In this blog post, we will analyze whether the core theories of Korean medicine—Yin-Yang, the Five Elements, and meridian theory—can be validated by modern scientific standards, or if they are merely unscientific beliefs.
The dictionary definition of science is “systematic knowledge aimed at discovering universal truths or laws.” In a broad sense, it refers to academia; in a narrow sense, it refers to the natural sciences. However, there has been much debate among scientists and philosophers regarding what constitutes these universal truths or laws and what methods can be considered scientific. Among these, Karl Popper’s falsificationism brought about a major shift in the philosophy of science. Although more theories have emerged in the philosophy of science, falsificationism is still considered a valid criterion for distinguishing science from non-science.
Falsificationism is a theory proposed by Karl Popper. When a problem arises, a hypothesis is formulated; if this hypothesis is “scientific,” there must be statements that can be empirically falsified, and through this, rationality is established via deductive rather than inductive reasoning. Furthermore, predictions must be possible based on the hypothesis, and those predictions must actually hold true. In other words, it must be possible to “test and refute” the hypothesis. Therefore, if verification itself is impossible, if events incompatible with the theory cannot be anticipated, or if predictions are incorrect, it is not science.
Before discussing Korean medicine, let’s first briefly examine what it is. Traditional Eastern medicine practiced in Korea is called Korean medicine, a name that was recently changed. In the past, there was little difference in basic philosophy and theory from traditional Chinese medicine, but it was classified separately following the emergence of Sasaeng medicine in the late Joseon Dynasty. Therefore, the term “Korean medicine” used in this text refers to Eastern medicine as a whole. So, on what theories is Korean medicine based? The two foundational texts, often considered the “bibles” of Korean medicine, are the Huangdi Neijing (Yellow Emperor’s Inner Canon) and the Shanghan Lun (Treatise on Cold Damage), both written during the Han Dynasty. The Huangdi Neijing introduces the theories of yin-yang and the Five Elements, as well as the theory of meridians, while the Shanghan Lun is an empirical medical text documenting the progression of diseases and the corresponding changes in human physiology. In Korea, the Sasaeng Medicine system is also followed; this is a theory that classifies human constitutions and applies different treatment methods based on each constitution. Treatment methods used in Korean medicine include herbal medicine, acupuncture, moxibustion, and cupping.
First, let’s examine the theoretical background of Korean medicine. The most fundamental theory in Eastern medicine is the Yin-Yang and Five Elements theory, which posits that all phenomena in the universe manifest as pairs of opposing yet complementary forces—Yin and Yang—and that the five elements—Metal, Water, Fire, Wood, and Earth—operate according to this principle of Yin and Yang. If so, regarding the proposition that “the universe is composed of and operates according to the principles of Yin-Yang and the Five Elements,” is there any empirical statement that could refute this—that is, does an incompatible event exist? No, there is not. Just as Popper criticized Adler’s psychology in his work *Conjectures and Refutations*, the theory of Yin-Yang and the Five Elements can be made to fit any situation. For example, the fact that catching a cold is caused by a viral infection resulting from a weakened immune system has been confirmed through experiments, research, and observation. However, from a traditional Korean medicine perspective, it is explained as being caused by a disruption in the Yin-Yang energies. The crucial point here is that the existence of the invisible “qi” has not been verified through experimental methods. A theory that cannot be falsified is not scientific. For example, from the perspective of thermal energy, there is no such thing as “yin energy” in this world; only heat—which can be called “yang energy”—flows. Since the theory of Yin-Yang and the Five Elements cannot make specific predictions, anything can be forced into the theory to avoid refutation.
Next, I will examine the treatment methods of Korean medicine. These methods can be broadly divided into two categories: acupuncture and moxibustion based on the meridian theory, and materia medica concerning the formulation of herbal medicines. First, regarding the meridian theory, which serves as the theoretical foundation for acupuncture and moxibustion, it is nothing more than a complete fiction. The meridians mentioned in the meridian theory have not been discovered even using modern ultra-precise, state-of-the-art anatomical methods. It is difficult to believe that ancient people possessed wisdom and extraordinary capabilities far surpassing those of modern people. Rather, it is reasonable to view this as an imaginative theory devised to compensate for the limited anatomical knowledge of the past. In other words, the meridian theory has already been thoroughly debunked.
Of course, proponents of acupuncture and moxibustion argue that research on their efficacy is still ongoing today and that they are indeed effective. I agree with this. There are studies that have shown pain relief effects based on actual physiological principles, rather than the placebo effect. So, is traditional Korean medicine scientific? According to research on the efficacy of acupuncture, its effects are not due to stimulating acupoints to aid the circulation of qi, as claimed by traditional Korean medicine, but rather stem from modern medical principles, such as stimulating local areas to activate the secretion of neurotransmitters. However, traditional Korean medicine practitioners still insert needles to “unblock” acupoints and “smoothen” the flow of meridians. Let’s consider the following example. An epidemic struck the livestock, and both Group A and Group B killed and burned their animals. However, Group A killed the animals to prevent the spread of the disease, while Group B killed them as offerings to appease the angry heavens. Although both groups ultimately succeeded in controlling the epidemic, can we truly say that their actions were the same? If the propositions presented in the process of deducing hypotheses to solve a problem (the treatment of disease)—such as the theory of Yin-Yang and the Five Elements or the theory of meridians—are already unscientific, then even if acupuncture yields good results, it is not science.
I acknowledge that Korean medicine has its own system and that its treatment methods can demonstrate certain effects. However, several points of criticism are necessary regarding efforts to include Korean medicine within the realm of science. Even if research findings emerge showing that the pain-relieving effects of acupuncture or the efficacy of certain herbal medicines are “scientific,” this does not confer scientific rationality upon Korean medicine. The fundamental principles of Korean medicine are still based on the Theory of Yin-Yang and the Five Elements—which is open to conjecture and cannot be refuted—and on the theory of meridians, which has already been refuted by modern anatomy. Even if the effects of certain herbal medicines are analyzed pharmacologically and biologically, and the pain-relieving effects of acupuncture are proven physiologically, these findings are derived within the paradigm of modern medicine—that is, within the conceptual knowledge system of modern medicine—not within the conceptual knowledge system of Korean medicine. To prove a conceptual system while altering its core tenets is a form of “cheating.” My conclusion is that as long as Korean medicine is based on the theory of Yin-Yang and the Five Elements, it is pseudoscience; if that foundation is dismantled, it is no longer Korean medicine but modern medicine.
