Several Comments on the Phoenix TV "Yi Hu Yi Xi Tan" TCM Episode
By Zhang Xiaotong, Director, Beijing Cui Yueli Center for Traditional Medicine
Watching the Yi Hu Yi Xi Tan segment on Phoenix TV about Chinese medicine was a real disappointment. Watching and thinking, I have gathered these main points.
1. On Chinese Medicines
Chinese medicine has always held that every herb has three parts poison. Shennong's tasting of the hundred herbs is described as "in one day meeting seventy poisons and returning." Chinese medicine teaches: "With great-strong medicines treat illness, take six in ten and stop; with ordinary-strong, take seven in ten; with small-strong, eight in ten; with non-strong, nine in ten; then grain, meat, fruit, and vegetables — let food's nurture finish the work; do not exceed, lest the right qi be injured." That is to say: in using Chinese medicines, one uses the "poison" rightly. To dismiss Chinese medicine on the basis of aristolochic acid is to take the wrong as right and the part as the whole — wholly mistaken.
There are three principles in TCM medicinal use:
**1. You-gu-wu-yun — given the illness, use the medicine.** Use the herb's natural leaning to correct the patient's leaning: cold to warm the cold, hot to cool the hot. Leaning is what TCM calls poison: used well, it is medicine; used badly, it becomes poison. If a person has inner heat, ginseng is poison; if a person has a cold pattern, rhubarb is poison. After a full meal, three more steamed buns can kill — the bun, too, is poison. This is the TCM concept of poison, wholly unlike the Western-medical doctrine of ingredient toxicity.
**2. Junchen Zuoshi — the prescription as ruler, minister, aide, courier.** This stresses combination. One important purpose is precisely to counter and check toxicity. To use medicines on one's own without the doctor's prescription, and be poisoned, is inevitable. Many obvious truths need not be marked: too much sugar causes cavities, yet sugar carries no "not for children" label; too much wine causes cirrhosis, yet wine carries no "not for adults" label. Even so-called over-the-counter Chinese medicines call for basic TCM knowledge in their use. Worth noting: in today's climate of weakening basic TCM literacy, marketing Chinese medicines as OTC is a mistake. Many Western-trained doctors with no TCM grounding prescribe Chinese medicines wildly — that is even less acceptable.
**3. Zhongbing Ji Zhi — stop the moment the illness yields.** Even with non-poisonous medicines, one uses only to nine-tenths and does not take them long. Whatever discomfort remains is handled by dietary regulation. To use Long Dan Xie Gan to lose weight, and not end up sickened by it, would be a miracle. From this one can also see that TCM medicinal use is exacting, prudent, and indeed scientific.
Chinese medicines must be used under the guidance of a Chinese-medicine doctor; if you have no TCM, do not use Chinese medicines, or you will surely taste the bitter fruit of abolishing the medicine but keeping its herbs. After the Meiji Restoration's wiping-out of kanpō in Japan, this is the path Japan took; a few years ago the use of Xiao Chai Hu Tang for hepatitis ended in six deaths — clear proof of bearing one's own bitter harvest.
2. On Science
The science of Western medicine works chiefly by analysis: it divides the body into systems, organs, cells, cytoplasm, nuclei, all the way down to quasi-molecules, molecules… This kind of science has let Western medicine become ever finer in its knowledge of anatomy, pathology, and bacteria-and-viruses.
The science of Chinese medicine is utterly different. Its theoretical basis is to regulate the whole person (the mutual movement of liver, heart, spleen, lung, kidney), to regulate the relations between the person and the great Nature (wind, cold, summer-heat, damp, dryness), and to regulate the relations between the person and human society (joy, anger, worry, thought, grief, fear, fright). By regulating the balance of these three ceaselessly moving great circles, it brings the body's whole running into harmony.
So Western medicine is treating the illness; Chinese medicine is treating the person. Both are science — but science of wholly different systems. One cannot use Western-medical science to deny Chinese-medical science, any more than basketball rules can govern the football pitch. Use the aesthetic standards of blond hair and blue eyes to judge yellow skin and black eyes, and we all become ugly.
Chinese medicine is complex science. Professor Zhu Qingshi of the Chinese Academy of Sciences has written at length about this — TCM is exactly the theoretical ground of post-modern science. The scientific theory of Chinese medicine is in fact walking at the very front of the times. The senior elder Qian Xuesen also said as much: "The direction of medicine is Chinese medicine, not Western; Western medicine too must come around to the Chinese-medical road." "Chinese medicine may bring about a medical revolution; and a medical revolution may bring about a revolution across all science."
3. On Outcome Evaluation
The group is made of individuals; without the individual, what group is there? Human life is complex; one person's sex, height, weight, occupation, and history differ from another's. To examine individual difference closely, treat differently, and prescribe accordingly — this is exactly where TCM excels Western medicine.
If we must speak of the group: are not Chinese medicine's millennia and billions of clinical cases more scientific than a few hundred subjects over a few months or at most a few years of so-called controlled trial? Practice is the sole criterion of truth; that is beyond doubt. To use the medical truths one has grasped to serve human beings is the most humane course. Otherwise, to use on people only what has been proved non-poisonous on rats — that may be the least humane course of all.
We must acknowledge that today TCM's clinical efficacy has dropped sharply; a real, traditional Chinese doctor is hard to come by; the lack of successors is plain. TCM is facing at least a thirty-year generational break. Today's Chinese medicine has indeed walked a Western-influenced one-way road. This is the bitter fruit of a hundred years of TCM Westernization, the result of our country's Westernizing policies in TCM treatment, education, research, and pharmacy. Even if we could fully reverse course (next to impossible), the revival of Chinese medicine would still need thirty or fifty years. Done badly, it is extinction. This is the tragedy of TCM — TCM destroying itself, digging its own pit, and waiting for someone to give the gentle push. We cannot blame anyone else; we can blame only our own failure to live up to ourselves, our failure to keep our own distinctive ground. We learned the Handan walk, our knees went soft. Empty talk of "an excellent situation" is only fooling ourselves.
4. On Opposing "Pseudo-Science"
Chinese and Western medicine each have their strengths; so long as each serves humankind with its strengths, both are blessings. To say it more plainly: since Western medicine landed in China in 1835, by incomplete estimate, over seven thousand medicines have been used. Only a few hundred are still in clinical use today. The vast majority have been withdrawn for adverse effects, a process which continues. One might call this a scientific attitude — but where was that scientific attitude when those medicines were first being given to human beings?
Western medicines have done no little harm. If memory serves, the "science" of Western drugs is a long list: thalidomide for morning sickness causing deformities; tetracycline causing the tetracycline tooth; streptomycin causing deafness (the lead dancer of Thousand-Hand Guanyin was deafened this way); Viagra causing fatal heart attacks; Contac (PPA) causing leukemia; Fenbid causing kidney damage; the steroid drugs used to treat SARS causing femoral-head necrosis… Lately there are many cases of young-age leukemia, and we do not yet know what drug to blame.
Animal trials, acute-and-chronic toxicity testing, Phase I and Phase II double-blinded clinicals — how "scientifically" we manufacture how "scientific" drugs! Probably behind some "science" there is money at work. In the United States, where Western medicine dominates, iatrogenic-and-pharmacogenic disease has become the third leading cause of death — yet they still attack the thousands of Chinese herbs that have stood the test of millennia. This kind of "science" is rather overbearing. To wave the flag of science while opposing science — that is real pseudo-science. It is heart-piercing, and hair-raising.
As descendants of Yan and Huang, the revival of Chinese medicine is a duty we cannot duck. Long enough has TCM gone unable to walk its own road, breathing on others' faces. The recent online petition by tens of thousands to denounce Chinese medicine is no accident. It is both the continuation of a century-old current bent on wiping out TCM, and a true reflection of the present — TCM Westernized, efficacy generally fallen, real TCM doctors not to be found, fine outcomes not to be felt, while frauds run wild.
I am in the middle of it, like a fish in water. The sadness of it can hardly be said in words. Let me close with a small poem:
A hundred years of wind and rain — past abrogations no longer surprise.
Mount Tai, do not start; the great rivers run all to the west.
Three disasters — Heaven would wipe us out;
Eight troubles — we have warped ourselves.
Children of the same Yan and Huang —
Why does the cooking pot boil us so urgently?