All the people in the audience exclaimed in surprise and gathered around to see the excitement, but they were stopped by Li Pu with his guards and yamen soaps.

Du Wenhao took his hand and touched it, and sure enough, there was a faint pulse beating, and he leaned down to listen to the snort, and he could also feel a very slight breathing, and he was suddenly overjoyed.

The old man hurriedly stepped forward and touched his pulse, and also shouted in surprise.

They were happy, but Du Wenhao didn't dare to be too happy. Restoring spontaneous breathing is only the first step in a long march, and if the problem of acute abdomen is not solved, life is still in an instant, and it is possible to die at any time!

He immediately turned around and instructed Li Pudao: "You rush back to the inn immediately, and let my ladies prepare for surgery immediately!" Fast! ”

Li Pu didn't know what the word surgery meant, so Zhang Huang asked, "...... surgery?" ”

"It's laparotomy! Fast! Let's just say there is an emergency! ”

"Yes!" Li Pu was also very curious about this legendary magic skill, and immediately turned around and ran out, and the old man hurriedly ordered to bring the horse over to him, and Li Pu flew on the horse and galloped away.

Du Wenhao said: "Hurry up and prepare ginseng soup to save the adversity, quickly!" ”

Ginseng soup saves adversity, but Dr. Xie also knows it, and he is busy urging: "Shopkeeper Su!" Hurry up, do what the imperial doctor says! ”

This old man's surname is Su, and he has several businesses in the city, so he can be regarded as a big family, so there will naturally be no shortage of ginseng. Shopkeeper Su agreed again and again, and hurriedly ordered the servants to prepare.

Shopkeeper Su's family couldn't believe their ears and eyes, and they saw that their relatives who had swallowed their breath had breathing and pulse again, and they were all trembling with excitement, crying and laughing, and they all gathered around to see. Just now, the girl took advantage of this chaos and asked Du Wenhao: "Master Imperial Doctor, my father is ......, can he survive?" ”

"Well, but now he's in a critical condition and could actually die at any moment." Du Wenhao turned his head to the old man and said: "Old man, I can give your son a caesarean section to heal his injuries and try to cure his illness, but your son is very sick, I don't dare to guarantee that he can be cured, if you agree to me to perform surgery on him, please sign the consent form for laparotomy later, and promise not to blame me if it is not cured." All right? ”

Shopkeeper Su didn't know how to answer for a while, and turned his head to look at his daughter-in-law.

The woman stayed there, because she found that the breath she blew could make her husband breathe again, and she didn't know what the truth was, so she didn't know what to say, but seeing that her husband was similar to a dead man, her heart hung again, and she stammered to Du Wenhao: "...... imperial doctor, ...... imperial doctor, please save my husband......

Shopkeeper Su gave her a kick: "Go aside!" I haven't heard that the imperial doctor said that he would treat his son by caesarean section, what are you still yelling at here! ”

The woman stepped aside.

Du Wenhao said: "Shopkeeper Su, are you willing to sign the consent form for laparotomy and let me operate on your son to treat his illness?" If you agree, I will immediately transport your son to the inn, where I have an assistant to help and special equipment and medicines, and I will definitely try to save your son's life by caesarean section!" ”

Although Shopkeeper Su didn't know what this consent letter meant, since there was hope, it was better than doing things for his son, not to mention that he didn't know what the content of the consent form was, even if he knew, he didn't have a choice, so he nodded like a chicken pecking rice: "Okay!" Imperial Doctor, everything is hard, you must be able to save my son, I ......, I will be bankrupt, and I will repay your great kindness! ”

Du Wenhao didn't say a word, and immediately ordered the patient to be put in a carriage and transported to the Emei Inn where he lived.

The neighbors were all in a sensation, a person who had already died, was actually rescued again, and all the people were surprised, happy and curious, and they all gathered around the courtyard of the Su family to see the excitement. Fortunately, there was a yamen soap to quickly maintain order, and the Su family's carriage was able to go out smoothly.

But those curious neighbors refused to disperse, although there were no modern communication tools in ancient times, but the speed of word of mouth is also incomparable to modern society, so soon many people in the city knew that the capital came to the imperial doctor, it was this imperial doctor who saved the young master of the Su family, and also opened his stomach to treat him, all shouted and moved, more lively than the temple fair, buzzing behind them, came to the outside of the inn, stepped on their feet to look at the excitement, and talked loudly. If it weren't for the fast soap trap of the state government's yamen, I was afraid that I would have to rush in to see what was going on.

In the inn, Du Wenhao's heart is very heavy, he has never encountered such a critical patient, he is resurrected after faking death, and then undergoes laparotomy, whether there will be multiple organ dysfunction is unknown, and he is likely to die on the operating table. So far, dozens of laparotomy surgeries have been performed, and not a single case has failed, and not a single patient has died as a result. He doesn't want that record to be broken here. He's going to push the limits of his abilities.

All the way to the inn, he asked the patient about the symptoms before and after the onset of the disease, and in order to make the operation successful, it is the key to accurately determine what causes the acute abdomen.

However, Su Lao's shopkeeper and Su's family couldn't tell how the patient fell ill, only said that he came home from outside that day alone with his stomach, it was getting dark, said that his stomach hurt, and he couldn't tell him how he was in pain, and he couldn't tell if he found a doctor, his condition took a turn for the worse, and he soon fainted, and two or three days later he announced that he was breathing, fortunately he met the imperial doctor of Du in the capital.

These situations made his mood even heavier, and now the situation he is facing is not optimistic at all, the cause is still unclear, the patient is in a deep coma and cannot be consulted, there is a lack of modern diagnosis methods, especially modern first aid methods, and there is a real problem,—— there is no shadowless lamp!

Starting from the capital, Du Wenhao thought that there might be emergency surgery, so he also brought his customized surgical lighting and fireworks light source, although this lighting device is not as good as the shadowless lamp in the modern operating room, but it can barely meet the lighting needs.

The patient was sent to the inn, and Pang Yuqin and Xue Fei'er had already prepared the operating room and prepared for the operation, including the lighting equipment. A full set of surgical equipment and medicines this time they all carried with the car, both of them are familiar with the road, as soon as they heard Li Pu come back to tell them to prepare for the operation, they began to prepare in an orderly manner, and when Du Wenhao and they arrived, the preoperative preparations had been completed.

Ke Yao had to come to see the excitement, but was stopped by Lin Qingdai: "Laparotomy is no better than cutting a boil or something, it is a matter of dissecting the stomach, you Brother Hao can't be distracted, so don't mix it up." ”

Ke Yao also understood the power of it, and although he was unwilling, he still pouted and retreated to the next room to wait.

Du Wenhao asked the second daughter to send the patient to the operating table, urgently take antibacterial, anti-inflammatory, water-electrolyte, acid-base balance decoction, as well as anesthetic soup, and remove the hair in the surgical area to clean the skin.

After Du Wenhao washed his hands, Pang Yuqin helped him put on a sterile surgical suit. Taking advantage of this opportunity, Pang Yuqin asked in a low voice: "Xianggong, what is the patient's disease?" ”

Du Wenhao said in a low voice: "It's not clear for the time being, but when I did cardiac resuscitation on the patient before, I found that the deceased had a very low body temperature, severe coma, cyanosis of the lips and fingers, and a thin pulse after resuscitation. ”

Xue Fei'er leaned over and said, "Brother, no, you told us before that septic shock should have strong fever, but you just said that his body temperature is extremely low, then it is not an infectious disease, not purulent peritonitis." ”

Du Wenhao said while wearing sterile gloves: "That's right, in the early and middle stages of septic shock, there is indeed a continuous strong fever and a high body temperature, but in the later stage, it will suddenly drop and be lower than the normal body temperature of a person." When we took over, the patient was already in suspended animation, so we couldn't judge the condition by the current body temperature. It should be combined with the medical history and inquired on the road to learn that at the beginning of the onset, the patient reported severe abdominal pain, which was persistent, and they did not ask the specific location, and as the breathing and coughing worsened, it soon expanded to the whole abdomen with severe pain. and nausea and vomiting. These are clinical signs of purulent peritonitis. - It's just that they don't pay attention to whether the patient has a high fever. ”

"Wouldn't it? Isn't it a fever that is easy to detect? ”

"Well, maybe I didn't pay attention, but the change in body temperature is not the only basis for judgment." Du Wenhao walked to the operating table and stretched out his hand to press on the patient's abdomen: "According to the patient's obvious abdominal distension and the loss of abdominal breathing, it also indicates purulent peritonitis." However, this is only a suspicion and cannot be confirmed because the patient is unconscious and cannot be consulted. ”

"What now?"

"The cause is unknown, and time is pressing, so we can only open the abdomen immediately and decide on the next step of surgery according to the situation. Fei'er, you need to keep an eye on the patient's pulse, breathing, and body temperature changes. ”

"Okay."

Du Wenhao picked up the scalpel and was about to open his abdomen to explore, when he suddenly sighed, put down the scalpel, reached out and pressed it on the upper abdomen, where there was a purple scar!

Previously, he was checking through his clothes, but now he took off his clothes to prepare for the operation, only to find that he hurriedly pulled the towel up, revealing the whole purple spot.

It is an oblong area of subcutaneous hemorrhage, in which several bruising spots are noticeable.

Du Wenhao graduated from forensic medicine, and after just one glance, he can conclude that this is a subcutaneous hemorrhage caused by blunt force trauma! Location in the liver!

Du Wenhao's head flashed, and everything was immediately figured out,—— the patient was not in abdominal infection shock, but should be hypovolemic shock! It is no wonder that the patient's family did not notice the fever characteristic of abdominal infection, and the real cause was probably the internal bleeding caused by the rupture of the liver caused by this trauma to the liver!

The liver is fragile and prone to rupture when traumatized, and in ancient times, when surgery was lacking, internal organs ruptured and basically meant that the disease was incurable.

However, if it is a liver laceration, Du Wenhao is not sure to cure it, because the direct consequence of liver laceration is massive bleeding in the body, and due to the decline of the coagulation mechanism after liver injury, this surgery almost requires blood transfusion and hepatoprotective treatment. And Du Wenhao has never had a blood transfusion treatment!

In particular, the patient has been ill for a few days, and has been in shock due to hypovolemia, indicating that the blood volume is already very low, in this case, no blood transfusion, but I am afraid that if I can't wait for the end of the operation by closing my abdomen, the patient will die on the operating table due to blood loss!

Although this is only a preliminary judgment, and time is not allowed to think too much, it is obvious that he can only bite the bullet, Du Wenhao immediately decided to open the abdomen at this traumatic wound to determine whether it is a liver laceration, as for blood transfusion, it is still not on until it is absolutely necessary.

However, before that, he wanted to leave evidence, and immediately asked Pang Yuqin to bring a thin piece of glutinous rice paper, covered it with the purple spots, and drew the appearance of the purple spots, especially the darker blood spots.

After finishing, Du Wenhao fixed the incision skin with one hand and cut the patient's abdomen at the purple spot, and Pang Yuqin used gauze or forceps to help stop the bleeding.

As soon as the abdominal cavity opened, a thick smell of blood rushed up, Du Wenhao's heart sank, and he was bleeding internally! Ten of the ** is a liver laceration!

Liver laceration is often accompanied by damage to other organs, and the mortality rate is relatively high under modern surgical conditions, and I really don't know if I can get through it.

Du Wenhao asked Pang Yuqin to use a self-made simple rainbow aspirator to simply extract the blood in the abdominal cavity, and he directly reached into the abdomen, stretched into the omentum foramen, and pinched and blocked the hepatoduodenal ligament, so as to control the bleeding and prevent further deterioration of blood loss. The other hand is initially examined for liver damage.

Under the initial examination, it was found that there was a laceration on the surface of the liver!

Du Wenhao asked Pang Yuqin to use gauze pads to compress the wound to stop the bleeding, and then began to check whether there was any other damage to the liver and other organs.

The results of the examination made Du Wenhao's hanging heart slightly relieved,—— except for the relatively shallow laceration on the surface of the liver, there was no central rupture and bile duct injury and other organ injuries, which was really a blessing in misfortune, and fortunately, it was only this small laceration that allowed the patient to survive the continuous bleeding in the past few days.

Since there were no injuries to other organs in the abdominal cavity, the blood in the abdominal cavity was not infected. Originally, the blood in the abdominal cavity could be transfused back with autologous blood, but unfortunately, the retransfusion of autologous blood must be filtered, centrifuged and washed before it can be transfused back to the patient.

Just when Du Wenhao had just stitched up the liver wound, Xue Fei'er, who was in charge of monitoring vital signs, suddenly exclaimed: "Brother! It's not good, the pulse is almost untouchable, and if there is none, the breathing is intermittent! ”

Du Wenhao's heart was cold, it was over, he was bleeding too much and went into shock again. At this time, if there is no blood transfusion to replenish blood volume, the patient will definitely die!

The last resort, use your own blood to transfuse the patient!

Du Wenhao himself is blood type 0, and at the beginning of the preparation for abdominal surgery, he thought about using his own blood to transfuse patients in the event of a last resort in the future. He also imagined countless times how blood transfusions could be carried out under ancient conditions, without rubber products. He also developed a set of direct blood transfusion equipment that was stitched with animal leather and sterilized as a blood transfusion device.

He once used this equipment to test a calf's blood, draw the blood of a calf, and then transfuse it back through this rudimentary blood transfusion equipment, and it is reassuring that the calf did not die, or even had clotting or blood infections. This is due to the strict sterilization of his instruments.

After several tests, he was convinced that the transfusion device was viable. It's just that he has never used it in the clinic. The main reason is blood.

At present, he only knows his blood type, although he is a universal blood transfusion, but a healthy person cannot transfuse more than 400 milliliters of blood each time, otherwise it will be harmful to health, and more than 800 milliliters will cause serious damage to health, more than 1,200 milliliters, it will be life-threatening. In the case of heavy blood loss, the amount of blood transfused should exceed 400 milliliters. This is tantamount to exchanging one's own health for the lives of others.

Moreover, although the blood transfusion technology has been experimented with animals, but there has not been a similar experiment on the human body, I don't know what the consequences will be, because there is no blood preservation and extraction technology, only whole blood can be transfused, and the risk of whole blood transfusion is much greater than that of component blood, based on various considerations, so, in the previous treatment process, Du Wenhao can try not to use blood transfusion. However, this time, he couldn't dodge.

He decided to get a blood transfusion right away.

In order to minimize the amount of time the blood is outside the body, he uses a direct blood transfusion method. Blood transfusions are performed by gravity. Fortunately, at this time, the liver wound has been sutured, and all that remains is to clean the abdominal cavity and close the abdominal sutures.

Du Wenhao said to Pang Yuqin: "Qin'er, you come to clean the abdominal cavity and suture the abdomen, and Fei'er will help me transfuse the patient's blood!" ”

The concept of blood, blood type and blood transfusion Du Wenhao has told the second daughter in the previous teaching, and also took the second daughter to conduct animal blood transfusion tests, and the two daughters know this method, but Du Wenhao also told the two of them about the risks of this method, so when they heard that Du Wenhao was going to give a blood transfusion to the patient, they were taken aback.

Pang Yuqin was at a loss and said, "Xianggong, this ......, this is not good, I have never operated sutures." ”

Du Wenhao said: "Believe in yourself, you can do it, I have taught you, and you have practiced many times." ”

"However, it was practiced on pork, and I haven't tried it before!"

"Don't worry, I'm watching. Hurry up, it's too late to delay any longer! - Qin'er, you first give the patient a ginseng soup to help the adversity, and then help me transfuse blood. Fast! ”

Fei'er hurriedly said: "Brother, you ......, you want to transfuse your own blood to him?" ”

"Yes, I'm a universal blood transfusion, and a small amount of blood is fine."

"Is it okay to lose me?"

"I haven't tested your blood type, and you know the consequences of blood transfusions if you don't know your blood type. Less wordy! Fast! ”

Fei'er stomped her feet and ran to bring ginseng soup to save her adversity, Qin'er also began to tremble and carry out abdominal cavity cleaning alone, Du Wenhao took a direct blood transfusion device that had been strictly sterilized, moved a high cabinet in the room to the operating table, climbed on the top and lay down on the stool, plunged one head into his own blood vein, and fixed it.

At this time, Fei'er had already poured the patient with anti-adversity ginseng soup, came over to take the other end of the blood transfusion device, and according to Du Wenhao's instructions, waited for the blood flow to flow out of the needle at the other end, and after the air was discharged, she trembled and tried to insert the needle into the patient's veins. She had never pricked a needle, and under Du Wenhao's guidance, she tried several times before she got in, but fortunately, the patient had already drunk the anesthetic soup and didn't feel pain.

In order to control the speed of blood transfusion, there is a tube made of translucent glass in the middle of the blood transfusion device designed by Du Wenhao, which can barely see whether the blood is flowing and the flow rate.

After the anti-adversity ginseng soup was poured down, the blood in Du Wenhao's veins continued to flow into the veins of the eldest young master of the Su family. Finally, Xue Fei'er, who had been nervously checking the patient's pulse, exclaimed in surprise: "Brother, it seems that the pulse is stronger than before, and the breathing is also a little stronger." ”

Du Wenhao smiled weakly, the blood transfused into the patient's body must have exceeded four hundred milliliters, but he did not stop, saved people to the end, and sent the Buddha to the west. His own hematopoietic function is sound, and it doesn't matter much if the amount of blood loss is large, as long as he strengthens his recuperation, so he didn't stop the blood transfusion until he felt irritable, his heart rate increased, his hands and feet were cold, his eyes were black, he was drowsy, and he had symptoms of shock.

Little did he know that his blood transfusion was already close to eight hundred milliliters!

At this time, Pang Yuqin had completed the cleaning of the abdominal cavity, indwelling drainage tube and abdominal suture layer by layer under the guidance of Du Wenhao, this was the first operation she completed independently, although it was only an auxiliary part, and it was actually completed under Du Wenhao's guidance, but it was enough to make him happy.

Pang Yuqin happily turned to Du Wenhao and said, "Xianggong, my stitching is not bad, right......?" Messire! What happened to you? ”

Pang Yuqin found out that Du Wenhao's face was pale, cold sweat flowed from his forehead, and he immediately panicked and shouted: "Fei'er, what's wrong with Xianggong?" ”

Xue Fei'er also hurried over and held Du Wenhao's hand, only to feel that his hand was like an ice cube, and he was trembling.

Du Wenhao smiled reluctantly: "Don't ......, don't worry, I'm fine...... quick!" Give me frequent ginseng and Chinese soup...... Fast! ”

This decoction can quickly restore the hemodynamic stability of patients with hypovolemic shock, increase the partial pressure and oxygen content of tissues, improve microcirculation and tissue metabolism, and promote the resuscitation of shock.

As a first-aid medicine, Du Wenhao has already told Pang Yuqin and Xue Fei'er about the compatibility of this decoction and other relief medicines, so that they can pay attention to the corresponding medicine at ordinary times, so as not to be too late temporarily.

These potions were all fried in advance, so Du Wenhao only said the name of the medicine, Pang Yuqin rushed out, and soon brought a big bowl, Xue Fei'er hugged Du Wenhao and leaned on his arms, Pang Yuqin fed him with a spoonful of soup spoons with tears in his eyes.

Du Wenhao blinked: "Don't cry, isn't it good for me...... don't worry, how can a doctor treat himself and give him ...... Giving the Doctrine of Death...... Hehe. ”

Hearing this, Pang Yuqin's tears flowed even more, and while feeding him medicine, he sobbed and said, "Who is like you, you almost took your life to cure the disease!" You won't be allowed to do this nonsense in the future! ”

Xue Fei'er hugged Du Wenhao tightly in her arms, warmed his body with her body temperature, and cried: "That's it! If you don't think about yourself, you should think about us! ”

Du Wenhao drank the ginseng soup, felt that his body gradually began to warm, and his eyes were much brighter, he moved his head in Xue Fei'er's arms, and nodded comfortably: "Okay......, I will listen to you in the future, and I won't be brutal......"

"Hmmm! If you want to do it again, we won't say yes! Both of them said heavily. They regretted very much that they didn't stop Du Wenhao from doing this at that time, because they didn't know the terrible consequences of overdose, and now they found out that it was too late, and they just blamed themselves in their hearts.