Chinese medicine is based on traditional theories such as “qi” and the “yin-yang five elements theory,” which limits its ability to be verified by scientific methods. While some studies have confirmed the pain-relieving effects of acupuncture, this only proves the scientificity of the treatment, not the theory. Rather than scientific standards, TCM will have to develop according to its own characteristics and unique approach.
Terms like “qi,” “acupuncture points,” and “yin-yang harmony” may seem a bit unscientific at this point in time, when science is so advanced. Chinese medicine has been practiced for thousands of years, but in modern times, its efficacy has been questioned and its meaning as a medicine has faded. This is because modern medicine has accumulated anatomical knowledge based on a thoroughly scientific mindset, while Chinese medicine has been developed based on unscientific theories such as “chi” and “yin-yang theory.” For this reason, traditional Japanese medicine has already been absorbed and integrated into modern medicine, which has significantly narrowed its position.
To overcome this loss of public trust, the TCM community has recently emphasized evidence-based medicine (EBM), or evidence-based medicine. Evidence-based medicine is a methodology that organizes medical decisions based on scientific evidence obtained through well-designed research, and verifies the reliability of diagnostics and the effectiveness of treatments through reliable clinical trials. Chinese medicine has also adopted this methodology to uncover the mechanisms of treatment and prove that Chinese medicine is a scientific discipline. But is it possible to evaluate Chinese medicine as scientific simply by uncovering the mechanisms of treatment? Since TCM is fundamentally based on theories such as “qi” and the “yin-yang five elements,” it is unlikely that a proof that excludes these theories will be enough to conclude that TCM is scientific.
In this article, I will discuss whether it is meaningful to try to prove that TCM is scientific and whether it can make TCM more competitive.
Before we get into the nitty-gritty, let’s clarify the concept of “scientific,” which is a key word in this article. “Science” refers to the natural sciences in a narrow sense, and to a system of inquiry and logical knowledge for the rational understanding of natural and human phenomena in a broader sense. In this context, “science” is more of a discipline that explores the structure, properties, and laws of matter. In the context of Chinese medicine, EBM refers to a scientific approach that seeks to uncover the material mechanisms behind a treatment. With this in mind, let’s discuss whether Chinese medicine should be scientific, i.e., a discipline that analyzes the structure of matter and uses it to treat it.
First, let’s look at the evidence presented by those who argue for the scientific nature of Chinese medicine. One of the most prominent examples of the scientific nature of Chinese medicine is the research that uncovered the analgesic mechanism of acupuncture. A few years ago, Nature Neuroscience, a top journal in the field of neuroscience, published a paper that demonstrated that the analgesic effect of acupuncture is not just a placebo effect, but a scientifically explainable phenomenon. According to the paper, a signaling molecule called adenosine is produced around cells that have been stimulated with acupuncture needles, and it binds to nociceptors to inhibit chronic pain. Based on these findings, TCM practitioners claim that some of the mechanisms of TCM have been uncovered and that it’s only a matter of time before TCM is proven to be scientific. However, this only proves the scientificity of the treatment, not the underlying principles or theories of TCM. To prove TCM is scientific, we need a way to verify the existence of its underlying principles, the “qi” or “acupuncture points”.
In fact, there are studies that recognize the effectiveness of acupuncture but question the existence of “acupuncture points. A study by Professor Klaus Linde and colleagues in Germany, published in the Journal of the American Medical Association (JAMA), examined how well acupuncture relieved pain in migraine sufferers and found no difference in effectiveness between needles placed at the correct acupuncture points and those placed at random sites. This suggests that the analgesic effect of acupuncture does not depend on the location of the acupuncture points, but comes from the ‘act of placing the needles’ itself. After all, without a scientific basis for the underlying principles of Chinese medicine, it is impossible to clearly demonstrate the scientificity of the treatment.
So, can theories such as “qi” or the “yin-yang five elements theory” be proven to be scientific? Some people raise the following counter-question. “Why do you recognize Einstein’s invisible theory of relativity or quantum mechanics as science, but insist that ‘qi’ and ‘acupuncture points’ in Chinese medicine are unscientific? Chinese medicine has a scientific basis, having accumulated data from patients through thousands of years of clinical experience.” It may be similar to the theory of relativity or quantum mechanics in that when you first encounter them, they may seem outrageous because they are groundbreaking. However, groundbreaking theories in science are always accepted as orthodoxy through experimental evidence and rigorous predictions. For example, in quantum electrodynamics, the value of the magnetic moment of an electron was predicted theoretically and measured experimentally, and the errors were almost negligible. In science, a breakthrough theory must be supported by empirical evidence. However, the empirical data in Chinese medicine is insufficient to fully support the breakthrough nature of the theory.
Therefore, I believe that it is difficult for Chinese medicine to be recognized as a scientific discipline. However, this is not to say that Chinese medicine should disappear. Chinese medicine has the potential to cure diseases that are inaccessible to modern medicine or contribute to improving constitution. In other words, Chinese medicine should find meaning in its unique approach, not in its scientific aspects. If TCM can uncover the mechanisms of its treatments and prove them to be effective, they will likely be accepted and utilized by modern medicine, but at that point they will no longer be TCM, but part of modern medicine.
Therefore, for Chinese medicine to survive, it must not be subjected to the rigorous standards of modern natural science. As the renowned Chinese physician Zhang Zhengsheng once said, “We must recognize that Chinese medicine is not a science in the narrow sense, and accept that it is different from what modern natural science means by science.” This recognizes that Chinese medicine is not something that can be described mathematically or verified in a lab. This is because Chinese medicine has adopted an intuitive model of understanding the nature of human beings and life, and healing through experience instead of material structures. In other words, it understands and approaches human beings and life from a different perspective than the natural sciences, which are concerned with identifying physical entities.
It’s not that long ago that modern medicine came to rely on the scientific method as a measure of trust, and it’s also not true to say that modern science has understood everything. Does it make sense to blindly trust science as absolute truth and rely solely on modern medicine, and is it justified to be frustrated by conditions that modern medicine has labeled as incurable? I believe that this is where TCM has a role to play: to try to save lives with a different approach than modern medicine, and that can be its essential significance and competitive advantage.
It is true that it is still difficult to fully trust Chinese medicine, but to bring in modern natural science to solve this problem and claim that Chinese medicine is scientific is to ignore the essence of Chinese medicine. Rather than conforming to external criteria of being “scientific,” it would be preferable for TCM to develop from its own academic position while maintaining its original characteristics.
