Chapter 101: Touch the Eye [1] At Kanghyeok's words, a momentary silence fell over the room.
He was going to make a hole in the eye.
Was that really any different from saying he would blind him?
That was the question on everyone's mind.
As expected, the first to speak was the patient himself.
"You're going to pierce a hole in my eye...?"
He was trembling much as he had earlier, but for a different reason.
Now, it was clearly Kanghyeok himself who terrified him.
Only then did Kanghyeok realize there had been a slight problem with what he had said.
There had been far too little explanation.
This is inconvenient. Back when I was a professor, the residents handled the explanations beforehand.
Come to think of it, he could barely even remember ever personally obtaining surgical consent himself.
Anyone who had ever been admitted to a university hospital would probably know.
You did not get as many chances as expected to speak directly with the attending professor.
Instead, some young, shabby-looking fellow would be the one examining you.
Enough reminiscing.
What was the point of missing it so much?
There was no way back.
He had come all the way to Hanyang and met countless people.
Yet there had not been a single person in the same situation as him.
He deliberately carried that suspicious house-call bag around every day, and no one even questioned it.
Kanghyeok shook his head and spoke again.
"Ah. Um. It's not like I'm going to stab a huge hole straight through your eye."
"But that's what you just said."
"Mm. I did say that."
Kanghyeok rolled his eyes.
No matter how much he thought about it, there was no other way to explain it.
Whatever the case, the fact that he had to make a hole was not going to change.
"It won't be as big a hole as you're imagining. But I do have to make one."
"No... You can't just suddenly say that..."
It seemed difficult to make him accept it like this.
Kanghyeok let out a low sigh and began to explain.
Of course, he had no expectation whatsoever that the patient before him would understand.
"There's a fluid in the eye called aqueous humor. This illness happened because the opening where that fluid drains out became narrow. I don't know the cause, but that decoction likely made it worse. Once that opening narrows, it won't widen again on its own, so I can't just leave it like this. That's why I either have to forcibly widen the opening or make a new one."
"Mm."
The patient kept his mouth shut and only blinked.
Because the only thing he understood from all that was the part about the hole.
The one who spoke instead was Dongpa, who had been squatting in the corner.
He had understood barely half of it himself, but at least he had heard the part about the decoction making things worse.
"What kind of slander is this?"
"It's not slander. You just don't know a damn thing."
"How can you use such vulgar language again..."
"Ah, you're noisy. Makbong."
There was no point expecting Dongpa to realize his own mistake. He truly did not know a damn thing.
If it had been someone of Heo Jun's caliber, Kanghyeok might at least have felt like sitting him down and teaching him.
But Dongpa? This nobody was far too much of a nobody.
"Yes, Young Master."
In the end, Dongpa had no choice but to shut his mouth.
Makbong had stuffed a gag into it with his rough hand.
The last thing the man had said bothered him a little, but Kanghyeok ignored it for the moment.
He said one of his patients is someone important.
No matter how important, surely not higher than a prince.
Judging from the Bojewon talk and all that, at most it was probably some official here.
Heo Jun may be enough to settle this.
Thinking of Heo Jun reminded him that he had wanted to teach him.
He had intended to call him over when it came time for spinal surgery, but now that he thought about it, making a hole in an eye was no less a rare spectacle.
More than that, the anesthesia process itself would probably interest him.
Eye surgery could often be handled with local anesthesia.
But that only applied when it was done by someone skilled.
As far as ophthalmology was concerned, Kanghyeok was little better than a novice, so that was a distant prospect indeed.
For the patient's sake, and for his own, it was safer to use general anesthesia.
"Ah, and... Dolseok, go bring Teacher Heo here. On horseback."
"Ah. Yes, Young Master."
"It's not a very big surgery... but the way the anesthesia works will probably interest him. Then he'll come."
"Yes, yes."
Dolseok flew out of the room as if airborne.
By status, it would have made more sense for Yeoju to ride the horse, but it was better if she stayed out of sight whenever possible.
Besides, Dolseok had long held Kanghyeok's reins and was more used to riding anyway.
"Good. Then let's start preparing for the surgery."
"Ugh... Are you really going to make a hole?"
"You'll just take a nap. You won't feel a thing."
"A nap, you say?"
"That's right."
While Kanghyeok soothed the patient, Yeoni and Yeoju each began preparing decoctions.
One was an anesthetic made by mixing Cho-o with Sumsu, and the other was a muscle relaxant made from pufferfish poison.
Neither the patient nor Dongpa had any way of knowing what kind of medicine it was, so they merely blinked.
But when they saw the object Makbong brought out, they let out groans.
"What... is that?"
"Ah, that?"
Kanghyeok pointed at the iron balls, which had recently been modified again and reborn as a usable artificial respiration bag.
The bag itself was still literally testicles.
That was because it was hard to find anything in Joseon that could replace them.
The blacksmith Teacher Heo found for me really suffered over this one.
Kanghyeok ran his fingers over the two tubes attached to the sack.
The straw-like tube was for blowing air into the inside of the bag, while the wider tube was meant to be inserted into the patient's throat.
It was made of iron, so it would hurt a bit, but after testing it several times, the results had been very good.
"It's something that will be used while you're asleep, so you don't need to know the details."
"No... It's going to be used on my body, and I don't need to know?"
"Mm. Just think of it as something that'll keep you from dying."
"Keep me from dying... Is it really that dangerous?"
Until just now he had been distraught over his eye, but as that eased a little, his worries only piled up again.
Kanghyeok could not say he failed to understand that feeling entirely, so he simply patted the patient on the back.
At times like this, reassuring the patient was also part of being a famed physician, was it not?
"I'll make sure it isn't dangerous, so don't worry. Your eye is starting to hurt again, isn't it?"
"Yes..."
"Exactly. If you don't do this, you'll go blind. For now, drink the medicine one more time while we prepare."
"Yes, sir."
Kanghyeok made him drink the remaining Oryeongsan from earlier once again.
After all, once the anesthesia took effect, the intraocular pressure would likely rise even more for the time being.
It was necessary to lower the intraocular pressure as much as possible before that happened.
Watching the patient gulp down the Oryeongsan, Kanghyeok organized his thoughts.
First, wait for the eye pressure to settle a bit... In my experience, Oryeongsan reaches its peak effect in a little over an hour. It'd be good if Teacher Heo comes within that time, but if not, it can't be helped.
He could not let the patient's condition become critical just because he wanted to teach someone.
Unfortunately, the distance from Bojewon to Heo Jun's quarters was considerable, and because of that, Heo Jun did not arrive in time.
Kanghyeok spoke to the patient, who had just returned from urinating.
"All right, let's start now."
"Yes... oh dear."
"There's no need to tremble like that. Once you take a nap, it'll all be over anyway."
The problem was that "over" kept sounding ambiguous.
Still, a noble like Kanghyeok had personally laid out the mat and waited, so backing out now was hardly proper.
"Yes, sir."
With a deep sigh, the patient sat down on the mat.
The decoction truly had worked astonishingly well on the pain in his eye, and the threat of going blind if he did not undergo surgery was more frightening than those unknown medicines.
"Now, drink this first."
Kanghyeok gave him the pufferfish poison, with the dosage measured perfectly.
The time until paralysis set in was about one minute.
That was enough time for him to take the next decoction.
"Now, this next one."
The anesthetic would make him lose consciousness in no more than seven seconds, so it could not be given first.
After drinking the decoctions one after another, the patient tilted his head.
The taste was not as strange as he had expected, and his mind still seemed clear.
"Hm? This... uh..."
But seven seconds was all it took.
Kanghyeok caught the patient as he lost consciousness and fell sideways, then laid him straight down on the mat.
Makbong, who had been waiting nearby, rushed over immediately carrying the upgraded iron-ball bag.
"Please put this in."
"Right. It's not actually as difficult as it looks."
Kanghyeok inserted the iron tube into the patient's throat.
If it had been up to him, he would have liked to shove it directly into the airway, but if he did that, the man's upper and lower front teeth would all shatter.
This was not rubber, but an iron tube.
Well... even if I just lift the epiglottis and rest it in place, air will still go in.
The drawback was that it could not be used on the elderly or on children, but it was perfectly usable on a young, healthy adult like this.
After setting the tube in the proper position, Kanghyeok carefully handed the bag to Makbong.
"Here. If this comes out, it'll be a disaster, so be careful."
"Yes, Young Master."
"You know, right? Count to ten in your head, then blow. It's much easier this way, isn't it?"
"Yes. This is nothing. I can do this all day."
Because far less air leaked out the sides than when blowing directly by mouth, it took far fewer breaths than before to keep someone alive.
That was a tremendous relief for Makbong, who had somehow become the one in charge of the bag.
—Huff, huff.
With practiced skill, Makbong began blowing air into the patient's throat.
Kanghyeok watched him do it for about five rounds, then turned his head away.
As expected. This guy really is good at this one thing.
In truth, since both the anesthetic and the muscle relaxant had been given, any mistake in breathing would mean instant death.
No matter how much Kanghyeok had come to Bojewon for cadaver dissection, he could hardly go creating corpses himself.
He was Baek Kanghyeok, a physician worthy of the name.
And for something as minor as eye surgery, no less.
—Slide.
It was only when Kanghyeok had just started rummaging through his house-call bag that Heo Jun entered.
Dolseok was nowhere to be seen, but Kanghyeok's horse was there, so it seemed Heo Jun had been in such a hurry that he had ridden over himself instead.
Poor Dolseok.
Thinking of the man trudging all the way back from the palace made him feel a little sorry for him.
Only a little, though.
"Did I miss it?"
"No, not at all. I just put him under."
"I see. That's a relief. How exactly did this illness come about?"
"Yes. It's something called glaucoma..."
Kanghyeok handed Yeoni two small hooks to forcibly hold the eyelids apart and gave Heo Jun a brief explanation.
In summary, it was this.
There was a fluid in the eyeball called aqueous humor, and when that fluid could not drain out, the pressure rose.
As the pressure rose, it compressed the eyeball and caused pain, and eventually it damaged the optic nerve and cornea, resulting in loss of vision.
So now he was about to make an opening through which the fluid could escape.
"Mm. I see."
"So you understand."
"Roughly."
"As expected of Teacher Heo."
"But how do you plan to treat it?"
"Mm."
That was the problem, in fact.
If Kanghyeok had been an experienced ophthalmologist—
And if he had had a laser—
He would not have needed to put the patient under.
But unfortunately, neither of those conditions applied right now.
Even in the era before lasers, they did operate on angle-closure glaucoma.
It was an almost forgotten procedure now, one performed only very rarely.
Still, it was done once in a while.
For example, when laser surgery failed, or when the symptoms were too severe.
Or at times like this.
After taking a deep breath, Kanghyeok picked up the scalpel.
"I'll have to cut it open with a blade and make one."
"The eye?"
"Yes. More precisely, right beside the pupil..."
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