Chapter 611: A Touch of Hunger and Cold

Chapter 611: Chapter 611: A Touch of Hunger and Cold

Li Xu took his seat in the consultation room, with the two professors sitting in observation chairs to the side.

The consultations began.

The first patient, a young mother, walked in with a little boy.

The boy, about four or five years old, had a sturdy, round-faced appearance, but his complexion was rather pale. He looked puffy and bloated, as if inflated, with soft, flabby flesh.

Once the mother and son were inside, Li Xu gestured for the boy to sit down. "So, little guy," he asked, "what’s bothering you?"

"He hasn’t said anything hurts, exactly," the mother jumped in. "It’s just that he sweats so easily. The slightest movement leaves him drenched. He also catches colds all the time. We end up at the hospital twice a month. It’s worrying me to death."

Li Xu didn’t immediately move to take the boy’s pulse. Instead, he simply watched him quietly.

After a few moments, he suddenly asked, "Does he tend to kick his blankets off at night? And is he a restless sleeper, always tossing and turning?"

"Huh?"

The mother froze, her eyes wide with surprise. "Dr. Li, how could you possibly know that? That’s incredible! He kicks the covers off eight times a night. I have to get up several times just to put them back on."

Li Xu smiled and continued, "Aside from kicking off the blankets, is he also a picky eater? Does he dislike meat and hard foods? A poor appetite in general?"

"My goodness, Dr. Li, you knew that as well?"

This time, the mother was truly astonished. "Yes, yes, exactly! Mealtimes are the biggest headache. He’ll hold food in his mouth forever without swallowing. A single meal can take an hour."

At the side, Gao Guanghui and Zhang Liang exchanged a glance, a hint of admiration in their eyes as they nodded slightly.

In truth, from the moment the boy had pushed open the door, both professors had fixed their gazes on him.

For a practitioner of Traditional Chinese Medicine, diagnosis by observation doesn’t begin when the patient sits down. It starts from the very moment of "knowing by observing."

Observing their gait, their expression, their physique.

The boy had a sluggish gait, a condition known as "delayed walking," which indicates insufficient kidney qi.

A pale, puffy complexion indicates spleen deficiency and an excess of dampness.

His unfocused gaze indicated a deficiency in his "shen," or vital spirit.

This is why, sometimes, you can gauge a doctor’s skill by observing their attentiveness.

A skilled and principled TCM doctor begins their observation the moment a patient walks in the door, much like Sherlock Holmes.

This is especially true with children, who often can’t describe their own symptoms, putting a doctor’s powers of observation to the test.

Li Xu’s ability to discern the boy’s poor appetite and his habit of kicking off the blankets was a direct result of these subtle observations.

From those two precise questions alone, Professor Zhang Liang could tell that this young man didn’t just have a solid grasp of the fundamentals; he also possessed a wealth of clinical experience. He was clearly no armchair theorist.

Gao Guanghui, for his part, felt a deep sense of relief and pride.

Just last year, a case like this would have required Li Xu to deliberate at length, and he might have even had to consult him for advice.

Now, however, his diagnostic observation skills had taken on the air of a master. In his ability to catch certain details, he was already on par with Gao Guanghui himself.

Li Xu continued to explain, "In Traditional Chinese Medicine, there’s a saying: ’A child’s spleen is often insufficient.’ The spleen governs the limbs and muscles. Your son looks puffy, but in reality, his muscles lack substance, which is a sign of spleen deficiency. When the spleen is deficient, the defensive qi becomes unstable. It’s like a city wall with a breach—the moment a pathogenic wind blows, it collapses. That’s why he catches colds so easily."

"Also, his gait. When he walked in, it was somewhat labored. This is often due to qi deficiency with sinking dampness, a sign of insufficient central qi. With a deficient spleen and insufficient central qi, the body can’t properly contain its fluids. They tend to leak out, which is why he sweats so much."

"As for kicking off the blankets, that relates to the principle, ’An unharmonious stomach leads to restless sleep.’ When the spleen and stomach are weak, undigested food stagnates and generates heat. The child feels an internal, restless heat, so he naturally kicks off his covers."

The mother nodded emphatically, her head bobbing. "Dr. Li, you’re simply incredible. The way you explain it, everything about my son’s condition seems to make sense now. And you figured all this out without even taking his pulse?"

This, in fact, is a common misconception many laypeople have about Traditional Chinese Medicine.

People tend to think that TCM is all about "taking the pulse," as if a doctor can diagnose any illness, or even confirm a pregnancy and determine a baby’s gender, just by touching a patient’s wrist.

This is known as "confining the doctor to the pulse."

In reality, of the four pillars of TCM diagnosis—observation, listening and smelling, inquiry, and palpation—pulse-taking is merely the final step. It’s used to verify the conclusions drawn from the first three methods and to probe the deeper changes in the body’s qi and blood.

Just as he had done moments ago, Li Xu had already formed a near-complete picture of the boy’s condition through observation and inquiry alone.

"The *Nan Jing* states, ’For one whose spleen is damaged, food and drink do not nourish the skin and flesh.’"

As he spoke, Li Xu gestured for the boy to extend his hand for the pulse diagnosis. "In other words, when the spleen and stomach are impaired, the food one eats cannot be fully transformed into the qi and blood that nourish the muscles. When the skin and its interstitial spaces are deprived of this nourishment from qi and blood, they become porous, like a sieve."

"When the holes in the sieve are too large, pathogenic wind can easily get in, and the body’s fluids can easily leak out."

"Therefore, the key to treatment isn’t stopping the sweat or curing the cold. It is to fortify the spleen, replenish the qi, consolidate the exterior, and arrest the sweating."

After taking the boy’s pulse, Li Xu found it to be thready, weak, and soft. The tongue had a thin, white, and moist coating. This all confirmed his initial judgment.

"I’m going to prescribe a formula. It’s a modification of Jade Screen Powder combined with Four Gentlemen Soup. We’ll use a heavy dose of Astragalus Root to supplement the qi and consolidate the exterior, Atractylodes to fortify the spleen and dry dampness, and Siler root to travel to the exterior and expel wind..."

Li Xu explained patiently as he wrote out the prescription.

Listening from the side, the two professors nodded frequently. The prescription was conventional, yet it hit the very heart of the issue—the standard approach of the Classic Formula School.

’This Li Xu is a true talent.’

Jade Screen Powder was no ordinary formula. It was created by Zhu Danxi, one of the Four Great Masters of the Jin-Yuan period and the founder of the Yin-Nourishing School.

The Astragalus Root in the formula is a crucial herb for replenishing qi. It acts like a master craftsman, repairing the body’s "city wall"—the defensive qi—which has been weakened by spleen deficiency. It reinforces this wall until it’s solid and strong, allowing the defensive qi to be fully restored.

"Defensive qi," as the name suggests, is the qi that protects the body, analogous to what modern medicine calls the immune system.

It is the body’s first line of defense.

Siler root, meanwhile, acts like a patrolling soldier. It travels to the body’s exterior to expel wind, driving out any pathogenic wind that has already invaded.

Atractylodes fortifies the spleen and dries dampness. In Five Elements theory, this is "banking earth to generate metal," providing logistical support for the Astragalus Root.

Together, these three herbs act like the legendary Golden Bell Shield or Iron Shirt, forming an impenetrable barrier on the child’s body. Pathogenic wind can’t get in, and sweat can’t leak out.

"Go home and take the medicine as prescribed."

Li Xu printed the prescription and handed it to Song Sisi to have the herbs prepared. At the same time, he gave the mother some careful instructions. "In addition to the medicine, you’ll need to pay attention to his diet and how he’s dressed from now on."

"Life is better now, so parents worry their children aren’t getting enough nutrition. They see their child is a little thin and their heart aches, so they force-feed them all sorts of rich foods—fatty meats, oily dishes—even chasing them around to get them to eat. But constantly overfeeding a child with food that’s too rich is actually a heavy burden on their delicate spleen and stomach."

Li Xu continued, "There’s an old saying: ’To keep a child healthy and safe, they need one-third hunger and cold.’ This isn’t just some random phrase; it’s a pearl of parenting wisdom distilled from thousands of years of experience. Once a child’s digestive system is damaged, you get what we call ’food stagnation.’ This creates internal heat, which gives external pathogens an opportunity to invade. Then, catching colds and running fevers becomes a regular occurrence."