Dr. Xu: A Chinese Medicine Novel

Professor Liu’s name has made an impression. Clara still has a roomful of visitors to manage.

Leo surveyed their stunned faces with satisfaction. Professor Oliver Liu’s name certainly worked wonders. All he had to do was mention it, and everyone was amazed.

Even Clara was taken aback. This man was Professor Liu’s disciple? Their county hospital of Chinese medicine had someone with those connections tucked away in its obstetrics and gynecology department?

Evan’s gaze, meanwhile, had suddenly grown positively paternal. This man was Oliver’s disciple, and Evan was Oliver’s senior fellow disciple. By the rules of their lineage, that made Evan his uncle![1]

So they were family!

“What’s the matter? Did you need something?” Clara asked.

Leo gestured vaguely around them. “Something urgent. We’d better talk in the other room. There are still patients here.”

Clara’s eyes lit up. She’d been struggling to find an excuse to send this family away. And here was one!

She cleared her throat and turned to Little Octopus. “Excuse me, we’re about to hold a private meeting. We won’t be seeing any more patients this morning, so if you could…”

Before Little Octopus could answer, Evan asked in surprise, “A private meeting? What meeting?”

“Well…” Clara looked at Leo. “Dr. Cao has come all this way. He must have something important to discuss. Surely we ought to give him our full attention?”

Leo’s eyebrows shot up. He gave a smug little snort. Now that was respect…

Ben’s wife lifted her chin proudly too.

Ben stood behind them, at a loss for words.

Evan was baffled. The county hospital of Chinese medicine was only a few kilometers away. What did she mean, “all this way”?

“Go ahead and have your meeting,” he said. “I still have patients to treat.”

“Haven’t you finished her follow-up?” Clara asked.

Evan pointed toward the bathroom. “There’s still a woman in there with vomiting from her pregnancy.”

“She hasn’t asked you to treat her!” Clara said urgently.

Evan gave her a puzzled look. “You’re usually trying everything you can to bring patients in. Why are you trying to send one away today?”

Clara had no answer.

Just then, Little Octopus’s mother and Second Sis came out. Second Sis kept stroking her chest downward, trying to settle her stomach, while holding her belly with her other hand. Her brow was tightly furrowed. She looked utterly miserable.

Her Majesty had no time to assess Evan now. “Em, come on. Let’s go home first.”

Evan looked at Second Sis. “Comrade, would you like me to take a look at that vomiting from your pregnancy?”[2]

Before the patient could speak, Clara cut in. “Next time. We’re having a meeting now.”

Evan looked at her strangely.

“It’s all right. There’s no hurry,” Leo said mildly. “Let Dr. Xu finish seeing his patient. We can talk afterward.”

Clara stared at him. Hadn’t he just said it was fucking urgent? Now there was no hurry? The bastard had switched sides!

“Leo.” Ben’s wife gave her brother a tug.

He turned and spoke quietly to them. “I’ve been trying to find something solid to use against that boy. And here’s a patient, ready and waiting.”

Ben’s wife understood. “She’s not one of his hired patients, is she?”

“Definitely not,” Leo murmured.

That reassured her.

Second Sis raised her head, one hand pressed to her chest, fighting the nausea that kept surging up. “Can you treat it?”

“Holly, you’re pregnant,” Little Octopus’s mother said. “You can’t just take any medicine!”

“Mom!” Little Octopus glared at her.

Her mother pressed her lips together. She didn’t have much faith in Chinese medicine. Going for a little help with some minor discomfort was one thing. But Holly was pregnant now. Who knew whether she could take Chinese herbs? What if something went wrong?

Evan frowned.

“Why not let Dr. Xu take a look?” Leo said, with a hint of mockery. “There are still plenty of good Chinese medicine doctors out there… outside the hospitals.”

Evan nodded at him. This unexpected nephew knew how to say the right thing.

Second Sis’s whole face was screwed up in discomfort. “Auntie, I really feel awful. I’m so nauseated!”

“Shall we take you to the hospital?” her aunt asked anxiously.

Second Sis waved a hand. “No. The hospital… it’s no use. I’ve seen Chinese medicine doctors and Western medicine doctors. None of it helped. I even went to this Dr. Cao, and I didn’t get better.”

Leo’s expression faltered.

Ben and his wife both looked at him. No wonder he was so certain she wasn’t a hired patient. He’d failed to treat her himself!

“You didn’t get her better?” Evan asked Leo.

Leo looked uncomfortable. “Well… Chinese herbs don’t work that quickly to begin with. Besides, there may be… other factors in her condition… And you’re vomiting so badly that you bring the medicine straight back up. You’d better go to the hospital for another examination later.”

“It’s all right,” Evan reassured him. “No doctor can promise to cure every patient on the first attempt. Just assess the pattern carefully again.”

Leo’s face changed completely. He gave Evan a sidelong look. What a show-off. Did he need some damn kid to comfort him?

Evan looked around at them and said evenly, “If you don’t want to take medicine, we can try acupuncture first.”

“Acupuncture?” They all looked startled.

Taken from NovelPhoenix, this narrative should be reported if found on Amazon.

“You know how to do that too?” Leo asked curiously.

Evan gave him a small, kindly smile. “A little.”

Little Octopus’s eyes shone. “Is it like in those martial-arts movies? Pew, pew, pew, and you’re cured?”[3]

Evan was speechless. “Don’t watch so much silly TV.”

“Oh.” Little Octopus sounded aggrieved.

Second Sis clutched her chest. “Will acupuncture help?” she asked miserably.

“Acupuncture will bring relief more quickly,” Evan replied. “Then I’ll prescribe some medicine as well. Using needles and medicine together will work better.”

Second Sis hesitated.

“Second Sis, give it a try!” Little Octopus urged. “He’s really good!”

Despite her nausea, Second Sis couldn’t resist asking, “Have you tried him?”

Little Octopus went bright red.

Her mother’s murderous gaze swung toward her at once.

Behind the counter, Clara’s eyes went wide!

Little Octopus turned pale with fright and waved her hands. “No! No!”

“I meant acupuncture!” she hastily explained. “Oh, Sis! Just try it. You don’t want to keep feeling this awful, do you?”

“All right, all right. I really can’t stand this nausea.” Second Sis agreed.

Evan pointed to the seat beside him. “Come and sit down.” He began examining her.

Everyone else watched from the side.

He went through his questions one by one and completed all four diagnostic methods, weighing the findings together.[4]

As Evan wrote up the case, he explained, “After a woman becomes pregnant, blood gathers in the womb. The Liver stores blood, but now it has too little in reserve, so the blood fails to nourish it. The more deficient the Liver blood, the stronger the Liver fire becomes.”[5]

“Then there can be internal injury from the seven emotions. Pent-up anger harms the Liver. As Liver fire grows stronger, Wood overwhelms Earth and attacks the Stomach. In pregnancy, the qi of the Chong Vessel is also abundant. Its qi rises with Liver fire to attack the Stomach, causing disharmony between the Liver and Stomach. Stomach qi can no longer descend as it should. That’s why the vomiting is so severe!”[6]

“Another cause is weakness of the Spleen and Stomach. The Spleen raises the clear; the Stomach lowers the turbid. When they’re weak, that upward and downward movement is disrupted, and Stomach qi can no longer descend properly.”[7]

“This is also related to the abundance of qi in the Chong Vessel. During pregnancy, blood gathers in the Chong and Ren Vessels to nourish the fetus, and qi becomes abundant in the Chong Vessel. The Chong Vessel belongs to Yangming, so its qi can readily attack the Yangming Stomach. If the Spleen and Stomach are weak, the rising Chong qi can easily assail them and cause vomiting.”

“Generally, those are the two mechanisms. But that’s the textbook account. In clinical practice, we usually distinguish three patterns: an overactive Liver with counterflow qi, disharmony of Stomach qi, and deficiency in the middle with Stomach cold. As well as the main pattern, you must always consider any accompanying patterns.”

Evan finished the case record, looked up, and smiled kindly. “Got all that?”

Everyone was baffled. Dr. Xu was calm, composed, and unsmiling with everyone else. Yet whenever he looked at Leo, his face was full of warmth.

What the hell?

If the man hadn’t been in his forties, Little Octopus might have felt a surge of jealousy.

Leo had goose bumps too. Fighting his discomfort, he said, “You… just get on with treating your patient…”

Evan shook his head slightly. “What was your diagnosis? What formula did you prescribe?”

Leo was even more bewildered. “What’s that got to do with you?”

“If I don’t know what formula you prescribed,” Evan said, “how am I supposed to know where you went wrong?”

Reader Notes

↩︎ An uncle in the lineage. A senior fellow disciple entered the same teacher’s lineage before another disciple; seniority need not follow physical age. Apprenticeship relationships borrow family terms, so Evan regards his fellow disciple’s student as a nephew. The Chinese title’s “uncle” claim also echoes an insulting expression. Evan, however, is delighted to have found a junior in his own lineage. The English title preserves that family joke; their connection is through teachers. Sources: Ministry of Education — shixiong, senior fellow disciple (in Chinese); Xinhua — Regional differences in family forms of address (in Chinese).↩︎ Comrade. This public form of address recalls the historical setting Evan has just left. He carries that manner of speaking into the present-day consultation; the address gives no information about the patient’s politics. Source: Laishan District Government — Social etiquette and forms of address (in Chinese).↩︎ Acupuncture and martial-arts fiction. Acupuncture uses needles; moxibustion, often paired with it in the Chinese term zhenjiu, uses heat from burning mugwort. Here Evan is proposing needles. Little Octopus imagines the spectacular feats of martial-arts screen stories, a genre closely connected with wuxia novels. Her sound effects turn the proposed treatment into a movie fantasy. The exchange keeps that fantasy distinct from Evan’s actual proposal. Sources: WHO — International Standard Terminologies on Traditional Chinese Medicine, entries 3003, 3008 and 3138; Hong Kong Heritage Museum — Jin Yong Gallery.↩︎ Four diagnostic methods. Chinese medicine combines inspection, listening and smelling, questioning, and palpation. Evan completes this combined assessment after questioning Holly. The narrative supplies no particular tongue or pulse findings at this point. Source: Hong Kong Polytechnic University — Four Diagnostic Methods.↩︎ Blood, Liver fire, and pregnancy. Evan’s traditional account describes blood supporting the fetus while leaving less to nourish the Liver. Liver blood deficiency and Liver fire are functional patterns rather than laboratory findings of anemia or inflammation. Emotional strain, especially anger, can also disturb the Liver in this model. In five-phase language, the Liver corresponds to Wood and the digestive Spleen and Stomach to Earth. Wood “overwhelming” Earth describes excessive interference with digestion. Evan is explaining possible mechanisms before naming this patient’s particular pattern. Sources: WHO — International Standard Terminologies on Traditional Chinese Medicine, entries 38, 138, 284–285, 1237 and 1317; Shanghai University of Traditional Chinese Medicine — Gynecology syllabus, printed p. 175 (in Chinese).↩︎ The Chong and Ren Vessels. These channels belong to Chinese medicine’s functional map and are associated with reproductive activity. “Vessel” here names a traditional channel rather than an anatomical blood vessel. In the pregnancy model Evan describes, Chong qi rises against the Stomach’s normal downward action, particularly when digestion is weak or the Liver and Stomach are out of harmony. Yangming is the Stomach’s channel affiliation. Evan’s phrasing that the Chong Vessel “belongs to Yangming” expresses the connection within his traditional account. Sources: WHO — International Standard Terminologies on Traditional Chinese Medicine, entries 1363 and 2928–2929; Shanghai University of Traditional Chinese Medicine — Pregnancy sickness mechanisms, printed p. 175 (in Chinese).↩︎ Raising the clear, lowering the turbid. In this traditional digestive model, “clear” refers to useful nourishment distributed upward by the Spleen, while “turbid” refers to material passed downward by the Stomach. These directions explain why disrupted Stomach descent can be described as vomiting or counterflow. “The middle,” in Evan’s later three-pattern list, refers to the digestive functional region; “Stomach cold” is a pattern term rather than a measured temperature. He distinguishes weakness of this system from the Liver-related mechanism without yet selecting Holly’s pattern. Source: WHO — International Standard Terminologies on Traditional Chinese Medicine.