Rebirth 1977 Great Era

Chapter 1079 Old Meng in His True Form; Ten Years of Streptomycin Poisoning (Two Chapters Combined)
Upon hearing Lao Fan's question, Fang Yan analyzed it for him:

"The patient in this medical case likely had phlegm and stagnant heat in his body, leading to a dysfunction in the coordination of defensive qi and nutritive qi."

"When dampness and stagnant heat interact and steam each other, they will force the body fluids to leak out."

"Traditional Chinese medicine theory holds that the left side belongs to Yang and the right side belongs to Yin, so abnormal sweating may occur on the left side of the face or even the left half of the body where Yang energy is predominant."

Old Fan frowned slightly, his mind starting to race.

At this moment, Meng Jimin also realized what was happening and said:

“I understand Lao Fang’s reasoning now. He’s saying that there is phlegm in the patient’s body, which is why the patient coughs up a lot of phlegm that is yellow, sticky, and clumpy.”

"At the same time, this person also has symptoms of internal heat, such as irritability, sore throat, bitter taste in the mouth, and a reddish tip of the tongue."

"In this way, phlegm and stagnant heat combine with each other to form pathological products, which is the key internal cause of the disease."

“Yes!” Fang Yan nodded, confirming Meng Jimin’s statement.

Encouraged, Lao Meng continued:

“The defensive qi is responsible for protecting the body surface and regulating sweat excretion, while the nutritive qi is responsible for nourishing the body and generating blood.”

"When these two are out of balance in the patient's body, the defensive qi cannot properly retain body fluids, and the nutritive qi cannot properly guard the interior, which leads to uncontrolled sweat excretion."

"Phlegm and turbidity belong to the category of dampness. Dampness and stagnant heat steam each other, just like water in a pot being boiled by fire, forcing body fluids to leak out and forming abnormal sweating. This kind of sweating is often related to emotional fluctuations, such as irritability, or to the current rise in temperature."

"As for his sweating on the left side of his face, it's simple... The liver belongs to the wood element and governs the upward movement of qi. Its meridians are mainly distributed on the left side of the body. The patient's liver qi stagnation transformed into fire, coupled with phlegm and heat obstruction, leading to an excess of yang qi on the left side and forcing the body fluids to leak out, resulting in sweating on the left side of the face or left side of the body, while the right side is relatively cold and damp, and there is also phlegm and heat obstruction. Therefore, there is no sweating."

Fang Yan nodded and said:
"That's right, what Lao Meng said is exactly what I meant."

Meng Jimin finally made an appearance today. Before, everyone treated him like he was invisible. Apart from his close relationship with Fang Yan, no one remembered him. Even the fact that he was Zhu Liangchun's apprentice was almost forgotten by everyone.

Unfortunately, he didn't have any particularly outstanding performances.

Sometimes he doesn't even have the same presence as Wang Zhijun. At least Wang Zhijun can stand up and say a few words at times, so that no one can underestimate his presence.

Old Meng, on the other hand, was basically just a layabout. Although he was Zhu Liangchun's apprentice, he didn't show any special talent during his apprenticeship.

It's not quite like he's deliberately keeping a low profile; he's more like the average person in the class.

Today, at Dongzhimen Hospital, Comrade Meng Jimin suddenly stood up. Under the guidance of dialect, he understood things very quickly, as if he were a completely different person.

Only Fang Yan knew that this was Meng Jimin's true form; this guy had always been too lazy to compete with the younger students in class.

Among the elite class, Meng Jimin is the oldest. Apart from being able to help Fang Yan, he is always in a "conservation mode" and tries his best not to compete with others.

But today, Lao Meng seemed to have figured it out and was determined to show off his brainpower in front of everyone.

Perhaps it's because this is Dongzhimen Hospital, or perhaps it's because he's about to take the postgraduate entrance exam, but in any case, Lao Meng let down his guard today and showed off a little in front of everyone.

He made everyone in the class look at him with new respect.

Seeing Lao Meng's state, Fang Yan simply said to him:
"Now that we've explained everything clearly, why don't you just give me a prescription?"

But all I heard was Old Meng chuckle and say:

"I'm just helping to analyze the situation. Prescribing the specific medicine is Old Fan's job. He didn't ask me to do it, so I won't overstep my bounds. Besides, everyone has their own style. The prescriptions I write aren't cheap, and they contain a lot of insects, which the elderly can't accept."

Fang Yan discovered that this guy was really slippery, and after showing off for a bit, he immediately stopped.

Let everyone know his abilities, but don't completely steal the limelight.

Upon hearing Meng Jimin's words, Lao Fan, who was standing to the side, was taken aback and also felt a bit amused and exasperated.

However, he still picked up the conversation and said:
"Since Brother Fang and Brother Meng have explained it so clearly, it's no problem for me to prescribe a medicine."

"Simply put, the patient's lungs have lost their ability to clear and purify, resulting in internal accumulation of dampness, phlegm, and heat, and disharmony between the Ying and Wei. The treatment should focus on clearing the lungs and resolving phlegm, clearing heat and promoting diuresis, and regulating the Ying and Wei."

"If I were to write the prescription..."

He paused slightly, then picked up his notebook and wrote as he spoke:
“桑叶9g、稽豆衣9g、薏苡仁20g、杏仁9g、枇杷叶9g、陈皮6g、木瓜15g、桂枝9g、白芍15g、胆南星4.5g、冬花9g、芦根15g。”

"For left-sided sweating, use Guizhi Tang with mulberry leaves to release the exterior, clear the liver and drain heat. It can both dispel wind and treat fear of wind, and clear internal heat and relieve bitter taste in the mouth. For right-sided obstruction, use Dan Nanxing with apricot kernels to clear phlegm, open the orifices, and promote lung function and clear the nose. This is the treatment of left and right yin and yang separately."

"In addition, papaya with coix seed can dispel dampness and unblock the meridians, relieving 'highland redness'; arisaema cum bile with coltsfoot flower can resolve phlegm and extinguish wind, thus targeting internal wind due to deficiency. Adding reed rhizome can protect body fluids, and soybean husk nourishes yin and stops sweating, avoiding damage to yin from warm and drying drugs such as cinnamon twig and arisaema cum bile."

After saying that, he crossed out the previous content and said:

"However, Arisaema cum Bile is toxic, so it should be replaced with 12g of bamboo shavings and 9g of Fritillaria thunbergii. This can enhance the heat-clearing and phlegm-resolving effects and reduce the risk."

Fang Yan thought about it after hearing it. This prescription could be used, but it wasn't comprehensive enough. After drinking the medicine, the main problem could be solved, but there would probably still be some minor issues.

However, considering that the patient was a robust forty-year-old, Fang Yan didn't say anything more. After solving the main problem, the recovery of the other minor ailments was only a matter of time.

Moreover, they will be providing free medical consultations here for the next ten days or so. If there are any problems later, they can come and find Lao Fan, which will also be a boost for Lao Fan.

At this moment, Xiao Chengzhi nodded and said:

"Yes, this recipe is similar to what I had in mind."

Having figured it out, Xiao Chengzhi quickly said that he had indeed just caught up with the train of thought.

After speaking, he glanced at Meng Jimin, but the guy didn't even look at him, as if he was lost in thought.

“Then let’s do it this way!” Fang Yan said to Lao Fan.

Old Fan felt quite pleased to receive such affirmation.

Speaking in dialect:

"Okay, then I'll prescribe this medicine for him tomorrow."

……

Now everyone's happy. The dialect issue has been resolved, and now they're just waiting to see if any other problems can stump the locals.

Meanwhile, Xiao Chengzhi and his team also started seeing patients after finishing lunch.

The atmosphere quickly became lively.

Li Zhengji also started seeing patients on site, while Fang Yan was the only one who did nothing, wandering around behind his classmates.

I don't know if it was the dialect that put some pressure on the students, but I felt that their pace slowed down.

Fang Yan became curious and began to observe them, only to discover that these people had started writing detailed medical records and asking patients more questions about various aspects of their cases.

That's why the speed is reduced.

They don't have the ability to chat with people while keeping their hands busy, like people speaking in dialects.

After asking all the questions, they would start taking notes.

"Brother Fang!"

Suddenly a voice interrupted Fang Yan's thoughts.

"Hmm?" Fang Yan asked, following the sound.
"Who?"

At this moment, Yang Jingxiang from the class raised his hand:

"Me! Me, me, me!"

Fang Yan walked over and asked:
"what's the situation?"

Yang Jingxiang said:
"This woman said it was... streptomycin poisoning!"

Looking over, Fang Yan saw a woman sitting in a wheelchair being pushed around.

The patient was a woman in her forties, and the person who pushed her over was probably her husband.

Generally speaking, the patients that are most afraid of seeing during a free clinic are those who cannot move on their own. At the very least, they have a fracture, and other conditions would be even more serious.

"Streptomycin poisoning? Have you checked it?" Fang Yan walked over and asked the patient and the person pushing the wheelchair.

Streptomycin is an aminoglycoside antibiotic, and poisoning is caused by its neurotoxicity.

Mild cases may present with dizziness, nausea, vomiting, nystagmus, and balance problems when walking (such as a drunken gait). Severe cases can lead to persistent dizziness and affect daily activities.

In addition, it can also lead to hearing loss, which usually starts with high-frequency hearing loss and gradually affects low frequencies. In severe cases, it can lead to deafness, and the damage is likely to be permanent.

If administered by injection, it may also cause muscle weakness, respiratory depression (such as chest tightness and difficulty breathing), or even respiratory arrest.

In addition to these, there may be skin itching, rashes, urticaria, proteinuria, casts in urine, and pain, redness, swelling, and induration at the intramuscular injection site.

Anyway, this thing has quite a few side effects, including several that can paralyze a person into a wheelchair.

When Western medicine detects streptomycin poisoning, it typically involves injecting vitamins, adrenaline, and calcium gluconate, followed by oxygen therapy.

If you become deaf, the hospital can compensate you with a hearing aid or a cochlear implant.

“It’s already been checked,” the patient’s husband replied in dialect.

Listening to the voice, Fang Yan realized it didn't sound like a local accent.

However, Fang Yan didn't say anything but asked:

"What exactly happened, and how long has this been going on?"

The patient's husband said:
“In 1968, my wife was diagnosed with ‘functional uterine bleeding with infection.’ At that time, the doctor prescribed streptomycin to treat her, and she was given 2 grams of it every day.”

"After using a total of 50 grams, my wife started to feel dizzy."

"But the doctor said it was normal and continued the treatment. As a result, my wife became unsteady on her feet, felt like she was going to fall while walking, and also had tinnitus, difficulty hearing, headaches and nausea."

"After the doctor saw the problem, he told us to stop taking the medication and rest at home."

Yang Jingxiang, standing to the side, asked with a puzzled look, "What kind of doctor?"

The patient's husband said:
"The doctor at our unit's clinic."

"..." Yang Jingxiang was speechless.

The dialect was a signal for him to continue.

The patient's husband paused for a moment, then said:
"Then we rested for a month, but there was no improvement. So we went to the city hospital for a checkup. The hospital there said that my wife had vestibular dysfunction and cerebral arteriosclerosis. In the end, she was diagnosed with streptomycin poisoning."

"Then we started treatment. Over the years, we've tried all sorts of Chinese and Western medicines, but none of them worked. The illness just dragged on. We came all the way from Inner Mongolia to Beijing specifically to see a doctor. Now that we see you here offering free medical consultations, we wanted to see if you have any solutions."

"Haven't you gone inside to find a doctor yet?" Fang Yan asked.

The patient's husband said:
"I wanted to check it out here first. You're university students, you should know more, right?"

Fang Yan touched his chin.

Well, what they said makes sense. Nowadays, a college degree is indeed a prestigious qualification. Everyone thinks that people who can get into college are exceptional individuals, and that is indeed the case.

But this disease... is indeed very serious.

Fang Yan sighed and asked the patient's husband:
"What's her situation now?"

The patient's husband gestured as he spoke:
"She's dizzy, has tinnitus and hearing problems, and sweats even when she's not moving, including when she's asleep at night. It's even worse now that the temperature is higher. But the strange thing is that she's also sensitive to cold. How can she be sensitive to cold when she's sweating like that? Now I have to give her some water every half hour. And I don't know what's wrong, her face is swollen, and she's been urinating more lately, sometimes even experiencing urinary incontinence."

"What about eating, sleeping, and going to the toilet?" Fang Yan asked.

The patient's husband said:
"I can't eat much, and I can't sleep for long. I feel drowsy all day, and I really want to drink water. As for going to the toilet, as I just mentioned, I urinate frequently and occasionally experience urinary incontinence. I also have some constipation."

Upon hearing this, Fang Yan realized that the patient's condition was very serious.

He glanced at Yang Jingxiang, who had already started writing medical case records.

Fang Yan thought for a moment and asked the patient loudly:
"Comrade, can you hear me?"

He deliberately spoke loudly in a dialect, and sure enough, after he finished speaking, he saw the patient nod and said:

"Yes, I can hear some. My hearing has also deteriorated a lot due to tinnitus. You need to speak louder."

Hearing this, Fang Yan raised her voice a few decibels and asked him:
"Comrade, could you open your mouth and let me see your tongue?"

Yang Jingxiang felt like his ears were about to ring from being shouted in dialect.

The other patient then nodded and said:

"Okay! I can hear you."

Fang Yan said to Yang Jingxiang:
"Writing, hearing has not been completely lost."

Yang Jingxiang quickly wrote it down, and then he saw the patient open his mouth and stick out his tongue.

The tongue is reddish-brown with little coating.

Yang Jingxiang saw this and quickly wrote it down in his medical record.

Then, instead of shouting, he gestured to the patient, indicating that he wanted to take her pulse.

The patient understood immediately and began to cooperate with the pulse diagnosis.

He diagnosed both her left and right hands, speaking in dialect.

The pulse is deep and thready, especially thin in the left and right cun positions.

Yang Jingxiang asked:
"Brother Fang, there's nothing about Western medicine causing problems in ancient Chinese medicine texts. How should this be treated?"

The dialect explanation is as follows:
"Streptomycin poisoning is not mentioned in the medical books of our ancestors, but it can be understood by thinking about the root cause of the disease."

"Based on the patient's symptoms, medical history, and the four diagnostic methods of traditional Chinese medicine, I believe this is a typical case of drug-induced yin deficiency and depletion of essence, liver and kidney deficiency combined with internal wind."

"Streptomycin, as a modern chemical drug, has ototoxicity and nephrotoxicity, which can actually be classified as exogenous drug toxicity, or 'drug evil', in traditional Chinese medicine."

The Treatise on the Causes and Symptoms of Various Diseases states, "If medication is taken inappropriately, toxic pathogens will attack the internal organs."

"I understand!" Yang Jingxiang exclaimed in realization.

Fang Yan pointed to the medical record and said:
"Write it."

Yang Jingxiang then came to his senses and quickly began writing down the medical records.

Fang Yan considered his words for a moment before speaking:

"The patient's illness has lasted for ten years. In the early stage, he experienced dizziness and tinnitus, which was due to simple kidney yin deficiency. Then it developed into the current deficiency of both yin and yang. We do not know the medications they took during their treatment, but we know that they were not very effective. Judging from their current condition, these medications have also aggravated their condition. The excessive sweating is due to the inability of qi to consolidate the exterior, the facial swelling is due to yang deficiency and water retention, and the aversion to cold is due to yin damage affecting yang."

"When I took your pulse just now, it was deep, thin, and weak at the cun position. We all know that the pulse at both cun positions corresponds to the kidneys, and a deep and thin pulse indicates a deficiency of both yin and yang."

"I believe that the sequelae of streptomycin toxicity can be classified as 'damp-heat toxin' in the category of drug evil. After obstructing the middle jiao, the spleen loses its function of transporting and transforming, leading to poor appetite, constipation, and deficiency of both qi and yin, resulting in insufficient propulsion. The fumigation of the head and face causes the deficient yang to float upward, resulting in facial edema and worsening dizziness."

"During their previous examination, they discovered that the vestibular nerve damage was causing the balance disorder."

"This should correspond to the description in Ling Shu·Kou Wen: 'When the upper qi is insufficient, the brain is not full, the ears suffer from tinnitus, the head suffers from dizziness, and the eyes suffer from vertigo.' The essence is a syncope caused by the failure of clear yang to ascend and the upward reversal of turbid yin."

Yang Jingxiang quickly wrote down the judgments made in the dialect, then asked thoughtfully:

"So, Brother Fang, if you put it that way, this woman is currently in a critical condition of yin and yang deficiency, and depletion of essence and marrow?"

He said in dialect:

"It's not critical yet, but treatment would be a bit complicated."

At this moment, the patient's husband heard this and said in dialect:

"Doctor, we're not afraid of the trouble!"

"Just tell us how you want to treat it, and we'll cooperate fully."

Fang Yan said to the patient's husband:
"Leaving aside the treatment process."

"It's not easy for you to come here from Inner Mongolia. This disease requires hospitalization and the treatment will take a long time. These are all problems that need to be overcome."

The dialect made it very clear: in this day and age, there are many more troubles to overcome when seeking medical treatment across regions.

First of all, they are a completely different group from overseas Chinese businessmen. Many issues that overseas Chinese businessmen don't need to worry about are big problems for ordinary people.

I can think of several dialects right now.

Firstly, patients and their families traveling to the capital for medical treatment need to solve their accommodation problems.

Accommodation options were limited in 1978, with few hotels to choose from, and prices were likely not cheap for ordinary families; long-term stays would be a significant expense.

Different regions have different dietary habits, and patients will likely need to adapt to the local diet after arriving in the capital. Moreover, with limited accommodation, it may be inconvenient to cook for themselves, and they may have to eat out, which may also affect their dietary health.

Secondly, medical treatment requires certain expenses, including medical fees, accommodation fees, transportation fees, and food expenses. For ordinary families, these expenses can be a heavy burden, especially given the current economic situation where many families are not well-off.

Thirdly, and very importantly, the current household registration system is quite strict. Patients from other places may face household registration restrictions when seeking hospitalization in the capital, which may cause inconvenience in accessing certain medical services.

Finally, the patient's family members also need to leave their jobs and homes for a period of time to come to Beijing. This requires the understanding and support of their employers. At the same time, someone in the family also needs to take care of the patient and handle family affairs, which is also a considerable challenge for the family.

Not to mention all the other miscellaneous things like communicating with family members, handling procedures, and obtaining certificates.

Either way, it's not easy.

“We can overcome this. We’ve already made arrangements with our workplaces, and our families are fully supporting us this time. Our siblings have also given us a lot of help. Even if it’s a long hospital stay, it’s okay. I also have friends in Beijing who are former educated youth who have returned to the city, and they can help us,” the patient’s husband told Fang Yan.

Fang Yan heard him say that and asked:
"Where in Inner Mongolia are you from?"

"Baotou," the other party replied.

Dialect of surprise:

"What a coincidence?"

The other party was taken aback and asked, somewhat disbelievingly:
"Are you also from Baotou?"

Dialectal wave:
“I’m a local, but I know people in Baotou… Well then, since you say you can handle it, let’s get you admitted to the hospital first. I’ll try to help you arrange it. We’ll do our best to help you in any way we can.”

"Okay! Thank you, doctor. You're such a kind person. I knew college students were all great!" The other person thanked him repeatedly and praised everyone around them.

Fang Yan waved his hand, thinking that he was still an expert at Dongzhimen Hospital, and that he would have to find the relevant department here later to complete the admission procedures and ask the people here to take care of him.

It would be best to give Dean Ouyang a heads-up, and then I can come over more often to help solve some problems later.

Or share another medical achievement. Anyway, I have a ton of achievements to share, and I'll be winning a ton of awards at this year's Ministry of Health mid-year conference.

They could have been sent to Peking Union Medical College Hospital, but it wouldn't have been appropriate to send them to Peking Union Medical College Hospital when we were having a free clinic at Dongzhimen Hospital.

"Brother Fang, how do we treat this?" Yang Jingxiang's voice brought Fang Yan back to reality.

Fang Yan then realized that he hadn't yet explained the treatment method.

He composed himself and said to Yang Jingxiang:
"We will address the issue by simultaneously focusing on emergency treatment to prevent collapse, replenishing essence and marrow, and detoxifying and clearing the meridians."

"Drug residue can cause nerve damage, so insect-based medicines are needed to detoxify and unblock the meridians. Common kidney deficiency rarely presents with the critical condition of 'facial edema accompanied by diabetes insipidus,' so it is necessary to use large doses of stone-based medicines to suppress the floating yang. If the brain marrow is empty, it is necessary to add blood and flesh-nourishing products, preferably placenta and deer antler glue to fill the marrow sea."

After he finished speaking, he paused and said:

"Of course, this takes a long time to eat, so you can switch to something else that's relatively cheaper..."

After saying that, he thought for a moment, then took out a pen, gestured for Yang Jingxiang to move aside, and began to write quickly on the paper.

PS: The basic chapter of 6000 words is now complete. There will be an extra chapter later.

(End of this chapter)