335. Draining pus

Author: Hao Xifeng

The Department of Internal Medicine at the Main Palace Hospital is the same as the Municipal General Hospital. It gathers all kinds of patients regardless of system or severity.

If the Internal Medicine Department of the Municipal General Hospital is a good baby who has never left home and only knows how to listen to his parents' teachings, then the Internal Medicine Department of the Main Palace Hospital is a young man who has seen a lot of the world. He seems to understand many diseases but does not really understand them.

I understand, and I have just entered the rebellious stage, and my character is also very immature.

Insufficient research in basic disciplines has greatly restricted the development of internal medicine. Physicians always feel an indescribable sense of powerlessness when facing diseases.

And when one knows the types and causes of diseases but cannot cure them, repeated setbacks will gradually wear away a person's will.

"If you want to become a qualified internist, you must not only have skills and unique diagnostic vision, but also have a tenacious spirit!" Const. Jean Bour, director of the Department of Internal Medicine at the Palais-Dieu Hospital, is imparting experience to the doctors in his hands.

, "Although Mrs. Walter's tapeworm treatment is a bit troublesome, there is a chance as long as you persist."

"Yesterday we increased the content of castor oil to 20g and the fern resin viscose liquid to 50g. The cathartic effect has been greatly improved."

"But you can still only see some of the tapeworm segments in the feces."

Const took out a magazine from the cabinet, and then took a bottle of ointment from his pocket: "This is a recently developed medical ointment. It seems to have a good effect on treating tapeworms. According to the book, every day

Take 3g and mix it into milk and swallow it. It only takes 3-5 days to force out the tapeworm."

The magazine comes from The Lancet, England. The author is a doctor who specializes in treating tapeworms in Fife County and is best at catharsis. The article was published in 1865.

"Okay, we will arrange for her to take it tomorrow morning."

Const sighed: "If even horse oil is ineffective, we can only try our luck in the electric shock room like tuberculosis patients. Huh? By the way, has the tuberculosis patient sent there an hour ago come back?

"

"not yet."

"Why so slow?"

"There may be too many patients who need electrotherapy. Dr. Sneed will accompany them personally, so there shouldn't be any problems."

Their judgment about Sneijder himself was correct. He was an attending doctor with rich clinical experience. He had solved many patients' problems for many years. But the results that appeared in front of everyone ten minutes later far exceeded their expectations.

, the patient was carried in and was very weak.

The good news is that the hemoptysis that has troubled both the patient and the doctor for a long time has disappeared, and the coughing has become much less severe. However, at the same time, a large 10cm gash was opened on the back.

"What's going on? The electroshock room has started to practice bloodletting now?"

"No, it looks like someone cut it with a knife."

"Don't be kidding me. A single cut in the back can cut the lungs into pieces, not to mention the bones. How is it possible to sew up the wound properly?"

Several possibilities appeared in their minds, and they even thought of the hospital being broken into, hijacked, and burned. But they never thought that the tuberculosis patient had just undergone an operation and the location of the apex of his right lung.

Several golf balls were stuffed into my body.

"He collapsed on the way to the electroshock room, and he had severe hemoptysis." Sneijder explained to Const and other colleagues, "Because the electrostimulation room has express regulations that vomiting, sweating, and drooling are not allowed, which is what he just experienced.

Patients who have not completely stopped bleeding after bloodletting are afraid that there will be a problem with the circuit. So "

"So what happened?"

"So I followed a surgeon's advice and operated on the patient."

"Surgery? How long has it been since?"

Const looked at the wall clock that had been gone for an hour and a half and felt very surprised. For a while, he could not figure out the logical relationship between tuberculosis and surgery. Then he put aside this "ignorance" and began to investigate his subordinates for their arbitrary changes.

Treatment plan, even at the expense of surgical procedures.

"Professor Const, I am his attending physician." Sneijder thought about his explanation when he was questioned. "I am only responsible for his health, so after the surgeon convinced me, I agreed.

Had this surgery.”

The domestic modern medical system is similar to the political system. Directors can intervene in patients who are responsible for other doctors.

In foreign countries, the attending doctor is the sole person in charge of the patient. The so-called director is only responsible for managing the department operations and his own patients, and will not interfere in the treatment of other patients. Of course, there are far fewer surgical patients, and the director is often solely responsible for it.

France in the 19th century had just taken its shape and was still very immature. Const would sometimes intervene, but more often than not he would give advice.

"It's up to you how your patient is treated in the end, but this is ridiculous. Surgery? Tuberculosis? Can these two things be linked together?"

The relationship between Sneijder and him is very delicate. They are both master and apprentice, superior and subordinate, and he is also a candidate for director after Const retires.

He didn't want to make the relationship stalemate, and he also knew that Const had the right to intervene in these matters. As the attending physician, he should give an explanation: "The patient had severe hemoptysis on the road, with the total amount exceeding 300ml. At this stage, it is difficult to survive for more than a week, even if

It won’t work even if you use electrical stimulation.”

"Well, although electrotherapy is effective, it also has great limitations in treating refractory pulmonary tuberculosis." Const returned to the surgical issue, "Can surgery be able to handle it?"

"The patient's hemoptysis has indeed stopped."

"It's a coincidence."

"He is an old patient, and you know what the situation is." Sneijder poured himself a glass of wine, then found a chair to sit down, and briefly explained the current situation, "The operation is not particularly difficult, and the speed is also very fast.

It was very stable after that, but my breathing was a little faster."

"Where's the hemoptysis?"

"Not once."

"Haha, this is impossible."

Const smiled and shook his head repeatedly. It was not that he did not believe what Sneijder said, but that what he said was seriously inconsistent with the surgery he knew.

But the magic of surgery is that it can always achieve some results that cannot be achieved by internal medicine through a series of dangerous and invasive operations in a way that is beyond ordinary people's understanding. The golf ball used by Carvey was completely beyond the scope of Const's understanding.

But it only takes a little explanation from Sneijder to understand the principle.

After hearing the whole process of Kawei's operation, the director of internal medicine, who has been practicing at the Diocesan Palace Hospital for more than 20 years, finally believed the evil: "Relying on compressing the entire right lung to close tuberculosis cavities and ruptured blood vessels? How can this be done?

, this old guy Cedieu isn’t stupid either.”

"Well, actually" Sneijder took a sip of wine, "In fact, Professor Cediyo is the assistant, not the chief surgeon."

"Huh? Not him? Who is that? Now the surgery department has lost its only commendable theatrical performance, and only one Cedieo can do it."

His ideas were obviously several generations ahead of the others present, so it took three assistants following him for a while to understand the meaning of these words.

Especially for an elderly surgeon like Cediyo, it is difficult for him to understand the importance of postoperative incision management: "I admit that there are certain skills in draining pus, but whether the postoperative recovery can be cured depends entirely on luck. If the patient's body is already in trouble,

It’s not good, and there’s nothing we can do.”

This is the reason Kawei heard it many times in Vienna: "Is there a big syringe here?"

"Big syringe? How big do you want it to be?"

"At least 20ml."

"No."

"Then use a wide-mouth bottle, just seal it well, and the effect will be about the same." Kawei has already begun to consider the care plan after the operation, "Just use the big bottle that is connected to the suction device during cesarean section."

"That one has."

"Choose five and use them after surgery."

"Do you want that much?"

"Not enough stock?"

"It's not that it's not enough, I just think it's too much. If we take them all away at once, more than half of the suction bottles that can be used in the surgical theater will be missing." Cediyo doesn't quite understand the use of these bottles. "In fact, bleeding is special.

A fierce cesarean section doesn’t require so many bottles, so why prepare so many?”

"If it's not enough, then make more preparations."

In terms of medical equipment, as long as conditions permit, Kawei has always advocated increasing revenue over reducing expenditure, and things that are useful for surgery and postoperative recovery cannot be saved: "Don't be so petty in such a big hospital."

Cediyo didn't know what the bottle was for, so he thought it was just a bottle, so why bother with it.

If it were anyone else, he would have complained a long time ago, but now it is Kawei who is making the request. If you want to learn the technique, you have to be "pious" enough. Especially the golf filling technique, the effect is immediate, and the process is not complicated.

However, watching it once was not enough for him to gain the confidence to be the surgeon. He needed to watch it a few more times.

"I'll send someone to get it and we'll have enough for tonight."

"The next step is the rubber tubes, which we need roughly." Kawei made a calculation, "Let's get 10 of them first."

"so many?"

"No?"

"Rubber is not glass, and it's not that easy to get. If you really want that much, you have to find a rubber company to find a way."

"Then go quickly, we need it tomorrow."

Cediyo responded to every request: "Okay, I'll ask someone to make a trip."

"The last thing is gauze and ointment. There are always these two, especially ointment, which is popular from France." Kawei suddenly thought of something and asked again, "By the way, is there a sponge?"

"Sponge? What do you want that for?"

Kawei has seen nobles use high-end natural sponges, which feel very good and have good water-absorbing properties: "If you want a high-end sponge, it must be soft and have good water-absorbing properties."

The surgical instruments in Cediyo's mind are still limited to various metal instruments such as knives, saws, pliers and tweezers: "These are not cheap, and what use are they for surgery?"

"It's not for surgery, it's for after surgery."
Chapter completed!