Chapter 156 153. The gate to the new world

Bleeding, pain and infection are three difficulties in the evolution of modern surgery.

Bleeding can be fought by some violent means such as mechanical compression and burning, and pain can also be overcome by the patient's tolerance and surgical speed. Only infection is not transferred by will, and there is no effective way to deal with it.

The infection hidden in the shadow for thousands of years has claimed too many lives, so that after learning about the cause of the infection, surgeons have made anti-infection to the extreme. Preoperative disinfection, during-operative masks, hats and gloves, post-operative disinfection, and preventive use of antibiotics are effective measures to fight infection.

The concept of conventional skin preparation also emerged in the breakthrough of this concept. [1]

Kawi also wanted to uphold the modern surgical philosophy and not take skin care as long as it does not affect the surgical incision. However, Fernan's hair is thick, and in addition to the necessary cleaning after anesthesia, it also needs to be cleaned.

Logically speaking, it shouldn't be used [2], but Kawei has big scissors at his hand, which is not convenient to operate. There are a lot of residual hair after trimming, which is not conducive to surgery. The most important thing is that he has learned craftsmanship with Master Beipi before and has confidence in his own technology.

Kawei took the razor, lifted the small thing in one hand and pulled it in front of him, and gestured with the other hand like peeling sugarcane skin in the opposite direction.

Five minutes later, Fernan, who had been simply cleaned, was pushed into the surgical theater.

Because the proportion of doctors in the audience is far beyond that of ordinary people, the host was cancelled here and everything was left to the surgeon himself: "Everyone, today I am going to introduce a rare case, bilateral breast hyperplasia caused by gao pill cancer."

As soon as he finished speaking, Herman and Koch lifted the blanket covering Fernan's body, revealing the swollen left vagina and the breasts with very obvious hyperplasia.

The two cooperated with Amore, who entered the venue with anesthesia equipment, to start preoperative disinfection work together, while Kawei stood in front of the operating table to introduce the cause of the disease, the purpose and the general process of the operation.

However, before this, he still needs to explain the specific situation of the patient.

Because Fernan had previously undergone bladder lithotripsy at the Municipal General Hospital, from a modern medical perspective, it was also a mistake to fail to detect gao pill cancer in time. Even if there is no basic imaging examination equipment and the patient did not mention specific discomfort, the doctor should also see some clues from inquiring about the medical history.

The patient was Ignaz, and Kavi only went to the assistant seat to participate in the surgical treatment, and he was not responsible for the reception and follow-up.

But Kawei still mentioned his shortcomings in the medical response:

"The patient had a bladder lithotripsy in our hospital. At that time, the size of the bilateral nervous nervation had changed. However, I did not further doubt or ask about the patient's other discomforts. It seems a little inappropriate now. I hope everyone can learn from this and be as detailed as possible in the process of inquiring about the medical history."

The collection of medical history in the 19th century is very short. Even internal medicine doctors who attach great importance to the detailed process of the disease often summarize all the patients' experiences in just a few sentences, and cherish words like gold.

But this is obviously contrary to the complex human body structure and physiological pathological phenomena.

"I had the honor of seeing pathological sections after cancer resection of gao pills, and the entire tumor was very hard." Kawei began to lay the foundation for his surgery again. "The main symptoms of the patient are enlarged yin, and there is nodules on the gao pills, and there is tingling and swelling, which is perfectly consistent with my patient."

The four surgeons on the four corner VIP seat have long been accustomed to Kawei's rich experience in the field of medicine and are not in the mood to ask questions. Their attention is all focused on bilateral breast hyperplasia.

However, before watching the operation, there was a thought that kept lingering in their minds: "Is gao pill cancer related to breast hyperplasia?"

"I personally think it's a close connection." Kawei looked back at the disinfection progress and explained, "The reason why men are male is because of their unique organs. The reason why women are female is because of their unique organs."

"You mean uterus and ovaries and gaowan Yin J?"

Kawei nodded, gave them some time to think, turned around and began to clean their hands. While the surroundings were talking, he put on sterilized rubber gloves and picked up Fernan's vagina: "His testicles were hit by tumors and gradually lost the function of maintaining the male appearance, so there was a unique sign of women."

“The function of gao pill”

Doctors in the 19th century did not have the concept of hormones, and only had visual understanding of the internal organs of the body. They understood some relatively simple functions, such as the heart pumping blood, lung breathing, gastrointestinal digestion of food, gallbladder storing bile, and uterine giving birth.

But the significance of the existence of some substantial organs is too advanced for them. Pancreas, spleen, liver, thyroid, prostate, gao pills, ovaries, brains?

Don't know anything.

Because they do not understand the functions of substantial organs, these two sentences of Kawei are equivalent to opening the door to a new world.

The first reaction was Watman: "Did you mean that the two oval things in our lower body are constantly working to maintain their masculine traits?"

“It’s true.”

Orgi nodded repeatedly, agreeing with Kavi's statement: "I heard similar arguments more than ten years ago."

"Someone has asked?"

"It's just a similarity. I remember it was a French doctor who was not talking about gao pills but the liver." [3]

"This is the first time I have heard this explanation." Masimov found the view very strange, but also interesting. "If it is really as you said, how does gao mafia work normally? How does it rely on work to maintain our physical characteristics?"

"Referring to the internal tissue structure of the human body, I prefer protein."

Protein was still a very novel concept in the 19th century. It was first proposed by a Dutch chemist. After years of experimental demonstration, it finally became a consensus recently. It just became a medical knowledge point, and Kawei has already made great strides on this basis.

“Gao Pills produce a protein that the human body needs and rely on it to maintain our male traits.”

"It sounds so weird, my mind is a little out of reach."

"After Jing Ji said this, I always feel that these organs are too powerful, and I feel cold on my spine."

This passage has a good effect, and at least it can arouse the interest of many people in the audience. If someone can continue to delve into this "discovery" and discover various hormones in the human body as soon as possible, then he will really enter a new world.

However, before that, Kawei still had to pull everyone's attention back to the operating table: "These are just my guesses. We shouldn't set the nature label for that substance before it is truly separated."

There were finally some different voices on the stage.

The source of the voice is Greg, the youngest surgical reporter in the daily newspaper: "But the 'gao pill you have now decided that male administration is thinking' is itself labeling the gao pills."

"Do you think it's not the impact of the work of gao malphin?"

"Although I have never studied medicine, I have read many anatomical maps and medical textbooks." Because the Municipal General Hospital has established a new surgical theater, Greg successfully became a regular half a year ago and became a permanent reporter observer here. "At least I don't think it's absolute enough."

"So how to explain the relationship between gao pill tumor and breast hyperplasia?" Kawei asked back, "It is precisely because gao pills have tumors that affect the output of this special substance, and the breasts finally occupy the peak."

"But you still have no examples to prove it." Greg maintained Varella's style and marked it on the record book, "I can't report it."

"It's okay, it will be published in the British and German medical journals."

Watman saw them coming and going, and refused to give in to each other, so he could only come out to smooth things out: "Okay, today is a surgical theater, not a surgical conference. If you have any arguments, you can wait until the operation is over. Don't waste everyone's precious time now."

At this time, the preoperative disinfection has been completed, so I waited for Kawei's explanation: "The procedure: we first deal with the swollen vaginal nanga, and then explore the surrounding tissue to determine the boundary of the tumor to see if it invades the right side. After the removal, the operation will continue to transfer to the chest and treat the hyperplasia of the breast on both sides.

At the patient's request, I chose a small incision with a length of no more than 5cm and performed a mastectomy."

Fernan's posture is a classic stone cutting position. Kavi is standing in the middle, with Herman on the left and Koch who came to work in the right. The surgical instruments are placed in a metal round basin and placed on the patient's belly.

"The surgery officially began."

The reason why Kavi sent Fernan to the operating table was entirely because the gao pill removal is still at a relatively low level. Whether it is incision selection, operation skills, or drug maintenance, it is impossible to compare with the 21st century.

If it is in modern times, chemotherapy alone can treat most gao pill cancers. As long as it is discovered early, the 5-year survival rate will exceed 95%.

In the 19th century, the only possibility of curing Fernan was the scalpel. In order to improve the success rate of the surgery, Kavi needed to show the most standard gao pillectomy so that the doctors observing around could avoid detours as much as possible.

"Today I will choose an incision position that no one has ever chosen: the left groin incision."

Kavey found Fernan's left groin and drew a long arc with a knife: "If the patient has bilateral gao pill removal, then he should choose a central incision of the vagina. Here, considering the recovery after the surgery, I still chose a unilateral groin incision." [5]

The scalpel is facing downward, first incising the skin, and then starting to separate the subcutaneous muscles.

They are all routine incision operations, waiting for the aponeurosis of the internal oblique muscles and external oblique muscles to open, and with the help of two hooks, I encountered the first difficulty in the operation: "Next, I need to separate the sperm cord."

The sperm cord is a complex traffic pipeline tied together with arteries, veins, lymphatic vessels, nerves, cremaster muscles, and vas deferens, which together form the blood pathway of the gao Wan.

Since you want to cut the gao pills, this sperm cord must be cut off.

Carvey opens the external oblique muscle of the abdominal muscle and separates the sperm cord until it is near the inner ring. Separate, ligate, and cut off the vas deferens slightly below the inner ring. Then use new vascular forceps to clamp and cut off the sperm cord blood vessels. Use chrome-containing chrome-containing sheep intestine thread to make a penetrating sewage to prevent blood vessels from slipping and bleeding. [6]

Olgi is mainly engaged in urinary tract and has some objections to Kawei's gao pill removal method: "Why do you have to go along the far path of groin?"

"I personally prefer to cut off the back path first and siege it." Kawei put the statement of analogy hormones just now on the tumor. "The tumor also grows in our bodies. Isn't it an alternative organ? It's just that its work will have many side effects."

In the environment where tumor cognition has not yet entered the microscopic field [7], this view has once again refreshed everyone's cognition.

"Can tumors control our bodies?"

"It's not impossible. Tumor patients are often very weak and will lose their lives in a short period of time." Kawei's fingers went down the exposed semen cord and separated them all the way into the vagina and outside the testicle wall layer. "Because they have organ properties, be careful whether they are cut or separated."

While speaking, he pulled the entire content out of the incision. "Give me the blood vessel forceps." Kawei took the forceps, and Herman immediately pushed the empty ** down, exposing the connection lead between the gao pill and the bottom of the yin nang. "Fortunately, the tumor range is not too large, and there is no adhesion around the yin nang. If adhesion occurs, this part of the yin nang needs to be removed." [8]

The operation quickly came to an end with Kawei's superb operation.

"After the removal, we need to briefly observe the internal interval to see if the tumor invades the other side of the gao pill. Fortunately, there is no tumor on the right side yet, and the gao pill resection surgery is successful."

Then there is a three-piece set of hemostasis, suture and drainage done by Herman.

He needs to make a small incision at the bottom of the vagina, put a small piece of rubber tube, and then suture the external oblique muscle aponeurosis and skin incision at the inguinal groin. [9]

Kavey and Koch were excited to bring the newly cut left gao pills to the pathology examination table. Pathology examination is the gold standard for deciding the final diagnosis. Pathology must be done as soon as possible after the tumor suspected of being removed.

Kawei used a knife to make the pathological tissue sections, while Koch on the other side set up a microscope at the beginning, and then turned up the cabinet next to him: "Doctor Kawei, where is the stain?"

"It's in my suitcase."

Koch quickly found a bottle of blue dye from it: "Hey? Why is it blue?"

"Oh, the blue dye I asked for from a girl is of good quality." Kavey looked back at Orgi and asked with a smile, "What's wrong?"

"Can blue staining agent dye tissues?" Koch had a strong interest in chemistry, and even his work unit after graduation was located in the Berlin Institute of Chemistry, so he is very familiar with dyes. "In Germany, artificial synthetic dyes are used, generally yellow or purple-red." [10]

"Oh, HE staining." Kawei had no idea about the history of the dye, but it is not difficult to judge from the color that it should be HE staining. "In fact, it was prepared to find a hidden rupture during the operation, but later it was found that it could be too."

"Hmm?" Seeing Kavi suddenly interrupted himself, Koch couldn't help but step forward and asked, "What can it do?"

Kawei looked down at the gao pill tumor in his hand, but what he thought was the heavy bleeding of the cesarean section that he took over at the Lakeside Theater a few days ago. During the operation, the peasant woman had severe bleeding, her uterus was cut off, and her vesicle was broken by Orgi.

Kawei used this bottle of blue dye to find the broken ureter, which was also used to test the suture density of the bladder and ureter.

What looks fancy is actually just the basic operation in modern surgical procedures. So many days have passed, so there is no need to think about it.

Kekawei has been thinking about a peasant woman who has recovered very well after surgery these days. She has got rid of the infection after surgery that may be caused by pelvic inflammatory disease and has also gotten rid of the chronic poisoning of herbal medicine.

I originally thought that everything was the reason for the peasant woman himself, but now I look back at the surgery process. Perhaps this bottle of dye is the key to all problems?
Chapter completed!