Chapter 800: Precocious

Chapter 800: Chapter 800: Precocious

While Zeng Yunjun was pulling Gao Mingxuan aside to get to the bottom of things, Li Xu had already returned to the emergency department’s treatment room. It was not even seven-thirty yet; the outpatient corridors were still completely empty, but the ER was already brightly lit. Li Lin was watching over a patient.

The patient was a man in his thirties. Although it was only late September and Feng City had not yet entered late autumn, he was bundled up in a thick coat over a hoodie, curled up in a chair and shivering violently.

"Dean Li," Li Lin greeted him hurriedly upon seeing him enter.

"Morning. What’s the situation?" Li Xu walked over and flipped through the medical records Li Lin had written.

"The patient has cold extremities and a severe aversion to the cold. He claims the chill pierces right through to his bones," Li Lin explained while checking the patient’s pulse. Li Xu stood to the side, observing.

The man’s face was pale and bluish. It certainly looked like a classic case of Yang Qi deficiency, but Li Xu’s gaze narrowed slightly when it swept over the corners of the patient’s nose and lips.

After taking the pulse, Li Lin checked the tongue coating. He found that the tongue proper was red with prickly red points at the tip, and while the coating was sparse, it appeared somewhat sticky. Frowning slightly at the contradictory symptoms and pulse, Li Lin pressed further, "How is your sleep usually? Do you sweat at night? Do you dream a lot?"

"I dream a lot. I’m always tossing and turning at night, unable to sleep. My chest feels unbearably hot and restless," the patient replied through chattering teeth.

Li Lin’s eyes lit up. He subconsciously glanced at Li Xu before his expression settled into certainty. Suppressed internal fire, a red tongue with prickly points, and restless dreaming. How was this a fear of cold due to Yang Qi deficiency? This was clearly a case of excessive internal heat trapping all the Yang Qi within the organs, leaving the limbs and skin without warmth. It was a textbook case of true heat, false cold. If he treated it as a Yang Qi deficiency, a few doses of warming medicine would cause the patient to erupt in a disastrous fever.

"Dean Li, take a look at this prescription..." Li Lin swiftly jotted it down on a piece of paper: Rising and Falling Powder combined with Gardenia and Fermented Soybean Decoction, with added Forsythia Suspensa, saposhnikovia root, peppermint, and reed rhizome.

After sending off the profusely grateful patient, Li Lin wiped his brow and chuckled. "Dean, if you hadn’t been standing right there, I really would’ve been fooled by that thick hoodie at first. My immediate reaction was to prescribe Four Reversals Soup to restore his Yang Qi and rescue him from the cold."

"In clinical diagnosis, preconceptions are your worst enemy." Li Xu patted his shoulder. "Remember, symptoms can be deceiving, but the logic of combining pulse and symptom analysis will never lie to you. The fear of cold is only a superficial sign; the restlessness and frequent dreaming are the true internal symptoms."

Li Lin nodded emphatically before asking with curiosity, "By the way, Dean, what exactly is the situation with your teacher’s granddaughter?"

Li Xu’s expression grew a fraction more solemn. "Premature menarche. She’s only nine years old this year."

GASP. Li Lin drew in a sharp breath, his tone indignant. "Only nine... With all the out-of-season foods, factory-farmed poultry, and those heartless manufacturers adding hormones to snacks nowadays... This poor kid is really suffering."

As the two spoke, Gao Jingyun led Gao Ruiping’s family of three into the emergency hall in a whirlwind of urgency. Gao Ruiping was a sturdily built man, but right now, he was sweating profusely from anxiety, tightly holding a little girl in his arms.

This was Li Xu’s first time meeting Gao Ruiping’s daughter, Miaomiao. At nine years old, she should have been at her most innocent and carefree, but sitting in the consultation room, she seemed unusually withdrawn and silent.

Li Xu observed her closely. Miaomiao’s complexion revealed an unnatural dullness, even faintly bordering on a dark, grayish hue. She wasn’t short for her age; in fact, she was half a head taller than the average nine-year-old girl. But her height didn’t look healthy; instead, it made her appear frail. Aside from her darker skin tone and a hint of melancholy in her eyes that didn’t belong to someone her age, she didn’t look much different from an ordinary child at first glance.

"When did you first notice this issue with her?" Once Zeng Yunjun and Gao Jingyun had settled down nearby, Li Xu gestured for Gao Ruiping’s wife to sit opposite him with Miaomiao in her arms. He didn’t immediately reach out to check her pulse, but first used the diagnostic method of observation to assess the child’s demeanor.

"About three months ago." Gao Ruiping’s wife’s eyes turned red, and she kept her voice very low. "First, she complained that her chest hurt. When we checked, there were already obvious signs of breast development. We didn’t think much of it at the time, assuming kids these days just have better nutrition. But later, we realized something was wrong and took her to the Provincial Maternal and Child Health Hospital for a checkup..."

Gao Ruiping hurriedly pulled a thick stack of medical reports from his briefcase and handed them to Li Xu with both hands. "Li Xu, take a look. This is the provincial hospital’s diagnosis. They said it’s Central Hub precocious puberty. The bone age assessment was the most terrifying part. They said even though Miaomiao is nine, her bones have already grown to the level of an eleven-year-old..."

Li Xu took the reports and scanned them quickly. Aside from her bone age being two years advanced, the baseline values for Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) on the sex hormone report were indeed absurdly high, having already reached pubertal levels.

"Miaomiao, tell me, besides your chest hurting, do you feel uncomfortable anywhere else?" Li Xu looked at the little girl gently.

Gao Mingxuan gently patted his granddaughter’s back, his eyes full of heartache. "Be a good girl, Miaomiao. This is your Uncle Xu. His medical skills are amazing, so tell him whatever you’re feeling."

"No..." Miaomiao replied timidly, lowering her head.

However, the moment Miaomiao spoke, Li Xu raised an eyebrow slightly. Even though it was just a single word, he acutely detected a very heavy odor from her mouth—bad breath caused by intense stomach fire. Moreover, in the brief few minutes leading up to the pulse diagnosis, Miaomiao appeared somewhat fidgety, her body swaying slightly, and Li Xu heard several faint sounds of flatulence.

"Come, let me see your tongue," Li Xu requested.

Miaomiao obligingly opened her mouth. Her tongue was a deep red, almost bordering on purple, and the coating was thin but appeared dry. Only then did Li Xu reach out, resting his fingertips lightly on Miaomiao’s slender wrist.

The consultation room fell silent. Gao Ruiping held his breath, terrified of interrupting Li Xu’s train of thought. Although he knew Li Xu was now a vice-dean, subconsciously, he still viewed this "younger brother" he had watched grow up as just a boy from the countryside. It wasn’t until this moment, seeing Li Xu’s steady and commanding presence, that his heart finally began to settle.

"Li Xu, a condition like Miaomiao’s... will it really have a huge impact on her future?" Gao Ruiping couldn’t help but break the silence, his tone laden with anxiety.

"Definitely." Li Xu didn’t sugarcoat the diagnosis just because they were close family friends. He withdrew his hand and looked at Gao Ruiping and his wife with a solemn expression. "Traditional Chinese medicine views the human body as a precise, balanced system. Whether development is too fast or too slow, as long as it goes against natural logic, it is a pathological state."

"In ancient times, because of poor living conditions, the most common issues in pediatrics were the ’five delays and five flaccidities,’" Li Xu began to explain in simple terms, both to enlighten the family and to teach Li Lin and Zeng Yunjun, who were standing nearby.