Krafft's Notes on Anomalies

A soul that has been destined for death is temporarily allowed to remain in the body, which lies on the bed board of the clinic.

The quilt was wrinkled, and the previous person who lay here had not tidied it up before leaving. The twisted folds of the fabric were a bit uncomfortable on the back, and those deep folds seemed to hide the odor of disease and unwashed light. Rusty spots, but much better than hard board.

He wanted to stand up and pull the blanket flat, but a violent cough interrupted his movement. There was some kind of pain in his chest, like a wound being forced to stretch. He clenched the nearest thing he could grab and pulled, making the blanket more wrinkled.

Something thicker and thicker than saliva spurted out with the cough. I wiped it with my hands subconsciously. I noticed the familiar moistness and thickness, and a conspicuous red color appeared in my palms, which catalyzed the steaming of heat and anxiety.

Occasionally, shadows carrying bottles and cans walked behind the white curtain, arousing a little instinctive hope, but it quickly cooled down.

So far, the expectations for the herbal decoction have been exhausted after the condition has worsened repeatedly. The doctor has also made it clear that the improvement may not be likely. Rather than treating it, it is better to describe it as a survival instinct. I am willing to believe that I can still struggle. one time.

Amid the discomfort in my heart, I could neither fall asleep nor stay awake. I just closed my eyes and tried to ignore the similar coughs coming and going next door, temporarily keeping my consciousness away from reality.

But this only made the hearing sharper. The suppressed sound of the cough was like some kind of sonorous footsteps of different shades, wandering between the indoor curtains. From time to time, it would stop and knock on the door in a high-pitched and urgent way, urging the call. Every time it sounded, Cause fright.

And in this sound, a series of footsteps on the ground walked down the wooden stairs and approached here. It sounds like it's coming this way.

A corner of the white curtain was lifted, and it was not the apprentice who usually delivered medicine, nor was it Dr. David who had only been seen during consultations and making conclusions, but a tall stranger whom he had never seen before, walking naturally to the bedside. stop.

A set of black robes that are similar to David's but newer, a facial expression that looks youthful behind a cloth mask, and a thick and forward hairline, all of which reduce his credibility.

However, he soon learned that impression does not necessarily have to be reflected in appearance.

Behind the young tall doctor, a middle-aged doctor wearing a black robe with red thread piping came in and automatically stood half a body next to him, holding his hands in front of him.

The only doctor I knew, Dr. David, walked last, helping the entourage holding the instrument tray to open the curtain, and followed the middle-aged doctor with a special black robe, actively marginalizing and reducing his presence.

Several assistants and apprentices followed silently in small steps, occupying the bed positions. Nearly ten people were crammed into the small compartment at once, completely surrounding the hospital bed. A pair of eyes that could not reach shoulder height were hidden outside the crowd, trying to see the inner circle clearly.

"Hello, I am a lecturer in surgery at Dunling University School of Medicine, Viren, and this is Professor Kraft from Rivers University." The doctor in a black robe with red edges stood up and threw out a few words that he had never heard of before. Noun, probably a very informative introduction.

"I came here to provide tuberculosis patients with a newer and more effective treatment, which is especially effective for hemoptysis."

"Ah?" The patient on the bed was stunned for a while. It seemed that he didn't understand much and was still thinking about whether he should sit up.

David looked over and translated, "These two are my teachers, specially here to cure you of the white plague."

“May Heavenly Father bless you.”

"This does not mean a complete cure, but it may be able to slow down the process of the disease and reduce the symptoms." Kraft held down the patient who was about to sit up and straightened the sheets. "Before that, we have to find out whether your condition is Suitable for treatment.”

Looking around, his intuition told him that something important was missing here.

"Dr. David?"

"I'm here, what can I do for you?" The clinic doctor felt that the next step should be to simply ask the patient and then start treatment. He only needs to study quietly next to him and seize the learning opportunities that fall on his head.

"Come and report your medical history."

It clicked, and Kraft finally found the right way to open it. Lecturer Willen stepped aside, exposing David who was 30% frightened, 70% surprised, and 90% confused.

The attention originally focused on Kraft, including the patients, was neatly transferred to the owner of the clinic, giving him a long-lost sense of déjà vu and returning to his not-so-good student days.

"The patient came to see a doctor because of 'coughing and hemoptysis'. He used..." Through a layer of cloth, David took a deep breath through his nose and caught the smell of herbal medicine wafting from the jar in the apprentice's hand. "The same as now, I used bone grafting." Raspberry decoction, considering the patient’s loss of appetite and occasional abdominal pain, added agaricus to increase appetite, and dill to relieve intestinal colic and strengthen the spleen and appetite.”

David felt a cold sweat running down his back, and he had the illusion that he was pointed out accurately by a teacher he knew in a big class. The people present today are not classmates, and not being able to answer anything would damage his social status much more than being in class.

He looked at Kraft, looking for his attitude towards this answer in his reaction, and found that the latter was also looking at him. That look clearly said, "Keep talking, why did you stop?"

What should I say? The cold sweat that had just stopped started to break out again. In his mind, he had almost said what needed to be said. Everyone knew that this was a tuberculosis patient, but it seemed that he was far from finished.

However, the professor was obviously a considerate person, and quickly noticed his difficulty, and decided to give some hints: "When and what did the patient come into contact with to start coughing? Is the cough violent? Is there a difference between day and night? Is there still phlegm in dry cough? Is there blood in the sputum? Has it gotten worse or relieved over such a long period of time? When did the hemoptysis start? Is there any chest pain?"

David looked at Viren for help, and Viren naturally asked with his eyes - You ask me about my surgery?

The atmosphere at the scene was not good, but fortunately the patient was aware of his own initiative and there was no communication barrier between the two parties.

"Doctor, I had a cough last winter. I drank some scented tea and it was fine in a few days. Then I had a cough again, this spring, and it became more and more frequent." The patient sat up from the bed with his body supported. , caused another cough, and you can see the old and new bright reds on your hands and the front of your clothes that are a mixture of dryness and freshness.

He tried hard to cover his mouth to stifle his cough, and hurriedly said as if he was afraid that the doctor would turn around and leave, "When the weather started to get hot, I found blood in the sputum, and I always felt that I couldn't exert myself, so I came here to see him."

"Okay, I understand." Kraft pulled a piece of absorbent linen from the plate and handed it to him, "Do you remember these specific times, such as what month they are? Especially when did the coughing and hemoptysis start?"

"I can't remember clearly. Does it matter?"

"It's okay. Just lie down and take a moment. Let me take a look." From this point of view, it is not unreasonable that today's medical history is generally incomplete. The view of time is unclear and the patient himself has little health awareness. As it stands, information collection on mobile patients is an absolute mess.

Kraft untied the patient's clothes. Unlike the Duke, who had always maintained adequate nutrition and was in excellent physical condition, the symptoms of emaciation were very obvious on the upper body. When the chest bulged, the faint ribs under the skin could be seen.

There is little need to look for bony landmarks, the location is intuitively clear by sight alone.

[Very suitable for teaching]

"Come on, Coop, put the thing aside and press it." Craft called Coop, grabbed his hand and pressed it on the center of the patient's chest, "What bone is this?"

"sternum."

"Very good, now how does this part you touch feel?"

"Uh, it seems uneven, a little convex?" Coop replied uncertainly.

"Yes, this is the sternal angle, which is flush with the second pair of ribs on both sides. We can count the ribs up and down based on this."

【It seems a bit troublesome】

Pressing Kupp's hand and guiding him to touch both sides to find the location of his ribs, Kraft felt such an idea forming. There should be an easier way for me, without having to rely on these rules and regulations.

After some searching in diagnostics, logic rejected the newly generated idea. This is indeed a very convenient method. It would be faster unless it was directly seen, but not all patients are so thin.

But his intuition still reminds him that he should not be trapped in inefficient methods, and guides his consciousness to follow his instinct and use that method, skip the tedious sight, touch, and hearing, and make a diagnosis for the patient with an absolutely accurate perspective.

[This is your responsibility to the patient, isn’t it? 】

Kraft thought for a moment and grasped the source of the idea, which was the daily vibration of the spiritual senses, such as the mouth reflexively secreting saliva when seeing delicious food.

He rejects suggestions from his part. This is certainly not irresponsible. What is needed now is a simple and easy method that can be completed by anyone with systematic education, rather than a human CT machine cheating by relying on extraordinary rational abilities that are difficult to reproduce.

If, as a pioneer, you cannot complete the entire set of operations under the conditions of an ordinary person, but you still want to implement the treatment method, that would be truly irresponsible.

Suppressing his mental senses, he palpated the pleural friction sensation and ruled out the contraindications of pleural adhesion in the normal order. Kraft in turn pushed through the intercostal space to locate the cavity, and then took out a cylindrical object from the tray brought by Kupp. The sides are tightly sealed with thin skin, and it looks like an elongated version of a snare drum.

This is also one of the works of Westminster craftsmen. The original version of the stethoscope, or more appropriately called a "receiver".

Place one end on the area that needs auscultation and put your ear on the other end. The advantage is that you can save the inconvenience of putting your head on the patient's chest to listen. It's still not very convenient, requiring you to bend down and twist your neck to adjust the position.

Kraft carefully positioned and moved the receiver, remembering the imaging department that he had been away from for a long time, corresponding to the position of the hollow that he touched, and distinguishing the hollow whistling sound. After confirming again and again, he fixed the receiver with both hands and released the ear end.

"Come here and listen. This is what the lungs of tuberculosis patients with cavities sound like."