Rebirth 1977 Great Era

Chapter 1372 Traditional Chinese Medicine Powder (Bonus Chapter for Monthly Tickets)
He said in a dialect, "Getting better is the most important thing right now. Your willingness to trust traditional Chinese medicine and cooperate with the treatment is more important than anything else."

Fearing that the family's eagerness for quick results might disrupt the treatment schedule, he deliberately steered the conversation back to the patient's condition: "The core of Ms. Sun's illness is to take care of both internal and external factors. We need to use traditional Chinese medicine to regulate the body internally, replenish qi and blood, reduce internal heat, and clear away blood stasis and toxins to strengthen the body's foundation; we also need to treat the ulcer externally to drain the pus and allow fresh granulation tissue to grow, while also preventing 'false healing'."

Fang Yan picked up a pen and drew a diagram on the medical record to explain: "Look, this sinus tract connects the lumbar spine and the groin. If we just block the ulcer and don't clear the stagnation and toxins inside, even if the surface heals, pus will still flow inside, and it won't be long before it breaks again. So the first step is to 'unblock' it, using Chinese medicine to let the pus and toxins inside drain out, while replenishing qi and blood so that the body has the ability to grow new flesh."

The family members crowded around to look, nodding repeatedly. Ms. Sun's father said:
"Dr. Fang, we'll listen to you! You tell us how to treat it, and we'll do it without rushing you!"

This is exactly the attitude doctors like best, so Fang Yan stood up and went to get the medicine.

The plan is to use Yanghe Decoction internally, and apply Hongshengdan medicine wick externally, along with Badu Powder and ointment.

The original formula of Yanghe Decoction was modified by adding 18g of Polygonum multiflorum and 5g of processed Aconitum carmichaelii to thicken the pus.

Yanghe Decoction is a classic Chinese medicine formula for treating "yin carbuncle".

The prescription is not very old; it comes from "Complete Collection of Surgical Prescriptions" by Wang Hongxu, a physician from the Qing Dynasty.

The formula contains Rehmannia glutinosa, deer antler glue, cinnamon, dried ginger, white mustard seed, ephedra, and raw licorice.

Rehmannia glutinosa and deer antler glue can replenish essence and blood, warm the kidney yang, and solve the deficiency of qi and blood caused by long-term illness; cinnamon and dried ginger warm the meridians and dispel cold and dampness deep in the bones; white mustard seed removes phlegm and dissipates nodules, and ephedra unblocks the meridians and dispels cold. The combination of the two can open the channels of stagnation and pave the way for subsequent pus drainage and detoxification; raw licorice harmonizes the various medicines and moderates their warm and dry nature.

Adding 18g of Polygonum multiflorum can enhance its ability to nourish the liver and kidneys and replenish essence and blood, making up for the deficiency of essence and blood caused by long-term illness. In addition, Polygonum multiflorum can help deer antler glue and Rehmannia glutinosa nourish tendons and bones and promote the repair of lumbar spine lesions.

Adding 5g of prepared aconite can warm and tonify kidney yang, dispel cold and relieve pain. Its warming yang power is stronger than that of cinnamon. It can quickly improve the cold pain in the waist and abdomen, aversion to cold and fatigue caused by yang deficiency and cold stagnation. It can also promote the circulation of qi and blood and help to expel blood stasis and toxins.

The purpose of applying a red cinnabar wick, combined with a detoxifying powder and a plaster, is to draw out pus, remove necrotic tissue, drain toxins, and prevent false healing. (The wick is usually a thin strip of medical gauze, or in some traditional Chinese medicine hospitals, a rolled-up piece of mulberry bark paper or hemp paper. Part of it is inserted into the wound, while part remains outside, absorbing the medication. This not only drains but also helps heal internal wounds.)
Ms. Sun's groin ulcer failed to heal for a long time. The core problem was that there was residual blood stasis and necrotic tissue in the sinus tract. Simply applying ointment could easily lead to "false healing".

Red cinnabar has a strong effect in draining pus and removing necrotic tissue. When made into a wick and inserted into the sinus tract, it can directly act on deep necrotic tissue and promote the drainage of pus.

Combined with the detoxifying powder, it enhances the effects of clearing heat and detoxifying, promoting blood circulation and removing blood stasis, which can reduce pus secretion; the outer layer is covered with ointment, which can protect the wound and prevent external pollution, while maintaining a local moist environment and creating conditions for subsequent tissue regeneration.

This external treatment plan follows the traditional Chinese medicine principle of "unblocking without obstructing" and "unblocking before tonifying," which can effectively eliminate hidden dangers in sinus tracts and prevent recurring ulcers.

This approach is most commonly used in hospital clinical practice to treat perianal abscesses.

Their core pathogenesis is "internal obstruction of blood stasis and toxins, and stagnation of qi and blood".

The only difference is that one is a yin carbuncle caused by yang deficiency and cold coagulation, and qi and blood deficiency, while the other is a yang-type sore caused by excessive heat and toxins.

Furthermore, this recipe will need to be further adjusted in the future.

After initial treatment with Yanghe Decoction, Ms. Sun's symptoms of Yang deficiency and cold stagnation were relieved and pus was initially discharged. She then switched to Tuoli Xiaodu Powder combined with Qinggu Powder to strengthen the body's resistance, remove toxins, clear away deficiency heat, and take Xihuang Pills to detoxify, disperse nodules, promote blood circulation, and reduce swelling.

When the pus in the sinus tract has been significantly reduced and the necrotic tissue has been basically cleared, but there is still a small amount of necrotic tissue or dead space, the external application formula is changed from "Hong Sheng Dan" to external application of Hua Fu San, Jiu Yi Dan and other medicated wicks for drainage.

Finally, when Ms. Sun's sinus tract closed and the ulcer was basically healed, she was given Simiao Decoction to invigorate her Qi and strengthen her spleen, thus consolidating the therapeutic effect.

This is the treatment approach that uses dialect to gradually progress. The main reason is that her condition is much more serious than a perianal abscess. Eight years of illness is not easy to treat, and the biggest fear with this is that the toxins are not completely eliminated, resulting in a false healing.

Then it will be like the situation after Western medicine surgery, where problems arise again after treatment.

After writing down the prescription, Fang Yan arranged for the nurse to prepare it. He was about to apply the external dressing to Ms. Sun.

The nurses quickly went to the traditional Chinese medicine pharmacy to prepare it.

"We're going to insert a medicated wick for you in a bit. You'll feel a slight soreness and swelling, but just bear with it. We'll change the dressing once a day after that. When we change it, we'll take out the old wick and put in a new one so that the pus can continue to drain." Fang Yan said to Ms. Sun while the nurse went to prepare the medication.

Ms. Sun asked, somewhat bewildered:

What is a wick?

Instead of using technical terms, Fang Yan took the gauze strip next to him and explained in layman's terms while demonstrating: "Look, this medicated wick is actually a 'thin strip of cloth soaked in medicine.' First, sprinkle the medicine powder that can help you drain the pus onto the gauze strip, then cut it into a thin strip. In a moment, gently insert it into the depth of the ulcer in your groin."

Fearing that Ms. Sun might still be worried, he added, "It has two uses: First, it can slowly 'bring out' any pus and necrotic tissue that hasn't been completely drained, just like using a small tube for drainage; second, the medicine on it can work directly inside to help clear away any residual toxins and prevent them from 'hiding' inside and causing recurrence. Also, a small section will remain outside, so you can easily pull it out when you change the dressing next time, without having to go through any extra trouble."

"Think of it as a transfer station for the 'wound' inside. It cleans up the garbage and delivers medicine to treat the disease. It's much more effective than just applying ointment on the outside. This way, you can avoid the situation where the surface heals well but the inside is still damaged."

Ms. Sun suddenly realized what was happening and asked in the dialect, "Does it hurt?"

She was actually more concerned about this: stuffing gauze soaked in medicine into her flesh—that might hurt a bit…

He spoke to the patient in a dialect:
"It doesn't hurt normally, but it might hurt a little when changing the dressing. However, we change the dressing quickly so it won't hurt too much, and we'll try to make you suffer as little as possible."

At this moment, the nurse brought over the external medicine, and Fang Yan was about to insert the wick into Ms. Sun's mouth.

Soon she will be able to experience what it feels like.

When Fang Yan saw the nurse come in with the treatment tray, he first helped Ms. Sun adjust her position, making her lie on her side with her left groin facing up and a soft pillow under her waist, which would reduce the pressure on her lumbar spine and allow the ulcer to be fully exposed.

"Let's lie down a little more comfortably, relax your waist and abdomen, don't tense up, the more relaxed you are, the less uncomfortable you will feel." He gently comforted Ms. Sun while tucking her clothes in.

The nurse placed the treatment tray beside the bed, with everything neatly arranged on it:

The gauze wicks coated with red mercury powder were cut thinner than chopsticks, about 5 centimeters long, with a 1-centimeter gap at one end for easy handling. There was also a small square dish containing saline solution, sterile tweezers, sterile cotton swabs, and a small packet of detoxifying powder and red ointment.

Fang Yan first picked up a sterile cotton swab, dipped it in saline solution, and gently wiped the skin around the ulcer, her movements as light as brushing away dust: "Let me clean it for you first. It's a little cold, just bear with it."

Ms. Sun subconsciously tensed her legs, and Fang Yan noticed, stopping his movements and patting her knee.

"Don't be afraid. See, it doesn't hurt when I wipe with the cotton swab, right? I'll apply the medicine wick just as gently later."

As he spoke, he gently lifted the old gauze at the ulcer with sterile tweezers. The gauze that Ms. Sun had applied herself was still oozing pale yellow pus. He folded it in half and put it into a medical waste bag.

The next crucial step is inserting the wick.

Fang Yan gently picked up the blank end of the medicated wick with tweezers, making sure the end with the medicine was facing down, and first lightly touched it on the edge of the ulcer to let Ms. Sun get used to it: "It's about to start, just for a little while."

His eyes were fixed on the ulcer, his wrist slightly lowered, and the medicated wick, like a fine needle, was slowly inserted into the sinus tract. The movement was so slow that it was almost imperceptible. Every time he pushed it in 1 centimeter, he would pause and ask Ms. Sun, "How is it? Is it soreness or pain?"

Ms. Sun bit her lip and whispered, "It's a bit swollen and painful, like something is slowly pushing it..." Fang Yan breathed a sigh of relief and continued to push it in slowly: "Swelling is normal, it means the medicine wick is going in and slowly loosening the pus inside."

He stopped when only 1 centimeter of the medicated wick remained outside the body. He gently adjusted its position with tweezers to ensure it wasn't crooked, then carefully sprinkled some detoxifying powder around the ulcer with a cotton swab: "This medicine can help reduce pus and allow the toxins inside to drain more smoothly."

The final step is to apply a red oil ointment.

Fang Yan dipped a piece of sterile gauze in warm red ointment and gently placed it on the ulcer, then secured it with medical tape. The tape was specially cut narrow so it didn't stick to the surrounding sensitive skin. "Okay, all done. Try turning over slowly and see if you feel any discomfort?"

Ms. Sun slowly turned over, touched the gauze in her groin, and whispered, "It doesn't seem... as painful as I imagined, but it's still a little swollen."

As expected of someone who has been ill for eight years, their pain tolerance is indeed stronger than that of the average person.

Fang Yan nodded: "The swelling means the medicine is starting to work. The pus will slowly drain out along the wick in a little while. Remember, I will come to your ward tomorrow morning to change your dressing. Don't touch the gauze yourself. If you feel very swollen or have any other discomfort, tell the nurse immediately."

Ms. Sun nodded repeatedly.

Next, Fang Yan said to them:

"Alright, let's go to the inpatient ward with the nurse now!"

"There will be medicine to drink later. They will bring it to the ward once it's brewed."

The patient's family members nodded repeatedly upon hearing this.

Then they prepared to push Ms. Sun out the door, and at this moment, Ms. Sun's father didn't forget to say something in the dialect:

"By the way, Dr. Fang, when are you going to coordinate the building donation?"

"I keep my word."

PS: I've gained another 100 monthly votes, so after finishing this chapter, I still owe everyone 65,000 words. There will be more this afternoon.

(End of this chapter)