Chapter 41 Where's the Patient?

An old needle technique is being put to the test, and everyone in the room is watching.

Setting the Mountain on Fire first appeared in the Jin Zhen Fu, the “Rhapsody of the Golden Needle.”

The text said: “Setting the Mountain on Fire treats stubborn numbness and cold impediment. Begin shallow and proceed deep, using the nine yang count with three advances and three withdrawals. Lift slowly and press firmly. When warmth arrives, close firmly at the insertion site. Thus cold may reliably be expelled.”^[1]

Needling techniques fell into two broad groups, tonifying and draining, with many specific methods within each. Setting the Mountain on Fire and Heaven-Penetrating Coolness were particularly strong examples of each. They worked exceptionally well, and fast.^[2]

But they were hard to master, and scarcely anyone still passed them on. Physicians through the ages had been fascinated and puzzled by them. Many doctors of Chinese medicine even believed the two techniques did not exist.

To those doctors, the techniques were no more real than the inner power cultivated through qi in martial-arts novels—things the old masters had dreamed up.^[3]

Those watching had never expected to see such a technique performed in front of them, much less by this young doctor.

Could he really produce the effect?

They could hardly believe it.

Dr. Qian watched Evan intently, expectation in his eyes.

“Do you feel any warmth here?” Evan asked the woman.

“It's starting to feel a little warm, but not very much.”

Evan quickly repeated the sequence. This time, when he reached the human level, she spoke at once.

“It's hot! My hand's so hot, and my body's much warmer too. I feel a little stronger.”

Everyone froze.

Dr. Zhao, the obstetrician, stared in confusion. What the hell? Was this real?

Director Liu's eyes widened too. Was it really that effective?

Evan gave a slight nod and continued the manipulation. When he had finished, he watched her breathing. As she slowly inhaled, he withdrew the needle, then quickly pressed the opening closed.^[4]

“How do you feel now?” he asked.

She seemed to have recovered quite a lot of strength. “I can feel waves of warmth coming out of my hand. My body's warming up too.”

“Good,” Evan said.

Still doubtful, Dr. Zhao came forward and touched her hand, then the other one. The hand that had been needled really was warmer. He could feel the difference himself.

He was astonished, still looking baffled. How was this possible?

He was hardly the only one. The Chinese-medicine specialists watching were stunned too.

Dr. Qian nodded slightly.

Evan was relieved. He had actually produced the effect of Setting the Mountain on Fire. He could manage it around seventy percent of the time now. That was a respectable success rate.

Her strong response to the needle was what had made him decide to use it straightaway. It worked well, and quickly. This was an emergency. Any further delay would put both mother and baby in danger.

With the opening covered and things steady, Evan repeated the method at Hegu on her other hand.

When he finished, he covered the opening again.

This time her reaction was strong.

“I'm warm! I can feel warmth rising all through my body. That feels so good.”

After a whole day in labor, she was exhausted and thoroughly agitated. At last she felt some relief, and a good deal of her strength seemed to have returned.

Dr. Zhao was utterly dumbfounded.

The Chinese-medicine specialists exchanged looks.

The woman's husband, the dark-complexioned man, held his hands tightly clasped, watching Evan with nervous excitement.

Once she felt warm all over, Evan took his hand away from the needle opening. He took out an alcohol swab to disinfect the next site. He was going to needle Sanyinjiao.^[5]

Having located the point, he told her, “Just as before. Breathe in through your mouth and out through your nose. Don't force it. Just breathe naturally.”

Watching her breathing, Evan stretched the skin with his supporting hand as she inhaled. Without twisting or rotating the needle, he slowly advanced it directly to the earth level.

This method was commonly called “stealth insertion.”^[6]

Setting the Mountain on Fire worked through heaven, human, and earth in that order, from shallow to deep. Heaven-Penetrating Coolness was the reverse: earth, human, heaven, from deep to shallow.

With the needle at the earth level, Evan worked it with his right hand while his left monitored the qi response. When he felt a heavy, tightening resistance, he lifted it quickly to the human level, then advanced the tip toward the responsive area at the earth level.

He kept asking the woman how she felt.

By now she trusted him completely and answered every question at once.

Evan thrust gently and lifted quickly six times, the reverse of Setting the Mountain on Fire. “Do you feel any coolness?” he asked.

He was a little nervous. Heaven-Penetrating Coolness was harder, and his success rate was around sixty-three percent.

But her response to the needle was particularly good this time.

“Yes. That part feels a little cool,” she said.

The onlookers were astonished.

“Good,” Evan said. He scraped the needle handle to hold the qi, then quickly lifted the needle to the heaven level. From there, he again advanced toward the responsive area at the human level, thrusting slowly and lifting quickly six times.^[7]

When he had finished, he withdrew the needle as she exhaled. This time he did not press the opening closed.

Dr. Zhao came over to feel her skin temperature again. The difference was not as obvious as before.

Stolen story; please report.

Evan repeated Heaven-Penetrating Coolness at Sanyinjiao on her other leg.

He completed the sequence and withdrew the needle.

Evan assessed her condition and frowned slightly. He took out some moxa wool, preparing to apply moxibustion at Zhiyin. This was the jing-well point of the Foot Taiyang Bladder channel, considered effective in traditional practice for correcting fetal position and inducing labor.^[8]

He had only just taken out the moxa wool and was about to begin when the woman suddenly clutched her belly and cried out in pain.

“It hurts… it hurts so much…”

Her husband panicked and hurried over. “Feng! What's wrong? What's wrong? You weren't hurting much before. Why's it getting worse with the treatment? What's… what's happening?”

“Make room.” Dr. Zhao pushed him aside and quickly examined her.

“Ah! The pubic bones have opened!” he said delightedly. “Quick, get her into the delivery room!”^[9]

The nurses hurried forward to help.

The anesthetist looked on and rubbed his hands. Why did it seem there was nothing left for him to do?

Evan relaxed too. The pubic bones had finally opened.

Dr. Qian nodded at him with satisfaction.

The Chinese-medicine specialists behind them looked at Evan with mixed expressions. They did not know what to say.

Director Liu checked his watch. “Remarkable! Remarkable! Fifteen minutes. It only took fifteen minutes!”

Evan wiped the sweat from his forehead. Until now, he had only handled emergencies in the acupuncture practice room. This was his first time in real life.

Only then did the husband seem to take it all in. His dark face flushed as he looked at Evan. He was trembling, too overcome to speak. Suddenly he started to drop to his knees before him.

Startled, Evan hurried forward and caught him before he could kneel. He could never accept such a profound gesture of thanks.

The other Chinese-medicine doctors looked even more conflicted.

The obstetric doctors and nurses were looking at Evan differently now—especially the female nurses!

A doctor earned his living by his skills. All the boasting in the world counted for nothing; real results were what mattered. With his acupuncture, Evan had proved himself, and proved Chinese medicine too.

“Make way! Make way!” The shouts came from outside. Oliver was running along, rapidly fanning the medicine in his hand to cool it.

When he burst into the consultation room, he was bewildered.

“Hey, where's the patient? Where did she go?”

Reader Notes

1. ↩︎ The Golden Needle text. The Jin Zhen Fu is a classical verse exposition of acupuncture, here translated as “Rhapsody of the Golden Needle.” Its language joins manipulation, traditional cold patterns, and numbered sequences: “nine yang” is a counting convention, rather than nine substances. “Cold impediment” belongs to that traditional vocabulary. The English follows the novel's quotation, including its compressed closing phrase. The surviving transcription supports the passage's wording; it does not independently establish the novel's claim that this was the technique's earliest appearance. Source: Jin Zhen Fu — the eight treatment methods (in Chinese).
2. ↩︎ Tonifying and draining. These are traditional ways of supplementing deficiency or reducing excess. As introduced in Chapter 34, the two named methods combine several needle manipulations, with warmth or coolness as their intended sensations. Neither name means applying actual fire or ice. The account of extraordinary speed and effectiveness belongs to the novel's narration; recognizing a technique in a terminology standard does not establish its effectiveness for this obstetric emergency. Sources: WHO — Chinese medicine terminology, entries 3045 and 3053–3054; Beijing University of Chinese Medicine — Compound manipulations (in Chinese).
3. ↩︎ Martial-arts fiction. Wuxia is the Chinese martial-arts adventure tradition, familiar to many readers through novels and their film and television adaptations. “Inner power” here evokes its imagined feats achieved through cultivating qi, rather than ordinary muscular strength. The comparison expresses the skeptical doctors' disbelief. It does not turn Evan's needle movements into a visible magical force. No particular novel or fictional school is named in the Chinese passage. Source: Hong Kong Heritage Museum — Jin Yong Gallery, on martial-arts novels and their cultural reach.
4. ↩︎ Closing the needle opening. Traditional needling terminology distinguishes tonifying and draining partly through withdrawal coordinated with breathing and through pressing the insertion site afterward or leaving it unpressed. These are called breathing and opening-and-closing manipulations. The sequence here preserves the novel's inhalation and immediate pressure; a later passage supplies the contrasting procedure. This is a description of the technique's traditional framework, without adding a measured physiological change or a new treatment step. Source: Beijing University of Chinese Medicine — Breathing and opening-and-closing methods (in Chinese).
5. ↩︎ Sanyinjiao. Also designated SP6, this acupuncture point lies on the inner lower leg above the ankle, despite the Chinese narrative's colloquial references to the “foot.” Its name means “Three Yin Intersection”: the three yin channels here are the Spleen, Liver, and Kidney channels. This is a channel relationship, distinct from the three yin divisions used in earlier fever-pattern discussions. The sources support the name and location; the woman's response and the obstetric result belong to the story. Sources: Hong Kong Baptist University — Sanyinjiao location (in Chinese); Original trial report — SP6 anatomical description.
6. ↩︎ Skin stretching and “stealth insertion.” The supporting hand steadies or stretches the skin while the other hand handles the needle. The novel gives its slow, untwisted entry the colloquial name “stealth insertion”; it does not describe secretly treating an uninformed patient. Heaven, human, and earth remain the relative shallow, middle, and deep levels explained in Chapter 40. The subsequent percentages refer to Evan's success in producing the named needle effects, rather than rates of successful childbirth. Source: Beijing University of Chinese Medicine — The supporting hand and skin-stretching insertion (in Chinese).
7. ↩︎ Scraping the handle. In this needling vocabulary, scraping means working a fingernail along the needle handle. It does not mean scraping the woman's skin, and it is distinct from gua sha. “Holding the qi” retains the passage's traditional account of maintaining the needle response. The text gives two sets of six slow-thrust, quick-lift movements at different levels; neither a new insertion nor a further textbook cycle has been added. Sources: Beijing University of Chinese Medicine — Handle-scraping method (in Chinese); WHO — Chinese medicine terminology, entry 3036.
8. ↩︎ Moxa wool and Zhiyin. Moxa wool is the soft, processed mugwort material used in moxibustion, a treatment involving heat from burning moxa. It is distinct from a finished moxa stick. Zhiyin, or BL67, is a point by the little toenail on the Foot Taiyang Bladder channel. “Jing-well” names a traditional point category, generally near the fingers or toes; the Bladder channel is a traditional pathway, not the urinary organ itself. The fetal-position and labor uses are the novel's traditional account. At this moment Evan is preparing the material; he has not applied or lit it. Sources: Hong Kong Department of Health — Moxa materials and products, page 1 (in Chinese); WHO — Chinese medicine terminology, entries 2970 and 3138–3142; Vas et al. — BL67 location in a trial protocol.
9. ↩︎ “The pubic bones have opened.” The Chinese uses jiaogu, then chigu, an older childbirth expression followed by an explicit reference to the pubic bones. Both are retained here rather than silently replaced with “the cervix is fully dilated.” Modern obstetric descriptions distinguish cervical dilation from the joints of the pelvis. The novel supplies no cervical measurement or specific finding of joint separation. Its wording signals the change that prompts transfer to the delivery room; it is not a precise modern examination result. Sources: Nüke Jinglun — the section on jiaogu not opening (in Chinese); NHS — Stages of labor, first stage; NHS — Pelvic joints and pregnancy-related pain.