Garrettās heart couldnāt help but race.
The illness he was facing now, at its mild stage, could be managed with vigorous administration of sugar-salt water, or WHO-recommended oral rehydration solution. Moderate dehydration might require intravenous fluid supplementation, but when it progressed to severe dehydration...
Muscle spasms!
Hypokalemia!
Uremia, acidosis!
Cardiac failure!
Acute renal failure!
Acute pulmonary edema!
Which one is easy to deal with! If it were in the emergency department, he would have started yelling by now: "Emergency blood gas! Electrolytes! Creatinine! Open the intravenous access! Start IV fluids!" And he would have to prepare hydrocortisone or dexamethasone, epinephrine, or dopamine to maintain blood pressure at the shock level, and so on and so forth...
But he didnāt have anything on hand now! No blood gas analyzer, no electrolyte analyzer, no injection needleāeven if he could immediately have the little demon conjure up an injection needle, sterilized it under high temperature and pressure, he still couldnāt produce sufficiently pure, sterile intravenous fluids!
Given the current situation, if he were to administer intravenous fluids recklessly...
Hey, septicemia is watching you.
He didnāt even have antibiotics to suppress it! Garrett could only do his best with what he had. Without intravenous injection, he could only resort to oral administration, but, of course, the first thing to do was to conduct a thorough examination!
The girl was covered in filth from head to toe. Garrett ignored it, knelt beside the girl, and took out his stethoscope, pressing it against her chest. Listening to her heartbeat while feeling her pulse, he quickly gave orders:
"Feel her calf muscles, see if thereās any cramping!"
"Cramping!"
The young woman trembled as she felt the girlās calf muscles. Garrett sighed inwardly: calf muscle cramping, or gastrocnemius spasm, was a manifestation of vomiting and diarrhea, leading to massive sodium and salt loss. As for the pulse, the sensation under the fingertips was fast and weak, almost imperceptible...
The heart rate was fast, but in terms of heart sounds, there were no signs of atrial fibrillation or ventricular tachycardiaāmeaning, hypokalemia wasnāt severe enough to significantly affect the heart.
The breath sounds werenāt too bad either, no crackles were heard, and the patient didnāt exhibit signs of pulmonary edema such as chest tightness, orthopnea, coughing up pink frothy sputum, or distended neck veins.
"Little sister, are you thirsty?"
Garrett asked softly. The little girl lifted her head slightly, her lips parted, but she couldnāt produce any sound. Garrett urgently shouted:
"Aurora! Bring water over here!"
"Coming!"
Aurora Worton held a bowl of sugar-salt water in her hands, bent over, leaned forward, and walked briskly with small, duck-like steps.
He knelt down, brought the bowl of water to the girlās lips, and the girl opened her mouth slightly but couldnāt swallow. As soon as a spoonful of sugar-salt water entered her mouth, it quickly flowed out from the corners of her mouth.
"Let me feed her!" the young woman hurriedly reached out to take the bowl. Garrett blocked her with his elbow:
"No. Let me figure it out!"
He had to make do with what he had! Garrett jumped up and rushed outside. Despite the urgency, he couldnāt afford to make mistakes. He thoroughly washed his hands to ensure that most of the bacteria on his hands were washed away, returned to his original position, and began to give orders:
"Let her lean to the side! Donāt lie flat or sit up straight! Good, thatās it!"
"Tilt her head to one side! Little sister, donāt be afraid, you canāt drink anything right now, so Iām going to administer the medicine you need through a tube into your stomach! Donāt be afraid, relax, Iām saving you!"
After saying this, he took out a seed, held it in his palm, and activated his divine magic. A gleaming green light flashed, and a slender green hollow tube grew out, extending towards the girlās nostrils. Garrett had conducted experiments before, and the bacterial load of tubes generated by divine magic was mainly positively correlated with the appearance of the seeds and the bacterial content on the palms. As long as he washed his hands, the tubes generated by divine magic for use as gastric tubes would still be tolerable in terms of cleanliness.
The tube gradually inserted. The girl was full of fear, but she was obedient enough to take deep breaths when asked to, and she tried hard to swallow when asked to. The lubricated green tube went all the way down. Garrett estimated that the depth was about right and
stopped generating the gastric tube, then took out a 50ml glass syringe.
Without a needle, he had to make do with it...
The tip of the slender green tube slightly expanded and automatically approached the syringe head. Garrett held his breath, slowly pushed in 10ml of air, and listened intently. Aurora stood by, holding the stethoscope for him, eyes full of nervousness, muttering incessantly:
"What did you hear? What did you hear?"
The sound of air passing through water... indicating that the gastric tube had entered the stomach... Garrett silently answered in his heart.
He withdrew the syringe, filled it with sugar-salt water, and slowly pushed it into the gastric tube. For children weighing less than 20kg, the hourly oral rehydration volume should be 250ml. How much does this little girl weigh? What should be the speed of liquid insertion into the gastric tube?
Damn it, Iām not a pediatrician or a nurse! Nasogastric feeding is a nurseās job!
Oh no, sheās vomiting again!
"Do we need to continue pouring?" Aurora was at a loss beside him. Garrett gritted his teeth: "Keep going!"
The guidelines say that vomiting is not a contraindication for oral rehydration! And, thereās no other way!
One syringe of sugar-salt water injected, followed by another. After two consecutive operations, Garrett handed the syringe to Aurora, instructing him to continue. He knelt beside the girl, hands folded, and placed them on the girlās abdomen. The white light of healing arts emanated from his palms, seeping into the girlās body:
Although cholera toxin can stimulate excessive secretion of water, chloride, and bicarbonate in the intestines, inhibit the absorption of sodium ions and chloride ions by the intestinal mucosa, leading to severe diarrhea and dehydration...
However, the patientās intestinal absorption capacity for glucose remains intact!
As long as glucose is absorbed, it can promote the absorption of sodium ions, potassium ions, and bicarbonate ions, and enhance water absorption!
With sugar-salt water entering the intestines, it can effectively replenish fluids and correct electrolyte imbalances!
So... Please, absorb faster!
Duodenum!
Jejunum!
Intestinal epithelial cells!
Move! Move faster!
Faster!!!
Garrett prayed earnestly. The white light emitted from his palms initially formed a large mass, gradually transforming into thread-like strands, twisting and turning. Suddenly, the girlās body moved:
"..."
"Whatās wrong?"
"I... I can drink..."
She could speak! Even though her voice was hoarse and weak, it signaled an improvement! Garrett was overjoyed and quickly grasped the gastric tube, canceling the induction spell. The verdant vines rapidly retracted from her nostrils, returning to a tiny seed in his hand. Garrett took the water bowl and offered it to the girlās lips:
"Keep drinking! Drink as much as you can!"
Oral rehydration!
The healing spell continued!
Although he was an emergency surgeon, Garrett had also read literature. The improvement of cholera patients wasnāt supposed to be this quick. The guidelines mentioned how things should progress within the first six hours, and then within 24 hours. But now, the improvement was immediate; within an hour, the girlās condition had shifted from severe dehydration back to moderate!
Moderate, where death wasnāt so imminent!
"Garrett! Weāre here!"
The sound of urgent hoofbeats. Before the people arrived, their voices preceded them. In a moment, Elder Wood strode in with purposeful steps. Upon surveying the scene, he halted in the center, slamming his oak staff:
"Garrett! Step aside!"
Garrett quickly moved aside, almost stumbling, and pressed himself against the wall. Elder Wood bowed his head in prayer, with five or six disciples behind him, gripping their oak staves and chanting prayers in unison:
"Great god of nature! You protect us, nurture us, comfort us, and guide us. We are all your children; you nourish our bodies and soothe our souls. Now, your children are afflicted with illness. May your grace heal them..."
Flickers of white light appeared at the tip of each staff, then gathered above the heads of the priests, converging into a single point before exploding outward, scattering sparkles. Soon, the patientsā complexions improved, and they began to rise.
"Thanks to the god of nature!"
"Thanks for the grace of the god of natureā"
Half of the people surrounded Elder Wood, while the other half surrounded Garrett, expressing their gratitude in a continuous chorus. Garrett quickly inquired about their conditions, and the patients clamored to respond:
"My stomach doesnāt hurt anymore!"
"I donāt feel like vomiting anymore!"
"Iām not having diarrhea anymore!"
Their smiles were truly radiant. Garrett couldnāt help but smile too, but his medical instinct urged him to shout:
"Donāt crowd here! Go wash your hands! Take a bath! Cleanse thoroughly, soak your clothes in disinfectant, soak the houses, soak the floors, everything! Hurry up!
āA little dirt might trigger another epidemic!!!"
He shouted and gestured, driving all the villagers out of the wooden house to clean themselves. Elder Wood wiped the sweat from his forehead and approached Garrett:
"How did this epidemic suddenly break out? I rushed over as soon as I received the news, and so many people were already sick! If you hadnāt noticed, half the village might have died!"
More than half... Garrett shrugged. As for the cause of the epidemic, he felt somewhat embarrassed to sayāit wouldnāt do to mention that the pathogen originated from his laboratory. After a moment of silence, Sam, the adept in molding magic, took over the conversation:
"It was a spy from the Radiant Church who brought in the dirt. Weāre tracking his escape route. Now, it seems Garrett was right; everywhere he passed through needs thorough cleaningā"
"And everyone who had contact with him! Horses! People in close contact with those people!" Garrett hastily added. Old Sam smiled kindly at him:
"Exactly. Iāve already spread the word. Now weāre checking everywhere for abnormalities. We hope the followers of the god of nature can assist us in tracking and tracingā"
He paused suddenly, looked up at the sky, and beckoned. A small bird with yellow beak and green feathers swooped down and landed in the old mageās hand, chirping urgently:
"Old Sam! The warhorse ridden by the spy has fallen ill with a strange disease! Several horses in the stable, the horseās owner, and the stable hands have all fallen ill! Please come quickly!"
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