novelSusiti Chapter 87 The Battle of Medical Skills
Chapter 87 The Battle of Medical Skills
"When did you start coughing up blood?" Although he had already made a decision, as a doctor, Wang Zhi did not let go of any information.
"In the afternoon, after Mother took her medicine, she first complained of chest tightness, then she started coughing, and the coughing got worse and worse, and finally—" Chang Le's voice tightened, "there were bloodstains on her handkerchief."
Wang Zhihuan stood up, walked to the table, and picked up the half-bowl of leftover medicine.
He first brought it to his nose and smelled it.
The pungent aroma of ephedra rushes straight to the nasal cavity, followed by a bitter and cold taste—either from scutellaria or gardenia.
He dipped his fingertip in the medicine and tasted it on his tongue.
The amount of ephedra was greater than he had imagined. Crucially, he also detected another ingredient in the taste.
Asarum.
His face darkened.
Asarum is a pungent and warm herb that can penetrate and disperse, and it is particularly effective in clearing the nasal passages. It is appropriate to use it for cough and asthma caused by cold pathogens binding the lungs.
However, for people with yin deficiency and excessive internal heat, using Asarum is like adding fuel to the fire.
Ephedra combined with Asarum, two pungent and dispersing herbs stacked together, is like blowing a fan hard on a nearly extinguished candle flame.
This is treating cough and asthma due to yin deficiency as cough and asthma due to wind-cold.
"Who opened this place?" His voice turned cold, filled with barely suppressed anger.
By the window of the side hall, a thin, long-faced old man with a goatee stood with his hands behind his back and said coldly, "I run this place. Who are you? Making such a racket here."
"This is Wang Zhihuan, a junior."
At this point, Wang Zhihuan no longer cared about the other party's terrible attitude.
She just stared at him, speaking slowly and deliberately, "Senior, your prescription contains ephedra and asarum."
"Senior, your wife has a constitution of yin deficiency and excessive fire. These two herbs are too pungent and dispersing, which is tantamount to adding fuel to the fire. This is why she has forced the blood to flow erratically and damaged the lung vessels!"
The old man's goatee twitched. He clearly hadn't expected this young man in plain clothes to be discussing pathology with him.
The old man twitched his beard: "You ignorant brat! What do you know! Madam has been coughing and wheezing for years, and only ephedra can open her lungs! Today her condition is critical, and this is precisely the time for the medicine to fight off the evil. Don't spread your nonsense here!"
"Even when attacking evil, we must not damage the root cause!"
Wang Zhi was also anxious. Pointing to the dying Madam Li on the bed, he said, "Look at her pulse! Her radial pulse is floating and large, like boiling water. This means her yang energy is escaping! If we continue to attack her like this, she'll collapse before she even coughs up blood!"
The old man gave a cold laugh and turned to look at Empress Zhangsun on the bed. His cold laugh froze the moment he saw her.
He was an experienced doctor; his pulse diagnosis might not be as precise as Wang Zhihuan's, but he could read facial complexions.
Empress Zhangsun's complexion at this moment was ashen with a flushed look, and she had sweat on her forehead. This was not a sign of improvement as her fever subsided, but a sign of her vital energy being depleted with sweat and her deficient yang energy escaping to the outside.
But he had already spent thirty years in the Imperial Medical Academy, treating countless important figures.
He couldn't bear to lose face being pointed out as a misdiagnosis by a country boy in front of the important person.
Coughing up blood is not necessarily a bad thing.
The old man's tone hardened. "The blood in your phlegm is the release of lung heat. As the heat is expelled with the blood, the cough and wheezing will naturally subside. If you don't understand, don't make rash judgments here."
Wang Zhihuan remained silent for a while after hearing this.
"Senior, the outward leakage of lung heat and damage to the lung meridians are two different things."
When he spoke, his tone remained calm and unhurried, but every word was heavy: "When lung heat is released, the blood streaks in the phlegm are bright red, and the amount is small. After coughing, the breathing becomes smooth and the wheezing will be relieved."
The lung vessels are damaged, the blood vessels are dark red, and there is a lot of blood. After coughing, the wheezing doesn't lessen but actually worsens. Please look at the handkerchief beside your wife's pillow.
The old man subconsciously looked towards his pillow.
On that plain handkerchief, the bloodstains were not bright red, but dark red, and they had spread out into a patch.
Wang Zhihuan also said: "Damage to the lung vessels is caused by excessive use of pungent and dispersing herbs, which burns the blood vessels."
If ephedrine is used at this point, the damage to the lung vessels will worsen, and the patient will no longer just have blood in their sputum—they will cough up large amounts of blood.
The old man's composure vanished completely.
He stared at Wang Zhihuan, his lips moved as if he wanted to retort, but his gaze fell on Empress Zhangsun's ashen face and the dark red bloodstains, and the words stuck in his throat.
The hall was eerily quiet.
Li Shimin stood at the foot of the couch, having remained silent since Wang Zhihuan entered. Now, he finally spoke.
"I understand your diagnoses," he paused, then said urgently. "One advocates using ephedra to clear the lungs, while the other argues that pungent and dispersing herbs are not suitable for treating deficiency-heat."
I don't care about any of that. I only have one question: given Madam's current condition, what method should we use? Are we confident we can succeed?
The old man's lips moved.
Li Shimin's gaze shifted to Wang Zhihuan.
Wang Zhihuan said, "First, use acupuncture to stabilize the breathing, then change the prescription. We can't wait any longer."
The old man abruptly turned his head: "No! The lady is coughing up blood right now; it's due to excessive heat in the blood. If we prick her with acupuncture to force the blood to flow, and the bleeding doesn't stop, who can bear the responsibility?"
Wang Zhi met his imposing gaze without flinching.
"Senior, you mentioned that needling to force blood out is a situation that only occurs when the purging method is excessive."
The younger generation did not use the purging method—Chize (尺泽) was used to relieve asthma, Taiyuan (太渊) was used to strengthen the lungs, and Lieque (列缺) was used to regulate the Qi mechanism with a balanced purging and tonifying method.
The combination of these three acupoints drains the stagnant Qi in the lungs and replenishes the depleted Yin.
The principle of acupuncture is to tonify what is deficient and to purge what is excessive.
The lady's condition is a mixture of deficiency and excess, not purely excess; therefore, a purely purging method cannot be used, nor should it be treated with only herbal decoctions for intensive treatment.
His face was stern, his brows furrowed with worry, yet he suppressed his anger and anxiety, and shouted, "Enough! The person is in this state, and you're still arguing! Tell me, is there any way to save him?"
The old man looked at Li Shimin, and his imposing manner immediately diminished.
Wang Zhihuan took a deep breath, forcing himself to calm down, and bowed to Li Shimin: "Master Li, the lady must first use acupuncture to stabilize her breathing, otherwise the needles and medicine will be difficult to administer. I am willing to give it a try."
Li Shimin gave him a deep look, his eyes filled with gratitude and an unspeakable sense of entrustment. He nodded emphatically: "Alright! Young Master Wang, go ahead and do as you please. If anything goes wrong, don't blame me; I'll take responsibility!"
The old man's lips moved, but he ultimately didn't dare to utter another word of "no".
Wang Zhi stopped wasting words, opened his medicine box, and laid out his needle pouch. "Zhou Xia!"
"Disciple is here!" Zhou Xia could no longer contain himself. Upon hearing the summons, he gripped the silver needles in his hand tightly.
"Chize, Taiyuan, Lieque. You stab the left, I stab the right."
Chize (尺泽) is used to relieve asthma, Taiyuan (太渊) is used to strengthen the lungs, and Lieque (列缺) is used to regulate Qi by balancing tonification and purgation.
Remember, be careful; this is evidence of a feint combined with a real attack. Do not use brute force!
Wang Zhihuan spoke very quickly, but his hands moved as steadily as a rock. He picked up a silver needle and pierced the acupoint.
Zhou Xia took a deep breath, forced herself to calm down, found the acupoints, and inserted the needles without hesitation.
The two worked in perfect harmony, one on the left and one on the right. The only sound in the hall was Empress Zhangsun's gradually calming breathing.
The old man stood by the window, watching this scene, his expression shifting between anger and uncertainty.
He didn't believe that this kind of acupuncture technique from a country doctor could be effective.
But after watching for a moment, his expression changed—these two young men's methods were not amateurish.
Accurate acupoint selection, along with precise angles and depths of needle manipulation, requires more than just a few days of practice.
After about the time it takes for an incense stick to burn, the unsettling whistle disappeared.