The Tao of Chinese Medicine

[somtingwong]

Kevin said:

 

I actually came into it through anthropology, then I started a Chinese medicine school so I could study it.

 

Chinese medicine is based almost entirely on empirical observation, so it depends on what you mean by science. In bio-medicine there is a bias that says if it isn't based on a double-blind experiment it isn't science. However, empirical observation is also science as we can see by such things as the study of plate tectonics and cosmology. There is the impression on the outside of Chinese medicine that it involves a lot of magical beliefs, however, you will find that modern people are actually much more fantastical in their thinking about the world that the ancient Chinese were when it comes to health. Chinese medicine is based on very pragmatic observations of pathological changes in many body systems.

 

Even though the language may be colourful doesn't mean the thinking is vague. Take "heart fire" for example, the classic Chinese were not stupid, they were not talking about literal fire in the heart. Instead they used the imagery of fire to convey the circumstances of a series of inflammatory processes in the body that centred on heart function and showed in a series of interrelated symptoms that form a recognizable syndrome (red tip of the tongue, increased cognitive agitation, insomnia, frequent and relatively rapid speech, increased heart rate, palpitations, and so on).

 

This is the pattern of diagnosis in Chinese medicine and the treatments are based on the same kind of observation. Acupoint and herb selection isn't based on magical formulae, its based on predictable changes based on observation. A person who argues for a more "scientific" approach may say "so (the acupoint) 内关 Neiguan may reduce symptoms of nausea, but if you can't tell me what the exact mechanism of action is its just magic thinking." In Chinese medicine we say, "how will understanding the mechanism make it better for the patient?" Its not that it wouldn't be useful to understand it, but there no reason not to use the acupoint to treat nausea before that is understood. If it were merely a placebo effect of the patient's belief in getting cured the results would not be so consistent, nor would it work on animals.

 

So to answer your question, I probably know as much biomedical pathology as your average MD, and I also know a pragmatic and highly practical medicine that has been clinically tested for over 2300 years and still stands up today. Not much faith needed.

[somtingwong]

Let's examine this statement:

 

"Even though the language may be colourful doesn't mean the thinking is vague."

 

The way the learned Chinese uses his language is indeed colorful. It's metaphorical. If we can cut through the flowery symbols and grasp the precise thinking, would traditional Chinese medicine (中醫) share the same concept of disease and model of the body as the western scientific method? Taking the pulse, for example, is measuring the number of beats per minute to the western doctor, while the Chinese doctor is detecting some underlying disharmony of the yin-yang kind.

[kevin_wallbridge]

The diseases identified and the models of the body (along with the mind!) are will never be exactly the same due to some fundamental differences. If we look at how bio-medicine has used reduction as a method of understanding the body we can see the incredible power of the approach. Identifying the individual components, whether organs, cell, hormones, biochemical processes, whatever, has enabled some stark clarity about many aspects of the body previously hidden.

 

Chinese medicine looks more at how the systems of the body, together with the mind, function and dysfunction. It is vastly weaker when it comes to understanding the individual parts, yet it is able to see interrelationships between systems that continue to elude the reductionist approach.

 

That being a said I always try to point out to students of the medicine that the ancient Chinese were not looking at a different kind of human than modern biomedical researchers. They were trying to reconcile the same symptom pictures that present to modern doctors; to understand the same etiology and pathogenesis as modern observers. This is why a modern practitioner of Chinese medicine must avail themselves of the fruits of biomedical research and learn what the structures are that are hidden under the skin. There a truth to be found in anatomy and physiology from the biomedical perspective, its just not the truth.

 

Where a profound difference lies is in the role of mental emotional aspects of the self. We in the modern world are beginning to give some lip service to idea of integrated consciousness, but to be honest our cultures and languages are dominated by mind-body dualism and most of the time we talk, think and behave as if it is a simple fact of nature. This is were biomedicine falls flat. Despite all of the truly incredible advances of medical science they cling with almost a child-like fear to the separation. There is nothing intrinsic to the methodology of double-blind experimentation, so beloved in biomedicine, that suggests it will ever be suitable for experiments that involve recognition that the mind and body are integrated. Because the experiments cannot be devised (at least without profound ethical issues) that include integration, it gets treated as if it isn't important.

 

If we use the pulse taking as an example of how different the perspectives are we can see something of the differences in style. In biomedicine do they really take the pulse? Its usually called "measuring heart-rate." The only space for it on a patient's chart read "BPM" for beats per minute, which is then compared to a statistical "normal". This is completely reductionist thinking as if the rate was the only relevant factor, and statistical norms applied to everyone. If there are any other issues (tachycardia, arrhythmia, atherosclerosis...) then it falls into the realm of a different test and a different examination to derive what other issues are present. In all this is an underlying assumption the the various aspects may or may not be related.

 

In Chinese medicine when the pulse is taken we compare the rate of the beats in usually the wrist (although throat, ankle and abdomen are also used) to the patient's own breathing rate. Then we decide if the rate is fast or slow for them. As well we are feeling for qualities that are being shown by the arteries themselves. One problem with mechanistic views of the body as used in biomedicine is that short-hand references sometimes take over consciousness. The view of the heart as a pump and the arteries as pipes dominates thinking in the modern world. This ignores the fact that arterial walls are smooth muscle and some of the most bioelectrically active tissue in the body. When the heart beats it begins as an electrical event at the base of the heart which is propagated from there throughout the whole body. You can feel the effects of each beat in the most distal places of the body and this can show a great deal of information about the state of, not just the heart and its system, but the whole body as well.

 

Its not that the ancient Chinese knew about electrical conductivity in the heart, yet they did recognize that the pulse was showing changes that accompanied disease states. They were seeing that there was consistency to these changes and some predictions about physical and emotional states could be made from these changes.

Edited July 28, 2013 by kevin_wallbridge