Yong-Yan Wang

1Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing,China.

Our country enters a new era of post-modernity,high concept and large data technology,which includes three main features.Firstly,it’s vital to combine science with humanities.Medical humanities gradually fade away and reductionism in science field need to reform,concept of holism also should be reacquainted.Secondly,people should pay more attention to the evolution of anthropological ontology,focus emphasis on the relevant studies,and make their persistent efforts toward the real world.Finally,based on the excellent and characteristic culture of the Chinese nation,absorbing other culture in different nationalities and regions will be more meaningful,this kind of integrated approach also presents massive advantages for us.

Traditional Chinese medicine(TCM)was a weak subject at last century.On the one hand,it was misinterpreted at the soft power level,mainly because the traditional culture was oppressed,the education was westernized and the rationality was considered to be supreme.Besides,conceptual logical thinking model represented everything,and reductionism was put on the altar,leading to several considerable controversies over the abolition of TCM in the recent hundred years.Some critics thought that TCM stood still,only regarded sages’classics(Miraculous Pivot and Plain Questions)as theoretic basis.Butoldergeneration revolutionists,represented by President Mao Zedong,deemed that Chinesemedicineand pharmacology wereagreat treasure-house,if TCM and western medicine had a perfect combination and learned from each other,one type ofunified new medicine pattern would be established.The national policy is proper,while TCM is still in a subordinate and disadvantaged position due to the unprosperous executing processes.On the other hand,the hard power level,mainly including the therapeutic effects of TCM,is not widely recognized.Some people firmly believe that measurement standard is quantifiable,repeatable,and reproducible,otherwise,there is no any scientific evidence,they even totally deny all those which do not match the requires.In addition,some people ignore the most important point that TCM contributed greatly to the prosperity of the Chinese nation for two millennia.

The post-modern situation is transforming towards the favorable direction for the development of TCM,mainly manifesting six aspects as follows.

Firstly,the state has advocated that the integration of traditional culture serves as the cornerstone of development and construction.From the perspectives of Chinese traditional culture,everything in the world,like heaven,earth,nature,Taoist principle,is harmonious and unified,showing the holism of TCM at the level of philosophy.The state vigorously advocates the revival of traditional Chinese culture and promotes the country’s cultural soft power.As a kind of quintessence of Chinese culture,the development of TCM is of vital importance.

Secondly,Xiang-thinking,namely Yuan-Xiang and Ju-Xiang,owns the rich scientific connotation and evidence.Yuan-Xiang is a kind of natural and simple realm without any artificial trace.The body is invisible,voice is silent,and all of these reflect the empty of Yuan-Xiang.Yuan-Xiang is also called spiritual experience,which means invisible thinking,not tangible feeling.Moreover,people can conduct the consideration and spiritual activities if they are under the terrible circumstance,and it is also a sort of manifestation of Yuan-Xiang.Based on such phenomena,creation and innovation of human beings have reached a higher realm and horizon.Ju-Xiang,including image,appearance,can perceive everything via senses of sight,hearing,smell,taste and touch,which is also interpreted as conceptual thinking,logicaldeduction oranalyticaljudgment.Ju-Xiang can convert into Yuan-Xiang,and both of this two Xiang-thinking are unified and mutually complemental.According to the Big Bang Theory from the British theoretical physicist Stephen Hawking,there are stars,black holes in the universe,which have dark matter and dark energy,and material movement is nonlinear and irregular.In our country,reductionism has played a significant role in the period of scientism for almost a century. ‘Hide one’s capacities and bide one’s time’,a type of metaphysical negative logic,is beneficial to obtain more opportunities for the development of reform and opening.Besides,it is more accordant with Yuan-Xiang thinking,owning vitality,nonlinear and unfixed form.Additionally,Dirac equation is created as one kind of innovation achievement after suspending conceptual thinking.

Thirdly,TCM reflects the holism of natural laws in Chinese philosophy.Xiang-thinking,not only Yuan-Xiang,but also Ju-Xiang,has great effects on human health,preventive treatmentof disease and syndrome differentiation.The essence of TCM is holistic,concrete,and dialectical,and it’s also changing,renewing and developing.Chinese medicine and pharmacology has its tortuous historical trajectory,filling with contradiction,opposition,struggle and integration,interaction,coordination.Besides,Yuan-Xiang and Ju-Xiang can transform and integrate from each other in TCM theory.From the objective pointofview,to reconsider Xiang-thinking is advantageous to promote development of TCM and discipline progress,further enhancing the soft power of Chinese medicines and creating more advantageous opportunities.

Fourthly,the curative effects of TCM are the enduring and core competitiveness.Compared with traditional medicine in other countries,TCM has a long history and vigorous life,which mainly owes to internal therapeutic effects,after all,the efficacy is the vitality of the discipline.Thus,on the basis of health and disease prevention,recognizing and judging the curative effects is our primary goal at present.

Fifthly,it is the opportunity and challenge to conduct appropriate methodology study.Looking back on the last century,most methods of clinical drug-developing studies are group-oriented,as represented by randomized controlled trials(RCTs).TCM conductsthe same group-oriented pattern,neglecting individualized treatment.On the one hand,TCM generally follows western model without considering syndrome differentiation;On the other hand,the syndrome and acute/chronic stages of diseases varies over time,the prescription needs to be adjusted correspondingly,but physicians usually ignore these points during the therapeutic process.Thispattern which only pays attention to the whole and ignores the individual,will not truly and scientifically reflect the curative effect of TCM.However,it’s difficult to establish a kind of appropriate method for individualized therapy.

In addition,owing to the small sample of RCTs,safety evidence of medicines,such as the side-effects,contraindications and precautions,need to be further explored and researched,although some medicines have already been put on the market for two and three decades.Thus,the integrated research of four evidential features(point,line,surface and body)has turned the keystone and hotspot of the current.We should seriously strengthen the safety and effectiveness study of the new Chinese patent medicines in the market,and thoroughly solve the correlative existing problems.

Sixthly,the technical method and practical data in the era of large data offer a great opportunity and challenge for the development of TCM.Nonlinear large data is an innovative resource,under the background of Xiang-thinking,conducting integration of body,observation and considering,paying more attention to the change of mood,feeling and psychology,improving the narrative ability to care patients,combining narrative medicine with evidence based medicine,all of these actions enable to accord with holistic pathogenesis of physiology,psychology and pathology,and reflect the original advantages of TCM in the treatment of stubborn diseases.The group-oriented model to evaluate curative effects is imperfect,we should explore more methods in the limited experimental conditions,such as coordinating individual differences,standardizing scales and terms,making norm,integrating large data technology,expressing efficacy in mathematical way and evaluating the improved effects of psychological disorder in the narrative medicine.

In the end,the development of TCM needs to be extensive inclusiveness.Everybody should humbly learn from Chinese and foreign scholars,listen carefully and study different opinions to seek truth.It is important to cultivate awed and humble morality,as we all know,people’s wisdom is the result of historical evolution,and any scientific discoveries and research results are set by people,which also need to be tested by time and practice.If we are awed and humble,and constantly correct our views,we can gradually accumulate and renew our knowledgeable and cultural precipitation.