Nineteenth Century Medical Guide

Chapter 10 10. New Methods

Ignatz just wanted to go back to the ward to take a look at his patient before going to the theater, to see where the knife was being operated, and to confirm some details of the operation. Unexpectedly, he just happened to see a farce when he entered the door.

He had dragged Carvey into the hospital to be his surgical assistant, mainly because the kid had a wealth of anatomical knowledge and was a talented person. It would be a pity to let him cut down trees or go to the Academy of Fine Arts for internal investigation.

second words
Ignatz is still a little cautious.

He is a typical gifted school in the field of surgical teaching. He has always believed that no matter whether he is a college graduate or a clinical practice graduate, he must have surgical talent to be eligible to enter this profession.The two good seedlings under his command, Hills and Herman, both graduated from medical school, have gradually accumulated surgical experience with him, and have already achieved some achievements.

The path of the college is considered smooth.

So Ignaz still needs a talented wild way to go another way for him to prove his point.

He tried many apprentices, but in the end, he was full of enthusiasm and lack of calmness, and he was often in a hurry when he encountered trouble.Moreover, these apprentices have low education levels, low literacy rates, and none of them know Latin.

Even if they have really practiced some surgical skills, their inability to read magazine literature will still limit their hands and feet.Others working behind closed doors can at least look at the blueprints and pick up the wisdom of the predecessors, but these apprentices can't even understand the blueprints, so how can they succeed.

In the end, Ignatz could only settle for the next best thing, starting with an art student who had learned some anatomy knowledge.

An art student has no medical theoretical knowledge, no practical experience, and is also a three-no apprentice.But no matter what, when receiving surgical training, it is better than illiterate ordinary people who can't even understand the language.

Of course, in this city full of artistic atmosphere, a painter who graduated from the Higher Academy of Fine Arts has no lower status than a surgeon.Moreover, the painters are all independent creations, but the surgeons have to start as apprentices, which one is higher and which is lower, you can know after a little weighing.

Just when Ignatz searched to no avail and agreed with Elena to give up the apprenticeship, he suddenly met Karvey.

He has an anatomical basis and is also very interested in surgery. The most important thing is that he was born with a big heart.Walking in a top restaurant full of nobles and celebrities, you can chat and laugh happily with your top surgeon, just thinking about it is a bit dreamy.

This is something that a surgeon must have, and it is also one of the "talents" that Ignatz has been talking about.

Of course, in addition to the pursuit of teaching, Carvey is also one of the candidates that Ignatz uses to check and balance the noble students of the academy.What he needs to play is a fishbone stuck in his throat. Although it will be pulled out sooner or later, it is disgusting enough.

So at the beginning, he only hoped that Carvey could gain a foothold in the hospital, but this idea was shattered.

The debate in front of us can be regarded as a debate for the time being, because judging from the situation on the scene, it looks more like a one-sided crush.Kawi, who was standing aside, seemed calm, but with one against three, every word could hit the opponent's pain point. The gap was so huge that even Ignatz could hardly listen to it.

"This is an operation ordered by the teacher, how can we just stop it."

"I didn't say to stop, I just need to discuss with the teacher before the operation."

"What qualifications do you have to discuss with the teacher at your level?"

"You mean that no matter what happens to me in the future, I don't need to consult with the teacher?"

".No, that's not what I meant."

"That's negotiable."

"We mean you can't deny the teacher's point of view!"

"Yes, I don't even think about the identity of Mr. Ignatz. What are you?"

"I said it was a discussion, do you understand the discussion? It's just not to the point of denying it, it's just a reasonable doubt about the result."

"Doubt is not acceptable!"

"Yes, no!"

"Can't question it? Surgery isn't medicine?"

"Of course!"

Carvey frowned, but his moderate tone and low voice made his tone more serious: "So in your eyes, medicine is following the line of religious authority? Medicine has been removed from science by you?"

"You and I, I didn't mean that, of course not!"

"Then medicine still belongs to the category of science."

"of course."

"What is the most basic spirit of science?"

"Spirit? What spirit?"

The three of them glanced at each other, not knowing what Kavey was asking.

"Science is rational, and requires a rational spirit of seeking truth from facts and pioneering and innovating."

Carvey talked about a general concept, and then quickly turned to his own topic: "First of all, the first is the spirit of criticism and doubt. Copernicus, Bruno, Kepler, and Galileo all held high the banner of questioning and continued to study. Step on your own footprints on the road of science."

A low-level apprentice actually gave examples of the founders of scientific development. After hearing this, the three of them could not refute it as if they had eaten flies.

However, Carvey did not mean to stop talking, and moved out Descartes, the ancestor of modern philosophy and science: "Modern philosophy René Descartes even put forward the idea of ​​'universal doubt', in his book "No. A collection of philosophical meditations "[1] gives a lot of space to prove it."

"Okay, okay, what are you doing? Don't work?!"

Ignatz stepped forward in a timely manner and smoothed the seemingly chaotic scene of controversy.

Now that Carvey has the upper hand, he has to "suppress" a few words: "You are just an apprentice who has not officially joined the job, and they can be regarded as half of your seniors. How can you talk to the seniors? You know how to show off your knowledge?" Didn't they learn that in college?"

This is not suppressing, it is obviously adding fuel to the fire, and the faces of the three of them are turning green.

"Yelling in the ward early in the morning, this is not a vegetable market, you are doctors! You are not liars who say that they can cure all diseases, and sell those colorful panacea ointments in their hands."

Seeing that both sides stopped talking, Ignatz sighed and asked, "So what happened?"

Facts have proved that he still underestimated Carvey's pulling ability. An amputation that can be solved in a few minutes will be raised to a philosophical level by him, and he tried to use Descartes' famous scene in the book to help him further consolidate his advantage.

too harsh.
Ignatz appreciates this, and has no negative emotions because of Kavey's questioning.

Everyone is working for the patients, solving the pain, preventing the death of the patients, and reducing the mortality rate of the patients are their common responsibilities.But before refuting his decision to amputate, Carvey needed to do one more thing: "Are you saying no amputation?"

"Because the family members insisted, I think his legs may be treated conservatively."

"What's the reason?"

"The deformation of the tibia is limited, there is no dislocation, the main blood vessels are not broken, and the functions of the distal limbs are also good [2]." Carvey briefly stated these reasons, "Now the only thing that needs to be solved is this wound, as long as it is done well. With the immobilization of the fracture, once the wound has healed, his leg will return to function."

Ignatz was very satisfied with these opinions, and looked back at the three young people: "What do you think? Does it make sense?"

All three of them are excellent graduates of the school, and amputation is a must-learn content in the branch of surgery, so they are very clear about the indications. It is true that the left calf of the 11-bed child can be cut or not, and it depends entirely on the decision of the surgeon.

"Makes sense, but the chance of gangrene in this type of wound is over 85 percent."

"85% is still conservative. In my opinion, the toxic components in the air have been higher these years. Even ordinary sutured wounds will be gangrene, let alone this. I think the probability is [-]%. Surgery is the best now. Choose, and it will be too late if you procrastinate.”

Ignatz nodded, and threw the question to Carvey again: "So, how do you solve the wound problem?"

Carvey knows that the principle of "infection" is a fantasy. No one would believe that their living environment is full of densely packed microbes.So he chose to use a statement that was more in line with the theory at the time: "Since there are toxic components in the air, we just need to isolate the air."

"How to isolate it? Could it be that his legs are covered with glass?"

"Why don't you bring the mask used in the bloodletting therapy? I remember it's in the warehouse of the internal medicine ward. Say hello to Dr. Lund and maybe I can borrow it for a while."

"Forget about that thing. It's okay to cover it for a day or two. His wound will take at least two weeks to heal completely. It will definitely not work if it is worn for a long time."

"It seems to make sense, but who knows."

Carvey knew that this would not work, the wound had already been exposed to the air all night.If you use that kind of airtight glass cover now, although it can isolate the bacteria floating in the air, the sweat produced by the skin will accumulate around, and the humid environment and various nutrients in the sweat will become anaerobic bacteria. paradise.

But if not a glass cover, what can it be used for?

There isn't even a proper piece of gauze in the hospital now, only strips of that kind of linen.

"By the way, is there any lint in the hospital?" Kazuo couldn't help it. Since he didn't have a finished product in hand, he started with its raw materials, "It's the kind made by cotton textile factories."

"American cotton? There are only cotton cloths in the hospital, which are usually used for wiping things, and the rest are cloths such as bed sheets and quilts."

"Cotton cloth is fine." Carvey breathed a sigh of relief. Cotton cloth can at least ensure moisture absorption and moisture dissipation, and then some isolation methods will be used, "Teacher, what kind of oil is used in the French dishes we ate last night?" ?”

"Did you mean fried cod? Or the pan-fried halibut you brought home?"

"No, no, it's a salad. In addition to the seasoning, the beef salad has oil in it. Does the teacher know what oil it is?"

As soon as Ignaz heard his description, he recalled the unique greasy feeling of court French cuisine.But for the dishes, he only stays at the stage of tasting, and has never cooked them himself: "I don't know, you have to go to the restaurant and ask the chef."

Carvey looked up at the wall clock on the wall, and calculated the time: "Mr. Ignatz, the original plan was to follow you into the theater for surgery, but now it seems that it will be postponed for a while."

"You don't really want to go to a restaurant, do you?"

"Because one minute later, it will add an extra layer of risk to this leg."

Although Ignatz has been maintaining Kavi, his maintenance is not cheap and cannot be static.At least on the question of whether to operate or not, he, the famous surgeon, still prefers surgery.

However, he still saw the persistence in Carvey's eyes, so he leaned over and asked the little boy and his mother: "Are you sure you want to keep this leg, or even lose your life because of this decision?"

"We're sure."

Ignatz nodded: "In this case, well, I have no reason to reject the decision of the patient and family members. But Carvey, you have to remember that there is a very important abdominal surgery at 2 pm, very important! I hope Don't miss it."

　[1] Descartes doubts everything, and even tries to prove the existence of God in this book.His proof ideas can be briefly described as follows: "God is perfect, and perfection includes its existence, otherwise it cannot be considered complete. Therefore, a perfect God must exist! The proof is complete." Although it seems that he firmly supports "God exists", but the "God" he proved is not the objectively existing "God" in the original theological sense, but the rational "God" that exists in people's thinking.Since this God exists only in our minds, believing in it is just a personal belief.Therefore, Descartes proved from the side that the God that exists has nothing to do with scientific research activities.This laid a "theoretical" foundation for future scientific research to get rid of the shackles of theology and coexist in the world.St. Germain Cathedral wrote on Descartes' tombstone: "Descartes, since the European Renaissance, the first person to fight for and guarantee the right of reason for mankind."

　　【2】Descartes also did neuroanatomy. Although he did not do it very well, he classified the brain into the ranks of organs in an unconventional way, and created the analysis and experimental research of brain function.

　　
　
(End of this chapter)