You Nuo

Can tradition be enriched by innovation?

By You Nuo (China Daily)
Updated: 2010-01-21 07:53

What is wrong with our medical science, the science of Western medicine as well as traditional Chinese medicine (TCM)? Why are doctors at a loss to find cure for more and more diseases and often divided, if not opposed, on their causes? Has modern man reached the limits of his quest for good health and a longer life, or has he reached a new frontier from where science will progress further?

Dr Liu Hequn, an astronomer-turned-registered TCM practitioner (he also holds a degree in modern medicine and a physician's license), believes in progress, and is probably half a step ahead of others in unraveling some of the above riddles. It would take nothing short of a paradigm shift to reach that new frontier: a return to the practice of classical medicine as well as a "cognitive revolution", Liu tells China Daily, sitting in his apartment near Beijing's Olympic Village.

"There is nothing mystic about it, although what my teacher taught may make it appear so." The teacher he is talking about happened to be an illiterate Taoist master, who in the early 1960s taught him the skills to diagnose a medical condition. The Taoist master, in turn, had learned the skills at Baiyun Guan, or the White Clouds Temple, Beijing's most famous Taoist facility till the early days of People's Republic.

The Taoist master must have belonged to the last generation of TCM practitioners, trained in the secret tradition: handing down of knowledge orally. TCM began to be incorporated into the national medical education system in the 1950s. Today, all TCM practitioners have to graduate from medical colleges, where they are also taught the theories of modern medicine.

In 1960, as an eight-year-old. Liu had to undergo some specialist treatment for the injuries he sustained in his arms and legs while learning kungfu. That was how he was taken to his Taoist teacher, who inspired him to become the first person educated in modern science to practice the traditional method of medicine.

This method is different both from modern medicine's standard diagnosis and that of TCM taught in medical colleges, which to a large extent is based on feeling a patient's pulse and is seen by Liu as inadequate. In contrast, Liu says, his method is closer to being holistic and true to the philosophy of TCM. It requires a doctor to feel the patient's body (usually without taking off clothes) to identify not just one or two troubled spots, but, more often than not, also a troubled sub-system connected to a series of related and seemingly unrelated conditions.

"All medical researchers know about some interrelated conditions and symptoms. Only in my research, some connections may at first defy imagination," Liu says.

Liu can detect a medical condition by feeling a patient's body with his hands, the unique method of diagnosis his teacher taught him. He started learning and practicing the skill while he was still in primary school, and tried to treat the injuries of his classmates and school friends, who like millions of other urban students, were sent to re-education farms in the early 1970s.

But how can he be so confident about his "hand diagnosis"? Liu says with a smile: "They haven't created a better substitute yet." No matter how advanced and precise a medical scanner may be, it can help a doctor perform only one set of scanning operations on a patient. But in his diagnosis, symptoms that doctors give different names to are sometimes related to each other in ways that neither modern medicine nor TCM talks about.

After the diagnosis, the treatment that Liu often prescribes is acupuncture, which is crucial for connecting and re-connecting a patient's inner system. Liu says he must have practiced this on at least 10,000 patients, most of who had been suffering from conditions that are not easily curable by modern medicine or the medical school version of TCM.

Liu's hands are his medical equipment, scanner et al, and give him "a more straightforward feeling and thus more comprehensive understanding of a disease or medical condition". A pair of well-trained hands, like his, can process a lot more information than medical equipment especially the kind of information modern medical science is yet to translate into words. They range from the subtle variations of pressure and shape in a patient's body to the inner abnormalities and imbalances.

"This is no mysticism," he repeats. "I can measure medical problems by hand and trace their connections to different systems and parts of the body." It is not metaphysical like the yin-yang dialectics, which used to be at the center of the TCM theory. It is an empirical experience, he insists, as real as the different shapes and strengths of a fire in a fireplace.

In fact, despite deriving intellectual inspiration from TCM and Taoism and his admiration for Zhang Zhongjing (2nd century AD), one of earliest known practitioners of TCM, he seldom talks about his methodology in yin-yang terms. "That is an area I'm not good at," he concedes.

Interestingly enough, like all medical practitioners and partly like the yin-yang dialectics, Liu emphasizes the relations in man's inner system: its balance and harmony based on smooth circulation and connectivity and accompanied by enough exercise and healthy food. The shapes of flames and the strength of fires in different fireplaces can be measured by an expert pair of eyes. But it is hard to translate the results into a manageable set of indices. It would take a huge amount of research and theorizing, and perhaps many generations of work before that can be done.

Liu has delivered lectures on his principle of diagnosis and treatment both at home and abroad. He has trained many a student, too. But he says his priority now is to produce the theoretical assumptions based on his own practice of 40 years. "We cannot rely only on what patients say or how they describe their condition and symptoms. We have to be clear about what is not said if a disease or medical condition is developing (in a patient's body), you should be able to observe it from the changes in the body channels, and analyze it by integrating all the clues."

But modern medical practitioners or, for that matter, of the medical school variety of TCM understand a patient largely on the basis of the results produced by medical equipment.

"Sophisticated they may be, but a machine is a machine. It can do precision jobs, not a complete analysis of the human system. It doesn't build its own understanding, nor can it develop imagination based on understanding." That is the job of a human brain, with trained eyes and hands, which seeks only additional help from medical equipment.

So dependent are doctors on equipment today that their relationship with patients has been reduced to a kind of industrial operation, designed to prescribe exactly the same treatment for patients showing similar symptoms. The emphasis is on similar symptoms, not multiple causes. Personal-level understanding of a patient is thus becoming a luxury.

A bigger irony is seen in more complicated cases, which cannot be diagnosed easily and the effect of the same treatment on them varies from patient to patient. In such cases, hospitals try to address the problem by introducing more precision treatment, making patients spend more money on more advanced technologies, without realizing that new technologies can be programmed with the same old logic and yield similar results.

"The less effective the treatment, the more expensive the equipment," Liu laments. "It is followed by even more expensive equipment and even a more dubious record of treatment." This is part of the reason why medical bills have skyrocketed in industrial countries.

This is a reductionist model, Liu says, close to its end. Micro-level analyses and precision technologies are important. But they have embarrassing limitations if they remain one-dimensional, without allowing for variations on the personal level. "People have seen the problem. Now the question is where the innovation will come from."