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

After lunch, Song Luojun left and did not stay. He took a short break at noon and continued the communication at two o'clock in the afternoon.

The first patient in the afternoon was a female patient who was transferred from Kyoto Hospital before Shun Yoshihiro came. He himself had not yet started treating her, as the patient had been treated by other doctors before.

"The patient went to the outpatient clinic for treatment because of wind-cold, aversion to wind, spontaneous sweating, pain in both temples, fever, and floating pulse. At that time, a light dose of Guizhi Decoction was given. After taking the medicine, the patient sweated, the headache was relieved, and the cold and fever were also relieved. However, after a day, the fever returned, the pulse was weak, and the body was restless. The outpatient doctor gave him Baihu Decoction..."

Xun Jiahong talked about the patient's condition: "After taking the medicine, the patient's condition worsened. He took Baihu Decoction again the next day, and his fever became even worse. He was irritable at home, thirsty, and sweating severely..."

After Xun Jiahong finished talking about the patient's condition, someone came forward to examine the patient, and then the group began to discuss.

"The patient has fever, thirst, sweating, and a strong pulse."

Gu Yingyin said: "From the pulse and symptoms, the four major symptoms of Baihu Decoction are all present, how can it have no effect?"

"Yes, the patient's condition can be said to be completely consistent with the symptoms of Baihu Decoction, and Baihu Decoction is undoubtedly the right medicine for the condition." Other doctors also expressed their opinions.

"Could it be that the dosage of gypsum is insufficient?" Wen Haoxue said.

"That's what I thought too."

Xun Jiahong said: "The dosage of raw gypsum used before was only 24 grams, which is obviously a bit light. You can increase the dosage and try 100 grams."

"100 grams?"

Some people questioned: "Isn't 100 grams a bit too heavy?"

Just this morning, Song Luojun talked about gypsum, aconite, etc., and the nicknames of some famous doctors in history, such as Zhu Fuzi and Zhang Gypsum.

Zhu Fu Zi refers to Zhu Weiju, and Zhang Shigao refers to Zhang Xichun, both of whom are very famous doctors in modern times.

The reason why the use of large doses of aconite and gypsum in clinical practice is so famous is mainly because of the characteristics of these medicines. For example, aconite belongs to the Aconitum family and is poisonous. Therefore, doctors are very cautious when using aconite in clinical practice. Those who dare to use aconite in large doses are all famous doctors.

Gypsum is a chemical drug, a dihydrate of calcium sulfate, and a natural mineral.

Gypsum is very cold in nature and tastes sweet and spicy. In traditional Chinese medicine, gypsum is also called white tiger medicine.

Many people know that the White Tiger is responsible for killing. In traditional Chinese medicine, the lungs correspond to gold, white, and the west. The White Tiger, as a symbol of the western constellations in ancient astronomy, is responsible for killing and cooling. Gypsum is called the White Tiger by doctors of all dynasties for its powerful function of clearing away heat and purging fire, which is a metaphor for its medicinal mechanism and powerful effect.

Because of its strong medicinal effects, gypsum is used with great caution in clinical practice.

Xun Jiahong said that up to 100 grams of raw gypsum can be used, which is definitely a large dose.

"As expected of Director Xun."

Someone whispered, "If it were me, I would use at most 60 grams to try out the effect. I wouldn't dare to use 100 grams of gypsum."

"I think fifty grams is not a small dose." Someone said with a smile.

"Well, I think it's feasible." Qu Wenxuan nodded.

"I think it's okay." Zhu Gaoyuan also said.

"Does anyone have any different opinions?" Xun Jiahong asked.

"The patient has been ill for several days."

Chen Yang said, "Since the patient became ill, he has been treated with Guizhi Decoction once and Baihu Decoction once. He has been ill for a week. Now he still has a high fever, irritability, sweating, and a strong pulse. Judging from the symptoms, the pathogen has entered the body. This is a serious illness. The dosage of 100 grams of raw gypsum is still a bit too small."

"Doctor Chen, how much do you think is appropriate?" Xun Jiahong asked.

"250 grams." Chen Yang said after a moment of hesitation.

"what?"

"250 grams?"

Many people couldn't help but exclaim when they heard Chen Yang's words. Is he crazy?

"Is this Chen Yang in conflict with Xun Jiahong?"

"Even if we're at loggerheads, there's no need to joke around like this, right?"

The patient has already used Baihu Decoction once, with a dosage of 24 grams of raw gypsum. Xun Jiahong suggested increasing the dosage to 100 grams, which is four times the previous dosage, but Chen Yang suggested using 250 grams.

250 grams, this is ten times the previous dosage. Even compared with the dosage proposed by Xun Jiahong, it is 2.5 times.

I have seen large doses of plaster used, but I have never seen such a large dose. With such a large dose, is this going to send the patient to death?

"The patient has a high fever and is thirsty, and drinks a lot of water, which means the pathogen has penetrated deep into the body, and only a large dose can work."

Chen Yang said: "Chinese medicine looks at the severity of the disease and penetrates the interior. If the dosage is insufficient and it cannot be effective, the patient's condition will still not improve much."

Song Luojun was not there at the moment, and there was no one to make the final decision for Chen Yang and Xun Jiahong. Dong Yongnian and Hao Xiangchen next to them were not capable of making a final decision either.

"250 grams, that's too much."

Xun Jiahong pondered for a moment and said, "Then let's compromise and try 150 grams first."

"Since Director Xun said so, we can give it a try. However, I still reserve my opinion. If the first dose doesn't work, Director Xun can change the prescription and try again." Chen Yang said.

Without someone at a higher level to make the final decision, the current situation is that neither Chen Yang nor Xun Jiahong can convince the other.

The dialectic of this disease is very clear, and even the prescription prescribed by the previous doctor was appropriate. Baihu Decoction was correct, but the dosage was a bit conservative. It was really difficult to convince the other party about the specific dosage.

Song Luojun said before that dosage is the secret of traditional Chinese medicine. The grasp of dosage is the real test of a doctor's level. The same prescription may be mediocre in the hands of some doctors, but magical in the hands of other doctors. This is precisely because of the changes in dosage and additions and subtractions. The tricks involved cannot be explained in just a sentence or two.

"Okay, if one dose is ineffective, change it to 250 grams. I will then personally apologize to Dr. Chen." Xun Jiahong nodded. He still didn't believe it.

After that, the patient was taken back, the next patient was brought in, and the group continued the discussion.

Three patients were discussed in the afternoon. Except for the first patient, Chen Yang, who had some disagreements with everyone, there were no major disagreements on the next two patients. Everyone expressed their opinions, and Xun Jiahong made a summary at the end.

"Well, this exchange meeting was a complete success. All the doctors spoke actively and performed very well. I hope everyone will continue to improve themselves after returning..."

Dong Yongnian also made a summary speech, and then the exchange meeting ended. Some doctors stayed for dinner, while others went home directly.

Chen Yang, Wen Haodong, Wen Haoxue and others found a restaurant nearby and ate while chatting.