“…… Therefore, in summary, the appendice's susceptibility to inflammation is determined by its anatomical characteristics, its anatomical structure is an elongated blind tube, the lumen is rich in microorganisms, and the intestinal wall is rich in lymphoid tissue, so it is prone to infection! ”

“…… After synthesizing more than 100 cases, we can see that the most common symptom is naturally abdominal pain, which starts with the upper abdomen, and then quickly metastasizes and is confined to the right lower abdomen, of course, a few start in the right lower abdomen! In addition, gastrointestinal symptoms such as anorexia, nausea, diarrhea, and vomiting, as well as systemic symptoms such as fatigue and fever may occur. ”

“…… So based on the nearly 60 patients I examined, I can see that tenderness in the right lower quadrant is a typical sign, and the tender point is always fixed in one position, and this point is like what I drew on the diagram......"

"Perforation of the appendix is very easy to occur after verification, which is easily evident in the six cases I performed autopsies, and when perforation occurs, it is likely to lead to peritonitis, with pain in the abdomen with rebound tenderness...... That is what I said about the obvious pain at the moment when I quickly lift my hand after pressing on the sore spot for a period of time, and I think it is a clear sign of peritonitis! ”

“…… Therefore, the last key diagnostic criterion is a sharp increase in the number of white blood cells, although a small number of people, especially the elderly, may not have this expression. ”

“…… That's all there is to it, Professor, do you think my reasons are good enough?

Licking his somewhat dry lips, John looked at Professor Bergman, who was already stunned, and asked with a smile.

"Uh...... It's okay. ”

After being stunned for a while, Professor Bergman nodded with a blank look in his eyes and subconsciously replied.

Fooling Bergman is not an easy task for people of this era, but it is not too difficult for future surgeons either. John used a lot of anatomy, physiology, and pathology. It's easy to get a professor of surgery stunned.

After a moment's pause, Bergman didn't continue.

There was a small part of what John said just now, and Bergman didn't understand it!

That's a shame for a professor of surgery!

Of course, Bergman didn't suspect that John was fooling him, after all, there were too many things he hadn't heard of, but if you consider the two articles that this kid had published. The abdominal impingement method illustrates his deep understanding of anatomy, and the blood group theory reflects John's attainments in physiology.

"Just assume he's right."

While secretly smiling bitterly, Bergman took a deep breath and said in a deep voice: "John, I can see that you have indeed put a lot of thought into it, and you have also studied the pain in the right lower abdomen very deeply, but if you want to identify them on the appendix, I am afraid that the evidence is still not enough......"

"So we need to confirm it!"

John raised his eyebrows and said, "I believe that if these signs and symptoms are met." As long as we do an open abdominal examination, most of them can find that it is an appendix problem! ”

John did not mention the differential diagnosis of a perforated gastroduodenal ulcer, a right ureteral calculus, and some gynecological diseases, because it was not yet the time, and it would be counterproductive to say too much. Anyway, acute appendicitis is certainly the most common acute abdomen, and this is enough for patients in this era.

"Have you thought about bleeding and anesthesia?"

After frowning and pondering for a moment, Bergman was again embarrassed.

Although he has vaguely agreed with John's theory, for some reason, Bergman is quite resistant to really accept it. Subconsciously wanted to find some more questions for John.

"In fact, if you look at it further, I'll describe the bleeding later."

John calmly replied, "Just be familiar with the anatomy." If you plan in advance, in fact, there will not be much bleeding at all, and as for anesthesia......

After a slight hesitation, John finally smiled slightly: "I have been researching new anesthetics for a while now, and I have just achieved results, and it seems that the effect should be good." ”

"A new type of anesthetic?!"

After hearing John's words. Bergman was slightly stunned, and then a ball of essence instantly erupted in his eyes!

Bergman might have been suspicious if someone else said this, but he knew that the student in front of him was no ordinary guy. Not to mention that there are many achievements such as high-pressure steam disinfection, blood grouping and abdominal impact method, this kid has learned chemistry very well. Bergman once met an acquaintance in the chemistry department, and the other party once praised him harshly.

And......

After taking a deep breath, Bergman remembered what the chemistry acquaintance had said, and immediately asked, "You rented a chemistry room to study this?" ”

"Uh, yes."

Although it was a little strange how Bergman knew about this, John nodded anyway.

After getting John's confirmation, Bergman's mood suddenly became excited, and he seemed to have forgotten the unhappiness just now, stood up and said urgently: "Go, John, go to the chemistry room!" ”

"Huh? What to do in the chemical room? ”

Stunned, John didn't know what Bergman meant for a while.

Glaring at him, Bergman frowned, "Didn't you want to show me your new anesthetic?" ”

"Professor, I've already brought something!"

John suddenly laughed and cried, and quickly took out a small bottle from his leather bag and placed it on Professor Bergman's desk.

"Is it liquid?"

Upon seeing the vial, Bergman's eyes widened again.

"Yes, it's liquid!"

John smiled, nodded, and said, "And the route of administration is no longer inhalation...... Professor, I don't know if you have heard of an ophthalmologist in Vienna, Mr. Kohler? ”

"You mean, this is KKY?"

Sure enough, he was a professor of surgery at the University of Berlin, and John just mentioned his personal name, and Bergman guessed it right away! As a professor at medical school, keeping an eye on medical journals is part of Bergman's daily routine, and it's no surprise that he has read Dr. Kohler's paper on KKY being instilled into the eye for anesthesia.

"Nope. It's not KKY. ”

John denied it again: "But it does have something to do with Kky, in fact, the drug I named Lidocaine is indeed a derivative of Kky, which I made after many experiments in the real yàn room." ”

"He's drinking it better than smoking KKY?"

Professor Bergman frowned, a little skeptical in his heart. In fact, since seeing Dr. Kohler's paper, Bergman has also tried to anesthetize patients with KKY, but there is no effect at all except for the excitement of the anesthetic. Could it be that its derivatives can?

"No, it's not for the sick to drink."

Grinning and reluctantly rejecting Bergman's speculation, John explained, "Professor, this liquid needs to be injected into the patient's body to be effective...... It can be used for many purposes, it can be used for topical anesthesia, that is, sprayed on mucosal surfaces such as the eyes, nasal cavity and so on, or it can be used for local infiltration anesthesia, for example, if we just need to do a lumpectomy. It can be injected into the tissue of the surgical area, so that only a small area loses the pain, but it does not affect the rest of the body......"

"Are you sure? Can it really be? ”

When he heard this, Bergman's eyes were already as wide as eggs, and his breath instantly became heavy.

"Uh...... Of course! We've tried it. ”

After seeing Bergman's reaction, John smiled helplessly in his heart. He hasn't finished his words yet, especially lidocaine, a key neuraxial anesthesia!

But John can understand Bergman's reaction.

LVFANG and Yimi have always been the main force of anesthesia. However, the performance of this inhaled gaseous anesthetic is unstable, and its use also carries great risks. Many surgeons are not satisfied. And most of the surgeries that surgeons do nowadays, such as dealing with abscesses, benign tumors or fractures, don't actually require the patient to be completely unconscious, so you can imagine how the birth of local anesthetics will shake Bergman's heart!

Sure enough, after John said that the experiment had been carried out, Bergman was completely excited!

He couldn't even listen to the explanation at this point. grabbed John's arm and said urgently, "Quick, show me!" Right now! ”

“…… All right. ”

After seeing Bergman's eagerness, John knew that he probably didn't want to say anything to Bergman before demonstrating the effects of lidocaine, so he simply nodded and said, "I've got Thomas ready." Feel free to show you how it works! However, Professor Bergman ......"

"How?"

Seeing John's expression that suddenly became a little strange, Bergman was stunned.

Smiling slightly, John paused for a moment and then said, "Professor, I think you have just roughly understood all my thoughts, so if I solve the problem of anesthesia now, does it mean that you will agree to my request?" ”

"This ......"

Professor Bergman opened his mouth and said nothing.

Deep down, Bergman didn't want to agree to John's request, on the one hand, because this kid hadn't even gotten his Ph.D., and it was hard to believe that he could do complex and dangerous abdominal surgery, and on the other hand, the strange feeling in Bergman's heart strengthened again, and he seemed to be very resistant to John really starting to explore areas that even he rarely touched!

But if he didn't agree, Bergman was almost certain that the John in front of him would leave Charlotte Hospital, or even the University of Berlin Medical School, immediately!

With a few papers, he is not afraid of running out of places at all!

"How do you answer him?"

Looking at John with an expectant expression, Professor Bergman was in a dilemma...... (To be continued......)

PS: I was warned, the ancient narcotic drugs are all keywords......

Well, it will appear in pinyin in the future, so let's take a seat by yourself. I have to admire the people of more than a hundred years ago, they can really stuff anything into their bodies, and they are not much worse than those guys in ancient times in our country, haha.