Parallel World Pharmacy

3: 11: Diagnostics and Procedures

"What are you doing, Eleonor, as an apprentice pharmacist, make Pharmacy owner or something"

Palle picked up the wand she had removed and scolded Ellen as she sat on her hips.

Ellen asks back what she's saying because Palle is making a mistake.

"Yes?"

Palle believes Pharma is still an unqualified apprenticeship pharmacist. So I was deciding what his mentor, Ellen, was making Pharma do pharmacies and do insane things. Palle mourns, sighs loudly all the time.

"Even though you're still unqualified and immature, you'll only have to struggle later if you put the decorations on the shop owner and make him do something out of the way."

Pharma and Ellen looked at each other.

(What do we do?) After an exchange of glances (to which Farma replies that you are good), Farma replies without difficulty.

"Ellen didn't tell me I was letting the owner do it."

"Hey Farma... I clouded my tea like that again. Pallet, I think you should tell the truth."

Ellen conquers Pharma.

Ellen was worried that the story would just get unnecessarily twisted if the truth wasn't revealed early. I don't mind Ellen caring like that, Palle said.

"Don't hang out, you better get into school soon, too, Pharma. Once you do not systematize and learn pharmacy, self-study is a long way from studying. You don't have to be a Novarut or an Imperial School of Medicine, so go to school as well as tutors"

Palle seemed genuinely worried about the fate of Pharma.

"Huh? Yeah, I'm gonna go to Imperial Pharmaceutical."

Pharma hammered worried about what was going on.

If Pharma were to enter the Saint Fluve Imperial School of Medicine, it would be as a professor, not as a student, but my brother has no reason to know. Ellen, for Christ's sake, breathed on her shoulder.

"If that's the case, brother, why don't you let me take care of it? I'll go to the pharmacy and explain my brother's illness."

"Then I'll ask you in advance, what disease do you think you are...?

Palle asks Pharma. Pharma responded instantly without hesitation.

"Leucémie."

The name of the disease is based on the first discovery by nineteenth-century German pathologists that the blood of a patient suffering from a splenoma turned white and died.

"What, is that your finding? You didn't even look at me, did you?

I never even heard of it from Palle. It was a disease.

Palle was stunned to see if he had finally started to create his own medical name.

"You have an idea."

"You're doing a mess. The disease name must not be created at will somehow, it must be based on the diagnosis of proper procedures. Is that how you run a pharmacy?

Palle teaches Pharma.

"Look, I'm not ashamed that I can't make a diagnosis. There are many unknown oddities in the world. It's more embarrassing to be a pharmacist to have a proper medical name."

"I think so too."

Farma fully agreed with Palle.

Ellen put her hand on her forehead and said, "Farma, I can't follow your farce." But Farma was never making fun of Palle. Instead, I honestly respected his attitude in trying to sincerely confront the disease and objectively see the disease and accept death as something beyond the control of the pharmacy of this world. Farma thinks Palle is an excellent pharmacist, having learned his life expectancy based on all the knowledge and experience he can, not on the dark clouds.

In contrast, Pharma only followed her around with an eye exam.

"We'll do it when we get back to the pharmacy, it'll be a long story, and we'll make a diagnosis based on the procedure. Ellen, I've got a lot going on at the pharmacy, so I need you to come back in the carriage with your brother. 'Cause I'm sending a carriage over here."

"What, why do I have to ride home in a carriage with you, Palle? I'm going home with my horse."

Ellen looks blatantly disgusted.

I don't like waiting for carriages, and I don't like going home with Palais any more.

"No, what are you talking about on your own? I told you I had to go back to Novaroot."

My brother has made up his mind about my upcoming plans, and I'm sick of Palais. And I didn't even expose myself to follow what I was told.

"No. Don't ride a horse because it's easier for your brother to have a brain bleed right now."

Farma, who could have told his brother that, rode a horse with the dotard and went back to the pharmacy.

'Cause that's what my brother says.

Ellen takes the horse's reins and calls on Palle. Both Ellen's horse and Palle's horse return to their homes on their own if they let go.

"And you went home on a horse."

"Palais, I think it's for you. Maybe."

"What the hell is that guy? Are you nuts?"

Palle tries to ride a horse if she can't stay with him.

Ellen stopped it.

"No, I'll wait for the carriage."

From here to the pharmacy, even if you walk home, it's like half an hour. But the ground is wet and guzzled with snow. You'd still rather wait for the carriage than walk.

"Well... I should have let the horse tow you."

To Ellen's joke, Palle returns it in a sermon.

"Hey, why are you hanging out with Farma's self? You're a first-class pharmacist, too, assuming? Can't Pharma be alone forever if you're a teacher with that halfway attitude? Though he's my second son, he needs to be alone as a pharmacist."

"I'll ask you a story, while you wait for the carriage."

"Damn."

Ellen and Pallet ended up winged waiting for the carriage. The carriage arranged by Pharma came quickly.

On the way home, Palle was moaning about his brother.

"My brother's an idiot and I'm sad. What happens to the de Medicis family if I die sick, my stupid brother will crush my house. How unlucky, you can't die like this."

Palais was just saying it was already dark about the future of the Pharma and de Medicis families. Blanche hates studying too, Pharma is a highly presumptuous idiot, and Palle groans.

"Really? I think you're lucky."

Ellen said that to Palle with a naughty smile.

"Are you so happy about me being dead and sick? Hmm?"

Palle provokes reflexively, but Ellen recieves.

"Hey, Palle, you've always been a brain muscle for everything, but you're hot and painfully confident in the patron saint."

From the time he became conscious, while in Imperial Capital, he went through the temple like every day and lacked worship.

Even if my family didn't go, I went to worship alone every morning.

It went through with flutter, whether it rained or snowed, with a big cold, and Ellen said, "What are you going to do until then? You can rest," he said. I've had big fights.

"Naturally. It is only with the protection of the patron saints who have given us divine power that we can use divine art. You have too little faith in the god of water! We just need the divine punishment to come down and make the divine art unusable!

"Look, something like that"

Ellen's patron saint is a water god, but he'd still rather visit the temple once a month to worship. It's not that I don't have faith, but just because I believe enthusiastically doesn't mean I'm born with more divine power. Even though it is common sense that prayer to the patron saint should not be lacking in the mornings and evenings, few aristocrats are quite protected.

From that situation, Palle was too exemplary a believer in the drug God.

"As usual."

Ellen smiles with pleasure.

"Because you're so faith enthusiastic, didn't the patron saint come beside you through all the prayers you've had?

"What do you mean?

Ellen's patron saint is the water god, but Palle's patron saint was the medicine god, the kind of man who was born with a court pharmacist and as heavenly a life as possible. Palle is proud that his patron saint is the medicine god. No matter how much effort Ellen makes as a pharmacist, it will never be filled, the difference between the patron saints.

It is only if the patron saint is the medicine saint that Ellen cannot be, but Palle can also be a court pharmacist.

It makes me lie that Ellen has never thought of Palais, who was born with the asylum of the drug God, as envious.

"Yeah, nothing"

Ellen clouded her words. That's something I can't help but envy.

Because the medicine God doesn't confess, I thought Ellen might want to reveal it.

When Palle and Ellen returned to the pharmacy, Pharma judged the guests and closed the pharmacy, standing in front of the front door and waiting for the two of them.

"Welcome back, both of you"

"I drove you home in the carriage as you wished, are you satisfied with this?

Farma receives her brother's coat and prepares the footwear for two.

By the way, Blanche was letting him go home to the mansion before his brother returned.

"Welcome to a different world pharmacy, brother. Please come inside."

"Oh, wow."

Palle steps inside the pharmacy.

"Is this... a pharmacy"

Pharmacies had intervened to overshadow traditional pharmacy concepts. He is also surprised to find Palle's unknown and useless products. The way the medicine was stored was also a breeze. Few medicine bins containing herbs or biologics have been found. Palle was quite impressed when he toured the pharmacy ground floor intervals and dispensing rooms.

It was clear that it was not the result of Ellen's guidance.

"Come here, you two."

Farma lets Pallet and Ellen sit side by side at the reception desk on the ground floor.

Before Palais and Ellen, the text was partly distributed, with drinks and tea treats placed.

"Yes, yes, that's very thoughtful of you."

"I'll explain my brother's illness again."

Pharma sits across from them.

"Why should I give you a lecture?"

Palle is grumpy.

"Well, don't say anything until you hear the end of the story. If you're convinced, you'll get my treatment."

"Oh, if only you could convince me, give me your tongue-demo theory."

Silly, the word came up to my throat about what to say in front of this me in the head of the Novarut Medical University, but Pallet, who remembered if I should ask him until the end and then hit him with Cotempan, drank tea and instead made himself some water to moisten his throat.

"Before you do that, both of you get your arms out"

Pharma took out glass syringes and blood collection sets such as test tubes, blood bands, etc.

"What are you doing, Farma?

Ellen, who saw the needle, snaps both hands that were out on the table.

"It's a blood sampling, stabbing a needle in the arm and taking blood from the blood vessels. If you're scared, you should keep your eyes closed."

"Wait, I'll do it too!?

What does that have to do with me? and Ellen asks Pharma, but Pharma says to cooperate as a healthy human sample. In this world, it was normal to slightly scratch my hands and bleed to find out when examining the blood condition. Ellen figured out what she was going to do because that's what the needle appeared to be, not the knife. That was the same with Palais.

"You can take my blood, but you can't take your own blood, so help me."

"Farma, do you have any experience with that psycho procedure?

"Yes, don't worry about that."

When it comes to the experience of blood sampling, I'm glad to say I'm an experienced skilled person in my previous life.

Wrap the blood bands around Palle's upper arm first and lift the veins to stab the needle quickly. Pallet was hard to see blood vessels, so wiping them gently with alcoholic cotton makes the blood vessels angry and visible easier.

"It's just that we don't have human experience, so we're doing animal experiments."

Pharma later confessed.

Ethically, Pharma also knows that pharmacists should not draw human blood. But it is not the case that Palle's medical condition is worsening and he is in a situation where he may still have brain bleeding. All we can do is do it.

"Hey, wait a minute, you! Stop it! Don't use me as an experimental bench!

Hearing that, a panicked pallet tries to get up, but Pharma just pulled the needle out after he's already finished collecting blood.

"It's over, aren't your arms numb?

It was an instant event. Pharma shakes the blood in the syringe with a cool face in the test tube with anticoagulant. Ellen, who was reluctant, also reluctantly responded to the blood draw when she saw Palle's reaction.

Pharma drains a drop of Palle's blood from the syringe into the slide glass and extends it with thin glass instead of a cover glass. Shake immediately with both ends of the slide glass to dry. Soak it in a glass container with a kind of alcohol called methanol.

"What's that work you're doing for?

"Fixed, I stick blood cell components to the glass so they don't break."

Ellen's blood was also applied to the slide glass and treated in the same way.

"Let's observe in this state. Have you ever seen blood before?

"Oh, that's in the microscope too."

Palle snorts good at it. Palle's pride was about to start, but Pharma scratches his nose.

"That's good. You must have seen different shapes of particles."

If it wasn't for Pharma's made monomicroscope, Palle wouldn't have believed that blood contained a particle called a cell. But now anyone can't help but believe it.

"You saw something of a different kind. I even sketched it."

"Wasn't that a particle like this? Open ten pages of text."

The 10P of the distributed text depicted a lot of rounded particle illustrations. Ellen and Palle's text was the exact same thing. It is an elaborate sketch for handwritten writing and even depicts microstructures. Palle was impressed. Indeed, it is depicted as it seemed so in the microscope.

For the creation of the Imperial School of Pharmacy School of General Pharmacy, what Pharma had made the text and copied it on a copy board had been helpful.

"Wait a minute. How did such a fine structure look?

"If you look in a high magnification microscope, you can see it."

Pharma slowly puts out the microscope in the box in front of Pallet and Ellen. It was a brass duplex optical microscope, achieved 500 times magnification by a quality lens that I asked Lord Melody to do.

I set a mirror under the stage and it also has a light collection function.

"Behold, what is this!

"This is a duplex microscope that further enlarges the lens portion of the single-lens microscope to make it visible."

"Why do you have it! Did your father take it back for you?

Palle believes and does not doubt that he would have picked up something of good performance at Conne in Bruno, the general director of the Imperial School of Medicine.

"Well, there's a lot going on."

In fact, Pharma grabbed the blueprint and made the artisans make it, but for the first time, I couldn't get on with the conversation, so I left it at bay.

"By the way, what do you think the blood is carrying all over your body?

"It would be nutritional"

Palle answered with a few thoughts. Novarut Pharmaceutical University teaches the theory that human body fluids consist of four things: blood, mucus, yellow bile, and black bile. And when the blood was left in containers, it was also known to divide into clear supernatants and red and black precipitation. Blood was thought to be cleansed in the spleen. It has been taught that this balance of body fluids is broken down by evil spirits and that people get sick.

"Exactly. It's nutrients and then oxygen you're taking in through your breathing."

The element of oxygen is also known as pallet.

"Blood consists largely of blood cell components, plasma components, and other components.

Red blood cells that cause blood to appear red… these are particles that serve to carry oxygen to the body's mistletoe.

Colorless white blood cells… This kills bacteria or particles related to immunity. Oh, I'll explain immunization another time.

And platelets... components that clot the blood and stop the bleeding. "

I see, and Ellen nods and loads the text. After reading the whispering text she was able to do, Ellen was impressed by the fruits of Pharma's efforts.

"Heh! That's right - it just looks like red liquid, it's amazing!

Lotte hammers at the perfect time.

Cedric and Lotte were also listening single-handedly to the lecture with the text from a little further away.

"These particles are called cells. Not just the blood component, but every creature has a structure called a cell."

"I see."

By microscopic observation, Palle knew that every piece of tissue, whether plant or animal, did have what Pharma called a small chamber-like structure. I have considered that in my graduation thesis experiments.

Even though the organism was said to be made of cells, it was convincing.

"But there's only one type of blood cell that creates a wide variety of blood components."

Pharma pointed to the particles drawn upstream of the various blood components depicted.

"It's called stem cells that make blood (kansaibo), hematopoietic stem cells. Its stem cells make blood components like red blood cells, white blood cells, platelets, etc."

"Hmm."

Palais hears that it is well made up.

"So, what do you think is causing the bleeding on my older brother to be harder to stop?

Pharma asks Palle the opposite question.

Palle decided to hang out with Pharma. It is a cause of susceptibility to bleeding from the gums, as well as difficulty in getting blood together and developing moles.

"Platelets... the ingredients that are supposed to stop the bleeding are making it impossible?

"Exactly"

Pharma nodded loudly. My brother swallowed well and saved me.

"There are anomalies in the route that matures from hematopoietic stem cells to each blood component, and in the case of my brother, the route that creates neutrophils (a type of white blood cell)."

That doesn't explain it.

Palle makes the point immediately.

"If that's what's causing it, why are the other ingredients down? I guess it's part of the route where the anomalies are happening, huh? Are the platelets, the routes that make red blood cells, the routes that make other types of red blood cells and white blood cells safe?

Around immediately absorbing knowledge and disputing it, he is just a brilliant brother.

"Abnormal leukemia cells increase indefinitely. Place of hematopoiesis on them...... mainly because it's bone marrow, but it's occupied there and there's not enough space and I can't make any other ingredients. So less red blood cells and anaemia, shortness of breath without oxygen being carried all over the body, less white blood cells and more susceptible to infection with bacteria, less platelets and less likely to stop bleeding"

……

All reason was perfect, and Palais had a tremor.

"Let's compare the blood components on my brother to those of Ellen to see if what I just said is true. That said, it is difficult to see and observe the blood cell components in a transparent state. So, color the cells. This is called dyeing, but it'll take some time, so let's have lunch."

Pharma puts Palle through the staff lounge on the third floor.

By Lotte and Cedric, lunch was ready.

The five of us surround the table and sometimes go to the laboratory to work on dyeing while Pharma also talks. Palais was sluggish with a small mouth count where his usual rap went. I guess I'm touching new knowledge and I'm in shock.

Ellen soothes the place with such a pallet mood in mind.

"This soupe à l 'oignon gratiné warms my body. Lotte, you've gotten better at cooking, too. Perfect for cold days."

"Eh heh, Mr. Cedric helped me too! There are plenty of them!

The praised lotte was lit. She's been into making pharmacy lunches lately. At the end of the meal, Ellen and Pallet wait for Pharma.

Farma came down from the laboratory on the fourth floor to the third floor with a sliding glass and began to explain the results.

"It stained well. Red blood cells are red, platelets are blue, of the white blood cells, neutrophils are red purple, eosinophils are red, basophils are dyed blue purple, this is Ellen's blood. This is my brother's blood."

"Is it that conveniently dyed?

Palle, who was half-hearted, peered into the microscope and stunned.

Indeed, cells are colored by the step of staining. It's not that it's colored properly, it's color-coded properly.

"Ellen's blood and the blood on her brother. You see the difference is obvious? Inside the purple-colored blood cells, you will see a structure that resembles a collection of needles. It's a structure called the Awell corpuscle, not in Ellen's blood. You see that?"

"... oh, sure. Visible."

Palle's voice was blurred.

"That's the leukemia cell that became the leukocyte."

Palle also notices an overall decrease in red blood cells and platelets compared to Ellen's. Palle was burning an enlarged statue of his own blood into its eyes. Not so much evidence.

"While we were all eating, I was calculating my brother's whole blood cell. Erythrocytes, leukocytes, platelets decreased, and characteristic leukemia cells were seen. It's the truth of stabbing the bone marrow to diagnose it, but there's also pain, and leukemic cells have already been revealed in the peripheral blood. So go with this result."

Pallet's hands and feet are getting colder and colder in Pharma, which theoretically packs the story without giving him a escape gap.

"I diagnose acute premyelocytic leukemia."

……

Ellen had also lost her word. Pharma uses the eye most of the time when she visits the patient. Because it leads to a simplification of practice.

However, I know how to diagnose the disease without having to use the diagnostic eye to prove it and convince the patient. Ellen felt shown off that he could make a diagnosis even if he lost his divine power without having to clean up everything with the divine power of the drug god.

"Brother, if you don't treat this disease, Brother will die within a few months."

When Pharma put her hands on the shoulder of the silent Palais, Palais weakened and collapsed out of her chair. Palle could no longer fully dispute the results shown by Pharma.

God's knowledge far beyond human intelligence, I just thought so for Palais.

It is no longer in the stage of whispering.

"I'm going to explain my treatment policy. I can't guarantee it will work 100%. The treatment will be hard. Still, if my brother believes me and is convinced..."

There is no longer a shadow of my brother in Pharma that I cannot rely on.

Palle felt as if Pharma had become someone else altogether.

"Let me treat you right now"