The next morning, when Miaozhen woke up, she noticed a round fan on the table—a gift from Lin Xiaoxiao. It had a palm bamboo handle in a begonia shape, with double-sided silk gauze embroidered with a floral and butterfly pattern. She gazed at it for a while, lost in thought, then instructed someone to carefully put it away before heading to Mei Shi’s quarters. There, she mentioned that she would be accompanying Ru Shi to the free clinic that day.
Mei Shi had a plate of willow-leaf dumplings brought over. “In that case, eat a bit more to fill your stomach.” After saying this, she also ordered a bowl of lamb noodles and two eggs to be prepared.
Miaozhen massaged her forehead. “You’re going to burst my stomach.”
“Eat more to stave off hunger. I’ve also had two packs of pastries prepared for you to take along.” Mei Shi wished she could go with her daughter, especially since it was her first time interacting with strangers.
After hastily eating a little and wiping her mouth with a handkerchief, Miaozhen took a maid and went out by carriage to the Tao family’s residence first. Ru Shi then brought her and Ru Xiniang to the Xuanmiao Temple.
Ru Shi had borrowed a few rooms here for the free clinic. Inside, curtains were hung, and she instructed Miaozhen, “Light the Bihui Incense.”
In ancient times, there were no modern disinfectants, so they used burnt atractylodes or Bihui Incense instead. Additionally, when treating patients, one had to avoid being affected by their energy, or else they might fall ill themselves. Many acupuncturists and massage therapists practiced exercises like Baduanjin in the morning to strengthen their bodies.
Besides lighting incense, Ru Shi also instructed someone to boil water with salt and wash the needles and surgical tools in the pot.
“Before treating others, we must first protect ourselves.”
Miaozhen and Ru Xiniang both agreed.
As soon as the gong sounded at the front, the first patient to enter was a woman who was helped in by others. It was said she had fainted after experiencing heavy uterine bleeding. Miaozhen naturally began writing the medical case.
“Madam Tao, should we stop the bleeding first?” asked the woman’s sister, who was supporting her.
Ru Shi first checked the pulse and shook her head. “Although excessive fire has agitated the blood, this fire is not a true fire. If we only use hemostatic agents, it might stop temporarily, but I fear it will recur later.”
The patient might not have fully understood this, but Miaozhen did. The Yellow Emperor’s Inner Canon states, “Yin deficiency with yang excess causes collapse.” This woman likely had yin deficiency fire disturbing the blood chamber and causing the bleeding. Thus, stopping the bleeding alone wasn’t enough—nourishing yin was also necessary.
The woman’s sister asked, “What medicine would you prescribe, Doctor?”
“We’ll use Guben Zhibeng Decoction: one liang of thoroughly steamed Shu Di Huang, one liang of Bai Zhu stir-fried until charred, three qian of Huang Qi, five qian of Dang Gui washed in wine, two qian of Hei Jiang, and three qian of Ren Shen. Decoct all in water. Usually, one dose can stop the bleeding, and ten doses will prevent recurrence.” Ru Shi said.
Miaozhen naturally noted down the prescription and handed it to the woman’s sister.
After the patient left, Ru Shi explained to them, “Heavy uterine bleeding leads to excessive blood loss and deficiency of both qi and blood. Therefore, we must first replenish qi, then blood. Notice how the Hei Jiang helps guide the blood back to its channels.”
Miaozhen asked, “What if the bleeding doesn’t stop, the six pulses are absent, and the condition is even more severe than that woman’s?”
“Then we cannot start with Guben Zhibeng Decoction. Instead, use three qian of Ren Shen (with the root removed) decocted into a medicinal broth, then mix it with one qian of powdered Guan Zhong Tan and have her take it first. Once her breathing stabilizes slightly, administer the original prescription, still adding one qian of Guan Zhong Tan.” Ru Shi replied.
“But what if her breathing remains weak and shows no improvement?” Miaozhen asked.
“Then use ash-free yellow wine to mix three qian of carbonized cyrtomium rhizome powder. Wait until she’s fully conscious, then administer the Consolidating Foundation and Arresting Flooding Decoction, but replace the ginseng with codonopsis root, and still include one qian of carbonized cyrtomium rhizome.” Ru Shi explained in great detail.
Miaozhen finally understood – cyrtomium rhizome had the effects of clearing heat, detoxifying, cooling blood, and stopping bleeding. The carbonized version was processed through roasting.
Soon another woman arrived, pale-faced and hesitant, especially when she saw Miaozhen and Ru Xiniang. Ru Shi, however, showed no reservation: “They’re both physicians, and both women. You needn’t be afraid.”
The woman then confessed: “I was with child, but one day, the baby miscarried, and the bleeding hasn’t stopped since.”
“Did you observe the postpartum confinement?” Ru Shi asked.
The woman nodded: “Even after the confinement period, it continued. I’ve tried numerous hemostatic medicines with no effect.”
Ru Shi personally checked her pulse, then had Miaozhen do the same. Miaozhen first observed the sunken lower eyelids – clearly indicating uterine deficiency. This being her first practical experience, she carefully completed the pulse diagnosis before stating: “The middle feels hollow and soft, while both sides are firm – a hollow and tight pulse.”
The hollow pulse typically appeared in cases of acute blood loss, severe vomiting, or serious diarrhea. After checking the left pulse (corresponding to heart, liver, and kidney), she checked the right (corresponding to lung, spleen, and kidney).
“This disciple only detects excessive deficient fire.”
Ru Shi told them: “Miscarriage with flooding bleeding is usually caused by sexual intercourse. This differs from the previous case, so you must pay attention. The earlier patient had deficient fire disturbing the blood chamber, while this one results from qi deficiency causing blood collapse.”
Ru Xiniang, being somewhat knowledgeable about such matters, blushed slightly. But Miaozhen, not yet eleven, remained perfectly composed, as if hearing about ordinary matters like eating or drinking.
Seeing this, Ru Shi couldn’t help but nod inwardly, prescribing the Consolidating Qi and Replenishing Essence Decoction.
After the woman left, Miaozhen realized why she had been so hesitant – it was indeed due to miscarriage caused by intercourse. During pregnancy, the fetus relies heavily on kidney essence, so merely stopping bleeding wasn’t enough. They needed to strongly tonify kidney essence; otherwise, kidney water depletion would worsen deficient fire.
She listened as Ru Shi explained further: “If miscarriage results from falls or impacts, the bleeding often contains dark purple clots with dizziness and blurred vision. In such cases, we prescribe the Regulating Qi and Dispelling Stasis Decoction.”
Miaozhen carefully noted all of Ru Shi’s teachings. She thought Ru Shi seemed particularly skilled in gynecology – clearly explaining women’s flooding bleeding and postpartum care – though perhaps less exceptional in other areas.
Remembering how both Lin Xiaoxiao and her mother had lung diseases, she understood why they said Ru Shi’s medical skills were inadequate. This wasn’t Ru Shi’s fault.
She resolved to focus on mastering gynecology, setting aside other distractions.
Several more women came, most with gynecological issues. The last one had a twisted mouth, slanted eyes, and drooling, saying this happened after exposure to wind, accompanied by occasional chills.
This was wind-cold facial paralysis. In her previous life at the hospital, Miaozhen had frequently performed acupuncture for this condition. But Ru Shi didn’t fully trust her to handle it alone, only teaching her which acupoints to needle for facial paralysis and having her remove the needles.
“Madam, young ladies, your meal is served.” A Taoist nun brought their food.
Everyone washed their hands and went to the side room to eat. Having eaten so much in the morning, Miaozhen wasn’t very hungry and only picked at her food.
Ru Shi didn’t pressure her, saying: “Take a walk nearby. I need to speak with a Taoist master anyway.”
After Miaozhen left, Ru Shi indeed took her niece to visit a female practitioner. These female practitioners often moved among wealthy families and associated with the powerful, thus knowing a great deal of information.
Ru Xiniang had reached the age of hair-pinning. Having lost both parents, Ru Shi treated this niece as her own daughter, taking her along on medical visits to wealthy households in hopes of securing a good marriage for the girl. Unfortunately, most people nowadays valued substantial dowries and criticized her lack of parental support, leaving few satisfactory marriage proposals.
There was one alternative: if her niece could be recommended for palace service, that would be ideal.
Coincidentally, she had taken a young lady from the Xu Family as her apprentice. This girl had mastered in less than two years what had taken Xi Niang five years to learn. With rumors that Emperor Jiajing’s mother, Empress Dowager Jiang, was suffering from ulcerative toxins, and knowing that the inner court recruited through recommendations from local offices, she planned to use this female practitioner’s connections to get her niece into the palace.
Naturally, they first needed to find a skilled ulcer specialist for the girl to study under—another task requiring connections.
Their discussion lasted two full hours. Miaozhen had wandered outside for a while before returning to her room to rest, only seeing the aunt and niece return later.
Noting their evident delight, Miaozhen asked no questions. She understood that mastery mattered more than quantity in learning. She’d heard from her father’s yamen friends that Emperor Jiajing was seeking ulcer specialists for his mother among the populace. While Suzhou Prefecture had many renowned doctors, each specialized differently. Following the imperial example, their family’s bookstore now found previously neglected ulcer treatment manuals selling steadily.
Just as her previous life’s study of acupuncture had been her parents’ choice, her current focus on gynecology reflected both her innate talent and personal decision—one she had no intention of changing.
A lifetime spent perfecting one craft was accomplishment enough.
Thus, she applied herself diligently throughout the afternoon.
When Chou Niangzi from the Girls’ School taught them to prepare Braised Abalone with Bone, Miaozhen specially set aside two boxes for Ru Shi. Though Ru Shi favored her niece, she recognized talent and saw Miaozhen’s young but earnest character, gradually investing more effort in teaching her.
After the Summer Solstice, the growing heat left them drenched in sweat after each outing. Noticing this, Chou Niangzi granted them over a month’s break until after Autumn Begins.
This allowed Miaozhen to study full-time with Ru Shi from dawn till dusk. Her acupuncture skills advanced rapidly—already familiar with acupuncture points, she adapted to ancient needles and techniques, practicing countless times on her own legs. Her moxibustion skills likewise improved through constant practice.
One sweltering day, she returned with hair plastered wet and robes soaked through. Mei Shi suggested, “Perhaps rest a day or two?”
“Consistency yields best results,” Miaozhen replied. “That she takes me out two or three times monthly is already good. I had two bowls of iced kumiss on the road and feel much better.”
Mei Shi worried about chilled organs and advised moderation, but Miaozhen insisted iced treats prevented heatstroke in such weather. As they spoke, her father arrived with a cartload of ice purchased from an ice-ship vendor. Having repaid two hundred taels of silver over two years with another two hundred saved—now debt-free—the family no longer needed to count every coin.
Before the ice in the carriage had been fully used, heavy rain began to pour. Their house, built on higher ground, remained dry, but the homes of Da Fang and the third branch were leaking everywhere, with water flooding halfway up the walls.
Da Bomu’s family was relatively fortunate—they went to stay with her uncle. However, Da Bofu refused, feeling it would lower his status to rely on his wife’s family. He insisted on coming alone to seek shelter here. Left with no choice, Da Bomu brought Miaoyun along as well. Meanwhile, the third uncle and aunt, whose ground floor was flooded up to the bed legs, had to send Xu Siniang over, drenched like a drowned rat, since Xu Laoguan and Xu Laotai could move upstairs, but it was unsuitable for her to stay.
In an instant, the household gained four more people. Seeing the crowd, Miaozhen knew trouble had arrived.