Discussion on the Integration of Traditional Chinese Medicine and Western Medicine Based on the Characteristics of TCM Theory 1977.8.10

Discussion on the Integration of Traditional Chinese Medicine and Western Medicine Based on the Characteristics of TCM Theory 1977.8.10

The foundational theories of TCM represent the essence of traditional Chinese medicine. As Chairman Mao once said, "Chinese medicine is a great treasure trove that we should strive to explore and enhance." To unlock this treasure, one must first study the fundamental theories of TCM, as these theories permeate every aspect of traditional Chinese medicine, giving it a unique theoretical system distinct from other medical systems worldwide. When Western medicine practitioners study TCM, they often struggle to adapt to its diagnostic methods, which affects their learning progress to varying degrees. Why does this incompatibility arise? To understand this, we need to examine the historical context in which TCM theory was developed.

1. TCM evolved in a completely different historical context from modern medicine.

Like other disciplines, TCM is part of the superstructure of society, and its form and characteristics are closely tied to the economic base upon which it depends. TCM emerged during the long feudal era. In the slave society, due to low productivity, there was no economic foundation for the development of medicine; people relied solely on superstitious practices such as prayer and witchcraft to survive. Starting in the 3rd–4th centuries BC, with the rise of the new landlord class, China transitioned from a slave society to a feudal society—a monumental transformation that marked a revolutionary breakthrough in productive forces over production relations. From then on, agriculture and handicrafts in China broke free from the shackles of slavery and began to develop rapidly, laying the groundwork for the earliest theories of TCM. The emergence of the outstanding physician Bian Que at that time signaled the separation of TCM from witchcraft, establishing TCM as an independent discipline. Over the following two millennia, China remained in a feudal and semi-feudal society, with an economic base dominated by individual agriculture and handicrafts that never changed. Due to this characteristic, it was impossible to develop advanced tools like microscopes and X-ray machines, which only modern large-scale industry could produce, let alone biochemical, pathological, and clinical diagnostic and therapeutic instruments. Consequently, when practicing medicine, people could only observe the external manifestations of disease and the subjective sensations of patients; beyond that, the only resources available were the clinicians' own thinking and analytical abilities. It was within this social context that traditional Chinese medicine developed. What about modern medicine? Its historical context is entirely different from TCM. From the mid-16th century to the early 17th century, the Industrial Revolution in Britain gave rise to large-scale industries powered by steam engines, leading to the emergence of capitalist society in the West. Under such transformed economic conditions, the superstructure inevitably underwent corresponding changes. With the invention of the microscope, the discovery of bacteria, and advances in biochemistry, pathology, and anatomy, Western medicine presented itself to the world in a completely new light. We can say that TCM developed on the basis of agriculture and handicrafts, while Western medicine developed on the basis of large-scale industry. Because of this difference, the former had to rely on doctors' sensory perception and reasoning to analyze and synthesize clinical conditions and achieve differentiated treatment without advanced tools, whereas the latter could use sophisticated instruments to conduct systematic, direct research on the changes caused by pathogens within the body.

2. Comparison between TCM and Western Medicine

(1) Using dysentery as an example to compare the characteristics of TCM and Western Medicine

Western Medicine: Dysentery bacilli (Shigella, Sonnei, Flexneri, and Franz) cause congestion, edema, and inflammatory exudation in the lower colon; systemic toxic symptoms include fever, headache, body aches, irritability, delirium, coma, convulsions, circulatory failure, and respiratory failure; local irritation symptoms include tenesmus and purulent bloody stools. Treatment: Primarily focuses on inhibiting the pathogen through medication, supplemented by fluid replacement and correction of electrolyte imbalances.

TCM: Tenesmus ← pain due to obstruction ← qi stagnation causes obstruction ← dampness and heat combine to cause qi stagnation. The basis for damp-heat: Long summer brings dampness, summer brings heat—season of onset; pus represents dampness, blood represents heat—characteristics of stool; yellow color indicates heat, greasiness indicates dampness—tongue appearance; slippery pulse indicates dampness, rapid pulse indicates heat—pulse diagnosis. Treatment: Clearing heat and draining dampness to address the root cause, regulating qi and relieving pain to treat the symptoms; Xianglian Wan is a standard formula formulated according to this principle. Additionally, promoting blood circulation can help resolve pus in the stool, and regulating qi can alleviate tenesmus—these principles can be applied as appropriate.

From the analysis of dysentery above, we can see: ① Western Medicine—starts from the inside out, from cause to symptom; TCM—starts from the outside in, from symptom to cause. ② Western Medicine—focuses on the pathogenicity of the agent; TCM—focuses on the body's reaction. ③ Western Medicine—conducts direct observation and scientific experimentation; TCM—relies on objective analysis and philosophical reasoning. Due to these three differences, the following consequences naturally arise: Western Medicine—focuses on the local (sometimes neglecting the whole); TCM—focuses on the whole (sometimes neglecting the local). Some say Western Medicine is like looking at Lanzhou from the South Gate Crossroads—prone to metaphysical thinking (separating the local from the whole); TCM is like viewing Lanzhou from Mount Gaolan—prone to subjective abstraction (substituting macro for micro). Engels stated in "Anti-Dühring": "When we thoughtfully examine nature, human history, and our own mental activities, what first appears before us is an endlessly interwoven tapestry of interconnected and interacting phenomena, in which nothing is static or immutable—everything is in motion, changing, arising, and disappearing. This primitive, simple, yet fundamentally correct worldview is the worldview of ancient Greek philosophy... However, although this view correctly captures the general nature of the overall picture of phenomena, it is insufficient to explain the details that make up this overall picture. Without knowing these details, we cannot fully grasp the big picture. To understand these details, we must isolate them from their natural or historical connections and study each one individually in terms of their specific characteristics, causes, and effects. But this approach also leaves us with a habit of isolating natural objects and processes from their broader connections, examining them separately rather than as dynamic entities, treating them as static rather than changing, as eternal rather than transient, as dead rather than alive. This method of studying things, after being transferred from natural science to philosophy by Bacon and Locke, led to the limitations characteristic of recent centuries—the metaphysical way of thinking." Engels' words can be vividly applied to the relationship between TCM and Western Medicine. In fact, the theoretical system of TCM, like the worldview of ancient Greece, belongs to naive materialism and spontaneous dialectics. This dialectical approach only considers the overall picture of disease occurrence and development, correctly grasping the general outline but knowing very little about the details that compose this overall picture. To gain a more complete understanding of these details, we must extract each detail from the overall picture of disease occurrence and development and study it individually. Western medicine's research methods are somewhat similar to this approach and can be categorized under it. Through the above discussion, we have identified five fundamental differences between the two medical systems: ① philosophical reasoning versus experimental research; ② starting from cause to effect versus starting from effect to cause; ③ starting from the inside out versus starting from the outside in; ④ the whole versus the local; ⑤ the body's reaction versus the pathogen's pathogenicity. Among these, the first three factors pertain to research methods and the order of approach, making them secondary distinctions, while the fourth and fifth are primary distinctions. The fourth relates to scope, and the fifth to nature—essentially two sides of the same issue. Approaching from the whole tends to prioritize the body's reaction, while approaching from the local tends to prioritize the pathogen's pathogenicity. Each medical system has its own strengths and weaknesses.

(2) Using meningococcal encephalitis and Japanese encephalitis as examples to compare the advantages and disadvantages of the two medical systems

TCM: Adopting a holistic perspective and focusing on regulating the body's reaction, TCM has proposed effective formulas for treating Japanese encephalitis, partially resolving the challenge of treating this disease—this is an advantage; however, in clinical practice, TCM still struggles to distinguish Japanese encephalitis from meningococcal encephalitis—this is a disadvantage.

Western Medicine: Focusing on the pathogenicity of the agent and successfully distinguishing between Japanese encephalitis and meningococcal encephalitis—this is an advantage; however, the treatment of the pathogen in Japanese encephalitis remains unresolved—this is a disadvantage. In summary, both TCM and Western Medicine have their respective strengths and weaknesses.

3. Integrating TCM and Western Medicine is the only way to create a unified national medical system

Chairman Mao taught us, "Integrating TCM and Western Medicine to create a unified national medical system." Based on the above analysis, TCM and Western Medicine are two distinct academic systems that study the same phenomenon from two different perspectives: one emphasizes the body's reaction, while the other emphasizes the pathogen's pathogenicity; one approaches from the whole, while the other approaches from the local. Practice has shown that for diseases characterized primarily by systemic manifestations and focused on the body's reaction, TCM tends to be more effective; for diseases characterized primarily by local manifestations and focused on the pathogen's pathogenicity, Western Medicine tends to be more effective. Examples of the former include neurasthenia, arthritis, connective tissue diseases, chronic hepatitis, cirrhosis, and menstrual disorders in women; examples of the latter include various infectious diseases, infections, and surgical conditions. Over the past century, both medical systems have become aware of their inherent biases and have undertaken reforms within their own academic frameworks to correct these biases. In Western medicine, Pavlov's theory of reflexes and Selye's theory of stress response have emerged, along with immunology, which has made significant progress in recent years. These developments have gradually shifted the focus of Western medicine from the local to the whole, from emphasizing the pathogen's pathogenicity to focusing on the body's reaction. In TCM, the Warm Disease School represented by Ye Tianshi and Wu Jutong has introduced numerous heat-clearing and detoxifying herbs such as honeysuckle, forsythia, dandelion, purple flower, burdock, and belamcanda, strengthening TCM's weak points in pathogen inhibition and shifting the focus from the whole to the local, from simply focusing on the body's reaction to focusing on the pathogen's pathogenicity. These facts demonstrate that, driven by objective circumstances, both medical systems are currently undertaking self-reform to address their existing shortcomings. We believe that if this closed-door introspection is transformed into an open, comprehensive reform—integrating TCM's holistic perspective with Western Medicine's localized perspective, combining TCM's emphasis on the body's reaction with Western Medicine's emphasis on the pathogen's pathogenicity—then the resulting new medical system will undoubtedly reach the cutting edge of global medicine. This is the only path for Chinese medical professionals to scale the heights of world medicine, and it is also the glorious road pioneered for us by the great leader Chairman Mao, whose vision transcends time and space.