Chapter 36: Infectious Diseases Together [1] Smallpox.
An infectious disease one no longer got many chances to see.
But because of how terrifying it was, every physician had to learn about it.
Kanghyeok had been no exception.
"This..."
It was his first time seeing it in person.
That did not mean he could fail to recognize it.
A patient stood before him who looked exactly like the photographs he had seen in textbooks.
Heo Jun, with a more defeated expression than ever before, muttered,
"To think it is smallpox... in the middle of summer..."
Since ancient times, epidemics had been a kind of disaster.
Something human effort could not control.
That was all the more true of a disease like smallpox, which had both a high fatality rate and strong infectivity.
How terrifying must it have been for people to call it Mama out of fear?
There were even shrines dedicated to the Smallpox Deity.
What do I do? I don't think that can be treated.
Even Kanghyeok could not see a clear answer.
"Dolseok, Makbong. Step back for now."
"What?"
"It's dangerous. Get back."
"Ah, yes."
First, Kanghyeok moved to keep Dolseok and Makbong from getting too close.
When dealing with an infectious disease, the most important thing was preventing infection.
I should be fine, though.
A terrifying disease like smallpox was naturally classified as a Class 1 legally notifiable infectious disease.
It had not been discovered since 1979, and ordinary civilians were no longer vaccinated against it.
But medical personnel like Kanghyeok could still receive the vaccination.
If, by any chance, they became infected, they could endanger countless other people.
Good thing I listened to my friend in infectious diseases.
Just thinking about how he had once refused the shot because he did not want a pockmark scar on his arm made his mind reel.
If he had really skipped it, he might have ended up in the same condition.
Caressing the pockmark on his left arm, Kanghyeok approached the patient.
Up close, it was even more horrific.
Pustules and blisters full of yellow pus covered the entire face.
Isolation comes first.
Smallpox could spread even without direct contact.
Simply being in the same room was enough.
That meant the person who had brought the patient also needed to be isolated.
He had likely been exposed long ago already.
"Come with me first."
"Ah, yes."
Kanghyeok led the two of them into a room being used as a storeroom.
"Wait in here."
"Yes, yes. When will you treat him?"
"For now... just wait."
"Yes, yes."
The patient and his guardian obediently followed Kanghyeok's words.
Since it was a small village, it seemed the rumor of the surgery from earlier that day had already spread fast.
And Kanghyeok's appearance was not one that could be easily disregarded.
Heo Jun, who had been silently watching Kanghyeok, hurried over and asked,
"Scholar Baek, it is smallpox... what do we do?"
"Well. I do not really know either."
That was his honest feeling.
If it had been the sort of illness that could be solved with a knife, that would have been better.
At least then Kanghyeok could have tried something.
But this was not that kind of illness.
Judging by his clothes, he was a farmer...
In the worst case, they might have been doing communal labor together.
It was the season when weeds grew thick, and everyone would have been short-handed.
A small village like this might disappear in an instant.
No. If only this village disappeared, that would be the lucky outcome.
If it started spreading into Suwon itself, that would truly be the start of disaster.
With a dark expression, Kanghyeok looked toward the storeroom where the patient had been taken.
Naturally, the history of medicine he had learned in school came back to him.
Mortality rate around 30 percent. If it's hemorrhagic smallpox, then 100 percent...
Before Jenner's cowpox inoculation, it had truly been one of the worst infectious diseases.
Thank God it was eradicated. Hm? Wait...
Cowpox inoculation.
It was not an easy name to forget.
Medical history almost never appeared on exams, but this one had been treated as fairly important.
"Scholar Baek, what is it that has you thinking so deeply?"
Heo Jun asked Kanghyeok, who had been staring blankly into space without saying a word.
When he came back to himself, even Yeoni and Yeoju had come out of the room.
Apparently more time had passed than he had realized.
"No, I think there may be a way."
"Ah, is that so? For smallpox?"
Heo Jun looked at Kanghyeok with shining eyes.
It was an attitude befitting the scholar who would later write Comprehensive Notes on Smallpox.
"Please give me a little more time to think."
"Yes, yes. By all means."
Heo Jun shut his mouth again at once.
Yeoni and Yeoju looked rather puzzled, but Dolseok seemed used to this.
No, he was placing absolute trust in Kanghyeok.
He had looked like that before too, when Kanghyeok had cured Seungmun's illness.
He starts rambling about things no one understands, and then suddenly he finds the herb.
His master's skill was beyond question.
He had strange sides to him, and he could be completely headstrong, but still.
Everyone held their breath and looked only at Kanghyeok.
"Mm."
Rubbing his jaw, Kanghyeok desperately searched through old memories.
It was a common exam question. It was in the old exam files too.
The old exam files.
In other words, a collection of past test questions.
For lower-ranked students on the verge of repeating a year, they were practically a lifeline.
A high-ranking student like Kanghyeok had been one of the people who compiled those files.
That naturally meant he knew the contents better and remembered them better than others.
The cowpox method itself wasn't anything special. Korea also used human variolation, didn't it?
He had heard that the famous Dasan Jeong Yak-yong had introduced it.
Because of the limitations of human variolation itself and the state of the country at the time, it had not spread widely.
That's too dangerous.
Trying to treat people that way might only spread the disease further.
It was better to approach this through cowpox inoculation after all.
The problem was that there was no easy way to deliberately infect a cow with cowpox.
"Ah. Ah!"
The sight he had seen when they first entered the village flashed through his mind.
The cow with pus running down it.
That cow with scabs all over it.
"W-what is it? Did you think of a method?"
Heo Jun reacted to Kanghyeok's sudden cry.
The others, including Dolseok, perked up their ears as well.
"The cow, the cow!"
"What?"
Dolseok shot back with a baffled look.
They had been talking about treating smallpox, so why was he suddenly shouting about a cow?
"The cow, you idiot! When we first came in!"
"What in the world do you mean..."
Yeoni scratched the back of her head too.
"That... no, forget it."
It was too difficult to make them understand right away.
Kanghyeok gave up on explaining and began taking out gloves and masks from his house-call bag.
"Put the masks on first. And the gloves. Physician Heo Jun, you have to put them on too."
"Why is this...?"
"If you touch the patient directly, or breathe in the air he exhales, you can catch the disease."
"Ah."
Heo Jun tilted his head.
His understanding of infectious disease was still limited.
In fact, it was only in the eighteenth century that prescriptions for epidemic diseases really began pouring out in East Asian medicine.
That was long after the fall of the Ming and the rise of the Qing.
Even before that, people seemed to have had a vague sense of it.
I heard that when there was smallpox, they refrained from banquets and gatherings.
Of course, the reason had supposedly been to avoid offending the Smallpox Deity.
But as a result, it would also have helped prevent infection.
If people did not gather, the disease could not spread.
"For now, I will do as the scholar says."
Heo Jun did not deliberate for long.
He had only just asked for instruction from Kanghyeok, after all.
Kanghyeok personally fitted the mask onto Heo Jun.
It was only a temporary measure, but even this alone should make things considerably safer.
I have to protect my own people first.
The people he had met after coming to Joseon were few enough as it was.
Treating others came after that.
That did not mean he could just stand by and let everyone die.
"Is this right?"
Compared to Dolseok and Yeoni, Yeoju was much less familiar with masks and gloves, so she asked.
As expected of a painter, her eye was good; she had put them on correctly.
"Yes."
"It feels stifling."
"You have to bear it. If not, you'll catch it. You know what kind of disease smallpox is, right?"
"I do..."
"Good. First, I need to ask the patient whether he had contact with anyone else. As for the rest of you... just stay right here and do not move."
"Ah, yes."
At Kanghyeok's forceful tone, Yeoju merely nodded.
Instead, Yeoni stepped forward.
Her voice was full of worry.
"But Young Master, are you really all right?"
"Me? I'm fine."
"Why?"
As expected, it was Dolseok who asked the insolent question.
"Because I'm immune."
"What kind of immunity? There you go again with your strange..."
"Quiet. I'll tell you later. You'll need it too."
"Yes, yes."
Leaving the others standing stiff as wooden figures, Kanghyeok entered the storeroom.
Since the patient had received no treatment at all, his condition had not improved from when they arrived.
No, it would be more accurate to say he had gotten worse.
He was even gasping for breath now.
With a dark expression, Kanghyeok raised the stethoscope.
The patient flinched at the cold touch, but only for a moment.
"Take deep breaths."
"Hoo, hoo."
Each time the patient inhaled and exhaled, harsh sounds came from the lungs.
Not good.
It was not from phlegm or anything like that.
It was the sound of damage to the alveoli themselves.
Pneumonia?
One of the common complications of smallpox.
Just because it was common did not mean it was easy to cure.
Even if I use cowpox inoculation, this patient might still die.
If the body had already been damaged to this extent, it would not be able to buy enough time to fight the virus.
With a half-resigned expression, Kanghyeok asked the patient,
"Did you meet anyone over the last few days?"
"The last few days...?"
"Yes. Who have you met?"
"Mm..."
With a high fever and shortness of breath, there was no way he could answer properly.
The guardian answered instead.
"He stayed home because he was sick. Me, the friend from the next house, this man's wife, and then..."
He kept listing people, and the number was not small.
This was why education about disease mattered.
If this had been the twenty-first century, they would have been careful on their own or isolated him early.
"Among them, is there anyone showing similar symptoms?"
"What? Well... I've felt a little feverish since yesterday too."
The guardian replied while touching his own forehead.
When Kanghyeok checked him with the thermometer, sure enough, it was over 38 degrees.
Which meant he had been infected long ago.
"Where is your house?"
"It's just a little way from here. Shall I guide you?"
"No, no. The two of you stay here. I'll go."
He could not allow two bundles of virus to go wandering around.
"Then do we just leave this friend as he is?"
"Mm. I'll give him some medicine. It should help."
Kanghyeok handed over an anti-inflammatory medicine.
There were also many blisters inside the throat, so even swallowing water was difficult for the patient.
At this rate, he obviously would not be able to eat proper food, much less thin rice gruel.
At this rate... of course he'll die. Ah.
There was a prescription he had learned from Heo Jun.
No, Heo Jun himself was right there.
Kanghyeok quickly left the storeroom and went over to Heo Jun.
"Physician, please prepare some Yanggyeok-san. I need to use it on the patient inside."
"Yanggyeok-san? For smallpox?"
"Yes. He has to get something down first, but the inside of his mouth is a mess right now."
"Ah. That makes sense. Is there anything else that might help?"
As expected of Heo Jun.
He immediately grasped Kanghyeok's intention.
"I gave him something for the fever, but... it probably won't be enough. If possible, please also prepare something that can be used for the pustules."
"Understood."
"Do not go inside under any circumstances. I'm going to see whether there are any other patients in the village."
"By yourself?"
"Yes. For now. I'm the only one with immunity."
Leaving behind incomprehensible words until the very end, Kanghyeok stepped out through the brushwood gate.
First, isolate everyone even remotely suspicious... and then find the cow.
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