Nineteenth Century Medical Guide

Chapter 470 466. Lonely Fernan
Because of the French's indifference to Maximilian, who was promoted to puppet emperor in Mexico, the American Civil War was viewed with indifference. Moreover, people were more sympathetic to the defeated Confederacy, even though they opposed slavery.

However, Mexico's plan failed prematurely, and France's resentment towards northern Americans soon disappeared. Fortunately, Maximilian was successfully persuaded to come back, otherwise the relationship between France and Austria would have been ruined.

This bankruptcy has shaped the image of the United States in the minds of Europeans from another perspective.

Europeans marveled at the integrated industrial power and rapid productivity of the North, and also at the successful suppression of the world's most amazing rebellion. Because of this war, and the huge wealth brought by high productivity, the actual status of the United States has reached the forefront of the world.

The French, who benefited from the World Expo, have the most say.

The hotel managers, clothing store owners, department store owners, and employees of various companies on the streets of Paris are very welcoming to Americans. They spend money generously, rarely bargain, and are not as pretentious as the old European aristocrats. In addition to squeezing into the invitation list for the Tuileries Palace ball, they come to Paris just to spend money.

Of course, if you like something, you will naturally dislike it.

The old nobles, led by Darnay, were very disgusted with the rude way Americans spoke, and felt that they lacked education, acted casually without principles, and had no artistic beauty in their gestures. At the same time, they were disgusted by the American flag flying everywhere in Paris, the cheap American goods everywhere, and even more disgusted by Lincoln's portrait being placed next to portraits of other celebrities.

This actually has nothing to do with nationality. They are disgusted by all nouveau riche.

August is considered to be a relatively moderate person among those who "don't like America". Of course, he has many things that he dislikes about Americans, but most of them are related to his medical profession.

American medical students are a whole level lower than those in Paris. American medical masters may not even be as good as undergraduate medical students in Paris. They have poor learning ability, narrow knowledge, too hasty actions, and lack of reasonable planning and research spirit. Perhaps "innovation" can be regarded as an advantage, but "innovation" without any basis is just a fantasy and a disaster for academic research.

This is also the reason why almost all hospitals in Paris do not recognize American diplomas. As the chief of the Hôtel-Dieu, Auguste’s requirements are naturally higher.

No matter how you look at it, James and Wade won't make him nod.

But for some unknown reason, the two apology letters pushed the unknown Holmes to the forefront. After a group of unscrupulous reporters dug deep, Holmes' identity, family background, property, and daily life were all turned out, as clear as the plowed soil in spring.

How did he get into the Hôtel-Dieu? Why was he appreciated by Kavi? And why was he able to stand out in Kavi's surgery?
With this question in mind, the reporter conducted open and secret investigations, and finally gave all the credit to Landreth, who just wanted free labor.

It turned out that it was such an open-minded and wise surgeon who successfully discovered such an outstanding rising star. It turned out that it was such a medical professor who inherited his teacher's legacy and trained the American student who had no ability to become what he is now in a short period of time.

It turned out that this "rural" doctor who was appointed to take over the mess left by Sediyo, relied on his extraordinary medical courage and strong management skills. In just half a year, he successfully transformed the surgery department of the Zhugong Hospital from a mess into a super high-level department that even Kawi could not refuse.
In order to highlight Holmes's strength, writers tried every possible means.

In the end, Landreth didn't think anything of it, but August, who had always been regarded as the chief physician of the Main Palace Hospital, felt uncomfortable.

Although the person who could sit in this position had long since become indifferent to everything, he was still concerned about the operation of the department and his own academic research. However, as he watched the surgeries being performed one after another, and the surgeries on the three emperors also receiving much attention, his existence became more and more transparent. In addition, there were comments from the outside world questioning the fairness of the chairman's evaluation, and August always felt uncomfortable.

If it was just like this, maybe after things calmed down, his mentality would return to its original position. But the appearance of James and Wade completely disrupted everything.

When a force powerful enough to change the status quo appears before one's eyes, it becomes a difficult question for the person concerned whether it is still necessary to stick to the decision that one was willing to take a step back and see a broader horizon.

With the mentality of giving it a try, August did not reject James and Wade.

James and Way were already good enough, at least their clinical thinking was not a problem, and their handling of the Batisso case was enough to prove this point. In addition, his mentor was definitely top-notch, and the medical theory level of the Three Musketeers of the Dublin School was enough to influence the development of medicine, which was only higher than that of Cavi.

Since even Stokes took a fancy to this American student, he took the opportunity to accept James and Wade.

For American students who have just arrived in Paris, in addition to considering language issues, the challenge of integrating into such a new world is both exciting and unsettling.

That's what James and Wade are like.

When he first arrived in Paris, he wrote a very brief letter to his family, expressing his anxiety and homesickness. This is why he found Delafield and Holmes to study and work together, find a female companion together, and rent a large apartment to live together.

This negative emotion was diluted a lot by the company of the two, but it never left and kept lingering around him quietly. It was not until Holmes and Delafield found their own goals and the time they spent together was greatly reduced that he seemed to have returned to his previous state.

Lonely, sensitive, and overwhelmed.
In other words, August's acceptance of James and Wade also saved him from this kind of hesitation. The full schedule of medical school courses plus the heavy workload in the hospital were enough to squeeze out the negative emotions from James and Wade's mind.

In fact, like Holmes, he had a very low status in the ward. If he were in North Carolina 50 years ago, his status would be equivalent to that of an apprentice doctor who had just graduated from high school and joined a small clinic.

This was the path that most American doctors had to take at the time, washing horses, cleaning medical instruments, helping to tidy up the clinic, and being responsible for cleaning and all clerical work. It is only in recent years that American medical schools have really been able to put themselves on the table. The educational level of medical schools at the time was so low that they were simply a lousy option of living a life of idleness and idleness.

August didn't regard James and Wade as a student, but more as a laborer in the ward and a tool to improve his status. James and Wade didn't regard August as a superior, but more as a professor who appreciated his talent and a mentor who was happy to see him grow.

With all this going on, it’s no wonder that we have the current situation.

In fact, if we had explained the difference between inside and outside to James and Wade and let him know his position, he would have insisted on watching Kavey's autopsy. But it was August's strange possessiveness, or some kind of competitive spirit that led to a dead end at the beginning.

"I, I just think that anatomy is the foundation of medicine." Janeway's voice was trembling, and he didn't know whether he was excited or afraid. "Attending Dr. Carvey's anatomy class is also a kind of learning!"

August knew that what he said was too harsh, but he still couldn't swallow it: "An internist should act like an internist. Dissection is just knowledge. To know the knowledge, you don't need to operate a knife, or watch others operate a knife." "But that was an aortic transplant!!!"

Perhaps after seeing the notice of Carvey's surgery, James and Wade did some research. When they talked about this, they suddenly felt confident: "This is a transplant that no one has ever tried before! From skin transplants to blood vessel transplants, isn't this a great innovation?"

"Surgeons like to imagine some unrealistic surgical scenes to show off their skills and talents. Of course, I am not belittling Dr. Kawi's ability. I just think they lack accuracy in assessing the difficulty of the operation and the upper limit of surgical technology."

August, who had almost no experience in surgery, couldn't understand why anyone would like such a major surgery that cut open the abdomen: "No matter how exaggerated the words are, and how much resources are mobilized, it has to succeed in the end."

"Medicine is all about trial and error. How can medicine progress if it is timid?" James Wade took off the doctor's badge of the Main Palace Hospital on his chest. "Besides, Dr. Carvey has never made a mistake!"

There was no room for maneuver at this point. James and Wade had to say goodbye to the internal medicine department, or at least to the internal medicine department of the Hôtel-Dieu. It didn't matter how to go on the rest of the way. The most important thing now was to go to the autopsy room and watch Kavey's autopsy.

Before he could act, Amadeo, who was eavesdropping at the door, took action first.

In fact, the large blood vessel transplantation animal experiment that started in early June did not go smoothly.

First, a large number of stray dogs disappeared, which triggered a wave of public opinion. Several people testified that the University of Paris was involved in evil stray dog ​​experiments, which almost exposed the university. In the end, the matter was settled. The key to the success of the World Expo and the sudden explosion at the train station attracted everyone's attention.

But even so, the experiment itself was not very successful.

6◇9◇Book◇Bar

The various preservation methods used by Kawi are all to keep the blood vessels in a dehydrated state so that the intercellular matrix will not be changed or denatured. But in fact, the reagents used will more or less cause changes to the blood vessels.

Before transplantation, carbolic acid will cause inflammatory lesions in blood vessels, loosening of the blood vessel walls and rupture of elastic fibers. Alcohol will directly cause glial changes in blood vessels, affecting the anastomosis. Paraffin oil will be better, but it will still cause cell degeneration, loss of elasticity, and cause mid-section expansion.

After transplantation, almost all blood vessels developed inflammatory lesions, with infection being the main cause. Mild inflammation will breed granulation tissue and thicken the vessel wall. Severe inflammation will cause a large number of cell necrosis, leading to vascular stenosis, thrombosis, and even lumen rupture, resulting in transplant failure.

Various other changes are also emerging, which will directly affect the success rate of surgery and postoperative survival rate.

Surgery has various risks. Even if we are optimistic, the overall mortality rate will fluctuate between 5-10%. If we add the 20% mortality rate one month after the transplant, the risk is too great. The cumulative mortality rate after two months, three months, six months, one year, five years is definitely not a number that people can easily accept.

Rather than taking such a risk to undergo surgery, it is better to choose conservative treatment.

Kavi has no psychological burden. He will not complete the aortic transplant just because he has promoted it. For him, the operation is just a tool to treat patients. If the operation increases the risk of survival of the patient, he will ruthlessly abandon it.

As for the huge amount of resources and money that have been spent, they can be converted into data in future journals, so they are not in vain.

With this thought in mind, Kawi has already begun to prepare to abandon the experiment. The next thing to do is to complete the remaining transplant operations and then prepare a complete laboratory report to announce to everyone that the experiment has failed.

However, things developed just like what happened to Amadeo and August. Just when Kavi decided to give up, the opportunity inexplicably appeared before him.

About two weeks ago, Sir Hag, who worked at the Natural History Museum, suddenly came to visit. The reason was simple: Fernando seemed a little lonely again, and he hoped that Kavi could sell another dog corpse to make the entire specimen exhibition more spiritual.

The experiment was supposed to kill most of the stray dogs that participated in the transplantation operation, so it didn't matter if they sent a few more to Hag as a favor. But the problem was not with the dogs, nor with Kawi, but with the embalming tank that held both the people and the dogs.

The pond is not big to begin with, and putting one person and two dogs in would make it look crowded. What's more troublesome is that even if the specimens are processed, it is still not easy to completely prevent corruption.

The dog was just a decoration, Fernan was the real valuable thing. If Fernan's body was damaged, even if it was just a critical point of the abdominal incision, it would bring irreparable losses to Hag.

However, Hag was very confident and came up with his own plan: "I have asked someone to replace it with a larger glass pool and replace the preservative liquid. As for the specimens, I will freeze-dry them first and then put them into the pool."

Kavi had just finished performing several vascular transplants and thought he had misheard: "What did you just say?"

"Replace the glass pool."

"No, the latter one."

"Change the preservative." Seeing that Kavi was still shaking his head, Hager said the key point, "Freeze the specimen."

"Freeze-drying?" Kavi had not thought that such technology existed in the 19th century. "First, the body must be frozen to -30-50 degrees Celsius, and then a vacuum is created to allow the ice to sublime. Can freeze-drying really be done now?"

"Uh," Hag was asked anxiously, and didn't know how to answer for a moment, "Actually, the temperature is not that low, and vacuum is relative. But after this treatment, the speed of decay of the corpse will definitely be greatly reduced."

"Who can provide the machine?" Kavi was anxious. "Who?"

"You know this man. He's your old friend, Laszlo."