A Third Discussion on the Success or Failure of Chinese-Western Integration in Our Country
In 1956, in his talk with musicians, Chairman Mao Zedong proposed for our medical development the conception of "combining the knowledge of Chinese medicine and herbs with that of Western medicine and drugs, to create a unified new medical science and pharmacology of China." Before this could undergo specialist discussion and full debate, our country entered the political atmosphere of "catch up with Britain, overtake America"; the conception was compressed into the conceptually unclear slogan Chinese-Western integration, which appeared in newspapers in 1958, and academic problems were politicized. Under administrative impetus, teaching, treatment, research, prevention, and media in our health field all joined the movement and put in active effort. During the Cultural Revolution, the Ministry of Health's Liu Xiangping published Chinese-Western Integration Is the Only Path of Our Medical Development, raising a new high tide of Chinese-Western integration. The two high tides cost our country enormous human, material, and financial loss, and produced not one true dialectically thought-out integration research result. On the contrary, it severely struck the TCM theoretical system and diagnostic-therapeutic skill, lowering medical quality.
Practice is the sole criterion of truth. Chinese-Western integration has been pursued in our country half a century, yet to this day no organic integration result has appeared, no unified new theory produced. It shows the incommensurability of Chinese and Western medicine; that integration is a subjective wish; that it does not fit the actual situation of TCM and Western-medicine development in our country. Even if our two medicines may possibly integrate in the future, that is decades away; forcibly bringing it to the present — seeking speed yet not reaching — gains effort without reward. Some, knowing perfectly well Chinese-Western integration has no way, still — for their own vested interest — at the cost of national interest and the medicinal culture of the nation, shout Chinese-Western integration against conscience to grab personal capital. Wholly losing the scholar's social conscience, they have sunk to despicable speculators.
In State and Revolution, Lenin says: "In converting Marxism into opportunism, eclecticism masquerading as dialectics is most easily able to deceive the masses." Some have changed Mao Zedong's dialectical conception of combining... create a unified new medical science and pharmacology of China into the eclectic, internally unconnected piecing together of "TCM content" and "Western-medicine content" — peddling a Chinese-Western piecing-together theory to deceive the masses and the leadership. The result: a TCM theoretical system in fragments; mixed and confused TCM personnel; gradual alienation of Chinese-drug theory; and a crisis of patient trust. As Lou Yulie pointed out: "In recent years, much of so-called 'Chinese-Western integration' is in fact using Western medicine to dissolve TCM..." (Guangming Daily, March 20, 2007, p.12). The TCM enterprise, behind a surface of prosperity, has lost its soul; almost only a dried-out shell remains; name without substance. Most TCM hospitals across the country are not surnamed TCM; most TCM workers are westernized; comparatively, they have aphasia — no scholarship of their own, no thought of their own, no language of their own. TCM's features of simplicity, convenience, cheapness, effectiveness are receding; the warm bond of doctor-and-patient is being severed. And Chinese-medicine plus Western-medicine — this falsified Chinese-Western integration — under market-economy conditions has won wide approval among clinical doctors, becoming one cause of expensive and hard medical care. To this some are blind, deaf, and even drag along a band of followers to speak nonsense with eyes shut: "Our country still has a Chinese-Western-integrated force and a body of integrated medical institutions, also an important force pushing the TCM enterprise." (China TCM News, October 10, 2003, Attention to Famous-Physician Training) Have they pushed the TCM enterprise forward? In which direction? Is westernization development? Inverting black and white, confusing right and wrong — shameless!
Some, knowing well that "those licensed in TCM may not practice Western medicine ... this system favors TCM clinicians' wholehearted research and lifting of TCM level" (same article), insist by nihilist worship-of-foreign psychology — looking down on their own nation's TCM culture — on using every method, administrative, economic, and ideological, to strip TCM clinicians of the right to "wholeheartedly research TCM and lift TCM level" and force them toward Western medicine, realizing their joined-but-not-integrated Chinese-Western piecing theory. TCM in clinic thus becomes pale and powerless; the TCM is lost; becomes second- or third-rate Western medicine, forever subordinate to Western medicine, crawling at its heels. This is the chief reason most TCM hospitals across the country are not surnamed TCM, most TCM workers are westernized.
It is well known: TCM and Western medicine are two wholly different theoretical systems, belonging to different cultural realms, each with its own cultural features. Western things, copied over, may not all help TCM; TCM things copied over may not all serve Western medicine. The TCM-is-backward school insists: "If a licensed physician in clinical work cannot use the most common medical equipment — thermometer, stethoscope, sphygmomanometer — nor read the most routine blood/urine/stool test data, TCM diagnostic-therapeutic level is hard to lift." By using thermometer, stethoscope, sphygmomanometer and reading test data, one lifts TCM diagnostic level? Judging TCM by Western standard, disregarding TCM's whole-view and pattern-discernment need — absurd and ignorant! All know test diagnosis serves treatment; take fever in a patient — TCM's traditional method is touch-diagnosis knowing the temperature as slight or high, different from the thermometer's 38°, 39°, 40°. Higher precision, yes, but it does not help TCM choose drugs. Which TCM drug or formula is for reducing 38°? For 39°? For 40°? None — absolutely none. TCM treats illness by the whole; thought from the whole. Simply, fever — see whether fever is simultaneous with aversion to cold, or alternating cold-and-heat coming and going; or only fever, no aversion to cold; or with headache, or without — treatment differs. This is bianzheng shizhi. Stethoscope likewise. There is no specific Chinese drug or formula for dry rales, moist rales, or gallop. To copy Western diagnostic tools into TCM and let TCM treat by Western test results will certainly not give good results — countless cases prove this. This is, under the slogan of lifting TCM diagnostic level, pushing TCM toward extinction! In fact, seeing TCM's scholarly recession with pain, people have suggested the government — like Hong Kong and Taiwan — adopt a divided-practice system in the mainland, permitting TCM clinicians wholeheartedly to research TCM and lift TCM level. This is the act of social conscience and should be welcomed! In my April 28, 2003 letter to Vice-Premier Wu Yi I made the same suggestion: "In clinical practice, strictly the lines of Chinese and Western medicine should be drawn; TCM physicians may not freely prescribe Western drugs, Western physicians may not freely prescribe Chinese drugs; clean up the medication mix in treatment; reduce harm and stop waste." Unforeseen, this suggestion offended a manager in the TCM regulatory system, who in work pushed back against the proposer unjustifiably and even mobilized a band on newspapers to attack, denounce, and silence. This attempt to bind people's thought severely blocks the free discussion of TCM scholarship, runs counter to the Fifteenth Congress's liberate thought, seek truth from facts, advance with the times. What good does it bring? In truth, my suggestion would block the eclectic Chinese-Western piecing theory from realization, but in no way did it oppose TCM's correct absorption and dynamic use of all Western diagnostic technique to develop itself. To speak frankly, thirty years ago in 1976, lecturing for Yue Meizhong's high-level TCM Research Class, I said: "We must, under the guidance of TCM basic theory, in clinical work, use modern scientific examination — stethoscope, sphygmomanometer, cardiotachograph, ECG, scanner, ultrasound, EEG, X-ray, all kinds of biochemistry," (and today CT, MRI), "accumulate new data, find new regularities, serve TCM bianzheng shizhi, so as to develop TCM bianzheng shizhi" (Compilation of Special TCM Lecture Materials, vol. 1, July 20, 1977, National TCM Research Class). Modern test methods, for TCM, are a two-edged sword. Used well, brought into bianzheng shizhi and dynamically used with innovation, they can push TCM forward; used poorly — Western methods copied over, statically used, again led by the nose by Western existing conclusions — effect will be low, and the gradual decline assured. This is exactly the road the TCM-is-backward school led us on decades ago — never again to be taken!
Lunyu · Zilu: "The Master said: One must rectify names ... If names are not rectified, words do not follow; if words do not follow, things do not get done." Chunqiu Fanlu · Shen Cha Ming Hao: "Name comes of the real; if not real, do not use as name. Name — that which the sages use to make things real; name is the same as real." Hence name should match real. Mao Zedong's conception, "combine the knowledge of TCM and herbs with that of Western medicine and drugs, to create a unified new medical science and pharmacology of China," though not fitting the objective laws of Chinese and Western medical development — even after half a century, no ideal result — itself called for a new medical-pharmacological system that integrates: this is dialectical thinking. Yet the TCM-is-backward school, under nihilist sway and with ulterior intent, set aside the "combine the knowledge of TCM and herbs with that of Western medicine and drugs, to create a unified new medical science and pharmacology of China" phrasing and put forth only the conceptually unclear Chinese-Western integration, causing name-and-real confusion. As Lüshi Chunqiu · Xian Shi Lan · Zheng Ming says: "All disorder comes of name-and-shape not fitting." The TCM-is-backward school, to meet Western cultural hegemony's splitting and westernizing of us, on one hand altered Chinese-Western integration into Chinese-Western piecing theory, on the other made up lies — that Chinese-Western integration lifts and advances TCM — without allowing question or discussion; managers and the media, with very imprecise attitude and inexact words, talked daily of Chinese-Western integration, so the public's eyes and ears were filled with this falsified Chinese-Western piecing theory. The shallow rushed to imitate: Chinese drug plus Western drug, Western infusion plus Chinese-medicine drip, Western diagnosis treated with Chinese drugs, Western surgery with acupuncture analgesia, classes split between Chinese and Western lecturers training two middle-school-level personnel in parallel, Western hospital wards using Chinese and Western drugs, isolating chemical constituents like qinghaosu — all without the scholarship of integration, mixed into the integration category. In our country's present level of Chinese-and-Western treatment, by need, combining Chinese and Western methods to treat illness is fine and good. But this is Chinese-Western cooperation — a work issue — strictly distinct from the scholarly issue of dialectically thought-out true Chinese-Western integration. If in clinical treatment, regardless of situation, one calls it Chinese-Western integration to chase economic benefit — that is error. It wastes our country's medical resources, adds the patient's drug-suffering and economic burden, confuses the very definition of Chinese-Western integration, strikes TCM's theoretical system and dialectical thought, harms our national TCM culture — and must be exposed and clarified.
Let Chinese-Western piecing theory end here!
Li Jinyong, May 4, 2007. Written at Hubei TCM College.