Nineteenth Century Medical Guide

While the whole of Vienna was looking forward to this open-air surgery, Carvey and his small experimental team became very interested in a machine that had just come out of the Laszlo Foundry.To be precise, it should be someone other than Kavey. Kavey's interest is just pretending.

After all, this thing has been by his side since he first studied medicine, and it has been more than 40 years.

"This thing is really interesting."【1】

Savarin squeezed the rubber ball, feeling the pressure from the cuff on his left upper arm, swept away the haze of the experiment a few days ago, and shouted excitedly: "Look, look, now it's 160!
"

"Can you hear the sound?" Koch was sitting next to him, also curious.

"...Well, I can still hear some." Savarin put on a stethoscope, and pinched the ball a few more times, "Here, come, it will reach 180 soon, and the sound will disappear immediately!"

"Really disappeared???"

"It's gone, all the pulsating sounds of blood vessels are gone!" Savarin was very excited, "This cuff is like a big hand, pinching and closing all the blood vessels in my entire arm."

"Give me a try too!"

"Don't worry, I have to loosen it slowly according to the instructions for use." Savarin found the vent valve on the ball, and then found the scale line of the mercury column, and continued, "while loosening You have to look at the tick mark and listen to the sound in the stethoscope."

"How much do you want?"

"I don't know." Savarin looked at the description in the instruction manual again, "It just said that when your blood pressure is reached, you can hear the sound in your ears, and the mercury column will also vibrate up and down."

"It's amazing, this is much simpler than the metal blood pressure stent used before."【2】

"shush"

Savarin is now focusing all his attention on his eyes and ears, for fear of missing this historic moment.

The liquid level at the top of the mercury column slowly dropped with the loss of gas in the cuff, and the pressure on the outer circle of Savarin's left upper limb also gradually weakened.No one knew when the brachial artery would start to pulse again, or if the sound in the stethoscope would match.

All the unknowns vanished with a crisp arterial blood vessel pounding sound.

"I'm coming!
Savarin was very excited, "The mercury column is also moving, and indeed it is moving, this is the pressure change in the blood vessels, winter, winter, winter"

This pulsating feeling lasted until a lower level, and then disappeared in his ears.In addition to Carvey, Savarin became the first person to try to use this blood pressure monitor, and successfully recorded his own blood pressure values.

"Not bad, not bad, very interesting." After untiing the cuff, he was still a little unsatisfied, "When the pressure was raised to 180, it was like being in the dark night. Breaking through the feeling of the silent night."

"Give me a try too."

Savarin took off the stethoscope and pushed the whole machine in front of Koch: "Although the structure and principle are very simple, it still requires a little skill to operate. Especially pay attention to the speed of deflation, neither too fast nor too slow .”

"OK, got it!"

Koch also knew how to learn it at once, and he quickly got an extraordinary experience: "It's not bad, I feel that I can feel the impact in the blood vessel at the moment the sound appears."

"It seems that there is indeed a feeling for the first time." Savarin nodded, "Why don't I try again."

"Hey? Shouldn't it be my turn now?" Mattick stood aside and couldn't bear it any longer. "It's agreed to be done once per person."

"Okay, okay, I have to try again after you have played."

The sphygmomanometer went back and forth several times in the hands of the three people, and it came to an end when Carvey came back from the dean's office: "The laboratory we applied for expansion has been approved, and the dean promised that half of the third floor will be under my management." .”

"Amazing!"

"Great, this way we can create a new animal breeding room, instead of being crowded together!"

"There will be not only voles, but also dogs, rabbits, and sheep"

The allocation of the laboratory was within Carvey's expectations.

In just over a month, Carvey has produced several new drugs. Although they have not been unanimously recognized by the outside world, and Carvey's papers have not been published, the effects of the drugs are obvious.

At least it played a very good role in the patient, and did not find too many flaws.

Two of them have already applied for national patents, and half of the methylene blue carvet has patents. The effect of the adrenal extract is even more amazing, and the patent is only a matter of time.Such a productive experimental team deserves to be assigned to a more advanced laboratory.

The three gathered around the experimental table, still discussing the next experimental project, and it was only then that Carvey noticed that they had played with the blood pressure monitor for a full hour and a half: "Why are you still playing?"

"This thing is so much fun."

"It's much simpler than the one used in the hospital." Koch put on the stethoscope and came again. "After it goes into production, we might not be able to afford it anymore. Naturally, we have to play more now."

"Why can't I afford it? My price is only 50 crowns." Carvey put down the laboratory transfer procedure and said.

"Only 50?"

"This is the world's first sphygmomanometer that anyone can operate and learn. It's much simpler than the old antique used before!"

Mattik, who was born in a bourgeois family, really didn't understand why Carvey did this: "According to market rules, this kind of epoch-making work should sell for 300, no! 500 crowns a piece. Only in this way can it reflect its due value , can also make people notice the painstaking efforts of the researchers."

"But its cost price is only 20 crowns, and I have already sold it very expensive." Carvey said.

"You really lack business acumen!

"

Carvey is definitely not as bad as he said, but he thinks that the principle of the sphygmomanometer is not difficult to understand, and imitations will appear sooner or later after the finished product enters the market, so there is no need to set the price too high.In fact, with its mission of existence, it is impossible for Kavi to set the price too high.

"It's okay, it's just some money, so what can I do if I have more."

Carvey smiled, and there was nothing to justify: "By the way, what do you think of this machine? Is there any room for improvement? Feel free to ask if you have any comments. I can discuss it with the design team in the Laszlo Foundry. improvement."

"The measurement method seems simple, but it needs to mobilize the three parties to act together." Savarin has not shown such a gratified smile for a long time, "It is indeed a good machine. If it finds its use, it should sell well. "

The evaluation is quite satisfactory.

Compared with the most commonly used folding sphygmomanometers in modern times, this Kavi cannot be folded, and it must occupy a larger volume.Ease of operation is actually compared with the past. Compared with modern fool-like electronic products, this sphygmomanometer, which has been in the clinical frontline for more than 100 years, is still a bit complicated.

In fact, it is a matter of design principles, and it has done all the problems that can be solved.And its problems have become meaningless because of its low cost and precise numerical values. Therefore, after its birth, all people can do is fine-tune the structure, and there is no need to change the core at all.

Even the electronic sphygmomanometers that have begun to be popularized cannot match the sense of reliability of measuring blood pressure by hand.The value on the LCD screen is not more intuitive than the sound of the blood vessel being opened.

After all, it adds sound to the scale value, and presents the pressure in the blood vessel to the examiner in a better way.

"The most useful thing is that at least when the surgery is dealing with massive wound bleeding, the relationship between blood pressure and blood volume can be used to clarify the blood loss of the wounded."

Carvey didn't rush to say too much, but changed the subject: "The usage can be discussed later, and I'm more concerned about your blood pressure now. Savarin, what's your blood pressure?"

Savarin handed over his recording paper, and he wrote down the value and time of each test.The habits accumulated through a large number of experiments are good, but the values ​​on the paper are not so good, and the quality of these values ​​is quickly reflected on Carvey's face.

Systolic blood pressure 154, diastolic blood pressure 92, typical high blood pressure, if combined with Savarin's age, the prognosis is not optimistic.Of course, high blood pressure is a chronic disease. If only the life expectancy is counted, it should be much longer than the average life expectancy. It seems that there is no need to be too pessimistic in this era.

But he is half of his "employee" anyway, and as a "boss", Kawei still needs to take care of it.

"What's wrong with you?" Savarin thought that the format or content of his recording was not in compliance, so he leaned forward and asked, "Did I record it wrong?"

"it's okay no problem."

Carvey didn't know how to tell him, so he could only turn his head and look at the blood pressures of Mattick and Koch. Both of them had normal blood pressures, so he was finally relieved.Carvey put down the recording paper, looked at Savarin, and suddenly asked, "By the way, how long have you been working here?"

"Counting the days in the hospital, it's been two months."

Along the way, Savarin was a bit awkward about the safety of animals, but he was very reassuring in other situations, and he worked very hard: "Why do you ask this suddenly? Are you trying to fire me?"

"That's not true." Carvey chatted with him with a smile, "You stay in the laboratory every day, and you often work late. Now the laboratory has improved, and it has changed to a new place, and the experimental project is basically completed. I think you should be given a break."

It is indeed time for Savarin to take a rest. This kind of high blood pressure is very likely caused by staying up late for a long time.

But he himself does not want to take a break, because once he takes a break, he will lose his job, and without a job, he will have no income.Savarin is no better than Koch's connections and scholarships, nor is he richer than Mattik's family. The laboratory is his only way to get money, so he can't stop it.

"No, what am I doing on vacation at such a young age?" He joked, "I would like to buy an apartment on the Ring Road, and then I can go to the theater and listen to operas when I have time."

"I'll give you paid time off."

Carvey immediately took out a pen and paper, and wrote a leave note on it: "I'll give you a month's vacation, you can take a good rest, and your salary will still be paid as usual."

Savarin looked at Carvey in disbelief, not believing his ears.But when I heard the sound of my blood pressure just now, my ears were obviously good: "Is there such a good thing? Will I want it when I come back?"

"When you come back, there must be a lot of projects to do, so I will give you a raise."

Taking advantage of the upgrade of the laboratory, which happened to be the day when the sphygmomanometer was finished, Carvey incorporated an eight-hour working system that may not be often seen in modern times into the laboratory work schedule.After all, if the laboratory wants to continue to operate, qualified talents are the most important.

"Okay, take the blood pressure monitor, I'll show you something more interesting." Carvey turned around and opened the door.

The occasional blood transfusion of the adrenal extract produced by the laboratory team can basically maintain Fernand's body, but this can only cope with blood loss, and definitely has no effect on the tumor in the body.

But in the eyes of outsiders, it seems that only blood transfusion is the key point, and there is no way to prove the effect of adrenal extract.

So in order to let everyone understand the effect of adrenaline, Carvey moved this latest blood pressure monitor into the cell of the police station, and also prepared for tomorrow's open-air surgery.

Even if it was an operation with a very high mortality rate, Carvey couldn't let Fernan die at the beginning, and he had to last until after the operation was over.Adrenaline is the magic drug that can hang his life, and the sphygmomanometer is the key device to measure the dose of the drug and Fernand's vital signs.

Carvey is the chief surgeon, so he and his team can go in and out of the police cell at any time these days.

"How is he today?"

Witt shrugged his shoulders: "It's still the same. Last night after the blood transfusion, I vomited twice. I think it's a waste of money."

"It's good to be alive." Carvey said, "If he vomits blood again, let Teacher Musil give him another bag. Anyway, he only needs to last until tomorrow afternoon."

Witte didn't have much to say, so he nodded and left first.Carvey took over the cell smoothly, and asked the three to put on a posture: "He hasn't used adrenal extract today, so you can take his blood pressure as a baseline value first."

Savarin stepped forward, tied the cuff step by step according to the operating specifications in the manual, stuffed it into the auscultation head, and then continued to pressurize.In fact, judging from the amount of blood loss these days, it is enough to increase the pressure to 140, but Savarin still increased it to 180 in a very standard way, and then began to deflate slowly.

".Why is there no sound?"

Savarin was a little surprised. Compared with his own blood pressure, Fernan had already dropped by half.Carvey was very calm and had a lot of experience with the blood pressure of a patient like Fernan: "Don't worry, keep deflated."

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In the end, the mercury column level jumped on the 96 scale line, and Savarin heard a heavy pulsating sound in his ears: "Come on, press up to 96!"

"It's really low."

"How many down there?"

"It's past 70, and there is still a voice." Savarin shook his head, and kept silently chanting as the liquid level dropped, "68666360"

"Yes, it's 58!"

"Okay, let's give him some adrenal extract and see how his blood pressure changes."