Kavi didn't know that Ignatz also had an abdominal surgery, because there were no such patients in this general surgical ward. The other two wards treated ordinary fractures, sprains, and several postpartum women.

Of course he hopes to go to the operating table. It is difficult for a surgeon to be busy with operations.

Not only can he get his hands on the stage, but he can also remind Ignatz and make some improvements to the current surgical methods. But if he has any aspirations for this abdominal surgery, I'm afraid he has to let Ignatz

disappointed.

The abdominal cavity was a restricted area for surgery in the 19th century. If you really dared to do it, it would be a trivial matter. After all, the time left for surgical operations at this stage is very short. When cutting and splicing tender organs, it is often necessary to deal with it.

It's very rough.

Roughness represents hidden dangers. Swelling, necrosis, and collapse of the anastomosis at the ends of the intestinal tube can eventually lead to intestinal fistulas and peritonitis, which are the inevitable outcomes of almost every gastrointestinal surgery.

This is not only a matter of knowledge reserve, but also the reason why surgical instruments, sterilization, anesthesia and suturing methods are too rudimentary.

According to Carvey, there are only two surgeries that Ignatz can perform: appendectomy and inguinal hernia repair. Even so, the mortality rate of the two surgeries still ranks at the forefront of surgery despite the haze of postoperative infection, about

About 40%, second only to the 60-70% of cesarean section.

This is because the surgeon is given extra points. If it had been anyone else, he probably wouldn't have even thought of touching it, so what's the success rate and mortality rate?

In the anatomy atlas compiled by Ignatz, Kawei saw the increasing perfection of amputation and the repeated failures of abdominal surgery. He could feel the author's constant frustration from the text and lines of the pictures.

You can also feel the pain and his perseverance to continue to actively explore forward after setbacks.

I'm afraid this time is another new attempt by Ignatz.

As for where he got the patients, Kawei didn't care, maybe they were just sent to the hospital. The only thing he cared about now was to treat the wounds of the 11-bed children, so that he could change Ignatz

Postoperative care concepts.

Of course, the premise is that he can really do it well.

According to Kawei's method, the child's wound needs to be debrided first. Use boiled, sealed and cooled water. The dirt and other dirt on the surface need to be cleaned as much as possible. Some skin and flesh that have become necrotic must be cleaned first.

Cut it off immediately to prevent the infection from spreading.

The next step is to sew.

There is nothing wrong with the suturing itself. The needle and thread are just larger and thicker, and they don't look as detailed, but the operation is not difficult.

The key difficulty still lies in how to deal with exudation after wound infection.【1】

Under the dual effects of strict debridement and preventive anti-infection, ordinary wounds will heal after suturing. The amount of exudate is not large and ordinary gauze dressings can handle it. If it is a large-area degloving injury, the doctor will

After the debridement surgery, the injured person is covered with VSD (closed wound negative pressure drainage set) [2] to deal with leakage.

Kawei had nothing in his hand, and the only thing he could think of was the lint he asked for earlier.

Cotton cloth has good water absorption, but its function is still too single, lacking the ability to drain exudate and the necessary airtightness.

There is really no good solution in terms of drainage. The only thing that can be done is to change the dressing frequently every day. It is relatively simple to create an airtight seal. There is no modern film dressing, so Kawei can use oil-soaked cotton cloth instead.

There are many kinds of oils, including industrial oils, such as whale oil and kerosene, and edible oils, such as last night's French meal.

"Let's rent a carriage and go there. The restaurant is quite far from here."

"No need, the public carriage [3] is much cheaper for a round trip."

"Here you go, take it..."

When Kawei was about to leave the hospital, Ignatz suddenly went back to the ward and brought him carriage money. Two 1-kronor coins were given to him happily, but his expression was not very good: "After that

According to discussions with the upper management of the hospital, your salary is not much, and you can only be given 7 crowns a month."

"so little?"

In fact, Kawei is somewhat mentally prepared for wages. If you look at the income of doctors who are trained in hospitals and formally admitted to the hospital, you should know that technology will develop over time, but money is difficult to change.

However, being mentally prepared and acting indifferent are two different things. Even if you can't get a satisfactory answer, you still have to ask: "Last night you said you could pay about 12-15 kroner a month, why have you cut it in half now?"

?”

"Seven kronor is indeed a bit less, but you can eat the staff lunch here for free, which can be considered as saving some money."

Ignatz felt a little embarrassed and avoided his sight. He looked back at the cotton cloth that had been wrapped around the little boy's left leg and comforted him: "Actually, the money is not much different. I will give you a certain amount at work."

As compensation for your help. Just now you said you would give me a chance, and I also gave it..."

At this point, Kawei's mouth was basically blocked: "Okay, 7 crowns is 7 crowns, but I have a request."

"any request?"

"I can't pay the rent, so why don't I stay in the hospital?"

Ignatz thought that Kawei was going to ask him for rent money. He originally wanted to agree, but he didn't expect this result: "Stay in the hospital? Where?"

"Whatever, as long as there's a place to sleep."

"Then... why don't you sleep in my office?" Ignatz made a good offer, "Sometimes I need an assistant when I dissect a corpse at night. Can you be on call?"

"no problem."

"Then it's decided."

...

After leaving the hospital, Kawei quickly got into a carriage and rushed to the Roche Shuart restaurant.

The store manager and chef is a fat man, slightly taller than Kavi, with a very French name, Alphonse Francoise Rochechuart. He is of aristocratic descent, and relied on his superb cooking skills after his family became lonely.

He served as the royal chef of the French royal family and came to Vienna two years ago to open this high-end French restaurant.

With Kawei's identity, he would not be able to enter the main entrance without Ignatz, so he could only find an opportunity to sneak in through the back door of the kitchen.

Anyway, he didn’t come here to eat, it’s the same everywhere.

For chefs, the restaurant is the exhibition place for dishes, and the kitchen is the battlefield. Before every battle, chefs, especially the head chef, need to check the preparation status of various ingredients to prepare for the upcoming lunch.

"Potatoes, onions, pork, steak, lamb chops, lamb loin, halibut, butterfly fish, chicken, duck, quail, partridge, pigeon, snail, black mushroom, mushroom, asparagus, lily, pepper, tomato...

.Where are the banana leaves and sage? Were they not delivered?”

"There are still a lot of unused ingredients in the food warehouse."

"when?"

"It was delivered at noon yesterday."

"Throw it all away tonight."

"yes."

"Where's the lobster? Where's the lobster I specially emphasized yesterday?" Alphonse was a little anxious, "You must have run out of stock, right?"

"Austrians don't eat much seafood, and it's very difficult to transport lobsters. We really can't reach Vienna today."

"If we don't have lobster, what should we do with the cold dishes? Today's main dish is Parisian lobster cold dishes, and the sign has been posted!" Seeing that everyone was silent, Alphonse could only make his own decision, "Forget it, let's change it to Portuguese grilled dishes."

Stuffed chicken and hot quail pâté.”

"OK."

"Finally, let's review the Three Emperors Banquet menu [4] again. Listen carefully to me and make sure there are no mistakes..."

The menu comes from the "English Café" [5] during the World Expo in Paris, France. It was amazing at the time, but now it is a dish that the chef is used to making. So Alphonse only ordered a few details after inspecting the ingredients.

Once again, he got into his own private kitchen.

Although he is a loyal fan of classical French cuisine, because he has been to the far East and has learned a lot about the local southern specialties, his development of dishes is not conservative at all, and is even a little weird.

"Where is the dried salted fish I asked you to prepare half a month ago? And the bottle of honey barbecued pork sauce I brought back?"

"Just...holy crap, where did the thief come from!!!"

"What's wrong?"

Alphonse ran out following the sound, and the first thing he saw was the young man named Kawei from last night: "You? Aren't you the poor boy yesterday? Why did you come to the kitchen?"

"I want to ask you for something!"

Alphonse ignored Kavi at all. He looked at the chefs in his hands and grabbed his clothes, and sighed: "Your hands are for cooking, so you don't think it's dirty if you grab his clothes? Kick me."

go out!!!"

"Ahem, wait!"

"What are you waiting for? I don't want to see this guy again!"

"Master Chef, I just want to ask you to borrow something to save someone."

The words "chef" should have made Alphonse feel comfortable, but the person who spoke was too humble, which had the opposite effect: "Only you? And you can save people?"

Alphonse shook his head, listening to the roar of laughter from all the chefs, and said: "Doctors, especially those who can cure diseases and save lives, are all learned gentlemen. Don't think that just having a meal with Ignatz will make you happy.

When you are a doctor, you should ask your teacher if you can join the Royal College of Physicians before you talk about these big words in front of me."

What he said was true. Surgeons did have a low status, but this had nothing to do with the bottle of oil that Kawei wanted.

"It doesn't matter whether I am a doctor or not, but I am certain that you must often have a dull throbbing pain in your upper right abdomen."

Pain is a very vague concept. From the patient's dictation to the doctor's completion of the medical history record, there are three points that need to be improved: location, nature, and degree. Kawei only used half a sentence to summarize all three points.

Go in and use the simplest and most direct method to make Alphonse change his mind.

"Forget it, you all go do your work, I will handle it myself."

Kawei already knew from the look in his eyes that he had guessed the answer, and a big stone finally fell to the ground in his heart.

Alphonse dismissed the chefs under him and pulled him into his room: "How do you know that I often have cramping pain in my upper right abdomen? It's still faint... I haven't mentioned it to anyone.

You haven’t learned any witchcraft, have you?”

"This is medicine, science, not witchcraft." Kawei had the "health" trump card in his hand, and his tone became tougher, "It's okay to tell you, but I need to borrow a bottle of oil. You are the cleanest place here.
Chapter completed!