Rebirth 1977 Great Era

Chapter 1078 Is he actually afraid of the wind? Old Meng's brain is actually quite sharp after all? (Bonus chapter for 3K monthly votes)

Fang Yan never expected that even an experienced doctor like Lao Fan would encounter a problem. Among all these people, Lao Fan should be the one with the most clinical experience. Mainly, he has been doing rehabilitation treatment at Peking Union Medical College Hospital, and he has read all of Fang Yan's medical cases from Peking Union Medical College Hospital.

If this disease can stump him, then he must have some skill or ability.

"What's going on?" Fang Yan asked Lao Fan.

“It’s a very strange illness, half of his face is sweaty.” As he spoke, Lao Fan handed the medical record to Fang Yan.

Fang Yan asked curiously:
"Half a face sweaty?"

Meng Jimin chimed in at this moment:

"Yes, at first I thought it was the same as the half-body sweating you saw at Tongrentang, but after Lao Fan examined it carefully, I also found that it was not like that."

The half-body sweating he mentioned was a case of an elderly man in his seventies who was sweating on the left side of his body when Fang Yan was practicing medicine at Tongrentang. That patient had been brought over by Guxiutang to cause trouble for Fang Yan.

Fang Yan had prescribed a traditional Chinese medicine formula called Huangqi Chongteng Yin, which is how he met Meng Jimin.

Meng Jimin knew the whole story clearly, so it left a deep impression on him. (See Chapter 54)
Fang Yan nodded and looked at the medical record written by Lao Fan:

Zhang, male, 40 years old.

He described his condition as starting in June 1974, with sweating on the left side of his face and sometimes on the left side of his body, as if he had been caught in the rain.

When the weather is warm, I sweat a lot if I get a little anxious.

The situation arose because of a job transfer within the company.

However, after the transfer ended, things did not improve. In addition, I became irritable, thought too much and was forgetful. I had many dreams at night and would often wake up inexplicably in the middle of the night. I also had a sore throat and a bitter taste in my mouth when I woke up in the morning.

In addition, he coughs up a lot of sticky, yellowish phlegm that forms hard lumps that are difficult to cough up. He also has frequent nasal congestion and runny nose on the right side, and frequent sweating on the left side of his face.

He described himself as having his right cheek in winter and his left cheek in summer.

The examination revealed that the patient had a high-altitude red complexion on both sides of his face. After questioning, it was found that he worked in Beijing as a mechanic. His eyes were a little red, and he said that he had a lot of eye discharge in his left eye when he woke up in the morning, but not in his right eye.

The tongue is pale with a reddish tip and teeth marks on the sides. The coating is thin and white, and the pulse is slightly wiry and slippery.

After reading the dialect, he looked thoughtful.

This patient's condition is actually a type of left-sided sweating, and the symptoms are similar.

He recalled the old man who was half-sweating before.

He looked haggard, with bloodshot eyes and obvious dark circles. He spoke with a strong smell of smoke and smelled of Chinese medicine. His tongue was pale with a white coating, and his pulse was weak, thin, and slow. The old man also said that he had been sweating for many years.

At the time, I consulted many doctors, and some of them thought it was due to a deficiency of qi and blood.

Some believe that wind-cold or wind-heat causes stagnation, which is the obstruction of external pathogens.

Some people believe it's due to excessive thinking and imbalance of the heart and liver.

Others believe it's due to aging causing imbalances in Qi and blood, and disruption of the Chong and Ren meridians.

It was precisely because so many messy and unreliable arguments failed to be accurately interpreted that Gu Xiutang thought of having the old man set a trap for Fang Yan, but in the end, Fang Yan immediately saw the problem.

That is a precursor to stroke, indicating depletion of essence and blood and blockage of meridians. Half-body sweating is a manifestation of "blood stasis," which means that blood and qi are blocked on one side of the body, leading to imbalance of yin and yang, which can cause stroke if it develops in the long term.

This one looks somewhat the same, but it's not exactly the same.

"Oh right, they had a Western doctor examine them, and they said it was autonomic nervous system dysfunction. I didn't know what that was at the time, so I didn't write it down," Lao Fan said to Fang Yan.

Fang Yan snapped out of his daze and said to Lao Fan:

"Autonomic nervous system dysfunction is a non-organic neurological disorder, mainly caused by an imbalance in the regulation of the sympathetic and parasympathetic nervous systems, leading to functional disorders in multiple systems throughout the body."

"Long-term anxiety, depression, excessive stress, mood swings, or sleep disorders are the most common triggers. In addition, some people have a genetic predisposition, while others develop the disease due to long-term sleep deprivation, irregular eating habits, lack of exercise, smoking, and excessive drinking."

"But from the perspective of traditional Chinese medicine, this disease is only a result, not a cause."

"To give an analogy, if we compare the autonomic nervous system to the strings of a musical instrument, Western medicine sees an imbalance in the tension of the strings, while traditional Chinese medicine analyzes why the imbalance occurs. Is it a problem with the structure of the instrument itself (internal organs)? Or is it a problem with the player's technique (emotions)? Or is it the influence of environmental temperature and humidity (the six pathogenic factors)? Or are all three factors present at the same time?"

“Autonomic nervous system dysfunction is indeed the symptom, but traditional Chinese medicine aims to treat the three root causes that produce this symptom.”

Everyone nodded in agreement upon hearing this.

"Brother Fang's level is really high, he understood it as soon as he heard it!" Song Jianzhong flattered from the side.

Fang Yan smiled and turned his gaze to the medical record in his hand.

Suddenly, he asked, "Is he afraid of the wind?"

Old Fan was taken aback, and said somewhat awkwardly:
"Um... I didn't ask, and he didn't seem to say either. If he had, I would have written it above."

Cheng Baogui asked with some curiosity:
Is there any saying about whether or not someone is afraid of the wind?

He said in dialect:

"Whether one is afraid of wind or not can indicate whether the disease is affecting the Ying and Wei levels or the Zang-Fu organs."

“Look at what Lao Fan wrote in this medical case. The patient’s left side of his face was sweating profusely, while his right side was frozen like in winter. The difference between the two sides was huge. If he was afraid of the wind, it was mostly due to the imbalance of Ying and Wei, with wind evil affecting the half of the exterior. The Treatise on Cold Damage says, ‘In Taiyang disease, one side of the body sweats,’ which belongs to the exterior syndrome. However, if he was not afraid of the wind, the disease was inside, mostly due to the obstruction of Qi and blood in the internal organs. The Ling Shu says, ‘When Qi and blood are not in harmony, all kinds of diseases will arise.’”

Old Fan picked up the conversation, saying somewhat uncertainly:
"If it wasn't mentioned, then it must mean they're not afraid of the wind, right?"

Fang Yan touched his chin, "This is the drawback of not being able to read the complete medical records."

If the person were here, he could ask more questions. But now it's like solving a case; we can only make a judgment based on the limited clues we've gathered.

At this moment, Fang Yan suddenly had a flash of inspiration and said:

"No, he should be afraid of the wind!"

"Why?" Old Fan asked.

He said in dialect:

"The patient sweated profusely on the left side of his face and left side of his body, and sweated more when he was irritable in warm weather. Combined with the fact that his tongue tip was reddish and his pulse was wiry and slippery, it suggests that there was stagnation of heat in the liver meridian and that the heat was forcing the body fluids to leak out."

"The right cheek is dry as if in winter, accompanied by 'right nasal congestion and runny nose, with yellow, sticky phlegm that is difficult to cough up, indicating that phlegm and turbidity are obstructing the meridians, and the defensive yang is blocked by phlegm and heat, unable to warm the right side."

"If the disease is caused by obstruction of qi and blood in the internal organs, it is mostly due to the imbalance of yin and yang in the whole body. The symptoms on the left and right sides of the patient are completely opposite (heat on the left and cold on the right), which is more in line with the symptoms of 'wind evil invading half of the exterior, causing disharmony between ying and wei'. Wind evil invades the left side of the muscle surface, causing the wei qi to be unstable and resulting in sweating, while the wei yang on the right side is blocked by phlegm and turbidity, resulting in no sweating and nasal congestion. This is similar to the exterior syndrome characteristics of 'Taiyang disease, wind evil invading half of the body, causing disharmony between ying and wei' in the Treatise on Cold Damage."

Upon hearing Fang Yan's analysis, Li Zhengji suddenly had a clearer understanding of the clues in his mind. He nodded and said:
"Yes, I agree with that view. Moreover, the flushing on both sides of the face is not simply due to internal heat, but more like wind attacking the skin surface and accelerating blood flow. It's a very simple principle: wind has the function of opening up and causing qi and blood to surge upward. This is a manifestation of the combined Taiyang and Yangming disease, where 'the exterior syndrome has not been resolved and internal heat has already arisen.'"

"In addition, the liver opens into the eyes. He has a lot of eye discharge and redness on his left eye. I think this is because the liver meridian is stagnant and hot, and wind evil disturbs the upper body. Because wind evil is prone to movement, the secretions are biased to one side. And 'fear of wind' is a typical accompanying symptom of wind evil attacking the surface. For example, the 'Essentials of Ophthalmology' says, 'When wind and heat attack the upper body, the eyes are red and have a lot of discharge, and there must be aversion to wind.'"

Fang Yan nodded and said:

"Furthermore, you wrote here that the patient has a cough with yellow, hard phlegm, which suggests internal accumulation of phlegm and heat. But why does the phlegm only obstruct the right side? So I speculate that it is more likely that "wind evil first affects the left side, causing the left side to lose its protective function and sweat, while the right side's protective function is blocked by wind evil and phlegm and heat." Wind evil acts as a trigger, first breaking the balance of protective function, and then triggering internal phlegm, forming a complex pathogenesis of "wind evil on the surface and phlegm and heat in the interior."

“In this case, ‘fear of wind’ is direct evidence that the wind evil is on the surface, rather than simply internal evidence.”

As everyone watched the two of them, their minds raced as they tried to keep up. Some looked enlightened, some were still a little confused, and most frowned as they pondered, trying to piece together the clues.

And at that moment, Meng Jimin suddenly slapped his thigh and said:
"Oh, that's right, I understand now too!"

Everyone looked at Meng Jimin, none of them expecting him to be the third to figure it out.

Although this person had a good relationship with Fang Yan, everyone felt that he was just average in class and didn't have any outstanding performance. At this moment, Meng Jimin spoke eloquently:

"Yes, I agree with Lao Fang's judgment. Considering what the patient said before, that he was emotionally distressed due to a job transfer, he clearly has liver stagnation turning into fire. Think about it, his symptoms match up."

He counted on his fingers and said:

"Irritability, sore throat, bitter taste in the mouth, and red tongue tip, along with a weak, wiry, and slippery pulse, indicate liver stagnation with phlegm, while a wiry pulse also indicates wind-evil."

In traditional Chinese medicine theory, "wind is the leader of all diseases." Those with liver stagnation are prone to attracting external wind. When wind evil fights with internal heat, it leads to both "fear of wind" and "sweating." As stated in the "Essential Prescriptions of the Golden Chamber," "When external wind evil attacks and internal heat forces out body fluids, one feels aversion to wind and sweats."

"The elderly man with 'half-body sweating' that Lao Fang treated before was suffering from depletion of essence and blood and obstruction of meridians, manifested as 'sweating on the left side of the body for many years, with a weak and thready pulse,' without obvious signs of heat. Lao Fan's patient had symptoms of phlegm-heat and liver stagnation, and the temperature difference between the left and right sides was significant, so it was more in line with 'external symptoms with internal heat' rather than simple internal deficiency and blood stasis."

After saying that, he said with certainty:

"He's afraid of the wind! He must be afraid of the wind!"

After hearing the three of them speak so confidently, those around them who understood nodded in agreement.

I just didn't expect that Meng Jimin, who is almost invisible, would suddenly understand so quickly.

Old Fan, who was standing to the side, thought for a moment and asked Fang Yan:

"So, what exactly is the problem with this patient?"

PS: After finishing this chapter, I still owe everyone 22000 words.

That's all for today, please come early tomorrow.

Lao Feng is working hard to write tomorrow's code.

(End of this chapter)