Chinese Medicine: Starting with Daily Intelligence

Chapter 614: Chapter 614: Equal Negotiation

The process of searching for a medicine guide actually serves a purpose: to encourage the patient to exercise and get fresh air.

This approach is targeted at wealthy women who tend to be lazy and lack exercise.

In the past, before cesarean sections were available, it was common for lazy, physically weak pregnant women from well-off families—who were often over-nourished—to die from difficult childbirth.

Furthermore, giving patients something to do keeps them from being left alone to ruminate and dwell on their pain.

This is another reason why Traditional Chinese Medicine places such high demands on its practitioners.

This is because TCM itself has no fixed, rigid formula.

It has its own theories, foundations, and a complete medical system, but how much a doctor can learn and apply depends entirely on their own insight and skill.

Zhang Liang stared at the prescription Li Xu had written, speechless for a long moment.

The reason was that Li Xu’s modifications to the prescription were simply too good. Not only did he minimize any potential harmful effects, but the new formula’s efficacy was likely even better suited for this physically weak patient than the original.

He had also thoughtfully considered the patient’s financial situation, substituting expensive animal-based ingredients with cheaper herbs.

This compassion and meticulousness made Zhang Liang feel completely outmatched.

After a moment of stunned silence, Zhang Liang finally printed out the prescription, signed it, and handed it to the patient.

"Take this as prescribed, get plenty of rest, and avoid raw or cold foods. This is a gentle formula that will slowly regulate your system. Come back for a follow-up appointment after you’ve finished the course."

After the patient left, showering them with thanks, Zhang Liang finally turned to Li Xu, his expression complex.

Li Xu felt a little unnerved by Zhang Liang’s intense stare. Feeling rather awkward, he scratched his head. "Elder Zhang, did I just... overstep my bounds?"

Zhang Liang sighed, his voice tinged with emotion. "Xiao Li, I really underestimated you. I thought you were just young and promising, but I never imagined your skills were already this advanced."

"That prescription just now... the modifications were brilliant. It treats the illness, protects the patient, and even saves them money. In comparison, my prescription only focused on ’expelling pathogenic factors’ and forgot to ’support healthy qi.’ It seems crude, making me look like an inflexible clown."

Li Xu quickly waved his hands in a gesture of humility. "Elder Zhang, you’re being too harsh on yourself. It was just a minor oversight on your part. I’m merely standing on the shoulders of giants. I just happened to have studied a similar case not long ago, so it was a bit of a lucky break."

Gao Guanghui, standing nearby, laughed and chimed in, "Old Liang, don’t get discouraged. But honestly, Li Xu’s performance today has truly impressed me. Even I didn’t immediately think of such comprehensive changes for that prescription."

Although his old friend tried to console him,

Zhang Liang still felt a bit indignant.

After all, he was a renowned doctor in the provincial capital, with appointments so sought-after they were nearly impossible to get. Plus, he was more than twice Li Xu’s age.

Being professionally outshone by a junior was a little hard on his pride.

A competitive fire lit up inside Zhang Liang, and an idea for a contest formed in his mind. ’Traditional Chinese Medicine is vast and profound. Internal medicine and complex cases are the true test of skill. Let’s continue seeing patients and see what comes next.’

"Alright. I look forward to your continued guidance, Elder Zhang."

Li Xu, not one to back down, accepted with a smile.

Soon, the clinic door was pushed open, and a middle-aged man in his forties walked in, supported by his wife.

"Doctor."

The man had one hand on his left lower back, his complexion was slightly sallow, and fine beads of sweat dotted his forehead. He was clearly enduring considerable pain.

"Have a seat."

Zhang Liang pointed to the chair in front of him.

After the man sat down, his wife quickly handed over a plastic bag stuffed full. "Doctor, these are his previous medical records. They’re all in here."

Zhang Liang took the bag, pulled out a thick stack of test results and medical records, and began to look through them carefully.

Li Xu, who was beside him, also leaned in to examine them.

The medical records showed that the man had mainly been treated at the City People’s Hospital’s nephrology and gastroenterology departments.

The main complaint was a left kidney stone, about 0.8cm in size.

In addition, he also had a history of early-stage liver cirrhosis and chronic cholecystitis.

"He had lithotripsy once before."

His wife added from the side, "The tests said the stone had been broken up and had fallen into the ureter, but... it’s just stuck there and won’t come out. The pain makes him roll around on the bed."

"What discomforts are you feeling now?"

Zhang Liang asked while looking at the medical records.

"Right now, it’s this spot. It’s a sore ache, and sometimes it’s a sharp, twisting pain."

The man pointed to his left lower back, his brow furrowed. "And this area here, there’s a dull ache, like something is pulling it down. It’s really uncomfortable."

As he spoke, he pressed his lower abdomen.

"A feeling of distention and bearing down in the lower abdomen." Zhang Liang nodded, making a note in the medical record. "Anything else?"

"I also feel dizzy, light-headed, and this area hurts too."

The man then pressed the area below his right ribs, where the liver and gallbladder are located.

"Also, my mouth is dry. I always want to drink water but it doesn’t quench my thirst. I’ve also been having nosebleeds recently. There are bloodstains on my pillow when I wake up in the morning."

Listening to the man’s description, Zhang Liang also asked about his urination and bowel movements. He learned that urination was frequent but scanty, and the color was yellow.

"Put your arm up here."

Zhang Liang motioned for the man to extend his hand. He placed three fingers on the man’s wrist and began to take his pulse.

A moment later, he withdrew his hand and turned to Li Xu. "It’s a taut Xian Vein."

A Xian Vein primarily indicates liver and gallbladder disease, and its tautness suggests either an excess of pathogenic qi or a case of yin deficiency with yang hyperactivity.

After Li Xu’s ingenious modifications to the gynecology prescription earlier, Zhang Liang had come to see Li Xu as an expert on his own level, and even looked up to him in some respects.

So now, his tone was completely one of equal discussion and exploration.

"Open your mouth. I want to see your tongue coating."

The man opened his mouth.

Li Xu and Zhang Liang both leaned in for a look.

The tongue body was crimson, with little to no coating, and its surface was somewhat dry.

"What do you think?" Zhang Liang asked Li Xu.

Li Xu pondered for a moment before analyzing, "Judging from his medical history, the patient has had a long course of illness and has an underlying condition of liver cirrhosis and cholecystitis. The dizziness, dry mouth, nosebleeds, taut Xian Vein, and crimson tongue are all typical signs of blood deficiency with an overactive liver, and insufficient yin."

"The liver and kidneys share a common source. The kidney stones, being a chronic and unresolved issue, have depleted the kidney yin. The liver cirrhosis has led to liver yin deficiency, causing liver yang to become hyperactive. The two are mutually causative."

"As I expected..."

Zhang Liang nodded, a trace of admiration in his eyes. "I agree. The patient’s condition should be lung and kidney deficiency, yin deficiency with yang hyperactivity, and liver qi stagnation. Because the Lung (Metal) generates the Kidney (Water), a lung deficiency means it cannot regulate the water passages, making it hard for the stone to pass. Kidney deficiency leads to exuberant fire from yin deficiency, forcing the blood to move erratically and causing the nosebleeds. And liver qi stagnation obstructs the qi mechanism, which worsens the pain."

"Mm," Li Xu agreed.

"So, for the treatment plan, we could clear the lungs and tonify the kidneys, nourish yin and subdue yang, and supplement that by transforming stasis, invigorating blood, and expelling the stone to clear the urinary dysfunction. We can start with that and see how he responds?"

Zhang Liang asked tentatively.

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