Chinese Medicine: Starting with Daily Intelligence-Chapter 58: The Four-Deficiency Pulse

Li Xu squatted down and rolled up the old man’s pant leg.

The old man’s calf was swollen and shiny, the skin stretched taut. His knee was an unnatural purplish-red and hot to the touch.

The joint was clearly deformed, as if it had been twisted out of shape by some invisible force.

They were classic symptoms, exactly as described in the books.

"Rheumatic obstruction, with cold penetrating the bones," Li Xu said, frowning. "How long has your leg been hurting like this?"

The old man thought for a moment. "About ten years or so. It’s an old injury from working in the rain when I was young. I could bear it in the early years, but it’s gotten awful these last two. When it’s overcast or raining, it feels like needles are stabbing me."

"What a coincidence."

Li Xu had just gathered some Gastrodia today.

Gastrodia can treat joint pain and numbness, but it needs to be combined with other herbs that dispel wind and dampness, like Qianghuo and Qin Jiao.

He didn’t have any on hand.

"I’ll make a trip to town tomorrow to get the herbs for your prescription. After drinking it for a few days... even if it doesn’t cure it, it should at least ease the pain."

Li Xu said.

But he had paused noticeably when he said "a few days."

Darkness had fallen, and a light flickered on inside the adobe house.

In the dim yellow glow, Li Xu crouched before the stove to start a fire while the old man sat on a small stool, kneading dough.

"You rest, let me do it," Li Xu said, taking the basin of dough.

"You know how to make flatbread?" the old man asked, looking at him doubtfully.

"I can try," Li Xu said with a grin.

As it turned out, he kneaded the dough too hard, and the resulting flatbread was like the sole of a shoe.

The old man roared with laughter. The big yellow dog, Da Huang, trotted over for a sniff, then walked away in disgust.

In the end, the old man had to take over. With a few deft movements, he rolled out several thin discs of dough and slapped them onto the iron wok. A SIZZLE filled the air, and the fragrance instantly filled the room.

As they ate their congee with pickled vegetables, the old man began to share stories from his past.

It turned out the village once had about a hundred people at its liveliest. But then the young people left one by one, until finally, only he remained.

"The year before last, the town offered me a basic living allowance and told me to move to a nursing home." The old man took a bite of flatbread. "But what would happen to Da Huang? Who would sweep the graves of my old buddies? Besides, I’m used to living alone. After thinking it over, I decided to stay."

The light shone on his face, and every wrinkle seemed to hold a story.

When he got to a happy memory, the old man fumbled in a crack in the wall and pulled out a cloth bundle. He unfolded it carefully, revealing a yellowed photograph. Inside, dozens of strong young men stood under the old locust tree at the village entrance, all of them full of vigor.

"This is..."

"A group photo from ’64, when we were building the reservoir." The old man’s withered finger traced across the picture. "Now... I’m the only one left."

Da Huang suddenly rested his head on the old man’s knee, gently nuzzling his thigh.

The old man broke off a piece of flatbread and fed it to him. "But I still have Da Huang to keep me company," he said with a smile.

Before bed, Li Xu washed some foxtail grass and boiled it in water.

The golden spikes unfurled in the boiling water, gradually brewing into an amber-colored liquid that gave off a crisp, herbal fragrance.

"Drink this. It’ll help your eyes feel better."

After letting it cool a little, Li Xu handed the bowl to the old man.

The old man blew on it to cool it down, then suddenly held the bowl out to Da Huang. "You want to try some?"

The dog actually took a few licks, its tail wagging like a pinwheel.

Only then did the old man tilt his head back and drink it all, smacking his lips. "Not bitter."

In traditional Chinese medicine, bitter herbs are usually associated with clearing heat, purging fire, and drying dampness. Common examples include Huang Lian, Huang Qin, and gentiana.

Foxtail grass isn’t one of them.

And on its own, it doesn’t have much of a bitter taste.

Of course, it wasn’t particularly delicious either.

Night deepened, and the mountain wind swept over the thatched roof.

Li Xu lay on a makeshift wooden plank bed, listening to the old man’s steady snores and Da Huang’s occasional whimpers from the next room.

Moonlight seeped through a crack in the window, drawing a silver line on the floor.

The white noise of the mountains should have been soothing enough to lull anyone to sleep.

But when Li Xu recalled taking the old man’s pulse that evening, he tossed and turned, unable to rest.

He had learned a great deal of knowledge in school.

He had mastered the four diagnostic methods: observation, listening and smelling, inquiry, and palpation.

But in truth, he had very little practical experience.

For a true practitioner of Chinese medicine to develop their skills, they needed a master to guide them personally, followed by many years of practice just to be considered a novice.

Pulse diagnosis alone could stump the vast majority of people.

Even some TCM doctors who had been practicing for years wouldn’t dare claim they could perform an accurate pulse diagnosis every time.

Some of Li Xu’s classmates had entered formal hospitals but still weren’t allowed to see patients independently.

For instance, Miaoli was still shadowing Guo Yu.

Hu Qiming also had a mentor.

The therapeutic principle of Chinese medicine is "pattern differentiation and treatment, holistic regulation."

If one could accurately differentiate a patient’s condition through pulse diagnosis...

...they could definitely be called a master.

Every year during winter and summer breaks, his father taught him personally.

He had only managed to grasp a little.

He could roughly diagnose some simple illnesses.

That evening, when he took the old man’s pulse, he suspected it was a "four-loss pulse."

’This is a huge deal.’

He couldn’t be sure.

’After all, my skills are half-baked.’

’If I’m wrong, I’ll make a complete fool of myself.’

But this concerned the old man’s health.

Li Xu didn’t dare to be careless.

He pinned his hopes on tomorrow’s intelligence.

According to the rules of his intelligence system, the daily report was always related to something he had experienced.

Li Xu was betting that tomorrow’s intelligence would be about the old man.

"I hope my diagnosis was wrong..."

Li Xu gradually fell asleep.

「The next day, before the sky had brightened.」

The first thing Li Xu did upon opening his eyes was to check the system.

[Today’s Intelligence: Zhou Shugen, four-loss pulse.]

It was a single, simple sentence.

Li Xu stared at it for a long time.

"Ah..."

He let out a long sigh.

So his diagnosis from yesterday had actually been correct.

But he would have rather been wrong.

What was a four-loss pulse?

The Treatise on Cold Pathogenic and Warm Pathogenic Diseases records:

When a healthy person takes four breaths for every one beat of the patient’s pulse, it is called the four-loss pulse.

Anyone with a four-loss pulse will die within three days.

When a healthy person takes five breaths for every one beat of the patient’s pulse, it is called the five-loss pulse.

Anyone with a five-loss pulse will die within one day.

When a healthy person takes six breaths for every one beat of the patient’s pulse, it is called the six-loss pulse.

Anyone with a six-loss pulse will die within two hours.

This essentially means that anyone with a four-loss pulse will die within three days.

The so-called four-loss is when a healthy person takes four breaths for every one of the patient’s heartbeats.

If a five-loss pulse appears, the patient will die within a day.

A five-loss is when a healthy person takes five breaths for every one of the patient’s heartbeats.

If a six-loss pulse appears, they will die within two hours.

A six-loss is when a healthy person takes six breaths for every one of the patient’s heartbeats.

...

It was obvious the old man’s lamp had run out of oil; his days were numbered.

Even the system’s intelligence hadn’t provided a treatment plan.

The old man’s condition was already beyond human intervention.

He had been single his whole life, with no children, toiling for years in the mountains.

Living to seventy-nine was, in fact, considered a long life.

But he had never known a day of ease in his life.

And here he was, still thinking about putting away his farm tools so he could plant again next year.

He was just like most people—a life of toil, like an ant carrying crumbs of time, yet never able to piece together a complete spring.

Li Xu had originally planned to leave today.

Now, he decided to wait another two days.

Breakfast was noodles.

The two men and one dog ate in silence.

"Grandpa Zhou, the air in the mountains is so nice, I’m thinking of staying another two days. I’m going to town to buy a few things. Is there anything you need me to pick up for you?"

"...Let me think... Could you get me some cucumber and bean seeds? I want to plant some on the hillside. Oh, and buy some bones, too. Da Huang’s gotten skinny from eating noodles with me every day."

The old man went back into the main room and took out a brand-new bank card from a cloth bundle. "My welfare money is all in here. The PIN is..."

Li Xu pushed the card back. "Grandpa Zhou, a few seeds and some bones won’t cost much. I’ll get them for you."

With that, he walked briskly out of the village.

Outside the village was a small gravel path.

After about five or six li, it connected to a three-meter-wide asphalt mountain road that led to the outside world.

Yesterday, Li Xu had taken a wild mountain trail to pick the Gastrodia, which had been more difficult.

If he took the mountain road, he could probably hitch a ride to town.