Should TCM Value Experience or Medical Theory?
I am now simultaneously studying TCM and Western internal medicine; I cannot say I prefer either, I simply use whichever works. But when using TCM to treat disease, I pay less and less regard to its foundational theory and more to mastering drug properties and disease pathology. In judging pathology I refer to some knowledge of Western internal medicine; in remembering drug effects I focus on what symptoms a drug can resolve and what its expected effects and side effects are.
TCM foundational theory is truly a headache; much of it is sophistry, purely the private speculation of medical theorists. Students of TCM love to over-mix philosophical theory into TCM doctrine, winding back and forth, and have developed the folk-derived, vivid empirical medicine into the idealist medicine of bookish scholars—which is most headache-inducing. The more superstitious one is about TCM foundational theory, the less reliable the efficacy. Of the four great masters of the Jin-Yuan period, Li Dongyuan taught his disciples by first discarding TCM foundational theory and having them memorize drug properties; I think this method is excellent. At least seventy percent of TCM foundational theory is unreliable; it has turned TCM into a medicine of sophistry, ultimately leading some students away from practice and into obsession with various doctrines.
When some Western medical theories are immature, they are honestly labeled as hypotheses; most TCM foundational theories, though highly unfounded, are revered as the canon of medicine and believed in, promoted and defended by a host of TCM fans, with no room for question. That is not good. I have no doubt whatsoever about the efficacy of TCM therapies and prescriptions, but I have always studied the theories advanced by the various TCM schools with skepticism; when treating clinically, I carefully weigh things again and again and will not casually prescribe according to those theories. Because my own experience and what I have observed of other doctors tell me that treating disease that way does not yield ideal results. On the contrary, when I combine relevant modern medical knowledge with using TCM, the chance of going off track is much lower.
No doctor alive dares to brag that he is so erudite and experienced as to cure disease with every dose; a doctor with 100% clinical efficacy is unlikely to appear for a long time, and all doctors inevitably miss some cases. Given the low clinical effective rate, if we do not boldly question the stale theoretical system and strive to discover the truly scientific laws of TCM treatment, then TCM will never advance.
If a few sophistries from a doctor could cure a patient's illness, that would be fine; the problem is that those good at sophistry mostly have regrettable therapeutic results. If a doctor has no efficacy, what the hell is the use of poring over a few books from one's ancestors?