The Physician of Traditional Medicine Returns from Murim - Chapter 366

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This chapter was translated by Lunox Team. To support us and help keep this series going, visit our website: LunoxScans.com
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Chapter 366

“Both hands, all ten fingers hurt.”

Jo Yura bent and straightened her fingers, showing me the movement.

All of them hurt?

While there were many patients with finger pain, patients complaining that all ten fingers hurt weren’t that common.

Unless it was trauma from breaking or hitting something, most cases were overuse injuries.

Since the fingers used most tend to hurt, problems usually occur mainly in the thumb or index finger of the right hand.

“Do you also play piano, Ms. Yura?”

Of course, if she played piano or had a job involving a lot of typing, she would use all ten fingers.

Park Miseun had also had pain in all her fingers.

“No, not really. Miseun and I are from the same arts high school, but I haven’t played in decades. I’m just an ordinary housewife.”

“You don’t overexert yourself with anything besides housework?”

“That’s right.”

Jo Yura didn’t seem to be a case of particularly heavy finger use.

“How long have you been in pain? Do you have any suspected causes?”

“The fingers have been hurting for just under a year. Before that, my wrists would hurt a bit when cutting things, then get better. As for the cause… I really don’t use my fingers for anything special.”

“You haven’t had any tests or treatment at all?”

“No. At first it wasn’t too severe, so I thought it would get better if I rested. On bad days I just took some painkillers.”

“Hey, she talks like it’s nothing, but even at the reunion she kept rubbing her fingers.”

I had suspected as much.

If a patient neglected their condition for nearly a year, they were likely taking it more lightly than the actual severity warranted.

Still, if she needed to seek painkillers, it couldn’t be very mild.

“That’s right. Usually I’m fine in the evenings, but that day maybe because I drank, my condition was a bit bad. They kept swelling and aching, so while I was rubbing them, she suggested we come here.”

At least Jo Yura didn’t argue and acknowledged it.

“Please point to where it hurts the most.”

“All the finger joints hurt. This is the worst, and this also hurts a bit. My wrists also feel stiff, I think?”

Jo Yura pointed to the metacarpophalangeal joints (MCP joints), the first joints connecting the back of the hand to the fingers, as the most severe.

The second joints, the proximal interphalangeal joints (PIP joints), also hurt a little, but the distal interphalangeal joints (DIP joints) right below the nails seemed fine.

This was quite different from typical degenerative arthritis, where pain mainly occurs in the proximal and distal interphalangeal joints.

“Is it more of a dull ache than a sharp pain?”

“Both. When I wake up in the morning they’re stiff and rigid, then I have to move them like this to loosen them up, but sometimes they also ache sharply.”

She said her fingers didn’t move smoothly in the morning and needed stretching.

She even demonstrated using her left hand to stretch her right hand and her right hand to stretch her left hand.

“It’s not that one side is worse, but both sides hurt equally?”

“Yes. Exactly the same. I really don’t even use them much, so I don’t know why this is happening.”

Bilateral symmetry and morning stiffness.

The distal interphalangeal joints were fine while the metacarpophalangeal joint symptoms were the most severe.

A certain condition came to mind.

“Do you have any other systemic symptoms besides your fingers? Things like fatigue, loss of appetite, or low-grade fever?”

“Fatigue, well, maybe because this keeps bothering me, I’m always tired. I also feel a bit of heat in my head, but I thought it might be menopause. What was the other thing you asked about?”

“Appetite.”

“Oh, I don’t usually eat meals regularly anyway.”

“Oh my. No wonder you’re so thin.”

Jo Yura spoke casually, but Park Miseun added a sympathetic comment.

The two must be the same age.

Since Park Miseun was someone who performed on stage, she had paid attention to her appearance.

But even accounting for that, Jo Yura gave a much more gaunt impression.

At this level, I had to consider that she had loss of appetite, fatigue, and low-grade fever.

The possibility that this wasn’t simple arthritis had increased considerably.

“Should I take herbal tonics?”

Jo Yura tilted her head.

Since she had made the big decision to come to the traditional Korean medicine clinic, she seemed to have some thoughts about taking herbal tonics.

“It would be good to take them. But that’s not why I was asking.”

“Oh, I see.”

“…I suspect rheumatoid arthritis. It would be best to start with blood tests.”

“…!”

Rheumatoid arthritis.

A chronic inflammatory disease where inflammation appears in multiple joints including hands and feet.

While the exact cause hasn’t been identified, it’s known that autoimmune inflammation occurs in the synovial membrane surrounding joints, white blood cells gather in the joints, and swelling and pain develop as the main mechanism.

And Jo Yura’s symptom pattern was quite similar to rheumatoid arthritis.

In rheumatoid arthritis, vague systemic symptoms like fatigue, loss of appetite, and general weakness initially appear in many patients.

Morning stiffness occurs where joints are stiff and immobile in the morning, then loosen up after more than an hour.

This lasts for several weeks to months.

Then the typical pattern is for full-blown joint symptoms of pain and swelling to begin.

“Ah… now that you mention it, that’s right. The stiff strangeness and fatigue have been going on for a while, and the pain bad enough for painkillers is recent.”

She probably wasn’t hearing about rheumatoid arthritis for the first time.

But it seemed she hadn’t thought of it until coming to the clinic today.

Perhaps because it seemed to fit even to her own thinking, Jo Yura’s face darkened considerably.

“Oh no, then what do we do? Can you test for it right now?”

Park Miseun asked worriedly.

“Ah! I had blood tests during my health checkup last year. Everything was clean then.”

Jo Yura tried hard to find evidence to deny it.

However, to accurately diagnose rheumatism, tests including rheumatoid factor (RF) and Anti-Cyclic Citrullinated peptide Antibody (Anti-CCP) items had to be performed.

“Rheumatism isn’t part of the national health screening program, and our clinic doesn’t have that equipment either. Since you’ll need to receive Western medical treatment alongside anyway, let’s go to the rheumatology department at a major hospital for detailed tests.”

Does Sowon General Hospital have a rheumatology department?

I said I would write a referral letter for now.

Acupuncture is also very effective in terms of controlling inflammation.

Since overall immune regulation is ultimately necessary, herbal tonics with the concept of condition recovery are also excellent.

However, rheumatism is an autoimmune disease.

I don’t recommend traditional Korean medicine treatment alone without immune suppression when severe pain and swelling appear, at the point when joint destruction is actively occurring.

“Ah… once I start taking those medications, don’t I have to take them for life? My aunt had rheumatism – could it be hereditary? Ugh.”

“It’s not the type where dependency develops from starting to take it, requiring continuous use. Since long-term breaks are possible once it’s controlled, don’t be too scared already.”

Rather than taking medication for life, one should worry about the progression of joint destruction and deformation.

Since Jo Yura showed resistance, I persuaded her step by step.

Pain and swelling had already begun, and inflammation in the synovium was growing.

The progression speed of joint destruction is fast at this time.

If medication isn’t taken early, joints may be permanently deformed.

Though it started with fingers now, if it progresses further, complications affecting internal organs can occur.

“I understand. I’ll go to the hospital once.”

After explaining this much, Jo Yura also accepted the seriousness.

Park Miseun, who had come to the clinic casually to chat with me, worriedly patted her friend’s shoulder.

“You made a good decision. Today I’ll do acupuncture treatment targeting inflammation control. Since testing and getting results will take time, let’s start treatment and let me know when the results come out.”

“Yes, Doctor.”

* * *

The concept of autoimmune diseases appeared relatively late in the history of modern medicine.

Even in the early to mid-20th century, there was a firm belief that immunity was unconditionally good.

Diseases that caused excessive inflammation like rheumatoid arthritis were thought to be the result of viral or bacterial infection.

They had been trying to find pathogens by administering completely ineffective antibiotics.

The term autoimmunity first appeared in academic journals in 1957, making its debut in the medical world.

“…So, you can think of it as the vital energy that protected the body against external evil energy attacking one’s own body for some reason.”

Naturally, the martial arts world had no concept of this at all.

So I would explain the story of ‘the immune system recognizing substances in my body as foreign substances, attacking them and damaging the body’ in this simplified way.

“Huh, vital energy transforms into evil energy? Is it like qi deviation?”

“It’s internal strife!”

Of course, it wasn’t very common in the martial arts world.

I had seen countless patients complaining of hand pain, but patients suspected of having rheumatoid arthritis could be counted on one hand.

Though it’s also a case of discovering the mechanism of a disease that existed before in modern times.

The prevalence of allergies and autoimmune diseases caused by immune hyperactivity has tended to increase in modern times.

There’s probably influence from environmental or dietary changes.

In fact, since autoimmune diseases have no perfect cure even in modern times, functional medicine approaches actively improving lifestyle habits like dietary control, smoking cessation, exercise, and stress management were prevalent.

Anyway, when I rarely encountered patients suspected of having autoimmune diseases.

I would earnestly explain that this phenomenon was different from general pain.

I made sure they understood well that they needed to persistently treat and manage it even if it was difficult.

Most patients achieved remission somehow through long-term treatment.

Among them, the patient who showed the most surprising progress was.

Jidamdaesa, who was an elder of Shaolin.

He was a martial artist who had mastered fist techniques befitting a Shaolin monk, and like Jo Yura, he began feeling joint pain in his fingers at some point.

Since it was extremely rare for a master who could control his own qi and blood to suffer from minor illnesses.

He was puzzled and came to see Master for treatment at a somewhat late stage.

“Qi deviation is… hmm, it might be similar in some ways. Internal energy can go berserk when consuming elixirs beyond one’s capacity.”

“Righteous faction martial artists boast about protecting common people from evil faction villains, but there are often those who commit sins behind the scenes.”

…But even after receiving treatment for a month, he said it wasn’t getting better at all.

He asked if he could see the Divine Physician… so I took over his case.

Was that somewhat offensive to me?

How could he make such remarks in front of a monk from Shaolin, the center of the righteous martial arts faction?

Back then, when meeting famous figures from the martial arts world was still burdensome for me, I answered while sweating profusely.

“If you’re going to make that kind of analogy, it would be more appropriate to say they mistook common people for evil faction members and attacked them, haha.”

That was my attempt at smoothing things over.

But Jidamdaesa narrowed his eyes and glared at Master and me.

“The Sichuan Dang Family really… I understand.”

“Hmph.”

Of course, Master just snorted.

“So it’s different from ordinary wind arthralgia and migratory arthritis? Then, is treatment possible? Surely I won’t be unable to use my hands like this forever?”

The situation where he hadn’t recovered despite receiving treatment for the previous month and not using his hands according to Master’s instructions.

As a martial artist who had trained fist techniques his entire life, he must have been very worried about the course of the disease that only kept getting worse.

“That won’t happen. With consistent treatment, you’ll definitely see improvement.”

“See improvement? You mean it can’t be completely cured?”

“…It’s difficult.”

At first, I answered conservatively.

If we reduce the inflammation, the symptoms themselves will improve.

We’ll find areas where qi and blood are excessive or deficient and try to balance them, while also attempting to reduce the autoimmune response.

But since it’s not an invasion of pathogenic qi, wouldn’t it be impossible to completely eradicate the root of the disease?

“Island Lightning Hand. There have been those whom the Divine Physician spoke of and treated like this…”

“They do exist.”

However, Jidamdaesa did not give up hope.

He approached the treatment very actively.

Master and I made every effort to heal him somehow.

Beyond standard treatment methods, we also tried approaches that only a martial artist could attempt—ideas that transcended conventional thinking.

And in the midst of all this.

We discovered a complete cure that we had never imagined before.

…It was none other than bone transformation and marrow cleansing.

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This chapter was translated by Lunox Team. To support us and help keep this series going, visit our website: LunoxScans.com
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