Krafft's Notes on Anomalies

It is a good thing to have ideas, 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 to the Duke the progress of his work over the past two weeks and learning about his condition, Kraft took a piece of bread from his lunch plate and headed to the workshop without stopping to see 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 showed that it was indeed a hollow tube with evenly thin walls, a sharp end, and a polished surface. The few remaining traces of hammering indicate that it may have been worked from struck silver.

He thought he would never see such a delicate thing in his life. A narrow brush with the terrible fate of using feathers or tiny bones as needles. Although the diameter of the patient's blood vessels would be too high for this thing to be used as a syringe, by the standards of a thoracotomy needle, it has barely reached the standard.

The only worry is the strength of the material. It's okay if it bends, but the real trouble is if it breaks.

The needle was fixed to a wooden peg that matched the connecting leather tube that Craft had requested. They made this tube out of rolled up thin leather, and used some kind of adhesive on the overlapping surfaces. Compared with rubber tubes, the texture is tougher and inconvenient to bend, but the airtightness is trustworthy.

"Will this glue melt?"

“You can even use it to blow bubbles underwater.”

The craftsman's assurance reassured Kraft, and 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. It's just that 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 needed to use the needle connected to the leather tube to pierce the Duke's chest wall, penetrate the layer of pleura adjacent to the chest, and reach the middle of the two layers of pleura. Then the next step is to pump the air in and "flatten" the lungs with air pressure.

This process will not be accomplished overnight, and several injections of air will mean that the patient needs to receive several more injections. The experience without anesthesia was not much better, to put it mildly, but since the Duke survived the enema and bloodletting, it makes sense to place some trust in his tolerance.

Looking back now, the original plan is basically in line with current needs. Under the rising air pressure, the lungs will be gradually compressed, and the cavities in the lungs will shrink and close simultaneously, leaving less and less space for the bacterium to live comfortably, until it voluntarily abandons this habitation with an increasingly deteriorating environment.

This is true in theory.

But this brings up another question: How will it move?

Under the best conditions, bacteriozoites will control the main host hyphae balls from the tuberculosis cavity into the bronchi, main bronchi, and all the way up into the trachea. Then it will crawl through the longest section of the trachea, which is probably not too short.

It is best to ensure that the airway is open and not blocked by the diastolic hyphae. As it happens, there is already something that can be used.

"The leather tube is well made. 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 does not 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 to him by the craftsman did not include that it could still 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. His expression was much more relaxed than the doctor's, like an unrelated bystander. "This smell reminds me of when I was young. I had to quit smoking after getting lung disease."

No, that's not possible. I'm afraid you won't get lung disease if you drink this kind of 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. In the short term, subcutaneous emphysema may occur. 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 item, 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 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, extending 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 cold mass pressed against the skin.

"Please relax, we are just cleaning the skin now." The cotton ball dipped in alcohol was centered on the puncture point and expanded in circles, and you could 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 and took out the puncture needle connected to the leather tube. The tube was temporarily clamped and sealed with small pliers. "I suggest that the guards hold you down. Otherwise unnecessary damage may occur.”

Of course, this suggestion was not adopted.

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 squeaking of his clenched teeth, all he could hear was his heartbeat.

The mind "sees" how the metal penetrates the subcutaneous tissue, easily pokes a smooth path 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 passing through a layer of membrane attached to the chest.

The feeling of failure was synchronously fed back to his hand, reminding him that he had successfully entered the pleural cavity. The needle tip was currently stopping in front of the lungs, less than three fingers away from the cavity where the bacteria resided.

The fungal spheres adhere to the walls of the cavity woven with necrotic proliferative tissue and granulation through their 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, Sir."

As the rhythm of breathing rises and falls, gases that are less noticeable compared to the amount coming in and out are mixed into the 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 very poorly differentiated from the lung field. The fine texture of the lungs ends in front of the dark area. translucent boundaries.

After each short burst of air, Kraft pauses for two breathing intervals to assess the degree of compression and the state of the bacterium.

Probably because it is used to the periodically changing air pressure in the lungs, it seems that this thing is far less sensitive to pressure changes than other stimuli. Even when the volume of air injected was close to half of the Duke's calm breathing volume, he still showed no agitation.

At this time, the degree of compression has begun to take effect. There is a difference in the expansion of elastic lung tissue and scar tissue during inhalation, which has produced an initial compression effect on the cavity. I could vaguely feel the commotion of the velvet of the mushroom ball with reduced space for movement, and seemed 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. I don't want to see you show extraordinary courage at least until the next meal."