedures she uses include an eyewash of weak, strained agrimony on the infected and inflamed eyes of an old, nearly blind woman; amputating the gangrenous foot of a young man, using a cloth soaked in opium as an anesthetic, then stitching the edge of the wound and bandaging it. Meanwhile Dr. Mansur, now puffed up with his new importance, prescribes sugar for a child with a cough. Furious at this useless advice, Adelia substitutes an inhalation of essence of pine, which she maintains should help the youngster if his lungs are not too badly damaged.
Not all of her efforts are successful, because these patients come to the âforeign doctorâ too late, so that the child with the cough develops pneumonia and a man with the ague dies, as does a new mother who hemorrhaged after delivery.
Perhaps Adeliaâs greatest medical accomplishment is saving Sir Rowley Picot from death after a brawl, during which a cleaver in his groin struck an artery, causing a major bleed. Putting her fist in the wound to plug off the site of hemorrhage then closing the wound on the proverbial kitchen table with thread and needle from the sheriffâs wifeâs sewing kit may stretch the readerâs credulity somewhat, particularly as Adelia is not sure during the procedure if she extracted all the pieces of his tunic from the wound, which would inevitably have caused infection and death from gangrene. Why was Sir Rowley brawling? We cannot reveal the cause except to say he was behaving heroically and that we must bear with the author, as Sir Rowley needs to survive to play a pivotal role in the denouement of this story and in solving its central crime. To say more would ruin the ending for the reader.
Meanwhile Adeliaâs doctoring is not over. A sickness has attacked the Saint Radegundâs nunnery, where no man may enter. Adelia must go, pretend to report to Dr. Mansur and do his bidding. Plague is the rumor but Adelia thinks it is cholera, and a less virulent form than found in the east. She is faced with 20 vomiting, diarrheal nuns, a verminous kitchen and a resentful prioress who could not care less. Nevertheless, by using opium to ease the nunsâ pain and calfâs-foot jelly to nourish her patients, all but two of the nuns survive.
Finally, Ulf, who has become dear to her, disappears and Adelia goes to find him. In the course of this search the reader learns the identity of the monster child-killer and witnesses his flamboyant, over-the-top finish. But that is not the end of the novel, which twists and turns in very satisfactory ways. Remarkable Adelia is rewarded, we wonât say how, the conflict between church and state is illuminated, and King Henry II, known throughout history primarily as the murderer of Thomas Ă Becket, comes off very well as a sly and crafty but decent king, whose gift to his country of trial by jury started England on the road to fairness and justice.