Chapter 101 98. You have nothing!

Women in a patriarchal society have always been representatives of weakness and uselessness. They are beautiful, but also very fragile, just like a vase that can give birth to children. A girl with such a petite figure can actually beat two men, which is worse than a cesarean section.

More story-telling.

Kawei was surprised to find that these surgeons had always been skeptical or negative when faced with reasonable disinfection methods. But after hearing about the successful deeds of a woman who killed two men, they all unanimously agreed that all this was necessary.

It is a real fact.

In the end, they just believe what they want to believe.

As a witness, Carvey briefly described the process of Nora's "murder". The exaggerated range of movements and rhythmic stabbing process gave this cesarean section a legendary color.

"She is really less than 1.6 meters tall?"

"Well, I'm a little over 1.5 meters tall."

"It's so strange. Unless a girl of such a height has muscles all over her body, she is seriously lacking in strength. Moreover, she is wearing a skirt, which makes her movement very inconvenient. Even if it is a sneak attack from behind, without receiving strict military training, there is no way to do it at the same time.

Let’s deal with two men.”

"Is she a veteran?"

"She's a girl! A girl!!!"

"You are too ignorant. It's not like there is no precedent for a woman to disguise herself as a man and sneak into the military camp."

"Would the Austrian army want a soldier under 1.6 meters tall?"

After their analysis, Kawei suddenly realized that he seemed to have unknowingly helped Nora create a space for revenge: "I think the anger of being oppressed is her best source of strength, and the rest is classified as the blade being sharp enough."

Bar."

"In a small space, if the gap between weapons is too large, it is not impossible."

"Wait a minute, have you overlooked an important issue?"

"What's the problem?"

"No matter how sharp the knife is, you have to cut it. She has just had a cesarean section. She is very weak and she is so short. Why should she cut someone? Especially that part." The man tried to imitate what Kawei said.

Speaking of the process of Fleny turning into a sieve, "Such a large movement of the upper and lower waist and abdomen, the longitudinal incision in the abdomen can easily collapse."

It is said that interest is the best teacher of learning, and soon their interest in Nora slowly shifted to surgery.

Because this result is the product of various coincidences, Kawei still needs to explain: "The incision is actually not bad. The person who sutured the incision himself was Dr. Herman of our hospital. The operation was stable and delicate, and the alignment was no problem. After the operation,

I cleaned the incision and wrapped a lot of bandages around my abdomen to prevent it from splitting."

"Dr. Hermann? I remember that his suturing skills are only average. He probably hasn't reached this level yet."

Hermann's suturing was indeed not very good, but they underestimated the role of the facilitator. As long as he helped to close the incision, determine the needle insertion position, and stabilize the suture knot, he was even an intern who had just learned how to tie knots.

Even though he was still alive, Kawei could lift him directly to the standard level for surgical suturing.

What's more, Herman has performed many surgeries, so he already has a good foundation, but he's far from being in a bad situation.

Kawei naturally omits these processes and instead emphasizes the high concentration of alcohol used:

"One thing that deserves our attention is that incision dehiscence is not only a suture problem, but also a healing problem. Under the interference of miasma, the incision will soften and ulcerate, so I will use high-concentration spirits before the operation. After two

The sub-distilled brandy has isolated the miasma."

This is an attempt by Kawei, hoping to use Nora's bravery to help him open up the situation.

The effect was pretty good, and some doctors finally became interested: "Can alcohol block miasma?"

"right."

Kawei smiled and told the reason he had made up before: "Miasma and ulcers have an unpleasant smell. Alcohol has a fragrance and can resist the invasion of miasma. If everyone can put aside their prejudices, take a look at Liszt

The carbolic acid my husband used actually had the same original intention as the alcohol I used, because carbolic acid also has an aromatic smell."

"."

There was silence under the stage.

They are all old diehards who grew up in the Austrian conservative quagmire and are unwilling to easily believe in all new theories and discoveries that go against "common sense".

But their profession is to be surgeons who must be at the forefront of technology. Compared with internal medicine, where the results are unclear, and obstetrics, where the data is not clear enough, surgery, where the results are immediate, is more likely to expose problems and needs to be solved more.

These surgeons say that ulceration of incisions is a matter of probability and related to piety, but in their hearts they still hope to change the status quo. Who would want the surgery they worked so hard to perform and the incisions they worked so hard to sew to turn into a big piece in the end?

What about rotten meat.

Kawei gave them an opportunity to re-understand surgery.

Of course, this also includes Nightingale’s bold attempt, Dr. Lister’s innovation, and Waterman’s persistence. In addition, Kawei’s incision infection rate of less than 20% and a mortality rate of 0% are enough to illustrate the problem.

.

But Kawei knew that even in the face of so much evidence, they still couldn't get over the hurdle in their hearts.

So he didn't force it. He put the anti-infection aside and introduced his new oxytocin drug first: "Forget it, let's talk about surgery first. At that time, the patient's uterine bleeding was severe, and we could only rely on crow's-beak forceps and hands to stop the bleeding.

.”

This is a problem encountered by all cesarean sections.

In the 19th century, it was difficult to remove a fetus by cesarean section, and the uterus was a long vertical incision similar to the abdomen, making it very difficult to stop bleeding. The vast majority of cesarean sections that died on the operating table were related to massive bleeding, and those mothers who died after surgery also

Most of them suffered from severe bleeding.

"Several seniors here must have gone to the surgery site at that time. I used a new obstetric medicine from the East." Kawei dug into his pocket and took out a tube. "This colorless and transparent liquid can be used in the original surgery."

On the basis of uterine contractions, further violent contractions allow the uterus to stop bleeding on its own within a short period of time.”

"How to use?"

"Use a syringe to inject into the uterine muscle layer."

"Is it really that magical?"

“It’s really amazing and the effect is remarkable”

A person's boasting always seems weak. The surgeons who had been to the scene had to admit the effect of oxytocin after seeing Kawei's eyes: "It is indeed a very useful drug. I forgot how many injections were given."

, but the swollen uterus quickly shrunk by half, and the bleeding quickly stopped."

"I can also testify that the hemostasis effect is almost like magic. Although as a good surgeon, I shouldn't describe it like this, but I really can't find a suitable metaphor to describe this matter."

"The hemostatic effect is indeed good, but the side effects still need to be verified in the long term."

Kawei heard a different sound and immediately followed up and said: "I have given medicine to voles, and the only side effect is probably an increase in blood pressure."

"Blood pressure? How did you measure your blood pressure?"【1】

"You have to know that even with the most advanced blood pressure monitor, it is impossible to accurately record readings. Blood pressure is a very vague concept. Please be sure to be more detailed."

There was indeed no convenient blood pressure monitor in the Municipal General Hospital. In order to test the limit of oxytocin, Kavey sacrificed many voles. Now he needed an old concept to explain the new concept of increased blood pressure. The first thing Kavey thought of was

Four liquid theory: "In other words, it is probably to increase blood."

Hearing this sentence, the confused eyes in the audience instantly understood everything.

"The old-fashioned blood pressure measuring machine in the general hospital is too big and ineffective for hamsters, but I chose an older method, such as the carotid artery puncture blood column method in the 1930s."[2]

Kawei sighed: "Later I learned that there is no need to record any detailed readings at all, because as long as a large dose of oxytocin is injected, it will cause a sharp increase in blood pressure. If the dosage continues to be increased, the vole will die within a short time.

Causing severe internal bleeding."

The four-liquid theory, which has been passed down for thousands of years, can indeed justify itself under certain circumstances, and now it has finally become an important tool for Kawei to promote his medicines.

Compared with "helping shrink the uterus" and "stopping bleeding in a short time", the increase in blood is not a particularly harmful side effect. For women who have had a cesarean section with a large amount of blood loss, additional blood and increased blood pressure are not harmful.

"Dr. Carvey, have you ever tried to put the drug into production?"

"It will take some time to officially put it into production," Kawei said, "but considering that there are still several women who need cesarean section sleeping in the ward, I made another batch of medicine for subsequent use."

“Have you ever considered the price of the medicine after it was put into production?”

"Due to problems with the production process and raw materials, the cost of drugs is quite high, so the pricing will naturally not be too cheap."

The current crude level of the chemical industry makes Kawei very helpless. Natural leaching takes a long time to produce and is cumbersome to operate. It is much more difficult than the synthetic method in the future. But at the moment, there is only one way: leaching, and the only way is to use pig brains and press it again.

Cost.

"On the premise of protecting the patent, I will try to reduce the cost as much as possible, so that at least all mothers who need cesarean section can use oxytocin."

After talking about oxytocin, Kawei started to walk them through the details of the operation from beginning to end, including abdominal incision, uterine incision, method of fetal retrieval, how to remove the placenta after retrieval, how to further stop bleeding, how to suture the uterus, final abdominal cavity exploration, etc.

wait

Although Waterman added the adjective label "nearly perfect" to this cesarean section, in Carvey's eyes, it was not perfect because the power to perform the first half of the cesarean section had always been in the hands of Hills. And the obstetrics department

It is not Kawei's strong point in itself, and there is definitely room for optimization in the process.

The next step was placenta previa, which caused even more dangerous bleeding. Kavey still had a long way to go before having a cesarean section.

"At the end of this cesarean section report, I still want to talk about another patient in advance."

Cavett carefully prepared the negative teaching material of Li Ben: "He was a survivor of that murder. If you have the program list, you should be able to see that the patient with compound trauma at the end of the entire regular meeting was him.

I didn't mean to disrupt the flow of the meeting, I just wanted to use him as a negative example when it came to preoperative preparation and postoperative care.
To be continued...