It was a bit difficult to stop Lord Damian.
No matter what, he argued, "Are dogs and people the same?" and things like that...
He did have a point.
In reality, animal testing doesn't always guarantee results, does it?
There have been cases where a drug was safe in animal testing but turned out to be dangerous when used on humans, and many cases where a drug was highly effective in animals but had little effect on humans.
There's a reason clinical trials exist.
Some things only become clear when tested directly on humans.
'But this is going too far.'
To think of cutting out a human pancreas just to see what happens...
That's nothing short of murder, isn't it?
By 21st-century standards, even experimenting on animals is questionable.
The problem is, this isn't the 21st century—it's the 19th century.
Human experimentation is so unacceptable that I had to vehemently oppose it.
"Then what about using Black people?"
"Well, Your Grace, the slave trade is now..."
"There are also those who sell their bodies voluntarily. It's not entirely impossible to find them."
"Ah, voluntarily? Well, then..."
Look at them, just look at these lunatics.
Damian might seem like a fairly decent person...
But then again, anyone would seem decent next to someone who voluntarily cut off their own balls...
Even so, this is how it is.
Is Liston any better?
He seems to think it's acceptable if it's voluntary?
Should I explain that this could kill them?
No.
They'd probably say they'd pay a lot of money, even if it might kill them.
And strangely enough... there are people who would step forward. That's the reality.
Just look at how many people are willing to sell their blood.
"No, it's not acceptable. Let's use dogs for now. I oppose using humans."
"Huh... I was going to use Black people anyway."
"Well..."
I wondered how Lord Damian would react if I shouted, "Black people are human beings too!"
I don't know.
I really don't!
One thing is certain: his reaction wouldn't be very friendly.
This is Europe, where human zoos existed even in the late 19th century.
Imperialist bastards...
How do I persuade them?
As I was pondering this, our little红茶 (hongcha) brat, Liston, spoke up.
"Wouldn't using Black people be inaccurate? There might be some differences between White people and Black people..."
"Ah, right! Yes! I hadn't thought of that. Let's use dogs."
"Yes, yes."
Well...
It doesn't feel good.
It doesn't feel good, but... fortunately, things are moving in the direction I wanted.
"We've brought them."
Where did we get the dogs?
Dogs are just everywhere.
Considering the problems stray dogs cause, something had to be done about them.
Not just rabies, but many people die from dog bite wounds themselves.
In a world without antibiotics... I'm increasingly realizing how terrifying a Dirty Wound can be.
"Well done. Now... what shall we do?"
"Let's anesthetize them first."
"Anesthetize?"
"We can't just kill them. We need to remove only the pancreas and observe, right?"
"Ah, right. Alfred?"
Alfred, the anesthesiologist, stepped forward at Liston's call.
Colin was with him.
He probably doesn't like the idea of having to catch dogs as a medical student.
But wasn't he just used as a urine dipstick reader earlier?
Compared to that, this dog experiment is quite meaningful.
"Yes!"
Moreover, it wasn't that difficult.
Alfred made a hissing sound and sprayed gas at the stray dog, which was already trembling in the stablehand's strong grip.
The stablehand also inhaled some gas, causing his eyes to roll back slightly and his grip to loosen, but given the stablehand's much larger size, what do you think happened to the dog?
It was already done for.
"Hey, isn't this going too far?"
It was somewhat... concerning as an anesthesia accident.
"Won't it be fine?"
"Well..."
Since it's a 19th-century dog, it might be okay.
This is a place where neither dogs nor people can survive unless they're strong.
Anyway, since we'd already anesthetized it, Liston and I cut open the dog's abdomen and removed the pancreas, which was located in a slightly different area than in humans.
It was my first time seeing a dog's pancreas, but it wasn't too difficult.
Just find something that looks similar and remove it.
"Good."
"Do that one too."
"Yes."
Just in case, we removed the pancreas from both dogs the stablehand had brought.
With that, today's experiment was over.
It didn't seem like they'd be urinating anytime soon.
Doing anything more on the day we cut open their bellies and removed their pancreases... seemed like it would be too much.
'First of all, it's obvious that diabetes will develop. What's more important than that is treatment.'
Diabetes treatment.
In the 21st century, there are so many drugs.
So many...
But the only one remotely accessible now is insulin.
And even then, the insulin we know is completely out of the question.
We'll have to use the very early form of insulin.
What is the early form of insulin?
It's simple.
Just give what living organisms naturally have.
'But we can't just squeeze this pancreas and give it.'
I looked at the two chunks of dog pancreas I'd brought to the lab like souvenirs.
They were much smaller than human pancreases.
Even so, the contents inside shouldn't be much different from humans.
That means there's insulin in those pancreases... but of course, there are also digestive enzymes.
The problem is, those digestive enzymes break down proteins, and since insulin is also a protein, the moment we squeeze the pancreatic juice, all that precious insulin will turn into the amino acids that once were insulin.
No matter how much of that juice we give to a patient, it won't be of much use.
Historically, that failure actually happened.
So how do we handle this?
"Hmm..."
I was alone in the lab now.
Alfred and Colin had tried to pick a fight with me over the urine issue but were dragged away to the dissection lab by Liston.
Joseph?
That guy...
- Did you wash your hands?
- Hands!
- Wash your hands!
He's probably barging into some ward somewhere and doing that.
Thanks to him, the death toll has significantly decreased...
But he's also making enemies.
Since Joseph's enemies are essentially my enemies, I thought maybe I should stop him.
But what can I do?
He's doing the right thing.
Although we should probably find a less cumbersome alternative to washing with chloride of lime...
Squeak
While lost in these thoughts, I began examining the dog's pancreas under the microscope Lord Damian had given me.
I could see the structures I'd learned about in pathology class.
First, the most abundant were the acinar cells.
These are the ones that secrete digestive enzymes and are essentially the core of the pancreas.
In the original history, when pancreas removal experiments were conducted, wasn't the expectation related to difficulties in protein and fat breakdown rather than something related to diabetes?
'Right. Found it.'
Besides the acinar cells, I could also see small, island-like cells.
These are the famous islets of Langerhans.
Perfect timing, right?
They're the cells that produce insulin.
'The problem is, if it becomes known that I know all this right now, it would be very troublesome.'
Even the statement, 'Removing the pancreas causes diabetes,' could sound suspicious, couldn't it?
Thankfully, Liston has decided to trust me for now; otherwise, I'd already be in trouble.
And the various connections I've made through Liston are also providing some defense?
But talking about acinar cells and islets of Langerhans... that's crossing the line way too much...
Heck, even the knowledge that these things exist and what they do won't be known for another 50 years.
'I could suggest a pancreas transplant.'
Our 19th-century folks...
These pioneering folks...
I heard they're already performing all sorts of bizarre surgeries, and it hasn't been that long since anesthesia was introduced.
I deliberately avoided the details because I thought I might vomit if I heard them, but I vaguely heard they even do plastic surgery.
What the hell...
What on earth are they doing?
My hands were trembling so much I left the room.
If I learn more, it's obvious I'll feel compelled to do something, right?
'Well, I could just try it on dogs and say, "Oh, they died," and that would be that...'
There will be many trials and errors.
I'll do my best to stop them from using humans, but many dogs will die.
It can't be helped.
It can't be helped, but...
What's urgent right now is that, following the original history, we need to extract pancreatic juice and use it on patients.
But not by squeezing the whole pancreas like this—by extracting only the insulin.
'It's simple, really.'
If you know the principle, the function of the pancreas, it's very simple.
If you tie off the duct that leads from the pancreas to the intestine, digestive enzymes build up and eventually the cells that produce them all die.
Then, if you cut open the pancreas and squeeze the juice, you can extract only the insulin, without the digestive enzymes.
Then you inject it.
That can save them.
It's a very... tedious process, though.
But the artificial synthesis of insulin...
Wasn't that achieved around the end of the 20th century?
How can we do that now?
It's impossible.
'But I heard they later used pancreases from slaughtered cows for something...'
But does that mean we have to tie the pancreatic duct, wait, then cut it out, squeeze it, and give it every time?
Ugh...
Lord Jamie can do it.
He's incredibly rich, after all.
But what about everyone else?
We need a much simpler process.
'Ah, right. Cows. I heard they used cows. Insulin... doesn't dissolve in alcohol. Hmm.'
How can I use that simpler process while also avoiding damn... suspicion?
As I searched for that pretext, I simultaneously!
I started to feel like I understood why heaven specifically chose to send me to the past.
This is something only I can do...
The Master of Bluffing.
Only Kim Tae-pyeong from Joseon can do this.
Others?
Internal medicine specialists?
Internal medicine doctors can't perform surgery, so they're out.
Other surgeons?
Surgeons are usually in the business of wielding knives, so they're... not very good with words.
Me?
I'm different.
"Oh...! The ants are really swarming to the urine!"
"Not only that, look! The dog is practically dying!"
Anyway, a few days later, after letting the pretext I came up with on the spot mature, we gathered again to see the dogs.
Actually, Liston and I checked on them daily, and today's special guest was Lord Damian.
The two of them were excitedly examining the two dogs, which were in a pitiful state—anyone could see that.
They might seem like heartless bastards, but since this was a hundred, a thousand times better than doing this to a person, I didn't say anything.
Besides, there was something I needed to confirm.
What good would it do to just extract insulin and give it?
In reality, we wouldn't know the dosage, so we couldn't give the right amount.
We couldn't administer it as frequently as with commercially available insulin pens.
I'd have to do it.
That means, ultimately, the patient themselves also need to make an effort, on top of the insulin.
"Does Lord Jamie exercise much?"
"Huh? Ah, no. He's too busy."
See? This is how it is.
He'll probably only start managing his health after he goes blind and has his legs amputated.
Anyway, what's more urgent now than that is the insulin, so I took a sip of water and opened my mouth to spin the tale I had prepared.