I am a small factory doctor re-walking my life.

Chapter 85 Prescription (Additional update)

Traditional Chinese medicine prescriptions, those with three herbs are small prescriptions, those with nine herbs are Chinese prescriptions, and those with thirteen or more herbs are generous. Each prescription, no matter how big or small, has a very clear division of labor for the emperor, ministers and envoys.

There are more than 100 prescriptions in Treatise on Febrile Diseases, but only one has more than twelve flavors. Synopsis of the Golden Chamber is called the ancestor of prescription books and the classic of medical prescriptions. There are more than 200 prescriptions in the whole book, and only one has more than twelve flavors. Four.

As long as it is not a difficult or complicated disease, prescriptions containing less than ten herbs are the most common.

This has also caused misunderstandings among many people, including TCM doctors themselves. Many people have a soft spot for small and medium-sized prescriptions and are disgusted with large prescriptions. They believe that smaller prescriptions represent precise dialectical skills and superb medical skills. And large prescriptions are often dialectically inaccurate, disorganized and of low quality.

It seems that no matter the severity of the disease, the prescription of traditional Chinese medicine should not exceed twelve medicines. It is best to treat it within ten medicines. If the small and medium prescriptions are ineffective, it means that the dialectics are not accurate and the medical skills are not refined.

Even if a large prescription of more than twelve herbs is cured, it is not praised. It is considered that a blind cat has touched a dead mouse and does not represent the level of traditional Chinese medicine.

In fact, Dafang often combines many methods in its treatment. Its prescriptions are both ingenious and extremely precise. Clinically, there are some stubborn diseases with long course, lingering and difficult to cure, complex pathogenesis, mixed deficiency and excess, and syndromes. It is highly variable and requires generous and heavy doses to achieve the purpose of comprehensive treatment.

In reality, there are also doctors who prescribe [-] to [-] medicines, or even hundreds of medicines, in order to make a fuss, regardless of the patient's condition. This can really scare a person to death. They do not consider whether the medicine pot can hold so many medicines at all. And this It is also an important reason for the debate between big and small parties.

In fact, there is a discussion about generosity as early as in the Huangdi Neijing. The book believes that if small and medium prescriptions are not effective for complex diseases, heavy prescriptions can be used. The heavy prescription here refers to generosity.

Whether a prescription is generous depends not only on the number of medicinal flavor combinations, but also on the large dosage and long duration of medication.

Just like the cancer patients Li Tang treated before, they have gone home now, but their medication has not stopped. They have to come back for follow-up visits every three months or six months to adjust their medication appropriately according to the changes in their condition. This situation may last for a year or several years.

Now what Mr. Chu mentioned about asking Li Tang to try not to go astray was because the prescriptions he had previously prescribed for treating cancer patients included a generous prescription of eighteen herbs, as well as some contraindicated drugs.

Mr. Chu has been practicing medicine for decades, so his understanding of prescriptions is definitely not that extreme, but over the decades, he has been able to prescribe very few generous prescriptions. Compared with the generosity of his senior apprentice, who often prescribes fifteen kinds of medicine, It was so small that it seemed like a big witch, so he had to remind him.

"Uncle Master, what you mean by taking a slanted sword is..."

"For example, the medicine you prescribed to a rectal cancer patient last time contained arsenic, and the dose was quite large. Although you used its medicinal properties to attack and combined the toxicity with other medicines, some Sometimes, for some patients, we have to avoid such operations.

We all know that heavy medicines are needed to treat severe jaundice, but sometimes we can also change our thinking, such as changing small amounts more often. We originally drank the prescription for five days and seven days instead of taking it for three days, so that we can grasp the patient's condition in time and treat it at any time. Would changing parties also have an effect? "

!!!

After listening, Li Tang raised his eyebrows. This was something new. Maybe it was a different way of thinking when dealing with different patients.

Like Mr. Guan, he has always been a sitting doctor, and he faces all the patients who come to seek medical treatment. If this patient needs to be treated slowly, you can ask him to come for a follow-up visit every three days, and change the prescription at any time, which lasts for a year. After half a year, the patient will probably curse the doctor to death. Isn’t my time time?

But Mr. Chu is different. The situation of the patients he faces is different. He provides door-to-door service. Not to mention changing prescriptions every three days, he has to do one prescription in the morning and one prescription in the afternoon.

"Thank you, Uncle Master, for reminding me. I remember it."

"You're welcome. Faced with different patients, we adjust our methods in time."

After finishing speaking, Mr. Chu lowered his head and glanced at the watch on his wrist. Seeing that it was still early, he pointed to the north and said, "I remember when I came here last night, I saw the street over there, right?" "Yes, that way. Less than 200 meters away is the town street.”

"Come on, come with me and take a look around."

"Okay, uncle, today happens to be the 23rd of the lunar calendar. We go to the market every three or nine days here, and the streets are quite lively now."

"That's just right. I haven't been to a market for a long time. I just wanted to see how this place is different from the markets around Sijiu City."

Mr. Chu's slightly excited look reminded Li Tang of his master and his wife.

The same is true for the two elders. As long as there is a market in the town, they have to go around whether they want to buy something or not. Sometimes it happens to be rainy and there is no one at the market, so the elder couple will complain for a long time.

I walked around the town streets with Mr. Chu and bought nothing. It was almost ten o'clock before the two of them returned to the guest house, and Li Tang finally saw the patient.

"Doctor Li, thank you for your hard work."

In addition to the patient, there are four people in the room. One is the patient's personal care worker, and there is a staff member who should be beside the patient. According to Mr. Chu, the other two are doctors, but they are Western medicine doctors who understand Chinese medicine.

There are quite a few doctors like this in hospitals now. When you go to see a doctor, they will first take your pulse. I don’t know if they can feel it accurately. Anyway, the subsequent examination and treatment will be a combination of traditional Chinese and Western medicine.

The patient was very polite and spoke softly. When she learned that young Li Tang was the doctor she was going to see during this trip, there was no expression of surprise on her face.

"You're welcome, please sit down."

The slightly pale complexion, gray hair that has lost its luster, and the thick yellow coating on the tongue all indicate the patient's physical condition.

The pulse rate in the right cun is as rapid as a bean shape.

A few minutes later, Li Tang sighed silently in his heart and withdrew his hand.

After inviting the patient back to the inner room, he didn't say anything, just sat at the table and took out a pen to write a prescription.

When he was writing the prescription, he hesitated for a while, but finally he slightly adjusted the prescription in his mind according to what his uncle had just told him, and changed the prescription that was supposed to prescribe sixteen flavors of medicine to thirteen.

But this change also meant that the effect that was originally supposed to take five days became visible after ten days.

After filling out the prescription and signing his name, he handed the prescription to his uncle who had been standing by and watching.

After Mr. Chu took it, he just asked a few questions casually, and then signed his name, and then the other two doctors. At the same time, one of them copied the prescription again in the book, and the four of them kept the same. After signing again, the prescription was finally completed.

(End of this chapter)