Chapter 349: The Book of Epidemic Relief and Pox Control

Smallpox.

In the eyes of Horse Camp Commandant Yang Yao, at least for the Marshal's Manor's most elite cavalry under his command, smallpox did not exist in this world.

This was not merely because the three thousand-plus riders under him had all been inoculated with human pox; it was mainly because Yang Yao trusted himself.

The Marshal's Manor's inoculation effort had initially been spearheaded by Liu Chengzu. Liu Chengzu trusted the pox doctors. One doctor inoculated the Zhenhai Camp soldiers — thirteen out of one hundred and twenty soldiers died. Treating human life like weeds, he was executed by Liu Chengzu.

Another pox doctor inoculated the Xining Guard banner troops. The failure rate was one percent; over twenty people died.

Later, when it was Ju'erwan's turn, as the sole remaining garrison Commandant of Ju'erwan's three great camps, Yang Yao was dissatisfied with those numbers and decided to personally supervise the entire inoculation process.

Every day, he followed behind the pox doctor with his hand on his saber. When the doctor selected seedlings, he would glare at him from the corner of his eye, applying a tiny bit of pressure. This directly reduced the inoculation failure rate for the garrison soldiers of Ju'erwan's three great camps to two-tenths of a percent.

Only nine soldiers contracted full-blown smallpox, and of those nine, only one died from it. The remaining eight merely endured a bout of severe suffering and were left with indelible pockmarks on their faces.

The blade is a productive force.

Practitioners of the human pox technique need not understand medicine. Folk pox doctors treat this wondrous art as a livelihood and a secret never to be passed on, but for the army, no secret can stay hidden.

Yang Yao watched it every day and kept asking questions, and the pox doctor dared not refuse to answer. Over time, he even learned how to perform the inoculation himself.

Originally, the Grand Marshal was still besieging a city and had ordered him to lead his troops east first. Yang Yao had felt a tiny bit of reluctance in his heart, thinking this was using a butcher's cleaver to kill a chicken. He had not participated in the southern campaign and had been stuck on garrison duty at Ju'erwan for a very long time; he was already thoroughly bored.

Anyway, there were only two jobs.

On one hand, complete the encirclement of Ye Guoqi and his men to prevent their escape; on the other, seal off the valley to stop news of the eastern reinforcements from spreading west. The newly recruited Mongol Tatars were most suited for this task.

The truth was, the Grand Marshal had given him no chance to discuss it. The order had already been issued, and Yang Yao could only obey.

Had there been any opportunity to confer, Yang Yao would certainly have raised this issue of using a butcher's cleaver to kill a chicken with the Grand Marshal.

He had started out as a Centurion in the Guyuan border army. After the mutiny, he had followed many muddle-headed fools. Of the veterans who mutinied with him, probably not many were still alive today. The ones who had fared best were likely just him and Wang Wenxiu.

If he had any trick for survival in this chaotic age, it was definitely to identify the right leader and offer absolute loyalty in times of war.

When an order comes, obey. Even if faced with a ten-thousand-ren sheer cliff, united as one, a path forward can be forced open.

But now, upon hearing that the Gansu reinforcements were bringing smallpox with them, Yang Yao's feelings immediately changed.

On one hand, for his subordinates, the pox inoculation had previously been a useless experience. But now that the enemy had contracted smallpox and the east would become a smallpox-ridden region, the significance of inoculation was entirely different.

On the other hand, Yang Yao knew how to inoculate. This, too, had been a damn useless skill before, but with smallpox now rampant, this skill of his could be put to tremendous use.

A perfect professional match — double the joy!

Guided along the way by Dai Daozi's reconnaissance riders, the Gansu reinforcements had been delayed by smallpox at Hekou and dared not continue advancing west. Thus, Yang Yao led his troops east for a full fifty li in one go.

He also dared not go to Hekou. His and Liu Chengzu's troops had all been inoculated, but the Grand Marshal had not yet been inoculated.

Therefore, he scouted the terrain along the way and ultimately chose to encamp at a river bend fifty li west of Hekou. This river flat was an area of the valley that was very easy to seal off.

Here, the Huang River bent sharply against the mountain wall, perfectly enclosing this river flat of over a dozen li. Whether coming from east or west, one had to cross a bridge to enter the flat, making this land relatively isolated.

This place was called Hezui. It was truly a fine location. The river valley alone held over thirty thousand mu of irrigated farmland. On the northern mountain, there were five large plateaus. Even excluding the more expansive mountain lands of the north-south ravines, there were over forty thousand mu of fertile fields.

Moreover, the terrain here was much lower than Xining; in fact, it already belonged to Lanzhou.

The local populace had either fled or run away, leaving behind only a few impoverished households and tenant farmers to watch over the estates of the walled compounds below and the great households up in the mountains. As soon as Yang Yao's western army arrived, the remaining people also fled into the ravines. Across the boundless fields, only a few solitary old men, like guttering candles in the wind, remained.

Yang Yao had his men invite the elders over. He lamented to his subordinate officers Wei Qian'er, Yang Chengzu, and Han Shipan that land like this, if placed in northern Shaanxi, would absolutely have nothing to do with common civilians.

A few elders arrived, kowtowing and begging for mercy. Yang Yao asked a few questions, then retracted his previous lament.

He had been too hasty. In He-Huang, land like this also had nothing to do with common civilians.

The three hundred and twenty qing of fields at Hezui below the mountain, the seventy-two shop fronts along the village main road, the nine water mills, the one boat mill, the two coal tunnels in the mountain, and the one glass and porcelain kiln — all of it belonged to the Prince of Su of the Su fief.

In this entire area, what belonged to the common people was only eighty-three qing of mountain fields and garden plots, one oil press, and one oil mill.

Yang Yao handed the task of pacifying the populace to Wei Qian'er. At Hezui's west bridge, he selected a few villages not far apart and sent him to bring back all the fleeing refugees, inform the people of the Marshal's Manor's victory and the news of the epidemic pox appearing in the east, and tell everyone not to run about recklessly.

When smallpox appears in a place, people fall ill, some live and some die. Those who survive will all possess antibodies and will not transmit the disease to others.

Because smallpox is not contagious when carried, only when it breaks out. As smallpox sporadically appears in one place after another, after a period of time, most of the survivors possess antibodies, and smallpox will temporarily vanish.

A few years later, all the newborns lack antibodies, and smallpox rekindles from the ashes. The entire process repeats itself, which is why smallpox seems as if it will never die out.

It is precisely for this reason that, under normal circumstances, inoculation is only given to children, as if this disease only affects children.

There has never been anything like what the Marshal's Manor did: hauling over all the soldiers, and regardless of whether you had been inoculated or had contracted smallpox before, everyone had to go through a unified round of human pox inoculation.

Because inoculation is a unique skill. In places where the law has not collapsed and the court's rule is peaceful and happy, inoculation requires paying the pox doctor. And in places where the law has collapsed and rule has broken down, no pox doctor is willing to go there.

But once Yang Yao understood the operational method of this process, he believed it could absolutely be popularized to every single person. It required no money and no medical skill; his own soldiers could do it.

The reason he chose this land to encamp was for isolation... The Marshal's Manor's large-scale inoculation of soldiers was precisely because Little Lhazang had implemented measures in Huangnan to separate the living and the dead.

Yang Yao did not plan to implement such a high-level quarantine. His soldiers had antibodies and were not afraid of this. He only needed to ensure that smallpox did not travel west.

Therefore, he planned to conduct a large-scale experiment here: inoculate everyone.

The migration of the populace to the villages west of the river did not go smoothly. Initially, upon hearing that the western army was coming, the people hiding in the mountains were not very willing to come out. Later, upon hearing that the government troops had an outbreak of smallpox, they were even less willing to emerge.

However, the western rear-support troops soon arrived. In truth, the moment the first tribal soldier scaled the city wall, the fall of Machang City was only a matter of time.

Small-scale skirmishes and surrenders continued without pause, but Ye Guoqi's defending troops still held out in the government offices until dusk, when the heavy cannons outside the city were moved into the streets. Seeing no further hope of victory...

Li Tianyu had requested Liu Chengzong outside the city to capture the Ye brothers alive, but Liu Chengzong did not permit it. He merely dispatched the heavy arquebusier team to follow the artillery into the city. Subsequently, Li Tianyu's final call for surrender proved ineffective.

In the twilight, Ye Guoqi and Ye Bingqian donned their armor and gripped their swords. Shouting "Long live!" from the government offices, they charged toward the heavy arquebusier team occupying the street. Amid the crack of volley fire, the He-Huang chieftains' campaign to resist the western invaders was declared utterly defeated.

It was not until the brothers' corpses were carried out that Liu Chengzong saw Ye Guoqi for the first time. He did not say much, only personally writing the epitaph for the late General of Manifest Might, Commander Ye, and ordering craftsmen to carve the stele, permitting his descendants to find a place for burial.

At the same time, he ordered that merits be recorded for his own soldiers, and likewise personally wrote epitaphs and found burial grounds for them. Only then did he continue to march his troops east.

By the time Liu Chengzong arrived at Hezui, Yang Yao had already divided this land into five estates. He drew a plan on paper and said, "Grand Marshal, along the irrigation canal from east to west, it is divided into five pox estates: East Pox, Seed Pox, Awaiting Pox, Treating Pox, and Avoiding Pox. Each will be garrisoned by troops to dig trenches and build stockade walls. I can inoculate the commoners and soldiers coming from the east."

Liu Chengzong asked in surprise, "You can inoculate people?"

Yang Yao responded with a beaming smile, "Rest assured, Grand Marshal. I have watched the pox doctors do this thousands of times. It is not difficult at all, and I have already grasped all the key points... Grand Marshal, please rest easy and station the army west of the river. Once the best seedlings are selected from the best, the Grand Marshal and the various troops can also be inoculated then."

To be honest, Liu Chengzong found it rather unreliable. He understood the principle of pox inoculation, but that did not mean he could perform it, just as a person knows that scattering seeds on the ground and watering them will grow something, but that does not mean that person is a good farmer.

Why is a vaccine called a vaccine? Because the only vaccine in this era was the pox seedling. Yang Yao making it sound so simple, he did not believe it.

Sensing Liu Chengzong's expression of distrust, Yang Yao hurriedly said, "Grand Marshal, this matter truly is not difficult. It is only because those pox doctors treat it as a unique secret art that it seems so mysterious. In truth, it is just like farming."

Liu Chengzong asked in astonishment, "You know how to farm?"

That cut deep. Yang Yao truly didn't know how to farm. He shook his head and defended himself: "Let me put it to the Grand Marshal this way — planting vaccine is treating the person as the field, the pox toxin as the seed, growing and declining on the human body."

Liu Chengzong nodded. He understood that principle. "Tell me something I don't know."

"Farming is all about seed selection, seed storage, and field selection. Planting vaccine is the same. Smallpox symptoms divide into favorable pox and virulent pox; vaccine seed divides into two kinds — one is propagated seed, the other is seasonal seed... these are what the Grand Marshal must know first."

Liu Chengzong knew this too. Favorable pox and virulent pox were essentially the two forms of smallpox — the lesser form had a low fatality rate, the greater form a high one. In essence, mild versus severe cases.

Yang Yao said: "Seasonal seed is made by selecting pox from the seasonal epidemic, using scabs naturally shed from the body to prepare the vaccine. This vaccine is fiercely toxic and easily harms the recipient."

"Propagated seed is made by selecting pox from an inoculated person — ideally choosing those favorable pox cases that heal without medicine — grinding them into powder, pouring it into a water bowl when needed, soaking cotton in the water, and inserting it into the nostril."

"For storage, the selected vaccine must be wrapped in paper, placed inside a bamboo tube, and the time carefully noted. In winter it keeps thirty to forty days, in summer a dozen or so days. The longer it's stored, the weaker its potency and the harder it is to bring out the pox. Expired vaccine must absolutely never be used."

"Otherwise the inoculated person thinks they've been inoculated, but in truth they never developed the disease. When the seasonal epidemic spreads, it will ruin everything."

Yang Yao smiled as he spoke: "As for field selection, that's much simpler — just look at the recipient's complexion and vitality. Inoculation is nothing more than pitting the body's righteous qi against the pox toxin's evil qi. If the person's righteous qi is robust and strong, it can drive out the toxin, forcing the toxicity to recede and disperse on its own."

"Conversely, the toxin will spread throughout the body, causing severe illness. Therefore, those who are listless, in poor health, or women during their monthly courses or pregnancy cannot be inoculated — inoculation in such cases will mostly bring on disease."

As Yang Yao spoke, he finally said to Liu Chengzong: "So the most critical part of this lies in vaccine selection. Inoculation itself costs practically nothing. I suggest not rushing at the start — select ten batches of vaccine, inoculate ten people, take the scabs from those who produce favorable pox, make new vaccine, then inoculate a hundred people; then take the scabs from the favorable pox cases among them to make vaccine, and inoculate a thousand."

"Selecting the best from the best layer by layer, the vaccine's toxicity will be greatly reduced. That's exactly how I had the pox physicians do it in the Three Great Camps. Don't fear the time it takes — they all survived."

Hearing Yang Yao's explanation, Liu Chengzong now understood the entire process completely. This relatively primitive vaccine had already formed a system — selecting a milder strain of the virus for inoculation to defend against the virulent strain.

And through existing manual methods to reduce toxicity, inoculating again and again to weaken the seed vaccine's virulence; and judging the recipient's immunity to determine suitability for inoculation.

Having heard all this, Liu the Lion thought the process was quite good. He smiled: "Sounds like you truly know your trade. Fine, we'll do as you say. However... try it on cattle too."

"Cattle?"

Yang Yao had been waiting for praise. Hearing Liu Chengzong approve his method, he was quite pleased at first — but the moment he heard "try it on cattle," he couldn't help feeling the Grand Marshal's words were somewhat flippant.

How was Liu Chengzong supposed to explain it to Yang Yao? He didn't explain. He only said: "Trying can't hurt. See whether cattle catch the disease, and whether that disease can then pass to humans. See if the cattle smallpox that humans catch is milder than human smallpox. General Yang."

Liu Chengzong's expression turned solemn: "Every few years, tens of thousands die of smallpox. This is a blessing that benefits all under heaven. Every possibility is worth testing. If we can eradicate smallpox, generations to come will remember your name."

"Besides inoculation, this spot you've chosen is good. We'll attempt plague isolation here... how fine it is."

Liu Chengzong suddenly sighed with soaring ambition, gazing out at the fertile wilderness around him and spreading his arms wide: "This smallpox has come at just the right time. In northern Shaanxi we learned to fight famine; in He-Huang we will learn to fight plague. Now, with disasters and epidemics rising everywhere under heaven, if the Old Man in Heaven wants people dead, we'll keep them alive. Let's see who the hell can outlast whom!"

"This is a good moment. We'll inoculate the common people, properly isolate and treat the sick, and at the same time maintain our defenses. I believe the government troops to the east will soon send soldiers who've already had smallpox." Liu Chengzong smiled: "Beyond that, I want to compile a book."

"What book does the Grand Marshal want to compile?"

Liu Chengzong bared a mouthful of white teeth and smiled proudly: "The Book of Famine Relief and Plague Control. In the future, our scholars and officers of every rank will study it. Natural disasters and man-made calamities destroyed our homeland — we'll rebuild it brick by brick!"