sbdcsierra Chapter 835 Breaking up
Chapter 835 Breaking up
"Director Lin and I are angry with each other."
Qin Dongliang said to Chen Yang: "Xiao Chen, you go see the patient first, don't have any psychological burden, I will take care of everything."
As a department director, Qin Dongliang is a very responsible one. He will never let his subordinates take the blame for him.
"Director Qin, you are being too polite." Chen Yang smiled.
In fact, only someone with Chen Yang's level can understand the benefits of meeting a responsible leader.
After all, curing illnesses and saving lives is different from ordinary things and does involve risks.
One of the most crucial reasons why it is difficult for junior doctors to get ahead is that senior doctors will not easily delegate authority to you in many matters.
Even if you have the skills, there is still a chance of something going wrong, right?
Who is responsible if something goes wrong?
Especially in some emergency situations and consultations, the final decision is often made by the department director, who is a senior doctor. Even if the treatment plan is not his own, as long as he agrees, he is responsible.
You are just a small attending physician, how many senior doctors can trust you?
After Chen Yang came to the Affiliated Hospital of Shanzhou Medical University, he was able to quickly stand out and treat many difficult patients because of Qin Dongliang's support.
Only with Qin Dongliang's support can you achieve results, and only with results can you gain more trust.
Chen Yang sat beside the bed and took the patient's pulse while Qu Heng told Chen Yang about the patient's condition.
The patient had undergone a splenectomy due to liver cirrhosis five years ago and had frequent gastrointestinal bleeding since then. This time, the hiccups were caused by the bleeding.
Just as Qu Heng had told Qin Dongliang and others before, although hiccups are uncomfortable, they are not life-threatening for ordinary patients. However, if they occur in patients with advanced liver cirrhosis, there will be great risks.
Patients with advanced liver cirrhosis have poor coagulation function and dilated gastrointestinal veins, which can easily lead to venous rupture and massive bleeding, endangering their lives.
Chen Yang placed his fingertips on the patient's wrist. The pulse was heavy and stagnant like a turbid undercurrent, with the pulse at the Chi part being weak and rootless, and the pulse at the Guan part being slippery and strong. This was a typical symptom of a mixture of deficiency and excess, with liver and kidney yin deficiency as the root cause and stomach qi reflux as the symptom.
Qu Heng added: "Western medicine antispasmodics were used for three rounds, and acupuncture at Neiguan and Zusanli points was ineffective. The patient now hiccups more than 40 times per hour and has already vomited bile."
"The patient's CT scan showed that his liver showed typical nodular changes and there was significant abdominal effusion."
Qin Dongliang said: "Before you came, Lin Jiaming and I both looked at the patient's condition. Lin Jiaming suggested using Xiangsha Liujunzi Decoction, but I rejected it."
Before Chen Yang came, Lin Jiaming and Qin Dongliang had examined the patient, and Lin Jiaming also gave a treatment plan, but it was rejected by Qin Dongliang.
This was also the reason why Lin Jiaming was unhappy at the time and said, "It seems that nothing can be accomplished in the department without Chen Yang."
Lin Jiaming felt that Qin Dongliang was suppressing him and not giving him the opportunity to perform.
As he spoke, the patient began to hiccup again.
Chen Yang didn't say anything. After taking the patient's pulse, he stood up, raised the patient's head, and suddenly tapped the Tiantu point with his fingers.
After the patient choked and coughed violently, the hiccups miraculously stopped.
Chen Yang's actions made the pupils of the people present shrink suddenly. Liu Xi couldn't help but blurt out: "Master, are you trying to test the Qi by provoking me?"
"good."
Chen Yang said to Liu Xi: "Silver needles, alcohol lamps, moxa cones."
There was a nurse nearby, who immediately went to prepare upon hearing what was said.
When the silver needle was delivered, Chen Yang picked it up and burned the needle tip on the alcohol lamp, saying, "The patient has been ill for a long time and has damaged his yin, and the virtual fire is disturbing him. He also has liver depression and qi stagnation, and the stomach qi is not descending. The conventional method of stopping hiccups is like stirring the soup to stop it from boiling. You must first break the adverse qi, and then nourish the yin and suppress the yang."
As he spoke, Chen Yang found the three acupoints of Yifeng, Lianquan and Geyu. His technique was as smooth as a dragonfly touching the water. The silver needle instantly sank into the acupoints, and he then slowly lifted and inserted the needle using the vibration tonification method.
Qu Heng took a closer look and saw that the patient's tense facial muscles were gradually relaxing and the frequency of hiccups was significantly reduced. He could not help but exclaim: "This acupuncture technique is even more effective than Western medicine!"
Qin Dongliang remained cautious: "Acupuncture can only treat the symptoms, and we still need to rely on decoctions to strengthen the body."
"Director Qin is right."
After Chen Yang finished acupuncture, he wrote a prescription while talking: "30g of raw ochre should be decocted first, 15g of northern adenophora, 12g of ophiopogon, 10g of dendrobium, and 9g of scutellaria baicalensis should be decocted in a package. Daizheshi can calm down the adverse reaction, while the adenophora and ophiopogon decoction can nourish yin and moisten dryness, and then the scutellaria baicalensis Daizhe decoction can be used to harmonize the stomach qi." He paused, "But the decoction will take time to take effect, so we have to add an external treatment."
“Grind up the Evodia rutaecarpa into powder, mix it with white vinegar to make a paste, and apply it to the Yongquan acupoints on both feet of the patient.”
Chen Yang then said to Liu Xi: "Yongquan is the well point of the kidney meridian. It can guide the fire downward. Combined with decoctions, it can achieve the effect of treating both the upper and lower parts."
"Yeah." Liu Xi nodded.
At this time, Lin Jiaming suddenly turned back, leaned against the door frame and sneered, "Doctor Chen, are you treating acupuncture as a joke and external treatment as metaphysics? The patient's blood coagulation function is extremely poor. The slightest mistake in acupuncture will cause hematoma. Can you bear the responsibility?"
Chen Yang raised his head and glanced at Lin Jiaming: "Director Lin, why don't you take a look at the patient's four coagulation tests - PT extended by 2 seconds, INR 1.3, which are within the controllable range. But the 'Xiangsha Liujunzi Decoction' that Director Lin just proposed, with its warm and dry nature, won't it help the evil?"
"Moreover, the yellow greasy tongue coating gradually fades and the tongue is crimson. This is a sign of yin deficiency and excessive fire. Warming tonic is really a taboo." Chen Yang continued.
Lin Jiaming's face turned pale. Qin Dongliang suppressed him and didn't give him the opportunity to perform. Chen Yang was also so disrespectful to him.
Lin Jiaming was about to refute when the patient on the bed suddenly retched and vomited blood.
Qu Heng immediately shouted, "Quick! Prepare the three-chamber two-balloon catheter! Contact the interventional department!"
Qin Dongliang's expression also changed slightly.
A flash of joy flashed across Lin Jiaming's face.
Well, Qin Dongliang trusts Chen Yang, so now that something has happened, it has nothing to do with him.
With this matter, and with the help of his uncle, it is just the right time to get rid of both Chen Yang and Qin Dongliang.
Originally, Lin Jiaming was not so anxious. He had just arrived and had only been in the Traditional Chinese Medicine Department of Shanzhou Medical University Affiliated Hospital for four or five days.
According to Lin Jiaming's plan, some things will have to wait at least a year before we can talk about them.
So during this year, Lin Jiaming had no intention of going against Qin Dongliang, he just wanted to establish his own prestige.
And Chen Yang is the stumbling block for Lin Jiaming to establish his prestige.
Chen Yang's face was calm, and his tone was steady: "Don't worry! The patient has a weak pulse, sweats and cold limbs, which is a sign of Qi and blood loss. The most urgent task is to stabilize the loss, not to stop the bleeding!"
As he spoke, Chen Yang picked up the moxa stick and began to apply moxibustion to the patient's Guanyuan and Qihai points. At the same time, he ordered: "Boil the Shenfu decoction, and drink it immediately!"
Qin Dongliang did not hesitate: "Listen to Doctor Chen!"
As time passed, the patient's blood pressure gradually returned to normal and his complexion changed from cyanosis to light red.
Qu Heng wiped the sweat off his forehead and sighed: "Doctor Chen's method of 'treating the symptoms in an emergency and treating the root cause in a slow manner' is a textbook-level treatment!"
Lin Jiaming stared at the steady curve on the ECG monitor. His throat seemed to be blocked and he couldn't make a sound. He snorted coldly and turned away.