Arc 35. One Needle. Jiang Ziya Fished for the Moon, a Physician Fishes for Life

Without the need for high-minded slogans like “renewing oneself daily,” life in Hangzhou was improving by degrees. With the sheer volume of work handled daily, progress was inevitable. We hired scholars to manage the administration and integrated physicians sent from the White Qilin Medical Pavilion headquarters, but we also aggressively recruited and utilized local Hangzhou physicians.

If this was coexistence, then perhaps it was working.

In Hangzhou, the name of the White Qilin Medical Pavilion was becoming absolute. Public sentiment improved by the day, but setting that aside, the gap in skill among the physicians in the city was vast. There was a stark difference between general clinics that relied on traditional apprenticeship models and a massive Medical Pavilion equipped with a systematic education system. Adding a modern curriculum, where pedagogical techniques were extremely developed, naturally widened that gap even further. As a result, private clinics found it increasingly difficult to survive unless they affiliated themselves with us.

Since the Pavilion was perpetually short on manpower, we were eager to accept even one more pair of hands. Thanks to that, there was a lot to teach.

Of course, admission to the White Qilin Medical Pavilion didn’t mean knowledge magically filled one’s head. The first priority was increasing the accuracy of diagnoses. Patients who were difficult to treat were to be sent to the Hangzhou Branch immediately. However, patients who could be treated on-site should be handled at local clinics. In a way, it wasn’t much different from the existing referral system, but the crucial point lay in the triage—determining whether it was an illness they could manage themselves or if the patient required swift transport to the main branch.

Learning just these two judgment criteria was not easy. However, realistically speaking, it was the most correct course of action.

Yoo Ho and Mu Wol… they aren’t coming. Damn it.

He hadn’t even expected the Four Great Department Heads, but for these guys to not show even a hair, claiming they were busy with their own work… He knew this would happen.

Jin Cheon-hee clicked his tongue and stepped outside after finishing his paperwork, feeling as drained as if he were coughing up blood.

I’ll leave this place someday. Until then, I have to lay all the groundwork.

He couldn’t live in Hangzhou forever. Eventually, he had to hand over his duties and return to the main mountain where his master resided. He needed to prepare for that time, but the city of Hangzhou itself was a formidable beast to tame.

Cheon Woo seems to be traveling for spars again.

Occasionally, rumors of Cheon Woo’s martial fame reached him. They were all domineering tales that made him sound far from Orthodox—more like a tyrant of the Unorthodox factions—but there was no doubt he was on a roll.

Smelling the air that had turned sharp and cold before he knew it, Jin Cheon-hee muttered softly.

“Ah, the smell of winter.”

Winter had begun to descend upon Hangzhou. A single snowflake stuck to his cheek, and soon, countless others began to fall. However, even with the snow falling like this, it wouldn’t pile up; it would soon melt into water and flow away. That was usually the way of the first snow.

It was then.

“Benefactor! Benefactoooor!”

It was Sama Hye.

“Hmm? Hye-ah. What’s wrong?”

“I think you need to come quickly.”

An emergency patient must have arrived—one that even the Senior Physicians of the White Qilin Medical Pavilion couldn’t treat. Jin Cheon-hee immediately ran after Sama Hye.

***

On the bed lay a young child, gasping for breath, skin erupting in angry rashes. As soon as Jin Cheon-hee arrived, a Senior Physician spoke, his voice trembling.

“This is… Smallpox!”

Jin Cheon-hee spoke calmly, cutting through the rising panic.

“Everyone, cover your noses and mouths. What are you doing? Have you forgotten everything I taught you?”

At his command, the startled physicians scrambled to cover their faces with cloth. Smallpox was transmitted through the respiratory system. Of course, it wasn’t comparable to the transmissibility of modern viruses like COVID-19, but the patient had arrived right when the rash had just erupted—the most contagious stage.

Jin Cheon-hee also covered his nose and mouth and stepped closer.

Wheeze… Hrk…

The child could barely make sounds resembling breaths, the throat too swollen to voice anything else.

The Senior Physician continued his report.

“It appears the child’s mother and father have already died from smallpox. This child is in danger too.”

Smallpox. It could be called the worst infectious disease of humanity. A plague that caused at least a billion cumulative deaths in history, eventually eradicated on modern Earth. However, here, there was no cure, nor any way to prevent transmission.

Fatality rate is thirty percent. Respiratory transmission.

It might be considered better than the Black Death, which killed so quickly there was no time to do anything, but in some ways, it was worse. With the Black Death, the infected died rapidly—so fast that they perished before their immunity could even activate. Historical records spoke of people holding funerals for Black Death victims only for the mourners to die the very next day.

Smallpox, however, had a fatality rate of thirty percent. Conversely, the survival rate was as high as seventy percent. That meant if one could boost immunity, they could live.

Orthodox martial arts masters possessed high immunity thanks to internal energy or health cultivation arts, so they usually had a higher chance of recovery even if they caught a disease. Unorthodox masters, while lacking specific health cultivation, still had high survival rates due to physical conditioning and better nutrition than the average peasant. For a martial artist, the probability of dying by the sword was far higher than dying from smallpox.

But civilians were different. And the surviving seventy percent of civilians would fight the illness while spreading it to those around them.

Viruses were like that. If the lethality was too high, the host died before spreading it, slowing the infection rate. If the lethality was low, the individual survived easily, but the spread increased. Smallpox was more vicious than the Black Death because it hit the “golden ratio” of mortality and transmissibility perfectly. That was why it had tormented humanity throughout history, leaving traces even in ancient Egyptian mummies.

And on top of that, the fact that it’s a virus makes it nasty.

Antibiotics didn’t work. Antiviral drugs were required, but with the technology of this world, creating them was impossible. Even in modern times, smallpox had been eradicated so early that there hadn’t been opportunities to test modern antivirals extensively, though the hypothesis that they would work was credible.

Wow… damn it…

Ultimately, they had to feed the child decoctions to boost immunity and hold onto his life using Qi Healing until he recovered. If they were unlucky, the physician performing the Qi Healing could get infected too.

But right now, is there no other way besides this?

Was symptomatic treatment the only option? The physicians exposed to the child were also in danger. He had to prepare for that. Before going on medical volunteer trips in his past life, he used to look up various materials thinking they might help. He recalled texts stating that if a vaccine made using the cowpox method was injected within three to four days of infection, smallpox symptoms would be alleviated and the chance of a cure increased.

But… this is also just a probability.

Still, he couldn’t do nothing. Shouldn’t he do something?

Since there are no machines, I’ll have to make it using primitive methods.

He had studied the cowpox method in the past, briefly seeing it in a reference book during high school. He remembered reading it with interest back then because he wanted to become a doctor.

First, he isolated the exposed physicians separately and immediately summoned the rest of the staff.

“You must have all learned about the symptoms of smallpox. There shouldn’t be anyone who doesn’t know what kind of disease this is, how it infects, and what the treatment is.”

At that moment, an Intermediate Physician raised his hand.

“We learned that there is virtually no cure.”

“Yes. Correct. There is virtually none. At best… the preventive measure is extracting pathogens from a cow infected with cowpox and using it as a vaccination.”

At the mention of vaccination, the physicians murmured nervously.

Right. This is the natural reaction.

Even in modern times, all sorts of bizarre rumors circulated regarding vaccinations. From ‘Bill Gates plants chips to control us’ to ‘You can receive 5G with your brain,’ or ‘Magnetic force is emitted from the body’—conspiracy theories were endless. One of the most famous was that vaccination caused infertility or shortened lifespans. Because this was more plausible than the sci-fi theories, people who hadn’t studied the basic principles often believed it.

Surprisingly, such people existed even in an era of public education.

Of course, vaccinations weren’t without side effects. Fever or fatigue due to the immune response were typical. That was a problem all medicine carried. However, considering the mortality rate of the disease and the permanent aftereffects even if one survived—like polio leaving survivors paralyzed—the risk was necessary. If human immunity were that great naturally, the average lifespan in the past wouldn’t have been thirty years.

However, in this world with absolutely no public education system, and without even the concept of bacteria and viruses, vaccination appeared to be truly insane. Practicing such “wicked sorcery” could get one beaten to death.

Right. Everyone disliked surgery at first too.

It was fortunate that the forced propagator of surgery, the symbol of the jackpot, the Bloodborne Elder Eccentric, existed to pave the way.

If I were a King or Emperor, I would have forced it.

In an era where concepts of hygiene weren’t even fully established, introducing this was a nightmare. There was variolation—grinding smallpox scabs or pus from an infected person and inserting the powder into the nose. But since this used the live smallpox virus, people with weak immunity could die from the procedure itself.

In this situation, if he said they had to prick pus from a cow with cowpox to prevent smallpox… this would be treated as the second coming of the Five Poisons Sect.

At least the people of the Five Poisons Sect wash frequently and thoroughly.

Typhoid fever spread because people used unpurified water and had no soap. It wasn’t that the concept of cleanliness didn’t exist, but pushing out an existing mindset to bring in a completely different method was incredibly hard. Edward Jenner, who discovered the cowpox method, faced backlash when he first introduced the vaccine.

‘Does it make sense to put cow germs into a human body!’ ‘How do you prevent a disease by injecting a disease?’ ‘Edward Jenner is plotting to turn people into cows to rule England. I heard if you take that vaccine, you moo like a cow!’

He faced all sorts of conspiracy theories and opposition that would give a medical professional Qi Deviation.

I even thought about starting a cult. For about three seconds.

A religion where you wash your hands every day and get cowpox vaccinations. However, no matter how much he thought about it, he could only see an ending where Prince Gold Silver sent the Imperial Army to subjugate him as a heretic.

Still, in gaming terms, I’ve achieved quite a few achievements in the Gangho, so maybe it won’t fail now?

Unlike the past, maybe it was possible.

Sure enough, some Senior Physicians looked skeptical.

It’s easy once you do it, but until you do, this is exactly what makes it hard.