Nineteenth Century Medical Guide

Chapter 146 143. Old Injuries and Sickness

The pharmaceutical factory co-founded by Carvey, Laszlo and Chino is located in the outskirts of Vienna. The main production items are oxytocin and sodium citrate for surgery.Recently, the preparation of hydrogen peroxide has also been put on the agenda. The verification experiment will definitely be successful, and the finished product will be produced next month.

Due to the tight construction time and short construction period, the factory has just opened, and the retail channels have not yet fully developed. Laszlo now focuses more on wholesale.

Most of the people who come to the pharmaceutical factory to order are famous surgeons in Vienna, or purchasers from the hospital where they work.Because of the particularity of the medicine and the patent in Carvey's hand, anyone who wants to have a cesarean section or some surgery with a lot of blood loss needs to come here to buy goods.

However, the radiation for purely medical purposes is still too small, and Carvey's reputation is far from being well-known throughout the country. The real sales volume is still in the military.

The autologous blood transfusion pioneered by Carvey can greatly save the lives of the wounded. It has limited use in the quiet and peaceful art capital, but it can save many lives in hospitals on the frontline.And oxytocin contains vasopressin, which also has a great effect on those wounded who have lost too much blood.

Since Carvey made the proposal, the Military Political Department and the Chief Medical Officer have been considering whether it is necessary to purchase sufficient medicines for the upcoming war.

Franz naturally knew about this, and he had also heard about the pharmaceutical factory Carvey mentioned: "Is it someone from your pharmaceutical factory?"

"No, I mean he should have gone to buy medicine." Carvey explained, "The operation of bloodletting itself is very simple, just cut a large blood vessel, such as the femoral artery or carotid artery, and it will die in a short time. But It's not that easy to drain all the blood from a person's body."

Musil, who was standing aside, suddenly realized: "You mean to buy sodium citrate?"

"Yes, he needs to use a lot of anticoagulants." Carvey said, "My pharmaceutical factory is the only one in Vienna that can produce so much sodium citrate."

Werther hurried forward and asked, "Where is the pharmaceutical factory?"

"Along the Danube, take the avenue in the southeast, and you will pass a small town." Karvey has only been there twice, and he is not familiar with the specific location, so he only gave a general route, "When you get there, you can see the road. signage."

Werther jotted down these key words: "I'll have to check something when I get there."

Carvey understood what he meant: "We are a formal company, and we will definitely cooperate with the investigation. And to buy medicines, you need to register your name and the address of the hospital. The fear is that someone will mess around, and they will provide it to you."

Hearing this, Werther was like a hunting dog smelling a scent, and pulled Del Rio out of the bedroom.

Franz saw that the matter came to an end, and he had nothing to help, so he stood up and said, "I still have something to do, so I'll go first. Let the old marshal wake up and let him have a good rest. We will have the first combat meeting in a week. , can’t do without him.”

The steward nodded repeatedly and led the king out.

"Then I'm leaving too."

Musil has basically completed the task of coming here, and the next step is to wait for the two sheriffs to bring back new clues.So seeing that the king had left, he didn't intend to stay any longer: "Kavi, let's go, let the marshal rest."

Carvey changed his seat and sat beside Ludwig's bed: "The breathing and heart rate are indeed stable, but the old marshal is the commander-in-chief of the entire army, so I still don't feel at ease."

"That's right, you are a military doctor anyway, and you really have to be responsible to the old man." Musil rubbed his stomach, remembering the sumptuous lunch the manor was preparing for everyone, "I'm a little hungry, I'll go to the kitchen to see what's there Delicious. By the way, do you want me to bring some over for you?"

"No, I'm not hungry."

"OK then."

In just 10 minutes, only Carvey and Ludwig were left in the bedroom.

The old man was still lying quietly on the bed, the sunlight shining on his face through the glass window.

Carvey did his best, measured his pulse and breathing again, and then continued to clamp Ludwig's middle fingers with both hands down.The wrist joint is slightly dorsiflexed, and the nail of the patient's middle finger is quickly flicked with the thumb. 【1】

After the end, she moved her hands up to his face, first touched the eyelashes lightly, then opened both eyelids to look at his pupils, and finally pressed deeply on the upper eye sockets. 【2】

A set of examinations allowed Kawei to basically grasp Ludwig's physical condition: "Your Excellency, Marshal, wake up, everyone is gone."

"."

"It's pointless for you to pretend to be asleep like this."

"."

Carvey felt that when he said this, the other party should have a showdown.The Hoffman's sign was negative, the eyelash reflex was present, the pupils were normal, but the orbital depressive reflex was absent. It can be concluded that the old marshal was not in a coma at all.

But Ludwig is indeed a general who has experienced wars big and small, and he can bear it. Facing the pressure in his eyes, he lay motionless on the bed, without any reaction.

Since he was determined to persist, Carvey had no choice but to spoil his mood, saying: "I'm not interested in your marshal's family affairs or some kind of choice. The only thing I'm interested in is your waist and legs, which seem to hurt Very powerful."

"."

"The orbital depression reflex doesn't work for you, but the pain in the lower back and legs is not so unbearable." Carvey got up and came to the end of the bed, holding his ankle with one hand, and putting the other hand on the knee joint to keep his legs stretched. Straighten, and then slowly lift it up, "If it hurts, it means that there is indeed a serious problem with your waist, Marshal."【3】

"."

Ludwig still didn't respond, but Carvey could still see some slight tremors, indicating that the old marshal's sciatica was very serious: "It seems that there is no response, so it seems that a strengthening experiment is needed."

"."

If the normal straight leg raising test is painful, the strengthening test will cause severe pain in the back of the thigh.

Carvey didn't have the guts to really try it, he could only live with his mouth, if the other party continued to endure it, there was really nothing he could do: "I will slowly put my leg back to a position that doesn't hurt too much, and then quickly Lift height, if it's a problem, shouldn't hurt. But if it's a problem, it will."

While talking and doing, he really relaxed his hand and slowly put back his raised right leg.

But under the processing of language, this kind of relaxation has become a prelude to intense stimulation, just like a slowly climbing roller coaster, which will cross the apex at any time and let it go down.

Finally, the old marshal responded.

He quickly withdrew his right leg, leaned on the mattress and slowly sat up with his teeth grinning.Looking at his cheeks at this time, apart from the marks left by the years and the war, a lot of sweat has already oozes out.

"Your Excellency, Marshal, you are awake."

"You kid is too cruel."

"I'm just confirming your physical condition." Carvey explained with a smile, "It's all medical examinations, it shouldn't be a big deal."

"It's okay?" Ludwig slowly moved his legs and got off the ground, "It's okay to press my eye sockets, and I can bear it, but isn't it too much for you to insist on lifting my legs?"

"I can't help it either." Carvey continued, "Judging from the reaction of His Majesty the Marshal, it should be very painful, right?"

"Of course it hurts"

Ludwig did not continue to talk about his waist and leg pain. In his eyes, this seemed to be a gangrene, which could not be treated at all.He is more concerned about his son now: "I really can't tell whose piece of meat belongs to it?"

Carvey was a little surprised, because he always thought that this was the corpse of the old man looking for the locals, and he directed and acted in a play: "Isn't this the old man looking for someone to send home?"

"Of course not!" Ludwig was also surprised, "Why do you think so?"

"I thought you didn't want to take on this important task, so I just"

Kavi didn't finish his sentence, but Ludwig had a temper: "What is this called? It is my job to fight for the empire, and it is also your job. It's just that sometimes, when you get older, you will I can't do what I want. Now that this happened again, how can I have the mood to go to the front line."

"The incapacity you said refers to the pain in the waist and legs, right?"

"It's been an old problem for more than 10 years. I was about to retire, and I didn't expect to be promoted." Ludwig shook his head. He didn't know what the way this young man was. How did he feel his pain? , "How do you know I have waist and leg pain?"

Carvey recalled the first time he met him: "I still remember when I went to report to the Military and Political Office, I saw you. At that time, you couldn't walk, and you couldn't walk for a short distance. You needed With the help of others, you can rest for a while before you can return to normal."

"You look carefully enough."

Ludwig looked at him, moved his body to get the cane beside the bed, and stood up with difficulty: "I was lifted by you just now, and I even struggled to get out of bed. This kind of body can't even command myself, how can I get up?" Commanding 10,000+ people on the battlefield?"

Carvey doesn't talk about empty things like the imperial spirit like Franz. As a doctor, he must first consider the patient.

The old marshal can't travel far now, it's too cruel to force him to the front line.And even if you really go to the front line, the severe pain caused by the long journey will affect the final judgment on the battle situation.

In fact, even now, the work of the commander of the entire army is extremely complicated, and Ludwig is simply unable to do it in his current state.

"Didn't the marshal go to find out what the problem is?"

"Check? It's all old wounds, who do I ask to check?" Ludwig pulled off his clothes on the back, revealing several scars, "The top one is the Galician rebellion in 46, and the middle one is the 49 Ku "Battle of Ertatoni"

Having said that, he pulled down his pants again, revealing the scar on his leg:

"This one is left from the Battle of Vincennes. There is also a bullet hole on the shoulder from the Battle of Novara. The most serious one is the one in the lower back. In April 49, I followed Julius as the chief of staff of the Second Army General, take part in the suppression of the Hungarian riots. The enemy's knives split my bones, and if it hadn't been for the two old comrades in arms who desperately rescued me, I would not be alive now."

Having said so much, Ludwig just wants to prove that the current pain is all due to war injuries, and there is no need for examination and treatment at all.

But from Carvey's point of view, it looks more like a herniated lumbar intervertebral disc: "I personally think that the pain in the waist and legs of Your Excellency the Marshal is only due to problems with the spine, and has nothing to do with old injuries."

"It's ok?"

"You have a strong body, so many flesh wounds have healed early, and even infection is rare." Carvey explained, "Some war wounds are treated too hastily, which will leave sequelae of old wounds. But even if it is true It’s a sequela, and there shouldn’t be such severe pain.”

"Isn't it caused by an old injury?" Carvey is really young, and Ludwig can only be skeptical.

"The probability is more than 90%."

"What is the reason?"

"A piece of nucleus pulposus between the upper and lower layers of the spine, if the nucleus pulposus loses its elasticity and the surrounding fibrous ring ruptures, it will protrude backward under the action of external force, and then compress."

Carvey looked at the bewildered old marshal, knowing that the anatomical structure was too difficult for him, so he could only use the Austrian national treasure dessert as a metaphor [4]: ​​"It's like a Sacher layer cake, if the outer chocolate icing shell is broken Yes, you only need to press lightly, and the chocolate filling inside will flow out."

"I see."

"Now the chocolate flowing out has irritated your waist, and you need an operation to take it out." Carvey said, "Of course, the operation is difficult and dangerous. If there is a problem, it can be purulent infection. , in severe cases, the lower body will be paralyzed, and even your life may be lost. So this needs to be done after getting your "

Before he finished speaking, the old marshal interrupted him and asked, "You mean surgery?"

"Correct."

"I heard that the recovery period after surgery takes a long time?"

"It does take time." Carvey roughly calculated, "If the opening is not very good, it will take about 4-6 months after the operation to resume daily work."

"So long?" Although Ludwig said a question sentence that did not match his own judgment, a smile appeared on his face, as if the result was better. "What is the success rate of the operation?"

Seeing that he was interested, Carvey said: "If everything goes well, I'm 80% sure. The remaining 20% ​​are accidents, which are complications of the operation. To be honest, I There is no way to control it.”

The illness has been tormenting the old man, seriously affecting his daily life and work.At this age, let alone 80%, he dares to try even if the success rate is only half.

Ludwig nodded again and again, and first expressed his appreciation to Kawei for daring to propose surgery to him.Then the topic changed, and the subject of the discussion was brought back to himself: "If the operation is really successful, will the symptoms be relieved?"

"There will be some postoperative discomfort, but the previous symptoms will definitely be relieved. As for how much it can be relieved, it depends on the severity."

Carvey said it was very objective, but this kind of objectivity has greatly exceeded Ludwig's goal, and it was quickly exchanged for his decision: "It can be alleviated as long as it is."

(End of this chapter)