Return to Common Sense, Value Experience, Strive for Accuracy

The development of TCM is not the achievement of one age, let alone of one person. Neither Yi Yin nor Zhang Zhongjing could have completed such a thing alone. It came from experience, so TCM is, simply put, empirical medicine, worked out in the struggle against disease.

— Professor Hu Xishu, Beijing University of Chinese Medicine, a renowned scholar of classical formulas

In any scholarship, if theory and fact are to correspond without the slightest discrepancy—as in mathematics—one need only devote oneself to theoretical research; experiential knowledge is of no use. As for medicine, it cannot be resolved by theory alone, so one has no choice but to seek the combination of experience.

— Tōyama Yoshihiro, renowned Japanese Kampo physician and author of "Kōkan Igaku"

TCM has a long and profound history, and even today it still exerts a fascinating charm. "Huangdi Neijing," "Shanghan Lun," "Jingui Yaolue," "Shennong Bencao Jing," "Waitai Miyao Fang," "Qianjin Fang," "Nan Jing," "Bencao Gangmu," "Yizong Jinjian"—the wisdom on health preservation and disease treatment contained in these classical TCM texts attracts many people.

But it is also an undeniable fact that the TCM world has always been factional, with endless disputes and no consensus. For thousands of years, many people have believed themselves to hold the truth of TCM; each faction has many disciples, each clinging to its own views, considering itself supreme and attacking other schools' scholarly opinions, making it very hard for later TCM learners to choose. Some factions hold extreme views with endless pernicious influence, causing many people to lose their lives.

Beings in this vast world are very complex, and the diseases they get differ accordingly. Whoever clings to a single, biased TCM notion is in trouble—such as the so-called yang-supporting school or the yin-nourishing school. The reason is plain: the world's countless people are not identical, so how could there be only one constitution? In the past, the senior physician Zhu Weiju said: "Everyone says I am a yang-supporter; this is a great misunderstanding. It is simply that everyone knows I am good at using yang-supporting formulas and herbs, so yang-deficient patients come to me more. How could TCM be summed up merely by the words 'support yang'?"

I have read TCM books for more than twenty years, almost every day without interruption, and I also try to write every day—mostly about what I have learned from studying TCM and using it to treat patients. Though I am not clever, I firmly believe this perseverance is not shared by every TCM learner. When one has read many books, as Professor He Ren said, the more one reads, the more confused one becomes; then suddenly, one day, the channels open and one goes from breadth to simplicity, from complexity to concision, and all becomes clear.

This is a process most researchers go through. Just as Wang Guowei divided scholarship into three realms, after passing through "climbing the high tower alone, gazing to the horizon's end" and "wasting away for her sake, undiminished even as my sash grows loose," one finally reaches the third stage: "Suddenly, looking back, she was there, where the lamps dwindled."

Most TCM learners eventually find their homecoming in classical formulas. Many people do not know what "classical formula" (jingfang) means; in fact the two characters are simple: they mean "empirical formula." In Professor Hu Xishu's words, TCM is empirical medicine, and TCM classical formulas are empirical formulas for treating disease, worked out in daily life by ancient people—and by ordinary, not highly educated common folk, not by sages—rather than marvelous formulas deduced from profound metaphysical theories such as yin-yang, five phases, and the I Ching's eight trigrams.

Professor Hu Xishu's definition of TCM may anger some who are infatuated with TCM's various mysterious theories; they feel Professor Hu Xishu has taken the wrong side, eating TCM's rice but smashing TCM's bowl, discarding many mysterious TCM theories and reducing TCM to the crude level of empirical medicine.

Professor Hu Xishu's clinical efficacy was plain for all to see. Professor Liu Duzhou said that whenever a difficult or severe case came up and the many senior TCM professors at Beijing University of Chinese Medicine held a consultation and could not decide, it was always Professor Hu Xishu who delivered the final word with the best treatment plan. Old Hu treated disease with immediate effect and was deeply welcomed and trusted by patients; his doctrines were also very popular.

Ultimately, Old Hu's proposition simply returned to common sense, pulling TCM back from the deification campaign carried out by successive TCM enthusiasts to its original face. Many TCM physicians who previously lived off that mysterious veil greatly disliked Professor Hu Xishu's frank words, because if Old Hu's doctrines spread widely, they would lose the pretext for feigning profundity and playing god.

As the great Japanese Kampo master Tōyama Yoshihiro said, medicine differs from any other scholarship: medicine must value experience. After developing for many years, TCM accumulated many abuses; the greatest of these is valuing theory over practice.

Principle, method, formula, herb—TCM placed principle first. TCM learners must study many ambiguous and mutually contradictory theories; when these theories guide clinical practice, they often not only have no effect but actually harm patients. I believe this is because TCM, in its development, gradually violated basic common sense, elevating living empirical medicine into such "high-grade goods" as "medicine is change" and "medicine is intent," departing from medicine's spirit of seeking truth and moving from the practical to the theoretic.

Later scholars, reading TCM theories fabricated by successive TCM theorists through their own subjective judgment, lost the correct direction. Most TCM physicians must prove or disprove theories in practice; only after a great deal of clinical practice can they understand that the essence of TCM is empirical medicine. Many doctors treat disease through experience, not through so-called medical principle.

We have read many books to learn TCM, and a large part of that time was actually wasted, which is a sad thing. In the end, this is because our nation has never encouraged a spirit of questioning. Professor Chen Susheng said: "The way of scholarship is to both study and ask." Asking is like ringing a bell: a big strike gives a big sound, a small strike a small sound; the greater the questioning, the greater the gain. We cannot accept our ancestors' ideas wholesale, without choice; if we do, we become foolish.

A physician who treats and saves patients, curing them as soon as a hand is applied, is the lifelong dream every doctor longs for and the dream every patient holds. If we want to improve clinical efficacy, we must strive for precision; we cannot forever circle around fuzzy medicine, using a set of vague medical theory as the foundation of TCM.

We should return to common sense, recognize the basic fact that medicine comes from practice, value experience, and devote ourselves to learning and organizing the experience of our predecessors in using herbs and formulas. Only thus can our treatment become ever more accurate and our success rate ever higher.