Chapter 36: The Epidemic is Shared [1]
Smallpox.
A rare disease in the present day.
Yet, its terrifying nature meant every doctor had to study it.
Kang-hyuk was no exception.
“This is… unbelievable.”
It was his first time seeing it in person.
But there was no mistaking it.
Before him stood a patient with the exact symptoms depicted in medical textbooks.
Heo Jun muttered with an unprecedentedly somber expression.
“Smallpox… in the summer, no less…”
Since ancient times, epidemics were regarded as a form of calamity.
Something beyond human control.
Especially diseases like smallpox, with high mortality and strong infectiousness.
It was feared to such an extent that it was called “Mama (마마)” in reverence.
There were even shrines dedicated to the deity of smallpox.
‘What should I do? This seems impossible to treat.’
Even Kang-hyuk struggled to find an answer.
“Dolseok, Makbong, stand back.”
“Pardon?”
“It’s dangerous. Step back.”
“Oh, yes.”
Kang-hyuk stepped in to prevent Dolseok and Makbong from getting too close.
The most critical aspect of dealing with an infectious disease was preventing its spread.
‘I’m safe, but…’
Smallpox was classified as a first-degree legal infectious disease.
Though it hadn’t been seen since 1979 and the public no longer received vaccines, medical professionals like Kang-hyuk were vaccinated.
If he were to contract it, it could endanger countless others.
‘Good thing I listened to my friend in infectious diseases.’
He shuddered at the thought of almost refusing the vaccine due to the scar it left.
Otherwise, he would be as helpless as the patient before him.
Kang-hyuk rubbed the small scar on his left arm as he approached the patient.
The closer he got, the more horrifying the sight became.
The patient’s face was covered with pustules filled with yellow pus and vesicles.
‘I need to isolate them.’
Smallpox could spread even without direct contact.
Being in the same room was enough.
This meant that anyone who had brought the patient also needed to be quarantined.
They had probably been infected some time ago.
“Come with me.”
“Oh, yes.”
Kang-hyuk led them to a room used as a storage space.
“Wait here.”
“Yes, yes. When will the treatment begin?”
“For now… wait.”
“Yes, yes.”
The patient and their guardian obeyed Kang-hyuk without complaint.
In a small village, news of Kang-hyuk’s surgery earlier that day had already spread like wildfire.
Even his attire commanded respect.
Heo Jun, who had been watching Kang-hyuk, stepped forward urgently.
“Sir Baek, it’s smallpox… what do we do?”
“I don’t know.”
That was the honest truth.
If it were a disease that could be resolved by surgery, it would be easier.
At least then, Kang-hyuk could attempt something.
But this wasn’t that kind of disease.
‘Judging by their appearance, they were probably farmers…’
In the worst case, they could have been working together.
It was the season when weeds grew wildly, and every hand was needed.
An entire village could disappear overnight.
‘No, it wouldn’t just be this village.’
If it spread into Suwon, it would be the start of a catastrophe.
Kang-hyuk looked at the storeroom where the patient was quarantined with a grim expression.
Memories from his school days flooded back.
‘A mortality rate of around 30%. Hemorrhagic smallpox… 100%.’
Before Jenner’s vaccine, it was one of the deadliest diseases.
‘We were fortunate to have eradicated it. Hm? Wait…’
Vaccination.
It was an unforgettable topic.
Even if it didn’t appear often on exams, it was important enough to study thoroughly.
“Sir Baek, what are you thinking so deeply about?”
Heo Jun’s voice interrupted Kang-hyuk’s thoughts.
He realized that Yeon and Yeoju had joined them, apparently having come out during his lapse into thought.
“I think there might be a way.”
“Really? For smallpox?”
Heo Jun’s eyes lit up as he looked at Kang-hyuk.
It was the reaction of a scholar who would later write *Du-Chang-Jib-Yo* (두창집요).
“Give me a moment to think further.”
“Of course, take your time.”
Heo Jun fell silent again.
Yeon and Yeoju exchanged puzzled glances, but Dolseok seemed used to this.
He had seen Kang-hyuk behave this way before when treating Seungmun.
‘He mumbled things no one understood, then suddenly demanded herbs.’
He was an unconventional but undeniably skilled master.
Everyone waited with bated breath, eyes on Kang-hyuk.
“Hm.”
Kang-hyuk rubbed his chin, racking his memory.
‘It was a frequent exam question. It was in the test guides too.’
The test guide.
Or as they called it, the cheat sheet.
It was a lifeline for lower-ranked students on the verge of failing.
For a top student like Kang-hyuk, compiling those guides was part of his role.
That meant he knew the contents better and remembered them more clearly than anyone.
‘There’s nothing special about the cowpox method itself. We also used variolation in this country.’
He recalled that the great scholar Dasan Jeong Yak-yong had introduced it.
Variolation hadn’t spread widely due to its risks and the state of the country at the time.
‘It’s too risky.’
Attempting treatment could instead spread the disease.
The cowpox method was the safest approach.
The problem was finding a way to infect cows with smallpox.
“Ah. Ah!”
The scene he had witnessed upon entering the village flashed through his mind.
The cow with pus dripping from its sores.
The one covered in scabs.
“What is it? Did you think of something?”
Heo Jun reacted to Kang-hyuk’s sudden exclamation.
Dolseok and the others pricked up their ears.
“Cows, cows!”
“What?”
Dolseok looked confused.
He had no idea why Kang-hyuk, who claimed he could treat smallpox, was suddenly shouting about cows.
“The cow we saw when we arrived!”
“What are you talking about…?”
Yeon scratched the back of her head, baffled.
“Never mind, forget it.”
It was too complicated to explain.
Kang-hyuk gave up and began taking gloves and masks out of his medical bag.
“Put these masks on. Wear the gloves. You too, Heo Jun.”
“Why is this necessary…?”
“If you touch the patient or breathe in their air, you’ll catch the disease.”
“Oh.”
Heo Jun tilted his head, still not fully understanding.
Comprehensive prescriptions for epidemics in traditional Korean medicine only began emerging in the 18th century, long after the Ming dynasty fell and the Qing took over.
There had been vague awareness before then.
‘I remember hearing that gatherings were avoided during smallpox outbreaks.’
To avoid angering the “smallpox deity,” supposedly.
Ironically, it helped prevent the spread.
No gatherings meant fewer opportunities for transmission.
“I will do as you say, sir.”
Heo Jun’s hesitation didn’t last long.
He had just sought guidance after all.
Kang-hyuk personally helped Heo Jun put on a mask.
It was a temporary measure, but it would provide some safety.
‘First, I need to protect my people.’
He had made few connections since coming to Joseon, and these were precious.
Treating others would come next.
He couldn’t stand by and let them all die, though.
“Is this correct?”
Yeoju, less familiar with masks and gloves than Dolseok or Yeon, asked.
True to her artistic eye, she had put them on properly.
“Yes.”
“It feels stifling.”
“You need to bear with it. Otherwise, you’ll get infected. You know what smallpox is, right?”
“Of course…”
“Good. Now, I need to ask the patient if they’ve had contact with anyone. You all… stay here and don’t move.”
“O-okay.”
Intimidated by Kang-hyuk’s stern tone, Yeoju just nodded.
Yeon, however, spoke up with evident concern.
“But what about you, sir?”
“Me? I’ll be fine.”
“Why?”
The question came from Dolseok, ever the curious one.
“I’m immune.”
“What do you mean? You’re speaking nonsense again…”
“Quiet. I’ll explain later. You’ll need to know too.”
“Yes, yes.”
Leaving them like statues, Kang-hyuk entered the storeroom.
The patient, having received no treatment, was in the same state as when they arrived.
Or worse, considering their labored breathing.
Kang-hyuk placed the stethoscope on the patient’s chest with a serious expression.
The patient flinched at the cold touch, but only momentarily.
“Take deep breaths.”
“Hoo, hoo.”
Each breath produced harsh lung sounds.
‘Not good.’
It wasn’t just phlegm.
The sound indicated damage to the alveoli.
‘Pneumonia.’
A common complication of smallpox.
But common didn’t mean easy to treat.
‘Even with vaccination, this one might die.’
The patient’s body was too far gone to buy time for the vaccine to work.
Kang-hyuk, half-resigned, asked the patient.
“Have you met anyone recently?”
“Recently…?”
“Yes. Who have you met?”
“Hm…”
High fever and breathing difficulties made answering almost impossible.
The guardian spoke up instead.
“He stayed home because he was ill. I was with him, as well as a neighbor and his wife. And then…”
The list went on.
Disease education was crucial for this reason.
In the 21st century, people would have known to be cautious or isolate themselves.
“Is anyone else showing similar symptoms?”
“Pardon? Well… I have felt a bit feverish since yesterday.”
The guardian touched his forehead as he replied.
The thermometer showed over 38 degrees.
He’d been infected days ago.
“Where do you live?”
“Just a short distance from here. Shall I show you?”
“No, stay here. I’ll go.”
He couldn’t let someone potentially infected roam around.
“And this man? Should he stay like this?”
“Hm. I’ll give him some medicine. It will help.”
Kang-hyuk handed over an anti-inflammatory.
The patient struggled even to swallow water with their mouth covered in sores.
In this state, they wouldn’t be able to eat proper meals or even gruel.
‘At this rate… death is inevitable. Ah.’
There was a treatment Heo Jun had mentioned.
No, Heo Jun himself was here.
Kang-hyuk swiftly left the storeroom and approached him.
“Doctor, please prepare some Yanggyeoksan. I need it for the patient inside.”
“Yanggyeoksan? For smallpox?”
“Yes. They need to eat something, but their mouth is a mess.”
“I see. That makes sense. Is there anything else?”
Heo Jun grasped Kang-hyuk’s intention immediately.
“I’ve given them fever medicine, but it might not be enough. If you can, make something for the pus as well.”
“Understood.”
“And don’t go inside under any circumstances. I’m going to check the village for other potential patients.”
“Alone?”
“Yes, for now. I’m the only one immune.”
Leaving those cryptic words behind, Kang-hyuk stepped outside.
‘I need to isolate anyone showing symptoms… and find that cow.’