Chinese medicine: from rural hospitals to top three hospitals in Kyoto

Chapter 723: Doctor Liu’s words hit the mark

While the father and son were talking, a family member helped an old lady in her sixties to Chen Yang's desk.

The patient did not look very old, probably in her early sixties. She was supported by her daughter. What was more striking was that the old lady was wearing earmuffs.

Moreover, when she walked over, the old lady was obviously a little afraid to look at people, with her eyes narrowed, as if she was very afraid of people.

Liu Jun, who was standing next to her, also hurriedly stood up and lent a hand, helping the old lady to sit down.

"Where do you feel uncomfortable?" Chen Yang asked the patient's daughter.

“This is my mother’s previous examination.”

The patient's daughter took out a stack of test sheets from the bag and placed them on the examination table.

Chen Yang picked it up and looked at it, then looked at the old lady again. No wonder the old lady was wearing earmuffs.

In the middle of winter, it is normal to wear earmuffs to protect your ears, but it is not that cold now and the first month of the year has passed.

And the weather is nice today, the sun is shining brightly, and standing in the sun, you may even feel a little hot.

The examination form was from Jinjiang Central Hospital, and the old lady was diagnosed with Meniere's disease.

A while ago, when Chen Yang was giving a lecture at the Shanzhou Provincial Hospital, Ran Yuanbin, deputy director of the Provincial Hospital's Department of Traditional Chinese Medicine, used a medical record of He Wenliang to challenge Chen Yang. At that time, the patient was also diagnosed with Meniere's disease.

However, the patient was diagnosed with Meniere's disease, which was obviously a misdiagnosis. The patient's actual illness was not Meniere's disease.

Meniere's disease is an idiopathic inner ear disease. The main pathological change is hydrops of the membranous labyrinth. The clinical manifestations are recurrent rotational vertigo, fluctuating hearing loss, tinnitus and a feeling of fullness in the ears.

Judging from the old lady's behavior, she was afraid to look people in the eye, was afraid of light, and wore earmuffs, obviously to block out the noise around her. These symptoms were indeed consistent with Meniere's disease.

Usually when Meniere's disease occurs, the patient will feel dizzy. This strong feeling of vertigo often makes the patient extremely uncomfortable and fearful. A noisy environment often aggravates the vertigo. This is why the old lady avoided his eyes and wore earmuffs.

"When you get sick, do you feel very dizzy?" Chen Yang asked.

"Yes, I felt very dizzy and the house was spinning. My ears were buzzing and swollen," the patient's daughter replied.

Chen Yang asked again: "Does your mother have frequent attacks? How long does each attack last?"

The patient's daughter paused for a moment and replied, "The attacks have become more and more frequent in recent months. Sometimes they occur several times a month. Each attack lasts for several days. I can't eat or sleep well."

Just as Chen Yang was asking about the old lady's condition, Mo Xinzhi and his son also walked to Chen Yang's side, listening to Chen Yang's questions and the patient's daughter's answers.

"Put your arms up."

Chen Yang asked the old lady to put her arm up, stretched out his hand to feel her pulse, and continued to ask: "Besides dizziness and tinnitus, are there any other symptoms, chest tightness and shortness of breath?"

"Yes." The patient's daughter nodded: "I always feel that my mother is a little depressed."

"How's the food?" Chen Yang continued to ask.

Then Chen Yang said: "Auntie, tell me."

Just now, after the old lady sat down, the patient's daughter helped her take off her earmuffs. The old lady could hear Chen Yang talking, but she never spoke. It was her daughter who spoke, and now Chen Yang hoped that the old lady would answer herself.

"I have no appetite and feel nauseous," said the old lady.

"Is your throat dry?" Chen Yang asked again.

"My throat is dry and I feel like there is something there," said the old lady.

"How does your mouth feel, bitter? Sweet?" Chen Yang asked.

"My mouth feels bitter, sticky, and my stomach is bloated..."

After these questions and answers, Chen Yang let go of the old lady's wrist and recorded her condition first.

Dizziness, afraid to go out alone, tinnitus, depression, chest tightness and shortness of breath, dry throat and foreign body sensation, poor appetite and nausea, abdominal distension, insomnia, irritability, bowel movements once a day, dry and hard.

Chen Yang also checked and found that the old lady had obvious tenderness in the right upper abdomen, a thin and stringy pulse, and a greasy yellow tongue coating.

According to the hospital's examination list, the patient not only has Meniere's disease, but also has chronic cholecystitis and neurosis...

"Why don't you continue your treatment in the hospital?"

While Chen Yang was taking notes, he asked the patient's daughter.

"After staying in the provincial capital hospital for a month, my mother felt that there was no effect and insisted on being discharged."

The patient's daughter said: "After returning home, I stay at home every day. I dare not go out. I often stay in my room alone and don't want to be disturbed. I have lost a lot of weight during this period..."

Mo Taihong, who was standing nearby, frowned slightly.

Meniere's disease is difficult to treat, and now the old lady also suffers from chronic cholecystitis and neural tube dysfunction, which undoubtedly increases the complexity of treatment. From the perspective of traditional Chinese medicine, multiple diseases are intertwined, and one hair can affect the whole body. The cause and pathogenesis of each disease must be accurately grasped. If there is a slight mistake in treatment, it may be difficult to take care of one thing while neglecting another.

Whether from the perspective of traditional Chinese medicine or from the perspective of Western medicine, diseases can influence each other. Although Western medicine can separate some symptoms and treat them specifically when treating diseases, it cannot completely ignore the influence and entanglement between diseases.

After all, a person is a whole, and various situations influence each other. How can he be truly independent?

Mo Xinzhi glanced at his son and asked in a low voice: "What do you think?"

"Meniere's disease is a mixture of deficiency and excess. The patient also has chronic cholecystitis and neurosis..."

Mo Taihong pondered and whispered, "In this case, we must distinguish the primary from the secondary and find the right entry point... There are several symptoms intertwined, so we must first distinguish the primary from the secondary and the severity..."

"The dizziness caused by Meniere's disease seriously affects the old lady's quality of life and even makes her afraid to go out. This is the most urgent symptom to be alleviated and the first thing to be solved..."

While Mo Taihong and Mo Xinzhi, father and son, were talking in low voices, Xun Jiahong, Liu Xi and Li Haofei also stood up and came over.

After all, the free clinic is not a hospital outpatient clinic, so when they encounter special patients, Liu Xi and his friends are naturally very interested.

"Chen Yang, what's going on?" Liu Xi walked over and asked Chen Yang.

Chen Yang handed the patient's medical information he had just recorded to the three people, and the three people read it carefully.

"hiss."

Li Haofei took a breath and said nothing. This was a bit too much for him, so he decided to listen to other people's opinions first.

Liu Xi pondered for a moment and said, "The patient has a variety of symptoms, but in terms of the duration of the disease, chronic cholecystitis is the earliest and has the longest duration, followed by neurosis, and then Meniere's disease..."

Xun Jiahong smiled and said, "Doctor Liu hit the nail on the head."

Mo Taihong: "......"