Your turn to perform, I step onto the stage, mistakenly believing that a foreign land is home — commentary on the 'Stroke Wake-up Formula' research published in The Lancet

Theoretical Struggle
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Originally published at: http://sg.lsepcn.com/archives/632

Review of "Stroke Awakening Formula" Study Published in The Lancet

Editorial Board of the League of Struggle for the Emancipation of the Proletariat

0. Internal strife, Good news for Guangzhou University of Chinese Medicine's funeral affairs

On November 14th, Guangzhou University of Chinese Medicine officially announced good news that a study titled "Traditional Chinese Medicine FYTF-919 for the Treatment of Acute Cerebral Hemorrhage: A Multicenter Randomized, Placebo-Controlled, Double-Blind Clinical Trial" conducted jointly by the team of Guo Jianwen from the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Traditional Chinese Medicine), Song Lili from Fudan University, and Craig Anderson was published in The Lancet. The Lancet is the most prestigious publication in the bourgeois medical field. Publishing an article there signifies entering the highest hall of medicine, a pursuit many doctors today dare not dream of. Once Guo Jianwen’s article was published in The Lancet, Guangzhou University of Chinese Medicine felt honored and proudly announced: This is the first time in 200 years since its founding in 1823 that The Lancet has published a multicenter clinical study on Chinese herbal medicine, marking a milestone.

However, this study is a complete "slap in the face" article. The official WeChat post of Guangzhou University of Chinese Medicine claimed: "This study proves the safety of the Stroke Awakening Formula, with subgroup analyses showing potential benefits in patients with intracerebral hemorrhage volume greater than 15ml and lobar hemorrhage." But the original paper shows: "There were no significant differences between the drug group and the placebo group in prognosis, survival rate, quality of life, or serious adverse events in moderate to severe intracerebral hemorrhage patients [1]." That is, the Stroke Awakening Formula and placebo are the same, neither effective nor causing side effects. Meanwhile, the original text also clearly states: "Because of the lack of superficial cortical hematoma patients, when dividing hematoma volume into three equal parts, the results of the grouping were not significant, and the potential benefits of the two subgroup groups are unreliable." It can be said that the true content of the original text and Guangzhou University of Chinese Medicine’s loud propaganda form a perfect ironic scene. Soon, the university became a laughingstock in the Chinese medical community due to this "funeral good news," and this boastful article also became a boomerang attacking traditional Chinese medicine by the "quack medicine" and "quack drug" factions [2]. Originally, whenever they discussed Chinese medicine, they would mock Chinese herbal preparations for not being able to conduct double-blind trials. Now, their laughter is even more rampant. They celebrate that large-scale randomized double-blind trials of Chinese herbal preparations have finally humiliated themselves, exposing pseudo-science as a sham. Under these circumstances, the so-called "Chinese medicine masters" who claimed to cure many "incurable Western diseases" and had miraculous hands fell silent, only weakly defending with statements like "Chinese herbal ingredients are complex, and research cannot be generalized," or "Measuring Chinese medicine efficacy by Western standards is inappropriate."

At first glance, this seems like a trivial slapstick, but in reality, it is just the tip of the iceberg in the century-long "debate over the survival of Chinese medicine," and a microcosm of the chaos in China’s current medical research field.

"The economic production of each historical era and the social structure inevitably arising from it are the foundation of that era’s politics and spiritual history" [3]. Similarly, "Medicine, like other sciences, has always been determined by the economic life and social structure of that era." This article attempts to use the recent "Stroke Awakening Formula" being published in The Lancet as a starting point, applying Marxist analysis to see through the ongoing disputes between Chinese and Western medicine factions, understand how reactionary and imperialist factions smear China's traditional medicine, grasp the causal relationships, and give proper recognition to Chinese traditional medicine—"both for carrying forward the past and opening up the future, and to avoid the ridicule of 'forgetting one's roots'" [4].

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Good news for Guangzhou University of Chinese Medicine

1. Even a meticulous approach, is "scientific research" truly "science"?

The reason Guo Jianwen’s study gained attention was primarily because it used the double-blind trial method. Double-blind trials are considered a relatively rigorous experimental method in bourgeois medicine, often used in drug efficacy testing. Patients are randomly assigned to control and experimental groups. The control group receives a placebo, while the experimental group receives the actual drug. Neither the patients nor the observers know who receives the real drug until the end of the study. This method is believed to avoid subjective bias affecting the results, making it scientific and rigorous. At first glance, this study appears to eliminate subjective and objective interference factors, a "pure scientific experiment," but is that really the case? Let’s first look at the "placebo" itself.

The placebo effect, also known as pseudo-effect, fake effect, or substitute effect, refers to the phenomenon where patients experience symptom relief despite receiving ineffective treatment, simply because they "expect" or "believe" the treatment works. "This powerful phenomenon relies on faith—that our health improves because we believe our body will get better" [5]. Just by believing, the condition can improve or even be cured, which makes the placebo itself questionable. The movement of matter in the material world follows objective laws. A person’s thoughts are determined by their worldview, and the changes in their mental state belong to social movement, while life and death are biological movements. Different forms of movement laws cannot be confused or applied interchangeably. Shouting "Go" at a chemical reaction does not act as a catalyst; Lu Xun did not die from not believing his tuberculosis could be cured; China’s victory over schistosomiasis was not achieved by shouting slogans. Strong revolutionary fighters can endure pain and move forward, but cannot heal wounds solely by faith. Moreover, quantities have internal and external aspects. "Temperature, color depth, metal hardness, lifespan, labor productivity, etc., belong to the internal quantity. Internal quantities cannot be simply summed up mechanically" [6]. Human thoughts and beliefs cannot be quantified, nor can their influence be simply summed up with data indicators. Materialist dialectics states that matter can transform into spirit, and spirit into matter, but only through practice, not by a single thought. Marxists are not Jesus; just touching a leper’s head and saying "Be healed" does not cure the disease immediately [7].

Double-blind trials are neither scientific nor suitable for Chinese medicine research. Chinese herbal medicine is usually multi-effect, and the same herb can have different effects in different formulas. As early as Zhang Zhongjing’s Shang Han Lun, it was mentioned: "Cinnamon twig is originally for releasing the muscles; if the pulse is floating and tight, and the patient has a fever with no sweat, it should not be used." The same disease can have different symptoms, and the same symptoms can have different causes. Therefore, "treat the root cause," which is the etiology. Also, the same herb, in different doses, produces different effects. Small doses of Astragalus can raise blood pressure, large doses can lower it. Wang Qingren once lamented: "The medicinal flavor is crucial, and the dosage is even more critical." In severe cases, small doses may be ineffective, called "serious illness, light medicine"; in mild cases, large doses may cause adverse effects, called "mild illness, heavy medicine." The effects of single herbs are already complex and variable, and combining them into formulas according to certain rules makes it even more unpredictable. Clinically, formulas are tailored based on specific conditions. Double-blind trials set a series of criteria and include patients meeting those standards, but do not analyze individual cases. As medical scientist Li Shizhen criticized: "If you want to eliminate formulas, they are useless without form and substance" [8]. Traditional Chinese medicine and Chinese herbal medicine can only work together; using double-blind methods to verify Chinese herbal efficacy separates them, preventing Chinese medicine from truly functioning.

Thus, using double-blind trials as the "gold standard" for Chinese herbal efficacy is completely untenable. Yet many Chinese medicine practitioners dare not respond directly to this issue. Some adopt a lofty attitude, claiming that Chinese medicine has been passed down for thousands of years with its own efficacy, no need for double-blind proof; others hint that this study is a Western medical conspiracy, not to be trusted; some simply call for putting aside disputes and wait for clinical results. Faced with Western medicine’s heavy-handed approach, they remain silent, unwilling to challenge the authority of The Lancet or the seemingly precise scientific results of Western medicine, and even less willing to answer why this attack is launched by "their own people." "Medical science itself has no class character, but in class society, those who control medical knowledge always have class interests, and medicine always serves certain classes and political lines" [9]. In a class society, pure science does not exist. Western medicine’s manipulation of concepts like single-blind and double-blind, and its attacks on Chinese medicine, are rooted in social and historical causes. The reason Guo Jianwen bowed to Westerners and became a "dog that bites the hand that feeds" is also rooted in social and historical factors.

2. Relying on others, why has Chinese medicine become a "broken spine" dog?

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On October 22, 1978, Deng Xiaoping visited Japan and meekly signed a series of "sell-out" treaties

After the capitalist restoration in China, the pro-capitalist faction led by Hua Guofeng and Deng Xiaoping took power and raised the banner of "profit first." They extensively introduced foreign capital, relying on Western and Japanese imperialist forces to dismantle the public ownership economy, collaborating with foreign bourgeoisie to accumulate capital. The same situation exists in the pharmaceutical field. At the beginning of the restoration, compared to well-funded old imperialist pharmaceutical companies, Chinese reformist pharmaceutical companies faced capital shortages. Instead of competing in high-cost, uncertain innovative drug research, they collectively chose to become OEMs for foreign drugs, establishing joint ventures to provide the vast Chinese market and cheap labor. In 1978, China launched reform and opening-up, and the State Administration of Traditional Chinese Medicine was established. On October 22, 1978, Deng Xiaoping’s first international visit after seizing power was to Japan. Before the Law of Sino-Foreign Joint Ventures was enacted in 1979, the central government proposed a sell-out policy that foreign shareholders hold at least 25% of shares, opening China’s pharmaceutical market to foreign capital. On August 2, 1980, Lin Dong and Akihiko Otsuka signed three documents: the "Joint Venture Contract for China Otsuka Pharmaceutical Co., Ltd.," the "Technical Cooperation Contract," and the "Articles of Association of China Otsuka Pharmaceutical Co., Ltd.," marking the beginning of foreign pharmaceutical companies’ development in China. Over the next five years, the "Big Five" [10] pharmaceutical companies invested in China. By the early 1990s, foreign enterprises reached a peak in China’s pharmaceutical field, with major companies like Roche and AstraZeneca settling in. By 2010, all top 20 global pharmaceutical companies had established manufacturing bases in China [11]. Compared to new drugs with uncertain success rates after 5 or 10 years of R&D, reformist Chinese pharmaceutical companies prefer to quickly accumulate wealth through OEM, as reflected in their internal capital allocation. In 2016, the top 10 global pharmaceutical companies, including Merck, Johnson & Johnson, and Pfizer, invested about 20% in R&D, while only three of China’s top 100 pharmaceutical enterprises had R&D investment intensities around 10%, with others below that level [12][13].

Compared to purchasing chemical raw materials for direct production of Western medicines, herbal medicines require a certain growth cycle. Due to land rights and private ownership monopolies in agriculture, capital turnover for herbal medicine production is slower, unable to meet the bourgeois desire for rapid wealth accumulation. Therefore, Chinese herbal medicine was abandoned. For a long time, Chinese herbal medicine production technology has been extremely backward. Zhong Guangde, vice president of the Chinese Medical Equipment Engineering Association, admitted: "Our traditional Chinese medicine production faces 'three highs, three lows, and unfit' problems—high energy consumption, high pollution, high costs, low process level, low production efficiency, and low utilization of medicinal materials. Many processes and equipment are unsuitable for modern Chinese medicine production" [14]. However, capital’s greed for wealth is endless. Monopolistic capitalists in Western medicine will never be satisfied with existing profits; they want to monopolize all markets. They do not want to see some regions still using Chinese medicine to treat diseases, nor do they want Chinese medicine to occupy market share. So they took up the "abolish medicine and test drugs" baton handed down by predecessors and attacked Chinese medicine. They stand aloof from the masses and the people, propagating nationalism nihilism, denying that Chinese medicine is a product of the working people’s struggle, and denying the great contributions Chinese medicine has made to the development of global medicine. At that time, reformist Chinese medicine did not care about being a discarded pawn. The denial of the achievements of Chinese medicine during the Cultural Revolution by liberal factions pleased them. They turned a blind eye to the rampant attacks on Chinese medicine and did not stop them.

Therefore, during the process of restoration that worships foreign powers and prioritizes profit in everything, Zhongxiu accumulated a large amount of wealth: "Since 1978, China's pharmaceutical industry entered a period of rapid development, with the total output value of the national pharmaceutical industry jumping from 7.3 billion yuan to nearly 3 trillion yuan in 2017, a 410-fold increase over 40 years, making it the fastest-growing industry in the national economy, far surpassing the growth rate of GDP. From 1978 to 2017, pharmaceutical imports also increased from $40 million to $55.88 billion, a 1,397-fold increase."[15] As foreign capital continued to establish joint ventures in China, a large number of pharmaceutical representatives also emerged. They, as drug formulators, colluded with doctors to sell medicines to patients. **"The rise of Xi Jinping's reactionary group, like that of his predecessor Brezhnev's group, announced that the country had become an imperialist state. He openly used 'strengthening' to describe the changes in China during his tenure, and declared his ambition to dominate the world with phrases like 'realizing the great rejuvenation of the Chinese nation' and 'building a community with a shared future for mankind.'"**[16] As Zhongxiu increasingly grew into a mature imperialist country, the bureaucratic monopoly bourgeoisie also increasingly sought to monopolize China's vast market and continually invade and compete for the global market, including in the pharmaceutical field. Domestically, they became less willing to follow foreign pharmaceutical companies to scavenge leftovers and were increasingly dissatisfied with the "medicine-funded medical treatment"[17] model, which cultivated doctors closely tied to private monopoly assets. Abroad, they watched anxiously as Japanese Kampo medicine, with 80% of its raw materials imported from China, monopolized 90% of the global Chinese medicine market[18]. Thus, they increasingly sought to establish their own spokespeople in the pharmaceutical field and realize their ambition of "unifying the world" in medicine. On October 20, 2011, Beijing launched reforms to address the current situation of "medicine-funded medical treatment" in large hospitals, and in 2015, Zhongxiu fully abolished the "medicine-funded medical treatment" in all public hospitals nationwide. In 2016, the State Council issued the "Opinions on Reforming the Review and Approval System for Drugs and Medical Devices," and in 2017, the General Office of the CPC Central Committee and the State Council issued the "Opinions on Deepening the Reform of the Review and Approval System and Encouraging Innovation in Drugs and Medical Devices," encouraging the development of innovative drugs. However, to independently develop drugs and seize the domestic market, large fixed capital investments are required in the pharmaceutical sector, leading to high drug prices that are difficult to compete with the mature formulations and processes of foreign companies. Therefore, Zhongxiu chose a different path—investing in traditional Chinese medicine (TCM) production to achieve "overtaking on curves" and expel foreign capital from the healthcare market.

In terms of formulations, they directly extracted “miraculous medicines” from old texts for production, leveraging state monopoly capitalism policies to pave the way for TCM production. On August 29, 2016, the draft second review of the “Traditional Chinese Medicine Law” mentioned, “Producing qualified Chinese medicine compound preparations based on ancient classical prescriptions, when applying for a drug approval number, can only provide non-clinical safety research data.” The “Regulations on Simplified Registration and Approval Management of Chinese Medicine Compound Preparations from Ancient Classical Prescriptions” issued in May 2018 simplified the approval process for such preparations, allowing applications with only pharmaceutical and non-clinical safety data, exempting efficacy and clinical trial data, thus opening a convenient door for TCM production. A banner of “Reviving Chinese Traditional Culture” became the pass for Chinese medicine compound preparations. The bureaucratic monopoly bourgeoisie used state power to include large quantities of Chinese patent medicines into the medical insurance system, dividing the limited insurance funds. For example, in Hunan Province, “488 types of Chinese medicine hospital preparations account for 84% of all hospital preparations”[19]. With support from Zhongxiu, Chinese medicine preparations rapidly developed. In 2023, according to data from the National Bureau of Statistics, “In the first half of this year, China’s pharmaceutical industry above designated size saw a year-on-year decrease of 4.1% in added value, with operating income exceeding 1.46 trillion yuan, down 2.9%; profits reached 214 billion yuan, down 17.2%. However, during the same period, the operating income of Chinese patent medicines and Chinese medicine decoction pieces increased by 13.4% and 18%, with profits growing by 26.5% and 16.7% respectively.”[20]

To accelerate the turnover of Chinese medicine capital, they studied rapid cultivation methods and harvested or produced imitation drugs before the medicines were mature. As a result, counterfeit and inferior medicines flooded the market. “In 2017, the former China Food and Drug Administration issued 46 drug inspection notices, 22 of which involved Chinese medicine decoction pieces, with 792 batches of unqualified products involving 343 manufacturers and 37 varieties of Chinese medicine.”[21] The poor quality of Chinese medicine has become an industry secret: “Everyone in the industry knows that top-grade medicinal materials are exported, second-rate materials go into large hospitals, and unqualified, inferior third-rate medicinal materials or even medicinal residues are made into all kinds of Chinese patent medicines.”[22] In Zhongxiu’s Chinese medicine industry, one extreme is wealth accumulation, and the other is the suffering of patients harmed by fake and toxic medicines… The bureaucratic monopoly bourgeoisie exploits state policies to promote and force the widespread use of traditional Chinese medicine, flooding the market with low-quality, toxic, and untested Chinese medicines, and amassing wealth. By 2023, 220 Chinese patent medicines sold over a billion yuan in urban retail pharmacies[23]. Western medical groups, seeing their interests threatened, became frantic, shouting slogans like “abolish medicine, test medicines,” and vowed to regain lost ground.

Meanwhile, the increasingly greedy Chinese medicine groups refuse to give up their lucrative gains. However, a large number of Western pharmaceutical capital that relied on importing and relying on foreign capital to dismantle the socialist medical industry still dominates a significant part of the market, leading in capital strength and surplus value extraction. According to the “2020 Statistical Analysis Report on the Operation of the Pharmaceutical Circulation Industry” issued by the Ministry of Commerce, Western medicines dominate sales, accounting for 69.2% of the total sales of the seven major categories of medical products, Chinese patent medicines account for 14.9%, and Chinese medicinal materials for 2.3%[24]. Since China’s restoration, the most rotten bureaucratic monopoly capitalism groups have ruled, unwilling to spend time and money researching the complex internal components and interactions of Chinese medicine, preferring to plunder the maximum surplus value in the fastest way. “Developing Chinese medicine” is just one of their sweet lies to deceive and exploit the people. To quickly accumulate wealth, they are willing to destroy the foundation of Chinese medicine’s survival and development. Unlike emerging industries like new energy vehicles, Chinese herbal medicine, as an agricultural subsidiary, inherits its backwardness, often adopting dispersed small-farmer production methods. In fact, Chinese medicine is a decayed sector. China cannot adopt the latest production technologies in Chinese medicine and invest heavily to “overtake on curves”; its development is a complete retrogression. In today’s scientific research field, the world-renowned journals are Western medical journals, and the celebrated achievements are Western medicines, using Western-approved experimental methods to verify drug efficacy. While Western medicine research advances into molecular drugs and biological agents, Chinese medicine scholars still manipulate empty talk and hold on to feudal guilds of “master-disciple inheritance,” wrapping traditional Chinese medicine in a layer of mysticism, stifling innovation and vitality. These “national medical masters” represent the most rotten and reactionary interests of the Zhongxiu bureaucratic monopoly group—they are the grave-diggers of Chinese medicine, supported by Zhongxiu! They cannot and will not take responsibility for resisting the countercurrent of “abolishing Chinese medicine,” nor can they represent the future development of Chinese medicine. Although they curse foreign ambitions with their mouths, they are blinded by fame and profit, kowtowing at every research project, drooling over “The Lancet.” They criticize clinical trials targeting stroke awakening formulas for lacking “syndrome differentiation and treatment” principles, with flawed experimental design, making results unreliable. However, in Chinese journals proving the effectiveness of stroke awakening formulas, there is not a trace of “syndrome differentiation and treatment” principles; instead, they all use the research methods despised by Chinese medicine scholars—“foreigners with ulterior motives.” Their academic achievements for professional titles are full of articles based on these research methods. They claim that double-blind experiments are unreliable, yet they bow to the bourgeois medical concepts of double-blind experiments and “The Lancet,” and slavishly follow Western scientific methods, showing servility and hypocrisy. They are essentially no different from the “abolish medicine and test medicines” faction—they secretly despise Chinese medicine, disguised under the guise of “developing Chinese medicine.”

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Workers, peasants, and soldiers using acupuncture anesthesia to perform surgery

In socialist China, the medical and health事业 (shìyè - undertakings) are not developed by waiting for city hospital white coats to sit in offices and investigate or research, but by坚持 (jiānchí -坚持) serving the people’s medical and health needs,坚持 (jiānchí -坚持) fighting class struggles in the medical and health领域 (lǐngyù - field). As early as before the founding of the country, Chairman Mao pointed out that “we should actively prevent and treat the people's diseases, promote the people's medical and health事业 (shìyè - undertakings).”[27] After the founding of the People's Republic, the Chinese Communist Party, represented by Chairman Mao, further mobilized the masses, actively involving them in medical and health事业 (shìyè - undertakings), achieving the elimination of various infectious diseases in most provinces across the country. At the second National Health Conference in 1952, the Party established the work guideline of “focusing on workers, peasants, and soldiers, prevention first, uniting Chinese and Western medicine, and combining health work with mass movements,” launching a vigorous patriotic health运动 (yùndòng - movement). Our traditional Chinese medicine (TCM), our祖国医学 (zǔguó yīxué - homeland medicine), found a development path—“focusing medical and health efforts on rural areas”[28], “古为今用 (gǔ wéi jīn yòng - ancient for modern use), 洋为中用 (yáng wéi zhōng yòng - Western for Chinese use), “推陈出新 (tuī chén chū xīn - innovate and develop), “中西医团结合作 (zhōng xī yī tuánjié hézuò - unite Chinese and Western medicine in cooperation). The integration of Chinese and Western medicine is not about unilaterally elucidating the so-called “syndrome differentiation and treatment” of traditional Chinese medicine, nor simply extracting effective components from Chinese herbs. It is neither staying at the original level of Chinese or Western medicine nor merely improving on the existing level of both. The integration of Chinese and Western medicine is under the guidance of Marxism-Leninism and Mao Zedong Thought, utilizing modern scientific knowledge and methods to explore and enhance our祖国医学 (zǔguó yīxué - homeland medicine), combining Chinese herbal knowledge with Western medicine and Western pharmaceuticals, creating a new medical system that originates from both Chinese and Western medicine but is different from and surpasses them. Therefore, the integration of Chinese and Western medicine is not about substitution, merely accepting and collecting, or mechanical addition, but about融合贯通 (rónghé guàntōng - integration and unification), taking the strengths of both, resulting in a qualitative leap.”[29] Using the medicines created by the working people to serve the working people, creating a new unified Chinese medicine and pharmacology—this is the only correct development path for our medical and pharmaceutical sciences. All these can only be achieved in socialist countries. During the Cultural Revolution, in the deepening movement of批林批孔 (pī lín pī kǒng -批判林彪批判孔子 - criticize Lin Biao and Confucius), the broad revolutionary medical personnel in socialist China, through思想解放 (sīxiǎng jiěfàng -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 -思想解放 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  1. In medicine, "prognosis" refers to the predicted course of a disease based on experience. ↑

  2. "Abolish Medicine and Test Drugs" is a proposal put forward by foreign slave comprador groups supported by imperialism under the background of the Opium War invading China. They demand the abolition of traditional Chinese medicine theory, testing the efficacy of Chinese medicines, and abolishing those that cannot prove efficacy, thereby achieving the effect of "abolishing medicine and drugs." ↑

  3. Marx and Engels: "The Communist Manifesto," Selected Works of Marx and Engels, Volume 1, first edition May 1972. ↑

  4. "History of Chinese Medicine" compiled by the History of Medicine Teaching and Research Group of Heilongjiang University of Chinese Medicine, 1976. ↑

  5. Lanzhou University Second Hospital: "The Top Ten Psychological Effects of Humanity—Placebo Effect": https://www.lzush.com.cn/Item/11237.aspx. ↑

  6. Li Da: "Outline of Marxist Philosophy," 1965. ↑

  7. From the Gospel of Matthew. ↑

  8. Li Shizhen: "Compendium of Materia Medica." ↑

  9. "History of Chinese Medicine" compiled by the History of Medicine Teaching and Research Group of Heilongjiang University of Chinese Medicine, 1976. ↑

  10. China Tuo, Shanghai Shiguibao, Wuxi Huazui, Xi'an Yangsen, and Suzhou Capsule successively established factories and started production in China. These five earliest joint venture pharmaceutical companies in China are called the "Old Five." ↑

  11. Han Lu: "Reflections on 30 Years of Foreign Pharmaceutical Entry," Institute of Clinical Pharmacology, Xiangya Hospital, Central South University: http://www.csupharmacol.com/xwzx/856.html. ↑

  12. National Bureau of Statistics: Investment intensity refers to the ratio of total expenditure to gross domestic product, a widely used international indicator to measure the scale and level of independent innovation investment in a country or region, officially called "Research and Development (R&D) expenditure and its investment intensity." ↑

  13. Xinhua News: "Why Are Domestic Innovative Drugs Always Difficult to Produce? Three Major Gaps Cause New Drug Development to Lag Behind": http://www.xinhuanet.com/politics/2018-10/19/c_1123580281.htm. ↑

  14. Pi Weiping: "The Prominent Problems of 'Three Highs, Three Lows, and Unsuitability' in Traditional Chinese Medicine Quality Improvement," China Medical News: http://www.zjda.com/facade/infoDetail.shtml?infoId=13130. ↑

  15. Research Report Network: "2018 Rapid Development of Medical Manufacturing Industry, China's Medical Market Has Become the Second Largest in the World": https://www.chinabaogao.com/detail/350325.html. ↑

  16. Fenghuo Flame: "The Road of Future Revolution in China". ↑

  17. "Using Medicine to Support Medical Care" means doctors prescribe specific drugs to patients and earn commissions from them, increasing income. In 1985, China officially launched healthcare reform, with the core idea of decentralization and profit-sharing, expanding hospital autonomy. Under the banner of "Only policy, no money" and "Construction relies on the state, eating depends on oneself," hospitals were stimulated to generate revenue to make up for insufficient income. In 1989, the State Council approved the Ministry of Health's "Opinions on Expanding Medical and Health Services": "Under normal medical tasks, specialized clinics can be established, equipped with high-level medical and nursing staff, providing high-quality services, charging high fees (public funds and labor insurance medical expenses are not reimbursed), and opening to society." Subsequently, a wave of full-scale "using medicine to support medical care" was launched. ↑

  18. 39 Health Network: "The Tragedy of Chinese Medicine: Domestic Controversies, Japanese Kampo Medicine Sells to the World, Accounts for 90% of the Chinese Medicine Market," https://www.163.com/dy/article/FOTS08PO05148PF4.html. ↑

  19. Hunan Provincial Medical Security Bureau: "Reply to the Proposal of 'Adding Traditional Chinese Medicine Reimbursement Items' by CPPCC Members," https://ybj.hunan.gov.cn/ybj/jyta/202206/t20220628_26528204.html. ↑

  20. Yang Ping: "Wu Han, Chairman of Zhongkang Technology: Service Supply and Demand Grow Harmoniously, the Market Scale of Traditional Chinese Medicine Will Reach 2.2 Trillion Yuan by 2025," https://www.bj.icbc.com.cn/page/910199136794517504.html. ↑

  21. Wang Junping: "People's Daily Investigates the Quality of Chinese Medicinal Materials: Uneven Quality, Price Differences Nearly 20 Times," https://finance.sina.cn/2018-11-30/detail-ihpevhcm4015715.d.html?vt=4&cid=76675. ↑

  22. CCTV Economy: "Chinese Medicine Quality Declines Linearly: First-Class Medicinal Materials Exported, Medicinal Residues Used in Chinese Patent Medicine," https://jingji.cctv.com/2016/09/23/ARTIyqlKB6oc6AgA3c6Bly9I160923.shtml. ↑

  23. Qianzhan Industry Research Institute: "Forecast 2024: Analysis of the Market Size, Competitive Pattern, and Development Trends of China's Traditional Chinese Medicine Industry in 2024, with Six Major Trends in Future Development," https://bg.qianzhan.com/trends/detail/506/240903-b8bbe72a.html. ↑

  24. CCTV News: "<2020 Drug Circulation Industry Operation Statistical Analysis Report> Released, Western Medicine Sales Account for Over 70%", https://m.news.cctv.com/2021/08/04/ARTI7ZN5KKx3ygP4NvSOvneh210804.shtml ↑

  25. The authors of the research paper found that the preset subgroup indeed showed more significant effects in hemorrhage volume and location. For the former, the authors temporarily changed the method, dividing hemorrhage volume into four groups (originally two groups: above and below 15 ml), and then the efficacy of hemorrhage volume groups was no longer significant, neither at 90 days nor at 180 days; but for the latter, the efficacy based on hemorrhage location remained significant, with the "hemorrhage location" group still showing significantly higher efficacy than the placebo group. However, the authors changed the method again in the discussion: "Although subgroup analysis shows that the stroke awakening liquid is effective in patients with superficial hemorrhages and larger hemorrhages (15 ml or more), these results are unreliable because there are few participants with superficial cortical hemorrhages, and when hemorrhage volume is re-divided into four groups, the subgroup analysis results are not significant." The significant results are unreliable, and the non-significant results are considered reliable, which is a form of sophistry. ↑

  26. Mao Zedong: "Chinese Medicine and Pharmacology is a Great Treasure House," October 11, 1958. ↑

  27. Mao Zedong: "On the United Front," Selected Works of Mao Zedong, Volume 1, 1967, simplified horizontal layout, People's Publishing House. ↑

  28. Mao Zedong: "626" Directive. ↑

  29. Wang Jisheng: "Discussion on the Characteristics of Traditional Chinese Medicine Theory and the Issue of Integrating Chinese and Western Medicine," New Medical Science Journal, 1975, Issue 11. ↑

  30. Fuxing Network: "Development Achievements of Traditional Chinese Medicine During the Cultural Revolution," https://www.mzfxw.com/m/show2.php?classid=18&id=174521&style=0&cpage=226&cid=1&bclassid=4. ↑

  31. Fuxing Network: "Development Achievements of Traditional Chinese Medicine During the Cultural Revolution," https://www.mzfxw.com/m/show2.php?classid=18&id=174521&style=0&cpage=226&cid=1&bclassid=4. ↑

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