The Bleeding Noble

The woman they brought to us was dying in a way that made no sense.

Lady Anastasia von Kleist arrived at dawn in a gilded carriage, carried by four guards who looked more terrified than protective. She was maybe 14, with the pale complexion of nobility and the kind of refined features that spoke of generations of careful breeding. But something was wrong with her blood.

It wouldn't stop flowing.

"She's been bleeding for six days," her personal physician wheezed, his plague doctor mask askew with panic. "Started as a nosebleed. Spread to her gums, under her skin, everywhere. We tried fire therapy, leeches, even mercury purges. Nothing stops it."

I knelt beside the stretcher they'd laid her on. Lady Anastasia's skin was a map of bruises, purple blotches that seemed to spread as I watched. Blood seeped from her nose in a steady trickle, and when she tried to speak, pink foam bubbled from her lips.

"How long since it began?" I asked.

"Six days ago she attended a feast at Baron Wilhelm's estate," the physician said. "Everyone who ate the same dishes is fine. But the next morning..."

He gestured helplessly at the woman bleeding to death in front of us.

Karin frowned, studying the bruises. "Plague corruption doesn't look like this. This is something else."

Kaguya was already scribbling, her eyes wide. "Spontaneous hemorrhaging from multiple sites. No external trauma, no obvious poisoning..."

I pressed my fingers to Lady Anastasia's wrist, feeling for her pulse. Weak, rapid, but regular. Her eyes tracked my movement. She was conscious, aware, just... bleeding to death from the inside out.

"Tell me about the feast," I said to the physician. "Every detail. What she ate, what she drank, who she spoke with."

"Everything was normal," he insisted. "Roasted fowl, wine from the Wilhelm cellars, honeyed cakes. She barely ate anything. Said she had no appetite."

Something nagged at the back of my mind. A pattern I'd seen before, in another world, another life. But here in this medieval city, it should have been impossible.

"Did she take any medicines recently?" I asked. "Tonics, herbal remedies, anything for pain or illness?"

The physician hesitated. "Well... she had been complaining of headaches. I prescribed willow bark tea, but she said it upset her stomach. So I gave her something stronger."

"What exactly?"

"A tonic. From the apothecary in the merchant quarter. He assured me it was the finest imported remedy, made from a rare fungus that grows in the deep forests."

My blood went cold.

"Bring me that bottle," I said quietly. "Right now."

◇◇◇◇

While we waited for the tonic, Lady Anastasia's condition worsened. The bleeding under her skin spread, creating a patchwork of bruises across her arms and chest. Her gums bled freely, and every few minutes she would cough up bright red blood.

"This isn't natural," Karin muttered, watching the woman's life ebb away. "Even plague corruption has limits."

Kaguya looked up from her notes. "Could it be a curse? Some form of blood magic?"

"No," I said, pacing beside the stretcher. "This is medical. Physical. Something is preventing her blood from clotting properly."

The physician returned with a small glass vial, half-empty and labeled in spidery script. I held it up to the light, examining the thick, dark liquid inside.

"He called it 'blessed coagulant,'" the physician said. "Supposed to thin the blood and improve circulation. She's been taking it daily for three weeks."

I uncorked the vial and smelled it. Musty, earthy, with an undertone that made my stomach turn. But it was the color that confirmed my worst suspicion: that deep, wine-dark red that looked almost black in shadow.

"You fool," I breathed. "You've been poisoning her."

The physician recoiled. "Impossible! The apothecary swore it was beneficial"

"The apothecary is either an idiot or a murderer," I snapped.  "It's a toxin!"

I turned to Kaguya, who was scribbling frantically. "I need every rat in this building. Living ones. And I need them now."

"Ken," Karin said slowly, "what is that stuff?"

I held up the vial so they could all see it clearly. "In my world, we call it warfarin. It's a blood thinner so powerful that a small dose prevents clots, and a large dose causes exactly what you see here: spontaneous bleeding that won't stop."

The physician went white behind his mask. "But... but the apothecary said"

"The apothecary is selling rat poison as medicine," I said. "And your patient has been taking it for three weeks."

Lady Anastasia gurgled, blood bubbling from her throat. Her eyes were still aware, still terrified, but her body was shutting down as her blood refused to do its job.

"Can you save her?" the physician whispered.

I looked at the dying woman, then at the vial of poison in my hand. In my world, this would have been a matter of vitamin K injections and fresh plasma. Here, with medieval technology and no understanding of blood chemistry...

"Maybe," I said. "But first, we need to prove what we're dealing with."

◇◇◇◇

The rats arrived within the hour. A cage full of squirming, squeaking vermin that the clinic used for testing various remedies. I selected two of similar size and placed them in separate containers.

"Watch carefully," I told the sisters and the physician. "Science in action."

I fed the first rat a small portion of the 'blessed coagulant,' dissolved in water. The second rat got plain water. Then we waited.

"This seems like a waste of time," the physician muttered. "She's dying while we play with vermin."

"She's dying because we need to understand what we're fighting," I replied. "Medicine without diagnosis is just guessing."

Within two hours, the difference was obvious. The first rat had developed small bruises under its fur, and when I pricked its tail with a needle, the bleeding wouldn't stop. The second rat clotted normally.

"You see?" I said, holding up the bleeding rat. "The same substance that's killing Lady Anastasia."

Kaguya was scribbling so fast her ink splattered. "Remarkable. A substance that prevents blood from sealing wounds. But how?"

"Blood clotting is a complex process," I explained, settling into lecture mode. "It requires multiple factors working in sequence: proteins, minerals, cellular components. This poison disrupts that cascade, preventing the formation of stable clots."

The physician stared at the rat, then at his dying patient. "But if you know what it is, surely you can reverse it?"

That was the question I'd been dreading. In my world, yes: vitamin K, fresh frozen plasma, supportive care until the poison metabolized out of her system. Here, with no modern pharmaceuticals and no way to transfuse blood...

"I need green vegetables," I said finally. "The darkest, leafiest ones you can find. Spinach, kale, anything rich in natural clotting factors."

"Vegetables?" The physician looked skeptical. "You want to treat noble blood with peasant food?"

"I want to save her life with whatever works," I snapped. "The same compounds that help peasants survive on poor diets can restore what this poison has stolen."

Karin was already moving. "I'll raid every garden in the quarter."

"And I need to make a compress," I continued, my mind racing through possibilities. "Something to apply direct pressure while the natural clotting factors rebuild in her system."

But even as I spoke, I could see Lady Anastasia growing weaker. Her breathing was shallow, her skin pale as parchment. The bleeding showed no signs of stopping, and every minute brought her closer to complete circulatory collapse.

This wasn't just about understanding the poison anymore. It was a race against time to reverse three weeks of accumulated damage before her body gave out entirely.

"Kaguya," I said, "I need you to help me calculate dosing. If this substance has a half-life in the body, we can work backwards to estimate how much has built up in her system."

She looked up from her notes, eyes bright with the challenge. "Like predicting plague spread, but in reverse?"

"Exactly like that. And our patient's life depends on getting the math right."

◇◇◇◇

The treatment protocol was straightforward: compensate for depleted clotting factors with concentrated natural sources, then introduce healthy blood to kickstart normal coagulation. Simple in theory. Potentially fatal in practice, given our limited equipment and the patient's critical condition.

We juiced every green vegetable Karin could find, creating a thick, bitter concentrate of natural vitamin K. I forced Lady Anastasia to drink it despite her protests, hoping her body could absorb enough to kickstart her clotting cascade.

For external bleeding, I created pressure bandages soaked in a solution of salt water and crushed herbs that Kaguya's notes suggested might have coagulant properties. Medieval medicine was crude, but some of their remedies worked for reasons they didn't understand.

The real challenge was time. The poison had been building in her system for weeks, and her body's natural clotting factors were completely depleted. Even if we could stop the source of the problem, it would take days for her blood chemistry to normalize.

Days she might not have.

"Her pulse is getting weaker," Karin reported, fingers pressed to the woman's throat. "And she's not responding to voice anymore."

I looked at Lady Anastasia's pale face, the blood still trickling from her nose despite our efforts. In my world, she would already be in an ICU with multiple transfusions running. Here, all I had was vegetables and hope.

"There's one more thing we can try," I said slowly. "But it's dangerous, and I've never attempted it in these conditions."

The physician leaned forward eagerly. "Anything. Her family will pay any price."

"Payment won't help her," I said. "She needs a transfusion."

I turned to face them all, my expression grim. "She needs new blood. Healthy blood from someone whose clotting factors still work. A transfusion."

The room went silent except for Lady Anastasia's labored breathing.

"Blood... transfusion?" Kaguya whispered, her quill frozen above the parchment. "Taking blood from one person and putting it into another?"

"The concept exists in theory," I said. "But it requires precise matching of blood types, sterile conditions, and careful monitoring. In my world, it's routine. Here..."

"Here it sounds like dark magic," the physician finished, his voice hollow.

Karin cracked her knuckles. "Dark magic that works is still magic. What do you need?"

I looked at her, then at Kaguya, weighing the risks. Blood typing without modern equipment, transfusion without proper tubing, monitoring without electronic devices. Any one of a dozen complications could kill Lady Anastasia faster than the poison.

But she was dying anyway.

"First, we test compatibility," I said, reaching for my medical kit. "A small sample from each of you, mixed with hers. If the blood clumps together, it's not compatible. If it stays smooth, we might have a match."