No.4: Secret Slang of TCM — The Small-Town Pharmacy Ecosystem

Traditional Chinese medicine has its own slang — a kind of insider code that can leave outsiders completely lost. Sometimes even people who work in the trade, if they haven't spent enough time in that particular town, won't catch half of it.

My father used to chat about this with his friends. Take one of the most common herbs: licorice root (Gan cao, 甘草). In the old pharmacies it goes by nicknames like cao xiao or guo lao — literally "state elder," because the herb is considered the grand mediator that harmonizes other ingredients in a formula.

Some doctors would simply write on a prescription: Guo 15g (short for "state elder"). To anyone outside the loop, that looks like gibberish. To the pharmacist, it means: 15 grams of licorice root.

Or consider Sheng di (生地, raw rehmannia root). The name sounds like "strange land" in Chinese, so the slang for it became wen lu — "asking for directions." Because if you're in a strange place, you have to ask, right? (Side note: I heard Germans supposedly never ask for directions; they'd rather solve the problem themselves. So at least in Germany, this nickname would make absolutely no sense 😂.)

Then there's Da huang (大黄, rhubarb root), which I mentioned before. Its alias is "the general," because its medicinal punch is fierce — it works the moment you take it, usually by sending you straight to the bathroom. When rhubarb is wine-processed, it becomes jiu jun (酒军), the "drinking general." Some physicians don't even write the name; they just put down the number 9, because in Chinese "nine" (jiu) sounds exactly like "wine" (jiu).

This is all entry-level stuff. Veteran TCM pharmacists know hundreds of these terms. To an outsider trying to break in, the threshold is deliberately high.

In a way, old-school TCM practice is simple. There are only a few dozen commonly used herbs. If you learn their properties and read the classical texts for the basic concepts, you should, in theory, be able to write prescriptions. But even if your prescriptions are good, nobody will come to you — because you lack credentials. You can't name your master. You don't belong to a lineage. In modern terms, it's like having no diploma and no professional license.

Before the year 2000, in small Chinese cities and throughout thousands of years of imperial China, there was no modern licensing system. Most industries protected themselves through unwritten rules. An outsider trying to muscle in would find it nearly impossible. If someone without backing tried to practice — to see patients and write formulas — the local insiders would quickly squeeze them out. The community would close ranks, and within a short time the newcomer couldn't stay open. It had nothing to do with how good their medicine was.

TCM slang is one of the classic tools used to shut outsiders out.

Of course, money is also part of it.

Exclusive Prescriptions

My father's pharmacy had a cooperation with a local hospital. The question was: how do you make sure patients who get a prescription from a hospital doctor end up walking two kilometers to your family's shop instead of just filling it at the hospital pharmacy?

Easy. Use private abbreviations, and add a quiet word from the doctor:

"Go get the medicine at the pharmacy by the department store on San Yuan Front Street." (That, of course, was my father's shop 😂.)

Some clever patients won't listen. They take the prescription to another pharmacy, or fill it right at the hospital, where the doctor's bonus is smaller. That's fine. They're free to go anywhere.

But I can make it so you can't buy it anywhere except the designated pharmacy.

Because the staff at other pharmacies can't read the writing on the prescription at all. You could think of it as alien script — humans simply can't decode it.

An experienced pharmacist, however, takes one look and knows it's an exclusive formula. He'll politely tell the patient that a few ingredients are out of stock — some believable excuse — and then point the way:

"Go to the shop by the department store." 😂

Since this is my father's shop's private code, only a few insiders can read it. And if they want to keep working in this town, they can't steal the business.

The consequences of undercutting are serious — a bit like a worker breaking union rules in the West. It can make life very hard for you in the industry later on.

TCM slang and exclusive prescriptions are really one big network of interests.

Whether patients like it or not, once the prescription is written, they can wander around all they want. But if they actually want the medicine — surprise — they end up walking right into my father's pharmacy 😂.

This naturally annoys some patients. The same formula costs at least 50% more at the exclusive pharmacy than elsewhere. But that extra 50% doesn't go to my father. He has to spread it around to keep everyone happy — doctors, middlemen, the whole chain — so in the end he only makes the normal profit on the herbs.

People who visit doctors and buy medicine often know the game. They're not stupid. They know exclusive prescriptions cost more.

So when they walk into my father's shop, they usually arrive already angry.

Customers with these prescriptions are easy to spot the moment they come in. My father would take the paper, glance at it, then look the person up and down and say, almost casually:

"Your stomach's been bothering you a little?"

"You've got a bit too much phlegm, haven't you?"

Those two sentences were usually enough. The patient, who had walked in fuming about being steered to an overpriced pharmacy, would suddenly forget the price. After all, they wanted to get better. And here was a pharmacist who actually understood their condition. Their attention shifted to their illness, and the anger faded.

Without those two sentences, the complaints would start:

"How much did you pay the doctor to force us to buy here?"

"Your medicine is way more expensive than other pharmacies, isn't it?"

"Will the disease not get better if we don't use your medicine?"

Sometimes they'd just start cursing.

But with those two precise observations about their symptoms, most patients didn't even have time to complain. Their attitude flipped immediately, and they'd start asking politely about how to take the medicine and how to take better care of themselves.

That's the work of an experienced pharmacist 😂.

My father could sell medicine for 1.6 yuan that cost him more than 3 yuan. And he could also cooperate with hospitals to sell overpriced medicine.

Only by doing both could the pharmacy survive long-term — and raise me along the way.

Which is why you're reading these words now.

— From Bong: Have you eaten? (A loaded Chinese blessing.)