Chapter 97 94. The fallen angel

Whether it is the definition of divine right or the debate on the success factors of cesarean section, broadly speaking, the two people are just mocking each other. Before it really rises to the level of widespread practice, there is no doubt about medicine, or even about this little thing.

There is no point in any surgical meeting.

Kawei didn't want to convince them with such nonsense, and he didn't think anyone would believe such nonsense as the "Hand of God". He was just annoyed by the sayings about gods on the left and gods on the right, so he used the other party's explanation to explain it.

Mouth addiction.

After the laughter and scolding in the venue ended, the regular meeting had to continue.

Massimov is a doctor and a priest, so he certainly has his limitations, but from a surgical perspective, his operations are pretty good. At least he did not give up when he encountered the next huge abdominal tumor.

He resolutely chose to undergo abdominal dissection.

Of course, in terms of time, this operation was earlier than the failed cesarean section.

"Female, 23 years old, had abdominal distension and pain for two months."

This is the main complaint given by Massimov, which is concise and clear at a glance:

"I remember she came to the hospital at the end of November last year and saw a well-known internist. After a brief consultation of less than one minute, the internist easily attributed the cause of the disease to her gender and told her to go on a hunger strike.

Three days, and then during these three days you need to put a whole roasted potato on the painful area."

It was clear that this diagnosis and treatment method could not solve the girl's abdominal pain, and a week later she returned to St. Mary's Hospital, still the same internist.

Massimov sighed and continued: "This time the doctor realized the seriousness of the problem and once again emphasized her gender. At the same time, he did not forget to ask about X. The cause of the disease did not transfer to her private life, but to hygiene.

concept.

The treatment method given this time was bathing once a day, riding horses twice a day, and a bottle of cathartic herbal juice. Oh, and yes, there was also an enema, because the girl told him that there was a lump in his stomach. The guy prepared an exclusive solution from our hospital on the spot.

The enema formula can relieve abdominal distension and has a strong skin care effect, but it cannot cure abdominal pain!" [1]

Two medical consultations once again delayed the girl's treatment. When she returned to St. Mary's Hospital, it was already the 52nd day since she discovered abdominal pain.

"This time the pain was more severe. The internist saw that there was nothing he could do to help her, so he handed her over to the obstetrician next door." Massimov said, "Fortunately, the obstetrician didn't mind touching the woman. According to the feeling on her bulging belly,

After going through some doorways, I concluded that it was an 'evil fetus'."

Upon hearing this word, everyone in the audience immediately thought of teratoma.【2】

Teratomas are not unfamiliar to surgeons, because they have been doing dissections, and they always encounter some when the number is large enough to a certain extent, and there are not a few recorded. But those who really thought of solving teratomas by incising the abdomen

Very rarely, at least Ignatz has never done it, which is why Massimov can be ranked in this position.

"Her abdominal pain is getting worse and worse, and I can feel that the mass in her stomach is causing trouble." Massimov explained, "I'm not sure whether I should have surgery because the risks are too high, including mortality and cesarean surgery.

It was almost like a uterine delivery, but she was really in too much pain."

In order to appease the girl's mood and to appease himself, Maximov took her into the cathedral in the center of the hospital.

This is a typical rose window Gothic building with pointed towers, pointed arches, long beams and stained glass windows with biblical stories, which together create a light and slender feeling of flying into the sky. In the center is a wooden pulpit, and

There are many people in the nearly 100 seats near the statue of Jesus and the cross, most of them are family members, as well as some patients and doctors.

"I prayed with her, and also held her parents' hands in prayer. Together we praised God for his mercy, hoped to forgive their sins, and prayed that this girl would regain health."

Massimov sighed: "The operation was performed in a small room in the hospital. I chose a midline incision. After entering the abdomen, I saw a white spherical tumor, with slender and curved purple-red blood vessels on the surface. It

It was connected to the girl’s right ovary, and I immediately prepared to perform a right ovarian and mass resection. But”

The next scene after the operation moved him and shocked everyone.

"You must have never seen a bilateral 'evil fetus'. Two oblong tumors hung on both sides of her uterus, like angels that fell in her belly. [3]" Massimov simply drew

A sketch said, "The removal of the right ovary soon turned into a bilateral removal, and the difficulty of the operation went up to a new level."

Kawei also had to admit that doctors who dare to enter the abdominal cavity in this era are worthy of admiration, but he still had to complain that the operation was too rough.

The vast majority of teratomas do not require ovarian incision at all. The outer membrane can be simply peeled off to remove the tumor body inside. Bilateral ovary incision should not be performed, as this will directly cut off fertility.

At first, he thought that Massimov did not understand the anatomy of ovaries and teratomas, so during the time-limited ether anesthesia surgery, for the sake of safety, he had no choice but to perform a faster removal.

But later in his speech, he told Kawei that his guess was completely wrong.

Massimov did not understand the anatomy of ovaries and teratomas, but he even less understood the importance of ovaries to women.

This is not a matter of shallow understanding, but a bizarre misunderstanding based on male superiority: “I remember that Virchow, the father of pathology, once said about the importance of the ovary to women [4], and it was also mentioned in textbooks.

Clearly tell students who are new to medicine that the ovaries are dangerous organs that men do not have.

Menstrual disorders, neurasthenia, and hysteria are all related to the ovaries. Removing the ovaries is physically harmful, but mentally she may be one step closer to men.【5】

This inspired me to continue trying this surgery, but unfortunately God did not give me too many opportunities. Because the two tumors were too large, I encountered a lot of bleeding during the right side resection, and I had to cut the wound in a panic.

Break that lump”【6】

Kawei was not too surprised by the results of the operation. It would take a long time just to peel off the surrounding tissue of the bilateral teratomas. If it were successful, it would definitely be big news, and the ranking in the regular meeting would not be as bad as the subsequent failure.

Cut lower.

What really made him feel strange was his previous understanding of ovaries.

He felt that a bunch of familiar German words came into his mind, but he composed a few sentences that he couldn't understand. He couldn't understand why Massimov thought that the ovaries played a role in determining gender, but the doctors around him nodded.

, expressed his approval, but he could only give up.

Kawei has been here for more than half a month, during which time he has experienced many strange theories.

But those theories are just detours, or the theories behind them have not been understood. None of them is so outrageous as to praise the removal of an entire set of organs.

"What's the matter?" Ignatz realized that Kawei was confused and asked, "Interested in ovaries?"

"Um, I don't quite understand what Mr. Massimov said just now." Kawei tried to ask, "Can removing the ovaries really have that effect?"

"Oh, it's normal that you don't understand. It's only found in the physiology and pathology textbooks in medical schools. We don't cover much in surgery." Ignatz didn't answer directly. He only mentioned one source and seemed to understand the problem.

Wei's bottleneck, "You, a surgeon with a wild background, should go to medical school for further studies."

Wild road???

Kawei took a slight breath and said nothing more.

Compared with the teratoma removal process that Massimov vividly explained on the stage, he was more concerned about what was taught in medical schools in the 19th century. Although he, a little man standing on the shoulders of giants, is not qualified to criticize

A pioneer, but human curiosity cannot be stopped.

This made him look forward to the life of studying in the academy even more

Judging from the time, not long after Massimov's bilateral oophorectomy failed, another failed cesarean section followed. The two blows took away the young lives of the two girls, and completely

It shattered his confidence in surgery.

After many days of reflection, Massimov had no choice but to propose the abdominal no-no zone.

Waterman took into account his views on abdominal surgery, so he put a lot of effort into arranging the meeting.

After three failed abdominal surgeries, he underwent an almost successful tracheotomy halfway through, which was the fifth letter of the original, addressed to a surgeon from a small clinic: Damirgaon.

Judging from the quality of the surgery alone, there is nothing outstanding about this surgery.

The operation was not successful, it failed very simply.

The introduction also says: It only takes three minutes for a patient to go from having difficulty breathing to suffocating to death. In the past, this kind of crappy operation could not be included in the regular meeting. After all, the tracheotomy was done for this purpose, and it was really difficult to distinguish whether the surgeon was a serious one.

A surgeon is also a barber.

Waterman still added it in. The superficial reason may be that since December last year, apart from the emergency tracheotomy performed by Laszlo, this is the only clinic that has performed tracheostomy.

But tracheotomy is not a major operation after all. Death caused by failed tracheotomy is often not due to surgical errors but to the cause - suffocation.

Therefore, it is always a bit novel that a failed tracheostomy can be ranked in this position.

Damirgaon is a young man, even younger than Herman. After graduating from the medical school with a master's degree, he did not choose to continue his studies and went directly to work in a small clinic. Due to the shortage of people, he went directly to the operating table as soon as he graduated.

Surgeons mainly perform work such as amputations and epidermal abscesses.

Last year, I finally completed five years as an surgeon, so I entered the College of Surgery on the recommendation of two teachers at the medical school.

It was a tentative submission, but unexpectedly, I received a reply from the dean of the college himself and was selected.

He was very excited and nervous. After hearing the host call his name, he quickly came on stage. He couldn't say a sentence clearly and incoherently: "I'm sorry, I was a little over the top. I was too excited. I didn't

I thought that I could explain this operation to all the teachers, some of whom are my teachers.”

The duration of the operation was really short, but under Damirgaon’s intermittent description, the three minutes was stretched to twenty minutes: “The patient came to my clinic in early February, emm, probably in mid-to-early February. A

A very small clinic, left by my father, just east of the city."

The patient was a young man about 20 years old, a leatherworker, and he was very ill.

Before going to the clinic, I had been suffering from fever for nearly a week, with cough and sputum production. I had been prescribed medicine before, but it had no effect. As a result, the cough worsened three days ago, and I began to have difficulty breathing, which became more and more serious.

Based on Damirgaon's description of the symptoms, Kavey guessed that this was a case of severe pneumonia. In the era before antibiotics, once the body could not suppress the infection, death would be imminent.

"It was very difficult for him to breathe, until finally he couldn't even cough." Damirgang shook his head helplessly, "I prescribed him a large amount of crow's tincture mixed with honey, but he didn't see any improvement.

, my breathing is getting worse and worse, I can tell without using a stethoscope."

The audience has been waiting for the key points of the report, but the lengthy prelude made them lose patience.

However, just when they felt that this was just a grounding operation without much nutrition, Kawei kept nodding. Because compared to others, Damirgaon may not be very skilled and his words are verbose, but his statement of medical history is
To be continued...