Chinese medicine can be differentiated from Western medicine in three ways. These are:
1. Its holistic view of man and nature (systemic) 2. Its syndrome differentiation/Bian Zheng Lun
Zhi (individual)
3. Its consideration of permanent variable factors (dynamic).
These are explained in detail below.
HOLISTIC VIEW OF MAN AND NATURE The human body is viewed as a complex, inter-woven system that in itself interacts with and is linked to its environment (living space, work-place, social and natural surroundings).
Likewise, in TCM it is obvious that the weather can make someone prone to certain diseases, or that one may succumb to other climatic influences such as localized winds (for example the alpine wind in South Germany), dampness, sea winds etc. Different seasons have different effects, too. In a similar way, chronobiology, for example, has been able to conclude that rhythmic variations of the immune system, sleep, body temperature and other cycles are influenced by the season.3
3 Moore-Ede: Clocks that time us, Meier Knoll:
Chronobiology, Reiter: Melatonin, Orlock: Inner Time, as well as articles by Wagner, Emslie, Levy, Zawilska and many more (see Bibliography).
THEORY AND BACKGROUND KNOWLEDGE 6
Finally, the inner emotional state is incorpo-rated into the analysis of the present state of the body, and the social environment as part of the human network also belongs here; doctors in China nearly always enquire about family or work-related issues, because aggravation, stress and so on have been proved to have an effect on physical disease processes. This is all part of the first step in TCM, the diagnosis.
For some decades now, such a nonlinear, joined-up and systemic view has been found within the most up-to-date front-line branches of science, starting with non-Newtonian physics and quantum physics, dissipative structures in bio-chemistry, and going as far as chaos theory and dynamic system theory in complex mathematics.
While medicine in the West has traditionally been regarded as the ‘unreliable’ discipline among the exact sciences, it has now, ironically, become obsessed with detail and precision. As a result, having become a Cartesian-rigid, linear science, it is now lagging behind the new flexibility of its nonlinear siblings. Although first signs of a systemic medicine are emerging, as seen in geo-medicine, chronobiological medicine and inter-disciplinary systems, they are barely noticed in mainstream medicine and are poorly promoted, because the fundamental structure of medicine today has failed so far to overcome the limits of Cartesian thought. In this respect, integrated Chinese medicine is one step ahead of us.
SYNDROME DIFFERENTIATION (BIAN ZHENG LUN ZHI)
Bian Zheng Lun Zhi or syndrome differentiation means discussion of symptoms in order to draw up a treatment concept. All data that was gathered during diagnosis is now arranged in such a way as to obtain a clear picture of the situation that pre-vails inside the body. Then an appropriate treat-ment concept is matched with this picture, to restore those functions that were unbalanced to a state of stability. Syndrome differentiation is the second step in TCM. Someone who does not master this will unfortunately only be able to treat symptomatically (e.g. prescription acupuncture) and will fail to achieve good therapeutic results because of the lack of precision. The application of
syndrome differentiation is not based only on the principle of cause and effect (causal analysis) that is commonly used in Western thought, but mainly on a system-linking model, for which one may use the term ‘inductive synthesis’.4
Using syndrome differentiation allows the physician to treat not only every disease, but also every patient; this means the treatment is individu-ally and specificindividu-ally adapted to every person’s present condition.
CONSIDERATION OF PERMANENT VARIABLE FACTORS
Every time a patient goes to see a doctor in China, a new case history is completed (although not in as much detail as the initial one). Treatment is based each time on this up-to-date history. This procedure makes sense as each (successful) treat-ment should bring about some physical changes which will be apparent in the subsequent consul-tation. Thus the third step in diagnosis and treat-ment is consideration of the patient’s present condition.
Unfortunately, patients are usually prescribed the same medication in the same dose each time they visit their general practitioner, which is understandable because conventional medicine does not aim to address the whole functional con-dition of the body but is focused primarily on treating symptoms. However, in TCM if a practi-tioner believes he is able to cure a patient of a complex condition using only one acupuncture combination or one herbal prescription, then he has not grasped the concept of TCM.
To give an example, one of the professors who taught me in Tianjin told me that on his 1-year stay in Germany he got to know a therapist. He worked in his practice for a while treating patients. For every new patient the professor’s new colleague made some notes about the acupuncture combination, but did not ask about the reasons for the selection of the points. At the patient’s second consultation he was astonished and asked the Chinese if he had made a mistake, as he had in part used different points the last
4 M. Porkert: all his work, especially Theoretische Grundlagen der Chinesischen Medizin, Stuttgart 1982.
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Introduction: thought models in Chinese medicine 7
time. Amused, the TCM doctor answered him:
‘Yes of course. But that was last week!’
This anecdote is a typical representation of the prevalent attitude towards TCM; traditional Chinese medicine cannot be applied correctly if its theoretic concepts and foundations are not understood.
This is not about teaching Western medicine a few more prescriptions and tricks to complement its storehouse of therapies. The aim of this book is to present an independent medical system, which is superior to Western medicine in those areas where Western medicine is limited by its own conceptual mode. It cannot be denied that both systems are successful in their respective fields.
However, this is only the case as long as they are
employed according to their own fundamental logic.
By taking the dynamic aspects of diseases into consideration, which calls for a new syndrome dif-ferentiation in every case, it is possible to adjust the treatment to the individual and his present condition in a highly specific way. Furthermore, one is even able to be one step ahead of the disease development and to prevent its progression. For this reason this book is structured systematically, according to the approach in contemporary TCM.
Introduction and case history are followed by Western diagnosis (which, in most cases, the patient already has), Chinese aetiology and diag-nosis, syndrome differentiation, treatment princi-ple and treatment application.
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