The death of Lu Xun (1881–1936), founder of modern Chinese literature, who later became the leader of the intellectual opposition to the Kuomintang government, has never elicited much discussion in Western scholarly circles. The author of this article suggests that may have been due to Lu Xun’s own talent as a sardonic humorist, in that he effectively dismissed speculation on it with his memorable essay on “Death” (Si), written after he had recovered from a bout of illness, but before the days leading up to his actual death. By contrast, there has been contention on the subject in China for over eighty years, resulting in an international investigation that mustered a team of physicians to pour over the still-extant x-ray image of his lungs, learned scholars in both countries to quibble over whether the character wu (five) could be mistaken for san (three), if written cursively, and two worldwide sojourns by Dr. Izumi Hyōnosuke (1930–2018), a Japanese medical historian, in search of the descendants and the ancestral graves of Dr. Thomas Balflour Dunn (1886–1948), the American pulmonary specialist who examined Lu Xun in person. The author of this article was at several points engaged in this multinational project. The article traces the historical origins of the dispute back to the 1930s, continues into the 1980s, and concludes with the current state of affairs in China and Japan, reading the debate against historical evidence (Lu Xun’s diary, correspondence, and the “record of treatment” by his Japanese physician) and the growing international tensions during Lu Xun’s final years.