Chinese medicine: from rural hospitals to top three hospitals in Kyoto

Yu Shiyun took a deep breath, raised her head, and looked firmly at Qiu Yimin in the direction of the judges' panel and the surveillance camera. She knew that Director Chen and the others would definitely be able to see it.

After a moment of contemplation, Yu Shiyun took a deep breath and said clearly, "Judges, based on the patient's condition and constitution, I believe that combining oral herbal decoctions with external treatment using traditional Chinese medicine fumigation will yield better results."

"This prescription uses mugwort, clematis root, and clematis root to warm and unblock the meridians, and adds 3 grams each of prepared aconite root and prepared aconite root to enhance the effect of dispelling cold and relieving pain. However, the decoction time must be strictly controlled, and family members should be instructed to supervise to prevent ingestion. This prescription has been used in my family's TCM clinic for many years. As long as it is operated properly, it is safe and effective."

After Yu Shiyun finished speaking, the seventh examination room fell silent.

Qiu Yimin's brows furrowed instantly!

Sure enough! These quack doctors love using folk remedies and poisons! They completely disregard safety!

In the monitoring room, Feng Huanzhang shook his head first: "Nonsense! This is too audacious for an assessment setting! Even if it's controlled, there are still risks!"

The other judges also looked worried.

Only Chen Yang's eyes flashed with admiration.

Although Chen Yang didn't know much about Shi Yun, he could tell that she was a very pure female doctor. She was a bit introverted, but she loved traditional Chinese medicine. What was rare was that she dared to insist on what she believed was the most effective treatment for patients under pressure and took the initiative to propose strict safety operating procedures.

This requires not only medical skills, but also immense courage and a sense of responsibility.

“Director Chen, this…” Sun Zhiren also looked at Chen Yang with some hesitation.

Chen Yang calmly spoke into the microphone: "The assessment continues. Contestant Yu Shiyun, please elaborate on your safety control measures for the external fumigation and washing formula, and the reasons why you judge its necessity in this case."

Chen Yang's voice, steady and powerful, came through the broadcast to the seventh examination room. There was no blame, but he gave Yu Shiyun a chance to continue her statement.

Yu Shiyun felt a warmth in her heart and gained more courage. She explained in a clear and organized manner the decoction of the fumigation and washing formula, the precautions for use, and the advantages of combined internal and external treatment compared to oral administration alone, such as directly reaching the disease site, taking effect quickly, and reducing the burden of oral medication.

Clearly, Yu Shiyun's treatment plan has caused considerable controversy among the judges, and the scoring is destined to be uneven.

Just as things were temporarily settled on Yu Shiyun's side, all eyes turned to the first assessment room where Xiao Jingyun was.

How will this titan of a figure respond to his test? Will he be able to demonstrate overwhelming strength?

Xiao Jingyun was facing a real patient with an extremely complex condition.

The patient was a 70-year-old man, thin and with a sallow complexion, sitting in a wheelchair and being pushed in by his family.

The patient's medical records show that he suffers from "chronic obstructive pulmonary disease (severe)," "pulmonary heart disease," "heart failure (NYHA Class IV)," and "severe edema of both lower extremities."

The elderly man was breathing rapidly, making rattling sounds in his throat, had cyanosis of the lips, and was lethargic, barely able to answer questions completely. His family reported that his cough and wheezing had worsened over the past week, with copious, white, sticky phlegm that was difficult to expectorate. He also experienced chills, cold limbs, decreased urination, abdominal distension, poor appetite, and swelling in both lower limbs extending to the thighs, which were deeply indented upon palpation.

This is a typical case with a clear diagnosis from Western medicine, multiple severe illnesses, and a life-threatening condition.

For traditional Chinese medicine practitioners, this is an extremely severe challenge, testing their ability to diagnose and treat critical illnesses, as well as their courage and skill in administering medication.

Inside and outside the examination room, everyone held their breath. Such a patient could be seriously injured if not treated carefully... No one dared to take it lightly.

Chen Yang subconsciously glanced at Qiu Yimin and Mo Xinzhi beside him. Normally, such a patient shouldn't exist, but they did.

Clearly, Qiu Yimin and others were building momentum for Xiao Jingyun.

Xiao Jingyun's expression was solemn, but he was not flustered. He first gently calmed the family members down, and then stepped forward steadily.

Despite the patient's critical condition, Xiao Jingyun did not act rashly and still strictly followed the four diagnostic procedures.

Observe the patient's complexion, appearance, and tongue coating (the tongue is dark purple with a thick, greasy, and slippery white coating); listen for phlegm sounds and smells; carefully feel the pulse (the pulse is deep, weak, thready, and rapid, almost imperceptible, with an indistinct number of beats); gently inquire about the patient's feelings, even if the elderly person's answers are intermittent.

Throughout the process, Xiao Jingyun appeared calm and composed, with every movement exuding a sense of composure and confidence honed by experience.

After completing the examination, Xiao Jingyun closed his eyes and pondered for a moment, then opened them with a glint of light in his eyes, already confident of success.

He turned to the judges and monitors, his voice steady as a bell, clearly explaining his diagnosis: "This belongs to the critical condition of 'asthma,' 'edema,' and 'palpitation' in traditional Chinese medicine. The pathogenesis is yang deficiency with water retention, water and phlegm attacking the heart and lungs, accompanied by blood stasis."

"The patient has been ill for a long time, and the yang qi of the lungs, spleen and kidneys is deficient, especially the kidney yang deficiency is the root cause."

"Yang deficiency prevents the body from warming and transporting fluids, leading to water retention and edema, and reduced urination. Water retention ascends to the heart, obstructing the heart's yang energy, resulting in palpitations, shortness of breath, cyanosis of the lips, and a weak and rapid pulse. Water retention affects the lungs, impairing their function of dispersing and descending qi, causing cough, wheezing, and excessive phlegm. Yang deficiency causes cold stagnation, hindering blood circulation, resulting in a purplish-dark tongue, a sign of blood stasis. The condition is characterized by deficiency in the root and excess in the branch, with yang deficiency as the root and water retention and blood stasis as the branches, indicating a critical condition."

Xiao Jingyun's analysis was insightful and to the point, perfectly combining complex Western medical diagnoses with profound TCM pathogenesis, which made everyone nod in agreement.

As expected of Xiao Jingyun, his profound skills and broad knowledge are extraordinary.

"The treatment principle should be to warm the yang and promote diuresis, purge the lungs and relieve asthma, and invigorate blood and remove blood stasis. In an emergency, treat the symptoms; in a less urgent case, strengthen the root cause. At this moment, the symptoms are urgent, so we should prioritize rescuing the patient from collapse," Xiao Jingyun said decisively.

Immediately, Xiao Jingyun picked up his pen and wrote the prescription, his brushstrokes flowing and powerful. The prescription was a combination of three formulas: Zhenwu Decoction, Tingli Dazao Xiefei Decoction, and Xuefu Zhuyu Decoction.

"60g of Aconitum carmichaelii (decocted first and then for a long time), 30g of dried ginger, 30g of Poria cocos, 20g of Atractylodes macrocephala, white peony root... This is the base formula of Zhenwu Decoction, which warms the kidney yang, strengthens the spleen, and promotes diuresis."

"15 grams of Lepidium seed, 5 jujubes - to purge the lungs and promote water metabolism, relieve asthma and fullness; 10 grams of peach kernel, 15 grams of safflower, 15 grams of red peony root, 10 grams of chuanxiong rhizome, 30 grams of salvia miltiorrhiza... to invigorate blood and remove blood stasis, and improve blood circulation; add 30 grams of astragalus root to invigorate qi, warm yang and promote water metabolism, and 3 grams of cinnamon to guide fire back to its source and assist yang in transforming qi."

The moment this prescription was revealed, even Chen Yang in the monitoring room was slightly moved.

Rehabilitation is recommended!

Zhenwu Decoction warms the Yang and promotes diuresis to treat the root cause; Tingli Dazao Xiefei Decoction strongly expels water retention to treat the symptoms; Xuefu Zhuyu Decoction invigorates blood, unblocks collaterals, and improves circulation. Especially noteworthy is the use of 15 grams of Aconitum carmichaelii in this formula, even after pre-decocting, demonstrating remarkable boldness! This is precisely the spirit of a master of classical formulas—daring to use potent and potent medicines to directly target the root of the disease, based on accurate diagnosis!

Qiu Yimin, Feng Huanzhang, and others showed expressions of approval and even admiration. This was the true demeanor of a master of orthodox classical prescriptions! Precise diagnosis, decisive use of medicine, and strict adherence to rules!

"at the same time,"

Xiao Jingyun added, "It can be combined with acupuncture at Neiguan, Tanzhong, Feishu, Shenshu, Shuifen, Yinlingquan and other acupoints, with a balanced tonifying and reducing technique, to help relieve chest tightness, regulate Qi, promote diuresis and reduce swelling. The patient is weak, so the technique should be gentle and stop as soon as Qi is obtained."

The treatment plan was completed in one go, combining theory, methods, prescriptions, and medications, and was flawless.