The Apothecary Diaries - Volume 15 - Chapter 4

Chapter 4: Drug Trials

At Luomen's direction, Maomao and the others began commuting to the clinic on the edge of town. Still, the four of them weren't enough to keep the place constantly staffed. The clinic already had nurses of its own, and it was much more efficient to make medicine at the medical offices in the palace.

"I'd like to suggest we work in pairs," said Tall Senior, summing up the situation. "At the clinic, we'll make records and look after the patients, while at court we'll continue to make medicine like always." It was nice to have somebody taking charge.

"How are we going to pair off?" asked one of the other physicians.

"I think for starters, the oldest of us should split up."

That makes sense.

The two older doctors knew what they were doing, so they would be able to keep their younger colleagues from getting into any real trouble.

"First, Maomao and me," said Short Senior, so that's who Maomao was paired with. They decided to have the junior and senior colleagues work as pairs, occasionally trading off. "Good to work with you," the doctor said.

"And you," Maomao replied politely. Short Senior didn't talk as much as Tall Senior, but it was clear that he was very capable. He was somewhere in his early thirties, and probably knew a bit more than Tall Senior, who was roughly his same age. He was a careful worker, fastidious in the way he made medicine. His nimble hands suggested he was probably also an excellent surgeon.

So he could have been in surgery ...

The fact that he was nonetheless doing apothecary's work suggested that he loved drugs just like Maomao did.

Short Senior's small stature and average looks made her think of a certain abacus-brain (who shall remain nameless), but this man was far more mature.

"All right, shall we go?" Short Senior said.

"Yes, sir."

Since they would have to bring cargo with them, a carriage would be provided for trips from the court to the clinic. It wasn't that they couldn't possibly walk, but they would have to cut through the shopping district on the way, and it was all too likely that they would encounter a pickpocket. Soldiers might travel through unharassed, but a couple of well-dressed civil officials? They'd look like marks all the way.

Maomao and Short Senior arrived at the clinic and replenished the medicine with the supplies they had brought.

"Should we go straight into checking on the patients?" Maomao asked. She'd brought a tie for her sleeves so they wouldn't get in her way. Now she rolled them up and tied them back so she could move freely.

"No, I think we should start by checking the records," said Short Senior, grabbing the book where the notes were kept.

Maomao simply had to look on. She suspected they used paper and not wood strips because of the sheer quantity of writing. But she noticed to her dismay that the paper wasn't of very good quality.

They should get in touch with the quack doctor, have him sell them some at a decent price!

The quack's family made paper for a living, so Maomao occasionally went to him for a friends-and-family rate on quality material.

The book didn't record the patients' names, but it did include their age and physical size as well as their occupation and other details.

"Looks like there used to be a lot more patients than there are now," Maomao observed. The drug trials appeared to have started about a month prior with around thirty people. Now only a third of them were left. She'd wondered why the clinic seemed so large for the number of patients, and this explained it.

"Sounds like some people were faking," Short Senior said.

"I can see why."

Yes, the physicians were developing drugs, but they were offering free treatment, food, and so on. Who could blame a few people for showing up claiming to have the condition the doctors were looking for?

"A few other people left because the medicine couldn't help them," Short Senior went on.

"Right." If the physicians decided the drugs weren't going to cure you, they would ask you to leave.

"What condition do you think it is?" Short Senior asked.

"Typhlitis, maybe?" Maomao suggested.

"I think so too."

No specific name of an illness was written down in the book of notes-after all, they'd only assembled patients showing similar tendencies; they couldn't be certain what disease each had.

"Typhlitis ... "

Maomao had dispensed medicine for this condition more than once. On most of those occasions, she'd given out drugs much like the ones being administered to the patients here.

Typhlitis, huh ...

Maomao made a thoughtful noise. The condition involved the inflammation of an organ called the cecum. It was possible to relieve the symptoms with medicine, but that was all they were doing-treating symptoms. Some people got better, if their symptoms were mild, but in more severe cases the inflamed area could fester and spread toxins through the body. In such cases, it could spawn other illnesses, and mortality rates went up. She'd heard that more than half of people in that situation died.

It was a decent idea to study the treatment of typhlitis, because it wasn't particularly uncommon. She wondered, however, why they were using court physicians to conduct such large-scale drug trials.

And there were two other groups too.

Were they also researching the treatment of typhlitis?

Those thoughts led to a natural question.

Who are these experiments being done for?

Maomao knew that it was not a question she could ask, however much she might want to.

"Whatever disease it is, I suppose we should get to work," said Short Senior.

"Right." For the moment, getting down to business would be better than pursuing questions she wouldn't get an answer to.

First, she got an overall view of the situation: She went around checking on the patients.

They were divided into two large rooms, five in each-but this did not correspond to the groups receiving the real medicine and those getting the placebo.

That would be the wrong way to go about it.

It did mean, however, that she would have to be careful to make sure the right people got the right pills.

As for food, the patients got three meals a day-all congee, good for the digestion. The ingredients were finely chopped, and the porridge was thoroughly cooked. It didn't look like much, but the stock had been made from meat and bones to give it plenty of nutritional value.

If someone had stomach troubles, typhlitis or not, food that was easy to digest was the basic treatment.

Maomao went among the patients, organizing the information in her head. Then she and Short Senior moved to the kitchen so that the patients wouldn't overhear them.

"It does seem to be the case that the patients receiving the real medicine are in better shape," she said.

"Yeah. Inflammation's gone down for some of the ones in the placebo group, but not many."

"Probably the ones with the most physical vitality."

In an experiment like this, the more people you could get, the more precise your results would be. Testing on human subjects meant there would be differences from one individual to another, but increasing the number of subjects would help average out the numbers.

If Lahan were here, he would be adding them up already.

Which did not mean she was going to call him.

"Master Physician," she started.

"Yeah?" asked Short Senior, who was writing something. She was glad they were alone and she could get away with simply calling him "Master Physician." She could hardly ask his name at this late date.

"If a case of typhlitis doesn't get better with medicine, what exactly is the subsequent treatment?"

Whatever it was, Maomao, unfortunately, hadn't learned it. Her specialty was herbs and medicine, after all.

"You could open their stomach and take out the pus," Short Senior said.

"Would that solve the fundamental problem?"

"I'm not sure. Maybe not." Short Senior didn't sound like it much concerned him.

"Have you ever done that operation?" Maomao asked.

"Never. I doubt I could." Short Senior scratched the back of his neck with the barrel of the brush uneasily.

"Why not? You look like you would be good at surgery."

Maomao could see how well Short Senior used his hands. Even his handwriting was neat, although she didn't know if that made someone a better surgeon.

"No, I ... I couldn't. Can't."

"Can't?"

"It's ... blood. I can't stand ... blood." He sounded embarrassed.

"Ahhh." Maomao definitely understood that. Everyone had certain things they just didn't cope well with. That was life.

"I'm not actually cut out for doctoring," Short Senior said. He came, however, from a long line of physicians, and had been pushed to take the medical exam whether he wanted to or not. It would have been so easy for him if he'd failed, but other than his aversion to blood, he was really quite talented.

"Honestly? I'm in hell," he confessed. It was hard when you had the skill but not the aptitude for a vocation.

'You have my sympathies," was all Maomao could say.

So it was that they decided to divide the labor between them while they were there at the clinic with its experiments. Short Senior couldn't stand blood and Maomao couldn't stand buckwheat, so they would cover for each other's weaknesses. They were just giving the patients pills, so there wasn't likely to be blood involved, but then one time someone going to the bathroom had taken a bad step, tripped, and split his forehead open, so Maomao had been the one to treat him. Meanwhile, she left it to Short Senior to make the placebo pills.

Short Senior always looked like he really had it together; somehow, learning about his vulnerability like this made her feel closer to him than she had before.