"Buwei, write the prescription."
"Alright."
Du Heng took the cotton swab from Wu Buwei to wipe away the blood, then immediately instructed him to write out the prescription.
Wu Buwei pulled a prescription paper from the table, picked up his pen, and waited.
When it came to medicating children, utmost caution was paramount. A moment's carelessness could lead to medication that was too potent or a dosage that was too high. Either could inflict irreversible harm upon an infant.
Du Heng glanced at the snowflakes still swirling outside the window before returning to his meticulous examination.
The Pediatrics Department used to be referred to as the 'mute department' because patients, especially young children, couldn't articulate their symptoms clearly. This made diagnosis and treatment incredibly challenging for doctors. Currently, Du Heng's primary challenge was his limited knowledge of pediatrics, confined mostly to the foundational content he'd studied for his professional practice and Mid-level qualification exams. However, the child's current condition wasn't purely a pediatric issue; it could theoretically be addressed using principles from adult internal medicine. The main point of contention for Du Heng was the medication.
After completing the physical examination and checking the child's oral cavity with a tongue depressor, Du Heng was taken aback. A high fever, throat inflammation, a red and thin tongue coating, and blisters around the lips—it was a clear case of heat poison.
Du Heng glanced outside again, then back at the weeping young mother. He couldn't fathom how a child could contract heat poison in such cold weather and at such low temperatures. If it were a common cold or a wind-chill ailment, I would understand, Du Heng thought. But heat poison… this is truly an eye-opener.
"High fever, inflammation in the throat, a red and thin tongue coating, and blisters around the lips. It's a case of heat poison. Treatment should focus on clearing heat and detoxification."
Heat poison? Wu Buwei, while recording, was momentarily stunned. His hand moved swiftly across the paper, but his eyes couldn't help flicking towards the child's mother. Honestly, he too was curious how such a young child could develop heat poison in this weather.
However, Wu Buwei quickly shifted his gaze back to Du Heng. In fact, everyone in the room turned their attention to Du Heng.
Five seconds passed. Then ten. Thirty seconds. A full minute ticked by.
The silence in the room was heavy, broken only by the sound of shallow breaths and the child's intermittent coughs.
He was so quick with the acupuncture needles earlier, people wondered. Why has Dr. Du fallen silent now that it's time to prescribe medication?
At this moment, perhaps only Zhang Jinlian, standing by the door, truly understood Du Heng's hesitation. This is precisely why I didn't dare to take this case, she thought. The Zhonghu Town Health Clinic, apart from an X-ray machine, had little other auxiliary diagnostic equipment. Treating illnesses here relied almost entirely on a doctor's individual skill and experience. For a pediatric patient so young, suffering from a critical illness, and with no other diagnostic tools available, who would dare prescribe medication lightly?
Zhang Jinlian's medical skills weren't exceptional, but she had been a doctor for twenty years, and her judgment was still quite sharp. Watching Du Heng now, she couldn't help but sneer inwardly. He was trying to look impressive, wasn't he? Let's see how he gets himself out of this one.
Suddenly, Du Heng let out a calm breath. "Buwei, write this down: isatis root, indigo leaf, and Panax Notoginseng, 9 grams each, and forsythia, 3 grams. Prepare one decoction, to be administered in two doses."
Wu Buwei looked at the short list of herbs and the surprisingly small dosages, then couldn't help asking, "Senior Brother Du, isn't this dose a bit too small?"
"It's fine. After the acupuncture, the high fever should gradually subside to a manageable level. This dosage will be sufficient."
Once Du Heng finished speaking, Wu Buwei asked no more questions and took the prescription paper straight to the pharmacy.
The child's high fever seemed to be gradually receding. He appeared a bit more energetic, though he was now struggling more fiercely with his arms and legs.
Believing the acupuncture had achieved its intended effect and worried the child's struggles might cause injury, Du Heng removed the needles from the infant's arm and then placed a thermometer to take his temperature.
Li Qingde and Wang Zhenzhen also breathed a sigh of relief, wiping beads of sweat from their foreheads.
The child's mother, however, clutched him tightly, her heart aching, and was about to bundle him up again in the small quilts and blankets.
Seeing this, Du Heng quickly intervened. "Don't wrap him so tightly. One small blanket is enough, and make sure not to cover his mouth and nose."
Looking at the anxious mother, Du Heng asked, "How do you usually care for the child? Is the room kept very warm?"
"My mother-in-law is terrified he'll catch a cold, so the stove in our room is always burning fiercely, and the heated bed is kept very warm."
"Has it always been like this?"
"It's been like this since winter began. Last night, the weather turned cold, and the stove went out for a while. I was so scared he'd get chilled that I dressed him in a padded cotton coat and covered him with several layers of quilts. But he still caught a cold and developed a fever." As she spoke, her tears began to flow anew.
Du Heng felt a sense of helplessness but explained gently, "Your child isn't suffering from a chill. This problem was caused by being overheated."
He checked the thermometer. "37.8," he read.
Not bad, the fever has broken, Du Heng thought with relief. A weight lifted from his shoulders, and his tone visibly lightened.
The others present also visibly relaxed, their estimation of Du Heng's medical skills rising another notch. Witnessing how a few simple needles achieved such immediate results forced them to reconsider their previous views on traditional Chinese medicine.
"Xiao Du, those few needles were miraculous! How did you do it? I've seen other TCM doctors perform acupuncture, but never with such remarkable effects."
Du Heng put away his needle utensils and chuckled. "It's about mastering the combination of acupoints, the depth of needle insertion, and using the appropriate stimulation techniques."
Du Heng's explanation sounded simple, and in essence, it was. Yet, many TCM practitioners failed to achieve this 'simplicity.' Many contemporary TCM practitioners, much like their counterparts in Western medicine, were increasingly specializing. Furthermore, without the guidance of a master, determining the correct depth for needle insertion and mastering stimulation techniques through self-experimentation was a daunting task. Firstly, time was a luxury few had; secondly, the current medical environment hardly permitted such trial and error. Consequently, many avoided the relatively riskier practice of acupuncture, opting instead for the perceived safety of prescribing medication—a skill more readily learned from textbooks.
An old saying in traditional Chinese medicine speaks of three treasures: a needle, a stick of moxa, and a bowl of medicine. Used in combination, they were said to cure stubborn illnesses and perform miraculous recoveries. Take, for instance, the facial paralysis patient admitted a few days prior. Du Heng had combined these three methods, and in a mere four days, the patient had almost fully recovered. Apart from a slightly crooked mouth and a faintly asymmetrical face, he was hardly distinguishable from a healthy person. His eyes could close, he could speak, eat normally, and no longer drooled. That was the tangible result.
However, with societal development and the pervasive spread of Western medicine, the 'life-saving needle' had largely vanished, and moxibustion had been relegated to a mere wellness therapy. The potent 'bowl of medicine' had been effectively neutered by the Pharmacopoeia. TCM itself had grown timid; practitioners, fearing repercussions, prescribed minimal doses, earning them the moniker 'Slow Doctors.'
Nowadays, some places, hospitals, and even doctors were championing projects focused on 'treating unmanifested diseases.' This, Du Heng felt, is an attempt to drag TCM entirely into the realm of preventative healthcare. What is an 'unmanifested disease'? It refers to an illness that has yet to occur. Despite all the elaborate theories, like 'the superior doctor treats unmanifested diseases, the average doctor treats impending diseases, and the inferior doctor treats manifested diseases,' it all boils down to one thing. It means that because you can't effectively treat existing illnesses, you resort to preventative care and simply 'tuning up' people's bodies. Don't speak of how noble it is to treat unmanifested diseases. If it were truly so noble and effective, why hasn't Western medicine—which is prevalent nationwide and holds the dominant position—ever championed such an approach? Therefore, this 'treatment of unmanifested diseases' is nothing more than a self-deceiving slogan chanted by a pack of strays who have lost their true craft.
Du Heng pondered this issue deeply, but these were thoughts he couldn't voice. Speaking them aloud would offend many, and some would undoubtedly twist his words to claim his entire ideology was flawed.
Du Heng's concise answer genuinely impressed those present. They knew they couldn't achieve such results, nor could anyone they knew.
Zhang Jinlian, however, felt extremely uncomfortable. Including the previous incident, this was the second time Du Heng had effectively slapped her in the face. Just moments ago, she hadn't dared to handle the case and had even advised transferring the patient. Yet, Du Heng had resolved the situation in a few swift moves. Didn't that make her appear utterly incompetent?
Her mind reeled. Unsure what prompted her, she suddenly blurted out, "If it's just about lowering the fever, why not use alcohol rubs or cold compresses? Those methods are quick, safe, and don't cause the patient to suffer. Look at the child's arm! You just wanted to show off your skills, needlessly increasing the patient's risk!"