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Episode 25. Finally Pasteur (1)

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Today is the clinic again. Fortunately, there aren’t many hospitalized patients. There were only a few patients with pneumonia and colds lying around.

On the other hand, there was a considerable amount of outpatient treatment.

“This is Liselotte.”

First impression of a patient… … It’s a bit strange to say that. There are several pieces of information that can be gleaned from the patient’s complexion and the way they come in.

First of all, today’s female patient is thought to be an academy student. Her steps are a bit unsteady, but it doesn’t seem like she’d fall over.

She had blond hair mixed with brown, and her eyes were also brown with a red tint. Her hair was rolled up and attached to the side of her head.

It would be perfect if you called it Star Wars Princess Leia hair, or Western-style Pucca hair.

Either by some means or by mere misplacement, two long strands of hair hung down her back, between the ponytails on either side.

That’s about it. There could be many reasons why your steps are unsteady.

Dehydration, not eating, tired, or just plain weird. It’s possible that your legs are uncomfortable, but it doesn’t look like it.

Judging by the expression on his face as he entered the examination room, he probably has a medical condition that affects his daily life. His expression is gloomy and he looks tired.

It’s different from just being worried or sick.

This is all we can tell from its appearance.

“Yes, go ahead.”

“I’ve been feeling nauseous for the past few days and it’s hard to walk around. When I get up, my vision spins, but after a few minutes, I feel better.”

There are a few disease names that come to mind.

Dizziness is a common symptom, but it is not a problem to be taken lightly. It has a significant impact on the patient’s daily life and can very easily lead to nerve or brain problems.

“Open your eyes wide.”

The first thing to check is nystagmus.

You should check to see if your eyes are twitching. Spontaneous nystagmus can be a sign of a serious problem, such as a brain tumor. Okay, let’s take a look.

There is no eye twitching.

“When did you say you were dizzy?”

“If you sit down and then stand up.”

“Does it make you dizzy when you move your head?”

The human head is automatically fine-tuned to remain level.

This is not a conscious process. It is an automatic process that takes place via the cerebellum, etc.

When you tilt your head, such as to lie down or turn your head, your brain knows this and compensates.

Vertigo due to changes in posture. There are many possible causes, including otitis media, but the most common is benign paroxysmal positional vertigo.

To put it simply:

It means that you suddenly feel dizzy depending on your position. Benign means that there are no other serious problems.

First, let’s finish the nerve examination.

“Don’t move your head, just follow my finger with your eyes. Yes, that’s good.”

There is nothing particularly visible.

“Oh, is this a serious illness?”

“I don’t think so.”

It’s not a serious disease. Benign paroxysmal positional vertigo is, as the name suggests, benign. It’s not a disease that will kill you or cause any serious harm to your body.

There is no medicine. Instead, it is better to shake your head in a certain order. Positional vertigo is a disease caused by stones connected to the sensory nerves in the inner ear being displaced.

This journal is called the Epley Journal.

“Please sit on the examination room bed.”

“Why?”

“I’m trying to confirm. The most likely diagnosis is a disease called benign paroxysmal positional vertigo. It’s a disease where the stone in your ear can’t find its place and rolls around, and that’s why you feel dizzy.”

Liselotte looked at me.

“Does that make sense?”

“Yes.”

“Is there a stone in your ear originally?”

It’s a look of disbelief.

Well, if you don’t know anything about the internal structure of the ear, you might react like that. How should I explain it?

“I dissected it and found it.”

“Aha.”

Liselotte nodded.

Of course, if you dissect a person (a donated body), you can see the cochlea inside the ear. There are small stones inside.

“How do I do it?”

Dix-Halpaike test. I don’t know why the test is called that. Are they Nordic people? Are they two names together?

anyway.

This is a differential diagnosis for kidney stones.

“First, turn your head to the side where you feel dizzy. Lie back down like that. I will hold the back of your head, so relax.”

Lisellote did as I said.

If it was positional vertigo, nystagmus should have started at this level. I checked Liselotte’s pupils. Her right pupil was definitely twitching. Can you see well?

“Close your left eye. What do you see?”

“Well, it’s just a little blurry.”

Aha. That’s amazing.

Even when nystagmus is in progress, the patient doesn’t feel the eye twitching? It’s just a little uncomfortable or blurry.

“You may sit back down.”

Now it’s time to explain.

“So what disease is it?”

“The conclusion is out. The disease is called ‘benign paroxysmal positional vertigo’. What is it?-”

“Position? I didn’t do that?”

“… … .”

Are you an idiot?

“Posture… … . That’s what I’m talking about. You said that you get dizzy depending on your posture. Because you get dizzy depending on your body position… … .”

Sigh.

I turned my head away to hold back my laughter, and Liselotte blushed.

“Ah. Oh, sorry.”

“There is a problem with the organ that maintains the balance of the head, so there is a discrepancy between the actual position of the head and the position perceived by the brain. There is no medicine, but you will have to adjust the head properly so that the stone can be put in place.”

“Yes.”

“Please sit down again.”

Liselotte sat down on the bed again.

“Epley’s manual begins. Turn your head to the right about 45 degrees. Yes. Lie back quickly with your head turned. I’ll hold the back of your head. Wait 30 seconds.”

The first step is over.

“Turn 90 degrees to the left. You should be facing 45 degrees to the left. Again, wait 30 seconds.”

Second step.

“This time, turn completely to the left. You must wait 30 seconds in this state as well.”

This concludes the third step.

Lisellote rose from her seat.

“Are you still dizzy?”

“Oh, not really.”

I don’t know if it’s been resolved. It might come back soon. Dizziness is a disease that happens twice once you get it once.

Still, it’s better than having a migraine or dizziness for no reason. What would have happened if they had found a brain tumor? It’s not like they can do brain surgery here.

“If it’s severe, you can take medicine, but it’s not a fundamental solution. If it relapses, try the same thing you did before, and if that doesn’t work, come back.”

“Thank you.”

Lisellote bowed her head in greeting.

****

Back to the lab.

Let’s review one last time.

How many times have we mentioned Pasteur’s experiment in the past few days, but time, resources, and academic interest have been lacking.

I have already published three papers, including the one by Istina. The academic world must be getting tired of it. I should have waited a while and published the paper.

“Istina. Pasteur.”

You must have heard Pasteur so many times that your ears were about to itch. I kept reciting it to you like a sutra to a deaf ear. You must have memorized it by now.

Istina coughed.

“Pasteur’s experiment is an experiment that refuted the hypothesis that maggots and molds are naturally generated from organic matter and established the general principle that living things are only generated from living things. It is an experiment that experimentally proved that sterilized organic matter, unlike unsterilized organic matter, does not decay until it comes into contact with particles in the outside air. The experimental process is-”

Long, long.

“Good job.”

I know for sure. I pointed to the swan-necked flask on one side of the lab. Istina turned her gaze.

“That experiment. Can you do it now?”

“Istina. Think about it.”

“Uh, what should I think about… … .”

My lab uses culture media quite often.

It is rare for a new culture medium to develop bacterial colonies. Although it is not completely absent, it is due to poor hygiene or bacteria that somehow survived the boiling process.

Istina blinked.

“We often make culture media in the lab. We boil the culture medium to sterilize it, right? Nothing grows in the culture medium until it is boiled and exposed to air.”

Istina nodded.

“Ah. Now that I think about it, that’s true.”

“It’s because of the bacteria.”

“Bacteria die when boiled, right?”

That’s true. There are some germs that don’t die, but it’s the numbers that matter.

“When you boil the culture medium, all the bacteria inside die, and until we open the lid and intentionally culture it, the bacteria do not grow.”

If you touch the boiled, sealed, and cooled culture with your fingertips, bacteria will grow. Before that, nothing would grow. It’s no different from a miniature Pasteur experiment.

“Actually, this experiment is also being done to show others. We know, right? Because we use the same principle when using culture medium.”

Istina sighed.

“This is really… … . difficult.”

“The experiment itself is simple.”

The preparations are complete. Now all that’s left is to run away with Pasteur’s experiments and papers.