Symptomatic manifestations, while neglecting the local features of pleuritis. Based on this difference in perspective,

Symptomatic manifestations, while neglecting the local features of pleuritis. Based on this difference in perspective, different therapeutic approaches have emerged. Western medicine adopts thoracentesis to drain pleural effusion, thereby alleviating local symptoms caused by pleural fluid accumulation, while simultaneously administering antibiotic therapy targeting the pathogen; Traditional Chinese Medicine, on the other hand, uses modified Xiaochaihu Tang combined with Xiaoxianxiong Tang for clinical treatment, primarily focusing on systemic syndromes, essentially emphasizing the regulation of the body's reactivity. In view of this, when pleuritis patients still experience residual pleural reactions after pleural fluid absorption—such as chest pain and bitter taste in the mouth—Western medicine often achieves very limited efficacy; likewise, for patients with excessive pleural effusion, purely TCM treatment also finds it difficult to achieve complete success. Engels stated in "Dialectics of Nature": "Among the Greeks ------ precisely because they had not yet entered into the anatomical and analytical study of nature ------ nature was still regarded as a whole and observed from a general perspective. The overall interconnectedness of natural phenomena had not yet been demonstrated in detail; for the Greeks, this interconnectedness was a direct intuitive result. Herein lies the flaw of Greek philosophy, which later had to yield to another viewpoint. However, here also lies its advantage over all subsequent metaphysical adversaries. If, in detail, metaphysics is more correct than the Greeks, then overall the Greeks are more correct than metaphysics." Although this argument pertains to ancient Greek philosophy and modern metaphysics, it aptly evaluates the advantages and disadvantages of viewing things solely from a holistic or solely from a localized perspective. This can provide inspiration for a deeper understanding of both Chinese and Western medicine. Of course, modern Western medicine is by no means equivalent to metaphysics; nor is Traditional Chinese Medicine entirely identical to ancient Greek philosophy—this must be clarified. Due to these differences between Chinese and Western medicine, their respective paths of development have revealed distinct achievements and shortcomings. Taking research on Japanese encephalitis and epidemic cerebrospinal meningitis as examples, for many years Traditional Chinese Medicine has only adopted a holistic approach, believing that these two diseases both belong to the category of heat invading the pericardium, with excessive heat damaging yin and causing blood stasis. This overlooks the fundamental differences between Japanese encephalitis and epidemic cerebrospinal meningitis, thus revealing a deficiency in TCM’s understanding of these two diseases. At the same time, TCM’s treatment of Japanese encephalitis focuses on regulating the body’s reactivity, employing methods such as detoxification, opening the orifices, and relieving spasms, achieving certain clinical efficacy—here again demonstrating the positive significance of TCM’s syndrome differentiation and individualized treatment. Western medicine, by contrast, approaches these two diseases from a pathogenic perspective, conducting thorough experimental research on the pathogens that cause Japanese encephalitis and epidemic cerebrospinal meningitis, thereby enabling a complete distinction between the two diseases in terms of etiology, pathology, and clinical presentation. From this it can be seen that these are two completely different illnesses, highlighting the superiority of the Western medical pathogenic viewpoint. However, because Western medicine places too much emphasis on inhibiting the pathogen, this to some extent weakens the possibility of improving treatment outcomes through other avenues. For many years, this has resulted in very limited progress in treating these diseases, thus exposing the limitations of a purely pathogenic perspective. Through this example, we can clearly see that, during their respective developmental processes, Chinese and Western medicine, due to their differing approaches to understanding disease, have developed unique strengths in certain areas, while also encountering insurmountable weaknesses in others. III. Integrating Chinese and Western Medicine Is an Important Path for Developing Traditional Chinese Medicine According to the above discussion, Chinese and Western medicine are two distinct medical systems that study human diseases from different directions and using different methods. Clinical practice has proven that for diseases primarily characterized by systemic manifestations and focused on changes in the body’s reactivity, the efficacy of TCM often surpasses that of Western medicine—for example, in cases of neurasthenia, menstrual disorders, arthritis, connective tissue diseases, chronic nephritis, and chronic hepatitis. Conversely, for conditions mainly presenting with local symptoms and centered on the pathogenic properties of the causative agent, Western medicine generally outperforms TCM—for instance, in various acute infectious diseases, infectious ailments, and localized damage to specific organs or limbs. Some say that Western medicine excels at treating acute illnesses, while TCM excels at treating chronic conditions—this assertion does have some merit. This is because, at the onset of a disease, its impact is usually confined to the affected area and related systems; once it becomes chronic, however, it inevitably leads to systemic dysfunction, affecting the endocrine system, immune system, metabolic system, autonomic nervous system, and so forth. Therefore, the Western medical pathogenic perspective and localized interventions are more suitable for the former, whereas TCM’s holistic systemic view and measures aimed at regulating bodily reactivity are better suited to the latter. This situation arises as an inevitable consequence of the inherent biases within each medical tradition. Throughout the history of modern medicine, many innovative physicians in both Chinese and Western medical fields have recognized these shortcomings in their respective systems. In the Western medical field, Pavlov’s theory of reflexes and Selye’s theory of stress response have emerged one after another, along with the rapidly developing field of immunology in recent years. These theories have, to a certain extent, shifted the focus of Western medical scholarship from the local to the holistic, and from the pathogenic properties of the causative agent to the body’s reactivity. In the TCM field, schools such as the Warm Disease School represented by Ye Tianshi and Wu Jutong have also appeared, advocating the extensive use of herbs like Forsythia, Lonicera, Bovine Bezoar, Rhinoceros Horn, Dandelion, Burdock Seed, and Belamcanda to clear heat and detoxify, thereby strengthening TCM’s previously weak link in pathogen inhibition. To some extent, this has begun to shift the focus of TCM scholarship from the holistic to the local, and from the body’s reactivity to the pathogenic properties of the causative agent. These facts demonstrate that, under the impetus of objective circumstances, both Chinese and Western medicine have already initiated internal reforms aimed at addressing their own shortcomings. There is no doubt that this is beneficial for further reform of medicine; however, if this internal reform is extended to the relationship between Chinese and Western medicine—that is, combining TCM’s emphasis on the holistic with Western medicine’s emphasis on the local, and integrating TCM’s focus on regulating bodily reactivity with Western medicine’s focus on inhibiting pathogenicity—then it will greatly benefit the development of modern medical science, enabling traditional Chinese medicine to make its due contribution to the health care of people worldwide. 9 On the Modernization of Traditional Chinese Medicine Pei Zhengxue The Four Modernizations are the top priority in building socialism with Chinese characteristics. The modernization of medical science is no exception. This includes both the modernization of Western medicine in China and the modernization of traditional Chinese medicine. The modernization of Western medicine in China benefits from the wealth of experience accumulated by Western countries, significantly reducing the complexity of this task. In contrast, TCM is a medical system entirely different from modern medicine; its theoretical system still falls, to some extent, within the realm of naive materialism and spontaneous dialectics. Consequently, its modernization process appears relatively complex and arduous. Nevertheless, as long as we unite in purpose and strive diligently, this glorious historical mission will surely be accomplished step by step. I. Studying and organizing classic TCM texts and traditional TCM theory is the foundation of TCM modernization Traditional TCM theory originated with the emergence of classics such as the "Inner Canon," "Difficult Classic," and "Shanghan Zabing Gou," and through the development and supplementation by generations of scholars, it has evolved into an independent theoretical system encompassing yin-yang, five elements, qi and blood, nutritive and defensive qi, zang-fu organs, meridians, causes of disease, pathogenesis, diagnostic methods, treatment principles, prescriptions, acupuncture, and health preservation. It pays close attention to the interconnections among various systems of the human body, as well as to the close relationship between humans and changing natural conditions, objectively summarizing the patterns of disease onset and progression to guide clinical practice. Looking back at the formation of this theoretical system, although classics such as the "Inner Canon" played an indispensable role in laying its foundation, the painstaking efforts of later generations of scholars in gradually perfecting it are equally significant. Notably, following the four classic works, Wang Shuhe and Huangfu Mi systematically elaborated on pulse diagnosis and acupuncture, respectively; later, Chao Yuanfang wrote "Various Causes and Symptoms of Diseases," and Sun Simiao authored "Thousand Gold Prescriptions" and "Thousand Gold Supplemental Prescriptions," making important expositions and summaries on causes, pathogenesis, and syndrome differentiation. By the Song and Yuan dynasties, a flourishing era of diverse schools of thought emerged in the history of Chinese medicine. Liu Hejian’s clearing heat and draining fire, Zhu Danxi’s nourishing yin and lowering fire, Zhang Zihe’s attacking and eliminating fire, and Li Dongheng’s sweet-warm heat elimination—all strengthened the understanding of fire-related syndromes from different angles, thereby advancing the treatment of fiery diseases in traditional Chinese medicine by a significant step. After the Ming and Qing dynasties, the Warm Disease School rose to prominence, with Ye Tianshi and Wu Jutong proposing the “Wei Qi Ying Xue” and “San Jiao” syndrome differentiation systems, advocating the use of herbs such as Forsythia, Lonicera, Dandelion, Indigo Root, Burdock Seed, and Radix Scrophulariae to clear heat and detoxify, thus reinforcing the weak link in pathogen inhibition that previous generations had overlooked and supplementing the “Shanghan” school’s emphasis on pungent-cold and yang-recovering therapies. Prior to this, there were also the Yishui School represented by Zhang Jiegu and the Warming and Tonifying School represented by Zhao Xianke and Zhang Jingyue (the “Mingmen School”), whose arguments greatly enriched the content of traditional Chinese medicine regarding zang-fu organs and organ-specific syndromes. All of this demonstrates that the formation of traditional Chinese medicine theory has been the result of continuous enrichment and development by generations of physicians, gradually evolving into an independent theoretical system. Over the past century, although the further refinement of this theoretical system has been somewhat slowed down due to factors such as imperialist cultural aggression and domestic national nihilism, there have still been numerous outstanding medical scholars who have made remarkable contributions to its development—for example, Tang Rongchuan’s exposition on clearing fire and stopping bleeding, and Zhang Xichun’s argument on atmospheric collapse. Particularly since the founding of New China, under the guidance of the Party’s TCM policies, renowned senior TCM doctors have each presented their own views. Pu Fuzhou’s application of Zhenwu Tang to treat hypertension achieved remarkable results, correcting the notion that “all cases of high blood pressure are due to yang excess”; Yue Meizhong’s insight that “acute illnesses require courage and insight, while chronic illnesses require method and adherence,” along with his discussions on the rules of treating geriatric diseases, have all provided substantial supplements to traditional TCM theory. This shows that even amid the rapid advancement of TCM modernization and the integration of Chinese and Western medicine, the enrichment and development of traditional TCM theory continue to proceed under the impetus of objective needs. This is a continuation of the trend in TCM development since the “Inner Canon,” “Difficult Classic,” “Shanghan,” the “Four Great Masters of the Jin and Yuan Dynasties,” and the Warm Disease School—it represents an important source of traditional Chinese medicine development, and any basic TCM theory upon which TCM modernization and the integration of Chinese and Western medicine are based ultimately originates from this source. If we neglect the inheritance and development of this source, so-called TCM modernization and the integration of Chinese and Western medicine will inevitably become water without a source and trees without roots. Therefore, in the current effort to develop traditional Chinese medicine, inheriting and refining traditional TCM theory is the foundation of all TCM development initiatives. Neglecting this foundation will reduce TCM modernization to the situation of “if the skin is gone, where will the fur cling?” II. Enriching Traditional Chinese Medicine Through the Integration of Chinese and Western Medicine (1) The inevitability of integrating Chinese and Western medicine Throughout its historical development, traditional Chinese medicine has always been closely linked with the development of other ethnic medical systems around the world at the same time. Renowned physicians of each era have been adept at absorbing the essence of foreign medicine and adapting it for their own use, thereby enriching the content of traditional Chinese medicine and promoting its development. For example, Zhang Zhongjing’s use of karela in the “Shanghan Zabing Lun” was an imported variety; Sun Simiao’s “Thousand Gold Prescriptions” included portions of India’s “Five Sciences” and recorded more than ten prescriptions from the Hu people’s medical traditions. Wei Yilin’s “Effective Prescriptions of World Physicians” introduced a large number of theories and prescriptions from Arab medicine, with drugs such as senna, fenugreek, psyllium husk, frankincense, myrrh, and amomum cardamomum all being imported. The Warm Disease School’s insightful theory that warm diseases enter through the mouth and nose has been suggested to be related to the introduction of Western medicine into China during the Ming dynasty. As for the works and achievements of Wang Qingren, Tang Rongchuan, and Zhang Xichun, they clearly reflect the incorporation of certain Western medical concepts into traditional TCM theory. In short, throughout the history of TCM development, previous generations of physicians have never rejected the intervention of advanced ideas from contemporary foreign medicine. Today, global medical development is progressing so rapidly that it has advanced to a new stage of transition from micro to macro and from a systems-oriented perspective. When we attempt to develop traditional Chinese medicine, if we fail to consider integration with modern medicine, it is tantamount to losing the most direct and effective avenue for progress. (2) The necessity of integrating Chinese and Western medicine Chinese and Western medicine differ in form and content due to their distinct historical contexts. The former relies solely on external manifestations of disease and the relationship between humans and nature to conduct logical reasoning and identify causes; the latter, however, utilizes advanced tools provided by modern industry—such as microscopes, electron microscopes, X-rays, ultrasound, electrocardiograms, and more—to penetrate deep into the human body and conduct direct, intuitive investigations of the essence of disease. For these reasons, Chinese and Western medicine exhibit the following differences: ① Different approaches to understanding disease: TCM—logical reasoning; Western medicine—experimental research. ② Different perspectives on disease: TCM—macroscopic understanding; Western medicine—microscopic understanding. ③ Different treatment priorities: TCM—regulating bodily reactivity; Western medicine—suppressing the pathogenicity of the causative agent. From these three aspects of difference, we can see that both Chinese and Western medicine have their own strengths and weaknesses. If we combine TCM’s macroscopic understanding with Western medicine’s microscopic understanding, and integrate TCM’s focus on regulating bodily reactivity with Western medicine’s focus on suppressing the pathogenicity of the causative agent, this will undoubtedly deepen our understanding of disease and promote the development of medical science. Moreover, we can even hope that this integration will give rise to a “new pharmacology” that is neither purely Western nor purely Chinese. Modern cybernetics holds that the human body is like a black box: any change inside the box, regardless of size, constantly transmits information to the outside. TCM’s understanding of disease is akin to inferring and determining the internal changes of the black box based on this information; the more information available, the more mature the inference, and the closer the result is to accuracy. Western medicine’s understanding of disease, on the other hand, is like opening the black box and directly observing the internal structural changes. The task of integrating Chinese and Western medicine is therefore akin to combining the analysis of internal structural changes with the analysis of external information, thereby achieving a more comprehensive and systematic understanding of the essence of the black box. Recently, the Beijing Institute of Traditional Chinese Medicine has applied the treatment experience of veteran TCM doctors such as Guan Youbo, following the principles of cybernetics, treating symptoms and signs as information, standardizing them, and then inputting them into computer systems for processing. This has been successfully applied clinically, marking a promising step forward in the integration of Chinese and Western medicine and the modernization of TCM. (3) The advantages of integrating Chinese and Western medicine TCM understands disease from a macro perspective, while Western medicine understands it from a micro perspective, which inevitably leads to the following tendencies: TCM emphasizes the whole and neglects the part, whereas Western medicine emphasizes the part and neglects the whole. Over the past century, both medical traditions have felt that this tendency is a hindrance to their own development, prompting a wave of “modernizing and systematizing Western medicine” within the Western medical community. This movement was spearheaded by Pavlov’s theory of reflexes and followed by Selye’s theory of stress response. In the past 20 years, the rapid development of immunology, cybernetics, and information theory has further deepened this trend. The goal of modernizing Western medicine is to shift its disease perception from the local to the whole, from cells and organs to the overall system, ecology, climate, and society. In contrast, the trend in modern TCM development is exactly the opposite: moving from a systemic and holistic view of the seven emotions, six pathogenic factors, qi, blood, phlegm, dampness, meridians, and zang-fu organs toward a gradual exploration of the local and concrete. The Warm Disease School’s view that diseases enter through the mouth and nose and emphasize clearing heat and detoxifying, Wang Qingren’s anatomical practice and blood circulation promotion, as well as modern research on the essence of the spleen and kidneys, are all components of this process. In summary, the Western medical trend toward systematization and holism, coupled with the TCM trend toward localization and concreteness, is an inevitable outcome of medical development—a natural law of historical evolution. If TCM’s systemic and holistic views are used as a reference for Western medical systematization, and Western medicine’s localized and concrete understanding of disease is used as a reference for TCM’s move toward localization, then the pace of medical development will inevitably accelerate. This mutual borrowing is, in essence, what is commonly referred to as the integration of Chinese and Western medicine. Since the implementation of the integration of Chinese and Western medicine, numerous facts have proven that adopting an integrated approach to studying traditional Chinese medicine can elevate TCM theory to a new level. Chest oppression is a traditional disease name in TCM, analogous to coronary heart disease in modern medicine. The “Jin Gui·Chest Oppression, Heart Pain, Shortness of Breath” chapter states that this condition arises when yin occupies the yang position and yang energy fails to disperse, requiring treatments that invigorate yang energy in the chest. Nine prescriptions are listed, including the Gualou-Saibai-Baijiu decoction, all of which focus on the qi aspect. Although these formulas do have some therapeutic effect, they still fall short of achieving a complete cure. Since the integration of Chinese and Western medicine began, given that this disease is caused by narrowing of the coronary arteries due to atherosclerosis, resulting in insufficient blood supply, it broadly falls under the TCM category of “blood stasis.” Integrators of Chinese and Western medicine have tried using blood circulation-promoting and blood stasis-resolving therapies, significantly improving the efficacy and opening up new avenues for understanding and treating this condition. Based on this new understanding, the Beijing regional collaborative group formulated the “Coronary Heart II” prescription, which is used in combination with Gualou-Saibai-type herbs in clinical practice, achieving an overall effectiveness rate of over 90%. This addition of the “blood stasis” component to the pathogenesis of chest oppression has greatly deepened TCM’s understanding of this condition. Regarding the treatment of edema, TCM has traditionally relied on warming yang to transform water, strengthening the spleen to drain dampness, and dispersing lung qi to promote diuresis, with all medications focusing on the qi aspect. Since the integration of Chinese and Western medicine began, considering that kidney inflammation is the most common cause of edema, and that the pathological changes in kidney inflammation are based on the proliferation of the glomerular basement membrane, this “proliferation” still falls under the TCM category of “blood stasis.” Accordingly, the Shanxi Institute of Traditional Chinese Medicine formulated the “Yishen Decoction,” primarily aimed at promoting blood circulation and resolving blood stasis, for treating various types of kidney inflammation, achieving an effectiveness rate of over 70%. This fact demonstrates that the integration of Chinese and Western medicine has deepened TCM’s understanding of edema and revolutionized its treatment methods, breaking away from the traditional approach of merely warming yang to transform water, strengthening the spleen to drain dampness, and dispersing lung qi to promote diuresis. In recent years, integrators of Chinese and Western medicine have conducted extensive experimental research on the essence of the spleen, discovering that TCM’s relationship with the autonomic nervous system, metabolic system, immune system, and endocrine system is extremely close. Using spleen-strengthening and qi-tonifying methods, they can perform syndrome differentiation and treatment for diseases affecting these systems, thus providing a material basis for “treating different diseases with the same approach.” This has significant implications for strengthening traditional TCM theory. After the founding of New China, Chinese and Western medicine integrators have also conducted a series of experimental studies on the “kidney,” discovering that, in addition to its function in the urinary system, the kidney primarily represents the functions of the hypothalamus-pituitary-adrenal cortex system and the hypothalamus-pituitary-gonadal system. This provides experimental evidence for the traditional TCM view that the kidney is the “foundation of innate constitution” and the “root of life.” Elevating a conclusion formed through logical reasoning in clinical practice to a theory supported by scientific experiments is undoubtedly a major boost for the development of traditional Chinese medicine.