Official Zhang Yiduan of the Zhili Provincial Treasury, a straightforward man from a prominent family, was awaiting an official appointment in Zhili. After returning home to observe mourning for his mother, he often attended banquets with me, displaying an elegant demeanor. As his nephew, Sima (a historical official title) Zhang Wenquan, shared the same scholarly rank as me, I respectfully addressed Zhang Yiduan as “Uncle.”
In the summer of 1860, Zhang suddenly developed hearing loss, requiring others to shout to communicate. When I invited him to a summer gathering, I noticed his sluggish reactions and learned of his condition. During our conversation, I offered to examine his pulse.
He explained the illness had begun in mid-April. Four previous physicians had diagnosed “Liver Qi stagnation” and prescribed dozens of doses of liver-soothing herbs, all ineffective. Upon examination, I found his six pulses deep, rapid, and slightly weak. I explained: “This is caused by flaring of deficient fire (yin huo shang chong). In medicine, the ears are governed by the Kidneys: strong Kidney Qi ensures sharp hearing; deficient Qi causes muffling; cold in the Kidneys leads to auditory decline; heat in the Kidneys blocks the ear passages. Your condition is Kidney Heat Syndrome, not Liver Qi stagnation. Children in my hometown often suffer this—severe cases even discharge yellow fluid. Continuing liver-soothing herbs would worsen it.”
When asked for (used in traditional contexts), I prescribed Anemarrhena & Phellodendron Rehmannia Decoction (Zhi Bai Dihuang Tang). He expressed concern about its cooling properties. I clarified: “Summer heat exacerbates internal fire, and your damp-heat in the stomach aligns with this formula. Stop once hearing recovers. If unresolved, switch to Ophiopogon & Schisandra Rehmannia Pill (Maiwei Dihuang Wan), though its effects are slower.”
I later forgot this case. Over a year later, his cousin Zhang Li, a Xiucai (a scholar rank), informed me Zhang had regained full hearing after just four doses. Zhang subsequently thanked me repeatedly.
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