I Can Hear the Heart's Voice of Traditional Chinese Medicine-Chapter 133 - 66: Interstitial Cystitis (2/3)

The "Middle Treasury Scripture" divides Lin Syndrome into eight types: cold, heat, qi, exhaustion, cream, sand, deficiency, and excess. In the "Treatise on the Origin and Manifestation of Various Diseases," it’s divided into seven types: stone, exhaustion, qi, blood, cream, cold, and heat.

By the Tang Dynasty’s "Essential Formulas for Emergencies Linbai," the term "Five Lin" was first proposed. "Arcane Essentials from the Imperial Library" specifically categorized them: stone lin, qi lin, cream lin, exhaustion lin, and heat lin, which are still used today.

Ji Xiuwen stared dumbfounded, looking as if he were meeting Lu Xuan for the first time.

This isn’t scientific!

He had memorized these things too, but to recall them so clearly was absolutely impossible. Most of the time, he had to look them up in medical books. He could say that he only had a vague impression of the vast majority of the content.

To achieve such fluency, one would need a photographic memory.

Back in school, the two often studied together by asking each other questions and memorizing various medical books. While Lu Xuan performed slightly better than him, it wasn’t by much. Many times, they could only remember a line or two. To memorize the entire content of several medical books instantly was fundamentally unattainable.

Forget about newly graduated students like them; even some veteran Chinese medicine doctors may not remember everything.

In fact, it’s safe to say that no one can remember everything so clearly.

Even a genius must adhere to science!

But at this moment, Lu Xuan’s performance was beyond scientific explanation.

This guy didn’t seem to have just memorized the content; he seemed to embody the medical books themselves. How else could he know so much?

And he could recite it just like that?

Even with the medical books in front of him, it would take a while to go through them.

Ji Xiuwen’s mind was shouting "unscientific," while Lu Xuan ignored Ji Xiuwen’s strange look and asked, "Interstitial cystitis, purple tongue, choppy pulse, what’s the pathogenesis?"

Ji Xiuwen opened his mouth, looking aggrieved like a little wife who had been wronged.

Lu Xuan turned to look at Su Kenan.

Su Kenan thought seriously for a while but then gently shook her head, clearly unsure either.

Lu Xuan didn’t mind, glancing at Gao Suyun: "Ms. Gao, we might need a bit of your time."

Gao Suyun smiled, "No problem, I’m not in a hurry."

The word had spread among patients that Lu Xuan explained things to his assistants, and everyone found it normal.

Besides, many patients believed that the more people Dr. Lu taught his outstanding medical skills to, the better, so more patients could benefit.

Though the pace was a bit slow, no one complained.

Everyone understood the principle of "fishing the pond dry, hunting the forest bare."

No matter how skilled Lu Xuan was, he was only one person, not a deity. He could only see a limited number of patients a day, benefiting only a small fraction of all patients.

But if a group of Chinese medicine doctors could learn under Lu Xuan’s guidance, the number of beneficiaries would multiply exponentially.

Lu Xuan thanked her and then looked at Ji Xiuwen and the others:

"You heard what Ms. Gao just said — recurrent urinary tract infections over several years, long-term antibiotic treatment, prolonged illness leading to deficiency, overuse of bitter cold substances further depleting the righteous qi. As the saying goes, ’chronic illness affects the kidneys,’ resulting in kidney qi deficiency, yang qi deficiency, impaired bladder qi transformation, hence the symptoms of frequent urgency and discomfort.

Kidney qi deficiency, lacking the power to steam and ascend the fluids, leads to thirst. Since there’s no actual heat accumulation, the patient wants to rinse the mouth without swallowing. Weak bladder qi transformation results in difficulty in urination, requiring manual assistance. This condition presents as kidney yang deficiency with internal transmission of pathologic factors, hindering the bladder’s qi transformation.

Kidney qi being insufficient weakens movement, causing poor blood flow, hence the somewhat purplish tongue indicating blood stasis and cold coagulation in traditional Chinese medicine."

Looking at Lu Xuan, Ji Xiuwen was awestruck.

Holy shit!

I didn’t understand a word!

This time, his view of Lu Xuan was completely different.

We’ve been classmates for years, are you still the same person I knew?

Even though he couldn’t fully grasp what Lu Xuan was saying...

This isn’t something you can just make up; without a certain foundation and skills, you couldn’t even fabricate this if you tried.

This, Ji Xiuwen knew very clearly.

For the first time, Ji Xiuwen felt the terror of being dominated by a genius.

He used to think their levels were similar, and even if there were a slight gap, it was negligible. But now, Ji Xiuwen realized how vast the gap between him and Lu Xuan had become.

You couldn’t articulate so much without some real ability.

"Where did you... learn all of this..."

At that moment, Ji Xiuwen had so many doubts swirling in his mind. But just as he was about to ask, he stopped in time, then said, "How should it be treated?"

Lu Xuan thought for a moment and said slowly, "For interstitial cystitis patients with kidney yang deficiency and blood stasis blocking the collaterals, the treatment principle should be to invigorate blood, remove stasis, warm the kidneys, and disperse cold.

Lower Abdominal Blood Circulation Decoction from Wang Qingren’s "Medical Error Correction" uses Chuanxiong and red peony to invigorate blood, remove stasis, nourish the blood, and unblock the channels;

Dry ginger and cinnamon disperse cold, promote yang, warm the middle, and relieve pain; Yuanhu invigorates blood, dispels stasis, dissolves nodules, and relieves pain, with peach kernel and safflower aiding blood removal and stasis clearance;

Frankincense and myrrh invigorate blood circulation, relieve pain, reduce swelling, and promote muscle regeneration; Epimedium, Dodder Seed, Psoralea, and Wolfberry support kidney qi, enhance warming the kidneys, and dispersing cold; Amber powder invigorates blood, removes stasis, promotes diuresis, and clears lin.

The whole decoction collectively achieves warming bones, promoting yang, transforming qi, clearing lin, removing blood stasis, and unblocking the channels. As the blood stasis is removed and the kidney yang is nourished, the bladder’s qi transformation returns to normal, and with unblocked qi and blood flow, all symptoms resolve naturally."

"However..."

Here, Lu Xuan shifted his tone: "Strictly speaking, Lower Abdominal Blood Circulation Decoction is not entirely appropriate for the symptoms and needs to be adjusted. The specific formula includes dry ginger, cinnamon, Yuanhu, peach kernel, frankincense, myrrh, Chuanxiong, red peony, safflower, Psoralea, Epimedium, Dodder Seed, Wolfberry, amber powder, and licorice."

Ji Xiuwen frowned deeply.

He had heard of Lower Abdominal Blood Circulation Decoction; it was meant for treating blood stasis in the lower abdomen.

The lower abdomen includes the liver and kidneys. Due to liver and kidney dysfunction, cold coagulation leads to qi stagnation and poor discharge, causing blood stasis and discomfort, resulting in lower abdominal lumps and pain, or irregular menstruation and related disorders.

The treatment promotes stasis removal, blood circulation, warms yang, and regulates qi. Thus, Lower Abdominal Blood Circulation Decoction uses fennel, cinnamon, and dry ginger, which are pungent and warm, entering the liver and kidneys, guiding the spleen in regulating qi, activating blood, and warming the blood vessels; Danggui and red peony enter the liver to move stasis and invigorate blood; Puhuang, Five Spirits Ointment, Chuanxiong, Yuanhu, and myrrh enter the liver, invigorate the blood, and regulate qi, making qi move smoothly, improving blood circulation, and thus relieving pain, forming a decoction to warm and dispel blood stasis in the lower abdomen.

But why Lu Xuan made such modifications was something Ji Xiuwen could not comprehend, no matter how hard he tried.

If it were him, knowing the patient’s symptoms and clear differentiation, he might just prescribe a standard Lower Abdominal Blood Circulation Decoction without making these adjustments.

Lu Xuan seemed to notice Ji Xiuwen’s confusion and explained, "The simultaneous presence of yang deficiency and blood stasis, with dampness blocking the bladder, qi stagnating and collaterals being obstructed, using too much nourishing could invite pathogens, and excessive clearing and benefiting could further harm the righteous qi. Therefore, the medication should warm yang without trapping pathogens, invigorate blood without breaking and harming the righteous, which is the correct approach."

"Do you understand now?" Lu Xuan asked him with a slight smile.

For this long-time classmate, he naturally wouldn’t hold back.

Ji Xiuwen seemed deep in thought.

"What about you?"

Lu Xuan turned to the always silent Su Kenan.

Su Kenan had been studying gynecological symptoms extensively these days. Blood stasis is common in gynecological diseases, and she was quite familiar with Lower Abdominal Blood Circulation Decoction, yet she still had doubts about Lu Xuan’s modifications to treat Gao Suyun’s interstitial cystitis.

Or more accurately, she didn’t fully understand.

Even though Lu Xuan had explained clearly and thoroughly, it wasn’t something easily grasped in a short time.

Seeing both in such a state, Lu Xuan calmly said, "It’s okay not to understand. Just note it down, and if you have any questions, feel free to ask me."

After saying this, he wrote down the prescription and handed it to Su Kenan to register in the system.

While Gao Suyun was paying, Ji Xiuwen came to his senses, looking at Lu Xuan with a complex expression.

At this moment, there was only one thought in his mind.

What exactly happened in the past six months?

Or rather, what happened in the short span of half a month since Lu Xuan arrived at the Health Center?

To cause such a drastic change in a person.