Nineteenth Century Medical Guide

Chapter 27 26. Internships for medical students
The difference in mortality in the maternity ward intrigued Carvey. It should be his innate curiosity, which has not changed after so many years.But time has to take something away, and what Carvey takes away is the drive to turn curiosity into action.

To put it nicely is to be calm and cautious, but to put it bluntly, it is to be too lazy to meddle in those nosy things.

Just as those obstetricians thought, the death rate of patients in the surgical ward is much higher than that of the mothers, and many people will even die directly on the operating table, at the hands of the surgeon.He didn't take care of an acre of land in his own home, so where did Kawei, a little assistant, get the energy and power to take care of other people's affairs.

Dominated by such complicated emotions, he took the opportunity of seeing the pregnant woman about to have a cesarean section and entered the first obstetrical ward.

There are hundreds of hospital beds neatly arranged in the spacious large room, and most pregnant women ran outside the ward to seek medical advice.Those lying sparsely on the bed are basically lying still waiting for delivery, and a few are fighting fiercely with the help of the nurses against the malposition of the fetus that has not yet entered the pelvis.

"This is ice water, now put your belly in it"

"so cold."

"Yes, this is the place. When the child's head is cold, he will find a way to leave, so that the fetal position will become normal."

"Is it really possible to do this?"

"It was ordered by Dr. Simpros, please trust us."

Carvey walked from bed to bed and finally found Nora.She was lying alone on bed number 24, with the name on the patient number plate: Nora, no surname.The age is 19 years old, which is two years younger than the legal marriage age of 21 in Austria at the time.

But the additional clause of "parental consent" can give the green light to underage marriage, which is how Nora should have married.

She is not tall, slender, really thin, much thinner than Kawi who eats black bread and polenta every day. Even more haggard.

This is just an ordinary poor woman, her beautiful face has long been ruined by life, no one will take a second look at her even if she walks on the street with a full set of makeup.

The bed fee of 1.5 crowns made Nora remember Kavey thoroughly. When she saw the person coming, she sat up with difficulty and squeezed out a smile on her face: "Doctor, I really thank you for helping me stay here." here."

"You're welcome." Carvey glanced at the pregnant women around him, and finally his eyes fell on Nora, "How do you feel now?"

"pretty good."

“I just came to see”

Carvey is not an obstetrician and gynecologist, and he knows very little about the scope of knowledge [1] in obstetrics in this era.However, many years of clinical experience have made him familiar with the cesarean section operation process and the basic abdominal examination techniques in obstetrics.

When internal medicine was still learning traditional Chinese medicine and using medical dolls[2] for diagnosis, obstetricians had already let go of their hands and feet as early as the last century, not only allowing male doctors to do examinations, but also male midwives.

Of course, this also reflects the extreme objectification of pregnant women at that time.

Surgery in the 19th century is very similar to modern surgery, that is, surgery if you can do it.In modern times, it is to reduce the damage caused by surgery, but at that time it was to reduce unnecessary mortality.

Nora was clearly included in the category of patients who required surgery.

Judging from the judgment of Ignatz and several obstetricians, she has obvious bony birth canal stenosis [3], and the baby is still breech.Although she has not entered the pelvis yet【4】, the difficulty of natural delivery can already be foreseen, which gave the surgeon the opportunity to perform a cesarean section.

According to Kavey's habit before time travel, when encountering a major operation, he must give the patient two complete physical health assessments.

Once at admission and once before surgery.

Carvey doesn't trust these doctors, so he has to come and do a four-part palpation method in person【5】.If the degree of stenosis is not serious and there is a chance to restore the fetal position, then this fatal cesarean section can be completely avoided by skillful use of forceps and appropriate delivery techniques.

To Nora, this wasn't some shady inspection.Carvey's hands just pressed and pushed her swollen belly back and forth a few times, and the inspection was over.

"ended?"

Nora was surprised, because Carvey was much faster and more stable than those doctors and midwives.

"Well, it's over."

Kavey was also very surprised, because many scars could be found on her stomach.Most of them are bruises, ranging from mild to severe, and it can be seen that the old and new are alternating very frequently.A few of them were scalded. With the western cooking habits and the weather in Vienna, it should not be possible to expose the belly.

To be honest, it is a miracle that this child survived till now.

Carvey is not interested in the patient's family disputes. In his eyes, the patient's current physical condition is the first priority.

Judging from his hand test, Ignatz and the obstetricians had no problem with Nora's judgment.The child is in a breech position. Although only part of the pelvis can be measured, and the data are all calculated, Nora’s pelvis is so small that it can be seen with the naked eye【6】.

If it is placed in the 21st century, it is necessary to perform internal pelvic measurement, that is, internal examination, so as to comprehensively evaluate whether the birth canal is really narrow, but it is obviously impossible to do it now.

In this case, it is also difficult for Carvey to draw a conclusion objectively.

Now that Nora can be cut, Carvey naturally accepted Ignatz's diagnosis with pleasure: "You do have a narrow pelvis and an abnormal fetal position. Now Mr. Ignatz is doing all the surgery exercises, and we are all I will try my best to help you find a way to complete this operation.”

Nora nodded, and had no objection to the number of the maternity ward: "Thank you, thank you very much."

"Sure, let's rest"

Just as Kawei was about to leave, Nora suddenly grabbed his sleeve with his hands, and his face was full of embarrassment: "Doctor, I still want to ask a question."

"Just ask."

"Is cesarean section dangerous?"

"It is indeed dangerous, but dystocia is also very dangerous." Carvey said very tactfully, and helped her make a decision from her own perspective, "Compared with the pain caused by dystocia, I personally feel that cesarean section is more comfortable. , after all, we now have the greatest invention of our time: ether anesthesia."

"It doesn't matter whether it hurts or not." Nora hesitated for a moment, and then asked, "If I go home now, will I definitely die?"

Carvey didn't quite understand what she meant: "Do you want to go home?"

Nora was very grateful to the young man in front of her for helping her block the man's fist, and she also hoped to stay in the hospital, where the free meals were even better than those at home.But after the man left, and after more than two hours of calmness, she seemed to have changed her mind, feeling that the previous decision was a bit hasty.

"He can't cook, I'm afraid he has nothing to eat at home alone."

Carvey sighed, seeing her like this, he could only continue to use strong medicine. "Intimidation" has always been his regular skill: "If you go home and wait for delivery in this situation, you are waiting to die, and he will still have nothing to eat by then."

"But."

A fierce battle was going on in Nora's mind, and the results of disobedience to men often turned out badly.What's more, she has to take care of the child after giving birth, and life will become more difficult, but this is not the reason for Kawei to let her go back.

Now that the person has been handed over to the surgeon, as long as the indications are appropriate, Carvey will not let go.

"I advise you to stay here with peace of mind. The bed and operation fees have been waived. The best surgeon in Austria performed the operation. He has just cured the earl's hernia. He has made headlines in the newspaper and is very popular. Respect."

Carvey has only one purpose, which is to keep this woman. "Such a good treatment is rare in the whole country."

Nora touched her swollen belly, weighed it for a while, and finally made a choice: "Okay, then I'll stay first."

"That's right, rest here and prepare for the operation." Carvey heaved a sigh of relief, "I still have to find Teacher Ignatz, let's go first."

"Um"

There were still discussions in the corridor outside the first ward.

After seeing the insistence of those doctors, the women with big bellies had no choice but to choose to hug each other for warmth with sad faces, and then accept their fate together.

Carvey bypassed the scattered crowd and was about to go to Ignatz to explain about Andre's body, but he never thought that a group of people would pour in at the gate of the third ward behind him.They wore black suits, combed their handsome hair, and wore ties and bow ties. They walked straight to the first maternity ward as soon as they entered the hospital.

"Who are they?" Carvey asked a random nurse.

"Students from the medical school of the university next door."

"The imposing manner is really enough." Carvey thought of Bergett who made a fool of himself in the surgery theater before. In terms of temperament alone, he was not a star and a half. "I thought he was a big shot."

The nurse glanced at Carvey like a country bumpkin, and joked, "Of course they are big men with noble backgrounds. Especially the leader, he is the eldest son of Uncle Karl, and of course his aura is different from ordinary people."

"The frontier uncle, the rank is higher than the earl."

"Who knows, but it also depends on the status. For example, although Moraso is only an earl, his status as the king's cousin is a plus, so Dr. Ignatz can make the headlines."

This is indeed the capital of Austria, and even the little nurse has a deep understanding of the ranks of nobility.Carvey didn't want to have anything to do with the nobles, so he stood aside and listened to the story: "Why are the medical students here?"

"Of course it's an internship. You don't even know that?" The nurse muttered, "Hey, I just came here at this time, and it's 12 o'clock after the ward check."

"Forehead"

Carvey really didn't know that there were hospital internship programs in medical schools in this era, and it was the first time he saw medical students who came for internships.He glanced at the wall clock in the aisle, and said casually, "It's almost 11 o'clock. The two wards together have 200 beds. Can you check it in an hour?"

"Huh? What two wards?" The nurse didn't realize it for a while, and said, "They only make rounds here, and never go to the next door."

(End of this chapter)