Taiwan Today

Those interviewed were Chung Chieh, director of the Acupuncture Department, Veterans General Hospital; Hsieh Yen-yau, professor of Medicine, College of Medicine. National Taiwan University, and visiting staff member in Internal Medicine, National Taiwan University Hospital; and Yang Ling-ling, professor in the Department of Pharmacology, Taipei Medical College.

FCR: What influenced you to choose your profession, and what was your first exposure to the history of Chinese medicine?

Chung: During the eight-year War of Resistance Against Japan (1937­-1945), my family took refuge in Kwangsi Province. I experienced and witnessed many wartime hardships, and hoped some day I could relieve the physical suffering of human beings. My father encouraged me to become a doctor, and the old Chinese teaching "to be a wise prime minister, or to be an able physician" was also deeply rooted in my brain during my youth.

My father was a lawyer, but he had always been interested in Chinese medicine. His goal was thwarted by the war, but after the war ended he enrolled in a Chinese medical college and eventually was able to enter practice. Although I was in touch with Chinese medicine from childhood, I had always been against it, considering Chinese medicine out-of-date and anti-scientific.

After graduating from the Department of Medicine, National Taiwan University, I became a doctor of internal medicine in the Veterans General Hospital for seven years. Although I considered myself a well-trained modern physician, there were many cases which were beyond my ability to cure, and as far as I knew, were beyond modern medical knowledge as well. I transferred these cases to my father in a sense "to challenge him." Some cases were hopeless for him also, but to my surprise some were cured. Only then did I began to perceive there might be something that Western medicine could not teach me while Chinese medicine could. I then began serious research in Chinese medicine, although before entering the acupuncture department my medical practice focused on "Western" areas, from internal medicine and metabolic medicine to aerospace medicine.

Hsieh: I chose medicine as my life­ long career because it is interesting, exciting, and challenging. It is an independent profession and is beneficial to human beings. My first exposure to the history of Chinese medicine was in a history class when I was a pupil in elementary school. I have had continued exposure to the history and practice of Chinese medicine since I entered the medical school in 1955.

Yang: Both my grandfather and my mother are practitioners of Chinese medicine. I have therefore witnessed closehand the efficacy of Chinese medicine. Seeing many patients relieved of physical pain because of my grandfather's excellent medical skill, I decided to explore the subtleties of Chinese medicine for myself. I remember how surprised I was when I learned that ex­tracts of traditional Chinese medicines could be expressed in chemical structures. In October 1965, I entered the research department of pharmacology, which was indeed the turning point of my life-long career of engaging in the research of Chinese pharmacology.

FCR: What specific aspects or the Chinese medical tradition are particularly important to your own work?

Chung: The development of Western medicine during the past two to three centuries has emphasized the research and application of medical "chemistry" and "mechanism" in the human body. The former includes such things as blood tests and the use of drugs, and the latter includes the fields of surgery and physical rehabilitation. But only in recent decades did the "physical properties" of the human body attract proper attention. For instance, we now know that the human body is electrified; many instruments such as the electrocardiogram were invented to test this energy. The study of human physical properties has greatly sped up the progress of medical science.

We feel proud, though also disappointed, to say that the Chinese have a practical research history of five thousand years into medical physical properties, but they do not know how to express it adequately. Chinese physicians always referred to chi— you will get sick if your "chi and blood is not smooth," I can talk with you now because I still have the chi, etc. But what is chi? For modern medicine, chi is indeed "energy" or "bioenergy." The medical treatment of acupuncture, for example, is to produce physical stimulation with needles in order to cure patients by physical changes. Because the character of chi is so important to Chinese medical practices, the Acupuncture Department of the Veterans General Hospital is dedicated to its research with the help of modern equipment.

The 20th Century has concentrated on chemical and mechanical properties, but the next century must be one for the rise of physical properties research. Whenever Chinese physicians can make a sophisticated arrangement of their intrinsic heritage and prove it clearly, it will be a great breakthrough in the history of medicine.

Hsieh: Ancient Chinese physicians applied their best knowledge to treat sick people honestly and out of goodwill and charity. But today too many traditional Chinese herb physicians treat patients with disguised modern medicines simply to make money and without due concern for the safety and welfare of their patients.

Thanks to the development of modern medicine, today many diseases can be prevented or cured, greatly prolonging the longevity of human beings. But continuing general practices of traditional Chinese herb medicine deprives patients from receiving the benefits of modern medicine, or it may interfere with the appropriate practice of modern medical care and research. Therefore, I urge that the practice of traditional Chinese herb medicine should be restricted to research only.

Yang: Generally speaking, Chinese medical practices depend more on "experience," which is one reason why Chinese medicine gives the impression of abstruseness. But "experience" can no longer be accepted without the support of scientific methods and statistics. For instance, some Chinese physicians have claimed Chinese medicine is efficacious for the cure of cancer, but where is the statistical proof? No wonder some people feel traditional Chinese medicine is too careless and casual in medical treatment.

After I dedicated myself to research in Chinese pharmacology, I was really stunned with its abundant resources. Through modern scientific investigation, the great efficacy of numerous ancient Chinese medical prescriptions can be confirmed. The critical challenge for developing Chinese medicine nowadays is join it with research and scientific methods.

FCR: What future do you see for integration between Western and Chinese approaches to medicine?

Chung: It is not a problem whether Western and Chinese medicines will be integrated—certainly they will. Medicine is medicine; the distinction between Western and Chinese medicine is manmade. The utmost goal of medical practice is to relieve human beings of physical suffering. So long as people of the medical circle are open-minded enough, any matter that can reach this goal should be covered in the field.

What we should cultivate today are neither Western doctors nor traditional Chinese physicians, but "the doctors of the ROC." We particularly need those who are well-trained in the field of modern medical science and, at the same time, are willing to undertake research in traditional Chinese medicine.

Modern western medicine makes rapid progress because physicians and researchers are not selfish. They publish what they discover for public discussion. But traditional Chinese medical practitioners treat each prescription as a secret, as a family possession. This selfish orientation has restricted its progress. Chinese medicine will stay at the same spot after another five thousand years if we regard every ancient discipline as a golden rule to follow blindly. My goal is to cultivate the heritage of our ancestors with modern science and technology.

Hsieh: The field of medicine has evolved from the old concepts of medicine mixed with speculation, superstition, and trial and error into a discipline of objective, solid, logical and assessable science of remedy. It has been well accepted by all human beings without international boundaries. It should not be regarded as a foreign, Western art of remedy.

Anybody who understands the cost and effort required for the evaluation of drug safety and efficacy would not dare to conduct research in Chinese herb medicine indiscriminately. The general practice of traditional Chinese herb medicine should be immediately prohi­bited; it needs to be systematically scrutinized for the selection of appropriate items deserving further research by true experts. The most likely category in this aspect is drugs used for the treatment of cancer, while the only technique of traditional Chinese medicine that deserves systematic clinical trial is acupuncture. Only when drugs and techniques have been proved to be effective, useful, and reasonably safe by properly conducted clinical trial can they be incorporated into modern medicine.

Yang: Pharmacology should not be divided into Western and Chinese medicine. Take the instance of Japan. There is no "Chinese physician" there; all those who prescribe Chinese drugs are "Western doctors." Even though the two lines of Western and Chinese medicine are not as integrated in Taiwan, almost all the medical colleges here do offer courses in Chinese pharmacology. The National Science Council has also conducted a large-scale plan to com­bine Western and Chinese medicine. The integration of the two will certainly provide insights and practical perspec­tives into the field of medicine.

Traditional Chinese pharmacy is our valuable heritage, and is particularly attractive to researchers. The study of Western pharmacology in my college years was helpful for establishing a disciplined methodology, while traditional Chinese medicine is now my material. With my research skills—and the rich, abundant material available from the Chinese pharmacopoeia—I, like a chef, can easily prepare delicious dishes.