🌿 Folk Prescriptions

In today’s China, even globally, few would propose abolishing TCM. If someone did, people might consider them mentally ill or merely drunk. Yet, seventy years ago in China, such debates were commonplace, frequently appearing in newspapers. A group of May Fourth Movement intellectuals openly advocated it. Those familiar with history know this well. Even without knowing, a basic understanding of Lu Xun’s disdain for TCM suggests how TCM was perceived by these elites. Yet, even I, a specialist in modern Chinese intellectual history, never expected that ten years after the May Fourth Movement, such talk would be seriously considered by the newly established Nationalist Government, sparking a minor controversy.
In 1928–1929, shortly after the Nationalist Government settled in Nanjing, it wasn’t entirely as portrayed in party histories and modern textbooks—completely losing public favor and collapsing. At least, the middle class and many intellectuals still harbored hope. The government also aimed to act decisively, though its actions were clumsy, much like students who burned Zhaojialou. The abolition of TCM was one such example. The incident unfolded like this: In early 1929, the newly formed Nationalist Government’s Ministry of Health convened a National Central Health Conference. Despite the name, attendees were limited to hospital directors (Western doctors) from major treaty ports, renowned physicians, and a few health administrators. At that time, Western medicine in China had vastly improved compared to the late Qing Dynasty. Though internally divided—British-trained doctors called "British doctors," German-trained "German doctors," Italian-trained "Italian doctors"—they united against TCM. In this atmosphere, the Western-only conference naturally showed hostility toward TCM. Calls to abolish TCM grew loud, resulting in the passage of the "Old Doctor Registration Case," requiring all TCM practitioners under 50 with less than 20 years of practice to re-register with the health department, undergo supplementary education, pass exams, and receive licenses to operate. Practitioners over 50 faced restrictions on clientele and were banned from promoting TCM or running TCM schools. Four key figures stand out: two central figures in the debate. One was Yu Yan, a renowned physician with Japanese study experience, who proposed the Old Doctor Registration Case. The other was Chen Cunren, a famous Shanghai TCM physician and compiler of the "Great Dictionary of Chinese Pharmacy." A supporting figure was Chu Minyi, a Nationalist Party Central Committee member who studied in Japan and France, active in politics, academia, and business, and served as supervisor for the Shanghai Physicians Association (exclusive to Western doctors). He was reportedly one of the conference’s driving forces. Later, he joined Wang Jingwei’s faction and became a collaborator, so Chen Cunren blamed him. The last figure was Minister of Health Xue Dubi, a man from Feng Yuxiang’s circle, ignorant of both Western and TCM. He became minister only because the Northern Expedition leaders—Chiang Kai-shek, Feng Yuxiang, Yan Xishan, Li Zongren—divided spoils, and Feng got the Health Ministry. Though educated in new schools, Xue was far more rustic than the others. Though claiming neutrality between Western and TCM, his statements before and after the event clearly favored Western medicine—or science.
Under the fierce conflict between TCM and Western medicine, the health department dominated by Western doctors was tasked with registering TCM practitioners. The outcome was predictable: effectively ending the livelihood of TCM practitioners under 50, destroying their careers. The proposal explicitly aimed to abolish TCM, with registration merely a transitional step. Upon announcement, the entire TCM community erupted in outrage. Led by Shanghai TCM practitioners influenced by democratic ideals, nationwide protests erupted. Newspapers in Shanghai saw heated exchanges between TCM and Western medicine factions. In Nanjing, TCM practitioners petitioned, invited officials to meals, lobbied military and political leaders. Business, industry, and academic circles added chaos with supportive voices. The uproar delighted journalists (newspaper sales soared). Ultimately, the Old Doctor Registration Case was abandoned. TCM practitioners continued practicing, and the instigator, despite public anger, kept his position. Chiang Kai-shek and Li Zongren soon clashed again, diverting attention to war games, and the literary drama faded into oblivion.
As with all disputes where neither side can dominate, naming is a key battleground. Both sides exchanged insults. Before the TCM vs. Western medicine clash, warlords had been exchanging hostile telegrams for decades. Doctors, dedicated to healing, were relatively polite. Western doctors called TCM practitioners "old doctors" and themselves "new doctors," while TCM practitioners called themselves "national doctors," refusing to acknowledge Western medicine as "new" and instead calling them "Western doctors" or "foreign doctors." Unlike warlords’ mutual accusations of bandits and villains, the four labels thrown back and forth—old/new, national/Western—precisely revealed the ideological undercurrent of this controversy. Since the opening of China’s doors, the cultural conflict between East and West shifted from "Chinese vs. barbarian" to "East vs. West," then to "old vs. new." This wasn’t a simple reversal; the earlier moral judgments in the "Chinese vs. barbarian" context underwent a transformation. In the "old vs. new" context, not only were the evaluations reversed, but they acquired evolutionary significance—positive and negative meanings—more powerful and intimidating to Chinese intellectuals.
We see that the TCM debate echoed the earlier "science vs. superstition" argument of the New Culture Movement. Yet, the arguments on both sides were essentially the same. Western doctors attacked TCM as unscientific, naturally enough. They dismissed TCM’s yin-yang, five elements, meridians, and pulse diagnosis as belonging to the realm of Zhang Tianshi and Hu Da Xian. The proposer of the Old Doctor Registration Case, Yu Yan, even labeled TCM as a profession relying on divine powers to profit. With confidence in anatomy, chemistry, physics, and pharmacology, their tone was bold and aggressive. Surprisingly, TCM practitioners didn’t invoke Bian Que or Hua Tuo, nor cite the "Huangdi Neijing" or "Wang Shuhe Pulse Classic" to rebut. Instead, they argued: "China’s medicine has proven effective, but due to theoretical inconsistencies with science, it lacks global scholarly acceptance. Yet, medicine originated from experience, achieving results first, then explaining them theoretically—impossible to avoid philosophical speculation. Yet, the results are real. Recently, Westerners have proven the efficacy of Chinese medicine matches what is recorded in the Materia Medica. They have established societies to study Chinese medicine, and domestic scholars are increasingly using scientific methods to organize and expand it, gradually winning trust from both Chinese and foreign scholars." (Dagong Bao, March 21, 1929) They focused on efficacy, seemingly leveraging science and foreigners.
Yet, this weakened TCM’s confidence compared to Western medicine, which is the "authentic" science. Thus, in this debate, Western doctors were overwhelmingly dominant, appearing triumphant and imposing. In their view, protesting TCM practitioners were merely greedy for their livelihoods, even likened to Boxers (the Righteous Harmony Society)—obstacles to progress and reform. Yu Yan’s forceful words are worth quoting: "Opposing the abolition of TCM means opposing the scientificization of medicine, opposing government health administration, opposing China’s medical internationalization, and ignoring cultural aggression without seeking ways to revitalize. With such actions, pursuing such desires, China will inevitably sink into a stagnant, outdated, and obsolete tradition. Railways can be abolished—let horses pull carts. Warships should be banned—what about thousands of boats? Long spears and large swords can defeat guns and cannons—then factories are useless. Eight-part essays and poetry can produce talents—mathematics and physics are mere tricks. Not knowing astronomy, geography, or meteorology, barely literate, yet boldly discussing cosmic mysteries. Scientific experiments, based on real facts and strength, are seen as redundant. Vague, general terms like yin-yang, qi, cold, heat, tonification, and drainage can explain all diseases and drug mechanisms. Anatomy, physiology, pathology, and pharmacology are ridiculed as studies in bone piles—the killing ground of medical school. Oppose innovation, oppose reform. Even if territory shrinks and national power declines, leading to national destruction and annihilation, they remain indifferent. This is driven by momentary anger, forgetting the nation’s grand strategy." (Dagong Bao, March 17, 1929) This eloquent, ornate writing, though not necessarily full of gems, overwhelmed opponents momentarily. Clearly, both Western and Chinese medicine wielded the same classical rhetoric—yet TCM seemed to lag behind. Western doctors could write classical essays to attack, while TCM couldn’t craft a Western-style response. The form of writing isn’t crucial; the issue is the extreme, top-down rhetoric that’s unbearable—blaming TCM, especially protest organizers, for national ruin and extinction. (Clearly, China produces massive critique easily—no quarrel until it escalates to ideological level, from housewives to celebrities.) In the author’s view, TCM and Western medicine are like mules and railways, sailing ships and warships, long spears and guns—One belongs in a museum, the other is the reigning champion of the age.
Chinese people’s awareness of evolution was, to some extent, shaped by Western cannons, goods, and doctrines. A side effect was mixing two equations: West equals new, China equals old. West signifies progress, civilization, science; China signifies backwardness, ignorance, superstition. Practical efficacy is the key driver of this shift in consciousness. In other words, Chinese people believe the West is progressive because they witnessed Western warships, cannons, and institutions surpassing their own—effective results led to belief. But the comparison between TCM and Western medicine is far simpler than comparing Chinese and Western guns and ships. Amid Western cultural triumph, TCM remained an exception. Under joint attacks from Western medicine and fashionable intellectuals, TCM hadn’t truly lost ground—even in the most Westernized city, Shanghai. Though TCM had many incompetent doctors, even charlatans (Western records weren’t flawless either), many genuinely skilled practitioners existed. Their medical outcomes weren’t inferior to Western medicine—sometimes even saving lives when Western doctors had given up (a phenomenon still occurring today). Even skeptics can’t deny this. Worse for Westernizers, TCM case histories are repeatable—same disease, same formula, same effectiveness—just like scientific experiments. Western medicine couldn’t eradicate TCM largely because it couldn’t decisively surpass it in efficacy, especially in internal medicine. Even modern intellectuals in the 1920s–30s weren’t all like Liang Qichao, who insisted on maintaining Western medicine’s reputation after mistakenly having his healthy kidney removed during surgery. When seriously ill, they still sought the best doctor regardless. This may explain why Western doctors resorted to government intervention (health administration).
Naturally, Western doctors’ motives weren’t merely to monopolize space and eliminate rivals. They genuinely aimed to advance China’s modernization, especially in healthcare. But the question remains: Could TCM hinder Western medicine’s development by 1920s–30s? Undeniably, Western medicine was scarce—only about 6,000 doctors nationwide, mostly in big cities. Health Minister Xue Dubi admitted only 20–30% of counties had Western doctors. Yet, Western medicine had only decades of history, with significant growth only in the early 20th century. In such a short time, this scale is impressive. Moreover, medical development is constrained by market and national development levels. China’s economy was so underdeveloped—its total import-export volume less than Belgium’s small size—that even iodine tincture had to be imported. Naturally, Western medicine, dependent on industrial equipment, couldn’t reach high standards. Also, medical services were mainly market-driven. Market share depended on two factors: efficacy and price. TCM was far cheaper than Western medicine, while Western medicine lacked absolute superiority in efficacy. Thus, both shared the market—not one dominating. Even in cosmopolitan cities, this was true. In areas without Western medicine, it wasn’t because TCM dominated, but because most people were too poor to afford Western medicine unless missionaries offered free treatment. Certainly, traditional beliefs and local doctors influenced the entry of Western medicine in China. When missionaries first introduced Western medicine, such obstacles existed. But by the time even TCM practitioners claimed to embrace science, these barriers, if any, were minimal. I’m skeptical about how much traditional beliefs actually hindered medicine. Missionary doctors recalled many instances of Chinese resistance, but their memoirs also noted these obstacles were overcome by their relatively mediocre medical skills. After all, the Chinese are pragmatic—when effective, they readily abandon preconceptions, especially when life is at stake. I once lived in a very remote rural area, where medical conditions and attitudes were no better than in the 1920s–30s. But as long as a doctor (from the Western system) could cure their illness, all prior beliefs would yield to the doctor’s orders.
During the TCM practitioners’ petitions, various sectors sent supportive telegrams. One was particularly notable: blaming TCM for China’s world-leading population (Dagong Bao, March 16, 1929). Obviously, attributing China’s large population to Qibo and Huangdi’s inventions is illogical. Yet, China’s huge population coupled with poor healthcare became the strongest argument for TCM’s survival. With 80% of the country lacking Western medicine and a population of 400 million versus only 6,000 Western doctors, this stark imbalance was a reality the government’s health authorities couldn’t ignore. In essence, most Chinese people still relied on TCM for illness treatment. The fiery proposals at the Central Health Conference, though alarming TCM practitioners, were essentially no different from the idle talk of May Fourth intellectuals—neither could solve China’s real problems. The petitioning TCM practitioners seized this point, lobbying officials at all levels. The Health Ministry was caught between a rock and a hard place. Xue Dubi sat on hot coals, even receiving a scolding from boss Feng Yuxiang. The result? Everyone made a fuss, Western doctors wasted effort, saliva, and ink, returning to their clinics and hospitals lamenting in vain. TCM practitioners celebrated victory, feasting together.
Certainly, the TCM victory was exhilarating for participants. Chen Cunren, one of the petition organizers, repeatedly mentioned this event in his memoirs decades later, brimming with pride. But the victory was heavily discounted. Though TCM won the right to survive, it publicly acknowledged the opponent’s logic and had to justify its existence using the opponent’s standards. Yet, TCM’s theoretical framework—yin-yang, five elements, meridians, pulses—differs fundamentally from Western science, belonging to entirely different cultural systems. It shares deeper ties with Western science’s criticized "superstitions" like Daoism and alchemy. Objectively, from Zhang Zhongjing to Li Shizhen, they never clearly separated from alchemy. Even accomplished TCM practitioners were somewhat blurred between medicine and divination. In a sense, TCM and Western medicine belong to two different cultural systems of medical practice. Explaining or interpreting one in terms of the other is extremely difficult. Judging TCM by Western medical standards is akin to viewing things through tinted or distorted glasses. Even "medicine and divination inseparable" is merely our modern perception—after accepting Western scientific values. In Western contexts, TCM practices like acupuncture, massage, or cupping are hard to truly comprehend. Even today, with advanced science, the physical existence of meridians remains unproven by any scientific method. Yet, anyone who has undergone acupuncture can genuinely feel the presence of meridians and acupoints. In this TCM vs. Western medicine debate, Western doctors claim TCM lacks scientific basis, while TCM insists on scientific proof to validate itself. TCM’s theoretical surrender is obvious. After all, in that era, "science" held infinite power—everyone bowed before it. Who says the May Fourth Enlightenment of science and democracy failed? At least, the word "science" became a magical wand. Perhaps most ordinary people didn’t think this way—many didn’t even understand the term "science." But society always has dominant, minority, and silent groups. In certain circumstances, if the dominant group accepts a rationale, it becomes social orthodoxy. That’s why, despite Western medicine being immature (Shanghai had only one X-ray machine), outnumbered by TCM, Western doctors dared propose abolishing TCM, while the powerful TCM movement could only plead for mercy, needing lobbying and bribery to resist. Such is the irony: when most of society still didn’t know what science meant (including some who shouted "science"), reverence for the term "science" could still flourish.
After the incident, Chu Minyi didn’t propose abolishing TCM at the Kuomintang’s Third National Congress as rumored, but instead advocated promoting science and selecting talent. Health Minister Xue Dubi declared TCM couldn’t be abolished but must be scientificized. In reality, the health department built on Western medical ideals (though still immature) was fundamentally at odds with TCM. To establish a modern health system, the department had to transform TCM. As the "Dagong Bao" editorial put it: "Chinese physicians bear a special mission to the world—resolving the Chinese-Western medicine problem" (likely written by Zhang Jiluan). Moreover, TCM itself had undeniable flaws. As mentioned earlier, there were too many incompetent doctors. Though Western medicine also had its share, the sheer number of TCM charlatans was overwhelming—many practiced after merely memorizing "Tangtou Ge" (Medicinal Formula Songs). This stemmed from TCM’s highly personalized transmission, overly experiential and intuitive learning, with enormous gaps between individuals, lacking a basic benchmark. Plus, TCM overall lacked concepts of sterilization and hygiene, posing risks to public health and epidemic prevention. Since then, solving the Chinese-Western medicine issue has been one-sided. The Ministry of Health required TCM practitioners to pass exams (like Western doctors), but the exam content focused on Western medicine. Passing Western exams earned the title "doctor," while passing TCM exams earned "medical officer" (though better than Hong Kong’s "Herbalist," meaning herb grower or seller). Research and compilation of TCM also largely followed Western scientific perspectives and methods. In fact, during the incident, TCM’s status had subtly changed. Some Western and Japanese scholars had already noticed TCM’s potential and begun studying it (mainly herbs), which TCM practitioners cited as evidence of their value. However, Western research on Chinese medicine (also called Han medicine) focused on pharmacology—within the scope of Western science—aiming to incorporate TCM components into Western medicine. This approach has consistently guided the transformation of TCM. Today, TCM has indeed embarked on a scientific path—prepared medicines can be mass-produced—but increasingly resembles Western medicine. Generation after generation of medical elites, driven by scientific ideals and instruments, explore the physical existence of meridians—only to become more confused. In modern TCM hospitals, the traditional diagnostic methods of observation, auscultation, inquiry, and palpation vanish, replaced by lab tests, X-rays, CT scans—prescriptions are a mix of Chinese and Western medicine, with prepared medicines dominating over decoctions. Undoubtedly, Chinese and Western medicine are highly integrated—but TCM has become a supplementary role. Generation after generation, famous Western doctors emerge (especially in surgery and ophthalmology), but famous TCM practitioners disappear after the older generation passes. A mid-career TCM doctor told me: "Nowadays, there’s no real TCM—just Western doctors." Of course, as an outsider, I can’t deny the reasonableness of this path. But I ask: Is there a second path?
Looking further back, since our classical heritage has been systematically analyzed with the same scientific spirit and methods, all schools of thought—Confucianism, Daoism, Legalism, etc.—have ultimately become "philosophical ideas," "ethical thoughts," "management theories," etc., further broken down into ontology, epistemology, methodology, etc. More advanced thinkers derive questions from Western frameworks and prove them using Western theories. Our entire heritage—including classical texts—is reduced to materials for argumentation. So, the same question arises: Even if this form of classical scholarship is unavoidable, can there be a second way? Can we organize our ancient knowledge without using Western concepts and frameworks? Can Confucius, Laozi, Sunzi’s teachings not be reduced to ingredients like danggui and shudihuang, merely serving as raw material for Western instruments?