The Obstruction of Imperial Medicine

In the classroom on the second floor of the People’s Medical Clinic, dozens of midwives sat at long tables, their expressions focused, waiting for today’s lesson.

Today was the day Wei Lan would teach them a practical class.

Previously, Wei Lan had taught these midwives theoretical knowledge based on the “Comprehensive Good Prescriptions for Women” by Chen Ziming of the Song Dynasty. While there were books on obstetrics and gynecology in the Ming Dynasty, most people relied solely on experience, with little systematic learning. After Wei Lan’s clear and easy-to-understand theoretical explanations, the midwives had gained a deeper understanding of obstetrics and gynecology. Now, they eagerly awaited the practical class to learn real skills.

Wei Lan stood at the front of the room, holding an exquisitely crafted cloth doll in her arms. It was a masterpiece by Honghua, made from different materials, layer upon layer, carefully sewn together. From the outer skin to the inner abdominal membrane, uterus, placenta, baby, and umbilical cord, every part was vivid and lifelike, resembling a pregnant woman carrying a child. The doll’s abdomen already had a simulated incision, waiting for Wei Lan’s demonstration.

“Today, we will simulate a cesarean section surgery,” Wei Lan’s clear voice echoed through the room, and the midwives immediately became alert.

She took a specially made surgical knife and gently placed it on the incision of the cloth doll. “A cesarean section should not be performed lightly unless absolutely necessary,” Wei Lan said solemnly. The midwives stopped whispering and focused intently.

“Let’s first discuss how to avoid difficult labor,” Wei Lan continued seriously. “First, we must measure the woman’s pelvis, particularly the bone area around the buttocks. There is a saying, ‘A large pelvis is good for childbirth,’ and this is not without reason. Each woman must control the weight of the fetus and avoid letting the baby grow too large, as this greatly increases the chances of difficult labor.”

The midwives nodded in agreement, and some murmured about similar experiences they had encountered while assisting with childbirth.

Wei Lan continued, “Second, before labor, regular checks on the baby’s position are essential. If the fetus is not in the correct position, we need to try and adjust it. When the position is right, the birth will proceed much more smoothly.”

She looked around the room and emphasized, “In short, we should avoid performing a cesarean section if possible. It is very dangerous. When I performed a cesarean section for the daughter-in-law of Mrs. Li, it was truly a stroke of luck that it succeeded. We cannot rely on luck in the future.”

The midwives were shaken and nodded in agreement.

“Now, let’s formally introduce what a cesarean section involves.” Wei Lan picked up the surgical knife and carefully simulated the incision. “The incision should be made at an angle to avoid the bladder.”

The midwives leaned forward, some whispering, “Can such a small incision work?”

Wei Lan smiled and explained, “Don’t worry, there’s a lot of skill in such a small incision.”

Then she carefully simulated cutting through the fabric layer by layer, as if peeling away real tissue. “First through the skin, then the abdominal membrane. Be careful with the uterine wall, don’t break the amniotic sac.”

The midwives watched intently, some reaching out to feel the doll and examine each layer’s texture.

When Wei Lan finally “reached” the placenta and baby, the midwives exclaimed, “This baby is so well made! It’s almost the same size as a real one!”

Wei Lan smiled proudly, “It’s Honghua’s craftsmanship.” She continued demonstrating how to carefully remove the baby, handle the umbilical cord, and stitch up the incision.

The midwives were captivated, nodding, frowning, and occasionally whispering among themselves, discussing their thoughts.

After the demonstration, Wei Lan looked around the room and said seriously, “Today, we’ve demonstrated the cesarean section to help you understand the process and its dangers. From now on, we must do everything we can to avoid difficult labor. We should only resort to a cesarean section when absolutely necessary.”

The midwives nodded again, and some whispered, “Doctor Wei is right. Cesarean sections are indeed dangerous. We need to be more cautious and avoid letting the mothers reach that point.”

The room became heavy with a serious atmosphere. This practical lesson not only imparted knowledge but also deepened the midwives’ respect for obstetric matters.

Wei Lan, seeing the midwives so absorbed, cleared her throat and continued, “Everyone, there’s one more important thing to tell you. One week from now, you’ll undergo a qualification test. Those who pass will receive a certificate.”

“This certificate is not only an acknowledgment but also a guarantee for the mothers,” Wei Lan smiled. “With this certificate, you’ll be more confident when assisting in childbirth, and the mothers will trust you more.”

Upon hearing this, the midwives cheered and eagerly prepared for the test, but they didn’t seem in a hurry to leave. Instead, they crowded around the cloth doll model, eager to examine it carefully.

“This model is so detailed! The texture of the placenta is so clear,” one midwife marveled.

“Yes, the length of the umbilical cord is just right, just like what we see during delivery,” another midwife agreed.

After the class, Wei Lan decided to visit the next door to see how the pharmacist’s theory class was going. She quietly slipped through the back door and saw Pharmacist Deng engrossed in explaining “Compendium of Materia Medica,” with the apprentices hanging on every word. With years of herbal gathering experience, Pharmacist Deng made the originally dry pharmacological knowledge come alive.

The apprentices were sitting attentively around him, nodding, taking notes, and occasionally whispering to each other. Deng’s voice rose and fell as he spoke, at times passionate, at times soothing, as though telling a series of magical stories, making the apprentices feel as though they were in a deep forest, experiencing both the hardships and joys of collecting herbs.

The seven apprentices were carefully selected from the beggars of Shunxing, all carrying the spirit of self-reliance. They were named Huangqi, Danggui, Fuling, Baizhu, Zhike, Chenpi, and Gancao, and now they were all dressed neatly, without a trace of the ragged appearance of their former lives.

Looking at these energetic apprentices, Wei Lan was confident that, under Pharmacist Deng’s careful guidance, they would surely grow into excellent herbalists.

After listening quietly for a while, Wei Lan quietly exited the classroom and happened to run into Liu Mingyi downstairs. He was holding a newly carved seal, one that Wei Lan had asked him to find and carefully carve for her earlier, unique in design.

Wei Lan took it with great joy, dipped it in red ink, and pressed it onto a piece of white paper. The seal’s design was intricate and exquisite.

Liu Mingyi examined the seal and asked, “What is this seal for?”

Wei Lan smiled and explained, “I’ve been teaching the midwives for months, and now that the course is over, I plan to issue certificates to those who pass the qualification test.”

Liu Mingyi raised an eyebrow, puzzled. “You’re issuing the certificates yourself?”

Wei Lan nodded confidently. “Yes, I’ll be issuing them personally.”

Liu Mingyi sighed slowly and said, “If you issue them yourself, no one will recognize them. You need approval from the Imperial Medicine Bureau.”

Wei Lan was taken aback, incredulous. “What do you mean? Why didn’t you say this earlier?”

Liu Mingyi helplessly explained, “I only just heard you mention it. The process for issuing qualification certificates is complicated. You need to submit an application to the Imperial Medicine Bureau, detailing your course content, assessment standards, and the list of those who passed.”

“The Imperial Medicine Bureau will send someone to review whether your teaching is legitimate and whether the assessment is fair. If everything checks out, they’ll approve your certificate issuance, but you’ll need to affix the official seal for it to be valid. Only then will people accept it.”

Wei Lan, though slightly anxious, quickly regained her composure and said firmly, “Then I’ll go to the medical official right away.”

Wei Lan arrived at the Imperial Medicine Bureau, followed the proper protocol to report her name and purpose, and soon met with the medical official.

Zhang Wenyuan, the head of the department, was deeply engrossed in reviewing documents when Wei Lan entered. He looked up slightly and smiled, “Doctor Wei, it’s an honor to meet you.”

Wei Lan politely responded and handed over the documents, “You flatter me. I’m here today to request approval for my training application. This is the detailed material about the midwife training program. Please take a look.”

Zhang Wenyuan took the materials, slowly flipped through them, and studied the contents carefully, pondering what lay behind the words.

Wei Lan stood quietly to the side, feeling nervous inside, but maintaining a calm demeanor.

After finishing the documents, Zhang Wenyuan looked up, his gaze deep as he said slowly, “Doctor Wei, you’ve truly come out of nowhere. In just a few months, you’ve established both a clinic and a pharmacy. I wonder which influential person guided you behind the scenes?”

Wei Lan was slightly taken aback, not fully understanding the implication of his words, and smiled, “There’s no one guiding me, just good luck.” She paused, then asked, “Sir Zhang, do you think my training application will be approved?”

Zhang Wenyuan, on the surface courteous, was privately calculating his own thoughts.

He was pondering that medical education in this region had always been under his purview. Now, Wei Lan had begun conducting training and assessments without his approval, and she had made quite a success of it. It was a direct challenge to his authority, making him appear incompetent.

Feigning difficulty, Zhang Wenyuan said, “According to the rules, your teaching should be under the jurisdiction of the Department of Education. Have you received their permission to conduct this course?”

Wei Lan was puzzled. “What is the Department of Education?”

Zhang Wenyuan explained, “The Department of Education, officially known as the Superintendent of Education, oversees local education matters. If you want to conduct this kind of training, you first need to submit an application to them, detailing the purpose, content, and teaching staff. Once they approve it, you can submit it to the Imperial Medicine Bureau for our approval.”

Wei Lan finally understood, though she felt a little uncomfortable. Still, she knew this was a necessary step. She nodded and said, “Thank you, Sir Zhang. I’ll go handle this immediately.”

Zhang Wenyuan smiled faintly and watched Wei Lan leave, a hint of something unreadable flashing in his eyes.

Wei Lan thought to herself that the bureaucracy here was quite deep. But since it was all for a legitimate cause, she would follow the necessary procedures. She turned and left the Imperial Medicine Bureau, already planning her next steps.