A basic requirement for the professional practice of any system of medicine is a strong base of evidence upon which therapeutics are applied. From a clinician's standpoint, we need this evidence in order to treat with confidence. Though no absolute guarantees can ever be made, we need strong reason to believe there is a good chance of having specific effect.
The beauty (and power) of classical Chinese medicine (that system of medicine based on the long history of clinical use) is the tremendous amount of experiential evidence we have. One of its primary distinguishing characteristics (especially in contrast with modern biomedicine) is its maturity as system of medical care.
Chinese medicine is defined by:
- 1) its grounding in a basic theoretical framework that is, at least, two thousand years old, combined with
- 2) a long unbroken lineage of medical practitioners collaborating and passing on clinical experiences.
This wholly unique situation has led to a rich and complex system of diagnosis and treatment modalities and techniques. Chinese medicine is the epitome of a system that has "stood the test of time". It is, quite literally, the product, the result, of billions of patient interactions.
Modern biomedicine ('Western' medicine) is, interestingly, a near perfect complement to this. It almost defines itself by being young, with a strong emphasis on the most recent 'advances', always growing and being new. Where Chinese medicine is, effectively, theory based on a vast collection of experiences, biomedicine is in the stage of rapidly collecting such experience. This is one major contribution of modern science to the field of medicine - rigorous application of rationality, via the scientific method, to the collection of clinical evidence.
Modern clinical research is the employing of strict reductionistic logic to investigation of diagnosis and treatment. As such, it melds perfectly with biomedicine, in that they are of identical fundamental mindsets, or ways of perceiving the world. This only makes sense, as they are both children of the same era. Such research is the method by which biomedicine learns and grows.
The role of such investigative theory and technique in the practice of Chinese medicine is slightly different. Whereas with biomedicine research is the method by which it develops, and therefore is reliant upon such research for its very identity, Chinese medicine is a fully matured system of medicine; its growth and development is a matter of application of well established medical theories to new clinical scenarios.
Additionally, and perhaps more importantly, while Chinese medicine includes the basic paradigms of modern research and medicine (eg. reductionism, materialism, mechanism), it is not limited to them. The harsh reality of clinical interaction with patients over many generations has led to the inclusion of many different approaches to medical thought.
A simple example could be where an attempt to reduce a patient's suffering to one isolatable concrete structure simply fails - No single entity, much less tangible structure, may be to blame. In such situations, the clinician must adjust their mindset to a more holistic and functional view of the situation. This altering of internal viewpoint alters the reality facing them, allowing them to 'see' a different scenario - one that may very well contain an effective treatment option! (The importance of this ability to exercise flexibility in one's basic approach to medical care can not be overstated! And it is a great example of maturity in medicine.)
Often times, clinical research is seen as an avenue of validation for Chinese medicine, a way of verifying that it 'works'. Though understandable, as this is essentially the role research plays with biomedicine (a way of deciding what theory and technique is to be included in biomedicine), a much more efficient use of research would be to help translate the Chinese medicine into modern scientific terms.
For example, there is much current research focusing on the biomedical mechanism underlying the effects of acupuncture. Of course, there exists a complete theoretical framework for explaining how acupuncture works within its native medical system (thus allowing us to use it with high confidence), but no such understanding exists within the framework of biochemistry, neurology, etc. Here, then, is a great focus for rational investigation.
Unfortunately, too often clinical trials are used as a type of gateway for inclusion of Chinese medicine into mainstream health care. This has the significant downside of limiting health care options to those suffering, even when therapies successfully accepted through the gateway fail to provide positive effect or perhaps even cause harm (as in surgeries where alternatives may have existed, or where pharmaceuticals cause damage). At best, safer and more effective medical options may be simply overlooked. At worst, suffering, harm, and possibly even death may occur for the unjustified exclusion of differing medical systems.
The current situation will eventually resolve itself, as the efficacy of Chinese medicine will inevitably make itself apparent to those for whom it holds the most advantage - the patient. The main concern is how long, and thus how many will suffer and to what degree, occlusion of integration will persist.
Towards the end of eventual integration, I conduct my own investigation into modern research to help bring to light those trials that demonstrate how and where Chinese medicine is effective. Currently, I post these on my blog, under the label 'Research'.
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