Krafft's Notes on Anomalies

"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 to compare it with his memory. However, except for the point just below the subscapular angle, the sounds of other percussion parts are basically the same as the previous percussion results.

This makes no sense at all. If the results of two percussions at the same position are completely opposite due to slight differences in breathing movements, then one of his memories 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 the internal affairs officer, Wilbot showed much more anxiety than the Duke himself. Whether it was because he was confident about his body or because he didn't care, the patient just said "Oh?"

Kraft realized that he should explain the purpose and rationale 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 using the echo of knocking to determine whether there is a secret door or secret room behind the wall, 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 struck, but not so clear as to be almost empty. To be precise, it's like this." He said in the Duke's still intact A tap outside the lung area demonstrates a pleasant voiceless sound.

"But wasting disease is a terrible disease. It gradually eats away at the lungs, forming large lesions in them. When they decay, dissolve and are expelled, they become cavities, which are 'chambers behind the walls'. In When struck, a hollow object makes a sound like a drum or an urn.”

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 shoulder blade, "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. However, this did not make him feel enlightened. Falling into some deeper confusion with unspeakable emotions, "Just during the attack?"

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 "the patient does not get sick according to the book" has been proved countless times as a classic traditional item, this development is still too beyond recognition.

Having said that, there is actually another sentence that I heard later, "No matter how difficult the topic is, it will find its counterpart in the book." The book editors can always squeeze unexpected content into the nooks and crannies that are hard to see.

He searched for details in those words, looking for content related to tuberculosis, pneumothorax, empyema, hemorrhage, airway stenosis, atelectasis, pulmonary aspergillosis, and cor pulmonale. Each noun was accompanied by paragraphs and pages of text. , maybe one of them contains the answer to explain the "impossible event".

There are many forced explanations. For example, what kind of liquid is poured into the cavity during the activity, and the sound is particularly strange because of the special position; or the airway stenosis caused by the disease accidentally forms a valve, like a tension pneumothorax, but in the opposite direction, and finally gets a very strange sound. Special atelectasis.

Everything may eventually be summed up in one sentence - do you believe this nonsense?

It can also be explained in an extremely 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 without 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 an offer and he had a hard time saying no.

"This shouldn't affect my treatment, right?" However, there are still people who are worried about his treatment plan. The old Duke was wrapped in a piece of fur. It was not a precious species, but the color of the fur was probably that of some animal hunted in the nearby mountains.

He curled his fingers and gestured in front of his chest. Apparently nothing happened. "A hole as long as a knuckle is not too 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 stunned silence. Fortunately, this was probably not the first time Fernan had 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 will 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. I could only give Kraft a look that said, "You can handle your suggestion," and someone else took over.

The initial purpose was to find new ideas for the Duke's near-unsolvable illness. Now the goal is 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.

"The preparation of artificial pneumothorax equipment takes time, 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 and foods that the Duke came into contact with before the new symptoms appeared. Or been somewhere."

Of course, there is a special inspection.

"Wilbert will satisfy your request. You can explain to him the tools that need to be made and the medicines that need to be used." In response to this expense, the Duke did not even raise his hand in interest, "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, it's like a recovering alcoholic twitching his nose at the mouth of the bottle to get over an alcohol addiction. It can relieve the repression that suppresses the mental 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 had convinced himself, but the shield blocking his mental senses was indeed lifted for a moment.

Consciousness eagerly absorbs the information absorbed at this moment, like falling rain. The riddled lungs were mapped into my 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 that contained confusion, curiosity and a little fear, and I felt a sense of enigmatic pleasure from 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 spiritual vision is particularly good.

It seems a bit inappropriate to call it an "empty" hole now. A ball-like 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. Therefore, it can also distinguish unexplored materials when concentrated. The surface that conforms to the cavity wall.

It was a weird and delicate spherical surface like raw velvet, showing a sense of exuberance that was different from the increasingly weakened respiratory organs.

Happy New Year!

I wish my dear readers good health in the new year! )*