An Old Doctor’s Notes on Self-Cultivation (No. 99)

— Reinterpreting TCM with Modern Language: Pulse, Tongue, and the Five Systems

For many years, I believed Traditional Chinese Medicine (TCM) and Western medicine were two separate systems—two different worlds that could never truly communicate. Only in recent years have I gradually realized that they were never two worlds at all. They are simply two ways of describing the same human system, shaped by different eras and different languages.

If we want TCM to move into the future, the first step is not “innovation,” nor the invention of new theories. The real beginning is rewriting the language. Once the language changes, the entire framework reshapes itself; and when the framework changes, the wall between TCM and Western medicine naturally dissolves.

One of the clearest examples is the pulse. We were taught that cun–guan–chi correspond to the heart, liver, spleen, lung, and kidney—as if the radial artery were a map of internal organs. But the radial artery is a single vessel; it cannot be divided into three anatomical zones. Today we can understand it differently: cun–guan–chi are not anatomical locations but three interpretive directions of one signal.
The cun position reflects the dynamic system—autonomic tone, circulatory force, sympathetic–parasympathetic balance.
The guan position reflects the metabolic system—digestive load, dampness, phlegm, dietary burden.
The chi position reflects the compensatory system—fluid balance, endocrine tone, and long-term energy reserves.

It is an information-classification method, not an anatomical map.
One input signal, interpreted through three functional dimensions.

Tongue diagnosis is similar. The tongue is not an imaging tool for organ pathology, nor is it merely a set of vague labels like “dampness” or “heat.” The tongue is a window into the body’s material state—a slow-changing layer that reveals the baseline of a person’s physiology.
Cold reflects slow metabolism and sluggish circulation.
Heat corresponds to inflammation and accelerated metabolism.
Dampness shows fluid burden.
Phlegm represents accumulated metabolic by-products.
Deficiency reflects insufficient energy or nutrients.
Stasis reflects micro-circulatory problems.

The tongue shows what is present in the body’s material layer.
The pulse shows how the system is currently operating.

One describes material, the other describes dynamics.
Once these two dimensions are separated, much of TCM’s confusion disappears.

The same applies to the Five Zang. They were never meant to be anatomical organs but metaphors for five functional systems. Ancient physicians had no vocabulary for neurology, endocrinology, immunology, or metabolism, so they borrowed organ names to represent systems. In modern language:
“Heart” refers to the nervous system + circulatory dynamics.
“Lung” refers to the respiratory system + superficial circulation + immune barrier.
“Liver” refers to the autonomic nervous system + fascial tension system.
“Spleen” refers to digestion + metabolic processing.
“Kidney” refers to fluid regulation + endocrine function + long-term compensation.

Once the Five Zang are translated from organs into systems, TCM aligns immediately with modern physiology. The language barriers vanish instantly.

When the pulse represents the dynamic layer, the tongue represents the material layer, and the Five Zang represent the system layer, these three forms of observation naturally form a complete modern medical framework. And the “Four-Level Thinking” model I have been shaping over the years—structure, chain, system, and regulation—happens to provide the larger map that integrates them all.
Point for structure,
Chain for connections,
Plane for systems,
Spirit for regulation.

Within this framework, TCM concepts like cold, heat, deficiency, and stagnation become logically explainable; Western medicine’s anatomy, imaging, and biomarkers also fit naturally into the system. They are not opposites, but complementary views; not rivals, but partners in a higher-level understanding of the human body.

This is why I often tell myself: in the future, there will no longer be “TCM” and “Western medicine.” Those terms belong to a historical stage. The medicine of the future will be integrated medicine—a unified, higher-dimensional model that explains the true complexity of human life.

When language is rebuilt,
when the framework is reorganized,
when ancient experience and modern science meet in the same coordinate system,
our understanding of medicine finally enters the next stage.