Traditional Chinese Medicine doctor Gao-Yuan

Zhao Huanzhang glanced cautiously at Gao-Yuan. In truth, the situation had become clear to him right after seeing Li Runyu's prescription. Zhao Huanzhang was an excellent doctor himself, and by this point, he had figured out the full picture.

Gao-Yuan nodded and said, “Hiccups, or ergi, are referred to as ‘retching’ in the Huangdi Neijing (The Yellow Emperor's Inner Canon). Zhang Jingyue discussed it in his Jingyue Quanshu (The Complete Writings of Jingyue), specifically in the section on hiccups, where he explained, ‘The causes of hiccups are of three types: cold, heat, and deficiency.’”

“Dr. Li Runyu treated your condition as cold-induced hiccups and included tonics to address deficiency. This was based on the assumption that, given your advanced age, your body's vital energy might be weak. However, your condition isn’t due to a cold in the stomach but rather from stomach heat.”

“Oh?” Director Qi looked puzzled.

Gao-Yuan explained, “You’ve only been ill for eight days, so it’s not a case of prolonged illness, meaning you wouldn't have extreme deficiency causing the hiccups. But your fever has been growing worse, you’re experiencing constipation, and your tongue coating is thick and yellow—all signs of excess internal heat in the yangming system.”

“You previously had an external ailment, which gradually invaded deeper into your body and lodged in the yangming meridian. This caused excess heat to accumulate inside, obstructing the flow of qi, which led to the hiccups. What’s confusing about your case is the misleading pulse.”

Director Qi glanced at Gao-Yuan and asked, “I know a little about traditional Chinese medicine. Isn’t a slow pulse usually a sign of cold?”

Gao-Yuan nodded. “Yes, a slow pulse is typically associated with cold, but sometimes the pulse can deceive you.”

Director Qi looked surprised.

Gao-Yuan continued, “That’s why traditional Chinese medicine emphasizes the four diagnostic methods—observing, listening, questioning, and feeling the pulse. Each method could potentially give misleading information. For instance, your pulse is slow, but it doesn’t signify a cold pattern; instead, it indicates yang heat penetrating deep inside.”

“The reason for your sluggish pulse is that pathogenic heat has obstructed your meridians, causing stagnation in the flow of qi and blood. The Treatise on Cold Damage (Shanghan Lun) states, ‘In yangming disease, a slow pulse... Da Chengqi Tang (Major Order the Qi Decoction) is prescribed.’ You see, even with yangming heat illness, a slow pulse can appear, and Chengqi Tang can be used to purge the heat.”

Director Qi pondered for a moment before asking, “Are you saying that Dr. Li Runyu misdiagnosed me?”

Zhao Huanzhang immediately became tense.

Gao-Yuan, however, nodded directly. “Yes. If the diagnosis and treatment were correct, you would have already seen some improvement.”

Zhao Huanzhang broke into a sweat. Goodness, Gao-Yuan really wasn’t afraid of offending people.

Director Qi looked at Gao-Yuan thoughtfully. “I suppose the next time I see Dr. Li Runyu, I’ll have to discuss this thoroughly with him.”

But Gao-Yuan shook his head. “Treating illness in Chinese medicine is always a delicate process. We nearly fell into the same trap ourselves, misled by your pulse. In fact, we should thank Dr. Li Runyu. If it weren’t for his initial diagnosis, we might have made the same mistake.”

Upon hearing this, Zhao Huanzhang let out a sigh of relief.

Director Qi chuckled. “You’re quite the interesting young doctor. When you first came in, before treating me, you were full of bravado, even looking down on Dr. Li Runyu. Now that the treatment is working, you’ve become modest and even speak up to cover for him.”

Zhao Huanzhang also looked at Gao-Yuan.

Gao-Yuan didn’t reply but simply gazed out the window, looking toward the New Life Clinic.

Seeing that Gao-Yuan wasn’t speaking, Director Qi said, “In that case, why don’t I trouble you both to prescribe me some medicine?”

Gao-Yuan turned back and replied, “Very well, let’s use Xiao Chengqi Tang (Minor Order the Qi Decoction).”

“Wait,” Zhao Huanzhang hurriedly pulled Gao-Yuan aside and whispered, “Shouldn’t we be more cautious? Director Qi is already quite old, and using Chengqi Tang with Da Huang (rhubarb) and other purgatives could be risky.”

Gao-Yuan was speechless. Zhao Huanzhang’s overly cautious habit was resurfacing again. He said, “Not all illnesses in the elderly are deficiency syndromes. Not all old people are too weak to endure aggressive treatment. If the condition is present, the appropriate medicine should be used. If there is illness, the illness will bear the treatment; only when there is no illness will the body suffer from the medicine.”

“If the diagnosis is correct, we should boldly administer the treatment. Hesitation will only delay the illness. If we allow the pathogenic factor to sink deeper into the body, it will be the doctor’s fault. When the disease worsens, will you still hesitate and worry, just as you are now?”

Zhao Huanzhang was left speechless, unable to refute this reasoning.

Gao-Yuan sighed inwardly. Everyone in their joint clinic had their own issues, and Zhao Huanzhang was no exception. His problem was excessive caution. He had three major fears: fear of treating serious illness, fear of treating leaders, and fear of failing and being held accountable.

As a result, more than half of Zhao Huanzhang’s medical skills were locked away. This was why, in their past lives, Zhao Huanzhang had privately lamented that if he had returned earlier, Zhang Yuancai’s mother might have had some hope. With his capabilities, such illnesses should have been manageable, but his overcautious nature always held him back.

In rural areas where medical resources were scarce, doctors frequently encountered critical cases. Yet, when faced with such diseases, Zhao Huanzhang would always tread lightly, often causing delays in treatment. Afterward, he would fall into deep regret, but the next time he encountered a critical illness, his fear and caution would resurface again.

He was a walking contradiction, trapped in a vicious cycle.

Seeing Zhao Huanzhang silent, Gao-Yuan fetched some paper and a brush to write out a prescription for Xiao Chengqi Tang, then handed it to Zhang Yuancai. “Can you get the medicine here?”

Zhang Yuancai nodded. “Yes, we can.”

Director Qi joked, “They say Ren Shen (ginseng) kills without guilt, but Da Huang (rhubarb) saves lives without credit. You’re quite bold for a young doctor, daring to prescribe such strong medicine.”

Zhao Huanzhang quickly interjected, “Director, would you like to change the prescription?”

But Director Qi responded, “What’s that supposed to mean? Since when do patients pick their prescriptions? I’m not a doctor—you two are. If this young doctor dares to prescribe it, I dare to drink it.”

Gao-Yuan gave Director Qi a small smile.

It seemed these two were in sync.

Soon, the medicine was brewed and brought in.

Gao-Yuan instructed Director Qi to drink half of it first.

As Director Qi held the bowl, he joked, “If this bowl knocks me out, who’s going to save me?”

Zhao Huanzhang let out an awkward laugh.

Director Qi added, “Don’t tell me that after drinking this, you’ll have to call Dr. Li Runyu to clean up the mess. Some people were talking big just now, weren’t they?”

Gao-Yuan replied calmly, “You’ll have to drink it to find out.”

Director Qi laughed a few more times, then, without further ado, drank half of the medicine. Shortly after, he began to experience bowel sounds and started passing gas.

However, soon after, he became restless, fidgeting in his chair and feeling a little irritated. “Why do I still feel somewhat agitated?”

Gao-Yuan replied, “You’ve started to pass gas. Now, drink the remaining half of the medicine.”

Zhang Yuancai asked, “He should drink more?”

Gao-Yuan nodded. “Yes, drink the rest.”

Zhao Huanzhang seemed like he wanted to say something but held back.

Director Qi took the bowl, glanced briefly at Gao-Yuan, and then tipped his head back to drink the rest.

Afterward, Director Qi frowned and began fiddling with his collar, visibly uncomfortable. He asked, “Now that I’ve taken the medicine, let’s talk business. What is it that you came here for?”

Gao-Yuan responded, “It’s like this. We came today to discuss two matters with you.”

Before Gao-Yuan could finish, there was a knock at the door, and a young man rushed in to whisper something in Director Qi’s ear.

“What?” Director Qi suddenly looked alarmed. He stood up quickly and said, “Doctors, is your matter urgent?”

“Huh?” Gao-Yuan and Zhao Huanzhang both looked confused.

Director Qi continued, “If it’s not urgent, can we discuss it tomorrow? You see, it’s already dark outside. How about I ask Xiao Zhang to arrange a place for you to stay tonight?”

Gao-Yuan could tell that the other party had an urgent matter to attend to, so he nodded and said, "Very well, Director Qi, if you have something pressing to take care of, we can discuss this tomorrow. It makes no difference to us."

"Alright." Director Qi grabbed his coat and hastily said to Zhang Yuancai, "Xiao Zhang, make sure you arrange for them to stay the night."

With that, Director Qi hurriedly left the room, leaving the group standing there, exchanging uncertain glances.

Zhao Huanzhang let out a sigh and said, "Actually... it would have been better to discuss the matter today."

Gao-Yuan asked, "Why?"

Looking at the empty medicine bowl with a concerned expression, Zhao Huanzhang replied, "What if the treatment doesn’t work, or worse, it backfires and damages his vital energy? It’ll make things much more difficult to discuss tomorrow."

Gao-Yuan: "..."