Chapter 407: The Imperial Medical Academy

Liu Laoye had had his eye on the people and land of Gansu for quite some time.

It was just that the timing hadn't been ripe before, but now he believed the moment had come — and it would not wait.

The several battles that had broken out in quick succession in Qinghai, whether the early Weicha Campaign or the later Yuanwei Campaign, appeared on the surface to have no connection whatsoever to the Great Ming, yet in reality they had transformed the strategic situation of the Ming's northwestern border defenses.

With Chahar virtually wiped out and the Later Jin occupying the city of Guihua in Hohhot, the Ordos Tumen between Yansui Garrison and Ningxia Garrison had become a chaotic no-man's-land, and the Three Frontiers of Shaanxi had become a border defense army with no enemy to fight.

Frontier troops, frontier troops — they were troops who lived at the foot of the border wall. The entire purpose of their stationing in that barren land was to guard against the Mongols north of the wall.

Now the Southern Desert Mongols had splintered and been carved into three pieces, one each taken by the Later Jin, the Northern Desert Khalkha, and the Marshal's Office.

What remained were minor tribes that had neither fought to the death for the Tumed Great Khan nor followed the Khan on his thousand-li strategic withdrawal — mere fringe remnants, roaming the Ordos Tumen grazing lands that now had no Jinong.

Those called heroes are men who embrace grand ambition, harbor profound stratagems within, possess the capacity to encompass the cosmos, and hold the will to swallow heaven and earth.

Though Liu Xiangyu resided in the remote frontier of Xining, as an official of frontier origin, he was steeped by ear and eye in an exceptionally clear understanding of the northern situation. With only a little mental deduction, he arrived at his own conclusions.

From the Marshal's Office's perspective, this war was merely the Qinghai Campaign that began in the fifth month of the sixth year of Chongzhen and ended in the sixth month; even counting the Weicha Campaign, the entire war had lasted no more than three months.

But stepping outside the Marshal's Office's viewpoint, he realized that this war had perhaps entangled every Mongol army across the entire north, and its time span might need to be counted from the sixth year of Tianqi.

That year, Ligdan Khan and Hong Taiji attacked from two sides, jointly annihilating the Five Great Camps of the Inner Khalkha's Chaohua, and it was not until Liu Chengzong defeated the Oirat coalition that the battlefront, starting from the Liao River bend, had pushed westward all the way to the shores of Qinghai Lake.

Every power had played its own role in this war. Be that as it may, what Liu Xiangyu saw now was that as the war entered its final stage, the many victors who had survived the war in the north were about to enter the phase of seizing the spoils.

A man can only eat as much as his belly can hold.

From the Liao River to Guihua City had fallen to the Later Jin, while the Ordos between Guihua City and Ningxia remained a masterless land. This situation led Liu Xiangyu to two judgments.

First, given that the Jin state's power had advanced to Jining and Zhangjiakou, the next time the Jin army bypassed the passes to raid the Northern Metropolitan Region, Beijing's northwest, northeast, and south would all become zones vulnerable to Jin raids, and the capital would become a solitary isolated city.

This meant that from now on, the Jin state would hold a strategic advantage over the Great Ming.

Second, because the Three Frontiers of Shaanxi had lost their external enemy, the various border defense battalions, guard posts, and military fort garrisons would free up their hands, and over a hundred thousand troops would be transferred by the Emperor into the Central Plains to suppress the rebels.

The border garrisons were both geographical areas and paramilitary organizations. They contained retired veteran generals, battle-hardened elite soldiers, guard-post troops serving as field-army reserves, and large numbers of civilians with a military tradition acting as paramilitary personnel. In the broader environment of drought, their capacity to generate new soldiers was extremely strong.

Especially in Yulin and Ningxia, the two border garrisons were fully capable of dispatching a cumulative total of seventy to eighty thousand troops over five years.

This, in turn, meant that starting from the sixth year of Chongzhen, the massive, surging tide of rebel armies would gradually ebb under suppression and amnesty offers.

But this was not necessarily a good thing for the Great Ming. The fundamental logic of grain shortage would not vanish simply because rebels turned into government troops. The meat-grinder war of attrition would utterly devastate Shaanxi, Shanxi, and even Henan.

He began to believe his son's prediction that the Jin state had the capability to seize the realm.

The so-called urgency in mobilizing the Gansu frontier troops meant that if they did not find a way to shift the Gansu frontier troops outward right now, the Chongzhen Emperor and his lackeys would snatch those men before them.

At present, the Marshal's Office still lacked the ability to recruit the Gansu frontier troops and was still unable to take control of Gansu.

Otherwise, he would even have wanted to demarcate a national border with the Jin state in the Southern Desert.

But defeating the Oirat had created favorable conditions for them to mobilize the Gansu frontier troops to break into the Tianshan Mountains.

This so-called mobilization was of course not a matter of Liu Laoye giving Wang Ziyong a single order and the frontier troops who had joined the Three Tribulations Society shouldering their packs and charging northwest.

The Marshal's Office needed to prepare a full set of strategies to stir the Gansu frontier troops' initiative, so that they would go on their own.

The merchant caravans heading to the Tianshan Mountains would be funded by the Marshal's Office and staffed by the Three Tribulations Society, recruiting guards from Gansu for the caravans bound for Tianshan.

Once the Marshal's Office seized land in the Ili River Valley, it would recruit tenant farmers. As long as they could offer good terms, the caravan guards who went there could stay, and those who stayed and put down roots could establish the Tianshan Guard.

Those who did not stay, upon returning to Gansu, would continue to spread the word. As long as the caravans kept flowing, armed settlers would keep arriving.

Moreover, these people were also members of the Three Tribulations Society. On one hand, they had a military organization; on the other, they had the organization of a secret society. On defense, they would not fear the monk's proselytizing; on offense, they could form up into an army and rampage.

Liu Xiangyu considered this a fine thing that killed two birds with one stone. He had carefully read Wang Ziyong's record and concluded that the Three Tribulations Society was not to be feared — what was to be feared was Wang Ziyong himself.

This man was a Daoist priest by origin, specializing in rain-seeking, but his studies were not refined. In his entire life, he had only ever succeeded in seeking rain once, and that single rainstorm scattered the rebel army he had gathered in Yanchuan.

He fled to Yan'an Prefecture to join forces with Liu the Lion, never accomplished anything major, yet his talent for winning over the common people was exceptionally outstanding. He consistently served as the Lion Battalion's largest but weakest link in combat — retreating in every battle, collapsing at every engagement.

Later, this man entered the Yan'an Guard and transformed into a military officer. He even followed the Yan'an God of War to the capital to serve the King, making substantial progress in military affairs and leadership, and also witnessed the great generals of the Guan-Ning battlefield and got acquainted with outstanding talents from various secret societies.

Wang Ziyong, upon returning to Shaanxi, had undergone a qualitative leap in ability and had also done more thinking about the rebellion enterprise, learning from the Great Ming's finest rebel, Liu Chengzong, the benefits of recruiting frontier troops.

A character like this, Liu Laoye felt, would always be a hidden danger if kept in the interior, but if thrown into the Tianshan Mountains, he could instead become the Marshal's Office's sharpest blade.

A peasant-army leader who dares to fight and kill is not to be feared; a cult leader who deludes the masses with sorcery is not to be feared; a general or officer who rises in rebellion is still not to be feared.

But combine the three into one, and you truly have the makings of a man who can accomplish great things. His entire being is maxed out on destructive rebellion skills — is it possible for him to be content with the status quo?

Regarding the development of the Marshal's Office and the Three Tribulations Society, what Liu Laoye worried about most was that everything would go smoothly.

If everything went smoothly, the Marshal's Office would enter the Central Plains, the Three Tribulations Society would perfect its doctrine, and in the end, they would inevitably come to blows.

So a cult should be thrown where it belongs. Don't the Oirat also believe in Buddhism? The Marshal's Office would dispatch them a grand state preceptor.

Liu Laoye had just stolen a moment from his busy schedule to reply to Liu Chengzong's letter when a second letter arrived at the Marshal's Office yamen.

At a single glance, Liu Xiangyu knew that the matters mentioned in this letter were far from as easy as the first. The Lion's first demand was to have Hooge leave the Marshal's Office.

"Leave" was just a polite way of saying expel.

This in itself was no great matter; Liu Chengzong had never concealed his hostility toward the Jin state.

What was more, Liu Xiangyu already agreed that the Jin state was an obstacle to the Marshal's Office entering the Central Plains. Unless the Jin state stayed obediently outside the passes, war between the two sides would break out sooner or later.

If the Ordos were not so far away, Liu Xiangyu would want to push the front line to Guihua City right now and prevent the Jin state from occupying the Southern Desert.

But expelling Hooge at this moment meant that the Marshal's Office's plan to send an envoy to the Jin state would be shelved forever, which would pose a great obstacle to the Marshal's Office's grasp of Jin intelligence.

Gao Xian had even been called back from Pingliang, and now the mission he was to undertake had fallen through — quite a hassle for the man.

Liu Xiangyu did not care about Jin intelligence. He merely deduced from the Lion's demand that the matter to follow was extremely important — so important that no outsider, especially the Jin state, could be allowed to know of it.

But what he never expected was that the matter Liu the Lion deemed important enough to require expelling the envoy was actually the establishment of an Imperial Medical Academy.

This was almost entirely a blind spot in Liu Xiangyu's knowledge; he had only a very scant understanding of the Imperial Medical Academy.

Because he had previously dealt with the medical instructor of Mizhi County and the physician of the county jail, he knew it was a subordinate institution managed by the Ministry of Rites, tasked with carrying out the Emperor's commands regarding medicine and pharmaceuticals, and responsible for the registration, summons, selection, appointment, dismissal, assignment, education, training, examination, and management of medical households.

Medical households had their own examination system. If the civil service examinations were the test for public officials, then the medical household examinations were the test for a medical practice license, held once every three years, with results divided into three grades: first grade was Medical Scholar, second grade was Medical Student, and third grade was a fail requiring a re-examination the following year.

If one failed the re-examination the following year and failed yet another re-examination the year after that, they were stripped of their status and reduced to commoner. Those who achieved first grade in five consecutive examinations would be recommended by the medical school instructors for promotion and appointment.

Moreover, even after obtaining the status of Medical Student or Medical Scholar, one still had to study a specialty and take examinations, with results divided into four grades.

First grade: Medical Student promoted to Medical Scholar; Medical Scholar granted the Ninth-Rank cap and sash; those already with cap and sash promoted in rank and salary, and assigned to serve in the inner palace.

Second class: doctors likewise promoted to medical scholar, medical scholars granted the Ninth-Rank cap and sash, those already with cap and sash receive a promotion in rank and salary.

Third class: maintain original status. Fourth class: those with rank are fined salary, those with cap and sash lose the cap and sash, those without cap and sash are demoted, and must retake the exam after half a year; if they still fail, they are sent to the Imperial Medical Academy to grind medicines.

In all prefectures, subprefectures, and counties, medical schools are to be established alongside the official schools and yin-yang schools. The head of a prefectural medical school is called the Principal, a term taken from the division of medical disciplines, and holds the Lower Ninth Rank; Principals of subprefectural and county medical schools are unranked.

Furthermore, the Imperial Medical Academy is also responsible for selecting and dispatching physicians to the various princely estates' Medical Offices, all prefectures, subprefectures, counties, prisons, the National Academy, the Interpreters' Institute, border garrisons and guard posts, villages, and towns nationwide.

Establishing the Imperial Medical Academy was not difficult for Liu Xiangyu. Allocate funds, allocate land, allocate personnel, build the Academy, register all medical households, and appoint officials to manage it — that was all. Xining itself already had a Medical Principal; though only a Guard-level medical officer, he was at least someone who knew the trade.

What was new to Liu Xiangyu, however, was the Epidemic Prevention Bureau and the Epidemic Prevention Section that Liu Chengzong had mentioned in his letter.

But it was not hard to guess.

More than establishing the Imperial Medical Academy, what Liu Xiangyu focused on was what Liu Chengzong's expulsion of Hooge signified.

Liu Chengzong believed that future major epidemics in each region would pose a great obstacle to the Marshal's Office entering the Central Plains, and that this same obstacle would likewise affect the Jin Kingdom thousands of li away.

To avert such an impact, Lion Cub wanted to establish the Imperial Medical Academy and add one bureau and one section, but to prevent the Jin Kingdom from learning of it, the Jin envoy Hooge had to be driven away.

The very day Liu Xiangyu received the letter, he first contacted the army, then summoned Hooge.

Hooge had grown accustomed to life outside the new city. When they met, he was the same old picture of deference, bowing and greeting, smiling as he asked Liu Xiangyu, "Grand Lord, has the southern campaign been decided?"

Liu Xiangyu, however, wore a deeply worried frown and shook his head. "Hooge, you must go back."

"Ah?"

Hooge felt as if struck by a bolt from the blue. "Why is that? I have not yet met the Grand Marshal."

All this time, he had been closely following the military achievements of the Marshal's Office. Grand Marshal Liu Chengzong had swept aside the Great Ming's five-border-district coalition army like dry twigs; he had not yet arrived at the time, and even now still had no accurate assessment of the Marshal's Office's military capability.

Word had just arrived that the Marshal's Office and the Oirat allied forces had already clashed, and he would soon learn the Marshal's Office's precise military strength.

Even if he wanted to return, he had to do so only after confirming the Marshal's Office's military strength — at least he would have something to report back to his father the Khan.

Yet Liu Xiangyu wanted him to leave now.

What would leaving the Marshal's Office at this moment amount to? He had neither persuaded the Marshal's Office to make any agreement with the Jin Kingdom, nor obtained accurate intelligence on the Marshal's Office's military capability. His entire trip would have been for nothing.

How could he bear to?

But to his surprise, Liu Xiangyu spoke two words with a grim expression: "Smallpox."

Hooge's face changed drastically. The Han and the Jurchen held nearly opposite attitudes toward smallpox. Ming troops always dared to fight in the face of smallpox, whereas the Jurchen shunned it like a tiger.

Even when fighting the Great Ming, if intelligence reported that smallpox was raging in Ming territory, the troops sent to battle had to be specially selected from those who had already survived the pox.

This was not only because the Jin Kingdom held the initiative on the Liaodong battlefield, but also because smallpox was viewed as two entirely different things.

For the Jurchen Jusen who contracted it, it was a near-certain death sentence.

And Hooge, as it happened, had never had smallpox.

"Wh-where did smallpox come from?" Hooge was utterly astonished. "I heard the smallpox in Hehuang was already over."

From this remark, Liu Xiangyu judged that Hooge still did not know about the Marshal's Office's large-scale variolation.

"Not from Hehuang. It's on the southern battlefield. No one knows where it came from, only that a letter arrived this morning saying soldiers infected with smallpox in the south have already become a flood."

Liu Xiangyu's words were nine parts truth and one part lie, and they thoroughly duped Hooge. "The day the great army returns in triumph, smallpox will follow it back. You are, after all, the Jin Kingdom's heir. I know you are very brave, but if you were to die here, I fear your father might misunderstand."

Hooge nodded as well. Misunderstanding aside, if such a thing really happened, he would be dead — what use would misunderstanding or not be then?

"Then before I leave, might I see the Grand Marshal?"

Liu Xiangyu thought to himself: if Lion Cub wanted to see you, he would have seen you long ago. You want to ask some questions and get some answers, but not seeing you is also a kind of answer.

It was only because Lion Cub Liu had his old man holding the fort here that this answer did not seem so blunt.

Old Master Liu shook his head. "He has also been to the battlefield in person. Smallpox does not care who is Grand Marshal and who is an heir. I think you should not take this risk. Set out immediately. I have prepared five hundred guards for you, led by the Marshal's Office's great general Gao Xian, to escort you to Guihua City."

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Good evening!