"May I ask Mr. Li, according to what you mean, can I understand that Jing Fang can not only adjust the dosage and decoction method according to the actual clinical situation, but also increase or decrease the taste of the medicine, and even replace some of the medicines?" Zhang Jing thought about it for a while and decided to ask for clarification.

Li Yu bowed slightly, and then asked: "Come and see, later generations respect "Treatise on Typhoid Fever" as the ancestor of Fang Shu, how to understand the word 'Fang'?" ”

"The prescription can be understood as a classic prescription, the prescription contained in the "Treatise on Typhoid Fever", the medicine is small and refined, superb, resurrecting the dead, and the effect is like a drum, so it is regarded as a prescription by later generations."

"This is just a general understanding, but I think this method should be more of a method, that is, the law of dialectical argumentation." Li Yu smiled slightly.

Zhang Jing thought about it carefully, felt quite reasonable, and couldn't help but praise again in his heart, he really deserved to be the academic inheritor of Liu Lao, and his insights were profound and unique.

"Teacher Li, in this way, Yi Yin's "Soup Sutra" should be the ancestor of the prescription book that people understand, and it can also be said to be the source of prescriptions, right?"

"That's right! The greatest contribution of the medical saint Zhang Zhongjing is that he refers to the contents recorded in ancient medical books such as "Suwen", "Lingshu", "Difficult Scripture", "Yin and Yang Treatise", "Placental Medicine Record" and "Pingmai Differentiation", and discusses the content of Yiyin Tangye as more than ten volumes, creating the soul of traditional Chinese medicine such as syndrome differentiation and treatment. ”

"Uh-huh!" Zhang Jing nodded again and again, indicating complete agreement.

Li Yu suddenly changed his words and continued to ask: "Tell me more, what is the core of the dialectic of the Six Classics?" ”

Zhang Jing pondered for a moment and replied solemnly: "The dialectic of the Six Classics is the system of three yin and three yang, and the core of the three yin and three yang should be yin and yang. ”

Li Yu bowed slightly: "That's right, Zhang Jingyue said that although the medical Tao is complicated, those who can be covered up in one word are just yin and yang." Therefore, there is yin and yang, there is yin and yang in the pulse, and there is yin and yang in medicine. In short, everything is inseparable from yin and yang. Regarding the distinction between yin and yang, you might as well give two of the most obvious examples. ”

"Women are yin, men are yang. The night is yin and the day is yang. Zhang Jing immediately replied.

"Well, that's good. Let's take day and night as an example, how to divide three yin and three yang on the basis of yin and yang? ”

Zhang Jing had never thought about "......" before, and for a while, he couldn't answer at all.

"It's okay, let's talk about it first, which of the three yangs has the most yang, which one is second, and which one is the least?"

"The sun is three yangs, the most yang, the less yang is one yang, the least yang, the yang is two yangs, and the amount of yang is in the middle."

"What about the three yin?"

"Taiyin is three yin, yin is the most vigorous, less yin is two yin, second, yin is the end of yin, and yin is yang at the end, so it is one yin."

"Very good, very good," Li Yu nodded again and again, suddenly turned his head, and said to Li Simeng, who was drooping his head and carelessly, "Learn more." ”

Li Simeng pursed her mouth, and she didn't dare to argue, but she just glared at Zhang Jing secretly.

"Knock knock!" The knock on the door rang again.

Zhang Jing was eager to try and was ready to receive another treatment.

Unexpectedly, Li Yu smiled faintly.

"The first patient is a bit delayed, and the next patient should come first, otherwise the patient who made the appointment will have to wait in a hurry. You don't have enough experience in the four diagnoses, especially the pulse diagnosis, which is the housekeeping skill of traditional Chinese medicine, and it is also very hard-working. When you go back to rest, let Simeng take you to the pulse diagnosis study room to practice well. ”

"Pulse study room?" Zhang Jing was a little confused.

"That's right, didn't you use the pulse teaching examination instrument when you took the "Diagnostics of Traditional Chinese Medicine" exam in your university?"

"Oh, yes, yes."

Zhang Jing remembered that this is a machine that can simulate various pulse waveforms and then ask candidates to answer.

He still remembers that he only got two of the five questions right. However, with this correct rate, it is already one of the best in the class.

After all, the pulse is subtle, its body is difficult to argue, it is easy to understand in the heart, but it is difficult to understand under the fingers.

It's really too difficult for a medical student who has no clinical experience at all!

"Although the machine simulation does not fully reflect the real pulse of the human body, the overall feeling is still very different. After passing the machine exam first, and then combining it with the actual clinical pulse diagnosis, you can achieve twice the result with half the effort. ”

"Moreover, for TCM doctors who are new to clinical practice, they only need to grasp the overall situation and grasp the main pulse. Then, according to the tongue diagnosis, questioning, etc., the four diagnoses are combined, and the syndrome differentiation and treatment are carefully discussed, and there will be no major mistakes. ”

As he spoke, the second patient sat across from the table.

This is a young woman, very different from the previous male patient, who was wearing only a shirt. It's not winter yet, and I'm already wearing a thick down jacket.

Even so, he shivered from time to time and sniffed from time to time.

Zhang Jing knew very well in his heart that this was a typical manifestation of cold.

Li Yu handed the medical record book to Zhang Jing.

Zhang Jing took a look, and the body temperature column said 39 degrees 8.

I can't help but feel a chill in my heart: such a high body temperature is so cold, and there is not a drop of sweat on my forehead, which is really rare.

Li Yu still didn't let the female patient describe the condition, and directly felt the pulse first.

After a long while, he slowly said, "Pulse floating." ”

Next, the tongue diagnosis begins.

While observing carefully, there are words in his mouth: "The tongue is light, and the moss is thin and white." ”

After finishing speaking, he turned his head and asked Zhang Jing: "Judging from the current situation, according to your preliminary diagnosis, what is the most likely disease?" ”

Zhang Jing is full of confidence: "According to the first article of "Treatise on Typhoid Fever": the sun is sick, the pulse is floating, and the head is strong and cold. Patients with swollen pulses and significant chills should be sun sickness. ”

"What kind of certificate does it belong to?" Li Yu asked.

“…… Should be a solar typhoid syndrome. Zhang Jing thought for a moment and replied.

Li Yu still did not comment, and then asked Li Simeng: "What do you think?" ”

"I ...... I think it's a sun stroke certificate. Li Simeng actually didn't think much about it at all, just to raise the bar with Zhang Jing.

"Simeng, let's talk about your analysis first." Li Yu frowned slightly.

"The patient is female with a pale tongue...... and obvious fear of cold, indicating that the constitution is weak...... If you are weak, you are prone to qi deficiency, which is a sign of sun surface deficiency, that is, a sun stroke card, and it is advisable to have Guizhi soup. Li Simeng was a little nervous at first due to lack of preparation, but the more she talked about it, the more confident she became.

"Dr. Zhang, what is the basis for your diagnosis?" Li Yu turned around and asked Zhang Jing again.

"The presence and absence of sweat and the tendency of fever can be used as key points to distinguish solar typhoid fever from solar stroke. The patient had obvious chills, no sweating after a lot of clothing, and his body temperature was as high as nearly 40 degrees. Therefore, the diagnosis of solar typhoid syndrome can be preliminarily made, but it needs to be combined with the examination before it can be finalized. ”

"Very good, if you ask for a consultation, what is the first thing you want to ask?"

"Ask about sweating after illness."

"Why?"

"Solar stroke and solar typhoid fever are both caused by wind chill and disorders of camp and guard. The basic symptoms were fever, headache, chills, and pulse floating. However, the basic pathogenesis of stroke syndrome is that Weiyang is not solid, and Yingyin is lost, which is characterized by sweating and slow pulse, while the basic pathogenesis of typhoid syndrome is that Weiyang is suppressed, and Yingyin is depressed and stagnant, characterized by no sweating and pulse fluctuation. Therefore, the presence or absence of sweat can be used as the core point of distinguishing between solar typhoid fever and solar stroke. ”

"Teacher, I have an objection." Li Simeng suddenly interjected.

"If you have any doubts, then read "Treatise on Typhoid Fever" carefully." Li Yu glanced at her and said angrily.

Immediately afterwards, the conversation changed: "Doctor Zhang, I'll come to consult, and you continue to record the medical records." When there is a high fever, the body must be very uncomfortable, prescribe medicine as soon as possible, and do not make the patient wait for a long time. ”

Through medical history, it was learned that the female patient was from a mining area, and unfortunately contracted the flu a few days ago, and the high fever has not gone away since then.

First take the cold medicine of Western medicine against the flu, but it has no effect.

Then I took Yinqiaosan, Sangju drink granules and other Chinese patent medicines, which were not only ineffective, but the symptoms of headache and joint pain all over the body were significantly aggravated.

Zhang Jing carefully recorded in the medical record book: the patient, female, 28 years old, complained of fever and chills, head and body pain for 3 days. Due to the evil epidemic poison when the external sense, taking Western medicine is ineffective, and after retaking the Chinese patent medicine of Xinliang and detoxification, the symptoms are aggravated. The current body temperature is 39 degrees 8, nasal congestion, a little runny nose, no sweating, no sleep, two can be. Check: The tongue is light, the moss is thin and white, and the pulse floats. Diagnosis: solar typhoid syndrome.

"Well, let's prescribe it." Li Yu nodded after seeing it and said to Zhang Jing.