The Next Morning Free Clinic
The next morning, when Xu Miaozhen woke up, she saw a round fan on the table, a gift from Miss Lin Xiaoxiao.
It had a brown bamboo handle and was shaped like a begonia, double-sided with silk gauze and embroidered with a flower and butterfly design.
She was lost in thought for a moment.
After instructing someone to carefully put it away, she went to Mei Shi’s place and mentioned that she would accompany Ru Shi to the free clinic today.
Mei Shi had someone bring over a plate of willow-leaf dumplings.
“Since that’s the case, eat more to fill your belly.”
After saying this, she also had someone prepare a bowl of mutton noodles, with two eggs added.
Xu Miaozhen supported her forehead.
“Are you trying to burst my stomach?”
“Eat more so you won’t be hungry later. There are also two packs of snacks at home; I’ve had someone wrap them up for you.”
Mei Shi only wished she could go with her daughter herself.
After all, this was her daughter’s first time dealing with so many strangers.
After hastily eating a bit and wiping her mouth with a handkerchief, Xu Miaozhen took a maid and set out by carriage, arriving first at the Tao Family residence.
Ru Shi brought her and Ru Xiniang together to Xuanmiao Temple.
Ru Shi had borrowed a few rooms here to use for the free clinic, with curtains hung inside.
She instructed Xu Miaozhen, “Light the warding incense.”
In ancient times, there weren’t any modern disinfectants, so they would burn atractylodes or warding incense.
Also, when treating patients, you had to avoid being affected by their aura, or you could fall ill yourself.
Many doctors in their acupuncture and massage department would go running or practice Ba Duan Jin in the morning for health.
Besides burning incense, Ru Shi also had people boil water with salt to wash the needles and knives.
“Before treating others, we must protect ourselves first.”
Both Xu Miaozhen and Ru Xiniang agreed.
When the gong sounded in front, the first patient to come in was a woman being supported inside.
She had fainted after heavy uterine bleeding.
Xu Miaozhen, understanding her role, began writing the medical case.
“Madam Tao, should we stop the bleeding first?” asked the woman’s younger sister, who was supporting her.
Ru Shi first took the pulse, then shook her head.
“Although excessive fire can move the blood, this fire is not a real fire. If we only use hemostatic medicines, it may stop the bleeding for now, but it will likely recur in the future.”
The patient might not have understood, but Xu Miaozhen did.
The Huangdi Neijing says, “Collapse from deficiency of yin and excess of yang.”
This woman likely had fire from yin deficiency stirring the blood chamber, causing the bleeding.
So it wasn’t enough to just stop the bleeding; nourishing yin was also needed.
The woman’s sister asked, “Then, Doctor, what medicine will you prescribe?”
“We need to use Gu Ben Zhi Beng Tang: one liang of large prepared Rehmannia, steamed nine times; one liang of white atractylodes, stir-fried with earth until scorched; three qian of astragalus; five qian of angelica, washed with wine; two qian of Black Ginger; and three qian of Ren Shen. All boiled in water and taken as a decoction. Usually, one dose can stop the bleeding, and ten doses will prevent recurrence.”
Ru Shi replied.
Xu Miaozhen naturally wrote down the prescription and handed it to the woman’s sister.
After they left, Ru Shi said to them, “Uterine bleeding leads to excessive blood loss, depleting both qi and blood. That’s why we must tonify qi first, then blood. You see, Black Ginger helps guide the blood back to its channels.”
Xu Miaozhen asked, “What if the bleeding doesn’t stop at all, with no pulse, even worse than the last patient?”
“In that case, you can’t use Gu Ben Zhi Beng Tang at first. Use three qian of peeled Ren Shen, decocted into medicine, then mix with one qian of powdered Guan Zhong Charcoal and have her take it. Once her breathing improves, then she can take the original prescription, still adding one qian of Guan Zhong Charcoal.”
Ru Shi explained.
“What if her breath is still weak and doesn’t improve?”
Xu Miaozhen asked.
“Then use Wu Hui Huangjiu to mix with three qian of Guan Zhong Charcoal. When she’s fully conscious, then use Gu Ben Zhi Beng Tang, but substitute Dang Shen for Ren Shen, and still add one qian of Guan Zhong Charcoal.”
Ru Shi explained in detail.
Now Xu Miaozhen understood that Guan Zhong was used for its effects of clearing heat, detoxifying, cooling the blood, and stopping bleeding.
Guan Zhong Charcoal was processed for this purpose.
Next, a young woman came in.
Her face was pale, and she stammered, especially when she saw Xu Miaozhen and Ru Xiniang, making her too embarrassed to speak.
Ru Shi, however, was direct.
“They are both doctors and both women. There’s no need to be afraid.”
The woman finally spoke, “I was pregnant, but one day, I had a miscarriage and couldn’t stop the bleeding.”
“Did you do the postpartum confinement?”
Ru Shi asked.
The woman nodded.
“I finished the confinement, but the bleeding continued. I’ve taken all kinds of hemostatic medicines, but nothing works.”
Ru Shi took her pulse herself and had Xu Miaozhen do so as well.
Xu Miaozhen first checked her lower eyelid, which was sunken—evidence that the child palace was depleted.
This was her first real-life experience, so she took the pulse seriously before saying,
“Empty in the middle, full on both sides, wiry and tight.”
This kind of pulse often occurs in acute blood loss, severe vomiting, or serious diarrhea.
She checked both sides: the left was heart, liver, kidney; the right was lung, spleen, kidney.
“Disciple only feels excess empty fire.”
Ru Shi said, “Bleeding after miscarriage is usually caused by intercourse, which is different from the last case. You must be careful. The previous one was due to fire from deficiency stirring the blood chamber; this one is from qi deficiency and blood loss.”
Ru Xiniang, understanding somewhat, blushed slightly.
Xu Miaozhen, not yet eleven, remained calm, as if she were hearing about eating or drinking.
Seeing this, Ru Shi nodded inwardly and prescribed Gu Qi Tian Jing Tang.
After the woman left, Xu Miaozhen finally realized that the woman’s embarrassment was because the miscarriage was caused by intercourse.
When a woman is pregnant, the fetus relies on kidney essence most, so you can’t just stop the bleeding—you also have to strongly replenish kidney essence.
Otherwise, kidney water will be depleted, and empty fire will become worse.
Ru Shi continued to explain, “If the miscarriage was due to a fall or strain, and the bleeding is dark purple with dizziness, then prescribe Li Qi San Yu Tang.”
Xu Miaozhen carefully recorded Ru Shi’s words.
She thought Ru Shi was very skilled in women’s medicine, especially in treating uterine bleeding and postpartum care, but perhaps less so in other areas.
Thinking of Miss Lin Xiaoxiao and her mother both suffering from lung disease, it was no wonder people said Ru Shi’s skills were lacking.
But that wasn’t Ru Shi’s fault.
She still wanted to master gynecology, so she focused her mind and didn’t let herself be distracted.
Several more women came in, most with gynecological complaints.
The last patient had a crooked mouth and eyes and was drooling, saying she became this way after being exposed to wind and now suffered from chills.
This was wind-cold facial paralysis.
Xu Miaozhen had treated this with acupuncture in her previous life and was very familiar with it.
But Ru Shi didn’t let her take full charge, only teaching her which acupuncture points to use, and let her withdraw the needles.
“Madam, young ladies, your meal has arrived.”
A Daoist Nun brought their food.
Everyone washed their hands and went to the side room to eat.
Xu Miaozhen wasn’t very hungry, having eaten too much that morning, so she just ate a few bites.
Ru Shi didn’t mind and said,
“Go take a walk nearby. I need to talk with a certain Zhenren.”
After Xu Miaozhen left, Ru Shi indeed took her niece to see a Daoist Nun.
These nuns often moved among wealthy households and had ties to the powerful, so they knew a lot.
Ru Xiniang had reached the age to wear hairpins.
With both her parents gone, Ru Shi treated her as her own daughter, bringing her along to visit wealthy families, hoping her niece could marry well.
Unfortunately, people nowadays valued a heavy dowry and looked down on her for having no parents. Most suitors weren’t satisfactory.
There was, however, a solution: if her niece could be recommended to the palace, it would be ideal.
It just so happened she had taken the Xu family’s girl as a disciple. In less than two years, this girl had caught up with what Xiniang learned in five.
Empress Dowager Jiang, the Emperor’s mother, was said to be suffering from sores and toxins, and the inner court recruited doctors from civilian recommendations.
Ru Shi was hoping to use this Daoist Nun’s connections to send her niece into the palace.
Of course, they’d first have to find a doctor skilled in treating sores, which required connections.
The conversation lasted an entire hour.
Xu Miaozhen wandered outside for a while, then went back to her room to rest, only seeing Ru Shi and her niece return after some time.
Seeing their delighted faces, Xu Miaozhen didn’t ask further.
In truth, learning isn’t about quantity but quality.
She’d heard from her father’s friends at the magistrate’s office that Emperor Jiajing was seeking doctors among the people to treat Empress Dowager Jiang’s sores.
There were many famous doctors in Suzhou Prefecture, each with their own specialty.
As a result, the books on sores and ulcers sold at her family’s bookshop were kept in the bottom of the chest, but now there were still a few buyers.
Just like in her previous life, she studied acupuncture because her parents chose it, but she herself was best at gynecology, and she chose it in this life as well.
So she had no intention of changing.
If a person can do one thing well in their whole life, that’s enough.
So, in the afternoon, Xu Miaozhen studied diligently.
Later, Qiu Niangzi taught them how to make abalone with bone, and specially prepared two boxes to send to Ru Shi.
Although Ru Shi favored her own niece, she appreciated talent.
Seeing that Xu Miaozhen, though young, was kind and loyal, she treated her with more care.
After the summer solstice, the weather turned hot.
Every time they returned from outside, their clothes were soaked with sweat.
Seeing this, Qiu Niangzi gave them a break for over a month, telling them to return after the start of autumn.
This way, Xu Miaozhen could spend all day at Ru Shi’s place learning.
Her acupuncture skills improved by leaps and bounds.
She was already very familiar with acupuncture points, and now she adapted to ancient needles and techniques, pricking her own legs countless times.
She also frequently practiced moxibustion.
One day, coming home, her hair was soaked with sweat, and her back was drenched.
Mei Shi said, “Why not take a break for a couple of days?”
“Everything is best done in one go. These days, she only takes me out two or three times a month, which is already good enough. I even had two bowls of Bingluozi on the way home, and I feel quite comfortable.”
Mei Shi worried she might get a cold stomach and told her to eat less.
Xu Miaozhen replied that in such weather, not eating something cold might lead to heatstroke.
Just then, her father came home, having bought a cart of ice from the ice boats.
In the past two years, their family had paid off two hundred taels of silver, and her father still had two hundred taels in savings, more than enough to cover their debts, so they weren’t as tight with money as before.
But before they could finish using the ice, a torrential rain began.
Their house was on high ground and wasn’t flooded, but the main house and third branch’s homes leaked everywhere and were half-flooded.
Her eldest aunt’s family was fine—they went to borrow rooms from her uncle, but her eldest uncle was unwilling, feeling it made him lose face at his wife’s family.
He came alone to ask for a place to stay.
In the end, her eldest aunt brought Miaoyun Jiejie as well, and since the third uncle and aunt’s house was flooded up to the bed, Xu Laoguan and Xu Laotai could stay upstairs, but Xu Siniang couldn’t, so she too came over, looking like a drowned chicken.
All of a sudden, there were four more people in the house.
Xu Miaozhen knew that with so many people, trouble was bound to come.