I Can Hear the Heart's Voice of Traditional Chinese Medicine-Chapter 218 - 98: What Are You Good At? Why Not Just Write "General Practice

At this point, Lu Xuan also recorded the prescription in the medical record book: "I'll prescribe Zhi Zi Chi Tang with Deng Xin for the child, take it boiled in water three times a day, or you can leave it here to be boiled and come to pick it up in the afternoon."

Lu Xuan finished writing and handed the medical record book to Su Kenan.

Su Kenan glanced at the prescription, momentarily dazed.

It wasn't because there were too many herbs, but rather because Lu Xuan prescribed only four kinds of herbs, all of which were very common Chinese medicines.

However, this expression appeared only briefly; Su Kenan quickly recovered, diligently entered the prescription into the records system, printed the payment receipt, and handed it to the woman for scanning and payment.

After the woman paid, Ji Xiuwen picked it up and prepared to go to the herbal pharmacy. Upon seeing the prescription, he also hesitated for a moment, then suddenly understood why Su Kenan showed that expression.

The child's condition is so complicated, yet who knew only four herbs were needed.

The woman paid, saw Ji Xiuwen entering the pharmacy, greeted Lu Xuan, and went out to wait.

Having already wasted quite a bit of time visiting Hu Meiqiao this morning, Lu Xuan didn't wait for Ji Xiuwen and directly asked Su Kenan to continue calling patients.

No sooner had the next patient been called than the second patient walked in.

The man seemed to be in his early thirties, not from Yong City, but working here. During a morning exercise two days ago, he suddenly felt a burning, dry, and painful throat. Shortly after breakfast, his throat became swollen and painful, with headache, fever, chills, dry thirst, and little phlegm. After taking antibacterial medications and Liushen pills, his symptoms did not improve, but by afternoon his throat was swollen and painful, making swallowing difficult, accompanied by headache, chills, and a high fever of 38.9°C, hence seeking treatment here.

Lu Xuan took out a flashlight to examine the man's throat and found it was congested and purplish-red, with purulent mucosa attached, and follicles on the posterior pharyngeal wall were swollen.

"Does it hurt here?" Lu Xuan pressed on the swollen submandibular lymph nodes.

"Pain, pain, pain..."

The man exclaimed in pain, informing Lu Xuan of the painful area, after which Lu Xuan nodded and recorded the situation.

The submandibular lymph nodes were significantly swollen and tender, with pain radiating to the ear root and jaw, dry mouth with bitter taste, constipation, and yellowish-red urine.

The tongue was red, the coating thick and yellow, with the pulse floating, rapid, and surging.

Floating pulses were not uncommon for Lu Xuan, but it was his first time seeing a surging pulse.

A surging pulse is wide, full, and forceful, resembling turbulent waves, strong when coming and weak when going.

It indicates intense heat in the Qi level, or it can indicate that the pathogen is powerful and the vital Qi is weak.

If internally there is excessive heat, the pulse path expands, Qi is abundant and blood surges, thus showing a surging pulse. If in chronic Qi deficiency, or symptoms like deficiency and wilting, blood loss, or chronic diarrhea show a surging pulse, it often indicates that the pathogen is strong and the vital Qi is weak.

A physiological surging pulse can be seen in the summer; when Yang Qi is flourishing during this season, the pulse manifests somewhat surging and large.

Cui Yanzhong: "Dr. Lu, what exactly is going on with me? Is it pharyngitis? But I've already taken medicine, and rather than improving, it has gotten worse."

"Acute pharyngitis," Lu Xuan nodded.

The throat is critical for human respiration and diet, the pharynx in the front and the throat at the back, thus called the throat.

As stated in the "Spiritual Pivot Jingbie" and other chapters, the pharynx is referred to as the "Ai" or "Yin Xi," being the shared passageway for food and breath.

As noted in "Key of the Jade Tower," "The throat is also responsible for the passage of water and grains, a conduit for the stomach Qi."

In ancient medical texts, it is often mentioned together with the throat, as in "The Spiritual Pivot Chapter of Worry and Silence" which states "The throat, the pathway of water uniting."

In modern medicine, the pharynx is divided into the nasopharynx, oropharynx, etc.

Therefore, ailments of the throat firstly affect sound, breathing, and diet.

Local redness, swelling, pain, or ulceration with pus is mainly associated with today's acute tonsillitis, acute and chronic pharyngitis, and throat tumors.

Ancient medical texts often refer to it as "throat blockage," as stated in the "Suwen Yin Yang Separation" that "One Yin one Yang knots, it is throat blockage."

Throat blockage is characterized by throat swelling, blockage, and pain, where water and liquid cannot enter. It's caused by wind poison lodging in the throat, where Qi knots and accumulates heat. The condition is acute and severe, thus it shouldn't be viewed as a trivial ailment. If it's not diphtheria, it's acute throat edema, pain, and high fever, sometimes with pus, or wind poison entering the heart, causing anxiety and potentially fatal outcomes. Immediate examination and treatment can quickly alleviate local swelling, pain, and fever.

As noted in the "Essential Prescriptions of the Golden Cabinet Treatment of Blood Paralysis and Weakness," "deficiency with rapid heartbeat, nosebleeds, abdominal pain, dream ejaculation loss, aching limbs, hot hands and feet, dry throat and mouth."

Throat pain as stated in "Treatise on Cold Pathogenic and Warm Pathogenic Diseases Diagnosis and Treatment of Taiyang Disease" points out "dry throat, dry mouth and throat ulceration" and are closely linked to external pathogenic heat blocking and stagnation.

Throat disease, its etiology, is often associated with external wind-cold, Yin and Yang blockage unresolved, often seen in throat blockage. Its pathomechanism often involves the lungs, heart, stomach, kidneys.

"It really is!" Cui Yanzhong opened his mouth; he was just speaking offhand. After all, any previous flare-ups of pharyngitis were ameliorated with a few doses of medication, but this time, instead of improving, it got worse.

So I just made a casual guess, and it turned out to be true.

Cui Yanzhong asked, "How could it be so severe? I used to have frequent throat inflammations too, but they'd heal in a day or two."

Seeing the patient curious, Lu Xuan patiently explained, "Your condition is due to excess heat in the lungs and stomach causing acute pharyngitis. Acute pharyngitis develops quickly and aggressively. However, if treated properly, the effects are usually very significant.

You inherently have excess heat, and combined with being exposed to Wind Evil during your morning exercise, it leads to congestion in your throat. This mixes with the heat from your stomach, which is why you're experiencing throat swelling, pain extending to your earlobes and jaw, all symptoms of concurrent lung and stomach heat.

The treatment should clear heat and detoxify, relieve sore throat, reduce swelling, and promote bowel movement.

I'll prescribe you some medicine to take back and decoct twice a day."

As Lu Xuan spoke, he wrote down the prescription. Cui Yanzhong, seemingly curious about the prescription, couldn't help but take a peek.

Seeing Cui Yanzhong's curiosity, Lu Xuan patiently explained, "In this prescription: Scrophularia, raw Rehmannia, cowherb seed, and honeysuckle are for clearing heat and cooling blood; Rhizoma Coptidis, Scutellaria baicalensis, Amur corktree bark, rhubarb, and raw gypsum clear excessive heat and promote bowel movement; Danggui and white peony root activate the blood and relieve pain; withered stalk acts as a medium to carry the medicine upwards, and licorice harmonizes the herbs, detoxifies, reduces swelling, and expels pus.

This formula is very effective against acute pharyngitis, laryngitis, and acute tonsillitis, with modifications as necessary. Using the formula as is when needed is standard practice, but adapting it based on the patient's specific symptoms is the true method.

If pharyngitis occurs, don't use medication haphazardly. Using the wrong medicine won't solve the problem; it can make symptoms worse."

Even though Cui Yanzhong didn't fully understand, he nodded anyway.

...

Lu Xuan was efficient in his morning consultations, with no particular cases requiring detailed introduction for the two observers.

When the last patient of the morning left with their medication, Lu Xuan and the others were planning to go to the cafeteria for lunch when an unfamiliar number called.

Lu Xuan instinctively wanted to hang up, but seeing it was a landline from Yong City, and recalling Hu Meiqiao mentioning someone from United South contacting him in these days, he went outside to take the call.

A female voice came through from the other end: "Is this Dr. Lu Xuan from Qiu City Street Health Center?"

"This is him, and you are?" Lu Xuan took a deep breath.

"Oh, I'm the head of the United South Chinese Medicine Association. My surname is Wu. I'm calling today to invite you to consult at our association and wanted to see what you think."

"That's fine." Although Lu Xuan had known since the morning that he would be consulting at United South, he couldn't help but feel thrilled at their invitation.

"When would you be available?"

"Weekends are fine."

"Both days?"

"From what I understand, Dr. Lu, you're already consulting at the health center five days a week. Consulting both days on the weekend would leave you with no rest. Maybe just choose one day?"

"Then let's make it Saturday."

Initially, Lu Xuan thought of consulting at United South for both weekend days, but upon hearing this, he realized it made sense. Two consecutive days with no rest seemed a bit much.

It's not that he minded not resting, as gaining clinical experience is best, but he was concerned about the hassle if something urgent came up.

"By the way, when are you free to come over to the United South Chinese Medicine Association so we can discuss the consulting details? How about this Saturday?"

After thinking it over, Lu Xuan replied, "Let's do this Saturday, Teacher Wu, if that works for you?"

"Sure, when you arrive, just call this number."

"I have one more thing to ask."

"Go ahead, Teacher Wu."

"Since we prepare an introduction plaque for consulting doctors, I need to ask which ailments you're most skilled in so we can prepare it in advance and you can start consulting either this Saturday or the next."

Lu Xuan: "What am I skilled in? Let's just put general practice."

Wu: "..."

General practice expertise?

That's quite bold!