Case Number 89

Abstract

This case is interesting for a number of reasons. First, the female patient exhibits mainly what we would term psychological symptoms, including delirious speech, seeing ghosts, and manic behavior. Song physicians, who had no use for the European mind-body dichotomy, saw them as real, simply abnormal. Xu Shuwei regards her symptoms as manifestations of Cold Damage, which he then treats. Second, the husband of the patient reports to Xu that the disorder has transformed into a disorder named Coagulation in the Chest. He or another family member had enough knowledge of medicine to see it that way. This is a reminder that he did not need much; the terminology of medicine was to a large extent based on ordinary language. Third, Xu asks the patient’s husband to trust him with the treatment, apparently because earlier incorrect therapy had worsened the patient’s condition. This plea suggests that well-known and established physicians had to seek trust overtly when their predecessors had made the patient’s condition worse. Fourth, the treatment itself includes a drug formula and acupuncture in the abdomen. The latter at the time was a rather drastic measure, mainly performed by acupuncturists than by physicians. Xu remarks that the drugs cannot reach as deep as needling this locus, an attitude that stands in contrast to a cliché in today’s TCM. The location of the acu-point suggests that physicians or their assistant needled points located in parts of the body that they did not usually examine visually.