Chapter 193: Ergotism (5)

"Older Brother."

The day the clinical trial for MR-4872 passed the deliberation.

Freya said during dinner.

"I heard you made a new medicine in just a week again, was there a need to make it in such a hurry?"

It seemed the rumor that I had made another new medicine had spread throughout the Academy.

The reason was because of the stock.

After the consecutive successes in new medicine development, people began to take an interest in my new medicines.

Whenever I put any new medicine into a clinical trial, the trading company's stock would fluctuate.

As you could tell from the numbering MR-4872, this medicine was our trading company's 4872nd attempt.

Of course, I didn't make all those attempts alone.

Most of them were clinical trials conducted after the researchers belonging to the trading company improved existing medicines.

However, a few of my own attempts were among them, and quite a few of those attempts were failures.

But the stock investors didn't seem to care about that.

— "Lord Saint's new medicine failed? But they say it was a partial success?"

— "Don't you get it? It means an improved version will come out in a few years based on that prototype."

— "Wow. This guy still doesn't believe in the Lord Saint. Your problem isn't distrust, it's your intelligence."

I had ears too, so news like this kept reaching me.

Such conversations could often be heard in the infirmary or the lecture hall as well.

Thanks to that, I could tell how people viewed me.

'I'm a Saint, but it feels like people believe in me in a different sense...?'

Was this kind of belief impiety, or faith?

Such useless doubts were just a bonus.

Anyway, it seemed the news that I had made a new medicine had reached Freya's ears as well.

"Who told you?"

"Senior Jenny did. She seemed very interested in your new medicine development, Older Brother."

"Certainly, it makes sense that Miss Jenny would know."

As expected of an exemplary student vying for the top of the class in the second year of the Department of Healing Arts.

In matters like this, she was a student even more dedicated than her peers.

"So, why did you make it? You seemed to be rushing more than usual."

"Did it look that way?"

"Yes."

Freya nodded.

"Going out of your way to covet the technology of the Lohengrin Trading Company that broke a taboo, and delaying your sleep time to do research. You were a bit different from your usual self, Older Brother, so you seemed to be in quite a hurry. Did you rush because you were afraid someone else might make it..."

"That's not possible."

Of course, I didn't rush for that reason.

...No, I make a correction.

I did have a tiny bit of that thought.

Still, that only accounted for 30 percent of my motive.

70 percent of the reason I rushed was something else.

"Because I thought this medicine would be needed soon."

I had planned the modification of Lohengrin's new medicine, LWGN-0004, from the moment that new medicine came up in the Deliberative Council.

Because among the patients I was currently seeing, there was a patient who seemed like they would need this medicine.

"A situation where it's needed? I heard it's a medicine for a mother in childbirth. Is there someone like that?"

"Yeah. It looks like I'll be using it on the Imperial Princess Consort."

"Her Highness...?"

Freya seemed a bit flustered, as if she hadn't expected that name to come up.

"Why would the Imperial Princess Consort...?"

As it happened, the princely couple were my youngest sibling's workplace bosses.

Because my youngest sibling was the bodyguard for Imperial Grandchild Aster.

At the mention of our youngest sibling's workplace, Freya also seemed a bit worried.

"Is this childbirth dangerous by any chance?"

"Right. You remember that Her Highness has difficulty receiving Heal because of her Demon Disease, right?"

"Yes, I know."

The Imperial Princess Consort is currently suffering from Antiphospholipid Syndrome.

It's a disease that easily causes blood clots, and because of this disease, she had to suffer the tragedy of miscarriage four times.

It was also a problem that had been resolved after I prescribed Aspirin and Heparin.

The problem was this pregnancy.

"If I say she has Placenta Previa this time... would you understand?"

Shake, shake.

Freya shook her head.

Perhaps having focused on the conversation, Erika also shook her head.

They both seemed not to know well since they weren't Healers.

"It means she's a high-risk pregnant woman whose placenta is in a dangerous location. In this case, a natural birth is dangerous, so she must have a Cesarean Section."

The problem was that this person was suffering from Antiphospholipid Syndrome.

Right now, the Imperial Princess Consort was taking medicine that prevents blood from clotting well in order to maintain her pregnancy.

What would happen if she underwent surgery in this state?

"We will stop the Aspirin and Heparin before the surgery. But some amount of the components will remain. Her blood won't stop easily."

It couldn't be helped.

If she didn't take the medicine, the baby would be in danger.

If she took the medicine, the mother in childbirth would be in danger.

In such situations, most mothers in childbirth would rather choose to put themselves in danger.

So, the probability of a bleeding problem occurring for the Imperial Princess Consort had to be seen as very high.

"The problem is that this disease is a Demon Disease. It's too dangerous to treat with Heal."

"Aha. So..."

"Yeah. I rushed the medicine development because of this."

I couldn't just let the Imperial Princess Consort die, could I?

That was why I had wanted to rush the development even if it meant taking the unreasonable step of siphoning off the Lohengrin Trading Company's research data.

"The medicine that Lohengrin left behind happened to have the pharmacological mechanism of the medicine I wanted."

The migraine medicine LWGN-0004 made by Lohengrin was a substance close to poison.

Because it put a strain on the heart in order to treat the migraine.

However, if you knew the pharmacological action of this medicine, you couldn't help but think of the medicine that would be created when it was improved.

'If I just modify the migraine medicine a little, a medicine for a mother in childbirth can be made.'

This was why clinical trials were important.

If only Lohengrin had conducted animal testing diligently and meticulously recorded the results of the clinical trials on humans.

If they had done that, they might have paid attention to the side effects of the existing medicine and created a medicine for mothers in childbirth.

Because usually, such medicines are discovered by chance during clinical trials.

Just like the Viagra I introduced to this world, or the weight loss drug that was famous in my previous life.

In that sense, Lohengrin had paid the price for not being diligent.

'Tsk tsk. Using a loophole for nothing.'

It wasn't for nothing that our trading company conducted clinical trials diligently after the Viagra incident.

Anyway.

It meant that my creation of this medicine wasn't a simple coincidence.

"Originally, I had already made one medicine for the Imperial Princess Consort, but isn't it a rule that the more tools you have, the better?"

I had already prepared the first medicine to control the bleeding.

This new medicine was a backup medicine in preparation for the case that the first medicine failed.

Because a person only has one life.

No matter how much preparation I made, it wasn't enough.

"It's amazing. They said the medicine Lohengrin made was dangerous and it immediately disappeared from the market."

"I emphasize it every time, don't I?"

"That poison and medicine depend on how you use them?"

"Yeah."

With those words, I sipped my wine and looked at the document in my hand.

「Considering the emergency nature of the cases where the medicine is administered, conducting a Phase 1 Clinical Trial is permitted only if the relevant medicine is disclosed in advance to high-risk pregnant women.」

MR-4872.

Thinking about which mothers in childbirth I should introduce the Phase 1 Clinical Trial of that medicine to.

***

Several days later.

Ahead of the surgery, the Imperial Princess Consort was admitted to Meyer Infirmary.

She had flown all the way from the distant capital to the Academy Territory for childbirth.

It wasn't a strange thing.

It's a bit much to say with my own mouth, but the most popular infirmary in the Empire right now is here.

You could tell just by seeing Duke Keres fly here on an airship with the Duke's Daughter.

In people's perceptions already, this place was Johns Hopkins and the Mayo Clinic.

"I leave her in your care, Lord Yulian."

"I will do my best effort. Let me help you with the admission procedure first."

I welcomed the patient at the Airship Terminal.

Normally I didn't go this far, but since the other party was a VIP, I gave them a bit of special treatment.

As her guardian, naturally, Imperial Prince Edmund accompanied her.

This man, he had been slightly neglectful of his wife because it was their second child, but,

As soon as he heard the news that she needed surgery due to Placenta Previa, he reverted right back to devoted husband mode.

He looked to be staying in the Academy Territory for his wife, using up all his saved annual leave at once.

Naturally, with a high-ranking person from the military staying at the Academy, the Academy was also bustling.

— "Praying for Her Highness's safe and easy delivery, this is some ginseng that this subject has humbly prepared."

— "This is a silver-crafted cradle, a specialty of my hometown in the West. I prepared it for the imperial grandchild to be born."

— "This is mineral water from this humble one's territory. I heard that bathing in this water is good for postpartum care."

In front of the terminal.

Nobles each gathered in front of the Imperial Prince and flattered him diligently.

They had flown in from afar after receiving contact from their children.

Only after seeing that crowd did I realize the Imperial Prince's influence anew.

'Right. This man is a hero of the Southern Region.'

The title of Supreme Commander of the Southern Front didn't just go anywhere.

To me, since I had seen him for a long time, he was just Patient A, but.

This person was a hero to the extent that he was even used for propaganda in the Empire.

Perhaps for that reason, at the news that he visited the Academy Territory for the childbirth, the nobles had flocked to flatter him.

In the process, I shot down all the bribes that would be a problem for the mother in childbirth.

"Ginseng is fatal to a mother in childbirth. It might be a different story if she were in a healthy state, but using it in an unhealthy state could cause liver failure."

"Wool is the best for a child. Rather, a silver-crafted cradle would be dangerous as the body temperature loss is severe."

"A mineral water bath after a Cesarean Section... It would be perfect for the wound to burst open."

These people.

They were shoving alternative medicine at the Imperial Princess Consort.

Even though two years had passed since I even announced the germ theory!

Thinking about it, it wasn't a strange thing.

Even in the 21st century Republic of Korea, alternative medicines for mothers in childbirth used to overflow...

The Imperial Prince listened carefully to my advice and rejected most of the bribes.

"I have The Black Saint. I don't need them, so take them back."

Of course, among them, there were those who used their heads quite well.

Some of the nobles suddenly made a donation to the infirmary.

It was blatant, but I didn't dislike it.

I also welcomed this kind of donation.

Naturally, the Imperial Prince also gave off the feeling that he welcomed this type of flattery.

"They are all people I know. Once the childbirth is safely over, let's have a meal sometime."

After arriving at Meyer Infirmary like that.

I immediately checked the Imperial Princess Consort's condition.

Blood pressure, blood sugar, and so on were all stable.

However, despite these numbers, the nerves of the Healers in charge of the Imperial Princess Consort were on edge.

Because they knew well that this mother in childbirth was a difficult patient.

The next morning, I visited the hospital room to check the patient's condition before the surgery.

And as soon as I saw the Imperial Princess Consort's face, I couldn't help but furrow my brow.

"...Her Highness. The rash around your cheeks and the bridge of your nose... since when did you have it?"

"Ah, this?"

The Imperial Princess Consort carefully stroked her own cheek.

An erythematous rash spread widely in the shape of a red butterfly could be seen.

"It appeared on the way here riding the airship this time. The flight must have been a little hard on me."

"I think it's been about fifteen days. It seems her skin is acting up as she enters the last month of pregnancy. The maids at the Imperial Palace also said it's a common occurrence during pregnancy."

Imperial Prince Edmund, who was beside her, chimed in casually.

Pregnancy skin trouble.

It was a symptom commonly seen in full-term mothers in childbirth.

If it were an ordinary Healer or mother in childbirth, they would have just brushed it off like that.

But to me, that rash came across differently.

I suppressed my feelings of wanting to rub my face dryly right this instant, and asked the Imperial Princess Consort a few questions.

"By any chance, have you had joint pain recently? The symptom of your finger joints being stiff or swollen when you wake up in the morning."

"Oh my, how did you know? My every joint aches a bit, perhaps because my body weight has increased due to pregnancy, but... it was like that during my first child too, so I didn't think much of it."

"Is there foamy urine mixed in, by any chance?"

"...Recently, a little bit has been coming out mixed in."

"Have you been very tired recently?"

"I don't know if it's because of the flight... but I do have a feeling of extreme fatigue..."

The Imperial Princess Consort also seemed to realize that something was wrong from the continuous questions.

At this, the Imperial Prince interjected as if slightly puzzled.

"She is a full-term pregnant woman. Isn't it normal for her to be tired just from breathing?"

It wasn't wrong.

Joint pain, foamy urine, and fatigue are symptoms that frequently appear in pregnant women.

However, if that is combined with a 'butterfly-shaped erythema', the story becomes completely different.

Even more so for a patient who has already received a diagnosis of Antiphospholipid Syndrome.

"Let's proceed with a blood test right away."

I immediately ordered a blood collection.

Blood was drawn and run through the Magic Power Analyzer, and we waited until the result came out.

And the result was disastrous.

The Imperial Princess Consort's platelet count had plummeted to less than half that of a normal person.

At this level, it was almost a confirmed diagnosis.

'I can't check the ANA Titer, but...'

Even if I were to make what didn't exist right now, it would just be too late.

To begin with, even without it, if this level of clinical symptoms gathered, a diagnosis could be made.

Because what was more important than the diagnosis was the golden hour.

"Your Highness, Her Highness."

I spoke while setting a heavily serious mood.

"Lupus. Systemic Lupus Erythematosus. Her Highness has... developed a new form of Demon Disease."

"Lupus...? Another Demon Disease...?"

Hearing my diagnosis, the Imperial Prince's face contorted miserably.

His full-term wife was about to undergo a surgery that meant life or death, and on top of that, another incurable disease was added.

There couldn't be a greater unfair nerf than this.

But it couldn't be helped.

"Originally, diseases often come all at once."

Diseases naturally create synergy with each other.

A stroke patient is vulnerable to pneumonia.

Just like a heart disease patient is vulnerable to kidney disease.

The Imperial Princess Consort's diseases were also diseases that created synergy with each other.

'I did think it would turn out like this someday.'

The Imperial Princess Consort's chronic illness, Antiphospholipid Syndrome, is frequently accompanied by Lupus.

Added to this, if she is a woman of childbearing age, that risk factor becomes even greater.

In other words, the risk factors were already sufficiently gathered.

That is, this was not misfortune, but close to inevitability.

Of course, I didn't explain this fact to the patient and guardian.

Because doing so would only make me seem like nothing more than a psychopath.

Before long, the Imperial Prince, who had maintained silence, opened his mouth again.

"However... are you not my wife's personal physician, and the personal physician of my child to be born, Lord Yulian."

"Of course. Because I was already anticipating this."

It was a situation I had already anticipated and made preparation for.

"Steroid is already being mass-produced, so there's no worry. Added to this, a medicine called Chloroquine has recently come out as well."

"Chloroquine?"

"It is an item created by a certain Alchemist who was tinkering with Quinine, the malaria medicine. It is very useful in managing Lupus."

It is a new medicine recently created by an Alchemist who had dug into Quinine for several years.

Was it MR-3857?

To be exact, I don't remember the number, but.

It was a medicine currently undergoing a clinical trial at Meyer Infirmary.

Chloroquine was a medicine that improved upon a significant portion of Quinine's drawbacks.

Once that medicine starts circulating in the market, Quinine will now fade into the back roads of history.

'Well, it doesn't matter, though.'

I wasn't particularly regretful.

The Alchemist who made that Chloroquine is an Alchemist belonging to our trading company.

There was no particular reason to feel a sense of competition.

Besides, I already took the 'first' title, so it was a matter that didn't matter either way.

"With Chloroquine and Steroid, it is a Demon Disease that can be sufficiently managed."

Only then did a look of relief wash over the Imperial Prince's face.

However, I couldn't easily relax my facial expression.

"However, Your Highness. The real problem lies elsewhere."

"The real problem?"

"Lupus is a disease that only requires long-term management after surgery, but the 'massive bleeding' that will occur during the Cesarean Section that is right around the corner is a different story. Her Highness is a mother in childbirth who cannot use Divine Magic, namely Heal, at all because of the Demon Disease."

Preventing massive bleeding caused by Placenta Previa without the cheat code called Heal.

That was indeed the greatest obstacle of this surgery.

"If she only had her existing chronic illness, she would have been able to use Heal as an adjunctive hemostasis."

If she only had Antiphospholipid Syndrome, she would have been able to partially use Heal for hemostasis.

Because with the Imperial Princess Consort's Demon Disease, it could still be used to the extent of achieving hemostasis on an arteriole.

However, if Lupus has newly developed, the story is a bit different.

"It seems Her Highness's Demon Disease has worsened. We will have to cope without Divine Magic."

It's probably because of the pregnancy.

Because of this, using Heal for arteriole hemostasis became impossible as well.

That is, it was a situation where we had to cope with pure medicine alone.

Naturally, the Imperial Prince's facial expression stiffened at the fact that Divine Magic could not be used.

"...Lord Yulian. Do we perhaps need to make mental preparations in advance?"

"No."

But to me, it wasn't a problem.

In my previous life, I had even performed surgery on a mother in childbirth who had been in a traffic accident.

Of course, I was just a sidekick to Obstetrics and Gynecology, though.

Even so, I participated in the hemostasis work too.

"Therefore, I intend to try using two medicines through a clinical trial."

I took out two documents.

They were medicines respectively undergoing Phase 2 Clinical Trial and Phase 1.

"The first medicine is MR-4126, Oxytocin."

Oxytocin.

A labor inducer that induces uterine contraction, and a medicine for stopping uterine bleeding.

The principle is simple.

The uterus contracts → the blood vessels constrict and hemostasis is achieved.

It was a hormone extracted by splitting open the heads of cows or pigs, and although it was an incomplete product that hadn't been separated from Vasopressin.

Now was not the time to be picky.

And the next medicine was a medicine that had a stronger hemostasis effect in exchange for greater side effects.

"The second medicine is MR-4872, named Methylergonovine. I believe Your Highness may have heard of it as well, but it's a medicine I made several days ago."

"By any chance, did you, don't tell me... knowing it would turn out like this?"

"..."

I substituted my answer with a faint smile.

Because I had recently learned from Freya that sometimes it's better to express it this way rather than openly bragging about it.

For some reason, the Imperial Prince's shoulders flinched, but.

I handed out the papers without paying attention to that.

"I want to get permission for these two medicines in advance."

I couldn't exactly get permission for a clinical trial after an emergency situation broke out, could I?

That's why I was getting permission in advance.

Of course, someone might harbor doubts.

What if I jump the gun like this and there are no problems?

To answer that...

'It's the best if nothing happens.'

Then I just wouldn't use it.

"Since it is a clinical trial, I have a duty to provide risk disclosure in advance. First of all, these medicines are..."

Scribble, scribble.

The Imperial Prince signed his signature on the paper even before my explanation was finished.

The Imperial Princess Consort, too, nodded without hesitation.

"I believe in you, Lord Saint. No need for explanations."

The two of them just signed right away without even reading the risk disclosure document.

...I don't know what to do with myself in the face of this infinite trust.

A corner of my heart almost felt touched for a moment.

However, there was a problem.

"Even so, you must listen to the explanation until the end."

I have a duty to disclose this.

It was a clause I made, so I couldn't break it either.

Because for a medical professional, risk disclosure was an issue separate from trust.

"...Ah."

In front of the sheepish princely couple, I stubbornly continued my explanation.