Introduction to Traditional Chinese Medicine

Inheriting the fire of Qi Huang, a public account with substance and warmthEveryone can learn Traditional Chinese Medicine (TCM) and experience its essence. Learning TCM is about understanding the world around us and introspecting our own bodies.Learning TCM does not require innate talent; for ordinary people, TCM teaches methods of health preservation and ways to prevent and treat diseases. Anyone with interest can learn. However, if one pursues TCM as a profession, the requirements will be higher, and one must understand more, which is understandable, as human life is at stake. Patients entrust their lives to us, and if we do not improve our skills, we are not saving lives but endangering them.1. Who is Suitable for Learning 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 literature on TCM and wonder how to find the entrance to the treasure trove of TCM. This is both the charm and the shortcoming of TCM.In ancient times, most TCM practitioners were literati who pursued the ideals of becoming either a good minister or a good doctor. Literati often loved to show off their literary skills, making simple issues sound profound, as if complexity was necessary to prove their competence, similar to some modern poetry that evokes feelings but is hard to understand.In fact, TCM originated from folk medical practices, which were summarized and elevated by literati into TCM theories that then guided clinical practice. It is a simple and straightforward knowledge passed down from 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 for health, some for glory, and some aspire to become masters…Different thoughts lead to different starting points, and learning TCM is no different!Some mothers want to learn TCM just to keep their children healthy and free from illness.Some patients who have long suffered from diseases learn TCM simply to regain their health and live well.Some clinical TCM practitioners study TCM to better serve their patients and improve their clinical skills.Researchers learn TCM to find new methods for tackling difficult diseases.Some people learn TCM to acquire a skill for making a living and supporting their families…Learning TCM does not require innate talent; for ordinary people, TCM teaches methods of health preservation and ways to prevent and treat diseases. Anyone with interest can learn. However, if one pursues TCM as a profession, the requirements will be higher, and one must understand more, which is understandable, as human life is at stake. Patients entrust their lives to us, and if we do not improve our skills, we are not saving lives but endangering them.In ancient times, humans had no clothes or stable food sources. To survive, they had to adapt to nature, seeking ways to survive amidst its changes. Health and longevity were not yet concerns; survival was the only priority. Their thoughts were simple, without the pursuit of fame or profit, only considering how to adapt to cold and heat, how to avoid wind and rain. Everyone was a health preserver; otherwise, survival would be impossible. With the advancement of human society, we have many ways to adapt to changes in nature, but this has led to a neglect of nature’s changes, and our ability to adapt to nature has been declining. Even slight changes in nature can lead to many people falling ill. Learning TCM allows us to understand nature and our own bodies, helping us integrate into nature and seek the path of health and the means of treating diseases.Everyone can learn TCM and experience its essence. Learning TCM is about understanding the world around us and introspecting our own bodies. Feeling the world from the primitive and essential is what we need to learn! So, who is suitable for learning TCM? It is not about a specific type of person, but rather all of humanity!Travel Tip: Learning TCM is a long and enduring process. If there is no purpose, if one blindly follows trends, or if one is forced to choose it just to go to university, learning will lack motivation! What is your purpose in learning TCM?2. Experiencing TCM in Daily LifeIs TCM a metaphysics?Does TCM have efficacy?Should TCM be promoted?These questions can only be deeply understood through personal practice, allowing us to know how to treat TCM and build confidence in learning it.“In ancient times, the teachings of the sages warned against the ‘evil winds’ and advised avoidance at times, advocating tranquility and emptiness, allowing true energy to flow, and keeping the spirit within. Where do diseases come from?”“Avoid the evil winds at times.” If the weather turns cold, we instinctively know to wear more clothes; this is a basic principle of health preservation, the most fundamental and simple concept. Is it profound? Not at all!But if we think deeply, when we add clothes to protect ourselves from the wind, isn’t taking restorative herbs like Fu Zheng (supporting the body’s upright energy) akin to adding clothes to protect our internal organs from the evil winds? By avoiding cold foods, aren’t we allowing our internal organs to avoid cold evils? These are all very ordinary principles, derived from the simplest and most fundamental aspects of life. Yet, the application of these principles can protect our bodies and enable us to live healthily. This is TCM; this is the way of medicine.“Thus, enjoy your food, wear what you like, and be content with your customs. The people are said to be simple.”How many modern people can adhere to such a simple health-preserving principle?If we can calm our restless hearts, view things with indifference, reduce our material pursuits, and not place too much importance on fame and profit, we can naturally enjoy our customs. Who cares whether we eat “abalone” or “pork ribs,” or whether we wear “mink” or “cotton clothes”? As long as we can keep warm, we can achieve the purpose of avoiding the evil winds. When our mindset reaches a certain height, we can achieve harmony with nature and enjoy health and longevity.These words from the Huangdi Neijing are very simple, like an elderly person in their seventies sharing their life experiences with us. When we listen humbly, we realize how superficial our understanding of life is and how restless our mindset is. We often find ourselves losing sight of the essentials, and when disease strikes or life ends, we hope to eliminate ailments instantly and revive ourselves! Why don’t we learn the health-preserving principles of TCM earlier, allowing our hearts to find peace and our bodies to be healthy, and not be so extreme in our attitudes towards our surroundings?“Desires cannot tire the eyes, and evil lust cannot confuse the heart. The wise and the foolish are not afraid of material things, thus they align with the way. Therefore, those who can live to a hundred years and remain vigorous do so because their virtue is complete and not endangered.”This is the way of health preservation; this is the way of medicine!Does TCM have efficacy?First, I want to ask those who doubt TCM’s efficacy: Have you tried it? Have you adopted TCM thinking? Have you applied TCM treatment methods based on syndrome differentiation?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 believed an IV would help them recover quickly! I asked, “How many days do you think is quick?”The patient laughed and said, “Every time I get an IV for a cold, I recover in three days.”“Then if I cure you in one day, is that considered quick?”“Of course, that would be quick! Can TCM do that?”“Of course it can!” I answered without hesitation.The patient had caught a cold due to sleeping in an air-conditioned room at a low temperature. So, I used ginger oil to perform Gua Sha (scraping therapy) on the patient’s back along the Bladder Meridian, producing purple-black bruises in just a few minutes. The patient felt significantly better, and I then prescribed Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction). The so-called severe cold was treated with TCM in less than a day. In the following year or two, this patient would drink TCM every time they caught a cold, and just one dose would suffice. For mild colds, they would simply boil ginger and scallion water to drink, and they would be fine. The belief that “a cold must be treated with an IV” was completely replaced by an understanding of how to prevent colds and how to manage them in their early stages.This is the charm of TCM; this is its efficacy!Only through personal experience can we understand that diseases can be treated this way, that TCM can be effective, and that TCM treatments can be quick!When I was a child in the countryside, medical care was not as convenient as it is now. Many ailments were treated by my great-grandfather in this way. I became accustomed to this treatment method and to my family making ginger and scallion tea for me when I caught a cold. From my memories until now, I have not had an IV drip even once in thirty years. 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 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 envy the powerful? Should we be profit-driven?No!Our bodies have a sophisticated self-regulating mechanism. What we need is health preservation, learning to maintain this intricate 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 the essence of TCM. Promoting TCM is a natural duty, promoting this science that integrates prevention, treatment, health preservation, and wellness for the health of all humanity, forever shining brightly. This is not only the responsibility of TCM practitioners but also of every Chinese person.Tip: If you want to learn TCM, it is best to first drink some herbal medicine when you feel unwell or use other TCM methods for treatment. Only through personal experience can you feel the efficacy of TCM and enhance your confidence in learning it.3. Learning Should Focus on 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, then walk a certain number of kilometers, then turn right.” This will confuse you and others. How to walk, no one can clearly describe. You might say to look at a map; yes, a map can clarify things. Today, I write these articles to draw a map for learning TCM, but no map, no matter how detailed, can tell you that at 1501 meters ahead, there will be a mud pit, nor can it indicate where the road is uneven or where there are obstacles. However, this map can tell you the direction, the direction of learning TCM, helping us understand why we should learn TCM and how to learn it!From Beijing to Shaanxi, you must first understand that you are heading west; west is your goal and direction. The first step in learning TCM is to understand the framework of TCM. Under the guidance of this big framework, you will not go wrong, and your chances of success will be greater.So, what is the big framework? What is the big direction?Earlier, I mentioned that learning TCM is about experiencing nature, understanding the most essential aspects of the natural world, and then introspecting our own bodies to understand the methods of health preservation and disease treatment.Experiencing nature starts with our Earth, seeking its laws, while also drawing parallels to understand ourselves. I believe that learning TCM this way will be more acceptable to everyone. Because we live in such an environment, understanding our living environment helps us understand why we get sick and how to treat diseases.Climb a high mountain, stand at the summit, and take a good look at our Earth!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 them the spirit to face a new day.Because of the atmosphere surrounding it, we can breathe freely while also protecting the Earth from many external impacts, safeguarding the flora and fauna on Earth.When solar flares and sunspots are active, the sun emits a large number of charged particle streams that move along the magnetic field lines towards the north and south poles. They enter the upper atmosphere at high speeds, with energy equivalent to tens of thousands or hundreds of thousands of hydrogen bombs. Thanks to the magnetic field, our Earth is constantly protected, preventing catastrophic disasters for life on Earth.Now look at the fertile land beneath your feet; the growth of all things depends on it. Look at the ocean; without its vastness, the land would be submerged, and humanity would have no place to stand. Look at the wildflowers around you; look at the little fish swimming in the river, and deeply feel the breath of life…Look at the sky, look at the earth, look at every grass and tree around you, and then look at us humans. From the vastness of the heavens to the smallness of humans, you will find how marvelous humanity is.The first chapter of the Huangdi Neijing discusses health preservation, and from the second chapter onward, it talks about the four seasons and how to maintain health during spring, summer, autumn, and winter. This is to encourage us to approach from a broader perspective and recognize humanity from a larger viewpoint.Once we understand this, we can read the Suwen: Four Qi Regulation and find how friendly the Huangdi Neijing is.“In the three months of spring, this is called the time of emergence. Heaven and earth are born together, and all things flourish. Sleep late and rise early, walk freely in the courtyard, let your hair down, and walk slowly to allow your spirit to flourish. Give life and do not kill; give and do not take; reward and do not punish. This is the response to spring qi and the way of health preservation. If you go against it, you will harm your liver. Summer will bring cold changes, and those who nourish will be few.”This passage can be understood as: The three months of spring are the season when all things awaken and flourish. Humans should follow the laws of heaven and earth, going to bed late and rising early, and in the morning, wear loose clothing and let their hair down while walking slowly to promote the flow of liver qi. Spring is the season of growth; humans should adopt an attitude of “giving life” and “not killing” towards all things. This is the way to respond to spring qi and the way of health preservation. If you go against these natural laws, you will harm your liver, and if the liver is harmed, it cannot nourish the heart (as wood generates fire in the five elements), and if the liver cannot generate fire, cold diseases will occur in summer.“In the three months of summer, this is called the time of flourishing. The qi of heaven and earth interacts, and all things blossom and bear fruit. Sleep late and rise early, do not be weary of the sun; keep your spirit calm, let the flowers bloom, and allow the qi to flow. This is the response to summer qi and the way of nurturing growth. If you go against it, you will harm your heart, and autumn will bring pestilence, and those who harvest will be few.”This passage can be understood as: In the three months of summer, all things grow abundantly, and the yang qi of heaven rises while the yin qi descends, reaching a peak of interaction. At this time, humans should sleep a little later and rise a little earlier, not feeling weary of the sun, and should not get angry (as great anger harms the liver, and if the liver is harmed, it cannot nourish the heart). The yin and yang of the body must flow, and the internal stagnant qi must be released, allowing the yang qi to spread outward, in accordance with the abundant yang qi of summer for nurturing growth. If you go against this principle, the heat evil cannot be released and will remain inside, harming the heart, leading to pestilence in autumn, and when it is time to harvest, there will be no yang qi to harvest, resulting in serious illness in winter.“In the three months of autumn, this is called the time of balance. The weather becomes urgent, and the earth’s qi becomes clear. Go to bed early and rise early, rise with the rooster, keep your spirit calm, and ease the autumn’s harshness. Gather your spirit, let the autumn qi be balanced, and do not let your spirit wander outside. This is the response to autumn qi and the way of health preservation. If you go against it, you will harm your lungs, and winter will bring diarrhea, and those who store will be few.”This passage can be understood as: In autumn, nature’s fruits have matured, and the essence is stored in the seeds. The atmosphere reveals a command of harshness, and the earth presents a scene of harvest. Humans should go to bed early and rise early, getting up when the rooster crows. This lifestyle can calm the spirit and alleviate the harshness of autumn. Gather your yang qi so that the lung qi can be cleared. If you go against this principle, you will harm your lungs, and if the lung qi is harmed, the winter will bring diarrhea (referring to watery stools with undigested food residues), and at that time, the yang qi will be insufficient.“In the three months of winter, this is called the time of closure. The water freezes, and the earth cracks. Do not disturb the yang; go to bed early and rise late, waiting for the sunlight. Keep your spirit hidden and concealed, as if you have private intentions or have already gained something. Avoid the cold and seek warmth, do not let the skin leak, and let the qi be quickly seized. This is the response to winter qi and the way of nurturing closure. If you go against it, you will harm your kidneys, and spring will bring weakness, and those who nourish will be few.”This passage can be understood as: Winter is the season for the closure of yang qi. In nature, plants wither, seeds are buried under ice and snow, and all vitality is hidden from view. The water freezes, which is characteristic of the closure of yang qi. At this time, humans should go to bed early and only rise when the sun rises. The spirit should be more reserved, and one should pay attention to warmth, preventing the yang qi from leaking. This is the way to nurture closure in winter. If you go against this principle, you will harm your kidneys, and the yang qi will not be able to be stored, leading to insufficient yang qi in the following spring.The above four passages are original texts from the Huangdi Neijing, guiding us in health preservation from a natural perspective, allowing us to feel the changes of the four seasons and grasp their characteristics—growth, flourishing, harvesting, and storing. Following these natural characteristics is the way.In addition to observing the characteristics of the four seasons, we can also see the concept of “yin and yang”!The Earth’s rotation creates day and night; daytime is called yang, and nighttime is called yin.We also see the “five elements,” which are the five basic substances on Earth: wood, fire, earth, metal, and water.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 serve as the framework for our study of TCM, just as if you know to go west from Beijing to Shaanxi, if you do not even know what “west” is, 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 like finding the direction to enter. Therefore, the Neijing devotes five chapters to discussing yin and yang, starting from the perspective of yin and yang to discuss the physiological and pathological aspects of the human body.Now let’s look at the texts of the Neijing:“Yang qi is like the heavens and the sun; if it loses its place, it will shorten life and not shine. Therefore, the heavens must operate with sunlight. Thus, yang rises and ascends, protecting the exterior.”“Therefore, yang qi governs the exterior for one day. At dawn, yang qi is born; at noon, yang qi is abundant; in the evening, yang qi is depleted, and the qi gates are closed. Therefore, at dusk, it should be gathered and not disturb the muscles and bones, nor see mist or dew. If you go against these three times, the body will be exhausted.”“In spring and summer, nourish yang; in autumn and winter, nourish yin.”Once you understand the direction that the Neijing guides us in learning health preservation, reading these seemingly profound texts will feel very straightforward. They directly and clearly tell us the laws of nature and how to learn health preservation in accordance with nature.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 way of thinking, which looks at the big picture and considers yin and yang and the five elements, contains wisdom and foresight that has endured for millennia.When Western medicine cannot make new progress in microscopic research, many insightful individuals attempt to borrow TCM’s thinking model to analyze diseases from a macroscopic perspective, returning to simplicity and often achieving breakthroughs.Learning TCM is about cultivating a mindset of returning to simplicity and not being bound by localized, minor symptoms. It is about starting from yin and yang and the five elements. Cultivating this way of thinking and developing this habit will greatly broaden our horizons. This is beneficial not only for learning TCM and health preservation but also for many aspects of work and life.Tip: Learning TCM requires focusing on the big picture. After reading this chapter, do you understand what the “big picture” refers to? How does the Neijing systematically elaborate on these “big pictures”? After reading this chapter, it is recommended to repeatedly study the first and second chapters of the Neijing to feel the ancient understanding of heaven and earth, yin and yang, and the five elements, thus guiding your study of TCM so that you will not lose your way.For example, in clinical practice, we often encounter patients with nasal congestion, diagnosed by Western medicine as “allergic rhinitis.” When they come to TCM, we do not need to consider how many things the patient is allergic to. TCM has a classic saying: “When the upright qi is preserved internally, evil cannot invade.” There is also “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 has nasal congestion every morning, have them wear a cotton hat while sleeping at night to warm the head and induce sweating for several nights, and the 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 1: Understanding TCM from the Perspective of Yin and Yang“Yin is quiet, yang is active.” It is because of the balance of yin and yang that there is a balance of movement and stillness, and life has vitality without becoming restless.Earlier, 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 you go west from Beijing to Shaanxi is not enough; you must also know which provinces and cities you will pass through to reach Shaanxi smoothly. Similarly, only by understanding the connotation of yin and yang can our journey of learning truly begin.1. The Importance of Yin and YangIn the Suwen: Discussion on Yin and Yang, it is written: “The Yellow Emperor 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 spirit. To treat diseases, one must seek their 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 spirit. The ancients placed such high importance on yin and yang, indicating how crucial it is to understand yin and yang for learning TCM and health preservation. This passage emphasizes the importance of yin and yang and also warns future generations that learning medicine must start from yin and yang; only by understanding yin and yang can one treat diseases effectively. 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.The founder of the “Fire God School,” Zheng Qinan, derived his academic roots from the Neijing, and his clinical practice follows Zhang Zhongjing’s methods. He emphasizes “understanding the principles of yin and yang” and that “the effort is all in the consideration of yin and yang.” His true teaching is: “Recognize only the distinction of yin and yang,” and “the changes in disease cannot be fully explained by one aspect; they are ever-changing and do not exceed the principles of yin and yang.”So, what exactly is yin and yang, and why is it so important? Let’s look at the descriptions in the Neijing.2. The Universality of Yin and Yang“Accumulated yang becomes heaven, accumulated yin becomes earth. Yin is quiet, yang is active. Yang generates, yin nourishes. Yang kills, yin stores. Yang transforms into qi, yin forms into shape. Extreme cold generates heat, extreme heat generates cold; cold qi produces turbid, hot qi produces clear. Clear qi below leads to diarrhea; turbid qi above leads to distension. This is the reversal of yin and yang, the origin of disease.”This passage can be understood as follows: Yang qi accumulates and rises to become heaven, while yin qi accumulates and descends to become earth. The characteristic of yin is stillness, while that of yang is movement. Yang qi governs growth, while yin qi governs nourishment. Yang qi governs expulsion, while yin qi governs storage. Transforming qi rises as yang, while forming matter becomes yin. Extreme cold will turn into heat, and extreme heat will turn into cold. Cold evils in the body can produce turbid evils, while hot evils can produce clear qi. Clear qi 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…This is how the ancients described yin and yang, starting from heaven and earth, and from the characteristics and transformations of yin and yang, allowing us to see the yin and yang within the human body. From the natural characteristics of yin and yang—movement and stillness, rising and falling, growth and storage, expulsion and storage, and the transformation of qi and form—we can deduce the “cold” and “heat,” “clear” and “turbid” within the human body, as well as the formation of diseases when yin and yang are reversed…When we read these passages from the Neijing, what should we further contemplate?From the text, we see that “heaven,” “earth,” and “humans” all exist within yin and yang, and we realize that 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 yin and yang of the human body, let’s examine our bodies from the perspective of yin and yang:“In terms of the human body, the exterior is yang, and the interior is yin. In terms of the human body, the back is yang, and the abdomen is yin. In terms of the organs, the organs are yin, and the bowels are yang.”Discussing the human body from the perspective of yin and yang.The exterior of the body is yang, while the interior is yin;The back of the body is yang, while the chest and abdomen are yin!The upper part of the body is yang, with the head being the convergence of all yang. All the yang qi of the body rises and gathers in the head, which is why the head is also called the “abode of clear yang.” The clear yang of the body rises and exits through the upper orifices…The lower part of the body is yin, with the yin qi descending, and the turbid yin descending through the lower orifices…The gallbladder, small intestine, stomach, large intestine, bladder, and san jiao are the six bowels. The six bowels are yang, they excrete but do not store, and they are solid but not full. The six bowels are active, so they function by passing through and transforming substances without storing them…If the six bowels do not pass, they will become stagnant, leading to illness. For example, bile accumulation can form gallstones; obstruction in the small intestine can lead to intestinal blockage; food stagnation in the stomach can lead to food accumulation; constipation can occur if the large intestine is not smooth; obstruction in the bladder can lead to dysuria; and if the san jiao is obstructed, water and fluids can accumulate, leading to edema…The liver, heart, spleen, lungs, and kidneys are the five organs. The five organs store but do not excrete, and they are full but not solid. The five organs are yin, governing stillness, and their function is to store, so they store essence and qi without excreting. If they do not store, they will also become ill…The qi of the body is yang, while the blood is yin. Qi can promote the circulation of blood throughout the body, nourishing the five organs and six bowels…From the grand scale of the entire human body to the five organs and six bowels, down to the meridians and blood vessels, 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! Treatment must differentiate between yin and yang!3. The Application of Yin and Yang Differentiation in Clinical PracticeThe classics say: “In all matters of yin and yang, yang must be dense and solid. If the two are not harmonious, it is like spring without autumn or winter without summer. Therefore, harmonizing them is the holy way. If yang is strong but not dense, yin qi will be exhausted. If 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 is that yang must be dense and solid,” which means that the key to yin and yang lies in the density and protection of yang qi. Although this is a brief statement, it reveals profound truths. In clinical practice, the goal of treatment is to “harmonize them,” that is, to adjust yin and yang to achieve 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 insights and innovative thinking for clinical treatment of diseases. For example, the phrase “yin is quiet, yang is active” has significant guiding meaning in clinical practice. On the surface, it describes the activity of yang and the stillness of yin, but it actually reflects the universal characteristics of yin and yang. When yang qi is excessive, things will be in a state of agitation, while when yin qi is excessive, things will be in a state of calm.Because of the balance of yin and yang, there is a balance of movement and stillness, and life has vitality without becoming restless.In clinical practice, when we see a child who is hyperactive, we should think of “yang agitation.” The child has abundant yang qi, and if it becomes stagnant, it will transform into fire, leading to internal heat and restlessness. When we see a child who is not active and overly dull, we should think of “yin stillness,” indicating that the child has insufficient yang qi and excessive yin qi.“Yin stillness, yang agitation” reflects the characteristics of yin and yang. However, when the imbalance of yin and yang becomes severe, resulting in “heavy yin” or “heavy yang,” what will happen?“Heavy yang leads to mania, heavy yin leads to epilepsy!” This is the further consequence of the imbalance of yin and yang.For treating “mania,” we need to drain the excessive yang and support the deficient yin.For treating “epilepsy,” we need to support the deficient yang and drain the stagnant yin.Furthermore, consider the Neijing text: “If yin cannot overcome yang, the pulse will be thin and weak, leading to mania.” This understanding of mania and epilepsy becomes clearer!Thus, the Neijing states: “A good diagnostician observes color and pulses, first distinguishing between yin and yang; examines clarity and turbidity to understand the parts; observes breathing and listens to sounds to know the suffering; observes proportions and measures to know the disease’s master; palpates sizes, observes floating, sinking, slippery, and rough to know the origin of the disease. By treating without excess and diagnosing without loss, one will not err.”The guidance of yin and yang is indeed precious. Only those who have worked in clinical practice for many years can deeply appreciate why the Neijing devotes so much space to discussing yin and yang. In the following chapters, we will further study yin and yang in conjunction with clinical practice.Tip: Through reading this chapter, have you realized the importance of yin and yang? If you want to delve deeper into yin and yang, you can repeatedly read the third to seventh chapters of the Neijing. Reading it multiple times will gradually help you comprehend the importance of yin and yang. After reading the Neijing, it is recommended to refer to the book True Transmission of Medical Principles to see how a master uses yin and yang differentiation to understand diseases.Chapter 2: Discussing the Framework of TCM from the Perspective of the Five ElementsIn fact, as long as we think about the five-element attributes of the human body, remembering “the heart governs blood vessels, its manifestation is on the face”; “the lungs govern qi and the skin,” we can categorize facial diseases as issues of “face” and “skin,” primarily addressing the heart and lungs, regulating qi and blood, warming and unblocking the blood vessels, and naturally recovering. Of course, sometimes heart and lung issues are related to the liver and kidneys. For patients with liver qi stagnation or kidney yin deficiency, it is also necessary to regulate the liver and kidneys while treating the heart and lungs, but ultimately, do not forget that the heart and lungs are the “masters” of the face!The Five Elements of Yin and YangIf 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 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: wood, fire, earth, metal, and water. The ancients believed that nature is composed of these five elements, and with the rise and fall of these elements, nature undergoes changes that not only affect human destiny but also cause the cycle of all things in the universe.In the Shangshu: Hongfan, a dialogue between King Wu of Zhou and Ji Zi is recorded: “The five elements: one is water, two is fire, three is wood, four is metal, five is earth; water moistens and descends, fire rises and burns, wood bends and straightens, metal transforms and changes, earth is for farming; moistening produces salt, rising produces bitterness, bending produces sourness, transforming produces spiciness, and farming produces sweetness.” This summarizes the five elements and their characteristics. If learning TCM’s yin and yang is the framework, then the five elements are the lead. The combination of the two makes the theoretical system of TCM complete.1. The Five Element Attributes of the Human BodyWood: 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 expressed through anger, is associated with the voice of shouting, and is linked to tears.Fire: The heart belongs to fire, governs blood vessels, houses the spirit, opens to the tongue, manifests in the face, is expressed through joy, is associated with laughter, and is linked to sweat.Earth: The spleen belongs to earth, governs transformation, distributes fluids, governs blood, and is associated with muscles and limbs. It houses intention, opens to the mouth, manifests in the lips, is expressed through thought, is associated with singing, and is linked to saliva.Metal: The lungs belong to metal, govern qi, control respiration, govern the skin, regulate the body, and promote the dispersal and descent of qi. They open to the nose, are expressed through sadness, are associated with crying, and are linked to nasal discharge.Water: The kidneys store essence, govern reproduction, control water, regulate qi, and are the source of pre-natal essence. They govern the bones and marrow, open to the ears, manifest in the hair, are expressed through fear, are associated with saliva, and are linked to moaning.Many may say that these are the most basic aspects of TCM, and there is nothing mysterious about them!Indeed! It is these basic principles that guide clinical practice 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.In clinical practice, many doctors, when encountering diseases, first think about the pathological attributes of the disease: is it phlegm? Is it stasis? Or is it dampness? Some even consider whether it is bacteria or viruses. In fact, the first thing to consider should be the classification of the five elements: which organ should be addressed, and where is the source?TCM does not treat “disease” but rather treats people, the five organs and six bowels! Understanding this statement allows us to grasp where the “root” of treatment lies.2. The Application of the Five Elements in Clinical Practice(1) The Five Element Attributes of the Human Body and Diseases.Let’s look at a few examples to see how the five elements are applied in clinical practice.The first exampleThere are many diseases related to hair, such as common hair loss, yellowing hair, and white hair. When seeking treatment, one is often influenced by Western medical thinking, failing to trace back to the root, resulting in unsatisfactory outcomes.In fact, understanding the following three statements makes treating these conditions much easier!The first statement: Hair is the surplus of blood.The second statement: The lungs govern the skin.The third statement: The kidneys’ essence manifests in the hair.From these three statements, we can see that hair diseases are closely related to the lungs, blood, and kidneys. In clinical practice, identifying this direction allows for targeted treatment.Patients with dry, split, or prematurely white hair can achieve good results through nourishing blood and supplementing kidney essence. The representative formula for this is the “Sheng Fa Yang Xue” (Nourishing Blood and Promoting Hair Growth) capsule, which consists of: Shu Di Huang (Rehmannia), Dang Gui (Angelica), Qiang Huo (Notopterygium), Mu Guo (Papaya), Chuan Xiong (Chuanxiong), Bai Shao (White Peony), Tu Si Zi (Cuscuta), Tian Ma (Gastrodia), and Zhi He Shou Wu (Processed Fo-Ti).Among them, Shu Di Huang, Dang Gui, Chuan Xiong, and Bai Shao are the four herbs for nourishing blood; Zhi He Shou Wu and Tu Si Zi are excellent for nourishing kidney essence; combined with Qiang Huo, Tian Ma, and Mu Guo to dispel wind and eliminate dampness, this formula is naturally suitable for alopecia areata, total alopecia, itchy scalp, excessive dandruff, oily scalp, and postpartum hair loss.For seborrheic alopecia, regulating the lung’s dispersing and descending functions can yield excellent treatment results! This statement may not be fully understood now, but I will elaborate on it in the clinical chapters.The second exampleOral ulcers are frequently encountered in clinical practice, referred to in TCM as “oral sores.” Many doctors believe they are due to deficiency fire rising, suggesting patients take “Zhi Bai Di Huang Wan,” which may be effective but not always. Some stubborn cases recur for a long time, causing great suffering to patients. In treatment, if we first consider “the spleen opens to the mouth,” and approach it from the spleen’s perspective, clearing the spleen’s damp-heat and accumulated heat often yields good results.For ulcers on the tongue, we can treat them from the heart’s perspective, achieving good results.If sores occur in both the mouth and tongue, we can approach treatment from both the heart and spleen…The third exampleWomen in their thirties or forties often develop facial spots. When treating them, it can sometimes be difficult to differentiate whether it is blood deficiency, qi deficiency, kidney deficiency, or liver qi stagnation.Some TCM practitioners diagnose them as “liver spots”; others as “kidney spots”; some simply diagnose them as “endocrine disorders,” which is irresponsible to the patient and to themselves. The endocrine system is a vast system, and almost all diseases will show abnormal changes in the pathological process. “Endocrine disorders” do not equate to “liver and kidney yin deficiency!” The diagnosis of “endocrine disorders” is too vague!In fact, as long as we think about the five-element attributes of the human body, remembering “the heart governs blood vessels, its manifestation is on the face”; “the lungs govern qi and the skin,” we can categorize facial diseases as issues of “face” and “skin,” primarily addressing the heart and lungs, regulating qi and blood, warming and unblocking the blood vessels, and naturally recovering. Of course, sometimes heart and lung issues are related to the liver and kidneys. For patients with liver qi stagnation or kidney yin deficiency, it is also necessary to regulate the liver and kidneys while treating the heart and lungs, but ultimately, do not forget that the heart and lungs are the “masters” of the face!The fourth exampleWhen encountering patients with lumbar disc herniation, osteoporosis, bone hyperplasia, or delayed healing of fractures, do not forget that “the kidneys govern the bones.” The kidneys are the source of these diseases. All diseases related to bones should be addressed from the kidneys to fundamentally resolve the issue. In clinical practice, we see that patients with lumbar disc herniation can quickly relieve symptoms through traction, and in severe cases, surgery can dissolve or remove the herniated disc, theoretically curing it, but they are prone to recurrence. This is because the patient’s kidney deficiency has not been resolved. As the patient puts it, “After the surgery, my back doesn’t hurt anymore, but I still feel weak and sore in my lower back.” Such patients will naturally experience a recurrence of their old ailments in no time. “The lower back is the residence of the kidneys.” As long as we treat the kidney deficiency fundamentally, the recurrence rate will naturally decrease.There are many such examples. As long as we understand the five-element attributes discussed above, learning TCM will be very easy because each statement corresponds to a series of diseases. Grasping the five elements is like catching the pulling rope of a fishing net when casting a net. Yin and yang, and the five elements are the guiding principles of TCM, and they are also shortcuts to learning, serving as the entrance!Understanding the five-element attributes provides insight into the classification of many diseases, but these insights may still be rough and superficial. For example, if you know that oral and tongue sores are related to the “heart and spleen,” you must also understand why the heart and spleen are problematic. Sometimes it is simply a heart-spleen issue, but other times, it may be caused by other organs. Understanding the five-element attributes is like entering the main door, but you must also enter the small door to explore the wonders of TCM!(2) The Relationships Among the Five ElementsIn addition to their inherent natural attributes, the five elements also have relationships of mutual generation, mutual restraint, mutual overcoming, and mutual insult.Mutual generation among the five elements refers to the supportive, nurturing, and promoting relationships among wood, fire, earth, metal, and water. The rules are: wood generates fire, fire generates earth, earth generates metal, metal generates water, and water generates wood.Mutual restraint among the five elements refers to the restraining and controlling relationships among wood, fire, earth, metal, and water. The rules are: wood restrains earth, earth restrains water, water restrains fire, fire restrains metal, and metal restrains wood. The Neijing refers to the restraining relationship as “what conquers” and “what is not conquered”: “What conquers me” is “not conquered,” and “I conquer” is “conquered.”Mutual overcoming refers to an excessive restraint of one element over another, leading to an abnormal restraining phenomenon among the five elements. The rules are: wood excessively restrains earth, earth excessively restrains water, water excessively restrains fire, fire excessively restrains metal, and metal excessively restrains wood.Mutual insult refers to a reverse restraint of one element over another, leading to an abnormal restraining phenomenon among the five elements. The rules are: earth insults wood, water insults earth, fire insults water, metal insults fire, and wood insults metal.Mutual overcoming and mutual insult refer to the pathological interactions among the five elements under the influence of external factors, indicating abnormal restraint among the five elements. In the human body, this represents pathological interactions.Mutual overcoming refers to excessive restraint, surpassing the normal restraining force, causing the structural relationships of the five elements to lose their normal coordination. This abnormal phenomenon generally arises in two situations:First, the restrained element is inherently insufficient, and the restraining element takes advantage of its weakness. For example, if the earth element is weak, wood will excessively restrain it (weak).Second, the restraining element is excessively strong and not restrained by other elements, relying on its strength to attack the element it should restrain. For example, if the wood element is excessively strong and not restrained by metal, wood (excess) will excessively restrain earth, damaging the earth element.Understanding mutual generation, restraint, overcoming, and insult may be challenging for beginners, but analyzing the following clinical manifestations will make it easier to comprehend!1. Understanding Mutual Generation(1) The Application of “Wood Generates Fire” in Clinical PracticeWood represents the liver, and fire represents the heart, meaning that the qi and blood supply of the heart is closely related to the liver’s smooth flow. The liver stores blood, and the rising liver qi can nourish the heart’s blood, ensuring its sufficiency. Conversely, if the liver qi is stagnant, its rising function will be abnormal, leading to insufficient qi and blood supply to the heart. Clinically, patients with long-term liver qi stagnation may experience insomnia, irritability, and palpitations due to insufficient heart qi and blood. By soothing the liver qi and nourishing the yin blood, the condition can be quickly alleviated.(2) The Application of “Fire Generates Earth” in Clinical PracticeThe heart is the sovereign, residing in the sovereign position, like the sun in the sky. The growth of all things depends on the sunlight. The sun warms the earth, allowing it to nurture all living things. In the human body, the warming effect of heart fire can warm the stomach, facilitating the digestion of food. If heart fire is weak, the stomach will be cold, and food cannot be digested, leading to symptoms such as undigested food and a lack of appetite. For such patients, supplementing heart fire can enhance digestive function.For example, a patient named Zhang, 35 years old, has suffered from bloating and indigestion for a long time. Five to six hours after eating, he still burps up undigested food. If he eats cold food, he experiences diarrhea. He has taken countless digestive medications, but none have resolved the issue. After suggesting he take TCM, I prescribed Gui Zhi (Cinnamon Twig), Xie Bai (Garlic Chives), Gua Lou (Trichosanthes), Gan Jiang (Dried Ginger), and Chang Pu (Acorus) as the main herbs, along with some digestive herbs. He was cured in a week, and his long-standing heart discomfort also improved significantly. The application of “fire generates earth” in clinical practice is to supplement heart yang, allowing heart fire to flourish, thus enhancing the stomach’s function.(3) The Application of “Earth Generates Metal” in Clinical PracticeFood enters the stomach, is digested by the stomach, absorbed by the small intestine, and then transported by the spleen to the lungs. The lungs then distribute the clear parts to nourish the skin and hair while the turbid parts descend to nourish the five organs and six bowels. The phrase “the spleen transports to the lungs” refers to “earth generating metal.”For chronic diseases, especially chronic lung diseases, regulating the spleen and stomach can significantly improve lung health. For example, a patient named Chen, 45 years old, has suffered from tuberculosis for many years and has undergone anti-tuberculosis treatment for two years but remains emaciated, coughing up blood, and lacking appetite. I suggested he consume yam porridge to nourish the spleen and stomach, aiming to cultivate the earth to generate metal. After half a month of regulation, the patient’s constitution improved significantly, and two months later, he gained 7.5 kg. Continuing to regulate while combining anti-tuberculosis treatment, the lesions calcified, and he returned to work.(4) The Application of “Metal Generates Water” in Clinical PracticeAs mentioned earlier, the lungs transport the nutrients sent by the spleen through dispersing and descending functions. The downward flow becomes the source of nourishment for the kidneys. If the lung’s descending function fails, the kidneys will lack nourishment, leading to kidney deficiency. Such patients are often encountered in clinical practice. Simply taking kidney tonics can lead to excessive heat, causing throat swelling and pain, and while the lower back may feel better, facial breakouts may occur. After stopping the medication, kidney deficiency persists. Patients often take kidney tonics and then take heat-clearing medications, only to repeat the cycle without resolving the kidney deficiency. In fact, the human body has a strong self-regulating mechanism. Our current living standards are not poor, and we do not need to take kidney tonics every day. As long as we understand that “the lungs generate the kidneys,” we can improve lung function to naturally resolve kidney deficiency.Medicinal herbs that promote lung qi include bitter apricot kernels, winter flowers, loquat leaves, ginkgo seeds, schisandra, and five-flavored herbs. Any herbs that have the effect of stopping cough and nourishing lung qi can help the kidneys. By correcting the body’s reversed qi mechanism and transforming a vicious cycle into a virtuous one, we can fully utilize the body’s self-repair mechanisms, and many difficult diseases can be resolved.(5) The Application of “Water Generates Wood” in Clinical PracticeIn nature, the growth of trees depends on sunlight, moisture, air, and soil. Without water, the earth becomes dry, and all living things wither and die. The ancients drew parallels from nature, comparing it to the human body, and summarized the valuable experience of “water generates wood,” meaning “kidney water nourishes liver wood.”In clinical practice, when encountering patients with excessive liver yang, the pathology often includes not only excessive liver yang but also insufficient liver yin (as fire is strong, water is deficient). If we only use methods to clear excess liver fire without nourishing liver yin, the liver fire will continue to rise. This explains why patients often say, “Doctor, why is my fire so strong? I have taken so many heat-clearing medications, yet it remains high.” For patients with excessive liver fire and liver yang, nourishing kidney water and liver yin will naturally prevent liver yang from becoming excessive.2. Understanding Mutual Restraint(1) The Application of “Wood Restraining Earth” in Clinical PracticeWood represents the liver and gallbladder, while earth represents the spleen and stomach. The smooth flow of the liver is closely related to the function of the spleen and stomach, just as tree roots can loosen the soil. Without the tree roots to loosen the soil, the soil will become compacted. If the liver’s smooth flow is abnormal, the function of the spleen and stomach will weaken. Borrowing from Western medicine, bile can emulsify fats; if bile secretion is insufficient or obstructed, the fats ingested by the body cannot be digested properly.(2) The Application of “Earth Restraining Water” in Clinical Practice“When soldiers come, generals block; when water comes, earth covers!” Many people often say this, but its profound meaning may not be immediately apparent. If we relate it to TCM clinical practice, it may seem absurd.In fact, this statement refers to mutual restraint: “earth can restrain water,” which is why water is covered by earth! In the human body, the spleen belongs to earth, and the kidneys belong to water. The kidneys govern water, and the spleen governs the transformation of water and fluids. With the normal function of the spleen, the water and fluids of the kidneys will not be abnormal.This explanation may seem tedious and difficult to understand, so let’s look at a case: A patient named Zhang has experienced lower back pain and soreness for three months, which is most severe before getting up in the morning and alleviates after moving. The pain worsens in cold weather and eases in warm weather. Taking painkillers like Fenbid has not provided significant relief. Taking Liu Wei Di Huang Wan has not only failed to alleviate the condition but has worsened it. The tongue is pale, the coating is white and slippery, and the right pulse is deep, slow, and tight. The patient’s lower back pain is caused by excessive cold dampness, and the root cause lies in kidney and spleen yang deficiency, leading to internal water and dampness evils. The treatment method is to warm the kidneys, strengthen the spleen, and eliminate dampness. The prescription includes fried Bai Zhu (Atractylodes), Fu Ling (Poria), Gan Jiang (Dried Ginger), Du Zhong (Eucommia), Fu Zi (Aconite), and Sheng Gan Cao (Raw Licorice). After three doses, the lower back pain disappeared.This case illustrates that by heavily using Bai Zhu and Fu Ling to strengthen the spleen and eliminate dampness, we can use “earth to restrain water” to achieve excellent results.(3) The Application of “Water Restraining Fire” in Clinical PracticeThe heart belongs to fire, while the kidneys belong to water. The kidney water rises with the liver qi, nourishing the heart fire. This physiological mechanism ensures that heart fire does not become excessive. If kidney water is deficient and kidney yin is insufficient, there will be no way to nourish the heart fire, leading to excessive heart fire, insomnia, irritability, and yellowish urine, even causing oral ulcers. For such patients, if we only clear the heart fire, it may be effective temporarily, but it will soon recur. Clearing heart fire is a symptomatic treatment, while nourishing the deficient kidney water is the fundamental treatment. With kidney water to restrain it, heart fire will naturally not become excessive.(4) The Application of “Fire Restraining Metal” in Clinical PracticeThe heart belongs to fire, while the lungs belong to metal. The lung’s dispersing and descending functions also require the strength of heart fire. For anyone with weak heart fire, they will inevitably experience coughing and kidney deficiency (metal does not generate water). For patients who cough when exposed to cold, their resistance is low, and only by supplementing heart yang can we achieve the “fire restraining metal” effect, allowing the lung’s functions to recover and completely curing the cough.In clinical practice, patients with asthma often feel coolness in their backs, and as soon as they encounter cold, they immediately cough. TCM textbooks refer to this as “hidden phlegm.” Why do normal people not experience this? Because such patients have weak heart yang, and “fire does not restrain metal,” leading to cold phlegm accumulating in the lungs. If we do not understand the underlying pathology, no amount of medication will work. Once we grasp the principles, using Dai Ge San (a TCM formula) can yield immediate results.This is the essence of TCM; once you understand it, it becomes simple. If you do not understand it, it will be difficult to achieve effective treatment. If you truly want to learn TCM, you must keep the five elements in mind during clinical practice, and when taking pulses, you must consider the state of the five elements in the body, identifying which links are problematic. Only then can you improve your diagnostic and treatment skills!Tip: This chapter elaborates on the importance of the five elements in TCM theory. By understanding the five elements corresponding to the five organs, we can systematically discuss the mutual generation, mutual restraint, mutual overcoming, and mutual insult among the five organs, as well as their clinical applications. Many diseases arise from the imbalance among the organs rather than the diseases themselves. Therefore, TCM focuses on the state of the five organs, their deficiencies and excesses, rather than the diseases themselves. Only by establishing this way of thinking can we deeply understand TCM and the five elements. Do you understand?