Chapter 96 A Great Physician Passes Away

Evan asks his teacher to rest. Dr. Li still has patients to see.

“Well, Dr. Xu? Am I going to get better?” Dr. Li asked with a cheerful smile.

Evan had just finished examining his pulse.

“Keep wearing yourself out like this, and even Zhang Zhongjing couldn't help you,” he said irritably.

Dr. Li had only just recovered from a serious illness. He still looked exhausted and weak. Thin to begin with, he had lost still more weight from overwork. He now weighed only 43.5 kg, little more than skin and bone.

Evan shook his head slightly and began writing.

“The wind has been expelled, but some pathogenic influence remains. You're still a little numb. Take a few more batches of medicine.”^[1]

“All right,” Dr. Li said, smiling. “Whatever you say, Dr. Xu.”

“If you listened to me, you'd take some time to rest. Think how old you are. You travel all over the country and see so many patients every day. When did you last go to bed before two in the morning? This is no way to live a long life.”

His teacher's wife joined in.

“That's right, Evan. Give your teacher a good scolding. This old fool won't listen to a word I say. He gave me a terrible fright this time. If you don't rest, I'll have the children tie you up and take you to the countryside. Let's see who can find you there!”

Dr. Li gave a rueful smile and lowered his head without a word.

Before she had finished, the telephone rang again.

“There, another patient. That telephone never stops, all year round. People call in the small hours, and your teacher talks to them forever. He might as well forget about sleeping.”

Still looking down, Dr. Li said quietly, “If they're calling that late, they must be seriously ill, mustn't they? … I can't very well refuse to answer.”

“So no one else can treat them if you're not there?”

Dr. Li fell silent again.

Having had her say, she went out to answer the telephone.

Only when she was gone did Dr. Li speak.

“It's not that I'm afraid of her. I just don't want to argue.”

Evan smiled, finished the prescription, and handed it to him.

Dr. Li read it over, nodding repeatedly.

“Good, good. You've reached a real level of mastery in prescribing. Your clinical skills are far beyond those of most practitioners of Chinese medicine.”

Evan smiled.

“You spend all your time in Lingshi,” Dr. Li went on. “Have you ever thought about going somewhere else? South, for example. Guangdong is a good place to practice Chinese medicine. There are big cities there too. It would be good for your future.”

Evan shook his head.

“I'm used to the countryside. There are too many restrictions in the city. I have more freedom in the villages. The hospital director is very supportive too. He spends his days doing nothing but signing things for me.”

Dr. Li laughed as well. It reminded him of his own younger days. Evan was just as he had been.

Dr. Li took out a cigarette and lit it.

“That stroke gave us a fright, but I came through it. It certainly scared my wife, though. Fortunately, it wasn't too serious. The Western doctors diagnosed a lacunar infarction.^[2]

“The right side of my body was numb. My tongue was stiff, and I had difficulty speaking. I prescribed something at once. After taking Xuming Zhusan for a while, I'm almost well again.

“Sun Simiao also suffered a stroke at a hundred, worn out from being surrounded by patients. That was when he devised Xuming Zhusan to treat himself. He had difficulty speaking too, and his limbs would not move properly. He dictated the prescription and sent his young disciple to have it filled. He took four batches a day, and after ten days and ten nights he recovered completely.^[3]

“Da Xuming Tang, Xiao Xuming Tang, and Xuming Zhusan are all excellent formulas for stroke. Xuming Zhusan in particular treats every kind of wind disorder, mild or severe. Yet they're seldom used now. Why? Because Chinese medicine keeps moving closer to Western medicine.^[4]

“Modern pharmacological research says that fuzi, mahuang, and guizhi can raise blood pressure, so no one dares use them. Pearls left gathering dust! I think I ought to clear the names of Da Xuming Tang and Xiao Xuming Tang. Such good medicines, falsely accused until no one dares prescribe them.”^[5]

“You said yourself that Sun Simiao's stroke came from exhaustion,” Evan said. “Aren't you doing the same thing? All the hardship you went through when you were young left you with a weak constitution. At your age, working this hard—even a young person couldn't stand it.”

Dr. Li took a drag and shook his head.

“I can't help it. As the old saying goes, if no great physicians come forward, what are ordinary people to do? I'm only a village doctor, but opportunities like this don't come often. You want me to enjoy a quiet old age. I simply can't sit still.

“The Chinese medicine profession is a disgrace these days. All sorts of nonsense have found their way into it. We desperately need to put things right. I love Chinese medicine too much to see it reduced to this. I just want it to live with dignity!”

Evan felt his heart pound.

His teacher's wife returned from the telephone.

“Who was it?” Dr. Li asked.

“Who do you think? A patient, of course.”

“What did you tell them?”

“What else could I tell them? I arranged a time for them to come.”

Dr. Li smiled and nodded, then lowered his head and took another drag.

…

After about half a month of medicine, Dr. Li recovered from the stroke. He resumed his constant journeys south to lecture and teach. He was determined to put Chinese medicine right.

He also saw large numbers of patients every day. People posted updates on his whereabouts online, and patients from across the country followed him wherever he went. His workload was immense.

The following June, six months later, Dr. Li had another stroke.

He sent Evan some academic material on his “Revised Xuming Zhusan,” with a note:

“After finishing in Guangzhou, I went to Shenzhen. Saw patients after the lecture. Exhausted myself. Stroke, dizziness, mouth pulled to the right, incessant drooling. All symptoms have subsided with treatment. Don't worry.”

Ten months later, Dr. Li had his third stroke.

A copy without the author's consent is being shown here; the official page where they publish the chapter supports them through reading.

He described it himself: “Three strokes from overwork in two years. My right arm has lost its function.”

This time his wife was truly furious. She gave him a fierce scolding.

A man of 80, with three strokes in two years. How could anyone not be terrified?

Dr. Li kept his head down and did not dare answer back.

She had the children take him somewhere in Guangzhou to hide away and rest for a while. But before he had fully recovered, he was back. His right arm still wasn't working properly when he began treating patients again.

At the time, Guangdong Hospital of Chinese Medicine had established a center to pass on Dr. Li's medical teaching. Several of his disciples were also planning an intensive care unit, or ICU, at the provincial hospital, using Chinese medicine alone to treat critically ill patients.^[6]

Dr. Li was impatient to get there.

His wife scolded him again. An ICU stay cost more than 10,000 yuan a day, she said, while a batch of his herbs cost only two or three hundred. He would be taking other people's business, taking away their livelihoods. They would resent him for going there.

But nothing she said could change his mind. He did not answer back, but he was determined to go. He told Evan this was a chance for Chinese medicine to revive. He had to be there.

Unable to stop him, his wife could only send the children along. If something happened, she wanted them beside him. She had been frightened too badly already.

The Chinese medicine ICU was established.

Later, with the approval of the State Administration of Traditional Chinese Medicine, several centers were established to carry on Dr. Li's medical teaching. For a village practitioner to be held in such esteem delighted him. It also made him busier than ever.

Over the next few years, he fell ill again and again. Still he would not stop working. Even his wife could no longer persuade him.

At last, years of overwork took their toll. At 84, Dr. Li was nearing the end of his life.

Evan had just returned to the county town after treating patients in the countryside when he heard the news. He hurried to Dr. Li's home.

The main room downstairs was filled with people.

“Go on up,” Dr. Li's son told him. “Dad's waiting for you.”

Evan rushed to the second floor. Only Dr. Li and his wife were in the room.

He approached carefully. Grief rose in him, and his eyes stung. Dr. Li lay with his eyes tightly closed, so emaciated that there seemed scarcely any flesh left on him. His breathing was barely perceptible. His face had the look of death.

His wife sat quietly at his bedside.

“Evan's here,” she said into his ear.

His body twitched a few times. Slowly, he opened his eyes and looked at Evan, bewildered. For a moment he seemed not to recognize him. Then, at last, he understood.

“You're here.” His voice was faint and indistinct.

Evan hurried to the bedside and crouched down. He nodded.

“I'm here.”

“Dr. Xu,” his teacher whispered, “take my pulse…”

Evan lifted Dr. Li's hand and placed three fingers over the pulse at his wrist.

Barely breathing, Dr. Li spoke slowly.

“Do you remember what I taught you? If you can't rely on the wrist pulse, examine Fuyang, Taixi, and Taichong, to assess Stomach qi, Kidney qi, and Liver qi.”^[7]

Evan let go of his hand and examined the three pulses at his feet.

“Well?” Dr. Li asked.

Evan's fingers trembled slightly. He smiled, his eyes filling with tears.

“All three pulses have ceased. There's no hope left.”

Dr. Li smiled.

“Heh… heh… You've always been so good at reading pulses.”

He spoke to his wife.

“Help me sit up.”

She put a pillow against the head of the bed and raised him a little, letting him rest against it.

Dr. Li looked at her, then at Evan. Slowly, he began to speak.

“There have been three great blessings in my life. The first was happening to learn Chinese medicine after I went to prison. I found something to pursue for the rest of my life. For all the suffering and hardship, I have never regretted it. I'm content.”

He looked at his wife.

“The second was being lucky enough to marry you. I've made you suffer so much over the years.

“If there's another life, I'm afraid I'll still be a doctor of Chinese medicine. You'll have to worry and suffer for me all over again. Next time, I'll find you sooner. And you must scold me more, to make up for what I owe you from both lives.

“Everyone says I'm afraid of my wife. There's nothing wrong with that. I wouldn't feel right if you didn't scold me. But I have to go first. You must go on living.”

She sobbed, unable to speak.

Dr. Li turned back to Evan. His voice trembled.

“Evan, you are a very, very fine doctor of Chinese medicine. I'm going now. I'm afraid I won't be here to see what becomes of our profession. If no great physicians come forward, what are ordinary people to do?

“With your skills, you could do so much more! Remember, you must be a true practitioner. You mustn't let Chinese medicine die! Let it live with dignity!”

Evan nodded desperately.

Slowly, Dr. Li raised a trembling hand and clasped Evan's.

“The third blessing I wanted to tell you about… Having you as my disciple has been one of the great blessings of my life.”

Evan could no longer hold back. He wept uncontrollably.

That day… a great physician passed away.

Reader Notes

Reader Notes

1. ↩︎ Wind and a lingering pathogenic influence. Wind here belongs to the traditional medical explanation of illness, rather than describing air moving through the room. Zhongfeng, conventionally translated as “wind stroke,” covers a historical group of conditions associated with sudden disability, including weakness and facial deviation. Evan's statement about what has been expelled and what remains is his assessment within that framework. It is distinct from the biomedical diagnosis Dr. Li gives later. Source: WHO — International Standard Terminologies on Traditional Chinese Medicine, entry 1758.
2. ↩︎ A lacunar infarction. This is a small, deep area of brain injury caused by blockage of one of the brain's small blood vessels. It is a type of ischemic stroke; “small” describes the affected area, not a guarantee of a harmless illness. Here Dr. Li reports what the Western doctors diagnosed. The manuscript supplies no scan findings or further investigation, and none have been added to his account. Source: NINDS — Secondary Prevention of Small Subcortical Strokes Trial, background.
3. ↩︎ Sun Simiao's account. Sun Simiao was a Tang-dynasty physician associated with the Beiji Qianjin Yaofang. Its section on Xuming Zhusan contains a first-person account of impaired speech and limb movement, followed by recovery after ten days and nights of treatment. That passage does not establish the age of a hundred, exhaustion from patients, or the disciple's errand described here. Those remain part of Dr. Li's telling. The novel says four prescription batches, ji, each day; the classical text says four administrations, fu. The two are not automatically equivalent quantities. Source: Beiji Qianjin Yaofang, volume 8 — Xuming Zhusan (in Chinese).
4. ↩︎ The Xuming formulas. Xuming means “continuing life,” a traditional formula name rather than a promised outcome. Da and xiao distinguish “major” and “minor” Xuming Tang formulas. Tang denotes a decoction; zhusan denotes a preparation of coarsely divided ingredients that is boiled before drinking, rather than a dry powder simply swallowed. These names therefore remain distinct in English. The classical text discusses several such preparations under wind disorders. Their historical use and Dr. Li's praise do not establish equal effectiveness for every modern stroke diagnosis. Source: Beiji Qianjin Yaofang, volume 8 — the Xuming preparations (in Chinese).
5. ↩︎ The medicines in Dr. Li's argument. Fuzi is the aconite lateral-root medicine already encountered in the story; mahuang is ephedra; guizhi is cinnamon or cassia twig, distinct from cinnamon bark. Their identities and risks differ. Ephedra has documented associations with raised blood pressure and serious cardiovascular events. Aconite-containing medicines can cause poisoning, including abnormal heart rhythms. These sources do not establish Dr. Li's blanket claim that all three medicines raise blood pressure, or that the formulas have been unfairly abandoned. Sources: NCCIH — Ephedra; Hong Kong Department of Health — aconitum-containing medicines (in Chinese); Hong Kong Baptist University — Cassia Twig, D00380.
6. ↩︎ Passing on a physician's learning. An academic transmission center preserves and teaches a practitioner's clinical experience, methods, and ideas, often through disciples working with senior physicians. “Transmission” here concerns medical learning, not biological inheritance or ownership passing automatically to the physician's children. Such mentorship and teaching centers are recognized forms of Chinese medical education. The proposed ICU, its treatment approach, and the later approvals in this chapter belong to the novel's account; this general educational source does not verify their particular history or results. Source: China's Ministry of Education — reply on Chinese medical education, section 5 (in Chinese).
7. ↩︎ The three lower pulse sites. This recalls the lesson in Chapter 88. Cunkou is the usual wrist-pulse region; Fuyang, Taixi, and Taichong are sites around the foot and ankle examined by touch, not three needles inserted or three extra heartbeats. Dr. Li pairs them with Stomach, Kidney, and Liver qi. Capitals mark traditional functional systems. WHO terminology describes the wrist region, Fuyang's association with Spleen and Stomach qi, and Taixi in assessing Kidney qi; the complete three-site interpretation and the prognosis remain the characters' traditional judgment. Source: WHO — Chinese medicine terminology, entries 855–856 and 919.