Abstract: The Four Astonishing Cases of Wu Zetian's Era is a detective fiction written in the early years of the Guangxu era of Qing dynasty. Influenced by Western medicine's emphasis on objective examination and anatomical knowledge, the author intricately wove numerous medical descriptions into the narrative, such as Di Renjie disguising himself as a physician to investigate cases, directing autopsies, and treating patients involved in cases. Through these depictions, the author endowed the criminals with formidable adversary traits while portraying Di Renjie as an advocate of scientific methods and objective evidence. This not only mirrors the innovative aspects of Western detective fiction but also echoes the cultural ideals of Western rationalism and heroism. This indicates that the novel had already begun a preliminary transformation under the influence of Western detective fiction before the introduction of the Sherlock Holmes series of detective novels to China. However, influenced by the "Chinese learning as the foundation, Western learning for practical application" ideology of the Self-Strengthening Movement at the time, The Four Astonishing Cases of Wu Zetian's Era did not fully accept the ideology of Western medicine nor draw on the chracteristics of Western detective novels, and still retains some characteristics of traditional detective fiction and adheres to certain traditional ideological concepts.