Dear Professor Deng
How are you recently? Can’t imagine how time flies, I’ve already come to England for more than two years now. During these two years, I’ve been working in a Chinese Medicine Clinic affiliated with a UK university both as a doctor and a teacher and I’ve gathered much impressions. Thinking about some of the recent criticisms on the practice of Chinese Medicine in China, I feel the need to let you know my experience here and hope that you can spread the ideas to both the supporters and those who disagree. I hope my experience and impression here can exert some influence on the development of Traditional Chinese Medicine in China.
In UK, there are many practising Chinese medicine practitioners. The main difference between the practice here and that in China is that we practise the pure Traditional Chinese Medicine here. This is evidenced as follows:
1. Only Chinese medicine can be prescribed, no Western medicine can be used coherently
It is very difficult to absolutely avoid the use of Western medicine for most of TCM practitioners in China, me included before I came here. However in UK, only pure Chinese herbs can be prescribed. Decoctions, pills and powders are commonly used forms. Everything we use has to be pure Chinese herbs. This country has a very strict legislation for the control of Chinese medicine imports. No patented pills containing any Western medicine are allowed to be imported. As a Chinese medicine practitioner here, we are not allowed to prescribe any Western medicine, or use any Western medicine to treat patients. In this sense, we are compelled to use only pure Chinese herbs. Although this leaves us with no choice but to practise in total independence of Western medicine, on the other hand the therapeutic characteristics of purely using traditional Chinese medicine has fully been shown. In fact, we still can get very good effects for most diseases even without the use of any Western medicine. I personally have a lot of successful cases within my scope of practice.
2. Combining Chinese herbs with acupuncture and other non-drug therapy
In China, most TCM doctors seldom use acupuncture. The doctors of acupuncture department do not prescribe herbs very often. Chinese herbal medicine and acupuncture seem to be divided. However, in ancient time, nearly all the TCM practitioners used both therapies. In the history of Chinese medicine, before the Ming and Qing dynasty, every famous master was very good at both herbs and acupuncture. If we hope that our treatment could be as effective as our ancestors’, maybe we need to follow their way of practice. Only in this way, the real spirit of TCM can be developed. That is the approach we adopt abroad. In the treatment of most of our patients, we combine herbs and acupuncture together. Some other non-drug therapy such as moxibustion, cupping, electric acupuncture, ear seed, tuina massage, cutaneous scraping etc are also applied according to individual cases. With this multi-therapy interaction, the therapeutic effects can be seen much enhanced.
3. Extensive clinical aspect
London is a multi-cultural metropolis. People here are of different races and come from different parts of the world. Their life style, diet, and constitution are varied. The scope of disease is also very different from China. Some diseases which are rarely seen in China could be very common here. The different conditions that we come across here are very wide, including internal disease, surgery, gynaecology, paediatrics, dermatology and ENT disease. We must learn to be a good all-round general practitioner at all times. No matter what disease I encounter, I always remember two important essence of TCM ---- the holism conception and differentiation diagnosis. In my opinion, the holism conception is helpful in breaking through the demarcation of clinical classification; whilst the differentiation diagnosis is applied to analyse all the new problems. In most of the larger TCM hospitals in China, the division of clinical departments tend to be more and more refined. Each department only focuses on one of the zang-fu organs. Isolating a particular area too much may inevitably lead to overlooking other related aspects. In the long run, the holism conception will be diminished; the traditional practice of TCM is also altered. At this stage, shouldn’t we ask ourselves whether we should be developing TCM according to its original concept? Must we follow the Western clinical divisions?
4. Combining teaching with clinical treatment
The university which I’m now working for first started enrolling full time students for a 5 year TCM programme in 1997. Starting from this year, it also started enrolling for a TCM master degree programme. Our students come from all over the world, mainly from Europe. TCM education here has been greatly influenced by higher education of UK. Emphasis is being placed more on practical training. Clinic placement starts at the first term of the first year. As the term progresses, the students will have to take up more and more clinic placement, until they can treat patients independently. After 3-4 years of training, most of the students will be able to master quite skilful acupuncture techniques and will have acquired some knowledge about herbs. During the whole 5 years study, the students spend more time on clinic placement than classroom teaching. Compared to the education in China, UK students have more own time for self study. They have more paper work, case study and presentations to do. The emphasis is more on clinical practice.
Since ancient times, the Traditional Chinese medicine had been passed down from generation to generation by an individual teaching method. Teaching and treating are carried out at the same time. In fact, the students who get high marks in the exam may not necessarily turn out to be good doctors in the clinical environment. Clinic practical training is therefore very important. I feel that TCM education overseas resembles TCM teaching in ancient China more and I think that teachings in China should follow more closely with this trend.
All of the above are the impression I obtained with my work in UK. TCM is a quintessence of Chinese culture. It has been accepted by all races over the world. Many of my students have a great unbelievable enthusiasm to TCM. They are diligent and hard working. Every year, they graduate from here and go to different parts of the world. During these two years, I have treated many patients by applying the clinical experience that you taught me and many unbelievable good results have been achieved. I will report these cases to you in future.
I remember you used to take an undiscovered jade as the metaphor for TCM. I would like to tell you now that this precious gem is already glittering outside China. You can rest assured that TCM will live on forever and be even more and more widely accepted.
Your student : Tiejun Tang
6th September 2007