Chapter 649: Sky-high Compensation

Chapter 649: Chapter 649: Sky-high Compensation

Following an investigation, the court found that the dosage used for certain traditional Chinese medicines was excessive. Specifically, Banxia, a toxic herb, was administered at a dose of 40g, which exceeds the range stipulated in the Materia Medica.

The court determined that the TCM clinic was at fault for having an unclear diagnostic basis, violating its duty of care, and possessing insufficient justification for the prescribed medication. This negligence was found to have a causal link to the patient’s subsequent damages.

Ultimately, the court ordered the company that owned the clinic to compensate the patient for medical expenses, lost wages, and transportation costs, totaling over 5 million yuan, within ten days of the verdict.

This verdict was final.

Banxia is the dried tuber of the Pinellia plant, a member of the Aconite family. It is pungent and warm in nature, toxic, and affects the Spleen, Stomach, and Lung meridians.

It has the effects of drying dampness to resolve phlegm, reversing ascending qi to stop vomiting, and reducing nodules to dissipate clumps. When used externally, it reduces swelling and alleviates pain.

Clinically, it is often used for conditions such as cough and asthma with excessive phlegm due to dampness and cold, phlegm-induced syncope and headaches, dizziness, insomnia, vomiting, nausea, a feeling of fullness in the chest, persistent boils and swelling, globus sensation in the throat, and scrofula.

The Materia Medica recommends a dosage of 3 to 9 grams.

Additionally, Article 27 of the ’General Principles’ section specifies: ’Regarding the [Usage and Dosage] of prepared herbs, unless otherwise stipulated, ’usage’ refers to oral administration after being decocted in water. ’Dosage’ refers to the standard daily dose for an adult, which may be adjusted as necessary.’

However, the Treatise on Cold Pathogenic and Warm Pathogenic Diseases and the Essential Prescriptions of the Golden Cabinet, written by the Eastern Han Dynasty physician Zhang Zhongjing, are classic texts widely used in modern universities of traditional Chinese medicine.

The original formula for ’Banxia Xiexin Decoction,’ recorded in the Treatise on Cold Pathogenic and Warm Pathogenic Diseases, and ’Gualou Xiebai Banxia Decoction,’ from the Essential Prescriptions of the Golden Cabinet, both call for a Banxia dosage of half a sheng—equivalent to more than 100 grams in modern measurements.

This shows that the defendant physician’s use of 40 grams of Banxia in a modified ’Gualou Xiebai Banxia Decoction’ from the Essential Prescriptions of the Golden Cabinet to treat chest pain was, in fact, based on established precedent.

Furthermore, a search of medical literature from 1989 to the present in the CNKI, Wanfang, and VIP databases revealed only seven reports related to adverse reactions to Banxia.

Only one paper, titled ’New Clinical Applications and Adverse Reactions of Banxia,’ mentioned that overdosing or long-term use could lead to chronic toxicity and compensatory renal enlargement.

Moreover, of the seventeen types of conditions discussed in that paper for which Banxia was newly applied, fourteen of them involved the use of raw, unprocessed Banxia.

The Materia Medica stipulates that processed herbs are generally to be used for internal administration. According to the ’Regulations for Dispensing Chinese Herbal Medicine,’ Banxia is a substance for which simply writing the herb’s name on a prescription defaults to the processed form. In other words, if a prescription reads ’Banxia,’ the pharmacist should dispense ’Purified Pinellia,’ as processing significantly reduces its toxicity.

No other literature, including the ’Pharmacology of Chinese Materia Medica,’ has reported Banxia causing kidney damage.

But for the court to order the clinic to pay 5 million in compensation based on the reasoning that ’the 40g dose exceeds the range stipulated in the Materia Medica’ was a decision that many in the medical community found difficult to accept.

For an ordinary doctor, 5 million yuan is an astronomical sum. They couldn’t pay it off even if they worked for forty years without spending a single cent.

’Does practicing medicine really mean you have to put your entire life on the line?’

"This verdict is like a knife plunged into the heart of every TCM practitioner. It tells us that if you dare to exceed the standard dosage to save a life, even if there’s only a one-in-ten-thousand chance of a problem, you’ll be forced into bankruptcy and total ruin the moment something goes wrong!"

"So now, doctors have learned their lesson. Everyone is just trying to protect themselves. They see a critical case and they don’t dare treat it, don’t want to treat it, and aren’t willing to treat it. This has led to a full-scale retreat of traditional Chinese medicine from the field of acute and critical care. In the end, it’s the patients who suffer."

"I took a huge risk myself this time by daring to use 30 grams of Aconite. If the patient’s family hadn’t trusted me, if every TCM doctor in the hospital hadn’t signed on to share the liability, I never would have dared to write that prescription."

"But that’s the tragedy of it all. When did saving people’s lives become a matter of gambling on luck and signing liability waivers?"

After hearing his story, Lin Xiaoyu’s eyes filled with a mixture of confusion and shock.

She had always thought of doctors as angels in white, healing the sick and saving the dying. She never imagined that behind that halo, they carried such heavy shackles and a sense of powerlessness.

"So... that kind of thing really happens..."

Lin Xiaoyu murmured, "In that case, who will dare to practice real traditional Chinese medicine in the future?"

The atmosphere of the interview grew heavy as Li Xu spoke.

Li Xu lifted his teacup to moisten his throat and continued, "Let me tell you another story. It’s a case my father handled before he passed away, one that left a deep impression on me."

"The patient had been suffering from liver cirrhosis for seven years. He’d been in and out of the hospital several times, his condition constantly fluctuating. Then, he fell for an advertisement and sought treatment at a private TCM clinic in the provincial capital that claimed to ’specialize in liver diseases.’"

"The practitioner there had a big name, but his methods were very ’modern.’ He didn’t check the patient’s pulse or examine his tongue. Instead, he just took the patient’s thick file of Western medical reports and prescribed herbs based on the arrows on the lab results."

Li Xu shook his head in resignation. "He saw ’liver cirrhosis’ on the ultrasound report. ’Cirrhosis’ implies hardening, right? So he added herbs meant to ’soften hardness and disperse nodules’ like tortoise plastron, turtle shell, and Oyster, thinking he could ’soften’ the liver back to normal."

"Then he’d look at the bloodwork. Transaminase levels are high? Then use Schisandra or pseudostellaria root. Modern pharmacology has shown that the schisandrin in Schisandra effectively lowers transaminase, and pseudostellaria root has a similar liver-protective, enzyme-reducing effect."

"Patient’s urine is yellow? That must be jaundice. So he’d prescribe isatis root and Chenpi to promote bile flow and clear it up. Hemoglobin is low? Anemia. So he’d add large doses of Ginseng, Astragalus Root, Danggui, and Rehmannia Glutinosa to ’enrich the blood.’"

"Finally, he made a point of recommending a ’three-lows, one-high’ healthy diet—low fat, low sugar, low salt, and high protein. The whole approach seems scientific and rigorous, treating the disease he sees, treating the symptom he sees. It’s a classic case of using traditional Chinese herbs like they’re Western pharmaceuticals."

Lin Xiaoyu was dumbfounded. "That... doesn’t sound wrong, though? Isn’t prescribing medicine based on the symptoms what you’re supposed to do?"

"Completely and utterly wrong."

Li Xu raised his voice, his tone laced with anger. "From a TCM perspective, that is a textbook case of ’treating the head when the head hurts, and treating the foot when the foot hurts.’ It’s the work of a quack, ’killing without drawing blood.’ The man was a complete fool."

"That patient was already in the late stages of liver cirrhosis, suffering from a weak spleen and stomach and a collapse of central qi. But that quack prescribed large quantities of bitter, cold, and aggressive herbs like isatis root and Chenpi to ’reduce inflammation.’ Then he used greasy, cloying herbs that burden the stomach, like Rehmannia Glutinosa and donkey-hide gelatin, to ’enrich the blood.’ And on top of that, he added those indigestible shell-based medicines like tortoise and turtle plastron."

"And the result? After taking his medicine, the patient completely lost his appetite, felt unwell all over, and his abdomen bloated up like a drum. Later, a minor dietary indiscretion caused his esophageal varices to rupture, leading to massive hemorrhaging. He nearly died. They barely managed to stop the bleeding in the emergency room."

"Eventually, the patient came to see my father. The moment my father took his pulse, he found the True Qi of the man’s five major organs was depleted. The qi of his spleen and stomach was nearly extinguished—he was on the brink of death. My father immediately focused on saving his stomach qi and preserving his organs. He prescribed the warming and tonifying Lizhong Decoction combined with Ginseng Rehmannia Powder. After a period of treatment, the patient’s symptoms gradually eased, and his life was saved."