Mr. Zhao Churen, a pawnshop owner in Tianjin, lived comfortably but had an overbearing wife. They had several daughters and one son, all deeply cherished. During the summer of WuWu year*, their fifth daughter (about 6-7 years old) contracted smallpox.
When summoned for consultation, I observed dense pox lesions resembling silkworm eggs covering her entire body. The area around her lips showed particularly severe clustering without gaps. Her extremities were cold, and she couldn’t eat or drink.
Q&A:
- “Duration of symptoms?”
“Two days.” - “Fever present?”
“Mild.” - “Bowel movements?”
“Loose stools, frequent urination.”
Diagnosis:
“Typical smallpox manifests with fever and gradual eruption of distinct red papules over three days. This case shows alarming deviations: sudden full-body eruption within two days, abnormal lesion morphology, digestive/excretory dysfunction, and locked mouth (suokou). This constitutes a life-threatening complication (nizheng) with poor prognosis.”
The mother took offense at my frankness. Mr. Zhao silenced her with a glare. I stated: “I came to treat illness, not endure disrespect. Should anyone (supports) this within ten days, I’ll apprentice under them.” As I turned to leave, Mr. Zhao insisted on a prescription.
Prescription:
Shengma Gegen Tang (Cimicifuga Rhizoma [shengma] and Puerariae Lobatae Radix [gegen] decoction)
Add: Ginseng Radix et Rhizoma (renshen)
Astragali Radix (huangqi)
“This is palliative management,” I clarified.
Outcome:
The lesions slightly elevated next day. The family urgently requested follow-up, which I declined. They consulted another practitioner. Within ten days, the child succumbed to ulcerated lesions. The family later acknowledged my initial assessment.
Postscript:
Months later, Mr. Zhao bowed deeply upon meeting me:
“Why thank me for failed (used in traditional contexts)?”
“Had we heeded you, we’d have saved several guan*.”
“Destiny governs life. Without that expense, death might have tarried.”
He left tearfully.
Annotations
- *WuWu year: Traditional Chinese calendar designation
- *Guan: Ancient currency unit (1 guan = 1,000 copper coins)
- Locked mouth (suokou): Critical complication where perioral lesions impair breathing/nutrition
- Life-threatening complication (nizheng): TCM term for pathological progression contradicting normal patterns
- Shengma Gegen Tang: Classic formula for toxin eruption
- Cimicifuga Rhizoma (shengma): Black cohosh rhizome
- Puerariae Lobatae Radix (gegen): Kudzu root
- Ginseng Radix et Rhizoma (renshen): Ginseng root
- Astragali Radix (huangqi): Milkvetch root
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