Chinese Medicine: Starting with Daily Intelligence

Chapter 641: Chapter 641: Salvation

Li Xu lifted the blanket and examined the patient’s lower limbs.

Below the knees, both legs were as cold as stone, the left one especially so.

On the inner side of his left big toe, a coin-sized ulcer had formed, so deep the bone was visible. The surrounding tissue had turned black.

And all ten of his toes had taken on a terrifying bluish-purple color—a sign of ischemic necrosis.

This was—gangrene.

In Western medicine, it’s known as late-stage thromboangiitis obliterans, or limb gangrene.

True heart pain plus gangrene. The blood vessels in his heart and limbs were all blocked.

It was like a tree with rotten roots and a withered trunk, ready to topple over at any moment.

’The situation is grim.’

Lin Guorui thought for a moment before suggesting, "Dean Li, the patient’s limbs are cold and numb, especially his lower legs, which are abnormally cold and wracked with sharp, electric-shock-like pain. Given this, we could check the Fuyang and Taixi pulses on his feet to see the state of qi and blood in his lower limbs..."

He hadn’t even finished speaking when he saw that Li Xu had already bent down, his hands placed on the patient’s instep and ankle.

Those were the locations of the dorsalis pedis and posterior tibial arteries.

A moment later, Li Xu withdrew his hands and shook his head. "The dorsalis pedis arterial pulse is completely gone in both feet. I can’t feel it at all. The Taixi pulse is also so faint it’s almost non-existent."

As soon as the words left his mouth, Lin Guorui’s heart sank.

To not even be able to find a pulse meant the blood supply to the lower limbs had been completely cut off.

If they didn’t clear the blood vessels soon, his legs would truly be unsalvageable.

After speaking, Li Xu stood up and went directly to check the patient’s cunkou pulse at his wrist.

This time, his examination was meticulous.

A moment later, Li Xu finished taking the pulse, his expression grave. "The pulse is deep, fine, slow, and faint. Combined with the patient’s pale, dark complexion, fatigue, and aversion to cold, this is a classic case of yang deficiency and cold coagulation, leading to qi and blood stagnation."

"The heart-yang is weak and lacks the strength to propel the blood, causing chest obstruction and heart pain. A cold pathogen has congealed in the meridians, obstructing the flow of qi and blood, which is why the limbs are cold, painful, and necrotic."

"Director Lin, would you like to take his pulse to confirm?"

Lin Guorui nodded. "Yes."

He wanted to verify it for himself.

After taking the pulse, his conclusion was identical to Li Xu’s.

"Shall we step outside to discuss a treatment plan?"

Li Xu suggested.

This was a patient’s room, after all, and some things were best not said so bluntly in front of him.

"Alright." Lin Guorui nodded.

The two were about to head out.

Suddenly, Wang Guoliang, on the hospital bed, seemed to muster his last ounce of strength and grabbed the corner of Li Xu’s coat.

His hand was trembling and weak, but his grip was deathly tight.

He looked up, his cloudy eyes filled with desperation, and his voice was hoarse.

"Doctor Li... I don’t want an amputation... I’d rather die than have an amputation..."

"I’m a soldier... If I lose my legs... what kind of soldier would I be...?"

Li Xu looked into the old veteran’s eyes, a pang of sorrow striking his heart.

He gently patted the back of Wang Guoliang’s hand and promised solemnly, "Don’t worry. We’ll do everything we can to save them."

As they walked out of the room, their mood grew even heavier.

Save his legs?

’Easier said than done.’

「...」

Li Xu and Lin Guorui walked out of the ICU.

Everyone in the hallway turned to look.

The patient’s wife had been waiting by the door. Seeing them, she hurried over. "Dean Li, Director Lin, how is he? Old Wang’s legs... can they be saved?"

Li Xu remained silent, his expression grave.

Lin Guorui glanced at the family member, his expression sinking slightly. "Let’s talk in the office... This isn’t the place."

Hearing this, the patient’s wife’s heart instantly sank, and a chill ran through her hands and feet.

She was all too familiar with this kind of opening. She had heard it countless times during those seven months in the provincial capital, and it never preceded good news.

「In the ICU Director’s Office.」

Director Si brought over a thick stack of medical records and placed it on the table. "Dean Li, Director Lin, take a look at these first. These are the patient’s treatment records from the major provincial hospitals over the past six months."

The two men each picked up a file and began to quickly flip through it.

The only sound in the office was the SHUSH of rustling paper, and the atmosphere was so oppressive it was suffocating.

After a while, Lin Guorui closed the file and let out a long sigh.

He looked at the patient’s wife, his tone heavy and sincere. "Your husband’s condition is truly difficult. In TCM terms, we call it ’latent cold transforming into fire, with cold congealing the blood and causing stasis.’"

"That severe case of frostbite from thirty years ago seemed to have healed, but in reality, a cold pathogen has been lurking inside his body ever since, like a ticking time bomb. When he was younger, his qi and blood were vigorous and his vital qi was strong, so it could be suppressed and didn’t manifest."

"But as he aged, his vital qi declined, and the cold pathogen gradually penetrated deeper into his organs. Now, the cold pathogen has reached the ’blood level.’ Oh, ’blood level’ is a technical term for us. According to the theory of febrile diseases—the four levels of Wei, Qi, Ying, and Xue—reaching the blood level means the pathogen has invaded the core of the body. The illness has become extremely severe, even life-threatening."

"Because the cold pathogen is deeply entrenched at the blood level, it has blocked the vessels, leading to the ’gangrene’ and ’true heart pain.’ His current condition is even more serious than when you were hospitalized in the provincial city. He is at risk of dying from heart failure or infection at any moment."

Li Xu didn’t rush to speak. He was still carefully looking through the previous doctors’ treatment records.

He had to admit, the experts in the provincial capital were skilled.

Whether it was their pattern differentiation or their prescriptions, their fundamental approach had been correct.

In fact, the way some less-competent TCM doctors treated illnesses was absurd.

They don’t perform pattern differentiation; they just look at the Western medical test results and disease names.

Take "vasculitis," for example. The Chinese character for "inflammation" is literally composed of two "fire" characters. So they think, ’How can there be inflammation without heat?’

So they directly prescribe herbs that clear heat, detoxify, cool the blood, and reduce inflammation.

They fail to realize that this patient’s condition stems from a cold pathogen deep within the blood level. The root cause is "cold" and "deficiency."

If it had been one of those quacks, using bitter, cold, and purgative herbs to "reduce inflammation," it would have been like pouring fuel on the fire. The patient would likely have died today.

This is also why TCM practitioners can’t rely solely on Western medical reports to treat diseases.

When they get lucky and the disease matches the pattern, it’s a case of a blind squirrel finding a nut. When they’re not lucky, it’s murder.

The experts in the provincial capital obviously hadn’t made such a basic mistake. The formulas they used also contained herbs to warm the yang and dispel cold. Their thinking was correct.

After listening to Director Lin’s explanation, tears welled up in the patient’s wife’s eyes, but she fought to keep them from falling.

Her voice trembling, she asked, "Director Lin, please just tell me straight. We can take it. This illness... can it be treated at all? Even if we can’t save his legs, can his life be saved?"

Lin Guorui shook his head and told her the truth. "The condition is very serious and extremely difficult to treat. His cardiovascular and cerebrovascular vessels are already blocked. This isn’t a problem that amputation can solve."

The patient’s wife asked again, "Then... can it be controlled? Even just to buy a little more time?"

Lin Guorui shook his head again, his tone helpless. "It’s very difficult. I can’t make any promises, and I can’t guarantee his condition won’t continue to worsen. I can only say that I will do my best, and the rest is up to fate."

Everyone’s hearts sank.

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