Chinese Medicine: Starting with Daily Intelligence
Chapter 268: Treating Both the Symptoms and the Root Cause
"Thank you for your guidance, Director Zhu! I've learned a great deal."
Li Xu felt the trip had been incredibly fruitful.
"Ah, don't be so formal," Zhu Quanxin said with a smile. "Those of us in medicine should be like this, exchanging ideas and improving together!"
Just then, the door to the consultation room was pushed open again, and a young man walked in.
"Director Zhu, I'm back again."
The man greeted him listlessly.
One side of his face was also stiff and crooked.
Zhu Quanxin recognized him as one of his regular patients.
He pulled up the patient's case file on his computer.
Li Xu glanced over.
This patient was the exact person from the intelligence report—Zhang Jianing!
Zhang Jianing was a "repeat offender" when it came to facial paralysis.
He had a weak constitution, and the slightest exposure to wind and cold, or overwork, would easily trigger a relapse.
It had happened twice last year, and this was already the third time this year.
A couple of days ago, he had been exposed to a cold draft, causing facial paralysis on the right side of his face, so he had come to Director Zhu for acupuncture.
Today, he was here for a follow-up treatment to consolidate his recovery.
Zhu Quanxin had already given him one day of acupuncture according to the standard treatment protocol.
Although it had some effect, his recovery was never ideal. The condition would recur repeatedly and could not be completely cured.
Zhu Quanxin was about to administer the needles as usual.
But just as he picked up a steel needle, he paused.
He glanced at Li Xu beside him and suddenly had a thought. 'Li Xu's diagnostic reasoning is unconventional and his eye for detail is sharp. Why not... let him take a look too? Maybe he'll spot a problem I've missed?'
"Doctor Li," Zhu Quanxin said to Li Xu, "this is a patient of mine, also with facial paralysis. His condition keeps relapsing and can't be fully cured. Could you take a look for me? Is there a problem with my diagnosis? Why is his facial paralysis so stubborn?"
Li Xu's interest was piqued. He recalled a sentence from Elder Cheng's notes: 'Recurrent facial paralysis is always a sign of a hidden ailment.'
Under normal circumstances, when faced with such a complex, recurrent case,
with his current level of experience,
it might have been genuinely difficult to find the deep-seated cause.
But today, with the intelligence "cheat" at his disposal, everything became simple.
Li Xu didn't refuse. "Alright, I'll take a look."
He had Zhang Jianing lie down on the examination bed.
First, he carefully took his pulse.
The pulse was weak and feeble, a classic sign of qi and blood deficiency.
Then, he began to perform palpation on Zhang Jianing's body.
While pressing with varying degrees of force on different acupoints and areas on his limbs, abdomen, and back, he asked, "Does it hurt here? ... What about here? ... What do you feel?"
Zhu Quanxin watched from the side, nodding repeatedly.
He understood why Li Xu was doing this.
Treating facial paralysis wasn't just about examining the meridians and acupoints on the face and head.
Western medicine focuses on treating the disease, while Chinese medicine focuses on treating the underlying pattern of disharmony.
To treat the pattern,
a comprehensive examination was needed to find its source.
It was just that...
Zhu Quanxin shook his head to himself. He had examined the patient before.
Aside from discovering the patient's qi and blood deficiency, he hadn't found any other particular symptoms.
Could Li Xu really find anything?
Just as this thought arose,
Li Xu pressed on the right side of Zhang Jianing's chest and hypochondriac region.
This was the problem area mentioned in the intelligence report.
Li Xu saw an extremely inconspicuous, millet-sized red mole below the patient's right nipple.
He reached out and pressed down on that red mole.
"AH!"
Zhang Jianing, who had been silent until now,
suddenly cried out in pain.
His body tensed up violently from the sharp pain.
"Here... it hurts so much here, like a needle stabbing me," he said, gasping for breath.
Li Xu moved his finger and pressed with the same force on the corresponding spot on the left side of his chest. "What about here? Does it hurt?"
"Here... no, it doesn't hurt," Zhang Jianing said, shaking his head.
'Found it!'
Li Xu nodded.
The intelligence was as accurate as ever.
The root of the illness was right here.
He stood up and said to Zhu Quanxin, "Director Zhu, I know the reason for this patient's recurrent facial paralysis now."
"Oh? And what is it?" Zhu Quanxin asked eagerly.
Li Xu explained, "For this patient, the facial paralysis is just a 'symptom,' the external manifestation. His 'root cause,' the source of the illness, lies in his internal organs—specifically, there's a problem with his liver and gallbladder."
He pointed to the small red mole under Zhang Jianing's right breast. "This mole, though small, is a classic external sign of stagnation in the liver meridian and obstructed qi and blood flow.
"Just now, when I pressed on the mu-front points of the liver and gallbladder meridians on his right side, such as Qimen and Zhangmen, he felt excruciating pain;
"but when I pressed the corresponding locations on the left side, he felt no pain at all.
"This indicates that there is a severe blockage in his liver and gallbladder meridians!"
Understanding dawned on Zhu Quanxin.
He hurried forward, carefully examined the small red mole, and pressed on it. It was exactly as Li Xu had described.
'So that's it. The root cause was hidden so well.'
He had examined other areas when he diagnosed Zhang Jianing before.
But firstly, he hadn't been this meticulous, and secondly, he hadn't made the connection to the mole.
Li Xu continued, "The area around the mouth and eyes on the face is where the Stomach Meridian of Foot-Yangming and the Gallbladder Meridian of Foot-Shaoyang run and intersect.
"If the patient's liver and gallbladder meridians are stagnant and blocked for a long time, causing the flow of qi to become disordered, then when he encounters triggers like fatigue or cold, this stagnant pathogenic qi will travel up the meridians to attack his face, leading to recurrent bouts of facial paralysis."
"If we don't address this fundamental problem in his liver and gallbladder, then even if we use acupuncture to temporarily clear the meridians in his face and cure his paralysis this time, the 'root cause,' this 'lesion,' will remain in his body. Next time, as soon as the opportunity arises, it will make a comeback and strike again!"
Zhu Quanxin nodded. He understood all of this.
It was just that he hadn't detected the underlying pattern before.
Now that the cause was known, the treatment was simple.
Treat the facial paralysis as the symptom, and the internal organs as the root.
By treating both the symptom and the root cause, the problem could be eradicated.
"Director Zhu, should you do it, or shall I?"
Li Xu asked.
Zhu Quanxin thought for a moment. "You do it. It's a good opportunity for me to observe your needling. If you make any mistakes, I can correct you."
"Alright."
Li Xu was happy to oblige.
After Director Zhu's guidance just now,
he felt he had improved a great deal.
Li Xu took out his steel needles and began to perform acupuncture on Zhang Jianing.
This time, his choice of acupoints was completely different from the ones he used on the middle-aged man earlier.
He first needled points on Zhang Jianing's back like Ganshu, Danshu, and Geshu, using a gentle, tonifying technique to soothe the liver, benefit the gallbladder, and regulate the qi of the internal organs.
Next, he applied the "penetratingly cool" reducing technique to points on the patient's right side, such as Qimen, Zhangmen, and points on his leg like Yangling Spring and Zusanli. This was to guide the pathogenic qi stagnating in the liver and gallbladder meridians downward, allowing it to exit from the lower body.
Finally, he needled the main acupoints on the patient's face using a neutral, even-supplementing and even-draining technique to clear the facial meridians and restore muscle function.
The entire sequence of techniques involved both tonifying and reducing, ascending and descending, and a combination of local and distal points, treating both the symptom and the root cause.
The reasoning was clear, and the combination of points was exquisite.
It made Zhu Quanxin, watching from the side, nod repeatedly in approval.
Most importantly, Li Xu's technique had improved remarkably.
The accuracy and force of his needling had increased significantly.
His careful guidance just now had not been in vain.