I can hear the voice of Chinese medicine

Chapter 93: Sweet and warm, replenishing qi and eliminating severe fever

"Student Ji Xiuwen, don't think about it too much, go and get the medicine for him first, and I'll talk to you about digestive system diseases after get off work."

Seeing that Ji Xiuwen was still in deep thought, Lu Xuan reached out and touched Ji Xiuwen's arm, reminding him aloud.

Only then did Ji Xiuwen come to his senses, he got up and walked towards the Chinese pharmacy with the fee receipt handed over by Su Kenan.

Seeing that Ji Xiuwen had already entered the Chinese medicine pharmacy, Liu Zhendong did not stay in the consulting room for long. He said hello to Lu Xuan and got up to leave.

As soon as Liu Zhendong left, Lu Xuan signaled Su Kenan to call the number and picked up the water glass at hand to drink some water.

This time, Lu Xuan took a special look and saw that he had taken it correctly, so he raised his head and took a few sips.

Su Kenan who was at the side saw Lu Xuan's cautious look, blinked his eyes, a faint red glow appeared on his face, and whispered: "I put the water glass here, don't worry about taking it Wrong, and..."

"It doesn't matter if you get it wrong."

At this point, Su Kenan's voice was as thin as a mosquito.

Lu Xuan didn't expect that his subconscious actions would be noticed by Su Kenan, so he could only find an excuse casually: "I was just thinking about something, don't think too much about it."

"Oh."

The fair oval face was slightly drooped, and the slight redness that had just appeared gradually faded away at this moment. The shining luster in Porphyrin's eyes suddenly dimmed a lot.

She pursed her lips and asked cautiously: "Doctor Lu, is it because I'm too timid that you don't like talking to me?"

Lu Xuan looked at her: "Why do you think so?"

"because……"

Su Kenan raised his head, a slight mist suddenly appeared in his clear eyes, and he said in a tone of bewilderment: "My aunt said before that I am too shy and timid, this is not good, and I also I saw Dr. Lu and Mr. Ji Xiuwen going out for dinner talking and laughing, so I wondered if it was because of Dr. Lu that he didn't like talking to me."

The light in the consulting room was cold, shining on Su Kenan's facial features as delicate as snow in early spring, there was a hint of self-blame in his brows.

Su Kenan is a bit introverted and doesn't like talking much, but she's not stupid either.

A woman's sense of smell is often very keen. Since she was a child, she has no friends. She has always been like this, even in college. In the dormitory, she is that maverick girl who rarely talks to other people. At night, what I listen to most is listening to other people in the dormitory talking about some anecdotes in the school.

Sometimes, she wanted to join in, but after hesitating, she chose to back down.

Over time, the other people in the dormitory naturally chose to distance themselves from her.

As for the boys who were pursuing her, the way they looked at her made her feel uncomfortable. They were not as pure and without a trace of desire as Dr. Lu.

She likes this feeling.

Unlike before, if you don't own it, you don't have those worries. At most, you just feel a little envy in your heart, and then you regain your peace.

Once you have it, you don’t want to lose it.

"That's not the case. Ji Xiuwen and I have been classmates for many years. We haven't gotten together for a long time after graduation, so naturally we talk a lot. Plus you are a girl, so I don't know what to say. I just talk naturally. Just less."

Lu Xuan took a deep breath: "Don't forget, we are friends now, why would you not want to talk to you because you are shy."

While feeling helpless, I also gained a new understanding of this timid girl.

"Are we friends?" When he said this, there was a hint of joy.

"Of course, aren't we friends?" Lu Xuan asked back.

"Yes." Su Kenan nodded heavily.

Lu Xuan reached out and patted her soft shoulder, and said seriously: "Since we are friends, don't think too much about it."

"Ah."

The slightly intimate gesture made Su Kenan's heart tremble.

"Okay, let's call the number, that guy Ji Xiuwen is about to get the medicine, don't wait for him."

Just as Lu Xuan was talking, he saw Ji Xiuwen walking out of the Chinese medicine room.

At this time, Pan Yuqian, the patient who was called to the number, opened the door and entered, and greeted Lu Xuan after sitting down.

Without waiting for Lu Xuan to remind him, he told some of his own situation, along with some checklists from the hospital.

Patient Pan Yuqian, female, 30 years old.

On the 11th of last month, I developed chills and fever for no apparent reason, with body temperature fluctuating between 37.7 and 40.8°C, accompanied by mild cough, no phlegm, no vomiting, nausea, abdominal pain, or diarrhea;
No obvious frequent urination, urgent urination, painful urination, or obvious joint pain;

He was treated with anti-infective drugs such as "penicillin and cefazolin" in the hospital, and antipyretic analgesics and hormone drugs at the same time. Although the temperature can be lowered for a short time, the temperature will rise again soon;

One month ago, the intravenous infusion of Fuxinbitu and sparfloxacin was ineffective. I stopped taking all drugs for 5 days. I developed flaccid fever. The experimental antimalarial treatment was ineffective. After that, it was changed to erythromycin. My body temperature fluctuated between 36.3 and 39.3. ℃, intermittent heat type;
Since no reason was found, a comprehensive systemic physical examination was done, but no obvious abnormalities were found, the heart and lungs (-), the shape and structure of the lungs were normal, and there was no abnormality;

Fast heart rate, "sinus tachycardia" in ECG, no palpable liver, spleen and superficial lymph nodes, no rash;

多次血常规： RBC(3.42~4.19)×10/L， Hb98~120g/L， WBC(3.2~5.8)×10/L，N0.58~0.86， L0.12~0.34， PLT (138~258)×10/L;多次血沉50~85mm/h: C反应蛋白 41mg/L；血嗜酸粒细胞计数 40×10/L;
Feida reaction, Legionella reaction, anti-autoantibodies, blood culture, bone marrow culture, mid-section urine, and sputum culture were all normal; bone marrow cytology showed "active proliferation and increased eosinophils."

Liver and kidney function and electrolytes were normal: LDH318 U/L: CT of the chest and abdomen showed "gallstones" and "mild splenomegaly".

According to the examination of Western medicine, except for gallstones, Pan Yuqian was in good health and had no problems at all, but she developed a fever for no reason.

It was the first time Lu Xuan saw this situation, and couldn't help frowning slightly for a while, and said to Ji Xiuwen: "Take her temperature."

After listening to Pan Yuqian's self-report and the dense checklist, Ji Xiuwen's scalp was already numb. After hearing Lu Xuan's words, he came back to his senses and took the ear thermometer on the side to measure Pan Yuqian's temperature: "The body temperature is 39.3°C."

Pan Yuqian then said: "Doctor Lu, this is the case. It will get better in the morning, and basically stay below 38. After noon, the body temperature will rise rapidly, rarely below 39. When the temperature rises, it can I feel cold, and I will sweat a little when the fever subsides, and I am very thirsty..."

Pan Yuqian talked about some of her symptoms in one gulp, and Lu Xuan also took the opportunity to observe the other person's condition, and recorded the syndrome differentiation process in the medical record:
On July 7, the body temperature at the first visit was 18°C. In the afternoon, there was a slight chill when the fever rose, and sweating when the fever subsided. pulse……

Seeing that Lu Xuan was recording some of her own situation, Pan Yuqian asked, "Doctor Lu, what's going on with me? The test results are all good, but I just have a fever all the time, and no antipyretics I take have any effect. I have been off work for more than a month now, and it has affected my life too much."

After finishing speaking, Pan Yuqian also looked distressed.

Anyone who encounters this situation will probably not be in a good mood.

Fever is fine. After all, except for a few people, most ordinary people will get sick once or twice throughout the year. Fever is also a common thing.

But I have had a fever for more than a month, I have taken all kinds of medicines, and I have been hospitalized to no avail. I even did a comprehensive system check for this matter. Except for a slight gallstone, there is no other symptoms at all. question.

When she got the results, Pan Yuqian was depressed for a long time.

She was even thinking, since there is nothing wrong with her body, how could Keren have a fever for no reason?
The question was thrown to Lu Xuan, but at this moment Lu Xuan couldn't come up with any good explanation. Even the other party's pulse, except for the pulse number, which was easy to judge, had other clues, but he had never met Pan Yuqian. Due to this strange pulse condition, he had no choice but to seek help from those omnipotent teachers in his mind.

And this group of teachers obviously never let him down.

[The pulse is moist and the pulse is a pulse condition with complex factors. It is a combination of floating, thin, and weak conditions. Therefore, the ancients used the description of "floating on the water", but this regulation was not clarified until the "Mai Jing" stand up.

Before the "Mai Jing", Mai Ru just meant weak. For example, the "Nei Jing" said that the Spring Vein was weak in Zhaozhao, the Changxia Vein was weak, etc.Zhongjing's "Pulse Identification Method" said: "The Yang pulse is large and moist, and the Yin pulse is large and moist." The Eastern liver pulse is "micro stringy and weak". "

Why does "weakness" fit the eleven heads?" and so on. Moreover, "wetness" and "weakness" are very close. From the literal meaning of "wei" and "wei", they both mean weak, weak and small.

In ancient books, the word "ruan" is often used for "lumai", but in modern times, "lumai" is often used.

"Mai Jing" says: "The soft pulse is extremely soft and floating."

There is also a small line at the bottom that says: "One day presses there is nothing, but there is more than enough. One day is small and soft, and the soft one is wet, and the wet one is like a silk garment in the water, and you can touch it with light hands."

The theory of "Mai Jing" has therefore become the criterion for moistening the meridians.

As for judging the wet pulse, "Mai Jue Jian Wu" has relevant records: "It is extremely soft and floating and thin. You can get it with a light hand, and you don't have to search for pressure."

Li Shizhen also said in "Binhu Pulse Study": "The wet pulse is extremely soft and floating, like silk in the water. If you touch it with your hands, there is nothing there when you press it. It is like floating on the water."

"Yi Zong Shuo Yue" said: "If you are wet, you will be weak and weak. When you see it with a light hand, you will go away with a heavy hand, like a thread floating in water."

...]

Hearing this, Lu Xuan took a deep breath, and while keeping these in mind, he also made some summary of what he said in his heart.

According to the voice of the heart, the Rumai is a pulse condition with complex factors; it is formed by combining several conditions: floating, thin, and weak. Because the Rumai has the conditions of floating, thin, and weak, its fingers feel light, soft, and small. Therefore, there is an image of floating water, floating on the water, like a thread floating in the water; and the Ru pulse can form concurrent pulses with related pulse conditions, such as slow moistening, rapid moistening, etc.

According to "Pinghu Veinology · Body Shape Poetry": the water surface floats softly, and the floating force is unstoppable.There are still medicines during childbirth after illness, and if ordinary people see it, they have no roots.

What do you mean?
The previous sentence means that if the person is sick or postpartum, the occurrence of moistening of the pulse at this time means that Qi and blood have been depleted. Therefore, it is understandable that the moistening of the pulse occurs due to insufficient righteousness, and it can be restored after medical treatment.

The meaning of the latter sentence is that it looks like a normal person. If you feel the moistening pulse, it is not very good, indicating that the patient is relatively weak.

How to cure?
Rumai Lu Xuan gained some understanding by relying on his photographic memory, but he still had no idea how to treat it. The main reason was that the patient did not have any discomfort except fever, which suddenly increased the difficulty of syndrome differentiation.

Regardless of whether Lu Xuan has received divine help from doctors recently, these are all situations he has been exposed to a lot recently, and when he encounters such complicated situations, he is still blind.

Fortunately, he can't shake people, otherwise Lu Xuan would have to ask the patient to find another doctor.

This group of knowledgeable teachers obviously did not disappoint Lu Xuan.

["Pinhu Pulse Science Main Disease Poems" mentioned the feeling of moistening the pulse as the main disease, moistening is a disease of blood loss and yin deficiency, and the marrow sea and dantian have been lost.Sweat and rain come at night and steam to the bone, and blood landslides pour dampness into the spleen.However, as far as modern times are concerned, wet pulse is more often caused by dampness.

The patient keeps alternating cold and heat, which is a typical cold and heat symptom of Shaoyang disease. The specific manifestations are intermittent occurrence of fever and aversion to cold. The tone is caused by the struggle between good and evil.

According to the physiological function and pathological characteristics of the Shaoyang meridian, Shaoyang diseases can be roughly divided into Qi stagnation syndrome, Water stagnation syndrome, and Qi and water stagnation syndrome.Due to the difference in the degree and time of qi stagnation, qi stagnation syndrome can also be divided into qi stagnation syndrome, qi stagnation syndrome and qi stagnation syndrome.

Therefore, according to the patient's condition, it is planned to fall from qi deficiency to yin, Shaoyang cardinal unfavorable, Weibiao disharmony and fever, and too little reconciliation, sweet and warm to remove heat. 10g of white peony root, 10g of kudzu root, 10g of cohosh, 15g of astragalus, 5g of angelica, 15g of Atractylodes macrocephala, 10g of licorice, 10g of fried scutellaria baicalensis, 3g of tangerine peel, 10g of pinellia chinensis, 6g of ginseng, 10g of Baiwei, 12 slices of ginger, jujube 15 pieces. 】

When Lu Xuan heard this prescription, he immediately thought of a rarely used method of removing heat.

Gan Wen heat removal method.

The therapeutic idea of ​​the sweet and warm method of removing heat originated from the Huangdi Neijing, which was founded by Zhongjing, established by Dongyuan, and continuously developed and improved by later generations of doctors.

"Internal Classics" pointed out: "The laborer warms it; the damaged one benefits it", "Spleen desire is slowed down, eat sweets quickly to relieve it, use bitterness to relieve it, and sweetness to replenish it."These theories later became the cornerstone of the spleen and stomach theory of Li Dongyuan, a famous medical scientist in the Jin and Yuan Dynasties. Zhang Zhongjing also created Xiaojianzhong Decoction, a prescription for treating fatigue and heat in "Synopsis of the Golden Chamber".

"Synopsis of the Golden Chamber Blood Arthralgia Deficiency and Overwork" says: "Asthenia, urgency, palpitations, epistaxis, abdominal pain, dream loss of sperm, sore limbs, restless hands and feet, dry throat and mouth, Xiaojianzhong Decoction is mainly used .” This prescription is actually the earliest prescription of the “sweet and warm method of removing heat”.

However, it was Li Dongyuan, a famous medical scientist in the Jin and Yuan dynasties, who really perfected the development of Ganwenwen to eliminate hot fever.

Can Ganwen get rid of severe heat?
There has been controversy in the academic circles for a long time, and many people deny this, thinking it is a fallacy.

Lu Xuan has some knowledge about this aspect, and he feels that it is too absolute to completely deny the saying of "sweetness and warmth eliminate great heat". It is absolutely not correct to ignore the achievements of Mr. Li Dongyuan's lifelong scientific research without a good verification. .

Many people also say that the severe fever mentioned by Li Dongyuan is deficient heat, which means that the patient feels feverishly but there is no fever when detected by a thermometer; or that the "great fever" eliminated by Ganwen is not "high fever".

There are doubters, and there are many Chinese medicine practitioners who think it is reasonable and apply it in practice.

However, as far as Lu Xuan was concerned, it was really the first time that he used the method of warming and nourishing qi to eliminate severe heat to treat a patient.

On the other hand, Ji Xiuwen, who hadn't made any movement from Lu Xuan for a long time, couldn't help feeling a little worried.

After coming here for a few days, it was the first time that he saw his old classmate thinking about it for so long.

Thinking of Pan Yuqian's situation, Ji Xiuwen could understand it, and it was understandable that Lu Xuan needed to think.

After all, this was the first time he had heard of such a complicated situation.

What Ji Xiuwen is worried about now is that Lu Xuan has no good way to deal with Pan Yuqian's condition, and it is possible that this time he will break the invincible golden body that he has finally built.

Although no one can cure all diseases, not even a miracle doctor.

But as far as Ji Xiuwen is concerned, he still hopes that his old classmates can always maintain their undefeated golden body.

(End of this chapter)