Episode 84: Do I Need Surgery for This? [1]
All the way home in the carriage, I couldn’t stop thinking about white phosphorus matches. It wasn’t that I had smoked something. I was just worried. Would it make sense if I weren’t?
Mask… would using one prevent it?
It would be nice if I could make other kinds of matches, but I didn’t know how. That was the real problem. I didn’t even know the names of the other matches. So how could I tell them how to make safer ones? Opposition without an alternative was meaningless, so it was impossible to simply tell them not to make these matches at all. Of course, if I had power and money, I would have done something to prevent it…
If you’re chronically exposed to white phosphorus… your bones literally melt…
White phosphorus was a very dangerous poison, even in acute poisoning. It was also dangerous with chronic exposure. Would it fall under the Serious Accident Act? It wasn’t something covered in any of the main subjects, but I still remembered that it wasn’t an ordinary poison.
“What are you thinking?”
As I was lost in thought, Alfred spoke up. He looked confused, as if he didn’t understand what was going on. I knew from what I saw earlier that the white smoke produced by white phosphorus matches was dangerous, but that didn’t mean we had to visit a match factory.
If it were me, I’d think maybe I was hoping for some other great news from the director…
Looking at Alfred, whose thoughts were clearly visible, I answered.
“No, it’s just… I’m worried about white phosphorus.”
“I don’t even know what happened yet, so why are you worried?”
Okay. That was understandable. This was a world where there wasn’t even a word for preventive medicine. It was a time when you had to get sick before you received treatment, or people simply didn’t care. In fact, many didn’t even recognize illness as illness. I smiled and thought about something else.
“Yes, that’s true. But…”
While I was trying to explain, Alfred’s face came into view. As always, he had a somewhat goofy expression, but he also looked a little pained. We weren’t even lovers, so how could I know? I was the savior of his life. I was the one who prevented his fingers from rotting. At that time, they operated without anesthesia, so even if no one else noticed, I would be the best at recognizing Alfred’s pained face.
“Are you sick?”
“Uh? Uh, uh, no… but this is making me feel a bit upset.”
“Where?”
“Here.”
Alfred pointed to his solar plexus. At that moment, white phosphorus poisoning came to mind. One symptom of acute poisoning was vomiting and abdominal pain…
No. We ate grilled meat a few hours ago…
Besides, Alfred was a bit of a coward, right? Such a coward that I didn’t know how he had even thought of becoming a surgeon in this era. He backed away from anything suspicious, like a little while ago. So this seemed like a completely different cause. That meant there was hope, so I relaxed my expression and asked.
“Since when has it been like this?”
“Uh… an hour or two? But it was bearable, so I just stayed.”
“An hour or two? That’s quite a while. Is it gastritis?”
“I guess so. Just… are you okay? Why don’t you try holding out?”
It was gastritis. A common disease. For modern people, it was almost a constant companion, but back then, its prevalence wasn’t low either. It was natural to put up with anything. We lived in an age where you had to be strong to survive, so stomach acid was also really strong.
“What do you mean, hold out? At least eat some cabbage.”
“Cabbage? Does that work?”
“It did in Joseon.”
I thought the cabbage he meant was the Western kind. What did it matter when there was already a mountain of other remedies?
“Oh, yeah?”
Besides, the credibility of my Joseon stories was already clear to me by now. No matter what I said, Alfred would probably believe me. I think he would believe me even if I said they made meju with real red beans.
“Huh.”
Anyway, although gastritis was painful, I thought that as long as it didn’t cause a perforation, nothing immediate would happen. Right? In the long run, neglected gastritis and ulcers could cause stomach cancer… but unfortunately, not many people back then lived long enough to develop it.
“Now, eat this.”
As soon as we got home, I brewed cabbage tea, made him drink it, and fed him some cabbage just in case.
To conclude, I shouldn’t have fed him anything.
“Ugh…”
Alfred and I were sleeping in rooms separated by a wall. Originally, he was supposed to sleep in the annex, but since he had saved my life and helped make condoms, and since I wasn’t going out anytime soon, he gave up and stayed in the main building. It was great, but not tonight.
“Senior, are you sick?”
I suddenly opened my eyes and looked out the window at a hazy moon. Considering London’s usual gloomy sky, it was truly the middle of the night.
“I feel like I’m going to die… It hurts so much.”
It hurt a lot. This was unusual. Even though Alfred was a coward and a bit weak, this was the nineteenth century, right? By twenty-first-century standards, everyone here was like Guan Yu, able to tolerate pain well. But if someone like him was very sick, we needed to take a closer look.
“Should I come in?”
“Uh, uh…”
I headed to Alfred’s room with Joseph Lister, who had just woken up. There was a clock there, and I saw that it was already one in the morning.
Since he said it hurts… it’s been almost ten hours now. I fed him cabbage juice… that was five hours ago.
Was it gastritis? It seemed unlikely. This man had not only eaten cabbage but also drunk the soup.
If it was simple gastritis, the cabbage juice should have helped, and he should have been feeling better by now. Even if not, it shouldn’t hurt this much…
“Uh… does it hurt here?”
I approached Alfred and saw him clutching his stomach. People instinctively pointed to where it hurt, right? Before, he had pointed to his solar plexus. Now, he touched his lower right abdomen.
“Uh… uh, uh.”
Damn it. Without realizing it, I swore for the first time in a long while and moved closer to Alfred.
“Lie down like this.”
“Eww…”
Up close, Alfred’s face was covered in cold sweat. It looked like he was in severe pain. At this point, appendicitis was a strong possibility. I instinctively helped him lie down straight and bend his knees.
“Ugh…”
“Pyeong, what’s going on? Is your senior dying?”
Alfred couldn’t say much. It must have hurt terribly. Joseph said something odd in the middle, but considering the times, it wasn’t strange. Death was closer than I thought, and it didn’t discriminate by age. It was rare at Alfred’s age, but it was difficult to expect that he wouldn’t die.
“Stay still for now, senior. I’m going to press your stomach. Tell me if it hurts.”
“Ugh. Huh.”
Ignoring Joseph, I continued the examination. There was no time to waste.
“How about here?”
“It hurts more… eww…”
First, I pressed the solar plexus. It hurt there, but there was no tenderness.
It really looks like appendicitis…
At this point, I started to sweat a little. Typhlitis, more precisely, appendicitis, caused radiating pain. It started at the solar plexus but then moved to the lower right abdomen as inflammation spread to the peritoneum.
“How about here?”
“Aww!”
I pressed the lower right abdomen, and Alfred screamed. I hadn’t pushed hard. That was not a good sign.
“What about when I let go?”
“Oops!”
I confirmed rebound tenderness. Tenderness could be seen in diseases that didn’t require surgery, but rebound tenderness, pain upon releasing pressure, usually meant surgery was necessary.
Damn it! Damn it!
What should I do with this?
Alfred. I sometimes ignored him, teased him, and even took money from him… Besides Joseph, he was the only person I had shown affection to since coming here. And if he died, it would be unbearable.
If this is left untreated, he’ll die… but I can’t take him to the hospital…
Jémel came to mind. Jémel, the master of bloodletting. If that bastard saw Alfred like this, he would stab him in the stomach and drain blood without asking. Robert Liston would agree that abdominal surgery was taboo. So everyone would probably join forces to kill Alfred now…
Damn. Here too…?
When I snapped back to myself, Alfred was rolling around in pain. First, I needed to do something about it.
“W-what’s going on?”
Just then, a startled man, Alfred’s father, came in. He arrived with the other servants, but he was clearly distressed when he saw Alfred like that. He eyed me and Joseph suspiciously for a moment, but only briefly.
“My stomach… It hurts, Father!”
Thanks to Alfred.
“Hospital! No, call the doctor!”
The man immediately called the servants. One servant, quick on his feet, ran off. To others, he might have seemed reassuring, but to me, he looked like the Grim Reaper. No matter who they called, no one could cure appendicitis. It wasn’t arrogance. It was simply the limit of the times.
“Wait!”
Only I knew Alfred’s condition and could treat it. Alfred wasn’t a stranger. He was my friend. He had shown me kindness. It might be a misunderstanding, but I couldn’t ignore it. So I shouted loudly.
“Huh?”
“Yes?”
It worked because the servants already recognized me as a Joseon nobleman, a close friend of the youngest master, and a renowned doctor. The running man stopped and looked back.
“I’ll take a look. I need some equipment. Go to the hospital and bring it. In the meantime, give him some willow bark extract. It should ease the pain.”
“No, no, wait. What do you mean? You’re going to treat him?”
“Yes. I’ll examine him.”
“His stomach hurts. This is internal medicine. I was going to call Dr. Jémel.”
No. Not Jémel. That bastard would get excited and stab Alfred with a bunch of unwashed needles. It was almost criminal. They said it hurt, and then they soaked people…
“No. It’s a surgical disease. We have to operate.”
“Yes…?”
Despite what I said, people looked at me like I was some quack from a city of crime.
Ha. What was this…
Footnote 1 — Translator’s Notes
White phosphorus — Highly flammable and toxic form of phosphorus used historically in early matches and associated with severe occupational poisoning.
Preventive medicine — Medical approach focused on preventing disease before it occurs.
Acute poisoning — Sudden toxic reaction after short-term exposure to a harmful substance.
Chronic exposure — Repeated or long-term exposure to a harmful substance.
Serious Accident Act — Modern Korean workplace-safety law referenced by Pyeong when thinking about white phosphorus exposure.
Solar plexus — Upper central abdominal area below the breastbone; pain from some abdominal conditions can begin there.
Gastritis — Inflammation of the stomach lining, often causing upper abdominal pain, nausea, or discomfort.
Stomach acid — Acid produced by the stomach to digest food; excess irritation can worsen gastritis.
Cabbage juice / cabbage tea — Folk or nutritional remedy sometimes associated with stomach discomfort and ulcers.
Perforation — A hole forming in an organ wall, such as the stomach or appendix; a surgical emergency.
Appendicitis — Inflammation of the appendix. Untreated appendicitis can rupture and become fatal.
Typhlitis — Historical or older term sometimes associated with inflammation near the cecum; here, Pyeong clarifies it as appendicitis.
Peritoneum — Membrane lining the abdominal cavity; irritation of it can cause severe abdominal pain and rebound tenderness.
Rebound tenderness — Pain that worsens when pressure on the abdomen is suddenly released, often suggesting peritoneal irritation.
Bloodletting — Historical treatment based on removing blood from the patient.