Complexity & Reductionism
The Sciences
The Healing Arts (TCM)
- The Concept of Qi
- Yin & Yang
- 5 Elements
- Acupuncture
Uniting Science with Chinese Medicine
Conclusion
References
Introduction
One doesn’t need to look deeply to find failure in today’s Western Medical Model. Incredible wait times in emergency rooms, astronomical drug costs, and lack of available beds in Canadian hospitals are not news. The pharmaceutical industry alone is weighing heavily on our HealthCare system. While advancements in drug research such as biopharmaceuticals sound promising, the reality is that more and more medications are not insurable with many extended healthcare agencies and therefore most Canadians will never be able to afford such drugs. Slowly but surely we are witnessing our amazing universal healthcare system, which Canada is known for, become a system only of the upper class. And for the rest of us, one begs the question: what good is a universal healthcare system if one doesn’t have access to it when it is needed?
The Medical system has relied on modern science and, in doing so, has given us great advancements in technology. This has lead to the eradication of numerous epidemics which once threatened human population. One example of a discovery that has benefited human health is the perfection of the total hip replacement surgery . We are now able to understand what happens at the microscopic and micro-molecular levels of our being and to find the precise mechanism of specific pathologies and. In having done so, we have been able to find solutions in the form of drugs and surgery to rectify the problems. However, there are clear indications that perhaps we have reached the limits of this linear, hierarchical system as there are still many chronic illnesses to which Western Medicine has little to offer.
Much debate has gone on in political arenas across Canada in attempts to reform the current pitfalls of the healthcare system. However, because many of the solutions offered have been brought forth by people currently within the Western Medical system, few viable solutions have led to lasting results. Perhaps the answer to Healthcare reform needs to come from beyond the current Western system. By viewing the bigger picture of human health from a systems theory approach, we can further expand our current base of knowledge and apply general principles to our existing ideas. Admittedly, a systems theory approach may be viewed as threatening to the current medical model. However, the paradigm shift needed to solve the healthcare problem doesn’t necessarily require that the old model needs to be thrown out. It merely means looking at it from a new perspective and refining the principles it currently operates under.
Complexity and Reductionism
E. O. Wilson (1998) noted that “…the love of complexity without reductionism makes art, the love of complexity with reductionism makes science”. Perhaps the distinction Wilson makes in this statement is exactly what is needed in refining our healthcare system. We must distinguish between the Sciences and the Healing Arts. In exploring not only the difference between the Sciences and the Healing Arts but also how they might complement each other, one might find solutions our healthcare situation.
The Sciences
Considering our medical system has always relied on science to “prove” what goes on within the body, it has always been incredibly narrow-minded in this approach. In reducing the human body to a “biological machine,” science considers only what to do when things go wrong. Research has primarily focused on disease states rather than on understanding health. Furthermore, the linear model of science continues to look deeper into smaller and smaller aspects of human physiology. Then, it attempts to isolate the variables thought to be problematic, create a drug to alter the dysfunction and relieve the symptoms caused by the diseased state. This strategy that seems to give relief to patients suffering from various ailments often generates additional unanticipated consequences.
When we look at some of the side effects of many drugs, we must weigh the benefits against the consequences. An understanding of human physiology can account for many of a drug’s side effects once the pharmacokinetics and pharmacodynamics of a specific drug are identified and understood. The human body is a beautiful system which is complex and amazing at maintaining homeostasis. An example of this beautiful complexity of homeostatic regulation can be found by examining the actions within the autonomic nervous system (ANS).
Essentially, the two divisions within the ANS are the sympathetic and parasympathetic nervous systems. Each communicates with the central nervous system to regulate the effector organs, muscles, and glands. There are only two different neurotransmitters, acetylcholine and norepinephrine, which are released from various efferent neuronal terminals which control all the neurally controlled effector organ responses. Sherwood (2010) states that “acting independently, these neurotransmitters bring about such diverse effects as salivary secretion, bladder contraction, and voluntary motor movements. These effects provide a prime example of how the same chemical messenger may elicit a multiplicity of responses from various tissues, depending on the specialization of the effector organs”. Therefore, the same acetylcholine receptors are found on various tissues throughout the body. Attempts to isolate just one tissue and chemically control, via drugs, the function of neurotransmitter-receptor action within the one type of tissue while having no effect on all the other types of cholinergic receptors are not possible. Consequently, patients with glaucoma prescribed cholinergic eye drops to decrease the pressure in the eye, may experience side effects such as diarrhoea, nausea, vomiting, increased tearing, salivation, or sweating because the acetylcholine receptors within the GI tract, salivation glands and sweat glands are also affected by the drops.
The idea of isolating just one variable and manipulating it with drugs is a flawed notion. The complexity of the human body cannot be reduced to a single event that renders all other areas of the body unaffected. The problems associated with this way of thinking are essentially three fold. First, as mentioned, there has arisen an increasing cost of most medications which is limiting access to those who can afford it. Secondly, many drug side effects are often treated with other drugs which carry their own additional side effects. This leads to a vicious cycle of medicating patients. Thirdly, by removing accountability, the patients begin to rely on the doctor in determining what is best for them. The patient takes little or no responsibility for the healing. The mentality that there is a pill for everything eliminates all other treatment modalities (such as diet and exercise) as people become complacent in healing themselves.
Perhaps the most alarming concern with this lack of responsibility is that patients stop listening to their own bodies. Often times, they cannot describe how they feel and frequently answer the question “how do you feel” with “my doctor says I have ….”. Above this, the notion that the doctor knows best is not necessarily the case as the individual should know his or her body better than anyone else. By taking away accountability, patients take little to no responsibility in helping their own bodies to heal or the responsibility for their part in the onset of their illness (ex. poor lifestyle choices, poor diet, overwork, too much stress, etc). This disconnection is a major issue which has not yet been adequately investigated from the current medical perspective because the role of the mind-body connection falls outside the physical materialistic Newtonian model science operates under.
The Healing Arts (TCM)
The Healing Arts, specifically Traditional Chinese Medicine (TCM), operate from a different framework than science. Definitely within TCM there are methods of using reduction to arrive at a diagnosis or simplify a treatment plan. But because TCM takes into account the patient in his or her environment, their relationship to the universe, this reductionism is not a central theme and therefore far less detrimental to human health. The central theme in TCM is the holistic view, in which the patient cannot be separated from his or her environment and, as such, his or her emotions as well as his or her physical environment may constitute causes of disease. TCM therefore takes on a more integrated, systems theory approach when examining human health.
Because TCM views human beings as a microcosm within the macrocosm, TCM cannot isolate a small variable such as a cholinergic receptor in order to manipulate the action of this one receptor on a specific tissue. This is one huge distinction from a science-based medical model. Because TCM works by general principles to restore harmonious balance, it acts on a greater scale of healing utilizing the universal intelligence found within the human body. Some key concepts need to be identified to understand how TCM theory works in congruency with the natural laws of the universe which the human body follows.
Subtle energy & the Concept of Qi
Of great importance in TCM is the idea of Qi, which can be described as “a unique energetic substance that flows from the environment into the body” (Gerber, 2001). As a subtle energy form, even with our technological developments, science has yet to adequately measure and therefore understand Qi and the pathways in which it flows within the body. This lack of understanding prevents the concept of Qi to be fully accepted in the scientific community. After all, we have yet to dissect a human body and visibly see the energetic pathways in which Qi flows. Because Qi is a subtle energy and not a physical one, it has largely been discredited by the medical community.
Because TCM deals with subtle energies, it can be said that it more accurately reflects an Einsteinian quantum mechanical holistic model. Quantum theory examines the level in which all matter is energy, and all energy is matter. Acupuncture works on the physical body (matter) by manipulating the Qi flow (energy). Perhaps as we continue to understand quantum physics, science may one day fully understand this concept of Qi.
TCM understands how a disruption in the subtle energy or Qi flow may give rise to an actual, physical manifestation such as an internal organ pathology and, consequently, the manifestations of this organ pathology. Gerber (2001) elaborates that “through twelve pairs of meridians, the Chinese feel that ch’i (Qi) flows into the bodily organs to provide life-giving/sustaining energy. Each pair of meridians is associated with a different organ system or function”. Therefore, an imbalance in the paired meridians in terms of Qi flow can impair the associated organ on the physical level. Thousands of years before we ever dreamed of instruments that could allow us to see and measure subtle energies, the Chinese fully understood how they work and utilized acupuncture to manipulate them.
Though Qi is a subtle energy, what science has been able to measure, is the electrical properties of the acupuncture points in relation to the epidermis around them. Furthermore, “the electrical resistance measured in the skin overlaying the acupuncture points is lower than the surrounding skin by a factor of approximately 10 to 1”(Gerber, 2001). Not only are acupuncture points more electrically conductive than the skin around them, acupuncture points may vary according to physiological and emotional changes within the human body.
This accentuates yet another distinction of TCM which requires the evaluation of each patient as an individual within his or her environment as a unique entity. Thus far, the science model of medicine has not accounted for individual differences (such as emotional influences) and has treated each individual with the same disease with the same protocol for that disease. TCM is unique in that it looks at the individual and even though one person may present similar symptoms as another, his personalized pattern of disharmony will be what is treated. Therefore all patients with the same diseases will not be treated in the same manner, allowing for personalized treatments according to what each individual needs.
Yin & Yang
An equally important theory in TCM is the idea that everything is in constant balance through the concept or Yin and Yang. Yin and Yang must be balanced within the body in order to establish perfect health of mind, body and spirit. Gerber describes this balance as “…a dynamic equilibrium within a universe of constant change” (2001). The key idea is that the body is constantly balancing Yin and Yang as aspects within our internal and external environment are constantly changing; we are never static. An example of this Yin/Yang balance within the body can be reflected once again by the actions of the sympathetic and parasympathetic nervous system. Although these systems have essentially opposing functions, they work synergistically to maintain that dynamic equilibrium within a constantly changing environment. Many bodily functions from hormone balance, temperature regulation and even blood pressure are regulated in this manner.
5 Elements
Finally, a third important theory in TCM is that of the 5 Elements. Again, following natural law, TCM links each organ within the body to one of five elements: Fire (Heart), Earth (Spleen/Pancreas), Metal (Lungs), Water (Kidney), and Wood (Liver). Through two cycles (Generating sequence or the Controlling Sequence) each element is kept in balance. Just as in nature, if one element dominates over another, natural disasters occur. When this happens within the body, patterns of disharmony develop.
Acupuncture
Acupuncture essentially helps resolve the underlying patterns of disharmony which are impeding Qi flow, Yin and Yang balance, or the order of the 5 elements. The human body becomes disharmonious for several reasons such as poor diet, inadequate exercise, excessive behaviours such as suppressing or exhibiting excessive emotions or engaging in excessive sex, smoking, drinking alcohol, not properly dressing for the weather, among other causes. Essentially all aspects of the human environment can contribute to illness. Consequently, all factors in a patient’s life must be taken into consideration. By ignoring the importance of all areas of a patient’s life, the science-based medical model has dropped the ball in a big way.
In a presentation on stress prevention, Dr. Norman Anderson, Associate Director of the NIH, claimed that over 90% of diseases are caused or complicated by stress (ISTPP, 1998). As discussed previously, all aspects of human life contribute to a person’s state of health. And because stress is rarely a physical event, the science-based medical model has failed to perceive its debilitating toll on human life. However, by treating the whole person, TCM can mitigate a person’s stress. This, in turn, could help to alleviate approximately 90% of diseases.
Effectively, TCM can correct the three fold problem mentioned earlier (cost, cascade of drug side effects, and lack of patient accountability) in several ways. First, utilizing acupuncture to stimulate the body’s own healing mechanism effectively reduces the necessity for pharmaceuticals, thereby alleviating cost to the patient and the system overall. Because acupuncture activates the body’s own innate healing mechanisms and restores balance, once restored the body requires no further outside help. Secondly, acupuncture can treat side effects (such as nausea and vomiting for patients undergoing chemotherapy treatment, or post-operative pain) of conventional medical treatments. In this way, TCM could be used to manage drug side effects or minimize pain for patients who do undergo western medical procedures. This essentially puts less strain on the liver which would otherwise be further damaged by medications. Thirdly, acupuncture puts the responsibility back into the hands of the patient. By allowing patients to understand how their diet and lifestyle affect their physical bodies, they are better able to make adjustments to remove the root causes of their ailments rather than using pharmaceuticals to bandage them up. Furthermore, when patients realize that they have more influence in their health than they previously thought, they are empowered to make wiser choices.
Uniting Science with Chinese Medicine
Though the Newtonian worldview of a science-based medical model has its limitations and the Einsteinian TCM worldview of quantum mechanical holism has its benefits, it would be erroneous to conclude that one perspective or the other is better. Rather, both worldviews can work synergistically to create a medical model that more accurately fits with the natural laws of the human organism and its relation to the universe.
Perhaps one example of how the two medical models are uniting lies in recent discoveries such as the field of epigentetics which argues that a person’s environment can alter the expression of their genetic information. John Cloud (2010) describes epigenetics as follows:
At its most basic, epigenetics is the study of changes in gene activity that do not involve alterations to the genetic code but still get passed down to at least one successive generation. These patterns of gene expression are governed by the cellular material — the epigenome — that sits on top of the genome, just outside it (hence the prefix epi-, which means above). It is these epigenetic “marks” that tell your genes to switch on or off, to speak loudly or whisper. It is through epigenetic marks that environmental factors like diet, stress and prenatal nutrition can make an imprint on genes that is passed from one generation to the next.
Epigenetics brings both good news and bad. Bad news first: there’s evidence that lifestyle choices like smoking and eating too much can change the epigenetic marks atop your DNA in ways that cause the genes for obesity to express themselves too strongly and the genes for longevity to express themselves too weakly. We all know that you can truncate your own life if you smoke or overeat, but it’s becoming clear that those same bad behaviors can also predispose your kids -before they are even conceived -to disease and early death. The good news: scientists are learning to manipulate epigenetic marks in the lab, which means they are developing drugs that treat illness simply by silencing bad genes and jump-starting good ones.
So perhaps the Chinese were correct in their understanding of the role the environment plays on human health and modern science has the ability to alter the way genetic expressions of illnesses present themselves. For the first time in history, by uniting modern science with the healing arts in the form of Chinese medicine, we may actually make huge progress in the way we practice healthcare.
However, like the concepts of Yin and Yang, both science and TCM must be balanced in maintaining human health. We cannot simply alter the epigenome for each disease in order to prevent it as this will prove to be too costly and of course unnecessary. We will need to come back to natural law and follow the general TCM principles such as eating a proper diet with organically grown foods, getting up and going to sleep at regular times, regulating the amounts of work, exercise, and sexual activities one part-takes in, balancing mind-body health with yoga, meditation, Qi Gong, or Tai Qi exercises, and many more. Any registered acupuncturist can assist one in realigning with these principles in order to restore the precious balance within the body which will ultimately result in improved health.
Conclusion
In stepping back and looking at the big picture of human health, we can certainly see that science and Chinese medicine are very different entities. In fact it is not possible to study TCM from a science framework and vice versa and this is one reason why TCM has not been welcomed with open arms into the science community. However, Perhaps TCM and science are more like Yin and Yang in that although they are opposites they are also mutually symbiotic.
Like the Yin/Yang symbol, TCM has a tiny bit of a science framework within it such as the reductionist way a practitioner might use the eight principles to arrive at a TCM diagnosis or differential diagnosis. Likewise, in the Western medical model we see the concept of holism making a tiny appearance in ways such as the beginnings of examinations into mind-body influences most notably with the effects of stress on human health. Similar to the way Yin flows into Yang and Yang flows into Yin, if we accept and allow the natural progression of TCM into science and science into TCM, we may arrive at the ultimate end result which is improving human health, on all levels.
Furthermore, because of this Chinese Medicine-Science co-existence, the progression of one will only further progress the other. This is especially true if one agrees that TCM operates from a quantum mechanical model in which the acceptance of quantum physics will give rise to the understanding of subtle energy bodies and further give merit to the effects of external influences (environment) on human health. Reciprocally, as more patients begin to demand more TCM treatments and find great benefit in these modalities, the medical community may question why this shift is taking place and make further inquiries that can lead to fuller appreciation of TCM. Ultimately within both TCM and science the awareness that the other exists and plays an important role in healthcare will be the grand result of all the inquiring. In understanding that each medical model operates from a different framework but that they are indeed mutually supportive only enhances each system. Suddenly, when we begin to examine human health in this way, we aren’t so limited.
References
Cloud, J. (2010). Why Your DNA Isn’t Your Destiny. Retrieved Feb. 19th, 2012 from: http://www.time.com/time/magazine/article/0,9171,1952313,00.html#ixzz1nAOGTXCx
Gerber, Richard. 2001. Vibrational Medicine: The #1 Handbook of subtle-energy Therapies, 3rd Ed. Rochester, VT: Bear & Company.
ISTPP (Institute of Science, Technology & Public Policy). (1998). Notes from a presentation given to the USA Congress from the Congressional Prevention Coalition on June 24, 1998. Retrieved February 20th, 2012 from http://istpp.org/coalition/stress_prevention.html
Sherwood, L. (2010). Human Physiology: From Cells to Systems. 1st Canadian Ed. Toronto, Ont: Nelson Education Ltd.