Parallel World Pharmacy

It was too noon one day in July 1147.

Farma, who was about to go out of the pharmacy to college, just got hit by a boy who crossed in front of the pharmacy while pushing a hand held luggage.

The boy fell flashly and slipped, his luggage car leaning and part of the load flipped.

"Stay eh! Where are you looking and walking, you fucking kid!... Whew!

The boy yells at him without looking closely at him, and then finds out that he was the owner of a different world pharmacy.

"Watch your language, impudent!

Pharmacy gatekeeper knights awesome, but Pharma controls them.

"No, it's my fault. It was definitely my carelessness, I'm sorry. Are you hurt?

"More than that, luggage!

Farma peeks into the luggage car the boy was pushing because the boy says so, the impact of the collision is spilling milk from the milk bottle of the sale that was arranged neatly.

"Oh, I have to pay for this."

Pharma and the boy are subtly familiar. The boy sells milk in the streets of Teito early in the morning, and by the time the pharmacy takes a lunch break, he always passes by with a tired face. That's what Pharma used to see sometimes.

"That's right, it's a payoff!

The boy gets up, checks the load and barks.

He was a boy the same age as Farma, a civilian in a situation that could be described as poor.

(Speaking of which, you suddenly lost weight, this kid. meal, I wonder if they haven't eaten enough)

Looking directly at the risen boy, Pharma puts his inner neck up.

"I didn't mean to make fun of you. To apologize for bumping into you, I'll buy it all."

Pharma put out his wallet and tried to reimburse the goods.

"You're throwing it away anyway!?

"No. Drink."

"... the royal family of court pharmacists drink milk."

Farma said softly to the boy who would incite him not to sound like a gatekeeper.

"I'll drink. Shouldn't you be drinking, too?

Pharma comes up with something to eat with cereal in it.

"It's sour, this"

"You're being honest. Fine, I'll yogurt it."

Farma bought all the milk that was on the load, without saying anything to the words she said she would buy. In exchange for the whole wallet of Pharma.

In the wallet was a sum of about a few years of the boy's annual income.

"Because I don't need a change"

"Oh!? You're selling fights! Can you take this, Hebo Pharmacist?

The boy is already in a fight. Pharma, wondering if there was any proper reason, found his pants torn when the boy rubbed them off.

"Then you should buy new clothes because your clothes are torn. Then I think if you pay attention to hygiene, you'll make more sales. It might be an extra favor."

He said, "Take extra care of him!

"What noise? Farma, what are you fighting about?

Ellen, who heard a loud voice, came outside asking if she wanted to go into arbitration.

"I just bought milk."

It's not a child fight, and I almost realize that Farma was a child. The boy ended up pulling only the money out of Pharma's purse and threw it at the pharmacy and left.

Then a few days later, Farma watched a milk-selling boy pass outside the pharmacy, calling it off each time and buying milk. But I don't show up that day.

"It's late for him to come through today."

"It's that milk-selling boy, isn't it? I'm looking down the street."

Lotte will also cooperate.

It's finally time for Lotte to find the boy who wanted to go through and call Farma from inside the pharmacy store.

"Dear Farma! I'm here! Wait, I'll buy milk!"

As Pharma approached to buy milk from the boy, the boy was not visibly energetic.

"... it's you again"

The boy was more and more sluggish than he was a few days ago. Farma was increasingly concerned about the sudden change in the boy.

"You were too late. Whatever. You should take a few days off from work, you don't look well."

Farma cares about the boy while paying for the milk.

"Oh... I have a sore throat and I don't feel well. I can't get my hands on a sale."

"Right. I'll give you some water, put on that empty bottle."

Pharma now washed the bottle containing the milk with divine production water and handed it to the boy by producing and filling it with cold water inside. Ringing my throat and drinking.

"You still drink?

Farma observed carefully the boy drinking two or three bottles.

I couldn't help but get my throat all day today.

"That's weird, huh? Not even hot today."

(For dehydration... you're breathing strangely)

An abnormally deep breath continues regularly. Farma had a bad feeling.

(Intake is longer than breath... isn't this Xmaul breathing)

This is not normal. Pharma, who wonders, uses an eye exam.

Then, the boy's entire body fluids were glowing blue.

(WHAT!?

When he sees the condition, Pharma takes his breath into a serious pathology.

I have dehydration, but that doesn't explain it.

It smells like a unique fruit, felt from the boy's exhalation. Along with that, unusual breathing.

"" Diabetic ketoacidosis "

There was a reaction.

Diabetic ketoacidosis (DKA) is an acidosis caused by the lack of insulin, the only hormone that lowers blood sugar (which can take up blood sugar in the tissue).

When insulin deficiency occurs, blood glucose cannot be trapped from the blood to each tissue and organ, and blood glucose levels rise, and each organ goes from lack of energy to starvation, breaking down muscles and the like to try to obtain energy. As a result, the ketone body of proteins and lipid metabolites increases in the blood (ketosis) and the pH of arterial blood tends to be acidic.

(That means it's going as far as ketoacidosis!

"" Type 1 diabetes ""

It was in the middle.

Type 2 diabetes progresses gradually, so it is unlikely to reach ketoacidosis. However, in type 1 diabetes, which is rapidly advanced by the loss of insulin secretion, it can occur.

Incidentally, type 1 diabetes, unlike type 2 diabetes, which occurs in lifestyles, is caused by the breakdown of autoimmunity. It therefore develops in the wealthy and the poor, who are not responsible for the onset of type 1 diabetes.

In Japan, diabetes was often misconstrued as a result of lifestyle, and patients were occasionally tormented by misunderstandings from around them, Pharma recalls.

(You can't erase the ketone body...)

All ketones are simple compounds. It can be erased by Pharma. In order to improve ketoacidosis, Pharma also thought about erasing all the ketones in his body by their ability to erase them. But it would be the ketone body, not the sugar, that his flesh, which is absolutely lacking in insulin, is the source of nourishment. If he abruptly erased that ketone body, wouldn't he be in a coma?

I couldn't dispel that concern, so I erased part of the ketone body as a first aid - i.e. acetone, which he didn't use for metabolism, with the ability to erase it. Conditions should calm down somewhat.

"It's type 1 diabetes?

Ellen punches Farma in the ear. Doesn't sound like a patient.

"Pharma, maybe you can tell by instinct if you see a patient. That, how do we find it?

"Ketoacidosis can be seen by Ellen and the others if tested. Stick a little fingertip with a needle, take some blood and put pH on it. Not good if even the pH test paper seems to tell."

There are ways to apply blood sugar, but it has not yet been practical in this world.

"What a mess..."

"Hospitalization, immediate hospitalization! You're seriously ill."

Pharma began persuading the boy.

"Ha? Sleep back at home and you'll be cured..."

Farma drinks where the boy tries to say it back in a pompous way.

"... I won't, I'm dying! Ketoacidosis is happening. I mean, the blood's getting acidic."

Farma feels at risk because the boy was pompous.

"Like milk turns into yogurt?

"It's like that."

"I don't like it, you can pluck expensive pills anyway!

The boy was trying to refuse with all his might.

"The cost of the treatment you charge is for three bottles of milk! I will never take any more, yes the contract!

Pharma showed the boy by writing a contract expropriating him to the vigilant boy.

Damn, I don't like words.

I heard that. Cedric comes out and reads out the contract.

"Indeed, it says that the medical treatment fee to be charged to the patient is three bottles of milk, and that the pharmacy pays for more than that in full and does not charge the patient. Along with the pharmacy seal, it's a formal contract. If you sign, it's valid."

"Shit, I can't believe it. I can't even sign it! You're not sure you can fix this, are you? Hebo Pharmacist, I know!

"What do you know about Farma?"

Ellen frowns rather than angry.

"I don't care what they think, but this disease won't heal. It does not heal, but it can alleviate the symptoms. By the way, if you leave me alone for a few more days, I'm really gonna die. You want me to treat you or not! You don't wanna die, do you?

"Whoa, whoa..."

"Then you're in the hospital! It's critical that you stand like that right now!

Pharma gets his consent, but he leads him to the procedure room upstairs.

"Farma, you're so pretty."

Ellen's glasses slipped.

"I've never seen Master Pharma absurd his voice. It must be really urgent."

Cedric whines as he gathers the paperwork.

In the upstairs treatment room, the boy was rampaged after measuring his height and weight and then put to bed.

In the meantime, Pharma estimates the estimated amount of dehydration by seeking plasma osmolarity based on the results of the ophthalmic examination, and performs various calculations necessary for fluid correction.

"Get off me! I didn't hear about the needle! What are you doing? The pharmacist is unbelievable!

"Mr. Roger, if this girl gets busted, it's dangerous, so keep it."

Pharma has called for a man.

"Infusion Desne. Omaka Sekdasai"

Roger, a part-time youth pharmacist from the Nedale country, was also the type of pharmacist to resolve with muscles.

"Farma, what's the infusion?

Ellen prepares the infusion formulation.

Pharma had already made and packaged several infusions.

"0.9% saline. About two hours, over time. After that, to 0.45%. Thereafter, the potassium will be supplemented as appropriate while examining the container."

"If I die, I'll be evil spirits and curse you guys!

With the boy swinging his left hand and rambling, I deduce that Pharma is the dominant hand.

"The dominant hand is to the left. Then I'll stab you in the right hand."

Wrap the rubber blood band around the boy's arm and stab a venous retention needle in the boy's right hand. An extension tube with infusion was connected to the retained needle.

"Doesn't the flow rate have to be fast? You'd better get rid of the acidosis."

That's Ellen's question.

"It's good to be fast because you're likely dehydrated, but don't be too fast because being too fast can cause brain edema. We need to be careful and keep it under control."

Farma added, recalling that sudden acidosis correction and blood sugar loss should cause brain edema, so don't use sodium bicarbonate for correction. Especially since children are susceptible to cerebral oedema, after the correction of dehydration, they go on to administer insulin.

"Your brain's swollen, Death. That's a tough day."

Pharma, Ellen and Roger discuss the infusion.

By the time the needle was stabbed, the boy, disappointed to solidify his bedside by three pharmacists, began to perceive it.

"Don't pull the needle out. He's in the hospital today, no, I'll have him hospitalized for about two weeks. If you have a parent or someone you should contact, let me know because I'll get the use out of the pharmacy and get back to you."

"Only the parents."

"Okay."

Asked for his parent's address, Farma sent him a use to tell him about the boy's medical condition and his stay in the hospital for a while.

"Mr. Farma, the medicine for type 1 diabetes was... insulin, wasn't it? If ketoacidosis starts to improve, what shouldn't it be administered?

Ellen single-handedly asks questions about Farma's textbooks.

"Oh. Yes... you're right."

Pharma snorts, but the words are badly toothed.

"Maybe, insulin, don't you?

Ellen's face turned blue.

(… finally, is this the time)

Pharma grips his fist hard.

"Speaking of not, and there is"

"Which is it?"

"I have a few times, but it's not enough. Because it's something you can't build right away..."

Yes, insulin is simply a drug that can't be created with Pharma's ability to create matter.

Historically, insulin formulations have been purified from pigs and bovines for practical use. Historically, however, early extraction, purification techniques were immature, causing severe allergies when administered to patients, and also unstable yields. Farma's laboratory research facilities are not so different from those of the early recent past that we cannot overtrust the extraction and purification techniques.

I wasn't looking for cows and pigs from now on and shrugging them off for a long time. I can't make it. Also, once it had to be continuously extracted and loosened rather than once, it came off Pharma's option. Although it is not possible to genetically engineer large amounts of insulin into E. coli or the like using reagents brought back from laboratories in different worlds, even if the sequence was known, it would take several days. If the array is not known, this method cannot be used.

Insulin is needed now.

"Insulin is not a simple compound"

It was protein, wasn't it?

Ellen spreads Pharma's textbook to show her amino acid section to part-time pharmacists. Take care of yourself. The two part-time pharmacists who had finished prescribing their pharmacy patients were also coming up to the infirmary.

"Yes, this is the amino acid used in people's bodies."

Pharma looks sinister as she looks at those lists.

"The protein consists of a peptide, which pearls each of these amino acids in a determined order. Simply put, it's protein if you connect amino acids in a set order to fold them..."

Pharma explains to the pharmacists, Ellen keeps the word. Ellen was pretty much loading textbooks and studying herself.

"Isn't the problem in that order? Do you know the order of insulin?

There are dozens of amino acid sequences of insulin.

Nor does that pharma even remember how that sequence was.

(That was a detour, I should have reproduced the structural analysis from Sanger's DNPization but analyzed the array)

It's too late for such regrets,

"I don't remember"

Pharma put his hand on his forehead like it was gone.

(If I could go to the lab again, I could check the insulin sequence...)

Going to the laboratory of the other world behind the Holy Springs now would be a considerable waste of time.

"I wonder if there's any way to figure out the order. I don't think you can see insulin in a microscope."

Having heard Ellen's words, Pharma realized there was still one.

"But... I know, maybe. Just give me a minute."

Thanks for the tip, Ellen! and Pharma screamed and jumped out.

Pharma rushes up to the laboratory on the fourth floor.

Thanks to Ellen, I flickered. When Pharma visited the laboratories of different worlds, she had also brought home only one vial of the insulin formulation along with numerous reagents.

Because that's one bottle too much.

After a few doses, it will be gone.

If you can't synthesize the insulin within a few days, the boy will die.

Insulin vials were removed from the reagent vault in the laboratory on the fourth floor.

Pharma lifts up his white coat and reveals the wrapped arms of the bandage, removing the divinely sealed daemon that had been given him from Salomon. If you don't fully open your abilities, you probably don't see that.

"Look at me!

Use special abilities that I haven't used in a long time.

Ring your right hand, use the "enlarged vision" activated by watching the subject, and go see the amino acid sequence of the insulin directly with its eyes. I also feel pretty unscrupulous, but if I think it's an interatomic force microscope or an X-ray structural analysis, I don't think I can do it. Where the maximum magnification can no longer be enlarged any further, the optical microscope is furthermore caught in between to attempt an enlarged vision.

"I see... I see!

Pharma read the amino acids one by one and began to write the sequences down into the notebook. Speaking of, it sounds easy, but when it comes to reading, some amino acid sequences are very similar and almost indistinguishable to the naked eye, except for those that are clearly characteristic of the structure. So he used dinitrophenylation to label only the leading amino acids and combine substance elimination to sequence and guess what disappeared to solve the puzzle.

Finally, the amino acid sequences that were made were erased with substance erasure to confirm that the synthesis was correct.

And an hour later, Farma came down from the lab.

"Done... this is insulin"

"So much! How did you synthesize it?

"In principle, the peptide solid-phase synthesis method… that is, we fixed one amino acid at a time and stuck one amino acid at a time from there in sequence."

"But you did it differently."

Ellen assumes that Pharma used the abilities of the drug god because the drug god print on his arm that Salomon said he sealed for me looks perfectly clear from under his white coat. He forgot to put it back.

"It's urgent. I thought I'd run out of concentration and die."

"I can tell you that it was a fine task. Your eyes are running blood, Farma."

Ellen swings Pharma.

"annoying"

Lotte, who was eager to interact more urgently with Sumi, gently handed the steamed towel to Pharma. For all the pharmacists.

With it thankfully above his eyes, Pharma takes one thought to his chest.

(I knew I had to use that)

Although it seems good that dozens of amino acids were linked by peptide bonds this time, if the sequence becomes hundreds, Pharma's concentration will not be achieved. There can also be mistakes. Now, if Farma sweats, there's an easy way to do it...

(We need to develop biopharmaceuticals, not chemical synthesis)

Biotechnology enables numerous drug discoveries that were not possible in chemical synthesis. Farma, who was a pharmacist, knew all kinds of know-how.

"Dear Farma. Aren't you taking insulin?

In the words of Rebecca, Pharma is unto Us.

"Oh, I'll do it."

On that day, the boy with type 1 diabetes was given insulin, the first peptide drug from a different world pharmacy.

"Now you can rest assured..."

Speaking to the boy, the pharmacists take turns observing his body. My turn to stay was for Pharma and Ellen to take on. It's a permanent pharmacist's rule.

In the middle of the night, the boy's parents also came to visit him, and encouraged the boy to return by saying that he would do the milk sales job instead for a while.

"Aren't you a good man, parent?"

At night, Farma, often alone with the boy, turns to the boy.

"I'll yell right at you, though."

"I wanted to ask you one thing... you have quite a grudge against the pharmacist. Why?"

If you ask, they sold the ineffective drug to a tertiary pharmacist, saying he lost his mother.

(It's a common story...)

Not just this boy, but everywhere in this world there was such a story rolling around.

Before Pharma began supplying modern medicines to the citizens of Imperial City, the civilian medical situation was already terrible.

"Can't you believe the pharmacist?"

The boy looked bad and turned away.

"If you don't trust me, that's fine. But suppose you drugged me and it made it easier. That's the answer."

……

The boy bites his lips and shuts up remorsefully.

"In the future, I will have this medicine administered by myself. Every day. Yes, you'll be the chief medic yourself."

Pharma taught the boy how to administer insulin. I need as much information as I need on how to melt insulin, how to handle syringes and needles, when to administer them, and what else he needs.

Pass disposable syringes and needles.

Since you cannot apply your own blood sugar, calculate the amount of carbohydrate and determine the dose of insulin. I gave him the food list and taught him how to do it.

"What do you say? It won't be hard. Think of this injection as a lifetime relationship. We may be able to reduce the amount, but we basically can't stop injecting."

"For the rest of my life..."

The boy, who was slapping his mouth down, turns his thoughts on at an unmistakable time and complains.

"But if I can find another way, I'll teach you first. I'm going to find it. So until then, it's a promise."

"You... you're a good one"

The boy squeaked in a loud voice, whether it sounded Pharma or not.

"Is this a relief?

Ellen asks.

"No, I'm pretty worried. We also need to build a simple blood glucose meter. You should also have ultra-fast and active insulin analogs ready for the future."

The challenge was a pile.

Two weeks later, from the boy who was well discharged from the pharmacy, Farma received three bottles of milk as a reward.

"I did receive the cost of the treatment, but the real treatment came from here."

Protect your own health and life under your own responsibility. The boy had that awareness budding.

"You took care of me...... court pharmacist. Was it insulin or don't forget to hit the pills"

"Ha, palace pharmacist? I've made progress since I first called Hebo Pharmacists."

"Ugh!

"If you can, you'll come see me every day. I'll give you the medicine then."

"Okay, sweetheart."

Even the day after that, the pharmacy received three bottles of milk.

Every day, three at a time. At the time of Pharma's examination. In exchange for the milk he brings, Pharma is giving him glucose in a stick type so that he can drink it immediately to prevent hypoglycemia. Insulin also prepares and passes what it uses that day.

"I told you to come see me, but I didn't know you'd bring milk every day"

Otherwise, the pharmacy staff drank it before work and Lotte used it to cook it deliciously.

Pharma taught the boy how to pasteurize and manage from raw milk so that the imperial people could drink milk safely. The boy called his parents to make uniforms for sale, taking care of his familiarity and feeling clean. I'm the recipient of Pharma's guide.

I recommended that milk to the Empress, whose pharma made it delicious, and the Empress wanted to like it.

The milk sold by the boy is now popular as "luxury milk for the court". The boy was getting busier and busier, pushing a nicely remodeled hand-held car and running around the Imperial City energetically.