Chapter 101 Collapse of Yang

Words : 1629 Updated : Sep 12th, 2025

Du Heng stopped asking and began the examination, somewhat perfunctorily. The patient’s complexion was ashen blue, her eyes lifeless. Her voice was barely audible, her breathing labored with raised shoulders, and her breath was faint. A gurgling phlegm sound rattled in her throat, and when she coughed, she expectorated white, frothy sputum. Upon touching her limbs, her hands were cold past the elbow, and her feet were cold past the knee. Moreover, her lips and fingers were cyanotic, and there was pitted edema in her lower limbs. As soon as Du Heng placed his fingers on her pulse, he was startled by its rapid and hurried nature. He roughly estimated that the patient’s pulse was approaching three beats per second, which was 160 or 170 beats per minute. Collapse of Yang, complicated by various symptoms. Moreover, according to the village head, the patient had a 30-year history of cough and asthma, which must have caused her lung lobes to atrophy, with deep-seated damp phlegm and dead blood stagnation. However, the lungs are delicate organs. They cannot be treated with aggressive measures to directly target the core of the illness. Striking a balance between aggressive treatment and supportive care was truly difficult; it felt impossible to salvage the situation. Du Heng sighed silently in his heart but still insisted on completing the pulse diagnosis. Suddenly, while examining the patient’s pulse, Du Heng’s eyes brightened. Li Qiuhua’s instep yang, LV-03, and Tai Xi pulses were surprisingly still palpable and regular. This meant that the patient’s stomach function was still intact, and there was no problem taking in and digesting food. Du Heng’s finger twitched slightly. The presence of stomach qi means the patient still possesses vitality. If the stomach qi were absent, it would signify a truly fatal condition. Addressing the family, he asked, "Do you have the patient’s disease records?" The patient’s daughter, though somewhat numb, still took out a thick stack of papers from her bag. There were inspection sheets and payment receipts, but no disease record book. It seemed all big hospitals now used electronic records. If a paper copy of the disease record was needed, it would take half a month to a month to get it printed from their archives room. With no other option, Du Heng could only examine the inspection sheets. Two minutes later, he put down the papers in his hand, hesitating, unsure what to say. If I say there’s no hope, I won’t lose face. After all, the Municipal Hospital already gave up, so I wouldn’t have to take any responsibility. However, the patient does have a glimmer of hope; she could be saved and successfully treated. If I don’t say it, my conscience won’t allow it. But if I do say it, I’ll have to bear significant risk. Inspired by Mr. Xu from the county town, Du Heng understood a principle of traditional Chinese medicine: be meticulous in seeking evidence, yet bold in prescribing medication. With my current Internal Medicine Expertise, as long as I’m careful with syndrome differentiation, there’s no cause of illness I can’t clearly identify. However, regarding treatment and medication, I’m still as timid and cautious as before. The development of Western medicine also greatly aids traditional Chinese medicine. With various tests and instruments, the root of illness can be directly identified. Previously, the cause of a disease was identified based on symptoms. Now, the cause can be found directly from the root, which is faster and more accurate. So, if I can only differentiate syndromes but don’t dare to be bold with medication, or don’t know how to use it, then I’m no different from a machine. However, that said, being bold with medication and using excessive doses could lead to trouble. I’m not a saint, after all. Why should I gamble my future on the potential gratitude and sense of justice of the family members? If I cure her, great. But if I can’t, the subsequent trouble could be overwhelming. Seeing Du Heng stand up, Song asked anxiously, "Xiao Du, what’s the situation?" Looking at Song’s enthusiasm, Du Heng suddenly had an idea. Why should I be the one to make the choice? Why can’t Song make this choice? After all, the medication I’m considering this time requires the leaders’ approval. "Leaders, the patient suffers from a chronic illness. Her qi and blood are depleted, Yin is exhausted, Yang has collapsed, and her breath is faint. This constitutes a state of great deficiency. Furthermore, the illness is in her lungs, which show lobe atrophy and are afflicted by deep-seated damp phlegm and dead blood stagnation. This constitutes a state of great excess. The patient has had recurrent episodes, causing her constitution to grow weaker while the pathogenic factors became more entrenched. Therefore, the patient is now exhibiting all the manifestations of Yang collapse, presenting with signs of impending death." The leaders couldn’t understand most of what he said, but the final words "signs of impending death" were clear enough. They were about to say something when Du Heng, after a dramatic pause, spoke again, "However, the patient’s stomach qi is still present. There is still a trace of vitality." Everyone present was taken aback by this sudden turn. At this point, the two brothers, who had heard their wives and sister calling, also came over. When they heard Du Heng say there was a glimmer of hope, their eyes lit up. The leaders were dazed and didn’t react immediately, but Song and An Chunhui instantly grasped the significance of Du Heng’s words. Song quickly stepped forward and hissed in a low voice, "Xiao Du, do you realize what you’re saying?" "I know." Du Heng looked at Song without changing his expression. "You..." "Doctor Du, is it?" The leader, displeased by Song taking matters into his own hands, addressed Du Heng. "Since you say there’s hope, do you have a method to treat her?" But Song’s face turned dark. Du Heng cleared his throat, organized his thoughts, and said, "The priority is to use a large dose of Extraordinary Heart-saving Decoction to rescue Yang and stem desertion. This will be followed by Ginseng-Gecko Powder to promote qi absorption by the kidney. Musk will then be used to expel foulness, transform turbid phlegm, and open the upper orifices, thereby treating the respiratory failure." The leader didn’t understand the technicalities but, seeing Du Heng’s confidence, asked, "Are you sure?" "I am sure." The moment he finished speaking, Li Qiuhua’s two sons dropped to their knees before Du Heng, startling him. "What are you two doing? Stand up quickly." Du Heng hurriedly reached out to pull them up. But both men remained kneeling; Du Heng tried to pull them up but couldn’t manage both. "Doctor Du, please save my mother." Both were filial sons and desperately didn’t want to miss this chance, however slim. "You two get up first." Du Heng was so anxious that sweat beaded on his forehead. There are leaders and fellow villagers here! What will it look like if they kneel and beg me like this? Finally, the village head intervened, persuading the two men to stand, which relieved Du Heng’s awkward situation. The leader, also moved by the two filial sons, said to Du Heng, "Since there’s a method, proceed quickly." Everyone looked at Du Heng with hope, but he shook his head. The leader frowned, looking at Du Heng with some displeasure. "Is there a problem?" "Leader, the proposed medication requires a large dose of aconite. I need approval from my superiors, and the patient’s family must sign a Special Drug Treatment Informed Consent Form." "Why?" "Aconite is toxic. The National Pharmacopoeia stipulates a maximum dose of 15 grams, though up to 60 grams may be used in special circumstances. However, the dosage I’m proposing is 200 grams for the first administration, and subsequent doses might be even larger." The leader didn’t understand the specifics of the medicine, but he understood the implications when regulations were mentioned. Exceeding the stipulated amount by more than tenfold was no trivial matter. If the family didn’t sign the consent form and the leader didn’t give his approval, no one would dare administer the medicine. Regardless of whether the patient recovered or not, the prescribing doctor would undoubtedly face severe consequences. If the patient died, the prescribing doctor could even face imprisonment. However, if the forms were signed, it would provide a significant degree of protection against potential legal repercussions. While it couldn’t entirely prevent unforeseen complications, it could guard against opportunistic individuals with malicious intent. Upon hearing Du Heng’s explanation, both sons immediately agreed, "We’ll sign, we’ll sign!" Du Heng looked seriously at the two of them and said, "The cost might be quite high." "No matter how expensive, we’ll pay for the treatment!" "Alright." Du Heng returned to his car, found a pen and paper, and began to handwrite the Special Drug Treatment Informed Consent Form. While he was writing, Gong Daoyang approached. "Xiao Heng, this is no laughing matter. Have you truly thought this through?" "Gong, do you see this?" Du Heng said, holding up the form. "This is essentially a liability waiver. With this, regardless of the outcome, and whether the leaders here acknowledge it or not, I should be clear of any trouble. Don’t worry." Gong Daoyang thought, What I’m afraid of is precisely that the leaders *won’t* acknowledge it. If it succeeded, it would be a joyous outcome for everyone. The family would be spared the grief of losing a loved one. Du Heng would earn their gratitude and the leaders’ approbation, gaining an immense reputation in the process. Even the leaders present would be commended for their calm decisiveness and effective leadership in a crisis. But what if it failed?

Chapter 101 Collapse of Yang

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