"Is there any problem?" Seeing that the inspection process was stuck, Professor Fernand approached and asked.
Kraft did not respond immediately, but extended the percussion range further down and compared it with his memory. However, except for the point just below the lower corner of the scapula, the sounds from other percussion areas were basically the same as the previous percussion results.
.
This is completely unreasonable. If the results of two percussion tests at the same position are completely opposite due to slight differences in breathing movements, then one of his memory and common sense must have been insulted.
"I can't understand that the sound produced here is inconsistent with the previous one."
"What does this mean?" As a house officer, Wilbot appeared much more anxious than the Duke himself. I don't know whether he was confident in his body or not caring, but the patient just said "Oh?"
Kraft realized that he should explain the purpose and principle of the examination to his colleagues and patients, so that the information gap would not give them the illusion that "it is not a big deal."
"Similar to judging whether there is a secret door or secret room behind a wall through the echo of knocking, different components produce completely different sounds when subjected to appropriate knocking techniques."
"Generally speaking, as a loose, lightweight organ, the lungs should respond with a clear sound when percussed, but not so clear as to be almost empty. To be precise, it's like this." He said in the Duke's still intact
Knock outside the lung area to demonstrate pleasant voicelessness.
"But pulmonary wasting disease is a terrible disease. It will gradually erode the lungs, forming large lesions in them. After they decay, dissolve and are expelled, they will become cavities, which are the 'secret chambers behind the wall'."
When struck, a hollow object makes a sound like a drum or an urn.”
[To be honest, I have been using the Huanyuan app recently to read and catch up on updates. It allows me to switch between sources and read aloud with many sounds. .huanyuanapp is available for Android and Apple.]
Choosing another hole to explore, Craft knocked on the sound that represented disease.
Finally, he pointed out the area under the lower corner of the right scapula, "And this area was also like this during the first inspection. A cavity with an inner diameter of at least the length of a finger bone is definitely not small."
"But now it's not."
A thick, solid sound sounded under the percussion knuckles. Compared with the previous two, it was like a barrier filled with sand and gravel, turning the vibration into a dull, low reply, "I call it solid sound.
"
"What do you mean...is there anything that fills this hole?" As a scholar with strong comprehension ability, Fernand quickly understood the meaning through word formation, but this did not make him feel enlightened.
Falling into some deeper confusion with hidden unspeakable emotions, "Just when it happened?"
Kraft nodded slowly and firmly in response. He couldn't believe this either, but the objective result was such that he couldn't refuse.
Wilbert took the teapot from the servant and carefully filled the Duke's second cup of hot tea to soothe his throat. He understood Professor Fernand's summary and interjected: "But what does this mean?
Could it be filled with phlegm or something like that?"
"Liquid shouldn't sound like this." Compared with Professor Fernand, precisely because of his deeper knowledge and understanding of the disease, this change brought Kraft a more bizarre and unreasonable feeling.
Although "patients do not get sick according to the book" has been proven countless times as a classic traditional item, this development is still too beyond recognition.
Having said that, there is actually another saying that I heard later, "No matter how difficult the topic is, you will find its counterpart in the book." The master editors can always squeeze unexpected content into the nooks and crannies that are hard to see.
He searched for details in the text, looking for content related to tuberculosis, pneumothorax, empyema, hemorrhage, airway stenosis, atelectasis, pulmonary aspergillosis, pulmonary heart disease, and each noun was accompanied by paragraphs and pages of text.
, maybe one of them contains the answer to explain the "impossible event".
There can be many forced explanations. For example, what kind of liquid was poured into the cavity during the activity, and the sound was particularly strange because of the special position; or the narrowing of the airway caused by the disease accidentally formed a valve, like a tension pneumothorax, but the direction
Instead, you end up with a very specific form of atelectasis.
Everything may eventually be summed up in one sentence - do you believe this nonsense?
It can also be explained in a very simple and crude way. He didn't want to do it without clear evidence.
And no matter what guess he made, he could not confirm his guess in the absence of imaging examination results.
The tangled and unbearable feeling of losing vision once again climbed into his brain, and Kraft felt that desire was spreading in the sulcus like a subarachnoid hemorrhage, bringing stimulation that was no less than painful.
The spirit made a suggestion, and it was difficult for him to refuse.
"This shouldn't affect my treatment, right?" However, there were still people who were concerned about his treatment plan. The old Duke was wrapped in a fur, which was not a precious species, and the color of its fur was probably that of some animal hunted in the nearby mountains.
He bent his fingers and gestured in front of his chest. Apparently nothing happened. "A hole as long as a knuckle is not that wide. I still have such a big lung to use. If there are no other problems, start preparing for treatment as soon as possible."
"..."
Silence, silence is today's Westminster.
Not only Kraft, but also Professor Fernand fell into a state of shock and speechlessness. Fortunately, it was probably not the first time that Fernand faced such a request, and his train of thought was not completely disrupted.
"Sir, this is a very dangerous behavior. No one knows what accidents an 'active' lesion may cause during treatment." He paused and re-read the word "active", knowing that this word should not be used in its common literal meaning.
, it is even more uncomfortable to put it here, as if to admit that a moving thing can exist in the lungs.
"I think Knight Kraft's therapy makes sense. Maybe we can crush this lesion together?" The previous description of the treatment that emphasized risks did not seem to have any intimidating effect. Instead, it gave the patient some overly brave thoughts.
.
Fernand had no choice. As the patient's old attending physician, he knew the Duke's temperament very well. He could only give Kraft a look that said, "You will do what you suggest," and let someone else take over.
The original purpose was to find a new idea for the Duke's almost unsolvable illness. Now the purpose has been achieved, but unfortunately not in the way expected.
"I agree with Professor Fernand that we need to discuss more carefully." Kraft didn't think he could change the Duke's mind on the spot, but he could give a buffer time and more.
"It takes time to prepare the equipment for artificial pneumothorax, and the patient needs to adjust his physical condition before that. During this time, I would like to trace the detailed medical history, such as the people the Duke had contact with before the new symptoms appeared, and the food
, or somewhere I’ve been.”
Of course, there is a special inspection.
"Wilbert will meet your requirements. You can explain to him the tools that need to be made and the medicines that are used." The Duke didn't even raise his hand in interest at this expense, "But the menu and the interview list... forget it.
, it doesn’t matter much.”
[For the sake of funding and curiosity]
After careful consideration, Kraft decided to use his spiritual senses once. After all, this was indeed a special situation that was completely incomprehensible.
Just for a moment, like an abstainer from alcoholism, he twitches his nose at the mouth of the bottle to overcome his alcohol addiction. It relieves the depression that suppresses the spiritual instinct, and can also solve a particularly unique case puzzle and provide guarantee for the subsequent treatment. Kill three birds with one stone.
.
He convinced himself. No, Kraft wasn't sure if he convinced himself, but the shield blocking his mental senses was indeed lifted for a moment.
The consciousness eagerly absorbs the information absorbed at this moment, like rain. The riddled lungs are mapped into the mind in a three-dimensional and perspective form.
Focusing on the lower corner of the right scapula and the shallow layer under the chest wall, I focused on the answer to the riddle that contained confusion, curiosity and a little fear, and I felt like I was enjoying the mystery of peeking at the answer.
The first percussion was correct. It was indeed a tuberculosis cavity. The size was as estimated, and the inner diameter was slightly longer than his middle phalanx. The sense of distance under the mental field of vision was particularly good.
It seems a bit inappropriate to call it an "empty" hole now. A ball of spherical filling occupies the internal space, with a volume slightly smaller than the inner diameter, leaving a long and narrow arc-shaped cavity like a crescent, so it can also distinguish unexplored materials when concentrated.
The surface that fits the cavity wall.
It was a weird and delicate spherical surface like wool and velvet, showing a sense of exuberance that was inconsistent with the increasingly weakened respiratory organs.