Chapter 56: Staying the Night

“Well…”

Zuo Gui was troubled. In truth, he still had not worked out what was wrong with young Master Jia. The earlier prescription had been his son’s. It now appeared to have treated only the symptoms, leaving the root untouched. Did the boy have any further means of treatment?

Stroking his beard, he looked sideways at Shaoyang.

Shaoyang had no idea either. His prescription had targeted the acute convulsions, extinguishing wind, relieving spasms and reducing fever. The underlying illness remained unclear. But having taken the case, he had little choice but to face it. Slowly, he nodded.

That nod only made Zuo Gui less certain.

Previously he had believed the boy’s teacher an immortal, or at least a remarkable wandering physician whose prescriptions must surely cure. Now Auntie Li had relapsed, and Master Jia said his son had too. Neither illness had been eradicated. He could not help doubting that supposed teacher.

Perhaps he was simply an old freeloader who had copied a couple of prescriptions from somewhere and taught them to the boy. The woman with the undelivered dead child might have recovered by blind luck. Now the fraud was being exposed.

Whatever his doubts, they still needed a solution. Master Jia had fed and feted them, cursed Huimin Hall and praised them to the skies. They were riding a tiger and could not get off.

Zuo Gui gritted his ageing teeth in secret, forced a smile and nodded.

“Very well. We’ll examine him after the meal.”

“Wonderful! Thank you!”

Master Jia and his father beamed and urged more food and wine upon them.

Since they had a patient to see, the physicians stopped at a mild tipsiness. After the meal, maids served fragrant tea. Only when they had drunk it did the examination begin.

The boy wore a thick brocade padded jacket and was wrapped outside it in a heavy silk-floss quilt. His mother held him on a chair. He coughed now and then, with phlegm audible in the sound. His nostrils flared continually, and his little mouth hung open to help him breathe. Brow furrowed, he twisted restlessly. His face was greyish white and his lips faintly purple. Clearly some degree of suffocation persisted.

“What did Huimin Hall diagnose?” Zuo Gui asked. “And what medicine did they give?”

“That Doctor Ni said wind-cold had closed the lungs and the pathogen had sunk into jueyin, causing acute convulsions. I wrote down the medicines this time. Pills and powders: Ox-Bezoar Powder, Heart-Clearing Pills, and something called antelope horn powder.

“He also took that decoction with the long name from before. Let me think… ephedra and apricot kernel… gypsum… gypsum something…”

“Ephedra, Apricot Kernel, Gypsum and Liquorice Decoction.”

“Yes! That was it. He improved after taking it, so we brought him home. I never expected another attack that evening.”

Shaoyang considered the diagnosis and medicines. Wind-cold closing the lungs, with the pathogen sinking into jueyin, did not seem wrong. Ox-Bezoar Powder and antelope horn powder extinguished wind and relieved spasms. Heart-Clearing Pills cleared heat and toxins, reduced high fever and could restore consciousness. The decoction was a classical treatment for cough caused by unresolved exterior pathogens and heat congesting the lungs.

Judged against the symptoms, Doctor Ni’s medicines were appropriate. Why, then, had the illness recurred?

There was only one explanation: they had not identified the primary disease causing the high fever.

The boy showed a pattern of damp-heat congesting the lungs—in Western terms, childhood pneumonia. Bacteria and viruses commonly caused it. Without modern diagnostic equipment, identifying the precise cause quickly was difficult. Treating the symptoms, as Huimin Hall had done, was a common approach and could not be called wrong. But it did not address the root.

How, then, should the root be treated? What was it?

Shaoyang could not work it out.

Zuo Gui took the pulse, examined the tongue and stroked his beard.

“The boy is rather frail.”

“Yes, indeed.”

Master Jia looked round. Seeing his father seated some distance away, he lowered his voice.

“We have only this one son. His grandfather treasures him beyond anything. Never mind a beating or scolding—we aren’t even allowed to speak sharply to him. He’s been spoiled.

“To get him to eat a meal, someone has to follow him about with the bowl and coax him for ages, and even then he only eats half a little bowl. He’s terribly picky too. No meat, hardly any vegetables. He’s ill every few days. The slightest carelessness brings on a cold or cough, and whenever he’s ill, he gets a fever.”

“Children must not be indulged too much,” Zuo Gui sighed. “That is harm, not love. If he were stronger, he might never have become so ill.”

“Yes, yes.”

“Unwrap the quilt and open his clothes so we can look,” Shaoyang said.

The young mother looked distressed and held her son more tightly.

“Must we? It’s so cold, and he’s already caught a chill. It will make him worse.”

“Yes, exactly,” Master Jia agreed with an apologetic smile.

“Then never mind,” Zuo Gui said.

Shaoyang could not insist after that.

His father took the pulse a while longer and deliberated, but could find no way forward. He could only get through the immediate difficulty.

“The same pills as before, Zhong?”

He knew that Shaoyang’s substitution had helped the child, but had not yet had time to ask what the medicine was.

“The young physician gave me two yesterday,” Master Jia said eagerly. “We used one last night, and one remains. Since they work so well, could you leave us a few more?”

Zuo Gui nodded and looked at his son.

“How many have we brought?”

Shaoyang was in a quandary.

Purple Snow, which he had substituted for Three-Ingredient White Pills, was effective at reducing fever and restoring consciousness. It worked well for acute convulsions from high fever. But this boy’s convulsions came from fever, the fever from pneumonia, and the pneumonia kept returning because its cause had not been found.

Unless that cause was treated, the fever would recur. Each high fever could trigger further convulsions. Even if Purple Snow suppressed the fever and spasms, they would simply fall into a cycle: fever, convulsions, relief, then fever and convulsions again.

High fever was dangerous in itself. Failing to identify the primary illness meant not only failing to cure it, but risking other illnesses and critical complications, even death.

Prescribing blindly before differentiating the pattern would not remove the root. It might produce a changed pattern and complicate the illness, making treatment harder. Until he understood what was causing the pneumonia, he dared not prescribe at random or hand out Purple Snow indiscriminately.

“I… haven’t brought any,” he said quickly. “Could I bring some next time?”

“Of course. I still have one.”

Privately, however, Master Jia was thinking. The boy had taken the medicine twice: once before they brought him down to town, with marked improvement, then once after the relapse at home, again with improvement.

Was the recurrence due to stopping treatment, or did the pills merely suppress symptoms?

If the latter, perhaps the old physician was holding back until he received more money. Yet a covert glance at Zuo Gui’s face revealed no deliberate obstruction. Better not raise the fee for now. It would be best to keep them nearby, in case the boy worsened.

“It is late,” he said with a smile. “The town gates must be closed. Would you both do us the honour of staying here tonight?”

Zuo Gui knew the chief purpose was to have them at hand should the child suffer another attack. Their presence would reassure the family.

“Then we shall accept your hospitality. Auntie Li is seriously ill too and needs watching. We will stay the night.”

---

**Enjoyed this story?**
Discover more chapters of **The Young Physician of the Tang Dynasty** at [**NovelPotato.asia**](https://novelpotato.asia/the-young-physician-of-the-tang-dynasty/).