2. Traditional Chinese and Western medicine have different forms and contents

2. Traditional Chinese and Western medicine have different forms and contents

Because the economic foundations upon which traditional Chinese and Western medicine rely are different, this determines that the two have different forms and contents. Let's take bacterial dysentery as an example to illustrate the different characteristics displayed by the two in diagnosis and treatment.

Western medicine, through experimental research in pathogenetics, first recognizes that this disease is caused by dysentery bacilli (such as Shigella sonnei, Shigella flexneri, Shigella dysenteriae, and Shigella boydii). Through epidemiological experiments, it further understands that these bacteria enter the human body via water, hands, flies, and other routes. Pathological experiments reveal that inflammation occurs in the mucosa of the descending colon and rectum (congestion, edema, inflammatory exudation, ulcers), and this inflammatory change triggers a series of systemic poisoning symptoms—fever, coma, muscle spasms, respiratory failure, circulatory failure—and local irritation symptoms—tenesmus, diarrhea, mucus and pus in the stool.

In terms of treatment, the key is to use antibiotics to suppress the pathogens, combined with correcting fluid and electrolyte balance, as well as addressing respiratory and circulatory failures.

Thus, we can see that Western medicine's understanding of this disease adopts an experimental research approach, proceeding from cause to symptom, with treatment focused on directly controlling the pathogen. In contrast, traditional Chinese medicine's understanding of dysentery begins with analyzing the most important symptom—pus and blood in the stool. Zhang Jiebin said, "Anyone with dysentery must have pus and blood; if there's no pus and blood, how can it be called dysentery?" Pus is slippery and greasy, indicating dampness; blood is bright red, indicating heat; when pus and blood mix, it's a combination of dampness and heat. Additionally:

1. Dysentery often occurs at the transition between the long summer (damp) and summer (hot).
2. The tongue coating in dysentery is often yellow (heat) and greasy (damp).
3. The pulse in dysentery is often slippery (damp) and rapid (heat).

These three observations also support the above view, reflecting both the relationship between humans and nature and the overall relationship among various parts of the human body. Dampness and heat combined easily obstruct the flow of qi, and when qi flow is blocked, pain arises, leading to tenesmus. Therefore, traditional Chinese medicine believes that dampness and heat combined are the root of dysentery, while tenesmus is the manifestation. In treatment, the focus is on clearing heat and drying dampness to address the root, and on regulating qi and relieving pain to address the manifestation.

Part One: Academic Thought

From the above argument, we can see that traditional Chinese medicine's understanding of dysentery adopts a method completely different from Western medicine's experimental research—namely, logical reasoning. Its understanding proceeds from symptom to cause (syndrome differentiation to seek cause), and its treatment focuses on adjusting the body's reactivity to reduce or eliminate the pathogen.

Table 1: Comparison of Disease Understanding Between Traditional Chinese and Western Medicine

Given the above differences in how traditional Chinese and Western medicine understand diseases, each inevitably develops certain preferences and shortcomings. Western medicine's experimental research method, proceeding from cause to symptom and focusing on directly suppressing the pathogen, often results in an emphasis on local manifestations of the disease while neglecting the overall condition of the body and its own resistance capabilities.

Traditional Chinese medicine's logical reasoning method, proceeding from symptom to cause (syndrome differentiation to seek cause) and suppressing the pathogen by adjusting the body's reactivity, often results in an emphasis on the overall condition of the body while neglecting the specific characteristics of the local lesion. Let's take pleurisy as an example to illustrate this issue. Western medicine's understanding of this disease focuses on visual inspection, palpation, percussion, and auscultation of the chest, combined with radiographic and laboratory diagnostics to determine the amount and nature of pleural effusion, which is considered the key to diagnosing the disease. In contrast, traditional Chinese medicine's understanding of this disease focuses on systemic symptoms such as alternating chills and fever, chest oppression, heart palpitations and nausea, and reluctance to eat, combined with pulse and tongue color to determine that the pathogenic factor resides in Shaoyang, which is considered the key to diagnosing the disease.

In diagnosing this disease, Western medicine only focuses on the local manifestations of pleurisy while ignoring the systemic response symptoms; traditional Chinese medicine, on the other hand, focuses on the systemic response symptoms while ignoring the local manifestations of pleurisy. Based on these differing perspectives, the treatment approaches also differ. Western medicine uses thoracentesis to drain pleural effusion to alleviate local symptoms caused by the accumulation of pleural fluid, while simultaneously administering antibiotic therapy to target the pathogen; traditional Chinese medicine, on the other hand, prescribes Xiaochaihu Tang combined with Xiaoxianxiong Tang, adjusted according to the patient's condition, to treat systemic symptoms, essentially focusing on regulating the body's reactivity.

Given this, after the pleural effusion has been absorbed, patients with pleurisy often still experience residual chest pain and bitter taste in the mouth due to lingering pleural reactions, and Western medicine often achieves very little effect in such cases; however, for patients with excessive pleural effusion, purely traditional Chinese medicine treatment is also unlikely to be fully effective.

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Engels stated in his book "Dialectics of Nature": "Among the Greeks—precisely because they had not yet advanced to the dissection and analysis of nature—they still regarded nature as a whole and observed it from a holistic 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 would later have to yield to another viewpoint. However, it also possesses an advantage over all subsequent metaphysical adversaries. If metaphysics is more accurate than the Greeks in details, then, on the whole, the Greeks are more accurate than metaphysics." Although this argument pertains to ancient Greek philosophy and modern metaphysics, it appropriately evaluates the merits and demerits of a purely

[Pei Zhengxue’s Traditional Chinese Medicine—An Introduction to TCM Theory and Clinical Case Studies]{.underline}

The holistic view versus the purely localized perspective—the advantages and disadvantages of understanding things. This can inspire 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 the same as ancient Greek philosophy—this must be clarified.

Due to the aforementioned differences between Chinese and Western medicine, their respective developments have revealed distinct achievements and shortcomings. Take, for example, the research on Japanese encephalitis and epidemic cerebrospinal meningitis: for many years, Chinese medicine has approached these two diseases solely from a holistic perspective, believing that both fall under the category of heat invading the pericardium, with excessive heat injuring yin and causing blood stasis. This overlooks the fundamental differences between Japanese encephalitis and epidemic cerebrospinal meningitis, revealing a deficiency in Chinese medicine’s understanding of these two conditions.

At the same time, Chinese medicine treats Japanese encephalitis by regulating the body's reactivity, employing methods such as detoxification, opening the orifices, and relieving spasms, achieving certain clinical efficacy. This demonstrates the positive significance of TCM’s syndrome differentiation and treatment. In contrast, Western medicine approaches these two diseases from the perspective of pathogens, conducting thorough experimental research on the causative agents of Japanese encephalitis and epidemic cerebrospinal meningitis. As a result, the two diseases can be completely distinguished in terms of pathogen, pathology, and clinical presentation, confirming that they are entirely different illnesses. This highlights the superiority of the Western medical approach based on pathogens.

However, because Western medicine places too much emphasis on suppressing pathogens, this to some extent weakens the possibility of improving treatment outcomes through other avenues. Consequently, for many years, progress in treating these diseases has been limited, revealing the limitations of a purely pathogen-centered approach.

Through this example, we clearly see that, in their development, Chinese and Western medicine, due to their differing methods of disease recognition, have each developed unique strengths in certain areas, while also encountering insurmountable weaknesses in others.

Integrating Chinese and Western Medicine Is an Important Path for Developing Chinese Medicine

Based on the above arguments, Chinese and Western medicine are two distinct medical systems that study human diseases from different directions and using different methods. Clinical applications demonstrate that for diseases primarily characterized by systemic manifestations and focused on changes in the body's reactivity, the therapeutic effects of Chinese medicine often surpass those of Western medicine—for instance, in cases of neurasthenia, menstrual disorders, arthritis, connective tissue diseases, chronic nephritis, and chronic hepatitis. Conversely, for diseases mainly presenting locally and centered on the pathogenicity of the causative agent, Western medicine typically outperforms Chinese medicine—for example, in various acute infectious diseases, infections, and localized damage to specific organs or limbs. Some say that Western medicine excels at treating acute illnesses, while Chinese medicine excels at treating chronic ones—there is indeed some truth to this statement.

This is because, in the early stages of a disease, its impact is usually confined to the affected area and related systems; however, once it becomes chronic, it inevitably leads to systemic dysfunction, affecting the endocrine system, immune system, metabolic system, autonomic nervous system, and so on. Therefore, the Western medical focus on pathogens and localized treatments is more suitable for the former, whereas the Chinese medical holistic view and measures aimed at regulating bodily reactivity are more appropriate for the latter. This situation arises naturally from the inherent biases of each medical tradition.

Throughout the history of modern medicine, many innovative physicians in both Chinese and Western medicine have recognized these shortcomings in their respective fields. In Western medicine, Ivan Pavlov’s theory of reflexes and Hans Selye’s stress response theory emerged one after another, followed by the rapid development of immunology in recent years. These theories have, to some extent, shifted the focus of Western medical scholarship from the local to the holistic, and from the pathogenicity of the causative agent to the body’s reactivity.

In the field of traditional Chinese medicine, schools such as the Warm Disease School, represented by Ye Tianshi and Wu Jutong, have advocated the extensive use of herbs like Forsythia, Lonicera, Bovine Bezoar, Rhinoceros Horn, Dandelion, Burdock Seed, and Belamcanda to clear heat and detoxify, thereby strengthening the weak link in Chinese medicine’s ability to suppress pathogens. To some extent, this has begun to shift the focus of Chinese medical scholarship from the holistic to the local, and from the body’s reactivity to the pathogenicity of the causative agent.

These facts demonstrate that, driven by objective circumstances, both Chinese and Western medicine have already begun internal reforms to address their own shortcomings. There is no doubt that this is beneficial for further medical reform; however, if we expand these internal reforms to encompass the integration of the two medical traditions—that is, combining the holistic emphasis of Chinese medicine with the localized focus of Western medicine, and integrating the body-reactivity-regulating aspect of Chinese medicine with the pathogen-suppressing aspect of Western medicine—this will greatly benefit the development of modern medical science, enabling traditional Chinese medicine to make its due contribution to global healthcare.

(Shanxi Medical Journal, 1978.2)

① Engels: “Dialectics of Nature,” People’s Publishing House, 1971, p. 30 ② Zhang Jiebin: “Leijing (Volume 1),” People’s Health Publishing House, 1980, p. 577

A Discussion on the Modernization of Traditional Chinese Medicine—Pei Zhengxue

The Four Modernizations are the top priority in China’s socialist construction. The same holds true for the modernization of medical science, which 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 available in Western countries, significantly reducing the complexity of this task. In contrast, traditional Chinese medicine is a completely different medical system from modern medicine; its theoretical framework still falls, to some extent, within the scope of naive materialism and spontaneous dialectics. Consequently, its modernization process appears more complex and challenging. Nevertheless, as long as we work together with one heart and one mind, striving diligently, this glorious historical mission will surely be accomplished step by step.

[Pei Zhengxue’s Traditional Chinese Medicine—Introduction to TCM Theory]{.underline}

Facts show that the formation of Chinese medical 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 by factors such as imperialist cultural aggression and domestic national nihilism, there have still been numerous physicians who have made outstanding contributions to its development—for example, Tang Rongchuan’s exposition on draining fire and stopping bleeding, and Zhang Xichun’s argument regarding downward collapse of qi. Particularly since the Chinese Civil War, encouraged by policies promoting traditional Chinese medicine, renowned senior TCM doctors have each presented their own views. Pu Fuzhou’s successful use of Zhenwu Decoction to treat hypertension corrected 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 to principles,” along with his discussions on the rules for treating geriatric diseases, have all provided significant supplements to traditional TCM theory. This shows that even amidst the rapid development of TCM modernization and the integration of Chinese and Western medicine, the enrichment and development of traditional TCM theory continues to proceed under the impetus of objective needs. This represents the continuation of the trend in TCM development since the Huangdi Neijing, Shanghan Lun, the Four Great Schools of the Jin and Yuan dynasties, and the Warm Disease School—it is an important source of Chinese medical 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 efforts to develop Chinese medicine, inheriting, organizing, and enhancing traditional TCM theory is the foundation for all approaches to developing TCM. Neglecting this foundation will lead to a situation where TCM modernization becomes what is known as “if the skin is gone, how can the fur remain?”

Part One: Academic Thought