Deng Tietao's Address at the Pearl River Forum
Master of Chinese Medicine Deng Tietao —
Address at the Fourth National Forum on Chinese Medicine Development:
The Pearl River Forum
Esteemed comrades, esteemed specialists, esteemed leaders — good morning.
I am very honored to have the chance to take part in this important meeting — the Pearl River Forum — and even, though absent from the floor, to deliver an address. To this gathering I send warm congratulations and wish it complete success. Below I offer my unrefined personal views.
The first subject I want to take up is the importance of carrying on a fine national culture, drawing from the comparison of the Jews and the Roma. Some comrades here may say, Old Deng has indeed grown old — wide of the mark by ten thousand zhang. In truth, the root of Chinese medicine is Chinese culture; Chinese culture is Heaven and the human as one. Chinese medicine is not a microscopic medicine — it is a macroscopic medicine. So I still speak in that tradition. My first question is a world question.
We know that the world has two peoples. There is in Europe a wandering people, the Roma. There is also a people who scattered across the whole world — the Jews — and who in the end re-founded their nation and became Israel. Compare these two. As to the Jewish people of Israel: by report, two-thirds of Nobel laureates are Jews. As to the Roma: this year they were expelled from France — they are a people who wander on caravan wagons. Why do these two peoples stand in such different circumstances? I looked into this once — only partially. It is said the Jewish people give children three treasures: first, study the classics deeply; second, do not block a child's creativity; third, teach the child to obey rules. That is the tradition of the Jewish people's fine culture, and that is what built their wholly different circumstance from the Roma's. This is greatly instructive. China has five thousand years of fine cultural history — our contribution to world civilization is far greater than that of the Jewish people. My whole address will circle around the importance of carrying on a fine national culture, and from there speak of the transmission of Chinese medicine's culture. Chinese medicine is a jewel of Chinese culture; the transmission of Chinese medicine is bound tightly to the carrying-forward of that jewel. So I begin with the strengths of the Jewish people's culture and reflect against ourselves — there is no straying. I had asked the meeting permission not to keep to the topic in the invitation, because I felt I could not speak my mind there, so let me speak my mind here.
The second subject is the spirit of the Hengyang Meeting, which must be carried forward. What did the Hengyang Meeting discuss? The question of Chinese medicine's distinctive character. Our former Minister of Health, Comrade Cui Yueli — though originally a Western doctor — saw the future and fate of Chinese medicine. He went to a Chinese-medicine hospital, looked, and reached this conclusion: the sign is Mei Lanfang's; the tune sung is Zhu Fengbo's. That puts a finger on Chinese medicine's sore spot. Today across our country, in teaching, in clinical care, in research, the tune is all Zhu Fengbo, not Mei Lanfang. This is fatal. Because Chinese culture is the source of Chinese medicine's foundational theory. If the tune of Chinese medicine's theory has even drifted off, is it still Chinese medicine? So this is Chinese medicine's vital weak point. If it is not revived, our fate becomes the Roma's.
Third I want to speak of Chairman Mao Zedong's evaluation of Chinese medicine, and the situation since. Chairman Mao thought very highly of Chinese medicine, calling it "a great treasure-house, which should be diligently mined and raised up." How did the situation go? In 1952 the former Deputy Minister of Health Wang Bin acted with overbearing power, requiring Chinese-medicine practitioners to learn Western medicine in order to reshape Chinese medicine. Chairman Mao removed him and required Western doctors to learn Chinese medicine instead. But although Wang Bin fell, Chinese medicine, after a hundred years of being beaten, still has not been beaten down. From Wang Daxie, who excluded Chinese medicine from the education system; through Yu Yunxiu, who wanted to wipe Chinese medicine out; through Wang Bin, who wanted to reshape it. Wang Bin was dismissed by Chairman Mao, but Wang Bin's thought — that ghost — still circles around Chinese medicine and has not been extinguished. A few years ago the "Gang of Four" wanted to bid Chinese medicine farewell. I said that was a national-nihilist farewell — pay it no mind. But to Wang Bin's ghost-thought we cannot be careless: Wang Bin wanted to reshape Chinese medicine. You are a TCM practitioner — yet what you practice is Western, what you think is Western, your mode of thought is Western, your research is Western: that is fatal. So I would ask each comrade here to look inward — is any residue of Wang Bin's thought in you? If so, throw it away, cleanse it.
Look — many years after Wang Bin's fall, in 1975 when Comrade Deng Xiaoping returned, the first document he signed was the famous Document No. 56. What did 56 correct? Lack of TCM practitioners; lack of TCM craft. Before liberation when China had 450 million people, there were 500,000 TCM practitioners. A central count of recent years shows only 270,000. Is that not a lack of practitioners? Lack of craft — well, consider our TCM hospitals today, and ask what share of treatments and cures are by TCM. By report, the head of cardiology at a teaching hospital of one TCM university actually said cardiology has expelled Chinese medicine. Would you say Wang Bin's thought is gone? And the students we ourselves are training — is there not a saying among us: "Chinese medicine, change-it-must-change; not-change-it-must-also-change." These are our own grave-diggers. This is what we must guard against. To clear Wang Bin's thought from within our own community matters most — because a fortress is most easily breached from inside. The pressure from outside we have withstood. A hundred years — Chinese medicine has not been beaten down, on the strength of its results. But if the results become Western-medical results, does Chinese medicine still exist? So the question deserves deep thought: are you to be Israel, or the Roma?
Fortunately our country had Comrade Deng Xiaoping. Deng's view was: build socialism with Chinese characteristics. That is of one mind with Minister Cui Yueli's view. Cui thought of Chinese medicine; Deng thought of all of China. Looking macroscopically: where does socialism actually go? At the founding, the great slogans said Marxism-Leninism is the foundation of our theory. By the close of the last century, Comrade Deng Xiaoping proposed building socialism with Chinese characteristics. That came from a synthesis of the development of Marxism-Leninism. Look at the papers today: one rarely sees "Marxism-Leninism" — what one sees is "Marxism," and the newest phrasing is Marxism is to be sinicized, modernized, popularized. Apply those three to Chinese medicine and they all fit. Medicine, too, must be sinicized. In the future Western medicine will walk the Chinese-medicine road — sinicized, modernized. What is modernization? It is this: that with little money and little suffering, the patient is cured. That is modernization. Yet looking back at our medical institutions, they are walking the opposite road. A patient with a fracture, treated with a small wooden splint, spends little money and suffers little. The trouble is the doctor is busy and earns little. With surgery, anesthesia and so on, costs run high, perhaps he can walk a few days earlier, but the metal plate must be taken out later. Which then is modernization? "Modernization" needs re-evaluation. The present system is hard on Chinese medicine — under it, the path that saves money, reduces pain, restores function fastest, leaves the doctor underpaid and the hospital without revenue. That a Chinese-medicine hospital does not bear its true name is partly that system's doing. If we are to talk medical reform, that is a great reform. To promote Chinese medicine, to develop it, to lower the patient's bill while keeping it reasonable, to keep the TCM hospital alive — we must support Chinese medicine at the system level. That is the great medical reform.
On the academic plane, everything I say above looks empty — and yet it is large; it shapes the small. From the academic side: Western medicine is biomedicine; in philosophy it is atomistic. Chinese medicine is people-centered medicine; it is full of dialectical-materialist content. The methodology of Western medicine is white-box — visible, touchable, alluring, and considered the only truth. The methodology of Chinese medicine is practice-theory. Shennong tasting the hundred herbs — that is practice. Then Yi Yin, who by repeated practice raised knowledge into prescription. The decoctions we use — Mahuang Tang, Guizhi Tang, and the rest — go back to Yi Yin combining many foods into good nutrition and good taste, transplanted into medicine: ruler, minister, aide, courier, not a wild rock thrown into a bamboo grove. So He Dayi's cocktail therapy — we are above him; he is only at the pre–Yi-Yin level, pile herbs together and use them. By report, AIDS patients in Henan are given sacks of drugs free and don't want them — taking them, they cannot eat, cannot work, cannot bear it. That is the result of Western methodology. Chinese medicine's method is practice-theory: practice, know, practice again, know again, lift constantly. Chinese medicine can be called a theoretical medicine because it concentrates and lifts experience into theory. Our theory was yin-yang and the five phases, the storehouse-image and the meridians. Speaking of meridians: they are extraordinary. I predict that on the day the world recognizes meridians, the medicine of the world will undergo a revolution — the smallest unit is not the nerve, it is the meridian. Solve the meridian, and many problems are solved. So Chinese medicine's theory is precious.
Or take stone-needles. In the West they say it is superstition — rub with a stone and the illness goes? what reason is there? Before, in truth, we could only say "this is the reason of the meridians." But in the 21st century my friend Xie Nanzhu, a physicist, asked a geologist to analyze the bianstone from Shandong. It is calcite, with twenty or thirty constituents — and when heated, the stone emits low-frequency infrared; while rubbing, it emits ultrasound. What people thought most backward turns out to be most advanced. There is the power of the fine Chinese cultural tradition. Therefore, in clearing Wang Bin's thought, you will see — recognize that these are science, true science, and at the leading edge. Why leading edge? Look at foreign astronauts: there is the "space motion sickness," incidence 50%. Our space program asked the elder Mr. Wang Mianzhi to do "treat-what-has-not-yet-become-illness" work for the astronauts. Our astronauts each returned and walked out of the capsule on their own; foreign astronauts come out with heart rates over a hundred — ours are basically the same before and after. Whose credit? Chinese medicine's. The foreign side studied the disease half a century before us — they have not solved it. Elder Wang solved it inside two years. Unfortunately he has passed; we miss him greatly. He took his doctoral students to study space-motion sickness — in not even two years, the problem was solved. Is Chinese medicine science? Is it leading-edge science? Look at the fight against SARS: First Affiliated Hospital said three zeros — I said it should be four. Three zeros: zero deaths, zero transfers out, zero infections (among students, doctors, nurses, aides — not one infected). I would add: zero sequelae. No one needed joint replacement, no femoral-head necrosis. The most expensive patient was discharged at five thousand RMB. Hong Kong patients ran tens of thousands, even hundreds of thousands, and mortality was 17%. That is a comparison: 17 versus 4 in Guangzhou. In Beijing TCM was not allowed in at first; later, on Vice-Premier Wu Yi's orders, it was. The pre- and post-TCM mortality ratio is said to be 5:1. That is statistically meaningful. As for medical statistics — that is where the trouble lies. Meng Qingyun once said medical statistics is the killer of Chinese medicine. I find that incisive. In 1956–57, the elder Pu Fuzhou was called to the Children's Hospital to rescue Japanese encephalitis B patients. Western treatment had 30–50% mortality. Pu's outcome, I do not have detailed numbers — by report, no deaths, no sequelae. Later the Ministry of Health sent experts to evaluate; the statistician said: many cases were treated, but the prescriptions varied across 19 or 20 — "no statistical significance." With one sentence, Pu's results were wiped out. Pu's experience, fortunately, was summarized by Chinese medicine; but the Ministry did not promote it as a great contribution to humanity. That is what comes of letting Wang Bin's thought live.
How was Chinese medicine's foundational theory obtained? Its method is black-box: information in, information back, conclusions drawn. So one may call Chinese medicine information-medicine. Zhang Zhongjing did not dissect the sick or the dead, yet he knew the spleen had immune function — immune function is the modern term; he put it: when the spleen flourishes through the four seasons, evil cannot strike. The Western side has known this less than half a century — they used to remove an injured spleen, judging it useless. That kind of thinking flows from their mode: biological model — a mouse's spleen, remove it, no problem, apply to people. That is white-box thinking. Zhang Zhongjing's came from practice, knowing, practice, knowing — across a gap of 1,700 to 1,800 years, with no anatomy, we knew the function of the spleen. Some say the West is remarkable — can transplant hearts and livers. True, they have done enormous experimental work, with remarkable results. Does Chinese medicine play a role here? An example: Comrade Fan Zhenglun of Beijing treated a woman in her forties who had a transplanted liver and was experiencing rejection. Western means could not resolve the rejection; she was given three to four months. Then she came to Doctor Fan, who applied the lifa-fangyao of Chinese medicine. He himself was not certain, but he proceeded. Seven days of medicine; she returned, and first the body's jaundice cleared, her appetite opened. He said: there is hope. Continuing the same method, he cured her. She finally went to see her transplant surgeon, who said: unimaginable. Is that not leading-edge? So when Chinese medicine faces new diseases — H1N1, SARS — its results are not bad. It has no million-fold microscope, no way to identify the viral culprit by shape; you would say it is unscientific. But it is exactly this medicine, grounded in black-box theory, that both cures and prevents.
I just mentioned the First Affiliated Hospital — call it however many tens of cases; that was the work of the team led by my classmate Liu Shichang. Deng Xiaoping said practice is the sole criterion of truth. This deserves study. Develop a statistics that accords with dialectics. We cannot throw everything away because it does not fit current medical statistics. Mr. Fan Zhenglun is no Master of Chinese Medicine — he went to the countryside and planted trees, of the up to the mountains, down to the village generation. Yet that generation too can grapple at the leading edge. How? By Chinese medicine's foundational theory. So do not, on whether a white mouse nods or shakes, throw away the very essence of Chinese medicine. That is the most dangerous thing. That is what we senior practitioners cannot put down. Because of Wang Bin's thought, the models of our teaching, treatment, and research were almost completely taken over — the Fifth Encirclement-Campaign, total collapse. That collapse came of running things by the Comintern's theory. The previous four campaigns succeeded under Mao Zedong Thought, Chinese culture plus Marxism. That is why "Marxism in Chinese form" is now being called for. We may not be clear on every tissue and structure, and yet be able to be a doctor — because we can reach deeper levels of information about those tissues and structures. The Western side has grasped the outer form, dead and unmoving, or moving in animal experiments — a gap still remains from the human; their road is long. Ours is long too, and we have already walked it five thousand years. To throw away lightly what those five thousand years have given would be to fail our descent — to be turncoats. So this is at once an academic question and a great national-cultural question.
In closing, my own view. Has President Hu Jintao not put forward a Scientific Outlook on Development? I have studied it. My thinking on Chinese medicine's Scientific Outlook on Development: the Four Great Classics are the root; the writings of the schools are the trunk. The root is important. Our past education demoted the Four Great Classics to electives, twenty or thirty class-hours and done. But what is the leading edge of medicine today? The superior physician treats what has not yet become illness. Where do those words come from? From the Suwen of the Neijing. We are lifting the first line of defense in world medicine from medicine-as-cure to medicine-as-health. Our aim is not to treat disease but to ask that everyone be well. That is a high level; who is the lower level? So we should revisit the Four Great Classics. The first chapter of the Suwen is Heavenly Innateness of High Antiquity; this is theoretical medicine. The Suwen names every chapter discourse. Zhang Zhongjing's book is the Discourse on Cold-Damage and Miscellaneous Diseases. The Jin-Yuan-era Discourse on the Spleen and Stomach, Discourse on Pestilence, the Qing-era Discourse on Warmth-Heat — all discourses, lifted to the theoretical level. Chinese medicine is not at the experimental level but the theoretical level. So: the Four Great Classics are the root; the schools are the trunk. Are we then stuck at the Warring States, Qin-Han? No. The schools are the trunk — the trunk reaches up to the Republican era. Clinical practice is the lifeline. Take Chinese medicine away from the clinic and life stops. Medicine is applied science; if it does not cure in application, what is its value? Looking back over twenty to thirty years of master's and PhD students — how many were lifted in clinical practice, and how many earned the certificate by making a mouse nod its head? That is a question worth thinking about. Of course Chinese medicine is not without experimental research; the future demands it. But clinical practice is the lifeline.
And yet what world medicine lacks today is the doctor's soul of humane heart and humane art. The United States, with all its wealth, cannot deliver health for all; its insurance companies face bankruptcy because medical costs only rise. A PET scan in our country costs 8,000–9,000 RMB — and that is not treatment, only diagnosis of metastasis. Is that science, or is it not? It is science only in this: it clearly shows one point in the body in one time-slice. It does not represent the person as a whole, or his whole life. We know cancer cells arise and are also eaten by defensive cells. So at that 8,000 RMB you see cancer cells now; you do not see them eaten in the next stage. What good is that 8,000? I hold it harms rather than helps. Yet "science" thinks this is the leading edge — it can see so clearly. So American medical costs are astronomical figures. If we westernize wholesale and the 1.3 billion of China go in for full check-ups, our productive capacity, never mind food, will be hauled abroad — instruments brought in cost so much, and again so much, and so on, the country falls. So experimental research is not to be cast off — but under Chinese-medicine theory we must do the research and make our own instruments. Humane heart, humane art — practice the work in that mode. Another thing: I would add a line — take Marxist philosophical thought combined with Chinese culture as guide; mine the treasure-house of Chinese medicine. Mao said Chinese medicine is a great treasure-house; use philosophical thought to mine it. Let the treasure-house combine with the new technologies — that is the great direction of self-innovation. Chinese medicine must develop — that is the direction. Mine our five-thousand-year treasure-house and let the treasure combine with the new technologies. Not the simple "integration of Chinese and Western medicine" alone — that can drag Chinese medicine back. It must combine with the new technological revolution.
What is the new technological revolution? The phrase is from American futurist Alvin Toffler's The Third Wave: it names five — the information revolution, the biotechnology revolution, the new-materials revolution, ocean technology, and space technology. New materials — materials that did not exist, we invent. I have two knives at home that someone gave me — sharper than steel; but they cannot be dropped to the floor or they shatter, because they are not metal but ceramic. That is new-materials technology. Ocean technology — currently we can only go down to six thousand meters; below that is forbidden territory. Space technology — to the moon, to Mars. There Chinese medicine has a place too — our astronauts take Chinese medicine in orbit. Yes, in orbit, Chinese medicine.
We must add popularization — Marxism sinicized, modernized, and popularized. Chinese medicine is the most popular of all. My own diseases as a child were treated by my grandmother — not by my father, who had not yet studied medicine. I had ringworm; my grandmother went to the herb shop and bought mercury and sulphur, came home and boiled them together, blended them. We were poor; the floor was earthen. She took a chopstick, poked a hole, poured the molten mixture in, let it dry, took it out; she found a small bowl, ground it with oil, applied it a few times, and I was cured. My grandmother cured many of my illnesses. She was an ordinary woman, never trained in medicine. So Chinese medicine has its popular side. The fine traditional culture of Chinese medicine — if our generation cannot carry it forward, our generation is the fool. If our generation lets it be lost, we are the guilty. I have said my piece. Thank you.