Establishing a Correct View of Life and Values (Part 1) (2012-09-02)
Establishing a Correct View of Life and Values (Part 1)
Xu Wenbing
2012.9.2
I have brought a small gift: the recording from 2009 when Liang Dong and I spoke on the Huangdi Neijing on Central Broadcasting Station — the recording version, which differs from what was aired. Unabridged. What was thought feudal, superstitious, dross in TCM — can we stand on another angle and ask whether it has a specific meaning and reasoning? In that program I spoke on five chapters of the Huangdi Neijing; the Shanggu Tianzhen Lun speaks to establishing a correct view of life. The Chinese have their own view of how to be a person, how to be a healthy person.
Though I learned medicine from my mother from childhood and have childhood foundation, let me tell you: many famous physicians of history learned medicine only after age 40 — and learned to high accomplishment. Why? All the prior literature, philosophy, life experience is help for studying medicine. So now I greatly favor what I call post-bachelor education in TCM. Think — a high-school student studies a few years in a TCM college and comes out a doctor. Some have never had a girlfriend, never touched a girl's hand. The patient says, my husband and I fought, I cannot sleep — how will you reason with her? Speaking from experience or without — can it be the same?
I do not believe those who oppose TCM can extinguish it. My mother's teacher said: "The one who extinguishes TCM is TCM itself." If a TCM insider does not study seriously and does not treat patients well, in the end he loses people's hearts and trust. So those of us in practice must be the more careful.
Remembering the Forebear
Yueli — Cui Yueli. Who was he? Cui Yueli was our country's former Minister of Health, originally surnamed Zhang, named Zhang Guangyin, of Shen County in Hebei. He worked as an underground party member in Beiping; the film Pingjin Campaign shows the figure of Minister Cui. After Liberation, Cui served on the leadership of the Beijing municipal government, but during the Cultural Revolution he was imprisoned for eight years. After the Third Plenum of the Eleventh Central Committee, Cui Yueli returned; in 1982 he became our country's Minister of Health. As people in TCM circles, we must not forget the elder Minister's promotion and development of the TCM cause.
Some say: as Minister of Health, of course he should develop TCM — that is the duty of the office; what is there to remember? Let me tell you something many do not know. After 1949, the Ministry of Health's regular leadership — Wang Bin and He Cheng — set policies aimed at abolishing and extinguishing TCM. They wholly inherited the Republican-era Yu Yunxiu line — remake TCM, then gradually wipe it out. Every measure cut to the root of TCM. First, doctors had to register and take exams — in Western medicine. Fail and you could not practice. Second, abolish the master-apprentice system. Third, abolish TCM schools. People think TCM colleges were founded after 1949. Not so. Beijing had its Four Famous Physicians — Kong Bohua founded the first, Beiping Guoyi College. Later Shi Jinmo founded North China Guoyi College — both before 1949, even surviving under the Japanese-puppet rule, trained many TCM practitioners. By these policies all were abolished. This dire state was found in time by Chairman Mao and Premier Zhou — because some top senior TCM practitioners worked on their health, and these elders said this was a matter of cutting off the line of descent. Chairman Mao then inscribed: "Chinese medicine is a great treasure-house." In 1956 those two backward-running heads of the Ministry of Health were removed, and on the nation's name, TCM colleges were opened. First an Academy of TCM — a national-level TCM research institution. And four TCM colleges — Beijing (my alma mater), Chengdu, Shanghai, Guangzhou. So TCM met a phase of great post-Liberation development.
But these TCM colleges had a problem. Because our country had no precedent for so large a TCM education, we went wholly by the Western-medicine model — in fact by the Soviet Western-medicine model. By the Cultural Revolution, this hard-built accumulation was destroyed. The old professors at TCM colleges — Ren Yingqiu, Dong Jianhua, Chen Shengwu, Hu Xishu, Zhao Shaoqin — were heavily struck during the Cultural Revolution. Classes all stopped; professors and teachers were sent down to the countryside under the 6-26 health directive; the whole school was thrown into disorder.
After Minister Cui took office, he did several things. First, putting the development of TCM into the Constitution was done under his advocacy — a great matter. Second, in 1982 Minister Cui chaired the Hengyang Meeting — full title National Conference on Work in TCM Hospitals and TCM Higher Education — to solve the problem of TCM being surnamed TCM. At the time the slogans TCM scientization and TCM modernization had pulled TCM out of all shape. In TCM-college curriculum, Western-medicine weighted heavily. The senior professors had an evaluation: our TCM college's six years produces two middle-school graduates — Western medicine to middle-school level, TCM to middle-school level. TCM hospitals were heavily westernized: do inspection, listening, asking, palpation — people think you crude; order chemistries, CT, MRI — they think you scientific. After the 1982 meeting under Minister Cui's chairmanship, TCM textbooks, courses, and hospital character were greatly promoted in their TCM identity. Minister Cui also chaired the rehabilitation of unjust cases in TCM, releasing many reactionary academic authorities. As Cui's son, Zhang Xiaotong runs the Pingxintang clinic; that so many senior specialists could be invited to consult there, I believe, comes of those elders' gratitude to Minister Cui.
I came out of a TCM college, and the contributions Cui made gave TCM a sunny spring — and I was the direct beneficiary. I entered Beijing TCM University in 1984; the textbook we read was the fifth edition — comparable to the second edition of the early 1960s — which weeded out much pseudo-scientific, pseudo-integrationist content and restored basic TCM concepts. So my six years of college were on fairly orthodox texts. Cui also restored TCM clinics — because large hospitals had to westernize for income. So in 1986 on Sundays I rode my bicycle and followed my teachers, the elder Liu Duzhou or Pei Yongqing, to a small clinic to copy prescriptions — and saw with my own eyes TCM, simple, convenient, cheap, effective, without external aid, cure illness. So I say I am a direct beneficiary.
Later, what Minister Cui feared came to pass: westernization of TCM. My 1984 class of 120 in TCM — set aside those who went into administration, editing-and-publishing, drug sales — left as doctors maybe 80; those who truly practice TCM? Yes, all in TCM hospitals — but without chest X-ray, can the pulmonology see patients? Without steroids, can you treat asthma? Nephrology — how do you treat? Of the 80, those purely making a living by TCM: five.
By the early 2000s came several chilling things. First, abolish resident clinicians (TCM in pharmacies) — aligning with international. TCM clinics — said to be encouraged, but with high thresholds. And no multi-site practice — if I see at Yuyuantang and at Pingxintang, I am illegal. These were spells set on our heads. TCM slowly slipped, worst in 2006 when Fang Zhouzi and Zhang Gongyao launched the abolish TCM campaign — the mountain rain to come, wind fills the tower; black clouds press the city to ruin. Director Zhang Xiaotong then struck the table and said we must do something. He invited Pingxintang's TCM specialists to give free public lectures. Many benefited. Six years on, I meet Beijing-TCM-University graduates now practicing — they greet me: Teacher Xu, thank you; back then we heard your lectures at Pingxintang. Our wavering hearts firmed up.
After 2007 TCM met another small spring. TCM private clinics grew; TCM lectures on TV and radio grew; resident clinicians were restored; from single-site practice, multi-site is now allowed. Beijing has just issued 18 articles encouraging TCM clinics — a rare post-Liberation chance to develop.
The reason we remember Minister Cui: he was a statesman, not staring at petty gain. He placed TCM at national strategy height, and so TCM had a better stage.
TCM's Wisdom
Many say: drugs produced in our country are Chinese drugs. TCM speaks of daodi (place-of-origin) herbs — chuanxiong, zhebei, Shanxi dangshen, huangqi, Northeast wild renshen... Not so. TCM has many imported drugs — ruxiang, moyao — not produced in China. Why are these still called Chinese drugs? It does not matter where they grow — even on the moon — so long as they are used under TCM theory, they are Chinese drugs. Many argue: they are effective regardless of theory. From the Republican era on, there has been talk of abolish-medicine, keep-the-herbs — meaning TCM is useless, Chinese herbs useful. I ask: give you a dish to cook with the same ingredients — why is your dish not the same as a chef's? In chess, the pieces are useful, the player useless? Then let us compare who has more pieces? Shallow, coarse people see only the form, not the thought behind it. So in the war with Japan, why did many turn to the Japanese? Weapons-only-ism: they had tanks, grenade-launchers, the 38-type rifle; we had red-tasseled spears, the Hanyang-made. But who won in the end? Likewise: a band needs only players, no need for a conductor; a soccer team goes out and plays, no need for a coach. So in beginning with Chinese drugs, I want to make clear what TCM is.
Broadly speaking, our PRC has 56 ethnic groups. Broad TCM includes many of these traditions — Tibetan, Mongolian, Yao, Dai, Zhuang. What we study today is narrow TCM — the Han Chinese medicine — which comes from China's most ancient Daoist transmission. We know the Huangdi Neijing; before Huangdi was Shennong; before Shennong, Fuxi. This is one line of transmission — the Daoist philosophical line — and the diagnostic-medicinal-acupuncture-massage-guasha-tuina methods under this thought are TCM.
Low-level people compare things; high-level people do not look at the thing but at what is behind the thing. They always say TCM is xuan xue (the dark study). In China xuan xue is pejorative, but I take it as praise. Why? Those who research the abstract are advanced. Put a board and pieces and play — that is low-level. The expert? Plays blindfold chess. Going to the front-line is the jiang (general); planning within the tent, deciding victory a thousand li away — not seeing the concrete — that is high-level. Some say: don't play xuan; I say only those who can play xuan are masters. Xuan xue is high abstraction; it is precisely because of this xuan xue that there is concrete application. If TCM cuts off the xuan, TCM is finished.
The world is material. But I ask: what is behind the material? Divide a piece of chalk endlessly — what is it in the end? A tumor on the body is material — but what was its initial state? Now we say: research must go to the molecular-biology level. What is behind the molecule? Atom? And after the atom? What at the end? Everyone knows wave-particle duality. Is light matter or motion of energy? Cannot be said. So first one should study TCM's jingqi-shen theory — you will know the world is not only material.
Second, yin-yang and five-phase theory explains the universal connection and the development-and-change of things. The wisdom of the ancient Chinese tied together what seemed unrelated and found their inner law.
We must also study TCM zàng-xiàng theory. Zàng-xiàng is not anatomy. Anatomy sees what has form and substance — cut open a stomach, that is anatomy; but it cannot answer why the stomach peristalses, why not, when, why not, why an ulcer grows on the stomach wall. People say: you don't study anatomy. We do — but only anatomy is useless. You must explain what is behind the anatomy. Then it has meaning — then it is TCM.
The traditional character for medicine — yi (醫) — describes the TCM treatment act: a person wounded by an arrow comes to a physician for treatment; the physician uses alcohol for anesthesia and disinfection. Beneath is the character wu (巫 — shaman). Over many years our education has made wu pejorative — witches and necromancers. I say: one who can summon spirits is high-level. One who can connect with heaven, earth, ghosts, and spirits is high-level. Many say TCM must be studied critically, selectively. Who do you think you are? Some TCM doctors say: I feel ashamed — our ancestor was a wu. In my definition, wu is the highest intellectual of the Chinese people, the descendants of Yan and Huang — something to be proud of.
On culture (wenhua): many Chinese words sound familiar — ask what they mean and people are uncertain. I summarize it as: wenzi (writing) and jiaohua (transformation by teaching). Two concepts. Writing carries the Way — the Way can be expressed in a small part through writing, but the larger part cannot even be reached by writing. So the ancients said sages teach by oral transmission and heart-to-heart transmission — not dwelling in writing, pointing directly to the heart. So to learn TCM's culture two means: borrow the surviving ancient texts — recognize characters, read the books. But don't think memorizing the Huangdi Neijing makes you a TCM. Zhuge Liang said of useless scholars: "Searching for chapters and seeking lines till the head is white, exhausting the classics — though a thousand words from his pen, in his heart not one stratagem." Paper-talk. So jiao — teaching — is needed. What is teaching? Teacher passes on, brings along, by word and personal example, infects. Why did the ancient apprentice serve the master for three years? You think it was child labor abuse? It was teaching — invisible influence, a shaking and shaping of the heart.
This year I am 46; from my own experience of studying medicine, two directions are needed: writing — reading; and apprenticing — practicing. We say xuexi (study); translate as study. I say your shallow English profanes our Chinese language. Xue and xi are not the same. Xue is I speak you listen, you read. Xi is going to practice. The oracle-bone form of xi shows two small birds flying under the sun: when fledglings leave the nest, they follow the old bird in stumbling flight — that is xi. Most people only sit and natter. Many TCM doctors say I can cure cancer. I say: don't speak of curing cancer — today I catch cold and fever, can you cool it for me tomorrow? Don't worry about others not acknowledging you, always wanting to land a big one. Look at the children's hospital queues, the anxious parents holding their children. The reason I copied prescriptions under Teacher Pei Yongqing: I saw he never went above three doses to drop a fever — usually half a dose did it. The teacher said something amusing: what is the Shanghan Lun for? It begins with fight colds. After studying Shanghan Lun one cannot treat a cold? So everyone, sit-and-discuss, then rise-and-act.
And in studying TCM, do not aim too high. Don't think I told you a formula today and out you go saying you can cure this and that — you will harm people. There was once a scholar who tried military examination — missed the target, killed the target-keeper; tried civil exams — failed repeatedly; then studied medicine. When he was ill himself, "he wrote his own prescription, took it, and died." So do not crave the quick.