NOVEL NEXT WORLD Chapter 35
Episode 35: Heart-Pounding (1)
****
Imperial Palace Infirmary.
Violet was lazing around all by herself. Asterix had gone off to the Academy, and the other healers were either slacking off or just late for work today.
Anyway, no one was at their post.
When Asterix was around, he’d handle anything that came up, even if it was minor—because he’s the type who can’t stand being idle.
But now Asterix isn’t here. At least someone has to show up on time and hold down the fort—and that someone is Violet.
Knock knock knock.
A sharp knock followed by Imperial Prince Manfred entering the infirmary door.
“Sorry to bother you during your busy schedule-”
Manfred glanced around the empty infirmary, seeing only Violet sitting there awkwardly scratching her head.
“Not busy?”
“Did I hear you wrong?”
“Where is everyone?”
“Hmm… They seem to be tied up with important matters. The academic community’s been buzzing lately with some new theories making waves.”
Though the prince doesn’t directly fund the palace healers’ salaries, angering him would bring nothing but trouble. Violet tried her best to gloss over things.
“Hmph, is that so? You’re doing a great job keeping things together.”
Thankfully, Manfred wasn’t the type to nitpick his subordinates’ faults. Violet let out an almost silent sigh of relief.
“I heard the medical field’s been stirring up quite a fuss recently. Didn’t you go on a business trip to the academy, Violet?”
“Yes. Professor Asterix seems to have thrown everything into chaos with his research.”
The prince nodded.
“That’s actually what I wanted to talk about.”
“Ah, please continue.”
“I read his latest paper—the one about epidemic dysentery. It’s caught the attention of high-ranking officials in the empire.”
Violet had seen this paper before.
Honestly, it was impressive. Solving such problems was undoubtedly remarkable, but beyond Asterix’s personal brilliance, what else was there?
“Like His Highness said?”
“I’m included in that.”
“Oh, I recently met Professor Asterix too. I also read the paper.”
“How was it?”
“It’s still experimental. Even if the claims are true, it’s too early to draw conclusions.”
Some corners of the academic world believe this discovery could shift paradigms—not just in medicine but even how the state operates.
If Asterix’s theory holds true, and plagues and diseases are mostly preventable and manageable, then governments must approach them differently.
“Is that not correct?”
“No, it’s not wrong… I just don’t know enough yet.”
Violet didn’t feel ready to judge. There needed to be more experimental verification. Besides, she didn’t even have access to a microscope yet.
This was also the reaction of some bureaucrats who reviewed Asterix’s paper on epidemic dysentery.
If something as catastrophic as epidemic dysentery could be solved merely by mixing alcohol into water, what does that say about everything we’ve done until now?
“Could you explain the contents of the paper a bit, Violet? You’re somewhat of an expert in this area.”
“Ah, yes.”
Violet rummaged through her desk drawer and pulled out a journal. Where did it say…
“The core point of this paper is this: Diseases are caused by microscopic particles, and epidemic dysentery spreads through contaminated water.”
****
I pressed my temples. A letter from Prince Manfred. Looks like giving this lecture won’t be easy.
Trouble brews. Delivering a lecture in front of a prince is no small task, especially when government officials will also be present…
Still, opportunities to influence policy don’t come every day, so it’s not entirely meaningless. But I’ve got blood research to conduct and patients to see too.
Anyway.
Let me finish what I’m doing first and think about it later.
“Istina, do you think you could get me a manometer?”
“Not sure. Maybe it’s in the lab?”
“If you find one later, could you bring it over? I need it to measure blood pressure.”
“Got it, I’ll check.”
The components of a sphygmomanometer include: an auscultation device, a balloon band for the arm, and a manometer.
You can measure blood pressure with just a manometer and auscultation device, though it takes some practice.
We already have the auscultation device, so we just need the manometer. As for the balloon band, I can improvise one.
After some time—about an hour or two—Istina returned after searching the lab.
There was indeed a manometer. An old-school one made of wood, ivory, and mercury.
Maybe I should wear a mask when using it? Mercury might leak.
There was also some rubber tubing and an inflatable strap-like object. Apparently, it was part of a device used to blow away dust.
This world seems to have technology equivalent to the 18th century. Though, considering magical tools and artifacts, there might be items comparable to 20th-century tech too.
Regardless, I don’t know exactly what these parts originally belonged to. Their origins aren’t crucial.
What matters is that after half a day’s effort, I managed to assemble a makeshift sphygmomanometer. Now all that’s left is testing it—but where?
“By the way, how do you use this thing?”
“Sit down first. Let’s put this strap around your arm.”
It’s a bit complicated to explain.
Istina sat down with the strap around her arm.
“Do you know what pressure is?”
“Yes.”
“So, blood moves through the arteries at a relatively constant speed and pressure. We want to know how much pressure the blood is moving under.”
“Okay.”
“Your heart beats, right? When the heart contracts, it squeezes the blood, creating a peak pressure known as systolic and diastolic blood pressure.”
She looked slightly confused.
“Uh… Okay.”
“Now, I’ll place the auscultation device over your brachial artery and listen for sounds in the blood vessels.”
I placed the auscultation device in my ears.
“Normally, you don’t hear any sound. But when you press the artery with a pressure higher than the blood pressure, the blood stops flowing, and there’s still no sound.”
“Ah?”
“Next, I’ll use an air pump to inflate the strap around your arm. Since normal systolic blood pressure is around 120, it’s better to inflate it to 150. For suspected hypertension cases, go up to 180.”
I inflated the balloon band around her arm to 150.
An easily missed detail: when the strap’s pressure falls between systolic and diastolic blood pressure, the movement of the artery against the strap subtly pulses the pressure inside the balloon.
Just observing that pulse carefully…
“I don’t really understand what you mean.”
“Right now, you shouldn’t hear any sound. As I slowly release the air from the strap, there will be a point where the sound of blood flow returns.”
I focused on the auscultation device. Hmm, I can hear something… Is it the equipment?
“Okay.”
“That’s the systolic blood pressure. If you keep lowering it, the blood vessel’s pressure exceeds the strap’s pressure, allowing free blood flow again without any sound. That’s the diastolic blood pressure.”
Istina’s measured blood pressure was approximately 130/90. Was she nervous about something?
Istina frowned.
“I don’t understand any of this!”
****
Maybe I should explain further.
I pulled out paper and a pen.
“It’s not hard at all.”
“Yes.”
“Look. When the pressure inside the balloon strap is between the diastolic and systolic blood pressure, you hear turbulence noise caused by vortices. There’s also a sound when the blood pressure equals the pressure inside the balloon.”
“This is difficult.”
Graphs. Even though this concept is a bit complex, expressing it as a graph might help understanding.
The pen moved across the paper.
“Look. Let’s represent blood pressure as a wave function over time. The x-axis is time, and the y-axis is pressure. Blood pressure can be shown as a wave function oscillating between the peak systolic and trough diastolic pressures. If we start lowering the pressure inside the strap from 150 at a steady rate, we can plot that as a straight line, right?”
She still looked bewildered.
“Uh…”
Maybe I shouldn’t bother explaining further. At this point, it’s less about the explanation and more about the basics.
Has Istina ever even heard terms like pressure, laminar flow, or turbulent flow?
And I can’t possibly teach her everything from high school education. How should I phrase this?
“Then let’s simplify, Istina. Sound occurs when the pressure is between the highest and lowest blood pressures. This is essentially checking where the sound starts and ends.”
“I’ll just memorize the process.”
That’s one way to approach it. I nodded. There’s value in having tried.
“Still, maybe writing papers will improve your understanding. Drawing graphs related to the topic might help too.”
“I suppose so…”
While mathematical and physical concepts form the foundation, they aren’t directly applied clinically. Understanding provides the basis for publishing research, that’s all.
On Istina’s side sat a preserved heart in a glass jar.
The heart appears heavier than alcohol, as it was closer to the bottom than the top of the jar.
“Still, I’ll give it a shot!”
Istina rekindled her determination.
Yeah, that’s the spirit of my graduate student. What can’t a grad student do?
“Teacher, can you try putting an elephant in the fridge?”
“Excuse me?”