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

"Mr. Wen's granddaughter, Wen Manlu, is also Xiao Chen's girlfriend." Si Zhenhua introduced her to Zhong Dongyang with a smile.

"Xiao Chen is so lucky." Zhong Dongyang said with a smile.

"Yeah." Chen Yang nodded with a smile. He felt that being able to meet Wen Manlu was a gift from fate to him.

"Since the patient is constipated, can we use enema to get rid of the old stool?" a doctor suggested.

Wen Manlu continued, "The patient's dry stool is one of the causes of high fever, especially when the Shaoyin Yin is damaged. It is not so easy to be discharged, and it may also damage the secretions in the intestines."

Wen Manlu continued, "And I asked the patient's family, the patient hadn't defecated for two days before he fainted."

"That's the situation." Gao Jingyun said.

"So how should we solve this situation?" Peng Lixue asked Wen Manlu.

"In the Shaoyin chapter of Treatise on Febrile Diseases, it is said that in Shaoyin disease, the patient will have clear water discharge of pure and clear color, heart pain, and dry mouth. He should be treated with purgatives urgently, and Dachengqi Decoction is suitable."

Wen Manlu said, "It is also said that if vomiting or diarrhea does not relieve the symptoms of typhoid fever, the patient may have constipation for five to six days, or even more than ten days... If the patient is in a severe condition, he or she may not recognize people after the disease breaks out... If the patient is in a mild condition, but only has fever and delirium, Dachengqi Decoction is the main treatment. If the patient has a bowel movement after taking one dose, stop taking it."

"The patient is delirious, has cold limbs, a dry and scorched yellow tongue coating, and constipation. This is a case of Yangming Fu Shi syndrome... Dachengqi Decoction can be tried."

"What do you think, Xiao Chen?" Si Zhenhua asked Chen Yang after listening to Wen Manlu's analysis.

"Well, you can use Dachengqi Decoction."

Chen Yang nodded and said, "Yangming is a meridian that is prone to bleeding. Excessive heat in Yangming often disturbs the mind, causing irritability at the mildest and coma and delirium at the worst. Once the heat is removed, the mind will be free of disturbance and will naturally recover."

Even in Western medicine clinical practice, whether the patient farts or has bowel movements after surgery is a very important symptomatic treatment and a criterion for judging the patient's gastrointestinal motility after surgery.

The patient had an argument with someone while exercising in the park early in the morning. Because he went there early and did not eat breakfast or drink water, he did not have to wait for a craniotomy. Instead, an emergency craniotomy was performed to relieve pressure and drain the blood.

Therefore, defecation after surgery is very important.

In modern medicine, when a patient suffers cerebral hemorrhage and damages the nervous system, his gastrointestinal function is inhibited and the intestinal microenvironment changes, causing gastrointestinal bacteria to become ectopic. After entering the blood, they release toxins, stimulating the vascular endothelium to release a variety of inflammatory factors. These bacteria, toxins, and inflammatory substances pass through the blood-brain barrier and cause further damage to the brain.

If the patient has a high fever after surgery, especially if the fever worsens after the afternoon, it is very telling.

Zeng Yunhui glanced at Wen Manlu and was in a trance for a moment.

Not only has he failed to surpass Chen Yang, but he has also been left behind by Wen Manlu?

Dual cultivation is so amazing, how many years of skills have been added?

"Just follow what Xiao Wen said and try Dachengqi Decoction."

Si Zhenhua spoke and gave the final conclusion to the consultation.

Wen Manlu prescribed a prescription, Chen Yang walked to the side to take a look, and gave some advice on the dosage. Wen Manlu's Dachengqi Decoction used 12 grams of raw rhubarb, and Chen Yang asked to change it to 15 grams, and 20 grams of Glauber's salt, and Chen Yang asked to change it to 30 grams...

"After the decoction is ready, give the patient medication through nasogastric feeding. Closely observe the patient's bowel sounds and flatulence after taking the medicine. If the patient's intestinal motility does not increase after taking the medicine, give the second dose until bowel sounds and flatulence appear." Chen Yang instructed Gao Jingyun.

"Don't worry, Doctor Chen. I've taken note of it and will keep an eye on it myself." Gao Jingyun nodded.

After coming out of the consultation room, Zhong Dongyang followed Si Zhenhua to the office, while Wen Manlu walked with Chen Yang.

"How was my performance today?" Wen Manlu asked Chen Yang with a smile, like a child showing off in front of his parents.

Wen Manlu herself felt that she had made rapid progress during this period of time.

"Very impressive." Chen Yang said with a smile.

In fact, Chen Yang could clearly see Wen Manlu's progress. Wen Manlu's level was originally higher than Zeng Yunhui's, but the gap between the two was not big before, so Zeng Yunhui didn't notice it.

But now, Wen Manlu's ranking on the Qingyun List has risen from the previous ninety-sixth to the current sixty-second, and her ranking is even ahead of Wen Haohui.

Among the younger generations of the Wen family, Wen Manlu's level can be said to be second only to Wen Haoxue.

Especially during the time that Chen Yang came to Kyoto, Wen Manlu's progress was the fastest.

After all, Wen Manlu was not often in the hospital before. During this period, the number of times Wen Manlu came into contact with clinical work was second only to when she was interning in the hospital.

With enhancement items and Chen Yang's explanation, it would be strange if you don't make rapid progress.

When Chen Yang was accepting apprentices in Jialin County, the system showed master-apprentice binding. Chen Yang guessed that since there was master-apprentice binding, there should be a couple or marriage system like in the game. Maybe he would have to wait until he and Wen Manlu got their marriage certificate or had a formal engagement ceremony to trigger it.

Of course, this is just Chen Yang's guess.

During this period of time, Chen Yang was in Kyoto, and Li Haofei, who was far away in Jialin County, also made rapid progress. With the master-apprentice system binding, Chen Yang could see Li Haofei's level. Li Haofei's internal medicine level has now reached the fourth level, which can be said to have reached the level when Chen Yang first arrived at Jialin County Hospital.

"Really?" Wen Manlu asked with a smile.

"of course."

Chen Yang smiled and said, "There's no need to explain the patient's condition. You were just a little too cautious when using the prescription."

In fact, as doctors, especially Chinese medicine practitioners, they tend to be conservative and cautious when using medicines. That is subconscious. After all, normal people think that the larger the dose, the higher the probability of something going wrong. Even if the dialectic is accurate, they will subconsciously reduce the dose when using medicines.

The reason why Chen Yang was cautious when using the medicine in the beginning was that he had a system. Chen Yang could judge based on his experience and make continuous adjustments, gradually forming habits, or summarizing his experience.

After all, everyone subconsciously has the idea of ​​protecting themselves. Taking small doses, not causing trouble, and not getting into trouble are actually protecting yourself.

"Well, I did reduce the dosage subconsciously." Wen Manlu nodded.

"In fact, many drugs are not as terrible as we think. As for the few drugs I just mentioned, even if I increase the dosage a little bit based on the dosage I just mentioned, it won't cause too much trouble."

Chen Yang said: "For some special medicines, you can be cautious if necessary. Even for things like Aconitum, as long as you understand the efficacy of the medicine, you don't have to be restrained."

"Yeah." Wen Manlu nodded.

In fact, to be honest, Wen Xiuping's level is definitely high, but when Wen Manlu asks Wen Xiuping for advice, she is not as relaxed as she is with Chen Yang. This is the advantage of people of the same age.