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

Chen Yang had already spoken to Xun Jiahong, Gao Anliang, and even Wen Manlu about this before.

This matter concerning Xiao Jingyun is not easy to handle.

Xiao Jingyun's prestige and skill level are extremely high. He is almost unchallenged in Qianzhou Province, and even nationwide, he is a respected figure in traditional Chinese medicine. He is a renowned expert in traditional Chinese medicine who can be treated as an equal with Wen Xiuping, Chu Yiyun, and others.

To be honest, if Xiao Jingyun hadn't signed up for this competition herself, and Xiao Jingyun was qualified to be a judge, Chen Yang would definitely have treated her with utmost respect.

However, since Xiao Jingyun lowered his status to participate in the competition, Chen Yang, as the chief judge, had to respect Xiao Jingyun's status but also fulfill his own responsibilities.

Chen Yang raised this issue again today, partly to try to persuade Xiao Jingyun to realize her mistake, and partly to express his own attitude.

Even if he couldn't convince them, he wanted to let them know that Chen Yang had seen through the problem long ago and wasn't blindly following.

It's like voting: the minority obeys the majority, but if the majority is wrong, even if you oppose it, you can't change the result. However, if you oppose it, and the other side's mistake is exposed, then you are right.

Chen Yang pulled up a magnified image of the patient's tongue, pointing to several fine peeling points: "Please look, everyone. Although the tongue surface is mainly purplish-dark and thick, here and here, you can vaguely see fine peeling. This cannot be explained by pure yang deficiency, cold, and dampness, suggesting that the yin aspect is also damaged. Combined with the occasional faint signs in the fine and rapid movements, is it possible that there is a deficiency of both yin and yang, or even a sign that the deficient yang is about to collapse?"

Then, several key laboratory indicators were presented: "The patient's liver and kidney function indicators are close to dangerous levels, and the body's metabolic environment is extremely fragile. Is such a large dose of strong medication an overwhelming risk for the patient at this moment?"

Chen Yang's analysis, combining clear images and objective data, is not an empty theoretical debate, but directly addresses the most realistic safety issues in clinical practice.

The venue was completely silent.

Many contestants fell into deep thought, especially the younger generation like Li Haofei and Xun Jiahong, as if a new door of thought had been opened for them. They realized that even a master like Professor Xiao, with his seemingly perfect plans, might have potential risks depending on the patient's specific situation!

A look of understanding flashed in Zhuang Qiwen's eyes. He recalled some similar situations he had encountered in his medical practice. Sometimes strong medicine was indeed very effective, but sometimes it had the opposite effect. The key was to judge the degree to which the patient's vital energy was preserved!

Xiao Jingyun's face darkened completely. He had been practicing medicine for decades and was renowned in the medical field. He had never been questioned like this by a young junior in public.

Although Chen Yang spoke respectfully and asked the right question, Chen Yang saw it as a challenge to his authority.

"Theoretical deduction is ultimately just empty talk."

Xiao Jingyun said calmly, "The patient's condition is critical, and only this potent medicine can break through the ice and restore yang! I am confident and have follow-up measures. If we hesitate due to fear of risks and watch the yang energy decline, that would be a failure for a doctor!"

He firmly believed in his judgment and in his ability to handle this potent medicine.

Chen Yang looked at Xiao Jingyun and knew that he could not persuade this stubborn senior with words alone.

"Professor Xiao is experienced and decisive. I bring this up not to negate his plan, but to encourage deeper thinking—how to find the most precise and individualized balance between 'eliminating the pathogen' and 'supporting the body' in the treatment of critically ill patients. This is also the significance of our competition and mutual learning."

Instead of forcibly suppressing Xiao Jingyun, Chen Yang elevated the debate to the level of academic discussion, expressing his concerns while maintaining the harmonious atmosphere of the competition, and giving all the contestants a vivid lesson in clinical thinking.

But everyone knows that the ideological differences between Chen Yang and Xiao Jingyun have become public and irreconcilable. This confrontation is not over; it has simply moved into the shadows, awaiting its final eruption.

The review session didn't end until the evening, and the final results will be announced in two days.

......

As night deepened, most of the contestants had already turned off their lights and were resting in the hotel arranged by the Kyoto International Medical Center.

However, Xiao Jingyun did not fall asleep in a suite on a high floor of the hotel.

He stood by the window, gazing at the dazzling night view of Kyoto, his brows furrowed slightly. The scene of the assessment during the day replayed in his mind, especially Chen Yang's last comment about "patient tolerance," which felt like a tiny thorn pricking his heart.

He has practiced medicine for decades and has always been very confident in his diagnostic skills and medication.

In his calculations, 60 grams of aconite was precisely the critical threshold for reviving the dying yang energy. He would first decoct it for a long time to remove the numbness and retain its properties, and then add dried ginger and licorice to supervise the process. This was a classic combination in classical prescriptions for "restoring yang and rescuing from collapse," and he was more than 90% confident in its effectiveness.

Of course, given Xiao Jingyun's cautious nature, he would not have used such a large dose in the past. This time, Xiao Jingyun prescribed Zhenwu Decoction instead of Sini Decoction. Zhenwu Decoction is a dampness-removing agent with the effects of warming yang and promoting diuresis.

Xiao Jingyun chose Zhenwu Decoction because he believed the patient suffered from Yang deficiency, which impaired the body's ability to warm and transport fluids, leading to excessive dampness...

Therefore, there is generalized edema and reduced urination; water and fluid rise to the heart, obstructing the heart's yang energy, and at the same time, palpitations, shortness of breath, cyanosis of the lips, and a weak and rapid pulse are observed; water and fluid attack the lungs, causing the lungs to lose their ability to disperse and descend, hence the cough, wheezing, and excessive phlegm.

Yang deficiency and cold stagnation lead to poor blood circulation, hence the purplish-dark tongue, which is a sign of blood stasis. The root cause is deficiency and the manifestation is excess, with yang deficiency as the root cause and water retention and blood stasis as the manifestations. The condition is critical, and Zhenwu Decoction is the most suitable treatment.

"Chen Yang is still young and lacks experience and knowledge."

Xiao Jingyun muttered to himself, "Upholding righteousness is important, but without eliminating evil, righteousness cannot be at peace. Such a deep-rooted problem cannot be shaken without swift and decisive measures."

He was convinced that his plan was correct and the only hope to quickly reverse the disease's progression.

As for the subtle tongue and pulse signs mentioned by Chen Yang, Xiao Jingyun believes they are merely accompanying symptoms that inevitably appear in the later stages of the disease, and are insufficient to change the fundamental pathogenesis of "yang deficiency and water retention." As long as the water retention is eliminated and the yang energy is restored, those so-called "yin deficiency" symptoms will naturally be alleviated.

His strong self-confidence, coupled with a hint of displeasure at being questioned by a younger colleague, led him to selectively ignore the fleeting thought that crossed his mind about the patient's specific constitution and liver and kidney function data. He was immersed in the amazed and approving gazes of others during the day, believing that that was the best affirmation of his medical skills.

"Everything needs to be done step by step. Mr. Wen and the others are too impatient."

Xiao Jingyun felt a surge of emotion.

Chen Yang's skill level is indeed good, and Xiao Jingyun also acknowledges this. However, Chen Yang is only in his early thirties, and to be elevated to such a high level at such a young age is a potential problem in Xiao Jingyun's eyes.

Without tempering, how can one's character possibly keep up?