Inheriting the legacy of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
I have always wanted to write down my insights on learning Traditional Chinese Medicine (TCM) to help those who are studying TCM and enthusiasts, reducing their learning curve. However, I struggled to express the profound theories of TCM in simple, straightforward language, so that wherever there are Chinese people, they can learn TCM and understand health preservation. Recently, I have been contemplating that this project must be undertaken; it is also the duty of a TCM practitioner to promote TCM, simplifying and clarifying TCM theories.
In ancient times, it was said, “Wherever there is well water, people can sing the willow songs!” Today, I hope that “Wherever there are Chinese people, they can discuss TCM!”Chapter One: Who is Suitable to Learn TCMMany people complain that learning TCM is too difficult; they want to learn but do not know where to start. They feel overwhelmed by the vast amount of material, and with so many books on TCM, finding the door to the treasure trove of TCM seems really hard. In fact, this is both the charm and the shortcoming of TCM. In ancient times, most people who learned TCM were literati from scholarly backgrounds, who loved to show off their literary skills. Simple issues were often written in a convoluted manner, as if not being obscure would not prove their competence, similar to some modern poetry that evokes feelings but is hard to understand.In reality, TCM originated from folk medical practices, which were then summarized and elevated by literati into TCM theories, guiding clinical practice. It is a simple and straightforward knowledge derived from the repeated summaries of our ancestors. Why should we fear learning it? Why should we reject it? Learning TCM is actually quite simple. Everyone has a different understanding of learning TCM, just like practicing martial arts; some do it just for health, while others aim for glory; some want to become masters; others… Different thoughts lead to different starting points. Learning TCM is the same!Some mothers want to learn TCM just to keep their children healthier and free from diseases. Some patients who have long suffered from illnesses learn TCM simply to regain their health and live each day healthily. Some clinical TCM practitioners study TCM to better serve their patients and improve their treatment skills. Researchers learn TCM to find new methods for tackling difficult diseases. Some learn TCM to acquire a skill to make a living and support their families…Not all learning of TCM requires innate understanding; this is a misconception. TCM provides methods for health preservation and teaches people how to prevent and treat diseases. However, if one takes TCM as a profession, the requirements will be higher, and one should understand more, which is reasonable, as human life is at stake. If one does not improve their skills, they are not saving lives but endangering them.In the ancient primordial era, humans had no clothes or stable food. To survive, people had to adapt to nature, seeking ways to survive amidst natural changes. They did not talk about health and longevity; they simply focused on survival, with pure thoughts, not chasing fame or profit, only considering how to adapt to cold and heat, and avoid wind and rain. Everyone was a health preserver; otherwise, they could not survive.With the advancement of human society, there are now many ways to adapt to changes in nature, but because of this, we have neglected the changes in nature. Our ability to adapt to nature is continuously declining, and even slight changes in nature can lead to many people falling ill. Learning TCM allows us to understand our natural environment, recognize our bodies, change some unhealthy habits, and integrate into nature, seeking the path of health preservation and the way to treat diseases.Everyone can learn TCM and feel TCM. Learning TCM is about experiencing the world around us; it is about introspecting our own bodies. To feel the world from the primitive and essential aspects is what we need to learn! It is not limited to a certain type of person but encompasses all humanity!Chapter Two: Experiencing TCM from LifeIs TCM metaphysical? Does TCM have efficacy? Should TCM be promoted? These questions can only be deeply understood through our own practice, and only then will we know how to treat TCM and build confidence in learning TCM. The “Neijing” states in the “Ancient Heavenly Truth” chapter: “The teachings of the ancient sages all say that the virtual evil and the wind of thieves should be avoided at times, remaining calm and empty, allowing the true qi to flow, and the spirit to guard within; where does illness come from?” “Virtual evil and the wind of thieves should be avoided at times.” If the weather turns cold, we all know to add clothes; this is an instinctive response and also the most basic concept of health preservation, the most essential and straightforward concept. Is it metaphysical? Not at all!But if we think deeply, we can give our bodies clothes to avoid the wind of thieves; isn’t taking restorative medicine like giving our internal organs clothes? By adding clothes, we avoid the wind of thieves! By avoiding cold foods, we are allowing our internal organs to avoid cold evils, which are all very ordinary principles derived from the simplest, most essential, and most straightforward aspects of life. Yet, the application of these principles can protect our bodies and allow us to live healthily; this is TCM, this is the medical way. The “Neijing” states in the “Ancient Heavenly Truth” chapter: “Thus, enjoy your food, wear what you like, and be happy with your customs; the people are called simple.”How many modern people can achieve such a simple way of health preservation? If we can calm our restless hearts, view things lightly, reduce our pursuit of material wealth, and not place too much importance on fame and profit, we can naturally enjoy our customs. Who still cares about eating “abalone” or “pork ribs”? Who cares about wearing “fur” or “cotton clothes”? As long as we can keep warm, we can avoid the wind of thieves. When our mindset reaches a certain height, we can achieve harmony between heaven and humanity, leading to health and longevity.These original words from the “Neijing” are very simple, like a seventy-year-old man sharing his experiences with us. When we listen humbly, we realize how superficial our understanding of life is, how restless our mindset is, and we often find ourselves losing sight of the essentials. When illness strikes or life comes to an end, we hope to eliminate the disease instantly! We hope to resurrect immediately! Why don’t we learn the health preservation methods in TCM earlier, allowing our hearts to be at peace and our bodies to be healthy, treating our surroundings with less extremism! Borrowing the original words from the “Neijing”: “Desires cannot tire the eyes, evil desires cannot confuse the heart, foolishness and wisdom do not fear material things, thus they align with the way. Therefore, those who can live to be a hundred years old and remain active do so because their virtue is complete and not dangerous.” This is the medical way!Does TCM have efficacy? First, I want to ask those who doubt TCM efficacy: Have you tried it? Have you adopted TCM thinking and used TCM treatment methods? For example, two summers ago, a patient came to me asking for an IV drip. I asked why. The patient said they had a severe cold and that an IV drip would help them recover quickly! I asked, how many days do you think is quick? The patient laughed and said that every time they had a cold and got an IV drip, they recovered in three days. “Then if I cure you in one day, would that be considered quick?” “Of course, that would be quick! Can TCM do that?” “Of course!”The patient had caught a cold due to sleeping with the air conditioning too low at night. So, I used ginger oil to perform guasha on the patient’s back along the bladder meridian, producing purple-black spots in just a few minutes. The patient felt significantly better, and then I prescribed a formula called Ma Huang Fu Zi Xi Xin Tang. The so-called severe cold was resolved in less than a day, and that night, the patient was fine. In the following one or two years, this patient would always drink herbal soup whenever they caught a cold, and just one dose would suffice. For mild colds, they would just boil some scallion and ginger water, and they would be fine. The belief that “a cold must be treated with an IV drip” was completely eliminated, replaced by an understanding of how to prevent colds and how to adjust during the early stages of a cold. This is the charm of TCM, the efficacy of TCM!Only through personal experience can we understand that diseases can be treated this way, and TCM can be this effective. TCM treatments are not slow! When I was a child in the countryside, medical care was not as convenient as it is now. Many illnesses were treated this way by my great-grandfather. I became accustomed to this treatment method and got used to drinking scallion and ginger tea whenever I caught a cold. For over thirty years, I have never had an IV drip. Whenever I feel slightly unwell, I can quickly adjust with some very simple methods. This is my personal experience. Because of these experiences, I firmly believe in the efficacy of TCM; it is not slow and is not inferior to Western medicine. This is also the confidence of a TCM practitioner in their work, in themselves, in TCM, and in the “Huangdi Neijing”.If a body of knowledge is closely related to our lives and serves as our health guide, how should we treat it? Should we abandon it? Should we not add clothes when it snows? Should we envy the powerful? Should we be profit-driven? No! At the beginning of humanity, nature is inherently good! Everyone has a kind heart, and our bodies have a sophisticated regulatory mechanism. What we need is health preservation, learning to maintain this sophisticated and perfect body, preventing it from being harmed by external evils and internal injuries. This is the principle of preventing disease before it occurs; this is treating diseases before they manifest. This is the characteristic and advantage of TCM. It is our duty to promote TCM, to promote this science that integrates prevention, treatment, health preservation, and wellness, allowing it to shine brightly for the health of all humanity. This is not only the responsibility of TCM practitioners but of every Chinese person.Chapter Three: Learning Should Start from the Big PictureIf you walk from Beijing to Shaanxi, others will say to go west, not to say, “First walk a certain number of kilometers, then turn left, and then walk a certain number of kilometers to the right.” This will confuse you and others. How to walk, in detail, no one can clearly explain. You might say to look at a map. Yes, looking at a map can clarify things. Today, I am writing these articles to draw a map for learning TCM. However, no matter how detailed the map is, it cannot tell you that there might be a mud pit 1501 meters ahead, nor can it indicate where the road is uneven or where there are turns. But this map can tell you the direction, the direction of learning TCM, helping us understand why we should learn TCM and how to learn TCM!From Beijing to Shaanxi, the first step is to understand that you are heading west. The first step in learning TCM is to understand the framework of TCM. Under the guidance of the big framework, you will not go wrong, and the chances of success will be greater. So, what is the big framework? What is the big direction? As mentioned earlier, learning TCM is about experiencing nature, learning the most essential things in the natural world, and then introspecting ourselves to understand the methods of health preservation and disease treatment. Experiencing nature starts from the Earth we live on every day, seeking the laws of the Earth, while also drawing analogies and using modern knowledge to discuss ourselves. I believe that learning TCM this way will be more acceptable to everyone because we live in this environment. Understanding our living environment helps us understand why we get sick and how to treat diseases.When you climb a high mountain and stand at the summit, take a good look at the Earth around you! What a marvelous celestial body it is! Because it revolves around the sun, it creates the seasonal climate changes of spring, summer, autumn, and winter, allowing us to grow healthily amidst the transitions of cold and heat, enabling plants to sprout in spring, grow in summer, harvest in autumn, and store in winter. Because of its rotation, it creates the phenomenon of day and night, allowing busy people to rest quietly at night, alleviating the fatigue of the day, and giving us the energy to face a new day. Because of the atmosphere surrounding the Earth, we can breathe freely while also protecting the Earth from many external impacts, safeguarding the flora and fauna on Earth.Because of the existence of the magnetic field, when solar flares and sunspots are active, the sun emits a large number of charged particles that move along the magnetic field lines towards the north and south poles. They enter the upper atmosphere of the Earth at high speeds, with energy equivalent to tens of thousands or hundreds of thousands of hydrogen bombs. The magnetic field constantly protects our Earth, preventing biological disasters. Look at the fertile land beneath your feet; all life depends on it. Look at the ocean; without its vastness, humanity would be submerged and have no place to stand. Look at the wildflowers around you; look at the little fish swimming in the river, deeply feeling the breath of life…After observing the heavens, the earth, and the flora and fauna around us, let’s look at humanity. From the vastness of the heavens to the minutiae of humanity, we will discover how marvelous humans are. Just as the “Huangdi Neijing” begins with health preservation, the second part discusses the four seasons, emphasizing the importance of seasonal care, guiding us to recognize humanity from a broader perspective. Once we understand these, we can look at the “Four Seasons and Spirit” chapter and see how friendly the “Huangdi Neijing” is. “In spring, during the third month, this is called emergence; heaven and earth are born together, and all things flourish. Sleep at night and rise early, walk broadly in the courtyard, let your hair down and relax your body, so that your will can flourish. Give life but do not kill, give but do not take, reward but do not punish; this is the response to spring qi and the way of health preservation. To go against it is to harm the liver. Summer is for cold transformation, and those who nourish should be few.”This is a guide to health preservation from the perspective of nature, from a broad angle, allowing us to grasp the seasonal changes and characteristics of the four seasons. Adapting to these natural characteristics is the way; going against them leads to illness. “Therefore, the sage does not treat existing illnesses but prevents them; does not treat existing chaos but prevents it. This is the principle. Treating an illness after it has occurred is like digging a well when thirsty or forging a nail after a fight; is it not too late?” Besides observing the seasonal changes and understanding the significance of health preservation, what else can we see from our Earth? We see “Yin and Yang”! The Earth’s rotation creates day and night; during the day, we call it Yang, and during the night, we call it Yin.We also see the “Five Elements”, which are the five basic substances on Earth: Wood, Fire, Earth, Metal, and Water. We see that Wood can generate Fire, Fire can create Earth, Earth can refine Metal, Metal can transform into Water, and Water can nourish Trees. The four seasons, Yin and Yang, and the Five Elements are the basic laws of nature, representing the ancient understanding of the natural world. They are the framework for learning TCM, just as if you were to walk from Beijing to Shaanxi, knowing to head west. If you do not even understand the direction of the west, you will take many detours and may not reach your destination. Learning TCM, understanding the four seasons, Yin and Yang, and the Five Elements is finding the direction to enter. Therefore, the “Neijing” uses five chapters to discuss Yin and Yang, addressing the physiological and pathological aspects of the human body.Once we understand these, we can read the “Neijing” texts: “Yin Qi is like the heavens and the sun; if it loses its place, it will shorten life and not shine. Therefore, the heavens operate with sunlight. Thus, Yang rises and goes up, guarding the outside. Therefore, Yang Qi governs the outside for a day; at dawn, Yang Qi is born; at noon, Yang Qi is abundant; at dusk, Yang Qi is already weak, and the gates of Qi are closed. Therefore, at dusk, we should not disturb the muscles and bones, nor should we see mist and dew. If we reverse these three times, the body will be exhausted.” Understanding the guidance of the “Neijing” in learning health preservation makes reading these seemingly profound texts much clearer. They directly inform us of the laws of nature and how to learn health preservation in accordance with nature.Isn’t it marvelous? A book that has existed for thousands of years analyzes and deduces the physiological and pathological mechanisms of our bodies based on the laws of nature. We cannot help but admire the greatness of the ancients. This broad perspective, focusing on Yin and Yang and the Five Elements, keeps us ahead of our time. When modern medicine has made no progress in the microscopic field, many insightful individuals attempt to analyze diseases from a macroscopic perspective, returning to simplicity and achieving significant breakthroughs. Learning TCM is about cultivating a mindset of returning to simplicity and avoiding being bound by localized, minute symptoms. Treating diseases must seek the root cause. Cultivating this mindset and developing such thinking habits will greatly broaden our horizons, making learning TCM and health preservation much easier in various aspects of work and life.
For example, in clinical practice, we often encounter patients with nasal congestion, diagnosed by Western medicine as “allergic rhinitis”. When they come to us in TCM, we do not need to consider how many things the patient is allergic to. TCM has a classic saying: “When the righteous Qi is preserved within, evil cannot invade”; and “the head is the convergence of all Yang”; and “the lungs open to the nose”. Understanding these three statements, the so-called allergic rhinitis can be treated simply by nourishing the Yang Qi of the head and supplementing the lung Qi. There is no need to follow the allergic thought process. “Returning to simplicity and returning to the essence” is that simple. If you do not believe it, when you encounter a patient who wakes up every morning with nasal congestion, let them wear a cotton hat while sleeping at night to keep their head warm and sweat for several nights, and their nasal congestion will greatly improve. Why? The patient has insufficient Yang Qi in the head; protecting the Yang Qi and dispelling the cold evil will resolve the illness. It is that simple!Chapter Four: Understanding TCM from the Perspective of Yin and YangIn the previous section, we discussed the framework of learning TCM, which is Yin and Yang and the Five Elements. How to systematize and clarify these abstract concepts is very important. Just knowing that the journey from Beijing to Shaanxi is to head west is not enough; you must also know which provinces and cities you will pass through to reach Shaanxi smoothly. Only by understanding the connotation of Yin and Yang can our journey of learning truly begin. The ancients understood the properties of Yin and Yang through their observations of nature and summarized them very clearly.First: The Importance of Yin and YangYin and Yang are described in the “Yin and Yang Theory” chapter: “Huangdi said: Yin and Yang are the way of heaven and earth, the framework of all things, the parents of change, the source of life and death, and the abode of the divine. To treat diseases, one must seek the root.” The way of heaven and earth, the framework of all things, the parents of change, the source of life and death, and the abode of the divine. The ancients elevated the importance of Yin and Yang to such a high status, indicating how crucial it is to be familiar with Yin and Yang for health preservation. This passage emphasizes the importance of Yin and Yang while also advising future generations that learning medicine must start from Yin and Yang to find the root of diseases. Without understanding Yin and Yang, it is like a blind person touching an elephant, unable to recognize the human body or diseases from a holistic perspective. So, what exactly is Yin and Yang, and why is it so important? Let’s look at the descriptions in the “Neijing”.Second: The Universality of Yin and Yang“Thus, accumulating Yang is heaven, and accumulating Yin is earth. Yin is still, and Yang is active. Yang promotes growth, and Yin stores. Yang transforms Qi, and Yin forms shapes. Extreme cold generates heat, and extreme heat generates cold. Cold Qi produces turbid Qi, and hot Qi produces clear Qi. Clear Qi below leads to diarrhea; turbid Qi above leads to bloating. This is the reversal of Yin and Yang, the cause of disease.” This passage can be understood as follows: Heaven is Yang, and Earth is Yin. The characteristics of Yin are stillness, while those of Yang are movement. Yang Qi governs growth, while Yin Qi governs storage. Qi transforms into Yang, while matter takes shape as Yin. Extreme cold will turn into heat, and extreme heat will turn into cold. Cold evils in the body will produce turbid evils, while hot Qi in the body will produce clear Qi. Clear Qi belongs to Yang and should rise to the upper jiao; if it stays in the lower jiao, it will lead to diarrhea. Turbid Qi should descend to the lower jiao; if it remains in the upper jiao, it will cause swelling in the head and face…This is how the ancients described Yin and Yang, starting from heaven and earth, from the characteristics and transformations of Yin and Yang, allowing us to see the Yin and Yang of heaven and earth. We see the characteristics of Yin and Yang: “movement and stillness”, “rising and falling”, “birth and growth”, “Qi transformation and material formation”, and further deduce “producing clarity and producing turbidity” and the formation of diseases after the reversal of Yin and Yang… When we read these passages in the “Neijing”, what should we see? We see that “heaven”, “earth”, and “humanity” are all within Yin and Yang; the birth, aging, sickness, and death of all things are inseparable from the changes of Yin and Yang! To gain a clearer understanding of the human body’s Yin and Yang, we can look at our bodies from the perspective of Yin and Yang: “In terms of humanity’s Yin and Yang, the outside is Yang, and the inside is Yin. In terms of the body’s Yin and Yang, the back is Yang, and the abdomen is Yin. In terms of the organs, the organs are Yin, and the bowels are Yang.” This is the original text from the “Neijing”.The upper part of the body is Yang, the head is the convergence of all Yang, and all Yang Qi rises in the head, thus it is also called the “abode of clarity”. The clear Yang of the human body rises and exits through the upper orifices; the lower part of the body is Yin, and Yin Qi sinks, with turbid Yin descending and excreting through the lower orifices. The right side of the body is Yang, which is active, so we habitually use our right hand and foot. The left side of the body is Yin, which is still, so we are not accustomed to using our left hand and foot. The gallbladder, small intestine, stomach, large intestine, bladder, and san jiao are the six fu organs. The six fu are for draining and not storing, being solid but not full; the six fu are Yang and active, so they function by passing through and transforming substances without storing. If they do not pass, they will store, leading to illness.For example, bile accumulation can form gallstones, small intestine obstruction can lead to intestinal blockage, food stagnation in the stomach can cause fever, large intestine obstruction can lead to constipation, bladder obstruction can lead to dysuria, and san jiao obstruction can lead to water retention… The liver, heart, spleen, lungs, and kidneys are the five zang organs. The five zang are for storing and not draining, being full but not solid; the five zang are Yin and still, their function is to store, thus they store essence and Qi without draining. If they do not store, they will also lead to illness. Qi in the body is Yang, while blood is Yin. Qi can warm the body, while blood nourishes the five zang and six fu; this is also Yin and Yang. From the whole person to the five zang and six fu, to the meridians and blood vessels, down to cells and molecules, all contain the principles of Yin and Yang. The universality of Yin and Yang constantly reminds us that to treat diseases, we must seek the root and differentiate Yin and Yang…Third: The Application of Yin and Yang Differentiation in Clinical PracticeThe “Neijing” states: “In all matters of Yin and Yang, the density of Yang is crucial. If the two are not harmonious, it is like spring without autumn, like winter without summer. Therefore, harmonizing them is the way of the sage. If Yang is strong but not dense, Yin Qi will be exhausted. When Yin is balanced and Yang is dense, the spirit will be treated. If Yin and Yang are separated, the essence and Qi will be exhausted.” “The key to Yin and Yang lies in the density of Yang Qi, which protects and solidifies the exterior.” Although these few words are brief, they reveal profound insights. In clinical practice, the goal of treatment is to “harmonize them”, achieving a state of “Yin balanced and Yang dense”, preventing the situation of Yin and Yang separation.The discussions on Yin and Yang in the “Neijing” can provide us with many inspirations and innovative thinking in clinical treatment of diseases. For example, “If Yang is strong but not dense, Yin Qi will be exhausted” is often applied in treating sweating disorders. When the Yang Qi of the body is overly exuberant but cannot protect the exterior, it will inevitably force Yin fluids to leak out, leading to sweating disorders. Sweat is the fluid of the heart; prolonged or excessive sweating depletes Yin fluids, further exacerbating the inability of Yin to control Yang, resulting in an even more exuberant Yang. To treat sweating disorders, we must ensure that Yang Qi can be “dense”; for “Yang dense”, we can use Yu Ping Feng San; at the same time, we must support the depleted Yin, using Ren Shen Mai Dong Tang to nourish Yin. Achieving a state of “Yin balanced and Yang dense” will naturally resolve the sweating disorder!The phrase “Yin is still, and Yang is active” also has great guiding significance in clinical practice. On the surface, it describes the activity of Yang and the stillness of Yin, but if we think deeply, it can guide clinical practice well. For example, in treating pediatric hyperactivity, have we considered that the exuberance of Yang Qi may be due to insufficient Yin? In treating patients with mania, have we thought about “excessive Yang leads to mania” and “excessive Yin leads to epilepsy”? For treating “mania”, we should heavily drain the exuberant Yang and support the depleted Yin; for treating “epilepsy”, we should support the deficient Yang and heavily drain the accumulated Yin… Furthermore, the “Neijing” states: “If Yin cannot overcome Yang, the pulse will be thin and rapid, leading to mania!” This understanding of mania and epilepsy becomes clearer!Chapter Five: Discussing the Framework of TCM from the Perspective of the Five ElementsIf Yin and Yang are the foundation, then the Five Elements are the five pillars on that foundation, supporting the vast theoretical system of TCM. Through these five pillars, we can see how the great tree of TCM flourishes. If we view learning TCM as a journey from Beijing to Shaanxi, then Yin and Yang divide the entire journey into two segments, while the Five Elements divide it into five segments, each with beautiful scenery. Let us appreciate the medical journey we are about to embark on!If Yin and Yang represent an ancient theory of opposites and unity, then the Five Elements can be seen as a primitive system theory. The Five Elements refer to Metal, Wood, Water, Fire, and Earth. The ancients believed that nature is composed of these five elements, and the changes in these elements affect not only human fate but also the continuous cycle of all things in the universe. The “Shang Shu: Hong Fan” records a dialogue between King Wu of Zhou and Ji Zi, discussing: “The Five Elements: One is Water, two is Fire, three is Wood, four is Metal, five is Earth; Water moistens downwards, Fire blazes upwards, Wood bends and straightens, Metal transforms, Earth is for agriculture; moistening downwards produces salt, blazing upwards produces bitterness, bending and straightening produces sourness, transforming produces spiciness, and agriculture produces sweetness.” Here, the Five Elements and their characteristics are highly summarized. If learning TCM sees Yin and Yang as the framework, then the Five Elements serve as the lead. The combination of the two makes the theoretical system of TCM complete.Let’s first look at the Five Element attributes of the human body. Wood: The liver belongs to Wood, governs the smooth flow of Qi, stores blood, and is associated with the soul. It opens to the eyes, governs the tendons, manifests in the nails, is associated with anger, is expressed in the voice as shouting, and is represented by tears. Fire: The heart belongs to Fire, governs blood vessels, houses the spirit, opens to the tongue, manifests in the face, is associated with joy, is expressed in the voice as laughter, and is represented by sweat. Earth: The spleen belongs to Earth, governs transformation, distributes fluids, controls blood, governs muscles and limbs, stores intention, opens to the mouth, manifests in the lips, is represented by saliva, is expressed in the voice as singing, and is associated with thought. Metal: The lungs belong to Metal, govern Qi, control respiration, govern skin and hair, regulate the body, open to the nose, are represented by mucus, expressed in the voice as crying, and are associated with sadness. Water: The kidneys store essence, govern reproduction, control water, regulate Qi, and are the source of pre-natal essence, governing the two Yin, opening to the ears, manifesting in hair, represented by saliva, and expressed in the voice as moaning. We can summarize these into a chart:Many may say that this is the most basic knowledge of TCM and is not mysterious! Yes! It is these basic concepts that guide clinical work at all times. If you truly want to enter the sacred hall of TCM, these are the doors to enter. If you only look at the door without entering or do not believe this is the door, it will be difficult to truly become a TCM practitioner and deeply understand the essence of TCM. Let me give a few examples:The first example: There are many diseases related to hair, such as common hair loss, yellowing hair, seborrheic alopecia, and white hair. When seeking treatment, some people may be influenced by Western medical thinking and adopt modern treatment plans. In fact, understanding three statements can make this series of diseases manageable! The first statement: Hair is the surplus of blood; the second statement: The lungs govern skin and hair; the third statement: The kidneys’ essence manifests in hair. From these three statements, we can see that hair diseases are closely related to the lungs, blood, and kidneys. In clinical practice, finding this direction makes treatment easier. For patients with dry, split, or prematurely white hair, nourishing blood and supplementing kidney essence can yield excellent results. The formula “Sheng Mai San” is a representative medicine, and the “Si Wu Tang” is a classic blood-nourishing formula, while He Shou Wu and Tu Si Zi are excellent for nourishing kidney essence! For seborrheic alopecia, regulating the lung’s dispersing and descending functions can achieve good treatment effects!The second example: Oral ulcers are frequently encountered in clinical practice, known in TCM as “kou chao”. For treating oral ulcers, most believe it is due to excessive fire, recommending patients take “Zhi Bai Di Huang Wan”. This is effective for some but ineffective for stubborn cases that recur over a long period, causing significant suffering for patients. In treatment, if we first consider “the spleen opens to the mouth”, we can approach it from the spleen’s perspective, clearing the spleen’s damp-heat and accumulated heat, often achieving excellent results. For ulcers on the tongue, we can approach it from the heart’s perspective, treating it from the heart’s angle, which can also yield good results. If there are ulcers on both the mouth and tongue, we can approach treatment from both the heart and spleen…The third example: Women in their thirties and forties often have facial spots. When treating, it can sometimes be difficult to differentiate whether it is due to blood deficiency, Qi deficiency, kidney deficiency, or liver stagnation. Many clinical TCM practitioners conclude it is “endocrine disorder”, which is irresponsible to the patient and to themselves. We only need to think about the Five Element attributes of the human body, remembering that “the heart governs blood vessels, and its manifestation is on the face”; “the lungs govern Qi and skin”. We can consider facial diseases as issues related to the “face” and “skin”, primarily approaching treatment from the heart and lungs, regulating Qi and blood, warming the blood vessels, and naturally, recovery will follow. Of course, sometimes heart and lung issues may also relate to the liver and kidneys. For patients with liver Qi stagnation or kidney Yin deficiency, while treating the heart and lungs, it is also necessary to regulate the liver and kidneys, but do not forget that the heart and lungs are the “boss” of the “face”!There are many such examples. As long as you thoroughly understand the Five Element attributes discussed above, learning TCM will become much easier. This is also a shortcut to learning, a door to enter! Understanding the Five Element attributes provides insight into many diseases, but this understanding may still be superficial. For example, if you know that oral ulcers are related to the “heart and spleen”, you must also pursue the root cause. Sometimes it is simply a heart-spleen issue, but sometimes it may not be; it could be caused by other organs. In pursuing the root cause, it is like entering the big door, but you must also enter the small door to explore the intricacies of TCM.
Chapter Six: The Compass for Learning TCM
Having discussed Yin and Yang and the Five Elements, we have gained some clarity on the theoretical framework of TCM for those beginning to learn. Oh! So this is what TCM is like! It is not that difficult! But to continue deepening our learning, we need a comprehensive understanding of the human body, so we do not get lost and can grasp the direction of our studies. Just like traveling from Beijing to Shaanxi, knowing that Shaanxi is in the west and that you will pass through several provinces and cities, but if you do not have a compass, a coordinate that always points you in the right direction, you may lose your way during the journey and ultimately fail to reach your destination. Understanding the cities you will pass through becomes meaningless!Now, let’s create a compass for learning TCM, guiding beginners and TCM enthusiasts, so you can clearly know the shortcut to learning TCM. The “Huangdi Neijing” describes the physiology of the human body extensively, stating that the human body is formed by the merging of the Qi of heaven and earth. The Qi of nature has ascending, dispersing, collecting, and storing properties. The human body, influenced by nature, has corresponding Qi mechanisms of rising, descending, and circulating. The sun rises slowly from the east, while the liver Qi of the human body rises slowly from the left side! The sun sets slowly in the west, while the Yin Qi of the human body descends slowly from the right side through the lungs!The water in the earth nourishes trees, preventing them from withering; the water in the kidneys also nourishes the liver wood! It can also prevent excessive liver fire! The water in the ocean is evaporated by the sun, rising as vapor to form clouds that can shield the sun’s heat; the water vapor in the kidneys rises with the liver Qi, nourishing the heart fire and preventing it from becoming excessive! The sun’s warmth can nurture the earth, allowing it to grow all things; the heart fire of the human body can descend to warm the stomach soil, allowing the stomach to digest food! After the sun shines, the land warms, and the warmth of the land can transmit heat downwards, allowing the moisture in the soil to warm up; the warmth of the heart fire can descend through the stomach Qi to warm the cold water in the kidneys!The core of the earth can radiate heat outward, warming the deepest parts of the earth, and this warmth can slowly rise. The moisture in the soil can rise to form clouds, and the gathering of dark clouds can lead to rain! A thread of Yang Qi slowly rises from the kidneys, warming the spleen, which receives the Yang nourishment from the kidneys, transforming the nutrients from the small intestine into refined Qi, which rises to the lungs. The lungs then disperse the clear parts of the refined Qi to nourish the skin and hair, while the turbid parts descend to nourish the five zang and six fu, with waste Qi transformed into water through the san jiao meridian, entering the bladder and becoming urine!This is the correspondence between heaven and humanity, the result of the interaction between humans and heaven. Understanding these laws is essential for learning TCM. If we emphasize its importance, this is the compass for the journey of learning TCM! Next, we will draw a diagram of the circulation of Yin and Yang Qi in the human body. With this diagram, you can begin your journey of learning TCM without getting lost. It is as follows:The sun rises slowly from the east, while the water flows in the west;The kidney water nourishes the liver, allowing it to flourish, rising with the liver to nourish the heart fire.The bright sun warms the stomach soil, its warmth penetrating the stomach to warm the cold spring;The hidden dragon in the kidneys rises slowly, warming the spleen as it transforms the food into refined Qi, which rises to the lungs;The lungs act as a canopy, regulating the flow of Qi, transforming vapor into water through the san jiao meridian;The waterway of the san jiao connects to the capital, allowing the turbid to exit and the refined to enter the kidneys.The external Qi flows from right to left, while the central stomach descends and the spleen ascends;The Yin and Yang of the human body are like two wheels, with the right side being Qi and the left side being Yin.Chapter Seven: The First Stop on the Learning Journey – Chinese Medicine
Patients often say to me: Doctor, give me some good medicine to help me recover quickly! So, what is good medicine? Is ginseng good medicine? Is deer antler valuable, thus good medicine? If you are hungry and have not eaten for a day, feeling dizzy and cold, the best medicine for you at that moment is food! A hearty meal will do you better than ginseng soup! If you have not rested for three days and nights, feeling sore and dizzy, a good rest will be better than taking a tonifying pill!In the above two examples, “food” and “rest” are the best medicines! Therefore, targeting the patient’s condition, finding the root of the disease, and treating the root cause is the essence of seeking the root. Treating the root with medicine can achieve miraculous effects; there is no distinction between expensive and cheap medicines; the best medicine is the one that is appropriate for the condition. By deeply understanding Chinese medicine, you will find that many things around us are medicinal materials. As long as we use them correctly, they can work wonders.For example, a few months ago, one night, an elderly lady came to me, feeling very dizzy and with high blood pressure. Both her pulses were showing an upward trend, indicating that Qi and blood were both rising. If she was anxious and her blood pressure rose, the patient was at risk of a cerebrovascular accident. The patient’s condition was due to insufficient Yin in the lower jiao, unable to contain Yang, leading to excessive Yang rising, causing dizziness. It was already past 11 PM, and it was too late to prescribe Chinese medicine, so I asked the patient to go home, crush some garlic, and apply it to the Yongquan point on both feet for one hour.The next day, the patient came back joyfully, saying that after applying it for just a quarter of an hour, she felt her head clear and her legs strong. By the end of the hour, she was reluctant to take it off and fell asleep. In the morning, she felt completely better, but her feet had some blisters. She did not expect garlic to have such good medicinal effects. I treated the small blisters on her feet, and upon checking her pulse, I found that although her pulse was not strong, it had returned to normal, and the upward trend had disappeared. The illness was cured.This example illustrates the importance of paying attention to every herb, flower, and leaf in our lives; they all have their unique properties. If used well, they can cure patients’ diseases, just like a martial arts master can kill with a mere flower or leaf. When one reaches a certain level in medicine, it is like Ye Tianshi saving two lives with three leaves of the phoenix tree; one can also save lives effortlessly with flowers and leaves. To cultivate everyone’s interest in learning, let me share the story of Ye Tianshi’s clever use of phoenix tree leaves.
In the Qing Dynasty during the reign of Emperor Qianlong, the famous physician Ye Tianshi was writing medical cases at home when he heard someone come to request treatment for a woman in labor. Without hesitation, he immediately went to help. On the way, he heard the family say they had already consulted the renowned physician Xue Shengbai from the same school, but there was still no sign of delivery. Xue Shengbai was a neighbor of Ye Tianshi, and his medical skills were equally renowned in Jiangnan, though he was younger. Ye Tianshi was puzzled; Xue Shengbai’s skills were good, so why was there no effect?When Ye Tianshi arrived at the patient’s home, he found the woman was already in critical condition. Her family said that Xue Shengbai diagnosed her with dual deficiency of Qi and blood, unable to deliver due to stagnation of Qi and blood, and prescribed a formula mainly composed of Qi and blood tonics, promoting labor and expelling the fetus. Ye Tianshi took a look at the prescription and found it excellent, but it was difficult to treat this patient’s condition. Due to the lack of a common Qi medicine, how could all the herbs reach the disease site? It was autumn, and as the phoenix leaves fell outside the window, Ye Tianshi seemed to have an epiphany. He immediately replaced the “three bamboo leaves” in the original prescription with “three phoenix leaves”. The patient followed the prescription and, as expected, soon delivered a healthy baby, and both mother and child were safe!This incident reached Xue Shengbai’s ears, and he did not take it seriously, thinking that Ye Tianshi was just making a name for himself. Upon hearing this, Ye Tianshi immediately wrote a letter to Xue Shengbai, with a poem riddle: “Having eyes but no pearls, a treasure in the belly; the lotus flower rises from the water, joyfully meeting; the phoenix leaves fall, parting ways; a loving couple will not meet until winter.” During the autumn equinox, the phoenix leaves fall, and the common Qi seeks each other. Therefore, by adding phoenix leaves to Xue Shengbai’s original prescription, the herbs could reach the disease site, and the treatment would be effective. Soon, the story of “Ye Tianshi’s three phoenix leaves saving two lives” spread throughout the Jiangnan water town.The importance of the nature of Chinese medicine far exceeds its efficacy. Medicines have cold, hot, warm, and cool properties. If one does not understand the nature of the medicine, simply stacking them according to their effects will not yield miraculous results. In the example above, garlic was used for its ability to guide Qi and blood downwards. Once Qi and blood descend, the illness resolves. Modern medical research tends to focus on the components of medicines. Garlic contains allicin, which can fight bacteria and inflammation, soften blood vessels, and even have anti-cancer effects, but it cannot research that garlic can guide Qi and blood downwards. Why? This is the inherent bias of the medicine itself!From this perspective, viewing and researching Chinese medicine will not be limited by modern research thinking. According to TCM theory, when ascending, we use herbs with ascending properties; when descending, we use herbs with descending properties, without being constrained by their components.For example, patients with liver Qi stagnation often feel a bit breathless, and in severe cases, they may experience palpitations or even chest tightness. Using the herb Chai Hu to promote the stagnant liver Qi can provide immediate relief. Once, when I happened to run out of Chai Hu, a familiar patient asked me what to do. I told her to drink some raw malt soaked in water. The patient said, “Isn’t raw malt used for digestion and milk production?” I explained that it can also treat chest tightness, and after much effort, I finally convinced her to take some raw malt.The next day, she told me that the raw malt was effective, and her chest tightness improved. This demonstrates the ascending effect of raw malt. Are there any other herbs? The patient experienced liver Qi stagnation, and as long as we can promote liver Qi, any herb that can smooth liver Qi will work, such as mint! This is the application of medicinal properties. Once you master this thinking, using medicine in clinical practice will become very easy and natural.In current TCM textbooks, Chinese herbs are categorized by function. For example, Ma Huang is classified as a pungent warm herb for releasing the exterior; Bo He is classified as a pungent cool herb for releasing the exterior; and Mai Ya is classified as a digestive herb. Is this correct? Yes, it is correct. For those learning Chinese medicine, it makes it easier to understand the general effects of herbs, meaning that after learning this model, you quickly know “which herb treats which disease”! However, this is not the same as “which disease uses which herb”. Although it is just a reversal of order, it represents two different aspects of the issue.Knowing “which herb treats which disease” only indicates that you have read the material thoroughly; it means you have memorized what is in the book without integrating it with clinical practice. To illustrate: Treating diseases is like going to war. The first step is to understand the characteristics of each soldier and each weapon, but that does not mean you know how to fight. You must skillfully use your soldiers on the battlefield, utilizing the available weapons, and organize the most suitable strategies and tactics for the current battle to achieve victory.The first step in the operation of life is like two wheels; if any point gets stuck, the wheels cannot move forward. Treating diseases is like repairing the stuck wheels, finding the cause of the blockage, and fixing it. Let’s first look at the liver:1. A common clinical issue is liver Qi stagnation. Once it stagnates, it is like a point on the wheel getting stuck. By smoothing the liver Qi, we can repair it. What herbs can smooth liver Qi? Chai Hu, Xiang Fu, Yu Jin, Qing Pi, Chuan Lian Zi, Ju Ye, Bo He, and Bai Ji Li.2. If the condition is neglected for too long, it can transform into fire. What should we do? We can clear the liver fire. Herbs to clear liver fire include Sang Ye, Ju Hua, Qing Sang Zi, Jue Ming Zi. To drain liver fire, we can use Long Dan Cao, Hu Lian, Huang Qin, Qing Dai, Zhi Zi, Dan Pi, Xia Ku Cao, and Ling Yang Jiao.3. If the condition continues to worsen, leading to liver fire damaging liver Yin, resulting in liver Yin deficiency, what should we do? We need to nourish liver Yin! Herbs to nourish liver Yin include Shan Yao, Sheng Di, Nu Zhen Zi, E Jiao, Bai Shao, and Wu Mei.4. If the condition worsens further, leading to liver Yin damage and liver atrophy, what should we do? We need to nourish blood and soften the liver! Herbs to nourish blood and soften the liver include Dang Gui, Bai Shao, He Shou Wu, Gou Qi Zi, Ji Xue Teng, Mu Guo, and Bie Jia. This categorizes the pathological changes caused by liver Qi stagnation into four levels, which can be referenced when encountering patients with long-standing liver Qi stagnation.5. Besides liver Qi stagnation, are there other pathologies? Are there other issues at this point on the wheel? Yes! If liver Qi is supposed to rise but does not, what should we do? If it rises too much, what should we do? If it does not rise enough, it is called “wood Qi sinking into water”. We can promote liver Qi. On one hand, we can supplement liver Qi to enhance its rising force, using Huang Qi; on the other hand, we can use herbs that promote rising, such as Chai Hu, Bo He, and Sheng Mai Ya.If it rises too much, liver Qi may surge, leading to headaches. Some patients may experience palpitations or even elevated blood pressure. In this case, we need to lower the Qi. To calm and stabilize liver Qi, we use “calm the liver” and “level the liver”. Why do we call it “calm” and “level”? Here, it means to suppress liver Qi and pacify it. Although it sounds a bit rough, the use of medicine is similar; it cannot be vague. Otherwise, if liver Qi rises, it will lead to significant problems! To calm the liver, we can use Dai Zhe Shi, Ling Zhi Shi, Shi Jue Ming, Zhen Zhu Mu, Sheng Long Mu, and Ling Zhi Shi.To level the liver, we can use Ju Hua, Bai Ji Li, Tian Ma, and Gou Teng. If the patient’s liver Qi rises excessively and has already transformed into liver wind, causing tremors, what should we do? In this case, besides calming and leveling the liver, we also need to extinguish the liver wind. What herbs can extinguish liver wind? Ling Yang Jiao, Gou Teng, Tian Ma, Bai Ji Li, Jiang Can, Quan Xie, and Wu Gong.6. By relying on calming, leveling, and extinguishing liver wind, we can alleviate the condition. If we stop using medicine, and liver Qi rises again, what should we do? There is a method established by the ancients called “nourishing water to cover wood”, which means nourishing kidney Yin to nourish liver wood, making liver Qi more gentle and preventing excessive rising. What herbs can nourish kidney water? There are many, and we will discuss them in detail when we reach the kidney section.7. Besides the issues discussed above, are there other problems at this liver stage? Yes! If cold invades, it can condense the liver meridian, causing testicular pain, etc. We can use Wu Yao, Xiao Hui, and Xian Ling Pi, Li Zhi He, and Chuan Jiao. The liver stores blood, and liver Qi stagnation can also lead to blood stasis in the liver, for which we can select Chuan Xiong, Tao Ren, Hong Hua, San Leng, and Wu Zhu Yu.8. Additionally, if dampness lingers in the liver meridian, leading to excessive damp-heat in the liver meridian, we can select Zhi Zi, Long Dan Cao, and Huang Qin.Understanding these eight points gives us a clue on how to repair the point of the liver on the wheel. This way, learning Chinese medicine will integrate textbook content with clinical practice. Now, let’s look at the heart from the perspective of “heart”. Since we are learning Chinese medicine from the perspective of the heart, we need to examine the functions of the heart and the potential issues that may arise, making our learning objectives clearer. The heart belongs to fire and stores Yin blood! The heart governs blood vessels and houses the spirit! Its manifestation is on the face!Since it belongs to fire, there can be excessive fire and insufficient fire, clinically referred to as “excessive heart fire” and “heart Yang deficiency”. Since it stores Yin blood, there can be Yin blood deficiency, clinically referred to as “heart Yin deficiency” and “heart blood deficiency”. Since the heart governs blood vessels, any blockage or stagnation in the blood vessels is a problem, clinically referred to as “blood vessel obstruction”. Since the heart houses the spirit, if the spirit is not well housed, it is referred to as “heart spirit deficiency”. Since its manifestation is on the face, how is the facial complexion? Is there vitality in the face? Are there any lesions on the face? All these are related to the heart. There are many aspects related to the heart, and we will discuss the relevant Chinese herbs based on the above.1. For excessive heart fire, we can select Dan Zhu Ye, Sheng Di, Zhi Zi, and Deng Xin Cao. Do not underestimate Deng Xin Cao; it seems ordinary but is very effective for excessive heart fire. For example, I once treated a patient with insomnia. After checking the pulse, I found the patient’s left pulse was floating and firm. The patient’s tongue tip was red, so I used Dao Chi San (Sheng Di, Mu Tong, Gan Cao, and Zhu Ye). The effect was good; after five days, the patient was able to sleep well. However, a few days later, the patient had another flare-up of fire and insomnia. When he asked for more Chinese medicine, he found it too bitter and could not accept it. After much thought, I finally told him to boil Deng Xin Cao in water and drink it as tea. To my surprise, the effect was excellent, and the patient was very satisfied!Later, I encountered a child with excessive heart fire, especially one under one year old who cried at night due to excessive heart fire. I used Deng Xin Cao with a bit of sugar as a drink, and the effect was very good; the child accepted it easily.2. For heart Yang deficiency, we can select Gui Zhi, Rou Gui, Fu Zi, Xie Bai, and Gan Jiang. Patients with heart Yang deficiency often have cold hands and feet, lacking warmth. Naturally, they feel cold, and in winter, such patients suffer greatly. In the morning, if they eat a bowl of porridge with 3 grams of ground Rou Gui and some sugar for taste, they will feel warm all day.3. Patients with heart Yin blood deficiency need to nourish Yin blood, for which we can use Bai Zi Ren, Jujube Seed, Dan Shen, Mai Dong, and Dang Gui. Do not underestimate Dan Shen; it is said that “a dose of Dan Shen is equivalent to four substances”, meaning that Dan Shen can nourish blood, invigorate blood, and nourish blood, making it very beneficial for heart Yin blood deficiency.4. For heart spirit deficiency, we can select Gui Ban, Fu Xiao Mai, E Jiao, Zi He Che, and He Huan Hua.5. For heart Qi deficiency, we can select Ren Shen, Huang Qi, Dang Shen, Fu Shen, Wu Wei Zi, Yuan Zhi, and Zhi Gan Cao.6. For blood vessel obstruction, we can select Dan Shen, Chi Shao, Tao Ren, Hong Hua, Ji Xue Teng, and Hong Jing Tian.When the balance of Qi and blood in the heart is restored, the face will naturally become radiant, and facial spots will gradually disappear, and wrinkles will lessen. This is the “spirit”. For those learning TCM, if you can experience the foundational theories of TCM in this way and learn Chinese medicine in this manner, when you go to clinical practice, you will be confident and will not encounter patients with facial spots, telling them it is due to endocrine disorders!Perhaps those who have been engaged in clinical practice for many years may think, “What about the interaction between heart and kidney? What about gallbladder fire disturbing the heart?” Why not delve deeper? Not to worry; these will be discussed after we cover the five zang organs, and understanding will be deeper!Article content is for reference only,non-professionalsplease do not attempt acupuncture or medication.