Rebirth 1977 Great Era

Chapter 1106: For those suffering from a combination of deficiency and stagnation, treatment should be tailored to the specific day, with one day addressing the deficiency and the other day addressing the stagnation (combined chapter).
Instead of answering her question, Fang Yan asked:

"Is it that your stool isn't dry, but you still have to strain a lot?"

The patient was clearly taken aback. She said:
"It really is!"

After saying that, she asked Fang Yan:

Is there any explanation for this?

Fang Yan explained to her:

"I just looked at your tongue and noticed that it was pale and had bluish-purple ecchymosis at the base."

"In traditional Chinese medicine, tongue diagnosis suggests that a pale tongue is a direct manifestation of deficiency of both qi and blood, while bluish-purple spots at the root of the tongue are a typical signal of blood stasis in the lower jiao (lower burner)."

The patient nodded, seemingly understanding.

Fang Yan continued:

Traditional Chinese medicine believes that "Qi is the commander of blood and blood is the mother of Qi." Deficiency of both Qi and blood will lead to weak intestinal motility (Qi deficiency) and insufficient body fluids (blood deficiency), which in turn will cause constipation.

"This type of constipation is characterized by difficulty in defecation, with stools that are not dry but require straining to pass, which is clearly different from constipation caused by excess heat, which is characterized by dry and hard stools."

The patient and their family members both looked enlightened.

Fang Yan continued:

"Because blood stasis in this person can lead to poor circulation of qi and blood in the lower abdomen, it will affect the abundance of qi and blood in the Chong and Ren meridians of the uterus on the one hand, and it will also cause stagnation of qi in the intestines on the other hand, causing abnormal transmission of feces in the intestines and leading to constipation."

"During a woman's menstrual period, qi and blood mainly flow down to the Chong and Ren meridians to nourish the menstrual blood. At this time, the qi and blood in the whole body are relatively insufficient. If there is a pre-existing deficiency of both qi and blood and blood stasis, the menstrual period will result in a state of 'further deficiency of qi and blood and further stagnation of blood stasis'."

"When qi and blood are deficient, the intestines are unable to move, like a horse pulling an empty cart, making it difficult to pass stool. When blood stasis in the lower abdomen obstructs the flow of qi in the intestines, like a river blocked by silt, it leads to irregular bowel movements, which often occur suddenly during menstruation."

After speaking in dialect, he looked at the patient, who fell into thought. She had just said that she was fine, but now he had found out.

At this moment, the patient's mother asked in dialect:

"Dr. Fang, is this related to my miscarriage, Xiaoxue?"

"Yes," Fang Yan nodded.

He said:
“It’s not just about miscarriage. If you want to get pregnant again, you need to rule out these physical problems. Otherwise, the hospital won’t be able to find anything, and you’ll be completely confused. I can’t help you even if I want to.”

Traditional Chinese medicine believes that "Qi can support the fetus, and blood can nourish the fetus." It is important to know that if the production of Qi and blood is insufficient, the uterus and fetus cannot be nourished, which will directly lead to an unstable fetus.

"When the meridians of the reproductive system (lower abdomen) are blocked, blood stasis obstructs the Chong and Ren meridians. This meridian, which governs reproduction, will affect the flow of Qi and blood in the uterus."

“When the fetus is weak, the fetal essence is not secure; when there is stagnation, the uterine vessels are blocked

"If we don't find the underlying physical problem, there's still a risk of miscarriage later on!"

After the dialect was spoken, the family of three suddenly realized what was going on. Jiang Xue nodded repeatedly and said:

"Dr. Fang is right. I did overlook this problem."

Jiang Xue's mother also said:
"As expected of the renowned doctor that everyone travels thousands of miles back to China to see, he can spot problems we didn't even notice just by looking at our tongues!"

Wei Ziyu, who was standing to the side, seemed to be deep in thought and asked:

"Dr. Fang, are you saying that this is Xiaoxue's own problem and has nothing to do with anyone else?"

Shaking his head in dialect:

"I didn't say that."

"We are checking her current physical condition, which is a factor that may lead to miscarriage. I don't know what the reason was before."

Based on the patient's tongue appearance, physical signs, and constipation symptoms, a clear pathological basis has been established, namely, qi and blood deficiency combined with blood stasis.

This internal factor is sufficient to independently cause recurrent miscarriages, and the condition can be explained without external intervention.

However, the possibility of external triggers cannot be ruled out.

The key point of suspicion is that the date of the third miscarriage, February 14, 1978, was repeatedly marked in red pen. This date is indeed a bit suspicious, and people in the dialect are wondering if it was deliberately done at a specific time.

Having pre-existing health problems, coupled with even the slightest external interference, could become the final straw that leads to Jiang Xue's miscarriage.

Of course, Fang Yan didn't specifically intend to help him solve the case.

Now he plans to figure out Jiang Xue's physical condition and help her deal with the potential risk of miscarriage.

But when he said that, Wei Ziyu wondered what the dialect meant by saying that.

Is it certain that someone did tamper with things before, and he was just responsible for solving the problem but not involved in other matters?

Just as he was thinking, Fang Yan said to Jiang Xue:

"Switch to your right hand."

Jiang Xue switched to her right hand, and Fang Yan said to her:

"Think about whether there is anything else that makes you uncomfortable, and tell me about it so that I can find the cause."

Jiang Xue thought for a moment and said:

"It seems like I don't feel uncomfortable anywhere anymore."

Fang Yan heard her say that, thought for a moment, and then asked her:
How was your sleep?

Do you dream a lot and wake up easily?

Jiang Xue said:

“I’ve been like this ever since my miscarriage. Is that considered a problem?” Jiang Xue asked Fang Yan.

Fang Yan was speechless. This young lady was really thick-skinned. Taking a deep breath, Fang Yan nodded:

"Of course it counts, even if you eat very little."

Jiang Xue was surprised; she hadn't expected this to count.

Fang Yan knew this was due to different living environments, so he could only continue asking Jiang Xue:

Do you experience fatigue, lethargy, shortness of breath after a short period of activity, cold hands and feet, or aversion to cold water?

Jiang Xue thought for a moment and said:
“I don’t do much work usually, and I only participate in activities with Ziyu. The amount of exercise is not high, so I don’t feel anything. Besides, when I was pregnant, the doctor said this was a normal phenomenon.”

"As for being afraid of the cold... Singapore is quite warm, and we don't wash with cold water at home."

dialect:"……"

Okay, that makes a lot of sense.

At this point, the pulse diagnosis on the right hand was completed, and both hands showed deep and thready pulses.

A deep pulse indicates a deep-seated disease, while a thin pulse is a typical sign of insufficient Qi and blood, which is highly consistent with tongue diagnosis of Qi and blood deficiency.

Fang Yan said to them:

"I have to say, your understanding of your physical condition is somewhat flawed. Symptoms such as easy fatigue, frequent dreams, and sensitivity to cold are all different from a normal state, and these are signals that your body is sending out problems."

Upon hearing this, Jiang Xue glanced awkwardly at her husband and mother-in-law, and said:
"Well...that is indeed a bit off..."

At this moment, the patient's mother quickly asked in dialect:

"Dr. Fang, what problems can we tell from Xiaoxue's symptoms?"

Fang Yan began writing medical records at this moment, and said:
"The fatigue, excessive dreaming, and aversion to cold that Ms. Jiang just mentioned, along with the pale tongue and deep, thready pulse that I just observed, all point to one problem: she has a severe deficiency of both qi and blood."

"In my traditional Chinese medicine, I believe that Qi is the driving force of life. When it is deficient, it will lack the power to propel it. Qi deficiency, such as fatigue and shortness of breath, will lead to the decline of organ function. When blood does not nourish the heart, the spirit will be restless, which will lead to dreaming and waking up easily. Blood deficiency cannot nourish the heart and spirit. When Qi and blood are deficient, the warming function will fail, which will lead to fear of cold and cold limbs. Insufficient Qi and blood will lead to the decline of Yang Qi."

"Actually, as I just mentioned, her tongue appearance already confirms these points. All of her symptoms are directly related to the miscarriage! Traditional Chinese medicine believes that Qi and blood are the foundation of the fetus. If Qi cannot hold the fetus, the embryo cannot be stable. To give an example..."

Fang Yan paused, hesitated for a moment, and then said:
"Just as a sapling will fall over if the soil is loose, a fetus will be deprived of nourishment if the blood does not nourish it, just as a seedling will wither if it lacks water."

"I always dream when I sleep, and I still feel tired when I wake up. This isn't just about overthinking." Fang Yan wrote "blood not nourishing the heart" on the prescription slip with a fountain pen and continued:

"Blood is like a blanket covering the heart. If her blood is deficient, her heart is like a blanket in winter, easily disturbed by the slightest noise. This corresponds to the fetal development, which is 'restlessness of the mind makes the fetus more prone to movement.' In addition, it is also said in folk medicine that this pregnant woman has poor sleep quality and a higher risk of miscarriage, which is the same as the Chinese medicine concept of 'blood not nourishing the fetus.'"

"Aren't you afraid of the cold in Singapore's hot weather?" Fang Yan turned to Wei Ziyu and asked.
Do you use air conditioning at home?

Wei Ziyu was taken aback, and he said:
"Yes! After Xiaoxue became pregnant for the first time, our family specially switched to a German Stuttgart."

"Do you often eat raw or cold foods?" Fang Yan asked again.

"Not often, only occasionally if the weather is hot."

Fang Yan pointed to Jiang Xue's tongue image on the medical record:

"A pale tongue is a sign of a weak and cold constitution. Adding cold drinks and air conditioning for a long time is like pouring ice water into the uterus."

“When cold air encounters blood, it congeals, just like water in a pipe freezes in winter. The blood in her Chong and Ren meridians is also in a ‘semi-frozen state.’ The fetus is like crops planted in icy soil; how can it possibly grow well?”

Wei Ziyu opened his mouth.

Before he could speak, Fang Yan said to Jiang Xue:

"Also, less physical activity does not mean that qi deficiency does not exist."

Fang Yan picked up the teacup on the table and shook it. "Just like this teacup, it's very light when it's empty, but it becomes heavy when it's full of water. After she got pregnant, the fetus was like 'water.' People with weak Qi can't feel it normally, but once they get pregnant, it's like an empty teapot suddenly being filled with water. They immediately 'can't lift' it, which manifests as shortness of breath and a feeling of heaviness. This is the early sign of 'Qi failing to support the fetus.'"

He deliberately pulled out the test report he had just taken and turned to the footer of the Hong Kong report, which stated "cervical insufficiency".

"The Western medicine here says to cervically ligate, which is essentially using external force to replace 'qi' to stabilize the fetus. But if the root cause of qi deficiency is not addressed, it's like using a rope to tie up a leaky bag; it's only treating the symptoms, not the root cause."

"This is the pathological basis for the three miscarriages, especially the last two asymptomatic miscarriages, excluding external factors."

"Ms. Jiang thinks there's 'no major problem,' which is precisely the biggest issue! Her body has already sent out SOS signals through fatigue and cold intolerance, but these signals are mistaken for 'normal.' Her thoughts also mask the underlying pathology. Furthermore, repeated pregnancies can exacerbate the deficiency. You haven't recovered properly since your first pregnancy. This long-term neglect of the depletion of qi and blood is like a lamp running out of oil but you keep adding fuel to the fire... Do you know what I mean?"

The three of them exchanged glances, and then Wei Ziyu asked:
"Then... what should we do?"

He said in dialect:

"We must take a two-pronged approach: resolve blood stasis in the lower abdomen, clear blockages in the Chong and Ren meridians, and then replenish qi and blood. Otherwise, even if no one intervenes, if the deficiency and stasis are not eliminated, the next pregnancy may still be difficult to conceive due to poor soil conditions!"

After saying this in dialect, he began writing the prescription.

However, this time the prescription he wrote was a little different. He wrote two prescriptions.

Prescription 1: Codonopsis pilosula 15g, Poria cocos 6g, stir-fried Atractylodes macrocephala 6g, Angelica sinensis 10g, roasted Astragalus membranaceus 20g, Rehmannia glutinosa 15g, Paeonia lactiflora 6g, Salvia miltiorrhiza 15g, Platycladus orientalis 10g, Bupleurum chinense 3g, Taxillus chinensis 15g, roasted Glycyrrhiza uralensis 5g.

Prescription 10: Cuscuta chinensis 15g, Lycium barbarum 10g, Ligustrum lucidum 10g, Rubus idaeus 15g, Epimedium 15g, Angelica sinensis 6g, Polygonum multiflorum 15g, Jujube 10g.

The patient should take the first and second prescriptions alternately.

This treatment method is rarely used, but it was first proposed in the "Suwen·Biaobenbingchuanlun" (素问·标本病传论): "Intermittent cases proceed in parallel, while severe cases proceed alone."

Of the two prescriptions in the dialect, prescription one focuses on strengthening the spleen and replenishing qi, promoting blood circulation and soothing the liver, emphasizing the improvement of qi and blood generation and circulation.

Prescription 2 focuses on tonifying the kidneys and replenishing essence, as well as nourishing both yin and yang, with an emphasis on consolidating the Chong and Ren meridians and warming and nourishing the uterus.

It uses the traditional Chinese medicine treatment principle of "tonifying deficiency and unblocking stagnation", and also takes into account the theories that "the spleen is the source of qi and blood" and "the kidney is the foundation of innate constitution".

These two prescriptions are suitable for Jiang Xue's complex pathogenesis, which is characterized by deficiency of both qi and blood, blood stasis in the lower jiao, and deficiency of kidney yang, while avoiding contraindications due to her constitution.

The design of alternating dual-treatment regimens avoids the drawbacks of prolonged use of a single treatment and forms a synergistic treatment chain that replenishes qi and blood, removes blood stasis, and strengthens the kidneys. This is the principle of "staged treatment" for miscarriage management in gynecology.

Fu Shan, a renowned gynecologist of the Qing Dynasty, favored this alternating therapy in his book "Fu Qingzhu's Gynecology".

Fu Shan emphasized in "Postpartum Chapter":
“For those with deficiency and stagnation, treatment should be carried out on separate days. One day, the deficiency should be replenished, and the stagnation should be treated on the other day. In this way, the yin and yang will not be harmed and the chronic disease can be cured.”

Ye Tianshi and Zhang Xichun also used it.

In the capital, Fang Yan had previously met Qian Boxuan, one of the eight great masters of modern gynecology in traditional Chinese medicine (see Chapter 814), at Xiyuan Hospital. Fang Yan had also seen the medical cases that Qian Boxuan had shared with her.

After writing it down in dialect, he said to them:

"This prescription can be used alternately. If you are hospitalized, our nurses will help you decoct the medicine every day."

After pausing in his dialect, he asked:

"Are you planning to stay in the inpatient ward, or somewhere else?"

Wei Ziyu thought for a moment and asked:

Where does Mr. Hu live?

Fang Yan had already guessed that they would ask this question.

Said:

"They are staying in the rehabilitation ward."

Wei Ziyu said:
"How about we do it this way? I don't know if it'll work?"

Fang Yan nodded:

"Sure, but I need to speak with the dean first before I can arrange rooms for you."

"Okay!" Wei Ziyu nodded.

For them, all they need to do is greet them in dialect.

After finishing writing in dialect, he said:

"In addition, we also need to pay attention to our diet."

"The meals you recorded before are fine; you can order directly from the Yanjing Hotel."

"Don't drink tea or eat radishes for one hour before or after taking the medicine, as these will counteract the effects of the qi-tonifying medicine."

"Remember, dietary adjustments are just as important as taking medicine. You've gotten used to eating raw and cold foods in Singapore, and you must change that when you come back. This is not only for treating your illness, but also to lay the foundation for future pregnancies."

“Our staff will keep detailed records of what Ms. Jiang ate every day, what time she ate, how much she ate, and whether she felt unwell. You just need to cooperate with them in recording these things.”

“I also come here every morning to check on Ms. Jiang’s condition.”

"If you have any special circumstances, you can tell the medical staff there at any time, and they will try to notify me."

"If you develop a rash or diarrhea after taking the medication, immediately stop eating any new food that day, and focus on checking for seafood and nuts."

"Okay, sure!" Wei Ziyu nodded and said.

Then Fang Yan turned to look at Jiang Xue and said:

"Pay special attention to the stool condition, including the time of defecation, consistency, and whether it is difficult. This is the most direct indicator of the medicine's effectiveness. If constipation improves after taking the medicine, it means that the body's Qi and blood are beginning to recover. If it worsens, it may be because the tonic is too nourishing and requires adjustment of the prescription."

Jiang Xue nodded somewhat awkwardly and said:
"I will write it down."

After speaking, Fang Yan thought for a moment and then said:
"Oh, right! I'll give you a recipe; it's for taking before and after your period."

Speaking in dialect, he began writing a prescription, saying:
“Eat this motherwort boiled eggs for 3 days before your period. Take 15g of motherwort (in a cloth bag), boil 2 eggs in their shells, eat the eggs and drink the soup, once a day.” Fang Yan paused after writing this and said, “This can help expel stagnant blood from the uterus, corresponding to the blood-activating effect of prescription one, but remember to stop on the first day of your period to avoid excessive bleeding.”

The patient nodded.

Some curiously asked:
"Is this earthwork?"

He said in dialect:

"Yes, legend has it that in a small mountain village on the banks of the Yi and Luo Rivers in western Henan, there was a boy named Chongwei. His mother suffered from a postpartum illness after giving birth to him, which could not be cured despite treatment. Chongwei learned that a certain herb might be able to cure his mother's illness, so he went up the mountain overnight to collect it. This herb has palm-shaped leaves and blooms with pale red or pale purple flowers, which is the motherwort."

"He used motherwort to treat his mother's illness, and her condition gradually improved. Later, this story spread among the people, and they discovered that boiling eggs with motherwort had a good conditioning effect on some women's diseases. This dietary therapy method gradually spread."

“Back when I was sent to the countryside, the village women and wives who had stomach aches or new mothers were recovering from childbirth would often have their elders gather motherwort and cook it with eggs. The usual way they did it was to wash the motherwort, put it in a pot with the washed eggs, add water, and cook until done. Then they would take the eggs out, crack the shells, and put them back in the pot with the motherwort to continue cooking, allowing the eggs to fully absorb the broth from the motherwort until they were flavorful. Then they would drink the soup and eat the eggs, which was believed to have the effects of relieving pain, nourishing blood, and promoting blood circulation.”

"However, the methods vary from place to place. In the next village, people dry the motherwort and boil it with eggs. They boil it for 15 minutes, then crack the eggs and boil it for another 5 minutes. They eat the eggs and drink the soup, but the methods are just different."

Hearing Fang Yan say this, they realized that Fang Yan's recipe had been tested by many people.

"Okay, got it!"

He continued writing in the dialect, while simultaneously speaking aloud:
"Eat donkey-hide gelatin and red date porridge after your period ends. After your period ends, melt 10g of donkey-hide gelatin, cook 10 red dates and 50g of glutinous rice into porridge, and drink it for 3 consecutive days."

"You can just ask our hospital cafeteria to make these; it's not difficult at all."

"Of course, you can do it yourself for safety reasons."

After writing it down, Fang Yan tore off the prescription and handed it to the patient.

The patient immediately and carefully put it away. Then, Fang Yan tore off the two previous prescriptions and said to them:

"Alright, you all wait here for a while. I'll have someone go and tell the dean, and also brew the medicine for you."

He then walked to the door and opened it.

At this moment, besides the patient's family assistants and attendants, Chen Wenwei and Xie Chunrong were also outside.

Fang Yan handed the prescription to Chen Wenwei and said:
"We'll prepare the first prescription today and the second one tomorrow. We'll hand them over to the pharmacy and have them keep a record of it. Also, we'll send the prepared medicine to the rehabilitation department of our hospital."

"Okay!" Chen Wenwei agreed.

Then asked:

"Brother Fang, it's rare to see these two prescriptions used alternately."

He said in dialect:

"It is rare... Alright, I can't tell you more about this, just do as I say."

They want to keep it a secret, and Fang Yan doesn't want to say much.

After speaking in dialect, he said to Xie Chunrong:
"Go tell the dean that I have a patient who needs to be transferred to the rehabilitation department. The patient and her family should go there. The patient's name is Jiang Xue, and the person who brought her here is Mr. Wei Ziyu."

"Understood!" Xie Chunrong nodded and immediately turned to go and do his work.

After giving these instructions, Fang Yan returned to his room and said:
"Alright, you guys wait here for a bit. It'll take some time to tidy up the room."

At this moment, Wei Ziyu said:

"Dr. Fang, please keep this case confidential!"

He said in dialect:

"Don't worry, only the relevant personnel know. These are people we can trust in our hospital."

"We will definitely do it for you in the same way that Mr. Hu did back then."

After receiving Fang Yan's assurance, Wei Ziyu finally breathed a sigh of relief and nodded.
"Great! Thank you so much, Dr. Fang, for your trouble."

Fang Yan waved his hand, indicating that he shouldn't be so polite.

At this moment, Jiang Xue said to Wei Ziyu:
"Hey, Ziyu, don't forget what you brought!"

Wei Ziyu suddenly realized:
"Oh, yes, yes!"

After saying that, he ran straight to the door and said to the people outside:

"Bring the things in."

Then someone from outside brought in a box and said to Fang Yan:

"Dr. Fang, this is just a small token of our appreciation, please accept it!"

Jiang Xue said:

"We'll repay you handsomely when we have children in the future!"

“Yes, yes!” Wei Ziyu nodded repeatedly.

Fang Yan looked at the box with some surprise; it looked quite large.

Remembering that their family was in the precision instrument manufacturing business, Fang Yan thought to herself:

Did he bring back some kind of sophisticated instrument?
Considering that he was the direct contact with Director Liao, Fang Yan thought it was indeed very possible.

"Before I came back, I heard from Director Liao that you are still working on the processing and export of Chinese medicine. You need to cooperate with them to optimize the overseas market, but the instruments in our country are not up to par. So before I came back, I tried to get a set of instruments that are specially used to check and analyze the components. This is the same model used by European inspection agencies. Japan also uses this. I hope this machine can help Dr. Fang."

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

(End of this chapter)