Traditional Chinese Medicine doctor Gao-Yuan

Following the departure from the train...

Gao-Yuan and Zhang-Yuancai carried sacks of medicinal herbs back. Zhang-Yuancai finally found a helper to carry the load.

Gao-Yuan had some recollection that Zhang-Yuancai’s house was not far from the town's united clinic.

"Indoor!" Zhang-Yuancai shouted loudly at the entrance, "How's mom?"

An anxious voice came from inside the house: "Come in quickly; mom is not doing well. Doctor Liu Sanquan has already arrived."

Zhang-Yuancai quickly threw down the large bags on the ground and rushed inside.

Gao-Yuan also placed the sack in his hands on the ground and followed behind.

Before they even reached the inner room, they heard violent coughing.

"Mom." Zhang-Yuancai rushed in.

Gao-Yuan looked at Doctor Liu Sanquan, who was pondering on the side; his eyes dazed.

Liu Sanquan also looked back, puzzled as to why this young man kept staring at him. "Is something wrong?" Liu Sanquan asked Gao-Yuan.

Gao-Yuan shook his head and turned his attention to the elderly lady leaning on the bed.

Zhang-Yuancai anxiously asked his wife, "How did it get this serious?"

Zhang-Yuancai’s wife replied, "Just these past three days since you went out, it suddenly worsened. Mom said it felt like a slab of stone was pressing on her chest, making it hard to breathe. Every breath feels like needles pricking her; the pain is unbearable."

Zhang-Yuancai looked increasingly worried.

Gao-Yuan observed the old lady’s condition: her face was haggard, eyes sunken, sweating profusely, and coughing violently. Speaking and breathing had become extremely difficult, as if an invisible hand was gripping her throat.

Gao-Yuan wasn’t sure what illness she had. In his past life, when he had just returned, he was an utter novice in traditional Chinese medicine. When he worked as an assistant at the United Clinic, the old lady had already passed away.

He only remembered that after the old lady passed away, the clinic's director, Zhao Huanzhang, returned from out of town. He privately lamented that if he had returned earlier, the patient might have had a chance.

Zhao Huanzhang dared to say this because he was exceptionally skilled in medicine, ranking among the top in the county as a traditional Chinese doctor.

Recalling this past event, Gao-Yuan felt assured that Zhao Huanzhang had the capability to help.

Gao-Yuan asked, "Uncle Yuancai, what illness does the old lady have?"

Zhang-Yuancai anxiously replied, "Severe bilateral tuberculous exudative pleurisy, with pleural effusion. Experts from the city hospital said that except for the first to third ribs on both sides, all others were filled with fluid."

"They initially suggested draining the fluid, but my mom refused, so we could only bring her back. How did it suddenly worsen?" Zhang-Yuancai anxiously asked his wife, "Did you give mom her medicine?"

Zhang-Yuancai’s wife responded, "Yes, the streptomycin that the city hospital had prescribed. It hasn’t been stopped for the past ten days. I had Xiao Cai from the public pharmacy come over to administer it while you were away."

Zhang-Yuancai scratched his head in frustration.

Gao-Yuan observed that the old lady’s lips had turned blue. She could no longer speak and was struggling to breathe.

Wanting to ask Zhang-Yuancai for more information, Gao-Yuan saw that he had gone to consult Doctor Liu Sanquan.

Gao-Yuan could only ask Zhang Yuancai’s wife. He learned that the old lady initially had fever and chills like a cold but continued working without paying much attention. Later, she experienced chest tightness, night sweats, and severe coughing.

She was sent to the county hospital, but since they didn’t have an X-ray machine, she was transferred to the city hospital. The diagnosis was severe bilateral tuberculous exudative pleurisy with pleural effusion. After returning home, her condition suddenly worsened, making it hard to breathe. Each breath felt like needles stabbing her, and she could barely eat more than three ounces of food daily.

Gao-Yuan stepped forward to observe the old lady’s tongue. Her tongue’s edges and tip were covered in blood spots, and her lips and tongue were blue.

Gao-Yuan pondered, noting that the color of her tongue resembled visible blue veins on the skin, lacking red color, indicating cold condensation, Yang depression, and blood stasis. The tongue was also covered in blood spots, indicating more stagnation.

Zhang-Yuancai urgently asked Liu Sanquan, "Doctor Liu, when will Doctor Zhao Huanzhang return?"

Liu Sanquan rubbed his wrinkled forehead and said, "It’ll probably be another four or five days."

Zhang-Yuancai, growing increasingly anxious, exclaimed, "We can’t wait that long! Please prescribe something immediately to provide urgent relief! We can’t let my mom suffocate to death!"

Liu Sanquan nodded cautiously and glanced over at the old lady, only to be taken aback: "Who’s that person you brought back?"

"What’s the matter?" Zhang-Yuancai turned to see the young man he had brought back, taking his mother’s pulse. He was stunned, realizing that the young man was indeed a doctor, though he had initially thought of him as merely a helping hand.

Soon, Gao-Yuan finished taking her pulse and made his judgment: it was a critical case of suspended fluid retention, soon to become terminal.

He walked over to Liu Sanquan and looked at him.

Puzzled, Liu Sanquan looked back at Gao-Yuan. Why was this young man staring again? Gao-Yuan leaned in and whispered, "What formula are you planning to use?"

"Hmm?" Liu Sanquan was taken aback. He glanced at Zhang-Yuancai and then asked Gao-Yuan, "Do you know how to do it?"

Gao-Yuan was at a loss for words.

At this, Zhang-Yuancai's expression changed, and he said irritably, "Young man, don’t disturb Doctor Liu. Doctor Liu, please prescribe something quickly; my mom’s life is on the line!"

Given the urgency, Liu Sanquan didn’t dare delay and said, "Let's start with the Shizao Tang (Ten Jujube Decoction). I’ll prepare the medicine and bring it over."

With that, Liu Sanquan turned to leave.

But Gao-Yuan reached out and grabbed him.

Startled, Liu Sanquan shook off Gao-Yuan’s hand, displeased, "What are you doing?"

Gao-Yuan finally understood the prescription Liu Sanquan was going to use. No wonder Zhang-Yuancai had sought trouble later. With things as they were, he couldn’t worry about saving face for Liu Sanquan; saving a life was more important.

Gao-Yuan shook his head and said directly, "No, it’s too late to use Shizao Tang now."

Liu Sanquan laughed and said, "Synopsis of the Golden Chamber, saying, ‘For suspended fluid retention, use Shizao Tang.’ Pleural effusion is suspended fluid retention, understand? You’d better read more books, young man."

After saying this, Liu Sanquan was about to leave again.

Seeing Gao-Yuan about to stop him, Zhang-Yuancai became displeased, "Hey! Young man, why are you being unreasonable? How could you know more than an experienced doctor?"

Gao-Yuan quickly explained, "But the 'Treatise on Febrile Diseases Caused by Cold' clearly states that Shizao Tang requires the precondition of 'relieving the exterior syndrome first' before it can be used, and there must be symptoms of fullness, hardness, and stuffiness in the epigastrium and abdomen. Therefore, Shizao Tang is used for suspended fluid retention with both exterior relief and unresolved internal symptoms, not for every case of suspended fluid retention!"

Hearing this, Liu Sanquan paused, stunned, and turned to look at Gao-Yuan.

Zhang-Yuancai also froze, unable to understand.

Seeing Liu Sanquan stop, Gao-Yuan continued, "If this had been more than a month ago when the suspended fluid retention had just started, using Shizao Tang after relieving the exterior syndrome would have been effective. But now, it’s dragged on for so long and has worsened. She can no longer eat and can barely breathe. Her body is so weak; she can't withstand the drastic effect of Shizao Tang."

Liu Sanquan became skeptical. Was this mentioned in the Treatise on Cold Damage Diseases? Gao-Yuan said frankly, "The patient’s pulse is thin, rapid, and inconsistent. A thin pulse indicates dampness or Yang deficiency, matching her suspended fluid retention condition. The rapid pulse suggests heat, yet a thin and rapid pulse often appears in Yin deficiency, which doesn’t match the patient’s condition. When pulse and symptoms match, it’s auspicious; if they don’t, it’s ominous. The pulse is erratic, and the patient is already at the brink of danger. If you use Shizao Tang, can you take responsibility?"

Upon hearing this, Liu Sanquan felt nervous, instinctively clenching his muscles. He knew the aggressive nature of Shizao Tang.

Zhang-Yuancai’s eyes shifted between Gao-Yuan and Doctor Liu, uncertain of whom to believe.

Liu Sanquan felt nervous and immediately said to Zhang-Yuancai, "The treatment of suspended fluid retention with Shizao Tang is written in medical books; I didn’t make it up. Your mother’s illness couldn’t even be handled by the big hospital in the city. I'm just an ordinary rural doctor. If you want to find someone else, go ahead, but I’m not confident and can’t bear the consequences. Don’t blame me!"

"I…" Zhang-Yuancai was at a loss for what to do. In a panic, he said, "Then what should I do? Where can I find another doctor? Zhao Huanzhang hasn’t returned yet."

Liu Sanquan spread his hands and said, "To be honest, even if Zhao Huanzhang were back, it would be the same. Though it may not be pleasant to hear, you know this deep down. Even the experts at the big hospital couldn’t do anything, and her condition only worsened. Around here, who could have a solution? Who could be sure?"

Gao-Yuan calmly said, "I can."