A surgeon came to me one day with a device.

He asked me if I knew it?.

“Yes,” I replied, “apparently an electronic thermometer.”

He said he needed my help to realize his brilliant idea.

So, he measured the temperature of the skin on his leg to determine the degree of development of obliterating atherosclerosis of the arteries of the lower extremities. After pronouncing this long scientific name, he looked at me with condescending irony, thinking, how could this ignoramus understand SUCH a THING! But, seeing no embarrassment or misunderstanding on the face of the dumb non-medic, he continued, rightly deciding “Not to throw beads in front of pigs.”

By measuring the temperature, he can determine which areas of the skin, and therefore the entire leg, are supplied with blood better, and which are worse. But its problem is that it does not need to be measured at a single point, but on a fairly large surface. And there’s ONLY ONE probe sensor! And each measurement takes some time until the probe head changes its temperature in accordance with the skin temperature.

And his brilliant idea is to run many probes at once, 20-50 and connect the device from one to the next probe with a switch, and then mark the temperature of this point on a special leg drawing.

A question for me: Can you make such a thing?

My counter question is: What will these 50 probes attach to the leg?

He was confused for a second, because he hadn’t thought…

But he thought fast: Stick them on by adhesive tape!

I immediately informed him that this procedure was lengthy and ineffective, and the probes would fall off.

Then fix them with a rubber band with holes, like electrodes in cardiography, – he offered

I explained to him that there are only four ECG electrodes on arms and legs, but he wants 20-50.

So let the tapes have lots of holes.

I explained again that in that case it would be necessary to wrap the full length with a wide ribbon, and hold the probes in the form of “pencils with a handle” and a wire, he still would not be able to.

His next, well, downright brilliant idea was to make a BOOT with lots of holes in the boot and sole and insert dozens of thermal probes there.

I said: Oh, so you want to make an analogy of a “Spanish boot” thermometer?

He obviously studied Medieval history inattentively and did not understand my ironic question what the “Spanish boot” had to do with it.

Okay, I explained to him that it would take a long time to insert the probes again, but there was no guarantee that they would all have a close contact with the skin, and the boots should be different in size and shape for different feet.

My critical explanations, which negate all the genius of his ideas, angered him and he resolutely said: In general, you don’t want to do this?!

Yes,- I agreed, – in general and in particular I don’t want to, because it’s pointless and useless! But I’m ready to help you, so I want to ask you:

There are special heat-sensitive liquid crystal paints that change their color depending on the temperature. Put paint on patients foot, take pictures from different angles, and you’ll have a complete picture of the temperature distribution in seconds!

He looked at me with contempt: Such paints are terribly expensive! Where will I get the money for them?

But 20-50 test probes and boots can also cost a lot!

“Well,” he said, “that’s why I’m asking you for help.

Then I realized belatedly that according to his brilliant idea, I not only had to assemble all this wonderful installation, but also BUY everything I needed MYSELF!

Okay,” I said, “then let’s get back to the original question:

Why do you need to measure skin temperature?

That’s what I explained,” the doctor replied with obvious irritation, “in order to establish the blood circulation level!

– You can set the blood circulation level using an ultrasound Doppler scanner, and precisely and directly in each artery, and the skin temperature depends on a number of parameters: arteriole tone, capillary tone, depth of their occurrence, thickness of the epidermis and subcutaneous tissue, the presence or absence of leg hair, and many others.

The same answer again: The department where he works doesn’t have the money for such an expensive device.

Therefore, I did not remind him about the thermal infrared imager at all.

Okay,” I said, getting tired of this pointless discussion, seeing that he was fixated on TEMPERATURE and his brilliant idea of multipoint measurement of this temperature, “You don’t need SKIN TEMPERATURE, but knowledge of the integral pattern of blood circulation in the leg. Right?

HE THOUGHT ABOUT IT. SUCH “STUPIDITY” never entered his brilliant head!

Then he added hesitantly: Yes, maybe …

Not “maybe,” I firmly corrected him. BUT FOR SURE!

General pattern of blood circulation in the leg!

So, have you heard about such a “non-bloody method” of studying blood circulation, called “Impedance plethysmography”?

The second word vaguely reminded him of something from a medical school course on diagnostic methods, the first – nothing. I briefly explained to him that in this method, a weak high-frequency current is passed through the organ under study, which is imperceptible and does not harm anything. By the difference in electrical conductivity of blood and tissues, it registers fluctuations in conductivity, and these fluctuations, both in amplitude and shape, directly show the degree of blood filling and the many problems that change it!

I have such a device (I built it myself) and I can demonstrate its effectiveness at any time. He perked up a little and said listlessly, with obvious doubt, that he was ready to conduct a series of experiments with this device.

(It NULLIFIED his whole brilliant ideas!!!)

A couple of days later, I was invited to the surgical department to check the proposed technique. I brought the device, connected it to the writer, an electrocardiograph, and went to the ward where the object of study he had selected was located. A woman after abdominal surgery, during which a blood clot broke off, severely narrowing the lumen of the artery in one leg.

They said “on the left.”

My device was a two-channel device, so I immediately applied four ring electrodes with pads soaked in saline solution to both legs. I turned it on and looked at the cardiograph tape.

On the left, .With BLOCKAGE, the IPG (Impedance PlethysmoGram) has a good amplitude and a distinct characteristic shape indicating normal blood circulation.

The right one has a sharply reduced amplitude, a very strong dome shape with no visible signs of a normal plethysmogram with a outlined top, incisor and dicrotic tooth.

What the hell is this?

The doctor is triumphant: Your method is no good!!!

I ask: Are you SURE that the blockage is on the left. and not on the right?

There’s not the slightest doubt,” he replies, “and the temperature and the CAT (Computer-Assisted Tomography) X–ray confirm it!

And when I applied the electrodes, I felt just the opposite with my fingers. The right one was noticeably colder at the bottom, but I thought it was a mistake of my thermoreceptors, as I first applied the electrodes to the left one, and then, with SLIGHTLY DAMP fingers from the pads, to the right one.

I recorded it again. The same thing!

I tell him: I think I’m SURE that the blockage on the right is severe. It’s visible on all the curves! I do not know and do not understand how you got the opposite result.

Once again, I was invited again, and with the same fiasco: The device shows one thing, and they claim the opposite.

Complete discrediting of the method!

A week later, the doctor came and sheepishly said that they had deliberately deceived me in order to check whether I had correctly diagnosed using the device!

And it showed quite correctly where the artery blockage was!

Since then, when I occasionally entered the department, I saw how doctors, puffing, applied thermal probe to different points of patients’ legs…

Progress is evident!

By the way, the same thing happened with the “buzzing panties” of the “Stop-pisser” for the treatment of enuresis! (See the corresponding note.)

And so it is to this day!

19 X 2023