The Quest for Anti-inflammatory

I’ve long since seen the need for better medical definitions in our Chinese/English dictionaries. But my recent quest for a stronger anti-inflammatory drug has made me think there’s a problem that might not be the dictionaries’ fault.

The standard over-the-counter anti-inflammatory and painkiller out here is Fēnbìdé 芬必得 (picture here). The English on the back of the box says “Ibuprofen Sustained Release Capsules” and according to Wikipedia, Ibuprofen is an anti-inflammatory.

Ok, so I’ve got Ibuprofen. But I want something stronger for a little case of tendinitis. So I go to the pharmacy and ask for what most dictionaries agree is the Chinese for anti-inflammatory drug:

xiāoyán yào 消炎药 [disappear inflammation medicine]

The guy nods knowingly and gives me a box of Cefradine, an antibiotic!

Pharmacists out here aren’t always the most knowledgeable. Maybe the guy just made a mistake. So I go to the local (village) hospital and talk to a doctor.

Here’s the English translation of our conversation (with some select Chinese words to show what was said):

Me: I’m looking for a stronger anti-inflammatory (xiāoyán yào 消炎药).

Doc: (picks up my box of Cefradine) You’ve got it. All we can give you is this.

Me: But that fights bacteria (xìjūn 细菌), right?

Doc: Right.

Me: I don’t need that. I’m looking for something to fight inflammation (yánzhèng 炎症).

Doc: We don’t distinguish between those kinds of medicine.

Me: What?! For example, this box of Fēnbìdé 芬必得 that I’ve brought. What kind of medicine is this?

Doc: That’s just a painkiller (zhǐtòng 止痛).

Me: Ok, you know if I play tennis for a long time, the tendons in my elbow will get inflammed?

Doc: It’s called tennis elbow (wǎngqiú zhǒu 网球肘).

Me: Yes exactly! What kind of medicine would you give me for that?

Doc: (picks up box of Cefradine again) This.

Now, I’m no doctor. But I’m pretty sure antibiotics aren’t going to help with tennis elbow.

I went to another pharmacy and faked a back injury to see what medicine they would give me. I kept asking for the strongest stuff they’ve got (stronger than Fēnbìdé 芬必得, please) and finally ended up with Meloxicam. Now, that actually is an anti-inflammatory.

So why this blog post? I’ve noticed that, perhaps just as we don’t have a concept of shànghuǒ 上火 (which amazes the Chinese), the Chinese don’t really have a concept of what antibiotic and anti-inflammatory drugs really are. The recent news about cracking down of overuse of antibiotics in China usually cites corruption as the main contributing factor. Only one article I found (in my 2-second Google search) talked about the need for better education to correct the problem, and that was public education. But remember it was the doctor himself who said “We (doctors? Chinese?) don’t distinguish between those kinds of medicine.”

From time to time, I’ve asked students or friends what kind of medicine they took for various things (ear infection, etc.). While I’ve heard names of antibiotics like amoxicillin (ā mò xī lín 阿莫西林) thrown around, they’re always called “xiāoyán yào” 消炎药 by the Chinese. I’ve never heard anyone say “kàng shēng sù” 抗生素 or “kàng jūn sù” 抗菌素 or any of the dictionary entries for “antibiotic”. MDBG is the only dictionary I’ve seen that lists “antibiotic” as the definition of “xiāoyán yào” 消炎药 (which, remember, literally breaks down to “disappear inflammation medicine”).

So, please leave a comment if you have any theories as to:

  1. What words I really should use when referring to “antibiotic” or “anti-inflammatory”?
  2. Why doctors and Chinese don’t differentiate between the two (in my opinion) very different kinds of medicine?

Comments

  1. I’m terrified of ever having to go to a Chinese hospital. Luckily I’ve been able to get what I want for sicknesses by asking friends back home and then google translating medicine names and going to pharmacy and asking directly for it.

    It amazes me that if you go to a hospital here with a cold, or tonsilitis or something else minor that could be treated with a mild course of ingestable anti-biotics, they instead hook you up to a drip with heave duty antibiotics; thus, contributing to unecessary overcrowding in hospitals.

    I suppose the adoption of western medicine techniques is still in its infancy over here.

    And yes, I am astounded by the 上火 theory. But there must be something in it, because I don’t know how all these Chinese still walk around in denim and jackets when it is 30 degrees outside; whereas me, on the otherhand, am in shorts and a singlet and still sweating it up.

  2. I’ve never had the impression that 消炎药 meant “reduce inflammation ,medicine”, but rather “reduce infection ,medicine”. That’s without looking in the dictionary. After looking, I see that “infection” isn’t given as one of the definitions for , but different kinds of infections do have in their names. Also, I’ve always used 发炎 to mean “get infected”. I guess I was just lucky in picking it up that way (as opposed to “inflammation”).

  3. Randy Alexander,

    Well…now that I think about it, I have no idea what the difference between and infection and inflammation is. Time for some more research. But you’re pretty confident that means infection rather than infection? The “double fire” character, or should I say, “double flame”? InFLAMmation…?

  4. I think it can mean either, depending on the context, but I seem to have been lucky in understanding 消炎药 to mean antibiotic (something that reduces infection). In the US, (and I’m guessing other English speaking countries), you would most likely take acetaminophen or ibuprofen for pain, reducing fever, or reducing inflammation, so if I wanted something that did one of those, I might ask for one of the others; for example, if I wanted a pain reliever and didn’t know how to say that, I might ask for something for a fever (发烧药).

    I couldn’t find any pain relievers (other than aspirin) for a few years in Jilin until some son of a rich landowner (who thought he was cool carrying around a 40cm blade, and hired military guys as bodyguards) thought it would be fun to have a foreign friend (there aren’t many in Jilin). I went out with him and his entourage a couple times to clubs. Once he had one of his guys go get something at the pharmacy. The guy came back with bottles of oral codeine suspension (!) and passed them around. I stopped hanging out with the guy (that night he got kicked out of a club for bringing a weapon), but I knew from then on if I ever got into serious pain, I would know where to get something for it.

    Sometimes you can learn a lot from complete idiots. 🙂

  5. The wikipedia entry for 炎症 has this info.

    抗生素
    如果是由感染引起的感染性炎症,可以使用一般人所說的「消炎藥」或注射「消炎針」,實際上指的是抗生素,其實是殺死或抑制細菌的繁殖,而使感染引起的發炎減少。

    [編輯] 抗發炎劑
    如果不是由感染引起的炎症,醫學上對於抑制炎症反應,用的是非類固醇抗發炎劑或類固醇。在中國大陸常說成「消炎藥」。

    So, inflammation can be caused by infection or by other things. For an infection, antibiotics are effectively 消炎藥. (Although that is just a side affect of controlling the infection, so it seems a strange thing to call an antibiotic.) If you want to refer specifically to a non-antibiotic anti-inflammatory, then it looks like 抗發炎劑 would be appropriate.

    I hope this was just a matter of miscommunication. If you ask the doctor what he would prescribe for joint pain, I don’t think he would respond with an antibiotic. I think directly asking for 消炎藥 might not be concrete enough to prescribe a medicine.

  6. The doctors and nurses I dealt with in Shanghai said 抗生素.

    Also, if you figure out that you have a viral infection, they will sometimes give you retrovirals (whereas in canada we would just say “go home and get bed rest, yo”).

  7. @ Albert

    Yes. Unfortunately (or, fortunately?) I never had the need for anti-inflammatory drugs.

    For getting drugs, I always had the best luck finding the Chinese name and taking that to a pharmacy. The people I dealt with (at several places) would give me whatever I wanted without a prescription as long as I said I’d taken it before. Not sure if this works for narcotics though.

  8. I teach English at a local hospital and have linked this blog post to our class blog, hoping my students might come over and give you a little insight!

    Here’s our class blog in case you want to see, it’s not too exciting if you aren’t in our class though 🙂

    http://haikouhospital.livejournal.com/

  9. Anti-inflammatory drugs can be use to relieve pain, reduce fever, or reduce inflammation. In chines medicine books it is called “解热镇痛抗炎药”.Antibiotics can be used to control effections caused by bacteria and it’s called “抗菌药”in chinese medicine books. “消炎药” are confused words that doesn’t have exact definition. Ordinary pople can not distinguish them but doctors definitely should can!

  10. I have embarqued on some medicine quests myself here in the middle kingdom And I can tell you there is no easy way to relate the east versus the west relationship to medicine. Completely night and day in most cases.
    I have found the best way to treat a multitiude of ailments is through the diet.
    I’ll post info about an experience I had over my first Chinese winter via my blog when I can.
    I really enjoy your posts!

  11. Interesting example …I remember reading some of Arthur Kleinman’s stuff a while back. He’s a psychiatrist and anthropologist at Harvard who’s done a lot of work on the categorization of illnesses and the role played by culture – especially China.
    http://www.amazon.com/Patients-Healers-Context-Culture-Kleinman/dp/0520045114/ref=pd_sim_b_5
    http://www.amazon.com/Patients-Healers-Context-Culture-Kleinman/dp/0520045114/ref=pd_sim_b_5

    FYI, “antibiotic” in Hong Kong is 抗生素. HK’s medical system is pretty westernized…although you can also find traditional Chinese doctors dishing out herbs and other stuff…

    http://hanyu.com/2011/06/23/%E6%BF%AB%E7%94%A8%E6%8A%97%E7%94%9F%E7%B4%A0-who-us/

    Hmm…so I wonder why China has such a bad reputation for abusing antibiotics…could be a connection – it’s all in the categorization.

  12. Maybe you were just unlucky with your doctor. The thing is: as was pointed out by eric, a lot of inflammations are caused by infections, so they will be cured by antibiotics. But antibiotics in the strict, scientific sense of the word are called 抗生素 – for example if you add antibiotics to a medium in a lab to select bacteria.

  13. While I understand that this is intended to be a problem of English/Cantonese translation, you should also consider the possibility that the doctors who were offering Cefradine as an anti-inflammatory may have been aware of recent research showing that many antibiotic drugs are also potent anti-inflammatory drugs. Please see the following site for more information: http://www.chronicprostatitis.com/abx.html.
    Good luck!

  14. Just seen a dentist at Clifford Hospital, Panyu about a broken tooth that lost its filling a few weeks back and recently got painful. I asked if there was any infection and he said no, its just inflammation. He prescribed me 3 medicines which he said were to reduce the inflammation and to deal with the pain. When I checked what he’d given me it turned out that there were 2 antibiotics (one of which was cefradine) and ibuprofen. So I called the hospital and asked why I’d been given antibiotics if there was no infection and was told that the antibiotics were for the inflammation and the ibuprofen was for the pain. Didn’t get anywhere when I pointed out that antibiotics aren’t anti-inflammatory if there’s no infection, and that ibuprofen, though it may help with pain relief, is actually an anti-inflammatory. The ibuprofen was also woefully under-prescribed. Have now bought paracetamol for the pain and got more ibuprofen. Will be interesting to see what they say when I go back to have the tooth re-filled. When I went to buy the ibuprofen they couldn’t find out what it was online so I mimed an inflammation being reduced and they instantly went and got a pack of cefradine. I got on their computer and looked up ibuprofen myself and found it, but it seems that they had no idea that its an anti-inflammatory. So this confirms that Chinese doctors and pharmacists think that cefradine is an anti-inflammatory.

  15. @Martin,

    Oh wow! It pays to know about drugs. But I’ve found it can be kind of tricky talking to doctors about this sort of thing. The last thing I want to do is make enemies with them… and they might not appreciate a know-it-all Laowai coming in and pointing stuff out. I’ve often just bought the medicine, come home, and not taken it.

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