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Dr. Xu: A Chinese Medicine Novel

Chapter 62 The Paradox of Obstruction · Nov 09, 2026

↩︎ Qi, blood, and the root of the problem. In Chinese medicine, qi describes bodily activity and functions, while blood provides nourishment and supports qi. “Commander” and “mother” express this interdependence. Here the mother-and-child comparison concerns blood and qi, not the patient’s baby. “Root” means the underlying deficiency; “branch” means the resulting signs, including the apparent obstruction. Evan is arguing that insufficient power to move things can resemble an excess that needs purging. These are traditional categories used in his reasoning, rather than measurements of a physical substance called qi. Source: WHO — Chinese medicine terminology, entries 243, 250–255, 384–385.↩︎ Two kinds of evidence. As in Chapter 61, “6 g” preserves the source’s incomplete hemoglobin unit; no volume denominator is supplied. A hollow pulse is a traditional tactile finding, not a blood-test result. Simon’s “blood deficiency” is his interpretation in Chinese-medicine terms. Sources: MedlinePlus — Hemoglobin test; WHO — Chinese medicine terminology, entry 905.↩︎ Middle qi and the classical quotation. Here “middle qi” refers to the functions associated with the Spleen and Stomach, including processing and transporting nourishment. Capitals distinguish these traditional functional systems from anatomical organs. Evan also calls it Stomach qi. The Lingshu, or Spiritual Pivot, is a classical medical text; its “Oral Inquiry” chapter contains the line he quotes about altered elimination. The quotation itself does not specify that this patient needs a particular formula. His argument about both failure to retain and failure to expel follows in his own explanation. Sources: WHO — entries 188 and 243; Lingshu — chapter 28, electronic transcription (in Chinese).↩︎ Buzhong Yiqi Tang. The name means a decoction for supplementing the middle and replenishing qi. In its traditional description, it also raises yang and lifts sinking, which explains Leo’s association with persistent diarrhea and prolapse. “Raising” concerns the formula’s role in that theoretical framework; it does not mean pushing a physical blockage upward. The name identifies a formula, while the quantities and preparation in this scene describe the doctors’ particular prescription. The reference below records the formula’s conventional composition and traditional purposes, rather than the outcome of this fictional consultation. Source: Hong Kong Baptist University — Chinese Medicinal Formulae Images Database, F00069 (in Chinese).↩︎ Treating apparent obstruction with tonification. The Chinese phrase sai yin sai yong deliberately pairs two uses of “blocking.” The first is the appearance of obstruction; the second refers to tonifying or securing treatments that might seem to hold things in. The rationale is to address an underlying deficiency that prevents movement. This belongs to “paradoxical treatment”: following the appearance of the symptoms while treating what is understood to cause them. Evan’s explanation supplies the application to this patient. It does not mean physically plugging an outlet. Source: Jiangxi University of Chinese Medicine — He Xiaohui’s account of sai yin sai yong, opening definition (in Chinese).↩︎ The three burners and rising and falling. Sanjiao, translated here as the three burners, is a traditional division into upper, middle, and lower regions and their related functions. It is not three literal furnaces or a single anatomical structure. “Clear” and “turbid” distinguish what nourishes the body from what is directed onward or eliminated. Evan links their movement to the Spleen and Stomach. The later earth comparison belongs to the five-phases framework, in which these systems correspond to earth. None of these terms describes visible currents inside the patient. Sources: WHO — entries 118, 188–194, 207–210 and 245; Bencao Tongxuan — baizhu entry (in Chinese).↩︎ Baizhu and the medical writings. Baizhu is a medicinal material, distinct from the similarly named cangzhu. The passage attributes an experience with constipation and a minimum quantity to Wei Longxiang’s “Four Medical Notes.” That precise dose statement has not been checked against the original article. The following praise of baizhu and the explanation using earth, ascent, and descent can be located in the baizhu entry of Bencao Tongxuan, a historical materia medica. That supports the literary attribution and traditional explanation; it does not establish a generally effective minimum dose. Source: Bencao Tongxuan — baizhu entry, electronic transcription (in Chinese).↩︎ The prescription in the scene. Huangqi, baizhu, and danggui are retained as consistent medicinal names. Red ginseng is kept distinct from an unspecified ginseng preparation. The source explicitly gives baizhu 30 g, huangqi 60 g, red ginseng 15 g, and danggui 30 g, with the red ginseng simmered separately. It says the other quantities were settled but does not list them. They have not been reconstructed from a standard formula. The database below provides a conventional formula for comparison, not these exact quantities or an independent verification of Simon’s intestinal-motility claim. Source: Hong Kong Baptist University — Buzhong Yiqi Tang, composition and explanation (in Chinese).↩︎ A physician’s teacher. Studying as a master’s disciple is a relationship of training and lineage, not biological descent. Simon’s “one of the country’s greatest physicians” conveys the source’s admiring da guoshou; it is not presented here as a formal credential or government-awarded title. Source: Taiwan Ministry of Education — shifu, first definition (in Chinese).↩︎ Why everyone welcomes the sound. Passing gas can be a sign that the bowel is active after surgery, which explains the relief and envy in the room. It is distinct from passing stool or urine. The neighboring patients’ expectation of going home soon belongs to the scene; passage of gas alone does not establish a discharge date or complete recovery. The hospital leaflet below concerns bowel surgery and supports only the general point about bowel activity, not this cesarean case’s diagnosis or treatment. Source: Norfolk and Norwich University Hospitals — Discharge information following bowel surgery, p. 1.

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