Zhou Junwei, confident in his extensive knowledge, stepped forward without hesitation.
He also emulated Professor Gao and perford a pulse diagnosis on the patient.
But he only took the pulse for a short ti. Clearly, he had more faith in modern diagnostic thods.
"Professor Gao," Zhou Junwei said, standing up and adjusting his glasses with an air of complete confidence. "From a Western dical perspective, the patient’s symptoms are complex. However, I believe the root cause is autonomic nervous system dysfunction brought on by a viral cold, leading to a secondary electrolyte imbalance."
He began his analysis, applying his theory that integrated Chinese and Western dicine. "The patient’s fever and head sweats are classic signs of thermoregulatory center dysfunction caused by a viral infection. His cold hands and feet, on the other hand, are due to poor peripheral circulation, which also results from the infection. As for the alternating periods of sweating and not sweating, along with his dry stool—these are all specific manifestations of autonomic nervous system dysfunction."
"Therefore, my treatnt plan is as follows,"
he said with great certainty, "First, we need to administer antiviral treatnt. I suggest an intravenous drip of a broad-spectrum antiviral drug, supplented with an oral heat-clearing and detoxifying Chinese patent dicine, like Lianhua Qingwen capsules.
"Second, we need to provide symptomatic and supportive care. This includes replenishing his electrolytes to maintain his water and salt balance.
"Finally, we can add so neurotrophic drugs to regulate his autonomic nervous system.
"With this approach, the patient’s symptoms will certainly be relieved very quickly."
He spoke with clarity and logic, referencing his sources. His explanation was filled with the "scientific" and "rigorous" nature of modern dicine.
After listening, Professor Gao gave a noncommittal nod, then turned his gaze to Li Xu.
"Li Xu, what about you? Tell what you think."
Li Xu also stepped forward and carefully took the patient’s pulse.
His fingers remained on the patient’s wrist for a long ti as he concentrated, feeling for the subtle changes in the flow of qi and blood hidden beneath the deep, tight pulse.
After a long while, Li Xu finally withdrew his hand.
"Professor Gao, Senior Brother Zhou."
"This patient’s illness is truly perplexing. His symptoms are complex and contradictory—sotis in the upper body, sotis in the lower; sotis on the exterior, sotis in the interior."
"If we were to treat it purely as an ’exterior pattern’—a Taiyang stage disease—and use thods to induce sweating and release the exterior, that would certainly resolve his head sweats and fever. However, it wouldn’t address his ’interior pattern’ of cold hands and feet and dry stool."
"But if we were to treat it only as an ’interior pattern’—using thods to clear interior heat and unblock the bowels—that wouldn’t resolve his unresolved exterior pattern. It might even draw the pathogen deeper into the body and worsen his condition."
"Therefore," Li Xu stated his conclusion, "for this kind of ’Shaoyang stage disease,’ where the pathogen is half in the exterior and half in the interior, we can neither simply induce sweating nor simply purge the bowels. The only thod is ’harmonization.’"
"Harmonization?"
Zhou Junwei’s brow furrowed imdiately.
"Yes, harmonization," Li Xu explained. "The so-called harmonization ans to regulate the pivot chanism and clear the pathways between the interior and exterior. It gives the pathogen in the interior a way out and prevents the pathogen on the exterior from invading deeper. By supporting the upright qi to expel the pathogen, we help the body restore its own balance. Therefore, my treatnt plan is to prescribe Minor Bupleurum Granules for the patient."
"Minor Bupleurum Granules?"
Zhou Junwei was taken aback. "That’s it? Just a patent dicine?"
He felt Li Xu’s diagnosis was far too "vague" and "esoteric."
’What is all this "half in the exterior, half in the interior" and "harmonization" stuff? It’s all just ambiguous, unquantifiable, and ethereal TCM theory. It’s not "scientific" at all.’
"Junior Brother Li," Zhou Junwei voiced his doubts bluntly, "what you’re saying might make sense in theory. But in a clinical setting, the patient’s symptoms are objective facts.
"As doctors, we should provide precise treatnt plans, not fob off patients with such vague and generalized theories.
"Are you really saying that just Minor Bupleurum Granules can solve his viral infection, autonomic nervous system dysfunction, electrolyte imbalance, and all these other complex issues?
"I think that’s being far too simplistic."
Faced with Zhou Junwei’s skepticism, Li Xu didn’t get angry. He simply said calmly, "Chinese dicine treats the ’person,’ not the ’disease.’ What we see is the person’s state of yin-yang imbalance. As long as we correct this state, all the so-called ’symptoms’ will naturally vanish. The Minor Bupleurum Decoction is the foremost classic formula for harmonizing the Shaoyang pivot chanism, making it the most suitable for his current condition."
The two of them stuck to their own opinions, unable to reach an agreent.
Just then, Professor Gao Guanghui, who had been silent all this ti, finally spoke.
"Both of your diagnoses have rit. Junwei, your line of thinking aligns with the standards of modern dicine. Li Xu, your approach is closer to the core of TCM’s pattern differentiation and treatnt."
He then changed his tone.
"However... Li Xu’s diagnosis is a better fit for the patient’s condition."
As soon as he said this, the color drained from Zhou Junwei’s face, and his expression turned ugly.
He couldn’t understand why his "scientific" and "rigorous" plan had lost to Li Xu’s "esoteric" theories.
He was not convinced at all.
Professor Gao didn’t explain further. He turned to the patient and said, "I’m going to prescribe you a box of Minor Bupleurum Granules. Go ho and take it twice today. If your symptoms don’t improve after taking the dicine today, or if they even get worse, co back and see first thing tomorrow morning. I’ll adjust your treatnt plan then. How does that sound?"
"I’ll do whatever you say," the patient said, nodding eagerly.
He took the prescription and went to the pharmacy to get his dicine.
Zhou Junwei shook his head.
’There’s no way just drinking Minor Bupleurum Granules can cure him,’ he thought.
’The patient will definitely be back tomorrow.’
’And when he does, we’ll have to treat him according to my plan after all.’
Soon, the next patient walked in, and Professor Gao continued with his consultations.
In between patients,
he didn’t forget to instruct the two of them. "Both of your diagnoses just now had their own rits. Junwei, your thinking is rigorous, ticulous, and keeps pace with the developnts in modern dicine. That is your strength. And Li Xu, your understanding and application of classic TCM theory are more profound and flexible. That is your strength."
"However," he said, his tone turning serious, "what I want to tell you today is that regardless of whether you choose the path of integrating Chinese and Western dicine or the path of pure TCM, there is one fundantal skill you must spend your entire life honing and perfecting. And that is—pulse diagnosis!"
"Inspection, listening and slling, inquiry, and palpation—the four diagnostic thods of Chinese dicine—complent each other, and not one can be omitted. But among these four, pulse diagnosis is the most important, the most central, and the one that best reflects a TCM practitioner’s level of skill!"
"Why is pulse diagnosis the most important? Because the other three—inspection, listening and slling, and inquiry—are all prone to error."
He explained, "Take ’inquiry,’ for example. A patient’s subjective description can be inaccurate or biased. So patients exaggerate, so are reluctant to discuss their illness, and others simply don’t know how to accurately describe what they’re feeling. All of these things can interfere with our judgnt."
"’Inspection’ and ’listening and slling’ are also subject to interference from various external factors. But the patient’s pulse is an objective reality! It’s like the most precise instrunt, faithfully reflecting the real-ti state of qi and blood circulation in our bodies, the waxing and waning of our internal organs. It absolutely does not lie!"
"Therefore, as long as your pulse diagnosis skill is high enough, you can perceive the essence of an illness through the subtle throbbing at the wrist. You can even discover hidden problems that the patient hasn’t even noticed themselves. You can truly achieve a state where you understand the patient better than they understand themselves!"
Professor Gao’s words made both Li Xu and Zhou Junwei agree wholeheartedly.
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