Nineteenth Century Medical Guide

At the same time and space, most of the operations performed by other chief surgeons were limited to two hours, and most of them were simple and minor operations of less than one hour.However, Carvey has already extended the operation time to a full three hours, and there is no sign of it ending.

This time has already made history. Regardless of whether the operation is successful or not, the 3-hour time has firmly taken the throne of the world record.

This is definitely not delaying time. If you are really watching the operation seriously, you will never say such a thing.The general opinion of everyone present was that the operation content greatly exceeded the operation time.For other people, it would be impossible to finish within four or five hours.

The first two hours of splenectomy and venous shunt were done at a fast pace, as if a child was wearing a piece of clothing from two years ago, which did not fit well.

And the next time, the operation turned into a rectum. Although it was a child's clothing of about the same size, the person was replaced by an adult, which was even tighter.

With the support of the equipment from the Laszlo Instrument Factory, Carvey seemed to have found the feeling before time travel again, and he compressed a lot of tedious surgical details into a short period of time.Not to mention that ordinary audiences can't understand it, many doctors can't understand it either. Even if they are on the operating table, few of the three assistants can understand it.

The blood supply of the pelvic floor is abundant, and Kavey accelerated himself, and many small bleedings were in a state of letting go.They will not affect Fernand's body, but they will greatly affect the vision of the operation area.

What is before their eyes is a bloody hole, in which soft tissue, fascia, peritoneum, mesentery, omentum and intestinal tube are all mixed together, and the anatomical relationship between them is impossible to understand without experience.

Therefore, after Carvey started the operation, many self-aware viewers simply gave up watching the operation before the climax came, and focused on other places.

Fortunately, the successful removal of the spleen was regarded as a wave of sluggish popularity, and the appearance of Bergett and Damirgang bleeding the spleen together was really exciting.Watching the blood slowly flow into the metal basin with the help of the two, the audience finally regained the feeling of watching the surgery.

It is because of this strange feeling that Sansuke Bergett is the most popular on the operating table besides Carvey.

He not only processed the spleen blood with Damirgang, but also undertook the heavy responsibility of blood transfusion, and at the same time helped pass various instruments from time to time, which was much more conspicuous than Herman and Damirgang.

Although he is an assistant, his work is still not sloppy, and being able to perform this operation that thousands of people watch already shows his strength, which made his mother Elena in the audience very happy.From the beginning of the operation to the present, her face is full of smiles: "Bergett has really grown up."

Compared with internal medicine, surgery is indeed much lower. Bergot chose surgery with the best grades in all medical schools, which once made his father Chrissy puzzled.After officially entering the Municipal General Hospital, he didn't even think about what Bergett could do, he just hoped that he wouldn't lose face too much.

Now it seems that being able to work in front of such a large audience is actually not bad.

Chrissy had nothing to say, just followed what his wife said, and said, "Yeah, I have grown up."

These words naturally have two meanings, one is about work, and the other is about life.After Chrissy finished speaking, he turned his face to look at Laszlo beside him, but Felix, who was next to him, came up first: "Mr. Laszlo is looking for someone?"

"Oh, no no."

Felix is ​​only 19 years old, no matter how capable he is, it is impossible to lead the marriage of his sister Naya, and it is impossible for Chrissy to speak directly to him.But in order to be able to catch the conversation, I still have to give a little guidance: "Mr. Felix is ​​19 this year?"

"Yes, Mr. Viscount." Felix carefully watched the operation on the stage, with a smile on his face from beginning to end.

"It's almost time to talk about marriage."

"Me?" Felix pointed at himself with a smile, shook his head and said, "I'm not in a hurry, it's my sister who should be in a hurry."

As soon as Chrissy heard the opportunity, he said, "Yes, Naya is 21 years old, and it's time to get married."

"I think Mr. Bergert is pretty good." Felix called Bergert's name directly like a free uncle. First place. It is more meaningful to have a job with a future, and with Mr. Viscount as his backing, he is completely worthy of my sister."

Chrissy stared at him in a daze as he said all his thoughts, but he was a little too slow to react, and finally he could only find a sentence to fill the embarrassment: "I didn't expect Mr. Felix to treat me right after he returned to Vienna. Son understands so clearly."

"Oh, don't get me wrong, Mr. Viscount." Felix quickly explained, "I'm not targeting Mr. Bergett, I'm doing the same to everyone."

Chrissy was a little surprised, and then looked at Laszlo, who was sitting next to him, who did not respond at all, and only then did he understand why this guy dared to hand over the business of the steel plant to his son.They are all fathers, and they are afraid that their sons are not capable enough, and they are afraid that their sons will not be stable enough if they are capable.

Looking at it now, what Felix said just now seemed to be praising Bergott, but he was actually praising him Clichy by this means.

Chrissy knew that he shouldn't say this to a junior, but considering that he was in full charge of the steel plant, and he couldn't talk to Laszlo, he could only chat first before saying: "Oh? interesting?"

"Is that so?" Felix smiled. "A woman's mind is too difficult to understand."

"What about your father?" Chrissy lowered his voice slightly.

"My dad?" Felix looked back at Laszlo, then shook his head and said, "He said he didn't want to care about it, so just don't just find someone on the street and go home."

Ok?
What kind of education method is this?
Chrissy had never heard of anyone being so casual about their children's marriage, and thought it was just Felix talking nonsense, but the 19-year-old young man taught him a lesson immediately: "It's like when I was 17 years old. People ran to New York, but he didn't stop him, he helped pay for the boat ticket and left."

"You went to New York alone?"

"Yeah." Felix has learned too much this year, "New York is a good place, but"

"Ok?"

"Hehe, it's nothing, let's talk about my sister's marriage." Felix said to him with a smile, "No matter how you look at it, I am firmly on Mr. Bergert's side, but the final decision is still on my sister in my own hands."

"It stands to reason that I shouldn't manage the child's marriage too well." Kerry said with a smile: "But I still hope that Mr. Felix can help me a lot."

"It must be, it must be."

Speaking of this step, Felix finally revealed his purpose: "It's definitely okay to help, and I also value Mr. Bergert's talent. It's just that some things are mutual. I don't know if Mr. Clichy can help. How about a little favor for me?"

Chrissy was taken aback for a moment, and immediately understood what he meant: "What's the matter?"

"Recently, some people think that father's business is not pleasing to the eye, and they always want to suppress us in every way." Felix withdrew his gaze from the operating table, "Once the steel factory of the Laszlo family is suppressed, I am afraid that Hungary will be there."

"I see what you mean."

Nowadays, there are not many people who dare to move and move Laszlo's business territory. It is estimated that the House of Lords and the king in Austria have this ability.But the vast majority of these people are unwilling to have a deadlock with Laszlo, after all, who doesn't love money.

But if you narrow the time frame down to the last month, someone has to pay attention.

"It's Edinson?"

Felix didn't nod, but said: "Some people have no business acumen. The price of steel products in Austria is naturally determined by the steel companies themselves. What's the point of restricting price fluctuations? Although I know that the country is in some difficulties temporarily, it doesn't matter. It’s time to take our small business under the knife.”

After his reminder, Chrissy did remember that there was a proposal from the Edinson family in the parliament, which was about the Austrian steel company.The proposal clearly states that there is a serious unbalanced trend in the Austrian Iron and Steel Enterprises, which is not good for the long-term development of the country.

Although Franz was not positive about the proposal, he couldn't resist being asked repeatedly. If something went wrong, Clichy didn't know what would happen to others, at least he would definitely be in trouble.

"If Mr. Felix is ​​talking about the proposal of the steel plant, there are indeed rumors that are not very favorable to Mr. Laszlo recently." Chrissy said, "But it's just a rumor, who will be with Laszlo? Mr. Luo is right."

Felix turned his face and glanced at him, a little surprised by his reserved and cautious style: "Does Mr. Viscount believe in our intelligence capabilities?"

"Is the rumor true?" Chrissy hesitated for a moment, trying to appear embarrassed, "Although it is troublesome, I can try to find a way."

The typical ten points are only three points, but for Felix, with the Hungarian factory in his hand, three points are enough to express his opinion: "Then I will wait for the good news from Mr. Viscount."

"Me too."

Suddenly, the voice of the nurse just now came from the operating table, which seemed to be a problem with blood pressure and heart rate.Felix looked at the operating table again: "Let's take a quick look at the operation, I feel that if we don't watch it, we won't have a chance to watch it."

Unstable blood pressure is often encountered during surgery, especially for elderly patients, who have a very high chance of hypotension.

Although it is necessary to rule out massive bleeding accidents during the operation, in many cases, this type of hypotension is just a manifestation of hemodynamic instability, reflecting a phenomenon that the value of vital signs is changing dynamically at all times.

But because there is no detection method, in the 19th century, this kind of fluctuation could not be found immediately by relying on human hearing and finger touch.

This surgical nurse is worthy of being the elite left behind after Kavey's screening, and she still maintains a certain sensitivity even after three hours of work.At least she captured the changes in blood pressure and heart rate, which is quite impressive.

Intraoperative mean arterial blood pressure has a critical value of blood pressure and time. Theoretically, it should not be lower than 70mmhg for more than 10 minutes, and 65-60mmhg should not exceed 5 minutes. That's all.

Fernan's blood pressure is still some distance away from the critical value, as long as it is not lower than 90/50, it is acceptable.

But Carvey is far from having modern first aid measures in his hands. Basically, it can be said that everything that can be used has been put on the table from the beginning of the operation, and there is no room for further processing.So he had to kill all possible accidental factors in the cradle: "Speed ​​up the No. 1 bottle a little bit."

"Okay." Amor slightly adjusted the pimp valve, staring at the liquid in the glass tube, ". 10 drops/min more than before."

"Hmm." Carvey buried his head and continued to look at the operation area, "You should pay more attention to the patient's blood pressure and heart rate, as well as the depth of anesthesia, the time should be up soon."

"There are still about 20 minutes." Amor has figured out Fernan's physical reaction to the application of ether in the past three hours. "This time, the amount given is quite a lot, so it should last a little longer."

It's a bit drastic, but it's justifiable considering the length of the operation and the short-term effect of ether.

"Well, pay more attention."

Carvey has nothing to suggest. He can still take care of the patient's vital signs for ordinary minor operations, but he can't concentrate on this operation: "Give me the blood pressure and heart rate after 5 minutes, and we will continue the operation. The hooks are all stabilized for me, exposing the field of vision."

"it is good."

"Come over with the lamp." Carvey pinched Bergett's wrist holding the oil lamp, pulled it to a suitable position, and then said, "Just put it here first, don't move it."

"it is good."

"I will slowly lift the rectal segment that needs to be removed out of the incision. Where is the gauze prepared just now?"

"Here." Bergett held the oil lamp and did not forget to bring a metal basin filled with warm water gauze to the operating table. "I prepared it before."

"Okay." Carvey found two right-angle forceps from the pile of instruments, and clamped the rectal tube at the lower edge of the tumor. "First determine the cutting position, which should be close to the lower edge of the tumor. Then let's cut it in a hurry. Instead, the patient's rectum should be thoroughly disinfected again."

Herman asked, "Carbolic acid?"

"Well, let's use carbolic acid, it's too irritating to use alcohol."

Carvey still followed the method of rectal disinfection when he performed hemorrhoid surgery on Alphonse before, clamped a gauze covered with carbolic acid with a pair of gauze forceps, and stuffed it directly into Fernand's gang door for cleaning back and forth: "It's okay The bowel emptying was done well before the operation, otherwise this scene would have been unthinkable."

This is not superfluous, but to prevent the residue from overflowing and contaminating the pelvis when the rectum is cut.

Because modern people are resistant to enemas, intestinal preparations are often not adequate, which can easily cause infection during surgery.But this does not seem to be a problem for people in the 19th century. At least there is not much residue on the gauze after disinfection, and it is still clean.

"When disinfecting, you also need to be careful not to touch the tumor, otherwise the tumor that infects the mucosal layer can easily cause bleeding."

After cleaning his rectum a little, Carvey threw away the contaminated forceps and gauze, and returned to the operating area: "Okay, it's time to say goodbye to Mr. Fernand's rectum, and give me the scalpel. "