Chapter 153: The Bleeding Had Stopped

The young doctors finally get their answer.

Alex was getting a beating.

The little bastard!

“Help! Help!” he begged. “It's stopped. It's pretty much stopped!”

Everyone was delighted.

“Really? He's not vomiting blood anymore?”

One burly young doctor still had a thick arm hooked around Alex's neck.

Alex flapped like a chick. “Let go! You can let me go now, can't you?”

The big man showed no intention of loosening his arm. “Tell us the truth. When did he start getting better?” he demanded in a rough voice.

Alex let his tongue hang halfway out, trying to look pitiful. No one cared whether he lived or died. Miserably, he answered, “After he took the medicine yesterday, he gradually started vomiting less blood in the second half of the night. By this morning it had pretty much stopped.”

Everyone was overjoyed. It had worked. Dr. Xu's prescription had worked!

They were all excited.

“Boss, can you let go of me now?” Alex pleaded with the big man above him.

The young doctor was big, but he wasn't careless. “No. Why didn't you tell us in the group chat when the patient got better?”

“I told you. My phone died,” Alex said, aggrieved.

The big man didn't believe a word of it. “Bullshit. All those people in the hospital, and you couldn't borrow a charging cable?”

“I'm a dedicated student, okay?” Alex hurried to explain. “I don't spend my time on my phone. I had books to copy out!”

“Bullshit.”

“Oh, please!”

“You were messing with us just now!”

“Get him!”

They started beating Alex again. Even the two women doctors joined in.

They were all so happy and excited that they took it all out on him.

Their opening shot had gone off with a bang. A very loud bang.

Poor Alex.

After their excited horseplay, the young doctors hurried inside.

The moment they entered the patient's room, they became serious.

Only Alex was still miserably rubbing his sore spots.

Evan was still examining the patient's pulse.

The patient and his wife watched him. Now they, too, were convinced. The amount of blood the man had been vomiting had been frightening.

He had suffered gastric bleeding before, so his wife had seen it happen and had some experience. Otherwise, she would probably have been terrified out of her wits.

The previous time, nonsurgical treatment had worked well and stopped the bleeding quickly. That was why they had been unwilling to agree to surgery this time.

Who would have expected nonsurgical treatment not to work now? Fortunately, Evan's prescription had.

Since taking the medicine around midnight, he had barely vomited any more blood. It had essentially stopped, apart from an occasional small amount at long intervals.

They were both full of admiration. Chinese medicine really was impressive! That old man's stories in the central park were surprisingly true to life. Apparently, he was a realist storyteller after all.

Evan finished examining the pulse and looked back at the young doctors.

“After I wrote the prescription last night, the medicine was given frequently, and the vomiting of blood gradually stopped,” he said. “His tongue is now pale, with no coating. His pulse is deep, thready, and choppy.”^[1]

They were taken aback for a moment, then immediately began writing it down.

A deep pulse indicated an interior pattern. Both thready and choppy pulses could indicate deficiency. In particular, a choppy pulse indicated loss of blood and body fluids. Bleeding from various causes, or dehydration caused by vomiting and diarrhea, could all produce a choppy pulse.

Loss of reproductive essence in men could also produce one. The Jinkui Yaolue said, “In a man, a floating and choppy pulse indicates inability to father a child; his essence-qi is clear and cold.”^[2]

“The patient has been vomiting blood for two days,” Evan continued. “He has lost a great deal of qi and blood. These pulse and tongue findings are only to be expected.

“Blood is the mother of qi. When the mother is ill, the child suffers. Loss of blood inevitably damages qi. Remember this in your clinical work: once blood is lost, tangible blood cannot be replenished all at once, but intangible qi must be strengthened promptly.

“Qi is the commander of blood. When qi is sufficient, it can command the blood effectively and reduce bleeding. The same applies to this patient.^[3]

The author's official page contains this chapter, but the displayed copy was taken from it without permission.

“When a formula is working, don't change it. Continue the previous prescription. Add American ginseng to strengthen qi and hold the blood in place. Also add sanqi, ground into powder and swallowed, to stop bleeding and dispel blood stasis. Go and write the prescription.”^[4]

“Yes.” The young doctors were excited.

Evan was getting ready to leave.

The patient's wife hurried to ask, “Dr. Xu, will he still need surgery?”

“We'll have to see how he responds to the medicine,” Evan replied. “Your husband's Spleen and Stomach are in quite a serious condition. It isn't just the gastric bleeding. He's had gastric ulcers for years, and there's hidden blood in his stool as well.

“The Spleen and Stomach are the foundation of life after birth. If they remain damaged, a person can't be healthy. You can see that from these two episodes of gastric bleeding.^[5]

“Even if we stop the bleeding, treatment has to continue. Restoring the Spleen and Stomach to health is how we address the root. You don't want your husband complaining every day that his stomach hurts, unable to eat this or that, do you?”

“Exactly!” she said at once. “Every day he tells me his stomach feels awful. If he goes even a little while without food, he says it feels like something's digging away inside him. Then he eats, and he complains of bloating. Hot, cold, sour, sweet—there's hardly anything he can eat. It's miserable! And then he vomits blood every so often. He's going to scare me to death!”

“Yes, it's a little complicated,” Evan said. “Work with us on his treatment.”

She nodded quickly. “Of course, of course. Dr. Xu, we have every confidence in you.”

He smiled at her and went out.

The young doctors crowded in, lined up, and took turns examining the patient's pulse.

The patient and his wife didn't know whether to laugh or cry.

Evan went back to Mingxin Clinic.

He had now joined the hospital's specialists' clinic, but he only saw patients there twice a week. Today wasn't one of his scheduled days. He had simply been called in to help with a consultation.

As Evan remembered it, consultations outside his scheduled hours were paid separately, according to the fee scale. His rate was that of a full senior specialist. He still wasn't sure exactly how much that meant. All he knew was that, adding everything together, he might be earning thirty or forty thousand yuan a month.^[6]

That was a very high salary in a small county town like this. He probably also had the best pay and benefits of anyone graduating from his postgraduate program that year.

Evan felt a little relieved and happy. At last he could start saving up to repay Ryan Yao. Ryan's family had paid out hundreds of thousands of yuan because of him. Until he paid them back, he couldn't face seeing Ryan again.

He saw patients at Mingxin Clinic all day.

That evening, after seeing his last patient and locking up, he headed to Clara's home.

As usual, he examined Adam Zhang. The large doses of medicine to calm the Liver and extinguish wind had largely settled Adam's Liver wind. He still needed to keep taking the medicine, though, or the condition might recur.^[7]

As usual, once the examination was over, Adam watched the palace drama Story of Yanxi Palace on the sofa.

As usual, Evan went to help in the kitchen.

As usual, they ate.

After dinner, Evan said goodbye. He had gone outside when Clara came hurrying after him.

Still watching Story of Yanxi Palace, Adam gave an exaggerated roll of his eyes.

Reader Notes

Reader Notes

1. ↩︎ Pulse and tongue terms. These are traditional diagnostic descriptions. A deep pulse is felt more clearly with firm pressure; thready describes a thin pulse, while choppy describes a rough or obstructed quality. The latter can be associated with depleted essence, blood, or fluids, but also with qi stagnation and blood stasis. The tongue's body color and its coating are separate observations. These terms explain the narrative's reasoning; they are not measurements of blood pressure or laboratory confirmation of blood loss. Source: WHO — Traditional Chinese Medicine Terminologies, entries 642, 890, 896, and 901; tongue examination section.
2. ↩︎ The classical aside. The Jinkui Yaolue, or Essentials from the Golden Cabinet, includes this discussion in its sixth chapter, on depletion disorders. The transcription checked here reads “floating, weak, and choppy”; the novel's quotation omits “weak,” and that omission is retained. Jing, translated as reproductive essence in this passage, belongs to the traditional account of reproduction. This is a general example of pulse interpretation, not a new fertility diagnosis for the hospitalized patient. Source: Jinkui Yaolue Fanglun — Chapter 6 (Chinese primary-text transcription).
3. ↩︎ Blood as mother, qi as commander. These paired metaphors describe interdependence in traditional Chinese medicine. Blood provides a material basis for qi and carries it; qi is said to generate blood, move it, and keep it within the vessels. Evan uses that framework to explain why he wants to strengthen qi after blood loss. “Intangible” contrasts qi's functional role with visible blood. His treatment reasoning remains part of the story, rather than a description of modern hematology. Source: WHO — Traditional Chinese Medicine Terminologies, entries 250–255.
4. ↩︎ American ginseng and sanqi. American ginseng is the root of Panax quinquefolium. Sanqi, or notoginseng, comes from Panax notoginseng; the two names identify distinct medicines. Traditional descriptions classify American ginseng as replenishing qi and nourishing yin, while sanqi is used to disperse blood stasis and stop bleeding. Evan assigns them those different roles here. The novel gives no doses for either addition. These materia medica descriptions establish names and traditional uses, rather than demonstrating the outcome of this patient's treatment. Sources: Hong Kong Polytechnic University — American Ginseng (in Chinese); Hong Kong Polytechnic University — Sanqi (in Chinese).
5. ↩︎ The foundation of life after birth. In this traditional framework, the Spleen and Stomach support life by processing food and drink and distributing nourishment. The capitalized names denote functional systems. Evan's phrase concerns nourishment acquired after birth; it does not mean that the anatomical spleen alone performs digestion. Source: WHO — Traditional Chinese Medicine Terminologies, entries 114 and 191–192.
6. ↩︎ A fee scale. Full senior level, zheng gaoji, is a professional rank; the physician's title at that level is chief physician. As in Chapter 150, Evan's fees are calculated at this rate. The arrangement does not establish that he has been awarded the title or become a hospital administrator. Source: Hubei Department of Human Resources and Social Security — medical professional titles, article 2 (in Chinese).
7. ↩︎ Liver wind. This continues the traditional explanation in Chapter 150. “Calm the Liver and extinguish wind” names a treatment aim concerning internal wind, rather than a specific formula. The passage reports improvement and the need for continued medicine, without naming new ingredients or declaring Adam cured. Source: WHO — Traditional Chinese Medicine Terminologies, entries 1258 and 2485.