Nineteenth Century Medical Guide

Chapter 48 47. Cleft Lip
Ignaz used a traditional light guide instrument (Lichtleiter) [1].

It is much more complicated than simple nose mirrors and otoscopes【2】, and it penetrates into relatively narrow, long and hidden parts of the body, and the distance is also deeper. It can be regarded as the originator of all endoscopes today.

In the 19th century, something that was very tall [3], in the eyes of Carvey, is just a toy, and it is more useful than a simple anal dilator, but the usage is very complicated.The most important issue is the light source, which requires built-in candles or small kerosene lamps to provide light, and the light is guided into the dark cavity by the refraction of the mirror.

The second is the discomfort caused by the material. The metal sheet is too hard. In order to see clearly, the cavity needs to be enlarged as much as possible, which makes the patient very painful.

"Mr. Alphonse, please be patient." Ignatz opened the regulating valve of the anal dilator to the maximum, looked at the bleeding hemorrhoids, without any worry, "Examination is painful, think about it ten years ago When there was no ether, this examination was like being bitten twice by a leech."

"Are you kidding, leeches don't bite their butts!" Alphonse was really unbearable as this was the first time he had used something of this size, "Well, can you hurry up?"

"No, the height of the candle is not adjusted properly, so I can't see clearly." Ignatz still wants to use a kerosene lamp, but there is no matching lamp in the whole instrument, and the specification in the ward is too big. A little candle."

".?"

"Unscrew the top cover, put in the slightly longer candle first, and light it up." Ignatz said his own operation steps habitually, "Then close the top cover, poke in again, open it, Lock the valve switch, secure."

"Hiss, why do you surgeons have such strong hands? Wow~ Baron, please be gentle!!"

"The sword wound did not penetrate the anal canal." Ignatz withdrew the anal dilator and finally made a diagnosis, "But your hemorrhoids need to be dealt with properly."

"Is surgery necessary?"

"Well, it's going to have to be done," Ignatz explained. "I'll do a modified hemorrhoidectomy and remove all of these bumps. You'll feel refreshed and less swollen. And repeated bleeding symptoms, defecation will be very smooth."

Alphonse comes from France, where the development of surgical operations is at its peak, and now he has anesthesia, so he doesn't have much resistance to surgical treatment.The only thing he was worried about now was the duel with the little man Li Benjian, and the reports of last night in today's Vienna Daily and Daily Morning Post.

"Karvey, did you buy the newspaper?"

Karvey yawned, and took out the newspaper he just bought from behind him: "Look, it's all written in it." This rare street duel will soon come to an end, but it's a pity that the upright Alphonse The honor of the chef is still not respected by the other party, and everything is not over yet.'."

"Well, then? That's all?"

"Wait, I'll look for it." Carvey flipped it up and down, shaking his head, "It seems to be gone."

Alphonse was taken aback: "Where's the letter I sent them? Are you sure the letter was really delivered?"【4】

"I arrived at the newspaper office at 2 o'clock in the morning, and personally delivered your letter to the reporters, and repeatedly reiterated your position and decision." Carvey recalled, "The editor is not here, so I guess I haven't read it yet." .”

The report on Alphonse was not small. Although it did not enter the front page, it also entered the back page. By the way, the menu he tried last night was also moved out.

But the reporter who wrote this report didn't grasp the real point, and only spent a lot of pen and ink describing the scolding battle between the two.

The letter he gave and his plan to continue the duel were not included in the report.

"What kind of people does the daily raise? Can they write manuscripts?" Alphonse said angrily, "After being written by them like this, isn't it just two boring men who disliked each other and got into a fight? It doesn't capture the central idea of ​​why I want to fight at all."

Suddenly, Ignatz, who was sorting out the equipment, interjected: "Mr. Alphonse, this is no longer the age when you can solve things with a swing of a sword."

"But the law cannot punish slanderers. The duel at least gave me a chance to fight back."

"It's true, I admit it, but a duel has its risks."

Ignatz didn't have as many concerns as Carvey, and said bluntly: "Now our average life expectancy has risen from 20 years old 37 years ago to 42 years old. In the past ten years, we have learned more about the human body than we have learned in the previous 300 years." There are more people here. Medicine is protecting everyone's lives, and it would be too wasteful to just use it for a duel."

Alphonse glanced at the newspaper and sighed, "It's really unlucky!"

Ignatz patted him on the shoulder and comforted him, "Don't think too much about it. Let's have surgery and recuperate with peace of mind. I will send someone to notify the restaurant."

After coordination, Alphonse's surgery was scheduled for the afternoon.

In the morning, it was a patient with a cleft lip. The repair operation itself is not difficult, but the difficult thing is that it was born in the 19th century.

Although there is a relatively mature surgical method for cleft lip repair in this era, the understanding of the anastomosis between the skin and the lip cleft is not enough. The lack of disinfection also makes wound healing difficult, and the plastic surgery effect is not good.

But fortunately, Ignatz is very confident in his skills, and after Laszlo's gas cut yesterday morning, he is full of confidence in Kavey's ability to work.

"I left in a hurry yesterday, and I didn't have time to thank you."

"Thank me?"

"At any rate, you saved the reputation of me and the hospital. You probably can't imagine what Austria will be like after Mr. Laszlo's death." Ignatz has been able to face this setback calmly, and the topic has returned to the professional field , "By the way, I didn't have time to ask you at Mr. Laszlo's house that day."

"Teacher, please speak."

Ignatz put on his favorite red and black dress, stood in front of the mirror and asked, "How did you find out that Laszlo was still suffocating after I passed out?"

"The chest does not rise and fall, and the gas flow is not felt at the catheter port." Carvey suddenly felt that this answer was not appropriate, so he simply added, "My father taught me to check the patient's condition after the operation since I was a child." , If you can’t finish it, just leave.”

"That's right." Ignatz slowly buttoned himself up, pointing out his shortcomings, "If I hadn't been drinking, I would never have made such a mistake, and I would definitely be laughed out of my mouth if I said it."

"Teacher, you're worrying too much. This is considered a difficult operation in all of Europe." Carvey didn't dare to admit how successful he was, let alone mention it, so he could only let the topic revolve around him, "Are you still drinking? Even though you stayed up all night, you still dared to do this kind of operation, and you have slapped many people in the face. If anyone still dares to laugh at you, I am afraid they are either stupid or stupid."

Ignatz nodded, but his eyes were on the daily newspaper on the table, and the date was still yesterday.

".As for the things in the newspapers, just have fun reading them."

Carvey followed his gaze and moved the topic to the media: "They just want to increase sales, and the same is true of Mr. Alphonse's duel. The matter is just right, I guess they will treat the following process as a novel Write."

"Forget about it, and bring my hat here." Ignatz took care of his clothes, took the top hat from Kavi, and suddenly asked, "By the way, you are in Rumba Have you ever seen cleft lip surgery in the first time?"

Carvey was an emergency surgeon and couldn't do plastic surgery, but he did see it.

Because maxillofacial trauma in the emergency department is not uncommon, once the critical period has passed, cosmetic surgery will be admitted.A person like him who almost sleeps in the operating room will visit the door when he feels bored in his spare time. Naturally, plastic surgery will not be missed.

However, modern surgery is a different concept from the past, and Ignaz did not draw a picture of cleft lip repair in the atlas of anatomy and surgery.

Having not seen the repaired artwork and the equipment used, Carvey dared not say nonsense: "I haven't seen much."

"Oh? Your father doesn't do this kind of surgery?"

"Well, I haven't seen him do it, maybe I don't think it's necessary." Carvey sighed, "After all, a simple cleft lip won't kill people, but the wound after the operation may be."

"There is some truth to this statement, but I am sorry that I cannot agree with it. The face is the appearance of a person. If you can't show people the most perfect posture while alive, that feeling may be worse than death."

Ignaz straightened his bow tie, then gently smoothed the small folds of the gown: "Are you interested in taking a look? Just to see how Austrian cleft lip repair is done. Many of my operations have been documented at the University of Vienna In surgical textbooks, it is quite authoritative.”

Carvey was already curious, and it was impossible for him to refuse even after saying so.

Unexpectedly, just as she nodded, Alina knocked on the office door.

The same place, the same three people, which reminded Ignatz of the quarrel between the husband and wife the morning before yesterday.Later, with the help of the ball and Laszlo's throat, the two resolved their conflicts last night.

But reconciliation is reconciliation, and the strict teacher and person in front of Kawei cannot be collapsed: "I'm going to the theater, and if there is anything to do, wait until I come back."

Alina suddenly walked up to Carvey: "You don't care, I'm looking for him."

"Why are you looking for him?"

"I'm the director of the personnel department, so it's natural to find employees."

"Herman is in class, Hills has his own amputation this morning, and he has to go to the theater to help me." Ignatz didn't want to let him go, "We'll come back to you when the operation is over. Don't worry, it won't It's too late, we must be there before lunch."

"No, the dean is looking for him besides me, so I just came here to pass a message."

Seeing that Ignatz felt strange and wanted to speak, Alina quickly said, "Don't ask me why, I don't know."

"No!" Ignatz insisted, "Without Herman and Hills, I only have Kawei as an assistant. Now that you take him away, I don't necessarily want me to carry those three students into surgery." Right? When the time comes, shall I have my cleft lip repaired, or murdered?"

After hearing this nonsense, Alina didn't have an outburst like last time.

She gently lifted her long black dress, walked up to her husband, helped him straighten the cuffs and hat, and then came forward and warned in a very low voice:

"I don't want to quarrel with you because Kavey is in the office. Don't think that the whole hospital is only paid by Laszlo, and you can yell at other investors if you save him. My father, Viscount Clichy They have invested money in the hospital, you can't say that about me, and you can't say that about his son!"

Looking at his wife's smiling face, Ignatz knew that he had accidentally stepped on another mine, so he had no choice but to shut up.

It's true that I have been venomous again, and Bergett also helped a lot yesterday, so it's not appropriate to say that.And he didn't want the newly repaired relationship between husband and wife to be broken in just two days, so he could only clear his throat and say to Ka Wei: "Forget it, just go with her."

"Ah."

"If you haven't let you go after 9 o'clock, then don't use it." Ignatz was very aware of his surgery time, picked up the surgery kit and came to Kavey, "Remember to cry when you see the dean, After all, they are the ones who helped with two major surgeries, and they are all famous people, so it’s too stingy to only pay 7 crowns a month.”

After speaking, he opened the door and left the office.

Although Ignatz was at a disadvantage during the whole process, and it was very uncomfortable to go home these two days, but the suggestion about salary increase when he left finally made sense.

Carvey is no longer an ordinary assistant. Leaving aside the influence of Morazo and Laszlo, just being on the headlines of the evening paper has already raised his worth.After all, surgery in this era still has half the attributes of an artist. If you want to sell tickets well, technology is very important, and traffic is also very important.

"Don't worry, the monthly salary has been adjusted. It's 30 crowns a month, the same as Bergett's. And it's just basic income. If you can go to the theater for surgery, you can also get a commission of 1% of the ticket price."

Alina led Carvey on the way to the dean's office: "Don't feel less, your teacher only gets 10%, and the hospital can get 30%, because the money the hospital usually spends on Ignatz Not a lot."

"What about the rest?"

"The rest is owned by the theater. Anyway, there are so many people in the theater, and they have to pay a lot of wages."

Carvey nodded and calculated in his mind.

Based on the operation performed by Morazo, 50 people could enter the theater, and the ticket price for one operation was 5000 crowns. The 1% promotion means that as long as he participates in an operation, he can get 50 crowns.

With higher income, taxes will also rise, but at least it is much more comfortable than before.

Carvey didn't appear very excited, and always maintained a flat expression on his face.In his mind, he was still thinking about the next experimental plan, after all, the amount of money was directly linked to the content of the experiment.

But Alina beside her was thinking about another question: "Where do you live now?"

"Still the same, in Basinger Street."

"Didn't you say you would quit the lease and move to the hospital? Why are you still living there?"

"Oh, there was a small change in the middle, I'm afraid I can't move." Carvey couldn't say it clearly, but just replied casually, "Anyway, now that the income is guaranteed, there is no problem going back and forth with the carriage."

"So that's how it is." Suddenly Elena stopped in her tracks and asked, "Do you want to make more money?"

(End of this chapter)