In the eyes of every surgeon, cesarean section [1] is a major operation. From the moment the operation is performed to one month after the operation, the maternal mortality rate can be said to be horrific.

The most embarrassing point is that the mortality rate of other surgeries is higher after surgery than during surgery, and infection accounts for a large proportion. In cesarean section, it is just the opposite. The mortality rate during surgery is much higher than after surgery, and people who die on the operating table

It's their normal state.

For other people suffering from surgical diseases, they still have options. Unless the outcome is death, no one wants to lie on that blood-stained operating table.

But for mothers, they have no choice. Cesarean section is the only solution for women with difficult labor and placenta previa [2]. Without surgery, difficult labor and massive bleeding from placenta previa will cause fetal death. At this time, a mother will die.

Instead, it became “good news”.

The existence of cesarean section will always remind those surgeons who have a sense of achievement from time to time. Although they have escaped the dark age of using irons to stop bleeding, the light of the candles and oil lamps they hold tightly in their hands is still limited, and there is still chaos ahead.

Therefore, many people only dare to guard their own one-third of an acre of land and are unwilling to have a cesarean section.

Of course, there is always no shortage of rebels in this era. They know that the outcome is not good, but in the face of a certain death situation, they still put part of the pressure on their shoulders, hoping to lead pregnant women to give their fate a try.

Ignatz is one of them.

I have to say that courage is indeed commendable, but the reality is cruel.

Without oxytocin [3], strong hemostatic agents, and proper uterine suturing techniques, cesarean section will cause heavy intraoperative bleeding that is difficult to control. Even if the uterus and appendages are removed, it will be difficult for the weak body after the heavy bleeding.

Resist the attack of postoperative infection.

"So, we must be fast!"

While Kawei and Musil were bargaining with each other, Ignatz had already pulled Herman, Hills and the three interns to do the dissection work. In this rare exercise, speed became the

The primary focus he emphasized again and again.

"My goal is to complete the process within three minutes." Ignatz looked at the five colleagues behind him, "There will be obstetrical midwives to assist, but you as assistants and preliminary assistants also need to practice."

In order to treat this pregnant woman and successfully perform a cesarean section, Herman and Hills made a lot of preparations.

"Teacher, it is difficult to sew the uterus and the healing is very poor. Should we cut off the uterus after delivering the baby?"

Ignatz held the scalpel in his hand, looked at Rosa's body, shook his head and said: "Nora is still very young, only 19 years old. It would be a pity to cut off the uterus directly. I hope to try suturing the uterine incision.

"

Hills was startled and quickly warned: "Two years ago, the cesarean section performed by Dr. Morrow next door was due to problems with the sutures, which caused the pregnant woman to lose too much blood..."

"I know." Ignatz had no reaction: "That's why I just said, the speed must be fast."

"I went to see him and he was already very fast. He sutured the uterus in less than 3 minutes."

"Then we'll reduce it to 2 minutes."

Hills still felt something was wrong and continued: "No, no, this is not a matter of time. By then, the enlarged uterus will continuously pour blood into her abdominal cavity, and the crow's beak forceps [4] will not be able to clamp it.

The whole uterus. Your eyes are full of blood, how can you sew it up?"

"So I asked the hospital to buy a hand-operated suction device [5], made in Germany."

"I've seen that tube. Although the flow rate is greater than the previous one, it is still not enough to cope with the amount of bleeding caused by cesarean section. It only takes less than 10 seconds for her abdominal cavity to be filled with viscous blood.

When......"

At this time, Herman next to him gave him a gentle push and continued: "At that time, you and Mr. Ignatz just do it, and I will shake it faster beside you."

"The faster you shake it, the better..."

"You still don't believe me? I've been practicing recently." Herman smiled and showed his upper arm muscles. "It only takes half a minute to drink 1 liter of water."

Ignatz finally raised his head and looked at Hills: "It's better to practice quickly after talking so much nonsense. God knows when that girl will give birth."

...

Even a girl with a graceful figure cannot retain her original appearance two days after her death. What’s more, Rosa’s face has long been rotted, and obvious bruises and scattered wounds can be seen. If it weren’t for the weather in Austria at the end of February,

Before it gets warmer, those annoying little bugs will visit her cheeks one after another.

Two pieces of coarse cloth covered her upper torso, legs and feet, exposing only her flat and firm abdomen.

Ignatz's scalpel fell about 6cm above the umbilicus, made an incision next to the midline, and gently cut down to her lower abdomen. After three or two knives entered the abdominal cavity, they pulled apart the thin fat and muscles and began to search for the uterus.

.

The cesarean section they want to perform is very different from the modern cesarean section that has been improved many times. It is called classical cesarean section by modern people [6]...the earlier "ancient style" cesarean section.

The incision is similar to the classical method, but because the operation method is too rough and there is no decent practice, the process will be very messy.

If the surgical object is replaced by a corpse that has been dead for two days, the blood will be coagulated, and the tissues will have no elasticity or temperature. The scene will look extremely empty and even more fragmented.

"The unpregnant uterus is too small and has no blood, so it is difficult to simulate the feeling during surgery."

Hills pushed away the cold intestines and tried his best to make room for the surgeon to operate. Herman squatted on the side with a red face, shaking the suction device crazily: "It's been two minutes, can it be sutured?"

"Sew it up."

Ignatz took out a ball of cotton from the small uterus, threw it on the ground, and then took the needle and thread handed over by Hills: "To suture hollow organs, the endometrium and muscle layer should be sutured first, and then

It’s the outer serosal layer…”

While saying these words, he inserted the needle into the muscle layer, using simple continuous sutures, and then continuous mattress inversion sutures at the serosa layer [7].

For Ignatz, who had experienced anastomosis of the small intestine, suturing the uterus did not seem to be difficult. From entering the abdominal cavity to suturing the uterus, it only took 5 minutes, which was already quite fast.

But they know that this is not enough.

"Again!"

Ignatz cut open Rosa's uterus again, stuffed the cotton cloth on the ground back into place, simulated the appearance of a baby, and practiced again in the same order.

It's faster this time.

"4 minutes and 43 seconds."

Ignatz shook his head: "Continue!"

"4 minutes and 39 seconds..."

"4 minutes and 28 seconds..."

Ignatz closed Rosa's uterus for the fourth time. The small uterus was covered with sutured incisions. The time was shortening, but he still seemed dissatisfied.

"Teacher Ignatz is so amazing. This speed should be second to none in Austria."

Berget, who was standing aside, had just been embarrassed yesterday, and today he wanted to stand back on the operating table with words of praise and repaint his image as a top student.

Seeing him like this, the other two students were not to be outdone and stood up one after another: "The teacher's needle insertion and threading are very stable, much better than the French master Duran, I think we can book the front page of Vienna Daily"

Already."

If these words were put after the operation yesterday afternoon, there would be no problem. But now the three people on the dissecting table still have sad faces. The smoother the practice process, the more it reflects their inner uneasiness, because this kind of practice content is simply impossible.

Reflect the actual situation during surgery.

The more unknown, the more frightening it is.

"You have time to talk nonsense, why not go to the meat factory and ask for a pig bladder."

Ignatz looked at the sutured uterus and thought of a way: "Fill it with water and stuff it into her belly. Will it look like that?"

Herman rubbed a circle in the air with his hand and nodded: "It does look similar."

Hills also agreed with this approach: "It needs to be hot water, which can also solve the problem of amniotic fluid."

"Why don't you go quickly?!" Ignatz yelled at the three interns again, "Are you going to wait for me to give you each a lunch before stuffing the travel expenses into your hands?"

The three of them looked at each other and knew that they had said the wrong thing, so they had no choice but to obey his wishes and leave the autopsy room.

Unexpectedly, as soon as they arrived at the door, a nurse hurried in, followed by a trolley: "Doctor Ignatz, the police station has sent another corpse. I hope you will sign for it."

"Oh? It's been delivered?"

Ignatz was still very excited. Finally, a male corpse came. Although he was a little fatter, the abdominal fat and the enlarged pig bladder made it easier to simulate the appearance of a pregnant woman.

However, what he didn't expect was that a policeman who came in shortly after suddenly mentioned the money: "Teacher Ignatz, the body has been safely delivered to you. According to the verbal agreement, you need to pay

We pay 25 kronor, thank you."

"Hmm? 25 kronor?" Ignatz knew the verbal agreement between himself and Musil, but still didn't understand what he meant. "What 25 kronor? Hasn't the money already been paid?"

"This is what Dr. Musil told me." The policeman was also confused.

"Didn't I give him my money?"

"I don't know. Dr. Musil asked me to come here to get the 25 crowns."

...

At this time, Kawei had already entered the drug store. He had no idea that the police station would make a decision so quickly and send the body to the hospital immediately. He also had no idea that Ignatz and the policeman who sent the body would do it for him.

25 kroner is still lingering.

He is now "intoxicated" in front of the colorful pharmaceutical containers, trying to find out something that can be used for himself: "Boss, I often feel pain all over my body. Do you have any recommendations?"

The boss is an old man in a black suit, sitting behind the counter.

He was wearing gold-rimmed glasses and looking at the tattered book in his hand. He seemed to have lost patience with his questions: "I suggest you go to the hospital, either the city general hospital or Grizi. Although I think it's useless.

But at least it's better than staying here."

"Huh? Isn't there any medicine to treat pain here?"

"Yes, there is." The old man adjusted his glasses, gently turned his fingers over the page, and said calmly while looking at the page, "But this medicine cannot treat the colds, sprains, and headaches you just mentioned at the same time.
Chapter completed!