Nineteenth Century Medical Guide

Chapter 383 379. Zhen Shui Yin

The grievances between Kavi and Mick that have been entangled for so long have long been unclear from Vienna to Paris and then to Zurich.

After pulling and pinching each other for so long, and now seeing him coming to the hospital alone, still taking the same path to the internal medicine clinic, I feel an indescribable feeling in my heart.

Putting aside these troubles and entanglements, they can be considered old acquaintances. After all, he was the first person Kawei saw when he came here. Kawei didn't know how Mick felt now. At least after the end of the Austro-Prussian War, he disliked him much less, and the relationship had slowly faded to the level of an ordinary colleague with some malicious intentions.

Kawei decisively agreed to the wealthy businessman's request for 2 surgical fees, gave the operation time to Beget, and found Mick himself.

Mick felt uncomfortable before going to Paris. After going to Paris, he was busy with the security issues of the Queen and Kavi. He saw a physician once or twice and ignored it. Since leaving Paris, this kind of intermittent abdominal pain has become more obvious. It's not unbearable, it's just ordinary swelling and stretching pain. I think I can just ask a local doctor to prescribe some medicine.

This is not the first time he has come to this hospital. He has visited this hospital before. After using the medicine for nearly a week, the effect was very average. He wanted to come back today to see if he could try a different medicine.

"You're too outspoken." Kawei took him to the surgical clinic on the first floor and said as he walked, "Your health determines the safety of Her Majesty the Queen. You can't be careless. You can come to me at any time if you feel uncomfortable in the future. "

The haggard-looking Mick was less sinister in the hospital, and even a little embarrassed. Without the title of security chief, he is no different from an ordinary middle-aged man who works well: "You are a busy man, involved in the diplomacy between France and Austria. Isn't it a waste of your time to ask you for help with such a small matter? Time. Besides, I just have a stomachache, it’s nothing serious.”

When Kawei heard the symptoms, he turned around and glanced at his thin face: "You seem to have lost weight recently, and your face is quite ugly."

"The second time I came here, I was given a prescription. Well, maybe it should be called a recipe, or a seasoning formula, right!" Mick took out a beautiful handwritten piece of paper with a lot of ingredients written on it, "said I drink some of it when I eat, and it helps regulate my digestion. It also makes me soak in the hot springs here, which is very helpful for my body.”

Kawei simply took notes and continued to ask: "Does it hurt obviously after eating?"

"Correct."

Put 2 teaspoons of ginger powder into a mortar, chop 50g of Jamaican sweet pepper, add 1 teaspoon of chili powder and 3 teaspoons of ground coriander seeds, mix in some nutmeg, and finally pour half a bottle of red wine. After mixing thoroughly, you need to add some unknown plant root powder.

"Yeah, maybe it's because I never had much appetite in Paris."

Kawei could already predict how outrageous this piece of paper was, but he couldn't help but shake his head after unfolding it.

"Is it because I prefer Viennese sausages?" Mick rubbed his stomach and followed Kavi through the door. "Maybe it's because I was too busy at work and under great security pressure. I was so hungry that I forgot to eat."

Long-term abdominal pain can screen out many diseases, but the remaining ones are not easy to identify, so you can only take it step by step. Since it is chronic pain in the abdomen and its location is in the upper abdomen, it is basically related to the gastrointestinal tract. When it comes to the digestive tract, vomiting and defecation are two important things that cannot be avoided.

Kawei didn't respond, but gently pressed his stomach to see his reaction. He was suddenly very interested in the content of his medical consultation: "What did the doctors here give you?"

"I've had a few times, just recently, and all I vomited were things I ate. But I usually don't eat much, so the amount of vomiting is very limited." Mick always feels that his 40-year-old body will be fine. , "Other symptoms are fine, nothing uncomfortable."

Kawei glanced at the words written on the ingredients [Goode Kabarel's special fresh sauce], then gently folded it and returned it to his hand: "Forget it."

"Probably, about 4 months." Mick replied, "I can only give an estimate of the time. I forget the specific time."

Mick explained: "The doctor said that just mixing these things into a paste and spreading it on bread and vegetables can help eliminate flatulence and make your stomach easier."

Perhaps it was because he changed from a security chief to a patient that his character became much more restrained: "I really have to forget about it. The taste is indescribable. It's like sending a good Vienna sausage into a British kitchen. It's not hard to swallow anymore." It’s descriptive.”

This rhizome was so weird that Kawe had never seen it in his college plant class. The doctors here are also very particular about it. They specially marked it on the side. It should be an indigenous herbal medicine from somewhere in Iran. It is sold in the pharmacy next to the hospital.

Kawei happened to see the position where his hand was covering, and combined with the gloomy expression on his face, he felt confident. He first found a bed to lie down on, with his legs bent, preparing to do a simple abdominal physical examination. Just as soon as the hands came into contact, a troublesome feeling came from the fingertips, and the question followed: "How long has it been hurting?"

Mick had never seen Kawei's appearance when he received a doctor. He was stunned and replied: "About half a year."

"Have you ever vomited?"

"That's where chefs gather. How can I lose my appetite?"

"At first, they said my excretion was not smooth enough, so they gave me an antimony pill." Mick took out a paper bag from his pocket and wanted to open it, but Kawei declined, "Then what? This thing should not only make you excrete continuously. , it will have no other effect until you see it again.”

"Exact time."

"The pain is in the upper abdomen, not just in the stomach, but also in other places." Kawei was not easy to judge, and his hand changed from touching with one hand to tapping with both hands, and he had to continue asking, "Really? Any other symptoms?”

Mick shook his head.

Kawei turned his body to one side, tapped his abdomen gently with both hands, and helped him recall: "How has your bowel movement been lately?"

Mick felt like a role reversal. After asking questions to others for so many years, this was the first time he was being pursued like this. Perhaps something called self-esteem was at work, and his answer slowly became vague: "It's okay."

"Is it okay?" Kawei frowned, knowing that it was inappropriate to ask, so he further refined the question, "Has the color gotten darker?"

"It gets darker. Oh, it has happened before, just last week, and once or twice when I was in Paris. When I pulled it out, it was black and sticky."

"Black stool." Kawei made another note, "Has the color ever faded?"

Mick was confused. What was going on was getting darker and lighter. But even a veteran like him who was very good at interrogation didn't realize that such a simple question, like an inconspicuous pebble, stimulated the memories that had sunk in his mind.

"When you say that, it seems that it has really faded away."

"Judging from your reaction, it should be different from the occasional black stool. It has been going on for a long time." Kawei seemed to have grasped the key point, "When did you start to notice that it became lighter?"

"About two months ago, when I was leaving for Paris." Mick felt strange, "Is the color of stool related to stomach discomfort?"

Kawei ignored him and wanted to take advantage of the rhythm of the questions to continue to ask some questions: "What color is it specifically? White? If it is yellow, what kind of yellow is it? Light yellow? Or..." "Actually, it hasn't changed. It's too light, just like ordinary light yellow." Mick couldn't find the right words to describe the color. After thinking for a long time, he could only find an inappropriate comparison, "It's more yellow than white, and it's more yellow than Nasanzai. The carriage gilding is lighter."

Kavi:.

At this time, there was a noise outside the window, and several figures could be seen passing quickly through the curtains. Mick immediately became alert out of professional habit. He pressed his hand on the suitcase that had been kept beside him, avoided the light and hid in the darkness as much as possible. It wasn't until nothing else happened that I realized it was just a hospital staff member.

Even after he relaxed, he still stared out the window and at the door, and even his tone became stiff: "What I said is the truth, and I didn't mean to slander the French Emperor. It was just a color."

"This is Switzerland, and it's a hospital. It's not the old town of Vienna. Don't be so nervous."

Mick sighed: "I'm used to it, maybe I won't be able to change it in this life."

Kawei did not ask any more questions this time, but came forward to take a closer look at his face, and then gently raised his eyelids with his hand: "Don't you think your face has darkened recently? And your eyes, too. Not as energetic as before.”

"is it?"

Mick didn't care about this. Seeing Kawei take back his hand, he sat up and said, "What does Dr. Kawei think is my problem? What medicine do I need to take?"

Kawei must have suspicions, and they are highly suspicious, but there is still no definite evidence. He did not answer, but continued to ask questions. In the 19th century, when there was a lack of diagnostic tools, apart from physical examination, the only way to get closer to the final diagnosis was to rely on the accumulation of symptoms.

He put down his pen and his attitude gradually softened: "Do you feel that you have no energy recently?"

"It's a bit. It's quite normal as you get older, and you can't guarantee enough sleep time." Mick pinched the skin on his brow bone with his fingers, "Is this related to stomach pain?"

"Have you ever choked on something? Or have difficulty swallowing?"

"Why are you always asking questions?"

Mick, who had never experienced modern medical consultation, seemed a little impatient, maybe because of work. He didn't like the feeling of being asked all over the place: "It's just abdominal pain. He asked so carefully, is it me?" Do I need to tell you what I’ve eaten these days?”

"You really have to tell me." Kawei took over, "But before that, let's answer the question just now."

"I haven't choked, at least not in my memory. I have difficulty swallowing. I do, but it's not a big deal. It's just that the French bread is too hard." Mick knew that he was going to ask where he was stuck again, so he Pointing to the position a little above the protrusion of the sword, "Here, it's stuck here. It will go down after a while."

"Okay, let's talk about what we ate."

With Mick's appetite, he really didn't eat much, and it was all soft and tender fish, mushroom soup, sausage slices, eggs and soft bread. He basically didn't touch ham, steak and many hard and chewy things.

Since he asked about food, defecation became a new problem for Kawei: "Here comes the question, since you said before that you can defecate, why should you be prescribed antimony to help with excretion?"

"Because my bowel movements have not been good recently, and as you can see, I seem to have lacked exercise recently, and my belly has become bigger."

"So why didn't you tell me before?" Kawei went around in a big circle, collected most of the symptoms, and finally took out the stethoscope, "Lie back, I still have to listen to the sounds in your body."

His approach is completely different from those conservative physicians, and he has never stopped since he started receiving patients. Palpation and percussion brought up quite a bit of information, and combined with Mick's seemingly simple yet complex symptoms, the diagnosis was right there on the tip of his tongue. But Mick's identity determines that this diagnosis is not good, not only for himself, but also for the Queen and Austria.

"The heart rate is 113, which is a bit fast."

Kawei's face darkened, he held the receiver in his left hand and moved it downwards, and placed the four fingers of his right hand together further down, "You just drank some milk and a small piece of bread for breakfast?"

"Well, I couldn't drink it after two sips. It's about half a piece of bread."

Kawei nodded, and gently touched his slightly bulging abdomen with his right hand. A very obvious sound of liquid and gas hitting his ears was immediately heard. This is not the amount of two mouthfuls of milk, it is a typical positive sound of vibrating water. The vibrating sound indicates gastric retention. If it is on an empty stomach or 6-8 hours after eating when the stomach should be empty, it indicates gastrointestinal obstruction.

Anorexia, abdominal distension, abdominal pain, vomiting, occasional black stools, recent changes to light yellow stools, weight loss, weakness, difficulty swallowing, dark complexion, slight jaundice of the sclera, but no Murphy's sign, which can be detected by palpation Abdominal mass, mild ascites, gastrointestinal obstruction.

The previous assumptions were basically correct, and Kavi couldn't think of any other disease that could encompass all these symptoms at once.

"The situation is not good, you have to do well."

As soon as the words were spoken, there was a very urgent knock on the door, and at the same time there was Bergt's shout: "Kavi, Kawi!!! Things are not going well!!!"

"What's wrong?" Kawei didn't answer the door, "I'm busy here."

"Just now, the Hofstetten Clinic arrived in a carriage with a patient!" Bergt took a breath, swallowed his saliva quickly and continued, "The situation is not good, a lot of things have happened. Blood, robe, robe, shirt and pants are all blood!”

This kind of emergency room is naturally different from an outpatient clinic. If it is an ordinary trauma, other surgeons can also handle it. There is no need to come to this place to find yourself.

Kawei quickly stood up and opened the door: "Tell me clearly, what's wrong?"

"It's the Swiss Federal Council member who stayed in a hotel with us. You've met him before." Bergert didn't know how to describe the matter clearly, so he could only start from the beginning, "His son, a freshman I rode horseback to a horse farm outside the city early, saying I wanted to experience it."

"Tell the important point!!!" Kawei interrupted him.

"Oh, he wants to play with those fierce horses at the racecourse. Those horses are hungry and very grumpy."

"Then what happened?"

"The young man reacted very quickly. Most of his body was dodged, but it was a pity that a small part could not be completely dodged." Bergt looked down, but it seemed inappropriate to look at Kawei, so he could only continue to look towards him. He looked down at his own, "Professor Sedieu and I both looked at the wound. It's quite serious. It feels like it's going to break."

(End of this chapter)