Two Random Notes on Traditional Chinese Medicine
I
People keep asking me to put together a reading list and explain how to begin learning traditional Chinese medicine (TCM). I am only a half-baked practitioner myself, so I dare not take on such a task, fearing that I might mislead others.
I have always loved reading. From the age of seven, when I began school, to thirty-seven, I kept a book in my hand every single day for thirty years, and I will probably go on like this for the rest of my life.
In my school days I could be considered an outstanding student both in conduct and grades. In high school, my teacher did not teach me in the ordinary way. Because I could score first in every subject and full marks in mathematics, physics, and chemistry, he specially allowed me to skip lectures and study on my own, and he went out of his way to broaden my horizons. He let a science and engineering student study philosophy, psychology, religion, history, and other social sciences broadly. This special tutoring has benefited me for a lifetime; it makes it hard for me to form prejudices and hard for others to brainwash me.
I have often seen top science and engineering students, upon hitting a few setbacks in life, lose their way and become depressed or leave home for monastic life. This is related to their lack of humanistic cultivation during adolescence. Once such people form an extreme personality, they tend, after becoming monks or nuns, to swing to the opposite extreme.
In my youth I was romantic, in early adulthood I loved debate, and in middle age I value evidence. This shift has also influenced what books I choose. As a boy I liked to read widely, quickly, and in quantity; increasingly now I prefer thin books, specializing in a few and reading slowly. The ancients said: "Truth is half a sheet of paper; idle talk fills ten thousand volumes." The late Professor Jiang Chunhua, a well-known TCM physician in Shanghai, once said that in its development TCM absorbed too much philosophy and religion and gradually became a discipline of sophistry rather than evidence-based medicine, greatly reducing its clinical efficacy and wasting students' energy. After many years of reading and clinical practice, I have a firsthand appreciation of Professor Jiang's late-life realization.
Many TCM physicians devote their whole lives to producing only a very thin little book. Yet that thin book drains the author's entire lifetime of thought; by the time it is written, his temples are already gray, but it will benefit later generations for thousands of years. It is not easy for readers to understand such condensed works and apply them. Even now I still feel I need another twenty years of growth before I can truly claim to have penetrated the inner sanctum of medicine.
Over the years, thanks to help from fellow patients across the country, I have not only absorbed a great deal of book learning but also studied under dozens of clinical physicians, and I have even collected some ancient and rare editions of TCM classics. The ancients say: "Study medicine for three years and you think there is no disease you cannot cure; treat patients for three years and you feel there is no book worth reading." Because medical practice is as hard as climbing to heaven, achieving good clinical results is not easy. If a physician can achieve a forty percent cure rate, that is already remarkable; almost every doctor has more failures than successes. Therefore those who actually practice medicine grow more and more humble, while those who merely talk about medicine grow more and more arrogant.
Contemporary medical scholar Shan Shujian once said: There has always existed a kind of "literary physician" who does not actually practice medicine, but once in a while happens to cure a few patients by chance, then becomes smug and unbearable, talking boastfully as though he had plumbed the deepest mysteries of medicine. This bad habit has persisted to this day, and yet the writings and utterances of such people become wildly fashionable, influencing countless people.
Some of my patients often urge me to publish a book, and I always put them off to twenty years from now. Without the tempering of time, I feel unworthy of writing a medical book. Twenty years from now, I may select the most valuable of the medical articles I have written and edit them into a book; those will certainly be real, repeatedly verified experiences of mine. The veteran TCM physician Ren Yingqiu said: Before the age of sixty, one should not lightly claim to understand medicine, because medicine rests on a great many repeatable therapeutic results, on empirical research, and on a lifetime of extensive clinical cases. Those with little clinical experience who talk glibly about medicine are liable to cost people their lives. This is probably why many veteran doctors who have spent their whole lives saving lives leave behind only a single thin book.
Nowadays, when I read medical books, I am no longer willing to waste time on massive tomes full of empty talk, especially those stuffed with opinions based on personal speculation rather than clinical data. I prefer genuinely condensed, short works. Compared with a book's reputation, I care more about whether its author has a truth-seeking scholarly attitude and rich clinical experience.
I cannot draw up a reading list for you, because I do not yet consider myself learned enough to be anyone's teacher. I can only offer this account of my own inner journey, to share with you all as my reply.
II
Although I practice TCM, I feel that many TCM enthusiasts have serious problems and are a bit like frogs at the bottom of a well. They often cite examples of how revered TCM is abroad. The examples they give about TCM overseas are exaggerated, and judging from my own experience of contact with overseas TCM practitioners, the level of TCM in mainland China is still the best in the world—far ahead of Japan, Korea, the United States, and Australia. After all, our base is large, so it is normal that more outstanding practitioners emerge.
Chinese and Western medicine each have their strengths. On the whole, modern medicine has progressed beyond traditional medicine; this is beyond doubt. And TCM should keep pace with the times rather than always putting on the airs of diehard conservatives, stubbornly refusing to progress and whenever the occasion arises trotting out yin-yang and the five phases to explain everything indiscriminately—which is no different from writing rigid eight-legged essays in imitation of the ancients.
I have already passed the best age at which to learn Western surgery, but if my son is interested in medicine in the future, I hope he will master Western surgery well, while also studying TCM internal medicine with me. The aseptic surgery of modern medicine has saved who knows how many lives. It is just that in China today, both private and public hospitals have a tendency toward overtreatment. Chinese and Western medicine are not opposites but complements. Those who manufacture antagonism between the two are biased, and bias is one of humanity's greatest weaknesses.
At nineteen I wrote my first prescription and treated the owner of a small restaurant near my school, curing a chronic, deep-seated ailment she had suffered for years. Thereafter I grew ever more eager to learn medicine. I went to the National Library and read through ancient medical texts, and I delved into Confucianism, Buddhism, and Daoism, studying the arts of yin-yang and the five phases.
Over nearly ten years of clinical practice, I gradually realized I had been led astray by books, so I discarded all kinds of stale theories and focused on TCM case records and proven formulas with marked efficacy. My clinical results improved greatly; often only one to three doses were needed to cure chronic, stubborn ailments that had resisted prolonged treatment (other than tumors). My results in treating tumors also improved greatly. Approaching forty, I have gradually entered the true door of medicine.
Medicine is a practical science, not a science of deduction. The essentials of learning medicine lie in diligent study and hard practice, in accumulating over time and drawing on deep reserves, and in starting from bits of experience—not in abstruse talk and idle debate. The world loves simplicity and hates complexity, always hoping one simple theory can explain everything. Once one strays into this error, it not only delays one's own growth but may also mistakenly take countless lives. Discussing disease is as easy as turning over one's hand; treating disease is as hard as climbing to heaven. Those who discuss medicine while abandoning the principle of seeking truth from facts are windbags.