(reproduced from http://shaolin.org/answers/sp-issues/chinese-medical-philosophy.html)
Western medicine kills 250,000 people per year and is the third leading cause of death in the United States. Death caused by Western doctors has been called iatrogenocide. Ignoring this fact, many Chinese doctors want to integrate Western and Chinese medicine. Do you think that Chinese and Western medicine should be integrated or combined into a single system?
— Marcus, USA
Answer by Grandmaster Wong Kiew Kit
I admire your brave and honest statement, made with sincerity and hope that something could be done to overcome a big problem facing modern societies regarding health and illness.
To me this situation is pathetic on two points. One, traditional Chinese medical philosophy and practice can be used to overcome this big problem of numerous so-called incurable, and sometimes fatal, diseases facing modern societies, but this is not being done due to ignorance, prejudice or vested interest.
Two, instead of introducing traditional Chinese medical philosophy and practice into modern societies to overcome this urgent problem, even those in a position to do so are turning to conventional Western medicine. In China, for example, there were hospitals where traditional Chinese medicine and conventional Western medicine were offered side by side on an equal footing, and patients could choose which medical system to use.
But the trend now is that traditional Chinese medicine is becoming a secondary system, with traditional Chinese physicians fearing that they would be phrased out eventually. Most decision makers in hospitals as well as in governmental health care bodies are trained in Western medicine. Against such a background, your question becomes the more important.
Many people, including most Western trained doctors and some mediocre traditional Chinese physicians, view health and medicine from only one perspective, and it is usually the Western medical perspective. In practical terms it means that if a Western doctor who is sympathetic to traditional Chinese medicine, could not overcome a particular disease, he may look for a traditional Chinese medical method, such as acupuncture or herbs, to treat the disease. To most people, this is only logical. This is because most people view health and medicine from only one perspective, the Western medical perspective.
On the other hand, when a Chinese physician treats his patient, he may take his patients’ temperature and blood pressure, and recommends Western medical drugs in his treatment. This is often regarded as an improvement, and the Chinese physicians is regarded as more advanced than his traditional counterparts who do not know how to use Western medical instruments.
Such enterprising Western doctors and Chinese physicians may be successful in individual cases, but for Western medicine as well as traditional Chinese medicine as a whole, it is not a good development. The reason is that Western medicine and traditional Chinese medicine employ different paradigms and methods which are often incompatible. Hence, Chinese medicine and Western medicine should not be integrated or combined into a single system. This does not mean that they cannot work together. They can work together side by side, but they cannot work together as an integrated, single system.
Suppose you live on a river bank and you wish to travel to the river mouth. You can reach your destination by car or by boat, but you cannot use your car as a boat or your boat as a car. You may, if desirable, make part or parts of your journey by car, and part or parts of your journey by boat, consecutively or in any order, but you cannot drive your car on the river or sail your boat on the road.
This gives a rough idea of the incompatibility of integrating Chinese and Western medicine into a single system. In your effort to help a patient make the journey from illness to recovery, you may, if desirable, make part or parts of the journey using Chinese medicine, and part or parts of the journey using Western medicine, but not using Chinese and Western medicine as an integrated, single system. This can’t be done simply because Chinese medicine and Western medicine use totally different philosophies and approaches.
Take for example a patient suffering from an illness that Western medicine calls high blood pressure. Western doctors define the illness from its symptoms. Thus, to overcome the illness, doctors overcome the high blood pressure. This is normally done by taking drugs to dilate the blood vessels which will them reduce the pressure of blood flowing through them. Western doctors are satisfied with this treatment because from their perspective they have done their job, i.e. lowering the patient’s blood pressure. But for the development of medicine, this is unsatisfactory because the treatment only eliminates the symptoms but not the illness.
An enterprising Western doctor employing Chinese medicine as an integrated system, may incorporate Chinese therapeutic methods like herbs and acupuncture (if they are permitted by their medical authorities to do so). But this is also unsatisfactory because actually he is still using the Western system although he substitutes herbs or acupuncture for pharmaceutical drugs. Basically, his attempt is still eliminating symptoms, and not the illness itself, although the therapeutic agents he now uses are herbs and acupuncture.
Chinese medicine operates in a different paradigm. In Chinese medicine an illness is defined not by its symptoms, but by the patient’s reaction to disease causing agents. Often it may not be necessary to know what the disease causing agents are! This fact may appear ridiculous to those who only view illness from the Western medical perspective, but paradoxically it is one of the crucial differences between Chinese and Western medicine that will help Western medicine to overcome its present impasse.
In traditional Chinese medicine, a high blood pressure patient will not be described as suffering from high blood pressure! The description depends on his reaction against known or unknown disease causing agents, and in this case it is usually “rising yang energy from the liver”. In other words, a patient described by Western doctors as suffering from high blood pressure, is likely to be described by traditional Chinese physicians as suffering from “rising yang energy from the liver”. The crucial difference is that “high blood pressure” is a symptom, whereas “rising yang energy from the liver” is the cause of the illness.
When Western doctors succeed in eliminating “high blood pressure”, they eliminate the symptom, but the illness remains. When Chinese physicians succeed in eliminating “rising yang energy from the liver”, they eliminate the cause, and the illness disappears.
There are different ways to eliminate “high blood pressure” and “rising yang energy from the liver”. In their historical development, Western doctors have found pharmaceutical drugs useful for eliminating “high blood pressure”, whereas Chinese physicians have found herbs, acupuncture, massage, chi kung and other means useful for eliminating “rising yang energy from the liver”.
The use of pharmaceutical drugs, herbs, acupuncture, etc are means, whereas “eliminating high blood pressure” and “eliminating rising yang energy from the liver” are principles. People often identify a medical system by its means, and seldom by its principles.
In my opinion, while both are important, principles are more important than means. Principles come first, means follow. When we have decided on the principles, we find the means to realize the principles.
The impasse faced by Western medicine today, I believe, is that many of its therapeutic principles may not be valid. In the example of high blood pressure above, Western medicine mistakes the symptom for the disease. Thus, although the means are excellent, the disease still cannot be cured because the therapeutic principle is faulty.
Another example is the case of SARS. The principle underlying research today in finding a cure for SARS is that if doctors understand the SARS virus they can cure patients of SARS. In my opinion, this principle may not be valid. If out of 100 persons infected with the virus, 98 of them could overcome it, the problem lies not with the virus but with the 2 persons who succumb. The question then is not how the virus kills people, but why the 2 persons could not overcome the virus when the other 98 could. The onus of the research, therefore, should be on the patients, rather than on the virus.
Research scientists could ask “What went wrong in the natural working of the two persons who succumb to the virus?” In other words, the Chinese physician attempts to find out the patient’s conditions in relation to the disease causing agents. If, for example, the patient’s condition is “weakening of the lung system”, by strengthening the lung systems by appropriate therapeutic means the Chinese physician can help the patient recover.
As shown in the two examples above, due to the different philosophy between Chinese and Western medicine, these two systems cannot be integrated into a single system. The greatest contribution Chinese medicine can make towards Western medicine, I believe, is its philosophy.
According to traditional Chinese medical philosophy, a person becomes ill because one or more of his natural systems are not working properly. If we restore the natural working of these systems, the patient will recover as a matter of course. Therefore, the onus of medicine — in diagnosis, pathology, therapeutic, research, etc — should be on the patient, finding out what went wrong inside him due to the influence of outside factors, and not on the outside factors like cholesterol and virus that cause the changes inside him.
The question and answer are reproduced from Question 1 of the May 2003 Part 1 issue of the Question-Answer Series.