CHAPTER 216: 216 THE PRESSURE IS IMMENSE

Fortunately, at this moment, their de facto Eldest Senior Brother stepped forward. He shielded everyone from Li Jianwei’s gaze and slightly eased the tense atmosphere. "Hello, Senior Brother Du," he asked, "I would like to ask, what is your approach to syndrome differentiation?"

"Syndrome Differentiation and Treatment is the guiding principle," Du Heng replied. "Overall systemic regulation is key, with the foremost task being to regulate the Spleen and Stomach and preserve stomach qi."

"When you say ’regulating the Spleen and Stomach,’ does that mean tonifying them?"

Now, that was a pertinent question.

After these two questions, Li Jianwei’s flushed face finally relaxed somewhat. At least he had taught a few sensible students.

Du Heng, upon hearing this question, shook his head. "Not necessarily. Regulating the Spleen and Stomach still requires Syndrome Differentiation and Treatment; one cannot blindly resort to tonification."

Saying this, he reached for the prescription he had just written, laid it flat on the table, and pointed to the characters on it. "Look, the patient’s tongue is pale with a white, greasy coating. A pale tongue often indicates a deficiency syndrome, while a white, greasy coating points to damp-cold. Furthermore, the patient’s pulse is soggy... By the way, do you know what a soggy pulse signifies?"

As expected of their Eldest Senior Brother, he replied immediately, "Superficial and fine, like feeling silk floating in water—that is a soggy pulse. A soggy pulse primarily indicates conditions of blood and yin deficiency, and also injury from dampness."

"And how is it treated?" Du Heng continued to press.

The Eldest Senior Brother remained composed, stating word by word, "A soggy pulse at the cun position with weak yang and profuse sweating; how can one overlook qi deficiency in the guan position? At the chi position, it signifies severe cold from deficiency of essence and blood; warming and replenishing True Yin can cure the ailment."

Du Heng chuckled softly, and Li Jianwei also felt a sense of relief. This student shows promise; he hasn’t disgraced me.

"You remember it very well. So, if I diagnose the patient with chronic spleen deficiency and damp obstruction, is there any problem with that?"

The Eldest Senior Brother shook his head. No sooner had Du Heng finished speaking than he understood.

Seeing him shake his head, Du Heng continued, "With chronic spleen deficiency and damp obstruction, the transport and transformation functions are impaired, dampness obstructs the Middle Jiao, and the stomach yang fails to ascend. Is there any issue with my therapeutic approach of strengthening the spleen and transforming dampness, warming yang, and regulating qi?"

The Eldest Senior Brother still shook his head. "No problem."

Du Heng pointed at the already prepared prescription on the paper. "I’m using raw atractylodes to invigorate the spleen, and herbs like prepared aconite and aucklandia to warm yang and transform dampness. Can you understand this?"

"I can understand."

"The patient has a poor appetite and bad digestion. I’ve used four herbs, including scorch-fried medicated leaven and chicken gizzard, to help improve digestion. Is there any problem with that?"

This Eldest Senior Brother was starting to feel the pressure. He glanced back at his peers cowering behind him and could only shake his head again.

"The patient reports having a bowel movement only once every four or five days, indicating mild constipation. Using raw atractylodes can also alleviate constipation, so isn’t that killing two birds with one stone?"

"...Yes."

"And the combination of raw atractylodes and chicken gizzard is a targeted pairing for symptoms like poor appetite, lack of hunger, and abdominal distension. Isn’t that killing three birds with one stone?"

The Eldest Senior Brother swallowed hard. "Yes."

Du Heng tapped the table and pushed the prescription slip back to the doctor who had originally written it. "Then, regarding my diagnosis, syndrome differentiation, and medication, are there any parts you still don’t understand?"

"Nothing." The Eldest Senior Brother slowly tried to back away, but his ’enthusiastic’ fellow students behind him blocked him, preventing any retreat.

"Traditional Chinese medicine utilizes the four diagnostic methods: Inspection, Auscultation-Olfraction, Inquiry, and Palpation. Aren’t my diagnosis, syndrome differentiation, and prescribed medication for the patient all derived from these four aspects?"

Du Heng spoke very softly, his tone gentle, yet the practitioners of TCM present, including Li Jianwei, felt immense pressure.

Indeed, the simplest methods are often the most effective.

"All the patient’s conditions are clearly revealed to us through her physical signs, her pulse, and her self-reported symptoms. Yet, we are using the diagnostic conclusions and treatment philosophies of Western medicine to guide our TCM prescriptions. That is wrong from the very foundation."

Du Heng sighed. "Let me put it another way: Western medicine aims to eliminate the bacteria and viruses themselves. In contrast, traditional Chinese medicine aims to alter the internal environment where these pathogens thrive, making it inhospitable. Consequently, they naturally diminish."

Li Jianwei now understood and said frankly, "That’s indeed true. My method of clearing heat and detoxification doesn’t have the ’disinfecting’ power of Western medication, nor can it improve the stomach’s environment, so it’s normal for it to be ineffective. The error in my treatment approach is my fault."

Li Jianwei’s frank admission of his mistake made Du Heng feel a little embarrassed. After all, some of his earlier words had been rather harsh.

Xu Pinglin noticed this and quickly stepped in to smooth things over and change the subject. Addressing the patient and her husband, he said, "You see, Doctor Du has explained everything very clearly. Do you have any more questions?"

The couple looked at each other and both shook their heads.

Xu Pinglin let out a sigh of relief. Although the patient hadn’t taken the medicine yet, after listening to Du Heng’s explanation and his reasoning for the medication, he couldn’t find any flaws.

Moreover, Du Heng was so confident. Coupled with his past successes, Xu Pinglin felt reassured. "Alright, then. We will arrange for you to get the medicine, and you should take it according to Doctor Du’s medical advice."

He paused for a moment before adding, "Actually, if it’s possible for you, inpatient treatment would be best. We could monitor and examine you at any time, which would make it easier for us to adjust the treatment plan promptly."

The patient’s husband looked at his wife expectantly, hoping she would agree to be hospitalized for treatment. However, he respected his wife’s decision and would defer to her wishes.

The patient, too, was hesitant. But thinking about her job, and considering her physical condition wasn’t yet so bad that she couldn’t work, she ultimately shook her head, declining the suggestion.

Since that was her decision, Xu Pinglin had no choice but to agree. "In that case, go home and take the medicine regularly. Return to our department for a follow-up appointment in a week."

The patient looked a little puzzled. "Can’t I see Doctor Du for the follow-up?"

Xu Pinglin really wanted to agree, but he couldn’t. After all, no one could predict the final outcome. If he simply referred the patient to Du Heng, and things went awry, Du Heng might end up shouldering the blame for their department.

"That won’t be necessary. You should still come to our department for the follow-up, and we’ll ask Doctor Du to make another trip then."

"Alright then."

Xu Pinglin pointed to the doctor who had written the initial prescription. "Take the patient and her family to get the medicine."

"Yes, Director. We’ll go right now." The young doctor turned to the patient and her family members. "The three of you, please come with me. I’ll take you to the pharmacy."

The couple didn’t say much more. Their original intention wasn’t to cause trouble but to seek effective treatment. Now that there was a glimmer of hope, they naturally wouldn’t continue to cause a disturbance and followed the doctor out.

However, the final outcome still depended on whether Du Heng’s prescription this time would be effective. If it proved ineffective, the fuss they intended to make would still happen.

The couple left, but their daughter lingered, phone in hand, reluctant to go. Her parents hadn’t noticed she hadn’t followed them out.

Xu Pinglin glanced at the girl, his brow furrowing slightly. This girl didn’t seem to be here to accompany her mother for treatment, he thought, but rather to live-stream everything.