episode_0033

Episode 33. Whose body is this (2)

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Death, corpses, and healers.

I sometimes think about it. In the sense that so many people come to the hospital to die, and in the sense that we send them off to the afterlife, we are no different from the gods of death.

The work of seeing people off to the afterlife. Today’s work is an extension of that. Today is not the last day of a patient, but of someone who has already died.

Autopsy of the corpse.

Istina tilted her head.

“Istina. I told you last time, structure and function are closely related. Check the entrance of each blood vessel. Do you see the split there?”

I’m talking about the valves that are located at each point where the large blood vessels and the heart connect.

“That’s right.”

“Then, Istina. In which direction would a structure like that impede the flow of blood?”

Istina touched the valve with her gloved finger. She seemed to still not know.

“Oh, wait a minute. This structure. This one opens inward, so it blocks the exit, and this one opens outward… … . Ah!”

Blood moves in only one direction.

“Do you know what it means to bleed?”

“That’s amazing.”

There are things that cannot be known without seeing them directly. Likewise, if you understand the structure of the heart properly, you can know exactly what it does.

If you feel an artery, you will find that it is thicker than a vein, and if you put your finger on the valve or pour water on it, you will see why the valve is one-way.

The heart is a bit of a strange thing to touch. It is one of the strongest muscles in the human body, never resting for a single moment while we are alive.

anyway.

Two holes for liquid to come out, two holes for liquid to go in. You can guess from the structure that the heart is not a place to make or send blood, but a place to circulate it.

I gave my heart back to Istina.

“See the four chambers in the heart? Two small chambers where blood comes in, and two large chambers where blood leaves.”

“That’s right.”

“Open it. You have to see inside too.”

Istina took the knife and opened the heart. The left ventricle was opened. The mitral valve and aortic valve were revealed. The important thing is the direction.

As expected, the two valves face opposite directions.

“Not visible. The mitral valve is a structure that only allows liquid to enter. The aortic valve is a structure that only allows liquid to exit.”

When the left ventricle is opened, the structure of the mitral valve is visible. The valve leaflet of the mitral valve is connected to the inner wall of the left ventricle by a thick ligament-like structure.

That means the force required is strong.

“So, to put it simply, the heart only takes out as much blood as comes in.”

“Hmm.”

“The claim that blood is consumed may seem common sense, but it doesn’t make sense when you actually open it.”

“Is that so… … .”

Although that is currently the general consensus in academia.

That’s because the concept of experimental medicine hasn’t been properly established yet. It seems more correct to say that organizations ‘eat’ blood.

In reality, that’s not the case.

“When you feel someone’s pulse or see a big wound, you know? The blood isn’t just pooled, it’s flowing.”

Blood that leaves the heart returns to the heart. There may be minor changes in composition, such as the exchange of nutrients and waste products, but the principle does not change.

“So. Blood circulates through the blood vessels throughout the body. If you put the heart back into the chest -”

It’s not visible yet because the connective tissue hasn’t been completely removed. It was a task that took me hours when I was practicing dissection.

There’s no way I can do it in a few minutes.

There’s no way around it. I touched the aortic arch with my fingertips. Istina looked at my fingertips.

“See here?”

“Yes.”

“The aorta is a thick and elastic blood vessel at the top, which sends blood to the entire body. The vena cava is the blood vessel that returns blood that has circulated around the entire body from the right side. This blood vessel is thin because the blood pressure is low, and it is divided into the superior vena cava and the inferior vena cava.”

Still, I couldn’t see very well. I wiped the tip of my glove with a tissue, then used my hand to peel away the area around the superior vena cava, which was a mixture of blood and connective tissue.

“Can’t you see it?”

“Ah… … . That’s right.”

“Follow the blood vessels. Blood goes out to the whole body, and when it comes back in, it goes through the right atrium and into the right ventricle. From the right ventricle, it goes back to the lungs and then to the left ventricle where it started.”

Istina raised her hand to scratch her head, but when I tapped her hand, she realized the problem and put it back down. There was blood and body fluid on her gloves, and she shouldn’t have touched my head with those.

It is a poor environment.

When I was doing dissections at the hospital, I was fully equipped with disposable plastic gowns, face shields, masks, and gloves.

Our current equipment is rather crude.

“Hey, be careful.”

“Yes.”

“So, Professor, your theory of blood circulation is that blood circulates through the lungs and every nook and cranny of the body and returns? Along the path of the large blood vessels?”

It’s a little bit wrong.

“Pulmonary circulation and systemic circulation rarely mix except in the heart. But the conclusion is that.”

“I think there will be more backlash than the last bacterial study I did. It’s unconventional, and the liquid moving along the pipe seems like a machine.”

“Really?”

“That’s what’s accepted. Isn’t it true that the human body is a continuous entity where the balance of components is important?”

I think I heard that.

There seems to have been a classic theory that an imbalance between components causes disease.

The four elements, the four humors, and expressions such as sanguine and melancholic come from this way of thinking.

“So, are you saying that we might have to stand in opposition to the academic world again this time?”

Istina shook her head.

“Rather than that. I think the debate will be more heated than when we discussed germ theory. Germ theory had practical and verifiable results in the Lapis Territory right away, but… … .”

Not this time, you say.

However, the academic world cannot ignore experimental evidence. There is a lot of evidence that can prove that blood actually circulates.

Let’s think about it some more.

The aftereffects of the germ theory have not yet subsided in the academic world. Most of them are probably still struggling with microscopes and dyes.

Suddenly, ‘Everything you know about blood circulation is wrong!’ It’s impossible. But it’s doubtful that anyone would care and try to prove or disprove it.

“Still. I think the professor is right this time too. When you were looking at blood pressure, there is a way to quantify the speed of blood in the body, right? That means… … .”

“Huh?”

“It seems like you are talking about something that is completely unknown with the current level and equipment of the Academy.”

“I don’t know if it’s that much.”

“To the professor, it’s just common sense that you make bread with flour, right?”

I don’t think blood pressure is something that is completely unknowable. However, it is true that there are things that the academy or the current academic community cannot even imagine.

It can’t be helped, but it will take time for new theories related to blood to spread and be verified. Academia is not infinitely flexible.

If you submit another paper in a few weeks, there will definitely be people who will say, “Nonsense again? You’re persistent, you’re persistent.” There was one last time, too.

We’ll have to wait at least a few more days.

The problem is that the cholera paper is not being published quickly. No, isn’t it true that papers that can save patients right away are distributed quickly?

I was wondering how to explain it.

“Do you remember when I took the patient’s pulse last time?”

“Yes.”

Istina nodded.

“By feeling the pulse in the jugular vein, you can estimate the blood pressure at which blood flows through the patient’s veins. You can also tell the blood pressure range by feeling the pulse in the wrist.”

The maximum height at which a pulsation can be felt in the jugular vein is the central venous pressure, expressed as water level.

A pulse at the wrist means that the systolic blood pressure is 80 or higher.

As a side note, doctors usually check the pulse in the neck. Specifically, the pulse in the carotid artery is the fastest and most accurate.

The two methods I mentioned above are very rough ways to measure blood pressure, but they are better than not being able to measure it at all. Even in that patient who had his spleen removed.

You can’t remove the spleen without clear evidence. It’s right to confirm at least one more thing.

Phew.

“Let’s finish. Istina, collect the body as much as possible, and put the heart in an alcohol vial. We’ll preserve it and take it to class.”

The corpse that had just been dissected had many problems, such as blood clotting inside due to poor preservation. The structures could not be seen properly.

Maybe next time I can get some fresher corpses? I’d like to bring some to class.

Thinking differently, instead of taking the corpse, why don’t the students come? Why don’t we get a new corpse and have the class in the underground dungeon? … I need to think about it some more.

with a splash!

With a splash of water, the heart of the body donor was placed in a glass vial. Oh, come to think of it, it wasn’t the donor’s heart this time.

Should I call him a corpse donor?

Although her expression was uneasy, Istina now held the vial containing the heart in both hands.