Rebirth 1977 Great Era

Chapter 1152 So what if he's tricky? Following Brother Fang's advantages are showing! (Bonus chapter for monthly votes)

As soon as the announcement ended, the crowd fell silent for half a second.

"Wow!"

Then the scene erupted in excitement, with a rustling sound. Some people clutched their pencil cases, some took a deep breath and straightened their collars, and some quickly took out their admission tickets, which displayed the contents.

Lin Xueqin held up her admission ticket and waved it:
"I'm in the third exam room. Is anyone coming with me?"

The next second, four or five students from Capital Medical University responded. They nodded to each other, quickly gathered together, and headed towards the examination room.

Fang Yan and his group were assigned to the first and second examination rooms. More than twenty people lined up, with Song Jianzhong at the front, still reciting, "What are the external symptoms of Yangming disease..."
Wang Zhijun, who was standing nearby, complained:
"Stop memorizing, or you'll make a mistake and write the wrong lines later."

Outside the examination hall, two teachers in Zhongshan suits stood guard at the door, holding lists to check the admission tickets.

One of the teachers, wearing gold-rimmed glasses, looked up, saw Fang Yan, and nodded slightly.

Fang Yan remembers that this is someone from the research institute.

He nodded in response.

There were thirty wooden tables in the exam room, spaced far apart. On each table was an ink bottle and half a new eraser. I glanced at my watch; it was 8:55.

Fang Yan found his seat, the third row by the window, with his name pasted on the corner of the table.

I had just sat down when the proctor walked in carrying a stack of manila envelopes.

"Everyone, sit down." The head teacher's voice was loud and clear as he placed the envelope on the podium. "The written exam will last one and a half hours. It will test your understanding of the four classic texts and your clinical practice. No talking or whispering, and no leaving early. Raise your hand if you have any questions. Don't move around or look around."

He paused, looked around at everyone, and finally lingered on Fang Yan.

I recognize him by his dialect; he is Geng Jianting, a leading authority in traditional Chinese medicine otolaryngology in China.

He is also a member of the editorial board of the Chinese Pharmacopoeia and one of the editorial board members of the Chinese Materia Medica Processing Science, which is led by Fang Yan.

In his youth, he co-founded the "Shanghai Guanghua Medical Journal" with Ding Zhongying, Ding Jimin, Zou Yunxiang, Ren Yingqiu, and Dong Demao.

The fact that the proctors are all such top-notch individuals shows just how important the postgraduate entrance exam is.

At 9:00 AM sharp, the exam papers began to be distributed.

The envelope made a slight "rustling" sound when it was opened, and everyone tensed up.

After receiving the test papers, the expressions of the people present varied. Fang Yan had already received the paper, unfolded it, and scanned the questions with his eyes.

He then glanced at the class and the others. Most of them visibly breathed a sigh of relief. These questions were tricky, but not far from what Fang Yan had predicted.

Then Geng Jianting explained the requirements for answering the questions to everyone.

Next, everyone was asked to fill in their names and categories, and then everyone began answering questions.

The exam paper was densely packed with questions, yet every single one followed the line of "rooted in classic texts and applied clinically," perfectly aligning with the approach of analyzing the dialect over the past few days:

The first question comes from the "Huangdi Neijing Linglan Secret Canon": "Please combine the statement 'The liver is the general's organ, from which planning and strategizing arise' to analyze the pathogenesis of hemiplegia and slurred speech in stroke patients, and explain why Tianma Gouteng Decoction is often used in the acute phase."

The question was followed by a brief explanation: The patient has a history of hypertension, and suddenly experienced slurred speech, weakness in the left limbs, and flushed face and eyes. At this moment, a clear solution was already forming in Fang Yan's mind.

After thinking for a moment, I began to write:
The phrase "When a general loses his post, wind and fire disturb the mind" describes a condition where the liver, responsible for regulating the flow of Qi, becomes excessive. This is like a general wielding too much power, causing Qi and blood to surge upwards in disorder. The brain, the abode of the spirit, becomes slurred and difficult to speak when disturbed by wind and fire. Furthermore, the liver governs the tendons; malnourishment of the tendons and vessels leads to hemiplegia. In the Tianma Gouteng Decoction, Tianma and Gouteng calm the liver and quell wind, like subduing a restless general; Shijue Ming (a type of abalone shell) suppresses yang, like defending a city; and Niuxi (a type of achyranthes root) guides blood downwards, like channeling rebellious troops. This perfectly aligns with the principle of "strategic planning arising from harmony."

After writing this, he added a slightly deliberate sentence about clinical observation:

"These patients often suffer from constipation, so cassia seeds are often added to the prescription to help soothe the liver and regulate bowel function, which is consistent with the idea that 'the liver and large intestine are internally and externally related'."

The second question focuses on the differential diagnosis in the "Treatise on Febrile Diseases": "The patient has 'fever and chills, with more fever than chills and a weak pulse,' which is easily confused with 'Taiyang wind-stroke' in clinical practice. Please point out the differences between the two in terms of etiology, pathogenesis, and treatment, and list the corresponding prescriptions."

A simple diagram of the pulse was drawn next to it, though the drawing was somewhat abstract.

Fang Yan continued writing the answer:
Taiyang stroke is due to wind-cold attacking the exterior, causing disharmony between Ying and Wei (nutritive and defensive qi). The pulse is floating, slow, and forceful. Treatment should focus on inducing sweating to release the exterior and harmonize Ying and Wei, using Guizhi Tang (Cinnamon Twig Decoction). However, in this case, the pulse is weak, indicating a pre-existing Yang deficiency. Using Ma Huang (Ephedra) and Guizhi (Cinnamon Twig) to forcefully induce sweating might violate the principle of "deficiency of deficiency." The underlying cause is insufficient Yang Qi and external wind-cold invasion, a pathogenesis of "Taiyang cold damage combined with Yang deficiency." Treatment should focus on warming Yang and releasing the exterior, using Guizhi Er Yuebi Yi Tang (Cinnamon Twig and Two Yuebi Decoctions) with modifications, or adding Huangqi (Astragalus) to strengthen Yang and consolidate the exterior, ensuring moderate sweating so that the pathogen is expelled without harming the body's vital energy.

While Fang Yan was writing furiously, everyone else was still reviewing the question.

As soon as he answered the question in dialect, everyone glanced at him and quickly picked up their pens to start writing. Who cares, it's already this late, just write down whatever comes to mind.

Fang Yan answered quickly, soon moving on to a topic combining classical medical texts with clinical practice. He provided a passage from the *Qianjin Yaofang* (Essential Prescriptions Worth a Thousand Gold Pieces) about diabetes: "Diabetes, when it flares up, is caused by kidney deficiency. Each flare-up is accompanied by sweet-smelling urine." He was asked to first translate the passage, then, using modern clinical examples, explain the connection between "kidney deficiency" and diabetes's polydipsia, polyuria, and weight loss. Finally, he was asked to list the processing methods for three commonly used kidney-tonifying herbs.

He didn't stop speaking in his dialect, and his pen wrote rapidly.

Soon, the questions were answered by Fang Yan. Geng Jianting couldn't help but take a look. Fang Yan's handwriting was neat, his thoughts were clear, there were no corrections, and his answering speed was quite fast. This was not surprising, as that was how he usually answered. What surprised him was that the other students in the classroom seemed to have some Fang Yan's style. Although they were not as fluent as him, they were not stumped by the questions on the test.

Upon closer inspection, all of them were Fang Yan's classmates. Remembering that they had been selected through the college entrance examination last year and had even spent more than a month with Fang Yan at Peking Union Medical College Hospital, Geng Jianting immediately understood.

Next, everyone gradually got to the final, most challenging question.

This question best demonstrates a deep understanding of regional medical principles:

"In the north, earthworms and ephedra are often used to treat asthma, while in the south, perilla seeds and radish seeds are commonly used. Let's analyze the differences in medication from the perspective of 'regional climate affecting physical constitution,' and provide a clinical case to support each."

Aside from the dialect, the students in their class were completely stumped. The earlier parts were fine, but when it came to medical cases, that was a different story. Who would come across such medical cases for no reason? They could only answer the earlier ones, and either didn't answer the later ones or made them up.

As everyone can see, this is a question designed to differentiate scores.

Only the students in Fang Yan's class, who had heard Fang Yan talk about many similar medical cases in his lectures, were not alarmed when they saw this question. Instead, they quickly started writing it down.

The advantages have finally become apparent.

Especially when they see others pausing to think while they are writing, they know that this is the moment when the score gap will finally widen.

The hour-and-a-half written test seemed to pass by exceptionally quickly; some people hadn't even finished writing before the papers were being collected.

Geng Jianting said loudly:

"Everyone stop writing, stand up, and immediately follow the teacher to the meeting room for the next interview."

P.S.: That's all for today. Please come back early tomorrow.

(End of this chapter)