Chapter Thirty-Nine: Blood Heat and Weak Vital Energy, a Grave Illness Taking Hold

The little girl’s eyes were full of surprise. She had not expected this lecherous fellow before her to know medicine. Among her people, anyone who understood healing was revered by all, so if Li Zisheng truly did know his art, then this scoundrel would count as a genius indeed.

For no reason at all, the little girl began to drift into strange, scattered thoughts, and a faint redness rose in her cheeks.

Still doubtful, she offered her arm. Looking at Li Zisheng, her gaze remained somewhat skeptical. Her illness was about to strike again, and she had to hurry back for her medicine. If she did not make it in time, the agony of the attack would be unbearable.

Li Zisheng’s somewhat cool hand rested directly on the little girl’s arm, sending a faint chill into her body. Feeling that gentle coolness, the tension in her heart gradually eased.

After taking her pulse, Li Zisheng carefully felt the beat beneath his fingers. Her pulse was irregular, and after a close examination, he finally found the unusual point.

A normal pulse should be even in speed and rhythm, neither too thick nor too thin, steady and orderly. That is what a healthy pulse looks like.

But hers was clearly not like that. Her pulse was plainly thin and rapid. The last person he had checked, Zhou Linqing, had a similar kind of pulse, but the little girl before him was obviously different.

A thin pulse means the beat does not feel full, but like a slender thread, fine and quick, more than five beats in a breath. This is a classic sign of heat illness.

Strong means excess, weak means deficiency. Such signs are often seen in heat disorders, including the entire course of some febrile diseases.

If the evil enters the defensive level, the pulse becomes floating and rapid. If it enters the qi level, the pulse becomes surging and rapid, or slippery and rapid. If it enters the nutritive level, the pulse is often thin and rapid. If it spreads into the blood level, the pulse may be thin and rapid or weak and rapid.

A rapid pulse can also be seen in sinus tachycardia. When caused by infection, the pulse is often rapid and forceful. If the excitability of the heart muscle increases, or if the heart’s strength weakens and its beats compensate by increasing in order to maintain output per minute, then the pulse will be rapid but feeble.

If that were truly the case, then the little girl before him was clearly suffering from a blood disorder. Such illnesses were difficult to treat even in modern times, so if she truly had a blood disease, the chance of curing her could almost be said to be vanishingly small.

But Chinese medicine emphasized the four examinations of observation, listening, inquiry, and palpation. Relying on pulse diagnosis alone was still not enough.

“Chu Mo, I’m going to ask you a few questions. Don’t hide anything from me. Just answer honestly. I don’t know your name, so even if you tell me, I won’t spread it around.” There was a slight awkwardness in what he was about to ask, and he was still uncertain, not wishing for the little girl before him to be afflicted with a blood disease.

“Mm, ask away. Many doctors have already asked me questions. Don’t worry.” The little girl, in turn, comforted Li Zisheng.

“Chu Mo, do you often have lingering low fevers, with heat at night and coolness by morning?” Li Zisheng began with the most basic signs pointing toward a blood disorder.

The little girl looked at him in disbelief, then nodded. She did indeed experience persistent low fever, night heat and morning coolness, yet Li Zisheng had determined her condition merely by taking her pulse. That was rare enough already. The most important thing was that Li Zisheng truly knew medicine. As she had suspected, he really was a genius.

The little girl felt astonished, somewhat envious, and a little awed.

“And do you also have a swollen, painful throat, ulceration in the mouth, and enlarged nodules in the neck and armpits? Ah, I mean your mouth, your throat, and over here.” Li Zisheng pointed to his own armpit, worried that the little girl might not know where he meant, and gestured to those places on his own body.

The little girl nodded, saying that yes, those symptoms did appear, and added that they were very painful.

By now, Li Zisheng was sixty percent sure that the little girl was indeed suffering from a blood disease, and very likely from leukemia, which even in later generations was notoriously difficult to cure. Li Zisheng felt a trace of fear and did not quite dare to think any further.

“Then let me ask one more thing. You don’t need to feel embarrassed; it’s just a simple question. Chu Mo, do you ever have dizziness, ringing in the ears, thirst and a dry throat, night sweats, soreness in the lower back, pain in all your joints, nosebleeds or bleeding gums, or perhaps vomiting blood, blood in the stool, blood in the urine, dizziness and blurred vision, dry and gritty eyes, unclear sight, a dry mouth and parched tongue, restlessness and insomnia, tinnitus, weakness and soreness in the lower back and knees, and burning heat in the palms, soles, and chest? And does it happen often?”

Li Zisheng spoke each phrase slowly, inwardly hoping fervently that none of these symptoms were present in the little girl.

When he finished, the little girl gave him a definite look and nodded, her face flushing slightly. Yet because her complexion was already pale, the redness was not very visible.

“Chu Mo, may I look at your tongue?” Li Zisheng asked his final question.

The little girl was very cooperative and immediately stuck out her tongue, adjusting her position and angle so he could see it clearly.

The moment Li Zisheng saw her tongue, his heart trembled. Just as he had suspected, Chu Mo’s tongue was indeed abnormal.

Her tongue was swollen with tooth marks at the edges, the body pale, and the coating thin and white. This was a classic sign of a blood disorder.

Taking all the findings together, Li Zisheng now knew with great clarity that the little girl’s illness was leukemia, a disease extremely difficult to treat even in modern medicine. However, judging from the condition, it did not seem to be acute leukemia, but chronic leukemia.

Even so, Li Zisheng deeply understood the suffering of leukemia patients. Once it flared up, the pain was simply not something ordinary people could endure.

His compassion for the little girl rose sharply. Li Zisheng had seen much of life, illness, and death, but when it stood before his eyes in the flesh, it was still deeply painful. As for how to treat it, he had not yet figured that out. Thankfully, it was chronic rather than acute, so there was still hope.

Li Zisheng comforted himself inwardly.

He took out the cloth bag he carried with him, along with his treasured ink, Xuan paper, and other writing tools.

He was just about to write a prescription.

Seeing that Li Zisheng was so well prepared, the little girl said weakly, “You have so much ink and paper and writing brush stuff. Why don’t you use these to practice calligraphy instead of practicing with that brush that’s almost worn down to nothing?”

“Nothing much. I don’t have money at home. Besides, practicing calligraphy on this great rock not only helps me calm my mind, it also lets me feel the vast force of nature, which makes my heart even more peaceful.”