The kettle in her hands was still empty. I seized it with a cry of exasperation.

“Water! I need water!”

“But I—Mr. MacNeill, he’s—”

I thrust the kettle back into her hands and shoved past her.

“I’ll find him,” I said. “Get water! Give it to them—the baby first! Make Lizzie help you—the fires can wait! Run!”

I heard the flies first, a buzzing noise that made my skin crawl with revulsion. Out in the open, they had found him quickly, attracted by the smell. I took a hasty gulp of air and shoved through the buckbrush to where Padraic lay, collapsed in the grass beneath a sycamore.

He wasn’t dead. I saw that at once; the flies were a cloud, not a blanket—hovering, lighting, flicking away again as he twitched.

He lay curled on the ground, wearing only a shirt, a water jug lying near his head. I knelt by him, peering as I touched him. His shirt and legs were stained, as was the grass where he lay. The excrement was very watery—most had soaked into the soil by now—but there was some solid matter. He’d been stricken later than Hortense and the children, then; his guts hadn’t been griping long, or there would be mostly water, tinged with blood.

“Padraic?”

“Mrs. Claire, thank the Lord ye’ve come.” His voice was so hoarse I could scarcely make out words. “My bairnies. Have ye got my bairnies safe?”

He raised himself on one elbow, shaking, sweat plastering strands of gray hair to his cheeks. His eyes cracked open, trying to see me, but they were swelled to mere slits by the bites of deerflies.

“I have them.” I put a hand on him at once, squeezing to force reassurance into him. “Lie down, Padraic. Wait a moment while I tend them, then I’ll see to you.” He was very ill, but not in immediate danger; the children were.

“Dinna mind me,” Padraic muttered. “Dinna … mind …” He swayed, brushed at the flies that crawled on his face and chest, then groaned as cramp seized his belly again, doubling as though some massive hand had crushed him in its grip.

I was already running back to the house. There were splashes of water in the dust of the path—good, Brianna had come this way, hurrying.

Amoebic dysentery? Food poisoning? Typhoid? Typhus? Cholera—please God, not that. All of those, and a lot more, were currently lumped together simply as “the bloody flux” in this time, and for obvious reasons. Not that it mattered in the short term.

The immediate danger of all the diarrhetic diseases was simple dehydration. In the effort to expel whatever microbial invader was irritating the gut, the gastrointestinal tract simply flushed itself repeatedly, depleting the body of the water necessary to circulate blood, to eliminate wastes, to cool the body by means of sweat, to maintain the brain and membranes—the water necessary to maintain life.

If one could keep a patient sufficiently hydrated by means of intravenous saline and glucose infusions, then the gut would, most likely, heal itself eventually and the patient would recover. Without intravenous intervention, the only possibility was to administer fluids by mouth, or rectum as quickly and as constantly as possible, for as long as it took. If one could.

If the patient couldn’t keep down even water—I didn’t think the MacNeills were vomiting; I didn’t recall that smell among the others in the cabin. Probably not cholera, then; that was something.

Brianna sat on the floor by the elder child, the little girl’s head in her lap, pressing a cup against her mouth. Lizzie knelt by the hearth, face red with exertion as she kindled the fire. The flies were settling on the motionless body of the woman on the bed, and Marsali crouched over the limp form of the baby on her lap, frantically trying to rouse it to drink.

Spilled water streaked her skirt. I could see the tiny head lolled back on her lap, water dribbling down a slack and horribly flattened cheek.

“She can’t,” Marsali was saying, over and over. “She can’t, she can’t!”

Disregarding my own advice about fingers, I ruthlessly thrust an index finger into the baby’s mouth, prodding the palate for a gag reflex. It was there; the baby choked on the water in its mouth and gasped, and I felt the tongue close hard against my finger for an instant.

Sucking. She was an infant, still breastfed—and suckling is the first of the instincts for survival. I whirled to look at the woman, but a glance at her flat breasts and sunken nipples was enough; even so, I grabbed one breast, squeezing my fingers toward the nipple. Again, again—no, no droplets of milk showed on the brownish nipples, and the breast tissue was flabby in my hand. No water, no milk.

Marsali, grasping what I was about, seized the neck of her blouse and ripped it down, pressing the child to her own bared breast. The tiny legs were limp against her dress, toes bruised and curled like wilted petals.

I was tipping back Hortense’s face, dribbling water into her open mouth. From the corner of my eye, I saw Marsali rhythmically squeezing her breast with one hand, an urgent massage to make the milk let down, even as my own fingers moved in an echo of the motion, massaging the unconscious woman’s throat, urging her to swallow.

Her flesh was slick with sweat, but most of it was mine. Trickles of perspiration were running down my back, tickling between my buttocks. I could smell myself, a strange metallic scent, like hot copper.

The throat moved in sudden peristalsis, and I took my hand away. Hortense choked and coughed, then her head rolled to the side and her stomach heaved, sending its meager contents rocketing back up. I wiped the trace of vomit from her lips, and pressed the cup to her mouth again. Her lips didn’t move; the water filled her mouth and dribbled down her face and neck.

Among the buzzing of the flies, I heard Lizzie’s voice behind me, calm but abstracted, as though she spoke from a long way off.

“Can ye stop cursing, ma’am? It’s only that the weans can hear ye.”

I jerked round at her, only then realizing that I had in fact been repeating “Bloody fucking hell!” out loud, over and over as I worked.

“Yes,” I said. “Sorry.” And turned back to Hortense.

I got some water down her now and then, but not enough. Not nearly enough, given that her bowels were still trying to rid themselves of whatever troubled them. Bloody flux.

Lizzie was praying.

“Hail Mary, full of grace, the Lord is with thee …”

Brianna was murmuring something under her breath, urgent sounds of maternal encouragement.

“Blessed is the fruit of thy womb, Jesus …”

My thumb was on the pulse of the carotid artery. I felt it bump, skip, and go on, jerking along like a cart with a missing wheel. Her heart was beginning to fail, arrhythmic.

“Holy Mary, Mother of God …”

I slammed my fist down on the center of her chest, and then again, and again, hard enough that the bed and the pale splayed body quivered under the blows. Flies rose in alarm from the soaked straw, buzzing.

“Oh, no,” said Marsali softly behind me. “Oh, no, no, please.” I had heard that tone of disbelief before, of protest and appeal denied—and knew what had happened.

“Pray for us sinners …”

As though she, too, had heard, Hortense’s head rolled suddenly to one side, and her eyes sprang open, staring toward the place where Marsali sat, though I thought she saw nothing. Then the eyes closed and she doubled suddenly, onto one side, legs drawn up nearly to her chin. Her head wrenched back, body tight in spasm, and then she suddenly relaxed. She would not let her child go alone. Bloody flux.

‘Now and at the hour of our death, amen. Hail Mary, full of grace …”

Lizzie’s soft voice went on mechanically, repeating her words of prayer as mindlessly as I had said mine earlier. I held Hortense’s wrist, checking for the pulse, but it was mere formality. Marsali curled over the tiny body in grief, rocking it against her breast. Milk dripped from the swollen nipple, coming slowly, then faster, falling like white rain on the small still face, futilely eager to nourish and sustain.