In all complex health issues, there is more than one way to define the problem.
It is easy to accept that issues in relationships, the economy, international politics — and any other complex system — can encompass multiple stances and approaches. However, for some reason this is a bigger leap, when it comes to illnesses and the body. I believe that the chronic health problems can be seen from multiple logics, because they are so complex.
Like many, you may be interested in more than what conventional pharmaceuticals offer. Does that mean we should jump to look for herbs that can take the place of antibiotics, acid blockers, laxatives, anti-inflammatories, pain relievers, antispasmodics, and antidepressants?
While this is a reasonable starting point, it is not the only logic available. There is a deeper perspective that is far more compelling and fascinating, and — I would argue — useful.
When you set limits, by seeking herbs that have an equivalent function to modern drugs, what you get are more tools that follow the exact same logic as regular medicine. However, what if it wasn’t the drugs that limited progress with your health? What if it was the logic itself?
To many people’s surprise, there are categories of herbs that do no exist as modern drugs. This is because the frameworks that support their use approach the problems of health and illness differently.
You can see this through the chart below, comparing the logic and approach of modern medicine and traditional chinese medicine (TCM).
These are good reasons to seriously consider the difference in logic between these two medical systems. It goes beyond just swapping herbs for drugs. In China, Taiwan, and Korea (and to some extent in Japan), clinicians have an excellent understanding of modern medicine — and practice it daily — but in parallel or in combination with their traditional medicine. In the West, we know almost nothing about this approach, and it really is to our detriment.
The focus in the chart below is on treating through prescription drugs (modern medicine) and traditional medicinals (chinese medicine) and not acupuncture.
| — | modern medicine | chinese medicine |
|---|---|---|
| Method | Mostly based on isolating parts and mechanisms | Mostly based on observing whole patterns |
| Focus | Mostly seeks internal causes | Mostly organizes external presentations |
| Assessment | Diagnoses diseases and syndromes | Identifies patterns of disharmony, while incorporating disease diagnoses |
| Approach | Treats according to standards of care | Treats according to the individual pattern of symptoms and signs |
| Knowledge Base | Tries to base treatment on modern research, when available | Draws from centuries of clinical development and incorporates modern research when useful |
| Ideal | Seeks the best treatment for each diagnosis | Patients with the same diagnosis receive different treatments; patients receiving the same treatment, have different diagnoses |
| Flexibility | Often has a limited set of treatments for each condition | Has many possible treatment strategies for each presentation |
| Levels of Organization | Prioritizes tests, imaging, and lower-level biological data | Prioritizes clinical observation at the level of the whole person: symptoms, signs, pulse, and tongue |
| Pharmacy | Mostly treats with isolated or synthesized compounds | Mostly treats with processed whole medicinals, each containing many active constituents |
| Complexity | Drug effects are usually considered separately; combinations are based mainly on indication, safety, and common use | Medicinals are combined to enhance effects, moderate side effects, guide actions, and shape the whole formula |
| Speed | Drug effects range from very fast to gradual | Medicinal effects range from somewhat fast to very slow |
| Side Effects | Often manages side effects as trade-offs | Often reads side effects as signs the treatment needs adjustment |
| Medicine and Therapy | Prescriptions often remain stable once an effective drug is found | Prescriptions are adjusted as the patient’s pattern changes |
| Specialization | Organized around specialists and body systems | Organized around one clinician reading the whole presentation |
| Patient Encounters | Visits are often shorter and less frequent | Visits are often longer and more frequent, especially during active treatment |
| Advantage | Especially strong in emergencies, acute disease, surgery, and clearly defined pathology | Especially useful in chronic, complex, functional, or shifting patterns |
| Prognosis | Identifies risk factors, based on population research | Identifies health trajectories based on deviations from functional balance |
| Length of treatment (chronic cases) | Chronic treatment is often long-term or indefinite | Treatment aims to resolve or shift the pattern, then reduce or stop when possible |
| Goal | Stabilization, symptom control, risk reduction | Symptom relief, functional balance, and resolution when possible |
| Responsibility | Outcomes are often framed through standards, evidence, and available options | Outcomes depend heavily on the clinician’s diagnostic and prescribing skill |
| Disease and Health | Rich theories of disease; thinner theories of health | Rich theories of both disease and health |
| Wellness | Few medicines are intended to build health directly | Many medicinals nourish, enrich, boost, warm, move, clear, consolidate, regulate, and more |
| Psyche and Soma | Often separates mental and physical care | Often treats mental and physical signs as one connected presentation |
| Safety | Powerful treatments can carry significant risks, especially when misapplied or used long-term | Usually gentler, but still requires skilled prescribing |
| Purpose of Research | To discover, test, and revise knowledge | To refine, test, and deepen clinical understanding |
| Maturity | Rapidly developing, with major gaps in chronic care | Mature as a clinical system, with treatment strategies for a wide range of illness experiences |
When people hear the word “traditional” they assume that it means “antiquated.” Actually, traditional medicine is a vibrant part of medicine, just not in Western nations. For example, a search on PubMed shows that there are 120,000 research papers published on TCM herbal medicine, in English.
Also, hospitals and clinics practicing TCM treat more than 1.3 billion people annually. About 90% of general hospitals in China have traditional medicine departments, where they treat the full spectrum of chronic illnesses and diseases.
Many who are struggling with chronic digestive disorders are already taking a critical look at regular medicine. The point here is that chinese medicine is very different from what most in the West have come to know as “medicine.” It is especially valuable to incorporate this other logic in the care of chronic health problems.
Among the herbal medicine departments in China, some of them are focused on prescribing herbs according to modern research instead of traditional practice. One of my professors had been a gastro-surgeon in China before immigrating to the US, and he gave me some perspective on this. He told me that these departments of modernized herb prescribing have a less than adequate reputation among doctors in the hospitals. This was because the results of their treatments compared unfavorably with more traditional departments. They were known to have difficulty treating even simple chronic conditions.
Note that choosing herbs based exclusively on modern research — as these less successful departments of “modern herbology” do — is exactly the approach used by many people and many supplement companies today. As a result, many people hear about chinese herbs and approach the situation with modern questions such as, “Which herbs are good for intestinal motility? Which are good antibiotics? Which will reduce histamine sensitivity?”
I understand where these questions are coming from because I used to only ask these sorts of questions. When you start from these kinds of questions, though, you are thinking through the lens of modern medicine and using its concepts. What makes chinese medicine valuable is the difference in its logic. Even drugs can be prescribed according to chinese medicine, but when you look at herbs only according to their biomedical properties, you’re using herbs as if they are drugs. This can cause us to rely exclusively on the logic of our modern system, while making us blind to the limitations in this logic.
It is well known that some approaches will help some people, while other approaches will help others, and everyone is trying to find their own way through the morass. If this works for you, I would be the first to say “great!” However, if you are stuck, there is this other way…