Why Is It So Hard to Study Chinese Medicine by Western-Medicine Methods?
In the 1950s, some Western-trained physicians began to study Chinese medicine systematically under teachers. In the early 1960s they tried to study Chinese medicine using Western-medicine means and obtained some very meaningful results — sparking the 1970s–80s wave of studying TCM by Western-medicine methods. If one also counts the modern-pharmacology study of Chinese herbs beginning in the 1930s, two or three decades of such research have gone by. Many stage results have come, and certain deeper mechanisms of TCM have been disclosed; yet many difficulties remain — chiefly that all the research is only explanatory and demonstrative. It only shows that certain TCM theories or experiences can, here and there, be explained by modern Western medicine; it has not systematically revealed new mechanisms or important new facts. As a result, the originally well-knit body of TCM theory and clinical experience has been dismembered. TCM stands stripped before the interrogation of a "heretic": whatever ideas and clinical experiences the interrogator can accept are "affirmed" as "scientific"; the rest awaits removal to the rubbish bin. Western medicine has been made the final "judge" of TCM's scientific and applied value. Plainly such research has — in motive, aim, and meaning — strayed into the wrong path. It is no surprise that some traditional practitioners reject and attack it. And yet, even research of this kind, when pushed to depth, grows ever harder to sustain on its own terms. A great pile of comment and doubt follows.
Some say Chinese medicine cannot and need not be studied with Western-medicine (or modern-science) means; it can develop independently. This is plainly the talk of holdovers from a past century, not worth a second look. Every learning has the question of progress and development; science especially has the question of constant abscheidung, of moving in step with the age. In the West some even speak of modernizing religion — should we not give TCM theory and practice a modern breath? The question is not whether to research, but why such research is so hard, and how to find the remedy. Others, not without seduction, say: "It is not that TCM theory cannot be studied, but that it is too deep — touching the deepest mysteries of life such as jing-qi-shen — and modern medical-scientific methods cannot yet penetrate them." A TCM administrator once put it this way: "Isn't it true that people have not even sorted out the nature of a single blade of grass — and they would talk of penetrating the mysteries of the human?" The line is: Western-medicine methods are not enough; wait. To shift the problem onto modern research methods is highly misleading. Modern science is indeed far from perfect at revealing life's essence, and never will be perfect. But this is not the main cause of the difficulties of TCM research; the cause is internal. Worse, many use this to peddle pseudoscience, talking up mystical methods to study Chinese medicine, to create a new science, prattling of human-cosmology and such — alienating serious scientific inquiry and denying modern research methods. In their view, the Yijing has already revealed all, transcended all, reached the eternal; one need only meditate over the Yijing and the work is done once for all. These "science-illiterates"' dream-mutterings deserve only one response: they need a "literacy class" in science basics.
So what really causes the difficulty? Many causes can be listed; the most important is the heterogeneity between TCM theory and modern scientific method (in TCM's case, mainly Western-medicine method) — and the rejection that this heterogeneity provokes.
People often hold an illusion that scientific method is just method, fit for anyone and any subject. So for a time take-it-as-given-ism in TCM research became fashionable; people waved the multi-discipline banner as if importing the sharpest scientific means and the most advanced research methods could, overnight, transform Chinese medicine into the leader of modern world medicine. It is like our enterprises: management is backward, per-capita efficiency is low — and many think that simply copying American and Japanese methods will solve the problem at the root.
But it is not so simple. Modern science's research methods and equipment are built around reductionism; reductionism and atomistic natural-view are twin siblings, well matched. A given view of nature corresponds to a given methodology and to a given set of research methods (instruments, means, etc.); from these arise a corresponding science and conceptual system. They mate. Modern Western medicine is just such a self-matching, self-consistent whole; it can be connected with and matched to Western biology, physics, chemistry, all built on reductionism. So whenever one of those disciplines throws up a new method, light adjustment lets it serve medicine. This is the common picture. The key is the consistency of guiding view (natural-view) and dominant method (methodology).
Plainly, Chinese medicine and Western medicine (and the whole of modern Western science) are heterogeneous — from natural-view and methodology down to the specific theoretical concepts. This heterogeneity limits TCM's use of Western-medicine methods. Consider Western morphology — even at the cellular and molecular levels — confronting concepts of natural philosophy such as qi and qihua (qi-transformation): how much can it accomplish? Morphology is fit for well-defined entity concepts and can observe, record, and analyze concrete structural features; but how can it cleanly observe concepts as broad as qi and qihua, which bind together many specific experiences and facts? Functional-study methods are much the same: they can study specific, particular phenomena, but cannot mount a full study of broad, fact-bundling concepts like yin, yang, kidney-yin, kidney-yang — at most they can disclose the mechanism of some of the phenomena gathered under such terms, and even that disclosure comes at the cost of leaving out the other contents of those terms. So we see Western-medicine studies of TCM's qi yielding more than twenty different hypotheses, each based on a partial subset of facts, none on all. It is hard for anyone to fully accept that such results capture the main outline of what TCM theory originally contained.
In recent years, as China opens up and moves toward the world, people often speak of connecting tracks with the world. In truth, scientific culture also has a track-connecting problem — not abandoning the tradition and national character outright, but absorbing all that is genuinely advanced, scientific, and bearing the freshest spirit of the age. Chinese medicine, striding into the world, faces a track-connecting problem with the world's scientific system, to stand the better in the forest of medical science. But before connecting, Chinese medicine must first prepare its own track-supporting work. That preparation touches many aspects of the discipline. Reorganizing and rebuilding the TCM theoretical system is perhaps the most important link. Rich and reasonable as the system is, it is also old, with much out of step with the spirit of the age. The responsible attitude to traditional culture is to cast off what has fallen behind, and to bring forth fully and elevate the reasonable kernel — to dig up and uphold the scientific essence. The pressing task is therefore a major adjustment to TCM itself, especially its theoretical system, just as introducing advanced Western management requires first sorting out relationships, making many-sided adjustments and adaptations, and modifying for Chinese conditions before rollout. Adjusting TCM theory involves many specific links and steps: a top-down analytic decomposition; distinguishing levels and treating them differently; for the important theoretical concepts, combining with confirmed facts to give as clear an analysis as possible, identifying what each refers to; on that base, where appropriate, using modern scientific method to elucidate, and rebuilding the theory as the results require (for details see Part Five of my edited volume Difference, Perplexity, and Choice). This is a great and far-reaching project. I believe it will bear fine fruit, and every step of progress will, in turn, help the rebuilding of Chinese cultural tradition.
Excerpted from Decoding Chinese Medicine