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

"What's wrong with you?"

In the outpatient clinic, Chen Yang was asking about the patient's condition.

The patient was a white-haired old lady in her seventies, very thin. Accompanying the old lady was a woman in her fifties, who should be the patient's daughter or daughter-in-law.

"Doctor Chen, my mother has had this illness for more than a year. She has been to several hospitals and has had several examinations in our hospital. Not only has her condition not improved, but it has worsened."

As the patient's daughter spoke, she took out a pile of test sheets.

"You go on."

While checking the patient's examination list, Chen Yang spoke to the patient's daughter, who continued to talk about the old man's condition.

"About a year ago, my mom started to feel very hungry and her appetite increased a lot. We were very happy at the time and thought it was a good thing that she had a big appetite. Being able to eat and drink showed that she was in good health."

The patient's daughter continued, "But who would have thought that within less than a month, not only did her weight not increase, but she lost several kilograms, and her physical strength also deteriorated. We felt that something was wrong, so we took my mother for a check-up. The Western doctor diagnosed her with hyperthyroidism. After a period of treatment, there was no effect. We then went to see a Chinese doctor, who said it was yin deficiency and hyperactivity of fire, and prescribed Liuwei Dihuang Pills, but there was no effect after taking them. After that, she also took Zhibai Dihuang Pills..."

As the patient's daughter was talking, Chen Yang was looking at the patient's list. From the list, it can be seen that the patient had taken a lot of medicines in the past year, including Western medicine and Chinese medicine. He had taken a lot of medicines and had a lot of examinations. He took all kinds of medicines, imported medicines, domestic medicines...

During this period, the patient was still taking Western medicine, but did not go to see a doctor. After a year, the patient's family members were a little desperate.

I've spent a lot of money and tried many things, but the disease hasn't gotten better. If I ignore it, it won't work. If I try to take care of it, I don't know where to start.

"How's your poop?"

Chen Yang looked at the patient's information, took his pulse and asked questions.

“The stool is very dry.”

"What shape is the stem, strip-shaped or block-shaped?" Chen Yang asked.

"They are in small grains, a bit like sheep dung balls," said the patient's daughter.

"How was your sleep?" Chen Yang asked again.

"I sleep normally, and I like to dream..."

"How about drinking water normally?"

"I am always thirsty, drink a lot of water, and like to drink cold water," said the patient's daughter.

Chen Yang asked a few more questions and then looked at the old lady's tongue coating.

"The pulse is thin and stringy, the tongue is red, and there is little coating."

Chen Yang let go of the old lady's wrist and asked Wu Mengmeng beside him: "What do you think?"

"Judging from the symptoms, the patient does seem to have yin deficiency and hyperactivity of fire," said Wu Mengmeng.

“Many doctors say so, but the medicine has no effect,” said the patient’s daughter.

"The patient does have yin deficiency and hyperactivity of fire, but it is not kidney yin deficiency, but liver yin deficiency."

Chen Yang smiled and said, "Yin deficiency and excessive fire is a general term in traditional Chinese medicine. The five internal organs in the human body all have yin and yang, so it is necessary to dialectically identify which internal organ the yin deficiency or yang deficiency belongs to."

"Many doctors prescribe Liuwei Dihuang Wan, Zhibai Dihuang Wan and other drugs that nourish kidney yin and clear yang fire to patients because they see that the patients are old, over 70 years old, and subconsciously think that they have kidney yin deficiency without detailed diagnosis..."

Chen Yang explained to Wu Mengmeng.

In front of the patient, there are some things Chen Yang can't say too directly.

Many of today's Chinese medicine practitioners are indeed inadequate in their skills and abilities. When treating certain diseases, they often make judgments based on symptoms. For example, when they encounter elderly patients, the first thing they consider is the problems that are most likely to occur in the elderly.

Elderly people in their seventies suffer from yin deficiency and hyperactivity of fire, so naturally the probability of kidney yin deficiency is highest, so we should start with nourishing kidney yin. But in fact, the patient's yin deficiency and hyperactivity of fire is not kidney yin deficiency but liver yin deficiency, and the hyperactivity of fire is stomach fire.

"It is said in Suwen Qijue Lun that the large intestine transfers heat to the stomach, and people are good at eating but thin, which is called food poisoning."

Chen Yang continued, "When the liver yin is deficient, the liver fire is strong. When the liver fire is strong, it is easy to lose temper, dream, and even have nightmares."

Then Chen Yang asked the patient's daughter: "Does the old man usually have a bad temper and get angry easily?"

"Ah."

The patient's daughter glanced at the old lady, smiled bitterly and nodded.

This year, the old lady's temper was really bad. She was always angry and said that she had given birth to two daughters, but no one took care of her, one didn't care about her, and the other didn't do what she wanted.

The patient's daughter also thought that her mother was sick, which was why she had a bad temper. In fact, she was very accommodating to the old lady.

"In addition to liver yin deficiency, stomach yin is also deficient. When stomach yin is deficient, stomach fire is also strong. When stomach fire is strong, the peristalsis of the stomach is strong and digestion is fast, which manifests as easy hunger. However, strong fire is easy to consume yin fluid, resulting in lack of nutrition. Lack of nutrition will lead to excessive eating and weight loss. At the same time, strong stomach fire is also prone to thirst. People like to drink cold drinks because coldness has the effect of temporarily clearing away heat."

Chen Yang began to prescribe medicine, and said, "It is precisely because the patient suffers from liver yin deficiency and excessive stomach fire that the Liuwei Dihuang Pills and Zhibai Dihuang Pills used before have little effect. Liuwei Dihuang Pills and Zhibai Dihuang Pills can only nourish kidney yin and relieve kidney fire, but have little effect on other organs. If it is not the right medicine, no matter how much you take, it will be useless."

Chen Yang handed the prescription to the patient's daughter and said, "Take it as prescribed when you go home, and come back for a follow-up visit after you finish it."

"Thank you."

The patient's daughter took the prescription and took the old lady out of the clinic.

"do you understand?"

After the patient left the clinic, Chen Yang asked Wu Mengmeng with a smile.

"Doctor Chen, I understand now. Treating diseases with medicine is actually like putting out a fire. You have to put out the fire in the right place. If the fire is at Zhang San's house, but you go to Li Si's house to put it out, it will definitely be useless." Wu Mengmeng said with a smile.

"Well, the analogy is very apt." Chen Yang smiled and said, "To use medicine based on syndrome differentiation is to understand the cause of the disease and determine the location of the disease, rather than using medicine randomly based on general concepts and preconceived notions."

As Chen Yang was speaking, the next patient entered the clinic.

The people who accompanied the old lady to see the doctor just now were the wife and mother of He Pengjun, the taxi driver who had previously picked up Li Haofei and Yang Xiaohui.

He Pengjun's wife accompanied his mother back home. She first prepared food and boiled medicine for the old lady, and then returned home to cook for He Pengjun.

When He Pengjun came in, the meal was already ready.

"I took my mom to the hospital today and saw the doctor you mentioned, Chen Yang."

He Pengjun's wife said to him, "I don't know if he is a young doctor in his thirties or not."

"Around thirty years old, so young?" He Pengjun was surprised. He had only heard Li Haofei and Yang Xiaohui say that Chen Yang was Wu Yaolin's apprentice, and Li Haofei kept calling him Master. He was thinking how could he be a Chinese medicine expert around fifty years old, around thirty years old?

"You don't even know anyone, and you dare to ask me to take my mother with me?" He Pengjun's wife was speechless.

However, she thought what Chen Yang said made sense. Since the medicine had been prescribed, she might as well take it and see how it goes.