Where Is the Hope of Chinese Medicine? (2) — The Hints of Diagnosis
Where Is the Hope of Chinese Medicine? (2) — The Hints of Diagnosis
Even many people who believe in Chinese medicine treat "Western diagnosis, Chinese treatment" as the sensible arrangement, as if TCM's look-listen-ask-feel were not scientific enough — without the direct imaging, without the exact data, without the authoritative report… In response, I once asked my audience at a lecture: what instrument can detect whether a person is angry? (Anger is no small matter; it causes all sorts of illnesses.)
And yet the simplest Chinese-medicine diagnosis can accomplish what the most cutting-edge modern technology cannot.
Because human feeling is real, sensitive, and accurate, Chinese-medicine diagnosis takes the patient's feeling as its basis. What the physician picks up is the whole signal — spirit through body — of the patient; strictly speaking, the signal of life itself. The signal is then combined with the motion of heaven and earth and nature, and from this the cause and mechanism of the illness are grasped under the categories yin/yang, cold/heat, exterior/interior, deficiency/excess.
When TCM diagnosis also pays attention to blood pressure, blood sugar, blood lipids, blood oxygen, uric acid, urine protein, hormone levels, and so on, there are in fact two utterly different paths.
1. Abandon Chinese-medicine diagnosis
That is: write Chinese medicine directly against the lab numbers, turn the medicine's mechanism from "correcting imbalance" to "treating disease" (which is in truth the Western model of treating indicators). This is exactly what Old Gan — Gan Zuwang, the TCM ENT specialist who passed at 106 the year before last — criticized: "These people are not Chinese-medicine doctors; they are doctors who prescribe Chinese herbs."
2. Keep Chinese-medical reasoning as foundation
Use the lab numbers for reference, and in abundant clinical practice work those numbers into TCM reasoning. This will not bring Chinese medicine a qualitative leap, but it does give TCM diagnosis the backing of numbers and images — adds visibility and comparability.
Look, listen, ask, feel
However useful the lab numbers may be, I do not agree with rewriting "look, listen, ask, feel" as "look, listen, ask, feel, examine."
Putting "examine" on the same level as the classical four is a shaking of Chinese medicine's root principles; it will inevitably haul Chinese medicine into the pit of Westernization. Laboratory examination is only an auxiliary method. Chinese medicine was doing cadaver dissection more than two thousand years ago; we had early understanding of human anatomy. Why did we then give it up? Because under TCM's core reasoning, the anatomical form of the organ is only a reference.
A classic example: Pingxintang once received a patient with massive vaginal bleeding. Through look/listen/ask/feel, Professor Fan Zhenglun diagnosed it as an ectopic pregnancy. She was sent to the municipal obstetrics hospital — on examination, "intra-abdominal tumor." She was transferred to Beijing Hospital — examined again, still "tumor." Surgery began; when they opened her up, it was an ectopic pregnancy, and the so-called "tumor" was nothing but a blood clot. Two top-tier hospitals, with the sharpest instruments and deepest learning, did not match three fingers on a pulse. This was not a fluke; it was the difference between two medicines.
The absence of an integrated, holistic, systemic grasp of life is the fatal weakness of Western medicine.
The defects of Western diagnostic examination
Western scholars themselves noticed long ago that their diagnostic examination is partial, isolated, and static.
In the 1950s, an American researcher held that a drop of blood carried full holographic information. Over several decades he collected the blood images of more than 500,000 people and worked out drop-of-blood super-microscopic detection correlated with patterns of a hundred diseases. Qualitative rather than quantitative, fuzzy rather than precise, holistic rather than fragmented — his method approached Chinese medicine. But without the backing of TCM reasoning, it could not break free of the Western medical frame; it lacked clinical usefulness; neither Chinese nor Western medicine took interest; and within a few years it was gone.
Over the last century, however proliferating the new Western diagnostic techniques, they are in the habit of oversimplifying life — staying at a Newtonian-physics-and-chemistry level. Essentially, not much has changed.
Dressed in modern technology, Western medicine has not fundamentally improved its understanding of life or its control of disease; surgeries are only more precise, dosages more exact, replacement materials prettier. Even the clear-eyed among Western doctors, who now borrow from Chinese medicine's way of knowing and investigate non-singular functions of each organ, have only grasped a few surface details. They are still at odds with post-modern science's thinking. They disregard the mystery of life, cannot accept the fuzzy, the variable, the empty, and do not need a giant-system support of complexity science.
Chinese medicine, by contrast, is closer to the source of life; it resonates with post-modern science at every turn; here it has a natural advantage.
Chinese medicine will draw on post-modern technology — large data, cloud computing — to reorganize the ancient literature and practice (Dajia Zhongyi is already doing so); it will use artificial intelligence and advanced algorithms to collect and analyze tongue coating, facial color, pulse, and so on (Hexinkang's tongue-image detection and analysis system is already in trials).
If this happens, TCM's "treat before it becomes illness" no longer relies only on a dwindling handful of senior experts. It will have high-tech eyes that notice the finest detail and span past and present, attending to the changes in life itself, breaking the riddle of the heaven-human relation. People will move from the cult of the lab number to a whole-life attention; from valuing the visible and measurable "physical" to understanding the heaven-earth-human "meta-physical"; and Chinese medicine will stand up where it is and leap ahead — an overtaking in substance — to become the medicine of the future.
Chinese medicine really has no reason not to believe in itself. What makes us good is not a small thing — it is everything, every dimension. What we lack is self-confidence, and the courage to recast Chinese medicine's soul. So long as self-confidence is there, hope is there.