"Tell about your specific situation." As soon as the mother and daughter returned to the consultation room, Du Heng began his inquiry.
Before the woman could speak, her mother interjected, "They've been married for six years but haven't had a child. They've both been to the hospital for various examinations, and the results have always been normal. Doctor, can you please examine my daughter thoroughly? We need to find out if the problem lies with her or my son-in-law."
The woman frowned. "Mom, why did you have to bring Zhang into this?"
The old lady, unfazed by her daughter's attitude, said, "Let Doctor Du examine you. If it's your problem, we'll treat it. If it's not, then it must be your husband's. So, what's going on?"
Seeing the mother and daughter on the verge of arguing, Du Heng quickly asked the woman, "Have you never been pregnant since you got married?"
The mother and daughter imdiately stopped arguing. From the mother's expression, it was clear she was very worried about her daughter and wanted to answer for her again.
Du Heng quickly waved his hand. "Auntie, could the patient please speak for herself?"
The old lady nodded quickly. "Yes, yes, of course." She turned to her daughter, urging, "Doctor Du is asking you a question. Hurry up and answer."
The woman hesitated for a mont, glanced at her mother, and then finally said, "Yes, I've never been pregnant since we got married."
"What about before marriage?"
The woman hesitated again. "No."
Her repeated hesitation made Du Heng frown slightly. She isn't telling the truth, he thought. If the woman wasn't going to be truthful, there was no point in asking further questions.
"Let take your pulse."
Du Heng proceeded to the next step, not wanting to waste any more ti.
As Du Heng perford the pulse diagnosis, his frown deepened. This made the mother, who was watching intently, increasingly nervous. She couldn't help but ask, "Doctor Du, what's wrong with my daughter?"
Du Heng opened his mouth to speak but, suddenly recalling the woman's earlier hesitation, he changed his mind. "Auntie, could you please wait outside the door? May I speak with the patient alone for a few monts?"
Clearly startled by Du Heng's words, the old lady's eyes flickered, and her voice trembled slightly. "Doctor Du, just tell . I'm her mother."
Du Heng smiled. "I need to ask about so matters concerning her and her husband. While it's fine for you to hear as her mother, as her mother-in-law, I think it would be better if you weren't present."
Hearing this, the old lady visibly relaxed. As an elder, it truly wasn't appropriate for her to listen to private matters between her daughter and son-in-law.
Once the old lady had left, Du Heng's expression turned serious. "Let confirm one more ti: you've truly never been pregnant before?"
This ti, the woman's hesitation was even more pronounced, but she still denied ever having been pregnant.
Du Heng withdrew his hand from her wrist and looked at her intently. "Your mother isn't here now; it's just the two of us. There's no need to lie to . It won't help your condition. Let ask you again: have you never been pregnant?"
The woman still shook her head.
"Alright. Let ask you this: have you experienced any bleeding from your lower body recently? And I'm not referring to your nstrual period, of course."
At Du Heng's question, the woman's expression changed dramatically. Her gaze, however, now held a great deal of surprise as she looked at him. It was unclear what she was thinking, but after a long pause, she gave a slight nod.
"Do you understand what this type of bleeding signifies?"
"Yes."
This ti, her answer was much more direct.
"What is it?" Du Heng pressed.
"A miscarriage."
"So, it's not that you can't conceive, nor that you've never been pregnant. Rather, you've been experiencing habitual miscarriages. Each ti you conceive, you don't even make it past ten weeks."
The woman lowered her head, remaining silent. After a long while, she slowly raised her head. "Doctor, I lied to you earlier. I was pregnant when I was in college. But I was young and foolish back then. Whenever I found out I was pregnant, I would imdiately take abortion pills or go to the hospital for an induced abortion. Later, it developed into the current situation, where every ti I get pregnant, it doesn't last two months; the pregnancy ends on its own."
"How many tis have you taken abortion pills, and how many induced abortions have you had?"
"I don't rember how many tis I took the pills, but I've had four induced abortions."
Du Heng sighed. "Is your current husband the sa boyfriend you had back then?"
Hearing his question, the woman lowered her head again. "No. After graduation, he took to get treatnt, but it was never effective, so he broke up with ."
"So, you've never told your current husband about your history of miscarriages?"
"That's right. I've always told him I've simply never been able to get pregnant."
Du Heng pursed his lips. What a complicated situation, he thought. But what does it have to do with ?
Du Heng composed himself and asked again, "How did you know you were pregnant each ti? And how did you distinguish between a miscarriage, a nstrual issue, or so other gynecological problem?"
The woman also took a deep breath. "Whenever I get pregnant, I beco extrely thirsty, my throat gets very dry, and I beco irritable. When it's severe, I get sores on my tongue, and my lips beco dry, cracked, and swollen. No amount of water helps. Then, I experience constipation, sotis going one or two weeks without a bowel movent, accompanied by unbearable pain in my lower abdon. Once the bleeding starts, all my symptoms gradually subside."
Du Heng listened intently. When she finished, he asked, "Has this condition worsened in the last two years?"
"Yes, it's much more severe than it was in the earlier years." The woman's expression was grim. She knew that worsening symptoms ant her condition was deteriorating, making treatnt even more difficult.
"Have you sought dical treatnt for this before?"
The woman gave a bitter smile. "Of course. I've secretly seen Western dicine doctors—no fewer than twenty of them. As for traditional Chinese dicine practitioners, I've consulted everyone from Directors in large hospitals to village doctors."
"And what did the traditional Chinese dicine doctors say?"
"Most of them said I had large intestinal exuberant fire, with dampness accumulating in the intestines, leading to habitual miscarriage."
Indeed, Du Heng mused, her thirst, irritability, tongue sores, swollen lips, and constipation do align with symptoms of excessive intestinal fire.
Du Heng paused, then asked, sowhat curiously, a question unrelated to her illness, "I'm curious. I can understand why you wouldn't tell your husband the truth, but why haven't you told your mother?"
The woman's expression turned bleak. After a considerable pause, she answered, "My mother has always seen as a good woman; I've always been her pride and joy. If she knew how... difficult my college years were, I'm afraid she couldn't bear it."
A devoted daughter, indeed, Du Heng thought.
Du Heng leaned forward slightly, straightening his posture. "Let's discuss your physical condition now. You do indeed have heat in your body, but it's not large intestinal exuberant fire. It's blood heat."
"Blood heat?" This was the first ti the woman had heard this diagnosis, and a flicker of emotion disturbed her otherwise calm expression.
Du Heng nodded, reaffirming, "Yes. Blood heat causing habitual miscarriage. That is the actual reason for your recurrent miscarriages."
After her initial surprise, doubt filled the woman's eyes. "I was fine during my university days. How did I develop blood heat? And what exactly is blood heat?"
"Blood heat is often caused by pathogenic heat entering the blood. It can also arise from emotional stagnation or extre emotions transforming into fire," Du Heng explained gently. He then continued, "Do you think those abortion pills you took back then had no side effects? Do you believe the induced abortions had no impact on you?"
Noticing the woman's slightly wavering gaze, Du Heng continued, "Furthermore, after multiple induced abortions, your emotional state likely changed. You may have beco more irritable, easily agitated, or even depressed. Especially after years of marriage without being able to carry a pregnancy to term, your emotions have probably been stretched to their limit. This has caused a progression: you used to miscarry around the ten-week mark, but now it happens within a month."
This was the first ti the woman had heard an explanation that so closely matched her own experience. A glimr of hope ignited within her.
"Doctor Du, why does blood heat lead to miscarriage?" She wanted to be absolutely sure, to find more reasons to believe him.
"In early embryonic developnt, the embryo relies on your essence and blood for nourishnt. If the blood temperature is favorable, the fetus thrives. But if there is blood heat, the fetus is hard."
Du Heng tapped his fingers lightly on the desk. "Currently, your blood is hot. The fetus in your uterus, nourished by your essence and blood, experiences sothing akin to being scalded in boiling water. To survive, the fetus naturally tries to move downwards, to escape. Concurrently, the essence and blood in the uterus are transford from Yin water. Your blood heat prevents this Yin water from quickly regenerating into blood, leading to yin deficiency and hyperactivity of fire. These two types of fire combine within your uterus, and the intense heat essentially 'cooks' and expels the fetus, inevitably leading to a miscarriage."
The woman, as if seeing a ray of hope, asked eagerly, "Doctor Du, can my condition be treated?"
Du Heng nodded gently. "Yes. We need to clear the fire in the uterus and nourish the essence of the kidney. The fire in your uterus is currently a deficient fire, not an excess fire. Excess fire can be treated with the Reduction thod, whereas deficient fire should be addressed by nourishing and clearing simultaneously."
With that, Du Heng turned on his computer. After a mont's thought, he began typing. "I'll prescribe you a formula based on the Four Agents Decoction. You should see results within half a month. If you and your husband are actively trying to conceive, you can try again next month."
The woman's face lit up with surprise, and she stood up abruptly. "Doctor Du, are you serious?"
"Of course." Du Heng smiled faintly. "But you must follow my instructions carefully. It's not just about consistently taking the dicine. During the period you are taking it, you must also avoid consuming cold-natured dications and fruits."
After a brief pause, Du Heng continued, "Because of the blood heat, you'll sotis feel very dry and parched, and you might be tempted to use cold things to find relief and reduce the heat. While this thod can indeed provide temporary relief from discomfort, using cold substances to reduce heat this way disregards the actual condition of the fetus and will inevitably cause the stomach qi to beco depleted. If the stomach qi is weakened, how can it transform an essence to produce Yin water? Not only will it fail to help your condition, but it will actually make it worse."
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