Chapter 738: Confused

Li Xu looked at the patient's medical records. Specifically, the patient had a history of a malignant tumor. This was an extremely dangerous sign.

Although regular check-ups showed no recurrence, the chemotherapy and radiation therapy from fourteen years ago had long left her immune system riddled with holes. Her baseline physical condition was extremely poor, making her highly susceptible to catching colds. With such a weak foundation, once she contracted a fierce influenza virus, the rate at which her condition deteriorated would often be several times that of an ordinary person. Therefore, the moment this patient was admitted to the hospital, she was directly diagnosed as a "severe case."

Her admission physical examination revealed: T (temperature) 38.6 degrees Celsius, P (pulse) 82 beats/min, R (respiration) 22 breaths/min, and a normal BP (blood pressure).

In terms of auxiliary examinations, her routine blood test showed a white blood cell count of 2.14 (low) and an absolute lymphocyte value of 0.65 (extremely low, indicating the virus was destroying a massive amount of immune cells). As for inflammatory markers, her C-reactive protein was 10.91 mg/L (elevated), while procalcitonin was <0.020 ng/ml (normal, ruling out severe bacterial infection). Furthermore, her serum amyloid A was 30.72 mg/L (significantly elevated), and blood gas analysis showed a pH of 7.44 (still in the compensatory stage). Her liver, kidney, and coagulation functions were currently still normal.

In terms of Western medical treatment, after admission, the attending doctor administered intravenous ribavirin and oral arbidol for a potent dual antiviral therapy. However, a follow-up blood test post-admission indicated a further drop in the white blood cell count!

Considering the possibility of bone marrow suppression as a side effect of the antiviral drugs could not be ruled out, the attending doctor decisively discontinued the intravenous ribavirin on the second day of admission. They solely maintained the oral arbidol antiviral treatment, supplemented by supportive symptomatic care. And in the latest blood test this morning, the influenza virus showed a strong positive.

Li Xu frowned as he read. In traditional Chinese medicine, there was a saying regarding the inherent vitality of the body's natural constitution: when a room is filled with gentlemen, there is no place for a scoundrel to stand. This patient had always been weak and hadn't received effective treatment beforehand, which was why she was already a severe case upon admission. The drop in white blood cells after admission actually indicated that the vital energy within the patient's body was retreating further—the vital qi was weak, allowing the pathogenic factors to advance.

It had been ten days since her fever first started. Over these ten days, this lady's temperature had been like a roller coaster, fluctuating repeatedly, but the fever simply wouldn't break completely. Right now, her condition was stuck at the "severe" stage.

In the eyes of traditional Chinese medicine, this was the period of the fiercest struggle between the vital qi and the pathogenic factors. If the vital qi could still hold on, or if medicine could assist it in beating back the pathogenic factors, the illness would improve. However, if it continued to progress and the vital qi was excessively consumed, she would enter the "critical" stage.

By that point, she wouldn't even be able to muster up a fever. Her temperature might drop to normal or even lower, indicating "flourishing pathogenic factors and declining vital qi"—a sign that her Yang Qi was about to collapse. Even if Hua Tuo were alive, he would be powerless to save her.

This patient was indeed somewhat difficult to handle. Otherwise, she wouldn't have been treated here for three days with all sorts of premium medicines without showing a sliver of progress.

In truth, Western antiviral and broad-spectrum anti-inflammatory drugs could indeed kill many viruses and bacteria on a microscopic level. However, while destroying the enemy, they often acted like herbicides, indiscriminately damaging the human body's own vital qi regardless of friend or foe. This was what the instruction manuals called "side effects."

If these medicines were used on a young person with a naturally good constitution and abundant vital qi, it wouldn't be a big problem. But for this patient, who had a history of malignant tumors and a baseline of weak qi and blood, using this carpet-bombing Western medical approach was truly a case of killing a thousand enemies at the cost of losing eight hundred of your own. Before the virus was completely eradicated, her own body's defense line would collapse first.

"Dean Li." Lin Guorui pushed open the office door and walked in. "Have we taken over the patient in bed 3?"

Li Xu looked up from the medical records and nodded. "Yes, I just had the nurse transfer the medical orders."

"Alright, then I'll go re-evaluate her with a traditional Chinese medicine diagnosis right now." Lin Guorui didn't waste any words, picking up his stethoscope and medical clipboard, ready to head out.

Li Xu stood up. "Let's go, I'll go take a look with you. This patient's foundation is too poor, and the situation might be more complex than we anticipated."

Lin Guorui was slightly taken aback. Normally, when Li Xu did ward rounds, he only checked on those in critical condition or special cases. Although this lady was a severe case, logically speaking, it wasn't yet time for him to step in personally. However, since Li Xu offered, Lin Guorui naturally couldn't ask for anything better.

"Alright."

The two walked out of the office and headed toward the inpatient ward. Pushing open the door to the hospital room, the fierce lady's expression stiffened as soon as she saw Li Xu and Lin Guorui walking in together. She subconsciously pulled the blanket up a bit and quietly turned her head away.

In the adjacent beds, Uncle Guo and Xu Huimin had already finished a routine of the Eight Brocades and were sitting on the edge of their beds drinking water. Seeing this lineup, the two exchanged a knowing glance and tacitly assumed the roles of eager spectators.

Lin Guorui was a seasoned veteran; naturally, he wouldn't stoop to the patient's level, much less embarrass her. He walked to the head of the bed, glanced at the information card, and said in his usual gentle tone, "Qiao Li, how are you feeling today?"

"Not good..." the stubborn lady answered in a muffled voice, sounding somewhat quiet.

Uncle Guo curled his lips as he listened from the sidelines. He thought, "A few days ago, when you were yelling at people, your vital qi was more than sufficient. Now you're acting all frail and delicate like Lin Daiyu."

Lin Guorui continued, "Where does it hurt? Turn around and let me take a close look at your complexion and tongue."

Seeing that Lin Guorui didn't mention her constant flip-flopping antics over the past few days at all, Qiao Li breathed a small sigh of relief. She dawdled as she rolled over and turned toward them.

Li Xu and Lin Guorui both looked at the patient's expression simultaneously. The lady looked haggard, with dark circles around her eyes and dry, peeling lips. She said weakly, "Uncomfortable... My whole body is sore and aching. I don't have a bit of strength. The ache seeps right into the crevices of my bones. And my chest feels terribly tight."

Lin Guorui looked at the electronic temperature chart at the head of the bed and asked, "Are you still running a fever now?"

The lady said weakly, "Still burning. The nurse just took it, 39.2 degrees. I get a fever every afternoon. I take fever-reducing medicine and it drops a bit, but once the medicine wears off, it spikes again."

Lin Guorui and Li Xu exchanged a glance, both frowning slightly. In the eyes of traditional Chinese medicine, this kind of "tidal fever" or periodic fever was often a sign of pathogenic factors lurking in the Shaoyang meridian, or damp-heat accumulating internally—a manifestation of a stalemate between the vital qi and the pathogenic factors.

Lin Guorui continued his inquiry, recording in the medical file as he asked, "Not bad, your mind is still clear. You haven't experienced any episodes of confusion or speaking nonsense, right?"

"Hehe..." The lady chuckled coldly a couple of times, seemingly finding this question a bit redundant. It wasn't like she had burned her brain away with the fever.

Uncle Guo and Xu Huimin, who had their hands tucked in their sleeves watching the show, almost couldn't hold back their laughter upon hearing this. If they weren't afraid of this lady flying into a rage out of humiliation, they really wanted to throw in a remark: "You've been confused since the first day you moved into this hospital room! Otherwise, why would you be so senselessly stubborn, ignoring the doctor's advice and refusing to use traditional Chinese medicine even if your life depended on it?"