Traditional Chinese Medicine- part 2

中醫學

Chinese Medicine: then and now (cont. from TCM part 1)
The earliest known traditions related to Chinese medicine date from the 17th to 11th centuries BC during the Shang dynasty and involved ancestral influences. It was believed that ancestors had influence over the living and were able to directly endanger and destroy human life. The focus of healing practice was directed at, not only the living, but the deceased.

Ancestral ritualistic healing practices were later supplanted by more generalized yet still identifiable entities such as demoniacal, magical, and supernatural beliefs. These forces were thought to be the cause of disease. For example, "swellings" were thought to be caused by possession and healing practices utilized instruments such as needles in an effort to purge the affected body of the demon.

The Han dynasty was a period of significant importance to historical Chinese Medicine and is described as being the most formative period of its development. During the 2nd century BC to the 2nd century AD, a Chinese intellectual elite attempted to categorize and explain the world and its phenomena to a reduced number of causes and effects. An attempt to supplant "demonological forces" with so called natural laws gained momentum.

During this period, there were varying attempts to systematize the natural world by creating grouped contexts or constructs associated with the natural environment. This led to the creation of systems and thought in which the practice of healing could be connected with these now categorized phenomena. Here there are glimpses of a more rational approach to medicine. Alas, the earlier magical influences would not be eliminated and eventually a hybrid version of naturalistic/magic Chinese medicine began to take root.

There erupted a plethora of different world views, healing practices, and methods. These approaches often contradicted each other in sometimes fundamental ways. Unfortunately, this intriguing period of inquiry and observation never led to further developments and refinements of Chinese medical theory. The bubbling pool of thought that could be considered a "pre-enlightenment" era never reached a point of general consensus and no method to move toward a reconciliation ever developed.

Concepts such as the ying/yang and the five elements were combined with healing practices creating a confusing litany of disarticulated therapies. During this era, practitioners created forms of "systematic correspondence" which were comprised of assumed links between a practitioner’s perception of the natural world and the human body.

There followed a period after the Han dynasty where two general schools of thought came to the fore. A traditional view of "systematic correspondence” continued creating often baroque and elaborate intuitive theories. Interestingly, it is at this point that acupuncture literature begins to frequently appear in the historical record. These worldviews supported the belief that all things were related through some unseen web of connection and the body for example, could be influenced by changes elsewhere in this system.

"If in winter one behaves as one would in summer, bad things might happen"

In some ways, these systems like many other ontologies – even today- have some empirical seed of truth to them but then proceed to commit the error of fallacious or magical thinking. One big fallacy at the time was confusing correlation and causation –“correspondence”- the results of which produced a realm of completely fictional medical paradigms.

The other area of thought concentrated on a more pharmaceutical approach to medical treatment exploring herbal medicine, and was initially more promising. Unfortunately, this early methodology continued to emphasize very basic and erroneous themes. Disparate and conflicting concepts such as qi, yin/yang, and the five elements are intermingled with the use of herbs and they loose therapeutic coherence and potential refinement as reason and observation give way to assumption and belief.

There was an attempt, especially between the 12th and 15th centuries to reconcile these two traditions but they were ultimately unsuccessful and the whole of Chinese medicine theory remained stagnant and irreconciled from that time on. Epler (CAVMC, ch2, pg 22) elucidates;

" In the history of Chinese Medicine, rather than progressing from a reasonable, although incomplete knowledge of the body to a more detailed one by systematic dissection, the medical writers go in the opposite direction, under the sway of the cosmologists, to a less accurate picture."

It is important to note that until recent times, Western and Eastern medicine had similar belief based origins. Ramey and Rollins note “It is only in modern times, with the development of science-based medicine in the West, and the subsequent discarding of metaphysical approaches to medicine, that Chinese (Eastern “traditional”) and Western practices have been brought into opposition.”

In fact, Chinese traditional medicine is actually beginning to fade in China as a primary practice with the country’s rapid progression towards modernization. Some estimates reveal that about 15-20% of people in China presently use only traditional therapies contradicting the claims of many alternative practitioners.

In Western countries, the Traditional Chinese Medicine actually observed and practiced is based on a westernized version of Zhongyi, or "modern Traditional Chinese Medicine". Zhongyi is in turn a distillation, a "best hits" version of the more rational parts of Chinese Medicines vast and disarticulated past. Much of Zhongyi was put together from the 1950's to the 1970's at which point the West eagerly received what they thought of as "ancient medicine".

According to Ramey and Rollins “…the transformation of Chinese traditional medicine into Traditional Chinese Medicine from the 1950s and 1970s did much to bring Chinese medicine closer to modern rationality…the vast heritage of Chinese traditional medicine that directly contradict modern science and rationality have been omitted from the many publications on zhongyi published in the People’s Republic of China since the mid-1970s. Hence, Westerners returning from China in the late 1970s and 1980s took home a “gift”, which they considered to represent two millennia of Chinese medicine while in fact it was a streamlined body of concepts adapted to modern rationality. It is this streamlined body, then, which was once more modified in the West to meet the expectations of Western audiences.”

Here the tale loops to the beginning of the West’s current fascination with Traditional Chinese Medicine or better said a twice removed, manipulated, and designer made Western version of Traditional Chinese Medicine.

Ref:

Complementary and Alternative Veterinary Medicine Considered (Ramey & Rollin)

Traditional Chinese Medicine- part 1

中醫學

A large part of alternative veterinary medicine and much of its philosophical foundations base themselves on a rather loose jumble of historical Chinese theories that concerned themselves with the universe and humanities role in it. Many of these systems had their own unique take on diseases and to how treat them.

If you look at the span of time from ancient to modern day China one notes a fascinating and irregular waxing and waning of effective medical progress. Periods of “endarkenment” intermingled with those of “enlightment” where literally dozens of medical paradigms –like the faddism of today- came and went. That most of these practices represented medicine in the pre-scientific age is often not considered by many of its western proponents.

Many Complementary, Alternative or Integrative Veterinary Medicine (CAIVM) supporters seem to have cherry picked and modified ideas from one or another of these archaic nonmedical/beliefs based systems and gathered them under a broad conceptual umbrella called “Traditional Chinese Medicine” (TCM).

It is interesting to note that modern China is rapidly entering an increasingly scientific era regarding medicine and the country as a whole is experiencing an age of unprecedented growth and modernization transforming itself in the process.

During the recent transnational world congress on Scientific Inquiry and Human Well-Being in Beijing, Ren Fujan, professor at three Chinese universities and executive director of the China Research Institute for Science Popularization noted that “China is now in a great flourish of development in science popularization.” As it struggles with major growth pains, it appears resolute in advancing society with science based methodologies while leaving behind superstition and other archaic belief systems- including those used in medicine.

On the other hand, there are those in the west that pretend to separate medicine instead of considering it of one body. With this in mind, it is important to have a better historical context of Traditional Chinese Medicine. The root of much of the alternative veterinary movement grows from many of these socio-cultural events.

A History Revealed

"How did you get your clothes so clean?...
....Why, it's an ancient Chinese secret!"
Calgon Commercial (circa 1973)

Years ago, a television add parodied the illusion of magic while promoting a cleaning product. Although it was a promotion for a clothes detergent, the skit humorously played on the rediscovered allure the West had for the mysterious orient.

This famous (or infamous) add reflected the remarkable events occurring at the time in the US during the early 1970's. The anti-institutional "Flower Power" decade of the 1960's and its societal effects still reverberated throughout the country. The ongoing Vietnam War served as a backdrop to pacifist protests such as the disastrous Kent State Massacre. The Watergate scandal was just beginning to unfold and would help to push the entire country towards profound levels of disillusionment.

The timing was just right to introduce "other ways of knowing" as the national consciousness yearned for relief and comfort. It is not hard then to imagine, that when President Nixon took his unprecedented trip to the Peoples Republic of China in 1972 the nations interest and attention turned towards things Chinese.

Enter a president eager to demonstrate effectiveness, a naive western media, and a strained "proletariat" communist party keen on representing its uniqueness, stability, and power to the world. Like a perfect storm, these swirling events coalesced into a golden moment capturing the ever fickle US curiosity.

Here the Chinese delegates, knowingly or not, played an ingeniously subtle card capitalizing on China's long history and presented the concept of a unified "Chinese version" of medicine. It was represented as all encompassing, highly effective and based on ancient tradition. The West took the bait hook, line, and sinker!

Hence, was born the seeds of our present day conceptualization of Traditional Chinese Medicine. The smoldering embers of public interest of the unknown were fanned into flame as a new wave of popular fascination took hold of the West. There followed a virtual explosion of thought, theory, publications, seminars, gurus, and wise men that promulgated profound universal concepts that professed salvation based on "ancient Chinese secrets". Traditional Chinese Medicine was the panacea to a perceived cold and impersonal Western style of practicing medicine.

However, fundamental misconceptions of Traditional Chinese Medicine fomented then have, for the last several decades, taken a firm grip on the Western imagination, growing and propagating as allegedly factual.

Some of these alleged facts include the impression that Traditional Chinese Medicine (TCM) is a historically coherent and unified practice, that it is the only or mostly used medical practice in China and that TCM is made up of a large body of well researched "alternative" therapies having similar or equal efficacy to modern Western medicine.

That none of these facts bear out under scrutiny underscores the need to discuss what the actual historical record and evidential data reveal. The next post will touch on the first two points. The efficacy of TCM “alternative” therapies will be considered in due course as this blog posts on specific therapeutic modalities (i.e.; acupuncture, pulse diagnosis, herbal medicine, vitalism).

Traditional Chinese Medicine-part 2

Vetskeptics: a blog

The internet is an easy to use and powerful tool for accessing all kinds of useful information. It represents a real revolution in communications and offers a hopeful way for spreading useful and constructive ideas to a global community.

At the same time, this virtual landscape is littered with misleading and false information that misrepresents and twists the facts to fit all kinds of beliefs, dogmas, and points of view. It is important to have your “thinking cap” on when navigating these sometimes turbulent waters searching for the good stuff- especially when it come to important matters such as medicine.

This brings me to the core of the issue. When it comes to health we are obligated to tread with great care. Medical therapies need to go through a rigorous and continual process that works to keep them “honest”. Therapies in veterinary medicine also have to pass this all important prerequisite. They need to be vetted and put through the filter of scientific methodology- the best tool we have for holding on to and refining that which works while being able to disregard what doesn’t.

This is becoming ever more critical in this -what many would call- an “anti-enlightenment” era of confusion and non-science based pressures which threaten to dilute true medicine with delusional practices and magical thinking- even if they seem well meaning.

The veterinary e-world reflects this frustrating situation especially with respect to Complementary, Alternative or Integrative Veterinary Medicine (CAIVM) where one can find a sea of promotional and apologetic sites supporting its use, but precious little in the way of balanced resources that evaluate them critically. The often over the top claims by CAIVM proponents needs to be tempered with a good dose of science and skepticism of which there is precious little of.

In that regard, Vetskeptics endeavors to provide a haven for those interested in reason and critical thought from where CAIVM or -for that matter- any veterinary topic can be considered and discussed with the goal of open and honest inquiry. There are some excellent veterinary resources that support this goal and I will continually add to our link list as I- and you- discover them.

Initially, Vetskeptics will serve as a concentrated repository for several veterinary topics I have written about in the Wanderingprimate blog site which is developing a broader topic range. I plan to review many of these posts and improve on them here, while others will be archived here for better referencing.

Another goal for Vetskeptics is to encourage and promote new work and posts from various authors. Whether you are a veterinarian, veterinary technician, animal care giver or animal lover this blog is interested in quality writing that will improve on and add to what’s here.

It is our hope that this blog will become one of a growing number of voices that promote science and evidenced based veterinary medicine. With your continued help it can become an ever better critical thinking oasis for the veterinary and animal care community.