“What I want is to use rational, quantifiable, standardized and evidence-based methods to optimize medicine.
Let medical skills move from experience to rationality.
That is, evidence-based. "
Li Ang said: “Traditional dialectical treatment is mainly based on personal experience, so there are chaos such as quacks are rampant, good doctors can’t expel quacks, and the industry can’t clean itself up.
The father-in-law said that the father-in-law was right, and the mother-in-law said that the mother-in-law was right.
Some effective treatments are shelved because they are not understood by the public.
Some treatments that are ineffective or even harmful, such as cutting the legs to feed the mother, etc.
If it is widely spread and used for a long time, the impact will be severe and long-term.
Evidence-based medicine is different.
Follow, follow. Evidence, evidence.
Take malaria, for example. It is said that malaria is caused by external evil. So what are external evils?
Which one is wind, cold, heat, dampness, dryness, or fire?
If you throw someone into a windy day, will you get malaria?
Will people get malaria if they are left to dry in the sun on a hot day?
If you take off your clothes and throw them on the ice, will you get malaria?
The answer is obviously no. "
Li Ang shook his head, "Dr. Qiu Zhen should have mentioned the malaria prevention experience in Chang'an at the Imperial Medical Office.
They didn't adopt my suggestions from the beginning,
Instead, I followed my method and found a lot of evidence.
For example, when we go door to door, we find that people who live in low-lying areas with dense mosquitoes have a higher overall probability of contracting malaria than people who live in highlands.
People who hang mosquito nets at home are less likely to contract malaria;
Such evidence has been found one after another,
Later, we cleaned up stagnant water, closed canals, raised fish in the canals, proactively eliminated larvae, and hung mosquito nets in every household...
After the implementation of targeted measures, the malaria incidence rate in Chang'an that year dropped significantly.
Therefore, it can be said that malaria is related to mosquito bites.
Mosquito bites are the main culprit of malaria, not factors such as wind, cold, heat, and dryness.
And now, with microscopes and thought thread detection methods, we can go one step further and find more evidence.
For example, the cause of malaria is further targeted to the Plasmodium parasite in mosquitoes.
Layer by layer, we constantly look for evidence and classify all the evidence according to its strength and reliability.
Just like doing a math problem, narrow down the final answer.
This is evidence-based.
Who can say that this method, which lacks the eight principles of syndrome differentiation, is not rational enough and does not conform to medical theory? "
"..."
Qiu Feng frowned, vaguely feeling that something was wrong, but he didn't know where to refute.
Li Ang smiled slightly when he saw this, and was not worried that Qiu Feng would not understand. The charm of evidence-based medicine lies in rationality, and she is also a disciple of the academy.
“Moreover, evidence-based medicine can also falsify and self-examine.”
Li Ang added: "If someone suspects that malaria is not caused by mosquitoes, he can conduct reasonable experiments.
For example, put a person and a group of mosquitoes with their mouthparts removed and observe whether the subjects react.
Let people hear the sound of flying mosquitoes, but not be bitten by mosquitoes.
Or to test the efficacy of artesunate,
Three groups of people with roughly similar physical conditions were given three types of medicines.
artesunate, potassium antimony tartrate, and saline as a placebo,
Neither the doctor administering the drug nor the patient knows what drug the patient is taking.
Finally, long-term observation of the patient’s survival rate, quality of life, etc.
From this we can conclude whether artesunate is useful or ineffective.
In this way, after long-term and extensive verification, a complete set of data evidence can be obtained.
Doctors can then use the theoretically most effective treatment method based on past medical cases, combined with their own experience and the patient's specific conditions.
Some of them are well-founded and can be repeated, widely used, and tested.
I am confident that evidence-based medicine based on anatomy, pathology, etc. is as effective as medicine based on syndrome differentiation and treatment. "
Li Ang put his hand on the physical diagnosis book and said seriously.
Qiu Feng frowned deeply: "Even if it goes against existing medical principles?"
"What is medical science? Being able to cure patients and return them to a healthy state is medical science."
Li Ang said: "The doctor added hundreds of poisons, and the medicine was smoked and irrigated without any downtime.
The moxibustionist uses moxibustion sticks, as cool as hunting fire.
If you hold a mugwort candle and pretend to be a ghost, you can cure the pain of malaria 100%, or at least with a high probability.
So no matter how confused I am, I will always think that there is something in it that I don't understand yet, and I will try to analyze and understand it until I understand what is going on.
Instead of talking a lot like when I encountered malaria before, I still couldn't pinpoint the cause and couldn't explain the process. "
"..."
Qiu Feng finally understood Li Ang's purpose, took a deep breath, and said in great shock: "Risheng, do you want to reinvent medicine?"
"I should say, push."
Li Ang corrected: "Evidence-based is a more rational dialectic.
It is based on a set of quantifiable standards and is the product of Neo-Confucianism and social development reaching a certain stage.
Without microscopes, statistics, and universal recognition of rationality, evidence-based science would never be possible.
Just like a person, can it be said that the eighteen-year-old him is not the same person as the eight-year-old him? "
"You're being sophistical."
As a disciple of Neo-Confucianism, Qiu Feng immediately reacted, "If this set of teaching materials is distributed, in a few decades, will there still be medical students in the Imperial Medical Office who understand the Eight Cardinal Principles syndrome differentiation?"
"Decades of hard work should allow the world to see the overall picture of a thing clearly."
Li Ang smiled and said: "Do you still remember our practice in the hospital? We accumulated a large number of cases and recorded the patient's identity information, illness history, medication process, etc.
All are recorded on paper documents, with evidence to follow.
We can definitely test it with practice.
In long-term practice, accumulate data, test the efficiency and practicality of the two methods, and compare the advantages and disadvantages of the two methods.
Medical students, if they are willing to learn the original teaching materials, then learn it; if they are willing to learn evidence-based teaching, then learn evidence-based teaching.
The truth becomes clearer the more we debate it, and the more we practice it, the clearer it becomes.
And I also have enough patience and time to see the results appear.
In the end, medical science eliminates the waste and retains the essence, stimulates the turbidity and promotes the clear. "
"Decades to do an experiment..."
Qiu Feng was shocked by Li Ang's ambition and grand plan.
The expansion of wards in various places can be said to have laid the foundation for practice and data collection.
Seven to eight hundred states and counties, with a population of 40 million, are all part of Li Ang's plan.
Did he have this in mind when he came up with allicin?
She once again stared at the familiar yet unfamiliar young man in front of her, and said slowly: "Risheng, have you ever thought that with your current reputation and status, you have already made it clear in the Imperial Medical Office.
Decades later, who can compete with you? "
"You."
Li Ang smiled and said: "It was you and I who invented the thread-reading surgery together, and it was you and I who witnessed the beginning and end of water poisoning in Suzhou.
The debate you and I have today is all about how to better treat illnesses and save people. The door view only accounts for a small part of it.
I believe in your medical skills, medical ethics, and your recognition of reason and truth.
This world is yours and mine,
But in the end, it belongs to future generations, our descendants. "
"!!"
Qiu Feng's face quickly turned red at a speed visible to the naked eye, and he stammered: "What nonsense are you talking about, for future generations."
"Well, I mean the descendants of all mankind, not you and me..."
The moment Li Ang finished speaking, he also realized that his words were inappropriate, his expression froze slightly, and he quickly waved his hands to make amends: "Sorry, I didn't turn around for a while, my, my, my."
"snort."
Seeing him like this, Qiu Feng became even more embarrassed. He picked up the physical diagnosis on the table and said with a slightly straight face: "I'm going back first, I haven't finished reading your book yet.
The Imperial Medical Office will expand its enrollment in a while, and you must show up.
If you want to promote evidence-based medicine, you can't do it without being present. "
"must."
Li Ang breathed a sigh of relief and glanced at Qiu Feng's blushing face, "Shall I see you off?"
"Um."
Under Chai Chai's doubtful and curious eyes, the two pushed open the study door and walked dully across the courtyard.
Li Ang stood by the door, thinking about what to say as a farewell. Qiu Feng also held the book and slowed down.
"See you in the academy tomorrow..."
Before he finished speaking, there was a heavy knock on the courtyard door, and anxious Chang'an Mandarin with a slight Turkic accent came from outside the door.
"Are you Mr. Li Xiaolang? I am Ashtoku Tumen."
