Chapter 131: Easing the Pain with Acupuncture

Leo has been caught off guard. Evan is still taking the patient's pulse.

Leo Cao was almost sweating. He had a guilty conscience, after all. He gave an awkward laugh.

“Ha… ha… Director Guo. You're here.”

Guo looked at the group in puzzlement. Why were they all wearing masks?

“Who are you?”

Leo froze, then remembered his own mask. He quickly pulled it off.

“It's me. Leo Cao.”

Guo gave him a slight nod and held out his hand. “Hello, Dr. Cao.”

Guo was nearly sixty, with only a few years left before retirement. His face was lean, his brow often furrowed. He rarely smiled or joked. His hair was neatly combed, and his clothes were spotless and tidy.

A man like that did things by the book and took his work seriously. The drawback was just as clear: he was stubborn, and grew more stubborn with age.

Leo felt even more awkward. The very thing he had been dreading had happened.

The other young Chinese medicine doctors didn't dare speak out of turn either.

Guo surveyed the masked youngsters, all crowded at the doorway, none daring to look at him. Had they come to watch some eminent specialist treat a patient?

He turned to take in the gathering. “Are you here for a consultation?”

Leo hurried to change the subject. “Uh… yes, yes. Director Guo, why don't we go to Director Du's office first? He has something he'd like to report to you.”

“All right.” Guo nodded, then glanced into the room again. A doctor was sitting beside his wife's bed, taking her pulse. His brow tightened.

“Who's that doctor? Your Dr. Zhong?”

“Uh…” Leo grew even more uncomfortable.

“That's our teacher, Dr. Evan Xu,” Alex said proudly.

Leo's vision went dark. He nearly fainted. He was trying to bluff his way through this, and the bastard had just given him away.

The other young doctors nodded earnestly, looking as proud as though the credit were theirs.

“Evan Xu?” Guo's frown deepened. His expression slowly grew grave.

Leo had already covered his face with one hand.

The other youngsters hurried to nod again, excited. Every one of them was an Evan Xu fan.

Leo wanted to bang his head against the wall. Damn it, why were these idiots looking so pleased with themselves?

Guo's face darkened at once. “Dr. Cao, what's going on?”

Leo had no choice but to force out an explanation. “Well… Dr. Xu is one of our invited specialists. We've had a consultation agreement with him all along, so we asked him to come and examine your wife.”

Looking displeased, Guo stared at him for a while. Even Leo, thick-skinned as he was, began to squirm.

Guo looked inside again. Since he had arrived, Evan hadn't so much as turned his head. He was still in exactly the same position, taking his wife's pulse.

Leo rubbed his nose and called into the room. “Dr. Xu. Dr. Xu, Director Guo is here.”

“Quiet!” Evan said, continuing his careful examination.

Leo looked embarrassed by the rebuff, but still tried to explain for him. “Please don't mind him, Director Guo. He… he's just like that.”

Guo nodded slightly and said nothing. Standing at the doorway, he looked at Evan again. Instead of darkening further, his expression eased a little.

After a while, Evan finished taking the pulse and brought out the acupuncture case he carried with him.

“Dr. Xu, what are you doing?” Leo asked quickly.

Evan didn't turn around. “She's in unbearable pain. I'll relieve that with acupuncture and moxibustion first.”

Leo paused. Was Evan planning to show what he could do? If he really proved his skill, things would be easier from here. But what if he failed? Leo started worrying again.

Guo frowned deeply too. He opened his mouth to speak, then closed it. He stayed at the doorway, looking grimly at Evan's back.

Leo cautiously checked Guo's expression.

Evan took out a three-edged needle and pricked the Chize points at both of the patient's elbows, letting out a little black blood.^[1]

“Prick Chize on both sides and let out the black blood,” he said. “The Yizong Jinjian, the Golden Mirror of Medicine, says: ‘Chize is needled for the various Lung disorders, twisting intestinal sha pain and throat-locking wind, unresolved cold-damage and febrile illnesses, and children's acute and chronic wind disorders.’^[2]

“Chize is the He-sea point of its channel. He-sea points treat the internal fu organs. This point harmonizes the Stomach and directs counterflow downward, regulates the intestines and checks diarrhea.

“When an acute seasonal illness brings cramping, abdominal pain, vomiting and diarrhea, bloodletting can drain it away, like opening a sluice gate. This method can treat acute abdominal pain with vomiting and diarrhea.”

The young doctors all took out their notebooks at once and began writing in earnest.

Source note: the author publishes this chapter on their official page, but this reproduction was made without permission.

Guo stared. They moved in such perfect unison. Had they rehearsed this?

Evan used a large moxa cone over the patient's navel.^[3]

“Use a large moxa cone at Shenque,” he said. “This point shouldn't be needled, only treated with moxibustion. It can treat icy-cold limbs, collapse in wind stroke, pain around the navel, swelling with difficulty urinating, and other conditions.

“Together with Zusanli, it regulates the Stomach and intestines and treats rumbling and abdominal pain. The Zhenjiu Daquan, the Complete Compendium of Acupuncture and Moxibustion, says, ‘For the belly and abdomen, retain the needle at Sanli.’ Zusanli can be used for disorders of the abdomen. For this patient, we'll use the tonifying method.”^[4]

He disinfected her lower leg, inserted a fine filiform needle, and began the tonifying manipulation.

Everyone watched from behind him.

Guo watched too, frowning.

As Evan continued manipulating the needle, the patient's expression gradually became less strained. The crease between her brows relaxed a little.

After a while, Evan asked, “How is it? Does it still hurt?”

The woman lay back against the bed and let out a long breath. “A little. But it's much better.”

Leo looked delighted. Thank goodness. It hadn't gone wrong!

The young doctors took it entirely for granted. As if Dr. Xu would fail!

Guo looked surprised as well. Could acupuncture work that quickly?

Leo glanced at Guo's expression and couldn't suppress a smile.

Seeing that the pain had eased, Evan nodded slightly. He left the needle in place, stood up, and walked over. Only then did he notice the stranger by the door.

Leo hurried to introduce him. “This is Director Guo.”

Evan gave him a slight nod. “Hello, Director.” Then he said to the others, “Come over here. Let's discuss the patient's condition.”

Everyone froze. A single hello—that was all the director got?

Guo was visibly taken aback too.

Leo hurried over and reminded Evan in a low voice, “Director Guo is with the health authorities. He's also the patient's husband.”

Evan turned to look at him. “Oh? A family member? All right, you can listen to the discussion too.”

Leo froze again. Shit. Had he automatically filtered out the first half?

Guo looked at Evan once more. “All right. I'll sit to one side and listen.”

Leo stole another cautious look at him. Had they offended him again?

“Have you all read her chart?” Evan asked the young doctors.

They nodded.

“Then tell me what disease and pattern you think she has. What's the pathomechanism?”^[5]

They looked at one another. No one dared answer.

Evan called on Alex directly. “Alex. You tell me.”

Alex wished he could make himself invisible. No luck. The doctor who taught his exam-prep class knew him best. So much for showing off. This was a difficult case to begin with.

Unable to get out of it, Alex forced himself to answer. “Well… her tongue coating is yellow. Her mouth is dry and bitter, and she's restless and thirsty. It must be a heat pattern. And the intestinal spasms haven't been cured in five years…”

As he went on, he realized he was heading toward qi stagnation with bowel excess again. But they'd already tried Xiao Chengqi Tang, and it hadn't worked.

In the end, he could only say awkwardly, “At least the yellow tongue coating must indicate heat. Treatment should mainly use cold and cool medicines.”

“What do the rest of you think?” Evan asked.

No one else could come up with an answer either.

Evan nodded slightly. “This patient's pathomechanism is very well hidden. There's a lot you can learn from it. Now, take good notes.”

The youngsters all readied themselves to write in unison.

Sitting to one side, Guo stared again.

Reader Notes

Reader Notes

1. ↩︎ Chize and bloodletting. Chize (LU5) is a point at the elbow crease on the Lung channel. It belongs to the five-shu point system, whose names compare the movement of qi to water; the He-sea category describes qi entering inward. Evan links that category to the fu, the traditional functional group that includes the Stomach and intestines. The three-edged needle is a lancet-like instrument, distinct from the slender filiform needle used later. “Black blood” preserves his observation in the story; it does not identify a toxin or establish a laboratory finding. Sources: WHO — International standard terminologies, entries 2969, 2974 and 3080; Beijing University of Chinese Medicine — Chize's traditional classification and location (in Chinese).
2. ↩︎ The language of the classical quotation. The Yizong Jinjian is a Qing medical compendium. Its disease vocabulary belongs to a historical system: cold damage is not automatically typhoid, and “wind” can name a traditional disease category rather than weather. “Twisting intestinal sha” describes a severe abdominal presentation; “throat-locking wind” describes a throat disorder, while children's acute and chronic wind disorders refer to convulsive presentations. These are the conditions in Evan's quotation, not additional diagnoses of this patient. The English follows the wording supplied in the novel. Sources: Yizong Jinjian — Harvard scan, PDF page 20 (in Chinese); Beijing University of Chinese Medicine — Discussion of Chize and classical references (in Chinese).
3. ↩︎ Moxibustion and Shenque. Moxibustion uses burning moxa, a material prepared from mugwort, to apply heat to selected points or areas. It is distinct from acupuncture with a needle. A moxa cone is a compact shaped portion of moxa; the source does not specify a barrier material, burn duration, or other technical details here. Shenque (CV8, also called Ren8) is at the navel. Evan's statement about using moxa rather than a needle reflects its traditional treatment convention. The list of uses is his teaching, not a list of conditions established in this patient's chart. Sources: WHO — International standard terminologies, entries 3138–3144; Shandong University of Traditional Chinese Medicine — Shenque and the traditional prohibition on needling (in Chinese).
4. ↩︎ Zusanli and tonifying. Zusanli (ST36) is a Stomach-channel point on the outer front of the lower leg below the knee. The line Evan quotes occurs in the “Song of the Four Command Points” in the Zhenjiu Daquan, a Ming acupuncture compendium. It associates Sanli with abdominal disorders. “Tonifying” describes a traditional treatment intention and a class of needle manipulations, contrasted with draining or reducing. The novel does not specify a full sequence of rotations or lifting movements here. Evan's choice is shown before he explains the patient's underlying pattern. Sources: Hospital Authority — Zusanli diagram, PDF page 24 (in Chinese); Zhenjiu Daquan — Song of the Four Command Points (in Chinese); Beijing University of Chinese Medicine — Tonifying and reducing needle techniques (in Chinese).
5. ↩︎ A pattern and its pathomechanism. A pattern groups findings within Chinese medicine's account of illness; a pathomechanism explains how that process is understood to arise and develop. Neither is simply another name for a biomedical disease. Alex is repeating the hospital's earlier line of reasoning. A yellow tongue coating and the traditional cold/cool classification of medicines belong to that reasoning; “cold” does not mean the medicine's serving temperature. Xiao Chengqi Tang is the formula that failed in the preceding chapter. Evan has not yet given his own explanation. Source: WHO — International standard terminologies, entries 364, 548, 550 and 2639–2641.