THINKING EAST AND WEST
Why do Chinese and Western medicine approach the business of healing in such different ways?中醫與西醫的醫理與治療方式截然不同，原因何在？
Is there a future for traditional medicine?
ÔC hinese medicine rolled out in flu fight,’ ran the front-page headline in Hong Kong newspaper
The Standard in July. In the annual battle against the flu virus, the city’s Hospital Authority was sending patients (more than 27,000 of them between April and August) to Chinese medicine clinics. Among the suggested treatments for viruses spreading due to the hot, humid summer weather were boiling chrysanthemum, mint and beefsteak plants into a drink, and a new treatment that will ‘clear heat’ and ‘eliminate dampness’ in the body.
Today, Chinese medicine is still regarded as a legitimate choice, if not a necessity, in China, Hong Kong and other ethnic Chinese communities in Western cities.
It is at least an alternative when Western medicine fails; and in the most extreme cases, it is the only option. While old
香港的《英文虎報》於7月曾以「推出中藥抗流感」作頭條。今年流感虐肆 期間，香港的醫院管理在局 4月月至8 曾逾將27,000名病人送往中醫診所就醫。香港的夏季炎熱潮濕，容易傳播流毒感病 ，中醫師建議市民以菊花、薄荷及紫蘇葉用沸水沖泡飲，用 以此達到清濕熱去 的效果，可以預防流感。
在華人社會或社區，大如中國至，小 香港以及一些歐美城市裡華聚人 居之處，仍有不少人有病會看；中醫 有些人是先看西醫、治不好才看，中醫 有些則相，反 有極少數人甚至只看。中醫在西方，古老的醫理如希臘人相信的四種「體液」學說早， 就被現代醫學取代了；，可是老古 的中醫在東方卻仍然大行其道。這種情況，對於不諳醫藥的行外人來說，實在令人費解。
這種看法假定了中醫不外是一些代代相傳的民間療法和草藥藥方，科缺乏 學根據，而且大部分均有只 輕微的效療 。至於西方的民間療法被現代醫學取代，是為因
systems of treating the body, such as the belief in the four humours, developed by the ancient Greeks, have long been replaced by modern medicine in the West, the endurance of ancient Chinese medicine in the East is an intriguing phenomenon to outsiders.
They assume that Chinese medicine is no more than an inherited suite of folk remedies and herbal cures that lack scientific support and efficacy. After all, Western folk remedies were abandoned because they were unreliable and unsystematic (see Julian’s piece). Their fate was sealed when modern medicine emerged, along with it a systemised structure – and much better outcomes.
These assumptions may not be completely wrong: yet they are also an oversimplification.
By definition, traditional Chinese medicine goes way beyond folk remedies. It is a medical system supported by arcane theories extended and developed over time. The substitution of folk remedies for modern Western medicine was an inevitable evolution. But for Western medicine to supersede its Chinese counterpart in the East, it will take a paradigm shift.
That’s not to say Chinese medicine is rock-solid. The Chinese version of Wikipedia, for example, has an entry for Movement for the Abolishment of Chinese Medicine, which calls for action against ‘unscientific and far less competent Chinese medicine’. The notion can be traced back to Yu Yue, a Qing dynasty scholar who launched a full assault against Chinese medicine practitioners in his text On Abolishing Chinese Medicine, saying it was pointless favouring doctors over shaman healers as there was no essential difference between the two. (He meant Chinese doctors in his attack.)
That Chinese medicine is unscientific is a direct criticism of its unproven, esoteric nature. Its theories remain untouchable by science nowadays. At best, science can gauge the therapeutic efficacy of a treatment or herb, but this alone cannot prove the validity of Chinese medicine. Even the idea of therapeutic efficacy is disputable: Chinese medicine judges efficacy differently from Western medics.
Chinese medicine takes a metaphysical view of the human body, whose constitution is dictated by the yin-yang balance and the five elements. Esoteric Scripture of the Yellow Emperor, the earliest Chinese medical text, concludes that ‘yin and yang are the principle of nature, the order of all beings, the source of change, the origin of life and death, and the realm of the gods. To cure a disease, one must seek its roots.’
The Chinese belief in energy channels and qi (energy flow) has been rejected outright by Western medicine. The Western idea of the human body is strictly biological.
To criticise the esoteric traits of Chinese medicine is to criticise its metaphysical basis. Western civilisation and philosophy certainly has a fair share of metaphysics that concerns non-physical entities such as the soul, but it has long since been divorced from modern medicine, which is considered a branch of natural science. Even if the doctor who treats you believes in the soul, he or she will only tend to your physical body. You would have to turn to a priest or pastor to heal the wounded soul.
The combination of Chinese and Western medical sciences, as proposed by some, can only be a superficial one – one that concerns the cures but not the theories. If Western medicine is to incorporate the metaphysical understandings of Chinese medicine, it
那些民間療法的效果不可靠，而且毫系方統（參後朱閱 頁 立安巴吉尼的文章） ，直到有系統的現代醫學有長足的發後展 ，療效明顯地勝過民間療，法 自然便取而代之了。
這些假即定 使不是錯全 ，亦是過分簡單。
其實中醫並不只是堆間一 民 療，法 而是有悠久歷史的醫學系，統 其中有一套複雜的理論，歷來亦有不少論著說明和發展這套理論。，因此西方的民間療法被現代醫學取代，可以說是同一個傳統內的變化或進步；可是西，要 醫取代中醫，那就是一個傳統取代另一個傳，統 同時也是一套理論取代另一套理論，沒麼這就 有那 容易了。
然而中醫的地位亦並非穩如泰山，事實上，反對中醫的人不在少數，中文《維基百科》就有除〈廢 中醫運動〉這項條目；這個運動的主要理據是中醫不科，療學 在 效方面遠遠及不上西方現代醫學。廢除中醫運動可以上溯至清代考據學家俞樾的《廢醫論》，他認為中醫跟古代迷巫信的 醫根本沒麼，有什分別 因而說：「世之人賤巫而貴醫，不知古之醫巫一也，今之醫巫亦一也，吾未見醫之勝於巫也。」他這裡說的「醫」，指的當然就是中醫。
說中醫不科學的人，批除評了 中醫沒有科驗學 證的支持，批也 評中醫含有太多神秘主義。中醫肯定在古代沒有經過科驗學證因， 為種這 要求和做是法 現代科學發展 will lose its scientific stance; and if Chinese medicine hacks off its metaphysical roots, as Yu Yue would have it, what remains will be a mere existence of traditional cures – Chinese medicine without its soul. 後有才 的；問是題 ，到了今時今日，要用科學方法來檢驗中醫理論，也是難乎其難的事，極其量只能做到測試中醫療法和草藥的效用，但等這不 於測試中醫理論的對錯。其實，即是使只 測試療，效 由於中醫對療效的理解跟西醫不完全一樣，測試的結果未必會得到中醫師的認同。
中醫對療效的理解，是中醫理論的一部分，與中醫理論的其他部分息息相。關 單是講人體，中醫的看法便充滿了陰陽行五的形上學，臟五 六腑有陽都 陰 調合的關係，並與天地萬物的陰陽行五 相連互動國；中最早的醫書《黃帝內經》便有這個概括的說法：「陰陽者，天地之道也，萬物之綱紀，變化之父母，殺生 之本始，神明之府也。治病必求。於本 」由於中醫對人體的理解有很重的形上學成分，而西醫的理解則純粹是生物學的，兩者說的五臟，六腑 雖日表面相同，事實上有很大分別此；，外 中醫認為人體有的經絡和精氣，西醫是否認其存在的，或至是度疑少 極 懷 ，這也是對身體的形上學理解與生物學理解之別。
批評中醫有太多神秘主義，其實就是批評中醫有太多形上學。西方文化當日亦有形上學，相例如 信人除了身體，還有非物質的靈魂；日而，現代西方醫學已是自日科學的一部分，排除形了 上學，醫生只會醫治你完是那 全 物質的身體，就算你和你的醫生都相信身體之外還有靈魂，假如你認為自己的靈魂「有病」，你們都知道只能向神父或牧師求，助而不是醫生。
有些人倡議西結的中 醫學 合，不過是醫藥方面，理論方面的結是合 不可能的。西醫加入了中醫的形上學，便不夠科；學 中醫放棄了陰陽五行學說和精氣說等形上學，餘下的便只是可供科學研究的醫藥（即樾張俞 主的「廢醫存藥」） ，那就不再是中醫了。
FOR WESTERN MEDICINE TO SUPERSEDE ITS CHINESE COUNTERPART, IT WILL TAKE A PARADIGM SHIFT要西醫取代中醫，那就是一個傳統取代另一個傳統，一套理論取代另一套理論