Koop leaned over aggressively, pressing his ear to the earpiece, feeling himself rapidly close to the lungs in his craggy chest, as if he were leaning against a giant bellows.

Turbulent air currents are passing through some narrow air ducts, pouring into the undulating box, emitting smooth and alternating breathing sounds.

Here, however, they did not move smoothly, whining as they passed through a cavity of apparent calibre that was not in line with the pipe, as if blowing in a limescale-heavy hollow urn.

It is also like blowing with a soft reed pipe under the thin layer of water that has deteriorated and slightly sticky, making a dense and long bubble bulging and bursting sound.

As the breath rises and falls, the rales repeat. He listened for a few cycles, and was sure that he would be able to distinguish the sound at least the next time, so he gave up his position.

"So what's the polite way to do? Come and hear it, sooner or later. Kraft pressed the earpiece to initiate the invitation.

Now it is impossible to reduce the sense of existence, David and several assistants and apprentices took turns to try out this new gadget, and Lecturer Velen also curiously came to listen to the voice in his lungs for a while, affirming its practicality.

"I think it's true that you can really tell the inside by the different breath sounds in your lungs when you can't really see it." He took the earpiece and tried to place it on the patient's chest, abdomen, and neck.

"Maybe I can hear the other guts with this. Some people have thought of doing this before, but it is really hard to hear clearly and inconvenient to put their ears on. ”

"Yes, with a few small methods, we can be more proactive in gathering the information we need from our patients. Such as touching, percussing, listening, etc. Kraft explained the previous inspection.

"It's based on the fact that we know what's underneath in order to correctly interpret the meaning of the sound and tactile change information. If I have time, I will explain it in text. ”

"Now we have a preliminary understanding of the basic condition of the patient through a simple physical examination, the patient has a cough for more than half a year, hemoptysis for about two to three months, and the diagnosis of pulmonary tuberculosis is considered. An urn-like breath sound may be heard in the lungs, but there is no friction sensation, indicating that there is no exudate adhesion between the two pleuras. ”

"It's fortunate that the tuberculosis did not invade the pleura, allowing us to inflate between the two layers of the pleura, which is the basis for the implementation of the treatment."

"Of course, before that, the patient's consent needs to be obtained." Kraft pulls out the pre-transcribed informed consent form for traumatic treatment and holds it with a pen.

"The purpose of this treatment is to control hemoptysis and prolong life, but there is a risk of complications such as pneumothorax, hemothorax, lung collapse, and in the most severe cases, it can be fatal.

"Since we have also been given the opportunity to learn from you, we will waive the cost of treatment as appropriate."

The extension of life and the waiver of costs have played a decisive role, with little hindrance in tipping the scales to one end. The thin man sitting on the bed suddenly became excited, took the paperwork handed over, but did not sign his name for a long time.

"If you have any doubts about this, you can choose to refuse, and this does not prevent Dr. David from continuing to pursue conservative treatment."

"No, that's not what I meant." He grabbed the paper, squeezed out the ink from the feather pen, smeared it in the palm of his hand, and covered the paper, "I mean, is it okay to have a handprint?" ”

"If you have difficulty reading, you can also find someone you trust to read the content of the certificate on your behalf." It's rare to do the whole process once, and Kraft hopes he hasn't copied it in vain.

"If you need to stick a needle into your chest during treatment, you can choose to regret it before you start, even if you sign and seal it."

The fear of pain made the patient hesitate for a moment, but another cough that brought out patches of red made a decision for him, reminding him that life was being lost from the wound in his lungs every moment.

"I feel like I have more than one needle in my chest, and one more wouldn't be worse. Please hurry up before I finish coughing up blood. ”

He looked expectantly at Kraft and the large white cloth-wrapped platter, a precious glimmer of hope in his eyes.

As he wished, some objects that he had not seen much but knew at a glance were expensive.

"As mentioned earlier, once we have identified the second rib based on bony landmarks, we will be able to find the intercostal space where the needle was inserted in turn." The doctor washed his hands with a surprisingly strong, solid-colored liquor, and scrubbed his chest with a cotton ball dipped in spirits, while continuing to explain.

"Lecturer Weilun, you can take out the fruits of our labor in the first two days."

A glass bottle with a suction mouth is placed next to the patient's mouth, containing a small amount of oily clear liquid, which the two men have made with the help of medical school equipment. The equipment condition is good, but due to the level of manual control, the yield is really worrying.

Ether, a less stable substance, has no safe storage method for the time being, and the best way to deal with it is to use it immediately to prevent it from becoming something else after being left out for too long.

"Adjust the air valve a little smaller, it's just a big injury from the tip of the needle, and it's no good to suck too much. Koop, help me come and press the patient, if the anesthesia is not deep, it may move, be careful not to touch my cleaning area. ”

Considering that there is no need to worry about anything that will alarm the lungs this time, anesthesia can be used to make the patient more comfortable.

The patient took a few puffs from the mouth of the bottle, and before falling into darkness, he saw Veron's surprised and delighted gaze.

He almost used the stability he had cultivated for more than ten years to control the hands holding the bottle from trembling with excitement, watching the needle tip contact with the skin and penetrating, and the recipient slept in ignorance.

"There will be a breakthrough feeling when the needle is inserted, which means that it has entered the chest cavity, and it should be stopped in time." Kraft pinched the skin and controlled the volume of the gas with a good sense of space.

The amount of air delivered needs to be just right, too much will cause the lungs to collapse and lose respiratory function, and too little will not compress the lesion and close.

Fortunately, he was also an adult male of similar size, and the experience accumulated in the duke helped him grasp this degree.

The process of artificial pneumothorax was successfully reproduced, and the skin tube was clamped and the chest wall was percussed, at which time the periphery of the chest cage was already a homogeneous cavitary hyperavoidance, indicating that the air replaced a mess of lung tissue and occupied half of the chest cavity.

The whole operation takes less than 10 minutes, which is about the average time of modern surgery. Kraft pulls out the needle and presses the puncture point, signaling the end of the vinylon operation and removing the anesthesia.

The patient, who had not inhaled much ether, woke up from shallow anesthesia, and the irritation of the respiratory tract caused him to cough violently and involuntarily.

He coughed for a few moments before realizing what he was doing, and frantically checked his shirt and sheets, suspecting they were completely red.

However, there was not half a fresh spot of blood, and only a short nap was there, and the fear that the blood was going to leak out of the broken trachea and drown the person seemed to be just an illusion. The results are as quick as immediate.

【Coughing up blood immediately】

Before David's self-doubting transcript was sent to the still-nowhere colloquium, the simple description could have taken any patient who heard of it to this once-obscure clinic.