TCM2000 — New Strategic Thinking on the Century-Long Systems-Engineering of Chinese Medicine
(I) The current situation
1. Biotechnology is advancing rapidly and has scored real results in agriculture; biomedical engineering has had certain successes within the Western-medicine system; the human genome has in principle been read; the organic-chemical structure and main constituents of more than three thousand plants have been analyzed; 162 plants have been successfully bred using gene-recombination technology and can in principle be put into industrial-scale production; many other high-tech methods have entered medical care, producing a dazzling array of new diagnostic-and-treatment instruments and equipment and accelerating hospital modernization.
2. Medical-care spending in every country has been rising far faster than national-economic growth, most strikingly in the developed countries: in the United States, Western Europe, and Japan, medical-care spending has reached 17%, 16%, and 15% of GNP respectively — and is still climbing.
3. Because of the surge in costs, the two pillars holding up the medical-care system of the developed West — medical insurance and the medical-care industry — have both tipped badly. Insurance is on the brink of bankruptcy; without strong government intervention, bankruptcy would be unavoidable. The pharmaceutical industry, on the other hand, posts soaring profits. And the deeper issue is this: for all the spending, the population's medical-care level has not visibly risen. Take the United States, the most modernized of all: annual medical spending reaches US$1.4 trillion, and yet thirty-seven million Americans have no medical coverage. If even the U.S. is in this state, the rest hardly need be mentioned.
(II) Reflection
By sharp contrast with the U.S., Europe, and Japan, China — with only 1% of the world's medical spending — has served 22% of the world's population. Far from comfortable, but the work has been visible and respectable. This is the result of socialism with Chinese characteristics' long support of traditional Chinese medicine. Since reform and opening, the Party Central with Jiang Zemin at its core has cared deeply for the people's medical and health work; the medical budget has grown more than twentyfold — from an original annual allocation of 2.8 billion yuan to over 70 billion — a growth rate first in the world, far beyond China's fast-rising economic growth, giving the Chinese people an unprecedentedly favorable material basis for medical security.
If we can, from the standpoint of development strategy, earnestly and correctly mine the great treasure-house of Chinese medicine and pharmacy, clear up some confused notions on the road forward, seize this excellent historical opportunity, and value every drop of the people's hard-earned funds — then in the near future, not only will China likely be the first to realize the WHO's great goal of health for all, but we will also help free developing countries from the long anxiety of being trapped before a Western medical-security system built on heaps of money.
First we must clear up the most harmful confused notions. Chiefly:
(1) That modernizing Chinese medicine means "integration of Chinese and Western medicine." TCM and Western medicine are entirely different academic systems; they may cooperate in the clinic, but neither can serve as a tribunal to disprove or replace the other. Each system will continue its own modernization; this is not a matter of "lifting" Chinese medicine to Western medicine's level.
(2) That modernizing Chinese medicine means "aligning with international standards." Aligning the Western-medicine side of China with international standards is inevitable. The development of Chinese medicine, however, is for the world to align with China — because internationally there are as yet no rails to align with. The premise, of course, is that Chinese medicine's industrial modernization be realized and continuously improved.
(3) That modernizing means Chinese-and-Western medicine "seek common ground and shelve differences." Just the opposite: if the two are to develop in health, they must seek difference and shelve common ground; only by foregrounding each medicine's strengths can future medicine make great progress. Remake Chinese medicine to look "very much like" Western medicine, or vice versa, and both lose. To shelve Chinese medicine's strengths is to extinguish it.
(4) Carving up the system of Chinese medicine — willfully or not, freezing the medicine itself. This is the greatest obstacle to modernization. A "Chinese pharmacology" detached from Chinese medicine is in fact "plant biochemistry." If "chemical analysis and isolation of plant constituents" is the full content of "Chinese-herb modernization," then that modernization began two centuries ago — quinine from cinchona was such a feat; ephedrine from mahuang, isolated in 1921, was a bit more "modern," and that is itself eighty years old. By the way, before Western medicine adopted chemically synthesized drugs en masse two centuries ago, it too relied mostly on herbs — yet we don't call those Western herbs. Stimulated by Chinese-medicine results, the Western pharmaceutical world is now keen on plant-derived drugs — but on no account should that be confused with "Chinese-herb modernization." In a hundred years, 59 drugs have been extracted from plants; none of them is a Chinese drug.
(III) Concept
The systems-engineering of Chinese medicine and pharmacy with Chinese-socialist character is a new-type industrial complex grounded in the theory and practice of Chinese traditional medicine and built up using modern high-tech means. This complex must include four functions, organically linked and none dispensable:
(1) Scientific-research center. Chinese medicine and pharmacy, rooted in Heaven-and-the-human-as-one, has been fully validated through millennia of safeguarding the Chinese people's existence. It only fell outside modern science's field of vision in the past two hundred years for special historical reasons. As science leaves its infancy and matures, it becomes ever closer to Chinese medicine — and an important means of advancing it. Scientific research will therefore be the most vital part of the new industry.
(2) Talent-cultivation center. This new industry's talent is not ordinary. Only those who command both Chinese traditional medicine, modern science, modern Western medicine, and classical-to-modern philosophy can become its backbone — and so far no aligned higher-education system trains such people. The new industry must take this burden on. Without talent, nothing.
(3) Academic-exchange center. Two halves: domestic and international. Domestic exchange to find talent, find new research directions, find new development-points in Chinese medicine and pharmacy. The very making of Chinese medicine was the result of "open" academic exchange. Inbreeding — running an exclusive so-called "pure-TCM circle" — only dries up academic resources. So exchange that includes folk practitioners, senior multi-disciplinary researchers, social-science workers, senior Western-medicine specialists — that is the lifeline of the new industry's vitality. International exchange is the main means of opening markets; without understanding or applause, no market. Moreover, only by direct collision with strong Western medicine can strong Chinese medicine strike its finest "common-ground-and-difference" sparks. Without exchange, no steady stream of talent and no market share.
(4) Economic-development center. The new industry's economic base. Without successful development of new results, the other three functions have no ground. The center's priorities:
(A) Digest existing results first.
(B) Adopt long-line high-tech achievements prudently.
(C) Build and promote a modern standard system for Chinese medicine and pharmacy — pushing the world to align with China.
(IV) Project layout
Principles: long-and-short combined (long-line products combined with short-line products); virtual-and-actual combined (real product manufacture and marketing combined with the "virtual" work of R&D, training, and exchange); fundamental research combined with digestive development (fundamental research means basic work like standard chromatographic atlases for source materials; "digestive" development means moving research that has cleared experimental or small-batch stages into final industrial-scale production); hardware-and-software combined (hardware: products, drugs, instruments, equipment; software: invention-IP, new technology).
Layout for scientific research, talent, and academic exchange will be discussed separately. As to economic development, near- and long-term parts. Long-term, as the foundation of the enterprise, is of course of greatest strategic weight; though principled, much remains hard to detail. So this article omits the long for the short, the virtual for the real — limited to near-term directions of urgent development.
Given how many projects there are, only category names are listed.
(1) An integrated TCM diagnosis-and-prescription electronic hardware-and-software system.
(2) Non-drug TCM health-care diagnostic-and-treatment systems (popular, hospital, pocket forms).
(3) Standardization research for basic Chinese herbal raw materials (standard quality, place of origin, chemical spectrum, production craft, expert-system-validated spectra). Of China's 12,807 medicinal resources — of which 11,146 are medicinal plants — at least 400 should be studied as a near-term emergency.
(4) Modern refined raw-material products: 100 single-herb, 100 compound.
(5) Modern-process technology and equipment for Chinese-herb dosage forms (single and compound) — research and development.
(6) Non-preservative preservation technology for herbal raw material.
(7) A standard series of TCM pattern-discernment model-formulas (three major models, 150 standard formulas).
(8) High-tech biological compound products from herbal raw materials.
(9) Refining, purification, and chemical analysis of high-grade TCM mineral drugs (80 products): e.g., xionghuang (realgar), zhusha (cinnabar), arsenic, heixidan.
(10) New non-acupuncture meridian-stimulating agents; a global zi-wu liu-zhu (timing-of-channel-flow) positioning system.
(11) Meridian magnetic-field therapy with gold-silver compound magnetic discs (for 53 common conditions).
(12) High-information-density molecular-spectrum harmonizing health instruments (40 conditions; low interference, high density, low energy).
(13) Trigeminal-nerve dedicated-effect therapy device.
(14) Bioenzymatic-degradation craft: extracting 21 amino acids needed by humans from soybean dregs. Raw material: dregs left after oil extraction and tofu-making. Principle: degrade crude protein (hard to digest and absorb) into short-chain amino acids via biological agents. Key: optimizing the enzyme; preservation and purification of strains.
(15) Gene-recombination production of rare and precious Chinese drugs: 126 plant-bioreactor studies completed with this technology. Advantages: (a) high efficiency, vastly shortened production cycle; (b) controllable quality, with directed quality-control of active components via changing experimental conditions; (c) independent of natural environment, easy to scale; (d) excellent economics — renshen, American ginseng, hongjingtian and others can all use this, with cost only 1/10–1/20 of traditional cultivation.
(16) A series of diabetes-recovery products, comprising:
1. Insulin-activity diagnostic software.
2. TCM pattern-discernment prescription software.
3. Non-drug health-food pattern-discerned products.
4. Non-drug therapy instruments and devices.
5. Rational arrangement of traditional self-cultivation health practices, effectively improving the quality of life of diabetic patients.
Features: (1) Correcting the present "diabetes is incurable" view. (2) Using only the modern fruits of Chinese traditional medicine. (3) No side effects of ordinary drugs. (4) Distinctive modern-scientific experimental and theoretical basis. (5) Wide potential market. (6) Great social significance — fully embodying the TCM2000 plan's values.
The above 16 projects taken together cover more than 900 new-technology or new-product combinations; each new technology or new product has its own distinctive scientific content and economic value. We will, when needed, develop and argue each in turn.
These do not exhaust TCM2000. They provide the near-term tactical strike-points for the realization of the TCM2000 systems-engineering. The selection and arrangement of these strike-points aim at:
1. Building, in as short a time as possible, a Chinese-national industry of decisive weight that competes for the world.
2. Drawing on that economic strength to attract as many world-class talents as possible.
3. Through the gradual maturing of the scientific-research-and-industry complex, influencing the world to build a correct TCM consumption ethos.
4. Comprehensively lowering medical-care costs and lifting people's quality of life — easing developing countries' economic-development burdens.