19 The Ma Family Patient

In the morning, Miaozhen stretched on her bed; there was truly nothing like the comfort of home. Reluctantly rising, she first shared a meal with Madam Mei and greeted her two younger brothers. She distributed the trinkets she had brought back from Wuxi to them, then visited Madam Ru at the Tao residence before finally setting off to find Ma Yulan.

To her surprise, Mrs. Ma was evasive. Confused, Miaozhen asked, "Auntie, what is wrong with Sister Ma?"

"Zhenzhen, you should go back. Your Sister Ma is ill and cannot receive visitors," Mrs. Ma said, ushering her away.

Upon returning home, Miaozhen immediately asked Madam Mei, "What is the matter with Sister Ma? Her mother wouldn't even let me see her."

Madam Mei whispered, "I heard she has contracted a grave illness. They even invited a Taoist priest to ward off evil spirits, and they refuse to let outsiders in. I don't know what to make of it."

"If that is the case, she likely wishes not to disturb others," Miaozhen thought. Fearing it might be a private, sensitive matter, she decided to press no further.

Over the years, she had accompanied her master in treating illnesses, often for wealthy and prominent families. She knew that for a patient to recover, they must be proactive; if they hid their symptoms or spoke in riddles, a physician could not make an accurate diagnosis, rendering the treatment futile.

At noon, she rolled moxa sticks the size of jujube pits and performed moxibustion on Xu Erpeng’s *Shousanli* acupoint, placing a slice of ginger in between.

After the treatment, Miaozhen proceeded to scrape his *Hegu* acupoint. Xu Erpeng leaned back on his lounge chair, feeling deeply refreshed: "Having a physician like Zhenzhen in the family is better than anything else. I can feel the *qi* and blood flowing through my arm again."

"Father, you are exaggerating," Miaozhen said with a smile.

Xu Erpeng, who had often been kept awake by pain in his shoulders and arms, felt so comfortable after the midday treatment that he felt drowsy.

If Madam Ru was renowned for her achievements in gynecology and precise diagnoses, the Tan family was celebrated for their mastery of moxibustion—a technique capable of treating deep-seated, chronic illnesses. They also placed great importance on the teachings of Zhu Danxi, which was why most of the medical texts Miaozhen studied were related to his school of thought.

Just as Xu Erpeng finished his treatment, Feng Niang arrived. She was worried about a lump on the left side of her neck. "I’ve tried applying chicken blood and burning incense, but nothing works. Miss, what kind of illness is this? It even seems to move."

Miaozhen felt the lump, first acting to ease the patient's nerves. "Do not worry. I have encountered this before; it is a case of phlegm-nodules. *Danxi’s Heart Mirror* states that when a person suffers from internal deficiency, such lumps can manifest throughout the body."

Feng Niang had been hardworking during her time at the Mei residence, and even after arriving at the Xu household, she remained unable to sit idle. Miaozhen led her into the inner chamber, asked her to remove her outer garment, and applied moxibustion to her *Yifeng* and *Jianjing* acupoints. The *Yifeng* point is the intersection of the *Shaoyang* meridians of the hand and foot, and the *Jianjing* point is even more critical. During the treatment, she also wrote out a prescription.

"I will have you drink the *Danggui Lianqiao* decoction to fortify your health and expel toxins, promoting the drainage of pus and the regeneration of tissue. I am also adding the *Erchen* decoction; you may not know this, but *Erchen* decoction can treat phlegm throughout the entire body. Two *qian* of *Cangzhu* (atractylodes) will serve to eliminate the phlegm, and one *qian* of *Qingpi* (green tangerine peel) will help dissipate the stagnation," Miaozhen explained.

Although she held the title of Tan Yunxian’s disciple, she knew she had to carve out her own reputation. In the modern era, one could slowly build a name in a hospital, but in the ancient world, one had to build a reputation through word of mouth—which meant starting from within one's own circle.

By first healing her own family, she would soon be able to treat neighbors, and her name would spread naturally.

Thinking of this, she feared Feng Niang might be reluctant to pay for the medicine, so she prepared to use her own private savings. Feng Niang quickly protested, "It is enough that you, Miss, have diagnosed and treated me; if you were to pay for my medicine as well, I would not be a person at all."

Although Feng Niang was originally from the Mei family, she had earned Madam Mei's deep trust since joining the Xu household. She received a bonus every Lunar New Year and intended to spend her twilight years with the Xu family, thus treating Miaozhen and her two younger brothers as her own children.

"I have money of my own, so do not worry," Miaozhen insisted. She then asked a maid to take the prescription to the front for a servant to fill at the pharmacy.

Feng Niang was filled with gratitude, but Miaozhen waved it off as nothing.

After Feng Niang left, she prepared to rest for a while, as acupuncture was taxing, especially after the recent exhausting travels. No sooner had she dozed off than Miaoyun arrived. Miaozhen quickly rose, "Big Sister, why have you come?"

"I heard from my father that you were back, so I came to visit." Miaoyun noted that Miaozhen was dressed in a simple, plain top of medicine-spotted cloth and a white cotton-linen skirt, looking nothing like a wealthy young lady.

Miaozhen did not consider her family wealthy either; her father had only a few hundred taels of silver to his name, and the entire household relied on the bookstore. Without land or ancestral assets, a single misfortune could leave them vulnerable.

Seeing that Miaoyun had come specifically to see her and had even brought fruit, Miaozhen smiled. "It has been years since we last saw each other. Let us sit and talk."

Miaoyun nodded with a smile, mentioning that her mother was currently working on a dowry for the Fang family, a job that would take two years. "My mother’s eyesight isn't what it used to be. I truly wish she wouldn't embroider so much."

"Embroiders are prone to that. You should buy some chrysanthemum and goji berries for your aunt to drink as tea," Miaozhen suggested.

In Suzhou, where needlework and weaving were common, many women found their vision blurred by the age of forty, though a gifted few could continue embroidering well into their eighties or nineties.

After some casual conversation, Miaoyun remarked nonchalantly, "I recall you learned embroidery from your family’s female tutor, didn't you?"

"Yes, she taught me everything from drawing patterns to matching colors and selecting threads," Miaozhen said, feeling a pang of nostalgia for Mistress Qiu.

Miaoyun was clearly fishing for information. Though her mother had once served as a private tutor, that was only out of respect for her great-uncle; such opportunities were no longer available. Since she presented herself as a student of Mistress Qiu, she had to be well-informed. She asked to see the pattern manual, and Miaozhen, unaware of her ulterior motives, had Xiaoxi bring it over.

As Miaoyun held the manual, she spoke of what to give as a wedding gift for Xu Siniang while secretly memorizing the order of the patterns.

Trying not to make it obvious, she shifted the topic. "Look, your manual goes from easy to difficult. It's just like our studies. I remember you studied with Scholar Yu, and later with Mistress Qiu. Was there a difference?"

"Indeed, a massive one. Mistress Qiu taught us not only reading, writing, cooking, and needlework, but also placed great emphasis on poetry and prose," Miaozhen smiled.

Seeming very interested, Miaoyun begged to see Miaozhen’s notes. Miaozhen pointed to the bookcase on the left: "There, they are right there."

"I’ll take a look and see how they compare to what I’ve learned," Miaoyun said, smiling as she walked over.

Miaozhen stood up, saying, "Go ahead, Sister. I need to organize my medical records." Maintaining medical records was a vital task, providing a basis for evaluating the effectiveness of treatments.

After writing her notes, she still had to roll moxa, make sachets, and attend to various other chores.

Miaoyun secretly perused the notes. After half an hour, seeing the room was quiet, she immediately rose to leave, and Miaozhen had a maid see her out.

Once the maid returned, Miaozhen asked, "Did you feel as though Big Sister was unusually interested in my studies today?"

Xiaotao, who was always slow to notice things, said she didn't know. But Xiaoxi replied, "You spent so much money on your education; she surely wants to find a way to learn it for free. Perhaps I should help you pack your books away in a trunk?"

"That would be fine. Leaving the medical books out is enough," Miaozhen decided.

Unaware that Miaozhen had seen through her, Miaoyun went home and immediately wrote down what she had seen. She didn't worry about the patterns, as she had learned to draw and embroider from her mother since childhood. However, to create her own manual, she needed pigments, and her supply had long since run out.

She had to ask her father for money for the pigments. Her mother kept a tight grip on every copper coin, but her father, though socially inept and sometimes pretentiously aloof, was soft-hearted and easily swayed by a plea.

She went to Xu Dalang and wept, "Daughter has finally secured this work with such a wealthy family. If I cannot produce professional evidence of my skills, I fear they will speak ill of me."

Seeing his daughter’s distress, Xu Dalang took three taels from the five that Xu Erpeng had lent him for rent, keeping the remaining two for himself—money he intended to use for Xu Siniang’s wedding gift.

After giving her the money, he offered a bitter smile; he truly had nothing left.

The wedding of Xu Siniang was the following day. Miaozhen’s new dress had already arrived. While it was fine to dress simply at home, she needed to look presentable when going out.

She wore a white pleated skirt, a bean-green vest, and a gold *jinbushi* (a set of three ornaments) hanging from her chest, with golden willow-leaf earrings. She applied a light touch of powder to her face. Looking at herself in the mirror, she didn't possess a beauty that could topple cities, but she looked graceful and refined.

After dressing, she accompanied her parents to Fengqiao. A tent had been erected in front of the building, and the kitchen staff consisted of the younger brother of Madam Bao’s family.

Madam Mei looked slightly displeased. "Why did they hire him?"

"Is there some history there?" Miaozhen asked.

Madam Mei replied, "Last time, when your brother had his three-day celebration, your Third Aunt invited her brother to our house. They brought all their equipment, and we agreed to it. We expected nine tables of guests, but they prepared ten. Not only that, they charged five *qian* per table, and when the guests finished, he wouldn't even let his people clean up."

"No wonder. Even the finest banquets on the market, with five fruits and five vegetables and all the trimmings, cost only five *qian*," Miaozhen thought. The Bao uncle was truly unscrupulous.

Madam Mei added, "There’s more. Old Gao, who sells sesame cakes, fell gravely ill. He hadn't even passed away yet, but Uncle Bao brought a crew to the house to handle the funeral arrangements, and he was beaten out by the Gao family."

Miaozhen was left speechless.

The family had originally wanted Xu Erpeng to record the gift register, but he would only come for lunch, as he had to work on his book in the morning. Therefore, Old Madam Xu had her younger brother, Old Uncle Xu, handle the register.

Madam Mei brought two taels of silver. It was a gift, but because they were family, it was labeled as a "contribution to the dowry" for Xu Siniang.

Having not seen her for over a year, Miaozhen was surprised to see the sixteen-year-old Xu Siniang. Despite her past grievances with her, seeing her in a red dress, shy and blushing, and about to be married off, Miaozhen felt the fleeting nature of time.

It was said that Xu Siniang had become quite skilled at cooking, washing, and sewing, proving more capable than Old Madam Xu herself.

Leaving the bridal chamber, Miaozhen saw Xu Dalang standing alone and asked, "Has Big Sister not come yet?"

"She and your Aunt have matters to attend to," Xu Dalang replied.

Miaozhen did not press further. It was clear that her aunt was unwilling to attend. She had been slighted during her time in the old house and was now even less inclined to keep up appearances for the Xu family. This was understandable.

Unlike Madam Mei, Madam Huang lived a less contented life and had no patience for flattering her husband’s family. Madam Mei kept to herself, living a life free from want, and only interacted with her in-laws two or three times a year, which made her more tolerant.

As the guests arrived, Madam Mei and Miaozhen took their seats. The dishes were all greasy. When the groom came to offer the "door-opening" money, he gave two thicker red envelopes to the third branch of the family. Miaozhen saw the new groom—his head was pointed, his mouth protruded, and he appeared to be calculating.

In the end, it was a lively affair, and the bride was carried away amidst the sound of gongs and drums.

Three days later, when the bride returned for a visit, Miaozhen and her family did not attend. The gifts were all taken by Old Madam Xu. Thinking of how she lived with her third son, she gave one portion to him and kept the rest for herself.

Madam Mei was a discreet woman and knew exactly what had happened, but with her infant son only three months old, she couldn't leave him, and she didn't trust the wet nurse.

Miaozhen, meanwhile, had more free time, spending her days studying medicine and doing needlework, which she found quite pleasant.

A month later, the phlegm-nodule on Feng Niang’s neck had truly vanished. Feng Niang was so overjoyed that she praised Miaozhen’s medical skills to everyone she met.

When the Ma family servants overheard this, Madam Ma wiped away her tears and seemed to reach a decision. She went to the Xu residence while the family was eating dinner. Miaozhen was helping her brother recite his studies; as she handed him his soup, Madam Ma arrived.

Seeing Madam Ma’s hesitation, Madam Mei invited her into the inner chamber, fearing she had a difficult matter to discuss. Madam Ma said, "I would like to ask Zhenzhen to come and take a look at our side."

Miaozhen paused, wondering if Ma Yulan was truly gravely ill, and followed her immediately.

The Ma household, once a place of laughter, felt eerie. Madam Ma remained silent until they reached Ma Yulan’s small courtyard. They entered the main room, and Miaozhen took one look.

The once lively Ma Yulan now had a face that flushed and paled by turns, and her abdomen was distended, appearing as if she were pregnant.

Ma Yulan looked dazed. Madam Ma whispered in Miaozhen’s ear, "Zhenzhen, look. Your Sister Ma was perfectly fine during the New Year. After the holiday, her period stopped, and her belly grew. We held two rituals and spent a fortune, but there was no improvement. Later, a physician came and claimed your sister had been 'visited by ghosts,' or worse, suggested she was promiscuous. I was trembling with rage, and for fear of gossip, I had to pay him to keep his mouth shut."

Miaozhen felt a lump in her throat. "Have you asked Madam Ru to examine her?"

"I did. At first, she said there was a 'stone mass' in your Sister Ma’s belly, but it had no effect. Then she claimed it was a 'ghost fetus' and suggested I invite someone to perform a ritual," Madam Ma said, deeply distressed. She knew that if Madam Ru couldn't help, there was little hope for her disciple, but she had no other choice.

Miaozhen suddenly remembered a case of "maiden ghost fetus" described in *Fu Qingzhu’s Gynecology*. While it had its limitations, the symptoms seemed to match. She calmed herself and said to Madam Ma, "This is not a ghost fetus. My method only has a thirty percent chance of success. If you trust me, I will do my best. If you do not, I will keep this matter to myself."

Without modern medical technology, Miaozhen had to be extremely cautious. Fortunately, Madam Ma truly loved her daughter and was not an ignorant woman.

Seeing Miaozhen’s cautious and humble attitude, Madam Ma said immediately, "I trust you. If I didn't, I wouldn't have come to you."

"Very well. I must state the ugly truths first: I will document her symptoms in my records, and if any complications arise during treatment, you cannot hold me accountable. If you agree, please find someone to witness it, and we shall sign a document." Having traveled through time due to a medical dispute, Miaozhen still felt a lingering fear, so this was the only way.