Chinese Medicine Is 75 Years Old

From The Magick That Never Left: Classical Chinese Medicine and the Tradition Still Beneath It

Note: Names and identifying details of clients in this book have been changed or composited to protect privacy. The clinical patterns are real, the specific people aren't pinpointable.

So she comes in for a reading and I tell her, pick the tile closest to you, whatever tile, don't move it, leave it where it was, just flip. Mahjong tiles, right. Same game your grandma plays but also a divinatory tool depending who's sitting at the table. This is a more modern adaptation by the way, not ancient classical divination, but it works in my hands so I use it.

She flips. Three. I told her you get threes a lot in your life. She said yeah, three's actually her number. Three keeps popping for the whole reading too, generally going wild on threes.

I told her, your spirit guides, and that's a broad term I'm using, there's actually three ancestresses you should be working with. And this here, this says they've been trying to get to you in your dreams, you get pissed off that they bug you in your dreams, I think you actually wake up with night terrors occasionally. It's because you're not listening to them. Don't ask for a door to be open if you don't want it open, right. That's why I had to work with the dead here, because it's pretty clear your ancestors want to work with you and they got goods, but there's going to be some harsh lessons. It's coming from far back in the line.

I asked her where her family's from. Mountains or ocean. She said her dad's side is ocean, mom's side is mountain. That's what I thought. So this was all the maternal line, threes everywhere, Korean ancestresses on the mountain side. And they don't really sugarcoat anything in the readings, mountain people generally don't. So this was them being polite about it. To be clear, I'm not claiming Muism credentials, the mudang have their own tradition and their own training, I'm reading what showed up in front of me with the tools I work with and pointing her back to her own line where it lives.

It was time for the shit or get off the pot moment. The ancestresses don't wait around forever, and if you don't show up they'll move to someone else down the line eventually. They got better things to do.

She told me she was preparing to start a business. She'd been training for years, didn't feel ready. I told her, you're never ready, that's not how this works, you don't get to feel ready for something like this. And what she was calling her business, that's not any different than actual Korean shamanic or magic work, she was just using a different language for it. Same work Korean shamans have been doing for thousands of years with drums and chants and trance. The name had changed. The work hadn't.

The reading also threw out a folk-magick offering for her practice. Korean mountain ginseng for a Korean mountain woman, the tiles pointed at resonance with the line, that old folk-magick thing where you match the plant to the bloodline. Correspondence work, not herbal medicine, those are different categories. She left with the reading and some homework.

What I'd done in that room wasn't fortune-telling, even though from the outside it probably looked like it. It was the kind of pattern reading classical CM did before that work got carved out into a separate category from clinical practice. Most people reading this wouldn't recognize it as Chinese medicine either, which makes sense, because what most people think Chinese medicine is, isn't really what it is.

A few things upfront

I'm writing this as a working practitioner first and foremost. Quick on the credentials so you know where I'm coming from: Master of Medical Qigong (trained under Robert Youngs at IIMQ Canada), holder of Mao Shan Shangqing transmission (direct master-to-student, not institutional ordination), plus Daoist folk magic practice. On the broader magick side, my primary teacher and spiritual guru is Andrieh Vitimus, and through his training I'm a chaos magician, work in Wu shamanic practice (combined with my own family ancestor work, Cantonese with northern roots), and work with Tangmi material (Tang Dynasty esoteric Buddhism, modern reconstruction stream rather than unbroken Shingon-line transmission, since the original Tangmi lineage in China ended in the Tang persecution of 845 CE). On the TCM side, my education is through a CTCMPAO-accredited acupuncture program, that's what my R.Ac registration is built on. Outside that regulated education, I've also trained with teachers in Daoist medical and imperial-acupuncture lineages who'd rather not be named publicly, supplementary lineage stuff rather than the formal piece. I'm not a historian and I'm not a translator. There are practitioners who trained in mainland China, or with mainland-trained teachers, who'll tell you a different story than this one, and they're not wrong, they just trained in a different stream.

Quick note on scope. I'm registered as an R.Ac with CTCMPAO in Ontario, and my regulated practice operates under their scope. This book is about the broader Chinese medicine tradition, which is larger than what any single regulatory curriculum covers. A lot of what people think of as separate from "real" Chinese medicine, the cultivation work, the diagnostic pattern recognition that goes beyond pulse and tongue, the cosmological frame around the points, is actually part of the original tradition. Practitioners with classical training have always brought more of that depth into their clinical work, within whatever scope of practice applies to them in their jurisdiction. The book is about that depth, what it is, where it went, and how the tradition's full toolkit reads differently than the standardized version of it. Folk-magick herbal correspondences aren't herbal medicine prescription, by the way, that's a different category needing a different designation, and the book is careful about that distinction throughout.

There's also serious historical scholarship on this period if you want to dig in. Heiner Fruehauf out of NUNM has been making the Classical Chinese Medicine vs Traditional Chinese Medicine distinction in print since the 90s, that's the position closest to my own framing. The post-1949 standardization period itself is documented by scholars like Kim Taylor, Volker Scheid, Sean Hsiang-lin Lei, and Paul Unschuld, plus Liu Lihong from mainland China, even where they don't all draw the same conclusions Fruehauf does. The academic record on the political reform of Chinese medicine after 1945 is actually pretty well documented at this point, this just isn't that kind of book I'm writing.

What I care about most is whether the medicine works in the room. That's it really. The history matters to me because it kind of explains why my lineage's approach gets results that my standard-trained colleagues don't get, and that's the practical claim I'm actually making here. This isn't traditionalism for its own sake. The clinical claim is that the framing and cultivation that got de-centered are exactly what makes the methods land harder. Not everything historical belongs in modern healthcare, fair, but I'd argue what got cut wasn't decorative culture, it was the load-bearing part of why the methods worked. As one of my TCM teachers used to say, can you get clinical results, that's what it comes down to. Medicine is medicine. The rest of this book is just one practitioner's reading of his own tradition.

Chinese medicine is 75 years old

Most people think Chinese medicine is thousands of years old. This is seriously old stuff, you'd think. Reality is, what you'd actually learn in a Canadian acupuncture college, that's about 75 years old as of writing this in 2026, really from the 1950s, so you can do the math on however many years it is by whenever you're reading this. About as old as some of your grandparents, depending on your age. When I teach the history segment in foundation of Chinese medicine, I usually open class with this and tell the students welcome to your 9:31am, I'm sorry I already broke all your dreams in the first ten minutes. Same energy for you, the reader, basically.

Most people, when you ask them, they're picturing classical Chinese medicine, not traditional Chinese medicine. There's a big difference on that. I have to start with this because if I don't, well, it's just a whole lot of illusions you start building on for the rest of the conversation.

Real quick on the modern Canadian curriculum. It's roughly two to three years for acupuncture, three to four years for the TCM practitioner designation in Ontario and BC, the extra year being herbology. You memorize 361 acupoints across the 12 primary channels plus Du Mai and Ren Mai, the four examinations (looking, listening and smelling, asking, palpation), yin-yang and five phases theory, zangfu pattern diagnostics, plus all the clinical subjects and modalities. Qigong and tai chi are in the curriculum as coursework (Yang style usually for tai chi), but typically as one or two courses rather than the daily cultivation practice they are in classical lineages. Hundreds of hours of student clinic before they let you graduate. It's a lot, basically.

That's the official curriculum. Unofficially, faculty bring lineage material into clinical instruction, Master Tung's points, Balance Method, methods from the parallel Japanese and Korean acupuncture traditions, medical qigong, Wu Yun Liu Qi calendrical acupuncture, bazi diagnostics, family-line technique adjustments, and plenty more depending on the instructor. Stuff that's not in the syllabus but every decent instructor brings in anyway.

So that's what TCM is. Comprehensive enough that you can actually treat patients, and you'll get results out of it. But it's also a specific historical version of Chinese medicine, the post-war reform version, and that history matters for what comes next.

So what happened?

This isn't how Chinese medicine always looked, and the political history's actually more layered than expected.

So in 1929 you had Nationalist health officials, who were more Western-influenced at the time, they actually approved a proposal to ban traditional medicine outright. There was this thing called the Abolition of Old Medicine proposal, drafted by Yu Yunxiu and approved by the Ministry of Health. They saw the old medicine as backward and superstitious, basically. There was a real organized fight to keep it alive, mass protests by practitioners, and the proposal got shelved before becoming national policy. So the medicine survived, but only barely. Sean Hsiang-lin Lei's book Neither Donkey Nor Horse: Medicine in the Struggle Over China's Modernity covers this Republican-era struggle in detail if you want to dig into the actual political history.

Then years later when the communists won the civil war, they did the opposite of that. Mao officially promoted Chinese medicine in 1950 at the First National Health Conference, partly because the country was too poor for Western medicine and they had to care for hundreds of millions of people. In that speech, Mao said: "Our nation's health work teams are large. They have to concern themselves with over 500 million people, including the young, old, and ill." The basic logic was that with so few Western-trained doctors, they had to rely on Chinese medicine to treat illness. Now this was a mix of pragmatic and political. Scaling Western medicine for 500 million people wasn't realistic given post-civil-war resources, and promoting TCM also worked as anti-imperialist signaling, indigenous Chinese knowledge versus Western medical dominance. So the public TCM promotion was state policy driven by resource constraints plus nationalist political utility, not ideological commitment to the tradition.

What's even more screwed up around this whole thing, Mao himself didn't actually believe in Chinese medicine. His personal physician Li Zhisui wrote about it in his memoir The Private Life of Chairman Mao, where he recounts Mao telling him directly: "Even though I believe we should promote Chinese medicine, I personally do not believe in it. I don't take Chinese medicine." That quote's been challenged by some Mao biographers for its sourcing, fair, it's a physician's memoir of a private conversation rather than a public document, but Li Zhisui's account is the most-cited English-language source on Mao's actual private views and it lines up with the broader pattern of his behaviour. So he was promoting Chinese medicine publicly while privately using Western medicine for his own care and telling his own doctor he thinks Chinese medicine is nonsense.

Then later, during the Cultural Revolution that kicked off in 1966, you got the Four Olds campaign, where they were going after Old Customs, Old Culture, Old Habits, Old Ideas. And a lot of Chinese medicine got swept into that. This is documented stuff, not folk story, you can find it in academic medical history work like the Cambridge Medical History journal coverage of the period, plus Heiner Fruehauf's writing on it. Ancient medical tomes burned, family grave sites and lineage halls destroyed, medical lineage genealogies destroyed, and an extraordinary number of the elite elderly doctors, who were the actual repositories of the tradition, got persecuted, tortured, sometimes killed outright. To give you one illustrative example, an academic study tracking forty-six elite physicians in Jilin Province found 63% of them had Cultural Revolution experiences that led to retirement, severe illness, or death. That's one province's elite. Nationally, the total number of Chinese physicians went from 361,000 in 1959 down to 240,000 by 1977. So the medicine the state was officially promoting was simultaneously getting its core infrastructure dismantled in real ways. That's the messy part most people don't tell you about.

After the Cultural Revolution wound down in the late 70s, there was a reconstruction effort. Heavy stuff to land on, I know, but it matters for where the book goes. The elders who held the actual transmissions, a lot of them didn't make it through, and the lineages had to rebuild from what was left. Now this part is more lineage understanding than mainstream academic history, but the way my teachers tell it, a lot of what got pulled back together came from material that had been preserved outside mainland China. Korean Hanui and Japanese Kampo had kept records and texts, Vietnamese traditional medicine too, plus rural pockets in places like Yunnan and Sichuan that the destruction hadn't reached as fully. There's at least partial historical basis for the Korean piece specifically, works like the Precious Mirror of Oriental Medicine (동의보감) genuinely had preserved earlier Chinese medical texts that were no longer extant in China. Academic accounts of the reconstruction tend to emphasize domestic recovery more than the diaspora-lineage version does, fair enough, both can be true at their levels. Kim Taylor's book Chinese Medicine in Early Communist China covers the political construction of TCM in detail if you want to dig in there.

What survived in the standardized curriculum is most of the methods, just reframed without their spiritual context. Familiar enough that people recognize it as some kind of medicine, but exotic enough that it still gets filed under alternative. Kind of like the panda, technically a bear but marketed as something else.

What got cut was the framing, not the methods

So when I talk about what got cut, what I mean is mostly the framing, not the methods themselves. That's an important distinction and worth being clear about upfront.

If you're a practitioner reading this and going, wait, plenty of these methods are still in mainland TCM, my teachers still teach Ling Gui Ba Fa, qigong is in the curriculum, what got cut exactly? Yeah, fair question. The answer's in four parts and it's subtler than the diaspora version usually tells.

First, the methods themselves mostly survived. Acupuncture points, herbal formulas, channel theory, pulse diagnosis, all that stuff is still in the textbooks. Practitioners with lineage transmission migrated to Taiwan, Hong Kong, Singapore, North America, Europe, kept teaching the older material outside the mainland framework. Mainland TCM kept and developed plenty of classical methods too, things like Ling Gui Ba Fa and Zi Wu Liu Zhu timing acupuncture, classical moxa techniques, qigong work in hospital clinics. The methods are there if you train in the right stream.

Second, the framing changed. Where classical CM held all of this inside a traditional Chinese cosmological and ritual context (Daoist, Buddhist, Confucian, and folk-religious strands all woven in depending on the lineage and the period), post-reform TCM holds it inside a Marxist-materialist and biomedical-adjacent context. Same points, different cosmology around them. Same herbs, different language describing what they do. The technique is preserved, the worldview it sits inside is swapped out.

Third, the centrality of cultivation dropped. In the cultivation-central lineages this book comes out of, classical CM assumes the practitioner is doing their own internal work as a core requirement, qigong, meditation, ritual hygiene, dietary discipline, all of that, because the work runs through your body and some days it's a lot depending on what the client's going through. A car won't run without gas, right. Without cultivation, the work doesn't really run. Not every classical practitioner did this kind of cultivation work, classical CM was diverse, scholar-physicians and folk practitioners had different relationships to it. But in the lineages where cultivation was central, that centrality is what got de-prioritized in the reform curriculum. The modern curriculum still teaches qigong, just as one or two courses rather than as the daily core practice it is in cultivation-central lineages, more supplementary than foundational. Most students treat cultivation as a side hobby they'll get around to eventually, and then they wonder why their treatments aren't really landing like their teachers' did.

Fourth, the public naming of the magick went underground. The state doesn't officially endorse ritual or spirit or magick as part of clinical medicine, so classical methods that depend on those frames get either reframed in materialist language or quietly dropped from public curriculum. Some ritual practice does survive in regulated forms (state-recognized qigong, registered Daoist temples, some Buddhist medical contexts), but as part of the standardized medical curriculum, the magickal frame is not on the menu. The methods are there if you know to look, but they're not named for what they are.

So when I talk about the magick that never left, that's what I mean. The techniques are still there. The framing that held them as magickal, the cultivation that activated them, the public naming that said any of this out loud — that got reframed and de-centered and sent underground. But the magick itself never actually left. It migrated to the diaspora, persisted in cultivation-central lineages, hid in folk practice and family transmissions. The standardized curriculum dropped its public name. The work itself didn't go anywhere.

Lineage and apprenticeship are basically cheat codes for this stuff, but they don't play the game for you, you still have to put in the hours yourself.

Every pre-modern medicine system had some version of cosmological layers connected to clinical practice, by the way, though they worked differently across cultures. European doctors did iatromathematics, Persian-Hellenistic medicine read star charts. Different epistemic structures, but cosmology connected to medicine was widespread before modernity ironed it out. The specifically classical-CM version is that the cultivation infrastructure wasn't decorative, it was practitioner-attunement that made the needles and herbs land harder, do their work better. Where streams of training kept that infrastructure central, the work lands the way it was supposed to. Where it became optional, two different practitioners can use the exact same point selection and get totally different results, and the cultivation is usually the difference. This is practitioner observation, not peer-reviewed research, fair point. Self-reporting has known biases. But it's the pattern I see in the room, and the claim I'm willing to put forward.

Here's the thing though. The same split runs right through the textbooks today, and it surfaces in the moments that actually matter. Those COVID hospitals that got built in Wuhan in early 2020, they were named Huoshenshan 火神山 and Leishenshan 雷神山, Fire God Mountain and Thunder God Mountain. These are Five Elements names, folk-religious and Daoist deity names. Mainland TCM was classifying COVID at the time as cold-damp plague (寒湿疫), which is a yin pathogen pattern in TCM terms. That classification came out of Academician Tong Xiaolin's work and was adopted in the official Chinese government COVID treatment guidelines. Fire and thunder are yang energies. So you've got state medicine in an officially Marxist-Leninist political system naming new hospitals after yang deities to counter what its own TCM doctors were diagnosing as a yin pathogen, using the old conventions the moment the stakes got real. You can read the motives on that however you want, but the pattern's pretty clearly there.

Mao did the same thing himself, by the way. He said publicly he didn't believe in Chinese medicine, Li Zhisui's account backs that up. The folk record though, that tells you he consulted Daoist diviners on big decisions, the story goes he picked auspicious dates and times for major moves based on Daoist readings, and the number for his special security unit (8341) is supposedly tied to a Daoist prediction about his life. He also reportedly used qimen dunjia, the old war-magic calculation system, in his military planning. Officially there was no superstition allowed in the new system. Unofficially, the folk record says basically every big move he made was inside that framework anyway.

So when we get to the chapters on bazi diagnostics, ritual intervention, channel narratives, all the stuff that follows, don't file any of that under the magick department for me. The standardized curriculum names some of it and not the rest, but the rest is still part of the tradition. Both versions are Chinese medicine, the standardized and the classical, but they aren't doing the same job. The classical version with its framing and cultivation infrastructure intact does work that the curriculum version, with that infrastructure de-prioritized, can't quite reach. Same tradition, different operating modes, the classical mode just has more of itself online. The buffet's open, the food's safe, you'll get results out of it. But the rest of this book is going to be about the secret menu, the stuff that isn't really mainstream but is in the kitchen if you know to ask.

Same world either way, just two eyes looking at you, doesn't really matter which one you focus on, you're still looking at the same face anyway.

Next chapter: The Magick Was Never the Add-On. How classical Chinese medicine sits underneath the language, why the words for "acupuncturist" and "herbalist" are doing more work than they look like, and why Sun Simiao didn't bother coding any of it. Subscribe and you'll get it when it drops.