🌿 Folk Prescriptions

Reflecting on the turbulent journey of TCM development in the 20th century, we find that TCM has long been overshadowed by scientism and persistently pursued the ideal of medical monism. Scientism regards modern science as the supreme value standard, using this standard to understand, evaluate, and develop TCM. The inevitable result is viewing TCM as "non-scientific," and anything non-scientific must be abolished or reformed in the eyes of scientism. This led to slogans like "Abolish Traditional Chinese Medicine," "Preserve Drugs, Abolish Medicine," and "Scientize Traditional Chinese Medicine," leaving TCM still trapped in a precarious position of doubt and reform. Medical monism and scientism are inherently complementary, forming the dominant theme of Chinese medicine in the 20th century. Medical monism holds that "there is only one true thing in the world," and the coexistence of various medical systems is temporary, destined to converge like rivers flowing into the sea, ultimately unifying. Monism seeks "unity," while scientism specifies that unity should be achieved through science. All 20th-century trends in TCM—whether the practice of integrating Chinese and Western medicine, attempts to abolish TCM, the promotion of combining Chinese and Western medicine, or efforts toward TCM modernization—though differing in slogans, share a common goal: establishing a unified, monistic modern new medicine. However, practical outcomes reveal a vast gap between these ideals and reality. "Integration without communication" characterizes "Chinese-Western Integration"; "abolishing TCM" ended in failure; "combining Chinese and Western medicine" remains in a state of "combined but not integrated," and the path to TCM modernization faces immense challenges.
Entering the 21st century, to escape the predicament of the 20th century, TCM must step out of the shadow of scientism and the cognitive pitfalls of medical monism, reframe its perspective, renew its thinking, and establish the concept of medical pluralism, re-examining and developing TCM from a multicultural viewpoint.
I. What Is Traditional Chinese Medicine?
Some believe TCM is science; others view it as technology; some regard it as natural philosophy, experience, culture, pre-science, or latent science. There is still no consensus on TCM’s academic nature. In fact, understanding TCM’s essence is not merely a metaphysical debate—it crucially determines the direction of TCM’s development. If TCM is science, we can apply general scientific standards to examine, evaluate, study, and develop it. If TCM is not science, then terms like "scientificizing," "modernizing," and "integrating Chinese and Western medicine" require further discussion. Simply labeling TCM as "science" or "not science," or as "experiential medicine" or "philosophical medicine" based on scientism and monism leads us into an awkward dilemma. Perhaps understanding TCM from a medical pluralistic perspective can broaden our horizons and help us overcome this impasse.
Those who argue TCM is not science rely on modern scientific standards. Using modern scientific criteria, not only is TCM not science, but ancient Western medicine was also not science. Neither ancient East nor West had science. Reducing science to "modern science" and medicine to "modern medicine" erases the origins of science (medicine). In reality, medicine did not suddenly appear in modern times. Like other natural sciences, medicine evolved through a long historical process—from infancy, youth, to maturity, each stage having distinct characteristics. Medicine, like other natural sciences, initially emerged as culture, influenced by cultural contexts and tied to specific times and ethnic groups, giving medicine a pluralistic nature.
1. Stages of Medical Development—Temporal Pluralism. Different stages of medical development exhibit different characteristics. Ancient medicine, whether Chinese or Western, carried experiential and natural philosophical traits. This is evident in foundational texts like the "Huangdi Neijing" and "Hippocratic Corpus," which reflect that ancient medicine was largely in the stage of phenomenological description, experiential summary, and speculative reasoning. Since modern times, Western medicine has detached from the womb of natural philosophy, embracing experimental science. It employs anatomical, experimental, analytical, and quantitative reductionist methods to study the human body and treat diseases, forming a mechanistic view of life and the biomedical model. Modern medicine, through continuous specialization, has begun a new integration, emphasizing the body’s wholeness, organicity, and dynamism, striving to overcome the limitations of the biomedical model by adopting the biopsychosocial medical model. Clearly, medical development is not static. Modern medicine is not the final or sole form of medical development; it is merely one stage. Future medicine will undoubtedly differ from modern medicine. Thus, equating a single stage’s characteristics with medicine’s sole feature and using it as a universal standard is unreasonable.
2. National Character of Medicine—Expression of Cultural Pluralism. Different nations possess unique cultural traditions and ways of thinking. These different modes of thought give rise to distinct scientific traditions. Chinese and Western medicine originated in different cultural soils. The values and thinking patterns of each nation profoundly influence the formation and development of medicine, affecting choices of medical objects and methods, and constraining medicine’s nature and direction. Essentially, differences between Chinese and Western medical paradigms stem from cultural shaping. Although other natural sciences have increasingly shed their national characteristics to become "world science," medicine’s object and nature remain partly preserved due to their specificity. These national medicines still occupy a place in modern healthcare systems and continue to play irreplaceable roles. Replacing one medicine with another or transforming one undermines diverse ethnic perceptions of the world, ignores alternative ways of thinking, and denies traditional medicine’s modern value. Replacing TCM with Western medicine is essentially "Western Scientific Centrism" in the medical domain.
3. Relativity of Medical Knowledge—Expression of Epistemological Pluralism. Though Chinese and Western medicine face the same human body and diseases, differing research angles and methods have led to two distinct medical paradigms. Each summarizes different theories and employs different methods and tools to treat diseases and promote health. These two paradigms exhibit considerable "incommensurability." Both possess relativity, rationality, and limitations, so they cannot be simply judged as superior or inferior, advanced or backward. While modern medicine uses empirical methods to uncover many human mysteries and dominates contemporary medicine, it is not omnipotent. Its inability to address psychosomatic diseases and modern civilization-related illnesses, and its shortcomings in explaining psychological phenomena, show it needs improvement and supplementation. TCM, however, demonstrates clear advantages in these areas. Attempting to replace TCM with modern medicine ignores the relativity of medical knowledge and undervalues TCM’s modern significance.
4. Pluralism of Medical Evaluation Standards. Medicine studies the human body and aims to treat diseases and promote health. Compared to other natural sciences, it differs significantly in research subjects, purposes, values, and efficacy standards. This difference implies that "medicine is not merely science." It is not only about exploring truth regarding the human body and diseases but also a technology for disease prevention and health promotion—and even a humane art embodying compassion. Medicine is an organic unity of science, technology, and benevolence. Therefore, evaluation standards for medicine should also be pluralistic: not only assessed for objectivity and truth but also for practicality, effectiveness, and humanity. Modern medicine uses empirical methods to open countless "black boxes," delving into molecular levels, achieving relatively objective and precise understanding of physiological activities and disease mechanisms, demonstrating strong "scientificity." Yet, modern medicine still struggles with many diseases—despite identifying clear causes and pathologies, it lacks effective treatments. TCM, through long-term clinical practice, has accumulated rich experience, effective prescriptions, and health preservation methods. For many diseases, especially complex, difficult-to-treat conditions like cardiovascular, oncological, immunological, metabolic, psychosomatic, and viral diseases, TCM achieves varying degrees of cure, control, and relief. Although TCM’s understanding of disease mechanisms remains relatively crude—"scientificity" lacking—it is undoubtedly successful in achieving medical goals of curing and improving health. Clinical effectiveness and technical utility are the foundation of TCM’s survival and development, creating strong complementarity with modern medicine. Denying TCM effectively negates its clinical effectiveness, violating the pluralism of medical evaluation standards.
Medical research targets the human body—complex entities with both natural and social attributes, physiological and psychological features. With the shift from the biomedical model to the biopsychosocial model, the limitations of medicine’s purely technological positioning have become increasingly apparent, especially under the impact of medical scientism, technicism, and monism. Medical humanism has declined, and the separation between scientific and humanistic cultures has intensified, turning modern medicine into a "one-dimensional" discipline. Therefore, medicine must be repositioned, enriched and supplemented by cultural positioning to complement its technological role, truly becoming "human-centered medicine." TCM boasts a long-standing humanistic tradition: "Medicine is benevolent art" embodies deep humanitarian compassion and healing spirit. TCM itself is an organic unity of scientific and humanistic cultures. Scientism and monism have misread, simplified, and fragmented this complex text, sidelining TCM’s profound humanistic spirit, even subjecting it to criticism and rejection. Thus, integrating science, technology, and humanities organically, merging scientific and humanistic cultures, and examining medicine from multidimensional perspectives—scientific, technological, and human—is the proper stance for 21st-century medical practitioners. The exploration and enhancement of TCM’s humanistic spirit will provide new insights for transforming modern medical perspectives.
II. Multicultural Development Is Inevitable
At their core, differences between Chinese and Western medicine reflect differences in methodology. Some scholars argue these differences lie in holistic systems versus analytical reductionism, generative theory versus constitutive theory, and model theory versus prototype theory. Are different medical methodologies inherently ranked? Is medical methodology monistic or pluralistic? American renowned philosopher of science Paul Feyerabend, in his seminal work "Against Method," offers insights. Unlike traditional monolithic methodological principles, Feyerabend’s pluralistic methodology permits all methods and ideas, opposes the exclusivity and universality of traditional methods, and rejects the exclusion and suppression of other methods. He emphasizes that no single method is universally valid—each has a specific scope and limitations. His principle isn’t against all scientific methods but against rigid, "universal" rules. He opposes dogmatizing methods applicable only within certain domains and extending them to all fields and eras, rejecting traditional methodological thought detached from history and reality. Instead, he advocates an open, freely creative, dynamic, historically adaptive, personality-enriching, and ultimately effective method for revealing the hidden secrets of the external world. Feyerabend concludes: "Reality’s science is closer to pluralism than imagined—only methodological pluralism leads to truth." Though his epistemology and methodology carry anarchist and relativist flaws, his pluralistic approach is reasonable and enlightening for understanding methodological pluralism and choosing paths for TCM development.
Due to the diversity and complexity of life phenomena, efforts to explain all human and disease mysteries through a single method will inevitably fail. Since modern times, Western medicine’s success with reductionism is undeniable, but as medicine advances, reductionism’s limitations have become glaring. TCM’s methodology, emphasizing holism, connection, dynamics, function, and intuition, aligns more closely with life’s essence. German sinologist and professor of TCM theory and methodology, Max E. Müller, remarks: "We should accept that they are two different teams climbing toward the same peak of strict science via different paths. Clearly, reaching the same goal—rational definition of definite empirical facts—can employ different methods (paths)." Chinese and Western medical methodologies each have strengths and weaknesses. Only through complementary coexistence can they advance medicine. Trying to reduce TCM research and development solely to reductionist methods denies TCM’s modern value and contradicts the pluralistic essence of medical methodology.
In the 21st century, TCM must move beyond the shadows of scientism and monism, establishing a pluralistic ontology, methodology, value theory, and developmental theory. "We should understand medicine generously, viewing it from multiple angles, not excluding those medical systems not yet empirically verified or elevated to modern scientific levels." Generous understanding of medicine means not only modern medicine’s tolerance of traditional medicine but also tolerance for various paths and models of TCM development. The failure of 20th-century Chinese medical monism teaches us that TCM’s development path should be pluralistic and multidimensional. Currently, three main directions exist: traditional TCM, integration of Chinese and Western medicine, and TCM modernization. Given current realities of modern and TCM development, no isolated model alone can fully inherit and promote TCM’s characteristics and strengths. Differences, complementarity, and competition among these models form essential mechanisms for TCM’s advancement.
The 21st century will be one of coexistence and mutual complementarity among multicultural systems. With the end of "European Cultural Centrism," the value of Eastern traditional cultures represented by Chinese culture will be rediscovered. The 21st century will be an era of convergence between Eastern and Western cultures, a time for Chinese traditional thought to shine brightly. TCM in the 21st century hopes to return with Chinese culture to a pluralistic world, continuing to contribute wisdom and experience to human health.