Rebirth 1977 Great Era

Chapter 1333 Remote Treatment by Telephone: Pregnant Woman Infected with Scarlet Fever (Two Chapters Combined)
"Huang Huijie is in the hospital?" Fang Yan asked, somewhat surprised.

Fang Yan checked her out this morning before she left home. Everything was normal then. She got pregnant a little later than Zhu Lin. Even if she was an older mother, she wouldn't have given birth so early. After all, Fang Yan had been taking care of her health, so Fang Yan thought she knew the situation quite well.

Why were you suddenly hospitalized?

Zhu Lin said to Fang Yan on the other end of the phone:

"Yes, she said she wasn't feeling well and felt uneasy staying at home, so she went straight to the hospital."

"Several doctors at the hospital have examined her, and it seems to be just her nervousness."

"Blood pressure and pulse are normal."

Fang Yan glanced at Lao Hu outside the window. He was still busy arranging dinner for the others, and it seemed that he hadn't called home yet.

He thought for a moment and asked:

"By the way, does she have any headaches, blurred vision, upper abdominal pain, nausea, or vomiting?"

The biggest fear for people with dialects is the onset of eclampsia.

This disease is one of the most serious complications of gestational hypertension, which usually occurs from 20 weeks of gestation to one week postpartum. It is one of the important causes of maternal and infant mortality. If the reactions mentioned earlier appear in clinical practice, we should be highly vigilant and treat them in a timely and standardized manner.

This refers to multiple pregnancies, first pregnancy, and a pregnant woman who is under 18 years of age or over 40 years of age.

Huang Huijie suffered multiple miscarriages and was over forty years old.

This is the first situation that comes to mind when considering dialects.

“No…” Zhu Lin replied.

After she finished speaking, she paused and added:
"But she said she felt a little dizzy. She was fine when sitting, but felt dizzy when standing."

"However, her blood pressure was measured in two different positions at the hospital, and both were normal."

Fang Yan touched his chin after hearing this and said, "Dizziness when changing position, but blood pressure is normal. This situation fits the concept of 'failure of clear yang to rise' in traditional Chinese medicine."

Zhu Lin asked curiously:
"How to say?"

The dialect explanation is as follows:
"She is pregnant at an advanced age, so her blood and energy are naturally weaker than when she was younger. In addition, she has a history of miscarriage, which has depleted her kidney energy to some extent. Traditional Chinese medicine says that the kidney is the foundation of innate essence, which stores essence and produces marrow. Marrow nourishes the brain. If the kidney energy is insufficient, the marrow sea is easily depleted, and the brain is not nourished. She is prone to dizziness with the slightest movement. Furthermore, she has probably been under a lot of stress lately. Emotional stress during pregnancy is most likely to deplete spleen blood. The spleen is the foundation of acquired essence, which is responsible for transporting and transforming qi and blood. If the spleen blood is insufficient, the clear yang qi cannot rise smoothly to the head. When standing, the qi and blood flow downwards, and the blood supply to the head cannot keep up, so naturally she feels dizzy."

He paused, then added, "Another possibility is phlegm and dampness obstructing the body. During pregnancy, the spleen and stomach functions are naturally weaker. She has been eating some nourishing foods with you recently, and her spleen and stomach functions are not as good as yours. Phlegm and dampness can easily get stuck in the middle jiao, like a layer covering the qi. Clear yang cannot rise, and turbid yin cannot descend, which can also make people feel heavy-headed and dizzy, especially when they get up."

"However, she didn't mention feeling heavy-headed or nauseous, so this condition doesn't seem like severe phlegm-dampness. It's more likely due to qi and blood deficiency and failure of clear yang to rise."

"I'll talk to Lao He later and ask him or Lao Zeng and Lao Tao to go and take a look. They can prescribe some formulas to invigorate qi and strengthen the spleen, such as Buzhong Yiqi Tang with modifications, or simply boil astragalus and codonopsis in water and drink it. They can also massage acupoints like Baihui and Zusanli, which should provide some relief."

"The key is to tell her not to keep worrying. When her emotions are stable, her blood and qi can flow smoothly, and her dizziness will be lessened."

Fang Yan can't go back to the city right now, so he can't go to the hospital to see Huang Huijie. But luckily, he still has people in the city, so arranging for them to go and check on her should solve the problem.

“I think you should just call the Traditional Chinese Medicine department and speak directly with her. She doesn’t trust anyone else, so listening to your call is more effective than anything else,” Zhu Lin said to Fang Yan.

From the time she became pregnant until now, Huang Huijie has been consulting Fangyan. Fangyan can clearly analyze any problems she has and provide corresponding solutions, resolving them as quickly as possible. Others are clearly not as efficient. Even if He Puren had come and offered the same solution, Huang Huijie would still prefer to trust Fangyan.

This has now become a habit.

The traditional Chinese medicine techniques spoken in the local dialect are Huang Huijie's source of security.

“Okay, I’ll call her directly later and then have someone go over to take a look at her,” Fang Yan agreed.

After speaking, he paused and asked:
"By the way, are you alright?"

"Of course I'm fine, I'm in good health," Zhu Lin replied over the phone.

Then she instructed Fang Yan:
"You're always thinking about others, but you should think more about yourself. While you're in quarantine at the factory, don't just stay up all night thinking about work. You've been busy all day, so get some rest early at night. Don't stay up all night by yourself."

"Also, if the food delivered from the cafeteria gets cold, ask them to heat it up before eating. And... remember to call home every day. Oh, and don't forget to call your workplace and your superiors..."

"Okay, okay, I remember!" Fang Yan replied, and his wife started nagging.

After hanging up with Zhu Lin, Fang Yan didn't dare to delay and immediately called the Department of Traditional Chinese Medicine at Peking Union Medical College Hospital from her office phone.

After a while, a nurse's familiar voice came through the phone: "Hello, this is the Department of Traditional Chinese Medicine at Peking Union Medical College Hospital."

“Xiao Wen? This is Fang Yan,” Fang Yan replied.

"Director Fang?!" The nurse on the other end of the phone was somewhat surprised.

Without wasting any words, Fang Yan immediately asked:

Is Huang Huijie hospitalized in our department?

Nurse's response:

"Yep."

He said in dialect:

"Let her take the call, and also call our on-duty doctor over. I need to give you a detailed explanation of how to handle the situation later."

"Okay, just a moment." Xiaowen immediately went to find someone.

Footsteps were heard shortly afterward, followed by Huang Huijie's weak voice: "Fang Yan? Is that you?"

"It's me, Sister Huang." Fang Yan softened her tone. "I heard from Zhu Lin that you were hospitalized. How are you feeling now? Is the dizziness still noticeable?"

Huang Huijie sighed softly on the other end of the phone, her voice tinged with grievance and anxiety: "I'm still dizzy. The nurse helped me up to go to the toilet, but as soon as I stood up, my vision went black and my legs went weak, so I quickly sat down again."

"And I just took a nap, and I feel weak all over. I also had a dream that I saw scenes of my child having an accident..."

When are you and Lao Hu coming back today?

Fang Yan tried to keep his tone steady, afraid that Huang Huijie would panic if she heard that he wasn't going back. He said, "Sister Huang, Lao Hu and I are currently in quarantine at his factory. This morning we encountered a child with scarlet fever at Dongfeng Commune. We had contact with the child, and according to the epidemic prevention regulations, we have to be observed for three days to rule out the risk of infection before we can go back. The earliest we can go to the hospital to see you is the day after tomorrow. Safety first."

Huang Huijie on the other end of the phone was visibly stunned when she heard the news.

Fang Yan continued, "..."

"But don't worry, I know your situation best. Just tell me where you feel unwell, and I'll explain your condition to the doctor on duty in detail. I'll order the prescription, and the pharmacy will expedite the decoction so you can drink it in no time."

"You need to tell me the truth now. Besides dizziness, weakness, and dreaming, are there any other discomforts? For example, a bitter taste in your mouth, loss of appetite, heart palpitations, numbness in your hands, or fever?"

There was a few seconds of silence on the other end of the phone. Huang Huijie's voice was hesitant as she slowly said:

"I don't feel anything in my mouth, but I haven't been eating well. I managed to drink a mouthful of porridge at noon, but I feel a tightness in my chest, and I can't swallow it. I also have heart palpitations; my heart was pounding really hard when I was talking to you just now. My hands aren't numb, but I feel a bit hot. The nurse took my temperature and said it was 37°C..."

Fang Yan frowned and began to quickly analyze the symptoms, providing much more information than Zhu Lin had previously provided.

However, he suppressed his analysis and softened his voice to reassure her through the receiver:
"Sister Huang, don't panic. 37℃ is the upper limit of normal body temperature, it's not a fever. Feeling tightness in your chest and palpitations isn't a big problem, we can adjust it. You haven't been eating properly, your stomach is empty, and your blood and energy can't keep up, which is why you feel more and more dizzy as you panic. Relax, these symptoms will be relieved once you take the medicine."

He paused, then deliberately spoke in more detail to give her hope: "The medicine the doctor will give you later is a mild herbal decoction. One dose will be divided into two servings, once in the morning and once in the evening. Drink it warm half an hour after meals, so it doesn't get cold and upset your stomach. Drink it slowly, one sip at a time, don't rush. If you feel a little warm after drinking it, that's the medicine helping to regulate your blood and qi, it's not a bad thing, just drink a few more sips of warm water."

Seeing that Huang Huijie didn't say anything more, only gave a soft "hmm", Fang Yan added, "Now give the phone to the doctor on duty, I'll tell him the prescription and ask the pharmacy to prepare it quickly, so you can have your first dose by evening."

Huang Huijie sounded much better on the other end of the phone, and then handed the phone to the on-duty doctor next to her.

"Hello, Director Fang! This is Zeng Ming." The voice of the on-duty doctor came from the other end of the phone.

"This is a long-time employee," Fang Yan said to him.
“Old Zeng, I just found out about Huang Huijie’s situation. Please write it down.” Fang Yan’s tone suddenly became clear and organized. “Her core problem is ‘deficiency of both spleen and kidney, and malnourishment of the heart and spleen.’ First, she became pregnant at an advanced age and had a history of miscarriage, so her spleen and kidney were already deficient. The spleen is responsible for transportation and transformation, and the kidney is responsible for storing essence and producing marrow. If the spleen is deficient, the production of qi and blood will be insufficient, and if the kidney is deficient, the marrow sea will not be full. That’s why she feels dizzy when she stands and has no strength. Second, she is under stress and overthinks, which depletes her heart and spleen. Deficiency of both heart and spleen will cause palpitations and a feeling of blockage in the chest. Loss of appetite is also a manifestation of spleen deficiency and weak transportation and transformation.”

He paused, then further elaborated on the pathogenesis corresponding to the symptoms: "She doesn't have a bitter taste in her mouth, which means there's no obvious liver stagnation transforming into heat. Her body temperature of 37℃ is just deficiency heat caused by qi and blood deficiency, not actual heat. Therefore, the medication should focus on tonifying without causing stagnation and nourishing without being cloying. Please write down the prescription: Astragalus membranaceus 15g, Codonopsis pilosula 12g, these two are the principal herbs, tonifying qi and strengthening the spleen, helping her to support the foundation of qi and blood production; Atractylodes macrocephala 9g, Poria cocos 10g, strengthening the spleen and removing dampness, solving her problems of food stagnation and poor digestion; Angelica sinensis 6g, a small amount to nourish blood, avoiding excessive tonification of qi and damage to yin; Polygala tenuifolia 6g, Ziziphus jujuba var. spinosa 9g, nourishing the heart and calming the mind, relieving her palpitations and insomnia; add 3g Citrus reticulata peel, regulating qi and strengthening the spleen, preventing the tonifying medicine from stagnating in the stomach, so that she doesn't feel more stagnation after drinking it."

"The dosage must be accurate, especially the angelica and tangerine peel; don't add too much," Fang Yan emphasized. "This prescription is a modified version of 'Gui Pi Tang,' which is gentle and suitable for pregnancy. It can nourish the spleen and kidneys and replenish the heart and blood without being too rich or harmful to the fetus. I'll prescribe three doses first, to be taken for three days, one dose each morning and evening. Go to the ward later and take her pulse and check her tongue coating. If the tongue coating is white and greasy, add 1g of Poria cocos; if the tip of the tongue is a little red, add 2g of Ophiopogon japonicus. Adjust it flexibly."

Old Zeng agreed to each of them on the other end:

"I understand, Director Fang. Astragalus 15g, Codonopsis 12g, Atractylodes macrocephala 9g, Poria cocos 10g, Angelica sinensis 6g, Polygala tenuifolia 6g, Ziziphus jujuba var. spinosa 9g, Citrus reticulata 3g, three doses. Adjust the amount of Poria cocos and Ophiopogon japonicus according to the symptoms. I'll go and write the prescription now and have the pharmacy prepare it quickly so that Ms. Huang can drink the first dose by evening."

Fang Yan added:

"Also, tell the nurses to keep a close eye on Huang Huijie's diet. Order some millet porridge and yam porridge for her from the Yanjing Hotel. Tell the hotel to put it on Lao Hu's tab. The taste should be the same as usual, they know. She should drink it in small amounts frequently, and not eat too much at once. If she still has no appetite, boil some water with 3g of hawthorn and 6g of malt for her to drink as tea. It will help with digestion and stimulate her appetite, and it won't affect the fetus."

“Okay, I’ll go arrange it right away,” Old Zeng replied.

The medications prescribed in this dialect avoid all contraindications during pregnancy, and the dosage is controlled within a safe range, making it a reasonable and safe treatment plan.

Of course, for added security.

After hanging up, Fang Yan immediately called He Puren from the research institute, explained the situation, and asked him to check on Huang Huijie at Xiehe Hospital later to confirm the details.

He Puren immediately agreed and said he would go right away.

He will report the situation to Fang Yan later.

Fang Yan then called Director Liao, the Ministry of Health, Peking Union Medical College Hospital, and the school, explaining the current situation.

However, the leaders were clearly more informed than he thought; they already knew what he was talking about when he spoke of it.

After he finished his call, He Puren called.

“I just came out of Huang Huijie’s ward. She hasn’t taken her medicine yet. Her pulse is a typical ‘weak pulse’. Her right spleen and kidney pulses are especially weak, and her left heart pulse is also deep. This matches exactly what you said about ‘deficiency of both spleen and kidney and malnourishment of the heart and spleen’. I looked at her tongue. It has a pale white coating, her tongue is a little swollen, and there are slight teeth marks on the edges. There is no yellow greasy coating, which means that there is indeed no phlegm-dampness or heat. It is just a simple deficiency of qi and blood and a weak spleen and stomach. She herself said that the porridge she drank at noon still feels like it’s stuck in her stomach and hasn’t gone down. This is clear evidence of spleen deficiency and poor digestion.”

“I just pressed her Zusanli and Neiguan acupoints. When I pressed Zusanli, she didn’t feel any pain, only a soreness and heaviness, which is a sign that the Qi and blood cannot reach the acupoints. When I pressed Neiguan, she said she felt a little bloated, which means that her heart Qi is indeed insufficient and there is slight stagnation, but it is not serious. The ingredients in your prescription, such as Yuanzhi and Chenpi, are enough to clear it.”

“She chatted with me for a few minutes, and her emotions were much calmer than when you called. She was still worried about Lao Hu and asked a couple of questions about the quarantine. I told her that Lao Hu was doing well at the factory and that she shouldn’t worry too much and should take care of herself and the child first. She listened to me, so it seems that your call had a good effect in comforting her.”

“I think your prescription is fine in terms of dosage and combination. It’s all medicines that are safe during pregnancy. The angelica is only 6g, which nourishes the blood without being greasy. The tangerine peel regulates qi without depleting qi. There’s no problem at all.”

"I'll stay for another half hour to observe her after she takes the medicine and see if she feels any discomfort. If everything is fine, I'll go back to the research institute. I'll have Lao Zeng report to me every day afterward, so you can rest assured at the quarantine site."

Fang Yan breathed a sigh of relief upon hearing this and said:
“Okay, I feel relieved knowing you’re going. As long as she stays calm and takes her medicine properly, she should see improvement by tomorrow. Ask the doctor on duty to keep a close eye on her sleep tonight. If she’s still having nightmares, add 1g of jujube seed instead. It won’t affect the overall formula.”

“Okay!” He Puren agreed.

Fang Yan then continued:
"There are still a few days left, could you check on the patients in the mornings?"

“Okay, no problem.” He Puren agreed as before, and Fang Yan had nothing more to say. After hanging up the phone, Fang Yan let out a long sigh.

"call……"

"What's wrong? Are you alright?" Old Hu walked in from outside and asked Fang Yan.

Fang Yan turned around and saw Lao Hu coming. She then told Lao Hu about Huang Huijie's situation. Lao Hu was obviously nervous when he heard this. His wife and children were his biggest worry, and now that they had just started quarantine, a problem had arisen.

"Everything was fine this morning, so what do we do now?" he asked Fang Yan.

"Don't panic. When I examined her this morning, her pulse and spirits were indeed good. Her condition gradually appeared this morning, so it wasn't sudden," Fang Yan comforted him.

Then, to explain:

"Her main problem is that she was already weak in qi and blood during pregnancy, and she was constantly thinking about you and the baby. When her emotions got tense, it brought out her 'spleen and kidney deficiency' problem. It's not an acute illness."

He pulled Lao Hu to sit down in a chair and continued:

"She went to the hospital as soon as she felt unwell. The hospital checked her blood pressure and pulse, which were normal. Her temperature was 37°C, but she didn't have a fever, ruling out dangerous conditions like eclampsia, which is the most crucial thing. Right now, she feels dizzy when she stands, has no strength, and her heart is racing. She only had a sip of porridge at noon and said her stomach felt blocked. These are all signs of insufficient blood and qi supply and weak spleen and stomach function. I have already prescribed a prescription, which is a modified Gui Pi Tang (Spleen-Nourishing Decoction), which she has taken before."

"Astragalus and Codonopsis replenish qi and blood, Atractylodes macrocephala and Poria cocos help with digestion, and Polygala tenuifolia and Ziziphus jujuba seeds are added to calm the nerves. They are all mild medicines that can be taken during pregnancy. The pharmacy is rushing to decoct them, and she can drink the first dose this evening."

“I’ve also arranged her meals. I asked the nurse to order millet porridge and yam porridge from the Yanjing Hotel, and told her to drink them in small amounts frequently so she doesn’t go hungry. He Puren just came out of the ward and said she was much calmer than when I called her. She just asked about you, and I told He Puren to tell her that everything is fine here.”

Seeing that Lao Hu's brows were still furrowed, Fang Yan added, "I've also asked He Puren to help with the morning rounds these past few days and report on the situation daily. He'll let us know as soon as there are any changes. Once our quarantine ends the day after tomorrow, we'll go directly to the hospital to see her. By then, she'll have taken her medicine for two days, and her blood circulation will be better. There's no use in you being anxious now; it will only make her worry more."

"I think this is a good time. You should call her again and have a good talk with her. Tell her not to worry about you and just focus on recovering."

Upon hearing this, Lao Hu immediately picked up the phone and called the hospital.

A little while later, Huang Huijie answered the phone, and her emotions were much more stable than before.

Hearing Lao Hu's words of concern, she reassured him in return.

Right now, Lao Hu couldn't wait to drive back to the city, but he also knew that going to see Huang Huijie wouldn't make any difference and might even bring the virus with him.

He told Huang Huijie, "Don't overthink it. Fang Yan and I will only be in quarantine for three days. As soon as it ends the day after tomorrow, I'll go to the hospital to be with you. Take your medicine and eat well."

Huang Huijie also gave him some instructions from the other side.

After a long, drawn-out conversation and a series of instructions to each other, the two finally hung up the phone.

Old Hu was finally relieved.

Fang Yan then told him about Huang Huijie's situation and explained why things were like this. After listening, Lao Hu basically understood everything and no longer had the urge to rush back to the city to see what his wife was like.

After a while, a car horn sounded outside. Fang Yan and the others went out to see what was going on and found that another group of professors and students had returned.

Professor Yue Meizhong brought them all over, and they are now in quarantine together.

Old Hu went out again to make arrangements for them, while Fang Yan went out to inquire about the situation on Yue Meizhong's side.

Yue Meizhong said:
“I’m not entirely clear on the situation at the brigade level. It’s the epidemic prevention team that’s been notifying them to stay put and wait for treatment. They’re the ones who discovered the problem and reported it themselves, and then the epidemic prevention team came to their homes. After we finished handling the on-site free clinic, we treated some emergency cases that came in. We prescribed Yinqiao Powder with some added cicada slough and purple gromwell for rash relief, and asked the health center staff to quickly decoct the medicine for the children. The epidemic prevention team also has their own medicine, so we organized them to come over. By the way, how are things going for you?”

Professor Wang Yuchuan said:
"We handled the situation collectively outside the commune's grain station, treating a dozen or twenty trainloads of emergency cases..."

He then explained the situation to Yue Meizhong, leaving Yue Meizhong and the group of elderly professors dumbfounded. If the illnesses on both sides were the same, then the situation of the children in the countryside must be dire after they concealed the truth on their side.

People might die.

Fang Yan was talking to Yue Meizhong and Wang Yuchuan about the commune's situation when suddenly a series of hurried footsteps came from the courtyard gate, accompanied by a middle-aged man shouting, "Doctor! Is there a doctor?"

"Help me!"

Several people turned around at the sound and saw a man in a patched cotton-padded jacket rushing into the yard. His trouser legs were covered in mud, his forehead was covered in sweat, and his voice was trembling with anxiety.

He spotted Fang Yan and the other professors at a glance, and immediately rushed over to grab the arm of Yue Meizhong, the oldest among them:

"Are you a doctor? Please come with me to take a look! Xiulan from our village is pregnant. She started having a fever and a rash yesterday. This morning her fever reached almost 40 degrees Celsius, and she also said her stomach hurts. The village doctor said it sounds like scarlet fever. We didn't dare to delay, so we rushed here!"

"Scarlet fever? Pregnant woman?" Everyone was shocked.

Fang Yan and Lao Hu were even more visibly shaken.

Their biggest fear was infecting the pregnant woman in their family with the disease, and now one of them has arrived in the epidemic area.

Fang Yan hurriedly asked:

How many weeks pregnant is the pregnant woman? Besides fever, rash, and abdominal pain, are there any other symptoms?

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

(End of this chapter)