Case Number 19

Abstract

This case presents some of the problems a Song-dynasty physician confronted when dealing with his patients. Xu presents the patient’s symptoms and provides a clear-cut diagnosis of the condition. However, a member of the patient’s household claims that the same diagnosis was made previously, and that the prescription did not help and even exacerbated the sweating. Xu claims that this cannot be correct, but the patient’s relatives insist that it is. Xu then asked them what the prescription’s ingredients were. He explains to the patient and his relatives that they are talking about two distinct prescriptions with quite different effects. Once he prepares the correct prescription and administers it, the patient recovers. This case, like many others in the collection, shows that the power to accept or reject the doctor’s decision remained in the patient’s or the patient’s family hands. The doctor had to convince them that the diagnosis and treatment he suggests are correct and appropriate. As in many other case records, Xu discusses the incorrect prescription to stress the incompetence of other physicians as well as to stress the main differentiating symptom in the diagnosis of this case.