When it comes to environmental management within the barracks, Carvey has pared back to a minimum.
According to the health standards of the real army, there are many things to consider. In addition to the water source issues mentioned before, the most important thing is to prevent infectious diseases. After doing the necessary disinfection work, we must also prevent various mosquitoes and poisonous insects, deal with bites, and finally eliminate rats.
In addition, there are many details to consider.
Military doctors are not just about dealing with injuries and diseases. They also need to do a good job in providing health protection under various circumstances.
Marching on foot, night marching, excessive fatigue, long-term noise, the impact of gunpowder exhaust gas, artillerymen's waist and leg pain, explosion sound damage, tunnel smoke and dust, moisture prevention and dehumidification, and fecal sewage treatment all need to be considered. There are also nutritional issues with food, as well as a host of wild poisonings and an endless stream of internal diseases.
Rat eradication is a top priority that Kawi has emphasized many times.
Although they didn't understand and even regarded rats as an interesting part of the boring life in the barracks, they still obeyed Kawei's request.
Rats in the real world are not Jerry from Tom and Jerry. They will appear wherever there is food, bite like crazy and then give birth to a bunch of babies.
The war itself required the storage of a large amount of food, so rodent-proof ditches and ridges were dug and rodent-proof walls were built where food was stored. Thick layers of sharp gravel were laid on and around the bottom floor of the warehouse. 【1】
"I have done experiments before. As long as the wall is buried 30 centimeters deep and the surface is smooth enough, it can effectively protect the food and equipment warehouse." Kawei drew a sketch and said, "If the bottom layer is paved with sharp stones, and the outer ring is buried with Once the ditch of the water tank is installed, everything will be safe."
Ignatz and Hermann knew the importance of protecting food because he had encountered food shortages during the Franco-Austrian War.
Even dry meat and vegetables can be barely supplied, but there is a shortage of bread, an extreme shortage of bread, and a considerable part of it is caused by rats.
But in addition to warehouses, Kawei requires that all hospitals, barracks, and first aid centers should be of this level, and a mouse trap must be placed every 15 square meters. This is a huge project and requires a large budget.
They didn't understand why they were doing this until Kawei said "The Black Death."
In fact, there are many other infectious diseases related to rats, such as epidemic hemorrhagic fever, scrub typhus, typhus, forest encephalitis, leptospirosis, etc. But for Europeans, the Black Death was far more terrifying than those infectious diseases. No disease could compare with it.
“Is the Black Death related to rats?”
This overturned Ignatz and Hermann's understanding of the plague. After all, it would take another 30 years or so for Yersinia pestis to be discovered in history. Even though Kawei had already published a theory on microbiology, the response was not good, and it would still take some time to understand bacteria.
"Let's talk about the disease rate among Imperial Army soldiers during the Franco-Austrian War." Kawei said while drinking coffee, "The teacher must have done statistics, right?"
"Probably around 25%." Ignatz replied. "At that time, the number of patients in several central hospitals on the front line exceeded 4,000. A major battle would not only increase the number of injured and injured, but also increase the number of patients to a certain extent. .”
"It's normal," Kawi said, "because a corpse is a corpse to us, but to a mouse, it's the most delicious delicacy."
Ignatz recalled some bad memories [2]: "I think the number of people in the rodent control team of the General Hospital is enough to prevent rats."
"I hope so."
Kawei got a headache when he thought about the four months of preparation time. It took a lot of time just to take over the management of the logistics of the Military Medical Department, and what he took over was a complete mess.
The various changes he made at the Municipal General Hospital seem to have surprised many people, but if the scope is relaxed, the impact of such changes is very small. In Vienna, the only people who can truly trust themselves and be willing to act according to their own ideas are concentrated in the Municipal General Hospital.
Edinson's theoretical knowledge is still old, and his understanding of hospitals is still stuck in the Napoleonic War period, and he did not even refer to the idea of the Crimean War.
The most important thing is that he perfectly inherited the steel-like character of the German people. This kind of personality can bring extraordinary long-term work efficiency, but you will encounter various difficulties when accepting new things.
He held high the banner of miasma and did not approve of any changes to the hospital.
After more than half a month of quarreling, Franz simply separated the two. All hospitals on the Northern Front were reformed in accordance with Carvey's ideas, while Edinson was based in Vienna, and all hospitals on the Southern Front and possible subsequent Western Fronts adhered to the original system.
"When I get to the general hospital, I'm going to do a thorough inspection," Kawei said. "I can't control other frontline ambulance stations, but at least there can't be rats in this general hospital."
"knew."
"Next is the prevention and treatment of those plagues." Kawei once again explained the diseases he classified as plagues, "dysentery, typhoid fever, cholera, encephalitis, hemorrhagic fever, typhus, I will talk about these first. Before These are the basic operations, and what I need to explain next are the more detailed parts.”
Herman must have listened to Kawei, but Ignatz was different. He was much more assertive: "You said these are all caused by microorganisms?"
"After all, I wrote the paper, and I naturally agree with the point of view of the paper." Kawei defended, "According to the diversity of microorganisms described in the theory of microorganisms, each microorganism has its own unique way of life, and will also follow the way of life." Produce a unique disease disease."
“So there’s a microbe for every disease?”
"At least this is true for contagious plagues, such as cocci in surgical incisions and streptococci in puerperal fever. These were confirmed by experiments by Koch and I." Kawei said, "We should be lucky that Koch did not This war is back home.”
Now everyone, including the Berlin Institute of Chemistry, only regards Koch as an ordinary medical student. Only Kawei knows the value of Koch.
Ignatz couldn't help but glance up at the empty carriages around him, hoping to find some traces of microorganisms in the transparent air, but this was definitely impossible: "Just stopping those microorganisms can reduce the occurrence of diseases. ?”
"Theoretically, that's true"
"Then preventing and treating the disease is too simple."
"In fact, that's not the case." Kawei sighed and glanced at the wall clock, "After talking about this, I have to talk about some special cases of combat injury infection. Time is limited, so hurry up."
The level of battlefield medical care in the 19th century was completely incomparable with the military medicine that experienced the baptism of World War I and World War II. Historically, Austria’s military medical system was simply unacceptable, but it also represented the average level in Europe.
It is still far behind the more advanced Britain and France, but it is already ahead of most countries.
Most doctors only learned something superficial during training, but even so, Kavina's four months were not in vain. His medicine and surgical skills are deeply affecting this team. For those surgeons who can perform their duties independently, these four months have brought about progress that they may not be able to achieve in several years.
Bill Rotter is the perfect example.
At the age of 35, he has become the vice president of the College of Surgery, relying on his excellent surgical knowledge and rich clinical work experience. Of course, the most important thing is his innovative ability to constantly challenge himself and his courage to try new surgeries.
Billroth was not without flaws. In Kavey's eyes, he was the originator of abdominal surgery and pioneered a series of general surgeries. However, because of his different views on microorganisms, he "opposed" Kavey on many issues. .
For example, on the military hospital model, he firmly opposed the new model proposed by Carvey, and he also opposed the old model insisted on by Edinson.
Bill Rotter proposed to break up medical resources into parts and only build independent hospitals belonging to each infantry regiment or even infantry battalion, rather than a large hospital like the Army General Hospital. The reason is actually very simple. The mortality rate of general hospitals is much higher than that of independent small hospitals.
He summarized this concept in "An Overview of the Medical History of the Austrian Army in the Franco-Austrian War" and set out the basic medical supplies needed for a mature independent hospital. 【3】
[Everywhere you can see hospitals that provide comfortable places for patients to recuperate. There is no need to worry about the route being interrupted during transfer, nor the wounded soldiers' bad mood after seeing the crowded central hospital. ]
This is the view held by Bill Rotter, and the best evidence is the death figures and mortality rates calculated by Ignatz in "Memoirs".
But in fact, to realize his vision requires not only huge medical supplies, but also a more important key factor, doctors. After all, there are still a small number of people who are willing to give up a superior working and living environment. The number of doctors evenly distributed to the infantry regiments is very limited, and their medical ability cannot be guaranteed.
All three were surgeons and had had a big quarrel at the College of Surgery two months earlier.
In the end, Billroth was unable to compete with Carvey and Edinson, and even his letter to Franz did not receive a response [4], but he still agreed to Carvey's invitation and became the leader of the second shift of the trauma emergency team.
Because he knew that he could learn a lot by staying with Kawi.
"Too much blood loss, open intravenous access first." Bill Rotter is one of the few doctors who can thoroughly understand Kawei's first aid principles. This is also the reason why he can stand on the second shift as the surgeon. "Give me a bandage. You put pressure on the two bleeding points in your lower limbs, tighten them!!!"
"Nurse, are the anticoagulants ready?"
"Ready."
"Okay, one will collect the blood, and the other will match the blood!"
"Where's the anesthesia assistant?"
"coming!"
"Just give me anesthesia, give me a basin of salt!"
"coming!"
"Is there anything warm?"
"The water is already boiling."
"No matter what, get ready to rinse your abdominal cavity."
The soldier who was delivered to him had several wounds, two on the abdomen, one on the shoulder, one on the left and right arms, and two on the left leg. Judging from the severity of the injuries, he suffered a shotgun blast from the front.
However, because of the long distance, the penetrating power of the projectiles in the shotgun shells is not strong. Billroth immediately judged that the wound on his arm was not serious, and the wound on his shoulder had basically stopped. The most serious ones were the two places on the left leg and the two places in the abdominal cavity that had penetrated into who knows where.
Almost at the same time, Billroth and Bottini made the same decision:
"I take care of the belly."/"I take care of the thighs."
"You handle the thighs."/"You handle the belly."
One spoke stilted French with a strong German accent, and the other also spoke French, but it smelled like pizza.
Fortunately, the language difference did not affect the tacit understanding between the two. Billroth cut off the wounded soldier's clothes, while Bottini checked the bleeding of the lower limbs while stopping the bleeding.
Immediately afterwards, the two men exchanged scissors and gauze. Billroth picked up the scalpel and cut open the wounded soldier's abdominal skin regardless of the fact that the anesthesia was not fully effective. Bottini used the scissors to cut open his socks. and pants.
The first operation of the second shift was a complex abdominal dissection of the left lower limb.
Four months ago, the two of them had not learned Kawei's first aid strategies and techniques, and would have had no desire to use a scalpel when facing such a wound. Even if the projectiles are really taken out, the soldier will die from excessive blood loss. This is almost 100%, otherwise the shotgun would not be called a big killer of infantry.
But now they are very confident to complete the operation and give the nervous general hospital a shot in the arm.
For Bottini, what the lower limbs have to do is to minimize bleeding, and preserving blood vessels is more important than anything else. As long as the blood vessels and the distant blood supply of the thigh are preserved, the function of the thigh can be preserved, and there will be no need for amputation.
For Billroth, the situation in the abdominal cavity is much more complicated.
Just like Orgi's abdominal injury, the shooting angle of the shotgun projectiles was inherently messy, and they would become unstable and flip over after entering the human body. If you can find all the bleeding points, it's half a success. If you can still find all the ruptures of the organs, it's basically a success.
If you can't find one, it just depends on the luck of the wounded soldier.
"Two more people, hold him down!" Billroth was like a cold machine, ignoring the violent reaction of the soldier who had not really fallen asleep, and quickly opened his peritoneum, "Give me the hemostatic forceps, gauze, Saline rinse!”
"coming!"
At this time, the surgical operating room of the General Hospital was already in full operation, and the benefits of early assembly were also apparent. Facing the wounded caused by this battle, the surgical team and medical supplies that had been prepared for a long time in the hospital seemed to be able to handle them with ease.
But war is always full of uncertainties, and Hills dared not take a gamble.
"I don't know what Lockard is doing in front. I agreed that the military department would launch an ambulance station at any time to deal with some wounded soldiers who can be treated on the spot to reduce the pressure on the general hospital."
Hills was in a bad mood. After complaining, he could only continue to focus on the wounded soldiers. He has now become the real material distribution officer. As the person in charge replacing Ignatz and Kawei, he must ensure that there are sufficient medical resources to face unknown situations: "Are the three groups ready?"
"We are already preparing. Do you want them to come?"
"It's still stable for the time being." Hills added, "One more person will go to the Medical Committee office and try to find as many people as possible."
"good."
"Then the warehouse in the third ward of the Department of Internal Medicine will be emptied and basic disinfection done. The operating room is almost full and another room must be freed up."
"good."
"There is also a supply box, including hemostats, anticoagulants, and bandages. By the way, there is also water. Surgery requires a lot of water, so the water must be good! Infusion bottles and water basins are all needed for surgery! "
"Preparations are already underway. Dean Kawei has been emphasizing this before. Don't worry."
After thinking of this, Hills finally breathed a sigh of relief and took off his coat: "Where is my surgical instrument box? Bring my box over."
