Kawei originally had no favorable impression of the 19th century. The inconvenience in life was secondary, mainly because the medical equipment was too crude and he couldn't use it well. The lack of disinfection and antibiotics is even more of a nightmare for the surgeon, which seriously affects his enthusiasm for work.
But for a person who has been able to work in clinical practice for so many years without too many complaints, he has already mastered the skill of taking pleasure in hardship to the full level.
It's been the sixth day since he came here, and he slowly discovered many benefits that are not available in modern times.
There is a huge gap in identity and culture between doctors and patients. Patients have great trust in doctors and almost obey them. At the same time, due to the lack of a medical system, doctors do not need to spend a lot of time talking to explain the disease, not to mention that many doctors cannot explain clearly.
There are the remaining feudal class factors that have lasted for thousands of years, and there are also the dividends brought by the rapid development of medical technology away from ignorance and toward modernity. It should be able to survive for several decades more.
Of course, if you put yourself in the patient’s shoes, there is no doubt about the necessity and importance of talking. It's just that since the hospital has no regulations in this regard, those doctors who are lazy or more self-centered like Kawei will automatically omit this process.
If the patient is an acquaintance, the process will only be simpler.
But sometimes in the eyes of the other party, he is not familiar enough to do a direct physical examination.
Most of Alphonse's face was filled with confusion, and the rest was filled with discomfort and a little bit of embarrassment: "What are you doing?"
"examine."
He sighed, relaxed his muscles and lay down on the examination bed. However, as the examination progressed, his expression became a little painful: "Can you please be gentle, it hurts..."
"Does it still hurt like this?" Kawei picked up a piece of linen and threw it in front of him. "I've already done it with my bare hands. Do you want to try wrapping it in this?"
"...Then, let's forget it."
Surgeons have always been informal, especially in the anorectal department, where the private parts are their working area. As a hard-working anorectal surgeon who loves his work, he will naturally not shy away from a place like this.
And Kawei may have gone one step further than his colleagues in the anorectal department.
Naturally, he doesn't like to operate without gloves, but compared to those gloves full of bacteria, washed fingers are cleaner, not to mention there are no gloves here. Cloth strips such as cotton and linen are not unusable, but unfortunately they will seriously block the touch on the fingers, which is very disadvantageous for finding tears in the anal canal.
However, these factors alone were not enough for him to sacrifice his fingers, and he was not taking care of Alphonse's feelings. It was entirely because the chef's ass had limited conditions and was not suitable for rough treatment.
"Your hemorrhoids are a bit serious. How long have you had them?"
Faced with an old illness, Alphonse seems to have chosen to lie down: "I don't know how many years have passed, but it's just a little uncomfortable and inconvenient, but it's not a big problem." [1]
"I usually bleed a lot."
"Come on, I'll just treat it with bloodletting. It's pretty good."
"But you are too serious."
Kawei is not an anorectal doctor, and his knowledge of hemorrhoids is not extensive. He is still stuck in the modern prolapse and blood clots, which really cannot be compared with the bulging and strange-shaped lump of flesh in front of him. In terms of grading, others were classified into Level IV only after reaching Level IV standards, but Alphonse was classified into Level IV because the highest level was only Level IV. 【2】
"It feels like it's all stuck on the outside. You don't feel pain when you duel?"
"It will definitely feel a little bit when you encounter it, but that's all you get used to."
"I think it's better to have an operation. If Teacher Ignaz comes, he will also choose surgery. There is really no need to delay it any longer."
Generally speaking, Alphonse still trusts his new friend.
Not only because he made the headlines of the evening newspaper today, but also because of his previous judgment on his liver and the calmness he has always shown. In comparison, the other three who took Li Ben to another ward were much worse.
"Okay, just surgery, it shouldn't be troublesome, right?"
"We'll talk about this tomorrow." Kawei washed his hands and found the anorectal examination equipment that was placed in the cupboard. "Don't get up in a hurry. It's not over yet."
Looking at the complicated toolbox in front of him, Alphonse frowned: "You might as well just give me an enema and then swallow a longevity pill [3], no matter how much dirt is in my butt, it will Clean it up quickly.”
"I'm checking the wound, not washing my butt!" Kawei emphasized the necessity of his work and suddenly asked, "Shengsheng Pill? What is it?"
"You haven't seen it? It's just a small black pill."
After he mentioned it, Kawei seemed to remember that he had seen a medicine box when he went to the drug store, and it said "Yongsheng Pill" on it.
But he has no intention of taking care of all kinds of medicines now. The other party's butt is more important at the moment. It's okay if it's just mixed hemorrhoids, and the treatment is not too difficult. But if the traumatic wound penetrates the anal canal, especially the area above the dentate line, it will be really troublesome.
With the current surgical conditions, sooner or later his anus will turn into a tap without a valve, just like a water pipe that goes straight in and out.
Fortunately, the fingers that just penetrated did not touch the cracks, but considering that some cracks are not obvious to the touch, for safety reasons, some props are still needed.
"I'm going to continue to use some equipment, you have to be patient."
Alphonse immediately became nervous when he heard it, thinking it would be something extraordinary. Unexpectedly, he raised his head and saw a slightly curved stick in Kawei's hand. The texture should be silver-plated brass. It is very hard, but the thickness is a bit off. "That's it?"
Kawei wetted a piece of clean cotton cloth with the enhanced brandy he just got from the drug store, and while wiping the stick, he felt funny: "What? Not enough?"
"Haha, this is too thin." Alphonse's face felt relieved, "By the way, what is that bottle in your hand?"
"The wine should be brandy."
"You actually want to use brandy for enema. This is too advanced. Why didn't I think of that before?"
Kawei knew that people in this era were still obsessed with this way of cleaning the intestines, so he didn't pay attention and just said casually: "This bottle of brandy is also very different."
"Why is it different?"
"It will be more exciting."
Alphonse burst out laughing: "I just like excitement, hurry up~"
Kawei was stunned, realizing that they were not on the same channel, and warned: "Not only is the wine stimulating, this stick is also stimulating."
"Forget about the stick, it's not my first time doing an enema." Alphonse didn't pay attention to this combination at all. "With this spare time, O might as well just pour a whole bottle of brandy into it. By the way, Do you have an enema pump here?" [4]
"You still have to use the stick, it's a rule! Although it is much thinner than my finger, thickness is always a relative concept, and it is not thin at all compared to where it is going."
Kawei finished the simple disinfection work, his hands were very fast, and he didn't give him much time to react. As soon as he finished speaking, he stretched out his finger and inserted it back into the original place, and then controlled the stick to slowly poke it in from the wound where the rapier was inserted. 5]: "Don't move around. If you move, the wound will open, and you won't be able to cook again."
Alphonse never expected that the so-called stimulation would be like this. The forcibly opened wound and the strong alcohol made it feel like being pierced by a spiked Langya rod.
He was holding the mattress with both hands and his whole body was shaking with pain. He wanted to speak, but all his strength was in his lower body and could not reach his throat and mouth at all: "You..."
"Don't move!" Kawei warned, and couldn't help but use more strength on his hands, "You don't want to end up cooking and have a lot of shit on your pants."
"I......"
"Don't be nervous, just check to see if the sword wound has penetrated the anal canal. If it has penetrated, there will be a break inside, which will be very troublesome if not treated." Kawei fiddled with his fingers for a while, and with the bloody wound, He shook his head and said, "It doesn't look like it was punctured. You're lucky."
In just one minute, Alphonse was already soaked with pain. It took him a while to calm down before weakly holding back a sentence: "If it weren't for you... you are a student of Ignatz , I will definitely fight you... fight you!"
"Are you still dueling?" Kawei cleaned the instruments and hands again, and then picked up Ignatz's box. "I'm afraid you will have to lie in bed for half a month after the operation."
"It takes that long?"
Kavi nodded.
"Then I can only choose to give up the surgery, and I must fight with Li Ben!"
Since he was the patient he brought into the hospital and he performed the examination, Kawei had already identified Alphonse as his patient. How could he let the fat sheep go so easily after he got it? Even if he tied it, he would have to tie it to the bed: "I think it's better to forget it."
"Can't count!"
Seeing his insistence, Kawei could only tell the truth: "Your butt is hurt so badly, and you have no paper or pen in your hand. Let alone write a letter to the newspaper and send it, you can't get out of the door even if you walk."
Alphonse didn't believe it at first, because there was no problem when he got into the carriage before. But as soon as he moved his buttocks, he suddenly realized something was wrong. Kawei's stab just now was really severe. It not only enlarged the wound, but also made him unable to move in pain.
"I said you can't move, so you can't move." Kawei slapped him on the back with a whole bottle of brandy in his hand, "Lie down and stay still!"
...
Early the next morning, Ignatz walked into the third ward quickly as usual, seeming to have completely shaken off the burden of failed tracheostomy. What greeted him was the nurse from the surgical ward and Kawei who had been busy for several hours and had not slept well.
Ignatz glanced at the ward and asked, "Why are you alone?"
"There was an operation this morning, and Berget and the others went directly to the theater." Kawei explained, "After all, they didn't go home all night."
"Not home?"
"It's a long story." Kawei thought it would be better to introduce the patient first and said directly, "Teacher, let's get to the point first. Two new patients came in last night. They are lying on bed 28 in the surgery ward and in the orthopedics department. 5 beds.”
"Oh? What's the problem?"
"The two were dueling, and the thin 5 bed was stabbed in the chest with a sword. It was a little red and swollen, and the sternum was probably cracked. The fat 28 bed was stabbed in the buttocks with a sword, which was quite deep. I happened to be there at the time and took them all away. Came over and checked immediately.
It's probably not a problem if you're thin, and you'll be fine if you cultivate yourself for a while. The fat one was more serious. I found that he had severe hemorrhoids, but fortunately the sword wound was not a big problem. "
Kawei quickly described Alphonse's condition: "I treated the wound and packed it with cotton. As for the hemorrhoids, I personally think that surgery needs to be performed as soon as possible."
Ignatz took the empty medical record from the nurse, picked up a pen and wrote down the admission information on the paper: "You said the sword wound hit the butt?"
"Yes, it was pierced from the lower edge of the gluteus maximus side."
"It won't cause an anal fistula."
"I checked with a probe and the wound was not that deep."
"Probe? After all, the probe is only for checking ordinary anal fistulas, and is not suitable for this kind of examination." Ignatz shook his head, "The reason is very simple, because the end of the probe is round and the rapier is pointed. Even if There is an opening in the anal canal, and the probe may not be able to reach the bottom.”
Kawei nodded repeatedly, not only took a piece of paper to write down this passage, but also said a bunch of compliments in conjunction. But in fact, he had already taken this factor into consideration, otherwise Alphonse wouldn't have been in so much pain last night.
In the final analysis, the mental damage done to Ignatz yesterday morning was too great. Today, Kawei must show off his flaws and restrain himself: "So that's the case. It's because I was careless."
"You don't deal with many traumas, you just lack experience."
Ignatz quickly wrote a few paragraphs, then threw away the medical records and ran to the examination room to take out his instrument box: "Is this the probe you used here yesterday?"
"right."
"In fact, for the examination of such small fistulas, we usually choose direct observation."
"Observation? How to observe inside the anal canal?"
This time it was Kavi's turn to frown.
If you want to directly observe the internal wound, unless the wound is very large, it will not be visible at all even if the anus is dilated. As for high-end products such as anorectal endoscopy, it was a fantasy in the 19th century, and it was impossible to have it...
"This is the anoscope invented by the Germans."
Ignatz closed his anorectal instrument box, took out a very strange thing [] from the ward cabinet, and introduced: "This is a new guy, I heard it is very useful. It just so happens that this patient also has If you have severe hemorrhoids, let’s just check them out together.”
"Can this thing see inside the anal canal?"
"Yes." Ignatz demonstrated with great interest.
"What about the light source?"
"There is a light source!" Ignatz turned back to look at the nurse, "Bring the kerosene lamp."
