Intern Accompanying Angel Dream 2
The second " typical case " that Miss Yulu came into contact with was Xiao, male, three years old.
The patient was admitted to the hospital for treatment due to fever for 2 days. After admission, her body temperature gradually increased from 38.3 ° C to 40.8 ° C. She had fever and no sweat. Her white blood cells were 8000 nim3, neutral 37%, lymphoid 60%, mononormal 1%, and acidophilia 2%. The diagnosis of X-ray was "pneumonias". Since he was admitted to the hospital for 5 days, he had been given a drip of cyan, streptomycinin, tet and hydrogen test, and Chinese medicine for clearing heat and detoxification. His stool was dry for 3 days, his tongue was thin and white, his fingerprints were slightly purple, and his lungs were covered with dry rales and wheezing sounds.
The patient's parents were very anxious. "Hurry up and think of another way. If you can't control the high fever, the child's tendons will pull out." Someone said,""How could this happen in the hospital?”Doctor Huang was also anxious.
Miss Yulu came to the child's bed and observed the patient's shape, complexion, tongue, and tongue coating. According to the changes in shape and color, she determined the location and nature of the disease. Teacher Huang pointed out that the human body was closely related to the three zang-fu organs. If there were changes in the function of the zang-fu organs, it would inevitably be reflected in the spirit, color, shape, and state of the human body. The five viscera and six bowels were connected to the surface of the body by the twelve Meridians, which matched the tendons, bones, skin, flesh, and meridians of the whole body. The five senses were also related to the five viscera. Therefore, by observing the signs of changes in the body surface and the five senses, one could infer the changes in the internal organs. At the same time, it could also reflect the loss of the body's essence. The changes of essence, qi, and spirit were mainly manifested in the head and eyes, as well as in the shape of the whole body, language, breath, facial color, pulse, tongue, and so on. Therefore, inspection could not only diagnose the diseases of the internal organs, but also understand the dynamic changes of the human body's essence, qi, and spirit. The so-called inspection:
Spring, summer, autumn, winter and long summer, green, red, white, black and yellow are suitable. The left liver and right lung are shaped like cheeks, and the heart, forehead, kidney, cheek, nose and spleen are in charge. The five orifices of the five zang organs correspond to each other, giving birth to auspicious qi and restraining evil qi. The liver, eyes, heart, tongue, lung and nose are opened, and the kidney, ears, spleen and mouth are pushed together. The color is dry and lustrous, old and new, faint yellow is the time of recovery. Miss Yulu listened to Teacher Huang's instructions while performing the two aspects of "listening" and "smelling".
Teacher Huang said,"
The liver is angry and shouts, the heart is happy and laughs, and the spleen is missing and singing. The lung is full of gold, and the body is full of worry, which is called crying. The kidney is in charge of moaning and fear. Words are thick and thin, strong and weak, and the behavior is different from yin and yang. His footsteps transmitted his Qi through his body, and he carefully pondered over his ups and downs.
Listening and smelling was a method used by traditional Chinese medicine practitioners to use their sense of hearing and smell to understand the patient's language, breathing, coughing, hiccups, heating, and other sounds, as well as abnormal smells such as secretion and excrement. This was to judge the balance of healthy qi and the nature of evil qi, and to infer the disease. All kinds of sounds and smells produced in the human body are produced in the physiological and pathological activities of the five zang-organs. For example, the five tones (call, laugh, song, cry, groan), the five tones (horn, sign, palace, Shang, feather) and the five smells (smelly, burnt, fragrant, fishy, rancid) correspond to the five zang-organs and are the reflection of the changes in the functions of the five zang-organs. Therefore, changes in sound and smell could reflect internal diseases, and thus infer the rise and fall of good and evil and the types of diseases. Only by combining auscultation, inspection, interrogation, and palpation could one fully and systematically understand the condition and make a correct judgment of the disease. Listening and smelling included two aspects. Finally, Miss Yulu took the child's pulse. Teacher Huang said,"Taking the pulse was also called feeling-the left inch was the heart pass, which belonged to the liver, and the right inch was the lung pass, which belonged to the spleen. Two feet back to the kidney Mingmen, the upper, middle and lower Jiao follow in front and back. Deep inside, floating outside, divided into yin and yang, slow cold, frequent heat, should think carefully. There should be differences between small and large, and the eight cardinal guides of short, weak, long and prosperous should be known.
Pulse diagnosis was also called taking the pulse. It was a method for doctors to use their fingers to press on the pulse of the patient's wrist to observe the changes in the pulse and identify the ups and downs of the function of the internal organs, as well as the deficiency of qi, blood, and essence. The doctor used his fingers to touch the patient's head, skin, limbs, chest, abdomen, back, and other parts of the body to check the temperature, moisture, accumulation, lumps, swelling, and pain response. This was called palpation.
Teacher Huang emphasized that consultation was also essential. The first question is about cold and heat, the second question is about sweat, the third question is about the head and body, and the fourth question is about convenience. Five questions about diet, six questions about the chest, seven deaf and eight thirsty should be identified. Nine questions about the old disease, ten questions about the cause, and then take medicine to participate in the changes of the situation. Women especially asked about the birth of the belt, smallola, hives and other diseases in children. Birth eight characters yin and yang house, time and space exchanges devout divination verification.
Zhang Jingyue, a famous medical scientist of the Ming Dynasty, believed that inquiry was the main point of diagnosis and treatment, and the first thing to do in clinical practice. The symptoms and signs obtained by the four diagnosis methods. Most of them came from consultation. The consultation was mainly a systematic and purposeful inquiry to the patient or the accompanying doctor. The questions included the patient's physique, lifestyle habits, cause of onset, course of onset and treatment, current symptoms, past medical history, family history, etc., in order to obtain accurate and effective information to prepare for diagnosis and treatment. Therefore, Miss Yulu asked the family about the cause of the child's illness, the onset of the illness, and the treatment process. Teacher Huang said that after a comprehensive analysis of the above situation, he could consider using a prescription. Miss Yulu analyzed,"
This child's pneumonias were caused by external evils invading the lungs. The lung qi was blocked and heat was produced. The body fluid was suffocated and turned into phlegm. The phlegm heat was blocked and blocked, blocking the airways. It could not be unblocked and the ascending and descending were abnormal. It often had high fever, phlegm ringing in the throat, cough, wheezing, rapid vomiting, chest tightness, fullness, white and greasy tongue coating, stringy and slippery pulse, and other symptoms. This kind of exopathic qi that was not in season had a large amount of sticky phlegm, resulting in the accumulation of heat poison and phlegm blocking the lung orifices. It was definitely not effective for Ma Xing Shi Gan Tang. Because the lung and stomach are the same disease, bitter and acrid herbs must be used to open and descend, phlegm must be removed, and the disease should be treated with acupuncture. Therefore, he was often given Kujiang Xinkai Soup to treat children's pneumonias, which often achieved good results. Because acrid herbs enter the lung first, the lung governs qi, and qi is the commander of blood. When qi flows, blood flows. Therefore, when lung qi is blocked and qi circulation is unfavorable, acrid herbs can be used to dredge the lung qi, dredge the lung qi, open the pores, eliminate pathogenic factors and go out. The so-called "Xin can dredge, should guide the line" is in line with "Xin Tong its closed" meaning. Bitterness first enters the heart, which governs the blood and governs the fire in the body. The fire is hot and upward. Therefore, when the evil fire is excessive, bitter herbs can be used to suppress the evil fire, calm the fire and discharge the evil inside. This is the so-called "bitter medicine can suppress the reverse". If the evil fire cannot linger, the yin and yang will naturally harmonize, and the qi transformation function will be smooth, and the disease will be cured. This is my analysis. I hope teacher can give me some pointers. Teacher Huang thought for a moment and nodded in agreement. According to the child's situation, I suggested,"Can we use the Kujiang Xinkai Tang? 1 gram of Coptis (or 3 grams of Sargassum), 10 grams of scutellaria, 1 gram of dried ginger, 3 grams of Pinellas, 5 grams of bitter orange, 5 grams of Sichuan turnip, 3 grams of radish seeds."
Bitterness descends pungent opens soup [Function] Bitterness descends pungent opens soup, opens phlegm, opens phlegm.
[Attendance] Infantile pneumonias, symptoms include high fever, wheezing phlegm in the throat, acute cough and asthma, chest distension, abdominal distension, phlegm obstruction, vomiting, white and greasy tongue coating, and stringy and slippery pulse.
[Usage] One dose per day, decocted in water three times and taken separately.
[Fang Jie] This prescription uses the bitter qi of Qinlian to descend, treat lung and stomach stagnated heat, and relieve the evil qi of internal obstruction; Jiang Xia's acrid medicine can dispel chest fullness, dredge internal depression and phlegm. The bitter orange, turnip root and radish seed expel phlegm water, break solid, directly guide the stagnation in the chest, make the interior knot guest evil, without attachment and self-solution, every time open the middle jiao disease excess, dredge the lung qi blocking effect.
[Add and subtract] This prescription can be used when phlegm obstruction and vomiting, chest fullness and abdominal distension, white and greasy tongue coating, and stringy and slippery pulse appear in children with pneumonia-like symptoms. If wheezing, expectoration, wheezing, purplish complexion, vomiting, deep and thin pulse, it belongs to cold phlegm. The method is mainly to warm and revitalize stomach yang, eliminate phlegm and eliminate drinking, which is not the indication of this prescription. In clinical use, it should be noted that it should not be excessive, because excessive bitterness and cold can hurt the spleen and stomach. Xin Wen and great heat, there are the disadvantages of dry mouth and dry throat. Therefore, the Guide to Clinic and Medical Records earnestly warned us: "Slightly bitter to clear down","slightly pungent to open up", the main key lies in the word "micro". When using this prescription, if you can add almond, cape jasminum, fermented soybean, roasted loquat leaf, south ladybell root, wolf bark, mulberry bark, Daiha powder, ginger and other herbs according to different clinical symptoms at the same time, flexible compatibility, syndrome identification and treatment can often obtain better efficacy.
Note: Lung disease is a common disease in children. Its pathogenic mechanism is mostly due to lung qi stagnation, heat production of phlegm, phlegm with the reverse flow of qi, so wheezing cough phlegm. Therefore, in the treatment of children with pneumonias, removing heat, phlegm, and wheezing was the key to clinical diagnosis and treatment. It could often control the development of the disease in time and prevent the occurrence of symptoms.
"Girl, you are indeed Grandpa Han's granddaughter.”Teacher Huang said.
" Alright, it should be possible. Add and subtract from the original formula." Teacher Huang then changed the prescription to: Coptis root 1g, scutellaria root 5g, dried ginger 0.5g, pinella 1g, bitter orange 3g, almond 6g, raw plaster 20g, and rhubarb 1.5g. After taking two doses, sweating, defecation, and body temperature dropped to 37.8 ° C. After that, he used this prescription as the main prescription. Because of his poor physique, he added 300ml of 5% G. S and 00ml of VitCl-IV. After taking three more doses, her body temperature gradually dropped to normal, and all her symptoms disappeared. After he was discharged from the hospital, it didn't happen again.
Teacher Huang commented,"The pathologies of childhood pneumonias are: Wind evil invades the lung, phlegm heat blocks the lung, healthy qi deficiency and evil qi are attached, the spleen and stomach are involved, the heart and liver are invaded, and yang qi is deficient and weak. In addition, this kind of disease is caused by the feeling of untimely disease, there is choking qi in the body, and there is sticky phlegm in the diaphragm. The combination of these three conditions will cause qi to rise and phlegm to rise, resulting in fever, cough, adverse flow and uneven phlegm and asthma. The disease belongs to the internal restraint of phlegm and heat, and the lung and stomach are the same diseases. The treatment should be combined with dispersing and descending, so Kulong Xinkai Tang is used to dredge the lung and cleanse the phlegm, and the bitter and pungent taste is used to dredge and descend. This prescription was made on the basis of Banxia Xiexin Tang. Coptis and scutellaria are bitter and cold, deep and prosperous, clearing heat and descending adverse qi; Dried ginger, Pinellas, pungent taste, open chest, expectorant and relieve fullness; Aurantium triflorum and tulip root are bitter and cold, deep and long, and can clear heat and reverse qi; Dried ginger, Pinellas, pungent taste, open chest, expectorant and relieve fullness; bitter orange and turnip root are bitter and acrid, which can promote qi circulation and relieve depression and relieve pain. Radish seed can lower qi, eliminate distension, dredge stagnation and phlegm. All kinds of herbs are used together to clear away heat, dredge the lung, cleanse phlegm and calm asthma. It has been used in more than a thousand cases for a long time in clinical practice, and the effect is accurate. The dosage of this prescription should not be too large. If the high fever does not fall, add 25 grams of raw plaster (first); 1.5 grams of Shanzhi and 10 grams of light fermented soybean were added for vexation and pus. 10g of uncaria and 6g of Tianzhu yellow were added for panic and restlessness; For hiccups, add 10 grams of agastache rugosa and 15 grams of stove soil (instead of water); 10g of prepared Chinese Rhubarb and 10g of snakegourd seeds were added for stool obstruction; cough is not smooth, add almond 10g, aster 5g, burdock 10g, roasted loquat leaf 10g; Cheekbone red phlegm plus Dai Ge San 10 grams (bag), sea pumice stone 10 grams, big fritillary 5 grams; For those with severe asthma, 3 grams of Draba seeds and 10 grams of perilla seeds are added. Dr. Huang concluded,"The prescription of traditional Chinese medicine varies from person to person. It is not a fixed and monotonous prescription. It can only be prescribed according to your clinical symptoms, laboratory results, and the four diagnosis methods of traditional Chinese medicine."
Miss Yulu will remember this.
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