Li Xu walked over to his classmates, and they exchanged a few pleasantries.
Hu Qiming clapped him on the shoulder and laughed. "What have you been busy with lately, man? We never see you in the group chat anymore. If it weren't for this lecture, I would've almost forgotten you were in it."
Li Xu smiled. "The clinic keeps me busy. It's nothing like the cushy life you guys have at the big hospitals."
Miaoli chimed in, "Oh, come on. You're your own boss, you can do whatever you want. We get chewed out by our department head every single day."
As they were laughing and talking, the auditorium doors opened, and people began to file inside.
The grand auditorium, with a capacity of 500, was nearly full.
It seemed like nearly every ambitious Traditional Chinese Medicine doctor in the city with a free moment had shown up.
Li Xu and his classmates found their seats and sat down.
At 8:50, after a brief introduction from the host, Professor Gao Guanghui walked onto the stage.
Professor Gao looked to be in his sixties. His hair was graying, but he was full of spirit.
He wore a dark blue tunic suit and had a kindly smile on his face, showing none of the airs one might expect from a famous physician.
"Good morning, my fellow practitioners." Professor Gao's voice was resonant. "I'm delighted to be here to exchange ideas with you all today. I know many of you are curious about my topic, so allow me to build a little suspense. I'd like to begin by sharing a case study, as the content of my lecture is hidden within it."
The auditorium immediately fell silent, and everyone pricked up their ears.
Professor Gao scanned the room, clicked the remote in his hand, and a patient's case file appeared on the large screen.
He began to explain as he advanced the slides. "This is a real case. The patient, a thirty-eight-year-old male, first came to the Provincial Hospital of Traditional Chinese Medicine for a consultation on July 21 of last year.
The patient reported that two years prior, during the summer, he developed cold symptoms such as a high fever, headache, and cough after catching a chill.
After treatment with large doses of White Tiger and Three-Yellow type formulas, his cold symptoms disappeared.
But his body temperature constantly fluctuated between 37.5℃ and 38℃, and he was unable to sweat at all.
Even at the height of summer, he couldn't produce a single drop of sweat. He felt feverish, agitated, and unwell, with a poor appetite. Numerous other treatments had proven ineffective.
He also sought treatment at the Provincial First Hospital, where tests, X-rays, and other examinations found no abnormalities. He was diagnosed with 'autonomic nervous system dysfunction.'
He was prescribed Western medicines like oryzanol and various vitamins, and for over half a year, he was also treated with a succession of formulas to supplement qi, nourish blood, enrich yin, and warm yang, all to no avail.
My diagnosis upon his first visit was as follows: his body was hot to the touch, and he felt a sense of inner vexation. His tongue was a pale purple, and the veins beneath it were dark purple, thick, and long. His pulse was deep, wiry, fine, and choppy. I observed no other abnormalities.
By analyzing the pattern to determine the cause, I concluded this was a case of fever from an external pathogen. The excessive use of cold-natured herbs had caused contraction, leading to blood coagulation and impaired circulation. This resulted in internal blood stasis, compounded by qi stagnation. The qi stagnation then impeded the movement of fluids, and this combination of stagnant blood and fluid obstructed the body's ability to produce sweat, resulting in anhidrosis.
The treatment principle should be to transform stasis and promote diuresis, unblock and regulate the water passages, and guide fluid down to the bladder to facilitate qi transformation.
Therefore, I prescribed the following formula for the patient: 18g of Cinnamon Bark, 9g each of red peony and spatholobus stem, 6g of pangolin scales, 12g each of motherwort, Eupatorium leaf, and giant knotweed, and 6g of amber. The instructions were to take one packet per day, decocted in water and consumed warm in two to three doses.
I was very confident at the time. This formula would definitely be effective for the patient's condition. Even if it couldn't cure him, it should at least alleviate the symptoms.
But things did not go as I expected. When the patient returned for a follow-up visit a week later, his condition hadn't improved in the slightest."
Professor Gao paused for a moment, his gaze sweeping over the audience. "My question is this: why was my prescription ineffective for this patient? Was my diagnosis wrong? If it was, what medicine should have been prescribed? The first person to answer correctly will receive the last spot to observe my clinical consultations this afternoon."
The moment he finished speaking, a stir went through the auditorium.
Everyone knew Professor Gao's itinerary for his visit to the City Hospital of Traditional Chinese Medicine: a lecture in the morning and seeing patients in the afternoon.
There were a total of three observation slots.
The City Hospital of Traditional Chinese Medicine had claimed two of them.
This left one spot for Professor Gao to award at his discretion.
Everyone had been wondering how Professor Gao would make his selection.
No one had expected him to do it by posing a question.
Everyone fell into deep thought,
studying the case file on the screen and analyzing the cause.
Li Xu also racked his brain. 'Cinnamon Bark promotes sweating and improves circulation; red peony clears heat and cools the blood; spatholobus stem unblocks the channels. Combined with supporting herbs like pangolin scales and motherwort, the formula should be perfectly suited for the condition. So why didn't it work?'
'Could Professor Gao's diagnosis have been wrong?'
Li Xu couldn't figure it out.
After all, his practical experience was limited.
If Professor Gao's diagnosis was wrong, he wouldn't be able to provide the correct one either.
Many others in the audience felt the same way.
The younger doctors, in particular, didn't dare to venture an answer.
After a moment, a middle-aged doctor in the front row raised his hand.
Professor Gao gestured for him to answer.
"Perhaps the patient is suffering from pathogenic dampness trapping the spleen. The treatment should first focus on expelling dampness before promoting the flow of qi."
Professor Gao shook his head. "A good line of thought, but the patient's tongue coating isn't greasy, and there are no obvious signs of dampness."
Next, a female doctor stood up. "Could it be a case of liver qi stagnation? That would require a formula to soothe the liver and relieve constraint."
"The pulse is deep, wiry, fine, and choppy, which doesn't quite fit," Professor Gao refuted once more.
A few more people offered answers. Some suggested adding herbs to invigorate blood and dispel stasis, while others suspected a kidney-yang deficiency, but Professor Gao negated each theory in turn.
Gradually, fewer and fewer people raised their hands.
Li Xu frowned deeply in thought. Suddenly, he recalled the intelligence he'd received that morning—"a lecture concerning the development of Chinese medicinal herbs."
This seemingly unrelated piece of information flashed through his mind.
He suddenly realized something: Professor Gao had never once mentioned the actual topic of his lecture.
'But the system's intel couldn't be wrong.'
'In other words, Professor Gao's lecture today is about Chinese medicinal herbs.'
'Could it be that Professor Gao's diagnosis was correct, and the problem lay with the herbs themselves?'
He took a deep breath and raised his hand.
Hu Qiming gave him a thumbs-up. "Damn, brother. Gutsy."
Miaoli also whispered, "That's impressive."
Whether he knew the answer or not, just daring to raise his hand in front of all his peers from across the city, including some senior TCM physicians, was an impressive feat in itself.
Professor Gao noticed him and smiled. "Yes, the young man there. Please, speak."
Li Xu stood up, took a deep breath, and tried to keep himself calm. "Professor Gao, could it be that there was no problem with your prescription, but rather a problem with the medicinal herbs?"
Just a simple sentence.
Yet it was like a ray of light piercing the fog, bringing a sudden realization to many of the TCM practitioners present.
They all felt there was nothing wrong with Professor Gao's prescription.
'But why couldn't it cure the patient?'
Until now, everyone had been focused on the formula itself.
But they had overlooked the issue of the medicinal herbs.
Of course, some TCM doctors shook their heads.
'How could it be that simple?'
But Professor Gao laughed. "Well said, young man."
He looked around at everyone and raised his voice. "Everyone, when the patient came back for a follow-up and told me there was no effect, I was completely baffled. 'Could it really be that my diagnosis is flawed?' I wondered."
"So, I made a point to consult my own teacher..."
Hearing this, the audience was stunned.
'Professor Gao is already so accomplished.'
'Wouldn't his teacher have to be on another level entirely?'
Professor Gao continued, "After hearing my account, my teacher also agreed that there was nothing wrong with the prescription I had written.
I wracked my brain but couldn't get to the bottom of it.
So I decided to personally decoct the herbs for the patient, observing the entire process in order to find the cause.
As it turned out, when the patient brought the packet of herbs from the hospital's dispensary, I saw the problem the moment I laid eyes on them."