Chapter 405: Complications

Outside the Eight-Pointed City.

One li beyond the west gate, Batur Hong Taiji reined in his horse and wheeled around. Watching Liu Chengzong, with just over ten guards, walk into the Eight-Pointed City utterly fearless, his stunned expression looked as if he had seen an immortal.

The Jungar chieftain shed all his arrogance, almost overwhelmed by an urge to prostrate himself in worship. He said to Dai Daozi, "Anda, now I understand why you said the Grand Marshal is a very special man. He truly has no fear of death!"

The Eight-Pointed City had already become a plague zone.

Inside the broken rammed-earth walls along the moat bank, corpses wrapped in Mongol tent-cloth and animal hides lay in orderly rows. From either side of the city gate to the limits of sight, one body pressed against the next, tight against the foot of the city wall — the stench was almost visible, reeking to high heaven.

There was smallpox inside that city.

The smallpox that makes a father flee his sick son, a brother flee his sick brother, a wife flee her sick husband, a chieftain flee his sick tribesmen — the smallpox against which physicians and monks alike are helpless!

Yet Hong Taiji watched Liu Chengzong show not a trace of fear. He simply tied a cloth over his face, then strode head high into the city.

But to his surprise, Dai Daozi gave a scornful laugh and raised a hand to point at the city gate. "Look at that Chahar man, Shaktu Taiji — he's acting like nothing's wrong too. Know why?"

"That's his brother, and the Great Khan at that. If he dares go in and tend to him, I respect him for it." Batur Hong Taiji's face was full of righteous certainty. "But the Grand Marshal has no ties to Khundulen, neither kin nor friend. Why take such a huge risk to see a dying man?"

"It's not because Khundulen is his brother. When you entered Qinghai, I was with the Marshal fighting in Hehuang. He was the envoy the Chahar sent to the Marshal's headquarters. The Marshal made him catch smallpox."

As Batur Hong Taiji's face froze as though struck by lightning, Dai Daozi added lightly, "We all caught smallpox."

"No, wrong, that can't be right."

Batur Hong Taiji's face said don't-you-dare-lie-to-me. "I've seen people who had smallpox — faces full of pockmarks. None of you have them."

Dai Daozi pointed at his own right cheek. "See this pit? That's from smallpox."

Batur Hong Taiji could see nothing at all. He searched Dai Daozi's face meticulously for ages before finally spotting, beneath his right cheekbone, a tiny pit so faint it was nearly invisible. He curled his lip in disdain and declared with absolute conviction, "That's not smallpox. When I was fifteen or sixteen I got bumps all the time. Not the same thing."

Dai Daozi opened his mouth, then found himself choked speechless.

How exactly was he supposed to prove he'd had smallpox?

He shook his head. "Believe it or not. The Marshal's headquarters has already defeated smallpox. Including Shaktu — none of them entering the city will catch smallpox. We can receive the vaccine."

"Receive... vaccine?"

Hong Taiji's face was full of suspicion. Due to the language barrier, the words sounded to his ears like planting sickness into the ground. He asked, "What kind of sorcery is that?"

"It's not sorcery. A person accepts the planting of a mild illness with weakened virulence. A person only gets smallpox once — if you get the mild one, you won't get the severe one."

Hong Taiji seemed to grasp the general idea and asked, "How is it done?"

Dai Daozi knew the principle behind the smallpox vaccine.

Artificially select smallpox scabs with a relatively mild disease course, then store them to further weaken their virulence.

Then let Pock General Yang Yao go on one of his indiscriminate planting sprees — into monkeys, into rabbits, into Shaktu Taiji, into cattle — and in the end, produce a universal vaccine with even weaker virulence and higher safety. The inoculation results in Hehuang had been excellent.

But knowing all this did not mean he would tell Batur Hong Taiji.

He simply shook his head and said, "I don't know either. I'm not in that line of work. The Marshal's headquarters has specialized pox physicians. Once the Grand Marshal finishes dealing with the Chahar matter..."

Dai Daozi sighed as he spoke and gazed worriedly toward the Eight-Pointed City. "Before you take your oath of alliance, go and beg the Grand Marshal. Perhaps he can make the Jungar unafraid of smallpox too."

He figured this matter would be extremely thorny — not just the Chahar, but also the seven or eight newly formed battalions. Over twenty thousand surrendered Ming troops under the Marshal's headquarters still had no immunity to smallpox.

There would be plenty of work ahead.

Batur Hong Taiji turned his head and exchanged glances with the nobles of his own tribe. They were all half-doubting, half-believing of this almost magical technique, but equally filled with intense longing.

Who wouldn't wish to be immune to a disease that was utterly terrifying to everyone else?

Revisiting the old haunt, Liu Chengzong's brow was tightly furrowed.

Conditions inside the city were no better than outside. It was mealtime. As far as the eye could see, among the orderly rows of layered military tents, beside nearly every campfire sat a pox-ridden, listless Chahar veteran.

And it was not only the Chahar, of course. Among the four hundred Han artillerymen under Mo Yujing, a few had also been infected — though these former Ming artillerymen had not caught the disease from the Chahar.

The Eight-Pointed City garrison had its defense zones divided. Mo Yujing's artillerymen were further protected inside by Mongol soldiers under Ahaidaiqing. The ones truly infected were the Khalkha Battalion soldiers under Ahaidaiqing.

The Khalkha Battalion was made up of soldiers from Tumed. They had long since completed inoculation and served as a quarantine wall for the artillerymen under Mo Yujing.

Only because some vaccine matter had been improperly stored, or because the sought-after attenuation had instead extinguished virulence entirely, a small number of soldiers had failed inoculation. Trapped in a state of believing themselves immune when they were not, they were the ones who caught it.

Since this batch of soldiers was, in base numbers, far smaller than the Chahar troops who had contracted smallpox, infections among Mo Yujing's artillerymen were very few.

Moreover, although the Mongol soldiers under Ahaidaiqing did not understand the principles, they all had experience from Hehuang with quarantine, inoculation, and pox avoidance. They knew that people breaking out in pox must not be contacted, so the scale of contagion was also contained and did not cause worse effects.

But in Liu Chengzong's eyes, the situation for the Chahar soldiers inside the Eight-Pointed City was nowhere near as good.

Although Shaktu Taiji had overseen pox avoidance for the Chahar soldiers in the Eight-Pointed City, it had not been properly brought under control... By the time he discovered it, the situation was already very dire.

Liu Shizi had compiled the plague manual in Hehuang and presided over the army's previous large-scale inoculation. He knew smallpox well. Over a thousand Han and Mongol soldiers inside the Eight-Pointed City had contracted smallpox — this degree of infection was absolutely not the state of smallpox just beginning to spread.

What he witnessed with his own eyes were Chahar soldiers, but what weighed on his heart was his own army — the more than twenty thousand troops under the direct leadership of the Marshal's headquarters who had not yet received the smallpox vaccine.

On the way to the Chahar main camp, Liu Shizi pondered and asked Shaktu Taiji, "Is it possible that this and the Hehuang smallpox share the same origin?"

Shaktu Taiji looked utterly lost, his mind clearly in turmoil. He said blankly, "The same origin? I... I don't know."

Liu Chengzong stopped walking. A sudden fury rose from his heart.

His conjecture was that as early as when the Chahar entered Qinghai, soldiers in the army had already been infected — only they had not yet broken out in pox, or so few had broken out that it went unnoticed.

Then, as the war progressed, smallpox would have spread along with the scattering and surrender of Chahar soldiers, circulating among the herder-soldiers of the Khoshut, Jungar, and Dörbet tribes. And now, following their defeat and surrender, it had already spread into the armies of the Marshal's headquarters.

The slightest misstep, and this would be a great plague infecting tens of thousands of troops and killing thousands of soldiers!

On a matter this critical, Shaktu Taiji gave him only such a vague answer, stirring in him an unprovoked urge to draw his blade and kill. But seeing the taiji's red-rimmed eyes and face full of bewilderment, he let out a soft breath and adjusted his mood.

In the end, Liu Chengzong simply raised both hands and pressed them heavily on his shoulders, patted his face firmly, and his tone softened — less anger, more reproach. "What the hell is wrong with you, drifting around in a daze? Several thousand Chahar are waiting for you to save their lives!"

But he never expected that at this single reproach, Shaktu Taiji would let out a howl and break down completely.

Shaktu Taiji did not understand why — one war, one migration, then another war, then another migration. The Eastern Mongols, who had once bestrode the steppe incomparably mighty, had seen their tribes scatter and hearts grow estranged through all this wandering and displacement.

One defeat was not the end, only the prelude to another defeat. The heavy cavalry troops he had taken such pride in had been utterly lost almost without his noticing.

Noble as the Chahar imperial younger brother, he had returned to the Khan's court only to find himself with nothing in the blink of an eye. The sole authority left to him was the post of Chahar Battalion Commander, granted by the Han Marshal's headquarters.

Just when the war situation finally seemed to hold hope, smallpox acted as though it had grown eyes, singling out the Chahar to infect. Even his own elder brother had caught smallpox and ordered him to temporarily take charge of the Khan's court — his final command being to seal off all news of the Chahar Great Khan's illness from the outside world.

He himself was struggling alone and unsupported in the Eight-Pointed City. He had done everything he had seen and heard about pox avoidance in Hehuang, yet smallpox in the camp was like trying to hold a gourd underwater — push one down and another popped up.

Shaktu felt that nothing he did was right.

Liu Chengzong was also thrown off by his sudden breakdown. He could only offer a few gentle words of comfort before leading him outside the khan tent that enshrined the Nine-Tasseled White Banner.

Just then, two weak-kneed Mongol soldiers came out carrying a monk-like physician. The physician was covered in pox scabs, with pustules on his hands, face, and chest. Unconscious and breathing rapidly, he looked like he was on his last breath.

Liu Chengzong stepped aside to let them pass, then lifted the tent curtain for a glance. The gold-and-silver-adorned interior was dim and empty, with Mongol medical instruments scattered across the floor. Only the Tiger Khan lay on the couch, seemingly in a coma.

He turned and withdrew, his face helpless.

The trickiest thing about infectious disease isn't whether a physician can treat it — it's that physicians are human too, and they can catch it. If he can't even cure himself, how is he supposed to cure others?

He shot a look at his accompanying physicians. Several doctors and apprentices carrying medicine chests and toolboxes immediately entered the tent to examine the patient.

Standing outside the tent, Liu Chengzong took a few breaths of fresh air, closed his eyes and pondered for a moment, then said to Shaktu Taiji, "If you caught smallpox before entering Qinghai, and it shares the same source as the Hehuang outbreak, then Gansu is in danger."

By his judgment, the source of this smallpox epidemic was very likely in Gansu. The Chahar army had caught it while battering their heads against the border walls, then carried it from the west into Qinghai. The Gansu border troops, transferred southeast to Hehuang, had then passed the disease to the border armies of the Five Garrisons.

This had brought smallpox closing in on the Marshal's Manor from both sides.

Just then, Shaktu Taiji beside him seemed to finally snap out of it. His body suddenly dropped as he fell to his knees before Liu Chengzong, his face full of pleading. "Marshal, I beg you, save my brother! You can definitely save my brother, just like you saved my life. I'll give you anything you want!"

Shaktu Taiji knew it was Liu the Lion who had saved his life.

If he hadn't been inoculated in Hehuang, he too would never have escaped the catastrophe sweeping through the Chahar tribe at Eight Corners City.

Liu Chengzong could not agree to this. He could only rely on brute strength to haul him up, but no sooner had he pulled him upright than the man dropped to his knees again. He had to have two guards hold Shaktu up as he said to him, "You didn't tell me from the start that the army was infected with smallpox. You know, before anyone catches it, prevention is easy."

"Now, at this stage, you ask me to save him — I'm no immortal. You ask me to kill — King Yama takes souls, how could I be his match! Why didn't you tell me earlier?"

Shaktu fell silent, his eyes turning sorrowful.

Hudun Tu's order to him had been to seal off the news of the Great Khan's illness.

That order was not meant to guard against anyone else — it was aimed squarely at the Liu Chengzong standing before him, fearing he would seize the chance to swallow up the Chahar Khan's Court.

But now, Shaktu Taiji no longer cared about the Chahar Khan's Court. What was left of the Khan's Court anyway? Tens of thousands of women and children in Liu Chengzong's hands, impossible to get back. A few thousand sickly soldiers — how could that still be called a Khan's Court?

If his brother died, he feared even this meager family inheritance could not be preserved.

Liu Chengzong paid no mind to what he was thinking. He simply turned and ordered his guards to prepare paper and brush, then wrote a letter to his father in Xining Prefecture, telling him to first send someone to return Hooge — he was no longer seeing him.

Then prepare smallpox vaccine, summon physicians, purchase medicinal materials, and establish an Imperial Medical Academy modeled on the court system.

And on that foundation, plan within two years to establish hospitals, medical schools, and public-benefit dispensaries at every level — prefecture, county, and the Five Garrisons of Hehuang — as institutions to manage physicians, treat the common people, collect medicinal materials, conduct formula experiments, assess skill grades, and provide remedial study.

Moreover, Liu the Lion knew that the Ming dynasty's hospital system would be shattered by the plague at the dynasty's end. But against the plague, all he could rely on were the physicians of this era — he could only do his best to reduce the plague's impact.

Therefore, an Infectious Disease Prevention Bureau must be added, and beyond the eleven medical disciplines, an Infectious Disease Prevention discipline must also be established.

Fortunately, compared to plague, smallpox was an easier epidemic to handle. It could give the Marshal's Manor rehearsal experience in epidemic prevention and quarantine before facing the plague, and thereby cultivate personnel with epidemic prevention knowledge.

Unfortunately, these personnel would have to be found from the army.

Finally, he gave orders to Yang Yao, commanding him to organize a thousand-strong corps of marching smallpox physicians, allocate three thousand-man squads to assist, and divide the Qinghai Lake region into pox villages in preparation for a second round of universal inoculation.

To prevent smallpox from spreading unchecked among the surrendered troops.

Just as he finished writing his letter, the physician inside the khan tent came out, his expression grim. He had an apprentice help him hold liquor in his mouth and spray it onto his hands. Liu Chengzong asked urgently, "How is the Tiger Chieftain?"

The old physician wiped his hands as he spoke. "Marshal, the man has been ill for nearly a month. The pox sores on his body have already formed thick scabs. In a few more days they will fall off. The smallpox has already passed."

Hearing this, Liu Chengzong thought, That's good news. He felt a bit lighter at heart and asked, "Then why the long face?"

"The smallpox is no longer a threat, but the toxins have entered his body. There is wind-warmth lung heat, suppurating into abscesses. Unconscious and unresponsive, his face deep purple, neck stiff and convulsing, back arched in opisthotonos — he has also contracted a pestilential disease. Furthermore, abscess toxins cling to the bone, septic toxins flow and spread, and the toxins have already reached his head and face. Both eyes are nearly blind."

The old physician rattled off a string of symptoms that Liu Chengzong could not understand, then finally sighed softly. "This is a case where smallpox is easy to leave, but the various complications are hard to treat. The Mongol Great Khan... his days are numbered."

－－－－－－Off-topic－－－－－－

Good afternoon!

Wind-warmth lung heat, suppurating into abscesses, is severe pneumonia. The pestilential disease is encephalitis. Septic toxins flowing and spreading is septicemia. Abscess toxins clinging to the bone is osteomyelitis. There are also blindness, coma, meningitis, bronchitis, otitis media, and laryngitis — all complications of smallpox and the main causes of death.