Chapter 28: Treating Patients on the Road

“Well…” Zuo Gui faltered. “The weather’s bitter, and he has chills and fever. He must have… caught wind and cold in the fields. It’s… greater-yang wind strike.”

The “greater yang” had nothing to do with the sun. It was one of the channels in Chinese medicine. Put simply, greater-yang disease referred to externally contracted illnesses—what people commonly called colds.

Zhang Zhongjing, the Sage of Medicine, classified the syndromes that arose as such illnesses progressed by their location, tendency towards heat or cold, and the strength of the pathogen and the body’s healthy qi. He distinguished six channels: greater yang, yang brightness, lesser yang, greater yin, reverting yin and lesser yin.

External pathogens such as wind and cold generally entered at the surface through the greater-yang channel. The body’s resistance there produced symptoms such as pain and stiffness of the head and neck, chills and fever. The *Treatise on Cold Damage* called this greater-yang disease, divided into cold-damage and wind-strike patterns.

“Is that so?” His hesitation only deepened the mother’s doubts.

Zuo Shaoyang knew his father still worked at the elementary stage of matching a medicine to a complaint. He could not systematically analyse a disease’s cause and mechanism, derive a treatment principle and construct a suitable formula.

He clearly had little confidence now.

“Father, may I practise taking his pulse?”

Embarrassed and unsure how to answer the woman, Zuo Gui welcomed an interruption that would give him time to think.

“Yes. Have a try.”

Zuo Shaoyang took the man’s wrist. The pulse was floating and rapid; the tongue coating white. With the crooked eyes and mouth, difficulty moving his limbs and the history of the attack, he judged this a wind strike in the channels: weakened nutritive blood had allowed pathogenic wind to obstruct qi and blood.

His father had called it greater-yang wind strike. The “wind strike” was right, but not the kind associated with a greater-yang illness. This was wind entering the channels.

Zuo Gui had evidently noticed only the chills and fever, or could not explain the facial distortion, and was treating what he did understand. It would not work.

The attack was recent and the wind had only just entered the channels. During his placement, Zuo Shaoyang had seen his teacher treat such a case promptly with Major Gentiana Decoction, Da Qin Jiao Tang, and eel blood applied externally.

But the formula came from the Song. It did not exist in the early Tang. He could hardly tell his father about it, still less point out his error in front of everyone.

He would have to support him.

“Your son has indeed been struck by cold, ma’am. It has affected the channels, causing his mouth and eyes to twist. Don’t worry. Father is a well-known physician from Shijing. Our shop is Guizhi Hall. With New Year near, he was concerned about people in the mountains lacking medicine and doctors, so he brought me to help.”

She nodded repeatedly.

“Thank you! Please give him a prescription.”

“Go ahead, Father.”

His son’s support restored some of Zuo Gui’s confidence. Greater-yang wind strike called for Cinnamon Twig Decoction, his speciality and the source of his nickname.

Even travelling doctors wrote prescriptions for later reference. Zuo Shaoyang brought out paper and brush, and his father wrote the formula.

“Do you have an earthenware medicine pot?” the son asked. “I’ll decoct it for you. The preparation matters.”

“Yes, yes. I’ll show you. How much will it be?”

“Travelling fees are much lower than a shop’s. The ingredients cost six wen. Add two for the journey. And you needn’t pay until he’s better.”

“Not until he’s better?”

“Exactly.”

He dared promise that partly because he was confident of the cure, and partly because such assurance was needed to win trust on the road. A few wen were worth staking on their reputation.

“He really will recover after taking it?”

“I’m not boasting. Father’s medicine is the finest in Hezhou. It’ll cure him. If it doesn’t, we won’t even charge for the ingredients. We’ll be making rounds here over the next few days. Pay whenever he’s well.”

She smiled.

“You look like honest men. Yesterday’s doctor charged twelve wen for one prescription, and it did nothing! Only eight, and payment after recovery—you’re kind indeed.”

In the rear kitchen she produced a pot. Zuo Shaoyang took off the medicine chest.

“Could you find two eels? I need them for the treatment.”

“Certainly! There are some in the fields. I’ll catch them.”

She hurried off.

He prepared Major Gentiana Decoction and put it on the stove. By the time he finished, the woman had returned with two eels.

He had her bring her son inside and lay him on the bed. Meanwhile, he killed the eels and collected nearly half a bowl of blood. Taking it to the bedside, he dipped his fingers in and smeared it over the man’s twisted face until he was as red as Guan Yu on a battlefield.

The strange treatment gave the mother more hope. People commonly believed unusual remedies could cure grave illnesses; the stranger the method, the more effective it seemed.

When the medicine was ready, he told her to give it all in one serving. Then he went outside to join his father.

Zuo Gui was enjoying a conversation with the neighbours about their fields. They asked about minor ailments and injuries, and he answered patiently, withholding nothing. Everyone was at ease.

Seeing his son, he stood.

“Finished? Let’s go.”

Zuo Shaoyang shouldered the chest, took leave of the woman and continued through the village with the bell.

At its edge, someone called from behind.

The mother was hurrying after them through muddy snow with several others. One limped and waved.

“Doctor, wait!”

They stopped.

“What is it?”

“We want you to see us. These two households have sick people too. I told them you’re inexpensive, promise a cure and only charge afterwards. They’d like you to examine them.”

Father and son exchanged a delighted glance and followed them back.

First came the limping woman’s poor farmhouse: bark walls, bare inside, not even smoke from the stove. Only a large pile of firewood stood behind it.

Four small children sat bare-bottomed on the stone paving outside, staring wide-eyed, long strings of mucus hanging from their noses. The youngest sucked a finger and periodically burst into tears.

Apart from that firewood, there was nothing worth anything. Collecting a fee seemed hopeless; they might have to pay for the medicines themselves.

But a physician should care as a parent would. Saving and treating people was his duty. There was no choice.

The family had no stools. The two men sat on large stones outside while neighbours gathered round.

The thin-faced limping woman seated herself on another stone, smiling apologetically.

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