Sent to the countryside, I turned the health center into a top-tier hospital.

"Dr. Chen! Dr. Chen, come quick!"

Just as Chen Ping was in a daze, Wang Tao suddenly shouted, his sharp voice audible to everyone on the street.

Hearing Wang Tao's shout, Chen Ping knew there must be a patient he couldn't handle.

Chen Ping stuffed his phone into his pocket and rushed into the consultation room.

A middle-aged couple, around thirty-five or thirty-six years old, stood in the consultation room. They looked like the kind of people who worked in the fields all year round.

The man, wearing a faded gray-blue work jacket with frayed cuffs, stood in the middle of the consultation room.

His hands hung stiffly in front of him, his expression a mixture of tension and confusion, like a child who had gotten into trouble and didn't know how to explain.

The woman stood beside him, wearing a floral blouse, her hair casually tied in a ponytail. Her skin was rough and red from the mountain wind, her lips were chapped, and her eyes were red, clearly from crying.

Chen Ping first noticed the man's hand.

The tips of all ten fingers were black, not the purplish-black of ordinary bruises, but a charcoal-like dead black.

Starting from the base of the nail and spreading towards the fingertip, the skin becomes dry and wrinkled, as if something has sucked all the moisture out of it.

His heart skipped a beat. He had only ever seen pictures of this level of gangrene in medical school textbooks; this was the first time he had ever encountered it in real life.

If it continues to progress, the fingers will die off one by one, eventually requiring amputation.

He gestured for the man to sit down, pulled up a chair and sat opposite him, then gently turned the hand over to examine it.

The palms still had some color, but the black areas on the fingertips felt cold and hard to the touch. The skin temperature was at least five or six degrees lower than that of the wrist. There was almost no pain or tactile sensation in the fingertips, and there was no reaction when a cotton swab was gently run over them.

The skin on the back of my hands is dry and flaky, my nails are thickened and yellow, and the nail beds of several fingers have begun to atrophy.

"When did it start to turn black?" Chen Ping asked, hanging the stethoscope around his neck as he took his pulse.

The woman took half a step forward, nervously rubbing her hands on her clothes. "About two months ago, I started feeling cold and numbness in my fingers. I thought it was just because of the cold weather, so I didn't pay much attention to it."

"Later, the area around my fingernails started to turn purple, so I went to see the village's barefoot doctor. The barefoot doctor said it might be a blocked blood vessel and prescribed some herbal medicine to promote blood circulation and remove blood stasis. After taking the medicine for a few days, it didn't get better; instead, it got darker and darker."

The man placed his hands on his knees, his fingers stiffly curled, and hadn't said much since he entered the room.

He was wearing those liberation shoes, the soles of which were almost worn flat, and the uppers were covered with dried mud.

Chen Ping noticed a deep callus between his index and middle fingers, which he had developed from years of holding a hoe.

These hands, which supported their family by toiling in the fields, are now slowly decaying.

Have you been to any other hospitals before?

Chen Ping continued to press the pulse, which was deep, thin, and hesitant, a typical sign of yang deficiency and cold stagnation, and qi and blood stasis.

"I went to the county hospital."

The woman's voice changed at this point, and her lips trembled before she continued, "I spent more than three thousand yuan on tests, and the doctor said it was thromboangiitis obliterans, and that it was incurable and that my finger would have to be amputated."

"We didn't believe it, so we went to the city hospital. The city hospital also said it was vasculitis and that we had to amputate the finger. They said that if we didn't amputate, the gangrene would spread upwards and we wouldn't be able to save the whole hand."

Wang Tao was writing down the medical record book quickly. When he heard the words "finger amputation," he paused, looked up at Chen Ping, and then lowered his head to continue writing.

Zhou Jie and Sun Xiaoyan were also standing in the corner of the consultation room, holding the IV bottles they had just replaced. They were so engrossed in the case that neither of them said a word.

After taking the man's pulse, Chen Ping released his wrist and carefully examined his complexion and tongue coating.

The patient's complexion was sallow, the tongue was pale purple with a white, greasy coating, and the sublingual veins were bluish-purple and engorged.

He pushed the man's coat up, exposing his forearm.

The skin on my forearm was dry and flaky, with sparse hair, and the blood vessels felt thin and rough to the touch, like rubber tubes frozen in winter.

He already had a hunch: this was a late-stage manifestation of thromboangiitis obliterans, which is called "gangrene" in traditional Chinese medicine.

The root of the problem isn't in the fingers, but deeper inside.

When cold and dampness enter the meridians, the yang energy is suppressed, the qi and blood stagnate, the meridians are blocked, and the skin, flesh, tendons and bones at the extremities begin to die because they have not received nourishment from qi and blood for a long time.

"Don't rush."

Chen Ping asked the couple to wait on the bench in the waiting area, then went back behind the consultation table, opened the medical record book, and began writing a treatment plan.

Wang Tao leaned closer, and Zhou Jie and Sun Xiaoyan also quietly joined in, their eyes all fixed on the tip of his pen.

"Thromboangiitis obliterans is called gangrene in traditional Chinese medicine."

"The Western medicine treatment for this disease mainly involves anticoagulation, anti-inflammation, and vasodilators. At this stage, conventional drugs can no longer be administered because the peripheral blood vessels are completely blocked. Therefore, both the county hospital and the city hospital said that amputation of the finger was the only option."

As Chen Ping wrote, he slowed down his speech, as if he were lecturing to students, "But from the perspective of traditional Chinese medicine, amputating a finger is only treating the symptoms, not the root cause."

"His illness is not in his fingers, but in the small and medium-sized arteries below his calves."

"When cold and dampness penetrate deep into the meridians, the yang energy is suppressed, and the qi and blood stagnate."

"As long as the main blood vessels are cleared and the blood supply to the extremities is re-established, new flesh can grow back after the necrotic tissue at the fingertips falls off."

"Silver needles unblock the meridians, medicinal baths dispel cold, and decoctions strengthen the body's foundation—three approaches working together."

Chen Ping put down his pen, stood up and walked out of the consultation room. "Wang Tao, turn on the shadowless light in the treatment room, prepare the acupuncture instrument tray, and three sets of 0.35 x 75 mm silver needles."

"Zhou Jie, move the Chinese herbal fumigation equipment to the treatment room. If there aren't enough fumigation devices, just use large beakers to mix the herbal solution and adjust the temperature to 45 degrees Celsius, not too high."

"Xiao Yan, go tell Li Fang to get my medicine ready."

"Ephedra, Asarum, Aconite, Cinnamon Twig, Safflower, Red Peony Root, Ligusticum, Leech. The leech should be raw and ground, not roasted. Prepare the ingredients according to the prescription I just wrote. Decoct two doses, one for internal use and one for external use."

"Then go to the ward and find a few hot water bottles, fill them up, and keep them ready for use."

Chen Ping's orders were methodical, and the three men immediately nodded upon hearing them.

Wang Tao was the first to rush into the treatment room, turn on the shadowless lamp with a snap, and then ran back to retrieve the acupuncture instrument tray from the cabinet, neatly arranging the silver needle boxes.

Zhou Jie and Sun Xiaoyan jogged to the pharmacy and warehouse, the wheels of their cart clattering on the cement floor.

After giving the prescription to Li Fang, Sun Xiaoyan ran over from the other end of the corridor to find a stack of hot water bottles, filled them with boiling water, tightened the caps, wrapped them one by one with a towel, and stacked them on the treatment bed.