"Classmate Ji Xiuwen, don't think about it, go and help someone get the medicine first, and I'll talk to you about digestive diseases after work."

Seeing that Ji Xiuwen was still pondering, Lu Xuan reached out and touched Ji Xiuwen's arm and reminded him loudly.

Only then did Ji Xiuwen react, took the charge slip handed over by Su Kenan, got up and walked towards the Chinese medicine pharmacy.

Seeing that Ji Xiuwen had already walked into the Chinese medicine pharmacy, Liu Zhendong didn't stay in the clinic for long, and got up to leave after saying hello to Lu Xuan.

As soon as Liu Zhendong left, Lu Xuan motioned for Su Kenan to call the number, and at the same time, he picked up the water cup in his hand and prepared to drink saliva.

This time, Lu Xuan deliberately glanced at it, and saw that he was not mistaken, so he raised his head and took a few sips.

Su Kenan, who was on the side, saw Lu Xuan's cautious appearance, blinked his eyes and flashed his eyes, his face flushed with a faint red glow, and whispered: "I put the water cup here, don't worry about taking it wrong, and ......"

"It's okay to take it wrong."

Speaking of which, Su Kenan's voice was already as thin as a mosquito.

Lu Xuan didn't expect that his subconscious movements would be noticed by Su Kenan, so he could only casually find a reason: "I was thinking about something just now, don't think about it." ”

"Oh."

The fair-skinned goose egg face drooped slightly, and the slight redness that had just appeared gradually faded at this moment, and the flickering luster in the porphyrin eyes suddenly dimmed a lot.

She pursed her lips and asked cautiously, "Doctor Lu, is it because I'm too timid that you don't like to talk to me?" ”

Lu Xuan looked at her: "Why do you think so?" ”

"Because ......"

Su Kenan raised her head, a slight mist suddenly appeared in her clear eyes, and there was a hint of confusion in her tone: "Auntie said before that I was too introverted and too timid, which is not good, and I saw Dr. Lu and President Ji Xiuwen going out to eat with a smile before, so I was wondering if it was because of this Dr. Lu that I didn't like to talk to me." ”

The light in the consultation room was cold, hitting Su Kenan's facial features as delicate as snow in early spring, and there was a faint sense of self-blame between his eyebrows.

Su Kenan is a little introverted and doesn't like to talk much, but he is not stupid.

A woman's sense of smell is often very keen, from childhood to adulthood, she has no friends, all the time, even in college, this is the same, in the dormitory, she is the maverick girl, rarely has anything to say to other people, in the evening, the most she hears is to listen to other people in the dormitory talking about some interesting anecdotes in school.

Sometimes, she also wants to join it, but after hesitation, she chooses to back down.

Over time, the other people in the dormitory naturally chose to distance themselves from her.

And the boys who pursued her, the way they looked at her made her very uncomfortable, not as pure as Dr. Lu, without a trace of desire.

She loved it.

Unlike before, if you don't have it, you don't have those troubles, at most it's a little envy in your heart, and then you return to peace.

If you have it, you don't want to lose it.

"It's no such thing, Ji Xiuwen and I have been classmates for many years, and we haven't gotten together for a long time after graduation, so naturally there are more words, plus you are a girl, I don't know what to say, so naturally there are fewer words."

Lu Xuan took a deep breath: "Don't forget, we are friends now, how can we not want to talk to you because you are more introverted." ”

At the same time, I also have a new understanding of this timid girl.

"We're friends?" When he said this, there was a hint of joy.

"Of course, aren't we friends?" Lu Xuan asked rhetorically.

"Yes." Su Kenan nodded his head heavily.

Lu Xuan stretched out his hand and patted her gentle shoulder, and said seriously: "Since we are friends, don't think about it." ”

"Hmm."

The slightly intimate behavior made Su Kenan's heart bump into a deer.

"Okay, let's call the number, Ji Xiuwen's guy is about to grab the medicine, don't wait for him."

As Lu Xuan was talking, he saw Ji Xiuwen walking out of the Chinese medicine pharmacy.

At this time, Pan Yuqian, a patient who was called, pushed the door in, and said hello to Lu Xuan after sitting down.

Without waiting for Lu Xuan to remind him, he told about some of his own situation, along with some checklists from the hospital.

Patient Pan Yuqian, female, 30 years old.

On the 11th of last month, there was chills and fever for no obvious reason, and the body temperature fluctuated at 37.7~40.8 °C, accompanied by light cough, no phlegm, no vomiting, nausea, no abdominal pain and diarrhea;

No obvious urinary frequency, urgency, dysuria, no obvious arthralgia;

He was treated with anti-infective drugs such as "penicillin and cefazolin" in the hospital, and at the same time used antipyretic analgesics and hormone drugs.

A month ago, he was hospitalized intravenously ineffective with intravenous drops of Fuxingbital and sparfloxacin, and all drugs were stopped for 5 days, showing a flaccid fever type, and the experimental antimalarial treatment was ineffective, and then changed to erythromycin, and the body temperature fluctuated at 36.3~39.3 °C, showing an intermittent fever type;

Since no cause was found, a comprehensive systematic physical examination was done, but no obvious abnormalities were found, and the morphological structure of the heart, lungs (-), and lungs was normal, and there was no abnormality;

The heart rate is fast, the electrocardiogram is "sinus tachycardia", the liver and spleen and superficial lymph nodes are not palpable, and no rash is seen;

Multiple blood count: RBC(3.42~4.19)×10/L, Hb98~120g/L, WBC(3.2~5.8)×10/L,N0.58~0.86, L0.12~0.34, PLT (138~258)×10/L; Multiple ESR 50~85mm/h: C-reactive protein 41mg/L; Blood eosinophil count 40×10/L;

Fertilization reaction, Legionella reaction, anti-autoantibody, blood culture, bone marrow culture, midstream urine, and sputum culture were normal; Bone marrow cytology shows "hyperplastic activity and eosinophilia".

Liver and kidney function, electrolytes were normal: LDH318 U/L: CT of chest and abdomen showed "gallstones" and "mild splenomegaly".

According to the examination of Western medicine, except for gallstones, Pan Yuqian's body is very healthy and there is no problem at all, but she has a fever for no reason.

Lu Xuan also saw this situation for the first time, and he couldn't help frowning slightly for a while, and said to Ji Xiuwen: "Take her temperature." ”

After listening to Pan Yuqian's self-description and the dense checklist, Ji Xiuwen's scalp was already numb, and after hearing Lu Xuan's words, he came back to his senses, and took the ear thermometer on the side to measure Pan Yuqian's temperature: "Body temperature 39.3 °C." ”

Pan Yuqian answered: "Doctor Lu, this is the case, it will be slightly better in the morning, basically keep it below thirty-eight, and the body temperature will rise rapidly in the afternoon, rarely lower than thirty-nine, and you can feel cold when the body temperature rises, and when the fever subsides, you will sweat a little, and you will be very thirsty......

Pan Yuqian said some of her symptoms in one bite, and Lu Xuan also took the opportunity to observe the other party's situation and record the syndrome differentiation process in the medical record book:

On July 18, the body temperature was 39.3 °C at the time of initial diagnosis, and in the afternoon, it was slightly cold when the heat rose, and there was sweating when the heat receded, the body temperature gradually decreased, the mouth was dry and wanted to drink, the tongue was dark red, the moss was thin and greasy and yellowish, and the pulse was ......

Seeing that Lu Xuan was recording some of his own situation, Pan Yuqian asked, "Doctor Lu, what's going on with me?" The results of the examination are very good, but I have been feverish, and what antipyretic medicine I take has no effect, and I have not gone to work for more than a month now, which affects my life too much. ”

After speaking, Pan Yuqian also looked distressed.

Anyone who encounters this situation may not be in a good mood.

Forget about fever, after all, all year round, except for a few people, most ordinary people will get sick once or twice, and fever is also a common thing.

But I have had a fever for more than a month, I have taken any medicine, and it is useless to be hospitalized, and even for this matter, a comprehensive systematic examination has been done, except for a slight gallstone, there is no other problem at all.

When she got the results, Pan Yuqian was also depressed for a long time.

She even wondered, since there was nothing wrong with her body, how could a person have a fever for no reason?

The question was thrown to Lu Xuan, but at this moment, Lu Xuan couldn't come up with any good explanation, and even the other party's pulse, except that the pulse number was easy to judge, there were other references, but he had never encountered Pan Yuqian's strange pulse, and in desperation, he rarely asked for help from the group of omnipotent teachers in his mind.

And this group of teachers obviously never let him down.

[The number of pulses, the pulses belong to the pulses with complex factors, it is a combination of floating, thin, and powerless conditions, so the ancients had "floating on the water" and other descriptions, but this kind of regulation was not clear until the "Pulse Meridian".

Before the "Pulse Meridian", the pulse Confucianism just meant weakness, such as the "Neijing" said that the spring pulse was weak, the long summer pulse was weak, and so on. Zhongjing's "Pulse Identification Method" says: "The yang veins are large and wet, and the yin veins are large and wet." The "Oriental liver vein" is "slightly weak". “

How can weakness be contrary to eleven heads" and so on. Moreover, the wet pulse is very close to the weak pulse, and from the literal meaning of the words wet and weak, it means weak and weak.

In ancient books, the soft word is often used for the vein, but the modern word is mostly used.

The "Pulse Sutra" says: "The soft veins are extremely soft and thin. ”

There is a small line under the clip line that says: "There is nothing to press in a day, and there is more than enough." One day is small and soft, soft and wet, and the one who is said to be wet is like silk clothes in the water, and he can get it lightly. ”

The theory of the "Pulse Sutra" has thus become the criterion of the pulse.

And judging the pulse, there is a relevant record in the "Pulse Recipe Publication Error": "Very soft and floating, light hand is obtained, not to be pressed." ”

Li Shizhen's "Pulse of the Lake" also said: "The veins are extremely soft and floating, like silk in the water, with light hands, and there is nothing to press, like floating on water." ”

"The Doctor Says the Covenant" said: "Wet, the floating is weak, the light hand is at first glance, but the heavy hand goes, like the line floating in the water." ”

……】

Hearing this, Lu Xuan took a deep breath, and while keeping these in mind, he also made some generalizations about what he said.

According to the voice of the heart, the pulse is a pulse with complex factors; It is a combination of several conditions of floating, fine and powerless; Because the veins have the condition of floating thin and weak, their finger sense is light, soft and small, so there is a floating water and floating on the water, such as the image description of the line floating in the water; The undergarment pulse can form a concurrent pulse with the relevant pulse, such as the wetness, the number of wetness, etc.

According to the words of "Pinghu Pulse Study: Body Poem": The wet-shaped float is light according to the mustache, and the floating force on the water surface cannot help it. There is still medicine in childbirth after illness, and ordinary people have no roots if they see it.

What do you mean?

The previous sentence refers to the fact that if the person is sick or postpartum, the appearance of the pulse at this time means that the qi and blood have been depleted, so it is understandable that the pulse appears due to the lack of righteous qi, and it can also be recovered after medical treatment.

The latter sentence means that it looks like a normal person, if you touch the pulse, it is not good, indicating that the patient is relatively weak.

How to treat it?

Lu Xuan has some understanding by looking at it, but he still has no clue how to treat it, mainly because the patient has no discomfort except for fever, which suddenly increases the difficulty of syndrome differentiation.

Don't look at Lu Xuan's recent medical help, but it is all some situations that he has been in contact with a lot recently, and when he encounters this kind of complexity, he is also blind.

Fortunately, he can't shake people, otherwise Lu Xuan can only let the patient go to other doctors to see.

This group of knowledgeable teachers obviously did not disappoint Lu Xuan.

[In "Pinhu Pulse Study: The Main Disease Poem", there is a mention of the main disease of the pulse, which is the death of blood and yin deficiency disease, and the marrow sea dantian has been lost. Sweat and rain come and steam into the bones, and the blood mountain collapses and wets the spleen. However, in modern times, the veins are more often seen as a result of dampness.

The patient's constant cold and heat is a typical cold and heat symptom of Shaoyang disease, which is manifested as intermittent appearance of fever and chills, coming and going, alternating attacks, several times a day, without a certain time regularity, which is caused by poor qi depression, uncoordinated camp and guard, and the division of good and evil.

According to the physiological function and pathological characteristics of Shaoyang meridian, Shaoyang disease can be roughly divided into qi depression pattern, water depression pattern and qi and water depression syndrome. Due to the different degrees and timing of qi depression, qi stagnation syndrome can also be divided into qi stagnation pattern, qi stagnation pattern and qi stagnation pattern.

Therefore, according to the patient's condition, it is intended to fall from qi deficiency and yang to yin, less yang cardinal is unfavorable, health and surface disharmony and fever identification, to reconcile too little, sweet and warm heat removal method, the medicine is Bupleurum 10g, boiled cinnamon branch 10g, fried white peony 10g, pueraria root 15g, cimicifuga 5g, astragalus 15g, angelica sinensis 10g, atractylodes 10g, licorice 3g, fried skullcap 10g, tangerine peel 6g, Fabanxia 10g, light ginseng 12g, white myrtle 15g, ginger 3 slices, jujube 4. 】

When he heard this prescription, Lu Xuan immediately thought of a method of heat removal that was rarely used.

Sweet and warm heat removal method.

The treatment idea of Ganwen heat removal method originated from the "Yellow Emperor's Neijing", which was founded in Zhongjing, established in Dongyuan, and continued to develop and improve by later generations of doctors.

The "Neijing" points out: "The laborer is warm; Those who lose benefit from it", "The spleen desires to be slow, and the urgent food is willing to slow it, and the bitterness is used to make up for it". These theories later became the cornerstone of the spleen and stomach theory of the famous medical scientist Li Dongyuan in the Jin and Yuan dynasties, and Zhang Zhongjing also created a prescription for the treatment of fatigue and irritability in the "Jin Kui Yaolu" - Xiao Jianzhong Tang.

"Jin Kui Yaolu: Blood Paralysis and Deficiency Labor Disease" cloud: "Fatigue and urgency, palpitations, sickness, abdominal pain, dream loss of sperm, sore limbs, hot hands and feet, dry throat and dry mouth, Xiao Jianzhong soup master." This recipe is actually the earliest prescription of the "sweet temperature heat removal method".

However, it was Li Dongyuan, a famous medical scientist in the Jin and Yuan dynasties, who really perfected the development of Ganwen to the peak.

Can Ganwen remove the heat?

There has been some debate in the academic circles, and many people have denied this and considered it a fallacy.

Lu Xuan also had some understanding of this knowledge, and felt that it was too absolute to completely deny the theory of "sweet and warm to eliminate the great heat", and this kind of ignorance of Mr. Li Dongyuan's lifelong scientific research results without being well verified is absolutely not correct.

There are also many people who say that the fever mentioned by Li Dongyuan is a deficiency fever, which is the patient's conscious fever, while the thermometer detects that there is no fever; Or it is said that the "great heat" that Ganwen removes is not the "high heat".

There are doubters, and there are many TCM practitioners who think that it is reasonable and apply it in practice.

However, as far as Lu Xuan is concerned, it is really the first time to use the method of sweetness, warmth, and qi to eliminate great heat to treat patients.

On the other hand, seeing that Lu Xuan hadn't moved for a long time, Ji Xiuwen couldn't help but be a little worried.

After coming for a few days, it was the first time he had seen his old classmate think about it for so long.

Thinking of Pan Yuqian's situation, Ji Xiuwen can understand that it is understandable that Lu Xuan needs to think.

After all, it was the first time he had heard of such a complicated situation.

What Ji Xiuwen is worried about now is that Lu Xuan has no good way to deal with Pan Yuqian's condition, and he may break the undefeated golden body that he has built with great difficulty because of this time.

Although no one can cure any disease, not even a miracle doctor.

But as far as Ji Xiuwen is concerned, he still hopes that his old classmate can always maintain his undefeated golden body.

(End of chapter)