Doctor of Healing

He was very interested in "solving the puzzle" with Meng Qingfei.

About an hour later, those people dispersed, and the corridor became much quieter. Only then did Ji Xiang and Meng Qingfei go to see the patient together.

The patient had gastric lavage, poured 8000ml of warm water in and then spit it out, and half of his life had already been tossed.

He was lying on the observation bed, receiving an infusion.

The liquid is sugar salt water, plus some vitamin C and potassium to avoid ion disturbance.

"What's going on?" Meng Qingfei asked the emergency physician.

"A patient with osteoarthritis has depression and has taken medicine." The emergency physician said, "It is said that the osteoarthritis of the bilateral knee joints is more serious and has dysfunction. I can't go downstairs recently, and my mood is getting worse. It's getting worse."

"That's not enough, there were people coming just now, what are they doing?"

The emergency physician gave Meng Qingfei a wink, and the two came to the consulting room after going out.

"The patient provoked something 3 years ago."

"Don't talk nonsense." Meng Qingfei said, "You are all feudal superstition."

"Old Meng, what I said is true. There is a person on our side who said she would look at it. Since she has the ability, she looks more and more like a fox. Do you know about this?"

"I know, when our hospital was expanded, Feng Shui was consulted by her. I heard that she went to the imperial capital later, but died not long after going there."

"It's good to know." The emergency physician said, "We don't have to believe it, but we can't talk nonsense."

Meng Qingfei nodded.

Ji Xiang was confused, they were obviously talking about a past event, even related to Feng Shui when the Second Affiliated Hospital was expanded.

For this matter, Jixiang is very acceptable.

The richer and more powerful those people are, the more they believe in these things.

My old man has some understanding of this, but only limited to plum blossoms.

"Go ahead." Meng Qingfei became more cautious.

"Three years ago, the patient's urination began to change color. I just saw that there were black spots on his underwear."

"How long has it been since you changed your underwear?" Meng Qingfei asked.

"It was changed yesterday." The emergency physician said, "It is said that there are too many things like miasma in his body, so even the urination is black."

"..." Meng Qingfei smiled helplessly, "I said let's take a blood test."

"It's smoked." The emergency physician said, "It's red, but I still believe it."

Meng Qingfei shrugged, "Damn, I still think the patient's blood is not red anymore?"

"Lao Meng, I have already told him to observe this patient for one night, and to go home tomorrow if there is nothing wrong. The family also felt that nothing was wrong, so they asked someone to break it and agreed to leave the observation. Let me tell you, don't eventful!"

Meng Qingfei smiled slightly.

"Old Meng! I heard that group of people talking, don't get angry with them!" The emergency physician knew Meng Qingfei well, and she dissuaded her.

"I do not have."

"Did you feel uncomfortable after being scolded for a few words, and wanted to diagnose the patient, and then cut off the family's financial resources?"

"The sentence in the middle is what I thought, but the two sentences before and after are not." Meng Qingfei said.

The words were a bit complicated, and Ji Xiang had to react for a while before he understood what Meng Qingfei meant.

"Old Meng, I'm telling you very seriously, the farther away the better." The emergency physician urged again.

"Okay, okay, I see." Meng Qingfei waved his hand and said, "I saw small blue spots on the patient's ears and palms. Do you have any considerations?"

"I don't know. I also saw it during the gastric lavage. I thought it was weird and a bit spooky. I didn't want to provoke them."

Meng Qingfei chatted with the emergency physician for a few more words to understand the basic situation of the patient.

A 56-year-old male patient had bilateral knee joint pain for 10 years, accompanied by morning stiffness for more than half an hour.

Three years ago, the patient began to have deep staining of underwear after urinating.

Physical examination: there were scattered blue-black spots on bilateral auricles and finger skin, bilateral metacarpophalangeal joints and interphalangeal joints were swollen; lumbar flexion was limited.

Because the patient came to the emergency department because he committed suicide by taking medicine, other examinations were related to taking medicine.

The emergency physician went to work, Meng Qingfei thought for a while, "Xiaoji."

"Yes, Teacher Meng."

"You...forget it, I'll do it." After Meng Qingfei finished speaking, he got up and went to the treatment room to get a pair of PVC film gloves and a cup, and went to the observation room to let the patient's family members urinate.

Half an hour later, the urine cup was placed in front of Meng Qingfei and Ji Xiang.

"Mr. Meng, do you suspect porphyria?" Ji Xiang asked.

"No." Meng Qingfei looked at the cup of urine, and said softly, "There are black spots on the underwear. Could it be the reason why the prostate is hypertrophied, the urination is endless, and then urine falls on the underwear?"

"I remember a medical drama a few years ago. After receiving urine and observing it for a few hours, it was found that the urine turned red and it was diagnosed as porphyria. The urine turned black. I have never heard of it."

"Urine can become colorful, and each color is a disease. I haven't learned about it in detail. The probability of clinical occurrence is not high. This is the first time I have encountered black."

The two looked at the cup of yellow, frothy urine, and Jixiang thought of the apple juice squeezed out of the juicer.

Don't say it, it's really similar.

"Watch and see if it changes color. The black color on the underwear is most likely caused by the incessant urination." Meng Qingfei squinted at the urine and said.

"A young man like you who is defiant and pissed doesn't know. You will understand when you are older. How can something so simple be made so complicated?"

Ji Xiang really wanted to go to the operating room of the system, but he still forcibly held back.

Soon, a patient came to see a doctor, and Meng Qingfei ran out to get busy, and the two of them changed shifts to stare at the cup of urine.

It was a very strange night. Ji Xiang never thought that he would stare at a cup of urine for hours.

It was well past 11 o'clock in the evening, and Ji Xiang saw that the urine seemed to have changed color in a trance.

His first feeling was that he was dazzled, so he wiped his eyes vigorously.

It's not dizziness, but the urine really changed color under my gaze!

"Teacher Meng!" Ji Xiang shouted loudly.

Chapter 691

Ji Xiang roared as if he had discovered a treasure.

Meng Qingfei ran back quickly, and said while running, "Wait for me a moment!"

This was said to the patient, and it should not be a very serious patient, so Meng Qingfei immediately wanted to see the discoloration of the urine.

When he came to the duty room, Meng Qingfei saw at a glance that the urine cup on the table was slowly changing color.

Just like the urine of a porphyria patient turns red, the color of the apple juice coming out of the juicer from the patient's urine is gradually changing.

It was as if a drop of black ink had been dripped into the urine, and the black mass was rippling and gradually melting, watching the whole cup of urine turn black.

Meng Qingfei glanced at it and immediately took out his phone.

Ji Xiang was speechless about this.

Seeing a doctor on Baidu was originally a sarcasm, but I didn't expect Meng Qingfei, Teacher Meng, to enjoy it.

Shouldn't it be right at this time to directly say what the patient's problem is to be qualified?

"Teacher Meng..." Ji Xiang said softly.

"Wait a minute, let me check! The color of the urine is black, what is the disease?" Meng Qingfei said.

"Urinary tract tumors, there shouldn't be any, but we need to check carefully. It's really unreliable. Xiaoji, you were the first to train in the urology department, and now you are doing kidney cancer surgery. Have you ever seen black urine?" Meng Qingfei held The mobile phone began to make a differential diagnosis.

Ji Xiang couldn't laugh or cry, if he didn't know Meng Qingfei was Teacher Meng, he would definitely think he was here to make a joke.

"No, I guess it's dark red hematuria, which is described as black." Ji Xiang said helplessly.

"Yes, so this rule is ruled out." Meng Qingfei said to himself.

"Eating red dragon fruit and foods containing anthocyanins, eating too much urine will turn red and black, causing changes in the color components in the urine, which can usually be relieved by reducing the amount of food consumed." Meng Qingfei continued to hold the phone Make a differential diagnosis.

"This doesn't seem to be the case. The patient has eaten dragon fruit for 3 years? That's so loving. Besides, after eating dragon fruit, the stool is red, and black urine is rarely seen. This one is doubtful."

Ji Xiang watched Meng Qingfei doing differential diagnosis with his mobile phone, and found it very interesting.

"Orally taking cascara bark, senna, artificial bezoar, metronidazole, sorbitol, methylene blue and other drugs, these drugs contain specific substances, which react with tissues and organs in the human body, making the urine appear black."

"No, Xiaoji, have you ever heard of a case where eating senna leaves made the urine turn black?" Meng Qingfei mused, resting his chin.

"No." Ji Xiang reminded, "Mr. Meng, there are still patients outside."

Meng Qingfei patted his thigh, reluctantly put the phone into the pocket of his white clothes, wiped his hands behind his buttocks, and turned to see the patient.

Ji Xiang recalled Mr. Meng's Baidu differential diagnosis, feeling inexplicably complicated.

But it seems that Mr. Meng has found a breakthrough. Ji Xiang recalled and found that the key point of the problem was not the differential diagnosis on the Internet, but Meng Qingfei found the problem from the patient's underwear turning black, and then observed that the urine turned black.

Generally, it will be washed away after urination, and no one can see that there is a problem with the urine. If it is not hospitalization, indwelling catheterization, and the urine remains in the urine bag for several hours, it will not be discovered at all.

It seems that the whole step is not difficult, but Ji Xiang knows that there is a gap here, and Meng Qingfei directly crosses it.

If there are no pre-steps, even if you search through the online library, you may not be able to find the answer.

Ji Xiang quietly thought about Meng Qingfei's diagnosis process. Compared with the system NPC's performance of being more intelligent and close to monsters, Meng Qingfei is more like a living person with flesh and blood, a living doctor.

After ten minutes, Meng Qingfei walked in happily.

"Xiaoji! This is the first time I know that cascara bark is a diet product!"

"Uh……"

Ji Xiang saw Meng Qingfei flicking his cell phone, searching for information about cascara bark.

"Both cascara bark and senna leaves are medicines that cause diarrhea, and both may cause dark urine. I have never heard of it, but if you encounter similar problems in young women in the future, you must think of cascara bark superior."

Ji Xiang didn't know how to evaluate Meng Qingfei's unconstrained thinking.

"Again, metronidazole. I just asked, and the patient has no history of oral metronidazole."

"Mr. Meng, I haven't heard that metronidazole can cause urine to change color."

"I didn't find it either. The information on the Internet is always true and false. If you can't find it, put it there first. Generally speaking, taking metronidazole will cause the urine to darken, but it turns black, which is a bit too much." It's gone." Meng Qingfei said.

"One more thing - rare diseases such as hereditary methemoglobinemia, usually patients have dark urine due to methemoglobinuria."

Meng Qingfei said something that was very difficult to pronounce, and then began to recite it.

Ji Xiang wanted to cover his face in embarrassment.

However, Meng Qingfei didn't think there was anything wrong. After reciting a long passage on medical-related topics, he began to log on to various professional websites to find relevant information.

Finally looking like a professional doctor, Ji Xiang thought to himself.

Because of constant interruptions from patients, it took Meng Qingfei nearly an hour to select two case reports.

Black Diabetic Arthritis!

A mouthful and rare diagnosis surfaced.

Meng Qingfei happily took a picture of the phone in front of Jixiang, "Look, Xiaoji!"

His finger pointed to a passage, and Ji Xiang looked carefully.

[In the middle and late stage, a large amount of homogentisic acid is deposited in the tissues, and extensive skin pigmentation can be seen, especially the auricle, sclera, nose, and cheeks will appear brown or blue-black due to pigmentation, and osteoarthritis may occur in the terminal stage. 】

It took more than five hours from seeing the patient's doubts to finding out the evidence.

In the dead of night, the logical closed loop was finally completed.

Although Meng Qingfei used a lot of Internet searches, Ji Xiang had a different understanding of his behavior.

"Mr. Meng, it seems to be black diabetes arthritis, exactly the same as what we saw."

"The patient needs joint replacement. There is a precedent. Are you following Deng Chaohong in the orthopedics department?"

"Yes."

"Then I will talk to the patient's family at night. If they agree to the operation, I will ask the patient to come to you tomorrow, and you will take it to Deng Chaohong to have a look."

"Okay." Ji Xiang simply answered Meng Qingfei's words, and Meng Qingfei's dark white clothes seemed to be emitting light.

Meng Qingfei seemed very happy. He reached out his hand to find a cigarette in Ji Xiang's pocket, and lit one happily.