signingbooks Chapter 1081 Visiting the Medical Center (Part )
Chapter 1081 Visiting the Medical Center (Part )
"24-hour urine protein was 8.2g, albumin was 18g/L, electrolyte imbalance (low sodium and potassium), and ultrasound showed a 6cm deep dark area of fluid in the chest and ascites. Early signs of respiratory failure were already present."
Robert looked at the child's medical records and pondered for a moment, "Western medicine routinely uses furosemide and spironolactone, powerful diuretics, but he's not sensitive to them. Furthermore, using them in a hyponatremic state could very well induce cerebral edema, which is a significant risk."
"It's indeed quite tricky." Muller nodded.
Dongdong's mother sat by the bed with red eyes.
"From a Traditional Chinese Medicine (TCM) perspective, this child falls into the category of 'edema,' and the core syndrome is 'spleen and kidney yang deficiency, causing flooding of water and dampness.'"
An Zhengliang leaned over and gently touched Dongdong's forehead. The child opened his eyes weakly, whispered "Uncle", and closed them weakly again.
"The spleen is responsible for transporting and transforming dampness, while the kidneys are responsible for transforming fluids and qi. This child's long-term illness has damaged his spleen, and subsequently his kidneys. His yang energy has weakened like a dying flame, leaving him without the 'power' to transport and transform dampness, causing it to spread throughout his body. Coupled with this concurrent infection and the external invasion of wind evil, the symptoms of 'wind and water fighting each other' have been added. This is a typical case of 'fundamental deficiency and superficial excess', making treatment extremely difficult – tonifying yang is afraid of causing heat, while promoting diuresis is afraid of damaging yang."
"So what's your plan?"
Professor Robert's eyes fell on Dongdong's infusion tube - there was only a bottle of basic fluid, no diuretics or immunoglobulin, which made him very confused.
"It focuses on 'warming yang and promoting diuresis, strengthening the spleen and consolidating the kidneys,' supplemented by promoting lung function and clearing heat. The prescription is Zhenwu Decoction combined with Fangji Huangqi Decoction with modifications: 6g of processed aconite root (pre-boiled for 2 hours), 20g of raw astragalus root, 15g of Poria cocos, 10g of Atractylodes macrocephala, 6g of Stephania tetrandra, 3 slices of fresh ginger, 2 jujubes, and 10g of Houttuynia cordata to promote lung function and resist infection."
"aconite?"
Robert looked at the prescription and said, "Director Gao, I've seen this Chinese medicine in prescriptions more than once."
"Professor Robert, there's a saying in our TCM industry that a TCM practitioner who can't use aconite isn't a good one."
Gao Anliang smiled. "The processed aconite we use goes through four steps: salting, rinsing, steaming, and slicing. The cross-section is gray-brown and has a hard texture... This process removes over 90% of the aconitine, retaining its potent, effective ingredients that improve kidney circulation."
"Not only do we strictly prepare the medicine, we also require it to be decocted for two hours first. A dedicated person supervises the decocting process to ensure the liquid boils over and doesn't burn the pot. The dosage is also precisely calculated. Based on a child's weight (2kg), it's 20g per kilogram, far lower than the typical adult dose of 0.3g per kilogram. After taking the medicine, we monitor myocardial enzymes and electrocardiograms daily, and even measure the concentration of aconitine metabolites in the blood to ensure safety."
Gao Anliang paused and continued, "For this severe case of weakened Yang Qi and surging dampness, Aconite is like a 'fire-fighting general'—it can invigorate the weakened Kidney Yang and open up the channels for fluid metabolism. This is what Chinese medicine calls 'replenishing the source of fire to dispel Yin.' If you don't use it for fear of toxicity, the child's Yang Qi will not be able to sustain itself, and the dampness will not be expelled, and then there will be no hope of recovery."
Gao Anliang was speaking when a nurse walked in with the latest medical report. "Director An, Dongdong's urine output today is 800ml more than yesterday. The ultrasound of his pleural and peritoneal effusions shows the dark area of fluid has dropped to 4.2cm. The 24-hour urine protein has dropped to 3.5g, and the albumin has risen to 22g/L!"
"The diuretic effect is even better than that of strong diuretics. The key is——"
Robert took the list and looked at it. He was surprised and said, "Not only did the electrolytes not deteriorate, but the blood potassium level actually increased from 3.2mmol/L to 3.5mmol/L."
Gao Anliang smiled and said, "The core of Chinese medicine is 'given the right symptom, then the right medicine'. If the diagnosis is accurate, and you are bold and careful, a poison can be transformed into a good medicine. If the diagnosis is inaccurate, then no matter how careful you are, a good medicine can become a poison."
After coming out of Dongdong's ward, An Zhengliang took Robert and others to the ward in charge of Wen Haodong.
The patient is a 38-year-old veteran named Lao Zhou. Two years ago, he suffered a spinal cord injury at the T10 level in a car accident and has been plagued by intractable neuropathic pain ever since.
It felt like countless needles were pricking him from the waist down, especially at night, and the pain made him roll around on the ground...
"The core of Traditional Chinese Medicine's understanding of pain is 'pain due to obstruction' and 'pain due to lack of nourishment'."
Gao Anliang stood by and watched Wen Haodong perform acupuncture on the patient, saying, "The patient's condition involves both 'meridian blockage' caused by spinal cord injury (blockage leads to pain), and 'malnutrition of the meridians' (malnutrition leads to pain) due to long-term pain that depletes Qi and blood. Therefore, acupuncture requires a 'combination of dredging and replenishing' – both unblocking the meridians and replenishing Qi and blood."
"The acupoints selected by Dr. Wen are very targeted. The Hua Tuo Jiaji points are located on the T10-L2 segment, with three points on each side to directly stimulate the nerve segments corresponding to the injury. The kidneys are located on the Foot Taiyang Bladder Meridian, and they nourish the spinal cord. The kidneys are responsible for bone and marrow production, and can nourish the spinal cord. The Huantiao and Yanglingquan points are located on the Foot Shaoyang Gallbladder Meridian, to dredge the Qi and relieve radiating pain."
"In terms of manipulation, we use tonifying methods to treat 'lack of nourishment', and purging methods to treat 'blockage'. Tonify when deficient, and purge when excessive."
"Both of these acupuncture techniques are classic tonifying and draining techniques recorded in the Complete Works of Acupuncture and Moxibustion."
.......
In Chen Yang's office, Wen Rongxian sat opposite Chen Yang, and Chen Yang filled Wen Rongxian's teacup with tea.
"Where are those foreigners?" Wen Rongxian asked Chen Yang.
"Director Gao is accompanying us on the tour."
Chen Yang smiled and said, "The number of patients at the center has increased recently. Everyone is busy, and a group of foreign experts are very interested."
"Cleveland Clinic, Berlin Heart Center..."
Wen Rongxuan sighed, "In the past, we couldn't even get access to such a top international medical institution. I never thought..."
Chen Yang had only been in Kyoto for three or four months, and he had already had top international medical institutions come to visit and learn from him. His son-in-law...
The more I look at it, the more satisfied I am.
"Several hospitals including Kyoto Hospital and Union Hospital have contacted me in the past two days."
Wen Rongxuan smiled and said to Chen Yang, "How do you plan to allocate the exchange places between Mayo Clinic and Cleveland Clinic?"
Mayo invited Chen Yang, hoping that Chen Yang could stay there for two years, but Chen Yang refused. However, others were jealous.
Especially several hospitals such as Kyoto Hospital and Union Hospital, they were all watching eagerly.
The establishment of Kyoto International Medical Center has the support of several hospitals including Union Hospital and Kyoto Hospital, and now it is time to reap the initial rewards.
"You can arrange this."
Chen Yang smiled and said, "In the early stages, each hospital should have one quota, not too many."
"OK."
Wen Rongxuan smiled and nodded: "I think so too. At the moment, they are begging us, so we should be more reserved."
As the father-in-law and son-in-law were talking, Wen Manlu walked in from outside with a folder in her hand.
"dad."
Wen Manlu called Wen Rongxuan, placed the folder in front of Chen Yang, and said, "Ichiro Yamamoto is ill at Juntendo University Hospital in Kyoto."