Rebirth 1977 Great Era

Chapter 1396 The Clash Between Dialects and Western Medicine (Two Chapters Combined)
"Director Fang, I have a question to ask!" At this moment, a Western medicine doctor from Peking Union Medical College Hospital stepped forward and asked Fang Yan a question.

The doctors at Peking Union Medical College Hospital are all on the same side. Fang Yan nodded and raised his hand to signal the other person to speak.

"What I want to ask is, are there any specified standards for this prescription? For example, what dosage should be used for what kind of person? It would be best if there were quantifiable rules so that we laymen in traditional Chinese medicine could use it more easily."

As soon as he said this, all the Western doctors around him turned to look at the person who asked the question. Before anyone else had even said they wanted to learn, this person took the initiative to say that he wanted to use it, and even hoped that Fang Yan would guide them on how to use it.

However, everyone quickly figured out who this person was: a member of Peking Union Medical College Hospital.

That's normal.

Fang Yan stepped forward, took the microphone, and said:

"The core of medication standards lies in dialectical quantification. However, Dr. Shen and I, based on his experience, have summarized a three-level quantification principle. The basic formula, which is the original formula standard of the Golden Chamber, is applicable to patients in the young and middle-aged stage of the disease and those without serious underlying diseases. In addition, there is an adjustment table for special populations, such as pregnant women, children, and the elderly. These all have relative quantification standards. We have formulated at least a dozen possible situations, and we will continue to supplement them later."

"Finally, we also developed emergency response guidelines, which mainly address two situations: severe diarrhea or excessive bloody stools after medication, or worsening of laryngeal muscle spasms. These are the risks we encountered while treating Zhang Fushi."

As soon as the dialect-speaking answer was finished, the Western-trained doctor from Peking Union Medical College Hospital who had asked the question immediately stood up to express his opinion:

"Director Fang, your explanation is very clear! Our Western medicine department is willing to be the first to promote this plan within the hospital, and will strictly implement it in accordance with the three-level quantitative principles and response guidelines you summarized!"

The statement from Peking Union Medical College Hospital, a top-tier Western hospital, was like a stone thrown into a calm lake, instantly creating ripples.

Oh shit!

The dialect originally belonged to Peking Union Medical College Hospital, so what's the point of Peking Union Medical College Hospital's Western medicine doctors making a statement?
This is definitely an act in front of everyone, and the reason is self-evident: to encourage other hospitals to promote this formula.

No sooner had you finished speaking than the representative from Xiyuan Hospital stood up and said, "Xiyuan Hospital seconds this proposal! We will also immediately organize a study session to incorporate the Xia Yuxue Decoction treatment plan into our hospital's clinical pathway for dealing with the onset of rabies."

"Dongzhimen Hospital also supports this!" Another representative from a traditional Chinese medicine hospital followed suit. "Director Fang and Dr. Shen's experience is invaluable, and we have an unshirkable responsibility to promote it!"

This momentum has not stopped, and the heads of the two traditional Chinese medicine colleges have also expressed their views:
"Our college will also incorporate this program into the curriculum so that future TCM professionals can master this life-saving technique!"

"We will organize specialized training sessions to ensure that faculty, students, and doctors at affiliated hospitals can apply the techniques correctly!"

These were all things that had been agreed upon before the conference.

Fang Yan knew that if no one stepped forward, given the current situation, they might just let it go. What Fang Yan wanted was for these people to express their opinions.

Promotion requires making a splash.

However, the representative areas of hospitals combining traditional Chinese and Western medicine and purely Western medicine hospitals fell into silence.

After the enthusiastic applause subsided, a subtle silence, tinged with observation and even a hint of resistance, filled the auditorium.

The hospital representatives who had previously declared Zhang Fu "hopeless" were now bowing their heads in silence.

It was as if they hadn't heard the sound from earlier.

Just then, Vice Minister Li of the Ministry of Health, who was sitting in the front row, slowly stood up, his piercing gaze sweeping across the silent area below the stage, his voice not loud but extremely penetrating:

"Does the one who isn't speaking have any further questions?"

No one was talking around.

Shen Zhanyao then said:

"Please feel free to ask any further questions."

Vice Minister Li paused, then emphasized, "Or should I specifically ask him?"

This calm question carried an invisible pressure, almost freezing the already stagnant atmosphere in the room.

Everyone seemed to be muted, and no one responded.

Vice Minister Li's sharp gaze swept across the room, as if he were actually calling out names.

Just then, the two representatives from the Air Force General Hospital whispered to each other, and then one of them stood up and said loudly:

"Reporting to Minister Li! The Air Force General Hospital has no doubts! We are willing to learn from and promote Comrade Fang Yan's treatment plan!"

With the Air Force General Hospital taking the lead in breaking the silence, Vice Minister Li turned his attention to Station Chief Wang and others at the epidemic prevention station.

Station Chief Wang, recalling Zhang Fu's tolerance and the irrefutable evidence presented by the dialect, took a deep breath and stood up as well: "Of course our epidemic prevention station agrees to promote it! As soon as we get back, we'll immediately incorporate this plan into the rabies prevention and control emergency manual!"

Next, Vice Minister Li turned his attention to Director Xu and his delegation from the Second Municipal Hospital.

Director Xu and the doctor behind him stood up almost simultaneously, with a hint of urgency: "The Second Municipal Hospital fully agrees! We'll organize a study session as soon as we get back and apply it as quickly as possible!"

Seeing that some hospital representatives remained silent, Director Liao also stood up.

He faced the entire audience, his tone calm and powerful:
"Comrades, the use of the Blood Stasis Decoction to treat the acute phase of rabies is not just theoretical; it has been proven by Comrades Fang Yan and Shen Zhanyao with real cases and verifiable reports! It breaks the curse of 'incurable disease' and opens up a path to survival for patients! Its value lies in its ability to save lives! Promoting it is to give more desperate patients hope!"

After Director Liao finished speaking, he turned his gaze to the Western medicine representatives who had not yet expressed their opinions: "Now, let's hear from the Western medicine colleagues. What concerns do you have about promoting this plan? Or, in terms of specific application, what questions do you need our colleagues from the Fangyan department to answer? Please feel free to raise them!"

After Director Liao finished speaking, the room fell into a brief silence once again, with everyone's eyes focused on the Western medicine representatives' area, waiting for their response or questions.

At this moment, a representative of Western medicine stood up and said to Fang Yan:

"Director Fang, I have a few more questions I'd like to ask."

Great, it's good that someone stepped forward to ask a question.

Moreover, this time they weren't going for Shen Zhanyao, but for Fang Yan.

"Please speak!" Fang Yan gestured with his hand.

"We are not against its promotion, but as Western medicine practitioners, we still want to figure out a key question: through what scientific pathway do the rhubarb, peach kernel, and worm in this blood stasis decoction affect the rabies virus? Does it inhibit viral replication, destroy the viral structure, or regulate the immune system? If we only know that it 'can cure' but do not know 'why it can cure,' we will still be unsure when applying it in clinical practice."

His words were met with nods of agreement from many representatives of Western medicine.

"The theory of 'blood stasis and toxins' in traditional Chinese medicine can explain the therapeutic effect, but it does not touch on the 'molecular mechanism' that Western medicine is most concerned about. There is no clear scientific path, and there is always fear of unknown risks when it is promoted."

"Moreover, we are concerned about individual differences! For example, among young and middle-aged patients, some have high blood pressure and some have gastric ulcers. After adjusting the dosage according to the 'three-level quantification principle,' will there be any interaction with the medications for underlying diseases? These all require scientific data to support them and cannot be completely avoided by experience alone."

You can tell there must be such people just by listening to their dialect.

He took the microphone, looked at the Western medicine representative who had asked the question, and said:

"Your question is very important! The specific molecular mechanism of the antiviral effect of Xia Yuxue Decoction is indeed a topic that needs in-depth research."

"But then again, Zhang Fu's test results, which showed a complete negative result after he tested positive for antigen, have already demonstrated the efficacy of the treatment in modern medical terms, just like when penicillin cured an infection back then, humans did not fully understand its molecular structure."

He pointed to the data chart on the display board:

"From the perspective of traditional Chinese medicine, rhubarb, peach kernel, and worm work together to open up the pathway for 'expelling stagnant toxins'. Combined with modern medical understanding, this may be achieved by improving microcirculation disorders, reducing inflammation of nerve tissue, and activating the body's own clearance ability. The simultaneous decrease in CRP index and antigen seroconversion during Zhang Fu's treatment is the most direct evidence."

The dialect shifted, and the tone became more pragmatic:
"Regarding personalized medication, the three-level quantitative principle already includes adjustment plans for underlying diseases. For example, patients with gastric ulcers must take rhubarb with licorice gastric protective film, and patients with hypertension should not take it with rice wine. We are establishing a database of drug incompatibilities, and will subsequently conduct interaction screening in conjunction with the Institute of Pharmacology. The compiled data will be made public to all promotion units."

Finally, he looked at all the Western medicine representatives in the room:
“Mechanism research takes time, but patients can’t wait. Peking Union Medical College Hospital is willing to make Zhang Fu’s entire treatment record available for everyone to analyze. As Minister Li said, medical progress begins with reverence for life, not perfect theories. This prescription may not be perfect yet, but it can save lives. If everyone here is willing to work together to improve it, that will be true progress in medicine!”

The Western medicine representative was momentarily at a loss for words, and he turned his gaze to the others.

At this moment, a representative from another hospital, representing Western medicine, stood up and said:

“Director Fang, we agree with your point about ‘prioritizing efficacy,’ and Zhang Fu’s case is indeed convincing. However, as a pharmacological researcher, I still need to make my concerns clear. If we don’t understand the molecular mechanisms, we can’t even design accurate ‘adverse reaction warnings.’ For example, are there any components in the extract of the worm that affect liver enzyme metabolism? If the patient is taking lipid-lowering drugs and hypoglycemic drugs at the same time, will it cause abnormal blood drug concentrations? These are not issues that can be ‘waited for,’ but rather the bottom line for medication safety.”

The head of the emergency department at a Western hospital behind him added:
“We see patients with various complications every day in the emergency room. If we encounter an elderly person with rabies who also has heart failure and kidney failure, according to the ‘three-level quantification principle,’ the dosage for the elderly person should be reduced by 30%. But after reducing it, will the drug be effective enough? What if the toxin is not eliminated and the burden on the organs is increased? Who will bear the responsibility? Experience can cover most situations, but the risks of extreme cases must be covered by scientific data.” “Although this is a hypothesis, this situation is not impossible. We don’t need a ‘perfect theory,’ but at least we need to know ‘where the risk points are.’”

Others also echoed:
"Yes, what should we do if something goes wrong?"

Fang Yan took the microphone and glanced at the Western medicine representative who had asked the question:

"Your concerns are precisely the key to the promotion. We need more data to improve the standards! But please allow me to respond in three points."

"First, mechanism research is underway. The isolation and identification of the antiviral components of the worm and the effect of rhubarb on the permeability of the blood-brain barrier have been included in the key research plan of the Chinese Academy of Traditional Medicine. Interim reports will be sent to various hospitals within three months."

"Secondly, risk control is systematic. For example, when Dr. Shen treated a patient who was four months pregnant, he reduced the amount of rhubarb from two ounces to half an ounce, added donkey-hide gelatin to protect the fetus, and monitored fetal movement throughout the process. This approach of 'emphasizing protection and being cautious in attack' is perfectly applicable to elderly patients with combined heart and kidney failure. We have developed a 'balanced attack and supplementation scale', which will be shared immediately after the meeting!"

"Third, the responsibility lies with the medical professionals! When the Second Municipal Hospital and the epidemic prevention station told Zhang Fu to 'go home and prepare for his death,' it was traditional Chinese medicine that saved his life! Now everyone is worried about 'insufficient efficacy after reducing the dosage' and 'increased burden on the liver and kidneys,' but if we don't use this prescription out of fear of unknown risks, it's like personally extinguishing the patient's last chance for life!"

He picked up Zhang Fu's recovery report and held it high:

"Peking Union Medical College Hospital dares to publicly promise: for any adverse reactions that occur when medication is used in accordance with the three-level quantitative principle, our expert team will provide full support! But there is a prerequisite: please take this step first and use the prescription on the patient! True progress in medicine has never relied on theoretical discussions, but on us rolling up our sleeves and working together to find a way in clinical practice!"

Immediately after he finished speaking, someone else stood up and said:

“Director Fang, you said that the expert team will provide full support, but according to current regulations, any new treatment should have an ‘adverse reaction emergency plan’ before it is promoted. For example, if liver damage occurs, what drug should be used to counteract it? If severe hypotension occurs, how should the amount of fluid replacement and the dosage of vasopressors be determined? These cannot rely solely on the ‘on-site judgment of the expert team’; there must be a written operating procedure. Otherwise, grassroots hospitals will not be able to respond quickly in case of emergencies.”

Fang Yan knew there might be difficulties today, but she didn't expect there would still be so many problems even with the support of leaders from the Ministry of Health.

He took a deep breath and said:

“I fully understand your concerns. This is also a responsibility to the patients and an opportunity to promote medical progress! As for the written emergency plan, I have already compiled the ‘Guidelines for Clinical Risk Response to Xiaoyuxue Decoction’, which clearly lists three core contingency plans.”

"First, liver damage warning: liver function should be checked before medication (mainly jaundice index and transaminase). If the indicators are abnormal, stop taking the mites immediately, use licorice and mung bean soup to detoxify, and add liver-protecting drugs for severe cases."

"Second, management of circulatory failure: For heart failure patients with sudden drop in blood pressure, follow the principle of 'one supplement, two raises, three protections' and slowly infuse 200-300ml of compound sodium chloride solution, and use ginseng and aconite injection to raise blood pressure, while using 60g of astragalus decoction to protect the heart vessels."

"Third, emergency treatment for laryngospasm: If the spasm worsens, quickly acupuncture the Renzhong and Hegu acupoints, and administer Shaogan Decoction (white peony root and licorice root) to relieve the acute condition."

After the dialect was spoken, the people who had asked the questions were stunned.

I didn't expect that the dialect was actually prepared.

Is this guy even human?

At this moment, Fang Yan raised the draft plan in his hand and gestured to the entire audience:
"The guidelines will be sent to all hospitals! But there is no one-size-fits-all manual in medicine. Just like when Dr. Shen treated a pregnant woman, he immediately checked the fetal movement by hand to adjust the medication dosage when he found abdominal pain. Clinical practice always requires doctors to make on-the-spot judgments! The Peking Union Medical College Hospital expert team is on standby 24 hours a day to provide support, but the premise is—"

The dialect voice suddenly rose in pitch:

"Please take the first step! We saved Zhang Fu, whom the Second Municipal Hospital and the epidemic prevention station had given up on; Dr. Shen saved both mother and child of a pregnant woman who fell ill in her fourth month of pregnancy. These real-life cases prove that waiting and watching is the biggest risk, while daring to take action is the only way to find a way out!"

After hearing the dialect spoken, the Western doctors looked at each other.

In the end, it was the hospital that had asked the question that stepped forward, its tone clearly reluctant, yet it had no choice but to give in:
“We…our emergency department agrees to promote this approach. But there’s a condition: the first five patients must be consulted by a team of experts from Peking Union Medical College Hospital, and the medication dosage and emergency measures must be based on their consultation opinions.”

Upon hearing this, many representatives of Western medicine nodded in agreement. In fact, it was clear from Fang Yan's words that this was not a "condition" at all, but rather a way for him to save face.

These people neither completely rejected the prescription nor completely rejected it; they used a "consultation" to transfer half of the risk, thus saving face without being completely opposed to it.

Then, the director of the Department of Pharmacology at Tiantan Hospital also stood up. He adjusted his glasses, avoided Fang Yan's gaze, and said:

“Our pharmacology department can participate in the screening of medicinal materials and will also compile an interaction table between Yuxue Decoction and commonly used Western medicines. But... initially, it is only supported for use by the hospital's TCM department. Western medicine departments need to get approval before they can use it.”

Fang Yan paused for a moment upon hearing this.

The approval process he refers to here is the process by which medical technologies, drugs, clinical trials, or new therapies that involve human health must undergo a professional review process before they can be used. This process is usually established by hospitals or research institutions to conduct assessments and confirm that the technology complies with medical principles and will not pose unreasonable risks to patients.

Simply put, it involves having a professional organization determine whether the use of this new method/drug on patients complies with the core principles of "respect for life, non-harm, benefit to patients, and fairness and justice," thus avoiding harm to patients' rights due to improper technological exploration.

However, it's clear to everyone that this is just a tactful compromise. Once the approval is granted, promotion will be inevitable sooner or later. He just doesn't want to appear "too proactive."

At this point, the representative who had asked the question first also stood up. He was from the Ministry of Health and managed the epidemic prevention station.

He cleared his throat and said:

“We will add this formula to the rabies emergency guidelines, but... but it must be labeled as ‘Traditional Chinese Medicine treatment, to be used under the guidance of a TCM practitioner.’ If grassroots epidemic prevention stations want to use it, they must first report it to us for record.”

The underlying motives in these words are impossible to hide. They both respond to the promotion requirements and use "guidance from traditional Chinese medicine practitioners" and "registration" to absolve themselves of responsibility, as if to say, "It's not our responsibility if something goes wrong."

The TCM representatives present saw this but no one pointed it out. It was already a significant step forward that these previously "unyielding" Western doctors were able to loosen their grip.

Professor Fang Yaozhong quietly said to Liu Duzhou beside him, "These people are just stubborn. They know the prescription works, but they just can't bring themselves to admit it directly."

Liu Duzhou smiled and nodded: "Whether they acknowledge it or not is not important. As long as they are willing to use it and it can save lives, that's what matters."

Fang Yan, of course, knew what these people were thinking. He smiled and nodded on stage, not exposing their "little schemes." Instead, he took the initiative to speak, his tone showing a tone of tolerance that "gave them plenty of face."

"No problem! We will meet all the needs of the promotion units. Our TCM team will be on standby 24 hours a day. In addition, we will immediately organize the materials required for approval; we will work with everyone to simplify the filing process at the grassroots level. As long as the prescription can be used, we will do whatever is convenient."

His words gave Western medicine a way out, and the tense atmosphere instantly relaxed.

Finally, Vice Minister Li stood up, his gaze sweeping across the room, his tone conveying a clear sense of "knowing when to stop": "Very good! It's normal to have different opinions. Being willing to find a compromise is what it means to be responsible to the patients. The special task force will follow up on all needs to ensure that everyone has no worries during the implementation process."

After Vice Minister Li finished speaking, many other representatives followed suit and expressed their opinions.

Finally, the Western medical school also stepped forward to express its opinion.

Fang Yan kept staring at them. After they finished speaking, Fang Yan spoke again:

"Today's debate is not about opposition, but about the collision and exchange of medical ideas! Those questions about risks and the doubts about mechanisms are not stumbling blocks, but paving stones! They have transformed the Blood Stasis Relief Decoction from three herbs in an ancient book into a life-saving plan with quantifiable standards, emergency plans, and collaborative mechanisms! It is not perfect, but it is a path that our team has paved with Zhang Fu's life and the lives of the unborn children in the pregnant woman's womb! Now, I am opening this path to everyone!"

The dialect voice suddenly rose in pitch:
"The comrades from the Second Municipal Hospital and the Epidemic Prevention Station once gave up on Zhang Fu, but today they are sitting here learning; the Peking Union Medical College Hospital's laboratory confirmed the TCM detoxification theory with a 'completely negative report'; the Air Force General Hospital, Xiyuan Hospital, Dongzhimen Hospital... so many units are willing to jointly promote this! Why? Because we all understand—"

"When a patient lies in front of you, convulsing and waiting to die, you don't ask whether they are a practitioner of traditional Chinese medicine or Western medicine; you only ask yourself: What else can I do?!"

He finally looked at the representative from the Western hospital:

"Now, the answer is right before our eyes! We'll administer medication according to the three-tiered quantitative principle, and Peking Union Medical College Hospital will take full responsibility! We'll be available for consultations whenever needed! We'll disclose all the data! But there's one condition—"

"Don't let 'waiting for the right mechanism' or 'fear of risk' become excuses for refusing to help those in need! Taking this step today will save another life tomorrow! This is our duty as doctors!"

The auditorium was silent, all eyes were on him.

Fang Yan took a deep breath and bowed deeply to the entire audience:

"thank you all!"

At that moment, the camera flashes went off below the stage, followed by the clicking of shutters.

Then the professors from the Capital University of Traditional Chinese Medicine stood up and began to applaud.

Then the people from Fangyan's own secret formula research institute followed suit and began to applaud, followed by the people from the research institute, and all the traditional Chinese medicine practitioners stood up.

Then some Western doctors stood up and began to applaud.

Finally, Vice Minister Li stood up, Director Liao stood up, and everyone stood up and began to applaud.

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

(End of this chapter)