A Dose of Major Order the Qi Decoction

After returning to the clinic, Daoist Jin led the group straight to a room on the top floor.

Su Ziyang had never been in this room before. It was decorated in an antique style and kept exceptionally tidy, but a modern hospital bed stood inside, completely at odds with the old-fashioned surroundings.

"Come on, put the child on the bed!" Daoist Jin told Zhenzhen's brother-in-law.

Without oxygen, the child's breathing had become noticeably heavier and faster.

"Xiao Su, palpate the child's abdomen and tell me what you find!" Although the child's condition was far from encouraging, Daoist Jin still hadn't forgotten to teach Su Ziyang.

Su Ziyang gently lifted the child's hospital gown and began feeling his slightly distended abdomen with his fingers.

Abdominal palpation was also known as abdominal diagnosis. It was a diagnostic method that the medical sage Zhang Zhongjing had strongly advocated. The method had been developed more fully in Japan, where many books had been published on abdominal diagnosis and its correspondence with classical formulas, including the famous "Marvelous Overview of Abdominal Patterns."

Su Ziyang slowly palpated from top to bottom. When he reached the child's lower left abdomen, he felt some very hard nodules and lumps inside. As soon as he pressed a little harder, the child frowned. Though the child showed no greater reaction, it still indicated tenderness and pain on palpation in that area.

Having found the problem, Su Ziyang straightened the child's clothes and told Daoist Jin what he had discovered. Daoist Jin nodded as he listened to Su Ziyang's report.

Su Ziyang thought Daoist Jin would ask him what he made of it. His mind raced as he tried to figure out what the lumps were, and he even directed the qi from his dantian into his eyes and looked at the child. Yet apart from seeing that the yang qi surrounding the child's entire body was extremely weak, he found nothing.

Seeing Su Ziyang deep in thought, Daoist Jin didn't ask him any questions. Instead, he turned to Zhenzhen's brother-in-law and asked, "How long has the child been in this state, neither fully asleep nor awake?"

"Twelve days!" Zhenzhen's brother-in-law answered with some certainty.

"And how long has it been since the child last passed stool?" Daoist Jin asked.

When Su Ziyang heard Daoist Jin ask how long it had been since the child last passed stool, something stirred in his mind, and he seemed to grasp something.

"Let me think..." Daoist Jin's question had stumped Zhenzhen's brother-in-law. He drew a breath, his brow tightly furrowed. Yes, how long had it been since the child last passed stool? He really hadn't paid attention!

"Well..." Zhenzhen's brother-in-law hesitated.

"It's been about a month since he last passed stool. He hasn't been allowed any food or water during this time, so he hasn't had a bowel movement!" Zhenzhen's sister, who had been silent and secretly wiping away tears, suddenly spoke up.

Compared with women, men were less attentive to details, after all. Zhenzhen's sister remembered certain details more clearly.

"All right, I understand. Rest here. I'll go downstairs and decoct some medicine for the child. Xiao Su, take the child's temperature and blood pressure, then come find me in the consultation room!" Having given his instructions, Daoist Jin left.

Su Ziyang took the child's temperature and blood pressure. At the hospital, the child had consistently shown a low-grade fever. In the short time since the IV had been removed, his temperature had risen to 38.5°C, though his blood pressure was still normal.

After taking his blood pressure and temperature, Su Ziyang hurried downstairs to Daoist Jin's consultation room.

Daoist Jin had already written the prescription and was waiting for Su Ziyang. "His temperature has risen, hasn't it?"

Daoist Jin asked before Su Ziyang could speak.

Su Ziyang nodded. "38.5°C."

"Go downstairs and have the prescription filled! Don't pay yet. Just go straight to the pharmacy and tell them I said to fill it first!" Daoist Jin handed Su Ziyang the prescription slip on the table, stamped with his own seal.

Su Ziyang took the prescription and saw a short formula written on it: rhubarb, wine-washed, 19 g; magnolia bark, roasted, 38 g; immature bitter orange, roasted, 19 g; mirabilite, 10 g.

When Su Ziyang had heard Daoist Jin ask how long it had been since the child last passed stool, he had already thought of Major Order the Qi Decoction. Neither the "Treatise on Cold Damage" nor "Essential Prescriptions of the Golden Cabinet" contained an explicit account of leukemia, and none of their individual passages directly related to reports on leukemia in modern medicine.

Daoist Jin had prescribed this formula based on three phrases from Zhang Zhongjing: observe the pulse and patterns, know what adverse condition has occurred, and treat according to the pattern.

The child now had hard lumps and tenderness in his lower left abdomen and hadn't passed stool for many days. There was clearly dry stool in his intestines, so Daoist Jin had chosen to use Major Order the Qi Decoction to expel it first.

With Daoist Jin's seal on the prescription, the pharmacy quickly wrapped up the ingredients and handed them to Su Ziyang. He didn't dare delay for a moment and went running up the stairs, his footsteps pounding.

The method for decocting Major Order the Qi Decoction was quite particular. Rather than have the pharmacy prepare it, Daoist Jin had chosen to do it himself.

When Su Ziyang returned to the consultation room, a purple-clay herbal kettle stood on Daoist Jin's desk, already filled with water.

The magnolia bark and immature bitter orange had to be decocted first for Major Order the Qi Decoction, so Su Ziyang had specifically asked the pharmacy to place the four ingredients in separate paper packets.

The water bubbled away. When the water in the purple-clay kettle had boiled down to half its volume, Daoist Jin turned off the heat. He strained out the cooked magnolia bark and immature bitter orange, then added the rhubarb.

Once again, it bubbled over high heat, the water quickly evaporating as steam rose. When the liquid had reduced by almost half again, Daoist Jin turned off the heat and strained out the rhubarb. Finally, he poured the mirabilite into the herbal kettle.

This time, the heat was lower, and only tiny bubbles broke the surface. The white mirabilite soon dissolved into the black decoction. After simmering it for another five minutes, Daoist Jin nodded in satisfaction and turned off the heat. He poured the liquid into a large bowl he had prepared earlier and carried it upstairs.

Although the decoction had taken only forty minutes to prepare, those forty minutes had been like roasting over a fire for Zhenzhen's family. During that time, Zhenzhen's brother-in-law had taken the child's temperature again, and it had gradually risen to 39°C.

When the three saw Daoist Jin return, they sprang up from their stools. Zhenzhen's sister immediately took the large bowl from his hands.

"Doctor Jin, his temperature keeps rising. It's already 39 degrees!" Zhenzhen's brother-in-law clasped his hands together anxiously, his feet stepping about on the floor in helpless confusion.

"Don't worry! Let the medicine cool first. Bring it over when it's warm!"

Daoist Jin patted Zhenzhen's brother-in-law on the shoulder, telling him to relax. Then he took a small spoon from a cabinet in the room and handed it to him to stir the medicine so it would cool faster.

Daoist Jin took a small bowl, filled it with clear water, and sat down beside the child. Then he exposed the child's arm.

Holding the child's little hand in his left hand, Daoist Jin dipped his right hand in the water and let a few drops fall onto the child's palm. His left thumb quickly rubbed the palm several times.

Then he dipped his fingers in the water again, held his index, middle, and ring fingers together, and briskly pushed from the wrist crease toward the elbow crease.

Seeing that Daoist Jin was busy, Su Ziyang stood to one side and watched carefully. He had trained in acupuncture and massage, so he recognized the movement. It was called Clear the Heavenly River Water, a technique for treating fevers in children. Though he had learned it, he had never used it, so his knowledge was limited to that.

"Do you know this one?" Daoist Jin asked Su Ziyang as he worked.

"Clear the Heavenly River Water," Su Ziyang said softly. Seeing that Su Ziyang had answered correctly, Daoist Jin nodded in satisfaction.

Daoist Jin's movements were fast and steady. To Su Ziyang, his hand was moving so fast it was almost leaving afterimages. Suddenly, Daoist Jin changed techniques. Instead of pushing upward from the palm crease, he pushed from the Laogong point in the center of the palm toward the elbow crease.

"Do you recognize this one?" Daoist Jin asked again.

The question left Su Ziyang feeling a little unsure. He remembered that Clear the Heavenly River Water involved pushing from the Zongjin, at the wrist crease, toward the Quze point. But now Daoist Jin was pushing from the Laogong point, something Su Ziyang had never seen before!

Su Ziyang thought for a moment, then stammered, "It should... also be Clear the Heavenly River Water, right?"

"This is called Great Pushing of the Heavenly River Water!" Daoist Jin's hands kept moving. Without dwelling on Su Ziyang's ignorance, he went on to explain.

After performing Great Pushing of the Heavenly River Water a hundred times, Daoist Jin changed techniques again. He pushed his three fingers down from the elbow crease to the Laogong point, his fingers still light and agile, moving so fast they left afterimages.

"This is called Draw the Heavenly River Water." Daoist Jin knew Su Ziyang didn't know it, so he began explaining without being asked.

After explaining Draw the Heavenly River Water, Daoist Jin changed techniques once more.

He pushed his three fingers from the wrist crease to the elbow crease, then quickly patted upward with his index, middle, and ring fingers while gently blowing cool air over the Tianhe area. As he blew and patted, Daoist Jin explained it to Su Ziyang.

"This is called Guide Water Up the Heavenly River."

With that, he changed techniques again. He pressed his left thumb against the Zongjin, flicked his right thumb and index finger several times over the Tianhe point as though playing a stringed instrument, then flicked from the Neiguan point to the elbow crease. Immediately afterward, he used both thumbs to gently pinch the Jianjing, Pipa, and Dingma points.

"This is called Strike the Horse Across the Heavenly River!"

After performing the several techniques, Daoist Jin had a fine sheen of sweat on his forehead. "Ah, I'm getting old. A few techniques and I'm sweating!"

Daoist Jin sighed self-deprecatingly, then got up, picked up the thermometer from the table, and took the child's temperature.

"37.6!!!"

A little later, Su Ziyang took out the thermometer and looked at the reading, speaking in some surprise.

At the same time, he marveled inwardly that the effect of this pediatric massage technique was almost too good.

Hearing Su Ziyang, Zhenzhen's brother-in-law hurried over and snatched the thermometer, then looked at the reading.

"Doctor Jin, what kind of skill is that? This... is incredible!"

Daoist Jin's technique had completely dispelled the worries and fears in Zhenzhen's brother-in-law's heart. If leaving the hospital just now had been an impulsive decision, he was already beginning to feel glad of his impulsiveness.

"Ah, it's just ordinary pediatric massage. This is only a stopgap measure; it can only bring down the fever temporarily. Has the medicine cooled?" Daoist Jin wasn't excited that the child's temperature had dropped. This illness was no ordinary cold, and simply reducing the fever would do nothing to treat it at the root. It treated the symptoms, not the cause.

"The medicine should be about ready, Doctor Jin. Take a look!" Zhenzhen's sister handed the large bowl to Daoist Jin.

"It's still a little hot. Let it cool a while longer!" Daoist Jin lightly touched the bowl with his hand.

Although the techniques Daoist Jin had just performed were complex, he had worked extremely quickly. Including the time spent taking the temperature, only fifteen minutes had passed, so the medicine was still hot to the touch.

Hearing Daoist Jin say the medicine was still hot, Zhenzhen's sister took the bowl and quickly began stirring again.

The medicine finally became warm, but getting the child to drink it posed a major problem. Zhenzhen's sister discovered that although her son's fever had gone down, he still hadn't woken up, and there was no way he could cooperate and drink the medicine.

Spoonful after spoonful failed even to enter his mouth. The liquid merely wet his lips before running back out.

Seeing her son like this, Zhenzhen's sister began weeping again, tears streaming down her face. "Son, wake up. Take your medicine. Let's take the medicine! Once you've taken it, you'll get better! Son, can you hear Mommy? Open your mouth!"

It had already been difficult to feed him the medicine, and now that Zhenzhen's sister was crying, her hand shook badly. More of the liquid spilled outside his mouth.

Zhenzhen and her brother-in-law stood helplessly by, their eyes red-rimmed. Watching from the side, Su Ziyang also felt a pang of sorrow.

"Ah!" Daoist Jin sighed softly. "I'll press the child's acupoints. Feed him a couple of spoonfuls!"

With that, Daoist Jin gently placed his right middle finger on the child's Lianquan point and pinched the Xiaguan points with his index finger and thumb. He applied a little pressure, and the child coughed from the pain, then opened his mouth and stuck out his little tongue.

"Cough, cough..." The child coughed softly twice. Uncomfortable from Daoist Jin's pinch, his little tongue kept licking his lips. Daoist Jin held the medicine spoon and gently dripped the decoction into the child's mouth.

The tongue slowly drew the liquid in. After half an hour, he had drunk only a quarter of the bowl.

Two fingertip marks had appeared on the child's little face from being pinched.

"That's enough. We'll leave it at that for now. Let's wait!" Daoist Jin waved at Zhenzhen's sister, indicating that she needn't feed him any more.

Only five minutes after the medicine had been administered, they heard the child's stomach begin to gurgle and rumble.

"Xiao Su, there's a bedpan under the bed. Take it out!"

Su Ziyang hurriedly pulled the bedpan out from under the bed.

"Pick the child up!" Hearing the continuous gurgling in the child's stomach, Daoist Jin told Zhenzhen's brother-in-law to hold him over the bedpan.

But after five minutes, the child still hadn't passed any stool, and the gurgling in his stomach gradually faded away.

Daoist Jin frowned and picked up the bowl of medicine, which was still slightly warm. The three of them hurriedly fed another half of the medicine to the child.

After two-thirds of the decoction had gone down, his stomach began gurgling again, followed by a pffft as he passed gas.

Hearing the child pass gas, Daoist Jin's expression eased a little.

A moment later, after a succession of farts, a crisp clink came from the bedpan. A piece of stool as hard as a stone had passed from the child's body.

Clink. Another sound...

The entire process lasted half an hour. The child passed more than a dozen pieces of dry stool, each the size of a chestnut and as hard as a pebble.

The gas stopped, and so did the bowel movement.

Zhenzhen's brother-in-law gently laid the child back on the bed. Daoist Jin lightly touched the child's lower left abdomen and found that all the hard lumps inside had disappeared. Only then did his expression fully relax!

"Let the child rest... Take care of him!"

Daoist Jin spoke quietly, then led Su Ziyang out of the room.