At the end of the 19th century, completing a platelet count was a very troublesome task.

To John's surprise, though, although platelets were only defined six or seven years ago, the technique was invented much earlier. Of course, this is also easy to understand, platelets are defined because someone discovered its hemostatic effect, and they were discovered much earlier, more than ten years ago someone invented the method of platelet counting.

John, of course, was using the future notation.

When he was in college, John didn't do a platelet count experiment, which was part of the laboratory department, but he did come into contact with it once when he was in graduate school. Visual counting of platelets is quite cumbersome, and there are many methods, such as treating blood with urea, sodium citrate, formaldehyde, and distilled water, which can lyse red and white blood cells and preserve platelets with intact morphology......

The perverted memory of this life made John record all the details.

Although the level of the laboratory was very unreliable in those years, when the laboratory department was first established, John spent two weeks there in order to standardize their operation and technology. At least in terms of blood routine examination, John has carefully trained the laboratory personnel one by one for those things that can be done by the technology of this era. In Miss Black's case, if it was due to thrombocytopenia, the reduction must have been quite large, and John believed that the men he had trained should be able to do the job.

After the test sheet was issued, John left the obstetrics and gynecology department.

Before leaving the room, however, John could clearly sense the change in the atmosphere of the Black family—a great sigh of relief, but soon another apprehension emerged. If the possibility of abortion can be ruled out, the family will naturally be happy, but if the girl is brought another unknown disease. That worry is right......

Because of this Jasmine? Miss Black, John came back to the hospital the next day.

After seeing the results of the laboratory overnight in the ward, John nodded with satisfaction and said, "It seems that it has been determined that Miss Black's bleeding is due to thrombocytopenia." ”

The number of platelets is more than half of the normal value, which is almost certain.

"Mr. Huntelaar, is there a cure?"

Kelly, who hadn't waited to see the results earlier, asked. The anxious Mrs. Black had already asked urgently, "What kind of sulfonamide and aspirin or something, can it treat this disease?" ”

As time went by, sulfonamides and aspirin became more and more famous.

"I'm afraid not!"

John immediately shook his head and replied solemnly: "Aspirin, in particular, can even aggravate Miss Black's condition, and it is absolutely forbidden to use it......"

While explaining to Mrs. Black, John also had a headache.

He didn't know much about thrombocytopenic purpura, and was limited to a little knowledge he learned in college internal medicine books - idiopathic thrombocytopenic purpura and thrombotic thrombocytopenic purpura. However, in the books, the causes of both diseases are unknown. And......

Even if the cause is identified, what can John do?

For example, for idiopathic thrombocytopenic purpura, the preferred treatment is glucocorticoids, but now there is no second person other than John himself who knows what hormones are; Gamma globulin or something, don't even think about it, how to do it?

Cut out the spleen?

Don't be funny!

Although removal of the spleen is the second-line treatment for idiopathic thrombocytopenic purpura, and John, as a general surgeon, has some certainty that the surgery will be done, he is not sure whether it will be useful to remove the spleen. Let's just say that before anyone discovered the effect of the spleen on thrombocytopenia in these years, he rashly proposed to cut off the spleen. The Black family and Kelly would treat him like a psychopath, right?

"If it's thrombotic thrombocytopenic purpura, it's fine."

After thinking about it, John felt a little headache again. If it is idiopathic, he certainly has no effective treatment to provide, at most he just gives some health education. However, if it is thrombotic, at least the first choice for the treatment of this disease is serum transfusion, and there are still ways to think about it.

But alas. John was unable to give an accurate judgment.

Again, the means of examination are too rudimentary, and John is really unable to come up with more accurate evidence, such as the obvious pentadic sign of thrombosis purpura, etc. And seriously, his knowledge of the disease is superficial. Almost never touched, and there was no confidence at all......

"Overall, we don't have a good idea for the time being!"

Without much concealment, John calmly told what he knew: "But I can tell you with great certainty that the cause of Miss Black's bleeding is not a ridiculous reason like an abortion, but a decrease in thrombocytopenia in the blood. And the reason for this phenomenon ...... We're sorry, but we can't figure it out yet. ”

The moment they heard John's denial of abortion, the Black family was visibly relieved.

The topic of abortion has been like a big rock in the past few days, pressing on the hearts of the Black family. The young girl's heart was full of grievances, and she even stubbornly started a cold confrontation with the couple; The Blakes are worried that their daughter is young and ignorant and has done something to disgrace the family, and this worry is definitely torment for them. Now that they heard John's unquestioning tone, they immediately moved the big stone in their hearts, and instantly became a lot more relaxed.

But......

When they heard the back, the family's expressions became gloomy again.

"Mr. Huntelaar, is there really no way?"

With a sparkle in her eyes, Mrs. Black put her arms around her daughter and asked sadly, "This child is ...... Sixteen years old! Can't you really think of another way? ”

"This ......"

Looking at Mrs. Black's sad appearance, John opened his mouth, and for a moment he didn't know what to say. For any patient who comes to his hospital, he naturally hopes to be able to cure the other person's disease and meet the needs of his family. But to tell the truth, at this moment, he can't give his own guarantee - this wish itself is impossible, even in the era of medical technology more than a hundred years later, there are still countless diseases that cannot be cured by hospitals, let alone this era!

Even if he found out the cause, John had little confidence.

However, in the face of the anxious Mr. and Mrs. Black, John hesitated for a moment and then quickly said seriously: "Mrs. Black, although we do not know much about this disease, please rest assured, we will do our best to cure Miss Black's ......."

……

This chapter is difficult to deliver, because I don't know how to write it.

The materials of that era were so hard to find that as long as it involved the disease, it would be very slow and depressing. (To be continued.) )