Medicine is what works

17 Sep

What is the difference between Chinese medicine and western medicine?

The practice of modern medicine is fragmented by many different philosophical and therapeutic approaches. Western biomedicine is the de-facto standard whilst many other disciplines are considered to be alternative or complementary.

A lack of interdisciplinary medical education and cooperation, polarising attitudes and misleading marketing are just a few of the many reasons misunderstandings and prejudice exist amongst the many diverse disciplines of health.

Common sense tells us that such hostile, defensive attitudes amongst health care professionals are barriers to better patient care, nor should we judge or discriminate against any person based upon the medical treatment they may prefer.

The future of medicine is integrative, evidence-based and compassionate. Good medicine is what works, and what works is what counts.

Kindness, virtue, blessing and longevity.

Chinese medicine and medicine in China

Chinese medicine is an independent theory of medicine which originated in ancient China over two thousand years ago. The publication of the Yellow Emperor’s Canon of Internal Medicine (Huangdi Neijing) between 600-300 BC established the basic ideas of physiology and medicine that continues to influence the practice of modern Chinese medicine. The Hippocratic Oath was also authored during this time by Hippocrates, who is widely regarded as the father of western medicine.

Despite its classification as a complementary therapy in the western world, Chinese medicine is a complete system of primary health care and many of its component therapies including acupuncture, moxibustion, Chinese herbal medicine, scrubbing, cupping, tui na massage, tai chi and qi gong are used by one quarter of the world’s population.

In China, western medicine has developed alongside Chinese medicine since its popular introduction over a century ago. This dual system of medicine serves the primary health care needs of 1.3 billion people.

Many schools of Chinese medicine in China integrate western medicine and train doctors who can diagnose and prescribe in the language of both systems. On the other hand, few western medical schools integrate training in Chinese medicine. Patients in China can also choose between western medicine, Chinese medicine or integrative hospitals.

In this context, many Chinese medical schools advocate that Chinese, western and integrative medicines should co-exist and advance together, as each is recognised to have their own unique advantages and disadvantages.

A different philosophy

Chinese and western medicine are two independent medical sciences which developed under different social, theoretical and historical influences. Chinese medicine originates from the holistic philosophy of Taoism, which teaches that the life and activity of humans have an intimate relationship with their environment on all levels.

The ancient Chinese recognised that living in large, complex societies was contrary to nature and brought with it many stressors and adverse environmental factors that caused disease. Poor nutrition and eating habits, smoking, alcohol and drug abuse, physical and emotional stress, overwork, sedentary lifestyles, poor sleep and environmental pollution are among the many unhealthy habits of our society which cause preventable diseases. Thus, Chinese medicine came to regard good health as an individual’s harmonious interaction with their community and environment: physically, mentally, emotionally, socially and spiritually.

The start of the western, scientific biomedical movement did not begin until the end of the 18th century with the discovery of vaccination, which was followed by the discovery of antibiotics at the start of the 20th century. These discoveries were influenced by scientific reductionism, which seeks to understand a system through the study of its isolated parts. This philosophy continues to guide the development of modern western medicine and surgery, which isolate and treat specific causes and symptoms of diseases.

Western medicine and modern technology have both progressed at an unprecedented pace to advance our scientific understanding of anatomy, physiology, biology and genetics. Advances in surgery and the development of epidemiology, diagnostic techniques and pharmaceutical drugs have saved countless lives from previously incurable diseases on a global scale.

Lost in translation

Chinese medicine theory is founded upon a deep understanding of the laws of nature and the rational organisation of the patterns, functions and relationships of living systems with their environment. Since Chinese medicine believes that no part can be understood except in relation to the whole, its development has emphasised physiology over anatomy in the understanding and treatment of diseases.

In diagnosis, this holistic theory is applied to understand each individual as a whole, physiologically and psychosocially, within the context of their life rather than isolate a specific cause or symptom of disease. When Chinese physicians use terminology such as “yin and yang, qi flow and stagnation, deficiency and excess, cold and heat,” they are speaking in a unique language that systematically describes the body’s physiological functioning.

Chinese medicine is grounded in empirical evidence gathered over two thousand years of continued observation and experience. In practice, it does not depend upon the existence of any mysterious, heavenly energy or life-force. This simplified view of qi mystifies Chinese medicine at the expense of scientific progress and understanding. Qi is actually a collective noun in the Chinese language that can describe many aspects of the physical world, in both form and function depending on its context of use.

However, the difficulty of translating traditional Chinese medical terminology and concepts accurately into english, let alone the language of biomedicine, has been a source of much medical confusion and misunderstanding.

Where is the evidence?

Some western educated physicians regard Chinese medicine as unscientific and therefore unworthy of practice. The efficacy of acupuncture was scientifically reviewed by the World Health Organisation in 2003 for over one hundred different diseases and conditions recognised by western medicine. Evidence based research exists for many more specific conditions which can be treated safely with Chinese medicine.

The evaluation of scientific research into Chinese medicine is frequently an area of controversy fuelled by bias and misguided preconceptions. Many randomised controlled trials are incorrectly designed due to poor understanding of Chinese medicine’s non-reductionist approach to disease diagnosis and treatment. However, this does not excuse Chinese medicine from the need to practice evidence based medicine and contribute its traditional knowledge to the international scientific community.

Any scientific medicine must be based upon empirical evidence, described in terms of physiological mechanisms and use clinical treatment to restore physiological function, all of which Chinese medicine has in common with western medicine.

What is remarkable is that the earliest Chinese medicine theories documented in the Huangdi Neijing have remained virtually unchanged over two millennia of continuous critical practice and observation. Chinese medicine remains as relevant and valuable today as it was then.

Both western and Chinese medicine share the view that medicine is both an art and science. The need for human compassion and traditional wisdom to guide our scientific understanding is as important as ever.

Different ways to treat the same disease

Chinese medicine aims to diagnose and treat the cause of the disease, not merely its symptoms. It treats the whole person without separation of mind and body, emotional, social, environmental and spiritual factors.

Fundamental to Chinese medicine is the concept of syndrome differentiation. It recognises that the same symptoms can be treated differently and different symptoms can have the same treatment depending on the underlying cause.

Pharmaceutical drugs have become the cornerstone of western medicine because of their powerful ability to target microorganisms and specific biological functions of the body. Chinese medicine pulse and tongue diagnostics as well as treatments including acupuncture make use of the body’s own physiology, immune and self-healing abilities. They are comparatively safer but slower than western methods. Western medicine cannot treat some conditions which Chinese medicine can, and vice-versa.

Lifestyle changes, dietary therapy and healing exercises such as tai chi and qi gong are by far the preferred interventions for chronic illnesses. Long term use of any medication is usually inappropriate and exposes the individual to toxicity and unknown side effects.

Possessing the knowledge of both Chinese and western therapeutic approaches is worthwhile in helping physicians and patients to make more informed choices.

Good health is a means to living a good life

Above all else, Chinese medicine has always emphasised disease prevention as superior to its treatment. Inoculation was practiced in China and India before the 8th century. Ancient Chinese doctors served as role models who advised their patients on the best way to prevent disease, preserve health and live a harmonious life.

The principle ideas of health preservation are woven into the fabric of Chinese culture and civilisation. They are easily understood by all members of society and are preserved and passed on within the traditions of Chinese families. These include dietary practices, martial arts, physical exercises, as well as basic Chinese medical concepts to recognise symptoms of disease and protect oneself from harmful environmental exposure.

The future of medicine is holistic and integrative

Western and Chinese medicine are both scientific approaches to medicine. They may differ in philosophy, diagnosis and therapy, but they both treat the same human being.

Chinese medicine’s rich history and philosophy is a reminder that we need to live in harmony with our environment, because we cannot be healthy on a sick planet.

Nor can we limit ourselves to only one way of thinking. The integrative future of medicine needs as much compassion and tolerance as it does science to build strong bridges between our allies in health.