The Martial Doctor-Chapter 65: Ectopic Pregnancy

Walking into Consultation Room No. 6, Lin Miao saw that the patient was a young woman, with a Medical Bureau supervisor sitting beside her.

He was supervising the exam.

There was surprisingly no ’physician’ to oversee the examination, which made Lin Miao feel a bit surprised.

"Lin Miao, let me remind you, you only have the time it takes for an incense stick to burn." The Medical Bureau staff reminded him, and he said the same thing to everyone who came in.

"Thank you." Lin Miao cupped his hands and sat down in front of the woman, "Miss, could you describe where your discomfort is?"

"My belly hurts." The woman gently stroked her abdomen as she spoke.

"Stomach pain, could you describe what kind of pain it is?"

As men and women should maintain propriety, the examination that could usually be performed directly had to be described by the patient herself, which consumed quite some effort.

Finally, Lin Miao looked at her tongue coating before proceeding to check her pulse.

There were restrictions on the consultation questions; the physician could not ask if the patient had a specific disease, only about symptoms, otherwise, it would result in a zero score.

After feeling the woman’s pulse, Lin Miao’s brow immediately furrowed. The diagnosis suggested a slippery pulse but it was not a double pulse, rather it was a subtle pulse.

This issue was serious. Such a pulse indicated pregnancy, but it was highly likely an ectopic pregnancy.

An ectopic pregnancy is extremely dangerous; if there is massive bleeding, it could result in immediate death, especially in this era, where it would likely be fatal.

Lin Miao was stumped. How should he approach this diagnosis and prescription?

Writing ’ectopic pregnancy’ directly would probably not be understood, and writing ’abnormal pregnancy’ might not make sense either.

An ectopic pregnancy can be treated with traditional Chinese medicine, but surgery is the best option. Here, there are no conditions for that, and even if there were, operating on a woman wasn’t allowed.

The chosen case most likely required the answer: pregnancy.

But this ’pregnancy’ isn’t a real pregnancy. At this moment, the woman doesn’t realize how perilous her condition is and that she’s standing at the brink of life and death.

As time ran short, the physician couldn’t deliberately make a false diagnosis. On the final paper, he wrote the four characters for ’ectopic pregnancy’ and prescribed a formula that promoted blood circulation and removed stasis based on the woman’s qi deficiency and specific condition.

Time was just right.

As he put down his pen, the incense stick burned to the end.

Such challenging cases made Lin Miao understand why consultations were so difficult; making a wrong diagnosis as a doctor could cost a life, so naturally, it was important to select genuine talent with expertise.

Lin Miao then proceeded to Room No. 1.

The patient was a six-year-old boy accompanied by his mother, with a bluish complexion, a thin and greasy tongue coating, a rattling phlegm in his throat, and a slippery, rapid pulse. After a detailed inquiry about his condition, he checked the pulse again.

Diagnosed with phlegm confusion.

Used Calming Heart Powder as the main formula and included Amber Embrace Dragon Elixir.

He left the prescription and signed his name, then Lin Miao immediately left Room No. 1.

By this time, most people had almost completed their consultations, leaving only three to five still there. Lin Miao calmed himself slightly before entering Room No. 3.

The patient in Room No. 3 was a man with a belly as large as a pot, groaning in pain, with a pale complexion, clearly very distressed.

Lin Miao touched the abdomen, knocked, and listened closely with his ear, quickly understanding what the condition was.

The pulse was taut, thin, with a white thin tongue coating, sunken eye sockets, and dry mouth.

The patient had not had a bowel movement for half a month; this was a typical intestinal obstruction, commonly known as bowel knot.

Prescribed Dahuang Decoction, to be boiled with water for drinking, additionally aided by enema for bowel movement, naturally the medicine would cure the disease.

Lin Miao first wrote the prescription and dosage as well as usage, then left, taking less than half the time it took for an incense stick to burn.

Among the three patients, apart from the first one, he nearly used the full time of an incense stick, while the conditions of the other two, although not simple, did not take him too much time.

The time for an incense stick to burn was about twenty minutes, with variability in medical consultations; some conditions could be resolved in a few minutes, while others might take longer.

Excluding the previous waiting time of over an hour, all consultations were completed in about two hours.

The results of the examination wouldn’t need to wait until the next day. They could be announced in the afternoon around You time.

With only ten cases, these were diagnosed by famous physicians and were correctly established, making it easy to judge right from wrong.

Lin Miao was not the last one, but the second to last; the last was Xia Zhu, the only one who entered the top forty of the written medical examination this session.

Seeing Xia Zhu come out of Room No. 6 with an unusual expression, it was clear that this female patient was also challenging for her.

"Everyone, leave Jinxian Tower and come back in two hours for the results announcement!" An official from the Medical Bureau announced, "Disperse now."

"Sanshui." Su Chen naturally went together with Lin Miao, "Come, let me treat you to a meal."

"Shall we go to Cuiyun Pavilion again?"

"I won’t go. I know a little restaurant that serves excellent donkey meat. Let’s go and try it," Su Chen said with a smile.

...

Inside the Jinxian Tower, the top ten renowned doctors of Dongshan City gathered, along with the heads of various clinics, the deputies of the Medical Bureau, and even the magistrate of Dongshan Prefecture.

The medical examination in Dongshan City, held every two years, is a grand event that not only affects the future of hundreds of medical students but also the health of Dongshan City’s citizens, and during each examination period, it also boosts the city’s economic consumption.

Everyone, from the magistrate to every common citizen, showed great concern.

Secret gambling also took place among the populace.

Each of the top forty medical apprentices had odds, attracting many participants. Some gained overnight fame and prospects, while others went bankrupt and disappeared without a trace.

"Let’s begin, everyone!" With the order from Magistrate Pei, the final scoring of the face-to-face diagnostic tests commenced.

"Ridiculous, clearly it was just an upset stomach, yet he diagnosed it as an intestinal abscess!"

"Absurd, completely off the mark. What was a simple case of heart palpitations, he diagnosed as a loss of soul symptom, and his prescriptions were full of errors..."

"This one is not bad; not only was the diagnosis accurate, but the prescription was also quite refined. It appears there are indeed some talents among this year’s candidates."

"This one is also acceptable, but the prescription is far too cautious. If the treatment follows this prescription, the patient might have to endure more suffering, deducting one point from this one..."

"This diagnosis is extremely accurate, a promising talent!"

...

"Ectopic pregnancy, this is ridiculous. Pregnancy is just pregnancy, why add ’ectopic’? And saying it could cause a hemorrhage, using a blood-activating decoction for treatment. Whose absurd prescription is this? It’s not saving lives; it’s harming them!" A furious doctor suddenly slammed the table while reviewing the prescriptions.

"Mr. Xia, what’s happened?"

Everyone turned toward the voice; it was Xia Yuan, the vice-chair of the Benefit People Pharmacy, and one of Dongshan City’s top ten doctors. Xia Yuan, over fifty years old and known for his fiery temper, spoke candidly without restraint.

"Look at this, such a diagnosis, this is the first time I’ve seen something like this!" Xia Yuan rudely denounced Lin Miao’s medical case (unbeknownst to him, all case records and diagnoses were transcribed and submitted for review anonymously).

All the renowned doctors put down their work and leaned in to look.

"Ectopic pregnancy, a condition where a woman’s pregnancy occurs outside the uterus. There are three diagnostic symptoms: missed menstruation, abdominal pain, and slight bleeding, with a slippery pulse that is not distinct. This condition is dangerous and could suddenly lead to a severe hemorrhage..."

"Isn’t this the case of the lady Xiaolian? I have checked her pulse, and she is indeed pregnant. As for the abdominal pain and slight Tiankui, these are normal and only require a dose of fetus-preserving medicine!" Another renowned doctor commented. Every patient was cross-examined by three distinguished doctors before being recommended for the face-to-face diagnostic test to ensure no errors.

"Indeed, I’ve also examined her pulse. It is as such; this candidate is just being alarmist, trying to grab attention. I suggest we remove them from the list immediately!" Chen Handian, the Hall Master of Qingyu Hall, chimed in.

"Since everyone is in agreement, then zero points it is." Xia Yuan picked up a brush and drew a big zero on the paper in front of him.

The group of renowned doctors was about to disperse and continue grading.

Just then, a scribe from the Medical Bureau rushed over, whispered something into Mr. Sang’s ear.

Mr. Sang’s face changed instantly, and he sprang up from his seat: "Madam Xiaolian has suddenly suffered a hemorrhage. Ladies and gentlemen, who will go and check on her?"

The Judges’ Hall fell silent.

Especially Xia Yuan, upon hearing this, collapsed into his seat. Just moments ago, he declared Lin Miao’s medical case as nonsense and sensationalizing.

Then came the news of Xiaolian’s sudden hemorrhage. This was a swift slap in the face.

Chen Handian of Qingyu Hall, along with another doctor who agreed with Xia Yuan, appeared very embarrassed. It was bad enough for one doctor to be wrong, but all three were incorrect.

"Could Xiaolian’s hemorrhage really be caused by this so-called ectopic pregnancy, or could there be another reason?" At this point, Ye Shengyuan interjected, attempting to shield Xia Yuan and the others.

"Yes, Mr. Ye is right, a hemorrhage is unpredictable, and we haven’t heard of ectopic pregnancy..."

"I have heard of it," Xu An of Baoan Hall suddenly stood up and said, "In Li Jing’s Imperial Pharmacy during the previous dynasty, I encountered records of such cases in Xin Yuanzi’s ’Miscellaneous Records.’ The name is different, but the description aligns with this candidate’s medical case."

"Mr. Xu, are you sure?" Mr. Sang asked.

"In matters such as this, do you think I would dare to recklessly speak nonsense?" Xu An replied, "If you don’t believe me, you can send someone to check the archives of the Imperial Pharmacy."

"The issue now is not confirming that, but what to do. If something happens to Xiaolian during our medical examination, what will be the consequences?" Magistrate Pei intervened, seeing how grave the situation had become.

The renowned doctors of Dongshan City gathered at Xinglin Institute, and if a patient died in their care, it would not only be a disgrace for the medical community but also for himself, Pei Jian, the magistrate.

If the court review brought this matter up, well...

"Whose case is Xiaolian’s?"

"It was recommended by me," Xia Yuan replied, his face pale.

"Mr. Xia, since she is your patient, please take action."

"Lady Xiaolian is a woman, and I am a man; it is inconvenient. I request permission for my daughter to accompany me to assist?" Xia Yuan knew he couldn’t back down; if he retreated, his reputation would be ruined for life.

"Agreed, special cases warrant special measures."

No one was foolish; hemorrhage is extremely dangerous, and the chances of saving her are slim. Anyone who disagrees, let them go!