The process of breaking stones was a bit bumpy, but overall it was smooth. The big and small stones were broken into pieces, and finally it came to an end with everyone cheering in unison.
The operation soon entered the second stage, circumcision. 【1】
Kawei was not familiar with circumcision, having only helped with some when he was young. If you put aside the circumcision device, traditional circumcision surgery still pays great attention to the knife technique. In the impression, the lines of the knife need to be prepared in advance. After all, it is considered half a plastic surgery.
In the 19th century, circumcision was not a very popular thing, and its acceptance in the West was also very low. After all, surgery was accompanied by the risk of bleeding and infection. No one wanted to risk the next person just for a little appearance. There is a risk of small tubes of pus being circumcised. Once the skin is not cut properly, it may be necessary to completely remove it.
Ignatz did refuse at first.
But Fernand seems to have some secrets and has been emphasizing his family and spiritual needs, which makes Ignaz decide to give it a try.
After flushing the bladder several times to remove the gravel, Kawei used a cotton cloth moistened with alcohol to help perform a thorough disinfection. It is self-evident that alcohol can irritate sensitive areas, but I don’t care about that much anymore.
Ignatz got a rare break. Looking at the stones discharged from the bucket, he felt very good:
"As we all know, circumcision is not a surgery worth advocating, although a series of demonstrations have shown that circumcision can effectively prevent uncontrolled masturbation and lack of concentration. But it is not a leg or a hand, it is every man's Only, I have to bear the very heavy work pressure in adulthood..."
Kawei used long tweezers to clamp Fernan's precious skin, and used the long tweezers with his other hand to repeatedly clean the inside and outside.
When the stone was broken just now, Kawei had already noticed a lot of problems in order to expose the urethral opening.
It was indeed time for Fernan to have it cut. The inner skin plate had been partially fused with the head, and it was difficult to lift it up when it was turned halfway. The head had also developed secondary inflammation, and the skin was red and swollen with a foul odor. After the alcohol was mixed with it and evaporated, a strange smell filled the center of the theater.
This situation is not uncommon in modern times and occurs in some middle-aged and elderly men.
If it is allowed to continue to develop, the skin and head will further adhere and fuse, causing more severe inflammation and further narrowing of the urethra. Although bladder stones are broken, they will definitely recur, and they will also be accompanied by kidney and ureteral stones, and then further urinary retention.
In the fused part of the skin and scalp, repeated inflammation will also breed growths, which are the prelude to cancer.
"...Out of consideration for Mr. Fernand's privacy, female spectators were not allowed to enter the venue today." Ignatz smiled and shook his head, "With all due respect, I still feel a little regretful, because everyone What we are about to see is the birth history of the most spectacular** in Austria.”
"Teacher, disinfection is complete."
"Leather pliers."
"..."
"You fix both sides and expose the field of view, and I will ligate the blood vessels." [2] Ignatz touched the epidermis with his fingers, felt the pulsating points of the blood vessels, then took the needle and thread, and suddenly asked, "Kavi, your father is not very good You should do this kind of surgery."
Kawei was stunned: "I have done a few cases."
"Oh?" Ignatz said with a smile, "When he was undergoing cleft lip repair surgery before, you said that he would try to avoid such surgery for fear that the wound would ulcerate and the patient would lose his name."
"Because the situation of those people at that time was more serious than Mr. Fernand, it was impossible not to do anything." Kawei defended.
"Serious..." Ignatz moved his hands quickly, seemingly unaffected by the previous failed surgeries. "How serious is it?"
Kawei shook his head helplessly, and could only imagine the worst outcome: "I didn't finish several of them, so I just cut them off."
"Has something bad happened?"
"Um."
"What a pity." Ignatz gradually introduced his topic in conversation, "I think that in order to avoid this happening, we should learn from Dr. Hutchinson's suggestion in the UK and promote circumcision nationwide. Especially for teenagers who have begun to develop. , circumcision before development can make them better prepared for the upcoming puberty."
This passage quickly aroused a lot of discussion.
In fact, Kawei knew very well that Ignatz's purpose was nothing more than to promote surgery through large-scale operations with scientific significance. Just like the obstetrics department has grown after the national level promulgated the application for childcare funds.
Maybe the degree of promotion is not that high, but at least it is promoted.
Unfortunately, the majority of Austrians believe in Catholicism, which prohibits circumcision of religious significance and only maintains a neutral attitude towards circumcision of non-religious significance.
Ignatz's profession represents a non-religious significance, and at least some scientific basis can be found. However, with such a large-scale circumcision, and extending down to the teenage population, it is difficult for the vast majority of Catholics on the field to doubt its purpose. .
The first person to raise the question was Varela, a daily reporter who specializes in covering surgical operations: "Dr. Ignaz, are you sure you want to promote this kind of 'circumcision' with obvious religious connotations in this land?"
"Mr. Varela, this is the 19th century, not 200 years ago."
Ignatz skillfully completed the ligation of several blood vessels, took the scalpel handed by Kawei, opened the epidermis and began to peel off further adhesions: "Look at Mr. Fernand's baby, the scalp is dead They were so stuck together that I had to cut them open with a knife..."
"This is different, doctor. Putting aside the feasibility of preventive circumcision, there are not that many surgeons like you in Austria."
Varela first complimented Ignatz, making it seem like he was discussing the matter from an objective and neutral perspective, and then launched a counterattack: "But that part of your remarks just now wanted to spread the rare circumcision. For young people, what is the difference between this and the 'circumcision' in barbarian lands?"
"Of course I have my own arguments, and the UK is already doing it." Ignatz has the exact information in hand, "The United States on the other side of the ocean is also preparing to follow suit."
"Is this a scientific basis?"
"Dr. Hutchinson once specifically studied the incidence of sexual intercourse among Jews, and it is indeed much lower than the overall incidence in Europe. And Dr. Lewis Seyer, who is now preparing to promote circumcision in the United States, is an American medical doctor. One of the founders of the association.”
Ignatz chose the method of incision in the middle of the dorsum and peeling off both sides [3]. It was like peeling off the skin of a grape with a scalpel. The knife technique was extremely rough, but it still separated most of the epidermis.
After the skin is completely separated...
"Scissors."
"Give."
Kawei held the little thing, and the Ignatz forceps clamped the skin, and made arc-shaped cuts on both sides along the bloody coronal sulcus, and finally chose to disconnect the ventral frenulum. The folded skin was stretched out in Ignatz's hand: "Kavi, record it, it's about 4cm long."
"......Forehead."
"Done!"
Next comes the daily interview work.
Perhaps out of respect for surgery, Varela did not refute during the final cutting stage. But after the operation, his rhetoric came back again: "Dr. Ignatz, if you insist on doing this, I will have to put you in the headlines again."
"Thanks."
"But the headlines this time are not complimentary. Once the newspaper is distributed to the citizens of Vienna, you will also be criticized by them..."
"Borrow it first."
Ignatz didn't care about this kind of thing at all. He squeezed through the crowd and came to the preparation area and started washing his hands: "Mr. Varela, it was you who scolded me more than ten days ago for not daring to innovate. I still remember the report, 'Only Dare to work like an old machine within the safe range drawn by others', is that what you say?"
Varela sighed: "That's true."
"Thank you for your previous reminder. I am now listening to your opinions and trying to change my work attitude."
Ignatz's mouth was full of smiles, and he seemed to have recovered from many previous failed surgeries: "I'm trying to change the way cleft lips are repaired, and I'm also trying to change the way blood vessels are sutured during amputation. Now the new lithotripsy machine The first attempt was particularly successful. Look at the gravel covered in blood in the bucket. This is the result of innovation."
"Lithotripsy was really successful, but..."
"There is no 'but', Mr. Varela." Ignatz is determined to seek change, "My next goal is circumcision, not only the body and age range for the operation, but also the suture technology and Improvements in Surgical Instruments.”
Varela completely lost his voice.
He knew very well that once the opponent tightly grasped the weapon called "science" in his hands, he would have no chance of winning. So Varela quickly changed the target and directed the topic to Nora's cesarean section: "Let's talk about the upcoming cesarean section."
Ignatz put lye soap on his hands: "You've asked me many times."
"But you didn't answer me directly to many questions."
"This is the lithotripsy theater."
"But there is really nothing to write home about in a lithotripsy except the special lithotripsy equipment used just now."
"What about circumcision?"
"It's so shocking that I can only regard it as your personal self-pleasure." Varela didn't care about his feelings at all and continued, "Even these hand-washing steps, I personally don't see any merit. It can only be regarded as some people grabbing the audience’s attention.”
Many people around Kawi were asking about the solvent ingredients of hand sanitizer. After hearing what Varela said, most of them laughed and left the theater, and only a few stayed there waiting for answers.
"Bleaching powder and high-concentration alcohol are used." Kawei briefly introduced, and further explained before Varela, "This is not a random choice. I tried hundreds of reagents before finally confirming Only bleaching powder and high-concentration alcohol can eliminate miasma and isolate it."
"Did an experiment?"
"I will write the experimental data in my own report. As for whether it can be published in a journal, more post-operative results are needed." Kawei looked at Varela and said, "I personally think this is also a kind of innovation. exploration.”
Varela nodded, and even though he was gagged, he did not forget to retaliate with a few more mocking words: "If the bleaching powder used by textile workers and the alcohol drunk by drunkards can be considered innovative, I don't seem to be able to refute it."
In fact, whether Varela can report on the disinfection process is meaningless to Carvey.
Sometimes public opinion can help fuel the situation, but what he wants now is to completely reverse everyone's concept of disinfection. Relying on public opinion alone is very unreliable. Semmelweis's failure was his eagerness to convince everyone with the obstetric mortality gap of less than 10%, which aroused public outrage, and Kawei did not want to make the same mistake again.
What he wants is the accumulation of surgical data and a medical status that is enough to convince everyone of his status.
Nora's caesarean section was the first step.
"Mr. Varela, the success of innovation cannot be judged by just a few words. It takes time to prove."
Kawei began to clean the surgical tools and said: "If five patients can't explain the problem, then ten, twenty, hundreds. I am only 17 years old, and I believe that by the time I am 37, I will now be called an innovation Something that has probably become a habit for all surgeons.”
...
Including Kawei's preoperative preparations, the operation only took less than an hour, and Ignatz used his "quick knife" to the extreme.
Considering that Fernan's urethra was repeatedly in and out during the operation, Kawi also wanted to discuss the treatment of urethral stricture with Ignatz. But as soon as he walked out of the theater, he hurriedly got into a carriage and left alone.
"He didn't say where he was going?"
"Didn't say."
Alina stood at the door of the ward, staring blankly at Kawei who had just returned and didn't know what to say: "He didn't say anything and you didn't ask?"
"I asked, and he said he was going to meet an old friend. He didn't tell me the specific address, so he asked me to come back first."
"You just came back like this?"
"Yes, Mr. Fernand has just completed the operation. He needs to explain the nursing matters clearly to the nurses. After that, I will be responsible for changing the bandages and gauze..."
"You know what I mean."
Kawei sighed in his heart that women are really troublesome, and continued to reply: "Teacher Elena, I am just an assistant at work, not his son. Teacher Ignatz can't take me with him everywhere."
"I got the lab for you!"
"Yes, yes, I will stay in the laboratory and wait for him to return to the anatomy room. Even if the teacher leaves in the middle of the night, I will follow him quietly. But the method you mentioned is too infeasible and is too easy to be discovered." Kawei saw She was really anxious, but she still didn't forget to explain, "Besides, isn't the teacher going home these days? Maybe he will be back soon."
Alina nodded first, but then quickly shook her head and said: "No..."
"What's wrong?"
"The cesarean section is coming soon, and he needs to find his condition. The failure rate of previous operations is so high, he will not remain indifferent." Alina seemed to remember something and ran out of the ward quickly, "I have to find him."
"Don't worry."
Kawei stopped in front of her: "This is not the solution. We still have to solve the problem from the source."
"What's the meaning?"
"When the teacher comes back, the carriage he is riding in will usually stay at the door of the hospital for a long time. There happens to be another carriage at the door, and the coachman sitting on it will definitely ask him for the high reward of 5 crowns. Where did it come from?”
