Nineteenth Century Medical Guide

Chapter 47 46. Inspection

Carvey didn't have a good impression of the 19th century, and the inconvenience in life was secondary. The main reason was that the medical equipment was too simple and he couldn't use his fists.The lack of disinfection and antibiotics is even more of a nightmare for surgeons, seriously affecting his enthusiasm for work.

But a person who has been able to work in the clinic for so many years without too many complaints has already cultivated the skill of taking pleasure in suffering to the full level.

It has been the sixth day since he came here, and he has slowly discovered many benefits that are not available in modern times.

There is a huge gap between the identity and culture of doctors and patients. Patients trust doctors very much and almost obey them.At the same time, because of the lack of a medical system, doctors do not need to spend a lot of time talking to explain the disease, not to mention that many doctors can't explain clearly.

There are feudal class factors left over for thousands of years, and there are also dividends brought about by the rapid development of medical technology from ignorance to modern times. It should be able to stand firm for another few decades.

Of course, there is no doubt about the necessity and importance of talking from the patient's perspective.It's just that since the hospital doesn't have regulations in this regard, those lazy or self-centered doctors like Carvey will automatically omit this process.

If the patient is still his acquaintance, the process will only be easier.

But sometimes in the eyes of the other party, he is not yet familiar enough to do a finger check directly.

Now most of Alphonse's face is full of doubts, and the rest of the face is uncomfortable, incomprehensible and a little embarrassed: "What are you doing?"

"an examination."

He sighed, and simply relaxed his muscles and lay on his side on the examination table.However, as the examination progressed, his expression became a little painful: "Can you be gentle, it hurts."

"It still hurts like this?" Carvey picked up a piece of linen and threw it in front of him, "I've already done it with my bare hands, do you want to try wrapping it up?"

"Then, let's forget it."

Surgeons have always been informal, especially those in the bowel department. Those private parts are usually their working areas.As a hard-working enterologist, in line with the principle of loving work, naturally I will not shy away from this kind of place.

And Carvey may have gone a step further than his enterology colleagues.

Of course he didn't like to do this inspection, but compared to those gloves full of germs, washed fingers are still cleaner, not to mention that there are no gloves here.It is not impossible to use cloth strips such as cotton cloth and linen, but unfortunately it will seriously block the touch on the fingers, which is not good for finding the breach in the intestine.

However, these factors alone are not enough to make him sacrifice his fingers, and he is not taking care of Alphonse's feelings, it is entirely because the chef's ass has limited conditions and is not suitable for rough treatment.

"Your hemorrhoids are a bit serious, how long has it been?"

Faced with old illnesses, Alphonse seems to have chosen to lie flat: "I don't know how many years, anyway, it's just a little uncomfortable and inconvenient, and it's not a big problem."【1】

"I usually bleed a lot."

"Come out, I'll treat it as bloodletting, it's good."

"But you are too serious."

Carvey is not an enterologist, and his knowledge of hemorrhoids is not extensive. He still stays in the prolapse and thrombus of modern people.In terms of grading, other people are classified as IV only after reaching the IV standard, and Alphonse is because the highest is only IV. 【2】

"It feels like it's all incarcerated outside, so you don't feel any pain when you duel?"

"It will definitely be a little bit if you encounter it, but it's just like that when you get used to it."

"I think it's better to cut it. If Mr. Ignatz came, he would also choose the operation. There is really no need to delay it."

On the whole, Alphonse trusted his new friend.

Not only because he made the headlines of the evening paper today, but also because of his previous judgment on his liver and the calmness he has always shown.In comparison, the three who took Li Ben to another ward were much worse.

"That's all right, the operation is the operation, it shouldn't be troublesome, right?"

"Let's talk about this tomorrow." Carvey washed his hands and found the inspection tools in the cabinet. "Don't get up in a hurry, it's not over yet."

Looking at the complicated toolbox in front of him, Alphonse frowned: "You might as well give me an enema, and then swallow an eternal life pill [3], no matter how many dirty things are in my ass, it can Quick clean up."

"I'm checking the wound, not washing the butt!" Carvey emphasized the necessity of his work, and suddenly asked, "Eternal Life Pill? What?"

"Haven't you seen it? It's just a little black pill."

After he mentioned it, Carvey seemed to recall that he had seen a medicine box when he went to the pharmacy, and it said "Eternal Life Pill" on it.

But now he doesn't care about all kinds of medicines, the other party's wound is more important at the moment.If it's just mixed hemorrhoids, it's okay, and the treatment method is not too difficult, but if the trauma wound penetrates the intestine, especially the part above the dentate line, it will be really troublesome.

With the current surgical conditions, sooner or later that place will become a water tap without a valve, just like a water pipe that goes straight in and out.

Fortunately, the fingers that just penetrated did not touch the breach. Considering that the touch of some breaches is not obvious, for the sake of safety, some props are still needed.

"I'm going to continue to use some equipment, you have to bear with it."

Alphonse immediately became nervous when he heard it, thinking it might be something terrible.Unexpectedly, when I raised my head, I saw a slightly curved stick in Carvey's hand. The texture should be silver-plated brass, which is very hard, but the thickness is a little bit different: "That's it?"

Carvey moistened a clean cotton cloth with the fortified brandy he just got from the pharmacy, and while scrubbing the stick, he felt amused: "What? Not enough?"

"Hehe, this is too thin." Alphonse felt relaxed, "By the way, what is that bottle in your hand?"

"Wine, it should be brandy."

"You actually want to use brandy as an enema, senior! Why didn't I think of it before?"

Carvey knew that people in this era are still obsessed with this way of cleaning the intestines, so he didn't care, and just said casually: "This bottle of brandy is also very different."

"Why is it different?"

"It will be more exciting."

Alphonse burst out laughing: "I just like excitement, hurry~"

Carvey was stunned for a moment, and found that they were not on the same channel, and warned: "Not only is the wine stimulating, but this stick is also very stimulating."

"Forget about the stick, it's not the first time I've had an enema." Alphonse didn't pay attention to this combination at all, "If you have this spare time, why not just put a whole bottle of brandy in it. By the way, you Is there a pump here?" [4]

"The stick still has to be used, it's a rule! Although it's much thinner than my finger, thickness has always been a relative concept, and it's not at all thin compared to where it's going to go."

After finishing the simple disinfection work, Kawei moved his hands very fast, without giving him any time to react, he stretched out his finger and inserted it back to the original place as soon as he finished speaking, and then controlled the stick to slowly stab it through the wound pierced by the rapier【 5]: "Don't move around, the wound will open, and you will never be able to cook again."

Alphonse never thought that the so-called stimulation would look like this. The forcefully opened wound combined with strong alcohol felt like being pierced by a thorny Langya stick.

He gripped the mattress with both hands and was trembling with pain. He wanted to speak, but his strength was all in his lower body, and he couldn't convey his throat and mouth: "You"

"Don't move!" Kavey warned, and he couldn't help using more strength in his hands, "You don't want to cook half of your pants and leak a lot of shi."

"I"

"Don't be nervous, just see if the sword wound has penetrated the intestine. If it penetrates, there will be a breach inside, and it will be very troublesome if you don't deal with it." Kawei fiddled for a while, accompanied by the bloody wound, shaking Shaking his head, "It doesn't seem to be pierced, good luck."

In just 1 minute, Alphonse was drenched in pain. After a while, he could hold back a sentence weakly: "If it weren't for you. You are a student of Ignatz, I would definitely have to fight with you. You duel with you!"

"Are you still dueling?" Carvey cleaned the equipment and hands again, and then turned over Ignatz's box. "I'm afraid you will have to lie in bed for half a month after the operation."

"It will take that long?"

Kavi nodded.

"Then I can only choose to give up the operation, and I must fight Li Ben!"

Since it was a patient brought into the hospital by himself, and he did the examination, Carvey had already identified Alphonse as his patient.Once the fat sheep is in his hands, how could he let it go so easily? Even if it is tied, he has to be tied to the bed: "I think it's better to forget it."

"Can't count!"

Seeing that he was so persistent, Carvey could only tell the truth: "You are seriously injured, and you have no paper or pen in your hand, let alone writing a letter to the newspaper office, even if you walk, you can't get out of the gate."

Alphonse didn't believe it at first, because there was no problem when he got into the carriage before.But as soon as he moved, he suddenly felt something was wrong.Kawei's stabbing just now was really powerful. It not only enlarged the wound, but also made him unable to move in pain.

"I said you can't move if you can't move." Carvey slapped him on the back with a whole bottle of brandy in his hand, "Lie down and lie down!"

Early the next morning, Ignatz walked quickly into the third ward as usual, and seemed to have completely shaken off the burden of failed tracheostomy.He was greeted by nurses from the surgical ward, and Karvey, who hadn't slept well after hours of work.

Ignatz glanced at the ward and asked, "Why are you alone?"

"There was an operation this morning, and Bergett and the others went directly to the theater." Carvey explained, "After all, I didn't go home all night."

"Didn't go home? Didn't Bergett ask for leave yesterday and stayed home?"

"It's a long story." Carvey felt that it would be better to introduce the patient first, and said directly, "Teacher, let's get to the point first. Two new patients came last night, and they were lying on the 28th bed in the waiting room and the orthopedics department. 5 beds."

"Oh? What's the problem?"

"The two fought. The skinny Bed 5 was stabbed in the chest. It was a little red and swollen. The sternum was probably split. The fat Bed 28 was stabbed in the ass with a sword. It was very deep. I happened to be there at the time and took them all. come over.

It is estimated that there is no problem with being thin, and it will be fine after a period of cultivation.The fat one is more serious. I found that he also has severe hemorrhoids, but luckily the sword wound is not a big problem. "

Carvey quickly described Alphonse's condition: "I have treated the wound and stuffed it with a thin tampon. As for the hemorrhoids, I personally think that surgery is needed as soon as possible."

Ignatz took the empty medical record from the nurse, picked up a pen and wrote the admission situation on the paper: "You said the sword wound stabbed the ass?"

"Yes, from the lower edge of the gluteus maximus side."

Ignatz's first reaction was the same as that of Carvey: "It won't be a fistula."

"I checked with a probe and the wound wasn't that deep."

"In the final analysis, the probe is only used to check ordinary steel fistulas, and is not suitable for poking with sharp weapons." Ignatz shook his head and said, "The reason is very simple, because the end of the probe is round, and the rapier is pointed. There are openings in the intestinal tube, and the probe may not be able to reach the deepest position."

Carvey nodded again and again, not only took a note of paper to write down the passage, but also said a bunch of compliments.But in fact, this factor has already been taken into consideration by him, otherwise Alphonse would not have been in so much pain last night.

In the final analysis, Laszlo's aggressiveness did too much damage to Ignatz's spirit. Today, Kawei had to sell a loophole to restrain himself: "So that's the case, I didn't think about it."

"You don't deal with trauma much, you just lack experience."

Ignatz quickly wrote a few paragraphs, then threw away the medical records and ran to the examination room to take out his equipment box: "You used the probe here yesterday?"

"Correct."

"In fact, for the inspection of such small fistulas, we generally choose to observe directly."

"Observation? How to observe in the intestine?"

This time it was Kavi's turn to frown.

If you want to observe the internal wound directly, unless the wound is very large, you won't be able to see it even if the intestine is dilated.But once it reaches the level where the opening can be seen intuitively, there is no need to take a lot of effort to observe, and fingers can completely touch it.

And high-end products such as endoscopes were a fantasy in the 19th century, and it is impossible to have them.
"This is a steel mirror invented by the Germans."【6】

Ignatz closed his equipment box, took out a strange thing from the cabinet in the ward, and introduced: "This is a new thing that just became popular a few years ago. I heard it works very well. It just so happens that this patient There are also serious hemorrhoids, so we simply checked them together."

"Can this thing see inside the bowel?"

"Yes." Ignatz flicked the switch below with great interest, and made a demonstration.

"What about the light source?" Carvey still felt strange, "It's pitch black inside, you can't see anything without the light source."

"Of course there is a light source!" Ignatz looked back at the nurse, "Come on, bring the kerosene lamp on the wall."

(End of this chapter)