Chapter 642: Malignant Hypertension and Snacks

"Ji Yisheng Xiang, what are your thoughts?" Zou Fuzhuren stopped playing guessing games and asked directly.

"When I first saw the Patient, she was constantly drinking water, and then she went to the restroom while I was taking her medical history. She just went to the restroom again, and I think there should be a connection between the two."

"A connection to suspected hypertension? Or is it urinary frequency and urgency caused by a urinary tract infection?" Lin Jiuze asked.

As soon as the words left his mouth, Lin Jiuze realized something was wrong.

He was very clear about his own persona; although his purpose in coming to chat with Ji Xiang was somewhat complex, it absolutely did not include the option of offending Ji Xiang.

But!

Faced with Ji Xiang's "unreliable" statement, Lin Jiuze could not suppress the urge to make a sarcastic remark.

This was a far cry from his usual harmless image.

How could he find Ji Xiang so disagreeable?

Lin Jiuze felt a chill in his heart and immediately focused all his attention, suppressing his extraneous thoughts.

One must not offend a master; Lin Jiuze never considered himself the best in the world, otherwise he wouldn't have stayed behind after the program ended.

"I think the Patient's complexion doesn't seem very healthy."

Complexion, hypertension—two unrelated terms linked together were full of points to mock, and Lin Jiuze was itching to do so.

He forcibly restrained himself and did not make a snide comment.

But in his heart, Lin Jiuze once again began to doubt his own judgment.

Was Ji Xiang truly capable of superior diagnosis, or was he just a weakling who made diagnoses based on luck every time?

However, what was certain now was that Ji Xiang's surgical skills were top-tier.

Lin Jiuze was left dizzy and confused by this strange young man, completely unable to figure out Ji Xiang's routine.

Zou Fuzhuren was also noncommittal; when the Patient returned, Zou Fuzhuren said, "Have you measured your blood pressure recently?"

"No, my blood pressure has always been normal, and I usually don't think to measure it," the Patient replied.

Zou Fuzhuren signaled for the Nurse to bring a mercury sphygmomanometer; he did not let the Patient use the electronic sphygmomanometer at the Nurses' Station, and he measured the Patient himself.

Lin Jiuze rushed to stand behind Zou Fuzhuren, aiming his gaze at the mercury column in the sphygmomanometer.

Although the stethoscope was not in his ears, the fluctuations of the mercury column could tell him something.

Zou Fuzhuren squeezed the bulb, the pressure rose, and the cuff made a creaking sound.

After the mercury column rose, it slowly descended; Lin Jiuze narrowed his eyes, watching meticulously.

Just as it dropped below 200 mmHg, the mercury column began to fluctuate.

Lin Jiuze felt a tightness in his chest.

Could it be that Ji Xiang "guessed" right again?!

That's impossible; the Patient is young, and she stated herself that she has no history of hypertension.

Teachers usually have 1-2 physical examinations a year, so hypertension shouldn't be missed.

At this moment, Lin Jiuze even began to doubt if his own eyes were a bit blurry and he had misread the fluctuations of the mercury column.

When the mercury column dropped below 190 mmHg, the fluctuations became even more obvious.

"Huh?" Zou Fuzhuren whispered in confusion.

Soon, Lin Jiuze confirmed that the Patient's systolic pressure was at least around 185 mmHg, and the diastolic pressure was 130 mmHg.

This already fell into the category of Malignant Hypertension.

A young patient, no past medical history, initial diagnosis was hematochezia, how could the blood pressure be this high?! Plus, adding in the urinary frequency the Patient just mentioned...

These symptoms, signs, and examinations dragged Lin Jiuze into a strange vortex from which he found it hard to extricate himself.

These symptoms were scattered and could not be connected at all.

"The blood pressure is so high," Zou Fuzhuren said, frowning. "Have you never felt anything? When was the last time you measured your blood pressure?"

"No, I don't have a history of hypertension, and there's no family history either," the Patient said, a bit dazed. "The last time... I don't remember."

"What about physical exams?"

"I said my blood pressure was normal, and the doctor doing the physical exam just wrote down a random number to get it over with."

"Could it have been measured wrong?" someone asked.

Zou Fuzhuren measured it again, and the blood pressure measured was about the same as before.

He measured it once more with the electronic sphygmomanometer, and the systolic pressure was also fluctuating around 190 mmHg.

Hypertension, from oliguria to polyuria—Lin Jiuze's brain CPU was spinning rapidly, and the heat generated was almost making smoke rise from the top of his head.

He quickly wrote in his notebook, and after finishing, he looked up at the Patient.

Finally, a rare diagnosis appeared in his notebook—Aldosteronism.

Lin Jiuze looked up, the anxiety and confusion in his eyes finally turning into calm.

It's this!

But, Aldosteronism is caused by an increase in aldosterone secretion due to a tumor or hyperplasia of the adrenal cortex glomerulosa; the Patient had a Fubu CT, and no tumor or hyperplasia was seen in the adrenal glands.

But...

Lin Jiuze looked at the purified water in the Patient's hand.

Everything was so strange.

"Please check the blood potassium to see if there's a problem with the potassium ions," Ji Xiang said.

"Oh? Ji Yisheng Xiang, what do you suspect?" Zou Fuzhuren asked.

"I smell a licorice scent on the Patient," Ji Xiang said, a remark that seemed irrelevant to the diagnosis.

A licorice scent?

Zou Fuzhuren was taken aback, and Zhao Zhe was also stunned; what did this mean?

"Do you usually have a cough?"

The Patient and the Family Member looked at Ji Xiang in surprise. Before they could answer, Xie Kai said disdainfully, "What does a cough have to do with blood in the stool? Zhao Zhe, you work with this kind of person?"

"Old Xie!" Zhao Zhe shouted in a low voice.

"What, am I wrong?" Xie Kai said with a look of disdain, "That's not how you take a medical history."

"It seems there might be a connection. Do you usually cough? What medicine do you take to suppress the cough?" Ji Xiang ignored Xie Kai and looked at the Patient with a gentle smile on his face.

"My lungs have been bad since I was a child, and I'm always coughing. The Doctor said I have chronic bronchitis. It's worse in the winter, so I was planning to go to Hainan for the winter break," the Patient said.

She was a bit long-winded, but Ji Xiang was not in a hurry; he just smiled and watched the Patient, waiting for her to continue.

"Since I was a child, the only cough suppressant I've taken is Compound Licorice Tablets. They work quite well; once I take them, I stop coughing."

No wonder there was no sign of the Patient coughing during the physical examination; it turned out she had been taking medicine all along.

"Compound Licorice Tablets are hard to get prescribed these days," Ji Xiang began to chat casually with the Patient.

"It's true. When I was in school, I could buy them at pharmacies outside, but now I need a doctor's prescription. You can't buy them at pharmacies, you have to go to the hospital," the Patient said with some distress, "I have to count them out when I take them."

"Then, besides Compound Licorice Tablets, what else do you usually eat?"

"Nothing else. Every medicine has its side effects, so I only take that one," the Patient answered very firmly.

"Oh, I didn't mean medicine. I meant... snacks, perhaps," Ji Xiang hesitated slightly.

Several Doctors cast puzzled glances.

Taking a medical history and asking what medicine a patient has taken is normal, but Ji Xiang had actually started asking about what snacks they ate.

Especially Lin Jiuze; he had never seen Compound Licorice Tablets at Massachusetts General Hospital, so he had no idea what Ji Xiang was doing.