Chapter 149 Disulfiram-like

Words : 1467 Updated : Sep 19th, 2025

Wu Buwei was now a medical practitioner. He could diagnose patients but could not prescribe and dispense medicine for them. However, he could prescribe over-the-counter drugs or Chinese patent medicine, which was completely fine. Medical practitioners, without prescription rights, must be supervised and guided by senior doctors when diagnosing and prescribing drugs. However, in Zhonghu Town, most village doctors were medical practitioners, with only Du Fei and two others being primary practitioners. As for them, the policy was slightly more lenient, and they could prescribe some prescription drugs in their own clinics. Otherwise, if there was an emergency in the village and no prescription drugs were available, the patient would probably be dead by the time they arrived at the hospital. Du Heng did not disturb him but sat down next to Wu Buwei’s stool. Wu Buwei glanced at him, and Du Heng shook his head gently. "Don’t mind me, just do your own thing." Hearing Du Heng say this, Wu Buwei stopped looking at Du Heng and focused on the pulse diagnosis. Du Heng didn’t speak but observed the patient in front of him closely. The patient was a woman in her fifties, with a flushed face, bloodshot eyes, and sweating profusely. By this time, Wu Buwei had finished the pulse diagnosis, but it took him a relatively long time, similar to how long Du Heng used to take. He was likely cross-referencing the pulse diagnosis with the knowledge in his head. "Auntie, besides dizziness, nausea, and vomiting, do you have any other symptoms?" "No, it’s just that I’m sweating a lot right now. Look, my clothes are already soaked." "Before you came here, have you taken any medicine?" The patient thought for a moment. "At noon, my head was a little dizzy, and I felt nauseous and wanted to vomit. I thought I might have heatstroke, so I drank a bottle of Huoxiang Zhengqi Tincture. After that, my head was still very dizzy, so I went to sleep. I don’t know how it happened, but when I woke up, I was like this, with so much sweat pouring out." Wu Buwei was also unsure. The patient had a rapid pulse. According to Binhu Sphygmology, a rapid pulse indicated excessive Yang heat. Treatment should generally involve cooling and purging excess or warming and tonifying deficiency, but one should be cautious with lung diseases in late autumn. Combining the patient’s signs and symptoms, it appeared to be a case of heat invasion, or mild heatstroke. But the sweating was indeed strange. Even if Huoxiang Zhengqi Tincture had a diaphoretic effect, it would only cause slight fever and sweating on the body surface, not the current state of profuse sweating. Wu Buwei was uncertain, so he turned his gaze to Du Heng. Du Heng saw Wu Buwei’s eyes seeking help, but he was also puzzled. Wu Buwei’s pulse diagnosis should not be wrong. Based on the patient’s symptoms and self-reported condition, it indeed looked like heatstroke. But the excessive sweating also baffled Du Heng. Since Wu Buwei was stuck, Du Heng had to take the initiative to ask the patient, "I hear your voice is a bit hoarse. Did you catch a cold?" The patient nodded. "Last night, I was exposed to the wind, and I already had a bit of pharyngitis, so I woke up this morning with a hoarse throat. It probably got inflamed again." "Oh, did you take any anti-inflammatory drugs then?" "Of course, I had to. You don’t know how much my pharyngitis has tortured me. If I don’t control it in advance and take anti-inflammatory drugs, I can’t speak, and I can’t eat." Upon hearing this, Du Heng immediately recalled his earlier conversation with Yu Haiting; the two had actually discussed this very issue. Du Heng’s spirits lifted, and he hurriedly asked, "What medicine did you take?" "It was that Cephalosporin something... I don’t remember the last three words of it." It didn’t matter if she didn’t remember the last three words, as long as she remembered the first part. As the saying goes, "Cephalosporins with alcohol, the suona horn plays all night." And Cephalosporins with Huoxiang Zhengqi Tincture was also a combination that could quickly lead to trouble. Taking these two medicines together could also cause adverse drug reactions. Milder reactions could include dizziness, nausea, vomiting, chest tightness, and lack of strength in the limbs, while more severe reactions might lead to anaphylactic shock, liver damage, acute heart failure, and even death. The simple reason was the presence of alcohol in Huoxiang Zhengqi Tincture. So, after taking Cephalosporins, it’s best to wait about a week before drinking alcohol or alcoholic beverages; otherwise, the suona horns might indeed play all night. "Oh my god, you’re having a disulfiram-like reaction from the Cephalosporins and Huoxiang Zhengqi Tincture," Du Heng said to Wu Buwei. "Go get Dr. Yu down here. Let him handle it. Western medicine is more direct and effective in this situation than traditional Chinese medicine." Wu Buwei understood and quickly got up to find Yu Haiting. The Auntie didn’t understand what a "disulfiram-like reaction" was and asked anxiously, "Doctor, am I poisoned?" "It’s almost the same thing." "Can I still be saved?" she asked, her voice cracking. Du Heng chuckled and shook his head. "Don’t worry, your condition isn’t too serious. We’ll have Dr. Yu help you out in a bit, and you’ll be fine." The Auntie finally breathed a sigh of relief upon hearing Du Heng’s words. He chatted with the patient for a few more minutes, encouraging her to relax and not be so nervous. While they were chatting, Yu Haiting had already walked in quickly. "Dean, what’s going on?" "Take a look. It should be what you just told me about: a disulfiram-like reaction caused by the combination of Cephalosporins and alcohol." Yu Haiting’s heart skipped a beat. He recalled how, just a short while ago, Du Heng had used only two simple medicines to solve a difficult problem that had stumped Yu Haiting himself, leaving him deeply impressed. And now, Du Heng had so quickly applied the knowledge about disulfiram-like reactions that Yu Haiting had just shared with him! This Dean’s mind is incredibly sharp! After carefully examining the patient, Yu Haiting confirmed Du Heng’s diagnosis: the patient was indeed having a reaction to the Cephalosporins. Actually, the correct approach now would be to do a blood test for the patient, but given the limited conditions at the Health Clinic, they had to skip such auxiliary methods. Du Heng saw Yu Haiting nod and asked, "Can you handle it here?" "Yes. Our medicines are fully stocked; we can definitely handle it." "That’s good. I’ll leave the patient to you." As he watched Yu Haiting lead the patient away, Du Heng sat down in his chair and fell silent. It wasn’t the first time a patient had taken the wrong medicine, leading to more severe health complications. When he first started visiting the villages in March, he had discovered several such cases. One of them was a close relative, an elderly woman from his clan, who had developed whole-body edema from taking anti-cold medicine. This problem also existed in cities, but it was much less common. When medicine was dispensed, both the prescribing doctors and the dispensing nurses would always tell patients which medicines shouldn’t be mixed and what the appropriate interval should be. But in rural areas, firstly, the overall level of village doctors was limited, and they themselves often didn’t know if these medicines could be mixed. Secondly, there simply wasn’t an established habit of informing patients about which medicines could not be mixed. And patients often lacked this awareness. They rarely asked, and even if they did, they would often forget after some time. However, medicines like Cephalosporins and Huoxiang Zhengqi Tincture were commonly kept in households. When people felt slightly unwell, they often wouldn’t go to a clinic or hospital; they would just take some medicine themselves. But it was precisely in these situations that accidents tended to happen. As the weather grew hotter, the use of air conditioners, consumption of cold drinks and ice cream, working under the scorching sun in the fields, and then sitting directly on the cool ground when tired, could all affect people’s health. People could easily develop gastrointestinal discomfort due to the invasion of summer-heat and dampness. Problems like fever, sore throat, and diarrhea would become more frequent, and consequently, the use of Huoxiang Zhengqi Tincture would increase. As for Huoxiang Zhengqi Tincture, every village clinic stocked it, so patients wouldn’t specifically go to the Health Clinic to get it. It now seemed necessary to have Yu Haiting conduct some training for everyone on the daily use of medicines, covering the proper combinations and contraindications of common medications.

Chapter 149 Disulfiram-like

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