My Thoughts on Learning Traditional Chinese Medicine

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This article was converted by Jianyue SimpRead; the original source is mp.weixin.qq.com

Yesterday, while discussing with a friend, I reflected on how—despite eight years of studying medicine—we remain deeply puzzled about how exactly to learn Traditional Chinese Medicine (TCM). I often recall my freshman and sophomore years, when my TCM studies repeatedly led me down divergent paths; despite earnest searching, I found no clear direction. Last night, however, after deep reflection, I realized that these “divergent paths” are not necessarily wrong ones—what matters is simply how one walks them. Tossing and turning, unable to sleep, I finally got up and walked over to Western Mahua (a local eatery), where I devoured a large bowl of beef noodle soup. Then, retracing my steps—both literally and figuratively—I reviewed my journey thus far, hoping it might serve as a reference for fellow learners and as a cautionary tale. More boldly still, I venture to discuss the fundamental differences between Chinese and Western modes of thinking—and how those differences shape the learning of TCM. Though this may invite ridicule from experts, it remains worth reading.

I come from a modest family with no surplus wealth or inherited prestige. Yet I have enjoyed basic sustenance and the luxury of focusing fully on my studies without needing to hustle for survival—a privilege owed entirely to my parents’ sacrifices. That said, I had no family tradition of medical practice, nor did I have access to renowned masters or accomplished peers. After the national college entrance exam, having grown weary of English and mathematics, I enrolled in the eight-year integrated program in Acupuncture and Tuina at Beijing University of Chinese Medicine. Fortunately, I retained an interest in traditional culture, and upon entering university, I found joy in spending time in the library. There, under Professor Bao Chun’s guidance, I learned his three core reading principles: “Only read the table of contents,” “Opening a book is always beneficial,” and “Opening a book—even just a little—is better than never opening it at all.” Thus, I began reading extensively from classical TCM theoretical texts—but only superficially, forgetting most of what I read soon after finishing. Worse yet, at that stage, I lacked discernment: I bounced restlessly among different schools of thought and lecture series, self-satisfied and emotionally moved by my own apparent diligence. In reality, however, theory remained disconnected from practice, resulting only in internal contradictions—and ultimately, no real understanding. Meanwhile, recommended by senior student Wei Xuejing, I began clinical observation with Professor Wang Yin at Guang’anmen Hospital, gaining my first glimpse of acupuncture—but still with almost no hands-on experience. By sophomore year, my impatience and restlessness intensified. At one point, I even concluded that TCM held little worth learning, and seriously considered switching to Western medicine instead—so much so that I collected Peking Union Medical College’s curriculum to emulate it. But, as usual, my enthusiasm lasted only three minutes. Around this time, my roommate Qinglin—a scion of an acupuncture family—was already independently managing many common conditions. Yet the saying went, “The masters of Jiangnan guard Zhang Zhongjing’s texts like secrets, refusing to transmit them.” This further discouraged me from pursuing acupuncture. On the other hand, I was fortunate to assist Professor Ya Ru with animal experiments and work alongside Professor Bao Jin on academic-historical literature research—two mentors whose teachings continue to benefit me profoundly to this day. Later, during the pandemic, I studied the Shanghan Lun (Treatise on Cold Damage) via online classes at home. It was precisely during this period—when much of my time was devoted to academic-historical research under Professor Bao Jin—that I first encountered Professor Huang Longxiang’s scholarship. Slowly, haltingly, I read several of his books; gradually, almost imperceptibly, my interest in acupuncture reawakened. So, in graduate school, I chose Acupuncture and Tuina as my specialization, studying under Professor Zhao. Moreover, benefiting from a relatively relaxed academic environment, I observed clinical practice outside class hours with senior clinicians—including Master Xing and others both within and outside the formal healthcare system—and have since been conducting independent outpatient consultations for over a year.

In research, I have engaged in basic laboratory science and published in SCI-indexed journals; conducted literature reviews and academic-historical studies, publishing in Zhonghua Zhongyi Yao (Chinese Journal of Traditional Chinese Medicine and Pharmacology); and acquired foundational philological literacy. Clinically, I have observed numerous masters—from folk practitioners possessing extraordinary abilities to elite physicians within the formal system; attended paid courses and free clinics alike—and accumulated basic personal clinical experience and insights. As graduation approaches, I feel compelled to record these reflections. Of course, everyone has their limitations. For instance, masters from TCM lineages may find it incomprehensible why I struggled so hard to learn TCM—or dismiss such writing outright. Still, I hope documenting this will prove useful to others. I hope fellow learners can resist the prevailing pressure for quick results and avoid being swept up in self-defeating competition and burnout—instead finding their own path, learning TCM joyfully, steadfastly, calmly, and patiently. And I hope future generations of TCM students will have a clearer roadmap—so that the hardships we endured need not be repeated.

Now, finally, let us turn to the central question: How should one learn TCM? This inevitably leads us to examine what I understand as the fundamental differences between Chinese and Western modes of thinking—and what, precisely, gives TCM its unique advantages and enduring significance. My perspective here has been significantly shaped by Professors Huang Longxiang, Huang Zifeng, and Lu Shengsheng.

Here is an excerpt from Teacher Gemini’s comparison of Chinese and Western ways of thinking:

1. Cosmology: Organic Wholeness vs. Mechanistic Reductionism

China: Generative cosmology and unity of Heaven and humanity. Ancient Chinese thinkers tended to view the universe as a vast, living organism—continuously generating and evolving itself. Nothing exists in isolation; all things exist in dynamic interplay through Qi-transformation and the alternating rhythms of Yin and Yang. To understand phenomena, one habitually seeks answers from the macro-level context—climate, environment, and interactions with surrounding entities.

West: Constitutive cosmology and the “clockwork universe.” From ancient Greek atomism to Newtonian mechanics, Western tradition has predominantly conceived the world as a highly intricate machine. Its method of understanding is “deconstruction”: if one disassembles the machine into its most basic gears and springs (e.g., elementary particles, cells, genes) and clarifies each component’s function, the whole mechanism’s operation becomes fully comprehensible.

2. Cognitive Focus: Relational Networks vs. Essentialist Attributes

China: Focus on “events” and “networks.” In cognition, Chinese thought emphasizes where a thing stands within a relational network and how it interacts with other things (e.g., mutual generation and overcoming). A thing’s attributes are determined by the system in which it resides. For example, when diagnosing localized pathology or surface ulcers, one does not focus solely on the affected tissue itself but views it as a local manifestation of systemic imbalance in Qi and blood—and applies holistic regulatory principles (e.g., xiao [elimination], tuo [support], bu [tonification]) to adjust the broader environment, thereby facilitating natural healing processes like necrotic tissue removal and granulation.

West: Focus on “objects” and “substances.” Western thought tends to seek the absolute essence and intrinsic attributes of things independent of external context. In scientific inquiry, this manifests as ever-deeper probing into the microscopic realm—to identify singular, decisive targets, bioactive compounds, or specific signaling pathways.

3. Epistemology: Empirical-Intuitive Synthesis vs. Logical-Positivist Analysis

China: Image-based thinking and experiential insight. Long-term macro-observation and accumulation of historical experience form the basis for grasping patterns (qu xiang bi lei, “drawing analogies from observable phenomena”). This mode of cognition is typically synthetic and intuitive, excelling at distilling highly generalized patterns from broad surface phenomena—yet comparatively silent on precise quantitative description.

West: Formal logic and mathematical quantification. Rigorous logical deduction (e.g., axiomatic systems) and empirical verification are paramount. Knowledge must be precisely and objectively defined, routinely expressed through absolute frequencies and stringent statistical criteria (e.g., support, confidence intervals), and every conclusion must rest on reproducible experimental data.

Teacher Gemini articulates this exceptionally well. Indeed, traditional Chinese thought abounds in qu xiang bi lei, association, and metaphor: ancient thinkers seemed remarkably adept at linking phenomena across disparate domains and extracting universally applicable principles. Consider classical Chinese prose taught in high school: ministers advising monarchs frequently cited natural phenomena—for instance, the fable “The snipe and the clam struggle, and the fisherman profits,” used to mirror interstate relations and counsel sovereign conduct. Snipes, clams, and statecraft share no intrinsic connection—yet ancient sages effortlessly unified their underlying principles, assuming laws derived from one domain could map onto others. Within this framework, it is unsurprising that pangolin scales’ reputed lactation-promoting effect was explained as “since pangolins burrow through earth, they must also ‘penetrate’ blockages in lactation.” I believe the strength of this mode lies in its ability—when encountering novel phenomena or newly recognized functions—to rapidly retrieve existing knowledge frameworks and employ analogy to infer new patterns and operational logics, or to locate novelty within its environmental context. Take Wu Xing (the Five Phases): five dynamic states of motion, encompassing virtually all developmental patterns observable to ancient people—thus readily projected onto medicine, military strategy, and beyond, yielding theories such as the Five Zang-organs. Such high abstraction and cross-domain association greatly enhances theoretical flexibility and explanatory power.

Let me offer a concrete example: in Mr. He Shaoqi’s Reading Doubts and Clinical Insights, there is a case where Bu Zhong Yi Qi Tang (Tonify the Spleen and Augment the Qi Decoction) successfully treated corneal ulceration.

The “image” (xiang) of corneal ulceration is depression; depression calls for lifting and uplifting—hence the use of Bu Zhong Yi Qi Tang, a formula renowned for its lifting action. This exemplifies flexible, adaptive clinical reasoning at its finest.

So, what is the cost?

We know human joints cannot simultaneously maximize both stability and mobility: the shoulder joint enjoys great range and flexibility but is prone to dislocation; the hip joint is more stable but less mobile. Similarly, traditional TCM theory and its underlying mindset may suffer from excessive flexibility and philosophical abstraction—so elevated that beginners struggle to ground it in tangible reality. In TCM theory, we observe that nearly any phenomenon can be “explained”—any disease linked to any organ through some theoretical bridge. Tragically, however, this flexibility dilutes theoretical stability and precision: explanations fail to anchor in concrete, observable phenomena. The physiological and pathological descriptions in the Huangdi Neijing (Yellow Emperor’s Inner Canon) may reflect perceptual capacities exceeding ours today—or may be shaped by historical contexts now irretrievable. The sensory foundations of TCM physiology and pathology have vanished; their certainty eludes direct apprehension by modern learners—leading to increasingly vague interpretations of classical texts, with theoretical discourse often collapsing into speculative exegesis of the Neijing alone. Formulas are casually described as regulating “the complete circulation of one Qi,” acupuncture as “shifting spirit and transforming Qi.” Clearly, beginners find no firm foothold in TCM—receiving no definite feedback—while only lineage heirs and those gifted with innate aptitude claim mastery of “TCM’s essence” or “ancient TCM.” As ordinary learners, we grow ever more bewildered and lost.

So, what should we do?

Let us turn to Chairman Mao’s On Practice (excerpted; subheadings added by me; quoted text is verbatim):

1. The First Stage of Cognition—Sensory Knowledge

“There are two points here that must be stressed. First—as stated earlier and repeated here—the issue of rational knowledge depending on sensory knowledge. In the history of philosophy, the ‘rationalist’ school acknowledges only the reality of reason, denying the reality of experience—holding reason alone reliable, while sense-experience untrustworthy. This school errs by reversing objective fact. Rational knowledge is reliable precisely because it originates in sensory knowledge; otherwise, it would be water without a source, a tree without roots—merely subjective, unreliable fabrication. In the order of cognitive development, sense-experience comes first. We stress the significance of social practice in cognition because only social practice initiates human cognition—only through interaction with the objective world does sense-experience arise. A person blind and deaf, utterly cut off from the objective world, has no cognition whatsoever. Cognition begins with experience—this is materialism in epistemology.”

2. The Second Stage of Cognition—Deepening from Sensory to Rational Knowledge

“Cognition requires deepening; the sensory stage must advance to the rational stage—this is dialectical materialism in epistemology. If one believes cognition can halt at the lower sensory stage—if one holds only sensory knowledge reliable while dismissing rational knowledge as unreliable—one repeats the historic error of ‘empiricism.’ This theory errs by failing to recognize that although sense-data indeed reflect certain objective truths (a point empiricists rightly affirm), they capture only partial, superficial aspects—rendering such reflection incomplete and incapable of revealing the essence of things. To fully reflect reality—the totality of things, their essential nature, and internal regularities—one must apply mental processing: refining rich sense-data by separating the essential from the inessential, the true from the false, connecting this with that, and penetrating from surface to depth—thereby constructing systematic concepts and theories. Only then can cognition leap from the sensory to the rational. This transformed cognition is not emptier or less reliable, but rather—provided it is scientifically refined on a practical foundation, as Lenin noted—more profound, accurate, and complete in reflecting objective reality. Vulgar pragmatists do not proceed thus: they honor experience while belittling theory, thus failing to grasp the full objective process, lacking clear direction or long-term vision, and smugly satisfied with isolated successes or narrow insights. Guiding revolution, such people lead it straight into dead ends.

Rational knowledge depends on sensory knowledge; sensory knowledge must develop into rational knowledge—this is dialectical materialism in epistemology. Neither philosophical ‘rationalism’ nor ‘empiricism’ grasps the historicity or dialectical nature of cognition—though each contains partial truth (referring here to materialist, not idealist, versions)—yet both are fundamentally erroneous in the full scope of epistemology. This dialectical-materialist movement—from sensory to rational knowledge—applies equally to small cognitive processes (e.g., understanding a single object or task) and large ones (e.g., comprehending society or revolution).”

3. The Third Stage of Cognition—Interaction Between Rational Knowledge and Practice

“Yet cognition does not conclude here. Dialectical materialist cognition, if stopping merely at rational knowledge, addresses only half the problem—and for Marxist philosophy, the less important half. Marxism deems the crucial issue not merely understanding the objective world’s laws to explain it, but using that understanding to actively transform the world. For Marxism, theory matters immensely—as Lenin put it: ‘Without revolutionary theory, there can be no revolutionary movement.’ Yet Marxism values theory only and precisely because it guides action. If correct theory remains mere talk, shelved and unpracticed, it loses all meaning. Cognition begins in practice, yields theoretical knowledge through practice, and must return again to practice. The active role of cognition appears not only in the leap from sensory to rational knowledge, but more importantly in the leap from rational knowledge to revolutionary practice. Knowledge of objective regularities must be applied back to practice—back to productive labor, revolutionary class struggle, national liberation struggles, and scientific experimentation. This is the process of testing and developing theory—the continuation of the entire cognitive process. Whether theoretical knowledge corresponds to objective truth—a question left unresolved, and unresolvable, in the earlier sensory-to-rational movement—can be fully settled only by returning rational knowledge to social practice: applying theory in practice to see whether intended outcomes are achieved. Many natural sciences are deemed ‘true’ not only when their founders constructed them scientifically, but when later scientific practice confirmed them. Marxism-Leninism is deemed ‘true’ not only when Marx, Engels, Lenin, and Stalin scientifically formulated it, but when later revolutionary practice confirmed it. Dialectical materialism is universal truth because no human practice escapes its scope. Human cognitive history shows that many theories’ truth is incomplete—and practice corrects that incompleteness. Many theories are false—and practice corrects those errors. Hence, ‘practice is the criterion of truth’; hence, ‘the standpoint of life and practice must be the primary and fundamental standpoint of epistemology’—for precisely this reason. As Stalin aptly stated: ‘If theory is not linked to revolutionary practice, it becomes theory without an object; likewise, if practice lacks revolutionary theory as its guide, it becomes blind practice.’”

Returning to our earlier question: Why do TCM lineage heirs and those endowed with exceptional talent possess greater confidence and assurance in learning TCM? The former have already completed the accumulation of sensory knowledge in advance; the latter possess superior capacity to acquire such knowledge. Crucially, both remain at the first stage of cognition—with little relation to theoretical architecture. In other words, within the cognitive process, theory fails to achieve its purpose of “fully reflecting the totality of things, their essential nature, and internal regularities”—so that newcomers cannot rely on this theory for precise clinical guidance. Only after prolonged clinical accumulation—acquiring sufficient sensory material—can existing TCM theory be partially interpreted and “accurately understood.”

If this were all, it would pose no serious problem—merely requiring more time spent accumulating clinical experience, since “TCM’s vitality lies in clinical practice” (Professor Xiong Jibai, National Master of TCM). Yet we find ourselves severely limited in “putting ourselves in ancient shoes”—in perceiving the world as ancients did—due to the absence of their possibly heightened perceptual faculties and their distinct linguistic and socio-environmental context. Here, “heightened perception” is no mystical excuse: consider how widespread electronic device usage has rendered myopia nearly ubiquitous today. In fifty or sixty years, perhaps our grandchildren will be born nearsighted. Should a naturally clear-sighted “ancient” suddenly appear, wouldn’t we marvel at their “heightened perception”? As the Dao De Jing says: “The five colors blind the eye; the five tones deafen the ear; the five flavors dull the palate; galloping and hunting madden the heart; rare goods impede proper conduct.”

The On Contradiction states: “In the order of human cognitive development, one always proceeds from recognizing individual and particular things toward recognizing general ones. People first grasp the particular essences of many distinct things, then progressively generalize to comprehend their common essence. Once this common essence is understood, it serves as guidance for continued study of hitherto unexamined or insufficiently researched concrete phenomena—revealing their particular essences, thereby enriching, supplementing, and developing knowledge of the common essence, preventing it from becoming barren and rigid.” If the bridge from “sensory to rational knowledge” is blocked, theoretical interpretation becomes rigid, flawed—and even devolves into “using the Six Classics to interpret me” (Liu Jing Zhu Wo). Historically, this phenomenon appears to have recurred across dynasties.

Another issue: in TCM academia, the third cognitive step—revising theory through practice—seems rarely undertaken. We elevate the Neijing to unquestionable authority; theoretical discussion halts abruptly before the declaration: “The Neijing says so.” Yet—as argued above—is our understanding of the Neijing truly the Neijing, or merely a product of “using the Six Classics to interpret me”? This creates a theoretical paradox.

The On Contradiction notes: “Our dogmatists err here in two ways: first, they fail to study the particularity of contradictions—failing to recognize the particular essence of individual things—and thus cannot fully grasp the universality of contradictions or the common essence of diverse phenomena; second, they fail to recognize that, once the common essence is known, one must continue studying newly emerging or inadequately researched concrete phenomena. Dogmatists are lazy—they refuse arduous study of concrete things, treating universal truth as something arising out of thin air, transforming it into purely abstract formulas inaccessible to human grasp, wholly denying and inverting the normal human order of truth-seeking. They also misunderstand the interconnection between the two stages of human cognition—from particular to universal, and from universal back to particular—and thus completely misunderstand Marxist epistemology.” We see that the Huangdi Neijing, TCM’s “universal truth,” is trending toward being perceived as “arising out of thin air,” “inaccessible,” and “uninterpretable.” Often, we merely use the Neijing to validate our preconceptions—not to study the Neijing itself.

Having laid out these problems, what should TCM practitioners and learners do? Admittedly, I lack extensive professional experience and my sensory accumulation remains insufficient; these are merely reflections drawn from my eight years of TCM study.

Regarding my familiar field—Acupuncture and Tuina education—the first priority is establishing clinical anchors and targets. Practically speaking: after grasping foundational TCM concepts, learn techniques before theory. We need opportunities and capabilities to directly perceive the human body; only after acquiring such immediate, embodied experience can classical theory yield deeper insights. What we require are repeatable, concrete, non-vague anchors and targets for evaluating “therapeutic change.” Two viable approaches, validated through my own practice, are:

1. Enhance perception: Improve perceptual acuity to approach ancient levels—and leverage modern technologies and training methods to deepen understanding of classical theories rooted in heightened perception. Then, continually develop theory via the cyclical process: sensory experience → rational-theoretical construction → practical verification → renewed sensory experience, ensuring theory stays grounded and accessible in contemporary terms. Though challenging, this is certainly achievable: for most people, perceptual development has barely begun—not yet reaching the threshold where innate talent dominates. Useful references include Western works like The Complete Book of Palpation, Visceral Manipulation, Craniosacral Therapy, and Awareness Through Movement; Eastern resources such as Zangfu Tu Dian Xue Fa (Illustrated Point-Pressing Methods for Internal Organs) and Tianzhen Anmo Xue (The Science of Innocent Massage); qigong practices like the 28-Posture Yijin Jing (Muscle/Tendon Changing Classic), Lu Shengsheng’s Tong Du Zhan Zhuang Fa (Spinal-Du Channel Standing Meditation), and Wuji Zhuang (Limitless Posture) from Slow Learning TCM; and even Taijiquan and Baguazhang.

2. Master concrete foundational material: Prioritize anatomical reality—understand human structure—and master definitive, indirect knowledge (i.e., knowledge distilled from others’ sensory experience, not one’s own). Regardless of whether one regards TCM zang-fu as “functional abstractions,” the physical organs, muscles, and nerves undeniably exist. Some classical descriptions of zang-fu relationships have already found structural explanations and validation—but most await rigorous examination. For example, in the syndrome “Liver Qi invading the Stomach,” does the lesser omentum—the physical link between liver and stomach—exhibit simultaneous tension or rigidity? This is directly palpable yet rarely enters traditional diagnostic awareness. Such observations can enrich traditional pattern differentiation and stimulate deeper inquiry into the relationship between “abstract functional zang-fu” and “physical zang-fu.” These discussions must move beyond classical texts, ancient manuscripts, brainstorming, or armchair theorizing—grounding instead in definitive anatomical knowledge and employing repeatable, relatively stable, or partially quantifiable indicators—such as palpation findings, visceral rhythm perception, and pulse changes—as the sensory data and primary evidence needed to close the loop: practice → theory → practice.

Thus, I propose that combining these two approaches—enhancing perception to strengthen sensory acquisition, and drawing on definitive knowledge as theoretical bedrock—ultimately centers the human being as subject, enabling deeper understanding of physiology and pathology to guide clinical practice. When supervising junior students in clinic, I first perform pulse diagnosis and physical examination; students then attempt the same, comparing their findings with mine to gain initial sensory experience. Only then do we analyze theoretically—followed by acupuncture or tuina intervention—and re-examine pulse and physical signs. If expected changes occur, the cycle closes. If not, we analyze why: Is theory incomplete? Is technique inadequate? This iterative process continuously refines our understanding of physiology/pathology and theory—and, with accumulating experience and sensory data, enables us to develop and revise theory.

Finally, another illustrative example:“The Su Wen · Jin Kui Zhen Yan Lun” states: “The east wind arises in spring; diseases associated with it affect the Liver, and its Shu points are located in the neck and nape.” In clinical practice, we have observed that patients frequently present with both fascial tension in the Liver region (right hypochondriac region, subcostal area) and discomfort in the neck and head. In such cases, one commonly palpates a nodular or stagnant sensation at the distal portion of the Right Guan pulse position—specifically, within the anatomical range of the radial styloid process, proximal to its highest point. Additionally, some patients exhibit a wiry pulse at the Right Cun and/or Left Guan positions. After manual intervention targeting the Liver region—for example, Yan Xihuan’s tendon-releasing and meridian-unblocking technique or Liu Yong’s visceral relaxation method—the nodular sensation at the Right Guan and the associated cervical discomfort often significantly improve. Based on this “sensory experience,” we propose an initial theoretical insight: “A functional connection exists between the Liver and the neck”—i.e., “The Liver’s Shu points reside in the neck and nape.”

Further abstraction grounded in Traditional Chinese Medicine (TCM) theory might be formulated as follows: A wiry pulse at the Right Cun and nodular stagnation at the Right Guan indicate impaired Qi movement across the diaphragm, leading to Qi and Blood stasis in the upper jiao, impaired middle-jiao transformation, and failure of the upper jiao to descend—manifesting clinically as neck pain and headache.

An anatomical explanation (image courtesy of Prof. Liu Yong) is as follows:

The liver lies beneath the right dome of the diaphragm and is tightly connected to the diaphragm via the coronary ligament, falciform ligament, and other structures. Both the diaphragm and the liver region are innervated by the phrenic nerve, which originates from spinal segments C3–C5—the same root level as the cervical plexus. Within the spinal cord’s anterior horn, the central pathways for the phrenic nerve and those for the sternocleidomastoid and trapezius muscles (the latter innervated by the accessory nerve) partially overlap. Abnormal tension signals originating from the liver may thus “cross-wire” centrally within the spinal cord, triggering involuntary reflexive contraction and abnormal sensations in the neck and suboccipital musculature. Moreover, as the primary respiratory muscle, the diaphragm’s motion can be impeded by hepatic-region tension; compensatory overactivity of auxiliary respiratory muscles—including the scalenes and sternocleidomastoid—then contributes to cervical discomfort.

Having reviewed both explanatory frameworks, we must now proceed to empirical verification—not halt inquiry at the observation that “the Liver’s Shu points reside in the neck and nape.” In classical TCM reasoning, analysis often stops here, since “Qi and Blood” remain intangible and non-perceptible to direct sensory experience. Consequently, the hypothesis that “Qi and Blood stasis occurs in the upper jiao” is neither empirically verifiable nor falsifiable. By contrast, the anatomical explanation—e.g., a “liver–diaphragm–neck reflex”—can be tested through targeted physical examination, controlled trials, or functional assessments. Therefore, while our perceptual acuity remains under development, we may provisionally place traditional theories beyond immediate empirical reach into the category of “acknowledged but undetermined”—prioritizing concrete anatomical findings as the foundational basis for understanding human physiology. Building upon this foundation, further questions arise: Under what clinical circumstances should cervical discomfort prompt evaluation of hepatic-region tension? Beyond the liver region, what other distal sites may influence the neck? Does every instance of hepatic-region tension inevitably affect the neck? Alternatively, we may pivot toward tangible diagnostic targets—such as pulse diagnosis—and ask: Is there a necessary correlation among nodular sensation at the Right Guan, hepatic-region tension, and cervical discomfort? For instance, if the Right Guan exhibits a wiry quality alone, does that also correlate with cervical symptoms? From the perspective of anatomically grounded pulse diagnosis, the distal segment of the Right Guan corresponds topographically to the hepatic region—how does this differ from the classical assignment of the Liver to the Left Guan? How should this be applied clinically? Does the nodular sensation at the Right Guan reflect muscular pathology or visceral dysfunction—and at which structural levels (i.e., the Five Bodies or the Zang-Fu system) does it manifest? Such questions must be repeatedly tested and refined through clinical practice.

In summary: either ground your evolving theoretical framework in objective, palpable diagnostic signs—such as pulse and palpation findings—or anchor your clinical work firmly in anatomical reality, ensuring each therapeutic maneuver is precisely targeted and physiologically justified. This, I believe, constitutes the optimal learning pathway for beginners studying TCM.

Under traditional pedagogical approaches, the advantages of TCM theory often only become apparent after many years of study and practice—unless one possesses extraordinary dedication and opportunity, akin to Ye Tian Shi’s intensive mentorship-based training. Today, classical TCM theory appears philosophical, general, and imprecise; yet paradoxically, this very characteristic endows it with remarkable flexibility. As the saying goes, “What makes it great also makes it difficult”: for novices, its vagueness renders it elusive and hard to grasp concretely; yet for seasoned clinicians who have accumulated rich “sensory experience” and a deep reservoir of “practical foundational material,” skillful application of analogical reasoning (“taking images and drawing comparisons”) and associative thinking enables them to discern “change within constancy”—transforming fixed principles into adaptable clinical wisdom. Thus they may truly become enlightened physicians.

One of my senior relatives graduated three decades ago from a renowned TCM university and began working in the TCM department of a major Western-style Grade-III-A hospital. At that time, he held no particular passion for TCM—it was merely his academic obligation. His clinical caseload averaged six or seven patients per day, mostly walk-ins referred organically by the hospital, and he found contentment in this low-pressure routine. Only after his daughter enrolled at Beijing University of Chinese Medicine did he begin re-studying TCM alongside her—attending the standard curriculum offered there: the “Four Fundamental Disciplines” and “Four Classical Texts.” Over two years, his clinical proficiency advanced dramatically. Today, he sees dozens of patients daily, and his appointments are perpetually oversubscribed.

Therefore, friends, I believe TCM should neither be the exclusive privilege of a select few nor a plaything open to arbitrary reinterpretation. What the TCM community needs is not merely a handful of legendary masters—but rather a broad, systemic elevation of professional competence across the entire field. For too long, TCM has suffered from excessive speculation and epistemological uncertainty. Either begin from personal sensory experience, systematically repeating, quantifying, and refining observations to build your own coherent theory and distill your own clinical patterns—thereby becoming an enlightened physician—or, building upon sensory experience and grounded in anatomical knowledge, strive diligently to comprehend the human body and the physiological and pathological laws governing it. Prioritize tangible anatomical structure; recognize objective functional relationships. Only then does “Qi transformation” cease to be empty rhetoric; only then does technical mastery arise spontaneously from heart and hand; only then do theory and practice align seamlessly, and practice nourish theory in return—making knowledge a living, flowing source. Ultimately, we aim to forge a coherent theoretical system accessible and learnable by the vast majority, empowering every practitioner to become an enlightened physician. This is no task for one person, nor must its completion be witnessed by any single generation—but it echoes the ultimate ideal articulated in the Ling Shu Jing: “To ensure transmission to future generations, the methods must be clearly defined; they must endure forever, persist without interruption, be easy to apply and unforgettable—thus establishing their enduring framework. Chapters shall be differentiated, interior and exterior distinguished, beginnings and endings established, forms given to all phenomena. First, the ‘Classic of Acupuncture’ shall be codified.”

Finally, let us close with a line from Tales of the Swordsman in Snow:

Li Chun Gang wishes that every sincere swordsman in the world may master the ‘Azure Serpent of Two Sleeves.’
Li Chun Gang wishes that every brilliant young successor may cleave open the Heavenly Gate with their sword.

Let us encourage one another!