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and vegetable substances decomposed by the heat in the lakes.” A hot southwest wind was believed to bring the plague, while a brisk wind from the north brought health. In a study of the 1806-7 Prussia-Poland campaign, an army doctor reported that “one cannot give a good history of the diseases which are epidemic in the army without having first described the medical topography of the theater of war and the state of the atmosphere whilst the army was in the field.” The doctor had to be an amateur surveyor and meteorologist to diagnose an epidemic.
    But Larrey also conceded that once plague had rooted itself in the ranks , it could become contagious. The rapid spread of the plague in Egypt, in differing meteorological circumstances and across different terrains, made it clear that disease wasn’t just arising from bad air. He and other doctors borrowed from both theories to fit the patterns they observed.
    C RUCIALLY, THERE WAS no accepted way to test which theory was true. Nor was there a way to find out which treatments worked best: the rest cure, the bark cure (using the outer layer of trees, the original source of aspirin), the cold-water cure, cupping, bleeding, and the split carcasses of small animals applied to the body—all of these were common treatments for typhus in the early 1800s, each with its own followers and detractors. There were fad causes and fad cures. In 1811 the American doctor Elisha North was compelled to study typhus by the dread it was causing in his patients. “Upon [its] first appearance,” he wrote, “in any place, so many fall sudden victims to the jaws of death, that a universal terror seizes the minds of all, and of physicians among the rest.” He began to study the illness.
    After months of research, he published his results. The disease wasn’t the result of outside causes, North found, of bad air or invisible creatures passed from victim to victim. Instead, he blamed “the typhus temperament.” Certain qualities made a person susceptible to the disease: a vigorous constitution, a rich and highly seasoned “animal diet,” living in a dry environment, and frequent alcohol intake, along with an “ardent spirit.”
    The idea took its place in the medical literature. But no one could definitely say what was true and what was bunk.
    One physician had attempted to change that. On May 25, 1747, twenty-two years before Napoleon’s birth, an experiment took place on board the Royal Navy warship Salisbury that would change the course of medicine.
    The doctor’s name was James Lind, and he was a Royal Navy surgeon and a specialist in diseases that affected mariners. Just thirty-one, the Scottish-born doctor had sailed all over the world as a surgeon’s mate, watching men die from typhus and scurvy from the west coast of Africa to the ports of Jamaica. He knew that the two maladies killed far more sailors than the king’s enemies ever managed to. Lind would do remarkable work in the understanding of both.
    Lind’s 1747 experiment looked at scurvy. Twelve sailors who had the illness were divided into six groups. The accommodations and diet of all the sailors were identical, but each received a different remedy: one group received cider; one got seawater; another, “elixir of vitriol”; the fifth group, two oranges and a lemon; and the sixth, a mix of spices with barley water. It was the first documented clinical trial in medical history.
    “I shall propose nothing dictated merely from theory,” wrote Lind. “But shall confirm all by experience and facts, the surest and most unerring guides.” This in itself was revolutionary, in an age when so much superstition and ancient theory overlay the world of medicine. When the sailors who received the citrus recovered completely, and the others did not, Lind had proved that orange and lemon juice was the true and universal corrective for the disease. He had created a blind test whose results were irrefutable.
    It wasn’t the oranges