At six o'clock in the evening, the quiet Hoints Street gradually became lively.
The bar lit candles for the guests, and the low buildings in the shadows also emitted ambiguous lights.
Unlike the young people who came after dinner, there was an elderly man who seemed to have just finished his work and was about to leave quietly.
He gently pushed open the small door of a building and peeked out furtively. Seeing no one around, he quickly stepped out. After closing the door, the old man walked down the street, put on his black hat, straightened his tie, propped up his cane in one hand, and carried the black box in the other, and walked towards the distant street.
After walking along Hoints Street for more than ten minutes, I finally got on a carriage.
"Go to the Lakeside Theater, hurry up, I'm in a hurry."
The coachman nodded, thought about the route in his mind, shook off his whip, and drove the carriage towards the destination.
With the old man's identity and status, he shouldn't have come to this kind of place. If he really needs it, he can go to a higher-end one, or he can spend more money and ask for door-to-door service. But he still came, partly out of admiration and partly out of curiosity.
The old man turned back and glanced at the low building he had just left through the glass window, still enjoying himself.
But recreation must be recreation, and work must be work. Over the years, he has long made rules for himself, and recreation must always serve work.
"Work work..."
The old man shouted twice, as if giving himself a hint, and shifted the picture in his mind to his next work: "First the left maxillectomy, then the ptosis, one needs new materials , and the other is a new technique, so you have to be careful."
He found a pair of pliers and a scalpel from the black suitcase and began to quickly simulate the surgery he was about to perform on the stage.
"Cut the skin, separate the fascia, peel off the muscles upward, ligate the blood vessels, find the bones and joints, cut and separate, continue to the left..."
The old man recalled how the patient looked when he first arrived. His mouth was full of stench, his left upper jaw was full of rotten teeth, and a lot of pus could be extracted. It was also a maxillary bone infection caused by tooth problems. The report on the previous total mandibular resection was still fresh in my mind, and so was Carvey’s suggestion, but the result might have been very different.
The old man looked at the various instruments prepared in the box and was secretly happy. Even if they were all cut off this time, the patient could still eat.
As for the next ptosis repair, he also had his own new ideas because of Kawei’s suggestion.
The old man was full of expectations for the operation and couldn't help but ask: "Car driver, how long will it take to arrive?"
"It's quick. Just go straight ahead and make two turns."
"well."
...
At this time, the ureter + bladder repair that Kawe received had just been completed, and overall it was a success. After suturing the two organs in sequence, repeated dye leak checks were performed and no problem was found.
After cleaning the abdominal cavity, Kawei handed over the work of closing the abdomen and subsequently inserting abdominal drainage to Hills and Lockard, and he began to receive inquiries from his colleagues around him.
The operation was not what he had expected, the temporary stage was a bit rushed, and if possible, Kawei didn't really want to use copper pipes. Because there is no support from the upper and lower poles, whether this bare metal tube can really work as it wishes depends on the subsequent recovery.
What's more troublesome is that its texture is too hard. Even if both ends are polished, it is difficult to say that it will not cause secondary damage.
In modern times, urologists often use softer plastic products, such as double-J tubes, when repairing the ureters. Not only can it provide sufficient support to the upper kidney and lower bladder, 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 Kawei can only use metal pipes. 【2】
In addition to the uncertainty of ureteral repair, the most troublesome thing for Kawei was the peasant woman's pelvic condition.
Abdominal adhesions often point to tissue damage, and the causes of damage 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 warranted Carvey's attention was an infection.
Because of their different anatomy, the female pelvic floor is easily affected by infection.
In rural areas in the 19th century, women were less likely to seek medical attention as long as the infection was not life-threatening. Even if you do go to a doctor, the advice is often to take some useless herbal medicine or poison, which will turn out to be even more fatal.
"You may have heard that I have recently been studying puerperal microorganisms. This adhesion in the pelvic cavity should be caused by bacterial infection." Kawei began to express his opinion, "In addition, after a long period of exposed surgical operations , I’m pessimistic about her recovery from the incisions after surgery.”
"But we have done enough disinfection work, isn't it still enough?"
"Not enough, far from enough." Kawei said, "Microorganisms cannot be perfectly killed by some external disinfection of the skin, but other methods are needed. This method must not only inhibit their reproduction, but also ensure that It does not affect the patient’s health.”
"What method? Is there really such a magical method?"
Kawei's pharmaceutical ability is basically 0, and he can only give a rough idea: "For example, drugs..."
"Mercury? Tincture of ya tablets? Or other herbs?"
Kawei shook his head: "I have tried many methods, at least all the drugs currently available in the Municipal General Hospital have no such effect."
Microbiological experiments have been carried out in medical school laboratories. Before the conclusion was published, many people still expressed doubts: "Is it true that all surgical incision ulcers are caused by infection, as you said?"
"At least the existing experiments support my view."
"Professor Bill Rotter has always believed that bacteria do not have much impact on the human body. For your experiment, he also feels that the factors that cause microorganisms to deform and degenerate need to be solved first."
Kawei's microbial experiments were not difficult to conduct, but they encountered some resistance, such as Professor Bill Rotter who appeared in other people's mouths. I 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 unique perspective.
On the one hand, he named the ulceration of the incision after surgery as "traumatic fever" and strongly agreed with the "Application of Thermometer" that Kawei had already submitted. At the same time, we hope to popularize this medical device as soon as possible, and advocate the use of thermometers in the diagnosis and treatment process of all patients.
But on the other hand, he firmly believed that traumatic fever was caused by certain chemical poisons. Although he paid attention to Nightingale's pre- and post-operative care and insisted on regular measurement of patients' questions, he firmly denied the ideas advocated by Lister and Carvey. All disinfectants.
What's even more strange is that after looking at Kawei's microscope, he actually questioned the diversity of microorganisms...
"Professor Bill Rotter's point of view is indeed novel, but I still say that whoever claims it is the one who provides evidence. I have proved my point, and now it is his turn." Carvey said, "But based on the existing experimental conclusions Look, cocci will always be cocci, bacilli will always be bacilli, and puerperal killer streptococci will always be streptococci.”
Regarding this point of view, the scene was divided into two groups, but as for the "first sentence" at the beginning, everyone held an opposing view.
"Personally, I still think Mr. Carvey's views are more novel."
"Although I agree that microorganisms have diversity, I really can't even think about such complex microorganisms and such complex pathogenicity."
"Just because I dare not think about it, I still agree with Professor Bill Rotter's idea. Bacteria will indeed change under certain conditions."
"This should be the hottest topic in Vienna medical journals recently, and it has also attracted the attention of many foreign medical circles..."
Kawei successfully concealed the experience of ureter + bladder repair by diverting attention. I thought that this matter would be over, and when the time came, everyone would go to the auditorium to continue watching Waterman's surgery.
Unexpectedly, Waterman arrived at the operating theater early in the morning and saw that there was no one in the lounge, so he came to the operating area to take a look.
It doesn't matter if you don't look at it, but you will be shocked when you look at it. The quarrel on the side has not completely ended, but Kawei is already standing in the center of everyone. The sense of immediacy was so strong that he couldn't help but think of the previous cesarean sections: "What's wrong? Shouldn't the previous one be Orgi's cesarean section?"
"Dean Waterman, you are here."
"Dean, good evening."
Everyone looked at Waterman, nodded respectfully, and then told the story of the operation just now.
"Broken your bladder? Broken your ureter?" Waterman looked at Orji, "I'll let you rest for a few more months. You'll make mistakes if you rush to the stage."
"The pelvic adhesion is too severe." Hills explained after wiping the peasant woman's belly with carbolic acid. "When the uterus was removed, the surrounding anatomical structures were very confusing and could not be distinguished at all."
Waterman didn't care about the cause of the complications, and quickly ignored these explanations, looked at Kawei and said: "First a hysterectomy, then a suture reconstruction of the ureter, and then a bladder repair... Dr. Kawei , where did you learn this set of things?"
Kawei smiled: "It's my father..."
"Is it your father again?"
"No, no, it's not my father this time, it's my father's friend." Kawei explained, "a German doctor named Gustav. He is very good at pelvic surgery, including kidney, cesarean section, ureter and bladder. I My father and he have always been friends, and I often watch them operate together.”[3]
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If this excuse was used only occasionally, the doctors present would still believe it.
But Kawei has used it too many times, and fewer and fewer people believe in him. Now a brand new character has been introduced, just to divert the firepower, but unfortunately the real effect is very small.
They are more willing to believe that these are the result of Kawei's surgical talent than the teaching methods of his father or a surgical friend.
Without excellent surgical talent, no matter how powerful a child is, it is impossible for him to learn so many complex surgeries in a short period of time.
"The center of surgery in the world has always been in 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 continued, and Kawei simply chose to lie down: "It is indeed a pity that such land was taken back by the Italians. If I were an imperial general, I would definitely lead my troops to retake this land!"
Another good shift of attention, the venue began to discuss the recent preparations for the Pu-Austrian war, and Kawei was quickly picked out.
However, Waterman had no interest in war and scorned Ignatz's invitation to work in the Military Administration. Of course, he is the president of the College of Surgery and has the ability to be proud of his talents. Ignatz still owes him some favors, and Kawei owes even more.
"Why are you talking about preparations for war? Look at them one by one, as if they were injected with chicken blood." Waterman also pulled away, took Kawei's hand and said, "Let's talk about surgery. "
“Still chatting???”
"It's not the one just now, it's mine." Waterman was very excited. "But the temporary repair work on this one is really beautiful, and it's enough to be included in the regular meeting report. Unexpectedly, less than two months have passed, and it was so shocking before. People who have undergone cesarean section have reached the point where they can no longer attend regular surgery meetings, so I really need to thank you very much."
Regular surgical meetings are held once a quarter. By the time the next regular meeting begins, even if cesarean sections are not popularized in all hospitals, the volume of surgeries in the past three months will be enough to smooth out the difficulty of surgery.
"It's good that this meeting can be included in the regular meeting. At least it can make many colleagues take a look at the complications of cesarean section." Kawei explained, "Let's talk about the dean's own surgery. Could it be that there are any new discoveries? ?”
"It's more than just a new discovery."
Waterman explained: "Before, I only arranged a ptosis repair here, and the maxillary resection was performed in-house at the School of Surgery. But then I met a noble person who completely changed my approach to maxillomandibular resection. concept.”
Kawei thought of his previous suggestion: "Have you found bone and joint replacement materials?"
“Not just the bones and joints, but also the gums!”
"It would be really remarkable if we could actually achieve this."
"It's not me, but the dentist from England. The materials he brought helped me a lot." Waterman took out a letter from his pocket with a smile, "Originally, this letter was prepared for surgery. I gave it to you at the hospital after it was over, and now that you are here, I give it to you in person."
"letter?"
"Well, it's a reply that Dr. List asked the dentist to bring you. Take a look."
...
Waterman's surgery began quickly.
Anyone who likes surgery knows Waterman. The position of dean of the School of Surgery is not something that other surgeons can easily reach. The director's surgery also omitted the host's introduction. Waterman directly entered the operating theater with his assistant.
"The patient is a young sailor. His upper teeth are rotten, and his maxillary bone is also rotten. What I have to do today is to cut off his maxillary bone. How much depends on the extent of the infection."
Waterman 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.”
