閱讀材料12：Traditional Chinese Medicine - A Language for Complexity源遠流長的中醫(yī)藥文化

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TraditionalChineseMedicine-ALanguageforComplexity?

Sunday,20May2007-16:22UTC

[TraditionalChineseMedicine.Source:F]

TheChinesepeoplehavereliedontheirownmedicineforages,untilrecentlywhensomescientistsraisedasignaturecampaigntocallforabandonmentofthe

\o"TCM"

TraditionChineseMedicine

–boththeoreticallyandpractically–allaroundChina.HoweverthiseventtriggeredmyconsiderationofsomefeaturesofTCMthatmaybeofthescienceofcomplexity.

TheTroubleofTCM

BasedonthetheYinYangandFiveElementstheories,TCMhasbeentheonlysalvationoftheillsincethe

YellowEmperor

period,inwhichthe

HuangdiNeijing

(YellowEmperor’sInnerClassic)isbelievedtoappearandbecometheearliestclassicofTCM.LaterclassicsincludesShangHanLun(OnTyphoid),

CompendiumofMateriaMedica

,JingKuiYaoLue,andseveralotherbooksfromdifferentdynasties(AshortyetcompleteintroductiontoTCMisavailable

here

).Afterthecommencementofmodernizationfrom1840,Chinastartedtoadoptmodernscienceasaforeignculture,whichsolidifiedintothemainstreamlateinthe1980sunderthepoliciesofDengXiaoping.Nevertheless,TCMstillsurvivedthroughoutthishistoryandremainsthealternativetomodernmedicine(orwesternmedicineaswecallit).TCMisthefirstchoiceofalmosthalfthepopulationtakenill,especiallynormaldiseases.ThestatusofTCMinChinesehygienicsystemisstillarulingone.

However,takentheanti-TCMsignaturecampaigntakingplaceinChinaasasign,compatibilitywithmodernscienceisaninevitableobstacleTCMtodayhastoface.TCM,theoreticallyspeaking,isadirectapplicationoftheChinesephilosophy.ItbasesitsclinicalpracticeontheancientYinYangtheory,althoughthedetaileddevelopmentandenrichmentlaterissystematicallyrigid.SothelanguageofTCMisuniquecomparedwiththatofwesternmedicine.Forexample,thereislittleconventionofanatomyinTCM.AllthenamesoforganisminTCMrefertovagueconceptsratherthanthespecificanatomicstructuresthatphysicallyexistinhumanbody.Andthereareonlycomplexandabstractguidelinesthatinstructwhatherbalstouseorwhichsitestoundergoacupuncturefordifferencediseaseintheseconceptualorganisms,andinclinicalpracticeitlargelydependsonthedoctor’swisdomandexperiencetowritetherightprescriptionforaspecificpatients.ThereforeTCMisaccusedforitsrandomnessandirreproducibility,letalonethedubiousandsuperstitiouspartsalongside,anddeniedtobearealscience.

TheTroubleofLifeScience

Ontheotherhand,hasthewesternmedicinetotallyescapedfromrandomnessorirreproducibility?AsanoutsiderIshouldnotdrawanyconclusionbutsincenotlongagotherehasbeenthediscussionofthe

\o"EBM"

Evidence-BasedMedicine

,whichactuallycallsforlessrandomnessandmorereproducibilitybothinclinicalandtheoreticalmedicine(Ipost

someofmyhumbleopinionsonthis

inmyoldblog).However,asourknowledgeoflifeaccumulates,basingmedicineonevidencebecomesincreasinglydifficult,becausewhatwehavediscoveraboutlifebelongstotheso-called

complexsystem

,whichthetraditionalreductionisticapproachcannotdealwith.

TheScienceforTrouble

Complexityisnotonlyfoundinlife.Weather,ecologicsystem,business,andsocietyareotherexampleofcomplexsystem,allofwhichweearlierfounditdifficulttoclarifybasedonreductionism,thegeneralconventionofsciencesinceitsmodernization.AviewpointarticlebyM.RegenmortelonEMBORep.2004,5,1016-1020(DOI:

10.1038/sj.embor.7400284

")discussedthisissueintermsofmolecularbiology,inwhichtheauthorproposedtreatingcomplexsystemssuchaslifephenomenawithan

emergent

approach–phenomenologicallyrealizingapropertyinsteadoffindingitscausesreductionistically.

Althoughthisapproachcontradictsinagreatmeasurewiththetraditionandmaynotseemsafetoapply,TCMhasalreadygivenmanypositiveevidencesoftheeffectivenessofemergenttreatmentofhumanbody.TCMtheoryistotallyemergent:InthecontextofTCM,entitiesarevagueinstructureandmorphology,whilerelationshipsandfunctionsareemphasized,betheyverticalorhorizontal.

Forexample,accordingtotheZang-Futheory,therearefivezang(heart,lung,spleen,liverandkidney)andsixfu(gallbladder,stomach,largeintestine,smallintestine,urinarybladderandthesanjiao–threeareasofthebodycavity)organsinhumanbody.Theseconceptualorgansareclassifiedaccordingtotheirdifferentfeatures,soinfacttherearenoanatomicanaloguestothesenames(asIhavementionedabove).ButaccordingthefunctionsoftheZang-Fu,theyallseemtocorrespondtoacollectionofanatomicorgansortissues,andtheTCMclassificationsuccessfullyovercomesthecomplexityoneotherwisemustfaceifhe/shehastoderivedthepatternoffunctionsfromthepatternofanatomicstructures.

Anotherexampleliesinthediagnose.InthediagnosticprinciplesofTCM,thebalanceofQiandtreatmentbasedontime(seasonalandclimaticconditions),place(geographicallocationandenvironment),andperson(suchpersonalcharacteristicsasage,sex,livingcustoms,andbodyconstitution)areemphasized.Humanbodyistreatedasanopensystemthatexchangesmatterandenergywiththeenvironment.Westernmedicinealsoemphasizesthisprinciple,inareduction