Chinese Medicine: Starting with Daily Intelligence

Chapter 613: Chapter 613: Medicine Guide

Zhang Liang’s prescription was too expensive.

Li Xu reminded him in a low voice.

Hearing this, Zhang Liang’s old face flushed, and he felt a little ashamed.

He had been practicing at the Provincial Hospital of Traditional Chinese Medicine for decades. His consultation fee was several hundred yuan, and his patients were invariably rich or powerful.

Over time, he had grown accustomed to prescribing the best and most expensive medicines, focusing solely on efficacy without considering the cost.

But he remembered what his teacher had taught him when he was a young student of Chinese medicine: "A doctor must have a benevolent heart. It’s not just about curing illness, but also about sympathizing with the patient’s suffering. If a cheaper medicine works, use the cheaper medicine."

Simple, convenient, effective, and inexpensive—that was the essence of traditional Chinese medicine.

’Have I slowly lost my way and forgotten my original intentions in the pursuit of fame and fortune?’ he wondered.

Seeing this, Gao Guanghui, who stood to the side, revealed the faintest hint of a smile.

Li Xu had essentially refuted Zhang Liang’s prescription from every angle—from the properties of the herbs and the patient’s constitution to the financial cost.

Yet, the refutation was so flawless that no one could find fault with it; in fact, it was utterly convincing.

’This kid... the student has truly surpassed the master.’

He said nothing, quietly watching to see how his old friend would respond.

...

"Then what prescription do you think we should use?"

Zhang Liang wasn’t angry. Instead, he humbly asked for Li Xu’s opinion.

Li Xu replied with confidence, "We’ll still use the ’Blood Exhaustion and Lumps Dissolving Soup,’ but we can modify it. We’ll remove potent herbs like dried lacquer, Da Huang, and pangolin scales..."

As he spoke, Li Xu detailed the modified prescription for Zhang Liang.

In truth, this wasn’t just due to Li Xu’s medical expertise; it was also a matter of coincidence.

A while ago, one of his daily "intelligence briefings" had provided a detailed analysis of this classic gynecological formula, even listing various case studies of its modifications.

His understanding of this formula had transcended the level of mere "application" and reached the realm of true "transformation."

Otherwise, when faced with a prescription from an old expert like Zhang Liang, he might not have been able to spot the flaws so quickly and propose a perfect alternative.

The modified prescription was now: dragon’s blood, Danggui, Danshen, processed Da Huang (in a reduced dose), Yanhusuo, white peony... lotus root node...

Zhang Liang studied Li Xu’s modified prescription, pondering as he read.

Li Xu had removed the toxic dried lacquer, replacing it with the gentler Danggui and Danshen to nourish and invigorate the blood.

He had removed the myrrh, which can easily irritate the stomach, and substituted it with Yanhusuo to promote qi circulation and relieve pain.

He also removed the expensive pangolin scales and the overly harsh Peach Kernel, adding lotus root node, which can both invigorate and stop bleeding...

With these additions and subtractions, not only did he preserve the original formula’s core effects of invigorating blood, dispelling stasis, and dissolving masses, but he also accounted for the patient’s constitution of being deficient in both qi and blood, all while significantly reducing the cost.

It was a truly comprehensive approach.

Zhang Liang read over Li Xu’s modified prescription again and again, his heart unable to find peace for a long time.

In terms of the prescription itself, the original one Zhang Liang had written was technically correct for the symptoms.

Although, as Li Xu had pointed out, some of the herbs could have adverse effects on the patient, in clinical practice, this was similar to the "adverse reactions" listed on the package insert of a Western medicine.

When treating a disease, one sometimes has to sacrifice secondary aspects to achieve the primary goal.

For example, inducing diarrhea to relieve constipation, or damaging the body’s healthy qi to dispel blood stasis.

However, the essence of traditional Chinese medicine lies precisely in "balance" and "neutralization."

TCM formulas emphasize the principles of "monarch, minister, assistant, and envoy," where herbs are combined to integrate their various properties, harnessing their benefits while avoiding their harms.

TCM treats illnesses by leveraging the specific "biases" or "tendencies" of medicinal herbs.

But some herbs may have biases that are too strong, or they may have more than one bias.

During treatment, you might need one of these biases, such as invigorating the blood.

But you don’t need another, such as harming the stomach.

This is where other herbs are needed for neutralization.

For instance, adding licorice to harmonize all the herbs in the formula, or adding Atractylodes to strengthen the spleen and protect the stomach.

The purpose of a whole formula, through skillful combination, is to eliminate useless or harmful side effects, ultimately leaving only the desired therapeutic effect.

In fact, the combination of herbs in a TCM formula is somewhat analogous to a chemical reaction.

When combining herbs, one must consider not only the properties of each individual herb but also the interactions between them.

Herbs don’t just counteract each other, as in mutual "antagonism" or "inhibition."

They also have enhancing effects, such as mutual "reinforcement" or "assistance."

Some herbs can neutralize toxicity, while others can enhance therapeutic effects; these are the profound mysteries one must deeply understand when formulating prescriptions.

A skilled doctor, when creating a formula, can minimize harm to the body and maximize therapeutic effects through modifications, dosage adjustments, and different processing methods.

Therefore, anyone who promotes slogans like "purely traditional Chinese medicine with no side effects" is either a fraud, an amateur, or a merchant with ulterior motives.

The saying, "All medicine is one-third poison," is not a modern invention. It was originally said about traditional Chinese medicinal herbs, not something that appeared only after the advent of Western medicine.

The reason for this saying is that it’s nearly impossible to create a formula that is 100% perfect and harmless.

It can only be said that some formulas cause less harm, while others cause more.

To solve this problem, TCM has various methods, such as using a "medicine guide," or combining treatment with acupuncture, dietary therapy, and other approaches.

Anyone who understands TCM or has seen medical case studies or dramas about it knows about the concept of a medicine guide.

Sometimes, when a patient takes their medicine, the doctor will ask them to find a strange medicine guide, and at times, this guide can seem critically important.

The main functions of a medicine guide are as follows:

First, to guide the herbs to the proper meridians.

This allows the medicinal effect to be concentrated in a specific area, directly reaching the site of the disease.

For example, Knotweed carries the medicine’s properties upward into the lungs, while Achyranthes bidentata guides the blood downward into the kidneys.

Second, to enhance the therapeutic effect.

It allows the medicine to exert more of its power, preventing the medicinal effect from being depleted or wasted.

For instance, pairing ginger with Banxia enhances its anti-nausea effect.

Third, to neutralize toxicity.

Some decoctions can cure diseases but are highly toxic. Consuming them directly is very harmful, so a medicine guide is needed for neutralization.

For example, ginger neutralizes the toxicity of Banxia and Arisaema.

Fourth, to improve the taste.

Some decoctions are extremely bitter or have other unpleasant tastes, like the foul, fishy smell of Trogopterus dung, making them difficult to swallow and affecting the stomach qi. In such cases, a taste-improving medicine guide like Large Dates or honey is needed.

Fifth, to protect the internal organs.

Some decoctions, like bitter and cold herbs, can be harsh on the spleen and stomach. A medicine guide like japonica rice or Large Dates is needed to protect the stomach qi.

Sixth, to provide psychological guidance.

This involves an element of psychological suggestion.

This type of medicine guide doesn’t actually enhance the chemical components of the medicine itself. Its purpose is to soothe the patient’s emotions, helping them move past anxiety or grief, or to guide the patient to perform certain actions.

For example, in ancient times, a famous doctor treating a pregnant woman from a wealthy family for difficult labor or qi stagnation might tell her she needed a specific medicine guide, such as the first drop of morning dew or a particular type of leaf from deep in the mountains, which she had to collect herself every day.

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