The Self-Treatment of Contemporary Chinese Medicine
School of Chinese Medicine, Hong Kong Baptist University · Li Zhizhong
The latter half of the 19th century and the 20th century were a period of great change in Chinese politics, economy, culture, and science. Chinese medicine — the jewel of traditional Chinese culture and science — went through, with all this, a hard course of being shaken into bewilderment and struggling for survival inside that bewilderment. This course is conventionally called the hundred-year bewilderment. For nearly half a century, Chinese medicine's international reputation has steadily risen, and the State has invested largely in treatment, teaching, and research — yet the overall academic level of TCM has trended toward "westernization" and "regression." This mismatch of motive and effect deserves serious reflection.
1. The loss of national cultural-psychological support is the era-character of the hundred-year bewilderment
After the 1840 Opium War, currents of reform and self-strengthening rose in China — but so too did self-blame and self-doubt. More than half a century later, the May Fourth Movement invited in the West's Mr. Democracy and Mr. Science but also brought a wave of total anti-tradition and smash the Confucius house. Today nearly all developed countries climb up on the basis of their own fine cultural traditions. But in modern China, no harmonious environment of plural cultural co-flourishing was built. In the cultural and scientific encounter of tradition with modernity, native with foreign, the childish disease of either-or and the bad-root habit of digging one's own ancestral graves are not yet fully cleared. In the 1960s, while other countries and regions were moving from the industrial-revolution stage into the new-technology-revolution stage, China was unprecedentedly making revolution against culture itself. A nation without cultural-psychological support is a sad nation. To pin our modern poverty, backwardness, and humiliation on economy, history, and ancestors is itself a derangement of lost cultural-psychological support. Under such conditions, the survival crisis of Chinese medicine was nearly unavoidable.
2. The distortion of traditional epistemology and methodology is a chief cause of Chinese medicine's bewilderment
Chinese medicine, formed in Spring-and-Autumn–Qin-Han, took the culture-and-science of that age as its soil and the epistemology and methodology of that age as its foundation. In that period China — along with several other ancient civilizations East and West — built the first peak of human culture; China was at the center of Eastern culture. But over the past hundred years, the Yijing, Laozi, and many immortal thoughts and theories of Confucian culture were now declared "objective idealism" and now "subjective idealism" — uniformly relegated to be cast off. By contrast, Indians have not forgotten the Buddha; Westerners have not cooled to the three sages of ancient Greece. Only in the Chinese heart do the hundred schools live as ghost-husks. The yin-yang and five-phase doctrine — the methodological source of Chinese medicine — was the fish in the pond hit by the moat-fire; long labeled backward, feudal, idealist. By the saving grace of Chinese medicine's undeniable millennial clinical efficacy, yin-yang and five-phase received the bare reprieve of plain materialism and spontaneous dialectical thought. Yet plain and spontaneous already disparage their philosophical value. And the doctrine in fact contains rich content from systems-science, fuzzy mathematics, and other modern methodologies — not only philosophy.
In the latter 20th century, even many self-styled dialectical-materialists in China ignorantly distorted the category matter itself. Mao Zedong complained: those in China who truly understand Marxism-Leninism are few. By Lenin's gloss, matter is "a philosophical category designating that objective reality given to man by his sensations, that is copied, photographed, reflected by our sensations, but exists independently of them" (Lenin, Selected Works vol. 2, People's Publishing House 1972, p. 128). This objective reality is in essence the all-that-is of Aristotle, the being of Laozi's being-and-non-being beget each other, and the five aggregates of the Buddha's "form, feeling, perception, volition, consciousness." All point to similar categories of matter's fundamental property objective reality. But in modern philosophy, the category of matter has been replaced by structural and morphological meanings drawn from physics and chemistry. Feeling, perception, volition, consciousness are excluded; Aristotle's and Laozi's all-that-is and being are heavily castrated. The wave reached Chinese medicine's yin-yang and five-phase too — relegated to be cast off. And even the body's whole-level response state — that is, the zheng (pattern) obtained by Chinese medicine through inspection, listening, asking, palpation, which is Chinese medicine's research object — has been stripped of objective reality under the supreme standard of physics and chemistry. For a hundred years the TCM field has anxiously chased — or doggedly sought — a physical-chemical material basis for Chinese medicine.
We know that research object and research method are the root elements that form and sustain a discipline. With the scientific value of yin-yang, five-phase, and zheng distorted, Chinese medicine fell wholly into wind-and-rain.
3. Chinese medicine's decline through "westernization" is the main face of the hundred-year bewilderment
The research object of both Chinese and Western medicine is the human being — but the human is the spirit of the ten thousand things. Spirit of the ten thousand things means his complexity is the greatest of all things; metaphysicians named Heaven, Earth, and Human the Three Powers and held Heaven and the human as one and Heaven and the human in correspondence — meaning the many properties of the ten thousand things must show themselves in the human. So from the standpoint of research object, Chinese and Western medicine each research only some of the properties of the human-as-thing. On the human there remain many unstudied blanks and many misperceptions. Because the two medicines chose different research objects and methods, two systems of medicine with very different concepts and categories formed. From the standpoint of the development of human medicine, future medicine should widen research on the human further — gain a fuller and more comprehensive knowledge — and not narrow-sightedly use today's Western medicine to explain and reshape Chinese medicine, turning existing medical science into a one-sided, one-school doctrine.
In modern China where two medicines coexist, another obstacle to fair, accurate understanding of Chinese medicine is the resistance of the known to the unknown. The known here is the modern math, physics, chemistry and the analytic methodology built on them; the resistance is the obstinate psychology that, drawing on familiar physical-class scientific notions, refuses the unfamiliar metaphysical-class science. The facts repeatedly show: once a person has first studied Western physiology and anatomy, the known will obstinately, unconsciously, use Western morphological and histological terms to interpret, modify, and reject TCM's zàng-xiàng, meridian, etiology, and pathogenesis theories. This is a common-sense problem of human cognitive science — overlooked today.
So under loss of cultural-psychological support and impoverishment of traditional epistemology and methodology, TCM-westernization has become almost a hundred-year tide-bias toward Chinese medicine. This tide-bias, interwoven with absolute administrative authority, is like the tight-band spell on the head of Chinese medicine — putting Chinese medicine firmly in the position of being slighted, excluded, and interpreted-and-reshaped. TCM's just-beginning enterprise in Hong Kong is not exempt either.
4. Empty academic atmosphere, restless academic heart — deepening the bewilderment further
Under wave after wave of tide-bias, the TCM field has grown empty in academic atmosphere and restless in academic heart. On one hand, bound books unread; rambling talk without root — endurance for serious study is thin; appetite for publication is keen. Compared with each historical period, the quantity of books published today fills oxcarts to overflowing, while works of fresh independent insight are too few. Most series are full of copying-from-copies; in repeat-copying, errors abound, even to unrecognizability. On the other hand, raise a doctrine at dawn and call it orthodoxy by evening. A line from a "big figure" or a new theory from another field can call up a swarm of warm enthusiasm and be enshrined as canon overnight — chased, used to gloss Chinese medicine, all called innovation.
It should be said: inner-traditional historical evolution is the gradual road to maturity and refinement of any discipline. As external cultural-scientific and linguistic environments change, the lexical refinement of conceptual content — without losing inherent meaning — is the theoretical task of each science in its self-evolution. And in real scientific sense, self-theory-evolution is always — and only ever — the rigorous and holy mental creation of a very small elite within a discipline; not the work of willful planting or mass campaign. Yet in nearly half a century, the categorical core concepts — TCM, Chinese pharmacy, zheng, biàn zhèng lùn zhì, Chinese-Western integration, and so on — have received no field-consensus, scientifically-grounded definition or explanation from the TCM field. And TCM modernization, TCM pharmacy modernization, clinical diagnostic standards, integrated medicine have, in full swing, been mobilized, promoted, and implemented for ten, even decades. This habit of putting cause before root in mass-campaign form runs on the same gene as the Great Leap Forward: strong drive without clear situation; many ideas without sound count. On disciplinary theory, when concept and category lack definition, the discipline's self-completion starting line cannot be set. Even technical research that proceeds on top will thus lack scientific grounds. Half a century of history has proved: lacking a sound starting line, the various efforts of TCM modernization, Chinese-pharmacy modernization, TCM clinical diagnostic standards, integrated medicine are the very fountain of TCM's traditional westernization and regression.
Tide is sometimes like plague. It arises in low rationality or low cultural-scientific grounding — a blind crowd phenomenon, yet often unstoppable in its surge, even drowning reason. Today, when we discuss the return or revival of Chinese culture, this historical lesson should be engraved on the heart.
For the survival and development of Chinese medicine, two things are crucial at present:
First: firmly establish the social consciousness of plural and co-flourishing culture and science, and stop TCM westernization as soon as possible. Over two thousand years ago, Xunzi — facing the mutual reproaches between Ru and Mo — clearly proposed harmony with difference, hoping for the objective stance among different disciplines: speak with the heart of humaneness; listen with the heart of learning; argue with the heart of fairness; honestly excavate mutual difference and work for co-flourishing. For TCM and Western workers today, Xunzi's hope still has unfading meaning. Now: the Constitution's develop modern medicine and our country's traditional medicine, the national health principle Chinese and Western equally weighted — these should become the principle of co-existence both sides actually keep, working to build the plural-harmony atmosphere Fei Xiaotong called each beautiful in its own beauty, beautiful in the beauty of the other, beautiful-with-beautiful in one — the great unity under heaven.
Second: begin from righting the root and clearing the source and bend all effort to halt TCM's regression. The patient most fears his physician misdiagnosing; medicine most fears the doctor himself falling ill. To stop TCM's westernization and regression, we must first self-treat Chinese medicine — root-right and source-clear it; bring TCM out of the westernization wilderness; right the inverted cultural beliefs and scientific notions; right the disordered academic categories and concepts; restore TCM's vigor and vitality.
I have summed up TCM's current state in one line: on the verge of extinction and on the eve of a new breakthrough. The two-horn-of-the-dilemma of TCM's rise-or-fall stands cruelly before contemporary Chinese people. I hold: TCM's self-treatment is our only, wise choice now. Because TCM's successful self-treatment means a new breakthrough — a true revival.
(This was a December 17–20, 2002 address at the 21st-Century World Forum on Chinese Culture held in Hong Kong, themed Cultural Awareness and Social Development. Written at Hong Kong Baptist University.)