Nineteenth Century Medical Guide

Chapter 192 189. Crazy
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The experimental group's experiments on adrenal extracts are still in progress, and it is impossible to talk about the so-called clinical experiments conducted by the modern pharmaceutical company.

In fact, from Carvey's understanding of adrenal hormones, a large part of the experiments can be deleted.For almost all doctors in the 19th century, whether the drug was poisonous or effective was a binary metaphysics question of God's gift or God's punishment, which was far from requiring experimental demonstration.

Just look at the self-filling pharmacies in major cities to get a glimpse.

Even if someone is willing to do the so-called experiment, it is only one or two small-scale animal experiments, and then it can be applied clinically.If the drug works, doctors and pharmacists will be successful and will be well-known; if it doesn't, patients will not have much problem.

After all, the periodic table of elements had a high degree of coincidence with the pharmacopoeia at that time.

The reason why these "drugs" can continue to be used is because the original drugs were basically taken orally, and no route of intravenous administration was discovered, so many poisons can only produce chronic effects.

Those that are really toxic, such as arsenic, can also achieve what doctors call various "curative effects" by controlling the dosage.

The reason why Carvey asked Savarin and the others to do as many animal experiments as possible is definitely not for toxicity, but because it is really difficult to control the concentration of the extract.

Intramuscular injection is fine, and the risk is not great, but in critical situations, especially when dealing with trauma in field hospitals, intramuscular injection of this impure extract may not be able to achieve the purpose of clinical use.

At that time, it was necessary to use intravenous infusion or more ruthless intravenous injection, unlike the pituitary extract, randomly injecting adrenaline into the blood vessels without knowing what was going on would not only kill people but also be meaningless. 【1】

The main problem is that drug sensitivity, main effect and detection methods are too single.

Pituitary extracts, namely vasopressin and oxytocin, are used in a narrow range, and their manifestations are very direct. They are only used for cesarean section, and their function is to increase heart rate and uterine contraction. limited.

The adrenal gland extract is different, because it is also mixed with corticosteroids, making it more widely used than modern times.

Only relying on heart rate monitoring can detect the safe range of medication, but it cannot detect its greatest effect-boosting blood pressure.If you can't measure the effect of the drug, you can't determine the effective dose, so at first Kavey just used it as his last card.

Even though Savarin has always said that he has basically calculated the safe concentration through experiments, after several days, Carvey has no plans to use it on patients for the time being.Because it is useless to use it, and it may even be due to individual differences that the conclusion after a certain patient uses it misleads the judgment of Kavey when the real patient uses it.

But I don't know if it was good luck or some other unspeakable reason, Fernan and the sphygmomanometer appeared in front of him one after another.

Fernan had upper gastrointestinal bleeding, and the amount of bleeding was not small. After all, blood transfusion alone would have the risk of blood transfusion reaction and incision infection. At this time, it is very important to have a shot of epinephrine.

And he is a death row inmate. Even if something happens, Carvey will not be thrown into prison like the doctor who gave strange treatment and caused the patient's death.

In fact, if Fernan hadn't used the adrenal extract the night before, even if he survived, it would be difficult to guarantee his physical condition. He might die from the stimulation of ether, hemorrhage during the operation, infection of the incision, or any other cause of death as soon as he took the stage tomorrow. .

"I'm sorry, Mr. Fernan. You should feel some discomfort next, such as nausea, vomiting, palpitation or... forget it, it's not the first time you have used it."

Carvey asked Savarin to prepare the extract after calculating the dosage, while he sat in front of Fernand's bed and said, "We have mastered the approximate dosage for intramuscular injection, and now we will choose intravenous infusion. Your blood pressure will be monitored during the process."

Looking at a sphygmomanometer that he had never seen before, Fernan felt like a prey for the first time. This was an experience he had never experienced after killing his wife and Albert: "You won't kill me now, will you?" "

"This machine is very safe." Carvey saw what he was more worried about, and comforted him.

Fernand looked at Savarin who was walking towards him with a syringe, and snorted softly: "Whether it's a twisted rope, guillotine, your scalpel, or some inexplicable drug injection, my end is death. Tomorrow When I get to Place Michel, look at the angry crowd, I have to go to God, no, God will not want me, I only deserve to go to hell."

"Who knows what will happen tomorrow." Carvey sighed, "But you have to know, I'm a doctor, and my job is to save people."

"Saving people? Isn't this operation killing me?"

"It's just that the mortality rate is relatively high. There is a 95% chance that you will die on the operating table." Carvey said, "I explained it to you before."

"What about the remaining 5%?"

"It depends on what's in your stomach, but the vast majority of the 5% will die on the same day, and it's almost impossible to live to the next day."

Fernan had already sensed his fate: "Isn't this still a death sentence? It may be more tormenting than the death sentence!"

"The crime you committed simply had no choice."

Carvey didn't take his words seriously: "I still have to thank His Majesty the King. If you were in England or France, you might have been tortured out of shape long ago. If time goes on for a while, you might be tortured in the basement." People are beaten to death with sticks indiscriminately, and there is no chance of going to the execution platform."

"Hahaha~~~" Fernan laughed a few times, "You're right."

Carvey watched the drug slowly infuse into his system, let Mattick monitor his heart rate, and went on to explain: "But even so, this is not the same as the death penalty."

"It's all dead, what's the difference?"

"The simple death penalty is just to destroy you, which may calm the anger of many people, but to the human race, you are just a trivial butcher, and it doesn't have much meaning."

Carvey looked at the sphygmomanometer in Koch's hand and the stethoscope in Mattick's hand, and said: "But this public surgery is different. Your life at least atones for sin and also slightly promotes the development of surgery."

The adrenaline reacted immediately after entering the blood, and Fernan could feel his heart beating faster, but he had no reaction to Carvey's words: "."

"Maybe in my opinion, this is also a kind of 'rescue'." Carvey asked the two, "How about the heart rate and blood pressure?"

"The heart rate has increased from 95 to 115, and the change is very obvious."

"The blood pressure is out, the upper pressure is 113, and the lower is 60." Koch took off the stethoscope on his ear, a little strange, "the lower pressure does not seem to change."

Carvey was not surprised, because this is a normal reaction of adrenaline [2]: "Monitor for a while, wait for half an hour to see the situation before deciding whether to increase the dose."

"it is good."

Fernan had killed many people and knew his state at that time, but he couldn't find this kind of thing in Kawei and his team.It seems that they are working for medicine, and never think about taking their own lives.

"You can find other people to test the medicine, or find other patients who vomit blood. Why do you need me?"

"Who told you to be my patient." Carvey sighed, and found that the other party seemed to have misunderstood, and quickly explained, "Don't get me wrong, I'm just regretting my technology. If you are so inexplicable If you die on the street, all the techniques I used on you will be in vain!"

This experiment was very successful. Fernan's physical tolerance was higher than Carvey imagined, allowing him to collect a lot of useful data, including a single effective treatment dose and a slight overdose.

After finding the boundary of medication, Kavey had a bottom line in mind during the operation.

Soon, the time came to the day of open-air surgery, May 5 at 10:1 pm.

I have to say that the Laszlo construction team is really strong. In less than three days, the open space around the fountain in the center of Michelle Square was turned into an open surgical theater with layers of wooden fences and seats.

In this way, an open-air carnival square that can accommodate thousands of people, similar to a reduced version of the ancient Roman economic field, was erected.

This is indeed a bold attempt, at least in the recorded history of Europe, only the autopsies of dead people have had this kind of battle. The combination of living death row prisoners + serious illness + surgery is really rare.

Because of its rarity, even if there is no room for money on the surface, money will pour into it recklessly.

Tickets for the operation are sold by four temporary ticket booths, which are located in the east, west, north, south, and north directions of the intersection of Michel Square.A limited number of 20 tickets will be sold from these places every hour, and the seats are completely random until sold out.

But the original ticket price of 1 kroner couldn't be suppressed at all, and it didn't take long for it to go up in the hands of some people.

Newspapers published the news on the morning of May 5th, when the ticket booth opened at noon that day and began to sell 8 kroner tickets, but the fares in some channels rose to more than 1 kroner within the first hour.

This price alone has turned away many poor people. They can only stand on the outermost side of the square to see the demeanor of the king and the French ambassador.

Or as a porter, waiting all night for the ticket booth to sell tickets.

This situation led to a lot of quarrels and physical conflicts, for which the police station had to send additional staff to maintain law and order.But the matter did not end there, because the uniqueness of the operation attracted many high-class audiences, so the price continued to rise at an incredible speed in the next 24 hours.

下午1点暗地里流通的票子只有12克朗，2点就已经卖到了20，3点卖到40
Immediately afterwards, the ticket price changed from an hourly quotation to a half-hour quotation. By the time the ticket booth closed at 9:160 pm, the ticket price in the hands of the scalpers had increased several times, reaching [-] kroner.

And this is just a day of market changes on May 5.

On the next day, May 5, the price changes were even more exaggerated, starting at 9 crowns in the morning.Many people said they were crazy, but the reality hit them hard in the face, because the increase in this day alone has reached a staggering 240 crowns.

The closing price was SEK 740 per seat.

As far as this is the outermost position of the infield, it is actually not much different from ordinary people outside the infield.The first row of seats that really flow out is firmly controlled by the nobles, because the seemingly random ticket sales process has already changed in the process of crazy bidding.

The conductor watched the scalpers make money, and he himself became a more advanced scalper.

The ticket price for the first row of seats has already exceeded four figures, and those who get it are nothing more than wealthy nobles and entrepreneurs.They are not necessarily interested in surgery, but in the face of this carnival, they have no reason not to join in the fun.

In the evening of the same day, this kind of bidding was not limited to tickets, but spread to the buildings and apartments around the square.

Because of a good visual distance and angle, a small apartment can be rented out at a rent of 500 crowns, and the time is only a short afternoon.By the morning of the operation, the tickets were sold out, and all the rooms in the surrounding corners were rented out. The warm-up activities before the carnival came to an end.

For this crazy move, Franz didn't seem to give any restrictions, because this is the effect he wanted.

Relying on the operation proposed by Kavey, zf did not get much income on the surface, but a large number of "scalpers" released secretly formed a tight organization, and the tickets were fired at sky-high prices. A supplement to the huge military expenditure.

"Your Majesty is really scheming." Edward entered the surgery plaza early, enjoying the tension and excitement brought by the crowd in front of him. "How much money can be earned from executed prisoners."

"War is fighting for money, and I can't help it"

Franz did not hide it, and there is no need to hide it. Anyway, for him, it is taken from the "people" and used for the people, without any psychological burden: "And the construction of this open-air square is not free, just rely on the 1 crown How is it possible to do that at the price of the fare?"

Edward nodded and did not continue the chat. Instead, he turned around and took today's host speech from the clerk, and looked down.

Seeing that he worked so hard, Franz couldn't help joking: "The ambassador is also very calculating. He actually prepared such a large section. There is always a sense of overwhelming the audience."

"Between the guest and the host?"

Edward was stunned for a moment, and then realized that no matter how long the host of the operation is, he can't change the position of the chief surgeon: "I didn't expect that other than the two of us, that kid is also very calculating, and the result of such a big show is to make a wedding dress for him." .”

"This calculation is not for nothing, it requires solid surgical skills." Franz said something fair, "At least other surgeons don't have the ability to enter the game."

"It doesn't matter." Edward is actually not interested in the operation itself, and he didn't take it seriously, "I should be able to follow the example of the host of the ancient Roman Colosseum, and get it from His Majesty at any time as the victim and the host. The power to pronounce sentence. Right?"

Franz didn't expect him to say that, but he couldn't think of any reason to rebut: "Of course."

(End of this chapter)