Chinese Medicine: Starting with Daily Intelligence

Chapter 642: Chapter 642: Prescribed Dosage

Director Si from the ICU let out a helpless sigh.

As a practitioner of Western medicine, he knew better than anyone how poor the prognosis was for a patient with multi-organ failure and severe vascular occlusion. It was a hopeless case.

The patient’s wife leaned back in her chair, tears finally starting to stream down her face.

But her expression wasn’t contorted, and she didn’t even make a sound. She just let the tears fall silently.

It was a quiet so profound it was numb, devoid of any expression.

Like a puppet that had lost its soul.

This was the weeping of someone who had reached the absolute depths of despair.

The illness had started ten years ago, and ten years of treatment had done nothing.

This year alone, he had been hospitalized in the provincial capital for seven months.

She had been by his side for all seven of those months.

She had been on edge for seven months.

And she had been in despair for seven months...

Their savings were gone, and so was their hope.

Now, even their last lifeline—Divine Physician Li—seemed to offer no hope.

For a moment, everyone in the office felt a heavy weight in their chests, making it hard to breathe.

"Actually, this isn’t an incurable disease. There’s still hope."

Just then, a calm voice suddenly broke the silence.

At these words, everyone present turned to look, stunned.

Even the patient’s wife, who had been as still as a puppet, lifted her eyelids slightly. A faint glimmer of light flickered in her ashen eyes.

The one who had spoken was Li Xu.

"Dean Li, you have a solution?"

Lin Guorui’s face lit up as he asked hurriedly.

If anyone else had said that, he would have assumed they were either boasting or just trying to comfort the family.

But Li Xu was different. He had performed too many miracles. Even if there was only a one-in-ten-thousand chance, coming from him, it was real hope.

Li Xu nodded, his expression composed. "The patient’s condition is severe, I admit. With over thirty years of deep-seated cold and pathogenic cold lodged deep in the blood vessels, it’s certainly a tricky case. But it’s not absolutely incurable."

"He is critically ill, that’s true, but his stomach qi is still present and his mind is clear. He hasn’t reached the brink of death yet. If we can use intensely acrid and hot herbs now, striking like a thunderbolt to break the ice, boost his qi, and clear the stagnation, it will definitely be effective."

After hearing this, Lin Guorui’s brow furrowed. He reminded him, "Dean Li... that approach might not work. I just looked at the case files. The specialists from the provincial hospital had the same idea. They also used yang-warming and cold-dispelling herbs, but the results... as you can see, were not ideal."

If that path had been viable, the patient wouldn’t have been transferred here in the first place.

Li Xu said, "I saw that. The previous doctor’s diagnostic approach was the same as mine, and the prescription wasn’t wrong either. Aconite, dried ginger, cinnamon... they used all the right herbs."

That just confused Lin Guorui even more. "If the previous doctor already tried that and it didn’t work, why are you still going down the same path? ’Do you expect a different outcome?’"

The others were also baffled.

Li Xu flipped open the file in his hands, pointed to a few of the prescription slips, and shook his head slightly, his brow tightly furrowed.

He said, "The previous doctor’s direction was correct, but—the dosage was far too low. It was like trying to scratch an itch through a boot."

"The patient has suffered from a deep-seated cold illness for over thirty years. The pathogenic cold has penetrated to the bone marrow. It’s like an ancient iceberg that’s been frozen solid for more than three decades!"

"If you toss a few pieces of red-hot charcoal on it, is that going to melt it? At most, you’ll get a little steam on the surface, but the inside will still be solid ice."

"Look at the previous doctor’s prescription. The maximum dose of one type of Aconite they used was 30g, while the maximum dose for the other was only 9g. The other herbs, like dried ginger and cinnamon, were also at conventional doses."

"To treat such a stubborn, deep-seated cold syndrome, you need ’fierce generals’—herbs like the Aconites, which are intensely acrid and hot, capable of reaching every part of the twelve meridians, inside and out—to defeat the enemy. But the ’fierce generals’ the previous doctor used were timid and their forces insufficient. Naturally, they couldn’t break the ice. Instead, their inadequate medicinal strength provoked the pathogen, causing the condition to rebound."

When he said this, the Western medicine doctors and the family members looked completely lost. They didn’t understand pharmacology, but they understood the two words "dosage insufficient."

But the TCM doctors, like Lin Guorui and Hu Qiming, were all clicking their tongues in astonishment, their faces filled with shock.

Lin Guorui hesitated, a worried look on his face. "But... Dean Li, the dosage stipulated in the Materia Medica..."

"I know," Li Xu cut him off. "The Materia Medica stipulates a general dose of 3-15g for the first type of Aconite, and 1.5-3g for the second. The previous doctor, by using 30g of the first and 9g of the second, was already exceeding the recommended dosage. You could say they had some nerve."

Lin Guorui fell silent.

He was also aware that the dosages recommended by the Materia Medica were often very conservative, established based on a baseline of "absolute safety."

In clinical practice, for some critical cases, such dosages were often just a drop in the bucket and wouldn’t necessarily be effective.

But the reason they were conservative was precisely for safety.

The Aconite family of herbs are notoriously toxic in Chinese medicine.

Aconitine poisoning can be fatal.

Using too much could even lead to cardiac arrhythmia and respiratory failure.

The previous doctor, daring to use 30g of one Aconite and 9g of the other, was already taking a huge risk to treat the patient.

"How many grams are you thinking of using?"

Lin Guorui asked cautiously, a bad feeling creeping into his heart.

Li Xu’s gaze was firm. He slowly held up three fingers.

"The dosage for the second type of Aconite needs to be—30g."

"What?"

The room erupted in an uproar.

Lin Guorui nearly leaped out of his chair.

30g?

That’s ten times the maximum recommended dose!

That’s not prescribing medicine, that’s prescribing poison!

"What’s wrong? Can’t you use this medicine?"

The patient’s wife asked, confused by the shocked expressions on everyone’s faces.

Everyone looked at each other, at a loss for how to respond.

Lin Guorui hesitated for a moment, then said with some difficulty, "Um... Dean Li’s approach is the same as the specialists from the provincial hospital. It’s just that his idea... is to increase the dosage quite a bit."

"How about this? Why don’t you and your family wait outside for a little while? We need to discuss and deliberate on this carefully. This involves a major issue of medication safety. We’ll give you the final treatment plan in a bit, okay?"

This was, in fact, a euphemism.

In medical circles, whenever an unconventional, high-risk medication plan was proposed, it typically required an internal consultation and discussion, sometimes even formal approval, to avoid causing unnecessary misunderstanding and panic among the family members present.

However, the patient’s wife shook her head.

"I’m not going anywhere. I’m staying right here."

She gently wiped the corner of her eye and said this with a blank, yet perfectly calm, expression.

It was the tranquility of someone who had weathered great storms and had long since seen past life and death; it was also an insistence that allowed no room for debate.

For a moment, no one knew how to reply.

The patient’s wife slowly lifted her head and looked at Li Xu. A flicker of light seemed to appear in her once-ashen eyes. "It’s been so long. There’s nothing left that I can’t bear. Dean Li, just say what you need to say. Life or death, I’ll accept it."

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