While taking the pulse, Du Heng also observed the young man’s complexion up close. Due to being excessively thin, his cheekbones were exceptionally protruding, which made his already sunken cheeks look even more emaciated. Similarly, because of his prominent cheekbones, his eye sockets appeared deeply set.
The young man’s overall spirit looked very poor; he appeared listless. But perhaps due to his profession, his speaking voice was still remarkably bright.
After taking the pulse, Du Heng examined his oral cavity.
"How are your bowel movents?"
"The stools are dry, especially dry."
"Constipated?"
"No, just very dry."
Du Heng frowned. "You’re able to defecate, but the stools are just dry. Are they shaped like strips or lumps?"
"...How should I put it? I don’t know if you’ve seen sheep dung, but it’s quite similar to that."
Du Heng leaned back. "Your pulse is thin and taut, your tongue is slightly red, and your tongue coating is sparse. According to the traditional Chinese dicine diagnosis, the TCM doctor you saw before was not wrong. Indeed, you have yin deficiency and fire prosperity."
After saying that, he looked seriously at the young man and asked, "Did your temper beco much worse after your appetite increased?"
The young man thought for a mont and nodded. "Yes, a bit. Before, when students didn’t understand and couldn’t solve problems, I would patiently explain things to them. However, since I beca ill, my temper has worsened, and my patience has beco pitifully scarce. Every ti a student cos to ask a question, I can’t help but get angry."
"Do you have trouble sleeping at night, and even if you manage to fall asleep, do you dream easily?"
"Yes, sotis I even have nightmares."
Du Heng tapped the table gently with one hand. "This is liver yin deficiency. When the liver is deficient, the fire gets stronger. When the liver fire gets stronger, it’s easy to get irritated and experience the symptoms you have."
The young man looked puzzled. "Then why didn’t the dicine prescribed before work?"
"Don’t worry; you still have other issues."
Du Heng spoke slowly, "You also have stomach yin deficiency, so your stomach heat is strong. When stomach heat is strong, stomach peristalsis intensifies and speeds up, making the food you eat digest much faster. Once digestion is faster, you’ll feel hungry more easily. But excessive heat can easily deplete yin humor. This results in a lack of nutritional replenishnt, leading to your present situation: you eat more but beco thinner day by day."
Hearing Du Heng’s clear explanation, the young man imdiately saw hope. "Doctor Du, can my condition be treated?"
"It’s not a big problem. I’ll prescribe you dicine. Take it for a week, and you’ll see results imdiately."
"Thank you, Doctor Du."
Du Heng took a pen from Gu Ping’s hand and wrote down the diagnosis and prescription on the disease record.
Diagnosis: Yin deficiency and fire prosperity. Prescription: Fructus liae Toosendan, dlar, radix pseudostellariae, etc.
After writing, he handed it to Gu Ping, asking him to sign and get the dicine. "After you go back, take the dicine on ti and avoid spicy food, as well as smoked and grilled food."
"I’ll rember that, Doctor Du."
"Co for a follow-up next Friday morning. I’ll be here."
The young man nodded in agreent, excitedly following Gu Ping to handle the procedures.
Du Heng also stood up and walked out of the Reception Room, straightening his clothes as he headed towards Xu Pinglin’s office. However, Xu Pinglin was not in the office, as he had sothing to attend to.
Du Heng sat and waited for a while, but when Xu Pinglin did not return, he decided to get up and leave.
Just as he was about to stand, Gu Ping knocked on the door and entered. "Mr. Du, the patient has already paid and left with the prescription. However, he didn’t get the dicine from our pharmacy. He said it was inconvenient to carry on the way, so he plans to get the dicine back in his hotown."
"That’s fine. It’s indeed not very convenient to carry seven large bags of dicine." Du Heng smiled casually. "Please tell Director Xu that I have sothing else to attend to and will leave first."
Seeing Du Heng about to leave, Gu Ping wanted to say sothing but hesitated.
Du Heng noticed. "What’s the matter? Is there sothing you want to say?"
Gu Ping said, sowhat embarrassedly, "I have a few questions I’d like to ask you, Mr. Du."
"TSK. If you have questions, just ask. But don’t call ’Teacher’ anymore. Just call Doctor Du, or Du Heng, or even Senior Brother if you like."
"Alright, Mr. Du." Gu Ping selectively heeded Du Heng’s words. "You just said he has yin deficiency and fire prosperity. The local doctor also diagnosed him with the sa condition and used the Six-Ingredient Rehmannia Pill to nourish yin, and the Anemarrhena, Phellodendron, and Rehmannia Pill to clear fire. So why was there no effect?"
Du Heng thought for a mont and sat back down in his chair. "Let ask you a question: do you think the two diagnoses of yin deficiency and fire prosperity refer to the sa syndro?"
Gu Ping was taken aback. "They’re different."
"Good. You say they’re different. So, tell , where are they different?"
I’m asking you precisely because I don’t know, so how could it turn out to be you questioning ? Gu Ping was at a loss.
Seeing Gu Ping dumbfounded, Du Heng didn’t embarrass him further. "The term ’yin deficiency and fire prosperity’ that we use is a very general concept. People have five viscera and six bowels, and both the five viscera and six bowels have Yin and Yang. So, if you want to treat it, you must first identify where the cause of the illness lies. Now, recall how I diagnosed it just now. Then tell what’s different, and why the dicine prescribed by the previous doctor didn’t work."
After saying this, Du Heng didn’t rush Gu Ping but just sat on the stool, quietly waiting.
"Actually, this question was a follow-up, further testing Gu Ping’s understanding of the Six-Ingredient Rehmannia Pill and the Anemarrhena, Phellodendron, and Rehmannia Pill. It’s not enough to simply know that they nourish yin and reduce fire. You have to be very clear about precisely which yin they nourish and which fire they reduce.
These two are very common Chinese patent dicines, and many people buy and take them on their own. However, while so people find them effective, others don’t. Patients may not know why this is, but as a doctor, one must understand it.
After thinking for a long ti again, Gu Ping suddenly slapped his forehead. "I know!"
"If you know, just say it. Why hit yourself?"
Gu Ping’s face turned red, and he hurriedly said, "The Six-Ingredient Rehmannia Pill is for nourishing kidney yin, and the Anemarrhena, Phellodendron, and Rehmannia Pill is for nourishing kidney yin and clearing phase fire, also known as life gate fire. As Mr. Du just ntioned, this patient has liver and stomach yin deficiency, so the dicine wasn’t targeting the right symptoms."
He basically passed. Du Heng thought.
These were things he himself had known thoroughly even before receiving his specialized expertise; they were fundantal knowledge for any TCM doctor.
So, he decided to increase the difficulty for the young man.
"You saw and heard the patient’s symptoms just now. I diagnosed that the cause of his increased food intake despite weight loss is stomach heat. Do you know the basis for this diagnosis?"
Du Heng felt he had raised the difficulty a bit, but Gu Ping beca completely flustered.
If he were asked about common knowledge or basic things, he wouldn’t panic at all. He was confident in what he had learned during his five years of university and from the experience gained in over a year of work.
However, being questioned about the theoretical basis was a different matter; that was truly challenging for him.
TCM literature is vast, and he had only started studying TCM in university. Learning the basics had already consud a great deal of his energy, so how could he possibly have mastered the theoretical underpinnings?
But looking into Du Heng’s eyes, he knew this wasn’t a valid excuse.
User Comments
0 comments from readers