Rebirth 1977 Great Era

Chapter 584: Osteoarthritis, Trigeminal Neuralgia (Monthly Ticket Plus)

Fangyan looked at the prescription written by Tongrentang over and over again.

The prescription is actually very simple, containing gypsum, raw rehmannia, Ophiopogon japonicus, Anemarrhena asphodeloides, and Achyranthes bidentata.

This prescription is relatively famous. It comes from "Jingyue Complete Works" by Zhang Jingyue of the Ming Dynasty, and is a classic prescription called "Yunu Jian" that is aimed at Yangming real heat and is mainly based on gypsum and rehmannia.

The effect is to clear stomach heat and nourish kidney yin.

It is mainly used to treat stomach heat and yin deficiency syndrome, the symptoms of which are generally headache, toothache, loose teeth, irritability, thirst, red tongue with yellow and dry coating.

Yunu Decoction is designed to clear stomach heat while nourishing kidney yin, and is mainly used to treat stomach heat and yin deficiency syndrome. If the patient has simple Yangming real heat, without any signs of yin deficiency, such as high fever, profuse sweating, thirst, a strong and powerful pulse, and no symptoms of kidney yin deficiency, the use of Yunu Decoction may cause the real heat evil to remain in the body due to the addition of yin-nourishing drugs, making the condition lingering and difficult to cure.

If the patient only shows symptoms of kidney yin deficiency, without symptoms of stomach heat, such as only soreness of waist and knees, dizziness, tinnitus, fever in the five hearts, red tongue with little coating, etc., and no symptoms of stomach heat such as toothache, fever and thirst, the use of Yunu Decoction, in which drugs such as gypsum and Anemarrhena asphodeloides that clear stomach heat may damage the vital energy and aggravate yin deficiency.

In addition, pregnant women should not take it, because Achyranthes bidentata has the function of promoting blood circulation and menstruation, and guiding blood downward. Taking it by pregnant women may affect the stability of the fetus, and there is a risk of causing fetal movement disorder or even miscarriage.

During the period of taking Yunu Jian, you should avoid eating spicy foods, such as chili peppers, peppercorns, mustard, etc. Spicy foods can easily increase heat and generate fire, which is contrary to the effect of Yunu Jian in clearing stomach heat, and may aggravate the heat evil in the body and affect the efficacy of the medicine.

However, all of the above are unlikely to cause the patient's current symptoms, unless the pharmacist picked up the wrong medicine. Otherwise, it is impossible for the medicine in the medicine to cause the patient to be unable to open his mouth.

Fang Yan saw that the patient was getting a little impatient, so he comforted him:
"Don't worry, I'll check it for you."

After careful observation, Fangyan found that the patient had diffuse swelling on the left cheek. The color of the cheek skin looked the same as normal, and it could be felt slightly hot when touched.

After recording the medical record, Fang Yan said to the patient:
"Take my pulse on both hands."

The patient nodded obediently, then stretched out his hand. Fangyan took the pulse of both hands and found that the pulse was strong and tense.

Then Fangyan asked the patient:

"Can you open your mouth a little so I can see what your tongue looks like?"

After hearing this, the girl hesitated for a moment, but still endured the pain and opened her mouth slightly to the width of a finger. It was obvious that this width alone made her very uncomfortable.

He frowned and clenched his fists as he tried his best to endure the pain of opening his mouth.

Fangyan also took this opportunity to check that the patient's tongue coating was thin and slightly yellow.

"Okay." Fang Yan said to her.

After hearing this, the patient immediately closed his mouth and showed a relieved expression.

At this point, Fangyan had a rough idea in his mind, and then asked the patient:
"Do you have a bitter taste in your mouth, dry throat, dizziness, or a painful feeling of fullness in your chest and ribs?"

After hearing this, the patient's eyes lit up and he nodded.

Fang Yan had already confirmed her condition at this time. She was in a state of wind and fire accumulation in Shaoyang.

When the evil wind and fire accumulate in Shaoyang, the Shaoyang meridian qi is blocked, the flow of qi and blood is hindered, resulting in tight blood vessels, thus forming string pulse. For example, just like when a river channel is partially blocked, the pressure on the river channel wall increases when the water flows through, similar to the increase in blood vessel tension forming string pulse.

In addition, the accumulation of wind and fire can easily turn into heat and generate fire. The excess of heat evil inside the body will further accelerate the circulation of qi and blood, causing the pulse to become rapid.

It is like throwing a lot of stones into a calm lake, causing ripples and making the originally calm water flow turbulent. It is similar to the way heat evil disturbs the Qi and blood and speeds up the pulse.

She had both stringy and rapid pulses, plus typical Shaoyang meridian symptoms of fever, bitter mouth and dry throat, dizziness, and fullness and pain in the chest and flanks, so she was diagnosed.

Fangyan now knows the reason why she can't open her mouth, it should be osteoarthritis.

It is a chronic suppurative disease that occurs in the alveolar bone. It is named because after the decay, pus flows out from the mouth or cheeks, like a leak.

In Western medicine, this disease is called: mandibular osteomyelitis.

In the Qing Dynasty, Gao Bingjun's work on Chinese medicine surgery, "Collection of Experiences in Ulcers", it is recorded:
"The symptoms of osteoarthritis can be caused by internal transmission or external transmission."

Translated into plain language, it means: The disease of osteoarthritis can be caused by the transmission of visceral diseases to the inside of the body, or it can be caused by the transmission of external evils to the outside of the body.

It is pointed out that this disease is caused by improper treatment of gum pain, or directly due to unclean oral cavity.

In the earlier Ming Dynasty, a classic Chinese medicine surgical book "Surgery Authentic" written by Chen Shigong, a famous doctor in Nantong, Jiangsu, clearly recorded:
"At first, it occurs in front of the ear and the jaw, with pain in the tendons and bones. After a long time, it gradually becomes swollen, with chills and fever like malaria, and the jaw is clenched, making it impossible to eat."

This patient girl's situation basically fits the description.

Therefore, the treatment plan is to clear away the wind-heat in Shaoyang, detoxify and reduce swelling.

Fangyan immediately started writing the prescription.

6 grams of Bupleurum, 5 grams of Notopterygium, 6 grams of Saposhnikovia, 6 grams of Schizonepeta, 10 grams of Bombyx Batryticatus, 9 grams of Scutellaria, 15 grams of Chrysanthemum, 15 grams of Lonicera, 15 grams of Xanthium, 3 grams of Menthus, 10 grams of Forsythia, 10 grams of Kirinjag, 5 grams of Isatis, 15 grams of Plantago, and 10 grams of stir-fried Gardenia.

In addition, Fangyan prescribed golden ointment, saltpeter, and camphor as external medications to be applied thickly to the affected area.

After writing the prescription, Fangyan handed it to his assistant and said:
"Take the patient to apply medicine first."

"After applying the compress, take the patient to the Chinese medicine pharmacy to get the medicine."

Then Fangyan turned to the patient and said:
"Your current condition has little to do with the medicine prescribed by Tong Ren Tang. It's just that they didn't diagnose the syndrome correctly and failed to clear the Shaoyang wind-heat in your body."

The girl nodded and believed what Fang Yan said.

Then Fangyan gave her another instruction:
"You need to come here and change this external application medicine once a day."

"The clinic here is always staffed after nine in the morning. Any doctor can change your doctor."

The girl nodded, then followed the assistant out.

Then the next one sat directly in front of him without even calling out in dialect.

The patient was a man in his 40s who looked somewhat familiar. He spoke in dialect:

"Hello, Doctor Fang. We met some time ago. Do you remember? Come to our bank to exchange US dollars."

When Fangyan heard this, he immediately remembered that this person was the bank manager who received them that day.

Fang Yan nodded at him and said:
"Well, hello, tell me, where are you feeling unwell?"

The bank manager said to the dialect:

"When I brushed my teeth and rinsed my mouth a week ago, my right teeth felt sore, as if all my teeth were going to fall out, but it only lasted for a moment. At the time, I thought it was because the water was too cold, so I didn't pay much attention to it."

"But then, when I was having breakfast, my right tooth socket suddenly hurt as if someone had hit me with electricity. Half of my right face was in pain for the next two hours, wherever it was touched, I would feel pain."

"After two hours, the symptoms eased and I thought I was well. But when I ate lunch, I immediately felt so much pain that I couldn't open my mouth after taking my first bite."

Speak, the man asked in dialect:

"Doctor Fang, do you think I am in the same situation as the last girl?"

Fangyan shook his head and said:
"No, judging from the location and nature of the pain, as well as the symptoms caused by eating cold meals and drinking cold water, this is not a bone problem. It should be a very typical trigeminal neuralgia."

The man didn't understand either. When he heard the word "nerve", he immediately became nervous:
"Ah, is there something wrong with your nerves?"

Seeing this, Fang Yan smiled and comforted him:
"Don't worry, your condition is much easier to treat than that girl's. I'll give you two injections in half an hour and I guarantee you won't feel any pain while eating lunch."

PS: After updating this chapter, I still owe you 82000 words.

There is also in the afternoon

(End of this chapter)