Under, Chinese medicine flavin

Chapter 233
Huang Su took a middle-aged man into the ward.

The middle-aged man's clothes were extraordinarily thick. Even though he was wearing such thick clothes, he still looked very afraid of the cold. Just a few short walks into the consultation room, the middle-aged man kept covering his mouth and coughing constantly.

Flavin observed the patient's symptoms and physical condition, and can roughly determine the patient's symptoms. This patient is very suitable for He Hui's first diagnosis and helps her build her confidence.

The middle-aged man sat down and saw an unfamiliar female doctor sitting in the doctor's seat. He looked at Huang Su in puzzlement and asked, "Cough, cough! Director Huang, it's not your consultation today."

The middle-aged man's face showed distrust of He Hui.

With the change in the medical habits of the people in Prairie City, and the fact that Huang Su has been on the news broadcast of Prairie City several times, many people in Prairie City have already known Flavin.

"It's Dr. He who is in the clinic today. Don't worry, the patient. Dr. He's doctor's level is also very good." Huang Su hurriedly explained.

Cough!

The middle-aged man coughed twice, looked at He Hui with a scrutiny, but didn't speak, his face still showed a hesitant look.

Seeing the patient still had concerns, Huang Su continued to explain: "Patient, don't worry, just sit here. If Dr. He makes a misdiagnosis, I will be the last check."

With the flavin guarantee, the middle-aged man said reluctantly, "That's fine!"

Seeing the patient's eyes meet her own, He Hui's heart suddenly beat very fast.

He Hui worked hard to calm down her nervousness and kept recalling every detail of Huang Su's consultation.

Cough!

After a while, He Hui coughed softly, imitating Huang Su and asked, "Name, age?"

The middle-aged man said: "My name is Zuo Jianjun, I am 42 years old today."

He Hui took a medical record book and carefully wrote the patient's name and age.

After putting down the pen, He Hui continued to ask, "What's wrong with you?"

"Doctor He, I have been suffering from a cough since I was in my 30s. This cough has been going on for seven or eight years, and it gets worse every winter. I went to the Respiratory Department of the City Hospital before and said that my cough was caused by bronchitis. I prescribed several medicines such as aminophylline and prednisone, and my cough was relieved after taking it. But today’s winter is very cold, and my cough is more serious than before. Since the severe cold, I have not only coughed , Recently, I have been short of breath, and it becomes more serious at night. I cough and wheeze, and I feel chest tightness and can’t sleep. Now that the medicines are not working, I want to come and have a look Can Chinese medicine treat it?"

He Hui carefully recorded Zuo Jianjun's condition in a concise and brief way.

Putting down the pen, He Hui imitated Huang Su and said, "Put out your hand, and I'll take a pulse."

Zuo Jianjun gently placed his right hand on the pulse pillow.

He Hui's slender fingers lightly rested on Zuo Jianjun's wrist, and the first feeling when three fingers touched it was the coldness of Zuo Jianjun's wrist.

A man's body is inherently yang, and a normal man's body temperature should be much higher than a woman's.

Moreover, the heating supply in the hospital and the consultation room is very sufficient. Zuo Jianjun did not just enter the hospital from outside, but his wrists are still so cold, which can only mean that the patient has yang deficiency or cold evil in his body.

He Hui placed her three fingers on the pulse, but could not feel any pulse. She pressed hard with the three fingers, and touched the pulse on the wrist bone.

Deep and weak pulse, weak yang qi, insufficient qi and blood, and inability to control qi on the surface, it is a syndrome of internal deficiency.

The late pulse is the main cold syndrome. Due to the lack of yang qi, the blood flow is weak. Therefore, the pulse comes with less than four pulses in one breath, and the late and strong pulse is caused by the accumulation of yin and cold, the lack of healthy movement of yang, and the poor blood circulation.If it is late and powerless, it is caused by Yang deficiency and cold.

He Hui had examined the pulse of the patient's hands, put down her hands and said, "Put out your tongue, let me see the tongue!"

He Hui imitated Huang Su's behavior and tone in every move and tone of speech.

Zuo Jianjun stuck out his tongue, only to see that the tongue was reddish with a thick white coating.

When Zuo Jianjun put away the tongue coating, He Hui asked, "Are you usually afraid of the cold?"

Zuo Jianjun replied: "I'm usually very afraid of the cold, but I feel very cold when I wear so many clothes."

Zuo Jianjun opened the zipper of his down jacket and saw that he was wearing a padded jacket inside. It was no wonder that his thin body looked so bloated.

He Hui continued to ask: "Do you usually cough with phlegm?"

"Sputum"

"What's the state of phlegm?"

"Phlegm is similar to water, not very sticky."

Seeing that He Hui has entered a state, such as the patient's questions and answers, Huang Su on the side showed a gratified smile and nodded with satisfaction.

Out of the corner of He Hui's eyes, she saw that her director was very satisfied with her performance.

He Hui, who was no longer nervous, was now more confident. Before she knew it, her body had to be straighter, and her tone of voice was more confident.

"How's the bowel movement?"

Zuo Jianjun replied: "Is it normal to have bowel movements, but as long as you eat something cold, you will have diarrhea, and you will urinate more frequently and more often."

"What color is pee?"

"Pee is like water, without any color?"

"Does urine smell bad?"

Zuo Jianjun shook his head and said, "It's not heavy, it doesn't have any flavor."

The frequency and amount of the patient’s urination are high, and the texture is clear and thin, and there is no obvious stinky odor. There is a professional term in Chinese medicine called clear and long urination. It is more common in patients with yang deficiency and cold, especially those with spleen and kidney yang deficiency. More common.

As for eating cold food and diarrhea, it is also a common symptom of patients with yang deficiency and cold.

Knowing the patient's condition, He Hui looked at Huang Su and said, "Director, the patient's pulse is fine and slow on the right, the tongue is pale and red, the tongue coating is white and thick and slightly dry, and the extremities are aversion to cold, the phlegm is clear and the urination is clear and long. It is the cold and persistent cold, the accumulation of phlegm and the accumulation of phlegm, the cold pathogens entering the lungs, and the lack of the power of dispelling and descending.

After speaking, He Hui looked at Huang Su nervously, like a candidate, waiting for the teacher to announce the answer.

Huang Su nodded with satisfaction and said, "Since you have already differentiated the syndromes based on the four diagnostic methods, you can prescribe it according to your ideas."

This is why Huang Su thinks this patient is the most suitable for He Hui's first patient, because cold cough and cold wheezing are the most common diseases in Northeast China, and they are also the most acute and severe diseases that Huang Su brought He Hui and Na Risong to diagnose and treat. one.

He Hui is no stranger to this disease. Cold phlegm, cold wheezing, and bronchitis are the diseases that build her confidence the most.

听到自家主任的肯定，何慧非常的兴奋地拿过处方单开始写处方：麻黄10g、细辛3g、五味子6g、干姜10g、法半夏10g、茯苓15g、杏仁10g、苏子10g、桑白皮10g、枳壳10g、厚朴10g、炙甘草6g、制附片6g。

When He Hui finished writing the prescription and looked at the doctor in the corner of the prescription, the pen in her hand trembled involuntarily.

The two fingers of He Hui's pen were already clenched into blue and white, and she took a deep breath. He Hui, like a primary school student who was writing for the first time, wrote her name behind the doctor, stroke by stroke.

From the moment she signed her name, He Huicai truly became a doctor.

He Hui carefully tore off the first prescription that she had written, and first handed it to Huang Su and said, "Director, this is the prescription I wrote for you!"

Huang Su took He Hui's recipe and read it carefully.

Ma Xin Wei Gan Decoction is based on Yang Baifu's Xiaoqinglong Decoction, which is used to treat the cold in the interior according to the "Golden Chamber Synopsis", and the Linggan Wuwei Jiangxin Decoction, which is used to treat cold and drink the lungs. A new and flexible formula.

Flavin is often used to treat cold cough and cold wheezing caused by cold drink that is not very serious, and the lung fails to disperse and descend, and the effect is remarkable.

Ephedra, Asarum and Dried Ginger in Ma Xin Wei Gan Decoction are the rulers, which are used to disperse the lungs and dispel cold and resolve the cold; the law Pinellia, Poria, almonds, Suzi, and Sang Baipi are the ministers, which can resolve phlegm and relieve cough, reduce qi and relieve asthma; Magnolia officinalis is an adjunct, which regulates qi, widens the chest and eliminates fullness; adjuvant Schisandra chinensis is intended to astringe the lungs and relieve cough, and prevent pungent and warm products from dissipating lung qi; licorice is an envoy to reconcile various medicines.In the formula, it is used to disperse and regulate lung qi; the combination of dispersing and collecting prevents qi consumption; the sweet and cold mulberry and white skin are combined to control excessive heat and acrid.The formulation is strict and the compatibility is precise.Combination of various medicines, to remove coldness and disperse, to disperse and lower lung qi, then cough and asthma will be relieved.

What really makes Huang Su gratified is that He Huineng Genjun's patient is cold and cold, which causes the patient to have symptoms of yang deficiency. In the original prescription, Zhifu Tablet is added to warm the spleen and kidney yang, and licorice is used instead of licorice. It can also play the effect of licorice reconciling various medicines.

This shows that He Hui did not learn by rote during the year she studied with herself, and the use of drugs will be flexibly added or subtracted according to the specific symptoms of the patient.

"Fangzi opened well!"

Huang Su handed the recipe to He Hui.

Hearing the director's affirmation, He Hui showed a sincere smile on her face.

He happily took the prescription and handed it to Zuo Jianjun, He Hui very patiently exhorted: "This prescription goes back to drink seven servings, and then come over to review, if I don't attend the clinic, you can ask Director Huang, and I will take care of Director Huang when he is in the clinic. also."

When Zuo Jianjun saw that the prescription given by the young female doctor was approved by Director Huang, he felt relieved and put away the prescription and said, "Thank you, doctor."

When seeing Zuo Jianjun leaving the clinic, Huang Suxian encouraged him, "He Hui, you did a good job!"

Hearing what Huang Su said, He Hui lowered her head shyly, but a beautiful smile appeared on her face, and she finally issued the first prescription.

Seeing He Hui's appearance, Huang Su also asked in a joking mood, "Now, are you still nervous?"

He Hui shook her head and said, "Director, I'm not nervous now!"

"Okay, I'll call you the next patient."

He Hui hurriedly stood up to stop and said, "Director, I'll go by myself!"

Huang Su waved his hand and said, "You are today's sitting doctor, just sit in your seat and leave the rest to me."

Looking at the back of Huang Su leaving, He Hui's eyes showed moving eyes.

It is the greatest luck in my life that I can meet such a good teacher as the director.

Hearing the sound of Huang Su leading the patient into the outpatient room, He Hui wiped the tears from her eyes with her hands.

The doorman saw Huang Su leading a fat middle-aged woman into the ward.

When the woman sat down, after the confidence built up by the previous patient, He Hui asked very naturally, "Name, age?"

The middle-aged woman said: "My name is Cao Shuang, I am 46 years old today."

He Hui continued to ask, "Where is it uncomfortable!"

Cao Shuang said: "The doctor has been suffering from stomach pain recently, and the back pain involved. I took the stomach treatment, but I didn't get better. Later, I went to the gastroenterology department and prescribed a bunch of western medicines, but it didn't work. If not, I will come to the Department of Traditional Chinese Medicine. Everyone says that the Department of Traditional Chinese Medicine in Prairie City is very good, so I just want to ask the doctor to help me find out what is going on with my stomach pain."

When Cao Shuang was introducing her condition, He Hui and Huang Suneng could hear her voice being heavy and hiccups.

After listening to Cao Shuang's vague introduction, He Hui frowned slightly and asked, "Do you have any other symptoms of stomach pain, such as acid reflux in your stomach, and how is your diet?"

Cao Shuang replied, "I'm still in the mood to eat when my stomach hurts, and I often reflux acid water."

According to Cao Shuang's vague introduction, she saw frequent belching and acid reflux in her stomach.

He Hui preliminarily concluded that the patient was caused by disharmony between the spleen and stomach and liver qi invading the stomach.

Disharmony between the spleen and stomach refers to the blockage of qi and the dysfunction of the spleen and stomach.Liver qi invading the stomach refers to the failure of the liver to disperse and disperse, the transgression invading the stomach, and the loss of harmony in the stomach.

The main clinical manifestations are chest and flank, epigastric fullness and pain.

Huang Su looked at He Hui's frowning and thoughtful look from the side. Meeting such a patient was actually a test for He Hui.

After all, you cannot expect all patients to clearly state all their symptoms.

For Chinese medicine practitioners, who rely on seeing, hearing, asking, and treating patients, how to extract what they want based on the vague descriptions of patients.

According to one's own judgment, guiding patients to express unclear symptoms is something that every qualified Chinese medicine practitioner must master.

Huang Su looked at He Hui, who frowned, to see what she was going to do next.

He Hui frowned and thought for a moment, then her eyebrows stretched out.

I scolded myself inwardly, how could I have preconceived ideas based on the patient's symptoms before conducting pulse diagnosis and tongue diagnosis, and set a range for myself first.

He Hui said to Cao Shuang, "Hold out your hand and I'll give you a pulse first."

Seeing that He Hui's reaction changed so quickly, Huang Su showed a satisfied smile.

Preconceivedness is a common mistake that many new doctors make. He often determines the patient's disease syndrome based on the symptoms described by the patient, and takes the root cause of the disease in his heart. Pulse diagnosis and tongue diagnosis They used the tools to confirm the disease syndromes they had delineated in their hearts, completely violated the law of the four diagnostic methods, and let their own subjective consciousness dominate the dialectics of traditional Chinese medicine.

This situation is often the main reason for the frequent misdiagnosis and misdiagnosis of novice TCM practitioners.

(End of this chapter)