Having ideas is a good thing, but having some confidence does not depend on the doctor himself, but on another group of people who have suffered a huge blow to their hair loss during this period.
After reporting the work progress in the past two weeks to the Duke and learning about his condition, Kraft took a piece of bread from the lunch plate and headed to the workshop without stopping to check on the work results of the craftsmen.
The jeweler, who looked unhappy, showed him something unexpected.
"How is this done?" Kraft carefully picked up the slender silver tube in the velvet cushion with two fingers and looked at the light.
The light passing through the middle shows that it is indeed a hollow tube with evenly thin walls, a sharp end, and a polished surface. The few hammering marks left show that it may be processed from beaten silver sheets.
He thought he would never see such a delicate thing in his life. He just missed the terrible fate of using feathers or thin bones as needles. Although this thing would have too high requirements for the diameter of the patient's blood vessels to be used as a syringe, with thoracentesis
In terms of needle standards, it has barely reached the standard.
The only worry is the strength of the material. If it bends, it's okay, but if it breaks, it's the real big trouble.
The needle was fastened to a wooden peg that matched the connecting leather tube that Kraft had requested. They made the tube from rolled up thin leather, with some kind of adhesive applied to the overlapping surfaces.
Compared with rubber tubes, the texture is tougher and inconvenient to bend, but the air tightness is trustworthy.
"Will this glue melt?"
"You can even use it to blow bubbles underwater."
The craftsman's assurance made Kraft feel at ease. He couldn't imagine what it would be like if the tube fell apart in the middle of the operation.
As for the air storage device, it is simply simplified into a large leather bag. The volume of the lung and chest cavity is only a few liters anyway, so there is no need to bother with a multi-component pump. It is difficult to make it without ensuring the sealing ability. However, this somewhat tests the operator's skills.
These items can basically meet the minimum requirements of Kraft's operation, and can artificially create a pneumothorax state under controllable conditions.
The specific operation steps are not complicated and are basically the reverse of thoracentesis.
He needs to use this needle connected to the leather tube to pierce the Duke's chest wall, and penetrate the layer of pleura close to the chest to reach the middle of the two layers of pleura. Then the next step is to blow the air in and use the air pressure to "flatten the lungs"
”.
This process does not happen overnight, and several injections of air mean that the patient has to take a few more injections. The experience without anesthesia is not much better, even to put it mildly, but since the Duke survived the enema and bloodletting, he can tolerate it.
It is reasonable to place a certain amount of trust.
Looking back now, the original plan is basically in line with the current needs. Under the increased air pressure, the lungs will be gradually compressed, and the cavities in the lungs will simultaneously shrink and close, leaving the bacterium to survive comfortably.
The space becomes smaller and smaller, until it voluntarily abandons this residence with an increasingly deteriorating environment.
This is true in theory.
But this brings up another question: How will it move?
Under the most ideal situation, the bacterium will control the main host hyphae balls, enter the bronchus from the tuberculosis cavity, the main bronchi, and all the way up into the trachea. Then it will crawl through the longest section of the trachea, which may last for a long time.
It will be too short.
It is best to ensure that the airway is open and not blocked by the diastolic hyphae. Fortunately, there is such a thing readily available.
"The leather tube is very good. Let's make another one and add a few metal rings inside to support it. It will be harder, but not too hard." Toughness also has the advantage of being tough, and it is just suitable for tracheal intubation.
"ah?"
…
…
"Your Excellency, before everything begins, I must inform you of the purpose of this operation and the risks."
"As mentioned before, this is a treatment measure to temporarily relieve the symptoms of your lung disease. It cannot completely cure the disease, and it may not even make you feel better." Kraft explained step by step.
Open the instrument package and wipe it with high-concentration alcohol.
The guarantee given by the craftsman did not include that it could be used after disinfection with boiling water. In the end, it had to be wiped manually, and the effect would be less effective. The strong and almost pungent smell of alcohol spread in the room.
The Duke closed his eyes and nodded to show that he was listening. He looked much more relaxed than the doctor, like an unrelated bystander. "This smell reminds me of when I was young. I had to quit smoking after I got lung disease."
No, that's not possible. I'm afraid you won't get lung disease if you drink such wine. Kraft cursed.
"After the start, there is a probability that some conditions beyond subjective control will occur, such as fluid leakage, persistent fever, worsening chest pain, difficulty breathing, etc. in the long term. Subcutaneous emphysema may occur in the short term, and in severe cases, it may damage blood vessels and cause vascular embolism.
life."
In fact, the probability is not high, puncture and gas injection will be carried out under the guidance of spiritual senses, but the notification process must be carried out.
Hearing the last sentence, the old Duke raised his eyelids slightly, "I would like to ask, have there been any patients who were scared away by this method before?"
"This is by no means a random fabrication, but a real risk."
"If you are lucky enough or unfortunate enough to go to the battlefield in the future, be sure not to talk to your soldiers like this." According to the request, he lay down on his left side, opened his robe, and exposed the right side of his chest where he was going to be treated.
Duke Min has agreed to this treatment, you can begin, Dr. Kraft."
"Thanks for your trust."
Count the fingers from top to bottom to the eighth intercostal space, then extend to the side of the body to the armpit, select the needle insertion point on the upper edge of the rib, and try to avoid the nerves and blood vessels running along the lower edge of the costal groove.
A ball of cold stuff sticks to the skin.
"Please relax, we are just cleaning the skin now." The cotton ball dipped in alcohol is centered on the puncture point and is expanded in circles. You can feel a large, cold circle appearing on your back.
"Now, I need you to be patient for a while and reduce your activities as much as possible." Kraft laid out the drapes, took out the puncture needle connected to the leather tube, and temporarily clamped the tube with small pliers to seal it. "I suggest that the guards hold you down.
Otherwise unnecessary damage may be caused.”
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After confirming that the preparations were completed, he connected his mental senses, fixed the skin at the puncture point, and held the needle against it for a few seconds to ensure that the patient was mentally prepared before starting to insert the needle.
Since I was standing on the back, I couldn't see the Duke's expression, but I could clearly feel that as the needle tip pierced the skin, the body changed from relaxed to straight, the muscles contracted and bulged, and the breathing stagnated.
Apart from the slight creaking of clenched teeth, all he could hear was his heartbeat.
The mind "sees" how the metal penetrates the subcutaneous tissue, easily pokes a smooth passage through the thin fat layer, and penetrates into the tense muscles. After being slightly blocked here, it continues to break through the chest wall and intercostal muscles.
, restrainedly pass through a layer of membrane attached to the chest.
The feeling of loss was synchronously fed back to his hand, indicating that he had successfully entered the pleural cavity. The needle tip was now stopping in front of the lungs, less than three fingers away from the cavity where the fungi resided.
The fungal spheres adhere to the walls of the cavity woven with necrotic proliferative tissue and granulation by means of filaments, as peacefully as a vole hibernating in its nest, unaware of what is happening.
After connecting the leather tube to the mouth of the air bag, Kraft tried to loosen the clamp and let the gas flow into the pleural cavity as evenly and slowly as possible. "You can continue breathing, Your Excellency."
With the rhythm of the ups and downs of breathing, gas that is less obvious than the amount in and out is mixed into this process, and the expansion of the lungs begins to be limited.
The form is not obvious at the moment. If a frontal chest radiograph could be taken here, it would probably appear as a narrow peripheral dark band that needs to be magnified to find. It is poorly differentiated from the lung field. The fine texture of the lungs ends in front of the dark area.
translucent boundaries.
After each small amount of gas is injected, Kraft pauses for two breathing intervals to assess the degree of compression and the state of the bacterium.
Probably because it is accustomed to the periodically changing pressure airflow in the lungs, it seems that this thing is far less sensitive to pressure changes than other stimuli. Until the injected air volume is close to half of the Duke's calm breathing volume, it still does not react agitatedly.
reaction.
At this time, the degree of compression has begun to take effect. There is a difference in the expansion of the elastic lung tissue and the scar tissue during inhalation, which has produced an initial compression effect on the cavity. I can vaguely feel the velvet commotion of the bacteriococci with reduced space for movement.
, seems to be about to wake up.
Kraft stopped the gas injection in time, pulled out the needle, pressed the puncture point with a cotton dressing, and ended the first gas injection.
"Your Excellency, please lie down and rest for a while, at least until the next dinner. I don't want to see you show extraordinary courage."