Pan Qingguo was a little lucky. Wang Xialin had a very good reputation in Tangdu Hospital. As long as he was for patients, Wang Xialin was easy to talk to and didn't have much airs. If this was Li Zhengshou, Pan Qingguo would be proud of it.
"Director Wang, the patient's previous examination and treatment information are all here. Can you let me take a look?"
After entering the consultation room, Fang Le said to Wang Xialin politely.
Wang Xialin was really easy to talk to. He turned around and said to the resident doctor who was following him: "Go get the patient's medical records."
The resident doctor hurriedly went to get the patient's medical records. In addition to the examinations done at Tangdu Hospital from last night to now, the patient's previous treatment was also at Tangdu Hospital, so he took them all.
A thick stack.
Fang Le took the information and read it carefully.
There is little difference with Fang Lechai. The patient had been in Gaotang County Hospital for a month, mainly for anti-tuberculosis treatment, targeting pulmonary infectious tuberculosis caused by Mycobacterium tuberculosis.
Anti-tuberculosis drugs have very serious side effects, especially damage to the gastrointestinal tract, which can cause patients to experience nausea, vomiting, upper abdominal discomfort, abdominal pain, diarrhea and other symptoms.
The patient's symptoms such as lack of appetite, vomiting and nausea can be said to be caused by long-term anti-tuberculosis treatment.
Of course, judging from the medical records, the patient's appetite was not good before admission, and his symptoms worsened after anti-tuberculosis treatment.
"Did the patient have any problems before the initial symptoms appeared, a family dispute, or an accident?"
Fang Le asked.
"Dr. Fang didn't understand the situation when he was on the road?"
Wang Xialin glanced at Fang Le in surprise and asked calmly.
"It was dark at the time and there was nothing visible. The patient's family was obviously very vigilant, so I didn't say I was a doctor."
Fang Le said with a smile: "And even if I say it, my age may make patients more vigilant."
Fang Le looks young, but he is very sophisticated in people's ways.
Before his rebirth, Fang Le's first exposure to Chinese medicine was traditional Chinese medicine, and Fang Le didn't learn Chinese medicine from one person. Basically, he didn't learn it for a long time. His father's teacher Guo Wenyuan passed away at the age of nearly ninety, so Fang Le
I don’t know much about Guo Wenyuan.
But Fang Le's grandfather Fang Yuanchen was ninety-seven when he passed away. Fang Le initially learned some basics from Fang Yuanchen, Professor Guan Baochengguan from the medical school, and his father Fang Han.
At the same time, several famous traditional Chinese medicine experts in Jiangzhou Province at that time also liked Fang Le very much, and they all taught Fang Le something.
So many people teach that different people have different ideas, which also led to Fang Le's thinking when he was a child being unconventional and able to draw inferences from one example.
In the car at that time, Fang Le did not say that he was a doctor, but out of various considerations, if Fang Le was the age of Wang Xialin and Pan Qingguo, he would have mentioned it.
"We have asked about this."
Wang Xialin said: "The patient has a son who is eight years old this year. The patient's onset of illness occurred six months after the second miscarriage... The second miscarriage resulted in excessive blood loss and multiple anemic shocks occurred after the miscarriage.
"
"Miscarriage and blood loss, excessive sadness, and long-term emotional depression..."
Fang Le has now figured out some issues that he had not yet figured out.
TCM diagnosis relies more on the doctor's experience and judgment. Therefore, when diagnosing a disease, TCM doctors must ask clearly about the antecedents and consequences, the origin and course of the disease, changes in the course of the disease, etc. These are all crucial.
In the ward just now, Fang Le had already seen a lot of problems, but as for the cause of the patient's illness, Fang Le was still a little unsure, but now he is basically certain.
"Did you use Chinese medicine last night?"
Fang Le looked at the previous treatment at Gaotang County Hospital, and then looked at the treatment at Tangdu Hospital last night.
After the patient arrived at the hospital, he underwent an X-ray examination, as well as blood and urine tests. The X-ray examination showed infiltrative tuberculosis in the right lung...
The treatment plan includes not only Western anti-tuberculosis drugs, infusions to supplement nutrition, but also Chinese medicine combined treatment.
"Yes, we also invited the Traditional Chinese Medicine Department for consultation last night."
Wang Xialin asked Fang Le: "Any questions?"
"The patient already has diarrhea. How can he use bitter and cold medicine to damage the stomach yang? Fortunately, I thought of it today and came here to try it. Otherwise, within three days of this, the patient's stomach qi will be cut off and there will be no medicine or stone to cure it."
Fang Le's tone was a bit heavy when he spoke.
Although Fang Le did not inquire about the patient's condition in detail last night, Fang Le also observed the patient's condition while taking care of him, and took the time to feel his pulse. He confirmed that the patient's condition was not too dangerous at that time, and then he left with confidence.
But when I checked again just now, I found that the patient's condition had changed too much, and it could be said that the disease progressed too quickly.
Fang Le thought it was caused by the continued use of anti-tuberculosis drugs. After reading the medical records just now, he realized that the patient also used traditional Chinese medicine.
"You are young and you are not ashamed to speak loudly."
As soon as Fang Le finished speaking, a middle-aged doctor about fifty years old came in at the door of the consultation room. When the middle-aged doctor entered the door, his face was gloomy and he snorted unceremoniously.
"Director Fang!"
Wang Xialin smiled and said hello to the middle-aged doctor, and then introduced to Fang Le: "Director Fang Manliangfang of the Department of Traditional Chinese Medicine."
The visitor is Fang Manliang, deputy director and deputy chief physician of the Department of Traditional Chinese Medicine, who still has the same surname as Fang Le.
When Fang Manliang came here just now, he didn't have much temper. But as soon as he arrived at the door of the consultation room, he heard Fang Le's comments, and his temper instantly rose.
Especially when I saw Fang Le's age, twenty-two or thirty years old, at best a medical student who had just graduated from medical school, he was so brazen about the bitter cold medicine he used.
"Hello, Director Fang."
Fang Le greeted Fang Manliang very politely.
"Don't dare to take it seriously."
Fang Manliang still had a droopy face and asked Wang Xialin: "Director Wang, you invited me over this late at night, are you just asking me to listen to the comments of such a young man?"
Hearing Fang Le's comment as soon as he entered the door, Fang Manliang was very angry and didn't care that Fang Le was there at all. I just said that, what can you do?
"Director Fang, I invite you here late at night to discuss the patient's condition."
Wang Xialin has a good temper and said with a smile.
"Discuss the illness?"
Fang Manliang chuckled: "Then I would like to ask, why is the prescription I prescribed inappropriate and why is it bitter and cold?"
"Is the prescription prescribed by Director Fang?" Fang Le asked.
"yes."
Fang Manliang nodded and stared at Fang Le with a clear meaning: "I drove it, what's wrong?"
"Pulsatilla soup, am I right?" Fang Le asked.
"Yes, it's Pulsatilla soup."
Fang Manliang nodded again: "Pulsatilla decoction can clear away heat and detoxify, and has the effect of cooling blood and stopping dysentery. Is there anything wrong with it?"
"The patient's complexion is gray and his breath is dying. He has had symptoms of anemic shock many times before. He has lost too much blood and his righteousness has been depleted. It should be that the evil has become tuberculosis..."
Fang Le stood up, looked at Fang Manliang, and asked one word at a time: "Then please tell me, Director Fang, in this case, a heat-clearing agent is used to clear away heat and detoxify, but the prescription does not include any strengthening and nourishing elements to strengthen the body and eliminate evil."
Is it appropriate to use the medicinal materials in this way?"
Fang Manliang's mouth opened slightly.
He didn't consider this issue.
Last night's treatment was a combination of Chinese and Western medicine. Western medicine targeted tuberculosis, which is tuberculosis, using anti-tuberculosis drugs while replenishing energy and body fluids. Chinese medicine targeted the patient's diarrhea, so Fang Manliang prescribed Pulsatilla Decoction.
From the very beginning, when Fang Manliang used the medicine, he only treated the patient's diarrhea without considering the overall situation, which was already wrong, but Fang Manliang did not realize it.
Now that Fang Le asked this question, Fang Manliang was speechless.
"So Director Fang, tell me whether Pulsatilla is a bitter cold medicine?"
Fang Le also snorted: "That is to say, the patient is young, about thirty years old, and in good health. Although the stomach yang is consumed, there is no crisis in a short period of time. If it were a person in his fifties or sixties, this dose would
After the medicine is gone, the stomach qi is gone, and all that is left is to prepare for the funeral."
"Director Wang, is this what you mean by discussing the condition?"
Fang Manliang's expression turned ugly when he was scolded by Fang Le, and he asked Wang Xialin directly.
"Director Wang, aren't we just discussing the condition right now?"
Pan Qingguo knew it was time for him to come forward, so he said with a smile, and then introduced to Fang Manliang: "Fang Le is from Xijing Hospital, and he is also a student of Sun Qingping and Sun Lao. He has high attainments in traditional Chinese medicine. He is currently discussing with Director Wang.
Take medicine, am I listening correctly?"
Even though he and Fang Manliang were from the same hospital, Pan Qingguo couldn't care less about it at the moment. He had no intention of studying Chinese medicine with Fang Manliang. Besides, even if he studied Chinese medicine, wouldn't Fang Le know how to do it?
It seems to be of a higher standard than Fang Manliang.
"?"
Fang Manliang's heart skipped a beat.
"Sun Qingping's student?"
If this were Sun Qingping's student, then he would be a bit hasty.
Before 2000, there were more old rules, and aspects such as teacher-to-teacher inheritance were stricter. At this time, the proportion of traditional Chinese medicine practitioners was still relatively high.
At this time, it has only been about ten years since the college entrance examination was resumed, and highly educated talents are still quite scarce across the country. Top students with master's degrees can only be found in some top-level hospitals, and top students with bachelor's degrees can only be found in county-level hospitals.
It is precisely because there are few highly educated talents and there is no unified physician qualification assessment nationwide that during this period, a large part of traditional Chinese medicine still followed the traditional model of inheritance from master to master.
Sun Qingping was well-known, senior, and had a high status in Qinzhou Province. The status of Fang Le, Sun Qingping's student, naturally rose accordingly.
At Cheng Zaiming's house, Fang Le beat snakes and followed the stick, and established a master-disciple relationship with Sun Qingping. This was actually what he valued.
"Why is Director Pan here?"
Although he was a little bit embarrassed and felt that he had been rash just now, Fang Manliang was still very stable. Is it possible that he immediately admitted his mistake to Fang Le, a young man, and apologized?
"I came here with Dr. Fang, who is also proficient in surgery." Pan Qingguo said with a smile.
Fang Manliang: "..."
Is it any wonder that someone named Pan also gave support to Fang Le?