This step out is a different world!

He faintly felt that this trip to Yangzhou might be his opportunity.

With this calculation in his heart, Zhihuan will not have the idea of an ordinary doctor who "says that it is more difficult to suffer first, and then takes advantage of it". The doctors who enter the Shixing Pavilion may still have the psychology of comparing or hiding their secrets at first, but in the atmosphere of dialectical evidence every ten days in the cabinet, hiding their secrets will only make people rest on their laurels, and explain their opinions without concealment, and the more criticism and supplementation they attract, the greater the benefits in medical skills.

Zhihuan agreed with Shen Qingyi before that after entering Yangzhou, the two would do their own thing first, and then explain in the dialectical argument. "There will be more sparks when there is an open debate." Zhihuan smiled slightly in his heart. He made a salute with one hand and said to everyone: "Yu is several years older than Senior Sister Zhiyuan, and she will throw bricks and lead jade first." ”

This opening sentence made all the doctors a little surprised, and after thinking about it, this should be the humble words of the Taoist Master of Zhihuan.

Zhihuan opened his mouth with astonishing words: "Yu thinks that this cholera should be divided into two kinds. The former is old cholera, and the latter is new cholera, and the source and cause are different from the old cholera. ”

His voice was thick and clear, "Let's talk about the old cholera, which is what the doctors talk about as cholera: the disease begins with the cold wind, and the vomit and urine are as clear as water, but not sour, the mouth is not thirsty, or thirsty prefers to drink hot water rather than cold water...... Based on the syndrome differentiation of various doctors, this cholera is subdivided into several syndromes, and each syndrome has different pathological changes, which need to be carefully examined and treated separately.

"One is said to be cold and damp and trapped in the spleen, the body is cold and the limbs are cold, and the pulse is weak or thin, which is the typhoid cholera mentioned in Zhongsheng's "Treatise on Typhoid Fever", and it is also the most common cholera disease.

"The second is the death of the yang syndrome, dampness and cold limbs, sweat and cold, or irritability, remove the clothes and quilts, the latter is the evidence of Dr. Yu, it is a cold syndrome rather than a heat syndrome, and it cannot be treated with heat; As Hu Yicheng distinguished, it is the internal deficiency of yin and the prosperity of yang, and it cannot be treated by cold and dampness and spleen trapping. Yu thought that it was advisable to take care of the soup, and the positive qi was dispersed and Wuling was not available; The heavier ones are four reverse soups. If after using the four reverses, vomiting and diarrhea stop, still sweating and syncopating, and the pulse is slightly desperate, that is, the yin has not retreated, and the yang has the image of dispersion, when the four reverses add dry ginger doubled, in order to save the desperate yang, and consider the warmth of the fault, but for the yin qi refusal, so add the bitter cold of pig bile, for the use of guides. If there is a person who has a violent diarrhea like water, cold sweat is reversed, and the pulse is weak and cannot be spoken, then rush into the slurry water to disperse the cold and take it to save him. ”

Chang Tao, Yu Bingzhi, Hu Rulin and others all nodded slightly, which is to distinguish the various symptoms of cholera in the cold syndrome clearly, and to distinguish the virtual and the real and discuss the treatment, which is the principle of "one disease and different treatments".

"The second type is the fever syndrome cholera identified by several doctors before, which is that there has never been a new cholera before: sudden and violent vomiting and diarrhea, the vomit is fishy and sour and rotten, the diarrhea is rice-swill, yellow or blood-like, hot and smelly, short urine, yellow and red color, thirsty and drinking a lot of cold water, and tendons in the hands and feet......

After comprehensively distinguishing the evidence, Yu agreed with the Zhongjiao dampness and heat syndrome discussed by doctors such as Hu Yicheng, Dr. Chang, and Senior Brother Zhihe. This is very different from cholera, which cannot be used with medicine; Nor should it be treated as a summer and autumn cholera cure. ”

The doctors who held the heat theory all nodded slightly.

Zhihuan looked at the doctors with either approval or contemplative looks, and said: "Today's epidemics are mostly mixed with cold and heat, and they cannot be cured by one certificate. Looking at the patients and medical cases, the epidemic patients are dominated by heat syndrome, and there is also cold syndrome, then the epidemic treatment should be based on heat first and then cold, that is, the scorching and damp heat in Qingli is the first, and then the warm medicine is used to treat the cold syndrome, or the temperature is dissipated from dampness, or the yang is returned to save the adversity, or the qi is invigorated, then the cold and heat cholera can be cured at the same time. ”

He stopped at this point.

Yu Bingzhi couldn't help but hurriedly say: "Where should I use it to treat?" ”

Most of the doctors who hold the theory of heat syndrome in this syndrome differentiation and treatment are not because they have not used the prescription of scorching dampness and heat in Qingli, but it is not effective, or some patients are cold and unable to stand the heat, and they die of deficiency. Whether it is used to treat cold or heat, it is not appropriate, which makes all doctors restrain their hands, and if they are trapped in the alley, their thoughts will be more disturbed. At this time, I can hear Zhihuan's dialectical argument and treatment, just like the bell of the thousand-year-old Taoist temple, rich and melodious, and has a clear sound that is out of the world, which makes people can't help but listen to it, and the mind is clear, only to feel that the turmoil in the brain seems to be sorted out again, and the eyes that look at Zhihuan have become hot. The doctor with sexual urgency also urged Yu Bingzhi to ask: "How to treat it?" ”

Zhihuan did not set up a treat, but said: "If you want to cure the disease, the prophet is the cause." There are many branches of the river in Yangzhou, the residents take more drinking water from the river, the people share a water, and the filth is produced for a long time, and the city is densely populated, it is common for dozens of households to share a well in the civilian square, after the summer steaming every year, the heat and poison are stored, and the earth is hot, and the filth is more and more prevalent, so there are many malaria, summer dampness and cholera such epidemics. It is not a miracle that cholera is born today. Looking at some poor alleys, the sewage pottery pipes are buried shallowly, some pipes have been damaged and have not been replaced, and the sewage seeps out from the pipes, flowing on the surface, and the stench is unbearable. It's like the big elm lane in Nanxuanfang," he said, "cork, coptis and unfold the plan of Ziluo City." ”

Standing in the corner of the scripture hall, the two Taoist attendants stepped forward, standing behind the pharmacists, one left and one right unfolded the rough hand-drawn plan of Yangzhou City, three feet long and wide, and the names of the plagued workshops, songs, and lanes were marked with block letters of different sizes.

Zhi Huan got up and walked to the side of the two, pointed to the picture and said: "Everyone, please look, the red dot in the picture represents the epidemic area, the bigger the red dot, the more epidemics." According to the statistics of the state government, it is precisely the Dayu Lane in Nanxuanfang that has the most epidemics, and all the households in the entire alley are infected with the epidemic. Everyone, please look at the black spot here in Dayu Lane, which is the leakage of the sewage pottery pipe; The black circle here is the well. The two are less than three feet apart. ”

Everyone hissed in unison.

Yu Bing smacked his leg suddenly, "...... No wonder! ”

How can the faeces of a cholera infected person enter the sewer pipes, leak out of the broken terracotta pipes, and then seep into the wells, and the contaminated water enters the population through food and drink, or is it not contagious to those who drink raw water?

Another doctor thumped his legs, "...... No wonder the cholera outbreak was so violent this time! ”

"The Taoist Master of the Supreme Huan is also meticulous in his observation. and so on. Chang Tao bowed his hand to him, and he couldn't wait to report to the Assassin Mansion immediately, arrange for the whole city to inspect the sewage pipes, repair and replace the broken pipes, otherwise, the plague will be exposed on the surface, even if it does not pollute the river water and well water, I am afraid that if you live in it for a long time, you will be infected.

Zhihuan waved his hand to let the Taoist waiter retreat, sat back in his position and said: "Although the dirty land of poor households is the cause, the new cholera is more contagious than the old cholera, which is also an important reason for the fierce epidemic. Now that the cause is clear, it can be eliminated from the source, so as not to increase the source of the epidemic, which is the foundation of the plague control and is also a top priority. ”

When Chang Tao heard this, how could he still sit still?

Although the Yangzhou government has acted quickly and the quarantine measures have been effective, and the epidemic has not increased sharply in the recent period, there are still new cholera patients, especially in the slums. He remembered that the sewers in Yangzhou seemed to have been laid fifty years ago, and it was estimated that the construction in the slums was lazy, and the pipes were laid shallowly.

He immediately instructed the medical assistant sitting below him, and ordered him to go to the Assassin's Mansion to explain the situation in detail, arrange for the personnel to be tested as soon as possible, and the poor households should issue an order prohibiting indiscriminate excretion, as well as clean up measures, and so on. The medical assistant was an old man, and he didn't need to say much, he rolled a few in his head, and with a low answer, he got up and retreated, and after he came out of the view, he got on his horse and galloped to stab Shi Zhouya.

Only then did Zhi Huan talk about the treatment: "The heat syndrome cholera disease starts from the smell of the epidemic, and the lesions are concentrated in the spleen and stomach. Yu thought that silkworm arrows could be used as the main medicine, and it could be used to remove turbidity and filth, and to develop the power of Xuantong. As he spoke, he dictated a recipe for silkworm arrows.

This is a new formula.

The doctors listened attentively, carefully wrote down each medication, and compared with the Qingzhong soup, Lianpu drink, and Sanren soup used before, there are four or five kinds of auxiliary drugs that are the same, but there are more adjuvant drugs in Xuanhua Changzhong, and the key is that the main medicine uses silkworm arrows.

Zhihuan explained: "The silkworm arrow dispels dampness, especially good at dissolving the dampness of the stomach and intestines. It's just that its effect is relatively slow, so doctors rarely prescribe it for dissolving dampness in the spleen and stomach, and mostly for slow treatment of rheumatism. All kinds of heat and cholera can be treated with this remedy. It's a recipe for this. ”

Everyone understands that as long as it is a disease, most of them can be solved by taking this medicine, but because of the difference between people's physique and reality, as well as the difference in individual symptoms, some people get better quickly, and some people get better slowly. And it is very important to have a prescription for the treatment of the plague, because there are too many plagues, and there are not so many doctors to prescribe medicine for each patient's constitution.

But Zhihuan added: "If the fever turns to cholera, vomiting and the heat and evil ruffians are scorched, and the chest is uncomfortable, Huang Ling can be used as the main medicine, and it can be used together with Coptis chinensis and Banxia." If it is cholera and the liver is on fire, neem, cork, mulberry leaves, and loofah can be used as the main medicine. If it is cholera and the blood is hot, you can use the root of the grass, the diding, the mother, and the dandelion as the main medicine. If the cholera has been exhausted, ginseng, keel, oysters, licorice, paraffin, and surplus grain can be used as the main medicine......"

The doctors pondered the medicine he prescribed, and realized the mystery.

Zhihuan's medicine is light and clear, and it is very "light and transparent", that is, to treat serious diseases with light medicine.

The use of light and transparent is the most in line with the meaning of the royal road of doctors, so it is deeply respected by doctors. But not every doctor can do it, especially those who are seriously ill and can be cured without heavy medicine, they are definitely the best doctors.

The doctors thought that they couldn't do it, and they couldn't help but sigh and admire.

Hu Rulin sighed: He is worthy of being a genius of the Imperial Medical Department! It's a pity that it was poached by the Daomen.

Zhihuan bowed to Shen Qingyi and said, "Please add to Senior Sister Zhiyuan." ”

All the doctors looked at the past, but they were thinking in their hearts: The dialectical whip of the Zhihuan Taoist Master penetrated into it, and the application of medicine was also deep and transparent, what else could be added? They freely thought back and forth about silkworm arrow soup and other medicines in their hearts, but they felt that there was no taste to reduce, nothing to increase, if they were replaced by other medicines, and they lost the wonder of lightness, and for a while they only felt that they could only use "just right" to say.

Although everyone's eyes were on Shen Qingyi, there was no expectation in their hearts, and some of them were even anxious and even wanted to come out and hurry up to apply the medicine, but they were afraid of etiquette and Shen Qingyi's identity, and forcibly waited for Shen Qingyi to speak, but they were looking forward to her leaving after a few words.

Shen Qingyi's expression was indifferent, he didn't seem to see the impatience of several doctors, his clear gaze swept over everyone, like a cold spring soaking people's hearts, making people's hearts feel cold, and secretly said: What a cold momentum. The doctor who was anxious for a while also felt impatient and calmed down.

Shen Qingyi's voice was also as clear as a cold spring, "The dialectical argument of the Taoist Master, Yu has no objection, and I don't say much about it." However, there are some different views on the source of cholera. ”

All the doctors were surprised, the cause of this disease was very clear, what else could there be to talk about?

The pharmacists of the Daomen, including Zhihuan, all showed a look of expectation: What is the unique view of Zhiyuan Senior Sister (Uncle Shi)?

Shen Qingyi said: "Since the two Jin Dynasty, doctors have discussed the epidemic, and they all believe that it is caused by the evil of feeling the current qi, because of the discord in the year, the lack of warmth, and the perverse temperament. Yu thought that the beginning of the plague was not caused by the anger of the year, but the feeling of a strange qi between heaven and earth, which Yu called 'boiled qi', that is, "Zhou Li Disease Doctor" said that 'there are boils at all times'. Its non-wind, non-cold, non-summer, non-humid, invisible, non-elephant, odorless, strong and weak every year, light and heavy in various places, and prosperous and declining in the four seasons, so there are epidemics in spring, summer, autumn and winter. However, the 'boiled qi' is the general source of the epidemic, which originates from the 'nothing', and becomes the disease again. ”

The doctors were confused, and Zhihuan asked, "What does 'have'?" ”

Shen Qingyi said: "For example, the yellow swelling disease is caused by the insects, and the insects are born because of the filth, which is from 'nothing' to 'have'. ”

The doctors were dumbfounded.

Yu Bingzhi frowned and retorted: "Zhiyuan Daoist is saying that cholera is because there are worms in the patient's body?" ”

The doctors felt a sense of absurdity, if it weren't for Shen Qingyi's identity, I am afraid that someone would blurt out "ridiculous", despite this, all the doctors showed disapproval on their faces, only the pharmacist of the Daomen was very patient, and Shen Qingyi's expression in the Shixingge dialectic, it was by no means a frivolous character.

Shen Qingyi said: "To be precise, it is cholera worms that attach to the contaminated diet, enter the mouth and enter the large intestine, causing violent diarrhea and then vomiting. The vomit of the plague carries cholera worms, which pollute the water source, and are ingested by people, and if the water is not boiled and boiled or drunk, the worms are likely to still survive, so they are easy to contaminate. ”

"This ...... If there is a worm, will it not be visible? A doctor blurted out.

Shen Qingyi replied lightly: "The insects are thin, and they are not visible to the naked eye. The rest is called microscopic insects. such as lungworm, and tuberculosis; dung insects, and leprosy; The white worm is attached to the fish and beef infected with insect plague, and those who eat it before it is cooked will parasitize it in the body - this is all contained in the "Treatise on the Origin and Syndrome of Diseases", and you should have seen it. ”

"Treatise on the Origin and Syndrome of Diseases" was compiled by the Imperial Physician Department during the Gaozu period, and the Taiyi Ling Chao Yuanfang, who was in charge of the editor-in-chief, was second only to Dao Xuanzi in the reputation of the Tang Dynasty doctors. Shen Qingyi is talking about the "Nine Worm Disease Symptoms" chapter in this book, and the doctors here have naturally read it, if you want to question Shen Qingyi's statement about "microworms", you must first refute Chao's "Nine Worm Disease Symptoms".

Although it cannot be refuted, the doctors still do not believe that cholera is caused by worms.

Hu Rulin coughed and said: "The insects that cannot be seen by the human eye are of course stored in zài, but how can the Yuan Taoist master conclude that cholera originated here, cough, microscopic worms?" He felt that the name Shen Qingyi was still very good, so he simply used it.

Shen Qingyi naturally has a basis, she said: "I have read the "Cholera Epidemic Case" by the Assassin Shifuli, and I found several clues from it. The epidemic in Yangzhou started at the birthday banquet of Ma Tianlu, a wealthy businessman in Jishanfang, who became ill due to the contamination of the well in Defu Lane. However, the guests who attended the birthday banquet in the house were also infected with the disease, and the house had its own well, and the water was not the well of Defu Lane. Could it be that the well in the horse house was also polluted?

"The well in Defu Lane was polluted, and there were infected people who appeared near this well, because they were thirsty, and when they wrung up the bucket to draw water, they vomited, and the plague insects entered the water with the vomit. This plague is Ma Tianlu's Kunlun slave, who returned from the South China Sea with Ma Tianlu in December last year, and the corner gate of the servant's courtyard where he lived is the well of Defu Lane. Because he was a Kunlun slave, the steward only casually found a doctor for him, and he died of diarrhea in less than two days, and was diagnosed as 'typhoid fever and diarrhea'. Similarly, two sailors of Ma Tianlu's merchant ship died of 'typhoid fever and diarrhea', one lived in Houtu Lane, Baodaifang, and the other lived in Chunhe Lane, Changyifang. These are the two places where cholera first broke out, except for Defu Lane. -- This is a detailed investigation by the Assassin's Palace, and Song Envoy Jun felt that it was useless to cure the epidemic, so he did not announce it to you. ”

Yangzhou Assassin Song Fangduo, doing things very meticulously and thoroughly, Chang Tao has heard of it, and being able to find out all kinds of details after the plague occurs, is what this Song envoy will do.

Shen Qingyi said in a clear voice: "There are detailed medical records of these three people in the epidemic case, and it can be determined that they died of cholera. These three have one thing in common, they all returned from the South Seas with Ma Tianlu's merchant ship Dalu. This should not be a coincidence, there must be a reason. Therefore, ninety percent can show that the source of the cholera epidemic in Yangzhou did not originate locally, but was brought back by sailors from overseas. ”

This negates the Yangzhou fever evidence that cholera originated from the aquatic smell and poisonous gas in the city.

Yu Bingzhi asked in a daze: "How can it be determined that it is overseas?" "It could also be a city in the lower reaches of the Yangtze River.

"Because there have been no outbreaks of severe cholera in other states in the southeast." Shen Qingyi said, "If it is a merchant ship carrying the epidemic overseas, there should also be cholera in other coastal states, but it has not caused a major epidemic." But if somewhere downstream is the source of the epidemic, it is impossible to be so calm. "It's already locked down like Yangzhou.

All the doctors were a little dumbfounded, listening to her like this, the clues were clear, the organization was clear, the reasoning was rigorous and there were no loopholes, and they couldn't say "wrong".

Zhihuan raised his hand and stroked his beard and said, "I see." I also wondered before, when the weather in the first month of the New Year is still cold, it is said that when it is not the summer humidity and transpiration, and the damp and turbid air is flourishing, how can this fever and cholera be prevalent? If, as the junior sister said, the epidemic came from overseas, then it makes sense. ”

He already believed what Shen Qingyi said.

Chang Tao pulled off his beard, raised his eyebrows and said, "Zhiyuan Daoist's analysis is credible. However, even if the source of the epidemic came from overseas, it cannot be confirmed that it originated in ...... That microscopic worm. ”

"This brings us back to the cause of the infection of the guests in the house: if it is not caused by polluted water, it is caused by contaminated food. It is like a white worm, parasitic in the body of fish and cattle, and people eat their flesh and become infected. ”

Zhihuan's thinking was quick and reacted quickly, and he was immediately surprised: "Senior sister is suspicious of the seafood brought back by the sea boat?" ”

Yangzhou people like to eat seafood, with Ma Tianlu such a rich maritime businessman, it is impossible not to carry a large number of sea fish, shrimp, scallops and the like. And Ma Tianlu made a birthday banquet for his mother, and it was impossible for seafood not to appear on the banquet.

Shen Qingyi said: "The birthday banquet in the horse house is based on sea shrimp scallops as the main dish, including raw shrimp belly. But not all of them are parasitic. I asked the attendant to take the feces of the plague, put it in the water of the observation tank, and put two more river shrimps, and the river shrimp are still alive after a day. I was tested with a cholera insect tester and it was shown to carry cholera microscopic worms. ”

"Insect testers?"

The pharmacists of the Daomen were all interested, and Zhihe said, "Senior Sister Zhihuan has a new potion again?" ”

Shen Qingyi shouted: "Songyin." ”

Songyin stepped forward, and there were four transparent glassware on the large tray held in both hands, which were marked with ink "A, B, C, D", among which there were two wide-mouthed cups, cup A was a shrimp in the clear water, and cup B was also a shrimp in clear water, but the water was slightly purple, and the other two were thin mouth long-necked round belly bottles, which were all yellow and turbid liquid, and overflowed with a faint sour smell, and the bottle of yellow water marked "Ding" also revealed two points of purple.

Everyone stared curiously.

Shen Qingyi said: "These four cups and bottles all use cholera insecticides. Cup A and cup B are full of water, and the river shrimp in cup A do not carry the disease, and the water color remains unchanged after the medication; In a cup of shrimp, the agent reacts with the pests and pests, revealing a purple color. The C bottle is diluted with the feces of normal people, and the feces of the epidemic are diluted in the D bottle, all with insect detection agents, and the color of the C bottle remains unchanged, while the D bottle reacts and reveals purple. ”

Zhihuan and other pharmacists have seen Shen Qingyi's method of using medicine to make real yàn many times in the medicine hall, and they don't think it's unusual, but this kind of plague insect is the first time they have seen it, and they are all excited, and Zhihe said: "The plague is also caused by microscopic insects?" Has my sister developed a pesticide to detect plague? ”

Shen Qingyi said: "It's already there, but I haven't had time to verify it yet." ”

"Is there a leprosy test?"

"And pox?"

The pharmacists of the Daomen were in high spirits.

Shen Qingyi was speechless, "You guys are my three heads and six arms?" This cholera insect detector is still relatively rough and needs to be further improved...... "As he spoke, he gave the prescription of the agent and asked everyone to refer to it together.

The three Taoist attendants who made the notes brushed down their pens and wrote down everyone's discussions.

The other doctors looked at each other and thought it was incredible.

Yu Bangmao said bluntly: "That river shrimp really carries epidemic poison? "Skepticism.

Shen Qingyi said: "If you want to confirm this, it is not difficult. If a prisoner voluntarily tests the epidemic and eats it with raw shrimp, it can be proven. ”

The doctors muttered in their hearts, which prisoner is willing to test the epidemic with his own body!

Chang Tao thought in his heart: Under the heavy reward, there must be brave men, if the sentence is commuted as a reward, there may not be no one to fight for their lives, not to mention that if the silkworm arrow soup is effective, it is not a fight, but just suffering. With this thought in his heart, he decided to discuss it with this Supreme Yuan Dao Master after the meeting.

After Songyin went down with the tray, the doctors were still discussing with each other, and they were still skeptical about Shen Qingyi's "theory of microworm epidemics" and "insect detectors".

Chang Tao and Hu Rulin glanced at each other, and thought in their hearts that if what Daoist Zhiyuan said was true, then this "insect detector" would be too useful for the quarantine and examination of cholera.

Shen Qingyi finally spoke: "The medical Tao talks about 'being' and 'nothing', and 'nothing' must be seen with the eyes of heaven, not with the naked eye. Even if there is, it is not visible to the human eye. Therefore, the medical Tao talks about 'internal evidence'. Just like a martial arts master, you can look inward through the guò Yuan Shen and see the meridians that belong to 'nothing'. Why is it said that viruses are insects, that is, they do not exist? It's just not what our eyes can see. ”

……

The next day, the imperial decree arrived in Yangzhou.

Hu Rulin and Chang Tao reached the will of the imperial court after reading the edict.

The doctors in Yangzhou knew that this new cholera was transmitted from Tianzhu, and remembered yesterday's meeting, and couldn't help but admire Shen Qingyi's reasoning and insight ability, and also, they were a little less skeptical and a little more convinced of the "microscopic insect epidemic theory" she proposed.

Hu Rulin and Chang Tao had already jointly approached Shen Qingyi and discussed with her about the prisoners' testing of the epidemic.

If it is confirmed that the river shrimp carries the disease and infects people, even if it cannot be proved that the epidemic virus is a "microworm", the agent that can detect the cholera epidemic virus is real - this can be very useful for the prevention of cholera in the states, especially in the coastal states and commercial ports!

“…… If this happens, you will be the greatest hero. Shen Lun said to his daughter excitedly.

(l~1`x*>+``+