A Straits Times article recently mentioned a new brood of Chinese physicians who are able to explain TCM concepts using Western medical terms. Traditionally, the two are not known to have much connection. But the scene is changing. In fact, it is common practice to practise the two side by side in China. This article explores some of the hurdles of collaboration between the two philosophies.

Mention traditional Chinese Medicine (TCM), and the things that come to mind are acupuncture, moxibustion (heat therapy with herb above the acunpucture point), tuina (Chinese therapeutic massage), cupping therapy, meridians, and Chinese herbs. One would probably not associate it with Western medicine at all, and there are even views that the two are distinctly different.

Differentiating between TCM and Western Medicine

This view is not entirely wrong. TCM and western medicine do in fact work with distinctly different elements. In TCM, the key concepts are the Qi, the Yin and the Yang, all based on the philosophy of Taoism. The Qi refers to the vital energy running through the body. In an individual with a healthy composition, the Yin (negative energy) and the Yang (positive energy) are balanced. An imbalance between the two energies hinders the Qi from running smoothly through the body, thus resulting in sickness. TCM then makes use of external techniques and/or herbal medications to help regulate the two energies, to enable the Qi to flow again.

In comparison, Western medicine adopts a more “targeted” approach by focusing on treating the symptoms. In this approach, each organ is treated “individually”. Take for instance, a person who is running a cold and a throat infection. Using the Western medicine approach, he will be prescribed anti-histamines and lozenges. TCM however, will adopt a holistic approach, focusing on how the cold and throat infection came about – such as whether it was due to a built-up of dampness in the body (yin) or whether it was due to too much heatiness (yang) – before any intervention.

Hurdles of collaboration between Chinese and Western doctors

1) The lack of, or insufficient documentation on the pharmacology of Chinese herbs

At present, many Chinese herbs have been studied, and their effects known. However, there remain many which continue to be extensively used for their established efficacies, but for which their exact properties remain largely unknown. The fact is, not each and every component of the herbs may be known – this includes the side effects and their possible interactions with known conventional medication.

Chinese medicine is now being increasingly used as a complement to western medicine in treating pain, as well as cancer management. There is potential for more room for collaboration between the two but more needs to be done to align the science of the two philosophies.

2) The lack of a common framework for proper integration

As described earlier, TCM and Western medicine function on distinctly different frameworks. The TCM theory is grounded on Chinese classics such as the Huangdi Neijing dating back more than 2,000 years. The theory behind TCM – such as the meridians, the acupoints, and even the Qi – is a foreign concept to Western medicine practitioners.

Currently, there is an effort to make use of metaphors to overcome the communication barriers. This includes translating Qi into “life energy flowing within the body”. However, there is still a need to modernise, and even revolutionise, the language of the therapies and practice in TCM - which have continued to adhere to the ancient texts - to make it more aligned to present-day western medicine.

3) The lack of or, insufficient proper documentation on the efficacy of TCM treatment

Very little research is currently done on the whole TCM system. What is usually done instead is focusing on a single type of treatment – such as acupuncture – and determining its efficacy singularly. Such a study may not prove too useful since the very basis of TCM is holistic. Singling out the treatment may not be indicative of the robustness of the whole system.

The lack of proper documentation on the efficacy of TCM treatment means that it is harder for western doctors to consider it seriously to even to administer to patients at all. It may not be a worthwhile risk since there is insufficient information to suggest its efficacy in the first place. MIMS

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