Chinese medicine: from rural hospitals to top three hospitals in Kyoto

Chen Yang's voice was strong and resonant, echoing in the auditorium: "The results prove that Dr. Zhuang's diagnosis was accurate!"

"After taking the medication, the patient experienced a 'drug-induced recovery' reaction, followed by normal bowel movements, increased urine output, and stable vital signs! This is not only about curing a patient, but also a successful expansion of the capabilities of traditional Chinese medicine in the field of acute and critical care!"

"Dr. Zhuang's breakthrough lies in his courage and sense of responsibility in facing crises, and even more so in his ability and wisdom to grasp the main contradictions in complex situations and dare to use 'extraordinary methods' to treat 'extraordinary diseases'!"

"He told us that traditional Chinese medicine is not a slow cure. In times of life and death, traditional Chinese medicine can, and should, step forward and play a leading role!"

After the words were spoken, the auditorium fell into a brief silence, which was then followed by thunderous applause!

This applause is not only for Zhuang Qiwen, but also for Chen Yang's insightful analysis, and even more so for the powerful potential that traditional Chinese medicine has demonstrated in the field of critical care!

Zhuang Qiwen sat in the audience, his heart filled with excitement.

Director Chen's explanation vividly expressed his thoughts, the pressure he faced, and the decisions he made at the time, giving him a sense of gratitude for meeting a kindred spirit.

Cheng Yi lowered his head deeply. He had to admit that compared to Zhuang Qiwen's sense of responsibility, his hesitation and conservatism yesterday seemed so insignificant.

After the applause subsided, Chen Yang returned to the center of the stage and began to explain the core theories of this lecture.

"Through these three cases, we can see that 'breakthrough in thinking' is reflected on multiple levels." Chen Yang switched to the PPT, and the key points were listed on the screen.

"Firstly, there is a breakthrough at the diagnostic level."

"Not satisfied with appearances and conventional diagnosis, Yu Shiyun discovered the role of the 'liver' in diabetes, and Xia Hongliang reinterpreted 'lily disease' and 'Shaoyang pivot'."

"Secondly, it is a breakthrough in the application of theory."

"Not bound by the boundaries of schools of thought, Xia Hongliang integrates the theory of typhoid fever with the theory of febrile diseases, and the differentiation of syndromes of the internal organs with the differentiation of syndromes of qi, blood and body fluids. He also connects classical prescriptions with mental and emotional diseases, and Zhuang Qiwen integrates attacking pathogens with supporting the body's resistance."

"Thirdly, it is a breakthrough in the level of treating courage."

"Zhuang Qiwen demonstrated this in the treatment of bloating by daring to take risks and use strong medicine in times of crisis."

Chen Yang then changed the subject: "However, breakthroughs are not based on mere imagination or novelty. All breakthroughs must be built within solid 'boundaries'."

What is this boundary?

New content appears on the screen.

"Boundary One: The Foundation of Classical Theory".

"No matter how innovative the ideas are, they cannot deviate from the core theoretical framework of traditional Chinese medicine, such as Yin and Yang, the Five Elements, the internal organs and meridians, Qi, blood and body fluids, and the Six Channels and Eight Principles. Xia Hongliang's theory is rooted in the Shanghan Lun and Jin Gui Yao Lue, while Zhuang Qiwen's method is in line with the principle of "the most severe cases act alone" in the Nei Jing.

"Boundary 2: Support from the four diagnostic methods."

"Breakthroughs must be based on solid evidence, and this 'solid evidence' is detailed and accurate information obtained through observation, listening, questioning, and palpation. Yu Shiyun grasped details such as a wiry pulse and dry mouth without thirst; Zhuang Qiwen relied on critical signs such as a purplish-dark tongue, a grayish-black coating, and a deep and weak pulse."

"Boundary Three: The Rules of Prescription and Drug Combination".

"Even when Zhuang Qiwen uses strong medicine, his prescriptions are still orderly in their attack and tonification, and the combination is rigorous. Leeches and horseflies break up blood stasis, Glauber's salt and rhubarb clear the bowels, and ginseng and aconite consolidate the body. They are by no means chaotic."

"Boundary Four: Testing in Clinical Practice"

"All theoretical breakthroughs must ultimately be reflected in their therapeutic effects. Only if they are effective can the value of the breakthrough be proven; if they are ineffective, the direction of the breakthrough needs to be reconsidered."

Chen Yang concluded: "Therefore, 'breakthrough' and 'boundary' are not opposites, but rather complementary."

"Boundaries are the cornerstone of our existence, ensuring that we do not go astray or stray from the right path; breakthroughs are the driving force for our progress, propelling us to continuously climb new peaks and expand the boundaries of our knowledge and capabilities. We must avoid 'drawing a line in the sand' and becoming complacent, and also prevent 'running wild and acting recklessly'."

"The delicate balance involved requires us to constantly understand and grasp it through extensive clinical practice and profound theoretical reflection."

Chen Yang's explanation was logically clear and progressive, harmoniously unifying the seemingly contradictory concepts of "breakthrough" and "boundary," opening a new door of thought for the audience.

After the theoretical explanation, the Q&A session began.

The audience raised their hands in enthusiastic support.

The first few questions were mostly raised by young students, and Chen Yang patiently and insightfully answered them on topics such as how to study the classics and how to cultivate clinical thinking.

At this moment, a middle-aged doctor sitting in the middle row, wearing black-rimmed glasses and with a serious demeanor, took the microphone handed to him by a staff member.

"Hello, Director Chen. I am the chief physician of the Department of Gastroenterology at the affiliated hospital, and my surname is Zhao."

The middle-aged doctor spoke calmly, with a scrutinizing tone: "Your lecture was excellent, and the case studies were very moving. However, I have a question."

The room fell silent; everyone sensed that a pointed question had arisen.

“You and your team seem to place particular emphasis on ‘breakthrough’ and the precise dialectic of ‘personalization’. That is certainly a good thing.”

"But have you considered how this model, which relies heavily on individual insight and experience, can be scaled up on a large scale?"

"How can we ensure that TCM practitioners in grassroots hospitals and even community clinics can also master this 'breakthrough' thinking? If it cannot be promoted, does this mean that what you are advocating is just a 'luxury' for a few elites, and has limited significance in improving the overall diagnosis and treatment level of the entire TCM community?"

This question is extremely sharp, pointing directly to the core weakness of Chen Yang's ideas, and even carrying a hint of questioning whether his ideas are "too sophisticated for the masses".

Wu Yongping, Lu Yuanmin, and others also showed expressions of concern.

This is indeed an unavoidable contradiction in the process of modernizing and standardizing traditional Chinese medicine.

Many people in the audience nodded in agreement, feeling that Dr. Zhao had asked the right question.

Zhuang Qiwen, Yu Shiyun, and others couldn't help but feel worried for Chen Yang.

Faced with this pointed question, Chen Yang did not panic at all; instead, he showed an appreciative smile.

"Director Zhao's question is excellent and very insightful. It is indeed a real problem that we must face and consider."

Chen Yang first affirmed the other party's point of view, then changed the subject: "However, I would like to ask everyone to consider a question: The standardized treatment of Western medicine is based on a profound understanding of the pathophysiology of diseases and the support of a large amount of evidence-based medicine."

"So what about traditional Chinese medicine? What is the basis for our pursuit of 'standardization'?"

Chen Yang asked and answered himself: "If our understanding of the pathogenesis of diseases in traditional Chinese medicine remains superficial, our 'standards' can only be low-level and rigid 'standards'."

"Even if such 'standards' are promoted, how effective can they be?"