Rebirth 1977 Great Era

Chapter 887 Do X-ray Results Matter? High-Risk Aplastic Anemia (Two Chapters Combined)
“Then I have a question,” Lu Ziwu said after hearing Fang Yan’s words.

"What's the problem?" Fang Yan and everyone else looked at him.

Lu Ziwu said:
"That's the X-ray taken in Hong Kong, which shows a secondary infection of a pulmonary cyst and anemia. Should we just ignore it?"

The dialect was actually prepared for this long ago.

The other party will most likely say that.

I had already mentally prepared how to respond.

He said to Lu Ziwu:
"Traditional Chinese medicine takes symptoms and signs as the core of diagnosis. Your spouse's symptoms of fever, vomiting, weak pulse, pale tongue with white coating are signs of deficiency of both qi and blood, cold stagnation and blood stasis, which are not directly related to the 'pulmonary cyst' shown on the X-ray."

“As I said before, if I don’t refer to the diagnosis from Xiangjiang Hospital, I can’t diagnose any problems with her lungs now. So the focus is on treating the deficiency of qi and blood and the invasion of cold pathogens after the induced labor, rather than targeting the lung cysts in the X-ray results.”

"And as you said, your wife has no history of contact with the rubber factory, and antibiotic treatment has not been effective, which is very likely a misdiagnosis by the Western medicine side."

After speaking in dialect, he also offered Lu Ziwu a solution:
"If you're really worried, I suggest you go to Peking Union Medical College Hospital for an X-ray first, and then decide whether or not to use my treatment plan."

Before Lu Ziwu could even speak after hearing the dialect, his wife spoke up first:

“I don’t trust Western medicine anymore. They just mess things up. I originally thought it was a minor problem, but after so long of treatment, I still haven’t gotten better. I’ve spent so much money and made myself like this, and I still haven’t improved.”

“Look at the results they gave us. They just made wild guesses after hearing about our business. I even suspect that they might have given us someone else's X-ray.”

"Looking at it now, what Dr. Fang said earlier actually makes more sense, at least it was related to me at the beginning,"

Upon hearing his wife's words, Lu Ziwu said:

"Oh dear, I didn't say I didn't trust Dr. Fang. He cured Xiaoqin and so many overseas Chinese businessmen, and he still has a 100% cure rate. Of course I trust him. I just wanted to ask if we should pay attention to the results of the previous X-ray. Look at you, you're getting all worked up again."

At this moment, Old Ren said to them:

“Prolonged and excessive use of antibiotics not only interferes with the recovery of the body's vital energy and aggravates the state of cold coagulation and blood stasis, but also damages liver and kidney function. The X-ray may have been a misdiagnosis, or it may have been because the lungs did develop problems due to the use of these drugs at the time. It’s hard to say.”

"However, I still believe in Fang Yan's diagnostic skills. Since he hasn't diagnosed any problems with his lungs yet, it's highly likely that there are no problems. I understand that you're really worried. Getting an X-ray will put your mind at ease and save you from worrying and arguing about it later."

"After all, a good mood is also an important indicator of recovery in Traditional Chinese Medicine..."

After hearing what Mr. Ren said, the couple both looked at him.

They didn't know Mr. Ren.

Now that I hear what the other person is saying, it makes a lot of sense, so I want to know Mr. Ren's identity.

Fang Yan then recited Mr. Ren's resume.

The couple were quite shocked to hear that Fang Yan was out for a medical appointment and that such a high-ranking person was accompanying him.

But if the bigwigs have said that, then there must be a reason.

Lu Ziwu said to Fang Yan:

"Dr. Fang, please prescribe the medicine first. We'll pick it up at the hospital ourselves and get an X-ray while we're at it."

He's quite good at talking.

By the way.

Fang Yan smiled and didn't pay much attention to it.

I've been wondering when this kind of thing could happen in reverse.

When the Western medical examination results came out, the patient couldn't believe it.

Then they insist on going to traditional Chinese medicine practitioners with the results in mind, and only believe in the results from traditional Chinese medicine practitioners.

Fang Yan thought about it and concluded that the probability of this happening was extremely small at present.

Next, Fang Yan prescribed a treatment for them.

Angelica sinensis 9g, Ligusticum chuanxiong 3g, Prunus persica 3g, Zingiber officinale (soaked) 3g, Glycyrrhiza uralensis (processed) 3g, Carthamus tinctorius 9g, Schizonepeta tenuifolia (charred) 3g, Cynanchum paniculatum 9g.

This formula combines ginger and safflower to warm and dispel cold, and peach kernel and chuanxiong to invigorate blood and remove blood stasis.

Angelica sinensis nourishes the blood, while charred Schizonepeta tenuifolia stops bleeding and prevents excessive blood circulation.

Baiwei clears deficiency heat, counteracts the drying properties of warming herbs, and avoids damaging yin.

The prescription closely addresses the patient's pathogenesis of deficiency of both qi and blood, and cold stagnation of blood. It integrates the essence of classic prescriptions such as Sheng Hua Tang and Wen Jing Tang, and combines cold and heat in a balanced way. It not only warms and unblocks the flow of blood and removes blood stasis, but also stops bleeding and replenishes deficiency.

After it was all set up, Fang Yan said to them:

"Since we're going to the hospital anyway, let's just take our luggage downstairs and go straight to the hospital to get admitted. There will always be medical staff there to take care of us."

"Although the staff here have undergone rigorous training, they cannot record and track your physical condition. In your case, you still need someone to pay attention to and take care of you at all times."

"Besides, it's relatively close to my home, so I can get there as quickly as possible if there's any problem."

Upon hearing this from the dialect, the couple exchanged a glance and then nodded in agreement.

"Okay, I'll do as Dr. Fang says."

"Let's go there now."

After speaking, he carefully put away the prescription that Fang Yan handed over.

Then he took a red envelope from the drawer and stuffed it into Fang Yan's hand.

"I came in a bit of a hurry and didn't know what Dr. Fang liked. This is just a small token of my appreciation. Please buy whatever Dr. Fang likes."

Fang Yan didn't say much and simply accepted it.

"That's thoughtful." Fang Yan nodded with a smile.

Without even looking at the amount, they simply accepted it.

Afterwards, they packed their things to go to Peking Union Medical College Hospital, and Fang Yan said goodbye to them before heading out to see the last patient.

This time they weren't on the same floor. After leaving, the waiter led them back onto the elevator, up to another floor, to a noticeably better floor.

The reason why speaking in the dialect is obviously better is because the doors here have become the double doors that open from the side, like the suite where the Ma family lives in Block A.

Although the texture isn't as elaborate, the door is already different from the ones below.

"Knock knock knock," the waiter knocked on the door.

Then he shouted:

"Miss Yang, Dr. Fang has arrived."

A few seconds passed.

no response.

Then the waiter knocked again:

"Miss Yang??"

Still no response.

Fang Yan asked the waiter:
Who's inside? Is there only one person?

The waiter said:
"No, three people lived there."

That's strange, what's going on?
"Is he asleep?" Xiao Chengzhi asked suspiciously from the side.

He asked in dialect:

Is it a suite inside?

"It's the kind where you walk in and there's a big main hall, and the bedroom is next door?"

The waiter nodded.

"Then there's probably no one in the main hall. If we knock louder, they should hear us." Fang Yan made this judgment as he walked to the door and slammed his hands on it twice.

It looked like he wasn't using much force, but the sound was incredibly loud, leaving everyone dumbfounded and wondering how he managed to do it in dialect.

"I'm coming!"

A woman's voice came from the room.

Then the door opened, and a woman in a business suit with short hair opened it.

She looked a bit disheveled; her trousers were rolled up and part of them were wet.

She was barefoot, without shoes or socks.

Fang Yan noticed a trail of wet footprints on the carpet behind her, clearly indicating that she had just come out of the bathroom.

"Miss Yang, Dr. Fang has arrived." The waiter introduced Fang Yan to the short-haired woman.

Fang Yan realized that he had never seen the other person before, and wondered if it was another one who had rushed back last night?

"Hello Dr. Fang, I'm Ms. Xiong's assistant, my surname is Yang." She extended her hand and shook hands with Fang Yan.

After letting go of her hand, Fang Yan tentatively asked:
"Ms. Xiong Jing from Singapore?"

Assistant Yang said:
"Yes, please come in first."

Upon hearing this, Fang Yan called out to the people behind him, and then they all entered the room together.

This Xiong Jing is in the shipping business.

Her husband owns several boats, and she brought her daughter back for medical treatment.

Last time, at the same table with Fang Yan and the others was a widow from a shipbuilding company in Singapore, who had also come back with her daughter for medical treatment.

After entering the room, Fang Yan pointed to Assistant Yang's bare feet and asked:
What happened to you?

Assistant Yang said:
"Oh, Ms. Xiong fell asleep in the bathroom while taking a shower. I was helping her get up. I didn't hear you knocking on the bathroom door earlier."

"..." Everyone looked at each other in bewilderment. Did he fall asleep while taking a bath in broad daylight?
What kind of schedule is this?

At this moment, a sound came from the bedroom inside:

"Dr. Fang, please wait a moment, I'll be done inside soon."

“Okay, no problem,” Fang Yan replied.

Secretary Yang rushed into the room, where Xiong Jing greeted her, saying:

"Don't worry about me, you make coffee for Dr. Fang and the others."

Fang Yan saw Secretary Yang run out barefoot to prepare the coffee that needed to be heated and extracted with an alcohol lamp. Fang Yan quickly said:
"No need for that, tea will do."

"Is that all of them?" Secretary Yang asked.

"Yes, all of them." Fang Yan looked around at the people and nodded.

Everyone sat down on the sofa in the room, and only then did they have time to look around. This place was basically a simplified version of the 16th floor of Building A.

The room's furnishings didn't seem particularly luxurious, but they were still noticeably different from the floor below.

Meng Jimin squeezed the sofa and said to Fang Yan:

"Hey Lao Fang, this sofa is pretty comfortable. When are we going to get one for our home?"

Fang Yan touched the sofa and said:

"Too many flowers, and they can't withstand dust, so they need to be cleaned frequently. They're all show and no substance."

After saying that, he added:

"Especially since you have a lot of kids, this sofa is very likely to break."

Upon hearing Fang Yan say this, Meng Jimin and the others who had initially been interested immediately changed their minds.

Only then did Old Ren whisper to Fang Yan:

Do you know what kind of patient this is?

Fang Yan shook his head:
"I don't know, but I've met the patient's family at their banquet." Fang Yan then briefly and quietly explained Xiong Jing's situation.

The people around were just enjoying the spectacle.

After a while, Secretary Yang's tea was ready.

It's a type of Longjing tea that's relatively hard to find. It's not that you can't buy it here, but it's a bit expensive, and most people don't particularly like drinking tea, so they've only heard of it and seen it on the counter, but haven't actually tasted it.

The tea leaves casually placed in the room here are of this quality, which shows that the standard of hospitality here is quite high.

Everyone took a sip without making a sound.

Hmm... it smells faintly like soy milk.

Only Old Ren seemed to be enjoying himself, Fang Yan looked calm, while the others looked at the cup with some suspicion.

I suspect that the cup may have contained soy milk and wasn't washed properly.

After pouring the tea, Secretary Yang went to the bedroom to help.

Just then, Comrade Cheng Baogui whispered:

"You guys think it's inappropriate for three women to come in with a bunch of us men?"

Upon hearing this, Elder Ren said with profound insight:

"It's better to have more people; the fewer people, the worse."

Aside from the dialect, everyone looked at Old Ren with curiosity, still somewhat confused about what was going on.

Fang Yan drank his tea and said:
"When it comes to private medical treatments involving patients of the opposite sex, maintaining openness and having multiple witnesses not only protects the dignity of the patient but also ensures the occupational safety of medical professionals. Traditional Chinese medicine has always emphasized the separation of men and women, especially when it comes to the patient's physical privacy, such as in gynecology and acupuncture, where the presence of a third party is required to comply with ethical norms. In modern times, it is also the open and transparent environment that can prevent gossip."

When Mr. Ren heard Fang Yan's explanation, he nodded in satisfaction. "This child is so insightful!"

He said to the others:
"Understand?"

Everyone suddenly realized what was going on.

With nothing else to do, Fang Yan took out the red envelope that Lu Ziwu had just given him.

It was distributed to everyone.

Take what you need, and we'll split the money.

Everyone was a little embarrassed about the second distribution.

However, they still managed to get the dialect into their hands.

At times like these, dialects should especially showcase their generosity.

Let everyone know the benefits of following him.

After the money was distributed, everyone knew, though no one said it, that they had run into each other today.

You might actually run into someone at other times.

Everyone here is smart; they'll keep it to themselves and won't brag about it when they get back.

The main problem is that there's no way to show it off.

The Ma family's affairs must be kept secret; it's best if even family members don't tell.

A few minutes later, things were finally done in the bedroom.

Xiong Jing and Secretary Yang came out and said to Fang Yan and the others:

"Oh dear, I'm so sorry to have kept you waiting!"

"I didn't sleep at all last night. I was going to take a shower to wake myself up today, but I ended up falling asleep in the bathtub. I'm so sorry."

He said in dialect:

"It's alright, I understand you're not used to sleeping well here."

"Shall we take a look at the patient first?"

Xiong Jing said:

"She just woke up and is still in bed. Also, the child's Chinese isn't very good; she can only understand some simple words. You can ask me directly."

Fang Yan nodded.

Then he invited everyone to go to the next bedroom.

When we got here, we found that this place was also simply furnished.

It's considerably smaller than Building A.

Although everything is still there, the area is much smaller.

There were quite a few of them, and it was noticeably crowded when they came in.

When I was treating Ma Wenying, there were a group of people in the room and it didn't feel crowded at all.

Fang Yan was thinking that Ma Wenying might be better off in this room.

But the next second his gaze fell on the child on the bed.

The little girl, about ten years old, had swelling in her head and face, her complexion was pale and dull, the sclera of her eyes was yellow, and her lower limbs, which were exposed outside the blanket, also showed signs of edema.

According to the Chinese medical text "Suwen", all swelling and fullness due to dampness belong to the spleen. In children, this condition indicates spleen deficiency and impaired function, causing dampness to overflow into the skin. If accompanied by aversion to cold and fatigue, it may also be due to kidney yang deficiency and impaired qi transformation.

A pale and dull complexion indicates a deficiency of qi and blood, resulting in insufficient blood nourishment of the face.

In traditional Chinese medicine, scleral yellowing falls under the category of jaundice, which is further divided into yang jaundice and yin jaundice.

That is, damp heat and cold dampness.

Based on the patient's edema, Fang Yan immediately diagnosed it as jaundice, which is likely due to cold-dampness trapping the spleen or liver and gallbladder stagnation.

With just one glance, these thoughts popped into Fang Yan's mind.

At this moment, Secretary Yang took out a file bag and handed it to Xiong Jing.

The latter opened it and handed it to Fang Yan.

"Dr. Fang, this is my daughter's diagnosis report."

"So much?" Fang Yan looked at the report that was handed to him; it was almost as thick as a magazine.

"Over the course of two years, I visited many hospitals and underwent numerous bone marrow aspirations..." Xiong Jing said in the dialect.

I saw the same diagnosis on several reports.

"Aplastic anemia?" Fang Yan read.

Aplastic anemia, or ASA for short, is a bone marrow failure syndrome, mainly characterized by decreased bone marrow hematopoietic function, pancytopenia, and syndromes of anemia, bleeding, and infection.

It is divided into two types: primary and secondary.

Primary aplastic anemia: The cause is unknown, but it may be related to genetic factors, and some patients have a family history of the disease.

Secondary aplastic anemia: It is caused by a variety of factors, such as drugs like chloramphenicol and sulfonamides, as well as exposure to chemical toxins like benzene and its derivatives. In addition, ionizing radiation and viral infections such as hepatitis viruses and parvovirus B19 can also cause it.

Clinically, patients typically present with progressively worsening symptoms such as paleness, dizziness, fatigue, palpitations, and shortness of breath, followed by petechiae, ecchymosis, nosebleeds, gingival bleeding, and menorrhagia.

In severe cases, internal bleeding may occur, such as vomiting blood, bloody stools, bloody urine, and intracranial hemorrhage.

Because of the decrease in white blood cells, patients are prone to infections, such as respiratory infections, oral infections, and perianal infections, which manifest as fever, cough, sore throat, oral ulcers, and perianal abscesses.

It's somewhat similar to the fox spirit disease that Fang Yan had encountered before.

This is what Western medicine calls Behcet's syndrome.

Aplastic anemia is prone to complications such as oral ulcers and perianal abscesses due to leukopenia, which overlap with the mucosal ulcers of Behçet's syndrome.

All of these conditions cause multi-system involvement in the body. In severe cases, aplastic anemia can be accompanied by visceral bleeding such as hematemesis and melena. Behçet's syndrome can also affect the digestive tract (such as Fang Yongxiang's gastric ulcer in chapter 695), all of which exhibit characteristics of systemic disease.

However, in traditional Chinese medicine, aplastic anemia is mostly classified as a deficiency syndrome with blood deficiency, and the diagnosis is mainly based on spleen and kidney deficiency and insufficient qi and blood.

Fox-like illness falls under the category of damp-heat and toxic evil. For example, Fang Yongxiang's oral ulcers and genital sores were caused by the accumulation of damp-heat and the transformation of toxins. (See Chapters 695 and 698.)
This similarity is only a local correlation at the symptom level, not an equivalence in the pathological essence.

The disease is usually diagnosed through blood tests, and as Xiong Jing mentioned, bone marrow biopsy.

This young girl underwent multiple bone marrow biopsies for diagnosis, and she couldn't help but frown when she heard the local dialect.

This has already started happening overseas, with people switching to a different hospital for a checkup.

Fang Yan looked at the reports; each one described a puncture.

As Fang Yan flipped through the diagnostic report, Xiong Jing continued:
“We have been treating the child with both traditional Chinese and Western medicine for two years, but the child’s condition has not improved much. Currently, the child is only able to survive through blood transfusions, and has recently developed jaundice.”

At this moment, Secretary Yang came over, took out a report, handed it to Fang Yan, and said:
"She has 90 red blood cells per cubic millimeter of blood, 2800 white blood cells per cubic millimeter of blood, and 2 platelets per cubic millimeter of blood."

"Liver function tests were conducted. The results showed a jaundice index of 50 units, a thymol turbidity test result of 10 units, a zinc sulfate turbidity test result of 8 units, and an alanine aminotransferase (ALT) value of 85 units."

"Huh?" Fang Yan was taken aback; he had been a seasoned report reader in his past life as well.

As soon as Secretary Yang said that, he sensed something was wrong.

This data... is very serious!
A routine blood test showed that her red blood cell count was 90/mm³, while a normal child's count should be around 380-500 million.

Next, her white blood cell count was 2800/mm, while the normal range should be 4000-10000.

A platelet count of 2/mm is even more outrageous. A normal child's platelet count should be 15 to 40. She has pancytopenia.

In addition, the jaundice index was 50 μmol/L, while the normal value should be <17.1, and the transaminase level was 85 U/L, while the normal value is <40, which suggests concurrent liver damage.

If this isn't done correctly, problems will arise immediately.

Fang Yan felt a chill run down his spine. It turns out he was a high-risk patient all this time.
Cheng Baogui and Mr. Ren also noticed the problem.

One is Zhang Xichun's grand-disciple who once worked at Tianjin Hospital, and the other is an academic bigwig.

The two of them visibly became serious.

All eyes turned to the dialect.

However, he didn't make a fuss about Fang Yan, and instead asked Xiong Jing:
What are the child's usual behaviors like?

He went to the child's side, took her hand, and said to her:
"Stick out your tongue."

The child could still understand those three words. He glanced at his mother and then stuck out his tongue in the dialect.

The tongue is pale red with a thin white coating.

After considering it for a moment, Xiong Jing said:
"The child has swelling in her lower body, yellowing of her skin, and low-grade fever in the afternoon. She often feels dizzy, tired and weak, has palpitations and shortness of breath... Oh, right, she also said that her mouth tastes bitter."

Fang Yan nodded, and after feeling the pulse on the left, he began to feel the pulse on the right.

At the same time, he asked:

"What about eating and using the restroom?"

Xiong Jing said:

"I don't like to eat, and my stool is loose and unformed."

After a while, Fang Yan finished taking the pulse, and Old Ren couldn't help but ask:

"How about it?"

"His pulse is weak and thready," Fang Yan said, standing up.

After saying that, he picked up the child and, under Xiong Jing's astonished gaze, said:
"Let's go downstairs and go to the hospital together."

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

There will be an extra chapter later.

(End of this chapter)