Nineteenth Century Medical Guide

Chapter 72. 69. Metamorphosis: Finale

While Nora was still struggling with the hemorrhage, the clear and resonant cries of the child echoed in the arena.

"How's your breathing and heart rate?"

"It's all good."

The uterine hemostasis was successful, the child survived, and the cesarean section was 80% complete. This time, the victory is really in sight.Seeing that the success of the operation was in sight, Sears wanted to regain the position of chief surgeon, so he immediately took the words of Kawei.

"Take the child away first, and give it to Teacher Marcus, and let him be sent back to the hospital." He slowly removed his hands from the abdominal cavity, and jumped off the operating table, "Remember to keep warm."

"Ah."

As an old doctor who has been in emergency surgery for decades, Carvey has experienced many ups and downs. Although he has never performed a cesarean section himself, he has seen a lot of cesarean section accidents.

Everyone in the world thinks that a cesarean section is good, but only experienced doctors know that there are traps everywhere in a small cesarean section.If at the beginning he still had the energy to let Hills do the incision and choose to intervene depending on the situation, then at the end of the current stage, he would not dare to do so.

Yu Gong, intrauterine cleaning of the uterus, suturing of the sarcoplasmic layer, and exploration around the uterus are all must-dos. No matter which step is wrong, the previous work of the operation will be wasted. 【1】

Personally, Kawei was not so easy to talk to, and he did all the dirty work of stopping the bleeding by himself, so how could he give up the operation again.So when Hills cast his gaze to take over, Carvey shook his head slightly.

He didn't respond, but just said all the things to be done before closing the abdomen in order, and continued to do it: "The first thing we have to do is to clean the uterine cavity. Don't think that the delivery of the placenta is enough. We still need to do it again." Check it out, anyway, Ms. Nora is still asleep, so she shouldn't object."

It was clear to the medical students and fellow surgeons on stage that a great cesarean victory was about to be born.

But what they didn't expect was that there are still so many ways to do surgery at this stage.The entire cesarean section starts from the selection of the incision, and it is full of dense knowledge points, which are also knowledge points that no one has ever talked about.

Those guys with a keen sense of smell have already taken out a pen and paper, and recorded the operation and what Kavey said verbatim.

Surgical theater has always been a winner or loser hero, but in the surgical circle, origin and status are also required.

The reason why Ignatz has gained so much attention is not only that he is good enough, but also thanks to the baron hat on his head.It is extremely rare for aristocrats to perform in theaters, so they will naturally win enough attention.

It's just that Carvey's victory came too thoroughly, and Laszlo's anger was the foreshadowing, so that the audience actively ignored his current assistant position.

After cleaning the uterine cavity with gauze, Kavey touched the mucous membrane inside the uterus back and forth with his hands, and only started suturing after knowing that there was no problem:

"I remember a case of successful cesarean section in Tsarist Russia five years ago. At that time, an unknown surgeon accidentally chose double-layer sutures. The first layer he chose was the continuous suture of the muscular layer of sheep catgut."

Herman has become an out-and-out equipment nurse, and immediately handed over the needle and thread.

Carvey clamped the incision with crow beak forceps with his left hand, and sutured the needle [2] with his right hand. Looking at the uterus with stagnant bleeding, he slowed down as much as possible: "The inside of the uterus is full of blood vessels. You can't suture quickly, you have to take it step by step. .”

Perhaps because of the different standards for speed, Carvey's sewing speed still exceeds most people's definition of "slowly".

Surprised, they didn't even have a chance to ask questions. Just after writing the previous knowledge points, Kavey's first layer of stitching has come to an end.

"After the first layer of suture is completed, we still need to do intermittent suture reinforcement. Because the catgut does not have enough tension, it is easy to break, so after reinforcement, we need to do the second layer, that is, the continuous suture of the serosa layer."

Carvey waved at Herman, and took the silver thread he found from rummaging through boxes and cabinets: "Mr. Ignatz prepared enough silver thread for this operation, but it's a pity that he can't use it today, what a pity."

His ridicule attracted a lot of laughter, but Carvey's hands were not idle, and the uterine suture was completed in the blink of an eye. 【3】

"The suturing is complete, but according to my father's requirements for the operation, I have to look around the uterus." Carvey once again pushed the credit to the father who never existed, "There are important organs around the uterus. organ tissue, and is full of supply vessels, if not probed clearly."

The voice was cut off by him at this point, and Kawei took two pieces of gauze from the side: "I need to emphasize that if there is bleeding at the needle hole where the uterus was sutured, you don't need to panic, don't use sutures to sew up again. , This will increase the burden on the uterus. In fact, the method is very simple, it only takes 3 minutes to stop the bleeding.”

If Earl Moraso's intestinal anastomosis reflects Ignatz's speed, then this cesarean section embodies Kavey's stability and leisure.

The stability when encountering heavy bleeding, and the leisure at the end stage, the ultimate leisure.

In the next 3 minutes, while pressing the bleeding point of the uterine suture, he looked at Nora's open stomach, like a professor who has the whole situation in his hands, and answered many people's questions: "You What you are asking about is the reagent injected into the womb just now, it is an ancient prescription that my father got when he traveled to the East."

"East? India?"

"No, no, go further north, China."

"Oh, it's the place that is rich in silk, tea and porcelain."

"This reagent is a special medicine used by local people when labor is difficult. It has been passed down for thousands of years. After my father's research, it was found that it can help the uterus contract." Carvey said, "That's exactly the truth, Ms. Nora The contraction of the uterus is very powerful, and it can compress and stop bleeding better than physical forceps."

Since it is an ancient prescription that has never been seen outside the world, and it is so effective, the audience is also very interested and did not ask about the details of the preparation.

"The hemostatic effect is really excellent."

"If Mr. Carvey is interested, my pharmacy can sell this hemostatic medicine on his behalf."

Carvey corrected: "Please pay attention, this is a drug only used for pregnant women to help uterine contraction, not a real hemostatic drug. I will improve the various experiments of the drug in a few days, hoping to calculate a Appropriate dosage."

After asking about the medicine, they quickly changed their goals and focused on the surgery.

Delivery of the baby's placenta first, placental cleaning, uterine contraction to stop bleeding, suturing methods, and the need for surrounding inspection after suturing are all things they have never heard of. They are not in textbooks, nor are they in the mouth of the professor.

Carvey had no choice but to drag out his father again: "It was mainly my father's three-year trip, not only to the East, but also to Africa. He found that the local African natives often had cesarean sections, and The success rate is not low.”

This sentence greatly exceeded the scope of everyone's cognition: "This is impossible, they lack decent surgical tools!"

"How could a black man have a caesarean section? I guess he must have read it wrong!"

"The operation is so complicated, but they don't even know the words. It might be convincing if they were replaced by people of yellow race from the east."

"This is what my father saw with his own eyes. Can you listen to me first?" Carvey sighed and said, "Their handling methods are very rough, and they still retain the bad habits of the Middle Ages, but the hemostatic effect is not bad. Because It has been handed down for many years, the method is fixed, and the death rate must be there, but it has never been too high."

"How did they anesthetize? They wouldn't just let the local witch doctors open their stomachs, right?"

"Cocaine is everywhere in the rainforest."

"What about stopping the bleeding?"

"The soldering iron, brutal as it is, but you should know it works, especially if the patient doesn't know it."

"Stitching? They don't have all that fine needles, guts, and silver thread."

"Use the thinnest palm rope for the uterus."

"What about the skin? If you use a rough palm rope for the skin, it will definitely cause skin ulceration. This is the consensus of surgery."

Carvey also admitted this, and replied: "Use an ant's head."【4】

"Ant?"

"Ants have huge mandibles that can bite down on the skin like a suture needle in my hand, go through the cut edge, stick in there with the barb, and cut off their body once they bite. And these giant ants will Secretes a saliva that prevents festering and helps wounds heal."

Carvey explained with a smile: "Don't look down on those backward places. Even if you see 99% of the dross and discard it like a shoe, you can always find some shining points worth learning in the last 1%."

There was another sound of brushing and brushing, and Carvey removed the gauze strip and carefully checked the sutured wound: "Very good, the bleeding was successfully stopped."

In the following investigations, no missing bleeding points were found, and the operation finally came to the final stage of lying down.Carvey checked the gauze strips used to raise the uterus again in accordance with modern surgical procedures, carefully counted the number of gauze strips, crow's beak forceps and suture needles with the surrounding nurses, and finally decided to close the abdomen.

"Ms. Hills"

Carvey finally let go of the needle and thread in his hand, because he knew that the next stitch would not be difficult, and it could be done with Sears' ability.But it's a pity that Carvey's smooth operation deeply hurt his self-esteem.

Hills declined.

"Let me do it." Herman took the needle and thread, and gave Hills a step down, "He was not feeling well just now, so let's go to the preparation room to rest for a while."

Hills took off his leather skirt, glanced at the audience and Nora, bowed slightly, and left the theater with a straight face.

It was not difficult to suture the skin, and Herman quickly completed the finishing work with a little guidance from Carvey.

The operation was successfully concluded, and there was no room for further commentary, and it was entirely the host's time to play:

"Ladies and gentlemen, I would like to congratulate you on your worthwhile trip. The operation was performed beautifully in the hands of the young generation of surgeons at the Municipal General Hospital. It doesn't matter whether Ms. Nora's wound will fester in the future, and it doesn't matter what the fate of her child is." , this caesarean section will inevitably be recorded in the history of surgery.

The one who successfully completed the operation and successfully saved Nora's life was an out-and-out Austrian doctor!It is a fact that other countries can only envy anyway! ! ! "

The host very cleverly avoided the name of the chief surgeon, saving enough face for Sears.However, it is not difficult to see from the postoperative interview and questioning session that the main surgeon in the audience's mind is obviously Kawei who is surrounded by those black gentleman's dresses in the preparation area.

After asking about some details of the cesarean section, they took the trouble to visit the disinfection equipment carefully.

Bleach, soap, and alcohol, which were ridiculed as decorations before, have now become the focus of their observation.

Unlike oxytocin, which needs to be controlled in dose and preparation process, it is not difficult to disinfect the skin surface. Anyone can do it as long as they have bleaching powder and alkaline soap.Carvey is willing to seize this opportunity and make a big fuss about disinfection.

"Actually, like everyone else, I have reservations about disinfection." He retreated to gain the trust of these people first, "I am at a loss about the disinfection process."

"Then why bother to make these preparations?"

"To prove that my father and his friends were wrong, gentlemen shouldn't wash their hands." Carvey shook his head helplessly, "but now the concept of surgery that has been carried in my heart for hundreds of years seems to be collapsing."

"Is it because the patients are recovering well after surgery?"

"Indeed." Carvey washed his hands and patted his chest. "In this age of innovation, we should speak with facts. I have seen 5 patients. If Nora is included, That's 6 people, none of their wounds festered."

This is what Ignatz told everyone before, and Kawei used it to emphasize it again.

It's just that it's very difficult to completely eliminate this long-standing disadvantage. Even at the current level, Kawei still can't make everyone believe in him.Only a few doctors and medical students in this audience are willing to try it, and others choose to wait and see.

"It doesn't matter. I will continue to study the mechanism of wound ulceration. Time will tell everyone the answer. I'm not in a hurry."

At this time, two people squeezed in from the crowd, both wearing simple shirts and coats, not even a hat.Regardless of the disgust and disdain of the people around them, they still came to the front: "Dr. Carvey, Doctor Carvey, we have a question, a very important question for you!"

Carvey nodded: "Tell me, please."

"I'm a reporter from The Times, and he's a reporter from The Free Press." A young man with long curly hair adjusted his clothes excitedly and congratulated with a smile, "Before asking questions, we still want to congratulate You, the operation just now was really wonderful."

"Thank you."

The two glanced at each other, knowing that this question was a bit inappropriate, but the reporter's strong curiosity still made the young man open his mouth: "In fact, we just want to ask, the chief surgeon of this cesarean section, Dr. Ignatz Where is it?"

"Because he just finished an operation with you in the afternoon, so he should be able to come back in time."

"Yeah, we're wondering if he's in some trouble, is he sick? Or something happened suddenly?"

(End of this chapter)