The manager of the restaurant is the head chef, who used to serve the French royal family full-time. Now that he was suddenly asked to cook for a commoner, it was inevitable that he would be concerned.
When faced with Kawei, faced with the rare situation of taking out food, although he was unforgiving with his words, he still did his best in terms of follow-up service.
The restaurant uses a set of gold-plated silver tableware that is imitated from the ones commonly used by the royal family, similar to the pots used for cooking and the lunch boxes used to place food. In order to make it easier to use and carry, and to reduce costs, the craftsmen changed the material to silver-plated copper, and removed many of the original decorations and unnecessary carvings, making it look simple, natural, and more approachable.
Because airtightness is not guaranteed, a waiter will need to accompany you home when taking out food.
Of course, Ignatz still paid the huge deposit of 4 crowns.
...
There is not much light on Basinger Street after dark. For most people living here, night means darkness and is a break after a hard day's work. They need to seize the rare opportunity to sleep to conserve their energy and prepare for the long hours of work the next day.
What's more, light is not free, and wasting candles is quite a luxury.
A carriage came from the west, and with the sound of horse hooves tapping in a fast rhythm, the carriage stopped at the gate of No. 73. Using the kerosene lamp next to the car, a young man quickly stepped out of the car and took the lunch box and bread bag from the car.
"Mr. Kawei, I will retrieve these things at this time the day after tomorrow. Please make sure that the cutlery and lunch boxes are not damaged."
"I see."
In the late winter and early spring, as long as they are stored properly, three dishes, one soup and a bag full of baguettes are enough to keep him fed for two days. By the time he finished eating all this food, he should have been eating at the Municipal General Hospital's working meals, at least he no longer had to worry about food.
Kawei slightly looked forward to the rest of his life, and went upstairs with a lunch box and a large bag of bread in both hands.
Only after he returned home did he realize that after he left, the police had sealed off his home, just like Room 302 next door. It seems that Detective Witte had no intention of letting him back from the beginning. Even if he was really innocent, the other party wanted to keep him for a while.
If he hadn't happened to meet Ignatz, he might have stayed in the police station for several days. Now that even Werther has decided not to cause trouble anymore, the matter basically has nothing to do with him, and Kawei no longer needs to worry about it.
The man in black named "Mick" appeared in his mind again. He couldn't help but curse a few words, tore off the seal, opened the door and entered the house.
After entering the house, Kawei tidied the room a little, put away the paintings and clothes scattered on the floor, and then made the bed clean. Then he moved a vacant seat by the window and placed the lunch box there, trying to keep the temperature low by relying on the cold wind that constantly blew into the window.
In the days before refrigerators, covering the food immediately after it was cooked could isolate airborne bacteria. The air inside will also be relatively sterile due to the continuous high temperature of the steam.
Anyway, it’s always a good idea to wait until you’re eating.
Since traveling here, Kawei's mind has been running at high intensity and he has never stopped for a good rest. Now that he finally has some free time, he needs to plan his future carefully.
Medical care in the nineteenth century was very confusing.
This kind of confusion is not only about the medical care itself, but also that the medical system that matches it is also extremely chaotic.
In fact, the word "chaos" is not appropriate here, because there is no complete system to support medical development.
Kawei is a modern person. Although he has studied medicine for half his life, he does not know much about the medical treatment of more than a hundred years ago. In addition to painting and gardening work, the original owner did not leave anything related to medical treatment in his memory. It wasn't until he met Ignatz just now that he became more or less clear about some details.
The occupations occupied by the entire medical system can be roughly divided into internal medicine, surgery, medicine and nursing.
Among them, physicians have the highest status and high requirements, so their number is naturally the smallest.
Physicians need to go through formal medical school training, at least have a bachelor's degree. In the Vienna Municipal General Hospital, physicians are often master's degree graduates and have undergone at least one year of clinical work and training.
In comparison, the status of surgery is much lower, and surgery is not included in orthodox medical services, but tends to be a public entertainment project.
Surgery was born out of barbers. The operation itself is rough and the fees are low. You need to rely on theater performances to earn appearance fees.
This setting seems outrageous to modern people, but it actually had certain advantages at the time. Because compared to directly sawing off a leg, using physical anesthesia to make people unconscious and then sawing off a leg is obviously more attractive to the audience.
If it is paired with well-designed commentary, it can also add a lot of immersion.
When a surgeon who does nothing special in sawing a leg sees that his colleagues who have carefully designed the procedure are making a lot of money, he will also try to put more effort into his own surgical procedures.
This has undoubtedly played a certain role in promoting the surgery itself. Even if sometimes the new procedures introduced are useless or even counterproductive, surgeons will still be happy to do them...
No matter what, the status of surgeons will not be comparable to that of internal medicine in a short time.
Surgeons like Ignatz are definitely a minority among the few and need to combine several conditions at the same time. Including a hereditary baronetcy, completing his undergraduate and master's studies at the University of Vienna Medical School, and possessing the best surgical technology in Austria.
This made him a big figure like a star. While bringing a lot of wealth to the hospital, he also gained himself the right to speak in influencing the hospital's decision-making.
Kawei has technical and theoretical knowledge of modern medical treatment, but these things are deeply tied to modern science and technology.
In the 19th century, there were no blood analysis instruments or X-ray CT machines. Surgical instruments were limited to crude tools such as knives, saws, scissors, pliers, and hammers made of metal.
Kawei can rely on the most modern medical equipment and one or two rookie assistants who only understand human anatomy to directly perform the most complex surgical operations in his department. But if the types of instruments are locked, the scope of surgery will become very narrow.
In addition, the ether anesthesia that had just begun to become popular was not low in risk, and the poor hemostasis technology basically relied on the assistant's finger pressure. There was not even a decent hemostat. Kawei even once doubted how those amputation surgeries could keep the patient alive. of.
Does it really rely on vascular contracture produced by physiological reflexes after blood vessels are severed to stop bleeding?
As for the problem of infection after surgery, it is even more troublesome. The editors of pharmacology will not include how to make medicines in the textbooks. Kawei can use antibiotics and knows when to use which antibiotics, but he cannot create antibiotics out of thin air. At most, he has some knowledge of the history of this area.
What was in front of him was a mess that was completely contrary to modern medical theory, and the conditions were worse than the simplest health clinic.
And these simple conditions cannot be improved with simple money, and Kawei has to do much more than he imagined when he first traveled here.
The difficulty of a clever woman making a meal without rice is vividly demonstrated at this moment.
"First of all, we need to familiarize ourselves with the surgical procedures..."
He picked up Ignatz's anatomy book and read it carefully for the first time with a learning attitude.
The first 2/3 of the album are pure anatomy atlases, including explanations of all named anatomical terms. Many anatomical terms have been used until modern times, but only the internal organs of the trunk have a lot of ambiguities. But in the current medical environment, the abdominal cavity is still a restricted area for surgery, and these differences can be made up for by time.
The last 1/3 of the album is a schematic diagram of some surgical procedures, which is divided into four parts: eyes and ears, limbs, maxillofacial surface, and genitals.
Judging from the process, the purpose of a small number of surgeries is actually very close to modern understanding, but it is difficult to make breakthroughs due to the precision of the instruments.
For example, cesarean section when the mother has dystocia, and incision and drainage of perianal abscess. Although the success rate of both is not high, and intraoperative bleeding and postoperative infection are common occurrences, there are no major problems with the indications and principles of the surgery.
Many operations are performed because the diagnosis is unclear, and when medical treatment cannot be performed, surgery can only be used as a "one-size-fits-all" treatment.
The most representative ones are direct amputation after open fracture and eye muscle amputation to treat strabismus.
Amputation is because if an open fracture is not strictly debrided, even if it is fixed and reduced, it will cause wound infection. Even if infection is avoided by chance, it is still very difficult to fix it in this era. Without fixation, it is difficult to establish a stable blood supply to the broken bone, eventually leading to necrosis of the distal end of the limb.
Necrosis will lead to secondary infection. In the end, not only the limbs will not be saved, but also the life will be lost.
But it is undeniable that the original amputation surgery had already preserved part of the muscle and skin flap for stump embedding, and the understanding was quite good.
The essence of eye muscle amputation is similar to the method used in modern treatment of strabismus, but the real reason behind strabismus is not understood, and the method is too crude. Anyway, there are quite a lot of eye muscles, and cutting off one or two of them can indeed alleviate strabismus to a certain extent.
The current method is to target the part of the eye muscles where the problem occurs, and do precise muscle shortening and retraction. (1)
Surgery that is truly contrary to modern surgery and is completely counterproductive is rare. The only thing that made Kawei exclaimed that he couldn't stand it was some negative pressure suction devices specially made for bloodletting...
What awaits him the next day will be the apprentice recruitment test at the city's general hospital, as well as some formal written assessments. Although Ignatz had already regarded him as his real student, and the admission work had been settled, and the test and assessment were just a formality, the habit he had developed over the years still allowed Kawei to roughly read the entire album.
He blew out the candles, closed the cover, and thought about it for a long time before going to bed.
