Chương 1: The Dispensary

Chapter 1: The Dispensary
A bitter wind swept through the empty corridors of the county’s traditional Chinese medicine hospital. The white curtains hanging over the outpatient doorways, already stained with grime, flapped and rattled in the draft, making the deserted halls seem lonelier still.
Zuo Shaoyang stood in the dispensary doorway with his hands buried in his trouser pockets and his neck hunched against the cold. He surveyed the quiet outpatient wing with a sinking heart. Traditional Chinese medicine had fallen on hard times in recent years, and the hospital saw few patients even on an ordinary day. With the New Year approaching, there were fewer still.
After graduating from a university of Chinese medicine and enduring a miserable hunt for work, he had finally landed a job here as a pharmacist. He had hoped to see patients in the outpatient department. He had passed the national medical licensing examination long ago and received his certificate, but for some reason the hospital had never assigned him to clinical work.
An elderly woman pushed aside one of the curtains and emerged from a consulting room. Her back was bent, and the wind had tousled her hair. Rubbing her temple with one hand, she stooped over a prescription held close to her eyes, struggling to read it as she made her way toward the pricing counter.
Knowing she would soon come to collect her medicine, Zuo Shaoyang went back inside and took his place behind the dispensing window. He stamped his cold-stiffened feet, pulled his hands from his pockets, and breathed on them before rubbing them together. There was no air conditioning in the dispensary, only a small electric heater humming in a corner. It did little to warm the room. The noise merely made the cold more irritating.
A little later, footsteps approached. The woman’s finely wrinkled face appeared at the window. She worked her frozen cheeks into a faint smile.
“Could I collect my medicine, please? Thank you.”
Zuo Shaoyang took the prescription and read it carefully. Then he laid it on the desk, secured it beneath a paperweight, and spread out several sheets of brown wrapping paper. Taking up his small dispensing scales, he began weighing out the herbs.
When he had finished, he asked, “Do you know how to prepare this, ma’am?”
“Yes. I’ve taken it before.”
“Good. Just remember to let it cool a little before you drink it.”
She looked at him in surprise. “Let it cool? Why?”
“The doctor has prescribed Wu Zhu Yu Tang. It treats deficiency cold in the liver and stomach. You often have dry heaves and headaches, don’t you?”
“Yes—oh! How did you know, young man?”
“I saw you rubbing your temples as you came over.” He chuckled.
“Well, you’re quite right. After every meal I feel like throwing up, but hardly anything comes out—just some sour liquid. And the top of my head keeps hurting, right here. Painkillers don’t do a thing. My hands and feet are cold, too, and I have diarrhea.”
Zuo Shaoyang smiled. “That fits. The Treatise on Cold Damage says, ‘For dry retching, vomiting frothy saliva, and headache, use Wu Zhu Yu Tang.’ This formula is meant for your condition.”
“But why should I let it cool? My stomach’s already upset, and it’s freezing outside. Wouldn’t it be better to drink it hot and warm myself up?”
“This particular medicine has to be taken a little differently, ma’am. Your condition is deficiency cold in the liver and stomach, while wu zhu yu is a very pungent, very hot herb. You need to let the decoction cool before drinking it so it can work more effectively. As the saying goes, ‘Treat cold with heat, but administer it cool.’ It’s a method called fan zuo—counterbalancing the treatment.”
She blinked, still looking puzzled. “Counterbalancing? What does that mean?”
“It means doing one part of the treatment the opposite way. Your illness is a cold condition, so we treat it with warming, pungent herbs. But if you drink those herbs while they’re hot, the cold inside you is put on guard, and the medicine has trouble doing its work. Wu Zhu Yu Tang is strongly warming. Let it cool first, and the illness in your stomach mistakes it for a cooling medicine. Since the illness itself is cold, it sees no threat. By the time it realizes what’s happened, the medicine has already subdued it.”
Her face brightened.
“I see! A warming medicine, taken cool, to treat a cold illness. It’s like two armies going to war. Their soldiers wear different uniforms, so they can spot one another at a glance. Once they meet, they fight it out head-on. But if our soldiers put on the enemy’s uniforms, with a special mark only our own side recognizes, the enemy lets its guard down. Then our men slip into their ranks and attack from within. The enemy falls into confusion, and we win the battle. Is that it?”
“Exactly. Are you a teacher, ma’am?”
“I am. How did you work that out?”
“You explained an abstract idea with a vivid comparison. Teachers often do that. And there’s still white chalk dust between your fingers.”
She hurriedly rubbed her fingers together, looking a little embarrassed.
“Oh dear. I came straight from class and forgot to wash my hands. You don’t miss much, do you?”
“In Chinese medicine, we diagnose through observation, listening and smelling, questioning, and palpation. Observation comes first. If we don’t look carefully, we can’t get a full picture of the patient’s condition.”
“Quite right! Well said, young man. You’ll make a fine doctor one day.”
“Thank you, ma’am. Here’s your medicine. Oh, and remember to lie down for twenty or thirty minutes after taking it. Did the doctor tell you that?”
“No.” The elderly teacher looked even more surprised. “Lie down for half an hour after taking herbal medicine? Why? I’ve never heard of that.”
“Not after every herbal medicine—just after Wu Zhu Yu Tang. It has certain side effects. You can feel dizzy, get a tight feeling in your chest, and sometimes feel nauseous. Those are normal reactions to this medicine. They don’t need any special treatment. Just lie down for a while.”
“Really? That explains it. That’s exactly what happened when I took it before—every time. I thought the medicine might be wrong for me, so I came back and asked the doctor. Director Wang, in the Chinese medicine internal medicine department. He didn’t explain any of this the way you have. Just told me it was nothing, and that was that.”
“Perhaps Director Wang was too busy to explain,” Zuo Shaoyang said with a small chuckle.
“Busy? Hmph! He was busy…”
She glanced toward the consulting rooms and lowered her voice.
“He was busy playing games on his computer! When I asked him, he was terribly impatient. Kept his eyes on the screen and said, ‘It’s nothing.’ Wouldn’t even look at me. Nothing? I take your medicine, get dizzy, feel tight in the chest, and want to throw up, and you call that nothing? I was so angry. Still, I thought he must have something important to do, so I left. Then I peered back through the doorway. What did I see on his screen? Playing cards! That’s what he was so busy with—playing cards on his computer.”
She sighed.
“If only all doctors were as patient as you, young man. Is there anything else I should watch out for? Please tell me.”
Zuo Shaoyang hesitated, then spoke.
“The side effects can be quite strong. Ideally, a little huang lian could be added. It can reduce and control the toxic effects and other adverse reactions caused by wu zhu yu, so the symptoms would be much milder. But that combination isn’t part of the standard Wu Zhu Yu Tang formula. And I’m not working as a doctor yet, so I can’t prescribe it for you. That means…”
“That’s all right. I trust you! I’m sure you know what you’re talking about. Put in a little huang lian, and I’ll pay for it.”
“No, no, ma’am. You need to ask Director Wang to add it. We can’t prescribe medicine directly from the dispensary. Prepared Chinese medicines are one thing, but adding an ingredient to a decoction requires a doctor’s prescription. Just tell him you’ve heard huang lian can reduce the side effects of Wu Zhu Yu Tang, and you’d like a little added. It doesn’t take much. Three grams will do.”
“All right, then. Give me the prescription. I’ll go and ask him.”
The elderly teacher took the slip and headed back to the consulting room.
Zuo Shaoyang laid another sheet of brown paper on the desk, picked up his scales, and turned to weigh out the huang lian. He had barely finished when hurried footsteps approached.
The dispensary door crashed open. A gust of cold air swept in, sending the sheets of paper on the desk swirling to the floor.
“Zuo Shaoyang! What the hell do you think you’re doing?”
Director Wang stood in the doorway, his face dark with anger. The elderly teacher followed behind him, looking frightened.
“What’s wrong, Director Wang?” Zuo Shaoyang asked.
“What’s wrong?” Wang shook the prescription in his hand. “Tell me. Is there something wrong with my prescription?”
“No, of course not,” Zuo Shaoyang said quickly. “It’s entirely appropriate for her condition.”
“Then what gives you the right to add herbs to it?”
Zuo Shaoyang tried to smooth things over with a smile.
“I haven’t, Director Wang. There’s been a misunderstanding. I only suggested adding a little huang lian. When the two are used together, huang lian counteracts the harmful effects of wu zhu yu, which can reduce—”
“Do I need you to teach me?”
For some reason, Wang seemed furious beyond all proportion.
“I was treating patients while you were still kicking around in your mother’s belly!”
Zuo Shaoyang’s smile vanished.
“You’re an experienced doctor and my superior,” he said coldly. “I respect you. But I expect you to show me some respect, too.”
“You respect me? Is that what you call meddling with my prescriptions?”
“I only made a suggestion!”
“What suggestion? Don’t forget—you’re just a pharmacist! You’re not even a doctor. What right have you got to prescribe medicine for anyone?”
“I’ve passed the licensing examination, and I have my certificate. I’m qualified to practice medicine. The hospital just hasn’t reassigned me!”
Wang raised his voice.
“What’s that supposed to mean? The hospital management can’t recognize talent? You’re some thoroughbred they’ve failed to spot? They don’t know you’re a miracle doctor? Hmph! Even if you are, wait until you have a consulting room of your own. Then you can do whatever you please. Just keep your hands off my prescriptions!”