Eye diseases occupy their own specialized branch in traditional Chinese medicine precisely because they correspond to many different diagnostic patterns. Although medical case records passed down through the generations are as vast as the sea, documented cases of eye diseases are relatively few. However, among the modern medical cases that have been preserved and compiled into books, there are quite a number.
Xu Yi said slowly, “I need to see the patient before I can make a judgment.”
Ah Fu received an answer beyond his expectations. His eyes shifted, and he said, “I would like to invite… Doctor Xu to make a house call.”
He spoke these words with difficulty, as if saying them for the first time.
Xu Yi raised his eyebrows slightly and agreed, asking when he could go see the patient.
Ah Fu said, “I need to return first. Uncle Tang hasn’t settled the remaining payment with me yet.”
Xu Yi smiled and made the decision for him, “The day after tomorrow. Come find me at this hour the day after tomorrow.”
For an eye disease that had been developing for many years, a delay of two days wouldn’t matter.
Xu Yi still needed to repay Uncle Tang’s favor first.
“Alright.” Ah Fu nodded.
After agreeing, he turned and returned to the head of the mule cart, driving away.
Watching the mule cart disappear into the distance, Xu Yi turned and went back into the courtyard.
All the medicinal herbs he’d brought back were placed in the yard. Ah Xu and Ah Jin didn’t dare touch them without his instructions.
Ah Xu looked at him and asked, “Young master, how should we handle these medicinal herbs?”
Xu Yi said, “I’ll separate out the toxic herbs. You can arrange the rest in the same order as before.”
The toxic herbs were the datura flowers and such that Uncle Tang had brought back. Ever since Xu Yi obtained these, he’d been thinking of finding time to process them into “Sleep Saint Powder.”
Right now, he had no medical texts on hand and couldn’t remember some dosages, so he didn’t dare proceed rashly.
After picking out these toxic medicinal herbs, Xu Yi found a small bag wrapped in cotton cloth among them.
As soon as he opened it, he smelled a distinct fishy odor.
Xu Yi pinched a piece to examine it.
It looked like an irregular sac-shaped object. The top had crisscrossing textures with slightly wavy striations. This small package contained two colors mixed together, yellow and yellowish-brown. It looked like some kind of dried sac.
He quickly identified what medicinal herb this was.
He hadn’t expected Uncle Tang to bring him such a rare medicinal ingredient.
Calling it rare wasn’t quite right; “hard to find” would be a more appropriate description.
“Huh?” Ah Xu sniffed his nose, his head with its childhood bun leaning over.
He had a keen sense of smell. Having never seen this type of medicinal herb before, he couldn’t help but ask curiously, “Young master, what is this?”
Xu Yi held up a piece for him to remember the herb’s appearance, color, and smell, saying, “This is chicken gizzard lining. It’s made by taking the inner lining of a domestic chicken’s gizzard and drying it. Because the preparation method is troublesome, requiring one to kill the chicken and peel off the gizzard’s inner lining while it’s still hot, without washing it, and then directly dry it, I rarely saw it in medical halls in Yanting County.”
Perhaps there were some, but Xu Yi simply hadn’t encountered it.
Ah Xu was shocked. “When we used to kill chickens, we would always eat the gizzard. I didn’t know it could be dried and made into medicine!”
He told Xu Yi that from now on, whenever they killed chickens, they must peel off the gizzard’s inner lining to dry.
Xu Yi shook his head with an amused smile. “Do you know how many domestic chickens must be killed to accumulate one bag of chicken gizzard lining?”
Ah Xu pressed his lips together and said, “Young master, I’ll count them.”
“Go ahead.” Seeing his interest, Xu Yi handed him the bag of chicken gizzard lining.
The chicken gizzard lining had a brittle texture. Ah Xu carefully held it and poured it onto a plate, using his finger to push and count the pieces.
One, two…
He silently counted in his mind. This small bag of chicken gizzard lining actually numbered over a hundred pieces.
Ah Xu was even more astonished. He raised his voice to shout to Xu Yi, “Young master, there are one hundred and fifteen pieces!”
Xu Yi said, “This chicken gizzard lining is hard to accumulate. It’s not easy to gather this many. This one bag requires over a hundred wen to purchase.”
At this, Ah Xu’s astonishment turned to stunned disbelief. This chicken gizzard lining was so expensive!
Looking at the chicken gizzard lining on the plate, he even more carefully put it all back into the small cloth bag.
Afterward, Xu Yi explained the uses of chicken gizzard lining to them.
It has the effects of eliminating food stagnation, stopping bedwetting, and dissolving hard masses. It’s used for symptoms such as indigestion, poor appetite, abdominal bloating from food accumulation, and infantile malnutrition.
Xu Yi said to them, “The medicinal applications of chicken gizzard lining aren’t limited to just these. Sometimes prescriptions for treating other conditions also use this ingredient.”
He gave them an example, telling of a man who developed sores in his mouth that wouldn’t heal. The man went to see a doctor.
The doctor treating the man was an old physician skilled in using unusual medicines. Seeing that he only had mouth sores without any other additional symptoms, the old doctor directly burned chicken gizzard lining to ash, applied it to the mouth sores, and cured them within two days.
After finishing, Xu Yi saw they were listening with great interest, so he provided another example.
This example involved someone they actually knew in real life.
“Ah Xu, do you still remember Official Yang?” he asked first.
Ah Xu nodded emphatically. “Of course I remember. Brother Rong used to often come looking for Little Huang to play. He said that for the past two months, Official Yang hasn’t gone on any long trips.”
Xu Yi nodded.
He thought of the chance encounter with Madam Yang on South Street not long ago.
Madam Yang’s appearance had changed considerably. She seemed to have drawn her eyebrows and applied face powder. From her words, he learned she was now working as a servant in a household. She didn’t need to live in the master’s house and could return home at night. Yang Rong had been sent to a private school to study. When he returned from school in the evening, it was precisely when she came home from her duties.
When she spoke these words, her eyebrows were smiling. She said directly that with money she could control in her hands, a person no longer just stared at firewood, rice, oil, salt, sauce, vinegar, and tea.
Thinking of this, Xu Yi gathered his thoughts and said, “For this wasting-thirst and excessive drinking, reaching one dan per day, one can use chicken gizzard lining together with spinach root, grind them into powder, and take with rice soup three times a day. Light cases can be resolved in two days, severe cases can be cured in five days.”
Ah Jin raised a key question. “Young master, last time when you treated Official Yang’s illness, why didn’t you use this prescription?”
Xu Yi said, “The causes of disease are different. That prescription would be useless for Official Yang.”
Having said this, Xu Yi needed to explain to Ah Xu and the others how many classifications of wasting-thirst disease there were.
After such a long time, bringing up the diagnostic patterns of wasting-thirst disease again, Xu Yi still had much to say.
Things like how Official Yang drank alcohol and then engaged in sexual activity, and because his constitution already suffered from the five taxations and seven injuries, leading to wasting-thirst disease, couldn’t properly be told to two children. However, wasting-thirst disease caused by stomach and intestinal heat excess, inappropriate use of alcohol for warming the body, and deficiency heat still provided many examples worth mentioning.
Xu Yi pointed toward the yellow wine stored in the kitchen and asked them why he didn’t let them drink alcohol to warm themselves in winter.
Ah Xu said, “Young master said we’re still young and not suitable for drinking alcohol.”
Actually, in current times, children of a few years old would also drink a little wine. Yellow wine wasn’t high in alcohol content, and drinking it warm could indeed warm the body. Xu Yi didn’t let them drink partly because they were still in their growth period, and partly because the method of warming the body with alcohol wasn’t necessarily advisable.
People of the time believed that in the harsh cold of winter, after drinking alcohol a person became warm, so they loved drinking to keep warm.
However, after drinking alcohol, a person’s blood becomes abundant and heat dissipation increases, making it easier for wind evil to take advantage of weakness and enter. This is why stroke easily occurs after getting drunk.
Besides stroke, alcohol’s nature is intensely hot. Long-term unrestrained excessive drinking causes a person to heat up and the five organs to become dry. The body then appears “dried up,” yet urination becomes frequent and unceasing. This forms wasting-thirst disease (diabetes).
In this situation, stopping alcohol consumption is one thing, but secondly, one must take medicine. Otherwise, wasting-thirst disease won’t easily heal on its own.
Xu Yi felt it was necessary to start early, explaining to Ah Xu and Ah Jin the dangers of excessive drinking.
Whether from the heart of a physician or because he was Ah Xu and Ah Jin’s young master, giving this warning seemed like an instinctive impulse from within.
Xu Yi sighed lightly. He could advise them not to drink alcohol, but he couldn’t interfere too much with others.
“Young master, do you have some worries?” Ah Jin’s gaze had been resting on Xu Yi. She asked softly.
Xu Yi shook his head. “I have no worries, just thinking that learning medicine requires first learning how to make diagnoses. However, at present, you should still focus mainly on studying.”
After finishing the Thousand Character Classic, they should study the Elementary Training next.
…
The next day, Xu Yi invited Uncle Tang to drink at a restaurant, thanking him for bringing back so many medicinal herbs.
Since Xu Yi was still in mourning, Uncle Tang drank alone. He ordered one pot of warmed premium yellow wine and didn’t request another pot.
After drinking, Uncle Tang told Xu Yi about incidents they encountered on the return journey. “I’ve been a traveling merchant for many years and have encountered countless bandits. The bandits we met this trip numbered only five or six and tried to rob the cart. Ah Fu and Tiegou scared them away with one slash of a blade and one arrow. They ran off pissing and shitting themselves.”
Ah Fu’s blade was the most famous in the escort business.
With that blade, he’d intimidated many bandits who wanted to block the road and rob travelers. Some people said Ah Fu wasn’t purely from Sichuan, that foreign blood must flow in his body.
But he was born here, and his grandfather was from Yanting County. Others only dared to gossip about him secretly behind his back.
Because they all feared the blade in his hand.
Uncle Tang couldn’t help but mock, “Ah Fu’s birth father and mother are both from Yanting County. Those people are just jealous that Ah Fu earned money, so they want to use such bullshit to make others ostracize him.”
Xu Yi hadn’t expected Uncle Tang to have this side to him. He couldn’t help but laugh and told him to calm down.
Uncle Tang said he wasn’t angry, just that he’d eaten one bowl of rice too many and felt a bit stuffed.
Xu Yi: “…”
After drinking and receiving the silver Xu Yi handed over, Uncle Tang got ready to head home.
Xu Yi saw him onto the ox cart and called for Old Liu to take them to the Tang house first. Only after watching Uncle Tang enter the house did the ox cart once again sway leisurely toward the Xu residence.
When getting off, Xu Yi instructed Old Liu to come by once tomorrow at the si hour (10am).
The next morning, just after dawn, Zhou Fu arrived early outside the Xu residence. He didn’t knock on the door. Like a malevolent god, he stood with his arms crossed, leaning against the wall of the Xu family’s courtyard.
Neighbors passing by saw him and were startled by the curved blade at his waist.
Looking at his face again, they saw a fierce knife scar across his jawbone. When he lifted his eyelids to look over, it seemed he wanted to skin people alive.
The neighbors: “!”
Their hearts pounding with alarm, they hurried past, all worried that Young Master Xu had offended some fierce and malicious person!
“Who is that person?”
“Why is he standing outside Doctor Xu’s door? Is he looking for Doctor Xu?”
“But why isn’t he going in?”
Not far away, several children whispered quietly while covering their mouths.
Their voices were small. Zhou Fu didn’t hear them. His gaze fell on a wall of the household opposite the Xu residence, not knowing what he was thinking.
“Woof!”
“Woof!”
“…”
Behind him, separated by a wall, a yellow dog wagging its tail rapidly barked at the wall.
Zhou Fu hadn’t expected the Xu family to have a dog. He turned around and locked eyes with the dog.
“Woo—” Little Huang made an expelling sound.
Zhou Fu narrowed his eyes slightly, lowered his chin, and his gaze became sharp.
Just as he made a move, a little girl wearing a cotton jacket came out from inside and called to the yellow dog, “Little Huang, do you want to go out and play?”
She ran over and squatted in front of the dog called “Little Huang,” patting its head.
“Don’t be in a rush. Young master is still inside. We’ll go out after young master leaves. Be good and don’t make noise…” As Ah Jin spoke, she sensed something was wrong. It seemed someone was watching her.
She suddenly raised her head and saw a head appearing at the corner of the wall.
“Ah!”
She was startled. After seeing clearly who it was, not quite as frightened, she stood up and asked, “Are you here looking for young master?”
Zhou Fu, a man of few words, nodded.
Getting his response, Ah Jin ran into the house to find Xu Yi, saying that fierce person from the other day had come.
Hearing that Ah Fu had arrived so early, Xu Yi was somewhat surprised and personally went out to open the door.
“Woof woof woof!”
With its master backing it up, Little Huang became arrogant again and barked.
Xu Yi patted its head a few times to soothe it. After calming it down, he asked Ah Fu why he came without knocking.
“Too early. Afraid of disturbing you.” Zhou Fu squeezed out this sentence.
The corners of Xu Yi’s mouth twitched. He opened his mouth and said, “I rise at the mao hour (6am). When you come at this time, you can knock directly.”
After hearing this, Zhou Fu said “Oh” once, then returned to quiet.
Xu Yi already knew this person didn’t talk much and wasn’t good at socializing. He didn’t feel particularly offended by his cold and fierce demeanor.
However, he didn’t make any additional remarks. He told him to wait a moment while he went inside to prepare.
Xu Yi returned to his room, changed into a thick robe convenient for activity, tied a windproof scarf, shouldered his medicine box, and was ready to leave.
Before long, Old Liu arrived at the Xu residence driving the ox cart.
Xu Yi and Zhou Fu boarded the ox cart together and headed toward the outskirts of the city.
The place they were going was called Yellow Ditch Village, sixteen li from the county seat, with twenty households in the entire village.
The Zhou family was considered wealthy in Yellow Ditch Village. With the money Zhou Fu earned working as a traveling merchant escort, they’d built a three-room green brick and tile house in the village.
When Xu Yi and the others arrived at the Zhou residence on the ox cart, Grandfather Zhou sat under the eaves leaning on his walking stick. His right eye had been blind for several years. These past few months, his left eye had also become increasingly unable to see things clearly. He could no longer do much work, only feed chickens in the courtyard and watch over them.
But the cold came quickly. These past few days, the chickens at home didn’t dare leave their coop and all hid inside to keep warm.
With no work to do, Grandfather Zhou could only sit alone in the house in a daze.
Though old, his hearing was good. As soon as the ox cart stopped, he groped for his walking stick and stood up to look outside.
“Has Ah Fu come home?” Grandfather Zhou’s eyes were turbid and unclear. He called toward the direction of the door.
Zhou Fu quickly stepped forward and called out, “Grandfather, I’ve brought a doctor home.”
Grandfather Zhou made sounds of dismay. “Everyone says my eyes don’t need a doctor anymore. Why did you still go invite a doctor? You can’t spend money like this even if you have it.”
He groped to grasp Zhou Fu’s hand and continued rambling on. “During this trip you went out, Matchmaker Li just happened to come by and found you a good match. She said that a young lady’s family requires twenty strings of cash for betrothal gifts. As long as you gather the money, the match is settled.”
Zhou Fu furrowed his thick eyebrows. His already fierce features looked even more vicious. “That matchmaker is a swindler.”
Grandfather Zhou muttered in disbelief, “Really? I even gave her five wen to drink tea!”
Zhou Fu: “She’s already swindled money from several households.”
After saying this, he helped Grandfather Zhou inside.
Then he came back out to invite Xu Yi in.
As Xu Yi entered carrying his medicine box, he heard Grandfather Zhou muttering quietly, “How did he end up a bachelor?”
However, Grandfather Zhou didn’t mutter for long. After Xu Yi came in, he looked at him with his half-broken eye.
“You’re the doctor Ah Fu invited to examine me?” After Grandfather Zhou asked, without needing Xu Yi to respond, he continued, “Doctor, I’ve troubled you to make this trip. This eye disease has plagued me for many years. My right eye has long been unable to see anything. Previous doctors all said it couldn’t be cured. Only Ah Fu is unwilling to give up and always spends money looking for doctors.
If you ask me, he shouldn’t put his mind on me. If he really wants to make me happy enough to live a few more years, he should go get a wife, have a few boys and girls, and let me be a grandfather. That would be wonderful.”
Xu Yi calmly walked to his side. While listening to Grandfather Zhou ramble on, he carefully observed his eyes.
His right eye’s cornea had almost no luster, as if coated with a thick layer of congealed milky white grease. The entire eyelid was slightly swollen. When the eyeball moved, it revealed turbid gray-white spots at the corner.
Seeing the symptoms, Xu Yi felt a strange sensation and furrowed his brows slightly.
Seeing Grandfather Zhou still talking about Zhou Fu’s marriage prospects, Xu Yi appropriately interjected, unhurried, “Father-in-law Zhou, rest assured. I see Brother Ah Fu is a man with his own ideas. He won’t fail in the great matter of his life.”
Rarely did anyone willingly listen to him chatter about such things. Grandfather Zhou’s desire to confide became even more vigorous. He sighed repeatedly and said, “If he really had such intentions, that would be good. I’m just an old life. How much can I manage? But he’s already twenty-four and still hasn’t married. How can I not be anxious?”
Most families arranged matches at twelve or thirteen years old and could marry at fifteen or sixteen. At the latest, the engagement would be settled at fifteen or sixteen, and after one or two more years, the marriage could be completed and they could live together.
The widower in Yellow Ditch Village whose wife died last year was only twenty-one, three years younger than Zhou Fu.
How could Grandfather Zhou not be anxious? His family had a green brick and tile house, but after matchmakers came to arrange matches and saw Zhou Fu’s appearance, they all shook their heads.
With such a fierce appearance, which young lady would dare marry him?
Xu Yi had unexpectedly heard an earful of gossip and blinked innocently.
Fortunately, at this moment, Zhou Fu spoke up, telling Xu Yi to examine his grandfather’s illness first.
Grandfather Zhou hummed twice, knowing that after saying so much today, his grandson hadn’t taken in a single word.
He didn’t continue talking about Zhou Fu in front of an outsider. Instead, he asked Xu Yi how old he was and whether he was married.
Xu Yi’s brow twitched, but he still answered truthfully.
Hearing Xu Yi say he was only sixteen and not yet married, Grandfather Zhou was shocked.
Such a young doctor! He tried hard to open his left eye wide to see Xu Yi’s face clearly.
Unfortunately, his left eye’s vision was too poor. He could only make out Xu Yi’s facial contours, not his features. Combined with Xu Yi’s steady demeanor and clear voice, just listening to him speak made it truly difficult to determine his age.
He shakily raised his hand, wanting to touch Xu Yi’s face.
But his hand reached halfway and shakily lowered again. This was a doctor. He couldn’t treat him as rudely as he would his grandson.
“Please forgive me, Doctor Xu.” Grandfather Zhou’s face showed melancholy.
Xu Yi smiled lightly. “No harm done.”
Seeing Grandfather Zhou’s spirits somewhat deflated, he added, “Father-in-law Zhou, let me first examine your eye disease. Perhaps I can cure your left eye.”
Grandfather Zhou froze upon hearing this.
Zhou Fu beside him finally showed a different expression. He asked in surprised delight, “Doctor Xu has a method?”
Xu Yi said consideringly, “I see that father-in-law’s eye disease resembles infantile malnutrition affecting the eyes. However, this disease mostly occurs in young children after weaning due to improper feeding. It’s rare for elderly people to develop this illness.”
After speaking, he asked Grandfather Zhou thoughtfully, “When the disease first developed, were your eyes sensitive to light?”
Grandfather Zhou, mentioning past events, showed contemplation on his aged face. “Yes, that happened. At that time, seeing sunlight during the day made my eyes hurt. They would also tear up, like there were stones in them. Rubbing my eyes, I couldn’t rub anything out.”
Xu Yi asked again, “Could you see your surroundings clearly at night?”
Grandfather Zhou said, “Couldn’t see clearly. Everything was blurry, like shadows.”
Xu Yi continued his train of thought and asked, “When using the toilet, were your bowel movements normal?”
Grandfather Zhou found this difficult to mention. “Every time was diarrhea, but it didn’t hurt, so I didn’t pay attention.”
After asking several questions, Xu Yi examined Grandfather Zhou’s left eye.
The corner of the left eye had purulent discharge. The bulbar conjunctiva was congested. The cornea was dull and dry. On the temporal side of the eye were gray-white spots the size of sesame seeds.
These days, Grandfather Zhou’s eyes had been hurting. His appetite had declined somewhat, and he wasn’t as spirited as before.
However, these past two days with his grandson home, Grandfather Zhou was happy in his heart and his spirits improved a bit.
Especially this time, with a matchmaker saying a young lady was willing to marry his grandson, he was overjoyed.
Unfortunately, his grandson said that matchmaker was a swindler who came to deceive people.
Grandfather Zhou asked with a heavy heart, “Doctor Xu, can my illness really be cured?”
“The left eye can be treated.” Xu Yi said with certainty.
He withdrew his hand from examining the eyes and said to Grandfather Zhou and Zhou Fu, “Father-in-law’s eye disease is caused by weak spleen and stomach with damaged primordial qi. I’ll first prescribe a dose of Modified Ginseng, Poria, and Atractylodes Powder Decoction. Take it for five days first to see how effective the medicine is.”
Zhou Fu’s breathing grew heavy. He asked hoarsely, “What about the right eye?”
Xu Yi looked at him and said, “The right eye’s lesion is too severe. It cannot be treated.”
Zhou Fu tightened his arms hanging at his sides. Even so, for the Zhou family grandfather and grandson, this was already an incredibly joyful event beyond belief.
Under their overjoyed gazes, Xu Yi took out brush, ink, paper, and inkstone and began grinding ink.
The Modified Ginseng, Poria, and Atractylodes Powder he prescribed came from the Treatise on Damp Diseases. The prescription used eleven medicinal ingredients including poria, dangshen, baizhu, chicken gizzard lining, and shenqu.
This prescription has the effect of supplementing the spleen, benefiting the stomach, and promoting the middle burner. Grandfather Zhou’s eye disease had developed long ago. Using only this medicine wouldn’t be enough. It also needed to be combined with stone needle techniques to assist its effectiveness.
Whenever Xu Yi went out carrying his medicine box, he would bring his stone needles.
After writing the prescription for Zhou Fu to review, and before taking the medicinal decoction, he would first apply stone needle treatment to Grandfather Zhou’s acupoints.
Zhou Fu nodded and helped Grandfather Zhou into the inner room. Xu Yi then had him light an oil lamp.
The oil lamp lit up. Xu Yi opened his medicine box, took out stone needles, and heated them. He was going to needle the Sifeng points.
The Sifeng points are located on the palmar surface of the fingers, consisting of four acupoints. They are extra meridian points that can guide stagnation and eliminate accumulation.
Xu Yi carefully applied the needles, constantly paying attention to any changes in Grandfather Zhou’s eyes.
When a stream of thick, viscous yellow fluid flowed from the corner of Grandfather Zhou’s left eye, Xu Yi withdrew the needles.
After wiping away the yellow fluid, Xu Yi told Grandfather Zhou to open his eyes. Grandfather Zhou’s eyelids trembled as he opened his eyes. For some reason, his left eye’s field of vision seemed to have cleared somewhat.
He blinked, then looked around. It seemed he really could see more clearly!
Perhaps this young doctor really could cure his eye disease.