What could John have said about 19th-century surgery?

It may sound like a big topic, but it's a proposition that makes them scoff if it were to any surgeon in the 21st century. Because with the development of science and technology and the progress of medicine, it is impossible for any surgeon to explain clearly, but for surgery at the end of the 19th century, it is much easier to say.

To put it bluntly, surgery in this era is not so complicated.

The techniques of disinfection, anesthesia, and blood transfusion, which laid the foundation for modern surgery, have all begun to appear in this era, but in the eyes of later generations of surgeons, the current technology is not even crude. And as the absolute "authority" in these fields, John? It is enough for Mr. Huntelaar to follow along with his previous research and look to the future.

And......

"I just want to emphasize one thing about these basic operating techniques!"

More than an hour later, watching the crowd in the audience, John took a deep breath and said, "Gentlemen, if surgery wants to break away from the category of a skill and become a real science, we must treat it as a science!" And to do that, it is absolutely not enough to rely on our experience alone......"

At this time, in the entire auditorium, only John's voice was left.

For any surgeon, John's words speak to their hearts. Internal medicine has been one of the oldest sciences in Europe for a long time, but the development of surgery is very different. In the beginning, the surgeon and the barber became one, but gradually became independent, and it was not until the second half of the century that many medical schools began to have the course of surgery, and the name surgeon was born.

Rudeness was their synonym, and they wore dirty aprons, carrying axes and saws.

Although in recent years, because of the progress of anesthesia, disinfection and other technologies. Surgeons have gradually gained a certain status, but they are still far from those of internal medicine doctors. Therefore, for many people here, John's words can easily be agreed with by them, because only when surgery truly becomes a science, then it is possible to catch up with internal medicine doctors and no longer become a "barbarian" in their eyes!

"So I personally think. The most important thing is to operate standardly! ”

On the podium in the center, John? Mr. Huntelaar put it simply: "Why do patients need surgery? I don't think it should be decided arbitrarily, but there must be certain indications, that is, if the surgeon decides to perform a certain operation on the patient, the other person's symptoms must meet certain requirements, otherwise the operation cannot be easily ......."

"For surgery to be a real science, we have to pay close attention to our image! In my opinion, wearing an apron, a suit, or even going shirtless for surgery is absolutely unacceptable! And in order to ensure as much sterility as possible on the operating table. We should also wear hats, masks and gloves, wear isolation gowns, and ensure that they are strictly disinfected after each use......"

“…… In the process of surgery, we must standardize all operations, such as the scope of skin disinfection, techniques and surgical towel operation, etc., which may be troublesome and will increase the cost of our surgery, but our research has proven it. By doing so, you can greatly reduce the incidence of post-operative infections! ”

"There are still some details that we have to standardize after all. For example, the technique of holding the knife, such as the steps of cutting the skin and tissue, and the way of suturing and tying the knots at the end, etc. Perhaps these details may not seem necessary to everyone, but ...... Gentlemen, in a few years I will prove it to you. They are certainly more useful than you could have imagined, and they are extremely important......"

……

For the next half hour, John emphasized the importance of standard operations.

The word standard is actually quite foreign to this era, let alone in the field of modern medicine, which has just developed. Even in it, it is rarely seen in the industrial field. So John was foaming at the mouth when he spoke on stage, but the reaction of the people in the audience was not what he expected, and most of them were disapproving.

Of course, there are a very small number of people who are vaguely thoughtful.

John was not disappointed by this, he knew that to convince these people was either to produce detailed evidence or to have the prestige to refute them, both of which John did not possess for the time being. Just like he just said that surgeons are "armed", by now, counting the United States, there are not many hospital surgeons or operating surgeons who are willing to wear bulky isolation gowns, especially in the middle of summer, masks are unacceptable for them.

It is still not uncommon to go to the operating table shirtless in summer.

So John wasn't in a hurry, he needed time to collect a lot of clinical data to prove the validity of his theory. If a lecture like today's one can get the attention of a small group of surgeons and let them try their own theories, it will be a great victory – you can't ask too much of this day and age......

"Gentlemen, at the end of today's speech, allow me to present a new research result!"

When the hands of the clock pointed to half past eleven, John finally finished his opinion on surgery in this era, and threw out the final big killer: "It is about the principles of surgical wound treatment!" ”

"Buzz ......"

When he heard this, there was a slight commotion in a small area of the audience.

The conference in Germany made Huntelaar famous a little more than a month ago, but the main focus was on X-rays and antitoxin serums, and only a very small number of surgeons paid serious attention to this so-called principle of wound management. However, after coming to London this time, John's copy of "Heinz Surgery" was given away many copies, and many people saw it.

In the absence of evidence, of course, there are many doubts.

However, of course, John on the stage didn't care, and raised his spirit and said loudly: "Gentlemen, after my long time of exploration and experimentation, I have found a method that can effectively prevent subsequent infection of the wound......"

In the small hall of the University of London, John gave a detailed disclosure of the principles of wound management.

In all seriousness, the management of surgical wounds may seem simple, but in fact it is a rather complicated process, but for the medical knowledge of the late 19th century, the standards of the future are clearly not applicable - they are too complicated. For example, tetanus toxin injections and other treatment measures are simply not possible in this era. So, after careful consideration, John streamlined those steps considerably.

To put it bluntly, it's debridement, rinsing and suturing!

Doesn't that sound simple?

In the future, even an ordinary person who has never been in contact with medicine will know that after being injured, the dirt in the wound must be removed, and if the wound is long, the muscle tissue that has rotted or lost its vitality must be removed, and then disinfected and sutured. But in the 19th century, since surgeons were aware of the need to disinfect wounds, no one thought that wounds should be cleaned thoroughly, in addition to foreign bodies, and that tissues that had lost their vitality should be removed!

Just such a small step has cost countless people their lives.

Perhaps in normal times, people do not see the importance of this because of the low probability of occurrence, but once it comes to some special time periods, such as war, the importance of surgical debridement is fully reflected. Wounded soldiers who are not treated effectively can lead to a high rate of infections, which can occur in the era when antibiotics are not available......

Purely disinfecting with alcohol or something, it must be useful, but is it like what is written in many time-traveling novels, you can make medical alcohol with a precise concentration in ancient times, and make a great deal of power on the battlefield, saving countless injuries and diseases, John? Mr. Huntelaar is about to have reservations.

One is to remove foreign bodies and tissues that have lost their vitality, and the other is to rinse repeatedly and in large quantities!

This is not an easy answer, and it is not easy to know how to tell if muscle tissue is deviant, which is quite difficult for surgeons in this era, and all John has to do is spend half an hour to get the surgeons in London to form a rough concept......

……

By the time John left the University of London, it was already past four o'clock in the afternoon. And after communicating with dozens of people, John was already exhausted, and his face was full of exhaustion.

When sending John to the carriage, Liszt hesitated for a moment before asking, "John, what do you think...... Can a surgeon catch up to the status of an internal medicine doctor? ”

"Of course!"

Without hesitation, John nodded vigorously.

Thinking about the later generations of gold ophthalmology and silver surgery, thinking about the fact that most of the best graduates of medical school want to choose surgery over internal medicine, and thinking about the fact that surgery is far more difficult than internal medicine when American residents are matched, John has no doubt that the world will also go down this path. It does not mean that the surgeon must be better than the internal medicine doctor, the two are just different positions, but the status of the surgeon must be able to catch up, there is no doubt about it!

And at this point in time, it will definitely not be too far away.

Remembering his previous life as a surgeon, John said to Liszt seriously: "Sir, I can assure you that it won't be long before surgeons can get rid of people's traditional views and usher in a new era of surgery......

……

Before you know it, another volume is over. (To be continued......)