“…… Soft abdomen, no muscle tension, appendiceal tenderness and rebound tenderness, no abdominal mass, abdominal percussion tympanum, no moving dullness, bowel sounds 4 times/min, no bruit......"

Lying on his desk, John carefully filled in the results of the examination he had just done.

At this time, his heart was really excited!

Receiving a patient with an acute abdomen, of course, John could not directly examine the diagnosis of acute appendicitis at once, he had to comprehensively evaluate Mr. Miller's condition and signs, and make a comprehensive analysis and judgment......

But judging by the results of the physical examination, the possibility of acute appendicitis is undoubtedly the greatest!

At this time, John couldn't help but be excited, although acute appendicitis is indeed the most common acute abdomen, but the first patient introduced by Professor Wolfgang was acute appendicitis, and this result still made John sigh in his heart for his good luck......

……

After his rebirth as a physician, John first solved the problems of surgical disinfection, anesthesia and blood transfusion, and successively published the theories of human ABO blood grouping, surgical sterilization specifications, topical anesthesia, local infiltration anesthesia and neuraxial anesthesia, and also invented two local anesthetics commonly used in later generations!

For a surgeon, this is the obvious choice.

The standard of surgical sterilization will greatly improve the survival rate of postoperative patients, which has been proven in the history of surgery and does not need to be repeated. The advent of local anesthesia technology will also revolutionize the way surgery is performed, allowing physicians to calmly cope with some long-term surgeries without having to make surgery like slaughter on the premise of worrying about the danger of inhaled gas anesthesia and the pain of patients. As for the theory of blood grouping, which is the basis of blood transfusion, John also put it forward, but it was of much interest to surgeons. Then it's not that he can control it.

The control of infection, pain and blood loss is the basis for the real development of surgery!

In other words, just by virtue of the results of these three studies, it is enough for John to leave a strong mark in the history of modern medicine and surgery, and thus become a generation of masters.

Of course, that's when they can really influence surgeons all over the world.

After doing the groundwork. John set his sights on the soft abdomen of a human being, a part that surgeons considered off-limits, a body cavity that had been warned by countless surgeons never to open!

For surgeons, both the chest and the abdomen have a special significance. These two body cavities, which are divided into upper and lower parts by the diaphragm, one houses the human heart and lungs, and the other houses the stomach, liver, gall bladder, spleen, pancreas, kidneys, intestines, appendix, bladder and uterus, etc., and the lesions that occur in them are usually the responsibility of internal physicians, and most surgeons dare not touch them.

Of course, this is not absolute.

In fact, both in the West and in the East. In the history of medicine, there will be no shortage of pioneers who dare to break open the human belly, especially when Morton demonstrated the anesthetic effect of Yimi for the first time at Massachusetts General Hospital in the United States, opening the prelude to modern anesthesiology, the number of Western surgeons who dared to challenge taboos gradually increased, and the disinfection technology promoted by Liszt played a role in fueling the fire.

One of the leaders and pioneers of this was Professor Bierrot in Vienna.

Before Bergmann, Bierrot was a professor of surgery at the University of Berlin, where he began to study the way to open the human abdominal cavity. It took ten years to study safe surgical pathways, and finally left the University of Berlin to become a professor of surgery at the University General Hospital of Vienna. Began the greatest pioneering research of his life - the Bi 1 and Bi 2 surgeries that have been used today after countless improvements!

Anesthesia technology and aseptic sterilization technology are the strength of Bierrot.

At first, Bierrot was a staunch opponent of surgical sterilization, and frequently criticized Liszt's theory of sterilization, but after seeing the great effect of sterilization surgery, the surgeon changed his attitude in the seventies of the 19th century, and sent people to England to learn disinfection techniques. It has also begun to call for promotion throughout Europe.

With adequate preparation, in 1881, Bierrot began to open the human abdomen.

Of course, even the greats like Bierrot and his assistants have only performed 41 such surgeries in ten years. The surgical mortality rate is also more than 50%. The lack of adequate anesthesia and sterilization techniques reduces the effectiveness of surgery, and one of the important reasons is that patients are seen too late and the current diagnostic technology is insufficient.

However, the emergence of Bierrot surgery still caused a sensation in the entire European and American surgical circles, bringing Bilrot a huge and unimaginable reputation!

All John wanted to do was push Bierrot open the door and open it completely!

So he chose the inconspicuous organ of the appendix.

Acute appendicitis is the most common acute abdomen, and appendectomy is one of the most common surgeries, and John couldn't think of anything better for a young surgeon as fledgling himself.

And most crucially, appendectomy is simple enough!

Maybe this sentence is not appropriate, because for the surgeons of this era, they have not even figured out what appendicitis is, what are the characteristics of appendicitis, or how to open the abdominal cavity to remove the appendix, but for John, this is indeed the easiest kind of surgery, because in his previous life he did the most appendectomy!

Familiar with the road, steady and stable.

There were no antibiotics in this era, and John could not guarantee that an appendectomy would definitely allow the patient to survive, after all, appendectomy a hundred years later would have a mortality rate of less than 1%, and the conditions at that time were simply not comparable to what they are now. But what he can guarantee is that it is better to do than not to do, and it is definitely better for him to do it than others to do it!

Therefore, when John could roughly conclude that Mr. Miller was indeed suffering from acute appendicitis, he did not hesitate to give his own advice, that is, to do his best to operate......

……

“…… So, Mr. Miller, get the surgery! ”

Looking at Mr. Miller in front of him with a sincere face, John gave his final proposal.

"Surgery?"

Mr. Miller's face was sluggish, and he opened his mouth wide and said, "Mr. Huntelaar." You mean to open my stomach with a knife? ”

"Yes, Mr. Miller."

Squinting his eyes slightly, John said very seriously: "If you consider the more than 100 patients I have followed up, I personally strongly recommend that you immediately perform surgery!" ”

"Nope! No! I will never do it! ”

Mr. Miller jumped out of bed with a thud and cried out excitedly.

At this time, he had forgotten the shock he had just heard of those cruel numbers. Forgetting what Mr. Huntelaar had just said when he examined himself, he now had only one thought in his mind: this surgeon is going to break open my stomach, and I am going to die on that bloodstained operating table!

Instinctively afraid, Mr. Miller fiercely opposes John's office!

Mrs. Miller was also flustered, and stepped forward to grab her husband's arm, but her eyes turned to John: "Mr. Huntelaar, is there no other way to cure it?" There are no other medicines, no matter how expensive we can buy them! ”

"This ......"

Looking at the fierce reaction of the couple, John was speechless.

Even if you have been mentally prepared beforehand. But seeing a patient's reaction to an appendicitis surgery so violently made John feel a little helpless. But this is also the characteristic of this era, just like the disinfection method advocated by Liszt since 20 years ago, although it has been widely recognized, but there are still many surgeons on the European continent who scoff at it?

Qiē is all in the process of exploring, and it is impossible for him to change the environment in a short period of time.

Fortunately, in addition to psychologically, John had other adequate preparations, and immediately shouted in a deep voice: "Both. Please be quiet for a moment! ”

Hearing this, the couple immediately fell silent.

If at the beginning, the two had doubts about John's age and qualifications. If the attitude is relatively casual, now with the thick stack of materials and the unclear inspection methods, there is already a faint awe and conviction in my heart, plus there is the support of the professor of surgery at the University of Berlin next to me, so the attitude is naturally much more respectful. So John's shout immediately silenced them.

"Two. There is absolutely no need to be so nervous. ”

John frowned and said in a deep voice, "I know you guys are very intimidated by this kind of surgery, because the previous surgeons really didn't do it well enough...... But that was before, not now! And even though I'm young, I just got my MD from the University of Berlin. Nor is he an ordinary surgeon! ”

In this case, John has no intention of keeping a low profile at all.

He went directly to open his bookcase, took out four magazines from them and spread them on the table, and said very sincerely: "Both, you can take a look, I have been in a medical journal for more than half a year...... I think you know what the paper means, right? I've published five papers in a row, mostly on surgery! And this stack of materials is evidence that I have carefully studied your disease! ”

"Hehe, that's good!"

After seeing John's move, Thomas and Bergman next to him lit up at the same time, and secretly praised it in their hearts.

With the establishment of the University of Berlin, Germany's science and technology has developed rapidly in recent decades, and it has become one of the biggest drivers of the country's strength, so even ordinary people understand the importance of science and technology, and their interest in going to university is high. Although they live at the bottom of society, they may not even be middle-class, but the Millers don't even know what a thesis is. Although John's trick seems to have a strong flavor of showing off, I am afraid that the effect is really not small!

"Uh......"

Looking at the four magazines and a thick stack of materials in front of them, the Millers were stunned.

This young surgeon is really so powerful?!

Before the Millers came to their senses, John continued: "Of course, theory is theory, practice is practice, and the surgeon still has to rely on surgery to speak!" So it's a pity because I just got my Ph.D. and I haven't had this kind of surgery on a human yet......"

"Haven't done it to people? John, what do you mean by that? ”

When he heard this, Bergman suddenly interjected curiously. As a mere spectator, he was not like the confused Millers, and naturally immediately heard the inappropriateness of John's words.

"Huh?"

Slightly stunned by Bergman's question, John's face immediately filled with apologies, and he apologized again and again: "I'm sorry, Professor Bergman, I have forgotten to tell you about this matter, when the three of them were trained some time ago, we completed more than a dozen cases of animal appendectomy, and performed appendectomy on dogs, rabbits, pigs and other animals......"

"How did it turn out?"

Bergman was surprised and delighted, and hurriedly asked.

In order to create a relaxed environment for John, he didn't interfere with this kid much some time ago, so he really didn't hear him say a lot of things.

John smiled slightly: "I dare to recommend Mr. Miller for this operation, naturally because the effect is very good, and all the little things survived!" ”

"Really?"

This time, without waiting for Bergman to speak, Mrs. Miller asked in surprise.

People in this era are not necessarily unfamiliar with animals, you know, a few years ago, because medical scientists used animals to do things, but there was an opposition movement in Europe, and there was a lot of noise at that time, and many people had heard of it.

"Of course it's true!"

John nodded and said very seriously: "Mrs. Miller, the wounds on the stomachs of these little things have not completely healed, if you don't believe me, I can take you to have a look at them at any time and see if they are alive and well!" ”

In fact, John did not do these animals to convince the patient, but to let Thomas and others understand his surgical philosophy and put into practice what was given to them. So after the experiment, he didn't report to Mr. Bergman. But as soon as Bergman reminded him, John immediately thought of using this to convince the Millers!

Thinking of this, John continued: "Of course, if you are still not at ease, I can even arrange for another animal to be done right away, so that you can see the whole process of removing the appendix ......" (to be continued......