Do the TCM Classic Huangdi Neijing and the Yin-Yang Five Elements Theory Have Any Practical Value?

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) is a foundational text of TCM. In China, virtually every TCM student is required to read it, and many TCM enthusiasts are told they must study it carefully. Given the Chinese tradition of venerating antiquity, few dare challenge the authority of the *Neijing*. If a TCM practitioner dares to criticize it, they are sure to attract abuse from TCM fans. So the *Neijing* has become a major shackle on the development of Chinese medicine.

Countless works have been authored under the name of Huangdi, the celestial master, but the *Huangdi Neijing* is the most famous. The renowned *Neijing* certainly contains genuine insights, but it is also filled with dross and rubbish. For too long, the conservative old guard in TCM has reached for views from the *Neijing* to suppress innovative work in the field. This is utterly pedantic. The Chinese tradition of exalting the ancient and disparaging the modern has greatly hindered the progress of natural sciences, including TCM.

It is certain that the *Huangdi Neijing* has nothing whatsoever to do with the legendary Huangdi. It was written by fangshi (masters of methods) during the Warring States period under Huangdi's name. In the early Han dynasty, other fangshi added more content. The completion of the full text may have taken centuries.

According to textual research by Liang Qichao, Hu Shi, and other historians, concepts like yin-yang and the five elements in the *Neijing* were neither the product of Laozi's thought nor Confucius's, but rather a system organized by Zou Yan of Qi after Confucius and Laozi, based on ideas from the traditional folk religion of Qi.

Liang Qichao wrote: 'Before the Spring and Autumn and Warring States periods, the terms yin and yang appeared very rarely and their meaning was quite plain. Moreover, these two things were never treated as one. The classics and the great philosophers Confucius, Laozi, Mozi, and Han Fei never mentioned them. So those who invented these perverse theories to delude the people began among the fangshi of Yan and Qi. Those who established, propagated, and disseminated them bear responsibility: three men—Zou Yan, Dong Zhongshu, and Liu Xiang.'

Liang Qichao's research is sound. In the works of Confucius, Laozi, Mozi, and Han Feizi, the concepts of yin-yang and five elements appear rarely. Many people today unfairly blame Laozi for inventing the concept of yin-yang; Laozi only said something like bearing yin and embracing yang. The meaning of yin-yang in Laozi's work was far from as rich and magical as it later became. The true founder of the yin-yang school was Zou Yan.

Who was Zou Yan? He was a prominent figure at the Jixia Academy in Qi during the Warring States period. Qi was a coastal state with relatively developed commerce and lively intellectual life. Ban Gu's *Book of Han* records that Qi, 'with its coastal location and saline soil, had little grain and few people, so the Taigong encouraged women's crafts and opened up fishing and salt profits, and people and goods converged... Its customs grew extravagant; they wove fine silks and embroideries and were known as the foremost in dress throughout the world... To this day, the people there love classical studies, value fame and achievement, are relaxed and broad-minded, and are resourceful. Their faults are boastfulness, factionalism, mismatch between words and deeds, and hollow insincerity.'

According to Ban Gu, the people of Qi were leisurely and broad-minded, fond of debate, and had the faults of exaggeration and inconsistency between words and deeds. *Records of the Grand Historian* gives a similar account: 'Qi is bounded by mountains and sea, with fertile soil for a thousand li, suitable for silk and hemp; the people produce patterned cloth, fish, and salt... Its customs are relaxed, broad-minded, and resourceful, and the people love debate.'

That is, Qi, as a coastal state with developed industry and commerce, plus rulers who liked to gather all kinds of talkative people, was intellectually open. But the openness eventually, as Hu Shi put it, led to imagination unrestrained by reason, easily producing bizarre and implausible theories.

Contemporaries did not think highly of Qi's风气 either. Zhuangzi said: 'The Qi Xie is a book that records strange marvels.' When Mencius refuted Xianqiu Meng, he said: 'That is not the words of a gentleman; it is the talk of an eastern Qi villager.' The idiom east-of-Qi rustic talk comes from this—it refers to a group of loud, attention-seeking characters around the Jixia Academy inventing all kinds of impractical absurdities.

The Jixia Academy of Qi is arguably China's earliest institution of higher learning, said to have gathered hundreds or even thousands of people. These people specialized in issuing opinions at the academy while drawing stipends. The good side of Jixia was that it produced a great deal of new thought, eventually forming Qi learning and Daoist thought. The bad side was that it also produced a great deal of rubbish thought, which was likewise swept into the broad umbrella of Qi learning and Daoism, eventually becoming part of Chinese national culture that has lasted for over two millennia and still has many adherents today.

These comments on Jixia may be harsh, but they reflect a fact: much of the east-of-Qi rustic talk was exaggerated. Some rulers at the time believed these fangshi could find sacred mountains at sea and help them become immortals. Immortalists in Yan and Qi propagated that on three sacred mountains—Penglai, Fangzhang, and Yingzhou—lived immortals and the elixir of life, by taking which one could achieve immortality. This was originally just folk legend from the Bohai coast, but after promotion by fangshi in Yan and Qi, it gained many believers. Even Qin Shi Huang, who later unified the six states, believed these legends and was deceived.

Qi's greatest swindler, Xu Shi (i.e., Xu Fu), was the most successful. He persuaded Qin Shi Huang to send several thousand boys and girls, along with some soldiers, under his command to seek immortals and the elixir. Instead, he led these people east across the sea to Japan and established a colony. Relics of Xu Fu's colonization still exist in Japan today. Xu Shi's deception of Qin Shi Huang is clearly recorded in *Records of the Grand Historian*:

A man of Qi named Xu Shi memorialized the throne, saying that in the sea are three sacred mountains called Penglai, Fangzhang, and Yingzhou, where immortals dwell. He requested to fast and purify himself and go with boys and girls to seek them. So the emperor dispatched Xu Shi to gather several thousand boys and girls and enter the sea to seek the immortals.

The fangshi Xu Shi and others entered the sea seeking the divine medicine, but after several years did not obtain it, and spent so much that they feared punishment. They said: 'The medicine of Penglai can be obtained, but we are always hindered by great sharks, so we cannot reach it. We request that a good archer accompany us, and when we see one, shoot it with a repeating crossbow.'...

This fangshi Xu Shi was utterly audacious, tricking Qin Shi Huang twice—the first time out of large sums of money and boys and girls, the second time out of soldiers. In the end, he found no immortals, and the quest for the elixir was of course a farce. Fearing punishment on his return, Xu Shi simply fled, taking the boys, girls, and crossbowmen to Japan to become a local emperor.

But the life-fearing Qin Shi Huang remained deluded and sent other fangshi from Yan and Qi—Han Zhong, Lu Sheng, Hou Sheng, and others—to seek immortals. These fangshi all took Qin Shi Huang's money, pretended to seek immortals, and eventually vanished without a trace.

Qin Shi Huang finally saw through these men. There were several hundred such fangshi at his court seeking favor. In a rage, he buried alive 468 Confucian scholars and fangshi, and, acting on Chancellor Li Si's advice, burned the *Book of Songs*, the *Book of Documents*, and the words of the hundred schools that confused the people, allowing only practical books to remain. This is the famous story of burning books and burying scholars in Chinese history.

So what system of theory did Zou Yan and others use to delude the people? It was the yin-yang and five elements thought we today so readily discuss. These ideas were not rootless; they originated in the folk mythology and religious worship of the Qi people. The Qi people had worshipped the Eight Gods since ancient times, as detailed in the Feng Shan chapter of *Records of the Grand Historian*. The eight gods were: 1) God of Heaven, 2) God of Earth, 3) God of Warfare, 4) God of Yin, 5) God of Yang, 6) God of the Moon, 7) God of the Sun, 8) God of the Four Seasons.

Anyone who has read the *Huangdi Neijing* will find these eight gods very familiar, because many concepts from this Qi folk religion have corresponding chapters and concepts in the *Neijing*. Heaven, earth, sun, moon, yin, and yang go without saying; the four seasons are also an important concept in the *Neijing*. The chapter Treatise on the Regulation of the Spirit in Accordance with the Four Qi in the *Suwen* is devoted entirely to the four seasons.

The origin of the five elements was Zou Yan's theory of the mutual succession of the five virtues. Liu Xin of the Han dynasty recorded in his commentary on the *Wen Xuan*: 'Master Zou had the theory of the mutual succession of the five virtues, proceeding from what overcomes. After earth virtue comes wood virtue, then metal virtue, then fire virtue, then water virtue.' This earth-wood-metal-fire-water cycle eventually evolved into the five elements concept in Chinese traditional thought: metal, wood, water, fire, and earth, generating and overcoming one another.

Interestingly, Zou Yan's original purpose in proposing the theory was precisely to break the custom of exalting the ancient and disparaging the modern, and to promote intellectual liberation and social progress. *Records of the Grand Historian* says: 'Zou Yan saw that rulers were increasingly dissolute and extravagant and could not exalt virtue. If only they could embody the *Da Ya* in their own persons and extend it to the common people... So he deeply observed the waxing and waning of yin and yang and produced bizarre and unusual variations in works like Zhongshi and Dasheng, over one hundred thousand characters... Yet his essential conclusion always came back to benevolence, righteousness, frugality, and the proper relations between ruler and minister, superiors and inferiors, and the six kinship relations.'

From these accounts, Zou Yan's starting point was quite good: he wanted to use yin-yang and five elements theory to interpret the laws of political rise and fall, so that rulers and people would fear moral consequences and not live dissolutely. But he could never have dreamed that his innovation would eventually be exploited by ruling powers, forming the largest system of superstition in Chinese history. It gradually seeped from politics into philosophy, medicine, divination, astrology, and every sphere of social life.

The original theoretical source of the *Huangdi Neijing* was exactly this folk shamanism. The concepts of yin-yang and five elements, rejected by the orthodox educated class during the Spring and Autumn and Warring States periods, were brought onto the stage by the silver-tongued Zou Yan. From then on, yin-yang and five elements became a core concept of Chinese traditional culture and one of the most important theoretical roots of TCM. It did play a certain role in TCM development—for example, forming the holistic view of TCM—but the harm it caused was also considerable.

The poison of such pedantic theory is endless. The greatest harm is that it slowed the development of natural sciences in China for over two thousand years. Chinese traditional medicine became bound up with superstition, with good and evil mixed together. For over two millennia, the true treasures of medicine were often suppressed by this theoretical system and by the Chinese tradition of exalting the ancient and disparaging the modern, never allowed to rise. Meanwhile, pedantic and impractical medical theories still run rampant today. On television, in university classrooms, even on street corners and in TCM textbooks, all kinds of unverifiable TCM ideas are still propagated, while what is truly worth excavating in TCM is cast aside.

Zou Yan's social status alone was not enough to form such a mass superstition. It was the Jixia Academy, to glorify its teachings, that invented a celestial master—Huangdi. If one tallied up the works attributed to Huangdi, one would find that he is the most prolific author of all time, covering such a vast range that few through history can match him.

Forgery is truly our nation's greatest skill. For example, a modern lay Buddhist named Guoqing wrote a book called *Modern Records of Cause and Effect*, in which stories of three-life reincarnation and karmic retribution were written vividly, with names and details. Many superstitious readers, excited on reading, wanted to seek out the old monk Guoqing mentioned to examine their own karma and cure illness or change their bad fortune.

Then this layman Guoqing blandly announced that he had written the book out of good intentions, hoping to persuade people to do good. But the foolish men and women of the world still solemnly recite the stories from Guoqing's book to other believers, using them to persuade people to believe in reincarnation and karma. Many within Buddhism have vigorously defended Guoqing's forgery on the grounds that his intent was good and that he was doing good to change the world. Alas! Lie upon lie has finally become part of a misty history where truth and falsehood are indistinguishable.

We are now in an age when popular wisdom is supposedly enlightened, yet Guoqing's shoddy forgeries still captivate masses of believers. One can imagine how easy it was to captivate believers through forgery over two thousand years ago. With the sediment of history, the various hypotheses invented by the Jixia masters led by Zou Yan, and by their successors, became part of China's vast and profound traditional culture, occupying an authoritative position and forming unshakable faith among the people. Later scholars and physicians who did not conform to this belief system were bound to face public distrust. Truly lamentable.

So are yin-yang, five elements, four seasons, and later the monthly ordinances all worthless? Not necessarily. These theories, since they can be made self-consistent, must contain a certain measure of truth. The error comes in over-extrapolating from them. Especially in medicine, where lives are at stake and evidence and efficacy must take precedence over all, building a vast diagnostic and therapeutic system purely through deductive reasoning must be endlessly harmful.

Zou Yan never intended his yin-yang and five elements theory to guide medicine. His method of building intellectual systems was: first verify on small things, then extend推 outward to the boundless. This is the method of logical reasoning and analogy. I believe anyone who has studied TCM understands how central this method is to TCM thought. The yin-yang and five elements theory, the zang-fu organ manifestation theory, and other TCM systems were all derived through this observing-the-external-to-know-the-internal method—the black-box method of modern science.

This way of thinking is not entirely wrong, but in medicine it is far more often unreliable. Professor Shi Yigong of Tsinghua University says that when he began studying life sciences, he could never shift his thinking from mathematical and logical reasoning and found it painful, because someone good at math and logic always wants to reason things out to find answers. The problem is that medicine is an experimental science; conclusions reached by logical deduction are often completely wrong when applied to clinical treatment. Treating by logic rather than by experience gets people killed.

The Japanese Kampo physician Dōmoto Shinshin wrote a classic passage: 'Whatever the discipline, if theory and fact are to correspond without the slightest discrepancy as in mathematics, one need only study theory; empirical knowledge is unnecessary. But medicine cannot be resolved by theory alone; one must turn to empirical synthesis. If theory departs from empirical fact, it is simply not true theory. Therefore, empirical facts of the human body must come first, and theory afterward.'

Dōmoto Shinshin was originally a Western-trained physician. When his daughter died of intestinal typhus despite Western treatment, he resolved to switch to TCM. Through nineteen years of wandering without changing his resolve, he finally became a TCM master with outstanding clinical results. In his studies, he valued empirical evidence highly and refused to easily believe the various deductive, almost metaphysical medical theories.

Zhang Zhongjing of the Han dynasty is honored as the founder of TCM. Zhang Zhongjing himself was not a Daoist devotee of yin-yang and five elements; he was a physician who highly valued evidence. His works *Shanghan Lun* (Treatise on Cold Damage) and *Jingui Yaolüe* (Essential Prescriptions of the Golden Coffer) may be the world's earliest evidence-based medical textbooks. What disease produces what symptom complex, what formula to use, what reaction occurs after taking the medicine—each is matched precisely, without grand theorizing. Formula names are mostly derived from their constituent herbs, like Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction). As for the Daoist-flavored names like Baihu Tang (White Tiger Decoction) and Qinglong Tang (Azure Dragon Decoction) in his works, Professor Jiang Chunhua's textual research suggests these were later alterations.

According to the preface to Zhang Zhongjing's *Shanghan Lun*, he witnessed the cruel reality of over two hundred members of his own family dying. During his lifetime, Zhang Zhongjing must have participated in many rescue treatments before he could write medical works like the *Shanghan Lun* and *Jingui Yaolüe* that emphasized practice over blind adherence to authoritative theory.

Having studied TCM for nearly twenty years myself, in my view, the truly readable medical works are often the thin pamphlets treating specific diseases, not grand, empty works like the *Huangdi Neijing*. Some ideas in the *Neijing* can serve as reference, but their value in guiding clinical practice is limited. If one becomes overly attached to them, they are not merely useless but harmful.

For TCM to truly develop in the twenty-first century, it must follow evidence-based medicine, striving to build an entirely new diagnostic and therapeutic system and formula approach constructed along evidence-based lines. It must respect facts and improve clinical efficacy. If it continues to wallow in the traditional yin-yang and five elements theoretical system, it will gradually be thrown into the dustbin of history.

As expected, this humble essay of mine will, like my previous critical pieces, attract streams of abuse from fans of traditional culture. Fortunately I have been tempered long ago and no longer care about criticism. Let it all be!