Rebirth 1977 Great Era

Chapter 1352 The story begins in 1889, why wasn't this recipe passed down? (Happy National Day)

Seeing Fang Yan's shocked expression, Lu Donghua smiled and waved his hand:

"It's recorded in the book I gave you, but it's not an ancient book. It's a modern Chinese medicine magazine, and I guess you probably haven't read it."

Fang Yan was taken aback; there were indeed quite a few traditional Chinese medicine magazines among the books his master had given him.

Many of them were from other places. Fang Yan thought that he bought them out of boredom when he went out to find someone to spar with, so he didn't bother to look through them at all. When his master sent them over, Fang Yan didn't plan to look through them.

I haven't even finished reading the ancient books yet, how could I have time to read magazines?

Fang Yan nodded and said:
"I really didn't read the magazine. Can you tell me what happened?"

Lu Donghua said:
"This is a long story. It started in Xiangshan, Zhejiang in 1889. A cow was bitten by a rabid dog and died. When the cow's owner cut it open, he found a lot of purple, jelly-like stuff in the cow's stomach. It would solidify more and more when stirred. After examination, it was determined that these purple things were the product of blood stasis in the internal organs and some other substance."

"It wasn't the first time people had slaughtered a cow, but it was definitely the first time they had ever seen such a scene, and that's how the story spread."

"Then the news reached the ears of a local traditional Chinese medicine doctor. At that time, the doctor thought of a classic prescription called 'Xia Yu Xue Tang' in Zhang Zhongjing's prescriptions. He wondered if this prescription could also be used to treat the stuff inside a cow's stomach?"

"Then he tried it and found that it really worked. Whether it was an animal or a person bitten by a rabid dog, as long as this blood-stasis-removing decoction was used, it could cure them."

Fang Yan was somewhat surprised, as the formula for Xia Yuxue Tang (下瘀血汤) comes from the "Synopsis of Prescriptions of the Golden Chamber" (金匮要略) written by Zhang Zhongjing of the Han Dynasty.

The original text reads: "The master said: For postpartum women with abdominal pain, the appropriate treatment is Zhi Shi Shao Yao San. If the pain does not subside, it is because there is blood stasis in the abdomen below the navel. In this case, Xiao Yu Xue Tang should be administered. It also treats irregular menstruation." "Xiao Yu Xue Tang formula: Rhubarb 2 liang, peach kernel 20 pieces, worm 20 pieces (remove legs, boil). Grind the three ingredients into powder, mix with refined honey to form four pills. Boil one pill in one liter of wine, take eight he of the decoction, and administer immediately. Fresh blood will be expelled like pig liver."

This is supposed to be used to treat postpartum abdominal pain, but it's being used to treat rabies?
"This was recorded in the magazine?" Fang Yan asked.

Lu Donghua waved his hand and said:

"Wait, I haven't finished yet!"

Fang Yan nodded, signaling the old man to continue.

Lu Donghua continued:
"Then this story was published in the Shanxi Medical Journal by a man named Zhou Xiaonong from Wuxi. This Zhou Xiaonong was also a friend of Zhang Xichun, a famous doctor from Tianjin. Zhang Xichun also recorded this story of killing the cow in his book, which was written in 1909, 'Medical Records of Integrating Chinese and Western Medicine'."

"Then in 1924, Yan Cangshan, a famous doctor from Ninghai, Zhejiang, after testing this prescription to treat rabies, renamed it 'Rabies-Bite Poison Decoction' and recorded it in his book 'The Sequel to the Formula', which was published by Shanghai Science and Technology Press."

"Then in 1970, the Health Bureau of Heyuan County, GD Province, introduced the "Epileptic Disease Prescription" from Xiangshan, Ningbo, Zhejiang Province in a traditional Chinese medicine journal. It was Zhang Zhongjing's Blood Stasis Removal Decoction, which quoted this story and the medical case of Yan Cangshan. It was renamed Rabies Relief. At that time, many cured cases had been recorded, and there were follow-up reports. The longest period was ten years. A local doctor named Shen Zhanyao used this prescription to treat more than 100 patients over ten years, of which 45 patients were recorded."

Fang Yan looked surprised when he heard this. Goodness, so many people?

However, upon closer examination, it seems to make sense. Traditional Chinese medicine states that phlegm causes epilepsy, blood causes mania, and heat causes dryness. Zhang Zhongjing also said, "If a person is like a madman, it is definitely a blood disorder," and "bleeding will cure it."

Is that what you mean?
At this moment, Lu Donghua continued:

“At the time, some people suspected that these people did not really have rabies, so someone went to investigate and interview those people and found some records of their previous medical treatment in other places, which confirmed that it was indeed rabies.”

"Therefore, the decoction for removing blood stasis can indeed treat rabies."

Fang Yan nodded.

“However…” Lu Donghua paused again, then added.

The dialect is speechless; even the old man has learned to speak with heavy breathing.

Lu Donghua continued:
"However, this disease can only be treated with medication when it flares up. If it is not used when it flares up, it will only cause diarrhea, and after using the medication, there will be fresh blood in the urine."

He asked in dialect:

"Would his condition be considered a symptom of an illness?"

“Yes, and he’s still at the stage where medication is still effective.” Lu Donghua nodded and explained to Fang Yan and Zhang Fu, “Look at him now. Although he’s afraid of wind and water, has a low-grade fever and numbness, he’s conscious, can answer questions normally, and can sit still. This shows that although the blood stasis is deep, it hasn’t completely invaded his heart meridian, and hasn’t reached the point of convulsions, coma, or manic biting. Just now, we saw his tongue coating; there were petechiae on the tip of his tongue, and the scar on his calf felt cold and numb. These are all clear signs of ‘internal obstruction of blood stasis,’ which is exactly the approach of ‘breaking up blood stasis and detoxifying’ with the Upper and Lower Blood Stasis Decoction.”

“If it were later, for example, if he started having convulsions, talking nonsense, or even being unable to hear the name of water, then his blood and qi would already be disordered and his vital energy would be exhausted. If we used the Blood Stasis Decoction then, not only would it not expel the blood stasis and toxins, but it would also deplete the remaining vital energy due to the strong nature of the medicine.”

Lu Donghua paused, then looked at Zhang Fu, "It's lucky that you're still able to come here and talk to us. It's also the best time to administer the medicine."

Zhang Fu's brother nodded quickly upon hearing this, and then asked:

"Dr. Lu, is it normal to have fresh blood in my urine after taking the medicine? Will it harm my health?"

“It’s normal. That’s not real ‘bleeding.’ It’s the manifestation of stagnant toxins being expelled through urine.” Lu Donghua explained in simple terms, “It’s like when a water pipe in your house is clogged and dirty stuff accumulates inside, the stagnant toxins will flow out when you unclog it. The stagnant toxins in your brother’s body need to be expelled through urination and defecation. The red color in the urine is the ‘turbid stuff’ that is expelled after the stagnant toxins have dissolved. Once the stagnant toxins have been mostly expelled, the urine will naturally become clear.”

Fang Yan was still thinking, pondering the connection between "blood stasis" and rabies. Zhang Zhongjing said, "If a person is like a madman, it is a blood disease."

This is caused by internal heat and toxins disturbing the mind.

"The mind is the sovereign organ, from which the spirit emerges."

When blood stasis and heat disturb the mind, the spirit loses its master, and various complications arise.

Zhang Fu's tongue coating was yellow and dry, and his pulse was rapid, all signs of pathogenic heat.

The rhubarb in the decoction for removing blood stasis is bitter and cold in nature. It can break up blood stasis, clear internal heat, expel accumulated waste in the body, and promote the generation of new qi and blood. Peach kernel and ground beetle can break up blood stasis and dredge blood vessels.

Rhubarb can act on both the "Qi" aspect of the human body (which can be understood as the energy and functional level that maintains life activities) and the "Xue" aspect (which can be understood as the level of blood circulation).

However, when used in combination with peach kernels and ground beetles, it will act more focused on the blood, expelling stagnant blood and internal heat through bowel movements.

Cantharides can play three roles: First, it uses its strong medicinal properties to fight against toxins in the body with strong medicines, "using poison to fight poison"; second, it has a pungent taste and dispersing properties, which can break up blood stasis and dissipate lumps in the body; third, it can specifically act on the excretory channels of the lower body, clearing the urinary tract and expelling toxins and waste such as dirt and grease from the body through urination.

Take this medicine with rice wine and honey. Rice wine has a pungent taste and a dispersing effect, which can help the medicine to move better in the body and exert its effects. Honey has a sweet taste, which can alleviate the strong toxicity of the medicine, protect the "stomach qi", harmonize the medicinal properties of various herbs, and at the same time moisturize the intestines and help with defecation.

The entire prescription uses herbs with strong blood-activating properties. Taking it all at once can make the medicine more potent, and it can expel toxins through the two channels of defecation and urination.

Therefore, if the urine turns bloody after taking the medicine, it is a sign that the stagnant blood has been expelled and the toxins have dissipated.

Yes, that should be correct!

I went through the dialect from beginning to end, and logically it should be feasible, and the old man had no reason to lie to himself.

Now that Zhang Fu is in this state, he still isn't confident about using other methods to treat him.

Zhang Fu has been diagnosed as "incurable" by two hospitals. Instead of getting better, he is waiting at home for the stagnant toxins to slowly invade his heart and blood vessels. He has gone from being afraid of wind and water to having convulsions, talking nonsense, and eventually not being able to recognize people.

If he were to say now, "I'm not sure, you should find another way," what difference would that make from pushing someone to the brink of despair?
Moreover, he had just gone through the logic of "blood stasis obstructing the interior" and "blood stasis disturbing the heart," and compared it with Zhang Fu's tongue coating, pulse and symptoms. Every single one of them matched the formulation of the Blood Stasis Removal Decoction.

Master Lu Donghua had no reason to lie to him; the medical cases recorded in those magazines and the examples of ten-year follow-ups were not just empty words.

Even if there are risks, such as diarrhea or bloody urine after taking the medicine, that is a "reaction to expel toxins and stagnation," which is better than sitting and waiting for toxins and stagnation to block the flow of qi and blood, right?

First, write a prescription, admit the patient, and then go back to find that magazine and see what the medical cases in it are all about.

Fang Yan composed herself, picked up the prescription, paused for two seconds on the paper with her pen, and then looked back at Zhang Fu, who was staring at the warm water cup in the corner of the consultation table. There was still fear in his eyes, but there was more expectation for "possible improvement".

Lu Donghua's words gave him great hope.

That one glance made Fang Yan completely suppress his last bit of hesitation. With a swift stroke, he wrote down the revised "Blood Stasis Removal Decoction" formula: one mace of rhubarb (added later), seven peach kernels (skin and tips removed), seven ground beetles (legs removed and stir-fried), ten grams of ophiopogon japonicus, ten grams of polygonatum odoratum, and ten grams of saposhnikovia divaricata. At the end, he specifically noted, "Take it with one ounce of yellow rice wine and three mace of honey, and apply earthworm and borneol powder externally." After writing the formula, he didn't hand it out directly. Instead, he turned to An Dong and said, "Go and help them with the admission procedures. Arrange a private room by the window, but don't open the window too wide so the wind doesn't blow in directly."

Zhang Fu's brother was taken aback for a moment, then quickly waved his hand: "No need to trouble Dr. Fang, it's already very kind of you to treat us. We'll just get the medicine and decoct it at home. We'd be too embarrassed to take up another bed..."

“He needs to be hospitalized for observation for two days.” Fang Yan interrupted him, her tone leaving no room for doubt. “This medicine is potent, and there might be a reaction the first time he takes it. Hospitalization will allow us to adjust the prescription in time and keep an eye on his bowel movements and overall condition. Don’t worry, there’s no shortage of beds, and the cost will be calculated at the standard ward rate. Don’t worry.”

Although people say they'd sell everything they own to save them, you can't really expect them to actually sell everything they own just because of the local dialect.

Then they were taken to the hospital to complete the admission procedures. Fang Yan took the prescription and planned to go to the Chinese medicine pharmacy to get the medicine himself.

Seeing his master now, he remembered that his master was still seeing patients next door. If he left his master to come over and talk to him about rabies, the patients outside would probably be cursing him out.

When they went outside, they discovered that the patients had already been taken to other examination rooms by the triage nurses.

Lu Donghua said to Fang Yan:

"I'll go with you to get the medicine."

Fang Yan nodded, and then the two went downstairs to the Chinese medicine pharmacy to get the medicine.

The staff at the traditional Chinese medicine pharmacy, who hadn't seen Fang Yan in person for a long time, asked with some surprise:

"Director Fang, why did you come in person? Has a new patient arrived at the hospital?"

“Yes, rabies.” Fang Yan nodded.

"Huh???" The pharmacists on duty at the traditional Chinese medicine pharmacy were completely bewildered. Wasn't that thing a death sentence? Why was Fang Yan treating it?
The Chinese medicine pharmacy fell silent for two seconds. The scales and spoons in the hands of the pharmacists froze in mid-air, their eyes filled with disbelief.

Zhu Xin, who was in charge of dispensing the medicine, was the first to react. He put down the medicine bag he was holding and stepped forward, his voice lowered: "Director Fang, you're not joking, are you? Rabies... isn't it said that once it develops, it's incurable? Can your hospital treat this?"

The young pharmacist tidying up the medicine cabinet next to him also peeked over, his eyes filled with surprise and curiosity. He had only been working at the Chinese medicine pharmacy for less than two years and had only seen records of "rabies" in textbooks. He had never heard of Chinese medicine being able to cure it.

Fang Yan didn't explain much, but handed over the prescription and pointed to the herbs on it: "Make the prescription according to this formula. Wrap the rhubarb separately and mark it 'added later.' Remove the legs from the blister beetle and stir-fry it thoroughly. Don't get the dosage wrong." He paused and added, "Remove the skin and tips from the peach kernels. Use aged ground beetles, not newly dried ones. The new ones are too strong."

Lu Donghua chimed in with a smile, "Your Director Fang knows what he's doing. This prescription is a modified version of Zhang Zhongjing's classic formula. He's treated many cases with it before, so feel free to use it."

"A classical prescription?" Zhu Xin was stunned. He took the prescription and looked at it carefully. Rhubarb, peach kernel, ground beetle... Isn't this the Decoction for Removing Blood Stasis? He had prescribed this prescription for gynecological patients before to treat postpartum abdominal pain caused by blood stasis. How is it related to rabies?
But seeing the certainty in Fang Yan and Old Lu's expressions, he didn't ask any more questions. He quickly told his colleague to prepare the medicine according to the prescription: "Xiao Wu, go find the dried ground beetle. I'll weigh the rhubarb. Remember to wrap it separately!"

The young pharmacist responded and quickly went to the back of the medicine cabinet, rummaging through a ceramic jar labeled "Chen Di Bei Chong" (aged ground beetle). He poured out several dark brown, dry ground beetles, examined them carefully with a magnifying glass, and only dared to weigh them after confirming there were no impurities. Zhu Xin, on the other hand, carefully weighed the rhubarb with a steelyard balance. One qian (approximately 3 grams) was not a large amount, so he weighed it three times before pouring the powder into a special kraft paper packet and writing the words "added later" in red ink.

Fang Yan stood to the side, his eyes never leaving the medicine cabinet: "Where are the blister beetles? Take them out so I can see them."

Pharmacist Wang, who was in charge of toxic medicinal materials, quickly took out a sealed porcelain bottle from the drawer, poured out three blister beetles wrapped in white paper, and handed them to Fang Yan: "Director Fang, these were just processed last month. They were thoroughly cooked and the feet were removed. Please take a look."

Fang Yan picked one up, smelled it, and then examined the insect's color against the light—the brownish-red insect was dry and oil-free, with no burnt smell. He nodded and said, "Okay, use this one. Pack it separately from the other medicines and label it 'Poisonous, take as directed by a doctor.'"

Lu Donghua watched from the side, occasionally offering a suggestion: "Use jujube blossom honey, which is warm in nature and can better protect the stomach; the rice wine should be three years old, not newly brewed, as new wine is too strong and may harm the patient's spleen and stomach."

Only then did the pharmacists dare to proceed, and while dispensing the medicine, they couldn't help but whisper, "Can this prescription really cure rabies? I heard my grandfather say that in the past, when people in the countryside were bitten by rabid dogs, they would use moxibustion on the wound, but I've never heard of using a blood-stasis-removing decoction."

“Moxibustion is for early prevention and to stop the spread of toxins, but it is ineffective once the disease has developed,” Lu Donghua explained. “The key to this disease is that the stagnant toxins have penetrated deep into the body and blocked the blood vessels. The blood stasis decoction can expel the stagnant toxins through urination and defecation, just like unblocking a water pipe. In the past, many people in Xiangshan, Zhejiang Province, were cured with this prescription, and there are even ten-year follow-up records.”

As they spoke, the medicine had already been prepared and divided into five brown paper packets. One packet each contained rhubarb and blister beetle, while the other three were a mixture of other herbs. Each packet was then wrapped in a cloth bag printed with the hospital's logo. Zhu Xin handed over the packets and then carefully slipped in a slip of paper with "Dosage and Instructions" written on it: "Director Fang, everything has been prepared as you instructed, and the instructions for use are clearly written. Could you please double-check them?"

Fang Yan took the medicine bag, glanced at it, and nodded after confirming that the amount of each herb was correct: "No need to check. I trust you to prepare the medicine. Just decoct it according to my instructions and send it to the inpatient department later."

"Okay!" the pharmacist in charge of decocting the medicine agreed.

Fang Yan was about to leave when he remembered something and added, "I'll have someone come and get the earthworm and borneol for external application later. The earthworm should be roasted with wine, and the borneol should be natural, not synthetic."

"Okay, I'll get ready right away!" Zhu Xin quickly agreed.

Next, Fang Yan said to Lu Donghua:
“Master, which magazine are you referring to? I’ll take advantage of this free time and go back to find it and look at the medical cases inside.”

Lu Donghua said:
"The one with the dark blue cover, the 1972 edition of the Zhejiang Journal of Traditional Chinese Medicine, a bound volume, the one with the cover slightly curled."

It seems the old man has a deep impression of this.

Fang Yan immediately agreed:

"Okay! I'll go back and find it right away. After I'm done, I'll go check on Zhang Fu's condition in the ward. Would you like to come with me or stay here?"

“Let’s go back together!” Lu Donghua replied.

On the way, Lu Donghua said to Fang Yan:

“In that bound volume, Shen Zhanyao also wrote a detail: there was a patient whose condition was similar to Zhang Fu’s. He was also afraid of wind and water, had petechiae on the tip of his tongue, and had diarrhea for the first two days after taking the medicine. His family was very worried. Later they found out that it was the elimination of toxins. If you encounter this situation, you must explain it to Zhang Fu’s brother in advance so that they don’t panic.”

Fang Yan kept these words in mind and nodded in response, "I understand. I'll explain it to them when I go to the ward later, listing out all the possible reactions so they can be prepared."

Back home, Fang Yan went straight to the study. The magazines were all piled up together, and there were only a few dark blue ones, so they were easy to find. Soon, Fang Yan found the bound volume with the dark blue cover. The edges of the cover were badly curled, and it had the unique smell of old books.

He pulled out the book, patted the thin layer of dust off the cover, and was about to open it when Lu Donghua leaned over and glanced at it: "This is the book. Turn to page 126, the medical case is right there. I even drew a line next to it back then."

Fang Yan turned the page as instructed, and sure enough, on page 126, he found a report titled "Report on 45 Cases of Rabies Treated with Rabies Relief." A faint horizontal line was drawn next to the title in pencil, the handwriting still carrying a hint of aged strength, clearly left by Old Lu years ago. He read it word by word, his gaze lingering on the passage: "Patient Li, male, 38 years old, developed fear of wind and water, numbness in the lower limbs, petechiae on the tip of the tongue, and a rapid pulse half a month after being bitten by a rabid dog… He was treated with Rabies Relief (Xia Yu Xue Tang plus Ophiopogon japonicus and Polygonatum odoratum). After three days of medication, his urine was light red; after seven days, the toxins were cleared; and he remained free of recurrence for ten years during follow-up." His mind instantly clicked—weren't these Zhang Fu's current symptoms? Even the age and pulse were almost identical.

"You even highlighted the key points back then?" Fang Yan looked up at Lu Donghua, her tone filled with sudden realization.

Lu Donghua smiled and tapped a page in the book: "When I first came across this prescription, I found the approach quite remarkable, so I marked it down, thinking that I could use it as a reference if I encountered similar cases in the future. I never expected it would actually come in handy today." He paused, then pointed to the section on "addition and subtraction strategies," "Look here, it says 'For those with Qi deficiency, add Ophiopogon japonicus and Polygonatum odoratum; for those with severe wind-evil, add Saposhnikovia divaricata,' and the medicine you added for Zhang Fu is exactly the same, which shows that your diagnosis was correct."

Fang Yan felt more confident, and then discovered that someone had even written a few "precautions after taking the medicine": 1. Mild diarrhea may occur (3-4 times a day is normal, more than 5 times requires adjustment of the prescription); 2. Light red urine indicates the expulsion of toxins, do not panic; 3. Moisten the mouth with warm water when it is dry, do not drink too much water; 4. Apply earthworm borneol powder externally twice a day, avoiding scars and broken skin.

The handwriting was clearly not that of Master Lu Donghua.

Has anyone else read this magazine?

“That’s a friend from Zhejiang, who also practices martial arts and studies traditional Chinese medicine,” Lu Donghua said to Fang Yan.

Fang Yan understood that this must be someone like a master or friend.

No wonder he was so impressed.

Fang Yan then looked at several more medical cases.

All of them are based on the same formula, and there are even follow-up records.

Now, the last bit of uncertainty in his heart completely disappeared. The medical record stated, "Five years of follow-up, the patient did not experience any recurrence of fear of wind or water and could work normally." "Ten years of follow-up, the patient's diet and sleep were normal, and no sequelae were observed." Every point was written in black and white, which was more convincing than any explanation.

But here's the question: why wasn't such a powerful recipe passed down?

It can't be that rabies vaccines and immunoglobulins are too profitable, right?

PS: The basic chapter of 6000 words has been updated.

(End of this chapter)