I Can Hear the Heart's Voice of Traditional Chinese Medicine-Chapter 427 - 176: Guange (Chronic Renal Insufficiency)

"Dr. Lu, I’m here again."

Lu Xuan was wondering why no one had come in for so long when he heard a familiar voice at the door.

Looking up, he saw it was Liu Shao and curiously said, "The number just called wasn’t yours, was it?"

Liu Shao chuckled, "I’m next. Today I came with a friend, and I thought I’d also have you check my pulse to see how I’ve been doing lately."

"Hearing the strength in your voice, I can tell without looking that you’re doing well."

"Dr. Lu, you can even read faces, huh? You can tell just like that."

Lu Xuan rolled his eyes, "Your complexion is so good, there’s no need to check. Anyone who’s not blind can see it."

"Really? I feel like I’ve gotten better this week too."

"But it’s thanks to the medicine you gave me. I’ve only been on it for two or three weeks, and my urine sugar is down to just a plus, and my energy is way better than before."

Liu Shao helped Old Li sit down and said, "Dr. Lu, please persuade him. My friend’s dad is thinking of giving up. No matter what we say, we can’t convince him. He keeps saying he doesn’t want to end up with no money and no life."

Only then did Lu Xuan turn his attention to Old Li, "What’s going on, sir?"

"Chronic kidney insufficiency."

"Guan Ge?"

"Huh?"

Remembering how his diabetes was referred to as Xiao Ke by Lu Xuan, Liu Shao seemed to think of something and tentatively asked, "Is this a term in Traditional Chinese Medicine?"

"You sure know a lot," Lu Xuan said with a smile.

"Even if I haven’t eaten pork, I’ve at least seen a pig run," Liu Shao boasted. "I’ve visited you several times, Dr. Lu, so I naturally know these terms I don’t quite understand refer to chronic kidney insufficiency in Chinese medicine, just like how my diabetes is called Xiao Ke by you."

Lu Xuan didn’t continue this conversation with Liu Shao and instead asked, "How long has it been?"

While Lu Xuan asked these questions, Liu Shao skillfully lifted Old Li’s arm onto the pulse cushion.

Not knowing much about these things, Liu Shao turned to Li Chengyuan and said, "Your turn."

"Over a year."

Lu Xuan nodded and placed his right hand on Old Li’s inch-close-foot pulse, while Li Chengyuan began to recount Old Li’s condition and produced previous examination reports.

Lu Xuan took the examination reports, feeling Old Li’s pulse while looking at the reports Li Chengyuan handed over.

A year ago, Old Li was hospitalized because he felt unwell. During his stay, his blood creatinine was tested at 596μmol/L, and an ultrasound showed both kidneys had shrunk.

He had a history of diabetes. Initially, Old Li refused dialysis, thinking it was too expensive and required at least a dozen sessions a month. His son’s meager income was insufficient to cover the dialysis costs, and he also didn’t take any Western medicine.

Later, as the condition progressed rapidly to a point where dialysis was unavoidable, Li Chengyuan secretly paid for it, telling Old Li the money couldn’t be refunded. Only then did Old Li reluctantly accept the reality.

However, Old Li’s condition was severe, and even with hospitalization, dialysis, and Western medicine treatment, it wasn’t very effective. Eventually, Li Chengyuan ran out of money and had to arrange for discharge.

As a fan of Liu Shao, Li Chengyuan quit his local job on Liu Shao’s recommendation and brought Old Li to Yong City, seeking herbal treatment from Lu Xuan’s clinic.

Before coming, they tested his blood creatinine at 672μmol/L, hemoglobin (HGB) 89g/L, urine analysis showed protein (+++), occult blood (+).

It can be said that the situation was much worse than when he was first hospitalized.

While going through the examination reports, Lu Xuan continued to inquire about Old Li’s physical condition and meticulously recorded everything in the medical record book.

Symptoms noted: General fatigue, fear of cold, moderate edema in both lower limbs, pressing leaves a dent, sore waist and knees, difficulty walking, poor appetite, sleep issues, dry stools, scant and short urination, pale tongue with thin yellow coating, pulse deep and weak. Western diagnosis: Chronic renal insufficiency (renal failure stage); Chinese medicine diagnosis: Guan Ge (Kidney Yang Deficiency).

For Chinese medicine practitioners, recording medical cases is a fundamental skill.

The recording of medical cases, known as writing medical cases in traditional Chinese medicine, has strict requirements for elements and format.

In traditional Chinese medical parlance, regardless of the modern name for medical records or ancient medical cases, they are collectively referred to as medical case records.

In Chinese medicine, records of symptoms, prescriptions, and medications are often used as book titles, such as Ye Tianshi’s "Clinical Guide Medical Case" from the Qing Dynasty and Qin Bowen’s "Case Records of Famous Physicians from the Qing Dynasty."

A medical case is a medical record and serves as a continuous documentation of the diagnosis, methodology, and prescriptions used by doctors in treating diseases.

The renowned physician Chunyu Yi in the Han Dynasty creatively recorded twenty-five medical cases of his own treatments, then called "Diagnosis Book."

Medical cases are more than just a patient’s physical condition and include the patient’s name, address, occupation, pathology, syndromic differentiation, treatment, prognosis, and so on. Later medical practitioners organized and compiled their treated cases into personal medical casebooks.

There are also compilations of medical cases from famous physicians of past and present, like "Compilation of Cases from Famous Physicians," "Supplementary Compilation of Cases from Famous Physicians," "Past and Present Medical Cases by Example," and so on.

Modern medical writing of cases also follows a systematic and stringent set of requirements.

Medical records are a comprehensive record and summary prepared by healthcare professionals during the diagnostic process; they are the basis for making diagnoses and formulating treatment and preventive measures. They serve as important material for summarizing medical experiences, enriching educational content, and conducting research; sometimes, they provide truthful and reliable material for other tasks, and complete medical records can deeply reflect the level of medical quality and academic proficiency.