Chinese Medicine: Starting with Daily Intelligence

Chapter 608: Chapter 608: Fracture

Linyang was a neighboring prefecture-level city, over a hundred kilometers from Feng City.

This just went to show that Li Xu’s fame had well and truly begun to spread.

"What seems to be the problem?" Li Xu asked.

"Dr. Li, please, take a look."

The woman gently nudged the young man’s arm.

The young man reluctantly took his hand out of his pocket and placed it on the Pulse Pillow.

When she saw the young man’s hands, Song Sisi, who was organizing the medicine cabinet nearby, couldn’t help but gasp.

’It was horrifying.’

The young man’s hands were as withered as sticks, but that wasn’t the most frightening part.

The most frightening part was his fingernails.

Except for his two thumbs, which still had remnants of deformed, yellowed nails, the nails on his other eight fingers had completely fallen off.

His fingertips were bare, the nail beds exposed. Some areas were red, swollen, and inflamed. Just looking at them was enough to make you feel a piercing pain.

"How long has it been like this?"

Li Xu asked, observing them closely.

"For about two years."

The woman sighed, her eyes filled with distress. "It started as just paronychia, with a bit of pus. Then, for some reason, his nails started falling off one by one. We spent a long time at the dermatology department of the Linyang City Central Hospital. The specialists called it ’onychatrophy’ and ’anonychia.’ He took lots of medicine, got injections, and even used steroids, but nothing worked. In fact, they just kept falling off until they were all gone."

The dermatology department at Linyang City Central Hospital was considered one of the best in the province.

’If even they couldn’t cure him, this disease must be truly difficult to treat.’

This condition fell squarely into the domain of traditional Chinese external medicine.

"Lay your arm flat."

Li Xu motioned for the young man to roll up his sleeve.

As he took the boy’s pulse, he observed his complexion.

His face was sallow and dull, without any luster. His cheeks were sunken, and he was as thin as a rail.

"How are your bowel movements?" Li Xu asked.

"They’re not good. I’m always constipated, sometimes only going once every three or four days. It’s dry, like sheep pellets."

"Any other discomfort?"

"My stomach feels bloated. I get uncomfortably full and feel like my food isn’t digesting, even after eating just a little."

Li Xu focused on the pulse beneath his fingertips.

The pulse was deep, wiry, and fine. ’Deep indicates an internal condition. Wiry points to pain and liver qi stagnation. Fine suggests deficiency.’

"How’s his appetite?"

"He’s been a picky eater since he was a child. He won’t eat this, won’t eat that... He eats like a bird," the woman said helplessly.

Li Xu released the young man’s wrist. He already had a diagnosis in mind.

In traditional Chinese medicine, it is believed that "the nails are the surplus of the sinews." Furthermore, "the spleen governs transformation and transport, the stomach is the sea of water and grain, and together they are the source from which qi and blood are generated."

Although the nails are directly nourished by the liver’s blood (as the liver governs the sinews), their nourishment ultimately stems from the nutritive and defensive qi produced by the spleen and stomach.

When the spleen and stomach are weak, there is no source for the generation of qi and blood. This leads to insufficient liver blood, which in turn fails to nourish the sinews and nails, causing them to wither and fall off.

Coupled with the patient’s sallow complexion, emaciated frame, abdominal bloating, and constipation, it was obvious that his spleen and stomach functions were severely impaired. This had led to malnutrition, triggering a chain reaction of symptoms.

Before he had read *Liu Juanzi’s Ghost Remedy*, Li Xu might have been swayed by the Western medical diagnosis and treated it as a simple skin or nail disease. He probably would have used some standard formula to activate blood circulation, resolve stasis, reduce swelling, and alleviate pain.

However, the volume of "Lost Chapters" he had just been studying that very morning happened to contain a similar case.

It was called "Withered Nail Syndrome."

The book stated: "Spleen deficiency with a preponderance of dampness leads to damp-heat accumulating and obstructing the meridians. The flow of qi and blood is blocked, causing the nails to lose their nourishment, wither, and fall off."

’Wasn’t that a perfect description of the young man before him?’

The weak spleen and stomach were the root cause of the illness, while the internally generated damp-heat obstructing the meridians was the branch, or surface-level, manifestation.

"Based on his pulse and symptoms, the patient has a weak spleen and stomach. At the same time, there is internal damp-heat obstructing his meridians, which is blocking the flow of qi and blood," Li Xu said. "Western medicine calls this anonychia, while traditional Chinese medicine calls it Withered Nail Syndrome. The treatment can’t just focus on the nails; we have to treat the root cause."

"The treatment principle is to tonify qi and strengthen the spleen, clear heat and drain dampness, and activate blood to free the collaterals."

Li Xu quickly typed out the prescription on his computer.

"Atractylodes, 15g; raw gypsum, 30g; White Peony Bark, 15g; and Smilax Glabra Rhizome, 30g, to strengthen the spleen, clear heat, and expel dampness. Danggui, 15g; Curcuma Rhizome, 10g; and Sanleng, 10g, to activate blood circulation, resolve stasis, and clear the meridians..."

"Then add 30g of Astragalus Root to tonify qi and raise yang, and 15g of Chicken Gallbladder to promote digestion and resolve stagnation."

This was the advantage of TCM’s pattern-based diagnosis.

Instead of being misled by localized symptoms, it took a holistic view to find the root of the disease.

Li Xu printed the prescription, handed it to the woman, and explained the details.

"This formula will both nourish the spleen and stomach and clear out the damp-heat toxins from the body. It’s like tending to a tree: once you’ve nourished the roots and killed all the pests in the soil, the leaves will naturally become green and healthy."

"When you get home, decoct one packet of herbs twice. Mix the first and second decoctions together, then drink it in two doses—one in the morning and one at night."

"Remember, do not throw away the leftover herbs."

Li Xu added with special emphasis, "Add water to the dregs and bring them to a boil again. Once it has cooled down a bit, have your son soak his hands in the mixture for half an hour every day. This is what we call ’internal administration and external washing’—a two-pronged approach."

"One packet is a one-day supply. I’ll prescribe seven days’ worth for now. Come back for a follow-up appointment when you’ve finished it."

Holding the prescription, the woman thanked him profusely. "Thank you, Dr. Li, thank you so much. We’ll be sure to do exactly as you’ve said."

After seeing the mother and son off, Li Xu was filled with emotion.

’The wisdom of the ancients truly is a boundless treasure.’

*Liu Juanzi’s Ghost Remedy* would allow him to better treat conditions related to external medicine.

...

「The weekend arrived in the blink of an eye.」

Li Xu had spent the last few days immersed in studying *Liu Juanzi’s Ghost Remedy*, especially the five lost volumes. He was deeply inspired by the techniques for fracture reduction and trauma treatment they contained.

Though the ancients lacked the aid of modern imaging technology, their understanding of human anatomy and mechanics, as well as their intuitive perception—the ability to understand through touch—was something modern instruments could not replace.

That morning, he went to the City Hospital of Traditional Chinese Medicine as usual.

Just as he walked into the lobby, he bumped into Director Ren from the orthopedics department.

Director Ren was a genial middle-aged man who was on good terms with Li Xu. The two chatted casually about recent medical news as they walked toward the elevator.

"Director Ren! Director Ren!"

A nurse rushed over, interrupting their conversation. "A patient was just brought into the ER! It was a crushing injury—a fractured left lower leg. It looks pretty serious."

Director Ren’s expression changed. He turned to Li Xu apologetically and said, "Dean Li, my apologies. We have an emergency. Let’s talk later."

With that, he quickly turned and hurried toward the emergency observation room.

’A fracture?’ A thought struck Li Xu.

’Isn’t this the perfect chance to test what I’ve learned these past few days?’

"I’ll go take a look, too."

Li Xu followed him.

"Did you notify the orthopedic doctor on duty?" Director Ren asked the nurse as they walked.

"Yes, I’ve called. He’ll be here any minute," the nurse replied, though her tone was hesitant. "But... Dr. Hao said on the phone that based on the initial description, our orthopedics department probably can’t handle it. He recommended transferring the patient."

The orthopedics department at the City Hospital of Traditional Chinese Medicine was small and understaffed, typically only handling minor problems like sprains and dislocations. For severe cases like open or comminuted fractures, they usually recommended a transfer to the City People’s Hospital or a specialized orthopedic hospital.

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