Krafft's Notes on Anomalies

"I need a reason, a reason why I have to be here." Kraft smoothed his wet hair with his fingers, walked in and found a seat by himself.

He shouldn't have been out in this weather, or at least he didn't think he should.

About two hours ago, he was still in the overcrowded clinic, receiving the thirty-fourth patient of the morning, counting the time for lunch.

There is no such thing as registration these days. It is not that the clinic has never tried to limit the number of people in a similar way, but they soon discovered that limiting numbers without identity binding is equivalent to giving money to middlemen.

So the situation is like this, predicting the number of doctor visits the next day is harder than predicting the weather. At least the weather was really predictable, and Kraft never could have guessed whether his lunch would be in the afternoon or early evening.

The patients currently treated by the clinic are not limited to tuberculosis, and it is also much more difficult to screen the people who are suitable for digitalis at the same time.

Compared with tuberculosis, which has more obvious characteristics, currently people, including many doctors, cannot be said to have limited knowledge of the concept of "heart failure", but can only say that they have no understanding at all. After all, this thing really requires a certain amount of anatomy to explain the principle of symptom generation.

Even blood circulation has not yet gained an absolute upper hand in academia. According to the Four Liquids Theory, blood will emerge from the liver like spring water and be transported to every corner of the body. Some will be absorbed and consumed, and the rest will pass through the pores. Evaporation and escape can be called the "dissipation theory".

According to its explanation, edema means that the red fluid cannot be consumed and dissipated after being delivered to the place, and it is blocked there, so it swells up.

So how to deal with the traditional method? It's very simple. Since there are too many, just let go of some, so the treatment path returns to the most familiar bloodletting therapy. In fact, it can be observed that some patients have certain effects after bloodletting.

Don't ask how people are doing, just ask if the edema has been reduced, right?

The theory is used in practice and practice confirms the theory. It is a closed loop.

Before allowing David to prescribe medication, Kraft needed to correct his scant knowledge of anatomy and reshape it from his own perspective.

As we all know, the path of blood in the body starts from the left heart, returns to the right heart after passing through the systemic circulation, and finally returns to the left heart through the lungs.

Now, due to various reasons that can be explained for months, the blood pumping function of the right or left heart is no longer working, and it cannot send out a sufficient amount of blood, just like a river with a huge flow suddenly narrows.

The water in the front is too slow, and the water in the back can only be blocked in the river. The water level rises higher and higher, and the water pressure becomes greater and greater. Sooner or later, it will cause serious consequences such as flooding and bank breakage.

When the left heart fails, blood is blocked in the lungs, which manifests as coughing up blood-colored frothy sputum, difficulty breathing, etc.; when the right heart fails, blood is blocked in the venous system.

The venous system involves even more.

All unpaired organs in the abdominal cavity, including the veins of the stomach and intestines, drain into the hepatic portal vein, which passes through the liver and then takes the hepatic vein to enter the inferior vena cava and return to the heart.

Liver congestion leads to hepatomegaly and tenderness, gastrointestinal congestion leads to abdominal distension and nausea, and venous congestion in the limbs leads to edema. A series of problems manifested in the upper and lower parts of the body are all caused by the same cause.

So, when we return to the view of the Four Liquids Theory at this time, we will find that although the principle of this thing is completely wrong, it is actually partially correct in the general direction. There is indeed relatively too much blood.

Bloodletting therapy, except for some particularly outrageous ones, mostly uses venous blood, which does reduce the blood volume in the venous system and relieves the pressure to a certain extent.

What Kraft had to do was to break David's thinking into his own, so that he could understand why the combination of these symptoms suggested heart failure, rather than some other messy thing.

The bad news is that David was a little bit poisoned by the four-liquid theory and it took time to adapt; the good news is that he barely learned anatomy, so it was easy to fool him, and he quickly accepted this obviously more concrete explanation.

He does not need to know about ion pump inhibition or reflex vagal excitation to slow down the heart rate. He only needs to know that digitalis is a cardiotonic drug, which under normal circumstances will enhance the ability of the myocardium to contract and pump blood and at the same time make the heart beat slower.

However, clinical application is far more complicated than a few sentences. David needs more time to slowly learn the contraindications for drug use, which involves heart auscultation, which is another set of things that make people's hairline recede.

After actual operation, Kraft realized that it was very difficult to compile a set of instructions out of thin air without involving physiology. What was even more difficult was how to get others to agree, understand, and implement it in a standard way.

After just a few days of free time, a certain professor once again suddenly found that he had accumulated clinical work, drug experiments, teaching tasks and other things to do. His time was as invisible as the money he spent and he was always not enough.

Even the plan to start with the "samples" has been postponed indefinitely.

So when Wadding invited him to sit down and have a cup of tea at Green's, Kraft politely expressed his incomprehension - why did he come to the door before he even took action.

The Inquisition could not resist the hospitality, and considering that they would be in a state of oversensitivity now and for a long time in the future, Kraft finally decided to spare his precious afternoon time to meet and find out what these people had done to his work without permission. What should not be understood.

But when he actually sat across from the priest, he felt that things were not so simple.

Green looked very sluggish, not like he had been forced to take a few days off. His overall mental state was similar to that of when he had just climbed up from the Temu River.

Regarding the new drug, after seeing the sample, he accepted Kraft's explanation calmly. He seemed to be slightly relieved, and then fell into silence for a while.

The two of them were stunned for a while while listening to the sound of rain outside the window. Finally, Green spoke first:

"You don't seem to be in very good spirits. Have you had any special dreams in the past few days?"

"No, it's because I compiled the medication guide for most of the night last night, and you had to ask me to explain it." Every second wasted outside reminded Kraft how long his to-do list was. The secret sense of urgency is never far away.

But what Green meant was that he encountered a special situation. Otherwise, a priest asking a doctor to communicate spiritual dreams would be a bit blind.

Oh, no, it seems that there is indeed a dream interpretation project in the doctor's business these days.

"What did you dream about?" It's always a good idea to be cautious and ask more questions.

"It's hard to describe." Green supported his head with one hand and threw a piece of firewood into the stove, as if trying to dispel the dampness in the room. However, on a rainy day with abundant moisture, this little heat was only enough to dry them out. A circle that ends at your feet.

"Tell me about it, go with your gut."

"Here. No, it's a place very similar to here." He noticed that Kraft sat upright, and his attitude was changing from a little impatient to a little interested.

"anything else?"

"Moisture, knocking, vibration." Green searched hard for the scattered fragments of the dream, but those things that had a profound impact were extremely fragmented when they needed to be described. It was like peeking into the memory through a small hole, and only the most obvious ones could be found. A few undertones.

"Knocking, vibration, it's strangely dark outside, but there's a light source."

"White light?"

"Yes, white light." Green nodded affirmatively after being reminded, "You know?"

【I know it too well! 】

Kraft was satisfied that he got the information he wanted. Such a relaxed consultation was too rare: "Yes, it is indeed reasonable to have such symptoms after being exposed to those things."

"My suggestion is to find a place that is very high, difficult to climb, and where you can see the sky to live for a month. For example, the bell tower in your church is very good."

"If you find yourself waking up in a place that is similar but not the same as when you fell asleep, immediately - and I mean immediately - go look at the moon after confirming that it is temporarily safe. If everything goes well, you will wake up."

"Of course, you may need the guidance of a doctor for specific operations, and I also need more cases." The professor confidently stretched out his hand, "I wish us a happy cooperation again."

The priest held the hand hesitantly, but was not comforted by his faith: "But... there seems to be no moon over there."

"Um?"

"It's raining over there, very hard."