Doctors in the late Ming Dynasty
Chapter 166 The expert takes action
Zhang Jiebin looked at the people in the Tai Hospital greeting the common people, feeling unspeakable envy in his heart, but there was nothing he could do about it, because when he needed it most, he was hundreds of miles away.
Of course, in addition to Zhang Jiebin, there were several other people who also looked envious. They were either doctors from Gyeonggi Province or performing missions abroad.
Zhang Jiebin looked at Wang Tingfu and the others and suddenly felt that they were brothers in distress.
After walking and walking for three quarters of an hour, the group of people arrived at Gulou East Street. Zhang Jiebin was no stranger to this place. He had been running here frequently in the past five years.
Yang Jishi looked at everyone with a smile and said: "This medical examination involves diagnosis, prescriptions, acupuncture, massage... Therefore, we have to write notes. As long as it can help cure the disease, we will take the test. No matter how difficult it is, we will do it!"
"Doctors are no better than others. A doctor must know medicine, medicine, prescriptions, acupuncture and massage. He must also know the right time and place, and the various conditions of the world. Not only must he understand, but he must also be precise. For a doctor, time is life, and in one breath
, it’s life and death!”
Zhang Jiebin was convinced, Ma Shi's eyes were also brightened, and everyone was deeply touched.
Yang Jishi was very satisfied, and pointed to the Chu Di doctor on the side, and said to everyone present: "By the way, these are half of your classmates, well, they are all disciples of Mr. Binhu, and they are here to participate in the competition.
Let’s discuss things in advance today. Okay, let’s get ready, the diagnostic test is about to begin.”
Zhang Jiebin walked into the hall and was a little dumbfounded. He saw ten tables, ten medicine shelves, ten beds, and corresponding stools. There were pulse pillows, acupuncture, and knives on the tables... These were all fine.
, the problem is that the medicine shelves have no labels or scales.
Everyone was also surprised. Tang Xinglu asked: "Mr. Yang, are you trying to test our medicinal properties and control of dosage?"
Gong Dingguo also said: "It's very difficult to take the medicine by hand without weighing it!"
Chen Shigong finally smiled at this time: "This has little impact on me. It can be treated externally, but in the worst case, I won't need medicine."
"Yes, there are still some difficulties. There are ten patients per person, and each person has a time limit of one quarter, for a total of ten quarters of an hour. You can start with the easy ones and then the more difficult ones." Yang Jishi seemed to be saying a very simple thing: "There will be three rounds of competition.
In the first round with the top five from the top two, the remaining two will be yours!"
At the end, he said it to Li Jianyuan and others. Li Jianyuan nodded, looked at Mao Shihong and the others who were eager to try, thought for a while, and named Che Dajing and Fan Wei.
Mao Shihong was a little disappointed, but he still didn't say anything. Che Dajing and Fan Wei were very excited. When they heard that he was a master from the first or second class of Tai Hospital, they became high-spirited.
"Okay, ten of you, get ready. The timer will start after one stick of incense."
After Yang Jishi finished speaking, Wang Men lit a stick of incense, and Zhang Jiebin and the ten people immediately went to their own clinics in order and began to race against time to familiarize themselves with the medicinal materials.
Sharpening the knife is a waste of time. If you don't identify and write down the type and location of the medicinal materials first, it will take more time to prescribe the medicine later.
Zhang Jiebin, Ma Shi, Wu Kun, Yu Yaori, Vanke, Gong Dingguo, Chen Shigong, He Qihou, together with Che Dajing and Fan Wei, all used their hands, eyes, heart and mouth.
Fortunately, these are commonly used medicinal materials and are not difficult to identify. The only difficulty is that the prescription cannot exceed these medicinal materials. This requires doctors to flexibly formulate prescriptions, understand the properties of various medicines, and know the substitutes for each medicine.
Among the ten people present, Ma Shi, Wu Kun, Tang Xinglu and Chen Shigong were the easiest. Both Ma and Wu were good at classic prescriptions, Tang Xinglu was the best at medicinal properties, and Chen Shigong was the best at surgery and external treatment.
While the ten people were busy getting familiar with the medicinal materials, Yang Jishi came and sat down at Zhang Jiebin's consultation table. Zhang Jiebin took one look and continued to memorize the medicines.
At the same time, Gong Tingxian also came to sit down at Ma Shi's consultation table. There was also a medical officer at each of the other eight consultation tables, and ten others were responsible for maintaining order and arranging patients.
Seeing that the incense was about to be burned out, Wang Men said: "The time has come, let the patient come in."
With the sound of Wangmen's voice ringing out, the medical examination officially begins!
The first patient was a woman. Zhang Jiebin knew that this was a test of his gynecological skills. He saw the patient walking slowly, and his complexion was obviously not very good. Although his gait was balanced, he lacked some stability, his eyes were a little floating, and his complexion was slanted. In the color of green and yellow.
"Deficiency syndrome!" The moment Zhang Jiebin saw the visitor, he made a preliminary judgment in his mind. Then he looked carefully and found that the other person was deficient in yang energy, especially spleen yang.
Insufficient spleen yang, liver qi invades the spleen, and the cyan color appears, mixed with yellow, which is caused by the weak color of spleen earth.
After the woman sat down, Zhang Jiebin began to ask: "How old are you this year?"
"twenty."
"Where do you feel uncomfortable?"
"Some time ago, I vomited blood because I was anxious. I vomited twice."
"Put out your hand and I'll take your pulse."
The woman stretched out her hand, and Zhang Jiebin began to feel her pulse and asked, "How is your temper?"
"Easily anxious and easily angry."
"Have you taken any medicine?"
"I have eaten. The doctor prescribed me Xiaoyao Powder and Longdan Xiegan Pills. I have been taking them for seven days. Recently, my stomach has become even more uncomfortable, and..." After saying this, the woman's voice gradually became inaudible: "I woke up this morning. Stomach trouble... diarrhea..."
"The pulse is heavy and stringy." Zhang Jiebin took the pulse and came to a conclusion. He looked at the tongue coating and suddenly frowned. Sure enough, the difficulty was really high! In this first patient, the tongue and pulse were inconsistent.
My mind was spinning, thinking about the inconsistency between tongue and pulse, how to judge and how to choose.
This first patient gave Zhang Jiebin a disastrous blow, which completely wiped out his previous joy of winning the first place.
For such a patient, the probability of finding a good doctor outside is very low!
Because the patient is too young, it is difficult for him to develop deficiency symptoms. If he is judged based on his tongue appearance, he should be treated with clearing the liver and cooling the blood. This is another big problem!
In short, this is not an ordinary disease. It looks like vomiting blood, a bad temper, and a yellow and greasy tongue coating... But Zhang Jiebin is sure that the woman is actually "suffering from fatigue"!
Yes, this is a disease that is difficult for doctors to diagnose among the four diagnostic methods. It is called asthenia.
This chapter is not over, please click on the next page to continue reading! The name of the disease comes from "Synopsis of the Golden Chamber: Syndrome and Treatment of Blood Paralysis, Deficiency and Pulses", it is a frailty disease caused by the damage of righteousness and is contagious and manifests as weakness
Syndrome of disease.
It is generally difficult to have a main symptom of this disease. The main symptom is that there is no main symptom!
That's right, because consumptive fatigue is caused by the deficiency of the five internal organs, and the deficiency of each organ has different manifestations.
The patient seems to have liver qi invading the spleen, causing spleen deficiency. However, it is actually due to insufficient earth qi and weak spleen yang, which results in the inability to inhibit the normal behavior of the liver, which is why the bluish-yellow color appears on the face.
If it is excessive liver qi, this is not the case. Therefore, one wrong step will lead to a wrong step. Xiaoyao Powder can be used to harmonize the liver and spleen for liver stagnation and spleen deficiency, but its strength is too weak.
However, using gentian to purge the liver is too strong and excessively purges the liver and gallbladder qi. On the contrary, it will damage the liver yang. Liver yang originates from the yang qi of the heart and kidneys. If the basic yang qi is damaged, the spleen yang will be insufficient.
When doctors treat diseases, the difficult thing is diagnosis. It is difficult for a doctor to become a quack doctor if he can diagnose accurately. Of course, he cannot become a famous doctor if he cannot treat.
Zhang Jiebin clarified these things and finally breathed a sigh of relief. As for the seemingly severe vomiting of blood, it was not difficult to understand after clarifying these things.
The liver stores blood, and due to insufficient liver qi, it cannot absorb blood, causing blood to overflow.
Therefore, Zhang Jiebin judged that the woman's condition was due to spleen yang and kidney yang, which was bitter, cold, and lubricating, which hindered her normal growth and health, so she had abdominal pain and morning ejaculation and was unable to eat. This was also the reason for her heavy and thready pulse.
The idea of holistic dialectical treatment has since become completely clear.
This assessment is very interesting. Not only do you have to write a diagnosis, but you also have to write notes. The so-called notes are the reasons for the patient's physical discomfort.
Zhang Jiebin wrote: "This case is a case of damage to all three burners. The treatment is to build the middle burner first, because supplementing earth can produce metal, and the deficiency of kidney guan also depends on the stomach guan. Therefore, it is necessary to nourish the acquired day to nourish the innate, and then the effect can be achieved.
"
Subsequently, Zhang Jiebin drew up his own party as follows:
"Lotus seeds (with the heart removed) are five qian, Gorgon fruit three qian, white lentils half a qian, rock sugar three qian, Poria cocos cubes 3 qian, Guangpi charcoal one qian, ginseng one qian, sweet..."
When I wrote about the last flavor of licorice, I remembered that the medicine shelf did not provide licorice, a commonly used adjuvant. Licorice is a top-grade medicine that has detoxifying and tonic effects. It can be paired with most common medicines and has all the effects.
Its auxiliary effect can be called the first adjuvant.
It is a medicine with three parts of poison. It is usually used in combination with monarchs, ministers and assistants, so as to achieve the best effect while promoting the benefits and eliminating the disadvantages.
Seeing that there was no licorice, Zhang Jiebin began to reflect on himself. Was it because licorice was so effective that he relied too much on it?
After removing the licorice, he felt that the combination of these seven medicinal herbs was more reasonable. Zhang Jiebin was overjoyed and continued to write: "Thirty doses, it is better to take more slowly."
It doesn’t take too much medicine, just the right amount to be effective.
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