The Formation and Variation of Tradition

It is true that for quite a long time in history Chinese people regarded their country as the greatest land in the center of the world and taken their culture as the most excellent one in the universe. However, China has never stopped absorbing nutrients from cultures developed in other countries. In the medical field, the influence of foreign cultures on Chinese medicine appeared quite differently at the end of the Ming Dynasty (1368-1644) and in the early period of Qing Dynasty (1644-1911).

Before the period between the Late Ming Dynasty and the early stage of the Qing Dynasty, medicines from India, Arabian world and the middle southern Asian and western southern Asian regions were already introduced into China. However, such an introduction did not lead to any conflict because these medical systems were not totally different from Chinese medicine in nature. That was why most of the therapeutic methods and medical knowledge from these medical systems were adopted by the Chinese medicine. The adoption of the technique for removal of cataract was a typical example. Even in 1805 when smallpox vaccination was introduced into China, Chinese doctors still maintained their traditional way of thinking and believed that smallpox vaccination would be safer than variolization because cows were meeker than men.

Later when Western medicine, which was based on anatomy and substantial evidence, was introduced into China, Chinese doctors still rigidly stuck to the ideas that the Western medicine can be incorporated in the Chinese medicine and Western studies were originated from that of the Chinese. Only when some people appealed to abolish Traditional Chinese Medicine as was done in Japan during its reform did Chinese doctors realized the unprecedented crises facing them.

Things have changed with the lapse of time. Now when we are studying Traditional Chinese Medicine as a system of knowledge, it is unnecessary to mention the efforts made by Traditional Chinese Medicine doctors in the past to struggle for the existence of Traditional Chinese Medicine. The important thing is to see what has changed in Traditional Chinese Medicine under the influence and pressured of foreign medicine.

Firstly, there would be no such a term as Traditional Chinese Medicine if Western medicine had not been introduced into China. And there would be no such a concept of traditional medicine if the Western medicine developed in the West had not dominated over the whole world. Only when the Western system of medicine was introduced into China did Chinese people begin to think about the difference between the Chinese medicine and the Western medicine. Only when the existence of Chinese medicine was threatened did Chinese medical doctors start to defend for themselves, expounding the advantages and value of Chinese medicine and making use of the advantages of the Western medicine. If one looks at the medical journals and books published in the early 20th century, he will find how doctors of Traditional Chinese Medicine imitated those of the Western Medicine to establish the theoretical system of Traditional Chinese Medicine from the aspects of etiology, pathology, therapeutics and pharmacy. By carefully analyzing the compiling styles of these journals and books, one can easily find that doctors of Tradition Chinese Medicine then unconsciously imitated the thinking of Western Medicine and tried to learn how to analyze problems and think rationally.

Secondly, the introduction of Western Medicine into China had brought much basic scientific knowledge of biology to Traditional Chinese Medicine. According to Huang Di Nei Jing (Yellow Emperor's Canon of Medicine), the region beneath which the heart beats was considered as the major Collateral of the stomach because human beings depended on food to exist and perform physiological activities; urine was infused into the bladder from the small intestine. Such ideas in Traditional Chinese Medicine were gradually replaced by modern scientific knowledge of biology. Similarly, only when the Western Medicine had been introduced into China were practitioners of Traditional Chinese Medicine able to understand that the so-called jing luo (Channels or meridians) were not blood vessels. And that made them to think carefully about the nature of jing luo and zang fu (viscera). It was just based on such a new understanding that the theory of jing luo and the theory of zang xiang (viscera and their manifestations) were established.

Thirdly, under the pressure of Western Medicine, doctors of Traditional Chinese Medicine actively took measures to defend, promote and invigorate Traditional Chinese Medicine by means of setting up schools, starting training programs, publishing journals, organizing societies, translating Traditional Chinese Medicine books from Japanese into Chinese and developing traditional Chinese drugs. All these changes show that the introduction of Western Medicine into China, to some extent, has promoted the development of Traditional Chinese Medicine.

Historically, the introduction of any culture into a country will inevitably enrich and sublimate the culture of that country. Modern Western science is also a sort of culture and will not bring any harm to Traditional Chinese Medicine. Instead, it will provide Traditional Chinese Medicine with more chances to develop.

As a continuity of the collision between Traditional Chinese Medicine and Western Medicine in a special period in history, the compilation of textbooks of Traditional Chinese Medicine in 1958 by several colleges of Traditional Chinese Medicine under the supervision of Health Ministry had epoch-making significance. Ever since then, there appeared a course known as Essentials of Traditional Chinese Medicine and the concept of Basic Theory of Traditional Chinese Medicine. To compile a new-styled textbook of Traditional Chinese Medicine is of cause a systematic study of Traditional Chinese Medicine. But it is more like a re-establishment of the traditional ideas about medicine, selecting the essential parts as the basic foundation of Traditional Chinese Medicine through carefully differentiating the false from the truth. Several decades later, the basic structure and content of Traditional Chinese Medicine textbooks have almost remained unchanged, though the textbooks have been re-compiled and revised for several times.

In this re-constructed "tradition", the theory of Channels no longer includes the ideas that the visible ones in the body surface are Collaterals while the ones running deep in the viscera are Channels and that the bluish color of the vessels indicates cold while the reddish color of the vessels indicates heat. According to the revised theory of Traditional Chinese Medicine, wu zang (five zang-organs) and liu fu (six fu-organs) are defined as a physiological unit, not equivalent to the anatomic organs and no longer relating them to the hierarchy of imperial court. The theory of acupuncture and moxibustion is no longer a collective term for external therapeutic methods including incising ulcers and carbuncles, but defined as "the therapeutic methods for adjusting the flow of qi and blood and regulating the functions of viscera through physical stimulation". It has been worked out that the basic feature of Traditional Chinese Medicine, which is also its major difference from Western Medicine, is treatment based on syndrome differentiation, which means to differentiate the clinical manifestations of various diseases, with the consideration of the constitution of the patients, into different syndromes(such as deficiency, excess, cold or heat syndromes). Many Traditional Chinese Medicine doctors believe that this therapeutic principle was established by Zhang Zhongjing (150-219), a great doctor in the Eastern Han Dynasty (25-220). However, such an idea could not be so sophisticated if Western Medicine had not been introduced into China. Because in Chinese language, the original Chinese characters for syndrome and symptom mean the same thing though their morphological structure is a little different. And actually doctors in the past had never thought about differentiation between the two characters and the two concepts. In the old books, no matter deficiency, excess, cold and heat or abdominal pain and dizziness, they were all used as the names of diseases.

Understanding Traditional Chinese Medicine

To understand Tradition Chinese Medicine, one has to have a good command of knowledge about Chinese culture, especially the knowledge about philosophy, because the theory of Tradition Chinese Medicine was established in ancient times with the combination of the development in many other fields.

Another access to understanding Traditional Chinese Medicine is to learn anthropology because anthropology focused on the basic mode of thinking concerning the system of various different kinds of culture.

To be aware of the basic philosophic thinking of Traditional Chinese Medicine is prerequisite the understanding of Traditional Chinese Medicine theory and practice. Treatment based on syndrome differentiation is a typical example. The relationship between human body and diseases is complicated and thus there exists certain contraindication between modern medicine and "science". In Introduction to Experimental Medicine, Claude Bernard (1813-1878) said that he believed that medicine should not be special since it was a science, though doctors often told him that there existed many peculiarities in medicine. Traditional Chinese Medicine believes that no person is exactly the same as any others. Thus there will be no disease that is exactly the same as any others and there will be no treatment that is unchangeable and can be used repeatedly without any modification. In Traditional Chinese Medicine there also exist some decided prescriptions. However in clinical treatment, doctors have to frequently modify these prescriptions to make them suitable to the treatments of different patients. Such phenomena seem to be contradictory to the so-called "repeatability" emphasized by "science". Such a contraindication is actually easy to understand.

According to Traditional Chinese Medicine, the factor responsible for non-repeatability is that the treatment in Traditional Chinese Medicine focuses on patients, not on diseases. Since no person is exactly the same as any others, the treatments of patients if of course different. Theoretically speaking, Traditional Chinese Medicine is superior to Western Medicine.

Though there is no absolutely identical treatment, in many cases the difference is only reflected in quantity. That is the reason why Traditional Chinese Medicine has developed some basic therapeutic principles and effective prescriptions. In fact the treatment in Traditional Chinese Medicine is not absolutely non-repeatable.

Whether it is repeatable or not depends on what criteria one uses in analyzing it. In Traditional Chinese Medicine, "similarity" does not always include the same symptoms and "difference" may be explained as the same disease by modern medicine. If we take clinical manifestations or the "similarity" and "difference" in modern medicine as the criteria, there will be no non-repeatability in Traditional Chinese Medicine.

The 20th century witnessed twice occurrence of epidemic encephalitis. Western medical doctors used exactly the same therapeutic methods applied in the first time to deal with the second attack, but there was no effect. Doctors of Traditional Chinese Medicine advised them to change the methods and it was proved effective. In the eyes of Western medical doctors, epidemic encephalitis occurred twice was exactly the same, all caused by microorganisms. But in the eyes of Traditional Chinese Medicine doctors, it was different because of the change of seasons and fluctuation of "dampness" and "heat". Another example is bu zhong yi qi wan (pill for tonifying the middle and invigorating qi) developed by Li Gao (1180-1251) and used it to deal with anemia, neurasthenia and proctoptosis. Though the manifestations of these diseases are different, their cause and nature are the same.

Ginseng	Caterpillar Fungus (Cordyceps Sinesis)	Pilose Antler