This Doctor Is Too Wealthy

Du Heng fell silent and said no more. He could understand the behavior of this elderly man and his children. Rural people lack the conveniences of the city. They don’t typically use video calls, and their communication with children is usually through feature phones. The elderly tend to prioritize their children’s needs, wanting them to work diligently and earn money while away from home. During phone calls, they’d emphasize the good news and downplay the bad, so as not to worry their children. As the saying goes, parents’ hearts are with their children, while children’s hearts are like stone. Therefore, in such situations, children generally believe what their elderly parents say and rarely think twice. This slight discrepancy in communication and perspective between the two sides has led to the current situation.

Director Wu, noticing Du Heng’s silence, realized he himself might have become too emotional. After taking a deep breath, Director Wu asked, ”Can you treat him?”

Du Heng nodded unambiguously, ”The patient is almost seventy years old and has labored for many years. His constitution is severely depleted. But overall, the cause of the illness is easy to find, the pathogenesis is clear, so it is treatable.”

Director Wu fell silent for a moment at Du Heng’s response, though it was within his expectations. If Du Heng said it was untreatable now, that would be truly unexpected. Otherwise, Lan Changhua wouldn’t have gone to such lengths to invite Du Heng to the Capital.

”Where do you plan to start?”

Du Heng’s footsteps faltered slightly, but he quickly caught up with Director Wu’s pace, then slowly said, ”The patient’s pulse is slow and weak, barely reaching sixty beats per minute, and his tongue is pale and swollen. Considering the patient’s age, this indicates kidney deficiency and inadequate nourishment of the Eight Extraordinary Meridians. Moreover, the waist is considered the ’palace of the kidney’ and is the most Yin aspect of the body. The spine pertains to the Governor Vessel, and both the waist and spine are governed by the kidney. Therefore, I plan to start with the kidney.”

As they spoke, the two had already returned to the Traditional Chinese Medicine Internal Medicine Department. Director Wu turned his head and invited Du Heng, ”Let’s go to my office, and you can explain in detail.”

”Alright.” Du Heng agreed immediately. However, he didn’t go directly to Director Wu’s office. Instead, he first went to his own office next door, got his teacup, took a few sips of water, and then entered Director Wu’s office.

”Explain in detail, why do you want to start the treatment from the kidney?” After the two were seated, Director Wu couldn’t wait to ask.

He knew the saying that bone diseases should be treated from the kidney. However, he wasn’t entirely sure about the exact treatment methods or the specific points requiring attention. Especially with such severe conditions, there was no opportunity for him to experiment. Accurate diagnosis and precise medication lead to the patient’s improvement. But if any problems arise, the patient’s condition doesn’t allow for remedial measures. The patient and their family will lose trust in the doctor emotionally, potentially even triggering a broader distrust in traditional Chinese medicine. Most importantly, such patients need time; consequently, patients and their families cannot afford to give the doctor time for trial and error.

Generally, by the time patients turn to traditional Chinese medicine, the situation has already spiraled out of control, and they are seeking it as a last resort. Moreover, these practitioners often lack experience and cannot achieve the necessary precision in diagnosis and medication. So, the final outcome is predictable.

Du Heng set aside other considerations, focusing instead on clarifying the treatment approach for this disease.

”The patient reports that his lower back pain is mildest in the morning. It gradually worsens throughout the day but remains bearable. However, at night, the pain becomes unbearable—a sharp pain that makes it difficult for him to fall asleep.”

Du Heng leaned back in his chair, his expression serious and solemn. ”The timing of the disease’s progression aligns with the operational cycle of the Kidney Meridian. From this, it can be inferred that the patient’s kidney yin is weakened. Simultaneously, the patient has suffered from this illness for many years, leading to prolonged depletion. Prolonged illness damages Yin, which eventually leads to Yang losing its foundation. With this compounding effect, the patient suffers not only from Yin deficiency but also from Yang deficiency.”

Director Wu’s brow furrowed slightly. After pondering for a moment, he asked again, ”Is there any other supporting evidence? Based on this point alone, claiming the patient has both kidney yin and kidney yang deficiency seems somewhat tenuous.”

”Yes,” Du Heng stated immediately. ”The patient also mentioned that after every meal, if he sits and rests, he experiences alternating sensations of cold and heat. However, once he starts moving a little, this feeling disappears.”

As soon as Du Heng finished speaking, an idea popped into Director Wu’s mind. Could this be a problem caused by an invasion of external pathogenic factors, leading to a struggle between the body’s vital qi and the evil qi?

Du Heng, as if anticipating Director Wu’s thought, paused briefly before continuing, ”The patient also stated that he often feels dizzy and drowsy, wanting to sleep whenever he sits or lies down. However, as soon as he moves even slightly, he feels an internal heat and becomes unbearably irritable.”

Upon hearing this, Director Wu immediately understood. This wasn’t truly a struggle between pathogenic and healthy qi, but rather an issue with the body’s own Yin and Yang balance. It had lost its ability to self-regulate and had fallen into disarray.

Seeing Director Wu’s expression, Du Heng knew he understood and didn’t dwell on the issue, continuing directly, ”Therefore, the patient’s dry stools and dark, tea-colored urine are not indicative of true internal heat. Instead, it’s due to kidney deficiency, which subsequently weakens all the viscera, causing the Spleen and Stomach to lose their transportive function, so fire fails to generate earth. The Spleen governs the middle qi; if the middle qi is deficient, it will lead to issues like abnormal urination and dry stools.”

At this point, Director Wu couldn’t help but nod. ”Then, from what aspect do you plan to approach the treatment?”

This time, Du Heng didn’t answer directly but paused in thought for a moment before slowly saying, ”The patient is elderly, and the condition is advancing rapidly. Based on the current situation, it wouldn’t be an exaggeration to say he’s in the late stages of the illness. Crucially, multiple visceral organs are weakened, and his body already shows signs of being unable to cope. So at this point, I think focusing on the ’cancer’ itself would not be very meaningful. I plan to approach this holistically: support Yang and assist Yin, protect the Spleen and Stomach, and use potent tonics to nourish the Eight Extraordinary Meridians. As long as he can regain his appetite and his stomach qi is restored, there shouldn’t be any major problems.”

Gazing at the articulate Du Heng, Director Wu was momentarily lost in thought, his mind briefly unable to keep pace with Du Heng’s reasoning. When he regained his composure, Director Wu gave a wry smile internally, admiring Du Heng’s clear and precise thinking and quick mind, while also having to lament that his own skills were indeed inferior.

He then asked his last question, ”Are you confident in this approach?”

”The spinal cord is governed by the kidney; therefore, when kidney essence is abundant, the spinal cord is well-nourished,” Du Heng said confidently. ”As long as the patient’s stomach qi is preserved, the Spleen and Stomach function in an orderly manner, and both kidney yin and kidney yang are supplemented, there should definitely be no problem.”

At this point, Director Wu had no doubts left. He let out a long breath and said to Du Heng, ”Your thought process is clear, and your syndrome differentiation is orderly. Go ahead with your plan. If there’s anything you need me to do, just let me know.”

Director Wu knew his role and was aware of his own limitations. Thus, even knowing Du Heng’s treatment strategy, he wouldn’t rush to try it himself. He understood that he simply needed to perform his own duties well.

Normally, such words would contain an element of courtesy from him towards Du Heng. However, just as he finished speaking, Du Heng actually frowned and said, ”There is one matter where I genuinely need your involvement.”

Director Wu raised his eyebrows, somewhat surprised. ”What is it? Tell me.”

”It’s like this: according to my current estimations, I’ll need to use many expensive medicine ingredients, such as blast-fried pangolin scales and velvet.” Du Heng slowly enumerated on his fingers, ”However, I just observed that the patient’s son might be financially strained, and his daughter is quite overbearing. I’m afraid some problems might arise later on. Perhaps you could communicate with the family first and handle these various practical matters. With Professor Lan involved, there are some things that are truly awkward for me to say directly.”

It belatedly dawned on Director Wu, and he asked, ”Who makes the decisions in their family?”

Du Heng winced slightly, a hint of frustration in his voice, ”From my observations this morning, the son seems less well-off and is rather quiet and unassuming. The daughter is better off financially and is quite sharp and outspoken. From beginning to end, it was the daughter who communicated with me. She should be the decision-maker.”