Listening to Old Dean Guo tremblingly speak those words from the podium, Xu Ze couldn’t help but feel a sigh rising in his heart as he sat below. It was true—Traditional Chinese Medicine is in decline these days, while Western medicine is thriving everywhere you look.
Even though the country now has dozens of TCM universities and colleges, producing over ten thousand TCM graduates every year, the truth is that after they graduate and start working in TCM hospitals, most of them still rely on Western medical treatments to care for their patients. The use of genuine TCM and herbal remedies is extremely rare.
In the majority of TCM hospitals, even when Chinese herbs are prescribed, they’re only used as a form of supplementary support. The doctors themselves have never truly believed that they could achieve good results using only Chinese medicine.
A few years down the road like that, most of their understanding of TCM is limited to matching a few symptoms with pre-written formulas. They flip through prescription books or TCM internal medicine textbooks, treating it like they’re using Western medicine—prescribing the same fixed formulas, giving herbs that treat the head when the head hurts, and the feet when the feet hurt.
And so, it’s almost inevitable that the TCM talents produced by these institutions gradually turn into followers of Western medicine instead.
The only people who can truly carry forward the legacy of Traditional Chinese Medicine are mostly the few disciples personally trained by veteran TCM masters. They are the ones who can grasp the true essence of the art.
That said, in our modern society where diplomas are everything, although the state does have certain regulations allowing apprentices of famous veteran TCM doctors to qualify for a practice license directly, the process of getting that qualification approved is extremely complicated and tedious.
And after they finally obtain their license, most of them can still only run a small TCM clinic. It’s very rare for any county-level hospital or above to actually hire them.
So most people still choose to go through the university system to get their diplomas, because finding a job that way is much easier. This, in turn, has led to the gradual decline of TCM as we see it today.
As generation after generation of veteran TCM masters passes away, perhaps all that will be left of Chinese medicine is just a superficial shell, barely holding up the facade.
Xu Ze understood these concerns of the older generation very well, and he sympathized with them deeply. Still, he couldn’t help but feel a little ashamed himself. The only reason he was taking this assessment was to get that piece of paper—the certificate. As for TCM itself? He probably couldn’t even measure up to these genuine young TCM talents sitting right here in front of him.
Because his approach to treatment still relied mainly on clinical methods. The only thing that might make him stand out a little was that special electro-acupuncture emergency technique he knew.
As his thoughts drifted further away, the sound of Old Guo announcing the start of the assessment finally called him back from his wandering mind.
The format of this assessment wasn’t all that unusual. The only real difference from a standard licensing exam was that it started with a written test first.
On the exam paper, there weren’t many questions. But when Xu Ze looked over the content, he couldn’t help but feel secretly astonished. Some of the questions here had nothing to do with basic TCM theory at all. Instead, they tested differential diagnosis of special conditions using TCM principles. And the ones that did vaguely count as basic theory were all drawn from ancient medical classics like the Miraculous Pivot, Plain Questions, Supplement to the Golden Cabinet, Arcane Essentials from the Imperial Library, and so on.
Seeing all this, Xu Ze was completely dumbfounded. The TCM differential diagnosis questions for special conditions weren’t too terribly difficult for him, since he came from a family with a TCM background. He had also paid decent attention in his TCM classes over the years, and he’d read quite a few books on differential diagnosis written by famous veteran TCM practitioners.
Add to that his years of clinical experience, and there wasn’t really anything he found impossible. Maybe there would be a few points where his understanding differed slightly from that of the older generation, but it shouldn’t be too far off.
But then came the questions about the Miraculous Pivot and the Plain Questions, and that was when his mind went completely blank. It wasn’t that he’d never read the Yellow Emperor’s Inner Classic—it was that he’d only made it through the first few pages before giving up.
Those texts were just too dry and hard to understand. Even Xu Ze, who considered himself fairly well-versed in classical Chinese, had gotten dizzy and bleary-eyed trying to read them back then.
He did have some familiarity with the Supplement to the Golden Cabinet from later periods, and he’d also read a few modern annotated versions of the Arcane Essentials from the Imperial Library, so he knew a little bit about those. That didn’t mean he was completely ignorant.
After racking his brain and finishing the slightly simpler questions, he was left with only a few basic case analysis questions at the end. Looking at these, Xu Ze couldn’t help but sigh softly to himself. Questions like these—even if you took them to Xingcheng University of Traditional Chinese Medicine, they’d probably stump a whole bunch of people.
Still, Xu Ze wasn’t someone who would show up to an assessment like this unprepared. With the help of Xiao Dao’s online encyclopedia, he searched for the standard interpretations of these passages and used them as a foundation for his own analysis, eventually writing out a long, detailed essay.
The human body consists of “spirit” and “form.” The term “spirit” can be understood broadly or narrowly. Broadly speaking, it refers to the overall phenomena of life activities. Narrowly speaking, it refers to the mental faculties governed by the heart in TCM, including a person’s consciousness, thinking, willpower, personality, emotions, and so on.
The “form” refers to the entire physical body, including the five solid organs, the six hollow organs, the meridians, the four limbs, the hundred skeletal joints, and other structural components, as well as the basic nutritional substances like qi, blood, and body fluids. TCM emphasizes that “spirit and form must coexist and cannot be separated.”
The spirit governs the form; without spirit, the form cannot live. The spirit is the highest ruler of all life activities. It not only coordinates the changes of the organs, qi and blood, and yin and yang to maintain balance within the body’s internal environment, but it also regulates the organs and other tissues, allowing them to actively adapt to changes in the natural world and buffer the emotional stress caused by external factors, thereby maintaining balance between the body and its external environment.
At the same time, the spirit is born of the form; without the form, the spirit cannot exist. In other words, the spirit is a product of the form, and the form is the material foundation of the spirit. From a pathological perspective, diseases of the form can lead to abnormalities of the spirit, and changes in the spirit can also affect the physiological functions of the form.
Finally, he concluded: External factors must be avoided to nourish the form, and internal vital energy must be cultivated to enrich the spirit. Therefore…
The last question was: What is the “midnight-noon ebb-flow” acupuncture method, and what are its components?
Using the information Xiao Dao had found, Xu Ze smiled bitterly as he wrote his answer, one point at a time. The midnight-noon ebb-flow acupuncture method describes the state of qi and blood flow in the twelve meridians, which waxes and wanes according to changes in time. “Midnight-noon” refers to the passage of time. “Ebb-flow” refers to the process of qi and blood moving through the twelve meridians, as well as the fluctuations in the abundance of qi and blood at specific acupoints—the well, spring, stream, river, and confluence points—along these meridians. Because these fluctuations correspond to changes in year, month, day, and hour, the principle behind this method is to select the appropriate acupoints according to the time of treatment. That is the midnight-noon ebb-flow acupuncture method.
And its components are…
After writing the final stroke, Xu Ze finally breathed a sigh of relief. He had answered most of the questions from memory, so even though it might not be perfect, it shouldn’t be too far off. After carefully reviewing his answers one more time, he cautiously handed in his exam paper.
Seeing that Xu Ze was the first to submit his paper, the veteran TCM masters couldn’t help but look surprised, their eyes filled with disbelief. Old Wang had said this kid focused mainly on Western medicine, didn’t he? So how come he’s the first one done? Could it be that he just filled in whatever he could and turned it in as a formality?
Old Wang was especially worried, since he was the one who had recommended Xu Ze. He had originally thought that if Xu Ze could answer seventy to eighty percent of the questions, that would be pretty good, and he’d turn it in right at the last minute.
But now, Xu Ze had submitted his paper first, and Old Wang was getting nervous. He quickly reached out, took Xu Ze’s paper, and started reading it himself.
Seeing Old Wang grab the paper and start scrutinizing it anxiously, the other veteran masters understood exactly why. Each of them planned to wait until he was done before taking a look themselves.
Xu Ze, for his part, couldn’t be bothered with what the masters thought of him right now. He had already handed in his paper, and he was fairly confident he hadn’t made a fool of himself. So his mood was calm and peaceful. He went back to his seat and waited for the others to finish so the final results could be announced.
But what happened next was a bit unexpected. The moment he submitted his paper, the arrogant young man in the black Zhongshan suit raised an eyebrow and promptly turned in his own paper right after him. Xu Ze was quite taken aback.
Xu Ze knew very well how hard this exam was. He had only been able to answer so quickly with Xiao Dao’s help. But that proud young man was just as fast, which made Xu Ze’s jaw drop in astonishment.
Then, to his even greater surprise, within just five minutes of the two of them handing in their papers, the remaining four also submitted theirs.
Seeing this, Xu Ze couldn’t help but sigh inwardly. It just went to show that everyone who made it here was a true elite of modern TCM. These rookies certainly lived up to the name.
The six of them glanced at each other, a hint of rivalry flashing in their eyes. They exchanged slight nods and faint smiles, then waited for the veteran masters up front to grade their papers.
After all, everyone here could be considered the best of the best. In their everyday lives, they were all outstanding figures among their peers.
Now, sitting together, with their elders watching and carrying the weight of their families’ expectations, it was only natural that they’d feel competitive.
So, holding their breath, they watched the masters up front pass the papers around among themselves, waiting for the final verdict.
Up on the stage, the veteran masters had all received their sets of papers and began reading them separately, no longer paying attention to Old Wang’s corner.
Old Wang, who had been frowning slightly as he carefully read through Xu Ze’s paper, gradually saw his brow relax. Occasionally, he would nod lightly.
Seeing Old Wang’s expression, Xu Ze finally felt a wave of relief wash over him, and the trace of tension on his face eased.
Since Old Wang had started nodding, that meant his performance probably wasn’t too bad. At the very least, he shouldn’t embarrass himself too much.
The other candidates, noticing Xu Ze’s relieved expression, couldn’t help but feel confused. Why is this guy so nervous? Has he already found out he did well?
No, that can’t be right. These questions aren’t hard to get some points on, but scoring well isn’t easy. Just because someone nods a few times, how does he know he did well? That doesn’t mean he’s beaten us all.
And with that thought, a bit of tension crept into the group.
What they didn’t know was that Xu Ze’s only wish was to not make a complete fool of himself. He had no intention of beating anyone.
Old Dean Guo, sitting nearby, had also quickly finished reading the paper in his hand. Noticing that Old Wang had already finished the first submitted paper, he smiled slightly, handed his own paper over, and took Old Wang’s in exchange for grading.
Old Guo was genuinely curious to see how this student—who primarily studied Western medicine—would fare on the questions he had personally written. He had already made up his mind: as long as the kid wasn’t completely off the mark, he’d let him pass. After all, Old Wang had personally recommended him, saying his acupuncture skills were miraculous and his character was good. Letting him through the first round wouldn’t be a big deal.
But as he read through the paper, at first nothing stood out. It was just passable, in his opinion. But when he got to the last two questions, he was genuinely surprised. Both questions were quite obscure. Even a typical TCM major—unless they were at the graduate level—would struggle to answer them fully. Yet this kid had done quite well.
Based on this score, he wasn’t far behind the paper he had just read from his own grandson.
Old Guo looked up at Xu Ze with undisguised surprise. A student trained in Western clinical medicine, scoring this high—it was truly impressive and completely unexpected.
Looking at the calm, composed expression on that young man’s face, Old Guo nodded approvingly. Truly impressive. If every Western medicine student had even half his level of TCM knowledge, that alone would be a blessing for Chinese medicine.
Soon enough, after the six papers had been passed around among the masters, grading was completed in just half an hour. Since every senior had looked at every paper, everyone knew who stood where.
Now, as they looked down at Xu Ze, the masters couldn’t help but sigh with admiration. Among the six papers, his answers might have been a bit too conventional and by-the-book, but his overall score still ranked in the top three. That was no small feat.
If Old Wang hadn’t vouched for him so strongly, some of them might have doubted whether he was really a Western medicine student at all.
Down below, the five rookie candidates, excluding Xu Ze, watched the expressions of the senior masters and felt a little uneasy. Could it be that this guy actually came in first?
Their faces darkened a bit. The young man in the Zhongshan suit, in particular, looked at Xu Ze with barely concealed resentment.
As the grandson of Old Dean Guo, he had been trained by his grandfather since childhood. From middle school graduation until now, more than ten years had passed, including five years of advanced study at the Beijing University of Traditional Chinese Medicine. He considered himself one of the top figures of the younger TCM generation.
And now, it seemed he might lose to this unknown kid. Naturally, his pride wouldn’t allow him to take that lying down.
Amid everyone’s anticipation, Old Dean Guo took a couple of sips from his teacup and finally began announcing the written exam results.
Gu Xuejian: 75 points – Pass.
Wu Lin: 78 points – Pass.
Zhang Zhibo: 83 points – Pass.
Xu Ze: 86 points – Excellent.
Li Bo: 89 points – Excellent.
Guo Yujian: 92 points – Outstanding.
Hearing these results, the rookie candidates below were stunned. Wait, so he’s not first? Then why were the masters all looking at him like that?
Guo Yujian felt a surge of joy, but then grew even more confused.
Of course, they had no idea that Xu Ze was a Western clinical medicine student. If they had known that, they wouldn’t have been surprised at all. Instead, they would have completely understood why the masters were looking at him the way they did.
Old Dean Guo looked down at the group with great satisfaction and nodded approvingly. “These questions were quite difficult, and everyone did very well. Next, we will begin the practical assessment.”
With his words, several people quickly entered the room.
Looking at their pained or pale expressions, the candidates quickly realized that these were all patients suffering from various illnesses.
Xu Ze was taken aback. He hadn’t expected that an assessment like this would use real patients for the exam.
In most medical exams, you practice on mannequins. They never let you treat real patients. But today’s assessment was different—they brought in actual patients for on-the-spot testing.
And the patients brought in probably weren’t suffering from anything simple. Otherwise, why use them here? Thinking about this, Xu Ze couldn’t help but sigh deeply. This was definitely the strictest and most terrifying licensing exam in the country.
Compared to this, every other licensing exam out there was child’s play.
This one tested real skill. Those who only studied from books might have coasted through the last round, but this round? Nearly impossible. And unless you had real clinical experience treating patients, there was no way you’d pass.
Of course, among the six rookies taking the exam, Xu Ze was the only one who looked shocked. The others had known this round was coming.
Seeing the surprise on Xu Ze’s face, the others smirked slightly, assuming that he was just someone with no real clinical experience, looking nervous just at the sight of a patient.
Only Old Wang, up on the stage, continued to smile. He knew exactly why Xu Ze was surprised—because Old Wang hadn’t told him a thing about this.
Outside of an assessment of this caliber, you would never find real patients being used as exam material anywhere else in the country. Xu Ze’s surprise was only natural.
Of course, Old Wang wasn’t the least bit worried for Xu Ze. If we’re talking about real clinical experience, diagnosing and treating patients, the others probably couldn’t hold a candle to him.
The only thing that concerned Old Wang was that he didn’t know how skilled Xu Ze was in TCM specifically. Although he had done fine on the theory portion, when it came to actually treating a patient, Old Wang had only ever seen Xu Ze use acupuncture and Western medicine. Whether Xu Ze was actually proficient in TCM diagnosis and herbal formulas was still an open question.
And in treating a patient with TCM, the assessment certainly wouldn’t focus only on acupuncture.
Just then, Old Dean Guo began announcing the rules. The six rookie candidates would draw lots for the six patients. After drawing, they would diagnose the patient they were assigned and then respond with their treatment principles and methods.
The responses would cover herbal formulas, massage therapy, acupuncture, and all other relevant aspects.
