How Much Do You Really Know About TCM?

This is a very serious question — one I have pondered for a long time. My mind struggles to find peace, and the reflection is genuinely painful.

First of all: how should Traditional Chinese Medicine be studied, and to what level of mastery? This has been debated since ancient times. Sun Simiao, in his Da Yi Jing Cheng (On the Absolute Sincerity of Great Physicians), offered a remarkably clear answer. Allow me to quote:

“Whoever wishes to become a great physician must be thoroughly versed in the Suwen, the Jia Yi, the Huangdi Zhen Jing, the Mingtang Liuzhu, the Twelve Meridians, the Three Divisions and Nine Indicators, the Five Zang and Six Fu organs, the surface and interior acupoints, Bencao pharmacology, and the classical formulas of Zhang Zhongjing, Wang Shuhe, Ruan Henan, Fan Dongyang, Zhang Miao, Jin Shao, and others. Furthermore, one must subtly comprehend Yin-Yang destiny, the various schools of physiognomy, turtle-shell pyromancy and the Five Omens, the Zhou Yi hexagrams and Liu Ren divination — all must be mastered with fluency. Only then may one be called a great physician. Without this, one is like walking blind at night, courting disaster with every step.

Next, one must study these prescriptions thoroughly, reflect upon their subtle principles, and devote oneself to deep research — only then is one worthy of discussing the medical Dao. Moreover, one must read broadly. Why? Without the Five Classics, one cannot know the Way of benevolence and righteousness; without the Three Histories, one cannot know the affairs of past and present; without the writings of the Hundred Schools, one cannot silently recognize the patterns of events; without the Buddhist scriptures, one cannot know the virtues of compassion and charity; without Zhuangzi and Laozi, one cannot live authentically and move with the natural flow, and will instead be shackled by taboos about fortune and misfortune. As for the waxing and waning of the Five Elements, the Seven Luminaries, and astronomy — these too must be explored. If one can study all of these comprehensively, there will be no obstruction on the path of medicine, and one will achieve perfection.”

Clearly, the bar is extraordinarily high. By Sun Simiao’s standard, to be a good TCM practitioner, one must understand astronomy above, geography below, and human affairs in between —精通 all schools of thought without exception. Whether this was achievable even in ancient times is debatable; in the modern era, it is virtually impossible. Much of this body of knowledge has been dismissed as feudal superstition. The vast majority of TCM practitioners trained since the founding of New China — and even many folk practitioners active today — have barely scratched the surface of classical Chinese and traditional culture. Moreover, most have been thoroughly conditioned by modern scientific thinking, leading to significant misunderstandings of ancient patterns of thought. In my view, Sun Simiao’s standard is a reference point, but only that — and its practical value is limited.

Consider the selection criteria for the National Senior TCM Expert Academic Experience Inheritance Program. Those in the field know that being selected for this program essentially confers the title of National-Level Distinguished TCM Physician. The national standards are relatively relaxed: one must hold a full senior professional title, have at least 30 years of clinical experience, and possess some academic achievements. Beyond that, the selection process is in the government’s hands.

Notably, whether for National-Level Distinguished Physicians or the even more prestigious title of Guo Yi Da Shi (National TCM Grand Master), applicants are required to submit their outpatient volume — but no hard minimum is enforced. This is deeply problematic. Many senior physicians are not particularly passionate about clinical work and may be mediocre practitioners. Yet because of their seniority, reputation, and positions within the institutional hospital system, they have no shortage of patients. Under China’s unique healthcare system, outpatient numbers are both uninformative and highly informative. When practitioners of limited clinical caliber are elevated as benchmarks, the consequences are far-reaching — the ripple effects distort the entire landscape.

It follows that using professional titles and seniority as measures of TCM competence is clearly inappropriate. One cannot simply assume that senior experts or National Grand Masters possess superior skill. They may well be more learned and experienced — but what is the benchmark? Compared to sages? That comparison fails. Compared to novices? That comparison is meaningless. Pitting them against each other? Unthinkable!

We often hear senior experts in their sixties and seventies say that they feel they have only just begun to grasp TCM — that they are only now starting to truly understand it. I can relate, because I myself now feel that I have finally crossed the threshold of TCM. I am finally beginning to understand something — to comprehend what the ancients meant, to imagine their state of mind as they wrote their texts, and to feel it empathetically. But can this sense of “entering the door” truly be called understanding? The feeling is, after all, rather subjective. Can we be more objective?

All of this still demands further study.

中文原文 / Chinese Original