Daming kill

Chapter 221 Epoch-making

In 1735, Claudius Amirand accidentally performed the first recorded appendectomy on an 11-year-old boy in London while repairing an inguinal hernia.

The relatively recognized first case of active appendectomy in medical history occurred in October 1887 in the United States.

After that, appendectomy surgery developed rapidly, especially in the United States.

In 1898, American physician Charles McBurney reported 71 consecutive appendectomies without death in one go.

But at the same time, the overall mortality rate of appendicitis surgery reported in the West is 40%, while that of non-operation is 26%.

As to why the West is still so obsessed with surgery when the mortality rate is higher, it is mainly because the disease occurs too much and there are too many deaths. People are more inclined to actively intervene rather than passively wait for death.

According to statistics, the total death toll (including surgical and non-operative) of appendicitis patients in the United States reached 1936 in 2, when the operation was mature.

More importantly, the high mortality rate of appendicitis surgery is mainly in the early stage of surgery. With the advancement of technology, the mortality rate of appendicitis surgery has been decreasing.

Especially with the deepening understanding of the pathophysiology of peritonitis, the application of rehydration therapy and the joint effect of surgery on the treatment of contaminated abdominal cavity, the total mortality rate of appendicitis was as low as 20% by the 30s.

By 1940, however, the death rate had begun to rise again to a staggering 10%.

Then in the 1940s with the invention of penicillin and sulfa drugs and their use in the treatment of perforated appendicitis, the mortality rate began to drop dramatically to 1.2%.

In other words, Li Ping advanced active appendectomy by more than 200 years without antibiotics. The risk is still quite high, and it is not much better than guessing the simple pros and cons.

Both he and Xu Keran needed good luck.

Convincing patients, however, is easier than you might think.

Although Li Ping truthfully explained to Xu Keran the general details of the operation and the high possibility of failure, Xu Keran held Li Ping's hand without any hesitation and said, "General, I am willing to give it a try. I can write evidence to show the world that Everything is voluntary and strongly requested by me, and all consequences are borne by me personally."

This choice is not surprising.

In the face of life and death, Xu Keran, a businessman who has traveled extensively, is obviously more open-minded and more willing to choose to fight.

And since the patient himself does not object, everything is easier.

Soon, Xu Keran's residence was secretly sealed off, and the operation will be carried out directly at his residence.

During Xu Keran's illness, the five merchant ships did not stay in Fuchi to wait, but continued to Qizhou, the planned next stop after unloading the goods Li Ping needed. Only the ship's doctor and a few Xu Keran were left in Fuchi. care of servants.

This provides a great convenience to the blockade, and it also ensures that if the operation is not successful, it will always remain a secret.

This is exactly what Li Ping said was considered, he planned to block everything first.

Gao Lei soon arrived.

Gao Lei did not raise any objections to what Li Ping had already decided. She just started her preparations as a doctor. Although she was not the chief surgeon, she still insisted on participating in the whole process due to lack of rest.

Song Baolai and Zhao Lanyue also rushed over quickly, but they could only wait quietly in another room next to Li Ping.

Seeing that Li Ping kept his head down and only smoked without speaking, Zhao Lanyue broke the silence and said, "Don't blame Sister Gao, she used to be a doctor, and if she didn't have the qualifications, she couldn't do the surgery. The professional ethics that a regular doctor should possess.”

Li Ping raised his head in surprise and was stunned for a moment before saying, "I don't blame her, she's fine."

"It's just a little conservative." Song Baolai suddenly inserted a sentence at this moment.

Zhao Lanyue's eyes widened in an instant, she turned her head and stared at Song Bao angrily, and said, "No one will treat you as dumb if you don't speak."

But this time, Song Baolai was somewhat surprised and unwilling to show weakness and muttered in a low voice: "I'm just telling the truth."

"You..." Zhao Lanyue felt a little angry for a moment.

Seeing that the situation was not right, Li Ping hurriedly said: "She is right to be conservative. The chances of surviving with early surgery are similar to those without surgery. It is most appropriate for us to intervene at the last moment, otherwise we may do bad things with good intentions. And the current surgery The biggest hero is her, I heard that she only slept for a few hours these days, it is really hard and not easy."

"You know! Let me tell you, Sister Gao has really worked hard. The starting point for many of her considerations is you. You must appreciate it." Zhao Lanyue's face became cloudy.

"I know, I know." Li Ping replied mechanically.But after taking a puff of cigarette, he stopped talking, as if his mind was not here.

The scene was a little quiet again.

Just when Zhao Lanyue opened her mouth in depression and was about to say something else, Song Baolai suddenly took a deep breath of cigarettes, then frowned and asked Li Ping, "Do you think Zhang Xianzhong is going to attack Wuchang or us? If he comes to attack us, can we stop it?" live?"

Regarding military issues, Song Baolai hadn't taken the initiative to ask questions for a long time, but the current tense situation and the right opportunity finally made him unable to bear it anymore.

Li Ping was about to answer, Zhao Lanyue was dissatisfied and said first while fanning the cigarette with her hand: "So what if you can't stop it? Fight if you can beat it, run if you can't beat it! What are you worrying about. Besides, the peasant army There are no ships, we have ships, and Li Ping has gathered many non-combat ships to the docks of Fuchi Town and Wujiaba, are you afraid that you won’t be able to escape?”

But this time, Song Baolai didn't confront Zhao Lanyue.

Instead, he took another deep breath of the cigarette and said dully: "I'm not worried about safety, I can trust Brother Li. I'm just, hey! If we have to leave, all the things we built will be for nothing! This is terrible. It's all our heart and soul!"

"A man can afford it and let it go, so what if the situation is not going well? If you keep the green hills, you won't be afraid of running out of firewood!

Besides, how can it be done in vain?

Our construction itself is the greatest wealth.If there is no construction experience in Xiangyang, it is impossible to have the situation we are in Fuchi today.And we have all left Xiangyang, why are you reluctant to part with this little Fuchi?Do you still plan to stay in this small place for the rest of your life? " Zhao Lanyue said sarcastically.

Li Ping was taken aback.

Unexpectedly, Zhao Lanyue knew his military deployment like the back of his hand, and at the same time, he praised Zhao Lanyue for his understanding and ease, and his heart suddenly became clear.

So he smiled and said, "Miss Zhao is right. Even if the line of defense between Daye and Yuanhu can't be defended, we still have Fushui to block it temporarily. The staff office has a plan in this regard. It can guarantee that we can basically evacuate people safely. And as long as people are there, the newly built things will only get better and better, and we have nothing to lose."

"You even made a plan to escape? Are you really going to be unstoppable?" Song Baolai was stunned.

This guy's focus is very speechless.

Zhao Lanyue also rubbed her forehead with a dizzy face, and didn't add any more bad words.

Li Ping could only relieve himself and said: "It's just a plan, it doesn't mean anything. Wars are like this. We must be prepared to win as well as lose, so that we can advance and retreat with evidence and not panic.

You don't have to worry too much.It is not so easy for Zhang Xianzhong to break through the defense line of Daye and Yuanhu, and the later he comes to attack, the stronger our defense line will be. "

"How to say?"

Song Baolai actually pursued and asked, it seemed that he really cared too much.

Li Ping had no choice but to explain to Song Baolai in detail.And Zhao Lanyue rolled her eyes from the side and bit her finger.

……

The operation went faster than expected. In less than an hour, Gao Lei, who took off her white surgical gown, suddenly pushed the door open.

But just as Gao Lei wanted to speak, she was choked by the smoke in the room and coughed violently.

After slapping it hard for a few times and finally stopped coughing, Gao Lei stood at the door very dissatisfied and said, "Can you smoke less? What is wrong with this merchant, he insists on bringing you tobacco leaves, it is really harmful!"

Li Ping snuffed out the cigarette in embarrassment and said anxiously, "The operation is over? How is it?"

"The operation was successful, and it depends on the luck of the patient. Lan Yue, you can bear it? This can kill people!" After finishing speaking, Gao Lei turned around and went to the middle of the courtyard to take a deep breath of fresh air. .

At this time, the few people in the room could no longer sit still, and all of them rushed out of the room.

After briefly taking a look at Xu Keran who looked good and telling him to take a good rest, Li Ping found Gao Lei.

He wanted to talk to her about something serious.

"We need anatomy. Now is the time of war. There are enough fresh corpses. It is the best time to establish and develop anatomy." Li Ping said seriously.

This operation gave Li Ping too much inspiration, and it was something he had been thinking about just now.

Although he does not know professional medical knowledge, Li Ping also knows that anatomy is the foundation of modern medicine.

Gao Lei is not omnipotent, and her professional field is even very narrow.

If Li Ping wanted to achieve a systematic leap in the level of medical care, especially the level of surgical medicine that is closely related to war, and to achieve self-sustained progress in an all-round way, he must establish and develop anatomy.

Otherwise, their current medical ability will be deformed, and they will not have the ability to develop themselves.

Just like in ancient China, it was often possible to achieve a large lead in the world in a certain single item, but because there is no support from the scientific system, most of them are just the result of simple experience summarization and flashes of inspiration, so that in the end it is always short-lived and cannot be improved to a higher level. building.

The appendicitis operation just completed is also similar to this situation. In fact, other people are simply implementing Gao Lei's medical knowledge mechanically, that is, they know it but don't know why.

So that it is difficult to draw inferences about other cases from one instance and understand by analogy on the basis of this operation.

Western medicine can come from behind and become dominant, in fact, it is inseparable from its rich anatomical foundation and historical accumulation.

Many people don’t know that the famous scholar Aristotle (384-322 BC) conducted a large number of animal dissections, and proposed that the heart is the center of blood circulation, and also distinguished between tendons and nerves. .

Leonardo da Vinci, a famous painter in the Renaissance, also dissected at least 30 corpses and left a wealth of manuscripts.And because he was so famous, the then Pope Leo X specially issued a ban on him, prohibiting him from dissecting the corpse.

In the end, Leonardo da Vinci used wax to perfuse human pipelines to find out the course of blood vessels, proving that blood vessels originated from the heart; and produced a human bone anatomy map, which was finely and accurately depicted, laying the foundation for bone anatomy in later generations.

In 1543, Vesalius's epoch-making anatomical masterpiece "The Structure of the Human Body" supplemented by more than 250 illustrations finally laid the foundation of human anatomy and put the development of Western medicine on a new fast track.

Even in the seventeenth century, in order to meet the needs of anatomy, the corpse-stealing industry in the West developed rapidly. Many doctors had to spend an average of 8 guineas (British currency, 1 guinea is equivalent to 1000 to 2000 yuan) to buy a corpse. .

Therefore, it is not a coincidence and good luck that the West has come from behind and become the dominant medicine, but it has been accumulated step by step.

Gao Lei, who is a doctor, is also very clear about this problem.

Therefore, she also listened carefully to Li Ping's opinion and fully agreed with it. At the same time, she also very much agreed with Li Ping's way of efficiently promoting it by issuing orders.

Otherwise, it is basically impossible to achieve the goal by guiding the formation of a spontaneous atmosphere, given the current social environment of the Ming Dynasty.

However, Gao Lei raised objections to Li Ping's desire to hand over the task to Jia Youliang.

She said: "Jia Youliang is a good doctor, but he may not be able to lead the way in anatomy. He is a person with a strong bottom line and a person who pays great attention to dignity. He can do the necessary research for specific pathologies. But He will not be willing to do comprehensive and destructive anatomical research on the human body, and he will not do it."

"Then what should we do?" Li Ping was stunned.

Li Ping believed in Gao Lei's judgment on this aspect. After all, she and Jia Youliang were together almost every day, and this seemed to be in line with Jia Youliang's consistent performance when he was in Kaifeng and after he came here.

The fact that Gao Lei has been so tired for the past few days also speaks volumes, and Li Ping was already skeptical about it.

But apart from Jia Youliang, Li Ping didn't have any other candidates in his mind.

"I have someone to choose. The two assistant doctors for today's operation were arranged by me, and they are both very suitable. One of them was a butcher in Xiangyang, so it's no problem to take this job. Just let Hu Zhongshan arrange it."

"You actually trained a butcher to be a doctor?" Li Ping was very surprised.

Gao Lei said helplessly: "I don't want to either, but at present only butchers are able to achieve a quick career as a surgeon, and they are the only ones who dare and are capable of certain tasks."

……

Three days later, the businessman Xu Keran was still safe and sound, and there was no sign of suppurative infection on the incision.

The operation was basically considered a final success, and Xu Keran's life was also successfully saved.

The secret blockade was finally lifted.

But for the sake of caution, the news of the operation was not deliberately spread, so there are still very few people who know about it.

The boatman who was sent away with an excuse before was the first outsider to know the news and see Xu Keran.

He looked at Xu Keran's ruddy face and the knife wound on his stomach almost dumbfounded, and then murmured in disbelief: "Shenshu! Shenshu!"

(End of this chapter)