Then they shift to arguing over who looked the prettiest when Grandfather took the three of them to the Dragon Boat Festival earlier this year and whom he might select to take with him next year. Each is sure she will be his only companion. And all this happens in front of Grandmother! She ignores them until the fighting becomes too much.
“My husband does not visit your bedchambers for the quality of your food or music. As for who will go to the Dragon Boat Festival next year, that is for me to decide.” Grandmother glances at me and explains in a low voice, “I never go, and I don’t allow the wives to go either. I’m a doctor. I’m already doing something outside what is considered acceptable. But by staying home with other wives and their daughters, I show the world that we are Confucian women above reproach.”
I’m disappointed I won’t get to go, but I can’t miss what I haven’t experienced. The same cannot be said for Miss Zhao, who I bet will be saddened to learn that she will not attend the festival unless my father returns to take her. In any case, life will carry on in the inner chambers. Tomorrow will bring different squabbles, and the jostling for position will continue.
* * *
With my mother, I used to learn poems and passages from the classics. Now I do that with Miss Zhao. When we’re done, I practice memorizing symptoms, formulas for treatments, and the details of individual cases that famous doctors of the past have, as Grandmother puts it, chronicled across the millennia. I’ve come to understand the Five Concepts—Water, Fire, Wood, Metal, and Earth—which help to explain phenomena happening in the body. As Grandmother first instructed me, I’ve put aside the idea of function of different organs to focus instead on the Five Depot Organs—the Spleen, Heart, Kidney, Lung, and Liver. The Spleen warehouses energy from food; the Heart is the captain of Blood; the Liver stores Blood; and the Lung regulates qi through breath.
“Most important for women is the Kidney, for we are by our natures connected to water and darkness,” Grandmother explains to me when I join her in the pharmacy in the late afternoon. “We are also governed by the Seven Emotions of elation, anger, sadness, grief, worry, fear, and fright. Of the Five Fatigues, three specifically target women: fatigue from grief brought on by losing a child or husband, fatigue from worry about finances, a wayward husband, or an ailing child, and fatigue from trying to lift her family to a higher status. If women are prone to the Five Fatigues, then men are apt to fall victim to the Four Vices of drink, lust, desire for riches, and anger. Now, tell me about the Five Deaths.”
“They are from childbirth, fright, strangulation, nightmare, and drowning.”
“Very good. And how do we diagnose an illness?”
“We use the Four Examinations.” I hold up fingers one by one. “Looking, asking and listening, smelling, and pulse taking.”
Grandmother nods her approval. “At every moment, you should be looking for patterns of disharmony. With my eyes, I can see withering or blooming of the skin. Is it shiny and moist, as it should be, or is it puffy, bloated, lusterless, red, white, or yellow in tone? With my ears, I hear groaning, sighs, and sounds of desperation, but I also listen for strength, weakness, and high and low pitches. With my nose, I can smell the scent of disease, that something is as off or as turned as rotten meat. I ask my patients questions in hopes of having a soul-to-soul encounter. Of the Four Examinations, the art of taking a pulse will be the primary diagnostic tool you’ll use in the future.”
She reaches for one of my hands and pulls me to her.
“Before we visit Lady Huang,” she says, “we will review how to read the primary pulses. Place three fingers just below my left wrist bone. There are three levels that you will learn to feel—light, medium, and then with deep pressure. You will do this on each wrist, to gather a total of six readings.”
She moves my fingers to the depression below the joint of her wrist bone and the place from which the wrist bones lead to the pointer finger. “We call this location the Fish Border. It is on the Lung channel.” She presses lightly on my fingers so I might feel deeper. “You are now on the Liver pulse. You can ascertain a woman’s constitution if you take what you’re feeling deep within yourself. In time, you will learn to identify twenty-eight separate and distinct types of pulses. With experience, you may learn even more.” She pauses. “Tell me, Yunxian, how do you identify a hollow pulse?”
“A hollow pulse feels like the stem of a scallion,” I answer. “It’s hard on the outside but empty inside.”
“And what does that tell you?”
“Deficient Blood.”
“What about a wiry pulse?”
“It’s tight like a string on an erhu. It shows stagnation in the body.”
“And what do you feel on my wrist?”
I stare at her. I can recite but I can’t yet discern.
She pulls my fingers off her wrist. “Enough of that for today. Learning to read the pulses will take months, if not years. Let us take up another subject—symptoms. It is said that strange symptoms are as numerous as the spines on a hedgehog—”
I have been trailing my grandmother for more than a month as she treats our female relatives and their children, all of whom live with us. They suffer from common ailments—colds, coughs, and sore throats—and Grandmother is always keeping guard for signs of smallpox.
“Every baby brings fetal poison with him or her into the world,” Grandmother tells me. “Fetal poison is a product of the pollution found in the child palace long before birth. Sometimes it comes because mother and father were drinking when Essence met Blood, or the mother ate too many spicy foods, but it can also result from labor when a fetus’s excrement, hair, or the clotted blood of a mother finds its way into the infant’s mouth. It can flare up at any time. For boys, it often arrives with the onset of those dreams that come to them when they’ve reached twelve or thirteen years. But the most common eruption of fetal poison is smallpox. The disease sweeps across our great land every three years, when the smallpox goddess emerges from hiding to spread her heavenly flowers. The best way to keep the pestilence outside the gates is to invite in the smallpox-planting master.”
“Does he really glue scabs from the sick inside children’s noses?” I ask, making a face.
“It’s called variolation, and we’ve done it in China for centuries,” Grandmother answers. “There are other methods too. Some smallpox-planting masters collect the matter that oozes from the sores and then spread it on a cut, or they apply a dab of the pus to the bottom of a nose. Sometimes the smallpox-planting master grinds dried scabs and then uses a reed to blow the powder—from a distance—into a child’s nose. Sometimes, when a mother can’t afford to hire a smallpox-planting master, she dresses her child in clothes worn by another child who died from the disease. None of these techniques is without danger. A child can get sick with a mild case of smallpox. Some end up with scars. Some even die. But if they endure these days of discomfort, then most reach adulthood with no further problems. Always remember that prevention is the most important form of medicine.”
I’m about to ask why my brothers and I didn’t have variolation when Grandmother steers the conversation in a different direction. “The smallpox-planting master visited me when I was a girl, so I’ve been able to treat patients with the disease over the years. If smallpox ever enters your household, here’s what you should do…”
A few minutes later, she goes in yet another direction. “Boys and girls, and men and women, are essentially the same—both get skin rashes, upset stomachs, gout, and the like—except when it comes to the importance of Blood in women’s lives—menses, pregnancy, birth, and the postpartum period.” Seeing my cheeks redden, Grandmother adds, “There is no place for embarrassment in medicine. These are natural things that occur within women. As you will learn, most of my cases have to do with ailments below the girdle, because we are more susceptible than men to being invaded by pernicious elements. It is up to us to help the women in our household.”
I smile. It boosts my confidence whenever she says us.
Grandmother picks up a handful of sachets and an earthenware jar filled with a brew. “Nothing is more vital than giving birth to sons. Let us now go to Lady Huang’s chambers. I’ve requested that Midwife Shi join our consultation since the day is coming when Lady Huang’s baby—as does every fetus—will become an enemy in her body, fight to get out, and need to be expelled.”