Chapter 207: Hemoptysis Stops Immediately

Kup eagerly leaned in, pressing his ear to the stethoscope, feeling the distance to the lungs within that rugged chest rapidly close, as if leaning against a massive bellows.

A turbulent airflow was rushing through certain narrow ducts into a box filled with undulating changes, producing a smooth, alternating breathing sound.

But here, their progress was not smooth; when passing through a hollow whose caliber was clearly inconsistent with the pipes, they emitted a whine, a strange echo like blowing air into a water-scale-thickened empty jar.

Or like blowing through a water-softened reed tube beneath a thin layer of spoiled, slightly sticky water, creating dense, prolonged sounds of bubbles swelling and bursting.

As the breathing rose and fell, the rales repeated cyclically. After listening for several cycles, confident he could at least distinguish this sound again next time, he stepped aside.

"Why be so polite? Everyone come listen; sooner or later you'll encounter it." Kraft held the stethoscope and issued the invitation.

Now there was no way to reduce his presence; Dai Wei and several assistants and apprentices took turns trying out this new small tool, and Instructor Vilen also curiously leaned in to listen to the sounds in the lungs for a while, affirming its practicality.

"I think we can indeed distinguish the internal condition through different lung breathing sounds even when we cannot see it directly." He took the stethoscope and tried placing it on other positions of the patient's chest, as well as the abdomen and neck.

"Perhaps we can even hear sounds from other internal organs this way. Others have thought of doing this before, but pressing an ear against it is truly hard to hear clearly and is inconvenient."

"Yes, through some small methods, we can more actively collect the information we need from the patient. For example, palpation, percussion, and auscultation." Kraft explained the previous examination.

"This is based on our knowing what lies beneath before we can correctly interpret the meaning of changes in sound and tactile information. If I have time, I will put this into written form to elaborate."

"Now, through a simple physical examination, we have preliminarily understood the patient's basic condition: the patient has been coughing for over half a year and has been coughing up blood for about two to three months; we consider a diagnosis of pulmonary tuberculosis. An empty-jar-like breathing sound can be heard in the lungs, but there is no friction sensation, indicating no exudative adhesion between the two layers of the pleura."

"This is fortunate; the tuberculosis has not invaded the pleura, allowing us to inflate the space between the two layers of the pleura, which is the foundation for implementing treatment."

"Of course, before this, we need to obtain the patient's consent." Kraft pulled out a pre-copied Informed Consent Form for Traumatic Treatment and presented it along with the pen.

"The purpose of this treatment is to control hemoptysis and extend life, but there is a risk of complications such as pneumothorax, hemothorax, and lung collapse; in the most severe cases, it could be fatal. If you are willing to undergo treatment, you can sign here to acknowledge this."

"Since we have also gained a learning opportunity from your case, we will waive the treatment fees at our discretion."

Extending life and waiving fees played a decisive role, almost without hindrance tipping the scales of deliberation to one side. The emaciated man sitting on the bed immediately became agitated, took the document handed to him, but did not sign his name for a long time.

"If you have any doubts about this, you may also choose to refuse; this will not affect Dr. Dai Wei from continuing conservative treatment."

"No, that is not what I mean." He gripped the paper, squeezed ink from the quill pen onto his palm, and pressed it onto the document. "I mean, is a thumbprint acceptable?"

"If reading is difficult, you can also find someone you trust to read and certify the content for you." Having gone through the full process for once, Kraft hoped he hadn't copied in vain.

"During the treatment, a needle will be inserted into the chest cavity; before starting, you can still choose to regret it, even if you have signed and stamped."

Fear of pain made the patient hesitate for a moment, but another cough bringing up a mass of red blood made the decision for him, reminding him that life was flowing out from the unhealed wounds in his lungs every moment.

"I feel there is more than one needle in my chest; one more won't make it worse. Please hurry, before I cough up all my blood."

He looked expectantly at Kraft and the large tray wrapped in white cloth, a precious light of hope appearing in his eyes.

As he wished, some objects he had rarely seen but which clearly looked expensive were taken out from inside.

"As previously stated, once we identify the second rib based on bony landmarks, we can sequentially find the intercostal space for needle insertion." The doctor washed his hands with pure-colored liquor of surprisingly strong odor and wiped the side of the chest with a cotton ball dipped in strong liquor, while continuing to explain.

"Instructor Vilen, you can bring out the fruits of our labor from the past two days."

A glass bottle with a suction mouth was brought to the patient's lips, containing a small amount of oily, transparent liquid; this was the product the two had made by borrowing instruments from the medical school. The equipment conditions were good, but due to the level of manual control, the yield was truly worrying.

Ether, this somewhat unstable substance, currently has no safe storage method; the best approach is to make and use it immediately to prevent it from turning into something else after being left for too long.

"Turn the valve down a bit; this is only a needle-prick-sized injury. Inhaling too much is not beneficial. Kup, come over and help hold the patient down. If the anesthesia isn't deep, he might move around; be careful not to touch my sterile area."

Considering that this time there was no need to worry about disturbing anything in the lungs, anesthesia could be used completely to make the patient more comfortable.

The patient held the bottle mouth and inhaled a few times; before falling into darkness, he saw Vilen's surprised and delighted gaze.

He almost used the stability he had cultivated over more than ten years to control his hands holding the bottle from trembling due to excitement and anxiety, watching as the needle tip touched and penetrated the skin, while the subject slept in ignorant peace.

"There will be a breakthrough sensation when the needle enters, indicating entry into the chest cavity; at this point, you must stop in time." Kraft pinched the rubber bag, controlling the gas volume with good spatial awareness.

The amount of gas delivered needed to be just right; too much would cause the lungs to collapse and lose respiratory function, while too little would fail to compress the lesion and close it.

Fortunately, both being adult males of similar build, the experience accumulated on the Duke helped him grasp this degree.

The artificial pneumothorax procedure was successfully replicated; when he felt it was about right, he clamped the rubber tube and percussed the chest wall. At this point, the periphery of the thorax already produced a uniform, hollow, hyper-resonant sound, indicating that gas had replaced the messy lung tissue and occupied half of the chest cavity.

The entire operation took less than ten minutes from start to finish, probably ranking in the lower-middle range for average surgical times in the current era. Kraft pulled out the needle, pressed the puncture site, signaled to Vilen that the operation was over, and discontinued the anesthesia.

The patient, who had inhaled only a small amount of ether, awoke from light anesthesia; respiratory tract irritation caused him to cough violently involuntarily.

He coughed to his heart's content for a while before realizing what he was doing, then frantically checked his clothes and bedsheet, suspecting they had been completely stained red.

However, not a single fresh bloodstain appeared; after only a short rest, the fear that blood plasma would overflow from the broken trachea and drown him seemed to be an illusion. The speed of the effect was comparable to an immediate result.

【Hemoptysis Stops Immediately】

Before Dai Wei's self-doubting record document was delivered to the academic symposium that was still making no progress, the ripple stirred up by this simple description was already enough to bring any patient who heard of it to this once-unknown clinic.