Is There Still Medicine That Can Cure Chinese Medicine?
"Save Chinese Medicine," Part Three:
Is there still medicine that can cure Chinese medicine?
Modern Education News reporter — Hao Guangming
Setting the root straight — "Deeply rooted in traditional culture"
Mr. Fan Zhenglun of the Beijing Cui Yueli Center for Traditional Medicine told the reporter: "TCM, as a learning, is deeply rooted in Chinese traditional culture. In the soil of traditional culture, plant a seed of TCM and a tree of TCM will grow. Hence the old saying: a scholar studying medicine — like catching a chicken in a cage. Once one has the foundation in Chinese traditional culture, only a little push toward medicine is needed; one easily becomes a TCM, and a successful one. So TCM's own education must be deeply rooted in our cultural tradition."
"Since the May Fourth Movement, many have seen the strengths of Western culture and so dismissed Chinese tradition with a simple negation, leaving it to one side as baggage. Over recent decades this current has only deepened — and the result is that the student of TCM cannot find direction."
As researcher Fu Jinghua of the China Academy of Chinese Medical Sciences has pointed out: TCM has come to exist today as something to be explained, verified, and remade — and this is precisely because of TCM's blood-bond with Chinese traditional culture. Today, as traditional culture rapidly vanishes from our mainstream life (Professor Zhang Xianglong), the whole of Chinese traditional culture has been cast off by Chinese themselves as unscientific, backward. So TCM, deeply rooted in Chinese civilization, is also branded unscientific, backward. The drive within TCM circles toward TCM scientific-ization and TCM modernization is in effect to strip TCM out from that unscientific, backward Chinese tradition. Hence, as Mr. Fan put it: the hardest question in inheriting and developing TCM is — how shall we regard the national tradition?
"Let the pastor lead the monks"
Professor Li Zhizhong of Hong Kong Baptist University points out: it is precisely this rejection of tradition and blind worship of modern Western science that has, for half a century, made verifying, explaining, remaking TCM by Western norms and standards the current. Under such pressure, how can TCM live on?
Famed scholar Dr. Joseph Needham, author of Science and Civilisation in China, reaffirmed at the 17th World Congress of Internal Medicine, Tokyo, 1984, an important view: TCM and Western medicine can be combined fairly easily on the technical side; but to unify their medical philosophies is most likely extremely difficult.
The German sinologist Manfred Porkert put it well: to try to re-evaluate TCM by methods that arose in Western medical science and apply only to Western medicine is unreasonable; it must fail. The attempt is like watching stars by day, or studying clouds on a moonless night.
Professor Bi Quanzhong of Renmin University also points: long has the TCM-school education system practiced cutting TCM's foot to fit Western medicine's shoe; such a system cannot bring out TCM's own character and strength.
Professor Su Baogang of Beijing University of Chinese Medicine told the reporter: feeding pigs has its method; feeding chickens has its method. To remake TCM with Western medicine is like letting the pastor lead the monks. (Mr. Lü Bingkui's word.)
Senior TCM Professors Jiao Shude and Deng Tietao, nationally known, said: we cannot force a TCM of five-thousand-year experience into a Western medicine of only two-hundred-year experience. They stressed: TCM's five-thousand-year experience must not be thrown away. TCM must stand on its own.
Cui Yueli, at the Hengyang Meeting, stressed: TCM is TCM; we cannot use Western medicine to wipe TCM out. Chinese-Western integration is not a matter of one occupying the other. It should be a high-level integration: a method neither TCM's original nor Western's original, but a point of integration sought at a higher plane. We cannot hang Mei Lanfang's sign and sing pop tunes. To keep TCM pure is the first question for TCM's growth.
The key to keeping TCM pure is to hold to TCM's character. Professor Li Jinyong of the Hubei TCM Society, in a letter, told the reporter: "To replace TCM by a Western-medicine set is no good. The teaching hospital of Hubei TCM College, failing to set the three forces — TCM, Western, and Western-trained-in-TCM — to right purpose, lost TCM's character and strength; what came was neither-Chinese-nor-Western, with falling quality and collapsing volume. That is the example."
So what is TCM's character?
TCM's flavor comes from traditional culture
Professor Su Baogang told the reporter: "Today's TCM schools have no TCM flavor; students have no TCM flavor." Why? Because TCM has drawn from many fields of Chinese traditional culture. To learn TCM well, one must study Chinese ancient philosophy, military science, literature, martial arts, and more — TCM is built on many fields of traditional culture. Only one who knows these can master TCM.
The Neijing asks of every physician: exhaust the heavenly order; reach the earthly principle; take far from things, near from one's own body — to attain a broad, deep mastery. Famed ancients prized examining the boundary of Heaven and the human and seeing through the changes of antiquity and today, building a deep, sharp philosophical insight and an associative medical inspiration. Their knowledge structure was literature, medicine, history, philosophy — four in one. Zhang Zhongjing read widely and broadly chose many formulas; Sun Simiao in his early manhood was good at reading Zhuangzi, Laozi, and the Hundred Schools; Zhang Jingyue deeply studied the pre-Qin masters and Song-Ming neo-Confucianism, knew astronomy, calendar, mathematics, music, and held that medical study must begin with the Yijing. Because of this rich cultural learning they reached TCM's peak.
Clinical practice tests true and false
TCM's view of nature and its yin-yang and five-phases doctrine are bound tightly to biàn zhèng lùn zhì and clinical care; they pervade examination, prescription, and use of medicine. They cannot be separated. The great TCMs of every age were nearly all theorist, educator, and clinician in one — rare was the figure who, away from clinic, made true contribution by book alone, and never has there appeared a TCM pharmacologist born of a Western lab. This high consistency of theory and clinic, thought and experience, is the firm basis of TCM's high scientific character and tough vitality.
Professor Li Jinyong: Western foundational subjects — physiology, pathology, anatomy — can grow by experimental work; the practitioner need not see a patient. Can TCM's various branches, including foundational subjects, not see a patient? Can it not see a patient? Surely not. If TCM does not see patients or sees them badly, it has no reason to exist.
Japan's Sawanari Hisanori stressed: "Kanpo's greatest feature is that all research centers on treatment. Kanpo recognizes treatment as the physician's only calling. Kanpo's feature is treatment as center."
Bold reform of TCM school education
Knowing TCM's character — how to reform TCM school education by it? Professor Chen Guoquan of Hubei TCM College proposes:
Rewrite the talent-cultivation model
Revise the syllabus; quickly organize the seventh-edition textbooks; let TCM be primary — TCM hours should be at least 70% of all class hours. Western-medicine hours should match the TCM hours of Western-medicine schools — only an Introduction to Western Medicine (with parts of foundational, internal, and laboratory) is needed.
**Increase Medical Classical Chinese hours**
Medical Classical Chinese is the master key to the treasure-house of Chinese medical writing centered on the classics. Rather than translate the vast TCM canon into vernacular, raise the present 66 class-hours of Medical Classical Chinese to 120 or more — at least equal to foreign language.
Recruit humanities students; open humanities courses
Tradition is TCM's root. TCM students should be drawn chiefly from humanities students (TCM-herb majors unchanged), with at least 200 hours of humanities courses (music, chess, calligraphy, painting, poetry, song, ethics, sociology, ancient Chinese history of science and technology).
Strengthen the place of TCM classics
A people without classics is a childish, weak people. Restore immediately the disciplines named after the Four Great Classics; make them required for every TCM specialty; give each not less than 120 hours; study the original where possible.
Match every senior TCM with a permanent disciple
For senior TCMs of provincial, national, or international renown still seeing patients, fix 1–3 long-term disciples each — not limit to three years. Master's pay should tie to outcome; disciple's pay generous. Let the master pass on the real thing; let the disciple receive it.
Practicing TCMs must be tested on the Four Great Classics
Following Taiwan's practice of testing TCMs on the Four Great Classics and the Qing Yizong Jinjian, we on the mainland should likewise list the Four Great Classics in the practitioner's exam.
"Master-and-disciple" — a key way to solve TCM's lack of successors
Former Minister of Health Cui Yueli pointed out: we are a country of one billion; we cannot fix our eyes only on regular schooling. While strengthening school education, we must hold up many forms and channels of TCM education. One way — as a supplement to higher and middle TCM education — is to continue the TCM apprenticeship: have senior or mid-career TCMs with real learning and rich clinical experience take disciples.
History shows that master-and-disciple is a key way to solve TCM's lack of successors. In the old time, it was the chief form of raising TCMs. This long-used spontaneous education system endured because TCM demands strictness and detail, is highly practical, with biàn zhèng lùn zhì flexible and changing. Especially in some specialties — secret moves of single skills, the experience and techniques of different schools — what one cannot learn from a book is suited to mouth-transmission and heart-reception, hand teaching hand.
TCM apprenticeship, from content to form, has the genuine flavor of TCM. Those who came up by apprenticeship and went on to success — in li-fa-fang-yao, all aspects — inherit the senior's medical virtue and the school's strength. Their learning has individuality, depth, detail, secret moves; theoretical and yet uniquely practical. Many a can be sensed but hardly spoken skill — none not from the master's spark and the student's grasp.
Heartening exploration
Professor Deng Tietao of Guangzhou University of Chinese Medicine told the reporter: through discussion with the Guangdong Provincial TCM Hospital, Deng — on behalf of the hospital — invited senior TCMs nationwide. In the end fourteen were invited; then apprenticeships were arranged. The disciples are the backbone doctors of the hospital. One senior takes two disciples, no more than three. After ceremony, master-and-disciple identities are set; the disciples then transmit the senior's academic views, TCM theory, and clinical experience.
Later, the disciples formed the Qi-Huang Academic Research Society, meeting weekly. The TCM academic atmosphere thickened.
Guangzhou University of Chinese Medicine then linked with the First Military Medical University. The twenty-eight disciples born of the fourteen seniors took on a graduate class, pressing the mid-career staff: only by following the seniors well could they teach the students well.
In September of this year, the twenty-eight disciples returned to the Provincial TCM Hospital; the atmosphere of the whole hospital changed at once. Now, all take pride in learning TCM.
Originally in Modern Education News, 19 October 2001, page B1.