Rebirth 1977 Great Era

Chapter 1146 You really did have a trick up your sleeve, what kind of ice and fire double attack is this? (Bonus chapter for 3 monthly votes)

“Yes!” Jin Wubing said.

"You have money?" Fang Yan asked the most crucial question.

Jin Wubing shook his head:

"That's not the case."

After saying that, he added:

"But I can find someone to invest."

Fang Yan opened the door to her consultation room and asked him:
Do you have any investment ideas?

"No..." Jin Wubing scratched his head awkwardly, then turned to Fang Yan and said:

"But you decide the investment direction, right? You set the direction, and I'll get everyone to pool their money. That's how universities abroad operate, isn't it?"

Hearing him speak fluently and knowledgeably, Fang Yan realized he was well-traveled and experienced in America, so she said to him:
"You know quite a lot."

Jin Wubing bowed to the dialect:
"Hehe, thanks for the compliment."

"I've never been a good student since I was little, and I always doze off in class. But I can be very interested in anything outside of textbooks."

Fang Yan tilted his head and said after hearing this:
"me too."

Jin Wubing knew that Fang Yan was last year's top scorer in the college entrance examination, so he decisively stated:
"I don't believe it..."

If Fang Yan were like me, how could I have achieved what I have today?

If a top student says they're just like you, you can simply not believe them.

Fang Yan smiled and changed the subject, saying to Jin Wubing:
"But won't your parents feel at ease knowing you're all alone in the country?"

Jin Wubing said:
"Don't worry, I'm completely at ease. They were just afraid I'd go astray abroad, which is why they let me come back."

Fang Yan nodded. That makes sense. There are indeed too many special products in America. It's hard not to be influenced by someone like Jin Wubing.

Jin Wubing said:
"Besides, I'm an adult now and I can handle social issues."

As they spoke, the two entered the consultation room. Fang Yan began to organize his medical records, adding some information to make them easier for An Dong and the others to review.

Seeing that Fang Yan was still adding content, Jin Wubing gave him a knowing look and immediately came over to watch.

Based on the original diagnosis of "inherent weakness and disharmony of Ying and Wei", Ms. Xu's case added the pathogenesis analysis of "blood deficiency and wind invasion, blood stasis" and quoted "Treatise on the Causes and Symptoms of Various Diseases" as saying "when wind evil invades the skin and is further attacked by wind and cold, wind-induced itching and rashes will occur".

The supplementary dialect for the diabetic gangrene (elderly woman) includes details of traditional Chinese medicine surgical procedures:

Draw a simple diagram next to the steps of cleaning rotten flesh, and mark it "The blade is inserted obliquely along the direction of the meridian for 5 fen, avoiding the Foot Shaoyang Gallbladder Meridian (refer to the anatomical location diagram)," and add the note: "The tendon picking method requires precise control of force; too deep will damage the meridian, and too shallow will leave blood stasis."

For external treatment optimization, add the following to the gauze containing comfrey oil:
If the oozing from the ulcer turns yellow and thick, replace it with Sanhuang Ointment containing Scutellaria baicalensis, Phellodendron chinense, and Rheum palmatum to clear heat and promote detoxification.

The internal treatment related information was added after the "tonifying qi and nourishing yin" formula:
"External treatment focuses on removing necrotic tissue, while internal treatment strengthens the body and prevents recurrence. Ginseng and Atractylodes protect the spleen, while Rehmannia and Lycium nourish the kidneys, which aligns with the principle that 'the spleen governs muscles and the kidneys govern bones.'"

The dialect description of multiple sclerosis has been updated with an arrow diagram next to the pathogenesis deduction "dampness and blood stasis intertwined, liver and kidney yin deficiency," which is quite vivid (PS: not sure if the layout is legible):

Dampness obstructing the Triple Burner → Qi stagnation and blood stasis → Failure of clear Yang to ascend (dizziness)

│Loss of muscle nourishment (numbness in limbs)

Prolonged stagnation generates heat, which depletes yin fluids and leads to impaired vision (blurred vision).

Fang Yan then listed some of his own thoughts separately at the end of the medical record:
“Demyelination seems to be related to ‘emptiness of the sea of ​​marrow’. The Ming Dynasty book ‘Jingyue Quanshu’ records that ‘the brain is the sea of ​​marrow, and the gate of life governs it.’ Perhaps we can try using deer antler glue, tortoise shell and other fleshy substances to replenish the essence. We will consider this after observing the efficacy of this case.”

"You can also try using insect medicine to clear the meridians. If the dampness and blood stasis are difficult to resolve, you can try earthworm and ground beetle. However, it is not suitable for the patient due to their weak constitution. Please keep this in mind for future reference."

This stunned Jin Wubing, who then said to Fang Yan:

"Brother Fang, you really did hide something!"

Fang Yan glanced at him. This kid had just said that he was half a master, but now he was calling him brother.

Fang Yan responded to him:

"It's not that I didn't finish recording it before. There's a saying about medical case records: the goal is not to finish the case, but to improve. Ancient Chinese medicine doctors would see patients in the morning and study in the afternoon. In fact, they would summarize their medical cases, examine their treatment plans, and try to improve where possible. If they had any other ideas, they would write them down as well."

"As for why I didn't finish writing earlier, it's because I hadn't thought of it yet, and the patient was waiting, so I didn't have much time to think. The content I added later doesn't actually affect the overall treatment."

Hearing Fang Yan's earnest reply, Jin Wubing nodded thoughtfully and said:
"That makes sense..."

Then he sighed:

"Now I finally know why you're so amazing. It turns out you're always doing these things when no one's around."

Fang Yan was both amused and exasperated, as if he had been secretly doing something shameful.

After Fang Yan finished supplementing the medical record, he checked the time and it was only around eleven o'clock.

There was still about an hour left in his morning clinic sessions. Fortunately, no one came to see him today.

Fang Yan went out and started wandering around the various consultation rooms. Jin Wubing followed him like a shadow, wanting to see if there were any difficult or complicated cases that Fang Yan could solve.

When Fang Yan arrived at Xiao Chengzhi and Deng Nanxing's consultation room, she found it unusually lively. The six-person team from Guangzhou University of Chinese Medicine, who had just arrived, were all there; they hadn't gone to any of the other consultation rooms.

Upon closer inspection, it turned out that Xiao Chengzhi was treating someone.

And it was a difficult and complicated disease that they were examining.

Xiao Chengzhi was clearly stumped, while the others offered suggestions and helped him analyze the symptoms. Seeing Fang Yan arrive, Xiao Chengzhi greeted her:

"Brother Fang!"

Fang Yan asked him:
"Are you having problems?"

After Xiao Chengzhi went to Peking Union Medical College Hospital for treatment, he never asked Fang Yan for help; he solved all the problems himself.

I don't know if it's because I haven't encountered any difficult cases before.

But today was unlucky; we encountered this problem when people from Guangzhou University of Chinese Medicine came to visit.

"It's alright, we're discussing it, it should be resolved," Xiao Chengzhi said to Fang Yan.

No sooner had he finished speaking than a patient's family member said:

"We've been discussing this for over 20 minutes, and we still haven't reached a conclusion?"

For a moment, everyone present was embarrassed.

"How about we send someone else?" the patient asked Xiao Chengzhi.

The people queuing outside also said:
"That's right, there are so many people waiting behind us!"

Seeing that the patients were getting emotional, Fang Yan quickly tried to calm them down:

"Don't rush, I'm the director here, tell me what's wrong."

Upon hearing the dialect, the patient's family member's eyes lit up and they asked:
"Are you Dr. Fang, who speaks dialects?"

"It's me," Fang Yan nodded.

The patient's family member spoke in a dialect:

"Come and take a look, they've been discussing it for ages but haven't come to a conclusion."

Hearing the patient's family's words, Xiao Chengzhi was somewhat annoyed, and Chen Zhongping, who was participating in the discussion, couldn't help but complain:

"The main problem is that the patient took Western medicine first, and then his family gave him Chinese medicine soaked in alcohol to drink, which has complicated the situation."

The patient's family members were immediately displeased upon hearing this and angrily rebuked them:

"Hey, what did you say!"

Fang Yan quickly called out to them:

"Alright, alright, calm down, let me check the situation."

Fang Yan then went behind the consultation table and saw the medical records written by Xiao Chengzhi. The records were quite detailed. Fang Yan took a look and read the contents as follows.

The patient is 32 years old and works as a manager at a nearby cannery. He has been suffering from the disease for a year. Initially, he experienced weakness and heaviness in both lower limbs, which gradually radiated to his lumbosacral region, causing pain in both lower limbs.

The pain has worsened in the past six months, making it impossible for me to walk normally, but there is no redness, swelling or heat in the joints of my lower limbs.

It is also accompanied by yellow urine, hot palms, red tongue with thin and dry coating, and a deep, slippery, and forceful pulse.

I was diagnosed with "lumbosacral radiculitis" at a Western medicine hospital near my home, and the treatment with both Chinese and Western medicine had no significant effect.

They started using traditional Chinese medicine again, specifically a formula to dispel cold. Later, the family used their connections to get tiger bone medicinal wine, but after drinking it recently, it not only had no effect, but the pain actually worsened.

That's why I came to see a doctor today.

Xiao Chengzhi pointed to the records in the medical record, his brows furrowed, and said to Fang Yan:

“Look, the strange thing about this patient’s condition is that cold and heat, deficiency and excess are all mixed up. Normally, the pain in the lower back and sacrum is radiating to the lower limbs, which at first glance seems to be due to cold and dampness obstruction. However, his urine is yellow, his palms are hot, his tongue is red with a thin and dry coating, and his pulse is deep, slippery and strong. This is clearly a sign of heat.”

Chen Zhongping from Guangzhou University of Chinese Medicine chimed in:
"The key point is that after he used the cold-dispelling prescription and tiger bone wine, his pain became even worse. Tiger bone wine is warm and drying, so in theory, it should have some effect if it were a pure cold syndrome. But it made his condition worse, which means that he already had heat in his body. Adding fuel to the fire is like adding fuel to the fire."

Li Hui also pointed to the pulse record:

"That's right, but a deep pulse indicates internal problems, a slippery pulse indicates dampness or phlegm, and a strong pulse seems like an excess condition. But he has been ill for a year and it's been lingering. Could it be a case of deficiency in the root and excess in the branch? For example, yin deficiency with dampness? But yin deficiency usually results in a thin pulse, and his pulse is slippery and strong, which doesn't quite fit."

Fang Yan nodded without speaking, his mind racing with analysis.

Xiao Chengzhi didn't plan to solve it himself at this point. Since Fang Yan already knew, he simply analyzed it for Fang Yan: "What I feel is the most troublesome thing right now is the degree of the mixture of cold and heat. Is it mainly damp-heat obstruction, or is it cold-dampness stagnation transforming into heat? If we treat it as damp-heat and use bitter and cold medicines, will it damage his already potentially deficient vital energy? But if we use warm medicines, his symptoms of yellow urine and hot palms will definitely become more severe. We've been discussing this for a long time, but we're stuck on this step and dare not make a decision rashly."

The patient's family members were anxiously wringing their hands: "Doctor, we don't know anything about cold and heat, we just know that he's in so much pain that he's sweating profusely and can't sleep at night. Can you figure out what's wrong with him?"

Fang Yan said to the patient's family:
"Don't get excited, let me think..."

Just when everyone thought Fang Yan was going to be stumped, Fang Yan stroked his chin and then said:

"It should be heat-related arthritis."

At this moment, Xu Jianqiang said:

"That's not right. As we just discussed, heat arthralgia is characterized by red, swollen, hot, and painful joints, with pain like being burned or stabbed by a knife, which is aggravated by warmth and heat. It is not difficult to identify clinically. His case does not have the above typical manifestations."

He affirmed in his dialect:
"No, it's heat paralysis."

"Yellow urine, hot palms, red tongue, thin and dry tongue coating, and a deep, slippery, and forceful pulse indicate signs of blood deficiency and internal heat, falling under the category of heat-induced arthralgia. The 'Suwen Bi Lun' states: 'Arthralgia, when it is hot, is caused by an excess of yang qi and a deficiency of yin qi, with the pathogenic qi being excessive. Yang qi is affected by yin qi, hence the heat-induced arthralgia.' The deficiency of yin qi indicates blood deficiency; the excess of yang qi indicates excessive internal heat. The excessive pathogenic qi indicates wind-dampness obstructing the meridians."

"Although it does not have the typical symptoms you described, it still shows signs of 'excessive Yang Qi, insufficient Yin Qi, and predominance of pathogenic Qi,' so it is heat-induced arthralgia."

P.S.: Please come early tomorrow.

(End of this chapter)