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

The first round of "theoretical debate" ended in a heated exchange of ideas. After a brief deliberation, the judges, represented by Mr. Lu Yuanmin, announced the results.

"In the first round, both sides presented their arguments logically and well-founded, demonstrating profound theoretical knowledge."

Lu Yuanmin's voice was loud and clear as his gaze swept across the stage and the audience: "The Kyoto team's diagnosis of 'Yin deficiency and damp heat, with heat lurking in the Yin aspect' by Dr. Yu Shiyun is novel in perspective, hits the nail on the head, and shows true skill in the details. They are slightly better. In this round, the Kyoto team scores!"

A murmur of surprise, admiration, and a hint of dissatisfaction immediately arose from the audience.

The expressions of the young PhDs from the scattered provincial teams changed slightly, clearly surprised by the result. Cheng Yi remained calm, merely adjusting his glasses, his gaze towards Yu Shiyun becoming even more profound.

Yu Shiyun suppressed her excitement, bowed slightly to the judges and the opposing team, and then returned to her seat.

Zhuang Qiwen gave her an encouraging look, while Xia Hongliang quietly gave her a thumbs up.

"Well done, Shiyun!" Li Chengjie whispered, "Let's see if they dare to look down on us now."

Chen Yang sat on the judges' panel, his expression calm, but he was quite gratified.

Yu Shiyun's growth rate exceeded his expectations. This keenness and willingness to break with convention are precisely the qualities that excellent traditional Chinese medicine practitioners need.

Wu Yongping turned to Chen Yang and whispered, "Director Chen, your team is truly full of hidden talents. It's amazing that a trainee who hasn't even officially started practicing yet has such insights."

"Dean Wu, you flatter me. Shi Yun is good at thinking, but she still needs more practice," Chen Yang replied modestly.

The host skillfully managed the flow: "Congratulations to the Kyoto team for taking the lead! Next, we'll move on to the second round—'Prescription Speed ​​Race'! This round tests your ability to identify Chinese medicinal herbs, understand their properties and meridian tropism, and be proficient and accurate in composing prescriptions. The rules are as follows..."

The second round of rules is more complex and consists of three stages:

"Discerning the Essence": Images of partial features of Chinese medicinal herbs (such as cross-section, texture, and hair) flash randomly and rapidly on the large screen. Teams from both sides compete to answer, and must accurately state the name and main effects of the herbs.

"Prime Minister Assistant Herb": Given a classic prescription, both parties must write down all the constituent herbs of the prescription on a whiteboard within a specified time, and mark the principal herb, assistant herb, adjuvant herb, and guide herb.

"Random Combination": A primary symptom (such as "external wind-cold syndrome with excess symptoms") is randomly given, along with a list of drugs containing interfering items. Both parties need to quickly select suitable drugs to form a basic prescription and briefly describe the combination reasoning.

This round tests the solidity of basic skills and reaction speed. It is a compulsory course for almost all TCM students, but it is also the most tedious, difficult, and prone to errors.

"Round Two, Begin! First up, 'Identifying the Best'!" At the host's command, images of various medicinal herbs began flashing rapidly across the large screen.

Some are orange-red cross-sections with radial patterns; some are curled, hairy roots; some are close-ups of seeds with a distinctive aroma...

"Beep!" A member of the loose provincial team was the first to press the buzzer.

"Picture 1: Salvia miltiorrhiza! Its effects include promoting blood circulation, removing blood stasis, regulating menstruation, relieving pain, and calming the mind and relieving irritability!"

"correct answer!"

"Beep!" This time, Xia Hongliang got the prize.

"Picture 3: Artemisia capillaris! Its effects include clearing damp-heat, promoting bile secretion, and reducing jaundice!"

"correct!"

"Beep!" Cheng Yi made his move, as fast as lightning.

"Picture 5: Fritillaria cirrhosa! Its effects include clearing heat and moistening the lungs, resolving phlegm and relieving cough, and dispersing nodules and reducing swelling!"

"correct!"

The buzzers went off one after another as the two sides went back and forth, with the score fluctuating.

The audience watched with bated breath, occasionally letting out low gasps for the brilliant answers and accurate identifications.

This round of image recognition not only tested everyone's knowledge and understanding of medicinal herbs, but also their reaction speed, making the battle between the two sides quite intense.

Zhuang Qiwen remained seated calmly, not making a move easily. His strength lay in critical thinking during a case, and he trusted his teammates in this purely memory-based competition.

In Chen Yang's team, besides Chen Yang himself, Zhuang Qiwen is also the most skilled member, and he knows how to give others a chance.

Yu Shiyun, Zeng Yunhui, Xia Hongliang, Li Chengjie and others all demonstrated solid skills. Yu Shiyun, in particular, showed her family background in medicine, and her ability to identify some obscure medicinal materials was even more accurate than that of the doctoral students.

The "Discerning Expertise" segment ended with the score remaining close. The Kyoto team took a slight lead thanks to Yu Shiyun's timely and correct answers to two obscure medicinal herbs.

Next comes the "ruler, minister, assistant, and envoy" segment.

The names of prescriptions such as "Buzhong Yiqi Tang", "Xuefu Zhuyu Tang", and "Lingjiao Gouteng Tang" appeared in sequence on the big screen.

Both teams were engrossed in writing, the only sound in the room being the scratching of pens across the whiteboard. This round tested their precise memory and understanding of the ingredients in traditional Chinese medicine formulas. Occasionally, someone would write down the wrong flavor or mislabel the principal, assistant, and adjuvant herbs, eliciting slight shakes of the heads from the judges.

On the Kyoto team's side, Zhuang Qiwen and Zeng Yunhui performed consistently, getting almost everything correct. Yu Shiyun hesitated slightly on the "assistant herbs" label for "Lingjiao Gou Teng Tang" but ultimately got it right. The bulk provincial team, however, had a member who omitted "Jie Geng" (Platycodon grandiflorus) from "Xue Fu Zhu Yu Tang," resulting in a point deduction.

After two rounds, the Kyoto team's lead widened to five points.

The supporters from the bulk goods province in the audience began to get anxious, and their whispers grew louder.

Cheng Yi took a deep breath, glanced at his teammates behind him, and conveyed the signal to "stay calm" with his eyes.

"The final step: 'random pairing'!"

The host raised his voice: "Please look at the big screen—the main symptom: 'Liver Qi stagnation, blood deficiency, and spleen weakness syndrome'."

"List of optional medications: Bupleurum, White Peony Root, Angelica Sinensis, Atractylodes Macrocephala, Poria Cocos, Peppermint, Gardenia, Moutan Bark, Licorice Root, Fresh Ginger, Jujube, Rehmannia Root, Prepared Ginger... (Contains interfering items such as Coptis chinensis, Astragalus membranaceus, etc.)"

Upon seeing the question, both teams immediately fell into deep thought.

"Liver Qi stagnation, blood deficiency, and spleen weakness" is a very common syndrome in traditional Chinese medicine internal medicine. The core pathogenesis lies in liver Qi stagnation, insufficient blood and qi, and spleen Qi deficiency. Treatment should focus on soothing the liver, relieving stagnation, nourishing blood, and strengthening the spleen.

The classic formula is undoubtedly "Xiaoyao San".

The difficulty lies in the fact that the given list of drugs includes the original formula of Xiaoyao San, which contains Bupleurum, White Peony Root, Angelica Sinensis, Atractylodes Macrocephala, Poria, Peppermint, Prepared Ginger, and Licorice. It also includes Gardenia and Moutan Bark from Danzhi Xiaoyao San, as well as Astragalus from Guipi Tang, which is an interfering item, and Rehmannia Root and Jujube, which may be used together but are not part of the core formula.

This not only tests familiarity with the formulation, but also the ability to quickly eliminate interference and accurately identify the core drug group under pressure.

Time passed by minute by minute.

Zhuang Qiwen frowned slightly, and several options flashed through his mind: Should he use Xiaoyao Powder alone? Or should he choose Danzhi Xiaoyao Powder based on the possibility that "blood deficiency" might generate heat?

The list includes gardenia and peony bark, which seems to hint at something... but the description of the main symptom does not explicitly mention "heat symptoms"...

Just then, "Beep!" The buzzer sounded!

It's Cheng Yi!

Cheng Yi actually pressed the buzzer in just thirty seconds!