An Initial Exploration of the Theoretical Basis and Clinical Methods of TCM-Western Medicine Integration—Pei Zhengxue, Gansu Academy of Medical Sciences

bright teeth, various new machines and tools emerged one after another, especially the invention of astronomical telescopes and microscopes, which opened the door to the mysteries of nature for humanity and provided unprecedented favorable conditions. Thus, natural science broke free from the confines of scholastic philosophy and took bold steps toward experimental research. In the field of medicine, thanks to the widespread use of microscopes, medicine advanced into the microscopic world through experimental research; the discovery of cells and the understanding of blood circulation were both born on this foundation. In the mid-18th century, modern large-scale industry powered by steam engines emerged, providing even more conveniences for the development of medicine. Precise instruments promoted the development of basic medical research, and the emergence of a series of important theories and achievements quickly made Western medicine stand out with a brand-new appearance. In summary, the development of TCM is based on agriculture and handicrafts; the development of Western medicine, on the other hand, is based on large-scale industry. The different economic bases on which the two develop determine their completely different characteristics. First, looking at the research methods, Western medicine relies entirely on experimental research, using advanced instruments to complete every stage of the experiment; TCM, on the other hand, relies entirely on logical reasoning. Apart from observing the external manifestations of disease and inquiring about the patient’s medical history, the doctor’s thought processes run throughout the entire process of syndrome differentiation and treatment. Based on these differences in methodology, the two types of medicine inevitably differ in the following aspects. ① Western medicine emphasizes microscopic understanding; TCM emphasizes macroscopic understanding. ② Western medicine focuses on local understanding, while TCM focuses on overall understanding.

An Initial Exploration of the Theoretical Basis and Clinical Methods of TCM-Western Medicine Integration—Pei Zhengxue, Gansu Academy of Medical Sciences “The integration of TCM and Western medicine”—this major issue concerning the development of traditional Chinese medicine has attracted great attention from medical professionals both at home and abroad. The author attempts to offer personal views on the theoretical basis and clinical methods of this issue. Please feel free to criticize any shortcomings. I. Theoretical Basis of TCM-Western Medicine Integration TCM and Western medicine originated and developed on different social foundations. As Engels stated in “Dialectics of Nature,” “When the economic base changes, the entire superstructure undergoes change, sooner or later”①. The differences between TCM and Western medicine are precisely the result of such changes in the superstructure. TCM became an academic discipline around the fourth century BC, during a period of transition from slave society to feudal society in China. In line with the reform of the ownership of the means of production, TCM broke free from the shackles of divine authority and the concept of destiny, finally separating itself from witchcraft. The famous TCM physician Bian Que was a representative figure of this transformative period,

and the “Yellow Emperor’s Classic of Internal Medicine” was the representative work of that era. Over the subsequent two thousand-plus years, China remained in a long feudal society (after the Opium War in 1940, it became a semi-feudal, semi-colonial society), with an economic base primarily composed of individual farming and scattered handicrafts. Such an economic foundation could not provide modern instruments and equipment for the development of medicine, let alone microscopic data on physiology, anatomy, biochemistry, pathology, and other areas. Therefore, what people engaged in TCM clinical practice and theoretical exploration could rely on were only patients’ complaints and the external manifestations of disease. Beyond that, if there was anything else to rely on, it was the TCM practitioners’ own thinking and

analytical abilities. On the other hand, the development of Western medicine took place under completely different social conditions from TCM. Starting in the 16th century, with the development of mining, capitalism began to emerge in Europe, and various new machines and tools appeared one after another, especially the invention of astronomical telescopes and microscopes, which opened the door to the mysteries of nature for humanity and provided unprecedented favorable conditions. Thus, natural science broke free from the confines of scholastic philosophy and took bold steps toward experimental research. In the field of medicine, thanks to the widespread use of microscopes, medicine advanced into the microscopic world through experimental research; the discovery of cells and the understanding of blood circulation were both born on this foundation. In the mid-18th century, modern large-scale industry powered by steam engines emerged, providing even more conveniences for the development of medicine. Precise instruments promoted the development of basic medical research, and the emergence of a series of important theories and achievements quickly made Western medicine stand out with a brand-new appearance. In summary,

TCM’s development is based on agriculture and handicrafts; Western medicine’s development, on the other hand, is based on large-scale industry. The different economic bases on which the two develop determine their completely different characteristics. First, looking at the research methods, Western medicine relies entirely on experimental research, while TCM relies entirely on logical reasoning. In addition to observing the external manifestations of disease and inquiring about the patient’s medical history, the doctor’s thought processes run throughout the entire process of syndrome differentiation and treatment. Based on these differences in methodology, the two types of medicine inevitably differ in the following aspects. ① Western medicine emphasizes microscopic understanding; TCM emphasizes macroscopic understanding. ② Western medicine focuses on local understanding, while TCM focuses on overall understanding.

Theoretical Basis and Clinical Methods of TCM-Western Medicine Integration—Pei Zhengxue, Gansu Institute of Medical Sciences “The integration of TCM and Western medicine”—this major issue concerning the development of traditional Chinese medicine has attracted great attention from medical professionals both at home and abroad. The author attempts to offer personal views on the theoretical basis and clinical methods of this issue. Please feel free to criticize any shortcomings. I. Theoretical Basis of TCM-Western Medicine Integration TCM and Western medicine originated and developed on different social foundations. As Engels stated in “Dialectics of Nature,” “When the economic base changes, the entire superstructure undergoes change, sooner or later”①. The differences between TCM and Western medicine are precisely the result of such changes in the superstructure. TCM became an academic discipline around the fourth century BC, during a period of transition from slave society to feudal society in China. In line with the reform of the ownership of the means of production, TCM broke free from the shackles of divine authority and the concept of destiny, finally separating itself from witchcraft. The famous TCM physician Bian Que was a representative figure of this transformative period,

and the “Yellow Emperor’s Classic of Internal Medicine” was the representative work of that era. Over the subsequent two thousand-plus years, China remained in a long feudal society (after the Opium War in 1940, it became a semi-feudal, semi-colonial society), with an economic base primarily composed of individual farming and scattered handicrafts. Such an economic foundation could not provide modern instruments and equipment for the development of medicine, let alone microscopic data on physiology, anatomy, biochemistry, pathology, and other areas. Therefore, what people engaged in TCM clinical practice and theoretical exploration could rely on were only patients’ complaints and the external manifestations of disease. Beyond that, if there was anything else to rely on, it was the TCM practitioners’ own thinking and

analytical abilities. On the other hand, the development of Western medicine took place under completely different social conditions from TCM. Starting in the 16th century, with the development of mining, capitalism began to emerge in Europe, and various new machines and tools appeared one after another, especially the invention of astronomical telescopes and microscopes, which opened the door to the mysteries of nature for humanity and provided unprecedented favorable conditions. Thus, natural science broke free from the confines of scholastic philosophy and took bold steps toward experimental research. In the field of medicine, thanks to the widespread use of microscopes, medicine advanced into the microscopic world through experimental research; the discovery of cells and the understanding of blood circulation were both born on this foundation. In the mid-18th century, modern large-scale industry powered by steam engines emerged, providing even more conveniences for the development of medicine. Precise instruments promoted the development of basic medical research, and the emergence of a series of important theories and achievements quickly made Western medicine stand out with a brand-new appearance. In summary,

TCM’s development is based on agriculture and handicrafts; Western medicine’s development, on the other hand, is based on large-scale industry. The different economic bases on which the two develop determine their completely different characteristics. First, looking at the research methods, Western medicine relies entirely on experimental research, while TCM relies entirely on logical reasoning. In addition to observing the external manifestations of disease and inquiring about the patient’s medical history, the doctor’s thought processes run throughout the entire process of syndrome differentiation and treatment. Based on these differences in methodology, the two types of medicine inevitably differ in the following aspects. ① Western medicine emphasizes microscopic understanding; TCM emphasizes macroscopic understanding. ② Western medicine focuses on local understanding, while TCM focuses on overall understanding.

<!-- translated-chunk:2/22 -->

The various stages of experimental research conducted with the aid of advanced instruments; in contrast, TCM’s understanding of disease is entirely based on logical reasoning. Apart from observing the external manifestations of the disease and inquiring about the medical history, the physician’s thought process permeates the entire course of syndrome differentiation and treatment. Due to these methodological differences, the two systems inevitably emphasize different aspects: ① Western medicine focuses on micro-level understanding, whereas TCM emphasizes macro-level understanding; ② Western medicine focuses on localized understanding, while TCM emphasizes holistic understanding.

③ Western medicine emphasizes the pathogenicity of the causative agent, whereas TCM focuses on the body’s reactive response. Based on the above discussion, TCM and Western medicine are two completely different medical systems that employ distinct methods and approaches to explore the essence of disease. Clinical practice has demonstrated that for diseases primarily characterized by local manifestations or centered on the pathogenic changes caused by the causative agent, Western medicine often achieves better therapeutic outcomes than TCM. Examples include acute infectious diseases, infectious disorders, and localized damage to certain organs or limbs. Conversely, for diseases predominantly presenting with systemic symptoms and focusing on the body’s reactive responses, TCM typically yields better results than Western medicine. Examples include neurasthenia, menstrual irregularities, collagen diseases, chronic nephritis, and chronic hepatitis. Some argue that TCM excels in treating chronic conditions, while Western medicine is superior in managing acute illnesses—this view holds some merit. When a disease first manifests, its impact is usually confined to the affected area and the corresponding system; however, once it progresses to a chronic stage, it inevitably leads to dysregulation across multiple systems, including the endocrine, immune, metabolic, and autonomic nervous systems. Therefore, Western medicine’s microscopic perspective, focus on pathogens, and localized approach are highly suited to the former, whereas TCM’s macroscopic understanding, emphasis on the body’s response, and holistic view are better aligned with the latter. The aim of integrating TCM and Western medicine is to combine macro and micro perspectives, holism and locality, as well as the views on pathogens and the body’s response. Undoubtedly, this integration will benefit the advancement of medical science. At the same time, TCM will inevitably enter the modern scientific network through numerous points of convergence with Western medicine, becoming an indispensable component of the modern scientific system. In today’s era of rapid development in natural sciences, TCM will mutually reinforce and advance in tandem with modern technology. Work

Ling Shou Ya Jia Jie Xin

※ Author II. Clinical Approaches to Integrating TCM and Western Medicine East Tools 1. Combining Macro and Micro Perspectives

It is imperative to introduce Western medicine’s microscopic understanding of disease into the TCM syndrome differentiation system—a pressing task for advancing TCM-based diagnosis and treatment. By implementing this clinical approach, which integrates macro and micro perspectives, TCM will embark on a path of experimental research. Throughout history, TCM practitioners—from Bian Que to Xiao Longyou, Pu Fuzhou, and other predecessors—have never had access to the sophisticated machinery provided by large-scale industry for studying TCM. Traditional achievements in TCM have thus relied solely on observing and judging the external manifestations of disease, completely overlooking crucial microscopic indicators that can only be revealed through modern scientific methods and are vital for gaining insight into the inner essence of illness. Every discovery of a microscopic indicator in modern medicine is closely tied to advances in natural sciences; Western medicine and physics, chemistry, microbiology, meteorology, geology... all interpenetrate and mutually reinforce one another, progressing in sync. If the traditional TCM approach to syndrome differentiation and treatment could incorporate modern medical microscopic content and adapt it to TCM principles, there is no doubt that TCM would experience significant progress in the near future. Take liver disease as an example to illustrate this point. According to traditional TCM theory, liver disease is categorized based on macroscopic observations into conditions such as liver qi stagnation, liver wood overcoming earth, damp-heat in the liver and gallbladder, liver-kidney yin deficiency, spleen-kidney yang deficiency, and qi stagnation with blood stasis. For liver qi stagnation, the recommended formula is Chaihu Shugan San with added herbs; for liver wood overcoming earth, Xiaoyao San with added herbs is advised; for damp-heat in the liver and gallbladder, Longdan Xiegan Tang with added herbs is prescribed; for liver-kidney yin deficiency, Yigui Tongyuan Yin with added herbs is suggested; for spleen-kidney yang deficiency, Shibi Yin combined with Wuling San with added herbs is recommended; and for qi stagnation with blood stasis, Gexia Zhuyu Tang with added Lingzhi San is used. On top of these macroscopic diagnoses, if we were to incorporate modern medical microscopic data related to liver disease—such as changes in liver function tests, plasma proteins, alpha-fetoprotein, and so forth—and comprehensively consider them through the lens of TCM syndrome differentiation, it would undoubtedly greatly enhance TCM’s understanding of liver disease and improve treatment outcomes. Through long-term clinical practice, I have identified several patterns that colleagues may find useful when addressing this issue. To reduce GPI levels, one can use heat-clearing and detoxifying herbs such as Erhua, Lianqiao, Gongying, Baijiangcao, Xiakucao, Banlangen, Longdancao, and Chuipencacao on the basis of traditional macroscopic diagnosis; to lower turbidity in liver function tests and turn flocculent liver function test results negative, one should employ tonifying and consolidating herbs like Huangqi, Dangshen, Shouwu, and Danggui. According to pharmacological evidence, the former corresponds to excess conditions caused by heat-toxin, while the latter reflects deficiency conditions due to qi deficiency and blood loss. An increase in GPT indicates elevated serum transaminase levels, signifying “excess”; an increase in turbidity suggests reduced serum albumin levels, indicating “deficiency.” As stated in the Inner Canon: “Excess should be eliminated, deficiency should be replenished,”