This year marks my 30th year in full-time practice as a Chinese medical practitioner (医生 yi sheng), and my sixtieth birthday will be in the spring. So it seems like an ideal time to contemplate medical practice and where we stand in our emerging field. I have some thoughts about where I’d like to see further development happen.
- Refine diagnostic skills: the vast majority of reported cases on websites related to Chinese medicine are basically rehashes of biomedical diagnoses, sometimes with sloppy zang/fu (viscera/bowel) pattern diagnosis. Usually, the full symptom picture, pulse and tongue are not presented, and the formulas and points chosen are not precise. There is no way to maintain an independent profession without autonomy in diagnosis, and without this we will simply be technicians fulfilling the directives of presiding M.D.’s, nurses, or D.C.’s. Pulse diagnosis especially requires constant practice and training.
- Establish our resource base and materia medica: as Chinese medicinals disappear via FDA rulings, more physicians refuse to let their patients take herbs, and CM practitioners hesitate to give herbs to patients because of herb/drug interaction concerns, the foundations of our practice are slowly eroding away. Many practitioners do not use moxabustion, and many acupuncturists use methods not based in the source texts (Ling Shu, Jia Yi Jing, Nan Jing). We must demand that our colleges and national organizations support control of our raw materials, stressing that they are essential to well-trained Chinese herbalists. They can be restricted from public access, but why should we not be able to use such herbs as ma huang? When used according to traditional diagnosis and in classical formulas, these herbs are safe and have a long public record of being so.
- The recent history of Chinese medicine in both China and Japan has been confusing for western practitioners. In Japan, only M.D.s can practice herbal medicine, and in both China and Japan, ‘integrated’ Chinese/Western medicine is the mainstream of practice. The component of Chinese medicine in this setting is relatively basic and simplified, and this reflects in Western language textbooks as well. In order to practice Chinese medicine in its full depth and full range of application, we must study medical Chinese language and increase access to source materials, such as the Shang Han Lun, Jin Gui Yao Lue, Su Wen and Ling Shu. Without this depth, we will be hopeless in treating the complicated, auto-immune disorders that prevail in a post-modern society. There is no way to treat these disorders based on a biomedical diagnosis alone, or with a superficial Chinese zang-fu differentiation. We need to increase our sophistication, and that requires constant study of in-depth materials, both ancient and modern.
I hope that we will continue to evolve as a stand-alone profession, not as a complimentary technique-oriented field for relieving pain or enhancing IVF treatments only. But if our newer generation of practitioners are not aware of these possibilities, what hope is there? It is time for leaders in our field to step up to the plate and explain to the public, the Western medical profession, and various government agencies what a vast and broad medical tradition we represent. But in order to do so, we must continue to deepen our knowledge base and practice, and this can only be accomplished with a lifetime devotion to study and refining of our craft.