Many TCM Theories Are Wrong, But TCM's Therapeutic Effect Is Real
As a traditional medicine, much of TCM theory is wrong, yet TCM genuinely works when treating disease. This shows that there are many practical elements within traditional Chinese medicine, but these practical elements have been misinterpreted because of the limitations of the times.
Medicine advances as the times advance; the overall scientific level of an era determines the overall medical level of that era. As everyone knows, Chinese society went through a feudal era of more than two thousand years. During those two millennia, social progress was minimal, and both the political form and the ordinary person's ideology tended toward conservatism. Its influence persists even today; it is an indisputable fact that there are still many conservative thinkers in the Confucian cultural sphere.
TCM is an exception, because driving reform and progress in TCM poses no threat to political power and is instead beneficial to the national economy and people's livelihood. Moreover, emperors and nobles also fall ill; in the imperial courts of every dynasty, many princes died young, so the demand for medical progress objectively existed. Even so, because the development of society's overall strength was constrained, TCM was still unable to make great progress.
For example, because of the backwardness of anatomy, much of TCM's understanding of the human meridians and zang-fu organs is wrong. The meridian theory put forward by TCM in particular is highly problematic. The meridians recorded so confidently in TCM classics cannot be found anywhere today, when human anatomy is so advanced. This is because from the very beginning meridians were the product of analogy and imagination, not truths observed from real dissection; therefore not only can we not find meridians today, but even when science is more advanced in the future, the existence of meridians will still not be confirmed.
The reason such a large error arose is mainly that ancient physicians lacked the conditions for anatomical research. Meridians are the product of ancient TCM thinking rather than the product of scientific observational practice, and are too subjective. The meridian theory as first proposed may have been an advance at the time, but by today's standards it is very backward.
Yet the meridian theory is not water without a source. It was, on the basis of summarizing the actual therapeutic effects of acupuncture and tuina massage by past physicians, produced through analogy with certain phenomena in nature—mainly mountains, rivers, and streams—as a theoretical system attempting to systematize the efficacy of acupuncture and tuina massage. This is the ancient Chinese thinking method of “classification by analogy.”
TCM's understanding of the body's zang-fu organs is also wrong. Because ancient Chinese physicians lacked the practice of human anatomy, their understanding of the internal organs employed the “black box” observational method of “observing the exterior to know the interior.” In the past this greatly helped physicians understand the workings of the body, but as times have progressed, this method, being imprecise, is hard to take on trust.
Wang Qingren, the famous Qing-dynasty physician and author of the Yilin Gaicuo (Corrections to the Errors of Medical Works), was one of the earlier TCM physicians in Chinese history to engage in anatomical practice. He was a very bold man; through anatomical observation of the corpses of children who died in plagues and of executed prisoners, he discovered that most of the anatomical knowledge of the human body recorded in the Huangdi Neijing was wrong. Based on his own direct observations, he corrected many erroneous records and, through his own practice, created a series of blood-activating and stasis-resolving formulas, advancing the development of the TCM method of activating blood and resolving stasis.
We cannot judge the ancients by today's standards, but as medical learners we cannot close our eyes to these obvious errors either. The core of medical care is safety and efficacy; using imprecise TCM theory to guide clinical practice is an act that gambles with the patient's health and safety.
Contemporary TCM scholars have a responsibility to acknowledge these errors of our predecessors, to seek the true principles by which Chinese medicine achieves good effects in treating disease, to summarize the unsafe factors in TCM, to provide patients with safer, more reliable, and more precisely effective medical services, and at the same time to enlighten later learners, promote the development of Chinese medicine, and greatly enhance both its practicality and its safety.
Whether as an individual or as a nation, only by having the courage to reflect on one's own errors and shortcomings rather than striving to cover them up and argue for them can there be genuine progress. Those who labor to wrap themselves in vague, self-consistent explanations are, beneath their fragile self-esteem, covering up precisely a lack of learning and courage.
Chinese medicine is a great treasury, but this treasury is also a trash can, into which all kinds of historical rubbish have been thrown. Later learners of Chinese medicine should adopt an attitude of critical inheritance. With a spirit of independent thinking, they should value evidence and scorn empty talk, not be superstitious about authority, not worship the past, and strive to weed through the old to bring forth the new. We should seek more reasonable and scientific explanations for the clinical effects of TCM, provide more reliable evidence for later prescribers, and promote the improvement of TCM's clinical efficacy and safety.
This is both protecting patients from harm and protecting the physician's professional safety, because medical malpractice brings misfortune not only to the patient but also to the physician.
Although perfect precision medicine does not yet exist, the medical profession cannot abandon the pursuit of precision. Human life is at stake; as society develops, humanity values its own life more and more, and the demands on physicians' professional quality and skills will grow ever higher, which is entirely reasonable. Vague, poorly safe medical methods are bound to lose the trust of patients. If TCM does not face up to its own shortcomings and keep pace with the development of the times, it is entirely reasonable that it should be eliminated by society, and there is no reason to complain.