The Vitality of Traditional Chinese Medicine Lies in Clinical Efficacy

Recently, some newly graduated clinical TCM physicians—most just out of TCM universities—have contacted me after reading my articles. Some pour out their hardships, saying they are truly poor, financially strapped, and can barely get by. Others say that in school they never encountered a TCM teacher whose clinical results convinced them; as a result, these young TCM-trained doctors themselves lack confidence in TCM and feel it is hard to hold on to their TCM dream.

First I should say this is not only a problem for young TCM doctors; many young Western doctors share the same confusion.

About five or six years ago, I went to study under an old TCM physician. Along with me was a fellow who had studied Western medicine. He told me he was nearing a nervous breakdown from treating patients in hospital, because patients were admitted fine but discharged worse. After too many such experiences, he began to doubt whether Western medicine worked, and so switched to studying TCM.

I believe this psychology is something every medical student must go through when putting on the white coat and beginning to treat patients independently.

As someone who never went through the formal program, who is entirely self-taught, and who got licensed through the traditional apprenticeship route, I have probably suffered more frustration than you formally trained graduates.

I often had to face patients' disdain; at first, it stung. Gradually, as my clinical experience grew richer and my results more outstanding, and as patients I had cured referred more and more new patients, this situation improved greatly, and my confidence in medicine grew stronger.

But I have walked this rugged road of learning and practicing medicine for nearly twenty years. Each time I wanted to retreat, my teachers and patients encouraged me, and so I have walked on tremblingly to today. Now I handle many diseases with rich experience, and sometimes the results are so outstanding they seem almost unbelievable.

I once treated a cervical-cancer patient who had been paralyzed for nearly five years due to radiotherapy. I prescribed only two herbs: Baishao (white peony) and Gancao (licorice)—as you know, this is Shaoyao Gancao Tang (Peony-Licorice Decoction), whose other name is Qi Zhu Tang (Cane-Dropping Decoction). After drinking it for three days, she could go shopping; she was so excited she danced for joy, and I was even more excited than she.

Another patient experienced dizziness on any movement; each episode felt as though heaven and earth were spinning, and she needed IV treatment and weeks of tossing about to recover. Doctors at every hospital said nothing more could be done. Once, during a dizzy spell, she came to me. I likewise prescribed only two herbs: Baizhu (Atractylodes) and Zexie (Alisma)—as you know, this is Zhang Zhongjing's Zexie Tang (Alisma Decoction). After one dose she was never dizzy again; of the three doses she had, two remained. Later, when her husband got drunk and was terribly dizzy, she decocted the leftover Zexie Tang and gave it to him; after drinking it he was no longer dizzy either, and he has been using Alisma Decoction as a hangover cure ever since.

Today a couple came to me for follow-up; both had previously seen me for rhinitis.

The husband, from a science/engineering background and working in healthcare himself, had no use for TCM and always felt it unreliable. It was just that his allergic rhinitis was so severe—runny nose, streaming eyes, nonstop sneezing—that he simply could not work. He had stayed home from work to treat the allergic rhinitis for a while and had seen many TCM and Western doctors in Beijing without cure. I prescribed six herbs: Shigao (gypsum), Gancao (licorice), Mahuang (ephedra), Xingren (apricot kernel), Sugeng (perilla stem), and Suye (perilla leaf). The patient filled twelve doses; by the seventh he was cured.

The wife also said she had come about rhinitis. Taking her pulse, it was deep, fine, slow, and forceless. I told her her rhinitis was not serious, but that her heart was heading for trouble. She said her heart had always been fine. About a week after returning home, she suddenly developed premature beats.

This immediately changed their view of TCM; they became thoroughly convinced, began embracing traditional Chinese culture, and recently even went off to study it themselves. They have also sent their son to study TCM under me.

I tell this not to brag about my own skill, but because many of my readers are clinical TCM physicians, some of whom grow discouraged and cannot keep going. Having personally experienced TCM's efficacy, I do not want our already dwindling TCM community to lose even more people.

The veteran physician Xiong Jibai said that the vitality of TCM lies in clinical practice; for our medicine to survive, we must keep improving our clinical results. I deeply agree. I used to be unable to hold my head up in front of patients; now, when patients disdain me, I take it calmly. There are already many patients who trust me, and I just ignore the few who doubt.

The late Shanghai veteran TCM physician Qiu Peiran said that when he first started in TCM he was young and shallow, his results were unimpressive, and he had few patients. So, while patients were few, he read furiously; as his medical knowledge accumulated, his clinical results improved and he became popular. Dr. Qiu said that after he gained a certain reputation, there were times when a patient resisted repeated treatment yet stayed with him; after repeatedly adjusting the formula, he finally cured them. Dr. Qiu was an honest man who shared this firsthand experience, which is encouraging for those of us who come after.

The little you read in TCM school is far from enough; in clinical practice you must read a great deal more to raise your results. Looking at Dr. Xiong Jibai's case records, he is said never to write a prescription without a named decoction; he has memorized virtually all the famous classical formulas of every TCM school, and so his results stand out. No wonder the state sent him to treat an African president; his high results owe much to his wide reading, solid foundation, and vast store of formulas he can draw on effortlessly at the bedside.

There is no shortcut in learning medicine; only by reading more, memorizing more, thinking more, and practicing more, with perseverance and accumulation, will results naturally improve. Once your results are high, word-of-mouth spreads, a doctor's reputation travels fast, and making a living ceases to be a problem.

I used to doubt TCM's efficacy too, and even wondered whether I had ruined my life. My teacher answered me with just eight characters: Thick accumulation, thin release; great tools come late. Now, over these years, as my own clinical results often prove deeply satisfying, I understand those eight words ever more deeply.

Of the four famous Beijing doctors of old, three were self-taught. Why do the self-taught more often become highly effective physicians? My own sense is that self-taught TCM physicians read more. Take Shi Jinmo: reading his case records, I was deeply impressed by the volume of his reading.

I own a full set of current Chinese TCM textbooks from the elementary to advanced levels and have looked through them; in my humble opinion, studying only these textbooks is far from enough.

Professor Wang Yongyan summarized the knack of learning TCM in six characters: "Read the classics, practice clinically." My own experience is that the more a clinical TCM physician reads, the better his results; at the same time, the richer the clinical experience, the deeper one's understanding of the classics. A TCM physician should reread the classics again and again, reviewing the old to know the new.

Only by working hard at both "reading the classics" and "practicing clinically," and continuously raising our results, can we ultimately win patients' genuine conviction through our efficacy. The vitality of our TCM lies entirely in clinical efficacy. Only clinical efficacy can raise the joy and enthusiasm of our study.

I hope everyone will persevere on the TCM path, treating patients seriously and responsibly, without boasting, discouragement, or frivolity. Though the first ten years may be hard, generally speaking, after ten-plus years of reading and clinical practice, everyone will have good results.

As for the doubts from all quarters about TCM's efficacy, one may as well turn a deaf ear. As your own results improve, I am confident that no effective TCM physician will ever lack patients.