The Road of Every TCM Physician Is Hard-Won

Li Dongyuan, a great physician of China's Jin-Yuan period, took on a disciple named Luo Qianfu. When accepting the disciple, Li asked Luo: "Have you come to learn medicine as a money-making trade, or to learn medicine as a way to transmit the Way?" Luo Qianfu replied: "Only to transmit the Way."

Li Dongyuan, who knew Luo Qianfu's background very well, accepted the disciple on hearing this answer. Luo studied with Li for three years. One day, Li gave Luo twenty taels of silver and said: "I know your livelihood is very hard; I fear you might be tempted and give up halfway. Use this to support your wife and children."

Luo declined. Li said to his disciple: "I do not begrudge the great things, why would I begrudge the small? Do not refuse again."

This passage records how Li Dongyuan, one of the Four Great Masters of the Jin-Yuan period, cultivated an heir to his medical art: in accepting disciples, he strictly screened candidates and chose someone as pure and filial as Luo Qianfu. Luo had been recommended to Li by a close friend—a young man intent on studying medicine, of fine character and disposition, and of no ordinary intelligence.

Li carefully assessed Luo before deciding to take him on. After three years of study, fearing Luo might abandon his studies because of economic hardship, Li not only waived tuition but gave him twenty taels of silver to feed his family.

I myself now have three disciples, including my own son. I cannot know whether they will give up halfway, but from the day I accepted them, I decided to charge no tuition at all. Many do not understand why I do this. The Way of TCM is already in decline, with too few heirs; even teaching for free, it is hard to find anyone who will persist to the end, let alone charging fees.

According to the accounts of his contemporaries, Li Dongyuan was a scholar from a wealthy family. When his own mother fell ill, the family far and wide invited famous doctors, but by the time she died, not one doctor could say clearly what disease she had. In indignation, Li abandoned commerce and took up medicine, eventually becoming the founding master of the TCM Spleen-Stomach school.

Li's disciple Luo Qianfu later became a renowned physician in his own right. After Li died, Luo treated Li's widow as his own mother, brought her into his household to care for her in old age, and saw her to the end. Luo also systematized Li's academic thought and passed it on to later generations, so that Li's medical art still benefits humanity today. Well-known patent medicines we commonly use, such as Buzhong Yiqi Wan (Center-Boosting Qi-Bolstering Pill), are famous formulas created by Li Dongyuan.

The Japanese physician Tsumura Shinno (Tumoto Shinno) was, before studying Chinese medicine, a Western-trained doctor. After his eldest daughter died of typhoid fever despite Western medical rescue, he in indignation switched to TCM, and after eighteen years of wandering and hardship, became a great TCM master. In Japan he was the leading figure of modern Kanpo medicine; the price he paid was eighteen years of displaced life.

Many famous TCM experts in China, such as Zhang Renji and Academician Shen Zaiyin, also switched from Western to Chinese medicine.

Zhang Renji was a Western physician trained at Peking University Medical School and educated for years in Japan. When he himself developed ulcerative colitis and consulted famous Western specialists in Beijing without cure, by referral he went to see Shi Jinmo, one of the "Four Great TCM Masters of old Beijing." After only three doses of Chinese herbal decoction, he was cured; from then on he became Shi's disciple and switched to TCM. The hardship involved goes without saying; it was precisely because he personally experienced the efficacy of both systems that he was determined to study TCM.

Likewise, Academician Shen Zaiyin, who had also returned from overseas study, spent many years serving beside the late renowned Shanghai TCM physician Jiang Chunhua. Only after witnessing Jiang's outstanding results with his own eyes did he sincerely switch to TCM, going on to become a great master of the contemporary TCM theory of zang-fu manifestations.

It is a fact that TCM is not regarded highly. Shi Jinmo once worried whether, a hundred years later, TCM would still have a place to stand.

Now it seems his worry was well-founded. As modern scientific thinking gradually dominates the field, TCM is being seriously marginalized. Although the Chinese government recently passed the Law on Chinese Medicine, establishing a policy of equal emphasis on Chinese and Western medicine, in reality the number of newly registered TCM physicians each year is declining.

Nowadays I do not take on students older than twelve. The reason is simple: I believe that only those who can patiently study TCM for ten years or more can eventually become excellent clinical TCM physicians whose prescriptions actually work. And to study for ten years or more, probably only minors can manage it.

Quite a few adults want to study TCM with me, but I do not think any of it realistic. People over twenty have real survival problems to face; how can they spend ten-plus years patiently studying medicine?

In the past I briefly taught some TCM courses online, only to find that after a few months, having grasped the barest rudiments, some people went out and began prescribing for others. On reflection, that is an extremely frightening thing. Is life a trifling matter?

So later I discontinued such teaching, and no longer take on adults who treat TCM as a hobby. Nowadays many people who have skimmed only the surface of TCM prescribe for themselves, their families, and friends, and create all kinds of problems.

Studying TCM requires both broad vision and solid grounding; it truly cannot be rushed in a few months or a few years. A person of above-average intelligence, studying TCM for ten years, will only just have entered the door.

Shamefully, even now I myself remain only at the entry level, still far from the consummate mastery I hope to reach. Apart from the grass-roots herbalist knowledge I absorbed as a child, my real exposure to TCM began in 1998. From 1998 to now is already twenty years, but twenty years is still too short.

Besides my own son, I have taken two disciples. One disciple's father had severe allergic rhinitis; after many famous specialists in Beijing failed to help him, I cured him with five doses of Chinese herbal decoction. This father had once deeply despised TCM; after that, his view changed completely. The other disciple himself had several stubborn minor ailments, each of which was readily cured in my hands.

The reason I only take such people as disciples is that TCM is in an awkward position in our era. Many people think TCM is backward and cannot cure disease, so I choose disciples from among my patients and their families. Only they, having personally experienced my results, can develop firm confidence in the art I transmit.

As for my own son, from birth to now, the number of times he has entered a hospital for illness is countable on one hand; he has basically recovered readily from the Chinese herbal medicines I prescribed. So he will not harbor the slightest doubt about the efficacy of Chinese medicine.

These three young disciples—and any new ones I may take by chance in future—if they choose TCM as a lifelong career, their road will not be smooth. I worry about their future livelihood even more than their parents do.

I hope someone will inherit my medical art, but the students who study with me, even if they are not my own children—after ten or eight years of training, I am no different from their parents. When they grow up, if the practice environment is poor and their livelihood is hard to secure, I will worry about them.

So the first thing I teach them is not TCM, but the Qian and Kun hexagrams of the I Ching and important chapters of the Buddhist Sutra in Forty-two Sections, and I require them to memorize it after understanding it.

Some people find this strange: what does this have to do with TCM? My explanation might amuse many. Studying these does not help much in understanding TCM theory, but it is very helpful in building resilience to setbacks.

TCM has been drowned out by the chatter of the times. In this era, opinion leaders of every kind take pride in being anti-TCM. To study TCM, one must be mentally prepared to face a lifetime of sneering and derision.

The spirit of the Qian hexagram—self-improvement, gradual progress, deep accumulation before bursting forth, and not contending with others; the spirit of the Kun hexagram—bearing the world with generous virtue, keeping silent to avoid harm; and even the Buddhist spirit of forbearance and endurance—these are all essential spiritual weapons for a TCM physician. Lay a solid foundation, learn TCM well, go out to the patients who truly need it, and solve their health problems—that matters far more than shouting matches.

Because I have gradually built a modest reputation, passed on by word of mouth among patients I have treated, survival is no longer difficult for me and my mindset has grown steady. But what I hope most is that, whether my students or the young new TCM practitioners, they can all walk through this thorn-filled road and find a smooth path, so that ancient TCM, through its real efficacy, may win the trust of more patients and regain its vitality.

Disease is so merciless and so intractable that no experience humanity has accumulated in dealing with it should ever be discarded.