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Chapter 7 Same disease with different syndromes

In the next two days, there were no emergencies in the obstetrics and gynecology department. The three followed Dr. Yan Bing step by step every day, recording the changes in the patient's condition every day.

Today is the third day in the obstetrics and gynecology department, and it is the first time for the three of Huang Su to attend the morning meeting of the obstetrics and gynecology department.

Na Risong and He Hui came to the obstetrics and gynecology department early in order to see what the regular morning meeting would look like.

Walking into the office of the obstetrics and gynecology department of the inpatient department, more than 20 people had already formed a semicircle around Yan Bing.

Unlike the sparsely populated Chinese medicine department, there are occasional morning meetings.It is worthy of being a big department, and the morning meeting of the obstetrics and gynecology department is regular.

The two looked at Huang Su's serious study, and thought to themselves: It seems that after the job transfer is over, the morning meeting of the Department of Traditional Chinese Medicine will also be arrested by the director.

Director Liu and Dr. Liang went out for a meeting today. The morning meeting was hosted by Yan Bing. Just like her character, the whole morning meeting was simple and fast.

Huang Su did not expect that Dr. Yan Bing, who is only 27 years old, is now the chief resident physician and will soon become the attending physician.

Chief resident physician, a post that is basically set up in large hospitals, aims to allow doctors who are about to be promoted to attending physicians to exercise through high-intensity work.

Basically a one-year period.During one week of every month of the year, I will be on call at the hospital 24 hours a day.

Just as he was about to make rounds, Yan Bing stopped Huang Su and said, "Doctor Huang, since the director has handed over Chen Ping in bed 22 to your Department of Traditional Chinese Medicine, your Department of Traditional Chinese Medicine will be in charge of the rounds."

Huang Su nodded to show that he understood, and took Na Risong and He Hui to the inpatient area with the large army.

When Huang Su brought the obstetrician and gynecologist to bed No. 22, Chen Ping's husband warmly greeted her: "Director Huang, you are here for rounds, please sit down."

Unable to resist the enthusiasm of the family members, Huang Su sat down and first looked at the tongue coating, then felt the pulse.

The coating on the tongue has become thin and yellow, and the pulse condition of the disease is slightly relieved, and the pulse is slow and counting.

After a long period of heat and early clearing, the good and the evil are competing, it is normal to have insufficient qi and blood, and the pulse condition is slow and weak. The slow and thin pulse here is not a disease pulse, but the righteous energy is recovering.

Huang Su said to Chen Ping, "How does the lesion feel today?"

Chen Ping said weakly: "It doesn't feel so painful, especially after applying the medicine."

After listening to Chen Ping's narration, Huang Su nodded and said, "He Hui took the patient's temperature."

He Hui came over, took out the thermometer, shook it twice, and stuffed it into the patient's armpit.

Not long after, I took out the thermometer and saw that the body temperature dropped to 37 degrees, Huang Su said: "Let me check the condition of the lesion."

He Hui quickly closed the lattice curtain, and the patient unbuttoned his clothes to reveal the affected area covered with medical gauze, and the gold ointment was applied inside the gauze.

The main ingredients of golden ointment include garcinia and sesame oil.It has the effects of reducing swelling and attacking poison, and can dispel rot, suppress sores, stop bleeding, and kill insects.It is used to treat various carbuncles, swellings, tumors, including wet sores, ulcers, stubborn psoriasis, or various bruises, including bleeding and scalding.

Huang Su put on medical gloves with both hands, gently loosened the gauze, and saw that the area of ​​redness and swelling at the lesion had shrunk by half, and several purple-red areas had become only slightly darker than the surrounding redness and swelling.

After the examination, Huang Su told the patient's family: "It seems that the effect is good. Today is the last dose of medicine. I will adjust it according to the condition tomorrow."

While we were still checking here, there was a sudden sound of arguing from bed 23 next door.

When Chen Ping put on her clothes, He Hui opened the curtain.

A man in traditional Mongolian costume said to Yan Bing emotionally: "I don't agree to cut my wife's left breast."

Yan Bing explained reassuringly: "Family of the patient, please calm down first. The incision and drainage of the chest is just a minimally invasive operation, which does not cause much harm to the patient's physical illness. The purpose is to completely remove the pus in the lesion, and to make the lesion No longer suppurating repeatedly."

"In the past, every time you took out pus, you always said the same thing. You will recover after you take out the pus. But every time you take out the pus and it recurs after two days, you really ensure that the operation will not recur. What should you do if it recurs? The disease is not cured. Well, there are still scars that can't be erased."

Baolige's husband listened impatiently to Yan Bing's explanation, looked around emotionally, happened to see Huang Su leaking from the curtain, pointed at Huang Su and said, "I'll ask you if you can cure my wife without surgery." disease, if not, I will change doctors.”

Seeing that Baolige's husband involved her, Huang Su couldn't stay out of the matter, walked up to Yan Bing and asked, "Doctor Yan, what's going on with this patient."

Yan Bing explained the patient's condition.

The patient, Baolige, had undergone puncture and pus extraction three times in a row, all of which were repeated.Today, the family members were notified to perform incision and drainage, which aroused strong opposition from the family members.

After understanding the situation, Huang Su said, "Doctor Yan, why don't I take a look first."

Yan Bing pondered for a moment, did not speak, and nodded slightly to express his acquiescence.

Huang Su came to Baolige's husband and said, "Family, calm down first, or let me see the patient first."

Baolige's husband glared at Yan Bing, moved a stool for Huang Su graciously, and said politely: "Doctor, please show me quickly, we have been hospitalized for more than half a month, and we have been in the hospital for more than half a month. I saw that you treated the neighbor bed very well."

After speaking, he showed a successful smile at Huang Su.

Huang Su glanced at Baolige's husband and smiled, knowing that the temper was directed at herself.

This Mongolian brother is also very interesting. He acted in such a scene because he wanted to see a doctor for his wife.

Baolige's husband was not at all embarrassed when he saw that his petty thoughts had been exposed. He put the stool behind Huang Su, picked up a rag, wiped the stool carefully, and invited Huang Su to sit down.

After sitting down, Huang Su said: "Stick out your tongue, let me have a look."

Seeing the patient's thin yellow tongue coating, Baolige's husband said first: "Doctor, look at my wife's tongue coating is exactly the same as that of clinical patients."

Ignoring his pretending to be smart, Huang Su said: "Extend your arm and I'll take a pulse."

Huang Su rested three fingers on Cun Guan Chi three places, only felt the pulse was weak and feeble, four breaths at a time, equivalent to about 1 beats per minute, it was a sign of slow pulse, mainly dampness, appearance and deficiency syndrome.

Huang Su frowned slightly, thinking that he had made a mistake in diagnosing the pulse, so he changed his hand to diagnose and treat again, and after three or four minutes, the pulse was still slow.

Yellow moss dominates interior, heat, and evidence.The tongue coating is thin and yellow, which is a manifestation of heat evil. It is more common in wind-heat exterior syndrome and wind-cold-heat transformation syndrome. The pulse condition should usually show pulse number, which is contrary to bradycardia.

Seeing Huang Su frowned slightly, Baolige's husband hurriedly asked, "Doctor, is my wife okay?"

"I haven't read it yet, so how do I know if the patient is okay?" Huang Su said blankly.

Baolige's husband breathed a sigh of relief, "Doctor, your frown almost didn't scare me to death."

Huang Su understood instantly.

As the saying goes, you are not afraid of western medicine laughing, but you are afraid of frowning in Chinese medicine.

With a smile in his heart, he continued to ask, "Does your wife have a fever?"

Baolige's husband replied: "After the first pus pumping, the body no longer has a fever, but the redness has not disappeared."

Huang Su nodded and said, "Let me check the affected area."

The curtain was drawn, and the patient took off his hospital gown to expose the affected area. He saw that half of the affected area was dark red, and there were two swellings on the outside that looked like acne.

Putting on gloves, Huang Su pressed lightly on the dark red affected area and asked, "Does it hurt?"

"It doesn't hurt!" Baolige shook his head.

Afterwards, Huang Su lightly pressed on the bulge, which felt like a lump, and asked, "Does it hurt?"

"It doesn't hurt!" Baolige shook his head.

After examination, Huang Su basically understood the patient's condition.

The patient belongs to the syndrome of half yin and half yang, which is a syndrome that is often neglected and misdiagnosed.

Chinese medicine is based on the eight principles of syndrome differentiation, yin and yang are the total, exterior, deficiency, and cold are yin syndromes, and interior, excess, and heat are yang syndromes. However, many inexperienced Chinese medicine often ignores half-yang and half-yin syndromes.

Half-yang and half-yin syndrome is a stage of transition from yang syndrome to yin syndrome. In terms of symptoms, there are both yin and yang syndromes.

From the perspective of Baolige's syndrome, it looks like a yang syndrome but is neither hot nor painful, and it looks like a yin syndrome but has heat evil in it.

Symptoms manifested in patients include thin yellow tongue coating, hard swelling without pain, dark red skin color, and lack of heat all over the body.

This is why traditional Chinese medicine requires the combination of four diagnostic methods. Two people have the same pulse condition and slow pulse. One patient has a diseased pulse, while the other patient does not.

Huang Su asked the patient to put on the sick clothes and said: "I will prescribe a prescription for you to help yang and regulate qi, promote blood circulation and remove blood stasis, clear heat and detoxify. He Huiji prescription. Deer horn cream 10g, milk 10g each, angelica 10g, honeysuckle 10g, wheat bark 10g, Whole Gualou 20g, burnt hawthorn 30g, burnt malt 30g, 1 whole scorpion. There are five doses in total, Yin syndrome ointment is applied externally, five doses, one change per day."

After checking that it was correct, he handed the prescription to Baolige's husband.

The man looked at the prescription carefully, and asked doubtfully: "Doctor, my wife and the clinic have the same disease, so how come the prescription is different."

"The 22-bed patient has a syndrome of yang-heat, and your wife has a syndrome of half-yang and half-yin. Of course, the medicine prescribed is different." Huang Su explained.

Traditional Chinese medicine cannot be taken indiscriminately. It seems that they are all the same disease, but the syndrome and pathology may be completely different.

In Chinese medicine, it is very common to use different medicines for the same disease and treat multiple diseases with the same medicine.

Huang Su continued to explain to He Hui and Na Risong: "The medicine uses wheat bark to soothe the liver and promote qi, breast milk and angelica to promote blood circulation and remove blood stasis; antler cream to help yang and reduce swelling, scorpion and honeysuckle enter the liver meridian to detoxify and remove blood stasis. ; burnt hawthorn, burnt malt back into the milk; whole Gualou is a good product for treating mastitis and ulceration. Deer antler cream is warm in nature, honeysuckle is cold in nature, and cold and warm are used together. It is quite suitable for half yin and half yang syndrome. External application of yin syndrome ointment has the effects of warming yang and dispelling cold, promoting blood circulation and removing blood stasis, reducing swelling and relieving pain. It is a good product for treating yin syndrome and half yin and half yang syndrome."

After instructing the patient's family members on the precautions for external application of medication, the group was about to go to the next ward for rounds, when they saw a nurse running towards the crowd anxiously.

(End of this chapter)