Dr. Xu: A Chinese Medicine Novel

Evan decides to explain what he meant about medicinal herbs. The argument continues.

That generous reward had certainly caught Evan Xu off guard.

Who would have thought the system, so stern and respectable, would enjoy that sort of thing?

He shook his head. There really was no figuring it out.

He looked up at Clara Zhang, thoughtful. Why did she and the system seem so well matched?

After a little thought, Evan decided he should still explain things on Weibo. Too few people understood Chinese medicine these days. They dreamed up all kinds of wild theories.

He brought up Weibo on his phone and began a post.

In an earlier post, I mentioned problems with medicinal herbs. I’ve seen some people’s guesses about what I meant, so let me explain.

People often say medicinal herbs are less potent now because of pollution or because they’re cultivated. Usually, the people saying this don’t understand Chinese medicine.

Can those things affect potency? Yes! But the effect is small. They aren’t the main issue. People in ancient times cultivated medicinal herbs too. What matters most is where the herbs come from, their age, and how they’re grown. As the saying goes, an orange grown south of the Huai River is an orange; grown north of it, it becomes a bitter orange.[1]

Some herbs only work at their best when they come from a particular place. Think of fruit and vegetables. Lipu taro simply tastes better. Only Huai-grown Chinese yam is fit for medicinal use, and medicinal chenpi, aged citrus peel, has to come from Xinhui. To ensure potency, you have to use authentic regional medicinal materials![2]

Then there’s age and how things are raised. A pig raised on commercial feed and sent to slaughter after three or four months won’t taste the same as a grain-fed New Year pig raised for a full year. Why is something so easy to understand when it comes to food suddenly incomprehensible when it comes to medicinal herbs?

The last issue, and the most important, is processing: paozhi. Most medicinal materials have to be processed into prepared medicinal pieces before they can be used. And serious problems keep cropping up in that processing.[3]

Take fuzi, aconite lateral root. It’s a medicinal substance of pure yang. It travels through all twelve channels, reaching exterior and interior alike, leaving nowhere untouched. It’s the foremost herb for restoring yang and rescuing collapse, and the lifeblood of the Fire Spirit school. That school is known for daring to treat major, severe, critical, and acute illnesses.[4]

Especially when a patient’s yang is suddenly collapsing, the pulse has vanished, and death is close, a large dose of fuzi can force the gates at the crucial moment. It breaks through yin cold and restores yang, striking like thunder to save a life hanging by a thread!

But a few years ago, fuzi production dropped sharply. Leading doctors of the Fire Spirit school went to the growing region in Jiangyou to investigate. They discovered a major problem with the processing.

Fuzi is said to “rot overnight”: dig it up, and it’s rotten the next day. So growers soak it in danba solution (calcium chloride), keeping it available to take out as needed and process gradually.[5]

Danba solution is yin and cold, while fuzi is pure yang. Cold and heat cancel each other out, using up all the herb’s yang warmth and leaving nothing but dregs. Those dregs are then made into prepared medicinal pieces and sent to Chinese medicine clinics. What could they possibly treat? With all that danba accumulated inside, they don’t just fail to work. They upset the patient’s stomach!

All sorts of scholars and professors have done studies too. Aconitine, some benzoyl alkaloid, all these different compounds—how much is left after so many hours of soaking? And their conclusion is that soaking fuzi in danba solution is scientific!

Is that Chinese medicine? It isn’t! Why is Chinese medicine declining? Can you use that kind of theory to guide Chinese medicine and its medicinal materials? Are they even talking about the same thing?

Evan sent the post and sighed softly. Fuzi wasn’t the only problem. Many medicinal materials had serious processing issues.

Unscrupulous herb dealers had existed since ancient times. Chinese medicine practitioners had been fighting them for a thousand years. This was nothing new.

The problems with medicinal herbs weren’t so different now from what they had been in the past. You couldn’t guarantee a dealer’s conscience, but at least the pharmacopoeia ought to be reliable!

Eventually, the Fire Spirit doctors had been left with no choice. They took a large sum of cash to a pharmaceutical factory and commissioned their own supply. They contracted a group of growers to cultivate and process the roots strictly to their specifications. One or two metric tons a year for their own use: that was how they had managed to preserve the school’s lifeblood.

But Chinese medicine’s problems hardly ended with fuzi.

Clara looked up. “What’s wrong? Why are you sighing?”

Evan shook his head. “Nothing. Just thinking. Ah, there’s still a long way to go if we want to revive Chinese medicine.”

Her eyes shone as she looked at him. “You have such big ambitions!”

“Let’s start by doing our own work properly…”

He lowered his head, about to put his phone down and return to his book, when a Weibo notification appeared. Someone had replied. He opened it. The same argumentative Chinese medicine basher again: MaxMaxMax.

Frowning, he opened the comment.

MaxMaxMax:

Holy shit. You Chinese medicine people do so much harm! Don’t you know the aconitine in fuzi is poisonous? You misuse it, especially that so-called Fire Spirit school. Do you have any idea what the consequences are?

Aconitine damages the nervous and digestive systems. Long-term use does even more harm, damaging the liver and kidneys too! Don’t tell me you’re using this stuff to fight poison with poison![6]

Evan blew a hard breath through his nose. Damn it. Was this guy determined to pick a fight with him?

“Shut him down!”

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The voice sounded right beside his ear.

He jumped and turned. At some point Clara had come over and bent down close against his shoulder to look at his phone.

“What are you doing?” he asked.

“Seeing what you’re up to. You never used to be interested in your phone. So you’re on Weibo. Found someone bashing Chinese medicine?”

Ding. Inheritor, deliver a forceful response to the challenge to receive double the reward.

Evan pressed his lips together. Wherever someone was attacking Chinese medicine, the system might arrive late, but it would always turn up.

“How do you think I should answer him?” he asked Clara.

She thought for a moment. “This… isn’t the time for a clever comeback. You need solid evidence. Something he can’t argue with.”

“What sort of evidence? Case records?”

“Would someone like that believe your case records?”

“Then what should I do?”

Clara smiled faintly. “Let him watch you drink it.”

…

Jiangbin Medical University.

Max Ma, a chubby young man, tossed his phone aside with a victorious smile. At last, he’d beaten that Chinese medicine doctor in an argument. He’d almost thought he couldn’t win. Then the idiot had brought up fuzi. Wasn’t that just asking for it?

Max chuckled and went to watch pretty young women on Douyin, the short-video app. Half an hour later, he picked up his phone to order takeout. It took well over another half hour to arrive.

He opened the container, chopsticks in his right hand and phone in his left: the standard eating position for today’s university students. He opened Weibo and found another post from DrXuChineseMedicine.

A video.

Max paused, then tapped it. A man sat behind a desk, wearing a mask that made it difficult to see what he looked like.

It was Evan. He hadn’t wanted to show his face, so he’d put on a mask.

Seated behind the consultation desk, he said, “Someone just said that fuzi used in Chinese medicine is poisonous. Here’s my response. The pharmacopoeia currently specifies 3–15 g for processed fuzi. I’ve weighed out 20 g here, already above that range. You can see it on the digital scale.

“Now I’m going to boil this and drink it.”

He tipped the fuzi into a decoction pot and started it boiling. “Normally, when we use fuzi, we add gancao, licorice root, to the formula to restrain its toxicity while preserving its medicinal action.

“Today, though, I’m trying fuzi on its own.”

The video sped up. A caption appeared: One hour later.

Evan poured out the medicine. “I’ll go first. Cheers.”

He lifted the mask just enough to uncover his mouth, tipped his head back, and drank the whole lot.

A woman’s voice cut in. “Kids watching at home, don’t try this yourselves. Your uncle here has had training!”

The video ended.[7]

Max stared in disbelief. His chopsticks slipped from his hand.

“Holy shit. Man, you don’t mess around, do you?”

Reader Notes

↩︎ Oranges across the Huai River. The saying comes from an anecdote in the Yanzi Chunqiu, in which the envoy Yan Ying uses the different fruit north and south of the Huai to argue that surroundings influence behavior. Evan borrows that familiar image to make his point about growing regions. This is a cultural analogy about place and conditions; the translation follows the Chinese wording supplied by the novel, without treating the anecdote as botanical evidence. Source: Chinese Text Project — Yanzi Chunqiu, the orange analogy (in Chinese).↩︎ Authentic regional medicinal materials. Daodi refers to medicinal materials associated with particular producing regions and a reputation built through long use. The term links place, cultivation, and consistent quality; it does not simply mean wild rather than farmed. Evan’s examples are regional food and medicinal products: Lipu taro, Huai Chinese yam, and Xinhui aged citrus peel. His claim that only a particular region’s yam is suitable for medicine remains his claim. The official definition explains the category without proving all the exclusions in his post. Source: PRC Traditional Chinese Medicine Law — Article 23 (in Chinese).↩︎ Paozhi and prepared medicinal pieces. Paozhi is the processing of medicinal materials before dispensing or manufacture. Depending on the material, it can involve sorting, cutting, steaming, stir-frying, or other procedures. Yin-pian, translated here as “prepared medicinal pieces,” are materials prepared for medicinal use, not pharmaceutical tablets. This manufacturing stage is distinct from boiling a dispensed prescription into a decoction. Evan’s post concerns the quality of those prepared materials; the later video depicts a separate act of decoction. Source: Hong Kong Department of Health — Chinese medicine GMP, premises and processing areas, question 12 (in Chinese).↩︎ The Fire Spirit school and restoring yang. The Fire Spirit school is a medical tradition associated with Zheng Qin’an, emphasizing yang and the use of strongly warming medicines such as fuzi. Its name identifies a medical approach. In Evan’s account, yang sustains warmth and activity; “restoring yang and rescuing collapse” means countering a catastrophic loss of those functions. The twelve channels belong to the traditional functional network, rather than twelve anatomical blood vessels. This vocabulary does not name a modern resuscitation procedure or establish the efficacy of a particular emergency treatment. Sources: Nanjing University of Chinese Medicine — Lecture on the Fire Spirit school’s origins (in Chinese); Hong Kong Health Bureau — Meridian theory.↩︎ Danba and the chemical argument. Danba is a mineral-salt processing aid. The novel’s parenthesis identifies it as calcium chloride; experimental literature describes a mixture containing magnesium, sodium, and calcium chlorides. “Some benzoyl alkaloid” preserves an imprecise chemical name in the Chinese rather than supplying a specific compound. Laboratory work distinguishes aconitine from related alkaloids whose proportions change during processing. Evan’s yin–yang account and his conclusion that the processed herb becomes useless are his argument, not findings established by these sources. Sources: Zhang et al. — Comparison of salt-processing aids, 2020, p. 1224 (in Chinese); He et al. — Quantifying nine aconitum alkaloids, 2017.↩︎ Fuzi and aconitine. Fuzi is a lateral root medicinal material; its processed forms still contain aconitum alkaloids. Aconitine is one member of that chemical group. Hong Kong’s Department of Health describes poisoning that can involve numbness, digestive symptoms, and dangerous disturbances of heart rhythm. The comment’s blanket statements about long-term liver and kidney injury remain the commenter’s wording; this passage does not supply an individual exposure assessment. “Fighting poison with poison” is the polemical phrase he uses to challenge Evan, not an explanation of how processing works. Source: Hong Kong Department of Health — Safe use of medicines containing aconitum alkaloids (in Chinese).↩︎ The filmed demonstration. The 3–15 g range also appears in Hong Kong Department of Health material referring to pharmacopoeial sources. The novel identifies no edition. Its 20 g, one-hour caption, and licorice remark remain details of Evan’s demonstration, not a validated preparation method. “Uncle” is a playful adult-to-child self-address, without implying kinship. An individual’s filmed consumption does not establish general safety; a Department of Health alert records poisoning involving processed fuzi and identifies dosage and preparation as possible contributing factors. Sources: Hong Kong Department of Health — Aconitum medicines (in Chinese); Department of Health — Herbal medicine poisoning alert, 23 March 2023.