Song Yi

Chapter 96
Pang Yuqin nodded:

"Okay!—look, he has no sweat on his forehead, his face is flushed, his body is trembling slightly due to aversion to cold, and his tongue coating is thin and white; smell, he coughs from time to time, but there is no phlegm in his breath; ask, he complains of aversion to cold and strong fever, joint pain Aches and pains; chopping, pulse floating tight and strong. The combination of diagnostic methods should be the superficial syndrome of typhoid fever that Mr. said just now!"

Du Wenhao applauded: "It's absolutely correct! As I said, Yuqinlan has a smart heart, she is really smart, and she is a doctor!"

Xue Feier pursed her lips and scratched her face with her fingers: "Hee hee, my family is not ashamed to praise my family!"

Pang Yuqin blushed, lowered her head and said:

"Mr. said earlier when talking about the eight principles of syndrome differentiation that if a patient feels fever and aversion to cold at the same time, this is a typical feature of the superficial syndrome. The so-called 'everything with aversion to cold has a subsurface syndrome', so the disease is on the surface. And aversion to cold Fever is the characteristic of Taiyang disease, and the disease is caused by the sun.

The main complaint of catching cold at night should be caused by exogenous wind-cold evil. Just now Mr. Du also said that he was caused by exogenous wind-cold, so I judged that it was evidence of Taiyang typhoid fever. I was just opportunistic. "

Du Wenhao said: "I just said so much, you can memorize it and apply it vividly. This is what a medical student should have. It seems that Yuqin is born to be a medical student."

Xue Fei'er said: "Okay, okay, you two are less disgusting! There is still me, and two patients! —— You should tell us what is the positive evidence of Taiyang typhoid form."

Du Wenhao smiled and said: "Taiyang's typhoid fever is manifested because the evil guest of wind and cold is on the surface of the sun, Weiyang is suppressed, and the yin is stagnant. The cold evil is outside, and the body's yang cannot be dissipated, so the whole body is hot. The cold is closed, the pores of the skin are closed, and naturally there is no sweat.

If the camp is blocked and the normal function of resisting cold evil is lost, people will naturally feel cold. Because the cold evil enters the body and stagnates between the meridians, the yang energy is not relaxed, so the joints will ache.To put it simply, if the patient feels hot and cold without sweating after catching a cold, and the joints of the whole body are sore, it is probably a positive syndrome of Taiyang typhoid fever.do you understand? "

"I was confused," Xue Fei'er tilted her head to recall, then turned to Pang Yuqin, "What about you? Do you understand?"

Pang Yuqin's pretty face flushed slightly, and she nodded for a moment.

"It's fine if you understand it. Anyway, I'm just making up the numbers. Okay, now that we've got the proof, can you teach us how to get down?"

Pang Yuqin also opened her eyes wide, looking at Du Wenhao.

Du Wenhao said: "Treatment based on syndrome differentiation must be accurate in both syndrome differentiation and treatment. If the differentiation of syndromes is correct and the selection of classic prescriptions is wrong, it is not acceptable.

Physicians of the past dynasties have left many valuable proven prescriptions in the treatment of common and typical diseases, which can be used for us to choose and apply according to the syndrome differentiation. We only need to use these classic prescriptions, and then make appropriate additions and subtractions according to the specific situation of the syndrome differentiation, and then we can draw a specific prescription. "

"Then is there a prescription for this disease?"

"Of course there is! To treat this kind of disease, the medical sage Zhang Zhongjing has a famous classic prescription called 'Ephedra Decoction'. The prescription uses three qian of ephedra, two qian of cassia twigs, four qian of almonds, and one qian of moxibustion licorice. It is decocted and taken."

After Du Wenhao finished speaking, Pang Yuqin copied the prescription according to his dictation and sent it to the counter to pick up the medicine. The patient took the consultation fee with the medicine in his arms, thanked him and left.

The second patient is a farmer, about 40 or [-] years old, wearing a coarse cloth blouse, tied with hemp rope around the waist, carrying a parcel of blue cloth and flowers, wearing straw sandals, with muddy feet, and rolled trouser legs, sitting carelessly at the table , without waiting for Xue Feier to speak, he first said to Du Wenhao:
"Mr. Du, although my illness is also a cold, it is different from the previous one. I am afraid that only you can cure it. The two of them can't figure it out!"

Xue Fei'er was very unconvinced: "Oh? What's so great about a cold, and you can't even touch the door? You underestimate us too."

"Girl, I don't underestimate you. I have been sick for two or three years. I have sought many doctors, but they can't be cured. I heard that there is a young doctor in your county named Du who is good at Hua Tuo's magical technique of laparotomy. , I worshiped him as a teacher even if the genius doctor didn't charge money, so I came here full of hope.

My name is Tong Heizi, I'm from Hei'ao Village, about forty miles away from the county seat, and I came early in the morning before dawn.After seeing the disease, I have to go back. "

Xue Fei'er was very happy, she turned to Du Wenhao and said, "Sir, did you hear that? He came from the countryside forty miles away."

"Well, what happened?"

"What's the matter?" Xue Fei'er's eyes widened, "The countryside for dozens of miles! Then everyone knows your name from far away, and your reputation is getting bigger and bigger. One day, it will spread to the capital. Go, Wanzai has some kind of illness, maybe I will ask you to go to the palace to see him!"

"The more you talk, the more outrageous it is! Come on, hurry up and see a doctor, and they will rush back. ——But, brother, since your illness has been going on for two or three years, and it has been dragging on for a long time, I'm afraid the diagnosis is a bit complicated. You Don't worry, if you come, you will be at peace, and you can be cured if you see it properly, isn't that why you came to me."

"Yes, Mr. Du, I understand the reasoning. Okay, let the two girls show me first, and Mr. Du, please come back to see me."

"Okay, please, two doctors!"

"I'll come first!" Xue Fei'er did her part, thought for a while, and said to herself: "Look, hear, ask, look first!" She half got up, shaking her head, circling around the patient Tong Heizi, and said to Du Wenhao in doubt: " He...he looks normal, he doesn't look like he's sick!"

The patient said with a bitter face: "Girl, you are seeing that I am not sick now, but I have been sick for two or three years. I have a fever every day, once or twice a day. The fever is not high, but the fever makes me drowsy." I can’t work, and I’m afraid of the cold, sometimes it’s too cold to put on any clothes. My throat still hurts, and my joints hurt too, so I’m uncomfortable!”

Pang Yuqin took a closer look and said, "His complexion isn't normal either. Look at his mouth, it's abnormally reddish. Let me see your tongue."

The patient quickly stuck out his tongue.

Pang Yuqin stared at it for a while, then said to Du Wenhao: "Mr. Du, his tongue looks weird, how can we argue?"

Du Wenhao took a closer look, and said: "His tongue is a bit complicated, and you still can't understand what you have learned. You see, his tongue is light red and moist, and the coating is white and greasy. This is a sign of coldness. Pay attention." , the color of the tongue is still slightly purple, this is a sign of Chen Han's stagnation for a long time, and the cold has lasted too long. ——You can check his pulse again."

"Okay!" Xue Fei'er naturally took the lead. After taking the pulse, she thought for a while and said, "This pulse is also quite tight, and you can feel it right away. It's a floating pulse, just like the patient just now."

Pang Yuqin nodded after taking the pulse: "Yes, it's the same pulse."

Du Wenhao checked the pulse first, then nodded: "That's right, it's the same
Pang Yuqin said: "The same pulse, could it be that this patient is also suffering from typhoid fever?"

Xue Fei'er shook her head and said: "No! He has been having fever for two or three years, and the fever is relatively low. Mr. Du said that the superficial syndrome of typhoid fever is a superficial syndrome. You think, two or three years, how can there be such a long period of symptoms?" Certificate? I’m afraid it should have been converted into a certificate by now.”

Hearing what she said, Pang Yuqin lost her mind and looked at Du Wenhao.

Du Wenhao said: "Taiyang typhoid syndrome is caused by feeling external evils. The severity of feeling the evils is different from the ups and downs of the evils, and the severity of cold and heat symptoms will also be different.

When the pathogenicity is mild, both cold and heat are mild; when the pathogenicity is severe, both cold and heat are severe; when both positive and evil are prevalent, both cold and heat are severe; .But in any case, the simultaneous or alternate appearance of fever and aversion to cold is a distinctive feature of typhoid superficial syndrome, and it is not limited to the length of time.

Combined with his tongue being mainly cold, it confirmed the results of pulse diagnosis and clinic consultation. Therefore, Yuqin was right, his disease was the same as the previous one, and it was also a manifestation of Taiyang typhoid fever. "

Xue Fei'er pouted and said: "She is right again. Why can't I be right once?" Turning her eyes, she said: "This time I will prescribe the prescription - still use ephedra soup! Right?"

Du Wenhao shook his head: "Yes, not entirely!"

"why?"

"Mahuang Decoction is a strong medicine for pungent, warm and sweating. Excessive sweating will hurt people's righteousness. He has been sick for a long time, and he has already hurt his righteousness. He can't take it for a long time. Therefore, the amount of licorice in the prescription should be large. Only one penny is used in the front. This time it can be increased to six qian, and no moxibustion! Try to relieve severe sweating, and only take two doses.

He came from afar, and it was not easy to follow up for a follow-up visit, so the following prescriptions were prescribed together. ——After taking these two doses, you will sweat and reduce fever, but the Yingwei will be out of harmony. You should continue to take Guizhi Decoction with flavor, unblock the Yang and relieve the exterior, and reconcile the Yingwei. "

Du Wenhao mentioned the compatibility of Guizhi Decoction, but Pang Yuqin remembered it and sent it to the cabinet to pick up the medicine.

Xue Fei'er thought for a while, and wondered: "Since they are all evidence of typhoid fever, why are the prescriptions different?"

"Although the symptoms of the two patients are the same, their physical conditions are different, the length of the onset is different, and the pathogenesis is different. Of course, the treatment methods cannot be the same. This is the principle of 'same disease, different treatment'."

The farmer took the medicine, paid the consultation fee, thanked him and left.

Du Wenhao and his second daughter hurried to the dining room in the back hall to have lunch. When the doctor is free to eat, he has to eat quickly, otherwise, he will not be able to eat until the patient arrives. One day is also regular.

Sure enough, he had just finished his first bowl, and before he had time to refill, Silly Pang rushed in: "Mr. Du, Doctor Qian is here!"

"Oh." Du Wenhao continued to eat without raising his head.

"There is another patient, brought in by carriage."

"Oh," Du Wenhao thought to himself, the money does not charge a lot of beards, and he is also a medical practitioner. He is not ignorant to visit people during dinner. Since he is here, there must be some patients who cannot be handled. I came for my own consultation, so I continued to plan food, eat enough before talking.

"The patient vomited blood! He seemed to be dying."

Now Du Wenhao couldn't eat anymore, threw away the bowl, and stood up.

Silly Pang added: "It's from Fucheng, accompanied by a doctor from Fucheng."

"From Fucheng?"

Du Wenhao was taken aback.Fucheng is one or two hundred miles away from the county seat, so to be able to come to him for medical treatment from Fucheng can be regarded as coming from a long distance.Unexpectedly, even the people in Fucheng knew about his reputation, and at the same time he was quite proud of himself, but at the same time, he felt a little uneasy in his heart.

Even the doctor in Fucheng can't handle it if he doesn't accept the money. If you come to find yourself, the disease will definitely not be relieved.

Silly Fatty said another sentence, which made everyone stand up: "—the patient is a nun!"

　Yesterday, with the powerful firepower reinforcements from the book friends, after several consecutive tug-of-wars, the Song Medical Corps regained the No. [-] position!

　　This reminded Lao Mu of the Battle of Shangganling, how hard the battle was.At present, a powerful enemy is at the foot of the mountain, only three votes away from our position!The position may be lost again at any time!
　　There are still eight votes away from the No.3 No. [-] position ahead. In the afternoon, our army once broke into the front of the No. [-] position only three votes away, and even the enemy's guns could be seen clearly. Unfortunately, the enemy reinforcements When the troops arrived, our army was forced to retreat and failed to insert the red flag on the No. [-] high ground.

　　How fierce will today's battle be?

　　
　
(End of this chapter)