Coop actively leaned forward and put his ear to the receiver, feeling that the distance between himself and the lungs in his rugged chest was quickly shortened, as if he was leaning against a huge bellows.
The turbulent airflow is passing through some narrow air ducts and pouring into the undulating box, emitting smooth and alternating breathing sounds.
But here, their progress is not smooth, and they make a whining sound when passing through a certain hole whose caliber is obviously inconsistent with the pipe, like blowing air in an empty urn thick with scale.
It is also like blowing through a soft reed pipe under a thin layer of degenerated and slightly sticky water, producing dense and long bubbles that swell and burst into sound.
As his breathing rose and fell, the rales came again and again. After listening to it for several cycles, he gave up his position after making sure that he could at least distinguish the sound next time.
"Why are you so polite? Come and listen, we will meet you sooner or later." Kraft pressed the receiver to initiate the invitation.
Now it was no longer possible to reduce the sense of presence. David and several assistants and apprentices took turns to try out this new gadget. Instructor Velen also came curiously and listened to the sound in his lungs for a while, affirming its practicality.
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"I think it is indeed possible to distinguish the internal conditions through different lung breath sounds without being able to actually see them." He took the receiver and tried to place it on other parts of the patient's chest, abdomen, and neck.
"Perhaps we can also use this to hear the sounds of other internal organs. Some people have thought of doing this before, but it is difficult to hear clearly and inconvenient to put your ears on it."
"Yes, through some small methods, we can more proactively collect the required information from the patient. For example, touching, tapping, listening, etc." Kraft explained the previous examination.
"This is based on the fact that we know what is underneath so that we can correctly interpret the meaning of the sound and tactile change information. If I have time, I will formulate it into written content to elaborate."
"Now we have a preliminary understanding of the patient's basic condition through a simple physical examination. The patient has been coughing for more than half a year and hemoptysis for about two to three months. We are considering a diagnosis of tuberculosis. An empty urn-like breath sound can be heard in the lungs, but there is no friction.
This shows that there is no adhesion between the two layers of pleura."
"It's fortunate that the tuberculosis has not invaded the pleura, so we can inflate the air between the two layers of the pleura, which is the basis for treatment."
"Of course, before doing this, we need to obtain the patient's consent." Kraft took out the traumatic treatment informed consent form that he had copied in advance and handed it over with the pen.
"The purpose of this treatment is to control hemoptysis and prolong life, but there is a risk of complications such as pneumothorax, hemothorax, and lung collapse. In the most serious cases, it may be fatal. If you are willing to undergo treatment, you can sign here to express your knowledge.
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"Since we have also gained a learning opportunity from you, we will waive the treatment fee as appropriate."
The extension of life and the exemption of fees played a decisive role, tipping the balance to one end with almost no obstacles. The thin man sitting on the bed suddenly became excited and took the handed document, but did not sign his name for a long time.
"If you have any doubts about this, you can also choose to refuse. This will not affect Dr. David's continued conservative treatment."
"No, that's not what I meant." He grasped the paper tightly, squeezed out the ink from the quill pen, smeared it on the palm of his hand, and covered it on the paper, "I mean, is it okay to make a fingerprint?"
"If you have difficulty reading, you can also find someone you trust to read the certification content for you." It is rare to go through the entire process once, and Kraft hopes that he did not copy it in vain.
"If you need to insert a needle into the chest during treatment, you can choose to regret it before starting, even if it is signed and stamped."
The fear of pain made the patient hesitate for a moment, but a burst of red cough made him make a decision, reminding him that life was being lost from the unhealed wound in the lungs every moment.
"I feel like there's more than one needle in my chest. One more wouldn't be worse. Please hurry up before I finish coughing up the blood."
He looked expectantly at Kraft and the large plate wrapped in white cloth, and a precious light of hope appeared in his eyes.
As he wished, some items that he had never seen before, but which he knew were expensive at first glance, were taken out.
"As mentioned before, after we identify the second rib based on the bony landmarks, we can then find the intercostal space where the needle is inserted." The doctor washed his hands with a solid-colored wine that had a surprisingly strong smell, and used a cotton ball moistened with strong liquor to inject it into the intercostal space.
Scrub the sides of the chest while continuing to explain.
"Lecturer Wei Lun, you can now show us the fruits of our labor in the past two days."
A glass bottle with a suction mouth is placed near the patient's mouth, containing a small amount of oily transparent liquid. This is the result of the two borrowing medical school equipment. The equipment is in good condition, but due to the level of manual control, the productivity is really worrying.
Ether, this unstable substance, currently has no safe storage method. The best way to deal with it is to use it immediately to prevent it from turning into something else after being left for a long time.
"Turn down the air valve. This is just a needle-sized injury. It's not good to inhale too much. Kupu, help me press the patient. If the anesthesia is not deep, it may move around. Be careful not to touch my clean area."
Considering that there is no need to worry about disturbing the lungs this time, anesthesia can be used to make the patient more comfortable.
The patient held the mouth of the bottle and took a few sips. What he saw before falling into darkness was Velen's surprised and delighted eyes.
He almost used the stability he had developed over more than ten years to control the hands holding the bottle from trembling with excitement. He watched the needle tip come into contact with the skin, penetrate it, and let the recipient sleep in ignorance.
"You will feel a breakthrough when inserting the needle, which means it has entered the chest cavity. At this time, you must stop in time." Kraft pinched the skin bag and controlled the gas volume 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; too little will not compress the lesions and close them.
Fortunately, we are both adult men with similar body shapes, and the experience accumulated with the Duke helped us master this degree.
The process of artificial pneumothorax was successfully reproduced. When the patient was almost conscious, he clamped the leather tube and percussed the chest wall. At this time, there was a uniform hollow sound around the chest, indicating that the gas had replaced the mess of lung tissue and occupied half of the chest wall.
The entire operation took less than ten minutes, which is roughly considered average time for contemporary surgeries. Kraft pulled out the needle and pressed the puncture point, signaling the completion of the vinylon operation and removing the anesthesia.
The patient who had not inhaled much ether woke up from light anesthesia, and respiratory tract irritation caused him to cough violently involuntarily.
He coughed heartily for a while before realizing what he was doing. He frantically checked his clothes and sheets, suspecting that they were completely stained red.
However, not even a single drop of fresh blood appeared. There was only a short nap, and the fear that the blood would overflow from the broken trachea and drown the person seemed to be just an illusion. The effect was as fast as it was immediate.
[Stop coughing up blood immediately]
Before David's self-doubting record was sent to an academic seminar that still had no progress, the ripples caused by this simple description could already bring any patient who heard about it to this once unknown clinic.