Da Ming: Father, step aside, I'll be the prime minister!

Chapter 247 Knee-Chest Position and its Instruction for Female Doctors
The Ming Dynasty book "Jingyue Quanshu" records that "all cases of reversed or transverse births are caused by the mother's exhaustion before the baby is properly positioned, or by exerting force too early, causing the baby to go astray."

This clearly shows that the ancients were not as ignorant as later generations thought, and they even had a deep understanding of breech presentation.

However, the lack of information flow and systematic knowledge also contributed to the fact that ancient medicine was sometimes considered miraculous and sometimes incomprehensible.

Just like Li Shizhen and other "barefoot doctors" who traveled all over the country, they practiced medicine in various places for many years and were good at using all kinds of folk remedies and unusual prescriptions.

For them, these unorthodox remedies and miraculous cures were life-saving.

However, for an "academic" like Yang Jishi, Li Shizhen's method was far too risky.

With the woman outside and the fetus inside, and the condition inside the womb not visible, how can an accurate assessment be made and a reversal surgery performed from the outside?

Ordinary people already face a life-or-death situation, so they might as well take a gamble.

Can you afford to gamble on treating royalty and nobility?

It was precisely because of their differing medical philosophies that the two argued endlessly, neither able to convince the other.

Who knew that Zhang Yunxiu's proposed treatment method was even more outlandish than theirs?

Even Yang Jishi, the disciple who had closed his doors to the sect, seemed somewhat disapproving.

He frowned deeply and looked at Zhang Yunxiu.

“Master, this is a bit too frivolous. Can a woman’s breech position be cured simply by having her do some movements?”
"I have read through countless ancient texts, but I have never seen such a treatment method."

Zhang Yunxiu retorted irritably, "If everything has to be found in ancient books, why would you want to become my disciple?"

"Students.Students"

Standing in front of Zhang Yunxiu, even the arrogant and domineering Yang Jishi became as docile as a chick.

Shaking his head helplessly, unwilling to waste any more words on his dull-witted eldest apprentice, Zhang Yunxiu smiled and said to Li Shizhen.

"Does Mr. Dongbi have any insights?"

Li Shizhen, however, looked somewhat bewildered, his brows furrowed, and he muttered something repeatedly to himself.

"Knee-chest position. In the knee-chest position, separate your knees to shoulder width, keep your thighs perpendicular to the bed, keep your chest close to the bed surface, and raise your hips."

No matter how he thought about it, he still couldn't quite understand how this method could turn the baby into the correct position.

Does that mean if a woman twists her body, the fetus will turn itself around?

Seeing the other party's concerns, Zhang Yunxiu added.

"Not only that, it's best to do it three times a day, each time for about half an incense stick's time, gradually increasing the frequency. If you persist for seven to ten days, you will see results."

In later generations of medicine, there were two solutions for dealing with breech presentation in pregnant women: one was the "surgical reversal method," and the other was naturally the "knee-chest position."

Surgical inversion has a long history and precedents for its implementation. However, without modern equipment to clearly identify the fetus, performing this method is undoubtedly a high-stakes gamble.

The "knee-chest position" method is more of an auxiliary method, with a simpler and safer principle. Compared to the inverted position, it carries fewer risks and can achieve similar results.

That would obviously be more suitable.

"I don't know."

Li Shizhen pondered for a long time, but still couldn't figure out why the woman's actions could change the position of the fetus.

Zhang Yunxiu said with a smile, "Compared to Mr. Dongbi's inversion method, this method uses a non-invasive auxiliary means, which is safer and more reliable."

"Non-invasive, assistive methods?"

Li Shizhen understood each word individually, but he had no idea what they meant when put together.

Seeing that even the "Medicine Saint" was puzzled, Zhang Yunxiu patiently explained.

The principle behind this is simply to change the fetus's center of gravity by changing its position, thereby creating a natural flipping effect.
In the knee-chest position, the woman's abdomen is suspended, reducing pressure at the pelvic inlet and allowing the fetus some freedom of movement.
This kind of auxiliary method can relax the woman's muscles to a certain extent and make it easier for the fetus to adjust its position.

Even after he finished explaining, Li Shizhen and Yang Jishi still just stared at each other blankly.

Helpless, Zhang Yunxiu saw that Zhang Lanying had returned and looked at her, saying...

"Lan Ying, you will assist the patient in performing this 'knee-chest position' exercise."

"Words are no proof; we'll see the truth in ten days."

"what"

Zhang Lanying exclaimed in surprise, not expecting that the other party would entrust her with such an important matter.

Li Shizhen and Yang Jishi looked at each other in bewilderment. Indeed, as Zhang Yunxiu said, the "knee-chest position" was simply a matter of having women perform certain movements every day, which was not a difficult task.

Whether it's useful or not, we'll soon see the results.

Li Shizhen sighed.

If it were someone else, and they mentioned that some action could cause the fetus to turn in the wrong position, he would rush up and give them a good scolding, accusing them of "spreading rumors and misleading the public."

But since this was proposed by Zhang Yunxiu, it's quite different.

This man is the true founder of modern medicine.
The vast majority of the research at Renmin Medical Clinic was proposed by Zhang Yunxiu, rather than his direction being controlled.

In modern medical theory, his words are considered authoritative.

In the past, Li Shizhen had some concerns, relying on his own methods, but later facts proved him right.

Zhang Yunxiu has always been right.

Yang Jishi had a strange expression on his face, but he was already used to Zhang Yunxiu occasionally coming up with ideas that went beyond common sense.

He smiled and looked at Zhang Lanying, saying, "Madam Zhang, you don't need to be nervous. Just do as Master says."

Zhang Lanying nodded firmly and bowed repeatedly to the group.

"Mr. Zhang, Mr. Li, Director Yang, I will certainly do my best!"

A light gradually appeared in her eyes.

For the next few days, Zhang Yunxiu almost never left his home, hiding in the study of Renmin Medical Hall to create and compile "Prescriptions Worth a Thousand Pieces of Gold for Obstetrics".

Throughout history, the continuation of offspring has been the foundation of a clan. From the imperial family and high-ranking officials to ordinary people and commoners, all regard passing on the family line as the most important thing.

The reason why the curse "to cut off one's lineage" is so widely circulated is precisely because of this deep-rooted obsession with inheritance.

Therefore, "obstetrics and gynecology" is an unavoidable topic in the development of medicine in the Ming Dynasty.

If Renmin Medical Clinic can make progress in this field, it will not only earn more money, but more importantly, it will save countless lives.

Zhang Yunxiu's "Prescriptions Worth a Thousand Pieces of Gold for Obstetrics" was compiled based on various obstetric and gynecological common sense and details from later generations.

He didn't expect the female doctors to reach the medical standards of later generations in a short period of time.

But as long as one can surpass those midwives who are "empiricist" and "rely on folk remedies and superstitions," that would already be a great achievement.

For example, the current prevailing belief in the Ming Dynasty is that "the delivery room is foul-smelling," so doors and windows must be kept tightly closed, light must be blocked, and even cleaning of the delivery room is prohibited.

It can be said that a large part of the medical accidents in ancient times were due to such bad habits and ignorant ideas.

Midwives often like to use labor-inducing drugs, or even directly pull or tug at the fetus.

Whether it's in various diagnoses at a clinic or in obstetrics, popularizing scientific knowledge is extremely important.

In addition to compiling the materials, Zhang Yunxiu would often answer questions for the female doctors at the clinic.

"Sir, my daughter still has some questions about your explanation of creating a sterile environment."

"Sir, could you please explain the medical principles behind breech presentation in more detail?"

These days, Zhang Yunxiu has been constantly bombarded with questions by sixty or seventy female doctors, their thirst for knowledge even greater than that of the doctors in the medical school he used to be.

This is the first time in both his lives that Zhang Yunxiu has been so fervently "pursued" by so many women.

But there was no other way. In order to cultivate the backbone of the obstetrics and gynecology department of Daming in the future, he had to bite the bullet and go for it.

Especially if a concubine in the palace is pregnant with the emperor's child, it's not appropriate to have a male doctor from the clinic treat the imperial concubine or noble consort in obstetrics and gynecology.
Even in later generations, many patients felt uncomfortable when there were male doctors in obstetrics and gynecology departments, let alone in the Ming Dynasty, which was characterized by strict feudal ethics.

This female doctor is someone we absolutely must train.

Today, another female doctor came to Zhang Yunxiu's study. She knocked gently on the door, and after bowing to Zhang Yunxiu, she timidly spoke.

"Sir, I have some questions about the episiotomy procedure. I hope you can enlighten me."

Upon hearing this, Zhang Yunxiu was somewhat surprised and looked up at the other person.

This female doctor, whose given name was Liu Wan'er, had a fairer and more delicate face than the others, and it was clear that she came from a scholarly family.

What surprised Zhang Yunxiu was not her appearance, but the question she asked.

(End of this chapter)