*A Plain Discussion of Chinese-Western Cooperation* — Continued
School of Chinese Medicine, Hong Kong Baptist University · Li Zhizhong
Abstract
Under the banner of "Chinese-Western integration," our country's TCM scholarship and enterprise have grown ever more westernized. To reflect from the academic angle is now necessary. The use of language-violence to criticize a view in academic discussion violates the principles of academic freedom and contention. When Chinese-Western integration was first raised, the field's prominent double academic standard problem was already there: we stress preserve TCM's character while letting Western concepts and methods steer TCM research and development. Behind the double standard, the only real standard acknowledged is Western. So TCM's own inheritance and development have stayed for decades under contradiction and conflict. The first academic question — whether the medical system today is two or one — has not been deeply researched. So what is Chinese-Western integration? remains undefined. That is the root of its many sayings, each going its own way. Spending decades to create an integrated medicine without scientific theoretical support — history and fact already show — is a rare blindness in the history of human science. To bring TCM and integration out of bewilderment, we must break the shackles of the TCM field itself, the cultural environment, and self-notions. This needs courage, truth-seeking, and wisdom. On Chinese medicine and Western medicine are two wholly different medical-science systems, doing well at Chinese-Western cooperation is the only correct choice. Its principle and goal: with each medicine's science as base, strengthen workers' unity and cooperation, advance their treatment-techniques (and experience-strengths) in organic cooperation — to lift the clinical efficacy of disease-prevention and treatment as far as possible. This is the basic form of cooperation for the foreseeable future under coexistence.
Section headings
Preface · 1. Academic discussion must not be language-violence · 2. The double-academic-standard problem in TCM · 3. Renewed discussion of definitions · 4. Break the shackles, revive Chinese medicine · 5. Only with Chinese-Western equally weighted can there be Chinese-Western cooperation
Preface
Yang Jian-Mou, professor of theoretical TCM physiology at Beijing University of Chinese Medicine, recently sent me Chen Shikui's "Also on Chinese-Western Integration — Refuting Several Errors of Li Zhizhong" (China TCM News, June 17, 2004). The article's substance and style call for response. To meet the field's just need for honest, deep reflection on Chinese-Western integration and on TCM scholarship, and to keep my views before the field, I write A Plain Discussion of Chinese-Western Cooperation, Continued.
1. Academic discussion must not be language-violence
Academic discussion calls for thought democracy, academic freedom, hundred flowers blooming, hundred schools contending. Difference is normal. Chen Shikui's piece, however, breaks discussion-rules and falls to language-violence. Examples: he calls my views errors, falsehoods, paranoia; the article's tone is dismissive rather than substantively engaged; key counter-arguments simply ridicule rather than answer. This big-character-poster style is the bequest of the 1950s–70s political movements and has no place in scholarship. To call others wrong without addressing the substance is to give up the right to claim scientific.
2. The double-academic-standard problem in TCM
When integration was proposed, TCM in our country already labored under a double academic standard: on the surface, recognize TCM as science; in practice, run its research, education, and development by Western concepts and methods. The double standard means: nominally Chinese-Western equally weighted; actually Chinese subordinate to Western. The standards by which TCM's scholarship is judged are Western standards. So even in integration, the playing field is tilted. As a result, decades of modernizing TCM have westernized TCM, not lifted it.
For example: a TCM diagnostician's pulse-and-tongue knowledge is judged against Western specificity testing; a TCM therapy is proven by Western statistics; TCM education's Foundational Theory has been thinned and Western foundational medicine has filled the gap. Each of these is double standard in form, Western in substance.
The double standard also gives professional shelter to those who pretend to do integration: at the level of theoretical scholarship one says integrate, but in practice one is doing only Western medicine with a TCM label. The label collects subsidy and protects status; the actual work serves a Western model. The TCM field has paid for this with decades.
If we want TCM to advance, we must acknowledge the double standard openly and end it. Cooperation under the principle two-systems-one-goal is honest — integration under one standard masquerading as two is dishonest.
3. Renewed discussion of definitions
In my last piece I gave my definition of Chinese-Western integration: the practical process in which Chinese and Western workers cooperate, and the two medicines coordinate, aimed at lifting clinical efficacy. Mr. Chen Shikui disputes this and offers his own. I look at his with care:
Chen: "Chinese-Western integration is the discipline that, on the basis of Chinese-medical and Western-medical knowledge, integrates the two by modern science-and-technology methods, creating a new medicine surpassing both."
This is a circular definition — integrated medicine is integrated medicine. By the rules of definition, the definiens must not contain the definiendum — directly or indirectly. Integrates the two by modern methods is just renaming integrates the two. And: modern science-and-technology methods, in the contemporary usage of TCM, refer in fact to Western methods. So the definition is just Western methods make integration.
A genuine definition would (i) identify research object, (ii) identify research method, (iii) identify concept-system. Integrated medicine has none of these clearly defined. What it researches: TCM and Western medicine — both already mature sciences. What method: Western methods. What concept-system: not yet built; being created for fifty years and still not built.
The harder problem is the deeper one: can two incommensurable medical systems be united into one at the scientific level? My answer, given in On the Incommensurability of TCM and Western Medicine, is not foreseeably. Mr. Chen does not answer this question; he glosses over it.
Let me add a further reflection. Plain materialism and spontaneous dialectics — bestowed on TCM yin-yang and five-phase by Yang Zemin in the 1930s — gave us a sheltered seat under dialectical materialism. But the sheltered seat became a small cage. The richer truth — that yin-yang and five-phase carry early systems-theory content not reducible to dialectical-materialist formula — has been hidden by the cage.
Likewise integration gave TCM a sheltered seat under the science of Western methods — and that sheltered seat too has become a cage. To break out we must recover TCM's own paradigm.
4. Break the shackles, revive Chinese medicine
Three shackles to break.
(1) Inner shackle — TCM workers' own loss of confidence. Many TCM workers, after decades of westernization, have lost trust in TCM's own theoretical ground. They cannot answer the basic question what is TCM, on its own terms? without translating it into Western terms. Without that confidence, TCM cannot revive.
(2) Environmental shackle — culture and institution. Funding, promotion, hospital structure, professional ranks — all are built on Western terms. TCM workers face a daily incentive to act Western. Breaking this requires institutional reform that values TCM on its own terms.
(3) Self-notion shackle — modern scientism. The belief that modern physics-chemistry is the supreme criterion of all science must be rejected. Modern scientism is itself a partial view, even within Western philosophy of science.
Breaking these calls for courage, truth-seeking, and wisdom. Courage to acknowledge decades of misdirection; truth-seeking to face the gap between what we say and what we do; wisdom to find the road that lifts TCM without erasing it.
The revival of Chinese medicine is not a closed-door retreat to the past. It is the rebuilding of TCM's own scientific framework — on its own theoretical ground, drawing on contemporary systems-science and the philosophy of science where useful — without surrendering its identity.
5. Only with Chinese-Western equally weighted can there be Chinese-Western cooperation
The State has set Chinese-Western equally weighted as the new-period health-work principle. Equally weighted implies two systems on equal scientific footing. Cooperation — not integration — fits the principle. Cooperation says:
1. Two systems, one goal.
2. Each develops independently in scholarship.
3. Each cooperates with the other in clinic.
This is the basic form of cooperation under coexistence for the foreseeable future.
The first task is to acknowledge clearly: Chinese medicine and Western medicine are two wholly different medical-science systems. Once this is settled, the rest follows. Workers from both sides can cooperate on shared cases; each system can lift its own scholarship; clinical results will rise. Insistence on merging into one without honest scientific grounding has produced only confusion. Cooperation will produce results.
Conclusion
Twenty years ago I read Ye Tianshi's deathbed words to his son: "Medicine may be done and may not be done. Without keen wit, without ten-thousand-book reading, none may by craft save the world. Otherwise, few are not killers — medicine becomes blade." In writing this Continued, I bear that line in mind. I write not to fight; I write to ask the field to look honestly at where we are, and to choose the road of plain cooperation over the long-failed road of forced integration.
For the next long span — under coexistence — Chinese-Western cooperation is the only correct choice. Let us walk it together.
August 11, 2004
(Source text continues in the original on cuiyueli.com.)