"Ladies and gentlemen, good afternoon [1].

Today, a talented surgeon with rich experience is about to appear. He has contributed thousands of amputations and lithotripsy here, making him famous. He is the most outstanding scalpel master in Austria, and was named by "Vienna Daily"

Rated as 'the great man who brought about miracles'.

The praise ends here, and the miracle officially takes place.

Let us invite this surgeon with extraordinary speed, Austria’s sharp knife in the night, Mr. Ignaz von Kern~”

As his name was shouted by the host and kept echoing in his ears, the door was pushed open by Ignatz. In front of him were six rows of spectators, surrounded by oil lamps and candles, flickering lights.

Brightness and warm applause are paired with a faint smell of blood.

This was his kingdom: the operating room, or rather, the theater of surgery.

Ignatz is a famous actor here, he performs on stage every now and then, and he has long been used to such grand occasions.

But today, he still admitted that he was nervous.

This was not the nervousness of a novice on stage. His fingers did not tremble, and his mind did not go blank. He could still pick up the scalpel steadily, and the famous British surgeon Astley Paas was still playing over and over in his mind.

The hernia surgery performed by Don Cooper[2] while on tour in Austria.

Ignatz's nervousness still lies in his uncertainty about the outcome of this operation.

The success rate of hernia repair surgery performed by Dr. Cooper is very high. Excluding postoperative infection, the mortality rate is controlled below 15%. Even with the controversial postoperative recurrence rate [3], Dr. Cooper has achieved everything.

Europe's top.

Among all cases of hernia surgery that survived, his recurrence rate was only 38%, much lower than that of Dr. Heisenbach in Berlin (47%) and Dr. Popat in Paris (44%).

Both of them were very knowledgeable people in hernia surgery. The former named the triangle of direct hernia (Heide's triangle)[4], and the latter discovered the inguinal ligament. But surgery is a job that pays attention to technology after all.

If the gap cannot be widened, the treatment effect becomes the most intuitive reflection of the doctor's value.

At this point, Cooper, the first person to perform hernia surgery in the 19th century, is well-deserved.

It is a pity that the old man passed away more than ten years ago. Many people left behind can perform the surgery, but after all, only a few can truly understand the essence of his suturing.

Ignatz specializes in limb surgery, and he has always been a wild man in operation. This wide-opening and closing technique can win a lot of viewers, and it is also very good at amputation, but when it comes to the anatomical structure, it is very delicate and complex.

The groin has become a burden.

"Good afternoon, I'm really flattered that such a trivial trick can attract so many noble audiences."

Ignatz walked towards the nurse with a smile, took off his long cloak and hat to keep out the cold, and at the same time narrated what was about to happen in front of everyone: "The skills I will show you today are extraordinary, and they are unique to the entire vienna."

Inguinal hernia surgery that no one dares touch.”

As soon as he finished speaking, the audience burst into thunderous applause again. Even if they didn't understand what a "groin" was, it still didn't affect the audience's excitement while watching the performance.

"Now please bring out today's patient, Count Morasso Heyrich Carl Franz~"

Ignatz directed everyone's attention to the door, watched a cart push people into the door, walked to the corner and put on a surgical apron. This was a very historical white leather skirt with stains on it.

It was filled with the blood of patients who had undergone his surgery and had never been cleaned.

The cause is still an unfounded view. Many people regard the remaining blood stains as a sign of a doctor's superb medical skills.

Ignatz was very dissatisfied with this kind of thing, always thinking it was a gimmick that only incompetent doctors would come up with. But since he really couldn't find a reason to clean the apron, he didn't object and just kept it.

To him, an apron is just an apron, but the scalpel he holds in his hand is an extension of his fingers, the soul of the surgeon: "Today I will use the rb knife forging master Guozheng, who is tailor-made for me [5]

scalpel to demonstrate this complex surgery."

The golden knife box still smells of wood, and inside it is placed the seven types of surgical knives and two bone saws that are most commonly used in his daily operations.

Ignatz was like an excellent explainer, guiding everyone's attention: "Count Morazo, who is also an old friend of mine, suffers from inguinal hernia and is in excruciating pain. Even walking has become very difficult."

The assistant lifted the blanket placed on Morasso's body, completely exposing the mass on his lower right abdomen, and only covered some important areas.

"The cause of inguinal hernia is a hole in the abdominal cavity, and the intestinal tube falls in." Ignatz continued, "Twenty years ago, when I was a medical student, I had the honor to meet Dr. Cooper.

This kind of surgery was performed. He separated the adherent intestines from the abdominal wall, and then sewed the hole shut with silk thread."

After speaking, he raised his head and looked at the audience: "Everyone, I will recreate this operation."

The anesthesia technology that emerged more than ten years ago has gradually matured, and the nonsense "ether patent" has become a piece of waste paper.

For initial ether anesthesia, the simplest method is to cover the nose. Cover a piece of cotton cloth on a metal triangular support and then cover the nose. While ensuring air circulation, a few drops of ether in the cotton cloth can relieve the pain in a matter of seconds.

Let the patient fall asleep.

Although the method is simple, there are many uncertain factors.

In such a venue where candles and oil lamps are used everywhere, exposure to ether is not a good thing, so when anesthesia first emerged, "intraoperative coma" and "small fires" became an indispensable part of the surgical complications.

member.

In order to solve these troubles, there are now very practical ether inhalation devices.

The ether vapor is transported by glassware, and the transcortical nasal mask enters the patient's body. The entire process ensures airtightness. Not only does it avoid exposure to ether, it is also more convenient to use, but there is still some lack of control over the amount of inhalation.

How much ether should be used actually depends on the experience of the anesthesia assistant and a bit of luck.

Fortunately, Count Morasso's luck is pretty good.

"Teacher Ignatz, the anesthesia is complete."

"Okay, the operation will officially begin now..."

...

Just after Count Morasso fell asleep, across the street from the Theater on the River Venn, a black carriage sped from a distance and stopped at the gate of the Municipal General Hospital.

The person who got off the car was a young man who was less than twenty years old. His thick black coat was fluttering in the wind, but what attracted more attention was the tan glass bottle in his hand. If you didn't know him, you would think it was from a grocery store.

The store clerk is delivering oil to the hospital kitchen.

"I'm back, where's the cotton?"

The nurse looked up at him, pointed to the bed behind her and said, "It's right next to the patient."

"Okay, thank you~"

The debridement care method mentioned by Kawei was a fantasy to others, and no one would really believe it. In fact, Ignatz did not believe it either. However, because it was the insistence of the patient and family members, he still gave Kawei a certain amount of support.

.

After all, he is a surgeon with a good reputation, so he still needs to be open-minded.

But this kind of support came out of nowhere in the eyes of outsiders. Coupled with the previous debate with three medical school graduates, Kawei became a "man of the hour" in the hospital that day, and various gossips related to him

News is flying all over the place.

This is also blessed by the underdevelopment of information in the 19th century. Any conversation materials are precious and enough for others to chew on for several days.

Kawei hesitated for a while between the two bottles of cooking oil, and finally chose flaxseed oil first. There was no special reason, it was just the result of choosing one of the two.

He needs to soak the cloth with oil, wring it out, and wrap it around the bandaged left leg. The wet oily cloth can isolate bacteria in the air and create a relatively sterile space inside.

Moisture absorption inside, insulation outside...

It seemed perfect, but Kavi always felt like something was missing.

"You made the wound greasy. Can you really heal this leg?" The nurse I met at the door just now came over and felt strange.

"It should be fine, as long as the dressing is changed frequently." Kawei looked around and found no sign of Ignatz, "Where's the teacher?"

"Dr. Ignatz? He has already gone to the theater." the nurse said. "The operation this afternoon is very important. He went there right after lunch. He always behaves very calmly during normal operations, but today he seems to be a different person.

Same."

"What kind of surgery is it?"

"It seems to be a hernia repair surgery. The patient seems to be a count. He always visits the clinic for treatment."

"No wonder..." Kawei said casually, "The anatomy of that place is complicated, with ligaments, blood vessels, spermatic cords, fascia, and muscles. Everyone has to come together to express themselves, so it's difficult to perform surgery.

"

Seeing that he was speaking eloquently, the nurse had nothing to say, so she could only ask: "Aren't you going to the theater for the operation? It should have started by now."

Of course Kawei wants to go, but what is in front of him now is a left leg that is constantly leaking oil on the ground. Reason tells him that this matter is only half done and cannot be left alone: ​​"Does the hospital have thicker paper?

"

"Yes, yes, what's wrong?"

"Bring me some."

"How much do you want, you can tell it all at once..."

"Better get some more cotton."

The nurse was a little speechless: "You are using both cotton and paper, so the cost is not low."

"Don't worry about it. Teacher Ignatz will pay the bill when the time comes."

Edible oil will oxidize and dry out when exposed to the air, affecting the insulation effect. Kawei must keep it moist for at least 24 hours until the next dressing change. In order to achieve this goal, he immediately thought of

It's paper.

Kawei doesn't have any special requirements for paper. He only needs to wrap a layer of paper outside the oilcloth to prevent it from drying out.

It is not difficult to operate, it just requires a helper and takes a lot of time.

Wearing six layers of cotton and two splints, the slender left leg of the boy in bed 11 had become "swollen" into a stick. Kawei asked about the comfort, then checked the pulse of the dorsalis pedis artery and the mobility of the toes, and then he was satisfied

He breathed a sigh of relief.

"At 14:42, if it were placed in modern times, the operation should have been completed. I don't know how Ignatz is doing. I hope it will be successful..."
Chapter completed!