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|Author||A. J. Cronin|
Little, Brown (US)
|Media type||Print (hardback & paperback)|
|Pages||446 pp. (UK hardcover)|
The Citadel is a novel by A. J. Cronin, first published in 1937, which was groundbreaking in its treatment of the contentious theme of medical ethics. It has been credited with laying the foundation in Britain for the introduction of the NHS a decade later.
In the United States, it won the National Book Award for 1937 novels, voted by members of the American Booksellers Association.
For his fifth book, Dr. Cronin drew on his experiences practising medicine in the coal-mining communities of the South Wales Valleys, as he had for The Stars Look Down two years earlier. Specifically, he had researched and reported on the correlation between coal dust inhalation and lung disease in the town of Tredegar. He had also worked as a doctor for the Tredegar Medical Aid Society at the Cottage Hospital, which served as the model for the National Health Service.
Cronin once stated in an interview, "I have written in The Citadel all I feel about the medical profession, its injustices, its hide-bound unscientific stubbornness, its humbug ... The horrors and inequities detailed in the story I have personally witnessed. This is not an attack against individuals, but against a system."
In October 1924, Andrew Manson, an idealistic, newly qualified doctor, arrives from Scotland to work as assistant to Doctor Page in the small (fictitious) Welsh mining town of Drineffy (Blaenelly is the name given in some adaptations). He quickly realises that Page is unwell and disabled and that he has to do all the work for a meagre wage. Shocked by the unsanitary conditions he discovers, Manson works to improve matters and receives the support of Dr Philip Denny, a cynical semi-alcoholic who, Manson finds out in due course, took a post as an assistant doctor after having fallen from grace as a surgeon. Resigning, he obtains a post as assistant in a miners' medical aid scheme in "Aberalaw", a neighbouring coal mining town in the South Wales coalfield. On the strength of this job, Manson marries Christine Barlow, a junior school teacher.
Christine helps her husband with his silicosis research. Eager to improve the lives of his patients, mainly coal miners, Manson dedicates many hours to research in his chosen field of lung disease. He studies for, and is granted, the MRCP, and when his research is published, an MD. The research gains him a post with the "Mines Fatigue Board" in London, but he resigns after six months to set up a private practice.
Seduced by the thought of easy money from wealthy clients rather than the principles he started with, Manson becomes involved with pampered private patients and fashionable surgeons and drifts away from his wife. A patient dies because of a surgeon's ineptitude, and the incident causes Manson to abandon his practice and return to his principles. He and his wife repair their damaged relationship, but then she is run over by a bus and killed.
Since Manson has accused the incompetent surgeon of murder, he is vindictively reported to the General Medical Council for having worked with an American tuberculosis specialist, Richard Stillman, who does not have a medical degree, even though the patient had been successfully treated at his clinic. Stillman's treatment, that of pneumothorax, involved collapsing an affected lung with nitrogen, and was not universally accepted at the time.
Despite his lawyer's gloomy prognosis, Manson forcefully justifies his actions during the hearing and is not struck off the medical register.
The novel is of interest because of its portrayal of a voluntary contribution medical association which is based (not entirely uncritically) on the Tredegar Medical Aid Society for which Cronin worked for a time in the 1920s, and which in due course became the inspiration for the National Health Service as established under Aneurin Bevan.
The Citadel was extremely popular in translation, being sold in book shops in the Third Reich as late as 1944. The scholar and Holocaust survivor Victor Klemperer noted, "English novels are banned of course; but there are books by A.J. Cronin in every shop window: he’s Scottish and exposes shortcomings of social and public services in England."After the Second World War, it proved popular in Communist bloc countries as well, where Cronin was one of the few contemporary British authors to be published.
The novel was made into a 1938 film with Robert Donat, Rosalind Russell, Ralph Richardson and Rex Harrison, and television versions include one American (1960), two British (1960 and 1983), and two Italian (1964 and 2003) adaptations of the novel. There are also three film adaptations of the novel in Indian languages: Tere Mere Sapne (1971) in Hindi, Jiban Saikate (1972) in Bengali and Madhura Swapnam (1982) in Telugu.In 2017, an adaptation for radio by Christopher Reason was featured as the BBC Radio 4 15 minute drama. In June 2021, a longer radio adaptation was broadcast by Radio 4 as two 45-minute episodes, written by Christopher Reason and Tom Needham.
Archibald Joseph Cronin, known as A. J. Cronin, was a Scottish physician and novelist. His best-known novel is The Citadel (1937), about a Scottish doctor who serves in a Welsh mining village before achieving success in London, where he becomes disillusioned about the venality and incompetence of some doctors. Cronin knew both areas, as a medical inspector of mines and as a doctor in Harley Street. The book exposed unfairness and malpractice in British medicine and helped to inspire the National Health Service.
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Tredegar is a town and community situated on the banks of the Sirhowy River in the county borough of Blaenau Gwent, in the southeast of Wales. Within the historic boundaries of Monmouthshire, it became an early centre of the Industrial Revolution in Wales. The relevant wards collectively listed the town's population as 15,103 in the UK 2011 census.
The South Wales Coalfield extends across Pembrokeshire, Carmarthenshire, Swansea, Neath Port Talbot, Bridgend, Rhondda Cynon Taf, Merthyr Tydfil, Caerphilly, Blaenau Gwent and Torfaen. It is rich in coal deposits, especially in the South Wales Valleys.
The Citadel is a 1983 BBC television adaptation written by Don Shaw from A. J. Cronin's 1937 novel The Citadel. It was produced by Ken Riddington. The drama was directed by Peter Jefferies and Mike Vardy.
The Citadel is a 1938 British drama film based on the 1937 novel of the same name by A. J. Cronin. The film was directed by King Vidor and produced by Victor Saville for Metro-Goldwyn-Mayer British at Denham Studios. It stars Robert Donat and Rosalind Russell.
The Stars Look Down is a 1935 novel by A. J. Cronin which chronicles various injustices in an English coal mining community. A film version was released in 1940, and television adaptations include both Italian (1971) and British (1975) versions.
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La Cittadella is a 2003 Italian miniseries based on A. J. Cronin's 1937 novel, The Citadel, and produced by Titanus. It was directed by Fabrizio Costa and stars Massimo Ghini as Dr. Manson and Barbora Bobuľová as his wife, Christine. Other television versions include an American (1960), another Italian (1964), and two British adaptations.
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The Citadel was a 1960 British television adaptation of A. J. Cronin's 1937 novel, The Citadel. The series was directed by John Frankau and produced by Peter Graham Scott. It starred Eric Lander as Dr. Andrew Manson, and Zena Walker as Christine, his wife. This television adaptation is entirely missing, i.e. all nine episodes are believed to be lost.
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Walter Conway was the longstanding secretary of the Tredegar Medical Aid Society in South Wales. This society contributed the model which established the British National Health Service.
Tredegar Medical Aid Society was founded in Tredegar in South Wales. In return for contributions from its members it provided health care free at the point of use. This society contributed the model which established the British National Health Service. According to Colin Ward, the model had "evolved from the vast network of friendly societies and mutual aid organisations that had sprung up through working class self-help in the 19th century."
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