Chapter 98

"Why isn't Kudose Genshaku in the capital?"

In the end, Ashikaga Yoshiaki, who could only send letters to daimyo across the country and accomplish nothing, decided to re-enter the priesthood and spend his days copying and reading sutras at a temple.

Few of his retainers followed him, and this was also the case with Hosokawa Fujitaka.

He officially entered the service of the Oda family, but it might have been a bit too late.

He missed the opportunity to become a daimyo and was now serving as a civil official at Ishiyama Castle.

He had been granted the position of steward of the shoen (manor) of the former Ashikaga shogunate for reporting Yoshiaki's movements, but he had not been given any territory.

The reason was that he lacked military achievements.

If Fujitaka had led an army, he could have distinguished himself, but in reality, he could not leave Yoshiaki's side as he was under surveillance.

Nobunaga could not grant him territory since he lacked military achievements, so Fujitaka spent his days traveling between Ishiyama Castle and the shoen.

In such days, his eldest son, Yuiichiro, fell ill, and Fujitaka, with his wide network, tried to ask his acquaintance, the doctor Kudose Genshaku, for an examination.

However, it seemed that Genshaku was not currently in the capital.

"What's going on?"

"Well, he has gone to Edo..."

A doctor who was Genshaku's disciple, called in his place, explained to Fujitaka with a reluctant expression.

"Edo? For what?"

"He is studying abroad."

"Huh? Is a man like Kudose Genshaka going to seek further instruction?"

"Yes, he says that learning from the best is not a matter of shame... Lord Dosan is furious."

Genshaku lost his parents at a young age and was raised by his maternal uncle, Kudose Dosan.

He later became Dosan's grandson-in-law and succeeded the Kudose family.

"Lord Dosan must be angry."

"Yes."

Kudose Dosan was a man of such caliber that he was called the "Medical Saint" and had many patients and disciples.

He held the top position in the so-called Kudose school, and for him, it was a disgrace for his successor, Genshaku, to learn from other doctors.

In the past, the young Dosan went down to the Kanto region and studied at the Ashikaga School, where he learned the latest medical knowledge from Tashiro Sanki, also known as the "Medical Saint," which had been brought from Ming.

Unlike then, he now had many disciples and a great reputation.

In front of them, it was a matter of pride not to seek instruction from other doctors.

Unfortunately, Dosan was already over seventy.

He was too old to learn new medical knowledge and retain it.

"Edo, you mean the wife of Tsuda Mitsuaki?"

"Yes, a woman surpassing Lord Dosan as a doctor... It's outrageous to spread such rumors even in the capital!"

The young doctor, a disciple of Dosan, was indignant, but it was a major misunderstanding.

Kyouko had never considered the Kudose family as a rival.

She simply diagnosed and treated patients, provided health guidance, and made significant contributions to epidemic prevention.

The Kanto region was undoubtedly the most advanced in medical care in Japan at the time.

Not only Kyouko, but also many doctors, midwives, and nurses who had received her guidance were active throughout the Tsuda domain, and many had been invited to serve in other daimyo families.

There was also a medical school in Edo, and people from all walks of life, including samurai, merchants, and monks, as well as farmers and townspeople, were flocking to its doors to become doctors.

"That woman even treated Minister of the Right Oda Nobunaga..."

The young doctor was trembling with anger.

Dosan had once examined Nobunaga, and the self-aware great doctor thought he would be appointed as the Oda family's chief physician.

However, in reality, a young, high-achieving doctor who had been trained by Kyouko in Edo was appointed.

Kyouko, though in a temporary position, was also appointed as Nobunaga's chief physician.

Recently, she had also examined and provided health guidance to Emperor Ogimachi, from whom she received the rank of Junior Fourth Rank Upper and the title of "Bureau of Universal Healing."

These facts were unbearable for the proud Dosan.

Losing to a woman was even more of a blow to his pride.

The shame of the master was the shame of the disciple, and the doctor continued to vent his dissatisfaction with Kyouko even after examining Yuiichiro.

"What is Genshaku thinking in such a situation?"

The young doctor could not believe that Genshaku, who was to succeed Dosan, had gone to Kyouko to learn medicine.

He raised his voice, criticizing Genshaku and Kyouko.

Even if the other party was superior, the Kudose family was a great family of doctors, and it was unthinkable to bow to a sudden female doctor.

They should have come to the Kudose family and said, "Please teach me."

"Yes..."

Fujitaka personally thought that this young doctor, poisoned by the Kudose family's authority, was a victim in a sense.

He believed that Dosan's attitude was a kind of old harm, and that Genshaku, who had not been poisoned by it, was the right one.

However, Fujitaka also had a grudge against the Tsuda family, so he pretended to agree with the young doctor's thoughts on the surface.

First of all, this young doctor had lost himself to emotion.

He had initially claimed that they were superior, but then said that it was only natural for the other side to say, "Please teach me," which was a contradiction.

Fujitaka was worried whether it was okay to let this young doctor examine his son, but he was still one of the best in the Kudose school.

Thinking there was no other choice, he tried to let him focus on the treatment by listening to his story.

It was a lot of trouble, and Fujitaka harbored a grudge against Kyouko, whom he hardly knew.

He thought, "If only that woman didn't exist."

"There is also the matter of Shishin Ida."

Shishin was a disciple of Dosan but left the Kudose family halfway through.

He went to Edo to learn from Kyouko.

This incident also made Dosan furious, and his dislike of Kyouko became more intense.

This attitude spread throughout the Kudose school.

Thus, the two medical schools, the Kudose school and the Tsuda school (as Kyouko's school was known), were in a state of opposition due to the nature of human society.

"The world of doctors is quite complicated, isn't it?"

While pretending to show understanding to the young doctor, Fujitaka was also not amused.

It was because Yuiichiro could not be examined by Genshaku, and Kyouko was the wife of the man he disliked, Mitsuaki.

Fujitaka realized that he was listening to the young doctor because he disliked the Tsuda family.

"Indeed, a woman being a doctor is laughable, isn't it?"

"Do you think so, Lord Fujitaka?"

"Yes."

Through this incident, Fujitaka became more aware that he disliked not only Tsuda Mitsuaki but also his wife.

He thought it was irrational, but emotionally, he could not like them.

Fujitaka also realized that this was the nature of human beings.

"Please leave Yuiichiro's treatment to me."

Fortunately, Yuiichiro's condition improved quickly, but this incident deepened Fujitaka's resentment towards the Tsuda family.

"Today, we will perform a simple surgery."

There was a school in Edo to train doctors, nurses, and midwives.

Kyouko, who was also the principal of this school, had been busy and could not visit often, but today her schedule was free, so she would demonstrate a simple laparotomy to the young aspiring doctors.

The patient was a child with appendicitis.

In this era, it was almost an incurable disease, but the surgical method was gradually spreading in the Tsuda domain.

However, the anesthesia, drugs, and medical instruments needed for surgery were monopolized by the Tsuda family, and there were still many villages without doctors even within the Tsuda domain.

It was urgent to train doctors of a certain quality, as it took time to educate them.

To prevent fake doctors who claimed to have studied in Edo from appearing, they had also established examination and licensing systems.

"Questions will be accepted after the demonstration."

Kyouko performed the laparotomy, hemostasis, appendectomy, and suturing in a short time with practiced hands.

The young aspiring doctors watching were amazed at her speed.

"Today's surgical technique is..."

After the surgery, Kyouko explained the procedure from the beginning using a human anatomy diagram on the blackboard.

She also explained the necessary surgical instruments, how to administer anesthesia, how to disinfect, and the use of a portable sterilized transparent tent and why it was necessary.

"You can't see them, but countless tiny organisms are wandering in this air. We call them bacteria. If you don't remove them before opening the abdomen, the patient's condition is likely to worsen and die due to these bacteria, so it would be better not to perform the surgery at all. Bacteria are always attached to human hands. Before surgery, be sure to disinfect your hands and use clean gloves like this. Next..."

When the explanation was over and it was time for questions, hands shot up one after another.

The young aspiring doctors were eager to hear from Kyouko, who had successfully completed the surgery.

"Is it okay to remove part of the body?"

"Yes, the appendix can be removed without major effects. If left untreated, pus can flow into the abdomen and cause peritonitis, which is the cause of death in most cases. The appendix is a place where tiny organisms are kept to break down plant components and obtain nutrients. That's why horses and cows, which mainly eat grass, have large appendices. Humans eat a variety of foods besides grass and vegetables, and other organs can compensate for the role."

"Tiny organisms that can't be seen? Do they really exist?"

"A picture is worth a thousand words. Let's take a look."

Kyouko had her assistant prepare a microscope and samples, and showed the bacteria to the students in turn.

"These are bacteria that exist in large numbers in the human large intestine. This species is harmless, but there are also types that can cause serious symptoms if they enter the blood or urinary system. Next..."

Kyouko's surgical demonstration and subsequent explanation were well received.

"Every time I see it, your surgery is amazing."

"We still have a lot to improve."

"Yes, the path to becoming a Medical Saint is still long."

"I still have a lot to learn. I can't die yet."

Kyouko was busy with other things, so she currently had a responsible person in charge of the medical department.

This person was Ida Doho, who had a past of leaving Kudose Dosan's discipleship to become Kyouko's disciple.

Because of this, Kyouko was hated by the Kudose family and their disciples, but she did not care much.

She saw the Kudose faction as nothing more than bad authoritarians, residents of a white tower.

Kyouko unconditionally accepted Ida Doho, and he, who had talent, was now the second in command among the Tsuda family's doctors.

Others included Ose Hohan from Owari, Tamaki Yoshitaka, who had been dismissed from the Mori family due to a significant reduction in their fief and had come to Edo, and Nagata Tokumoto, who, despite being over sixty when the Tsuda family acquired the Kanto region, had relearned medical techniques from scratch.

They became famous doctors known as the Four Heavenly Kings among Kyouko's disciples.

The leader, Doho, also had many bureaucratic tasks, so he was treated as the leader of the Four Heavenly Kings for convenience.

Yoshitaka, a former Mori family retainer with excellent administrative skills, supported Doho.

"It's been a while, so I was nervous."

"It doesn't seem that way... Actually, there's someone I want to introduce to you..."

"Hmm, who is it?"

The person Doho introduced to Kyouko was none other than Kudose Genshaku, the successor to Kudose Dosan, whom Doho had previously been a disciple of.

"This is unexpected."

"In the Tsuda family, we hear that we do not reject those who come and do not pursue those who leave. I have learned all the Kudose school's medical techniques from my uncle Dosan, but I have become interested in learning more."

"I think you should be free to do so. We teach without reservation to those who are admitted."

If they made anyone a doctor, there might be people who would become fake doctors and commit fraud.

Therefore, the schools in the Tsuda domain had very strict exams.

The entrance exam was highly competitive, but if you passed, you had a chance to become a doctor regardless of your social status.

There was also a practical exam at graduation, and if you did not pass, you would not receive a license.

Even if you failed to become a doctor, there were other paths such as becoming a nurse or midwife, which were a bit easier.

"An exam?"

"Doctors are entrusted with people's lives. It would be a problem if anyone could easily become one."

"Indeed. I understand. I will work hard to pass the exam."

Genshaku, in his mid-thirties, moved to Edo with his family and passed the exam while working.

He maintained excellent grades after admission and passed the graduation exam, eventually becoming a figure on par with the Four Heavenly Kings.

"Sister, the Four Heavenly Kings have become five."

"Five Heavenly Kings sounds strange, doesn't it?"

"Five Heavenly Kings has a bad ring to it. If there are four Heavenly Kings but five people, people who care about such things might complain... What should we do?"

Seiki, who was in charge of the production and management of medical instruments, also interacted with the doctors.

In this world, it was unclear whether his skills would be useful, but he actually had a medical administrative qualification.

This was because he had once planned a flawed life strategy of marrying a female doctor and becoming a recluse.

Later, he was introduced to Kyouko, who was also a doctor, by his brother Mitsuaki, but Seiki shouted, "Real life is just a shit game, there's no such thing as a cute female doctor!" and was rejected by Kyouko.

This was the incident that became the first reason why Seiki could not stand up to Kyouko.

"I heard that the Ryuzoji family in Kyushu had five Heavenly Kings even though they were called the Four Heavenly Kings."

"Indeed, I thought Five Heavenly Kings sounded bad. Yes, let's keep it as the Four Heavenly Kings to avoid the situation where 'Feh, so-and-so is the weakest of the Four Heavenly Kings, next is this so-and-so...'"

"Kiyochan, all five are equally skilled, and if a doctor fails, the patient might die..."

"What! That scenario is impossible!"

In later generations, the medical technology of the Tsuda family was recognized by many historians as undoubtedly the best in the world, and Kyouko Tsuda became the first woman to be called the "Medical Saint."

However, where this technology came from remained a mystery that many historians could not solve.