Keywords
integrated Chinese medicine and Western medicine - TCM - Chinese essence and Western
utility - theoretical innovation
The development of traditional Chinese Medicine (TCM) should follow its due laws,
keep the right way and make innovations, inherit the essence, adhere to the equal
emphasis on TCM and Western medicine, drive the integrations and development of TCM
and Western medicine, promote the development of TCM to the world, and give full play
to the advantages and characteristics of TCM in disease prevention and treatment.
As Chinese medicine workers, we should review the medical history to make integration
and innovations.
Reviewing the History of Traditional Chinese Medicine and Exploring Its Source
Reviewing the History of Traditional Chinese Medicine and Exploring Its Source
TCM had developed into a discipline around the 4th century BC when our country was
in a period of change in social development. During that period, medicine broke through
the shackles of divine right and destiny and separated from witchcraft. An epoch-making
ancient medical masterpiece Yellow Emperor's Inner Classic (Huang Di Nei Jing) was published. It was formed on the basis of condensing the excellent traditional
Chinese culture such as Chinese meteorology, astronomy, and philosophy, representing
the ideological characteristics of oriental culture and consolidating the foundation
of TCM theory. At the end of the Eastern Han dynasty, Zhongjing Zhang (150–219 AD)
inherited the academic thoughts in the Yellow Emperor's Inner Classic (Huang Di Nei Jing), combined it with clinical practice, and established the system of syndrome differentiation
based on the six meridians in Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Za Bing Lun). Fumi Huang (215–282 AD), a physician in the western Jin dynasty, wrote The Systematic Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing), which identified the total number of acupoints as 349 at that time, expounded the
functions and indications of the acupoints, explained acupuncture skills, etc., laying
a foundation for the science of acupuncture and moxibustion. In 610, Yuanfang Chao
et al compiled Treatise on the Origins and Manifestations of Various Diseases (Zhu Bing Yuan Hou
Lun), the earliest extant monograph on etiology and symptomatology in China. The etiology
and pathogenesis of some diseases have been described in a detailed and scientific
way in this work. As it said, “Taeniasis is caused by ingestion of undercooked meat.”
The government in the Song dynasty attached great importance to TCM education and
established the “Imperial Medical Bureau” as a higher-learning institution for cultivating
TCM talents. Weiyi Wang, an acupuncture expert, once designed two cast bronze figures
(1026 AD) and finely carved 12 meridians and 354 acupoints, a pioneering work in Chinese
medical education. During the Jin and Yuan Dynasties, various academics contended,
and four distinctive schools emerged in TCM, which was one of the most active periods
of academic thought in the history of TCM. Shizhen Li (1518–1593 AD), a medical scientist
in the Ming dynasty, worked for 27 years and compiled The Grand Compendium of Materia Medica (Ben Cao Gang Mu) which recorded 1,892 kinds of herbs and over 10,000 prescriptions by referring to
more than 800 kinds of references. This made immortal contributions to pharmacology.
Around the 11th century AD, TCM performed the human pox vaccination method to prevent
smallpox, providing experience for the world's immunology. In the Ming dynasty, Youxing
Wu believed that the transmission of infectious diseases was from the nose and mouth,
breaking the traditional understanding of TCM in diagnosing and treating exogenous
diseases. Mengying Wang and Lishan Yang, et al enriched and perfected the theory of
warm diseases.
From the 4th century BC to the 3rd century BC, Hippocrates, the father of ancient
Greek medicine, whose work named The Collected Works of Hippocrates came out, with more than 70 chapters in it. This work collected the main ideas of
ancient Greek medicine in that period and became a beacon in the world's medical field.
Galen (129–199 A.D.), the most famous physician in ancient Rome, known as the “king
of medicine,” absorbed the academic ideas of The Collected Works of Hippocrates and further combined clinical practice. It laid the groundwork for the development
of Western medicine. By the end of the 16th century, Western industry developed rapidly,
in which the mining and machine industries ushered in vitality. The invention of the
microscope opened up the microscopic world for mankind and provided unprecedented
convenience. Natural science began to turn to experimental research at that time.
In the medical field, cells were discovered thanks to the intervention of microscopy.
In the middle of the 16th century, the development of sound, light, and electricity
industries provided technical support for the production of medical equipment, and
basic medical research became fruitful. The emergence of constant breakthroughs in
the theoretical results made Western medicine quickly stand out with a new look. Modern
Western medicine consists of physiology, anatomy, pathology, biochemistry, and other
disciplines closely related to clinical practice to form a scientific system based
on experimental research. Every link of this system is closely related to the development
of modern natural science and technology, so the system is naturally a part of modern
natural science. Every invention of modern science and technology will inevitably
lead to a corresponding technological breakthrough in the medical system. For example,
the development of smelting technology and glass promoted the production of microscopes;
advances in atomic physics spawned the clinical application of X-rays; radar technology
provided B-ultrasound to medicine; integrated circuits provided CT tomography for
medicine; isotopic techniques generated ECT. Looking back on the development history
of Western medicine in the 1,500 years since Galen, the experimental research in the
works of Heath and Galen has not been vigorously developed and makes it the main theme
of Western medicine because there has not been a great social change in the Western
world in which new productive forces break through the old production relations. On
the contrary, some maxims and preachings other than experimental research are regarded
as golden rules, seriously restricting the development of Western medicine. But there
is one thing worth noting: in addition to the same large amount of image thinking
as Treatise on Cold Damage and Miscellaneous Diseases (Shang Han Za Bing Lun) and Yellow Emperor's Inner Classic (Huang Di Nei Jing), the works of Hippocrates and Galen also had research works on anatomy, physiology,
and pathology, rapidly providing a suitable soil for the development of modern medicine.
Chinese Essence and Western Utility Being a Historical Inevitability
Chinese Essence and Western Utility Being a Historical Inevitability
TCM and Western medicine are two medical systems formed in different cultural backgrounds,
and their cultural “mothers” determine the characteristics of the two medicines.[1] This article discusses the differences between Chinese and Western medicine based
on people, diseases, and ways of thinking.
Different Understanding of People
TCM focuses on the study of the invisible state of the human body, while Western medicine
focuses more on the study of the visible state of the human body. The visible and
invisible are related to subjective concerns. When people pay attention to the morphological
structure, what they observe is the visible state of matter; what they observe is
the invisible state of matter when they pay attention to functional changes. TCM pays
more attention to the study of human energy and information, that is, the so-called
“spirit” and “qi.” Western medicine pays attention to the shape and the matter. Western
medicine is established through anatomy and physical observation, a discipline that
consists of metaphysical objects visible to the naked eye. Dissected things are dead
things, and the Western medicine is the healing of living things not archaeological
repair samples. What TCM puts into the organs is the color of life. Without the color
of life or without the understanding of life, there is no medicine.
Different Understanding of Diseases
TCM attaches great importance to systematicity and integrality. The human body takes
the five internal organs as the center which connects the whole body tissues and organs
into an organic and systematic whole through the meridian system. When TCM recognizes
and analyzes diseases both physiologically and pathologically, it connects the part
with the whole and returns to the part from the whole, which fully embodies the thought
of systematicity and integrality in TCM. Western medicine focuses on local evidence
and the analysis of the microstructure and properties of specific human tissues. It
adopts the linear analysis method of “reductionism.” For instance, it performs antibiotic
therapy to kill bacteria and antiviral therapy to kill virus. It is inconceivable
for Western medicine that “Zusanli (ST 36) acupoint can strengthen the spleen and
stomach,” “Zhiyin (BL 67) acupoint can correct the fetal position,” and “Jingming
(BL 1) can treat waist sprain” in TCM acupuncture and moxibustion.
Different Understanding of Chinese and Western Medicine
The differences in ways of thinking between Chinese and Western medicine determine
the speculative system of Chinese and Western medicines.[2]
[3] TCM attaches importance to dialectics, while Western medicine attaches importance
to materialism. The theory of TCM is full of original ideas of simple dialectical
materialism from its emergence to its development. The objective logic of TCM dialectics
is unified with the complexity of the human body. The “concept of holism,” “concept
of opposition and unity between yin and yang,” “concept of disease occurring in the
struggle between healthy qi and pathogenic factor,” and the “therapeutic concept of
treatment based on syndrome differentiation” in TCM theory all reflect the dialectical
concept of TCM. Western medicine believes that man is a simple integration of chemical
and physical substances. In the 20th century, the research on the structure of the
human body was very clear. However, in terms of the concept of the human body, it
still remained in the concept of anatomy in the 19th century, that is, the human body
was regarded as a single linear causal relationship, lacking a holistic, systematic,
and constant speculative thinking mode and understanding of the complex relationships
within the human body. The integration of TCM and Western medicine is inevitable in
history, and both TCM and Western medicine have their own development track.
Looking at the history of the development of TCM and Western medicine, both types
of medicine have their own strengths. They learn from each other and integrate and
complement each other's advantages, which is the inevitable law of medicine. In recent
years, acupuncture has become more and more popular in the West, and TCM has spread
all over the western land. In addition to the fact that TCM can effectively solve
clinical problems, the deeper reason is that the Westerners identify the Eastern culture.
Based on the TCM's way of thinking, it absorbs the experimental research of Western
medicine and expounds the therapeutic and action mechanism of TCM. While respecting
the brilliant achievements of the ancients, TCM should also take the initiative to
learn from and absorb all the advanced scientific and technological achievements in
the present world to continue to innovate and develop. That is what “ancient respected
and modern absorbed, Chinese essence and Western utility” means, thus making innovations
of TCM. The integration and complementation of TCM and Western medicine is an important
step in the great renaissance of TCM.
Some Thoughts on Innovating Traditional Chinese Medicine
Some Thoughts on Innovating Traditional Chinese Medicine
Integration of “Research on Traditional Chinese Medicine with the Thought of Traditional
Chinese Medicine” and “Research on Traditional Chinese Medicine Based on Thought of
Western Medicine”
“Research on TCM with the thought of TCM” and “research on TCM based on the thought
of Western medicine” are two concepts with essential differences. “Research on TCM
with the thought of TCM” refers to the research on TCM based on the thought of Western
medicine under the guidance of the basic theory of TCM and with the TCM's ways of
thinking. The characteristic of TCM lies in its analysis and adjustment of the information
of the human body. “Research on TCM based on the thought of Western medicine” is to
study TCM by using the thinking mode and methods of Western medicine and strive to
make TCM scientific and standardized. It stresses the research on TCM concepts such
as the essence of qi, meridians and collaterals, acupoints with modern advanced scientific
measures, or verification of the effectiveness of a Chinese herb or a TCM prescription
using animal experiments. “Research on TCM based on the thought of Western medicine”
is just a pointless verification of TCM by Western medicine, and “research on TCM
with the thought of TCM” based on the basic theory of TCM can really promote the development
of TCM. For example, the thinking mode in the theory of turbid toxicity is a research
on the theory of TCM, an innovation based on inheritance rather than using modern
medicine to verify TCM or constructing it on the basis of the Western medicine system.[4]
Integration of Scientization of Traditional Chinese Medicine and Scientization for
Traditional Chinese Medicine
Some people think that the science of studying human health is medicine, and medicine
should be science first, so they put forward “scientization of medicine” to strive
for the objectification and standardization of medicine. The same is true of TCM.
The ultimate goal of scientific research of “scientization of TCM” is to solve problems.
However, medicine is the one which is most closely related to human health among all
disciplines, and all scientific achievements should serve medicine and be “scientific
medicalization.” TCM is full of rich philosophical thinking, which has guiding significance
for many disciplines. Xuesen Qian once said, “The modernization of TCM is the right
way for the development of medicine, and it will eventually lead to the transformation
of the scientific system—scientific revolution,”[5] so “scientization for TCM” should be an important proposition in today's medical
and even scientific and technological circles.
Integration of Regulation Therapy and Allopathic Therapy
TCM regulation therapy emphasizes the human body's own immunity as the key factor
in determining whether the body gets sick or not. It is believed that “accumulation
of pathogenic qi can weaken healthy qi” and “healthy qi inside the body can prevent
pathogenic qi from invading the body.” It means that the body's immunity should be
enhanced first, and “healthy qi” is supposed to resist and expel diseases. Allopathic
therapy is a characteristic treatment of Western medicine. When a certain index of
the human body is found to be abnormal, the drug intervention is immediately performed
to restore it to the normal level. For the antibacterial and antiviral therapy of
Western medicine, it ignores the body's own resistance to disease. The most obvious
adverse reactions of allopathic therapy are drug-induced diseases for the abuse of
antibiotics and hormones. Is inflammation a bad thing, and is anti-inflammatory treatment
right? Should fever and elevated white blood cells be treated by allopathic therapy?
In fact, many of the body's responses are disease-fighting responses. Studies have
shown that the antibiotics only exert one-fifth of the therapeutic effect, while the
other four-fifth of the effect lies in the body's own fight against the disease in
the treatment of bacterial infections. We should study how the four-fifth of the effect
comes, not just how the antibiotics work. In medical science, we should shift the
focus of research from the diagnosis of etiology, pathology, and disease location
to how to enhance the body's own regulation to prevent and resist disease.
Integration of the Treatment of Patients and the Treatment of Disease
The so-called treatment of patients refers to considering the individual as a whole
in the process of treating the disease; the so-called treatment of disease refers
to focusing on the disease that the patient suffers from, which ignores the integrity
of the individual himself or herself. Western medicine mainly focuses on treating
diseases, while TCM focuses more on treating patients. For example, guided by the
theory of turbid toxicity, the clinical diagnosis and treatment of patients with advanced
tumors cannot only improve the quality of life of the patients, but also prolong the
lifespan of the patients, providing a strong clinical basis for the survival of tumor
patients. The phenomenon of “human-tumor coexistence” reflects the superiority of
TCM concept of treating patients.[6] We cannot deny that early surgery and intervention of radiotherapy and chemotherapy
play a certain or great role in the treatment of cancer, but not all patients are
suitable for these treatments. Therefore, both TCM and Western medicine should treat
both “diseases” and “patients.” This is also an issue worth exploring at the ideological
level of the integration of TCM and Western medicine.
Integration of Preventive Treatment and Existent Disease Treatment
“Preventive treatment” refers to the use of preventive or therapeutic methods to prevent
the occurrence and development of diseases. It is the basic principle of the theory
of TCM treatment, one of the core concepts of TCM, and an important theoretical basis
and guideline for TCM preventive health care. The existent disease treatment, as the
name implies, refers to the treatment of the disease on the basis of the pathological
information that the body has manifested. Our medical behavior mainly carries out
this work at present. We begin to intervene only when the body sends out pathological
information and the patient feels unwell. It would not only affect the patient's quality
of life and the treatment of disease but also be a great waste of medical resources.
For example, the essence of the study on precancerous lesions of gastric cancer based
on the theory of turbid toxicity is to perform preventive treatment. With the help
of modern medical knowledge of physiology and pathology and dynamic observation under
gastroscope and pathology, the pathogenesis can be clarified and the best TCM prescriptions
for the prevention and treatment of this disease can be explored, thus enriching the
basic theory of TCM.
Integration of Individuality and Commonality
People always think that only by finding commonalities and objective laws can the
secrets of life be revealed. TCM pays more attention to individual differences. The
clinical practice of TCM is nonrepeatable, subjective, and highly random. This requires
us to break through the shackles of allopathic treatment and pay attention to the
adjustment and self-healing treatment, individualized treatment, and different theories
and schools, integrating adjustment and self-healing treatment, individuality, and
commonality.
Integration of the Macro and the Micro
The dialectical view of the integration of macrodialectics and microdialectics is
to use microindex to recognize and identify “syndromes.” From the perspective of scientific
outlook and methodology, taking into account the unity of the whole and the local,
the synthesis and the differentiation, and the micro and the macro is the right route
to understand the essence of things. Only when the macrodialectics and microdialectics
are integrated, the nature of the syndrome can be accurately recognized.
Integration of the Chinese and the Western to Make Theoretical Innovation
Integration of the Chinese and the Western to Make Theoretical Innovation
The development of a discipline lies in innovation, and the innovation of academic
theory is the driving force for the development of TCM. Zhongjing Zhang founded the
syndrome differentiation based on six meridians. The four great masters of Jin and
Yuan dynasty, Wansu Liu, Congzheng Zhang, Gao Li, and Zhenheng Zhu, represent four
different schools. Wansu Liu believed that diseases were mostly caused by heat, and
cold and cool drugs were often used in treatment, so he is called “School of Cold
and Cool.” Congzheng Zhang believed that the treatment of diseases should focus on
expelling pathogenic factors. According to him, “elimination of pathogenic factors
ensures health.” He had enriched and developed the three methods of diaphoresis, emesis,
and purgation, which is called “School of Purgation.” Gao Li believed that “stomach
qi is essential to health.” He was skilled in warming and invigorating the spleen
and stomach in the treatment of diseases, which is called “School of Reinforcing the
Earth.” Zhenheng Zhu believed that “Yang qi is often excessive while yin qi is often
insufficient,” and he made good use of the therapeutic principle of “nourishing yin
and reducing fire,” which is known as the “School of Nourishing Yin.” Jutong Wu, a
master of warm diseases, created defensive phase-qi phase-nutrient phase-blood phase
syndrome differentiation and syndrome differentiation based on the triple energizer
in the treatment of warm diseases. All of these theories illustrate the importance
of academic theoretical innovation.
Medicine is a discipline that serves the health of all human beings. Both TCM and
Western medicine, with their own strengths and weaknesses, are aimed at solving clinical
problems. The strengths of the two should be utilized and the multidisciplinary cross-integration
should be performed to keep the right way and make innovations.
