A doctor who travels through two eras

Among the drugs used in the "quadruple therapy", isoniazid, rifampicin and pyrazinamide are all bactericidal drugs.

Ethambutol has an antibacterial effect on tuberculosis bacteria. When used in combination with other anti-tuberculosis drugs, it can delay the development of bacterial resistance to other drugs.

However, three of the drug ingredients, isoniazid, rifampicin and pyrazinamide, may damage liver function.

There are also gastrointestinal reactions such as nausea, vomiting, abdominal discomfort, and may also cause joint pain, blurred vision, allergic reactions, etc.

Therefore, young people like Zhao Yanxia can receive outpatient treatment and regular check-ups, while old men like Ma Lianliang can only be hospitalized for observation and have their drug dosage and quantity adjusted at any time based on examination indicators.

When Dean Shen heard that he had to be hospitalized, he suddenly became worried and reminded him in a low voice:

"Xiao Qi, our Chinese medicine hospital, whether it is the main hospital or the branch hospital, does not have an inpatient department. Look..."

Traditional Chinese medicine hospitals all adopt the outpatient model, so neither Kuanjie nor Changping have inpatient departments or relevant staff.

If Ma Lianliang needed to be hospitalized, there would be no place to put him.

When President Su of the Peking Opera House heard this, his mind started working quickly. He just wanted Master Ma to recover and return to the stage, and he didn't care how you treated him.

"Old Shen, I see that many of your dormitories are empty. Why don't you vacate one and use it as a ward for us?"

When the Changping branch was built, they feared that there would be a second and third round of staff reduction policies, so they built more dormitory buildings at the beginning to avoid a shortage of housing in the future. (This was the idea behind the construction of the Third Front back then)

This time the National Peking Opera Company came to Changping for a three-day performance, and these empty dormitories became temporary accommodation for the actors.

Dean Shen thought for a moment after hearing this and shook his head:

"No, that's not possible. The five dormitory buildings are all connected. There are 5 employees and their families in our hospital, including many elderly people and children. It's not appropriate to put tuberculosis patients in the dormitory area as wards."

After all, tuberculosis is an infectious disease, so Director Shen is still cautious. He doesn't want to infect the people in his unit, and the employees will not agree to that.

Ma Lianliang was a little anxious when he heard this. His senior disciple Zhang Xuejin was very perceptive. Seeing that his master was anxious, he immediately suggested:

"President Shen, Doctor Lin, can we go to Union Hospital for treatment? The inpatient department there is well-equipped. I heard that they just imported a lot of equipment from abroad, which will make it easier to monitor the condition of my master and Teacher Chen, right?"

The speaker has no intention, the listener has the heart.

Dean Shen was immediately unhappy: "How can we say that? Do we still need Union Hospital to treat our patients? Don't we have any face left in our hospital?"

Zhang Xuejin was also a smart man. He knew that he might have accidentally violated other people's taboos, so he quickly shrank his neck and stepped aside.

Lin Sanqi looked at Zhang Xuejin, a handsome young man who was only 19 years old, and thought that the Peking Opera circle was also a circle where people compete with their fathers.

Ma Lianliang is Zhang Junqiu's adoptive father, and Zhang Xuejin is Zhang Junqiu's biological son. But Zhang Xuejin also worships Ma Lianliang as his master. Look how messed up the generations are.

However, Zhang Xuejin was a man with a conscience. Ma Lianliang was persecuted to death. So many of his disciples and relatives and friends did not dare to see him off, for fear of avoiding him. Only Zhang Xuejin went to see him off.

True friendship is revealed in times of crisis, which shows that Ma Lianliang did not accept him as an apprentice in vain, and also shows that Zhang Junqiu's family education is really good.

Oh, by the way, Zhang Xuejin later married the movie star Song Jia, so he can be considered quite lucky.

Lin Sanqi thought about it again and remembered that Zhang Xuejin's health did not seem to be very good. He had hepatitis B, which is also an infectious disease. He later died young from this disease.

Although hepatitis B cannot be completely cured like tuberculosis, it is not difficult to control it.

Lin Sanqi thought that when he had free time, he would do something about hepatitis B. After all, China is a country with a high incidence of hepatitis B, with one in ten people being hepatitis B patients. This statistic is more exaggerated than that of tuberculosis, and the consequences are more serious.

Everyone in the small conference room had no idea that Lin Sanqi was having so much inner drama. They were all still racking their brains to think of a way to set up an inpatient department.

Dean Su looked out the window at this time, then pointed to a pile of rocks at the foot of the mountain in the distance and said:

"Old Shen, look over there, the ground is all stone, you can't grow crops there, but it's empty anyway, so you can build a ward there. This will not only meet the needs of hospitalized patients, but also keep it away from your dormitory area, killing two birds with one stone, right?"

The Chinese medicine hospital has 1000 acres of mountain land, with some fruit trees planted on the mountain, but they are left abandoned because they cannot produce crops.

When Dean Shen thought about it, the light above his head suddenly lit up, and he thought that this seemed to be a good idea.

Tuberculosis is an incurable disease in China today. If Lin Sanqi has a secret recipe that can cure tuberculosis, it will greatly enhance the reputation of the Chinese medicine hospital.

If a special "tuberculosis ward" is set up in a traditional Chinese medicine hospital to treat tuberculosis patients, it will not only create huge economic benefits, but more importantly, it will have huge social benefits.

Even if traditional Chinese medicine hospitals can cure most cases of tuberculosis, it will not only be able to suppress its old rival, the Union Hospital, domestically, but it will also make a sensation around the world, becoming a big satellite of my country's medical and health care industry and bringing glory to the country.

Thinking of this, Dean Shen quietly pulled Lin Sanqi aside and asked seriously:

"Xiao Qi, how confident are you in treating tuberculosis?"

Lin Sanqi thought that Dean Shen was talking about the two patients in front of him, so he replied without thinking:
"I am 99% sure about Zhao Yanxia. Ma Lianliang is a bit more troublesome. He is too weak. While taking anti-tuberculosis treatment, he also needs Chinese medicine to regulate his liver and protect his liver. The cure rate should be...more than %."

Dean Shen thought that Ma Lianliang's cure rate was 50%, half and half, but he didn't expect it to be 99%. What's the difference between that and a cure?

The old man glared at Lin Sanqi without hiding anything and continued to ask:

"Xiao Qi, you see there are many patients with tuberculosis now. For example, eight employees in our hospital suffer from tuberculosis. If our hospital sets up a tuberculosis department to treat tuberculosis patients and prepare 8 beds, are you sure about the treatment? Or is there any problem with the drug supply?"

Lin Sanqi instantly became alert.

He traveled to this era to make a fortune by monetizing traffic, not to be a doctor.

If he stays in the hospital every day to treat patients, even if he becomes the best doctor in the country, what's the point? What can he do with a salary of one or two hundred yuan a month?

Even if he works 12 hours a day, he can only see more than 100 patients a day at most. How many patients can he see in a year?

Therefore, he was absolutely unwilling to tie himself down to a clinical position, and he wanted to travel all over the country for procurement.

"Uncle Shen, please don't harm me. You know my role is to get supplies that others can't get, and to exchange Chinese medicinal materials for food and so on. I don't want to sit in the outpatient clinic every day. You let me be the head of the department, isn't this harming me?"

Dean Shen was furious when he heard this and slapped Lin Sanqi on the head:
"Get lost! How could I possibly harm you? There are so many tuberculosis patients in the country right now who are suffering from the disease. You are a descendant of a family of traditional Chinese medicine practitioners, but you have a prescription, so why don't you think about curing the disease and saving lives? Are you only interested in money?"

Lin Sanqi cried out, "Uncle Shen, I don't love money, I only love Chinese medicinal herbs. Please don't wrongly accuse me, a child of an aristocratic family, okay?"

Dean Shen was furious when he heard this, and he slapped Lin Sanqi on the head:
"You can treat patients without delaying your earning money from Chinese medicine. Think about it, when we open this tuberculosis ward, all the secret recipes will depend on you alone. Whatever Chinese medicine you want, our hospital will purchase it from all over the world for you.

The hospital will provide you with the quantity and types of herbs you need, and you can take them secretly. It won't show up in our hospital's account anyway. What do you think of my suggestion?"

Lin Sanqi was a little surprised, thinking that Shen Guoming, an old revolutionary with thick eyebrows and big eyes, actually taught him how to embezzle the company's Chinese medicinal materials? The sun rises from the west?
Dean Shen asked impatiently, "Boy, do you think this is feasible?"

Lin Sanqi thought that it was possible and there would be no problem in actual operation.

Anyway, he can have wild ginseng, musk, or officinalis. The hospital can purchase them and he can take them away secretly. He just needs to give the secret recipe and announce to the public that all the herbs have been used up.

But in theory this is fleecing socialism. If someone finds out and reports it, both Shen Guoming and Lin Sanqi will be in big trouble and will be killed at the drop of a hat.

"Uncle Shen, is this feasible?"

"Why not? If you can make a breakthrough in the treatment of tuberculosis, it will definitely be a world medical miracle and a great thing to bring glory to the country. Who dares to question you? As long as you can cure tuberculosis, everyone will only praise you.

Besides, you are the only one who knows the secret recipe for the medicine you want to make, and you are the only one who knows how many herbs you need. Anyway, you are a great guy, so as long as you transport the herbs without anyone noticing, no one can catch you. What are you afraid of?"

With the collusion between Dean Shen, Chief of Purchasing Kong Shuihu, Chief of Pharmacy Zhou Mingzhe, and Chief of Finance Zheng Meimei, it was very easy for him to "embezzle" these medicinal materials. It would be impossible to find out by just checking the accounts.

As long as he didn't do something stupid by secretly carrying bags of herbs out of the hospital and getting caught in the act, those herbs would only be considered to have been consumed in the making of the secret medicine rather than being embezzled.

Lin Sanqi is planning to open a pharmaceutical factory in 2023. In addition to precious natural musk, natural bezoar, and rhino horn, it also needs a large amount of pearls, cinnabar, realgar, coptis chinensis, scutellaria baicalensis, gardenia, curcuma, borneol, snake gall, Panax notoginseng, etc.

If all these medicinal materials were also brought over from 1960, it would be far more advantageous than purchasing them in 2023, and the efficacy would be more reliable.

Thinking of this, Lin Sanqi nodded firmly:
"Okay, Uncle Shen, let's do as you say. You'll be responsible for getting the herbs, and I'll be responsible for making the secret medicine. Let's try to build the most advanced tuberculosis treatment center in the world to open the eyes of those people at Union Hospital."

"Hey, you finally figured it out, haha."

Director Shen did what he said. He immediately took the people from the General Affairs Department of the Chinese Medicine Hospital to the foot of the farm mountain to survey the terrain, contact the construction team, and prepare to build the "Tuberculosis Department" ward.

Nowadays, many rules and regulations are not perfect. There is no need for approval from this department or that department, so there are fewer mothers-in-law, which can greatly improve work efficiency.

Finally, a relatively flat piece of land was selected at the foot of "White Tiger Mountain" to start building the ward immediately.

It is called a ward, but in fact it is just a row of bungalows.

Unlike later generations, we have to distinguish clean areas, isolation areas, contaminated areas, buffer zones, etc., and set up independent medical vacuum systems, isolated operating rooms, intensive care units, etc. Everything is simple and fast.

The ward was being built in full swing there, and Lin Sanqi was also beginning to prepare anti-tuberculosis drugs and related inspection equipment.

His personality is that if he does something, he either doesn't do it at all or he does it to perfection.

In fact, the main reason why Lin Sanqi was unwilling to be a clinical doctor in 1960 was that being a doctor would affect his ability to make money, which cannot be denied.

But there is another question: how many patients can a doctor see in a day? It's a drop in the bucket. To be honest, one doctor with more than 37 is not much, and one doctor with less than 37 is not much.

But in the end he agreed to serve as the "Director of the Tuberculosis Department", the main reason being.

As long as his appearance can cure tuberculosis, and then he can formulate standards for the diagnosis and treatment of tuberculosis, a system can be formed and promoted nationwide, and the people who will benefit will be millions of tuberculosis patients.

As for tuberculosis drugs, Lin Sanqi also has a plan.

If it really doesn't work, can't I just buy the equipment in 2023 and then build a pharmaceutical factory in 1960 to mass-produce tuberculosis drugs?

Anti-tuberculosis drugs are generally divided into first-line drugs: isoniazid, rifampicin, pyrazinamide, ethambutol and streptomycin.

Second-line drugs: sodium para-aminosalicylate, prothionamide, amikacin, kanamycin, capreomycin, levofloxacin, moxifloxacin, etc.

Second-line medications are basically not used because their efficacy is mediocre and their side effects are huge. They are usually only used when there is an allergic reaction to first-line medications.

Among the five first-line drugs, streptomycin was once used as a miracle drug. Selman Abraham, who invented streptomycin, also won the 1952 Nobel Prize in Physiology or Medicine.

However, this drug was later confirmed to be highly ototoxic and nephrotoxic, and could easily cause vestibular damage and lead to deafness in patients.

Several decades ago, a generation of children became deaf after receiving injections due to illness. The drug used was streptomycin, so it later became a backup drug and was no longer easily used.

Lin Sanqi is not going to take out streptomycin this time. Knowing that this drug is poisonous, but still using it, isn't that irresponsible to his compatriots?

The remaining four drugs are isoniazid, rifampicin, pyrazinamide and ethambutol.

Lin Sanqi checked the information and found that in the 1950s and 1960s, the most advanced treatment for tuberculosis abroad was: streptomycin + para-aminosalicylic acid + isoniazid.

This treatment plan can indeed treat tuberculosis, but the side effects of these three drugs are very serious, such as damage to the liver and peripheral nerves, strong gastrointestinal reactions, and allergic reactions that are difficult to prevent.

The key is that the combined treatment course of these three drugs is as long as 12-24 months, which means that long-term medication is required for 1 to 2 years, which creates a medical cost problem.

Streptomycin, para-aminosalicylic acid, and isoniazid are all drugs that were invented not long ago. They have very low production and are very expensive. Even in Europe and the United States, only a few wealthy people can afford them.

This is also why tuberculosis is still an incurable disease in China because anti-tuberculosis drugs have not yet been introduced into the country.

Lin Sanqi should either not be used for treatment or the most advanced quadruple therapy should be used for the treatment of tuberculosis:
Isoniazid + rifampicin + ethambutol + pyrazinamide pattern.

Isoniazid and pyrazinamide have already been invented, so Talin and Panax notoginseng can no longer get their hands on this piece of fat.

So how to intercept the patents of rifampicin and ethambutol has become a top priority.

European and American countries are very rogue, and registering patents is their favorite thing to do.

If Lin Sanqi took out the most advanced drugs of later generations and used them to treat tuberculosis in China, these advanced drugs would be secretly taken out of the country by "spies" and obtained by foreign pharmaceutical companies.

It is entirely possible that foreign pharmaceutical companies will first crack the drug ingredients and then apply for a patent.

By that time, if China wants to use anti-tuberculosis treatment, it will have to pay patent fees to European and American pharmaceutical companies. Wouldn't Lin Sanqi's work be in vain?
There are many painful lessons to be learned from drug patents.

Taking ginkgo as an example, there are currently 68 patents related to ginkgo applied for in China. Although there are only 4 patents applied for by foreigners, they almost cover the entire extraction process of ginkgo.

Although my country has the largest number of applications, most of them only cover details such as dosage changes and quality differences, and lack key innovative technologies. This means that the lifeblood of Ginkgo biloba leaves has been seized by foreign pharmaceutical companies, and China has to pay patent fees to foreign countries.

Take artemisinin as an example. It is a special anti-malaria drug that was successfully researched by several generations of Chinese doctors, such as Tu Youyou. However, it was eventually patented by a German company.

The patent for artemisinin is not in our country's hands, and we have to pay German pharmaceutical companies to use this drug. For this item alone, China loses at least US$2 million to US$3 million each year.

In addition, the Jiuxin Pills produced in Japan were developed based on the famous Chinese medicine Liushen Pills. Just because Chinese companies do not have registered patents and trademarks, more than US$1 million flows into the pockets of Japanese companies every year.

According to data from the World Patent Database, more than 70% of Chinese medicine patents are applied for by Japan, followed by North Korea, while my country only has a pitiful 0.3%.

China, the birthplace of Chinese herbal medicine, accounts for only 300% of the global trade in Chinese herbal medicine, which is about US$3 billion a year.

It is very annoying that a lot of money is being made by foreign companies.

Some idiots even shouted that "the methods passed down by our ancestors cannot be changed" and that Chinese medicine must adhere to tradition and cannot follow the methods of modern medicine.

These people are either stupid or bad, extremely stupid and extremely bad!

We just have to wait for foreign countries to register all the patents for our traditional Chinese medicine, so that it will be difficult to regret later.

As a time traveler, Lin Sanqi attaches great importance to patents. Patents are like a hen that lays eggs. With patents in hand, even if he does not produce them himself, the licensing fees can be a large sum of money.

Even if I don't want any money, it would be nice to hand over the patent to the country in exchange for large quantities of Chinese medicinal materials.

Wait, Lin Sanqi is criticizing others for registering Chinese patents, but the two drugs, rifampicin and ethambutol, don’t seem to be invented in China? They are all drugs invented by foreign pharmaceutical companies.

Lin Sanqi, a time traveler, registered their patent. Isn't that just as robbery and despicable as foreign pharmaceutical companies?
Do not do to others what you do not want others to do to you.

Humph! Those who say this are pedantic. If others can rob us, why can't we rob them?
Lu Shuren once said: We should be nobler than the noble and more despicable than the despicable.

The temperature in the capital has begun to warm up on May nights.

After watching the Peking Opera, Jin Caifeng and her grandchildren fell asleep in the house, and Pan Ye also returned to his dormitory.

The bright moonlight shines on the earth, illuminating the surroundings. At the edge of the cornfield, a pot of boiling water is bubbling on a small table.

Lin Sanqi used a lot of effort to make tea, and finally poured out three cups of water, holding them with both hands and giving them to his father.

Lin Kucan took the teacup and smelled it, then chuckled:
"Great tea. I haven't had this Phoenix Dancong tea for years."

Lin Sanqi picked up the cup himself and replied with a smile:
"Dad, I have prepared five catties of Phoenix Dancong tea and five catties of Huazhou tangerine peel for you. I will send them to you when you finish drinking them."

Lin Kucan drank the tea in three gulps and then leaned back on the bamboo chair:

"Xiao Qi, I feel like our Lingnan School's abilities are getting better and better. It's fine if it can reduce fever, but it can also cure plague? Now you've come up with a medicine that can cure tuberculosis. Is this also a Lin family heirloom?"

Lin Sanqi was a little embarrassed: "It must be inherited from our ancestors."

Lin Kucan nodded slightly, obviously having his own thoughts:
"You can say it's inherited from your ancestors, but I have to know how you plan to treat tuberculosis, right? This time is different from before. In the past, it was no big deal to reduce a fever, but this time it's tuberculosis, a huge problem that even foreign countries have not yet solved.

If you can really cure tuberculosis, even if you can only cure 80% or 90% of the time, you will have created a medical miracle. The higher authorities will definitely come to investigate and may even ask us to hand over the secret recipe."

Lin Sanqi thought that this was a high probability event.

Previously, some individuals asked for the secret recipe for treating influenza to be contributed free of charge, but in the end, President Shen and President Tu of Union Hospital helped to resist the request.

This secret recipe for tuberculosis concerns the safety of more than 10 million tuberculosis patients across the country, and the country cannot attach too much importance to it.

Moreover, the secret formula of Lin Sanqi can be used in China, so can it also be used abroad? Then can it be made into pills and exported to earn foreign exchange?
In 1960, the mainstream view was that everything on this land belonged to the country, individuals had no rights, and everything had to obey the overall situation. Once a private secret recipe was exposed, it would belong to the country.

Of course, is this wrong? Actually, it is not wrong.

The country is still so poor and ordinary people can't afford it. Does Lin Sanqi insist on holding on to the secret recipe and want to make a fortune from it?

If we want to eradicate tuberculosis, one or two doctors are not enough; we must rely on the power of the country.

Then the country needs to get the secret recipe, mass-produce it, and then promote it for free throughout the country to eliminate tuberculosis. There is nothing wrong with this principle.

"Father, I will never admit it to anyone else, but you are my father, so I will tell you the truth. I do have a secret recipe for treating tuberculosis. Look, it is this medicine."

Lin Sanqi took out a tablet from his pocket, on which was written the name of the medicine: "Ethylamine, Pyrazine, and Rifampicin Tablets".

This is a commonly used medicine for the treatment of pulmonary tuberculosis in 2023. In order to make it easier for patients to take it, the four drugs, isoniazid, rifampicin, ethambutol and pyrazinamide, are directly combined together to make a tablet.

The advantage is that the patient only needs to take one pill a day.

The original treatment plan required patients to take four kinds of pills orally, some once a day, some three times a day, and the number of pills varied. This was very troublesome and could easily lead to missed doses and affect the efficacy. (End of this chapter)