You said I misdiagnosed?
He Dali’s home was in a deep alley in the southern part of Xinan City. From the Baihua Alley across the noodle shop, one had to walk for the time it takes to eat a meal, twisting and turning, to reach the He family’s doorstep. Since the Mid-Autumn Festival was approaching, some households had already lit lanterns under their eaves. After walking for quite a while, the sky had darkened considerably, and the evening breeze blew softly, with the orange lights flickering.
Yu Jinnian walked in the middle, occasionally marveling at the various lanterns on both sides. When his pace slowed, he heard deep breathing from behind.
“Ji Hong?” He called back.
The panting stopped. After a long pause, Ji Hong responded heavily, “Hmm.”
Yu Jinnian jogged back a few steps and saw Ji Hong stopping under a lantern. The warm yellow light cast on his face, yet the man still appeared pale. Just as Yu Jinnian was about to walk over, Ji Hong straightened his back and walked slowly towards him.
“Let’s go.” Leaving the small lantern, the man was once again shrouded in darkness. He spoke slowly, weakly, “It’s getting cold… let’s hurry back after this.”
Yu Jinnian stood still, watching as Ji Hong’s hand rested lightly on his chest. He reached out to support him, but Ji Hong pushed him away.
Though Ji Hong looked thin, he was actually quite sturdy. His push did not move Yu Jinnian but instead caused himself to wobble. Yu Jinnian, not wanting to argue, grabbed Ji Hong and lent him half his shoulder to lean on. There was a head’s height difference between them, making it look from a distance as if Yu Jinnian was leaning on Ji Hong.
After moving slowly for a few steps, Yu Jinnian tugged at Ji Hong’s sleeve and asked, “Do you feel better? Should we sit down?” He called out to He Dali, who was hesitating ahead, “Master He, please wait a moment!”
Ji Hong lowered his eyes, inexplicably annoyed, his mouth tightly shut. He let go of Yu Jinnian and steadied himself. Just as he was about to speak, he coughed a few times. Earlier, he had been walking too fast, holding back his breaths, and couldn’t hold it anymore, leading to a few urgent coughs. He quickly turned away, trying hard to suppress it, and said, “โฆIt’s nothing, we’re almost there.”
Yu Jinnian stretched out his arm: “Then hold onto me.”
Ji Hong refused, insisting on walking unsteadily by himself. The road was dark, and after just a few steps, he leaned against the wall, clearly unable to continue.
Yu Jinnian also leaned against the wall and said, “Then let’s both stop here; no one is going anywhere tonight.” He was frustrated because, as a doctor, he had known from the first glance that Ji Hong’s health was not good, yet he had made him walk so much. He hadn’t noticed Ji Hong’s stubbornness and was only focused on the patient at the He family, forgetting that Ji Hong wasn’t strong either.
They were both patients, neglecting one for the other was a dereliction of duty.
He Dali, a straightforward person, heard Yu Jinnian and thought he really wanted to turn back, and immediately started to panic: “Brother Xiao Nian, this…”
“Why are you angry?” Ji Hong saw the boy’s eyebrows furrowed into a knot, and his already palpitating heart tightened even more. He shook his head and grabbed the boy’s arm, saying helplessly, “I’ll follow your lead. I’m not that seriously ill…”
Although he said that, Yu Jinnian could feel the body he was supporting leaning more and more, with almost half of Ji Hong’s weight pressing on his shoulder: “When we get back, I’ll give you a proper checkup.” If he hadn’t already promised He Dali, he would have wanted to return to the noodle shop immediately to check on Ji Hong.
“I trust Sir Yu’s medical skills,” Ji Hong said softly, his voice barely audible but because they were so close, it seemed to flow directly into Yu Jinnian’s ears, gentle and soft. Despite Yu Jinnian being just a young cook with a few medicinal dishes that had cured some ailments, he wasn’t deserving of the title “Sir.” But this playful compliment broke the tension between them, and the atmosphere became harmonious again.
He Dali also breathed a sigh of relief and led the two into his home.
The He family’s courtyard was narrow, leading straight into the main hall. He Dali asked them to sit and rest for a while and then turned to call his wife to serve tea. Yu Jinnian, anxious to get Ji Hong back, insisted on checking on He Ertian first.
He instructed Ji Hong: “You sit here, I’ll be back as soon as I finish.”
Ji Hong, feeling a bit better, shook his head and wanted to go with the boy. Naturally, Yu Jinnian extended his hand again, slightly supporting Ji Hong to prevent him from getting dizzy and falling.
He Dali, having heard Yu Jinnian call the handsome young man “brother” at Aunt Wu’s house, had always thought they were siblings. At this moment, he couldn’t help but sigh inwardly at their “brotherly love and respect.” He recalled the farce with his own brothers when they split the family, which was simply disgraceful.
The three of them had just reached He Ertian’s door when they heard coughing from inside. The door opened, and a doctor with a wooden medicine chest and a sighing woman walked out.
He Dali sighed as well, “Every afternoon and evening, the coughing starts again.”
The woman was not very old. She wore a silver hairpin, the most fashionable style of this season’s street market, with an exaggeratedly curled petal of some kind of apricot, pear, or peach blossom inserted diagonally into her bun, making it very delicate. He Dali, being able to buy such a refined hairpin for his wife, suggested that their relationship was deep, and thus, they doted on their only son even more.
Seeing her husband bringing two strangers, He Dali’s wife was momentarily stunned before she greeted them, guessing that her husband had found another doctor. Many doctors had come and gone over the past few months, but her son’s illness still lingered. Seeing Yu Jinnian and Ji Hong, she had no expectations and even felt somewhat numb.
“This is the skilled healer from Jiaan Hall, Doctor Zou,” she said.
The sharp-faced doctor raised his face, and a nasal sound came out as a greeting to Yu Jinnian.
In Xinan County, there were two well-known medical halls: one was Shouren Hall, and the other was Jiaan Hall. The two halls were less than a hundred steps apart, rivals and competitors. Doctor Zou of Jiaan Hall was notoriously difficult to invite.
He Dali respectfully greeted Doctor Zou, then introduced, “This is Brother Nian from the Noodle Shop, and the other is his elder brother. Everyone says Brother Nian can treat illnesses with food. Didn’t our Ertian say the sugar dumplings from Brother Nian’s shop were delicious? So I invited them over.”
Upon hearing it was Yu Jinnian, He Dali’s wife finally smiled. However, before she could exchange pleasantries, the doctor at the door coldly snorted, “Just a show-off.”
Yu Jinnian pretended not to hear and went inside to see the patient.
A moment later, there was a sudden exclamation from the doorway. The doctor, along with his medicine chest, fell to the ground. Yu Jinnian turned back at the sound, only to see Ji Hong withdrawing his foot and walking in with a composed expression.
“…”
As he reached Yu Jinnian’s side, Ji Hong brushed off his sleeve and coldly remarked, “Just a show-off.”
Yu Jinnian chuckled softly, then quickly regained his composure and seriously began examining He Ertian.
He Ertian was about the same age as Yu Jinnian. Seeing that the visitor was younger than himself, he didn’t even bother to lift his eyes. Holding a bowl of medicinal soup, his face was flushed. Just as he was about to drink it, he frowned and started coughing. The coughs were short and dry, with little phlegm.
“Not drinking it!” He Ertian said angrily.
“Did you take any other medicine or eat anything?” Yu Jinnian asked He Dali’s wife. After receiving negative answers, he sat opposite He Ertian, smiling, “Young Master He, could you show me your tongue?”
He asked about other medicines because they could affect the accuracy of the tongue examination, leading to a false coating that could mislead the diagnosis.
He Ertian, who spent his days with a group of idle youths, was considered a sycophant by his father. Yet, He Ertian himself felt quite accomplished and on par with those young masters.
So, hearing Yu Jinnian call him “Young Master He,” he was delighted and, clearing his already hoarse throat, stuck out his tongue. “Are you also a doctor?”
Yu Jinnian glanced at the unusually large water jug by his side and smiled, “Just a cook.” After examining He Ertian’s tongue and taking his pulse, he asked a few questions before focusing on the bowl of medicine on the table. He frowned slightly, “This medicine…”
“It was prescribed by me. What’s wrong with it?” The doctor, who had fallen, had not left yet and sneered.
Yu Jinnian looked at his bruised nose and then at Ji Hong’s indifferent face, almost laughing again but managed to hold back. He continued, “This medicinal soup smells very bitter.” Seeing some medicine residue in another bowl, he picked it up and examined it, identifying, “Scutellaria, Anemarrhena, Mulberry bark, Gentian…” No wonder it was bitter; they were all bitter and cold herbs.
He Dali had been seeking doctors left and right for quite some time. Seeing Yu Jinnian’s serious expression, he immediately asked, “Is there something wrong with this medicine?”
“Not exactly…” Yu Jinnian smiled.
The doctor snorted again, interrupting Yu Jinnian: “What do you know? Good medicine tastes bitter!”
Ji Hong glanced over, and the doctor, clutching his nose, took a step back in fear. Yu Jinnian’s gentle smile remained unchanged, but his gaze turned slightly cold. After assessing He Ertian’s condition, he bowed to He Dali and his wife, saying, “I will go back to prepare some food now and will have it sent over tomorrow.”
With that, he took his leave, pulling Ji Hong along with him.
The doctor was instantly angered. Zhou Heng, who walked in Xinan County, was always addressed as “Divine Doctor Zhou” by those who saw him. Even in the dead of winter, when the county magistrate sent someone to invite him, they had to wait in the clinic. This young boy actually did not show him any respect!
Yu Jinnian, having left the room, had no intention of being disrespectful. He had seen Doctor Zhou’s prescription and had some thoughts, but he was aware of the professional etiquette. Publicly pointing out someone’s mistakes, making their future work difficult, was unacceptable. After all, to err is human. He planned to find an opportunity outside to discuss He Ertian’s condition with Doctor Zhou.
Unexpectedly, Doctor Zhou, embarrassed and angry, grabbed at him: “You boy, don’t rush off. Explain yourself clearly!”
He was still holding his medicine chest. Yu Jinnian, facing away, didn’t see this action and was chatting with Ji Hong. Ji Hong’s expression changed, and he suddenly stepped back, wrapping an arm around Yu Jinnian’s waist.
Yu Jinnian felt a sudden dizziness as he was pulled into a cold embrace, hearing a muffled grunt above his head.
Startled, he quickly looked out from behind Ji Hong’s shoulder and saw that the wooden corner of the medicine chest had struck Ji Hong’s side. Anger surged from his heart. He broke free from Ji Hong’s arm, touched the spot where he was hit, and asked Ji Hong if it hurt.
Ji Hong looked down at Yu Jinnian and shook his head gently.
Although Ji Hong was to him like a temporarily sheltered stray, even if he was a temporary guest, this was still Yu Jinnian’s domain. How could he allow outsiders to bully him?
“What are you doing!” Yu Jinnian glared at Doctor Zhou. “Embarrassed into violence? Are you trying to silence us?”
Doctor Zhou, although he had accidentally swung the medicine chest, was taken aback by the sudden fierce reaction from the previously soft and gentle young boy: “You…”
Yu Jinnian retorted, “You what? Shouldn’t you apologize to my brother?”
Ji Hong glanced at Yu Jinnian again. For some reason, he felt a bit happy and didn’t stop the boy’s outburst, merely standing quietly on the side, continuing to “act weak.”
Hearing the commotion outside, He Dali hurried out to mediate, repeatedly calling Doctor Zhou “Divine Doctor,” which only inflated Zhou Heng’s ego further, making him even less willing to apologize to Yu Jinnian, whom he saw as an ill-mannered boy.
Yu Jinnian sneered and said, “Then let me make it clear as โDivine Doctor Zhouโ wishes. Your prescription is indeed a good one…”
Zhou Heng smugly replied, “Of course.”
“โBut it’s the wrong prescription for this condition.”
Hearing this, Doctor Zhou was infuriated and, ignoring Ji Hong’s cold glare, rushed over to confront Yu Jinnian: “Say that again, what’s wrong with my medicine?”
Yu Jinnian remained calm and raised his chin, slowly saying, “As a fellow healer, you should see that the young master of the He family is coughing. For coughing, one must differentiate the type of cough, the phlegm, and whether the condition is due to internal or external causes. Otherwise, it is easy to mistreat.”
“You say I misdiagnosed?” Doctor Zhou glared.
“From your prescription, it seems you used a method to clear the liver and reduce fire. However, the young master’s issue is not due to an excess of wood-fire overwhelming metal but rather due to lung yin deficiency. Using excessively bitter and cold medicines to clear the lungs and purge the liver will not only fail to relieve the symptoms but will also further damage the yin and deplete fluids.” Yu Jinnian wanted to ask for paper and pen to write a prescription but remembered he couldn’t write, so he put the thought aside. Seeing Doctor Zhou’s disbelief, he continued, “The patient’s face is red, yes, but it’s not a full-face redness. The eye veins show no signs of redness, only the cheeks are flushed. This indicates the redness is due to deficient fire, not liver fire. Look at his tongue and pulse: a red tongue with little coating is a clear sign of yin deficiency. His cough worsens in the afternoon, a symptom of lung dryness and yin deficiency. Furthermore, his pulse is rapid but not wiry. Without a wiry pulse, how can you say he has excessive liver fire?”
The doctor stammered a rebuttal, “But… how could he be yin deficient?”
Yu Jinnian turned to He Dali: “May I ask how your son fell ill in the spring?”
He Dali hadn’t yet spoken when his wife angrily began, “It’s those rascals! Just as spring started, they made my son go into the water to catch fish. The spring cold was still harsh, and when my son came back, he fell seriously ill, coughing violently. He had just started to recover after taking medicine when those rascals called him out again. This cycle of taking medicine and falling ill repeated, leaving him with this lingering illness…”
“Cough, mother, don’t say such things!” He Ertian came out, coughing anxiously.
So that was itโprolonged illness damaged his yin, causing deficient fire to rise and injure the lung meridians. That incident of falling into the water was the trigger.
The doctor mulled it over for a while, his face suddenly changing, and he fell silent. Yu Jinnian knew he didn’t need to say more. The next steps would involve removing the inappropriate medicine and using a method to nourish yin, clear heat, and moisten the lungs to gradually improve He Ertian’s condition.
Seeing the doctor silent, He Dali and his wife felt relieved and quickly gathered around Yu Jinnian: “Brother Nian, can Ertian be cured? What medicine should we use? Tell us, even if we have to sell everything we own, we’ll do it!”
Yu Jinnian, having vented his anger, could no longer stay angry and smiled, shaking his head: “No need to sell everything. There are still some key details I need to think through. Tomorrow, Master He, please come to the noodle shop, and I will give you the medicine and the prescription.”
“And one more thing. Until your son recovers, his clothes, bowls, and utensils should be kept separate from yours. After use, boil them in a separate clay pot. Also, do not sleep in his room at night, and if he drinks milk, it should be boiled first.”
He Dali, though not fully understanding, nodded repeatedly, agreeing to everything. His wife then gave some money to Yu Jinnian for travel expenses before sending the two of them out. The doctor who had prescribed the wrong medicine glared at Yu Jinnian before quickly disappearing with his medicine chest.
Yu Jinnian only symbolically took two copper coins, saying they would discuss money after seeing the effects of the medicinal food tomorrow.
—
As they slowly walked home, Ji Hong noticed the boy seemed absent-minded, no longer as enthusiastic as before. He grew solemn, thinking Yu Jinnian was still upset about the unethical doctor, and asked, “Are you still angry?”
Yu Jinnian looked up at Ji Hong, seeing that the man’s complexion had improved somewhat but his lips were still pale, and his expression remained weak. He quickly took off his outer robe and draped it over Ji Hong, smiling with curved eyes: “It’s nothing, I was just thinking about some things.”
“Have you figured it out?” Ji Hong, taking advantage of their close walking position, secretly touched the boy’s hand, feeling its warmth, which reassured him as he wore Yu Jinnian’s outer robe.
Yu Jinnian made a noncommittal sound and mumbled, “Perhaps it’s a gamble…”
“A gamble?” Ji Hong asked, puzzled.
A gamble that the He family’s young master’s condition was just a chronic cough due to lung yin deficiency, rather than the dreaded and feared tuberculosis, known in traditional Chinese medicine as consumption (่บ็จ, fei lao). Consumption is caused by tuberculosis bacteria eating away at the lungs, leading to a prolonged illness often characterized by yin deficiency symptoms, afternoon fevers, and a cough that is very similar to a yin deficiency cough but fundamentally different.
While consumption often presents with yin deficiency, not all yin deficiency coughs are consumption.
Yu Jinnian had seen many patients with consumption and had learned some experience during his apprenticeship. Although yin deficiency coughs theoretically also have afternoon fever symptoms, in clinical practice, truly feverish patients were rare. During his inquiry, he learned that He Ertian didn’t frequently have fevers. Although he had been ill for six months without recovery, he didn’t seem as frail as Yu Jinnian had imagined. However, this did not completely rule out the possibility of He Ertian being an atypical case of consumption.
Distinguishing between yin deficiency cough and consumption was inherently difficult. Without X-rays, CT scans, or sputum smears, Yu Jinnian couldn’t be entirely certain which condition He Ertian had, hence he referred to it as “a gamble.”
Instructing He Dali to use separate utensils for his son was a precautionary measure to prevent potential transmission if He Ertian did have consumption.
“Does your waist still hurt?” Yu Jinnian shifted the topic away from the “gamble” and looked up to ask.
Ji Hong was about to shake his head but, seeing the concern in the boy’s eyes reflected in the dim light, inexplicably nodded instead.
Yu Jinnian said, “When we return, the medicine shop at Shouren Hall should still be open. I’ll buy some liniment to massage your waist.”
Ji Hong didn’t agree or disagree, allowing Yu Jinnian to take charge. Moreover, the thought of having his waist massaged… He couldn’t help but lower his gaze to the boy’s slender fingers, a flicker of emotion crossing his eyes.
Authorโs Note:
Today, when I typed Ji Yu, it came out as “Crucian carp” (้ฒซ้ฑผ)… There’s no helping it; it must be fate. The “Crucian carp couple” actually sounds pretty cool. Wishing them a smooth debut (?)
(This reporter, Qing Amao, is currently being double-teamed by the Crucian carp couple…)
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And happy New Year’s Day to everyone!!! It’s 2018, and may you all become even more adorable! Mwah!!