Chinese Medicine: Starting with Daily Intelligence

Chapter 609: Chapter 609: Let Me Try

Li Xu and Director Ren arrived at the observation room.

Dr. Hao from the emergency department was the one who had admitted the patient. Seeing Director Ren, he breathed a sigh of relief. "Director Ren, you’re here."

When he saw Li Xu, he quickly greeted him as well, "Dean Li."

"What’s the patient’s condition?"

Director Ren asked as he put on a pair of gloves and walked toward the hospital bed.

On the bed lay a man in his forties or fifties, dressed in camouflage fatigues caked with dust and mud. His left pant leg had been cut open, revealing a bloody and mangled lower leg.

He was drenched in sweat from the pain, his teeth clenched tight as he let out occasional groans of agony.

"He was hit by a falling brick," Dr. Hao explained. "We just took some X-rays, but the results are still being processed. It’ll probably be a few more minutes before they’re sent over. But based on the external injuries, it’s definitely a fracture, and the swelling is severe."

Director Ren carefully observed the injured area. Although some basic first aid had been applied to stop the bleeding and bandage the wound, the lower leg was obviously deformed and severely swollen, with extensive subcutaneous bruising.

"This does look quite serious."

Director Ren’s brows furrowed.

Li Xu stood to the side, observing in silence.

’The patient is probably a migrant worker from a nearby construction site,’ he thought. ’He was moving bricks to make a living when the accident happened.’

"Director Ren, may I examine him?" Li Xu suddenly asked.

"Hm?" Director Ren was taken aback for a moment, but then he nodded. "Of course, you can."

Although Li Xu was a specialist in internal medicine, he was now the vice dean; there was naturally no issue with him wanting to perform an examination.

Li Xu disinfected his hands, walked to the bedside, and said to the patient, "Sir, please bear with the pain for a moment. I’m going to check the condition of your bones."

As he spoke, he extended both hands and placed them over the patient’s swollen lower leg.

This was the most fundamental diagnostic technique in TCM traumatology—the palpation method.

This palpation method was, in fact, a form of tactile diagnosis.

Tactile diagnosis involves more than just taking the pulse; it includes touching and pressing various parts of the body to perceive their temperature, hardness, shape, and any abnormalities.

Li Xu had previously mastered Massage, so he already knew the anatomical structure of the human skeleton like the back of his hand.

Now, combining this with the bone-setting insights from *Liu Juanzi’s Ghost Remedy*, it was as if his hands had X-ray vision.

His fingers moved slowly, applying pressure that varied from light to heavy.

The tactile feedback from his fingertips transmitted a clear picture of the broken bones beneath the skin directly to his mind.

"Does this hurt?" Li Xu asked softly.

"It hurts... HISS... It hurts!" the patient sucked in a sharp breath.

The examination proceeded with a back-and-forth of questions and answers guiding his touch.

After about five or six minutes, Li Xu had a clear understanding of the situation.

"A double fracture of the tibia and fibula."

Li Xu withdrew his hands, his tone certain. "The fibula is fine; the fracture is relatively clean. The tibia is slightly displaced with some angular deformity, but thankfully, the fracture surfaces are on the same plane, with no obvious signs of a comminuted fracture."

The lower leg is composed of two long, tubular bones: the sturdy, weight-bearing tibia and the slender, supporting fibula.

The upper end of the tibia expands to form the knee joint, while the lower end expands to form the ankle joint.

The fibula is the thinner bone on the outer side.

Since the patient was injured by a heavy object, the point of impact was concentrated, so although both bones broke, the fracture lines were relatively clean.

"Dean Li, you also understand traumatology?"

Director Ren’s face was a mask of astonishment upon hearing this.

He knew that Li Xu had profound attainments in traditional Chinese medicine, but that was in internal medicine and acupuncture.

Traumatology is a purely hands-on skill. Without a decade or more of practical experience, it’s impossible to develop such a feel.

To determine the fracture type and displacement just by touch?

’That’s just incredible!’

"I know a little."

Li Xu said with a smile.

Just then, a doctor ran over with the freshly processed X-rays. "Director Ren, the images are here."

Director Ren took the films and clipped them onto the light box.

One look, and he couldn’t help but suck in a sharp breath. He turned to look at Li Xu, his eyes filled with utter disbelief.

The images on the film were an exact match for what Li Xu had just described.

A double fracture of the tibia and fibula, angular displacement of the tibia, fracture surfaces on the same plane.

Not a single detail was off!

"Dean Li, your diagnosis was incredibly precise."

Director Ren praised him sincerely and handed the films to Li Xu.

Li Xu took them, glanced at them, and nodded.

Although modern imaging technology is advanced and can directly visualize the fracture, the TCM bone-setting principle of "perceiving with the hands and understanding with the heart" is still indispensable.

This is because during the reduction, you must rely on your sense of touch to perceive the alignment of the fracture ends—something a machine cannot replace.

"However..."

After looking at the films, Director Ren’s expression grew grim again. He sighed. "A double tib-fib fracture, and with such severe swelling... I’m afraid our hospital’s traumatology department isn’t equipped to handle this. This kind of injury requires an open reduction and internal fixation, or an external fixation frame. We don’t have all the necessary equipment, and we’re short-staffed."

"I’d recommend we transfer the patient to the municipal orthopedics hospital. We shouldn’t delay his treatment."

This was the safest course of action and the most responsible thing to do for the patient.

But Li Xu waved his hand, his expression calm. "No need to go through all that trouble. For this type of fracture, I can perform a manual reduction. No surgery needed."

"What? A manual reduction?"

Both Director Ren and Dr. Hao, who was standing nearby, were stunned.

’Such a severe double fracture with serious soft tissue damage, and he’s not going to operate and insert a steel plate?’

From the perspective of Western medicine, this was simply unbelievable.

"Yes, I’m confident I can do it," Li Xu said with self-assurance. "Transferring him from hospital to hospital is just more suffering for the patient. Besides, looking at his situation, his family probably isn’t well-off. The surgery and hospitalization fees would be a significant expense. A manual reduction is effective, costs less, and the recovery is faster."

This was also an opportunity for him to practice the master bone-setting techniques recorded in *Liu Juanzi’s Ghost Remedy*.

Looking at Li Xu’s determined gaze, Director Ren hesitated for a moment before finally nodding.

’After all, Li Xu has created so many miracles. Maybe this time will be no different?’

"Alright. Since you’re so confident, Dean Li, we’ll give you our full cooperation," Director Ren said. "I’ll lend you a hand."

"Good."

Li Xu didn’t stand on ceremony.

He had a nurse prepare splints and bandages, then returned to the bedside.

"The patient’s soft tissue damage is quite severe, and the muscles are tense and spasming. Director Ren, please hold his ankle steady. Don’t let him move around."

Director Ren did as he was told, gripping the patient’s ankle firmly.

Li Xu stood on the outer side of the patient’s lower leg. His hands didn’t immediately move to set the bone; instead, he began by gently touching and performing Massage on the area around the injury.

"Dean Li, are you trying to invigorate the blood flow first?" Director Ren saw what he was doing.

"Correct," Li Xu explained. "TCM bone-setting emphasizes the principle of ’to join, first separate; separate, then rejoin.’ Before the reduction, you must first manage the tendons. Because of the pain and trauma, the patient’s local muscles are extremely tense and spastic. If you don’t relax the muscles first and just pull and yank, it’s very easy to cause secondary trauma, increase bleeding, or even cause the fracture ends to pierce the skin."

He channeled his internal energy, his fingers gliding between the muscle gaps, pressing acupoints to clear the meridians.

The surrounding orthopedic doctors and nurses watched with bated breath, their attention completely fixed on him.

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