In addition to his duties as night watchman of the Knickerbocker Athletic Club, Joseph Moore, a forty-year-old Englishman, performed valet services for various members, including Henry Barnet.
Early on the morning of Friday, October 28, 1898, Moore received an urgent summons to Barnet’s room. He found the thirty-two-year-old clubman stretched out on his bed, ashen-faced and clutching his stomach. The normally dapper Barnet was wearing only an open-collared shirt and trousers, as though he’d been stricken while getting dressed for the day. His breakfast—which had been brought up to his room earlier—lay untouched on its tray.
“Moore,” gasped Barnet. “Call Dr. Phillips.”
Hardly had he spoken the words than Barnet let out a moan, leapt from the bed, and ran for the toilet. As Moore made for the staircase, he could hear the sound of violent retching through the closed door.1
The residence of Dr. Wendell C. Phillips, a surgeon at the Manhattan Eye and Ear Hospital and a longtime member of the KAC, was located on Madison Avenue, only a block away from the clubhouse. By 9:00 A.M.—less than fifteen minutes after Joseph Moore dispatched an errand boy to his home—Phillips was standing at Barnet’s bedside.
“Hello, old man,” he said. “What’s the matter?”
Before Barnet could answer, he was seized with a spasm of sickness and had to dash for the bathroom, where he suffered another bout of simultaneous vomiting and diarrhea. Minutes later, he staggered back to bed, a ghastly pallor suffusing his face.
Phillips checked his pulse, which seemed normal. He also examined Barnet’s throat. There was some inflammation of the membrane, though in Phillips’s professional opinion, “no more than would be present when a person was vomiting.”2
Phillips concluded that Barnet was suffering from “an irritant substance in the stomach” and asked if he had eaten anything unusual.
“It was that damned Kutnow’s Powder,” answered Barnet with a groan.
He explained that, after overindulging in food and drink the previous evening, he had awakened at around eight that morning feeling unwell. As it happened, he had received a sample tin of Kutnow’s Improved Effervescent Powder in the mail two months earlier. Supposedly made of salts from the Carlsbad mineral springs, Kutnow’s—a competitor of bromo-seltzer—was promoted as a surefire remedy for “biliousness, sick headache, loss of appetite, sour stomach, constipation, drowsiness, nervousness, gout, jaundice, and rheumatism.” Potential customers could receive a free sample by sending in a letter with their name and address.3
Barnet wasn’t sure why the little tin had been sent to him, since he hadn’t requested it. Still, as he was in the habit of treating his hangovers with Kutnow’s, he didn’t think twice about taking a dose. Almost immediately, however, he had gotten dreadfully ill.
Phillips went downstairs to telephone a local pharmacy for some remedies. He then returned to sit with Barnet, who lay shivering beneath a heavy wool blanket when he wasn’t in the bathroom throwing up and voiding uncontrollably.
After an hour or so, Phillips returned to his home, leaving Barnet in the care of Joseph Moore. Phillips checked on his patient two more times during the day. By 5:30 P.M., Barnet seemed greatly improved—so much so that, as Dr. Phillips would later testify, he saw “no reason to come again.”4
Though the vomiting and diarrhea had abated by the following day, Barnet still couldn’t eat. Swallowing food was too painful. His throat was agonizingly sore. Even his tongue hurt.
On Sunday, October 30, he went downstairs for the first time in two days and sought the advice of a friend, Colonel Austen, who suggested that Barnet get a second opinion from Henry Beaman Douglass, a fellow KAC member and prominent New York physician. A telephone call was promptly placed to Douglass’s home.
A graduate of the College of Physicians and Surgeons, Douglass had interned for two years at Presbyterian Hospital, then studied overseas in Paris, London, and Berlin before returning to New York. In addition to his private practice, he served as adjunct professor of diseases of the throat at the Post-Graduate Medical College and assistant surgeon and pathologist at the Manhattan Eye and Ear Hospital.
Within a half hour of receiving the call, Douglass arrived at the Knickerbocker Athletic Club. He found Barnet in the café with Colonel Austen. Leading the doctor into the adjoining reading room, Barnet explained what had happened on Friday after he had swallowed the Kutnow’s Powder.
“I was a damned fool to take something that came in the mail,” he said. He then described his current symptoms—the burning throat and painful tongue.
“Well, I can’t examine you here, old man,” said Dr. Douglass.
Taking the elevator to the second floor, they proceeded to Barnet’s room, where Douglass peered into Barnet’s throat and saw (as he later testified) a “membrane on the right tonsil and uvula.” He immediately concluded that Barnet had a case of diphtheria.
Leaving Barnet in his room, Douglass went out to a drugstore called Schoonmaker’s, where he purchased two culture tubes. He then returned to the club, took samples from Barnet’s tonsil, and departed again, this time for his lab in the Manhattan Eye and Ear Hospital.
When the cultures were analyzed, they revealed “streptococci in large numbers,” though no evidence of “diphtheritic bacilli.” Nevertheless, Douglass remained convinced that Barnet had a mild case of diphtheria and treated him accordingly, with injections of antitoxin.5
Over the next few days, Barnet—who was attended around the clock from that point on by two trained nurses, Addie Bates and Jane Callender—seemed to be in a convalescent state, though his tongue and gums continued to bother him.
By Friday, November 4, Barnet’s mouth was still inflamed and his tongue ulcerated. Curious about the content of the Kutnow’s Powder, Douglass brought the sample tin (which Barnet had saved) to a chemist named Guy P. Ellison for analysis.
No sooner had Ellison removed the cover of the tin than he detected the odor of bitter almonds, typical of “salt of cyanide.” Taking a tiny amount on the tip of one finger, he tasted it and found that the Kutnow’s had a “metallic, corrosive taste,” also characteristic of cyanide.
Ellison then performed a series of tests on the powder—first adding hydrochloric acid, then iodide of potassium, and finally heating it slowly in a test tube. The results clearly showed that the Kutnow’s Powder contained cyanide of mercury.6
When Douglass received the report, he decided that the sores on Barnet’s tongue and gums were probably “mercurial stomatitis”—an inflammation of the mucous membranes of the mouth produced by the ingestion of mercury. But that conclusion set off no alarm bells in Douglass, who saw no reason to alter his original opinion.
It’s natural to wonder why—when Dr. Douglass found evidence that Barnet had ingested mercury and pharmacist Ellison discovered cyanide in the Kutnow’s Powder—neither of them suspected that the patient was the victim of foul play. The answer, bizarre as it seems, is that both mercury and cyanide, along with many other toxic substances, were standard medicinal ingredients in the late nineteenth century.
The soothing syrups and aromatic bitters and revitalizing tonics so popular in that elixir-crazed period might have been utterly worthless, giving great-grandma a mild high while allowing whatever disease was killing her to run rampant through her system. But the medications prescribed by legitimate physicians were often no better, and in many cases far worse. American medicine in the post–Civil War era had not yet emerged from the Dark Ages, as even a cursory glance at the 1899 edition of the venerable textbook the Merck Manual makes alarmingly clear.
It was a time when formaldehyde was routinely prescribed for the common cold, arsenic for asthma, strychnine for headaches, morphine for diarrhea—and mercury for everything from anemia to yellow fever. A woman with morning sickness might be treated with a heaping spoonful of belladonna, a constipated man with a cup of turpentine oil, and a colicky baby with a chloroform-soaked rag placed over its nostrils. Gargling with cyanide of mercury was a recommended cure for sore throats.7
It was clear to Dr. Douglass that Barnet had consumed mercury. But then, so had millions of other Americans who customarily took calomel, one of the most commonly prescribed remedies of the time. In addition to its supposedly salubrious effects, calomel (also known as mercurous chloride) frequently produced ulcerations of the tongue, gums, and throat, caused teeth to fall out, and occasionally destroyed entire jawbones.
In short, despite the absence of “diphtheritic bacilli” in the culture and the presence of cyanide of mercury in the Kutnow’s Powder, Dr. Douglass was absolutely convinced that the symptoms displayed by Barnet pointed to only one diagnosis: a case of mild diphtheria.