Rebirth 1977 Great Era

Chapter 1118 The Battle of Aconite: Cousins ​​Clash, Jin Wubing Wins MVP (Two Chapters Combined)
Given her current condition, the fact that she has managed to survive for seventeen years is a testament to the blessings of her ancestors.

The problem only recently started; it's really hard to keep up with the pace.

However, on the other hand, this matter is related to Chu Qiaonan's master, Zhou Zuoyu. Back in Taiwan, this Mrs. Zheng had received medical treatment from Zhou Zuoyu, and at that time she should have recovered quite well.

It relapsed later due to her own reasons.

According to the patient's own account, excessive worry was the cause.

In traditional Chinese medicine theory, "excessive thinking" can easily damage the spleen and deplete blood, leading to the heart not being properly nourished, which in turn aggravates symptoms such as palpitations and shortness of breath, especially having a significant impact on patients with heart disease.

Atrial fibrillation is one of the most common arrhythmias in adults, and the vast majority of cases occur in patients with organic heart disease.

Patients often feel anxious and their heart is racing, as if something is disturbing them. These episodes usually occur in waves.

It is often triggered by emotional fluctuations or overwork, and is often accompanied by symptoms such as insomnia, chest tightness, and shortness of breath. An electrocardiogram can also show abnormal changes.

This disease falls under the category of "palpitation" in Traditional Chinese Medicine. The main cause is "deficiency of both Qi and Yin," meaning that both Qi and Yin fluids are insufficient. In older people, there is often also a problem of Yang deficiency.

The normal functioning of the human body mainly depends on the heart, and the heart needs blood to nourish it. If the heart blood is deficient and consumed, the heart rhythm will be disordered, which will eventually lead to palpitations.

For someone like Mrs. Zheng, who is in her fifties and has a nearly twenty-year history of heart disease, her body is already weak, so her Yang energy is insufficient. At this time, her heart Yang energy will also be damaged, and her heart will not receive enough warmth and nourishment, which will trigger palpitations. This is the beginning of a chain reaction.

Based on the dialect, it is speculated that the patient had recovered almost completely after being treated by Zhou Zuoyu, which suggests that the initial treatment was likely mainly focused on "tonifying qi and nourishing yin, promoting blood circulation and unblocking the meridians," which temporarily compensated for the deficiency of qi and blood and relieved the obstruction of the heart meridian.

However, as time went by and I got older, the root cause of the illness was not completely eliminated, so it recently relapsed due to "excessive thinking," which also fits the characteristics of "internal injury from the seven emotions."

Excessive thinking damages the spleen, leading to insufficient production of spleen qi and blood. This exacerbates the underlying deficiency of heart yang, further obstructing blood stasis and ultimately resulting in severe symptoms such as signs of heart failure and irregular pulse.

Li Ke, an expert in this field, also emphasized that "Yang deficiency is the root of all diseases," which is consistent with Mrs. Zheng's "insufficient heart Yang."

"Dr. Fang, how is my wife's condition?" Mr. Zheng asked Dr. Fang.

Fang Yan composed herself and said to him:
"Don't worry too much. I've encountered even worse cases like her. The most important thing now is to put business matters aside for now and not think about it too much. She's just overthinking things."

At this point, the patient is already overwhelmed by the bad news. Many diseases actually have treatment options, but some doctors, by telling the truth at this time, directly cut off the patient's path to survival.

Similar stories can be found in the medical cases from the Ming Dynasty recorded in "Continued Collection of Famous Physicians' Cases":
A wealthy merchant suffered from palpitations for a long time. A famous doctor treated him with ginseng and ophiopogon japonicus for three years and he recovered.

Later, due to business failures, he was filled with worry day and night, his old illness relapsed, and he was so anxious that he felt like he was going to die.

The physician said, "Although the medicine was effective in the past, it did not eliminate the root of the disease. Now, excessive thinking has damaged the spleen and further depleted the heart's blood. It is not enough to just treat the heart; we must nourish the earth to generate metal."

He was then treated with Gui Pi Tang to tonify the spleen and nourish the heart, combined with Sheng Mai San to replenish qi and nourish yin, and gradually recovered over three months.

He instructed, "If you continue to exhaust yourself, even Lu Xun and Bian Que could not save you."

Modern hospitals have even more cases like this. For example, in cases of late-stage cancer, severe heart failure, or end-stage renal disease, some doctors may directly tell the patient, "Your condition is very serious, there's not much we can do," or "You have at most three months left."

While such statements are based on medical facts, they ignore the patient's psychological capacity to cope, especially for patients with sensitive personalities and a strong will to live. They may instantly destroy their confidence in treatment, or even lead them to abandon basic treatment, thus accelerating the deterioration of their condition.

When Fang Yan was in college, she heard a story about a patient with advanced lung cancer. The doctor told him, "Chemotherapy is useless. Go home and eat whatever you want." The patient refused to eat that day and died of multiple organ failure a week later.

This matter is not over yet. The key point is that the family had already said not to tell the patient, as they were still looking for other treatment options.

As a result, the doctor insisted on "prioritizing the right to know" and directly disclosed the truth to the patient, causing the patient to have an emotional breakdown. By the time the family found another way to try, the patient had already been frightened to death.

Then, one of the patient's family members, who was particularly close to the patient, couldn't bear the situation and went directly to the hospital to find the doctor and say goodbye to the world together.

That one sentence killed three people.

The dialect left a deep impression on me.

An old professor at the school once said that you can say a patient is very ill, but only when you have a solution.

If you have no other options and you resort to scaring people, then you have a problem with your medical ethics.

Just because you can't be cured doesn't mean others can't. People aren't machines. Mental state has a direct impact on the immune system and treatment adherence. Protective communication isn't just about protecting the patient; it's also about protecting yourself.

Just now, He Dong said something like, "It looks like dilated cardiomyopathy!" Fang Yan was certain that he couldn't even offer a complete treatment plan.

After understanding the situation, the patient will most likely be allowed to eat whatever they want.

Waste is not scary; what's scary is that waste ruins important things.

"Alright! I won't let her worry about business matters," Mr. Zheng said, a glimmer of hope rising in his heart upon hearing Fang Yan's words. Such matters were not difficult for them.

At this moment, a middle-aged woman in her forties who had come with them also spoke up:
"Oh dear, I knew it was because you were overthinking it. I told you back when you were going to start that new business that it wasn't going to be a good thing. Now you see, even the doctor said that your sister-in-law's problems are caused by business issues."

Now, everyone in their family started talking at once. Although it was quite noisy, they were all concerned about Mrs. Zheng's health. Fang Yan didn't stop them and let them lighten the mood.

At the same time, he started writing medical records. When he saw Fang Yan start writing medical records, Jin Wubing was the first to go over, and then the others were not far behind, all of them gathered behind Fang Yan to read.

Seeing this, Mr. Zheng stopped the others and said:
"Stop messing around, don't interrupt Dr. Fang's train of thought, he's already written a prescription."

At this point, Fang Yan began to prescribe medicine, targeting the patient's pathogenesis of "insufficient heart yang as the root cause, blood stasis as the manifestation, and deficiency of both qi and yin as the foundation." It was necessary to avoid using only warming and tonifying or purely nourishing and greasy medicine, and to adopt the approach of "taking care of both the root cause and the manifestation, and combining warming and unblocking."

The prescription he gave was as follows:
Prepared licorice root 15g: It invigorates qi, relieves spasms, and harmonizes the effects of other herbs (a core herb in the Treatise on Cold Damage for treating "intermittent pulse").

Codonopsis pilosula 12g, Cinnamomum cassia twig 10g, Ginger 3 slices: warms the heart yang and replenishes heart qi, while Cinnamomum cassia twig also promotes blood circulation;
Ophiopogon japonicus 15g, Rehmannia glutinosa 12g, and donkey-hide gelatin (melted) 10g: Nourishes Yin and blood, and replenishes Qi and Yin deficiency (to prevent the warm and dryness of cinnamon twig and aconite from damaging Yin).

Salvia miltiorrhiza 15g, Ligusticum chuanxiong 10g, Carthamus tinctorius 6g: Promotes blood circulation and removes blood stasis, improves myocardial ischemia;

Atractylodes macrocephala 12g, Poria cocos 10g: Strengthens the spleen and replenishes qi, promotes the production of qi and blood (targeting "excessive thinking damages the spleen");

Raw aconite root 6g (decocted for two hours first): strongly tonifies heart yang and enhances the heart's pumping power (for heart failure and irregular pulse). Increase by 5g daily, up to a maximum of 30g. At the same time, closely observe for signs of yin deficiency transforming into heat, such as "dry mouth, irritability, and worsening palpitations," and adjust accordingly.

15g of Ziziphus jujuba seed and 6g of Polygala tenuifolia: to calm the mind and relieve palpitations, and alleviate insomnia and excessive dreaming (while also addressing the lack of nourishment to the heart and spirit).

He then wrote down the solution:
Aconite and cinnamon twig warm the yang and unblock the meridians, addressing the root cause of "insufficient heart yang";

Ophiopogon japonicus, Rehmannia glutinosa, and donkey-hide gelatin nourish Yin, while Codonopsis pilosula replenishes Qi, achieving "dual replenishment of Qi and Yin";
Danshen and Chuanxiong promote blood circulation and break the vicious cycle of "blood stasis and stagnation, further weakening of heart yang";
Atractylodes macrocephala and Poria cocos strengthen the spleen and improve the production of qi and blood from the source;

Sour jujube seed and polygala root calm the mind and relieve the symptoms of palpitations and insomnia.

Aconite should be decocted for two hours first, which reduces its toxicity and ensures that its warming effect is sustained and moderate (avoiding excessive stimulation to a weak heart).

Actually, I originally wanted to use Li Ke's recipe for today's recipe, but now I realize that firstly, it will definitely cause controversy, and secondly, it is easy for these people to steal it.

Fang Yan planned to first use a similar prescription from classical Chinese medicine to stabilize Mrs. Zheng's condition, using a small dose of aconite to gently replenish the heart yang, combined with qi-tonifying, yin-nourishing, blood-activating, and spleen-strengthening herbs.

Although she is in danger, she is not yet at the point of death and still supports Fang Yan's actions.

Using large doses of the formula now might dry out the yin fluids and worsen the stagnation, which would be counterproductive. Therefore, after comprehensive consideration, Fang Yan decided not to rush to use Li Ke's method.

Upon seeing that the dialect had been written, He Jingwei, who was standing to the side, said:
The Treatise on Cold Damage states: "When the pulse is irregular and the heart is palpitating, the Decoction of Prepared Licorice Root is the main treatment." This indicates that when an irregular pulse is accompanied by palpitations, the Decoction of Prepared Licorice Root can be used to nourish yin and blood, invigorate qi and warm yang, and is suitable for the syndrome of deficiency of both qi and blood.

"This formula is based on the principle of 'warming the Yang and unblocking the meridians, promoting blood circulation and removing blood stasis.' It uses aconite and cinnamon twig to warm the heart Yang, salvia miltiorrhiza and chuanxiong to promote blood circulation and unblock the meridians, and licorice root and codonopsis root to replenish Qi and blood. It is based on the modified licorice root decoction in the Treatise on Cold Damage."

“Uncle is right.” Fang Yan smiled at He Jingwei.

“However, doctors from the classical school of medicine use medication too rigidly…” He Dong muttered to himself, his voice low but everyone else heard him.

Fang Yan looked at him, wondering if his cousin was trying to cause trouble for him.

He Dong glanced at the prescription twice, and said with a hint of smugness:

"The traditional Chinese medicine formula for treating irregular pulse is 'prepared licorice root as the chief ingredient, four liang to invigorate qi and relieve spasms.' Your formula uses 15g, which is quite standard. However..."

He hesitated, and Jin Wubing's eyes were gloomy. However, he heard that what the other party said seemed to make some sense, so he did not go up to argue. He just waited for He Dong to continue.

Fang Yan looked at his cousin and asked:
"Why are not you talking?"

He Dong continued:

“The classical prescription school emphasizes ‘drug-symptom correspondence’ in the use of medicine. If you add raw aconite, and also add salvia miltiorrhiza and chuanxiong, you may have confused the original flavor of ‘nourishing yin and blood’.”

He looked up at Fang Yan, his tone even carrying a hint of guidance:
“The Treatise on Cold Damage uses cinnamon twig and ginger to warm the yang because the blood is weak and the qi is exhausted, so it is necessary to use pungent and sweet herbs to transform yang, rather than using aconite, which is a strong and potent herb. Your modifications are probably “excessive in warming the yang and insufficient in nourishing the yin.”

After saying that, he pointed at Mrs. Zheng, who was somewhat stunned:

“She already has both qi and yin deficiency. If you increase the aconite by 5g every day, what if the yin fluid is depleted? Wouldn’t that be ‘tonifying yang but damaging yin’?” The surrounding TCM doctors all looked thoughtful, clearly feeling that what He Dong said didn’t seem to be unreasonable.

He Dong smiled, waiting to hear Fang Yan's expression, which meant, "Brother, it's not that I'm causing trouble, it's that there's something wrong with your prescription."

Fang Yan, however, remained calm and composed. He picked up his pen and added a line to the edge of the prescription before looking up and saying:
“What you’re saying is the original meaning of classical prescriptions, and I won’t refute it.”

"But Mrs. Zheng's pulse was irregular, which was not simply a case of 'deficiency of both qi and blood,' but rather a case of 'deficiency with blood stasis, and damage to yang affecting yin.'"

He pointed to the patient's tongue and described it:

“A pale tongue indicates blood stasis, a thin white tongue coating indicates cold, and an intermittent pulse indicates that yang cannot transform qi and blood cannot circulate smoothly. The raw rehmannia and ophiopogon in the licorice decoction can nourish yin, but without aconite to promote its movement, it is like a stagnant pool, and even if you add it, it will not be able to dissolve the blood stasis.”

"As for 'Aconite damaging Yin'," Fang Yan paused, pointing to donkey-hide gelatin and Ophiopogon japonicus, "Donkey-hide gelatin, when melted, can nourish Yin and moisten dryness. 15g of Ophiopogon japonicus is nourishing without being greasy, which, together with 6g of raw aconite (initial dose), forms a balance of 'warming Yang without causing dryness and nourishing Yin without causing stagnation.' The subsequent increase to 30g is also based on close observation of the tongue and pulse. I wrote here that if dry mouth and red tongue appear, immediately reduce the aconite and add Scrophularia ningpoensis. This is 'dynamic prescription adjustment,' rather than rigidly adhering to classical prescriptions."

He then looked at He Dong:

“You say the classical formula school is ‘rigid’, but I think the soul of classical formulas is ‘treatment based on syndrome differentiation’. Zhang Zhongjing used Zhigancao Decoction to treat ‘intermittent pulse’ and Si Ni Decoction to treat ‘deep pulse in Shaoyin disease’, which is to select the formula according to the syndrome. Now Mrs. Zheng has three syndrome mechanisms of cold, blood stasis and deficiency. If we only stick to the original Zhigancao Decoction, we will fail to live up to Zhang Zhongjing’s teaching of ‘observe the pulse and symptoms, know what kind of adverse condition has been found, and treat it accordingly’.”

Upon hearing this, He Dong's expression turned rather unpleasant.

His fingers unconsciously tightened around the hem of his suit jacket, and he swallowed twice before managing to speak:
"Even if what you say makes sense, how do you calculate the toxicity of aconite?"

"You directly increased the amount of the Shengfu Huan Project to 30g? I've never seen anyone use it like that!"

Before he could finish speaking, Jin Wubing interrupted with a sneer:

"You're making a fuss over nothing..."

Very good, they just despise you for being unreasonable.

He Jingwei grabbed his son's arm and whispered, "That's enough!"

He Dong was still a little unconvinced, but when he saw his father glaring at him, he remembered that he hadn't come here to sabotage him.

But he was still indignant. He finally found a problem, only to have it solved by the dialect.

Now that he's pressed for more information, his father is stopping him again.

Mike Chen adjusted his glasses and tried to smooth things over:
"Academic debate is a good thing... However, using medicine is like using troops. Blindly following ancient methods is just theoretical; adapting to changing circumstances is the real battle. Dr. Fang is absolutely right!"

Fang Yan looked at He Dong, whose face was dark and ugly, and knew that he was definitely not convinced at this moment.

He put down his pen, looked calmly at He Dong, smiled, and then, mimicking the "gentlemanly demeanor" He Dong had maintained when he entered, spoke in a measured yet unwavering tone:

"It is common knowledge that raw aconite is poisonous, but poisonous does not mean it cannot be used. The Shennong's Classic of Materia Medica lists aconite as an inferior herb, saying that it is poisonous and that excessive or prolonged use will harm people. However, it also states that it is effective for treating coughs due to wind-cold, evil qi, warming the middle jiao, and treating wounds. Therefore, the key is to use it in the right place, at the right dosage, and in the right way."

He picked up the prescription, pointed to the line "6g of raw aconite (decoct for two hours first)," and said:

"If you decoct raw aconite for two hours, the toxic component aconitine will decompose into aconitine, thus reducing its toxicity, while preserving its warming and blood-activating effects. This is a method of reducing toxicity passed down from our ancestors. I have used much more aconite than this amount to treat patients before, and I have even drunk it myself first to make sure that my medicine is not toxic."

"If you have any doubts, try it yourself. That's more practical than just talking about toxicity."

Upon hearing this, He Dong's forehead veins bulged.

Fang Yan's smile became even more "sincere," and he continued:

"As for 'adding it to 30g'..." Fang Yan looked up at Mr. and Mrs. Zheng, paused, and said:
"Mrs. Zheng has had atrial fibrillation for seventeen years, and her heart yang has been depleted to the point that small supplements can no longer help. I set the daily increase to 5g because she is now deficient in both qi and yin, and her body needs to gradually adapt to the recovery of yang. Just like you can't throw a frozen person directly into boiling water, this is called 'gradual progress without harming the body'."

He paused, then suddenly asked He Dong:

"Cousin, have you ever seen a patient whose pulse is so irregular and intermittent? The kind of pulse that feels like a candle in the wind, as if it might stop beating at any moment. Without aconite to push it up, are you going to rely on rehmannia and ophiopogon to 'nourish yin' and save their life?"

These words hit the nail on the head. Although He Dong understood the theory, he lacked clinical experience, and he was even more speechless. He had been wondering why Fang Yan didn't refute him, but now he just wanted to beg Fang Yan to stop talking.

Fang Yan didn't give him a chance to refute and continued:
"Moreover, Zhang Zhongjing did not simply use a small amount of aconite. In the Treatise on Cold Damage, Zhenwu Decoction uses one piece of aconite, and Sini Decoction uses one piece of raw aconite, all adjusted according to the severity of the cold evil. My upper limit of 30g is for her serious illness of 'insufficient heart yang and blood stasis,' and I will observe her tongue and pulse throughout the process. If there are signs of 'yin fluid depletion,' I will immediately reduce the dosage. This is called 'knowing when to advance and retreat,' not acting recklessly."

He Dong wanted to refute, but this time he really didn't know how to refute.

His face flushed red, but he still had to maintain his "gentlemanly demeanor," forcing out a smile that looked worse than a grimace, and said to Fang Yan:

"My cousin is right!"

"Pfft..." Jin Wubing chuckled from the side, causing He Dong to turn around and glare at him.

He pretended to take something out of his pocket, but his fingertip made a provocative gesture towards He Dong, with a sly smile on his face, clearly saying, "Out of words?"

He Dong glared at him fiercely, but ultimately remained silent.

He Jingwei, standing to the side, quickly smoothed things over, a smile plastered on his face, and said to Fang Yan:

"That's just how your cousin is. He can't keep his mouth shut. He doesn't mean any harm, and it's not directed at you. Academic discussions should be like this, focusing on the issue, not the person."

As soon as he finished speaking, Jin Wubing picked at his ear and slowly opened his mouth:
"Ugh, it's that same old excuse again?"

Everyone was taken aback and turned to look at him. Jin Wubing smiled and shook his head:
"Based on my experience, when people say 'no malicious intent,' they are probably harboring malicious intent; when they say 'not targeting anyone,' they are definitely targeting that person; when they say 'it's about the issue, not the person,' they are most likely targeting that person."

"You...you're too presumptuous!" He Jingwei hadn't expected this cocky young man to speak so recklessly, and his face immediately darkened.

Jin Wubing blinked and waved his hand, saying:

"Hey, don't take it personally. I said 'ordinary person,' are you an ordinary person?"

He Jingwei was taken aback and did not respond.

Jin Wubing then added with a grin:
"Of course not! You are Dr. Fang's uncle, and he is Dr. Fang's cousin. How can you be the same as other people?"

Hearing this, He Jingwei and He Dong's expressions softened slightly, but they knew perfectly well that this kid was being sarcastic.

But before they could even breathe a sigh of relief, Jin Wubing changed the subject again:
"If you were like those 'ordinary people,' could you still be considered human? Wouldn't you just be a beast?"

"This kind of guy, he'll either get hit by a car or get shot in the back when he goes out. He deserves it!"

He Jingwei's face darkened instantly. He finally realized that Jin Wubing had come with ill intentions. His words were ostensibly insulting "ordinary people," but in reality, every sentence was aimed at him.

After Jin Wubing finished speaking, he shrugged and grinned at He Jingwei in a nonchalant manner:
"Hey, don't take it to heart. I'm involved in gangs in America, so I'm not very polite or good at talking, but I'm really just stating the facts, not personal attacks. I have absolutely no ill intentions, so please don't misunderstand!"

He Jingwei snorted coldly:
"Knowing you lack manners, you still speak recklessly here. Do you really think this is some amateurish place?"

He Dong directly retorted in English:

"Do you know who I am? How dare you threaten me, you country bumpkin?"

He was immediately stopped by He Jingwei's stern rebuke:
"Shut up! Are you going to lower yourself to argue with thugs?"

Jin Wubing, however, spread his hands and said to the others:
"What you heard is that I said I wasn't targeting them, I had no ill intentions, and I was only addressing the issue, not the person. They should take it personally."

"You all know what kind of people they are, right?"

The onlookers stared in disbelief as Jin Wubing's series of maneuvers completely overwhelmed the He family father and son. They all turned to look at Fang Yan, who seemed oblivious to the commotion, and said:
“Uncle, Mr. Jin grew up in the slums of New York and is quite outspoken. But he can’t stand people questioning my prescription, so he went astray. I apologize to you on his behalf.”

He Jingwei had actually figured it out long ago: Fang Yan was just trying to get Jin Wubing to cause trouble here. Otherwise, he would have intervened long ago. But he couldn't keep pressing the issue, and besides, he wouldn't gain anything by doing so.

There are more important things to do now. It's also He Dong's fault for overestimating himself; he shouldn't have brought him along today.

He Jingwei took a deep breath and said:
"It's alright, I don't bother with thugs."

Jin Wubing was hiding behind Fang Yan, his head slightly sticking out. He pursed his lips in He Jingwei's direction, his lips moving silently... The shape of his mouth was clearly "Asshole".

His eyelids drooped, but a provocative smile curled at the corner of his mouth. He secretly raised his right middle finger, then quickly withdrew it a second before He Jingwei looked over, his movements as fast as a cat stealing meat in the kitchen.

By the time He Jingwei frowned, he had already turned around with his hands in his pockets and started whistling off-key at the corner of the wall, as if the silent provocation just now was just the illusion of others.

This scene was witnessed by many people, and they were all amused by this guy. Although everyone could see that He Jingwei and his son were looking for Fang Yan, Jin Wubing perfectly retorted.

He Jingwei and his son He Dong were so angry they were practically steaming. They had clearly been offended, but they couldn't retaliate and could only suppress their anger.

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

(End of this chapter)