Nineteenth Century Medical Guide

Chapter 335 331. The Dinner Menu at Hendrick's Restaurant

The sudden surgical patients interrupted the rhythm of the outpatient clinic, and the people waiting in an orderly manner by the garden instantly broke their defenses.

Most of them just came to see the clinic, but after seeing the booth set up by Kawei, they turned to him, hoping to go through the screening first to see if it is possible to make this money.After all, the price given is their two to three months or even less than half a year's income, so it must be false to say that it is not attractive.

"What's the situation? This outpatient service is over like this? What about the whole morning???"

"What did you say to give money, and now everyone is running away."

"Stop making sarcastic remarks, the guy you sent just now is very bad, maybe something will happen."

"What does it have to do with us? If you want me to say that he even snatched our outpatient clinic opportunity! Do you understand first come, first served? Do you understand the principle of queuing? I have a problem with my body and I need surgery. Who can I ask for reason?"

"The outpatient clinic won't be limited to this day. Is there any more in the afternoon? Can you open a little longer?"

"Forget it, let it go, let it go"

At the beginning, some people were expecting, thinking that someone would come out to explain a few words, but after wandering around the garden for a while, the flow of people began to recede slowly like the ebbing sea.

After a while, except for those who were obsessed with money, more than half of the doctors and patients left, leaving only a few people here and there, and the originally inconspicuous garden returned to its original appearance.

"What shall we do now?"

Laura was also one of the people who stayed, and also one of the few people who really hoped to get the operation. "It will take at least an hour or two to complete the operation, and it may be ruined in the morning."

"He is not a person who quits halfway, wait for the afternoon."

Laura always felt that something was wrong: "Do you really know him?"

"of course."

"Then why didn't you let me get checked earlier. No, I don't need to be checked, and I can be admitted to the hospital directly."

"He has his own principles."

Laura was still skeptical, but it was not good to be blunt, so she could only ask some questions she had asked before: "Can I really do the operation I need? I am not a countess, in case he What should I do if I feel that my status is too low and I refuse to have surgery?"

"Don't worry, he only cares about surgery. Even if you are a beggar, as long as you are caught by him, you will be fished in, rinsed, and then arranged for good food and drink."

"Well, what a weirdo."

Yesterday evening caused a lot of trauma to Li Ben's heart, but after an ideological struggle, he still thinks that his own problem is bigger.

There was a reason for what Laura did, and it was true that he had no money, so he decided to go one step further, at least he had to fulfill Laura's wish and make up for his physical defects.Then as long as one's "career" enters the fast lane, supporting her is not a problem at all.

Speaking of which, I have been busy with emotional matters these days, and have not started any business. The wealthy daughter I met on the train before has not been in touch recently.

Once he felt a sense of crisis in his heart, Li Ben's eyes when looking around became different, it was a kind of eyes that can only be seen when looking at the prey carefully.To deal with the upper-class nobles, you may have to take a long line to catch big fish, but to deal with these little shrimps who have never seen the world, you only need to cut the mess with a sharp knife.

Now the bait of Kavi is right in front of his eyes, follow these unwilling people out of the hospital, and quietly send a sentence "I can help you get a good seat for the second outpatient clinic tomorrow", or "I have a way to let him accept it directly." A good way for you to go to surgery", can arouse the interest of many people.

Of course, the process is definitely not that simple, especially when you need to appear in front of them with a similar position at the beginning.But as long as the fish takes the bait and asks for a little labor fee, most of them will succeed.

This is Li Ben's bad low-end deception in the early years, and he didn't make much money. Now he prefers to play slowly with rich people, so that he can feel a sense of accomplishment.

But now that his pockets are empty, he can only make ends meet.

Who to look for?
The target must not be too poor, at least he must earn 200 francs a month, and the poor don't have much money.Of course, you have to be anxious enough, especially the kind of people who must make money when they see the cheapness in front of them.
The best age is between 30 and 50. Ladies are preferred. They are more emotional. Although they are guarded against outsiders, as long as they let their guard down, they will give them the greatest trust. They are the best prey for raiders.

As long as he concentrates on his work, Li Ben can become a top predator without mercy.

But he doesn't know that the hunting ground in his eyes is also someone else's hunting ground, and he seems to be at the top of the food chain, but he has already been targeted by a certain cook.If it weren't for the combination of hat + scarf to block part of his cheeks, Alphonse would have already confirmed his identity and prepared for the next revenge process.

And now, the "disguise" to deceive the man in black prevents him from quickly falling into the abyss, but it is not far from the abyss.

Alphonse noticed Li Ben not long after sending people away.

The height, posture and the broken leg resembled his enemy very much, but he was still hesitating in his heart, for fear of admitting the wrong person, and at the same time, he was limited by the various influences on him before, so he hesitated to make a judgment.

He wanted to protect his honor, and he had been nurtured in this way all along.

But recently, Alphonse's attitude towards life has changed a little, and he is also tired of dueling in his heart.But there is only a trace of it, and more of it is caused by time to sharpen the memory. As long as you don't think about it over time, you can passively choose to be relieved.

But...seeing Li Ben by accident made the flame in his heart that was about to extinguish rekindled.

Alphonse did not directly trouble Li Ben, but approached Laura first, because he found that Laura was the girl he met in the tavern before.He wanted to chat with Laura first, and then see Li Ben's reaction before making a decision.

But just in this short moment of mental struggle, Li Ben disappeared in front of him, never to be found again.

If Carvey was not in the theater of surgery at this time, but beside Alphonse, maybe he could pour a basin of cold water on this impulsive cook.But now Li Ben's sudden disappearance has aroused the animal nature in him, which is equivalent to pouring a tablespoon of olive oil on the newly ignited flame.

The original hesitation was dispelled, and the only thing he wanted to do now was to find this little German.

Of course, Carvey doesn't know this, and the problems he faces are even more difficult than Alphonse's.

A 26-year-old somewhat obese guy, he ate cold cuts and appetizers for 3 hours last night.After a night of "digestion", I felt abdominal pain and bloating when I woke up early in the morning. I wanted to defecate, but found that the abdominal pain became more severe, and then passed out.

It is difficult to study the specific medical history, and Carvey can only make a judgment by observing his current situation.

The person's consciousness is a little fuzzy now, he has difficulty in breathing and obvious shortness of breath, he is emotionally irritable, and his body begins to sweat profusely.Heart rate was 121, respiration was over 30, blood pressure was 86/55mmHg, and the most terrible thing was that his stomach was extremely distended, his abdominal wall was tense, and his skin was translucent, like a big drum when touched.

"There was a lot of bleeding on the trousers, so I took off the trousers."

".what is this?"

"Gang door, what else can it be? It should be that the pressure in the abdominal cavity is too high and the rectum is squeezed outwards, causing the door of the gang to valgus."

Combined with the medical history provided by Alphonse, he roughly deduced that this guy was just fed up.It's not ordinary food support, but a very serious acute gastric dilatation combined with gastrointestinal rupture.After gastrointestinal rupture, air will enter the abdominal cavity through the esophagus, slowly increasing intra-abdominal pressure.

This kind of patient is rare, and it is usually bulimia nervosa, or overeating after excessive hunger.

Carvey was fortunate enough to see two cases before. The basic procedure is conservative decompression treatment. If it is a severe gastrointestinal rupture like the one in front of you, especially this kind of rupture with a lot of food, you must operate immediately.

Even knowing that the chances of survival are slim, surgery is required.

"The upper extremity vein is connected."

"Give me fluids first, and pay attention to blood pressure." Carvey took a needle from Herman and handed it to Cedieu, "Professor, stab him in the stomach."

"Tummy piercing?"

"hurry up."

Cedieu had never seen such a swollen stomach. Judging from his own experience, it should be full of gas, but he couldn't tell why there was gas, so he couldn't be sure.Seeing that Kavey had the same idea now, he no longer had any scruples. He inserted a needle above the navel and drilled in hard.
There was only a puff, and an invisible gas slowly flowed out from the gap in the needle, followed by an extremely strong sour smell.

"vomit"

"Fuck, I'm about to throw up."

"What the hell is in here?"

Looking at Carvey again at this time, when the needle pierced the skin, he put his hand in front of his nose and took two steps back suddenly, avoiding the first wave of stench: "Open the door, by the way, there are people behind the auditorium. windows."

"What's going on in his stomach?" Cedieu suppressed the stench and asked, "Could it be."

"That's what the professor thinks." Carvey asked Karen who was on the side, "How is your breathing? Is it slowing down?"

"Well, it looks slower."

The puncture was basically synchronized with Kavi's abdominal entry, and his speed was very fast, completely ignoring the bleeding point when the skin was cut.After cutting open the peritoneum and enduring the second wave of stench, they can see some "spectacular sights" that they have never seen before.

"It's too exaggerated. How much did he eat?"

"The entire stomach is filling the abdominal cavity, and the diaphragm is lifted up, probably to the level of the seventh rib."

"The stomach is stretched like a layer of kraft paper, and there is no sign of digestion at all. The suction device is not very useful, and you have to fish it out by hand first." Carvey said, "Bring a plate and get ready. Clean water for rinsing."

"it is good."

Herman acted first: "...This should be chicken, mixed with some vegetables, peanuts, apples, spinach, this is asparagus???"

Immediately afterwards was Damirgang: "I can see beef dices, onions and porcini mushrooms here. He really swallowed them after chewing two bites."

"I have tomatoes and mushrooms here. The meat is a bit soft, and it looks like shrimp. That restaurant can really spend a lot of money, can you eat so much for 100 francs?"

"Fill it quickly, wash it with water after cleaning it, and cut off the stomach immediately." Carvey can already see some fragments of the stomach wall that were necrotic and shattered after extreme expansion, "What does this guy think? He eats too much too much."

Perhaps due to the inertia of the sense of smell, these doctors in the theater have gradually become accustomed to the sour smell, and even have leisure time to make food.

"Is this ox tongue?"

"Impossible, how could there be beef tongue, maybe it's just ordinary beef slices."

"So many cabbages and cauliflowers, I've fished them twice."

"There are also carrots and strawberries that are rotten into mud, and the color is about to change."

"Pecans with what look like crunchy hazelnuts and something fruity."

"Is it a pie?"

"Maybe cake or something."

"Here are some peas, rotten fish, chewed sausages, and raisins."

"The raisins should be counted among us, with a dessert. Huh? What is this, thin slices of meat? It doesn't look like it's cooked."

"The broken stomach wall." Carvey glanced and said, "Why are you playing, hurry up, there are still a bunch of them that haven't been cleaned!!!"

I have to say that this restaurant named Hendrick is really willing to spend money, and the ingredients taken from the stomach alone are enough for seven or eight kinds of cold appetizers.And the ingredients are exquisite, and you can even see large pieces of lobster meat that have not been bitten thoroughly and many oysters.
"Here, aspirator, suck up as much liquid as you can."

"what about others."

"If you can't catch it clean, wash it with water."

Bergett poured half a basin of clean water into the abdominal cavity, and several people shook it together to shake out all the residue stuck in the tissue gaps, then turned his body sideways, and poured out all the water with dirt.

This went back and forth three times, and the stomach was finally clean.

"It's not enough, but there's no time to do this now." Carvey found the ruptured part of the stomach wall, and after excessive stretching, the blood vessels were compressed, which eventually led to necrosis here. , have to do a subtotal resection. Look down to see if there is any problem with the small intestine, if there is no problem.”

"The intestinal wall was also compressed and necrotic."

"Not to the point of necrosis."

"The congestion is so severe that the color is dark."

Carvey quickly rummaged through the mesangium and omentum. Some blood clots could be seen in the blood vessels, and the smoothness of the hands also lost, replaced by a rough texture.All the signs point to the ischemia caused by the large-scale expansion of the stomach and the compression of the surrounding tissue. Even if there is no necrosis now, it is not far from necrosis.

And this situation is not limited to the stomach and intestines, but also affects the upper right liver.

"The mesentery with severe congestion must also be removed. From here to here, leaving a part should ensure the rest of the blood supply." Carvey has not given up, and is ready to do it after simply dividing the scope of resection, "Give me the hemostat and the operation Knife, let's start with the upper part of the stomach. Kallen? What's wrong? Give me the scalpel!!!"

Karen looked at Carvey, and silently took off the stethoscope: "Dr. Carvey, his blood pressure can't be measured."

(End of this chapter)