Rebirth 1977 Great Era

Chapter 1279 Another Genius Appears, What Kind of Monsters Are You and Your Disciple? (Two Chapters Combined)
Fang Yan was both amused and exasperated by Wei Guohao's statement.

This guy really has preconceived notions.

He doesn't even understand himself, saying he's from the North and doesn't know anything about the South.

He was genuinely unaware of his own research on the situation in Vietnam.

However, on the other hand, it's clear that Wei Guohao stepped forward to remind himself of this.

He was also afraid that he might have made the wrong judgment on this issue.

The petit mal seizures he mentioned are medically known as "absence seizures," a common type of epileptic seizure. They fall under the category of generalized seizures and are more common in children and adolescents, while being relatively rare in adults.

The characteristic feature is that the patient will experience a brief loss of consciousness during the attack, but it is usually not accompanied by obvious limb convulsions, falls or other severe symptoms, which are easily overlooked or misdiagnosed.

Many people categorize epileptic seizures as convulsions, but there are very clear differences between minor seizures and major seizures.

Minor seizures are short-lived, usually lasting about one minute.

A brief loss of consciousness, with no memory.

There were no obvious twitches in the limbs, only those tiny movements.

The patient can recover immediately after the attack.

A major seizure lasts a long time, usually several minutes.

Complete loss of consciousness, headache, drowsiness and memory loss after the attack, and generalized rigidity and convulsions during the attack.

It takes several hours to recover after an attack.

Childhood seizures are more often related to genetic factors, such as a family history of epilepsy in an older member.

In addition, insufficient sleep, excessive fatigue, drastic mood swings, infection and fever, and incorrect medication may also lead to this condition.

Finally, as Wei Guohao mentioned, this can also happen due to brain trauma, intracranial infection, or parasitic infection.

In the theoretical system of traditional Chinese medicine, the corresponding disease name for epilepsy is "epilepsy disease", also known as "sheep epilepsy" or "epilepsy". Its earliest record can be traced back to the "Huangdi Neijing" and it was also systematically discussed in subsequent classic medical books such as "Jinkui Yaolue" and "Danxi Xinfa". The core pathogenesis is closely related to factors such as "phlegm, wind, fire, blood stasis and deficiency", especially emphasizing that "phlegm evil" is the key pathological basis.

Traditional Chinese medicine believes that "epilepsy cannot occur without phlegm," and that phlegm lurking internally is the root cause of epilepsy.

When phlegm obstructs the brain orifices, leading to malnourishment of the spirit and clouded consciousness, it can cause symptoms such as loss of consciousness and brief loss of mind. If phlegm is further combined with wind (wind is prone to movement and can cause slight twitching of the limbs), fire (fire disturbs the heart and aggravates mental disorder), or blood stasis (blood stasis obstructs the brain collaterals and affects the circulation of qi and blood), the condition will become more complicated.

Fang Yan did not refute Wei Guohao, but instead asked the child's parents:

"Was the child injured or bitten by insects on the way?"

Upon hearing the question about dialect, the child's father replied:
"Yes, on our way back, the child's head was hit, and there were even more insects. You haven't been to the South, there are many insects in the forests there. Some insect bites can make people sick. Our child was bitten on the neck and face by some kind of insect, and then he started to get sick."

Upon hearing this, Fang Yan turned to Wei Guohao, who was standing nearby, and asked:
"So how did you handle it before?"

Wei Guohao said:
"There were no other options on the road at the time, so I could only use the pills, powders, ointments, and other similar items I had with me to keep the child warm."

He asked in dialect:

"Be specific?"

"When I examined the child, his pulse was wiry and slippery, and his tongue coating was white and greasy. It was clear that he had internal phlegm and turbidity, and had also been attacked by external evils from insect bites. I was afraid that the foul air would enter through the bite wound and disturb his mind, so I first gave him half a pill of 'An Shen Wan' (a traditional Chinese medicine formula for calming the mind). I prepared it when I was practicing medicine in Vietnam. It contains Gastrodia elata and scorpion to calm the wind, Pinellia ternata and tangerine peel to resolve phlegm, and a small amount of cinnabar to calm the mind and soothe the nerves. It can suppress the momentum of the phlegm and wind."

He paused and added:
"Afterwards, I saw that the place where the child was bitten was red, swollen and hot. I was afraid that there was heat toxin left. So I mixed the 'Qingdai powder' that I always carry with me with vinegar and applied it to the bite mark, thinking that it could clear heat and detoxify, reduce swelling and relieve itching, and prevent external evil from penetrating deeper."

"Unfortunately, the medicinal materials on the road were limited, so we could only do some emergency treatments and couldn't cure the condition completely. The child still had more than ten seizures a day."

After listening to Fang Yan, he nodded, then reached out and gently touched the bite marks on the child's neck. They felt numb and tingly, indicating that there had been quite a few bites. The child just flinched and didn't cry.

He then asked the child's parents, "After the child was hit on the head, did he vomit or become drowsy? How long after the bite did he start having epileptic seizures?"

The child's mother quickly chimed in, "He didn't vomit that day after the head injury, but he was a little more listless than usual. We thought he was just frightened. About two days after being bitten by the insect, he suddenly started to stare blankly and wouldn't respond when we called him. After a while, he would be fine again. At first, it happened two or three times a day, but then it happened more and more often, and today it's been more than ten times!"

Fang Yan nodded slightly, and then began to take the child's pulse.

Wei Guohao, standing nearby, used his index finger to press horizontally on the radial artery of the child's wrist, corresponding to the "cun, guan, chi" points by different parts of the fingertip, and simultaneously pressed lightly, moderately, and heavily.

He said with some surprise:

"One finger to three checkpoints?"

This traditional Chinese medicine pediatrician has honed his pulse diagnosis skills to a level that's almost like a dialect.

Generally speaking, it's impossible for someone who hasn't practiced to do this.

Fang Yan nodded at him. This Wei Guohao knew about the "one finger, three passes" technique, so he must have been involved in this area before and must have some knowledge of it.

Then, Fang Yan's gaze fell on the child's face, and he began to examine the child by observation. While pulse diagnosis can be one of the core bases for diagnosis in adults, children have poor expressive abilities and their conditions change rapidly. Pulse diagnosis alone is not enough to make a comprehensive judgment. Therefore, traditional Chinese medicine emphasizes "the four diagnostic methods for children should be used together, with particular emphasis on observation."

He first observed the child's expression. Although the child's eyes were somewhat vacant, they still held a glint of light when they occasionally moved, indicating that the child was not absent-minded or distracted. He then nodded gently.

"The child's spirit is still good. Although his mind has been disturbed, it has not been fundamentally damaged, and there is still room for treatment."

He then gestured for the child's mother to gently pry open the child's eyelids to examine the sclera:

"The inner eyelid is light red with no obvious bruising, which indicates that the head injury has not caused serious intracranial obstruction for the time being, which is a good sign."

He then noticed that the sides of the child's nose were somewhat bluish, adding, "However, bluish discoloration of the nose suggests that there is internal wind-evil, which is consistent with the pathogenesis of 'internal movement of wind and phlegm' in epileptic seizures."

While observing the child's condition, Fang Yan carefully examined the child's head, gently pressing various parts of the skull with his fingertips, especially the areas where the child had been hit before. He asked the child's mother, "Did the child cry when I pressed here?" The child's mother shook her head, "No, but sometimes he would scratch behind his ears." Following the child's movements, Fang Yan examined behind the ears and found a slight subcutaneous nodule. He said, "There is slight stagnation here. Although it is not serious, it is one of the factors that can induce phlegm."

The most crucial step is fingerprint examination. In the dialect, the mother is instructed to gently straighten the child's index finger and gently push the skin on the radial side of the index finger with her thumb to make the fingerprint clearly visible.

He bent down to observe for a moment and said, "The fingerprints are purplish and stagnant, reaching all the way to the Qi gate. This is a typical sign of pathogenic factors entering the Qi level and phlegm and heat accumulating internally. Combined with the foul heat and toxins brought by insect bites and the latent phlegm in the body, it leads to frequent seizures of epilepsy."

Then, speaking in dialect to the child:

"Open your mouth, let Uncle see your tongue."

The child looked at Fang Yan with some fear, but didn't make any extra movements.

At this moment, the child's mother said to the child in a comforting tone:

"Stick out your tongue. Uncle is a doctor, he'll treat you."

The child still didn't react and seemed a bit dazed.

The child's parents then said somewhat awkwardly:
"He's been like this ever since he got sick."

He waved his hand in a dialect, indicating that it was okay.

"It's okay if you don't look at it; you can judge from other places as well."

Upon hearing the dialect spoken, the child's parents nodded in realization.

Just then, the child suddenly burst into tears.

For a moment, everyone present was completely bewildered.

"It must be something that's not going on physically." Fang Yan noticed that the child, who was crying with his mouth wide open, had a white, greasy coating with a slight yellow tinge, and the edges of his tongue were a little red.

Now we can hear the child's tongue coating and voice.

A white, greasy tongue coating is a clear indication of internal phlegm and dampness, while a slightly yellow coating suggests mild signs of heat. Red edges on the tongue are a manifestation of heart and liver fire, which corresponds perfectly to the symptoms of mental confusion and restlessness during an epileptic seizure.

The voice wasn't loud, but it was still quite powerful.

A strong cry indicates that the child's vital energy is not weak, which is very important for subsequent treatment.

Then Fang Yan put his mouth close to the child's mouth and smelled it. He found that there was no obvious sour or fishy smell, which indicated that although the spleen and stomach's digestive function was affected, there was no serious stagnation.

The child's sudden outburst of crying shattered the tranquility of the examination room. The parents hurriedly held and comforted the child, but failed to notice that Fang Yan was intently observing the subtle changes in the child's crying.

Instead of rushing to comfort them, he gestured for the couple to calm down: "Don't rush to coax them, let me see."

Upon hearing this, the couple moved aside to let Fang Yan come and see.

Fang Yan frowned slightly. She noticed that when the child cried, it wasn't just a simple tantrum. Instead, his brows were furrowed, and his crying came in waves. When he cried too hard, he would unconsciously scratch his neck and behind his ears.

Fang Yan discovered that this was the area where there had been insect bite marks and subcutaneous nodules before.

More importantly, when a child cries, their head will tilt slightly to one side, and their eyes will occasionally appear briefly vacant.

It was like a warning sign before an epileptic seizure, only shorter in duration than a typical seizure, and was masked by crying.

Fang Yan's gaze sharpened, and she reached out to gently press down on the child's little hand that was scratching his neck. When her fingertips touched the child's neck, she could feel a slight burning sensation under the skin.

To confirm, he switched hands and tested the area. After testing, he turned to the child's parents and said, "Feel the child's neck; is it warmer than other parts of the body?"

The child's mother reached out and touched him, immediately nodding, "Eh? Yes! He's a little hot. I was so focused on comforting him that I didn't notice. What's wrong?"

“That must be why he’s crying,” Fang Yan said.

Wei Guohao, who was standing to the side, also asked curiously:

"How to say?"

Fang Yan glanced at him and said:

"Children's skin is delicate. If the residual filth and heat from insect bites are not cleaned out, they will accumulate under the skin and cause itching and pain when exposed to heat or touched."

"He can't speak, so he can only express his discomfort by crying."

After he finished speaking, he pointed to the child:

"And you see, when he cries, his eyes sometimes become fixed. This is actually caused by the interaction of heat toxins and phlegm, which induces a brief period of restlessness. Although it does not reach the level of a typical epileptic seizure, it is still a manifestation of the condition."

Wei Guohao leaned closer to observe and indeed noticed that the child's eyes would momentarily glaze over between crying spells. He suddenly realized:

"So that's how it is! I was only focused on the epileptic seizure and didn't notice the residual heat from the insect bite. No wonder the child was still restless after the emergency treatment."

Further additions to the dialect:

"Another point is that the white and greasy yellow coating on the child's tongue is more obvious when he cries, which indicates that the flow of qi is not smooth when he cries, aggravating the condition of phlegm and heat accumulation. However, fortunately, his cry is strong and there is no weak breath or hoarseness, which proves that the body's vital energy can still resist the pathogenic factors. This means that although the condition is urgent, the foundation has not collapsed, and the treatment will be much better."

He reached out and gently stroked the child's back, pressing and massaging the acupoints along both sides of the spine a few times, while softly saying to the child, "Don't be afraid, don't be afraid, Uncle will massage you and you won't feel uncomfortable anymore."

Wei Guohao had seen Fang Yan use massage to save people before, and now Fang Yan was using a different massage technique. He immediately started watching carefully. Although he thought Fang Yan didn't know much about the diseases in the South, it seemed that things weren't as he had thought.

As the massage was performed in dialect, the child's crying gradually subsided. Although the child was still sobbing, the child stopped scratching the neck desperately.

The child's parents were both surprised and delighted: "Dr. Fang, he stopped crying as soon as you rubbed him, it's amazing!"

The dialect explanation is as follows:
"This is from massaging the Fengmen and Feishu acupoints, which can slightly disperse the wind-heat toxins on the body surface and relieve itching and pain. However, this is only a temporary relief. The key is to rely on the prescription to clear the phlegm, heat and turbidity in the body."

Wei Guohao exclaimed sincerely, "Director Fang is truly meticulous!"

Fang Yan waved his hand and said:
"Please don't flatter me."

“The core problem of the child is ‘phlegm-heat accumulation, wind-evil disturbance, and unclean turbidity.’ Your previous use of Anshen Pills and Qingdai Powder as an emergency measure was correct, but to thoroughly treat the condition, we must take into account both eliminating the evil and strengthening the body’s resistance, and neither should be neglected.”

Wei Guohao asked:
"So you're already considering treatment?"

When Fang Yan was seeing the doctor, he basically talked about everything he saw. His thoughts followed Fang Yan's, and he still hasn't sorted things out in his mind.

He had barely finished speaking when he spoke in dialect:
"It's actually quite simple. We use Gastrodia elata and Uncaria rhynchophylla to calm the liver and extinguish wind, targeting the 'wind' in epileptic seizures; Pinellia ternata and Poria cocos to dry dampness and resolve phlegm, addressing the root cause of 'internal phlegm accumulation'; and we add Acorus tatarinowii to open the orifices and awaken the mind, improving the child's absent-mindedness symptoms. Considering the residual turbid heat and toxins from insect bites, we added Lonicera japonica and Forsythia suspensa to clear heat and detoxify, which is gentler than the chicken bone grass that Dr. Wei mentioned, making it suitable for the child's delicate spleen and stomach."

He paused, then added: "The child has slight stagnation behind the ear, so I added a small amount of safflower to promote blood circulation and clear the meridians; the slightly yellow tongue coating indicates signs of heat, so I added a little gardenia to clear the heart and liver fire; finally, I used roasted malt and chicken gizzard to strengthen the spleen and stomach, avoiding the cold nature of the medicine from damaging the child's spleen and stomach function... After all, the spleen and stomach are the source of qi and blood production. When the spleen and stomach are healthy, the medicine can be better absorbed, and the regeneration of phlegm can be reduced."

While they were talking, the prescription had already been written in dialect.

After reading it, Wei Guohao said to Fang Yan:

"Has Dr. Fang treated similar symptoms before?"

He said in dialect:

"We've done some research. Is there anything else Dr. Wei would like to add?"

Wei Guohao scratched his head awkwardly. What else could he add? He had previously said that he didn't understand southern diseases due to dialect, but the methods the other person demonstrated clearly exceeded his expectations. They were better than him in both pediatrics and thinking.

If you were to ask him to come, he still hasn't thought it through.

They're probably still thinking about how to stop the child from crying.

My preconceived notions have long since vanished, leaving only my recognition of my peers.

“I think your line of thinking is fine. I misspoke when I said you didn’t know about the diseases in the South.” He quickly tried to make amends.

Fang Yan smiled. The child's parents watched the two talk. Although they couldn't understand the technical terms, seeing that Wei Guohao praised the prescription, their worries were completely relieved.

The child's father couldn't help but ask, "Dr. Fang, how long will it take for this medicine to be effective? Our child has seizures more than ten times a day, and we are really worried."

Fang Yan put down his pen and responded earnestly:

“Traditional Chinese medicine treatment takes time. Generally, after three to five days of taking it, the frequency of attacks should decrease. If you continue taking it for about two weeks, most children's attacks can be controlled to once or twice a day or even less. I will prescribe seven days' worth of medicine for you. Come back for a follow-up visit after seven days, and the prescription will be adjusted according to the child's condition.”

He handed the prescription to the child's mother and carefully instructed her on how to prepare and administer it:

"This medicine is one dose a day, decocted twice, and taken in the morning and evening. Give it to the child half an hour after meals, and only half a bowl each time. Use an earthenware pot to decoct the medicine. Soak the medicine for half an hour first, bring it to a boil over high heat, then simmer over low heat for twenty minutes. Mix the two decoctions together and give it to the child."

"Also, when a child has an attack, make sure he lies on his side. Do not forcibly press him down or put anything in his mouth. Just gently wipe away the drool to avoid choking or suffocation. Try to keep the environment quiet and avoid startling the child. Feed him more millet porridge and mashed yam, and avoid raw, cold, or sweet foods to prevent dampness and phlegm production."

The child's mother carefully wrote down the prescription and repeatedly confirmed, "The medicine should be decocted in an earthenware pot, given after meals, and should not be raw, cold, sweet, or greasy, right?" After receiving a positive reply in Fangyan, she carefully folded the prescription and put it in her pocket, pulling the child's father aside to thank him repeatedly, "Thank you so much, Dr. Fang, and Dr. Wei! We really don't know what we would have done without you."

"Don't mention it, it's what we should do." Fang Yan got up and saw them to the door of the clinic, then added, "The pharmacy is on the east side of the lobby on the first floor. You can get the medicine with the prescription, and it's all free. If your child vomits, has diarrhea, or feels unwell during the medication period, feel free to come to the clinic to see me anytime."

Wei Guohao witnessed the entire process of using dialects to treat illnesses.

The level of dialects they displayed was superior to his, but he was puzzled as to how they managed to do it at such a young age.
In his mind, it was impossible for someone of that age to have such a high level of skill.

The couple thanked him again while holding their child and left, and the consultation room became quiet for a while.

Fang Yan is currently writing a medical case.

Wei Guohao looked at Fang Yan and then said somewhat embarrassedly, "Director Fang, I have really learned a lot today. I shouldn't have made a hasty judgment based on my impression of 'northerners'. Your diagnosis and medication are more meticulous than mine, who has been practicing medicine in the south for many years."

Fang Yan waved his hand: "We're all in the same profession, just learning from each other. Your experience in dealing with insect bites and damp-heat syndrome in the South is also worth learning from. By the way, have you finished your blood test? If you're okay, why don't you sit in the examination room for a while? I might need your help later."

"I've never been to Vietnam either, so I need your guidance on many of my ailments."

Wei Guohao readily agreed upon hearing this.

At that moment, he noticed the child who hadn't spoken a word.

Zhao Zhengyi came to observe today and has maintained the habit of observing more and speaking less; he hasn't said a single word yet.

Wei Guohao asked Fang Yan curiously:

"Why is there a child here?"

Fang Yan glanced at Zheng Yi beside him and said:
"Oh, this is my nephew, and also my apprentice."

"Apprentice? A TCM apprentice?" Wei Guohao was shocked.

Nodding in dialect:

"That's right!"

Wei Guohao said in surprise:
"At such a young age, they probably don't even know how to read, right?"

“Don’t underestimate him…” Fang Yan said with a smile.

He said to his young apprentice, Zhengyi:
"Although I don't know how to read, I've been learning from you for almost a year now, and I've made quite a bit of progress."

“I teach them every afternoon, and his senior brother also explains the medical records I left behind to him. Common illnesses should no longer be a problem for him.”

As for Zhao Zhengyi, we can be sure he speaks in a dialect.

Hearing his master's praise, little Zhao Zhengyi smiled.

They kept a very low profile.

Wei Guohao tentatively asked the child:

"Little friend, could you understand what your master just said?"

“Master said that the little boy’s illness was caused by ‘internal phlegm and heat, wind and evil disturbance, and unclean turbidity.’ The bluish discoloration of his nostrils indicates wind, the purple and stagnant fingerprints reaching the Qi gate indicate heat and phlegm, and the hot feeling on his neck indicates that the poison from the insect bite has not dissipated, right?”

Wei Guohao was stunned. He hadn't expected the child to be able to accurately recount the pathogenesis. His memory and logical thinking were very clear. How could someone this age have such abilities? And how could he match them with the details of observation diagnosis?
He thought for a moment, then deliberately pressed on, "Then tell me, why didn't Master use the chicken bone grass I mentioned, but instead used honeysuckle and forsythia?"

Zhao Zhengyi lowered his head and thought for a moment, his little hands unconsciously clenching into fists as he recalled the knowledge he had learned in the dialect, and then said:

“Master said that children often have weak spleens, and chicken bone grass is too cooling. Eating too much will cause diarrhea and loss of appetite. Honeysuckle and forsythia can also clear heat, but they are not as cooling and can also detoxify, so they won’t harm your little brother’s spleen and stomach. Moreover, Master added roasted malt and chicken gizzard to nourish the spleen and stomach, so that the body can absorb the medicine, right?”

PS: The basic chapter of 6000 words has been updated.

(End of this chapter)