Ch. 8: Chapter 8: Calculating the Medicine Bill

After writing down cinnamon twig, Zuo Gui paused, then added hawthorn fruit. Next came radish seed (lai fu zi), costus root (mu xiang), green tangerine peel (qing pi), and several other herbs to aid digestion, clear accumulated food, and relieve the resulting fullness and pain in the stomach.

When he had finished, he handed the prescription to Zuo Shaoyang.

“Make up the medicine according to this.”

“What exactly is wrong with me?” Madam Zhao asked.

“Mm…” Zuo Gui considered for a moment. “Stomach pain, sour fluid coming up, nausea, and loss of appetite. This is a pattern of food stagnation in the stomach.”

“But you haven’t looked at my tongue. You haven’t even asked properly about the pain—whether it comes in bouts, feels sharp and stabbing, or is just a dull ache. How can you tell it’s that pattern?”

Zuo Gui felt his face grow warm.

The trouble over the rent had left him thoroughly dejected. Then there was his son’s fall and the long wound at the back of his head. For some reason it had already closed, but he still did not know whether the boy had suffered an internal injury. With the landlady pressing for payment, he had had no chance to examine him thoroughly.

His son had accurately described her main symptoms, and she had confirmed them. Distracted as he was, Zuo Gui had prescribed on that basis, forgetting even to inspect her tongue or question her further.

Naturally, he could not admit that in front of the patient, nor could he now make up for the omission. He could only insist that he was right. Fortunately, the dim light concealed his blush.

He gave a little cough.

“Your condition is nothing serious. I can identify it without inspecting your tongue or asking further questions.”

“Really?” Madam Zhao still looked doubtful.

“Don’t worry. Take my medicine, and you’ll certainly get better. You said you liked hawthorn, didn’t you?”

“Yes, I love it. I eat it whenever I feel like it. People say it improves the appetite and helps digestion. Mine’s so poor that I have to eat hawthorn before I can manage a meal.”

“Exactly. Hawthorn is the second ingredient in this prescription, and it’s the principal herb. You’re sure to like it!”

“Is that so? Well, that’s good! Make it up, then. I need to get home for supper.”

“Certainly. But your condition will need gradual treatment. You may have to take the medicine for some time.”

“That’s fine. Make up a dozen or so doses. I can’t be bothered coming back and forth. Besides, if you can’t pay the rent on New Year’s Eve and have to leave, I’ll need someone else to prescribe for me. What a nuisance! You might as well earn a little money too. Give me plenty at once.”

While they were speaking, Zuo Shaoyang hurriedly took up the prescription and read it through. Hearing his new father explain his choice of herbs, he could only smile bitterly to himself.

Now he understood why the shop had so little business.

Madam Zhao ate hawthorn as a snack, before meals and after them, without restraint. He was convinced that this had given her a stomach ulcer. Although he had not yet questioned her properly or taken her pulse, he was already certain of the cause and had a prescription in mind. Whatever the final pattern diagnosis, the treatment ought to nourish her stomach.

Yet his father had diagnosed food stagnation. That was heading in entirely the wrong direction. One of her chief complaints was loss of appetite—how could he simply conclude that food was stagnating in her stomach? Worse still, he had prescribed a large amount of hawthorn. That would only make matters worse.

Clearly, his father had no idea what had caused her illness.

But Zuo Shaoyang could not openly say that the prescription was unsuitable and would aggravate her condition. His father would lose all face.

Before his journey through time, he had failed to consider Director Wang’s dignity, and the man had come storming into the pharmacy to quarrel with him. This time it was his father. Even if Zuo Shaoyang cured the patient, an open contradiction might ruin Guizhi Hall’s reputation.

Zuo Gui glared at him.

“Why haven’t you gone to make up the medicine?”

“Oh!”

Prescription in hand, Zuo Shaoyang headed towards the counter.

His father raised his voice.

“And how do you expect to do it without the lamp? What’s the matter with you? Wandering about as though your soul’s gone missing!”

Zuo Shaoyang hurried back for the oil lamp. He set it on the counter and laid the prescription beside it.

After a moment’s thought, he decided to dispense the medicine according to his own formula instead. The written prescription would not be given to the patient anyway. Madam Zhao had no way of knowing exactly what Zuo Gui had prescribed.

He made up the medicine, wrapped the packets, and brought them over to her.

“How much?” she asked.

Zuo Shaoyang looked at his father.

Zuo Gui glared back.

“Didn’t you calculate it?”

“I’m supposed to calculate it?”

In a modern hospital, the cashier’s office and pharmacy were separate. Zuo Shaoyang’s job had been to dispense what was on the prescription, not work out the price. He was not used to doing both.

“Of course! Who else? Do you expect me to calculate it for you?”

“Oh!”

He went back to the counter and picked up the prescription, feeling rather lost. There were no prices written on it. He looked around, but could see no price list either.

How was he supposed to work it out?

Huixiang hurried over.

“What’s wrong?” she whispered.

“I don’t know the prices!”

Thinking her brother’s memory still had not returned, Huixiang looked deeply worried. She glanced back at Zuo Gui, who was watching them with a puzzled expression of his own.

She lowered her voice further.

“They’re written on the medicine drawers. You’ll also find them in the drawer underneath, where we keep the ledger.”

Zuo Shaoyang raised the lamp and went to inspect the medicine cabinet. Sure enough, the labels at the corners of the drawers bore prices in tiny writing.

He considered for a moment. He could not charge for the herbs he had actually dispensed. His father would hear the total and immediately realise something was wrong. He would have to calculate the cost of his father’s prescription.

He turned back and took it up again. After fetching the first two ingredients, he suddenly came to a halt.

There was a herb he did not recognise.

Chinese medicine used tens of thousands of medicinal substances. Nobody could remember them all. Knowing the few hundred in common use was already an achievement; encountering an unfamiliar name was perfectly normal.

Holding the prescription, he scanned the labels on the cabinet, searching slowly. But with hundreds of herbs before him, how could he find it quickly?

“What’s wrong now?” Zuo Gui demanded.

“N-nothing.”

Zuo Shaoyang kept looking, growing anxious. Searching the drawers one by one would take even longer.

Huixiang hurried behind the counter.

“What is it?” she whispered.

He handed her the prescription and pointed to one of the ingredients.

“Where’s this herb—Shigu?”

She pointed.

“Over there!”

He went to look. Sure enough, the label read Shigu.

He pulled open the drawer and did not know whether to laugh or cry.

It was pinellia tuber (ban xia), a commonly used herb for warming and transforming cold phlegm!

The names of medicinal substances had been terribly inconsistent in ancient times. A single herb might have several names, even dozens of them, while the same name could refer to entirely different herbs.

Modern Chinese medicine had standardised the names through its pharmacopoeia. Hospital physicians generally used the official terms in their prescriptions, and those were the names Zuo Shaoyang had learned at university.

He knew a few common aliases too. For instance, he knew that pinellia was called Diwen or Shuiyu in Shennong’s Classic of Materia Medica. But Shigu appeared in the Supplementary Records of Famous Physicians from the Wei–Jin period, and the herb had more than a dozen other aliases besides.

How could he be expected to remember them all?

He had not recognised the name, but the moment he saw the herb—even processed into medicinal slices—he knew exactly what it was.

Once he had found all the prices, he set about writing them down with a brush. There were no computers or calculators here to do the arithmetic for him. He would have to work it out himself.

He found a sheet of brown paper. An inkstone stood on the counter, and a brush rested on its stand. He picked it up, only to find that the tip had frozen solid.

Then he remembered the brush on his father’s table. Zuo Gui had just used it to write the prescription.

He hurried over to borrow it.

“What do you want the brush for?” his father asked, staring at him.

“To calculate the bill.”

“Calculate it? With a brush?”

Zuo Gui was dumbfounded.

“How can you calculate with a brush?”

In ancient times, the earliest tools used for addition, subtraction, multiplication, and division were counting rods: short sticks arranged in prescribed patterns to represent numbers and manipulated according to fixed rules.

People who regularly needed to calculate would carry a small pouch of rods, ready to use whenever required.

Although the abacus had been invented as early as the Eastern Han dynasty, its methods of calculation were still imperfect during the Tang and Song. It was slower than counting rods and less convenient to carry, so it had not yet come into widespread use.

Zuo Gui and his family used counting rods. They had never seen anyone write out arithmetic with a brush.

Naturally, he was astonished.