Rebirth 1977 Great Era

Chapter 583: Pediatrics is difficult to treat, the girl was ruined by her old boss

"Her temperature is highest in the morning, at 39 to 39.5 degrees, and slightly lower in the afternoon, at 38 to 38.5 degrees."

"When I sleep at night, I sweat all over my body. Especially around my neck and head."

"When you have a high fever, the rest of your body will be hot, but your limbs will be cold."

"We previously sought treatment from Director Qi Yong of the Pediatrics Department at the Yanjing Hospital directly under the Ministry of Health. He specializes in pediatrics, but he was not cured..."

The patient's family members spoke about their child's condition in dialect and also mentioned the hospital where they had been treated before.

When Fang Yan heard the name Qi Yong, he immediately thought of what Old Deng had said. He said that his grandfather's eldest disciple was called Qi Yong, and he was also the director of the pediatric department in this hospital. (See Chapter 407)
If what they said was correct, the child in front of him should be the one who was not cured by his grandfather's eldest disciple and was then sent to him.

Pediatrics is a difficult subject in traditional Chinese medicine.

Children are full of vitality and develop rapidly, just like the rising sun, the sprouting of plants, their organs are delicate, and their physical energy is not yet fully developed.

This means that their internal organs, limbs, bones, qi, blood, body fluids, etc. are in the process of continuous growth and development, and have not yet reached the maturity and perfection of adults.

For example, children’s spleen and stomach functions are relatively weak, and their ability to digest and absorb food is far inferior to that of adults. They are prone to indigestion and food accumulation problems.

Moreover, children's skin is delicate, and their defense function is not strong, so they are easily invaded by external pathogens and become sick.

Therefore, the disease in children is easy to spread quickly.

Due to their imperfect body functions and weak resistance, once they are invaded by external evil spirits, encounter climate changes and improper diet, they are likely to develop diseases.

Moreover, the disease progresses and changes very quickly, and the transformation from cold to heat, deficiency to excess is likely to occur during the course of the disease.

For example, if a child’s cold is not treated promptly and correctly, it may quickly develop into more serious symptoms such as pneumonia and cough.

Therefore, there is a saying in traditional Chinese medicine: Children are prone to weakness or excess, cold or heat.

Excessive symptoms can easily turn into deficiency symptoms, and cold symptoms can quickly turn into heat symptoms.

In addition to their physical constitution, which changes very quickly in the face of illness, children of this age, especially infants and young children, also have a big problem when expressing their symptoms and communicating their condition.

Children who cannot speak can usually only express themselves through crying.

If you are not a doctor who has specialized in pediatrics, it is difficult to directly obtain the correct key information from the patient.

Moreover, there are many differences in the four examinations for children.

For example, when taking a child's pulse, the Cun, Guan and Chi parts are quite short and the pulse beats fast, so it is difficult to accurately distinguish subtle changes in the pulse like an adult. In addition, children often cry and become restless when seeing a doctor, which can cause the pulse to become more disordered and interfere with the doctor's judgment of the true pulse.

There are also some children with extremely low cooperation, just like Old Chen’s grandson last time. He was completely uncooperative and even spit. It was almost impossible to observe their tongue quality and tongue coating.

In addition, when parents are highly concerned about their children's condition, they all hope for a quick recovery.

So the general pediatrician needs to face crying children and extremely anxious parents. You can imagine the pressure.

Pediatrics is also one of the key departments for medical disputes.

Finally, children have large differences in weight and height and are in the growth and development stage. It is impossible to use the same dosage as adults for different age groups, so doctors need to make a careful consideration.

Communicate with the patient's family as much as possible before treatment.

Ask for more details and some details of the treatment by the previous doctor, who was his grandfather's eldest apprentice.

After understanding and communicating these details.

Fangyan then turned his gaze to the child.

This child has been suffering for a month now. He has lost the energy to cry and makes a fuss. He looks listless and listless. His facial skin is dark and unhealthy, with a yellowish and dark color as if covered by a layer of haze. To Fangyan, he feels like a withered plant that has lost water, without any life or vitality.

The dialect was whispered softly, causing the little girl to stick out her tongue.

She was stunned for a moment, and then actually did as she was told.

She stuck out her tongue, and Fangyan saw that the tongue coating was thin and clean, there were teeth marks on the edges, and the tongue was light red and moist.

After checking the dialect, he said to her:
"Good boy! Let me feel your pulse again."

The little girl cooperated and stretched out her hand.

Then Fangyan took the little girl's pulse. A child's pulse is difficult to judge, so Fangyan took a longer time than before and finally determined that the pulse was rapid and strong.

Then Fangyan remembered and asked whether the child's urination and defecation were normal.

The parents replied that everything was normal.

Then, Fangyan started thinking quickly in his mind.

Based on the situation of adults, the normal tongue coating is thin, white and evenly distributed, with moderate dryness and wetness, clings to the surface of the tongue and cannot be wiped off.

A thin and clean tongue coating means that the tongue coating is thinner and the tongue texture can be faintly seen, which is usually a sign of normal stomach qi.

This indicates that the spleen and stomach functions of the human body are basically normal and can transport and transform the essence of water and grain normally, allowing the stomach qi to rise to the surface of the tongue to form a normal tongue coating.

In the absence of other obvious symptoms, a thin, clean tongue coating is a sign of good health or a mild illness.

But now this child has nothing to do with normality.

There are traces of teeth on the edge of the tongue, which is mostly caused by the enlarged tongue being pressed by the edge of the teeth. Therefore, tongue with tooth marks is often seen together with enlarged tongue, which is mostly caused by spleen deficiency and internal retention of water and dampness.

Spleen deficiency cannot transport and transform water and dampness, which causes water and dampness to stagnate inside the body, and then causes the tongue to become enlarged and form tooth marks due to being squeezed by the teeth.

A pale red tongue indicates that the Qi and blood are in balance. In a normal body, the Qi and blood are abundant and flowing smoothly, which is reflected in the pale red color of the tongue.

If the tongue is moist, it means that the body fluid is sufficient, which is due to the balance of body fluid metabolism, that is, the spleen and stomach transport and transform water normally, the lung's function of spreading and descending, and the kidney's function of evaporation and gasification, which together maintain the tongue's moisture. The condition of the tongue coating indicates the potential problem of spleen deficiency or internal water retention.

This situation may be caused by recent improper diet, such as overeating of raw, cold, and greasy food, which damages the spleen and stomach, or by a humid living environment, which allows external moisture to invade the human body and affect the spleen and stomach's function of transporting and transforming.

In addition, the pulse beats quickly but lacks strength.

A rapid pulse generally indicates heat syndrome. However, when combined with a weak pulse, it is not a symptom of excess heat but a manifestation of deficiency heat.

This may be due to the deficiency of Yin fluid in the body, which is unable to control Yang, resulting in a relatively hyperactive Yang Qi, internal generation of false heat, and the stimulation of Qi and blood circulation, resulting in a rapid but weak pulse.

For example, excessive fatigue, long-term illness and damage to the yin may lead to yin deficiency and internal heat, resulting in this pulse pattern.

Combining the tongue and pulse, the tongue is pale red and moist with a thin and clean tongue coating, which is a relatively normal phenomenon. However, there are tooth marks on the edge of the tongue, indicating spleen deficiency.

Plus she had a high fever for a month.

If the disease is treated according to the condition of an adult, Fangyan would definitely believe that it is a disease caused by the excess of evil.

But after the conversation with the child’s parents just now, I learned that my grandfather’s eldest apprentice also treated the child in the same way.

So dialect immediately rules out this possibility.

Then I thought of another possibility.

It cannot be viewed as an adult disease, but should be considered in light of the child's immature yin and yang constitution.

If that is the case, another judgment immediately appeared in Fangyan's mind.

That is, her Ying is weak and cannot protect herself internally, and her Wei is weak and cannot protect herself externally. Both the Ying and Wei are weak, and the yin and yang are out of balance.

This is the root cause of the child's long-term fever.

To cure a disease, one must first treat its root cause. Although this child has had a long-term high fever, it is only an illusion. We must start with harmonizing the Ying and Wei systems, and assist with invigorating Qi and suppressing Yang, to prevent the Yang from becoming uncontrolled and leading to sudden death.

In other words, the key point of treating this disease is to strengthen the body. According to the physical characteristics of children with immature yin and yang, "Suwen. Qi Tongtian Lun" records:

"The key to yin and yang is that yang is solid."

This means that yin and yang are interdependent and complement each other. If the yang energy in the human body is not dense, it will not be able to protect the yin energy, causing the leakage of yin fluid and the disruption of the balance between yin and yang.

The Yellow Emperor's Classic of Internal Medicine mentions that "Yang Qi is like the sky and the sun. If it loses its place, life will be shortened and not obvious." It compares Yang Qi to the sun in the sky, vividly illustrating the importance of Yang Qi to life. If Yang Qi cannot be dense, external evils will easily take advantage of the opportunity to enter and cause various diseases.

That is to say, if the body's Wei Yang is weak, the skin will not be dense and firm, the body fluid will leak out, and the Yang Qi will be lost along with the loss of Yin fluid. When the deficiency Yang floats to a more serious degree, there will be a critical situation where the Yin and Yang Qi are exhausted and lost to each other.

This child had a long-lasting high fever, but his limbs did not become warm. In addition, his complexion was dull and his body was thin, all of which were manifestations of insufficient Qi and Yang.

Moreover, his parents also said at the beginning that sweat would naturally flow out from his neck and head when he was sleeping, which was a condition of Ying Yin loss.

High fever means that Yin cannot suppress Yang, and the tongue is moist, which shows that Yin is not seriously damaged. So judging from the dialect, she has Qi deficiency and Yang decline, and the Ying and Wei are not in harmony. It is a true cold and false heat syndrome, and the method of treating heat with heat should be used.

Although Fangyan had a lot of thoughts, only a dozen seconds had passed in the outside world.

Just when the child's parents wanted to ask Fangyan if he had any clue, Fangyan had already started writing the prescription.

This time, the dialect selected is the classic prescription Guizhi Longgu Muli Decoction from Zhang Zhongjing's Synopsis of the Golden Chamber, which is used to harmonize yin and yang and calm the mind. It uses a large amount of Astragalus, and also adds cooked aconite and ginseng root.

The dialect was written on the prescription: 5 grams of roasted cinnamon twig, 10 grams of raw white peony root, 5 grams of roasted licorice root, 30 grams of calcined dragon bone and oyster shell, 20 grams of processed astragalus, two slices of ginger, 5 red dates, 10 grams of cooked aconite, and 10 grams of ginseng root.

Speaking in dialect, he handed the recipe to the assistant beside him and said:

"Arrange for hospitalization. Take five doses of this prescription, one dose per day, divided into several doses."

After that, he said to the patient's family:
"Also, I stopped taking all the medicines I was taking."

The patient's family asked:
"You're not going to take the fever-reducing medicine anymore?"

The dialect said:

"Stop all other treatments and just trust me."

The patient's family looked at Fang Yan for about two or three seconds, then they were moved by his eyes and nodded repeatedly:
"well!"

Fang Yan turned around and called out to the people behind him:
"Next person."

As soon as the voice fell, a girl in her 20s came up. She didn't say anything, but took a notebook and wrote quickly on it:

"Three days ago, I had pain in my left mandibular molar, accompanied by chills and fever. I went to a nearby clinic to see a Chinese doctor, who diagnosed me with Yangming heat. The doctor prescribed this prescription for me. After taking the medicine according to the prescription, I couldn't open my mouth. In order to eat, I could only open it one finger wide at most. It was very painful and I couldn't chew. I could only drink some liquid food."

After saying that, the girl took out a prescription and placed it in front of Fangyan.

Then Fangyan saw the three big red words "Tong Ren Tang" on the list at first glance.

This sight made Fangyan’s scalp tighten immediately.

He really didn't expect that not long after he left, the two old men from Tongrentang would make such a big move.

Looking closely, the prescription contained large doses of gypsum and rehmannia.

The dialect is really hard to understand. How could this little thing make the girl unable to open her mouth?

PS: The 6000-word basic chapter has been updated.

There will be more updates later.

Also, I would like to ask, do you like this kind of treatment process which is described in a little more detail?

(End of this chapter)