Chapter 122 Support the Patient, Fight the Disease

As preparations continue upstairs, Evan explains to Alex why treating an illness also means protecting the patient.

Clara took Adam back to his room, then spent a little while in the kitchen tending the medicine.

They had originally planned to give him his medicine and carry out the treatment in the little storeroom downstairs. But it was too small. Opening the door to bring in food or medicine would make it easier for pathogenic wind to enter again.

After taking the medicine, Adam would sweat all over. That would leave him especially vulnerable to pathogenic wind, which could interfere with the treatment.

Since he would be sweating for several days, he needed a room protected from drafts. The downstairs space would not do. They had to close all the doors and windows of the upstairs suite instead.

Adam was now in a closed room inside another closed room. Opening a door to bring him food or medicine would be less likely to expose him to pathogenic wind. It was a safer arrangement.^[1]

“You mustn't overlook the closed-room method of taking medicine,” Evan reminded Alex. “Every word the ancient sages wrote mattered. Neglecting this detail may be one reason their methods fell out of use.”

Alex nodded.

“I've treated stroke patients this way myself, with very good results,” Evan said. “Remember: with a very old stroke patient, or one who's always been frail, you must use the closed-room method. Don't get careless and let all your work go to waste at the last moment.”

“Yes, Dr. Xu. I'll remember.” Alex wrote it down in his notebook.

Evan gave a slight nod. “Come to the clinic with me later and copy down the prescription. Study the combinations and dosages carefully. With patients like this, you must remember one principle: support healthy qi and expel pathogenic factors.^[2]

“It's one of Chinese medicine's great weapons, and one of its advantages over Western medicine. The struggle between healthy qi and pathogenic factors is like a battle between two armies when an enemy invades.

“Supporting healthy qi and expelling pathogenic factors means giving your own army the best equipment, the greatest strength, and the best conditions to fight in, then driving the enemy out in one sustained effort. The pathogenic influence is expelled without badly damaging our own healthy qi.

“Chinese medicine has a complete body of theory on this. You must study it thoroughly. Never focus only on expelling pathogenic factors while neglecting healthy qi, or even damaging it. You'd lose more than you gained.”

Alex nodded earnestly.

Evan smiled and shook his head. “In the modern rivalry between Chinese and Western medicine, Chinese medicine still had a considerable advantage before 1929. In the early Republic, the educated men calling for its abolition day after day still ended up relying on it when they were ill, didn't they?^[3]

“Take Hu Shi's nephritis. Peking Union Medical College Hospital couldn't cure it despite prolonged treatment. Lu Zhong'an was the one who finally cured him. Then there was Wang Jingwei's mother-in-law, who had dysentery that wouldn't respond to treatment.

“That was when the proposal to abolish Chinese medicine was about to be introduced, and Beijing's Four Great Physicians had gone south to appeal against it. Wang's wife asked Shi Jinmo to treat her mother. Two batches of his medicine stopped the diarrhea, five restored her to normal, and ten cleared the remaining pathogenic influence.

“Kong Bohua, another of the Four Great Physicians, went south to challenge the Western doctors. There were twelve patients, six for each side. Before the Western doctors had achieved any results, Kong had cured his patients and gone on his way.

“So Chinese medicine was angry in those years, but it wasn't afraid. Why? It had results to back it up. But that soon changed.

“Western medicine discovered antibiotics. They really were a formidable weapon. In Kong's contest, the illnesses had been fever, asthma, respiratory infections, and other infectious or feverish conditions. Western medicine couldn't match Chinese medicine then.

“But when antibiotics arrived, Chinese medicine was knocked senseless. In our battle between the two armies, we supported healthy qi and expelled pathogenic factors by giving our troops the best equipment and conditions. Antibiotics were like artillery fire coming straight down from the sky.

“It was like bringing a handgun into an age of swords. With a gun, even a child could kill a martial arts master. After that, Western medical science and technology developed rapidly, and Chinese medicine lost more and more ground.”

Alex sighed too, feeling helpless.

Evan patted his shoulder. “Don't belittle yourself. Chinese medicine in the Republican era didn't represent the height of what it could achieve. Elder Li's results are often better than those of modern medicine.

“And the principle of supporting healthy qi and expelling pathogenic factors isn't outdated. Powerful as antibiotics are, they only expel the pathogenic factor. They don't support healthy qi. Their overuse in past years caused a great deal of harm.

“Especially in children. Too many antibiotics brought the fever down but weakened their resistance. Then they kept getting sick and needed antibiotics again, stronger ones each time.

“Overusing antibiotics has left quite a few children with deafness, tinnitus, liver or kidney damage, and a whole range of other problems. China is notorious for overusing antibiotics, just as America is for overusing painkillers. Only in recent years have we tightened up antibiotic use here.^[4]

“Some cancer chemotherapy drugs are another example. The numbers on the test reports fall, but the patient suffers terribly. That too comes from expelling pathogenic factors without supporting healthy qi.”^[5]

Clara had just come out of the kitchen. She joined in. “I've been doing publicity online these past few days. Every day, people who hate Chinese medicine come along and say this herb is poisonous, that one contains some acid that'll damage your kidneys and liver, or cause uremia and kidney failure.”

Evan chuckled and shook his head. “Talking about toxicity without considering the dose is arguing in bad faith. Western medicine uses digitalis drugs for the heart. They're toxic too. Why don't they mention those?

“Even yardlong beans contain toxins. Don't people still eat them? Pickled vegetables contain nitrites too. Ignoring the dose, the processing, the patient's condition, and the combination of ingredients, and talking only about toxicity—how foolish is that?”^[6]

“It's just people who know nothing about medicine talking nonsense,” Alex said. “Not one of the Western doctors I know attacks Chinese medicine.”

“Anyone with some medical knowledge wouldn't argue like that,” Evan said. “Western medicine has plenty of drugs with serious side effects. Using that argument against Chinese medicine simply doesn't hold up.

“Besides, Chinese medicine has always emphasized supporting healthy qi and expelling pathogenic factors. Expelling the pathogenic factor must not damage healthy qi. That's always been one of its most important principles. During the SARS outbreak, the patients treated with Chinese medicine alone at the First Affiliated Hospital of Guangzhou University of Chinese Medicine had no lasting effects at all. That's what this principle means! Leaving someone battered and damaged in the process of treating their illness isn't the Chinese medical way.”^[7]

Alex and Clara both smiled.

“There's something even more ridiculous,” Clara said. “They say some high-ranking Qing official once got sick but was afraid to take medicine. So that proves Chinese medicine is useless—otherwise, why would he have been afraid to take it?”

Alex laughed. “If a high-ranking official today got sick but was afraid of surgery, would that prove surgery was useless and ought to be abolished? Their logic is mindless.”

Evan pointed at Alex. “All right, enough about people attacking Chinese medicine. These days, the aim isn't competition between Chinese and Western medicine. It's cooperation. With illnesses like cancer, for example, the tumor may have been removed surgically, but some pathogenic influence remains in the body.

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“That's where you can work with Western medicine, supporting healthy qi and expelling pathogenic factors to clear what's left without damaging the patient. You must also help the patient recover as quickly as possible after surgery. Or you can work alongside chemotherapy, supporting healthy qi to protect the patient's own qi.

“When parents don't want antibiotics for their children, you can also use this Chinese medical approach. And with viral illnesses, where antibiotics don't work very well—like the adenovirus pneumonia I helped your teacher treat last time—you can use Chinese medicine to support healthy qi and expel pathogenic factors too.

“There are other operations, such as cesarean sections. Adequately replenishing qi and blood before and after the operation can help the mother recover and improve her prognosis.”

Evan reminded Alex again. “Never underestimate this approach. Take some patients with late-stage cancer. Western medicine can't cure them, and neither can Chinese medicine.

“What do we do then? Help them live with cancer. Support healthy qi and expel pathogenic factors to extend their lives as much as possible and improve their quality of life. Take the physician Li Ke's mother. Li had been falsely accused and imprisoned. When he was released and went home, he found that his elderly mother already had advanced cancer in the middle section of her esophagus.

“They went to their province's No. 3 Hospital. She had thirty-seven days of radiotherapy, which left her in terrible shape without curing the cancer. Her hemoglobin was only 6 g, her white blood cell count only 3,400, and her weight only 75 jin.^[8]

“She was critically ill by then. The provincial hospital had issued a critical-condition notice and said there was no hope of saving her.

“Li took his dying mother home and treated her with Chinese herbs alone. He used every skill he had, and within three days he finally pulled her back from the brink.

“But he couldn't cure cancer that advanced either. All he could do was help her live with it. After she improved, she took large decoctions every day for three years—more than a thousand batches. She continued taking powdered medicine until she died.

“She lived another ten years, and her quality of life was good. She could even work in the vegetable plot. Li relied on supporting healthy qi and expelling pathogenic factors. As for Chinese herbs being toxic… ha.

“Her prescription included 30 g of mubiezi. It's highly toxic. The prescribed limit is no more than 1.2 g, because too much can kill you.^[9]

“But it's meaningless to discuss that without considering her condition, the combination of ingredients, or the processing. She took a prescription containing 30 g of mubiezi every day for three years. Not only was she all right, she could still work in the fields.

“Take it recklessly, though, and someone will die. You have to think in Chinese medical terms when using Chinese herbs, especially potent, toxic medicines like these. In skilled hands, they can have extraordinary effects.

“By the way, did you taste the fuzi and chuanwu I told you to try?” Evan asked Alex.^[10]

Alex's expression froze.

Reader Notes

Reader Notes

1. ↩︎ A room protected from drafts. This continues the historical closed-room method discussed in Chapters 120–121. Here the bedroom is within an upstairs suite, allowing an additional enclosed space between the patient and an opened outer door. “Pathogenic wind” belongs to the traditional explanation of illness; the room is not a sterile isolation chamber. Sun Simiao's text discusses shelter from wind during treatment. That establishes a historical source for the method, rather than clinical evidence that closing doors and windows improves recovery from a modern stroke. Source: Qianjin Yaofang — volume 8, discussion of wind paralysis (Chinese transcription).
2. ↩︎ Supporting healthy qi and expelling pathogenic factors. The Chinese expression fuzheng quxie consists of four characters. “Healthy qi” concerns the body's normal functioning and ability to resist illness; “pathogenic factors” are influences understood within the traditional framework as causing disease. Evan's military comparison emphasizes helping the patient withstand illness while addressing its cause. The terms are broader than a particular immune response or a named microorganism. This is a treatment principle within Chinese medicine, not a direct translation of immunotherapy or a demonstration that one medical system produces better outcomes. Source: WHO — TCM terminology, entry 2258.
3. ↩︎ The 1929 controversy. In 1929 a proposal to abolish the practice of Chinese medicine provoked organized opposition and a petition movement. This is the historical dispute Evan invokes when discussing medicine in China's Republican era. “Beijing's Four Great Physicians” is a collective honorific; this passage names Shi Jinmo and Kong Bohua without listing all four. The institutional history below supports the controversy and opposition, but does not independently establish the individual cures, dose counts, or twelve-patient contest in his account. Source: China Association of Acupuncture-Moxibustion — Chinese medicine and the abolition controversy (in Chinese).
4. ↩︎ Antibiotics and resistance. Antibiotics treat certain bacterial infections; they do not treat the viruses themselves. Their adverse effects and the development of antibiotic-resistant bacteria are distinct issues. Resistance in bacteria is different from a child's general ability to resist illness. Evan's account of children growing weaker and needing progressively stronger medicines is his explanation here. The cited public-health guidance documents harms from unnecessary use, including serious reactions, but does not establish that antibiotics as a group inevitably weaken children in the sequence he describes. Source: CDC — Antibiotic Do's and Don'ts.
5. ↩︎ Treatment effects and supporting the patient. Chemotherapy can damage healthy, rapidly dividing cells as well as cancer cells, which helps explain why treatment can be physically demanding. Side effects alone do not show how well it is treating a cancer. Evan interprets those burdens through healthy qi and pathogenic factors, then discusses care alongside surgery and chemotherapy. His proposed benefits of herbs remain his clinical claims; the source explains chemotherapy and its effects without verifying those benefits or identifying what his unspecified falling test results measure. Source: National Cancer Institute — Chemotherapy to Treat Cancer.
6. ↩︎ Processing and toxicity.Paozhi means preparing or processing medicinal materials before their use in a prescription; it is not simply another name for boiling a finished decoction. Dose, material identity, preparation, and interactions can all matter, but their relevance does not establish that a particular prescription is safe. Clara does not identify the acid she has seen discussed online, so the translation leaves it unnamed. The chapter's digitalis and food comparisons are Evan's argument, not an independent assessment of each product. Sources: WHO — TCM terminology, entry 2612; NCCIH — Traditional Chinese Medicine, safety section.
7. ↩︎ SARS and the limits of a reported outcome. SARS is severe acute respiratory syndrome, associated here with the 2002–2003 outbreak. “Lasting effects” translates houyizheng, or sequelae: health problems remaining after the acute illness. Evan makes an absolute claim about patients at one hospital treated with Chinese medicine alone. WHO's report concerns studies of Chinese and Western medicine used together; that scope cannot by itself confirm his statement about Chinese medicine alone or the absence of every later complication. Source: WHO — SARS: Clinical Trials on Treatment Using a Combination of Traditional Chinese Medicine and Western Medicine.
8. ↩︎ The reported case and its measurements. The account distinguishes surviving with cancer from curing it. Its thirty-seven days of radiotherapy, three-day rescue, three years of decoctions, and ten additional years of life remain figures in Evan's retelling. The Chinese text gives hemoglobin as “6 g” without a volume denominator and the white blood cell count as “3,400” without a unit. Neither has been silently converted into a complete laboratory result. Seventy-five jin, using the modern mainland measure of 500 grams per jin, is 37.5 kilograms, about 83 pounds. The individual case has not been independently verified for this draft.
9. ↩︎ Mubiezi. This medicinal material is the ripe seed of Momordica cochinchinensis. It is distinct from the aconite materials named later. Evan's comparison between 30 g and a 1.2 g limit is preserved as stated; he does not identify the edition or authority for that limit. The regulatory list below establishes the material's identity, not the safety of his reported dose. A single account of prolonged use cannot establish a generally safe dose, and this passage supplies no verified preparation specification for reproducing it. Sources: Hong Kong Department of Health — Schedule 2 list, Semen Momordicae (in Chinese); Chinese Medicine Council of Hong Kong — medicinal materials list, mubiezi (in Chinese).
10. ↩︎ Fuzi and chuanwu. These are distinct aconite medicinal materials: fuzi concerns the lateral root, while chuanwu concerns the main root of Aconitum carmichaelii. Their names here do not specify the preparation Alex was asked to taste. Aconite alkaloids can cause serious poisoning, including dangerous heart-rhythm disturbances. The question returns to Evan's earlier teaching about tasting medicines; the chapter ends before Alex answers. It does not show him tasting either material or establish that the proposed exercise is safe. Sources: Hong Kong Department of Health — Aconite materials and safety (in Chinese); Department of Health — Chinese Herbs II, chuanwu and fuzi (in Chinese).