The Fortunate Lady and Her Mountain Man

Chapter 211: Chapter 211: You Can’t Make Bricks Without Straw

From ancient times to the present, many brilliant physicians have dedicated themselves to the matter of anesthesia.

They tried all sorts of methods to help patients withstand pain and successfully undergo surgery.

According to historical records, even before Hua Tuo, the physician Bian Que of the Warring States period used a "poisonous wine" to "stupefy a patient for three days."

A text unearthed from the Mawangdui Han Tomb, the *Fifty-Two Disease Formulas*, records an anesthetic that was simply wine mixed with aconite.

Jin Huangfu’s *Acupuncture and Moxibustion A and B* also contains records of using acupuncture for pain relief.

Sun Simiao’s *Essential Prescriptions of the Golden Cabinet* and Li Shizhen’s *Compendium of Materia Medica* also describe the anesthetic properties of the Mandala Flower.

But these were all in their infancy. In terms of both duration and safety, they were incomparable to modern anesthetic drugs.

As for using ice to freeze a limb until it lost sensation or tying a tourniquet tightly to make it numb—these unorthodox methods don’t truly count as anesthesia.

"Did you understand all that?" Ji Huan asked Xin Ziqi after summarizing the key points.

Xin Ziqi hesitated slightly.

"There are still some parts I don’t quite understand... My understanding is that there’s a type of medicine that can make a part of a patient’s body, or their entire body, lose sensation. This helps them get through surgery painlessly, comfortably, and safely... Is that what you mean?"

Ji Huan nodded. ’It’s impressive that he could grasp that much in such a short time,’ she thought.

"Since you specialize in this field, then—" Xin Ziqi’s placid face suddenly lit up. "Do you have this kind of medicine?"

"Well..." Ji Huan was at a loss.

’How could she tell him that clinical anesthesia required more than just anesthetic drugs?’

A solid theoretical foundation and specialized knowledge, proficient techniques and skills, and extensive clinical experience—these were just the basics.

On top of that, complex and sophisticated anesthetic equipment was needed for meticulous monitoring and treatment.

For example, when a patient is under anesthesia, you use blood pressure monitors, electrocardiograms, ventilators, and other monitoring devices to closely watch fluctuations in their blood pressure, heart rate, blood oxygen saturation, and even brain waves.

These vital signs help an anesthesiologist determine the depth of anesthesia, allowing them to use the anesthesia machine to take the next necessary steps in a timely and effective manner.

Moreover, clinical anesthesia isn’t just about knocking the patient out; it’s divided into general and local anesthesia.

And beneath those, there are further subdivisions.

Accordingly, anesthetic drugs include not only local and general anesthetics but also related analgesics, muscle relaxants, and so on.

The administration of these drugs isn’t as simple as taking them orally or applying them topically. Depending on the type of surgery, the patient’s age, and their physical condition, one must choose between intravenous liquid anesthesia or inhalational gas anesthesia.

Right now, Ji Huan had nothing but a head full of theory. With no equipment and no drugs, she was like a skilled housewife with no rice—there was very little she could do besides stare helplessly.

"So, you’re saying your master didn’t teach you how to make this medicine?"

Xin Ziqi’s heart, which had just been soaring in the clouds, came crashing down in an instant.

The feeling was truly hard to put into words.

But Ji Huan’s hands were truly tied.

Her specialty was in clinical practice, not pharmacology.

Although she had later studied traditional Chinese pharmacology out of interest and knew that herbs like toad venom, datura flower, menthol, asarum, and aconite all had anesthetic properties, she had her limits.

Unfortunately, she only had a superficial understanding of traditional Chinese anesthesia; it wasn’t her focus.

Because after Hua Tuo, breakthroughs and achievements in traditional Chinese anesthesia were quite limited.

It had been lost for too long in the river of history. Even with its early origins, it was eventually surpassed by the rapidly developing field of Western anesthesia.

Western anesthetics are convenient, long-lasting, safe, and reliable, but their administration is complex and requires strict dosage control.

An insufficient dose won’t produce a good anesthetic effect. An overdose, on the other hand, can have adverse effects on the human brain and nervous system.

Traditional Chinese anesthesia is comparatively safer, but it also has many drawbacks.

For example, the depth of anesthesia is often insufficient, and muscle relaxation is incomplete, so it frequently fails to achieve the desired effect.

But right now, there were no better options.

"By the way, last time we went to Yide Hall, besides the gypsum, I remember asking you to find a few other medicinal herbs for me. Did you gather them all?"

Xin Ziqi’s mind was clearly still on the anesthetic. He pointed casually. "They’re all here. In that other small bag."

Ji Huan opened the cloth bag he had indicated.

Kusnezoff’s aconite, toad venom, Sichuan aconite, arisaema, strychnos... That was it.

This was a formula for a surgical anesthetic she had once seen in a rare ancient text. It was called Sleeping Powder.

Xin Ziqi finally realized something. "Don’t tell me these herbs are for...?"

Ji Huan nodded, tacitly confirming it.

Both Kusnezoff’s aconite and Sichuan aconite stimulate the sensory nerve endings in the skin and mucous membranes, first causing a sensation of itching and heat, then suppressing them to produce an anesthetic and pain-relieving effect.

Arisaema acts directly on the central nervous system, reducing the patient’s activity, calming them, and dulling their reflexes. It significantly prolongs sleep time and also has a strong analgesic effect.

The anesthetic components in toad venom are slower to take effect than Dicaine but are longer-lasting—thirty to sixty times more potent than cocaine, and without the irritation.

Despite all this, her expression was not optimistic.

"To be honest, I’ve never used this formula in a clinical setting, so I can’t guarantee its effectiveness. But its side effects are known..."

The anesthetic concocted from these herbs is a general anesthetic; after drinking it, a person falls directly into a coma.

When the anesthetic reaches the bloodstream, the drug affecting the brain also flows through other blood vessels and organs, affecting them as well.

If you can’t precisely monitor the patient’s heart rate, blood pressure, respiratory rate, and oxygen saturation to make timely adjustments, the consequences are often uncontrollable. You can basically only leave it to fate.

The book recorded that when a physician used this agent to treat patients, only two out of ten cases recovered fully. The rest either suffered from slowed movement or had their speech or brain impaired, with obvious aftereffects.

’Using it rashly on the homeless man with no certainty of the outcome... I’m afraid that instead of saving him, we’d end up harming him.’

"Maybe we could test it on some animals first..."

"That’s not a bad idea, but the homeless man’s injury can’t wait. If we delay any longer, his limb will be useless. Even if we manage to set it, he’ll be left with a disability."

Xin Ziqi pondered for a moment before making a new suggestion.

"Instead of agonizing over it here, why don’t we ask the patient himself? Perhaps he’s willing to accept the risk. After all, for some people, when you compare slowed movement and impaired speech to complete paralysis, the choice isn’t that difficult. Besides... there have been successful cases, haven’t there?"

’A one-or-two-in-ten chance of success was far too small, and the risk was too great.’

But Xin Ziqi was right. They should hear what the homeless man had to say.

It was his life. The decision should be his.

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