Microscopes, Antibiotic Sensitivity Tests, and Chinese Medicine

Since starting clinical medicine, I have spent almost every week in the school lab: viewing cadavers, examining tissue sections under the microscope, dissecting experimental animals, doing antibiotic-sensitivity tests, and writing lab reports. Western laboratory results are plain and persuasive, and the "seeing is believing" spirit of Western medical education is impressive. Compared with TCM's reliance on reasoning and deduction to guide prescribing, the Western approach is plainly more scientific — and TCM should learn from it.

But this does not mean Chinese medicine lacks practical value. The long clinical experiments ancient Chinese conducted on human bodies yielded many valuable conclusions. The trouble is that many records in classical texts are unreliable, containing too much that the authors never verified in practice, which can easily mislead modern readers.

Over the past century, Chinese medical researchers have continually tried to study the actions and side effects of Chinese herbs with modern pharmacological methods, with many achievements. The most striking is Professor Tu Youyou's isolation of artemisinin from the Chinese herb Qinghao (Artemisiae Annuae Herba), a potent antimalarial for which she received the Nobel Prize in Physiology or Medicine.

Applying modern science to Chinese medicine should have been a good thing, but it provoked fierce controversy. Some argue that Chinese medicine should "abolish the medicine, keep the drugs"; others insist that studying TCM by modern scientific methods is nonsense, and that Chinese medicine should be used only under traditional theory.

I learned TCM through the traditional apprenticeship model plus self-study, starting with orthopedics and traumatology, later focusing on TCM treatment of malignancy and neurological disease. I have studied Chinese medicine for nearly twenty years and have had fairly rich apprenticeship experience; now I am receiving formal, systematic Western medical education. From my own experience, I endorse neither of the two extremes above.

I believe TCM should welcome modern research methods, but modern methods alone are not enough to unlock its full value. Modern pharmacology, animal experiments, and controlled clinical trials are expensive; it is still hard to carry out comprehensive animal and human controlled trials of Chinese herbs and formulas.

Moreover, having studied Western medicine for a while, I have come to see its own defects and limitations; we should not study TCM entirely through the Western lens. Western medicine, for its part, should be broad-minded enough to learn TCM's strengths and remedy its own shortcomings.

During my studies, many of my teachers cannot treat their own diseases — allergic and chronic conditions, for example. I was surprised to hear them describe years of suffering with no solution, because I had treated many such cases with TCM or integrated Chinese-Western methods. This may comfort some TCM students, who often tell me their teachers' clinical results are unimpressive, which leaves them discouraged.

Diseases are intrinsically hard to treat. "To cure sometimes, to relieve often, to comfort always" is the shared sentiment of medical workers. Medicine's powers are limited; after medical school, failing to cure many diseases is normal, and there is no need to be disillusioned.

Western medicine studies individual biochemical reactions and strives to treat disease with pinpoint precision; it has achieved great things and conquered many once-lethal diseases. But this approach fails in many conditions, because most diseases diagnosable today have complex causes and lack precise, effective treatments.

TCM, by contrast, emphasizes pattern differentiation and systematic prescribing — in TCM terms, the holistic view. It approaches disease through a "black box" method of reading the interior from the exterior, with systems thinking. Much in this framework is still crude, but its theoretical foundation is remarkable. Borrowing Western research results to make TCM theory more precise could produce truly breakthrough results.

Some Western basic theory is also moving toward systems thinking, but actual clinical prescribing has not yet seen a comparable breakthrough. Instead, long-used drugs have bred microbial resistance, forcing constant development of new agents.

Chinese and Western medicine each have strengths and weaknesses, and each can complement the other. Of course, even when both are practiced at a very high level, many diseases remain incurable and even hard to relieve. This is because overall human medical capability is still limited; as easy diseases are conquered, the remaining problems are the hard ones. Longer life expectancy has also shifted the spectrum of disease, demanding new medical approaches.

Some diseases of aging and degeneration should, in principle, be untreatable; we can only relieve symptoms and improve quality of life. If such diseases were curable, natural biological laws would be broken and humans would approach immortality. The dream of immortality has its seekers, but it remains distant.

Every advance in medicine is driven by extensive clinical practice. At this stage, maintaining the coexistence of the two medicines, continuously studying traditional medicine with more scientific methods, exploring the mechanisms by which it works, using its effects, elucidating its principles, and summarizing more precise and reliable evidence for prescribing — this is the pragmatic choice.