I. The Social Origins of Chinese and Western Medicine

I. The Social Origins of Chinese and Western Medicine

Like literature and art, medicine, as a superstructure, develops on a specific social foundation. In the earliest days, the social foundations of both TCM and Western medicine were agriculture and handicrafts; therefore, their forms and contents were largely similar. In the fourth century BCE, Hippocrates, the representative of Western medicine, wrote his twenty-volume “Hippocratic Works,” while the Eastern medical works of the same period, such as the “Yellow Emperor’s Inner Canon,” shared similar thoughts and content. The former proposed that all things possess opposing aspects, while the latter introduced the concept of yin and yang. The former proposed wind, fire, water, and earth, while the latter introduced the Five Elements’ interactions of generation and control. By the second century CE, the focus of Western medicine shifted from ancient Greece to ancient Rome, where a new star rose in Western medicine—the figure known as “the King of Physicians,” Galen (130–200 CE). Galen combined the medical ideas of the “Hippocratic Works” with clinical practice, bringing about a new leap in Western medicine. Around the same time, Zhang Zhongjing (150–219 CE) appeared on Chinese soil, known as the “Sage of Medicine,” who integrated the academic ideas of the “Yellow Emperor’s Inner Canon” with clinical practice, propelling Chinese medicine forward significantly. For more than a thousand years thereafter, both Eastern and Western medicine progressed slowly through logical reasoning, with little difference between the two. However, starting in the 16th century, Western medicine began to show signs of industrial development—mining, smelting, glassmaking, and other major industries took shape. Western medicine gradually acquired the foundations of modern industry, and microscopes were invented, as were chemical reagents. In 1628, British physician Harvey used a homemade magnifying glass to discover that blood travels from arteries to veins and returns to the heart; by 1661, Italian physician Mersenne discovered the capillaries connecting arteries and veins, revealing the true nature of blood circulation; in 1665, British physician Hooke used a homemade 200° magnifying glass to find that the thin slices of cork were composed of cells; in 1675, Dutch physician Römer used a homemade 270° magnifying glass to discover that animal muscle tissue was also composed of cells; in the early 18th century, German renowned pathologists Schleiden and Schwann concluded that all living organisms were composed of cells; in the mid-18th century, German great pathologist Weiliao discovered cell nuclei, cell membranes, and cellular organelles—and he concluded that living organisms were a kingdom of cells, and the human body was also a kingdom of cells. All diseases in the human body began in cells, affecting the entire body. Weiliao’s cytological thinking has guided modern medicine for over a hundred years. Meanwhile, Hungarian obstetrician Semmelweis believed that puerperal fever was not a gift from God, the universe, or nature—but rather the work of microorganisms. French physician Pasteur believed that fermentation in wine was caused by microorganisms, and he proposed the Pasteurization method. Around the same time, British physician Reid began using carbolic acid to disinfect operating rooms and boiled instruments for sterilization. By the late 18th century, German great microbiologist Koch created bacterial culture media and cultivation methods. His student Gram invented the Gram stain technique. Thanks to these inventions, Western medicine quickly shifted from the macro to the micro, from the holistic to the local, from emphasizing the body’s responsiveness to emphasizing the pathogenicity of pathogens. Thus, Western medicine emerged with a completely new face, standing out from the mother body of traditional medicine. We clearly see that every advancement in Western medicine was closely tied to the development of modern science and technology. Now let’s look at TCM: the holistic perspective of the “Yellow Emperor’s Inner Canon,” and Zhang Zhongjing’s six-channel reasoning, are regarded as truths that are self-evident. For over a thousand years, no one had ever incorporated these theories into experimental research. The “Su Wen · Yin Yang Ying Xiang Da Lun” states: “Yin and yang are the way of heaven and earth; they are the framework of all things, the parents of change, the origins of life and death, and the realm of divine wisdom—when treating illness, one must seek the root cause.” The “Su Wen · Shang Gu Tian Zhen Lun” says: “In ancient times, the sages taught their followers to avoid harmful winds and external evils at appropriate times, to cultivate tranquility and emptiness, allowing true qi to flow naturally, to guard the spirit within, so that illness would not arise.” The “Su Wen · Yang Qi Sheng Fa Lun” states: “Yang qi is like heaven and sun—when it is lost, one’s lifespan is shortened and one’s brilliance is obscured.” The “Su Wen · Yu Pian Cai Fa Lun” says: “Righteous qi resides within the body, and evil qi cannot invade.” The “Su Wen · Zang Qi Fa Shi Lun” states: “When evil qi gathers, its qi must be deficient.” The “Jin Kui Yao Lü” says: “Humans are endowed with the Five Constants, all of which grow through the influence of wind; wind can give rise to all things, but it can also harm them—just as water can float boats, but it can also capsize them.” “There are a thousand kinds of disasters, but they do not exceed three main causes: first, when the meridians are invaded by evil qi and enter the internal organs, becoming the root cause of illness; second, when the limbs, nine orifices, and blood vessels are blocked and obstructed, resulting in external skin infections; third, when houses, insects, beasts, or sharp objects cause injury—this is how we can fully understand the origins of disease.” These passages, from the causes and mechanisms of disease to the onset of illness, from the unity of human organs to the unity of humanity and nature, have become the guiding principles of TCM’s development. Since the Eastern Han Dynasty, after Confucianism’s strengthening through Dong Zhongshu’s policy of “abolishing all schools of thought except Confucianism,” all academic fields—except for the Four Books and Five Classics—were completely closed off. “Life and death are determined by fate, wealth and honor are ordained by heaven,” “One’s body and hair are given by one’s parents, and must not be damaged,” “Bare-chested and barefoot are not proper conduct”—the original teachings of the “Nei Jing,” such as “For those who are eight feet tall, the skin can be pressed, measured, and examined externally; when death comes, the body can be dissected and viewed; the size of the organs, the firmness of the viscera, the amount of nutrients, the clarity or turbidity of blood, the length of the pulse, the quantity of qi—all these are recorded in precise numbers,” were completely set aside. Viewing the holistic perspective of the “Yellow Emperor’s Inner Canon” and Zhang Zhongjing’s six-channel reasoning as truths that are self-evident, and absolutely prohibiting their further incorporation into experimental research, meant that TCM’s academic pursuits always moved slowly along the track of logical reasoning. In fact, when Western industrialization began, TCM had the opportunity to take advantage of experimental research findings from advanced Western medicine and apply them to its own practices. From the Ming and Qing dynasties onward, via the Silk Road and the Maritime Silk Road, Western clocks and machines flowed eastward, while Chinese silk, porcelain, and tea traveled westward. Due to the influence of Confucianism, exchanges between East and West were never truly opened. The social foundations upon which TCM depended for its development remained consistent—whether from the Qin and Yue people in the fourth century BCE to modern TCM masters like Xiao Longyou, Pu Fuzhou, and Yue Meizhong, their academic thoughts were always products of agriculture and handicrafts.

II. The Complementary Nature of Chinese and Western Medicine

Engels said in “Anti-Dühring” that “when the economic base changes, the entire superstructure will change sooner or later.” Since Chinese and Western medicine developed on different economic bases, their forms and contents differ fundamentally. Western medicine, with the backing of powerful industrial enterprises and advanced tools as productive forces, has the conditions to explore the essence of disease from its local, microscopic aspects, and from the pathogenicity of pathogens. TCM, however, has always developed on the foundations of scattered agriculture and individual handicrafts; it lacked the conditions and opportunities to make progress in these three areas. Therefore, TCM can only understand disease through its external appearances, its overall picture, and its macroscopic aspects. In the 1970s, some people compared disease to a “black box”—what is inside that “black box”? What kind of structure is it? This was a question people urgently wanted to understand. Western medicine used advanced tools to open the “black box,” gaining a direct understanding of its structure and content, and employing specific methods to eliminate and remedy the malfunctions within. TCM, however, had no conditions to open the “black box,” no tools to open it—so it relied on the weight of the “black box,” the smells emanating from it, the sounds echoing within it… to determine what was inside the “black box,” using logical reasoning to identify where the malfunctions occurred, and to decide how to repair these failures. Although this example has its limitations, it provides a vivid metaphor for the differences in how Chinese and Western medicine understand disease. Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Now let us look at two differences in how medical science understands disease. First, the methods of understanding: Traditional Chinese Medicine relies on logical reasoning, while Western medicine employs experimental research; second, the approaches to understanding: TCM starts from the outside in (examining symptoms and seeking causes), whereas Western medicine begins from the inside out (from causes to symptoms); third, the focus of understanding: TCM emphasizes the overall picture, the macroscopic perspective, and the responsiveness of the body, while Western medicine focuses on the local level, the microscopic aspects, and the pathogenic nature of diseases. Setting aside the methods and approaches for now, we should focus on the key differences in the emphasis of these two medical systems—each has its own unique characteristics: a disease is both holistic and localized, both macroscopic and microscopic, possessing both the body’s own reactive mechanisms and the pathogenic factors responsible for disease. Both Chinese and Western medicine each occupy one end of this spectrum, and their complementary relationship is clearly evident. Western medicine has advanced through cellular pathology developed by Weilchao, pathogenic etiology as proposed by Koch, and the use of advanced tools to gain a more detailed understanding of local phenomena. Its development has become increasingly sophisticated and refined, yet it has, to some extent, overlooked the dependence of the microscopic, the local, and the pathogenic factors on the body’s overall state and its environment. In recent decades, insightful scholars within Western medicine have recognized this shortcoming—through Selye’s stress theory, Pavlov’s neuro-reflexology, and even the rapid advancements in immunology over the past few centuries, thousands of bioactive factors have been discovered within the body, such as interleukins, the CD system, the P50 system, the CA system, the prostaglandin system… These factors constantly and spontaneously regulate the functions of various systems, organs, tissues, and cells. This regulation operates throughout the entire body, spanning systems, organs, tissues, and cells, thereby confirming the correctness of TCM’s holistic regulatory approach. Western medical academic perspectives have shifted from the local to the systemic, from the microscopic to the macroscopic, and from the pathogenic nature of diseases to the body’s own reactive mechanisms. Modern Western experimental research has achieved remarkable results in this regard, particularly in the field of TCM’s holistic view. When I first went to the United States for lectures thirteen years ago, I was deeply intrigued upon hearing the passages “Right qi resides within, and evil cannot invade,” and “When evil gathers, qi must be deficient.” Through repeated translations and inquiries, I was eager to fully explore and utilize every aspect of these teachings. On the TCM side, the warm-disease school that emerged during the Ming and Qing dynasties also initially aimed to move from an overall perspective to a localized one, from a macroscopic view to a microscopic one, and from the body’s own reactive mechanisms to the pathogenic nature of diseases. Wu Youke, a renowned scholar of warm-disease, once said, “Shanghan is not caused by wind, heat, cold, or dryness—it is a kind of harmful qi present between heaven and earth, entering through the mouth and nose and causing illness.” This concept of harmful qi is already similar to modern medical notions of bacteria and viruses… Wang Qingren of the Qing dynasty was not content with the logical reasoning of the Eight Principles and Six Meridians; he carried the corpses left behind by others home himself and conducted anatomical studies, discovering seven holes in the diaphragm… This shows that TCM still strives to compensate for its own shortcomings through spontaneous efforts.

In summary, Chinese and Western medicine exhibit distinct emphases and complementary relationships in the three areas mentioned above. Modern Western medicine has come to recognize the profound significance of TCM’s holistic and macroscopic thinking for the advancement of contemporary Western medicine—but do we, as TCM practitioners, not see the immense potential of modern Western medicine in developing TCM’s strengths in the local, microscopic, and pathogenic aspects? If we can harness the strengths of Western medicine for our own purposes, this is precisely an indispensable component in the current development of TCM—and it is also the core of TCM’s modernization today. It is precisely the embodiment of Chairman Mao’s famous saying: “Learn from foreign sources, but make them serve China’s needs; draw on the past for the benefit of the present.”

III. The “Sixteen-Character Principle” as an Effective Method for Modernizing TCM

TCM must integrate into the networked systems of modern science and technology in order to advance in step with contemporary scientific and technological progress and to ride the fast track of modern science and technology to keep pace with the times. The primary challenge currently lies in finding common ground between Chinese and Western medicine. Our ancestors left us an enormous amount of knowledge and rich traditions—yet it is impossible for a single person or even a single generation to fully uncover all the connections between these elements. However, a journey of a thousand miles begins with a single step; if we have a guiding principle, and if we, as generations of TCM practitioners, work together, we will find more and more points of convergence, eventually leading us from individual points to lines, and from lines to broader patterns. After more than forty years of clinical practice, I proposed the sixteen-character method for TCM development in the 1980s: “Western diagnosis, TCM syndrome differentiation, traditional Chinese medicine as the mainstay, Western medicine as a supplementary approach.” This method was endorsed by the late Minister Chen Minzhang. Encouraged by his support, I organized a group of 21 renowned experts in Chinese-Western medicine from five northwestern provinces to compile China’s first comprehensive monograph on integrated Chinese-Western medicine—“Practical Internal Medicine Integrated with Chinese and Western Medicine.” Since its publication, this book has received tremendous acclaim both domestically and internationally, earning the “World Traditional Medicine Outstanding Contribution International Gold Award” in the 1990s. I was invited to the United States to accept the award and deliver lectures, where I personally received the honor of being named one of “The World’s Top 100 Ethnic Medicine Stars.” The outline, structure, and content of “Practical Internal Medicine Integrated with Chinese and Western Medicine” were entirely guided by the “Sixteen-Character Principle.” After returning from the U.S., I was invited to Beijing, Dalian, Guizhou, Shaanxi, Qinghai, and other places to give lectures on the “Sixteen-Character Principle.” The Gansu Provincial Health Department commissioned the Gansu Provincial Association for Integrated Chinese and Western Medicine to host five provincial-level training courses focused on the “Sixteen-Character Principle.” As a result, this method gained further momentum across China, and people came to call it the “Sixteen-Character Approach.” Although the “Sixteen-Character Principle” consists of just sixteen characters, it may seem simple, yet its meaning is profoundly significant—(as Chen Keji put it). The sixteen-character principle comprises four sentences:

The first sentence, “Western diagnosis,” refers to using all modern medical diagnostic techniques to determine the location and nature of the disease;

The second sentence, “TCM syndrome differentiation,” means that after determining the location and nature of the disease using Western medical methods, TCM syndrome differentiation should be employed within that framework. When conducting this differentiation, we should fully embrace traditional TCM thinking and methods. Such differentiation is far more accurate than conducting extensive syndrome differentiation treatments across the entire body without Western diagnosis; TCM syndrome differentiation without Western diagnosis is like fishing in the vast ocean, while TCM syndrome differentiation with Western diagnosis is like catching fish in a fishing net—both are far more efficient and far more accurate;

The third sentence, “Traditional Chinese medicine as the mainstay,” means that when treating diseases, we must primarily rely on TCM methods, fully integrating TCM’s traditional principles, theories, formulas, and medicines, so that the millennia-old theoretical and practical foundations of TCM can be preserved and passed down. This fully embodies the principle of the “Sixteen-Character Principle”: to develop TCM, not Western medicine;

The fourth sentence, “Western medicine as a supplement,” means that for certain diseases, ancient physicians did not leave us specific formulas, or the formulas they did leave were not sufficiently effective. However, there are still several highly effective Western and Western medicine drugs available that can enhance therapeutic efficacy.

Looking at the “Sixteen-Character Principle,” its hallmark is that traditional TCM syndrome differentiation is built upon the foundation of Western diagnosis—this not only greatly ensures the accuracy of syndrome differentiation but also makes full use of modern medical science and technology, integrating them with TCM’s principles and methods. As doctors’ clinical experience and insights grow, over time, Chinese and Western medicine will find more and more points of convergence, broadening the pathways for TCM’s modernization. The crucial third sentence, “Traditional Chinese medicine as the mainstay,” ensures that the “Sixteen-Character Principle” is grounded in the development of TCM. Practice has shown that over the past twenty-plus years, the application of this principle has improved patient outcomes, enhanced personal prestige, and increased economic income for doctors; it has also raised the reputation of departments and, ultimately, elevated TCM’s status to a new platform in the broader medical community. The Integrated Chinese and Western Medicine Department of the Gansu Provincial Medical Academy has operated according to this principle.

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When integrated Chinese and Western medicine departments in Gansu Province—and even nationwide—were all facing a decline, this department not only managed to survive but continued to thrive. This is a striking example.

After a month of treatment, if you don’t employ Western diagnosis and instead blindly engage in TCM syndrome differentiation, conditions like cervical cancer, uterine fibroids, ovarian cysts, dysfunctional uterine bleeding, or even excessive menstrual flow—none of which can be easily distinguished through mere observation, listening, asking, and palpation alone. The treatment approaches for uterine fibroids and dysfunctional uterine bleeding are completely different, as are the treatment strategies for cervical cancer and excessive menstruation. But if the treatment approaches differ, how can we then develop appropriate formulas? One TCM practitioner mistakenly treated a cervical cancer patient as having menstrual irregularities and treated her for six months without success, missing the opportunity for surgery and the chance for radiation and chemotherapy. Her liver metastasis and brain metastasis occurred, and she took the case to court. Was the doctor right or wrong? How should we handle such cases?

Gastric pain, liver cancer, gallbladder cancer, hepatitis, cholecystitis, gastric ulcers, superficial gastritis, atrophic gastritis, gastric prolapse, gastric polyps, duodenal diverticula—all share this symptom pattern. Without proper diagnosis through observation, listening, asking, and palpation, it is nearly impossible to distinguish between them accurately. Many patients mistake gallbladder inflammation for gastric pain, or confuse pancreatic inflammation with gastric pain, and even misdiagnose liver cancer or bile duct cancer as common gastric pain. If diagnoses are unclear and syndrome differentiation is inaccurate, it becomes difficult to prescribe the correct formulas and medications. Some say that TCM can only treat minor ailments, not major ones, and that it is best suited for chronic conditions rather than acute ones—this is precisely why.

Today, liver diseases are rampant: hepatitis A, B, C, D, E, and G—without modern medical indicators for pathogens, it is often extremely challenging to distinguish between them. The symptoms of these liver diseases are largely similar, yet their outcomes vary significantly. Hepatitis A can be treated with a simple formula like Xiaochaihu Plus Jieyu, ensuring a high success rate; hepatitis B requires longer-term treatment, focusing on chronic illnesses and slow, steady care, waiting for the body to recover before taking action; hepatitis C, though it may take time to treat, often leads to cirrhosis and decompensation in seven out of ten cases. Understanding these Western medical perspectives allows us to respond appropriately to individuals and their conditions, making timely and effective decisions. Without Western diagnosis as a foundation, we might mistakenly treat a difficult-to-treat hepatitis C as if it were a mild hepatitis A, or mistake a mild hepatitis A as a severe hepatitis C. Misusing terminology or prescribing incorrect medications can lead to loss of confidence in oneself and delay treatment for patients. In conclusion, the “Sixteen-Character Principle,” in terms of tactics, can improve treatment outcomes and increase efficiency; in terms of strategy, it can accelerate the modernization of TCM and serves as an effective method for TCM’s modernization at this stage.

IV. Examining the Points of Convergence Between Chinese and Western Medicine Through Classic Formulas

With the perspective of the “Sixteen-Character Principle,” I have spent 50 years working on the front lines of clinical practice, and I have discovered some noteworthy insights regarding the intersection between Chinese and Western medicine. Let me share my views on the following aspects.