One consultation draws to a close, and the next patient has a very different problem.
Ben gave an embarrassed smile. “Not bad, not bad,” he mumbled. “I didn't expect you to get the better of me, Evan. You've made a lot of progress.”
Evan smiled and nodded.
The others rolled their eyes.
Little Octopus was delighted that Evan had won. She hurried to ask, “Dr. Xu, what medicine should I take, then?”
Evan considered for a moment. “Take… Siwu Tang…”
“Huh?” Ben and Clara both froze. Damn. Siwu Tang again?
Ben almost laughed. After all that, he was still prescribing Siwu Tang?
“With… Sijunzi Tang, plus ginseng and cinnamon bark,” Evan continued. “I'll use Shiquan Dabu Tang as the main formula.”[1]
“Shiquan Dabu Tang?” Little Octopus said in surprise. “Isn't that what those sleazy middle-aged men take on TV?”
Evan pressed his lips together. “You should watch less junk on TV. Shiquan Dabu Tang comes from the Song-dynasty Taiping Huimin Heji Jufang, China's first pharmacopoeia. It's also called Shiquan Yin. It's mainly used for qi and blood deficiency or persistent uterine bleeding.[2]
“The Siwu Tang in it nourishes and invigorates blood, moves qi, and dispels blood stasis. Sijunzi Tang replenishes qi and supports the Spleen. Your Spleen qi is too deficient. The Spleen controls blood. When it's deficient, there's too little qi in the middle to contain blood. That's why your periods come early. The ginseng I'm adding replenishes qi to help keep the blood in place.[3]
“The Spleen is the source of qi and blood. If it's deficient, there isn't enough being produced. With less coming from the source, your menstrual flow is lighter too. Sijunzi Tang supports the Spleen. As for cinnamon bark, it supplements fire and frees yang. I'll prescribe five doses first. Come back after you've taken them, and I'll see how you're doing.”[4]
“Okay!” Little Octopus grinned.
Evan wrote out her prescription, and she went to Clara to collect the herbs.
Only then did the reserved woman get up from her seat, walk over, and sit beside Evan.
He entered her personal details in the case record. Her name was Iris Gao.
Once he had finished, he asked, “Ms. Gao, what's troubling you?”
Iris frowned slightly and didn't answer.
“Ms. Gao?” Evan prompted.
She looked up at him. After a little hesitation, she said, “I… don't have period pain. But I have a strange illness.”
“A strange illness?” Evan asked, puzzled.
Iris nodded. “I get a fever when I have my period. Around the day before it starts, I begin to feel cold. After nightfall, I start running a fever. My temperature ranges from 38 to 39.5°C. Then, after midnight, the fever goes away on its own.
“It keeps happening for six or seven days—cold first, then fever, then the fever goes down on its own after midnight. Once my period is over, that stops too.”
The others were taken aback.
Clara had been about to dispense the herbs. She stopped, stunned. What sort of illness was that?
Little Octopus looked over too, baffled.
Ben looked at Evan in astonishment and suspicion. The kid had even found a shill with a difficult case!
Clara's expression shifted. Of course she knew this woman wasn't a fake patient Evan had hired. She really did have this illness. Clara just hadn't expected anything so strange.
Evan's brow furrowed too.
Iris took a large stack of test reports out of her bag. “I've had tests at hospitals too. When I have the fever, my white blood count is 8.1.
“Neutrophils, 70 percent. Lymphocytes, 30 percent. Urinalysis normal, urine culture negative, malaria parasite test negative, liver function normal. The gynecological examination described the left adnexa as cordlike. Nothing else abnormal.”[5]
She gave a self-mocking little laugh. “Wondering how I can recite all that so well? Every hospital sends me for these tests, and the results are much the same every time. I've been to several hospitals. None of them has been able to cure it.”
Her spirits sank. “I've taken so many medicines. Penicillin, streptomycin, kanamycin, erythromycin… Even antibiotics don't work! I really don't know what else to do. I've even wondered if I'm possessed. How can it be so strange? I'm really… a little scared…”
She looked at Evan. “Dr. Xu, can you do anything?”
“I…”
Before Evan could reply, a stern voice called from the doorway.
“Iris!”
They all looked over. A man under 165 centimeters tall stood in the doorway with a serious expression. A Mercedes-Benz S-Class was parked by the road.
Damn. Someone with money.
“Honey?” Iris looked startled.
Clara looked surprised.
Evan looked outside.
Ben's mouth fell open. Damn. She even had a husband in on it. This was a big-budget production!
The middle-aged man walked in, frowning, his expression grim. “Iris, what are you doing here?”
“I…”
“Come on. Let's go home.”
Iris frowned. “I want to see a doctor.”
Her husband sounded displeased too. “I've had someone book you an appointment with a leading gynecology specialist at the Provincial People's Hospital. Get your things together. You'll go to the provincial capital shortly. Xiaoduo will go with you.”
“What about you?” Iris asked.
“I have a project to discuss shortly. After that, I have to put in a bid.”
“Oh,” she said softly, slowly lowering her head.
“Come on. We don't have much time,” he urged.
Iris shook her head coldly. “I'm not going.”
“Don't be unreasonable,” he said sternly.
“I'm not being unreasonable. It's not as though I haven't seen specialists. The same tests, over and over. The same medicines, over and over. I don't want to do it again.”
“This specialist is very well known. It's hard to get an appointment with her. I only got one through a friend.”
Iris still shook her head. “I don't want to go. It's too far. And I want to try Chinese medicine.”
Her husband stared at her, displeased.
No one else dared say anything.
Iris kept her head down and said nothing.
After a moment, he let out a hard breath through his nose. “Fine! Even if you want to try your luck with Chinese medicine, we should go to a specialist at the provincial Chinese medicine hospital. At least the city one. What are you doing at a little clinic like this?”
Iris didn't answer.
“How did you find this place?” he asked.
Clara began to feel guilty again.
Ben wanted a handful of seeds to snack on. What an entertaining show. Who'd written the script? A real professional!
Iris answered with a quiet barb. “Don't you have a project meeting? Aren't you worried about being late?”
“You…” He wanted to lose his temper but held it in. “You want to see someone here? Fine. Go ahead. Who's the doctor? You?” He pointed at Ben.
Ben was dumbfounded. Damn. He had a part in it too?
Iris shook her head. “No. I want to see Dr. Evan Xu.”
Only then did her husband look at Evan. He was speechless with anger. A tiny clinic was bad enough. But a Chinese medicine doctor this young?
And so damn good-looking?
Reader Notes
↩︎ Three formula names. Siwu Tang, “Four Substances Decoction,” is the familiar blood-nourishing formula. Sijunzi Tang, “Four Gentlemen Decoction,” traditionally replenishes qi and supports the Spleen. Combining them gives Bazhen Tang; the usual Shiquan Dabu Tang adds huangqi (astragalus) and cinnamon bark. Sijunzi Tang already contains ginseng. The Chinese novel says to add ginseng and cinnamon bark; the translation preserves that wording. These are traditional formula descriptions, not confirmation of this patient's prescription. Little Octopus's TV joke reflects her association of tonics with sleazy men, rather than establishing who the formula is for. Sources: HKBU — Sijunzi Tang (in Chinese); HKBU — Bazhen Tang and the related Shiquan Dabu Tang formula (in Chinese).
↩︎ The Song formulary. The Taiping Huimin Heji Jufang was an officially compiled Song-dynasty collection of formulas and a standard for preparing medicines at dispensaries. A formulary of compound medicines differs in scope from a materia medica describing medicinal substances. Evan calls it “China's first pharmacopoeia”; that broad claim is retained from his dialogue. The earlier, Tang-dynasty Xinxiu Bencao of 659 is also described as China's first government-issued pharmacopoeia, so “first” needs that distinction. Sources: The Palace Museum — Taiping Huimin Heji Jufang (in Chinese); China University of Geosciences, Beijing — Ancient Chinese earth science, Xinxiu Bencao section (in Chinese).
↩︎ Producing and containing blood. Capitalized Spleen refers to a traditional functional system, not just the anatomical organ. “Qi in the middle” means the qi of the Spleen and Stomach. Evan links two traditional roles: transforming nourishment to provide qi and blood, and keeping blood within its proper course. In his explanation, too little production accounts for the scanty flow, while too little restraint accounts for the early timing. This continues the qi-containment argument in Chapter 16. It is a traditional diagnostic explanation, not the result of a blood test. Sources: HKBU — Sijunzi Tang, traditional rationale (in Chinese); WHO — Chinese medicine terminology, entries 117, 243, 253, and 442.
↩︎ Fire, yang, and five doses. “Supplementing fire” and “freeing yang” describe traditional warming functions. They do not mean producing a literal flame or raising the patient's measured body temperature. Rougui is medicinal cinnamon bark. A ji, translated here as a dose, is a prescribed portion of herbal medicine intended for preparation. The novel supplies five such portions but no weights or preparation schedule; the English does not infer five days or five individual drinks. Sources: WHO — Chinese medicine terminology, entry 2453, warming yang; HKBU — Cassia Bark; Taiwan Ministry of Education — Ji, noun sense 3 (in Chinese).
↩︎ The test reports. A total white blood count and a differential count provide different information: the latter gives the amounts or percentages of particular white cell types, such as neutrophils and lymphocytes. The Chinese text gives “8.1” without a unit, which is preserved here. In a gynecological report, adnexa refers to the ovaries, fallopian tubes, and supporting structures. “Cordlike” preserves the report's description without supplying a diagnosis or identifying a particular organ as diseased. Sources: MedlinePlus — Blood Differential; US National Cancer Institute, SEER — Abstracting Keys, anatomical definition of adnexa.