Once the patient’s condition had stabilized, Gao-Yuan remained calm and composed. Unlike the others, his heart was not overly stirred—he had already assessed the situation following the acupuncture and concluded from his experience that the critical state had been contained.
This was merely a small victory; the true test would lie in the subsequent differentiation and treatment phase.
Gao-Yuan continued his discussion with Dr. Han Dai.
Dr. Han pondered aloud, “It’s quite evident that the patient suffers from deep-seated cold accumulation in her zang-fu organs. Feeling cold even in midsummer speaks volumes—winter would surely be intolerable. Her previous bouts of Jīzhuǎfēng (claw-like spasms) stemmed from the same root cause. This time, her suǒyīnzhèng (retracted genital syndrome) and Jīzhuǎfēng share the same origin.”
“Cold constricts and contracts—this explains the retracted genitals and the claw-like spasms. The symptoms of extreme cold in the Shaoyin and Jueyin meridians are unmistakable. The cold energy rising from the liver and kidneys is why she foams at the mouth. When cold fluids invade the heart, it causes palpitations and unease.”
“Additionally, the emotional outburst during her argument with her husband triggered the rebellious Qi to surge upwards, leading to unconsciousness. The kidneys govern the two lower orifices, and the liver meridian runs through the lower body and the breasts. The cold in these two meridians has caused the contraction and spasm. Her essence has become disordered, which explains her double vision and inability to focus.”
Gao-Yuan nodded slightly. Though Dr. Han was a bit verbose, his analysis was solid and comprehensive, tying the patient’s symptoms to one root cause—cold.
Other TCM practitioners present nodded in agreement upon hearing Dr. Han’s explanation. However, when it came to prescribing the appropriate formula, differing opinions quickly emerged.
“Since the issue lies in obstructed joints and cold within the zang-fu, I believe we should use Wūtóu Decoction to unblock the twelve meridians and dispel the cold.”
“She only has occasional Jīzhuǎfēng episodes; her joints aren’t consistently stiff. Given her frequent spasms and vomiting of foam, I recommend Wúzhūyú Shēngjiāng Decoction. Wúzhūyú excels at alleviating spasms and dispelling cold. Her symptoms align perfectly with its indications.”
“That approach only treats the symptoms, not the root cause. Given the patient’s icy extremities, we should administer Sì Nì Decoction immediately.”
“No, it should be Dāngguī Sì Nì Decoction.”
“Why not try Shēnfù Decoction then?”
…
The practitioners debated fervently over various prescriptions, leaving Dr. Zhu, the modern medicine specialist, bewildered. Hearing names like this decoction and that decoction, he found himself longing for his mother’s homemade chicken soup instead.
“Is TCM prescribing always this complicated?”
Indeed, this was both the charm and the challenge of TCM. Traditional Chinese Medicine emphasizes individualized prescriptions—not just tailored to the patient but also to the practitioner. The same patient might receive entirely different prescriptions from different doctors, which makes TCM highly dependent on the skill and experience of the physician.
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For straightforward illnesses, prescriptions from various doctors might only differ slightly in effectiveness. But for complex conditions—where treating one symptom might exacerbate another—prescriptions could vary wildly. Each practitioner also has their preferred medicines and combinations.
This is why, during a TCM consultation, a single decisive authority is needed; otherwise, debates may never reach a consensus.
Even Gao-Yuan found himself scratching his head. The patient’s cold syndrome was similar to Su Pingchuan’s case, but the specifics differed. Faced with such a complex condition, Gao-Yuan also began deliberating carefully.
He glanced at Dr. Han, who was deep in thought, and then at Elder Wan, who was similarly contemplative. Upon closer observation, he noticed that the most skilled practitioners were pondering silently, while the less experienced ones were chattering away.
Elder Wan raised his hand to quiet the room. “Think carefully before you speak. If it were that simple, would we be stuck debating like this?”
The room finally fell silent.
For a moment, even Gao-Yuan struggled to settle on a formula.
Meanwhile, the patient’s husband, relieved that his wife’s condition had stabilized, sat beside her, half-regretful and half-reproachful, muttering, “I won’t argue anymore, never again. You scared me to death. Other people argue and hurt feelings; you argue and risk your life.”
“How can you have such a temper? One moment you faint, the next you go mad. When I get mad, at most, I feel my anger rush up to my head—maybe my face turns red and my neck swells. But you? Your anger is so strong you just pass out!”
Hearing this, Gao-Yuan couldn’t help but shake his head in exasperation. If the husband kept talking like this, he’d likely anger her again someday.
“Angered into fainting…” Suddenly, Gao-Yuan realized something. He turned his gaze back to the patient, and his mind clicked into place. Yes! Her condition wasn’t just about liver and kidney cold—it was the cold Yin energy surging upwards to her head that caused these symptoms.
“In that case… that formula would be perfect!”
Picking up a pen, Gao-Yuan began drafting the prescription.
Dr. Han was taken aback. “You’ve decided?”
As Gao-Yuan started writing, the others gathered around, eager to see. Gao-Yuan wasn’t an ordinary doctor; his prescriptions were never to be underestimated.
“Fùzǐ, one tael; red ginseng, three qian; Chinese yam, one tael; roasted licorice, two taels…”
At first, the others were shocked by Gao-Yuan’s boldness, starting with one tael of Fùzǐ (aconite). But recalling his previous daring actions, they found it fitting for his character.
“Wait… Isn’t this reminiscent of Sì Nì Decoction? I told you it should be Sì Nì Decoction! But where’s the dried ginger?”
“And there’s some resemblance to Guì Fù Lǐ Zhōng Decoction—except it’s missing Báizhú.”
“There’s also Wúzhūyú in there! I said Wúzhūyú was necessary to relieve spasms and dispel cold!”
…
The less experienced practitioners resumed their chatter.
Elder Wan squinted, feeling a sense of familiarity.
Dr. Han’s pupils slowly widened as he exclaimed, “Isn’t this Běntún Decoction?”
His comment drew puzzled laughter from the others. “Běntún Decoction? How could this be Běntún Decoction?”
Dr. Han quickly clarified, “Not Zhang Zhongjing’s Běntún Decoction—this is Dr. Wu Wenquan’s Běntún Decoction.”
Elder Wan seemed to recall something. “Ah, Dr. Wu Wenquan from the provincial capital?”
“Yes,” Dr. Han replied, recognizing the formula immediately due to his close friendship with Dr. Wu.
Having completed the prescription, Gao-Yuan confirmed, “That’s correct—this is Dr. Wu’s Běntún Decoction. It’s perfect for this case.”
“Oh?” Elder Wan had only heard of the formula but never studied it in depth.
Dr. Han smiled at Gao-Yuan. “So, Dr. Gao, you’re familiar with Dr. Wu’s Běntún Decoction! He’ll be thrilled to know that.”
“I’ve only studied it briefly,” Gao-Yuan replied modestly. “While it shares the name Běntún Decoction with Zhang Zhongjing’s formula, the methodology is different. Dr. Wu’s version modifies Renshen Sini Decoction by removing dried ginger, Guì Fù Lǐ Zhōng Decoction by removing Báizhú, and Guì Fù Eight-Ingredient Pill by omitting Shúdì, Dānpí, and Shānyúròu. He then adds Chénxiāng, Shārén, and Niúxī.”
“This is a masterful prescription that warms pure Yang and revives precarious situations. It harmonizes the upper and lower regions of the body, strengthens the Mingmen Fire, and restores depleted vitality. It’s truly a miraculous formula with boundless potential.”
Hearing this, even Dr. Han’s jaw dropped. He stammered, “Why didn’t Dr. Wu ever tell me his formula was this remarkable?”