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Tuesday, 26 October 2010

Traditional Chinese Medicine is an Undiscovered Science

Tiejun Tang

Since the development of modern medicine originated from the western countries, there has been great differences between traditional Chinese medicine (TCM) and western medicine in their way of understanding the human body and diseases. This difference is contributed to the different basic theories and research methods between the two. Along with the development of modern science, the doubts cast around TCM has never ceased in the modern history of China. Some doubts were even raised by some famous scholars. Even with all these doubts about TCM, great development can still be seen in recent decades. However, there are some people who are keen on raising doubts about TCM in recent years. Some of them had even become famous. Some people said TCM is not science, some considered it pseudoscience. Some people believed TCM is a traditional philosophy with scientific connotation. There are some scientists in UK who published their opinion in newspapers. They believed that acupuncture shouldn't be accepted by NHS. TCM education should not be included in national higher education systems, because there is a lack of scientific evidence. How to evaluate the academic status of TCM? Is it worth doing research on and keeping its existence? My opinion is that TCM should be considered as an undiscovered science.
These anti-TCM people cannot deny the effect of Chinese herbs and acupuncture. Most of their doubts are focused on the basic theory of TCM. The basic philosophy is the foundation for any subject. Is TCM theory an unscientific doctrine? The following evidence about TCM theory can help you get a reasonable answer.

1. Lung regulate the metabolism of body fluid, and is the source of fluid from the upper body.
From the point of western medicine, lung is just an organ for respiration. It carries out the gas exchange function by breathing in and out. But TCM believes lung has a function of regulating the metabolism of body fluid, and it is a source of fluid from upper. Some people believe that this is a silly nonsense. Until 1981, a Canadian scientist de Bold became the first person to report that atria of various animal species produce a hormone involved in the regulation of extracellular fluid volume and electrolyte balance. This atrial natriuretic factor (ANF) is capable of inducing diuresis, natriuresis and vasorelaxation (Brenner et al. 1990). Further studies on experimental cardiomyopathy model shows that the lung is an important source of ANF (Gutkowska and Nemer, 1989)。 In addition, physiological research had found that the lung can regulate fluid metabolism by renin angiotensin aldosterone system. Lung can also produce angiotensin converting enzyme. This enzyme has a function of activating angiotensin Ⅰto angiotensin Ⅱ. This activated angiotensin can stimulate the secretion of aldosterone, a key factor in regulate water and natriumv balance. Thus it can be seen that, lung is not simply only a respiration organ, it also plays a very important role in regulating the metabolism of body fluid. This TCM theory originated from Yellow Emperor’s Cannon of Medicine and has found broad application in clinical practice for two thousand years. For example, when treating oedema patient, if diuretic alone doesn’t works, the doctor will add one or two herbs which can disperse lung-qi in their prescriptions. It often shows significant effect. In ancient times, this method was called “Ti Hu Jie Gai”, which means keep the pot cap opened a little while you pour out the water.

2. Kidney dominating the bone
Western medicine believes kidney is an urinary organ. When TCM mentioned kidney control the water metabolism, there is no disagreement from western medicine, but when TCM mentioned kidney dominating the bone, kidney deficiency will cause osteoporosis, tonifying kidney will strengthen the bone and benefit the fracture healing, western medicine did not agree at the beginning. Even up till today, there are still many people who feel confused. The density of bone depends on calcium and phosphate metabolism. Vitamin D is an important substance in regulating this metabolism. However, no matter whether the Vitamin D is synthetical or exogenous, it does not have any activities themselves. After absorption, it has to be transported to the liver. It’ll then change into calcidiol (25-hydroxycholecalciferol) by the action of hydroxylase of the liver, then it’ll change into calcitriol (1,25-dihydroxycholecalciferol) by the action of hydroxylase of the kidney. The Vitamin D receptor (VDR) binds several forms of cholecalciferol. Its affinity for calcitriol is roughly 1000 times that for calcidiol, which explains their relative biological potencies. The gene expression of VDR is controlled by nuclear factor Yin-Yang1(P. Nezbedove 2004).This magical nuclear factor has many important two way regulation functions on many key gene expressions. It had been named with Yin-Yang by its founder. I think it is the material base of Yin-Yang theory.(T Tang 2004). Many patients who suffer from chronic renal failure also have osteoporosis because of the decrease of activated Vitamin D. Now more and more people believe that kidney dominating bone is a reasonable theory, because of the new research progress about bone metabolism.

3. Kidney has its opening at the ears.
TCM believes kidney has its opening at ears and many ear problems can be solved by treating kidney. Western medicine feels confused again about this theory. How could there be such close relationship between these two distant and totally different organs? An American otologist had reported that kidney and ear have a great similarity in ultra-structural anatomy, physiological mechanisms of fluid and electrolyte balance and pharmacological actions of certain drugs. The researcher used immunohistochemistry and immunofluorescent staining method to investigate kidney and the lateral cochlear wall. The results showed that kidney and cochlear have antigenically similar epithelial components. (Cedric A 1973). An affinity column chromatography was used to isolate aminoglycoside receptors from inner ear tissues and kidney. The toxicity of aminoglycosides was explained on the basis of these receptors.(Schacht.J 1979). Another report is from a UK hospital. The prevalence of sensorineural hearing loss, measured by pure tone audiometry, was determined in 66 patients with chronic renal failure and threshold changes following haemodialysis were measured in 31 patients. The incidence of hearing loss was 41% in the low frequency, 15% in the middle frequency and 53% in the high frequency range respectively.(Gatland D.1991). Both basic and clinical research showed the TCM theory about kidney-ear relation had its scientific evidence.

4. Heart dominating the mind. In TCM theory, the mind and intelligence are dominated by heart. Western medicine believes this ability is due to the function of brain. In my opinion heart dominates the mind is original, brain only dominates the mind as a phenomenon. (T Tang 2004). This opinion had been supported and referred to by many people. It had been noticed that heart transplant is not simply a question of replacing an organ that no longer functions. To gain insight into the problem of whether transplant patients themselves feel a change in personality after having received a donor heart, 47 patients who had transplants over a period of 2 years in Vienna, Austria, were called for an interview. Fifteen per cent stated that their personality had indeed changed, not because of the donors’ organ, but due to the life-threatening event that they had to go through. Six per cent reported a distinct change of personality due to their new hearts.(Bunzel B 1992). A ‘heart and soul’ research project had been carried out by a research group at the University of California San Francisco. (Whooley 2010) .They investigated 1024 cases of coronary heart disease from 2000 to 2002. They then carried out follow up studies on these patients for 8 years. More than 30 biological indicators were detected. This group had published 100 papers up till 2010, most of the papers had been published in some famous academic journals. Their research showed many coronary heart disease patients have some psychological problems such as mental depression and sleeping problems. Many related biological indicators have got significant changes in these patients. The results of this large sample research project gives us a solid evidence of the TCM theory of heart dominating the mind.

The above only showed some of the evidence supported by research. To evaluate TCM properly, one should have a deep understanding about TCM and bear a broad sense of scientific view. If someone only use general knowledge of western medicine to criticize the scientific basis of TCM, views will be very limited and one will not be able to see the whole picture. All the evidence mentioned above may still be just tip of the iceberg.

Along with the development of modern science and technology, more and more TCM theories will be seen to be approved in the future. Modern medicine could not solve all the problems of human health. It is not enough and impossible. The side effects of chemical drugs are always inevitable. The resistance of bacteria to antibiotic will emerge one after another. Surgical operations can only solve the problems of some disease. The human health needs the involvement of complementary and alternative medicine. TCM is the most important kind of complementary medicine. To quit TCM means giving up a powerful tool of saving human health. To study and develop TCM should be a wise decision for every government and individual.

Reference :
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BUNZEL B, SCHMIDL-MOHL B, GRUNDBOCK A, and WOLLENEK G (1992) Does changing the heart mean changing personality? A retrospective inquiry on 47 heart transplant patients Quality of Life Research 1(4): 251-256.
CEDRIC A. QUICK M.D., ALFRED FISH M.D., CARL BROWN M.D.(1973)The relationship between cochlea and kidney. The Laryngoscope. 83 (9):, 1469–1482.
DEBOLD, A. J., BORENSTEIN, H. B., VERESS, A. T. AND SONNENBERG,H. (1981). A rapid and potent natriuretic response to intravenous injection of atria myocardial extracts in rats. Life Sci. 28, 89–94.
GATLAND D, TUCKER B, CHALSTREY S, KEENE M, and BAKER L.(1991) Hearing loss in chronic renal failure-hearing threshold changes following haemodialysis. J R Soc Med. 84(10): 587–589.
GUTKOWSKA, J., NEMER, M., SOLE, M. J., DROUIN, J. AND SIROIS, P. (1989). Lung is an important source of atrial natriuretic factor in experimental cardiomyopathy. J. clin. Invest. 83, 1500–1504.
NEZBEDOVA.P, BRTKO.J. (2004).1α,25-Dihydroxyvitamin D3 inducible transcription factor and its role in vitamin D action. Endocrine regulation. 38, 29-38.
SCHACHT J.(1979) Isolation of an aminoglycoside receptor from guinea pig inner ear tissues and kidney European Archives of Oto-Rhino-Laryngology, 224 (1-2): 129-134.
TANG TIEJUN. (2004).The nuclear factor Yin-Yang1 and the Yin/Yang theory of TCM. Journal of Shanxi Traditional Chinese Medicine. 25 (3):239-242.
TANG TIEJUN(2004). A joint discussion about heart and brain dominate mind. Chinese Journal of Current Traditional and Western Medicine. 2(5): 443—444.
WHOOLEY MARY A. http://dgim.ucsf.edu/heartandsoulstudy