2010年1月19日，我接到了一宗以前从未听说过的特殊病例，从而使我有些困惑，不知如何下手是好。病患是位59岁的印度妇女，她女儿领着她进来看病时，给我的第一印象是，这妇女怎么如此眉头深锁，看似有极为烦恼的问题令她无法释怀，加上体型瘦弱，感觉上连走路对于她来说都是一件很费力的事。而我的感觉马上得到了验证，病患进来以后说她全身无力，问我是否能躺在诊室里的治疗床上休息，于是这个诊就是在她躺着回答问题的情况下开始进行。
患者于2个月前进行了白内障手术，手术后第3天开始自觉口中苦涩，症状严重到完全无法辨认除了酸性以外的味道，用患者自己的言语描述就是“连吃糖果都是苦的”！于是这2个月期间，她完全无法进食米饭、面条或面包等主食，每日只吃少许酸辣的tonyam汤。除此之外，患者还患有非常严重的咳嗽(也是2个月余)，给我的感觉似乎严重到像是要把整个肺都咳出来一样，真替她担心！
考虑到患者的严重咳嗽，所谓“急则治其标”，我告诉她应该要把咳嗽的问题先治好再考虑口苦的问题。先来说说她的咳嗽吧。
- 问诊：咳嗽甚两个月余，痰少难咳出，痰白质粘，咽痒口干，咳引胸胁痛，呼吸困难。头晕头痛，食少腹胀。睡眠质量差，易惊醒，每晚只能睡2－3小时。小便灼热尿黄，大便调。
- 舌诊：舌体稍歪向右侧，舌红少苔。舌中和两侧布满裂痕，中部有瘀点，后根部见大小不一的小泡(囊肿)。
- 脉诊：肝脉弦，肺脾脉数，肾阳脉沉细。
- 血压：125/65 mmHg
- 诊断：咳嗽 (肝火犯肺，肺失清肃)
- 治法：清肺平肝，顺气降火止咳。
- 注意事项：忌食甜食、生冷及油炸之品。
经过5剂药的治疗，患者于2010年1月26日复诊时称咳嗽已经痊愈。现在剩下的问题就是治疗那令她恐惧的口苦了！
- 就医病史：患者曾因此口苦的困扰在Kajang的KPJ Specialist Hospital花了RM6,800治疗，但症状完全没有得到任何改善，医院的医生告诉她回家静养观察，看看病情是否会改善。经友人介绍从Mantin, Seremban远到我的诊所就诊。
- 舌诊：舌体稍歪向右侧，舌红少苔。舌中和两侧布满裂痕，中有瘀点，后根部见大小不一的小泡(囊肿)。
- 脉诊：肝脉弦，肾阳脉沉细。
- 诊断：口苦 (肝胆郁热)
- 治法：清泻肝胆，疏肝解郁。
- 注意事项：忌食生冷、油炸之品。
- 按语：我之所以从肝论治，是因为考虑到患者在动了白内障手术以后出现的口苦症状，而中医认为“肝主目”，所以从这方面下手去治疗。
经过这次的经历，让我想起，在外面经常听别人说“被某某中医骗钱”等乱七八糟的胡话。试问各位，你们认为中医能够骗你们多少钱？如果3～10次治疗下去病情完全没有改善，别说10次，估计5次，我想大家就肯定不会再光顾那家中医诊所了！就拿每次看病在RM100-RM250左右来说，如果中医真的骗你的钱最多也就是不超过RM1,000的数额，而西医呢？就拿以上的病例来说，病人在KPJ治疗了2星期(只是门诊，并没有住院)，就花掉了RM6,800！！再说西药的各种毒副作用，就不需要我一一在这里解释了。可为什么就没有人说“被某某西医诊所/医院骗钱”呢？到底谁是真正骗钱的真凶？这是一个值得我们深思的问题......
Overview of Bitter Taste in Mouth (Dysgeusia)
Having a lingering bitter taste in mouth can be irritating, disgusting and frustrating. Medically, a change in the ability of taste is called Dysgeusia. The reasons of a bitter taste in the mouth can be manifold. In the view of Western Medicine, respiratory problems, bacterial infections, gum, dental and other oral problems, as well as certain types of diseases, drugs and medication are the most common causes for the bitter taste in mouth.
How Does TCM help Bitter Taste in Mouth (Dysgeusia)
The patient above was a 59-year-old Indian lady who came all the way from Mantin, Seremban on 19/1/2010 for her bitter taste in mouth. She had this problem soon after the 3rd day of her Cataract Surgery.
These are some of his medical records:
Symptom: She has a strong bitter taste in mouth that makes her lose the desire for food, as a steady unpleasantness from the bitterness prevents her from eating or enjoying anything. Just as what she told me : "I feel even bitter when I take candy or sweets! " She is very skinny due to the lost of appetite for the past 2 months.
BP: 125/65 mmHg
Diagnosis: Bitter Taste in Mouth (Dysgeusia)
Treatment: After having 2 packets of Chinese Herbs, she is totally recovered from disgusting problems! She can be able to taste as usual.
Note: After 1 year, she came to my clinic again on 12/3/2011 for the acupuncture treatment on Foot Numbness and she claimed that everything is good till now.
TCM: In the view of Traditional Chinese Medicine, we believed that eyes are contact with liver. So since this lady she has just had Cataract Surgery, it may in some way destroy the functions of her liver. Someone who is having liver problem, bitter taste will persist throughout the whole day in his/her mouth.
