My sworn brother Li Xiaopu, a talented scholar who obtained an official position, later assisted his cousin the Prefect of Yuzhou in administrative affairs. The prefecture greatly benefited from his capabilities. Later, when his cousin was dismissed due to rebel disturbances, Xiaopu remained to defend the city and was commended with a fifth-rank honorary title. Returning to Jiexiu in 1861, we developed a close friendship.
One day at his residence, I noticed his nephew present with an apparent request. Xiaopu explained: “My nephew’s daughter-in-law lies critically ill after consulting over ten physicians – her condition worsens with each (used in traditional contexts). We remain ignorant of her ailment. We implore you to examine her, that we might prepare accordingly if hopeless.”
Out of our close friendship, I followed them in to examine her. The patient lay curled under quilts like a plucked chicken, with pale lips, nails and complexion. I immediately observed: “This indicates severe blood deficiency. Was this postpartum-related?”
Her mother-in-law answered: “She’s been bedridden since miscarrying in April.” I privately considered using Sheng Yu Tang (Holy Restoration Decoction) for extreme blood deficiency.
Closer inspection revealed purple-tinged blood vessels standing out on her face. Suspecting blood-heat, I checked her pulse – all six positions were deep and rapid, with the left guan (liver) position hard and pounding. Suddenly understanding: “This is liver damage from intense rage with heat invading the blood chamber. She must have an irascible nature. The illness originated from fury – current symptoms should include flank distension, red eyes, tinnitus. The spleen suffers wood-overaction (liver domination), causing spleen deficiency that weakens the lungs. Expect alternating cough, diarrhea, fever and palpitations. Though not consumptive, it approaches that territory.”
“Immediate (used in traditional contexts) could reverse this, but further delay would be fatal.”
The patient nodded weakly from her pillow, maids concurring. Reporting to Xiaopu, all expressed relief. I prescribed Modified Xiaoyao San (Free Wanderer Powder) combined with Zuojin Wan (Left Metal Pill), advising: “Though not a complete (supports), four doses should show effect. Re-examine afterward.”
Five days later at a tavern, Xiaopu informed me the patient had refused medication due to family discord, and he hadn’t pressed the matter.
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