On the podium, Yun Heng continued to explain.
"In clinical practice, we don't recommend substituting modern medical disease names, but we can use some modern medical disease names as a reference for symptoms. The patient also has colitis, dry mouth, and bitter taste in the mouth. Combining this with the pulse and symptoms, we can conclude that in addition to hyperactivity of liver yang, the patient also has a deficiency of yin and yang, and an upward surge of yin fire..."
"Xiaoyun chose a very good medical record."
Qu Tongwen and Ji Fengwen were talking in low voices.
"Um."
Qu Tongwen nodded. "This condition isn't overly complicated. The patient's symptoms of hyperactivity of liver yang are quite obvious, but due to poor diagnostic guidance, it's easy to overlook this, leading to an incomplete diagnosis. This case history clearly illustrates the importance of combining the four diagnostic methods."
"yes."
Ji Fengwen said: "Although it was just a small oversight, the consequences were significant."
On the stage, Yun Heng continued to explain: "Liver Yang is rising, Yin and Yang are sinking, and Yin Fire is rushing upwards. Therefore, the treatment strategy is completely different. The original method should be to nourish Yin and suppress Yang, but now it should be changed to raising clear Yang and dispersing Yin Fire, while also extinguishing liver wind, nourishing Yin and blood, and suppressing liver Yang."
The group of doctors in the demonstration room nodded.
Everyone had a very clear understanding of this medical record, and Yun Heng also analyzed it very clearly. It was precisely because a certain expert in the medical record was overconfident that he asked questions without thinking and made a decisive conclusion, which led to an incomplete diagnosis.
"Old Ma, you can make such a mistake?"
Liang Wanming asked Ma Tiequan softly, "You're a veteran, but you ended up capsizing in a ditch?"
"Mr. Liang, if you frame me again, I'll turn against you, don't you believe it?"
Ma Tiequan glared at Liang Wanming and said, "Damn it! That's too much! What gives you the right to say that the expert on this medical record is me?"
"Haha, just kidding."
Liang Wanming was actually not sure, which meant he did it on purpose. Now that Ma Tiequan was obviously a little embarrassed and angry, Liang Wanming became certain instead.
Let’s not talk about that. Lao Ma is a very proud person. If this kind of thing really gets out, given Lao Ma’s personality, he might really turn against him.
A higher-ranking official can crush a lower-ranking official. Since Lao Ma is the chairman, he has to be timid.
"Therefore, when prescribing and treating patients based on syndrome differentiation, the accuracy and comprehensiveness of information are paramount. Only by observing, smelling, asking, and palpating, and adhering to the basic principles of TCM's syndrome differentiation and treatment, can we reduce misdiagnosis in clinical practice and ensure the longevity of TCM."
Yun Heng continued on the podium, "With the changing times, Chinese medicine needs to be constantly improved and cannot remain closed off. This is as it should be. However, at all times, priorities must be clearly distinguished and the cart before the horse must be put. If in actual clinical practice, we rely solely on auxiliary examinations with modern equipment and instruments, and lose the purpose of traditional medicine, do not pay attention to the four examinations, do not emphasize dialectical analysis, and even completely adopt Western medicine, this is equivalent to completely abandoning the foundation of Chinese medicine. In this case, it is better to learn Western medicine to avoid misleading others and ourselves."
As he spoke, the picture on the display screen changed and a new medical record appeared.
"Everyone, please look at this medical record..."
The second case Yun Heng talked about was a syndrome of heat entering the blood chamber that he encountered during training at Tanghua Hospital.
At the beginning, Yue Shaojiang and others made the mistake of preconceived ideas. Based on the patient's external symptoms and the characteristics of the patient catching cold during menstruation, they believed that the patient had heat entering the blood chamber, but ignored the patient's previous treatment.
This symptom is also very telling.
Yue Shaojiang and Ren Xuedong both knew about this case, but other doctors in West Asia Hospital were not very clear about it. Xu Bo had heard of it, but it was the first time for the young doctors in the inspection team to hear about it.
"Heat entering the blood chamber?"
"Just now, when I saw it, I also thought it was heat entering the blood chamber. The symptoms were too obvious."
"Yes, who says it isn't? Catching a cold during menstruation, becoming delirious, and talking nonsense are all signs of heat entering the blood chamber."
Since it was an explanation of Bingfan, Yun Heng had already arranged it when he was scheduling the shifts, so when the patient information was displayed on the big screen, it was done step by step, and some key information was hidden at the back, so that the problem could be explained.
Now it is an explanation, so there is no question-and-answer session, just like a teacher giving a lecture.
But when the teacher was explaining the questions, some smart students would start to check and think on their own while the teacher was explaining. At this moment, the young doctors in the demonstration room were all the best from major hospitals, and many of them were thinking based on the information displayed on the big screen.
"I just mentioned earlier that the patient had received treatment before, but I didn't think to ask or look at the patient's previous treatment history."
Luo Yahui and Pang Zhibo were talking in low voices.
"I also ignored it, but I knew that Yun Heng took out this medical record, it must not be that simple. I thought about it over and over again, but I couldn't figure out what was wrong. It turned out to be the previous treatment."
"Yes, heat entering the blood chamber, and misusing medicine to regulate qi and blood, this is a relatively common mistake, but we didn't even think to ask."
Luo Yahui nodded.
“This case is very good.
Several experts including Zhu Senqiang were also communicating.
The medical case that Yun Heng talked about before was very good, and this medical case is even better. Both can explain the problem in a practical way.
"The patient meets the criteria for heat invading the blood chamber in all aspects. In this case, many doctors may have decisively concluded that it is heat invading the blood chamber."
Yue Shaojiang lowered his head.
"But we continue to see that the patient has previously been treated with drugs to regulate qi and blood. This point is very critical."
Yun Heng continued, "Observation, auscultation, questioning, and palpation—each step is crucial. Sometimes, a detail we consider insignificant may reveal a more crucial issue. Asking about the patient's medical history and reviewing their previous medical records can lead to completely different results."
"Li Zhongzi's Neijing Zhiyao says that the pulse is a sign of the blood. There are countless different pathological conditions. To measure their changes with just three fingers is a skill that only the most skilled in the world can achieve."
Yun Heng said slowly, "The meaning of this sentence is very clear. Although pulse diagnosis can detect the signs of Qi and blood, the meridians, and pathological conditions, there are countless pathological conditions with many variations. It is not so easy to judge the changes with just three fingers. Looking across the country, how many people can reach this level?"
"So, if you want to diagnose a pulse correctly, you must combine the four examinations, corroborate and verify each other. First, observe the complexion, then listen to the ears, smell the nose, and then feel the body. Finally, feel the pulse with your fingers..."
"Since ancient times, there has been a saying that pulse diagnosis can hinder medical treatment. In fact, it is more than just pulse diagnosis. The four examinations alone are not in line with the principles of traditional Chinese medicine. If inaccurate and incomplete information is obtained, then the diagnosis will inevitably go wrong. If the diagnosis is wrong, the medication will not save the patient, but will harm him."
As he spoke, the picture on the big screen changed again, and a new medical record appeared.
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