Chapter 610: Ji Chang Learns Archery

"Not long ago, a great epidemic of cold damage raged through the three armies. The chariots and cavalry fell ill, the soldiers grew frail, and over a thousand died. Though all officers and men united their hearts and strength to fight the plague god together, and only thus won this battle, when it comes to the most outstanding merit, none surpass the army physicians. They braved danger to walk the sick camps, personally tasted decoctions to save the afflicted — the physician is a commander in the midst of epidemic, and must not go unrewarded."

Diwu Lun was generous. As soon as the cold damage in Xiapi showed some improvement, he lavished rewards on the physicians who had devised prescriptions and treated the sick, increasing some men's salaries and granting silk to others. At the same time he proclaimed: "The office of Grand Physician-In-Chief under the Privy Treasurer was originally a six-hundred-bushel post. When I reflect on how my imperial father and mother perished in an epidemic, and have seen with my own eyes the soldiers' suffering from stubborn illness, my heart still trembles. I know deeply that the physician is a great matter of state. I specially promote it to a thousand-bushel office. Extending from this, the Physician-In-Chief shall be six hundred bushels, and the physicians of disease, of wounds, of diet, of beasts, of women's ailments, and of children beneath them shall all rise one rank in office, promoted to four-hundred-bushel officials!"

This was a grand gesture! In the past, physicians had been regarded as one of the "hundred crafts." Though the most outstanding among them entered the system under the jurisdiction of the Privy Treasurer, compared to scholars who relied on the Five Classics to enter official careers, they were still a rung lower and despised.

Diwu Lun did not see it that way. From the moment he took power he had placed great importance on medicine. In the past, under the Privy Treasurer there had been four categories: physicians of disease, of wounds, of diet, and of beasts. The physicians of disease managed the myriad ailments of the people; the physicians of wounds treated all manner of abscesses, ulcers, metal wounds, and bone fractures — they were practically surgeons, and army physicians mostly came from this office; the physicians of diet were the equivalent of nutritionists, responsible for the food combinations of the Emperor and the rear palace; the physicians of beasts had to manage the vast numbers of cattle, horses, and livestock owned by the state — after all, a single livestock epidemic could cost the state millions upon millions in cash.

On this foundation, Diwu Lun added "physicians of women's ailments and children," specializing in gynecology, obstetrics, and childhood diseases, and not limiting them to the court. Every month he dispatched them to tour the four capitals, spreading knowledge about childbirth and child-rearing.

Now these five categories all rose one rank in office, from four hundred bushels to six hundred bushels — equivalent to the head of a county. The physicians' status had imperceptibly risen a notch, and everyone was naturally delighted.

Diwu Lun, however, was still not satisfied with this. He issued another edict: "Beneath the Grand Physician, add one more office, to be named 'Physician of Epidemics.' The Physician-In-Chief of Epidemics shall rank at four hundred bushels, specializing in seasonal epidemics. Beneath him shall be five medical chiefs — for cold damage, miasmic vapor, barbarian pox, pestilential wind, and corpse transmission — each ranking at two hundred bushels."

The State of Wei, as an impoverished feudal dynasty, also lacked physicians. It certainly did not have the means to open epidemic prevention stations everywhere, and could not even dispatch barefoot doctors. But Diwu Lun believed that no matter how poor, one could not stint on medicine. Research into the five great epidemic demons could no longer rely on the solitary struggles of some famous physician. It was time for the court to fund it and devote great effort to diagnosis and treatment.

"Open the gate of human dissection, so that physicians throughout court and countryside may soon 'know themselves.' Beyond that, they must also 'know the enemy.'"

When deliberating the candidates for Physician-In-Chief of Epidemics and the five medical chiefs beneath him, Diwu Lun summoned the several famous physicians accompanying the army and had them make nominations. Huan Tan also attended this meeting as an observer.

He heard the Emperor say: "Apart from cold damage, when it comes to those that kill the most people, none surpass these four — all great enemies of mankind."

"First, this miasmic vapor. The south is hot and damp; miasmic poisons breed together, and sicknesses abound. When the First Emperor of Qin attacked the Hundred Yue, the Qin troops crossed south of the ridges and encountered miasma; before battle, more than half died of disease. When Emperor Wu of Han campaigned against Minyue and Nanyue, though he annexed nine commanderies into Han territory, Jiaozhou was hot and damp, and great numbers of soldiers fell to epidemics and died. In Wang Mang's time, Juding in Yizhou refused to submit. Three times troops were sent to subdue it, but because they encountered miasmic poison, two or three out of every ten soldiers died. Two hundred thousand men were used, yet they could not make tiny Juding yield, becoming a laughingstock to the world. This also caused Yizhou to grow alienated, allowing Gongsun Shu to buy hearts and minds, until at last he carved out a separatist regime."

Beyond warfare, in Han times, if an official learned he had been dispatched to Nanzhong or Jiaozhou to serve, he would surely weep and wail and bid his family farewell, because so many outsiders died of disease on the journey to their posts. As for convicts banished to places like Cangwu, they too regarded it as a road of terror. Diwu Lun had even heard the absurd tale of men unwilling to go to Jiaozhou who spent money to bribe officials to change their exile sentence to the death penalty — at least that way they could die in the Central Plains and not have to leave their corpses exposed in the southern Jiao region. This showed the degree of terror toward the southern miasmic vapor.

In Diwu Lun's view, the regions where the above tragedies frequently occurred were basically all subtropical. The south was humid and sweltering, permeated with insect poisons, and indeed provided a breeding ground for disease and plague. Northern soldiers, after a long and arduous march, reached the distant southern lands and could not adapt to the climate, water, and soil there. Some were bitten by venomous insects and contracted malaria; some fell ill with dysentery from unclean food and drink. Beset by all manner of ailments, more than half of them died. They did not understand the true pathological causes and could only start from the harsh environment so different from their homeland, attributing all these misfortunes entirely to miasmic vapor. Those two characters became a catch-all basket into which anything could be thrown.

When Diwu Lun later advanced his armies south, he would certainly have to face this so-called "miasmic vapor," so of course he had to devise countermeasures in advance.

"On the one hand, we must separate malaria, dysentery, beriberi, and other diseases out of this basket of miasmic vapor. On the other, we must use this to spread knowledge and dispel the Central Plains' fear of 'miasmic vapor.'"

After all, Diwu Lun believed that Huaxia's future lay in the south. There would certainly be migrations, garrisons, and other such actions later. If the fog of miasmic vapor could not be dispelled, they would likely be seen as "driving the common people into the abyss" and face resistance.

If "miasmic vapor" was still a malady peculiar to the south, which northerners rarely contracted, then "barbarian pox" — that is, smallpox — was a foreign epidemic that was gradually invading the Central Plains bit by bit.

The grand physicians reported: "It is said that this disease was introduced during Emperor Wu of Han's campaign against the Western Regions, when Ferghana captives were brought back as tribute. After the Yuancheng era, it gradually spread through the Central Plains. Those infected develop pox on the head, face, and limbs, which in an instant spread all over the body, resembling fire blisters. When the skin breaks, all emit white fluid. In severe cases, most die."

This smallpox originated in foreign lands and entered the central realm. At first it was thought to be measles, but the symptoms were different and the fatality rate was extremely high. Among the common people, it was growing ever more severe. But as for how to diagnose and treat it, the physicians were also at their wits' end — after all, it was a new disease.

"When Bian Que and Cang Gong lived, they never saw this ailment — so later generations are helpless to deal with it?"

Diwu Lun scolded the physicians for a while, but in his heart he had no confidence either. Since smallpox had only been transmitted for a hundred years, had it infected cattle yet? If there was no cowpox yet, how could one speak of inoculation? He could not start with human pox first, could he?

These matters could only be left to the newly appointed medical chief of barbarian pox to investigate. They still had time.

Compared to smallpox, which had only been transmitted for a hundred years, "pestilential wind" — that is, leprosy — was a stubborn ailment long present in the Central Plains. It was said that Confucius's disciple Ran Geng had suffered from it. When Diwu Lun served as an official in Guanzhong, he too had seen some patients. Some had lost ears and noses; more had ulcerated, rotting skin. Those who saw them paled and drove them away. The scene was quite pitiful.

But this was something that had to be done. Diwu Lun decreed: "The Han system of disease-relocation wards shall be restored. Henceforth when leprosy patients are encountered, they must be relocated into them."

Unable to solve the treatment for now, they could only work on isolation. But among these diseases, the one Diwu Lun and the grand physicians discussed most was "corpse transmission" — that is, pulmonary tuberculosis, also called consumption.

Although diseases like cold damage and smallpox erupted violently, if one was fortunate enough to recover, at least one could return to normal. But this consumption was a terminal illness that drove men to despair.

"This disease is evil in every way. It drags on for months and years, gradually bringing debility and stagnation. Yin and yang are both depleted. One cannot labor, until death follows."

As a ruler, Diwu Lun found this consumption the most hateful. A perfectly good laborer, once infected, was basically ruined. What was more terrifying was that this disease was extremely easy to transmit. Visiting the sick or mourning the dead could both lead to infection. Often one person fell ill, and it would wipe out an entire family or even an entire village.

After coming to understand in detail the causes and devastation of these stubborn diseases one by one, Diwu Lun felt a deep ache in his heart. No wonder that for over two thousand years before 1949, even in so-called "golden ages," the average lifespan of Chinese people hovered around thirty-something. This endless, boundless plague alone was enough to make one suffocate.

Every person in ancient times who lived well into white-haired old age had endured too much.

But at least, starting from him, the first step would be taken to fight these five great plague gods.

Having gained a fairly thorough understanding of the past circumstances of these several diseases, Diwu Lun then turned to the main topic:

"I have also read the medical books in the Tianlu Pavilion. Physicians mostly hold that cold damage and miasmic vapor are all caused by externally invading pathogenic qi. But I have also heard that consumption is caused by consumption worms entering the body and gnawing at the heart and lungs?"

The crowd looked at each other. Such a theory did exist, but it was not mainstream. Ordinary physicians still vaguely attributed the cause of illness to indistinct "external pathogens."

"The famous Han physician Cang Gong once advanced this theory."

They explained: "But these so-called 'consumption worms' have never been seen."

Huan Tan also told Diwu Lun: "In the Tianfeng years under Wang Mang, they ordered corpses dissected to treat disease, and indeed found tiny worms in many people's intestines…"

He was probably talking about roundworms and other parasites. Diwu Lun could even picture their appearance. Fortunately, he had not eaten thin noodles that morning.

Unlike the Confucian scholars, the grand physicians, though they dared not openly approve of Wang Mang's permitting human corpse dissection, actually looked forward to it in their hearts. After all, Bian Que, the founding ancestor of the medical school, had once made two men sleep as if dead for three days, cut open their chests to probe their hearts, and swapped them around.

But they also used this to argue that Cang Gong Chunyu Yi's "consumption worm" theory was inaccurate:

"The imperial workshops have also opened the chests and lungs of those who died of consumption. But no matter how they searched and examined, they still could not find the 'consumption worms.'"

Diwu Lun, however, made a startling statement: "Not so. Perhaps it is simply because the consumption worms are extremely tiny and minute, and the human eye has limits and cannot detect them. Grandee Huan, what do you think?"

Huan Tan seemed to grasp something. The human eye had limits — he had a deep understanding of this. In the past, when Huan Tan, Yang Xiong, Liu Xin, and others explored the heavens, they could only rely on the naked eye. They observed the stars until their eyes ached, and when they encountered rare celestial phenomena, they hated only that they could not see more clearly. The calendars and star charts they made also had deviations.

After Diwu Lun ordered skilled craftsmen to produce the "thousand-li lens," Huan Tan felt as though his eyes had truly extended a thousand li into the distance! With the thousand-li lens, he could see the mottled surface of the moon and watch the stars grow ten or more times larger.

And now, Diwu Lun once again proposed an idea that opened the door to a new world for Huan Tan.

"The thousand-li lens can be used not only to observe the vastness of the sun and moon."

"It can also be used to examine the tip of an autumn hair!"

…

Huan Tan had read a story like this in the ancient book Liezi.

Ji Chang learned archery from the famous bowman Fei Wei. He had already trained to the point where he did not blink even as a loom shuttle flew back and forth, but Fei Wei felt this was not enough and demanded he continue looking at things: "See the small as large, see the faint as clear, and then report back to me."

So Ji Chang used the very tip of a yak's tail to tie up a louse and hung it in the window, gazing at it from the south. After ten days, the louse gradually grew larger in Ji Chang's eyes; after three years, the louse was as big as a cartwheel in his eyes. When he used this method to look at other things, human heads all seemed as large as hills…

Diwu Lun jokingly called this "pupil technique" and absolutely did not believe it. He said that to achieve such a feat, one could never rely on training the naked eye — one could only rely on the "microscope."

This was the name Diwu Lun gave to the lens specifically used to "examine the tip of an autumn hair." It was a pity that so far they had only produced a magnifying glass. When used to read the tiny fly-head script on ancient bamboo slips, it could illuminate the small and make it large. Huan Tan had received one as a gift from the Emperor, but the magnification was insufficient and still could not see the "consumption worms."

A true microscope still had to be researched and polished. After all, the hastily launched glass technology had only just begun, and at present even blowing a suitable transparent lens was not easy. In Diwu Lun's lifetime, seeing the true face of the tubercle bacillus would probably be very difficult. He set a small goal: first discover larger fungi like yeast and show them to the physicians, to establish a footing for the "microbe" theory.

But since the principles were the same, Huan Tan believed that this "microscope" would be made sooner or later. When that day came…

"Then nothing shall escape by a hair's breadth, what is distant can no longer hide, and what is minute will rarely be missed." Huan Tan was full of anticipation for that day.

Yes, what Diwu Lun wanted to do was to drag these little things hidden beneath the dense fog of "external pathogens" — the true culprits behind the five great disease demons — out one by one and shine a light on them until they were utterly exposed!

Refining the microscope was the work of craftsmen, but Diwu Lun gave Huan Tan another mission.

"I want you, Junshan, to make another trip to the King of Wu, Liu Xiu, in Huainan!"