First Time Performing Surgery? (Catching Bugs)
Yu Jinnian took the little maid to the backyard, led her to sit down calmly, and then brought a wet towel for her to wipe her face. Only then did he ask, “I forgot to ask last time, what’s your name?”
The little maid stopped crying and answered softly, “My name is Mei Dou…”
“Mei Dou?” Yu Jinnian thought to himself, isn’t this a food name?
When he first came, he thought it was a vegetable he often ate in his previous life. Later, he saw it in a tea house; it turned out to be a small, rose-colored, sweet and sour tea snack. He found it quite novel and asked the tea owner about the cooking method. Then he went home and made it himself.
The ingredients were quite simple: red yeast rice powder, dried plums, sugar, and yellow beans. Put the red yeast rice and dried plums together in a pot, add water, boil, add sugar, and then put the plump yellow beans in to cook, occasionally stirring a little to let them absorb the color and flavor. When the soup thickens and the water reduces, the beans turn rose-red, and the Mei Dou is ready. Paired with a cup of bitter tea, the taste was quite unique.
Mei Dou seemed to notice Yu Jinnian’s confusion and quickly said, “I was kidnapped when I was very young, so I don’t remember my real name. Later, I was sold several times, called different names, but never had a proper one. Because I love eating Mei Dou, the sisters in the hall all call me Mei Dou.”
Yu Jinnian nodded, seeing that she had calmed down, and said, “Mei Dou, tell me slowly, what happened to Qing Huan?”
At the mention of this, Mei Dou’s eyes immediately filled with tears. She tightly grasped her knees and looked at Yu Jinnian urgently, saying, “Brother Nian, I know you are a good person. I really have no other way. Sister Qing Huan is dying, please help her…”
Yu Jinnian thought Qing Huan had some acute illness and asked in surprise, “Qing Huan? Wasn’t she fine before? How did she become so seriously ill in just a few days?”
“It’s not an illness; she was beaten by the head teacher in the hall.” Mei Dou began to sob again, “I don’t know exactly what happened… That day during the Mid-Autumn Festival, a rich old man chose Sister Xue Qiao’s card and invited her to his mansion for a drink, and naturally, Sister Qing Huan had to follow. According to the porters who carried the sedan chair, on the way back, the two sisters wanted to stroll through the river street night market, so they asked the porters to wait at the entrance of the night market. They said they would return to the street entrance to take the sedan chair back to the hall after their stroll.”
Mei Dou became somewhat incoherent, “But who knew, who knew… the porters waited at the street entrance until midnight, but the two sisters never returned. They realized something had happened and hurriedly went to search for them. In the end, they only found Sister Qing Huan; Sister Xue Qiao is still missing…”
Upon hearing this, Yu Jinnian frowned. He now understood why Qing Huan had been disciplined by the teacher.
It had been mentioned before that the popular courtesans in the brothel often had a young girl who had not yet come of age accompanying them. Ostensibly, this was for learning skills, but in reality, it also served to monitor, remind, and restrain these popular girls.
If the girls made mistakes, such as rejecting or offending customers for personal reasons, or even had other thoughts, these young girls would be punished along with them, subjected to extremely harsh discipline. This was to force the courtesans to behave and also to set an example for other courtesans in the house. Although some girls were hard-hearted, most of them were soft-hearted and would quickly admit their mistakes when they saw the young girls being tortured in front of them.
But Qing Huan’s situation was somewhat different.
Xue Qiao had run away—a serious crime in the brothel, a top-tier offense. Moreover, when Xue Qiao escaped, Qing Huan was with her. If they had both been caught, it would be a different story, but now only Qing Huan had been caught. As an uninitiated young girl, even if she were beaten to death, in the eyes of the brothel owner and the head teacher, it was just a loss of a few taels of silver.
Mei Dou cried, “The head teacher asked where Sister Xue Qiao had escaped to, but Sister Qing Huan remained silent, refusing to speak. The head teacher then hung her up and beat her… all covered in blood, even broke her…”
Yu Jinnian was contemplating the ins and outs of the matter when he suddenly heard something break. He snapped back to reality and asked, “What did you say, what broke?”
“Her leg, her leg is broken… Sister Qing Huan is stubborn, and the head teacher beat her to death.” Mei Dou cried with a tear-streaked face and rolled off the bench, kneeling and holding Yu Jinnian’s leg, looking up at him, “Seeing that Sister Qing Huan’s leg was broken and she still wouldn’t say anything, and she was on the verge of death and couldn’t become a registered courtesan anymore, they rolled her up in a mat and threw her out of the city.”
“The other sisters were afraid of being implicated, so they didn’t dare to plead and all hid away. I begged the madam and also the head teacher, but I’m just a sweeping maid, not of any significant use.” Mei Dou knelt on the ground, wiping her face with the back of her hand. Her sleeves were soaked, and she cried so hard that she couldn’t catch her breath. “I know I’m ugly, and no one likes me, but Sister Qing Huan and Sister Xue Qiao have always been kind to me. They gave me food and shared their snacks… I don’t want Sister Qing Huan to die… The other clinics kicked me out when they saw I had no money…”
Ji Hong couldn’t help but frown as he listened, but he didn’t say anything. He turned to look at Yu Jinnian.
Mei Dou took out a handful of coppers from her sleeve. The coins were covered in dirt and bloodstains, and even if counted generously, there were only about a dozen. She held them up with both hands, her eyes wide open: “I know Brother Nian, you also know how to treat illnesses… I know this is not enough, but I will repay you, I promise! I can even carry wine jars; carrying five earns one copper.”
Seeing her thin arms and legs, Yu Jinnian recalled how she stumbled when carrying books before, and now she was talking about carrying wine jars. Even an adult man might struggle with that. The injuries on Mei Dou’s body and head were likely from kneeling at many clinics before finally reaching Yu Jinnian.
“It’s not about the money.” Yu Jinnian tried to pull Mei Dou up, but she stubbornly refused to rise from the ground. Yu Jinnian sighed, thinking, she must know I’m soft-hearted and came to plead specifically with me. He said, “Alright, stop crying. Where is Qing Huan now?”
Mei Dou paused, and instead of stopping her tears, she cried even harder. She laughed and cried simultaneously, kowtowing repeatedly, saying, “Thank you, thank you—”
Ji Hong pursed his lips and turned to enter the room. When he came back out, he had a cloak draped over his elbow.
Yu Jinnian glanced at him: “What are you up to? Where are you going?”
Ji Hong replied, “That depends on where you are going.”
Yu Jinnian chuckled amid his worries, “Alright, alright, you are both my ancestors.” He looked down at Mei Dou and asked, “Where is Qing Huan? Is her leg really broken, and has she been moved?”
Seeing that Yu Jinnian agreed to help, Mei Dou finally felt at ease but still had red eyes as she explained in detail: “After they threw Sister Qing Huan out, I took the opportunity while dumping dirty laundry water to look for her… her bones were sticking out. I didn’t know what to do, so I dragged her to a nearby abandoned hut using an old wooden board.”
If Mei Dou could see the bones, it wasn’t just broken; it was an open fracture—more complicated than expected.
Time was of the essence. Yu Jinnian explained the situation to Aunt Xu and then closed the shop, hurrying out of the city.
About a mile outside the city, there was a dense forest with thick branches and tall weeds, making it impossible to see a body thrown inside. Mei Dou led the two of them through many twists and turns before they finally saw a clearing, with a nearly collapsing dilapidated hut by the creek.
The hut had probably been abandoned for years, with a half-tilted door. To enter, one had to crouch down and crawl inside. While crawling, Yu Jinnian’s hair got caught on something. He pulled hard, causing a chunk of yellow mud to fall, covering his mouth with dust.
—Just this dusty and muddy environment was enough to make Yu Jinnian worry.
“Sister Qing Huan, I brought a doctor!” Mei Dou ran inside excitedly.
“Cough, cough!” A weak voice from the corner wheezed, “Mei Dou? Didn’t I tell you not to waste money… I can’t be saved… Keep the money to… redeem yourself later…”
Mei Dou held her hand, sniffling, “Look, I brought Brother Nian here.”
Yu Jinnian first smelled a faint scent of blood before turning to see Qing Huan leaning against the corner of the hut.
He was silent for a moment.
This lovely and charming young lady, whose laughter was as sweet as the sound of silver bells, was first seen shyly placing a step shaker in Ji Hong’s arms. When they met again, she was leaning on the railing with Yu Jinnian, listening to the opera. This was only their third encounter, yet she was covered in blood, her appearance disheveled, her face pale. The most frightening sight was her right calf, which was bent at an unimaginable angle, with bone protruding through the flesh. The tattered mat beneath her was half-soaked in blood.
Ji Hong followed in shortly after, standing still beside Yu Jinnian.
Qing Huan was propped up on some dry straw behind her. She opened her eyes and managed to force a barely decent smile, saying, “Young Master Ji… I apologize, Qing Huan cannot sing for you anymore…”
Ji Hong uncharacteristically responded, “Sing again when you’re well.”
Despite the pain that made her sweat profusely, Qing Huan still smiled and said, “Alright.”
“Stop talking, save your strength.” Yu Jinnian crouched beside Qing Huan, carefully examining her from top to bottom. Her leg was beyond hope—an open tibial fracture, with the bone protruding about two inches through the skin, surrounded by torn muscles and visible dirt contamination, a second-degree fracture.
Blood continued to trickle. Yu Jinnian pressed two spots with his fingers to determine which blood vessel was bleeding, then quickly tore a strip from his hem and tied it around her injured ankle.
At this moment, the leg was in the most critical condition, and the tourniquet couldn’t stay on for too long, or the blood supply would be cut off, risking the entire leg. But Yu Jinnian had other concerns. He ordered, “Remove the straw behind her, lay her flat.” He added, “Slowly, don’t stir up too much dust.”
Mei Dou hurriedly and cautiously removed the straw, laying Qing Huan flat on the ground.
Qing Huan said, “Brother Nian, stop fussing… If I could, I would love to taste your snow skin mooncakes again… They were the best I’ve ever had…”
“Don’t talk.” Yu Jinnian ordered, reaching out to check her temperature.
Damn, she was a bit warm.
Mei Dou rubbed her eyes, forcing a smile, “When sister Qing Huan gets better, there will be many delicious things!”
Yu Jinnian touched and pressed, or gently pinched, Qing Huan’s body from head to abdomen, occasionally asking her if it hurt and how it hurt. Qing Huan answered each question. He then spread his hand, covered her body with his palm, and used the pad of his middle finger to tap vertically on the back of his other hand’s fingers, listening closely for any internal sounds. Lastly, he lightly scratched specific points on her legs with his nails.
Ji Hong watched Yu Jinnian intently, occasionally helping with small tasks as instructed.
He completed these actions swiftly, yet it only took a moment. Yu Jinnian had a clear understanding in his mind. He mentally reviewed all possible treatments and their risks, still hesitant. Finally, he stood up and said, “Qing Huan, listen to me. I have two methods to treat you, and you need to decide for yourself.”
Qing Huan asked, “Which… two?”
Yu Jinnian replied, “The first option is to amputate your broken leg at the knee. This method can save your life and heals relatively quickly, but the downside is that you’ll lose a leg.”
Before Qing Huan could answer, Mei Dou anxiously asked, “What’s the other option?”
“The other option… I must remove the damaged flesh around your broken bone, cut open the skin and flesh, reconnect the broken bone, and then sew it back together with needle and thread.” All three present, including Ji Hong, had never heard of such a treatment method. Their eyes widened in surprise, and Mei Dou looked as if she had seen a ray of hope, her face glowing with excitement. Only Qing Huan remained indifferent, waiting for Yu Jinnian to continue. He indeed had more to say, “But I am not entirely confident in this method. It might heal after stitching, or it could worsen. If the latter happens, amputation of the limb would be the least severe outcome; in worse cases… it could be life-threatening.”
“Though I suggest directly amputating the broken leg, I understand that perhaps, for you, losing a leg might not be much better than losing your life. So… I must tell you both options and let you choose.”
“Alright.” Qing Huan responded almost without thinking, “I’ll choose the second option.”
Yu Jinnian frowned, “Think about it again.”
Qing Huan glanced at Mei Dou, who was tightly holding her hand, closed her eyes, and said, “I’ve thought too much. It’s precisely because I’ve thought too much that I ended up like this today… Let it be. The second option sounds very impressive. Regardless of life or death, I just want to try… Brother Nian, your cooking is so good, I’m sure you’re excellent at treating illnesses too…”
What kind of logic is that?
Yu Jinnian thought she was overwhelmed by the pain and somewhat delirious.
However, since she made such a firm choice, Yu Jinnian felt he should do his utmost.
He looked around and said, “This place won’t do. Mei Dou, see if there’s a cart nearby we can borrow. We need to get Qing Huan back to the One Bowl Noodle Shop quickly. After that, go to Silkworm Street to buy some prepared silk thread. Here’s the money. Ji Hong, you also go back with the cart, buy a jar of the strongest liquor, and prepare a pot of hot water and a pot of thick green onion soup. Get some cotton paper and clean cloth, and ask Auntie for the smallest sewing needle… Alright, let’s move!”
Ji Hong nodded to show he understood, then asked Yu Jinnian, “Where are you going?”
Yu Jinnian hurriedly headed out, answering, “I need to go to Pingkang Pharmacy to get some medical supplies.”
The three of them went their separate ways. Yu Jinnian ran all the way to Pingkang Pharmacy and specifically asked for Peach Blossom Powder. Peach Blossom Powder was best for treating injuries and external wounds, containing roasted red lime to stop pain and bleeding, and roasted rhubarb to stop bleeding and reduce bruising. While they were measuring out the ingredients, an elderly man with white hair came out from the back room and casually asked what the Peach Blossom Powder was for upon hearing Yu Jinnian’s request.
Yu Jinnian, hoping to borrow or rent some surgical tools from them, respectfully replied, “It’s for stopping bleeding after stitching a bone that’s broken through the skin.”
The old man shook his head repeatedly after hearing this, straightforwardly saying, “Bones breaking through the skin usually result in death nine times out of ten, and the other option is only to amputate the limb to save the life. Young man, you cannot recklessly treat someone and risk their life. Human skin and flesh are not like fabric that can be sewn together with needle and thread; it’s truly alarming.”
“If you don’t believe me, sir, you can come with me.” Yu Jinnian said, “However, I still need to borrow some surgical tools from you, such as a knife for cutting flesh, as well as lancets and fine needles. I am willing to put up silver as collateral and will return the tools after use.”
The old man thought for a moment and then sighed deeply, “Fine, take the tools.”
Yu Jinnian had expected more questioning or even opposition, but he was surprised by the prompt approval and felt a wave of relief. He bowed his head in thanks, “Thank you, sir.”
**
Back at the One Bowl Noodle Shop, Mei Dou and Ji Hong had completed all the tasks he had instructed. Yu Jinnian boiled all the necessary bowls, plates, knives, needles, and silk thread, and wiped them down with strong liquor. He also instructed everyone to wash their hands and then wipe them with strong liquor.
They then pushed several tables together, covered them with clean bed sheets, and carefully moved Qing Huan onto them to lie flat. She seemed a bit nervous, her eyes blinking constantly as she looked around at everyone.
Yu Jinnian spoke softly, “I will use needles for pain relief, but there might still be some residual pain. If you feel nervous, just talk to us.”
Seeing Qing Huan nod, he began inserting several fine needles into the corresponding acupuncture points for pain relief. At this time, there was no good method for anesthesia and pain relief, and he didn’t know how to make the legendary Ma Fei San. Fortunately, he had learned acupuncture anesthesia from his master, which had proven to be very effective. He turned to Ji Hong, who had already washed his hands, and said, “Ji Hong, from now on, don’t lower your hands or touch anything unless I tell you to.”
Ji Hong: “Alright.”
Yu Jinnian picked up a single-edged knife and closed his eyes. This was going to be a thorough debridement and closed reduction surgery for an open fracture. His mentor in a previous life had repeatedly emphasized the importance of integrating Chinese and Western medicine. Only by knowing both could one achieve success. Although Yu Jinnian was trained in traditional Chinese medicine, he had also assisted in many surgeries. Today, however, he was the main surgeon. This was his first time leading a surgery, and it was in such harsh conditions, far from being completely sterile or isolated.
The moment he picked up the knife, his heart started pounding, and doubts flooded his mind.
“If the reduction fails and infection sets in, how will he control it without antibiotics? If there’s a mistake during the surgery and excessive bleeding occurs, how will he save her? If Qing Huan dies because of his wrong treatment decision, how will he cope?” A voice inside him suggested, “Just amputate the leg directly. At least that way, her chances of survival are higher…”
“Jinnian.” Ji Hong suddenly called his name.
Yu Jinnian looked up at him, unaware that his own eyes were filled with confusion.
Had Ji Hong not been instructed to keep his hands clean and avoid touching anything, he would have grasped Yu Jinnian’s hand or patted his face. Instead, he stood opposite him, slightly furrowing his brow, and said, “Qing Huan has already made her choice. Now it’s your turn, Jinnian. Regardless of how you choose or the outcome, no one here will blame you.”
Qing Huan also spoke slowly, “But if I lose my leg, it won’t look… very nice!”
Yu Jinnian felt a bittersweet sensation in his throat, indescribable and hard to articulate. He took a deep breath, turned around, and rinsed the wound with water that had been boiled and cooled, then washed it again with strong onion soup. Taking two deep breaths, he tightened his grip on the single-edged knife and began to cut into Qing Huan’s injured leg.
He debrided the wound, removing any potentially contaminated flesh, repositioned the bone, and quickly stitched up the fascia and skin with silk thread.
“Ji Hong, scrape the handles of the needles to induce the qi.”
The qi must be induced for the acupuncture anesthesia to be effective.
Perhaps his intense concentration heightened the solemn atmosphere in the room, making everyone afraid to speak. Mei Dou, holding her breath, closed her eyes to avoid seeing the gruesome scene of Qing Huan’s leg. She silently prayed for the surgery to end quickly and for Qing Huan to recover.
Unexpectedly, it was Qing Huan, the one who should have been most nervous, who spoke first.
“Actually… I knew Sister Xue Qiao wanted to escape. It was I who let her go…”
Author’s Note:
Our Jinnian is about to showcase his skills!
PS: The dishes mentioned in the story can be freely tried, but do not attempt the medical treatments, prescriptions, or procedures lightly!
PPS: In ancient times, it was impossible to achieve complete sterility, making the success rate of surgeries very low. The treatment methods mentioned in the story are theoretically feasible and exaggerated for plot purposes. Do not overly scrutinize their practicality.
PPPS: Surgery did exist in ancient times. The Tang Dynasty’s “Qianjin Yaofang” documented the use of onion tubes for catheterization. The Song, Jin, and Yuan dynasties had surgical treatises. The Ming Dynasty’s “Wai Ke Zheng Zong” by Chen Shigong recorded many feasible and detailed surgical procedures, such as treating abscesses, traumatic injuries, tetanus, amputations, and even suturing self-inflicted throat wounds, saving countless lives. This demonstrates the boundless wisdom of ancient people.
Bowing in respect.