# Reassembly of Faith (6)
Erpen Adamberta.
The foremost authority on humoral theory — yet, after the germ theory presentation, he had become the most passionate advocate for it of any elf healer alive.
We had fallen into a regular correspondence since the presentation.
He'd told me that germs might be flowing through the blood, and asked me to help him prove it.
The moment I received his message, I accepted without a second thought.
It hadn't taken long for us to grow close.
— "I'm sorry about the presentation. We are healers, after all. When a new theory emerges, we have no choice but to subject it to rigorous verification. I'm afraid I may have questioned you rather aggressively, and it's been weighing on me."
— "Please don't worry about it. On the contrary, it's precisely because people like you exist that the healing arts can advance."
— "With pleasure."
Erpen had become a fervent adherent of the IV fluid and blood transfusion techniques I had developed.
But after I introduced IV fluids and blood transfusions to the field of healing arts, his bloodletting survival rate had improved dramatically.
The survival rate, once at thirty percent, had climbed to fifty.
Perhaps that was why.
Even throughout our joint research, Erpen never pulled rank on me — he showed nothing but a friendly face.
And from that connection, our relationship had grown close enough that the moment I discovered the antibiotic, he was the first person I contacted.
"I managed to isolate germs from the blood, just as you showed me."
"Congratulations, Lord Erpen."
The office of Erpen Adamberta, Director of the Adamberta Infirmary.
He hadn't yet been told that I'd come to share the news of my discovery.
The elf healer greeted me as warmly as always.
"It was no simple feat, I can tell you that. There were so few germs in the blood that finding them wasn't easy at all."
Blood cultures are, by nature, an extraordinarily delicate process.
Drawing blood under aseptic conditions is already a task in itself — and even after successfully drawing it, the bacteria often simply die off before anything can be done with them.
But Erpen had seen it through to the end.
He had demonstrated that germs flowing through the blood were responsible for causing fever.
"What will you name this disease?"
"I haven't decided yet. Have you given any thought to a name, Lord Saint?"
"How does Sepsis sound?"
"Sepsis... an intuitive name for a disease. Let's go with that."
It was a shame, but the title of sepsis discoverer had passed to Erpen.
In my heart, I had wanted to be the one to prove it first.
But the antibiotic had to take priority — which meant I had no choice but to yield that achievement to this elf healer.
'Well, I can't have everything for myself.'
Perhaps it was because he had made a discovery that would go down in medical history — and at what might be considered his twilight years, no less, though he had well over a hundred remaining.
Erpen seemed to be in particularly good spirits today.
"Well then, I suppose the next task will be finding a way to draw these germs out separately through bloodletting."
Or perhaps he was simply excited at the prospect of inventing a new bloodletting method.
Said aloud, it sounded like the obsession of a madman — but his bloodletting was, surprisingly, grounded in a fairly rigorous scientific framework.
If poisons were flowing through the blood, the logical approach was to cut a safe blood vessel, draw out the contaminated blood, and then use Heal to regenerate fresh blood, thereby diluting the concentration of the toxin.
Then repeat the process, again and again, until the concentration approached zero.
Doesn't that sound familiar?
Quite right.
It was no different in principle from emergency dialysis and IV fluid administration — only the method differed.
'In fact, it might even be more effective than emergency dialysis.'
21st-century dialysis was far from a perfect technology.
It couldn't filter out a full hundred percent of waste products, caused significant nutrient loss, and carried the complication of damaging blood cells and nutrients in the process.
Bloodletting using divine magic, on the other hand, required no such worries.
Setting aside the minor inconvenience that patients could die from hypovolemic shock or dehydration, Erpen's bloodletting was, by the standards of this era, cutting-edge medical technique.
His attachment to the practice was rooted in the simple fact that it genuinely worked.
However, no matter how effective, his bloodletting would be useless against sepsis.
"Germs, as I've explained, are living organisms that multiply continuously. Even if you draw out the blood, so long as germs remain inside the body and keep reproducing, you've simply returned to square one."
"Hearing you put it that way, I suppose you're right. Unlike toxins, germs multiply. Bloodletting may well be ineffective."
Erpen conceded immediately.
And then, all at once, his expression darkened.
"...I'll have you know, I'm aware you've been holding something back."
"Whatever do you mean?"
"Among all those who have died under my bloodletting — there must have been a fair number who died because germs were transmitted through the transfusion."
"..."
It was a remarkably logical deduction.
His transfusions had been far removed from anything resembling aseptic procedure.
Perhaps, as he suggested, some of his patients had died as a result of contaminated transfusions.
But I judged that possibility to be low.
"No — sepsis doesn't develop that easily."
A virus like Hepatitis C, perhaps. But sepsis from a blood transfusion was rare.
Unless the blood pack itself was teeming with bacteria, or someone had smeared feces on the needle.
Short of something like that, sepsis developing from the transfusion procedure alone was uncommon.
White blood cells and immune cells were not nearly so fragile as to allow it.
And so I denied his theory.
"The blood products are packaged cleanly by our trading company before being sent to you. So the number of people who developed sepsis from your transfusions should be nearly zero."
But Erpen didn't seem fully convinced.
"You needn't go so far to comfort me."
I'm telling you, it's true.
Perhaps it was all the time he'd been spending studying germs lately.
Erpen was severely overestimating how dangerous they were.
Naturally, that misapprehension needed to be corrected.
"If a needle prick were enough to cause sepsis, then wouldn't we also develop sepsis every time we got a paper cut turning a page?"
"Ah — when you put it that way, you're right."
"Germs are certainly frightening, but humans aren't quite so fragile as all that."
He knew of germs now, but not yet of white blood cells or the immune system.
His overreaction was understandable, in that sense.
Erpen cleared his throat with a slightly abashed air.
"Ahem... forgive me. Learning new knowledge at my age feels rather like returning to my school days. It seems I got carried away."
"I understand completely. I was the same way once."
So medical student's syndrome existed in this world too, apparently.
(*Medical student's syndrome: a form of hypochondria in which medical students, upon learning about diseases, begin to fear they have each one in turn — suspecting stomach cancer at the slightest indigestion, or lymphoma at any night fever.)
"Come to think of it, Lord Erpen, there is something I came here to tell you today."
"Oh? What would that be?"
"I've developed a medicine capable of treating most diseases caused by germs — including sepsis."
Stillness.
Erpen's hand, which had been lifting his cup, froze mid-air.
"...If I recall correctly, it's been roughly two months since germs were discovered?"
"I had some luck. Before I even began the germ research, our trading company had already been running a large-scale study into whether dyes might have medicinal applications — and as it happened, we were able to discover something effective against germs in the process."
It wasn't a lie.
The project to discover an antibiotic had been underway long before the germ theory research began.
The reason I was able to find it so much faster than it had been found in the original history came down to one thing.
I already knew the answer, more or less — and the scale of my research operation was in an entirely different league.
'Those who came before were individual researchers. I'm a director of a trading company. It's only natural, when you think about it.'
Research proceeding slowly because only one person is doing it?
Simple enough solution: hire a hundred people, lock them in a laboratory, and have them spend sixteen hours a day doing nothing but looking through microscopes.
Time and effort, it turns out, can be substituted with sufficient capital.
"I infected rats with bacteria and administered these medicines to the ones that developed fevers. Nine out of ten survived."
The bacteria hadn't encountered antibiotics before, which probably helped.
The efficacy was remarkable.
Back in 21st-century Korea, bacteria had built up so much resistance that they were difficult to kill.
"I've also run a few clinical trials in Limbus Pit. If things go smoothly, it should be ready for sale within two months."
"..."
I held the test tube filled with the red medicine up in front of him.
Erpen studied the contents in silence for a moment before he spoke.
"You didn't happen to have this ready in advance and simply wait for a good moment to present it?"
"..."
How did he figure that out.
As I sat in silence, Erpen let out a faint, amused smile.
"I'm joking. This is hardly the first time you've done something like this. You identified diabetes and had Insulin ready within six months. Something like this must have been no great difficulty for you."
"I had some luck."
"The gods, I've always found, bestow their luck only upon those who work for it."
*
The antibiotic was given the name Prontosil.
"So this medicine can now defeat all germs?"
"Unfortunately, it has effect against some germs but not others."
Prontosil was effective only against Streptococcus and Pneumococcus.
Against other bacteria, its effect was minimal at best.
'I need to develop penicillin soon.'
Blue mold.
This wretched stuff had still not turned up.
I was fairly certain I'd already had the healers sweating through practically every variety of blue mold in existence.
And yet — no penicillin. Not even anything remotely similar.
'What if it isn't blue mold at all?'
Now that I thought about it, in this world Quinine had been extracted from bark rather than a solution.
Perhaps the penicillin equivalent here came not from blue mold, but from some green lichen instead.
'I'll have to check other molds as well.'
In any case.
Until penicillin made its appearance, Prontosil would reign as the undisputed sovereign of antibiotics.
"Have you settled on a price?"
"I'll be selling it cheaply. Much cheaper than Quinine."
"As cheap as Rax?"
"Something along those lines, I'd imagine."
Bacterial infections were far more common than malaria.
The more common they were, the more accessible the treatment needed to be.
'Hygiene and prevention are like a group project, in the end.'
Hygiene and prevention accomplished little when only one person paid attention to them.
It was only effective when not just I, but my neighbor next door, and the neighborhood beyond that, all looked out for them together.
That was precisely why I was selling these cheaply.
Keeping the price high so that only a privileged few could benefit would render the whole effort pointless.
"I've already spoken with the board. There will be no need for ordinary citizens to feel burdened by the cost of this medicine."
Some of the directors had clearly wanted to price the antibiotic as high as Viagra, not understanding any of this.
When I pushed through anyway, they tucked their tails and agreed to sell it cheaply.
But Erpen, knowing nothing of my reasoning, looked at me with eyes full of overwhelming emotion.
"Even with the vaccine, you were the same way... you truly have no greed, do you? The more I think about it, the more it seems your canonization came far too late."
"This one feels that way every single time."
Gregor, who had been quietly following behind us, gave a vigorous nod, his beard twitching with emphasis.
Two pairs of rather intense eyes converged on my crow mask at once.
I clapped my hands to clear the air.
"That said, it's still too early to use it openly. I plan to keep its identity as a treatment for germs concealed and introduce it as a catalyst for healers instead."
"That does seem the right approach. Given that we don't yet know how black sorcerers might misuse these germs, spreading that knowledge indiscriminately would be unwise."
Perfect secrecy would be impossible, of course.
Even so, making the effort was far better than making none at all.
"Might we test this medicine straight away? As it happens, we have several patients currently admitted to the infirmary with strongly suspected sepsis."
"I'll stay beside you and walk you through the dosage and method of use."
Erpen's decisions were always refreshingly decisive.
Perhaps it was a sign of a world where the concept of clinical trials had yet to become widespread.
There was not the slightest hesitation about administering a new medicine directly to a patient.
"This is the oral Prontosil. It's used for mild infections and taken three times a day."
"And this injectable form here — does it work faster?"
"Yes. This is the water-soluble Prontosil injection. However, it cannot be administered directly — it must be given indirectly through an IV drip."
"What is the dosage?"
"A 2.5% solution, injected at 20mL."
Scratch, scratch.
Erpen noted it all down in his memo pad.
Before us lay a patient whose labored breathing suggested he might depart for the side of the Main God at any moment.
Erpen located the patient's vein with practiced ease, set up the IV line, and then administered the antibiotic according to my instructions.
"Shall I cast Heal now?"
"Yes. Here is the modified formula that uses the Prontosil in the patient's blood as a catalyst."
Divine magic shared the same conventions as regular magic — it just drew on divine power instead.
I handed over the formula I had reworked slightly.
"This is the formula I adjusted myself."
"The foundational framework is that of the Minor Heal formula. Ah — since it's built on humoral theory, there are still some unnecessary components remaining. These parts here can be removed."
This, I supposed, was the privilege of the man who had originally devised the divine magic for regenerating blood based on Heal.
The moment he saw the new formula, he began modifying it on the spot without missing a beat.
'Divine magic really is better left to the healers.'
He scratched at the formula a few times, nodded to himself, and then extended his hand toward the patient.
[Heal]
A pure white light seeped into the patient's body.
The miracle of divine magic, as always, was something to behold.
The patient's condition improved almost immediately.
Prontosil appeared to have worked successfully as a catalyst.
I posed my question to Erpen at once.
"What do you think? You are the first to use divine magic with Prontosil as a catalyst, Lord Erpen."
"..."
"Lord Erpen?"
Erpen gave no answer to my question. He simply stared down at his own hand in a daze.
Then he called out to a passing healer.
"You — you have a sepsis patient, don't you? Try treating your patient with this formula and this medicine."
"Understood, Director."
The priest also cast Heal on his own patient at once.
And showed the exact same reaction as the Director had.
He stood there, rooted to the spot, staring blankly at his own hand.
The process repeated itself again and again after that.
Administer the Prontosil, cast Heal. Administer, cast Heal.
By the time roughly ten healers had all stood dumbstruck in turn, Erpen finally spoke to me.
"Lord Saint?"
"What is it?"
"Just what is it you've made?"
"?"
"The divine power consumed by the Minor Heal has... been reduced to the level of a Refresh. With this... I could easily cast it thirty times in a single day."
And then Erpen turned his gaze upward, and murmured with an expression of profound shock.
"...I never imagined I would come to understand — in a way as visceral as this — that humoral theory was all wrong."
*
Afterward, an unexpected antibiotic boom swept through the Adamberta Infirmary.
— "I used Prontosil once on a festering wound — good heavens — the divine power consumption is...!"
— "Let me try it on a pneumonia patient — wait, what?"
The energy efficiency of divine magic using the antibiotic as a catalyst had improved by nearly tenfold.
That level of efficiency was something previously found only in symbols like sunlight, the cross, and holy water.
Intoxicated by that rush, several healers declared they needed to use up every last drop of their surplus divine power before the day was out — and so they purchased Prontosil and went down to Limbus Pit to volunteer.
— "More...! I need to accumulate more experience!"
Erpen and I watched their frenzied departure in silence, unable to bring ourselves to stop them.
Well — good things are good things.
Now and then, talk arose that the antibiotic ought to be declared a holy relic.
"Can it actually be declared a holy relic?"
"Why not? Quinine, Insulin, and the vaccine all received a blessing, didn't they? The antibiotic deserves nothing less."
Erpen seemed to have absolutely no doubt that the antibiotic would become a holy relic.
"What a shame about the Mencia Sect."
It was also the moment the fate of the Mencia Sect was sealed.
The Mencia Sect had built their livelihood on plagues — infectious diseases, specifically.
And now the Adamberta Sect had claimed antibiotic treatment for themselves.
What the future held for the Mencia Sect required no great deliberation to imagine.
"Tsk tsk... In the end, that friend Dormund didn't take the advice, did he."
Erpen clicked his tongue, sounding genuinely sorry.
But there was no particular pity for Dormund in his expression.
"He too represents an entire sect — he is an elder who has reached that station. He ought to bear proper responsibility for the choices he makes. So I hope you won't trouble your heart over it too much, Lord Saint."
I had been wrestling with whether to give them one more chance.
But Erpen said even that was their responsibility to bear, and spoke up to defend me.
The decisiveness in his manner lifted a weight from my chest.
And so it was, some time later, as we continued our joint research by testing Prontosil here and there —
"Director!"
A low-rank healer came rushing toward us with an urgent expression.
"A mother has been sent over from the Lafavre Sect! She has puerperal fever!"
"Those friends have sharp ears."
It seemed word that we had antibiotics here had reached even them.
I wasn't sure how they'd found out, but they had apparently decided that the mother needed the antibiotic immediately.
"Come to think of it, Lord Saint — those Lafavre friends are a rather pitiable lot. I don't imagine they genuinely disbelieve in germs."
"I know."
I had already thought of a way to help them.
But that was a matter for later.
For now, we went at once to assess the mother sent by the Lafavre Sect.
A somewhat stout woman was being carried in on a stretcher, her breathing coming in short, ragged gasps.
Erpen looked at the mother's face and let out a low sigh.
"My, my... now I understand why those friends swallowed their pride and sent her over straight away."
"Do you know her?"
"That is Marchioness Kerren. This is her fifth delivery. I treated her once before for white powder poisoning — lead poisoning — through bloodletting. We're acquainted."
Saying this, the elderly elf healer moved with practiced familiarity to check the patient's pulse.
"The vein is..."
Feeling along her arm.
"The vein is..."
Feeling along the top of her foot.
"...?"
A look of perplexity crossed Erpen's face.
"I can't...find the vein...?"
He was right.
I was watching from beside him, and the patient was simply not in any state that would allow a vein to be found.
'The edema is far too severe.'
The postpartum edema was severe beyond measure.
Severe enough that not a single vein was visible.
"An intramuscular injection, then —"
"It won't work."
Intramuscular injections are slow to absorb.
If I injected into the muscle, the medicine would finish spreading only after the patient had already left this world.
"Then what can we do, Lord Saint? Do you have something in mind?"
"Yes. Gregor should be bringing it shortly."
The moment I saw the patient, I had already anticipated that Erpen would have difficulty finding a vein — so I had sent Gregor to retrieve something.
By now, he would be searching through the infirmary for the item I had told him to find.
True to my expectations, he returned in under a minute.
"Lord Saint! I've brought it!"
"You didn't break any doors or walls, did you?"
"...The doorknob. I broke it slightly. In my haste."
"No — you did well."
A doorknob was nothing.
When a life is on the line, breaking a thing or two in a rush is perfectly acceptable.
"I'll compensate for it later, Director."
Saying this, I took the item Gregor had brought.
In my hand was a rather large needle — thick enough, with only a little exaggeration, to rival a pinky finger.
I instructed Gregor to press down firmly on the patient's shin.
Then I positioned the needle perpendicular to the bone.
"W-...Lord Saint, what exactly are you about to do?"
"You're aware that blood is produced in the bone marrow?"
"S-...surely not —"
"That's exactly what I'm going to use."
"W-wait just a moment —!"
Before Erpen could finish his words —
I placed the weight of my upper body behind the needle.
Crunch!
And the needle drove through the shin bone.