Chapter 410: Medicine

Liu Chengzong left the Khan's tent of Hudunmian. Eje, coached by his uncle Shatu Taiji, kowtowed to him with utmost respect and called him "Abu."

Having stripped Eje of his right to inherit the khanate, Lion Liu felt in his heart some guilt toward the child. That was why he had told Ligdan Khan that he would raise and cultivate Eje just as Emperor Wu of Han had done with Jin Midi.

In any case, this could be considered having obtained the parents' consent. Liu Chengzong helped Eje to his feet and said, "Since your father has entrusted you to my care, from this day forward your surname shall be Liu. Let us get along well. You also have two younger brothers. Your foster father will not treat any of you poorly... Come, let's go roast some lamb."

Afterward, Liu Chengzong issued an order to convene all Qinghai commanders for a council at dawn the following day.

When he returned to the command tent, Ligdan Khan's eight consorts were still there. They presented to him the Northern Yuan Imperial Heirloom Seal and the Nine-Tasseled White Banner that symbolized khanly authority.

But to Liu Chengzong, this jade seal was nothing more than a rock.

If the seal that the First Emperor had made — the one chipped when an empress dowager hurled it at Wang Shun during the Han dynasty — still existed, it might hold some meaning for Lion Liu. But the Imperial Heirloom Seal had clearly been unable to survive the countless calamities of a thousand years of wind and rain.

Never mind being thrown into lakes or wells or burned along with emperors — in the Yuan dynasty alone, the powerful chancellor Bayan ordered all jade seals in the realm to be collected and have their inscriptions ground flat. What chance was there for any heirloom seal to survive?

This Northern Yuan jade seal was, at best, a Yuan dynasty seal. It was even quite possible that during the wars of the early Ming, the Yuan seal had been lost, and this was merely one carved by the Northern Yuan themselves.

What difference was there between a seal carved by the remnant Yuan and one that Lion Liu might carve for himself?

The jade seal was sent off to Xining Prefecture that very night. The Nine-Tasseled White Banner, however, Liu Chengzong kept, intending to use it in the funeral rites for the last Great Khan of the Northern Yuan.

That night, Liu Chengzong planned out Eje's cultural studies for the next four years and drafted a plague prevention plan for the entire Qinghai region.

To Liu Chengzong, the smallpox plague had a very strong dual nature. On one hand, once someone was infected and complications set in, they were almost helpless. On the other hand, if someone was not infected, prevention was remarkably easy.

Therefore, handling this matter for the army was not complicated. It was merely a task of tallying numbers and deploying troops: designating quarantine zones, using troops who already possessed antibodies as isolation cordons, dividing the massive army into small squads for management, and inoculating the soldiers with the smallpox vaccine squad by squad.

Late at night, Liu Chengzong set his brush back on the rack and prepared to blow out the oil lamp. But his movement paused. He rose, carried his folding chair, lifted the tent flap, and sat in the open space before the tent, gazing at the sky full of stars and sighing silently.

According to his estimates, the number of Han and Mongol surrendered troops under the Marshal's Office who lacked antibodies was around forty thousand. Even after the subsequent rounding up and recruitment of the routed Qinghai Mongol forces, this number would at most not exceed fifty thousand.

The composition was roughly twenty thousand surrendered troops from the old Ming army, twenty thousand surrendered Oirat troops, and ten thousand surrendered Chahar troops.

As for the vaccines stockpiled by the Marshal's Office, according to Yang Yao's report, those west of the lake were likely all ruined. The Hehuang Pox Farm had three hundred doses in reserve, of which perhaps half should still be viable for inoculation.

That meant one hundred and fifty doses.

Yang Yao had given him a complete report in Hehuang: the manufactured smallpox vaccine could not be stored long-term. Under normal conditions, the vaccine matter was wrapped in paper and stored inside bamboo tubes, kept dry at room temperature in a sealed environment.

After drying, the storage time was roughly twenty to forty days.

This duration depended on the external temperature. In summer, it could only be stored for twenty days. In the cold of winter, the vaccine still had over a fifty percent inoculation success rate after forty days of storage.

This was all the experience of past pox doctors.

By now, a full month had passed since the last inoculation before the war. The Marshal's Office's vaccine reserves were all on the verge of expiration.

The reason only three hundred doses were kept was on the advice of Xining Prefecture. The annual births in the Hehuang mountain regions were impossible to count, while the annual births in the Hehuang Valley fluctuated between ten thousand and thirty thousand.

If the previous year was peaceful, more children were born the following year; if the previous year was turbulent, fewer were born. In recent years, births had hovered just above ten thousand.

However, this number did not represent the Marshal's Office's population growth. Since the Marshal's Office had taken control of Hehuang, the newborn population had been very low, while the annual death toll had basically remained fixed above ten thousand.

This year, because of war and smallpox, it was foreseeable that the death toll would exceed twenty thousand.

In truth, without the population increase brought by surrendered troops and annexed territory, the Marshal's Office actually experienced negative population growth every year.

In the matter of vaccination, however, there was no need to account for the population decrease caused by old age and disease.

Newborns were inoculated between the ages of one and three. Three hundred doses of vaccine could meet temporary needs. As long as there were children to inoculate, the Pox Farm could continue producing vaccine, forming a virtuous cycle to supply the people's needs.

But there was a flaw in this plan, overlooked by Xining Prefecture. West of Xining Prefecture, inoculation had been completed before the war. East of Xining Prefecture, it had been completed during the great Hehuang campaign.

As a result, the number of newborns requiring inoculation was far fewer than the Marshal's Office had anticipated.

This meant their stockpiled vaccine was almost entirely wasted. Under the best possible conditions, one hundred and fifty doses of the remaining vaccine could still be effective. If storage conditions were poor, perhaps only thirty doses would work.

Liu Chengzong was not overly concerned about the small quantity of vaccine. In the past, the Great Ming had been the only country in the world with the ability to prevent smallpox.

Now, the Marshal's Office stood on the shoulders of the Ming, implementing universal inoculation for the entire population in the form of a state regime. They were the people with the most authority to speak on the smallpox vaccine.

Yang Yao, at the Hehuang Pox Farm, had already completed the design and manufacture of a safe vaccine strain. Even if only a single dose of vaccine remained effective, it would allow the Marshal's Office to continuously produce new, safe vaccine.

Although the vaccine stockpiling had not been done perfectly, the problem was minor. Liu Chengzong could identify the gaps and fill them.

With a single effective dose, the cycle of smallpox infection in people lasted one and a half months, of which the period of pox eruption, contagion, and isolation was half a month. After three generations of attenuation through humans, cattle, and monkeys, it would take at most five months to cultivate a vaccine even safer than the previous one.

Even if not a single dose was effective, within seven months, the Marshal's Office could still cultivate the relatively safest possible vaccine.

Therefore, smallpox was not a life-or-death crisis for the Marshal's Office, but a test of grain, fodder, supplies, and organizational capability.

The greatest pressure this crisis brought to Lion Liu remained the surrendered troops. Thirty thousand surrendered Mongol troops from the Dzungar, Khoshut, and Chahar could not be disbanded to return to farming or herding because they carried smallpox.

The Marshal's Office would have to bear the burden of their grain and fodder during the inoculation period, which would bring an additional consumption of eighty thousand to one hundred sixty thousand shi of grain and fodder.

This nearly doubled the Marshal's Office's expenditure on military rations.

For Liu Chengzong, in this world, aside from grain, there was nothing else that could cause him worry.

Risking one's life to send others to their deaths was the simplest thing. On the contrary, wanting to keep people alive was far too difficult.

In preparing for this war with the Oirat, Xining Prefecture had prepared only this much grain and fodder.

Pulling the entire army back to the lakeside could save a little, but not much. Their transport attrition for supplies had never been very large to begin with.

Fortunately, the harvest in the Hehuang Valley this year was not bad. If the yields from the Five Garrisons' farm estates came in without mishap, the seven hundred twenty thousand mu of farmland might harvest or purchase three hundred thousand shi of raw grain. After processing, that would yield roughly two hundred thousand shi of finished grain.

They could only take it one step at a time.

Just as Lion Liu was about to return to his tent to sleep, the sound of hoofbeats came from outside the camp. Not long after, returning outpost riders brought a messenger and letters sent from Xining Prefecture.

Two reply letters from his father, Liu Xiangyu, had arrived.

The impact Liu Xiangyu had on this war was a refreshing revelation to Liu Chengzong as he sat before his desk, and it also greatly astonished him.

In his impression, the peasant uprisings at the end of the Ming had indeed surged like wind and waves in the early stages, gradually reaching a climax, only to suddenly come to an abrupt halt and sink into a low ebb.

During this period, nearly all the peasant armies either were defeated and killed, withdrew into the mountains and forests, or surrendered and accepted amnesty, until their banners fell silent.

In the past, Liu Chengzong had never considered the reason for this phenomenon, simply assuming that after a few years of chaos, the court had gradually adapted to the situation of the rebel armies and freed up its hands to suppress them.

Now, the viewpoint his father raised was entirely novel to him. The destruction of the Eastern Mongols had removed the external threat from the three border garrisons of Shaanxi, thereby strengthening the court's ability to suppress internal unrest.

Following his father's line of thought, mobilizing the Gansu border troops to break into the Tianshan Mountains became critically important.

This news undoubtedly invigorated Liu Chengzong. The Tianshan Mountains, the Oirat, the Gansu border troops, the merchant caravans, the Three Tribulations Society, Liu Chengzu, and the Western Regions — it was as if iron rings were being linked one by one, ultimately pointing toward Gansu and Lanzhou.

Once the Gansu border troops were mobilized and Lanzhou's supplies were cut off, the isolated Gansu officials, facing the pressure of the Marshal's Office and the threat of severed provisions, would fight back desperately. But without grain and pay, they would only receive limited support from the army.

This meant that once the plan to break into the Tianshan Mountains became a trend, Gansu would be riddled with holes, easily breached by the Marshal's Manor, and they would harvest Wuwei's Liangzhou Garrison and Zhangye's Ganzhou Garrison.

These two places were Gansu's traditional grain-producing regions, and they lay along the Great Wall.

By relieving local population pressure through the Tianshan breakout, and with no worthy opponents in the great desert beyond the border wall, this meant that after the Marshal's Manor took Gansu, it could be self-sufficient.

Liu Chengzong grew more and more excited as he thought. He trimmed the oil lamp and drew three dots on the white paper, linking Gansu, Lanzhou, and Xining into a triangle as the Marshal's Manor's grain-producing region. Their next strategic direction then became obvious — Ningxia.

To the north, they could advance along the first border wall toward Ningxia; to the south, they could descend directly on Lintao and Gongchang, deploying troops along the Fengxiang-Guyuan line.

On one front, they could thrust toward the Ordos, cutting off the Jin Kingdom's encroachment on the Mongol steppe; on the other, they could threaten Hanzhong and Xi'an.

Most importantly, once this strategy was completed, their rear would be a stable northwest, and wherever the blade pointed, the Grand Marshal would return to his loyal Yan'an Prefecture!

At this thought, Liu Chengzong swept away the worried look he had worn earlier over next year's insufficient provisions. His face full of vigor, he returned to the present and picked up his brush to draft the Marshal's Manor Imperial Medical Academy's plan for managing the smallpox vaccine.

The biggest problem with the smallpox vaccine at present was that it could not be stored long-term. Liu Chengzong could foresee that in the future, whether taking Gansu, advancing on Lanzhou, or even during the eastward thrust of their forces, they would experience many more situations like this.

If they could produce thirty thousand doses of smallpox vaccine at such a time, it would mean saving a hundred thousand dan of provisions and fodder.

Compared to that much grain and fodder, stockpiling tens of thousands of small bamboo tubes — what kind of big deal was that?

Yang Yao's thinking was constrained by traditional smallpox doctors. Traditional smallpox doctors were very skilled, but the Marshal's Manor operated with nearly a state-wide system, and the power it could wield was absolutely beyond what ordinary smallpox doctors could match.

First, he expanded the scale of the smallpox villages from the two in Haixi and Hehuang to establish medical schools in nine locations: Haixi, Haibei, Xincheng, Xining, Pingrong, Laoya, Jiashun, Binggou, and Dongguan.

In any case, with the establishment of the Imperial Medical Academy, medical schools were going to be set up in all these places anyway, so he would simply merge the smallpox villages into the medical schools, ensuring every county, city, and town had a smallpox village. Since the medical schools' eleven departments already included a smallpox and rash department, this was not a waste.

Summer smallpox vaccine did not store well, while winter vaccine could be stored for forty days. It was obvious, then, that the smallpox virus was cold-resistant but not heat-resistant — so they would simply place the vaccine storage in ice cellars.

Therefore, an ice cellar would be dug beneath every medical school. It did not need to take up much space, nor require much ice; it only had to ensure it could store three thousand bamboo tubes of smallpox vaccine.

Liu Chengzong estimated that this method could extend the vaccine's storage time to forty days or even longer in the summer.

Each month, smallpox doctors would rotate and replace the vaccine. They did not need much — if there were newborns needing inoculation, they would inoculate them and use their smallpox scabs to make new vaccine.

If there were not that many children to inoculate, they would find a few cows that had never had smallpox, inoculate them, use their scabs to make new vaccine, and discard the old stock.

Under normal circumstances, each smallpox village did not need to keep three thousand doses of vaccine on hand; a standing reserve of three hundred doses per village would suffice. On the eve of war preparations, within two months, they would carry out large-scale production according to the scale of the war, filling the storage to capacity. This would ensure the Marshal's Manor had over twenty thousand doses of smallpox vaccine available.

Even if they fought another great war, the number of surrendered troops would only be so large. Liu Chengzong had long since discovered the paradox of warfare in this era.

Liu Chengzong had never seen an opponent who placed more importance on or was more capable of preparing provisions for an army than he was. A lack of provisions was almost a common affliction of armies in this era.

He pondered it over and over. In all his hurried campaigns to this day, besides himself, the enemy with the highest ratio of soldiers to carried provisions he had encountered was probably Bai Yingzi.

That was the crippled bandit chief who, on the road home from Yuhe Fort, had been shot dead by Liu Shizi after looting an earthen stronghold.

Fewer than two hundred bandit soldiers had hauled over three hundred dan of grain — on average, each soldier carried two hundred jin of grain. In the several years since, Liu Chengzong had never again seen a ratio that high.

In his view, if he wanted to see an enemy with provisions reserves surpassing Bai Yingzi's, he would probably have to go to the vicinity of the capital to find them.

Because in this era, only the central imperial court had the ability to stockpile several months' worth of provisions for an army.

Apart from that, even if a single Regional Commander had the ability to lead an army of thirty thousand, he could only scrimp on rations and ultimately march to war with enough provisions to feed three to five thousand men for one month.

Moreover, future wars might not necessarily be like this one, with luck so foul that smallpox and war arrived together.

Normally, they would only need to inoculate surrendered troops and the people on newly conquered lands. As long as smallpox did not break out on a large scale, stretching the timeline to a few months would not matter — there would be ample time to prepare the vaccine.

With his meeting preparations done, Liu Shizi blew out the lamp with peace of mind. Only then did he lie down on the couch, watching the white light of dawn seep through the bed curtain. With the thought of returning to Xining to fully establish the Six Ministries, he sank into a deep sleep.

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Good evening!