Chapter 56: The Surgery

At this time, the young man slightly opened his eyes. Seeing someone was taking his pulse, he said with effort, “Sir, there is no need to trouble yourself. My intestinal abscess is a chronic illness, and I will not survive this time. I only beg my benefactor to bury my body and not let it be exposed in the wilderness. For your kindness, I can only repay you as a cow or a horse in my next life, tying grass in my mouth to repay you.”

Liu San thought to himself that without surgery, he could only prepare for the aftermath. Just as he was about to say a few words of comfort, a crew member came to report that they were almost at the Grand World pier.

Meng Xian said, “There’s a clinic in the Grand World that can perform minor surgeries.”

Liu San also remembered that there was indeed a small clinic in the Grand World, which was not open to the public. It was to ensure the health of the few Faction members and native cadres stationed in Guangzhou. After all, the medical standards of the Ming Dynasty were not very reassuring to the Faction members. Later, the Ministry of Health planned to use this as a basis to open a provincial and Hong Kong general hospital in Guangzhou to industrialize the medical industry and make a lot of money locally. Of course, the official reason was “to meet the needs of the Faction’s health services after the northward campaign.” A lot of materials and equipment were transported to the Grand World. Therefore, the equipment and medicine of this clinic were quite strong.

With these things, saving his life would be no problem. He quickly called the crew to find a stretcher, put the young man on it, and rushed to the Grand World.

Zhang Yikun, the manager of the Grand World, personally greeted them at the door. Liu San did not have time for pleasantries. After greeting him, he directly asked if the Grand World had the conditions for surgery. Zhang Yikun nodded, “There is a small operating room. Who needs surgery?”

Liu San briefly introduced the situation. Zhang Yikun looked troubled, “Saving the dying and helping the injured is originally what should be done, but you have saved a person of unknown origin and need to use controlled materials. This, this…”

Liu San said anxiously, “His life is in danger. We are not incapable of saving him. I can’t just watch him die.”

Faction members like Zhang Yikun, who were sent out, had long been accustomed to the cruelty of the medieval society. The life and death of non-native people had no meaning to them. Even though Liu San said so, he was still hesitant.

Liu San said, “How about this, I promise you. I won’t use any level-one controlled materials, only equipment and a small amount of consumables. I will pay for all of these at the listed price. What do you think?”

Since he had said so, Zhang Yikun was too embarrassed to object anymore. Without further ado, he took Liu San directly to the clinic. Liu San looked at the various instruments and medicines in the instrument cabinet. It was probably enough to complete the surgery. The operating room had an operating table, but no shadowless lamp, but the lighting equipment was sufficient for surgery.

Although he specialized in traditional Chinese pharmacology, he had graduated from a proper medical university and could handle general surgery.

At this time, he could only treat a dead horse as a living one. He asked the clinic’s medical orderly and nurse to be his assistants, and first washed his hands, disinfected, and changed clothes. His two apprentices also washed their hands and changed clothes to observe on the spot.

There were no modern anesthetics in the clinic—even if they hadn’t been used up, they would have expired. He used laughing gas for anesthesia. Nitrous oxide was the easiest anesthetic gas to produce in the Faction’s inorganic chemical industry. It was produced by heating and decomposing ammonium nitrate powder. When inhaled, it was generally mixed with oxygen. Since it was still difficult to produce pure oxygen, a mixture of laughing gas and air was used.

After the anesthesia took effect, Liu San immediately picked up the scalpel and made an incision. He did not use an electrocardiogram or blood pressure monitoring. Moreover, because the situation inside the abdomen was unknown, he did not use the standard McBurney’s point incision in the right lower abdomen. Instead, he made a large incision in the rectus abdominis muscle in the right lower abdomen. Because the patient was anonymous, he didn’t have to worry about the family coming to “make a scene” or extort money if he couldn’t be saved. Therefore, Faction member Liu was more daring to think and act. The patient was under anesthesia at this time and did not react to being manipulated.

He explained to his apprentice while operating. He opened the muscles and peritoneum in sequence, suctioned out the pus, and exposed the cecum. He found the appendix, which was already severely inflamed and had formed a gangrene. He first clamped it with a hemostat, ligated it with No. 4 thread, and made a purse-string suture on the cecal wall about one and a half fen from the root of the appendix before cutting off the appendix. The appendiceal stump was swabbed with an iodine-povidone cotton swab. The stump was inverted and buried in the purse-string suture. While tightening the purse-string suture, the mosquito forceps were withdrawn. Finally, the suture was tied tightly, so that the appendiceal stump was completely buried. Then, a few interrupted sutures were made on the seromuscular layer of the cecum at the root of the appendix with No. 1 thread for reinforcement. After cleaning and suctioning out the pus and exudate in the abdominal cavity, the cecum was released. A drainage tube was placed and led out from below the incision. The abdominal cavity was closed with absorbable sutures in a continuous suture. The wound was irrigated with normal saline to prevent infection. The external oblique aponeurosis was sutured with interrupted sutures of No. 4 non-absorbable thread, and then the subcutaneous tissue and skin were sutured with interrupted sutures of No. 1 non-absorbable thread. The surgery was thus completed.

Although it was only a minor surgery in the original time and space, Liu San was also sweating. His two apprentices had only learned traditional Chinese medicine from him before. Today, their eyes were obviously opened, and they frequently exclaimed in amazement and looked at their capable master with admiration.

Liu San had no confidence in his heart, because after the surgery, there was still the hurdle of anti-infection to pass. Otherwise, whether the patient could recover after the surgery would depend entirely on his own immunity, and the mortality rate would be quite high. Since he had said that he would not use controlled materials, he naturally could not use the antibiotics brought from the original time and space. Then he could only use the antibiotics manufactured by the health department’s pharmaceutical factory, which not only had limited purity but also had great toxic side effects. Every year, many patients treated by the health department died due to the side effects of the drugs.

“Let’s use it on him first,” he wrote a prescription and handed it to the nurse. “Do you have all of these?”

“We have all these medicines,” the nurse said respectfully. “Chief, your surgery is really brilliant.”

“It’s okay, it’s okay,” Liu San said. “I haven’t done it for a long time, so my hands are a bit rusty.”

Zhang Yikun came over to talk to him, and also complimented him on his superb medical skills and immeasurable merit, which made the tired Faction member Liu feel quite pleased.

For the next few days, Liu San went to various places to handle official business. He only came back for a follow-up visit a few days later and did some follow-up treatment such as removing the drainage tube and stitches. He instructed Liu De, who was staying behind, to give the patient Tongmai Sini Tang every day, followed by Huangqi Jianzhong Tang, Guipi Yangxin Tang, and other follow-up conditioning. Zhang Yikun also ordered an attendant to take care of him daily.

This young man’s body was originally strong. Coupled with proper breathing, sufficient nutrition, he gradually recovered after a few days. He had become very familiar with Liu San’s apprentice these days. When he learned that the one who saved his life was the famous Ao Song Faction member who was renowned in the south, he frequently raised his hand to his forehead and was moved to tears.

This day was the third day of the third month, the Shangsi Festival. Liu De told him that Faction member Liu had come. He hurriedly asked to be led to pay his respects. As soon as he entered Liu San’s temporary office, he saw the cheerful Liu San talking and laughing with Zhang Yikun. He immediately fell to the ground and kowtowed to thank Liu San for saving his life.

Liu San ordered his apprentice to help him up and asked about his physical condition and identity. The young man spoke Mandarin with a Shaanxi accent and respectfully replied, “Thank you for your concern, benefactor. My body has recovered greatly. My surname is Yu, my name is Qing, and my courtesy name is Zecheng. I am from Suide, Shaanxi. Because my hometown has suffered from disasters for years, I had no choice but to leave my hometown. On the way to escape, both my parents died. I wandered to Jingxiang and heard that someone in Guangzhou was recruiting refugees to go to Qiongzhou to farm, supplying three meals of white rice a day, all you can eat, and no worries about food and clothing. I was overjoyed to hear this news and came here to find a way to live. That day, I was about to arrive in Guangzhou by boat, but I unexpectedly encountered a white dragon patrolling the river. It was evening at that time, and suddenly the sky and the earth changed color, the wind was strong and the waves were rough. A white dragon’s head connected to the clouds and sky, its tail hung in the middle of the river, and it swam over. In an instant, the boat capsized. All the passengers were drowned. After I fell into the water, I was lucky enough to encounter a boat plank, and thus escaped with my life. Unexpectedly, my intestinal abscess broke out again. In the wind and rain, I was in pain and cold. I thought I would surely die. I didn’t expect the heavens to be so kind as to have the Faction member benefactor rescue me from the road to the netherworld. Otherwise, I would have been in the belly of a fish long ago! The benefactor also cured my serious illness with his divine skills. Such a great kindness is as high as the sky and as thick as the earth. I will never be able to repay it in my lifetime…” As he spoke, he was reminded of his sad past, and couldn’t help but shed tears and cry incessantly.

Liu San comforted him with kind words, and Yu Qing gradually stopped his grief and dared not cry anymore. Zhang Yikun, however, asked with great interest, “The white dragon you encountered that day, I think it was a tornado that is not common in southern China. This is commonplace in the Americas and is not divine. Tell me in detail what the tornado was like.”

Yu Qing obviously did not want to recall that terrifying scene, but he did not dare not to answer. He only said, “At that time, I was in a panic and my soul was scattered. I only vaguely saw the white dragon connecting the sky and the ground. Then the boat capsized, and I don’t remember what happened afterwards.”

Zhang Yikun seemed to smack his lips with some regret. Liu San comforted Yu Qing and said, “You have just recovered from your illness. Go and rest first.”

Yu Qing said again, “The benefactor has given me a new life. He is truly my reborn parent. I have nothing to repay him with. I have nothing of value with me except for an ancestral medical book, which is what my family has relied on for generations to make a living. Now I present it to the benefactor, and I hope the benefactor will accept it.” As he spoke, he took out an oilcloth package from his bosom, and after opening it, it was a thread-bound book, which he presented to Liu San with both hands.

Liu San took it and saw that the cover was made of waxed paper with the four characters “Qing Niu Yi Fang” (Medical Prescriptions of the Green Ox) on it. It seemed to have been soaked in water, and the handwriting was a bit blurry. After opening it, the core was made of hard yellow paper, and the content was all handwritten. He flipped through it and saw that they were all medical prescriptions. So he closed it and said solemnly, “A gentleman does not take away what others love. Since this is your family heirloom, you should keep it yourself. I am a doctor. How can I not lend a helping hand when I see danger on the road? It is my duty to save the dying and help the injured, not for any reward from you. As for my medical skills, even if the high officials and nobles of the Ming Dynasty came to seek treatment, I might not be willing to treat them. It is fate that you and I met. I am happy that I was able to cure your illness.” Half of what Liu San said was true, and half was high-sounding, to show the broad-mindedness of the Ao Song Faction member.

Yu Qing pleaded again, “I know that the benefactor’s medical skills are divine, and even if Hua Tuo were to be reborn or the Medicine King were to be resurrected, they would not be able to match them. But please, benefactor, consider my grateful heart and accept this. If it can be of any help, it will also be considered as repaying a little of my gratitude.”