I Can Talk to the Internal Organs-Chapter 113 - 91: Heart Failure!?

Lu Jiu was at a loss whether to cry or to laugh.

He didn’t expect the patient’s Five Viscera to refuse communication.

However, from the words of rejection from the Five Viscera, Lu Jiu picked up some meanings.

They seemed to have been hurt by some drug.

That’s why they were so resistant to doctors.

Lu Jiu also knew what the drug was.

Oseltamivir, the drug for treating influenza.

The side effects of this drug are also listed on the packaging; generally, if not taken much, the side effects aren’t too obvious, but no one dares to guarantee that.

After all, the drugs produced by pharmaceutical companies seem to have detailed descriptions but are actually quite rough.

For example, it says adults with influenza should take one pill, twice a day.

The concept of "adult" here is very particular: someone who is 1.8 meters tall and weighs about 178 pounds is different in constitution from someone who is 1.7 meters tall and weighs about 134 pounds.

Some may find the effect of one pill too light, while for others it might be too strong. How to manage this dosage is unknown not only to the person taking the drug but even to the doctor prescribing it.

Therefore, even in Western medicine, a dialectical thinking approach to diagnosis and treatment is required.

"Please calm down, Liver Wood, you should recognize the doctor who prescribed the drugs to you before, right? Take a good look at me, am I that doctor?" Lu Jiu said.

"What’s the difference?" Liver Wood replied grumpily.

"Of course there’s a difference. Doctors come in many kinds. I am the kind who won’t harm you even if I can’t cure you. Understand?" said Lu Jiu.

"I don’t understand," replied Liver Wood.

"Uh... then what do I need to do for you to trust me?" Lu Jiu asked.

"No matter what you do, we won’t trust you. Leave, or we won’t be polite!" Liver Wood said with undisguised anger.

"Then won’t you care about Heart Fire? It seems to be very sick," Lu Jiu said.

Upon hearing this, Liver Wood fell silent.

"None of your business!" Hydronephrosis chimed in.

"Can you help it recover?" Lu Jiu asked.

This time, Hydronephrosis also fell into silence.

If they could help, things wouldn’t be the way they are now.

"Let me try. Actually, even if you disagree, I can still prescribe medicine, but I really mean no harm, so trust me once." Lu Jiu said.

For now, just through observation and palpation, it was difficult for Lu Jiu to accurately judge Rong Jisheng’s physical condition, and even adding tongue diagnosis, it would likely still be difficult.

Because Rong Jisheng didn’t seem seriously ill outwardly, but the Heart Fire inside was silent, which was definitely abnormal.

Without a thorough inquiry, Lu Jiu had no way to start.

So, at this moment, Lu Jiu had to find every possible way to gain the trust of Rong Jisheng’s Five Viscera.

"You really won’t harm us?" Spleen Earth asked.

"Absolutely not!" Lu Jiu replied.

He had that confidence.

Herbal medicine has a natural advantage over Western medicine, which is that in Western medicine, regardless of whether you’re a novice doctor or a top figure in the field, there’s always side effects in whatever way you use it. Whereas in herbal medicine, if someone doesn’t understand Chinese medicine theory, they may harm the internal organs, but for those who understand, it’s absolutely impossible to harm the internal organs.

When Lu Jiu was in school, he read a report by two medicine researchers. The title was [Incidence and Etiology of Drug-Induced Liver Injury in Huaxia Continent].

This was the first large-scale epidemiological study of drug-induced liver injury in Huaxia Continent. The article reported the diagnostic rate of drug-induced liver injury among inpatients in comprehensive and specialized hospitals within Huaxia Continent, and estimated the incidence of drug-induced liver injury in the general population of Huaxia Continent based on that data.

The data in the article showed that the annual incidence of drug-induced liver injury is about 23.80 per 100,000 people in the general population of Huaxia Continent, higher than data reported in Western countries. The article indicated that the main causes of drug-induced liver injury were traditional Chinese medicine, herbal medicine, or dietary supplements.

Once this report was released, the outcry online about Chinese medicine damaging the liver was deafening!

However, two years after the report was released, the People’s Army General Hospital, Jinling Medical University, and several other units collaborated, using information technology to screen over six million ADR (adverse drug reaction) data over four years. Among them, DILI-related ADR reports (drug-induced liver injury reports) were 94,593, with chemical drugs accounting for 94.5%, herbal medicines for 4.5%, biological drugs for 0.8%, and others for 0.2%.

This report directly settled the matter, making the long-standing rumor that herbs are more liver-damaging than Western medicine fall apart effortlessly.

Of course, the fact that herbal medicine can account for 4.5% is mostly because many doctors prescribing herbal medicine don’t understand herbal materia medica interactions. Their prescription approach is the same as Western medicine; this one can relieve pain, so add it, that one can lower blood pressure, add that too, completely ignoring the roles of sovereign, minister, assistant, and envoy in herbal medicine interactions.

It’s like ancient generals deploying troops for battle, where the roles of sovereign, minister, assistant, and envoy are the pre-battle plan layout, the diagnosis is analyzing the situation: where to attack, where to defend, and where to use unexpected strategies, so you can arrange the troops. Otherwise, if you simply use a human wave strategy to prescribe medicine, it’s no wonder you meet with failure!

"How about we trust him once?" Spleen Earth suggested.

Lately, they’ve been trying hard to help Heart Fire, and Spleen Earth has been functioning at full capacity to generate and move qi and blood, but still to no avail.

The other three naturally understood too, that relying solely on themselves, they simply couldn’t help Heart Fire, and would need external assistance.

But the previous medication damage made them feel like once bitten, twice shy, and they naturally resisted doctors.

The Five Viscera were silent, and Lu Jiu didn’t speak. He was waiting for the other organs to respond.

"Then let’s trust him this time," Fei Jin said.

"Just this once," Liver Wood added.

"..." Hydronephrosis said.

Lu Jiu smiled; the negotiation was successful.

Then, Lu Jiu immediately asked, "Now let me ask you some questions. When did Heart Fire stop communicating with you?"

"About a week or two ago. Before that, Heart Fire was just a bit irritable and kept telling us that a drug had come in. It was fighting off the pathogenic evil while also targeting Liver Wood and Hydronephrosis. Then it joined the battle, trying to help Liver Wood and Hydronephrosis, but unexpectedly the drug suddenly turned to attack Heart Fire. At that time, Heart Fire was still saying how sinister the drug was—different from the previous ones. The previous drugs also targeted it, but none were as strong as this one. Actually, I was also attacked by the drug, but my damage was the least compared to them," Spleen Earth said.

Lu Jiu asked, "So before taking this drug, did Heart Fire exhibit any unusual behavior?"

Spleen Earth said, "Yes. After the pathogenic evil came in, Heart Fire led us in fighting it. During that time, Heart Fire was desperately providing Yang heat, operating over capacity. It was almost done dealing with it, but as soon as that drug came in, it instantly extinguished its fire. That drug seemed to be snatching the work. Once it came in, it forcibly stopped Heart Fire from intervening and went to deal with the pathogenic evil on its own. Honestly, it was quite powerful, but after it came in, it indiscriminately attacked, and we couldn’t resist."

Lu Jiu roughly knew, "So, Heart Fire didn’t stop speaking due to the flu, but after that drug came in, right?"

Spleen Earth said, "Yeah, maybe a week or two. The drug never stopped during this time, and Heart Fire asked me to find a way to get it out. So I started controlling the bowels, and after it finished, it stopped for two days. Then, on the advice of a doctor, it started again, and gradually Heart Fire spoke less and less, and eventually stopped speaking altogether. We were very worried. I also tried to transport and transform more Qi and blood to help it, but it didn’t react at all."

Indeed.

Based on the observation and pulse, as well as the description from the Five Viscera, Lu Jiu had already confirmed that the medication caused Heart Qi deficiency, currently still within a safe range. But if this continues, the excessive transportation of the Spleen and Stomach cannot resolve the Heart Qi deficiency, and the heart will rapidly fail, resembling sudden death, but not a normal sudden death.

In Ye Tianshi’s "On Warm and Hot", it is recorded, "Warm pathogen initially attacks the Lung, reversely transmitting to the Heart Bag."

The external pathogenic evil causes Heart Qi deficiency, repeatedly attacking with six excesses and pandemic poisons, invasively assaulting the heart, resulting in heart failure symptoms.

Lu Jiu cut off the connection with the Five Viscera, returned to consciousness, and looked at Rong Jisheng, "Open your mouth and let me see your tongue coating."

Rong Jisheng opened his mouth, his tongue was pale and dark with slight petechiae.

Lu Jiu nodded, gesturing him to retract his tongue, and then asked, "Before the flu, did you frequently catch a cold?"

Rong Jisheng froze, "Yes, yes, I indeed frequently caught a cold. I don’t know what happened this year, especially in the first half of the year, once a month, very abnormal."

Exactly.

Before the flu, frequent colds clearly indicate a Lung-Defensive deficiency, unable to block the six excesses. Coupled with this year being a year of insufficient Fire fortune, with insufficient Heart Qi, it is not surprising that Heart Qi deficiency occurred. At this point, if pandemic poisons are encountered again, like the flu, this pathogenic evil will continue to attack Heart Fire. If it could have been adjusted well here, it would have been fine, but the medication Rong Jisheng took killed the virus quickly, also severely damaging the Five Viscera, thus accelerating his heart failure symptoms.

No wonder he looks normal, and his pulse is also fine.

Because mild cases only show shortness of breath, fatigue, lack of endurance in activities—just that feeling of not having the strength as before—and severe cases can’t lie flat, have reduced urine output, edematous limbs, cyanotic lips, and cold extremities.

This illness is hard to detect in mild cases because too many symptoms manifest as shortness of breath, fatigue, so it’s extremely easy to overlook.

But if you really ignore it, the progression from mild to severe symptoms can exceed your imagination.

Perhaps one day, he may be speaking normally one second, and the next, his heart could stop with a stutter, and then he would fall motionless to the ground, frozen in time.

Lu Jiu couldn’t help but feel a bead of sweat for Rong Jisheng, fortunately, his family noticed, otherwise, had he collapsed one day, even immortals couldn’t save him.

"Luckily you came early, it’s currently just the initial stage of heart failure. It would be dangerous if you delay any further," Lu Jiu said.

Lu Jiu was actually weighing the options. If he hid the truth, it might keep Rong Jisheng’s mindset more peaceful, beneficial for his recovery, but it would require Lu Jiu to take on the risk.

If Rong Jisheng finished his consultation here and went home without taking medicine, pretending nothing happened, when the worst scenario occurs, Lu Jiu would be the first person responsible.

By then, it wouldn’t be him; it would have to be him!

Maybe his family isn’t as unreliable as Lu Jiu thought, but Lu Jiu dared not bet on human nature’s glory with his little rundown health center.

So, after pondering for a moment, he decided to tell the truth.

"Heart failure!? Dr. Lu, you’re kidding, right? I feel fine now. How could I have heart failure?"

Rong Jisheng exclaimed, bewildered.

Heart failure.

That’s no small illness.

How could he suddenly have such an illness?

If he wasn’t aware of Lu Jiu’s expertise, he would have stood up to question him on the spot.

Next to him, Tang Yi was also a bit surprised. Honestly, he hadn’t seen any symptoms of heart failure in Rong Jisheng.

Of course, with his current level, if he could diagnose a person’s condition just through observation, he wouldn’t need to return to Jianghan.

For a moment, with Rong Jisheng’s exclamation, other patients in the health center also turned to look at Lu Jiu.

Heart failure is not a common disease. Although it isn’t cancer, it’s basically incurable, requiring long-term medication to maintain.

Rong Jisheng looks almost like a normal person; how could he have heart failure?