Chinese Medicine: Starting with Daily Intelligence-Chapter 70: Induce Sweat with the Stem, Stop Sweat with the Root
Guanghe District Hospital of Traditional Chinese Medicine, Internal Medicine outpatient office.
There weren’t many patients today.
Miaoli was thinking about what Hu Qiming had said in the group chat.
She couldn’t bring herself to watch any short videos.
So, she decided to pull up Liu Zhibao’s medical records.
The record noted: "Alternating chills and fever, indicating a Minor Chaihu Decoction pattern."
Attending physician of Internal Medicine, Guo Yu.
Already knowing the answer, Miaoli reviewed the medical records again:
Patient’s chief complaint: Recurrent fever, aversion to cold, and cough with wheezing for over half a month.
History of present illness: Dry and hard stools, dry lips and red tongue, worsening cough and wheezing at night.
Tongue diagnosis: Red tongue with little coating, scattered red points.
Pulse diagnosis: Floating and rapid pulse on the right cun position.
These symptoms clearly pointed to Yangming interior heat damaging fluids. How could it have been diagnosed as a Shaoyang-pattern case for Minor Chaihu Decoction?
Miaoli’s fingers hovered over the keyboard. She hesitated, wondering if she should add a note in the internal system to correct it.
But the thought of Director Guo’s temper made her quietly pull her hand back.
"Miaoli, what are you looking at so intently?"
A voice suddenly sounded from behind her. Miaoli jumped, startled. When she turned, she saw Director Guo standing right behind her, holding a stack of medical files.
"D-Director Guo..." Miaoli hurriedly tried to switch her screen, but failed. "I was just reviewing some old cases."
Guo Yu’s gaze swept over the screen and landed on Liu Zhibao’s file. His interest was piqued. "Oh? This case is very educational."
He put down the files and pointed at the screen, speaking with great confidence. "The child’s alternating chills and fever are a classic sign of dysfunction in the Shaoyang pivot mechanism. The Minor Chaihu Decoction I prescribed both harmonizes the Shaoyang and expels the pathogen..."
Miaoli nodded stiffly, her palms breaking out in a cold sweat.
Every single word Guo Yu said contradicted the patient’s actual condition.
"Look here," Guo Yu said, pointing to the tongue diagnosis in the file. "A red tongue with little coating is a sign of constrained heat in the Shaoyang..."
Miaoli fought back the urge to argue and forced a smile. "Your analysis is very thorough, Director."
Just as the atmosphere grew awkward, the attending physician from the gynecology department, Lü Ying, rushed through the door.
"Director Guo, could you please take a look at my son?" Lü Ying asked, her expression anxious. "He caught a cold two days ago after getting caught in the rain. He has a very important interview with a state-owned enterprise tomorrow, but he can’t stop coughing..."
Guo Yu nodded. "Sister Lü, you’re being too formal. Of course, no problem."
"Xiaohao, come over here and let Uncle Guo take a look at you."
A young man in his early twenties walked in from behind her. "Uncle Guo."
"Young man, you’ve grown up so much."
Guo Yu had Xia Zhihao sit down. "Tell me, how did you catch this cold?"
"I was out a couple of days ago and got caught in the rain. I started sneezing as soon as I got home... COUGH, COUGH... Then I got a fever the next day."
"Are you averse to cold?"
"Yes, I feel cold all over."
"Does your head hurt?"
"It hurts... COUGH, COUGH..."
"Does anywhere else on your body ache?"
"...My whole body aches, and I feel sleepy."
"When did the cough start?"
"The cough started on the second day, and it’s getting worse... COUGH, COUGH... I have my interview tomorrow... COUGH, COUGH. If I keep coughing like this, it’s going to really affect my performance. Uncle Guo... I’m counting on you."
Lü Ying added from the side, "We went to get him an IV drip yesterday. The Western medicine doctor said it was an upper respiratory infection, but after a full day of the drip, it hasn’t improved. They said it would take at least three days, maybe even seven."
Guo Yu continued his diagnosis.
He had Xia Zhihao open his mouth.
The tongue coating was white and slick, with a purplish-blue tinge. He took his pulse, which was deep, fine, and tight.
Based on a comprehensive pattern differentiation, Xia Zhihao’s cough belonged to the Shaoyin pattern in TCM.
"He’s suffering from a deficiency of kidney qi, which has left his body’s surface unprotected. This allowed pathogenic qi to invade, with wind-cold penetrating directly into the Shaoyin level, resulting in a Shaoyin pattern."
If it were an ordinary patient, he wouldn’t have explained it in such detail.
An ordinary patient wouldn’t understand.
Lü Ying was a TCM doctor. Although she specialized in gynecology, she still understood the basic principles.
"Unlike treating a common cold and cough, the approach here should be to warm the kidney qi to release the exterior, and support the upright qi. We should use Ephedra, Aconite and Asarum Decoction, treating him with herbs like prepared Aconite, ephedra, asarum, and Cinnamon Bark..."
After finishing his explanation, Guo Yu added, "However, with this type of pattern, it will take at least two or three days to see any effect."
"What?"
Lü Ying’s disappointment turned to greater anxiety. "But my son’s interview is tomorrow! Is there any way to get immediate results?"
Guo Yu shook his head. "Sister Lü, you’re a doctor too. You should know that a cold is a self-limiting illness that primarily relies on one’s own immune system to resolve. The fact that we can use medicine to eliminate the symptoms ahead of time is already quite good. Three days is my most optimistic estimate..."
"Sister Lü, should I write the prescription?"
"Well..."
Lü Ying hesitated for a moment before making a decision. "No, I think I’ll just take him to get an IV drip instead."
As a TCM doctor herself, she had to admit that an IV drip could sometimes be very fast.
Lü Ying decided to take a gamble, betting that one more day of an IV drip would be enough to stop her son’s cold and cough.
"Alright."
Guo Yu wasn’t angry. He just went back to his work.
Miaoli’s eyes darted around thoughtfully.
She made an excuse to leave.
She stopped Lü Ying.
"Sister Lü..."
"Oh, Miaoli, what is it?"
Lü Ying stopped, her face clouded with worry.
"Sister Lü," she said, lowering her voice, "you should go try Doctor Li Xu at Li’s Traditional Chinese Medicine Clinic."
Lü Ying was taken aback. "A community clinic? Is he any good?"
"He has a real knack for treating coughs and wheezing," Miaoli said, looking around to make sure no one was listening. "A few days ago, there was a child who had been coughing for half a month. He was cured with a single dose of medicine."
Seeing Lü Ying still hesitating, Miaoli added, "Besides, there are no other options right now. There’s no harm in trying. And if you take him for an IV drip, he most likely won’t be better by tomorrow."
The reason Miaoli was so enthusiastic was that Lü Ying had taken good care of her ever since she started at the Hospital of Traditional Chinese Medicine.
Also, when they worked overtime, they were meal buddies and had a great relationship.
Lü Ying trusted Miaoli. "Send me the address. I’ll take Zhihao there now."
...
At Li’s Traditional Chinese Medicine Clinic, there weren’t many patients.
Li Xu was busy in the courtyard out back.
On his recent trip to Bailingyu Village, he had not only found foxtail grass but also several other precious Chinese medicinal herbs.
For instance, Gastrodia and Huang Jing.
In addition, during the two days he spent in Bailingyu Village, he had also gathered some ephedra from the surrounding mountains.
Ephedra is a special Chinese medicinal herb because it contains ephedrine. Ephedrine is a sympathomimetic drug that can excite smooth muscles, constrict blood vessels in the skin and mucous membranes, and lead to arrhythmia, dizziness, and even death.
It must be used with extreme caution.
Li Xu had also read a story in a medical text meant to remind future generations about the proper use of ephedra.
There was once an old TCM doctor who had no children and took on an apprentice.
Unexpectedly, the apprentice was arrogant. After learning only the bare basics, he began to look down on his master.
Heartbroken, the master expelled the apprentice and told him to start his own practice.
Before he left, the master repeatedly warned him, "There is one herb you must not sell to people casually."
"What herb?" the apprentice asked.
The master replied, "Leafless grass. Its root and stem have different uses: the stem is used to induce sweating, while the root is used to stop it. If you ever mix them up, you could kill someone! Do you understand?"
"I get it!" the apprentice said impatiently.
He even recited it back in front of his master, but he was just speaking the words without thinking, not using his brain at all.
After the master and apprentice parted ways, they both went on to practice medicine and treat patients.
With his master out of sight, the apprentice grew bolder. Though he knew few herbs, he dared to treat any illness.
Within a few days, he killed a patient by using leafless grass incorrectly.
The deceased’s family immediately seized him and brought him before the County Magistrate.
The County Magistrate asked, "Who was your teacher?"
The apprentice had no choice but to give his master’s name.
The County Magistrate ordered his men to fetch the master. "How did you teach him? He’s treated someone to death!"
After hearing the master’s explanation, the County Magistrate asked the apprentice, "Do you remember the method your master taught you? Recite it for me." The apprentice recited, "The stem is used to induce sweating, while the root is used to stop it. If you ever mix them up, you could kill someone."
"Was the patient sweating or not?" the County Magistrate asked.
The apprentice replied, "He was covered in a cold sweat."
"And what medicine did you use?"
"The stem of the leafless grass."
The County Magistrate flew into a rage. "That’s complete malpractice! The patient was already in a cold sweat, yet you gave him a diaphoretic herb. How could he not die?"
With that, he ordered the apprentice to be given forty strokes with a heavy bamboo cane and sentenced him to three years in prison.
The master was found blameless and released on the spot.
The apprentice spent three years in prison, which finally made him humble.
After his release, he found his master, admitted his mistake, and vowed to turn over a new leaf.
Seeing that he had changed, the master finally took him back and began to teach him the true art of medicine.
From then on, the apprentice was extremely careful whenever he used "leafless grass."
Because the herb had brought him so much trouble, he often called it "trouble grass." Later, since its root is yellow, it was renamed *mahuang*—the Chinese name for ephedra. The name is a play on words, combining a character that sounds like "trouble" with the character for "yellow."
...
The ephedra he brought back was still fresh.
It needed to be processed into a medicinal ingredient for easier storage.
Li Xu spread the ephedra out on a bamboo sieve.
The ephedra stems were long and slender, pale green, with fine vertical lines on the surface. The nodes were distinct, and the texture was tough.
He picked one up and smelled it. Its characteristic pungent, aromatic scent immediately hit his nose—a sign of high-quality ephedra.
Li Xu’s mind drifted for a moment.
’If Song Sisi were here, she’d definitely be like a curious child, asking about every little thing.’
He shook his head, clearing his mind of distracting thoughts.
Li Xu put on a pair of rubber gloves—the sap of fresh ephedra can cause skin irritation.
The first step of processing was to inspect each stem, removing any weeds or discolored parts. He used scissors to trim off the overly thick, woody root sections, keeping only the tender, green mid-stems.
Then he began to cut them. He sliced the selected ephedra stems at the nodes into sections about two to three centimeters long, ensuring the cuts were clean to avoid squeezing out the sap.
Much of the ephedra sold on the market is fumigated with sulfur, which not only affects its medicinal properties but is also harmful to the body.
The ephedra Li Xu was preparing was not only wild and natural, but also processed by his own hand.
Its effects would undoubtedly be excellent.
He spread the cut ephedra segments evenly on a bamboo tray. The next step was the most critical.
Honey-frying.
He took a suitable amount of honey and heated it in a double boiler to 60°C. Then, he poured the ephedra segments into the honey and gently tossed them, ensuring each piece was coated in a thin layer of honey.
Why use honey-frying?
Raw ephedra’s diaphoretic effect is too strong. Honey-frying moderates its properties. Generally speaking, people who are sick are in a weakened state.
The moderated ephedra is especially suitable for patients in a weakened condition.
The honey-fried ephedra was then moved to a dehydrator, set to slow-dry at a low temperature of 60°C.
Li Xu checked on it from time to time, waiting until the surface of the ephedra took on an inviting amber color and its texture became crisp.
After a flurry of activity, the ephedra was finally processed.
But he didn’t stop there. He continued on to process the Gastrodia, Huang Jing, and other herbs...
He also had to brew the foxtail grass water and prepare the eye drops to test their effects.
