Professor Liu Lihong of Guangxi University of Chinese Medicine: Chief Professor at the Institute of Classical Chinese Medicine Clinical Research, Guangxi University of Chinese Medicine, formerly a student of renowned physicians Li Ke and Lu Chonghan.
Introduction: The book “Thinking about Traditional Chinese Medicine” emphasizes the leading role of Yang Qi, and I am pleased that this thought has resonated with many, as many people agree with this viewpoint and even apply this idea.
Of course, there are also misunderstandings. For example, after morning rounds today, someone raised the question: since TCM emphasizes balance, how can you always stress Yang? This seems to contradict the balance of Yin and Yang, doesn’t it?
At first glance, this does seem to be the case. Should we emphasize both Yin and Yang? This indicates that our understanding of Yin and Yang has different levels.
1. The Relationship of Yin and Yang—The Middle Way and Balance
When I spoke on Phoenix TV, I mentioned that Chinese thought is based on a “Middle Way” philosophy. From thousands of years of culture, its core essence is the Middle Way. In fact, TCM embodies this spirit of the Middle Way, so TCM is not just about Chinese medicine; more importantly, it elucidates this spirit of the Middle Way.
At this point, someone might ask, since you emphasize the Middle Way and the core of TCM is the Middle Way, does emphasizing Yang deviate from the Middle Way? In fact, this question is similar to the one raised by the colleague earlier. How do we understand this Middle Way? How do we understand this balance?
In the past, balance might have been understood as half Yin and half Yang, but this may not truly represent balance. If this is what we call balance, then we should see this clue in the “Neijing” and “Suwen”, but the “Neijing” does not say this.
So how do we understand this balance? In fact, we should have a concept of a grand balance, where within balance, there is imbalance. Last time, Guangxi University of Chinese Medicine held a 50th anniversary celebration and a Pan-TCM Forum. We invited Academician Zhu Qingshi, whose expertise is in modern science, but he has an interest in TCM.
What did he discuss? He talked about complexity. What is this complexity? It is the state of being far from balance; the essence of life is to be in a non-equilibrium state. We talk about balance, and he talks about non-balance, so some people raised questions. His final explanation was that we cannot view balance in this way, nor can we view non-balance in this way.
As we know, nature is balanced; balance is in the Middle Way. Why did the Chinese summarize such a Middle Way philosophy? Emperor Yao instructed Emperor Shun to “hold to the Middle Way”; Emperor Shun instructed Emperor Yu to also “hold to the Middle Way”. This means that if we adhere to this Middle Way, there will be no problems in the world.
This Middle Way philosophy actually comes from nature, which fully embodies the idea of the Middle Way. Therefore, the way of nature is long-lasting, while the way of humanity is not. Now, if we look at nature, if we understand balance in this way, perhaps only Kunming is balanced, with spring-like weather all year round, neither cold nor hot, right?
Clearly not; most regions are not like this. There are very cold winters and very hot summers, so the way of heaven is not balanced. Therefore, this balance is not understood in this way. We need to have a grand perspective of balance, with spring giving birth, summer growing, autumn harvesting, and winter storing. There is rising and falling; this is what we call balance. However, at a certain stage, one aspect may dominate.
At one stage, rising may dominate, at another, falling may dominate; at one stage, growth may dominate, and at another, storage may dominate. Overall, there is rising and falling, there is storage and collection; this is balance. We need to have this kind of concept, and only with this concept can we better understand why Yang Qi is so important and why we need to emphasize Yang.
As you can see in “Fu Yang Jiang Ji”, I wrote a preface for my teacher. In fact, the main content today is to discuss the ideas in this preface. Of course, due to time constraints, I cannot elaborate extensively. I mentioned that the idea of supporting Yang is not merely a personal preference; it is the entire natural world and the cultural fabric of society.
Looking at Chinese culture, it is essentially a culture that emphasizes Yang, a culture where Yang is dominant. We see this in the heavens and the earth. As you know, what is the name of the star system we inhabit?
It is called the solar system, not the lunar system or the earth system, but the solar system. Therefore, this astronomical background has determined that the role of the sun is dominant; the sun plays a decisive role in our star system. It is not just that we sing during the red song, “The ocean sails with the helmsman, and all things grow with the sun”; there is indeed a scientific basis for this.
2. The Yang Dominates, Yin Follows Philosophy of the “I Ching” System
By the end of the Zhou Dynasty, the grand pattern of Chinese culture had been established. However, due to the decline of the Zhou, the feudal lords rose up.
At this time, a sage appeared—Confucius, the Great Sage, the one who brought together the essence of Chinese culture. He conducted a major sorting of the entire Chinese culture, editing poetry and books, establishing rites and music, and editing the Six Classics, especially the “I Ching”, which is the foremost of the classics. As we know, there were three versions of the “I Ching” in history: “Lian Shan”, “Gui Cang”, and “Zhou Yi”. It is said that “Lian Shan” dates back to the time of Da Yu. Why did only “Zhou Yi” remain by Confucius’s time?
This has its reasons. What is the characteristic of “Zhou Yi”? As we know, “Lian Shan” is based on Gen, and “Gui Cang” is based on Kun. So who does “Zhou Yi” take as its basis? “Zhou Yi” is based on Qian. This establishes that from Confucius’s time onward, Chinese culture emphasizes Qian, emphasizes the Qian principle, emphasizes heaven, and emphasizes Yang. Therefore, the emperor is called the Son of Heaven, which is not unrelated to this. We can see how “Zhou Yi” discusses Qian and Kun.
Why should those studying TCM have a slight understanding of the “I Ching”? I cannot say that I study it deeply; I only understand a little bit, but this little bit is very important. Why? Because the core of TCM theory lies in Yin and Yang, and the “I Ching” specifically discusses Yin and Yang, and it is very intuitive, with just two symbols. Therefore, we should have a slight understanding, not necessarily delve deeply.
Confucius was fifty when he understood the “I Ching”; this is truly not easy, so I do not dare to have such aspirations. However, understanding some of it is very helpful for our learning and understanding of Yin and Yang. When discussing the “I Ching”, Qian represents Yang, with all six lines being Yang, while Kun represents Yin, with all six lines being Yin.
When discussing Qian, it is said, “Great is Qian, the source of all things, it governs heaven”; when discussing Kun, it is said, “Most excellent is Kun, the source of all things, it follows heaven.” One governs heaven, and the other follows heaven; this is very clear. One is the leader, the dominant force, while the other is the follower, which means that the leader plays a dominant role in the process of change.
Why does the “Suwen” emphasize that Yang generates Yin and Yang kills and stores Yin, rather than Yin generating Yang and Yang killing and storing Yin? This reflects the dominant role of Yang; it is Yang’s generation that promotes the growth of Yin, and Yang’s killing that promotes the storage of Yin. This is indeed in line with the “I Ching” and is a continuous thread. Here, Qian and Kun represent this master-servant relationship, the relationship of leadership and following.
Another question is, why emphasize Qian so much? Because Qian is based on heaven, Qian is heaven and Kun is earth. Heaven has a very important function; everyone knows that “Heaven moves vigorously”. Tsinghua University’s motto is “Self-improvement and unceasing, virtue carries all things”. Where does self-improvement come from?
It comes from Qian, from Yang. The characteristic of Yang is self-improvement and unceasing. “A gentleman strives unceasingly”; heaven is “moving”. The movement of heaven is vigorous. What else is like this? Can anyone answer?
Life is also vigorous in movement. The West says that life is in motion; this is correct. However, we do not speak of motion; we speak of “movement”. Life is also vigorous in movement. Think about it: what happens if life does not “move” for a day? Of course, it completes its historical mission, and life stops.
Thus, the characteristic of life is also vigorous in movement. “Movement” belongs to what? It belongs to the characteristics of “Qian”, which also means it belongs to the characteristics of “Yang”. This is what the “Suwen” refers to as “Yin is still, Yang is dry”; dryness is movement, it is action. So why do people get sick?
We can ponder this. The classics have a famous saying: “When the five organs are in harmony, no diseases arise.” The harmony of the five organs means that they are “flowing” and “smooth”. What does smoothness mean? It means “movement”. Conversely, if the five organs are not in harmony, what will happen? Then diseases will arise. Therefore, “movement” is a characteristic of life.
From a very simple perspective, Qi and blood must flow and circulate well; there must be no stagnation. Otherwise, all diseases arise from stagnation, all diseases arise from depression. Whether it is depression or stagnation, it means that there is a blockage, that there is no movement. Movement is a characteristic of Yang. Even when we sleep at night, is there still movement? Yes, there is still movement; it is just in the Yin phase. Now it is in the Yang phase, and there is still movement. Therefore, heaven is vigorous in movement, and so is humanity.
Why is it called the five movements [xíng] and not the five actions [háng]? Why did the concept of the five movements arise in the Shaanxi-Gansu region and the Central Plains? As we all know, the characteristics of the Shaanxi-Gansu region or the Central Plains are different from those of the two Guangxi regions. When we go to Shaanxi-Gansu or the Central Plains, it is already snowing heavily, and it has entered the “storage” phase. Here, it is still winter, but it is still warm and sunny, quite comfortable.
The changes in heaven and earth there, with distinct seasons, give us a sense of “movement”. Therefore, the thought of the five movements arose there, while in the two Guangxi regions, it seems that summer is always lingering here, not moving. Thus, this culture could not arise here; it only arose after influencing us. In the past, we were considered barbaric, while the North was considered civilized, a land of barbarians.
So this question is very important. Because of “movement”, there is a “Middle Way”. Without movement, there can be no “Middle” or “Middle Way”. The “Neijing” defines what is “Middle”; of course, it does not state it directly, but later generations have supplemented it. However, there is a very important concept in the “Neijing”: “Excess” and “Insufficiency”. Many chapters discuss the concepts of “Excess” and “Insufficiency” and also discuss the concept of “Loss and Gain”.
The “Shang Gu Tian Zhen Lun” states the seven losses and eight gains. Why is there a concept of “Loss and Gain”? Why is there a concept of “Excess” and “Insufficiency”? This is for the purpose of achieving the “Middle”. What is “Excess”? What is “Insufficiency”? “Arriving but not arriving” is called insufficiency, and “arriving but not leaving” is called excess. If what should come does not come, and what should leave does not leave, does this indicate that it is in “movement”?
Of course not; it is not moving. There is stagnation, and with stagnation, there will inevitably be excess and insufficiency. This non-leaving indicates excess, while the later arrivals cannot come, occupying that space. Insufficiency will arise, so once there is no movement, once there is stagnation, excess and insufficiency will arise, and the Middle Way will not be balanced, and balance will be out of the question.
Therefore, “movement” is very important. Why do we emphasize that Qi and blood must flow smoothly, circulating without rest, like a loop without end? Why must rising lead to falling, and falling lead to rising? Rising must lead to falling, and falling must lead to rising. If it is always falling, excess and insufficiency will arise, deviating from the Middle Way. Therefore, this “movement” is very important; only with “movement” can there be spring, summer, autumn, and winter, can there be changes, and can there be balance.
Balance does not mean stillness; this is something we need to be clear about. In the hexagram text of Qian, it begins by stating that Qian is “Yuan, Heng, Li, and Zhen”. This hexagram text is very wonderful; it tells everyone about Qian, about Yang, about everything. What does “Yuan, Heng, Li, and Zhen” refer to? It refers to the body and function of Qian, taking heaven as the body, and this body is also vigorous in movement. Therefore, this movement gives rise to Yuan, Heng, Li, and Zhen.
This “Yuan, Heng, Li, and Zhen” actually corresponds to spring, summer, autumn, and winter. The ancients also had many corrections: Yuan represents spring, Heng represents summer, Li represents autumn, and Zhen represents winter. This means that due to the result of “movement”, the four seasons arise, producing spring, summer, autumn, and winter. In the Qian phase, when it reaches the “Yuan” stage, it produces spring. At this point, what is the characteristic of “Yuan”? What state is Yang in?
In the “Neijing”, it states that it is in a state of growth. Continuing to operate, when it reaches the “Heng” stage, it produces summer. What is the characteristic of summer? It is grand and long. We can see this clearly in the “Four Qi Regulation Theory”. Continuing to operate, when it changes to “Li”, it produces autumn. At this time, it already means that Yang Qi needs to be collected; this is called “excess leads to decline”. Yang Qi cannot always grow; it needs to be collected.
Then, continuing to operate to the “Zhen” stage, it becomes winter. What is the characteristic of winter? Yang Qi is stored. Thus, this operation produces spring, summer, autumn, and winter, growth and storage. In fact, in the “Neijing”, spring is referred to as Yin within Yang, summer as Yang within Yang, autumn as Yin within Yang, and winter as Yin within Yin. This divides Yin and Yang, and in fact, spring and summer have both Yin and Yang.
Therefore, we should know that the essence of Yin and Yang actually speaks of growth and storage; all changes arise from this growth. Thus, when we discuss Yin and Yang, we must recognize this foundation.
3. The Yang Dominates, Yin Follows Philosophy of the “Neijing”
With this foundation, it becomes easier. We can return to reading the classics, and reading the “Neijing” becomes very helpful. In the “Neijing”, we see many places emphasizing Yang Qi, especially in the well-known “Sheng Qi Tong Tian Lun”, which contains a famous saying: “Yang Qi is like heaven and sun; if it loses its place, it will shorten life and not shine.”
We know that the founder of the Huoshen School, Zheng Qinan’s disciple, is Mr. Lu Chonghan, who emphasized that if a physician can comprehend this sentence, they will have a way. How can this sentence be comprehended?
“Yang Qi is like heaven and sun”; it is like heaven and sun, as we just mentioned, it is like Qian. “If it loses its place, it will shorten life and not shine”; losing its place will lead to a shortened life and not shine. Therefore, a person’s lifespan is based on Yang. What does “place” refer to? Is this “place” an unimportant pronoun?
When I read this sentence, I felt deeply moved, realizing that for over 20 years, I had not understood this sentence. I had been skimming over it, thinking I understood that Yang Qi is important, but I had never seriously considered what this “place” is. In fact, this is the secret. Today, we want to discuss supporting Yang; to truly understand supporting Yang, the key lies in this word “place”.
Because this sentence is a famous saying, it must be read from the beginning, and it will certainly be tested in exams. However, I can say that I have read it for decades without truly understanding it. Now, looking back, the secret lies in this “place”. What is this “place”?
In fact, if we place it in Qian, we know that this “place” refers to the “Yuan, Heng, Li, and Zhen”. Therefore, “losing its place” does not refer to a single “place”; it refers to four “places”. If we also consider the “Yuan, Heng, Li, and Zhen” of Kun, then we have all five elements.
However, earth does not govern time, so in the “I Ching” of “Qian”, earth is also not the governing element; it flourishes in all four seasons. This indicates that Yang Qi is not a simple factor. So, in the “Yuan” place or in spring, what is lost? What is the function of Yang Qi? Yang Qi is the function of growth, which corresponds to the liver; spring corresponds to the liver, which corresponds to wood. This brings us to the five elements and the organs.
Where is the root of the liver? Whether we study the physiology or pathology of the liver, of course, this term is modern, but its essence is that the “Neijing” states that the source of life is based on Yin and Yang. The “Neijing” also states that to treat diseases, one must seek the root. What is the root? What is the essence of the liver?
We must explore this organ; its essence lies in “growth”. This “growth” refers to the growth of Yang, the growth of Yang Qi. Therefore, why does the liver become ill? Whether it is about the liver’s ability to regulate or store blood, it all revolves around this point; it all revolves around “growth”. Thus, the root of liver disease is that the Yang Qi of the liver cannot grow.
This issue is very important because there are too many misconceptions. Due to a lack of understanding of Yin and Yang, the treatment methods have primarily focused on bitter and cold remedies. Because Western medicine has provided us with the concept of viruses, everyone goes to clear heat and detoxify. However, this is not the case; bitterness and cold do not promote growth; they kill.
In spring, we talk about growth and not killing, giving and not taking. Now, why are there so many cases of liver cirrhosis? Everyone should reflect on this; many are harmed by the hands of physicians. My teacher, Mr. Lu, and I have a deep understanding of this. This year, a patient from Lanzhou, who is a Western physician and the deputy chief physician of infectious diseases, has been unable to manage his hepatitis and cholestatic liver cirrhosis, despite treatment from both TCM and Western medicine. His condition worsened, and he finally found me. To learn, I sought out my teacher. Now, after a few months, all indicators are very good, and most importantly, the person has completely changed.
So what is the thought process? It seems that the original thought process violated the sage’s words, which state, “Growth and not killing, giving and not taking.” This is a major principle. However, many of us have violated this principle. What happens when we violate it? The vitality diminishes, and how can it not lead to cirrhosis?
This point is very important. So this is the liver. What about the heart? What is the essence of the heart? How does the heart arise? In fact, the heart is responsible for the circulation of Yang Qi; its essence lies here, governing “growth”. What does the lung govern? It corresponds to autumn, and autumn is responsible for “storage”. This point is very clear in the “Suwen”. The West speaks of dryness; dryness produces metal, metal produces pungent, and pungent produces the lung. This is how it comes about; the West is responsible for storage.
The “Suwen” states that humans inherit the Qi of heaven and earth, and the laws of the four seasons are established. Therefore, the lung is formed according to the laws of autumn. What is autumn? It is “storage”; thus, the lung is characterized by “storage”. What about the kidney? It is responsible for “Zhen”; winter’s characteristic is storage. Therefore, the essence of the kidney is in storage; this has already been stated, the essence of sealing and storing, the essence of essence.
Thus, we have linked Yin and Yang to very specific issues. Therefore, when we say, “Yang Qi is like heaven and sun,” “losing its place” means this. If it is in spring, in the “Yuan” place, and it is lost, it means the liver cannot grow. If it is in summer, and the “Heng” place is lost, it means the heart cannot grow. If it is in autumn, and the “Li” place is lost, it means the lung cannot govern storage. If it is in winter, and the “Zhen” place is lost, it means the kidney cannot govern storage. If the kidney cannot store, the heart cannot grow, the liver cannot grow, the lung cannot govern storage, and the spleen cannot flourish in all four seasons, cannot circulate, cannot operate, then is there still life? Of course not; thus, life is shortened and does not shine. The root of this lies here.
Therefore, when we discuss emphasizing Yang and supporting Yang, is it biased? Not at all; this is a matter of understanding. Now, there are many specific questions. For example, what should we do if the “Yuan” place is lost? What should we do if the “Heng” place is lost? And so on for the “Li” and “Zhen” places.
Thus, supporting Yang is absolutely not just about supporting “Heng” or summer. Of course, warmth is the nature of summer; summer corresponds to the heart, and the heart is the great master of the five organs and six bowels. This is very important. However, if Yang is lost in autumn, in the “Li” place, should we support it? Of course, we should support it. If Yang is lost in winter, in the “Zhen” place, and cannot store, we must support it.
Therefore, supporting Yang is absolutely a systematic project; it is not something simple that can be solved by warmth. Spring and summer are easier to handle; they cannot be dispersed, and warmth can be used to disperse them; this is not a problem. Therefore, in the “Shang Han Lun”, for Taiyang disease, using Ma Huang, one dose of medicine can lead to sweating and recovery.
However, if it is in autumn and winter, and the “Li” and “Zhen” places are lost, what should we do? This brings up issues. Warm and hot medicines have a dispersing aspect, while now we need to descend and store. Therefore, many problems arise, and this is the root of life, the root of existence, which lies in storage.
Ancient Chinese people said, “The dead are the roots of the living.” What we doctors do is to promote life. When we cure a disease, people send us a plaque that says, “Wonderful hands return spring.” What is spring? It is life. But where does life come from? Life comes from storage. The thought of the Chinese is to look one step ahead; the root of the five organs lies in the kidney, and the root of life also lies in the kidney.
We see that the “Shang Han Lun” discusses growth and the “Yuan, Heng”; all are in Taiyang disease. But where is the root? It is in Shaoyin. Teacher Lu emphasized that if we grasp Taiyang and grasp Shaoyin, we have already achieved half of the goal; as a physician, this is already remarkable.
In fact, we also know that among the six channels, the most deaths occur not in Jueyin but in Shaoyin. Therefore, the root of life lies in Shaoyin; the use is certainly in Taiyang. Thus, the return of Yang Qi is the goal; everything else is a means.
So how does Yang Qi return to its root? For this reason, many means are formed. In the “Shang Han Lun”, many means emerge. The ancient people spoke of the six channels, which actually return to one channel or two channels: one is Yang, one is Yin; one is growth, one is storage; one is body, one is function. Conveniently speaking, it is the six channels.
So how does Yang Qi return to its root? There are Shaoyang, Yangming, Taiyin, and so on, leading to many methods. For example, Yangming; we should not only focus on Chengqi and Baihu; we must know where the true essence of Yangming lies. We must understand the fundamental purpose of Zhang Zhongjing using Baihu and Chengqi; the essence of Yangming is to govern descent, and what is the purpose of descent?
Of course, it is to make Yang Qi return to its root; it is from “Li” that it can reach storage, and from “storage” that it can reach “Zhen”. Are Baihu and Chengqi not for storage? Are they not for descent? They are a means because the path for Yang Qi to return to its root, the path for Yang Qi to descend, is blocked. At this time, true Yang cannot return to its position, leading to heat. Therefore, at this time, we need to use Baihu and Chengqi.
However, everyone must remember that this is only a means. If we take the means as the goal, as the purpose, then we are mistaken. All methods are means, not ends.
In this sense, we can see the essence of this supporting Yang concept, this supporting Yang thought. It is not simple; it is a systematic project. We know the goal of medicine, the goal of the way of Yin and Yang. In fact, we need to emphasize this goal, not others.
Therefore, we understand that supporting Yang is not a form of bias; it is a necessary understanding. The way of medicine is like this, culture is like this, and the way of heaven and earth is like this. We are merely following the trend.
Thus, it is not a matter of factions. Of course, when supporting Yang, in applying it, and achieving this goal, the means are diverse. Teacher Lu Chonghan mentioned that when we read the “Neijing” and the “Shang Han Lun”, this information has already been revealed to us.
Source: “Thinking about Traditional Chinese Medicine”, by Liu Lihong; image source from the internet; copyright belongs to the original author. If there is any infringement, please contact us for deletion.
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