Nineteenth Century Medical Guide

Generally, acute upper gastrointestinal bleeding will cause continuous loss of blood. If left untreated, the patient will soon develop anemia or even hypovolemic shock.Clinically, hemostasis is mostly combined with gastroscope to stop bleeding. If gastroscope is not available, three-chamber two-capsule tube with iced saline can be used to stop bleeding. 【1】

Kavey didn't have anything in his hand, so he had been emphasizing that Fernan couldn't live because of this.

But not being able to live does not mean that you will die immediately. As long as you find a way to delay time, there is still a chance, but the way is a little more brainless.

Since the digestive tract continues to bleed, the amount has been maintained at a high level, and the existing methods cannot stop the bleeding, so the only way to make up for it is to rely on blood transfusion.Autologous blood transfusion is definitely unrealistic. After the contamination of the digestive tract, the vomited blood cannot be reinfused, and allogeneic blood can only be used.

Allogeneic blood transfusion was not a particularly new concept in the 19th century. Many people had already tried it, in order to save the lives of the wounded after severe trauma, and to play a role in some complex operations.

"When I was doing the cesarean section, I discovered that Dr. James Brandel in the UK had tried blood transfusions for everyone several times as early as 50 years ago, but the success rate was relatively low." Carvey said, "But I Recently, some methods have been found to improve the success rate."

With Fattorad and Ingnac gone, Carvey became the only doctor in the police station who could guide the treatment.

It is obviously inappropriate and unnecessary to go outside to find a doctor at this time, because I am afraid that only Kawei in Vienna knows how to save him, and even the forensic doctor Musil is willing to believe Kawei's method: "Do you need us to give him a blood transfusion?"

"That's the only way to save his life."

Most of the police officers were resistant: "Is there no other way?"

But for journalists or some other people, the reaction is stronger: "Yes, it is the doctor's responsibility to save lives, why use our blood?"

"I don't agree to blood transfusion!"

In front of Kavey is the appearance of all beings, a bunch of irrelevant complex emotions, a strange phenomenon of choosing unanimous opposition after an extremely dissatisfied event.After all, when they proposed just now, like Fernan, they all immediately agreed.

Especially for those reporters, the change in attitude before and after is really too great.

"I'm not in the mood to waste time with you."

Kavi looked at the blood cup placed in front of Fernan again: "Since you are so hesitant, then forget it. I am also quite tired, and I should go back to sleep after a busy day."

After that, he was ready to get up and go out.

"Mr. Carvey's attitude is always so tough at times like this." Musil stumbled on Carvey, knowing that he would definitely not come back, so he got up and leaned over, stopped him and said, "I still hope you can wait, at least you have to wait for the results of those two."

"His Majesty the King will definitely agree, but Fernan's gastrointestinal tract has been bleeding. No matter whether the rescue is slow or not thorough enough, his life may not last three days." Carvey sighed, "So I just said, just give up if you can’t do it, don’t force yourself.”

"Don't give up. This proposal is actually quite good." Fernan was locked in a single cell and was lying on a small bed. "It's nothing more than giving me some blood transfusion, and I still have to die in the end." …

Carvey knew that this suggestion was counterintuitive. Although the result was death, everyone else had to choose a process that disgusted them.

He has his own reasons for bringing it up.

The first is to solve all the troubles at once, at least this way of performing surgery has been recognized by everyone.Perhaps under his own influence, Ingnac felt more and more that the operation should not have a strong performance nature, but he couldn't come up with a more suitable method when faced with this situation.

In addition, showing the operation is also a rare opportunity for Carvey.

Having done so many operations can only prove his talent and working ability after all, and the improvement of his status is very limited.

Many surgeries received enthusiastic responses from the circle, and to the ears of Morasso and Franz, they were actually just a modest surgical innovation, and the value would not be much greater than a telegraph.

If he could stay in Vienna all the time, Kavi would not care too much about his status, but there would be dangerous battlefields everywhere, and he had to mention his identity again to ensure his basic safety.

Now that the military medical department has Moraso as the inspector, it seems to be much safer, but in fact there is a hidden crisis.

He doesn't understand logistics, let alone medical care, and a lot of real power is still in Edinson's hands.Edinson has always regarded himself as a thorn in the side, and his evaluation is relatively objective, but when it comes to allocating medical resources, he might do some tricks.

In fact, Morazo's entry into the medical office is not a good thing, because with his somewhat assertive personality, he will rush to the front line at some point.It's okay for him to go to the front line, I'm afraid that he will bring himself by his side as a personal doctor accompanying him, this matter is serious.

Carvey has skills in his hands, but he is still a general surgeon. Although he will not be sent to the front line as a stretcher member, it is disgusting enough to be sent to be an accompanying doctor at the regiment and battalion level.

The situation on the battlefield is changing rapidly, and these entourages are not only tired, but also dangerous.

The key medical supplies are definitely not enough. The frontline troops only have the simplest surgical stress tools, and maybe those scalpels and pliers will have to be brought with them in the end.

That's why he took the old marshal's lumbar disc herniation and Giustina's mastectomy, in order to keep himself in the big hospital behind the battlefield.He doesn't care if he is a high-level or not, but at least he has to be like Hills, and he can't be someone else's abandoned son.

According to the original plan, the successful completion of Giustina's breast cancer resection has actually pushed Kavey to a very high position, basically squeezed into the first echelon of Vienna surgery where Ingnatz is.

But now it seems that some levels cannot be obtained by surgery alone. This surgery alone is not enough. There is a considerable gap between the main surgeon and the first assistant.

Although he gave the surgical technique, in the eyes of outsiders, it was Watman who performed the operation after all, and most of the credit was given to Watman in the end.Of course, Carvey has also been commended, but the money has no other meaning to him except to increase the funding for some research experiments.

Looking at the past two months before the war, only Marshal Ludwig was the only one who could truly be called a celebrity in Carvey's surgery. …

At the beginning, he used the gimmick of performing surgery on the marshal to increase his status, but now it seems that this may not be of much use.Because this does not bring benefits to Franz, and even because of the marshal's illness and his own surgery, the Supreme Commander-in-Chief of the Austrian Army is likely to be replaced.

It would have been nice for Franz not to hate himself.

So rather than saying that this is a show, Carvey prefers to call it a stage for the French ambassador. Who made Franz pay more attention to the French?

Of course, in addition to this, Carvey also hopes to use this absurd open-air surgery to test the effect of new drugs and the feasibility of upper gastrointestinal bleeding surgery.In such an era when alcoholic liver cirrhosis, liver cancer, gastric ulcer, gastric cancer and esophageal cancer are all high, acute bleeding really needs a treatment plan in line with the current era.

It has to be said that in an era when information transmission is extremely expensive and scarce, although this way of display violates the principle of surgical asepsis and infringes on personal privacy, it does have its merits.

"Who made Fernand damn it?" Carvey warned, "I just nodded to my suggestion and said yes there, why is there no sound now? If time drags on, the advertisement for open-air surgery will spread out." , people are gone, but it’s not good for anyone.”

"...It's just blood." Musil took off his shirt and rolled up the sleeves of his shirt. "How much do you want?"

"Don't worry, just a few drops of blood is enough for the first step." Carvey took the blood cup, which contained the two mouthfuls of blood that Fernan just spit out, "Bring the dropper and test tube Is it?"

"Here it is, as you requested, here are 11 pipes."

"Okay." Carvey glanced at the policemen in front of him, "Come on, there's a knife next to it, I've sterilized it, just put two drops into it with a tube for each person."

People are resistant to blood transfusions, but they can still do it with just a few drops of blood.A few minutes later, the tubes dripping with blood were labeled with their respective names one by one, and then lined up in front of Carvey.

"What are you going to do next?"

"See if your blood can coexist with this prisoner's."

The blood in the blood receiving cup had already started to coagulate, the cellular components inside sank one after another, and a layer of clear light yellow liquid formed on the surface.Modern people know that it is serum, but in the 19th century, blood components were not well understood. Even if they knew that there was such a thing, it was difficult to imagine its role.

Carvey sucked up this layer of serum with a dropper, and performed a blood type matching experiment on the blood samples of 21 people in front of him.

"There is a difference between blood and blood, and different blood is mutually exclusive." Carvey said while doing it, dripping serum into these test tubes one by one, "whether blood can be transfused is entirely God's will."

Once you put a religious cloak on things, you can always get twice the result with half the effort.

In fact, after Carvey brought out this theory, no one came forward to question the credibility of the experiment.They all watched the changes in the test tube, hoping to see some revelation from God.

The experiment is not very rigorous, because no anticoagulant is used, the results will be different.

Fortunately, the blood coagulation reaction was sensitive enough, and the 11 test tubes changed soon after being dripped with Fernand's serum. …

Among them, the blood of 7 roots only became thinner, and there was no agglutination reaction after the shock, while the remaining 14 roots soon appeared cotton-like precipitates: "What a coincidence, the two inspectors and Mr. Musil are both Same blood type."

Blood type was new to them, but this was simply not the time to think about it.

"Why us???"

"...It's unbelievable! My blood coexisted perfectly with the prisoner's blood?"

"How much blood do I need?"

"Let's try to transfuse 200ml first, but there are still a lot of things missing." Carvey is actually not particularly sure about blood transfusions. After all, he has encountered some dangerous blood transfusion reactions clinically. Without modern medical measures, he is likely to overturn." Wait until my men arrive before losing."

He had to wait for Damirgon, who lived in the Municipal General Hospital, and Savarin, who lived in the laboratory of the medical school.

In order to ensure the smooth completion of blood transfusion, in addition to needles and infusion hoses, a certain amount of anticoagulants and emergency medicines are also required.

The former can help him bring these infusion tools, while the latter can provide the adrenal gland extract that has already been finished.Because the adrenal gland is very small, it is not divided into cortex and medulla during extraction, so there are not only norepinephrine and adrenaline from the medulla, but also sugar and mineralocorticoids from the cortex.

Of course, in addition to these, there are dozens of other substances.

If the blood transfusion did go wrong, Carvey was left with them.

Early the next morning.

Various newspapers published reports about the mysterious disappearance of many people in Vienna, which described Fernand's figure, appearance and experience in a large space.In addition, a part of the crime process was also written, but most of the latter were compiled by reporters. 【2】

Carvey's blood type matching experiment was also mentioned by them, but the theoretical basis of these experiments is not the revelation of God he said, but the antigen-antibody reaction between blood types.

It was the introduction of Fernand's execution that really made the headlines.

It is not an ordinary hanging, nor beheading or other punishments, but an extremely dangerous operation.

As soon as this news came out, whether it was ordinary citizens, doctors who were also surgeons, or people who had intersected with victims and prisoners, they were deeply attracted by it.The once-closed surgical theater was turned into a surgical plaza, and the excitement increased by more than ten times.

And the most important thing is that people who could not afford to pay can also watch it live.

Those who put their minds to this operation specially offered a price that almost everyone could accept, and found a good place for the money:
"Each spectator only needs to pay 1 crown to occupy a good position on the arranged surgery square. The money will be used for Vienna's municipal administration and military construction. It doesn't matter if you don't have money, St. Michael's Square It can accommodate nearly a thousand people, and everyone can watch this grand event from the outside.”