"Doctor, what disease do I have?" The old man followed Zhang Yan's instructions, took the medicine, drank some water, and then asked.

"You have phlegm and blood stasis syndrome, which is called coronary heart disease in Western medicine.

When you get sick, not only will your heart hurt, but your shoulders and back will also hurt, there will be a lot of phlegm, and you will also feel nauseous." Zhang Yan said with a smile.

"Yes, everything you said is right, doctor!"

"Don't be nervous. You don't have acute coronary heart disease. I'll prescribe some medicine for you. You can take it first and come back for a follow-up visit in three days." Zhang Yan said and prescribed a prescription for the old man.

Modifications and subtractions of Xuefu Zhuyu Decoction.

Peach kernel 4 cents, safflower, angelica, raw rehmannia glutinosa, achyranthes root each 3 cents and 5 cents, Chuanxiong 1 cent and 5 cents, red peony root, citrus aurantium, licorice brother 2 cents and 5 cents, Bupleurum 1 cent.

"Thank you, doctor, thank you, doctor!" After the old man took nitroglycerin, his symptoms of coronary heart disease had been relieved a lot, and his complexion returned to normal. He thanked Zhang Yan repeatedly.

I don’t know anything else, but after he took a pill just now, the pain in his chest immediately improved a lot. This is a fact.

The old man left politely, and then another old man sat in front of Zhang Yan.

"Doctor, I also have chest tightness, can't breathe, and cough. When I cough, my whole back hurts."

The old man sat in front of Zhang Yan and directly told his symptoms without Zhang Yan asking.

Zhang Yan kept muttering in his heart, did he have trouble with chest tightness and shortness of breath today?

Three people in a row all had the same symptoms, chest tightness, shortness of breath and difficulty breathing.

"Well, let me take your pulse." Zhang Yan stretched out his hand to hold the old man's wrist, and then observed the old man's face.

"Does your back hurt when you cough, or do you always have back pain?" Zhang Yan asked with a smile.

In fact, Zhang Yan had basically determined the old man's illness through inspection, but he saw that Zhao Shengli and Qian Hongying had completed the diagnosis of the old man just now and were staring at him.

Then the old man was questioned according to the standard of consultation.

"Well...it seems to hurt all the time, and it hurts more when I cough." The old man thought for a while and then said hesitantly.

"Is there any phlegm?" Zhang Yan asked next.

"Sputum."

"Do you often have heart palpitations for no reason and then sweat profusely?"

"Yes, yes, that's right!" the old man nodded quickly.

"You also have coronary heart disease.

According to traditional Chinese medicine, it means that the heart yang is weak, the heart qi is deficient, the deficiency and cold are internally generated, and the yang qi is insufficient...

Don’t be nervous, I’ll prescribe some side medicine for you, and you’ll come back to me for a follow-up consultation in three days.”

Zhang Yan prescribed Baoyuan Decoction for the old man.

"Make a medicine and drink it in two doses. Come to me for a follow-up consultation three days later." Zhang Yan explained after handing the prescription to the old man.

This was the last patient. No other patients came in. Zhang Yan looked at Zhao Shengli and Qian Hongying and said, "Show me the diagnosis and treatment plan you just made."

"Okay, Brother Zhang!" Zhao Shengli and Qian Hongying quickly gave Zhang Yan the diagnosis and treatment plan they wrote.

Zhao Shengli writes about chronic obstructive pneumonia.

Qian Hongying writes about chronic asthma.

Both of them were considering pulmonary diseases and were not affected by the two patients Zhang Yan treated later. This is very good.

"Xiao Qian, why do you think it's asthma?" Zhang Yan looked at Qian Hongying and asked.

"The patient has a long-term cough, phlegm, and difficulty breathing. According to the patient's self-report, he has been working in the boiler room for a long time. Considering the impact of the working environment, it should be asthma."

"There is another symptom of asthma, that is, the coughing gets worse at night and in the morning. Did you ask about this?

In addition, asthma is a respiratory disease. When you auscultated it, did you confirm that it was a respiratory problem?"

Following Zhang Yan's series of questions, Qian Hongying lowered her head and stopped talking.

"The patient's problem is in the lungs. It is obvious that there are rales in the lungs. In addition, the patient has been working in the boiler room for a long time. Why can't it be considered that dust pollution caused COPD?" Zhang Yan continued to ask.

After hearing Zhang Yan's words, Zhao Shengli was obviously happy. His diagnosis was correct.

"It's not bad. Although Xiao Qian diagnosed COPD as asthma, it's not too wrong.

Remember in the future, when the symptoms are vague and cannot be accurately judged, a more detailed examination must be carried out, such as a more detailed consultation.

For a small sum of money, you ignored some of the more critical symptoms of asthma during your consultation, and that's why you made a misjudgment.

Also, when you auscultated, you only listened to the front chest, did you listen to the back? Did you listen to the side chest?

However, one thing is worthy of praise. You were not affected by the following two patients and were directly diagnosed with coronary heart disease." Zhang Yan finally praised with a smile.

Coronary heart disease and chronic pulmonary obstruction are relatively similar in some symptoms.

Doctors often mistake coronary heart disease for chronic pulmonary obstruction or other lung diseases.

Some people regard lung diseases as coronary heart disease and myocarditis.

Because the two are very similar in many symptoms.

If you are careless, misdiagnosis may occur.

"Brother Zhang, I see that you just treated the two people behind you. They both had coronary heart disease. Why are the prescriptions different?"

"Coronary heart disease, in Western medicine, refers to lesions in the coronary arteries, leading to myocardial ischemia, and then triggering a series of diseases. www.bǐqυgetν.℃ǒm

In Western medicine, it is nothing more than early, middle and late stages, acute and chronic.

However, in traditional Chinese medicine, there are many different symptoms of coronary heart disease, such as heart qi deficiency, heart blood deficiency, heart yin deficiency, heart qi and blood deficiency, etc.

Qi deficiency and blood deficiency are two symptoms in traditional Chinese medicine, and naturally require different medicines.

This is also the charm of traditional Chinese medicine. Different causes require different drug treatments.

But Western medicine treats all diseases as one kind of disease. Treatment methods are currently very scarce."

In this era, Western medicine really doesn’t have a good way to treat coronary heart disease, that is, using drugs such as nitroglycerin to relieve the disease, and then antibiotics to reduce inflammation.

In later generations, Western medicine mainly relied on surgery and interventional therapy to treat coronary heart disease.

For example, adding brackets, building bridges, etc.

"The weather has turned cold recently, which is a period when respiratory diseases, lung diseases, and cardiovascular and cerebrovascular diseases are more common. When you diagnose, you must be careful and careful, and don't miss any tiny clues.

In fact, you have all learned the symptoms of many diseases in school. Whether you can accurately diagnose them depends on whether you are careful or not.

The other thing is the accumulation of experience. There is no way to do this, we can only take it slowly."

After Zhang Yan took the opportunity to teach, he continued to read.

Today I gave my uncle two thousand yuan, and all the bonuses he had accumulated during this period were wiped out again.

I always feel uncomfortable when I have no money in my hand.

Zhang Yan immersed himself in studying, looking forward to the reward given by the system after completing "Treatise on Febrile and Miscellaneous Diseases".

He is not doing it for money and supplies, but for the medical skills rewarded by the system.

Only with medical skills can we serve the people better.

Um!

That's it.

Zhang Yan is a good doctor and a good comrade who serves the people wholeheartedly.

Cash, material rewards, etc. are not important.

In the evening, when he returned home, Zhang Yan handed over the pig's trotters that had been mutilated by Zhao Shengli and Qian Hongying to Tong Mei.

"Why is it pig's trotters again! When I talk now, my mouth smells like pig's trotters!" Tong Mei said happily looking at the pig's trotters.

"Are you sure it smells like pig's trotters, not pork?" Zhang Yan said with a smile.

"It's not the same?" Tong Mei rolled her eyes at Zhang Yan.

Zhang Yan smiled, took the pig's trotters to the water pipe outside, and cleaned the pig's trotters.

"Dr. Zhang, you are washing pig's trotters again!" Sister-in-law of the Li family said with envy.

"Yes! No, the two interns in our medical office are practicing suturing, which consumes a lot of pig's trotters every day.

You can’t waste it, right?

Sister-in-law Li, why don't you take two pig's trotters and go home to satisfy the child's craving?" Zhang Yan said with a smile.

"Forget it, these pig's trotters don't have much meat, and they cost materials." The sister-in-law of the Li family was a little tempted, but when she thought that braised pig's trotters required a lot of oil and a lot of materials, she declined Zhang Yan's kindness.

Pig's trotters are not valuable, but the oil and materials are.

But she saw that the ingredients used in Zhang Yan's braised pig's trotters were enough to buy a pound of high-quality pork belly.

Give her pig's trotters, and she won't part with those ingredients.

Of course, if Zhang Yan gave her braised pig's trotters, she would definitely not refuse.

It's a pity that Zhang Yan will definitely not give her braised pig's trotters.
To be continued...