Professor Yin Huihe: TCM Treatment Must Grasp the Main Symptom and Combine Pattern Differentiation with Disease Identification
Professor Yin Huihe (1923–2012) was one of the towering figures of contemporary Chinese TCM. His father Yin Bingzhong was a famous physician in southern China. Professor Yin Huihe read medical books with his father from childhood, absorbing the tradition by osmosis, and was keen to learn. His youth coincided with the Japanese invasion of China; his hometown fell, so he abandoned ordinary study to take up medicine, opening his practice in 1940 to save people and building rich clinical experience. After 1954 he taught at the Jiangsu Provincial School of Chinese Medicine (now Nanjing University of Chinese Medicine), serving as business head of the TCM teaching and research group and concurrently head of the "Jingui" teaching and research group.
After Beijing University of Chinese Medicine was founded, Professor Yin Huihe was transferred to Beijing, becoming a backbone talent at Beijing University of Chinese Medicine, Dongzhimen Hospital, and China-Japan Friendship Hospital. He served as director of the Warm-Disease teaching and research office and of the Basic TCM Theory teaching and research office at Beijing University of Chinese Medicine, and as vice president of China-Japan Friendship Hospital. The fifth edition of our country's "Introduction to Chinese Medicine" was edited by Professor Yin Huihe.
Professor Yin Huihe had profound TCM foundations and rich clinical experience. The Xiao Gu Tang he developed for early cirrhosis of chronic liver disease, the Shugan San he developed for benign tumors, and the "Min Gan Ling" he developed for urinary system diseases all had outstanding efficacy, were recognized by the State Administration of TCM, and became famous formulas.
Professor Yin Huihe's academic views were clear-cut. He held that TCM treatment must "grasp the main symptom" and not be confused by the patient's various incidental accompanying symptoms. Once the principal contradiction of the disease is grasped and solved, the problem becomes much easier. Professor Yin said: "If you cannot grasp its principal contradiction, the disease is like a raging tiger, hard to tame; but once you grasp the main symptom and its principal contradiction, it becomes docile, easing link by link."
The so-called main symptom is the most important feature of a disease. Professor Yin held that, compared with the main feature of the disease, the patient's various minor symptoms are unimportant; the physician must have his own views and not be led by the nose by minor symptoms.
In my own clinical practice I have deeply experienced Professor Yin's proposition. Different tumor patients may have a dazzling variety of symptoms, but their main symptoms are the same. Some TCM practitioners overemphasize "pattern differentiation and treatment," stressing the differences among tumor patients and the "one person, one formula" approach, while neglecting the main symptom of tumor patients; as a result, repeatable efficacy is hard to come by. But if we firmly grasp the main symptom of the tumor and focus on eliminating it, without fussing over the dazzling symptoms appearing in different patients, things become much simpler.
Of course, if a TCM physician is more learned and can also treat the patient's various accompanying symptoms, that would be ideal. But my years of clinical experience tell me that many patients' accompanying symptoms are not fatal; tumor specialists should focus on researching the tumor. Other problems are good to solve if possible, but if not, it may be better to seek help from other specialists.
Some patients have no main tumor symptoms, but this is only appearance; do not be misled by this appearance. When a tumor grows to a certain size, those common tumor-related symptoms all appear: pleural effusion, ascites, cancer pain, tumor ulceration and bleeding, cancer fever, and so on. If a patient is asymptomatic and pattern differentiation is difficult, one should differentiate and treat the disease according to the main symptom the disease will develop into, without hesitation or bewilderment; otherwise the patient's optimal treatment period will be missed.
TCM pattern differentiation is of course important, but one should not throw away the apple because of the core: overemphasizing TCM pattern differentiation while neglecting the patient's greatest peril is wrong. TCM must also value both pattern differentiation and disease-specific treatment.
Professor Yin held that one cannot say TCM is pattern-differentiation treatment while Western medicine is disease-differentiation treatment; both TCM and Western medicine should value pattern differentiation and disease identification at the same time. Speaking of pattern differentiation and disease differentiation, Professor Yin said: "TCM must unify Western disease identification with TCM disease identification, combining Western examination results with TCM pattern differentiation and disease identification. Specifically, add Western diagnosis into TCM pattern differentiation; that is what I do."
Some TCM practitioners reject Western medicine, dismiss Western test results, and believe TCM pulse diagnosis is far superior to Western examination, willing to diagnose only through TCM inspection, auscultation-olfaction, inquiry and palpation. This is wrong. TCM must keep pace with the times and accept new technology; it should not keep emphasizing that TCM pulse diagnosis is more accurate than Western examination.
Patients should also view medical progress rationally and not remain stuck in old ideas, lest they delay their own treatment. Once a patient came to me; I asked her what disease she had and whether she had Western test results, but she answered nothing and merely held out her hand for me to feel the pulse. She had not come in good faith to seek treatment but to test the doctor first; one could also say she had been brainwashed by some overly conservative TCM enthusiasts. For such a patient I also have a countermeasure: after the visit I prescribe a very safe, middle-of-the-road formula, only one dose, return the consultation fee in full, and politely see the patient out, not engaging with such patients. Treating major diseases like tumors requires mutual understanding, trust and close cooperation between doctor and patient; otherwise, achieving efficacy is harder than climbing to heaven.
Professor Yin Huihe was an honest man. His advocacy of "grasping the main symptom," boldly applying disease-specific empirical formulas based on the main symptom, and his view that TCM pattern differentiation should combine with Western disease identification, are all judicious opinions. Specialist TCM physicians should focus their research on disease-specific treatment. A person's time and energy are limited; the more focused the research, the easier it is to achieve better efficacy.
By the way, TCM has departments; some people claim TCM has no specialties, which shows they do not understand TCM—it is also because some TCM enthusiasts love to boast and exaggerate TCM's abilities. Before the Han Dynasty, our country already had different categories of TCM physicians such as jiyi (internal physicians) and yangyi (surgical physicians), who treated different diseases. In the Imperial Medical Academy of the Song, Yuan, Ming and Qing dynasties, TCM physicians were divided into thirteen departments.
True general-practice TCM physicians are rare. A TCM physician needs at least decades of clinical experience to become a generalist, and a generalist's experience in treating any particular disease cannot be as rich as a specialist's. So we should respect history and facts, not brag and talk big; those who overstate TCM as omnipotent mostly end up lifting a rock only to drop it on their own feet.
In recent years, following Professor Yin Huihe's approach of grasping the main symptom and combining pattern differentiation with disease identification, my clinical thinking has been much clearer, no longer aimless, and my results have been better. So I am happy to recommend Professor Yin Huihe's academic thought to readers.