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

"Lily disease? Isn't that the... somewhat mysterious disease from the 'Synopsis of Prescriptions of the Golden Chamber'? Are people still using this to diagnose it?"

"Bupleurum and Dragon Bone and Oyster Shell Decoction? This formula also contains rhubarb, dragon bone, and oyster shell, with mixed medicinal properties. Can it be used on this kind of weak anxiety patient?"

"That's outrageous! Dr. Cheng's plan is so sound and safe; it's clearly the right approach!"

"Has Xia Hongliang gone mad with a desire to be different? Has he lost his mind?"

A torrent of questions and discussions followed. Even the seasoned experts from the Wu School on the judging panel frowned, shook their heads, and whispered among themselves, clearly finding it difficult to understand and accept Xia Hongliang's unorthodox proposal.

Wu Yongping involuntarily looked at Chen Yang, his eyes filled with inquiry and confusion, as if asking, "Is this your team's secret weapon?"

Chen Yang's expression remained calm, but his deep gaze was focused on Xia Hongliang, as if waiting for him to unravel this "mystery" in everyone's eyes.

Cheng Yi also looked at Xia Hongliang, his brows furrowed. He believed that his plan was very comprehensive, taking into account almost all the overt symptoms and the pathogenesis. He really couldn't understand why Xia Hongliang would choose such an obscure, even somewhat "absurd" approach, which was completely beyond the scope of conventional diagnosis.

Zhuang Qiwen also looked at Xia Hongliang; this was the first time he had truly come to understand this Dr. Xia.

It was Xia Hongliang's turn to speak.

Xia Hongliang walked slowly to the front of the stage, his gaze sweeping over the skeptical faces below. The cynical smile on his face seemed to become more pronounced, but his eyes suddenly sharpened.

"Everyone,"

Xia Hongliang spoke, his voice clear and resonant, carrying a strange penetrating power that suppressed the noise in the room.

"This patient's condition is complex, with numerous symptoms that seem unpredictable and difficult to trace. If we follow the conventional approach and treat it based on the theory of liver stagnation transforming into fire, such as the modified Danzhi Xiaoyao San used by Dr. Cheng, it would be a safe approach and might achieve temporary relief, but it would probably not be able to completely cure the disease. It would be like scratching an itch through a boot, and the condition would easily relapse and become protracted."

As he spoke, Xia Hongliang pointed to the list of symptoms on the big screen, his tone becoming firm and powerful.

"Please pay attention to a few key points: First, the patient's symptoms are 'unpredictable,' with migratory pain and extreme mood swings. This cannot be fully explained by simple liver qi stagnation. It is more consistent with the characteristics of qi disorder and pathogenic factors without a fixed location."

"Secondly, the symptoms of 'mixed cold and heat' are obvious. There are heat symptoms such as irritability, insomnia, red tongue with yellow coating, and cold symptoms such as fatigue and cold limbs as often reported during consultation. Thirdly, and most importantly, the symptoms of 'impaired pivot mechanism' are significant. Chest tightness, epigastric fullness, and obstruction in the throat are all manifestations of abnormal operation of the Shaoyang pivot mechanism and disordered Qi movement."

Then Xia Hongliang changed the subject, quoting classical texts: "Article 107 of the *Shanghan Lun* states: 'If, after eight or nine days of typhoid fever, purgation is administered, and the patient experiences chest fullness, restlessness, palpitations, difficulty urinating, delirium, and heaviness throughout the body, making it impossible to turn over, then Chaihu Jia Longgu Muli Tang (Bupleurum and Dragon Bone and Oyster Shell Decoction) should be administered.' This formula harmonizes the Shaoyang, promotes Yang and clears heat, and calms the mind. The symptoms described in its formula—'chest fullness,' 'restlessness,' and 'heaviness throughout the body'—are remarkably similar to those of the patient in this case!"

Xia Hongliang's voice gradually rose, carrying a confident air as if the clouds had parted to reveal the sun.

"Therefore, I believe that the patient's disease location is not only in the liver, but also at a deeper level in the Shaoyang meridian! The Shaoyang meridian is the pivot, like the axis of a door, which governs the rise, fall, entry and exit of the body's Qi."

"The patient is approaching menopause, a special stage in which Yin and Yang are imbalanced and the body's mechanisms are easily disrupted. If the Shao Yang mechanism is not functioning properly, the gallbladder fire will stagnate internally, the San Jiao water passages will be disordered, and phlegm and fluid will be generated internally."

"When phlegm and fire combine, they disturb the heart, causing restlessness, anxiety, and insomnia; when they roam the meridians, they cause migratory pain throughout the body; and when they accumulate in the throat, they cause globus hystericus. The unpredictable nature of these symptoms perfectly matches the characteristics of Shaoyang disease, which is characterized by 'alternating chills and fever with periods of remission,' and also aligns with the description of 'Lily Disease' as 'often silent, with a normal body shape and a weak and rapid pulse'!"

"Therefore, I mainly use Bupleurum and Dragon Bone Oyster Shell Decoction to harmonize the Lesser Yang, promote Yang and clear heat, and calm the mind, combined with Wendan Decoction to clear the gallbladder and stomach, regulate Qi and resolve phlegm, and calm the mind and stabilize the will."

"In this formula, Bupleurum and Scutellaria harmonize the Shaoyang and clear away the stagnant heat in the gallbladder and viscera; Dragon bone and oyster shell calm the mind and subdue the floating Yang; Cinnamon twig and Poria promote Yang and transform Qi, and promote diuresis and eliminate dampness; Rhubarb is not used for purgation, but is used in small amounts to clear heat and harmonize the stomach, and guide the pathogens downward; Pinellia, Bamboo shavings, Fructus Aurantii Immaturus, and Pericarpium Citri Reticulatae resolve phlegm, regulate Qi, harmonize the stomach and descend rebellious Qi."

"The combined use of various medicines, employing both cold and hot herbs, and combining tonification and purgation, aims to activate the pivot of the Lesser Yang, clear away phlegm and heat in the gallbladder and internal organs, so that the Qi of the whole body can be regulated and the phlegm and fire can be eliminated. Then, all kinds of strange symptoms will naturally be cured!"

Xia Hongliang's argument is like that of a skilled detective, who perfectly connects a bunch of seemingly chaotic and unrelated clues (symptoms) through the main thread of "disruption of the Shaoyang pivot, gallbladder fire and phlegm heat disturbing the heart," and establishes a convincing and amazing connection with ancient classical prescription theories and disease names.

His thinking is grand and unique, insightful and comprehensive, yet firmly rooted in the classic theories of "Treatise on Febrile Diseases" and "Essential Prescriptions of the Golden Chamber," demonstrating an extremely profound understanding of febrile diseases and a strong ability to reason and analyze in clinical practice.

There was silence.

All the previous doubts and clamor seemed to be wiped away instantly by an invisible hand. In their place came profound shock, contemplation, and reflection.

Many people looked at Xia Hongliang, their eyes shifting from disdain to astonishment, and then from astonishment to admiration.

Li Chengjie muttered, "This guy is starting to look more and more like Director Chen."

Cheng Yi stared blankly at Xia Hongliang, his face filled with disbelief. His lips moved slightly, but no sound came out.

He subconsciously scrutinized and refuted Xia Hongliang's arguments in his mind, only to find that he couldn't find any obvious flaws! He even had a vague feeling that Xia Hongliang's approach of starting with the "cardinal" and governing the whole body seemed to be closer to the essence of the patient's complex condition, and he had a sudden sense of enlightenment...

On the judges' panel, Mr. Lu Yuanmin suddenly slapped his thigh, his face slightly flushed with excitement, his eyes gleaming with undisguised admiration.

"Wonderful! Absolutely wonderful! Dr. Xia's theory is novel and profound, capturing the essence of Zhang Zhongjing's teachings! I... how could I have been so fixated on liver stagnation, never considering treatment from the perspective of the Shaoyang pivot?! This theory is like the sun breaking through the clouds!"

Wu Yongping was also shocked, muttering to himself, "Bupleurum and Dragon Bone and Oyster Shell Decoction... Lily Disease... Combining classical and contemporary formulas, referencing the Treatise on Cold Damage and the Golden Chamber... How can he apply it so skillfully?! This young man's understanding and application of the Treatise on Cold Damage and the Golden Chamber has reached... reached a state of perfection!"

Looking at Xia Hongliang on the stage, who seemed casual and unrestrained but was actually full of talent, Chen Yang couldn't help but shake his head with a smile. His eyes revealed a bit of helplessness, but more so, a sense of satisfaction and recognition.

This kid may have a somewhat unconventional personality, but his talent, his understanding of the classics, and his courage in the face of adversity are truly remarkable and enough to make anyone look at him with new respect.