Reflections on Reading Dōmoto Kyūshin's Ko-kan Igaku (Imperial-Han Medicine)

Dōmoto Kyūshin (汤本求真) was a leading figure of Japan's Ko-ha (ancient-form) school—what in China is called the jingfang, or classical-formula, school. He lived 1867–1941, and Ko-kan Igaku was completed in 1927. Once published, it spread widely through the Confucian cultural sphere of China, Japan and Korea, which valued TCM, and its influence was unparalleled. Zhang Taiyan, the great modern Chinese scholar and physician, wrote of it: "Were Zhongjing alive, he would surely say: my Way has journeyed east."

In his preface to Ko-kan Igaku, Dōmoto recounts why he turned to TCM. He was originally a Western-trained doctor; in 1910 (Meiji 43), his eldest daughter died of typhoid fever. Overwhelmed by the futility of Western medicine, he suffered a mental collapse for years, then resolved to study Chinese medicine for eighteen years. Through those years he was displaced and poverty-stricken, yet his resolve never wavered.

The depth of his nature and firmness of his ambition were no less than those of the Tang monk Xuanzang. Master of both Chinese and Western medicine, Dōmoto read nearly all the TCM classics of every dynasty in eighteen years, moved from breadth to simplicity, and distilled them into Ko-kan Igaku, cross-referring Western medicine, elucidating ancient principles and fusing new knowledge. The depth of his theoretical and clinical grounding is rare. Hu Xishu, the great modern master of cold-damage studies, said that his own clinical results improved markedly after repeatedly studying Ko-kan Igaku.

For a period I settled down to read Ko-kan Igaku closely, and every day felt I had gained much. Though Dōmoto belonged to the classical-formula school, he differed markedly from the Chinese jingfang school: he was not opposed to any later accomplished physician, and showed no trace of arrogance or conservatism—a vivid contrast to the self-importance and conservatism of some Chinese jingfang physicians.

In his work, the range and completeness of quotations from Chinese and Japanese physicians across the dynasties would put to shame many present-day jingfang masters full of gimmicks. He read widely, cited extensively, reasoned clearly, and above all valued evidence and practice. He was deeply dissatisfied with later physicians' overuse of yin-yang and five-phase theory and idealistic explanations of medicine. Though rooted in classical formulas, he actually studied every TCM school in great depth.

For a doctor to study medicine so deeply and pragmatically—reading tirelessly after clinic and writing endlessly—requires extraordinary perseverance and intellectual power. As Dōmoto himself wrote, his grueling study was driven by grief over his daughter's death: he hated medicine's helplessness and mourned that the young could not be saved. Figures like Dōmoto—and Zhang Zhongjing, Li Dongyuan, Shi Jinmo and other great physicians—were all moved, after losing loved ones, by the thought that disease is common while good doctors are rare; they then steeled themselves to study medicine in depth and finally achieved something.

The Way of medicine is difficult; few can penetrate it. From the limited records, we know that the Medical Sage Zhang Zhongjing was a reserved man, indifferent to rank and wealth, devoted to the healing art, and so was able to synthesize the achievements of all schools before the two Han dynasties.

Jiang Chunhua said that one who studies medicine for fame and profit will never reach the first rank; those who seriously wish to learn must settle down, cast aside fame and gain, read and reflect hard, and reason carefully before they can succeed.

Dōmoto was exactly such a man. He turned grief into motivation, eighteen years of displacement without swerving, and lived in poverty most of his life—reaching the state of Confucius's disciple Yan Hui: "A dish of rice, a gourd of water, in a mean alley; others could not have borne the sorrow, but Hui never altered his joy." With such spirit, unchanged over decades, his mastery of medicine was no accident.

I often hear people say medicine is extremely simple, that a superficial study suffices for clinical practice. Shallow people casually describe terminal diseases like cancer as if they could be dispatched with a wave of the hand. Whenever I hear such self-deception, I feel an indescribable sadness.

My mother, while alive, was racked by illness and finally died of cancer in her prime, and my own complete happiness ended with her passing. While she lived, I exhausted everything seeking doctors and medicine for her, yet still could not save her. The ancients' saying—that disease is common while good doctors are rare—now rings deeply true to me.

This is the source of my own drive to study medicine, and Dōmoto Kyūshin is my model. If I study medicine, I want to study the truly profound kind he practiced—not the shallow, sensationalist, self-deceiving half-learning that deceives oneself and others and wastes a life.