Parallel World Pharmacy

July 26, 1148.

On that day, Pharma was dealing with Blanche, who had come to a pharmacy in another world for training.

Blanche, who aspires to become a pharmacist after Ellen's apprenticeship, is sometimes taken by Ellen to the Alien Pharmacy.Since I am an apprentice, I will naturally not be involved in dispensing medicine, but I often learn in stores, so I follow Ellen behind me and move slightly, and she is cuddled by customers.

Ellen went to the clinic in the morning, wearing the uniform of the otherworldly pharmacy, and came to follow Farma.

She is a noble lady, but cleaning, laundry, and miscellaneous services are also part of her training as a pharmacist.

The pharmacy is cleaned every morning by all staff.

They also know exactly how to clean, how to disinfect, how to dispose of waste from the pharmacy, and how to dispose of dirt.

I also teach the method of extraordinary cleaning. Today, there was a norovirus patient who vomited massively on the floor of the pharmacy in the morning, so Pharma and Blanche defended with a mask and plastic apron, and wiped and disinfected with sodium hypochlorite.

Contaminated gloves, etc. are treated as infectious waste due to virus.

When the vomit dries, the contamination spreads.

I will teach you one by one.

By the way, Blanche was vomiting immediately after the work was completed.

"I may be able to dispense medicine as a pharmacist, but I'm not sure I can get used to the smell of blood and vomit..."

She said that, and for a while it was in the backyard, in front of the sink.

It seems that it is no longer possible once it is in the dust, and I have repeatedly been vomiting because of the smell of my own vomit.

"I think I'll get used to it."By the way, the vomit is also an observation material, so we often observe the patient. "

I can observe it, but I can't smell it anymore.

But Blanche doesn't mind the smelly medicinal herbs in her house.

Farma encourages him the day after tomorrow.

"Eh, is there a lot of herbs in the house?"

Her face hardened.It seemed like my nausea had subsided for a while.

I think the medicinal herbs grown in Blanche's room are quite expensive.

Blanche's room has insect-shaped medicinal herbs by the window, but they smell pretty bad.Farma thought in her heart that if it was okay, she might have the talent of a pharmacist.

"I didn't know... I thought it smelled good"

"Well, well. Each person's sense of smell is different."If that's all I think and Blanche doesn't, that's fine. "

"Eh, is there something wrong with my sense of smell?"Could it be that the perfume you always use is also dull?But your mother didn't say anything. "

She said that it was okay because she was in a hurry with tears in her eyes.

"I thought the damp cloth that my mother used to put on my waist also smelled good"

"That's human... well, let's get some air in the garden to change our mood."

Vomiting settles down and takes Blanche, with a slightly flabbergasted face, to manage the medicinal herbs she grows in the store's backyard.

"My little brother went up and he also handled medicinal herbs other than genetically modified plants in the store."

"Some people who have been using traditional medicines have distrusted or resisted modern medicines.If you keep a few of the traditional medicines that such people seek first in our stores, not only in pharmacist guild stores specializing in herbal and traditional medicines, you will be inspired to go to our stores, and some people will be wondering if they can try modern medicines after receiving counseling. "

"Huh..."

Blanche is listening to Farma while watering herbs in the same way.

She's slowly trying to grow herbs and other plants for Ellen.

"Ah. You can't give them water today."Of course, we don't keep medicinal herbs in our stores that we know are obviously harmful.And even in pharmacist guild stores, we send patients who we think are out of hand. ”

"Somehow... it's tough, too, little brother."Think about the patients who don't come to the store.

“Of course, because pharmacists work to improve and promote public health.I only help customers who come to my house, I don't know the rest.That's not true. "

"I wonder what it is." Are you tired of living in such a world and thinking about it for others? "

Blanche looked at me with white eyes like she was frivolous.

Farma shut her mouth on how to answer this.

Nobles O'Brige is certainly persistently told by his father, but first of all, it's you.

Is it because of Ellen that Blanche's mouth has recently become full?

For some reason it is an angry Pharma.

"Basically, I only do what I want to do."

"Hmm... Oh, I took a lot of these medicinal plants, so I made a tree to grow them."Master taught me. "

Point to the herb that Blanche just picked and check with Pharma.

Pharma thought the same thing because the number of shares has been decreasing.

Pharma is relieved that Ellen's guidance is alive.

"Well, you should probably make more inserts, considering the heat of the summer ahead, which will kill the stock."Then, the thin branches don't have good leaves, so I'll do my best to cut them back. "

Well then, I'll cut it up for insertion.

Blanche put the scissors up, so Farma stopped.

"I haven't finished any other work, but are you going to do it now?"If you want to make an insertion tree, you have to cut it and treat it with water immediately.If germs enter the incision, the chance of rooting will decrease. "

I see. Okay, I'll do it right away.

Please check the shape of the plants collected and record the quantity.

"Well, you can't grow anything other than what you planted. When you plant it, you make a sign, so you just harvest it exactly as it is."

"That's the preconception, isn't it?"Fair enough. Similar forms of weeds and poisonous plants may come in from somewhere.Besides, I planted the seeds by mistake in the first place. "

Huh. I see.

"Let's not assume that we planted this here."Once I missed a weed I didn't know about, and I've had a hard time. "

Both Pharma and the Yakuza often check the plants at harvest time.

Weed seeds continue to enter the premises in the wind.

One of the most troublesome things about growing plants, not just medicinal plants, is weeding.There are weed killers on the modern planet, and some of them are used in Merseil's herb gardens, but the scale of the pharmacy's premises can only be taken by hand.

Blanche struggles to get rid of weeds as the soil fills up.

Pharma thinks the two of you are sweating.

"Blanche, don't miss the seeded weeds.If the seed falls into the field, more and more work will be done.Then you should wait a little longer before pulling out the weeds.It's too small to pull it out, right?There's also a perfect time to pick weeds. "

“Be careful, one at a time.”

First, don't drop weed seeds on the field. "

"Okay. Ooh."

Blanche misses the Oxalis.

"I won't throw the weeds I pulled all over the place." Put it in a bag. "

"Why, if you keep it, it will wither, right?"

"The stems will wither, but the seeds will fall.What happens when all these seeds fall? "

Eh?

"Yes, don't make it difficult for me."

Farma also quietly pulled out the weeds, gently urging attention.

I don't dislike this kind of work, but I feel careless.

"Oh, I hate weeds!" I don't know if I'm growing medicinal herbs or weeds!How to get rid of herbicides? "

You can use herbicides, but after all, you have to remove the ingredients when you use live medicine, so it's faster to remove them by hand.

I knew it ~

Yeah, well, Blanche's been taught how to control herbs by Pharma.

"Hi there. Oh, I was here."

Ellen, who was visiting, came back, left her horse at the gate, and walked through the backyard.

Farma and Blanche turn around at the same time.

Ah, Master! Welcome back!

“I'm home. Pharma, you're not in the shop.”

“I was teaching Blanche how to control herbs.Ellen was early today, wasn't she? "

I came home early because Agata-sensei is here today.

Farma remembered Ellen saying that at the morning meeting.

That's right, Ellen seems to be able to handle it.

I'll take care of it. I'm ready to go.

Ellen smiled confidently.

It's a good smile, and Pharma smiles.

Well then, please.

So far, Farma has left everything to the staff as much as possible, rather than taking on the pharmacy business on its own.I will definitely point out, but I also refrain from overstating.

It is most desirable to be able to do without yourself.

If you are told that you want to change the method, you may adopt the pharmacist's method after verifying the validity.

Little by little, difficult diseases have been passed on to Ellen and other pharmacists.

I don't need to be alone in this landscape anymore.

In another year, I was going to give Ellen the shopkeeper's name.

In the afternoon, Agata, the head of the Imperial Physicians Guild, led several civilian doctors to the Otherworld Pharmacy to get the rabies vaccine.

The rabies vaccine was requested by a local doctor, Donald, but it was provided in the name of Guild Leader Agata.

It was purchased and managed in bulk by the doctor's guild, and delivered to each hospital by dedicated delivery if necessary.In this way, the management of temperature, humidity, consumption expiration, etc. can be tightened, and the management costs at each hospital can be reduced.

Pharma interprets this system as like a drug control center in Japan.

Agata wore a gown with the Imperial Physician's Guild insignia and was not formal, but had a black leather eyebrow on her right eye.Farma wonders what happened, but decides to ask after work for the time being.

“Welcome, we have a rabies vaccine in the lot you ordered”

Ellen, the first person to order, greets her and invites her to a private room in the store.

Farma was also present as the person in charge.Ellen was looking at Agata's eyelids, but she didn't seem to care, so she decided not to ask.

“Please call us.”

Farma goes around to support Ellen and gives the doctors a chair.I also feel Pharma when I serve tea.

“No, I didn't expect the rabies vaccine to be finished.I want to try it quickly. "

Donald was so nervous that he could tell from Pharma.

“Did you say you couldn't meet the delivery deadline?”

Agata asks, and Ellen answers confidently.

“No, our Marseilles factory is producing on time.”

"I wish I had. Thank you again for your continued support."

"Then, please sign the delivery note and transfer it to our designated bank."

Ellen tactfully asks for the various documents to be signed.

Yes, I've already deposited my money.

“I'm sorry, but have you gone through the subsidy process?”

“Thanks to you, I'm good at public procedures.”

That's right.

I was originally a nobleman, and I didn't miss the agata of the samurai doctor.

"Now, explain the drug to me."

"Yes, this is a rabies virus infected and inactivated in primary cultured cells of chicken embryos, then concentrated, purified, stabilized, and powdered."

Ellen shows the actual contents of the vial for a moment and puts it back in the ice box to keep it cold.

There must be no deviation in temperature control.

"Should I give it to my dog when he bites me?"

“Yes, a wild dog, cat, skunk, raccoon, fox, bat, or carnivorous animal is basically considered rabies-infected.No special measures are required for rodents.Rinse bite wounds with soap and running water for at least 15 minutes prior to administration.Then disinfect and clean with benzalkonium chloride ”.

Will you sell me some antiseptics?

Agata asks anxiously, and Ellen offers an alternative.

"Yes, what do you use?"You can also use povidone iodine, etc., and I'll give you the list later.Rabies immunoglobulins and rabies vaccines are administered as prophylaxis as soon as the wound is cleaned. ”

"Rabies immunoglobulin is in a set, I wonder."

“Of course, it would be desirable to have all citizens of Imperial City vaccinated before exposure, but until we have a vaccine production and supply system in place, we are now starting post-injury dosing.”

With the movement between the Empire and the New Continent, Pharma is also working with Elizabeth to prepare publicly funded vaccinations for citizens of the Imperial Capital against tetanus, yellow fever, measles, rubella, and chickenpox, which are now mandatory only for trade officials."Farma supplemented and told Agata.

"Thank you for your decision."

"Seriously, I love you more and more as a citizen."

"When do you get the rabies vaccine?"

"Please store the powdered vaccine at 10 degrees or less with no light.The vaccinated person should be examined and tested to check his/her physical condition.If used, dilute 1 vial with the prescribed dose of water for injection and inoculate subcutaneously on the day of injury, 3 days, 1 week, 2 weeks, 1 month, and 90 days. "

Ellen takes the time to explain the precautions for inoculation.

Some questions from the doctors present fly, and Pharma answers what Ellen can't answer.

“Okay, I wonder if we can assess the risk of developing rabies after the injury.”

“If you were able to catch a chewed-up animal, you'd know in advance if the animal would develop rabies within a week or two.”

Yes, you develop faster than others.

In animals, initial loss of appetite and abnormal behavior can be seen.

Thereafter, the course of the

maneuver type with arousal symptoms, drowsiness, water phobia, and pharyngeal cramps;

It is divided into a paralytic type that is followed by a state of paralysis.

Both are zoonotic infections that cause almost 100% of deaths.

Ellen explained to Agata and the others.

Both Agata and doctors, including Donald, put textbooks on the side, write notes, and listen seriously.

“By the way, there's no way to help a patient once developed rabies.”

“I'm not saying zero, but it's extremely difficult.”

Pharma knows of several cases of survivors of rabies in cases of the Earth.

In 2004, for children who developed rabies a month after being bitten by a bat in Milwaukee, the doctors placed the children in a coma, administered the antiviral drugs ribavirin and amantadine, and survived by the children's own immune system.

This treatment, named the Milwaukee Protocol, has been administered to dozens of rabies patients in the modern planet, and only a few have survived.

Pharma tells Agata that treatment possibilities are not zero, but it also explains that the efficacy has not yet been clarified and the success rate is low.

"I see, then it's all about prevention."It might be the key to seeing if you have a history of bites when you develop rabies. ”

Agata stretched her spine as if she had squeezed her mind.

Farma and Ellen agreed in full.

“Exactly, especially since it can almost certainly be prevented with pre-exposure doses.”

"So, in order for our surgeons to treat rabies patients, considering the possibility of touching body fluids and blood, should we give rabies vaccine as a preexposure dose?"

Donald asks Ellen about Pharma anxiously, so she tells her that Pharma is highly recommended.

Excuse me, Agata-sensei, are you hurt in the eye?

Ask Agata what Ellen was concerned about before handing over the medicine.

If you give me the medicine, I won't be able to talk long because of temperature control.Agata laughed elegantly when Ellen asked, “Because it was something she didn't have when we interacted a few days ago.”

"No, this is it. I had cataract surgery yesterday.I wanted to report success after checking how it looked, but after all, I would be worried if I wore eye clothes. "

"Is it cataract surgery?"

Farma half surprised and asks to confirm.

I had surgery yesterday and I'm afraid that going out today will depend on my ability to act.

Where the hell did you get that?Cataract surgery has not yet been established in this world.I'm not an Agata-sensei because I can't do my own surgery.It wasn't the Imperial Pharmaceutical Cathedral.If you're a big Imperial Pharmaceutical, you should be able to talk to me.)

Of course, Pharma knew that Agata had cataracts.

And as a surgeon, I also knew that it was the cause of placing the scalpel.

Agata returns to active duty and wants to undergo surgery.

I heard such rumors, but I couldn't do anything about Farma.

The story of Agata undergoing cataract surgery is astonishing to Farma.

Cataracts are age-related diseases that cause abnormal aggregation and changes due to changes in the structure of a protein called crystallin, which constitutes the majority of the crystalline lens that maintains a transparent structure, and that prevent the transparency of the crystalline lens from being maintained. They occur in almost all elderly people over 80 years of age.

When the crystalline lens becomes clouded by cataracts, the vision becomes blurred or the visual acuity decreases.Since vision loss is also caused by presbyopia, vision loss in the elderly may not be discernible.

Not only aging, but also atopic cataracts.

The history of cataract surgery on Earth is unexpectedly ancient, and in a surgical technique called the "crash method", what had been performed in India since ancient times passed through China to Japan.

The method is a simple method of sticking a needled, cloudy crystalline lens under an anaesthetic and causing it to fall off into the vitreous, and it is also recorded as an illustration on sick sheets.It is said that many people were infected and lost their lives as a result of this treatment.

Furthermore, since there is no lens after the crystalline lens has been removed, thick glasses are still necessary.

Cataract surgery is relatively safe and common in the modern planet.

In cataract surgery, an ophthalmic anesthesia is used to incise the anterior capsule of the crystalline lens from a very small incision wound of 1 millimeter to 3 millimeters and to crush the crystalline lens.

Refractive correction is performed by removing the lens by aspiration and inserting a folded intraocular lens.

Incisions may be made with a laser.

Intraocular lenses also offer a monofocal or multifocal lens option for insurance coverage.

When Pharma previously looked at Agata's eyes, the right eye was in a state of mature cataract, and the left eye was a cortical cataract with cloudy margins.

At that time, Agata asked me if I could cure it, but I couldn't do anything else.

With Farma's hand-held technology, it was impossible to make an intraocular lens with high accuracy, so it had to be abandoned.I was a little bit embarrassed about that.

The lens was properly removed.

It is explained that Agata did not remove the crystalline lens with the so-called down ceremony.

What happened after the lens was removed?

"I put in a lens to replace the crystalline lens.Now, what ingredients do you think you used? ”

"... is it glass?"

Farma asked, looking at Agata's face.

If it were glass, Farma would have to report it as a pity.

Glass lenses are prone to dislocation in the vitreous, and furthermore, a large incision would have been made when inserting the glass, resulting in strong refraction.

By the time you take off your eye clothes, it is likely that you will not look the way you expected.

Agata then gave a childish look like she had outdone Farma.

“No. Did you still think it was glass?The correct answer is: intraocular lenses made of acrylic resin. ”

Is it acrylic resin? Wow!

Farma's eyes widened with excitement and joy.

"Fufu. It would be amazing."

Agata narrowed her eyes as if satisfied with Farma's reaction.

"You let me in, Mr. Donald."The hospital is well prepared for infectious diseases, so I was reassured. "

I hope it's going well.

Donald, a veteran doctor, is shyly blowing his head next to him.

Agata explains to Farma, turning her gentle attention to Donald.

"I've been going to the Bureau of Technology for the past month.You are probably a registered technician, but I have referred to many of them.Method for the synthesis of acrylic polymers, and processing method thereof.I read everything and actually moved my hands.And when I was able to satisfy my acrylic resin molding, I came up with it.I thought I'd use it on biomaterials, for example, my lens. "

In the history of technology development for intraocular lenses, acrylic resin and silicone lenses were also used.Pharma registered the synthesis method of acrylic resin with the Technical Bureau.

Agata learned and applied the knowledge.

But Agata seemed strangely surprised by Farma's reaction.

“It looks like you knew acrylic polymers could be crystalline.”

"... I'll leave it to your imagination."

Farma opens her mouth.

"If this procedure is established, I will also register with the Bureau of Technology"

But wasn't anaesthesia a burden on your body?

Ellen cares about Agata's body.

"It's a local anesthesia, it's nothing."You're such an old, short-aged, 80-year-old grandmother who bothered to have surgery?I wonder if that's what you thought.

Agata gives an unstoppable smile.

"No... that kind of thing?"

Ellen rushed to deny it.Agata gives a tolerant smile as she feels worried about how Ellen should follow up.

"On the contrary, I had surgery because I was eighty years old."It's already a short time ago, and if it works out well, we might be able to establish a new procedure.I have a great advantage, too, and I might be able to see with just one eye.Either way, it's invisible, and there's nothing to lose.I don't want to regret not doing it. "

"What is the shape of the intraocular lens?"

I was worried about Farma and couldn't help but ask.Agata then took out the model contained in the jewelry box.It is a crystalline lens with four supports, and it has a special shape.

"Based on anatomical findings, I thought that if I put the lens in, it would deviate and fall, so I tried to attach the support to the end of the lens."

"Oh! It's hard to fall or deviate in this case, isn't it?"

Farma shouted in admiration.

It has a similar shape to the intraocular lens in the modern planet, although it is slightly different.

It was probably a shape that Agata and the doctors had gathered their wisdom and knitted.

If you don't mind, I'll give you an antibacterial eye drop.

"Don't worry, I've already used it."It's been a day, so let's take off our eyelids. "

Agata decides for herself and slowly removes her eyelids.

Then, in a blink of an eye, I saw the landscape outside the pharmacy through the window of my private room.

"Oh, it's a vibrant flower garden."No problem with the way it looks, it's great.It's not distorted anywhere. "

Since the intraocular lens used by Agata is monofocal, glasses will be required, but at least the opacity of the field of view should be gone.

"Besides, wait, the sky looks so blue!" I wonder if it's your imagination. "

“It's not my imagination.The lens turns yellow due to aging.Even if he hadn't had a cataract, Dr. Agata's landscape would have gradually turned yellow. ”

Farma tells Agata how he feels.

"So now, you may see the sky as vividly as you did when you were young."Would you like to visit the Imperial City? "

Yeah, I'd love to.

Farma takes the elevator to the fourth floor of the store and the passageway on the floor where the lab is located.

The front window of the 4th floor of the Otherworld Pharmacy has a view of the Imperial City.

As Pharma and Ellen opened the windows, the wind blew in.And she stared at the Imperial Capital.Donald sees the same scenery next to Agata.

Agata took a handkerchief and placed it gently in front of her.

"Oh, what a beautiful thing. I feel like I can see everywhere.I'm glad that the haze that enveloped my life has been removed and the blue sky has been restored. "

Well then, would you like to try the left eye as well?

Donald asks in a fussy tone.

"Yeah, I'd love to. I'll be there as soon as I can."

Agata clearly informed Donald of her intention to undergo surgery on her left eye in the near future.

"No matter how old you are, don't forget to try."Otherwise, I wouldn't have seen this view. ”

I'm sure that the technology we put here will be close to each and every person's life for generations to come.

Farma held that thought to her chest.

“Try eating oranges today.I'm sure it has a vibrant, nostalgic color. ”

Orange, which until yesterday had seemed brown to her, should come back to orange.