episode_0048

Episode 48. An Unknown Plague (4)

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What kind of disease is this? After seeing the mayor’s son, I remembered a patient.

This was not a patient from my previous life, but one of the patients who came to the Academy Hospital.

The incident went like this.

A few days ago, a student from the Academy came into the clinic. He was worried that a bad cold was going around in the dormitory.

I felt it was a bit odd to prescribe medicine to someone who wasn’t even sick yet, so I just gave them vitamin C. Just lemona candy.

That’s exactly the situation right now.

Colds and vitamins.

Until now, I thought I was coughing up blood, but in fact, in addition to coughing, I was bleeding from my mouth. There is a very famous disease that causes bleeding from the mouth.

I returned to the conference room with Istina. The heavy door opened with a squeak.

“I think I know what disease it is!”

The market of Imentia and the officials looked at me. Hedwig was still silently standing in her seat. It’s fortunate that a hypothesis has been developed.

“Oh, already?”

“Sorry I’m late.”

“Only an hour has passed.”

That’s too late.

During the cholera outbreak, we knew what the disease was and what the solution was before we even got to the scene.

This time it took a full day.

It took me a whole day to make a diagnosis and come up with a solution, so I can’t imagine how many sacrifices were made in the meantime.

Of course, if you think about it that way, there’s no end to it. But considering that I had the answer in my head, it’s also too late. Anyway.

“The disease these people have seems to be vitamin C deficiency, or scurvy.”

Scurvy. A disease most characteristic of which is bleeding gums due to damage to connective tissue caused by vitamin deficiency.

Treatment is with vitamin C. Permanent damage, such as tooth damage, cannot be repaired, but most symptoms can be improved within a few days.

Hedwig and Istina immediately looked at me with puzzled eyes. As if to say, “Does that make sense?” Right, I didn’t know that either.

“Does that make sense?”

“It’s still just a guess, though.”

“Isn’t scurvy a completely different disease? It’s a disease that occurs when you’re exposed to a lot of sea wind.”

It’s a bit ironic.

Although everyone knows that scurvy exists, opinions differ as to why it occurs and what mechanism causes it.

The expeditionary son thought it was a disease caused by traveling to a faraway country, and the civil servant plague doctor thought it was a disease caused by the sea breeze. Of course, they were both wrong.

“Scurvy is a disease caused by a lack of vitamin C, a specific nutrient. It can happen if you are not prepared for the voyage.”

“Malnutrition isn’t a plague, is it?”

“Well… … . It depends on the situation.”

The market of Imentia sighed.

“My son wouldn’t have starved.”

“Not necessarily because they were starving. You never know what could have happened during a voyage or expedition. If someone hadn’t taken that into account when sailing.”

The British Navy solved this problem by feeding salted vegetables and fruits such as limes to their crews to help with vitamin C deficiency.

That doesn’t mean they cared about the treatment of the sailors. They were the ones who kidnapped drunkards sleeping on the street and sent them to the navy.

It was simply a rational judgment that soldiers who died from scurvy were useless.

In conclusion, this is a problem that cannot be solved without separate efforts, even if those efforts seem trivial from the outside.

The conference room was a bit noisy. Hedwig, who had believed me until now, tilted her head repeatedly as she flipped through the paper.

“No, Professor. Scurvy doesn’t explain hemoptysis. Actually, there were quite a few patients who hemoptysis, right?”

“Upon closer inspection, it was blood coming from the gums. That’s why I suspected scurvy.”

“What about patients found inside the city?”

“It’s a port city, right? There must have been one or two patients with scurvy in the past.”

He looked like he still couldn’t believe it.

I touched my temple.

Partial fraction.

Let’s say there’s a test for a disease that’s 90% accurate. It’s a disease that 9% of the population has. Common sense tells us that it’s a very accurate test, and it’s a disease that a lot of people have.

If you catch anyone and test them using this method… … there will be more fake patients than real patients. This is a similar case.

If plague doctors were going around examining patients, even if they were really good doctors with 90% accuracy, there would inevitably be more fake patients than real patients.

It’s a mess because you’re trying to make a judgment when there are more fake patients than real patients. It’s very likely that all of the assumptions, information, and everything about this disease and the patients are wrong.

How can I explain this in a logical way?

“Hedwig was wrong.”

“Huh?!”

Ms. Hedwig was horrified.

The mayor sighed and repeated the dry wash several times. Istina glanced around the conference room with anxious eyes.

****

“So, whose words are right?”

The mayor’s voice was starting to get a little irritated. Well, the situation was chaotic and his son’s safety was at stake. Isn’t there a limit to the mayor’s patience?

“First of all, there was no hemoptysis. Manta Knight also had a cough and there was blood coming out of his mouth, but there was no blood mixed in his sputum.”

“Let’s say that.”

“Skin damage and rashes may sound similar to the Black Death, but the clinical picture is completely different. In the case of the Black Death, the color turns black. It is different from our patients.”

Hedwig looked anxious.

“I don’t know… … . It seems like an interpretation that relies too much on coincidence. Don’t they teach that there is no coincidence in medicine? Scurvy doesn’t cause colds.”

It doesn’t directly cause colds.

“There are several possibilities. It could be that the flu is spreading because of the change of seasons, or that allergic rhinitis is spreading due to late spring pollen, or that colds are spreading. Or that the immune system is weakened due to vitamin C deficiency, making you more susceptible to colds.”

“Professor. You’ve been talking about vitamin C for a while now. What exactly is vitamin C?”

Oh, that’s right.

It was true that I had said something strange. I opened my mouth to answer, but I looked at the mayor who slowly raised his hand and closed my mouth again.

“Okay. What’s the solution?”

Hedwig lowered her head as if she had nothing to say. I had no choice but to open my mouth.

“Well, first, give citrus fruits to people who show symptoms of scurvy, and if that doesn’t work, other fruits or edible vegetables are fine too. After about three days, the condition will start to improve.”

“Vegetables?”

“Yes.”

The market looked quite displeased.

“Teacher, right now. You came here on a wyvern cavalry troop by imperial command, and you are telling me to eat vegetables across the empire? Do you think that makes sense?”

His speech also changed, perhaps because he was frustrated. Well, it’s not that I don’t understand his thoughts.

“That makes sense… right?”

“No, Professor. The city is currently implementing quarantine measures such as curfews, self-isolation, and entry bans, but you don’t seem to be taking the situation seriously.”

“That doesn’t mean you made a mistake. It’s natural to take preventive measures until the cause or control of the epidemic is known. But other evidence is now emerging.”

This is the important thing.

It may be a problem that can be easily solved by modern people’s standards, but it is a problem that cannot be solved without special effort.

From the perspective of someone who has heard that it is a disease that can be cured by eating lemons, it is hard not to mention the word lemon.

So did you eat it? You didn’t eat it.

“That, getting fruit isn’t that hard, right? Just do it.”

“Haa… … . Okay, I understand. What do you think, Hedwig?”

The market seems to have cooled down a bit. Believe me or not. They say that if you just eat lemons, you’ll get better. It’s only natural to give it a try.

Hedwig just nodded.

It seemed like he was starting to believe what I said. Maybe it was because of the shock from earlier, but he was staring into the distance with his eyes wide open.

I felt sorry inside.

Was that too harsh?

“Thank you. I’ll go to the temple and check on the patient. I’ll let you know if I find out anything new.”

“That… ….”

“What’s going on?”

The mayor hesitated before speaking.

“Professor, I know it’s shameful to ask, but please refrain from speculating about the cause of the disease or the initial quarantine process. At least outside of this castle.”

It’s a shameless request. I let out a small sigh. It’s probably necessary to avoid confusion.

“Ah, yes. Until a definitive conclusion is reached, we will not say anything that could cause confusion in the quarantine field. That is natural.”

The mayor of Imentia looked into the distance and breathed a sigh of relief. It was fortunate that there were not many deaths yet.