Influenza and the Circumstances of a Certain Pharmacy
It was high noon of the day. A father was carrying a young girl on his back, and was knocking at the gate of a certain physician within the San Fleuve Imperial capital.
“Please examine her! Doctor Donald! Please examine her!”
However the gate of the physician was firmly shut, the silence reverberating inside the clinic.
“I ask of you please! My child has a high fever! This is strange, she’s becoming limp, this is strange!”
The voice of the father that was screaming frantically could be heard echoing throughout the street. Although he had a pitiful expression, passersby just turned a blind eye and went on their way as nobody wanted to be involved.
“The clinic of Doctor Donald is on a holiday until next week.”
A calm boy’s voice was heard from behind the father. Behind the man called Pierre, was a boy who was holding a pouch from a bakery on his way home.
When Pierre saw the boy, he trembled. He was not a simple boy.
Although the boy wore a black coat, within it he was wearing a white doctor’s gown with a stand-up collar, while a golden badge with a crown symbol was affixed onto it. It was none other than the official proof of being a part of the Royal Court Apothecary. The child shop owner of the Diversis Mundi Pharmacy, seemed like he just finished shopping and was going back to the shop. It was a pouch from a popular bakery.
Damn, of all the things, a troublesome person had appeared. As Pierre steps back.
“Is your child okay?”
The child shop owner worryingly approached and talked to him.
Third Class Apothecaries and similar of this world would rub their hands as they got closer to examine a patient and would advise expensive medicines, but this boy, he sincerely looked worried. Is he a soliciting a business?, Pierre was vigilant.
“Weー well… You see…”
As for the father, Pierre, he was an apothecary and a member of the Apothecary Guild of the San Fleuve Empire. For her daughter who was having a high fever, he had used expensive medicinal herb and ointment from the guild, but it wasn’t effective, because she wasn’t responding anymore. As her state was deteriorating and her consciousness was becoming hazy, he decided to depend on a physician.
I wonder if the boy is aware that I’m an apothecary from the Apothecary Guild, the father suspects. The Apothecary Guild had been openly hostile to the Diversis Mundi Pharmacy, as the Guildmaster notified all members to stay away from the Diversis Mundi Pharmacy. Also, he heard that it was the Apothecary Guildmaster Veron’s plan to crash two wagons into the pharmacy, which caused the pharmacy to close for two days. Pierre thought it was unfortunate when he heard it and felt sympathy.
However, he cannot disobey the policy of the Apothecary Guild. If one’s membership was revoked, their business permit will be confiscated on that same day.
Therefore, being spoken by the child shopkeeper of Diversis Mundi Pharmacy, would be trouble as it would be seen by the surroundings as being close.
“Let me examine your child. I am the apothecary of the Diversis Mundi Pharmacy, Falma.”
He opened his coat, and showed his name tag. Although it was natural for pharmacist in Japan to wear their name tags, it was not common for this world. It’s probably pride in his work, Pierre guessed.
The child shop owner said to follow him back to the pharmacy, but Pierre was reluctant.
“What’s wrong? Your child, seems to be really ill.”
Her face was flushed red, it was clear to everyone she was completely limp.
He couldn’t become indebted to the Diversis Mundi Pharmacy, but where could he consult a physician? He was going to refuse the offer, but Falma strongly persuaded him to better hurry and so he put on his hat and lowered it to cover his eyes so as not to be identified by the pedestrians as he followed the child shop owner, Falma.
Diversis Mundi Pharmacy closes its gates during lunch break, the shop’s front sign being made of splendid stone. The golden emblem of the Royal Charter that was newly installed was dazzling. Probably because they encountered a surprise attack, there were three Knight Guards in plain clothes. It was a world of difference compared to the father’s dirty and sooty wooden pharmacy.
However, Falma didn’t enter the main gate, as he walked towards the alleyway to the back entrance.
“Please come in over here.”
Ah, a person who looked poor shouldn’t enter a splendid noble’s shop from the main gate, Pierre was ashamed. Upon entering the back entrance, there was a spiral staircase to the second floor. Beds were lined up upon entering the examination room, and Pierre was instructed to lay her on the bed.
“Let us begin the medical examination. First of all, the father should wear this.”
Pierre was handed a mask. To him, he didn’t understand what the meaning of covering the mouth and nose was. However, it was a tradition to abide by the person’s instructions who was conducting the examination.
“We entered the back entrance so as to prevent spreading the disease to other people.”
Falma explained. It seemed it was not because of social status or personal appearance.
Falma’s white doctor’s gown was now visible when he took off his black coat, and he brought out his note. It was a patient’s chart. The name of the child, age, medical history, when was the last time she ate, since when has she had her fever, and so forth were asked in detail. The examination ended with the father questioning the reason behind knowing such trivial matters. Pierre was impressed at the collected article of accurate information.
Falma politely told Pierre to place the little girl on the carrier at the corner of the examination room. When the little girl was placed on the box-type carrier, something like a scale attached on the side of the box moved. The shop owner was reading it.
“What are you doing?”
“I’m measuring the weight.”
Isn’t weight measured in a scale balance, Pierre was surprised.
“This is called a spring balance. The spring is stretched directly proportional to the weight of the load (Hooke’s Law). By converting the extension of the spring to the length of the lever, you can measure the weight by reading the length. The reason why I measure the weight, is to decide how much medicine to administer.”
Falma explained fluently while smoothly recording the data. Pierre couldn’t believe the child’s explanation. Although there was slight anxiety regarding medicine prescribed by a child apothecary, even more so when that child received special education from the nobles, nevertheless that child might be a dependable apothecary in the neighborhood, so Pierre resolved himself.
“Thiー this instrument, did you invent it?”
As a Third Class Apothecary, Pierre was ashamed for being ignorant. He seemed to have realized the difference of education level between a Third Class Apothecary and a Royal Court Apothecary. It was a convention among Third Class Apothecary to roughly calculate children’s medicine to about half for an adult. However,
“I made this instrument, but it is not me who invented it, the design was given to the Imperial Technology Bureau and anyone can read it.”
Falma was smiling. Falma wrote the blueprint that was on the Imperial Technology Bureau, but the design of the weighing scale was not made by Falma. He paid respect to the original inventor from Earth. “Well then, I shall start examining.”
Falma quickly performed tapping, visual examination, palpation, and finally placed his fingers on his left eye. While staring at the daughter, he mumbled and started to chant something. Meanwhile, Pierre can see that Falma’s eye glowed in bluish white color, it also seemed to have changed slightly. He knew that noble apothecaries use Divine Arts. But observing the boy using Divine Art for the first time, or was it really Divine Art? Either way, Pierre felt deeply impressed.
Apparently, diagnosis was done in few tens of seconds.
“It’s a severe cold.”
Falma declared. However, Pierre disagrees. Pierre’s judgement was that is was not a mere cold.
“Her fever is too high, it does not go down at all! Is that a cold!? She froths from the mouth, and has spasms! Don’t you think she’s possessed by an evil spirit!?”
When asked to keep talking, Falma said “I wonder if there is a name?” in befuddlement.
“Ah, right, let’s try that.”
It seemed like he decided an appropriate name for the disease.
“Shall we give it a special name? How about Grippe (old fashioned term for influenza).”
It was a name Pierre hadn’t heard before. In this world, common cold and influenza are just called “cold” in the same way, since they can’t distinguish between them. Is that a new name for the disease?, Pierre swallowed his doubt.
Falma went to the compounding room on the first floor, and brought with him the compounded medicine.
“I will explain the treatment plan and the medicine.”
He began to explain with an earnest look.
Pierre involuntarily straightened back. His daughter’s whole body was being affected by a microbe which caused the severe cold, so her body increased the internal temperature to fight off and kill the microbes. The cure for Grippe is Laninamivir. The medicine will still work after full day when the symptoms appeared, by taking this first, he thought it was possible to reduce the time for the fever to stay when the medicine would be effective, is what he told Pierre.
“The powdered medicine is breathed in from the mouth? Why isn’t there a medicine that can be administered through drinking?”
As for this too, was a medication delivery method that he hadn’t heard of. As for this world’s medicines, there was only two choices to administer, either by applying it directly to the affected part, or by drinking it.
“This medicine will not be absorbed by the body when drank. By inhaling this, it will stick to the mucous membrane of the respiratory tract, then it will be absorbed.”
Falma said that the medicine will help the daughter’s body in fighting the microbe inside. It was an anti-viral drug that can also be used on infants, as it has an effect of preventing the cells infected by Influenza virus to be spread outside the body.
“Let’s practice the inhalation. A 10 year old child or younger can do it, but it will be slightly difficult.”
Falma told the method for the daughter to take it, and after having practiced several times, the powdered medicine was inhaled.
“I think it went well. Next item. It’s not a bad thing for the fever to surface, when the fever continues to rise, stamina is exhausted. As for that, this medicine will lower the fever a bit. Although it may not drop that much, let the body rest since the high fever will continue for a while. That is all.”
The child shop owner instructed the father without any hesitation.
“Please show your daughter’s buttocks and face it towards me. Sideway facing is good enough.”
“What? wha, huh!?”
The father’s jaw almost fell off.
In this world, it was common to perform a prayer as a folk remedy for the disease. During that time, they sometimes assume a strange pose, however, however. Although the father was young, he had a cute seven year old daughter. Even if it was a doctor, showing someone’s buttocks to an opposite sex was nothing but an insult.
“How can you suggest that! Is that really a method to cure!?”
Suffering with fever painfully, the daughter’s consciousness was faint. The gaze of the boy overlooking the daughter, only shows sympathy towards her. Any wicked intention couldn’t be seen.
“I will administer the medicine to lower the fever through her anus. Because she is barely conscious, there is an oral medicine but I have provided a suppository. It would be best if the father administer it, but there is a trick to do it.”
The suppository was Acetaminophen. Since she was only seven years old, he made the dosage smaller to be greatly effective. He also thought it would be a bit more comfortable for her.
“What kind of treatment is that!? I’ve never heard of it! Is it really no use to administer it through the mouth?”
This outrageous medical treatment would soil the chastity of his daughter.
As Pierre began to regret letting Falma examined his daughter,
“The medicines enter the blood vessels immediately because it will be absorbed by the mucous membrane. It’s fine if I give her the medicine through her mouth, but it will cause dizziness and make her unconscious.”
The explanation of the child shop owner was logical, and it seems he was not joking about it.
“Hmm… is that so.”
When Pierre showed his daughter’s buttocks reluctantly, the child shop owner quickly inserted a small medicine to her anus.
The daughter leaked out her voice as she was surprised at the feeling of a foreign substance.
“Aah… What else do I have to say to her. My daughter won’t be able to get a groom anymore…”
He laid the daughter to rest quietly for a while in the bed. And then, the daughter began to breathe like a sleeping person.
In the meantime, Falma poured a liquid into a feeding cup and came over.
“During a fever, large amounts of sweat will come out. This drink will soothe a parched body, please let her drink later.”
It was an oral rehydration solution made with clean filtered water. Falma still uses water made from Divine Art in limited situations when it comes to medication. He used ordinary water which was filtered and distilled. Because the potency of the medicine increases with water created through Divine Art, there was a risk for unknown side effects to occur.
“Well then, I still have business in the pharmacy. If something happens, please don’t hesitate to call me with that.”
The shop owner showed the doorbell and left the room.
Soon after, the daughter’s fever began to fall. And then, with some comfort, she began to respond to her father’s call.
“For it to be effective immediately…”
The medicine that was inserted to the buttocks seemed to have lowered the fever.
Throughout the day, the child shopkeeper even came to check on them for several times.
And he served Pierre and his daughter with food and water, he gently cheered up the daughter as he returns back to the shop downstairs. In the evening, the shop owner came with a medicine bag in tow.
“I think it’s okay now to nurse her in your home. If by chance, her condition suddenly changes, do tell the gatekeepers posted for night duty for I think it’s best they bring you to my house, I will certainly respond to your call even if it’s the dead of the night. Accept this antipyretic, please use it as needed.”
Pierre was worried that they would be abandoned because it was already evening and the store was about to close. Hospitals or pharmacies usually doesn’t accept medical examination during evenings.
It was the reason that there were many commoners who died during evenings. For Pierre, it was an unbelievable quality service.
“Thank you very much, how much do I owe you? Also, if I can’t afford it, I will borrow from my relatives.”
Because they accepted proper treatment, he wanted to ask how much it would cost. Pierre believed that the sales of his pharmacy dropped sharply was because his customers were stolen by Diversis Mundi Pharmacy, he may not be able to afford the medical cost due to running out of money.
“One bread will be enough for me.”
“That’s, that’s too cheap!”
After paying, he asked if this was really okay, the child shop owner just nods.
“Rates for children are cheaper compared to adults.”
At first children are free of charge, but the Empress said to just charge a little for the medical examination and cost of medicine.
“Hope she gets well soon.”
The shop owner said some pleasantries as he saw them off.
The medicine was effective, the shop owner was humble, and the shop was clean.
“Ah… No wonder my customers were stolen.”
“Oh don’t mind it, thank you for all of your help.”
Pierre reflected upon this taste of defeat.
Rather, he felt refreshed with this recent experience.
Pierre left the pharmacy carrying his daughter on his back and disappeared into the crowd.
One week later, at the headquarters of San Fleuve Apothecary Guild, dozens of apothecary representatives were gathered in the conference room as the monthly assembly was being held.
“All of the stores experienced a sharp drop in sales across the board?”
The guild leader Veron, who was inquiring about the slump in performance of the guild affiliated stores, was not amused.
“It is the fault of the pharmacy that was off-limits.”
“That’s annoying! It may just be a hobby of a noble, but it’s really getting on my nerves.”
Diversis Mundi Pharmacy. At first they assumed that the off limits noble’s pharmacy with an eccentric name would go out of business immediately when it was founded. So the Apothecary Guild took a stance of wait-and-see. However, what they came to realize was that the opponent was very tough, as it transformed into an unprecedented threat.
Although it was a noble’s shop that was formally called a Royal Chartered shop, the pharmacy had no shortage of customers that were commoners. In addition, there were queues of people waiting outside the shop for their prescription. They don’t complain either, as they just chat while waiting in line. There was an awning outside the shop, with chairs for the patients, all lined up. They were served with water and candies while they waited.
In less than half a year, the second shop that specialized and cosmetics and skin care, Medique, was made public. It was said that a third shop that specializes in dental care would open soon.
The most humiliating thing about it was that Vernon’s wife bought whitening cosmetics from Medique in secret. Recently, her white skin was always pointed out and praised. He smashed it all and threw it away.
“The re-opening of the business was strangely quick.”
“I wonder if it has to do something with the financial power of the Archduke. Since that pharmacy is backed by the famous Royal Court Apothecary.
“The Empress too. Ever since that incident, Imperial Guards were patrolling that area every day.”
It was said that it only took two days to recover from near total destruction. Because the wagon that crashed the shop was extremely contaminated, they estimated it would at least take the pharmacy out of commission for a month, it seemed that estimate was too optimistic. Of course, it was Veron who hired people of the underground organization to crash the wagon.
Whether you knew it or not, Vernon’s pharmacy had received a three week business suspension as pinpointed by an imperial edict. It was because it was exposed that his pharmacy was selling medicine containing lead that was prohibited. Not only that, from some reason the Church often comes to do spot inspection, the Head Priest of the Diocese of the Imperial Capital can be seen frequently in and out of Diversis Mundi Pharmacy. With these, he can’t touch that pharmacy anymore.
In any case, when Diversis Mundi Pharmacy was established, the sales of the shops affiliated with the Apothecary Guild suddenly dropped.
40% of their customers were taken. Their regular customers also went to Diversis Mundi Pharmacy.
In addition, products that contains mercury or lead were prohibited by the Empire through an Imperial Edict, so they can’t deal with some medicines containing those anymore.
“Her Majesty must have been brainwashed by that pharmacy.”
Veron bitterly said so. The other members also agreed.
“What do you think, Mr. Pierre of Apricum per Foliis Pharmacy.”
Among the apothecaries who were bad-mouthing Diversis Mundi Pharmacy, he asked the poor apothecary, Pierre, who just sitting on his seat and kept silent, for his opinion. Pierre’s shop was the first one to suffer from decreased sales because it was the closest to Diversis Mundi Pharmacy.
Since Pierre was silent the entire time, it naturally attracted attention.
“What is your opinion? Isn’t your store the one that got heavily affected by this?”
Pierre was suddenly cut-off.
“Who among us apothecaries have ever entered Diversis Mundi Pharmacy?”
“I won’t even dare to go there since that is business competitor.”
The apothecaries snickered.
“You should at least go and see it once. It almost looked like a sanctuary.”
Pierre stood up vigorously from his seat.
“Once you visit that place, you will understand the feelings of the customer as to why they won’t come to our shop anymore.”
“Don’t tell me, Pierre… Did you go to that pharmacy?”
A directive had been issued that they shouldn’t go near that place. Breaking that directive was going against the guild’s policy… The assembly hall was in uproar.
“Yes, I admit I went there. I went to that shop.”
Pierre said passionately.
How good was the treatment provided by the shop owner of Diversis Mundi Pharmacy? Lets just say that after Pierre’s daughter recovered, he made up his mind to revisit the pharmacy. He looked at all the items that was sold in the shop, and bought numerous candies. He listened to stories directly from the patients who visited the pharmacy. The child shop owner said hello and asked “Did your daughter recover?”, and they chatted for a while.
The more Pierre learned about the shop, the more he felt that this pharmacy shouldn’t be ostracized and all pharmacies should become like this one. He thought that it won’t be profitable because the medicines were cheap, but due to the sheer amount of customers that came, it made a profit. The apothecaries should humble themselves and insist on letting the pharmacy teach them the medical treatments and medicines sold there.
“On the contrary, just look at us. We can’t even diagnose properly, we don’t know proper treatment, we don’t even offer words of consolation, even if we didn’t know if the medicinal herb we sold could heal a patient. Deceiving people to sell at expensive prices is already akin to fraud.”
“What did you say?”
“Although we have healed some, it was just a fluke. We have left many people dead. Because we can’t use Divine Arts, we are only forced to sell common medicines, and it’s only a poison that worsen the symptoms if it wasn’t made properly.”
Pierre raised his voice.
“Everything in that pharmacy is totally different from our own! Reasonable, advanced, and really serious to the patient’s well-being.”
“Arghー, that’s enough. I understand what you want to say, leave the guild immediately.”
Veron told him in a mean-spirited manner. Pierre was expelled from the guild headquarters.
On that same day, the business permit of Pierre’s pharmacy was taken away, his medicinal herbs and medicine was confiscated by the guild, and his business ruined. A dilapidated shop, Pierre sat down in front of it in an utter daze crying manly tears. At that place, a boy in black coat and a girl with pink hair, who was holding a bag of bread passed by.
“Ehehe, I bought lots of raisin bread, Master Falma!”
“Each person will have three piece, then I have one promise to do for that patient.”
“Understood! Each person will have three pieces.”
It was the owner and an employee of Diversis Mundi Pharmacy who passed by. Both of them were going back joyfully from shopping on a popular bakery.
“Oh? What happened to you?”
Falma noticed Pierre, who came to his pharmacy a few days ago, slumped on the ground, and called him out gently. He noticed immediately that the business permit from the Apothecary Guild was missing. Falma guessed that the business can’t continue without the permit from looking at the ruined store. He also thought about the possibility that the cause might be because Pierre received treatment from Diversis Mundi Pharmacy.
Pierre was a coward who even hated being pitied upon, and was unable to face Falma.
“Without a permit, I am unable to do business. Will you listen to my circumstances?”
Pierre told him in summary what had happened in the Apothecary Guild. About how he told the other apothecaries regarding the new medicines sold in Diversis Mundi Pharmacy and how much good it would be to learn new treatment methods.
“Is that so…”
“I will move to another country and work as an unlicensed apothecary.”
It was almost the only road left for him. Still, the type of medicine he can sell will be limited.
“Can you open your business if you entered another guild?”
“But, only those in the Apothecary Guild can sell medicine. If I can’t join there, there’s no guild that I can join anymore.”
And Pierre drooped his shoulder. As if waiting for his words, Falma did a cheerful proposal.
“A few days ago, a pharmacy guild that manages new medicines was established.”
He got permission from the Empress to establish a guild. In cooperation with Diversis Mundi Pharmacy, they will train people on the formulation, and be able to open a store. Would you like to join the Pharmacy Guild that manages new medicine and not the Apothecary Guild?, is what Falma proposed to Pierre.
“Does it need an expensive membership fee?”
“It’s free of charge. You are also free to leave anytime you want.”
“Will it also require several years of internship?”
“You will be trained for 2 months, you will be able to see the formulation and a manual will be given afterwards. As for the other things, there will be regular classes so you will have to attend, and I will be periodically visiting around the shops to offer guidance.”
Formulation of modern medicine was difficult, and it’s dangerous to immediately dabble in chemistry and pharmacology without the other world pharmacist.
However, even if they aren’t a pharmacist, they can still sell it, in Japan it’s the equivalent to OTC medicines (over-the-counter medicines), a registered seller like a convenience store can even sell it. If they have mastered how to use it properly, each pharmacy that was helped with the otherworld system would be able to stand on their own. Even then, the potency of the medicine would be far higher than those in the Apothecary Guild. Also, it can be cheaply stocked.
Pierre can’t believed what he heard as his shoulder trembled.
“Yes, you can do business if you receive protection.”
“I, I, I will look forward working with you…!”
It was at that moment that the first member of the Pharmacy Guild increased by one.