Nineteenth Century Medical Guide

Chapter 353 349. The end of the little man (6)

Burns are very common acute injuries in surgery, and the range between mild and severe is very large.

Mild burns may only hurt the epidermis, and the skin will be reddened, which will recover on its own in a few days.However, a large area of ​​severe burns caused by a large-scale fire accident has completely changed its appearance, becoming a complex traumatic disease that may be fatal at any time, and the recovery time is calculated in months.

Although burns appear to belong to surgery, various problems will be encountered in the treatment, which requires considerable knowledge of internal medicine.

Shock, inhalation injury, water and electrolyte disturbance, immunity, infection, wound treatment, metabolic nutrition support, complications of various organs after burns, for these items that need to be treated, scar repair and plastic surgery after burns, and treatment of special burns are removed. need to face later.

Looking at the requirements of modern burn diagnosis and treatment, none of them could be really handled well in the 19th century.

What Kawei can do is to try to get closer to the good direction. Whether he can really save people depends on their own luck, and it is no longer something that people can control.

"What's most lacking now is people! It's really tricky at night!"

Sedieu looked at the number of people left behind in the hospital at night and shook his head: "It is conservatively estimated that there are nearly a hundred people here. It is impossible for us to deal with the crude configuration of the battlefield and call all the active doctors and nurses! The drawer in the dean's office There are their residence addresses in it, hurry up!"

The modern pre-hospital first aid process is completely different from the treatment model here. Without the help of a large number of medicines and equipment, that process may not work. The only thing that can be relied on or more practically, the only thing that can be used is manpower.

Now that manpower is in short supply and supplies are not available, it seems that they can only choose one of them. Carvey obviously holds the opposite view to him.

People are important, but as long as they are enough, medical supplies are more important in the face of large-scale disaster relief.

Just like the construction of the Olmitz Fortress Hospital, his modern medical philosophy will definitely be questioned by many people, even by himself.If Olmitz hadn't survived several waves of pressure, he wouldn't have dared to make completely different suggestions in a foreign country.

"By the way, professor, what about the recovery fluid I asked to make?"

"Rehabilitation fluid" Cedieu felt disgusted when he heard the word, but in fact it was really easy to use, so he resisted and said, "It's all in the warehouse."

"I should have kept four or five bottles, and let people move them all out." Carvey's brain was running fast, and he continued, "In addition to the good wishes before, I still need a few people to help run errands, and I have to rush to send the wounded to the hospital in time. Get ready before you come."

"There's no time! Maybe there will be a horse-drawn carriage coming soon. Now there are not enough people, so we have to go out to run errands?" Cedieu didn't understand Kawei's approach, "Think about the number of audiences in the theater, This scale is not at all easier than the battlefield, do you think this manpower is enough?"

"The situation is different. The ratio of the number of supplies needed to 'rescue people' and 'just do our best' is different. What I want to do now is to save people as much as possible, and those medical supplies are more useful than people."

Carvey insisted on his own ideas, "You have to give me at least 6 people first!"

"so many?"

"One needs hydrogen peroxide to go to the Chemical Research Institute, and the burnt skin needs to be treated, otherwise it will fester soon." Carvey's reasons are also very good, but most of them are newly established by him, "One has to go to the rubber factory, the same as before. For a perianal abscess, you need to get more rubber tubes, and they need a lot of fluids."

"Rehydration."

Sediyo didn't understand why he needed to add liquid to his body after burning his skin, but Kavi didn't miss it these days, which made him have to think about the inner connection between the two: "High temperature does make the mouth dry, but There's no need to be in such a rush."

"The role of the skin is not only to protect the body, but also to prevent moisture from evaporating."

Carvey didn't have time to explain too much: "Anyway, listen to me, this situation can only be avoided if we have to be fully prepared. Otherwise, we don't have to wait until tomorrow to see the wounded die in front of us one by one. "

Sedieu has also seen many fires, which were very common in the 19th century. Burns to limbs often required amputation, and extensive burns are equivalent to the death penalty. It doesn’t make much difference whether you come to the hospital or not.

Faced with this kind of injury, doctors have been limited in what they can do for thousands of years.It's just that Carvey's "reform" came so fast that he didn't have time to digest it.Cedieu rubbed his forehead with his hands, and his head became dizzy. After thinking about it, he simply acted as the shopkeeper: "All right, all right, you can figure it out, I don't care."

The medical supplies needed for a fire are not only huge in quantity, but also of various types, and all aspects need to be taken care of.

But Cedieu's concerns were not unreasonable. Carvey did not choose the scarce number of doctors and nurses after repeated consideration. He only found two janitors and a cleaning woman in the hospital.The rest can only call a few family members who take care of the patients and persuade them to help.

Fortunately, they were very grateful to Carvey, and all they did were life-saving good deeds, and they almost obeyed him.

In addition to the rubber tubes for infusion, hydrogen peroxide for infection, and healing fluid for scar growth mentioned earlier, Carvey also needs someone to prepare a lot of water, buy a lot of cloth from the fabric store to make bandages and gauze, and buy salt from the restaurant .
In addition, it was impossible to house these wounded in wards, where there was a severe shortage of beds and the corridors were cramped.Fortunately, the weather has been good these days, and we can tide over the difficulties by placing a large number of tents.

"Professor Cedieu, military tents are the most affordable." Carvey even did not hesitate to send the chief surgeon abroad, "I am a foreigner after all, so I can only trouble you to make a trip."

"Me?" Cedieu didn't expect that he was just an errand runner in his eyes, "Who will take care of the consultation when I leave? Who will take care of the distribution?"

"You can rest assured"

Carvey only spoke half of what he said, but the meaning was obvious, and he could do it for him: "But you can only do the renting of the tent, and only your status and connections can talk to them."

The uniqueness can be regarded as offsetting the previous doubts, and Cedieu will not question Kawei's on-the-spot command ability. After all, after so many days of surgery, the opponent has this ability.He was just surprised: "Don't you have a good relationship with that Justina?"

"Countess?" Carvey finally realized, "I only know her, not her father. Besides, we just rented a few tents, so there's no need to bother General McMahon."

Cedieu had no choice. The only person who could contact the Military Supply Department at the first time was himself: "How much do you want?"

"How many beds can the French military tent hold?"

"Twenty or so."

"Borrow at least 5 first." Carvey roughly calculated the area occupied by the lower garden and the open space before and after the hospital, and continued, "There is no guarantee that other wounded will come in the future. It is best to ask for more, 7-10."

Cedieu sighed, put on his coat and top hat, and left immediately.

"You guys go too, and explain the ins and outs of the matter. If you have to pay, tell them that Professor Cedieu will make it up for them afterwards. Don't make any noise." Carvey advised, "Can the treatment be maintained? Let's see if you can get something."

"No problem, leave it to us."

Kawei watched these people get into the carriage, and murmured: "Except for you, there must be no problems with Shanwang."

The Paris Opera House caught fire around 20:50, and the Palace Hospital responded 10 minutes later. Cedieu and Carvey organized rescue matters together.

However, the transportation was inconvenient, and it was already 21:20 when Shanwang left the hospital and came to the hotel.After getting along for many days, the relationship between the surgical assistant team and him became more and more harmonious, and even some small conflicts were hidden in my heart and did not affect the relationship on weekdays.

After saying a few words, the three of them picked up their things and rushed to the hospital.

But Shanwang has to go to the pier according to Kawei's request to see if the fish market is closed.

There are many piers on the Seine River in Paris, and many fish markets have been born because of the large demand for fish and shellfish in French cuisine.Coupled with the special eating habits of the French, most of those fish markets are open late, for fear of missing business.

Shanwang rented the carriage with 5 francs, and began to look for docks and fish markets along the Seine River.

Every time I found one, I bought all the river and sea fish in it at a price higher than the retail price, and asked for it to be delivered to the door and slaughtered on the spot.Of course, just like before, Shanwang also used Cedieu's identity to mainly pay on credit.

The director of surgery and Shanwang's black uniform, most of the fish merchants agreed.

After all, they paid the money and delivered the goods, even if they really didn't pay, they would lose some travel expenses.But as long as this deal is made, the amount agreed upon verbally will be a large amount of income.

But most of them felt strange, wondering why a hospital bought so many fish, and Shanwang's answer made them even more strange: "Do you see the fire over there? The Paris Opera House is on fire."

"What does this have to do with fish?"

"Fish can heal burns." Shanwang didn't know how many times he used Kawei's original words to explain, "Hurry up and deliver it. Remember that you will be responsible for killing the fish after delivery."

"Killing fish is easy."

"Don't jump to conclusions, our request is not simple." Shanwang explained, "Killing the fish is the only second thing, and the skin must be cleaned! Every fish must be scaled and finned, and the skin must be completely peeled off. Try not to break it, and the peeled fish skin should be washed repeatedly according to the regulations."

"It's so complicated, don't you like eating fish skin?"

"No, no, we only want fish skin!"

"what?"

"Don't ask, I've explained enough along the way."

The follow-up process seemed to be different from what they had imagined. The focus of the question quickly shifted from "why use fish skins in the fire" to "huge workload": "Less say forty or fifty fish, all of them have to be peeled?"

"of course."

"Is the workload too much?"

"Don't worry, Professor Cedillo won't treat you badly." Shanwang took out his wallet, "Here is 20 francs, which can be regarded as a deposit, and the final account will be settled after all the work is done."

"Sure enough, there is no cheap lunch in the world."

"Do or not?"

"Do, of course!"

Most fish merchants can keenly feel that business will not be easy in the next few days. With such a big accident and the flames soaring, I am afraid that many people who can eat fish on weekdays will lose their appetite.

The fish will also stink if left unattended. It is better to dump them all at once than to sell them cheaply at that time.

As for killing fish for its skin, let’s be more tired, at least the money can be obtained.

The fish skin that Shanwang is responsible for is a very useful biological dressing for burns. Compared with pigskin and cowhide, fish skin is softer after drying and has stronger adhesion to the wound.This greatly reduces the drying speed and antibacterial effect of the wound surface. As long as the wound is debrided, it can isolate the wound surface from the air and play the role of a spare skin.

But fish skin alone is not enough, burns also require a lot of healing fluid.

And this burden fell on Albaran.

As an intern who closely followed Juyong, he happened to be studying urinary tract anatomy in the ward today, but was arrested by Kawei.What he has to do is similar to Shanwang, but less difficult, but a little dirty and tiring.

But it's not the first time I've done it, this time I'm much more familiar with the road.

"anyone there?"

Albaran walked along the road to the door of the eighth apartment tonight. He had long lost his previous gentlemanly attitude and patience, and everything was in line with speed.He knocked on the door loudly and shouted, "Mr. Tiro, Miss Merris, and Mr. Ferrio, come and open the door for yourself!!!"

"Who is it so late?"

"It made my chest panic, stop knocking!"

"What's wrong? What happened!?"

Hearing someone's response, Albaran finally breathed a sigh of relief: "It's me, Doctor Albaran from the Main Palace Hospital, here I come again."

"Doctor Albaran."

"Ah, this name is so familiar, I seem to have heard it somewhere."

"It's the polite doctor before. He won't come to give money again, will he?"

"Yes, yes, I'm here to send money again!!" Albaran watched the door being gently opened by the tenant inside, and said with a wry smile, "It's still the old rule, 20 pieces for 1 franc, as long as they are dried or dried , don’t live, it must be over 3cm tall.”

The man named Tilo couldn't help but frowned: "Last time we used up all the more than 100 we collected in the whole apartment?"

"100 is not enough. I made two sacks in three districts." Albaran said, "For the next week, no matter how many, I will take as much as you give me."

Soon the other tenants in the apartment also came out and saw him stepping up to say hello.Hearing that they came to collect bugs again, they all shook their heads and said, "I collected so many bugs before, but now I can't find them at home."

"Yeah, besides, it's still winter, and the temperature is so low that I don't know where to hide."

"Please help, practice has proved that the effect of cockroaches making medicinal oil and potion is very good."

This is the death task that Carvey set for him, and Albaran has no choice: "See there? The opera house is on fire, and there must be many wounded people who have been sent to the hospital now. The hospital is in urgent need of cockroaches! Otherwise, I will give Tell me about the price, how about 15 pieces for 1 franc?"

(End of this chapter)