A Sustainable Road for Ethnic Medicine (Excerpts)
China's traditional medicine comprises three parts: TCM, ethnic medicine, and folk herbal medicine. Because Han culture has long been our society's dominant culture and TCM our mainstream medicine, and because TCM still holds high scholarly value, it is naturally the representative of Chinese traditional medicine. But TCM and ethnic medicine share much yet differ — TCM cannot encompass each minority's medicine. In long history and the classical-cultural sphere, ethnic medicine and TCM share identity — both traditional medicine, both legally protected under the constitutional clause develop modern medicine and our country's traditional medicine, both can be handled by a common TCM policy. But each ethnic medicine and TCM each have their own cultural background and theoretical system, their region's herbal resources and clinical techniques, their own laws and features. They are not branches of TCM; they are TCM's brothers.
Ethnic medicine names the medical works of China's minorities, outside the TCM tradition. China has 55 minorities. From the ancient to the modern, in different settings of survival and development, they passed countless birth-illness-death sufferings; they had countless medical creations and pursuits. Only part has come down. Each ethnic medicine has developed unevenly — gathered and lost in different proportions; inheritance and development at different levels. Since the late 1970s, about 30 have been fully surveyed and systematically organized. Tibetan, Mongolian, Uyghur, Dai medicines, and Zhuang, Miao, Yi, Yao, Tujia, Korean — rich in material and with significant R&D and modern application. Tibetan, Mongolian, Uyghur, Dai medicines have built medical, teaching, and research systems with state-organized professional ranks.
Take Tibetan medicine: its understanding of plateau-human physiology and pathology, its diagnosis and treatment, its use of local natural herbs — open a rarely-known scholarly field; it holds a special place in international traditional medicine. If TCM is a great treasure-house, ethnic medicine is also a great treasure-house. We must, in building socialist medical-health work with Chinese characteristics, fully know our national condition, master the medical resources existing in history and life, inherit and develop ethnic medicine. This widens and deepens our medical knowledge, is needed to flourish our medical science, and fully serves the people's health. Our right attitude toward historical tradition is always selective inheritance, not idol-worship. In our health work, ethnic medicine must have its place. In academic research, the only-I-revolutionary, only-I-scientific, only-I-orthodox mentality is very harmful.
Three issues to solve for sustainable development of ethnic medicine:
One: lead with the medicine, prevent abolish-medicine, keep-the-drug.
Two: ensure quality; do not destroy the treasure-house oneself.
Three: protect resources; do not drain the pond to catch the fish.
1. Persist in leading with the medicine
Pair medicine and pharmacy; fully value the role of ethnic-medicine theory in guidance and of folk experience in suggestion; prevent abolish-medicine, keep-the-drug.
Ethnic medicine was always medicine-and-pharmacy as one. As productive forces grow, drug production is at once guided by medicine and pulled by clinic, and ruled by economic laws — understandable. But if we one-sidedly stress Chinese-herb in Western way, ever further from the source, drugs become only plant-drugs and chemicals from plants — likely to leave most behind, abolish-medicine, keep-the-drug, finally losing the role and character of ethnic drugs. Ethnic-medicine basic theory is somewhat more complex than TCM's, even untidy; some still carry traces of shaman-doctor not separated; some lack rational lifting and systematic ordering. Generally, compounds have more theoretical backing; single-herb formulas are mostly experience. Some ethnic medicines have their own script and books, and a higher theoretical level; others, lower. So we must treat them differently: Tibetan, Mongolian, Uyghur, Dai — fully use their theoretical-system guidance; Zhuang, Miao, Yi, Yao — alongside theory, more attention to folk-use experience. A current problem: some ethnic drugs go through media and ads straight to households, with function-indication entirely in Western or TCM terms, neglecting the original medicine, neglecting ethnic-medicine doctors' use and explanation — turning multi-function ethnic drugs into narrow ones, or exaggerating a single-action drug. Inappropriate. And there is the issue of building ethnic-medicine clinical-and-research bodies and training talent — without practice and research as base, without senior ethnic-medicine specialists, theoretical guidance has nowhere to stand.
2. Raise the quality of ethnic drugs
Quality is the life of ethnic drugs, the base of long-flourishing. In the past, ethnic-drug production from raw material to process was done by old doctors and apothecaries themselves, even with a near-religious ritual — to show credit, to mark genuineness, with devout responsibility for people's health. A fine tradition.
Ethnic-drug production is now in fine shape: about 500 proprietary medicines listed in the Pharmacopoeia or ministerial standards, plus several hundred new local-standard ones — about a thousand kinds altogether. In recent years some ethnic-medicine enterprises have put effort into quality, strengthened publicity, built sales networks. Last year the China Ethnic Medicine Association held the First Ethnic-Medicine Products and Research-Results Promotion Conference, clearly proposing bring ethnic medicine down from the mountain into town, benefit humanity. Ethnic-drug reputation is growing; some big-city medical-insurance bodies now use and accept ethnic medicines — a very welcome thing.
But from what we know, since ethnic-drug production moved from workshop to modern industry, dosage form and packaging have improved a great deal, while material selection, dose, and special processes have eased — daodi (place-of-origin) and wild-grown herbs less and less, internal quality not as before. Some ads especially exaggerate effect, hurting ethnic medicine's credit. A serious concern.
3. Protect raw-material resources
Strengthen cultivation, introduction, and animal-husbandry; prevent reckless harvesting and hunting; do not drain the pond.
For drugs like winter-worm-summer-grass, snow lotus, hongjingtian, musk — long over-harvesting and -hunting have pushed some toward extinction, the species-loss crisis. Existing protection is weak. Cultivation and breeding lack support. Agricultural production of ethnic drugs and herb-procurement long in a free-flow state. The forest-musk-deer breeding base, with live-musk-extraction tech, has long had success and economic effect; but support is thin, and expansion and tech advance are hard. Endangered animals like rhinoceros horn and tiger bone, banned by international convention, are needed in clinic — research bodies are slow to respond. Some say cow-horn replaces rhino, cultivated bone replaces tiger — no need for further research. In fact substitution is not so simple; the over-simplification comes from too little knowledge of these herbs, indifference to TCM's emergency use. So research into substitutes for endangered animal-and-plant drugs should, we propose, be a major and urgent state-research-plan task for TCM and ethnic medicine.