Nineteenth Century Medical Guide

Chapter 376 372. Art is as good as God (1)

After Alex's successful delivery, Countess Bortale's salon became a popular place for Parisian social circles, and she naturally became the most popular young woman in Parisian social circles. one.

At least not for the next few months.

Countless people come to visit her salon every day. Everyone wants to see the auxiliary hall where the British royal family's heir was successfully delivered, look at the oil paintings on the wall, and hear the whole story.

This made her already tight social life even busier.

It is not easy to gain a foothold in the Paris social circle. Without fast communication equipment, maintaining communication is extremely time-consuming. Melanie has slowly developed from a social newcomer to the leader she is today, and only she and the ladies in her circle know the effort required.

After marrying her banker husband, she tried to attend every gala and dinner party she could, gradually branching out into public concerts and private theater performances.

As her connections gradually grew, garden parties and tea parties were also included in her daily schedule.

In addition to these basic social activities, she sometimes held white dances for young girls entering the social world and rose dances for young couples. When she has her own salon, she will also hold salon balls and charity dinners. Of course, in order to reciprocate, she also has to attend other people's salons.

When her connections reach a certain level, no matter how full her schedule is, she still has to attend important opening ceremonies, buffets, engagement banquets, costume parties, and embassy balls.

When her pastime changed from "never-ending carnival" to entertainment work, when she went from a social newcomer to the top, in order to maintain the glory of her family and class and play a role in Paris social circles, she had to spend almost all her time on herself. Dress up as a beautiful treasure in the eyes of others, and fall into the vortex of endless cycles every year, every month, every week, and even every day.

"As you command, ma'am."

She found one belonging to the Countess of Chevergne from a pile of famous invitations, and handed it to the coachman: "She is going to attend the engagement ceremony of her relative's daughter today, and she will definitely not be at home. When she arrives, hand the invitation to her. Give it to the butler and we’ll leave.”

Including extra seats, thousands of celebrities need to compete for less than 100 seats and tickets, turning "admission" into a dividing line between the top of the social circle and the lower class, vividly demonstrating that "prominence to the audience itself is also an important performance" .

A total of 26 operations were performed in one month, with 0 mortality and 23% infection rate. Almost all surgical goals were completed, crushing all peers.

At 12:22, Melanie left the Count's Palace of Chevergne.

Melanie is lucky enough to be a part of it.

The treasures in her eyes, the two naughty children who had just learned to speak, could only be left in the care of the nanny.

"Next is the Duchess de La Tremoyer."

The Countess of Bortale's schedule today started at 8 a.m., and it has been 4 hours now, and she still hasn't stopped for a moment: "The next step is to go to the Count de Chevergne Palace."

At first, these noble ladies, including Melanie, had no interest in Carvey. Later, Queen Eugenie took the lead and promoted cesarean section and shortened the original autumn and winter hunting season by two months. The ladies could only end their country manor vacation early in early November and return to Paris to start a new round of socializing. 【11】

Melanie looked down at the time, put the post away helplessly, and told her next destination: "It's almost too late. After leaving the Earl of Chevergne's Palace, we will go to the Bois de Boulogne first. The time has been advanced today. We must Go there early and show your face. You will be the lead car then, but you have to stabilize the carriage so that no one will laugh. "

From the completion of Alphonse's hand skin grafting a week ago, to the sudden fermentation of Alex's cesarean section, to Bizet's throat cancer surgery today, in less than half a week, the news that Caviere is leaving Paris has spread There was an uproar.

"Surgery?" The maid shook her head, "No, ma'am."

Melanie lowered her head to touch up her makeup, put on a pair of loose shoes that she usually wore when walking by the lake, then took Little Keith from the maid's hands and hugged her into her arms, and suddenly asked: "Olena, have you seen it? Surgery?"

"Ok."

Socializing in the winter is no easier than in the spring. In addition to the evening parties and banquets, their daytime schedule is also packed.

"As for the Duchess's house, I can only wait until the evening before going there. Alas, it's always been a mess lately."

In fact, she had a chance to get the tickets, but the salon delivery scene was too explosive, and by some combination of circumstances, she transformed from a marginal role to an organizer.

However, something unusual happened this year. There was a war between Pu and Austria in the autumn, and a certain surgical genius was welcomed in the winter.

The stage is supported by 12 columns, and the stage is divided into two stands on the left and right, each with 20 seats.

It would be a waste to limit viewing to medical insiders for such a legendary closing operation in Paris. Therefore, the Ministry of Foreign Affairs and the Surgical Association specially discussed not only extra seats in the largest surgical theater in the country, but also specially invited urban planner Georges-Eugène Haussmann to help build a second-floor viewing platform.

At 12:47, the carriage arrived at the Bois de Boulogne Park, leading other carriages in a parade and enjoying the gazes of passers-by. Especially those so-called diplomats who wear top hats and long dresses and are in the middle and lower classes of social circles. 【2】

At 1:23 pm, they went to St. Augustine's Church, located at No. 46, the southern end of Maleserbe Avenue, to greet Emperor Nazionale and Empress Eugenie, who had just finished church and had lunch.

The couple wore all-white gowns with flowing pearl necklaces around their necks, and were accompanied by their son Prince Louis. Under the escort of the Paris Guards, he got on the Crown Carriage, collected the convoy led by Melanie, and headed for the Surgical Association.

Arrive at the Surgical Association around 2:00.

After the greetings of the royal family and nobles who were watching the operation were over, they all took their seats. The host, Vice President of the Surgical Association, Huo Te, stood in the central operating area and announced that the operation was about to begin.

It was obvious that he was not a good speaker. His voice was too low and he could not immediately attract the attention of the noisy celebrities. His opening words were also not very good:

"Your Majesty the Emperor and Empress, ladies and gentlemen, welcome you to condescend to come to the Surgical Association to watch the operation. To be able to see you sitting in the operating theater in my lifetime is not only an honor for the Parisian surgical community, but also for the world's surgical community. I would like to express my gratitude as Vice President The position of president and more than 20 years of surgical experience guarantee that your trip will be worthwhile.”

Of course, the following speech of the Three Emperors, although it could be heard by everyone and attracted their attention, the content was also not very good:

"As Vice President Sartre said, Paris is the center of the world. Surgeons from all over the world focus here and devote themselves to the endless medical road, moving towards academic peaks. Praise France, praise Paris! Praise everyone A group of doctors who work tirelessly for human survival and health.”

After all the polite talk in these scenes is over, then the real knowledgeable people will enter the scene.

Rudolf Sallis is a somewhat crazy painter, but he is better known as his deputy, theater director. Today he was invited to preface the operation, and he made a startling statement:

"Your Majesty the Emperor and Queen, ladies and gentlemen, the person who is about to appear today is the best surgeon in the world, a young man who is famous for creating hundreds of new surgical techniques and constantly creating surgical myths. A true pioneer of medicine. He is the sharp blade of angels fighting against demons, the hands of God spreading grace, and the holy light that continues human history!

This is not my personal praise, but the judgment of everyone present and the consensus of all surgeons in Paris, the center of the world. Now, please, Dr. Kavi Friedrich Hines! ! ! "

For the sake of the scene, Kawi did not show off in a shirt and leather skirt today, but put on a dress first to show respect for the guests present. After entering, he was naturally greeted and polite, and then quickly introduced his assistant:

“The first assistant, Professor Sedieu de Paul Cavendish, is also the Director of Surgery at the Hôpital du Dieu in Paris.

The second assistant, Hermann Zalul Post, is the chief surgeon at the Department of Surgery at the Vienna City General Hospital.

Third assistant, Damilgan Moore Scarlet, resident surgeon at the Vienna Stadthospital.

Sideline assistants were Dr. Bergert von Celestine from the City General Hospital, Dr. Good Hope Chung from the Main Palace Hospital, and Dr. Jack Wolfe from the Glasgow Eye Hospital.

Finally, we would like to introduce our surgical assistants, the anesthetist Amor Godwin and the instrument nurse Karen Bettina from the Diocesan Hospital. "

The luxurious lineup that is completely different from ordinary surgeries, including anesthetists and nurses, is even more confusing to the VIPs on the second floor. After Kawei patiently made a brief introduction, he began to get down to business in a real sense: "Next, I would like to introduce to you today's patient, the genius playwright and composer, Mr. Georges Bizet!"

Unlike the doctors who were all dressed in fine clothes, Bizet had already put on his hospital gown and walked into the theater under the guidance of two nurses.

He did not forget the inspirational topic he had discussed with Kawei before, and his ears absorbed the noise, laughter and Kawei’s introduction to the disease:

"Mr. Bizet has a severe chronic cough, and sometimes you can see blood in the sputum. These only symptoms made me think of throat cancer, a dangerous disease that can kill the ability to speak in a short period of time. Fortunately, , Mr. Bizet's throat mass did not affect his vocal cords, and his voice remained intact.

Based on the results of the previous laryngoscopy, we basically determined the scope of the mass, which only invaded the supraglottic area. "

After that, a wide cloth slowly fell from the ceiling, with the anatomical structure of the throat on it. 【3】

Kawei continued: "In the anatomy textbooks of various medical schools, the anatomy of the larynx is often the least. Because except for tumors, its lesions hardly affect people's daily life, and no one will do it for throat lesions. Last surgery where he was likely to die on the spot.

But now I have to say, folks, times have changed.

The throat is an important part of the human body, and throat cancer can quickly consume a person's vitality. Look at this playwright genius. He has been severely tortured by throat cancer, and even his work that he used to have at his fingertips has been greatly affected. Today, I want to help him solve this trouble! "

Although a lot has been said about laryngeal anatomy, examination of laryngeal tumors, and subsequent laryngeal cancer surgery, the first step in surgery is always anesthesia.

With a cry of "good dreams", Bizet fell asleep under the anesthesia mask given by Amor. However, what comes next is not throat cancer surgery, but another preparation work.

"Dr. Hermann will be responsible for handling the tracheotomy prior to laryngeal cancer surgery."

As soon as he finished speaking, everyone present was in an uproar.

What caused an uproar was not Kawei's ability, but the "tracheotomy" that occurred during the operation. Paris and even the whole of France are very familiar with this word, and there is another word that often goes hand in hand with it, and that is "diphtheria".

Throughout the early 19th century, France suffered terribly from this disease. From the nephew of Napoleon, the brothers of the three emperors, to the common people, they were all brutally murdered.

As the only tracheotomy that could solve the symptoms of diphtheria asphyxiation at that time, it once became a skill that Paris surgeons must master. However, because there was no anesthesia and insufficient technical research, the number of deaths from tracheotomy was not much less than that from diphtheria.

However, before Carvey was about to leave Paris, he brought a tracheotomy that he "disdained to operate", which seemed like a sharp irony of Paris's self-proclaimed world's best surgical technology.

Cediyo did not expect this to happen. He stood aside and said in a low voice: "How many surprises do you want to bring us? When you take out the tracheostomy, have you thought about the feelings of the doctors present? Have you ever thought about His Majesty’s feelings?”

Of course, Kawei didn't have such evil intentions. It was just a step that needed to be done before simple laryngeal cancer surgery: "What's wrong? It's just a tracheotomy. I remembered it. The teacher seemed to have said it before."

"so"

"This is something that must be done before surgery. What can I do?"

After complaining, Kawei explained why a tracheotomy is routinely performed before laryngeal cancer surgery. It is simply to protect breathing and avoid the trouble of blood flowing back.

During this period, Hermann ignored outsiders, washed his hands early, and then took out the tracheostomy instrument box from the storage box, which contained the required tracheal bending tube, insertion tube and expansion bend. clamp. 【4】

Kawei put on an apron and began to wash his hands: "We first put a pillow under the patient's shoulders and tilt the head back. At this time, we need to determine whether the patient's breathing is smooth. If there is any abnormality in breathing, remove the shoulder pad. Of course, there are We may encounter patients who cannot lie on their backs, then we need to adopt a semi-supine or sitting position.【5】

A straight incision was made from the upper edge of the cricoid cartilage to the suprasternal notch. 【6】

The skin, subcutaneous tissue, and superficial cervical fascia were incised sequentially. "[7]

Kawei washed his hands, took the gloves from Karen, and asked while putting them on: "Did you see the superficial jugular vein?"

Herman's speed was the same as his speaking speed, and he could already see the veins: "Yes."

"How to do it?"

"I will try to use small hooks to retract them to both sides. If there is too much adhesion to the surrounding tissue or it cannot be retracted, I will cut off the ligation."

"Okay, after retracting the superficial jugular vein, start to expose the trachea layer by layer."

Suddenly, Kawei no longer looked at Herman, but looked up at the seats where the doctors were sitting, and asked: "Then the question is, starting from the subcutaneous tissue and superficial cervical fascia, to the front of the trachea, how much does Dr. Herman need to separate? layer organization?”

(End of this chapter)