Zhou Qiren Peking University, Changjiang Business

The spread of Western medicine in the East has triggered contradictions, conflicts and tensions between Western medicine and traditional Chinese medicine, and has also increased the interaction between medicine, medical technology and organizational systems of different civilizations. This is an important scene in China's modernization process, and it still has a great impact on the resource mobilization of medical services.

People of my age know that Lu Xun's disgust and criticism of traditional Chinese medicine. The first reading of "Call to Arms" should be when he was in junior high school 40 years ago. Lu Xun's writings have the power to keep you unforgettable: for the long-term illness father, the young author first pawned the pawn shop counters twice as tall as himself every day to get money, and then went to the pharmacy counters as tall as himself to buy medicine. What's even more nauseating is that "the doctor who prescribes prescriptions is the most famous, and the medicine used for this is also unique: the reed roots in winter, the sugar cane that has been frost for three years, the crickets must be the right one, and the flat wood that has made the seeds of the fruit, etc. are not easy to do." However, after four years of busyness, "My father finally died day by day." Friends, if you and I have had similar experiences, would you also use it as Mr. Lu Xun to determine that "Traditional Chinese medicine is just an intentional or unintentional liar"?

Later I learned that many cultural celebrities were critical of traditional Chinese medicine around the May Fourth Movement. Liang Qichao, Chen Duxiu, Hu Shi, Fu Sinian, Wu Changshuo, etc. had similar remarks. The first modern scholar who wrote "The Theory of Abandoned Medicine" in black and white was Zhang Taiyan's teacher, and Yu Yue, a master of Chinese studies in the late Qing Dynasty. By 1929, the first Central Health Commission held by the Ministry of Health of Nanjing National Government, Yu Yunxiu simply proposed to "abolition of old doctors to eliminate them."

The medical and health barrier case" - that is, it is not limited to criticism, but also the martial arts of traditional Chinese medicine must be abolished in the system. This case triggered a nationwide debate and forced traditional Chinese medicine to unite to "save the nation and survive." As a result, the case was passed but was not implemented. However, from then on, traditional Chinese medicine ("national medicine") was labeled as an "old doctor". The doctor registration regulations in the Kuomintang era stipulated that traditional Chinese medicine could only be registered as "medicians" and only Western medicine could be registered as "doctors".

In fact, whether it is "demolish" or "abortion", there is only one basis, which is "Traditional Chinese Medicine is unscientific". Yu Yunxiu's argument for abolishing traditional Chinese medicine, putting aside the intense and sharp words, it is in line with the views of a group of Chinese scholars since Yu Yue. It can be said that "Western medicine = science and advanced, Chinese medicine = ignorant and outdated", is almost the consensus of many modern Chinese intellectuals.

The question is, is Western medicine always scientific? Not to mention it, in the middle of the 18th century, Britain, "people generally believe that sweating in the early stages of fever is necessary. The general practice is to accumulate clothes on patients and provide substances with fever-producing properties such as alcohol, spices, etc. These things often make the blood boil, cramps worse, and the condition worsens" - what is this higher than "unscientific" traditional Chinese medicine? At that time, Europe generally believed in "methods to remove toxic fluids from the body" such as bloodletting, vomiting, and laxation.

Because before the 19th century theory of etiology was revealed, "diseases were attributed to imbalances of fluids and body fluids." The situation in the United States seemed even worse, because the Cambridge History of Medicine records that doctors in New England "have the same methods, bloodletting, vomiting, blisters, laxatives, pain relief, etc.; if the condition remains the same, repeat the measures used until the patient dies." A doctor on the Kansas border recalled his business in this way, "I hardly remember even a disease that could be truly cured by a doctor in his early years" (p. 216).

Western medicine is not much better. In 1869, an emergency room in a London hospital "was sent away at a rate of one patient every 35 seconds, with a suspicious dose of drugs" and "they are basically composed of laxatives" (page 222). Around 1900, when old American doctors came to the hospital, "they had almost no drugs in their treatment boxes." These old doctors not only had no "new" treatment methods used by young competitors, but also sincerely believed that "young doctors will eventually find that what they really need in their bags is drugs that make patients vomit and diarrhea" (page 223).

The biggest difference between China and the West at that time was perhaps that the Western world lacked a literary master like Lu Xun who was very observant and ruthless in writing. Shaw made up for the above shortcomings to some extent. In 1911, he wrote "The Doctor's Dilemma", saying, "After barely passing the exam and buying a copper sign, the doctor quickly found that the prescription he had made was nothing more than: prescribe boiled water for those who don't drink, brandy and champagne for those who don't drink; prescribe steak and dark beer at home, and vegetarian food that does not produce uric acid on the road; prescription for the old guy is closed windows, large stoves, and thick coats, which give young fashion suitors fresh air, try to be exposed without losing solemnity."

That is to say, traditional Western medicine has no "scientific" at all. The advanced and sensitive Chinese intellectuals' criticism of traditional Chinese medicine is almost all applicable to Western medicine before the 18th century. In many aspects, the "unscientific" of traditional Western medicine is far more than traditional Chinese medicine. What really widened the scientific level between traditional Chinese medicine has only happened in modern times. "History of Cambridge Medical" summarized that "the heyday of the development of (Western) medicine began around 1850.... Since then, anesthesia and elimination

The development of toxicology promoted the development of surgery; public health promoted public health; bacteriology explained etiology; experimental medicine also achieved success; and sulfonamide drugs and antibiotics triggered a revolution in pharmacy. Fatal diseases can also be treated, and the average life span increased. The relationship between medicine and society is as close as a honeymoon" (page 176). Yes, microscopes, thermometers, X-rays, stethoscopes and electrocardiometers were also widely entered into primary health care in Western countries in the second half of the 19th century.

What happened before and after this? To put it simply, the industrial revolution expanded in the West, while China still maintained a farm-based structure. The population and resource accumulation model has been significantly forked since then. We know that the meaning of Smith's theorem is that division of labor depends on the market size, and the market size first depends on the accumulation of population and resources. When 90% of the population lives in the countryside in a scattered manner, society neither needs nor can it support the deepening of division of labor, including the deepening of division of labor. At this basis, the model of knowledge accumulation has also been divided, and the result is that the scientific revolution is gradually drifting away from the former glorious Chinese Empire. What is becoming more and more backward is not just a Chinese medicine family?

The backwardness of traditional Chinese medicine is not because traditional Chinese medicine has no theories. In broad terms, all theories exist in the form of "hypothesis" and "conjecture". The question is whether theories - hypotheses and conjectures - are placed in a position of constantly being tested, and constantly creating conditions to verify these theories, constantly innovating, and approaching a higher level of understanding of laws. From this point of view, it is better to say that traditional Chinese medicine loses because it is unable to propose systematic and precise hypotheses and conjectures, but it is better to say that the lack of support conditions for verifying theories. For example, Li Bixi's series of hypotheses on biochemistry can

Soon, the University of Giesen, and then the University of Munich was verified in a laboratory with abundant funds and equipment and staffing, and in the process of being tested, the false and the truth were kept, and the essence was constantly removed. In contrast, traditional Chinese medicine proposed the "Meridian Theory" 2,500 years ago - a great conjecture and hypothesis - was almost until the 1970s that modern photography technology was used in Japanese universities to achieve the existence of "seeing" meridians. No matter how talented the conjecture is, there is no chance to encounter the test of observable phenomena in the long run. What science should we talk about?

Harol Balme said that modern medicine has two revolutionary breakthroughs. One is the pursuit of "exacttruth"; the other is the "trusteeship system", that is, patients entrust their bodies and lives to doctors, nurses and hospitals (quoted from Yang Nianqun, pages 62-62). My understanding is that the pursuit of "accuracy" is precisely to meet the requirements of constantly verifying hypotheses. What about "custody"? In addition to the meaning of humanitarian responsibility and reducing transaction fees, the most important thing is to turn the patient's body into an objective object of medical science (sub-ject), rather than patient-centered, especially the patient-centered imagination of their own condition. Because of these two breakthroughs, the scientific level of Western medicine has pulled traditional Chinese medicine further and further away.

It is definitely not that Chinese people are not smart, it is definitely not that traditional Chinese medicine has a history of thousands of years without experience, nor is it that traditional Chinese medicine lacks genius theories and hypotheses. In my personal opinion, the decisive difference is that China does not provide social conditions for continuous verification, overturning, and updating medical hypotheses. Just imagine, by the 1980s, there was still "1 billion people and 800 million farmers", where could a high degree of accumulation and division of labor? The limitations of economic conditions determine that the pursuit of "accurate authenticity" was a very luxurious need.

In a few large cities with a population of hundreds of thousands or even millions, there are conditions to achieve a higher level of knowledge division of labor. But unfortunately, traditional Chinese cities are centered on emperors and bureaucrats. Even in the Imperial Hospital, where the division of labor in traditional Chinese medicine is the highest, the emperor never entrusted his dragon body to his imperial physicians in the court. On the contrary, the emperor is always the center and dominant. The imperial physicians who "accompanied the king as a tiger" were cautious and too late to worry. How could they talk about taking the emperor's body as a sub-ject and following the scientific line of "observation-problem-hypothesis-verification"? After all, the only "benefit" of all the vague "theories" in the world is that they cannot clearly explain right or wrong - that is really the best amulet to evade responsibility.
Chapter completed!