Rebirth 1977 Great Era

Chapter 1088 First Aid for Acute Pancreatitis (Two Chapters Combined)
Since he returned to China with a group of overseas Chinese businessmen, it was actually quite easy to meet him.

All you need to do is greet Director Liao, and you'll be able to see him.

Fang Yan also told her family about this. Her mother's attitude was very clear: if it was her maternal grandfather's brother, that is, her uncle, or a relative of the family, it would be normal to receive him when he returned to the capital.

As for his father, he had absolutely no objections.

If they come, so be it. As long as they don't try to boss the family around, just treat them politely. Respect is mutual.

Fang Yan's attitude was similar to his father's. Of course, he still made some improvements to the He family's inherited secret manual. Judging from the current situation, Qi Yong had basically collected all of his maternal grandfather's inheritance, and Fang Yan had now learned almost everything.

As for the He family's heritage, there were some things that my maternal grandfather felt were inappropriate for his time, so he manually destroyed them. This was indeed related to the environment at the time. My maternal grandfather's actions were to protect his family, which is understandable.

However, the deleted parts, including dialects, seem to account for at least 40%, which is a huge information database containing the essence of the He family's inherited experience. Some of it must be useful.

It's even possible that my grandfather, due to the limitations of his time, didn't discover the usefulness of this thing.

Therefore, Fang Yan thought that other branches of the He family might have collections, which should have been completely preserved. Perhaps, due to the different branches, there are even some things that his maternal grandfather had not learned.

This is entirely possible.

Of course, others might not easily share their heritage; they would definitely have to pay some price.

It depends on whether he wants money or other technologies.

Both dialects have a certain foundation now. If they want money, they can partner up to make money. The dialect group in the UK is looking to expand into a larger market, so they can cooperate then.

If he wants technology, then it depends on what he wants, and a decision can only be made after a dialect assessment.

It's impossible for them to sacrifice national interests for what he has.

Although we're relatives, I've been in the UK for so many years, who knows if I've become a "banana" (yellow on the outside, white on the inside)? With that in mind, I have to be careful about using dialects.

In summary, treat others with courtesy, maintain appropriate boundaries, have clear goals, and set clear bottom lines for yourself.

After thinking it through, Fang Yan waited for the person to return.

Two more days passed, and it was time for the overseas Chinese businessmen to arrive in Beijing, as Lao Hu had mentioned.

Just as Fang Yan was planning to work the night shift and attend the banquet that evening, the Traditional Chinese Medicine department received a patient transferred from the emergency department as soon as they started seeing patients that morning, and they invited Fang Yan to consult on the case.

They said that based on the consultation results, they directly referred all the patients to the Traditional Chinese Medicine department.

She was a woman in her thirties.

Her husband was also by her side.

When asked in dialect, the emergency room doctor who brought the person in replied:
"She had been experiencing pain in her upper left abdomen for a day. She said that around 10 p.m. last night, she suddenly felt a sharp, cutting pain in her upper left abdomen, which radiated to her left shoulder, and she vomited several times."

"At the time, the patient thought it was food poisoning caused by eating the chili sauce he made himself, and he drank water to try to relieve it."

"But by 4 a.m. this morning, my condition had not improved and had worsened, so I came to our hospital's emergency department at 4:40 a.m. and was the one who saw me."

"After seeing her, I took her measurements. Her temperature was 38.6 degrees Celsius, her blood pressure was 120/80 mmHg, she had an acute illness appearance, abdominal muscle tension, tenderness in the left upper quadrant, no rebound tenderness, no jaundice in the sclera, white blood cell count was 18.1 x 10⁻⁶/L, neutrophils were 0.82, urine amylase was 256 U, and blood amylase was 256 U. At that time, we diagnosed her with acute pancreatitis edematous type."

"We treated her with penicillin, streptomycin, and atropine, but there has been no significant improvement. Currently, the patient is experiencing intermittent cramping pain in her left ribcage, which extends to her chest and shoulder. After we administered medication at the hospital, she has vomited three times and has a fever, but she does not experience chills."

At this point, the family added:
"I have a bitter taste in my mouth, yellow urine, and I feel the urge to defecate but can't."

After listening to Fang Yan, he nodded and said to the patient lying on the bed:
"Stick your tongue out so I can see it."

The patient looked pained, but still followed the instructions in the local dialect.

While taking her pulse, Fang Yan looked at her tongue, which had a thick, greasy, and yellow coating.

It's the yellowest tongue coating I've ever seen in this dialect.

The pulse is wiry and rapid.

Fang Yan immediately diagnosed the illness as affecting the liver, gallbladder, and pancreas (in Traditional Chinese Medicine, these fall under the categories of "liver," "gallbladder," and "spleen and stomach"), caused by liver qi stagnation and internal damp-heat.

Pathogenesis: Dampness and heat combine and obstruct the liver and gallbladder meridians, causing stagnation of the bowel qi (constipation), qi and blood stagnation (severe pain), and stagnation transforms into heat (fever, bitter taste in the mouth, yellow tongue coating).

Acute pancreatitis is clinically characterized by severe upper abdominal pain and radiating pain, accompanied by nausea, vomiting, abdominal distension, and constipation.

Similar symptoms have been recorded in traditional Chinese medicine literature. For example, the "Synopsis of Prescriptions of the Golden Chamber" states: "If there is fullness and pain in the epigastrium, this is a case of excess. It should be treated with purgatives, and Da Chai Hu Tang is appropriate." The "Treatise on Cold Damage" says: "If there is heat and fullness in the chest, the pulse is deep and tight, and there is pain in the epigastrium that feels like a stone whip when pressed, Da Xian Xiong Tang is the main treatment."

Adding to what the doctor in the emergency room had just said, Fang Yan immediately started writing down a prescription:
柴胡10g、黄芩10g、黄连2g、制半夏10g、大黄10g、番泻叶15g、木香6g、郁金10g、炒积壳10g、延胡索10g。

This kind of acute illness cannot be delayed.

The longer it dragged on, the more serious the problem would become. After writing the prescription in Fang Yan's hand, he handed it to Xie Chunrong, who was following behind him, without explaining it.
"Hurry to the traditional Chinese medicine pharmacy!"

"Fry for twenty minutes and then serve."

Xie Chunrong knew from the dialect that the situation was critical; acute pancreatitis could be fatal if not treated properly.

The attack happened last night and it's been going on for quite a while now. He immediately grabbed the prescription and ran out.

At this moment, none of the classmates had gone to their own clinics yet. Seeing that Fang Yan was already busy, they all came over to ask if he needed any help.

They were listening at the door and know what the problem is.

After this period of holding clinics, everyone has come to regard the dialect as the backbone of the class.

Whenever he has any problems, everyone immediately comes up to him to ask if he needs help.

Hearing the enthusiastic students, he said to them in dialect:

"No need for help, you can go see the patients now. If I need to find someone, there are other people here."

There are many people around, but they can't help much. On the contrary, the commotion outside is making the others in the ward even more nervous.

After everyone else had left, Zhao Qingkai and Chen Wenwei stayed behind to keep Fang Yan company.

On the other side, they took out the sea dragon needle.

The medicine hasn't arrived yet, so the prescription says to first treat the acupoints on the liver and gallbladder meridians to relieve the stagnant heat in the liver and gallbladder.

Finally, the Qi and blood should be harmonized and the pain relieved at the distal acupoints on the lower limbs.

"Lift up your clothes," Fang Yan said to the patient.

The patient and her husband were both taken aback when they heard this. Fang Yan gestured to her on his ribs:
"The sixth intercostal space on the left, Qimen."

This area is just below the chest, and you can tell they're still a bit conflicted.

"Human life is at stake! What are you thinking about now? Do you want to die?!" The emergency room doctor said very rudely.

He's seen a lot of emergency cases. Sometimes, if you don't say anything harsh, these people will just drag their feet and wait until something goes wrong before blaming you.

So in this situation, the emergency room doctor got really angry and immediately started yelling.

After being scolded, the patient immediately lifted her clothes, revealing a vest underneath. Fang Yan's eyes were clear as she located the acupoint, disinfected it with alcohol, and then inserted the needle 0.8 inches downwards at an angle.

Once a red halo appears around the needle, indicating that the Qi has been obtained, the practitioner begins to use the twisting and turning method (lightly turning clockwise and heavily turning counterclockwise).

"Pay attention to the needle sensation. You will feel a surge of energy in the area of ​​your cramping pain," Fang Yan said to the patient.

The patient realized what was happening and responded in dialect:
"A chill has passed, and now it's in the location of the cramping pain!"

This is the first needle used to relieve colic caused by stagnation of liver and gallbladder qi, where the needle sensation travels to the left hypochondrium.

The patient's furrowed brow relaxed slightly.

"The cramping doesn't feel as bad anymore!"

Upon hearing this, the patient's husband also looked surprised. They had tried a bunch of Western medicines before, but none of them worked. Now, one injection had caused this?

Without pausing, Fang Yan picked up the second needle and aimed it at the patient's liver and gallbladder meridian acupoint, Qimen below the rib, which is the seventh intercostal space. This area is called Riyue, and it is the Mu point of the gallbladder.

He spoke to the patient in a dialect:
"Take a deep breath now, and I will insert the needle as you inhale."

When the patient took a deep breath as instructed, Fang Yan quickly inserted the needle into the seventh intercostal space using the finger-cutting needle insertion method, with the needle tip slightly inside to avoid the ribs. After inserting the needle 0.5 inches, Fang Yan stopped the needle. At this point, Fang Yan noticed that the patient was holding their breath in tension.

He said, "Keep breathing through your mouth, don't hold it in."

"Hoo..." the patient exhaled softly.

Fang Yan continued inserting the needle, made a slight adjustment, and a reddish glow appeared around the needle tip, indicating that the Qi had been obtained.

Fang Yan then used the "lifting and inserting purging method" for needling, which means lifting the needle tip upward by 0.1 inches for tonification and inserting it downward by 0.2 inches for purging, combined with the trembling technique, which means rapidly and slightly vibrating the needle handle with the fingers. After a few seconds, the patient suddenly burped.

After she finished burping, she said:
"It feels like the tightness in my chest has eased!"

After he finished speaking, the patient's abdominal muscles visibly relaxed.

She had been tense the whole time, and Fang Yan could feel the sensation under the needle change from "pressing a zither string" to "touching cotton wool".

Then, Fang Yan left the needles on her acupoints and pointed to the patient's knee, saying:

"Bend your knees to ninety degrees."

The patient felt much better than before. It was only the second needle prick, and when he heard the dialect saying that more needles were to be inserted, he immediately cooperated by bending his knee to a standard 90-degree angle.

In this method, the thumb is placed in the depression below and in front of the fibular head, the needle is inserted at a 90-degree angle to the skin, and then inserted perpendicularly for 1.5 inches.

This is the Yanglingquan acupoint.

After three thrusts, he asked:
"How are you feeling? Is your left shoulder still hurting?"

The patient was taken aback, somewhat surprised that the pain in the shoulder was treated as a foot ailment.

She moved her left shoulder and felt a series of tremors under the needle.

The patient said in surprise:

"My shoulders feel so much lighter! It felt like there was a string pulling on them, but now that string has snapped."

The patient's husband asked in dialect:

Is this break a good thing or a bad thing?

Fang Yan's silver needles trembled slightly with the patient's movements. Hearing this, she turned to look at the patient's husband, her fingertips still maintaining control of the needle handle, and explained:

"It's not that the thread broke, it's that the knot blocking the meridian has been untied."

He gestured with his free left hand on his shoulder and said:

"You see, the liver and gallbladder meridians are like water pipes that run from the abdomen to the shoulders. Now, there is damp heat and stagnation in the abdomen, and the water pipes are blocked by sludge, which is why the shoulders hurt."

Fang Yan continued acupuncture, gently lifting and inserting the needle at the Yanglingquan acupoint. The patient let out another soft cry. Fang Yan continued to explain: "Yanglingquan is the 'lower He-Sea' point of the Gallbladder Meridian, like the main valve of a water pipe. Just now, needling Qimen and Riyue was to clear the blockage upstream. Now, opening this valve will allow the 'sludge' downstream, which is what Western medicine calls inflammation and edema, to be drained along the meridian." He pointed to the Qimen acupoint, where the needle was still in place below the patient's chest.

"Look at the redness around the needle mark. This is the blood and qi flowing through the blockage, which naturally reduces the pulling pain in your shoulder."

The patient's husband took a closer look and indeed saw a faint reddish tinge around the needle mark, like a ring of cinnabar.

The patient's husband remarked:

"It's amazing that pricking my foot helped relieve my shoulder pain!"

He said in dialect:

"Traditional Chinese medicine says, 'Where the meridians pass, the treatment reaches.' So, what seems like treating the feet is actually regulating the Qi and blood of the liver and gallbladder meridians from the root. It's like if the drain in your house is clogged, just unclogging the floor drain won't work; you have to find the cause in the main pipe."

Next, Fang Yan used the same method to insert needles into the patient's Zusanli acupoint.

After that, the patient's pain was relieved.

Although the pain was gone, the fundamental problem remained unresolved. When the needle insertion time was over, Fang Yan checked his watch and saw that someone from the pharmacy had finally arrived.

Fang Yan withdrew the needle, and the patient frowned. She said:
"Dr. Fang, why don't you just keep the needle in there?"

"It started hurting again right after you removed it."

He said in dialect:

"No, acupuncture needles shouldn't be left in for too long. Now that the medicine is here, drink it quickly."

The patient's husband asked:
Why can't the needles be left in for too long?

He said in dialect:

"Our traditional Chinese medicine acupuncture regulates the flow of Qi and blood in the body by stimulating acupoints. If I leave the needles in for too long, it is very likely to overstimulate your loved one's acupoints, causing her Qi and blood to accumulate or dissipate excessively in the local area, which may lead to symptoms of insufficient Qi and blood such as fatigue, dizziness, and palpitations. This effect is even more pronounced for someone like her who has been sick all night."

The patient's husband nodded repeatedly after hearing this. Although he didn't quite understand, he knew that the needles shouldn't be left in, as it would have negative consequences.

An emergency room doctor standing nearby said:
"Alright, stop asking. Just listen to Dr. Fang now."

The patient's condition is still very dangerous. The doctors are really afraid that the patient will die again if they suddenly stop.

Then, Fang Yan brought the medicine to the patient and told her to drink it herself.

The patient held the bowl of Chinese medicine, which had cooled to a perfectly suitable temperature, looked at the yellowish liquid inside, tilted his head back, and drank it all in one gulp.

As soon as the patient swallowed the last mouthful of medicine, a strong bitter taste rose in her throat, along with an indescribable slight numbing sensation. However, it was fleeting, and she subconsciously pursed her lips.

Then I shuddered!
bitter!
"Is it ready now?" the patient's husband couldn't help but ask again.

"Wait a bit, lie down for a while," Fang Yan said.

At this moment, the emergency room doctor took out a thermometer and said to the patient:
"Place it under your armpit for a few minutes."

The patient took it after hearing this and held it to his left side, mainly because that side was painful.

Fang Yan started tidying up his sea dragon needles, disinfecting them before putting them away.

Just as we finished cleaning up, the patient said:

"Hey, I feel a warm sensation in my stomach."

As she spoke, she began to gesture to her upper abdomen, rubbing it with her hands.

A muffled gurgling sound came from her abdomen, and the patient was stunned for a moment.

Her stomach is growling.

Just then, she clutched her left side.

He addressed the crowd:

"The cramping is back!"

Hearing this, everyone's hearts tightened. Fang Yan calmed down a bit and said to the crowd who all wanted to see him:
"Don't worry!"

At this moment, the patient couldn't help but curl up, looking as if she was in some pain.

Fang Yan frowned slightly.

Just when he thought there was something he hadn't figured out, the patient relaxed again and started breathing heavily.

Then she heard several rumbling sounds from her stomach.

As her stomach growled from not eating, her pained expression gradually lessened.

At this moment, the patient suddenly covered his mouth and gagged, but did not vomit anything.

Separated by her husband, all she felt when she leaned in was a pungent, medicinal smell rising from her stomach.

She gagged several times.

It finally stopped.

"It seems like the thing that was blocking my ribs has gotten out!" she said breathlessly, fine beads of sweat appearing on her forehead, but her complexion was much better than before.

Fang Yan reached out her hand and said to him:
"I'll press your acupoints. If it hurts, just say so."

"Mm." Fang Yan nodded.

Then Fang Yan pressed her Zhongwan acupoint. The patient didn't flinch in pain like before; instead, she burped.

"Burp!" She then burped again.

"What's going on?" The emergency room doctor was also bewildered and asked Fang Yan.

Fang Yan ignored him and instead asked the patient:
"Do you need to go to the bathroom now?"

The patient paused for a moment, then nodded somewhat embarrassedly: "It seems, it is a little..." Before she could finish speaking, an even stronger rumbling in her intestines came, and she couldn't help but clench her legs together.

Just then, Chen Wenwei, who was standing nearby, suddenly pointed at the patient and said:
"The yellow coating on her tongue seems to have faded a bit!"

Everyone was taken aback, and the patient quickly stuck out his tongue for everyone to see.

Then, sure enough, the thick, greasy coating on the tongue, which had been like tofu dregs, had receded considerably, and the edges of the tongue were showing a hint of pink. Although the center was still yellow, the texture of the tongue was now visible.

"Good news, don't panic," Fang Yan said to the crowd.

"Excessive bowel sounds and the urge to defecate are typical manifestations of the laxative effect of rhubarb and senna leaves in the prescription."

"These two herbs can stimulate the intestinal mucosa, enhance intestinal peristalsis, and promote the expulsion of accumulated damp heat and turbidity from the body, which corresponds to the treatment goal of 'clearing the bowels and purging heat' in traditional Chinese medicine."

"In acute pancreatitis, pancreatic inflammation can easily lead to intestinal paralysis, which is the obstruction of bowel function. The return of bowel sounds and the urge to defecate indicate that gastrointestinal function has begun to recover, which is a key signal of improvement in the condition."

Upon hearing the dialect spoken, everyone suddenly understood, and then the emergency room doctor asked:

"What caused the pain just now?"

"The brief recurrence of colic after taking the medicine is a manifestation of the medicine's effect in pushing the stagnant blood and qi to fight against the pathogenic damp-heat. When the bowel-clearing effect of rhubarb and senna leaves works synergistically with the liver-soothing and qi-regulating effects of bupleurum and turmeric, the originally obstructed liver and gallbladder meridians are forcibly cleared, triggering a brief 'disease-eliminating reaction.' As you can see, the pain is relieved because the blood and qi are flowing smoothly."

"Yes, I'm not in pain anymore!" the patient said.

"belch!"

She hiccuped right after she finished speaking.

I suppressed the urge to gag.

"Burning is the effect of Pinellia ternata to relieve nausea and vomiting, and Coptis chinensis to clear stomach heat."

"The stomach qi rises due to damp heat obstruction. The prescription we just received helps to harmonize the stomach and descend the upward flow of turbid qi."

Just now, when I pressed her Zhongwan acupoint, she burped. This means that the Qi in her stomach and intestines has shifted from "stagnation" to "flow." As the stomach's Mu point, the reduction in tenderness at the Zhongwan acupoint directly reflects the recovery of stomach and intestines function.

"In addition, her thick, greasy yellow tongue coating was a typical sign of internal damp-heat. After taking the medicine, the edges of the tongue coating turned lighter and the tongue texture was revealed, indicating that the Scutellaria baicalensis and Coptis chinensis in the prescription had taken effect in clearing damp-heat. The damp-heat in the body will be expelled with bowel movements, and the tongue coating, as an external manifestation of stomach qi, will improve more significantly."

After saying this, the patient could no longer contain himself and addressed the crowd:

"I can't hold it anymore, I need to go to the toilet!"

Fang Yan said to the nurse:

"Take her there."

The nurse nodded and then took the patient over.

After a while, the patient returned.

When Fang Yan touched her forehead, the burning heat had subsided considerably.

At this moment, she also took out her thermometer.

The temperature above shows it's already 37 degrees Celsius.

The emergency room doctor nodded after seeing it.
"The hiccups have stopped, and the temperature has gone down."

The dialect says:

"You might have diarrhea a few times next, which is a good thing, it will help expel the damp heat."

He had barely finished speaking when the patient's stomach started growling again:

"Excuse me, I need to go to the restroom!"

After saying that, he hurriedly walked out again. Fang Yan and the emergency room doctor saw this and knew that the situation was improving.

After the patient left, the emergency room doctor said to Fang Yan:

"Director Fang is truly amazing!"

"I think you could arrange for some people to set up a consultation room in the emergency department later?"

Fang Yan smiled and said:

"I'd like to, but right now I'm only doing this part-time. Let's talk about it again when we've recruited full-time employees."

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

(End of this chapter)