What is medicine? Western Medicine & western society are continually changing. Today, in the global arena, the concept of 'medicine' is continually evolving.
The culture of our societies and thus our 'medicines' is changing rapidly, as the world changes. In many western countries, with new understanding, many traditional medicines have become the first choice in healthcare for some. This is leading to changes in Western Medicine, (WM), which is rapidly adopting approaches that have previously been the domain of Traditional Chinese Medicine, (TCM), or other traditional medicines. In the United States acupuncture is now being used in hospitals and in the battlefields of Afghanistan. Over the past 30 years, chinese herbal medicine has also been used to great effect by TCM practitioners in the States and other western countries. In Europe there are more than 3000 TCM clinics in the UK and a TCM hospital operating in Germany. Clearly, change is happening rapidly now in other parts of the world. Goji berries (gou qi zi) are now available at the supermarket and Ginseng (ren shen) can be bought from the local chemist, healthfood store or over the net. The concept of using 'food as medicine' is fundamental in TCM thinking, and this concept is now being rediscovered in the west, as long held western concepts of 'nutrition' and 'diet' are brought to question. With the rate, and types of disease in the west, it is clear that past thinking in this area needs to be reviewed.
Traditional Chinese Medicine (TCM), is vastly different from Western Medicine (WM). The World Health Organization has recognized many traditional forms of healthcare as 'Primary'. That is, that they are just as valid as Western Medicine, and rather than be termed 'complimentary', they are Primary forms of medicine in their own right. In China, they use both WM and TCM within their hospital systems, to great effect. When the Bird Flu epidemic hit China, many resorted back to TCM in order to treat it. With the recent Swine Flu, they did the same, and as a result, had very few deaths.
Western Medicine is a product of the culture of the Western civilization and, as we know it today, is relatively new in the world of medicine.. Cartesian in philosophy and scientific in nature, the view is reductionist: It considers humans are independent of the living systems that surrounded them and assumed we could dominate and exploit nature without being affected by it.... people can be dismantled like a machine and reduced into 'parts', independent of each other.
In stark contrast, Traditional Chinese Medicine (TCM) has been around for over 4000 years. Based on Taoist philosophy, the view is holistic: It considers human beings are a microcosm of the universe that surrounds them, body and mind are one. Humans, animals, earth, and nature are essentially reflected in each other, reliant on each other, and in a continual universal dance.
The recent shifts in thinking in WM have created another area of medicine called 'Integrative Medicine'. From my experience, this appears to be Western Medicine adopting and using components of complimentary medicines within a Western Medicine framework, (sometimes without acknowledging the origins). I'm not sure this will be a successful marriage, as there are great philosophical differences between these medicines and completely different diagnostic frameworks. To use TCM within a WM context is often not appropriate. You can't just use 'bits' of a medical system.. you use the whole system, or a different system... or two whole systems to enhance each other, as is seen in the use of acupuncture as a non-pharmaceutical support to IVF. The way herbs are used in TCM is different to how they are prescribed and used in Integrative Medicine, so I feel this medicine still has a long way to go. Perhaps it is a step in the right direction, perhaps not. My feeling is that this could, infact, have a detrimental effect on traditional medicines, because it is using parts of the medicine, and using them outside of their traditional context. Used in the correct way, Chinese Herbal Medicine and acupuncture can be extremely effective, but if used in ways not intended, or outside a TCM diagnostic framework, they can be contraindicated and detrimental, or at the very least, ineffective.
So as medical approaches develop, the philosophical ideas must also develop to incorporate the whole medical system. The thinking must be multidimensional. Western thought needs to change from the reductionist view, generic mindset, and generic medicines. One size does not fit all, and this is why many western medicines have disasterous, sometimes fatal 'side-effects' on some people and not others. It is one thing to understand that Ginseng is 'good for you', but it must also be understood that there may be times when it is contraindicated. Medicines suitable for one person, may not be the best choice for the next person, at that point in time:
"Everything has the potential to be a medicine, or a poison, depending on the dose". A TCM and Taoist concept which can be applied to any area of life.
In the past, Chinese Herbal Medicine has often been unfavorably scrutinized by pharmaceutical companies in 'clinical trials', but this is now changing, partly because of a raging nutraceuticals industry, (which some pharmaceutical companies are now supporting), and partly too because it is clear that it is misleading and incorrect to try to assess one medicine within another medical framework. Clinical trials are often flawed in the way they are conducted, and there could also be some other motivation to achieve a certain result. Any 'clinical trial' should be viewed with an open mind, and should take into account 'who' was conducting the trial. Evidence Based Medicine, and the term 'scientifically proven' is the love-child of Western Medicine, and the pharmaceutical companies that run it. TCM has been used in China for thousands of years .... and since the Chinese population is thriving (the only country with a one-child policy), and they often claim 'the oldest person in the world', their traditional medicine system seems to have served them well!
multiculturalism and medicine
There is a direct relationship between culture, philosophy and medicine. Every culture has their own form of medicine and they are usually inextricably linked with their philosophy, religion and belief systems. In Australia, the dominant medicine has been Western Medicine, while other non-Western civilisations and cultures have their own medical systems—Islamic, Chinese, Ayurvedic, etc..
Unfortunately, non-Western cultures are still not really seen as equal or full partners within our multicultural society, although we pretend otherwise. Though subtle, this inequality is often expressed in terms of a language of inferiority. Thus non-western medicines are described as ‘alternative’, ‘complementary’ and ‘traditional’ systems. Such a terminology equates a sophisticated system of medicine such as TCM with 'New Age' upstarts, and defines them as substandard. Without incorporating, or at least appreciating certain values, differing philosophies and thus other approaches to medicine from these cultures, we really cannot speak of any meaningful multiculturalism.
A changing culture in most Australian cities these days has resulted in changes in attitude towards religion, culture and 'medicine' and an increase in the use of traditional medicines. Change in smaller cities and some regional towns is generally happening at a much slower rate and an increase in awareness, and a willingness to accept other forms of medicine is often met with great resistance and scepticism (but some regional towns like Castlemaine, embrace it!). Perhaps changes in awareness and acceptance will occure in these states/cities/towns when National Registration of TCM practitioners comes into play in July 2012. In Victoria, all TCM practitioners are required to be registered already. This registration board is similar in effect to the AMA.
In Australia - National registration for all TCM practitioners is now in operation in Australia. - TCM is currently being taught in many Australian universities. - Research into TCM is being driven locally by Australian universities and hospitals, as well as international pharmaceutical companies. - It was proposed that a TCM hospital would be built in In 2012 in NSW. It seems this has been delayed but it would have been the first TCM hospital with an integrated Medical centre in North Sydney, which was to be supported by both the Australian and Chinese governments. There has also been talk of developing a TCM hospital in Goulburn, NSW ...stay tuned!
In Victoria TCM is being researched and evaluated for use in hospitals as well as being used successfully in conjunction with western medicine, such as with IVF to increase the success rates of IVF. Alfred Hospital and Monash University Evaluation of the efficacy and safety of acupuncture and Chinese herbal medicine in the clinical management of allergic rhinitis, chronic obstructive pulmonary disease and headache. These projects are funded by four Project Grants from The Australian National Health and Medical Research Council (NHMRC) and an International Research Grant from Guangdong, China.
Northern Hospital Victoria: Evaluation of acupuncture in acute pain management at an Emergency Department of a public hospital: This project is funded by the Department of Health, Victoria and a NHMRC project grant.
which medicine is best?
In my opinion, all medicines have their strengths and weaknesses and one great benefit of multiculturalism is the availability of other medical systems. Western Medicine offers great tools for diagnosis and surgery. TCM also offers great tools for diagnosis, as well as offering non-surgical and non-pharmaceutical interventions (treatments) for any health issue. I my opinion, using Western Medicine in conjunction with TCM, (done by a registered TCM practitioner) is a very effective way to manage your health. 'Acupuncture' done by a physio or osteopath is actually 'dry needling', and should not be called acupuncture. Dry needling does not use a TCM diagnostic framework.
One of the best things you can do for your body and maintaining health is to get to bed early. WHEN you go to sleep is perhaps more critical than getting 8 hours of sleep. Going to bed with the sun and getting up with the sun is the general rule. Therefore in winter, you must go to sleep earlier, and rise later. This helps regulate your body's systems such as, the endocrine system, the cardiovascular system and your immune system. If you want to understand this more, you can read up on Circadian Rhythmn. This can assist the body and aid the treatment of any health issue, especially those that involve hormonal imbalances, including depression. Try to be in bed, asleep, by 9.30pm in summer, by 8.00pm in winter, and somewhere inbetween for autumn and spring.