"How are the two patients doing?" Liu Banxia, who was triaging patients at the ergency center, casually asked when Xu Yino ca over.
"The child’s ocular muscles are trapped in the fractured eye socket. He’s undergoing a procedure to remove them. However, Doctor Ma said the issue shouldn’t be severe because we managed to treat him in ti. There were no problems with his head, and the nasal bone setting went well," Xu Yino explained.
"The girl’s father’s CT results just ca out, and it seems there’s no problem with his brain. A few stitches on the scalp should be enough. Teacher Liu, will he be held responsible?"
Liu Banxia nodded. "How could he not? He was the one who initiated the conflict. The law isn’t based on personal sentint; it’s dealt with case by case."
"This also serves as a reminder to you: don’t lay your hands on difficult patients in the future. If things get out of hand, call security. If you start a physical confrontation, you’ll be held accountable."
Xu Yino nodded. She didn’t have any opportunity to initiate any conflict herself. In fact, the one who really needed to pay attention to this advice was the formidable Liu; she couldn’t stand how set in his ways he was.
Just then, a patient approached. Seeing that Xu Hui still had two patients waiting, Liu Banxia waved him over.
"What seems to be the problem?" Liu Banxia asked.
This patient was an interesting case, with two scratch marks on his face and so animal fur clinging to his clothes.
"Doctor, I have itchy hives. They’re driving crazy. Could you give an injection of dexathasone?" the patient asked.
Liu Banxia frowned. "Let see what your rash looks like first. We can’t just use dexathasone carelessly. Have you used it before?"
The patient nodded. "I have in the past. After three days of injections, it cleared up. The clinic said they couldn’t give the injection and told to co to the hospital."
With that, the patient unbuttoned his pants, exposing several patches of scratched and damaged skin on his thigh.
"Alright, pull them up. Have you taken any dication? Can you rember how many tis you’ve had outbreaks?" Liu Banxia asked.
"I haven’t taken any dication; it doesn’t seem to help. I had an outbreak last sumr, and then it happened again the day before yesterday," the patient replied.
"What have you been up to lately? You seem to have severe dark circles under your eyes," Liu Banxia asked after a mont’s thought.
"My child is only two months old, and with the Lunar New Year approaching, there are a lot of things to deal with. Doctor, please just give the dexathasone. If I recall correctly, 5 units will do the trick," the patient implored.
"dicine shouldn’t be used carelessly, especially a drug like dexathasone, which has potent side effects," Liu Banxia cautioned.
"This drug is mostly used by patients with rheumatoid arthritis, acute leukemia, and malignant lymphoma. While it does have so antihistamine effects, it’s generally not used unless absolutely necessary."
"Doctor..."
The patient started to speak, but Liu Banxia held up a hand. "I understand how you feel. Urticaria is indeed a very troubleso condition. I had it once, and it bothered for several days."
"You’ve been sleeping poorly recently from taking care of your child, and your stress levels are high. This has resulted in a weakened immune system, possibly triggering the urticaria."
"Of course, there are many causes of urticaria. If you insist on injections or IV treatnt, we’d need to draw your blood to test for allergens and check your electrolyte levels before we can prescribe dication."
"Doctor, isn’t that too much trouble? If the tests reveal the allergen, can’t I just avoid it and be fine?" the patient asked hesitantly.
Liu Banxia shook his head. "Each occurrence of this type of urticaria could be incidental. Tobacco, alcohol, beef and lamb, various seafood, or even egg whites and yolks can trigger it."
"However, when your immune system is strong, consuming and coming into contact with these things usually won’t be a problem. Therefore, I recomnd a second treatnt option: taking cetirizine. This is also a long-acting antihistamine."
"However, just because you take this dicine doesn’t an all your problems will disappear imdiately. You have a weakened immune system, so it’s essential to make lifestyle adjustnts for the ti being."
"Ask the elders in your family for help with your child. Ensure you get enough sleep every day, maintain a bland diet, and try to keep a positive mindset. For now, avoid tobacco, alcohol, tea, beef, lamb, eggs, and seafood—these are what we traditionally call ’heating’ foods that can aggravate conditions."
"Also, limit contact with household pets for a while. With your weakened immune system, bacteria that wouldn’t normally affect you might seize the opportunity to cause problems."
"You can also take so multivitamins to improve your overall health. This will have less impact on your body than injections or IV drips, and it’s also much cheaper. How does that sound?"
The patient grimaced. "Doctor, why are you being like this? Shouldn’t you be drawing blood and running tests? Why are you just prescribing dicine? What if I don’t buy it from your hospital and get it from an outside pharmacy instead?"
Liu Banxia shrugged nonchalantly. "That’s your choice. It’s the New Year period; going through a whole round of tests in the hospital might make you more stressed and anxious, which could actually worsen your condition."
"Avoid bathing for the next few days, as the hives react to hot and cold stimuli. Eat warm food and avoid als that make you sweat—that’s just asking for trouble."
"If you choose the second option, I’ll prescribe the dicine for you now. Try it for three days. If your condition worsens during these three days despite following my advice, then co back to the hospital."
"That would an your condition has likely beco more severe. If it’s not that bad, continue to observe it. However, don’t expect to indulge in rich or spicy foods during this holiday period."
"Well... then please prescribe the dication for . After you’ve explained so much, I’d be too embarrassed to go buy it elsewhere," the patient said.
"Rember, getting enough rest is crucial. The course of urticaria can often be long, and try to avoid sweating or exposure to wind as much as possible," Liu Banxia said while writing the prescription.
"Also, you need to be vigilant. If this happens once or twice every year, your body might gradually develop an autoimmune component to it. If it flares up then, it won’t be the sa as it is now."
The patient nodded, took the dical record and registration slip Liu Banxia had written, and went to get his prescription filled.
Ding! Consultation completed.
Experience points gained: 10.
"Teacher Liu, are you sure no tests are needed?" Xu Yino asked curiously.
"There’s no need. The young man is probably just under a lot of pressure and not getting enough rest, hence the reaction," Liu Banxia said with a laugh.
"Why do you think I always tell you all to eat more vegetables during our als? People like us, who burn the midnight oil, are under imnse ntal stress."
"However, we seize every opportunity to rest. So of us even resort to a glucose drip when we’re about to crash. Otherwise, things would get chaotic, and we’d all be scratching ourselves raw, just like that patient."
"Teacher Liu, how do you manage to consider so many things?" Xu Yino asked, wrinkling her nose.
"You think that’s a lot? I can also tell you that the young man’s stress isn’t solely from lack of sleep," Liu Banxia chuckled.
"What else could it be then?" Xu Yino asked in astonishnt.
"I suspect he and his wife had a dispute. The scratches on his face are rather wide—what kind of cat has such thick nails? It’s likely his wife who scratched him."
"Usually, when a couple has a baby, both sets of parents help care for it, especially when the child is two or three months old—that’s when they tend to be the most demanding, right?"
"The fact that he has to care for the baby himself implies so family conflict. Under these multiple pressures, his immune system probably couldn’t cope."
"But let remind you, this kind of rapid diagnosis is only suitable for urticaria that doesn’t flare up often. Patients who suffer frequent outbreaks must undergo allergen screening."
Xu Yino nodded. She had watched the entire consultation, but her thoughts hadn’t ventured that far. Her mind was solely focused on how to treat the urticaria.
"What seems to be the problem?" Liu Banxia asked the next patient who walked over.
"I’ve been feeling feverish, dizzy, and weak. I had cupping therapy a couple of days ago, and I don’t know if it’s related to that," the patient said after sitting down.
"Did your skin get burned during the cupping?" Liu Banxia quickly asked.
"It wasn’t burned, but quite a few blisters ford. They said it was a lot of toxins being drawn out," the patient replied.
"Xu Yino, draw the curtain. Sir, please take off your shirt so I can look at the cupping marks," Liu Banxia said.
Xu Yino quickly drew the curtain, and the patient obediently removed his shirt and lay face down on the exam bed.
"And you said your skin wasn’t burned? Looking at it, three of the four cupping sites are already showing signs of infection," Liu Banxia declared after a quick glance.
"It’s a good thing you ca in when you did. If you’d waited until after the New Year, you could have developed sepsis. Who told you that bigger blisters an more toxins are being drawn out?"
"That was excessive cupping! Honestly, you might as well have just tried cupping thin air! We’ll need to draw blood for a culture and a chemistry panel. We’ll also need a stool culture. And right now, we need to treat these wounds on your back."
"You should contact your family. It looks like you’ll be spending the New Year with us in the hospital. Your temperature is probably around 39 degrees Celsius. Any later, and it would have been truly dangerous," Liu Banxia said, sighing in exasperation.
Cupping therapy is a traditional practice passed down by our ancestors. Even if he doesn’t understand the principles behind it, he won’t dismiss it entirely.
However, these folk beliefs are truly harmful. He had no idea when this absurd theory—that the bigger the blister, the more ’dampness and toxins’ it draws out—started circulating. It would probably make any practitioner of traditional Chinese dicine furious.
If they were just small blisters, it wouldn’t be a big deal. But these were clearly due to excessive suction or the cups being too hot inside.
Now, the patient’s large blisters have ruptured, leaving open wounds. Because the skin barrier was compromised, pathogens had a chance to invade.
Three out of the four cupped areas showed signs of infection and pus. The person who perford the cupping must have been really aggressive.
If it weren’t for so many folk misconceptions, if he had sought dical attention for debrident sooner, he wouldn’t be facing this hospital ordeal now. He could have been happily celebrating the New Year with his family.
As it stands, the outco depends on how severe the infection is. If his liver function is already compromised, it’s highly unlikely he’ll be having a quiet New Year.
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