Nineteenth Century Medical Guide

Chapter 159 156. Surgical diplomacy?

In the 19th century, the understanding of tumors was still at the stage of the four fluids theory, which believed that tumors were caused by the accumulation of black bile in the blood.Breast cancer, which is swollen or even festers outwards, as a relatively serious body surface tumor, will bring quite stimulating visual experience, which often arouses doctors' strong desire for treatment.

Internal medicine is obviously unable to limit the growth of tumors, and this burden has been borne by surgery from the beginning. 【1】

It coincided with the golden age of surgical development, and the recurrence rate after breast cancer surgery was very high. Breast cancer resection gradually achieved total mastectomy from local excision at the end of the 18th century.

The surgery is very aggressive and the success rate is steadily increasing, and several surgeons who routinely perform breast cancer removal have been able to reduce the mortality rate below 50%.However, the recurrence rate after surgery remains high. Even if the risk of surgery is escaped, nearly 90% of patients who have undergone mastectomy cannot escape the bad luck of recurrence.

There are very few people who can really survive the operation and survive for more than five years.

The main reason is the backwardness of the examination, the early diagnosis is unclear, and the later diagnosis is clear, but the tumor has already metastasized throughout the body.Surgical technique is also a reason. Many rough techniques will also increase the risk of tumor metastasis during surgery and provide an environment for tumor recurrence.

Since the treatments that make such an embarrassing surgical incision can't completely cure breast cancer, the patient will do the opposite and think some strange thoughts.Even if these ideas go against medical philosophy and don't do much to help breast cancer, it's at least decent enough for the patient.

This is especially true when the status of the other party is higher than that of the doctor.

"I personally think that breast cancer removal is inherently difficult, far from being able to talk about the beauty of the incision."

The operation is over, and Kavey is standing by Fernan's hospital bed waiting for him to wake up, and beside him is Watman who just wanted Lakawei to join (jin) partner (keng): "This request is of course based on the ability of the operation. based on the successful completion of the

"Let's discuss the surgery itself first, and leave the 'beauty' to the second surgery later." Carvey suggested.

Waterman certainly knows that it is difficult to solve all the problems at once in this situation, and he also suggested this before today.But after seeing Carvey's small incision mastectomy, he had a bold idea: "Do you think it is possible to save your breast after breast cancer removal?"

"Dean Watman, even if you do a complete breast resection now, you can still curb the recurrence of breast cancer." Carvey was a little surprised, "It's right to pursue beauty, but health is the most important thing."

"It's because the recurrence rate is too high."

Waterman has his own reasons.

The patient was brought by the British Royal Dentist Charles, who admired Watman's special plastic surgery technique and hoped to keep the breast while removing the mammary gland.This is obviously an idea that is out of date and very impractical.

But considering that Charles brought him new materials, and the other party was a prestigious nobleman, Watman dared not refuse easily.

Carvey, of course, has his own ideas.

Cancer is the king of all diseases. For any treatment of cancer, it is necessary to accurately judge the extent of spread before specifying a relatively complete and effective surgical plan.The degree of tumor spread cannot be judged only by looking and touching, so the treatment effect on tumors at this stage is very poor.

Fernand's gao pill cancer really couldn't be compared with breast cancer, all Carvey could do was to cut out the lesion and check whether the inguinal lymph nodes on the body surface had metastasized.

As for whether the retroperitoneal lymph nodes and other lymph nodes have metastasized, or whether the blood has metastasized, he doesn't know, and he can only resign himself to fate.

Moreover, Kavey's ability range is more in the front line of trauma, and he doesn't have much experience in tumor surgery.Now all my energies are preparing for the rescue of the front line of the war, and it is really difficult to be distracted from studying the tumor surgery plan.

"Then it seems that this operation can only be rejected." Watman was very helpless, "It's a pity, this is an important operation that King Franz is also paying attention to, and now we have to give up."

Carvey:? ? ?
"Doctor." At this time Fernan slowly came to life, the effect of ether gradually lost, and the pain in his chest and lower body slowly came to him: "Ah, it hurts, it hurts so much!"

"The operation was successful." Carvey did not call his name, but simply outlined the operation process and diagnosis, "It is indeed a gao pill tumor, but the lesion is confined to the penis, and there is no sign of spread for the time being."

"Then, those two swollen ones."

"It has been cut off." Carvey lifted the cloth blanket covering him, revealing the flat chest wrapped in bandages, "You look exactly the same now as before."

Fernan had a headache, but he insisted on looking up at his body, and finally smiled with satisfaction.The operation took a lot of energy from him, and now he is very weak, but Fernan still raised his arm and grabbed Carvey's hand: "Thank you doctor, thank you so much."

"The next three days will be more difficult. You need to go through an incision and change the dressing, and the pain will not disappear so quickly." Even if he didn't want to, Kavey had to take out a few bottles of ya tablet tincture, "If you can't help it, take a few sips , if there are no accidents, I will come to see you again the morning after tomorrow."

"Thank you."

Fernand's operation came to an end, and Carvey and Waterman left the theater.Because the king's name was mentioned just now, the conversation between the two returned to mastectomy.

"The patient is a French aristocrat, and her father can speak at a high level." Watman described the triangular relationship between France, Prussia, and Austria in general. "You also know that the current situation is tense, and Prussia will declare war anytime and anywhere. At this time, if If we can win France over, it will be in our favor."

Medical diplomacy is beyond Carvey's imagination, because French surgery has always been at the forefront of the world.

"It depends on what kind of surgery it is." Watman is very proud of his technique. "If it's breast cancer, it's definitely not as good as the UK and the United States. When it comes to plastic surgery, it's far worse than me and Professor Corrigo." .So she found Charles, and together they took the train to Vienna, hoping to ask for my help."

Now that there is such a relationship, Carvey has to pay attention to it: "It's not that I don't want to help, but the risk of surgery is too high, and it is very likely to become a double-edged sword in this delicate international relationship."

"The king has also thought about this issue, but when things have come to this point, the risk does not only stop at the success of the operation." Watman wants to see more clearly, "The mortality rate of breast cancer is very high, and not receiving surgery is equivalent to Hand over your allies."

"This is so weird"

Carvey does not believe that a single operation can affect the country's decision-making, and Watman does not believe it either.But as long as there is a possibility, the king is still willing to let the two serve the future of the empire. Anyway, it is not Franz himself who is on the operating table.

According to his words, as long as people are still alive before the end of the war.

"The domestic investment in surgical scientific research is decreasing, which is also attracting sponsorship to the School of Surgery." Watman walked on the garden path leaving the hospital, and said, "I don't know if the success of the operation can bring more benefits to the School. There is too much money, anyway, if you don’t accept the operation, it will definitely make the king lose confidence.”,

Once Franz loses confidence, according to the continued economic downturn in the country, surgical funding will inevitably be affected.

Carvey knew this very well. Considering the surgery he had experienced before, he was indeed too cautious: "Okay, I can consider joining, but I have to see the patient first. I have to clarify the location and size of the tumor, as well as whether there is any cancer." It didn't spread elsewhere."

Seeing that he finally convinced him, Watman couldn't help but patted him on the shoulder: "What a good boy! Ignatz is right!"

The patient was over forty years old, wearing a very exaggerated yellow-green dress, and was drinking afternoon tea with Franz and Elizabeth.

Desserts in Vienna never disappoint just like its music, but her worries about her body are still beyond her control, her mouth is full of sweetness, but her heart is extremely bitter: "Your Majesty, when will Professor Watman Come?"

"It was said to be three o'clock in the afternoon, so it should be soon." Franz explained, "After all, he is the dean of the School of Surgery and has a lot of work to do."

The female patient put down the teacup in her hand: "Please forgive my presumptuousness. Since I saw Dean Watman two days ago, I always feel that he doesn't know much about breast cancer, and he doesn't want to treat me."

"No, Justina, you are wrong." Franz still hoped to stabilize her first, "Although Dean Wattman is the most famous surgeon in Austria, the operation is really complicated, he just needs Just some time."

"But my body can't wait! And I heard that he went to see an operation, if my news is accurate enough." Justina sighed.

"Well, I know about this, it's a very meaningful breast surgery." Of course Franz also knew about it, "but I don't know much about surgery, and I can't intervene in the rapidly developing medicine , or wait for him to come and explain to you slowly."

After finishing speaking, Franz glanced at Elizabeth beside him.

Franz didn't care what disease the daughter of the French general had, nor did he care whether Waterman could cure her.What he is most concerned about is the attitude of France in the upcoming Prussian-Austrian war. Whether it is pro-Prussian or pro-Austrian is crucial to the direction and final outcome of the war.

But as a king, he couldn't be too selfish, so he could only hope that Elizabeth would ask around.

"Dean Waterman will definitely not go to see other people's surgery for no reason." Elizabeth smiled and comforted, "He must also be looking for a perfect cure for the disease, so you can relax."

"Oh." Justina shook her head helplessly, "My grandmother died of this disease on the operating table. Although my mother survived, the wound left by the operation is really terrible. I don't want to be like them, I want to live a good life, live like a woman!"

"You will, trust me." Elizabeth held her cold hands, "You really decided to have the operation in Vienna?"

"Who made the best plastic surgeon in Europe live in Vienna?" Justina said without hesitation, "In fact, I wanted to go to the UK at first, where there is a breast cancer research center. But you also know that my father The attitude of the UK, if those newspaper reporters know that I am going to the UK for treatment, my father will definitely be blown up when he reads the newspaper."

Elizabeth tried every step of the way, and said tentatively: "I think you still have to send a telegram to General McMahon to report that you are safe."

"I will, but I have to wait until I get the exact news of the operation before sending a telegram." Giustina's mood finally improved, "I am only 42 years old this year, I just hope to live a good life, look at me My son is growing up slowly, but it is too difficult for me."

"It'll be fine."

Feeling depressed to such an extent, Elizabeth could only use her own experience to comfort her as much as possible: "A while ago, my health was also very bad, and I almost thought I was going to die, but in the end I received treatment in a nursing home before slowly recovering. "

"Really?"

"Really, Franz has always been by my side, he can testify." Elizabeth spoke very realistically, her face brimming with happiness, "If possible, why not let your brother come to Vienna to accompany you."

"Forget it, Duai is just like my father. He runs to the barracks every day. He is a war madman."

Hearing this sentence, Franz suddenly asked: "Oh? Is the old general preparing an army?"

"I don't know about that."

After that, the couple tentatively asked her a few more questions, but they didn't get a definite answer.In Justina's eyes, only Watman's surgery can make her feel better.But it was hard work, because after chatting with Kavito for a while, Wattman didn't arrive at the palace until 03:30 in the afternoon.

"Your Majesty, Professor Waterman has arrived."

"It's finally here!" Franz seemed more excited than Justina, "What are you waiting for, let him in!!!"

The chief guard glanced at Justina, and whispered, "By the way, he seems to have brought Dr. Kavey along."

"Kavi??? The one who saved the little boy by the river?"

"Yes, that's him." The chief guard glanced at Justina, who looked a little embarrassed, "Dean Watman insisted on bringing him in, but his noble status was bought, so he doesn't qualify for admission." The conditions of the palace. Therefore, this matter is up to you, Your Majesty, to decide."

Outside the palace, Franz may be more easy-going, but once he enters the inner courtyard of the palace, even he must abide by the rules of the Habsburg dynasty for thousands of years: "Let Dean Watman come in first, according to Carvey. Just let him wait at the reception."

(End of this chapter)