"Can it, can it be cured?" Yong Hongzhong asked, a mixture of surprise and joy in his voice. He had been tornted by this mysterious ailnt that caused dizziness whenever he squatted, leaving him ntally and physically exhausted. To avoid ridicule, he had deliberately maintained a ramrod-straight posture while standing and sitting. But every night, when he lay down in bed, he still suffered from nausea, sotis even vomiting.
Li Ang nodded calmly. "Hmm."
"Doctor Li, what illness does my lord truly have?" Yong Hongzhong’s personal old servant asked respectfully, his form of address changing from "Young Master" to "Doctor."
Benign Paroxysmal Positional Vertigo. Or, in other words, canalithiasis. Li Ang silently recited the answer in his mind.
As vertebrates, humans maintain balance during movent primarily due to balance-regulating organs in their ears. This organ system is composed of three canals and two sacs. The three canals—the anterior, posterior, and horizontal semicircular canals—are responsible for sensing the head’s angular movents. The two sacs are the utricle and the saccule. Within the structure of these sacs are calcium carbonate crystals, resembling small stones or chalk dust; hence, they are also called "ear stones." These ear stones are usually embedded within the sacs, aiding them in sensing the head’s acceleration and transmitting positional signals through nerves to the central nervous system. It is because of these canals and sacs that humans can "sense" their balance and gravitational state, preventing falls on flat ground or sensations of the world spinning.
However, if for so special reason the ear stones dislodge from the sacs, a chain reaction occurs: the dislodged ear stones float within the endolymph of the inner ear. When the person’s head position changes, these ear stones can abnormally stimulate the hair cells in the semicircular canals. This causes the canals to send incorrect signals to the brain, inducing intense vertigo in the individual. Canalithiasis primarily affects middle-aged individuals, with a slightly higher incidence in won. Potential causes include head trauma, vigorous exercise, chronic sleep deprivation, or middle and inner ear surgeries.
Just now, Li Ang had first ruled out niere’s disease and migraines through physical examination and questioning. Subsequently, he employed the Dix-Hallpike maneuver. By supporting Yong Hongzhong’s head and swiftly guiding him to lie back face-up, he caused the ear stones to contact the semicircular canals, inducing a vertiginous reaction. This finally led to the diagnosis of posterior semicircular canal canalithiasis.
(Posterior semicircular canal canalithiasis ans the ear stones have migrated to the posterior semicircular canal. When this occurs, the Dix-Hallpike maneuver only causes nystagmus when the patient’s head is turned to the affected side while they are lying down; the healthy side will not exhibit nystagmus. In contrast, with anterior semicircular canal canalithiasis, nystagmus would occur on both sides.)
Of course, explaining these processes to the people present was not going to be easy.
Humans rely on stones in their ears to perceive their own position? That’s truly too inconceivable.
He recalled from his Otherworld mories that doctors had discovered canalithiasis by 1921. However, it wasn’t until 1980 that a doctor nad John Appley realized that dislodged ear stones were the cause and began treating patients with repositioning maneuvers. In the interim, doctors "cured" canalithiasis by severing the vestibular nerve, which unfortunately resulted in the patient’s loss of hearing and balance. Moreover, even after John Appley proposed that repositioning maneuvers could cure canalithiasis, his findings were not widely accepted. Instead, he faced exclusion and mockery from his peers, and was even subjected to legal accusations of practicing dicine unlawfully.
Li Ang’s mind raced. It would be difficult to convince the people before him that their ability to sense gravity and positional changes was due to stones in their ears. Even if he managed to convince them, he had no evidence. Instead, he might arouse suspicion that he had secretly engaged in sothing as shocking as dissecting human bodies.
The dical knowledge of Yu Country lagged considerably behind its advancents in architecture, material science, and astronomy. This was partly because the Cultivators of the Academic Palace rarely fell ill and thus had no motivation to advance dical research. Another reason was that dissecting human corpses for research was taboo in both the Forr Sui and the Yu Dynasty, an act considered almost akin to treading the Demon Path.
Li Ang rembered Pu Liuxuan’s advice: first gain admission to the Academic Palace. This would secure social status, a foundation in life, and ultimately, a voice and influence.
A doctor must first protect himself to be able to protect his patients.
In the blink of an eye, Li Ang had formulated an explanation that those around him could accept. Without a change in expression or a skip in his heartbeat, he said, "There are many pathological chanisms for dizziness, but they generally fall into two categories: deficiency and excess. Deficiency usually stems from a lack of qi and blood, insufficient marrow in the brain, or inadequate nourishnt of the clear orifices. Brother Hongzhong, you’ve been studying too intensely lately, expending too much energy. This, combined with a weakened constitution and insufficient blood supply, has led to your dizziness."
"I see," Song Shaoyuan and the others murmured, their expressions conveying a sudden, complete understanding as they nodded thoughtfully.
Qiu Feng, however, sensed that sothing was amiss. Frowning slightly, she looked towards Li Ang, seeming to want to speak but hesitating.
"So... Doctor Li, are you suggesting my sir should eat more at?" Yong Hongzhong’s personal old servant asked respectfully.
Li Ang shook his head. "Eating thoroughly cooked beef, mutton, and fish, and avoiding unboiled water is one aspect. On the other hand, manual repositioning is also necessary as an auxiliary treatnt. This involves rotating the head to allow qi and blood to surge to the head, clearing the pathways there. Only by combining both thods can a complete cure be achieved. Co, Brother Hongzhong, please sit properly again."
Li Ang had Yong Hongzhong sit at the table again. He supported Yong Hongzhong’s head and turned it 45 degrees toward the affected left ear. Then, he applied gentle traction to the head and guided Yong Hongzhong to lie down, with his head slightly extending beyond the edge of the table, the affected left ear facing downwards.
"Brother Hongzhong, look straight ahead of you."
"Risheng, I feel dizzy."
"Feeling dizzy is normal. Don’t worry, I’ve never failed with this repositioning thod."
"Then... how many people have you... have you treated successfully?"
"Congratulations, you’re the first."
Li Ang calmly observed Yong Hongzhong as he lay supine until his vertigo and nystagmus symptoms disappeared. He then turned Yong Hongzhong’s head 45 degrees to the right, observing for another minute until the vertigo and nystagmus subsided again.
"Last step. Turn your head and torso to the right together. Yes, just like that, lie on your side."
Li Ang had Yong Hongzhong lie on his right side, maintaining the position for a minute, and then helped him sit up. "Now, sit still, don’t move. Focus and remain calm."
Yong Hongzhong closed his eyes and sat still obediently. After five minutes, Li Ang allowed him to open his eyes. "Alright, we’re done."
Yong Hongzhong stuttered, "Is it... is it cured just like that?"
"You used to get dizzy when you bent down, didn’t you?" Li Ang said calmly. "Try it now."
With the aid of his personal old servant, Yong Hongzhong cautiously climbed down from the table. As the surrounding crowd watched intently, he slowly bent over and lowered his head. Astonished, he exclaid, "I’m not... I’m not dizzy anymore!"
"WOW—"
"Treating an illness just by turning the head? Is such a thing possible?"
"Incredible..."
Song Shaoyuan listened to the buzz of the crowd, standing proudly beside Li Ang.
Ji Linlang and the other students from Yizhou smiled, a hint of shared pride in their expressions.
The Imperial Physician’s daughter, Qiu Feng, pursed her lips tightly. While she nodded in admiration, her eyes also flashed with a mixture of confusion, stubbornness, and a touch of unwillingness to concede.
"Thank... thank you, Brother Risheng," Yong Hongzhong said emotionally, cupping his hands in a bow towards Li Ang.
Li Ang waved his hand dismissively. "We’re fellow students. It’s nothing to make a fuss about."
"No, I insist. A gentleman must repay acts of kindness." Without waiting for an objection, Yong Hongzhong untied a flawless white Jade Pendant, carved in the shape of a fish, from his waist. He pressed it firmly into Li Ang’s hand, patting the back of Li Ang’s hand repeatedly in gratitude.
"Brother Hongzhong, you’re too kind." Li Ang managed an embarrassed yet polite business-like smile, his sharp ears catching the muttered words of a slightly chubby student in the crowd, "Wow, Yutian Soft Jade..."
Yutian Soft Jade? Is it very valuable? Li Ang mused idly on the gift’s worth.
Yong Hongzhong paused for a mont, as if just rembering sothing. He then turned and spoke respectfully to a richly dressed young woman on the other side of the crowd, "And... and thank you also to Dr. Qiu and... and Princess Le’an."
"What ’Commandery Princess’? Just call cousin," the young woman known as Princess Le’an said, smiling warmly and kindly at Yong Hongzhong. Her gaze swept accurately over everyone present, keenly observing their expressions, including the peculiar look in Li Ang’s eyes.
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