My Medical Philosophy: The Wisdom of Avoiding or Minimizing Illness

The most effective, safest, and most economical health strategy is preventing disease. If you never fall ill, you need no treatment, take no therapeutic risk, and spend nothing. Even if you do fall ill, proactive self-care can still compensate to some degree. If patients actively take these compensatory steps, their disease becomes easier and cheaper to treat.

This brings us to another topic: preventing disease and self-directed recovery.

As a medical philosophy that advocates comprehensive treatment of refractory disease, the large-formula multi-target special therapy must first emphasize the patient's own agency in maintaining health. Physicians have a duty to educate patients, communicate with them, persuade them to make changes, and remove some causative factors—bad habits such as smoking, drinking, and staying up late.

In the TCM classic Huangdi Neijing, the chapter "Tangye Laoli Lun" says, "The disease is the root, the physician is the branch." This means that in medical care, the "disease" (i.e., the patient) is the root (subject), while the "physician" is only the branch (auxiliary).

The core of the "root vs. branch" idea is to establish the primary–secondary relationship between patient and physician, emphasizing the patient's fundamental position. Patients must actively adopt every measure that helps prevent disease, support recovery, and prevent relapse—including lifestyle, dietary, and sleep-habit adjustment, psychological adjustment, self-rehabilitation, and the three levels of prevention: "preventing disease before it arises, preventing progression once ill, and preventing relapse after recovery." Only thus can we maximize cure rates, reduce relapse and treatment costs, and lighten the economic burden on patients' families and on society.

At the same time, "Tangye Laoli Lun" also says, "When root and branch do not match, the pathogen will not submit." This means that if physician and patient do not trust or cooperate with each other, recovery is hard. Modern medicine likewise emphasizes patient trust and adherence; a doctor–patient relationship lacking trust harms recovery.

So what should we do to avoid illness as much as possible, and once ill, what self-rehabilitation steps should we take?

Modern medicine promotes the "biopsychosocial" model of medicine. The WHO defines health as: "Health is not merely the absence of disease or infirmity, but a state of complete physical, mental, and social well-being." Under this model, human health is tied to biological, psychological, and social factors.

This new model shows that health is no longer merely the absence of physical pain; it includes mental health and good social adaptation. Nor is health purely an individual matter; it is a public, systemic issue deeply bound up with the natural environment, sociocultural context, interpersonal relations, and the way humans relate to nature.

Clean air, safe water, and wholesome food are prerequisites for human survival and health. Ecological destruction and pollution directly damage bodily function and trigger disease.

At the same time, humans' excessive encroachment on wildlife habitats and the breaking of ecological boundaries between people and nature easily cause cross-species transmission of viruses and bacteria. The emergence of SARS and COVID-19 has deeply confirmed the importance of revering nature and safeguarding ecological balance for public health.

Dominant social trends and cultural environments directly shape public psychology, which in turn affects physical and mental health. If society is permeated by money-worship and utilitarianism, it easily breeds short-termism and cutthroat competition, leaving people in chronic mental stress and spawning anxiety, depression, and restlessness; long-term accumulation produces psychological imbalance and psychosomatic disease.

Meanwhile, in the self-media age, some platforms deliberately peddle anxiety and manufacture group polarization, accelerating the spread of negative emotions and amplifying social stress—also a major driver of national mental-health problems.

A good social environment is an important pillar of health. Fostering an environment that treats nature kindly, is friendly and mutually supportive, and is tolerant and benevolent requires both policy guidance and each of us taking the initiative to start with ourselves.

Moreover, each person's interpersonal relationships and social adaptability significantly affect physical and mental health. Medical research and abundant clinical data confirm that good social ties and moderate interpersonal contact are important safeguards of health.

For example, a stable marriage significantly raises health and life expectancy in both sexes; childbearing effectively lowers women's breast-cancer risk; fathers' involvement in child-rearing promotes a second brain-development phase and lowers dementia risk. Even divorced people are generally healthier and longer-lived than those who remain single and isolated long-term.

Beyond this, harmonious family and friendship ties and moderate social contact provide stable psychological support, effectively lowering the incidence of depression, cardiovascular disease, Alzheimer's disease, and malignancy. Conversely, excessive socializing and pointless networking cause mental and physical exhaustion, leading to illness from overwork.

Interpersonal exercise is especially crucial for young people. Children who lack social stimulation receive insufficient external input to the brain, easily leading to poor social adaptation and a higher risk of anxiety, depression, and allergic somatic disease in adulthood.

Today, rapid technological iteration and accelerated social change outpace human biological evolution. New social shifts—AI proliferation, intensifying employment competition—leave some groups facing job anxiety and survival pressure; chronic mental tension has become an important determinant of health in the new era.

These problems are both new and old.

Ours is the people on Earth that most values written memory; we have the noble tradition of "establishing words, establishing merit, and establishing virtue." From antiquity to today, many among us have written diligently, and for many authors the basic stance is to strive for truth.

In the Spring and Autumn period, the three brothers who served as court astrologer-historians of Qi, determined to record a bit of history truthfully, wrote "Cui Zhu murdered his ruler." The powerful minister Cui Zhu was enraged and killed the eldest brother; the second continued to write the same thing. Cui Zhu killed him too. The third brother was undaunted and wrote it still. Finally Cui Zhu gave up.

This story reflects the integrity of ancient Chinese intellectuals in seeking truth, a spirit passed down through the ages. That is why we possess unique, rich, and reliable historical documents that offer us many wellsprings of wisdom. The same holds in medicine: most of ancient Chinese medical literature is trustworthy.

The ancient social conditions and health problems recorded in our medical texts are not very different from today's. We now face biological, psychological, and social challenges; so did the ancients. Reading more historical literature not only broadens the mind but also calms the heart.

Learning from history, we can see that the absurdities caused by human weakness, ancient and modern, are nothing to complain about. Do not expect society to be tailored to you; society was not built for any one individual, and we must learn to adapt. If we want to be healthy and happy, the point is not to wait until everything goes our way before being happy; the point is to be happy now.

Many of the health-related psychological and social problems we face today were already widespread in the Spring and Autumn period.

In the "Shanggu Tianzhen Lun" of Huangdi Neijing, we read: "People of old who knew the Way modeled themselves on yin and yang, harmonized with art and numbers, ate and drank with moderation, regulated rest and work, and did not rashly overexert themselves; thus body and spirit were united, and they fulfilled their natural span, passing away after a hundred years. People of today are otherwise: they treat wine as water, take excess as norm, enter the chamber while drunk, exhaust their essence through desire, dissipate their true energy, do not know how to conserve fullness, do not guide their spirit, rush to please the mind, live contrary to the joy of life, and rest irregularly; hence they decline at half a hundred."

In this passage, the author describes many people of his time living without restraint in routine, diet, or desire, fond of drink and excess, so that they were already frail past fifty.

"Modeled themselves on yin and yang, harmonized with art and numbers" means following natural law; "ate and drank with moderation, regulated rest and work, did not rashly overexert" means regular, moderate diet and rest, stopping at enough.

The same chapter says: "The sages of old taught the people that deceptive evils and wind should be avoided in season. They were quiet and vacant, true qi followed, spirit was kept inward, and illness came from where? Thus they were spare in ambition and few in desire, peaceful in heart and free of fear, their bodies labored but not exhausted, qi flowed smoothly, each followed its desire and obtained what it sought. Thus they were content with their food, pleased with their clothing, happy in their customs, and did not envy one another's station; their people were simple. Therefore desire could not tempt their eyes, licentiousness could not confuse their hearts; the foolish, the wise, the worthy, and the unworthy did not fear for external things, and thus they were in accord with the Way. That they all lived past a hundred without failing in their movements is because their virtue was complete and free from danger."

"Shanggu Tianzhen Lun" honors four types of people (zhenren, zhiren, shengren, xianren). Among them, I find the "sage" most practically relevant: "Next come the sage, who dwells in the harmony of heaven and earth, follows the patterns of the eight winds, accommodates desires within the mundane world, harbors no resentment or anger, acts not apart from the world, wears ordinary clothes, moves not seeking to be noticed, externally does not overwork the body, internally has no anxious thought, takes tranquility and joy as his task, and regards contentment as achievement; his body is not worn, his spirit not scattered, and he too can reach a hundred."

I will not translate these classical passages word for word. Readers who want to understand them can use Doubao or DeepSeek. Let me summarize their gist and add my own view.

The above passages encompass health wisdom on three levels: physiological, psychological, and social adaptation.

Physiologically, Huangdi Neijing advocates "avoid deceptive evils and wind in season" and "eat and drink with moderation, regulate rest and work, do not rashly overexert"—staying alert to and away from pathogens. In life, do not indulge, and do not wreck the body for the sake of taste or fleshly pleasure.

Psychologically, Huangdi Neijing advocates: "Be tranquil and vacant, true qi follows; keep the spirit inward, and illness will never come. Thus be spare in ambition and few in desire, peaceful in heart and free of fear, labor the body but not to exhaustion, let qi flow smoothly, and each desire obtain its wish." It opposes utilitarianism and the relentless pursuit of fame and gain, advocating restraint, low desire, and inner peace and contentment.

Socially, Huangdi Neijing advocates: "Accommodate desires within the mundane world, harbor no resentment or anger, act not apart from the world, wear ordinary clothes, move not seeking to be noticed, externally do not overwork the body, internally have no anxious thought, take tranquility and joy as your task, and regard contentment as achievement." Be moderate in gratifying desires and pursuing goals. Do not blindly follow fashions, drift with the tide, or burn yourself out; keep your inner core stable against outside interference. Stay on friendly terms with neighbors, do not anger easily, and do not make a showy spectacle of yourself.

A special note on relationships: our ancestors honored getting along harmoniously with others, not being condescending or hypercritical. If someone finds most people around them disagreeable, complains constantly, and always feels others are out to get them or targeting them, that person usually has a psychological, emotional, or personality problem. With professional help, they should take psychological tests, identify the cause, and receive treatment and adjustment.

"There are no good people in Hongdong County" is an exaggeration of literature. Most people in this world are neither very good nor very bad, basically passing on character. The aloof and contemptuous are not actually of higher cognition; quite the reverse—their cognition is insufficient to blend in and adapt to society, which is a sign of poor mental health.

People of truly high cognition can tolerate and accept almost everyone around them. Some call this high EQ; as a medical person I prefer the medical term: such people are mentally healthy, optimistic, sunny, positive, tolerant, easy to get along with, and long-lived people usually fit this type. It is lucky to be born this way, but those without the genetic predisposition can also cultivate such a state through learning.

Long-lived people are mostly optimistic—though this cannot be absolute. Most long-lived folks are open, optimistic, and easygoing, but we also see irritable ninety-something grandpas and grandmas. Former British PM Winston Churchill was a famous depressive, often furious and hypercritical, yet he lived to 91. His longevity may have other explanations: his family had no longevity genes—his father died of syphilis at 45, his mother lived only to 67.

You could say every aspect of today's "biopsychosocial" model was already recognized by the ancients, who found approaches broadly equivalent—and in some ways more sophisticated. Huangdi Neijing is not a clinical treatment guide, but it offers profound insight into prevention and health preservation.

Throughout Huangdi Neijing, what it advocates is a restrained, disciplined way of life. Dietetically it opposes "rich, fatty, thick flavors" (overly greasy, salty, spicy, and stimulating diets), arguing that long-term indulgence breeds all sorts of "large boils." It advocates regular routines and good habits, opposes excess indulgence and overwork while promoting moderate activity. It opposes chasing fame and gain, arguing that over-pursuit exhausts body and mind. It advocates living in harmony with the outside world without being led by the nose—neither following fads nor blindly conforming.

As an individual, doing all of the above is enough to maintain basic health on the "physical, mental, and social" levels in any era and any society.

Strictly speaking, TCM's medical model goes even beyond the "biopsychosocial" model; traditional TCM belongs to a "natural–biological–psychological–social" model. Beyond biological, psychological, and social factors, it pays special attention to natural environment (regional characteristics, climate, seasons) in shaping people.

The "Siqi Tiaoshen Dalun" chapter of Huangdi Neijing discusses the influence of seasons and climate on the body; the "Shengqi Tongtian Lun" discusses nature's influence on humans, called in TCM "the correspondence of heaven and humanity." From a scientific standpoint, these chapters are quite reasonable. The high prevalence of depression and joint pain in Nordic regions correlates with lack of sunlight and cold climate.

Of course, some chapters of Huangdi Neijing are unrealistic. Studying this classic, we should take the valuable parts and discard the impractical ones.

Modern preventive-medicine research has not ventured far beyond these bounds. For example, Singaporean researchers recently published a long-term study of over ten years finding that smoking and excess body weight are strongly tied to biological aging; conversely, regular exercise and a plant-rich diet make biological age younger.

The scientists explain that biological age refers to the degree of aging reflected in a person's bodily function, metabolic level, and health state, including the cumulative effects of genetics, lifestyle, and environment on aging. This may not match chronological age.

The gap between biological and chronological age correlates closely with long-term lifestyle and health habits. Smokers' biological age is about 3.6 years older than non-smokers; obese people's is about 4.2 years older than normal-weight people. Regular exercisers are about 1.25 years biologically younger than those who never exercise or exercise less than monthly; those who eat plant foods frequently are about a year younger biologically than those who do not.

This study merely operationalizes, down to each small item, the healthy habits our ancients advocated—and its scope is not even as broad as what the ancients covered.

If a person does not smoke or drink, exercises regularly, eats a mainly plant-based diet, and maintains normal weight, just these alone make them about 10 years younger physiologically than those who do the opposite. Add regular routines, emotional balance, and good social ties, and it is easy to be 10–20 years younger biologically than peers.

Clearly, health is partly within our own control. Grasping this and then practicing what you know—becoming a practitioner of healthy principles and lifestyle—lets us avoid many diseases and greatly cut medical spending.

Modern cardiovascular disease, about a third of cancers, COPD, obesity, and the "three highs" are basically lifestyle-related; these are within our control. Controlling them, however, requires strong self-discipline, which not everyone has.

Not all disease is within our control. When very young children develop cancer, we cannot blame their lifestyle, diet, or sleep habits; we must attribute it to genetic or chromosomal defects. There are many similar hereditary and mutation-based diseases. So the idea of disease prevention cannot be absolutized either.

A work like Huangdi Neijing, which has survived two millennia, must have high practical value; otherwise it could not have survived. Remember, in ancient times engraving such a book was costly in labor and materials. It spread because it reveals fundamental principles that convince.

Huangdi Neijing most likely took shape from the Warring States through Qin–Han, and its main thought is Daoist. The ancients often called Daoism the "Huang-Lao learning"; "Huang" comes from Huangdi Neijing itself.

Strictly speaking, "Huang-Lao" should be "Lao-Huang," because Huangdi Neijing was written after Laozi and even after Zhuangzi. Many of its concepts, such as zhenren and zhiren, were borrowed from Zhuangzi.

The way of living and cultivating health advocated in Huangdi Neijing is of one piece with Lao-Zhuang thought. Within Chinese cultural circles, people past middle age are more or less influenced by Daoist philosophy. Lin Yutang said one feature of Chinese philosophy is "old smoothness"—which should be read as "mellow and rounded," a state reached only in middle and old age.

As life experience grows, the edges of youth wear smooth. We come to like Lao-Zhuang philosophy more and more, and the health ideas of Huangdi Neijing.

Because chronic diseases common in middle and old age—the three highs, diabetes, fatty liver, cancer—are hard to cure by medicine alone. To live longer with them, one must master self-management of chronic illness, and those techniques already exist in Huang-Lao thought.