Nineteenth Century Medical Guide

Chapter 140 137. The center of world surgery is in Lombardy

At six o'clock in the evening, the quiet Hoinz Street gradually became lively.

The bar lit candles for the guests, and the low buildings in the shadows also emitted ambiguous lights.

Unlike those young people who came after dinner, an elderly man seemed to have just finished his work and was about to leave here quietly.

He gently pushed open the small door of a building, looked out furtively, and when he saw no one around, he quickly dodged out.After closing the door, the old man walked down the street, put on a black hat, straightened his tie, held a cane in one hand, and carried a black box in the other, and walked towards the street in the distance.

After walking along Hoynz Street for more than ten minutes, I finally boarded a carriage.

"Go to the Lakeside Theater, hurry up, I'm in a hurry."

The groom nodded, thought of the route in his mind, shook off the whip, and drove the carriage towards the destination.

With the identity and status of an old man, he shouldn't have come to this kind of place.If he really needs it, he can find a more advanced one, or he can pay a little more money for door-to-door service.But he still came, half out of admiration, and the other half out of so-called curiosity.

The old man looked back through the glass window and glanced at the low building he had just left, his amusement was not over.

But entertainment is entertainment, and work is work. Over the years, he has set a rule for himself, and entertainment must always serve work.

"Work work."

The old man yelled twice, as if giving himself a hint, and shifted the picture in his mind to his next work: "First left maxillary resection, then ptosis, one needs new materials , and the other is a new technique, you have to be careful."

He found a pair of pliers and a scalpel from the black suitcase, and began to quickly simulate the operation to be performed on the stage.

"Cut the skin, separate the fascia, peel the muscles upward, ligate the blood vessels, find the bone joints, cut and separate, and continue to the left."

The old man remembered the appearance of the patient when he first arrived. His mouth was full of stink, his left upper jaw was full of rotten teeth, and a lot of pus could be pumped out. It was another dental problem that caused the upper jaw infection.The previous report of total mandibular resection is still vivid in my mind, and so is Carvey's suggestion, but the result may be quite different.

The old man looked at the various instruments prepared in the box, and was secretly delighted that even if they were all cut this time, the patient's food problem could be guaranteed.

As for the next ptosis repair, he also had his own new idea because of Carvey's suggestion.

The old man was full of anticipation for the operation, so he couldn't help asking: "Coachman, how long will it take to arrive?"

"Hurry up, go straight ahead and turn two corners."

"well."

At this time, the ureter + bladder repair operation that Kavey took over had just been completed, and overall it was considered a success.After the two organs were sutured in sequence, repeated dye leak checks were performed and no problems were found.

After cleaning the abdominal cavity, Carvey handed over the work of closing the abdomen and subsequent placement of abdominal drainage to Hills and Lockard, and began to receive inquiries from colleagues around him.

The operation was not what he expected, and it was a bit hasty to go on stage temporarily. If possible, Carvey actually didn't want to use copper pipes.Because there is no support from the upper and lower poles, whether this bare metal tube can really work according to its own wishes depends on the follow-up recovery.

What's more troublesome is that its texture is too hard. Even if both ends have been polished, it is hard to say that it will not cause secondary damage.

In modern times, urology often uses softer plastic products, double-j tubes, when repairing ureters.Not only can it give enough support to the upper kidney and lower bladder, but it is also slender and soft enough to support the lumen. 【1】

Nowadays, the development of rubber and plastic products is far from mature, and the only metal pipes that Kawei can use. 【2】

Apart from the uncertainty of ureteral repair, the most troublesome thing for Carvey was the peasant woman's pelvic condition.

Adhesions in the peritoneal cavity often point to tissue injury, and the causes of the injury are nothing more than physical and infectious.Such as trauma, surgery, infection.There were no scars on the peasant woman's body, and surgery and trauma were unlikely. The only thing that deserved Carvey's attention was infection.

Women's pelvic floors are more susceptible to infection because of their anatomy.

In the rural 19th century, women were less likely to seek medical care as long as the infection was not life-threatening.Even if you do find a doctor, the advice is often to take some useless herbs or poisons, and the result is worse.

"You should have heard that I'm studying puerperal microbes recently, and this kind of adhesive pelvic cavity should be caused by bacterial infection." Carvey began to output his point of view, "In addition, after a long period of naked surgery , I am pessimistic about her recovery from the postoperative incision."

"But we have already done enough disinfection work, isn't it enough?"

"Not enough, not enough." Carvey said, "Microorganisms cannot be perfectly killed by some disinfection work outside the skin, but other methods are needed. This method must not only inhibit their reproduction, but also ensure Does not affect the patient's health."

"What method? Is there really such a magical method?"

Kawei's pharmaceutical ability is basically 0, so I can only say roughly: "For example, drugs."

"Mercury? Tincture of ya tablets? Or other herbs?"

Carvey shook his head: "I have tried many methods, at least none of the existing drugs in the Municipal General Hospital have this effect."

Microbiological experiments have been carried out in the laboratory of the medical school. Before the conclusion is published, many people still expressed doubts: "Is it really like you said that the ulceration of the surgical incision is caused by infection?"

"At least existing experiments support my view."

"Professor Bill Roth has always believed that bacteria do not have much impact on the human body. For your experiment, he also thinks that the factors of microbial self-deformation and denaturation need to be resolved first."

Carvey's microbiological experiments were not difficult to do, but encountered some resistance, such as this Professor Bill Roth who appeared in someone else's mouth.Just returned from Zurich, Switzerland three weeks ago, and was directly hired as the vice president of the School of Surgery.

This is a guy with a very peculiar point of view.

On the one hand, he named the postoperative incision ulceration as "traumatic fever", and he very much agreed with the "Thermometer Application" that Carvey had already submitted.At the same time, it is hoped that this medical device will be popularized as soon as possible, and it is proposed to use the thermometer in the diagnosis and treatment process of all patients.

But on the other hand, he firmly believes that traumatic fever is caused by certain chemical poisons. Although he attaches great importance to Nightingale's preoperative and postoperative care, and insists on regularly measuring patients' questions, he firmly denies the ideas advocated by Lister and Carvey. All disinfectants.

What is even more strange is that after looking at Carvey's microscope, he even questioned the diversity of microorganisms.
"Professor Bill Roth's point of view is indeed novel, but I still say that whoever advocates should provide evidence. I have proved my point of view, and now it is his turn." Carvey said, "But from the existing experimental conclusions See, a coccus is always a coccus, a bacillus is always a bacillus, and a puerperal killer strep is always a strep."

For this point of view, the scene is divided into two factions, but everyone is against the "first sentence" at the beginning.

"Personally, I still think Mr. Carvey's point of view is more novel."

"Although I agree with the diversity of microorganisms, I really can't even imagine such a complicated microorganism and its pathogenicity."

"Because I dare not think about it, I still agree with Professor Billroth's idea that bacteria will indeed change under certain conditions."

"This should be the hottest topic in the Vienna Medical Journal recently, and it has also attracted the attention of many foreign medical circles."

Carvey successfully concealed the experience of ureter + bladder repair by diverting his attention.I thought this matter was over, and when the time came, everyone would go to the auditorium to continue watching Watman's operation.

Who knew that Watman arrived at the surgery theater early in the morning, and when he saw that there was no one in the lounge, he first came to the surgery area to have a look.

It doesn't matter if you don't look at it, you are startled when you see it, the abdominal closure on the side is not completely over, but Kawei has already stood at the center of everyone.The visual sense is so strong that he can't help but think of the previous cesarean sections: "What's wrong? Shouldn't the previous one be Olgi's cesarean section?"

"Dean Waterman, you are here."

"Dean, good evening."

Everyone looked at Watman, bowed their heads respectfully, and then told about the operation just now.

"Burn the bladder? Broken the ureter?" Watman looked at Olgi, "I'll let you rest for a few more months, and things will go wrong if you rush to the stage."

"The pelvic adhesions are too serious." Hills explained after wiping the woman's stomach with carbolic acid. "When the hysterectomy was performed, the surrounding anatomical structures were very chaotic, and it was impossible to distinguish them."

Watman didn't care about the reasons for the complications, quickly skipped these explanations, looked at Carvey and said, "First, hysterectomy, then ureteral suture reconstruction, and then a bladder repair. Dr. Carvey, where are you? This set of things you learned?"

Carvey smiled: "It's my father."

"It's your father again?"

"No no, it's not my father this time, it's my father's friend." Carvey explained, "A German doctor named Gustav, he is very good at pelvic surgery, including kidneys, cesarean section, ureters and bladder. I My father and he have always been friends, and I often watch them operate together.”【3】

If this kind of reason is only used occasionally, the doctors present can still believe it.

But Kavey has used it too many times, and fewer and fewer people believe in him.Now that a brand new character has been moved out, it is nothing more than to divert the firepower, but unfortunately the real effect is very small.

They are more willing to believe that these are the result of Carvey's surgical talent than the teaching methods of their father or a surgical friend.

Without excellent surgical talent, no matter how powerful a child is, it is impossible to learn so many complicated operations in a short period of time.

"The center of world surgery has always been Lombardy."

"Yeah, I didn't think so before, but now that I think about it, I'm still narrow-minded."

"It's a pity that Lombardy doesn't have a decent medical school."

The ridicule was endless, and Kavey simply chose to lie flat: "It's really a pity that such a land was snatched back by the Italians. If I were an imperial general, I would definitely bring troops to retake this land!"

Another good diversion of attention, the field began to discuss the recent Pu'ao preparations, and Kawei was quickly picked out.

However, Watman has no interest in war, and scoffs at Ignatz's invitation to work in the Military and Political Department.Of course, he is the president of the Academy of Surgery, and he has the capital to be proud of his talents. Ignatz still owes some heat, and Carvey owes even more.

"Why are you chatting and talking about preparing for the battle, and looking at them one by one, it's like having a chicken blood." Watman also pulled out, took Carvey's hand and said, "Let's talk about the operation. "

"Still talking???"

"It's not the one just now, it's mine." Watman was very excited, "But this temporary prosthesis is really beautiful, enough to be included in the regular meeting report. Unexpectedly, less than two months have passed, and I was shocked before." Human cesarean section has reached the point where I can't attend the regular operation meeting, thank you very much."

The surgical regular meeting is held once a quarter, and when the next regular meeting starts, even if cesarean section is not popularized in all hospitals, the volume of surgery in these three months is enough to smooth out the difficulty of the surgery.

"It's not bad to be able to enter the regular meeting. At least many colleagues can take a look at the complications of cesarean section." Carvey explained, "Let's talk about the dean's own surgery. Could it be that there are some new discoveries? ?”

"It's more than just a new discovery."

"Before I only had a ptosis repair scheduled here, and the maxillary resection was done in-house at the School of Surgery. But then I met someone who completely changed my approach to maxillary and maxillary resections," Watman explained. concept."

Carvey thought of his previous suggestion: "Have you found bone and joint replacement materials?"

"Not only the bones and joints, but also the gums!"

"If you can do this, it's really quite remarkable."

"It's not that I'm amazing, it's the dentist from England, the materials he brought helped me a lot." Watman took out a letter from his pocket with a smile, "Originally, this letter was to be prepared for surgery. I went to the hospital to give it to you after the end, and now that you are here, I will give it to you face to face."

"letter?"

"Well, it's the reply letter that Dr. Lister asked the dentist to bring to you. Let's have a look."

Wattman's surgery began quickly.

Anyone who likes surgery knows Watman, and the position of dean of the School of Surgery is not something that other surgeons can just grab.The dean's operation also omitted the host's introduction, and Watman directly entered the operation theater with his assistant.

"The patient is a young sailor. The teeth in the upper jaw are rotten, and the upper jaw is also rotten. What I am going to do today is to cut off his upper jaw, depending on the extent of the infection."

Watman waved his hand and pointed to the door behind him: "Before the operation begins, please allow me to introduce today's special guest, a famous dentist from London, England: Dr. Charles Thomas. He will bring me a brand new dental material , can reshape the patient's lost gums."

(End of this chapter)