Chapter 814: Good

Chapter 814: Chapter 814: Good

"Do you feel nauseous?" Ju Jiahong asked gently.

"COUGH... A little," the patient replied, gasping for breath. "It always feels like there’s something stuck in my throat. I want to throw up but I can’t."

After finishing the pulse diagnosis, Ju Jiahong pondered for a long time before sitting back in his seat. "The patient’s Qi and Yin are both damaged. Although the previous treatment cleared the fluid retention, it clearly damaged his bodily fluids as well. His tongue is thin, small, and a dark, purplish-red—a clear sign that his true Yin is on the verge of exhaustion. Director Zhu, looking at the previous prescription, I see the dosage of Yuzhu was twelve grams. Given the current severe depletion of bodily fluids, I believe we could try increasing it to twenty-five grams or even higher. We need to nourish the Yin and moisten the dryness to see if we can stimulate the generation of fluids."

Ju Jiahong’s train of thought was strictly by the book—textbook perfect, even. When Yin was deficient, naturally, one had to increase the dosage of Yin-nourishing herbs.

Upon hearing this, a bitter smile touched the corners of Zhu Gaoyuan’s lips. He looked at Ju Jiahong with an indescribable expression. "Director Ju, to be honest, I already quietly increased the dosage of Yuzhu to twenty-four grams in his last three doses. However, the patient’s feedback hasn’t been ideal. Not only did it fail to relieve his dry mouth, but the rich, cloying nature of the Yuzhu actually worsened his appetite."

Ju Jiahong’s expression stiffened slightly, and he subconsciously rubbed his fingers against the tabletop.

He had indeed intended to test the other man just now, but he hadn’t expected Zhu Gaoyuan to lay a trap for him. Since twenty-four grams had proven useless, his suggestion of twenty-five grams was essentially absolute nonsense.

The atmosphere in the room turned somewhat subtle. It was obvious that Zhu Gaoyuan, widely considered the "number two" in Feng City, wanted to make the city’s "number one" expert taste defeat in front of Elder Song.

"Li Xu, what are your thoughts on this?"

Just as Ju Jiahong fell into deep thought and a heavy silence settled over the conference room once again, Liu Haodong’s voice suddenly rang out.

He spoke loudly, instantly shattering the awkward tension left by Ju Jiahong’s misstep. Everyone’s gaze shifted in unison, landing squarely on Li Xu, who was seated quietly in the corner.

Ju Jiahong looked up, shot Liu Haodong a glance, and then turned his attention to Li Xu. "Dr. Li, you likely have a unique perspective on critical cases like this. What do you think?" he asked calmly.

In reality, Ju Jiahong didn’t think Li Xu would have any brilliant insights. This kind of simultaneous collapse of Qi and Yin in end-stage heart failure was a world-class medical challenge, even for the top experts at Renmin Hospital. If the best of the best were out of ideas, how could they possibly rely on this self-taught, "wild" vice director?

Li Xu wasn’t the least bit flustered by the half-probing, half-provocative question. He remained seated, not even bothering to stand, but his words acted like a scalpel, cleanly slicing through the complex disguise of the illness.

"Actually, both Director Zhu and Director Ju have overlooked a crucial point." Li Xu’s voice echoed with pristine clarity in the quiet room. "And that is the ’resonance’ effect between the Astragalus Root and the Western diuretics."

Zhu Gaoyuan and Ju Jiahong both froze in surprise.

"In the previous prescription, the dosage of Astragalus Root reached thirty grams, and it was administered continuously for six doses. Astragalus Root has an ascending nature; it lifts the Qi and fortifies the exterior." Li Xu stood up and pointed at the patient’s purplish-red tongue. "However, under the intervention of Western medicine, the diuretics are forcefully draining fluids downward. This creates a bizarre paradox: the diuretics are at the forefront, purging water and damaging the Yin, while large doses of Astragalus Root are ’fanning the flames’ from behind, accelerating the upward and outward dissipation of the body’s Qi. The patient’s Yin fluid is already struggling to circulate due to a low cardiac ejection fraction. Caught in this violent tug-of-war between ascending and descending forces, it will naturally deplete even faster."

"Yin is the vessel that carries Qi," Li Xu continued, looking directly at Zhu Gaoyuan. "When Yin is damaged, the Qi loses its anchor. At this stage, no matter how much Astragalus Root or Ginseng you add, it’s akin to pumping a bellows into a stove full of holes. Rather than providing any restorative benefits, it will merely make the flames burn hotter and leave the tongue even drier. Yuzhu is an excellent herb, but in this raging storm of chaotic Qi and dried-up bodily fluids, its minor moisturizing properties are like tossing a single drop of water into a roaring bonfire. Worse still, its cloying nature simply turns it into sludge that hinders the digestive functions of the spleen and stomach."

Zhu Gaoyuan’s eyes widened in realization as he mentally reviewed the case.

He was absolutely right!

Zhu Gaoyuan realized he had been hyper-focused on the traditional Chinese medicine prescriptions, completely neglecting to factor the continuous use of Western diuretics into the dynamic equilibrium of the patient’s body.

"Therefore," Li Xu continued, "we can no longer rely on ’ascending’ and ’purging’ methods for this condition. We must do the exact opposite. We have to clear that ’deficiency fire’ while simultaneously ’capturing’ and holding onto the dissipating central Qi."

"May I ask, Dr. Li, how would you write the prescription?" Zhu Gaoyuan had entirely abandoned his petty competitive mindset; his tone was now filled with genuine respect and a desire to learn.

"We can use the ’Heat-Clearing and Qi-Tonifying Decoction,’ which was recorded by the Ming Dynasty physician Xue Ji in his work, *Essentials of Mouth and Teeth Diseases*."

As soon as Li Xu said this, a flurry of whispers swept through the conference room.

Many of the younger doctors desperately wracked their brains, mentally flipping through their medical texts. The Heat-Clearing and Qi-Tonifying Decoction? Wasn’t that just a minor prescription used to treat canker sores, a swollen tongue, or inflamed gums?

Using it to treat end-stage rheumatic heart failure? Was he joking?

Ju Jiahong furrowed his brows. "Dr. Li, the Heat-Clearing and Qi-Tonifying Decoction is considered a light, delicate minor formula. The dosages of Rehmannia, Danggui, and Ginseng in the original text are all quite small. We are dealing with a critical case of Stage IV heart failure, where the patient can’t even lie flat without gasping for air. Are you absolutely certain that such ’minor herbs’ can stabilize the situation?"

Li Xu offered a faint, confident smile.

"Director Ju, the medical philosophy you practice leans toward the ’domineering’ path—using heavy dosages to achieve miraculous results. However, this patient is already too weak to withstand heavy tonics. The bodily fluids in his spleen and stomach have been utterly depleted to the extreme. He can’t even digest a relatively mild herb like Yuzhu. If you prescribe heavy medications, it will only trigger severe vomiting and potentially induce a lethal episode of heart failure. Think of it like a man dying of thirst in the desert. If you force him to chug a bucket of ice water, he’ll die on the spot. You have to use a small spoon to feed him warm water, drop by drop. This is the concept of ’gentle nourishment.’"

Li Xu pointed to the diagram of Qi flow he had just sketched on the whiteboard. "Although the Heat-Clearing and Qi-Tonifying Decoction was originally intended for canker sores, its true essence lies in treating the deficiency heat of the middle burner.

"His tongue is glossy, red, and devoid of any coating—a glaring signal that the true Yin of his spleen and stomach is on the verge of total exhaustion.

"We need to use small doses of raw Rehmannia and Ophiopogon to ’moisten,’ pair them with a touch of Ginseng to ’capture’ the Qi, and then add white peony to astringe the Yin, alongside Danggui to invigorate the blood without causing dryness.

"It’s like a gentle drizzle after a prolonged drought. It isn’t meant to form rushing rivers; its only goal is to moisten the top inch of soil.

"Once that inch of soil is softened, the functions of the spleen and stomach will reawaken. Once the root of acquired constitution resumes its work of digestion and absorption, the body can generate fresh Qi and blood, allowing Yin and Yang to naturally restore their balance."

Ju Jiahong stared at Li Xu, a storm of emotions surging in his heart. He had assumed Li Xu was only skilled in "fierce and domineering" methods, like using massive doses of Aconite. He never expected the man to possess such an enlightened, masterful grasp of "light and delicate minor prescriptions" as well.

"Excellent! Excellent! Excellent!"

While the rest of the room was still savoring Li Xu’s analogy of the "gentle drizzle moistening the soil," Song Luojun—who had been sitting in statue-like silence this entire time—suddenly clapped and praised him three times in a row.

The moment Song Luojun spoke, Ju Jiahong forcefully swallowed back the questions he had been about to raise regarding the "dosages."

Like iron filings drawn to a Magnet, the gazes of the hundreds of young doctors in the room instantly converged on Song Luojun.

"Many practitioners of traditional Chinese medicine have developed a rather terrible habit," Song Luojun said slowly. "We’ve become accustomed to judging the severity of a patient’s condition based entirely on the diagnostic labels of modern Western medicine."