Seeking the Key That Opens the Door to Disease
Since I began studying medicine on my own, I have read many books; a few statements have left a deep impression. The most important one is something Professor Zhao Shaoqin mentioned about how his father, Zhao Wenkui—who had been director of the Imperial Medical Academy in the Qing dynasty—educated him: using medicine to treat disease is like using a key to open a lock; the crucial thing is to find the right key. Once the right key is found, a gentle turn opens the lock. The Zhao father and son used medicine lightly, purely, and evenly; one often sees them using doses of only 1g or 0.5g, yet with remarkable results—a very mild formula that rescues patients from critical, life-threatening conditions.
In my own earlier prescribing, I found it hard to achieve this in dosing. Later I gradually reduced my doses. Because clinical experience told me that, applying the pharmacology of modern science to treat major diseases like cancer, if the prescribing approach is not correct, no matter how large the dose, it is not enough to check the growth of cancer cells. But if the direction of medication is right, then to treat cancer with Chinese medicine, many herbs need only a few grams each, and the formula need not contain many herbs, to achieve the ideal effect. This reduces the patient's financial burden and, because less medicine is used, also reduces damage to the patient's liver and kidneys.
With every patient I treat, I constantly summarize successes, failures, gains, and losses. As the proverb says: "Having read Wang Shuhe thoroughly is not as good as seeing many patients." From theory to practice, after going through it, my understanding of TCM gradually moved from vague to clear, and from clear to profound. Though I cannot yet say I thoroughly understand the thousands-of-years-old TCM culture, I do have the felt sense of one who knows the essence in their own heart.
The essence of TCM lies in the two characters yin and yang. Grasp this key and use it in pattern differentiation and treatment; though the patient's condition may be complex, one can always find a way through. But understanding the two characters yin and yang is far from easy.
National medical master Professor Ren Yingqiu said that a person under sixty can hardly understand true TCM. I did not quite understand this saying before. But now that I have studied medicine for nearly twenty years, looking back at my evolving understanding and experience of TCM theory, I often feel that what I previously thought right now seems wrong; thus I have come to deeply agree with Old Ren's words. I believe that as I grow older, my understanding of TCM will become deeper still.
Wu Jutong, the famous Qing-dynasty master of warm diseases, used cooling herbs when young and warming, tonifying herbs when old. Over ten years ago, based on my own experience of taking medicine, I also leaned toward the warm-disease school, and its formulas indeed worked for me. But as I grew older, I found that the ball of "fire" in my body naturally faded away, and using cold herbs was no longer appropriate.
As a person grows older, the rise and decline of the body also changes markedly. After entering middle age, one no longer has the hot-blooded vigor of youth. Once the fire fades, the direction of medication naturally must change with it. By Wu Jutong's later years, having experienced the multi-functional decline of his own body, his preference for warming, tonifying herbs is no surprise.
Without such life experience, it is hard to grasp the meaning of the Song-dynasty pediatrician Qian Yi's saying that children's bodies are "pure yang without yin," or to understand why TCM thought is of one piece with the Yijing (Book of Changes), which holds that all things are in constant change.
The rise and decline of the human body can only be deeply understood through one's own personal experience. Thus Professor Ren Yingqiu's statement that one under sixty can hardly thoroughly understand TCM is not without reason. A physician must first of all be a person skilled at observing the world and at observing their own body. Only such observation and discovery can let a TCM learner truly and deeply understand TCM theory. TCM theory memorized by rote is often useless when guiding clinical practice. Learning TCM this way easily traps one in sectarian disputes; forming prejudices can kill many people.
Disease arises in a healthy body under the inducement of various internal and external factors. If we cannot recognize these pathogenic internal and external factors, we cannot truly know how to treat disease. The most important work in treating disease with TCM is to remove the influence of the pathogenic internal and external factors on the patient's body. In my understanding, this work is precisely what Professor Zhao Shaoqin's father, Zhao Wenkui, spoke of: finding the key that unlocks the lock of disease.
How can we find the key to the lock of disease? Reading the literature, thinking carefully, and practicing—cultivating one's own critical capacity—is the key. The excess or deficiency of yin, yang, cold, and heat in the body need not be addressed with heavy doses at every turn; using too much medicine is absolutely harmful, not beneficial. If the right approach is found, a mere few herbs, each a mere few grams, can treat many diseases and achieve immediate results.
From my own clinical experience, in treating many self-limiting diseases, TCM can be both rapid and free of aftereffects, while using light medication. For example, in illnesses like the common cold and diarrhea, Chinese medicine often resolves the problem in just one meal or one dose, with few aftereffects such as bronchitis, asthma, or chronic enteritis. But using Western medicine takes a long time and very easily leaves sequelae. Respiratory diseases have long been among the greatest killers of human health; this is largely related to the many patients who catch a minor ailment like a cold and, after erroneous Western treatment, are left with sequelae. I myself am one of the victims.
TCM may not be precise, but whether human biology is the better for being ever more precise is a highly questionable question. For instance, after a person develops an infection for various reasons, using antibiotics to kill bacteria is indeed very effective and highly targeted; yet once many people use antibiotics, they must spend the rest of their lives under the shadow of antibiotic aftereffects. By contrast, TCM pattern-differentiates the patient's problem from the perspective of cold, heat, warm, and cool, and, according to the idea of reducing the excess and supplementing the deficiency, adjusts the patient's excesses and deficiencies, thereby effectively correcting the body from an unhealthy state to a healthy one.
The cold-disease master Professor Hu Xishu once said that when he was young studying medicine, he read many books; after reading so much, the various schools became complex and confusing, and he gradually did not know which way to turn. Finally, after reading the works of the Japanese classical-formula master Yumoto Kyuzo, he saw the light, and his clinical results improved dramatically from then on. The great TCM grandmaster Cheng Menxue also said that after reading a vast number of medical works, he finally moved from breadth back to simplicity, understanding that the true essence of TCM is actually very simple.
I think that serious TCM learners probably all travel this road: searching and searching, growing haggard over medicine, until suddenly, looking back, one finds that the person is there, in the dimmest light of the lanterns. Not to be immodest, up to now I have read a very great number of both Chinese and Western medical works and have accumulated considerable clinical experience. Looking back now, I find that the core things one truly needs to master are not many, and they are all commonplace TCM theoretical basics. Yet to wield these TCM commonplaces with easy mastery, and to find the key that opens the lock of disease, is not nearly so easy a thing.