2.Basic Characteristics of Traditional Chinese Medicine
Currently, many people believe in Traditional Chinese Medicine (TCM), while many others oppose it. Both sides hold their own views, often engaging in heated arguments without convincing each other. If you ask them, "What is TCM? Can you define it?" the answers would vary greatly. Therefore, what they either believe in or oppose may not be the true TCM but rather the TCM they imagine in their minds.
Only by understanding what true TCM is can you decide whether to believe in or oppose it. Otherwise, whether you support or oppose TCM, it is blind faith and a form of superstition.
How can we accurately define a medical system? What exactly is true TCM? In this lecture, we will explore these questions.
Composition of Medicine and the Five Elements of Medicine
There are various medical systems in the world, such as TCM, Western medicine, Tibetan medicine, Mongolian medicine, etc. In China, the most influential systems are Western medicine, derived from modern science, and TCM, derived from Eastern philosophy.
Any medical system is composed of two parts: a theoretical system and treatment methods.
The theoretical system is determined by the worldview of its founders, while treatment methods are determined by the theoretical system and the level of productive forces. The basic characteristics of a medical system are determined by its theoretical system, while treatment methods are merely external manifestations of the medical system and can change with the development of productive forces. For example:
Sun Simiao's "Thousand Golden Prescriptions" records a method of catheterization using onion tubes. Nowadays, catheters are made of rubber, but rubber was not available back then.
Previously, Chinese patent medicines were in the form of pills, powders, ointments, and elixirs. Now, pills can be encapsulated in capsules, which was not possible in the past.
You cannot say that TCM catheterization must use onion tubes today, or it wouldn't be TCM. Nor can you say that only pills are TCM medicines, and encapsulated ones are not.
In fact, TCM treatment methods have been constantly evolving: the earliest methods were guidance and massage. When one was ill, depending on the condition, they would engage in specific movements or get others to pat or massage them. This evolved into acupuncture and moxibustion, with the earliest needles made of stone or bone, then bronze, iron, and now stainless steel. Finally, herbal decoctions emerged as treatment methods.
A medical system's treatment methods are not static. Enlightened physicians of different eras, guided by their theoretical systems and adapting to changes in disease patterns, can create new treatment methods by reasonably incorporating the achievements of productive force development.
Therefore, we cannot define a medical system based on the external forms of its treatment methods.
Many opponents of TCM are unwilling to deeply understand TCM and only define it by some external and superficial aspects, even believing that tools like X-rays and ultrasounds belong to Western medicine, which TCM should not use. If used, it is no longer TCM.
Conversely, some conservative traditional TCM practitioners or traditional culture researchers are stuck in their ways, believing that only the terminology and treatment methods passed down from ancient times are TCM, and some even identify themselves as TCM practitioners by wearing traditional robes.
These understandings are all incorrect.
To define a medical system, one should look at its theoretical system and grasp its characteristics from the following five aspects:
How does it understand life?
How does it understand health?
How does it understand disease?
How does it understand the causes of disease?
How does it treat disease?
These five elements are the key to defining any medical system. Once these five elements are clarified, the medical system can be defined. Simply put, these are the views on life, health, disease, causes of disease, and treatment. The TCM popularization textbook by Zou Shizhen clearly defines the basic characteristics of TCM through these five elements.
The View of Life in TCM
TCM and Western medicine have significant differences in their understanding of life.
Western medicine understands life through anatomy, physiology, and biochemistry, focusing on the tangible and visible, even with high-magnification electron microscopes, the objects observed are already formed. Western medicine is entirely limited to physical form and denies anything beyond the physical form.
This understanding of life by Western medicine is incomplete. We can further think, why do human bodies grow in this particular way? What force dictates that cells must arrange themselves in this particular shape? For example:
Our arms are cylindrical, with two sides being relatively flat and the other sides curved. No matter what kind of microscope you use, the skin cells on the flat sides and the curved sides of the arm are identical in appearance. But why do the cells on the flat side naturally grow and arrange into a flat plane, while those on the curved side automatically bend and arrange into a curve? If the cells on the curved side grew straight like those on the flat side, your arm wouldn't be cylindrical but an infinitely extending plane. What force determines this?
Traditional Chinese philosophy believes that "existence arises from non-existence." Our tangible world is born from the intangible. First, the formless and imageless "nothing" gives birth to the formless and imageless "Qi" (vital energy). Then, according to the image of Qi, tangible matter is formed.
The "Huangdi Neijing" states, "In heaven, it becomes Qi, and on earth, it forms shape." This is consistent with the traditional Chinese philosophy of "existence arising from non-existence." Here, "heaven and earth" are not literal references to the sky and the earth. The sky is intangible and resembles Qi, so it refers to the state before things take physical form. The earth is tangible, so it refers to the state after things take physical form. The phrase means that the process of forming a tangible object starts with invisible Qi, which gathers and then forms. Qi determines shape, and the visible and tangible body is determined by the invisible and intangible Qi.
If a tumor grows on a patient's body, it is not without reason. First, there is an abnormal gathering of Qi in that area, and over time, it gradually forms a tumor. Western medicine believes that as long as the tumor is removed and the remaining cancer cells are killed with chemotherapy or radiotherapy, the disease is cured. However, this only addresses the tangible part, not the abnormal Qi that caused the tumor in the first place. The Qi is still there, and after some time, a new tumor will grow. Western medicine calls this a relapse, but it is actually because the root cause was not treated.
The original meaning of Qi is the substance between existence and non-existence during the process of existence arising from non-existence. Qi objectively exists but is intangible and formless. Qi determines the tangible and substantial world.
Later, the concept of Qi was extended. Many objectively existing but intangible things were also called Qi, such as air, visceral Qi, and Ying Qi wei Qi （——-）. Therefore, in ancient TCM texts, Qi has multiple meanings. If one interprets Qi with only one fixed meaning, many contradictions will arise when reading TCM texts. This is something to be mindful of when reading TCM classics.
Anything that can be detected by eyes and instruments has already taken shape. The primordial Qi, the source of all things, exists between existence and non-existence, and thus cannot be detected, no matter how precise the instrument. Western medicine does not recognize the existence of Qi, and those who oppose TCM use this to deny TCM theories.
The "Huangdi Neijing" states, "Those who are skilled in discussing Qi must manifest it in objects." Objects refer to tangible matter that can be seen and touched. Qi cannot be seen or touched, but it can be manifested through the results of its actions—objects. Truly knowledgeable TCM practitioners can predict a patient's Qi-related problems, the treatment results, and the process based on the theory of Qi movement. If the subsequent facts match the predictions, it proves that Qi indeed exists. This is essentially a form of indirect evidence, a method also often used in physics to prove the wave nature of light.
In terms of the view of life, compared to Western medicine, TCM has a unique concept—"Qi."
Western medicine's research is confined within the physical form, and its theories are applicable to the tangible world. However, without recognizing Qi, the root cause of physical changes cannot be found. Merely focusing on the physical form will never reveal the reasons for physical changes. Why can TCM explain phenomena that Western medicine cannot? Why can TCM treat diseases that Western medicine has yet to understand? It's because TCM theory has a broader scope than Western medicine. TCM extends its theoretical application to the intangible world of Qi, making it a more advanced theory than Western medicine.
In modern times, due to the power of Western science and the inferiority complex of TCM practitioners, TCM has increasingly leaned towards the physical medicine of Western medicine. This is akin to cutting off one's feet to fit the shoes and self-degradation, ultimately leading to the Westernization of TCM. As a result, phenomena that Western medicine cannot explain cannot be explained by TCM either, and diseases that Western medicine cannot cure cannot be treated by TCM either. Therefore, one should not abandon TCM theory just because Qi cannot be seen or touched.
The TCM view of life considers that the process of life is essentially the movement of Qi. The tangible body is the site where Qi moves. If the movement of Qi ceases, life will end. Similarly, if the site of movement is completely destroyed, life will also cease to exist. This is the relationship between the body and Qi in TCM's view of life.
The "Huangdi Neijing" states, "If the movement of Qi stops, the divine machine will be destroyed; if the form and shape cease, the essence and spirit will follow suit."
