1. Western Medicine Emphasizes Microscopic Understanding, While Chinese Medicine Emphasizes Macroscopic Understanding

1. Western Medicine Emphasizes Microscopic Understanding, While Chinese Medicine Emphasizes Macroscopic Understanding

Since the 16th century, as modern industry gradually rose in the West, Western medicine, aided by advanced tools provided by modern large-scale industry, quickly shifted its focus from the macroscopic to the microscopic. In 1665, the Englishman Robert Hooke first used a self-made microscope to observe cork slices, thereby proposing the concept of plant cells. Subsequently, the Dutch scientist Antonie van Leeuwenhoek, using a microscope with 270x magnification, was the first to observe human bone cells and striated muscle cells and drew detailed illustrations of them. In the early 19th century, the great German philosopher Johann Gottlieb Fichte pointed out that all organisms are composed of cells. By the late 1830s, two German biologists, Matthias Jakob Schleiden and Theodor Schwann, discovered the cell nucleus and described the basic structure of the cell. They argued that although the external forms of organisms vary greatly, their internal structures are unified: they are composed of cells. In the mid-19th century, building on the findings of these scholars, another renowned German pathologist, Rudolf Virchow, conducted his own groundbreaking research in "cell pathology," setting a new milestone in medical research. He believed that living organisms are societies made up of cells, and the body is a federation of cells. As he put it: "Every animal is the sum of countless units of life, and each unit exhibits all the characteristics of life."^②^ Disease, he argued, is the result of changes occurring within a group of cells in the body—a composite of microscopic alterations—and this view opened up a new frontier for Western medicine's emphasis on microscopic understanding. The eminent German bacteriologist Paul Ehrlich once fairly remarked: "Since Virchow's brilliant research pioneered new avenues, people's thinking has focused on locating diseases and identifying their causes, and it is quite evident that this insight has been decisive in our therapeutic work."^③^ Virchow's theory continued to shape the overall trend of Western medical development from the 19th to the 20th century. Western medicine's microscopic understanding of disease has always been the mainstream of modern Western medical epistemology, permeating all branches of Western medical basic theory—such as anatomy, physiology, histology, biochemistry, and pathology—and firmly influencing clinical practice across all specialties.

In contrast, Chinese medicine, which has never benefited from the support of modern large-scale industry, has only been able to move forward slowly along the traditional path of logical reasoning. A review of ancient and modern Chinese medical texts reveals that not a single viewpoint originates from experimental research. For example, the "Six Exogenous Pathogenic Factors" and "Seven Internal Emotional Disorders" theories proposed in the Huangdi Neijing, as well as Chen Wuzhe's "Three Causes Theory," are all based on logical reasoning rather than experimentation, and thus can only be understood from a macroscopic perspective. The "Nine Principles of Pathogenesis" section in the Suwen: Zhenzhi Yaolu is a widely known guiding text for discussing pathogenesis in Chinese medicine; however, since it is purely a macroscopic framework, it lacks precise localization, qualitative analysis, and quantitative assessment. Although it can generally guide clinical practice, as conditions become more complex and variable, different interpretations may arise based on individual experience. For instance, Liu Hejian viewed the "Nine Principles of Pathogenesis" as focusing exclusively on "fire," and from this he derived numerous new insights into "fire" syndromes; Zhang Zihé, on the other hand, found in it new grounds for attacking pathogenic factors. Some have therefore argued that such theories can only provide vague directions for exploration. In recent years, scholars have reorganized the "Nine Principles of Pathogenesis" from the Huangdi Neijing into a more systematic classification, but even after doing so, the results remain largely macroscopic, offering no insight into the microscopic changes underlying disease onset and progression. In short, the etiology, pathogenesis, principles, formulas, and prescriptions of Chinese medicine all fall within the macroscopic realm, with conclusions drawn primarily through logical reasoning.