Various cultures throughout history have sought to orient a life view to understand the relationships between birth, death, sickness and health. When civilised cultures developed their skills and became specialised, healthcare physicians became a separated class within the community. Since then, they have sought to influence humankind's daily life. Traditional Chinese Medicine (TCM) has been notably more concerned with the nature of the cosmos in relationship to the human being, whilst the West preoccupied itself with the individual, personal identity and the body's own cosmos. In Europe from the Greco-Roman times and in Asia, medicine changed its explanations of disease and healing from a transcendental basis to one in which the natural elements were governed within the law of the cosmos.
The aim of this paper is to explore the development of Western orthodox medicine and Chinese medicine with their accompanying philosophies. The comparisons of the two ideologies will also be discussed along with how these two philosophies might merge at a later date.
Western Medical Philosophy
Western medicine is greatly related to Greek thinking. Porter (1997, p7) states that Greek medicine emphasized the microcosm/macrocosm relationship between man and nature. Great attention was given to hygiene, which was seen as the route to all disease prevention. This was carried forward later during the Renaissance period, when in actual fact no cures were ever found for humankind's great ills; i.e. the black plague, typhoid, tuberculosis, etc. Rather it developed a preventative measure of medicine. The Renaissance period did more for knowledge than for health, for it was the foundation of modern Western medicine.
It was in the work of Galen that recorded dissections were first carried out, but only on dogs and rarely. This was later carried on solely by European medicine in late medieval Italy. Later during the Renaissance period, a flourish of anatomical and physiological studies began to emerge. These investigations were based upon the philosophy that all our answers could be found by delving deeper into the structure and flesh of humanity. It was Rene Descartes, the philosopher and physician who made a major contribution to Western medicine. He needed bodies to dissect, however these bodies were literally the 'property' of the Christian Church. He deal was struck between Descartes and the Pope of Rome. The Pope agreed that Descartes could have bodies to dissect if his medicine wouldn't have anything to do with the soul, mind or emotions. These were left to the Church for exclusive control (Pert 1997). This caused a major split between the body, emotions and the soul. Suddenly Western medicine had moved completely into the Greek notion of microcosm/macrocosm, but not within nature but just within the body itself. This is contra to TCM, where dissections were frowned upon even more medical learning. Rather, organs relationships were theorised without the need to open the body. These theories of organ inter-relationships and functions were surprisingly accurate.
It was not until the publication of Paduan's De humani corporis fabrica in 1543 that this theology was truly indoctrinated. It challenged Galen's teachings of anatomy with its own maps of the body drawn and studied during dissections. Later Harvey's De motu cordis, published in 1628, showed for the first time the workings of the heart in relation to blood. Medicine then began to sub-divide itself in scientific entities that we see today, notably physiological experimentation, pathology, microscopy, biochemistry and surgery. The advent of technology also helped to prove and encourage the growth of the microcosm/macrocosm relation held solely within the body. This was seen with the invention of the microscope during the nineteenth century. Medicine went truly inward as cell biology was born along with pathological anatomy. This lead to a greater understanding of the respiration system, digestive system and nutrition. It was largely Louis Pasteur and Robert Koch who established micro organic biology. Now medicine could look at infectious diseases like air pathogens, soil and water hygiene and person-to-person contact. Then within the twentieth century came the age of genetics and molecular biology.
During the West's industrial revolution, thinking began to be broken down into its sub units with Isaac Newton's philosophy of singular components. Suddenly everything was specialised and categorised according to its component properties. This advocated Western medical thinking. They believed that the body was a complex biological system in which abnormally functioning components could be removed and replaced with man-made mechanical ones, i.e. the heart. After some time Albert Einstein's famous equation, E=mc, was birthed. It opened the way, as Gerber (1988) puts it, for 'the conformation of the human being as a multidimensional organism made up of physical/cellular systems in dynamic interplay with complex regulatory energetic fields'. It thus confirmed Qi as the vital force of all things and the etheric body, although it has never been fully indoctrinated in Western orthodox medicine.
The modern mechanisms of thought were collaborated upon Renaissance thinking and Isaac Newton's theories by Charles Darwin. He reiterated the clinical view of human evolution in the quest for survival and re-propagation of one's genes. This contrasts the idea of struggle, pain and death with the Greek and Chinese concepts of harmony with the environment.
Since Western medicine moved away from its origins and developed its own philosophy on illness and disease it has created a personalisation of the physician. Chinese medicine however, is a collective weight of its tradition as a whole. Individual Chinese doctor skills lie in their ability in translating and interpreting traditional texts. This is better accomplished with a collective amount of practical experience. This is why so much importance is given to practical application rather than theory.
Chinese Medical Philosophy
Chinese theory was greatly politically orientated with the shifting of views from Daoism to Confucianism to Buddhism to Communism. The Chinese empire became politically united in 221 BC. The Han dynasty established political, philosophical and religious teachings. It was built upon the four major classical texts, the Yellow Emperor's Classic of Medicine, the Divine Husbandman's Materia Medica, the Canon of Problems and the Treatise on Cold-Damage Disorders (Porter 1997). One of the most important shifts in theory came from the transcendental texts of the I Ching. It was from there that the theories of Qi movement within nature derived from: the theory of Yin and Yang. This theory represents the duality of our universe: light and dark, high and low, good and bad, etc, where Yin and Yang are in a constant state of dynamic balance. It is a philosophical concept in constant flux, therefore it is never fixed, but in a state of continuous mutual consumption and support.
Daoism was based upon the teachings and writings of Laozi and Zhuangzi (c.339 – 295 BC). It stressed non-action (Wu Wei) by the need to withdraw from the world and following 'the way' or Dao. Daoism is one of the oldest forms of Chinese philosophy. It has had popular support from society and the imperial state in which it co-existed alongside Confucianism throughout Chinese history. Confucianism was founded by Confucius (c.551 – 479 BC). It focused upon a series of key relationships and behaviour within social hierarchy. Confucius looked back to the 'Golden Days' of far-gone Emperors, where people lived in harmony with nature and others. His idea was to solve your own problems first then your family's and then your community's. Confucianism later brought in Daoist thinking to combat the sophisticated Buddhist teachings in an effect to maintain popularity. It became a corner stone of Chinese thinking and subsequent structures within Chinese state and society. Buddhism was introduced to China from the Indian subcontinent as early as the Han dynasty (200 BC – AD 220). It brought the ancient Sanskrit texts into China, which greatly influenced medicine and philosophy.
Chinese phonetics played a great part in all aspects of learning and life throughout history. Because Chinese characters remained the same throughout time, it helped to keep the important philosophical and medical knowledge that would otherwise have been lost. With that, the idea that spirits walked with the living also helped to maintain Chinese medical traditions, because of the need to uphold the ancestor's traditional ways.
East versus West: A Comparison
There are many comparisons between Chinese philosophy and that of the ancient West. As Reid (1989, p80) reminds us, Hippocrates once said to his students 'Thy food shall be thy medicine'. This is identical to Chinese thinking: Sun Su-miao, the physician wrote in Precious Recipes, 'a truly good physician first finds out the cause of the illness, and having found that, he first tries to cure it by food. Only when food fails does he prescribe medication'.
Another example of similarities between East and West can be found in ancient Greek and Roman thinking: The influential Roman physician Claudius Galen devised a theory on breathing based on earlier Greek writers. He thought that a natural 'world spirit', seeped from the air down the windpipe into the lungs, along hollow pulmonary veins and into the heart, where it added special life to the vital flame. This vital spirit was then distributed throughout the arterial system (Parker 1993, p24). In TCM, air (Qing Qi) is mixed in the chest with the essence from food and fluids (Gu Qi) and then given the spark of life by the primary Qi (Yuan Qi) stored in the Kidneys to produce Zong Qi. This Zong Qi is dispersed around the body and to the Heart where it is transformed to produce the vital substance of all mammals, blood.
From Hippocrates to Galen humoral medicine was based upon the Greek's four elements; fire, water, air and earth, which in turn related to the four bodily fluids; blood, phlegm, yellow bile and black bile. In Chinese medicine, there are five elements or phases which are related to certain organs of the body, water, wood, fire, earth and metal.
There is a highly significant paradox to Western medicine: it is an unresolved dis-equilibrium between the powerful science-based medical establishment and the larger issue of unfulfilled health requirements of the people. Humanity today lives in a wishful dream ideal of genetic molecular biology, when everywhere around us there is still disease, ignorance and unanswered questions, hundreds of years old, rotting in the corner where no one wants to look.
Western medicine needs to change and update its philosophy from a Newton perspective to the more expanded Einsteinian view, even if this is difficult, if it ever wants to restore people's faith in it. How can Western medicine see itself separated from Eastern medical practices when its Greek and Roman roots are so similar to those of the Chinese? Advance in allopathic medicine can only be led by an evolutionary step in Western philosophy. We can only watch as Einstein's theory is fully integrated into Western and Chinese medicine. From there we shall see a more unified, whole and integrated philosophy and a new world healthcare system that is more effective at treating disease.
- Gerber, R. (1988). Vibrational Medicine. Santa Fe: Bear & Company.
- Reid, D. (1989). The Tao of Health, Sex and Longevity. London: Simon & Schuster.
- Parker, S. (1993). Human Body. London: Dorling Kindersley.
- Pert, C. (1997). Molecules of Emotion. London: Simon & Schuster.
- Porter, R. (1997). The Greatest Benefit to Mankind-A Medical History of Humanity From Antiquity to the Present. London: Harper Collins.
About the Author
Attilio D'Alberto graduated from a jointly run program at Middlesex and Beijing University of TCM with a BSc (Hons) TCM (Middlesex University) and a Bachelor of Medicine (Beijing University of TCM). He currently practices at The Earth Health Clinic.