"Except for the liver?" Director Yang asked again.

"Uh...... There should also be gallbladder, because the liver and gallbladder are usually diseased at the same time. Su Minjuan hurriedly added.

"Well, Xiao Su, now you can use the theory of traditional Chinese medicine to explain why hepatobiliary diseases can cause jaundice?" Director Yang nodded, and then asked again.

Su Minjuan secretly complained in her heart, and originally thought about things very simply.

I just want to ask Zhang Jing to share the treatment ideas of this case, so that I can study it well.

As a result, I didn't expect that Zhang Jing and Director Yang took turns to test themselves.

However, after I joined the TCM hospital, I have been working in the pediatric ward, and I don't need to lose the theoretical knowledge of TCM at all.

Fortunately, after all, I have studied in the University of Chinese Medicine for many years, and I still have a little residual memory.

Traditional Chinese medicine is a bit special, as long as you understand some relevant basic knowledge and have a good eloquence, you can often speak the truth.

It's like Huang Biao in the Mingdetang Traditional Chinese Medicine Clinic, who only uses the five elements to restrain each other, going around and around, facing the patients who come to the clinic, which is called bluffing and accuracy.

Actually, that's not all.

Looking at the major health care places, the skillful technicians, the set of rhetoric that day is enough to fool the layman around, and he is regarded as a master of Chinese medicine.

However, Su Minjuan is a sincere person after all.

After thinking about it for a while, I still told the truth that I had almost forgotten it, and I could only try to analyze it according to my own understanding.

Director Yang nodded again, not only did not blame, but looked at her with encouraging eyes.

He wasn't here to deliberately make things difficult for her, or to make her embarrassed. Rather, they believe that only by personally participating in the process of learning Chinese medicine and thinking about it can the knowledge learned be deepened in the mind.

At the same time, Director Yang also hopes that in front of other pediatric doctors, through his own persuasion, everyone can become interested in the treatment of Chinese medicine.

Of course, that's not the most important thing.

Director Yang also wanted to use this to give Zhang Jingli his authority, so as to lay a good foundation for him to show his skills in the hospital in the future.

After Su Minjuan was encouraged, she couldn't help but feel refreshed.

After a moment of contemplation, begin to organize the language and begin to analyze.

"I think it should be caused by dampness and heat and internal depression, which affects the excretion of liver and gallbladder. Because the liver and gallbladder itself are in charge of dredging the qi of the whole body, now the visible evil of dampness and heat affects the excretion of the liver and gallbladder. ”

"As a result, the liver and gallbladder are not drained smoothly, so that the bile does not follow the usual path. It even reverses the flow of blood, which overflows the skin, which is why the body and eyes are yellowed. ”

After listening, Director Yang nodded approvingly, obviously satisfied with this answer.

Then he smiled and said, "Dr. Su's analysis is very good, and this can be regarded as the 'bile theory' recognized by most people." However, as for the explanation of damp heat and yellowing, there is actually a 'spleen yellow theory'. Because among the five colors, yellow corresponds to the spleen. ”

"We can also often see that malnourished children have yellow faces and thin muscles, and their hair is also yellow. This is because the spleen and stomach are weak, and the true color of the spleen is exposed. ”

In the same way, jaundice is the same, because the heat cannot be out, and the dampness cannot be discharged. When dampness and heat accumulate in the body, the spleen is forced to be exposed and the body is yellowed. ”

Speaking of this, he suddenly changed his words again: "Of course, I think this kind of spleen theory is more far-fetched. Dr. Zhang, what do you think? ”

Zhang Jing pondered for a while, but said slowly: "I don't think so. ”

"Oh?"

This was obviously unexpected by Director Yang, who looked at him in surprise and waited for the following.

Zhang Jing continued: "In the "Treatise on Typhoid Fever", it is said that dampness and heat are yellow, one is in the Yangming disease chapter, and the other is in the Taiyin disease chapter. That is to say, never leaving the spleen and stomach, never leaving Middle-earth. ”

"Yang Huang is damp and hot yellowing, and the external symptoms generally have 6 points. My personal understanding of the pathogenesis of these symptoms is as follows. ”

"The first one is that urination is not good, I think it is because of the combination of dampness and heat, and the dampness evil is restrained by the heat evil and cannot be discharged."

"The second is that the head sweats, because the dampness and heat are intertwined, and the heat evil is controlled by the dampness evil and cannot be crossed, and the head is the meeting of the sun and the damp evil cannot be contained, so the sweat is up to the neck and returns, which is manifested as the sweat of the head."

"The third one is as yellow as an orange, which I think is due to the heat and humidity in the body. Because heat is yang evil, the yellowing color is bright like orange, which corresponds to the cold and damp yellowing, that is, the dark color of yin and yellow. ”

"The fourth is a full stomach, my understanding is that damp heat blocks the qi, so it will lead to a full stomach, usually poor appetite, and constipation in severe cases."

"Fifth, thirsty drinking slurry. I think there are two main reasons, one is that the dampness and heat are intertwined, and the other is caused by the heat and the incarnation, of which the first reason is the main one. ”

"The last one is the frustration in my heart, I think it is caused by the combination of dampness and heat, and the depression and heat disturb the heart."

Hearing this, Director Yang suddenly had a flash of inspiration in his mind, and then said thoughtfully: "So, Doctor Zhang, did you use the gardenia soy soup after grasping the main evidence of annoyance in your heart?" ”

As soon as the words fell, he shook his head again, and said to himself: "No, no. Children are too young to describe how they feel, and I think you didn't seem to ask. ”

Zhang Jing smiled slightly: "That's right, I really didn't ask." Director Yang, please don't worry, listen to me and analyze it slowly. ”

Zhang Jing took a sip of water and continued: "In "Treatise on Typhoid Fever", Yanghuang, that is, the treatment of damp heat and yellowing, is to clear away heat, promote dampness and reduce yellowing, including three formulas: Yinchen Artemisia Soup, Gardenia Cypress Peel Soup, and Ephedra Lianyi Red Bean Soup. ”

Among them, Yinchenhao soup is composed of three medicines, Yinchenhao, gardenia and rhubarb, and has always been recognized by doctors as the first party for the treatment of jaundice. Of course, I don't agree with this very easy preconceived notion of it. ”

Zhang Jing paused for a moment and continued: "Analyzing its composition of the prescription, the effect is to clear heat and promote dampness, so it is used for jaundice where dampness and heat are flourishing. ”

The gardenia cypress peel soup is based on gardenia Wu cork, plus a taste of boiled licorice, which is mainly used to clear away heat and has the function of reducing dampness. Therefore, it is suitable for damp heat jaundice, which is more hot than damp. ”

"The last ephedra and red bean soup, Chapter 262 of "Treatise on Typhoid Fever": Typhoid fever and stasis are inside, the body will be yellow, and ephedra and red bean soup are the main ones."

"This party was originally designed for both yang and yellow. However, nowadays it is also mostly used for urticaria, eczema, and various itchy skin diseases. This is off topic and we will leave it at that. ”

"Now let's talk about why I think gardenia soy soup can treat jaundice in 616 children."

The point finally came, and everyone immediately pricked up their ears.

"First of all, let me talk about the results of the four diagnoses obtained through looking, hearing and asking." "The child's sclera is yellow, the body is yellow like orange, the mouth does not want to drink, the appetite is poor, the stool is normal, the urine is yellow, the tongue is red, the lichen is thin and greasy and slightly yellow, the pulse is slippery, and the left guan is slightly counted."

"According to the traditional method of visceral syndrome differentiation, this case can first be diagnosed as the yang yellow syndrome of hepatobiliary disease, and at first glance, if the pulse is misdiagnosed as a slippery number of pulses, it is easy to think of Yinchen Artemisia soup that treats both dampness and heat."