The First Patient

Su Ziyang had no patients all morning.

At noon, he had a little food in the Taoist temple's dining hall. He had to admit, the temple's vegetarian dishes were delicious, quite different from what Su Ziyang had imagined.

A little after two in the afternoon,

a middle-aged woman walked into Su Ziyang's consultation room.

"Hello. Are you Doctor Su?"

It was autumn, and the weather in the north had only just begun to turn cool, yet the middle-aged woman wore a hat and was wrapped up tight.

Su Ziyang took a close look at how she was dressed. She had to be a patient.

"Yes, I'm the doctor. Please sit down."

Su Ziyang gestured for her to take the seat beside the consultation desk.

After entering the room, the woman removed her mask and hat. Su Ziyang looked at her and asked, "What's bothering you?"

No sooner had Su Ziyang finished speaking than the woman began coughing violently.

There was no need to ask. It was definitely a cough.

"Oh, Doctor, it's this cough. It's terrible. As soon as my throat itches, I can't stop coughing."

The woman coughed as she spoke.

She didn't need to say it. Anyone could see how badly she was coughing, and she had been coughing ever since she came in.

Su Ziyang waited until the woman's breathing had steadied somewhat.

Then he took out the medical record book on the desk.

The Daoist Medicine Clinic's record book was simple, unlike the complicated medical records used in hospitals. Only basic personal information was entered at the top. Next came observations of the tongue and pulse. The rest was mostly blank paper.

The blank space was for prescriptions or the doctor's own analysis of the illness.

"May I ask your name?"

Su Ziyang began his consultation.

Traditional Chinese medicine placed importance on four diagnostic methods: observation, listening and smelling, inquiry, and palpation.

Observation meant looking at a person's appearance, complexion, and tongue coating.

Listening and smelling involved both listening to sounds and detecting odors.

Inquiry was the step Su Ziyang was carrying out now. All information about the illness was obtained by talking to the patient. Of the four diagnostic methods, inquiry was the simplest and easiest to learn. But it had a drawback: a doctor could easily be misled by a patient, and if a detail was missed, it was difficult to notice.

Palpation meant taking the pulse. The doctor mainly used three fingers-the index, middle, and ring fingers-on the patient's wrist to feel differences in the pulse and diagnose the illness.

Though Su Ziyang loved traditional Chinese medicine and studied it constantly, on the whole, apart from inquiry, he was not skilled in the other three diagnostic methods.

The ancients once said, "He who knows by observation is called divine."

Take the well-known historical story of Bian Que visiting Duke Huan of Cai. With a single glance, Bian Que diagnosed the duke's illness.

That story was a classic example of knowing by observation.

Su Ziyang loved traditional Chinese medicine, but he didn't believe such a thing.

Human eyes weren't like the ones in movies; they didn't have X-ray vision. How could anyone see an illness inside the human body with a single glance?

Looking at the tongue coating was reasonable enough. But how could it reveal an illness that would develop years later? Never mind an illness years in the future-even a current illness couldn't necessarily be identified clearly that way.

As for diagnosis by smell, it meant detecting odors. Su Ziyang knew that people with strong breath had stomach problems, and people with chronic kidney disease might smell of urine.

As for diagnosing an illness just by listening to someone's voice, Su Ziyang thought that was even less reliable than knowing by observation.

People spoke at different pitches and volumes, and their voices had different tones. But that was of little help in diagnosing an illness. If that was simply how someone normally spoke, how could a doctor tell?

Su Ziyang was even less capable of taking a pulse.

Apart from some mnemonic verses he remembered from school-floating, deep, slippery, rapid, large, long, and wiry; thin, faint, soggy, weak, deep, slow, and moderate, and so on-all pulses felt much the same to him. During his hospital internship, most of the doctors seeing patients couldn't take a pulse either, and no one held the practice in high regard.

Now that they had advanced medical equipment to support them, even fewer people bothered taking pulses. No matter how much feeling around you did, could you see as clearly as an X-ray? Could you see more clearly than an MRI?

Some particularly radical practitioners of traditional Chinese medicine even believed that pulse-taking was nothing but the ancients' conjecture.

Su Ziyang didn't agree, but he had never mastered the method and couldn't take a pulse himself. Even if he disagreed, his own inability left him with no way to refute them.

After a series of questions, Su Ziyang had a general understanding of her condition.

The middle-aged woman was named Liu Li.

Half a month earlier, while on her way to work, she had felt hot because she was wearing too many layers, so she had taken off her coat. After she took it off, a sudden gust of cold wind blew over her, and Liu Li's nose began to run.

Liu Li thought she had caught a cold. After all, colds were an everyday occurrence.

So Liu Li took some cold medicine at home, something like amantadine.

She had thought she would be fine after a night's sleep. Who would have expected her to start coughing violently in the middle of the night? Her temperature then shot straight up to 39 degrees.

Feeling absolutely miserable, Liu Li got up and took a packet of Anruike and some anti-inflammatory medicine. Only after her fever went down did she fall into a deep sleep again.

By the next day, her temperature had dropped, but she was still coughing. After a day at work, she felt the cough growing worse and went to the hospital.

The hospital ran a complete blood count and took a chest X-ray. They found a streaky shadow on her lung.

The hospital doctor explained that the streaky shadow indicated some inflammation, or it might have been left behind after she recovered from pneumonia or tuberculosis in the past. It was much like a scar left by an injury.

After hearing the doctor's explanation, Liu Li went to the hospital for an IV drip every day.

She kept it up for more than a week.

It only eased her cold and stuffy nose a little.

Not only had her cough failed to improve, it had gotten worse.

And after so much time on the IV drips, she felt weak all over.

After turning it over in her mind, Liu Li decided to stop seeing Western doctors. She found a traditional Chinese medicine clinic near her home instead.

After looking over her test results, the doctor at the clinic gave her much the same explanation as the hospital doctor.

The difference was that the clinic doctor recommended taking Chinese medicine.

Liu Li had no other options, so she followed the clinic doctor's advice.

She took Chinese medicine for more than half a month.

In that half month, she had actually spent nearly ten thousand yuan.

Only when the money was gone and she was still coughing did Liu Li finally realize what had happened.

She had been taken for a ride.

But there was nothing Liu Li could do. The clinic was legitimate and licensed, so complaining would be useless.

She still had to get treatment, though.

Angry, upset, and still coughing, Liu Li came to the Daoist Medicine Clinic on a friend's recommendation.

The doctors at the Daoist Medicine Clinic were all too busy. Only Su Ziyang's room was empty, so Liu Li went in.

After listening to Liu Li's story, Su Ziyang was so angry his teeth itched.

Traditional Chinese medicine was being ruined by swindlers like that.

Call him a swindler, and he wasn't entirely one, because he had a proper license and the required medical credentials.

Call him a traditional Chinese medicine doctor, and he couldn't cure illnesses, and the medicines he prescribed were mainly intended to make money. But if you complained and sued him, his prescriptions were perfectly conventional and had nothing wrong with them. All that could be said was that he hadn't cured the illness, and he wouldn't be held liable, because no doctor could guarantee a cure.

He had actually charged her more than ten thousand yuan for a cold and a cough.

Even if his consultation fees were high and he charged a lot, it would at least have been acceptable if he had cured her.

But in the end, he had accomplished nothing.

"Doctor Su, do you think my condition will be easy to treat?" Seeing Su Ziyang remain silent, Liu Li pressed him.

Su Ziyang made a token effort to take Liu Li's pulse, then looked at her tongue coating.

To Su Ziyang, her pulse seemed somewhat deep, which was consistent with the fact that Liu Li had been ill for quite some time. After a long illness, the body grew weak, and naturally the pulse beat weakly.

Her tongue coating was white, but the tongue itself was somewhat red.

"How about taking some Chinese medicine?" Su Ziyang asked.

Although Liu Li had been cheated by a traditional Chinese medicine practitioner, she was still very straightforward. "Of course. I came here for Chinese medicine."

After a moment's thought,

Su Ziyang wrote a prescription on the computer:

Platycodon root 4 g, schizonepeta 4 g, steamed aster root 5 g, steamed stemona root 5 g, steamed cynanchum root 5 g, aged tangerine peel 4 g, licorice root 5 g.

Three doses, to be decocted in water and taken orally.

The formula came from Medical Insights. It was a mild, balanced prescription for treating wind-cold coughs. It stopped coughs, cleared phlegm, released the exterior, and diffused lung qi. It was mainly used when wind pathogen invaded the lungs, causing coughing and an itchy throat, sometimes with slight aversion to cold and fever, a thin white tongue coating, and other symptoms.

In the original formula, the medicines above were ground together into a fine powder. Three qian were taken per dose, mixed with warm boiled water.

Su Ziyang had changed the formula into a decoction to make it easier to take.

The medicines in this formula were "warming, moistening, and gentle, slightly cooling but not hot. There is no danger of attacking too aggressively; rather, they have the power to open the door and drive out the thief. Thus, the invading pathogen is easily dispersed, and the lung qi is at peace."

It was a small formula, but it worked.

After Su Ziyang finished writing the prescription, Liu Li looked at his computer and asked a little awkwardly, "Doctor Su, how much will these medicines cost?"

Su Ziyang immediately understood. Liu Li had been frightened by being cheated and was afraid he would prescribe something expensive again.

Su Ziyang looked at the amount on the computer.

One dose of Chinese medicine cost 9.7 yuan; three doses cost 29.1.

Su Ziyang pointed to the computer and showed Liu Li. "That's 29.1 altogether, less than thirty yuan. Go downstairs to the first floor to pay, and pick up the medicine beside the payment counter."

"How much?"

Liu Li said in shock.

Her shriek startled Su Ziyang. You already spent ten thousand before, and now you think thirty yuan is too much?

Seeing Su Ziyang raise an eyebrow at her, Liu Li hurriedly explained, "No, no, Doctor Su, you've misunderstood. I was wondering if the medicine was too cheap."

Only then did Su Ziyang understand. Some people actually thought things were too cheap.

"Don't worry. Take it, and it'll work... Just prepare the decoction as usual when you get home. There are no dietary restrictions. Take it after meals."

Su Ziyang explained patiently.

"All right!"

Liu Li said "all right" with lingering doubt, then left.

Su Ziyang wrote the prescription he had just given her in the medical record book and added his own understanding below it.

The patient was a middle-aged woman. After she caught cold, wind-cold invaded her lungs, and the illness had not been cured despite prolonged treatment. Mistreatment with Western and Chinese medicines had also occurred, resulting in the door being shut on the bandit.

Therefore, he used Cough-Stopping Powder to gently regulate lung qi and expected her to recover after three doses.

Ever since his school days, Su Ziyang had recorded the cases he treated or encountered this way.

He had kept the habit ever since.

Su Ziyang also wrote down his own predictions.

Although he had treated few patients since his school days, Su Ziyang still kept his records very conscientiously.