UOPING, China — A worried Dou Zhe rushed into Dr. Wang Yujia's storefront clinic carrying a precious bundle. "He's sick," announced Mr. Dou, unwrapping layers of colorful blankets from his 2-year-old son, a chubby, listless boy in a blue jumpsuit. "He's normally mischievous, but since tonight he's hot. He just wants to sleep — he won't eat or play."

Dr. Wang, a kindly weathered man in a long white coat, determined that the boy had a red throat and a fever of 102. He had a cold, one that would almost certainly pass on its own in a few days.

Nonetheless, Dr. Wang drew up what has become an all-too-common rural Chinese cure — a syringe filled with four different medicines — and plunged the needle filled with yellow goo into the screaming boy's behind.

"We always come to see him, because he's a good doctor," Mr. Dou, a construction worker, said with a note of satisfaction. "My boy's had lots of shots."

China's love affair with injections and infusions is becoming a medical nightmare, spreading illness rather than curing it, experts say.

In large part because syringes and needles are often inadequately sterilized in rural China, experts say the overuse of medical injections helps explain the alarming spread of blood-borne infections in China, particularly hepatitis and, to a lesser extent, AIDS.

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Today, 60 percent of Chinese have had hepatitis B, compared with just 1 percent in the United States and Japan. Some 150 million Chinese have the chronic variety of the infection, which over time causes liver failure and liver cancer.

"To a large extent the very high rate of hepatitis B has to do with unsafe injections and excessive injection for common illness during childhood," the United Nations Common Country Assessment for China said in 1999.

The problem of needless shots is particularly severe in rural areas, where doctors often have little formal medical training and receive extra income for each injection they give, and where patients and doctors alike see shots as a sign of progress.

Dr. Wang, for example, is not really a physician, but a former farmer who learned his basics when he was appointed a "barefoot doctor" under China's Communist system in the 1960's. In all, he has received just two years of medical training, and that in the mid-1980's, when Western medicines were not available in the countryside.

And so when a little boy arrives with a cold, he draws up an injection composed of two antibiotics that are unnecessary and will promote resistance, an antiviral drug that has no use against the common cold and a powerful steroid that will only make his immune system less able to fight infection.

A 2000 survey of medical care in 40 rural counties conducted by Unicef and the Chinese Health Ministry found that 47 to 65 percent of children had received injections as treatment for their last cold.

While it is extremely rare for children in the United States to get shots aside from immunizations, many Chinese children get more than half a dozen a year.

But far more important than the immediate side effects of these freewheeling injections is the risk of acquiring devastating disease, since, as in much of the developing world, rural Chinese doctors try to cut costs by reusing potentially contaminated equipment.

While there is no evidence that this 2-year-old suffered lasting harm from his shot, in one 1999 study, Chinese researchers found that 88 percent of injections in a large rural county were unsafe, most often because doctors reused needles and syringes after inadequate or no cleaning.

The Health Ministry has encouraged clinics to switch to disposable needles and syringes, but even those are sometimes reused, or cleaned and repackaged in a large underground market, according to medical experts here and reports in the Chinese press.

Such practices have probably also contributed to China's emerging AIDS problem, though scientists believe that H.I.V., the virus that causes AIDS, spreads less efficiently than hepatitis by this route. Statistics on the spread of H.I.V. in rural areas have been shrouded by official secrecy and many victims do not even know that they are infected.

"We already know many people have been getting hepatitis from shots," said one health expert who has worked extensively in China. "And that worries me a lot about the spread of AIDS."

Although there is now a hepatitis B vaccine that is widely used in the United States, it is expensive and not included in the Chinese government's free vaccination programs, so a majority of poor rural children do not get it.

Government officials have acknowledged the problem of unsafe injections and have repeatedly tried to ensure proper use of sterile medical equipment and better regulation of its manufacturing and disposal. But the problem has been difficult to stop.

"Unfortunately, rural doctors often rely on medicines and shots for income, and the farmers think they need an IV to be cured," said Zhu Ling, an economist at the Chinese Academy of Social Sciences who studies health care. Even rudimentary clinics in rural China now have rows of IV bottles hanging ready along the wall.

Government regulations allow rural medics to charge only pennies per visit, but they may add fees for the medicines and shots. With only minimal training, many do not understand how to use many of the medicines that line their shelves, or even the risks of injection or failure to use proper sterilization techniques.

Dr. Wang owns one of many private clinics in this small city in China's far southwest, and he is clearly more careful and conscientious than most of his competition.

He is proud, for example, that he has switched to disposable plastic syringes and needles, which he unwraps to give 2-year-old Dou Youjun his shot and then quickly deposits into a large cardboard box on the floor overflowing with others like it.

In many rural clinics, used syringes and needles sit on the counter, waiting for reuse.

In a December 1999 study in The Chinese Journal of Epidemiology, 56 percent of rural doctors said they changed equipment only if they could see blood in the syringes.