Prof. Yucong Duan:Transforming Medicine from Passive to Active: Foundational Concepts of “Active Medicine”

Yucong Duan

International Standardization Committee of Networked DIKWP for Artificial Intelligence Evaluation(DIKWP-SC)

World Artificial Consciousness CIC(WAC)

World Conference on Artificial Consciousness(WCAC)

(Email: duanyucong@hotmail.com)

The original reference is derived from Laozi’s famous philosophical progression and its subsequent inversion or reinterpretation in educational and medical contexts:

Laozi’s Hierarchy: Dao => De => Ren => Yi => Li

• In Laozi’s thought, Dao is the ultimate principle of harmony and truth.

• De (virtue) emerges when Dao is not fully apprehended; it represents a moral and ethical order emanating from Dao.

• Ren (benevolence) follows when virtue (De) is lost; it is a human-centered moral goodness that attempts to fill the gap left by losing the higher principle.

• Yi (righteousness) comes after benevolence (Ren) is lost; it enforces standards of what is right and just as moral sentiments weaken.

• Li (ritual/propriety) arises when righteousness (Yi) is lost; at this stage, only external forms and rituals remain, devoid of the original, more profound moral essence.

This sequence is famously summarized in Laozi’s quote:“故失道而后德，失德而后仁，失仁而后义，失义而后礼。”(“Thus, when Dao is lost, De appears; when De is lost, Ren appears; when Ren is lost, Yi appears; and when Yi is lost, Li appears.”)

Educational Inversion:In traditional education, the return path can be seen as a reverse climb back up from Li to Dao:Education: Li => Yi => Ren => De => DaoThis suggests that through proper learning and cultivation, one might progress from merely following rituals (Li) to understanding righteousness (Yi), embodying benevolence (Ren), manifesting virtue (De), and ultimately realizing Dao.

Applications in Medicine – Passive vs. Active Medicine:When applying these philosophical concepts to medicine, we can consider two modes: “passive medicine” and “active medicine.” Passive medicine corresponds to a reactive approach—treating symptoms as they appear, much like descending from Dao to Li. Active medicine, conversely, aims to proactively restore the higher principles of health, reversing the downward sequence and ascending from Li back to Dao.

1. Passive Medicine (被动医学)

   In passive medicine, the approach is often symptomatic and reactionary. The text implies two aspects of passive medicine: “意” (intention) and “伪” (falseness):

   Thus, passive medicine may inadvertently indulge in superficial, ritualistic care lacking genuine moral and philosophical grounding.

• “非义之礼” (Li without authentic Yi) – Rituals devoid of genuine righteousness. In medical terms, superficial practices without moral or professional integrity.

• “非仁之义” (Yi without authentic Ren) – Righteousness without benevolence. Medical interventions that follow a rule but lack empathy.

• “非德之仁” (Ren without true De) – Benevolence without virtue. Showing kindness but lacking true moral grounding or understanding.

• “非道之道” (Dao that is not the true Dao) – A mere semblance of the ultimate principle without real comprehension or integration. Applying medical procedures without a true understanding of underlying health principles.

• Intention (意) in Passive Medicine:The sequence would be: Restore Li => then Yi => then Ren => then De => and finally return to Dao.This means starting from the most external forms (Li—ritual, or in medical terms, superficial treatment of symptoms) and gradually working inward to restore the fundamental health principle (Dao). This approach is slow, starting from external compliance with medical rituals and moving step-by-step toward true internal harmony and health.

• Falseness (伪) in Passive Medicine:The text contrasts genuine returns to principles with the existence of “fake” or “false” returns:

2. Active Medicine (主动医学)

   Active medicine aims to “reverse” the descending path and climb back up toward Dao directly. It seeks to actively restore the highest principle of health rather than merely reacting to symptoms. The suggested sequence for active medicine is:复道 => 复德 => 复仁 => 复义 => 复礼This means starting from re-establishing Dao (the holistic, ultimate principle of health) and then manifesting De (virtue), from which Ren (benevolence), Yi (righteousness), and Li (ritual/protocol) naturally follow as coherent expressions of a harmonious medical practice.

   In practice, active medicine would:

• Focus first on the patient’s overall harmony with life (Dao).

• Ensure that virtue (De) underpins all medical decision-making.

• Maintain benevolence (Ren) as a guiding principle in patient care.

• Ensure that any medical guidelines (Yi) and protocols (Li) serve the higher goals of health and well-being, not just mechanistic ritual or profit.

Reframing Medicine: From Passive to Active

• Passive Approach: Start at the bottom (Li—superficial treatments), gradually try to restore meaning up the ladder back to Dao.

• Active Approach: Begin with Dao—the ultimate understanding of health and harmony—and naturally let the virtues (De), humane care (Ren), just principles (Yi), and proper procedures (Li) fall into place.

This philosophical re-interpretation of medicine calls for a foundational shift:

• Instead of waiting to treat illness as it surfaces (passive), we aim to restore fundamental health principles proactively (active).

• Instead of layering superficial treatments and hoping to rediscover fundamental harmony, we start from the deepest, holistic understanding and ensure that every step of the medical practice aligns with a virtuous, compassionate, just, and proper approach.

In essence, Active Medicine means treating from the inside out, from the highest principle (Dao) down to the necessary procedures (Li), ensuring that all actions remain anchored in a holistic, ethical, and empathetic philosophy.

Conclusion:

By applying the Laozi-inspired sequence of Dao—De—Ren—Yi—Li to medicine, and contrasting it with the educational inverse, we clarify the difference between passive and active medical approaches. Passive medicine tries to climb back up from rituals to Dao, risking superficiality and moral compromises. Active medicine, by contrast, seeks to start from Dao—the ultimate principle of health and harmony—ensuring that every subsequent medical action naturally aligns with virtue, benevolence, righteousness, and propriety. This reframing encourages a proactive, deeply philosophical, and ethically coherent medical practice that honors both traditional insights and modern scientific rigor.