Chapter 273 Diagnosis
"Master, it's time to eat."
"Well, here we come."
In the Jinchengfang study room, Li Ang, who was single-minded and crazily rushing homework with a pen in his mind, let out a long breath, stood up, walked to the living room, and asked casually, "What do you have for dinner?"
"Master, what you want, stewed pork vermicelli with sauerkraut, fried pork with celery, braised fish."
"Well."
When Li Ang heard the word "sauerkraut", he froze inexplicably, and a bad sense of sight rose in his mind, "Is the sauerkraut made in our own jars?"
"Yes, this winter, what kind of cabbage did you use, young master?"
Chai Chai asked inexplicably, "Is there any problem?"
"no problem."
Li Ang heaved a sigh of relief. Before, he thought that sunflower was oily and unpalatable, so he tried to hybridize Chinese cabbage with southern womb and northern turnip, and now he has achieved some results, "By the way, don't buy sauerkraut outside again in the future. Yep, do it all at home.”
"Um."
Chai Chai didn't know why, but he nodded, and sat at the dining table listening to Li Ang's strange complaint about "the sauerkraut in the old altar, smoked with heart".
The two were about to eat when they heard a knock on the courtyard door.
"Who is it?"
"I."
Qiu Feng's voice.
Chai Chai tilted his head in doubt, while Li Ang stood up from his chair as if he knew Qiu Feng would come, and walked across the courtyard to welcome him.
Qiu Feng stood outside the door, frowning slightly, holding a book that read "The First Edition of the New Textbook of the Imperial Medical Administration-Physical Diagnostics", with an unhappy expression.
"Let's go into the study and talk."
Li Ang knew Qiu Feng's intention and took her back to the house. Qiu Feng forced her to smile, greeted Chai Chai, and followed Li Ang into the study.
"Sunrise,"
Qiu Feng put the imperial medical department textbook with "Editor: Li Ang" written on it on the table, and asked peacefully, "What's going on?"
"you mean?"
"Renovation of the Imperial Medical Administration."
Qiu Feng said seriously: "We are very happy about the expansion of the Imperial Medical Office. But why is there no content on syndrome differentiation and treatment in these textbooks?"
At the court meeting of the imperial court, the six ministries have agreed to the proposal of expanding the imperial medical office and recruiting more medical students—the financial appropriation for this purpose is within the acceptable range of the imperial court.
Increasing the quantity and quality of physicians will not do any harm to court officials or interested parties.
Qiu Quan and other physicians in the Imperial Medical Office have long suffered from insufficient funding and insufficient manpower. Li Ang was naturally very happy to bring them more material and manpower.
However, Qiu Feng felt something was wrong the first time she saw the book that Li Ang gave her alone.
"Risheng, it's written in the physical diagnostics book you edited,"
Qiu Feng opened one of the pages, "The causes of fever may include internal hemorrhage, huge hematoma, arthritis, dermatomyositis, pulmonary infarction, limb necrosis, cerebral hemorrhage, etc.
The same fever, accompanied by recurrent chills, may be malaria, sepsis.
With bleeding, it may be a blood disease.
With chest pain, it may be myocarditis, lung abscess.
with abdominal pain, possibly liver abscess”
She raised her head, stared at Li Ang and said seriously: "According to the appearance of the disease, directly delineate the scope of the cause of the disease, without argument or evidence, Risheng, what do you want to do?"
It is no wonder that Qiu Feng reacted strongly. She grew up in the imperial medical office, read all medical books since she was a child, and has a deep understanding of medical theory.
The physical diagnostics compiled by Li Ang seems to use observation, hearing and questioning, but in fact there is no dialectical link at all. Without the Eight Principles Dialectical.
To put it bluntly, Li Ang is highly skilled and bold.
At worst, Li Ang is violating medical principles.
"Sit down and talk."
Li Ang used his thoughts to move the chair, Xingping said calmly: "You and I both come from a family of doctors.
Since Zhang Zhongjing, Central Plains Medicine has established the principle of syndrome differentiation and treatment.
The so-called dialectical treatment,
Refers to the use of observation, hearing, questioning, and four-diagnosis to collect evidence, analyze, summarize, and identify the cause, nature, and location of the disease based on the evidence.
Then according to the dialectical results, determine the corresponding treatment.
Analyze specific issues.
This point, I am right. "
"Um."
Qiu Feng nodded.
"Okay. Then, the dialectical methods of medicine include eight cardinal principles, qi, blood and body fluid, viscera, six meridians, etc.
Among them, the most common and basic is the Eight Principles Dialectical.
Summarize all diseases with eight categories of yin, yang, exterior, interior, cold, heat, deficiency, and excess.
Among them, yin and yang are the general outline.
Summarize the depth and severity of lesions.
Cold and heat describe the nature of the disease.
Fiction and reality describe the state of struggle between the human body and disease. "
Li Ang briefly summarized the most important dialectical link in traditional medical syndrome differentiation and treatment, and said seriously: "The dialectical method based on the eight principles of syndrome differentiation can theoretically summarize and describe all diseases in the world.
It's just that there are no two identical leaves in the world, and there are no two identical patients.
Two cold patients with the same symptoms of chills, fever, and headache,
Due to different living habits, physical health conditions, living environment and other factors,
The etiology of colds may also be different, including wind-cold, wind-heat, summer-dampness, and so on.
Different causes will produce different prescriptions.
The same disease that the same patient suffers from at different times will have different prescriptions.
Even for the same patient, if two doctors diagnose him at the same time, they will prescribe completely different prescriptions.
Thousands of people and thousands of places, right? "
Qiu Feng nodded: "Yes."
"This is where the problem lies."
Li Ang said: "Excellent doctors, such as Zhichang and Feng Yu from the Imperial Medical Bureau and Shangyao Bureau,
Have a deep understanding of medical theory,
Observing the patient's symptoms, he can take a high-level view, observe carefully, and demonstrate repeatedly.
Even if they come to different conclusions and the dialectical process is different, the final medication is still effective.
However, in any field, outstanding people are a minority.
The excellent threshold for syndrome differentiation and treatment is too high. Not only must you read medical books, but also accumulate experience for a long time.
It also requires strong logical reasoning ability and meticulous observation ability, which is not enough to simply read some medical books and recite some prescriptions.
Many quack doctors are either not talented enough, or not thoughtful, or have no heart,
Follow the scriptures, rely purely on experience, and use whatever medicine you see.
Cough is to resolve phlegm and relieve cough, diarrhea is to protect intestines and stop diarrhea, and fire is to nourish yin and clear away heat, so that misdiagnosis, misdiagnosis,
Patients get sick in a daze, take medicine in a daze, die in a daze of running out of money.
Not to mention the kind of people who only think about how to make money.
So that when people got sick, they dared not go to a doctor, and were forced to copy the "Bodhisattva Sutra" and "The Sutra of Exhorting Kindness" to pray for blessings. "
Li Ang shook his head and said, "I once heard a story.
A patient suffered from edema, and the family finally found a famous doctor.
The famous doctor tried to prescribe many medicines, and the medicines were all strange.
In a while, two slices of **** and ten pieces of bamboo leaves will be removed.
After a while, I want reed roots dug by the river, and sugarcane that has been frosted for three years.
Two years passed, and the condition did not improve. The doctor who got enough money sincerely said that he had exhausted his knowledge and introduced another doctor.
He Mingming doctor who is the head of the Xinglin Association in a certain place.
And this doctor named He prescribed even weirder medicines, even asking for a pair of crickets from the same nest,
Finally, the broken drum skin was used to make the so-called defeated drum skin pills.
After eating this way for several years, the patient finally died of edema all over his body, suffering from pain, and most of his family property was lost in the process.
Quack doctors harm people, that's the end of the evil. "
Li Ang's tone was calm, and he silently added the second half of the sentence in his heart.
The patient in the story is named Zhou Boyi, and his son is named Zhou Shuren.
"The complexity and integrity of dialectical treatment, as well as the strict requirements for talent, logic, and observation,
Doomed physician ranks, mixed with fish and dragons,
It is difficult for the common people to distinguish between good doctors and bad doctors. "
When dealing with water poisoning in Suzhou, Li Ang saw with his own eyes, Qiu Jing Qiu Quan and other doctors, using acupuncture to relieve the pain of patients who took antimony potassium tartrate.
Although I don’t understand their medical principles, I still respect their medical skills and medical ethics-the medical skills that can achieve results are good medical skills.
It’s just that because there is no standard answer for syndrome differentiation and treatment, there will always be a place for quack doctors and bad doctors like Yu Miaoshui.
Talented and capable outstanding physicians like Qiu Jing and Qiu Quan are rare in number, and there is a high probability that they exist in the "hearing" and "hearing" of ordinary people.
"In the ranks of doctors, there are always fewer good doctors and more quack doctors. This is a fact of probability and has nothing to do with my likes and dislikes."
Li Angping said peacefully: "That's why I want to innovate."
(end of this chapter)