Chapter 278: Unexpected Efficacy

Kraft did not elaborate on the matter of dreams, and Kup did not wish to ask.

The three returned to the dining table, discussing the clinic's recent condition, learning things they ought to have known, arranging for someone to repair the door, and enduring Dai Wei's complaints.

The physician was nearly driven mad; the clinic was careening wildly in an unforeseen direction, transforming from a purely internal medicine clinic into the de facto tuberculosis treatment center for much of the new district.

With puncture procedures not yet classified as basic clinical skills, it felt as though surgery had usurped their domain.

A completely new diagnostic workflow had been dumped on his head; he could barely recall how he used to see patients.

In folk practice and among many physicians, the "one-glance diagnosis" model was highly esteemed, holding that the faster a diagnosis was made with less information, the higher the physician's skill.

This view was especially prevalent among internal medicine practitioners. Patients arrived, a single glance—preferably a sidelong one, to signal utter familiarity and no need for words—followed by superficial symptom inquiries, then immediate progression to prescribing.

Fever patients got antipyretics, cough patients got antitussives; most recovered after a while, reinforcing the doctors' confidence.

Some patients worsened, so they returned for adjusted medication and another try—unpredictable, no need to explain. After all, the entire medical field operated at this level; both doctors and patients knew it.

The remaining, especially stubborn cases, would over time exhibit classic signs of universally recognized incurable diseases—syphilis, tuberculosis, and the like—whereupon one could only express "deep regret."

This entire system could be neatly categorized into three types: most recovered, proving the treatment correct; a few did not improve initially but did after adjustment, classified as unavoidable difficult cases; and the incurable, the rare deaths that made no sense—clearly under Heaven's jurisdiction, not the doctor's.

Efficient, elegant, untouched by three things: not touched by patients, not touched by illness, not touched by responsibility.

Since Kraft took charge, all that was past. Now, from Dai Wei down to the apprentices, all were forced to write medical records and required to extract evidence supporting their diagnoses.

The deliberately simplified medical documentation imposed a heavy burden—not only in workload, but also financially.

With the clinic's daily patient volume, at an average of two sheets per patient, the stack had grown thick enough to serve as a stool, with several times that amount of discarded pages.

Even though these papers were not high-quality, and accounting for ink and pen consumption, the total cost made Dai Wei gasp when reviewing the month-end ledger—cold from tongue to heart. He had emptied his personal bookshelf and moved it downstairs to store these papers, needed a dedicated index like a dictionary to locate them, and still could not guarantee quick retrieval.

Had it not been for the clinic's other income rising with patient flow, they might not have afforded this expense.

If this continued, they would need not just a dedicated bookshelf, but an entire dedicated study to house them.

Moreover, the value of these records fell far short of books of equal volume—at least he could not imagine anyone paying for them.

So Dai Wei relentlessly complained to the professor's ear, his ceaseless grumbling once dampened the man's appetite, prompting Kraft to recall his most unpleasant night-shift memories—the half-eaten sour soup noodles on the table, family members standing by with fresh secretions asking about the condition.

So he could only push away the soup bowl and reluctantly say, I'll take a look.

Flipping through the financial records, the numbers did stir Kraft; his decent mathematical ability allowed him to estimate that this sum had reached a level payable in gold coins—Dai Wei's worries were not groundless.

He could, of course, announce higher consultation fees, or simply draw funds from his personal stash.

But as Dai Wei had said, tuberculosis was a poor person's disease; raising fees too much was unrealistic, while raising them too little solved nothing. Self-funding this pit, destined to grow ever larger, was unsustainable in the long run.

Kraft reaffirmed the importance of medical records—they needed to use these materials for statistics, to understand how much benefit patients truly gained from treatment, how long before they required re-inhalation, and which stages of patients were suitable for artificial pneumothorax therapy. And so on, until a relatively reliable evaluation standard was established.

This system was not brought by the otherworldly soul; in his former life, tuberculosis was being crushed by widespread vaccination and combination drug therapy, rarely progressing to the point requiring physical intervention. Even if it had, it was not this system he used now.

Currently, only they in Nos were doing this, and in the foreseeable future, few others would.

Whether they understood or not, everyone present nodded repeatedly, praising his foresight.

But hands were still sore, the ledger still unappealing. In short, they needed more people and more paper and pens—and all of this would feed back into the finances.

In response, the newly arrived superior, Kraft, declared that in medicine's impending new era, clinging to one or two dead techniques and surviving solely on clinical practice was destined for obsolescence. To keep pace with the times, one must be adept at discovery and summation; medical records, as the foundation of all this, must not cease.

As for financial issues, if expenditures could not be cut, then revenue must be expanded.

This "revenue expansion" arrived swiftly—precisely, the next morning, at the clinic's doorstep.

"Good day, Professor Kraft, it's truly difficult to meet you," said the man with neatly trimmed mustaches, "and Dr. Dai Wei, thank you for the medicine—it's highly effective."

Kraft took a moment to recall a slightly larger, slightly plump silhouette from memory—the financial officer of the Higo family, now seemingly thinner, "Ah, Mr. Barber, what a coincidence—how did you know I'd be here today?"

"Actually, I've been coming here frequently lately," the man replied, his smile noticeably more vibrant than their last meeting, his appearance markedly improved.

He stated his purpose and handed Kraft a box lined with velvet, containing several slender, hollow, silver-gleaming objects, "These are our new prototypes—please take a look."

Brand-new puncture needles, excellent quality—Mo Lisen's preference for commissioning instruments from them was no accident.

While Kraft checked the needles' patency, Barber chatted with Dai Wei beside him, who pulled a suspicious small bottle from behind the counter and handed it to the visitor.

Professional habit prompted Kraft to observe the financial officer; the changes in physique and mental state were unmistakable.

He quickly realized it was not that the man had lost weight effectively. That previous plumpness had not been fat—it had been edema, which had improved during this period, along with his overall condition.

"Mr. Barber?"

"I'm here, Professor. What do you think of these items?" The officer tucked the bottle into his pocket and rubbed his hands.

"The craftsmanship is nearly flawless," Kraft praised, "By the way, didn't you previously have edema—particularly noticeable in the lower limbs?"

"Reduced stamina, some private discomfort, loss of appetite, shortness of breath, palpitations, and so on."

"Did Dr. Dai Wei tell you?" Barber nodded slightly in surprise, glancing at Dai Wei, who shook his head, indicating it had nothing to do with him.

Kraft set down the needle; something new had piqued his interest. This was likely cardiogenic edema—heart failure causing edema and other signs of blood stasis—but his condition had clearly improved significantly recently.