Chapter 29: Preserving His Father’s Authority

Zuo Gui stroked his beard and looked the woman over.

“What’s troubling you?”

“Headache,” she said weakly. “I’m burning hot, and my bones and joints ache.”

“Sweating?”

She shook her head.

“Feeling cold?”

Her teeth chattered as she nodded. “Terribly…”

“How long?”

“Seven or eight days.”

Her pulse was floating and tight. He understood.

“This calls for Ephedra Decoction. One or two doses should put you right.”

“Doctor,” she begged, “we have no money. Could you treat me first? I’ll pay as soon as I can.”

He considered.

“You’re poor. Money is hard to come by. Don’t spend it on treatment. There are ways to cure illness without it. Find me a piece of bamboo and a knife.”

She did not understand, but dared not question him. One of the older children ran barefoot away and returned with bamboo and a chipped billhook.

Zuo Gui split off a sliver and laboriously sharpened the end. Setting the knife down, he had her tilt her face up. He carefully inserted the sliver into a nostril, flicked it with his other hand and drew it out.

“Ow!”

She bent forward. Blood dripped from her nose.

“What… what’s happened? I’m bleeding! Second boy, fetch me a rag!”

“No need,” Zuo Gui stopped the child. “Don’t worry. Let it flow until it stops by itself. You’ll feel better.”

“A nosebleed… cures illness?”

Bent over, she watched the drops in alarm.

“Yes.”

Nearly half a bowlful flowed before it stopped. A little later she stretched her arms.

“Oh! I feel much better. That feverish discomfort’s gone. My eyes are clearer and my limbs feel easier. Amazing! If I’d known a nosebleed could cure it, I’d have treated myself!”

“Not every nosebleed cures disease,” he said. “This is only for greater-yang cold damage with chills, fever, headache, body aches, no sweating and a floating pulse, persisting seven or eight days. Then bleeding the inner Yingxiang point inside the nose with a bamboo sliver can cure it.”

Zuo Shaoyang too was surprised. He had never seen this method used for an exterior-excess cold-damage pattern.

Such illnesses sometimes resolved by themselves after seven or eight days, with a sweat. If the patient could not sweat, cold remained in the nutritive aspect. A nosebleed might then carry it out and end the illness: “bleeding in place of sweating”.

If neither sweating nor bleeding occurred, leaving the patient feverish and distressed, blood and sweat shared a common source. The cold pathogen could be discharged through the blood aspect too. Deliberately pricking the nasal lining to cause a nosebleed could therefore release the exterior.

The crowd marvelled at Zuo Gui’s skill and began wondering whether their own ailments could be treated.

The other household invited them over. These people were better off: there were stools and hot water.

Their patient was an old woman, also shivering. She too had chills, fever, headache and body aches. After examining her pulse and tongue, Zuo Gui said, “Another case for Ephedra Decoction. With this snow and cold, many people have cold-damage and wind-strike illnesses. Two doses should do.”

He asked her name and wrote the prescription.

As ever, cinnamon twig came first. It was an ingredient in Ephedra Decoction, but ephedra was the principal herb and used more heavily; cinnamon twig played a supporting role in a smaller amount.

Seeing how weak she looked, Zuo Shaoyang said, “May I practise examining her before I dispense it, Father?”

“Certainly.”

Pleased at his son’s eagerness, Zuo Gui stroked his beard and nodded with an elder’s authority.

Zuo Shaoyang examined both wrists. The pulse came readily under light pressure, diminishing but not disappearing under deeper pressure, like floating wood. A floating pulse, characteristic of greater-yang disease.

Yet within it he detected softness and a deep, fine weakness.

His brow furrowed. A weak pulse meant declining yang and insufficient qi to drive the blood. Alongside her exterior pattern was internal deficiency. Ephedra Decoction would induce too much sweating and injure her healthy qi.

“Her pulse isn’t only floating,” he ventured. “It’s rather weak too.”

“So?”

His father’s face darkened.

“That suggests internal deficiency. Ephedra Decoction might harm the healthy qi. Perhaps Cinnamon Twig Decoction—”

“What do you know?”

Zuo Gui glared.

“‘No sweat, ephedra; sweating, cinnamon twig.’ She plainly isn’t sweating! How can you use Cinnamon Twig Decoction? I tell you to study, and you never listen. Dispense the medicine!”

That rule generally held. But when a greater-yang exterior pattern came with mild internal deficiency, Ephedra Decoction was unsuitable whether the patient sweated or not. Entirely acrid and warming, it induced sweat too powerfully and could damage the healthy qi, causing a changed pattern.

Cinnamon Twig Decoction supported the body strongly while inducing sweat gently, dispelling the pathogen without harming healthy qi and nourishing the nutritive blood without trapping the pathogen.

He could not argue. His father’s authority had to stand: people trusted an old physician, not a man his age. Yet following the prescription could worsen her condition.

Another substitution was necessary.

He turned the medicine chest away from his father, selected and wrapped the herbs and gave them to the woman, explaining how to take them and what to avoid.

An old woman in the crowd scratched her head.

“Doctor, I’m crawling with lice. The itching’s unbearable. Could you help?”

A child rubbed his own shaved head.

“Shave it, like mine!”

She made to kick him. He clapped his hands over his backside and dodged, making everyone laugh.

“Simple enough,” Zuo Gui said. “I’ll give you a medicine to boil and wash your hair with. Let it dry naturally afterwards; don’t rinse it with clean water. Wrap all your hair in a headcloth overnight. By morning, every louse and egg will be dead. The medicine isn’t poisonous. Don’t worry.”

“Wonderful! How much?”

“We’ll be back over the next few days. Pay when it’s worked.”

“Thank you!”

He instructed his son to wrap some stemona root, bai bu.

Zuo Shaoyang was impressed. He knew stemona killed parasites, but had never thought of using it for head lice. Modern life rarely offered a head full of them; that application had never become familiar to him.

They were about to leave when an old man ran up, breathless, and pointed at several male onlookers.

“You men! Come quickly! Our young master’s ill. We must carry him into town. The master wants you to help!”

They were presumably his tenants. They agreed at once and followed.

“Father,” Zuo Shaoyang said quietly, “let’s look.”

“What for? They haven’t asked us.”

His father’s scholarly pride was exasperating.

“We’re travelling doctors. We’re meant to bring help to people. There’s no harm in seeing whether we can do anything.”

“Well… very well.”

Zuo Shaoyang hurried after the men with the chest. Near the village entrance stood a substantial courtyard house with high walls and glazed roof tiles. Impressive here, though far below wealthy town houses. Some village rich man’s property, he supposed.

Outside waited a cushioned couch, four poles rising from its corners to support a gauze canopy. The curtains were drawn aside. It was empty; the patient had not yet been brought out.

Panting, he felt a little reassured.

He looked back. His father was still far behind, approaching at a leisurely stroll.

He hardly knew whether to laugh or rage.

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