Chinese medicine: from rural hospitals to top three hospitals in Kyoto

Chapter 929: Poisonous Evil

The early morning in Kyoto was a little chilly after the beginning of autumn. Chen Yang had just finished his morning rounds at Kyoto City Hospital of Traditional Chinese Medicine when he was stopped by Wen Haodong.

"Chen Yang, there is a patient with a complicated condition. Can you help me take a look?"

Wen Haodong's face was solemn: "The Western doctor has done various tests, but still can't find a clear cause of the disease, and the symptoms are still getting worse."

Chen Yang followed Wen Haodong into the ward and saw a male patient in his forties lying on the bed. He had a sallow complexion, sunken eye sockets and weak breathing.

Wang Li, the accompanying wife, had red eyes and held her husband's hand tightly.

"The patient's name is Zhang Liwei. Half a month ago, he suddenly developed fatigue, weight loss, and fever. He thought he had a cold, but it didn't get better after taking medicine. Later, he developed oral ulcers and joint pain. In the past three days, he has become confused and has ecchymosis on his skin and mucous membranes."

Wen Haodong quickly introduced his condition: "I have seen a Western doctor before. The blood routine showed a decrease in white blood cells and platelets, abnormal liver and kidney function, and autoantibody testing showed positive antinuclear antibodies, but the specific type was unclear. Western medicine considered connective tissue disease, but the treatment effect was not good."

Chen Yang walked to the bedside and first observed the patient's complexion and tongue coating.

The tongue is red, with little and dry coating, and there are multiple ulcers on the surface of the tongue.

Then I reached out and touched the patient's skin. It was hot and the bruises did not fade when pressed.

Then he took the patient's hand and began to feel his pulse, which was thin, rapid and stringy.

"Mrs. Zhang,"

Chen Yang asked gently, "Did your husband have any special experiences before he became ill? For example, did he come into contact with any chemicals, visit an epidemic area, or have major emotional fluctuations?"

Wang Li thought for a moment and choked up as she said, "He was a researcher working in a laboratory, but the protective measures were always very strict. A week before he became ill, something went wrong with the project he was responsible for, and he stayed up all night for several days in a row, which was very stressful."

"Laboratory? What exactly are they researching?" Chen Yang asked.

"It seems to be about the toxicity test of some new polymer material..." Wang Li said uncertainly.

Chen Yang's mind moved. Considering the symptoms and occupational exposure history, this might not be a simple connective tissue disease.

Chen Yang then carefully examined the patient's mouth and joints and found that in addition to the ulcers, there was slight swelling in the interphalangeal joints, but no deformity, which was consistent with the symptoms of "heat arthritis".

"Second brother."

Chen Yang looked at Wen Haodong: "From the perspective of TCM syndrome differentiation, the patient's Qi and Yin deficiency is the root cause, and the internal heat and toxicity and blood stasis are the symptoms. Fever, oral ulcers, and red tongue indicate intense heat and toxicity; fatigue, weight loss, and a thin and rapid pulse indicate Qi and Yin deficiency; ecchymosis and joint pain indicate blood stasis blocking the collaterals. However, the cause may be related to occupational exposure, and further investigation of the history of exposure to toxins or chemicals is needed."

"We have asked the Western medical department to conduct a toxicology test, but the results are not out yet."

Wen Haodong said: "I have also asked about the patient's medical history and occupational history. This is the first time I have encountered such a chemical poisoning situation. Currently, Western medicine's hormone and immunosuppressant treatments are not effective, and the patient's condition is getting worse..."

For many Chinese medicine practitioners, even some skilled ones, the more unfamiliar the disease is, the more difficult it is to treat.

For example, some new chemical infections, chemical poisoning, etc.

Wen Haodong’s level is not bad, but he was a little confused for a moment.

"I still think too much."

Chen Yang smiled and said, "In fact, no matter what the cause of the disease is, the cause and history are one aspect, and the clinical diagnosis is another."

"What do you mean?" Wen Haodong asked.

Chen Yang smiled and said, "From the perspective of traditional Chinese medicine, the patient is overworked. Without considering chemical exposure and other aspects, based solely on pulse and symptoms, the treatment principles can be to replenish qi and nourish yin, clear away heat and detoxify, and activate blood circulation and remove blood stasis. However, it needs to be adjusted according to the dynamics of the disease."

Chen Yang picked up a pen and paper and began to prescribe: "American ginseng 15g (decoction separately), Ophiopogon japonicus 12g, Schisandra chinensis 9g, Gypsum gypsum 30g (decoction first), Anemarrhena asphodeloides 12g, Scrophularia ningpoensis 15g, Cortex moutan 12g, Paeonia lactiflora 12g... Prescribe three doses first, one dose per day, decoct in water and take warm in two doses."

“Shengmai San combined with Baihu Tang with modifications.”

Wen Haodong took a look at the prescription.

"good."

Chen Yang said: "Maisan nourishes qi and yin, Baihu decoction clears qi and heat, add Scrophularia, Cortex Moutan, Red Peony Root and other herbs to cool blood and activate blood circulation. Pay attention to the heat when decocting the medicine. Gypsum must be decocted for half an hour first, and American ginseng must be decocted separately before adding to ensure the efficacy of the medicine."

"In fact, whether it is chemical substances or food, they are all poisonous evils. Modern science has many classifications. As a Chinese medicine practitioner, you should not be misled by some things in clinical practice. Just because something sounds new, you will feel confused."

Chen Yang smiled and said to Wen Haodong: "In fact, whether it is chemical substances or radioactive damage, it has existed since ancient times, but it has not been clearly named."

"Tsk."

Wen Haodong smacked his lips and said, "What's wrong with your brain, kid?"

Wen Haodong then asked, "If that's the case, then what do you mean by asking for a toxicology test?"

Chen Yang glanced at Wen Haodong and said, "If we know what it is, we can also determine its toxicity and prescribe the right medicine. Does Chinese medicine detoxify without knowing what the poison is?"

Wen Haodong: "......"

"At least we have to understand the properties. We have to understand whether it is warm, cool, cold or hot, right?"

Chen Yang smiled and said, "In martial arts novels, there are seven insects and seven flowers. If the order is not right, the poison cannot be detoxified. Chinese medicine is not omnipotent."

That night, Chen Yang returned to the dormitory and repeatedly studied Zhang Liwei's case. Western medicine examinations showed that his autoantibodies were positive, but no clear diagnosis could be made. This reminded him of the concept of "hidden evil" in traditional Chinese medicine - toxic evil lurks in the body, and when it encounters a trigger, it damages the qi, blood, body fluids, and blocks the meridians and internal organs.

Wen Haodong: "..."

The results came out in the afternoon. Based on the results, Chen Yang added a small amount of traditional Chinese medicine with detoxifying effects to the original prescription.

"The dosage must be strictly controlled. You must pay attention to the patient's condition at all times to avoid harm." Chen Yang instructed Wen Haodong.

The next morning, Chen Yang went to check on Zhang Liwei's condition first.

The patient's temperature dropped slightly, but he was still confused, and the ecchymosis had not subsided. His pulse was still fine, but the stringiness was slightly reduced.

"The medicine has taken effect, but the heat and poison are still strong, and the Qi and Yin are seriously damaged." Chen Yang said to Wen Haodong: "We still need to strengthen the detoxification and Yin nourishment."

说着陈阳又在原方基础上做了调整：西洋参增至 20g，加金银花 30g、连翘 15g 增强清热解毒；加生地 15g、石斛 12g 加强养阴生津；同时加入半枝莲 12g、白花蛇舌草 15g，这两味药现代研究显示有一定的解毒和调节免疫作用。

Chen Yang specifically reminded: "However, these two herbs, Scutellaria barbata and White Flower Snake Grass, are bitter and cold, so they cannot be used for a long time. Adjust according to the situation after three doses."

"Okay, I understand." Wen Haodong nodded.

Chen Yang is teaching his second uncle step by step.