Cholera (2)

The White Horseman of Conquest had at last made landfall in Joseon. Bow and sickle in hand, he laid about him without mercy, slaughtering the kingdom's wretched people.

The first mass casualties struck at Choryang, seat of the Japanese trading post, and at Busan, where the foreign settlements stood. From there the cholera tore northward at a terrifying clip — through Daegu, Gyeongju, and Sangju — until the rugged mountains of Mungyeong briefly checked its advance.

While the incompetent court seized upon that pause to catch its breath, the White Horseman, as if mocking the folly of men, loosed his pale host upon Gunsan, Incheon, and Wonsan as well, reaping casualties by the thousand. And so the Namwon magistracy, where I now languished in exile, had been thrown into utter chaos as officials scrambled to devise a quarantine.

The cramped main hall of the Namwon yamen was packed with local magistrates, naval commanders, and superintendents summoned from every corner of Jeolla Province — every last one of them with a cloth bound tightly over the mouth, just as I had instructed.

"I offer you my sincerest thanks. You have all labored day and night against this pestilence, and your hardships have not gone unnoticed."

I distributed copies of the countermeasure report I had wrung from my own body, twisting myself inside out to produce it, and opened my mouth with a grave expression. The small, slender hands that passed the documents among them were pale to the point of translucence.

"Every road leading into Jeolla Province must be sealed. We must operate quarantine stations staffed by personnel thoroughly drilled in public hygiene. Furthermore, until the day this pestilence is brought to heel, the secretaries of the Dongmaenghoe should convene a Sanitation Committee and assume a measure of civilian control as part of our response…"

Swathed head to toe in a snow-white durumagi, a matching white cloth over my mouth and gloves on my hands, I held forth with passionate intensity. The gazes that followed me were vacant, unfocused, as if they could scarcely believe what they were seeing.

To those men I drove the point home again and again, my eyes glazed with exhaustion. Frankly, remaining on my feet at all was more than my constitution could easily bear.

"…First and foremost, the foreign settlements and treaty ports — the presumed points of origin — must be sealed at the source. With no one able to say how far inland this pestilence will drive, there is no blunder more catastrophic than allowing every county office and agency to conduct its own inspections by whatever haphazard standard it pleases, waving people through as it sees fit. The court has yet to proclaim a proper Pestilence Ordinance, which makes the matter all the more urgent. That is all."

I bowed after summarizing the points that required explanation. A middle-aged man in military uniform immediately raised his hand and put a question to me.

"You propose we put thoroughly trained men in the right places and run quarantine stations with them. Fine. But what's the exact standard for judging these 'talents,' and how do you pick them? And a quarantine station isn't something a private man or a private association can fund. Personally, I don't think the government has any business dumping that kind of work on civilians."

The officials seated beside him murmured at the reasonableness of the middle-aged man's question.

Meanwhile I hesitated, not knowing who he was. The man sitting directly in front of me — Sim I-taek, Governor of Jeolla and Magistrate of Jeonju — leaned forward of his own accord and whispered in my direction.

"That is Han Gyu-seol, Commander of the Jeolla Left Naval Station. Posted here at the beginning of the year, I believe."

At his whisper I turned my head and stole several glances at the middle-aged man he had named Han Gyu-seol.

Compared with Choe Ik-hyeon, whose stiffness had been apparent from our first meeting, this one had put on a generous amount of flesh, which now spilled over at both sides. His eyes, at least, were still very much alive.

I hear this gentleman had quite a temper in the late Joseon years.

Reminiscences could wait. I had resolved to discuss the urgent cholera countermeasures first, and so I opened my mouth.

"Basic medical knowledge. We intend to select qualified personnel on the basis of every available means of preventing infection — medical knowledge, practical experience — and station them at the quarantine posts as a priority, then observe the results. By 'standard' I mean this: that those assigned to the quarantine stations and isolation wards wash their hands frequently and thoroughly, regularly clean away patients' waste and bodily fluids, and burn the corpses and clothing of the dead without exception. These are simple tasks, but they are of the utmost importance. Personnel thrown into a quarantine station with no training and no regulations may well become vectors of the disease themselves."

Han Gyu-seol cocked his head at my explanation, folded his arms, and spoke.

"Yes — and that 'basic medical knowledge' you mentioned is precisely what I want to hear about. As everyone here well knows, there is no proper cure for this pestilence. As with plagues of old, we herd the infected into one place and isolate them until the disease burns itself out. That is neither a fundamental countermeasure nor a treatment. What's more, that paltry scrap of knowledge is hardly grounds enough to have dragged us all the way here. Wouldn't you agree?"

"I would ask that you leave that matter to the Dongmaenghoe, Commander."

"Hrm. Elder Chan-gyeom…"

Before I could even answer, Choe Ik-hyeon — former Director of the Office of Royal Genealogy — strode up onto the dais and began addressing the assembled local officials.

It was less an explanation than a proclamation.

"At present our membership is densest in Jeolla Province, and our branches and substations lie scattered across the land in numbers sufficient to stand in for quarantine stations. Furthermore, as you will have gathered from recent reports of the eastern insurgency, the Joseon Youth Association — the Vanguard, which constitutes the Dongmaenghoe's true fighting arm — is composed of young men spiritually steeled by loyalty, filial piety, and righteousness. Should they take the field, the common folk, who would otherwise react with blanket hostility to coercive government directives, are far more likely to soften and offer their cooperation."

"Oh! If that can be arranged, we might even hope for the pestilence's early extinction."

Most of the officials responded to Choe Ik-hyeon's words with expressions of relief — Ah, of course, as expected! — but a few of the more clear-eyed men, Han Gyu-seol among them, had gone rather stiff for an entirely different reason. And then—

"Ah."

I had thought I was explaining things rather well. Then our Mr. Choe Ik-hyeon dropped a declaration that was practically a bomb, and I clapped a hand to my forehead.

"Have you any further questions?"

Choe Ik-hyeon's remarks were bold to the point of audacity.

Why, at this of all moments, did the phrase Sign here at once spring to mind? And why was Han Gyu-seol merely nodding along, his face flushed red?

Aigoo, you fool! If you put it like that, they'll start suspecting our intentions!

That was it, exactly.

What Choe Ik-hyeon had just said, in so many words, was: We literati of the three southern provinces have assembled ourselves this thoroughly and formed a power of this magnitude, so you — the penniless, undermanned, incompetent court — can shut your mouths and accept our help first. And he had said it in front of Han Gyu-seol, a man who would one day be remembered as one of the great patriots of the age.

Watching Han Gyu-seol's expression curdle in real time, I stared desperately at Choe Ik-hyeon, praying he would walk it back.

"If there are none, that is all."

He said his piece, found his seat, and sat down with the air of a man who had done his duty and not a whit more. I finally sighed and added a supplementary explanation.

"…To elaborate further: the senior officers, secretaries, and local chairmen of the Dongmaenghoe are all learned and distinguished elders who will take these matters in hand. As you gentlemen well know, a Confucian scholar respected throughout his village is a man who has lightly mastered medical texts that a country apothecary could scarcely dream of reading. The literati are volunteering to shoulder a considerable portion of the court's shortage of medical personnel."

"Hrm."

I then pointed a finger at Han Gyu-seol, who was wrestling with his inner conflict, and pressed him.

"Cost is a concern, yes — but I ask you to think first of the people who will die unjustly, moment by moment, without the nation's help or care. Had the court only established a Pestilence Ordinance sooner, dispatched superintendents to every region, and responded with speed, this debate would not even be necessary. But what has become of Choryang and Busan? Of Gyeongju and Daegu? And Hanseong?"

To put it bluntly: Kaesong, Pyongyang, and Jemulpo had failed comprehensively at cholera prevention — and so had Hanseong, the very capital of Joseon.

Rumor on the street has it that more than a thousand have already died in Hanseong alone.

In truth, it was not that the still-extant Office for Extraordinary State Affairs was incompetent, nor that King Gojong's measures and resolve had been inadequate.

The problem was the Qing army, which had swollen to twice its historical size and now occupied the Hanseong Magistracy and the Gyeonggi Provincial Garrison as two separate encampments. The barracks and camps where the Qing troops were stationed had never been designed as large-scale holding facilities, and so there were no waste-treatment works whatsoever to handle the refuse and filth generated nearby — which only compounded the disaster.

The result was that Hanseong, which had been a comparatively safe zone against the pestilence, collapsed in an instant, and cholera slammed through the surrounding Gyeonggi region. It was news of those deaths that had sent the local officials of Jeolla Province, pale with terror, seeking me out.

I drove the spike home into the still-deliberating Han Gyu-seol.

"If the members of our Dongmaenghoe and the literati who have rolled up their sleeves to aid the nation in its hour of crisis are not permitted to act — what will the people think, those who heard the news early and expected the pestilence to vanish? Will you simply follow the court's orders and sit here helpless? While the people die in the streets?"

"…Very well."

Pressed, Han Gyu-seol accepted the measures with visible reluctance, covering his face with his palm and nodding. It was, in effect, a tacit endorsement — a silence toward the court.

Then someone between us opened his mouth, his expression thick with curiosity.

"But why is it that Namwon has not a single pestilence patient to be seen? You haven't even set up a separate isolation ward."

"Ah. That is…"

I started to answer the questioner at once, then hesitated.

If I were to tell the story properly, a great many things had happened.

Some two weeks before I summoned every local official and administrator in Jeolla Province, I had used the regional Dongmaenghoe — whose roots stretched not only through the vicinity of Namwon but across Jeolla, Gyeongsang, and even Chungcheong beyond — to call in every last medical hand we could mobilize to Namwon.

It was, in the most literal sense, the first Buster Call the Dongmaenghoe had proclaimed since the day of its founding.

On the second day after the summons was issued, dozens of pairs of eyes followed my hands.

"…First: physicians and volunteers attending the patients must keep their hands and feet scrupulously clean at all times, and the isolation wards must be maintained in a state of hygiene."

I took up a stick of chalk and scrawled the word CLEANLINESS again and again across a blackboard that Kim Gae-nam, with his clever hands, had fabricated for me, then addressed the physicians clustered together like students in a university lecture hall.

"You are all familiar with the badges and tokens the Dongmaenghoe has distributed. All personnel other than those so identified are to be issued a new travel pass every three days at the quarantine station established in their county. Anyone without a pass will be detained or arrested by the local authorities whose cooperation we have requested."

"W-wait. Does that mean we are to keep watch over every last commoner in the counties under our charge?"

"Surveillance is too ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠strong a word. Let us call it a periodic procedure for confirming symptoms of outbreak. As for the shortage of hands, the Dongmaenghoe headquarters in Jeonju will recruit support personnel and volunteers and dispatch them, so you need not be overly concerned."

As you all well know, the standard response to a waterborne epidemic ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠such as cholera is a clean environment, regular disinfection, the maintenance of water and sewage systems, and the widespread adoption of Oral Rehydration Therapy.

And so the first task I undertook was to control the spread from the points of outbreak, establish isolation zones, and block the passage of unauthorized persons.

"Next: a comparatively advanced method of treating the patients."

That next method was the famous Oral Rehydration Therapy.

At the word "treatment," the physicians' eyes doubled in size, ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠and they crowded toward the blackboard. And why wouldn't they? A treatment for the pestilence? If they returned to their counties and followed it properly, they would hear themselves called miracle-workers until their ears grew calluses.

"Now then. Watch, and make it as I do. It is quite simple."

Clunk. ‍‍‌‌⁠​​⁠‌​​‍​​‍​‌​⁠‍‌‍⁠⁠‌⁠‌‍‌‍‌‌‌‍⁠​‌​‌​‌‍‌‌‌⁠‍​​‌‍⁠‌‌⁠⁠Clunk.

Before launching into the explanation, I set two enormous water casks down in front of the physicians, mixed in sacks of salt and sacks of sugar I had procured from Japan, and shook them as I spoke.

"The ratio of water, sugar, salt, and honey should be seven to two to one. However, depending on the number of days until the patient's condition improves and the management of repeated diarrhea, a fast of no less than a day and no more than two is essential. If you rely on Oral Rehydration Therapy alone, the patient's vitality may decline so severely that recovery itself becomes a problem."

At that, one of the physicians — a man who had thrown himself in with the Vanguard Party out of a spirit of service to the people (though the process had been rather rough, leaving his topknot torn in a fashion one did not easily forget) — opened his mouth.

"…So while the diarrhea persists, we simply feed the patient that drink and nothing else?"

That was precisely what you were not supposed to do.

"No. The sweat they shed and the maintenance of body temperature are equally critical. Should the body cool rapidly, or should the patient faint frequently, you must force even thin rice gruel down their throat and see that it is digested. This is why the physicians and volunteers in charge of the quarantine and isolation wards must remain at the patient's side at all times and never take their eyes off them."

"Mm. I shall bear it in mind."

When I had more or less finished my brief explanation, the physicians, who had been eyeing a certain unidentified object on the table, asked a question.

"And what, pray, is this? It has a needle attached, and the tube hanging from the back is tough as a snake's shed skin, twisted into a cord."

What had caught their curiosity was a primitive IV drip I had commissioned from Japan — medical supplies I had ordered by special express through Mitsui & Co., which maintained a branch office in Busan and dispatched its employees there directly.

"Ah. That…?"

"Oho. It seems something flows from this bottle at the back, down along the tube. The needle is remarkably thin, and hollow besides — foreign workmanship, by the look of it, and fine work at that."

The problem was—

"Well then, how on earth does one use it?"

I said nothing.

"Unam… Teacher…?"

For the first time, I chose silence over an answer. But what was I supposed to do? I didn't know where to put the needle either.

I had simply gone and had the things made, and this was the result.

The curse of knowledge.