Rise of a Lonely City: From Exiled Prince to Ruler of the Nine Provinces

October of the second year of Xuanji.

The news that Liu Chuang's troops had suffered nearly half their losses at Baiyue Market and had retreated in disarray, along with the descriptions of the "Black Water Plague" and other malaria-related calamities by the accompanying medical officer, weighed heavily on Chen Dao's troops like dark clouds. Furthermore, along with urgent military reports, these reports were delivered to Han Lie, who was stationed in Yingcheng, and Xiao Chen, who was stationed in Shenjing.

The poisonous miasma of the Nanling Mountains was far more terrifying than the fierce rebel army.

It is formless and intangible, yet it kills without leaving a trace. Within a few weeks, it can render a battle-hardened elite force ineffective or even annihilate it entirely.

If this problem is not resolved, not only will it be impossible to penetrate deep into Fujian and Yue to pursue and wipe out the remnants of Zhao Hui's forces, but it will also pose a huge threat to consolidating the newly occupied Jiangnan region and defending the southern border.

The reason why the Yue tribes, who were entrenched in the deep mountains and forests, were able to rebel and rise up repeatedly for thousands of years, causing headaches for the Central Plains dynasties, was that the harsh environment and deadly miasma that served as natural barriers were one of their most important advantages.

"Without eradicating the miasma, the southern border will never be at peace."

In the general's mansion in Yingcheng, Han Lie looked at the military report with a solemn expression.

Although he was born in the north, he was a veteran of many battles and had extensive experience. He knew that "acclimatization problems" could sometimes be far more damaging to an army than weapons.

When Emperor Wu launched his southern expedition, his army suffered heavy losses due to epidemics in the Lingnan mountains.

"Order Chen Dao to have the army rest and reorganize on the spot, hold the strategic passes, and temporarily suspend all military operations deep into the mountains. The most urgent task is to prevent and control the epidemic, preserve the existing forces, and thoroughly investigate the source of the malaria and its prevention!"

At almost the same time, Xiao Chen in Shenjing also reacted.

He knew that the Hanyuan Army was the pillar of the nation and must not be destroyed by such a "natural disaster".

He immediately summoned the head of the Imperial Medical Academy, imperial physicians skilled in plague prevention and control, and relevant officials from the Ministry of Works and the Ministry of Revenue, issuing a strict order: "Immediately select imperial physicians, recruit renowned folk doctors, and pharmacists familiar with the malaria of the south, carrying medicinal herbs and medical texts, and rush to the southern border military camp! Spare no effort to assist the army in controlling the epidemic and finding a way to prevent and treat the malaria! The necessary funds, provisions, and medicines will be fully provided by the imperial court!"

The emperor was furious and concerned, and the imperial machinery was quickly put into operation.

A medical mission to combat malaria, composed of imperial physicians, renowned folk doctors, and pharmacists, carrying a large quantity of medicinal herbs and plague prevention and control manuals compiled by the Imperial Medical Academy, traveled day and night under the escort of elite imperial guards to Chen Dao's camp.

At the same time, Han Lie also recruited doctors from all over Jiangnan who were knowledgeable about the damp heat in the south, local pharmacists who were familiar with local herbs, and even offered rewards to collect folk remedies and prescriptions for preventing and treating miasma, and gathered them in the army.

In the main camp, Chen Dao elevated the prevention and control of malaria and epidemics to a level of priority equal to, or even greater than, military defense.

He personally took the lead in establishing a temporary "malaria prevention and control center," mainly composed of military medical officers, medical envoys sent by the imperial court, and locally recruited doctors and pharmacists. The center was jointly managed by Qin Baicao, a senior and meticulous military medical officer, and a physician surnamed Lin from the Imperial Medical Academy.

The first step is isolation and treatment.

All patients evacuated from Baiyuexu, including Liu Chuang himself, were immediately isolated in a well-ventilated and dry camp area.

Patients were placed in designated areas according to the severity of their symptoms and were strictly prohibited from contacting healthy soldiers.

All medical workers and laborers caring for the sick must cover their mouths and noses with coarse cloth soaked in boiled vinegar and thoroughly clean themselves after handling the filth.

The bodies of the deceased were all cremated and buried deep, and their clothing and belongings were all burned.

Some of these measures were based on the experience of the imperial physicians in preventing and controlling plagues in the Central Plains, while others were suggestions made by local doctors based on the characteristics of "miasma".

Although it could not completely stop the spread of the epidemic, it greatly controlled cross-infection and prevented a large-scale outbreak of the plague among healthy soldiers.

The second step is to improve camp hygiene and eliminate the breeding ground for miasma.

Chen Dao ordered that all camps must be moved away from low-lying, damp, and stagnant areas, and set up camp in high, dry, and well-ventilated places.

Deep ditches were dug within the camp to discharge sewage, and domestic waste was centrally treated, buried, or incinerated.

All drinking water must be boiled before consumption. Chen Dao dispatched his personal guards to patrol daily, and anyone found drinking unboiled water was severely punished.

The camp was regularly smoked with lime, sulfur, and mugwort.

Soldiers were required to maintain personal hygiene, wash their clothes frequently, and keep their bodies as dry as possible.

These measures, though seemingly cumbersome and even causing complaints from some rough and tough soldiers, were carried out without fail under strict military law.

Soon, the sweet, rotten smell in the camp was greatly reduced, and the number of mosquitoes also decreased significantly.

The third step, and the most crucial and difficult one, is to develop effective drugs and preventative measures.

This requires experience, practice, and even luck.

Qin Baicao and Imperial Physician Lin, along with their medical team and local pharmacists, worked day and night without rest.

They carefully examined the patients and recorded various symptoms: the pattern of fever, the frequency of chills, the characteristics of vomit, the color and shape of skin ecchymosis, tongue coating and pulse... They categorized patients with similar symptoms and tried different prescriptions.

Local pharmacists contributed many folk remedies: some used a decoction of a certain type of wormwood for internal use, others used a decoction of a certain type of stinky vine for washing, and still others suggested wearing a sachet containing realgar, atractylodes, calamus, and other medicinal herbs.

The imperial physicians placed more trust in classical texts and the experience of the Central Plains, and tried to modify existing formulas for clearing heat and detoxifying, such as Baihu Tang and Qingwen Baidu San.

However, the results were not ideal at first.

Many patients experience recurring symptoms, and their condition may even worsen after taking medication.

Death is still happening, just at a slower pace.

A sense of pessimism and fear began to permeate both the military and the civilian population, who believed that this "malignant mother" was the work of a mountain spirit and could not be cured by medicine.

The turning point came by chance.

An elderly local herbalist, under the substantial reward offered by the medical mission, provided a strange prescription: a vine with silvery-white downy hairs on the back of its leaves (locally known as "silver-backed vine") that grows on limestone cliffs, mixed with pangolin scales (calcined to ash) and realgar, to be taken with strong liquor.

The old herbalist said that this method was passed down from a hunter in the mountains who was injured by the "mist mother" and survived by the skin of his teeth, but the dosage is extremely difficult to control and pangolin scales are rare.

Qin Baicao has a profound knowledge of herbal medicine and intuitively feels that this prescription may make sense.

He had seen silver-backed vine before; it had a peculiar pungent and cool aroma. Pangolin scales were used in traditional Chinese medicine to promote blood circulation and reduce swelling. Realgar dried dampness, eliminated phlegm, detoxified, and killed parasites. Strong liquor enhanced the medicinal effects.

He boldly decided to improve this prescription based on the imperial physicians' assessment of the illness as "internal accumulation of damp-heat toxins and obstruction of the meridians."

He reduced the amount of potentially toxic realgar and added heat-clearing and detoxifying herbs such as Coptis chinensis, Scutellaria baicalensis, and Lonicera japonica. He also replaced the hard-to-obtain pangolin scales with more readily available rhinoceros horn to enhance the blood-cooling and detoxifying effects.

After the prescription was prepared, it was first cautiously tested on a small number of critically ill patients.

Surprisingly, the high fever of several patients who took this prescription subsided within a day and night, and their consciousness became clearer. Although they were not yet fully recovered, their condition had clearly taken a turn for the better!

This gave the doctors tremendous confidence.

After repeated adjustments to the prescription ratios and verification on more patients, a relatively fixed prescription for this blackwater plague gradually took shape and was named "Qingzhang Baidu Yin" (Clearing Miasma and Detoxifying Decoction).

This formula uses herbs such as silver-backed vine, rhinoceros horn (water buffalo horn), rehmannia root, peony bark, and red peony root to cool the blood and detoxify, and herbs such as coptis root, scutellaria root, forsythia fruit, and honeysuckle to clear heat and dry dampness. It is supplemented with a small amount of malachite and calamus root to dispel foulness and turbidity.

Meanwhile, doctors have also discovered that taking large doses of Changshan and Caoguo decoction in the early stages of the disease can effectively curb high fever and chills.

In terms of prevention, several measures were promoted based on local experience: soldiers were required to take a small amount of "miasma-repelling soup" made from herbs such as areca nut, magnolia bark, and cardamom every day; they were required to carry sachets containing herbs such as atractylodes, angelica, realgar, and musk; large quantities of mugwort, atractylodes, and sulfur were burned around the camp to repel insects and purify the environment; and going out was strictly prohibited during times when miasma was likely to occur, such as early morning and dusk, especially avoiding damp areas such as valleys and ponds.

After nearly a month of arduous efforts, and at the cost of dozens of medical workers and laborers being infected and sacrificing their lives, the epidemic has finally been brought under initial control.

The number of new cases has decreased significantly, and the mortality rate of critically ill patients has dropped from more than 70% initially to about 30%, with most of those with mild symptoms recovering.

Liu Chuang also narrowly escaped death, but his body was extremely weak and he needed long-term recuperation.

Although prescriptions such as "Qingzhang Baidu Yin" are not effective for everyone, and preventive measures cannot completely prevent infection, it is a world of difference compared to the previous situation where people were helpless against miasma and died in large numbers.

The morale of the troops was boosted. Although the fear of the "malignant mother" had not dissipated, at least they had a way to deal with it and hope.

Chen Dao wrote a detailed report on his experience in prevention and control, as well as the preliminary effective prescriptions and measures, and sent it urgently to Yingcheng and Shenjing along with a list requesting additional medicinal materials. In the report, he wrote with deep sorrow: "The difficulty of the southern expedition lies not in the enemy chieftain, but in the malaria."

Thanks to His Majesty's grace, the soldiers' valiant efforts, and the physicians' tireless work, we have fortunately obtained preliminary methods of prevention and treatment. However, the miasma is insidious and varies from place to place; what we have obtained this time can only temporarily alleviate the immediate crisis.

To achieve long-term stability in the southern border regions, it is essential to thoroughly study the local conditions, prepare a wide variety of medicines, and, more importantly, ensure that the soldiers gradually adapt to the local climate and water.

The immediate priority is for the army to refrain from venturing further into dangerous territory. Instead, it should focus on holding key positions, pacifying the local population, and assessing the geography and local conditions. Only after the rear is secure and countermeasures are more effective should further advance be undertaken.

This experience, gained through bloodshed and the efforts of countless physicians, while failing to immediately eradicate the threat of malaria, served as a crucial beacon for the Hanyuan Army and for the imperial court's future strategy in the southern frontier.

This marks the beginning of the Great Xia Dynasty's shift from simple military conquest to a more complex and arduous comprehensive response, including medical care, logistics, and adaptation, in the face of the severe challenges posed by the natural environment in the south.

Thus began a long war against the invisible enemy—miasma.

At this moment, the army, which had been baptized by the miasma, temporarily halted its southward march. On the banks of the Ling Canal, it rested and recuperated while keeping a watchful eye on the misty, perilous mountains to the south.

The remnants of Zhao Hui's forces, protected by this natural barrier, gained a precious respite and continued their arduous escape into the depths of Minyue.