Smooth Road to Medicine

My name is Xu Yang. I am a traditional Chinese medicine practitioner. I have a postgraduate degree and graduated as the top of my department. I was even awarded as an outstanding graduate of the province. However, I was fired from the city hospital just two months after my employment. Today marks the sixth month and seventeenth day since my dismissal. The weather is sunny. My mood is still not good. I am currently working at a private clinic called Ming Xin Tang, located below the Sunshine New Village in W County. I earn a salary of 2500 yuan with no allowance for meals or accommodation, but I do have social security benefits. Sitting across from me is a patient, the first one I've had this month. Her name is Li Qing, and she came to see me for the treatment of dysmenorrhea. "The patient complained of physical fatigue, frequent urination, irregular periods, menstrual cramps and bloating in the lower abdomen before and during the period, nausea, black menstrual blood with clots, which eases slightly with warmth and pain after the clots come out. She also experiences constipation, with bowel movement occurring every 2-3 days..." I record the patient's medical history on the computer. Li Qing covers her lower abdomen with one hand and props up her chin with the other, looking at me curiously. She wonders why this handsome young man in front of her always has a hint of indescribable sadness between his brows. I requested, "Stick out your tongue and let me take a look." Li Qing sticks out her tongue. Then I requested, "Lift up your tongue and show me underneath." I frown and hesitate a bit while recording the pale red tongue and thin white coating. Meanwhile, I commented, "Extend your hand, and I will take your pulse." Li Qing obediently put her hand on the pulse area. I place my middle finger at the radial styloid process of her wrist, and then simultaneously set my index and ring fingers in place, measuring the pulse at the three points of cun, guan, and chi. Afterward, I closed my eyes and felt her pulse carefully. Li Qing blinks and stares at me while I'm performing the examination. When she has dysmenorrhea, looking at a handsome guy like me is an effective way to relieve her pain! After a short while, I removed my hand from her right wrist and said, "Hand me your left hand." Li Qing handed me her left hand, and I checked her pulse. The whole examination is shorter, and I condense my findings into the medical record. However, when I put my hands on the keyboard to type, I can't seem to write anything down. Li Qing tilts her head and asks, "What's wrong, Dr. Xu?" I shook my head and replied, "Nothing." Xu Yang frowned and pondered. The patient's menstrual pain was likely due to cold coagulation and blood stasis, which in traditional Chinese medicine can be attributed to two causes: insufficient nourishment and blockage. The patient experienced lower abdominal distension and pain which would decrease with warmth, and also had blood clots. This indicated that the lower jiao was affected by cold, with the cold pathogen residing there and forming blood stasis. This would then lead to obstruction of the circulation of qi and blood, resulting in pain due to blockage. During the premenstrual period, the pain is mostly caused by an excess syndrome, as qi and blood flow downwards and meet with blockages. Whereas, during the postmenstrual period, pain is mostly caused by deficiency syndrome. As the qi and blood are lost during the period, there is insufficient nourishment for the womb and pain occurs due to inadequate nourishment. The patient seemed to have both excess and deficiency syndromes. However, the main cause was most likely an excess syndrome due to cold, which should be treated with dispelling cold and warming methods, while also activating blood circulation and removing blood stasis. Therefore, the main treatment should be the Shaofu Zhuyu Tang decoction, which has both the warming and circulating effects needed for this condition. "Theoretically, there should be no problem with this treatment plan," Xu Yang said. When Li Qing saw Xu Yang's serious and melancholic expression while pondering, she couldn't help but feel a little moved. Her menstrual pain immediately eased a bit, and she asked, "Doctor Xu, how is my condition?" Xu Yang replied, "Let me prescribe you some medicine." Li Qing agreed, "Okay." When the girl with the ponytail standing next to the counter saw Xu Yang was about to prescribe medicine, she stared at him intently. Xu Yang began to tap on the keyboard to prepare the prescription. However, as he did, his hands couldn't help but tremble and his lips pursed into a knot of nerves. His eyes also flickered with a hint of nervousness. "But what about her other symptoms?" Li Qing asked, noticing the delay. "Ah?" Xu Yang was dazed for a moment, then quickly regained his composure. He swallowed hard and hesitantly said, "I'll give you the Si Wu Tang decoction to drink." Hearing that it was Si Wu Tang again, the girl with the ponytail standing next to the counter rolled her eyes. Li Qing was also taken aback. "Ah? I've tried the Si Wu Tang before, but it didn't really work." Xu Yang looked slightly flustered. "You should stick with it and give it another try... um..." "Okay." Li Qing pursed her lips in disappointment, but in her heart, she knew she should have sought out an experienced traditional Chinese medicine practitioner instead of a young handsome doctor who could only provide temporary relief. Such things only alleviate symptoms, instead of treating underlying causes. Xu Yang quickly prepared the medication, but his expression revealed a sense of despair. While he had completed his postgraduate studies, he possessed mostly theoretical knowledge and lacked experience in clinical practices. He was only familiar with simple illnesses, but complex diseases were beyond his ability to treat. Moreover, he was afraid of treating patients, as an incident from the past had left an indelible impact on him. Looking back, he saw Song Qiang, the other medical practitioner from Mingxin Hall who was sitting behind him. He was thirty-five years old, possessed a Bachelor's degree, and had been practicing medicine for ten years. Although he was not proficient at treating illnesses, he had a talent for persuading patients. Song Qiang was also seeing patients, and a middle-aged man sat in front of him, complaining, "Dr. Song, the medication you gave me last time was ineffective. I still have mouth ulcers all over my mouth." Compared to Xu Yang's cautious approach, Song Qiang was more relaxed and casual. He replied, "What medication did I prescribe for you last time? Oh, it was Zhibai Dihuang Wan... Previously, we suspected that your kidney yin was deficient. The lack of yin caused excess yang, resulting in mouth ulcers. Men always have some kidney issues, you know." "I don't have any kidney issues. Don't make false statements," the patient was immediately angered. Song Qiang waved his hand and said, "I'm referring to the disease. Excess yang from kidney yin deficiency caused the occurrence of mouth ulcers. Therefore, I prescribed Zhibai Dihuang Wan to nourish the kidney yin and Zhibai Baiwei herbs to relieve the excess yang. However, now it seems that it is not a kidney yang issue, but a heart fire issue." "Right, that's correct," Song Qiang nodded and affirmed, "It must be a heart fire issue. The tongue is the opening to the heart, and it is the seed of the heart. So, the appearance of mouth sores indicates the inflammation of heart fire, which can burn body fluid. You must feel thirsty, right?" "No, not at all," the patient shook his head. "What?" Song Qiang was taken aback, then immediately said, "You must have drunk water." "Yes, that's right!" the patient pondered and felt that it made sense. Song Qiang continued, "The heart and small intestine are interrelated, and the small intestine governs liquid. If the heart fire moves to the small intestine, it will burn the small intestine fluid, leading to short and dark-colored urine, right?" "I don't have that," the patient replied, shaking his head. "What?" Song Qiang was taken aback again and said, "Then... it must be that the heart fire hasn't moved to the small intestine yet. You are lucky. Plus, you love drinking water, so it dilutes the urine. Your first urine in the morning is always very yellow, right?" "Yes," the patient felt that it made sense. Song Qiang said, "Okay then, I'll prescribe Daochisan for you. It can reduce the fire and nourish yin while targeting mouth ulcers." "Okay," the patient nodded. After prescribing the medicine, Song Qiang said to the patient, "Come on, I'll give you a massage in the treatment room." The patient was confused, "Huh? Even if I have excess internal heat, do I still need a massage?" Song Qiang replied impatiently, "It's only thirty yuan. Even a paid massage chair at the station costs more than that. Besides, it's covered by medical insurance. What's the big deal?" After speaking, Song Qiang pulled the patient into the treatment room. Xu Yang shook his head and sighed bitterly. He knew that Song Qiang's diagnosis was wrong. The patient was most likely not experiencing excess internal heat syndrome, nor was it a deficiency of yin syndrome. But he couldn't say for sure what it was. Neither Song Qiang nor Xu Yang knew how to treat illnesses properly. They were both equally unskilled. Xu Yang sighed slightly, his expression somewhat worried. There was something that no one knew about him, which was that he had an illness besides being unskilled. When he opened his eyes, everything seemed normal, but as soon as he closed them, he could see a line of text reading "System loaded at 99%." This had been happening since the day he was fired, and initially, it was only at 1%. It took half a year to finally reach 99%. At first, he was very anxious and couldn't sleep at night, but later, he became curious and confused. Now, Xu Yang could coexist peacefully with this thing. If this continues for too long, he may even develop feelings for it. Xu Yang shook his head. He didn't know what the system that had been loading for half a year was. Based on its slow loading speed, it was most likely a knockoff version of Android.