Chapter 164 161. The real panacea

[This chapter is a bit too much, I have to write it slowly, I can read it tomorrow]

The blue vial is the dye that Kavey has been using before.

After the trip to the palace, its antibacterial experiment was raised to the highest level. Three days were not enough to make a conclusion, but it is not difficult to see from the growth of bacteria on the petri dish that the blue dye does have a certain antibacterial effect.

In addition to the nitrite-like toxicity of Zhonglian herbal medicine, Kavi is almost certain that this bottle of dye is methylene blue. [1]

Methylene blue is widely used in modern medical fields. Although it has certain toxicity, as long as the dose is controlled, it is a very useful safe dye, which can distinguish it from the blood in the body. At the same time, it is also a good reducing agent, which can treat nitrobenzene poisoning, nitrite poisoning, and cyanide poisoning.

But now, what Kawei is interested in is other characteristics of methylene blue.

For Kavey, who has gone through the age of lack of medical treatment, this dye can definitely be called a panacea for the 19th century, and it makes him more excited than completing a complicated operation.

The first is the antibacterial ability that has been experimenting with.

Modern antibiotics are emerging one after another. In order to cope with the constantly upgrading drug-resistant bacteria, humans also need to continuously upgrade their weapons. This is an inevitable result of evolution in the era of scientific development. When people reflect on antibiotics, methylene blue has retreated from the environment before it even emerges. [2]

In fact, before the change, there was a precedent in China to use the pharmacological effects of methylene blue kidney excretion to treat urinary tract infections. When it first appeared abroad, it also studied the use of treating bacterial dysentery, but at that time it was quickly submerged in the ocean of various antibiotics.

In the antibiotic world where you sing and I have appeared on stage, methylene blue has lost the necessity of appearance. People are more likely to see it as a fish tank fungicide displayed on counters in the ornamental fish shops in the flower and bird market.

In addition to detoxification and antibacteriality, Kavi also knows the third function of methylene blue: anesthesia.

If the modern antibiotic environment has its own characteristics and has its own antibacterial spectrum, no one will accept anyone. Then the anesthesia environment is the top of the pyramid, general anesthesia, local anesthesia, muscle relaxation, pain relief, and each has its own rolling methods.

Because everyone is human, except for some special circumstances, it is difficult to find an opportunity to choose unpopular anesthetics, except for some special circumstances that require anesthesia to fine-tune medications.

The simplest example is diethyl ether, the originator of general anesthesia that squeezes out laughing gas, and the magic medicine prescribed by chloroform Panax notoginseng, has long lost the right to anesthetize humans and can only go to the animal laboratory to continue to shine and heat. [3]

In contrast, the earliest penicillin is still active in the clinical frontline.

Methylene blue anesthesia was first used in the 1970s and was a clinical application based on practical medicine. Its anesthesia usage cannot be found from the drug instructions because its anesthesia mechanism lies in the side effects column.

It can affect the transmission of nerve excitation and impulses and can also cause a kind of nerve medulla damage. Injection of large amounts of subcutaneous tissue will cause peripheral nerve necrosis, and injection of large amounts of muscle will cause tissue necrosis. If it is intrathecal injection, it will cause paralysis.

However, this damage is reversible at low doses and low concentrations, so as long as the dose is controlled, it can produce a long-term pain relief effect.

Since it is an injury, there will definitely be many side effects. In addition to the blue-green urine [4], many functional changes caused by neuromedulla damage are also very important.

In the anorectal department, which uses the most methylene blue, it is often used to relieve severe wound pain caused by dressing and defecation after surgery.

However, once this reversible injury exceeds the safe dose and concentration, it will produce irreversible numbness, which will seriously affect the function of the sphincter, causing fecal incontinence ranging from about half a month to one month, and even permanent necrosis of the sphincter.

But compared to the dysfunctional ether, many surgeries use local anesthesia [5]. Especially in the upcoming Pratt-Austria War, mild and moderate injuries to the limbs often achieve very good analgesia effects by using local anesthesia alone.

Detoxification, staining, antibacterial, anesthesia, which is the important reason why Kavi calls it a 19th century panacea medicine.

However, today, methylene blue still appears as a simple surgical stain.

"Countess, the operation is over soon." Watman walked directly to the operating table after he came on stage and comforted the patient in his usual style. "When you wake up, you will find that the tumor has already left your body."

Giustina took a deep breath and barely cheered up: "I hope this can be true."

"Don't worry, with Dr. Kavey and me here, there will be no problem."

"Thanks."

Giustina turned her face and looked at her husband, holding his hand: "Camiy, if there is a problem with the surgery, or the tumor is too serious, or... Anyway, if I don't wake up, please be with Ilia."

"This" Kamiy was stunned, "Do you know everything?"

"Iliyako is much gentler than Edita, and that Anji only cares about your money."

"Well, I understand."

Giustina turned around and glanced at the theater, and continued, "This is just my suggestion. No matter who you are with in the end, please remember me."

"Of course!" Kamiy's eyes burst into tears, "You will always be my favorite woman."

"Thank you." Justina nodded to him with a smile, then easily opened her hands, lay calmly on the operating table, looking at the nurse beside her, "Get started."

It was not until then that Watman pointed his face to the audience and said the first introduction today: "Dear His Majesty the King, the Prime Minister and the French diplomatic ambassador, and all colleagues who are willing to spend the afternoon to watch the surgery. Today, Mr. Kavey Hines and I will show you the brand new breast cancer resection.

Breast cancer has always been a female killer, and there has been no way to operate surgical operations for the past century. It is not that it cannot be removed, but that it will recur.

Some experts think that the body of a breast cancer patient is causing trouble, while others think that the tumor tissue is not completely removed during the operation. Dr. Kave and I prefer the latter, but after studying dozens of breast cancer surgery records, we found that the recurrence of breast cancer may be related to lymph node metastasis.

So this surgery is different from the previous simple resection. We also included the removal of lymph near the armpits in the surgery."

The right to speak fell into Kawei, who was preparing a stained syringe: "There were descriptions of "swelling of the patient's axillary lymph nodes" in many surgical records before, and the relationship between breast cancer and lymph that Dr. Rudolph wrote about in Germany two years ago, which immediately aroused my interest."

After saying that, he showed the syringe in his hand: "This is a very perfect stain. Inject it into the skin, in the skin, and in the dizziness, and around the tumor, you can see the clear direction of the lymph." [6]

Not everyone reads papers like Kavi. Most surgeons prefer to do things and work alone.

Therefore, most doctors in the audience had never heard of Rudolph's name, and they had no impression of this article. But no matter what the content of the paper is, or whether the relationship between lymph and breast cancer is correct, since it was said by Kawei, it is absolutely correct to write it down.

In fact, this was already the case in the surgical theater before he successfully completed the cesarean section. After more than a month of consolidation, everyone developed the good habit of taking notes during his operation.

The four people who were watching the fun were surprised by this kind of page turning and writing sound.

"The best way to deepen your impression is to directly record the surgical process with text and images."

Edinson seemed to not understand what they were surprised at. It was not until Franz pointed it out that he said helplessly: "Doctor Carve always came up with some innovative new ideas every time he had surgery. When we encountered a method we had never heard of before, we would reflexively choose to ask and record it."

"He's too young."

"Mozart had written more than 20 symphonies at the age of 17." Franz gave examples of several Austrian geniuses to prove that Kavi's strength was just right. "Cherny and Schubert were also famous at a young age, and this situation is not uncommon in Vienna."

Edward frowned and felt a little nervous: I admit that you are good at music, but this is a doctor. Don’t doctors rely on study and learn, and they also talk about talent?

Watman's introduction and the dye in Kavey's hands swelled everyone's appetite. The audience looked at the anesthesia mask on Giustina's mouth and nose, waiting for the operation to officially begin.

Amor once again became Kawei's anesthesia assistant. According to previous judgment criteria, after the orbital pressure and eyelash reflex disappeared, he made a timely report: "The anesthesia of the director, Dr. Kawei and the Countess has been completed."

"disinfect."

With Kavey's order, Damiergaon, who was behind him, came to the operating table with a disinfection basin and a watering can. Amor also became Sansuke and Damiergaon to complete preoperative disinfection together. The carbolic acid disinfection range covered the entire right breast, right shoulder, armpit and right side of the trunk, while the air disinfection of alcohol spray covered the entire surgical area.

The needle quickly pierced into Giustina's skin, and the blue dye that had been diluted in advance slowly flowed into it.

"Just wait 5-10 minutes, the stain will flow step by step along the lymphatic duct to the surrounding lymph nodes. At that time, we can clearly see how the tumor metastasizes through the lymph."

After the introduction of two surgeons, Ambassador Edward also had questions: "Dr. Edinson, what exactly is the lymphatic vessel that Carvey just mentioned?"

"It is a duct system in the human body, with clear lymph flowing inside, called white blood by Hippocrates," explained Edinson. "And there are lymph nodes between the ducts, which should be used to produce and store these blood."

"What does lymphatic function?"

"According to the theory of the four fluids, lymph fluid can be classified as a type of blood, which is purer blood." Other doctors, including Aidinson, have also had a very shallow understanding of lymph. "Since the tumor has invaded the lymph, it means that the condition is very serious."

"So that's it." Edward was very interested in Kawei's staining method. "Although the seats are a bit far away, it can be imagined that such staining must be very intuitive, but is lymph and tumor really related?"

"I can't be sure, either."

Edinson looked at Kawei on the stage and suddenly thought of the suggestion he had made to Franz before. He changed the subject: "According to Dr. Kawei, lymph is actually like a railway, and tumors are materials. As long as we have an efficient and convenient railway system, we can continuously send the resources of materials to all parts of the front line."

Edward nodded repeatedly: "This metaphor is good, I like it. If I remember correctly, France now has the largest railway network in the world."

This not only helped him win back a battle, but also reminded Franz of the predicament he almost fell into the siege during the French-Austrian War. For this reason, Prime Minister Carl had to stand up: "Although the railway can help with transportation, when he really went to the battlefield, he relied on the brave and fearless Iron Knight soldiers."

Edward didn't find it strange, but said, "I think France will never be inferior to others in this regard."

Since the words were mentioned by the railways and soldiers, Franz no longer hid it and asked directly: "Since that is the case, not only the French emperor responded to Prussia's current radical preparations for war?"

"His Majesty the Emperor still hopes that the European continent can live in peace and cannot give the British an opportunity to take advantage of it."

"The Prussian railway has been built to the border line, and the steel mills have made guns and cannons day and night, and soldiers are gathering." Franz sighed, "This makes us very nervous."

"Isn't this the case in Austria?" Edward hit Tai Chi, "Why should we sit down and talk together?"

Although Franz talked about peace, peace was just an excuse. What he really wanted was the land of Prussia rather than peace. Seeing that the other party responded in this way and threw the problem back, he could not refuse to accept it or take it randomly.

Although he was reluctant at this time, Franz still had to advocate the Prussian threat theory: "We will have a war with Prussia, which is a matter of Germany's ownership. But once Prussia wins the war, the next step will be to deal with France. Bismarck's cunning fox has been staring at you from the beginning and will never give up on France's land."

"Isn't Austria?" Edward didn't take Prussia seriously. "France has long been used to it."

After a few rounds of tit-for-tat, Richard quickly smoothed out: "Okay, okay, let's put the state affairs first, and it's better to see the surgery."

The staining before the operation has begun to show results. Even without cutting the skin and subcutaneous fat, Watman and Kavi, who stand on both sides of the operating table, can vaguely see the blue-colored pipes. Just like what Altinson said just now, they spread out from the center, forming a spectacular network.

Watman saw Kavi nodding and immediately looked at the nurse: "The staining has been successful, give me a scalpel."
Chapter completed!