Chapter 753: Simple Prescription

Chapter 753: Chapter 753: Simple Prescription

"My friend saw how hard he was working. Even though he didn’t fix it, which meant no repair fee according to the rules, my friend still gave him an extra ten yuan for travel expenses, making it forty yuan in total for his hard work."

Li Xu smiled and continued, "Since the AC wasn’t fixed and it was so hot, my friend obviously had to find someone else to repair it. So, he called a second repairman.

"When this second repairman arrived, he didn’t even climb out the window to check the main unit. He just took a voltage tester and checked the indoor control panel and the breaker box for a minute or two before saying, ’I found the problem. The repair fee is four hundred.’

"My friend thought it was a steep price. But considering it was a scorching day and he couldn’t stand the heat without an air conditioner, he gritted his teeth and agreed.

"As it turned out, the repairman merely noticed that a section of the communication wire behind the control panel had aged and short-circuited. He cut off the bad wire and spliced in a new one. In less than five minutes, the air conditioner let out a BEEP and started up. He easily earned that four hundred yuan..."

Listening to Li Xu finish the story, Wang Lan’s son nodded in agreement. "Although the second repairman asked for a lot, he earned it with real skill. He hit the nail on the head. The money was well spent, so there’s nothing to complain about."

"Exactly. In fact, this is where the crux of treating an illness lies."

Li Xu brought the topic back to medicine. "If you find the right cause, solving it is a breeze—you get twice the result with half the effort. If you don’t find the right cause, you’ll be just like the first repairman, blindly messing around while risking your life, exhausting yourself half to death, and possibly making the problem even worse.

"Regarding Teacher Wang’s difficulty with urination, we can imagine the human body’s fluid metabolism system as a giant network of river channels. This network must have a final outlet to expel waste fluids from the body. That outlet is the bladder sphincter, which we can tentatively call a ’valve.’

"Once this outlet valve malfunctions, you’ll experience incomplete urination, difficulty urinating, and constant dribbling.

"Generally speaking, there are no more than two reasons why this valve malfunctions."

Li Xu held up two fingers. "The first is ’reduced power supply.’ This means the body lacks the momentum and energy to control the opening and closing of this valve. The second is that ’the gears are jammed.’ It’s blocked by rubbish like rust and dirt, preventing it from operating normally.

"Corresponding to the human body, the first kind of ’insufficient energy’ is what Chinese medicine calls ’body deficiency,’ where Qi and blood are weak and lack the driving force. The second kind, a ’valve blocked by dirt,’ is what Chinese medicine calls ’damp-heat pouring downward,’ where the pathogenic factors of dampness and turbidity congeal in the lower burner."

While Li Xu spoke, it wasn’t just Wang Lan’s family of three listening with rapt attention. Standing behind him, Li Lin and Wang Xue were completely absorbed, afraid of missing a single word. His explanation wasn’t just meant for the patient and her family; it was meant for Li Lin and Wang Xue, his two interns. He used the most straightforward, everyday analogies to clearly dissect the profound and dry pathology of Chinese medicine. This "teach a man to fish" method of mentoring was exactly his responsibility as the vice president of the hospital, cultivating good seedlings for traditional Chinese medicine.

"So, where does Teacher Wang’s urinary syndrome come from?"

Li Xu looked at the three people in front of him with a calm gaze. "Teacher Wang previously had suspected kidney disease, which is the root cause. Furthermore, her cloudy urine and difficulty urinating are directly related to this kidney issue. Add to the fact that the female urethra is naturally shorter and more prone to infection. As she aged, her constitution deteriorated, leading to a decline in her vital energy...

"Judging from the pulse," Li Xu turned to look at Li Lin and Wang Xue, conducting an on-the-spot teaching session. "Teacher Wang’s pulse is deep and weak. A deep pulse governs the interior and the bones; a weak pulse governs deficiency and the sinews. Bones are the extension of the kidneys, and sinews are ruled by the liver. When a deep and weak pulse appear together, it is a classic case of liver and kidney deficiency."

Li Xu continued his analysis. "Look again at Teacher Wang’s tongue. It’s red, and the body of the tongue is rather thin. ’Red’ indicates heat in the body. However, given her prolonged illness and weakened constitution, this is not excess heat, but rather internal heat generated by Yin deficiency. The ’thin’ tongue body indicates a deficiency of Qi and blood, and a depletion of body fluids. Taken together, it presents a picture of Yin deficiency with excessive fire.

"Therefore, in summary, the crucial point of Teacher Wang’s illness lies in the Yin deficiency and excessive fire of the liver and kidneys. This caused an imbalance in fluid metabolism and impaired the energy transformation in the bladder, thereby resulting in this chronic urinary syndrome that has dragged on for twenty years."

Wang Lan’s illness was actually extremely complex. The reason previous doctors’ treatments had been ineffective, leaving her uncured for so long, was precisely because they couldn’t clearly differentiate the underlying pattern of this complicated condition. Some doctors only saw the superficial symptoms of "cloudy urine, frequent urination, and urgency," and blindly prescribed bitter, cold medications to clear heat and expel dampness, such as Eight Corrections Powder and Sanjin Tablets. As a result, the more they tried to expel dampness, the more they damaged her Yin; the more they tried to clear heat, the more they ruined her stomach. Not only did they fail to cure the urinary syndrome, but they also made the patient’s body increasingly fragile.

Li Xu, however, dismantled the entire pathogenesis, analyzing it bit by bit and peeling back the layers. It was often said that "a doctor treating an illness is like a righteous official solving a case." It required sifting through complicated and sometimes contradictory clues, separating truth from falsehood, and meticulously uncovering the ultimate truth behind the disease step by step.

Li Xu had carefully reviewed Wang Lan’s previous medical records earlier. The medications prescribed by her previous doctors committed the cardinal sin of failing to distinguish between deficiency and excess.

For patients with urinary syndrome, the appearance of their urine was a highly important reference indicator. Clear and frequent urine mostly indicated a cold deficiency syndrome; dark yellow, thick white, or cloudy urine generally pointed to an excess damp-heat syndrome.

However, Wang Lan’s condition was a mix of both deficiency and excess. Even with such a mixed presentation, one had to distinguish which came first and which was primary versus secondary. Did the deficiency precede the excess, or vice versa? It was obvious that as a patient suffering for twenty years, Wang Lan’s primary issue was a "root deficiency," supplemented by an "excess branch" (damp-heat). If one ignored the root cause and blindly attacked the pathogenic factors, it would inevitably lead to the collapse of her vital energy first.

Having finished explaining his diagnosis, Li Xu typed out a prescription on his computer, printed it, and handed it to Wang Lan.

Wang Lan’s son hurriedly reached out to take it, carefully reading the names of the herbs on the prescription: Dried Rehmannia Glutinosa, Mountain Yam, Cornelian Cherry, Poria Cocos, Water Plantain, Tree Peony Bark...

Though he wasn’t a doctor, bringing his mother around to seek medical help had practically made him half a doctor through prolonged exposure.

He asked with a hint of disappointment, "Dr. Li, is this... is this the prescription for Six Flavor Rehmannia Pills?"

"More accurately, it is a modified version of the Six Flavor Rehmannia Decoction," Li Xu explained calmly.

"Six Flavor Rehmannia Pills... my mom took them for several months before, and they didn’t help at all."

The confidence that had just been built up in Wang Lan’s son’s tone instantly dissipated by more than half. They had traveled all this way and booked an expert appointment, just to be prescribed Six Flavor Rehmannia Pills—something available in every pharmacy on the street?

"A skilled traditional Chinese medicine practitioner knows how to dismantle classic prescriptions, break them down, and reassemble them."

Before Li Xu could reply, Wang Xue, who was standing nearby, couldn’t help but speak up. Coming from a family with a long lineage in traditional Chinese medicine, she absolutely couldn’t stand hearing a layman judge classic formulas with such a dismissive tone.

"Sir, you might not understand. In Chinese medicine, sometimes changing just one or two herbs, or even slightly tweaking the dosage, can result in completely different effects. A tiny discrepancy leads to a vastly different outcome."