Before explaining this problem, we must talk about pus. Where would a pustule come from without pus? Pus accumulates like a reservoir and turns into a pustule.
Where does pus come from?
Pus is the "stuff" formed during inflammation of the body's tissues.
This "thing" is a thick or watery-thin mixture visible to our naked eyes, basically in a liquid state.
The specific components contained in it are mainly pus cells.
Pus cells are white blood cells that have been sacrificed by the human body in a fierce battle with bacteria.
In addition to pus cells, there are a large number of bacteria, necrotic tissue fragments and exudate.
From the above descriptive words, we can draw the conclusion that it arises from the inflammatory process of the human body, but it is not inevitable.
Does inflammation necessarily produce pus? Not necessarily.
Corresponding to Western medicine and Chinese medicine, when there is inflammation and no pus or pustules, it is natural to focus on anti-inflammation.
Especially in Traditional Chinese Medicine and Surgery, it is clearly stated that elimination method is suitable at this stage.
Another question arises, if pus and pustules develop, will the inflammation not be cured?
That is also incredibly wrong.
If it is still difficult to understand the above statement, you can take a common disease that is well-known to almost everyone: acne on the face.
Pustular acne is the most common type of pustule.
We know that pustules and acne will break out on their own when they grow to a certain stage.
Regardless of whether the pustules and acne break out on their own, the doctor will usually prescribe antibiotic ointment or even oral antibiotics. This shows that it is correct to use antibiotics to treat inflammation in the human body from beginning to end.
So is it wrong for Dr. Ma to prescribe anti-inflammatory injections? That’s right.
Let's use this example to compare another point we all know. It is often reported in the news that some people have unbroken pustules and acne and need to go to the hospital for surgery to remove them.
This shows that if the pustule is not broken by itself, and if it is ignored and only reduces inflammation, it will be useless, and in the end it will require surgery to remove a big scar.
In other words, when the pustule reaches a certain stage, if it does not break by itself, surgical intervention is required. Both Western medicine and traditional Chinese medicine have very clear research results on this point: the pus must be incised and drained.
Do you think Dr. Ma doesn’t understand the above statement? You can’t say he doesn’t understand it.
Now comes the most critical question: how to determine what stage the pustule is currently at.
Being looked at expectantly by the eyes of Dr. Xie and Dr. Wen, as if being looked at by a teacher in class, Dr. Ma recalled the classroom knowledge and suddenly realized that he had made a basic mistake.
Is just observing with a medical flashlight enough to make a judgment?
In medical physical examination, the most important thing in this case is palpation. So you can understand why the gold standard of physical examination for appendicitis is McFarland's point during palpation.
If you have appendicitis, if you don’t have a physical examination, it’s not impossible to rely on more advanced medical equipment such as a CT machine to replace your doctor’s physical examination.
If you order a CT examination for a small pustule like this? Everyone in the clinic will laugh. It will make your surgical diagnosis skills super incompetent. Because such a pustule does not grow outside like appendicitis, your doctor's hands are always available
You can judge by touch.
If you really can't, it's just like what the common people are mocking. With machines, doctors won't be able to treat you anymore.
To sum up, Dr. Tam should have put on gloves to palpate the pustule at that time. It is impossible to identify the pustule carefully by just visual examination. It is necessary to feel the fluctuation of the pustule and see the patient's specific pain condition before making a judgment.