Always Angry, Putting Off Treatment, Falling for Quack Remedies? Whose Advice Should You Trust? — Doctor Gong Tingxian’s Ten Rules for Physicians and Ten Rules for Patients, from the Ming Dynasty’s 97-Year-Old Imperial Doctor

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Corresponding medical names: benevolence and medical ethics (yi de) · five movements and six qi (wu yun liu qi) · channels and collaterals (jing luo) · processing and preparation (pao zhi) · liver qi constraint (gan qi bu shu) · protecting upright qi (zheng qi) · nourishing the spleen and stomach

💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today we continue with Doctor Gong Tingxian’s philosophy of health and wellness. As we know, Gong Tingxian was an extraordinary clinician — I admire this man greatly. He had countless experiences and countless formulas, his skill was extremely high, and on top of all that, he took excellent care of his own health.

Opening: an imperial physician who lived to 97 in the Ming dynasty

What did it mean to live to 97 during the Ming dynasty? Doctor Luo says: this is no joke. When you are forty or fifty, you think your body is fine; wait until you are in your sixties, seventies, or eighties — by then your body is no longer yours. Illnesses tangle with you from every direction. To live to 97 — that is truly a person like an immortal, proof that his way of preserving health was superb.

💬 Note from Doctor Luo: He had some ideas about wellness, some lessons for ordinary people, that I find extremely valuable. He did not simply hand out prescriptions — he taught a great deal about preserving health, about adjusting the state of mind, and so on. Very important.

This old man who lived to 97 was the great Ming physician Doctor Gong Tingxian — courtesy name Zicai, literary name Yunlin, from Jinxi, Jiangxi. He served as an imperial physician in the Tai Hospital (the imperial medical academy), cured a strange illness afflicting the consort of the Prince of Lu, and was honored by the prince with a plaque naming him the “Medical Number One Scholar” (yi lin zhuang yuan). In his old age he wrote a book called Yun Lin Xia Bi (Leisure Notes from the Cloud Grove — xia bi means notes written in spare moments), in which he laid down ten admonitions for physicians and ten admonitions for patients — twenty in all. Today Doctor Luo walks us through all twenty, one by one.

First, rules for physicians: the Ten Essentials for Physicians (Yi Jia Shi Yao)

Gong Tingxian’s first rule: physicians must hold benevolence in the heart. To be a doctor you must first keep a heart of kindness and righteousness — these are sincere words of counsel: give help widely, save as many people as you can.

💬 Note from Doctor Luo: Rule one — hold benevolence in the heart. You must keep that heart of compassion, give help widely, do your utmost to rescue people. The ripples of this run very deep. That is the first one.

Second, master Confucian and Daoist learning — do not stop at reading formulas. You should be versed in Confucianism, Buddhism and Daoism alike, and through them understand the ways of the world, so you can untangle things for your patients. Explain the principles clearly, help people lay down the burdens in their minds, and only then can illness truly heal. This is what Sun Simiao spoke of long ago: in his Da Yi Jing Cheng (Great Physician Sincerity) he said there is much to learn — the foundations of the Chinese classics and of philosophy must all be studied.

Third, make pulse diagnosis precise — pulse-taking must be especially refined.

💬 Note from Doctor Luo: Why? First you separate exterior from interior. When a patient comes with an illness, you must first sort out exterior from interior — clearly recorded under your fingers. Only when the pulse is clear under your fingertips can serious illness be cured. The diagnosis must be precise: exterior/interior, cold/heat, deficiency/excess — all of it is in the pulse.

Fourth, know the source of disease — understand the cause of the illness. At the crossroads of life and death, only when you know where the root of the disease lies can you dare say what can be cured. This must be made clear.

Fifth, understand the movements of qi — know the five movements and six qi (wu yun liu qi).

💬 Note from Doctor Luo: Sometimes the weather changes, the climate shifts — we have the doctrine of the five movements and six qi. The climate changes each year follow roughly predictable patterns. You should know what the big pattern is this year and what the local climate pattern is. Before treating, ask what the local climate is like, what year the illness began, what the weather was then — keep this in mind. China is enormous and conditions differ from place to place. Analyzing the source of the disease and the influence of your environment is very important.

Sixth, be clear about the channels and collaterals — the network must be understood, confirmed without error. How do the organs and channels connect? How did this illness arise? Which organ is deficient, which is excess, which is cold, which is hot — all of it must be clear. Seventh, know medicinal properties — be intimately familiar with what each herb does.

💬 Note from Doctor Luo: Some doctors today are not familiar with the properties of medicines. They know the name written on the prescription, but they have never held the raw herb, do not know the dosage, do not know the effect — then you cannot treat well. You must know these medicines as well as you know your own body. Only then can you deploy your troops and win the battle. Why did Doctor Zhang Xichun treat illness so brilliantly? He knew exactly what each single herb could do, what its secret strengths were; when he combined them, his formulas came out exquisite and effective. So mastering medicinal properties is a lesson today’s physicians must catch up on — many Chinese medicine practitioners are drifting further and further away from the actual herbs. That will not do.

Eighth, master processing and preparation (pao zhi) — the art of preparing herbs must be thoroughly understood. Too much or too little, and lives hang in the balance.

💬 Note from Doctor Luo: The preparation of medicines is extremely important. Yesterday I talked about one of Gong Tingxian’s formulas and everyone said: how troublesome, so many steps to make a single dose! My friends — this is exactly how ancient Chinese medicines were made! Processing can increase efficacy, can reduce toxicity, can guide a medicine to a particular channel, can target it precisely. It was extremely refined. The ancients cared enormously about this.

Ninth, do not envy fellow physicians — never be jealous of your colleagues. Some doctors arrive at a patient’s home and say the previous doctor’s prescription was terrible, frightening the patient: “If you keep taking that you are finished — mine is the right one for you.” Slandering colleagues to elevate yourself is a moral failure. Tenth, do not value profit too highly — do not dwell on gain.

💬 Note from Doctor Luo: You should hold benevolence. Treating illness is a benevolent calling; do not constantly think of profit. It cannot be that you treat the rich attentively and treat ordinary folk carelessly — rich and poor differ, but medicine is dispensed without distinction. Before illness, rich and poor are the same; treat them all alike.

These are the Ten Essentials for Physicians. Gong Tingxian meant them as a mirror for doctors to examine themselves: those who can live up to them are good physicians, and their skill will keep rising.

Then, truths for patients: the Ten Essentials for Patients (Bing Jia Shi Yao)

After instructing physicians, Gong Tingxian turns to patients and gives them ten rules as well. The first: choose an enlightened physician — note that it is “enlightened” (ming, meaning one who truly understands), not “famous” (ming, as in a celebrated name).

💬 Note from Doctor Luo: Choosing an enlightened physician benefits the illness — you must not be careless, for life and death follow. You should choose a doctor who truly understands medicine and whose skill is high. “Enlightened” is not the same as “famous” — sometimes the famous are not necessarily skilled. Take me: I am famous, but my skill is not necessarily high. The truly good physician is the one who is enlightened, who sees the pathology with complete clarity.

The second: be willing to take medicine — treat actively; do not delay yourself.

💬 Note from Doctor Luo: You have found a good doctor, he gives you a fine formula and adjusts it for you, and your body will get better and better. But some people delay themselves — some men feel something wrong and simply refuse to see a doctor; by the time they finally go, the problem is already huge. Women will start regulating at the first sign of discomfort, so usually nothing serious develops; men grit their teeth and bear it, and when the trouble finally surfaces it is a major event. Illness must never be postponed — at the very first sign, go adjust it.

The third: treat early — the earlier, the better. Gong Tingxian quotes the Book of Changes:

💬 Note from Doctor Luo: “Frost underfoot leads to solid ice” — at first you see a little frost and pay no attention; the yin grows heavier and heavier, until finally solid ice arrives, more and more yin, and you cannot bear it. Many illnesses accumulate gradually from small things. If you ignore them, they pile up, and when they truly become acute, they are very hard to adjust.

The fourth: moderate the empty chamber — keep marital life in moderation. Doctor Luo adds that this depends on age: when young, a normal frequency is fine; as the years mount — into the forties and fifties — restraint is absolutely necessary. This is the law of nature. We should adjust ourselves according to the natural rhythms of life; reckless excess is certainly not good.

The fifth: guard against anger — anger and irritation must be awakened to. When anger flares, fire rises, and it is hard to be saved. Doctor Luo says he has felt this one too deeply:

💬 Note from Doctor Luo: Quite a number of the people who come to me have terrible tempers. To my face they are perfectly polite, but if I reply slowly, they start cursing. Precisely because their temper is fierce, they fall ill, and so they come to me. Many people do not realize it about themselves, or know it but do not take it seriously, thinking it has nothing to do with health. That liver fire of anger and irritation — you must wake up to it. When anger flares, fire rises, and even a divine physician cannot save you. And temperament and body feed each other: when the body is unwell the temper is worse — qi and blood do not circulate and discomfort makes you angrier; when the temperament is bad, the body suffers too. The two are mutually causal — everyone must pay attention.

Doctor Luo also tells a vivid story: a leader came to consult him and insisted his temperament was wonderful. Doctor Luo said his liver qi was constrained (gan qi bu shu); the leader denied it. But when the leader stepped out to the restroom, his secretary told Doctor Luo: “Do not believe a word our leader says. We all walk around him in this building — when he comes, we all suck in our breath. His temper is good? Please, do not listen to him.” — There you have a man who has no idea how hot-tempered he is.

The sixth: put an end to delusional thoughts — clear away obsessive imaginings and cultivate stillness.

💬 Note from Doctor Luo: Our lives are full of delusional thoughts; the mind is cluttered. On the subway everyone stares at their phones — all kinds of worries, all kinds of gossip. Our own fantasies are many too: I want this, I want to obtain that, my goal is a hundred million… Thinking too much is useless. Do the work well and do not dwell on the reward. Every day close your eyes, rest and nourish the spirit, let the mind grow still — once the worrying is cleared away, the spirit becomes brisk and the body begins to feel comfortable. Excessive worry is one of our great problems today — the things churning through our minds outnumber those of the ancients countless times over. The ancients lived simply; we know everything now, and we have endless things to fret about. So if you can cultivate stillness and expel those stray thoughts, it is wonderful.

The seventh: moderate food and drink — eat and drink with restraint.

💬 Note from Doctor Luo: In the Ming dynasty living standards were decent and the country was stable; people ate well and easily overate — the Jiangnan region was quite luxurious in those days. So Gong Tingxian told people to moderate food and drink, to adjust slowly, to eat a little less — it does you good. Our own age is exactly the same: diet has gone overboard, food is far too rich, and what cannot be digested and transported simply accumulates in the body. Many illnesses come precisely from food that is too good.

The eighth: be careful with daily routine — live by the normal rhythm of the day, and cut down on socializing.

💬 Note from Doctor Luo: Daily routine should follow the rhythm of the hours — do not upset it. As for socializing: keep it modest, do not be too fond of company. These past few days I have been socializing a bit much myself — friends arrived, I started receiving them, and my routine suffered. When friends come every day and you are hosting, eating out, drinking, going to bed late — it really does disrupt your rhythm. Also, do not overwork yourself; overwork easily drains your original qi (yuan qi).

The ninth: do not believe in heresies — do not trust crooked paths and strange doctrines. Gong Tingxian warned of this long ago, and Doctor Luo says it is especially worth hearing today:

💬 Note from Doctor Luo: Believe them and you go wrong — heterodox doctrines wreak havoc on people. In the past there were people injecting chicken blood; there were people drinking fermented tea cultures — raising cultures at home, feeding them sugar, brewing all kinds of strange bacteria and drinking them. It was really not sound. For a while the whole country was doing arm-swinging — swing your arms and cure every disease. Later they switched to eating eggplant and mung beans: “eat this and any illness is cured.” Good heavens — health is that simple! But this abandons Chinese medicine’s pattern differentiation: a person with phlegm-heat benefits from mung beans and greens; does a yang-deficient person benefit from mung beans? Not everyone can eat mung beans. To abandon pattern differentiation and promote some single thing as a cure-all is actually harmful to health.

And there are those who stuff themselves with vitamin C — a physician was recently telling us about someone who ate vitamin C until his kidneys failed; all kinds of crystals damaged the kidneys. Others eat protein powder as a meal, bucket after bucket. And even more frightening are the direct-sales networks online:

💬 Note from Doctor Luo: “Miracle water from America,” they say — “we specialize in diseases the hospital cannot cure; tumor cells degrade on contact.” A grandmother bedridden for ten years drank it and started leaping around town — that story was told by a shill! They are not doctors; they take no responsibility: they build a group on the internet, give their pitch, and dissolve the group immediately — you have no evidence at all. Two hundred elderly people in one group, gathering every evening, in a frenzy of excitement, ordering immediately — several thousand yuan a pop. They do not even register a company; industry and commerce authorities cannot trace them. I know a friend whose father — the director of the advertising division of a municipal industry and commerce bureau, the very person who approves these things — was talked into it, kept taking the supplements, and ate himself to death. This happened to someone in my own circle. So whenever anyone insists “just eat this one thing and every illness is cured,” there is something wrong — it is practically a cult. Listen to the principles of Chinese medicine taught by proper TCM doctors; do not believe these heresies.

The tenth: do not begrudge the cost of medicine — do not be stingy with your medicine money.

💬 Note from Doctor Luo: I ask you: your life and your money — which is more precious? Some people always feel Chinese medicine is expensive. Yet when they go to hospital for surgery and tests — several thousand, tens of thousands of yuan — they do not feel it is expensive. Chinese medicine costs a few hundred yuan and they cry, “how can it be so dear!” They have simply misjudged what matters. Take a little Chinese medicine regularly to protect the body, stay healthy, and you will never end up in the ICU. But if you do not prevent, do not regulate, and finally land in the ICU — how much does that cost? Which is lighter, which is heavier? Take the Lushan herbal balm I have mentioned: a tiny bottle for a dozen or so yuan; during the epidemic people rubbed it on their noses to ward off plague, and later scientific research confirmed it does have obvious protective and therapeutic effects against the novel coronavirus. Yet some people said, “it must just be camphor oil, same as cooling balm — I’ve been scammed.” A dozen yuan and you feel scammed? The drug administration requires ingredients to be listed in order of proportion — the first ingredients are the main ones; write them falsely and you go to prison. In truth, many people have been educated by Western medicine: antibiotics, CT scans, ICU rescues — tens of thousands a day is normal. But ask them to spend a few hundred yuan on wellness and herbal supplements, and they feel it is too dear — that is not weighing what matters.

Doctor Luo’s closing reflection: the great synthesizer of the school of supporting upright qi

💬 Note from Doctor Luo: Gong Tingxian should be called a master of health preservation — he kept himself alive to 97 and treated his patients brilliantly. His whole theoretical system runs quite deep; what I have presented is only a small part of it. Looking at his formulas and his overall system, this man was extraordinarily accomplished: he supported upright qi (zheng qi) and expelled pathogenic qi, with the emphasis on supporting upright qi; in that endeavor he inherited the experience of predecessors like Qian Yi, Li Dongyuan and Zhu Danxi. By the Ming dynasty he was truly a great synthesizer, and he developed Chinese medical theory further. Take any one of his formulas — the Wu Ji Wan (Black Chicken Pill), the Bai Feng Wan (White Phoenix Pill) — later these became the crown jewels of Tongrentang pharmacy: the Wu Ji Bai Feng Wan (Black Chicken and White Phoenix Pill).

Doctor Luo also leaves a preview: the next physician in the series may be Doctor Zhang Jingyue. Zhang Jingyue was a physician of the late Ming, somewhat later in time; his philosophy of supplementation was the same as Gong Tingxian’s — both were masters of building up.

💬 Note from Doctor Luo: I always want to cover them all thoroughly, but the theories are so rich — with formulas, for instance, I present a few and everyone’s head spins. Their dietary and wellness creations are dazzling, with far too many formulas to go through. So Gong Tingxian I will roughly leave off here; next we will slowly move into Zhang Jingyue and introduce more physicians. I hope these lessons can inspire you all and give you a deeper understanding of Chinese medicine. Thank you for listening — see you tomorrow.

Compiled from Doctor Luo Dalun’s lecture series on Doctor Gong Tingxian’s medical thought, based on Gong Tingxian’s Yun Lin Xia Bi (Leisure Notes from the Cloud Grove).