"This tooth of yours is already decayed, if you want to completely resolve it, I suggest you have it pulled out." Lin Miao examined the location of the patient’s toothache and found it had long been hollowed out, and most of the teeth in this mouth had problems.

It must be because of not brushing teeth regularly, neglecting dental health. There’s no help for it, the poor at most use salt water for rinsing their mouths. Many people’s teeth start to decay after turning forty, making eating meat a luxury.

Only wealthy families can afford tooth powder.

Lin Miao made his own toothbrush, but he could only let the people around him use it. If he wants to promote it, sorry, others might not accept it.

Even families of power and influence only use softwood or willow branches to brush their teeth. Haven’t they thought about making a toothbrush?

The bristles used for toothbrushes are boar bristles. Hair from other animals is either too soft or too hard, and cannot be used for making toothbrushes. Even after treatment, ordinary people may not accept boar bristles, let alone the affluent.

Before toothpaste was invented, using tooth powder to brush teeth made little difference whether with willow branches or a toothbrush. The latter merely makes it easier to clean the gums and deep inside the mouth.

Lin Miao is still in the startup phase, helpless but to maintain himself.

"Tooth extraction, that’s too painful..."

"If you don’t pull out this tooth, it might keep hurting, and in the end, you can only wait until it spoils and falls out by itself. I can prescribe you some medicine, which will have pain-relieving effects, but it will only treat the symptoms, not the root cause. You make the decision." Lin Miao said, for tooth extraction, he didn’t have the right tools yet. He’d have to have them custom-made later, as regular pliers were not handy.

"Mr. Lin, prescribe me the medicine, I won’t have my tooth pulled!" The patient was resolute about not extracting the tooth and chose to take medicine. He was extremely afraid of tooth extraction.

Lin Miao did not persuade further. A physician in treatment must ultimately consider the patient’s choice.

...

"Mr. Lin, I’m back again."

"Uncle, it’s you, how are you, here for a follow-up today?" Lin Miao somewhat remembered this hobbling uncle.

He was a carpenter, also the mainstay of his family. While working, a fallen beam had crushed his ankle, causing a fracture. It wasn’t a serious injury but had dragged on until now.

"I went back, and after turning it over and over in my mind, I decided to listen to you, Mr. Lin, and have you perform the surgery for me," said the uncle.

"Alright, since Uncle trusts me so, I’ll do it for you. But you’ll need to wait a little while, I’ll need to arrange things." Lin Miao nodded.

"Thank you, Mr. Lin." The uncle expressed his gratitude, but in truth, it was also for livelihood’s sake. With one lame foot, he couldn’t get work or earn good wages. Life wouldn’t be easy.

It’s still treatable now.

"Xia Zhu, prepare the operating room and take this uncle in for pre-surgical preparations," Lin Miao called Xia Zhu in and instructed.

For this possible surgery, Lin Miao had made prior arrangements. After all, if there were any emergency injuries, they couldn’t wait for an operating room to be set up. That would be too late.

So, a room was specially prepared in the backyard.

Guan Biyun had also curiously asked before what this room was for. Lin Miao said it was for "emergency trauma surgeries", but he didn’t explain much about what "surgery" was.

Today they would finally use this "operating" room. Guan Biyun was also interested when she heard about it and came with her apprentice Lien Yurou.

Xia Zhu was meticulously preparing for surgery, sterilizing all sorts of instruments, and mixing the light salt water for cleaning the wounds.

"Xia Zhu, where did all these knives come from?" Guan Biyun asked curiously, looking at the gleaming, seemingly very sharp instruments laid out in a row on a blue coarse cloth on a cart.

"They were custom-made by Mr. Lin."

"What is this, and why does it have teeth?" Lien Yurou curiously picked up a pair of curved pliers and asked.

"Don’t touch..." Xia Zhu’s warning came too late, and she said embarrassedly, "This is a curved haemostat, used to stop bleeding during surgery. Now that you’ve touched it, I’ll have to sterilize it again later."

"Sterilization, haemostat?" Guan Biyun closely observed the preparatory work Xia Zhu was doing and seemed to understand how it was used.

"Teacher Guan, all these surgical instruments must be sterilized before they can be used, to prevent external pathogens from entering the human body during surgery. Our hands all have unclean things, and once touched, they must be re-sterilized before use. During surgery, we must wear masks and surgical robes, to maximize ensuring that the external pathogens we carry do not infect patients..."

"It’s so complicated, and we even have to wear this unattractive clothing, just like the skirts worn by coroner examiners examining corpses..." Lien Yurou showed a slightly disdainful expression upon seeing the surgical robes designed and made by Lin Miao.

"Yurou!"

Lien Yurou quickly stuck out her tongue, scared to remain silent.

...

"Senior Sister, I’ll be performing the surgery on the uncle later; you should also join and observe." Lin Miao spoke to Sun Youwei.

"Alright, I also wanted to see it," Sun Youwei agreed, as she naturally didn’t want to miss such an opportunity.

Next, Lin Miao hastened through his consultations to save time for the upcoming surgery.

He didn’t know how long this surgery would take; since it was his first time, he made sure to set aside enough time. However, generally speaking, this surgery wasn’t particularly complex and shouldn’t take more than an hour.

With approximately three patients left after, Lin Miao instructed Sun Youwei to notify Xia Zhu to have the uncle take Mafeisan beforehand. Surgery requires anesthesia; otherwise, enduring such pain would not be easy for a normal person.

Local anesthesia is possible, but its duration is too short and may cause unnecessary troubles during surgery. General anesthesia is more convenient.

Lin Miao finished seeing all the patients, and Xia Zhu had completed all the preparatory work on her end; they were now waiting for him to proceed with the surgery.

"Master Guan, you’re here too?"

In the operating room, Lin Miao encountered Guan Biyun, who, along with Lien Yurou, was fully dressed in surgical robes and wearing masks.

Apparently, they don’t want to miss this rare opportunity for observation.

"Mr. Lin, mind if I observe and learn here?"

"No, I’m thrilled that you can come to guide us." Lin Miao chuckled, "However, this is both a surgery and a teaching session. If there’s anything amiss, please kindly correct me."

"I haven’t delved much into bone injuries, still learning from Mr. Lin." Guan Biyun said hastily.

"You’re too humble, Master Guan."

"Xia Zhu, prepare for surgery!"

On the operating table, the ankle to be operated on is exposed to the air, washed several times and disinfected thoroughly.

"Senior Sister, Xia Zhu, we’ve already studied the anatomy of the human ankle, so I won’t elaborate on that. Today, I will primarily discuss the surgical approach to avoiding critical areas on the ankle. I’ll explain as I go, watch carefully, and don’t interrupt. Ask your questions after the surgery..."

Skin is incised, avoiding nerves and major blood vessels, and bones are exposed to the air.

Xia Zhu has been through this before and is immune; Guan Biyun frowned slightly, but she’s seen a lot and is mentally composed. Only Sun Youwei and Lien Yurou struggle to contain themselves, their expressions twisted, luckily masked covered them.

For a medical student, this hurdle must be overcome. Eventually, they’ll encounter patients with bone injuries or other traumas, what then?

"See, his bone initially fractured from an impact. With proper treatment, it could fully heal and recover. However, he didn’t follow through and went right back to heavy labor, causing the bone fragment to shift out of place and deform the ankle. Additionally, it’s partially healed now, what to do?"

"Knock it down and fit it back..." Though no one speaks, a person covers their mouth and says.

That person is Lien Yurou.

"Miss Yurou’s suggestion is correct. That’s one approach, but once fitted back under pressure, it might pop out again. What next?"

"Mr. Lin, could a steel pin stabilize it?" Xia Zhu recalled the master of Qin Yanran at Huaye Tower using a steel pin to fix a fractured shoulder.

"Correct, it’s the simplest effective method." Lin Miao nodded, "Next, I’ll demonstrate, just watch. This surgery is quite simple, as long as you’re bold and meticulous, any of you can perform it in the future."

The surgical principle is simple, but execution is challenging, improper force can injure the patient’s ankle nerves.

Align all bone positions and insert the steel pin.

Then, wash the wound; the final step is stitching, without hand contact allowed. The surgery takes nearly half an hour.

Lastly, the bandaging.

Despite using a steel pin, Lin Miao still instructed Xia Zhu to make a foot mold, applying plaster for stabilization.

In this cold weather, plaster fixation is far better than splinting.

After the surgery, Guan Biyun was astonished; she had never seen this method for treating ankle deformation.

Of course, this is for post-trauma deformities; if congenital, is surgery still a possibility?

Truthfully, congenital conditions are challenging, unless using artificial bone replacement, which current technology cannot achieve.

But, if the disability is trauma-induced, surgery offers some recovery potential, at least not worse post-surgery.

However, it’s influenced by patient age and physical condition. The patient’s recovery ability is crucial to the final surgical outcome.

"Mr. Lin, I have a friend whose legs were injured in a battle, leaving her wheelchair-bound ever since. Is there a surgical solution to heal her?" Guan Biyun pulled Lin Miao aside, eyes filled with hope and earnestly asked.

"Master Guan, I need to see your friend personally to assess." Lin Miao contemplated; old adult injuries aren’t impossible to recover from, albeit his orthopedic knowledge only slightly surpasses this world’s physicians’, his experience is scant without ample case practice.

"She is immobile, coming to Dongshan would be difficult." Guan Biyun sighed.

"If there’s a chance, I could visit her in the future."

"Yes, you’re headed to Li Jing Qihuang Research Institute in three years, by then, she can meet you." Guan Biyun nodded.

"Alright." Lin Miao agreed.

"Xia Zhu, post-operative precautions, once the patient awakens, he shouldn’t leave yet. Inform him also I’ve given him a prescription, instruct him on medication use." Lin Miao directed Xia Zhu.

"Yes, Mr. Lin." Xia Zhu was cleaning surgical tools, drying and sterilizing them for reuse.

"Yurou, help Xia Zhu, and henceforth, assist me at the consultation point during the day." Guan Biyun suddenly turned to instruct her apprentice, Lien Yurou.

"Ah, Master, I..."

"This is a rare learning opportunity for you; if you don’t work diligently, I’ll expel you!" Guan Biyun said.

Lien Yurou grimaced instantly.

Lin Miao said nothing; he doesn’t proactively teach, how much Lien Yurou learns depends on her ability. If she asks, he wouldn’t hesitate to guide.

Master Guan’s female disciple was clearly indulged from a young age, lofty in demeanor.

Even more arrogant than the Xu Family’s seventh young lady.

Speaking of which, Xu Qixi hasn’t been seen since the start of the year; she used to often visit Lin Mansion and the consultation point.

Now, not a shadow to be seen.