Chapter 146: Let’s Reduce Amputation [4]
Lord Jude’s surgery had gone well, so I thought convincing other nobles would be easy, but it was not. Not everyone responded as reasonably as that particular nobleman. Those who had seen the surgery up close or had spoken with me directly were more receptive, but when it came to patients I treated through house calls, that was a different story. I could not even get there. Apparently, the carriage was full.
I had the money… Should I have just bought one in advance…?
It was not that I was broke. But I was still living in Alfred’s house. If I wanted my own carriage, I would also need a place to store it and a horse to pull it.
I doubt Alfred would go that far, even if I asked.
It was not like Alfred and his father were not generous. They were good people. I saved Alfred’s life multiple times, and they earned a lot thanks to me. I even heard they were planning to start selling condoms in Paris. I could not even imagine how much money that would make them.
No, seriously… I should’ve made arrangements sooner.
Scratching the back of my head, I decided to focus on what I could control first.
“Joseph.”
“Huh?”
“There’s probably a guy standing out in the hallway with a confused expression.”
“What are you talking about?”
Joseph looked at me like I was speaking nonsense. Before I reincarnated, I would not have been able to get used to situations like this. I was someone who always said the obvious. But in this era? I had basically become a local wizard.
“Oh, if you see someone out there, bring him in. Otherwise, he might end up dead or missing an arm.”
“Missing an arm? That’s not a big deal. We cut clean.”
“That…”
No. Let me rephrase. I was not the one who was mysterious. These idiots were just reckless. What did he mean, “We cut clean”? Absolute lunatic.
“Why are you frowning? Say something if you’ve got something to say.”
“Just go get him. Bring him in.”
“Alright, alright. Geez, why are you so mad?”
Joseph still did not seem to understand what he had done wrong, but like the obedient fool he was, he went outside. Sure enough, he returned dragging a confused-looking patient. I tried to catch this guy earlier, but I missed him because of Lord Jude’s visit. Thankfully, he came back just as I told him to.
“Why me?”
“Just come in.”
“No, I—”
“Wet.”
“…Fine.”
Joseph was a big guy. And in this era, wearing a white coat in a hospital was still a sign of status. Even in the twenty-first century, patients usually did not say no to a man in a lab coat unless they had a damn good reason. It did not matter how young Joseph and I looked. We wore the coat, so we had authority.
The patient finally stood in front of me, and I got a good look at the wound.
This is bad…
It was such a disaster that I could not even guess how the injury happened. The bandages alone were a mess, dirty and reused. When I took them off, the smell hit me, and I saw how the infection had spread.
Seriously… if you’re going to reuse a bandage, at least rinse it first…
It looked like he wrapped up the wound with whatever was lying around. The bandage had rotted, and the skin underneath was discolored. It looked like both secondary and tertiary infections had set in.
“Uh… that—”
“Don’t even look. We’re not using that again.”
I threw the bandage into the trash without hesitation. Weirdly, the trash still had usable pencils and paper in it.
No, why throw those away but keep this garbage?
Sighing, I examined the wound again. Thankfully, it was not too late yet. Not enough to require Amputation, but just barely.
Do I give him bread?
Meaning moldy bread. Green with Penicillium mold.
No, not yet…
That stuff was a last resort. If it came to that, someone might really die. Sure, as a nineteenth-century doctor, I had to make some sacrifices, but…
Wait… what is that?
Still lost in thought, I poured clean water over the wound. It was the same water I used earlier on the noble. The patient flinched slightly but did not complain. That was a good sign.
“Hmmm.”
As the pus washed away, I could finally see the wound clearly. It was not deep, maybe just the Dermis, or slightly into the muscle. In a modern ER, this would have been cleaned, disinfected, stitched, and well on its way to healing. Instead, it was left to rot.
If I debride everything that’s infected… wouldn’t that be the same as cutting it off?
Technically, yes. Debridement was about removing dead tissue. But in this case, if I followed it to the letter, I would be amputating.
“Uh, hey.”
Joseph had been examining the patient with me, but now he held something up.
A maggot.
White. Wiggly. Crawling maggot.
It had come from the patient’s bedding.
“You’ve got to be kidding me…”
And the worst part? I was not even that shocked. One had just crawled across the back of my hand moments ago. I barely reacted.
Wait… Stay still. Let me think.
Maggots. Gentle maggots.
You might think this was insane, but maggots had actually been used in medicine. They ate dead tissue, not live tissue. In sterile environments, they were an effective way to clean wounds.
Of course, sterile maggots did not exist in this era.
But what if… I just happened to drop one onto the wound?
People might criticize me. But maybe I could pass it off as an accident?
While pondering that, I continued rinsing the wound and wiping it with the cleanest cloth I could find. I rubbed gently. No bleeding, just sloughing flesh.
“Looks like it’s ripened well. What else is there to do?”
Joseph laughed as he said it.
Madman.
No wonder they amputate so much.
There were not even cars yet, so how were people injuring themselves so badly, so often? True, factory accidents probably explained some of it, but this many Amputations? No, the real problem was how they treated wounds. Or rather, how they did not.
“Do we really need to do more? Shouldn’t we just cut it off now?”
“It’s better than dying.”
“Otherwise, he’ll die.”
Wrong. Completely wrong. I shook my head hard.
“I’ll try not to amputate. Alfred—I remember him.”
“Ah, right! You treated him a bit differently. Was that because the corpse Miasma was more poisonous?”
Miasma. This damn theory again.
I had to choke back a wave of fury before I spoke.
“Patient.”
“Yes?”
“There’s a Miasma around your wound. It’s not… unusually toxic, but it’s still dangerous.”
I hated using that word. Still, I endured it.
“Should I… just go home?”
“Are you working right now?”
“Of course.”
“Right.”
I would rather hospitalize and treat him properly, but this was nineteenth-century London. Workers were treated worse than slaves. You did not take time off unless you were literally dying.
“This’ll hurt a little. Let me bandage it.”
“What kind of treatment? It’s already ripened, isn’t it?”
Ripened? You idiot. That was his flesh he was talking about.
“You said it was poisonous, right? Then we need to do more. You know I’m a student of Dr. Liston? He’s the only man who knows more about Amputation than I do.”
“Hmm.”
Sell it. Sell the Miasma theory. Sell Liston’s name. All in the name of saving this man’s life.
“Okay, fine… It doesn’t hurt, right?”
“It might sting a little, but it won’t get worse.”
The exposed tissue was probably numb by now. Only the swollen areas hurt.
“Scissors.”
“Are you really going to cut the flesh off?”
“It’s necrotic. There’s no bleeding.”
“Oh… is that the magic of ripening?”
I snipped away the worst of the tissue. Not everything, just what clearly would not bleed.
Plop.
I dropped three maggots I kept aside into the wound.
“Uh—?”
“What?”
“No, I… Did I imagine that?”
Before they could react further, I wrapped the bandage. Not too tightly. I did not want to crush them.
“Come back tomorrow. I’m not charging you.”
“Seriously? That’s… okay?”
“Yes. No money. Just come back.”
If the maggots died, I would just add new ones. In about a week, they would clear out the necrotic tissue. After that, real healing could start.
Unless the maggots are too dirty and cause another infection… No, don’t think like that.
I was not sure if what I was doing was truly right, but it was better than what others were doing. Still, I could not bring myself to take money for it.
Do no harm.
The most basic principle of medicine. I would not take a penny unless I could look this man in the eye with a clear conscience.
Besides, I was already making plenty from the condom business.
After the patient left, I headed straight to the library. I needed to find out whether maggots had ever been used for treatment before.
Honestly, I stopped expecting historical precedent. These guys had been playing with Anesthetic gas for decades and still did not use it properly.
But maybe this time…
If I can find even one record, I’ll have proof. Let’s go.
Even if I found nothing, this incident would be proof enough. At the very least, I would be able to convince Liston and Blundell.