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I have contributed little to the cause of Traditional Chinese Medicine (TCM), and I truly feel ashamed before my seniors. However, regarding three matters in the process of applying what I have learned, I would like to briefly state them.

Enlightenment and Masters

After the abolition of the imperial examination system, in small cities with closed-minded atmospheres, people were generally unwilling to send their children to "Western-style schools," preferring to keep them in private academies for study; I was one of them. My tutor was a Linsheng (a scholar supported by the government stipend) of the late Qing Dynasty who was quite knowledgeable in medicine and had certain research on classic works such as *Huangdi Neijing* (Yellow Emperor's Inner Canon). Therefore, when teaching me to read medical books, he explained both literary principles and medical theories. He selected books such as *Suling Leizuan Yue Zhu* (Abridged Annotation of Compendium of Su and Ling), *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), *Bencao Congxin* (New Compendium of Materia Medica), and *Tangtou Gejue* (Rhymed Verses on Formulas) for me to memorize thoroughly. Although I felt somewhat burdened at the time, I benefited greatly afterwards. The events from more than seventy years ago are still vividly before my eyes.

When I was seventeen years old and left the private academy, I alternated clinical internships at the clinics of my paternal uncle specializing in pediatrics, Xiao Quan Gong, and my master, the senior physician Ying Jintai. Although they were busy with consultations, they were strict with their apprentices and unreservedly passed on their valuable experience. Because I had some theoretical knowledge, it was relatively easy for me to accept their teachings under their close guidance. I remember my uncle once taught us: Children are bodies of "tender Yin and tender Yang." Once they fall ill, treatment should be swift and decisive; one must not delay matters with ineffective medicines. He said this and also did this. For example, regarding the then prevalent smallpox, in the early stage, he often heavily used methods to vent and support (Tuo Tuo) and clear and resolve (Qing Jie), and was skilled in using *Da Huang* (Rhei Radix et Rhizoma) to eliminate heat-toxins lodged internally. Subsequently, he engaged in tonifying Qi and Blood, combining warming or clearing as appropriate, focusing on supporting the interior and expelling pus, thereby curing many critical cases. As for Master Ying, he was exceptionally intelligent and erudite, especially skilled in treating Damp-Warmth diseases (Shi Wen Bing). He adhered to the principle that "when Qi transformation occurs, Dampness pathogen transforms itself." Using *San Ren Tang* (Three Seeds Decoction) from *Wenbing Tiaobian* as the basic formula, he modified it according to symptoms, being adept at both maintaining the formula and changing it. I recall he once treated a patient with Damp-Warmth disease. After taking modified *San Ren Tang* for four or five days, the disease trend did not decrease; instead, chest fullness and oppression worsened, but there was no pain upon pressure. Additionally, the patient suffered from inability to lie down, lack of hunger, and desire to drink. The tongue coating was thick, greasy, floating gray, and slippery; the pulse was deep, fine, and rapid. He resolutely changed to *Gualou Xiebai Guizhi Tang* (Trichosanthes Fruit, Macrostemon Stem, and Cinnamon Twig Decoction) added with *Gan Jiang* (Zingiberis Rhizoma Recens) and *Xi Xin* (Asari Radix et Rhizoma), directly penetrating the Yang of the chest and sweeping away the yin turbidity. After swallowing the medicine, the chest fullness instantly opened, various symptoms decreased, and the body heat was resolved through sweating all over the body. The master's accurate syndrome differentiation and agile response gave me a good education and left the deepest impression on me.

Failure and Success

Shortly after I started my practice, both my masters passed away successively. Under their legacy, my business was quite considerable. In early autumn of one year, an epidemic featuring symptoms such as fever, sweating, cough, and epistaxis occurred in the locality, spreading widely. Physicians at that time mostly treated it based on the theory that new pathogens trigger latent summer-heat, but failed to cure the patients. When encountering such patients, based on their rapid pulse which was larger on the right than the left, I considered it the "Autumn Dryness" disease mentioned in the Upper Jiao Chapter of *Wenbing Tiaobian*. I prescribed modified *Sang Xing Tang* (Mulberry Leaf and Apricot Kernel Decoction) or *Shashen Maidong Tang* (Glehnia and Ophiopogon Decoction) respectively, achieving immediate effects. Two years later, at the transition between summer and autumn, another epidemic characterized by vomiting and diarrhea spread, even causing cold limbs, muscle spasms, restlessness, and agitation. In syndrome differentiation, I confirmed it as "Hot Huoluan" (Cholera Morbus). Using formulas such as *Lianyu Jiedu Tang* (Coptis and Evodia Detoxification Decoction), *Jiaqing Tang*, and *Can Shi Tang* (Mulberry Root Bark Decoction) recorded in Wang Mengying's *Huoluan Lun* (Treatise on Cholera) and Yao Xungong's *Huoluan Xin Lun* (New Treatise on Cholera), I cured many patients who became critically ill due to mistakenly taking hot medicines. Consequently, my reputation grew daily, the number of seekers increased, and they entrusted difficult and severe cases to me without doubt. Thus, I encountered patients outside my scope of knowledge who could not be identified, resulting in deaths due to my misdiagnosis and mistreatment, such as acute and chronic appendicitis, acute pancreatitis, ectopic pregnancy, uremia, etc. Thinking of it now, I still feel sorrow! However, these failures can be attributed to the limitations of historical conditions. What pained me most and taught me the deepest lesson was the mishandling of a sick child: Around the summer of 1929, a boy of about ten years old developed high fever, irritability, coma, and convulsions immediately upon falling ill. I diagnosed it as Summer Heat Epilepsy (Shu Xian) and prescribed modified *Qingying Tang* (Clear the Nutritive Level Decoction). Initially, upon taking the medicine, irritability and convulsions stopped. Continuing with bitter-cold herbs to remove heat, the high fever remained unchanged; repeatedly administering aromatic orifice-opening agents, the coma persisted. Ten days later, while in a dazed state, the child frequently pinched his genitals with his right hand. Removing his hand, he pinched again. Asking him why, he could not answer. I was at a loss. Three or four days later, he died from internal closure and external collapse. I pondered the cause of death for a long time without finding it. It was not until I came to Shanghai in 1939 that I saw the Japanese author Genmoto Kei's book *Research on Warm Diseases*, which annotated *Wenyi Lun* (Treatise on Pestilential Diseases). At the end of the first volume, there is a section on "Pinching the Yin," describing a child infected with a pestilential disease. On the sixth or seventh day, he suffered from irritability, delirious speech, restless coma, and frequently pinched his genitals. Palpating his lower abdomen, pressing near the Henggu point, he showed a frowning expression of unbearable pain, and the pinching stopped; releasing the hand, he pinched again. I prescribed modified *Zhenwu Tang* (True Warrior Decoction). By the eighth or ninth day, the heat resolved, consciousness slightly recovered, and the pinching gradually ceased. Upon questioning, it was known that the reason for pinching was severe pain in the lower abdomen extending to the genital tendons. Thus, I confirmed it as a "Zang Jie" (Organ Knotting) syndrome. Reading this, I rose in horror, pacing around the room, recalling the death of the child I had previously encountered. He did not die from the disease, but from the medicine. From the beginning, the error lay in using cold and cooling herbs to suppress, forcing the pathogen inward, transforming it into a Yin syndrome, and subsequently failing to use warm herbs to rescue him in time. Who was responsible? I was filled with shame and regret! After learning from this lesson, whenever I encountered pediatric Summer Heat Epilepsy, I treated it with *Fengyin Tang* (Wind Guide Decoction), without arbitrary additions or subtractions, and recovery occurred within two or three days.

In 1936, introduced by a fellow townsman, I went to Nanjing to treat a prominent figure (48 years old) suffering from dizziness. Symptoms included heavy dizziness, sensation of the world spinning when standing up, occasional spitting of saliva, frequent generation of saliva after spitting, poor appetite, mental fatigue, lying quietly and speaking lazily. This lasted for nearly a year, with no effect from Western and Chinese medicine treatments. I palpated his pulse as wiry and slow, and observed his tongue as pale with a gray, slippery coating. I knew it was insufficient Clear Yang above, with Turbid Yin pathogen flooding upward, forming a situation where Yin invades the Yang position. However, repeatedly administering *Fu Ling* (Poria), *Sheng Jiang* (Zingiberis Rhizoma Recens), *Bai Zhu* (Atractylodis Macrocephalae Rhizoma), *Gui Zhi* (Cinnamomi Ramulus), *Ren Shen* (Ginseng Radix et Rhizoma), and *Lu Rong* (Cervi Cornu Pantotrichum) only brought slight improvement, with insignificant efficacy. The patient had a history of dysentria intermittens (resting dysentery), occurring monthly, stopping within three to five days with Western medicine. Combining this, following Zhang Zihe's theory that "cold-dampness and solidified cold can be drained out," and according to the *Ziyuan* (Purple Pill) formula from *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) for treating "phlegm wandering in the lower abdomen," I prepared the formula. First, taking three pills the size of wu zi (walnut seeds), resulting in mild purgation. One day later, taking ten pills divided into two doses, discharging water mixed with pus and blood several times. Two days later, dizziness significantly decreased, the gray, greasy, slippery coating gradually transformed, appetite increased, and spirit refreshed. Continuously administering herbs to regulate and tonify the Yang of Spleen and Kidney, he recovered as before, and resting dysentery did not recur again. He lived past eighty years old and died of other diseases.

Inspired by *Research on Warm Diseases*, I deeply felt the precision and broad vision of Japanese scholarship. I also studied *Kokkan Igaku* (Imperial Han Medicine) written by Kōmoto Masaki, feeling that the benefit of this book is teaching people to identify Yin and Yang syndromes through abdominal diagnosis. In clinical practice, based on confirmed diagnoses, I used *Guizhi Jia Lingzhu Fuzi Tang* (Cinnamon Twig Decoction plus Poria, Atractylodes, and Prepared Aconite Root), praised in the book, to cure several patients in Shanghai referred to as "Damp-Warmth Typhoid" belonging to the Yin syndrome type.

Environmental Update and Slight Progress

In the summer of 1956, I took up a position in TCM teaching. Like dead wood meeting spring, receiving rain and dew; celebrating the happiness of late life, "starting anew as an official." I was taught by good friends and benefactors, and read extensively through jade-scroll books. I could verify the ancient with the modern, and review the old to know the new. Although I studied without great effort, I gained something.

(I) Regarding Theory: After preliminarily studying some philosophical works, I understood: ① The formation of TCM theory stems from our ancestors' practical experience in accumulating long-term struggles against diseases. They recognized the law of contradiction in all things in the medical field, and the fundamental reason for change and development lies in the interaction and struggle of opposing forces contained within things. Guided by the principle of universality of contradiction, they applied the Yin-Yang theory, a philosophical method of contradiction analysis, to elucidate the special laws of contradictory movement within the medical field. The characters Yin and Yang in TCM books have different meanings in different places, but "movement itself is contradiction," and "movement is the form of existence of matter." Therefore, Yin and Yang themselves are objectively existing matter. The Yin-Yang theory in the TCM theoretical system is a tool for explaining the special contradictions of medicine, so Yin-Yang is not equivalent to universal contradiction. As for theories such as Zang-Xiang (Viscera and Manifestations), Meridians, Qi-Blood, Essence-Jin (Fluids), Ying-Wei (Nutritive and Defensive), and Etiology, regardless of whether they relate to physiological activities or pathological changes, they cannot leave the matter of contradictory movement, nor can they leave Yin-Yang. Therefore, *Suwen: Yin Yang Li He Lun* (Plain Questions: Discussion on Separation and Union of Yin and Yang) says: "Yin and Yang, counting can reach ten, pushing can reach hundred; counting can reach thousand, pushing can reach ten thousand; the vastness of ten thousand is incalculable, yet their essence is one." Wang Bing annotated: "One refers to separation and union." The so-called "separation and union" implies the contradictory movement of unity of opposites. Based on this, my belief in advocating the Yin-Yang theory as the core of the TCM theoretical system was strengthened. ② The spiritual essence of the "Heaven-Man Correspondence" theory conforms to Engels' view in *Dialectics of Nature* that "the basic factors of the mode of life existence lie in the constant metabolism with the surrounding external natural world." Undoubtedly, metabolism is the basic condition for life survival. As stated in *Suwen: Yin Yang Ying Xiang Da Lun* (Plain Questions: Great Discussion on Yin-Yang Correspondences): "Flavors return to form, form returns to Qi, Qi returns to Essence, Essence returns to Transformation." This merely roughly depicts the general situation of bodily metabolism. Similarly, *Liwei Zhi Da Lun* (Great Discussion on the Six Micro Principles) states: "Therefore, without exit and entry, there is no birth, growth, strength, aging, and end; without ascending and descending, there is no birth, growth, transformation, gathering, and storage. Thus, ascending, descending, exiting, and entering exist in every vessel." This summarizes the constant metabolism of everything in nature. The characteristic of TCM pathogenesis lies not only in recognizing the contradiction of struggle between Evil (Pathogen) and Zheng (Upright Qi) inside the disease, but more importantly, on the basis of unified understanding of internal and external causes, placing the body's Zheng Qi (internal cause) in the primary position. Whether the Evil Qi (external cause) can make people sick depends on the adaptability of the body's Zheng Qi. This coincides with the scientific assertion that "internal cause is the basis of change, external cause is the condition of change, and external cause acts through internal cause." As for Chen Wuzhe's "Three Causes" theory, which only one-sidedly sees the cause of disease and ignores the body receiving the disease, and Wang Qingren's theory of "getting sick without being weak," both violate the dialectical two-point view inherent in the naive dialectics of TCM, becoming metaphysical one-point pure external cause theory or passive theory. Only Xu Shumi had unique insight, able to dialectically treat the occurrence and development of diseases. In *Benshi Fang* (Prescriptions from Actual Cases), he repeatedly followed the classic text "Where evil gathers, its Qi must be deficient," adding "if it stays and does not go, the disease becomes excess." This is identical to the modern medical view that due to the stimulation of etiologic factors, the body's physiological defense mechanisms rise to resist. Actually, this is the dialectics of the disease itself.

In the work of compiling the textbook for internal miscellaneous diseases for the first batch of Western doctors learning TCM, I realized the most important thing was to include the most practically valuable parts of the cultural heritage of TCM to strengthen Western doctors' confidence in learning TCM. For example, when writing the lecture notes for the "Deficiency Consumption Chapter," given that previous discussions on deficiency consumption mostly believed it was "accumulated deficiency becomes damage, accumulated damage becomes consumption," emphasizing only Zheng deficiency and ignoring Evil excess, and including tuberculosis indicated by modern medicine. Actually, our ancestors believed that the formation of any disease involves both Evil and Zheng. *Neijing*, *Shanghan*, and *Jingui* have numerous records, which can be obtained by careful examination. Therefore, "Deficiency Consumption" was divided into "Xu Sun" (Deficiency Damage) and "Lao Zhai" (Consumption Disease). The former, because *Jingui* class was opened separately, only briefly described the principles, methods, formulas, and drugs regarding "Xu Sun" after the Han Dynasty that were more practical. The latter highlighted the "Su You Lun" cited in *Waitai Miyao: Bone Steaming Section*. Although someone had recognized it as an infectious disease before, it clearly pointed out that patients died because "toxic Qi transmitted internally, pervading the five Zang organs." The so-called "toxic Qi" naturally refers to external pathogens other than the Six Excesses, which is very precious. Also, in the "Swelling Chapter," the viewpoint from *Jingui Yaolue: Pulse, Syndrome, and Treatment of Water-Qi Diseases* "If blood flow is not smooth, it becomes water, named Blood Partition" was specifically proposed. Although it referred to "amenorrhea in women," inevitably having limitations, it already estimated the relationship between blood and water. These are the essence parts of TCM theory and should be made known to future generations. However, shortly after I undertook this work, I suffered from bronchiectasis, massive hemoptysis, recurrent episodes, physical exhaustion, and had to yield to capable persons.

In current numerous publications, many discuss the germination of "homeostasis model," "systems theory," and "cybernetics" within the TCM Five Elements theory. Inspired by these papers, I further realized that ancient TCM is indeed a great treasure house. And thus I believe that the saying in *Jingui Jinshi* "Five Elements can be abolished, Yin-Yang cannot be abolished" is baseless. Zhu Xi's annotation in *Taiji Tushuo* pointed out: "With Yin-Yang, there is variation and combination, and Five Elements are complete... The changes of Five Elements are inexhaustible, yet nowhere is there not the way of Yin usage." Here, it can be known that Yin-Yang exists in all Five Elements, and the TCM Five Elements theory, connecting the holistic unity of the body's internal and external environments and mutual nourishment, mutual restriction, and automatic regulation activities, contains the contradictory movement of Yin and Yang. Lu Shi did not see this, hence his illusion of abolishing one to preserve the other. As for the characters "Ke" (Overcoming/Restraining) and "Zhi" (Controlling/Regulating) in TCM terminology related to Five Elements, they should be distinguished and not confused. Because it relates to physiology and pathology, i.e., Zheng and Evil aspects, with different meanings. As *Yijing Huihui Ji* explains "Excess Harm Inherits Control": "Cheng (Inherit/Follow) is like following. If not excessive, just follow it; once excessive, rise to control it, Cheng is seen here." And the "Zhi" in *Leijing Fuyi*'s "Without control, excess becomes harm" belongs to physiological automatic regulation. Both the party applying control and the party receiving control belong to the Zheng aspect. Of course, the function of control can also be applied to the Evil side, such as cultivating Earth to control Water, nourishing Water to control Fire, what is controlled naturally belongs to Evil. However, this so-called control comes from external input. If it is Yangming Excess, frying Kidney Yin, it is Evil Earth overcoming Zheng Water; if Damp-Water floods upward, clouding Heart Yang, it is Evil Water overcoming Zheng Fire. In short, those overcoming me are the thieving harm of Evil Qi, those overcome are the injury of Zheng Qi. As *Suwen: Zhi Zhen Yao Da Lun* (Plain Questions: Great Discussion on Essential Truths) says: "When Clear Qi arrives largely, it is Dryness prevailing, Wind-Wood receives Evil, Liver disease arises; when Hot Qi arrives largely, it is Fire prevailing, Metal-Dryness receives Evil, Lung disease arises..." Therefore, to clarify concepts, it is necessary to strictly distinguish the use of the characters "Ke" and "Zhi".