Rebirth 1977 Great Era

Chapter 688: She has lost her gallbladder. What bile-boosting medicine are you prescribing? (Monthly ticket plus more)
"That's not right, Senior Brother Zhang!" Facing the aggressive Zhang Shouchang, Fang Yan did not choose to answer his question, but instead asked Zhang Shouchang questions.

After hearing Fangyan's words, Zhang Shoucheng was a little confused and asked:

"Huh? What's wrong?"

Fangyan pointed at the words on the medical record and said:

"There is something wrong with your medical records. The patient you just wrote had a cholecystectomy in 1968, but 1968 to 1978 was only 10 years. How did you write decades?"

“……” Zhang Shouchang was speechless.

However, in response to Fang Yan's sincere question, he admitted:

"Okay, I'm not rigorous. I'll change it."

As he spoke, he began to make changes on it.

After being interrupted, Zhang Shouchang lost a lot of momentum.

It even feels a bit awkward.

At this time Fang Yan asked Zhang Shouchang again:
"I wonder what prescription Senior Brother Zhang prescribed the second time? How did he diagnose the symptoms?"

After Zhang Shouchang finished editing the things in his hand, he turned to the second page and said to Fang Yan:

"The main cause of the patient's illness was intestinal dryness and heat, insufficient body fluid, and intestinal conduction disorders, so I prescribed Ma Zi Ren Wan."

After that, he explained in dialect:

"Ma Zi Ren Wan comes from Treatise on Febrile Diseases, which has the functions of moistening the intestines, purging heat, promoting qi and relieving constipation. The patient also suffered from long-term constipation and emotional distress, and showed signs of liver depression, qi stagnation and heat transformation, so Sini San was used in combination to soothe the liver and regulate qi, and Xiangfu and Yu Jin were added to enhance the ability to soothe the liver and resolve depression, so as to regulate qi and help relieve constipation."

When Fang Yan saw the prescription Zhang Shouchang had written for the second visit, he whispered:
"15g of hemp seed, 15g of peony root, 10g of immature bitter orange, 6g of rhubarb, 10g of magnolia bark, 10g of apricot kernel, 10g of bupleurum root, 15g of white peony root, 6g of liquorice root, 10g of cyperus rotundus, 10g of turmeric, 15g of hemp seed, 15g of trichosanthes seed..."

After speaking in dialect, he nodded and commented:
"Well, hemp seeds, hemp seeds, and trichosanthes seeds moisten the intestines and promote bowel movements; peony nourishes yin and harmonizes the interior; immature bitter orange and magnolia bark promote qi and relieve stagnation; rhubarb relieves heat and promotes bowel movements. Bupleurum, white peony, and liquorice soothe the liver and regulate qi, while cyperus rotundus and curcuma enhance soothing the liver and relieving depression. That's a good idea."

"..." Zhang Shouchang opened his mouth, feeling very annoyed. He came to ask Fangyan how he wrote the prescription, but now Fangyan didn't reveal a word, but instead looked at his whole side.

I also gave a review while I was at it.

He wanted to be angry, but he felt he had no right to do so.

Anyway, from the moment he entered the house until now, his moves have been broken.

The momentum is almost reaching its limit.

At this time, Old Liu at the side asked Fang Yan:

"How do you prescribe a prescription, then, Fangyan?"

Fangyan pretended to think, then said:

"You're talking about this patient. Actually, I just recalled it and I still have some impression of him."

Then Fangyan said:
"When she came to me, she just told me that she had been constipated for a long time and had her gallbladder removed. She also had pain in her wrists, elbows, knees, ankles and other joints. She ate less, and after six or seven days of bowel movements, she would eat a little more. She had a bitter taste in her mouth and liked to drink hot drinks. She also had frequent epigastric pain and dizziness."

"After my examination, I found that it was probably due to stagnation of damp-heat in the liver and gallbladder, and disharmony of qi and blood. In simple terms, this case is actually due to stagnation of qi in the liver, obstruction of the pivot function of the Shaoyang meridian, and stagnation and failure of the mechanism of qi going out, entering, rising, and falling, which led to dry and hard stools and difficult and sluggish defecation."

"So when I was treating the patient, I focused on the connection between the physiological functions of the liver and gallbladder and the gastrointestinal conduction function, and used the method of 'treating the disease from below' to restore the gastrointestinal conduction and transportation functions to normal. This way, the bowel movements would be smooth and the disease would be cured."

After hearing the dialect, Zhang Shouchang asked him:

"Then what recipe did you use?" Fang Yan said:

"I wrote the prescription myself and did not use any traditional Chinese medicine."

Fangyan knew that if he didn't say it, the other party would definitely not let it go, and might even come back to him later.

So he didn't wait for the other party to ask, and said:
"I remember it was... 15 grams of angelica, 15 grams of white peony root, 24 grams of centipede grass, 12 grams of golden bell charcoal (fried Chuanlianzi), 12 grams of Artemisia capillaris, 9 grams of Curcuma aromatica, 6 grams of Picrorhizoma. 9 grams of Scutellaria baicalensis, 9 grams of costusroot, 9 grams of Citrus aurantium, 6 grams of Jiujun (wine-processed rhubarb), 12 grams of lotus leaf, and 6 grams of licorice."

After hearing the words in tongues.

Zhang Shouchang quickly wrote down all the medicines that Fangyan had just mentioned.

Then I compared it with the prescription I prescribed.

Old Liu at the side was the first to comment:
"In fact, these two prescriptions are similar in style, both focusing on the effects of soothing the liver and regulating qi."

"In the combination of Ma Zi Ren Wan and Sini San, Sini San can soothe the liver and regulate qi, and relieve the discomfort caused by liver depression and qi stagnation; the drugs in the above prescription, such as Curcuma, Jinlingtan (fried Chuanlianzi), Aucklandia, and Citrus aurantium, also have the effects of soothing the liver and regulating qi, promoting qi and relieving pain, and can regulate the liver qi and improve the symptoms of fullness and pain in the ribs caused by liver qi stagnation."

"And they both have the effect of promoting bowel movements."

"Ma Zi Ren Wan itself is a prescription for moistening the intestines, purging heat, promoting qi and relieving constipation. Among them, hemp seeds and hemp seeds can moisten the intestines, while rhubarb, bitter orange, and magnolia bark can relieve constipation."

"In the dialect prescription, Jiujun (wine-processed rhubarb) can purge and attack the accumulation, promoting the discharge of intestinal stagnation. At the same time, drugs such as Centella asiatica and Artemisia capillaris can clear away dampness and heat, and also help improve intestinal function and relieve constipation."

After hearing this, Lao Lu also nodded and said:
"Yes, the same blending drugs were used."

"The licorice in your Xiao Zhang's Ma Zi Ren Wan combined with Sini San can harmonize the other medicines and make the prescription more mild."

"In the prescriptions prescribed in our dialect, licorice also plays a role in harmonizing the various medicines, and lotus leaves can promote the clear yang, regulate the rise and fall of qi, and assist the various medicines to work better. Both of their prescriptions focus on the overall coordination of the prescription."

After hearing what Lu Donghua said, Old Liu nodded.

Fang Yan also took the opportunity to say to Zhang Shouchang:
"Brother Zhang, actually, our prescriptions are similar. It's just that the patient didn't use your prescription and chose to use mine instead."

Zhang Shouchang didn't say anything. He stared at the two prescriptions in his hands.

After a few seconds, he shook his head:

"Still not right!"

After hearing this, Fangyan said helplessly:
"What's wrong again?"

Zhang Shouchang pointed to the recipe in dialect and said:
"My prescription is mainly based on the drugs of Maziren Pills and Sini Powder, and I also add some auxiliary liver-soothing and qi-regulating or intestinal-moistening drugs, focusing on intestinal-moistening and liver-soothing."

"In addition to the drugs that soothe the liver and regulate qi, your prescription also uses a large number of drugs that clear heat and promote bile secretion, such as the herb Centella asiatica, Artemisia capillaris, Picrorhizon, and Scutellaria baicalensis. You also used Angelica sinensis and White Peony Root to nourish the blood and soften the liver. The overall drug composition is more inclined to target the symptoms of damp-heat in the liver and gallbladder."

"The two prescriptions are similar in some aspects, but there are obvious differences in drug composition, efficacy and applicable diseases."

"Isn't this normal? It's not too obvious, just a little different." Fangyan responded.

Zhang Shouchang asked with a puzzled look:

"But the problem is... this patient's gallbladder has been removed, why are you prescribing heat-clearing and gallbladder-promoting medicine???"

PS: I got 100 more monthly tickets, so after updating this chapter, I still owe you 86000 words.

There's more in the afternoon.

(End of this chapter)