This article is transcribed by SimpRead, original source mp.weixin.qq.com
Textbooks Useless?
Understanding Knowledge = Mastering Knowledge?
I. Textbooks Useless?
There has always been a debate between institutional education and traditional apprenticeship education. I believe that any Chinese medicine student, now or in the near future, will hear a certain voice saying that textbooks are rubbish, and medical students who study textbooks will ultimately become worse than rubbish, turning into medical waste. Is this really the case? Those who criticize textbooks often hold the following views: first, textbooks do not conform to clinical practice, as in clinics there are no patients who exactly match the textbook descriptions; second, classifying symptoms and items in the textbook is meaningless, as understanding the essentials should be straight to the point—just grasp yin and yang, clarify qi transformation, and regulate the organs and meridians, no need to differentiate syndromes or diseases, thinking those are the lowest level. But is that really so? If we just talk about qi transformation, time and space, organs and meridians, and throw in a few case studies to make ourselves appear academically top-notch and scornful, completely dismissing current education and teaching, I think that is inappropriate. Sometimes, achieving the so-called effects in Chinese medicine is very easy. I often joke with students: if we list the first few herbs from every chapter of the Chinese herbal medicine book onto an A4 paper and for any patient just have them step on it, then prescribe the herbs sticking to their shoe print, at least half of the patients will respond, and they will praise you as a miracle doctor.
When I first entered university, my grandfather only told me two sentences related to studying Chinese medicine: one, don’t take medicine randomly if there’s no issue; two, study the textbooks well. At first, I didn’t understand, feeling textbooks were indeed dull and boring compared to reading medical theories, sayings, and cases—full of twists and turns, using medicine like deploying troops, analyzing principles like solving cases, appearing more practical and closer to clinical reality. It’s no wonder many students get confused and thus neglect the importance of textbooks. But my grandfather would not deceive me, because he first learned Chinese medicine from his father, and later transferred to Liaoning University of Traditional Chinese Medicine, having experienced both genuine apprenticeship education—family inheritance—and systematic university education.
In fact, most of us Chinese medicine students are like blank sheets of paper when facing Chinese medicine. To paint a good picture of Chinese medicine, the most important thing is whether the initial composition, outlines, and framework are well laid. How to build this framework is difficult relying solely on medical theories, individual opinions, or a single school of thought. Over thousands of years of history, Chinese medicine has many academic schools, each with its specialization or characteristics. If we abandon textbooks at the start and only focus on one school of thought, such preconceived notions will become deeply rooted in our minds, making it hard to later master experiences from other schools, because our Chinese medicine framework is built on the initially learned school. To learn other schools, we must dismantle and rebuild the foundation, whose difficulty can be imagined. This explains why textbooks are important.
Because textbooks are often straightforward and relatively fair and balanced, the contents included are recognized by past medical experts or the vast majority of them, representing a relatively impartial and harmonious thought system. Based on textbooks, when establishing one’s own thinking framework of Chinese medicine, it is less easy to develop excessive bias toward any particular school. Thus, when learning experiences or thoughts from other medical experts, there is no subjective rejection, and their experiences can truly be transformed into one’s own. The significance of textbooks is not to let us treat patients directly by them, but to sketch a preliminary, rough cognitive framework of entire Chinese medicine on the blank sheet of paper that is our learning, facilitating continuous filling and even renovation of the framework in future study until truly forming one’s own Chinese medicine thinking.
II. Understanding Knowledge = Mastering Knowledge?
“Learning from books feels shallow; to know thoroughly, one must practice.” I try to be early in clinical practice, do more clinical work repeatedly. Fortunately, after my grandfather retired, he opened a clinic at home, which was convenient. After the end of the second-year first semester exams, I started volunteering at home, uninterrupted for ten years through winter and summer vacations. I practice based on summarizing book knowledge, then realize in practice, then summarize again based on insights, and finally feed it back to clinical practice. Regarding clinical experience, I think the most important point is to avoid being impractical or having lofty ideals without skill, and to understand the difference between understanding and mastering, knowing which knowledge you understand and which you have mastered.
Because Chinese medicine knowledge is very straightforward, much is easy to understand. Before, I thought knowledge is about understanding, understanding is enough, understanding equals mastery. Only when I started volunteering in the second year did I realize it is completely different—not all understanding equals mastery. My biggest problem was often only remembering after finishing a clinic day or when reviewing that I failed to ask some important, directly guiding syndrome differentiation and prescription information for certain patients; or that a certain prescription would have been more suitable but didn’t occur to me. I did understand and even memorize these knowledge, but actual application was always unsatisfactory.
Of course, some students may think I didn’t memorize seriously and that mastery comes from thorough memorization. But it’s not so. In the second year first semester, I had thoroughly memorized Shan Han and Jin Kui formulas. Not only the main texts, but every herb’s properties, channels entered, effects, and indications in the pharmacology textbook I copied about 7 times. I could accurately recite the properties, channels, and effects of any herb in the textbook. For the formula book version I had, containing 207 formula songs, I repeated at least 300 times. So why did I sometimes fail to express knowledge I supposedly understood and memorized?
Ultimately because I didn’t completely master the knowledge. I understood and memorized, but it hadn’t become my own knowledge, not integrated into my own Chinese medicine thinking. It was just a small pattern on a blank paper outside the whole frame, so naturally not flexible or practical.
How to judge if you truly master knowledge? I have a simple trick: just “close the book.” For example, for basic theory of Chinese medicine, taking ‘heart’ out of the five organs. Just looking at the title, can you recall the major points of that chapter and which small points compose them? Then the five organs: which organs constitute the five, what do you know about each, and then gradually expand to the entire book—close the book—can you recall the chapters you’ve studied, and the knowledge points within? If not fully, you haven’t mastered it yet. Can you still do this a year after initial study? So constant review and consolidation are needed to keep integrating new knowledge into your thinking system. This is especially important when learning experiences from past medical experts, so that one can skillfully use them when needed, counting as true mastery.
III. Learn More and Ask More, But Also Learn to Discern
Due to graduation requirements and pressures from research, standardized training, etc., enthusiasm for learning Chinese medicine often inversely correlates with year of study. For lower-grade Chinese medicine students, when encountering learning problems, most first think to ask senior or familiar classmates, and their advice often becomes the main reference.
But the seniors available are usually not far advanced, often their understanding of Chinese medicine is not deep enough, and their views on many problems may be biased. If their answers are correct or at least reasonable, that’s fine. But what if a completely wrong answer is given? Such an answer may influence everyone’s future Chinese medicine learning path and possibly lead many detours. Thus, knowing how to avoid pitfalls is very important.
First, always have a questioning spirit. What seniors say is not necessarily wrong, but definitely not always right. Including myself and all seniors, no one is perfect or infallible. So don’t accept everything wholesale; always think for yourself.
Second, don’t mythologize Chinese medicine. It’s true no disease is incurable by Chinese medicine, but that does not mean Chinese medicine is always the best treatment option for every disease. We cannot let our curiosity endanger patients’ lives. In the future, you will hear seniors say their effects are miraculous, healing by overturned cup. Tumors and blood diseases are no problem. There is no denying such sharing is good, but you must learn to discern. Some may be so-called “miracle doctors on social media,” attracting attention for other reasons. They use very mystical theories to superficially explain their views, or use Chinese medicine symptom changes to evaluate Western medicine disease effects, or even distort Western medical test results, plus others with mixed interests. There are also some who always prescribe expensive drugs, which can work, but you should know treating diseases is like opening locks: a golden key can open it, a plastic key too, or even a hammer. So when learning such related experiences, carefully consider and think critically. Because Chinese medicine is simple and practical, not mysterious or illusory.
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