Da Ming: Father, step aside, I'll be the prime minister!

Chapter 371 Did the Ming Dynasty Also Have Surgical Procedures? An Inevitable Path of Scientific Development!

Zhang Yuangong looked over and saw that it was his stepmother, Madam Xia, speaking.

Madam Xia was Zhang Rong's legal wife, so she had naturally met Zhang Yunxiu several times. She immediately addressed the crowd.

"Didn't you hear what Commander Zhang said? What kind of behavior is this, all of you crying and sobbing? Get out of here! If you have any bad intentions, I will not let you off lightly!"

This statement immediately silenced the indignant younger generation of the British Duke's family.

"Mother! It's me!"

Zhang Yuangong wanted to speak, but seeing Xia's unquestionable gaze, he immediately lowered his head.

Xia ignored the other party and slowly spoke to Zhang Yuanhao.

"Hao'er, you stay here with your master and do your best to assist him with any instructions."

Zhang Yuanhao trembled slightly, tears still glistening on his face, and nodded emphatically.

"Please rest assured, Mother."

Upon hearing this, Zhang Yuangong, who had just stepped out of the room, couldn't help but turn back and look at her, his eyes filled with resentment.

Knowing the situation was urgent, Xia didn't say much. She bowed to Zhang Yunxiu from a distance and spoke earnestly.

"Shiyuan, I know you have always been a master of medicine, so today I will entrust you with your medical skills."

Zhang Yunxiu didn't even turn his head, still checking on Zhang Rong's condition, and nodded slightly as he spoke.

"Don't worry, Madam, I want the Duke to live more than anyone else."

Xia was stunned for a moment, then sighed and silently went out the door.

Qi Jiguang cupped his hands and said, "It's up to you now, young man."

Then, like a guardian deity, he stood outside the door, giving the impression that strangers should not approach.

Zhang Yuanhao opened all the doors and windows, and the room was no longer noisy. Zhang Rong on the bed seemed to have a chance to catch his breath. He took a few deep breaths and made a whimpering sound in his throat, but there was no sign of him waking up.

Looking at Zhang Rong, whose face was as red as a pig's liver, Zhang Yunxiu couldn't help but complain.

“I remember telling you before that oxygen is life, and when patients have difficulty breathing, it is necessary to reduce crowding and increase ventilation.”

Yang Jishi was startled. He hadn't seen Zhang Yunxiu so serious in a long time, so he quickly cupped his hands and said.

"This was the student's oversight, but this severe case of moth is truly beyond saving."

The so-called "severe tonsillitis" is described in medical texts as "phlegm obstructing the throat, shortness of breath, and even opening the mouth and raising the shoulders."

In modern terms, it would be called "acute suppurative tonsillitis".

Yang Jishi took a deep breath and finally managed to speak clearly.

"This throat inflammation is caused by excessive heat and toxins. Modern medicine has no way to cure it completely. The Duke of England had previously gone to the clinic to get a prescription and took medicines such as 'Yinqiao Powder' and 'Puji Xiaodu Drink'."

But the Duke of England had spent his life on the battlefield, accustomed to being unrestrained, and was unwilling to take medicine regularly, nor did he ever abstain from wine and meat.

Given his advanced age and frail health, it's likely that after indulging a little during holidays like New Year's Eve, New Year's Day, and the Lantern Festival, his condition worsened drastically.

For an old man like Zhang Rong, who was riddled with injuries and illnesses, even the slightest disturbance could be the last straw that breaks his life, not to mention that Zhang Rong was stubborn and never listened to advice.

Zhang Yuanhao, wiping away tears, said, "Father is always the one who has the final say at home. The doctor at the clinic keeps giving him instructions, but he naturally doesn't listen. I was thinking of asking you to treat Father after the Lantern Festival when you have time, but I didn't expect to delay things."

Zhang Yunxiu squinted, having roughly grasped the gist of what he was hearing.

Zhang Rong was no different from those old men and women in later generations who refused to listen to advice and spent all their time thinking about buying health products; they simply wouldn't listen to anyone's advice.

He was the Right Commander of the Five Armies Commandery, wielding considerable military power and holding a high position. He was a man of his word, and would even slap Zhang Yunxiu at the slightest provocation. How could he possibly listen to the words of a doctor with little experience in the clinic?
Yang Jishi used a specially made wooden pry bar to open Zhang Rong's mouth, and a foul stench immediately emanated from inside. He raised a small kerosene lamp specially made by the clinic and, by the small mirror on the lamp, clearly saw the condition of Zhang Rong's throat.

"The Duke's throat has developed an abscess, obstructing his airway. If this continues, the abscess will block his throat, and he will be unable to breathe."

Ultimately, the medical level of the Ming Dynasty was still insufficient. While allicin alone could reduce inflammation and inhibit bacteria, its effects were limited. Faced with such acute infections and inflammations, the Ming Dynasty was almost helpless.

What about surgically incising the abscess?

Zhang Yunxiu frowned deeply as he spoke.

Yang Jishi was stunned for a moment; this was indeed a method that Zhang Yunxiu could come up with.

Just like before, there was a patient in the clinic whose finger infection kept spreading until his entire hand was ulcerated. The doctors were helpless and it looked like he was about to die.

But after looking at it, Zhang Yunxiu simply said, "Why not just cut it off?"

The doctors present were all shocked, but surprisingly, after the hand was amputated, he was actually saved.

For a long time, when faced with intractable diseases, the doctors at Renmin Medical Center would have a common saying—"Just cut it out."

Was it really because the doctors in the Ming Dynasty were so incompetent?

In fact, the ancients were not foolish. Many medical books and ancient texts have recorded cases of various surgical procedures.

However, most ancient doctors were empirical. They might have tried it occasionally, but after discovering that the mortality rate was extremely high, they regarded it as an unworkable method and subconsciously abandoned it.

All of this only changed after Zhang Yunxiu and allicin appeared.

Zhang Yunxiu knew the other party didn't quite agree, so he continued to add to the discussion.

"This case is recorded in the classic book 'Orthodox Surgery'. For this kind of throat abscess and tonsillitis, it must be removed by stab, otherwise the pus will attack inside and endanger life."

His claim that he "read it from ancient books" was not unfounded; he could always find corresponding evidence for it.

Yang Jishi was taken aback and said, "What ancient book is 'Surgical Orthodox'? I have never heard of it."

Zhang Yunxiu was speechless. He then remembered that "Surgical Orthodox Manual" was written by Chen Shigong in 1617, which was more than 30 years ago. It would be strange if Yang Jishi knew about it.

Yang Jishi sighed and said, "I have also thought of this method, but the abscess has already formed and the acute attack is fierce. If it is easily removed at this time, the bleeding will be difficult to control, and the patient's life will also be endangered."

"That makes sense."

Zhang Yunxiu nodded slightly. He knew he was somewhat of an amateur, after all, he had little clinical experience, only some knowledge.

In later medical practice, the treatment of acute suppurative tonsillitis generally does not involve direct excision.

The key point is that the throat is too important. Other places can be cut easily, but cutting the throat easily can be life-threatening.

Yang Jishi sighed again and said, "It's too late after all."

If treatment is sought sooner, there may still be some hope.

At this time, the doctors at the clinic had already given Zhang Rong an IV drip as instructed by Zhang Yunxiu, trying their best to keep him alive.

But it's ultimately just a drop in the ocean.

Hearing that the two were still at a loss after their conversation, Zhang Yuanhao turned his gaze to his father on the bed.

At this moment, Zhang Rong's condition worsened again. His chest heaved, and there was a hissing sound in his throat. He looked extremely painful, and his face turned bluish-purple.

Zhang Yuanhao slumped to the ground, his eyes filled with despair, and began pounding his head as he spoke.

"It's all my fault! It's all my fault, this good-for-nothing! I've been idle and useless all day long! If I had sought out my mentor to treat my father earlier, he wouldn't be suffering here! He would have suffocated to death!"

Yang Jishi lowered his head, his face showing helplessness. He had seen too many partings and deaths, and he was already hard-hearted. But the Duke of Yingguo was someone he would see every day, so his feelings were completely different.

Thinking of the Duke of Yingguo, who was usually sharp-tongued but kind and gentle in his actions and always looked after everyone, Yang Jishi felt extremely sad.

But Zhang Yunxiu suddenly noticed something different.

"Suffocated?" He suddenly realized and hurriedly said to the two of them, "The Duke of England can still be saved! Quickly, bring Mr. Dongbi here! No! Quickly, get the Duke of England to the intensive care unit of the hospital!"

Surgery is not exclusive to Western medicine.

Later generations often have misunderstandings about traditional Chinese medicine, thinking that it is just about decocting medicine. In fact, ancient medicine was not entirely ignorant.

From Hua Tuo and Bian Que to Chen Shigong's "Orthodox Manual of Surgery" in the Ming Dynasty, there are records of clinical surgery.

There is a medical book in the Qing Dynasty called "Collection of Treasures on Throat Diseases" which records a treatment called "cutting the throat to allow air to pass through".

Similar to the tracheotomy intubation procedure of later generations, this method was specifically designed to treat emergency cases of airway obstruction.

However, the root cause is still the same: ancient medical conditions were limited, making it difficult to achieve a sterile environment, and the accuracy of surgical placement was also a concern. Most importantly, the wounds were difficult to heal after surgery.

Postoperative infections and complications are one of the main reasons why clinical surgery cannot be widely promoted.

This is why Zhang Yunxiu insisted on bringing Zhang Rong to the intensive care unit of the clinic.

Here you'll find the most advanced sterile operating table in the Ming Dynasty, and even a simple respirator. Combined with the well-crafted surgical equipment, this is what makes a successful surgery possible.

The carriage carrying Duke Zhang Rong of England traveled all the way to Renmin Medical Hall. When the carriage stopped, Li Shizhen was already waiting at the door.

He was originally on his way to the Duke of England's mansion, but after arriving halfway there, he received the news and made some preparations according to Zhang Yunxiu's instructions.

Upon seeing several people alight from the carriage, Li Shizhen, without saying a word, instructed the medical staff at the clinic.

"First, send the Duke to the intensive care unit."

The intensive care unit has more advanced medical equipment and can create a sterile environment. Most importantly, it is equipped with a simple oxygen supply system, which can at least keep Zhang Rong alive.

Yang Jishi was not skilled in surgery, so he volunteered.

"The students went to take care of the Duke."

Zhang Yunxiu nodded slightly and saw Li Shizhen coming towards him.

"The operating room is ready, and all the equipment is available, but we still need the balloon puncture needle and the intubation tube."

Li Shizhen looked completely bewildered as he held the note Zhang Yunxiu had just delivered.

Zhang Yunxiu sighed and said, "The situation is urgent, and we can't worry about so many things. We can have Xishan provide these things later. Let's keep things simple today and start the operation first, otherwise I'm afraid the Duke won't make it through."

Li Shizhen, of course, understood the implications and nodded slightly.

"This matter is urgent and should be started immediately once preparations are complete."

This kind of "throat abscess" is a fleeting condition; if it were delayed any longer, Zhang Rong would likely not live much longer.

Fortunately, Renmin Medical Clinic has now gained a lot of surgical experience. In addition to removing tumors and amputating limbs, they have even performed circumcision, a relatively "precise" procedure.

A few days ago, the clinic even tried an appendectomy, but the patient was already terminally ill. After the appendix was removed, the patient eventually died due to complications.

Accumulation of scientific and technological knowledge takes time, but in extraordinary circumstances, a leap forward is necessary.

While Li Shizhen and others were preparing for the surgery, Zhang Yunxiu was also busy. He reviewed the key points of "tracheotomy" and called Yuan Zongdao over.

Since participating in the medical center's experimental research, Yuan Zongdao, Liu Dongding, and Geng Zaichu have become experts in scientific experiments in the Ming Dynasty.

The development of medicine is closely related to biochemistry, and they already represent the highest level of experimental biology and experimental chemistry in the Ming Dynasty.

Upon seeing Zhang Yunxiu, Yuan Zongdao felt somewhat ashamed and cupped his hands in greeting.

“Master, your disciple is truly foolish. This method of using penicillin may still require some time. Today, the Duke's condition is critical, but penicillin has not yet been fully matured and purified. Your disciple dares not use it rashly.”

He was worried that Zhang Yunxiu might act impulsively and prematurely use penicillin. While it wasn't impossible to use it given the current research progress, the purity was insufficient, which would certainly involve a great risk.

Others were fine; with lives at stake, it was a good opportunity to test the effectiveness of penicillin. But the British Duke was in a completely different situation.

If this penicillin directly led to Zhang Rong's death, it would obviously be a huge blow to the medical center's research.

Zhang Yunxiu shook his head and said, "Penicillin has not been tested yet, allicin is enough. Besides, the Duke's condition cannot be solved by penicillin."

Antibiotics are indeed the most effective treatment for acute purulent tonsillitis. However, given Zhang Rong's current situation, by the time the medication takes effect, it will be too late.

The only solution is surgery.

Zhang Yunxiu said calmly, "The Duke of England needs to undergo surgery immediately, but there are some things you need to prepare after the surgery."

As he spoke, he handed the completed drawing to the other party.

Yuan Zongdao took the blueprints, which he found quite familiar, as Zhang Yunxiu had drawn them before.

As before, the blueprints depicted the structure and manufacturing process in a very clear manner.

Yuan Zongdao said with some surprise, "These blueprints..."

Zhang Yunxiu explained, "The surgery is simple, just an incision. The most crucial part is the post-operative care. The suction tube should ideally be made of intestines and sterilized with urine. Making an air bag and other instruments is the key to whether the Duke of England can survive."

Tracheotomy is not a difficult surgery, as evidenced by ancient records.

(End of this chapter)