Integrating Medicine​

By Bindi Zhu, M.D. (China) Ph.D. (Traditional Chinese Medicine)

Main building of Heilongjiang University of Traditional Chinese Medicine , Harbin, China

Most recently the prestigious Nobel Prize in Physiology or Medicine 2015 for studies of traditional herbal medicines was awarded to  Youyou Tu, a Chinese scientist who “managed to extract a substance, artemisinin, which inhibits the malaria parasite.”2 Has led to “a novel therapy against malaria.”1  “Drugs based on artemisinin have led to the survival and improved health of millions of people.”2

In China, traditional healing has a 5,000-year history. With the relatively recent emergence of conventional medicine in the last five hundred years, the Chinese have taken these two disciplines and successfully integrated them over the last fifty years.

Since 1990, physicians in the United States have begun to study complementary and alternative medicine (CAM). In 1998, the National Institutes of Health turned the Office of Alternative Medicine into a federal agency named the National Center for Complementary and Alternative Medicine (NCCAM). By integrating conventional and alternative medicine, options for treatment greatly increase. Some of these choices include any combination of physical therapy, massage, herbal medicine, surgery, conventional pharmaceuticals, guided imagery, biofeedback, acupressure or acupuncture.

Conventional medicine and Chinese medicine come from two very different paradigms. Modern medicine as we know it began its development during the Renaissance, a period in Western civilization marked by the transition from medieval to modern times. Chinese medicine originates from experimentation with medicinal substances from animal, plant, and mineral sources and pressure points, exact three-dimensional points of varying sizes located subcutaneously called acupuncture points. Empirical evidence collected from these experiments combined with Daoist and Confucian philosophy produced the body of knowledge that today we call Traditional Chinese Medicine (TCM).

Concurrent with their differing origins, conventional and Chinese medicine excel at addressing very different problems. Conventional medicines has huge success addressing

  • Trauma,
  • Diagnosis and treatment of many medical and surgical emergencies,
  • Diagnosis and correction hormonal imbalances,
  • Acute bacterial infections with antibiotics,
  • some fungal and parasitic infections,
  • The prevention of many infectious diseases by immunization,
  • The replacement of damaged hips and knees, and
  • Cosmetic and reconstructive surgery.

Conversely, Chinese medicine excels in

  • Preventive medicine,
  • Chronic degenerative diseases,
  • Pain,
  • Allergy,
  • Autoimmune diseases,
  • Stroke rehabilitation,
  • Viral infections, and
  • Side effects from chemotherapy.

The preceding lists make obvious the benefits of integrating conventional and Chinese medicine. It makes sense to use the treatment modality that best addresses each disorder. In order to fully understand the advantage of integrating Chinese and conventional medicine, we must first identify the fundamental differences between the two practices, and then we must review the philosophical concepts that support conventional and traditional Chinese medicine.

THE ORIGINS OF WESTERN MEDICAL THEORY

Medicine experienced the same revolution during the Renaissance as the art, music, science, and literature from this era. Scientists and theologians reevaluated and refuted the principles set forth by ancient Greek philosophers and the Catholic Church. Copernicus, a physician as well as an astronomer, revised Ptolemy’s work by placing the sun instead of the earth at the center of the universe. The Reformation arose from objections to doctrines and practices in the medieval church and ultimately led to the expression of dissenting opinions. Science and medicine experienced this same dissent which allowed for the investigation and questioning of established scientific knowledge.

Scientific thinkers in all fields attempted to refine the body of knowledge made available by ancient texts. The scientific revolution that followed was marked by Harvey’s work on the circulation of the blood in 1628, Schwann and Schleiden’s cell theory in the 1850s, and Pasteur’s formulation of his germ theory in the 1860s. These achievements came at a time when the publication of The Communist Manifesto by Karl Marx and Friedrich Engels (1848) and Origin of Species by Charles Darwin (1859) had an enormous impact, an influence that epitomized the intellectual reform, social, and scientific revolution of the times.

At the same time, expeditions to remote regions, tropical and polar, to high altitudes or abyssal depths coincided with explorations into new microscopic and atomic worlds. New techniques and instruments increasingly revealed the physio-chemical determinants and mechanisms of living material, and promoted investigations into disease causation.

At the end of the nineteenth century, Americans and Europeans brought western medical science to China and set up schools and hospitals. By the middle of the 20 th century, antibiotics revolutionized the treatment of infectious disease, effectively saving millions of lives. Once conventional medicine became firmly established in China, bridging the gap between them came as the next logical step.

FIGHTING DISEASE AND BOOSTING IMMUNITY

Western researchers focus on identification of external agents of disease and developing weapons against them. One of the great successes of this century, antibiotics changed the face of modern medicine by saving people’s lives from infectious diseases that formerly decimated villages and entire populations. Unfortunately, the misuse and overuse of antibiotics creates strains of bacteria that resist the power of the antibiotics we currently have available. With antibiotics quickly losing their power, infectious-disease specialists are beginning to investigate our health options once we can no longer rely on antibiotics.

In China, the fundamental concepts that make up the foundation of traditional Chinese culture also reflect traditional Chinese medical practices. Confucius’ philosophy and Daoism are standard fare in elementary and high school classrooms. With a background in ancient Chinese philosophy, the basic ideas and applications of traditional Chinese medicine are also common knowledge.

Instead of focusing on external agents of disease, in China, medicine takes a different focus. It explores ways of increasing immunity so that you remain healthy, even when coming into contact with harmful influences. Chinese doctors discovered many natural substances, animal, vegetable, and mineral, over thousands of years that have such tonic effects on the body.

In contrast to antibiotics, the human body does not develop resistance to the tonics of Chinese medicine. Tonics do not kill germs, thereby influencing their evolution; rather, they act with the body’s defenses. They stimulate the immune system by increasing related cellular activity and efficiency. This allows the patient’s immune system to resist all kinds of infections, not just those caused by bacteria.

ORIGINS OF CHINESE MEDICINE

Every culture has certain concepts ingrained into the fabric of a collective cultural identity. For example, every American is familiar with the Constitution’s preamble, which describes our inherent rights to life, liberty, and the pursuit of happiness. This concept and others, such as a free market economy, eggs for breakfast and even Elvis make up a small part of our American cultural foundation.

Traditional Chinese medicine developed during China’s “golden age,” an era of unprecedented cultural prosperity. This sophisticated culture pioneered the discovery and orderly use of medicinal plants and invented a unique therapeutic modality called acupuncture, now widely practiced around the world.

Daoist Influence

The Dao sets humans in a context of a natural world order. Therefore, Dao precepts emphasize an individual’s relationship in nature, rather than scrutinize their social status.   The Dao suggests that humans must find their own personal path, or way, that resonates within their surroundings and the natural world order.

Similarly, Chinese medical theory emphasizes the interdependence of each organ system in the unique environment of each different body. This fundamental concept underlies each diagnosis made by a doctor trained in traditional Chinese medicine.

Daoism’s influence extends not only to Chinese medical theory, but also to its practice. It recognizes the limitations of coercive power and encourages “leading, not dominating,” much the same way an acupuncture needle guides Qi or an herbal formula supports the immune system to fight off disease.

In ancient times, the Chinese enforced strict prohibitions against the autopsy or dissection of the human body.   This explains why Chinese medicine developed with a sense for systemic relations, related indications of illness, and an awareness of more subtle nuances of health issues. Without the detailed knowledge of the internal structure of the human body, traditional medicine had the daunting task of treating humans successfully with a limited knowledge of anatomy. Daoist’s considered the human body a sacred object designed purposefully and not intended for change through surgery or dissection.

Chinese Diagnosis and Differentiation of Syndromes

Chinese medicine emphasizes the differentiation of syndromes; that means that even within the same “disease,” each stage (e.g. pre-menopause, menopause, post-menopause) will have a different treatment. In addition, each individual presents their symptoms in a way unique to their body’s constitution.   For example, when treating hypertension, traditional Chinese medicine subdivides the disorder further into four different types. The corresponding treatment will differ for each presentation even within those four categories.

Qi

According to Traditional Chinese Medicine, each individual has a unique constitution determined by two sets of factors. The first set, called pre-heaven qi, encompasses genetic factors. The second set, called post-heaven qi, depends on the quality of our food, water, air, physical and mental activity, including how we treat others and us. Chinese medical theory states that post-heaven qi, our body’s input, has more importance in determining health than pre-heaven qi, or genetic factors.

Defensive Qi

Eastern medical science structures a treatment based on the strength of the patient’s bodily defenses. Defense allows the body to protect itself against threats to its equilibrium, whether they are physical, emotional, or spiritual. Chinese medicine emphasizes the human capability to resist disease, also known as defensive qi, anti-pathogenic qi, or wei qi. When treating any disorder strengthening defensive qi, similar to stimulating the immune system, plays a key role.

Yin Yang Balance

The human body exists in a state of relative balance described by the yin yang paradigm. Chinese medicine operates within that paradigm with a goal of balancing the yin and yang within an individual’s personal constitution. With this perspective, the Chinese medicine practitioner approaches syndromes such as menopause as an imbalance in need of a stabilizing force, not as a disease needing treatment. This balance relates to the individual’s constitution, stress level, emotional change, or illness, factors that vary as widely as fingerprints do. Therefore, no single treatment can adequately treat all menopausal women, but requires an individualized treatment plan contingent on the presentation of each syndrome.

Yin yang theory explains the workings of the body and the universe in terms of two interrelated and opposing forces.   The tension that maintains this opposition keeps our bodies and nature in a relative balance. The complementary agents associated with yin are dark, cold, feminine, and reducing; yang forces relate to light, hot, male, and expanding aspects.

The dynamic tension between yin and yang keeps our bodies, and everything else, in a relative balance. Yin yang theory relies on comparison; for example, although the internal organs are yin compared to the external (e.g. the skin), hollow organs, like the gallbladder are considered yang when compared to solid organs like the liver.

Keep in mind that perfect health or balance is not possible. A dynamic and temporary state of equilibrium, one achieves health through the continuous rebalancing of yin and yang. Disturbing that relative balance will result in illness at which point your healing systems will attempt to re-establish it.

Five Element Theory

The relationship between yin and yang is further illustrated with the Five Element theory. By observing the natural world, ancient Daoist monks came to parallel conclusions regarding seasonal changes, their associated properties, and the interaction of the body’s organ systems. The monks found that each seasonal element corresponds to, among other things, each organ system, thus further describing the interdependence and balance of the body’s health.

This concept of interdependence raises the question of mind-body interaction. Confucius (551-479 BC) spoke of this interdependence subtly, saying that a correct way to live exists, and how you live ultimately affects your health. Although diet and exercise play a critical role to good health, so do spiritual and emotional balance. The way you treat yourself and others, experience emotions, and relate to others can tilt the balance between health and sickness.

Meridians

Chinese medicine further breaks down the functional aspect of the body by describing the twelve regular meridian pathways and the four irregular meridians. A meridian forms an energetic pathway that conveys vital energy, or qi, to connect every part of the body with every organ, like a network of waterways. Traditional Chinese medicine recognizes 365 official acupoints and about 30 “extra” points. These points are each found in an exact three-dimensional location on the meridian pathway, denoting a collection of Qi.

Conclusions

Once we understand the theoretical basis for 5,000 years of empirical research in traditional Chinese medicine and the underpinnings of conventional medicine, we begin to grasp how conventional and traditional Chinese medicine can effectively work together. With the diagnostic tools available to conventional medicine, such as MRI, CT scans, needle biopsy, and laboratory assay and the diagnostic tools used in traditional Chinese medicine diagnosis, like using the pulse and tongue diagnosis as well as a thorough history, a new comprehensive type of medical care makes itself available to us all.

Some consider traditional medicine a healing system designed to discover and teach natural laws that will ensure a healthy mind in a healthy body. On the other hand, conventional medicine primarily treats disease and restores health by correcting any imperfections caused by accidents of life or birth.

Chinese medicine in conjunction with conventional medicine offers a restorative vision of a balanced human life lived in the context of a natural world community. Interpretations of the Dao to suit or influence contemporary society makes Confucianism dynamic while preserving a fundamental system of model behavior based on ancient texts.

The technological advances in conventional medicine provide a valuable counterpoint to Chinese medicine’s long history of healing. Together, they give us even more choices for healing body, mind and spirit.