Surgery has been in the history of Chinese medicine for more than a thousand years, and the development of modern medical surgery has been from extra-cavity surgery to intracavity surgery, from destructive surgery to reconstructive surgery, from expanded surgery to minimally invasive surgery, which is a return to the concept of Chinese medicine of “eliminating evil to save the root, eliminating corruption without hurting the new, and eliminating evil without hurting the right”. The purpose of surgery in Chinese hospitals is not to “westernize” but to develop Chinese medicine surgery. Chinese medicine has always treated surgery as a means of external treatment, surgical treatment in Chinese medicine occupies an important position, and in a certain period of history was at the forefront of the world, until the last hundred years, due to the Qing government’s closed-door approach, the decline of Chinese medicine surgery and the flourishing modern surgery to form a world of difference, and surgery into “Western medicine”. Many people think that surgery is “Western but not Chinese”, which is a big misunderstanding. This is a great misunderstanding. “Guiding clinical practice with the concept of TCM” is the consistent principle that Professor Cai Bingqin, a famous TCM doctor in Guangdong Province, has adhered to in his clinical work for nearly 50 years. Cai Bingqin has explored a path of development in the field of TCM surgery, which is based on the concept of TCM as the guiding ideology, modern surgery as the competitive means, and TCM treatment as the clinical characteristics. He is the head of the Department of Surgery of Guangdong Provincial Hospital of Traditional Chinese Medicine, and has proposed the concept of TCM surgery, which is “to remove the evil in order to rectify it, and to remove the evil in order to support the righteousness”, and has been used in the whole process of TCM surgery, which has achieved good social results. The concept of TCM surgery is an important part of Professor Cai’s academic thought, to be discussed from the following aspects: Surgery in the history of Chinese medicine for more than a thousand years As early as in primitive society, living conditions were difficult, human trauma, so the use of herbs, leaves to bandage wounds, pull out the body of foreign bodies, pressure to stop bleeding, this is the original Chinese medical surgical treatment methods. The earliest surgical instrument, the acupuncture needle, was recorded in the “Shanhaijing/Eastern Mountain Classic” during the Spring and Autumn Period, and was an effective tool for cutting open and draining pus. In the Zhou Li, surgeons were called “ulcer doctors” and were responsible for the treatment of sores, carbuncles and bruises, making surgery an important distinction between internal medicine and surgery. The surgical treatment of gangrene was first recorded in the Nei Jing: “The gangrene that develops on the toes is called gangrene, and its appearance is red and black, so it is not treated; if it is not red and black, it does not die. Does not decline, the urgent decapitation, not is dead”. The surgical treatment of inguinal hernia was proposed in the “Fifty-two Diseases Formula”. During the Sui and Tang dynasties, Chinese medicine surgery reached a very high level, and it was pointed out in the Treatise on the Origin of Diseases that “those with broken intestines …… can be quickly renewed. The first needle strands as the law, continuous severed intestine, then take the chicken blood coated with its interval, do not let the gas leak, that is, push within the “, and stressed that after intestinal anastomosis “as research rice porridge to drink. After the intestinal anastomosis, we should drink the porridge as a rice porridge. For more than 20 days, we should make a strong meal, and then we can eat after 100 days”, which preserved the surgical methods and steps of intestinal anastomosis, large omental vascular ligation and large omental necrosectomy in the Sui Dynasty. The tracheal and esophageal sutures performed by Chen Shigong and Wang Kentang in the Ming and Qing dynasties are the earliest records of this type of surgery in the world. In the Qing Dynasty, Gu Shicheng recorded in detail such surgeries as cleft lip repair, female congenital vaginal atresia, and ear and nose reimplantation in his “Ulterior Medicine Daquan”. Not only in the surgical procedures on the ancient classical discussion, for modern surgery in the emphasis on anesthesia, hemostasis, sterilization issues in the motherland medical history also have more discussion. The earliest anesthesiology from the “Three Kingdoms” in the biography of Hua Tuo recorded in the beginning of the anesthesia, to the Yuan dynasty Gui Yilin “Shi Medical get effective formula” in a detailed discussion of the relationship between the amount of anesthetic drugs and the depth of anesthesia, are in the world’s leading level at that time. Surgical hemostasis from the primitive leaves and grass roots to the Ming Dynasty burning and branding to stop bleeding, Chen Shigong emphasized the comprehensive hemostasis. Wang Kentang paid great attention to the prevention of infection, and proposed that “the medicine for washing sores should be decocted for ten or more boils with civil and military fires; when washing sores, do not touch the tender flesh with your hands, and do not blow on it with air, but avoid the wind”. Surgical instruments have also gradually developed, from the ancient stone knife cutting, to the Ming and Qing dynasties, large dagger, medium dagger, small dagger, willow leaf knife, over the anal cylinder, curved knife Ulong needle and other tools and instruments applicable to various parts of the human body, the scope of surgical treatment has also gradually expanded. It can be seen that the history of Chinese medicine surgical treatment is very long, and it is constantly developing and improving. In the Qing Dynasty, due to the influence of “science” on clinical medicine, the mindset of “taking analogies” and “trying to figure out what is inside” prevailed, and the techniques of surgery and anatomy were regarded as “The development of surgical techniques was subject to unprecedented constraints. In recent hundred years, modern medicine in anatomy on the basis of leading, solve the three major problems of sterilization, anesthesia, hemostasis, surgery has made rapid development, while China’s Chinese medicine surgery in the Qing government closed, presumptuous under the influence of the “demonic”, making the development of Chinese medicine surgery is far behind. Therefore, surgery is an important means of healing Chinese medicine for thousands of years, but only because of the influence of the closed state policy of a specific historical period and backward. Modern TCM practitioners have abandoned surgery, that is, they have abandoned the essence of traditional medicine, and surgery is both “Western and Chinese”. Surgery is the progress of Chinese medicine external treatment technology Chinese medicine is concerned with the “overall concept”, the combination of overall and local is an important feature of Chinese medicine surgery. TCM surgery has always been about the combination of local identification and overall identification, such as pus, sores, pain, numbness identification, identification of the presence or absence of pus of various methods: touch, pressure, light, puncture, etc., local identification using external treatment has been one of the greatest advantages of TCM surgery, but also an important feature that distinguishes it from the internal medicine of Chinese medicine. It is the basis of surgery to follow the principles of internal medicine to treat the disease of surgery; and the external treatment method that works directly on the affected area is unique to surgery. The combination of local and overall unique identification system of TCM surgery determines that TCM surgical treatment must be a combination of internal and external treatment. Generally speaking, minor illnesses can be cured by external treatment alone, while major diseases are difficult to achieve without the combination of Chinese and Western medicine, internal and external treatment. Bingqin Cai believes that surgery is the replacement of a patient’s pathological deformity (anatomical and functional abnormalities) with an anatomical deformity (anatomical reconstruction, different from the normal anatomical structure) that is consistent with the patient’s physiology. This pathological deformity is the “evil” in Chinese medicine theory, and the physiological function is the “right”. Surgery is a medical treatment to “remove the evil and correct”, and it is also one of the external treatment methods of TCM, and only by viewing surgery in this way can we provide the best treatment plan for patients. The rapid development of modern surgical techniques has expanded the space for the external treatment of traditional Chinese medicine surgery, and under the guidance of a holistic concept, when we consider performing surgery on a patient, we must fully weigh the benefits and risks of surgery for the patient. The purpose of surgery is to heal and save the patient, and for the sake of the patient’s health, surgery should not be performed for the sake of surgery. In Chinese medicine, surgery is not the only means of treatment. For example, for the treatment of severe acute pancreatitis, we have summed up a set of effective comprehensive treatment plan over the years, of which the core treatment concept is derived from the “Treatise on Typhoid”, which adopts the tactic of “avoiding the sharp edges of evil qi when it is in full force”. The treatment concept is derived from the “Treatments for the knotted chest syndrome” in the “Treatments for the knotted chest syndrome”. As for diseases such as adhesive intestinal obstruction, atherosclerotic occlusive disease, and diabetic foot, the treatments we use, such as internal Chinese medicine, external application, enema, external washing, and acupuncture, have achieved satisfactory results in clinical practice. The concept of surgery as one of the external treatment methods of TCM is best reflected in the choice of “timing of surgery”. The most prominent aspect of TCM surgery is the treatment of sores, which can be incised when pus is present, but not when pus is present, which is not beneficial to health. The timing of surgery means that when the body is operated on, the best therapeutic effect can be achieved and the body can tolerate a stage when the benefits of surgery outweigh the disadvantages. For example, in the acute phase of acute severe pancreatitis, the body is in a state of intense stress, and the necrosis of the pancreas has no boundaries, so surgery at this time is a fatal blow to the patient, which will expand the scope of inflammatory infection and cause high mortality after surgery. In contrast, for acute hemorrhagic intestinal obstruction, only early surgery can preserve the intestinal segment to the maximum extent and save lives. It shows that adherence to the holistic concept of TCM and reasonable selection of surgery timing can improve the surgical effect. Surgery is a means of Chinese medicine to support the righteousness and dispel the evil. When the righteousness and evil compete with each other, the strongest evil will hurt the righteousness, and only when the evil is gone can the righteousness be safe. The only difference between Chinese hospitals and Western hospitals is that they are guided by the philosophy of Chinese medicine, such as the removal of various solid tumors, the incision and drainage of abscesses, and the removal of local lesions such as appendixes and gallbladders, etc. Surgery can remove the lesions, reduce the damage to the body, and play an objective and precise role in “eliminating evil”. The surgery can be considered as “helping the righteous”; the surgery can stop the leakage of qi and blood and prevent the invasion of external evil from the wound; the surgery can release intestinal adhesions, resect intestinal tumors and remove bile duct stones can play the role of promoting qi circulation; the surgery can play the role of returning yang to save the rebellion, etc. The surgery can be considered as “helping the righteous”. However, surgery is a double-edged sword, which can remove necrotic tissues and bring damage to normal tissues, and any surgery is accompanied by the depletion of Qi and blood, and the formation of Qi stagnation and blood stasis, which is an important blow to the body. Historically, many TCM surgical experts are very important to this point, surgery is more concerned about the love of tissue. Chen Shigong, in the Ming Dynasty, constantly improved surgical tools and instruments in order to minimize tissue damage. Emphasis on anatomy, improved tools, and care for tissue are the three elements of successful surgical procedures. “From radical surgery to extended radical surgery, to the current modified radical surgery and breast-conserving surgery, it has been more than a century of difficult exploration and numerous clinical trials have confirmed the importance of protecting normal tissues. It is evident that the traditional concept and modern treatment methods are compatible, and the development of modern medical surgery has progressed from extra-cavity surgery to intracavity surgery, from destructive surgery to reconstructive surgery, and from extended surgery to minimally invasive surgery, which is a return to the concept of “eliminating evil to save the root, eliminating decay without harming the new, and eliminating evil without harming the right” in Chinese medicine. It is under the guidance of this TCM concept that minimally invasive instruments such as laparoscopes, biliary scopes and multi-functional surgical dissectors (scrapers and suction knives) can be used in a wide range of surgical departments in Guangdong Provincial Hospital of Traditional Chinese Medicine and achieve good results. The scraping and suction knife invented by Prof. Peng Shu is in line with the concept of “eliminating evil without hurting righteousness” in TCM surgery, and the anatomical operation is completed by electric cutting, electrocoagulation, blunt separation with simultaneous suction, which can not only remove the lesion, but also preserve the useful ductal tissue. Especially suitable for Chinese hospitals. Chinese hospitals to carry out surgical procedures, to ensure the safety and effectiveness, but also to minimally invasive and inexpensive, as the so-called “big coincidence to see the dull”. Chinese medicine highlights the “individual differences” of surgery Chinese medicine attaches great importance to the “surgery” of individual differences, dialectical view of surgery, with the changing times and scientific development, surgery is not absolute or unchanging. We should not use our limited knowledge of modern medicine to easily arbitrarily judge the infinite nature of the human body. For example, gallbladder stones are not always treated by cholecystectomy, but can also be removed by simple cholecystotomy or without surgery, depending on the individual. According to the literature, removal of the gallbladder is not without sequelae, and the incidence of colon cancer increases after cholecystectomy. On the other hand, the success of combined Chinese and Western medical treatment for acute abdominal disease has turned emergency surgery into elective surgery, and some patients who need surgical treatment into non-surgical treatment. This series of “changes” process fully embodies the “individualized treatment” of TCM, which is the highest level of modern medicine. Most of the surgical patients who come to the Chinese hospital have scruples about surgery, when carrying out surgical treatment, must adhere to the “people-oriented”, full communication, not only to emphasize the need for surgery, but also to prevent over-exaggerated surgical effects, highly respect the patient’s willingness to surgery, can do or not do surgery resolutely not do, can do small surgery, resolutely not This is the prerequisite to ensure the success of surgery in Chinese hospitals. We not only treat people’s diseases, but also treat people who are sick, focusing on the concept of “people-oriented” so that our clinical thinking is no longer limited to “surgery for the sake of surgery”. Respecting the wishes of patients and their families and taking into account the affordability of patients make our treatment plans more humane and personalized. This is also the practical application of the concept of “tailoring to the individual”. To take advantage of the perioperative treatment of TCM surgery, is surgery a cure for the root cause or for the symptoms? TCM believes that whether it is minor surgery or radical tumor surgery, it is a cure for the symptoms, and the so-called radical tumor surgery is not a cure, because it often cannot eliminate the cancer-causing causes of the patient. Therefore, perioperative treatment is the essence of TCM treatment, and it is also the most characteristic aspect of TCM. Upgrading the level of TCM participation is the key to perioperative TCM treatment. Pre-operatively, TCM plays a great role in regulating the patient’s mood and spirit to make the patient in the best condition for surgery, especially in eliminating the patient’s fear before surgery. In the postoperative period, Chinese medicine is used to improve immunity and reduce perioperative complications, and special attention should be paid to the treatment of common postoperative symptoms. For example, postoperative fever is often characterized by deficiency, stasis, phlegm and toxicity, and the fractional treatment can often achieve satisfactory results. “For example, postoperative fever is often characterized by deficiency, stagnation, phlegm and toxicity, and can be treated satisfactorily by typology. The concept of “balance” as the degree, “transportation” as the method, and “harmony” as the norm is our clinical treatment. Through the clinical application of various traditional therapies such as oral Chinese medicine, enema, external ironing, foot massage and various forms of acupuncture and auricular acupuncture, the quality of life of many patients after surgery has been improved, and the naturalness and certain efficacy of Chinese medicine have enabled us to reduce the dependence on chemically synthesized drugs in our clinical work, reduce the use of various types of western drugs represented by antibiotics, effectively reduce the hospitalization cost of patients, and reduce the economic pressure. Reduced economic pressure, recognized by society. Chinese medicine also has a wide scope of development for the follow-up treatment of primary surgery. For example, there are direct anti-cancer herbal medicines, such as curcuma oil, zebranin, ophiopogon oil, mountain cichlid, cordyceps, etc. There are also anti-cancer models based on the traditional method of supporting the righteous and dispelling the evil, such as ginseng, astragalus, ganoderma lucidum, cordyceps, porcupine, Liu Wei Di Huang Wan, Xiao Chai Hu Tang and other prescriptions that have significant effects in reducing the toxic side effects of chemotherapy and radiotherapy and enhancing the efficacy. In addition, we should boldly quote the research results of Chinese medicine related to surgery in the perioperative period. For example, Cheng Qi Tang-type formulas represented by the Tong Li attack method are widely used in abdominal surgery, both for preoperative intestinal preparation and postoperative intestinal function recovery. It has turned some emergency surgery into elective surgery and surgery into non-surgical treatment, significantly improving clinical efficacy and reducing patients’ pain. Postoperative comprehensive treatment, especially Chinese medicine diet and conditioning is the hot spot of modern research, which can effectively improve patients’ postoperative survival quality and prevent disease recurrence. Improving clinical efficacy is the basis of perioperative TCM treatment. To improve the clinical efficacy of TCM, it is necessary to improve the efficacy of the evidence, the efficacy of the formula, and the efficacy of the medicine. The “evidence” of TCM is identified by the four diagnoses under the guidance of the theoretical system of TCM. To improve the efficacy of the evidence, we must strengthen the training of the four diagnoses and improve the ability of comprehensive data collection; familiarize with the classics and strengthen the theoretical knowledge of TCM to improve the level of analysis and generalization in order to improve the efficacy of the evidence. It is especially important for surgeons to strengthen the basic training of the four diagnostic skills while carrying out surgical treatment. Due to the limitation of historical conditions, the external and internal aspects of Chinese medicine have become a way to identify evidence. Today, the development of surgery allows us to understand the condition of lesions in the body in a more intuitive way, and surgical methods such as dissection and laparoscopic exploration have unveiled the mystery of many lesions. This change in the way we think about evidence allows us to improve the effectiveness and accuracy of clinical evidence as much as possible. “The “prescription” is an important tool for Chinese medicine to treat diseases and save people. The clinical practice should use more “classic prescriptions”, “ancient prescriptions” and “seasonal prescriptions”. The “classic prescription” is Zhongjing’s prescription, which is the ancestor of all prescriptions, and can be obtained by familiarizing with the Treatise on Typhoid; the “ancient prescription” is the representative prescription of famous masters in the past generations, which can be obtained by familiarizing with medical cases and more clinical experience; the “current prescription” is the prescription of famous masters in recent times. The “ancient prescriptions” are the representative prescriptions of famous masters in the past generations, which can be obtained by familiarizing with the medical cases and more clinical experience; the “current prescriptions” are the innovative prescriptions of famous masters in recent times, which can be obtained by reading more literature and communicating with others. Although Chinese medicine is not all of Chinese medicine, but it is the most traditional and effective means of Chinese medicine, “use medicine like a soldier”, in clinical work, we must constantly understand the synergistic and antagonistic nature of a drug multi-purpose, the combination of Chinese and Western medicines, the advantages and disadvantages of Western medicine in use and Chinese medicine in the West, to expand the clinical use of drug ideas, so as to improve the clinical efficacy of Chinese medicine. Only by applying the concept of modern Chinese medicine today and keeping up with the times can we continue to expand the scope of treatment of diseases and cope with the new diseases and medical problems that are constantly emerging. Perioperative Chinese medicine treatment is a promising research topic. From the holistic concept of TCM, surgery is only a means of external treatment of TCM to “remove evil”, while the perioperative period is a process of TCM treatment. This is in line with the concept of “rapid recovery” in modern medicine and the idea of “treating the disease and preventing the disease before it occurs” in Chinese medicine. Chinese hospitals to carry out surgery is not “Westernization” in Chinese hospitals to carry out surgery, and not some scholars are worried about “Westernization”, its fundamental purpose is to develop Chinese medicine surgery. In any period of history, Chinese medical theory is based on the inheritance of continuous innovation and development, the basic theory of Chinese medicine passed down for thousands of years is the essence of Chinese medicine, and many of the theories are even ahead of their time. The “unity of heaven and man” in TCM is about the harmony between man and nature, which is the same as the social-psychological-biological medical model advocated by modern medicine, and the present-day holographic theory further confirms the scientific nature of the “holistic view of TCM “However, this does not mean that Chinese medicine is perfect and does not need to be developed. The natural method of discernment believes that everything is in constant motion, constantly changing, and developing in motion, and that Chinese medicine surgery absorbed the results of the warm disease Wei Qi and Ying Blood in the Ming and Qing dynasties to perfect and develop itself. In the Ming and Qing dynasties, TCM surgery absorbed the results of the warm disease of Wei Qi and Ying Blood to improve itself. “Poison entering Ying Blood” is treated with Qing Feng Wei Poison Drink, chills and fever with Zi Xue Dan, and delirium with An Gong Niu Huang Wan. At present, the intersection of modern science and Chinese medicine provides unprecedented opportunities for the development of Chinese medicine, innovation is the driving force for the development of Chinese medicine surgery. Under the guidance of TCM theory, all achievements of human civilization, including traditional methods such as Chinese medicine, acupuncture and moxibustion, as well as modern advanced science and technology can be used as effective means to prevent and treat diseases in modern TCM. Ultrasound, X-ray, CT, electrocardiogram, blood biochemistry and other modern medical treatment techniques can be considered as an extension of the “four diagnoses”. The purpose of the introduction and application of new technologies is to “strengthen my master” and “for my use”, and always insist on the use of Chinese medicine thinking to harness. Modern TCM treatment methods refer to all effective methods used under the guidance of TCM theory, including not only traditional Chinese medicine, acupuncture, massage, etc., but also various means such as surgery, infusion, physical therapy, diet and gong practice. Rehydration and blood transfusion can be seen as an expansion of TCM’s rule of supporting righteousness, removal of cancerous tumors can be regarded as a means of TCM to expel evil, and regulation of water and electrolyte balance can be considered as regulating qi, blood, yin and yang. Over the past few decades, Guangdong Provincial Hospital of Traditional Chinese Medicine has boldly applied surgery as a means to expand the treatment space of TCM surgery, improve the comprehensive service capacity of the hospital, and bring huge social and economic benefits, which has been well received by the public and recognized by peers. Chinese hospital “surnamed Chinese”, not to engage in “pure Chinese medicine”, does not exclude Western medicine, to ensure that the Chinese hospital surnamed Chinese, sometimes need to borrow the knowledge of Western medicine, methods and modern means to solve the difficulties of disease awareness and lack of treatment to meet the needs of the masses. In the treatment process of some diseases, due to the different stages of disease development, sometimes the advantages of TCM treatment need to be carried out on the basis of Western medical treatment or in conjunction with Western medical treatment. Perioperative treatment is the best platform for combining Chinese and Western medicine in the field of surgery, and it is also an important position to show the characteristics of Chinese medicine treatment. It can be seen that surgery in Chinese hospitals can better prosper the academic of TCM surgery and promote the further development of TCM surgery. Due to historical customary understanding and administrative restrictions, most hospitals in the country are increasingly limited to traditional body sores and ulcers. However, from the point of view of “a doctor’s vocation is to heal and save people”, TCM surgeons should actively expand the connotation of TCM surgery, focus on various diseases in surgery, learn and apply the most advanced surgical methods. Chinese medicine surgery people’s thinking should be liberated, do not be limited by the traditional stereotypical thinking, Chinese medicine surgery people’s vocation is to use the most appropriate technology to solve the patient’s surgical disorders, to provide the most appropriate treatment plan for patients. Only in this way, Chinese medicine surgery can reappear brilliant.