chapter 48
The Mysterious Epidemic (4)
The Mysterious Epidemic (4)
What kind of disease could this be? After seeing the mayor’s son, a patient came to mind.
It wasn’t a patient I saw in my previous life, but one who came to the academy hospital.
The story went like this.
A few days ago, a student from the academy came into the clinic. The student was worried because a severe cold was going around the dormitory.
It was a bit much to prescribe medicine to someone who wasn’t even sick yet, so I just gave them some vitamin C. Just a lemon candy.
The situation now is exactly like that.
A cold and vitamin.
I had thought the blood was coming from the cough, but in fact, the cough was just a side effect, and the blood was coming from the mouth. There’s a very famous disease where blood comes from the mouth.
I returned to the meeting room with Istina. Creak, the heavy door opened.
“I think I know what disease it is!”
The mayor of Imentia and the officials looked at me. Hedwig was still silently standing by. It’s a relief that I have a hypothesis.
“Uh, already?”
“Sorry for being late.”
“It’s only been an hour.”
That’s late.
During the cholera outbreak, we figured out what the disease was and how to solve it before even reaching the site.
This time, it took a whole day.
I spent an entire day diagnosing and coming up with a solution, and who knows how many sacrifices were made in the meantime.
Of course, thinking like that is endless. Considering I had the answer in my head, this is still late. Anyway.
“The disease these people have is a vitamin C deficiency, in other words, scurvy.”
Scurvy. A disease most characterized by bleeding gums due to connective tissue damage caused by a lack of vitamin C.
The treatment is the intake of vitamin C. Permanent damage like tooth loss can’t be fixed, but most symptoms can improve within a few days.
Hedwig and Istina looked at me with puzzled eyes. As if to say, “Does that make sense?” Right, I didn’t know either.
“Does that make sense?”
“It’s still just a guess.”
“Isn’t scurvy a completely different disease? It’s caused by a lot of sea breeze, isn’t it?”
It’s a bit ironic.
Everyone knows scurvy exists, but opinions differ on why it occurs and what mechanism causes it.
The son of the expedition knight thought it was a disease that came from visiting distant lands, and the plague doctor thought it was caused by the sea breeze. Of course, both were wrong.
“Scurvy is a disease caused by a lack of vitamin C, a specific nutrient. It can happen if you’re not prepared for a voyage.”
“Malnutrition isn’t a plague, is it?”
“Well… That depends on the situation.”
The mayor of Imentia sighed.
“My son wouldn’t have starved.”
“Not necessarily starved. Anything could have happened during the voyage or expedition. If someone didn’t consider that in the voyage.”
The Royal Navy of the British Empire solved the problem of vitamin C deficiency by feeding salted vegetables, limes, and other fruits to the sailors.
That doesn’t mean they cared about the sailors’ treatment. They kidnapped drunks sleeping on the streets and put them into the navy.
It was just a rational decision that soldiers who died of scurvy were useless.
In conclusion, it’s a problem that can’t be solved without making an effort. Even if that effort seems trivial from the outside.
The conference room buzzed a bit. Even Hedwig, who had believed me until now, kept tilting his head while flipping through the papers.
“No, professor. Scurvy doesn’t explain hemoptysis. There were quite a few patients who actually had hemoptysis.”
“Upon closer inspection, it was blood from the gums. That’s why I suspected scurvy.”
“What about the patients found inside the city?”
“It’s a port city, isn’t it? There must have been more than a few patients who had scurvy in the past.”
They still seemed unconvinced.
I rubbed my temples.
Partial fractions.
Let’s say there’s a test for a disease that’s 90% accurate. And 9% of the population has the disease. Common sense would say it’s a very accurate test and a very common disease.
If you test random people with this method… There will be more false patients than real patients. This is a similar case.
If plague doctors went around examining patients, even if they were very skilled with 90% accuracy, there would inevitably be more false patients than real ones.
Trying to make a judgment in a situation where there are more false patients than real ones leads to chaos. It’s highly likely that all assumptions, information, and everything about this disease and the patients are wrong.
How should I explain this coherently?
“Mr. Hedwig is wrong.”
“What?!”
Mr. Hedwig was startled.
The mayor sighed and rubbed his face several times. Istina scanned the meeting room with anxious eyes.
“So, who is right?”
The mayor’s voice was gradually getting angry. Well, the situation was confusing, and his son’s safety was at stake. The mayor’s patience must have its limits.
“First of all, there was no hemoptysis. Sir Manta was coughing and had blood coming out of his mouth, but it wasn’t mixed with phlegm.”
“Let’s say that’s true.”
“Skin damage and rashes may sound like the plague, but the clinical presentation is entirely different. In the case of the plague, the skin turns black. Our patients are different.”
Hedwig looked uneasy.
“I don’t know… It seems like an interpretation that relies excessively on coincidence. Don’t you teach that there are no coincidences in medicine? Scurvy doesn’t cause colds.”
It doesn’t directly cause colds.
“There are several possibilities. It could be the flu going around because of the changing seasons, allergic rhinitis due to late spring pollen, or just a common cold. Or it could be a situation where the immune system is weakened due to vitamin C deficiency, making them more susceptible to colds.”
“Professor, you’ve been mentioning vitamin C repeatedly. What exactly is vitamin C?”
Ah, right.
I realized I had spoken strangely. I opened my mouth to answer, but seeing the mayor slowly raise his hand, I closed it again.
“Enough. What’s the solution?”
Hedwig bowed his head as if he had nothing to say. I had no choice but to open my mouth.
“Uh, first, distribute citrus fruits to people showing symptoms of scurvy. If that’s not possible, other fruits or edible vegetables will do. Improvement should start in about three days.”
“Vegetables?”
“Yes.”
The mayor looked quite displeased.
“Doctor, you came here on a wyvern cavalry by imperial decree, crossed the empire, and now you’re telling me to eat vegetables? Do you think that makes any sense?”
His tone changed, perhaps out of frustration. Well, it’s not that I don’t understand his thoughts.
“It… makes sense, doesn’t it?”
“No, professor. The city is currently under curfew, with recommendations to stay indoors, and even port entry bans as part of the quarantine measures. It doesn’t seem like you’re taking the situation seriously.”
“I’m not saying you made a mistake. It’s natural to take preventive measures until the cause and control methods of the plague are identified. But now, other evidence is emerging.”
This is the important part.
It might be a problem that can be easily solved by modern standards, but it’s a problem that won’t be solved without special effort.
From the perspective of someone who heard that it can be cured by occasionally eating lemons, it’s hard not to mention just lemons.
So, did you eat them? No, you didn’t.
“Getting the fruits isn’t a difficult task, is it? Just do it for now.”
“Sigh… Alright. What does Mr. Hedwig think?”
The mayor seemed to have cooled down a bit. Whether he believes me or not, he said it can be cured just by eating lemons. It’s only natural to try it first.
Hedwig just nodded.
He seemed to be considering believing me. Though he was staring into the distance with wide eyes, perhaps still in shock.
I felt a bit sorry.
Maybe I was too harsh.
“Thank you. I’ll go to the temple and check on the patients. If I find out anything new, I’ll let you know.”
“That…”
“Is there something wrong?”
The mayor hesitated before speaking.
“Professor, I know it’s shameless to ask, but could you refrain from speculating about the cause of the disease or the initial quarantine process? At least outside this city.”
It is a shameless request indeed. I sighed softly. It’s necessary to prevent confusion.
“Ah, yes. I won’t say anything that could cause confusion at the quarantine site until we have a definitive conclusion. It’s only natural.”
The mayor of Imentia looked into the distance and sighed with relief. It’s fortunate that there aren’t many deaths yet.