Du Fei looked at Du Heng with gratitude. Du Heng’s complint had dispelled all his previous embarrassnt and re-established his good image in front of everyone. However, so things were best understood and left unsaid.
Du Heng ignored them and directly started writing on a prescription paper. After finishing, he tore off the duplicate copy and handed it to Du Jiang. "Go to the clinic now. Fei’s father is there; have him help you brew the dicine. You have children at ho, so don’t take it ho to brew."
Du Jiang gave Du Heng a thumbs-up, accepting the prescription with an admiring look. "You’re incredible, lecturing two people in one go."
"Stop talking nonsense," Du Heng retorted. "Scram and make way for the next person."
Du Jiang chuckled, took his prescription, and left.
The auntie waiting next took the seat, naturally extending her hand to Wu Buwei. This ti, Wu Buwei wasn’t flustered. He seed much more relaxed during the examination and consultation. However, Du Heng’s attitude changed this ti. For this patient, Du Heng expected Wu Buwei to accurately identify the cause of illness, or at least not be too far off the mark. That would be considered a pass. So, as Wu Buwei began the examination, Du Heng observed him attentively.
"Auntie, what’s wrong? Where are you feeling unwell?" Wu Buwei began the consultation after taking her pulse.
The auntie didn’t hold back and repeated what she had just told Du Heng. "My stomach has been hurting a bit these past two days. When I bend over to do so work, the soreness in my waist is unbearable. Standing for a long ti is also uncomfortable; it’s both sore and painful."
"Any other symptoms?"
The auntie thought for a mont. "I have a slight headache."
Wu Buwei thought he understood her condition. However, recalling that Du Heng had examined a patient with kidney disease and edema that morning, Wu Buwei had learned sothing. He carefully checked the auntie’s arms and legs again, finding no edema. Now he was sure. This patient’s characteristics were very similar to those of the patients they had encountered in Mubangou, just lacking a few symptoms. But that didn’t matter; the main symptoms were the sa. With Du Heng’s excellent precedent, he felt fully confident.
However, to be cautious, Wu Buwei didn’t speak to the patient directly. Instead, he first turned to Du Heng. "The pulse is thready and rapid, the tongue coating is pale white. There’s dizziness, and soreness in the waist and knees. This indicates kidney yang deficiency. Treatnt should aim to tonify the kidney and warm the yang."
Having said this, he calmly waited for Du Heng’s affirmation and praise. But Du Heng rely sighed.
As expected, Wu Buwei had fallen right into the trap. But he couldn’t bla the young man. After all, he was still a novice, and his diagnosis was sowhat close to the mark, which was acceptable.
Du Heng prompted, "When you were taking her pulse, did you notice if the auntie’s wrist felt a bit warm?"
Wu Buwei was startled but still didn’t realize his mistake. He answered honestly, "A little warm, yes. But her wrist was inside her sleeve, so it’s normal for it to be a bit warr, isn’t it?"
Du Heng shook his head. He didn’t criticize Wu Buwei but pointed to the record chart. "What was her temperature when you asured it earlier?"
Wu Buwei had already seen it and replied directly, "37.2 degrees. That’s normal, isn’t it?"
"How did we asure her temperature?"
"With a forehead thermoter."
"Alright, 37.2 degrees isn’t technically a low-grade fever by the numbers. But what’s the outdoor temperature right now? Have you considered that this auntie has been standing outside for so long, yet her temperature is still 37.2—and that’s a forehead reading? Doesn’t that make you a bit suspicious?"
Du Heng’s tone was light, yet Wu Buwei felt imnse pressure.
"Regarding kidney disease, I examined a case this morning. Besides the lesion itself, external factors can also trigger it. You didn’t consider that. You didn’t ask if the patient had been sick recently or taken any dication. That’s a failing in your consultation."
"I’m sorry, Senior Brother."
"Don’t say sorry. Focus on careful consultation and syndro differentiation."
The complacency that had just begun to swell in Wu Buwei’s heart was shattered by Du Heng’s few words. Though he felt dejected, the patient was right in front of him. He had to pull himself together and try again.
"Auntie, have you been ill recently? Have you taken any dicine?"
"Yes, actually. The day before the day before yesterday, I caught a cold. I took so dicine, then bundled up under a quilt and sweated a lot. After that, the cold seed to get better. My head didn’t hurt as much, and my nose stopped running. It was only starting the day before yesterday that my waist began to feel uncomfortable."
"What dicine did you take?"
"Four Seasons Cold Tablet."
"How many tis did you take it, and what was the dosage?"
"Only twice, two tablets each ti. What? Did I take too much? That can’t be right; the instructions said two to four tablets."
Wu Buwei was stumped too. Bundling up to sweat, the dicine taken, the dosage—none of it seed problematic. So where did this waist problem co from?
"Auntie, has your waist ever felt uncomfortable like this before?"
"No, it never really has."
Wu Buwei was at a loss. He couldn’t connect these factors to her waist discomfort. Du Heng didn’t press him further, as he hadn’t held high expectations to begin with.
Clearing his throat, Du Heng began to explain to Wu Buwei, "The ’Golden Mirror of dicine’ states: ’In the winter months, if one contracts a cold and resolves it with profuse sweating, there may be slight abdominal pain and an inability to bend or straighten the waist. So believe this is because the pathogen is still in the kidney ridian and has not been expelled. This is not the correct understanding. It is, in fact, because excessive sweating has led to a loss of yang qi, resulting in yang deficiency, which the yin cannot then support.’
"’Yin and Yang are interdependent. In this case, excessive sweating depletes yang qi. The yin, itself struggling, dares not draw the yang inward. With no place to return, the yang qi circulates in the abdon; this solitary yang, unanchored, causes pain. The yin in the kidneys, because the yang qi does not return, becos solitary yin without a partner. It dares not ascend via the ’river carriage path’, hence the inability to bend or stretch the waist.’"
Wu Buwei finally understood. Hadn’t he learned this before? Yes, he had! Hadn’t Du Heng explained it? Yes, he had. This was all covered when they studied the ’Treatise on Febrile Diseases’ not long ago. He could only bla himself for not studying diligently, not taking it seriously, and failing to thoroughly integrate what he had learned. Ah, a syndro of depleted yang!
"So, the root of the illness is still a Greater Yang stage condition, a disorder caused by cold," Du Heng said. He paused, looking at Wu Buwei’s dejected expression. He knew he needed to help this young man regain so confidence. "The condition is clear now. You write the prescription."
Wu Buwei hesitated. He had lost his initial decisiveness and was beginning to doubt himself.
Seeing his hesitation, Du Heng encouraged him again, "Go on, say it with confidence. The condition is clear; what’s there to be unsure about?"
Wu Buwei hesitated for a long mont, then said uncertainly, "Use... the Atractylodes and Aconite Decoction? Or the Yang-Drawing Decoction?"
Du Heng clapped enthusiastically. "Excellent! Both of those formulas are very suitable." Du Heng not only encouraged him with his expression but also provided practical validation. "The Atractylodes and Aconite Decoction can consolidate the exterior and warm the ridians. The Yang-Drawing Decoction boosts flourishing yang qi without excessively supporting weak yin qi."
With that, he picked up his pen and began writing the prescription. "This ti, I’ll use the Yang-Drawing Decoction. One dose will stop the abdominal pain, two doses will ease the waist discomfort, and after three doses, she’ll be able to bend and stretch naturally."
"I understand now. Thank you, Senior Brother."
Du Heng chuckled. "Thanking is useless. Go back, copy your texts, and morize what you need to. Now, focus on the next patient; don’t just stand there in a daze."
"Understood."
Du Fei, standing behind them, observed Du Heng’s way of teaching Wu Buwei. He felt nothing but envy. He was a dical student with an associate degree and had learned a few skills from his father. But whether it was his college education or learning from his father, a village doctor, the level he could reach was predictably limited. He also yearned to improve. However, in traditional Chinese dicine, the difference between having a good master and not having one was truly night and day. He often wondered who Du Heng had learned from and how he had managed it. A few years ago, Du Heng was unremarkable, yet suddenly he had beco so formidable. Seeing the auntie’s expression—confused yet deeply impressed—Du Fei truly felt a pang of envy.
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