Chapter 115: 115 qi does not enter the orifice (Happy New Year)
「Ward.」
"The patient is Yang Xiongzhi, 36 years old. He lives next to Central Primary School. This morning, he suddenly collapsed. He was unable to speak, drooling from the corner of his mouth, and his right hand was numb and immobile. There was no limb reaction when his right arm was touched. He initially went to the Municipal Traditional Chinese Medicine Hospital for treatment and was subsequently admitted to our hospital at noon."
Wu Buwei provided the introduction, as this was, after all, the patient he had admitted.
"He went to the Municipal Traditional Chinese Medicine Hospital, so why did he come back?" Du Heng asked casually while examining the patient.
The patient's wife smiled. "The doctor at the Municipal Traditional Chinese Medicine Hospital said it was a qi deficiency stroke and recommended hospitalization. But then I remembered you, Doctor Du. Aren't you renowned for treating strokes? There was so much positive commotion about your work last month. So, I brought my husband here for your treatment."
Du Heng chuckled. "I truly appreciate your trust."
After checking the pulse and pinching the patient's arm, which elicited no response, Du Heng became thoughtful. "Does your husband usually experience any discomfort?" he asked. "Such as dizziness or headaches?"
"I don't think so," the patient's wife replied after a moment. "He seems quite normal."
Du Heng nodded. "Does he have a weak stomach?"
"That's true," she affirmed. "He often complains about a burning sensation in his stomach and has taken a lot of medication for it."
Du Heng stepped back. "Your husband's condition is indeed due to qi deficiency," he stated, "but it's not a stroke."
The patient's wife asked in confusion, "If it's not a stroke, then why can't he move his arm or speak?"
Du Heng chuckled. "We shouldn't automatically assume that an inability to speak and limb numbness indicate a stroke. That's incorrect."
Du Heng had developed a habit of inadvertently testing Wu Buwei.
However, when he turned his head and saw Wu Buwei's face contorted like a wrung-out cloth, his heart softened.
With a low chuckle, he explained to the patient's wife, "His condition is due to a deficiency of both heart qi and stomach qi. When qi cannot flow to the stomach, it causes stomach qi deficiency, which in turn leads to internal heat. This heat steams the body fluids, transforming them into phlegm that obstructs the channels. Furthermore, this prevents qi from reaching the heart, thereby blocking the spirit's pathways."
Du Heng spoke slowly. His explanation was not just for the patient and his family, but also for Wu Buwei. In fact, the explanation was primarily for Wu Buwei's benefit; if he were only explaining to the family, he would have simplified it considerably.
Pausing, he continued, "When qi doesn't enter the orifices, the spirit becomes disoriented and loses its anchor. That's why his tongue is unable to form words. As for the drooling, it's because the Lianquan acupuncture point is open."
Du Heng returned to the patient's side, pressing his right arm and the limbs on his right side. "The body's ability to move and function relies entirely on the circulation of qi," he said. "When the heart qi is severely deficient, qi cannot reach the limbs, rendering the hand unresponsive. This is particularly true for the right hand, as it is strongly influenced by qi. Therefore, numbness due to qi deficiency usually manifests on the right side."
Du Heng lightly scratched the patient's arm with his fingernail; the arm showed no reaction at all. Instead, the patient looked up at Du Heng intently. He was desperately anxious, waiting for Du Heng to explain the treatment. If he could speak, he would have cried out already.
Du Heng, unaware of the patient's inner turmoil, simply paused for a moment before continuing, "If qi cannot reach the skin and muscles, then there is no sensation of pain or itching. If such a condition is treated as a wind disease, not only will it not improve, but it will likely worsen, potentially even leading to death. If Expelling Wind Medicine were added to a treatment meant for tonifying qi, it would merely prolong the patient's suffering and inevitably lead to a wind disease manifesting as hemiplegia."
These last few sentences were delivered entirely for Wu Buwei's benefit.
The cornerstone of treatment in traditional Chinese medicine is syndrome differentiation and the corresponding medication.
If the syndrome differentiation is off by even a little, the prescribed medication can be wildly inaccurate.
If the wrong medication is used and the patient doesn't die, it's simply a case of the prescribing doctor being lucky and the patient having a strong constitution.
This is why you sometimes hear of people walking into a traditional Chinese medicine clinic for treatment, only to be carried out later.
Therefore, there are two primary places to seek a traditional Chinese medicine doctor.
The first option is the city's leading hospital; about ninety percent of the best local traditional Chinese medicine doctors practice there.
The second is to find a doctor with a private clinic that has been operating for over ten years without going bankrupt or the doctor, metaphorically speaking, being run out of town. Such a doctor is definitely skilled, and they make up about another three percent.
The remaining seven percent of good traditional Chinese medicine doctors are scattered among the other ten or twenty hospitals in the area. Finding one of them often comes down to luck.
Being subtly reprimanded by Du Heng like this left Wu Buwei feeling rather embarrassed.
The patient and his wife, however, turned pale with fright.
After all, earlier that morning, the doctor at the Municipal Traditional Chinese Medicine Hospital had diagnosed him with a stroke caused by qi deficiency.
According to that diagnosis, Expelling Wind Medicine would surely be prescribed.
If Du Heng was correct, that course of treatment could have been fatal.
Du Heng also felt a sense of unease. This was the second consecutive patient who had previously been seen at the Municipal Traditional Chinese Medicine Hospital.
This patient was fortunate, as he hadn't undergone their treatment. The previous one, however, had already developed hemiplegia as a result of it.
What was he to do? Criticize that doctor? Or tell people not to go to the Municipal Traditional Chinese Medicine Hospital? Anything he said would sound like nonsense.
Du Heng shook the thought from his mind. He just needed to focus on doing his own job well.
As for the patients' choices, that was their own affair.
"Buwei," Du Heng said, "take this down. Then get the medicine for the patient. Prescribe Six Gentleman Decoction with added aconite. Ten doses should be sufficient."
Wu Buwei had already taken out his small notebook to jot it down, but upon hearing the word "aconite," he couldn't help but shiver.
Li Qiuhua was due to be discharged soon. This should have been a joyous occasion, a reason for everyone to celebrate.
However, when Wu Buwei and the Pharmacy Doctor reviewed her prescriptions the previous night, they did a quick tally. Li Qiuhua had consumed a total of 1.5 kilograms of aconite over the past ten days.
During her treatment, the aconite was dispensed in amounts of 200g or 90g at a time. Although these quantities initially felt large, they grew accustomed to it as Li Qiuhua steadily recovered.
But the final tally was truly frightening.
One and a half kilograms! Some doctors might not prescribe that much aconite in an entire year. Some even deliberately avoided using aconite, perhaps not prescribing such an amount in their entire careers.
Additionally, she had been given 3 grams of musk and 60 grams of blast-fried pangolin scales.
The authentic blast-fried pangolin scales were becoming increasingly rare; every bit used was a bit gone.
The Pharmacy Doctor had been scouring all his contacts recently, to the point where he was close to being blacklisted by his former classmates and colleagues.
"Senior Brother," Wu Buwei hesitated before asking, "why are we adding aconite this time? Is it still the primary ingredient?"
Du Heng was a bit displeased by this. This boy really needs to study more, he thought, then explained, "Adding aconite is like giving a general clear authority; its effects permeate all the meridians, connecting the heart and stomach, and preventing phlegm from causing blockages. Thus, it serves as a medicinal guide, directing the entire therapeutic strategy. Do you understand?"
Wu Buwei swallowed hard. What was wrong with Ma Zichen? Why wasn't he at work yet? Leaving him all alone to face the music… He was finding it increasingly difficult to keep up with Du Heng's demanding pace.
"Three grams per dose will be sufficient," Du Heng added.
He then addressed the patient and his wife, "Please rest assured and stay here. Take the medicine three times a day, punctually. I guarantee that after the first dose, his voice will return. After the second, the drooling and phlegm will cease. After ten consecutive doses, all his previous symptoms will be resolved. He should stay for three days, after which he can be discharged. He can then continue his recovery by taking the remaining medicine at home."
"Thank you so much, Doctor Du. We've really troubled you."
"Not at all," Du Heng replied. "If you need anything, just ask Dr. Wu. He…"
Before he could finish his sentence, Wang Zhenzhen rushed in, flustered. "Xiao Heng, come downstairs quickly! There's a child with a blue face!"
"A blue face?"
"Yes! His face and neck are completely blue!"