Rebirth 1977 Great Era

Chapter 1038 China Resources Tycoon's Bronchiectasis Over Thirty Years (Bonus Chapter for Monthly Tickets: 3K Chapters)

Fang Yan composed himself and took the file bag that the old man handed him.

Upon opening it, I saw a large stack of treatment records.

Many chest X-rays show increased lung markings, honeycomb-like patterns, track-like shadows, and bronchiectasis.

In recent years, bronchial iodized oil contrast imaging has also been used.

There are also laboratory tests, such as sputum bacterial culture and drug sensitivity testing, and complete blood count.

The data displayed showed the patient's physical condition at the time.

Finally, the dialect was translated to the Western medicine treatment plan.

Long-term use of penicillin and streptomycin to control infection.

When he was in his forties or fifties, he used postural drainage to adjust the patient's posture to promote sputum expectoration. However, the patient later stopped using it because he was too weak to continue.

Other hemostatic agents, such as vitamin K and posterior pituitary extract, are also used, but their effectiveness is limited.

In recent years, people have been using blood transfusions to replenish blood volume after severe hemoptysis.

Later, there were still unperformed surgeries. For localized lesions, lobectomy was recommended, but the patient was elderly (around 70 years old) and had a long disease course, making the surgery extremely risky, so it was not adopted.

I continued translating the dialect and finally found the traditional Chinese medicine treatment process I was looking for.

This percentage is not very large. Fang Yan looked at the records and found that there were only three treatments. All three doctors used prescriptions containing herbs such as Scutellaria baicalensis, Houttuynia cordata, and Agrimonia pilosa to clear heat, resolve phlegm, nourish yin, and cool blood, such as modified versions of Baihe Gujin Tang and Shi Hui San.

Later, some people chose acupoints such as Feishu, Kongzui, and Taixi to clear heat and stop bleeding, but the effects were not very good.

In general, patients tend to prefer Western medicine treatment.

However, Fang Yan was not concerned about that; he was more interested in what kind of treatments they had received and why those treatments were ineffective.

"Did you figure anything out?" Director Liao asked Fang Yan from the side.

It's rare to see Director Liao proactively showing concern for patients when he's seeing them, so this is clearly an exception; he must be an old friend of his.

Fang Yan held the examination report and treatment plan, pondered for a while, and then said to Director Liao:
"The old man has had bronchiectasis for over thirty years, which is a rather difficult chronic disease to treat. His bronchi have been so damaged that the elastic fibers and muscle tissue have all been destroyed, resulting in irreversible dilation, like a large hole in a water pipe, which is why the symptoms keep recurring."

He paused, then pointed to the antibiotic treatment record and said:
"Look here, long-term use of anti-inflammatory drugs such as penicillin and streptomycin may be effective at first, but bacteria will develop drug resistance over time, and there may be mixed infections with drug-resistant bacteria and anaerobic bacteria. Moreover, after bronchiectasis, the lumen becomes wide and tortuous, and sputum cannot be discharged, just like a stagnant pool, where bacteria multiply wildly. No matter how strong the anti-inflammatory drugs are, they cannot clear it completely, so the infection will never get better."

The old comrade nodded solemnly:

"My British doctor also said I was using too many antibiotics."

“That’s right,” Fang Yan continued, “Look at these hemostatic drugs, vitamin K and posterior pituitary extract are not very effective because coughing up blood is not just a simple case of a ruptured blood vessel. After the bronchi dilate, the structure of the blood vessels changes, and with repeated inflammation, hemostatic drugs only treat the symptoms, not the root cause. If it is massive hemoptysis, we have to use more aggressive methods, but the old man is too old to withstand such treatment.”

He put down the report and sighed:

"As people get older, their immunity and body repair capabilities can't keep up. Plus, after years of illness, they get thinner and weaker, so the treatment effect is naturally reduced."

Finally, pointing to the traditional Chinese medicine prescription, he said:
“The previous three TCM treatments all used medicines to clear heat and resolve phlegm and cool the blood, but the effect was not good. I think the diagnosis was not accurate. In addition to the heat symptoms such as coughing up blood and yellow phlegm, the old man also had deficiency symptoms such as fatigue, dizziness and palpitations. It is obvious that he is deficient in the root and excessive in the branch. His lungs, spleen and kidneys are all deficient, and there is also phlegm heat and blood stasis.”

“But the previous prescriptions only focused on clearing heat and resolving phlegm, without taking care to support the body’s resistance. It’s like fighting a war and only knowing how to charge forward without replenishing the soldiers’ supplies. The body’s resistance and the pathogenic factors kept clashing, so the illness naturally wouldn’t get better.”

"Moreover, everyone's constitution is different, and medication needs to be taken into account specific circumstances such as age and course of disease. The previous prescription and dosage may not have been adjusted properly, which affected the effect."

The old man's expression was quite calm after hearing this. He knew his own physical condition, but still, clinging to a last glimmer of hope, he asked Fang Yan:

"Then... is this disease curable?"

This time, Fang Yan didn't answer immediately, but thought for a moment before saying:

"I can't guarantee a cure, but controlling it should be no problem."

The old man's condition was extremely difficult to handle. Fang Yan had never seen such a serious case in his medical career. In addition, the old man was old and his physical condition was already weak, making recovery even more difficult.

Even when speaking in a dialect, one shouldn't make overly definitive statements.

However, Fang Yan's words had clearly exceeded the old man's expectations. He was slightly taken aback when he heard them, then smiled and said, "I didn't expect to be cured. As long as I can suffer less, that's enough."

"Comrade Fang, if you can control my condition, then you've succeeded!"

Hearing the old man's words, Fang Yan felt more at ease. He said to the old man:
"Alright, please extend your left hand so I can take your pulse, and then stick out your tongue so I can see it."

Fang Yan quickly observed the old man's tongue. The tongue was pale red but lacked saliva, had many fine cracks on the surface, and was wide with a yellow and greasy coating.

Fang Yan then diagnosed the pulse of both hands, finding them to be weak, slippery, and slightly rapid.

He took out paper and pen, pondered for a moment, and began to organize his thoughts:

The patient coughed up a large amount of yellow-green sticky phlegm, had a dry and sticky mouth, and a yellow and greasy tongue coating, which are typical signs of internal phlegm-heat accumulation; the bronchiectasis with recurrent infections is consistent with the pathological characteristics of "phlegm-heat obstructing the lung collaterals".

Looking at the hemoptysis symptom, whether the blood is dark red or bright red, mixed with phlegm or gushing from the mouth, combined with a pale red tongue with insufficient saliva and fine cracks on the tongue surface, it is clearly caused by heat damaging the lung vessels and depleting yin fluids. Long-term illness depletes yin and blood, making the symptoms of yin deficiency such as "dry mouth and cracked tongue" even more obvious.

From the perspective of overall symptoms, shortness of breath, reluctance to speak, emaciation, and poor appetite are manifestations of spleen qi deficiency; chest tightness, palpitations, and shortness of breath with slight exertion indicate lung qi deficiency; dizziness, vertigo, and a swollen tongue (suggesting spleen deficiency and dampness), coupled with a weak pulse, indicate that the long-term illness has affected the kidneys, resulting in a problem of both spleen and kidney deficiency.

Based on comprehensive assessment, the syndrome is diagnosed as phlegm-heat accumulation in the lungs, damage to the collaterals and yin deficiency, combined with deficiency of qi in the lungs, spleen and kidneys.

Then he started writing in the dialect.

He quickly added his analysis, and then began writing the prescription in dialect:
30g of reed rhizome and 30g of trichosanthes peel: Clears lung heat and resolves phlegm, especially yellow-green sticky phlegm;

10g of Lepidium seed: It clears the lungs and relieves asthma, promotes diuresis and reduces swelling, and alleviates chest tightness and shortness of breath caused by phlegm and heat obstructing the lungs.

10g of donkey-hide gelatin (stewed separately and taken with water), 10g of dendrobium: nourishes yin and blood, moistens the lungs and stops bleeding, and improves yin deficiency, tongue fissures and hemoptysis;

6g of charred cattail pollen and 30g of lotus root nodes: astringent and hemostatic, removes blood stasis and promotes new tissue growth, and reduces blood in sputum (charred cattail pollen stops bleeding without leaving blood stasis).

30g of yam and 30g of Job's tears: strengthen the spleen and replenish qi, eliminate dampness and stop diarrhea, improve poor appetite and emaciation;
30g of Adenophora stricta and 30g of Lilium brownii: Nourishes the lungs and yin, calms the mind and soothes the nerves, and relieves shortness of breath and reluctance to speak caused by lung qi deficiency;

Fritillaria cirrhosa 10g: moistens the lungs, resolves phlegm, disperses nodules and stops cough, and also addresses yin deficiency and phlegm-heat.

10g of peach kernels: promotes blood circulation, removes blood stasis, clears lung channels, and improves vascular damage caused by bronchiectasis;
30g of winter melon seeds: Clears the lungs and resolves phlegm, promotes diuresis and drains pus, and helps to clear phlegm-heat stagnation.

Bamboo shavings 10g, loquat leaves 15g (honey-processed): relieves nausea and vomiting, clears the lungs and stops coughing, and alleviates cough and dry, sticky mouth.

After writing it down, Fang Yan realized that she couldn't stay in Hong Kong to care for the patient, so she added some more precautions.

After finishing writing, Fang Yan put down her pen, pushed the prescription in front of the old man, and lightly tapped the pages with her fingertips, saying:
"Sir, you should try five doses of this medicine first. I think it might be inconvenient for you to decoct the medicine in Hong Kong, so I'll have someone find a reliable Chinese medicine pharmacy to do it for you. Remember to use a clay pot to decoct it, and avoid contact with iron utensils, as iron is too dry and can easily damage the efficacy of the medicine."

He paused, then picked up the sticky note next to him and wrote down some notes:

"Soak the herbs in cold water for half an hour, making sure the water level is about two finger joints above the herbs. For the first decoction, bring it to a boil over high heat, then simmer over low heat for 20 minutes, and pour out 200 ml. For the second decoction, add water and simmer for 15 minutes. Mix the two decoctions together and drink them warm in the morning and evening. The donkey-hide gelatin needs to be dissolved in rice wine separately and then added to the medicine, otherwise it will easily stick to the bottom of the pot."

As he spoke, he pointed to what was written on his prescription:
"If you cough up more blood in the next few days, take 3 grams of Panax notoginseng powder and mix it with water to drink, plus 15 grams of Bletilla striata; if the phlegm is too sticky to cough up, add 10 grams each of Platycodon grandiflorus and Peucedanum praeruptorum."

Fang Yan looked up at the old man, who nodded repeatedly. Fang Yan softened his tone and continued:

"If you feel short of breath and weak, ask the pharmacy to add 20 grams of Astragalus membranaceus and 15 grams of Codonopsis pilosula; if you have a slight fever at night, add 15 grams each of Lycium chinense root bark and Stellaria dichotoma. These additions and subtractions are not complicated, and the pharmacist can tell you at a glance."

"Okay!" The old man nodded.

“And also,” Fang Yan pointed to the dietary restrictions at the bottom of the prescription:
"Avoid chili peppers and fried foods, and also avoid mutton and longan, which are considered 'hot' foods. You can cook some lily bulb and lotus seed porridge every day, or stew pears with white fungus to moisturize your lungs."

Seeing that the old man was listening attentively, Fang Yan added:

“I have to go back to the mainland tomorrow, but if anything happens to you, just send a telegram to Beijing. I have your condition in mind. As long as you describe your current symptoms, I can give you advice remotely.”

The old man smiled and nodded repeatedly:

"Okay, that's for the best!"

Fang Yan neatly folded the prescription and handed it over:
"Take the medicine first, and now I'll give you a few acupuncture needles to make you feel more comfortable."

"Do we need acupuncture too?" the old man asked curiously.

"We'll only use acupuncture, not moxibustion," Fang Yan explained. "Your constitution is on the hot side, so acupuncture is more suitable than moxibustion."

As he spoke, he took out the needle box, and as soon as he took it out, he was stunned to find that he had actually touched the Wildfire Needle given to him by Grandpa Li Chunfang.

PS: I got 100 more monthly votes, so after finishing this chapter, I still owe everyone 67000 words.

There will be more this afternoon.

(End of this chapter)