After driving his good friend Wilson's car into his old lover Cuddy's living room, the hurt House finally found new excitement in the detention center while waiting for parole. Of course, the screenwriter did not forget to insert a new friend for House to train: this time, the one who was conquered by House was Adams, a beautiful female doctor with a mixed-race face. House once again showed his amazing talent in the new series. His extraordinary observation, bold reasoning, unconventional style of doing things and magical physical examination skills were all visible. Dr. Adams, a top student who had trained at Hopkins, also changed his attitude from arrogance at the beginning to surprise, and eventually became a follower of House's actions. The cases in this episode are still rare. Unlike usual, House did not have sufficient medical resources to use this time, and the diagnosis relied entirely on the most primitive means. A young man developed joint pain, fever, rash and other symptoms in prison. Adams initially thought it was gonorrhea, but House overturned Adams with a more convincing lupus erythematosus. However, the patient's symptoms were far more complicated than that. The man's tobacco-stained fingers and the subsequent fractures made House turn to the diagnosis of advanced lung cancer. At this time, House showed his amazing auscultation skills: without a stethoscope, House accurately found shadows in the patient's lungs. Experienced clinical experts can understand the condition of the patient's lungs by tapping them lightly, and some people can estimate the EF value of the patient's heart (ejection fraction, which usually requires the help of cardiac ultrasound to simulate calculations) by auscultation alone. House's talent probably concentrates the legends of the most experienced doctors in the world. Of course, for most mediocre mortals, pursuing this realm is actually far less safe than reading a chest X-ray or arranging a reliable ultrasound. House's magic did not help this patient. The chest X-ray showed that the man's lung shadow was not cancer. The patient's extremely easy bleeding did not conform to the hypercoagulable state often seen in advanced lung cancer, and the condition became more complicated. In addition, the patient suffered anaphylactic shock. Fortunately, there was a doctor on the scene, and a simple tracheotomy saved the young man's life. Now, all the clinical manifestations are finally complete: coagulation dysfunction, rash, osteoporosis, allergy, what will be the answer? House, who is about to leave, thought of mastocytosis. This blood system disease can invade multiple systems of the body and often manifests as paroxysmal allergies. Mast cells release inflammatory mediators such as histamine, causing patients to have urticaria, laryngeal edema and even suffocation. However, allergic symptoms such as flushing and hypotension are not limited to mastocytosis. Before making this diagnosis, it is necessary to carefully consider sepsis, carcinoid syndrome, neuroendocrine tumors such as VIP tumors or pheochromocytomas, medullary thyroid cancer and other diseases. The exclusion of these diseases requires a detailed systemic examination and multiple laboratory tests. House's screenwriter simplified the details here and chose to use aspirin for a simple diagnosis. Aspirin (acetylsalicylic acid) is a cyclooxygenase inhibitor that inhibits the biosynthesis of prostaglandins (PG) while promoting the production of allergic mediators leukotrienes (LT) and enhancing mast cell-induced allergic reactions. Therefore, when patients with potential allergies take aspirin, it is likely to induce anaphylactic shock on the spot. This will help rule out similar manifestations caused by other reasons mentioned above. The note on the dinner proves that House guessed the ending again. Of course, the highlight of this drama is far from this case itself. When House was in a crisis, he did not forget to save his roommate's poisoned pet cricket, and the means he used were still refreshing. And this successful rescue also laid the groundwork for House's rescue in the chaos later. House's talent comes from screenwriting. House screenwriters who can write all kinds of strange cases also have a great medical foundation. Coincidentally, there is a case report on mastocytosis published in the New England Journal of Medicine. In this report, the patient's allergic symptoms worsened after using aspirin, and the real-life Houses at Massachusetts General Hospital (MGH) finally confirmed the condition after careful diagnosis and treatment. Of course, in terms of differential analysis and treatment details, professional medical journals reflect another kind of beauty. Is the prototype of the story of House in this episode born out of this? Such a professional attitude is probably a level that domestic screenwriters cannot reach.