This article is transcribed by SimpRead, original from mp.weixin.qq.com
“The Way Arises from Simplicity”
▲ He Chao
On Tencent Video, looking at the young and slightly confused eyes of the students, I was discussing the crucial part of the principles and methods of traditional Chinese medicine (TCM). Learning TCM, the most important thing is not to rush to memorize the texts of the “Shanghan Lun” (Treatise on Cold Damage), nor to dive headfirst into some so-called “secret recipes” of certain sects—this would be like a traveler who hasn’t yet identified the stars’ positions, hastily venturing into the boundless wilderness.
You must first turn back, calm your mind, and solidly build the foundation of diagnostic science inch by inch. Halfway through the lecture, my throat suddenly tightened, and I stopped.
On the manuscript, the words “prescription and medication must be based on principles and methods” seemed to come alive, diffusing into an old light and shadow.
In that light and shadow was the lean figure of my master, Teacher Liu Ming. Back then, he told me: “People know that the spirit is spirit, but not why the spirit is not spirit.”
At that time I was young, restless in spirit, half understanding the words, only feeling that the statement was as mysterious as fog in the mountains.
Now, I myself have taken on the appearance of a “teacher,” and through daily clinical practice and lecturing, I have truly savored the profound meaning in those words—that the only secret in this world has never been some profound and mysterious secret teachings, but the most simple, unnoticed “foundation.”
This thought makes me involuntarily recall the legendary encounter in front of Shaoshimen Mountain depicted by Jin Yong.
Xiao Feng, this towering and righteous hero, actually uses the most ordinary “Taizu Changquan (Founder’s Long Fist)” style in the martial arts world. That move “Charge and Slash the Generals” in his hands is full of internal strength, with the fist wind carrying the sound of thunder, turning decay into wonder, astonishes the heroes of the world. His martial arts foundation came from Shaolin; Master Xuan Ku strictly forbade him from seeking too much. He was only ordered to practice every move and form until he was extremely skilled.
This is the power of foundation—the most common grain brewed into the richest wine.
Now look at his two sworn brothers.
Duan Yu possesses the astonishing internal strength absorbed from “Beiming Divine Skill,” and learns “Six Meridian Divine Sword.” However, due to a weak foundation, the divine skill works intermittently, like a child owning a treasure trove but anxiously unable to find the key.
Xu Zhu obtained the profound skill of Wuyaozi from over seventy years of training, with internal strength rare among his peers. However, initially, he knew nothing about how to use it; his fist and foot skills were crude, and facing top experts, he was awkward and helpless. Xiao Feng saw through at a glance: “Second brother’s internal strength is profound, far beyond mine, but his martial arts moves are like a beginner… ultimately hard to win.”
This is not just talking about martial arts! Everyone must remember TCM originates from life.
That mighty internal strength is our deep understanding of the principles and methods of the “Nei Jing” and “Shanghan Lun”; those skilled moves are our proficient use of the four diagnostic methods combined and the properties of herbs and prescriptions.
Theory without flexible application is Duan Yu; only remembering formulas without understanding principles, mechanically applying them to symptoms is the early Xu Zhu.
Only by being like Xiao Feng, practicing the most basic “Taizu Changquan”—the study of yin and yang, exterior and interior, cold and heat, deficiency and excess, the organs and meridians—until it integrates into your blood and becomes instinct, can you remain calm and hit the mark amid the complexities of disease patterns.
The palace of TCM has never relied only on abstract principles and methods alone.
Its freshest vitality is hidden between the words of medical cases throughout history—that isn’t cold medical record archives, but wisdom condensed from the confrontation between theory and reality.
The value of medical cases lies more in their “honest” attitude. Ye Tianshi once candidly wrote: “Previously used Si Junzi decoction plus mulberry leaf and tree peony to harmonize the spleen and stomach, suppress liver fire, but the effect was not as expected. Considering the patient’s yin and yang have already been damaged, how can the power of herbs revive? Treating symptoms and diseases is ultimately not the best strategy.” Then he turned to discuss treatment based on nutrient division—facing challenges without concealment or avoidance of mistakes.
Wang Xugao also truthfully recorded his change in thinking: “The previous day’s delirium indicated disease in Yangming, so I used purging; now the patient has abdominal distension, white tongue coating, and thin pulse, indicating the disease mechanism has shifted to Taiyang—therefore, warming and dispersing with pungent herbs to open Yang and regulate the central pivot is key. Clinical practice is like confronting an enemy, changing with the situation, prioritizing the urgent.”
These writings neither mystify effects nor conceal difficulties. They restore the reflections of physicians in confusion, adjustments after failure, conveying the most authentic spirit of medical inquiry in mundane reality.
Nowadays, legendary medical cases of “one dose cures, three doses sufficient” are everywhere, but we gradually forget—on the path of medicine, there are many inconspicuous symptoms, repeated probing, and ordinary perseverance. What truly nourishes learners is often not those meticulously edited “miracles,” but these plain, even puzzled “honest records.”
And it is precisely these countless vivid medical cases that gather into the spring of TCM’s foundation, making it ever new.
I always say prescriptions must be precise, like artisan craftsmanship.
A disease needs to follow the formula of “(cause + location) + symptoms.”
The cause is the storm’s origin, location is the eye of the storm, and symptoms are just the storm’s traces.
True fundamental treatment lies in calming the source of the storm and stabilizing its eye, not merely repairing doors and windows.
Therefore, medication must be like an arrow, directly targeting cause and location; symptoms only receive “appropriate care”—a follow-through clearing, never just treating the head or the foot separately.
Consider a typical case: patient has aversion to cold, itchy throat, cough, copious thin white phlegm, floating slippery pulse, and greasy white tongue coating. To a novice, this is a tangled mess. But to one well-versed in principles, this is a clear chain of evidence, directly pointing to the core pathogenesis of “wind-cold invading the exterior, lung qi losing dissemination, fluid congealing into phlegm.”
With clear principles, the formula arises: disperse wind-cold to resolve the cause, disseminate and lower lung qi to restore location, assist with phlegm transformation to stop cough and relieve symptoms.
In formula terms, it is (disperse wind-cold + disseminate lung) + transform phlegm to stop cough.
Thus, Xing Su San arises appropriately: Perilla and Qian Hu as the vanguard generals, pungent and dispersing wind-cold, lowering qi and transforming phlegm to strike directly; Apricot kernel, Platycodon, Fructus Aurantii, and licorice as the central army coordinating, disseminating lung and regulating qi to ease chest congestion; Pinellia, Chenpi, and Poria as logistics support, transforming phlegm and smoothing qi, soothing cough and wheezing. The medicine follows the principle; the principle stands on evidence, all connected.
This is the magic of principles and methods—making the chaotic clear, making the complex simple.
It explains why Xing Su San is superior to Yin Qiao San: the former tightly follows the cause “wind-cold,” the latter treats “wind-heat.” A tiny divergence leads to a thousand-mile mistake.
It also reminds us that “caring for symptoms” means focusing on removing the soil that produces symptoms—once external pathogens are resolved, lung qi naturally recovers. How can cough not be cured? Without understanding this, simply stopping cough by abusing lung-constricting herbs is like locking the door but leaving the bandits inside.
My master Liu Ming taught us to be so meticulous.
Not merely memorizing syndrome types, but like the butcher Ding dissecting an ox, seeing only the muscle fibers and bones, not the whole ox.
For example, TCM diagnosis must combine the four diagnostic methods, none is dispensable. The formula may be broadly correct, but the details must be closely reviewed.
Why use Fructus Aurantii? Because of chest bloating and qi stagnation. Why add Fritillaria? Because phlegm is sticky and difficult to cough out.
If phlegm is more, increase Poria and Pinellia; if chest oppression is obvious, more Fructus Aurantii and Chenpi.
Additions and subtractions are never arbitrary but subtle adjustments commanded by principles—a natural deployment born of solid foundational skills.
Mastering a firm root in principles is like a general well versed in the Art of War. Yet the battlefield changes rapidly; one cannot be rigidly fixed to a set formation. Facing prescriptions and medication, true masters show the art of “following the heart’s desire without overstepping the rules”—an art founded on humble basics.
Prescriptions are crystallizations of predecessors’ wisdom, classical battle arrays refined for thousands of years, naturally to be treasured. But they must not be treated as rigid dogma, rather as beautiful compositions open to interpretation.
For example, Liuwei Dihuang Wan primarily treats kidney yin deficiency but is not a “panacea” for all yin deficiencies. Zhang Jingyue’s Zuo Gui Yin and Zuo Gui Wan are developments based on Liuwei Dihuang Wan, removing Danpi and Ze Xie’s draining herbs, adding Gou Qi and Zhi Gan Cao’s sweetening herbs, or adding deer antler glue and tortoise shell glue—all subtly tuning the formula to “use the intent of the six flavors, rather than the six-flavor formula,” achieving innovation.
Why remove Danpi and Ze Xie’s draining herbs, and add Gou Qi, Zhi Gan Cao sweeteners, or deer antler glue and tortoise shell glue? This is precisely where we make gains.
Such shifts based on foundation abound in medical cases.
Like You Zai Jingyun: if kidney essence is insufficient, replenish it. While following Liuwei Dihuang’s intent, adds Poria to avoid water hindrance, uses Chuan Lian Danpi to vent liver fire, and adds Ejiao and Ligustrum to help Sheng Di instead of Shanshan.
Why did You Zai Jing remove Corni Fructus and Dioscoreae Rhizoma from Liuwei Dihuang Tang? Because Corni Fructus is warm, which is unsuitable with liver fire, and its sour astringency hinders venting. Dioscoreae is white and sweet, enters the lung and spleen, but is not as good as Ejiao and Ligustrum.
Wu Jutong treated Taiyang exterior syndrome not yet resolved; but since the patient “normally had damp-heat and disliked sweetness” and “slight cough,” he did not mechanically apply Guizhi Tang, but “removed sweet herbs, added pungent dryness.” This precise tailoring arises from deep understanding of Guizhi Tang’s formula principles and the patient’s constitution.
Similarly, nourishing liver and kidney may arrange Rehmannia, Corni Fructus, Gou Qi, Ligustrum, Angelica, White Peony, Polygonum Multiflorum, Ejiao, etc., in different orders of dominance: nourishing liver and kidney is a balanced approach; nourishing kidney yin with mild liver tonification focuses on rebuilding kidney yin; replenishing child deficiency and nourishing mother focuses on moistening liver substance. This is still a general therapy.
If dizziness occurs, add tortoise shell and oyster shell to subdue yang; for afternoon tidal fever, add Danpi and Diguipi to clear deficiency heat—these refine general formulas into targeted treatments, precise work on a foundation.
Looking at predecessors’ cases, we realize the essence of prescription does not lie in complicated ingredients or heavy doses but in precise fit with pathogenesis.
The “Nei Jing” clearly instructs: “Few herbs if heavy, many if light,” “One chief, two ministers controls the minor; one chief, three ministers, nine assistants controls the major.”
This is not a simple number rule but a strategy based on the severity, depth, and location of pathogenic factors. Li Dongyuan’s many herbs are clear in hierarchy, thus plenty but orderly.
Conversely, if one does not understand principles, adding herbs for every symptom leads to “lots of herbs, no formula,” a disorderly crowd, which is seen all too often today.
“Using medicine like using troops” values quality over quantity, precision over complexity. This “refinement” and “accuracy” come from thorough grasp of foundational principles. Only then can one navigate freely the ocean of formulas, precisely command the world of herb properties.
Traversing the vast sea of medical cases, comprehending strict principles, practicing formula modification, we still must ask: in today’s fast-changing medical technology and disease spectrum, what is the fundamental survival and development of TCM?
The answer is clear and certain: return to the human body’s qi, blood, yin, and yang; return to solid mastery of four diagnostic methods and eight principles; return to the fundamental law of syndrome differentiation and treatment.
Those diseases considered difficult by modern medicine—like lupus erythematosus, polycystic ovary syndrome, chronic hepatitis—their treatment is never simply searching for antagonistic “special-effect Chinese medicines,” nor rigid application of Western diagnosis matched to herbs, but requires returning to TCM’s most basic cognitive model.
Gather all human information in disease state through observation, listening, questioning, and pulse-taking; then, using eight principles, organs, qi, blood, and body fluids theories, comprehensively analyze and judge yin-yang imbalance, cold-heat deficiency-excess, exterior-interior progression. This seemingly most traditional, even “backward” method, is actually the supreme wisdom to grasp life state holistically.
It does not cling to local “disease,” but focuses on the whole “person.” This seemingly the most clumsy and patience-demanding path is actually the true shortcut to reach roots and solve complex problems.
Looking at these young and slightly confused eyes in front of me, I seemed to see my former self and the hope of unbroken TCM heritage.
The silence on the podium was but a moment, yet felt like a long journey. I gently closed the manuscript; the ink did not dissolve into tears. The figure of my master, the ink fragrance of medical cases, the metaphor of martial arts—all quietly settled into the firmest background in my heart.
“So,” my voice returned to calm, deeper than before, “when we talk about the essence of TCM, it is not found deep in the sea of texts, not in mysterious secret formulas, but right in the diagnostic foundation you need to solidify inch by inch, in every careful observation, listening, questioning, and pulse-taking, in every careful weighing of herb properties and prescriptions.”
“This humble foundation is the star chart handed down from my master, and now I pass it on to you.
May you have enough patience to recognize the stars’ positions, and enough courage to step into clinical wilderness—where you will use the sturdiest steps to walk your own medical path.”
The inheritance of TCM, on this ordinary night, completed a quiet arrival—returning to the foundation is walking toward the true distant place.
And all this always begins with the most genuine reverence and sincerity toward life.