By then, he wouldn’t be treated this well.
He must seize the mont to crazily improve himself.
Even at that ti, when others co, he might already have the ability to consult independently.
In this way, the gap will naturally widen.
Thinking of this, Ji Xiuwen felt extrely excited, but soon cald down, knowing that whether he could stand out depended on his own efforts.
Just like Lu Xuan said, if he didn’t attend the gathering, he could learn a lot at ho in one day. The key was that he could review the cases and dical records he encountered last week several tis to enhance his mory.
Instead of wasting ti on indulgences and neglecting important matters.
Seeing Ji Xiuwen so serious, Lu Xuan didn’t say much more, but continued, "You should know how to treat damp-heat arthritis, right?"
"The main treatnt is to clear heat and expel dampness," Ji Xiuwen thought for a mont and replied.
Lu Xuan nodded slightly and continued, "This condition is ntioned in the ’Essential Prescriptions of the Golden Cabinet Treatnt of Wind-Strokes and Arthritis’, ’In corpulent individuals, the pulse is choppy and small, shortness of breath, spontaneous sweating, joint pain making flexion and extension difficult, all caused by drinking alcohol, sweating and exposure to wind’.
Overweight persons generally have qi deficiency, unstable exterior, hence spontaneous sweating, prone to Wind Evil, coupled with high-calorie food and alcohol, competing with wind, stasis in the joints causing unbearable pain like being bitten by a tiger.
Zhu Danxi’s explanation of the pathogenesis of gout is the clearest, holding that in gout, heat affects the blood, boiling it, then exposed to cold water, standing on wet ground, seeking ventilation with fans, or sleeping in windy places, cold and dampness externally assailing, hot blood encountering cold, turbid and stagnant, causing pain, which worsens at night, as it travels through Yin channels.
Why?"
Lu Xuan answered himself, "Because at night, the body’s tabolism is slower, so dampness and turbid accumulates in the joints causing pain that is hard to endure. This is as stated in the Comntary on the Golden Cabinet Essentials, ’In corpulent persons, the pulse is choppy and small, indicative of blockage; dampness causes shortness of breath, Wind causes spontaneous sweating, qi and blood obstructed by evil, causing pain and difficulty in flexion and extension. However in corpulent persons, due to much damp, how is the pulse small and choppy, is it not the constraint from wine-dampness? Why does pain intensify and sweating persist, is it not carried with dampness? Pulse and signs differ, but the reason is Wind, hence it’s said: All these are caused by drinking alcohol and exposure to wind’.
Ji Xiuwen remained silent, very calm.
He was now used to Lu Xuan’s ability to quote various dical texts fluently, feeling envy for sure, but knowing he couldn’t do it, achieving recitation of the Inner Canon within a year was already comndable.
As for other dical texts, he could only study and understand occasionally.
Seeing this, Lu Xuan said no more and took Chen Xinghua’s dical record.
Diagnosis: Gout (acute phase) with damp-heat obstruction.
Treatnt principle: clear heat and expel dampness, reduce swelling, unblock collaterals and relieve pain.
Modified Four Marvels Powder, with added baked Amur Corktree Bark, fried Atractylodes, Scrophularia, Wintergreen Vine, Danggui, red peony, River cow knee, Parthenocissus, Spatholobus Suberectus, Fuling, Fangji, and Plantago Seed (decoct in a bag).
After writing, Lu Xuan double-checked to ensure the prescription was correct before handing the dical record to Su Kenan for system entry.
Ji Xiuwen, anwhile, curiously glanced upwards.
However, from this position, and being across, even if he could see the handwriting, he couldn’t discern what dicine was prescribed, seeing this, Lu Xuan explained:
"Using Modified Four Marvels Powder. Within it, baked Amur Corktree Bark, fried Atractylodes, Fuling, and Fangji clear heat, expel dampness and dry dampness. Danggui and red peony invigorate blood, remove stasis, reduce swelling and relieve pain. Wintergreen Vine, Spatholobus Suberectus, Parthenocissus promote circulation and relieve pain, reduce swelling and clear heat. River cow knee guides all dicines to ridians, good for treating damp-heat descending, foot and knee redness and swelling. It should effectively treat gout.
However, gout commonly manifests as damp pain, but there are differences like blood heat obstruction, phlegm turbidity obstruction, liver and kidney Yin deficiency. Treatnts vary; however, the principle remains to clear heat, unblocked collaterals, reduce swelling, expel dampness and transform turbidity mainly, adjusting with additions and subtractions as needed, not sticking rigidly to one formula, but adapting flexibly to achieve efficacy.
For example, in cases of burning skin, add Anemarrhena to clear heat and drain fire, nourish Yin and moisten dryness; for swollen ankles, add Five-leaf Ginseng Bark; for fever with bitter taste, add Chaihu and Scutellaria baicalensis to clear heat, dry dampness, and detoxify; for constipation, add rhubarb and Cistanche to lubricate intestines and facilitate bowel movents."
After Lu Xuan finished speaking, Su Kenan had already entered the information, and after Chen Xinghua scanned to pay, Ji Xiuwen was about to get up and take the paynt slip to fetch the dicine when, unexpectedly, Su Kenan had already gotten up and headed to the pharmacy.
Standing, Ji Xiuwen paused, looking at Lu Xuan in surprise.
"Let her be."
Taking advantage of Kenan’s trip to fetch dicine, Lu Xuan advised Chen Xinghua, "Once you get the dicine, go back and decoct it. You can also have it decocted on behalf, but there will be a fee for that."
"I’ll take it ho."
Chen Xinghua quickly said, as he also wanted it decocted on behalf, but given his limited mobility, he couldn’t co back to the Health Center, so he decided to take it ho first.
Lu Xuan nodded and continued, "Rember to avoid certain foods, you should know what to eat and what not to eat, otherwise, if it progresses to tophi, it will be even more painful than now, and if Chinese dicine can’t clear tophi, it requires surgical removal."
"I will rember, and definitely avoid certain foods."
"When decocting at ho, Plantago Seed belongs to seed-category Chinese dicine, often containing large amounts of mucilage, so it needs to be decocted in a bag, no need to open it, this will be reminded by the dispensing doctor as well."
"Okay, okay."
Chen Xinghua noted all this carefully in his mind.
Lu Xuan didn’t say much more, directly instructing Chen Xinghua to wait at the dicine collection window, then moved to the computer to call the next number.
Unexpectedly, when the second patient ca in, Su Kenan also ca out of the pharmacy, surprising both Lu Xuan and Ji Xiuwen.
Ji Xiuwen could sowhat understand fast prescription grasping, given he had done it for a week and was familiar with prescriptions, but it was Kenan’s first ti in the pharmacy, yet she was unexpectedly fast.
However, there was no ti for curiosity now, as the second patient had already sat in front of Lu Xuan, speaking about their condition.
Lu Xuan had to suppress his curiosity and listen carefully.
At this mont,
Hu iqiao parked her car in the underground parking lot of the building, took the elevator to the 7th floor.
Arriving at the old leader’s office, the door was closed, but Hu iqiao knew the old leader was inside, as she had confird via phone beforehand.
She even made an appointnt a day in advance.
Otherwise, if she ca directly, she likely wouldn’t et him.
Walking up, Hu iqiao took a breath and gently knocked on the door a few tis.
After a short while, a strong, energetic voice ca from inside, "Co in."
Hu iqiao pushed the door open, seeing a middle-aged man in his forties sitting inside, and smiled as she said, "Old leader, busy, huh."
Hu iqiao’s old leader, Ma Shanjun, was now the head of the district health bureau, in his forties, with a promising future. He appeared young and was efficient and decisive, with a commanding presence.
Ma Shanjun also ca from the dical system, having transitioned from deputy chief physician to administrative work, later moving from the hospital to the administrative system, now serving as the head of the district health bureau.
When Ma Shanjun was a deputy chief physician, Hu iqiao was his subordinate, so he was considered her old leader.
Naturally, Ma Shanjun took extra care of his forr subordinate.
Otherwise, he wouldn’t have specifically set aside a morning to wait for Hu iqiao to visit.
Hearing iqiao’s voice, Ma Shanjun looked up, sowhat annoyed, "Don’t know if I’m busy, but there’s one thing I’m sure of, Dean Hu only cos when there’s sothing troubleso."
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