My Medical Skills Give Me Experience Points

Chapter 1517 - 613: The Importance of Inspection and a Breakthrough Discovery

On the very day of admission, the patient experienced another headache, particularly severe in both the frontal and temporal regions. The pain eventually became so intense that it led to vomiting.Pain severe enough to induce vomiting indicates a very high level of pain.

Upon admission, the patient’s temperature was 38.4 degrees, indicating a fever.

After admission, the hospital administered intravenous antibiotics, which is a basic package for most hospitalized patients. Especially for gastrointestinal surgery patients, glucose or sodium chloride intravenous infusion coupled with appropriate antibiotics has become an almost universal recipe.

Many blame small clinics for the rampant misuse of antibiotics, but the hands of big and small hospitals alike may not be completely clean.

However, large hospitals tend to have stricter control over the amount of antibiotics used.

Small clinics often increase dosage to pursue maximum therapeutic effects.

After using antibiotics, the patient’s temperature returned to normal by the third day of admission.

It must be said that antibiotics are indeed highly effective.

This is why both doctors and patients favor them.

The progression of the illness recorded the patient’s development; on the third day of admission, although the temperature had gone down and the headache had somewhat improved, the patient’s condition had not alleviated.

Because on the third day, she still experienced brief loss of consciousness and body spasms.

Each episode didn’t last long, only seven or eight seconds before resolving spontaneously.

Seeing this, Zhou Can felt the patient’s condition seemed confusing and difficult to piece together clearly.

When symptoms alone cannot pinpoint the cause, doctors often infer the cause based on examination results.

The patient currently has a temperature of 36.9 degrees, pulse rate of 74 beats per minute, respiratory rate of 29 times per minute, and blood pressure of 84/146mmHg.

The four major vital signs are basically all normal.

In other words, when the patient is not having an episode, her body is almost no different from a normal person.

It’s no wonder she sought treatment at the Neurology Department.

Under such circumstances, the suspicion is definitely first directed at neurological disease.

According to her symptoms, it’s likely there is an issue with the central nervous system. For example, brain abnormalities, or possibly epilepsy, etc.

The patient’s nutritional status is fair; skin and mucous membranes are not jaundiced, complexion not pale, and no bleeding points or spider nevi were seen on the body. Her thyroid is not enlarged, thoracic cage is not deformed, breath sounds are clear, and no dry or wet rales were heard upon auscultation.

Heart rate is 74 beats per minute, rhythm is regular, and no murmurs were heard in any valve area upon auscultation.

The abdomen is soft upon palpation, with no tenderness, rebound tenderness, or palpable masses. Spine and limbs are normal, with no deformities.

This series of physical examinations proves the patient’s body is basically normal, with no obvious lesions found throughout.

Diagnosis again points to the central nervous system.

The brain is a key suspect.

Both the first attending physician and Director Yin Hua conducted preliminary examinations on the patient’s brain.

Including conversing with the patient, her consciousness is clear, thought process coherent, speech normal, and memory, calculation, comprehension, and judgment abilities are all normal.

Her vision and visual fields are also normal.

Apart from diplopia (double vision), headache, and limb spasms during episodes, there are no other issues.

Director Yin also focused on examining the patient’s fundus optic disc; left eye movement in all directions is flexible, while upward and outward movement of the right eye is clearly restricted, with diplopia present.

During testing, when the eyes are in central position, diplopia is particularly evident when the right eye is viewing.

Zhou Can couldn’t help but be reminded of that child with high-level paraplegia. The little boy also exhibited significant differences between the left and right sides of his body after injury.

Tackling this case might provide some insights.

Despite the two having completely different conditions, since both involve neurological diseases, there ought to be some mutual learning.

Zhou Can decided to personally visit this female patient in the ward.

Neither the illness description in the medical records, nor the progression record, nor the various examination reports can compare to a doctor directly observing the patient.

Visual diagnosis has always been a fundamental skill for physicians.

It also ranks as the foremost diagnostic art among the four major diagnostic techniques in traditional Chinese medicine.

Visual diagnosis, though not the core of Chinese diagnostic methods, is the first diagnostic technique following patient reception.

Just like how a good day starts in the morning, and a good year begins in spring.

It serves as the physician’s starting point for diagnosis.

It has a significant influence on the subsequent assessment of the illness.

The most core diagnostic technique in Chinese medicine is pulse diagnosis.

Western medicine developed thousands of years later than traditional Chinese medicine, like a promising newcomer. Its diagnostic habits have copied some from Chinese medicine.

Visual diagnosis is still a primary examination item in Western medicine, comparable to physical examination.

As for pulse diagnosis, Western medicine doesn’t acknowledge the concept of meridians; it finds pulse study to be somewhat mystical and abstract. It’s possibly considered too complex, so Western medicine developed its own set of diagnostic methods to replace pulse diagnosis.

Those methods include ultrasound examination, biochemical tests, CT scans, MRI, endoscopy, etc.

Regardless of a cat being black or white, a cat that catches mice is a good cat.

Pulse diagnosis in Chinese medicine is robust; a skilled practitioner can diagnose just by feeling a patient’s radial pulse, equivalent to a hospital conducting a comprehensive check-up. Furthermore, diseases that might not be detected by advanced equipment could be spotted by pulse diagnosis.

However, pulse diagnosis is extremely difficult to learn, requiring very high talent and many years of study to achieve proficiency.

The training cycle for talent is too long.

Additionally, with the decline of Chinese medicine, there are very few genuinely knowledgeable old Chinese doctors who understand pulse diagnosis, making the transmission of knowledge even more challenging.