Rebirth 1977 Great Era

Chapter 1126 Is it prickly heat or lesbianism? (Bonus chapter for 3 monthly votes)

Zhang Zhongxiao spoke in dialect:

"As soon as I have a nightmare, I know it's over. I know in my dream that I will be paralyzed when I wake up."

"Speaking of this, Dr. Fang, I'm afraid you won't believe it. I'm used to it now. Whenever I have a nightmare, I can usually come to my senses within a short time, know that I'm dreaming, and then I know that my body is going to go paralyzed."

Fang Yan nodded thoughtfully, and then asked:

"Hmm, what about pooping and peeing?"

The patient said:
"His bowel movements were normal, but his urine was very yellow during the days he was paralyzed."

Fang Yan asked again:
"Was it difficult to eat when you were paralyzed?"

The patient said:
"No problem. This morning I ate four slices of bread, two fried eggs, and drank a glass of milk."

Fang Yan nodded, then said to the patient:
"Stick your tongue out so I can see it."

The patient opened his mouth and stuck out his tongue, and then Fang Yan saw that the patient's tongue was red with a thin, yellow coating.

Next, Fang Yan pointed to the pulse pillow on the examination table and said to the patient:

"Can you put your hands on the table?"

The patient said:
"Let me try……"

Then he began to make the movements, his facial expression showing great effort, and his hands slowly began to move.

But when I was halfway up, my arms started to shake and I started sweating.

Dialect didn't help; observe him carefully.

The patient clenched his teeth, his breathing became rapid, and sweat began to drip from his head.

"Alright!" Fang Yan called out, stopping the conversation.

"Phew!" The patient exhaled a long breath and said to Fang Yan:

"It was just a little bit short, but I just couldn't muster the strength."

Fang Yan nodded, then took his hand and placed it on the pulse pillow.

Fang Yan just told him to use force only to do a test.

The purpose is to observe the patient's muscle strength, coordination, and active movement ability while in a paralyzed state.

The patient's facial expression was very strained, and his hand started to tremble when he raised it halfway. He also started sweating and breathing rapidly, all of which indicate that the patient had a strong desire to move, but his body was unable to carry out the commands.

Fang Yan began to feel the pulse in the patient's left hand while asking:
Have you noticed any patterns?

The dialect added:
"Like what you've eaten, seen, heard, or smelled?"

The patient thought for a moment and said:

"no……"

"It's just that it's been happening quite frequently lately, which might be related to my attention to the stock market..."

After saying that, he laughed again:

"Haha...That's ridiculous, isn't it? My family summed it up for me: whenever the stock market fluctuates too much, I'll become paralyzed."

His family members beside him spoke in dialect:

"Yes, we found that the frequency of his illness increased precisely when he started playing the stock market."

"Apart from these, there shouldn't be any other patterns."

Fang Yan nodded after hearing this, without saying whether it was right or wrong, but just showed a thoughtful expression.

The others behind Fang Yan also looked puzzled.

This is so strange, I have no clue what to do.

Everyone is waiting for the dialect to draw its conclusion now.

Then, Fang Yan gradually finished taking the pulses of both of the patient's hands.

Both hands had thin, rapid pulses.

Then he picked up a pen and began writing medical records.

As he wrote, he began to think.

The patient experienced recurrent episodes of paralysis over a 20-year period. Before each episode, the patient would have nightmares as a warning sign. During the paralysis, the patient would be conscious but unable to move their limbs. Multiple examinations revealed no organic lesions.

Several key points are worth noting:
The paralysis attacks are directly related to nightmares, and patients can predict the occurrence of paralysis in their dreams; the symptoms are aggravated by emotional fluctuations, such as stock market changes; physical examination reveals no organic damage; and there is a clear pattern of psychological triggers.

The first thing that comes to mind when talking about dialects is the disease of prickly heat (fèi). The book "Treatise on the Causes and Symptoms of Various Diseases" describes the symptoms of prickly heat as follows: "The symptoms of prickly heat are: no pain in the body, inability to control the limbs, and no mental confusion." This is highly consistent with the characteristics of a patient who suddenly becomes paralyzed but remains conscious.

This disease is mainly caused by internal liver wind. The patient's nightmares (excessive heart and liver fire), thready and rapid pulse (yin deficiency), red tongue with yellow coating (excessive heat) also conform to the pathogenesis of yin deficiency and yang hyperactivity, and extreme heat generating wind.

However, when Fang Yan was about to draw a conclusion, he immediately thought of another disease.

That's a passage from the "Treatise on the Pulse and Symptoms of Lily, Fox, Yin and Yang Poisoning" recorded in the *Essential Prescriptions of the Golden Chamber*. The original text is as follows:
“Those suffering from lily disease… desire to eat but cannot eat, are often silent, desire to lie down but cannot lie down, desire to walk but cannot walk… feel cold but not cold, feel hot but not hot, have a bitter taste in their mouth, and have red urine… their pulse is weak and rapid.”

The inability to move is similar to Zhang Zhongxiao's paralysis (inability to move his limbs).

Regarding the bitter taste in the mouth, the patient himself said that before the onset of the attack, his mouth definitely tasted as bitter as if he had eaten Coptis chinensis.

The patient mentioned earlier that his urine was very yellow when he was paralyzed (yellow and reddish urine are both signs of heat).

Now it all makes sense.

The pathogenesis of lily disease is due to yin deficiency and internal heat in the heart and lungs, resulting in malnourishment of the meridians, which is completely different from prickly heat. Fang Yan scratched his head at this point.

The pen hesitated to be put down.

Is it prickly heat or lily disease?
When the others saw that Fang Yan didn't make any further moves, they realized that he was probably also stumped.

Everyone gathered around him, looking at the contents of the medical record, and each of them was quite curious.

After taking the pulses, both hands showed thin and rapid pulses. Thin pulses indicate yin deficiency, while rapid pulses indicate heat. Everyone began to ponder this.

Just then, everyone noticed that in another blank space, Fang Yan had written "Prickly heat?" or "Lily disease?"

Everyone was taken aback, as if they had suddenly found the conclusion.

He hasn't decided on his feelings yet; he's decided but hasn't made a final decision.

Before anyone else could figure it out, he had already come up with two conclusions.

At this moment, Fang Yan put down his pen and shifted his gaze from the medical record to Zhang Zhongxiao and the family members beside him. He decided to delve deeper into some details.

The patient's paralysis was strongly correlated with nightmares and emotional fluctuations (such as stock market ups and downs), and there were no obvious organic lesions, which is consistent with the psychological trigger pattern.

Fang Yan wanted to verify the possibility of the illness through targeted questioning.

Fang Yan adjusted his posture and looked at Zhang Zhongxiao, saying:
"Mr. Zhang, you just mentioned that nightmares are a precursor to paralysis, which is very important. Could you describe those nightmares in more detail? For example, what were they like?"

"Is the feeling of paralysis after each nightmare a complete sense of powerlessness, or is it like being trapped by something?"

Zhang Zhongxiao frowned, recalling the events and struggling to organize his thoughts:

"The content of the dreams was all over the place, but they were always scary scenes, like being trapped in the dark or being chased. Strangely, I could tell in the dream that it was definitely a nightmare, and then I knew that I would be paralyzed when I woke up. The feeling of being paralyzed after waking up... was like being sealed in cement, my whole body was stiff and I couldn't move, but my mind was very clear, and I knew that I was paralyzed."

His wife chimed in, "Dr. Fang, we've been observing this for a long time. Every time he has a nightmare, he groans in his dream, and as soon as he groans, he's paralyzed the next day."

"But a day or two later, he would suddenly get better again, and it became even more frequent after he started investing in stocks. We remember clearly that during the sudden surges and crashes, he was paralyzed several times in a row!"

Fang Yan nodded, then turned to the family members and asked:

"Besides stocks, are there any other stressful things in his life? Such as work or family conflicts? Does the frequency of his paralysis attacks change during these times?"

Zhang Zhongxiao's wife immediately responded:

“He gets paralyzed more often when he’s under a lot of work pressure! We’re opening a factory overseas, and when we were building the new factory last year, he would come in seven or eight times a month. There are no conflicts at home, but before each time he gets paralyzed, he always says that his mouth tastes bitter. He just said it himself, like he’s eaten bitter melon. It’s been like this for twenty years, and we’re used to it.”

Fang Yan turned to Zhang Zhongxiao and asked:

"When the paralysis occurs, besides a bitter taste in your mouth and yellow urine, do you experience any other sensations? For example, low mood, anxiety, or fluctuating body temperature?"

The patient shook his head:

"My mood is alright, I have a good attitude. But when it flares up, my head feels very heavy, like I'm drunk, but nothing else. You asked about the hot and cold sensations? No, I just feel completely paralyzed."

After listening to Fang Yan's explanation, he pondered for a moment, then picked up his medical record book and quickly made notes, while thinking:

In the "Treatise on the Causes and Symptoms of Various Diseases", wind-heat is described as "the limbs cannot be controlled, but the mind is not confused", which is similar to the characteristics of a patient who suddenly becomes paralyzed but remains clear-headed.

However, the definition of lily disease in the "Essential Prescriptions of the Golden Chamber"—"unable to walk, bitter taste in the mouth, red urine, and weak and rapid pulse"—is more in line with the patient's overall symptoms.

"Wanting to move but unable to move": When a patient is paralyzed, "the whole body is stiff and cannot move," but the patient is conscious. This is highly consistent with the "wanting to move but unable to move" in lily disease, which is a subjective desire to move but the limbs cannot move.

"Bitter taste in the mouth": Before the onset of the disease, patients experience a "bitter taste in their mouth, like they have eaten bitter herbs," which is a typical symptom of lily disease.

“Reddish urine”: “Yellowish-red urine” during the paralysis period is consistent with the description of heat symptoms.

“Pulse characteristics”: The patient’s pulse is thin and rapid (yin deficiency and internal heat), while the original text of Baihe disease is “pulse is faint and rapid”. The faint pulse and the thin pulse are similar, both indicating deficiency heat.

In contrast, while prickly heat can also cause paralysis, it is often accompanied by symptoms of liver wind, such as convulsions or pain, which Zhang Zhongxiao did not exhibit.

The patient's strong psychological triggers, such as nightmares and stock market stress, further support the pathogenesis of lily disease as "deficiency of yin in the heart and lungs with internal heat and malnourishment of the hundred vessels," which should be the transformation of emotional imbalance into physical symptoms.

Lily disease is considered a type of hysterical paralysis, also known in Western medicine as functional neurological symptom disorder. Its core cause is psychological stress, such as fright and extreme emotional fluctuations, which leads to unconscious bodily dysfunction.

Fang Yan quickly wrote down his conclusion, then took a deep breath, slowly exhaled, and turned to Zhang Zhongxiao and his family to state his conclusion:

"Based on all of Mr. Zhang's symptoms and medical history, I judge that this problem belongs to the 'Baihe Disease' in traditional Chinese medicine."

"Simply put, it is a deficiency of Yin in the heart and lungs, internal heat disturbing the mind, and malnourishment of the body's meridians, leading to mental stress."

“Nightmares or emotional fluctuations can manifest as physical paralysis.”

"The modern term is 'hysterical paralysis,' which means that psychological factors have caused functional impairment, but brain and nerve examinations are normal, which your test results also support. It matches your 20-year medical history, nightmare symptoms, bitter taste in the mouth and yellow urine during attacks perfectly."

At this moment, He Jingwei, who was standing to the side, asked:
"Why can't it be prickly heat? The patient's onset is sudden and can recover on its own, which is more in line with 'wind syndrome', right?"

Fang Yan looked at his uncle and explained:
"Why not prickly heat? Good question!"

“Prickly heat is more of a wind-related symptom, but look at him, he doesn’t tremble or feel pain.”

"The 'desire to act but inability to act' and psychogenic factors of lily disease can better explain Mr. Zhang's ability to foresee paralysis in his dreams."

After Fang Yan finished speaking, He Jingwei did not ask any further questions. He looked thoughtful.

The other doctors present, who had previously looked puzzled, now nodded in agreement.

After listening, Zhang Zhongxiao said to his family beside him:
"Hysterical paralysis? That name does fit my condition quite well."

PS: After finishing this chapter, I currently owe everyone 13000 words.

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

(End of this chapter)