episode_0018

Episode 18. Plague Doctor Dispatch (1)

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1831. A Parisian travel guidebook wrote, “The water of the Seine is drinkable, but has a laxative character.” By the way, laxative refers to a laxative. A drug that causes diarrhea.

Isn’t this the ultimate positive thinking? ‘I drank water from the Seine River and got the plague and diarrhea? I just needed a laxative!’

Modern people call it cholera. We can learn several things from this word.

First, cholera was common before the modern era. It had to be common. Before Pasteur, sewers were poured into rivers as quickly as possible according to the miasma theory.

This means getting the bad air away from people as quickly as possible.

It’s crazy by our common sense standards.

Second, for a healthy person, cholera water is something that can be passed over as ‘if you eat that, you’ll get diarrhea’.

My point is this.

In areas where there are many deaths due to bacterial dysentery, there is a very high possibility that other problems, such as malnutrition, are also present.

Let’s talk about the rest with our teacher Hedwig and decide. It’s not too late to hear it.

“How long can you wait, Knight?”

“About an hour.”

“Then let’s discuss for an hour and then leave.”

I picked up a wad of paper and a pen.

“Let me tell you the answer first. This disease is a type of bacterial dysentery, and it is transmitted through water contaminated with feces. Treatment is rehydration and antibiotics, but most cases end with the former, and antibiotics do not help much.”

Ms. Hedwig looked puzzled.

“How do you know that?”

“Of course it’s obvious. I’ll go and check again, but I’m sure what I say is right nine times out of ten.”

Hedwig nodded.

“Please keep talking.”

“Cholera bacteria and cholera toxin can be consumed by boiling water… … .”

“That’s a simple solution!”

“Hmm. It’s not simple. This is a preventive measure, not a cure. Does everyone in that city have the money or time to boil water every day?”

I don’t know. But historically speaking, it’s much more likely that they won’t be able to afford it.

“There is no evidence that it is transmitted through water, right? I understand your opinion, Professor.”

I nodded.

“It’s just my opinion that it’s transmitted through water. Now, why don’t we go to the field and experimentally verify it?”

Hedwig nodded.

There were still some things left to discuss, but we decided to discuss the rest when we got to the site. Since we had to go there and relay it anyway.

Especially to government officials in the area.

The wyvern was faster than I thought. The wind was so strong that it ruffled his hair and robe.

“When will it arrive!”

“It takes quite a while!”

I couldn’t hear you properly because of the wind noise.

“What is the destination name!”

“This is the Free City Lapis!”

Let’s give up on the conversation. I’ll get vocal nodules before I can get any meaningful information out of it.

I had been on airplanes a few times in my previous life, but in this world, this was my first time looking down from the sky.

The wind passed across my face like a blade.

There are three wyverns mobilized for this task.

I, Hedwig, and Istina were each riding one. In front, there was a wyvern knight riding one each.

The scenery was beautiful, but the city outside the well-maintained castle was dirtier and dreary than I expected. The city we were heading to would probably be in a similar situation.

We arrived at the scene after a long time.

Three wyverns landed in the open space in the center of the castle. Istina was holding onto a garden sculpture and retching.

“If you had told me in advance, I would have given you motion sickness medicine.”

“Ugh, I didn’t know I had motion sickness.”

“You’re not going to throw up, are you?”

“Yes… … .”

I took motion sickness pills before I came. I should have given you one. I knew this would happen.

“There is a relief center set up in front of the gate. We will discuss response strategies there.”

“Do you have staff?”

“Well… …. There are some church people, some healers from the original city, and a few people who were brought in in a hurry due to the intervention of the imperial government.”

Hedwig looked around.

“Let’s pack up, report to the scene, and see the patient. I’ll see you in front of the relief center in an hour.”

I nodded. Istina was still retching next to me. She must have had severe motion sickness. When will she feel better?

****

Treatment of cholera patients.

In most cases, patients with shigellosis do not require antibiotics. The direct cause of death from shigellosis is dehydration.

Antibiotics may save people’s lives, but that’s not always the case.

As with other infectious diseases, we cannot expect a great effect from antibiotics. Antibiotics may treat fever and cough, but they cannot resolve dehydration symptoms.

There are dozens of hospitalized patients at the relief center.

I have five patients assigned to me. I only brought one day’s worth of luggage from the academy. It might take longer than I thought.

Just do what you can.

“Istina. Healing magic.”

“Yes.”

Istina lifted the staff and began to pray. I checked the patients’ conditions.

Patient one.

He was just an ordinary man. His social status was probably commoner, and judging by the dirt on his clothes, he was probably a farmer.

It seemed like he was still alive, though his condition wasn’t all that great.

“Check the conjunctiva. Yes. Open your mouth for a moment. Oh, and I’ll check the skin tension too. ”

Since we already know what the disease is and have started examining it, we just need to figure out how severe the symptoms are. It’s not as severe as I expected.

The standard treatment for cholera is doxycycline. I keep a few pills by the patient’s bedside.

“Take one tablet with each meal.”

Istina was waiting at the side.

“Look. The most important symptom of bacterial dysentery is dehydration. The patient’s conjunctiva is dry, the tongue is a bit cracked, and the skin tone is also low.”

“Oh, that’s it.”

This is a typical finding of dehydration.

When dehydration becomes severe, nerve cells begin to malfunction due to abnormal electrolyte concentrations in the body. Blood pressure drops due to lack of blood volume.

The best treatment is to connect the fluids, but that is not the point. The point is to identify the cause of the disease and prevent its spread.

I brought a coat hanger from the side.

“Why a coat hanger?”

“I’m trying to connect the sap.”

The IV bag was hung on the coat hanger. I found the patient’s vein and inserted the needle into his arm. The patient looked at me.

“What is this?”

“It’s a type of magic.”

Well, it’s a lifeline. But it’s not a method that can be applied to all patients in this space, so we need to find the cause of the disease.

****

I was called here to find a solution. Of course, I had to see the patient, but the main point was to find the cause of the disease and solve it.

“Where are you going now?”

Is the work being done fast or slow? They don’t explain anything and just do something among themselves. Is it because they have good drive or because they can’t communicate?

This time, he’s taking me somewhere again. Looking at him going into the castle, I think he’s probably going to a meeting to discuss countermeasures.

“This is the conference room inside the castle. It seems that we will be discussing a solution to this situation in front of the Baron of Lapis.”

“I see.”

There must have been a critical point for things to turn out this way. In this environment, there must have been cholera patients, but the number of patients must have increased explosively due to a specific incident.

Contamination of major water sources.

“This is the conference room.”

It looks like we arrived a little late. There were already quite a few people gathered in the Lord’s conference room.

A woman wearing a feathered hat was sitting at the head of the conference room. She looked like a zombie, having been there for three nights. Could she be the Baron of Lapis, or a direct relative?

There were also several people in the conference room who were dressed like doctors, that is, wearing black coats and masks.

Now I get it.

Hedwig is from the Imperial Government. She came to support the Lord of Lapis, who is in trouble this time, and she brought me as part of that effort.

“Palace healer, Academy professor. We have invited Mr. Asterix with great difficulty.”

There was no applause. The Lord of Lapis simply let out a small sigh.

“Yes, Professor Asterix. I am Laplenia of Lapis. Please take care of me.”

“Thank you.”

I bowed my head in greeting.

“Then, let’s finish what we were talking about. In order to prevent the spread of this situation, it seems necessary to eliminate the cause… … .”

These people don’t know the cause.

“The plague is spreading exponentially. It seems that even healing magic is at its limit. Even if we continue to bring in healers.”

“Hmm. For now, we’re lighting up beacons all over the city to remove miasma, and preventing people from gathering in large numbers… … .”

Keeping people away from each other is a very modern idea. Bacterial dysentery is not a disease that can be spread by meeting people in the first place.

The Lord of Lapis looked at me.

“What do you think, Professor?”