Georg Ivanovas From Autism to Humanism - systems theory in medicine
The oldest texts on acupuncture date back until 300-500 BC. They are about as old as the oldest Hippocratic texts or a little younger. Because of some similarities a connection between the two has been postulated, but has never been proven (Unschuld 2000).
There is some confusion on what Chinese medicine or ‘traditional Chinese medicine’ (TCM) really is. Chinese medicine is a system of anatomy, physiology, pathology with a certain diagnostic approach and a therapeutic system using diet, massage, heat, bodily exercises, acupuncture, herbal drugs, meditation, guidance and advice (Hammer 1990: 82). They are bound together only by the concept of yin and yang and the balance of CHI. CHI is the basic energy inherent in all things. Without CHI stars would not shine. It creates weather and it circulates in the body (Hammer: 79). But as such it cannot be measured (Worsley 1982: 79). Only its effects can be observed. If the harmony of CHI in the body is disturbed, disease arises. Actually the loss of the harmony is already the disease. The signs and symptoms following a disturbance are but hints for the real nature of the disease. Therefore symptoms are but signals (Hammer: 44). Their modalities help to decide on the correct therapy (König/Wancura 1979: 122). Treated is always the disturbance behind the symptoms. A slogan is: “Don’t treat symptoms!” (Worsley: 15).
There is some difficulty in approaching Chinese medicine. It is no homogenous corpus of knowledge, something even more true for modern ‘traditional Chinese medicine’. TCM has been created by Communist China after a shortage of medical supplies (Süß/Scharl 2004) and after an initiative of the WHO, in an attempt to preserve old knowledge and to fulfil the needs of Western interest (Hammer: 32). At that period Western educated Chinese doctors studied their medical tradition, adopted what seemed ‘interesting’ and appropriate. Out of that they developed a system called TCM (Jing-Feng in Pearce 2001). It is mainly based on acupuncture (1/3) and herbal therapy (2/3). Both, herbs and acupuncture, are used to influence the flow of CHI in the meridians (König/Wancura 1979: 7). The development of modern Chinese medicine is therefore characterized by several inherent problems. First, there is not one tradition in Chinese medicine, but different sources (Unschuld 2000). Second, modern TCM is not identical with the old Chinese traditions. Third, there are newer Eastern developments in acupuncture that differ from TCM, especially in Japan. Fourth, there is a difficulty for Westerns to understand the philosophy of the East (Schneider 2000, Reibisch 2001). All this contributes to the heterogeneous conglomeration (Unschuld 2000) we see today under the label of Chinese medicine in the West.
The main problem in the Western reception is the attempt to simplify Chinese medicine. Often diseases are treated with certain herbs or by needling certain acupuncture points according to a Western diagnosis. Such reduced form of TCM became a supplement for frustrated orthopaedists, seeing no long term relief with their cortisone injections (Lewis/Halvorson 2003), an addition to the usual technical medicine (König/Wancura 1983: 10), making the physician’s practice less boring, i.e., fighting their own dissatisfaction on routine work (Zuger 2004). Or it may be a simple way for practitioners to fulfil the wish of patients demanding CAM.
Already the knowledge of some acupuncture points is sufficient for the relief of pain, as demonstrated by the British Medical Acupuncture Society (Süß/Scharl 2004). Therefore it is logical that the Society gives a certificate of “basic competence” after three months of practice (Lewis/Halvorson 2003).
Worsley, one of the charismatic figures in Western acupuncture, called this (common) way of practicing Chinese medicine as ‘barefoot-medicine’ and a shame for well educated physicians. He wonders why Western doctors (in contrast to their eastern counter-parts) prefer such a simple way of practicing (Worsley: 11-16).
One reason might be that the ‘barefoot’ type of Chinese medicine fits to the Western paradigm, where every clearly diagnosed disease has its clearly defined therapy treatable in a cook-book style (in haemorrhoids needle GV 20, GV 28, SP6). But the Western way to conceptualise diseases does not match the Chinese principles. Normal Western doctors can’t understand acupuncture (Schnorrenberger 1988: 8). A Chinese diagnostic is necessary (König/Wancura 1979: 19).
The main difference between the Western and Chinese medicine is that Chinese thinking is completely relational, a thinking Westerners are not educated in.