Chapter 323: Nutritional Excess

Now that they had these unplanned antibiotics, some friends who'd caught colds recently were lucky enough to enjoy a sudden round of antibiotic treatment.

And the other assorted medicines each found their own destinations... blood pressure drugs, for instance, were sent to Fuzhou and Hangzhou, where comrades at the local intelligence stations would sell them to old-wealth connections.

"Fine, consider it clearing out inventory and pointing the way for future drug stocking."

Though Dong Qiang wore a smile as he strode through the hospital corridor, with all manner of people bowing respectfully to him on both sides, his heart was bleeding.

Of these expired drugs, less than a tenth were actually used on the Transmigrators; the vast majority were money down the drain. Thinking of the import quotas these drugs had once occupied, Dong Qiang felt fury surge up from nowhere... "It's one thing for the Cao Emperor not to understand, but that old scoundrel Bai Shuchao didn't even write up a list at the time — truly a pig of a teammate!"

Dong Qiang's anger was not unwarranted; these expired drugs really were of no great use. The Empire now neither lacked that bit of drug money from old wealth, nor needed to put children on antibiotics — domestically produced sulfonamide was sufficient.

In later generations, due to the abuse of various antibiotics, by the era the Transmigrators departed from, many superbugs had already been selected out by those antibiotics. Meaning, for seemingly ordinary inflammations, antibiotics were sometimes already useless.

The Transmigrators, with their sights set on a thousand autumns and ten thousand generations, would certainly not leave such a colossal mess for their descendants regarding antibiotics... the important thing bears repeating thrice: sulfonamide, sulfonamide, sulfonamide.

For 17th-century humans, sulfonamide was a miracle drug. So the Transmigrators had no intention of researching any antibiotics further; putting all their effort into completing the full range of sulfonamide drugs would count as fulfilling their historical mission.

After a generation or two, or when widespread sulfonamide resistance developed, let the descendants produce the first-generation antibiotics themselves. The bacterial strains would be left for the silly sons anyway; they could just use them directly.

Under these circumstances, using antibiotics on friends seemed somewhat out of place... domestically produced sulfonamide could solve the problem just as well.

"A problem left over from history... ah!" Dong Qiang lamented the wasted quotas as he led his people into the obstetrics and gynecology department.

Chikan First Hospital now had only two strong departments: obstetrics and gynecology, and surgery.

Yes, due to the lack of medicines, equipment, and doctors, patients could now only come to the hospital for three types of ailments: external injuries, pregnancy, and everything else.

That is, for all bleeding external injuries, including the most common workplace injuries — severed hands or feet, for example — the hospital could help the patient debride, disinfect, and amputate, and afterward present the crippled with a crutch.

The remaining pregnant women went straight into obstetrics and gynecology.

Finally, for all internal medicine diseases, from the common cold all the way to cancer, the hospital would prescribe two medicines: sulfonamide and aspirin.

As for patients aspirin couldn't help, no one could do anything about that... conditions were what they were. The Great Golden Dragon Empire had only just achieved universal medical coverage; it was somewhat embarrassing to say, but they still needed to work for quite a few more years to catch up to Somalia's level of medical care.

There were quite a few expectant mothers awaiting delivery in obstetrics and gynecology. With a permanent population of four hundred thousand, a pregnancy cohort had certainly formed. Moreover, people of this era were quite considerate of the nation, with lofty ideological standards, each one desperately wanting to bear a few more children to pay into social security, so the pregnant women now filled several wards.

After entering, Dong Qiang looked over the case files hanging at each bedside one by one, inquiring about the mothers' conditions. By the time he finished examining them in turn, nearly an hour had passed.

After this, he summoned all the nursing assistants for a lecture.

The vast majority of households in the new society were "dual-worker" families deliberately broken up by the Transmigrators; the great clans of the medieval era did not exist here, so many pregnant women came to the hospital alone.

But this was not a worry: the hospital had specially trained a group of female workers as companions, which counted as publicly reimbursed.

These women ranged in age; in the future, as long as they could pass the cultural studies exam, they could transfer to become nurses, and could even apply for the hospital's physician training course.

In short, in this fledgling new society, as long as a person was willing to work hard, the channels for advancement were far too numerous — society had a great many top-level positions waiting for people to fill them; classes were still far from having formed. Unlike later generations, where if your family didn't have a certain something, don't bother applying to Harvard — no chance.

After lecturing the chattering group of female nursing assistants and then dismissing the students he'd brought along, Dong Qiang returned to the director's office on the third floor, brewed a cup of tea, and could now finally wait for someone to bring up lunch.

But before the food delivery arrived, Comrade Bai Old Scoundrel Dharma Name Miaoshu Lecherous Monk Shuchao walked in with his three concubine-assistant-nurses.

"Aiyo, you haven't eaten yet? Perfect, I haven't either, let's eat together!" Bai Shuchao, still keeping his shaved head, began changing clothes with the help of the three girls as soon as he entered; amid the laughter and teasing, he didn't forget to turn his head and say a word to Dong Qiang.

Hit with this sudden display of affection, Dong Qiang could only roll his eyes and bury his head in his tea: he was the more old-fashioned type, keeping work and life separate, so he would never train his own women to be nurses.

But that fellow Bai Shuchao was different. Having crossed over in the first place because of an affair, after he discovered the new time-space was a lawless land, he completely let himself go, revealing his wicked true nature.

With the Cao Clan's recruitment and amnesty, and the arrival of large numbers of immigrants from across the sea under official propaganda, the original crude policy of "one man, one woman" quietly died away.

And Master Miaoshu immediately found himself two more women... during those days, this guy would go loitering at the docks whenever he had free time. While others were still watching and waiting, the Great Master was already lecherously grinning without a shred of shame as he pulled women off the immigrant ships — a scene of extreme indecency that cast a great stain on the new society.

After this, Bai Shuchao conveniently trained all three of his concubines into "personal nurses"... fine, this fellow's great dream had finally come true: treating his post like home.

Just then, someone from the mess hall delivered a very vintage black-lacquered nanmu three-tier food box.

Wearing jeans and low-heeled leather shoes, He Yue, who had long since blossomed from a servant girl into a graceful young lady, hurriedly took the food box and then, together with the other two "sisters," took out the dishes and arranged them on the table.

Then Master Bai plopped himself down across from Dong Qiang: "Just did another C-section on an eight-jin chubby one. I tell you, this can't go on; there are more and more big fat babies — we've got to think of something!"

"Ah?" Dong Qiang, chopsticks poised to pick up food, didn't react for a moment; mouth agape, he thought for a bit before grasping the Great Master's meaning.

A cesarean section, to a greater or lesser degree, affects a woman's subsequent deliveries. Especially for Chikan Hospital, which lacked medicines, the aftereffects of a C-section were more numerous than in later generations.

For later-generation families who only had one child, this situation wasn't really a problem, or rather the problem was concealed: since they only had one, a C-section didn't matter.

But in the 17th century, this approach was unsuitable: both the imperial government and the populace itself were extremely eager to increase the number of newborns.

In this era, it was perfectly normal for a woman to give birth to three to five, even seven or eight infants over her lifetime, because people had to outrun the high infant mortality rate. A grown man having three or four siblings who died young above him was not news at all, but everyday life.

And what Bai Shuchao meant by his words just now was: control fetal weight to increase the chances of natural delivery.

Natural delivery was the best, safest, lowest-cost method of childbirth, and it had no aftereffects. In later generations, many pregnant women chose C-sections, first because they lacked confidence in the intensely painful natural birth, and second because the fetus in their belly was too large.

Generally speaking, for the Asian body type, a fetus around six jin is the most reasonable. Once the fetus reaches eight jin, one needs to pay attention... fetal growth has little relation to weight; excessive weight can actually bring certain illnesses.

And a certain regime had recently begun to see this situation emerge: more and more eight-jin chubby babies, and Bai Shuchao felt he couldn't handle it.

It was still the fault of rising living standards: after many immigrant couples began enjoying good days here, once the woman became pregnant, with the financial power of a dual-worker household, it was very easy to feed both mother and child into obesity.

These fair, plump babies, which only appeared among the official-gentry households of the Ming state, were rapidly spreading under the Transmigrators' rule.

"So that's it... mm, this is indeed a problem." After understanding the meaning behind the Great Master's words, Dong Qiang immediately nodded: "We must find a way to solve it."

As the hospital director, what Dong Qiang cared about more was the consumption of medicines and equipment by C-sections.

The current situation was extremely tight: domestically produced sulfonamide and aspirin, disinfecting alcohol, iodophor, anesthetics, saline solution, and other such most commonly used surgical drugs still could not be 100% domestically produced at present.

Moreover, consumables including various types of catgut suture, Mersilk suture, dressings, gauze, and the like also could not be fully domestically produced.

Under these circumstances, although the hospital had already simplified all patients into the aforementioned "three types of people," every C-section performed still consumed a small amount of the import quota... and over time, that added up to something formidable.

In fact, in order to domestically produce drugs and medical consumables, Cao Chuan had even specifically made "targeted invitations" to two industry insiders to join the great crossing-over enterprise. There was no helping it; this field was too niche. Even experienced doctors like Bai Shuchao and Dong Qiang likewise had no idea how Mersilk suture was made.

And that wasn't all; besides manpower, the specialized manufacturing equipment also had to be brought over to the New World. All of the above, plus daily consumption, meant the medical system was the third-largest consumer of import quotas, behind only industry and agriculture.

So in fact, Dong Qiang, who oversaw the medical system, maintained a state of strict defense against every single sign that might cause an increase in quotas.

As for Master Miaoshu... aside from seeing patients for the Transmigrators at the "internal hospital" on Dayuan Island, it was already good enough if he came to the big hospital to perform a few surgeries in his spare time; he couldn't be relied upon.

"Tomorrow I'll draw up a diet plan for pregnant women. First notify the newspapers to promote it, then train the nursing assistants and nurses. Every pregnant woman who comes to the hospital for a checkup must reasonably control her diet — no nutritional overflow allowed!"

After thinking for a moment, Dong Qiang resolutely found the corresponding solution.