Chapter 11-2 Difference Between TCM and Western Medicine

Western medicine originated in modern Western society, flourishing alongside the development of Human Anatomy, the invention of various drugs, and medical instruments. In recent decades, Western medicine has increasingly specialized into increasingly specialized categories, focusing on treatment methods discovered after identifying the lesions.

Reflecting on the past decades, Western medicine has held an overwhelmingly dominant position over TCM, much like how Western science has over Chinese traditional culture. Whenever controversies regarding TCM arise, they quickly escalate into debates about values, as if anything related to traditional culture is immediately labeled as "feudal superstition", and scientists tend to "avoid it for fear of being tainted".

Modern formal education in China is a product of the "Western learning spreading to the East", giving rise to what the common people perceive as "science". After the reform and opening up, the healthcare market also experienced unprecedented opportunities. During this period, a large number of Western medicines flooded in, multinational companies brought their own pharmaceutical representatives. These representatives marketed medicines in hospitals as commodities, leading to substantial profits for many of them and the hospitals. Compared to many traditional medicines available in the market, these Western medicines were indeed of higher quality, resulting in a phenomenon where Western medicines occupied more than 70% of the market for some time. Many families found themselves unable to afford expensive medications, leading to poverty due to illness, forcing the market to be dominated by "bad money driving out good". Prof. Li Ling, director of the Peking University Health Development Research Center, said, "The entire medical market is filled with chaos, with tens of thousands of drug numbers being approved every year... The most profitable drugs are those that are safe, ineffective, and highly profitable, which are not actually drugs. Anyway, they can be prescribed casually; they won't kill you, but they won't cure you either."

It is clear that the approach to treating illness in TCM is entirely different from that of Western medicine.

Tell a story from ancient China about "The Great Physician Treats the Unmanifested Disease".

King Wei-wen once asked the famous physician Bian-Que: "Your family has three brothers, all are skilled in medicine. Who among you is the best?"

Bian-Que replied, "My eldest brother is the best, my second brother is next, and I am the worst."

The king asked again:"Then why are you the most famous?"

Bian-Que answered: "My eldest brother is skilled at treating illnesses before they manifest. When he removes the root cause of a disease before it even appears, people don't realize his actions, so his reputation doesn't spread beyond our family, where we hold him in the highest regard. My second brother is good at treating illnesses in their early stages. When people see him treating minor symptoms, they think he only cures mild illnesses, so his reputation is known only within our local community. As for me, I am only good at treating diseases that have fully developed. When people see me using needles, bleeding and administering medicine, they all believe I have excellent medical skills, which is why my fame spreads across the entire country."

Whether Bian-Que was being overly modest, we cannot say, but he distinguished between superior, intermediate, and inferior physicians. The "inferior physician" becomes famous because he treats acute illnesses, as Bian-Que himself did. The contemporary renowned physician Lu Guangxin once said: "Physicians who treat illnesses before they arise are practicing preventive medicine; those who treat illnesses in their early stages are practicing health preservation; and those who treat established illnesses are practicing medical treatment." The last one is what we understand today as part of the hospital medical system. In this sense, most of Western medicine is still somewhat distant from the concept of the "superior physician".

If you encounter a TCM practitioner who is considered an "inferior physician", it usually means they have learned a set of modern Western medical methods in school. They may not be able to take a pulse properly (or only pretend to), and then they issue a bunch of lab tests. Based on the test results, they prescribe a combination of Chinese and Western  medicines. With such a TCM practitioner, getting cured relies on luck. Many TCM graduates only reach the level of an "inferior physician" after graduation, as they are limited to theory and reports. Although they may seem capable of prescribing medicine, they couldn't achieve the immediate results that Western medicine often does.

However, if you encounter a TCM "intermediate physician", they usually have rich clinical experience. They can combine tongue diagnosis, pulse diagnosis, hand diagnosis, and facial diagnosis to analyze imbalances in yin and yang. They then prescribe a treatment plan using very inexpensive, common Chinese herbs, often focusing on acupuncture points and meridians. The prescriptions given by a truly good TCM practitioner can deliver immediate and effective results, with the medicine working as soon as it is taken.

In TCM, the "superior physician" often possesses a worldview that aligns with the concept of "Unity of Man and Nature". This is why it is said that a "superior physician can heal the nation". In ancient China, such individuals were referred to as "national masters" because they could grasp the true essence of TCM and had the ability to foresee and harmonize the energies of an entire space.

So, why is it so difficult for TCM to produce a "superior physician" who is widely recognized by the public?

Firstly, there is a lack of academic criteria to judge TCM. Western medicine can be measured using surgical techniques and definitive scientific indicators, assessed through published articles and surgical success rates. However, it is challenging for TCM practitioners to write articles that are highly recognized by Western academic journals. In contrast, TCM involves numerous methods for treating a single illness, with hardly any two prescriptions alike among different physicians. Furthermore, the treatment methods in TCM defy standardization, making it challenging for modern medicine to acknowledge them.

Secondly, there is a lack of authoritative bodies or experts to evaluate TCM. The issue of who evaluates is crucial in evaluation itself. If the public cannot evaluate, then authority figures must step in, but who qualifies as an "authority"? Often, experts contradict each other, and there are so much skepticism about these "experts" from the public. Due to the absence of orthodox evaluation, TCM remains situated between folk mysticism and Chinese traditional culture, lacking top-down recognition or validation.

Thirdly, mastering TCM is an extremely challenging task. The true essence of TCM involves high-dimensional wisdom and requires a certain level of innate talent. Beyond understanding pharmacology, one must also comprehend celestial meridians, the interplay of yin and yang, the Five Elements, and even some aspects of Feng Shui and psychology. The amount of knowledge that must be integrated is immense. Every TCM treatment case is unique, with no identical prescriptions, which is contrary to Western clinical medicine, where the use of large quantities of repetitive, identical medications yields consistent clinical drug data. In contrast, learning Western medicine involves a "point-to-point" approach. With the aid of modern medical diagnostic tools, such as blood and urine tests, ECG, and ultrasound, it is easy to detect "abnormal" indicators in a patient, allowing the doctor to "accurately" identify the cause and prescribe treatments that address specific symptoms. Therefore, in a world where Western medicine dominates, the "clinical" test results on lab-mice have become the standard for science. By this logic, TCM, which does not prescribe small doses of human medicine to lab-mice or produce fixed prescriptions, can never be fully accepted by the "mainstream".

Not only is TCM difficult to learn and hard to find, but its space for survival is also becoming increasingly limited. In major hospitals, the TCM departments typically only have internal medicine, surgery, and gynecology. Compared to the highly specialized and often overbooked Western medicine departments, the TCM departments are often deserted and have a mediocre reputation. In terms of hospital "sales performance", the contribution of the TCM departments to "order volume" is hardly noticeable; and in the "paper publication" and "award" systems, there is little recognition of clinical "parameter validation" or "standardized" data from TCM. In contrast, Western medicine teams can continuously use patients' bodies to test the effectiveness of drugs, add to clinical data and research papers, and if a treatment fails, simply perform surgery. Any immune reactions are dealt with in the ICU.

This stark difference has given Western medicine an overwhelming sense of "superiority", leading many top hospitals to view TCM through a skeptical lens, considering it "pseudoscience". It's no surprise then that even certified practitioners in major hospitals may not fully grasp the true "Tao" in TCM, while highly skilled masters are often only found in the folk tradition (as they cannot obtain high-ranking titles to enter hospitals). Many people are reluctant to consult unauthorized doctors unless absolutely necessary, and even then, they may not have the fortune to encounter a truly skilled one.

People often believe that TCM is only suitable for slow, gradual treatment, and that for obvious symptoms, one must turn to Western medicine. In fact, TCM has many different therapeutic methods and can also treat acute and severe conditions, sometimes achieving immediate and effective results. Take the body's acupuncture points, for example. The human body has thousands of acupuncture points and hidden cavities, with even smaller points that are difficult to count. Each point functions like a micro-information processor, referred as Tai-Chi organs. These points are interconnected, influencing and sensing each other, and the connection of energy focal points of the same type forms the meridians, hence the saying "move a hair and the whole body moves".

The ability to move Tai-Chi organs and activate Tai-Chi acupoints throughout the body is what the ancients called "Tai-Chi Quan". If the Tai-Chi organs are dysfunctional, causing poor circulation of Qi and blood, leading to blockages and pain, then practicing "Tai-Chi Quan" may not bring immediate relief. So how can one reach the acupoints without causing pain or resorting to surgery? The ancestors were truly ingenious to invest acupuncture which can precisely target acupoints. Acupuncture doesn't just pierce a piece of flesh or skin; it directly targets the deepest hidden acupoints and cavities. Moreover, acupuncture can connect these acupoints at various depths. By regulating Qi within the Tai-Chi acupoints, acupuncture influences the circulation of Qi and blood along the meridians, thereby treating the internal organs.

Western and Chinese medicine approach diseases differently: Western medicine focuses on how to control the illness as quickly as possible to prevent the spread of the disease. In contrast, TCM, regardless of whether the illness is major or minor, asks the body: Why did this condition arise? Why did the immune system fail to block this condition effectively? From this perspective, TCM considers various viruses as "external evils". A healthy body maintains balance and order, akin to diligent housekeeping with vigilant guards, making it hard for intruders to breach. Even if they do, they are swiftly expelled, unable to affect the core. However, if illness penetrates deep within ("entering the vitals"), treating it requires a holistic approach.

The difference between TCM and Western medicine in treating serious illnesses is significant. Western medicine's approach to dealing with lesions is often akin to "whack-a-mole". Just as one area is surgically removed, the disease quickly spreads elsewhere; radiation and chemotherapy may suppress malignant cells locally, but the patient's immune system rapidly declines, leaving them emaciated. I came across a hand-drawn illustration online that vividly depicts the current reality of hospitals and patients, using exaggeration to provoke thought: What has been exchanged at the hospital? (See Figure 11.4)

Figure 11.4: What has been exchanged at the hospital?

When it comes to mild conditions, both TCM and Western medicine have certain effective treatments. However, for severe illnesses, restoring health often requires mobilizing the immune system for a "thorough house cleaning". I have personally experienced this.

My family carries genes for immune system disorders. During my freshman year in university, I was diagnosed with Ankylosing Spondylitis. Despite months of treatment, my low-grade fever persisted. Due to prolonged steroid treatment, I became significantly overweight, yet my joints remained swollen, and I was unable to walk. Later, upon returning hometown, with the help of a Chinese medicine practitioner, I underwent treatment using traditional medicine combined with high-dose penicillin injections. Fortunately, I had improved significantly within a month.

Recently, in the book "Internal Observation Notes", I came across a passage describing the internal view of how penicillin interacts with the body from the perspective of Chinese medicine. Here is an excerpt:

"Penicillin is considered a purely yin substance in TCM. After intravenous injection, it diffuses extensively throughout the major areas of the body's internal organs and spreads to most acupoints from the head to the limbs, which is quite different from Chinese medicine. Chinese medicine has specific areas of movement, time frames, and precise targets; it follows the meridians to locate and address the disease, with a relatively narrow distribution. In contrast, when penicillin is first administered in a large dose, it causes a tremendous movement of Qi and blood throughout the body, without any intelligent targeting—it indiscriminately reaches every part of the body, spreading evenly. This has a direct and widespread killing effect on diseases commonly present in the body. Its strong function in 'yin-elimination' is outstanding, but due to its yin-only structure, it loses the ability to combine with the body's Tai-chi organs to form yin-yang balance, simultaneously causing extensive harm..."

The author believes that penicillin, as a chemical drug, is indeed a highly effective and potent medicine. However, if we could combine the strengths of penicillin with those of Chinese medicine to create a "new form of medicine", one that not only retains the stability of chemical drugs like penicillin but also minimizes their widespread, indiscriminate effects on the body, wouldn't that be the best for the world?

Can we imagine a future where Chinese medicine and Western medicine are not in opposition but work closely together? As medical technology advances and our understanding of the human body deepens, the integration of Western and Chinese medicine may become an inevitable trend. From the perspective of long-term human health, TCM and Western medicine can certainly collaborate closely and progress together.

It is my sincere hope that, in the coming years, TCM, like Chinese traditional culture, will endure through challenges, continually revitalized with the energy of renewal, as in the saying: "Wildfire can't destroy it; the spring breeze brings it back to life." As our understanding of both Chinese and Western medicine deepens, the process of making Western medicine more like Chinese medicine—more natural, more humane—will likely become the necessary path for the future of chemical and genetic drugs. Likewise, TCM, when integrated with modern medicine, is bound to flourish and, in the not-too-distant future, will surely hold a vital and indispensable position in the global healthcare system.