Chapter 22: It turns out Sun Simiao has encountered a difficult problem.

  "Yes, Master!" Chen Yi responded with a nod and continued to explain, "Those who are born with an abnormal physique, have a weak constitution or are weakened after illness; when external pathogens invade, during seasonal changes, sudden weather changes or inhaling pollen, dust and other foreign objects; or if one's diet is improper, indulging in raw and cold foods, salty and greasy foods, eating seafood and shellfish that induce disease; or due to emotional imbalance, excessive fatigue and so on, all these can easily trigger this illness." Chen Yi opened his mouth and pointed to his own throat, "In people who are prone to this condition, because of exposure to cold air and the inhalation and ingestion of these substances, it stimulates the respiratory tract... leading to inflammation, which in turn causes patients to experience repeated episodes of shortness of breath, wheezing, chest tightness, coughing and so on. When breathing, especially when exhaling, it is very difficult, feeling like there's a tightness in the chest, and often accompanied by coughing and expectoration. When we listen with our stethoscope attached to the patient's chest, we can hear that whistling sound from their lungs, this is asthma..."

  "Asthma attacks often occur at night and in the early morning. Before an attack, patients may experience allergic symptoms such as nasal congestion, itchy eyes, sneezing, runny nose, tearing, and dry coughing. Shortly after, they may feel chest tightness... severe cases can cause a feeling of suffocation, like a heavy stone pressing on the chest. About a minute later, breathing difficulties appear, and even from a distance, you can hear the patient's wheezing sound. At this time, patients often cannot lie down and are forced to sit up straight, leaning forward with their shoulders hunched, using both hands to support themselves and gasping for air to avoid shortness of breath... Such attacks can last from one minute to half an hour. Some patients may recover on their own, while others need medication to relieve symptoms... If not relieved, it is possible to lose one's life! Even if they survive, prolonged illness will inevitably lead to severe cardiovascular disease!"

  Chen Yi said, and then stopped, he saw a rare look of surprise in Sun Simiao's eyes.

  Sun Simiao listened to Chen Yi's words and said: "Ziying, the situation of asthma you described is very subtle, I haven't observed it so carefully. It seems that your understanding of gas diseases and asthma is far deeper than mine. You must have better methods for treatment... Please teach me more!" Sun Simiao said, standing up and bowing.

  Chen Yi, startled, hastily returned the courtesy, "I dare not say that, Master Dao. I was just speaking nonsense, all of which came from those medical books. I haven't actually cured a single patient, and I'm just reciting what's written, without really understanding..."

  This statement is half true and half false. The true part is that Chen Yi, in this era, even after crossing over to the Tang Dynasty, really hasn't cured a single asthma patient. Even when practicing medicine in later generations, it can't be said that he completely cured asthma patients, but only effectively alleviated the symptoms of the patients and made those patients rarely relapse in subsequent treatments. However, if the symptoms are always well controlled, asthma patients will not have relapsed until death, although the physical constitution of asthma is still there, which can be barely considered as a cure.

  Chen Yi continued under Sun Simiao's urging gaze: "When I had nothing to do, I summarized some of the experiences of my predecessors... again..." Chen Yi almost let it slip, and quickly made amends, "I summarized what was said in that medical book, and came up with some immature ideas. When these asthma patients experience a relapse of symptoms, make every effort to control their condition with medication, this is treating the symptoms... when the patient's condition stabilizes, gradually start corresponding other treatments, that is treating the root cause..."

  Chen Yi, in his later years of research, adopted a treatment principle that combined traditional Chinese and Western medicine, with anti-inflammatory as the main approach, for patients with chronic or stable asthma. This replaced the previous method of mainly using bronchodilators during acute episodes, achieving good results... Unfortunately, nowadays some medications that alleviate asthma symptoms, such as β2 agonists, slow-release theophylline, leukotriene regulators, and corticosteroids, are not available. Relying solely on traditional Chinese medicine makes it difficult to achieve the same effects as in later generations. It is particularly challenging for patients with acute asthma attacks to quickly control their condition.

  In later generations, there were drugs that could alleviate asthma symptoms, as well as fully automatic electrocardiogram monitors, ventilators, and blood gas and biochemical analysis equipment and testing methods that could observe and grasp the patient's situation at any time. Now that these things are gone, Chen Yi feels a bit like what he has learned is useless, at least his confidence has been severely damaged.

  Modern medical means and modern equipment are inseparable, and many effective diagnostic and therapeutic methods in later generations would be empty talk without instruments. At least many methods that Chen Yi was familiar with and mastered could not be performed during the Tang Dynasty.

  However, Chen Yi still knew some Chinese medicines that had similar effects to Western medicines in relieving asthma symptoms. In the treatment of chronic diseases, Western medicine is often less effective than traditional Chinese medicine, and the underlying principles are difficult to explain, as in the case of chronic asthma. Later on, Chen Yi and his colleagues mainly promoted traditional Chinese medicine in treating such patients, and achieved extremely good results.

  "The drugs that control the symptoms of the disease include Cordyceps sinensis, Ephedra, Cinnamomum cassia, Anemarrhena asphodeloides, Sophora flavescens, Belamcanda chinensis, Pinellia ternata, Perilla frutescens, Pheretima aspergillum, and Schisandra chinensis. These Taoist priests must know much more than I do, so I won't say much. I just want to talk about some treatment methods recorded in medical books... As for Chinese medicine, Chen Yi would rather die than show off in front of Sun Simiao, although he had a few effective prescriptions in his mind, he only dared to explain them with a humble attitude. "According to my understanding, the treatment methods are: first, to control the symptoms of asthma patients as much as possible, including nighttime and morning symptoms, improve exercise capacity; second, prevent the onset or worsening of the disease; third, make the patient's lung and airway breathing function close to optimal. To achieve these, we still need to rely on medication and some preventive measures in daily life..."

  Seeing Chen Yi stop again, especially when talking about treatment, Sun Simiao couldn't help but urge: "Ziying, don't tease poor Dao's stomach anymore, tell poor Dao everything..."

  "In the long run, apart from medication treatment, daily preventive measures are crucial. Asthma... attacks of asthma all have inducing factors. If these factors do not appear, even if the patient has this disease in their body, it is not necessarily going to break out. According to what I know, patients usually need to pay attention and avoid contact with things that easily cause people to have excessive sensitive reactions, such as spring pollen, animal dander, dust, etc., and cannot eat some special foods like dairy products, eggs, beef, mutton, seafood, wine, onions, garlic, ginger, etc. high-protein or highly irritating foods. They also need to prevent mental stress and physical fatigue... If these preventive measures are done well, instructing the patient to strengthen their body through exercise, making their body strong, and then assisting with medication treatment, as well as some special therapeutic methods to improve the patient's breathing and avoid heart failure, then the condition may be completely controlled."

  As Chen Yi entered the state, he had a feeling of teaching interns in later generations. However, when he saw Sun Simiao staring at him with his piercing eyes and the surprised gaze of Sun's three disciples, he immediately came back to himself and stopped talking.

  "What special treatment method?" Sun Simiao asked further.

  "It was only when the patient's condition stabilized and their body became strong that they were allowed to have limited, long-term contact with things that easily triggered asthma attacks, allowing the patient to develop tolerance to those triggers. As the tolerance increased, the amount of allergens was gradually increased... Oh, the amount of substances that could exacerbate the patient's symptoms was increased, and this is the best way to cure asthma, called desensitization therapy! This is the method used by Chen Yi in his research on curing asthma patients in a later era. This treatment method is still quite effective, and many experts in his time strongly recommended it. However, this era does not have the same conditions as that later era, so Chen Yi did not dare to be too confident or speak too much about it, only vaguely describing it, without knowing whether Sun Simiao could understand."

  Sun Simiao thought for a moment, his face slightly puzzled, before seeming to understand, nodding his head. "Ziying, regarding the diagnosis and treatment of respiratory diseases and asthma, you know more than anyone else in this world. I am far inferior to you, and really need to learn from you. It's a pity that the sick young woman today didn't let you examine her..."

  "The Master said so, I am ashamed...". Chen Yi is telling the truth!

  Sun Simiao shook his head, gesturing to the three disciples to leave first. "Wang Chong, Liu Hai, Qing Er, you three go out first. The master wants to have a private conversation with Ziying. You three go prepare the things needed for tomorrow."

  "Yes, Master!" The three of them responded in unison and immediately turned to leave. Ning Qing, who was walking last, didn't forget to turn back and take a look at Chen Yi, with a gaze full of admiration. However, his eyes were caught by Sun Simiao, and after meeting his master's gaze, he was so scared that he ran away quickly.

  After Qing Ning and the others had all gone out, Sun Simiao lowered his voice slightly and said: "Ziying, you must be curious about why I asked you these questions today? I won't hide it from you, I've encountered a very difficult problem!"

  Chen Yi was very surprised, but he didn't ask any questions. He knew that Sun Simiao would continue to tell the story.

  Sun Simiao paused, furrowed his brow and thought for a moment before continuing: "It was just two years ago that I met an old friend who had developed various illnesses due to asthma. Unfortunately, I couldn't think of a way to cure him thoroughly, and until now, I haven't been able to help alleviate his symptoms... it's a debt I owe..."

  "Sun Daochang, what kind of patient is that?" Chen Yi had a strange feeling in his heart and asked cautiously. He immediately thought of the noble lady who came to the inn to invite Sun Simiao a few days ago, could it be that one of her family members was suffering from asthma or respiratory and cardiovascular diseases?