A doctor who travels through two eras

While the British were still arguing about penicillin, the Americans were clever and insightful, immediately making penicillin the country's second priority, second only to developing the atomic bomb.

In 1943, they began supplying small quantities of penicillin to the army, but the production cost was extremely high at the time, so it could only be used on wounded soldiers whose lives were in danger.

For example, in the first five months of 1943, a total of 500 million units of penicillin were produced, which was only enough to treat 180 critically ill patients, demonstrating how low the production of penicillin was.

Low production meant exorbitant prices; in 1943, penicillin cost $200 per dose in the United States.

If you ship it to Shanghai at this price, the price will be several times higher.

According to the memoirs of the bodyguards who served the great man, in 1948, the great man was on a business trip when he encountered a seriously ill little girl who needed to be treated with penicillin.

However, at that time, the great man only had seven vials of penicillin given to him by Song Guomu during the Chongqing negotiations, and he only had one vial left.

Despite the doctor's objections, the great man insisted on giving the last precious vial of penicillin to the little girl, thus saving her life.

This story shows that even great men couldn't get their hands on too much penicillin, otherwise the guards wouldn't have recorded it as such a big deal.

This shows how expensive penicillin is. The United States itself can't produce much, and when it's shipped to Shanghai and Hong Kong, the price is astronomical.

It's that simple: exchange 5 units of penicillin for a 31.5-gram small yellow croaker.

Some scientists in our country are insightful and recognize the importance of penicillin.

For example, Tang Feifan, a medical doctor who studied abroad, successfully developed a solution in Kunming in 1943 that contained 50,000 units of penicillin per bottle.

At that time, the conditions in his penicillin production workshop were extremely difficult.

They used a broken wooden boat as a recycling device, placing it in the lake for dialysis; there was no running water, relying entirely on a boiler that needed repair every day after use; the gastric mold was extracted from the stomachs of the pigs they raised, and so on.

It can be said that they have made the most of what they could, but unfortunately they cannot mass-produce it. Tang Feifan has been trying to find ways to improve it.

Unfortunately, Dr. Tom was wrongly accused and died suddenly in 58, a case of some people destroying their own cause.

Later, another doctor who had studied abroad, Zhang Weishen, successfully returned to China with a penicillin sample given to him by his mentor. He found a material to replace corn pulp and lactic acid, and in 1953, he officially began small-scale mass production.

Although it is said to be in mass production, a workshop with a dozen or so employees operating manually, without even a standard production line, shows that the output is so low that it is completely unable to supply the whole country.

Historically, the vast majority of penicillin in China was smuggled in from Hong Kong.

Penicillin was expensive to begin with, and with the added smuggling, the country paid out a lot of foreign exchange and gold, while the bold people in Hong Kong made a fortune.

As a result, Huo Daheng's family rose to become one of the top wealthy families. He made outstanding contributions to the country, and the country did not treat him unfairly.

Of course, the history of this life was deviated from due to the appearance of Lin Sanqi. He transported at least several million bottles to this time and space through time travel, which greatly alleviated the domestic antibiotic shortage.

But don't forget, this is a large country with 960 million square kilometers and 7 million people. Throwing millions of bottles of penicillin in wouldn't even make a splash.

Dean Zhang suddenly thought of something and said solemnly:

"Minister Lin, there is another issue I need to raise with you. Penicillin has a fairly high allergy rate. Every year, the proportion of deaths caused by anaphylactic shock due to penicillin injections is very high."

In particular, the penicillin produced by the Shanghai Third Pharmaceutical Factory had excessively mixed purity, resulting in an allergy rate of 15%, a very alarming figure from a clinical perspective. We must pay close attention to this.

As soon as he finished speaking, many people at the symposium started discussing it.

Director Sheng frowned and sighed, saying:
"Old Zhang is right. Just now, a medical accident happened in our department. One of our colleagues in the finance department died on the spot due to laryngeal edema and difficulty breathing after being injected with penicillin. It's very regrettable."

Because there is currently no comprehensive adverse drug reaction monitoring system in China, but according to my information, the allergy rate for imported penicillin is around 8%, while that for domestically produced penicillin is likely over 15%.

Lin Sanqi nodded, thinking that this was normal.

Even in 2016, a year of advanced technology, the penicillin allergy rate was between 1% and 10%.

Moreover, they either don't have allergies, or when they do, the allergic reaction is extremely severe. If they are in a large hospital, it might be okay, but if they are in a grassroots hospital that lacks emergency equipment and medicine, they will die.

After writing it down in his notebook, Lin Sanqi said helplessly:
"The allergic reactions you mentioned are indeed a problem. While medicine isn't 100% safe, such a high allergy rate still poses a significant risk." Director Sheng said with a wry smile:

"Even if the allergy rate is high, the treatment rate is higher. When faced with two evils, choose the lesser; when faced with two benefits, choose the greater. Right now, we lack antibiotics, so we can't afford to be picky. We're lucky if we can get any."

Lin Sanqi thought to himself, "In another time and space, the School of Pharmacy at Huadu Medical University has a complete drug library, containing all the antibiotic formulas and processes in the world."

Since penicillin has such a high allergy rate, it can completely replace another broad-spectrum antibiotic, such as cephalosporins.

While there is a certain chance of allergic reactions to cephalosporins, it is a low-probability event and completely acceptable.

Thinking of this, Lin Sanqi wrote down the words "cephalosporin" heavily in his notebook and underlined them twice.

"Dean Zhang, besides antibiotics, what other medications do you think are needed at the grassroots level?"

Dean Zhang pointed to the pharmacy and said:
"As I just mentioned, aspirin is a treasure of our hospital because it has a rapid fever-reducing effect and is also very effective at relieving pain."

Our local hospitals mainly treat minor illnesses like headaches and fevers, but traditional Chinese medicine is too slow to take effect and its effects are unstable.

For example, if a patient has a high fever of 40 degrees Celsius and is brought to our hospital, if we use traditional Chinese medicine, we need the doctor to prescribe the medicine, prepare it, decoct it, cool it down, and then administer it. This process takes a long time, at least an hour.

The key question is whether the Chinese medicine can guarantee an immediate reduction in fever. That depends on luck.

However, if I use aspirin tablets, it takes effect in almost half an hour. It works very well and the effect is stable and reliable.

Let me give you another example. Patients who have epileptic seizures due to high fever become rigid, their faces turn ashen, and they keep convulsing. In this case, the only treatment is to reduce the fever and remove the triggering factor for the seizures.

If we were to slowly administer traditional Chinese medicine at this point, it would be too late. By the time you've finished decocting the medicine and brought it over, the patient might already be dead. Therefore, it's best to use Western medicine to sedate the patient, followed by antipyretics and other symptomatic treatments, which will have an immediate effect.

Lin Sanqi nodded. This is actually a drawback of traditional Chinese medicine.

Decades later, there is still considerable debate about whether traditional Chinese medicine is effective in emergency care.

Those who support Traditional Chinese Medicine (TCM) can cite many examples, and it's even frequently seen in the news: when a passenger on a train suddenly falls ill, a TCM doctor steps forward, uses a few acupuncture needles, and the passenger recovers.

However, from a clinical perspective, no hospital in the country offers pure TCM emergency care.

Even in "Traditional Chinese Medicine Specialty Hospitals," the emergency department operates entirely with Western medicine practices and almost never offers TCM emergency services. Why do you think about that?
So don't look at what they say, but look at what they do; that's crucial.

The solution is simple: just pick any two drugs from the drug library.

As for drugs like aspirin, aminopyrine, and metamizole, which are effective but have significant side effects, let's skip them.

The main products are acetaminophen tablets and ibuprofen, which are sufficient for clinical use.

Lin Sanqi then thought of the "4+7" national centralized drug procurement program recommended by the state decades later.

A large bottle of ibuprofen, 100 tablets, costs only two yuan.

Although in 2016 such cheap drugs were looked down upon by patients who were reluctant to take them.

However, the fact that such a large quantity of cheap and effective drugs could solve the basic diseases of ordinary people in the 1960s was an absolute merit.

Thinking of this, Lin Sanqi wrote down in his notebook: fever reducer and pain reliever.

Dean Zhang continued:
"In addition, there are common cold medicines and gastrointestinal medicines. Oh, speaking of gastrointestinal medicines, these are actually in great need at our grassroots level."

First, let's talk about enteritis, also known as diarrhea. Every year, a large number of patients die from dehydration due to diarrhea. A minor illness can turn into a major one, and in the end, they cannot be saved, which is very regrettable.

Another issue is stomach problems. As you've seen, Minister Lin, although things have improved in recent years, it's still common for ordinary people to go hungry.

Prolonged hunger coupled with a diet of coarse grains led to a very high rate of stomach ailments among the population. The pain was so severe that people would break out in a cold sweat and completely lose their ability to work, which greatly impacted the productivity of factories and rural areas. (End of Chapter)