Krafft's Notes on Anomalies

Coop actively leaned forward and put his ear to the receiver, feeling that the distance between himself and the lungs in the rugged chest was quickly shortened, as if he was leaning against a huge bellows.

The turbulent airflow is passing through some narrow air ducts and pouring into the undulating box, emitting smooth and alternating breathing sounds.

But here, their progress is not smooth, and they make a whining sound when passing through a certain hole whose caliber is obviously inconsistent with the pipe, like blowing air in an empty urn thick with scale.

It's also like blowing through a soft reed pipe under a thin layer of degenerated and slightly sticky water, producing dense and long sounds of bubbles rising and bursting.

As the breathing rises and falls, the rales come and go. He listened for a few cycles, and after making sure that he could at least distinguish the sound next time, he gave up his position.

"Why are you so polite? Come and listen, you will meet him sooner or later." Kraft pressed the receiver to initiate the invitation.

Now it was no longer possible to reduce the sense of presence. David and several assistants and apprentices took turns to try out this new gadget. Lecturer Velen also came curiously and listened to the sound in his lungs for a while, affirming its practicality. .

"I think it is indeed possible to distinguish the internal conditions through different lung breath sounds without being able to actually see them." He took the receiver and tried to place it on other parts of the patient's chest, abdomen, and neck.

"Perhaps we can also use this to hear the sounds of other internal organs. Some people have thought of doing this before, but it is difficult to hear clearly and inconvenient to put your ears on it."

"Yes, through some small methods, we can more proactively collect the required information from the patient. For example, touching, tapping, listening, etc." Kraft explained the previous examination.

"This is based on the fact that we know what is underneath so that we can correctly interpret the meaning of the sound and touch change information. If I have time, I will formulate it into written content to elaborate."

"Now we have a preliminary understanding of the patient's basic condition through a simple physical examination. The patient has been coughing for more than half a year and hemoptysis for about two to three months. We are considering a diagnosis of pulmonary tuberculosis. An empty urn-like breath sound can be heard in the lungs, but there is no friction. This shows that there is no adhesion between the two layers of pleura.”

"It's fortunate that the tuberculosis has not invaded the pleura, so we can inflate the air between the two layers of pleura, which is the basis for treatment."

"Of course, before that, we need to obtain the patient's consent." Kraft took out the traumatic treatment informed consent form that he had copied in advance and handed it over with the pen.

“The purpose of this treatment is to control hemoptysis and prolong life, but there is a risk of complications such as pneumothorax, hemothorax, and lung collapse. In the most serious cases, it may be fatal. If you are willing to undergo treatment, you can sign here to express your knowledge. .”

"Since we have also gained a learning opportunity from you, we will waive the treatment fee as appropriate."

Extending life and waiving fees played a decisive role, tipping the balance in one direction with little impediment. The thin man sitting on the bed suddenly became excited and took the handed document, but did not sign his name for a long time.

"If you have any doubts about this, you can also choose to refuse. This will not affect Dr. David's continued conservative treatment."

"No, that's not what I meant." He grasped the paper tightly, squeezed out the ink from the quill pen, smeared it on the palm of his hand, and covered it on the paper, "I mean, is it okay to make a fingerprint?"

"If you have difficulty reading, you can also find someone you trust to read the certification content for you." It is rare to go through the entire process once, and Kraft hopes that he did not copy it in vain.

"If a needle is inserted into the chest during treatment, you can choose to regret it before starting, even if it is signed and stamped."

The fear of pain made the patient hesitate for a moment, but another burst of red cough made him make a decision, reminding him that life was being drained from the unhealed wound in the lungs every moment.

"I feel like there's more than one needle in my chest. One more wouldn't be any worse. Please hurry up before I finish coughing up the blood."

He looked expectantly at Kraft and the big plate wrapped in white cloth, and a precious light of hope appeared in his eyes.

As he wished, some items that he had never seen before, but which he knew were expensive at first glance, were taken out.

"As mentioned before, after we identify the second rib based on the bony landmarks, we can then find the intercostal space where the needle is inserted." The doctor washed his hands with a solid-colored wine that had a surprisingly strong smell, and used a cotton ball moistened with spirits to Scrub the sides of the chest while continuing to explain.

"Lecturer Wei Lun, you can now show us the fruits of our labor in the past two days."

A glass bottle with a suction mouth is placed near the patient's mouth, containing a small amount of oily transparent liquid. This is the result of the two borrowing medical school equipment. The equipment conditions are good, but due to the level of manual control, the productivity is really worrying.

Ether, this unstable substance, currently has no safe storage method. The best way to deal with it is to use it immediately to prevent it from turning into something else after being left for a long time.

"Turn down the air valve. This is just a needle-sized injury. It's not good to inhale too much. Kupu, help me press down on the patient. If the anesthesia is not deep, he may move around. Be careful not to touch my clean area."

Considering that there is no need to worry about something disturbing the lungs this time, anesthesia can be used to make the patient more comfortable.

The patient took a few sips from the mouth of the bottle, and what he saw before falling into darkness was Velen's surprised and delighted eyes.

He almost used the stability he had developed over more than ten years to control the hands holding the bottle from trembling with excitement. He watched the needle tip contact and penetrate the skin, and the recipient slept in ignorance.

"There will be a breakthrough feeling when the needle is inserted, which means it has entered the chest. At this time, it must be stopped in time." Kraft pinched the skin bag and controlled the gas volume with a good sense of space.

The amount of air delivered needs to be just right; too much will cause the lungs to collapse and lose respiratory function; too little will not compress the lesions and close them.

Fortunately, we are both adult men with similar body shapes, and the experience accumulated with the Duke helped us master this degree.

The process of artificial pneumothorax was successfully reproduced. When the patient was almost conscious, he clamped the leather tube and percussed the chest wall. At this time, there was a uniform hollow sound around the chest, indicating that the gas had replaced the mess of lung tissue and occupied half of the chest wall.

The entire operation took less than ten minutes, which is probably average among contemporary surgery times. Kraft pulled out the needle and pressed the puncture point, signaling the completion of the vinylon operation and withdrawal of anesthesia.

The patient who had not inhaled much ether woke up from light anesthesia, and respiratory tract irritation caused him to cough violently involuntarily.

He coughed heartily for a while before he realized what he was doing. He frantically checked his clothes and sheets, suspecting that they were completely stained red.

However, no fresh blood spots appeared, and there was only a short nap. The fear that blood would overflow from the broken trachea and drown people seemed to be just an illusion. The results are almost instantaneous.

[Stop coughing up blood immediately]

Before David's self-doubting documentation was sent to an academic seminar that still had no progress, the ripples caused by this simple description could already bring any patient who heard about it to this once-little-known clinic.