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The tongue coating is white, thick, and greasy, indicating that dampness (Dampness) is also present among the six qi. Therefore, we consider it from the perspective of Shaoyang disease (Shaoyang disease) complicated by dampness. I prescribed the original formula of Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Ju Fang Pingwei San (Local Formula for Calming the Stomach Powder), plus one additional herb: Zhe Bei Mu (Fritillariae Thunbergii Bulbus) and Juan Bai (Selaginellae Tamariscinae Herba). It was such a simple prescription. Within less than three days after the prescription was issued, there was feedback. The patient's husband called me to say that the effect after taking the medicine was very good; the pain was greatly reduced. For these two days, she did not need morphine injections or painkillers, could sleep peacefully at night, and vomiting was basically eliminated. Think about it, for such a patient with a highly malignant tumor, regardless of how her condition might develop in the future, this therapeutic effect alone is extraordinary. Pain that is difficult to alleviate with morphine and potent analgesics was significantly reduced by a small dose of Chaihu Tang (Bupleurum Decoction) and Pingwei San (Stomach-Calming Powder). What does this illustrate? It can only illustrate the importance of syndrome differentiation (Syndrome Differentiation), the importance of treating according to the syndrome (Treating According to Syndrome). In your view, this is pain caused by melanoma metastasis, but in my view, this is an issue of the Shaoyang channel (Shaoyang Channel). When the Shaoyang channel has problems, the circulation of Qi and Blood (Qi and Blood) in its territory will be obstructed, leading to blockage; blockage causes pain. Now that you have adjusted the Shaoyang channel and resolved the Shaoyang problem, and the circulation of Qi and Blood in the Shaoyang territory is unobstructed, how could there still be pain? And how do you know this is a Shaoyang problem? You rely on the syndrome (Syndrome). Regarding this "syndrome" in Traditional Chinese Medicine (TCM), we indeed lack the wisdom to fully penetrate its essence, but through the definition of the character "Zheng" (Syndrome/Pattern), we vaguely sense that it is a miraculous thing. Especially in *Shanghan Lun* (Treatise on Cold Pathogenic Diseases). *Shanghan Lun* discusses pulse (Pulse diagnosis) and syndrome, but emphasizes syndrome more. From the ratio of pulse to syndrome, the proportion of syndrome is much larger. Many clauses do not mention pulse at all, such as Clause 96: "In cold damage or wind strike after five or six days, alternating chills and fever, fullness and distress in the chest and hypochondrium, silent desire to eat nothing, irritability and frequent vomiting, or irritability in the chest without vomiting, thirst, abdominal pain, hardness and fullness below the costal margin, palpitations in the epigastrium, difficulty in urination, no thirst, slight fever on the body, or coughing—Xiaochaihu Tang (Minor Bupleurum Decoction) should be administered." This clause describes more than ten syndromes, yet mentions no pulse. Therefore, *Shanghan Lun* focuses more on syndrome, or rather, uses syndrome to govern pulse. If we discuss from the fundamental meaning of syndrome, pulse is actually a means to understand and obtain syndrome; thus, speaking of syndrome implies the inclusion of pulse. These things revealed by syndrome should be carefully pondered by everyone. We repeatedly emphasize the need to read and memorize the clauses of *Shanghan Lun* thoroughly. Why? To become familiar with, recognize, and master the syndrome. Whether a disease is superficial or deep, it manifests through the form of syndrome. If you do not know the relationship between syndrome and syndrome, syndrome and disease, or syndrome and formula, how can you conduct treatment? This would be very difficult. This is a discussion of syndrome in a general sense.

● Custom Definition of Syndrome

Specifically, syndrome helps us recognize the existence and changes of disease. The existence of disease is sometimes easy to recognize, but hidden diseases, those that have not manifested, like the disease of Wang Zhongxuan, the Grand Master of Ceremonies, you cannot know. Changes in disease, and the factors leading to this existence and change, are even harder to recognize. However, based on the aforementioned functions of syndrome, you can know through syndrome. Therefore, anything that reflects the existence of disease, reflects the changes of disease, or reflects the factors leading to the existence and change of disease can be called syndrome. If I were to give a relatively precise definition of syndrome, I would define it as follows. Western medicine relies on a series of modern methods to obtain such data. One can say that the entire modern science assists Western medicine in obtaining evidence: biological, chemical, physical, electronic, and even future nanotechnology, all helping modern medicine gather data. But who helps TCM obtain evidence? No one helps you. Science currently cannot help you; not only can it not help, it might even criticize you. If someone truly knows by observation alone, they might say you are practicing superstition. Thus, TCM is difficult! Previously, I introduced my late master, Li Yangbo. After my master passed away, I always had a wish to organize his thoughts. I think seeing these thoughts will help you learn TCM and study traditional culture. In 1997, by chance, I met an editor from China Publishing House of Traditional Chinese Medicine. He was interested in this book, agreed to assist in publishing it, and requested that I write a long preface to comprehensively introduce my late master. Since my master had no fame or academic degrees, I needed to use my PhD status to lend credibility. Thus, I wrote down everything I knew about my master from beginning to end. After writing the preface, I sought opinions from some teachers. They said: "It is well written, but you portray your master as too miraculous. Being too miraculous might have negative effects." What is so special about my master's abilities? Merely occasional knowledge through observation and diagnosis by pulse. Compared to Bian Que or Zhang Zhongjing, this minor miracle is insignificant. Yet, if you say my master's abilities are too miraculous, how could you possibly believe in Bian Que or Zhang Zhongjing? That is impossible. This is the situation of TCM: not only does science not fundamentally recognize or help you obtain evidence, but it also gossips and holds you back. Some might say, doesn't TCM look lively now? With calls for scientificization, modernization, and going global? But what you see is a false prosperity, a real bubble economy. I put these words in the book, in black and white, so I must take responsibility. Let's wait and see. So, I feel that learning TCM is truly not easy. Without Confucius' third maxim, "Is it not a pleasure to learn and to repeat or practice what has been learned? Is it not pleasant to have friends coming from afar?" one cannot succeed. TCM has no other help; we can only rely on our own Four Examinations (Four Examinations: Inspection, Auscultation and Olfaction, Inquiry, and Palpation) to obtain evidence. There is no second path. But once mastered, the significance is extraordinary. Like the case just mentioned, I also find it incredible how a small dose of Chaihu Tang (Bupleurum Decoction) could have such an effect. Over the years, I have increasingly felt the truth of the ancient saying, "When poor, cultivate oneself; when prosperous, benefit the world." Learning TCM indeed allows one to achieve this and resonate with it. When the opportunity arises, and everyone wants to hear my feelings, I will share them. After the publication of this small book, there will inevitably be a few kindred spirits who will influence some people. If this opportunity does not arise? Then you can truly retreat into your small room to maintain your integrity, caring not for spring, summer, autumn, or winter. The theory of TCM is too beautiful, too perfect. In my view, it is no inferior to the Theory of Relativity. Ponder this theory, and there is infinite joy within it.

● Basis of Syndrome

Earlier we said that modern medicine obtains evidence using entire scientific theories and technologies as its basis. So, what is the theoretical basis for TCM's evidence gathering? This basis is what *Neijing* (The Yellow Emperor's Inner Canon) states: "What exists internally must manifest externally." This is the greatest basis. Regardless of what internal changes occur, regardless of their magnitude or subtlety, they will definitely manifest externally. This is absolute, beyond doubt. The question is whether we can see the internal through the external. Do we know which external signs reflect which internal conditions? Can you establish this correlation? This is a difficult point. Correlation and correspondence certainly exist, which is unquestionable. Coarse changes can be detected by everyone; for example, if you have a dark face, it goes without saying that you are unhappy inside. Seeing you happy indicates you have joyful news inside. This is the most typical "what exists internally must manifest externally." But for finer, deeper internal changes, do you have a way to know? This depends on your skill of "seeing the significant from the minute" (Seeing the Significant from the Minute). Discovering profound, significant, or even long-standing changes from very subtle manifestations. Actually, the TCM system already has a complete set of such methods. Through rational thinking, and through internal verification and external verification methods, to "see the significant from the minute," to recognize disease and obtain the above-mentioned "syndrome." This entire set of thinking, methods, and techniques for obtaining evidence is called Syndrome Differentiation (Syndrome Differentiation). Examples recorded in TCM history, such as Bian Que observing the complexion of the Marquis of Qi, or Zhang Zhongjing diagnosing the illness of the Grand Master of Ceremonies Wang Zhongxuan, are processes of seeing the significant from the minute, processes of obtaining evidence and differentiating syndromes. If we also grasp this process, then the aforementioned matters are manageable. Recently, I treated an old patient and friend of my late master for a sore throat. People in Nanning, upon seeing a sore throat, assume there is fire (Heat/Fire) and like to drink cooling tea, resulting in increased pain. The patient became afraid and came to me. I palpated the pulse; both pulses were very deep. Looking at the tongue, it was pale. Where is the fire? Thus, I prescribed Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction). Less than two hours after taking the medicine, the sore throat pain was greatly reduced. After two doses, the illness was cured. This old patient told me about an incident from twenty years ago. A woman in her forties living downstairs from his house suffered lower abdominal pain for a period. She went to a large hospital for examination, which resulted in a diagnosis of pelvic tumor requiring surgical treatment. While packing to prepare for hospitalization and surgery, my late master's old friend learned of this and said to the patient's family, "Why not ask Dr. Li to take a look?" The patient followed this advice and saw my master. My master said, "This is not a tumor; it is parasites. Expelling the parasites will cure the illness." He prescribed medicine for the patient. A few days later, many thin, strip-like objects were indeed found in the stool. Finally, the illness was cured without surgery. Upon re-examination at the large hospital, no tumor was found. Therefore, everyone should not underestimate this "syndrome" in TCM. If you can truly grasp it finely, you possess all of modernity, and may even surpass it.

● Distinction Between Syndrome and Disease

Next, let us discuss the relationship between disease and syndrome. Disease refers to the general aspect, speaking broadly; syndrome refers to the specific aspect, discussing individuality and distinction. Disease speaks generally; syndrome speaks specifically. For example, Taiyang disease (Taiyang Disease) is relatively general, discussed from a broad perspective. Then, what about the Wind Strike Syndrome (Wind Strike Syndrome) within Taiyang disease? This is relatively specific, addressing distinctions. Furthermore, within syndrome, there are further distinctions and different levels. For instance, Wind Strike is a syndrome, while the components constituting Wind Strike—such as fever, sweating, aversion to wind, and floating pulse—are also syndromes, but they are next-level syndromes, subsystem syndromes, discussing distinction from a finer differential perspective. Syndrome is the form of reflection of the organism regarding the existence and changes of disease and etiology. Due to individual differences, these forms of reflection are not identical. Take a metaphor: Would the feelings of the dozen or so people here regarding the same event be exactly the same? Definitely not. Take the simplest example: watching the same movie. With different life experiences and concepts, individuals' feelings and evaluations of the film will differ. Some might say the movie is excellent, while others might say it is boring! The other day I asked someone how they liked *Crouching Tiger, Hidden Dragon*. He said it was terrible! If scored out of 100, he gave it at most 59 points. Hearing this evaluation, I wavered; was it worth spending two hours? Finally, I gritted my teeth and watched it, only to exclaim afterward that I had nearly been deceived! Martial arts films are my favorite, but producing a film like *Crouching Tiger, Hidden Dragon* is truly not easy. Everyone can ponder this distinction carefully. Sometimes the relationship between disease and syndrome is similar. For the same disease, due to different individuals, the reflection differs. This is called "Same Disease, Different Syndromes" (Same Disease, Different Syndromes); the disease is the same, but the syndromes can be completely different. Therefore, when formulating a treatment plan, besides considering the disease, we must also consider the factor of syndrome. Western medicine primarily emphasizes disease differentiation (Disease Differentiation); emphasizing disease differentiation is essentially emphasizing common factors. If a thousand people have tuberculosis, and all thousand use anti-tuberculosis drugs, there will be no difference. But think about it, if a thousand people get tuberculosis, would Zhang San and Li Si be exactly the same? Definitely not. Of course, Western medicine finding such a common factor is remarkable and great. Finding a common factor from such complex changes is called abstraction, which is indeed amazing. However, ignoring the complex individuality behind this commonality—is this perfect? It is also imperfect. Thus, Western medicine has its great and superior aspects, but also its shortcomings. TCM also seeks commonality, so one must differentiate disease; not doing so is unacceptable, as it is a prerequisite. Each chapter of *Shanghan Lun* begins with differentiating a certain disease, which is a good example. But this alone is not enough; one must also differentiate syndrome. Differentiating syndrome is to identify individuality. If you grasp the commonality and also the individuality, then it is comprehensive. By stating this distinction, everyone can evaluate the two medical systems and see which is superior in concept. TCM is a very excellent medical system. Unfortunately, we, the successors upholding TCM, are unworthy. We did not surpass the past; instead, we made TCM unbearable. It is not that TCM is bad; TCM is good, but we failed to inherit it properly!

● Detailed Explanation of Syndrome Meaning

A. "Having a disease does not necessarily mean having a syndrome"