"Let me see your tongue."
Dr. Lu softly called out.
Wang Yifen stuck out her tongue for Dr. Lu to see.
The tongue was pale and coated with a white fur.
This type of tongue symptom is generally associated with deficiency of qi and blood, often due to improper diet or excessive blood loss depleting the body's qi and blood, leading to insufficient qi and blood, and qi deficiency failing to firm the skin surface.
Upon seeing this, Dr. Lu frowned slightly.
After pondering for a while but still feeling unsure, he quickly shifted all his attention to the Heart's Voice.
"The pulse is soft and slippery, the tongue is pale with a white coating. From the pulse and tongue signs, they don't seem to have much relevance to the patient's symptoms; this is just the surface appearance. The patient has seen a Western doctor and hasn't improved, as they only focused on the symptoms without treating the root cause, so naturally, there was no effect."
"The concept of vomiting in traditional Chinese medicine often refers to the syndrome of disharmony and upward rebellion of stomach qi, caused by pathogenic factors invading the stomach or stomach deficiency. Overeating hurting the stomach can all lead to upward rebellion of stomach qi, resulting in vomiting.
In ancient times, it was said that vomiting with sound but no substance was considered vomiting, and substances without sound was retching, but both typically occur simultaneously."
"The 'Inner Canon' states: 'Due to overeating, the tendons are slack and the intestines wary.' The 'Essential Prescriptions of the Golden Cabinet' in the chapter on vomiting, belching, and diarrhea mentions: 'A wiry pulse indicates emptiness, when there is no surplus of stomach qi, morning food is vomited by evening, it changes to stomach reflux. When cold is above, and mistakenly treated from below, now the pulse is wiry, hence it's named day courtyard.'
"Therefore, if the stomach qi is injured by food, it will be deficient. If the patient ate unclean food, it can be considered an external pathogen invasion. The treatment should focus on dispelling pathogens to relieve the exterior, using aromatic herbs to transform dampness and dispel turbidity, allowing pathogens to be transformed and healthy qi to recover. The medication should consist of modified Huo Xiang Zheng Qi San, two doses, decocted quickly and taken twice a day."
Dr. Lu often felt grateful for his extraordinary memory, which allowed him to remember so much content word for word without fail.
However, if he couldn't remember and just listened, he might quickly forget, which would neither aid his growth nor help him accumulate clinical experience.
Following the Heart's Voice, Dr. Lu quickly wrote the prescription, handed the medical record to Su Kenan to input into the system, then got up and walked into the herbal medicine room.
Since only two doses were needed, when Dr. Lu came out, Wang Yifen had just finished making the payment under Su Kenan's guidance.
Dr. Lu placed the medicine in Wang Yifen's hands and instructed, "Auntie, take the medicine home and decoct it immediately. Once it's cooled slightly, drink it, twice a day. When the medicine is finished, come back for a follow-up."
Wang Yifen took the medicine but showed a troubled expression.
"What's wrong?" Lu Xuan noticed something was off with Wang Yifen.
Wang Yifen opened her mouth slightly and said, "I didn't... manage to get registration for the day after tomorrow."
Upon hearing this, Dr. Lu understood and patted Wang Yifen's back, comforting her, "It's okay if you couldn't get a slot, just come, and I'll add you in."
Wang Yifen was taken aback, not expecting that there would still be doctors willing to squeeze another patient in.
It was known that doing so meant working overtime.
For doctors who refuse to see patients even before their shift ends, Dr. Lu's action surprised but also deeply touched Wang Yifen: "Thank you, Dr. Lu."
"You're welcome."
After watching Wang Yifen leave, Dr. Lu turned his head to Su Kenan, who was sitting obediently: "This lady's condition is quite serious and urgent, so I couldn't let you try."
Su Kenan instinctively turned her head, her clear eyes showing a hint of surprise, as she didn't expect Dr. Lu, being a doctor, would bother explaining so much to her.
But he did.
He didn't ignore her just because she was an assistant.
Instead, he chose to show respect.
"Thank you."
Warmth rose in her heart.
"Call the next patient, please."
"Okay."
After a few clicks on the computer by Su Kenan, a woman in her forties came in with an elderly man in his seventies.
Li Jueying supported the elderly man to sit in front of Dr. Lu and placed the medical records and registration slip in front of Dr. Lu before speaking: "Dr. Lu, my father previously had advanced stomach cancer and underwent a palliative distal subtotal gastrectomy and Billroth II anastomosis in the hospital.
Less than half a month after being discharged, he suddenly started having upper abdominal distention, burning pain, and frequent nausea and vomiting. Other doctors said it was bile-related.
He can usually only consume liquids, but after eating, he soon feels nauseous and vomits again, which has been really worrying me.
We went to the provincial hospital, and the doctors there prescribed some medication, suggesting to maintain as he is due to his older age. I just wanted to ask if he can take Chinese medicine for maintenance, and for how long."
As she spoke, tears welled up in Li Jueying's eyes.
Seventy-plus years would have been considered longevity in the past, but today, it's nothing below eighty.
Children naturally wish for their parents to live one more day.
Perhaps in their lifetime, they couldn't avoid being nagged by parents, but without the nagging, life loses much of its fun and warmth.
A tree wants to be still but the wind won't stop, a child wants to provide care but their parents aren't there.
Seeing the sorrow on Li Jueying's face, Dr. Lu felt moved yet quickly pulled himself together, comforting her: "Let's take a look first. However, your father's illness has reached a late stage, and with the surgery essentially leaving him without a stomach, and given his age, I can only aim to maintain life with methods that support his righteous qi."
Li Jueying's father, Li Yuquan, listened to the conversation between the two. Instead of being weighed down by his terminal illness, he calmly accepted it: "Jueying, think in a positive way. After all, life has its ups and downs, and Dr. Lu isn't a deity, we should not expect too much."
"Dad."
Li Jueying cried with red-rimmed eyes.
But Li Yuquan shook his head at his daughter and held her hand: "Don't cry, I'm not dying yet. Always bear in mind that happiness or sorrow, a day is a day. I find everything quite okay now, grateful for more days to spend with all of you."
Hearing this, Dr. Lu looked at Li Yuquan with surprise, not expecting him to be so open-minded and unrestrained about life and death.
Such acceptance is rare among elderly people, as most are afraid of talking about cancer or death and fear it as they age.
It's often not the cancer that kills, but the fear.
It was the first time seeing someone diagnosed with cancer stay indifferent to life and death, and Dr. Lu couldn't help but raise a thumb in admiration: "You've got a magnanimous mindset, sir."
"Sometimes a good mindset works better than medication."
"Hearing your encouraging words, Dr. Lu, to tell the truth, I do want to live a few more years to perhaps witness my great-grandson's birth." Li Yuquan smiled as he spoke.
"With such a great mindset, sir, you'll definitely make it."
Dr. Lu replied with a smile and then said, "Sir, let me take your pulse first."
"Sure."
Though lacking in vitality, Li Yuquan still put effort into extending his arm to Dr. Lu.
Dr. Lu collected his facial expressions and focused on feeling the pulse.
"The pulse is deep and thin, with a slight roughness."
Dr. Lu slightly frowned, knowing that Li Yuquan's condition was not optimistic.
A deep pulse suggests an internal pattern, indicating internal retention of pathogenic factors, a sign of internal disease, and also a manifestation of weak organ qi and blood.
A fine pulse indicates yin deficiency and blood deficiency.
A rough pulse means it is uneven and not smooth, representing blood deficiency, qi stagnation, or blood stasis.
The overall deep, thin, and rough pulse describes that Li Yuquan's qi and blood are insufficient, with perhaps qi stagnation and blood stasis, exhaustion, and signs of deficiency, including interior and even blood deficiency.
Dr. Lu recalled that the 'Essential Prescriptions of the Golden Cabinet' in the section on vomiting mentioned:
"A wiry pulse indicates emptiness, food eaten in the morning gets vomited by the evening, termed stomach reversal... when the pulse is floating and rough, floating means excess, rough damages the spleen. Spleen deficiency leads to undigested food at day's end, named stomach reversal. A tight and rough pulse indicates difficult treatment."
This passage elucidates the situation, showing that curing Li Yuquan's illness isn't possible and only life-maintaining approaches for qi reinforcement should be adopted.
"Tongue."
The tongue was dark with a white coating, further confirming Dr. Lu's diagnosis.
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