Stomach expansion case (May 28, 2017)

• Post By: 汉青
• Date: 2017-08-02
• Category: Case Studies

On May 28, 2017, I visited the He Nian Tang Chinese Hospital. At about 10:00 in the morning, an old lady passed by the door. She wanted to see me and trusted me very much.
    The old lady complained of bloating in her stomach. She wanted to eat and felt hungry, but she could not eat a little, and even she could only eat one meal a day. When she rose, she felt that there was something under the sword, and she had to wait until the next morning to relieve it. Second, she had a nervous breakdown all the year round. She had been taking stabilizing drugs for more than 30 years, and her sleep quality was poor.It was engraved with strings and fine veins. The tongue was dark, and the moss was slightly dark.
    At that time, I thought that this was a typical syndrome. The syndrome belonged to spleen deficiency and bad luck. The internal obstruction of congestion should be added or subtracted with Zhiyu pills. Many such diseases have been treated. Generally, it can be significantly improved after eating for three or four days. I am very confident.

However, the reality was very cruel. Early the next morning, the old lady called me to say that after taking the medicine yesterday, she felt that her stomach was swollen. She did not eat at night, slept well, and was not comfortable in the morning. Her whole body was soft.My first reaction at that time was that I should eat some ginger, but the old lady said that she could not eat ginger. As soon as she ate ginger, she was dizzy and feverish, so she could only comfort herself and let her eat less and observe again.Sighingly, she did not come to me again the next week, which is probably very disappointing…
    I studied for half a day, discussed with four or five colleagues, and finally did not give a reasonable explanation.After I thought about it beforehand, the only possibility was that I used too much of Triangular Curdsmanship and broke my qi too much.Also recalled that Teacher Feng Xingzhong once told me in the outpatient clinic that he wanted to use aurantium shell and use less aurantium, because aurantium was broken, now that I think about it, it seems that it is also a little interesting.After all, the old lady may indeed be ill for a long time. Although there are beneficial products in the prescription, it will not help. If I reduced the amount of qi-breaking medicine slightly, or added a little more astragalus to it, would it be good?
    All in all, this is a great lesson. I am not afraid of tigers at first glance, and I can’t be too much. Meng Lang is often told by many teachers that I am too proud to face a disease that I think I have caught, and I can easily put down the medicine without holding it well, causing the pain of the patient. It is a great sin. In the future, I will quit and not act rashly.

—

    2017年5月28日，我在鹤年堂中医院出诊，上午十时许，一老太在门前经过，想找我看病，非常信任我。

    老太太主诉为胃胀，想吃东西，觉得饿，但是吃一点就涨的不行，甚至一天只能吃一顿饭，涨起来就觉得剑突下有一块东西，必须等到第二天早上才能有所缓解，二便可，常年神经衰弱，服用安定类药物三十多年，睡眠质量较差。刻诊为弦细脉，舌质黯，苔白厚略暗。

    当时我认为这是典型的痞证，证属脾虚不运，淤血内阻，应当用枳朮丸加减，此类疾病治过很多，一般吃个三四天就能明显好转，我很有信心。

    然而现实很残酷，第二天一早，老太太给我打电话说昨天吃了药之后觉得肚子更胀了，晚上没吃东西，觉也没睡好，早上也不舒服，浑身软软的。。。我当时第一反应是应该吃点姜，但是老太太说她不能吃姜，一吃姜就头晕脑热，于是乎只能安慰安慰，让她少吃一点再观察观察。令人叹息的是，第二周她并没有再来找我，估计是很失望吧。。。。。。

    我研究了半天，跟四五位同道讨论过，最后都没有给出一个合理的解释。我思前想后，唯一的可能就是三棱莪术用量过大，破气过甚。又回想起冯兴中老师曾在门诊上对我说，要用枳壳，少用枳实，因为枳实破气，现在想来，好像也有那么点意思。毕竟，老太太可能确实病久体虚，虽然方中有补益之品，但无济于事，如果我把破气药量稍微减一些，或者再加点炙黄芪进去，是不是就会好了呢？

    总而言之，这是个极大的教训，初出茅庐不怕虎，不能过于孟浪是多位老师常常叮嘱我的，如今我面对一个自认为手到擒来的病症就过于骄傲，没有好好拿捏就轻易下药，造成了病人的痛苦，真是罪过大焉，今后必引以为戒，不可冒然行事。