Nineteenth Century Medical Guide

As soon as Edward left, Brecht met him and entered Franz's office after exchanging pleasantries.

He sent the document just now.

The document is just an ordinary battle report in the recent period, which includes Kischin's inability to hold out on the western front and Olmitz's mutual offense and defense on the northern front.These are all obvious things. During this period of time, Prussia's attack strength has weakened, but the overall combat effectiveness is still strong.

Whether it is against Prussia or Austria, the war has so far failed to achieve their respective goals.

War is like an invisible quagmire, in which the two sides are getting deeper and deeper, and it is far from easy to get out.

However, in the eyes of Franz, this ordinary battle report is extremely precious, because there is an extra letter inside.The letter was written by Morasso, deputy marshal of the Italian Army Group, and the content was related to an unknown siege on the northern front. 【1】

"Such an important thing should be sent as soon as possible. Why did it get mixed up with other documents?" Franz was in a good mood, and he blamed it with a smile on his face.

"I was going to send it to His Majesty in person, but I met Edward on the way." Grand Duke Brecht was also very helpless, "He is very sensitive. If he finds out the signs and leaks the matter, it may be against us. .”

Franz nodded, and calmed down after his reminder: "Indeed, I was too happy."

Although France wants to help Austria on the surface, it actually wants to help Prussia, a weak country in the eyes of everyone, when it won the third prize a month ago.

"Since it's Dr. Carvey, shouldn't you be in charge of your operation?" Edm was very surprised. "It's a bit difficult for me, a non-medical patient, to make the decision."

Carvey's complexion was not pretty, he had dark circles under his eyes due to staying up late, and the smell of corpses and carbolic acid still remained on his body: "I'm here to discuss surgical options with Mr. Edem, because there are many options, and each has its own pros and cons. He has to make the decision."

"Dr. Carvey is really hardworking." Mosier seemed to see why Carvie was so good, "Those young people who are still nestled in Paris and are proud of being in a famous medical school will definitely not go to the hospital for a single operation." Waste your precious sleep time."

"If it's really that person, we at least have the initiative to negotiate." Franz folded the letter and stuffed it into his desk drawer, "You are right, things must be kept strictly confidential, especially for that Edward, At the same time, we need to send someone to Prussia to get some air."

But the good thing is that if the operation is successful, Edem's quality of life will return to normal after surgery.

Carvey was a little dazed, while Mosier and Edward on the side raised their red wine glasses and praised this passage: "Doctor Carvey?"

Now there is a sudden turning point. If France knows its own bargaining chip, the original "help" will no longer exist.If there are other variables, there may be a possibility of falling back to Prussia. After all, Austria has always been stronger in the eyes of the two countries.

"Yes, Dr. Carvey's efficiency is really high, and the time for surgery has been set. No matter whether we can succeed in the end, at least we tried our best." Franz is very satisfied with his attitude and judgment towards Carvey at the beginning, "When I was carrying Ai Ding Sen's pressure has raised his identity, and now he has indeed got what he deserves."

"Small problem? This is not a small problem! The first type of life is too short, I want to live for decades, how can I die so soon, what is the purpose of my surgery knowing that my life is limited?"

Franz nodded, affirming his plan: "Dr. Carvey has been busy for several months, and it's time to go out for a vacation and rest. When the war is over, I have to."

In fact, for him, he has already made a decision after learning about the quality of life after surgery: "Then definitely choose the third option."

"Puhuang has only one son."

The 30th was the day of Edem's operation. In order to have a smooth operation and to think about Edem's postoperative life, Carvey had to go to the embassy.

Obviously not, the distance is not enough.Even if it is really connected, the urine volume required to stimulate the urge to urinate will cause the ureter to continue to expand, and the result is pain similar to ureteral stones, and no one can bear such a toss.

This type of operation connects the ureter directly to the abdominal wall to make a stoma. The operation is simple and convenient, and chief doctors such as Massimov and Ignatz can do it well after introducing the process.But the problem is that the urine flows out through the abdomen, and you need to wear a urine bag for the rest of your life. Nursing is very troublesome and the quality of life is greatly reduced.

Before, he also hoped that he could make up for the lack of experience with practice, just like other operations before.But in fact, he still underestimated the difficulty of the fourth-level surgery.When the two opportunities of the School of Surgery were exhausted, the speed of experience accumulation was still slow, and Carvey still couldn't see the successful operation from the cadaver operation.

"Dr. Carvey, did you just say you wanted to discuss surgery with Mr. Erdem?"

In fact, urinary diversion surgery is not a surgical procedure unique to modern medicine. Carvey turned over the library of the University of Vienna Medical School, and there was a report on ureteral diversion.But this diversion obviously has quite a lot of complications. After the operation, the tumor is removed, and the body can't last long. 【4】

It's just that the development of the war was beyond everyone's expectations. Austria, which was supposed to be sure of winning, was beaten from the beginning to the end by Prussia, and a few sporadic counterattacks were not painful.

Edward and Edm were very surprised when they entered the door, because the scheduled operation time was at one o'clock in the afternoon, and the Municipal General Hospital would send a carriage to pick them up at that time. No one would have thought that Kawei, who had been "missing" for two days, would suddenly appear in front of them. before.

"Your Majesty is wise."

"Because of the different surgical procedures, the risks and quality of life are different." Carvey has long engraved the informed consent into his bones, explaining, "Mr. Erdem has a distinguished status, and is different from others. Make a decision. As for the professional issues you mentioned, it’s actually not difficult, and you’ll understand as soon as I talk about it.”

Edward was equally astonished, and finally understood why such a young doctor had such talent.If it is true as others have said, it is understandable to be able to achieve such a high level since he was exposed to surgery at the age of seven or eight and practiced diligently every day.

"It's a good thing I didn't say anything just now." Franz read Morazo's letter from beginning to end again, and asked, "By the way, does that man have any other brothers?"

After half an hour of drawing and explaining, Edm finally understood his urinary system and the various surgical methods he was about to face with the help of Carvey and Mocier.

The key is that there were no good rubber and silicone products in the 19th century, and the anti-infection and regular replacement of the stoma were also very troublesome.

In the modern perioperative period, there is multidisciplinary cooperation. If there is a problem after the operation, a second operation can be performed, and a consultation can be called to deal with it together. There are a large number of drugs that can be used for selection.But now Kavi can only rely on himself, a blood electrolyte disorder can give him a headache.

"Oh, that's right, that's exactly what Edward said just now." Franz relaxed his body and leaned back on the chair, rubbed his sore forehead, and followed his train of thought, "Paris. Chances are, it’s really a nuisance for him to stay here, so it’s better to let him go back to Paris and leave us some peace.”

"Can you confirm your identity?"

It is not difficult to cut off the bladder, but when the bladder, the urine storage container, disappears, what should we do with the urine that keeps flowing out of the ureter?
Connect the ureter directly to the urethra?

Brecht flattered and said: "I personally judge that no matter whether the operation is successful or not, I will choose to hold back if I win three. The situation was originally not good for us, but now things are going beyond expectations. We can definitely end this war as soon as possible behind France's back." War, don't give them a chance to intervene."

After finishing the consultation on the afternoon of the 27th, Carvey went to the Municipal General Hospital to find the corpse for surgery practice.Until the night of the 28th, he ran out of spare cadavers in the hospital, so he chose to go to the School of Surgery to rub the cadavers.

"But the third is very dangerous, and there is a possibility of failure." Carvey once again emphasized the disadvantages of the operation, "If the operation fails, your life may not last long."

This kind of operation takes a long time, is difficult, and requires high technical skills.

It was impossible for him to bet on Edem's body, so he could only minimize the operation time and increase the success rate of the operation.

"If you succeed, can you be like a normal person?"

Excluding such diversion methods, the most suitable and easily tolerated surgery for the elderly is ureterostomy. 【5】

"Well, that makes sense."

Speaking of this, he suddenly paused for a moment: "Forget it, let's talk about it after he returns to China and chat with him."

Franz was still immersed in the joy of Morasso's meritorious service, and he didn't understand what he meant: "Huh? What's the matter?"

"After fighting for a month, it is indeed time to talk." Brecht suddenly thought of something, and asked, "Edward is looking for His Majesty for Mr. Erdem's business."

"Yes, as long as you survive the dangerous period after surgery, you will be no different from a normal person after a period of urination training." Carvey explained, "Although the first two types have various minor problems, the risk of surgery is very high. Little, I can guarantee the success of the operation."

There are discussions, assessments, and consultations before the operation, multidisciplinary cooperation support during the operation, and assistance from various departments starting from the perioperative inspection.There are also emergency treatment mechanisms for serious complications such as rectal injury and acute renal failure.

Because the technology is not in place, it will greatly increase the chance of postoperative complications, which is an unacceptable difficulty for the medical level in the 19th century.Once complications arise, there is almost no way for Carvey to reverse them.

Carvey is not a urologist. He has seen pelvic floor reconstruction and neobladder surgery in urologists, but he obviously has the skills but no experience.

No matter how you look at it, it was only a matter of time before France intervened. The reason for not speaking was entirely because Austria's defeat was not bad enough.

Carvey was lucky enough to stay away from the flames of war this time, but the war is still closely related to him.

Edm attaches great importance to the quality of life: "Compared to the second one just mentioned, it is even more outrageous. You actually have to poop and pee on your stomach. Whether this thing smells or whether it will affect your appetite is not mentioned for the time being. Let me How can I be honest with girls with a poop bag hanging? This is worse than killing me!"

"No, I've eaten." Carvey was about to say no, but quickly changed his words, "I ate at four o'clock in the morning, and it's at the School of Surgery."

"You said four o'clock in the morning?"

If it were in the 21st century, in the hospital before Carvey traveled through, the urology department for bladder cancer would have established a comprehensive medical unit integrating outpatient department, ward, surgical diagnosis and rehabilitation.

"Yes."

"Ok?"

"You have to go if you don't succeed. Originally, the purpose of Edward's trip to Paris was not this operation." Brecht was confident in his judgment, "It's just that if the operation fails, this journey may be more uncomfortable. "

Brecht's method is simple: "As long as the operation is successful, Carvey can leave."

The three of them were very surprised after hearing this, and hurriedly asked the servant to prepare food: "Doctor Kawei, please sit down, by the way, have you had breakfast yet?"

It has been emphasized that Edem's operation is not simple, and whether it is successful or not is normal.But he knew in his heart that the gap between success and non-success was like the gap between the frontline trenches and the sense of security in a Vienna church, and it was difficult to measure with simple assumptions.

It is impossible to change the position of the bilateral kidneys where the urine flows out, and the ureter is not directly connected to the urethra, so the only choice is to divert.

"Yes, to study new surgical techniques, the only one that can get corpses now is the School of Surgery." Carvey greeted the servant who brought the food, "Please give me the pen and paper, thank you."

For that, he needs time, he needs a corpse, and he needs more practice.

The above two methods are not suitable for Edem, and Carvey decided to follow the modern urology treatment method for bladder cancer, to do radical bladder cancer surgery + in situ neobladder surgery.That is to take a section of intestinal tract and transform it into a pouch, which becomes a substitute for the bladder.

"Your Majesty, what Edward said at the beginning should be followed up as soon as possible."

Edward was eating breakfast with a newspaper in his hand, Edm could only sit aside and read the newspaper because of the fasting required for the operation, and on the other side of the dining table was Mosier who was also waiting for the operation to start: "Why is Dr. Carvey coming in person?" ? Could it be that the operation time has been advanced?"

"Just to go to Paris."

The diagnosis of bladder cancer is basically clear, and the tumor and a considerable range of surrounding tissues must be removed if it is to be cured by surgery.The bladder is not big, so it is unrealistic to do partial resection. The whole bladder must be removed in the operation. 【3】

"What if it doesn't work?"

It's been more than half a year since traveling here, this is the first time that Carvey is not sure about the operation.

As for the chief surgeon, after all, this is a fourth-level operation, and the experience and skills of the chief surgeon directly determine the direction of the patient's treatment.

Not only the war reports and gossip [2] flying all over the sky, Edem's surgery has also been bothering him.

"Although he didn't admit it, the troops are indeed the Prussian Guards. If there is no special arrangement, he is usually in command."

If he wanted to maintain the balance of power in Europe, he would not be able to help the stronger side, and if he wanted to achieve the goal of losing both sides, he would not be able to help at the beginning of the war.It will definitely behave very awkwardly, it is best to delay it for a few more months, and wait for the two sides to suffer more damage before ending up as a peacemaker, just like it is now.

However, it is not too much to say that the corpses in other people's hands are personal property. After being soft and hard, he only got two chances to try from Jacob.

The atmosphere is here, and Carvey has to pick up the glass: "Oh oh."

Edward shouted: "Cheers to Mr. Erdem's chic and romantic life in the future!"

"cheers!!!"

Carvey just touched his lips, but the two drank it down.And Edm's final answer was also very firm: "I want to be like a normal person, I choose the third operation. Dr. Carvey, please."

Supplement this chapter ing. . .