Here is an extract from The Keys of the Kingdom, a novel set in early 20th century China. It was the story of a Scottish missionary, but was written by the most famous doctor of all time, as far as the UK is concerned. A. J. Cronin’s 1937 novel The Citadel, inspired the creation of the British National Health Service (NHS).
So when reading the following extract from The Keys of the Kingdom, you should bear in mind that it was written by a doctor.
The Chia house was very quiet, the trellised verandahs empty, the fish pond brittle with a film of ice. Their steps rang softly, but with a momentous air, upon the paved, deserted courtyards. Two flanked jasmine trees, swathed in sacking, lolled like sleeping giants, against the tented, red-gold gateway. From the women’s quarters across the terraces came the strangled sound of weeping.
It was darkish in the sick-chamber, where Chia-Yu lay upon a heated kang, watched by the three bearded physicians in long full robes seated upon fresh rush matting. From time to time one of the physicians bent forward and placed a charcoal lump beneath the boxlike kang. In the corner of the room, a Taoist priest in a slate-coloured robe was mumbling, exorcising, to the accompaniment of flutes behind the bamboo partition.
Yu had been a pretty child of six, with soft cream colouring and sloe-black eyes, reared in the strictest traditions of parental respect, idolized, yet unspoiled. Now, consumed by remorseless fever and the terrible novelty of pain, he was stretched upon his back, his bones sticking through his skin, his dry lips twisting, his gaze upon the ceiling, motionless. His right arm, livid, swollen out of recognition, was encased in a horrible plaster of dirt mixed with little printed paper scraps.
When Mr Pao’s cousin entered with Father Chisholm there was a tiny stillness; then the Taoist mumbling was resumed, while the three physicians, more strictly immobolized, maintained their vigil by the kang.
Bent over the unconscious child, his hand upon the burning brow, Father Chisholm knew the full import of that limpid and passionless restraint. His present troubles would be as nothing to the persecution which must follow a futile intervention. But the desperate sickness of the boy and this noxious pretence of treatment whipped his blood. He began, quickly yet gently, to remove from the infected arm the hao kao, that filthy dressing he had so often met with in his little dispensary.
At last the arm was free, washed in warm water. It floated almost, a bladder of corruption, with a shiny greenish skin. Though now his heart was thudding in his side Francis went on steadfastly, drew from his pocket the little leather case which Tulloch had given him, took from that case the single lancet. He knew his inexperience. He knew also that if he did not incise the arm the child, already moribund, would die. He felt every unwatching eye upon him, sensed the terrible anxiety, the growing doubt gripping Mr Pao’s cousin as he stood motionless behind him. He made an ejaculation to Saint Andrew. He steeled himself to cut, to cut deep, deep and long.
A great gush of putrid matter came heaving through the wound, flowing and bubbling into the earthenware bowl beneath. The stench was dreadful, evil. In all his life Francis had never savoured anything so gratefully. As he pressed, with both hands, on either side of the wound, encouraging the exudation, seeing the limb collapse to half its size, a great relief surged through him, leaving him weak.
When, at last, he straightened up, having packed the wound with clean wet linen, he heard himself murmur, foolishly, in English: ‘ I think he’ll do now, with a little luck!’ It was old Dr Tulloch’s famous phrase: it demonstrated the tension of his nerves. Yet on his way out he strove to maintain an attitude of cheerful unconcern, declaring to the completely silent cousin of Mr Pao, who accompanied him to his chair: ‘Give him nourishing soup if he wakes up. And no more hao kao. I will come tomorrow.’
On the next day little Yu was greatly better. His fever was almost gone, he had slept naturally and drunk several cups of chicken broth. Without the miracle of the shining lancet he would almost certainly have been dead.
‘Continue to nourish him.’ Father Chisholm genuinely smiled as he took his departure. ‘I shall call again tomorrow!’
‘Thank you.’ Mr Pao’s cousin cleared his throat. ‘It is not necessary.’ There was an awkward pause. ‘We are deeply grateful. Mr Chia has been prostrate with grief. Now that his son is recovering, he also is recovering. Soon he may be able to present himself in public!’ The mandarin bowed, hands discreetly in his sleeves, and was gone.
So, it seems, people did not have to die for lack of antibiotics. From what I have observed from many sources, if a wound is clean and the area has a good blood supply, what do antibiotics really do? Drs Sam Bailey, Andrew Kaufman and many others, believe that bacteria auto-generate from microbial stem cells, to consume decaying matter, and are not pathogenic. I don’t entirely agree with that; I think the immune system can have an allergic inflammatory reaction to bacteria, just as it has an allergic inflammatory reaction to dirt in a wound, or to a transplanted organ (if immune suppressors are not given). This is why cleanliness is paramount; severe inflammation is life-threatening.
Dr Bailey also believes that antibiotics appear to be effective, not because they kill bacteria, but by having an anti-inflammatory action. Many other substances, especially vitamin C, have an anti-inflammatory action too. When I developed a dental abscess, I decided to see if I could treat it myself without visiting a dentist. I was indeed successful, though the deep cleaning was quite painful at first.
So that’s why I find the above-quoted passage from The Keys of the Kingdom very interesting. As a doctor, A. J. Cronin would have had to deal regularly with cases like this. The story is fictional, but the process described is not.
I would highly recommend that everyone read A. J. Cronin’s wonderful book The Citadel. This book exposes the shocking lack of medical ethics that existed before medical treatment became free to all in the UK in 1948.