Zhu Yuanzhang did not find Empress Ma at Kunning Palace.
"Where is the empress?"
"Your Majesty, Her Majesty has gone to the Imperial Food Bureau."
Zhu Yuanzhang was not surprised by this answer.
Both before he proclaimed himself emperor in Yingtian and afterward, Empress Ma had personally directed the palace servants in preparing his meals.
As Empress Ma put it, she could only rest easy if she watched the servants do the work.
"Go fetch the empress. Tell her I have something important to discuss with her."
"Yes, Your Majesty."
The Imperial Food Bureau was now staffed entirely by female officials, palace maids, and eunuchs, so it was also located in the inner palace. Before long, Empress Ma returned.
She was surprised to see Dai Sigong and Xiao Jiuxian there as well, bowing to her.
Once the greetings were over, she asked, "Chongba, are you feeling unwell again?"
Zhu Yuanzhang was already fifty. Though he looked hale and hearty, he was not free of illness. In his youth, he had endured prolonged hunger and starvation. Later, while serving in the army and fighting wars, he had eaten irregularly. After establishing his foundation in Yingtian Prefecture, he had often missed meals while attending to affairs of state.
Moreover, because his youth had been so bitter, Zhu Yuanzhang had developed a habit of binge eating and a preference for greasy food. In recent years, he had consequently suffered occasional abdominal bloating and congestion, as well as recurring indigestion.
The intense demands of governing, coupled with his constant vigilance and suspicion, also kept Zhu Yuanzhang's nerves taut. He already showed signs of "worries and fears accumulating in the heart," sometimes experiencing unease (anxiety), agitation, and irritability.
Empress Ma had repeatedly urged Zhu Yuanzhang to eat on time and not overwork himself, but to no avail.
It was not that Zhu Yuanzhang refused to heed her advice. He simply could not do it.
Seeing this, Empress Ma could only take greater care over his diet, instructing the Imperial Food Bureau to prepare three daily meals that suited his tastes without being difficult to digest.
That was why, upon seeing the imperial physicians, Empress Ma assumed Zhu Yuanzhang was feeling unwell again.
On second thought, however, something seemed wrong-if Zhu Yuanzhang was ill, why would he bring the imperial physicians to Kunning Palace?
Could he have developed some serious illness that required her to hear the physicians' instructions in person?
Just as Empress Ma began letting her imagination run wild, Zhu Yuanzhang said, "My dear, I want the imperial physicians to take your pulse."
Empress Ma looked thoroughly surprised. "I haven't been ill lately. Why would I need my pulse taken?"
"Who says you can't have your pulse taken when you're not ill?" Zhu Yuanzhang said. "They draw their salaries from me. I can have them take a pulse whenever I please."
At this point, Dai Sigong tactfully added, "Your Majesty, even if you are not ill, it would still be good for us to examine your pulse."
"Very well, I'll do as you say," Empress Ma said with a smile. "But Chongba, you must let the physicians take your pulse too."
Zhu Yuanzhang had already intended to do so. He went with the current and nodded. "All right. We'll both be examined."
Dai Sigong and Xiao Jiuxian then took turns examining Empress Ma and Zhu Yuanzhang, taking their pulses, observing them, and asking about their health. They employed all four diagnostic methods: inspection, listening and smelling, inquiry, and palpation.
When they finished, Dai Sigong and Xiao Jiuxian could not help exchanging glances. Seeing this, Zhu Yuanzhang asked bluntly, "How is my dear wife's health?"
Since Xiao Jiuxian was more skilled and experienced in treating women's ailments, he answered, "Your Majesty, Her Majesty's vital energy was damaged by inadequate recuperation after childbirth in her early years. Though careful treatment has restored some of it over the years, the foundation of her health remains unstable."
"She must not overexert herself in daily life, nor should she remain confined to one place. It would be best for her to walk about regularly and relax her mind. With some gently warming, restorative prescriptions as well, there should be no serious concern."
Empress Ma had heard such advice more than once. She was not surprised, and even the smile on her face remained unchanged.
"Did you hear that, my dear?" Zhu Yuanzhang said. "You mustn't overwork yourself from now on. If the Imperial Garden isn't enough for your walks, you can go out to the outskirts of the city."
"I know," Empress Ma said with a smile, then changed the subject. "How is His Majesty's health?"
"His Majesty's health concerns are the same old ailments..." Dai Sigong said.
After Dai Sigong repeated the diagnoses and advice he had given when treating Zhu Yuanzhang before, Zhu Yuanzhang fell into thought.
In truth, such minor ailments were perfectly normal at his age-many common men born into hardship did not even live to fifty.
For all his public claims that he was the true Son of Heaven, protected by Heaven's mandate, he knew perfectly well that he was only mortal flesh and blood. To govern the country and keep power in his grasp, he rose at cockcrow almost every day and did not rest until midnight. He also had countless matters to ponder. It would have been strange if his body had no ailments at all.
Still, even with a few health problems, he could live at least another dozen years.
But his dear wife...
At this thought, Zhu Yuanzhang looked at Empress Ma and said with solemn gravity, "My dear, this time I'm giving you an order-you must never overwork yourself again."
"Aren't there other consorts in this palace? Find one you trust and like, and have her shoulder some of the inner palace's affairs."
"Think about it. If anything happened to you, who could I entrust the inner palace to? And who would look after my meals properly?"
Though Empress Ma did not know why Zhu Yuanzhang was so solemn about this today, she found his words reasonable. She nodded. "All right, I'll listen to you. But you must follow the physicians' advice too and work a little less."
"I know," Zhu Yuanzhang said with a smile.
Then he turned to Dai Sigong and Xiao Jiuxian. "I intend to recruit a few more imperial physicians. Do either of you have anyone to recommend?"
Dai Sigong and Xiao Jiuxian both fell silent for a moment.
The title of imperial physician might sound impressive, but it was hardly a good post.
As physicians who treated members of the imperial family exclusively, their standing was far higher than that of ordinary doctors. Within the court, however, only Dai Sigong, as the academy's director, held a relatively high rank. Xiao Jiuxian, its administrative officer, ranked below even minor officials of the eighth or ninth rank.
Most importantly, when a physician treated ordinary people, failing to cure them would at worst result in someone coming to make a scene and demanding the consultation fee back. Even incorrect treatment would, at most, ruin his reputation.
But if an imperial physician made a mistake while treating someone in the imperial family, the lighter punishment was confiscation of his property and exile; the heavier was losing his head.
The man before them, in particular, killed without blinking-during last year's Blank Seal Case, he had executed several hundred officials in one fell swoop and exiled thousands!
On top of that, the salaries Zhu Yuanzhang paid imperial physicians were not particularly high.
Dai Sigong, as director, received an annual salary of only 192 shi of grain. Xiao Jiuxian, as administrative officer, received just sixty shi.
And part of those salaries was paid in paper currency.
The rewards for successfully curing members of the imperial family were substantial, however, and could be considered the two men's main source of income.
Yet those rewards came only if they cured the illness. If they failed, or treated it incorrectly, they could be exiled or beheaded.
Under such circumstances, very few physicians among the common people were willing to become imperial physicians. Dai Sigong and Xiao Jiuxian themselves had been forcibly recruited after Zhu Yuanzhang heard of their reputations and sent men to summon them.
With service as an imperial physician so dangerous and difficult, would recommending someone not amount to pushing him into a pit of fire?
But since Zhu Yuanzhang had asked today, they certainly could not simply say they knew no one.
Seeing that Xiao Jiuxian remained silent, Dai Sigong knew this task would fall to him.
Brother Lou, forgive me.
Sighing inwardly, Dai Sigong bowed with his hands clasped. "Your Majesty, I have spent many years in the capital and truly do not know which renowned physicians are practicing throughout the realm today. But I had an old friend during my years in Zhejiang whose medical skills were respectable. Perhaps he could be of service."
Zhu Yuanzhang never readily believed what others said to his face.
He asked directly, "What is his name? Where is he now?"
"His name is Lou Ying, courtesy name Quanshan, and he is from Xiaoshan in Zhejiang," Dai Sigong said. "His great-grandfather, Lou Wenjun, was once a renowned physician in Zhejiang. He has a strong foundation in his family's teachings, is well versed in the principles of the Book of Changes, and is especially skilled at preparing medicinal elixirs."
Zhu Yuanzhang nodded slightly, then fixed his gaze on Xiao Jiuxian. "Physician Xiao, do you have no one to recommend?"
Bracing himself, Xiao Jiuxian replied, "Your Majesty, I have been in the capital for nearly ten years. Apart from treating our noble patients, I spend my days buried in medical books and seldom make friends. I truly do not know whom I could recommend."
In Hongwu Year One, Empress Ma had developed a breast abscess (a nursing sore) after giving birth. Because the affected area was difficult to speak of and could not be shown to others, Chen Junzuo, the imperial physician at the time, had been almost helpless. Though he enjoyed Zhu Yuanzhang's trust, he was not skilled in treating women's ailments, and Empress Ma had nearly died.
To save Empress Ma, Zhu Yuanzhang had disregarded the risk of revealing intimate palace secrets and issued an imperial proclamation seeking a physician.
At the time, Xiao Jiuxian had been serving as a community head in his hometown and had escorted tax goods to the capital. Upon learning of the matter, he took down the proclamation and cured Empress Ma. Afterward, Zhu Yuanzhang recruited him as an imperial physician and administrative officer at the Imperial Medical Academy.
Zhu Yuanzhang still remembered the debt he owed Xiao Jiuxian, so when he saw his discomfort, he did not press him.
After dismissing the two men, Zhu Yuanzhang exchanged a few more words with Empress Ma before returning to a side hall of the Hall of Heavenly Favor. Instead of reviewing memorials, however, he drank tea and sank into thought.
He was considering two matters.
First, apart from recruiting more renowned physicians into the Imperial Medical Academy, were there other ways to improve its ability to diagnose and treat illness?
Second, he was recalling Dai Sigong's and Xiao Jiuxian's reactions and expressions when he asked them to recommend renowned physicians.
Especially Xiao Jiuxian's.
Back when he had posted the imperial proclamation to save Empress Ma, none of the physicians in the capital or the surrounding area had dared take it down.
Those who had discerned Empress Ma's ailment from the proclamation's veiled wording all understood that, with such an illness, failure to cure her would very likely bring his wrath down upon them.
Only Xiao Jiuxian had put aside excessive concern for his own safety, taken down the proclamation, entered the palace, and cured Empress Ma's breast abscess.
Why, then, was Xiao Jiuxian now unwilling even to recommend a renowned physician to the Zhu family?