Chapter 33 May the World Be Free of Illness

The students press Evan on how medicines should be tested.

At Mingxin Clinic, Charlie hurried on with another question.

“If you won't accept testing, aren't you worried something might go wrong when you use the medicines on patients?”

“Have you ever considered what would happen if we classified Western drugs using Chinese medicine's system of evaluation?” Evan asked him. “Take amoxicillin. Which nature does it have—warm, cool, cold, or hot? Does it rise, descend, float, or sink? Which flavor is it—sour, sweet, bitter, pungent, or salty? Would you listen to our evaluation and classification?”^[1]

Charlie shook his head without speaking.

“If you won't listen to our pharmacological assessment of Western drugs, why should Chinese herbs have to undergo your pharmacological tests? I'm not arguing for the sake of it.

“From the very beginning, you've already decided that Chinese herbs are unscientific and wrong, and that they need to be evaluated through your whole system of pharmacological research.

“Only herbs that meet your standards are valid and can be used on patients. You never gave Chinese medicine and Western medicine equal standing in the first place.”

The students facing him were stunned.

“But… but…” Toby murmured. “How can you give patients medicines that haven't been rigorously tested?”

“We tested them thousands of years ago,” Evan replied. “Your approach is different. You start with pharmacological experiments, then test on animals, and finally test again and again on people. If problems arise, the drug gets sent back. More than half the drugs you develop get sent back.

“Yes, you're very rigorous. But we skipped all those earlier steps and tested directly on people. We've been doing it for thousands of years, accumulating thousands of years of pharmacological experience, all drawn directly from human beings.

“Then you suddenly turn up today and tell us that the experience we've gained over thousands of years of testing on people is wrong. We have to start with in vitro research, then use the medicines on animals, then test them on people all over again!”^[2]

“If your herbs work on people,” Toby asked, “why don't they pass the pharmacological tests or the animal tests?”

“I don't know the reason. Your drugs can pass all those earlier stages and still fail in people. So our medicines could work in people and fail at one of the earlier stages.

“I don't know exactly why. Perhaps science and technology haven't advanced far enough to discover the reason. Perhaps the two theories are inherently different. Perhaps it's one of the mysteries of the human body!”

Charlie looked puzzled. “But surely there can't be two correct answers?”

“No. There's only one.” Evan pointed at Max's roommate, who was still turning at the waist. “The answer is right there.”

The roommate had been listening with great interest as he moved. Now Evan was pointing at him, and he looked bewildered.

“Holy shit. A medical question that big, and now it's down to me?”

The others were caught between laughter and exasperation. What a clown.

“Does your back still hurt?” Evan asked.

“Huh?” Only then did he remember. He'd almost forgotten about it. “Oh! It's much better. Look, I can turn now!”

His classmates were taken aback.

Max was a little surprised too.

Evan turned back to Charlie. “Clinical results are the only answer.”

Charlie stared at him.

Evan got up and checked the time. Exactly thirty minutes. He went over and removed the needle from the roommate's Renzhong point.

“Go and lie face down over there.”

The roommate lay on the treatment bed.

Evan brought over another needle.

“Holy shit! You're not going to stick that in my ass, are you?”

“Don't worry. Just a local spot,” Evan reassured him.

“Oh, shit—”

“Hold still.”

Evan held him still, then disinfected the area behind his knee with an alcohol swab.

“This is Weizhong!” he said, and recited:

“Weizhong lies in the hollow behind the knee,

at the center of the crease, where the pulse is felt.

Low-back pain that keeps you from rising,

a heavy ache that pulls along the spine;

aching sinews that will not stretch,

wind obstruction, changing and recurring;

knees that will not bend or straighten—

with the needle, health returns.”

Evan inserted the needle straight in to a depth of 1.5 cun, then continued:^[3]

“For stiffness and pain in spine and back, drain Renzhong;

for strains and aching low back, it too can work.

There is also the point Weizhong—

for ailments of the low back, put it to use.”^[4]

“You may not believe in Chinese medicine's theories of channels and acupuncture points. But when you see results, please acknowledge them.

“We don't accept Western-style tests on Chinese herbs. But we do accept tests of a patient's recovery after taking them. If the patient gets well, the patient gets well.”

Evan patted the roommate's backside. “Don't move around. We'll leave the needle in for thirty minutes.”

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He walked back to the students. “I'm not opposed to Western medicine. In fact, I greatly admire it. You've kept advancing rapidly, while Chinese medicine has been slipping backward all these years. There are fewer and fewer genuine practitioners who can treat illness, and more and more frauds.

“I hope modern medicine will one day reach such extraordinary heights that it can fully explain the questions we've been discussing.

“If that day comes, modern medicine will have surpassed Chinese medicine completely. Then Chinese medicine can go into a museum. That wouldn't actually be a bad thing.”

The students were taken aback again.

Evan smiled slightly. “May the world be free of illness and suffering; I'd rather the medicines gathered dust on the shelves. That's what we practitioners of Chinese medicine strive for. If that day truly comes, Chinese medicine will have fulfilled its historical purpose. But that day certainly isn't here yet.”^[5]

He looked at them. “I can accept Chinese medicine going into a museum. But not after being suppressed and wiped out, forced in with its head bowed. I can accept it going in at its most glorious, when it has truly shown its worth. Because that would be a blessing for all humanity!”

His words stunned every one of them.

Charlie couldn't speak for a long while. He hadn't expected the doctor in front of him to have such a broad vision.

Clara stared at Evan. In that moment, she understood. At last she knew why he had been willing to take such an enormous risk over something that had nothing to do with him—something that had nearly ruined his life.

Because he was a doctor.

A real doctor!

Eventually, the students left. Their visit and interview were over. After the needle was removed, Max's roommate was almost completely better; his back was hardly troubling him anymore.

Evan also prescribed some medicines to regulate qi and invigorate blood.^[6]

Before Evan could leave work, Clara stopped him.

“Evan, give me your Weibo login and password.”^[7]

“Are you going to… dock my pay?”

Clara smiled. “No!”

Evan smiled too. He still had more than four years to wait before he could enter the system a second time and train under a clinical mentor. How long would Clara need to run his account before she could cancel out that waiting period?

She'd certainly do a better job than he could!

That night, the medical educator “JiangMed Senior,” who had three hundred thousand followers, reposted Evan's Weibo post with a message:

Thank you, Dr. Xu, for your guidance and teaching. He's the first genuine practitioner of Chinese medicine I've ever met—and someone I respect and want to learn from!

After returning to his dormitory, Max deleted all his old comments and posts questioning Chinese medicine. He wrote a new post:

I apologize for my ignorance, and to every practitioner of Chinese medicine I've hurt. From today on, I'll study medicine seriously and become a real doctor!

Reader Notes

1. ↩︎ Two ways of classifying medicines. The four natures describe traditional warming or cooling tendencies, rather than the temperature of a preparation. The five flavors combine taste terms with functional associations. Rising, descending, floating, and sinking describe directions of action in that framework. Evan is asking whether the students would apply these categories to amoxicillin; he does not actually classify the drug. This returns to the previous chapter's explanation of medicinal properties. Source: Science Press — Chinese Materia Medica Notes, printed pp. 15–17 (in Chinese).
2. ↩︎ Laboratory studies and human evidence. In vitro means research outside a living organism, for example in cells or isolated material. Preclinical work and studies in people answer different questions. Clinical trials specify participants, outcomes, doses, and methods such as comparison groups to limit bias. A long history of use and a patient's improvement are different kinds of observation from such planned comparisons. Evan's account of historical testing, his rejection of Western-style evaluation, and his “more than half” figure remain his arguments in this conversation. Sources: FDA — Preclinical research; FDA — Designing clinical trials.
3. ↩︎ Weizhong and cun. Weizhong is the acupuncture point at the midpoint of the crease behind the knee. This is a different point from Renzhong, used earlier; the scene moves from one to the other. Cun here is a body-based proportional measure, not a fixed English inch. The 1.5-cun depth belongs to the novel's account of the procedure. Sources: Kaohsiung Medical University Hospital — Acupoints and body-based measurement (in Chinese); WHO — Chinese medicine terminology, entries 2997–3002.
4. ↩︎ Acupuncture teaching verses. The first recitation appears in the “Ma Danyang Twelve Points” song collected in the Zhenjiu Dacheng; the second appears in its “Jade Dragon Song.” Such verses use compact lines to remember point locations and traditional applications. “Wind obstruction” names a traditional category of painful or restricted movement, rather than literal wind inside the knee. “Drain” refers to the reducing method of needling, not removing fluid. The English follows the novel's quotations; their confident promises of recovery remain part of the recitation. Sources: Yang Jizhou — Zhenjiu Dacheng, volume three, electronic transcription (in Chinese); WHO — Chinese medicine terminology, entries 1798 and 3045–3047.
5. ↩︎ Medicines gathering dust. The paired lines express a physician's wish that people should no longer need treatment, even if that leaves the medicines unused on their shelves. Dust is an image of medicine no longer needed; Evan is not recommending neglected stocks. The wording also appears in modern Chinese accounts of medical service. Here it explains his willingness to imagine his own profession becoming unnecessary. No original author is assigned to the saying. Example of contemporary use: Anhui Medical University — A physician's account headed with this saying (in Chinese).
6. ↩︎ Regulating qi and invigorating blood. These are traditional treatment aims associated with qi stagnation and blood stasis, the explanation Evan gave for the roommate's back pain earlier. Qi describes functional activity within Chinese medicine; blood stasis describes impaired movement of blood in that framework. “Invigorating blood” names a therapeutic category. It does not identify a particular modern anticoagulant or establish that a blood clot was found. The prescription's ingredients and doses are not given here. Source: WHO — Chinese medicine terminology, entries 440, 2359–2360, and 2371.
7. ↩︎ Weibo and public posts. Weibo is the Chinese social platform used throughout these chapters. People can follow an account, comment on its posts, and repost them with their own words attached. A repost can bring the original to another account's audience; it is distinct from a private message. “JiangMed Senior” is an account name retained from the earlier chapters. The follower count and the two messages here belong to the story. Source: Weibo Corporation — 2017 annual report, “Individual Page” and “Repost, Comment, Favorite, Like”.