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On March 25, 1901, after graduation from Gent University, Charles returned to Java, together with his mother, widowed since 1899, in which year her husband Henri Louis had died from a gall bladder infection. In Semarang Charles Emile established himself as a general physician. His clinic was in the same house on the Bodjongse weg no 6, in which his father earlier had also run his doctor’s practice. His mother stayed in the adjacent pavilion, living semi independent with her own servant. The house Bodjongse weg no 6, around 1910-1991, is shown in images 013; the street is named Jalan Pemuda today.
In August 1901, soon after Charles Emile’s return to Semarang, his eldest brother Frederik Johan Benjamins 28-02-1870- passed away on 13-10-1901 and Charles took care of his widow and children. His eldest brother Frederik Johan had already returned to Semarang in 1897, where he married Christina Catherina Hazenberg in 1899, while working for the Victoria Trade Company. Here a son, Henri Louis, was born on 15 February 1900 and on 29 October 1901 a daughter, Frederika Johanna, who was born only two weeks after her father Frederik Johan had died during a cholera epidemic in 1901.
The official government statistics of 1901, the year of Charles Emile’s return to Semarang, show that the population of the Semarang region in that year included about 2.7 million inhabitants.
The population of Semarang town in 1901 was about 100.000 with the majority of the 8.400 Europeans of the region actually living in Semarang town.
Population Semarang region 1901
Source : Regeerings-Almanak voor Nederlandsch-Indie, Batavia, Landsdrukkerij 1906
(Governments Almanac for Netherlands Indie, Government printer 1906)
Semarang in those days was already an important centre for collection and shipment of plantation crops from middle Java. Crops included coffee, sugar, tea, tobacco, rice and other food crops. Local headquarters for most plantation companies from Central Java were located in Semarang, which was also the backstopping center for their European staff and their families.
In addition to those living in the Semarang region, some of the Europeans living in the Yogjakarta and Solokarta regions, respectively 2.043 and 3.637 persons, would also travel to Semarang for modern medical services, which were only available in this town. In this context one should also consider the considerable army garrison stationed in Semarang, whereby the resident army general was responsible for the entire Semarang region. In those days the commissioned officers were Europeans and the non-commissioned staff originated mainly from Ambon and other parts of the archipelago.
In the early 1900s the number of Europeans in Semarang and hinterland which would need access to modern medical services, based on the above data, can be estimated at between 10.000 to 15.000 persons. In addition, some well-to-do members of the Chinese and the Javanese population of Semarang and hinterland were also starting to use modern medical services in that period, particularly if the doctor had a command of the Chinese and Javanese languages, as was the case of Charles Emile, who spoke both languages.
An illustration of the relative size of each category of patients who consulted a modern medical doctor is given in a medical article Charles Emile wrote in 1915. In this article Charles Emile indicates that in Semarang 79 % of his patients were European, 18 % Chinese and 3% Javanese (Opera Omni no 024).
In 1901 there were five Dutch general medical practitioners in Semarang and hinterland to serve the European population and those members of the Chinese and Javanese community who already were using modern medical services.
Charles Emile soon found out that his four colleagues were all very hesitant to conduct surgery and were glad if he was prepared to carry out surgery on their patients. Fresh from his studies in Europe and with an interest in surgery and ear, nose and throat diseases, he was keen to help out and at the same time increase his own experience.
Since the early 1840s modern surgery in Europe and the USA had rapidly developed. This was initiated by William Morton’s development of surgical anesthesia in 1846; Louis Pasteur’s identification of bacteria as the source of infections in the 1850s; Joseph Lister‘s development of antiseptic surgery procedures in the 1860s; Wilhelm Conrad Roentgen’s invention of X rays in 1895 and Karl Landsteiner’s discovery of blood groups in 1901, allowing blood transfusions.
Charles Emile gradually improved his clinic for surgery. Image029. He further taught Christina Catherina Hazenberg, his future spouse, to assist him during operations and also trained two bright local Javanese boys to sterilize his surgical equipment and keep his clinic clean. In addition two coachmen, one for the day and one for the night, were instructed to take him to his patients and how to transport gravely ill patients.
A skull bone operation
The following story told by Christina Catharina to her grandchildren illustrates Charles Emile’s experiences with surgery.
One day Charles Emile, whose successful surgery work had started to be known, was asked if he was prepared to remove a life threatening skull bone tumor from the head of Colonel van Heutsz, the brother of Johannes Benedictus van Heutsz, Governor General of Netherlands Indie 1904-1909.
In spite of his lack of experience with skull operations at that time he volunteered on the condition that he received a written statement, that in case he failed he would not be held legally responsible. Furthermore he asked permission to practice skull bone surgery on some five prisoners, who had recently died. At that time skull bone surgery tools were not yet available on Java forcing Charles Emile to improvise and develop his’ own set of tools among which a special set of chisels to work on the skull bone. Charles Emile, after completion of his preparations several weeks later, invited the colonel to his clinic for the operation. His spouse assisted as usual.
In those days ether was the only chemical available for anesthesia. After Charles Emile had applied ether to his patient he only succeeded in bringing him partly under anesthesia. It turned out that Colonel van Heutsz was resistant to ether, as he was a heavy alcohol consumer and regularly consumed up to two liters of Dutch gin a day.
Thus, when Charles Emile, started to work on the skull bone with his chisels, the pain became nearly unbearable for the patient. Charles Emile therefore whispered to the colonel and grandmother, who held the patients head, to let the patient hold his arm around her and squeeze her. Grandmother remembered that she was very frightened during the operation as she could hear every beat of the chisel on the colonel’s skull. After the operation she remained black and blue for weeks from the colonel’s squeezing.
After the piece of skull bone with the tumor was removed, the hole was closed with bees’ wax and the skin stitched back on the skull. Fortunately Colonel van Heutsz quickly recovered from the operation and lived for another twenty years, making many additional useful contributions to society. We can assume that this skull bone operation was probably the first skull operation ever carried out on Java at that time.
His medical work in Semarang
No records have been kept of the number of patients who visited his clinic. Yet we know from his mother’s diary that he had a very busy clinical practice. However some indication on the number of patients is given in a medical paper he wrote in 1915. This shows that during the last three years of his work in Semarang 1127 ORL patients consulted him. One may assume that these patients formed only a small portion of all the patients who consulted him on other diseases.
In spite of his busy practice and his surgery work, he was already involved in medical research in those days, of which the result was reported in three papers he published during this period.-Opera Omni 003, 004, and 005. His Opera Omni shows that in total nine of his medical papers were based on research conducted while he was in Semarang.
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