On the same day after admission, the patient had another headache, especially in the bilateral frontal and temporal areas. Eventually, the pain was too intense and I vomited.

It can hurt so much that the patient vomits, indicating that the pain level is very high.

The patient's temperature at admission was 38.4 degrees, indicating the presence of fever.

After admission, the hospital gave her intravenous antibiotic drops, which is also the basic package for most patients after admission. Especially for patients in gastrointestinal surgery, intravenous infusion of glucose or sodium chloride, plus corresponding antibiotics, has almost become a universal formula.

Many people blame small clinics for the misuse of antibiotics, but in fact, the butts of large and small hospitals are not necessarily clean.

It's just that large hospitals have stricter control over the dosage of antibiotics.

Small clinics often choose to increase the dose in order to maximize the treatment effect.

After taking antibiotics, the female patient's body temperature had returned to normal on the third day of admission.

I have to say that the efficacy of antibiotics is really good.

That's why doctors and patients alike love it.

On the third day of admission, although the body temperature dropped and the headache improved to a certain extent, the patient's condition did not decrease.

Because on the third day, she still appeared to be unconscious for a short time, and her whole body was convulsed.

Each episode, the symptoms do not last long, lasting only about seven or eight seconds before relieving on their own.

Seeing this, Zhou Can felt that the patient's condition was a little confusing, and it was difficult for people to sort it out.

When symptoms alone can't pinpoint the cause, doctors can often infer the cause based on the results of the tests.

The patient currently has a temperature of 36.9 degrees, a pulse of 74 beats per minute, a breath of 29 breaths per minute, and a blood pressure of 84 mmHg.

All four signs were normal.

In other words, as long as the patient does not get sick, his body is almost the same as that of a normal person.

It's no wonder she's going to see a neurologist.

In this case, the first suspicion must be a neurological disorder.

Based on her symptoms, it is likely that something is wrong with the central nervous system. For example, brain lesions, or epilepsy, etc.

The patient's nutritional status is acceptable, the skin and mucous membranes are not yellow, the face is not pale, and there are no bleeding spots or spider angiomatas on the body. Her thyroid gland is small, her thoracic cage is not deformed, her breath sounds are clear, and no dry or wet rales are heard on auscultation.

The heart rate was 74 beats per minute, the heart rhythm was regular, and there was no murmur in each valve area on auscultation.

The abdomen is soft when pressed, there is no tenderness or rebound tenderness, and there is no feeling of the mass. The spine and limbs are normal, and there is no deformity.

This series of physical examinations proved that the patient's body was basically normal, and no obvious lesions were found throughout the body.

Again, the diagnosis points to the central nervous system.

The brain is the focus of suspicion.

The first doctor, Director Yin Hua, conducted a preliminary examination of the patient's brain.

The patient is conscious, clear-minded, speaks normally, and has normal memory, calculation, comprehension, and judgment.

The patient's vision and visual field are also normal.

There are no problems other than double vision, headaches, and twitching of the limbs at onset.

Director Yin also focused on examining the optic nerve disc of the patient's fundus, the left eye moved flexibly in all directions, and the right eye had no abnormalities in upward vision and abduction, which was obviously limited and had double vision.

During the test, diplopia is especially pronounced in the median of the eye and the right eye.

Zhou Can couldn't help but think of the high paraplegic child again. After the little boy fell and injured himself, there was also a clear difference between the left and right sides of his body.

Overcoming this case may be able to draw some inspiration from it.

Although the two have completely different conditions, if they have the same neurological disease, they can definitely learn from each other.

Zhou Can decided to go to the ward to see the female patient in person.

Whether it is the description of the condition in the medical record, the record of the course of the disease, and the various examination reports, it is not as direct as the doctor to see the patient with his own eyes.

Visiting has been a basic diagnostic skill for doctors since ancient times.

It is also the first diagnostic technique among the four major diagnostic surgeries of traditional Chinese medicine.

In the diagnosis of traditional Chinese medicine, it is not the core diagnostic skill, but it is the first diagnostic method after receiving the diagnosis.

It's like a day's plan in the morning, and a year's plan in the spring.

It is the beginning of a doctor's diagnosis.

It has a great influence on the subsequent diagnosis and judgment of the disease.

The core diagnostic technique of Chinese medicine is pulse cutting.

The development of Western medicine is thousands of years later than that of traditional Chinese medicine, and it can be regarded as a rising star. Its diagnostic habits are somewhat plagiarized from traditional Chinese medicine.

Visiting is still the first item of Western medicine, alongside physical examination.

As for the cutting of the pulse, Western medicine does not recognize the theory of muscles and pulses, and Western medicine feels that pulse science belongs to metaphysics and is very illusory. It is also possible to feel that pulse science is too complicated, so Western medicine has developed a set of diagnostic methods to replace pulse cutting.

That is ultrasonography, biochemical experiments, CT scans, MRIs, endoscopies, and so on.

It doesn't matter if it's a black cat or a white cat, it's a good cat if it can catch mice.

The pulse cutting of traditional Chinese medicine is very powerful, and a powerful Chinese medicine doctor only needs to touch the patient's inch, which is equivalent to the patient entering the hospital for a full-body examination. Moreover, it is possible that diseases that cannot be detected by advanced instruments and equipment can be found by traditional Chinese medicine through pulse cutting.

However, it is very difficult to learn, requires a high level of talent, and many years of study to achieve something.

The training cycle of talents is too long.

In addition, now that Chinese medicine is in decline, there are not many old Chinese medicine practitioners who really know how to cut the pulse, and it is even more difficult to preach and teach.

It is easier to spread the techniques of Western medicine, and students with a brighter mind can study medicine.

At this point, medical students who are suitable for studying medicine can be screened directly through the college entrance examination.

Therefore, it is now the world of Western medicine, and there are many talents.

The inspection and operation of various instruments is really not, and it is possible to operate according to the instructions.

According to the information in the medical history, Zhou Can found the inpatient ward where the patient was located.

Kaminai 37 beds.

A delicate-faced female patient was lying on a hospital bed, accompanied by a middle-aged and elderly woman in her sixties. It should be the patient's mother.

Even if a woman is married, the family members who accompany her when she falls ill are either her parents, her husband or children.

In short, it is rare for a father-in-law or mother-in-law to go to the hospital to take care of their daughter-in-law.

"Is it Ms. Zhao Caixiu?"

"Yes, I am."

When she saw the doctor coming, she quickly sat up.

"It's okay, it's okay, I'm just here to find out about your condition, you just lie down."

Zhou Can hurriedly reassured her.

Patients with such neurological disorders should be kept in a relaxed and natural state as much as possible. Otherwise, it is easy to get sick.

"I'll check your eyes."

"Okay."

She gladly accepted.

The vast majority of patients are happy to have a doctor come and examine them and take care of their condition.

Zhou Can stared at the patient's eyes, and his right eye obviously had slow rotation and difficulty in turning up.

"Look at my fingers and don't move your head."

After Zhou Can finished speaking to the patient, he stretched out a finger and moved it up and down, left and right in front of the patient's eyes.

The patient's right eye is more sluggish when it turns.

Zhou Can first blindfolded the patient's left eye, and then stretched out two fingers.

"How many fingers do you see?"

"It seems to be four!"

Yes, the patient's right eye did have diplopia.

He blindfolded the patient's right eye and asked, "How many fingers?" ”

"Two!"

The patient's left eye has normal vision.

Zhou Can's examination of her was not over, these examinations had already been done by other doctors, he just wanted to reconfirm the results and see the patient's eye performance.

"Did it hurt when your right eye was rolling?"

"It seems to hurt a little. When the right eye is turned, it seems to pull a certain nerve, and the head will hurt a little. ”

The patient replied truthfully.

"Okay. I touch your face and you relax. ”

Zhou Can touched the left and right sides of the patient's face, especially the cheeks and cheekbones, and there was no obvious abnormality.

"Do you usually eat chewing gum?"

"Occasionally, very little." The patient was a little embarrassed.

"Here, I'll give you a piece of gum. You can just open your eyes normally as you chew, and I'll do a further examination of both of your eyes. ”

Zhou Can took out a piece of Green Arrow gum from his pocket and handed it to the patient.

This unique way of examination immediately attracted other patients and family members in the ward. Everyone watched with curiosity.

After receiving it, the patient opens the package of aluminum foil, puts it in the mouth and begins chewing.

Although she didn't know what Zhou Can wanted to check, she still felt that this young doctor's examination method was very unique and novel.

Zhou Can stared into the patient's eyes and found that her corneal reflex was abnormally dull.

The chew is very powerful.

"Close your eyes."

She closed her eyes obediently, and Zhou Can tried to roll her eyelids, feeling that she had a lot of power when she closed her eyes.

I stared at her face carefully, the corners of my mouth were not crooked, the nasolabial folds were normal in depth, and there were shallow fluff on my lips.

Women do not have beards, but they do have fluff, which is normal.

Some women will experience an increase in male hormones for a certain period of time, and the down whiskers on the lips will become thicker and longer, like a long beard. Often many women feel panicked, but there is no need to worry, it is just a normal physiological phenomenon.

Especially in older women, postmenopausal is especially noticeable.

Just be calm.

If you really feel that it will affect your appearance and are worried about being discriminated against or laughed at by others, you can use hair removal cream to remove the fluff on your lips.

In addition, when a male compatriot is looking for a female partner, he wants to know whether the other party's personality is strong, and there is a small trick for reference.

As long as you secretly observe the other person's lip fluff, if it is thick and long, such a girl is likely to have a strong personality. After getting married, you should be prepared to be strict with your wife.

Of course, marrying such a girl is actually very happy.

This kind of girl is often very ambitious, loves and hates, and has a big temper, but she is very good to her husband and children.

If you can't get along with the elderly in the family, don't live together.

"Alright, please spit out the gum and try to drink the saliva."

Zhou Can's testing of her continues.

When the patient spits out the gum, wrap it in a piece of paper and signal the family member to throw it in the trash. Judging from her performance, she is still quite literate.

She took a sip from her glass.

Zhou Can noticed that she seemed to have a little difficulty swallowing. This phenomenon had actually been discovered when she was chewing gum just now.

The gag reflex is evident when swallowing.

But I didn't choke.

"With your tongue sticking out, you can open your mouth a little wider."

Zhou Can said to her again.

Fortunately, the patient's husband is not here, and it is easy to cause misunderstanding among the female patient's husband when doing this kind of examination.

In fact, the doctor is only trying to find out the cause of the patient's disease, and there are no other bad intentions at all.

Through observation, he found that the patient's tongue was naturally centered, and there was no tremor or atrophy of the tongue muscles.

"Okay, that's it."

Zhou Can continued to examine her in other ways.

The patient's limb muscles are normal, muscle tone is normal, and no voluntary movement of body muscles is noted. The ataxia movement was normal, the depth and shallow sensations of the limbs were not abnormal, and the tendon reflexes of the limbs were not hyperactive or reduced.

Bilateral Babinski's sign appears to be positive.

This is a new discovery.

The patient lies supine, the hip and knee joints are straight, the examiner holds the upper part of the ankle with his left hand to fix the calf, and the right hand holds a blunt-tipped metal rod from the outside of the foot from the back to the base of the little toe from back to front, and then turns to the side of the hallux, which is called the bilateral Babinski sign test.

Normal toe flexion to the plantar surface is negative.

The female patient was clearly abnormal and was initially diagnosed positive.

It seems that you still have to contact the patient in person.

If he hadn't come to the ward for an in-depth examination, it would have been impossible for him to find so many details.

If you only look at the test results and medical records, as long as the patient's body does not get sick, everything is normal.

Who would have thought that there are so many anomalies lurking under the seemingly normal performance?

"I'll touch your neck and try to relax and not be nervous."

Zhou Can tried to touch and press the patient's neck, and the skin was smooth and silky.

Only on palpation, there is significant neck resistance.

"Relax, don't tighten your neck, or the results of my examination will be inaccurate."

Zhou Can spoke gently to soothe the patient.

"Okay."

She closed her eyes and tried to relax.

However, neck resistance remains.

Zhou Can tested her on the Kelniggs sign and the Bruluski sign, and the results were both a +.

Not particularly serious.

"Okay, thank you for your cooperation, we will tell you when there is a new diagnostic breakthrough." Zhou Can has gained a lot, although there is no clear direction for the diagnosis of the cause of the patient, but combined with the patient's laboratory tests and various instrument tests, she should be able to diagnose the cause of her disease.

"Are you the patient's mother?"

He asked, looking at the middle-aged and elderly woman who was accompanying her at the bedside.

"Yes! I'm her mom. ”

"If she has a seizure, try to put her on her side, preferably on her left side. It would be safer for her. ”

"Okay, thank you."

The family members nodded, indicating that they remembered.

Family members generally follow the doctor's advice.

There are also some suspicious family members, or family members who think they know a little bit about medicine, who will be skeptical of the doctor's advice.

I can only say that if I don't listen to the doctor, I will suffer in front of me.

Sometimes it's easy to lose a lot.

Zhou Can returned to Director Yin's office and found that Director Yin Hua had returned.

"I thought you kid slipped away! How is it, have you read the information of the female patient? ”

Director Yin asked.

"When am I slipping by?"

Zhou Can couldn't help but roll his eyes. Director Yin looks serious and is an old pedantic character, but after getting acquainted with it, especially after his strength is recognized by the other party, he is quite open when talking.

(End of chapter)