The second time, Changsha Fang is particular about taking it, and it is very different from China and the West in terms of wind and cold.
Time flies by before you know it. Xi Jianzhong and Zhong Xiaoyi were busy in the outpatient clinic early in the morning, when they suddenly noticed two familiar figures coming into the clinic. The two looked at each other, and it turned out to be the couple who had come to seek treatment for a cold two days ago. At this time, the husband seemed to be in good spirits and talked and laughed freely, but the wife who snuggled up to him was not in good spirits. After the wife sat down, she opened the conversation, saying that she felt good after taking the medicine every time, but because she was busy taking care of the children and attending tutoring classes during the winter vacation, she did not have time to stay at home and rest. Therefore, soon after taking the medicine, the symptoms of cold intolerance on the body reappeared, accompanied by mild fever, headache, and sweating as soon as I moved.
The patient's words reminded Xi Jianzhong and Zhong Xiaoyi of Professor Guo's teaching two days ago: to be a qualified doctor, especially a qualified Chinese medicine practitioner, is not just to achieve accurate syndrome differentiation and diagnosis, and to prescribe drugs accurately. The rationale and prescription of TCM are a complete whole, and the omission of any link may directly affect the final clinical efficacy. For example, in the clinical use of Guizhi decoction, in addition to telling the patient to add an appropriate amount of ginger when decocting the medicine, he should also be told to use a simmer for a long time, which is completely different from the decoction method of ordinary antidote using Wuhuo quick decoction. More importantly, after taking Guizhi Tang, it is necessary to follow the requirements of Zhongjing in the "Treatise on Typhoid Fever" and administer appropriate care. If the sweating effect of Guizhi decoction is weak, the patient must stay on the bed and cover the quilt to keep warm after taking the medicine, and take hot porridge or boiling water to help sweating. If you still don't sweat after the above methods, you can continue to take the medicine until you sweat. If you take Guizhi decoction without sweating, the wind and cold in the patient's body will not be able to **, and the external disease will not be cured. At the same time, patients should also avoid eating cold, greasy, spicy and other substances during the period of taking the drug, so as not to affect the efficacy of the drug.
Xi Jianzhong and Zhong Xiaoyi looked at each other for a moment, and their faces couldn't help but flush a little.
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Professor Guo did not blame the two of them, but said kindly: "Let's think of a way together to see how the patient should deal with it now."”
After some inquiry, the two young doctors recorded the medical history as follows: the patient took two doses of Guizhi decoction after feeling the wind and cold, but the illness was not resolved due to improper care. He still has chills, fever, headache, sweating from time to time, no cough, heavy nasal voice, and runny nose. The tongue is pale and white, and the veins are floating and weak.
The patient's basic syndrome has not changed, and Guizhi decoction should still be given**. Xi Jianzhong hurriedly said.
However, if the patient's pulse is illusory, can he still sweat?Zhong Xiaoyi was more cautious and asked Professor Guo tentatively.
Sun disease, the external evidence is unsolved, and the pulse is weak, should be relieved by sweating, and Guizhi soup (42). Professor Guo said in a frustrated voice, "This patient, although the pulse shows an illusion, because the disease is on the surface, he still has to sweat to achieve the evil. Moreover, the sweat of the patient is 'sick sweat', and if the evil does not go, the sweat will not stop, and the sweat will not stop, 'sweat is the liquid of the heart', and excessive sweating will hurt the righteousness more and more. And in the formula, the cinnamon branch and licorice are sweet and yang, and the peony is combined with glycyrrhizic acid and glycyrrhizic acid to dissolve yin, so the whole formula can dissolve muscles and camp and guard outside, and can turn qi into yin and yang inside, and has the power of strengthening the right and reaching the evil. ”
Professor Guo also asked Zhong Xiaoyi to prescribe two doses of Guizhi Tang to his wife, and explained in detail how to decoction Guizhi Tang.
Is your cold cured?Xi Jianzhong asked the gentleman next to his wife.
Yes, but I just have one more question for you," said the gentleman, "I did not sweat every time I took Chinese medicine, so the fever has not been relieved, and I feel upset from time to time, but the symptoms of cold, headache, and joint pain have been reduced." Shortly after my last dose this morning, I suddenly started to bleed. However, after the nosebleed stopped, I found that the symptoms such as fever, cold intolerance, and headache had disappeared, and I no longer had any more upset, and I felt much more relaxed. ”
There seems to be a clause in the "Treatise on Typhoid Fever" that there is epistaxis after taking ephedra soup, but I can't remember it. Zhong Xiaoyi said regretfully.
It's really rare to use a book!Zhong Xiaoyi now realizes that he should memorize all the original texts in the book when he is studying, and should not only choose the first and second level articles, after all, there is no key or non-key clinical disease.
Sun disease, pulse tightness, no sweating, fever, body pain, ** day incomprehensible, the symptoms are still there, this should be sweating. Ephedra soup is the main one. The medicine has been slightly removed, and the person is annoyed and blinded, and the dramatist will be relieved, and the problem will be solved. Therefore, Yang Qi is also important (46). Professor Guo said, "For the epistaxis phenomenon that occurs after taking ephedra soup, later generations of doctors also called it 'red sweat', which is a manifestation of wind and cold from the nose with bleeding, so the patient's epistaxis disappears after the external symptoms disappear and the disease is cured." ”
Listening to Professor Guo's skillful recitation, Zhong Xiaoyi secretly made up his mind that he must make a study plan and memorize all the articles of "Treatise on Typhoid Fever".
After the patients left, Professor Guo said to the two interns: "Although epistaxis that occurs after taking ephedra soup is a phenomenon of external dissolution of evil qi, patients often lack such understanding, and it is easy to mistakenly think that the disease has worsened. Therefore, as a clinician, one must inform it of the correct care method when using ephedra soup to reduce the occurrence of this situation, such as the patient we just now, if the patient can properly warm up and sweat, in fact, most of the cases of epistaxis can be avoided;Second, doctors should be predictable about the evolution of patients' symptoms and give necessary explanations and guidance in advance to avoid unnecessary panic among patients. ”
It turns out that in order to become a qualified doctor, you must not only have superb medical skills, but also have a wealth of clinical knowledge and a serious and responsible attitude and morality towards patients. Xi Jianzhong said with emotion.
However, I still have a question that I don't understand, why did one of them have a 'stroke' and the other have 'typhoid fever' when they are both suffering from a cold at the same timeXi Jianzhong continued to mumble quietly, "I used to think that Chinese medicine was not scientific enough, but now I find that this is really the case." Could it be that the wind evil and cold evil in nature are still selective in hurting people, and one person only hurts the 'wind', while the other only feels the 'cold' evil?”
Haha!Professor Guo smiled kindly when he heard this, "Zhong Xiaoyi, as a Chinese medicine practitioner, do you understand the truth?"”
I know that solar stroke and solar typhoid fever mainly refer to clinical symptoms, and there is a difference in meaning between simply being injured with 'wind' or 'cold'. Zhong Xiaoyi replied honestly.
You have learned in the basic theory of Chinese medicine that there are six different external evil qi in nature: wind, cold, summer, dampness, dryness, and fire, which are called 'six evils', and their pathogenic characteristics are completely different. In fact, the theory of the six prostitutions of traditional Chinese medicine is based on the relationship between man and the natural world, and combines a series of symptoms and signs manifested in the process of human diseases with the attributes of natural phenomena to make extensive comparisons and connections. It is not a direct study of the impact of six different climates in nature on the human body, but a study of the pathological response of the body similar to natural phenomena due to climatic factors, and then according to its pathological response and natural phenomena analogous to each other, and then derived a kind of 'simulation**' Therefore, the understanding of Chinese medicine does not pay attention to its objective reality, but mainly according to the clinical manifestations of the disease, that is, through the analysis of the symptoms and signs of the disease to deduce, that is, the so-called "syndrome differentiation and cause". Then, according to the "cause" obtained by the deduction, the "cause is examined". Therefore, even if the patient is diagnosed in the same environment, there may be differences in clinical manifestations due to differences in the patient's constitution, etc., and it may be possible to deduce completely different **. Therefore, the "pathogenesis" of traditional Chinese medicine already has the characteristics of "pathogenesis". ”
Looking at the two little doctors who were still a little confused, Professor Guo continued: "The two couples who felt the external sense in front of them, of course, the evil qi they felt were wind cold, but the wife's physique was weak, and after the illness, there was fever, bad wind, headache, sweating, slow pulse and other manifestations, and its syndrome was similar to the nature of the 'wind' evil pathogenic attributes, therefore, the syndrome was differentiated and the cause was obtained, and its ** was 'wind evil';The husband has a strong physique, and after the onset of the disease, he has similar manifestations such as chills, fever, no sweating, and tight pulse, which are similar to the pathogenic attributes of the cold evil, so he is identified as 'cold evil'. Qian Tianlai of the Qing Dynasty has a sentence that sums it up very well, he said: "The evil of external sensation is difficult to know by the original, but it can be discerned because it is known." That's what it says. ”
Xi Jianzhong and Zhong Xiaoyi were listening attentively, and were suddenly interrupted by a violent cough, if you want to know what twists and turns will occur in the follow-up diagnosis and treatment, please listen to the next decomposition.